Amos Laar

Overweight and obesity epidemic in Ghana—a systematic review and meta-analysis

BackgroundIn many low and middle income countries (LMICs), the distribution of adulthood nutritional imbalance is shifting from a predominance of undernutrition to overnutrition. This complex problem poses a huge challenge to governments, non-state actors, and individuals desirous of addressing the problem of malnutrition in LMICs. The objective of this study was to systematically review the literature towards providing an estimate of the prevalence of overweight and obesity among adult Ghanaians.MethodsThis study followed the recommendations outlined in the PRISMA statement. Searches were performed in PubMed, Science Direct, google scholar, Africa Journals Online (AJOL) and the WHO African Index Medicus database. This retrieved studies (published up to 31st March 2016) that reported overweight and obesity prevalence among Ghanaians. All online searches were supplemented by reference screening of retrieved papers to identify additional studies.ResultsForty-three (43) studies involving a total population of 48,966 sampled across all the ten (10) regions of Ghana were selected for the review. Our analysis indicates that nearly 43% of Ghanaian adults are either overweight or obese. The national prevalence of overweight and obesity were estimated as 25.4% (95% CI 22.2–28.7%) and 17.1% (95% CI = 14.7–19.5%), respectively. Higher prevalence of overweight (27.2% vs 16.7%) and obesity (20.6% vs 8.0%) were estimated for urban than rural dwellers. Prevalence of overweight (27.8% vs 21.8%) and obesity (21.9% vs 6.0%) were also significantly higher in women than men. About 45.6% of adult diabetes patients in Ghana are either overweight or obese. At the regional level, about 43.4%, 36.9%, 32.4% and 55.2% of residents in Ashanti, Central, Northern and Greater Accra region, respectively are overweight or obese. These patterns generally mimic the levels of urbanization. Per studies’ publication years, consistent increases in overweight and obesity prevalence were observed in Ghana in the period 1998–2016.ConclusionsThere is a high and rising prevalence of overweight and obesity among Ghanaian adults. The possible implications on current and future population health, burden of chronic diseases, health care spending and broader economy could be enormous for a country still battling many infectious and parasitic diseases. Public health preventive measures that are appropriate for the Ghanaian context, culturally sensitive, cost-effective and sustainable are urgently needed to tackle this epidemic.

Predictors of fetal anemia and cord blood malaria parasitemia among newborns of HIV-positive mothers

BackgroundMalaria and HIV infections during pregnancy can individually or jointly unleash or confound pregnancy outcomes. Two of the probable outcomes are fetal anemia and cord blood malaria parasitemia. We determined clinical and demographic factors associated with fetal anemia and cord blood malaria parasitemia in newborns of HIV-positive women from two districts in Ghana.ResultsWe enrolled 1,154 antenatal attendees (443 HIV-positive and 711 HIV-negative) of which 66% were prospectively followed up at delivery. Maternal malaria parasitemia, and anemia rates among HIV+ participants at enrolment were 20.3% and 78.7% respectively, and 12.8% and 51.6% among HIV- participants. Multivariate linear and logistic regression models were used to study associations. Prevalence of fetal anemia (cord hemoglobin level < 12.5 g/dL) and cord parasitemia (presence of P. falciparum in cord blood at delivery) were 57.3% and 24.4% respectively. Factors found to be associated with fetal anemia were maternal malaria parasitemia and maternal anemia. Infant cord hemoglobin status at delivery was positively and significantly associated with maternal hemoglobin and gestational age whilst female gender of infant was negatively associated with cord hemoglobin status. Maternal malaria parasitemia status at recruitment and female gender of infant were positively associated with infant cord malaria parasitemia status.ConclusionsOur data show that newborns of women infected with HIV and/or malaria are at increased risk of anemia and also cord blood malaria parasitemia. Prevention of malaria infection during pregnancy may reduce the incidence of both adverse perinatal outcomes.

Preferred Interpersonal Distances: A Global Comparison

Human spatial behavior has been the focus of hundreds of previous research studies. However, the conclusions and generalizability of previous studies on interpersonal distance preferences were limited by some important methodological and sampling issues. The objective of the present study was to compare preferred interpersonal distances across the world and to overcome the problems observed in previous studies. We present an extensive analysis of interpersonal distances over a large data set (N = 8,943 participants from 42 countries). We attempted to relate the preferred social, personal, and intimate distances observed in each country to a set of individual characteristics of the participants, and some attributes of their cultures. Our study indicates that individual characteristics (age and gender) influence interpersonal space preferences and that some variation in results can be explained by temperature in a given region. We also present objective values of preferred interpersonal distances in different regions, which might be used as a reference data point in future studies.

Motivations for food prohibitions during pregnancy and their enforcement mechanisms in a rural Ghanaian district

BackgroundFood taboos are known from virtually all human societies and pregnant women have often been targeted. We qualitatively assessed food taboos during pregnancy, its motivating factors, and enforcement mechanisms in the Upper Manya Krobo district of Ghana.MethodsThis was an exploratory cross sectional study using qualitative focus group discussions (FGDs). Sixteen FGDs were conducted. Participants were purposively selected using the maximum variation sampling technique. Tape recorded FGDs were transcribed verbatim and analyzed using Malterudian systematic text condensation technique.ResultsAll the participants were aware of the existence of food prohibitions and beliefs targeting pregnant women in Upper Manya Krobo. The study identified snails, rats, hot foods, and animal lungs as tabooed during pregnancy. Adherence motivators included expectation of safe and timely delivery, avoidance of “monkey babies” (deformed babies); respect for ancestors, parents, and community elders. Enforcement mechanisms identified included constant reminders by parents, family members and significant others. Stigmatization and community sanctions are deployed sparingly.ConclusionsFood taboos and traditional beliefs targeting pregnant women exist in Upper Manya Krobo. Pregnant women are forbidden from eating snails, rats, snakes, hot foods and animal lungs. To a large extent, socio-cultural, and to a lesser, health concerns motivate the practice.

NUTRITIONAL STATUS OF SCHOOL-AGE CHILDREN IN THE NKWANTA SOUTH DISTRICT - VOLTA REGION OF GHANA

This research theme is the impact of the proactive transfer of motor learning between handball and basketball; carry out of the first year of secondary school pupils (15-17 years) of high school IdrisSenouci of Mostaganem city (Algeria). This study aimed to show the existence of a reciprocal proactive transfer of motor learning in the subsequent practice between handball and basketball in the direction of basketball to handball. For this, I hypothesized that there is a reciprocal proactive transfer motor learning engine between handball and basketball in favour of the sense of basketball to handball. To realize this study, I selected a systematic sample of 184 pupils’ boys and girls representing 36.44% of the population retort on four groups, two experimental and two controls to compare their results. And in order to measure the impact of reciprocal proactive transfer of motor learning between handball and basketball, I have conceived an experience based on the experimental protocol of Schmidt (1975) which compares between the performances of an experimental group to those of the control group. Thus, and after analyzing the results of the experiment, it is proved that the proactive transfer of motor learning was embodied in the sense of basketball to handball depending on three statistical means that are the T Students, the percentage of development, and the transfer index of Murdock.

Reproductive rights and options available to women infected with HIV in Ghana: perspectives of service providers from three Ghanaian health facilities.

BackgroundOwing to improved management of HIV and its associated opportunistic infections, many HIV-positive persons of reproductive age are choosing to exercise their right of parenthood. This study explored the knowledge of health workers from two Ghanaian districts on the reproductive rights and options available to HIV-positive women who wish to conceive.MethodsFacility-based cross-sectional in design, the study involved the entire population of nurse counselors (32) and medical officers (3) who provide counseling and testing services to clients infected with HIV. Both structured and in-depth interviews were conducted after informed consent.ResultsTwo main perspectives were revealed. There was an overwhelmingly high level of approbation by the providers on HIV-positive women’s right to reproduction (94.3%). At the same time, the providers demonstrated a lack of knowledge regarding the various reproductive options available to women infected with HIV. Site of facility, and being younger were associated with practices that violated client’s right to contraceptive counseling (p < 0.05) in each case. Some of the providers openly expressed their inability to give qualified guidance to HIV-positive women on the various reproductive options.ConclusionsTaken together, these findings suggest that many HIV-positive clients do not receive comprehensive information about their reproductive options. These findings highlight some of the problems that service providers face as HIV counselors. Both service providers and policy makers need to recognize these realities and incorporate reproductive health issues of HIV-persons into the existing guidelines.

Housing and Health Outcomes of persons living with HIV/AIDS (PLWHAs) in the Lower Manya Krobo District, Ghana

Objective. Although emerging in Western industrialized societies, limited research exists on the links between housing and health outcomes for persons living with HIV/AIDS (PLWHAs) in sub-Saharan Africa (SSA). Methods. Using survey data collected from 605 PLWHAs in the Lower Manya Krobo district of Ghana, this paper examined the effects of housing structure, arrangements, accessibility and conditions on the physical and psychological/emotional health of respondents. Results. Results indicate that housing variables have independent effects on health outcomes, controlling for socio-economic and demographic variables. Respondents living in poor housing structures and deplorable housing conditions had poorer physical and psychological health scores. Conclusion. The findings suggest that it is relevant to think about houses occupied by PLWHAs as important sources of health inequality.

Capacity for scaling up nutrition: a focus on pre-service training in West Africa and a Ghanaian case study.

The 2013 Lancet series on maternal and child nutrition is identified and advocated for improved institutional and human capacity in nutrition towards scaling up nutrition (SUN) in countries with high stunting rates. Of the fifty-four countries with high burden of child undernutrition who have committed to the SUN movement, thirty-six are in Africa. In the present paper, the academic platform of the SUN movement in Ghana presents an overview of nutrition pre-service capacity in West Africa with a focus on Ghana. The present paper is based on the findings of a sub-region-wide assessment of degree programmes in nutrition in West Africa, plus another report on pre-service nutrition capacity in diploma awarding nursing and nutrition programmes in Ghana. Although there is inadequate evidence on pre-service nutrition training in the sub-region, the two reports provide useful evidence for action, including inadequate number and distribution of pre-service nutrition training programmes, low nutrition graduate output, poor quality of the programme curriculum and instruction, and sub-optimal capital investment. The present paper calls for urgent action to improve pre-service nutrition capacity building as a critical step towards SUN in West Africa.

Partner notification in the context of HIV: an interest-analysis

Codes of confidentiality play an essential role in the intimate discourses in many learned professions. Codes with various prescriptions exist. The Hippocratic Oath for example, prescribes rewards to the secret keeper, for keeping secret what ought to be kept secret, and punishments for failing. In public health practice, partner notification, arguably is one endeavor that tests the durability of this secret keeping doctrine of the health professional. We present an interest-analysis of partner notification in the context of HIV service rendition. Using principles-based analysis, the interests of the individual, the state/public health, and the bioethicist’s are discussed. The public health interests in partner notification, which are usually backed by state statutes and evidence, are premised on the theory that partners are entitled to knowledge. This theory posits that knowledge empowers individuals to avoid continuing risks; knowledge of infection allows for early treatment; and that knowledgeable partners can adapt their behavior to prevent further transmission of infection to others. However, persons infected with HIV often have counter interests. For instance, an infected person may desire to maintain the privacy of their health status from unnecessary disclosure because of the negative impacts of disclosure, or because notification without a matching access to HIV prevention and treatment services is detrimental. The interest of the bioethicist in this matter is to facilitate a resolution of these conflicted interests. Our analysis concludes that governmental interests are not absolute in comparison with the interests of the individual. We reiterate that any effort to morally balance the benefits of partner notification with its burdens ought to first recognize the multivalent nature of the interests at play.

Evaluation of facilitative supervision visits in primary health care service delivery in Northern Ghana.

BackgroundIn Ghana’s health delivery services, facilitative supervisory visit (FSV) as a system of management is new. This paper presents the standard evaluation results of FSV, which formed an integral part of the community-based health planning services (CHPS) initiative.MethodsThe study was conducted in the Upper West Region of Ghana. The Project developed guidelines and tools for FSV for four different health system levels – regional, district, sub-district and community levels. Electronic data from all four levels representing quarterly results were compiled into their annual equivalents, and summarized graphically for comparison.ResultsThe data show that all the nine districts embraced the FSV concept even though they differed markedly with regard to the degree of adherence to some set benchmarks. Three DHMTs (Wa Municipal, Lawra and Jirapa) were graded as good while the remaining six DHMTs were adjudged as fair in relation to management of supplies, transport and equipment, information, meeting, and technical support.ConclusionsThe data further suggest that there is much to gain both individually and institutionally from FSVs. Generally, FSVs are crucial to the delivery of primary health care services in especially rural areas.