Dr. THOMAS AGYARKO-POKU BSc,MBCh.B.MPhil., MSc.Ph.D., FWACP,FRSM, FRSPH,MISSM | Kwame Nkrumah University of Science and Technology, Kumasi Ghana (original) (raw)

Papers by Dr. THOMAS AGYARKO-POKU BSc,MBCh.B.MPhil., MSc.Ph.D., FWACP,FRSM, FRSPH,MISSM

Research paper thumbnail of HIV destigmatization: perspectives of people living with HIV in the Kumasi Metropolis in Ghana

Frontiers in reproductive health, Sep 19, 2023

Research paper thumbnail of 2203. Risk Factors for Hepatitis C in Western Africa: An Observational Study in a STI Clinic

Open Forum Infectious Diseases, Nov 1, 2018

Background. Hepatitis C is a chronic life-threatening disease which is curable. However, ~60% of ... more Background. Hepatitis C is a chronic life-threatening disease which is curable. However, ~60% of Hep C-infected individuals are unaware of their infection status. The majority of Hep C has been documented in baby boomers (born 1946-1965; PMID:22895429). Methods. Prospective case study of adults presenting to the Emergency Departments (EDs) of a large is not for profit hospital system in the Houston, Texas area. Adults presenting between March 2013 and October 2016 were eligible for testing for antibody to Hep C (Gilead). Results. Over the 3.5 years study, 8,159 patients presenting to nine participating EDs in the Houston, Texas region were screened for Hep C. There were 744 (10.0%) individuals found positive. Prevalence of Hep C by testing ED ranged from 4.0 to 13.7% (P < 0.001) and males (11.8%) were significantly (P < 0.001) more frequently positive than females (6.6%). When parsed by age categories; individuals born before 1946 (3.8% Hep C positive) had a significantly lower (P < 0.001) prevalence of Hep C than cohorts born between 1946 and 1965 (9.6%+) or after 1965 (9.2%+). Conclusion. Hep C is prevalent in adult patients presenting to EDs in the Houston, Texas region. The 10% Hep C positivity rate is similar to that found (11.6%) in another Gulf state, Alabama (PMID: 26611776). Our findings differ in that prevalence in individuals born after 1965 was as high as that for baby boomers.

Research paper thumbnail of P12.13 Integrating sexually transmitted infections (sti) intervention project for female sex workers (fsw) into primary level of care in ghana: assessing the impact a decade after project implementation

Sexually Transmitted Infections, Sep 1, 2015

Research paper thumbnail of P3-S7.18 Aetiological agents of infective vaginal discharge among women attending a STD clinic in Kumasi, Ghana

Sexually Transmitted Infections, Jul 1, 2011

Research paper thumbnail of P3.359 My Goodness! Condoms Have Other Uses Besides Use During Sexual Intercourse

Sexually Transmitted Infections, Jul 1, 2013

Objective Evaluate introduction of rapid syphilis tests (RSTs) into antenatal clinic (ANC) servic... more Objective Evaluate introduction of rapid syphilis tests (RSTs) into antenatal clinic (ANC) services at low-level health facilities in 2 rural districts in Nyanza Province, Kenya-assessing coverage, testing quality, treatment, data recording, and effect on HIV testing. Methods From March 2011-February 2012, RSTs were introduced into ANC services at 25 rural facilities. Before introduction, handson training was conducted for nurses on use of RSTs, results counselling, appropriate maternal treatment, documenting data and proficiency testing. During the programme, 3 proficiency testing rounds were done. After the programme, ANC logbooks from 8 priority clinics were used to assess data reporting and compare coverage of syphilis and HIV testing and syphilis treatment for the 12-month intervals before and during the programme. Nurses and mothers were also interviewed. Results Thirty-four nurses from 25 clinics were trained. Proficiency testing identified and corrected early RST problems. In the 8 priority clinics, syphilis testing at first ANC visit increased from 18% (279/1586 attendees) in the 12 months before to 70% (1123/1614 attendees) during the 12-month programme (p < 0.001); 35 women (3%) tested positive during the programme vs. 1 (< 1%) in the previous 12 months (p < 0.001). RST use and results were routinely documented, but no clinic recorded treatment per training. In 5 clinics, assessment of HIV test coverage was limited by lack of prior HIV-positivity data; however, records from 3 high-volume clinics suggested no difference in HIV testing rates before and during the programme. Interviews indicated many new nurses were not trained, while mothers reported limited counselling about testing or results. Conclusions Introducing RSTs into rural ANC services greatly increased syphilis testing and detection without effects on HIV testing. We identified challenges in documenting treatment, counselling women appropriately, and adequate training. Amendments to existing and "refresher" training may improve services and documentation of treatment.

Research paper thumbnail of Research report: "It’s all about making a life": young female sex workers vulnerability to HIV and prevention needs in Kumasi, Ghana

This study would not have been possible without the partnership and support of many parties, abov... more This study would not have been possible without the partnership and support of many parties, above all, the young women and health care providers who participated in this study. The researchers would also like to thank USAID Ghana for sponsoring this study and the Ghana AIDS Commission for technical input. For their technical and programmatic input, we are particularly grateful to Kyemereh Atuahene from the Ghana AIDS Commission, Peter Wondergem from USAID Ghana, Yussif Ahmed Abdul Rahman and Kimberly Green from FHI 360, and to Abanish Rizal, Paul Ashigbie, Sarah Hurlburt, Evelyn Sakeah, and Arundati Muralidharan for their technical assistance. We also thank our excellent research assistants in both Kumasi and Boston, and anybody else who may have helped along the way.

Research paper thumbnail of P4.042 Ignorance! Major Cause of Advanced Form of Genital Warts Clinical Presentation in Kumasi Ghana

Sexually Transmitted Infections, Jul 1, 2013

Research paper thumbnail of Research report: Exploring the beliefs, attitudes, and behaviors of MSM engaged in substance use and transactional sex in Ghana

Research paper thumbnail of High mortality among people living with HIV and AIDS accessing care at hospitals in Ghana. Do they report too late?

BMC Infectious Diseases, May 1, 2014

Agyarko-Poku et al.: High mortality among people living with HIV and AIDS accessing care at hospi... more Agyarko-Poku et al.: High mortality among people living with HIV and AIDS accessing care at hospitals in Ghana. Do they report too late? BMC Infectious Diseases 2014 14(Suppl 2):P38.

Research paper thumbnail of Attitudes and behaviors among older MSM in Ghana

Attitudes and Behaviors among Older MSM in Ghana b a c k g r o u n d Men who have sex with men (M... more Attitudes and Behaviors among Older MSM in Ghana b a c k g r o u n d Men who have sex with men (MSM) are a particularly stigmatized group in Ghana. Male-tomale sex is viewed as "unnatural" and therefore illegal. MSM are a critical, though difficult, population to reach with HIV-related services. Preventing HIV among key populations is a goal of the National AIDS Control Program (NACP) and the Ghana AIDS Commission (GAC). 1 Until recently, specific data on MSM in the country were limited. The Ghana Men's Study (GMS), which collected information from 1,302 MSM in five regions in 2011, provides detailed data on HIV and sexually transmitted infection (STI) prevalence and risk behaviors among MSM. Whereas adult HIV prevalence in Ghana has been estimated 1.31% in 2013, 2 the GMS documented a nationwide average prevalence in 2011 of 17.5% among MSM, with the rate in Accra estimated at 34.3% and 13.7% in Kumasi. 3

Research paper thumbnail of P3.427 Exploring the Beliefs, Attitudes, and Behaviours of MSM Engaged in Substance Use and Transactional Sex in Ghana

Sexually Transmitted Infections, Jul 1, 2013

Research paper thumbnail of Autonomy-Supportive Healthcare Climate and HIV-Related Stigma Predict Linkage to HIV Care in Men Who Have Sex With Men in Ghana, West Africa

Journal of the International Association of Providers of AIDS Care, 2021

In Ghana, the HIV prevalence among MSM is more than 10 times greater than the general population ... more In Ghana, the HIV prevalence among MSM is more than 10 times greater than the general population of adults, and rates of engagement in HIV medical care are low among MSM diagnosed with HIV. Using structured surveys, we investigated the impact of HIV-related stigma, same-sex behavior stigma, and gender nonconformity stigma on linkage to HIV care (LTC) in MSM (N ¼ 225) living with HIV in Ghana. Autonomy-supportive healthcare climate (OR ¼ 1.63, p < .01), vicarious HIV stigma (OR ¼ 2.73, p < .01), and age (OR ¼ 1.06, p < .004) predicted LTC. Conversely, felt normative HIV stigma negatively predicted LTC (OR ¼ 0.65, p < .05). Finally, we identified regional disparities, with MSM from Takoradi being 4 times and 5 times more likely to be LTC compared to Kumasi and Accra, respectively. Our findings highlight the nuanced roles of stigmas in shaping the HIV care continuum among MSM living with HIV, while revealing potential gaps in current measures of HIV-related stigma.

Research paper thumbnail of P2.146 CD4 Lymphocytes Count At First Presentation of HIV Positive Patients Accessing Antiretroviral Therapy At a District Hospital in Ghana

Sexually Transmitted Infections, Jul 1, 2013

Poster presentations Conclusion We propose that with good interagency and MDT working, an efficie... more Poster presentations Conclusion We propose that with good interagency and MDT working, an efficient and effective ART delivery service is feasible, with patient and hospital benefits. Collaborative approaches between the delivery service and HIV MDT should be established and regularly evaluated with patient input. Identifying a key contact person for the delivery service is important to ensure continuity of communication, together with a local contractual service level agreement to ensure clear terms of reference and accountability. Results of a qualitative patient survey evaluating the delivery service are imminent. Do Patients Have ConfiDenCe in traineD non MeDiCal HealtH Care staff sCreening for sexually transMitteD infeCtions?

Research paper thumbnail of Low prevalence of cervical infections in women with vaginal discharge in west Africa: implications for syndromic management

Sexually Transmitted Infections, 2004

To measure prevalence and risk factors for cervical infections among a large sample of women cons... more To measure prevalence and risk factors for cervical infections among a large sample of women consulting for vaginal discharge in west Africa and to evaluate its syndromic management through a two visit algorithm. Methods: In 11 health centres in Bénin, Burkina Faso, Ghana, Guinée, and Mali 726 women who presented with a vaginal discharge without abdominal pain and who denied being a sex worker (SW) were enrolled. Cervical samples were tested for the detection of Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT) with polymerase chain reaction (PCR) assays. All participants were treated with single dose (2 g) metronidazole and clotrimazole cream for 3 days. They were randomised to be told either to come back on day 7 only if there was no improvement in the discharge (group A), or to come back on day 7 regardless of response to treatment (group B). Results: Overall, the prevalence of NG and CT was only 1.9% (14/726) and 3.2% (23/726) respectively. Risk factors previously recommended by the WHO were not associated with the presence of cervical infection, with the exception of the number of sex partners in the past 3 months. When taken together, these risk factors had a positive predictive value of only 6.4% to identify cervical infections. Prevalence of cervical infection was not higher in women who came back on day 7, regardless of the strategy used. Prevalence of NG/CT was lower in Ghana and Bénin (5/280, 1.8%), where comprehensive interventions for SW have been ongoing for years, than in the three other countries (27/446, 6.1%, p = 0.01). Conclusions: NG and CT infections are uncommon in west African women who consult for vaginal discharge and who are not SW. Syndromic management of vaginal discharge should focus on the proper management of vaginitis. The control of gonococcal and chlamydial infection should be redesigned around interventions focusing on sex workers.

Research paper thumbnail of Contraceptive decision-making among women living with HIV in Ghana and Kenya

APHA's 2020 VIRTUAL Annual Meeting and Expo (Oct. 24 - 28), Oct 26, 2020

Research paper thumbnail of P2.142 Too Bad! Single Molecule Antiretroviral Drugs May Not Be the Magic Bullet

Sexually Transmitted Infections, 2013

We studied C. trachomatis (CT) serotype-specific antibodies in Finnish women between 1980's and 2... more We studied C. trachomatis (CT) serotype-specific antibodies in Finnish women between 1980's and 2000's. C. trachomatis seropositive women (1,169) were available from a subcohort (11,067) of the Finnish Maternity Cohort representing the 1980's (N = 480) and 2000's (N = 331) for serotype specific classification by microimmunofluorescence test. Serotype distributions were comparable in the 1980's and 2000's, G, E and J being the most prevalent. Serotype D peaked in the 1990's. The overall serotype profile changed first between 1980's and 1990's but changed back in the 2000's. The rates of women with antibodies against two or more serotypes increased in the 1990's, but then decreased again. In conclusion, we analysed the rates and distributions of CT serotype-specific antibodies from the 1980's to 2000's in fertile-aged female population in Finland. We found that CT serotype distributions varied considerably over time.

Research paper thumbnail of HIV status disclosure and sexual activity among pregnant women in Ghana

Research paper thumbnail of Program brief: Exploring the beliefs, attitudes, and behaviors of msm engaged in substance use and transactional sex in Ghana

This study was implemented by Boston University in collaboration with the Kwame Nkrumah Universit... more This study was implemented by Boston University in collaboration with the Kwame Nkrumah University of Science and Technology with support from the President’s Emergency Plan for AIDS Relief (PEPFAR) through the U.S. Agency for International Development under Project SEARCH Task Order No. GHH‐I‐00‐07‐00023‐00, beginning August 27, 2010. The content and views expressed here are the authors’ and do not necessarily reflect the opinion or policy of USAID or the U.S. Government.Preventing HIV among key populations is a goal of the National AIDS Control Program (NACP) and the Ghana AIDS Commission (GAC).1 Men who have sex with men (MSM) are a particularly stigmatized group in Ghana, in part because male-to-male sex is viewed as “unnatural” and therefore illegal. MSM are a critical though difficult population to reach with HIV-related services. Until recently, specific data on MSM in the country were limited. The Ghana Men’s Study (GMS), which collected data from 1,302 MSM in five regions i...

Research paper thumbnail of Understanding the relationship dynamics between female sex workers and their intimate partners in Kumasi, Ghana

This study was implemented by Boston University in collaboration with the Kwame Nkrumah Universit... more This study was implemented by Boston University in collaboration with the Kwame Nkrumah University of Science and Technology with support from the President’s Emergency Plan for AIDS Relief (PEPFAR) through the U.S. Agency for International Development under Project SEARCH Task Order No. GHH‐I‐00‐07‐00023‐00, beginning August 27, 2010. The content and views expressed here are the authors’ and do not necessarily reflect the opinion or policy of USAID or the U.S. Government.This report presents findings from a qualitative study examining vulnerability to HIV and the prevention needs of men involved in intimate relationships with female sex workers (FSW) in Kumasi, Ghana. The study was conducted by a collaborative team of researchers from Boston University’s Center for Global and Health and Development (CGHD), Kwame Nkrumah University of Science and Technology (KNUST), and FHI 360. It is the last of nine small qualitative studies conducted under the Operations Research among Key Popula...

Research paper thumbnail of Additional file 1 of High levels of used syringe use and unsafe sex among people who inject drugs in Kumasi, Ghana: an urgent call for a comprehensive harm reduction approach

Additional file 1. Socio-demographic characteristics and behaviors of PWID completing surveys at ... more Additional file 1. Socio-demographic characteristics and behaviors of PWID completing surveys at major bases in Kumasi, Ghana (n = 221)

Research paper thumbnail of HIV destigmatization: perspectives of people living with HIV in the Kumasi Metropolis in Ghana

Frontiers in reproductive health, Sep 19, 2023

Research paper thumbnail of 2203. Risk Factors for Hepatitis C in Western Africa: An Observational Study in a STI Clinic

Open Forum Infectious Diseases, Nov 1, 2018

Background. Hepatitis C is a chronic life-threatening disease which is curable. However, ~60% of ... more Background. Hepatitis C is a chronic life-threatening disease which is curable. However, ~60% of Hep C-infected individuals are unaware of their infection status. The majority of Hep C has been documented in baby boomers (born 1946-1965; PMID:22895429). Methods. Prospective case study of adults presenting to the Emergency Departments (EDs) of a large is not for profit hospital system in the Houston, Texas area. Adults presenting between March 2013 and October 2016 were eligible for testing for antibody to Hep C (Gilead). Results. Over the 3.5 years study, 8,159 patients presenting to nine participating EDs in the Houston, Texas region were screened for Hep C. There were 744 (10.0%) individuals found positive. Prevalence of Hep C by testing ED ranged from 4.0 to 13.7% (P < 0.001) and males (11.8%) were significantly (P < 0.001) more frequently positive than females (6.6%). When parsed by age categories; individuals born before 1946 (3.8% Hep C positive) had a significantly lower (P < 0.001) prevalence of Hep C than cohorts born between 1946 and 1965 (9.6%+) or after 1965 (9.2%+). Conclusion. Hep C is prevalent in adult patients presenting to EDs in the Houston, Texas region. The 10% Hep C positivity rate is similar to that found (11.6%) in another Gulf state, Alabama (PMID: 26611776). Our findings differ in that prevalence in individuals born after 1965 was as high as that for baby boomers.

Research paper thumbnail of P12.13 Integrating sexually transmitted infections (sti) intervention project for female sex workers (fsw) into primary level of care in ghana: assessing the impact a decade after project implementation

Sexually Transmitted Infections, Sep 1, 2015

Research paper thumbnail of P3-S7.18 Aetiological agents of infective vaginal discharge among women attending a STD clinic in Kumasi, Ghana

Sexually Transmitted Infections, Jul 1, 2011

Research paper thumbnail of P3.359 My Goodness! Condoms Have Other Uses Besides Use During Sexual Intercourse

Sexually Transmitted Infections, Jul 1, 2013

Objective Evaluate introduction of rapid syphilis tests (RSTs) into antenatal clinic (ANC) servic... more Objective Evaluate introduction of rapid syphilis tests (RSTs) into antenatal clinic (ANC) services at low-level health facilities in 2 rural districts in Nyanza Province, Kenya-assessing coverage, testing quality, treatment, data recording, and effect on HIV testing. Methods From March 2011-February 2012, RSTs were introduced into ANC services at 25 rural facilities. Before introduction, handson training was conducted for nurses on use of RSTs, results counselling, appropriate maternal treatment, documenting data and proficiency testing. During the programme, 3 proficiency testing rounds were done. After the programme, ANC logbooks from 8 priority clinics were used to assess data reporting and compare coverage of syphilis and HIV testing and syphilis treatment for the 12-month intervals before and during the programme. Nurses and mothers were also interviewed. Results Thirty-four nurses from 25 clinics were trained. Proficiency testing identified and corrected early RST problems. In the 8 priority clinics, syphilis testing at first ANC visit increased from 18% (279/1586 attendees) in the 12 months before to 70% (1123/1614 attendees) during the 12-month programme (p < 0.001); 35 women (3%) tested positive during the programme vs. 1 (< 1%) in the previous 12 months (p < 0.001). RST use and results were routinely documented, but no clinic recorded treatment per training. In 5 clinics, assessment of HIV test coverage was limited by lack of prior HIV-positivity data; however, records from 3 high-volume clinics suggested no difference in HIV testing rates before and during the programme. Interviews indicated many new nurses were not trained, while mothers reported limited counselling about testing or results. Conclusions Introducing RSTs into rural ANC services greatly increased syphilis testing and detection without effects on HIV testing. We identified challenges in documenting treatment, counselling women appropriately, and adequate training. Amendments to existing and "refresher" training may improve services and documentation of treatment.

Research paper thumbnail of Research report: "It’s all about making a life": young female sex workers vulnerability to HIV and prevention needs in Kumasi, Ghana

This study would not have been possible without the partnership and support of many parties, abov... more This study would not have been possible without the partnership and support of many parties, above all, the young women and health care providers who participated in this study. The researchers would also like to thank USAID Ghana for sponsoring this study and the Ghana AIDS Commission for technical input. For their technical and programmatic input, we are particularly grateful to Kyemereh Atuahene from the Ghana AIDS Commission, Peter Wondergem from USAID Ghana, Yussif Ahmed Abdul Rahman and Kimberly Green from FHI 360, and to Abanish Rizal, Paul Ashigbie, Sarah Hurlburt, Evelyn Sakeah, and Arundati Muralidharan for their technical assistance. We also thank our excellent research assistants in both Kumasi and Boston, and anybody else who may have helped along the way.

Research paper thumbnail of P4.042 Ignorance! Major Cause of Advanced Form of Genital Warts Clinical Presentation in Kumasi Ghana

Sexually Transmitted Infections, Jul 1, 2013

Research paper thumbnail of Research report: Exploring the beliefs, attitudes, and behaviors of MSM engaged in substance use and transactional sex in Ghana

Research paper thumbnail of High mortality among people living with HIV and AIDS accessing care at hospitals in Ghana. Do they report too late?

BMC Infectious Diseases, May 1, 2014

Agyarko-Poku et al.: High mortality among people living with HIV and AIDS accessing care at hospi... more Agyarko-Poku et al.: High mortality among people living with HIV and AIDS accessing care at hospitals in Ghana. Do they report too late? BMC Infectious Diseases 2014 14(Suppl 2):P38.

Research paper thumbnail of Attitudes and behaviors among older MSM in Ghana

Attitudes and Behaviors among Older MSM in Ghana b a c k g r o u n d Men who have sex with men (M... more Attitudes and Behaviors among Older MSM in Ghana b a c k g r o u n d Men who have sex with men (MSM) are a particularly stigmatized group in Ghana. Male-tomale sex is viewed as "unnatural" and therefore illegal. MSM are a critical, though difficult, population to reach with HIV-related services. Preventing HIV among key populations is a goal of the National AIDS Control Program (NACP) and the Ghana AIDS Commission (GAC). 1 Until recently, specific data on MSM in the country were limited. The Ghana Men's Study (GMS), which collected information from 1,302 MSM in five regions in 2011, provides detailed data on HIV and sexually transmitted infection (STI) prevalence and risk behaviors among MSM. Whereas adult HIV prevalence in Ghana has been estimated 1.31% in 2013, 2 the GMS documented a nationwide average prevalence in 2011 of 17.5% among MSM, with the rate in Accra estimated at 34.3% and 13.7% in Kumasi. 3

Research paper thumbnail of P3.427 Exploring the Beliefs, Attitudes, and Behaviours of MSM Engaged in Substance Use and Transactional Sex in Ghana

Sexually Transmitted Infections, Jul 1, 2013

Research paper thumbnail of Autonomy-Supportive Healthcare Climate and HIV-Related Stigma Predict Linkage to HIV Care in Men Who Have Sex With Men in Ghana, West Africa

Journal of the International Association of Providers of AIDS Care, 2021

In Ghana, the HIV prevalence among MSM is more than 10 times greater than the general population ... more In Ghana, the HIV prevalence among MSM is more than 10 times greater than the general population of adults, and rates of engagement in HIV medical care are low among MSM diagnosed with HIV. Using structured surveys, we investigated the impact of HIV-related stigma, same-sex behavior stigma, and gender nonconformity stigma on linkage to HIV care (LTC) in MSM (N ¼ 225) living with HIV in Ghana. Autonomy-supportive healthcare climate (OR ¼ 1.63, p < .01), vicarious HIV stigma (OR ¼ 2.73, p < .01), and age (OR ¼ 1.06, p < .004) predicted LTC. Conversely, felt normative HIV stigma negatively predicted LTC (OR ¼ 0.65, p < .05). Finally, we identified regional disparities, with MSM from Takoradi being 4 times and 5 times more likely to be LTC compared to Kumasi and Accra, respectively. Our findings highlight the nuanced roles of stigmas in shaping the HIV care continuum among MSM living with HIV, while revealing potential gaps in current measures of HIV-related stigma.

Research paper thumbnail of P2.146 CD4 Lymphocytes Count At First Presentation of HIV Positive Patients Accessing Antiretroviral Therapy At a District Hospital in Ghana

Sexually Transmitted Infections, Jul 1, 2013

Poster presentations Conclusion We propose that with good interagency and MDT working, an efficie... more Poster presentations Conclusion We propose that with good interagency and MDT working, an efficient and effective ART delivery service is feasible, with patient and hospital benefits. Collaborative approaches between the delivery service and HIV MDT should be established and regularly evaluated with patient input. Identifying a key contact person for the delivery service is important to ensure continuity of communication, together with a local contractual service level agreement to ensure clear terms of reference and accountability. Results of a qualitative patient survey evaluating the delivery service are imminent. Do Patients Have ConfiDenCe in traineD non MeDiCal HealtH Care staff sCreening for sexually transMitteD infeCtions?

Research paper thumbnail of Low prevalence of cervical infections in women with vaginal discharge in west Africa: implications for syndromic management

Sexually Transmitted Infections, 2004

To measure prevalence and risk factors for cervical infections among a large sample of women cons... more To measure prevalence and risk factors for cervical infections among a large sample of women consulting for vaginal discharge in west Africa and to evaluate its syndromic management through a two visit algorithm. Methods: In 11 health centres in Bénin, Burkina Faso, Ghana, Guinée, and Mali 726 women who presented with a vaginal discharge without abdominal pain and who denied being a sex worker (SW) were enrolled. Cervical samples were tested for the detection of Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT) with polymerase chain reaction (PCR) assays. All participants were treated with single dose (2 g) metronidazole and clotrimazole cream for 3 days. They were randomised to be told either to come back on day 7 only if there was no improvement in the discharge (group A), or to come back on day 7 regardless of response to treatment (group B). Results: Overall, the prevalence of NG and CT was only 1.9% (14/726) and 3.2% (23/726) respectively. Risk factors previously recommended by the WHO were not associated with the presence of cervical infection, with the exception of the number of sex partners in the past 3 months. When taken together, these risk factors had a positive predictive value of only 6.4% to identify cervical infections. Prevalence of cervical infection was not higher in women who came back on day 7, regardless of the strategy used. Prevalence of NG/CT was lower in Ghana and Bénin (5/280, 1.8%), where comprehensive interventions for SW have been ongoing for years, than in the three other countries (27/446, 6.1%, p = 0.01). Conclusions: NG and CT infections are uncommon in west African women who consult for vaginal discharge and who are not SW. Syndromic management of vaginal discharge should focus on the proper management of vaginitis. The control of gonococcal and chlamydial infection should be redesigned around interventions focusing on sex workers.

Research paper thumbnail of Contraceptive decision-making among women living with HIV in Ghana and Kenya

APHA's 2020 VIRTUAL Annual Meeting and Expo (Oct. 24 - 28), Oct 26, 2020

Research paper thumbnail of P2.142 Too Bad! Single Molecule Antiretroviral Drugs May Not Be the Magic Bullet

Sexually Transmitted Infections, 2013

We studied C. trachomatis (CT) serotype-specific antibodies in Finnish women between 1980's and 2... more We studied C. trachomatis (CT) serotype-specific antibodies in Finnish women between 1980's and 2000's. C. trachomatis seropositive women (1,169) were available from a subcohort (11,067) of the Finnish Maternity Cohort representing the 1980's (N = 480) and 2000's (N = 331) for serotype specific classification by microimmunofluorescence test. Serotype distributions were comparable in the 1980's and 2000's, G, E and J being the most prevalent. Serotype D peaked in the 1990's. The overall serotype profile changed first between 1980's and 1990's but changed back in the 2000's. The rates of women with antibodies against two or more serotypes increased in the 1990's, but then decreased again. In conclusion, we analysed the rates and distributions of CT serotype-specific antibodies from the 1980's to 2000's in fertile-aged female population in Finland. We found that CT serotype distributions varied considerably over time.

Research paper thumbnail of HIV status disclosure and sexual activity among pregnant women in Ghana

Research paper thumbnail of Program brief: Exploring the beliefs, attitudes, and behaviors of msm engaged in substance use and transactional sex in Ghana

This study was implemented by Boston University in collaboration with the Kwame Nkrumah Universit... more This study was implemented by Boston University in collaboration with the Kwame Nkrumah University of Science and Technology with support from the President’s Emergency Plan for AIDS Relief (PEPFAR) through the U.S. Agency for International Development under Project SEARCH Task Order No. GHH‐I‐00‐07‐00023‐00, beginning August 27, 2010. The content and views expressed here are the authors’ and do not necessarily reflect the opinion or policy of USAID or the U.S. Government.Preventing HIV among key populations is a goal of the National AIDS Control Program (NACP) and the Ghana AIDS Commission (GAC).1 Men who have sex with men (MSM) are a particularly stigmatized group in Ghana, in part because male-to-male sex is viewed as “unnatural” and therefore illegal. MSM are a critical though difficult population to reach with HIV-related services. Until recently, specific data on MSM in the country were limited. The Ghana Men’s Study (GMS), which collected data from 1,302 MSM in five regions i...

Research paper thumbnail of Understanding the relationship dynamics between female sex workers and their intimate partners in Kumasi, Ghana

This study was implemented by Boston University in collaboration with the Kwame Nkrumah Universit... more This study was implemented by Boston University in collaboration with the Kwame Nkrumah University of Science and Technology with support from the President’s Emergency Plan for AIDS Relief (PEPFAR) through the U.S. Agency for International Development under Project SEARCH Task Order No. GHH‐I‐00‐07‐00023‐00, beginning August 27, 2010. The content and views expressed here are the authors’ and do not necessarily reflect the opinion or policy of USAID or the U.S. Government.This report presents findings from a qualitative study examining vulnerability to HIV and the prevention needs of men involved in intimate relationships with female sex workers (FSW) in Kumasi, Ghana. The study was conducted by a collaborative team of researchers from Boston University’s Center for Global and Health and Development (CGHD), Kwame Nkrumah University of Science and Technology (KNUST), and FHI 360. It is the last of nine small qualitative studies conducted under the Operations Research among Key Popula...

Research paper thumbnail of Additional file 1 of High levels of used syringe use and unsafe sex among people who inject drugs in Kumasi, Ghana: an urgent call for a comprehensive harm reduction approach

Additional file 1. Socio-demographic characteristics and behaviors of PWID completing surveys at ... more Additional file 1. Socio-demographic characteristics and behaviors of PWID completing surveys at major bases in Kumasi, Ghana (n = 221)

Research paper thumbnail of Cost Effectiveness of Option B+ for Prevention of Mother-to-Child Transmission of HIV in Resource-Limited Countries: Evidence from Kumasi, Ghana

Background: Achieving the goal of eliminating mother-to-child HIV transmission (MTCT) necessitate... more Background: Achieving the goal of eliminating mother-to-child HIV transmission (MTCT) necessitates increased access to antiretroviral therapy (ART) for HIV-infected pregnant women. Option B provides ART through pregnancy and breastfeeding, whereas Option B + recommends continuous ART regardless of CD4 count, thus potentially reducing MTCT during future pregnancies. Our objective was to compare maternal and pediatric health outcomes and cost-effectiveness of Option B+ versus Option B in Ghana.