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      Patterns of Frequently Diagnosed Pediatric Morbidities in Hospitalized Children in the Volta Region of Ghana

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          Abstract

          Background. The aim of this study was to identify the frequently diagnosed pediatric diseases in the Volta Region of Ghana, as well as to examine the burden of these diseases. The top pediatric diseases that were frequently diagnosed were malaria, gastroenteritis, systemic infection, anemia, pneumonia, and respiratory tract infection. Methods. Clearance was obtained from the Volta Regional Directorate of the Ghana Health Service to collect primary data on pediatric hospitalizations in the major hospitals in the Region. Diseases with more than 1000 recorded cases of hospitalizations were considered among the top frequently diagnosed childhood morbidities. Results. The data suggest that the Northern sector had different seasonal patterns of recorded diagnosed pediatric cases compared with the Central and Southern sectors, which had similar patterns of the reported diseases. Most of the pediatric diseases in the Volta Region were more prevalent during the dry seasons compared with the rainy seasons and resulting in seasonal patterns of hospitalizations. Conclusion. Although the frequently diagnosed pediatric diseases can be prevented and/or treated, many children are hospitalized, with a proportion of them dying. It is, therefore, important that efforts are made to reduce the burden of pediatric hospitalization.

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          Global, regional, and national levels and trends in under-5 mortality between 1990 and 2015, with scenario-based projections to 2030: a systematic analysis by the UN Inter-agency Group for Child Mortality Estimation.

          In 2000, world leaders agreed on the Millennium Development Goals (MDGs). MDG 4 called for a two-thirds reduction in the under-5 mortality rate between 1990 and 2015. We aimed to estimate levels and trends in under-5 mortality for 195 countries from 1990 to 2015 to assess MDG 4 achievement and then intended to project how various post-2015 targets and observed rates of change will affect the burden of under-5 deaths from 2016 to 2030.
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            Epidemiology of malaria in the forest-savanna transitional zone of Ghana

            Background Information on the epidemiology of malaria is essential for designing and interpreting results of clinical trials of drugs, vaccines and other interventions. As a background to the establishment of a site for anti-malarial drugs and vaccine trials, the epidemiology of malaria in a rural site in central Ghana was investigated. Methods Active surveillance of clinical malaria was carried out in a cohort of children below five years of age (n = 335) and the prevalence of malaria was estimated in a cohort of subjects of all ages (n = 1484) over a 12-month period. Participants were sampled from clusters drawn around sixteen index houses randomly selected from a total of about 22,000 houses within the study area. The child cohort was visited thrice weekly to screen for any illness and a blood slide was taken if a child had a history of fever or a temperature greater than or equal to 37.5 degree Celsius. The all-age cohort was screened for malaria once every eight weeks over a 12-month period. Estimation of Entomological Inoculation Rate (EIR) and characterization of Anopheline malaria vectors in the study area were also carried out. Results The average parasite prevalence in the all age cohort was 58% (95% CI: 56.9, 59.4). In children below five years of age, the average prevalence was 64% (95% CI: 61.9, 66.0). Geometric mean parasite densities decreased significantly with increasing age. More than 50% of all children less than 10 years of age were anaemic. Children less than 5 years of age had as many as seven malaria attacks per child per year. The attack rates decreased significantly with increasing cut-offs of parasite density. The average Multiplicity of Infection (MOI) was of 6.1. All three pyrimethamine resistance mutant alleles of the Plasmodium falciparum dhfr gene were prevalent in this population and 25% of infections had a fourth mutant of pfdhps-A437G. The main vectors were Anopheles funestus and Anopheles gambiae and the EIR was 269 infective bites per person per year. Conclusion The transmission of malaria in the forest-savanna region of central Ghana is high and perennial and this is an appropriate site for conducting clinical trials of anti-malarial drugs and vaccines.
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              Patterns and seasonality of malaria transmission in the forest-savannah transitional zones of Ghana

              Background Knowledge of the local pattern of malaria transmission and the effect of season on transmission is essential for the planning and evaluation of malaria interventions. Therefore, entomological surveys were carried out in the forest-savannah transitional belt of Ghana (Kintampo) from November 2003 to November 2005 in preparation for drug and vaccine trials. Results A total of 23,406 mosquitoes were caught from 919 traps over the two-year period (November 2003 to November 2005): 54.3% were Culicines, 36.2% Anopheles funestus, and 9.4% Anopheles gambiae. Infection rates with Plasmodium falciparum were 4.7% and 1.5% for Anopheles gambiae and Anopheles funestus, respectively. Entomological inoculation rates (EIRs) were 269 infective bites per person per year in the first year (November 2003-October 2004) and 231 the following year (November 2004-November 2005). Polymerase Chain Reaction (PCR) analysis detected only Anopheles gambiae s.s. Nineteen mosquitoes were tested by PCR in the wet season; 16 were S-molecular form, 2 M-molecular form and 1 hybrid (S/M). In the dry season, sixteen mosquitoes were tested; 11 S-molecular form, 2 M-molecular form and 3 S/M hybrids. The frequency of knock down resistance (kdr) genotypes F(R) was 0.60. Conclusion The dynamics and seasonal abundance of malaria vectors in the Kintampo area was influenced by micro-ecology, rainfall and temperature patterns. Transmission patterns did not differ significantly between the two years (2004 and 2005) and both Anopheles gambiae and Anopheles funestus were identified as effective vectors. EIR estimates in 2004/2005 were between 231 and 269 infective bites per person per year. The information provided by the study will help in planning intensified malaria control activities as well as evaluating the impact of malaria interventions in the middle belt of Ghana.
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                Author and article information

                Journal
                Glob Pediatr Health
                Glob Pediatr Health
                GPH
                spgph
                Global Pediatric Health
                SAGE Publications (Sage CA: Los Angeles, CA )
                2333-794X
                19 November 2019
                2019
                : 6
                : 2333794X19889230
                Affiliations
                [1 ]University of Ghana, Accra, Ghana
                Author notes
                [*]Osbourne Quaye, Department of Biochemistry, Cell and Molecular Biology, College of Basic and Applied Sciences, University of Ghana, Volta Road, Accra, Ghana. Email: oquaye@ 123456ug.edu.gh
                Author information
                https://orcid.org/0000-0002-0621-876X
                Article
                10.1177_2333794X19889230
                10.1177/2333794X19889230
                6868572
                77ba795d-dd98-44bf-be29-861576eed674
                © The Author(s) 2019

                This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License ( http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages ( https://us.sagepub.com/en-us/nam/open-access-at-sage).

                History
                : 22 February 2019
                : 19 August 2019
                : 22 October 2019
                Funding
                Funded by: World Bank Group, FundRef https://doi.org/10.13039/100004421;
                Award ID: ACE02-WACCBIP: Awandare
                Funded by: Wellcome Trust, FundRef https://doi.org/10.13039/100004440;
                Award ID: DEL-15-007: Awandare
                Categories
                Original Article
                Custom metadata
                January-December 2019

                hospital diagnosis,pediatric hospitalizations,pediatric diseases,volta region of ghana

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