Displaying publications 21 - 40 of 47 in total

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  1. Dutra NB, Chen L, Anum A, Burger O, Davis HE, Dzokoto VA, et al.
    Dev Sci, 2022 Sep;25(5):e13228.
    PMID: 35025126 DOI: 10.1111/desc.13228
    Self-regulation is a widely studied construct, generally assumed to be cognitively supported by executive functions (EFs). There is a lack of clarity and consensus over the roles of specific components of EFs in self-regulation. The current study examines the relations between performance on (a) a self-regulation task (Heads, Toes, Knees Shoulders Task) and (b) two EF tasks (Knox Cube and Beads Tasks) that measure different components of updating: working memory and short-term memory, respectively. We compared 107 8- to 13-year-old children (64 females) across demographically-diverse populations in four low and middle-income countries, including: Tanna, Vanuatu; Keningau, Malaysia; Saltpond, Ghana; and Natal, Brazil. The communities we studied vary in market integration/urbanicity as well as level of access, structure, and quality of schooling. We found that performance on the visuospatial working memory task (Knox Cube) and the visuospatial short-term memory task (Beads) are each independently associated with performance on the self-regulation task, even when controlling for schooling and location effects. These effects were robust across demographically-diverse populations of children in low-and middle-income countries. We conclude that this study found evidence supporting visuospatial working memory and visuospatial short-term memory as distinct cognitive processes which each support the development of self-regulation.
    Matched MeSH terms: Ghana
  2. Bougangue B, Ling HK
    BMC Public Health, 2017 09 06;17(1):693.
    PMID: 28874157 DOI: 10.1186/s12889-017-4680-2
    BACKGROUND: The need to promote maternal health in Ghana has committed the government to extend maternal healthcare services to the door steps of rural families through the community-based Health Planning and Services. Based on the concerns raised in previous studies that male spouses were indifferent towards maternal healthcare, this study sought the views of men on their involvement in maternal healthcare in their respective communities and at the household levels in the various Community-based Health Planning and Services zones in Awutu-Senya West District in the Central Region of Ghana.

    METHODS: A qualitative method was employed. Focus groups and individual interviews were conducted with married men, community health officers, community health volunteers and community leaders. The participants were selected using purposive, quota and snowball sampling techniques. The study used thematic analysis for analysing the data.

    RESULTS: The study shows varying involvement of men, some were directly involved in feminine gender roles; others used their female relatives and co-wives to perform the women's roles that did not have space for them. They were not necessarily indifferent towards maternal healthcare, rather, they were involved in the spaces provided by the traditional gender division of labour. Amongst other things, the perpetuation and reinforcement of traditional gender norms around pregnancy and childbirth influenced the nature and level of male involvement.

    CONCLUSIONS: Sustenance of male involvement especially, husbands and CHVs is required at the household and community levels for positive maternal outcomes. Ghana Health Service, health professionals and policy makers should take traditional gender role expectations into consideration in the planning and implementation of maternal health promotion programmes.

    Matched MeSH terms: Ghana
  3. Dalaba MA, Akweongo P, Aborigo RA, Saronga HP, Williams J, Aninanya GA, et al.
    BMC Health Serv Res, 2015;15:34.
    PMID: 25608609 DOI: 10.1186/s12913-014-0659-1
    The cost of treating maternal complications has serious economic consequences to households and can hinder the utilization of maternal health care services at the health facilities. This study estimated the cost of maternal complications to women and their households in the Kassena-Nankana district of northern Ghana.
    Matched MeSH terms: Ghana
  4. Amankwah O, Weng-Wai C, Mohammed AH
    Environ Health Insights, 2019;13:1178630219852115.
    PMID: 31217690 DOI: 10.1177/1178630219852115
    Objective: The multifaceted nature of health care delivery has led to the need to incorporate strategies that will help to enhance performance and maintain the quality of the health care environment. However, even though dedicated health care staffs contribute to patients' satisfaction of health care delivery, the health care environment must ensure the safety and well-being of patients. Like most developing countries, many public hospitals in Ghana are faced with challenges in the area of health care healing environment. Therefore, this article investigates the mediating effect of health care healing environment between health care core business and patients' satisfaction.

    Method: This is a cross-sectional study involving adult patients of Komfo Anokye Teaching Hospital, Tamale Teaching Hospital, and Cape Coast Teaching Hospital in Ghana. A questionnaire survey based on the 'A Staff and Patient Environment Calibration Toolkit (ASPECT)' dimensions and health care core service dimensions was used to collect data from 622 patients. SmartPLS was used to analyse the data collected.

    Results: The findings of the study show that the quality of health care healing environment mediates the relationship between patients' satisfaction and all of the constructs under the core health care delivery.

    Conclusion: Stakeholders of the Ghanaian health care sector should take initiatives to constantly improve the quality of health care healing environment as it has an influence on patient satisfaction of the overall core health care delivery.

    Matched MeSH terms: Ghana
  5. Rominski SD, Gupta M, Aborigo R, Adongo P, Engman C, Hodgson A, et al.
    Int J Gynaecol Obstet, 2014 Sep;126(3):217-22.
    PMID: 24920181 DOI: 10.1016/j.ijgo.2014.03.031
    OBJECTIVE: To investigate factors associated with self-reported pregnancy termination in Ghana and thereby appreciate the correlates of abortion-seeking in order to understand safe abortion care provision.
    METHODS: In a retrospective study, data from the Ghana 2008 Demographic and Health Survey were used to investigate factors associated with self-reported pregnancy termination. Variables on an individual and household level were examined by both bivariate analyses and multivariate logistic regression. A five-point autonomy scale was created to explore the role of female autonomy in reported abortion-seeking behavior.
    RESULTS: Among 4916 women included in the survey, 791 (16.1%) reported having an abortion. Factors associated with abortion-seeking included being older, having attended school, and living in an urban versus a rural area. When entered into a logistic regression model with demographic control variables, every step up the autonomy scale (i.e. increasing autonomy) was associated with a 14.0% increased likelihood of reporting the termination of a pregnancy (P < 0.05).
    CONCLUSION: Although health system barriers might play a role in preventing women from seeking safe abortion services, autonomy on an individual level is also important and needs to be addressed if women are to be empowered to seek safe abortion services.
    KEYWORDS: Abortion; Autonomy; Empowerment; Low-resource countries; Maternal health; Reproductive health
    Matched MeSH terms: Ghana; Ghana/epidemiology
  6. Gupta ML, Aborigo RA, Adongo PB, Rominski S, Hodgson A, Engmann CM, et al.
    Glob Public Health, 2015 Oct;10(9):1078-91.
    PMID: 25635475 DOI: 10.1080/17441692.2014.1002413
    Previous research suggests that care-seeking in rural northern Ghana is often governed by a woman's husband or compound head. This study was designed to explore the role grandmothers (typically a woman's mother-in-law) play in influencing maternal and newborn healthcare decisions. In-depth interviews were conducted with 35 mothers of newborns, 8 traditional birth attendants and local healers, 16 community leaders and 13 healthcare practitioners. An additional 18 focus groups were conducted with stakeholders such as household heads, compound leaders and grandmothers. In this region, grandmothers play many roles. They may act as primary support providers to pregnant mothers, care for newborns following delivery, preserve cultural traditions and serve as repositories of knowledge on local medicine. Grandmothers may also serve as gatekeepers for health-seeking behaviour, especially with regard to their daughters and daughters-in-law. This research also sheds light on the potential gap between health education campaigns that target mothers as autonomous decision-makers, and the reality of a more collectivist community structure in which mothers rarely make such decisions without the support of other community members.
    Matched MeSH terms: Ghana/epidemiology
  7. Kennedy C, Bowman R, Fariza N, Ackuaku E, Ntim-Amponsah C, Murdoch I
    J Telemed Telecare, 2006;12(2):88-91.
    PMID: 16539756
    A Web-based service was set up to link subspecialist ophthalmologists with those seeking advice on particular clinical problems in ophthalmology. The service operated between countries, with centres in Malaysia, Ghana, Tanzania, South Africa and Gambia seeking advice from Moorfields Eye Hospital in the UK. It also operated within country, where a rural clinic in The Gambia sought advice from the central hospital on difficult cases or cases for possible referral. Provision of Web access and training in image capture and manipulation were undertaken in each participating centre. During the first 12 months, 132 cases were posted to the Website from five of the six centres participating. The rate of case referral rose to about 12-14 cases per month by the end of the study. Overall, 24% of referrals did not use images. In the first four months the response time was 13 days, and in the last four months it was three days. Most cases were answered with a single response from the specialist. The main problem was the amount of Internet down-time in each of the locations. The main benefit was safe and reliable access to specialist advice for practitioners.
    Matched MeSH terms: Ghana
  8. Asare EA, Abdul-Wahab D, Asamoah A, Dampare SB, Kaufmann EE, Wahi R, et al.
    Environ Monit Assess, 2024 May 01;196(5):494.
    PMID: 38691200 DOI: 10.1007/s10661-024-12654-7
    This study investigated the impact of soil type, pH, and geographical locations on the accumulation of arsenic (As), lead (Pb), and cadmium (Cd) in rice grains cultivated in Ghana. One hundred rice farms for the sampling of rice grains and soil were selected from two regions in Ghana-Volta and Oti. The concentrations of As, Pb, and Cd were analyzed using ICP-OES. Speciation modeling and multivariate statistics were employed to ascertain the relations among measured parameters. The results showed significant variations in soil-As, Pb, and Cd levels across different soil types and pH ranges, with the highest soil-As and Cd found in alkaline vertisols. For soil-As and Cd, the vertisols with a pH more than 7.0 exhibited the highest mean concentration of As (2.51 ± 0.932 mgkg-1) and Cd (1.00 ± 0.244 mgkg-1) whereas for soil-Pb, the luvisols of soil types with a pH less than 6.0 exhibited the highest mean concentration of Pb (4.91 ± 1.540 mgkg-1). Grain As, Pb, and Cd also varied across soil types and pH levels. In regards to grain-As, the vertisols soil type, with a pH less than 6.0, shows the highest mean concentration of grain As, at 0.238 ± 0.107 mgkg-1. Furthermore, vertisols soil types with a pH level less than 6.0 showed the highest mean concentration of grain Cd, averaging at 0.231 ± 0.068 mgkg-1 while luvisols, with a pH less than 6.0, exhibited the highest mean concentration of grain Pb at 0.713 ± 0.099 mgkg-1. Speciation modeling indicated increased bioavailability of grains Cd2+ and Pb2+ ions in acidic conditions. A significant interaction was found between soil-Cd and pH, affecting grain-As uptake. The average concentrations of soil As, Pb, and Cd aligned with international standards. Generally, the carcinogenic metals detected in grain samples collected from the Volta region are higher than that of the Oti region but the differences are insignificant, and this may be attributed to geographical differences and anthropogenic activities. About 51% of the study area showed a hazard risk associated with grain metal levels, although, no carcinogenic risks were recognized. This study highlights the complex soil-plant interactions governing metal bioaccumulation and emphasizes the need for tailored strategies to minimize metal transfer into grains.
    Matched MeSH terms: Ghana
  9. Avicor SW, Wajidi MFF, Owusu EO
    Environ Sci Pollut Res Int, 2017 Sep;24(26):21138-21145.
    PMID: 28730366 DOI: 10.1007/s11356-017-9737-3
    Although evidence of mosquito coils' impact on disease epidemiology is limited, they are popularized as mosquito-borne disease prevention devices. Their usage affects the environment, human and mosquito health. This study investigated the perception, usage pattern and efficacy of coils in a predominantly poor malaria-endemic Ghanaian peri-urban area. Information on protection methods, perception and usage pattern was garnered using questionnaires. The efficacy of commonly used coils in the area was then assessed on the malaria vector, Anopheles gambiae, in a glass chamber. Sole or co-application of mosquito control methods and risky usage practices were reported. Coils were deemed harmful to humans and mosquitoes, and their perceived effectiveness varied, with several factors influencing their purchase. High d-allethrin concentration coils induced quicker mosquito knockdown; however, mortality was less than 85%. The coil usage pattern compromises users' health and can enhance mosquito tolerance to d-allethrin. The coils were ineffective against the vector, outlining a dichotomy between the users' perception of efficacy and the observed efficacy. Hence, the usage of other safer and more effective vector control methods should be encouraged to protect households.
    Matched MeSH terms: Ghana
  10. Ortiz RH, Leon DA, Estevez HO, Martin A, Herrera JL, Romo LF, et al.
    Clin Exp Immunol, 2009 Aug;157(2):271-81.
    PMID: 19604267 DOI: 10.1111/j.1365-2249.2009.03941.x
    Buruli ulcer (BU) is the third most common mycobacterial disease in immunocompetent hosts. BU is caused by Mycobacterium ulcerans, which produces skin ulcers and necrosis at the site of infection. The principal virulence factor of M. ulcerans is a polyketide-derived macrolide named mycolactone, which has cytotoxic and immunosuppressive activities. We determined the severity of inflammation, histopathology and bacillary loads in the subcutaneous footpad tissue of BALB/c mice infected with 11 different M. ulcerans isolates from diverse geographical areas. Strains from Africa (Benin, Ghana, Ivory Coast) induced the highest inflammation, necrosis and bacillary loads, whereas the strains collected from Australia, Asia (Japan, Malaysia, New Guinea), Europe (France) and America (Mexico) induced mild inflammation. Subsequently, animals were infected with the strain that exhibited the highest (Benin) or lowest (Mexico) level of virulence in order to analyse the local immune response generated. The Mexican strain, which does not produce mycolactone, induced a predominantly T helper type 1 (Th1) cytokine profile with constant high expression of the anti-microbial peptides beta defensins 3 and 4, in co-existence with low expression of the anti-inflammatory cytokines interleukin (IL)-10, IL-4 and transforming growth factor (TGF)-beta. The highly virulent strain from Benin which produces mycolactone A/B induced the opposite pattern. Thus, different local immune responses were found depending on the infecting M. ulcerans strain.
    Matched MeSH terms: Ghana
  11. Ayensu J, Annan R, Lutterodt H, Edusei A, Peng LS
    PLoS One, 2020;15(1):e0226026.
    PMID: 31978048 DOI: 10.1371/journal.pone.0226026
    BACKGROUND: Anaemia remains a major cause of morbidity and mortality among women and children worldwide. Because deficiencies in essential micronutrients such as iron, folate and vitamin B12 prior to and during gestation increase a woman's risk of being anaemic, adequate dietary intake of such nutrients is vital during this important phase in life. However, information on the dietary micronutrient intakes of pregnant women in Ghana, particularly of those resident in rural areas is scanty. Thus, this study aimed to assess anaemia prevalence and dietary micronutrient intakes in pregnant women in urban and rural areas in Ghana.

    METHODS: A comparative cross sectional study design involving 379 pregnant women was used to assess the prevalence of anaemia and low intake of dietary nutrients in pregnant women living in rural and urban areas in the Ashanti region of Ghana. Anaemia status and mid upper arm circumference (MUAC) were used as proxy for maternal nutritional status. Haemoglobin measurements were used to determine anaemia prevalence and the dietary diversity of the women were determined with a 24-hour dietary recall and a food frequency questionnaire.

    RESULTS: Overall, anaemia was present in 56.5% of the study population. Anaemia prevalence was higher among rural residents than urban dwellers. Majority of the respondents had inadequate intakes of iron, zinc, folate, calcium and vitamin A. The mean dietary diversity score (DDS) of the study population from the first 24-hour recall was 3.81 ± 0.7. Of the 379 women, 28.8% met the minimum dietary diversity for women (MDD-W). The independent predictors of haemoglobin concentration were, gestational age, maternal age and dietary diversity score. Such that respondents with low DDS were more likely to be anaemic than those with high DDS (OR = 1.795, p = 0.022, 95% CI: 1.086 to 2.967).

    CONCLUSIONS: A large percentage of pregnant women still have insufficient dietary intakes of essential nutrients required to support the nutritional demands during pregnancy. Particularly, pregnant women resident in rural areas require interventions such as nutrition education on the selection and preparation of diversified meals to mitigate the effects of undernutrition.

    Matched MeSH terms: Ghana
  12. Stanley GHM, Pitt ER, Lim D, Keloid Survey Collaborative, Research librarian, Manuscript revisers (in alphabetical order), et al.
    J Plast Reconstr Aesthet Surg, 2023 Feb;77:359-370.
    PMID: 36621239 DOI: 10.1016/j.bjps.2022.11.017
    INTRODUCTION: Keloid scars are associated with physical and psychological sequelae. No studies have investigated the general public's understanding of keloids. Targeted, short educational interventions in susceptible individuals may aid understanding of the condition and compliance with treatment. We aimed to identify the population with the highest prevalence and lowest knowledge.

    METHODS: We surveyed four countries to determine the public's understanding of keloids. A quantitative, subjective and cross-sectional street survey was designed using the knowledge, attitudes and practice model principles. The target populations were cities in Ghana, Australia, Canada and England. Surveyors used a hybrid stratified/convenience sampling method. Primary outcomes were prevalence, exposure to keloids as an entity and overall keloid knowledge score compared across demographic groups. Study data have been made fully available for reproducibility and education (https://doi.org/10.17605/OSF.IO/3KZ5E).

    RESULTS: There were 402 respondents, with a median age of 32 (interquartile range 25-45.25) years, of which 193 were females. The survey was carried out between June 2015 and October 2017. The prevalence of self-identified keloids was 11% in Ghana, 6% in Australia, 2% in Canada and 7% in England. Prevalence, exposure and knowledge were higher in the Ghanaian population.

    CONCLUSIONS: There was association between knowledge, prevalence and the exposure to keloids as an entity. Findings may suggest targeting public health campaigns towards populations where knowledge is lowest, and exposure to and prevalence of keloids are the highest.

    Matched MeSH terms: Ghana/epidemiology
  13. Taekul C, Johnson NF, Masner L, Polaszek A, Rajmohana K
    Zookeys, 2010.
    PMID: 21594118 DOI: 10.3897/zookeys.50.485
    The genus Platyscelio Kieffer (Hymenoptera: Platygastridae, Scelioninae) is a widespread group in the Old World, found from West Africa to northern Queensland, Australia. The species concepts are revised and a key to world species is presented. The genus is comprised of 6 species, including 2 known species which are redescribed: Platyscelioafricanus Risbec (Benin, Cameroon, Central African Republic, Ghana, Guinea, Guinea-Bissau, Ivory Coast, Kenya, Mozambique, Nigeria, Sierra Leone, South Africa, Tanzania, Togo, Uganda, Yemen, Zimbabwe); and Platysceliopulchricornis Kieffer (Australia, Bangladesh, China, India, Indonesia, Japan, Malaysia, Papua New Guinea, Philippines, Solomon Islands, Taiwan, Thailand, Vanuatu, Vietnam). Five species-group names are considered to be junior synonyms of Platysceliopulchricornis: Platyscelioabnormis Crawford syn. n., Platysceliodunensis Mukerjee syn. n., Platysceliomirabilis Dodd syn. n., Platysceliopunctatus Kieffer syn. n., and Platysceliowilcoxi Fullaway. The following species are hypothesized and described as new taxa: Platyscelioarcuatus Taekul & Johnson, sp. n. (Western Australia); Platysceliomysterium Taekul & Johnson, sp. n. (Zimbabwe, Botswana, South Africa); Platysceliomzantsi Taekul & Johnson, sp. n. (South Africa); and Platysceliostriga Taekul & Johnson, sp. n. (Western Australia).
    Matched MeSH terms: Ghana
  14. Myzabella N, Fritschi L, Merdith N, El-Zaemey S, Chih H, Reid A
    Int J Occup Environ Med, 2019 10;10(4):159-173.
    PMID: 31586381 DOI: 10.15171/ijoem.2019.1576
    BACKGROUND: The palm oil industry is the largest contributor to global production of oils and fats. Indonesia and Malaysia are the largest producers of palm oil. More than a million workers are employed in this industry, yet there is a lack of information on their occupational health and safety.

    OBJECTIVE: To identify and summarize occupational hazards among oil palm plantation workers.

    METHODS: A search was carried out in June 2018 in PubMed, Web of Science, Scopus, and Ovid. Relevant publications were identified by a systematic search of four databases and relevant journals. Publications were included if they examined occupational hazards in oil palm plantation workers.

    RESULTS: 941 publications were identified; of these, 25 studies were found eligible to be included in the final review. Of the 25 studies examined, 19 were conducted in Malaysia, 2 in Costa Rica, and one each in Ghana, Indonesia, Myanmar, Papua New Guinea, and Cameroon. Oil palm plantation workers were found to be at risk of musculoskeletal conditions, injuries, psychosocial disorders, and infectious diseases such as malaria and leptospirosis. In addition, they have potential exposure to paraquat and other pesticides.

    CONCLUSION: In light of the potential of palm oil for use as a biofuel, this is an industry with strong growth potential. The workers are exposed to various occupational hazards. Further research and interventions are necessary to improve the working conditions of this already vast and growing workforce.

    Matched MeSH terms: Ghana/epidemiology
  15. Aborigo RA, Allotey P, Reidpath DD
    Soc Sci Med, 2015 May;133:59-66.
    PMID: 25841096 DOI: 10.1016/j.socscimed.2015.03.046
    Traditional medical systems in low income countries remain the first line service of choice, particularly for rural communities. Although the role of traditional birth attendants (TBAs) is recognised in many primary health care systems in low income countries, other types of traditional practitioners have had less traction. We explored the role played by traditional healers in northern Ghana in managing pregnancy-related complications and examined their relevance to current initiatives to reduce maternal morbidity and mortality. A grounded theory qualitative approach was employed. Twenty focus group discussions were conducted with TBAs and 19 in-depth interviews with traditional healers with expertise in managing obstetric complications. Traditional healers are extensively consulted to manage obstetric complications within their communities. Their clientele includes families who for either reasons of access or traditional beliefs, will not use modern health care providers, or those who shop across multiple health systems. The traditional practitioners claim expertise in a range of complications that are related to witchcraft and other culturally defined syndromes; conditions for which modern health care providers are believed to lack expertise. Most healers expressed a willingness to work with the formal health services because they had unique knowledge, skills and the trust of the community. However this would require a stronger acknowledgement and integration within safe motherhood programs.
    Matched MeSH terms: Ghana
  16. Adzitey F, Huda N, Shariff AHM
    Microorganisms, 2021 Feb 05;9(2).
    PMID: 33562804 DOI: 10.3390/microorganisms9020326
    Meat is an important food source that can provide a significant amount of protein for human development. The occurrence of bacteria that are resistant to antimicrobials in meat poses a public health risk. This study evaluated the occurrence and antimicrobial resistance of E. coli (Escherichia coli) isolated from raw meats, ready-to-eat (RTE) meats and their related samples in Ghana. E. coli was isolated using the USA-FDA Bacteriological Analytical Manual and phenotypic antimicrobial susceptibility test was performed by the disk diffusion method. Of the 200 examined meats and their related samples, 38% were positive for E. coli. Notably, E. coli was highest in raw beef (80%) and lowest in RTE pork (0%). The 45 E. coli isolates were resistant ≥ 50% to amoxicillin, trimethoprim and tetracycline. They were susceptible to azithromycin (87.1%), chloramphenicol (81.3%), imipenem (74.8%), gentamicin (72.0%) and ciprofloxacin (69.5%). A relatively high intermediate resistance of 33.0% was observed for ceftriaxone. E. coli from raw meats, RTE meats, hands of meat sellers and working tools showed some differences and similarities in their phenotypic antimicrobial resistance patterns. Half (51.1%) of the E. coli isolates exhibited multidrug resistance. The E. coli isolates showed twenty-two different resistant patterns, with a multiple antibiotic resistance index of 0.0 to 0.7. The resistant pattern amoxicillin (A, n = 6 isolates) and amoxicillin-trimethoprim (A-TM, n = 6 isolates) were the most common. This study documents that raw meats, RTE meats and their related samples in Ghana are potential sources of antimicrobial-resistant E. coli and pose a risk for the transfer of resistant bacteria to the food chain, environment and humans.
    Matched MeSH terms: Ghana
  17. Md Noh UK, Then KY
    Malays J Med Sci, 2013 Jan;20(1):84-7.
    PMID: 23785259
    A 42-year-old man from Ghana presented with bilateral painful corneal perforations following ingestion of a sulphur-based antibiotic. Emergency bilateral penetrating keratoplasty was performed, with restoration of globe integrity. However, surgical complications arose such as non-healing epithelial defect, secondary infection, graft dehiscence, and mounting intraocular pressure. This case illustrates the challenges faced in managing corneal grafts in patients with already compromised ocular surfaces.
    Matched MeSH terms: Ghana
  18. Adyas A, Akazili J, Awoonor-Williams J, Dalingjong P, Ellangovan KK, Ismail MS, et al.
    Citation: Adyas A, et al. UHC Primary Health Care Self-Assessment Tool. Joint Learning Network for Universal Health Coverage: Primary Health Care
    Technical Initiative; 2016
    Matched MeSH terms: Ghana
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