Following the London declaration on neglected tropical diseases (NTDs) in 2012 and inspired by the WHO 2020 roadmap to control or eliminate NTDs, the Global Programme to Eliminate Lymphatic Filariasis (GPELF) intensified preventive chemotherapy and management of morbidity as the two main strategies to enhance progress towards the elimination of lymphatic filariasis (LF). This paper focuses on current perspectives of mass drug administration (MDA) towards the elimination of LF. The goal of MDA is to reduce the density of parasites circulating in the blood of infected persons and the intensity of infection in communities to levels where transmission is no longer sustainable by the mosquito vector. Three drugs, diethylcarbamazine, albendazole, and ivermectin are currently available for LF treatment, and their effectiveness and relative safety have opened the possibility of treating the entire population at risk. Currently, almost all LF endemic countries rely on the single-dose two-drug regimen recommended by the GPELF to achieve elimination. The 4th WHO report on NTDs has indicated that considerable progress has been made towards elimination of LF in some countries while acknowledging some challenges. In this review, we conclude that the 2020 elimination goal can be achieved if issues pertaining to the drug distribution, health system and implementation challenges are addressed.

Objectives:Timely and accurate health data are important for objective decision making and policy formulation. However, little evidence exists to explain why poor quality routine health data persist. This study examined the constraints to data reporting for the lymphatic filariasis mass drug administration programme in two districts in Ghana. This qualitative study focused on timeliness and accuracy of mass drug administration reports submitted by community health volunteers.Methods:The study is nested within a larger study focusing on the feasibility of mobile phone technology for the lymphatic filariasis programme. Using an exploratory study design, data were obtained through in-depth interviews (n = 7) with programme supervisors and focus group discussions (n = 4) with community health volunteers. Results were analysed using thematic content analysis.Results:Reasons for delays in reporting were attributed to poor numeracy skills among community health volunteers, difficult physical access to communities, high supervisor workload, poor adherence reporting deadlines, difficulty in reaching communities within allocated time and untimely release of programme funds. Poor accuracy of data was mainly attributed to inadequate motivation for community health volunteers and difficulty calculating summaries.Conclusion:This study has shown that there are relevant issues that need to be addressed in order to improve the quality of lymphatic filariasis treatment coverage reports. Some of the factors identified are problems within the health system; others are specific to the community health volunteers and the lymphatic filariasis programme. Steps such as training on data reporting should be intensified for community health volunteers, allowances for community health volunteers should be re-evaluated and other non-monetary incentives should be provided for community health volunteers.

Background. The Ghana Demographic and Health Survey 2014 report indicates that anemia among women in their reproductive age in the country stood at 42 percent, making it a severe public health problem according to the World Health Organization (WHO) classification. WHO Global Observatory data indicates that some sub-Saharan African countries have been able to reduce the prevalence of anemia among women of reproductive age compared to Ghana in 2016. To inform policy decisions, data from the Demographic and Health Surveys 2014–2018 were analyzed to determine the disparities in the prevalence of anemia and related factors among women of reproductive age in Ghana, Ethiopia, Uganda, Tanzania, and Rwanda. Methods. This research utilized data from the Demographic and Health Surveys 2014, 2016, 2014-2015, 2015-2016, and 2016 from Ghana, Ethiopia, Rwanda, Tanzania, and Uganda, respectively. Respondents were women aged between 15 and 49 years. Hemoglobin levels were measured by HemoCue hemoglobin meter. 45,299 women data were extracted from the five countries with 4,644, 14,923, 6,680, 13,064, and 5,988 from Ghana, Ethiopia, Rwanda, Tanzania, and Uganda, respectively. Association between anemia and selected predictive variables was assessed using Pearson’s chi-square test statistic. Poisson regression with robust standard errors was used to estimate the prevalence rate ratios of developing anemia. The deviance goodness of fit test was employed to test the fit of the Poisson model to the data set. Results. There was a statistically significant difference in prevalence of 1,962 (42.3%), 3,527 (23.6%), 1,284 (19.3%), 5,857 (44.8%), and 1,898 (31.7%) for Ghana, Ethiopia, Rwanda, Tanzania, and Uganda, respectively, χ 2 = 2,181.86 and p value < 0.001. Parity, pregnancy status, and contraceptives significantly increased the prevalence rate ratio of a woman developing anemia. Women in Ethiopia with a parity of six or more were 58% more likely to develop anemia than those with parity of zero. Tanzanian women who were pregnant had a 14% increased rate ratio of developing anemia. Factors that significantly decreased anemia in this study were wealth index, women’s age, and women’s highest level of education. Women who were in the higher education category in Ethiopia were 57% less likely to develop anemia. Ugandan women in the richest category of the wealth index were 28% less likely to develop anemia. Rwandan women in the middle category of the wealth index were 20% less likely to develop anemia. Women who were within the 45-49 age category in Ethiopia were 48% less likely to develop anemia. Conclusion. The individual country governments should encourage the implementation of increasing female enrollment in higher education. Women in their reproductive age should be encouraged to use modern contraceptives to reduce their anemia prevalence.

Background. In order for stakeholders of HIV and AIDS to effectively plan HIV prevention programs, it is expedient to assess the level of individuals’ knowledge on the most common preventive methods and misconceptions of the HIV virus. This study examines the trends and determinants of comprehensive knowledge (CK) of HIV and AIDS among Ghanaians from 1998–2014. Method. The data used for this study were drawn from the Ghana Demographic Health Surveys (GDHS), 1998–2014. A separate analysis was performed on each survey-year data and GDHS pooled dataset. Additionally, both the male and female datasets were combined. The samples used for the study were 6,389, 10706, 9484, and 13784 representing 1998, 2003, 2008, and 2014, respectively. The pooled dataset consisted of 40363 responses. The Pearson chi-square test and multilevel binary logistic regression analysis were carried out to assess the association between the study variables and CK of HIV and AIDS. Results. CK of HIV and AIDS was found to be lower in women than men (29.24% vs. 37.7%) using the pooled dataset. The Greater Accra region recorded the highest percentage of CK of HIV and AIDS (44.18%), whereas the Northern region recorded the lowest (17.87%) among the 10 administrative regions in Ghana. Comprehensive knowledge of HIV and AIDS was also found to be less likely with an OR of 0.72 (95% CI; 0.65, 0.79, p<0.001) among persons living in rural areas even after controlling for other study variables. There is also a decrease of CK of HIV and AIDS from 37.35% in 2008 to 32.5% in 2014. The lowest percentage (10.75%) of CK of HIV and AIDS among the four survey years was recorded in 1998. Conclusion. There are generally low levels of comprehensive knowledge among the Ghanaian adult population more especially among women. Those residing in rural areas have lower prevalence of CK of HIV and AIDS. To address some of these challenges, there is the need to intensify educational interventions more especially among women and people leaving in rural areas to reverse some of the knowledge gaps and correct the local misconceptions of HIV and AIDS.

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