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The coronavirus disease 2019 (COVID-19) pandemic devastated countries worldwide, and resulted in a global shutdown. Not all infections are symptomatic and hence the extent of SARS-CoV-2 infection in the community is unknown. The paper presents the dynamics of the SARS-CoV-2 epidemic in the Greater Accra Metropolis, describing the evolution of seroprevalence through time and by age group. Three repeated independent population-based surveys at 6-week intervals were conducted in from November 2020 to July 2021. The global and by age-groups weighted seroprevalences were estimated and the risk factors for SARS-CoV-2 antibody seropositivity were assessed using logistic regression. The overall age-standardized SARS-CoV-2 antibody seroprevalence for both spike and nucleocapsid increased from 13.8% (95% CI 11.9, 16.1) in November 2020 to 39.6% (95% CI 34.8, 44.6) in July 2021. After controlling for gender, marital status, education level, and occupation, the older age group over 40 years had a higher odds of seropositivity than the younger age group (OR 3.0 [95% CI 1.1–8.5]) in the final survey. Pupils or students had 3.3-fold increased odds of seropositivity (OR 3.2 [95% CI 1.1–8.5]) compared to the unemployed. This study reinforces that, SARS-CoV-2 infections have been significantly higher than reported. [ABSTRACT FROM AUTHOR]

The study assessed Ghana's COVID-19 lockdown and its effects on urban farmers in the capital city, Accra. Using phenomenology as the basis for studying the lived experiences during the lockdown, urban vegetable farmers expressed their feelings, views, and experiences during the period. The findings of the study were put under themes and perspectives. Farmers were allowed to express how they coped when they were affected. Our findings established that farmers were hemmed in during the locked down and could not easily liberate themselves from the harsh and difficulties they experienced. We recommend conscious efforts be made by organizations, both governmental and non-governmental, to which deal with the welfare and progress of these farmers within Ghana's cities. They should team up and train these vulnerable farmers on how to handle such shocks through the use of the most appropriate technologies, income diversification strategies and skills, well-built social support systems, and sound financial management to avoid such torment in the future. [ABSTRACT FROM AUTHOR]

Background: In Africa, approx. 675 million people were at risk of food insecurity. COVID-19 pandemic is likely to have exacerbated this situation, by damaging populations' access to and affordability of foods. This study is aimed at estimating the impacts of the COVID-19 pandemic on availability and prices of essential food commodities at 20 large markets in Ghana. Methods: Data on food availability and food retail prices collected through weekly market-level data during the period from July 2017 to September 2020 were used in this study. We performed interrupted time-series analyses and estimated the percentage increases between the observed and predicted food prices by food group and by region to assess the impact of COVID-19 pandemic on food prices. Results: As a result, the impact of COVID-19 on food availability was limited. However, the results of interrupted time-series analyses indicate a significant increase in overall mean food prices in Greater Accra, Eastern and Upper East regions. It was also found that mean price of starchy roots, tubers and plantains significantly increased across regions. Discussion: The impact of COVID-19 pandemic on food availability and prices was significant but varied by food type and regions in Ghana. Continuous monitoring and responses are critical to maintain food availability and affordability. [ABSTRACT FROM AUTHOR]

The unprecedented impact of the pandemic on both activities and profit of actors draws out the various areas of the value chain that need to be strengthened to ensure resilience in the face of global shock. This study fills the gap by assessing the extent at which COVID-19 impacted the profit of mango value chain actors in southern Ghana. It also analyzed the governance structure and the existing linkages in the dissemination of market information in relation to the profit of the actors. A two-year panel survey on 240 respondents was conducted in 2020 through a multi-stage sampling technique in Greater Accra, Eastern and Volta regions of Ghana. Net Farm Income, Social Network Analysis and Difference-in-Difference models were used in analyzing the data. Findings revealed that mango processors have more bargaining power and make the most profit while producers receive more information than other actors. Farmer-based organizations were found to be the prominent node and influential in the dissemination of market information within the value chain. The outbreak of COVID-19 negatively impacted the profit of mango producers and distributors; however, processors had a positive impact on their profit. The study therefore demonstrated that producers and distributors were vulnerable to the effect of the COVID-19 shock, whilst processors were robust to the shocks. Thus, reformed policies by all stakeholders for emergency preparedness should be targeted especially at those vulnerable actors in the chain. Additionally, FBOs, retailers and other key stakeholders should be considered in policy development to enhance market information dissemination. [ABSTRACT FROM AUTHOR]

Background: Malaria is a common and severe public health problem in Ghana and largely responsible for febrile symptoms presented at health facilities in the country. Other infectious diseases, including COVID-19, may mimic malaria due to their shared non-specific symptoms such as fever and headache thus leading to misdiagnosis. This study therefore investigated COVID-19 among patients presenting with malaria-like symptoms at Korle-Bu Polyclinic, Accra, Ghana. Methods: This study enrolled 300 patients presenting with malaria-like symptoms aged ≥18yrs. After consent was obtained from study patients, two to three millilitres of whole blood, nasopharyngeal and oropharyngeal swab samples, were collected for screening of Plasmodium falciparum using malaria rapid diagnostic test, microscopy and nested PCR, and SARS-CoV-2 using SARS-CoV-2 antigen test and Real-time PCR, respectively. The plasma and whole blood were also used for COVID-19 antibody testing and full blood counts using hematological analyser. SARS-CoV-2 whole genome sequencing was performed using MinIon sequencing. Results: The prevalence of malaria by microscopy, RDT and nested PCR were 2.3%, 2.3% and 2.7% respectively. The detection of SARS-CoV-2 by COVID-19 Rapid Antigen Test and Real-time PCR were 8.7% and 20% respectively. The Delta variant was reported in 23 of 25 SARS-CoV-2 positives with CT values below 30. Headache was the most common symptom presented by study participants (95%). Comorbidities reported were hypertension, asthma and diabetes. One hundred and thirteen (37.8%) of the study participants had prior exposure to SARS CoV-2 and (34/51) 66.7% of Astrazeneca vaccinated patients had no IgG antibody. Conclusion: It may be difficult to use clinical characteristics to distinguish between patients with COVID-19 having malaria-like symptoms. Detection of IgM using RDTs may be useful in predicting CT values for SARS-CoV-2 real-time PCR and therefore transmission. [ABSTRACT FROM AUTHOR]

Compound and shared low-income houses in Ghana have economic, social, cultural, and familial advantages. Yet, COVID-19 and its related lockdown and home confinement in two urban cities, Accra and Kumasi, raised questions about the appropriateness of staying in a compound house while observing the COVID-19 protocols. Whereas a few studies have underscored the ineffectiveness of COVID-19 protocols in low-income shared houses, these assume a homogeneity of such households without reflecting on the diversities that exist among and between the different categories of low-income households and the imperative nuanced implications for the spread of infectious diseases. Against this backdrop the paper employed qualitative methodologies of in-depth interviews and non-participant observations to interrogate the experiences of low-income households' utilisation of space as they observed COVID-19 protocols. Drawing respondents from four low-income communities in Accra, the authors examined how traditional family households and non-traditional family households implemented the safety protocols and their implications for shared housing. Issues of sharing inadequate communal facilities and public health concerns as well as lack of access to inadequate water and living spaces impacted the respondents' COVID-19 experience. The study discovered that households' socioeconomic status is directly related to the management of epidemics in urban spaces in Ghana. • Over-crowding and sharing of communal facilities in compound houses raised public health concerns. • A renewed sense of communalism and bonding resulted among households in compound houses during the pandemic. • Existing social networks in houses increased conviviality and psychological resilience for people to deal with lockdown. • Implementing COVID-19 lockdown directives did not take into consideration the socioeconomic status of urban communities. • Efficient planning should be people-centered as local communities become partners and agents of transformation. [ABSTRACT FROM AUTHOR]

The few works on COVID-19 in Ghana have a strong emphasis on the knowledge, attitudes, and practices of adults regarding the disease. As a supplement to the inadequate knowledge, this study examined children's knowledge and sources of information regarding COVID-19. It was a cross-sectional study that employed mixed research methods for data collection and analysis. The study utilized remote research methods, including a web survey and phone interviews, for data collection from a sample of 385 children in two COVID-19 hotspot cities, Accra and Tema, in Ghana. The results show that almost all children sampled were aware of COVID-19. The qualitative aspects, however, reveal that some children do not have accurate knowledge about the causes and prevention of the virus and disease. This is evident from some children's claims that bacteria, mosquitoes, and insect bites are the causes of the transmission of the virus and disease. The study reveals the internet, social media, and television are the most common methods for children to learn about COVID-19. The findings also show differences in the information sources across the major subgroups of sex, age, and educational attainment. The study further concludes that precautions should be taken by parents and carers regarding information consumed by children on social media. Hence, there is a need for the government and its partners to increase educational drives aimed at strengthening children's knowledge about the transmission and prevention of the virus in educational institutions and in settings where children and young people are the dominant groups. [ABSTRACT FROM AUTHOR]

The emergence and the rapid spread of the novel Coronavirus (COVID-19) have resulted in a global public health crisis. The debilitating social and economic impact of the COVID-19 pandemic on vulnerable societies has given rise to questionings, blames, and accusations about how the pandemic has been managed at the national level. This study uses the concept of 'Geographies of blame' to investigate how the national government, citizenry and other stakeholders have blamed each other for the rise in COVID-19 cases in Ghana. The study employs a qualitative research approach and administered 45 online surveys to the residents of Accra Metropolis, Ghana, that inquired about who is to be blamed for the rising COVID-19 cases in Ghana. Our results revealed that while the government of Ghana must share the blame due to how they poorly handled the pandemic, the citizens are more to blame for the spread and continued increase of the COVID-19 cases in the country. Based on the results, the study highlights the need for a pro-active and continuous analysis of the 'babel of blame' as a useful guide to create public awareness and help governments develop and implement strategic plans to tackle the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

The level of stigmatisation among health care providers has increased during the COVID-19 pandemic, and understanding the effect of COVID-19 stigmatisation on job performance has become increasingly important. The study explores the influence of COVID-19 stigmatisation on job performance among frontline health workers via the mediating role of anxiety. Furthermore, the moderating effect of resilience in the association between COVID-19 stigmatisation and anxiety is further examined. Participants were made up of 820 frontline health workers working in the epicentres of the Bono Ahafo, Western, Greater Accra, and Northern regions of Ghana. The hierarchical regression technique was employed in estimating the relationship between the variables. COVID-19 stigmatisation among frontline health workers directly affected anxiety and performance. In addition, the results showed that resilience moderated the relationship between COVID-19 stigmatisation and anxiety. The findings again demonstrated that anxiety partially mediated the association between concern for disclosure and public attitude and negative experience and job performance, whereas personalised stigma was insignificant. The study provides implications for establishing anti-stigma interventions and programs to enhance job performance among health workers. Many healthcare workers are subject to stigmatisation during the COVID-19 pandemic. The study employs hierarchical regression methods to examine the impacts of COVID-19 stigmatisation on job performance among frontline health workers. The health management team should strengthen interventions to control the stigma experienced by health workers during COVID-19 treatments. [ABSTRACT FROM AUTHOR]

Background: Adequate knowledge about COVID-19 in a population may be relevant in the fight to control its spread among the populace. Thus, the aim of this study was to assess the factors associated with real knowledge of COVID-19 among Ghanaians to promote effective dissemination of appropriate information aimed at containing the spread. Methods: A cross-sectional online survey and computer assisted telephone interviews (CATI) was conducted among Ghanaians aged 18 years and above across the 260 districts of Ghana. The survey assessed the level of knowledge of COVID-19 and its associated factors and compared differences between perceived and real knowledge. One district health promotion officer per district was trained for the data collection. Participants were recruited via use of phone directories of both organized and non-organized local district groups. Phone calls were made to randomly selected phone contacts to schedule options for participation in the study. We used multivariable logistic regression to investigate the associated factors of COVID-19 knowledge among respondents. Results: Of the 2,721 participants who completed the survey, the majority (99.3%) were aware of the existence of the COVID-19 outbreak, had good knowledge on infection prevention (87.0%) and rated their knowledge about COVID-19 as good (81.7%). Factors associated with COVID-19 knowledge were: age ≥56 years (aOR = 0.5; CI: 0.3–0.8; p = 0.002), tertiary education (aOR = 1.8; CI: 1.2–2.6; p = 0.003), residing in Greater Accra region (aOR = 2.0; CI: 1.1–3.6; p = 0.019), not infected with the novel coronavirus (aOR = 1.5; Cl: 1.0–2.1; p = 0.045), knowing an infected person (aOR = 3.5; CI = 1.5–7.9; p = 0.003), good practice of effective preventive measures (aOR = 1.2: Cl: 1.1–1.5: 0.008), not misinformed (aOR = 0.7; Cl: 0.5–0.9; 0.015), and perceiving spreading speed of the virus as slow (aOR = 0.7; Cl: 0.5–0.9; 0.007). Conclusion: The study found good knowledge regarding COVID-19, control measures, and preventive strategies. The Ghana Health Service should continuously provide accurate information to educate the media and citizens to prevent misinformation, which is vital in stopping the spread of the COVID-19 virus. [ABSTRACT FROM AUTHOR]

Objective: Presenteeism has, in a larger sense, been viewed as a negative behaviour, although a limited body of studies suggests and reports its positive implications in an organizational context. This study assessed the association between the physical work environment (PWE) and presenteeism as well as the moderating influence of workplace support for health (WSH) on this relationship. Methods: This study adopted the cross-sectional design alongside a sensitivity analysis and techniques against common methods bias. The study population was employees of private and public organizations in Accra, Ghana. A total of 590 employees participated in the study and hierarchical linear regression was used to present the results. Results: PWE had a positive relationship with presenteeism (β = 0.15; t = 3.04; p < 0.05), which means that higher presenteeism was associated with larger PWE scores. WSH positively moderated the relationship between PWE and presenteeism (β = 0.23; t = 4.84; p < 0.001). Conclusions: Organizations with more satisfactory work environments may serve as preferred protective places for employees during a pandemic, more so within organizations with higher WSH. Interventions rolled out to improve PWE and to provide WSH can attenuate the potential negative influences of presenteeism on individual health and organizational productivity. [ABSTRACT FROM AUTHOR]

Objectives: To explore governance, coordination and implementation actors, structures and processes, facilitators, and barriers within local government and between central and local government in Ghana’s COVID-19 response during the first wave of the outbreak. Design: Cross-sectional single case study. Data collection involved a desk review of media, policy and administrative documents and key informant in-depth interviews. Setting: Two municipalities in the Greater Accra region of Ghana Participants: Local government decentralised decision makers and officials of decentralised departments. Interventions: None. Main Outcome Measures: None Results: Coordination between the national and local government involved the provision of directives, guidelines, training, and resources. Most of the emergency response structures at the municipal level were functional except for some Public Health Emergency Management Committees. Inadequate resources challenged all aspects of the response. Coordination between local government and district health directorates in risk communication was poor. During the distribution of relief items, a biased selection process and a lack of a bottom-up approach in planning and implementation were common and undermined the ability to target the most vulnerable beneficiaries. Conclusions: Adequate financing and equipping of frontline health facilities and workers for surveillance, laboratory and case management activities, transparent criteria to ensure effective targeting and monitoring of the distribution of relief items, and a stronger bottom-up approach to the planning and implementation of interventions need to be given high priority in any response to health security threats such as COVID-19. [ABSTRACT FROM AUTHOR]

Objective: Describe the epidemiology of COVID-19 cases detected in the first four months of the pandemic in Ghana by person, place and time to provide an understanding of the local epidemiology of the disease. Methods: We conducted an exploratory descriptive study of all confirmed COVID-19 cases in Ghana from March 12 to June 30, 2020. Data was merged from the country's electronic databases, cleaned and summarized using medians, proportions and geospatial analysis. Design: A cross-sectional study design Setting: Ghana Participants: All confirmed COVID-19 cases in Ghana from March 12 to June 30, 2020 Interventions: None Main Outcome measures: Epidemiological characterization of all confirmed COVID-19 cases recorded from March 12 -- June 30, 2020 in Ghana by person, place and time. Results: A total of 17,763 cases were recorded with median age (IQR) of 33years (One month to 85 years). Among the confirmed cases, 10,272 (57.8%) were males and 3,521 (19.8%) were symptomatic with cough recorded in 1,420 (40.3%) cases. The remaining 14,242 (80.2%) were asymptomatic. Greater Accra region recorded the highest number of confirmed cases 11,348 (63.9%). All 16 administrative regions had recorded cases of COVID-19 by June 30, 2020 due to internal migration between the hotspots and other regions. The epidemiological curve showed a propagated outbreak with 117 deaths (CFR= 0.67%) recorded. Conclusion: A propagated outbreak of COVID -- 19 was confirmed in Ghana on March 12, 2020. Internal migration from hotspots to other regions led to the spread of the virus across the nation. Majority of cases were asymptomatic. [ABSTRACT FROM AUTHOR]

Globally, little evidence exists on transmission patterns of COVID-19. Recommendations to prevent infection include appropriate and frequent handwashing plus physical and social distancing. We conducted an exploratory observational study to assess compliance with these recommendations in selected transportation stations in Ghana. A one-hour audit of 45 public transport stations in the Greater Accra region was carried out between 27th and 29th March 2020. Using an adapted World Health Organization (WHO) hand hygiene assessment scale, the availability and use of handwashing facilities, social distancing, and ongoing public education on COVID-19 prevention measures were assessed, weighted and scored to determine the level of compliance of stations. Compliance with recommendations was categorized as "inadequate" "basic", "intermediate" and "advanced", based on the overall score. Majority (80%) of stations in Accra have at least one Veronica Bucket with flowing water and soap, but the number of washing places at each station is not adequate. Only a small minority (18%) of stations were communicating the need to wash hands frequently and appropriately, and to practice social/physical distancing while at the station. In most stations (95%), hand washing practice was either not observed, or only infrequently. Almost all stations (93%) did not have alcohol-based hand sanitizers available for public use, while social distancing was rarely practiced (only 2%). In over 90% of the stations, face masks were either not worn or only worn by a few passengers. Compliance with COVID-19 prevention measures was inadequate in 13 stations, basic in 16 stations, intermediate in 7 stations, and advanced in 9 stations. Compliance with COVID-19 prevention measures in public transportation stations in the Greater Accra region remains a challenge. Awareness creation should aim to elevate COVID-19 risk perception of transportation operators and clients. Transport operators and stations need support and guidance to enforce hand washing and social distancing. [ABSTRACT FROM AUTHOR]