Ghana AIDS Commission

Background: Effective health management in resource-limited settings requires strategic resource allocation and intervention planning. Pareto analysis, based on the 80/20 rule, aids in identifying key health conditions impacting outpatient morbidity, guiding intervention prioritization and resource optimization. This study applied Pareto analysis on outpatient morbidity data from Goaso Government Hospital, Ghana, to identify common health conditions and improve drug procurement and health promotion strategies. The methodology also serves as a guide for applying Pareto chart analysis to enhance decision-making in healthcare delivery. Methods: A cross-sectional study was conducted analyzing outpatient department (OPD) data from January to December 2023. Data were extracted from the Ghana Health Service Monthly Outpatient Morbidity Reports via the District Health Information Management System 2 (DHIMS 2). Data analysis was conducted using SPSS version 20 to estimate the mean and standard deviation. Microsoft Excel 2016 was employed for Pareto analysis and the creation of column charts. Results: The analysis revealed that female patients had a higher average number of outpatient cases (M = 259, SD = 430.7) compared to male patients (M = 156, SD = 282.5). Key conditions contributing to 80% of the cases included Upper Respiratory Tract Infections (URTIs), Pneumonia, Malaria, Acute Urinary Tract Infections (UTIs), Diarrhoeal diseases, Typhoid Fever, Anaemia, Rheumatism/Arthritis, Skin Diseases, and Septicaemia. Notably, young adults (ages 20-34) and children (ages 1-4) were most affected. Conclusions: A strategic approach to drug procurement is essential due to high disease prevalence. Key actions include maintaining a three-month supply of ACTs for malaria, stocking essential antibiotics, and ensuring a two-month supply of ORS. Utilizing data-driven forecasting and establishing strong supplier partnerships are crucial for optimizing drug availability. Simultaneously, targeted health promotion efforts should focus on respiratory health, malaria prevention, UTIs, WASH practices, anaemia, rheumatism, and skin diseases through public education. Additionally, qualitative research, such as patient interviews and provider surveys, is recommended to understand high morbidity rates and evaluate existing interventions.

Previous studies have suggested high Immunodeficiency Virus (HIV) and hepatitis B virus (HBV) prevalence in prisons in Ghana. However, this study was part of a nationally representative bio-behavioural survey and determined the prevalence of HIV and HBV among prison inmates and identified factors associated with these infections. Both biomedical and behavioural data were collected from a total of 2,443 prison inmates from 19 prison stations during 2013 in Ghana; 12 male prisons and 7 female prisons selected across the country. The national HIV screening algorithm was used for HIV testing while two rapid detection tests were used to confirm HBV infections. HIV and HBV prevalence among prisoners in Ghana were approximately 2.34% and 12.38% respectively. Only 5 inmates, had co-infection with both viruses. The prevalence of HIV was significantly lower among male inmates (1.5%) compared to the female inmates (11.8%). Age, sex, and marital status, were significantly associated with both HIV and HBV infections. However, BMI category, IDU, and time spent in prison were associated with HIV infections. The educational level was significantly associated with HBV infections. After binary logistic regression, being female (AOR: 0.18, 95% CI: 0.07-0.45, p<0.001) and having a stay of 5 years or more (AOR: 0.07, 95% CI: 0.01-0.60, p = 0.016), increased the risk of having HIV infection. While, those with no formal education (AOR: 0.65, 95% CI: 0.45-0.95, p = 0.024) and are underweight (AOR: 0.51, 95% CI: 0.27-0.99, p = 0.046), were more likely to have HBV infection. Forced penetrative sex may be a problem in the prisons. The need to have and strengthen an integrated screening, treatment and vaccination plan for the prison is emphasized. The prison does not serve as an exceptionally high risk to the general population. The findings support a critical look at the issue of forced penetrative sex in the prisons.

BackgroundHIV and negative coping mechanisms have a cyclical relationship. HIV infections may lead to the adoption of coping strategies, which may have undesired, negative consequences. We present data on the various coping mechanisms that HIV-affected households in Ghana resort to.MethodsWe collected data on coping strategies, livelihood activities, food consumption, and asset wealth from a nationally representative sample of 1,745 Ghanaian HIV-affected households. We computed coping strategies index (CSI), effective dependency rate, and asset wealth using previously validated methodologies.ResultsVarious dehumanizing coping strategies instituted by the HIV-affected households included skipping an entire day’s meal (13%), reducing portion sizes (61.3%), harvesting immature crops (7.6%), and begging (5.6%). Two-thirds of the households were asset poor. Asset-poor households had higher CSI than asset-rich households (p <0.001). CSI were also higher among female-headed households and lower where the education level of the household head is higher. Households caring for chronically ill members recorded higher CSI in comparison with their counterparts without the chronically ill (p < 0.05).ConclusionsInstitution of degrading measures by HIV-affected households in reaction to threat of food insecurity was prevalent. The three most important coping strategies used by households were limiting portion size (61.3%), reducing number of meals per day (59.5%) and relying on less expensive foods (56.2%). The least employed strategies included household member going begging (5.6%), eating elsewhere (8.7%) and harvesting immature crop (7.6%).Given that household assets, and caring for the chronically ill were associated with high CSI, a policy focusing on helping HIV-affected households gradually build up their asset base, or targeting households caring for chronically ill member(s) with conditional household-level support may be reasonable.

Poor nutrition is a determinant of death particularly among persons living with HIV (PLHIV). This paper discusses the state of food and nutrition assistance to PLHIV in Ghana. A review of published articles and program reports was done and supported by in-depth interviews with key stakeholders. Data were qualitatively analyzed. A matrix highlighting problems that need to be addressed, possible attributable factors, strengths, and opportunities of existing actions metamorphosed from the analysis. Although stakeholders agree that adequate nutrition is critically important for PLHIV, food and nutrition interventions to PLHIV are inadequate.

The study aims at establishing the trend of Trichomonas vaginalis infections diagnosed at the Komfo Anokye Teaching Hospital (KATH) in Kumasi over an eleven (11) years period (1994 to 2004). The retrospective study involves the yearly distribution of the infection as well as the monthly distribution relating them to the ages and sex. The mean ages of males and females infected were 28.8 and 26.0 years, respectively. The prevalent age groups mostly infected were found to be 18 to 31 for both males and females. The age distribution of T. vaginalis cases from the high vaginal swab (HVS) records gave a standard deviation of 3.47 and the standard deviation of the age distribution for males from the urine routine examination (R/E) was 5.13. Analyses of records of T. vaginalis suggest that even though there has been a drastic decline in &nbsp;prevalence, the infection still persist and requires efforts to ensure its absolute extinction. The monthly distributions did not reveal any particular month in which transmission of the infection remains constantly high. This suggests that the climatic seasons (rainy or dry/cold or warm) have no effect on the rate of transmission. More pragmatic measures are needed to ensure better records keeping of the infection at KATH. New and more efficient methods such as cultures and polymerase chain reaction (PCR) should be employed to increase efficiency in the detection of the organism in patients. Another study is being designed to ascertain the level of T. vaginalis from 2005 to date. &nbsp; Key words:&nbsp;Sexually transmitted infection, Trichomonas vaginalis, Komfo Anokye Teaching Hospital (KATH).

ObjectiveJust as HIV prevention programs need to be tailored to the local epidemic, so should evaluations be country-owned and country-led to ensure use of those results in decision making and policy. The objective of this paper is to describe the process undertaken in Ghana to develop a national evaluation plan for the Ghana national strategy for key populations.MethodsThis was a participatory process that involved meetings between the Ghana AIDS Commission (GAC), other partners in Ghana working to prevent HIV among key populations, and MEASURE Evaluation. The process included three two-day, highly structured yet participatory meetings over the course of 12 months during which participants shared information about on-going and planned data and identified research questions and methods.ResultsAn evaluation plan was prepared to inform stakeholders about which data collection activities need to be prioritized for funding, who would implement the study, the timing of data collection, the research question the data will help answer, and the analysis methods. The plan discusses various methods that can be used including the recommendation for the study design using multiple data sources. It has an evaluation conceptual model, proposed analyses, proposed definition of independent variables, estimated costs for filling data gaps, roles and responsibilities of stakeholders to carry out the plan, and considerations for ethics, data sharing and authorship.ConclusionThe experience demonstrates that it is possible to design an evaluation responsive to national strategies and priorities with country leadership, regardless of stakeholders' experiences with evaluations. This process may be replicable elsewhere, where stakeholders want to plan and implement an evaluation of a large-scale program at the national or subnational level that is responsive to national priorities and part of a comprehensive monitoring and evaluation system.

In industrialized countries, the initiation of antiretroviral therapy (ART) is based on virological, immunological and clinical markers. The objective of this study was to identify treatment gaps when ART initiation is based on clinical staging alone. The method employed was a retrospective study of 5784 patients enrolled in an HIV treatment programme in two urban and two rural sites in Ghana. Of the patients, 29.5% were in clinical Stages I and II and had a CD4+ T-lymphocyte count less than 200 cells/mm(3). Significantly more patients in clinical Stage I from urban sites (37.0%) had a CD4+ T-lymphocyte count less than 200 cells/mm(3) as compared with patients from rural sites (23.8%) (P value <0.05). In addition, more men (39.9%) in clinical Stage I had a CD4+ T-lymphocyte count less than 200 cells/mm(3) when compared with women (27.4%) (P value <0.05). In conclusion, clinical staging cannot identify a relatively large number of patients who need ART. A wider availability of CD4+ T-lymphocyte count testing will optimize the identification of patients eligible for ART.