Points of entry dynamics: understanding the cross-border threats for Ebola virus disease and COVID-19 in Ghana using a logic model approach
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Background. The influx of people across the national borders of Ghana has been of interest and concern in the public health and national security community in recent times due to the low capacity for the prevention and management of epidemics and other public health risks. Although the international health regulations (IHR) stipulate core public health capacities for designated border facilities such as international airports, seaports, and ground crossings, contextual factors that influence the attainment of effective public health measures and response capabilities remain understudied.
Objective. This study aims to assess the relationship between contextual factors and COVID-19 procurement to help strengthen infrastructure resources for points of entry (PoE) public health surveillance functions, thereby eliminating gaps in the design, implementation, monitoring, and evaluation of pandemic-related interventions in Ghana.
Methods. This study employed a mixed-methods design, where quantitative variables were examined for relationships and effect size interactions using multiple linear regression techniques and the wild bootstrap technique. Country-level data was sourced from multiple publicly available sources using the social-ecological framework, logic model, and IHR capacity monitoring framework. The qualitative portion included triangulation with an expert panel to determine areas of convergence and divergence.
Results. The most general findings were that laboratory capacity and Kotoka International Airport testing center positively predicted COVID-19 procurement, and public health response and airline boarding rule negatively predicted COVID-19 procurement.
Conclusion. Contextual understanding of the COVID-19 pandemic and Ebola epidemic is vital for strengthening PoE mitigation measures and preventing disease importation.
P03 - epidemics and other health emergencies: West African Health Organization. https://www.wahooas.org/web-ooas/en/programmes/p03-epidemics-and-other-health- emergencies.
International Organization for Migration (IOM). COVID-19 Response PoEs Rapid Assessment Ghana.; 2020.
World Health Organization. IHR Core Capacity Framework: Checklist and Indicators for Monitoring Progress in the Development of IHR Core Capacities in State Parties.; 2011.
World Health Organization. Building Bridges in Preparedness: Report of a Stakeholder Consultation on National Health Security and Pandemic Influenza Preparedness Planning, Accra, Ghana, 5–7 December 2017 (No. WHO/WHE/CPI/2019.14). World Health Organization.; 2019.
Lau LS, Samari G, Moresky RT, et al. COVID-19 in humanitarian settings and lessons learned from past epidemics. Nat Med. 2020;26(5):647-648. doi:10.1038/s41591-020-0851-2. DOI: https://doi.org/10.1038/s41591-020-0851-2
World Health Organization. World Health Organization. International health regulations. https://www.who.int/health-topics/international-health-regulations#tab=tab2.
Adokiya, M. N., & Awoonor-Williams, J. K. Ebola virus disease surveillance and response preparedness in northern Ghana. Global Health Action. Published online 2016:9(1), 29763. DOI: https://doi.org/10.3402/gha.v9.29763
Adongo, P. B., Tabong, P. T.-N., Asampong, E., Ansong, J., Robalo, M., & Adanu, R. M. Health workers perceptions and attitude about Ghana’s preparedness towards preventing, containing, and managing Ebola Virus Disease. BMC Health Services Research. 2017;17(1). doi:10.1186/s12913-017-2225-0. DOI: https://doi.org/10.1186/s12913-017-2225-0
Alexander, K. A., Sanderson, C. E., Marathe, M., Lewis, B. L., Rivers, C. M., Shaman, J., Drake, J. M., Lofgren, E., Dato, V. M., Eisenberg, M. C., & Eubank, S. What Factors Might Have Led to the Emergence of Ebola in West Africa? PLOS Neglected Tropical Diseases. 2015;(9(6)). doi: 10.1371/journal.pntd.0003652. DOI: https://doi.org/10.1371/journal.pntd.0003652
Awini, E. A., Bonney, J. H., Frimpong, J. A., Ampofo, W. K., & Koram, K. A. Information gaps in surveillance data and effects on the Ghanaian response to the Ebola outbreak in West Africa. Ghana Medical Journal. 2017;51(3), 115. DOI: https://doi.org/10.4314/gmj.v51i3.4
Gomes, M. F., Pastore y Piontti, A., Rossi, L., Chao, D., Longini, I., Halloran, M. E., & Vespignani, A. Assessing the International Spreading Risk Associated with the 2014 West African Ebola Outbreak. PLoS Currents. Published online 2014. DOI: https://doi.org/10.1371/currents.outbreaks.cd818f63d40e24aef769dda7df9e0da5
Nyarko, Y., Goldfrank, L., Ogedegbe, G., Soghoian, S., & de-Graft Aikins, A. Preparing for Ebola virus disease in West African countries not yet affected: Perspectives from Ghanaian health professionals. Globalization and Health. 2015;11(1), 7. doi:10.1186/s12992-015-0094-z. DOI: https://doi.org/10.1186/s12992-015-0094-z
Johnson, J. A., Anderson, D. E., & Rossow, C. C. Health Systems Thinking: A Primer. Jones & Bartlett Learning.; 2020.
World Health Organization. Integrated Disease Surveillance and Response Technical Guidelines: Booklet Three: Sections 4, 5, 6, and 7 (No. WHO/AF/WHE/CPI/03, 2019). World Health Organization. Regional Office for Africa.; 2019.
Means, A. R., Wagner, A. D., Kern, E., Newman, L. P., & Weiner, B. J. Implementation science to respond to the COVID-19 pandemic. Frontiers in public health. 2020;8, 462. DOI: https://doi.org/10.3389/fpubh.2020.00462
Spiegel, J., Bennett, S., Hattersley, L., Hayden, M. H., Kittayapong, P., Nalim, S., ... & Gubler, D. Barriers and bridges to prevention and control of dengue: the need for a social–ecological approach. EcoHealth. 2005;2(4):273-290. DOI: https://doi.org/10.1007/s10393-005-8388-x
Phillips, C. J., Harrington, A. M., Yates, T. L., Simpson, G. L., & Baker, R. J. Global Disease Surveillance, Emergent Disease Preparedness, and National Security. Lubbock: Museum of Texas Tech University. Museum of Texas Tech University.; 2009.
World Health Organization. Disease Surveillance for Malaria Control: An Operational Manual.; 2012.
WHO, & World Health Organization. World Report on Violence and Health. World Health Organization.; 2002.
World Health Organization. Point of Entry Screening and Quarantine Systems Enabled Thailand to Control COVID-19. World Health Organization. https://www.who.int/thailand/news/feature-stories/detail/point-of-entry-screening-and-quarantine-systems-enabled-thailand-to-control- COVID-19.
BBC News. Ghana. https://www.bbc.com/news/topics/cnx753jejjlt/ghana. 2021.
Ghana Ports and Harbours Authority, M. Ghana ports & harbours authority. Accessed October 1, 2021. https://ghanaports.gov.gh/page/index.
Field A. Discovering Statistics Using IBM SPSS Statistics (4th Ed.). SAGE Publications.; 2013.
Cohen, J., & Rodgers, Y. V. Contributing factors to personal protective equipment shortages during the COVID-19 pandemic. Preventive Medicine. 2020;141, 106263. doi: 10.1016/j.ypmed.2020.106263. DOI: https://doi.org/10.1016/j.ypmed.2020.106263
Curran, K. G., Gibson, J. J., Marke, D., Caulker, V., Bomeh, J., Redd, J. T., Bunga, S., Brunkard, J., & Kilmarx, P. H. Cluster of ebola virus disease linked to a single funeral — Moyamba District, Sierra Leone, 2014. MMWR Morbidity and Mortality Weekly Report. 2016;65(8):202-205. DOI: https://doi.org/10.15585/mmwr.mm6508a2
Gire, S. K., Goba, A., Andersen, K. G., Sealfon, R. S., Park, D. J., Kanneh, L., Jalloh, S., Momoh, M., Fullah, M., Dudas, G., Wohl, S., Moses, L. M., Yozwiak, N. L., Winnicki, S., Matranga, C. B., Malboeuf, C. M., Qu, J., Gladden, A. D., Schaffner, S. F., & … Sabeti, P. C. Genomic surveillance elucidates ebola virus origin and transmission during the 2014 Outbreak. Science. 2014;345(6202):1369-1372. DOI: https://doi.org/10.1126/science.1259657
Boddington, N. L., Steinberger, S., & Pebody, R. G. Screening at ports of entry for ebola virus disease in England—a descriptive analysis of Screening Assessment Data, 2014–2015. Journal of Public Health. Published online 2020. doi:10.1093/pubmed/fdaa216. DOI: https://doi.org/10.1093/pubmed/fdaa216
Astivia, O. L. O., & Zumbo, B. D. Heteroskedasticity in Multiple Regression Analysis: What it is, How to Detect it and How to Solve it with Applications in R and SPSS. Practical Assessment, Research, and Evaluation. 2019;24(1), 1.
Flachaire E. Bootstrapping heteroskedastic regression models: wild bootstrap vs. pairs bootstrap. Computational Statistics & Data Analysis. 2005;49(2):361-376. DOI: https://doi.org/10.1016/j.csda.2004.05.018
Roodman, D., Nielsen, M. Ø., MacKinnon, J. G., & Webb, M. D. Fast and wild: Bootstrap inference in Stata using boottest. The Stata Journal. 2019;19(1):4-60. DOI: https://doi.org/10.1177/1536867X19830877
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