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Predictors of hypertension among diabetic patients in the Ejisu municipality of Ghana [version 1; peer review: awaiting peer review]
(F1000Research, 2024) Brenyah, Florence; Apprey, Charles; Agbenorhevi, Jacob K.; Mills-Robertson, Felix C.; 0000-0002-4071-5049
Introduction The co-existence of hypertension with diabetes mellitus among diabetic patients is a setback to public health. About 40-75% of diabetic patients present with hypertension. The co-existence of hypertension and diabetes can accelerate complications such as stroke, myocardial infarction, nephropathy, and mortality. Available data indicate the devastating effects of hypertension and diabetes on individuals, families, and the economy as catastrophic. Therefore, knowing the predictors of hypertension among diabetic patients would inform the lifestyle and management of the two conditions. Objective The study focused on predictors of hypertension among diabetic patients in the Ejisu Municipality of Ghana. Methods The study employed a quantitative approach with a sample size of 120. Data were collected on sociodemographic characteristics, family history, 24-hour dietary recall, blood pressure, fasting blood glucose, glycated haemoglobin, total lipid profile, and anthropometrics. Data were analyzed using SPSS version 27. Results Out of 120 respondents, 85% were females with 77.5% above 50 years of age. A majority (66.7%) had a family history of diabetes with 76.7% having hypertension as a comorbidity. Fasting blood glucose was found to be 8.519 times more likely to present with hypertension. Systolic blood pressure, carbohydrate, and sodium intakes were 6.1%, 2.9%, and 0.1% respectively. However, diabetic patients with high HbA1c were 97% less likely not to present with hypertension. Conclusion Hypertension was found to be the most common comorbidity among diabetic patients in Ghana. Glycaemic control, systolic blood pressure, and dietary factors specifically carbohydrate and sodium intake were significant predictors of hypertension among the study participants.
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Dietary diversity and nutrient adequacy among women in Bosomtwe District, Ghana
(Maternal & Child Nutrition, 2024) Apprey, Charles; Addae, Hammond Yaw; Boateng, Grace; Aduku, Linda Esi; Annan, Reginald A.; 0000-0002-4071-5049
The sustainable development goals seek to end all forms of malnutrition of women of reproductive age (WRA) by 2030. As such, recent data on nutrient adequacy are needed to aid in tracking progress. However, data on specific dietary nutrient intakes includes only iron, folate, vitamin A, and vitamin B12 in Ghana. Therefore, women's dietary diversity score (W‐DDS) is often used as a proxy measure of nutrient adequacy. It is hypothesised that there is no association between W‐DDS and Nutrient Adequacy among WRA in peri‐urban Ghana. Hence, this research evaluated the associations between W‐DDS and nutrient adequacy ratio (NAR) and assessed the determinants of mean nutrient adequacy ratio (MAR) in the Bosomtwe District of Ghana. A community‐based cross‐sectional study was conducted, and data collected on anthropometry, food insecurity, socio‐demographic characteristics and dietary intake using the 24‐hour recall from 407 WRA. In all, 21 nutrients were assessed. The mean age, W‐DDS, and MAR were 29.0 ± 6.7 years, 5.3 ± 1.9, and 0.65 ± 0.19 respectively. The NAR were generally high for the macronutrients as compared to micronutrients and the nutrients with low NAR included vitamin C (0.27 ± 0.19), vitamin A (0.15 ± 0.23), vitamin B12 (0.54 ± 0.32), calcium (0.28 ± 0.20), zinc (0.52 ± 0.23) and iron (0.57 ± 0.28) ‐ signifying the WRA may be consuming monotonous carbohydrate‐based diet. The hierarchical multivariable linear regression found a significant association between W‐DDS and MAR after controlling for confounders (β = 0.404, p < 0.001). The determinants of MAR were ethnicity (β = 0.110, p = 0.006) and body mass index (β = 0.189, p < 0.001). This study supports the use of W‐DDS as a proxy indicator of nutrient adequacy. Strategies meant to address nutrient inadequacies should be adaptable to different ethnic groups and overweight‐reducing strategies should be incorporated into broader nutrition initiatives.
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Anemia Predicts Physical Fitness Among Adolescent Athletes in Ghana
(Health Science Reports, 2024) Eli‐Cophie, Divine; Apprey, Charles; Annan, Reginald A.; 0000-0002-4071-5049
Background: Anemia indicates low blood hemoglobin levels and has become a public health problem among adolescents in developing countries. The prevalence among adolescent athletes and its effect on physical fitness has not been studied in Ghana. The study aimed to assess the impact of anemia on physical fitness among adolescent athletes in Ghana. Methodology: The sample of 194 adolescent athletes was randomly recruited from competitive athletic groups, boxing, and football clubs in Greater Accra, Ashanti, and Volta regions of Ghana. Anthropometric parameters and Hemoglobin concentration were measured. Physical fitness was assessed using, right and left‐hand grip strength, reaction time, flexibility, and the Cooper‐12‐min run test, all following standard procedure. Results: The adolescent athletes of mean age (15.8 ± 2.5 yrs) and weight (54.0 ± 12.8 kg) were mostly of normal weight‐for‐age and height. The overall prevalence of anemia among the adolescent athletes was 14.3%. Anemia was however, more common among early adolescents (20.7%). The average hemoglobin level was lowest among the early adolescents (12.8 ± 1.1 g/dl), however, there was no association between anemia and the adolescent age group (X2 = 2.112 p = 0.348). Although the proportions of anemic males and females were similar (14.3%), the mean hemoglobin levels were significantly higher among males (13.6 ± 1.5 g/dl) than females (12.5 ± 1.2 g/dl). There was an association between hemoglobin and cardiorespiratory endurance (r = 0.324, p = 0.005), hand grip strength as well as relative handgrip strength (r = 0.379, p = 0.001). Hemoglobin significantly predicted 10.5% of the variation in cardiorespiratory endurance (R2 = 0.105, b = 0.623, p = 0.005) of the athletes. Conclusion: Hemoglobin levels could predict the cardiorespiratory endurance and muscular strength of adolescent athletes. Anemia is a public health problem among adolescent athletes and must be given the needed attention to make these athletes competitive and win laurels.
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Exclusive breastfeeding: an exploratory thematic analysis of the perspectives of breastfeeding mothers and significant others in the Tamale metropolis of Northern Ghana
(BMC Nutrition, 2024) Tahiru, Rafiatu; Amoako, Mary; Apprey, Charles; 0000-0002-4071-5049
Introduction: Exclusive breastfeeding is widely recognized as the optimal way to feed infants due to its numerous health benefits for both the child and the mother. Despite its advantages, Ghana is still far from attaining World Health Organization (WHO) recommended rates. This study is aimed at exploring the knowledge attitude and practices, where the practices hinged on facilitators, barriers, and sociocultural perspectives of breastfeeding mothers and significant others on exclusive breastfeeding. Methods: This study employed an ethnographic thematic analysis framed by the socioecological model (SEM). Thematic analysis was paired with focus group discussions (FGDs). The study participants were recruited purposively by employing a snowball sampling technique with the assistance of community health volunteers. Three (3) FGDs were formed, with 10 participants in each group, to gather perspectives from breastfeeding mothers and significant others (partners and grandmothers) in three communities with Community-based Health Planning and Services (CHPS) compounds within the Tamale metropolis. With an interview guide, all FGDs were audio-taped, transcribed verbatim, and translated from local dialects to English. The emerging themes were used in writing a narrative account, guided by the principles of thematic analysis. Results This study identified three thematic areas: knowledge of exclusive breastfeeding (EBF); attitudes toward EBF and practices of EBF (facilitators, barriers, and sociocultural practices). There was some knowledge disparity among lactating mothers despite the overall high knowledge and subpar attitudes of some mothers. The practice of exclusive breastfeeding was substandard. The major hindrances identified were cultural barriers propagated by partners/husbands and grandmothers; the belief that the weather here does not support EBF; and the need for spiritual herbs in infancy. Supportive healthcare providers helped increase the practice of exclusive breastfeeding. Some support also came from partners and husbands, and some mothers showed unique positive behaviors by exclusively breastfeeding. Conclusion::This study revealed that while exclusive breastfeeding education has been ongoing for decades, sociocultural norms still influence mothers to deviate from WHO recommendations. Public education is recommended to dispel misconceptions surrounding exclusive breastfeeding, develop a food galactagogue to help with breastmilk volumes and create a supportive environment that empowers mothers and families to make informed choices that optimize the health and well-being of both infants and mothers.
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Food acquisition and consumption by NOVAfood classification and lived poverty index among rural and urban households in SouthAfrica and Ghana
(Public Health Nutrition, 2024) Agyapong, Nana Ama Frimpomaa; Annan, Reginald A.; , Kroll, Florian; Apprey, Charles; Aduku, Linda Nana Esi; Aidoo, Robert; Swart, Elizabeth Catherina; 0000-0002-4071-5049
Objective: This study aimed to determine differences in food consumption by the NOVA food categories in South Africa and Ghana and how they relate to poverty and food supply systems. Design: This study used a cross-sectional design to assess household food acquisition and lived poverty index. Setting: The study was conducted in Khayelitsha and Mount Frere, urban and rural communities in South Africa, respectively, and Ahodwo and Ejuratia, urban and rural communities in Ghana, respectively. Participant: An adult in charge of or knowledgeable about household food acquisition and consumption was selected to participate in the study. Results: A total of 1299 households participated in the study. Supermarkets were a prominent source of ultra-processed foods for households in South Africa, while informal outlets were an important source of ultra-processed foods in Ghana. Consumption of unprocessed foods was higher among South African households (58·2 %) than Ghanaian households (41·8 %). In South Africa, deprivation was associated with increased odds of infrequent consumption of both unprocessed foods (OR 3·431 P < 0·001) and ultra-processed foods (OR 2·656 P <0·001) compared with non-deprivation. In Ghana, no significant differences were observed between deprived households and non-deprived households in relation to the consumption of the NOVA food classes. Conclusion: Different food supply systems and poverty are associated with household acquisition of the different NOVA food classes. Policies should be geared towards formal shops in South Africa and informal shops in Ghana to reduce the consumption of key obesogenic foods.
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Dietary diversity and opportunistic infections among adults living with human immunodeficiency virus on antiretroviral therapy in Kumasi metropolis; a facility-based cross-sectional study
(BMC Infectious Diseases, 2025) Apprey, Charles; Addae, Hammond Yaw; Osei, Monica; Danquah, Irene; Annan, Reginald A.; 0000-0002-4071-5049
Background: Despite advances in antiretroviral therapy (ART), people living with human immunodeficiency virus (HIV)/ acquired immunodeficiency syndrome (AIDS) continue to face heightened susceptibility to opportunistic infections (OIs). Adequate nutrition remains an essential factor that positively influences disease progression and the occurrence of OIs. In Ghana, no study has evaluated the association between dietary diversity and OI occurrence among adults with HIV. This study aimed to evaluate the association between dietary diversity and the presence of OIs among HIV-positive adults receiving ART. Methods: A facility-based cross-sectional study was conducted among 291 HIV-positive adults receiving ART from February 2023 to April 2023 at Kumasi South Hospital, Ghana. The study participants were selected using a convenient sampling method. A pre-tested questionnaire and review of electronic health records were used to collect sociodemographic, nutritional and clinical data. Binary logistic regression analyses were conducted to identify variables significantly associated with the study outcome and hierarchical multivariable logistic regression was used to evaluate the association between dietary diversity and the occurrence of OIs while controlling for confounders at p-value<0.05. Results: The mean age and dietary diversity were 46.2±10.9 years and 4.0 (IQR: 3.0 to 6.0) food groups, respectively. Out of 291 respondents, 152 (52.2%) had inadequate dietary diversity and 39 (13.4%) had at least one OI. The respondents with inadequate dietary diversity were three times more likely to have an OI than their peers with adequate dietary diversity [AOR 3.03, (95% CI: 1.20 to 7.64), p=0.019]. Conclusion This study revealed that inadequate dietary diversity is a significant nutritional problem and dietary diversity was associated with the presence of OIs among PLWHA on ART at the study site. Hence, there is the need to enhance the intake of diversified diets based on locally available foods. This could decrease the occurrence of OIs and eventually reduce HIV-related morbidity/mortality.
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Assessing the performance of equity mutual funds: A case study of some selected funds in Ghana.
(KNUST, 2016-10) POKU, ABENA BOATEMAA
Mutual funds are investment vehicles made up of a pool of funds collected from many investors for the purpose of investing in securities such as stocks, bonds and money market instruments. Equity mutual funds refer to financial service providers that pool investor monies and invest them in domestic and international equity and fixedincome securities. However, equity mutual funds are not allowed to be invested directly in real (tangible) assets thus; real estates, antiquities, commodities. The research measured how the equity mutual funds in Ghana have relatively performed against the Ghana Stock Exchange. Accordingly, the study sought to measure the following objectives; to find out whether the funds outperformed the Ghana Stock Exchange Index within the study period, to establish the impact of fund manager skills on equity mutual funds performance and finally to find out whether investment in mutual fund is better off than investment in a risk free rate fund. All the forty-six mutual funds operating in Ghana including the Government of Ghana 90-days T-bills returns (which acted as the risk free investment option) and finally the Ghana Stock Exchange return (as the benchmark investment index) constituted the study population. The study employed purposive sampling technique hence the study sample came from Databank Epack investment, SAS Fund and HFC Equity trust fund since they had a complete dataset for the whole eight-year period of the study time interval. It became evident that the mean return for all the three funds ranges from 2.30 to 7.49.The study found out that out of the three funds, HFC Equity trust outperformed both the Ghana Stock Exchange and the interest free rate investment options by a margin of 7.2 and 5.9 respectively. Also the study found out that the other two funds thus Databank Epack investment and SAS Fund performances all fell below the GSE market index and the T-bill rate average annual returns.