Search

Background: Fertility declines with age, but it remains important to protect women from unplanned pregnancies throughout their reproductive lives. The objective of this study was to describe factors that influence modern contraceptive use among women aged 35 to 49 years and their male partners in Gomoa West District of Ghana. Methods: In-depth interviews were conducted remotely for 22 women, 15 male partners of the women interviewed and seven family planning (FP) providers. In all, a total of 44 participants took part in the study. Seven refusals were recorded, four females and three males. Four focus group discussions were organized for 21 participants who took part in the in-depth interviews. Data collected were transcribed and coded after exporting to Nvivo12 qualitative analysis software. Thematic analysis was undertaken using an abductive approach. Results: Factors that influenced the use of modern contraceptives included: achieved desired family size, providing for the family, counselling by health professionals, influence of the male partner, and health reasons. Barriers cited included: religious or socio-cultural reasons, experience or fear of side effects, rumors or misconceptions, declining fertility, and the belief that contraceptive use is a matter for women. Within the study group, roughly half of women used modern contraceptives, while the majority of male partners were non-users. Conclusion: Contraception among women aged 35 to 49 years and their male partners is influenced by several factors such as achieved desired family size, influence of the male partner, rumors or misconceptions, and declining fertility. Strengthening male involvement in family planning activities and health educational activities could alleviate fear and reduce misconceptions about using modern contraceptives. [ABSTRACT FROM AUTHOR]

The purpose of this study was to analyze the beliefs of physical education teachers on teaching students with disabilities in inclusive classes. Participants were 29 physical education teachers from Ghana (Africa), Japan, the United States, and Puerto Rico. The research paradigm was qualitatively descriptive using a multisite interview design (Gay, 1996) situated in the theory of planned behavior (Ajzen, 1991). The primary data source was interviewing. Interview data were analyzed with constant comparative method (Merriam, 1998). Results indicate some teachers? self-efficacy was compromised and their pedagogies were troubled with difficulties and complexes beyond those of typical non-inclusive physical education programs. School districts should do more to engage teachers in professional development focused on teaching students with disabilities in physical education.

The purpose of this study was to analyse the beliefs about inclusion and teaching students with disabilities of physical education teachers from various countries and cultures. The participants were 29 physical education teachers from Ghana (Africa), Japan, the US and Puerto Rico. The research method was explanatory multiple-case study situated in the theory of planned behaviour. The primary data sources were attitude surveys and interviews. Survey data were analysed with descriptive statistics and the interview data were analysed using a constant comparative method. Results indicate that the teachers' beliefs tended to vary on inclusion and teaching students with disabilities. Paradoxically, they expressed compelling intrinsic motives while voicing a multiplicity of concerns on teaching students with disabilities. They all desired greater opportunities for relevant professional development, which should be made available more frequently by school districts. (Contains 3 tables.)

Recently, the emergence and rapid dissemination of extended-spectrum beta-lactamase (ESBL)-producing bacteria, particularly of the family Enterobacteriaceae, has posed serious healthcare challenges. Here, we determined the antimicrobial susceptibility and genetic characteristics of 164 Escherichia coli strains isolated from infected patients in two hospitals in Ghana. In total, 102 cefotaxime-resistant isolates (62.2%) were identified as ESBL-producers. Multilocus sequence typing of the ESBL-producers identified 20 different sequence types (STs) with ST131 (n = 25, 24.5%) as the dominant group. Other detected STs included ST410 (n = 21, 20.6%) and ST617 (n = 19, 18.6%). All identified ESBL-producers harbored blaCTX-M-14, blaCTX-M-15, or blaCTX-M-27, with blaCTX-M-15 (n = 96, 94.1%) being the most predominant ESBL allele. Further analysis showed that the immediate genetic environment around blaCTX-M-15 is conserved within blaCTX-M-15 containing strains. Five of the 25 ST131 isolates were clustered with clade A, one with sub-clade C1, and 19 with the dominant sub-clade C2. The results show that fluoroquinolone-resistant, blaCTX-M-14- and blaCTX- M-15-producing ESBL E. coli ST131 strains belonging to clade A and sub-clades C1 and C2 are disseminating in Ghanaian hospitals. To the best of our knowledge, this is the first report of the ST131 phylogeny in Ghana. [ABSTRACT FROM AUTHOR]

Extra-intestinal pathogenic Escherichia coli (ExPEC) is one of the world's leading causes of bloodstream infections with high mortality. Sequence type 410 (ST410) is an emerging ExPEC clone resistant to a wide range of antibiotics. In this study, we investigated the epidemiology of 21 ST410 E. coli isolates from two Ghanaian hospitals. We also investigated the isolates within a global context to provide further insight into the dissemination of this highly pathogenic clone. A phylogenetic tree of the 21 isolate genomes, along with 102 others from global collection, was constructed representing the ensuing clades and sub-clades of the ST: A/H53, B2/H24R, B3/H24Rx, and B4/H24RxC. The carbapenem-resistant sub-clade B4/H24RxC is reported to have emerged in the early 2000s when ST410 acquired an IncX3 plasmid carrying a bla OXA–181 carbapenemase gene, and a second carbapenemase gene, bla NDM–5, on a conserved IncFII plasmid in 2014. We identified, in this study, one bla OXA–181–carrying isolate belonging to B4/H24RxC sub-lineage and one carrying bla NDM–1 belonging to sub-lineage B3/H24Rx. The bla OXA–181 gene was found on a 51kb IncX3 plasmid; pEc1079_3. The majority (12/21) of our Ghanaian isolates were clustered with international strains described by previous authors as closely related strains to B4/H24RxC. Six others were clustered among the ESBL-associated sub-lineage B3/H24Rx and three with the globally disseminated sub-lineage B4/H24RxC. The results show that this highly pathogenic clone is disseminated in Ghana and, given its ability to transmit between hosts, it poses a serious threat and should be monitored closely. [ABSTRACT FROM AUTHOR]

Multidrug resistance, especially carbapenem resistance in Acinetobacter bacteria is a global healthcare concern. However, available data on the phenotypic and genotypic characteristics of Acinetobacter isolates from West Africa, including Ghana is scanty. Our aim was to investigate the antibiotic resistance profile and genotypic characteristics of Acinetobacter isolates from Ghana and to characterize carbapenemase producers using whole-genome sequencing (WGS). A total of 36 Acinetobacter isolates collected at three hospitals in Ghana between 2016 and 2017 were analyzed. MICs were determined by commercial antibiotic plates. Acinetobacter baumannii MLST was determined using the Pasteur scheme. WGS of OXA-carbapenemase producers was performed using short- and long-read sequencing strategies. The resistance rate was highest for trimethoprim/sulfamethoxazole (n = 22; 61%). Six (16.7%) and eight (22.2%) isolates were resistant to ceftazidime and colistin, respectively. Two (5.6%) isolates were resistant and one (2.8%) isolate had intermediate sensitivity to three carbapenems. Fifteen STs were identified in 24 A. baumannii isolates including six new STs (ST1467 ∼ ST1472). ST78 was the predominant (n = 6) followed by ST1469 (n = 3). Four carbapenemase-producing A. baumannii isolates also were identified. Isogenic ST103 isolates Ab-B004d-c and Ab-D10a-a harbored bla OXA–23 within Tn 2007 on identical plasmids, pAb-B004d-c_3, and pAb-D10a-a_3. ST1472 isolate Ab-C102 and ST107 isolate Ab-C63 carried bla OXA–58 and bla OXA–420, a rare bla OXA–58 variant, respectively, within novel genetic contexts. Our results show that A. baumannii isolates of diverse and unique genotypes, including OXA-carbapenemase producers, are circulating in Ghana highlighting the need for a wider surveillance of antimicrobial resistance. [ABSTRACT FROM AUTHOR]

In recent decades there has been a large migration stream of single women from the north to Accra in Ghana. Existing studies have focused on young migrant women’s livelihood strategies in their place of destination. However, once-married women – divorced and widowed women and neglected wives – also migrate, and their motivations for migration are less known. Drawing on qualitative and quantitative methods, the authors investigate the effects of gender norms, age, marital status, socio-economic status, and position in households on women’s decisions to migrate. The results revealed that migrant women from resource-poor households, regardless of age, marital status and position in households, commonly cited a gain in autonomy as an important motivation for their migration. From a differentiated perspective, young unmarried women aspired to prepare themselves for often expensive religious marriage ceremonies, whereas once-married women invest in their children’s education and build their own housing. By paying attention to the effects of gender norms, age, marital status, socio-economic status, and position in households on women’s decisions to migrate, the study illuminates the contradictory ways in which their migration practices are both shaped by and shape gender ideologies in parts of contemporary northern Ghana. [ABSTRACT FROM PUBLISHER]

Since the late 1990s, migration of single women from the rural north to the urban south in Ghana has been making up a growing share of migrant streams. While the livelihood strategies of these migrant women in their southern destinations have been recently examined, the experience of reintegration for those who return to their place of origin has rarely been studied. Drawing on qualitative research with migrant women, returned migrant women (RMW) and their family members, this study examines everyday reintegration experiences of RMW within their households in a rural Dagomba community in Northern Region, Ghana. We conceptualise the household as an arena of everyday life wherein RMW exercise agency to learn to generate livelihoods that support their own as well as household members’ joint well-being. We combine this conceptualisation of household with feminist scholars’ recognition of gender as situated process. Our conceptualisation makes it possible to illuminate gender dynamics around the everyday repetitive decision-making acts that constitute livelihood generation as performed by RMW within specific intra-household dynamics in the context of reintegration in the situated community. Through the examination of the diverse and contradictory ways in which RMW exercise agency in making decisions about livelihood strategies within their households in the studied community, we show how the everyday repetitive acts of RMW contribute to micro-transformations of a situated gender ideology. [ABSTRACT FROM AUTHOR]

Traditional medicine is known to be popular in sub-Saharan Africa, where over 80% have reported its utilization. It is claimed to be easily accessible, affordable, available and acceptable, but little is known about at which stage of treatment-seeking individuals turn to traditional medicines and the resulting satisfaction once used. This is due to a paucity of quantitative demand data on how many recourses of care people take for one episode of illness, whether individuals use traditional medicines as a secondary option to orthodox medicines, and if used, how satisfied they are with results. This study presents descriptive data from fieldwork carried out on 772 households in two regions of Ghana to ascertain actions taken for self-reported episodes of acute and previously diagnosed chronic diseases. Quantitative results that show by looking merely at first recourse, use of traditional medicines is fairly low, but once second recourses are accounted for there is a doubling and tripling of incidence of traditional medicine use for acute and chronic diseases, respectively. A commonly used patient-reported outcome measurement, the EuroQol 5 Dimension (EQ5D), is used to measure satisfaction before and after traditional medicine use, to reveal significantly positive changes. The study shows that whilst individuals are highly satisfied with traditional medicine, it is more often the second recourse of treatment with a revealed preference for orthodox medicines as a first recourse. This suggests that research is needed to investigate why individuals turn to traditional medicine only as a second recourse and to clarify the insufficiencies of orthodox treatment. Policies which guide individuals to take the most efficient recourses for given symptoms, and further exploration of key reasons behind high levels of satisfaction following utilization, are encouraged. [ABSTRACT FROM PUBLISHER]

Abstract: Although socioeconomic status is acknowledged to be an important determinant of modern health care utilisation, most analyses to date have failed to include traditional systems as alternative, or joint, providers of care. In developing countries, where pluralistic care systems are common, individuals are likely to be using multiple sources of health care, and the order in which systems are chosen is likely to vary according to income. This paper uses self-collected data from households in Ghana and econometric techniques (biprobit modelling and ordered logit) to show that rising income is associated with modern care use whilst decreasing income is associated with traditional care use. When utilisation is analysed in order, results show rising income to have a positive effect on choice of modern care as a first provider, whilst choosing it second, third or never is associated with decreasing income. The effects of income on utilisation patterns of traditional care are stronger: as income rises, utilisation of traditional care as a first choice decreases. Policy should incorporate traditional care into the general utilisation framework and recognise that strategies which increase income may encourage wider utilisation of modern over traditional care, whilst high levels of poverty will see continued use of traditional care. [Copyright &y& Elsevier]

Peripheral blood from a ball python (Python reginus) imported from Ghana was cultured in Barbour-Stoenner-Kelly (BSK) medium for Borrelia spp. isolation, resulting in the prominent appearance of free, and clusters of, trypanosomes in a variety of morphological forms. The molecular phylogenetic characterization of these cultured trypanosomes, using the small subunit rDNA, indicated that this python was infected with a species closely related to Trypanosoma varani Wenyon, 1908, originally described in the Nile monitor lizard (Varanus niloticus) from Sudan. Furthermore, nucleotide sequences of glycosomal glyceraldehyde- 3-phosphate dehydrogenase gene of both isolates showed few differences. Giemsa-stained blood smears, prepared from the infected python 8 mo after the initial observation of trypanosomes in hemoculture, contained trypomastigotes with a broad body and a short, free flagellum; these most closely resembled the original description of T. varani, or T. voltariae Macfie, 1919 recorded in a black-necked spitting cobra (Naja nigricollis) from Ghana. It is highly possible that lizards and snakes could naturally share an identical trypanosome species. Alternatively, lizards and snakes in the same region might have closely related, but distinct, Trypanosoma species as a result of sympatric speciation. From multiple viewpoints, including molecular phylogenetic analyses, reappraisal of trypanosome species from a wide range of reptiles in Africa is needed to clarify the relationship of recorded species, or to unmask unrecorded species. [ABSTRACT FROM AUTHOR]

Background: Abnormal birthweights are critical public health challenges accountable for most non-communicable diseases and perinatal mortalities. Regardless of the myriad of mixed evidence on maternal factors responsible for abnormal birthweight globally, most of these findings are attained from urban and rural settings. This study serves as one of the key pieces of evidence in view of the increasing prevalence of abnormal birthweight particularly in some parts of semi-rural Ghana. The study, therefore, aims to estimate the prevalence of abnormal birthweight and identify some possible maternal risk factors for abnormal birthweight in Northern Ghana. Methods: A retrospective cross-sectional study was conducted in Savelugu municipality from February–March 2022. A total of 356 mothers aged 16–46 years, having a neonate and attending postnatal care service, were recruited as study participants. Data were collected from maternal and child health record books and through structured interviews. To identify the maternal risk factors for abnormal birthweight, chi-square/Fischer's exact test and multinomial logistic regression were employed as bivariate and multivariate analyses, respectively, at 95% confidence level. Results: Prevalence rates of low birthweight and macrosomia were 22.2% and 8.7%, respectively. Maternal anaemia in first trimester (AOR 3.226; 95% CI 1.372–7.784) and third trimester (AOR 23.94; 95% CI 7.442–70.01) of gestation was strong predictors for low birthweight. Mothers belonging to minority ethnic groups (AOR 0.104; 95% CI 0.011–0.995); mothers who had ≥ 8 antenatal care visits (AOR 0.249; 95% CI 0.103–0.602); and mothers having neonates whose birth length > 47.5 cm (AOR 0.271; 95% CI 0.113–0.651) had reduced odds for low birthweight. Alternatively, mothers with gestational weeks ≥ 42 (AOR 23.21; 95% CI 4.603–56.19) and mothers from the richest households (highest socioeconomic homes) (AOR 14.25; 95% CI 1.638–23.91) were more likely to birth to macrosomic infants. Conclusion: The prevalence rates of low birthweight and macrosomia were relatively high. Anaemia in the first and third trimesters was strong determinants of low birthweight. Being minority ethnic group, frequency of antenatal visits, and childbirth length reduced the risk of low-weight births. Advanced gestational age and socioeconomic status of mothers were also predictors of macrosomia. Hence, nutrition counselling, community health education, and promotion of lifestyle improvement coupled with strengthening of health service delivery are recommended interventions. [ABSTRACT FROM AUTHOR]

Synopsis This article highlights how single migrant women (SMW) from rural northern Ghana generate livelihoods through the adoption of both market and non-market based strategies by extending and then prioritising moral obligations to community members beyond their immediate households instead of focusing on maximisation of profits. The setting is the Old Fadama market in Accra, Ghana. Communities of old and new SMW build a “moral community economy” through, amongst others, engaging in reciprocal labour, gift giving, childcare and food sharing. Our study reveals the importance of this moral community economy to SMW's livelihood generation and how it is sustained through social relations amongst women, in which also generation, ethnicity and regional background, play crucial roles. SMW give support to and receive benefits from the community through moral obligations and ethnic commitment. The analysis of these strategies contributes to the understanding of the intersections of household, livelihood strategies, gender and markets in urban settings. [ABSTRACT FROM AUTHOR]

• Ticks found on grasscutters were identified as Ixodes aulacodi and Rhipicephalus sp. • Ixodes aulacodi were positive for Anaplasma, Babesia and Ehrlichia infections. • The presence of Candidatus M. mitochondrii endosymbiont was observed in 85.5% of Ixodes aulacodi. Ticks and tick-borne pathogens constitute a great threat to livestock production and are a potential health hazard to humans. Grasscutters (Thryonomys swinderianus) are widely hunted for meat in Ghana and many other West and Central African countries. However, tick-borne zoonotic risks posed by wild grasscutters have not been assessed. The objective of this study was to investigate bacterial and protozoan pathogens in ticks infecting wild grasscutters. A total of 81 ticks were collected from three hunted grasscutters purchased from Kantamanto, the central bushmeat market in Accra. Ticks were identified as Ixodes aulacodi and Rhipicephalus sp. based on morphological keys, which were further confirmed by sequencing mitochondrial 16S ribosomal DNA (rDNA) and cytochrome oxidase I (COI) genes of specimens. Protozoan infections were tested by PCR amplifying 18S rDNA of Babesia / Theileria / Hepatozoon , while bacterial infections were evaluated by PCRs or real-time PCRs targeting Anaplasmataceae, Borrelia , spotted fever group rickettsiae, chlamydiae and Candidatus Midichloria mitochondrii. The results of PCR screening showed that 35.5% (27 out of 76) of I. aulacodi were positive for parasite infections. Sequencing analysis of the amplified products gave one identical sequence showing similarity with Babesia spp. reported from Africa. The Ca. M. mitochondrii endosymbiont was present in 85.5% (65 out of 76) of I. aulacodi but not in the five Rhipicephalus ticks. Two Anaplasmataceae bacteria genetically related to Ehrlichia muris and Anaplasma phagocytophilum were also detected in two I. aulacodi. None of the ticks were positive for Borrelia spp., spotted fever group rickettsiae and chlamydiae. Since I. aulacodi on wild grasscutters are potential carriers of tick-borne pathogens, some of which could be of zoonotic potential, rigorous tick control and pathogen analyses should be instituted especially when wild caught grasscutters are being used as foundation stock for breeding. [ABSTRACT FROM AUTHOR]

HIV-2 GH-1 is a molecular clone derived from an AIDS patient from Ghana. In contrast to the prototypic molecular clone ROD, GH-1 exhibits a narrow range of target cell specificity. By an infectious assay using HeLa-CD4 cells stably transfected with an HIV-1 LTR-beta-galactosidase reporter gene and transiently expressing various cloned chemokine receptors, we have examined the coreceptor usage of GH-1. In contrast to ROD, which uses principally CXCR4, GH-1 was found to use mainly if not exclusively CCR5 but not CXCR4. The distinct coreceptor usage of these two molecular clones allowed us to further map the region of gp120 that is important for the coreceptor specificity. By constructing a series of chimeric viruses between GH-1 and ROD, we have demonstrated that the C-terminal half of the V3 loop region of gp120 determines the differential coreceptor usage between GH-1 and ROD, and only a few amino acid differences in this region appear to be able to shift the specificity between CCR5 and CXCR4. Notably, the shift in the coreceptor usage from CCR5 to CXCR4 is associated with an increase in the net positive charge in the V3 region., (Copyright 1999 Academic Press.)