Bacterial infections caused by multidrug resistant organisms are a major global threat. There is still a knowledge gap on this situation in the Northern Region of Ghana. This study determined the prevalence and resistance profile of bacterial infections. It also identified factors associated with multidrug resistance in the study area. This was a retrospective cross-sectional design and it analyzed data from the samples received at the Tamale Zonal Public Health Reference Laboratory from June 2018 to May 2022. The data were analyzed using the R software version 4.2.0. Univariate and multivariable binary logistic regression analyses were used to determine the factors associated with multidrug resistance. The samples included all specimen types possible. The specimens were collected for the purpose of clinical bacteriology diagnostics. Overall a total of 1222 isolates were obtained. The three (3) main bacteria responsible for infections were: Klebsiella spp. (27%), Moraxella spp. (22%), Escherichia spp. (16%). High resistance levels were found against the tested antibiotics and about 41.60% of the bacterial strains isolated were multidrug resistant. Hospitalization was associated with multidrug resistance in univariate (COR 1.96; 95% CI 1.43–2.71; P-value < 0.001) and multivariable analyses (AOR 1.78; 95% CI 1.28–2.49; P-value < 0.001). There is the need for further research on the molecular epidemiology of antibiotic resistance genes in the study area to effectively control the spread of multidrug resistant pathogens. In addition, efforts to build the capacity of health professionals on infection prevention and control as well as diagnostic and antimicrobial stewardship needs urgent attention.
Background Serogroup A Neisseria meningitidis was the major cause of meningococcal meningitis epidemics in the African meningitis belt before 2010 when the monovalent meningococcal A conjugate vaccine (MenAfriVac) was introduced in the region. Therefore, this study aimed to establish the trends in N. meningitidis serogroups from 2016 to 2020 in Ghana’s meningitis belt. Methods Polymerase chain reaction (PCR) confirmed laboratory results of suspected cases of cerebrospinal meningitis from January, 2016 to March, 2020 were obtained from the Tamale Public Health Laboratory. The data were subjected to trend analysis using Statistical Package for the Social Sciences version 25. Differences between discrete variables were analyzed using the Cochran–Armitage trend test. Results Of the 2,426 suspected cases, 395 (16.3%) were confirmed positive for N. meningitidis using PCR. Serogroup X showed a significant upward trend (P < 0.01), and serogroup W showed a downward trend (P < 0.01). However, no significant trend was observed for any other serogroup. Conclusion This study showed the emergence of serogroup X, a non-vaccine type, as the predominant N. meningitidis serogroup in the wake of a declining serogroup W in Ghana’s meningitis belt.
Background: Bacterial meningitis is a dangerous infection that can kill children and adults alike. An estimated 1.2 million instances of bacterial meningitis are anticipated to occur globally each year, despite the discovery of polysaccharide and conjugate vaccines in recent years [1]. The study aimed to find out which bacteria isolates are linked to meningitis and to compare the culture method to the rT-PCR method. Method: This study examined data on bacterial meningitis from the Ghana Health Service's Public Health Division from 2015 to 2019. Patients' information was collected from case-based forms held at the Tamale Public Health and Reference Laboratory. The data from the case-based forms was transcribed into a pre-designed Microsoft Excel template. For analysis, the data was cleaned and loaded into Minitab version 18. Results: There were 2,446 CSM cases documented in all, 34.4 percent were confirmed. Males (52.7%) were more suspected than females (47.3%). Age group 15-44 were affected most (37.5%). The predominant pathogens were Neisseria meningitidis (W135) and Streptococcus pneumoniae (St.1) with NMX, St.14, St.19, and St. 12F/12A/12b as new emerging strains. Notwithstanding that, low NPV (72.6%), NLR (0.69), and sensitivity (31.8%) of culture method for detected pathogens of bacterial meningitis were found to produce a statistically significant false negatives compared to the gold standard (rT-PCR). Conclusion: Emergence of new strains of bacterial meningitis and the false negative results chained out by the culture method is alarming.
Background: Cerebrospinal meningitis (CSM) is a public health burden in Ghana that causes up to 10% mortality of the disease annually. About 20% of those who survive cerebrospinal meningitis suffer permanent sequelae. The study sought to understand the predictive signs and symptoms of bacterial meningitis implicated in its outcomes. Method: Retrospective data from the Public Health Division, Ghana Health Service on bacterial meningitis from 2015 to 2019 used for this study. A pre-tested data extraction form was used to collect patients information from case-based forms kept at the Disease Control Unit from 2015 to 2019. Data were transcribed from the case-based forms into a pre-designed Microsoft Excel template. The data was cleaned and imported into SPSS version 26 for analysis. Results: Between 2015-2019, a total of 2,446 CSM cases were reported. Out of these, 842 were confirmed. Among the confirmed cases, males constituted 55.3%. Children below 14 years of age were most affected (51.4%). The pathogens commonly responsible for bacterial meningitis were Neisseria meningitidis and Streptococcus pneumoniae with their respective strains especially Nm W135, Nm X, Spn St. 1, and Spn St. 12F/12A/12B/44/4 being responsible for most of the confirmed cases. The most predictive sign and symptom for bacterial meningitis was fever (X2=5.738a; p <0.05; AOR=1.303). Identified signs that were associated but less likely to cause disease were abdominal pain (X2=12.038a; p <0.05; AOR=0.597), neck stiffness (X2=6.447a; p <0.05; AOR=0.788), altered consciousness (X2=15.438a; p <0.05; AOR=0.673), and convulsion (X2=15.084a; p <0.05; AOR=0.678). Conclusion: The confirmed cases of bacterial meningitis from 2015 to 2019 had fever as the main predictive symptom. It is therefore noticed that abdominal pain, neck stiffness, altered consciousness and convulsion did not associate with CSM within the study period.
Background: Anemia remains one of the most severe and common public health conditions that predominantly affects children and women across the globe. It is defined as a condition in which the hemoglobin (Hb) concentration is less than 11.0 g/dl particularly in women. The World health organisation report indicated that 20 to 50 percent of the world population was affected by iron deficiency anemia. Method: An institutional cross-sectional study design was the method used through the data collection and management. Information was sought from four selected health centres across the nanton district with systematic sampling deployed to select respondents of interest. A sample of 420 respondents were obtained and processed for analysis. A bivariate and multivariate analysis uncovered the associated factors and its predictiveness. Results: The prevalence of anaemia in totality was 56.0% (95% CI 51.3%, 60.8%). The divergence of the blood concentration levels between the means of the anaemic and non anaemic group was statistically significance (F stat=68.233, t stat= 35.697, p<0.01). The multivariate statistical model showed that, lactating mothers who have suffered malaria episode(s) after delivery had a 94% chance of being anaemic [AOR = 0.054; (95% CI: 0.025, 0.119)]. Lack of post partum iron supplementation increased the risk of having anaemia [AOR = 15.336; (95% CI: 6.112, 38.483)], and lactating mothers had higher risk [AOR = 1.927, (95% CI: 1.031, 3.602)] of developing anaemia with increasing 'child's age beyond three (3) months. Conclusion: Anaemia remains very high in lactating mothers attributable to episodes of postpartum malaria, iron supplementation, and increasing child's age beyond 3 months. There is the need for public health interventions and measures such as extension of folic acid distribution and Intermittent Preventive Therapy (IPT) for malaria program to mothers at postnatal care and child welfare clinics across the region.
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