[Show abstract][Hide abstract] ABSTRACT: To obtain information about the staff resources available in licensed medicine outlets, assess their knowledge about malaria illness, current policy initiatives for malaria control, and the practices for prevention and management of malaria.
Hospitals/clinics and retail medicine outlets (community pharmacies and licensed chemical shops) from urban and rural areas in Southern and Northern Ghana.
A cross section of medicine outlets (n = 121) in the two geographic and socio-economically diverse settings in Ghana were sampled. Data on staff resources, their knowledge about malaria, and current initiatives for malaria control were obtained through structured interviews. Staff practices for prevention and management of malaria were assessed through observation of their practice during counseling, selection, and dispensing of anti-malarial.
Professional status of staff in the outlets, the proportion of staff with adequate knowledge on malaria illness and the initiatives for malaria control; skills and practices for the recognition, prevention, and management of malaria.
56% of the staff (n = 269) were non-professionals, whereas 44% (n = 212) were professionals. The hospitals/clinics had more professional staff per outlet than the retail outlets. One hundred and fifty four staff members, including those in-charge of the outlets at the time of data collection (n = 121), and others recommended by the in-charges or outlet owners (n = 33) were assessed. Of these, 83% knew the mode of malaria transmission, 81% could advise clients on practices for malaria prevention, 88% recognized signs/symptoms of uncomplicated malaria, and 64% those of complicated malaria. Less than 40% had adequate knowledge about current initiatives for malarial control, and only 21% could manage malaria cases as recommended by national guidelines.
Most of the staff, particularly those in the retail outlets were not professionally trained. The staff assessed could recognize malaria illness and counsel clients on practices for disease prevention. The majority, however, lacked knowledge on the current initiatives for malaria control and the skills to manage malaria cases appropriately. In order to achieve public health objectives, interventions to strengthen skills and improve practices for malaria case management are needed. Training on current initiatives for malaria control should also be considered a priority.
International Journal of Clinical Pharmacy 08/2010; 32(4):424-31. DOI:10.1007/s11096-010-9397-6 · 0.92 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Objective: To document the demography of paediatric admissions due to severe malaria, presentation and determinants of clinical symptoms and treatment for the condition at the KNUST Hospital, Ghana.
Methods: A prospective, non-randomized, observational study was undertaken at the Children’s Ward of the KNUST Hospital, in Kumasi. During a one month period, the symptoms on admission, treatment and treatment outcome of included children were documented. Inclusion criteria were age 0-144 months, verbal informed consent and severe malaria defined by presence of asexual Plasmodium falciparum parasitaemia coupled with at least one criterion suggestive of severe malaria as defined by WHO.
Results: Overall, there were 82 malaria admissions with 69 cases being enrolled. On admission, mean haemoglobin levels were consistent for both males and females. Mean body weight was higher for females. Main presentations were anaemia of moderate to severe form (56); fever (52) and convulsions (24). Prostration was observed in all cases. Children under 5 years of age were associated with anaemia (p=0.018) and neurological symptoms (p=0.003). Clinical presentation of severe malaria was found to be independent of patients’ sex. Quinine was used as treatment in 17 cases; monotherapy with artemisinin derivatives in 26 cases and artemisinin-amodiaquine combinations in 19 of the cases. No deaths were recorded.
Conclusions: Children under 5 years of age presented more often with severe malaria. Prostration, anaemia and neurological symptoms were the most frequent manifestations.
The Open Tropical Medicine Journal 09/2009; 2(1):39-44. DOI:10.2174/1874315300902010039
[Show abstract][Hide abstract] ABSTRACT: Although national and international efforts to combat malaria have intensified over the years, problems with availability, distribution, and choice of antimalarials at medicine outlets in Africa continue to exist. This article presents the results of an indicator-based assessment of availability and choice of antimalarials at 130 licensed medicine outlets in Ghana. We also discuss how the choice of an antimalarial to dispense conforms to recommendations of the national policy for malaria therapy. Data were obtained through face-to-face interviews, by reviewing facility records, and by observing the practices of dispensing staff in the medicine outlets. Antimalarials recommended in the policy were not readily available in the most accessible medicine outlets. Few outlets adhered to the policy when choosing antimalarials. Interventions targeting medicine outlets should be initiated to improve availability and access to effective medicines in order to support the national program for malaria control.
[Show abstract][Hide abstract] ABSTRACT: To assess the appropriateness of self-reported use of anti-malarial drugs prior to health facility attendance, and the management of malaria in two health facilities in Ghana.
A structured questionnaire was used to collect data from 500 respondents who were diagnosed clinically and/or parasitologically for malaria at Agogo Presbyterian Hospital and Suntreso Polyclinic, both in the Ashanti Region of Ghana. Collected information included previous use of anti-malarial drugs prior to attending the health facilities, types of drugs used, how the drugs were used, and the sources of the drugs. In addition, the anti-malarial therapy given and outcomes at the two health facilities were assessed.
Of the 500 patients interviewed, 17% had severe malaria, 8% had moderate to severe malaria and 75% had uncomplicated malaria. Forty three percent of the respondents had taken anti-malarial drugs within two weeks prior to hospital attendance. The most commonly used anti-malarials were chloroquine (76%), sulphadoxine-pyrimethamine (9%), herbal preparations (9%) and amodiaquine (6%). The sources of these medicines were licensed chemical sellers (50%), pharmacies (21%), neighbouring clinics (9%) or "other" sources (20%) including left-over medicines at home. One hundred and sixty three (77%) of the 213 patients who had used anti-malarial drugs prior to attending the health facilities, used the drugs inappropriately. At the health facilities, the anti-malarials were prescribed and used according to the national standard treatment guidelines with good outcomes.
Prevalence of inappropriate use of anti-malarials in the community in Ghana is high. There is need for enhanced public health education on home-based management of malaria and training for workers in medicine supply outlets to ensure effective use of anti-malaria drugs in the country.
[Show abstract][Hide abstract] ABSTRACT: We describe pharmacy training in Ghana with an emphasis on postgraduate clinical pharmacy education in the country. The Ghanaian clinical pharmacy programme was compared with the Robert Gordon University pre-1999 clinical pharmacy course because of the historical links between the two programmes. The course is delivered by distance learning over two years supplemented with one day residential tutorial programmes conducted by practising pharmacists and physicians. The course is open to pharmacy graduates with at least three years work experience. Successful candidates are awarded M.Sc degrees in clinical pharmacy. There are no exit points for intermediate qualifications. Baseline data is being collected to be used to measure the impact of our programme on pharmacy practice. Clinical pharmacy practice can only make a significant impact on health delivery in Ghana if there are enough working clinical pharmacists. Continuous staff development, recruitment and functional links with other schools of pharmacy are priorities in our efforts to keep pace with current trends in pharmacy education.