Systematic review and meta-analysis of pneumonia prevalence and antimicrobial resistance in Ghana
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Key Takeaway
Note high pneumonia prevalence and >70% resistance to key antibiotics in Ghana.
This systematic review and meta-analysis evaluates the epidemiology of pneumonia and associated antimicrobial resistance within Ghana. The study encompasses a large sample of 124 582 participants, including children younger than 5 years, elderly individuals, hospitalized patients, and community children. The primary outcome assessed was the pooled prevalence of pneumonia across these diverse groups.
The analysis reveals a pooled pneumonia prevalence of 22.01%. Regional variations were substantial, with rates reaching 32.31% in Greater Accra and Northern regions, while Upper West reported 4.83%. Specific subgroups showed distinct patterns, such as 17.79% prevalence in children under 5 years and 21.49% in community children. Hospitalized patients exhibited a prevalence of 22.14%.
Mortality rates for pneumonia were determined to be 3.07%. Antimicrobial resistance was notably high, with rates greater than 70% observed for co-trimoxazole, gentamicin, and tetracycline. The authors note that comprehensive data on prevalence and distribution remain limited. No safety data, adverse events, or tolerability were reported in the source material.
The authors conclude that these findings provide critical evidence for targeted public health strategies. Given the high resistance rates and regional disparities, clinicians and public health officials should consider these data when formulating treatment guidelines and resource allocation plans for pneumonia management in the region.
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View Original Abstract ↓
Pneumonia is a major cause of morbidity and mortality in Ghana, especially among children <5 y of age and the elderly. However, comprehensive data on its prevalence and distribution remain limited. This systematic review addresses this gap by analysing the prevalence, regional variations, risk factors, antimicrobial resistance and mortality rates of pneumonia in Ghana. We searched PubMed, ScienceDirect, Web of Science and African Journals Online databases, including 21 studies with a total of 124 582 participants. A random-effects meta-analysis estimated pooled prevalence and subgroup differences based on age, region and participant type. Heterogeneity was assessed using the I2 test and meta-regression, with sensitivity analysis also conducted. Study quality was evaluated using standardized Joana Briggs Institute checklists for prevalence studies. The pooled prevalence of pneumonia in Ghana was 22.01%, with significant regional variations. The highest prevalence was observed in a study conducted in the Greater Accra and Northern regions (32.31%), while the lowest was in the Upper West (4.83%). The prevalence in children <5 y of age was 17.79%. Hospitalized patients had a higher prevalence (22.14%) than community children (21.49%). Streptococcus pneumoniae was the most common pathogen, with high resistance (>70%) to co-trimoxazole, gentamicin and tetracycline. Key risk factors included indoor air pollution and seasonal changes. The mortality rate for pneumonia was found to be 3.07%. This systematic review highlighted significant regional disparities, pathogen resistance patterns and environmental risk factors that shape the burden of pneumonia in Ghana, providing critical evidence for targeted public health strategies. The findings highlight avenues for future research, including environmental drivers of transmission, focusing on underreported regions and surveillance of antibiotic resistance of pathogens isolated from pneumonia patients.
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