BackgroundThere is widespread use of Complementary and Alternative Medicine (CAM) in Ghana, driven by cultural consideration and paradigm to disease causation. Whether there is concurrent use of conventional medicine and CAM in cancer patients is unknown. This study investigates the prevalence, pattern and predictors of CAM use in cancer patients. Overlapping toxicity, sources of information, and whether users inform their doctor about CAM use is examined.MethodCross-sectional study using a questionnaire administered to cancer patients, who were receiving radiotherapy and or chemotherapy or had recently completed treatment at a single institution was used.ResultsNinety eight patients participated in the study with a mean age of 55.5 (18–89), made up of 51% females. Married individuals formed 56% of the respondents, whilst 49% had either secondary or tertiary education. Head and neck cancer patients were 15.3%, breast (21.4%), abdomen/pelvic cancers constituted (52%).Seventy seven (78.6%) patients received radiotherapy only, 16.3% received radiation and chemotherapy and 5.3% had chemotherapy only.Ninety five patients were diagnosed of cancer within the past 24 months,73.5% were CAM users as follows; massage(66.3%), herbal(59.2%), mega vitamins(55.1%), Chinese medicine(53.1%),and prayer(42.9%). Sixty eight percent were treated with curative intent. Overlapping toxicity was reported. Majority (83.3%) of users had not informed their doctor about CAM use.On univariate analysis, female (p=0.004) and palliative patients, p=0.032 were more likely to be CAM users. Multivariate analysis identified female (p<0.01), as significant for use, whilst head and neck site was significant for non use (p<0.028). Young, married and highly educated individuals are more likely to use CAM.Friends and Media are the main sources of information on CAM. There was increase in CAM use after the diagnosis of cancer mainly for Chinese Medicine and vitamins.ConclusionThere is high CAM usage among Cancer patients, comparable to use in the general population, there is concurrent use of CAM and conventional medicine with reported overlapping toxicity but without informing Oncologist about use. Women and palliative patients are more likely to use CAM. Doctor patient communication on herbal-radiotherapy and drug treatment interaction needs to be strengthened. Standardization and regulation of CAM use is paramount.

Electronic waste (e-waste) recycling is growing worldwide and raising a number of environmental health concerns. One of the largest e-waste sites is Agbogbloshie (Ghana). While several toxic elements have been reported in Agbogbloshie’s environment, there is limited knowledge of human exposures there. The objectives of this study were to characterize exposures to several essential (copper, iron, manganese, selenium, zinc) and toxic (arsenic, cadmium, cobalt, chromium, mercury, nickel, lead) elements in the urine and blood of male workers (n=58) at Agbogbloshie, as well as females (n=11) working in activities that serve the site, and to relate these exposures to sociodemographic and occupational characteristics. The median number of years worked at the site was 5, and the average worker indicated being active in 6.8 tasks (of 9 key e-waste job categories). Additionally, we categorized four main e-waste activities (in brackets % of population self-reported main activity): dealing (22.4%), sorting (24.1%), dismantling (50%), and burning (3.4%) e-waste materials. Many blood and urinary elements (including essential ones) were within biomonitoring reference ranges. However, blood cadmium (1.2 ug/L median) and lead (6.4 ug/dl; 67% above U.S. CDC/NIOSH reference level), and urinary arsenic (38.3 ug/L; 39% above U.S. ATSDR value) levels were elevated compared to background populations elsewhere. Workers who burned e-waste tended to have the highest biomarker levels. The findings of this study contribute to a growing body of work at Agbogbloshie (and elsewhere) to document that individuals working within e-waste sites are exposed to a number of toxic elements, some at potentially concerning levels.

BackgroundElectronic waste workers are prone to various illnesses and injuries from numerous hazards thus the need for them to seek health care. The aim of this study was to describe health-seeking behavior, and social and other factors affecting this behavior, among electronic waste workers at Agbogbloshie, Accra, Ghana.MethodsIn-depth interviews were conducted and analyzed qualitatively from a grounded theory perspective.ResultsWorkers experienced various kinds of ailments. These included physical injuries, chest and respiratory tract associated symptoms, malaria, headaches, body pains and stomach discomfort. They reported seeking health care from multiple sources, and the main determinants of health seeking behaviour were severity of illness, perceived benefit of treatment, accessibility of service, quality of service, ease of communication with service provider and cost of health care.ConclusionMultiple sources of health care were used by the e-waste workers. As cost was a major barrier to accessing formal health care, most of the workers did not subscribe to health insurance. Since enrollment in health insurance is low amongst the workers, education campaigns on the need to register with the National Health Insurance Scheme would facilitate access to formal health care and could result in improved health outcomes among e-waste workers.

e-waste recycling working conditions were very challenging and presented serious hazards to worker health and wellbeing. Formalizing the e-waste processing activities requires developing a framework of sustainable financial and social security for the e-waste workers, including adoption of low-cost, socially acceptable, easy-to-operate, and cleaner technologies that would safeguard the health of the workers and the general public.

BackgroundEbola Virus Disease (EVD) is not new to the world. However, the West African EVD epidemic which started in 2014 evolved into the largest, most severe and most complex outbreak in the history of the disease. The three most-affected countries faced enormous challenges in stopping the transmission and providing care for all patients. Although Ghana had not recorded any confirmed Ebola case, social factors have been reported to hinder efforts to control the outbreak in the three most affected countries. This qualitative study was designed to explore community knowledge and attitudes about Ebola and its transmission.MethodsThis study was carried out in five of the ten regions in Ghana. Twenty-five focus group discussions (N = 235) and 40 in-depth interviews were conducted across the five regions with community members, stakeholders and opinion leaders. The interviews were recorded digitally and transcribed verbatim. Framework analysis was adopted in the analysis of the data using Nvivo 10.ResultsThe results showed a high level of awareness and knowledge about Ebola. The study further showed that knowledge on how to identify suspected cases of Ebola was also high among respondents. However, there was a firm belief that Ebola was a spiritual condition and could also be transmitted through air, mosquito bites and houseflies. These misconceptions resulted in perceptions of stigma and discrimination towards people who may get Ebola or work with Ebola patients.ConclusionWe conclude that although knowledge and awareness about Ebola is high among Ghanaians who participated in the study, there are still misconceptions about the disease. The study recommends that health education on Ebola disease should move beyond creating awareness to targeting the identified misconceptions to improve future containment efforts.