The Greater Accra Region is the smallest of the 16 administrative regions in Ghana. It is highly populated and characterized by tropical climatic conditions. Although efforts towards malaria control in Ghana have had positive impacts, malaria remains in the top five diseases reported at healthcare facilities within the Greater Accra Region. To further accelerate progress, analysis of regionally generated data is needed to inform control and management measures at this level. This study aimed to examine the climatic drivers of malaria transmission in the Greater Accra Region and identify inter-district variation in malaria burden. Monthly malaria cases for the Greater Accra Region were obtained from the Ghanaian District Health Information and Management System. Malaria cases were decomposed using seasonal-trend decomposition, based on locally weighted regression to analyze seasonality. A negative binomial regression model with a conditional autoregressive prior structure was used to quantify associations between climatic variables and malaria risk and spatial dependence. Posterior parameters were estimated using Bayesian Markov chain Monte Carlo simulation with Gibbs sampling. A total of 1,105,370 malaria cases were recorded in the region from 2015 to 2019. The overall malaria incidence for the region was approximately 47 per 1000 population. Malaria transmission was highly seasonal with an irregular inter-annual pattern. Monthly malaria case incidence was found to decrease by 2.3% (95% credible interval: 0.7–4.2%) for each 1 °C increase in monthly minimum temperature. Only five districts located in the south-central part of the region had a malaria incidence rate lower than the regional average at >95% probability level. The distribution of malaria cases was heterogeneous, seasonal, and significantly associated with climatic variables. Targeted malaria control and prevention in high-risk districts at the appropriate time points could result in a significant reduction in malaria transmission in the Greater Accra Region.

Background Preterm delivery is the birth of a baby before 37 weeks of gestation. This global phenomenon is a critical issue of concern especially in developing countries that are resource-constrained when it comes to the management of preterm babies. Complications associated with prematurity contribute significantly to under-five mortality and are linked with feelings of despair, grief, and anxiety among mothers. Methods This was a qualitative descriptive study in an urban setting in the Greater Accra region of Ghana. Eleven mothers whose babies had been discharged from the neonatal intensive care unit in a major hospital and resided in Accra were interviewed in their homes using a semi-structured interview guide. Data were audiotaped, transcribed verbatim, and analyzed inductively by content analysis. Results All the mothers had formal education and the mean maternal age was 27.9 years. The majority of the mothers were multiparous. The gestational age at birth ranged from 32 to 34 weeks and the average birth weight of their babies was 1.61 kg. Four major themes emerged which included: Around the clock care; mothers’ self-perceptions and attitudes of significant others; mothers’ health and wellbeing; and support. Most of the mothers experienced physical exhaustion from the extra demands involved with care, had negative emotions, and unmet social needs. Conclusions The findings indicate that home management of preterm babies poses multiple stressors and is associated with poor psychological and physical wellbeing among mothers. Hence, the need for extensive education and identification of other social support systems to augment facility-based care for mothers and their preterm babies.

This article has been retracted. Please see the Retraction Notice for more detail: 10.1186/s12884-021-04185-7

Background: Efforts towards malaria control in Ghana have had positive impacts. However, these efforts need to be locally tailored to further accelerate progress. The aim of this study was to examine the climatic drivers of malaria transmission in the Greater Accra Region and identify inter-district variation of malaria burden.Methodology: Monthly malaria cases for the Greater Accra Region were obtained from the Ghanaian District Health Information and Management System from 2015 to 2019. Malaria cases were decomposed using the seasonal-trend decomposition, based on locally weighted regression to analyze the seasonality. A Poisson regression model with a conditional autoregressive prior structure was used to quantify associations between climatic variables and malaria risk, and spatial dependence. Posterior parameters were estimated using Bayesian Markov chain Monte Carlo simulation with Gibbs sampling.Results: A total of 1,105,370 malaria cases was recorded in the region from 2015–2019. The overall malaria incidence rate for the region was approximately 1 per 1,000,000 population. Malaria transmission was highly seasonal with an irregular inter-annual pattern during the study period. Malaria incidence was found to increase by 0.1% (95% credible interval [CrI]: 0.02–0.16%) for a 1°C rise in monthly mean maximum temperature lagged at 6 months and 0.2% (95% CrI: 0.5–0.3%) for 1°C rise in monthly mean minimum temperature without lag. No spatial dependency was observed after accounting for climatic variables. Only five districts located in the south-central part of the region had a malaria incidence rate that was lower than the regional average at > 95% probability level.Conclusion: The distribution of malaria cases was heterogeneous, seasonal and significantly associated with climatic variables. Targeted malaria control and prevention in high-risk districts at the appropriate time points could result in a significant reduction in malaria transmission in the Greater Accra Region.