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Opoku, Yeboah K., Johnson N. Boampong, Irene Ayi, Godwin Kwakye-Nuako, Dorcas Obiri-Yeboah, Harriet Koranteng, George Ghartey-Kwansah, and Kwame K. Asare. "Socio-Behavioral Risk Factors Associated with Cryptosporidiosis in HIV/AIDS Patients Visiting the HIV Referral Clinic at Cape Coast Teaching Hospital, Ghana." Open AIDS Journal 12, no. 1 (September 12, 2018): 106–16. http://dx.doi.org/10.2174/1874613601812010106.
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Objective:To identify the socio-behavioral risk factors associated with cryptosporidiosis among HIV/AIDS patients with chronic diarrhea symptoms visiting the HIV referral clinic at Cape Coast Teaching Hospital, Ghana.Methods:A cross-sectional study was conducted among 50 HIV/AIDS patients with recurrent diarrhea. Questionnaires were administered to collect social and behavioral risk factors associated withCryptosporidiumand other opportunistic protozoan parasitic infections in HIV patients. Stool samples were collected for the diagnosis of enteric protozoan pathogens using modified Ziehl-Neelsen and acid-fast staining methods. CD4+cells counts of study subjects were obtained from patients clinical records. The data obtained were analyzed using Pearson chi-square and multivariate-adjusted statistics tool on SPSS 16 for Windows.Results:Twenty-seven (54%) of the subjects were infected with enteric protozoan pathogens. The prevalences ofCryptosporidium,CyclosporaandMicrosporidiuminfections were 46%, 32% and 16%, respectively.Cryptosporidiuminfection was significantly associated with drinking water (×2=13.528, p<0.001),Cyclosporawas associated with the type of drinking water (×2=14.931, p<0.001) and toilet facilities used by the study subjects (×2=12.463, p<0.01), whilesMicrosporidiuminfection was associated with hand washing behavior (×2=12.463, p<0.01). Enteric protozoans were frequently encountered among subjects with CD4+ T-cell count <200 cells/mm3. However, coinfection ofCyclospora spp&Cryptosporidiumspp was not observed in CD4+cell count <200 and >500 cells/mm3.Multivariate analysis showed that the risk factor forCryptosporidiuminfection among HIV/AIDS patients was the source of drinking water (pipe borne water 76.2% prevalence: sachet water 25%; OR=0.10, 95%CI: 0.03-0.39, p<0.001).Conclusion:We report the risk factor for exposure ofCryptosporidiuminfection among HIV/AIDS patients for the first time in Ghana. The contamination of drinking water by protozoan parasites should be a public health concern. These results provide the stepping block to understand the transmission dynamics ofCryptosporidiumand other opportunistic pathogens in HIV/AIDS infected patients in Ghana.
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Dayie, Nicholas TKD, Michael Baffuor-Asare, Appiah-Korang Labi, Noah Obeng-Nkrumah, Edeghonghon Olayemi, Margaret Lartey, Hans-Christian Slotved, and Eric S. Donkor. "Epidemiology of Pneumococcal Carriage among HIV-Infected Individuals in the Conjugate Vaccine Era: A Study in Southern Ghana." BioMed Research International 2019 (February 13, 2019): 1–8. http://dx.doi.org/10.1155/2019/3427174.
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Carriage of pneumococcus is considered as the precursor for development of pneumococcal disease. In sub-Saharan Africa, very little research has been done on the pneumococcus in relation to people with HIV infection in the era of pneumococcal conjugate vaccines. This study investigated pneumococcal carriage among HIV/AIDS patients in southern Ghana to determine the prevalence, risk factors, serotypes and antibiotic resistance of the organism. This was a cross sectional study involving 245 HIV/AIDS patients recruited from Korle Bu Teaching Hospital and Princess Marie Louis Hospital in Accra from November 2016 to March 2017. Epidemiological data on demographic, household and clinical features of the study participants were collected. Nasopharyngeal (NP) swabs were also collected from the study participants and cultured for Streptococcus pneumoniae; the isolates were serotyped by latex agglutination and Quellung reaction. Antimicrobial disc susceptibility was performed on the isolates, and antibiotics tested included tetracycline, erythromycin, cotrimoxazole, levofloxacin, oxacillin and ceftriaxone. Prevalence of pneumococcal carriage among the study participants was 11% (95% CI: 7.4 to 15.6); carriage among children and adults was 25% (95% CI: 14% to 38.9%) and 7.3% (95% CI: 4% to 11.9%) respectively. School attendance (p=0.001) and history of pneumococcal disease in the past year (p=0.001) were significantly associated with pneumococcal carriage. The most prevalent pneumococcal serotypes carried by the study participants were 19A (15.4%) and 23F (15.4%). Serotype coverage of the various pneumococcal vaccines were PCV10 (23.1%), PCV13 (42.3%) and PPV23 (50%). The prevalence of pneumococcal multidrug resistance was 18.5%. In conclusion, pneumococcal carriage among HIV-infected children was three-fold higher compared to carriage among HIV-infected adults. Pneumococcal carriage among both HIV-infected children and adults in the study area tends to be characterized by a predominance of non-vaccine serotypes and a considerable level of multidrug resistance.
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Annan, Gertrude Nancy, and Yvonne Asiedu. "Predictors of Neonatal Deaths in Ashanti Region of Ghana: A Cross-Sectional Study." Advances in Public Health 2018 (2018): 1–11. http://dx.doi.org/10.1155/2018/9020914.
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Background. Neonatal mortality continues to be a public health problem, especially in sub-Saharan Africa. This study was conducted to assess the maternal, neonatal, and health system related factors that influence neonatal deaths in the Ashanti Region, Ghana. Methods. 222 mothers and their babies who were within the first 28 days of life on admission at Mother and Baby unit (MBU) at the Komfo Anokye Teaching Hospital (KATH) in Kumasi, Ashanti Region of Ghana, were recruited through systematic random sampling. Data was collected by face to face interviewing using open and closed ended questions. A logistic regression analysis was conducted to determine the influence of proximal and facility related factors on the odds of neonatal death. Results. Out of the 222 mothers, there were 115 (51.8%) whose babies did not survive. Majority, 53.9%, of babies died within 1–4 days, 31.3% within 5–14 days, and 14.8% within 15–28 days. The cause of death included asphyxia, low birth weight, congenital anomalies, infections, and respiratory distress syndrome. Neonatal deaths were influenced by proximal factors (parity, duration of pregnancy, and disease of the mother such as HIV/AIDS), neonatal factors (birth weight, gestational period, sex of baby, and Apgar score), and health related factors (health staff attitude, supervision of delivery, and hours spent at labour ward). Conclusion. This study shows a high level of neonatal deaths in the Ashanti Region of Ghana. This finding suggests the need for health education programmes to improve on awareness of the dangers that can militate against neonatal survival as well as strengthening the health system to support mothers and their babies through pregnancy and delivery and postpartum to help improve child survival.
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Fenny, Ama P., Aba O. Crentsil, and Derek Asuman. "Determinants and Distribution of Comprehensive HIV/AIDS Knowledge in Ghana." Global Journal of Health Science 9, no. 12 (October 8, 2017): 32. http://dx.doi.org/10.5539/gjhs.v9n12p32.
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Globally, nearly 37 million people are living with HIV with about 70 percent of these living in Sub-Saharan Africa (SSA). Stigma and discrimination remain one of the major barriers to preventing new infections in the country. However, misconceptions about HIV/AIDS have been indicated as one of the key drivers of the disease. Efforts to prevent new infections have not been entirely successful. Therefore, this study aims to examine the trends and distribution in comprehensive knowledge of HIV and AIDS and determine the factors associated with comprehensive awareness of HIV and AIDS among adult women and men. The study relies on data from three rounds of Ghana Demographic & Health Surveys conducted in 2003, 2008 and 2014 to show trends. Logistic regression was used for multivariate analysis. The thematic mapping of HI/AIDS comprehensive knowledge was conducted using ArcGIS version 10.4 using GPS coordinates in the 2014 GDHS which contained aggregated individual characteristics and HIV knowledge scores.While comprehensive HIV and AIDS knowledge is above 50% among adult population in Ghana, the results show a significant decrease in comprehensive knowledge from 72% in 2008 to 59% in 2013. The strongest predictors for having comprehensive knowledge were found to be education; gender, marital status, locality, occupation and wealth status. The paper demonstrates that preventive activities leading to improvement in the comprehensive knowledge of HIV and AIDS in Ghana is needed. Sound knowledge about HIV and AIDS is critical for the adoption of behaviours that reduce the risk of HIV transmission. Education on HIV prevention must be expanded to improve the comprehensive knowledge of the disease.
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Ayim-Aboagye, Desmond. "HIV/AIDS in different cultures." Scandinavian Journal of Pain 3, no. 3 (July 1, 2012): 198. http://dx.doi.org/10.1016/j.sjpain.2012.05.066.
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Abstract Background/aims HIV/AIDS is a disease that is taking many lives in Ghana and other countries in Africa. It is a disease that has infected people in Sweden, though not as many as Africa has reported. The present investigation concerns how HIV/AIDS patients in Ghana, a cultural tropic climate, and patients in Sweden, the Nordic region, experience their pain. Methods With empirical data from both countries, the research will unveil how these patients cope or adapt to their illness with all the attention they receive from the environments and their native resources. Apart from the theoretical considerations where literature/secondary sources on the subject will be analysed, the investigation will administer Coping Experience Questionnaires (CEQ) and The Medical Outcomes Study Short Form 36 (SF36) to reach a deeper analysis on how they adapt to their illness and wellbeing. The study will also utilise both the Structured Interviewed (SI) and In-depth Interview (IDI) to muster relevant data about their experience with hospital environments, native resources, and human relations. Results and conclusion It is estimated that the results of the investigation will firstly, help doctoral students to comprehend coping strategies and differences in conditions with HIV/AID patients in diverse cultures, and secondly, help to understand psychiatry care of patients from different cultural climates.
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Der, Edmund Muonir, Johnbosco B. Damnyag, Edwin K. Wiredu, Richard K. Gyasi, and Jehoram T. Anim. "Hiv/aids and tuberculous meningitis: a five year retrospective autopsy study at the korle-bu teaching hospital accra Ghana." Pathology Discovery 2, no. 1 (2014): 3. http://dx.doi.org/10.7243/2052-7896-2-3.
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Abu, Emmanuel Kwasi, Samuel Abokyi, Dorcas Obiri-Yeboah, Richard Kobina Dadzie Ephraim, Daniel Afedo, Lawrence Duah Agyeman, and Samuel Bert Boadi-Kusi. "Retinal Microvasculopathy Is Common in HIV/AIDS Patients: A Cross-Sectional Study at the Cape Coast Teaching Hospital, Ghana." Journal of Ophthalmology 2016 (2016): 1–6. http://dx.doi.org/10.1155/2016/8614095.
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Purpose. The purpose of this study was to evaluate the ocular disorders in HIV positive patients attending the Cape Coast Teaching Hospital, Ghana. Methods. A cross-sectional study using systematic random sampling was conducted on 295 HIV positive patients. Data collection consisted of semistructured questionnaires, laboratory investigation, medical profile, and ophthalmic examination. Statistical association tests including χ2, independent t-test, and ANOVA were done. A p value ≤ 0.05 was considered statistically significant. Results. Of the 295 participants, 205 (69.5%) were on antiretroviral therapy while 90 (30.3%) were not on therapy. Majority of the participants (162, 54.9%) were in clinical stage two, followed by stages three (68, 23.1%), one (62, 21%), and four (3, 1%), respectively. The overall prevalence of ocular disorders was 5.8%. The most common HIV related ocular disorder was HIV retinal microvasculopathy (58.8%), followed by herpes zoster ophthalmicus and Toxoplasma retinochoroiditis, both representing 11.8% of ocular disorders seen. Cytomegalovirus retinitis, Bell’s palsy, and optic neuritis were the least common (5.9%). CMV retinitis recorded the highest viral load of 1,474,676 copies/mL and mean CD4 count of 136 cells/mm3. The mean CD4 count for participants with HIV related ocular disorders was significantly lower compared to participants without disorders (t=2.5, p=0.012). Participants with ocular disorders also recorded significantly higher mean viral loads than those who did not have ocular disorders (t=2.8, p=0.006). Conclusion. Lower CD4 counts and high viral load copies were associated with the manifestation of HIV related ocular disorders.
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Tenkorang, Eric Y., and Adobea Y. Owusu. "Examining HIV-related stigma and discrimination in Ghana: what are the major contributors?" Sexual Health 10, no. 3 (2013): 253. http://dx.doi.org/10.1071/sh12153.
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Background Although AIDS-related stigma and discrimination are considered detrimental to HIV prevention activities, not many studies have attempted to understand stigma and discrimination in sub-Saharan Africa, particularly Ghana. Methods: Using the 2008 Ghana Demographic and Health Survey and applying the ordinary least-squares technique, this study examined what influences AIDS-related stigma and discrimination among men and women in Ghana. Results: The results indicate that Ghanaian men and women with relatively high knowledge about HIV/AIDS had low stigmatising and discriminatory attitudes (b = –0.097, P < 0.01; b = –0.083, P < 0.01), respectively. On the other hand, respondents who endorsed more myths about HIV transmission had high stigma and discriminatory attitudes. Women who had ever tested for their HIV serostatus reported significantly lower levels of stigma and discrimination (b = –0.085, P < 0.01) compared with those who had not tested for HIV. Individuals who are highly educated, employed and in wealthy households all reported significantly lower levels of stigma and discrimination compared with those who are uneducated, unemployed and in poorer households. Conclusion: AIDS-related stigma and discrimination can be reduced by encouraging HIV testing, and ensuring that Ghanaians understand and have factual knowledge regarding the transmission of the disease.
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Nwokelo, A. I., and S. Oppong. "A Comparative Study of Sickle Cell Disease Related Maternal Mortality at Korle-Bu Teaching Hospital, Accra, Ghana." Annals of Global Health 83, no. 1 (April 7, 2017): 196. http://dx.doi.org/10.1016/j.aogh.2017.03.489.
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Osei-Yeboah, James, William K. B. A. Owiredu, Gameli Kwame Norgbe, Sylvester Yao Lokpo, Christian Obirikorang, Emmanuel Alote Allotey, John Gameli Deku, et al. "Quality of Life of People Living with HIV/AIDS in the Ho Municipality, Ghana: A Cross-Sectional Study." AIDS Research and Treatment 2017 (2017): 1–7. http://dx.doi.org/10.1155/2017/6806951.
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Quality of life (QoL) is an important component in the evaluation of the wellbeing of people living with HIV/AIDS (PLHIV). This study was aimed at evaluating the QoL of PLHIV attending the antiretroviral clinics in the Ho municipality. A cross-sectional study was conducted from January 2017 to April 2017 involving 158 purposively selected HIV-positive patients who were attending the antiretroviral clinics both in the Volta Regional Hospital and Ho Municipal Hospital. An Interviewer administered standard questionnaire (WHOQOL-HIV Bref) was used to collect information on sociodemography, medical history, and the quality of life (QoL) of the respondents. Among these 158 HIV-positive respondents, 126 (79.75) and 14 (8.86) presented with excellent and good overall QoL, respectively, whilst 18 (11.39) had their life negatively affected by HIV/AIDS. Religious/personal beliefs (19.62%) were the most affected QoL component, followed by the physical (15.82%) and level of independence (15.19%) domains. Patients’ occupation, perception of health, sexual activity, and state of the disease were associated with poor overall QoL. In general, being an HIV-infected man, symptomatic patient, not being sexually active, or being ART naïve was also associated with poorer QoL in several HIV/AIDS QoL domains.
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Anie, Kofi A., Vivian Paintsil, Ellis Owusu-Dabo, Daniel Ansong, Alex Osei-Akoto, Kwaku Ohene-Frempong, Kofi Aikins Amissah, et al. "Organ damage in sickle cell disease study (ORDISS): protocol for a longitudinal cohort study based in Ghana." BMJ Open 7, no. 8 (August 2017): e016727. http://dx.doi.org/10.1136/bmjopen-2017-016727.
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IntroductionSickle cell disease is highly prevalent in Africa with a significant public health burden. Nonetheless, morbidity and mortality in sickle cell disease that result from the progression of organ damage is not well understood. The Organ Damage in Sickle Cell Disease Study (ORDISS) is designed as a longitudinal cohort study to provide critical insight into cellular and molecular pathogenesis of chronic organ damage for the development of future innovative treatment.Methods and analysisORDISS aims to recruit children aged 0–15 years who attend the Kumasi Centre for Sickle Cell Disease based at the Komfo Anokye Teaching Hospital in Kumasi, Ghana. Consent is obtained to collect blood and urine samples from the children during specified clinic visits and hospitalisations for acute events, to identify candidate and genetic markers of specific organ dysfunction and end-organ damage, over a 3 year period. In addition, data concerning clinical history and complications associated with sickle cell disease are collected. Samples are stored in biorepositories and analysed at the Kumasi Centre for Collaborative Research in Tropical Medicine, Ghana and the Centre for Translational and International Haematology, University of Pittsburgh, USA. Appropriate statistical analyses will be performed on the data acquired.Ethics and disseminationResearch ethics approval was obtained at all participating sites. Results of the study will be submitted for publication in peer-reviewed journals, and the key findings presented at national and international conferences.
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Wilson, Nana O., Samuel A. Obed, Richard K. Gyasi, Andrew A. Adjei, Winston A. Anderson, Jacqueline M. Hibbert, Adel Driss, Fatou K. Ceesay, and Jonathan K. Stiles. "Pregnancy Outcomes among Patients with Sickle Cell Disease at Korle-Bu Teaching Hospital, Accra, Ghana: Retrospective Cohort Study." American Journal of Tropical Medicine and Hygiene 86, no. 6 (June 1, 2012): 936–42. http://dx.doi.org/10.4269/ajtmh.2012.11-0625.
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Walsh, Kimberley, William Thompson, Joseph Megyesi, Clayton A. Wiley, and Robert Hammond. "HIV-1/AIDS Neuropathology in a Canadian Teaching Centre." Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques 31, no. 2 (May 2004): 235–41. http://dx.doi.org/10.1017/s0317167100053889.
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AbstractBackground:The nervous system is a major target of HIV-1 infection and site of many complications of AIDS. Most of our knowledge pertaining to the range and frequency of neuropathology in HIV-1/AIDS is from large centres outside Canada in different social and health care settings. The goal of the present study was to describe HIV-1/AIDS-associated neuropathology before and during the era of highly active antiretroviral therapy at a Canadian teaching centre.Methods:The records of the Department of Pathology, London Health Sciences Centre were electronically searched for cases of HIV-1/AIDS that came to postmortem examination since 1985. The clinical records and pathological materials were reviewed.Results:Sixteen autopsies of HIV-1/AIDS were identified. All patients were male. Fourteen contracted HIV-1 through high risk homosexual activity, one through the transfusion of blood products and one through intravenous drug use. Three patients (19%) had pre-mortem evidence of HIV-1 associated dementia. At autopsy, 12 of the 16 cases had neuropathological findings and the most common diagnoses were HIV-1 encephalitis, progressive multifocal leukoencephalopathy, toxoplasmosis, and primary CNS lymphoma.Conclusions:High risk homosexual activity was a more prominent factor in acquiring AIDS in cases coming to postmortem examination compared with previous reports from most larger urban centres outside Canada where injection drug use and high risk heterosexual activity factored prominently. The incidence of HIV-1 associated dementia was similar to that reported previously. This study confirms the heavy burden and wide spectrum of disease experienced by the nervous system in HIV-1/AIDS.
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Atanuriba, Gideon Awenabisa, Felix Apiribu, Adwoa Bemah Boamah Mensah, Veronica Millicent Dzomeku, Richard Adongo Afaya, Timothy Gazari, Joseph Kuufaakang Kuunibe, and Philemon Adoliwine Amooba. "Caregivers’ Experiences with Caring for a Child Living with HIV/AIDS: A Qualitative Study in Northern Ghana." Global Pediatric Health 8 (January 2021): 2333794X2110036. http://dx.doi.org/10.1177/2333794x211003622.
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With the advent of Anti-Retroviral Therapy, Human Immune Virus, and Acquire Immuno-Deficiency Syndrome is increasingly becoming a chronic disease as life expectancy among People Living With HIV/AIDS has increased. For Children Living With HIV/AIDS the role of the caregivers becomes essential as caregivers’ decisions affect CLWH health. However, the experiences of these caregivers are often unnoticed while all interventions are directed at PLWH. This study aimed at exploring the experiences of caregivers of CLWH in some selected hospitals in northern Ghana. This study employed a qualitative descriptive phenomenological approach. Purposive sampling technique was used to recruit 9 participants from 3 public hospitals in the Tamale Metropolis of Ghana. Data was manually analyzed using the approach of Collaizi and the findings were presented in themes and sub-themes. We conducted individual face to face interviews in English and Dagbani from September to November 2019. These interviews were conducted at the convenience of the participants in hospitals and at their homes. They were introduced to the study while awaiting to take antivirals for their CLWH. Five themes emerged: changed family dynamics, discovery of diagnosis, reaction to diagnosis, disclosure, stigma and discrimination, and burden and challenges of care. Caregivers were severely impacted by caring for CLWH and traumatized by changed family dynamics which exposed them to many difficulties. Stigma was widely perpetrated by immediate family members and majority reacted badly to their children HIV-positive status with fear, shame, guilt and even suicidal ideation.
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Darkwa, Ebenezer Owusu, Robert Djagbletey, Raymond Essuman, Daniel Sottie, Gifty Boatemaa Dankwah, and George Aryee. "Nitric Oxide and Pre-Eclampsia: A Comparative Study in Ghana." Open Access Macedonian Journal of Medical Sciences 6, no. 6 (June 16, 2018): 1023–27. http://dx.doi.org/10.3889/oamjms.2018.252.
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BACKGROUND: Preeclampsia is one of the commonest aetiologies of foetal and maternal mortality and morbidity. Though common, the aetiology of preeclampsia has remained unknown with several inconclusive theories surrounding the disease. Recent studies have implicated vascular endothelial dysfunction and possibly nitric oxide in preeclampsia.AIM: To compare plasma nitric oxide levels in pre-eclampsia and healthy pregnant women in a large tertiary hospital in Ghana.METHODS: This was a case-control study conducted among pre-eclampsia and healthy pregnant women in Korle-Bu Teaching Hospital over a four-month period. Thirty (30) pre-eclamptic and 30 healthy pregnant women aged 18-35 years with over 30 weeks’ gestation were consecutively recruited into the study after obtaining informed consent. Plasma nitric oxide levels were determined using the Griess Reagent system. Data were analysed using Statistical Package for the Social Sciences (SPSS) software version 20.0 and results were compared using the independent t-test. A P-value of ≤ 0.05 was considered statistically significant.RESULTS: The parity and body mass index (BMI) of the participants were similar. There was a significant difference in the blood pressure of the pre-eclamptic compared to healthy pregnant women. There was no statistically significant difference (P-value = 0.160) in the plasma levels of nitric oxide in pre-eclamptic (Mean = 1178.78; SD = 89.70 nM) compared to healthy pregnant women (Mean = 1365.43; SD = 95.46 nM).CONCLUSION: Plasma nitric oxide levels may not play a significant role in the aetiology of pre-eclampsia.
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Quayson, SE, EK Wiredu, DN Adjei, and JT Anim. "Breast cancer in Accra, Ghana." Journal of Medical and Biomedical Sciences 3, no. 3 (January 13, 2015): 21–26. http://dx.doi.org/10.4314/jmbs.v3i3.4.
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The aim of this study was to look at the pattern of breast cancer over a period of five years and to compare the findings to similar studies done in the Department and elsewhere within the African sub-region. All breast cancers diagnosed in the Department of Pathology of the Korle Bu Teaching Hospital, Accra, over a 5-year period were compiled. The slides for the cases were retrieved and reviewed. Invasive ductal carcinomas were graded according to the Scarff-Bloom-Richardson’s grading system. The data were entered and analyzed using the EPI-Info microcomputer software (Version 3.5.1, 2008, Center for Disease Control and Prevention (CDC) Atlanta). Breast cancer in Accra is mostly of the ductal type or its variants affecting relatively younger age groups. The mean age of incidence of cancer in Ghana is 48 years, and about 67% have lymph node metastases (at least Stage II or N1) and 74% are of high grade at the time of diagnoses. The percentage of male breast cancers in Ghana is 2.9% (2.0 - 3.75% within the West African sub-region) and is higher than what is reported in Western literature. The results of this study show that there has been no im-provement in the stage at which patients present with breast cancer in the past 30 years.Keywords: Breast cancer, cancer types, cancer grade, lymph node status, Accra
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KD Ephraim, Richard, Yaw A Awuku, Ignatious Tetteh-Ameh, Charles Baffe, Godsway Aglagoh, Victor A Ogunajo, Kizito Owusu-Ansah, Prince Adoba, Samuel Kumordzi, and Joshua Quarshie. "Acute kidney injury among medical and surgical in-patients in the Cape Coast Teaching Hospital, Cape Coast, Ghana: a prospective cross-sectional study." African Health Sciences 21, no. 2 (August 2, 2021): 795–805. http://dx.doi.org/10.4314/ahs.v21i2.40.
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Background: Acute kidney injury (AKI) is a syndrome associated with high morbidity, mortality and high hospital costs. Despite its adverse clinical and economic effects, only a few studies have reported reliable estimates on the incidence of AKI in sub-Sahara Africa. We assessed the incidence and associated factors of AKI among medical and surgical patients admitted to a tertiary hospital in Ghana.
Methods: A prospective cross-sectional study was conducted among one hundred and forty-five (145) consecutive patients admitted to the medical and the surgical wards at the Cape Coast Teaching Hospital (CCTH), Cape Coast, Ghana from April 2017 to April 2018. Socio-demographic and clinical information were collected using structured questionnaires. AKI was diagnosed and staged with the KDIGO guideline, using admission serum creatinine as baseline kidney function.
Results: The mean age of the study participants was 46.6±17.7 years, whilst the male:female ratio was 68:77. The overall incidence of AKI among the participants was 15.9% (95% CI: 10.33 – 22.84%). Stage 1 AKI occurred in 56.5% of the par- ticipants, whilst stages 2 and 3 AKI respectively occurred among 4.1% and 2.8% of respondents. About 20% of the partic- ipants in the medical ward developed AKI (n= 15) whilst 12% of those in surgical ward developed AKI (n= 8). Among the participants admitted to the medical ward, 60.0%, 26.7% and 13.3% had stages 1, 2 and 3 AKI respectively. Whilst 50.0%, 25.0% and 25.0% respectively developed stages 1, 2 and 3 AKI in the surgical ward. Medical patients with AKI had hyper- tension (40%), followed by liver disease (33.3%); 37.5% of surgical inpatients had gastrointestinal (GI) disorders.
Conclusion: The incidence of AKI is high among medical and surgical patients in-patients in the CCTH, Ghana, with hy- pertension and liver disease as major comorbidities.
Keywords: Acute kidney injury; KDIGO; medical; surgical; hypertension; liver disease.
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Mensah, Yaw B., Kwadwo Mensah, Hafisatu Gbadamosi, and Naa A. Mensah. "Magnetic Resonance Imaging (MRI) Utilization in a Ghanaian Teaching Hospital: Trend and Policy Implications." Ghana Medical Journal 54, no. 1 (April 9, 2020): 3–9. http://dx.doi.org/10.4314/gmj.v54i1.2.
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Background: The use of Magnetic Resonance Imaging (MRI) is new in Ghana compared with some Western countries.A number of studies have observed increased MRI utilization due to increased sensitivity to diagnosis, and the paradigm shift to modalities that do not use radiation. Challenges with MRI use include high cost of the examination and inappropriate requests by referring clinicians.
Objective: To determine the MRI utilisation trend in Korle Bu Teaching Hospital (KBTH), Ghana and its policy implications.
Materials and Methods: A retrospective study undertaken in the Radiology Department, KBTH, from February to March, 2017. Eight hundred and forty request forms for MRI studies between January, 2013 and December 2016 were reviewed. Information on patient’s age and sex, number of MRI studies done, body parts and clinical conditions evaluated, appropriateness of clinical requests and existing policies on MRI in Ghana was gathered. Measures of central tendency and spread were obtained. Chi square, Pearson’s correlation and linear regression analysis were also used in the analysis.
Results: The top three body parts requested were Spine (55 %), Brain (19%) and Joints (6 %); degenerative disease was the most common clinical condition evaluated.Significant association and correlation were obtained between of the number of body parts evaluated and examination year as well as the variety of clinical conditions requested and examination year.
Conclusion: A progressive increase was noted in MRI utilisation both in number and diversity but no policy guiding MRI use in Ghana exists.
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Boima, V., K. Agyabeng, V. Ganu, D. Dey, E. Yorke, M. B. Amissah-Arthur, A. A. Wilson, A. E. Yawson, C. C. Mate-Kole, and J. Nonvignon. "Willingness to pay for kidney transplantation among chronic kidney disease patients in Ghana." PLOS ONE 15, no. 12 (December 30, 2020): e0244437. http://dx.doi.org/10.1371/journal.pone.0244437.
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Background Kidney transplantation is the preferred treatment for patients with end stage renal disease. However, it is largely unavailable in many sub-Sahara African countries including Ghana. In Ghana, treatment for end stage renal disease including transplantation, is usually financed out-of-pocket. As efforts continue to be made to expand the kidney transplantation programme in Ghana, it remains unclear whether patients with Chronic Kidney Disease (CKD) would be willing to pay for a kidney transplant. Aim The aim of the study was to assess CKD patients’ willingness to pay for kidney transplantation as a treatment option for end stage renal disease in Ghana. Methods A facility based cross-sectional study conducted at the Renal Outpatient clinic and Dialysis Unit of Korle-Bu Teaching Hospital among 342 CKD patients 18 years and above including those receiving haemodialysis. A consecutive sampling approach was used to recruit patients. Structured questionnaires were administered to obtain information on demographic, socio-economic, knowledge about transplant, perception of transplantation and willingness to pay for transplant. In addition, the INSPIRIT questionnaire was used to assess patients’ level of religiosity and spirituality. Contingent valuation method (CVM) method was used to assess willingness to pay (WTP) for kidney transplantation. Logistic regression model was used to determine the significant predictors of WTP. Results The average age of respondents was 50.2 ± 17.1 years with most (56.7% (194/342) being male. Overall, 90 out of the 342 study participants (26.3%, 95%CI: 21.7–31.3%) were willing to pay for a kidney transplant at the current going price (≥ $ 17,550) or more. The median amount participants were willing to pay below the current price was $986 (IQR: $197 –$1972). Among those willing to accept (67.3%, 230/342), 29.1% (67/230) were willing to pay for kidney transplant at the prevailing price. Wealth quintile, social support in terms of number of family friends one could talk to about personal issues and number of family members one can call on for help were the only factors identified to be significantly predictive of willingness to pay (p-value < 0.05). Conclusion The overall willingness to pay for kidney transplant is low among chronic kidney disease patients attending Korle-Bu Teaching Hospital. Patients with higher socio-economic status and those with more family members one can call on for help were more likely to pay for kidney transplantation. The study’s findings give policy makers an understanding of CKD patients circumstances regarding affordability of the medical management of CKD including kidney transplantation. This can help develop pricing models to attain an ideal poise between a cost effective but sustainable kidney transplant programme and improve patient access to this ultimate treatment option.
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Badu-Peprah, Augustina, Ijeoma Anyitey-Kokor, Allswell Ackon, Obed K. Otoo, Nana A. K. Asamoah, and Theophilus K. Adu-Bredu. "Chest radiography patterns of COVID-19 pneumonia in Kumasi, Ghana." Ghana Medical Journal 54, no. 4 (December 4, 2020): 264–68. http://dx.doi.org/10.4314/gmj.v54i4.9.
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Objectives: To document the pattern of chest radiographic findings in coronavirus disease 2019 (COVID-19) patients with moderate to severe disease.
Design: Retrospective cross-sectional study.
Setting: The study site was Komfo Anokye Teaching Hospital (KATH) located at Bantama in Kumasi, the capital town of the Ashanti Region. It is the second largest hospital in the country and the major referral site for Ashanti region and the northern part of the country. The hospital hosts a highly infectious isolation unit (HIIU) for COVID19 patients with moderate to severe infections and receives referred cases from the region and within the hospital.
Participants: The study involved 27 patients admitted to the HIIU at KATH with COVID-19 infection who underwent chest X-ray as part of their investigations.
Results: The study enrolled 12 males and 15 females. The common comorbidities were hypertension and diabetes. Chest x-ray findings in most of the patients (81.5%) revealed ground-glass opacities while a few of them (18.5%) had lung consolidations without ground-glass opacities. For those with ground-glass opacities, eight (29.6%) had superimposed consolidation. All the participants had positive chest x-ray findings.
Conclusion: The chest x-ray findings in the 27 COVID-19 positive patients with moderate to severe disease on admission at the KATH HIIU enrolled in this study showed significant pulmonary abnormalities. The predominant pulmonary abnormalities were bilateral peripheral ground-glass opacities with the lower lung zones being mostly affected.
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Hobenu, Kafui A., and Florence Naab. "A qualitative study of the physical consequences experienced by women with cervical cancer in Accra, Ghana." African Journal of Midwifery and Women's Health 14, no. 2 (April 2, 2020): 2–12. http://dx.doi.org/10.12968/ajmw.2019.0006.
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Background/aims Cervical cancer is a highly prevalent type of cancer that causes severe physical consequences, including pain and sleep disturbance. However, in Ghana, little is known about the experiences of women with cervical cancer. This study explored the physical experiences of women with cervical cancer in Accra, Ghana to help healthcare professionals understand the experiences of their patients and improve the care given. Methods This study employed an exploratory descriptive qualitative approach, using purposive sampling technique to select study participants. In-depth interviews lasting between 45 and 90 minutes were conducted face-to-face with 15 women with cervical cancer receiving treatment at a teaching hospital in Ghana to gather information on their physical experiences resulting from the cancer. The interviews were recorded with the participants' consent. Data were transcribed verbatim and subjected to content analysis concurrently with data collection. Results Content analysis revealed the following sub-themes within disease-related physical consequences of cervical cancer: pain, impaired sleep patterns, weight loss and gynaecological problems. Conclusions The findings of this study suggest that women with cervical cancer experience physical consequences that negatively impact their wellbeing. Healthcare providers should employ a multidisciplinary approach in the management of women with cervical cancer.
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Ofosu-Poku, Rasheed, Michael Owusu-Ansah, and John Antwi. "Referral of Patients with Nonmalignant Chronic Diseases to Specialist Palliative Care: A Study in a Teaching Hospital in Ghana." International Journal of Chronic Diseases 2020 (March 16, 2020): 1–11. http://dx.doi.org/10.1155/2020/8432956.
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Ghana’s chronic disease burden is on the rise. An essential aspect of clinical care in chronic disease management is to improve the quality of life of both patients and their families and to help them cope with the experience of life-limiting illness. Specialist palliative care services help reach this objective, especially in the context of complex psychosocial challenges and high symptom burden. It is, therefore, necessary that as many patients as possible get access to available specialist palliative care services. This paper explores the factors influencing referral of patients with nonmalignant chronic diseases for specialist palliative care. A qualitative approach was used to explore these factors from eight (8) participants—four (4) physician specialists and four (4) next of kin of patients with advanced nonmalignant chronic illness. Individual face-to-face interviews were conducted using a semistructured interview guide. Interviews were audio-recorded and data coded, themes and subthemes were identified, and thematic analysis was done. Barriers and motivators identified were categorized as either related to physicians, institution, or family. Barriers to referral were perception of the scope of palliative care, medical paternalism, lack of an institutional referral policy, poor human resource capacity of the palliative care team, and lack of awareness about the existence of specialist palliative care service. Poor economic status of the patient and family, poor prognosis, previous interaction with the palliative care team, and an appreciation of patients’ expectations of the healthcare system were identified as motivators for referral. The palliative care team must therefore increase awareness among other health professionals about their services and facilitate the development and availability of a clear policy to guide and improve referrals.
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Olufemi Olaniyi, Taiwo, and Pam Sunday. "Oral manifestations of HIV infection in 36 Nigerian children." Journal of Clinical Pediatric Dentistry 30, no. 1 (September 1, 2006): 89–92. http://dx.doi.org/10.17796/jcpd.30.1.a75w1602n0x6577r.
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Oral manifestations of HIV/AIDS are early and common clinical indicators of HIV infection. There has been no report on the clinical prevalence of oral lesions associated with HIV infection in children in sub-Saharan Africa.We report the findings of a cross sectional study of 36 Nigerian children seen at the Pediatrics Infectious Disease Clinic of the AIDS Prevention Initiative in Nigeria (APIN), Jos University Teaching Hospital (JUTH) Jos, Nigeria.
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Agbokey, Francis, Elorm Kudzawu, Mawuli Dzodzomenyo, Kenneth Ayuurebobi Ae-Ngibise, Seth Owusu-Agyei, and Kwaku Poku Asante. "Knowledge and Health Seeking Behaviour of Breast Cancer Patients in Ghana." International Journal of Breast Cancer 2019 (April 1, 2019): 1–9. http://dx.doi.org/10.1155/2019/5239840.
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Background. Breast cancer is a major contributor to cancer-related deaths among women worldwide, despite the numerous measures employed to prevent and manage the disease. This study explored the knowledge and health seeking behaviour of breast cancer patients at the Komfo Anokye Teaching Hospital. Methods. A descriptive cross-sectional study was conducted at Komfo Anokye Teaching Hospital in Kumasi, Ghana, from June 2014 to July 2014. Thirty-five participants were purposively selected. The responses to questions about their experiences with breast cancer were determined using indepth interviews. Transcripts were coded and analysed using NVIVO version 10.0. Results. Participants’ knowledge about signs and symptoms of breast cancer after their diagnosis was high but low for risk factors. Screening for breast cancer through self-breast examination was infrequently performed prior to their diagnosis. The patients’ first point of care was generally health facilities. Some patients reported late due to misinterpretation of signs and symptoms, cultural influences and fear of losing their breast to surgery, physician delay, health providers’ laxity, and disinterest in breast cancer. Men, for example, husbands, decide on where and when breast cancer patients go for treatment. Conclusion. There is poor knowledge of the risk factors for developing breast cancer. Patients resorted to the hospital as first options for cure but were generally delayed in doing so. There is the need to create awareness about breast cancer among the general population.
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BORGES, Aércio Sebastião, Marcelo Simão FERREIRA, Sérgio de Andrade NISHIOKA, Marco Túlio Alvarenga SILVESTRE, Arnaldo Moreira SILVA, and Ademir ROCHA. "Agreement between premortem and postmortem diagnoses in patients with acquired immunodeficiency syndrome observed at a brazilian teaching hospital." Revista do Instituto de Medicina Tropical de São Paulo 39, no. 4 (July 1997): 217–22. http://dx.doi.org/10.1590/s0036-46651997000400007.
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Acquired immunodeficiency syndrome (AIDS) is one of the main causes of death in adults worldwide. More commonly than in the general population, in patients with AIDS there is substantial disagreement between causes of death which are clinically suspected and those established by postmortem examination. The findings of 52 postmortem examinations were compared to the premortem (clinical) diagnoses, and there was 46% agreement between them. Fifty two percent of the patients had more than one postmortem diagnosis, and 48% had at least one AIDS-related disease not suspected clinically. Cytomegalovirus infection was the commonest (30.7%) autopsy finding, but not a single case had been suspected premortem. Bacterial infection, tuberculosis, and histoplasmosis were also common, sometimes not previously suspected, postmortem findings. This study shows that multiple infections occur simultaneously in AIDS patients, and that many among them are never suspected before the postmortem examination. These findings suggest that an aggressive investigation of infections and cancers should be done in patients with AIDS, particularly in those who do not respond to therapy of an already recognized condition
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Obirikorang, Christian, Razak Gyesi Issahaku, Derick Nii Mensah Osakunor, and James Osei-Yeboah. "Anaemia and Iron Homeostasis in a Cohort of HIV-Infected Patients: A Cross-Sectional Study in Ghana." AIDS Research and Treatment 2016 (2016): 1–8. http://dx.doi.org/10.1155/2016/1623094.
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Aim.We determined the prevalence of anaemia and evaluated markers of iron homeostasis in a cohort of HIV patients.Methods.A comparative cross-sectional study on 319 participants was carried out at the Tamale Teaching Hospital from July 2013 to December 2013, 219 patients on HAART (designated On-HAART) and 100 HAART-naive patients. Data gathered include sociodemography, clinical history, and selected laboratory assays.Results.Prevalence of anaemia was 23.8%. On-HAART participants had higher CD4/CD3 lymphocyte counts, Hb, HCT/PCV, MCV, MCH, iron, ferritin, and TSAT (P<0.05). Hb, iron, ferritin, and TSAT decreased from grade 1 to grade 3 anaemia and CD4/CD3 lymphocyte count was lowest in grade 3 anaemia (P<0.05). Iron (P=0.0072) decreased with disease severity whilst transferrin (P=0.0143) and TIBC (P=0.0143) increased with disease severity. Seventy-six (23.8%) participants fulfilled the criteria for anaemia, 86 (26.9%) for iron deficiency, 41 (12.8%) for iron deficiency anaemia, and 17 (5.3%) for iron overload. The frequency of anaemia was higher amongst participants not on HAART (OR 2.6 for grade 1 anaemia; OR 3.0 for grade 3 anaemia).Conclusion.In this study population, HIV-associated anaemia is common and is related to HAART status and disease progression. HIV itself is the most important cause of anaemia and treatment of HIV should be a priority compared to iron supplementation.
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Nartey, Y., P. Hill, K. Amo-Antwi, K. Nyarko, J. Yarney, and B. Cox. "Clinical Features of Women Diagnosed With Invasive Cervical Cancer in Ghana." Journal of Global Oncology 4, Supplement 2 (October 1, 2018): 40s. http://dx.doi.org/10.1200/jgo.18.29000.
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Background: The incidence of cervical cancer continues to increase in many low- and middle-income countries. It remains the commonest cancer affecting females in Ghana. However, comprehensive information on the clinical characteristics of women diagnosed with invasive cervical cancer is scarce. Aim: To characterize the clinical features of women with invasive cervical cancer in Ghana. Methods: We conducted a retrospective study in two large referral hospitals in Ghana: the Korle Bu teaching hospital, Accra and Komfo Anokye teaching hospital, Kumasi. Through the review of paper-based, electronic, and pathology medical records, information on women diagnosed with invasive cervical cancer from 1st January 2010 to 31st December 2013 was collected. The information was entered onto a standardized data abstraction sheet and included demographics, comorbid conditions, treatment and follow-up. All analyses were conducted in STATA and described the distribution of key clinical features by the stage at diagnosis. Results: A total of 1,725 women with invasive cervical cancer were included in the analysis. Few had cervical screening before their cervical cancer diagnosis (1.1%). Women who were resident in a metropolitan area ( P = 0.034), or who had any comorbidity ( P < 0.001) were at an increased risk of FIGO stage III-IV disease. The majority of women had at least two diagnostic investigations (75%) with cervical biopsy performed for 95.5% of women. More than half received radiotherapy (55.4%) and only 22.4% receiving chemotherapy. Clinical follow-up after the first consultation was performed for 61%, with 73% of women with clinical follow-up having at least one follow-up investigation. Conclusion: Improvements in access to early diagnosis and optimal treatment of cervical cancer, such as an increased use of chemoradiation would reduce the burden of the disease in Ghana.
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Amo-Adjei, Joshua, Akwasi Kumi-Kyereme, and Derek Anamaale Tuoyire. "Transactional sex among female university students in Ghana: Implications for HIV education." Health Education 114, no. 6 (September 30, 2014): 473–86. http://dx.doi.org/10.1108/he-02-2014-0013.
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Purpose – Older males having sex with younger females is known to increase unsafe sex practices, exacerbated by power and economic imbalances between partners. The purpose of this paper is to examine transactional sexual relationships (i.e. long-term relationships constructed as “girlfriends not ‘prostitutes’” based on the exchange of gifts and other obligations) among female students of University of Cape Coast, Ghana. It particularly explores the implications for HIV education in institutions of higher learning. HIV/AIDS has been labelled as a disease of the poor and the uneducated, and it might be expected university students would engage in safer sexual practices: if they do not it highlights the problem around gender and economic imbalances and their repercussions even more clearly. Design/methodology/approach – Using snowballing, 40 university-educated female students engaged in transactional sex were interviewed using unstructured interview. The data were analysed thematically. Findings – These young women were not simple victims, these relationships were the result of complex and conscious choices. They did not want to marry their partners and were clear that these were short-term relationships primarily for material gain, which they nevertheless kept secret from family and most friends for fear of stigma, particularly in blighting their future marriage prospects. They protected themselves from emotional involvement, although they often saw their partners as loving, taking the provision of gifts as a sign of affection and sometimes a replacement for parental love. Their motivation was primarily economic, to fulfil “wants” not survival “needs” – the relationships enabled them to purchase the trappings of affluent society such as clothes, hairstyles, fast food and gadgets. They were also motivated by the enhanced experiences these relationships allowed, such as feeling protected, respected, “high class”, part of a daring elite of women and being able to travel and continue their education. The unequal nature of the relationships (often described as “father-daughter”) in a society in which parents, older people and men are given unquestioning respect, reduced their abilities to negotiate safe sex practices. In so far as they practiced safer sex it was to avoid pregnancy rather than disease, believing they would be able to tell from physical signs if their partner was infected. Practical implications – This study shows that the “privileged” status’ that higher education offers is no match for the socioeconomic and cultural factors which make female youths, whatever their educational background, compromise on safer sexual practices, rendering them vulnerable to STIs and particularly, HIV infection. It is also clear that students in higher education are nevertheless ignorant about the risk and invisible nature of sexually transmitted disease. Institutions of higher education need to do more to provide robust sex and relationship educational interventions for their students and faculty about HIV/AIDS, which take into account the complex and socially situated decisions that surround sexual relationships. Originality/value – Most of the work on transactional sexual relationships has come from South Africa – this is the first study in a Ghanaian context and of educated young women.
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Sifa, Jerry S., Stephen Manortey, Sharon Talboys, Gloria A. Ansa, and Ekua E. Houphouet. "Risk factors for loss to follow-up in human immunodeficiency virus care in the Greater Accra Regional Hospital in Ghana: a retrospective cohort study." International Health 11, no. 6 (June 11, 2019): 605–12. http://dx.doi.org/10.1093/inthealth/ihz043.
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Abstract Background Loss of human immunodeficiency virus (HIV)-positive patients to follow-up increases HIV-related morbidity and mortality. This study identified the factors associated with loss to follow-up (LTFU) in an urban health facility in Ghana. Methods A 12-y retrospective study was conducted using routinely collected data from the National Acquired Immune Deficiency Syndrome (AIDS) Control Programme (NACP) on persons living with HIV/AIDS (PLWHA) who initiated antiretroviral therapy (ART) from 2006 to 2017 at the Greater Accra Regional Hospital. Convenience sampling was used to select the study area. All gathered data were exported to Stata 14 statistical software for analysis. Results A total of 4330 PLWHA initiated ART between January 2006 and December 2017. Of these, 1166 (26.9%) were lost to follow-up over the 12-y period. The factors associated with LTFU included being a Muslim (adjusted hazard ratio [aHR] 1.31 [95% confidence interval {CI} 1.05 to 1.65]), having CD4 <250 cells/ml (aHR 1.45 [95% CI 1.21 to 1.76]) and completing adherence counselling (aHR 1.58 [95% CI 1.31 to 1.92]). Having other sources of health care funding and disclosure of one’s disease status were found to be protective (aHR 0.74 [95% CI 0.58 to 0.94] and 0.80 [95% CI 0.65 to 0.98], respectively). Conclusions Some of the determinants of LTFU in the hospital are comparable to those found in other parts of Africa and could be addressed using existing interventions.
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Appiah, Richard, Bempah O. Tutu, Mavis E. Oman, and Peter Ndaa. "Prevalence of positive mental health and functioning among adults with sickle cell disease in Ghana." Ghana Medical Journal 54, no. 4 (December 4, 2020): 245–52. http://dx.doi.org/10.4314/gmj.v54i4.7.
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Objectives: With increasing survival rates of children with sickle cell disease (SCD) reaching adulthood, there has been a growing interest in the quality of life and mental health functioning of affected individuals. Positive mental health is recognised as a significant dimension of human health that plays an important role in advancing well-being. This study explored the prevalence of positive mental health and functioning among a sample of Ghanaian adults with SCD.
Methods: A quantitative cross-sectional survey design was implemented for data-gathering. A random sample of 62 adult SCD patients (21 to 56 years; mean age of 29 years) receiving treatment at the Sickle Cell Clinic of the Ghana Institute of Clinical Genetics at the Korle-Bu Teaching Hospital completed the Mental Health Continuum–Short Form (MHC-SF). Descriptive statistics and reliability indices were estimated for the MHC-SF. We implemented Keyes’s criteria for the assessment and categorisation of levels of mental health to determine the prevalence of positive mental health and functioning.
Results: We found a high level of positive mental health (66% flourishing; 26% moderately mentally healthy; 8% languishing) and functioning, with no significant difference between the genders. A total of 34% of the participants were functioning at suboptimal levels and were at risk of psychopathology.
Conclusion: This study gives the first overview of the prevalence of positive mental health and functioning in a clinical population in Ghana. Although the majority of participants were flourishing, contextually appropriate positive psychological interventions are needed to promote the mental health of SCD patients who are functioning at suboptimal levels, which would, inherently, also buffer against psychopathology.
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Wang, Jing-Yuan, Kai-Ge Zhang, Jing-Xiong Ruan, Wei Chen, and Linchuan Wang. "Shift in HIV/AIDS Epidemic and Factors Associated with False Positives for HIV Testing: A Retrospective Study from 2013 to 2018 in Xi’an, China." Current HIV Research 18, no. 3 (June 12, 2020): 219–26. http://dx.doi.org/10.2174/1570162x18666200415123607.
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Background: In China, although quite a few bold programmes have been made for HIV/AIDS, the epidemic has still shown an increasing trend. Objectives: The study was aimed to investigate the characteristics of new HIV/AIDS and the major factors of false positives (FP) for HIV testing. Methods: A retrospective review was performed in a teaching hospital in Xi’an between 2013 and 2018. The overall characteristics and trends of new HIV/AIDS were described. Moreover, the major factors of FP were determined by the Pareto analysis. Results: A total of 469 new HIV/AIDS were diagnosed, with an increasing prevalence of the new HIV/AIDS from 0.0626% (41/65503) in 2013 to 0.0827% (115/139046) in 2018. Of them, the majority occurred in the males (88.50%), people aged 21-50 years (76.97%), migrants (60.98%), and sexual contact route (88.70%). There was a rapid increase in the annual number of new HIV/AIDS and increasing trends in groups of young individuals, students, and homosexual mode; however, a downward trend in the percentage of injecting drug use was also observed. Over 50 years old and patients from oncology, obstetrics, hepatobiliary surgery, nephrology, cardiology, and infectious disease constituted the major factors of FP. Conclusions: The HIV/AIDS epidemic in Xi’an is still evolving, therefore, effective strategies, appropriate education and scaling up HIV testing should be developed. In addition, old adults and specific departments were associated with FP.
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Adadey, Samuel M., Sylvester Languon, Richmond Ayee, Darius NK Quansah, and Osbourne Quaye. "Incidence and mortality of cancer in the Volta Region of Ghana." Experimental Biology and Medicine 245, no. 12 (June 2020): 1058–65. http://dx.doi.org/10.1177/1535370220931514.
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In Ghana, majority of cancer studies have focused on only two main teaching hospitals. However, there is the need to study the disease burden from other parts of the country. This study was designed to review cancer cases recorded in major hospitals in the Volta Region of Ghana, with the aim of determining the incidence of cancers and cancer-related mortalities, and contribute to cancer data in the country. In-patient diagnosis data from 2012 to 2014 were collected from 21 hospitals in the Volta Region of Ghana. The data were entered and structured in Microsoft Excel and analyzed with IBM SPSS Statistics 20 and GraphPad Prism 6. Cervical, breast, liver, soft tissue, and prostate cancer were identified as the commonly diagnosed cancers in the Region. Socioeconomic factors such as poor educational background and occupation were associated with incidence of cancer in the study area. The incidence of cancer was determined to be approximately 9, 11, and 6 morbidities per 100,000 people in the years 2012, 2013, and 2014, respectively, with liver cancer being the leading cause of deaths. Public awareness and screening efforts are thus needed to fight against cancer in the Volta Region, and Ghana as a whole. In addition, this study is an original report of cancers in the Volta Region of Ghana and underscores the need to report ethnic/population-specific frequencies to effectively evaluate the burden of cancer in the country. Impact statement Region-specific cancer reports are essential in knowing the common cancers in specific populations. This study reports all cancer types recorded in the major hospitals in the Volta Region of Ghana, a population that is sparsely captured in the national cancer registries. The study identified the common cancers as well as the death rates in the Volta Region, hence contributing to the national effort to report cancer data. Although not comprising all the elements of a cancer registry, our data will augment the effort of the two national cancer registries in Ghana to provide the national cancer reports.
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van der Kluit, Maria Johanna, Geke J. Dijkstra, and Sophia E. de Rooij. "Goals of older hospitalised patients: a qualitative descriptive study." BMJ Open 9, no. 8 (August 2019): e029993. http://dx.doi.org/10.1136/bmjopen-2019-029993.
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ObjectivesSince the population continues ageing and the number of patients with multiple chronic diseases is rising in Western countries, a shift is recommended from disease oriented towards goal-oriented healthcare. As little is known about individual goals and preferences of older hospitalised patients, the aim of this study is to elucidate the goals of a diverse group of older hospitalised patients.DesignQualitative descriptive method with open interviews analysed with inductive content analysis.SettingA university teaching hospital and a regional teaching hospital.ParticipantsTwenty-eight hospitalised patients aged 70 years and older.ResultsSome older hospitalised patients initially had difficulties describing concrete goals, but after probing all were able to state more concrete goals. A great diversity of goals were categorised into wanting to know what the matter is, controlling disease, staying alive, improving condition, alleviating complaints, improving daily functioning, improving/maintaining social functioning, resuming work/hobbies and regaining/maintaining autonomy.ConclusionsOlder hospitalised patients have a diversity of goals in different domains. Discussing goals with older patients is not a common practice yet. Timely discussions about goals should be encouraged because individual goals are not self-evident and this discussion can guide decision making, especially in patients with multimorbidity and frailty. Aids can be helpful to facilitate the discussion about goals and evaluate the outcomes of hospitalisation.
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Adzika, V. A., D. Ayim-Aboagye, and T. Gordh. "Pain management strategies for effective coping with Sickle Cell Disease: The perspective of patients in Ghana." Scandinavian Journal of Pain 12, no. 1 (July 1, 2016): 117. http://dx.doi.org/10.1016/j.sjpain.2016.05.005.
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Abstract Aims Prevalence of Sickle Cell Disease (SCD) is high in Ghana but not much is known in terms of research into non-medical strategies for managing and coping with the pain associated with SCD. This study was carried out to examine effective non-medical related strategies patients use to cope and manage their SCD condition. MethodsSCD patients (387) at the Korle-bu Teaching Hospital (Sickle Cell Clinic), consisting of 180 males and 204 females between 18 and 65 years old years participated in the study. A cross-sectional research design was used in which participants completed 9 questionnaires on pain, non-medical coping and management strategies, anxiety, and depression. ResultsOver 90% of participants reported that pains associated with SCD were the main reason for seeking treatment in SCD crisis. In terms of non-medical related coping strategies, attending a place of worship and praying were the main coping strategies used in SCD crises, suggesting that patients’ beliefs, particularly in a supernatural being, served as a mitigating factor in the process of coping with the pain associated with SCD crisis. Also, avoidance and withdrawal from people and social activities were reported to be strategies used to cope with the pain associated with SCD crisis. Results of multiple regression analysis showed that socio-demographic characteristics contributed to the variance in the pain associated with SCD. ConclusionThis study indicates that non-medical strategies, such as religious beliefs and psychosocial actions, are important factors for patients in Ghana for their coping and management of the pains associated with SCD. This knowledge may add to the understanding of the SCD-patients’ situation.
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Winangsih, Rini, and Made Dewi Sariyani. "Gambaran Pengetahuan HIV/AIDS Pada Ibu Rumah Tangga Di Desa Sambirenteng Kecamatan Tejakula Kabupaten Buleleng Tahun 2020." JURNAL MEDIKA USADA 4, no. 1 (February 28, 2021): 34–39. http://dx.doi.org/10.54107/medikausada.v4i1.93.
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Abstract - Human Immunodeficiency Virus Acquired Immunodeficiency Syndrome (HIV / AIDS) is a disease caused by HIV infection. HIV itself is a virus that causes immunodeficiency or immune system disorders in humans. The purpose of this study was to describe the knowledge of housewives about HIV / AIDS in Sambirenteng Village, Tejakula District, Buleleng Regency, Bali. The research methodology used is descriptive method with a cross-sectional design which was implemented in Sambirenteng Village, Tejakula District in August 2020. The sample in this study were housewives who live in Sambirenteng Village, Tejakula District, as many as 95 people and were taken by simple random sampling technique. The instrument in this study used a questionnaire distributed online. Data analysis techniques using univariate analysis. The results of this study included the level of knowledge of housewives about HIV / AIDS in Sambirenteng Village, most of them were in the good category, as many as 91 respondents (95.8%). So, the conclusion in this study is that the method of outreach through social media with unique teaching aids is necessary to make it easier for mothers to understand about HIV / AIDS in depth. Suggestion The description of housewives' knowledge about HIV / AIDS can be used as a reference in further research.
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Mogre, Victor, Robert Abedandi, and Zenabankara S. Salifu. "Correlates and Predictors of Increasing Waist Circumference in Patients with Type 2 Diabetes Mellitus: A Cross-Sectional Study." International Scholarly Research Notices 2014 (September 15, 2014): 1–6. http://dx.doi.org/10.1155/2014/318569.
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Type 2 diabetes mellitus (type 2 DM) has become a disease of public health concern worldwide. Obesity and elevated blood pressure have been shown to be comorbidities of type 2 DM. In this cross-sectional study in Tamale, Ghana, we determined the prevalence of abdominal obesity among type 2 DM patients. Furthermore, we examined the demographic, clinical, and anthropometric predictors of increasing waist circumference in this population. Three hundred type 2 DM patients attending the outpatient diabetes clinic of the Tamale Teaching Hospital, Ghana, were recruited for the study. Waist circumference (WC) and hip circumferences were measured appropriately. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) and fasting plasma glucose (FPG) were taken from the personal health record files of patients. Demographic data were obtained. Pearson correlation and multiple linear regression models were employed to identify predictors of increasing WC. The prevalence of abdominal obesity was 77.0% and was significantly higher in women than in men. A positive correlation was observed between waist-to-hip ratio (WHR) and WC (r=0.56, P<0.001), female gender (r=0.73, P<0.001), and age (r=0.20, P<0.001). A high prevalence of abdominal obesity was observed. Predictors of increasing WC were gender, age, FPG, and WHR.
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Gbadamosi, Hafisatu, Yaw B. Mensah, and Samuel Asiamah. "MRI features in the non-traumatic spinal cord injury patients presenting at the Korle Bu Teaching Hospital, Accra." Ghana Medical Journal 52, no. 3 (December 26, 2018): 127–32. http://dx.doi.org/10.4314/gmj.v52i3.4.
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Background: Neurological limb deficit due to non-traumatic myelopathy is a disabling and distressing neurological condition. In recent time Magnetic Resonance Imaging (MRI) has proven to be the ultimate imaging modality for evaluating pathologies of the spinal cord.Objective: To describe the Magnetic Resonance Imaging (MRI) features of patients with Non-Traumatic Spinal Cord Injury evaluated at the Korle Bu Teaching Hospital.Methods: A descriptive cross-sectional study was carried out at the Korle Bu Teaching Hospital (KBTH), Accra, Ghana. Results: Out of a total of 141 MRI’s evaluated 60.3% were males and 39.7% female. The majority of the respondents 85.1% had paraparesis/paraplegia,13.5% had quadriparesis/quadriplegia, 1.4% had weakness in one upper limb and both lower limbs. The commonest MRI features of NTSCI recorded was due to degenerative disease of the spine 75.9%, spinal metastases 5.7%, Pott's/pyogenic spondylitis 3.5%, demyelinating disease 2.8% and primary spinal tumours 2.8%.Conclusion: The commonest MRI findings in the study population were due to degenerative disease of the spine, followed by spinal metastases and infective spondylitis. Funding: Not declaredKeywords: paraparesis, paraplegia, tetraparesis, tetraplegia, Magnetic Resonance Imaging
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Gulzar, Mudabera. "How effective are planned teaching programmes regarding HIV/AIDS amongst the adolescent girl students? A case study using Ludwig von Bertanlaffy’s general system model." International Journal of Scientific Reports 4, no. 10 (September 29, 2018): 246. http://dx.doi.org/10.18203/issn.2454-2156.intjscirep20184192.
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<p class="abstract"><strong>Background:</strong> In the current times, HIV/AIDS is the most dreadful disease affecting human lives. The worst being that there is no cure or vaccine against it. Given this fact, a pre-experimental study was conducted to evaluate the effectiveness of planned teaching programme (PTP) and to assess the association of selected demographic variables with the pre- and post-test knowledge scores regarding HIV/AIDS among the adolescent girl students in a selected higher secondary school of Srinagar city.</p><p class="abstract"><strong>Methods:</strong> The study is based on Ludwig von Bertanlaffy’s General System model. The sample consists of 50 adolescent girl students who are studying in 9th and 10th classes. This sample was chosen using non-probability (convenience) sampling technique. The tool used for data collection was self-structured questionnaire. </p><p class="abstract"><strong>Results:</strong> The study showed that 10<sup>th</sup> class students’ HIV-related knowledge was more than that of 9<sup>th</sup> class students. Also, students with educated parents have more knowledge of HIV/AIDS. However, there was no significant difference in the HIV knowledge level of rural and urban areas students. The mean post-test knowledge score (39.12) was significantly higher than mean pre-test knowledge score (12.78). Furthermore, an association was found between post-test HIV/AIDS knowledge scores and demographic variables such as educational status of students, habitat, educational and occupational status of parents.</p><p class="abstract"><strong>Conclusions:</strong> The results showed the importance of sex education. It needs to be provided to the adolescents, particularly girls, so that they can safeguard themselves from HIV and other STDs/STIs. Also, awareness programmes should be conducted at all levels targeting whole population groups to decrease its incidence. Lastly, mass media should be involved actively in increasing awareness about HIV/AIDS amongst the public.</p>
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De-Graft Aikins, Ama, and Bernard Akoi-Jackson. "“Colonial Virus”: COVID-19, creative arts and public health communication in Ghana." Ghana Medical Journal 54, no. 4s (December 31, 2020): 86–96. http://dx.doi.org/10.4314/gmj.v54i4s.13.
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Since March 2020, Ghana’s creative arts communities have tracked the complex facets of the COVID-19 pandemic through various art forms. This paper reports a study that analysed selected ‘COVID art forms’ through arts and health and critical health psychology frameworks. Art forms produced between March and July 2020, and available in the public sphere - traditional media, social media and public spaces - were collated. The data consisted of comedy, cartoons, songs, murals and textile designs. Three key functions emerged from analysis: health promotion (comedy, cartoons, songs); disease prevention (masks); and improving the aesthetics of the healthcare environment (murals). Textile designs performed broader socio-cultural functions of memorialising and political advocacy. Similar to earlier HIV/AIDS and Ebola arts interventions in other African countries, these Ghanaian COVID art forms translated public health information on COVID-19 in ways that connected emotionally, created social awareness and improved public understanding. However, some art forms had limitations: for example, songs that edutained using fear-based strategies or promoting conspiracy theories on the origins and treatment of COVID-19, and state-sponsored visual art that representedpublic health messaging decoupled from socio-economic barriers to health protection. These were likely to undermine the public health communication goals of behaviour modification. We outline concrete approaches to incorporate creative arts into COVID-19 public health interventions and post-pandemic health systems strengthening in Ghana.
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Oladele, Rita, Folasade Ogunsola, Alani Akanmu, Katie Stocking, David W Denning, and Nelesh Govender. "Opportunistic fungal infections in persons living with advanced HIV disease in Lagos, Nigeria; a 12-year retrospective study." African Health Sciences 20, no. 4 (December 16, 2020): 1573–81. http://dx.doi.org/10.4314/ahs.v20i4.9.
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Introduction: Nigeria has a large estimated burden of AIDS-related mycoses. We aimed to determine the proportion of pa- tients with AIDS-related opportunistic fungal infections (OFIs) at an urban antiretroviral treatment (ART) centre in Nigeria.
Methods: A retrospective analysis of a cohort of ART-naïve, HIV-infected patients, assessed for ART eligibility and ART- experience at the PEPFAR outpatient clinic at Lagos University Teaching Hospital over a 12-year period (April 2004-Feb- ruary 2016) was conducted.
Results: During this period, 7,034 patients visited the clinic: 4,797 (68.2%) were female; 6161 patients had a recorded base- line CD4 count, and the median CD4 count was 184 cells/µl (IQR, 84-328). A baseline HIV-1 viral load (VL) was recorded for 5,908 patients; the median VL was 51,194 RNA copies/ml (IQR, 2,316-283,508) and 6,179/7046(88%) had initiated ART. Some 2,456 (34.9%) had a documented opportunistic infections, of whom 1,306 (18.6%) had an opportunistic fungal infection. The total number of OFI episodes was 1,632: oral candidiasis (n=1,473, 90.3%), oesophageal candidiasis (n=118; 8%), superficial mycoses (n=23; 1.6%), Pneumocystis pneumonia (PJP) (n=13; 0.8%), and cryptococcal meningitis(CM) (n=5; 0.4%). 113 (1.6%) were known to have died in the cohort.
Conclusion: Approximately 1 in 5 HIV-infected patients in this retrospective cohort, most of whom had initiated ART, were clinically diagnosed with an OFI. Improved access to simple accurate diagnostic tests for CM and PJP should be pri- oritised for this setting.
Keywords: Opportunistic fungal infections; ART Adherence; Advanced HIV disease.
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Osei, Tracy Bonsu, Charles Apprey, Felix Charles Mills-Robertson, and Agartha N. Ohemeng. "Nutritional status of children with sickle cell disease." Nutrition & Food Science 49, no. 2 (March 11, 2019): 232–39. http://dx.doi.org/10.1108/nfs-03-2018-0100.
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PurposeThis study aims to assess the nutritional status of children with sickle cell diseases using anthropometric measurements, biochemical markers and dietary intakes.Design/methodology/approachThe study was conducted in 100 children of 3-12 years of age with sickle cell diseases (SCDs) at the Komfo Anokye Teaching Hospital in the Kumasi Metropolis of Ghana. Weight, height and age of participants were used to calculate body mass index-for-age. The mid-upper-arm-circumference-for-age, weight-for-age (percentiles) and height-for-age (percentiles) were compared with standards growth charts for children. Biochemical measures such as serum albumin and ferritin, as well as full blood count, were assessed. Dietary intake was assessed using 24-h dietary recall and food frequency questionnaire.FindingsFrom the study, 73 and 37 per cent of the children with SCD recorded inadequate intake of iron and vitamin E, respectively, when compared to the recommended daily allowance. Out of the 100 participants, 37 per cent were underweight and 22 per cent were stunted. There was significant difference (p< 0.05) in underweight (weight-for-age) prevalence by gender. A multiple variate regression showed a significant association between zinc (r2= 0.763,p< 0.05) and haemoglobin levels.Originality/valueThe evidence in this paper is relevant for treatment, health education and nutritional counselling of parents with children who have SCD.
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Blazer, Ashira, Ida Dzifa Dey, Janet Nwaukoni, Margaret Reynolds, Festus Ankrah, Huda Algasas, Tasneem Ahmed, and Jasmin Divers. "Apolipoprotein L1 risk genotypes in Ghanaian patients with systemic lupus erythematosus: a prospective cohort study." Lupus Science & Medicine 8, no. 1 (January 2021): e000460. http://dx.doi.org/10.1136/lupus-2020-000460.
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ObjectiveTwo apolipoprotein L1 (APOL1) risk variants (RV) are enriched in sub-Saharan African populations due to conferred resistance to Trypanosoma brucei. These variants associate with adverse renal outcomes by multiple causes including SLE. Despite emerging reports that SLE is common in Ghana, where APOL1 variant allelic frequencies are high, the regional contribution to SLE outcomes has not been described. Accordingly, this prospective longitudinal cohort study tested the associations between APOL1 high-risk genotypes and kidney outcomes, organ damage accrual and death in 100 Ghanaian patients with SLE.MethodsThis was a prospective cohort study of 100 SLE outpatients who sought care at Korle bu Teaching Hospital in Accra, Ghana. Adult patients who met 4 American College of Rheumatology criteria for SLE were genotyped for APOL1 and followed longitudinally for SLE activity as measured by the Safety of Estrogens in Lupus National Assessment-Systemic Lupus Erythematosus Disease Activity Index (SELENA-SLEDAI) hybrid and organ injury as measured by the Systemic Lupus International Collaborating Clinics Damage Index (SDI) at baseline and every 6 months for 1 year. Outcomes of interest were kidney function, SDI and case fatality.ResultsAssuming a recessive inheritance, the APOL1 high-risk genotype (2RV) associated with end-stage renal disease (ESRD) at an OR of 14 (p=0.008). These patients accrued more SDI points particularly in renal and neurological domains. The SDI was 81.3% higher in 2RV patients compared with 0RV or 1RV patients despite no difference in SLE activity (p=0.01). After a 12-month period of observation, 3/12 (25%) of the 2RV patients died compared with 2/88 (2.3%) of the 0RV or 1RV carriers (OR=13.6, p=0.01). Deaths were due to end-stage kidney disease and heart failure.ConclusionAPOL1 RVs were heritable risk factors for morbidity and mortality in this Ghanaian SLE cohort. Despite no appreciable differences in SLE activity, APOL1 high-risk patients exhibited progressive renal disease, organ damage accrual and a 13-fold higher case fatality.
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Asare, Eugenia Vicky Naa Kwarley, Yvonne Adomakoh, Edeghonghon Olayemi, Enoch Mensah, Harriet Ghansah, Yvonnne Osei- Bonsu, Selina Crabbe, et al. "Prospective Implementation of Multi-Disciplinary Obstetric Team Decreases the Mortality Rate of Pregnant Women with Sickle Cell Disease in Ghana." Blood 128, no. 22 (December 2, 2016): 1017. http://dx.doi.org/10.1182/blood.v128.22.1017.1017.
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Abstract Introduction: Pregnant women with sickle cell disease (SCD) are at increased risk for both pregnancy and SCD related morbidity and mortality. At the Korle-Bu Teaching Hospital (KBTH), a national referral center in Accra, Ghana, the estimated maternal mortality ratio of women with and without SCD is 8,300 and 690 per 100,000 live births respectively (US, general population, maternal mortality ratio 14 per 100, 000 live births). In 2015, a multi-disciplinary obstetric SCD team was formed comprising obstetricians, hematologists, pulmonologists and nurses. In a before and after study design, we tested the hypothesis that implementing a multi-disciplinary team for care of pregnant women with SCD would significantly decrease maternal mortality. Methodology: The study received ethical approval from the Ethical and Protocol Review Committee, College of Health Sciences, University of Ghana Institutional Review Board and Vanderbilt University Medical Center (Data Coordinating Center (DCC). The pre-intervention period was from January 2014 to April 2015, and the post intervention period was May 2015 to May 2016. During the intervention period, members of the multi-disciplinary team evaluated participants at enrollment, during outpatient visits and during acute illnesses (inpatient and outpatient). Simple protocols were implemented for preventing and treating Acute Chest Syndrome (ACS). Balloons were purchased (substituted for incentive spirometry devices) and used routinely during management of acute pain episodes and after surgery. Multiple pulse oximetry machines were integrated into routine clinical practice for monitoring of oxygen desaturation. Close maternal and fetal monitoring were implemented. During the pre-intervention period, pregnant women were admitted to multiple wards throughout the hospital. Post-intervention, pregnant women were primarily admitted to two designated wards at the Obstetrics Department, for better coordinated care. All participants in the post-intervention period were followed from enrollment until six weeks postpartum. Members of the clinical research team and DCC adjudicated every vaso-occlusive pain episode, ACS episode, and acute event requiring hospitalization. Pain was defined as an acute episode, unrelated to labor and requiring hospitalization. ACS was defined based on the presence of at least 2 of the following criteria: fever, increased respiratory rate, chest pain, pulmonary auscultatory findings, increased O2 requirement or new radiodensity on chest roentgenogram. Results: A total of 154 and 91 deliveries by women with SCD were evaluated in the pre- and post-intervention period, respectively. The median age for cases in the pre-intervention period was 29 (range 18- 43) years. The median age for cases in post-intervention period was 29 (range 18-41) years and 35 participants had hemoglobin SSand 56had HbSC. Among the 91 participants, rates of pain and ACS were 194.6 (64/32.89) and 42.6 (14/32.89) events per 100 patient-years, respectively. Median gestational age at enrollment was 24 (range 7 - 40) weeks. Median gestational age at delivery was 38 (range 26 - 41) weeks. Perinatal mortality rates pre- and post-intervention were 74.3 per 1000 total births (11/ 148 X 1000) and 54.9 per 1000 total births (5/91 X 1000) respectively. Maternal mortality pre- and post-intervention were 9.7% (15 of 154) and 1.1% (1 of 91) of total deliveries respectively. The maternal mortality ratio pre- and post-intervention were 10,949 (15/137) and 1,163 (1/86) per 100,000 live births respectively. Cause of death pre-intervention period included: cardiopulmonary disease-60.0%, preeclampsia-6.67%, acute kidney injury-6.67%, severe anemia-20.0%, hypovolemic shock-6.67%. During the post-intervention period, the only death was an autopsy confirmed massive pulmonary embolism four days postpartum. Conclusion: In a low and middle income setting, a multidisciplinary team approach to care of pregnant women with SCD can dramatically decrease maternal mortality, as well as perinatal mortality. Further strategies must be employed to decrease the SCD related maternal mortality and perinatal mortality rates to levels expected in the non-SCD population and to implement multi-disciplinary SCD obstetric teams in other regions. Disclosures Asare: Vanderbilt University Medical Center Gift Funds: Research Funding; Intramural University of Ghana Research fund: Research Funding. Adomakoh:Vanderbilt University Medical Center Gift Funds: Research Funding; Intramural University of Ghana Research fund: Research Funding. Olayemi:Intramural University of Ghana Research fund: Research Funding; Vanderbilt University Medical Center Gift Funds: Research Funding. Mensah:Vanderbilt University Medical Center Gift Funds: Research Funding; Intramural University of Ghana Research fund: Research Funding. Ghansah:Vanderbilt University Medical Center Gift Funds: Research Funding; Intramural University of Ghana Research fund: Research Funding. Osei- Bonsu:Vanderbilt University Medical Center Gift Funds: Research Funding; Intramural University of Ghana Research fund: Research Funding. Crabbe:Vanderbilt University Medical Center Gift Funds: Research Funding; Intramural University of Ghana Research fund: Research Funding. Musah:Vanderbilt University Medical Center Gift Funds: Research Funding; Intramural University of Ghana Research fund: Research Funding. Hayfron- Benjamin:Vanderbilt University Medical Center Gift Funds: Research Funding; Intramural University of Ghana Research fund: Research Funding. Boafor:Vanderbilt University Medical Center Gift Funds: Research Funding; Intramural University of Ghana Research fund: Research Funding. Kassim:Vanderbilt University Medical Center Gift Funds: Research Funding; Intramural University of Ghana Research fund: Research Funding. James:Vanderbilt University Medical Center Gift Funds: Research Funding; Intramural University of Ghana Research Fund: Research Funding. Oppong:Vanderbilt University Medical Center Gift Funds: Research Funding; Intramural University of Ghana Research fund: Research Funding.
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Mobula, Linda Meta, Stephen Sarfo, Lynda Arthur, Gilbert Burnham, Jacob Plange-Rhule, Daniel Ansong, Edith Gavor, and David Ofori-Adjei. "A multi-center prospective cohort study to evaluate the effect of differential pricing and health systems strengthening on access to medicines and management of hypertension and diabetes in Ghana: A study protocol." Gates Open Research 2 (February 7, 2018): 6. http://dx.doi.org/10.12688/gatesopenres.12797.1.
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Background: There is evidence to suggest that the prevalence of non-communicable diseases (NCDs), in particular cardiovascular diseases and diabetes, are being recognized as forming a substantial proportion of the burden of disease among populations in Low- and Middle-Income Countries (LMICs). Access to treatment is likely a key barrier to the control and prevention of NCD outcomes. Differential pricing, an approach used to price drugs based on the purchasing power of patients in different socioeconomic segments, has been shown to be beneficial and leads to improved access and affordability. Methods: This is a quasi-experimental study, with a pragmatic trial design, to be conducted over the course of three years. A mixed methods design will be used to evaluate the effects of health systems strengthening and differential pricing on the management of diabetes, hypertension and selected cancers in Ghana. A public private partnership was established between all sites that will receive multi-level interventions, including health systems strengthening and access to medicines interventions. Study populations and sites: Study participants will include individuals with new or recently diagnosed hypertension and diabetes (n=3,300), who present to two major referral hospitals, Komfo Anokye Teaching Hospital and Tamale Teaching Hospital, as well as three district hospitals, namely Kings Medical Centre, Agogo Presbyterian District Hospital, and Atua Government Hospital. Discussion: The objective of this study aims to test approaches intended to improve access to drugs for the treatment of hypertension and diabetes, and improve disease control. Patients with these conditions will benefit from health systems strengthening interventions (education, counseling, improved management of disease), and increased access to innovative medicines via differential pricing. Pilot programs also will facilitate health system strengthening at the participating institutions, which includes training of clinicians and updating of guidelines and production of protocols for the treatment of diabetes, hypertension and cancer.
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Mobula, Linda Meta, Stephen Sarfo, Lynda Arthur, Gilbert Burnham, Jacob Plange-Rhule, Daniel Ansong, Edith Gavor, and David Ofori-Adjei. "A multi-center prospective cohort study to evaluate the effect of differential pricing and health systems strengthening on access to medicines and management of hypertension and diabetes in Ghana: A study protocol." Gates Open Research 2 (May 3, 2018): 6. http://dx.doi.org/10.12688/gatesopenres.12797.2.
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Background: There is evidence to suggest that the prevalence of non-communicable diseases (NCDs), in particular cardiovascular diseases and diabetes, are being recognized as forming a substantial proportion of the burden of disease among populations in Low- and Middle-Income Countries (LMICs). Access to treatment is likely a key barrier to the control and prevention of NCD outcomes. Differential pricing, an approach used to price drugs based on the purchasing power of patients in different socioeconomic segments, has been shown to be beneficial and leads to improved access and affordability. Methods: This is a quasi-experimental study, with a pragmatic trial design, to be conducted over the course of three years. A mixed methods design will be used to evaluate the effects of health systems strengthening and differential pricing on the management of diabetes, hypertension and selected cancers in Ghana. A public private partnership was established between all sites that will receive multi-level interventions, including health systems strengthening and access to medicines interventions. Study populations and sites: Study participants will include individuals with new or previously diagnosed hypertension and diabetes (n=3,300), who present to two major referral hospitals, Komfo Anokye Teaching Hospital and Tamale Teaching Hospital, as well as three district hospitals, namely Kings Medical Centre, Agogo Presbyterian District Hospital, and Atua Government Hospital. Discussion: The objective of this study aims to test approaches intended to improve access to drugs for the treatment of hypertension and diabetes, and improve disease control. Patients with these conditions will benefit from health systems strengthening interventions (education, counseling, improved management of disease), and increased access to innovative medicines via differential pricing. Pilot programs also will facilitate health system strengthening at the participating institutions, which includes training of clinicians and updating of guidelines and production of protocols for the treatment of diabetes, hypertension and cancer.
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Kumar, Aswin, and G. K. Ratnaprabha. "Awareness about HIV and post exposure prophylaxis among students of a nursing college from central Karnataka: a cross sectional study." International Journal Of Community Medicine And Public Health 6, no. 1 (December 24, 2018): 303. http://dx.doi.org/10.18203/2394-6040.ijcmph20185263.
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Background: Nursing students are the integral part of health care delivery system in future prospects. The accidental transmission of HIV infection to health care workers is a real threat in present situation. Adequate knowledge about the disease and post exposure prophylaxis will help to provide care to patients and prevent infection at health care settings. The objectives of the study was to assess the knowledge of nursing students about HIV / AIDS and post exposure prophylaxis (PEP) and association of knowledge level with the different courses of nursing.Methods: Cross sectional study was carried out among final year GNM and BSc nursing students of a nursing college in central Karnataka during December 2017, Data regarding knowledge about HIV infection and PEP was collected using self administered semi structured questionnaire.Results: Total of 108 nursing students took part in the study. BSc nursing students contributed 66.7% of the study subjects. Mean HIV/AIDS knowledge score was 7.86±2.25. Subjects studying BSc nursing had better knowledge when compared to GNM subjects. Seventy two (66.67%) students had heard about post exposure prophylaxis. Majority were unaware about time of initiation (94.6%) and duration of PEP (86.1%).Conclusions: Knowledge about HIV/AIDS and PEP are inadequate among nursing students. It is recommended to incorporate practical issues effectively in their teaching curriculum.
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Gupta, Suresh C., Karan J. Jain, Anjana Tiwari, Indu Padmey, Nandkishor J. Bankar, and Md Naushad Alam. "Knowledge and attitude regarding HIV/AIDS among patients attending medicine outpatient department in C. C. M. Medical College and Hospital, Durg." International Journal Of Community Medicine And Public Health 6, no. 12 (November 27, 2019): 5095. http://dx.doi.org/10.18203/2394-6040.ijcmph20195450.
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Background: Acquired immunodeficiency syndrome (AIDS) is one of the deadliest diseases that modern medicine has ever had to tackle. Understanding the knowledge about HIV/AIDS in general populations will help in formulating strategy for prevention and treatment. With this background, this study was conducted to assess the knowledge and awareness about HIV/AIDS among general population.Methods: A cross sectional study was conducted at C.C.M. Medical College and Hospital, Durg during December 2018 to January 2019. The data was collected from 450 patients attending the medicine outpatient department. Study subjects were selected using convenient sampling technique. Patients giving consent and willing to participate were included in the study. The data was collected in predesigned and pretested questionnaire.Results: 77.11% study participants were aware that unprotected sex can lead to transmission of HIV, 73.78% knew that shaking hands will not transmit the disease. 79.8% knew that use of condom can prevent transmission of HIV/AIDS. Overall males had better knowledge than females. 76.85% said they would behave friendly with people having HIV/AIDS and 69.78% were willing to take care of relatives with HIV.Conclusions: This study indicates that majority participants have good knowledge about difference between HIV and AIDS, modes of transmission and prevention though they were not completely aware of it. The proportion of those with lack of correct knowledge though comparatively less, needs to be taken as a challenge and addressed through well planned health educational activities at various platforms including teaching hospital premises.
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Wibisono, Yusuf, Indropo Agusni, Afif Nurul Hidayati, Rahmadewi Rahmadewi, Maylita Sari, Astindari Astindari, Septiana Septiana, and Dwi Murtiastutik. "Cutaneous Adverse Drug Reactions in Hospitalized HIV/AIDS Patients." Berkala Ilmu Kesehatan Kulit dan Kelamin 33, no. 2 (July 31, 2021): 96. http://dx.doi.org/10.20473/bikk.v33.2.2021.96-102.
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Background: Cutaneous adverse drug reaction (CADR) is the most common manifestation of drug hypersensitivity in humanimmunodeficiency virus (HIV), which presented as maculopapular rash. The incidence of CADR is found to be more commonin untreated HIV patients, and the frequency is higher in severe immunodeficiency status. Early diagnosis and appropriatetreatment give better outcomes. Purpose: To evaluate the incidence and management of CADR in HIV and acquired immunedeficiency syndrome (AIDS) patients. Methods: A retrospective descriptive study of HIV/AIDS patients with CADR whowere hospitalized at Intermediate Care and Infectious Disease Centre Dr. Soetomo General Academic Hospital. Result: Therewere more CADR cases in 2017, accounted 2.35% of the total Intermediate Care and Infectious Disease Centre RSUD Dr.Soetomo General Academic Teaching Hospital ward patients. There were more male patients (62.5%), with the mostcommonly found at the age of 25-44 years (64.3%), and which mostly (89.3%) originated from Surabaya. The most commondiagnosis was morbiliform eruption (60.7%), main complaint was red spots all over the body (45%), all of which are obscureerythematous macules. The most common causes were Duviral + Neviral antiretroviral (46%) and the most common treatmentwas dexamethasone injection. Conclusion: The incidence of CADR increased in 2017. The most frequent manifestation wasmorbilliform eruption due to Duviral+Neviral as the first line ARV treatment. Skin management varies widely in form oftopical, oral, and intravenous injection drugs, mostly using steroid class, dexamethasone intravenous injection in particular.
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Afaa, Taiba Jibril, Kokou Hefoume Amegan-Aho, Matilda Tierenye Dono, Eric Odei, and Yaw Asante Awuku. "Clinical characteristics of paediatric autoimmune hepatitis at a referral hospital in Sub Saharan Africa." PLOS ONE 15, no. 12 (December 23, 2020): e0239964. http://dx.doi.org/10.1371/journal.pone.0239964.
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Background Autoimmune hepatitis (AIH) is a progressive inflammatory liver disease of unknown aetiology. The number of reported AIH cases is increasing in the developed countries but the same cannot be said about sub Saharan Africa (SSA). Paediatric AIH diagnosis is usually missed and patients present with decompensated liver disease. Our study highlights the clinical profile of paediatric AIH cases at a referral hospital in Ghana. Methods This is a retrospective review of all cases of children diagnosed with autoimmune hepatitis at the gastroenterology clinic in Korle Bu Teaching Hospital, Accra, Ghana. Data was extracted from the patients’ records from April 2016 to October 2019. These children were diagnosed based on the presence of autoantibodies, elevated immunoglobulin G and histologic presence of interphase hepatitis with the exclusion of hepatitis A, B, C and E depending on their clinical presentation, Wilson’s disease, HIV, Schistosomiasis and sickle cell disease. Results Thirteen patients aged between 5 years to 13 years with a mean age of 10 years were diagnosed with AIH. All the patients had type 1 AIH with majority 8 (61.5%) being females. Most of the children presented with advanced liver disease with complications. Three patients had other associated autoimmune diseases. The patients were treated with prednisolone with or without azathioprine depending on the severity of the liver disease. Conclusion Majority of paediatric AIH presents with advanced liver disease. There is the need for early detection to change the natural history of AIH in SSA.
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Obasanjo, Olugbenga O., Peggy Wu, Martha Conlon, Lynne V. Karanfil, Patty Pryor, Geraldine Moler, Grant Anhalt, Richard E. Chaisson, and Trish M. Perl. "An Outbreak of Scabies in a Teaching Hospital Lessons Learned." Infection Control & Hospital Epidemiology 22, no. 1 (January 2001): 13–18. http://dx.doi.org/10.1086/501818.
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AbstractObjective:To investigate an outbreak of scabies in an inner-city teaching hospital, identify pathways of transmission, institute effective control measures to end the outbreak, and prevent future occurrences.Design:Outbreak investigation, case-control study, and chart review.Setting:Large tertiary acute-care hospital.Results:A patient with unrecognized Norwegian (crusted) scabies was admitted to the acquired immunodeficiency syndrome (AIDS) service of a 940-bed acute-care hospital. Over 4 months, 773 healthcare workers (HCWs) and 204 patients were exposed to scabies. Of the exposed HCWs, 147 (19%) worked on the AIDS service. Risk factors for being infested with scabies among HCWs included working on the AIDS service (odds ratio [OR], 5.3; 95% confidence interval [CI95], 2.17-13.15) and being a nurse, physical therapist, or HCW with extensive physical contact with infected patients (OR, 4.5; CI95, 1.26-17.45). Aggressive infection control precautions beyond Centers for Disease Control and Prevention barrier and isolation recommendations were instituted, including the following: (1) early identification of infected patients; (2) prophylactic treatment with topical applications for all exposed HCWs; (3) use of two treatments 1 week apart for all cases of Norwegian scabies; (4) maintaining isolation for 8 days and barrier precautions for 24 hours after completing second treatment for a diagnosis of Norwegian scabies; and (5) oral ivermectin for treatment of patients who failed conventional therapy.Conclusions:HCWs with the most patient contact are at highest risk of acquiring scabies. Because HCWs who used traditionally accepted barriers while caring for patients with Norwegian scabies continued to develop scabies, we found additional measures were required in the acute-care hospital. HCWs with skin exposure to patients with scabies should receive prophylactic treatment. We recommend (1) using heightened barrier precautions for care of patients with scabies and (2) extending the isolation period for 8 days or 24 hours after the second treatment with a scabicide for those patients with Norwegian scabies. Oral ivermectin was well tolerated for treating patients and HCWs who failed conventional treatment. Finally, we developed a surveillance system that provides a “barometric measure” of the infection rate in the community. If scabies increases in the community, a tiered triage system is activated to protect against transmission among HCWs or hospital patients.