We performed a microsimulation analysis predicting the societal cost of antimicrobial resistance (AMR), which represents the potential cost savings if Ghana eliminates AMR.

This study combined bacterial resistance epidemiology and cost data from Ghana to perform a microsimulation analysis focusing on sociodemographic groups, predicting the potential societal cost savings should Ghana eliminate AMR. The nationally representative data were collected from 12 reference laboratories across Ghana’s three geographical belts between June 2021 and December 2023. Case definition was enterobacterial third-generation cephalosporin (3GC) resistant infections, methicillin-resistant Staphylococcus aureus (MRSA) and multidrug-resistant Mycobacterium tuberculosis. Using an adapted microsimulation framework, the simulation incorporated four integrated data modules: population demographics, infection epidemiology, healthcare resource use and expenditure and labour market characteristics. This approach allowed for the construction of synthetic individuals from national data sets and the projection of annual outcomes over a 7-year horizon. Costs were calculated from a societal perspective under a status quo scenario, assuming that admission rates, resistant infection probabilities and mortality rates remain the same. This analysis also considers a 2.1% annual population growth rate, a 5% discount rate for future costs and age-specific resistance risk profile. We stratified the outcome of interest by age groups, sex and wealth quintiles to account for distributional effects and reported the costs in purchasing power parity equivalent in international US dollars.

Ghana in West Africa.

A simulated population of AMR patients of all ages and sex.

Societal cost attributable to AMR in Ghana.

Assuming probabilities of all-cause hospital admissions of 0.102 for females and 0.093 for males, along with probabilities of AMR infections of 0.239 and 0.193, we predicted nearly 78 000 (95% CI 72 000 to 83 520) annual AMR infections and approximately 6300 (95% CI 3900 to 8638) attributable deaths. MRSA and 3GC-resistant infections made up 20.2% and 79.2% of the predicted annual infections, corresponding to an estimated mean societal cost of about US$435 million. In decreasing order of magnitude, the estimated mean annual cost of productivity loss due to AMR attributable mortality accounted for 40.6% of the mean annual societal cost, followed by the cost to healthcare providers (24.1%), direct medical cost to patients and caregivers (22.4%), productivity loss for surviving patients and caregivers (10.4%) and direct non-medical costs to patients and caregivers (2.6%). Resistant infections in children under 5 and adults over 60 years contributed 48.2% and 26.9% of the estimated annual societal cost, respectively. Except for the number of resistant infections, the estimated mean annual costs between wealth quintile groups were significantly different (p=0.03) due to differences in productivity costs between wealth quintile groups.

The study shows that the societal cost implications attributable to AMR are enormous, requiring a concerted effort by society to mitigate the development and spread of AMR organisms.

We aimed to refine and culturally adapt an evidence-based communication intervention (EBCI), which consists of the 3R message framing model (Reframe, Reprioritise, Reform) and human papillomavirus self-sampling (HPVSS) for use in a teaching hospital in Ghana, and evaluated its acceptability, feasibility, appropriateness and adoption potential among stakeholders.

Convergent mixed-methods design.

The study was conducted at a teaching hospital and its surrounding communities in the Central Region of Ghana.

A 36-member stakeholder advisory board comprising women living with HIV (WLHIV) (n=14), healthcare providers (HCPs) (n=11) and community members (n=11) participated in Nominal Group Technique sessions to adapt the intervention. The adapted EBCI was subsequently evaluated by 45 participants (WLHIV=30 and HCPs=15).

Outcome measures included key characteristics of the EBCI, acceptability, feasibility, appropriateness and its potential for adoption, which were assessed using validated Likert-type scales and structured interview guides.

Core components of the intervention (HPVSS+3R) were retained. Hospitals and community pharmacies were the preferred self-sampling venues (97%). WhatsApp audio in English and Fante/Akan was the most favoured delivery mode for 3R messages (81%). Evaluation results revealed high acceptability (mean=22.84), feasibility (mean=22.40) and adoption (mean=21.73) on a 5–25 point scale, as well as appropriateness (mean=13.3) on a 3–15 point scale. Qualitative findings highlighted convenience, privacy, empowerment and cultural relevance, which reduced fear and increased participant engagement.

The adapted EBCI demonstrated high acceptability, feasibility, appropriateness and adoption potential among key stakeholders, supporting its integration into the Ghanaian health systems to advance cervical cancer elimination goals.

NCT06739772.

Antenatal depression (AD), a maternal mental health condition, has been increasingly prevalent in recent years. It is often triggered by various stressors, including hormonal changes, relationship problems and economic challenges. In Ghana, there is currently no recent nationally representative prevalence data on AD, despite a number of studies conducted in various regions.

Review will include observational studies which employed standardised diagnostic criteria or validated screening tools. We will search the PubMed, SCOPUS, African Index Medicus (AIM), Science Direct, Web of Science (WoS) and Google Scholar databases. The African Journal Online (AJOL) will also be handsearched. Targeted grey literature search will include selected tertiary institutional repositories, Ghana Health Service, Ministry of Health and Mental Health Authority websites. Studies in English will be included with no limits to date. Data extraction will be performed by two independent reviewers using a structured table, with a third reviewer resolving any discrepancies. Quality assessment of included studies will be conducted using the adapted National Institiute of Health (NIH) Quality Assessment Tool for observational studies. Pooled prevalence estimates will be calculated using a random-effects meta-analysis if studies are sufficiently homogeneous and subgroup analysis.

Given that this study involves no primary data collection, an ethical review is not necessary. The findings will be disseminated through publication in a peer-reviewed journal, presentations at academic conferences and key national stakeholder events.

CRD42025644715.