ORCID Profile
0000-0001-9519-7886
Current Organisations
University of East Anglia Norwich Medical School
,
University of East Anglia
,
The University of Memphis
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Publications
Rapidly increasing prevalence of overweight and obesity in older Ghanaian adults from 2007-2015: Evidence from WHO-SAGE Waves 1 & 2
Publisher: Public Library of Science (PLoS)
Date: 19-08-2019
The impact of household wealth on child survival in Ghana
Publisher: Springer Science and Business Media LLC
Date: 22-11-2016
The associations between relative and absolute body mass index with mortality rate based on predictions from stigma theory
Publisher: Elsevier BV
Date: 09-2022
The role of intergenerational educational mobility and household wealth in adult obesity: Evidence from Wave 2 of the World Health Organization’s Study on global AGEing and adult health
Publisher: Public Library of Science (PLoS)
Date: 09-01-2019
Health-related quality of life of patients with idiopathic pulmonary fibrosis: a systematic review and meta-analysis
Publisher: European Respiratory Society (ERS)
Date: 05-11-2020
DOI: 10.1183/16000617.0154-2020
Abstract: Idiopathic pulmonary fibrosis (IPF) is one of the most common forms of interstitial lung disease presenting in persons 50 years and older. Through a comprehensive review of available studies, we aimed to assess health-related quality of life (HRQoL) of people living with IPF and the instruments used in this assessment. Searches were conducted up to May, 2020. Quality appraisal and data extraction were performed using pre-designed forms. Narrative synthesis approach was used to report results of the systematic review and a random effects model was used for the meta-analysis. A leave-one-out sensitivity analysis was performed, and a trim and fill method was used to assess publication bias. The review included 134 studies. The most used instruments to measure HRQoL were St George's Respiratory Questionnaire (SGRQ), Short Form 36 (SF36) and EuroQoL (EQ5D). Standardised mean scores (95% confidence interval) for these instruments were as follows: SGRQ total score: 44.72 (42.21–47.22) SF36 physical component score (PCS): 37.00 (34.74–39.26) SF36 mental component score (MCS): 50.18 (48.41–51.95) King's Brief Interstitial Lung Disease questionnaire total score: 58.38 (55.26–61.51) and EQ5D utility: 0.73 (0.68–0.79). Analysis of standardised means for both SGRQ and SF36 demonstrated worse scores in physical health domains as compared to mental health domains. This systematic review confirms that IPF negatively affected HRQoL, mostly impacting the physical health domains. This study also demonstrated that a erse number of instruments are used to evaluate HRQoL. In view of this ersity, a standardised approach to measurement of HRQoL for IPF is important to ensure that comparisons made are reliable.
Evaluation of the Association Between Health State Utilities and Obesity in Sub-Saharan Africa: Evidence From World Health Organization Study on Global AGEing and Adult Health Wave 2.
Publisher: Elsevier BV
Date: 09-2019
DOI: 10.1016/J.JVAL.2019.04.1925
Abstract: Obesity is a major public health challenge and its prevalence has increased across the age spectrum from 1980 to date in most parts of the world including sub-Saharan Africa. Studies that derive health state utilities (HSUs) stratified by weight status to support the conduct of economic evaluations and prioritization of cost-effective weight management interventions are lacking in sub-Saharan Africa. To estimate age- and sex-specific HSUs for Ghana, along with HSUs by weight status. Associations between HSUs and overweight and obesity will be examined. Cross-sectional survey of the Ghanaian population. Data were sourced from the World Health Organization Study of Global AGEing and Adult Health (WHO SAGE), 2014 to 2015. Using a "judgment-based mapping" method, responses to items from the World Health Organization Quality-of-Life (WHOQOL-100) used in the WHO SAGE were mapped to EQ-5D-5L profiles, and the Zimbabwe value set was applied to calculate HSUs. Poststratified s ling weights were applied to estimate mean HSUs, and a multivariable linear regression model was used to examine associations between HSUs and overweight or obesity. Responses from 3966 adults aged 18 to 110 years were analyzed. The mean (95% confidence interval) HSU was 0.856 (95% CI: 0.850, 0.863) for the population, 0.866 (95% CI: 0.857, 0.875) for men, and 0.849 (95% CI: 0.841, 0.856) for women. Lower mean HSUs were observed for obese in iduals and with older ages. Multivariable regression analysis showed that HSUs were negatively associated with obesity (-0.024 95% CI: -0.037, -0.011), female sex (-0.011 95% CI: -0.020, -0.003), and older age groups in the population. The study provides HSUs by sex, age, and body mass index (BMI) categories for the Ghanaian population and examines associations between HSU and high BMI. Obesity was negatively associated with health state utility in the population. These data can be used in future economic evaluations for Ghana and sub-Saharan African populations.
Rapidly increasing prevalence of overweight and obesity in older Ghanaian adults from 2007-2015: evidence from WHO-SAGE Waves 1 & 2
Publisher: Cold Spring Harbor Laboratory
Date: 27-03-2019
DOI: 10.1101/591222
Abstract: Studies on changes in the prevalence and determinants of obesity in older adults living in sub-Saharan Africa are limited. We examined recent changes in obesity prevalence and associated factors for older adults in Ghana between 2007/08 and 2014/15. Data on adults aged 50 years and older in Ghana were collected in the WHO SAGE Wave 1 (2007/08 n=4158) and Wave 2 (2014/15 n=1663). The weighted prevalence of obesity, overweight, normal weight and underweight, and of high central adiposity was compared in Waves 1 and 2. Multinomial and binomial logistic regressions were used to examine whether the determinants of weight status based on objectively measured body mass index and waist circumference changed between the two survey periods. The prevalence of obesity (Wave 1=10.2%, 95% CI: 8.9-11.7% Wave 2=15.0%, 95% CI: 12.6-17.7%) and overweight (Wave 1=19.6%, 95% CI: 18.0-21.4% Wave 2=24.5%, 95% CI: 21.7-27.5%) was higher in Wave 2 than Wave 1 and more than half of the population had high central adiposity (Wave 1=57.7%, 95% CI: 55.4-60.1% Wave 2=66.9%, 95% CI: 63.7-70.0%) in both study periods. Obesity prevalence was 16% lower in males and 55% higher in females comparing Wave 1 to Wave 2. Female sex, urban residence, and high household wealth were associated with higher odds of overweight/obesity and high central adiposity. Those aged 70+ years had lower odds of obesity in both study waves. In Wave 2, females with physical activity level were more likely to be obese. Over the 7-year period between survey waves, the population prevalence of overweight and obesity increased by 25% and 47%, respectively, while underweight reduced by 43%. These findings differed considerably by sex, which points to differential impacts of past initiatives to reduce overweight/obesity, potential high-risk groups in Ghana, and the need to increase surveillance.
Health service utilization and direct healthcare costs associated with obesity in older adult population in Ghana
Publisher: Oxford University Press (OUP)
Date: 04-12-2019
Abstract: Obesity is a major risk factor for many chronic diseases and disabilities, with severe implications on morbidity and mortality among older adults. With an increasing prevalence of obesity among older adults in Ghana, it has become necessary to develop cost-effective strategies for its management and prevention. However, developing such strategies is challenging as body mass index (BMI)-specific utilization and costs required for cost-effectiveness analysis are not available in this population. Therefore, this study examines the associations between health services utilization as well as direct healthcare costs and overweight (BMI ≥25.00 and & .00 kg/m2) and obesity (BMI ≥30.00 kg/m2) among older adults in Ghana. Data were used from a nationally representative, multistage s le of 3350 people aged 50+ years from the World Health Organization’s Study on global AGEing and adult health (WHO-SAGE 2014/15). Health service utilization was measured by the number of health facility visits over a 12-month period. Direct costs (2017 US dollars) included out-of-pocket payments and the National Health Insurance Scheme (NHIS) claims. Associations between utilization and BMI were examined using multivariable zero-inflated negative binomial regressions and between costs and BMI using multivariable two-part regressions. Twenty-three percent were overweight and 13% were obese. Compared with normal-weight participants, overweight and obesity were associated with 75% and 159% more inpatient admissions, respectively. Obesity was also associated with 53% additional outpatient visits. One in five of the overweight and obese population had at least one chronic disease, and having chronic disease was associated with increased outpatient utilization. The average per person total costs for overweight was $78 and obesity was $132 compared with $35 for normal weight. The NHIS bore approximately 60% of the average total costs per person expended in 2014/15. Overweight and obese groups had significantly higher total direct healthcare costs burden of $121 million compared with $64 million for normal weight in the entire older adult Ghanaian population. Compared with normal weight, the total costs per person associated with overweight increased by 73% and more than doubled for obesity. Even though the total prevalence of overweight and obesity was about half of that of normal weight, the sum of their cost burden was almost doubled. Implementing weight reduction measures could reduce health service utilization and costs in this population.
Measuring Hypertension Progression With Transition Probabilities: Estimates From the WHO SAGE Longitudinal Study
Publisher: Frontiers Media SA
Date: 07-04-2021
DOI: 10.3389/FPUBH.2021.571110
Abstract: This paper assessed the transition probabilities between the stages of hypertension severity and the length of time an in idual might spend at a particular disease state using the new American College of Cardiology/American Heart Association hypertension blood pressure guidelines. Data for this study were drawn from the Ghana WHO SAGE longitudinal study, with an analytical s le of 1884 across two waves. Using a multistate Markov model, we estimated a seven-year transition probability between normal/elevated blood pressure (systolic ≤ 129 mm Hg & diastolic & mm Hg), stage 1 (systolic 130-139 mm Hg & diastolic 80-89 mm Hg), and stage 2 (systolic ≥140mm Hg & diastolic≥90 mm Hg) hypertension and adjusted for the in idual effects of anthropometric, lifestyle, and socio-demographic factors. At baseline, 22.5% had stage 1 hypertension and 52.2% had stage 2 hypertension. The estimated seven-year transition probability for the general population was 19.0% (95% CI: 16.4, 21.8) from normal/elevated blood pressure to stage 1 hypertension, 31.6% (95% CI: 27.6, 35.4%) from stage 1 hypertension to stage 2 hypertension, and 48.5% (45.6, 52.1%) for remaining at stage 2. Other factors such as being overweight, obese, female, aged 60+ years, urban residence, low education and high income were associated with an increased probability of remaining at stage 2 hypertension. However, consumption of recommended servings of fruits and vegetables per day was associated with a delay in the onset of stage 1 hypertension and a recovery to normal/elevated blood pressure. This is the first study to show estimated transition probabilities between the stages of hypertension severity across the lifespan in sub-Saharan Africa. The results are important for understanding progression through hypertension severity and can be used in simulating cost-effective models to evaluate policies and the burden of future healthcare.
Patient safety situational analysis in Ghana
Publisher: SAGE Publications
Date: 06-11-2018
Abstract: The objective of the study was to assess the patient safety situation in Ghana. Specifically, the study aimed at assessing the WHO’s 12 action areas of patient safety. This was a descriptive cross-sectional survey. Data collection methods included interviews and observation using WHO adapted questionnaire. The setting was mainly 16 selected hospitals, including two teaching hospitals selected from the northern and southern parts of the Ghana. Respondents were purposively selected based on their position in the health facilities and the type of information required. Main Outcome Measure(s): The main outcome measures were the WHO’s 12 action areas of patient safety. The median bed capacity of the hospitals assessed was 93 (min = 60, max = 1812). The country’s highest score (94%) was in the action area of knowledge and learning in patient safety where all (16, 100%) s led facilities had systems in place for recording adverse events, specific protocols for patient care, etc. Five (5) of the 12 action areas (i.e. national patient policy, hospital acquired infections, surgical safety, patient safety partnerships and patient safety funding) had scores lower than the mean score (66%). The key strength identified in the patient safety situational analysis of Ghana was knowledge and learning in patient safety while patient safety surveillance was the weakest action area identified. There were also weaknesses in areas such as national patient policy, healthcare associated infections, surgical safety, patient safety partnerships and patient safety funding, respectively.
Emollients for prevention of atopic dermatitis: 5‐year findings from the BEEP randomized trial
Publisher: Wiley
Date: 03-11-2022
DOI: 10.1111/ALL.15555
Abstract: The effectiveness of emollients for preventing atopic dermatitis/eczema is controversial. The Barrier Enhancement for Eczema Prevention trial evaluated the effects of daily emollients during the first year of life on atopic dermatitis and atopic conditions to age 5 years. 1394 term infants with a family history of atopic disease were randomized (1:1) to daily emollient plus standard skin‐care advice (693 emollient group) or standard skin‐care advice alone (701 controls). Long‐term follow‐up at ages 3, 4 and 5 years was via parental questionnaires. Main outcomes were parental report of a clinical diagnosis of atopic dermatitis and food allergy. Parents reported more frequent moisturizer application in the emollient group through to 5 years. A clinical diagnosis of atopic dermatitis between 12 and 60 months was reported for 188/608 (31%) in the emollient group and 178/631 (28%) in the control group (adjusted relative risk 1.10, 95% confidence interval 0.93 to 1.30). Although more parents in the emollient group reported food reactions in the previous year at 3 and 4 years, cumulative incidence of doctor‐diagnosed food allergy by 5 years was similar between groups (92/609 [15%] emollients and 87/632 [14%] controls, adjusted relative risk 1.11, 95% confidence interval 0.84 to 1.45). Findings were similar for cumulative incidence of asthma and hay fever. Daily emollient application during the first year of life does not prevent atopic dermatitis, food allergy, asthma or hay fever.
Annual transition probabilities of overweight and obesity in older adults: Evidence from World Health Organization Study on global AGEing and adult health
Publisher: Elsevier BV
Date: 02-2020
Emollients for preventing atopic eczema: Cost‐effectiveness analysis of the BEEP trial
Publisher: Wiley
Date: 13-08-2023
DOI: 10.1111/CEA.14381
Abstract: Recent discoveries have led to the suggestion that enhancing skin barrier from birth might prevent eczema and food allergy. To determine the cost‐effectiveness of daily all‐over‐body application of emollient during the first year of life for preventing atopic eczema in high‐risk children at 2 years from a health service perspective. We also considered a 5‐year time horizon as a sensitivity analysis. A within‐trial economic evaluation using data on health resource use and quality of life captured as part of the BEEP trial alongside the trial data. Parents/carers of 1394 infants born to families at high risk of atopic disease were randomised 1:1 to the emollient group, which were advised to apply emollient (Doublebase Gel or Diprobase Cream) to their child at least once daily to the whole body during the first year of life or usual care. Both groups received advice on general skin care. The main economic outcomes were incremental cost‐effectiveness ratio (ICER), defined as incremental cost per percentage decrease in risk of eczema in the primary cost‐effectiveness analysis. Secondary analysis, undertaken as a cost‐utility analysis, reports incremental cost per Quality‐Adjusted Life Year (QALY) where child utility was elicited using the proxy CHU‐9D at 2 years. At 2 years, the adjusted incremental cost was £87.45 (95% CI −54.31, 229.27) per participant, whilst the adjusted proportion without eczema was 0.0164 (95% CI −0.0329, 0.0656). The ICER was £5337 per percentage decrease in risk of eczema. Adjusted incremental QALYs were very slightly improved in the emollient group, 0.0010 (95% CI −0.0069, 0.0089). At 5 years, adjusted incremental costs were lower for the emollient group, −£106.89 (95% CI −354.66, 140.88) and the proportion without eczema was −0.0329 (95% CI −0.0659, 0.0002). The 5‐year ICER was £3201 per percentage decrease in risk of eczema. However, when inpatient costs due to wheezing were excluded, incremental costs were lower and incremental effects greater in the usual care group. In line with effectiveness endpoints, advice given in the BEEP trial to apply daily emollient during infancy for eczema prevention in high‐risk children does not appear cost‐effective.
Impact of overweight and obesity on life expectancy, quality-adjusted life years and lifetime costs in the adult population of Ghana
Publisher: BMJ
Date: 09-2020
DOI: 10.1136/BMJGH-2020-003332
Abstract: Prior studies have revealed the increasing prevalence of obesity and its associated health effects among ageing adults in resource poor countries. However, no study has examined the long-term and economic impact of overweight and obesity in sub-Saharan Africa. Therefore, we quantified the long-term impact of overweight and obesity on life expectancy (LE), quality-adjusted life years (QALYs) and total direct healthcare costs. A Markov simulation model projected health and economic outcomes associated with three categories of body mass index (BMI): healthy weight (18.5≤BMI .0) overweight (25.0≤BMI 30.0) and obese (BMI ≥30.0 kg/m 2 ) in simulated adult cohorts over a 50-year time horizon from age fifty. Costs were estimated from government and patient perspectives, discounted 3% annually and reported in 2017 US$. Mortality rates from Ghanaian lifetables were adjusted by BMI-specific all-cause mortality HRs. Published input data were used from the 2014/2015 Ghana WHO Study on global AGEing and adult health data. Internal and external validity were assessed. From age 50 years, average (95% CI) remaining LE for females were 25.6 (95% CI: 25.4 to 25.8), 23.5 (95% CI: 23.3 to 23.7) and 21.3 (95% CI: 19.6 to 21.8) for healthy weight, overweight and obesity, respectively. In males, remaining LE were healthy weight (23.0 95% CI: 22.8 to 23.2), overweight (20.7 95% CI: 20.5 to 20.9) and obesity (17.6 95% CI: 17.5 to 17.8). In females, QALYs for healthy weight were 23.0 (95% CI: 22.8 to 23.2), overweight, 21.0 (95% CI: 20.8 to 21.2) and obesity, 19.0 (95% CI: 18.8 to 19.7). The discounted total costs per female were US$619 (95% CI: 616 to 622), US$1298 (95% CI: 1290 to 1306) and US$2057 (95% CI: 2043 to 2071) for healthy weight, overweight and obesity, respectively. QALYs and costs were lower in males. Overweight and obesity have substantial health and economic impacts, hence the urgent need for cost-effective preventive strategies in the Ghanaian population.
Healthcare expenditure and its socio-demographic and clinical predictors in Australians with poorly controlled asthma
Publisher: Public Library of Science (PLoS)
Date: 05-01-2023
DOI: 10.1371/JOURNAL.PONE.0279748
Abstract: Asthma has substantial and increasing health and economic burden worldwide. This study aimed to estimate healthcare expenditure and determine the factors that increase expenditure in Australians with poorly controlled asthma. In iduals ≥18 years of age with poorly controlled asthma, as determined by a score ≥1.5 on the Asthma Control Questionnaire, were included in the study. Healthcare utilization costs from medical services and medications were estimated over an average follow-up of 12 months from administratively linked data: the Medicare Benefits Schedule and Pharmaceutical Benefits Scheme. A generalized linear model with gamma distribution and log link was used to predict participants’ key baseline characteristics associated with variations in healthcare costs. A total of 341 participants recruited through community pharmacies were included. The mean (standard deviation, SD) age of participants was 56.6 (SD 17.6) years, and approximately 71% were females. The adjusted average monthly healthcare expenditure per participant was $AU386 (95% CI: 336, 436). On top of the average monthly costs, an incremental expenditure was found for each year increase in age ($AU4 95% CI: 0.78, 7), being unemployed ($AU201 95% CI: 91, 311), one unit change in worsening quality of life ($AU35 95% CI: 9, 61) and being diagnosed with depression and anxiety ($AU171 95% CI: 36, 306). In a cohort of Australian patients, characterized by poor asthma control and co-morbidities in iduals impose substantial economic burden in terms of Medicare funded medical services and medications. Programs addressing strategies to improve the quality of life and manage co-morbid anxiety and depression and encourage asthma patients’ engagement in clinically tolerable jobs, may result in significant cost savings to the health system.
Willing or Hesitant? A Socioeconomic Study on the Potential Acceptance of COVID-19 Vaccine in Japan
Publisher: MDPI AG
Date: 02-05-2021
Abstract: The worldwide COVID-19 vaccination program is already underway, raising hopes and aspirations to contain the spread of the COVID-19 pandemic that halted economic and social activities. However, the issue of vaccine effectiveness and its side-effects is influencing the potential acceptance of vaccines. In this uncertain situation, we used data from a nationwide survey in Japan during February 2021, following the Japanese government’s initial phase of COVID-19 vaccination. Our results show that 47% of the respondents are willing to take a vaccine once it is available, while 22% are not willing and another 31% remain indecisive. Our ordered probit regression results show that demographic, socioeconomic, and behavioral variables such as gender, age, subjective health status, children, household income, household assets, financial literacy, future anxiety, and myopic view of the future are associated with willingness to take a COVID-19 vaccine. Our findings suggest that Japan’s government should not adopt a one-size-fits-all policy to promote the vaccination program, but rather target people with specific socioeconomic backgrounds who are less willing and more hesitant to take a vaccine.
Related Organisations
University Of East Anglia Norwich Medical School
Location: United Kingdom of Great Britain and Northern Ireland
University Of East Anglia
Location: United Kingdom of Great Britain and Northern Ireland
Related Funding Activities
No related grants have been discovered for Stella Twumwaa Lartey.