BackgroundThe impact of HIV on TB, and the implications for TB control, has been acknowledged as a public health challenge. It is imperative therefore to assess the burden of HIV on TB patients as an indicator for monitoring the control efforts of the two diseases in this part of the world. This study aimed at determining the burden of HIV infection in TB patients.MethodsWe conducted a retrospective review of TB registers in five districts of the Volta Region of Ghana. Prevalence of TB/HIV co-infection was determined. Bivariate and multivariate logistic regression were used to identify the predictors of HIV infection among TB patients and statistical significance was set at p-value <0.05.ResultsOf the 1772 TB patients, 1633 (92.2%) were tested for HIV. The overall prevalence of TB/HIV co-infection was (18.2%; 95% CI: 16.4–20.1). The prevalence was significantly higher among females (24.1%; 95%CI: 20.8–27.7), compared to males (15.1%; 95% CI: 13.1–17.4) (p < 0.001) and among children <15 years of age (27.0%; 95% CI: 18.2–38.1), compared to the elderly ≥70 years (3.5%; 95% CI: 1.6–7.4) (p < 0.001). Treatment success rate was higher among patients with only TB (90%; 95% CI: 88.1–91.5) than among TB/HIV co-infected patients (77.0%; 95% CI: 71.7–81.7) (p < 0.001). Independent predictors of HIV infection were found to be: being female (AOR: 1.79; 95% CI: 1.38–2.13; p < 0.001); smear negative pulmonary TB (AOR: 1.84; 95% CI: 1.37–2.47; p < 0.001); and patients registered in Hohoe, Kadjebi, and Kpando districts with adjusted odds ratios of 1.69 (95% CI: 1.13–2.54; p = 0.011), 2.29 (95% CI: 1.46–3.57; p < 0.001), and 2.15 (95% CI: 1.44–3.21; p < 0.001) respectively. Patients ≥70 years of age and those registered in Keta Municipal were less likely to be HIV positive with odds ratios of 0.09 (95% CI: 0.04–0.26; p < 0.001) and 0.62 (95% CI: 0.38–0.99; p = 0.047) respectively.ConclusionTB/HIV co-infection rate in five study districts of the Volta region is quite high, occurs more frequently in female patients than males; among smear negative pulmonary TB patients, and children <15 years of age. Findings also demonstrate that HIV co-infection affects TB treatment outcomes adversely. Strengthening the TB/HIV collaborative efforts is required in order to reduce the burden of co-infection in patients.

Introduction. Malaria is a major cause of morbidity and mortality worldwide, requiring individual and environmental level controls to prevent its adverse morbidity effects. This study examined reproductive-aged women’s knowledge and care-seeking practices for malaria prevention and control in Ghana. Methods. The 2016 Ghana Malaria Indicator Survey data for reproductive-age women was analysed (n=5,150). Multilevel mixed-effects logistic regression model was used to determine factors associated with reproductive-aged women’s knowledge and care-seeking practices for malaria. Results. 62.3%, 81.3%, and 64.6% knowledge levels on causes, signs/symptoms, and prevention of malaria were found, respectively, among respondents. Age, wealth and educational status, religion, region, and place of residence (rural) were found to significantly influence respondents’ knowledge of causes, signs/symptoms, and care-seeking practices for malaria. A 15% differential among Insecticide Treated Nets (ITNs) awareness and use was found. Increasing age (≥35 years) was associated with increasing knowledge of malaria. Regional variations were observed to significantly influence knowledge of malaria treatment. Conclusion. Though ownership of ITNs and knowledge of malaria prevention were high, it did not necessarily translate into use of ITNs. Thus, there is a need to intensify education on the importance and the role of ITNs use in the prevention of malaria.

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Background:Malaria infection during pregnancy is a major public health problem in the tropical and sub-tropical regions. This study determined the prevalence and factors associated with malaria and anaemia among pregnant women. Methods: A cross-sectional hospital-based study carried out from January to December 2016at the Hohoe Municipal Hospital. Pregnant women of all gravidities with gestational agebetween16-37weeks, attending focused antenatal care (Focused-ANC) were interviewed using asemi-structured questionnaire to obtainsociodemographic, obstetric and medical history data. Blood samples were examined for Hemoglobin levels and malaria parasitaemia. Chi-square test and logistic regression were used to determine the association between dependent and independent variables. Linear regression was used to determine the association between the risk factors of the covariates and the log parasite density. A P-value <0.05 was considered as statistically significant. Results: Of 1200 women, malariaparasitaemia was present in 244 (20.3%), anaemia (Hb<11.0 g ⁄dl) in724 (60.3%).Ownership and usage of long-lasting insecticide treatednet(LLIN) were95.3% and 86.5% respectively. Women who were anaemic and those who visited focused-ANC 5-8 times were 1.70 and 2.08 times more likely to have malaria, (AOR=1.70, p<0.001)and (AOR=2.06, p=0.039) respectively. Women in their 3 rd trimester were 41% times less likely to have malaria (AOR=0.59, p=0.033).Women aged between 30-39 years and those who took ≥ 3 doses of Sulphadoxine -pyrimethamine (SP-IPTp)were 42% and 54% times less likely to have anaemia [AOR=0.58; p=0.040] and[AOR=0.46; p=0.010] respectively. Women in their2 nd trimester were 1.39 times more likely to have anaemia [AOR=1.39; p=0.043]. Parasite density decreased with increasing age (r=-0.041, p=0.033).Conclusion: One out of every 5 pregnant women had malaria and 6 out of every 10 pregnant women had anaemia. Administration of ≥ 3 doses of SP-IPTp reduces anaemia. The presence of malaria results in anaemia and makes pregnant women increase the number of Focused-ANC visits. Age is arisk factor for parasite density. With the high prevalence, targeted interventions for younger women and women in their 2 nd trimesterare needed to reduce anaemiain pregnancy within Hohoe Municipality of Ghana.

Background. Low birth weight and preterm delivery are birth outcomes that can predict newborns’ survival, development, and long-term health outcomes. This study assessed the prevalence and factors associated with low birth weight and preterm delivery in the Ho Municipality of Ghana. Methods. This retrospective, cross-sectional study analysed data from 680 birth records between October and December 2018. Univariate and multivariate logistic regression models predicted low birth weight and preterm delivery factors. Results. The prevalence of low birth weight and preterm delivery was 12.9% and 14.1%, respectively. Increasing maternal age (AOR: 0.52; 95% CI: 0.28–0.98), multiparity (AOR: 0.54; 95% CI: 0.30–0.94) and increasing doses of sulphadoxine-pyrimethamine (AOR: 0.43; 95% CI: 0.22–0.84) significantly reduced the odds of low birth weight. However, caesarean section (AOR: 1.94; 95% CI: 0.1.16–3.27) and hypertension (AOR: 2.06; 95% CI: 1.27–03.33) significantly increased the likelihood of low birth weight. An increasing number of antenatal care visits (AOR: 0.38; 95% CI: 0.18–0.80) and doses of sulphadoxine-pyrimethamine (AOR: 0.43; 95% CI: 0.19–0.97) were significantly associated with decreased odds of preterm delivery, while caesarean section increased the odds of preterm delivery by two folds (AOR: 2.14; 95% CI: 1.15–3.99). Conclusion. This study shows that maternal age, parity, number of antenatal care visits, hypertension, SP/IPTp, and caesarean section were independently associated with low birth weight and preterm delivery. Education and interventions should be prioritised as vitally important on these factors to reduce the risk and complications associated with these birth outcomes.