Collins Ahorlu - Academia.edu (original) (raw)

Papers by Collins Ahorlu

Research Square (Research Square), Nov 21, 2019

Background: Global efforts to scale-up malaria control interventions are gaining steam. These inc... more Background: Global efforts to scale-up malaria control interventions are gaining steam. These include the use of Long-Lasting Insecticide Nets, Indoor Residual Spraying, Intermittent Preventive Treatment and Test, Treat and Track. Despite these, the drive for malaria elimination is far from being realistic in endemic communities in Africa. This is partly due to the fact that asymptomatic parasite carriage, not specifically targeted by most interventions, remains the bedrock that fuels transmission. This has led to mass testing, treatment and tracking (MTTT) as an alternative strategy to target asymptomatic individuals. We report the impact of MTTT on the prevalence of asymptomatic malaria parasitaemia over a one-year period in Ghana, hypothesizing that implementing MTTT could reduce the rate of asymptomatic parasitaemia. Methods: A population of about 5,000 individuals in seven communities in the Pakro sub-district of Ghana participated in this study. A register was developed for each community following a census. MTTT engaged trained community-based health volunteers who conducted house-to-house testing using RDTs every four months and treated positive cases with Artemisinin-based Combination Therapy. Between interventions, community-based management of malaria was implemented for symptomatic cases. Results: MTTT Coverage was 98.8% in July 2017 and 79.3% in July 2018. Of those tested, asymptomatic infection with malaria parasites reduced from 36.3% (1,795/4941) in July 2017 to 32.9% (1,303/3966) in July 2018 (p=0.001). Prevalence of asymptomatic parasitaemia among children under 15 years declined from 52.6% (1,043/1984) in July 2017 to 47.5% (820/1,728) in July 2018 (p=0.002). Implementing MTTT significantly reduced asymptomatic parasitaemia by 24% from July 2017 to July 2018 after adjusting for age, ITN use and axillary temperature (OR=0.76, CI=0.67, 0.85 p≤0.001). Conclusion: This study has demonstrated that implementing MTTT is feasible and could reduce the prevalence of asymptomatic malaria parasitaemia in children under 15 years of age. Furthermore, the use of community-based health volunteers could ensure high coverage at lower cost of implementation. Trial registration: NCT04167566, Date 14/11/2019 Retrospective registration. Background Over the last two decades, tremendous progress has been made in the fight against malaria

International Journal of Medical and Health Sciences, Mar 1, 2016

International Journal of Management Sciences, 2014

Crises management has become very important in recent years due to both manmade and natural occur... more Crises management has become very important in recent years due to both manmade and natural occurrences that could have disastrous effects on organizations. Crises cannot be effectively predicted or anticipated with a high level of certainty and this calls for some preparedness to handle crises whenever they occur. This study was designed to understand and describe the level of crisis management preparedness in a Ghanaian research institute. This was an exploratory study employing questionnaire for data collection. Majority of the respondents were not aware of the existence of any crisis management team in the organization. About 96.0% of respondents were not aware of the existence of crisis management plan in the organization. About 50.0% of respondents had identified some potential crises that could occur in the organization.

Tropical Medicine and Infectious Disease, Sep 28, 2022

This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY

BMJ Global Health, Apr 1, 2019

15% and 28% of these patients had severe hepatotoxicity at 4 and 24 weeks, respectively. Serum le... more 15% and 28% of these patients had severe hepatotoxicity at 4 and 24 weeks, respectively. Serum levels of all enzymes increased significantly (p<0.05) with increased treatment duration. Univariate analysis revealed that the risk factor of developing severe hepatotoxicity was significantly (p<0.05) greater in patients<30 years, males, low BMI, low monthly income earners and patient on AZT+3TC +NVP regimen. While multivariate analysis at p<0.09 showed that age <30 years, Low BMI, low monthly income, or the use of AZT +3TC +NVP regimen were independent risk factors. Conclusion Low BMI,<30 years, low monthly income and the use of AZT+3TC+NVP regimen were identifiable risk factors for the development of severe hepatotoxicity. As such, these factors should be considered as important for strategy by clinicians to prevent hepatotoxicity.

Frontiers in tropical diseases, Aug 11, 2022

Finding and eliminating the reservoirs: engage and treat, and test and treat strategies for lymph... more Finding and eliminating the reservoirs: engage and treat, and test and treat strategies for lymphatic filariasis programs to overcome endgame challenges.

Frontiers in tropical diseases, Apr 6, 2023

Founded in 1979, the Institute was built with a grant aid from the Government of Japan as a gift ... more Founded in 1979, the Institute was built with a grant aid from the Government of Japan as a gift to the people of Ghana in memory of the renowned Japanese medical scientist, Dr. Hideyo Noguchi, who died from Yellow fever infection while conducting research on the disease in Ghana. The Institute has a three-pronged mandate to conduct health related research, build human capacity and provide specialized diagnostic and disease monitoring services in support of the Ghana Health Service. Over the past 40 years, the Institute has grown to be a leading biomedical research institute in the African region. It has strong and long-standing collaborations with scientists and institutions in Africa, Japan, Europe, Australia and North America on several projects on diseases of public health importance. The Institute also hosts several regional and national centres such as Regional Influenza laboratory. The Institute's research activities are relevant to the control and prevention of infectious diseases in Ghana, particularly, HIV/AIDS, Tuberculosis, Buruli ulcer, Polio, Malaria and emerging infectious diseases. The Institute also plays a technical/advisory role to government through collaborations with disease control programmes and has since inception provided the country with needed critical evidence in support of health policy as well as laboratory diagnostic services among others. Going forward, the Institute seeks to expand and consolidate its activities in areas of antimicrobial resistance (AMR), clinical trials, genomic surveillance and academic programs and in the next 25 years, NMIMR hopes to approach every research area using the one health approach.

Research Square (Research Square), Oct 2, 2019

Research Square (Research Square), Mar 15, 2021

Background: Access to healthcare is important in controlling malaria burden and, as a result, dis... more Background: Access to healthcare is important in controlling malaria burden and, as a result, distance or travel time to health facilities is often a significant predictor in modeling malaria prevalence. Adding new health facilities may reduce overall travel time to health facilities and may decrease malaria transmission. To help guide local decision makers as they scale up community-based accessibility, we explore how the allocation of new health facilities might influence malaria prevalence in Bunkpurugu-Yunyoo district in northern Ghana. We perform a location-allocation analysis to find optimal locations of new health facilities by minimizing three district-wide objectives separately: malaria prevalence, malaria incidence, and average travel time to health facilities. Methods: We used generalized additive model to model malaria prevalence as a function of travel time to health facility and other geospatial covariates. The model predictions are used to calculate the optimization criteria for the location-allocation analysis. This analysis was performed for two scenarios: adding new health facilities to the existing ones, and a hypothetical scenario in which the community-based healthcare facilities would be allocated anew. We created an interactive web application to facilitate efficient presentation of this analysis and allow users to experiment with their choice of health facility location and optimization criteria. Results: Using malaria prevalence and travel time as optimization criteria, we found two locations that were not covered by existing community-based health services that would benefit from new health facilities, regardless of scenarios. Due to the non-linear relationship between malaria incidence and prevalence, the optimal locations chosen by using incidence criterion tend to be inequitable and are different from those based on the other optimization criteria. Conclusions: Our findings underscore the importance of using multiple optimization criteria in the decision-making process. We believe that our analysis and interactive application can be repurposed for other regions and criteria, bridging the gap between science, models and decisions.

Scientific Reports

Globally Antimicrobial Resistance (AMR) constitutes a health crisis, particularly in developing c... more Globally Antimicrobial Resistance (AMR) constitutes a health crisis, particularly in developing countries, where infectious disease are commonly fatal. There is clear evidence for microbial exposure and infection transmission within the home. Personal and environmental hygiene are the best ways of reducing household infections thus decreasing the need for antibiotics and consequently diminishing AMR. Despite this being an obvious step, research efforts to understand the home environment and its impact on AMR, cleaning and possible interventions on household cleaning are limited. We combined design and microbiology methods in an innovative mixed-method approach. A traditional survey design (n = 240), a design ethnography (n = 12), a co-design workshop and a pre-intervention microbiological dust sample analysis was undertaken to provide insights for codesign workshops in which new cleaning practices might be developed to minimise any AMR bacteria present in the household environments ...

Malaria Journal

Background Prompt diagnosis and treatment of malaria prevents a mild case from developing into se... more Background Prompt diagnosis and treatment of malaria prevents a mild case from developing into severe disease and death. Unfortunately, parasitological testing of febrile children is greater in the public and formal private sector than in the informal private sector where many patients with malaria-like symptoms first seek treatment. This study was aimed at improving implementation of the T3 policy among OTCMS using some interventions that could be scaled-up easily at the national level. Methods Interventions were evaluated using a two-arm, cluster randomized trial across 8 rural communities (4 clusters per arm), in two adjacent districts of Ghana. A total of 7 OTCMS in the intervention arm and 5 OTCMS in the control arm in the selected communities participated in the study. Five interventions were implemented in the intervention arm only. These were acquisition of subsidized malaria rapid diagnostic test (RDT) kits, training of OTCMS, supportive visits to OTCMS, community sensitiza...

Oguaa Journal of Social Sciences, 2015

Infant feeding has not always been seen as a social behaviour by health professionals and this ha... more Infant feeding has not always been seen as a social behaviour by health professionals and this has contributed substantiallyto infant mortality among various communities. This paper describes infant feeding practices among mothers in Cape Coast from a sociological perspective. A Symbolic interactionist perspective guided the study, and a descriptive crosssectional survey design methodology was used. The study targeted women, 20 years and above, with not more than six month old babies. A total of 138 mothers were selected at the Central Regional Hospital. Mother’s marital and employment status, their friends’ way of feeding their babies, social support and baby’s age influenced mothers’ infant feeding practices. Culturally, water, as a welcome drink, was also found to be an important part of infant feeding practices. It is recommended that the Ghana Health Service should fashion infant feeding education taking into consideration socioculturalfactors.

Malaria Journal, 2019

Background Mass and continuous distribution channels have significantly increased access to insec... more Background Mass and continuous distribution channels have significantly increased access to insecticide-treated nets (ITNs) in Ghana since 2000. Despite these gains, a large gap remains between ITN access and use. Methods A qualitative research study was carried out to explore the individual and contextual factors influencing ITN use among those with access in three sites in Ghana. Eighteen focus group discussions, and free listing and ranking activities were carried out with 174 participants; seven of those participants were selected for in-depth case study. Focus group discussions and case study interviews were audio-recorded, transcribed verbatim, and analysed thematically. Results ITN use, as described by study participants, was not binary; it varied throughout the night, across seasons, and over time. Heat was the most commonly cited barrier to consistent ITN use and contributed to low reported ITN use during the dry season. Barriers to ITN use throughout the year included skin...

BMC Public Health, 2019

Background Asymptomatic falciparum and non-falciparum malaria infections are major challenges to ... more Background Asymptomatic falciparum and non-falciparum malaria infections are major challenges to malaria control interventions, as they remain a source of continual infection in the community. This becomes even more important as the debate moves towards elimination and eradication. This study sought to quantify the burden of Plasmodium malaria infection in seven communities in the Eastern Region of Ghana. Methods The cross-sectional study recruited 729 participants aged 85 years old and below from 7 closely linked communities. Finger pricked blood was used to prepare thick and thin blood smears as well as spot filter paper and an histidine rich protein 2 (HRP2) rapid diagnostic test kit (RDT). Genomic DNA was extracted from the filter paper dry blood spot (DBS) and used in PCR to amplify the Plasmodium 18S rRNA gene using species specific PCR. Results 96.6% of the participants were identified as afebrile, with axillary temperatures below 37.5 °C. PCR identified 66% of the participan...