27 results on '"Julius Fobil"'
Search Results
2. Preponderance of vaccine-preventable diseases hotspots in northern Ghana: a spatial and space-time clustering analysis from 2010 to 2014
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Daniel Amoako-Sakyi, Dorcas Obiri-Yeboah, Anthony Ofosu, Kwadwo Asamoah Kusi, Kingsley Osei, Richard Adade, Ebenezer Aniakwaa-Bonsu, Reginald Quansah, John Arko-Mensah, Brodrick Yeboah Amoah, Godwin Kwakye-Nuako, Eric Yaw Frimpong, Mariama Combasseré-Cherif, Hidaya Mohammed, Boubacar Maiga, Julius Fobil, Isabella Quakyi, and Ben A. Gyan
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Vaccine-preventable Diseases ,VPD ,Ecological zones ,Hotspots ,Ghana ,Artisanal and Small-Scale Gold Mining ,Public aspects of medicine ,RA1-1270 - Abstract
Abstract Background Vaccine-preventable diseases (VPDs) persist globally with a disproportionately high burden in Low and Middle-Income Countries (LMICs). Although this might be partly due to the failure to sustain vaccination coverage above 90% in some WHO regions, a more nuanced understanding of VPD transmission beyond vaccination coverage may unveil other important factors in VPD transmission and control. This study identified VPDs hotspots and explored their relationships with ecology, urbanicity and land-use variations (Artisanal and Small-scale Gold Mining (ASGM) activities) in Ghana. Methods District-level disease count data from 2010 to 2014 from the Ghana Health Service (GHS) and population data from the Ghana Population and Housing Census (PHC) were used to determine clustering patterns of six VPDs (Measles, Meningitis, Mumps, Otitis media, Pneumonia and Tetanus). Spatial and space-time cluster analyses were implemented in SaTScan using the discrete Poisson model. P-values were estimated using a combination of sequential Monte Carlo, standard Monte Carlo, and Gumbel approximations. Results The study found a preponderance for VPD hotspots in the northern parts of Ghana and northernmost ecological zones (Sudan Savannah and Guinea Savannah). Incidence of meningitis was higher in the Sudan Savannah ecological zone relative to: Tropical Rain Forest (p = 0.001); Semi Deciduous Forest (p
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- 2022
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3. Maintaining essential health services during COVID-19 in Ghana: a qualitative study
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Duah Dwomoh, Rawlance Ndejjo, Rhoda Kitti Wanyenze, Steven Ndugwa Kabwama, Isaac Yeboah, Fidelia Ohemeng, Sylvia Akpene Takyi, Ibrahim Issah, Serwaa Akoto Bawuah, and Julius Fobil
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Medicine (General) ,R5-920 ,Infectious and parasitic diseases ,RC109-216 - Published
- 2023
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4. COVID-19 outbreak control strategies and their impact on the provision of essential health services in Ghana: An exploratory-sequential study.
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Duah Dwomoh, Isaac Yeboah, Rawlance Ndejjo, Steven Ndugwa Kabwama, Justice Moses Aheto, Anne Liu, Siobhan Lazenby, Fidelia Ohemeng, Sylvia Akpene Takyi, Ibrahim Issah, Serwaa Akoto Bawuah, Rhoda K Wanyenze, and Julius Fobil
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Medicine ,Science - Abstract
BackgroundThe COVID-19 pandemic has led to substantial interruptions in critical health services, with 90% of countries reporting interruptions in routine vaccinations, maternal health care and chronic disease management. The use of non-pharmaceutical interventions (NPIs) such as lockdowns and self-isolation had implications on the provision of essential health services (EHS). We investigated exemplary COVID-19 outbreak control strategies and explored the extent to which the adoption of these NPIs affected the provision of EHS including immunization coverage and facility-based deliveries. Finally, we document core health system strategies and practices adopted to maintain EHS during the early phase of the pandemic.MethodsThis study used an explanatory sequential study design. First, we utilized data from routine health management information systems to quantify the impact of the pandemic on the provision of EHS using interrupted time series models. Second, we explored exemplary strategies and health system initiatives that were adopted to prevent the spread of COVID-19 infections while maintaining the provision of EHS using in-depth interviews with key informants including policymakers and healthcare providers.ResultsThe COVID-19 pandemic and the interventions that were implemented disrupted the provision of EHS. In the first month of the COVID-19 pandemic, Oral Polio and pentavalent vaccination coverage reduced by 15.2% [95% CI = -22.61, -7.87, pConclusionThe implementation of different NPIs during the peak phase of the pandemic disrupted the provision of EHS. However, the Ministry of Health leveraged the resilient health system and deployed efficient, all-inclusive, and integrated infectious disease management and infection prevention control strategies to maintain the provision of EHS while responding to the spread of infections.
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- 2023
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5. The interplay between environmental exposures and COVID-19 risks in the health of children
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Peter D. Sly, Brittany A. Trottier, Catherine M. Bulka, Stephania A. Cormier, Julius Fobil, Rebecca C. Fry, Kyoung-Woong Kim, Steven Kleeberger, Pushpam Kumar, Philip J. Landrigan, Karin C. Lodrop Carlsen, Antonio Pascale, Fernando Polack, Mathuros Ruchirawat, Heather J. Zar, and William A. Suk
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Children’s environmental health ,COVID-19 ,Combined exposures ,SARS-Cov-2 ,Industrial medicine. Industrial hygiene ,RC963-969 ,Public aspects of medicine ,RA1-1270 - Abstract
Abstract Background An unusual feature of SARS-Cov-2 infection and the COVID-19 pandemic is that children are less severely affected than adults. This is especially paradoxical given the epidemiological links between poor air quality and increased COVID-19 severity in adults and that children are generally more vulnerable than adults to the adverse consequences of air pollution. Objectives To identify gaps in knowledge about the factors that protect children from severe SARS-Cov-2 infection even in the face of air pollution, and to develop a transdisciplinary research strategy to address these gaps. Methods An international group of researchers interested in children’s environmental health was invited to identify knowledge gaps and to develop research questions to close these gaps. Discussion Key research questions identified include: what are the effects of SAR-Cov-2 infection during pregnancy on the developing fetus and child; what is the impact of age at infection and genetic susceptibility on disease severity; why do some children with COVID-19 infection develop toxic shock and Kawasaki-like symptoms; what are the impacts of toxic environmental exposures including poor air quality, chemical and metal exposures on innate immunity, especially in the respiratory epithelium; what is the possible role of a “dirty” environment in conveying protection – an example of the “hygiene hypothesis”; and what are the long term health effects of SARS-Cov-2 infection in early life. Conclusion A concerted research effort by a multidisciplinary team of scientists is needed to understand the links between environmental exposures, especially air pollution and COVID-19. We call for specific research funding to encourage basic and clinical research to understand if/why exposure to environmental factors is associated with more severe disease, why children appear to be protected, and how innate immune responses may be involved. Lessons learned about SARS-Cov-2 infection in our children will help us to understand and reduce disease severity in adults, the opposite of the usual scenario.
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- 2021
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6. Spatial Distribution of Heavy Metals and Pollution of Environmental Media Around a Used Lead-acid Battery Recycling Center in Ibadan, Nigeria
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Elizabeth Oloruntoba, Olusegun Gurusa, Folashade Omokhodion, Julius Fobil, Niladri Basu, John Arko-Mensah, and Thomas Robin
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used lead-acid battery ,ulab informal recycling ,metals ,environmental media ,ibadan ,nigeria ,Environmental technology. Sanitary engineering ,TD1-1066 - Abstract
Background. Heavy metals are usually present in trace amounts in various environmental media such as water, soil, and air, and many are poisonous to human health even at very low concentrations. Objectives. To assess the risk of heavy metal contamination of water, soil, and plants around a used lead acid battery (ULAB) recycling center in Ibadan, Nigeria. Methods. Environmental samples (water, soil, and plants) were collected using standard methods and concentrations of arsenic (As), cadmium (Cd), antimony (Sb), chromium (Cr), copper (Cu), manganese (Mn), nickel (Ni), lead (Pb), selenium (Se), and zinc (Zn) were determined using inductively coupled plasma-optical emission spectrometry at the International Institute of Tropical Agriculture, Ibadan, Nigeria. Results. The concentration of metals detected in water samples were higher than permissible limits at more than 50% of the sampling locations. In contrast, heavy metals in soil were within permissible limits. Most of the heavy metals except Pb were found to be present in the plant within permissible limits. Lead levels in water and plants from all locations exceeded the permissible limits. The contamination degree and pollution load index of water sources around the ULAB recycling center indicate a high degree of pollution of water sources with heavy metals, while soil samples were within the normal baseline levels. The transfer factor of Pb from soil to Amaranthus viridis was 1.92. This has implications for human health as the plant is often harvested and for sale in local markets as a source of food and medicine. Conclusions. The present study recommends improved technology for ULAB recycling and adequate treatment of effluent/runoff from recycling centers before discharge. Competing Interests. The authors declare no competing financial interests.
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- 2021
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7. Mathematical modeling of COVID-19 infection dynamics in Ghana: Impact evaluation of integrated government and individual level interventions
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Duah Dwomoh, Samuel Iddi, Bright Adu, Justice Moses Aheto, Kojo Mensah Sedzro, Julius Fobil, and Samuel Bosomprah
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COVID-19 ,Mathematical modeling ,Intervention ,Effective reproductive number ,Infectious disease ,Differential equations ,Infectious and parasitic diseases ,RC109-216 - Abstract
The raging COVID-19 pandemic is arguably the most important threat to global health presently. Although there is currently a vaccine, preventive measures have been proposed to reduce the spread of infection but the efficacy of these interventions, and their likely impact on the number of COVID-19 infections is unknown. In this study, we proposed the SEIQHRS model (susceptible-exposed-infectious-quarantine-hospitalized-recovered-susceptible) model that predicts the trajectory of the epidemic to help plan an effective control strategy for COVID-19 in Ghana. We provided a short-term forecast of the early phase of the epidemic trajectory in Ghana using the generalized growth model. We estimated the effective basic Reproductive number Re in real-time using three different estimation procedures and simulated worse case epidemic scenarios and the impact of integrated individual and government interventions on the epidemic in the long term using compartmental models. The maximum likelihood estimates of Re and the corresponding 95% confidence interval was 2.04 [95% CI: 1.82–2.27; 12th March-7th April 2020]. The Re estimate using the exponential growth method was 2.11 [95% CI: 2.00–2.24] within the same period. The Re estimate using time-dependent (TD) method showed a gradual decline of the Effective Reproductive Number since March 12, 2020 when the first 2 index cases were recorded but the rate of transmission remains high (TD: Re = 2.52; 95% CI: [1.87–3.49]). The current estimate of Re based on the TD method is 1.74 [95% CI: 1.41–2.10; (13th May 2020)] but with comprehensive integrated government and individual level interventions, the Re could reduce to 0.5 which is an indication of the epidemic dying out in the general population. Our results showed that enhanced government and individual-level interventions and the intensity of media coverage could have a substantial effect on suppressing transmission of new COVID-19 cases and reduced death rates in Ghana until such a time that a potent vaccine or drug is discovered.
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- 2021
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8. Respiratory Disorders Related to e-Waste Exposure among Workers in the Informal Sector in a Sub-Saharan African City: An Exposed Nonexposed Study
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Ablo Prudence Wachinou, Nonvignon Marius Kêdoté, Geraud Padonou, Serge Adè, Joaquin Darboux, Mirlène Tohi, Arnauld Fiogbé, Julius Fobil, and Gildas Agodokpessi
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Diseases of the respiratory system ,RC705-779 - Abstract
Introduction. Exposure to electrical and electronic equipment waste (e-waste) has become a growing health concern. The objective of this study was to measure the effect of exposure to e-waste on respiratory symptoms and on lung function parameters in workers involved in informal recycling activities in Cotonou city, Benin. Methods. This was a cross-sectional study, in which exposed e-waste workers in Cotonou city were randomly selected. A matching nonexposed group based on age and sex was recruited from the general population. Respiratory symptoms were investigated using a questionnaire adapted from the British Medical Research Council’s standardized respiratory questionnaire. Participants underwent lung function test using a portable spirometer (MIR SPIROBANK). Data were analyzed with STATA version 15 software. Results. The overall prevalence of respiratory symptoms in e-waste workers was statistically higher in the exposed group (33.1% vs. 21.6%; p=0.027). Chest tightness (11.8% vs. 2.1%; p=0.003) and breathlessness (6.8% vs. 1.4%; p=0.018) were the most reported symptoms by e-waste workers. Lung function testing showed a higher proportion of disorders among e-waste workers (25.0% vs. 14.9%, p=0.029), with a higher proportion of probable restrictive (10.8% vs. 2.7, p=0.005) and mixed (4.1% vs. 0%, p=0.013) ventilatory disorders. Handling or working with e-waste was found associated with a significant reduction in forced expiratory volume in one second (FEV1) by 0.4 L (95% CI: 0.3-0.6) and forced vital capacity (FVC) by 0.75 L (95% CI: 0.6-0.9) after adjustment for age, BMI, smoking habits, asthma history, and daily income. Conclusion. Work involving e-waste is associated with a higher prevalence of respiratory symptoms and with an increased risk of FEV1 and FVC decline, as well as of lung function impairment, particularly of restrictive disorders. Further studies to better clarify this association are needed. Awareness on this major public health threat should be raised in other sub-Saharan and Asian urban areas.
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- 2022
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9. Air Quality Impacts at an E‐Waste Site in Ghana Using Flexible, Moderate‐Cost and Quality‐Assured Measurements
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Lawrencia Kwarteng, Emmanuel Acquah Baiden, Julius Fobil, John Arko‐Mensah, Thomas Robins, and Stuart Batterman
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Air pollution ,particulate matter ,e‐waste ,fires ,monitoring ,Environmental protection ,TD169-171.8 - Abstract
Abstract Air quality information is scarce in low‐ and middle‐income countries. This study describes the application of moderate cost approaches that can provide spatial and temporal information on concentrations of particulate matter (PM) needed to assess community and occupational exposures. We evaluated PM levels at the Agbogbloshie e‐waste and scrap yard site in Accra, Ghana, and at upwind and downwind locations, obtaining both optical and gravimetric measurements, local meteorological data and satellite aerosol optical depth. Due to overload issues, the gravimetric 24‐hr samplers were modified for periodic sampling and some optical data were screened for quality assurance. Exceptionally high concentrations (e.g., 1‐hr average PM10 exceeding 2000 μg/m3) were sometimes encountered near combustion sources, including open fires at the e‐waste site and spoil piles. 24‐hr PM2.5 levels averaged 31, 88 and 57 μg/m3 at upwind, e‐waste and downwind sites, respectively, and PM10 averaged 145, 214 and 190 μg/m3, considerably exceeding air quality standards. Upwind levels likely reflected biomass burning that is prevalent in the surrounding informal settlements; levels at the e‐waste and downwind sites also reflected contributions from biomass combustion and traffic. The highest PM levels occurred in evenings, influenced by diurnal changes in emission rates, atmospheric dispersion and wind direction shifts. We demonstrate that moderate cost instrumentation, with some modifications, appropriate data cleaning protocols, and attention to understanding local sources and background levels, can be used to characterize spatial and temporal variation in PM levels in urban and industrial areas.
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- 2020
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10. Severe dioxin-like compound (DLC) contamination in e-waste recycling areas: An under-recognized threat to local health
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Qingyuan Dai, Xijin Xu, Brenda Eskenazi, Kwadwo Ansong Asante, Aimin Chen, Julius Fobil, Åke Bergman, Lesley Brennan, Peter D. Sly, Innocent Chidi Nnorom, Antonio Pascale, Qihua Wang, Eddy Y. Zeng, Zhijun Zeng, Philip J. Landrigan, Marie-Noel Bruné Drisse, and Xia Huo
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Dioxin-like compound ,Toxicity ,E-waste recycling site ,Human exposure ,Health risk ,Environmental sciences ,GE1-350 - Abstract
Electrical and electronic waste (e-waste) burning and recycling activities have become one of the main emission sources of dioxin-like compounds (DLCs). Workers involved in e-waste recycling operations and residents living near e-waste recycling sites (EWRS) are exposed to high levels of DLCs. Epidemiological and experimental in vivo studies have reported a range of interconnected responses in multiple systems with DLC exposure. However, due to the compositional complexity of DLCs and difficulties in assessing mixture effects of the complex mixture of e-waste-related contaminants, there are few studies concerning human health outcomes related to DLC exposure at informal EWRS. In this paper, we have reviewed the environmental levels and body burdens of DLCs at EWRS and compared them with the levels reported to be associated with observable adverse effects to assess the health risks of DLC exposure at EWRS. In general, DLC concentrations at EWRS of many countries have been decreasing in recent years due to stricter regulations on e-waste recycling activities, but the contamination status is still severe. Comparison with available data from industrial sites and well-known highly DLC contaminated areas shows that high levels of DLCs derived from crude e-waste recycling processes lead to elevated body burdens. The DLC levels in human blood and breast milk at EWRS are higher than those reported in some epidemiological studies that are related to various health impacts. The estimated total daily intakes of DLCs for people in EWRS far exceed the WHO recommended total daily intake limit. It can be inferred that people living in EWRS with high DLC contamination have higher health risks. Therefore, more well-designed epidemiological studies are urgently needed to focus on the health effects of DLC pollution in EWRS. Continuous monitoring of the temporal trends of DLC levels in EWRS after actions is of highest importance.
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- 2020
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11. Spatiality in Health: The Distribution of Health Conditions Associated with Electronic Waste Processing Activities at Agbogbloshie, Accra
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Abenaa Adusei, John Arko-Mensah, Mawuli mdzodzomenyo, Judith Stephens, Afua Amoabeng, Saskia Waldschmidt, Katja Löhndorf, Kwame Agbeko, Sylvia Takyi, Lawrencia Kwarteng, Augustine Acquah, Paul Botwe, Prudence Tettey, Andrea Kaifie, Michael Felten, Thomas Kraus, Thomas Küpper, and Julius Fobil
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Infectious and parasitic diseases ,RC109-216 ,Public aspects of medicine ,RA1-1270 - Abstract
Background: A walk through the Agbogbloshie e-waste recycling site shows a marked heterogeneity in the spatial distribution of the different e-waste processing activities, which are likely to drive clustering of health conditions associated with the different activity type in each space. Objective of study: To conduct a spatial assessment and analysis of health conditions associated with different e-waste activities at different activity spaces at Agbogbloshie. Methods: A choropleth showing the various activity spaces at the Agbogbloshie e-waste site was produced by mapping boundaries of these spaces using Etrex GPS device and individuals working in each activity spaces were recruited and studied. Upon obtaining consent and agreeing to participate in the study, each subject was physically examined and assessed various health outcomes of interest via direct physical examination while characterizing and enumerating the scars, lacerations, abrasions, skin condition and cuts after which both systolic and diastolic blood pressure values were recorded alongside the administration of open and close ended questionnaires. All individuals working within each activity space and consented to participate were recruited; giving a total of one hundred and twelve (112) subjects in all. Results: A study of the choropleth showed that health conditions associated e-waste processing activities were clustered in a fashion similar to the corresponding distribution of each activity. While a total of 96.2% of all the study subjects had cuts, the dismantlers had higher mix of scars, lacerations and abrasions. Abrasions were observed in 16.3% of the dismantlers. Scars were the most common skin condition and were observed on the skins of 93.6% of the subjects. Prevalence of burns among the study subjects was 23.1%. Developing hypertension was not associated with activity type and while a total of 90.2% of subjects had normal blood pressure and 9.8% of them were hypertensives. Finally, 98.2% of respondents felt the need to have a first aid clinic at the site with 96.4% and 97.3% willing to visit the clinic and pay for services respectively. Conclusion: We conclude that while the observed injuries were random and were due purely to accidents without any role of spatial determinants such as the configuration, slope, topography and other subterranean features of the activity spaces, a strong association between the injuries and activity type was observed.
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- 2020
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12. Solid medical waste: a cross sectional study of household disposal practices and reported harm in Southern Ghana
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Emilia Asuquo Udofia, Gabriel Gulis, and Julius Fobil
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Healthcare waste ,Medical waste ,Disposal ,Community ,Ghana ,Waste management ,Public aspects of medicine ,RA1-1270 - Abstract
Abstract Background Solid medical waste (SMW) in households is perceived to pose minimal risks to the public compared to SMW generated from healthcare facilities. While waste from healthcare facilities is subject to recommended safety measures to minimize risks to human health and the environment, similar waste in households is often untreated and co-mingled with household waste which ends up in landfills and open dumps in many African countries. In Ghana, the management of this potentially hazardous waste stream at household and community level has not been widely reported. The objective of this study was to investigate household disposal practices and harm resulting from SMW generated in households and the community. Methods A cross-sectional questionnaire survey of 600 households was undertaken in Ga South Municipal Assembly in Accra, Ghana from mid-April to June, 2014. Factors investigated included socio-demographic characteristics, medication related practices, the belief that one is at risk of diseases associated with SMW, SMW disposal practices and reported harm associated with SMW at home and in the community. Results Eighty percent and 89% of respondents discarded unwanted medicines and sharps in household refuse bins respectively. A corresponding 23% and 35% of respondents discarded these items without a container. Harm from SMW in the household and in the community was reported by 5% and 3% of respondents respectively. Persons who believed they were at risk of diseases associated with SMW were nearly three times more likely to report harm in the household (OR 2.75, 95%CI 1.15–6.54). Conclusion The belief that one can be harmed by diseases associated with SMW influenced reporting rates in the study area. Disposal practices suggest the presence of unwanted medicines and sharps in the household waste stream conferring on it hazardous properties. Given the low rates of harm reported, elimination of preventable harm might justify community intervention.
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- 2017
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13. Integrating environmental health and genomics research in Africa: challenges and opportunities identified during a Human Heredity and Health in Africa (H3Africa) Consortium workshop [version 1; peer review: 2 approved]
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Bonnie R. Joubert, Kiros Berhane, Jonathan Chevrier, Gwen Collman, Brenda Eskenazi, Julius Fobil, Cathrine Hoyo, Chandy C. John, Abera Kumie, Mark Nicol, Michèle Ramsay, Joshua Smith, Adrie Steyn, Desire Tshala-Katumbay, and Kimberly McAllister
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Medicine ,Science - Abstract
Individuals with African ancestry have extensive genomic diversity but have been underrepresented in genomic research. There is also extensive global diversity in the exposome (the totality of human environmental exposures from conception onwards) which should be considered for integrative genomic and environmental health research in Africa. To address current research gaps, we organized a workshop on environmental health research in Africa in conjunction with the H3Africa Consortium and the African Society of Human Genetics meetings in Kigali, Rwanda. The workshop was open to all researchers with an interest in environmental health in Africa and involved presentations from experts within and outside of the Consortium. This workshop highlighted innovative research occurring on the African continent related to environmental health and the interplay between the environment and the human genome. Stories of success, challenges, and collaborative opportunities were discussed through presentations, breakout sessions, poster presentations, and a panel discussion. The workshop informed participants about environmental risk factors that can be incorporated into current or future epidemiology studies and addressed research design considerations, biospecimen collection and storage, biomarkers for measuring chemical exposures, laboratory strategies, and statistical methodologies. Inclusion of environmental exposure measurements with genomic data, including but not limited to H3Africa projects, can offer a strong platform for building gene-environment (G x E) research in Africa. Opportunities to leverage existing resources and add environmental exposure data for ongoing and planned studies were discussed. Future directions include expanding the measurement of both genomic and exposomic risk factors and incorporating sophisticated statistical approaches for analyzing high dimensional G x E data. A better understanding of how environmental and genomic factors interact with nutrition and infection is also needed. Considering that the environment represents many modifiable risk factors, these research findings can inform intervention and prevention efforts towards improving global health.
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- 2019
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14. Screening for retroviruses and hepatitis viruses using dried blood spots reveals a high prevalence of occult hepatitis B in Ghana
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Carmen de Mendoza, José M. Bautista, Susana Pérez-Benavente, Roger Kwawu, Julius Fobil, Vicente Soriano, and Amalia Díez
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Infectious and parasitic diseases ,RC109-216 - Abstract
Background: Recent advances in antiviral therapy show potential for a cure and/or control of most human infections caused by hepatitis viruses and retroviruses. However, medical success is largely dependent on the identification of the large number of people unaware of these infections, especially in developing countries. Dried blood spots (DBS) have been demonstrated to be a good tool for collecting, storing and transporting clinical specimens from rural areas and limited-resource settings to laboratory facilities, where viral infections can be more reliably diagnosed. Methods: The seroprevalence and virological characterization of hepatitis B virus (HBV) and hepatitis C virus (HCV), as well as human retroviruses (HIV-1, HIV-2, human T-cell leukaemia virus type 1 [HTLV-1] and human T-cell leukaemia virus type 2 [HTLV-2]), were investigated in clinical specimens collected from DBS in Ghana. Results: A total of 305 consecutive DBS were collected. A high prevalence of chronic HBV (8.5%) and occult hepatitis B (14.2%) was found, whereas rates were lower for HIV-1, HTLV-1 and HCV (3.2%, 1.3% and 0.6%, respectively). HIV-2 and HTLV-2 were absent. CRF02_AG was the predominant HIV-1 subtype, whereas genotype E was the most frequent HBV variant. Conclusions: DBS are helpful in the diagnosis and virological characterization of hepatitis and retrovirus infections in resource-limited settings. The high rate of hepatitis B in Ghana, either overt or occult, is noteworthy and confirms recent findings from other sub-Saharan countries. This should encourage close clinical follow up and antiviral treatment assessment in this population, as well as universal HBV vaccine campaigns.
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- 2019
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15. Feasibility of Electronic Health Information and Surveillance System (eHISS) for disease symptom monitoring: A case of rural Ghana.
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Aliyu Mohammed, Konstantin Franke, Portia Boakye Okyere, Johanna Brinkel, Axel Bonačić Marinovic, Benno Kreuels, Ralf Krumkamp, Julius Fobil, Jürgen May, and Ellis Owusu-Dabo
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Medicine ,Science - Abstract
INTRODUCTION:The current surge of mobile phone use in many African countries creates the opportunity to provide caregivers with limited access to the health care system with vital health recommendations. At the same time such communication system can be utilised to collect tempero-spatial data on disease symptoms. OBJECTIVE:We assessed the feasibility of an mHealth system among caregivers with children under-five years, designed as a health information and surveillance tool in a rural district of Ghana. METHODS:A mobile phone-based electronic health information and surveillance system was piloted from February to December 2015. Toll-free numbers were provided to 1446 caregivers, which they could call to receive health advice in case their children showed disease symptoms. The system was setup to evaluate the illness of a sick child. Symptoms reported via the system were evaluated and compared to clinician's report after follow-up. Cogency of the reported symptoms was assessed using Cohen's kappa coefficient. RESULTS:A total of 169 children with disease symptoms were identified based on phone calls from caregivers. The predominant reported symptoms were fever (64%; n = 108), cough (55%; n = 93) and diarrhoea (33%; n = 55). Temporal pattern of symptomatic cases revealed a peak saturation in the month of September, with fever registering the highest number of symptoms observed. Reported symptoms and clinician's report revealed a very good agreement for fever (95%, kappa = 0.89); good for diarrhoea (87%, kappa = 0.73) and moderate for cough (76%, kappa = 0.49). CONCLUSION:This pilot concept, has demonstrated the practicality of using mobile phones for assessing childhood disease symptoms and encouraging caregivers to seek early treatment for their children if needed. The strategy to use mobile phones in disease surveillance and treatment support is a promising strategy especially for areas with limited access to the health care system.
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- 2018
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16. Urbanicity and Paediatric Bacteraemia in Ghana-A Case-Control Study within a Rural-Urban Transition Zone.
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Peter Sothmann, Ralf Krumkamp, Benno Kreuels, Nimako Sarpong, Clemens Frank, Lutz Ehlkes, Julius Fobil, Kennedy Gyau, Anna Jaeger, Benedicta Bosu, Florian Marks, Ellis Owusu-Dabo, Bernd Salzberger, and Jürgen May
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Medicine ,Science - Abstract
Systemic bacterial infections are a major cause of paediatric febrile illness in sub-Saharan Africa. Aim of this study was to assess the effects of social and geographical determinants on the risk of bacteraemia in a rural-urban transition zone in Ghana.Children below 15 years of age with fever were recruited at an outpatient department in the suburban belt of Kumasi, Ghana's second largest city. Blood was taken for bacterial culture and malaria diagnostics. The socio-economic status of participants was calculated using Principle Component Analysis. A scale, based on key urban characteristics, was established to quantify urbanicity for all communities in the hospital catchment area. A case-control analysis was conducted, where children with and without bacteraemia were cases and controls, respectively.Bacteraemia was detected in 72 (3.1%) of 2,306 hospital visits. Non-typhoidal Salmonella (NTS; n = 24; 33.3%) and Salmonella typhi (n = 18; 25.0%) were the most common isolates. Logistic regression analysis showed that bacteraemia was negatively associated with urbanicity (odds ratio [OR] = 0.8; 95% confidence interval [CI]: 0.7-1.0) and socio-economic status (OR = 0.8; 95% CI: 0.6-0.9). Both associations were stronger if only NTS infections were used as cases (OR = 0.5; 95% CI: 0.3-0.8 and OR = 0.6; 95% CI: 0.4-1.0, respectively).The results of this study highlight the importance of individual as well as community factors as independent risk factors for invasive bacterial infection (IBI) and especially NTS. Epidemiological data support physicians, public health experts and policy makers to identify disease prevention and treatment needs in order to secure public health in the transitional societies of developing countries.
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- 2015
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17. An assessment of government policy response to HIV/AIDS in Ghana
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Julius Fobil and Ireneous Soyiri
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assessment response ,sentinel surveillance system ,prevalence ,vulnerability ,generalised epidemic ,évaluation ,Public aspects of medicine ,RA1-1270 - Abstract
The HIV/AIDS epidemic in Africa has assumed a dimension raising heartbreaking anxiety among national governments and civil society groups. In Ghana for example, the pandemic is well-documented and has gone beyond a health problem, and now encompasses all socio-economic aspects of life. The estimated rate of infection from the mid-1980s to 2000 has more than doubled, and in spite of the control efforts by various groups and organisations, prevalence of the disease has not declined notably. This paper assesses government policy, programmes and strategies to combat the disease, using analysis of time trend sentinel data and weighting these against control efforts. The assessment revealed that 380 000 adults and 36 000 children are currently infected. There are wide spatial variations in prevalence across the country and the overall national prevalence has fluctuated over time, standing at 2.6% in 2000, 3.6% in 2002 and 3.1% in 2004. This appears relatively lower than in adjacent countries, where prevalence is around 5% and over 25% in East and Southern African countries.Although the review found a robust multipronged government intervention approach to containing the disease, we are hesitant to claim that the fairly stable or low national prevalence in Ghana compared with its immediate neighbours may have been the consequence of the effectiveness of national AIDS control programmes and impact of government interventions.
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- 2006
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18. Screening for retroviruses and hepatitis viruses using dried blood spots reveals a high prevalence of occult hepatitis B in Ghana
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Carmen de Mendoza, Bautista Santa Cruz, José Manuel, Susana Pérez-Benavente, Roger Kwawu, Julius Fobil, Vicente Soriano, Díez Martín, Amalia, Carmen de Mendoza, Bautista Santa Cruz, José Manuel, Susana Pérez-Benavente, Roger Kwawu, Julius Fobil, Vicente Soriano, and Díez Martín, Amalia
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Background: Recent advances in antiviral therapy show potential for a cure and/or control of most human infections caused by hepatitis viruses and retroviruses. However, medical success is largely dependent on the identification of the large number of people unaware of these infections, especially in developing countries. Dried blood spots (DBS) have been demonstrated to be a good tool for collecting, storing and transporting clinical specimens from rural areas and limited-resource settings to laboratory facilities, where viral infections can be more reliably diagnosed. Methods: The seroprevalence and virological characterization of hepatitis B virus (HBV) and hepatitis C virus (HCV), as well as human retroviruses (HIV-1, HIV-2, human T-cell leukaemia virus type 1 [HTLV-1] and human T-cell leukaemia virus type 2 [HTLV-2]), were investigated in clinical specimens collected from DBS in Ghana. Results: A total of 305 consecutive DBS were collected. A high prevalence of chronic HBV (8.5%) and occult hepatitis B (14.2%) was found, whereas rates were lower for HIV-1, HTLV-1 and HCV (3.2%, 1.3% and 0.6%, respectively). HIV-2 and HTLV-2 were absent. CRF02_AG was the predominant HIV-1 subtype, whereas genotype E was the most frequent HBV variant. Conclusions: DBS are helpful in the diagnosis and virological characterization of hepatitis and retrovirus infections in resource-limited settings. The high rate of hepatitis B in Ghana, either overt or occult, is noteworthy and confirms recent findings from other sub-Saharan countries. This should encourage close clinical follow up and antiviral treatment assessment in this population, as well as universal HBV vaccine campaigns., Fundación Investigación y Educación en SIDA (F-IES), Fondo de Investigación Sanitaria-FIS (CES12/003), MINECO projects BIO2013-44565R and BIO2016-77430R, UCM-Development Cooperation project (2008–2009)., Depto. de Bioquímica y Biología Molecular, Fac. de Veterinaria, TRUE, pub
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- 2024
19. Derivation of sex and age-specific reference intervals for clinical chemistry analytes in healthy Ghanaian adults
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Serwaa Akoto Bawua, Kiyoshi Ichihara, Rosemary Keatley, John Arko-Mensah, Patrick F. Ayeh-Kumi, Rajiv Erasmus, and Julius Fobil
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Adult ,Adolescent ,Reference Values ,Chemistry, Clinical ,Biochemistry (medical) ,Clinical Biochemistry ,Age Factors ,Humans ,Alanine Transaminase ,General Medicine ,Ghana ,Lipids - Abstract
Objectvies This study is aimed at establishing reference intervals (RIs) of 40 chemistry and immunochemistry analytes for Ghanaian adults based on internationally harmonized protocol by IFCC Committee on Reference Intervals and Decision Limits (C-RIDL). Methods A total of 501 healthy volunteers aged ≥18 years were recruited from the northern and southern regions of Ghana. Blood samples were analyzed with Beckman-Coulter AU480 and Centaur-XP/Siemen auto-analyzers. Sources of variations of reference values (RVs) were evaluated by multiple regression analysis (MRA). The need for partitioning RVs by sex and age was guided by the SD ratio (SDR). The RI for each analyte was derived using parametric method with application of the latent abnormal values exclusion (LAVE) method. Results Using SDR≥0.4 as threshold, RVs were partitioned by sex for most enzymes, creatinine, uric acid (UA), bilirubin, immunoglobulin-M. MRA revealed age and body mass index (BMI) as major source of variations of many analytes. LAVE lowered the upper limits of RIs for alanine/aspartate aminotransferase, γ-glutamyl transaminase and lipids. Exclusion of individuals with BMI≥30 further lowered the RIs for lipids and CRP. After standardization based on value-assigned serum panel provided by C-RIDL, Ghanaian RIs were found higher for creatine kinase, amylase, and lower for albumin and urea compared to other collaborating countries. Conclusions The LAVE effect on many clinical chemistry RIs supports the need for the secondary exclusion for reliable derivation of RIs. The differences in Ghanaian RIs compared to other countries underscore the importance of country specific-RIs for improved clinical decision making.
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- 2022
20. Is There an Association between the Type of Activities and Respiratory Disorders among e-Waste Workers? Case of Two Major Cities in West Africa
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Parfait Houngbégnon, Marius Kêdoté, Eloïc Atindégla, Fadel Tanimomon, Alphonse Kpozéhouen, Jérôme Sossa, Joaquin Darboux, Edgard-Marius Ouendo, and Julius Fobil
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General Engineering ,Energy Engineering and Power Technology - Published
- 2022
21. COVID-19 Outbreak Control Strategies and their Impact on the Provision of Essential Health Services in Ghana: An Explanatory-Sequential Study
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Duah Dwomoh, Isaac Yeboah, Rawlance Ndejjo, Steven Ndugwa Kabwama, Justice Moses Aheto, Anne Liu, Siobhan Lazenby, Fidelia Ohemeng, Sylvia Akpene Takyi, Ibrahim Issah, Serwaa Akoto Bawuah, Rhoda K. Wanyenze, and Julius Fobil
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BackgroundThe COVID-19 pandemic has led to substantial interruptions in critical health services, with 90% of countries reporting interruptions in routine vaccinations, maternal health care and chronic disease management. The use of non-pharmaceutical interventions (NPIs) such as lockdowns and self-isolation had implications on the provision of essential health services (EHS). We investigated exemplary COVID-19 outbreak control strategies and explored the extent to which the adoption of these NPIs affected the provision of EHS including immunization coverage and facility-based deliveries. Finally, we document core health system strategies and practices adopted to maintain EHS during the early phase of the pandemic.MethodsThis study used an explanatory sequential study design. First, we utilized data from routine health management information systems to quantify the impact of the pandemic on the provision of EHS using interrupted time series models. Second, we explored exemplary strategies and health system initiatives that were adopted to prevent the spread of COVID-19 infections while maintaining the provision of EHS using in-depth interviews with key informants including policymakers and healthcare providers.ResultsThe COVID-19 pandemic and the interventions that were implemented disrupted the provision of EHS. In the first month of the COVID-19 pandemic, Oral Polio and pentavalent vaccination coverage reduced by 15.2% [95% CI = −22.61, −7.87, pConclusionThe implementation of different NPIs during the peak phase of the pandemic disrupted the provision of EHS. However, the Ministry of Health leveraged the resilient health system and deployed efficient, all-inclusive, and integrated infectious disease management and infection prevention control strategies to maintain the provision of EHS while responding to the spread of infections.
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- 2022
22. Pollution de l’air et comportement à risque des employés de boulangerie à Abidjan (Côte d’Ivoire)
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Leandre, Konan Loukou, primary, Rosine, Kouadio Ahou, additional, Laure, Essis Marie, additional, Marius, Kedote, additional, Julius, Fobil, additional, and Issaka, Tiembre, additional
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- 2022
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23. Knowledge, Practices, and Environmental and Occupational Health Risks Associated with Electronic Waste Recycling in Cotonou, Benin
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M. G. Karel Houessionon, Benjamin Fayomi, Catherine Bouland, Edgard-Marius Ouendo, N. Marius Kedote, N. Julius Fobil, and Niladri Basu
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Itchy skin ,Demographics ,business.industry ,Environmental health ,Medicine ,business ,Electronic waste recycling ,Personal protective equipment ,Occupational safety and health ,Material recovery - Abstract
Objective: The e-waste recycling is increasing worldwide, yet there remain outstanding environmental and occupational health concerns. Most research conducted on e-waste recycling has focused on only few countries (e.g., China, Ghana), thus there is a need to increase understanding of e-waste workers’ (recyclers’) knowledge and practices in other locations, that is purpose of this study. Methods: In a cross-sectional study conducted in Cotonou, Benin, 45 e-waste recyclers were interviewed from September to November 2018. Survey data was collected concerning their demographics, professional practices, and knowledge of occupational and environmental risks associated with e-waste recycling. Results: Most participants reported the following methods of material recovery of electronic items in declining orders: dismantling (97.8%) > sorting (91.1%) > incinerating (88.9%). Only 44.2% of the recyclers reported wearing ≥ 1 piece of personal protective equipment (PPE). More than 90% of e-waste workers noted that they disposed the e-waste in natural sites. About half, 46.7% believed that e-waste can pollute water and 71.1% considered that it can pollute air and soil. Recyclers reported several diseases including respiratory (67.4%), heart (62.8%), eye (65.1%), kidney (41.9%) and cancers (30.2%) could be linked to their work, respectively. Interestingly, we also found associations between the number of electronic items dismantled per month and self-report symptoms from the e-waste recyclers such as finding blood in urine and stool, wounds, dizziness, and itchy skin. Our results also indicated associations between the number of hours worked per day and blood in urine, dizziness, itchy skin and airway obstruction. Conclusion: To our knowledge this is the first study to interview e-waste workers in Benin. Doing this increase understanding of their work practices and knowledge to help inform intervention and prevention activities.
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- 2021
24. Methylmercury Measurements in Dried Blood Spots from Electronic Waste Workers Sampled from Agbogbloshie, Ghana
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Niladri Basu, Julius Fobil, and Andrea Santa Rios
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Ethical issues ,Health, Toxicology and Mutagenesis ,Mercury ,Methylmercury Compounds ,Method development ,Ghana ,Electronic Waste ,chemistry.chemical_compound ,chemistry ,Total hg ,Environmental chemistry ,Biomonitoring ,Environmental Chemistry ,Environmental science ,Humans ,Dried Blood Spot Testing ,Dried blood ,Methylmercury - Abstract
Biomonitoring methylmercury (MeHg) exposure is problematic in resource-limited settings and with difficult-to-access populations where traditional biomarker approaches present logistical, economic, and ethical issues. The present study aimed to validate the use of dried blood spots (DBS) to assess MeHg exposure in a real-world contaminated field setting. Whole-blood and DBS samples were collected from electronic waste workers (n = 20) from Agbogbloshie (Ghana) in 2017, and DBS were also artificially created in the laboratory using the field-collected blood. Whole-blood MeHg concentrations averaged 0.84 µg/L, which was not different from levels measured in the corresponding DBS samples (field-collected or artificially created). Whole-blood MeHg comprised 61% of the blood total Hg concentrations. Linear regression analysis revealed no differences in MeHg concentrations between whole-blood samples and field-collected DBS (slope 0.89, R2 = 0.94) and between field and laboratory DBS (slope 0.89, R2 = 0.96). The MeHg content in DBS punch blanks averaged 0.86 pg and thus was not of concern. These findings indicate that DBS are a suitable tool for assessing MeHg exposure in real-world environmental settings that may be heavily contaminated. Environ Toxicol Chem 2021;40:2183-2188. © 2021 SETAC.
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- 2021
25. Lead (Pb) exposure assessment in dried blood spots using Total Reflection X-Ray Fluorescence (TXRF)
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Julius Fobil, Niladri Basu, and Verónica Rodríguez-Saldaña
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Accuracy and precision ,Population ,X-ray fluorescence ,010501 environmental sciences ,01 natural sciences ,Biochemistry ,Article ,03 medical and health sciences ,0302 clinical medicine ,Humans ,030212 general & internal medicine ,education ,0105 earth and related environmental sciences ,General Environmental Science ,Exposure assessment ,Whole blood ,Detection limit ,education.field_of_study ,Chromatography ,Venipuncture ,Spots ,X-Rays ,Lead ,Environmental science ,Dried Blood Spot Testing ,Biological Monitoring - Abstract
Lead (Pb) exposure is often determined through the analysis of whole blood though venipuncture poses ethical, economic, and logistical barriers. Dried Blood Spots (DBS) may help overcome such barriers though past studies measuring Pb in DBS have been challenged with quality control, small sample volumes, and other issues. Total Reflection X-Ray Fluorescence (TXRF) may help address some of these challenges but has yet to be used to measure Pb in DBS. As such, the aim of the current study was to develop, validate, and apply a method to analyze Pb in DBS samples using TXRF for use in human biomonitoring studies. First, we developed a novel method (tested a range of parameters), and then used blood reference materials to validate the method against performance criteria listed in ICH Q2A and Q2B and the European Bioanalysis Forum. Finally, we applied the method to two populations who exemplify divergent conditions (41 university members with relatively low Pb exposures sampled in a clinical environment; 40 electronic waste workers with relatively high Pb exposures sampled in a contaminated field setting). The limits of detection and quantification of the method were 0.28 and 0.69 μg/dL, respectively. The overall precision and accuracy of the method were 15% and 111%, respectively. The mean (±SD) DBS Pb levels by TXRF in the university members and e-waste workers were 0.78 (±0.46) and 3.78 (±3.01) μg/dL, respectively, and these were not different from Pb measures in venous whole blood using ICP-MS. Bland-Altman plot analyses indicated good agreement between DBS Pb measures by TXRF versus whole blood Pb measures by ICP-MS in both groups. By combining data from the two population groups, there was no significant constant bias (intercept of 0.02 μg/dL) or proportional bias (slope was −0.02) between the two measures, and the lower and upper LoA were −0.86 and 0.91 μg/dL, respectively, with a LoA range of 1.77 μg/dL. These results demonstrate that TXRF-based analysis of Pb content in DBS is a good alternative to the gold standard (i.e., ICP-MS analysis of whole blood), and helps overcome some of the challenges associated with current methods.
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- 2020
26. Perceived Stress at Work and Associated Factors among E-Waste Workers in French-Speaking West Africa
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Nonvignon Marius Kêdoté, Ghislain Emmanuel Sopoh, Steve Biko Tobada, Aymeric Joaquin Darboux, Pérince Fonton, Marthe Sandrine Sanon Lompo, and Julius Fobil
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Adult ,associated factors ,perceived stress ,e-waste ,Health, Toxicology and Mutagenesis ,Public Health, Environmental and Occupational Health ,work ,West Africa ,Middle Aged ,Electronic Waste ,Article ,Africa, Western ,Young Adult ,Cross-Sectional Studies ,Medicine ,Humans ,Recycling ,Stress, Psychological - Abstract
Perceived stress at work is an important risk factor that affects the mental and physical health of workers. This study aims to determine the prevalence and factors associated with perceived stress in the informal electronic and electrical equipment waste processing sector in French-speaking West Africa. From 14 to 21 November 2019, a cross-sectional survey was carried out among e-waste workers in five countries in the French-speaking West African region, and participants were selected by stratified random sampling. Participants were interviewed on socio-demographic variables and characteristics related to e-waste management activities using a questionnaire incorporating Cohen’s Perceived Stress Scale (10-item version). Factors associated with perceived stress were determined by multivariate logistic regression. A total of 740 e-waste workers were interviewed. The mean age of the workers was 34.59 ± 11.65 years, with extremes of 14 and 74 years. Most of the interviewees were repairers (43.11%). The prevalence of perceived stress among the e-waste workers was 76.76%. Insufficient income, number of working days per week, perceived violence at work, and the interference of work with family responsibilities or leisure were the risk factors that were the most associated with perceived stress. The high prevalence of perceived stress and its associated factors call for consideration and improvement of the working conditions of e-waste workers.
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- 2022
27. High uptake of Intermittent Preventive Treatment of malaria in pregnancy is associated with improved birth weight among pregnant women in Ghana
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Isabella Quakyi, Bernard Tornyigah, Pascal Houze, Kwadwo A. Kusi, Nathaniel Coleman, Guillaume Escriou, Amos Laar, Michel Cot, Julius Fobil, Gloria Quansah Asare, Philippe Deloron, Abraham K. Anang, Gilles Cottrell, Michael F. Ofori, and Nicaise Tuikue Ndam
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Adult ,Adolescent ,Epidemiology ,Plasmodium falciparum ,lcsh:Medicine ,Ghana ,Article ,Cohort Studies ,Young Adult ,Pregnancy ,Sulfadoxine ,parasitic diseases ,Prevalence ,Birth Weight ,Humans ,lcsh:Science ,lcsh:R ,Middle Aged ,Malaria ,Drug Combinations ,Pyrimethamine ,Pregnancy Complications, Parasitic ,Multivariate Analysis ,Linear Models ,lcsh:Q ,Female - Abstract
Despite the clinically proven advantages of intermittent preventive treatment of malaria in pregnancy (IPTp) with sulfadoxine-pyrimethamine (SP), utilisation has been low in many African countries. To increase uptake and achieve the desired effect, the World Health Organization revised the policy to a monthly administration. Assessing the coverage and impact of the revised policy on pregnancy and neonatal outcomes is, therefore, a necessity. A 2-parallel cross-sectional hospital-based study was carried out among pregnant women attending first antenatal care (ANC) and delivery. Maternal and cord blood samples were assayed for malaria parasites by quantitative PCR targeting both the 18S rDNA and the acidic terminal segment of Plasmodium falciparum var genes, and plasma SP levels were measured by liquid chromatography coupled to tandem mass spectrometry. Parasite prevalence was similar between the two study sites but decreased significantly between the first ANC (9% or 43%) and delivery (4% or 11%) based on the qPCR target. At delivery, 64.5% of women received ≥3 IPTp-SP dose, 15.5% received 2 doses and 6% had 1 dose. Taking ≥3 IPTp-SP doses was associated with an average birth weight increase of more than 0.165 kg. IPTp-SP uptake was associated with plasma SP level at delivery (OR = 32.3, p ≤ 0.005, 95% CI (13.3;78.4) for those that reported ≥3 IPTp-SP doses) while the same trend of improved birth weight was observed with high plasma SP levels. The new IPTp policy is well implemented and well utilised by women in the sites considered in this study and translates to the improved birth weight observed. This study confirms the interest and the clinical benefit expected from this policy change.
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- 2019
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