Christabel Enweronu-Laryea

Christabel Enweronu-Laryea
UNIVERSITY OF GHANA SCHOOL OF MEDICINE AND DENTISTRY · Department of Child Health

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66
Publications
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Publications

Publications (66)
Article
OBJECTIVES Reducing the burden of bilirubin-induced neurologic complications in low-resource countries requires reliable and accessible screening tools. We sought to optimize and validate a sclera-based smartphone application, Neonatal Scleral-Conjunctival Bilirubin (neoSCB), for screening neonatal jaundice. METHODS Using a cross-sectional design,...
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Background Neonatal jaundice (NNJ) is a major cause of preventable childhood mortality and long-term impairment especially in countries with significant prevalence of the inherited condition, glucose-6-phosphate dehydrogenase (G6PD) defect. In Ghana, routine screening of pregnant women for G6PD defect is standard care. Prevention of poor health out...
Article
Background Rapid diagnostic tests (RDTs) have been extensively evaluated and play an important role in malaria diagnosis. However, the accuracy of RDT for malaria diagnosis in patients with sickle cell disease (SCD) is unknown. Methods We compared the performance of a histidine rich protein 2 (HRP-2) – based RDT (First Response®), and a lactate de...
Article
Background: Bloodstream infections (BSIs) are a major cause of morbidity and mortality in hospitalized neonates. Data on antibiotic resistance in neonatal BSIs and their impact on clinical outcomes in Africa are limited. Methods: We conducted a prospective cohort study at 2 tertiary level neonatal intensive care units (NICUs) in Ghana. All neona...
Article
Introduction: we examined the epidemiology, clinical and demographic characteristics of intussusception in Ghanaian infants. Methods: active sentinel surveillance for pediatric intussusception was conducted at Komfo Anokye Teaching Hospital in Kumasi and Korle Bu Teaching Hospital in Accra. From March 2012 to December 2016, infants < 1 year of a...
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Understanding the epidemiology of human norovirus infection in children within Ghana and the entire sub-Saharan African region, where future norovirus vaccines would have the greatest impact, is essential. We analyzed 1337 diarrheic stool samples collected from children <5 years from January 2008 to December 2017 and found 485 (36.2%) shedding the...
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Background: Individuals with sickle cell disease (SCD) are susceptible to infective conditions that predispose them to hemolysis and anemia. Folic acid is recommended as a preventative measure against anemia in SCD patients; however, there is scarce literature on the implications of this practice. Patients and methods: Plasma concentrations of f...
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Healthcare-associated infections (HAIs) remain a serious threat to patient safety worldwide, particularly in low- and middle-income countries. Reducing the burden of HAIs through the observation and enforcement of infection prevention and control (IPC) practices remains a priority. Despite growing emphasis on HAI prevention in low- and middle-incom...
Article
We sequenced 29 carbapenemase-producing Klebsiella pneumoniae isolates from a neonatal intensive care unit in Ghana. Twenty-eight isolates were sequence type 17 with blaOXA-181 and differed by 0–32 single-nucleotide polymorphisms. Improved surveillance and infection control are needed to characterize and curb the spread of multi-drug-resistant orga...
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Objective To determine the incidence of retinopathy of prematurity (ROP) and any associated risk factors among preterm infants at the Neonatal Intensive Care Unit (NICU) of Korle-Bu Teaching Hospital (KBTH). Design Prospective study. Setting Level 3 NICU of KBTH from June 2018 to February 2019. Participants Eligible infants with birth weight (BW...
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Background Carriage of multidrug resistant (MDR) Gram-negative bacteria (GN) in hospitalized neonates may increase the risk of difficult-to-treat invasive infections at neonatal intensive care units (NICUs). Data on MDR GN-carriage among hospitalized newborns in Africa is limited. Methods We conducted a cross-sectional study at the NICU’s of two t...
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SUMMARY Background: Neonatal mortality has been decreasing slowly in Ghana despite investments in maternal-newborn services. Although community-based interventions are effective in reducing newborn deaths, hospital-based services provide better health outcomes. Objective: To examine the process and cost of hospital-based services for perinatal asph...
Article
Introduction: We aimed to investigate whether the provision of water, sanitation, and hand hygiene (WASH) interventions were associated with changes in hand hygiene compliance and perceptions of healthcare workers towards infection control. Methodology: The study was conducted from June 2017 through February 2018 among healthcare workers in two...
Article
Background: Reliable local data for evaluating and planning neonatal interventions in low-resource countries are scarce. To provide data for evaluating neonatal interventions in an administrative region of Ghana, the study examined baseline data for inpatient neonatal services prior to the implementation of a 5-years national action plan to reduce...
Conference Paper
A smartphone app to screen for neonatal jaundice has a large potential impact in reducing neonatal death and disability. Our app, neoSCB, uses a colour measurement of the sclera to make a screening decision. Although there are numerous benefits of a smartphone-based approach, smartphone colour measurement that is accurate and repeatable is a challe...
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The World Health Organisation rotavirus surveillance networks have documented and shown eclectic geographic and temporal diversity in circulating G- and P- genotypes identified in children <5 years of age. To effectively monitor vaccine performance and effectiveness, robust molecular and phylogenetic techniques are essential to detect novel strain...
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In 2010, the rare OP354-like P[8]b rotavirus subtype was detected in children less than 2 years old in Ghana. In this follow-up study, to provide insight into the evolutionary history of the genome of Ghanaian P[8]b strains RVA/Human-wt/GHA/GHDC949/2010/G9P[8] and RVA/Human-wt/GHA/GHM0094/2010/G9P[8] detected in an infant and a 7-month old child ho...
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Key points: Therapeutic hypothermia (HT) to 33.0-34.0°C for 72 h provides optimal therapy for infants with neonatal encephalopathy (NE) in high-resource settings. HT is not universally implemented in low- and middle-income countries as a result of both limited resources and evidence. Facilitated passive cooling, comprising infants being allowed to...
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Background There is limited information on the safety or efficacy of currently recommended antimalarial drugs in patients with sickle cell disease (SCD), a population predisposed to worse outcomes if affected by acute malaria. Artesunate-amodiaquine (ASAQ) is the first-line treatment for uncomplicated malaria (UM) in many malaria-endemic countries...
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Background Excessive and inappropriate use of antibiotics in hospitalised patients contributes to the development and spread of antibiotic resistance. Implementing a stewardship programme to curb the problem requires information on antibiotic use. This study describes a multicentre point prevalence of antibiotic use among paediatric inpatients in G...
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The major causes of newborn deaths in sub-Saharan Africa are well-known and countries are gradually implementing evidence-based interventions and strategies to reduce these deaths. Facility-based care provides the best outcome for sick and or small babies; however, little is known about the cost and burden of hospital-based neonatal services on par...
Data
Parental costs for in-patient neonatal services in Ghana. (PDF)
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The West African subregion has the highest burden of neonatal mortality globally and the neonatal mortality rate is decreasing very slowly. A high proportion of newborn deaths are preventable and improved quality of care can reduce long-term morbidity in survivors. Perinatal asphyxia is the major cause of death and disability in term infants in the...
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Background Each year an estimated 2.6 million newborns die, mainly from complications of prematurity, neonatal infections, and intrapartum events. Reducing these deaths requires high coverage of good quality care at birth, and inpatient care for small and sick newborns. In low- and middle-income countries, standardised measurement of the readiness...
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Background: There is a paucity of data describing hospital acquired infections (HAIs) in Africa. Objective: To describe the prevalence and distribution of HAIs in acute care hospitals in Ghana. Methods: Between September and December 2016, point prevalence surveys were conducted in participating hospitals using protocols of the European Centre...
Article
Introduction: Ghana introduced monovalent rotavirus vaccine in April 2012. We sought to determine the long-term impact of routine rotavirus vaccination on rotavirus gastroenteritis hospitalizations in Ghana during the first 4 years following rotavirus vaccine introduction. Methods: Active sentinel surveillance for acute gastroenteritis hospitali...
Article
We used the dideoxynucleotide chain termination method to determine the strains of nine non-typeable rotavirus enzyme immunoassay-positive samples, which were identified as G2. We detected nucleotide changes in the primer-binding region and amino acid substitutions within the VP7 protein of the G2 rotavirus strains. Genotyping primers need to be up...
Article
Background: Ghana introduced the monovalent rotavirus vaccine (Rotarix) into its national paediatric vaccination programme in May2012. Vaccine introduction was initiated nationwide and achieved >85% coverage within a few months. Rotavirus strain distribution pre- and post-RV vaccine introduction is reported. Methods: Stool samples were collected...
Article
Introduction: Symptoms of sepsis are non-specific among neonates and diagnosis requires a high index of suspicion. The study sought to evaluate the utility of procalcitonin (PCT) versus C-reactive protein (CRP) in diagnosing early-onset neonatal sepsis. Methods: This was a cross-sectional study in which neonates admitted to the neonatal intensive c...
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Background The etiology of acute watery diarrhea remains poorly characterized, particularly after rotavirus vaccine introduction. Methods We performed qPCR for multiple enteropathogens on 878 acute watery diarrheal stools sampled from 14643 episodes captured by surveillance of children <5 years of age during 2013-2014 from 16 countries. We used pr...
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Background: Amikacin exhibits marked pharmacokinetic (PK) variability and is commonly used in combination with other drugs in the treatment of neonatal sepsis. There is a paucity of amikacin PK information in neonates from low-resource settings. Objectives: To determine the PK parameters of amikacin, and explore the influence of selected covariates...
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Background Diagnosis of bloodstream infections (BSI) in neonates is usually difficult due to minimal symptoms at presentation; thus early empirical therapy guided by local antibiotic susceptibility profile is necessary to improve therapeutic outcomes. MethodsA review of neonatal blood cultures submitted to the microbiology department of the Korle-B...
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Introduction Though giardiasis is an important public health problem in Ghana, several aspects of its epidemiology, particularly the molecular epidemiology has not been investigated adequately. This could be a major hindrance to effective surveillance and control of giardiasis in the country. The study was carried out to determine the prevalence, r...
Article
Background: Ghana was among the first African nations to introduce monovalent rotavirus vaccine (RV1) into its childhood immunization schedule in April 2012. We aimed to assess the impact of vaccine introduction on rotavirus and acute gastroenteritis (AGE) hospitalizations and to estimate vaccine effectiveness (VE). Methods: Using data from 2 te...
Article
Background. Ghana was among the first African nations to introduce monovalent rotavirus vaccine (RV1) into its childhood immunization schedule in April 2012. We aimed to assess the impact of vaccine introduction on rotavirus and acute gastroenteritis (AGE) hospitalizations and to estimate vaccine effectiveness (VE). Methods. Using data from 2 teach...
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Background Rotaviruses with the P[8] genotype have been associated with majority of infections. Recent improvements in molecular diagnostics have delineated the P[8] genotype into P[8]a and P[8]b subtypes. P[8]a is the previously known P[8] genotype which is common whilst P[8]b subtype also known as OP354-like strain is genetically distinct, rarely...
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Background: The Every Newborn Action Plan (ENAP), launched in 2014, aims to end preventable newborn deaths and stillbirths, with national targets of ≤12 neonatal deaths per 1000 live births and ≤12 stillbirths per 1000 total births by 2030. This requires ambitious improvement of the data on care at birth and of small and sick newborns, particularl...
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Background: An estimated two-thirds of the world's 2.7 million newborn deaths could be prevented with quality care at birth and during the postnatal period. Basic Newborn Care (BNC) is part of the solution and includes hygienic birth and newborn care practices including cord care, thermal care, and early and exclusive breastfeeding. Timely provisi...
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Sickle cell disease (SCD) is a genetic disorder common in malaria endemic areas. In endemic areas, malaria is a major cause of morbidity and mortality among SCD patients. This suggests the need for prompt initiation of efficacious anti-malarial therapy in SCD patients with acute malaria. However, there is no information to date, on the efficacy or...
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Background Almost all diarrhea deaths in young children occur in developing countries. Immunization against rotavirus, the leading cause of childhood severe dehydrating acute diarrhea may reduce the burden of severe diarrhea in developing countries. Ghana introduced rotavirus and pneumococcal vaccination in the national expanded program on immuniza...
Article
Rotavirus is a major cause of acute gastroenteritis (AGE) globally. Local data on disease burden will guide recommendations for rotavirus vaccination and monitoring impact of the intervention. Prospective surveillance for rotavirus gastroenteritis was conducted in 3 hospitals in southern Ghana during the period August 2006 to December 2011, as part...
Article
Background: Sickle cell disease (SCD) with its attendant increased energy requirements has an adverse effect on growth. Good nutrition is essential for normal childhood growth and development. Differences in growth between children living within the same SEC's are likely to be due to the effects of the sickle cell disease. Objective: To determin...
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Rotavirus immunization has been effective in developed countries where genotype G1P[8] is the predominant rotavirus strain. Knowledge of circulating strains in a population before introduction of rotavirus immunization program will be useful in evaluating the effect of the intervention. Rotavirus was identified by enzyme immuno-assay (EIA) on stool...
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Antibiotics are frequently used among people with sickle cell anemia (homozygous SS or HbSS disease), especially for prophylaxis. However, the relationship between antibiotic resistance and people with HbSS disease has not been adequately studied, especially in the developing world. The objectives of the study were (1) to compare antibiotic resista...
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Background Congenital malaria is defined as malaria parasitaemia in the first week of life. The reported prevalence of congenital malaria in sub-Saharan Africa is variable (0 - 46%). Even though the clinical significance of congenital malaria parasitaemia is uncertain, anti-malarial drugs are empirically prescribed for sick newborns by frontline he...
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Vaccination is the most effective preventive strategy against rotavirus disease. Regional differences in prevalent rotavirus genotypes may affect vaccine efficacy. Pre-vaccine surveillance for burden of rotavirus disease, prevalent rotavirus genotypes, and association between rotavirus disease and intussusceptions helps in monitoring the impact of...
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Malnutrition in preterm low birth weight infants has adverse long-term metabolic, growth, and neurodevelopmental effects. In the past 3 decades, parenteral nutrition, enriched preterm formula, and fortification of human milk have been used to alleviate these adverse effects. Unfortified human breast milk does not provide sufficient nutrients for th...
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Background: Diarrhoea causes about 1.5 million deaths per year. Rotavirus causes 20% of these. We aimed to assess any changes in the clinical features and outcome of rotavirus diarrhoea (RD) at the Royal Victoria Teaching Hospital (RVTH), since the last report 15 years ago.
Article
Background: Group B streptococci cause major perinatal bacterial infections including chorioamnionitis and endometritis in women and severe systemic infections in the newborn. Infections are a major cause of newborn deaths in Ghana but the organisms causing these infections are usually not identified. Group B streptococci colonization during pregna...
Article
Each year 3.6 million infants are estimated to die in the first 4 weeks of life (neonatal period)--but the majority continue to die at home, uncounted. This article reviews progress for newborn health globally, with a focus on the countries in which most deaths occur--what data do we have to guide accelerated efforts? All regions are advancing, but...
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To determine the magnitude and pattern of ocular manifestations in sickle cell disease at Korle-bu Hospital, Accra, Ghana. Hospital-based cross-sectional study including all patients with sickle cell disease reporting for routine follow-up at the Sickle Cell Clinic at Korle-bu Hospital, Accra, Ghana. A total of 201 patients with sickle cell disease...
Article
To assess midwives' baseline cognitive knowledge of evidence-based neonatal resuscitation practices, and short- and long-term educational effects of teaching a neonatal resuscitation program in a hospital setting in West Africa. All midwives (n=14) on the labor ward at Ridge Hospital in Ghana were trained using materials modified from the American...
Article
The enormous burden of almost 3.6 million neonatal deaths remains relatively invisible because of gaps in data or ineffective use of existing data, the perceived complexity and expense of solutions, and societal norms for seclusion of newborns and acceptance of neonatal deaths. The data for action for neonatal survival highlight many commonalities...
Article
The annual toll of losses resulting from poor pregnancy outcomes include half a million maternal deaths, more than three million stillbirths, of whom at least one million die during labour and 3.8 million neonatal deaths--up to half on the first day of life. Neonatal deaths account for an increasing proportion of child deaths (now 41%) and must be...
Article
To evaluate the effectiveness of a strategy for teaching neonatal resuscitation on the cognitive knowledge of health professionals who attend deliveries in Ghana, West Africa. Train-the-trainer model was used to train health professionals at 2-3 day workshops from 2003 to 2007. Obstetric Anticipatory Care and Basic Neonatal Care modules were taught...
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Compliance with hand hygiene recommendations is the most important measure in preventing health care-associated infections. The objective of this study was to assess the nature of patient contact and the hand hygiene practices of nurses and physicians in the neonatal intensive care unit in a tertiary hospital in Ghana. Unobtrusive observation of pa...
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Methylergometrine is probably the most commonly used drug in obstetric care at all levels of the health care system. Many communities in Africa lack skilled birth attendants and adequate health systems; medication errors are more likely to occur and go unreported in these settings. The morbidity and mortality that result from these errors can be re...
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Evaluate the impact of improved neonatal intensive care facilities on survival and referral patterns at a teaching hospital in Ghana. Retrospective cohort comparing birth weight-specific survival and referral pattern of newborns requiring intensive care before and after improvement of facilities. Improved survival of newborns <2500 g especially tho...
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Most neonatal deaths in developing countries are caused by infections, birth asphyxia and prematurity. Even though most of these deaths occur at home, newborns admitted to hospital neonatal units have a high risk of contracting fatal multi-drug resistant infections. To compare the type of bacteria and the pattern of antimicrobial susceptibility of...
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To determine the singleton preterm birth rate, the relative proportions of the clinical categories of preterm births and to compare the outcomes in these categories. Department of Obstetrics & Gynaecology, Korle Bu Teaching Hospital. Preterm births from 1(st) July to 31(st) December 2003. Out of a total of 4731 singleton births 440 were preterm, gi...