The African Journal of Primary Health & Family Medicine welcomes submissions that encourage scholarly exchange between family medicine and primary health care researchers and practitioners across Africa and the developing world, whilst providing a contextual and holistic view of family medicine as practiced across the continent.

Background: Carers of people with dementia (PWD) face a myriad of challenges. As dementia prevalence surges in the sub-Saharan population, the provision of data on the met and unmet needs of caregivers has become paramount. Aim: This study aimed to identify the needs of carers of older adults living with dementia in Ghana. Setting: This study was conducted in Kumasi, Ghana, among participants ≥ 18 years old, serving as carers for PWD. Methods: This was a multicentre cross-sectional study involving carers of patients (≥ 50 years) with dementia. The authors administered the Carer’s Needs Assessment for Dementia (CNA-D) questionnaire, containing 18 problem areas with interventions for each problem area. Pearson’s correlation analysis was performed to establish a relationship between demographic characteristics, problem areas and intervention score. Results: Fifty participants were recruited with a mean age of 48.8 (± 16.9) years, 72.0% were female participants and 98.0% were family members of PWD. The problem area most frequently identified as no/mild problem was ‘legal issues’ (92.0%, n = 46), and ‘lack of information about dementia’ was assessed as severe (48.0%, n = 24). The commonest unmet need was ‘printed information material’ (84.0%, n = 42), and the commonest met need was ‘diagnosis and treatment of carer by a general practitioner’ (42.0%, n = 21). There was a statistically negative correlation between age of carer and number of unmet needs (r = −0.308, p = 0.011) and a positive correlation between problem area score and number of unmet needs (r = 0.308, p = 0.030). Conclusion: Effective public education and provision of information on dementia to carers are essential interventions needed to equip them in performing their roles. Contribution: Carers in this study revealed that they lacked information on dementia but their commonest met need was accessibility to their general practitioner. This highlights the importance of promoting knowledge and awareness of dementia among primary care practitioners.

Gait speed is an essential predictor of functional and cognitive decline in older adults. The study aimed to investigate the gait speed of older adults in Ghana and South Africa and to determine its associated factors, as the Sub-Saharan representatives in the World Health Organization’s Study on Global AGEing in Older Adults (SAGE). A secondary analysis of data from the SAGE study which consists of nationally representative data involving participants aged ≥50+ years with smaller samples of younger adults aged 18–49 years in Ghana and South Africa was conducted. SAGE study employed a multistage, stratified clustered sample design and involved the use of a standardised questionnaire to obtain participants’ (n = 5808) demographic, anthropometric and gait speed information. The standard 4 metre-gait speed was used. Median gait speed for the study group, which comprised African/Black participants aged ≥50+ years was 0.769(Q1 = 0.571, Q3 = 0.952)m/s for males and 0.667 (Q1 = 0.500,Q3 = 0.833)m/s for females. For every unit increase in age, the odds of being in a higher-ranked gait speed category was 0.96(95%CI 0·96, 0·97, p<0.001) times that of the previous age. Females had odds of 0.55 (95%CI 0.50, 0.61, p<0.001) of recording higher gait speed, as compared to males. Rural dwellers had odds of 1.43 (95%CI 1.29, 1.58, p < 0.001) of being in a higher-ranked category of gait speed compared to urban dwellers. Underweight (OR = 0.85, 95%C1 = 0.73–1.00, p<0.05) and obesity (OR = 0.53, 95%CI = 0.46–0.61, p<0.001) were associated with slower gait speed. Amongst functional indices, the World Health Organization Disability Assessment Schedule (WHODAS) score was the biggest determinant of gait speed. Having a “Severe/Extreme” WHODAS score had the strongest association with gait speed (OR = 0.18, 95%CI = 0.14–0.23, p<0.001). These gait speed results provide an essential reference for older adults’ care in Ghana and South Africa.

Malaria and anaemia frequently co-occur among children under five globally, especially in low- and middle-income countries where both conditions are endemic. This co-occurrence significantly contributes to childhood morbidity and mortality, posing a major public health challenge. This study seeks to estimate the prevalence and identify the risk factors associated with the co-occurrence of malaria and anaemia (double burden) among children under five in Ghana. The study utilised data from the 2022 Ghana Demographic and Health Survey. Regional variations in the prevalence of the double burden were illustrated using a choropleth map. To identify factors associated with the double burden, mixed-effects multilevel binary logistic regression models were employed using a four-model approach. Findings were reported as adjusted odds ratios (aOR) with corresponding 95% confidence intervals (CI) and intra-class correlation coefficients. Analyses were conducted using Stata/SE Version 17, incorporating sampling weights, with statistical significance set at p < 0.05. The prevalence of the double burden of malaria and anaemia among children under five in Ghana was 6.4% [95% CI: 5.5–7.5]. Double burden was associated with fifth-born children [aOR = 3.92; 95% CI: 1.60–9.62], children who had fever within the two weeks preceding the survey [aOR = 2.49; 95% CI: 1.46–4.24], children whose mothers had attained primary education [aOR = 1.87; 95% CI: 1.07–3.28], children living in households headed by individuals aged 60 years or above [aOR = 0.33; 95% CI: 0.14–0.79], children from poorer [aOR = 0.51; 95% CI: 0.29–0.90], middle-income [aOR = 0.31; 95% CI: 0.13–0.74], and richer [aOR = 0.31; 95% CI: 0.12–0.80] households. The co-occurrence of malaria and anaemia remains a major health concern among Ghanaian children under five. Despite reduced malaria prevalence, anaemia persists at high levels. Integrated interventions that combine malaria prevention, nutrition improvement, and anaemia control, particularly in high-burden regions, are essential for enhancing child health outcomes. Not applicable.

Rational use of medicines, particularly antimicrobials, is critical for reducing antimicrobial resistance. In 2021, a study conducted at the outpatient department (OPD) of a district hospital in Ghana, identified high antibiotic prescribing and suboptimal adherence to World Health Organization (WHO) prescribing indicators. Based on those findings, antimicrobial stewardship (AMS) intervention was extended to the OPD. This before-and-after study was used to compare WHO prescribing indicators and patterns of antibiotic use, using WHO AWaRe (Access, Watch and Reserve) categorisation of the years 2021 and 2023. A total of 65,157 patients visited the OPD in 2023 with 171,517 patient encounters and 247,313 prescriptions. Encounters resulting in antibiotic prescriptions halved from 36% to 18%. The average number of medicines prescribed per encounter reduced from three to two. Prescriptions using generic names increased from 76% to 80% and injection use reduced from 7% to 6%. However, prescriptions from the Ghana essential medicines list reduced from 90 % to 79%. Access antibiotics use remained unchanged while Watch and Reserve categories increased by 5% and 2% respectively. The AMS interventions potentially improved three of five WHO indicators. Continued efforts are needed to achieve complete compliance to all indicators and in-crease Access antibiotic use to above 70%.