A model of co-creation: strengthening primary health care (PHC) in Ghana through an innovative "Nyansapo" partnership.

The Africa Health Collaborative (AHC) initiative embarked on a transformative ten-year collaboration with Kwame Nkrumah University of Science and Technology (KNUST) and the University of Toronto (U of T) to co-create continuing education programs geared toward augmenting the proficiency of primary care practitioners in Ghana. While upholding core principles within the AHC framework, emphasizing respect, inclusivity, equity, reciprocity, ethics, dynamism, and stewardship, seven teams of U of T and KNUST faculty engaged in collaborative efforts to design, administer, and evaluate five in-person "short courses" in Ghana on Palliative Care, Quality Improvement for Health Professionals, Prehospital Emergency Care, Community Emergency Care, and Emergency Preparedness and Response to Epidemic-Prone Diseases to approximately 100 Ghanaian primary care professionals. This paper describes a model of co-creation, highlights lessons learned from a robust evaluation process, and proposes that this co-creation model can strengthen primary health care in Ghana and ultimately transform health systems in Africa.

Prevalence and Determinants of Antenatal Depression Risk Among Urban Women Seeking Antenatal Clinical Care at a District Hospital in Ghana.

Aim: To determine the prevalence and factors associated with antenatal depression risk among pregnant women attending antenatal care at a district hospital in Kumasi, Ghana.

Study Design: This was a hospital-based cross-sectional study.

Methods: A questionnaire was used to collect data from 207 pregnant women attending antenatal care at Manhyia District Hospital from September 2020 to November 2020.

Vaccine value profile for invasive non-typhoidal Salmonella disease.

Invasive non-typhoidal Salmonella (iNTS) disease is an under-recognized high-burden disease causing major health and socioeconomic issues in sub-Saharan Africa (sSA), predominantly among immune-naïve infants and young children, including those with recognized comorbidities such as HIV infection. iNTS disease is primarily caused by Salmonella enterica serovar Typhimurium sequence type (ST) 313 and 'African-restricted clades' of Salmonella Enteritidis ST11 that have emerged across the African continent as a series of epidemics associated with acquisition of new antimicrobial resistance. Due to genotypes with a high prevalence of antimicrobial resistance and scarcity of therapeutic options, these NTS serovars are designated by the World Health Organization as a priority pathogen for research and development of interventions, including vaccines, to address and reduce NTS associated bacteremia and meningitis in sSA.

Application of Hierarchical/Multilevel Models and Quality of Reporting (2010-2020): A Systematic Review.

Introduction: Multilevel models have gained immense popularity across almost every discipline due to the presence of hierarchy in most data and phenomena. In this paper, we present a systematic review on the adoption and application of multilevel models and the important information reported on the results generated from the use of these models.

Methods: The review was performed by searching Google Scholar for original research articles on the application of multilevel models published between 2010 and 2020.

Incidence of typhoid fever in Burkina Faso, Democratic Republic of the Congo, Ethiopia, Ghana, Madagascar, and Nigeria (the Severe Typhoid in Africa programme): a population-based study.

Background: Typhoid Fever remains a major cause of morbidity and mortality in low-income settings. The Severe Typhoid in Africa programme was designed to address regional gaps in typhoid burden data and identify populations eligible for interventions using novel typhoid conjugate vaccines.

Methods: A hybrid design, hospital-based prospective surveillance with population-based health-care utilisation surveys, was implemented in six countries in sub-Saharan Africa.

Fever in focus: Symptoms, diagnoses and treatment of febrile children in Ghana-A longitudinal hospital study.

Background: Healthcare resources are often limited in areas of sub-Saharan Africa. This makes accurate and timely diagnoses challenging and delays treatment of childhood febrile illness. We explored longitudinal characteristics related to symptoms, diagnosis and treatment of hospitalised febrile children in a rural area of Ghana highly endemic for malaria.

Validation of prevalent diabetes risk scores based on non-invasively measured predictors in Ghanaian migrant and non-migrant populations - The RODAM study.

Background: Non-invasive diabetes risk models are a cost-effective tool in large-scale population screening to identify those who need confirmation tests, especially in resource-limited settings.

Aims: This study aimed to evaluate the ability of six non-invasive risk models (Cambridge, FINDRISC, Kuwaiti, Omani, Rotterdam, and SUNSET model) to identify screen-detected diabetes (defined by HbA1c) among Ghanaian migrants and non-migrants.

Study Design: A multicentered cross-sectional study.

Awareness of and participation in mass drug administration programs used for onchocerciasis control in the Atwima Nwabiagya North District, Ghana.

Background: Studies on Mass drug administration (MDA) in Ghana targeting various diseases, have mostly focused on factors that affect coverage and compliance to MDA with limited focus on evidence regarding awareness and community perception of the program. Therefore, this study sought to provide empirical evidence on the knowledge of onchocerciasis, and awareness of and participation in the MDA among community members.

Methods: A community-based cross-sectional survey was conducted from August to October 2019 in communities within the Atwima Nwabiagya North District, Ghana.

Determinants of modern contraceptive use among married women and those living with a partner in Ghana.

The objective of the study was to ascertain the determinants of modern contraceptive use in Ghana among married women and those living with a partner. Secondary data from the Performance Monitoring and Accountability 2020 Ghana 2015 survey were used for the study. A multivariate logistic regression analysis was used.

Subgroups of adult-onset diabetes: a data-driven cluster analysis in a Ghanaian population.

Adult-onset diabetes mellitus (here: aDM) is not a uniform disease entity. In European populations, five diabetes subgroups have been identified by cluster analysis using simple clinical variables; these may elucidate diabetes aetiology and disease prognosis. We aimed at reproducing these subgroups among Ghanaians with aDM, and establishing their importance for diabetic complications in different health system contexts.

Sleep and Happiness in Urban-Dwelling Older Adults in Ghana: A Serial Multiple Mediation Model of Generalized Anxiety and Depressive Symptoms.

Objective: Sleep problems (SP) are highly prevalent and seriously affect health and well-being in old age. The aim of this study was to examine the association between SP and happiness in an urban-dwelling older sample. The authors further explore the effects of generalized anxiety and depressive symptoms in the SP-happiness link using serial mediating modeling.

An exploration of stakeholder views and perceptions on taxing tobacco, alcohol and sugar-sweetened beverages in Ghana.

Background: Non-communicable diseases (NCDs) account for nearly 43% of Ghana's all-cause mortality. Unhealthy commodities (such as alcohol, sugar and tobacco) are an important factor in the growing NCD burden in the region of sub-Saharan Africa (SSA). Despite health taxes on tobacco, alcohol and sugar-sweetened beverages (SSBs) gaining renewed attention, adoption and implementation in SSA remain limited.

Examining the risk factors for overweight and obesity among women in Ghana: A multilevel perspective.

Overweight/obesity prevalence is on the increase in epidemic proportions across Low- and Middle-Income countries (LMICs). The public health burden associated with obesity/overweight cannot be underestimated due to its association with chronic health outcomes. This study investigated the individual- and community level risk factors for obesity/overweight among reproductive women.

Cardiovascular Risk Estimation Based on Country-of-Birth- and Country-of-Residence-Specific Scores among Migrants in the Netherlands: The HELIUS Study.

Background: Regional and country-specific cardiovascular risk algorithms have been developed to improve CVD risk prediction. But it is unclear whether migrants' country-of-residence or country-of-birth algorithms agree in stratifying the CVD risk of these populations. We evaluated the risk stratification by the different algorithms, by comparing migrant country-of-residence-specific scores to migrant country-of-birth-specific scores for ethnic minority populations in the Netherlands.

'This disease is not meant for the hospital, it is Asram': Implications of a traditionally-defined illness on healthcare seeking for children under-5 in rural Ashanti, Ghana.

Every child has the right to survive, grow and develop. However, in spite of the considerable global gains that have been made in child survival, Sub-Saharan Africa still has the highest child mortality rates and accounts for the greatest burden of mortality globally. The majority of these children die without ever reaching a health facility.

Extent of illicit cigarette market from single stick sales in Ghana: findings from a cross-sectional survey.

Objective: This study aims to measure the extent of illicit cigarette consumption from single stick sales, to determine the nature and types of illicit cigarettes present in Ghana, and to identify the factors associated with illicit cigarette consumption in Ghana.

Design: A cross-sectional study using empty cigarette packs generated by 1 day's single stick cigarette sales collected from cigarette vendors.

Setting: Five large cities (Accra, Kumasi, Takoradi, Tamale and Bolgatanga) and three border towns (Aflao, Paga/Hamele and Elubo) in the northern, middle and coastal belt of Ghana.

Pathogens associated with hospitalization due to acute lower respiratory tract infections in children in rural Ghana: a case-control study.

Respiratory infections are one of the most common causes of death among children under the age of five years. Data on prevalence and relevance of specific organisms in African children are still lacking. This case-control-study investigated prevalence and relevance of specific organisms in Ghanaian children admitted to hospital with symptoms of lower respiratory tract infection (LRTI).

A two-mediator serial mediation chain of the association between social isolation and impaired sleep in old age.

Poor sleep is a long-term public health issue that has become increasingly prevalent among socially isolated older adults. However, research on the mechanisms explaining the link between social isolation and impaired sleep (IS) remains limited, particularly in low- and middle-income countries. This study explored the serial mediating effects of loneliness and mental distress on the association of social isolation with IS among Ghanaian older adults.

Cohort profile: Research on Obesity and Diabetes among African Migrants in Europe and Africa Prospective (RODAM-Pros) cohort study.

Purpose: The Research on Obesity and Diabetes among African Migrants (RODAM) prospective (RODAM-Pros) cohort study was established to identify key changes in environmental exposures and epigenetic modifications driving the high burden of cardiovascular disease (CVD) risk among sub-Saharan African migrants.

Participants: All the participants in the RODAM cross-sectional study that completed the baseline assessment (n=5114) were eligible for the follow-up of which 2165 participants (n=638 from rural-Ghana, n=608 from urban-Ghana, and n=919 Ghanaian migrants in Amsterdam, the Netherlands) were included in the RODAM-Pros cohort study. Additionally, we included a subsample of European-Dutch (n=2098) to enable a comparison to be made between Ghanaian migrants living in the Netherlands and the European-Dutch host population.

Effectiveness of school-based interventions for preventing tobacco smoking initiation among young people in low- and middle-income countries: a systematic review protocol.

Background: Despite the commendable progress made globally in tobacco control, the world is falling short of achieving a 30% relative reduction in current tobacco use by 2025. The African region remains the least in the efforts in fighting the tobacco epidemic and is most exploited by the tobacco industry. Schools have been continuously used for over three decades as a setting for delivering youth smoking prevention programmes; however, the evidence of the effectiveness of those school-based interventions provides varying outcomes.

Using drones to transport suspected COVID-19 samples; experiences from the second largest testing centre in Ghana, West Africa.

Background: The declaration of COVID-19 as a pandemic on March 11 2020, by the World Health Organisation prompted the need for a sustained and a rapid international response. In a swift response, the Government of Ghana, in partnership with Zipline company, launched the use of Unmanned Automated Vehicles (UAV) to transport suspected samples from selected districts to two foremost testing centres in the country. Here, we present the experiences of employing this technology and its impact on the transport time to the second largest testing centre, the Kumasi Centre for Collaborative Research in Tropical Medicine (KCCR) in Kumasi, Ghana.

Effect of fear appeal mobile phone messaging on health behaviors of caregivers with children under-five in Ghana.

Social and Behavior Change Communication is a vital strategy in the control of malaria. However, the effectiveness of fear appeal tactic as a preventive strategy remains uncertain. This study examined the influence of a fear appeal mobile phone-based intervention, guided by Witte's Extended Parallel Process model, on malaria prevention among caregivers with children under-five.