Low-cost interventions accelerate epidemiological transition in Upper East Ghana

Meij, Johannes J.; Craen, Anton J. M. de; Agana, J.; Plug, D.; Westendorp, Rudi G. J.

doi:10.1016/j.trstmh.2008.09.015

Cited by 19 publications

(25 citation statements)

References 15 publications

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“…The area is poor and mortality rates are high, with the main causes of death being malaria, diarrhea and poor nutrition. 14,15 Inhabitants belong to different ethnic groups such as Bimoba, Fulani, Busanga, Kusasi and Maprusi. Surveys on demographics were held annually from June to August, starting from 2002, 16 in which population information including births, deaths and migration was updated.…”

Section: Study Populationmentioning

confidence: 99%

Polymorphisms in TLR4 and TLR2 genes, cytokine production and survival in rural Ghana

et al. 2009

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Toll-like receptors (TLRs) are involved in the induction of an adequate immune response on infection. We hypothesized that genetic variation in TLR4 and TLR2 genes could influence this response and lead to variability in cytokine production and survival. We tested this hypothesis in 4292 participants who were followed up for all-cause mortality for 6 years and live under adverse environmental conditions in the Upper-East region of Ghana, where malaria is endemic. In 605 participants, tumor necrosis factor-a and interleukin-10 (IL10) production, after stimulation with lipopolysaccharide and zymosan, was measured. In addition, 34 single-nucleotide polymorphisms (SNPs) in TLR4 and 12 SNPs in TLR2 were genotyped and tested for association with cytokine production, malaria infection and mortality. In this comprehensive gene-wide approach, we identified novel SNPs in the TLR4 gene that influence cytokine production. From the analyzed SNPs, rs7860896 associated the strongest with IL10 production (P¼0.0005). None of the SNPs in this study associated with malaria or overall mortality risks.In conclusion, we demonstrate that genetic variation within the TLR4 gene influences cytokine production capacity, but in an endemic area does not influence the susceptibility to malaria infection or mortality.

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Section: Study Populationmentioning

confidence: 99%

Polymorphisms in TLR4 and TLR2 genes, cytokine production and survival in rural Ghana

et al. 2009

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“…Characterized by a study setting typical in rural SSA, the study provides insights into rural context factors that need attention to accelerate progress for women contraceptive use in rural Ghana and in other rural settings in SSA. 33 . The study population included young women (18-28 years), women of reproductive age (15-49 years), male spouses and midwives.…”

Section: Introductionmentioning

confidence: 99%

Context-specific Factors and Contraceptive Use: A Mixed Method Study among Women, Men and Health Providers in a Rural Ghanaian District

Ayanore

Pavlova

Groot

2017

Afr J Reprod Health

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Suitable options for improving women's access to effective, safe and context-specific contraceptive methods must be explored to curtail rising unmet needs for contraceptive use in rural Ghana. The study aimed to outline context-specific factors associated with contraceptive use, access on demand and future use intentions among women in one district of Ghana. Using mixed method approach, quantitative data (n=720) was collected among women aged 18-28. Focus group discussions and in-depth interviews were also conducted among women (n=30) aged 18-49 and men (n=10) respectively. IDIs were conducted among 3 midwives. Women who received focused counseling on contraceptive use were twice likely to have ever used (OR=2 95% CI 1.163-3.467) or be current users (OR=2, 95% CI 1.146-4.010) of contraceptives. Male partner support can drive cultural sensitivities towards accepting use of contraception (OR=34.5, CI% 19.01-64.22). Covert use is still preferred by most in the study. Services delivered on good provider-relational grounds and convenient clinic hours encourage contraceptive use among women. Male targeting for improving contraceptive service use must first identify context-specific preferences of the woman, since covert use is highly valued. Ascertaining the prevalence of covert use and how community systems can address this for improved contraceptive uptake is further recommended. Keywords: context-specific factors, contraceptive use, access on demand, future contraceptive use, rural Ghana RésuméDes options appropriées pour améliorer l'accès des femmes à des méthodes contraceptives efficaces, sûres et spécifiques au contexte doivent être explorées pour réduire les besoins non satisfaits de l'utilisation des contraceptifs au Ghana rural. L'étude visait à décrire les facteurs contextuels associés à l'utilisation de contraceptifs, l'accès sur demande et les intentions d'utilisation future chez les femmes d'un district du Ghana. En utilisant une approche par méthode mixte, des données quantitatives (n = 720) ont été recueillies parmi les femmes âgées de 18 à 28 ans. Des discussions à groupes ciblés et des entretiens approfondis ont également été réalisés auprès des femmes (n = 30) âgées de 18 à 49 ans et les hommes (n = 10) respectivement. Les IDI ont été menées auprès de 3 sages-femmes. Les femmes qui ont reçu des conseils ciblés sur l'utilisation des contraceptifs ont été deux fois plus susceptibles d'avoir déjà utilisé (OR = 2 95% IC 1.163-3.467) ou être des utilisateurs actuels (OR = 2, 95% IC 1.146-4.010) des contraceptifs. Le soutien des partenaires masculins peut stimuler les sensibilités culturelles à l'acceptation de l'utilisation de la contraception (OR = 34,5,). L'usage secret est encore préféré par la plupart dans l'étude. Les services fournis sur de bons motifs relationnels avec les fournisseurs et les heures de clinique appropriées encouragent l'utilisation de contraceptifs chez les femmes. Le ciblage masculin pour améliorer l'utilisation des services de contraception doit d'abord identifier les pré...

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“…[8][9][10][11] Currently, many of these tropical countries are experiencing an epidemiologic transition, with mortality moving from child to oldage mortality. [12][13][14][15] This is primarily due to improved living conditions and a lower risk of death from infectious diseases. [15][16][17] At the same time deaths from chronic diseases are on the rise.…”

Section: Introductionmentioning

confidence: 99%

“…[12][13][14][15] This is primarily due to improved living conditions and a lower risk of death from infectious diseases. [15][16][17] At the same time deaths from chronic diseases are on the rise. 14 It is yet unclear how the seasonal variation in mortality has evolved now that many of these countries have undergone major changes in their mortality patterns.…”

Section: Introductionmentioning

confidence: 99%

Seasonal variation in child and old-age mortality in rural Ghana

Engelaer

Bodegom

Mangione

et al. 2014

Transactions of the Royal Society of Tropical Medicine and Hygi

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Background: Mortality in tropical countries varies considerably from season to season. As many of these countries have seen mortality moving from child to old-age mortality, we have studied seasonal variation in child and old-age mortality in a rural area in Ghana that currently undergoes an epidemiologic transition. Methods:In an annual survey from 2002 through to 2011, we followed 29 642 individuals and obtained the cause and month of death from 1406 deceased individuals by making use of verbal autopsies.Results: When comparing the seasons, we observed a trend for higher mortality during the wet season. When comparing separate months, we observed 34% more deaths than expected in September (95% CI 1.04-1.69; p¼0.024) at the end of the wet season and 43% more deaths in April (95% CI 1.13-1.80; p¼0.004) at the end of the dry season, while there were 42% less deaths than expected in December (95% CI 0.52-0.70; p¼0.003), shortly after the wet season. Cause-specific analysis indicated that the peak at the end of the wet season was due to excess mortality from infectious diseases in children and older people alike, whereas the peak in old-age mortality at the end of the dry season was due to non-infectious causes in older people only.Conclusions: Taken together, our data suggest that during the epidemiologic transition, mortality not only shifts from child to old-age and from infectious to non-infectious, but also from the wet to the dry season.

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Low-cost interventions accelerate epidemiological transition in Upper East Ghana

Cited by 19 publications

References 15 publications

Polymorphisms in TLR4 and TLR2 genes, cytokine production and survival in rural Ghana

Polymorphisms in TLR4 and TLR2 genes, cytokine production and survival in rural Ghana

Context-specific Factors and Contraceptive Use: A Mixed Method Study among Women, Men and Health Providers in a Rural Ghanaian District

Seasonal variation in child and old-age mortality in rural Ghana

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