BackgroundThis paper reports on the baseline prevalence and associated risk factor findings of a pilot, longitudinal study exploring community-wide treatment of schistosomiasis and soil-transmitted helminthiasis, using albendazole plus praziquantel in the Greater Accra region of Ghana. MethodFrom three communities, at least, 658 individuals were enrolled into the study via random household selection. Prevalence and intensity of schistosomiasis and STH infection were determined from stool and urine samples with a questionnaire being administered in order to explore other morbidities and risk factors. Factor analysis of household demographic variables was undertaken to generate a socioeconomic score; this was then further categorised into tertiles. Proportional-odds cumulative logit generalised estimating equation (GEE) models were used to investigate categorical ordinal intensity of infection associations with morbidity. Separately, logistic GEE models were used to investigate risk factor associations with infection prevalence.
Anaemia among women is a major public health concern globally. In developing countries, nutritional anaemia may be due to poor bioavailability of dietary iron, haemoglobinopathies, or intestinal parasites. The study objectives were to determine the prevalence of anaemia and current nutrient intakes essential to erythropoiesis among women of reproductive age (WRA) in peri-urban settlements in the Ga-East Municipality, Accra, Ghana. This cross-sectional study assessed the nutrient intake, sickling and haemoglobin levels of 134 women aged 15-49 years enrolled in a peanutbased field trial at baseline. A pretested semi-quantitative food frequency questionnaire was used to assess energy and nutrient intake using the Food Processor (ESHA) software. Whole blood was used to determine full blood count using the haematology automated analyser. Sickling was determined by blood staining. Anaemia was classified based on recommended cutoffs. Chi-square analysis was used as a test of independence between anaemia and age groups. Linear regression was used to determine predictors of haemoglobin concentration. The mean age of the women was 29 ± 8 years. The mean total caloric intake was 2315 ± 915 kcal, whilst protein and fat intakes were 67 ± 27g and 68± 30g, respectively. Almost three-quarters of the women met the recommended dietary allowance (RDA) for iron and vitamin C. However, only a third met the RDA for fat, and about two-thirds met their needs for energy and protein. None of the women met the RDA for folate which is integral for haem formation. Also 17% (23/134) of the women were sickle cell anaemia positive. Mean haemoglobin concentration was 12.1 ± 1.8 g/dL. Mild, moderate and severe anaemia due to iron deficiency was present in 35.8%, 6.7% and 1.5%, of the women respectively. All categories of anaemia was present in 44% of the women. Anaemia, prevalence increased during the early stages of the reproductive age (15-29 years) and declined towards the end of the reproductive age period (40-49 years). An increase in age of one year was significantly associated with a 0.056 g/dL rise in haemoglobin level (p=0.014). Anaemia due to iron deficiency exists as a public health problem among women in peri-urban settlements in the Ga-East Municipality, Accra, Ghana. Dietary diversity to include green leafy vegetables which are rich in folate and pro-vitamin A may reduce the current level of prevalence.
Vitamin A deficiency (VAD), anaemia, and parasitic infections are among the major nutritional and health problems confronting Ghanaian school children. This study assessed the impact of red palm oil bean-stew consumption on serum retinol and haemoglobin concentrations of Ghanaian school children in a malaria-endemic setting. The design was a pre-post nutrition intervention study. It involved 142 6-12 year-old children. Participants were selected by simple random sampling. After baseline sample and data collection, the participants consumed red palm oil bean-stew with gari (made from fermented, grated cassava flour), three times a week for a period of six months. Final biological samples and data were collected as at baseline. Dietary data were collected using Food Frequency Questionnaires and the 24-hour recall procedure. Serum retinol was measured with High Performance Liquid Chromatography and haemoglobin by Haemocue Haemoglobinometer. Malaria parasitaemia and hookworms were examined by microscopy from blood films and stool samples using the Giemsastaining and Kato-Katz techniques, respectively. Data were analysed with Statistical Package for Social Sciences version-23. Mean values for outcome variables were compared between baseline and final using paired t-tests. Results indicated that majority of the participants (82.4%) consumed cereals. Many of them also (98.6%) never consumed dairy or dairy products. Mean serum retinol concentration was 12.1 ± 6.6µg/dl during baseline and 16.2 ± 6.4µg/dl at final, the difference significant at p<0.05. The mean haemoglobin concentration at baseline was 119.4 ± 10.6 g/l and 126.0 ± 9.34g/l at final, with a significant difference at p<0.05. The prevalence of VAD defined as serum retinol concentration <20µg/dl was 76.2% at the end of the study being significantly different from that at baseline (93.6%), p<0.05. Prevalence of anaemia was 30.3% and 11.3% at baseline and final, respectively with a significant difference at p<0.05. Malaria parasitaemia was prevalent: 67.6 % at baseline and 62.7% at the end of the study. Only one participant (0.01%) was found with hookworm infestation. For participants with VAD, 48.3% and 36.2% improved to moderate and normal vitamin A status, respectively at the end of the study. The prevalence of anaemia among VAD participants was 36.2 % at baseline and 12.1 % at final. In conclusion, red palm oil beanstew consumption increased the haemoglobin concentration and minimized prevalence of anaemia among the study participants. It also increased serum retinol concentrations and minimized the prevalence of vitamin A deficiency (especially severe vitamin A deficiency) among the study participants.
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