College of Health Sciences

Permanent URI for this collection

https://ir.knust.edu.gh/handle/123456789/14

Browse

Now showing 1 - 20 of 680

Abortion in Bosomtwe District, Ashanti, Ghana: a Case Control Study at St. Michael’s Hospital, Jachie – Pramso
(2009-07-12) Momo Lokko, Christiana Naa
Strategies for preventing unsafe abortion have been unyielding as a result of which many women die and develop complications from unsafe abortion including those resulting in induced abortion ending up as incomplete abortion. There is increase in incidence of death due to abortion at Bosomtwe district. This study was an un-matched case-control study with the objective of assessing the specific differences in the socio-demographic, economic and reproductive health characteristic of incomplete abortion clients (cases) and normal delivery clients (controls) attending St. Michael’s Hospital, Bosomtwe district. A comparative analysis of 61 cases and 129 controls revealed that, there is no significant difference in their age (p=0.61), marital status (p=0.11), educational level (p=0.63) and their religious background (p=0.61). There was also no difference in their occupation (p=0.52), income earned (p=0.96) and partners employment status (p=0.40). There was a statistical difference in the reproductive history between the groups in terms of the number of children (p=0.000), age of last child (p=0.000), and number pregnancies lost (p=0.000). Cases were 12.7 times more likely to have had abortion; 19.0 times more likely to have attempted to stop the index pregnancy; and 6 times more likely to have self induced the index pregnancy as a means of termination as compared to controls. It is recommended that stakeholders, especially the district health directorate should use specific predictors for incomplete abortion among women to educate and encourage them to live a healthy reproductive life.
Acceptance of HIV Counselling & Testing Among Pregnant Women in the Kumasi Metropolis
(2008-07-13) Sakyi, Kwofie Gabriel
In Ghana, as in most parts of Africa, south of the Sahara, HIV/AIDS account for a lot of mortality and morbidity in children. Children born to infected mothers acquire infection and progress to clinical diseases. This mother-to-child-Transmission (MTCT), accounts for most of the cases in children less than 15 years. To help address this problem, the Ghana National Policy on HIV/AIDS and STIs has come out with strategies that include the use of routine Counseling and Testing (CT) as a tool for the prevention of MTCT (PMTCT). The main objective of this study was to determine the level of acceptance of this routine HIV CT, as well as factors associated with acceptance among pregnant women in Kumasi Metropolis. The study was a descriptive cross-sectional type, with structured questionnaire as the data collection tool served on 200 pregnant women attending Antenatal Clinic (ANC) in the Kumasi Metropolis. The sampling frame was pregnant women attending ANC at the three hospitals in the metropolis. The 200 ANC attendants were selected by a systematic random sampling technique. Findings include a high level of acceptance, with 87.5% of respondents accepting to undergo HIV testing either before or after counseling. The effects of socio-demographic characteristics on acceptance of HIV CT were not statistically significant. The knowledge level of pregnant women on HIV/AIDS and Prevention of mother to Child transmission (PMTCT) significantly affected HIV CT acceptance (p = 0.000): Those with adequate knowledge levels were twenty four times more likely to accept HIV CT than those with inadequate knowledge levels. Seeking Spousal permission did not significantly affect acceptance (p= 0.86). However, spousal involvement significantly encouraged HIV CT (p = 0.04) Given the high, level of acceptance which is consistent with high acceptance levels in some African studies, the existing strategy of routine HIV CT, as a tool for PMTCT of HIV, should be sustained, and if possible improved upon.
Acceptance of HIV Counselling and Testing Among Pregnant Women in the Kumasi Metropolis
(2008) Kwofie, Gabriel Sakyi (Dr.)
In Ghana, as in most parts of Africa, south of the Sahara, HIV/AIDS account for a lot of mortality and morbidity in children. Children born to infected mothers acquire infection and progress to clinical diseases. This mother-to-child-Transmission (MTCT), accounts for most of the cases in children less than 15 years. To help address this problem, the Ghana National Policy on HIV/AIDS and STIs has come out with strategies that include the use of routine Counseling and Testing (CT) as a tool for the prevention of MTCT (PMTCT). The main objective of this study was to determine the level of acceptance of this routine HIV CT, as well as factors associated with acceptance among pregnant women in Kumasi Metropolis. The study was a descriptive cross-sectional type, with structured questionnaire as the data collection tool served on 200 pregnant women attending Antenatal Clinic (ANC) in the Kumasi Metropolis. The sampling frame was pregnant women attending ANC at the three hospitals in the metropolis. The 200 ANC attendants were selected by a systematic random sampling technique. Findings include a high level of acceptance, with 87.5% of respondents accepting to undergo HIV testing either before or after counseling. The effects of socio-demographic characteristics on acceptance of HIV CT were not statistically significant. The knowledge level of pregnant women on HIV/AIDS and Prevention of mother to Child transmission (PMTCT) significantly affected HIV CT acceptance (p = 0.000): Those with adequate knowledge levels were twenty four times more likely to accept HIV CT than those with inadequate knowledge levels. Seeking Spousal permission did not significantly affect acceptance (p= 0.86). However, spousal involvement significantly encouraged HIV CT (p = 0.04) Given the high, level of acceptance which is consistent with high acceptance levels in some African studies, the existing strategy of routine HIV CT, as a tool for PMTCT of HIV, should be sustained, and if possible improved upon.
Access and coverage of healthcare among health staff in the Sunyani Municipality: Implications for the realization of universal health coverage
(NOVEMER, 2019) Abu, Juliet;
Universal Health Coverage seeks to ensure that everybody has access to quality healthcare without financial challenges. It is one of the global strategies towards the realization of the Sustainable Development Goals. Countries therefore need to track progress of universal health coverage not just across the national population but within different groups (e.g. by occupation, income level, sex, age, place of residence, migrant status and ethnic origin). The role of health workers in the realization of the universal health coverage cannot be overemphasized. Health workers are vulnerable to varying risks inherent in their profession, as they are exposed to infections, injuries, stress, violence, allergies, contact diseases and many others). There is a dearth of knowledge on access and coverage of healthcare among health staff who are the forefront of the effort at the realization of universal health coverage. It is this regard that access and coverage of health care among health Workers was investigated. The main objective of the study was to assess the access and coverage of healthcare among health Workers in the Sunyani Municipal. An analytic study type using a cross-sectional design was carried out in the Sunyani municipal. Data was collected using self-administered questionnaires, structured interview guide and subjected to univariate, bivariate and multivariate regression analysis. The study found that 52% of health staff had a degree,66% of health staff had worked for a period less than 5years, 57.1% monthly income was 1,500 Ghana cedis and above and 90% had a valid National Health Insurance Scheme card. Out of the four access and coverage areas the Occupational Health and Safety policy addresses, 71.5% of health staff were assisted during referral, 63.5% supported to access specialist care while 54.1% of health staff did not benefit from the health staffvi screening and 55.6% did not benefit from free Hepatitis B vaccination due to financial challenges as alluded to by Health Managers. Physical access and availability to healthcare by Health staff was highly encouraging as 95.9% of health staff had healthcare always available to them when needed and 83.2% of health staff usually visited the hospital, health centre or community Health Planning and Service Compound when ill. In terms of access to healthcare there was a significant association between income (p=0.017) and possession of valid National Health Insurance Scheme card (p=0.006). Coverage wise, 62% of health staff were moderately satisfied with their volume of healthcare needed and there was a significant association between income status (p=0.006) of health staff and quality of healthcare provided to them. A multivariate regression analysis indicated a highly significant association between volume of care health staff received (p=0.001), quality of Healthcare provided (p=0.001) and health staff healthcare needs satisfaction. The study concludes though health staffs of the Sunyani Municipal moderately accessed their needed health care and received moderate volume of their expected healthcare, one needed to be financially sound to access and obtained optimal healthcare needed. This study recommends effective implementation of the OHS policy and institution of special health package for health staff regardless of their income status to ensure health staffs are universally covered.
Access and utilization of family planning services among males in the Ga-East municipality of the Greater Accra Region of Ghana
(2009-08-08) Ababio, Selina
Family planning is a voluntary prevention of pregnancy and it entails the interruption of a chain of events that leads to conception. Family planning has been an age long practice, mostly among women. Although men are also included in the utilization of family planning services, practically, most men do not utilize the service. It is important to note that, increase in the usage of the service by men will help guard against unwanted pregnancy, improve child spacing and prevent sexually transmitted infections including HIV by using the appropriate contraceptive. Men’s support and commitment to the utilization of family planning is of importance in Africa. This is because of its contribution to the achievement of the millennium development goals (MDG) 5 and 6, which is to improve maternal health, by preventing both maternal and child mortality and also to combat HIV/AIDS, malaria and other diseases. The study was done in all the four (4) sub-districts in the Ga East District. The topic for the study is access and utilization of family planning among males in the Ga East Municipality. The study design was descriptive cross-sectional. The Sample size was 120 males with ages between 19-59 years. In addition, views about utilization of family planning among men from twenty (20) service providers were obtained to support the study. Interview was the data collection method used and questionnaires, the main tool for data collection. From the study it was discovered that: • Educational background was a significant predictor of ones knowledge about family planning. In other words, the higher one moves along the educational ladder, the more his knowledge about family planning • Generally, across the age groups, more people have knowledge about family planning than those who do not have any idea. (80%). • The majority of the respondents were within the age 19-39years (76.7%). • The respondents with some level of education are in the majority (91.5%), compared to those without any form of education, among others.
Accessibility to Tourism by Persons with disabilities in the Ashanti Region of Ghana
(2015-07-02) Aggrey Mensah, Susanna
Introduction: People continuously move from Europe, Asia, America, Africa and Australia to tour around the world leading to increased participation in tourism which brings individuals together. However, it appears persons with disabilities (PWDs) are underrepresented in the industry particularly in the Ghanaian tourism setting due to inaccessible tourism services and other provisions. Accessibility and participation of PWDs in tourism will, however, ensure a social inclusion of PWDs. The study aimed at assessing the accessibility to tourism for PWDs in Ashanti Region. Methods: Across-sectional study using both qualitative and quantitative data collection methods was conducted with workers at tourist centres and Persons with Disabilities in the Ashanti region, Ghana. Both voice recorded interview and structured questionnaires were used in collecting data for the study. Results were generated through thematic analysis for qualitative data and descriptive statistics for quantitative data using SPSS version 20. Results: The finding showed that although all participants have ever accessed tourism as consumers, they only paid occasional visit to tourist sites. The average expenditure on a single tourist visit was GHC 14.92 (equivalent of US$ 4.5), which majority (90.8%) said it comes from their personal income. This seems to put financial burden on PWDs who tried to access tourism services. The results further showed that PWDs faced barriers to facilities at tourist destinations since bath chairs, toilet raisers, wheel chair accessible vehicles, Braille format text and facility to climb walk ways were not available to ensure their access. Again, PWDs faced barriers to adapted tables and chairs. Some of the respondents (42.5%) therefore expressed dissatisfaction at the facilities and indicated that they depended on support from their care givers to access tourist services. Most (66.7%) of the respondents faced barriers to structures. These barriers were as a result of providers’ inability to factor the needs of PWDs into the design of such tourist sites. Conclusion: Participants’ suggestions in respect of the structures were that the drains should be covered; there should be proper walk-ways, ramps and elevators. Respondents again suggested that the Ghana Tourism Authority (GTA) should design specific disability-friendly tourist sites, and there should be a subsidy on gate fee for PWDs, whilst at the same time tourist workers should be given education and orientation on disability education
Accuracy of Diagnosis of Intestinal Helminth Parasites, and Relative Prevalence of Necator Americanus and Ancylostoma Duodenale Infections at the Komfo Anokye Teaching Hospital, Kumasi.
(2009-08-14) Gyampomah, Thomas Kwabena
There is a growing concern that stool reports from the Komfo Anokye Teaching Hospital (KATH) parasitology laboratory are frequently negative for intestinal helminth parasites. Over the years the wet mount technique has been the only method used at the KATH laboratory for diagnosis of intestinal parasites. The study evaluated the diagnostic sensitivity of the traditional direct wet mount technique using the formol-ether concentration as the gold standard method. After approval from the Committee on Human Research, Publications and Ethics, School of Medical Sciences, Kwame Nkrumah University of Science and Technology and Komfo Anokye Teaching Hospital, Kumasi, and with the permission of the hospital management, 2000 stool samples were collected from out-patients who visited the KATH parasitology laboratory between May and October, 2008 to do stool routine examination. Each stool sample was processed within 2 hours after collection using the direct saline wet mount, Kato-Katz and formol-ether concentration methods in accordance with standard protocols. All hookworm positive stool samples were cultured using the modified Harada-Mori test-tube technique and the isolated hookworm filariform larvae were identified by their morphological features in accordance with established criteria. Formol-ether concentration, gave the highest overall prevalence of 11.1% of helminth parasites made up of hookworm (2.9%), Dicrocoelium dendriticum (2.1%), Strongyloides stercoralis (2.1%), Schistosoma mansoni (1.8%), Hymenolepis nana (1.4%), Taenia species (0.6%) and Trichuris trichiura (0.1%). The direct wet mount and Kato-Katz detected total prevalence of 3.2% and 5.1% respectively. Direct wet mount was found to be 29.3% sensitive. Kato-Katz showed good agreement with the ether concentration for detection of hookworms, T. trichiura and S. mansoni infections (99.1% sensitivity; 95.0% CI, 97.1%-100%, with positive and negative predictive values of 100% (95% CI, 100%-100%) and 99.5% (95% CI, 99.0%-100%), respectively. Interestingly, no Ascaris lumbricoides eggs were detected using any of the three methods employed. EPG (eggs per gram) of feces counted by Kato-Katz method showed that most patients (89.9%) harboured low intensity infections of the parasites found. All 58 (100%) hookworm positive cases were identified as Necator americanus. This study reconfirmed reports that the direct wet mount has low sensitivity. It is recommended that stool samples that are negative for parasites by the wet mount method should be re-examined using the formol-ether concentration technique as the confirmatory test. This approach will improve the detection of helminths from stool specimens for accurate diagnosis of intestinal helminth infections, for effective management of patients and ultimately improve the quality of life of individuals in the communities.
Accuracy of Urine Microalbumin and Serum Uric Acid in the diagnosis of Preeclampsia
(APRIL, 2015 ) Kankam-Agyiri, Mabel
Preeclampsia (PE), a multisystemic disorder of pregnancy characterized by proteinuria and hypertension after 20 weeks of gestation, is one of the leading causes of maternal morbidity and mortality worldwide. Its aetiology is not fully understood though several studies attribute it to a widespread endothelial dysfunction originating from the placenta. The increasing prevalence of PE coupled with the need to identify and institutionalize more sensitive diagnostic tools has necessitated this study. This study sought to evaluate the diagnostic accuracy of urine microalbumin and serum uric acid as early markers of preeclampsia among Ghanaian women attending antenatal care at the Komfo Anokye Teaching Hospital (KATH). This case-control study was conducted among pregnant women at the Obstetrics and Gynaecology (O&G) department of the KATH, Kumasi-Ghana from October 2011 to May 2012. A total of 146 participants were recruited for this study. Written informed consent was obtained from the participants, and information on socio-demographic characteristics, medical history and previous obstetric history were obtained through medical records of the eligible participants. Blood pressure and anthropometrics were measured according to standard procedure; urine samples were collected for estimation of spot urine protein and microalbuminuria; and venous blood sample was taken for biochemical analysis and platelet count. The percentage of married participants with preeclampsia was significantly lower than the controls (p=0.004). More control participants had formal education compared to the participants with preelampsia (p=0.008), however, more preelamptics had informal education compared to the controls (p=0.004). The prevalence of abortion and blood pressure were higher in the preelamptics than the controls. Serum uric acid and hepatic enzymes (ALT and AST)] and urine microalbumin (p=0.005) were significantly elevated in the preeclamptic participants compared to the controls. The mean platelets count and serum albumin levels were however lower in the preelamptics than the controls (p>0.001). A significant positive linear correlation was observed between spot urine protein and urine microalbumin (r=0.324, p=0.006). A negative linear correlation was observed between uric acid and spot urine micro albumin (r=0.033, p=0.786). A urinary micro albumin value of 75.45 mg/g was identified as the best threshold to 2 detect a spot urine protein of > +2 with a sensitivity of 92.7% and a specificity of 80.0%, PPV of 81.03% and NPV of 33.3%. Area under the curve = 0.835; asymptomatic p-value of 0.0001 at 95% CI (0.678-0.991). In contrast, serum uric acid level of 263.5 mg/g was identified as the best cut-off point to detect a spot urine protein of > +2 with sensitivity and specificity of 89.1% and 33.3% respectively (PPV of 77.2% and NPV) of 20.8%. Area under the curve = 0.552; asymptotic p-value of 0.538 at 95% CI (0.364-0.740). Urine levels of microalbumin, as a measure of proteinuria are elevated in preeclamptics and can be used in place of spot macro protein estimation to diagnose preeclampsia especially in the early stages.
Acute chest syndrome in sickle cell disease: clinical presentation and pharmacological management
(AUGUST, 2016 ) Ansere, Afriyie Victor
Acute chest syndrome (ACS) is a common cause of hospitalization and mortality in sickle cell patients across the globe. There appears to be paucity of data concerning ACS and its pharmacological management in Ghana and Africa as a whole. This study was aimed at assessing the prevalence and clinical presentation of ACS, and its pharmacotherapy in children with Sickle Cell Disease (SCD) at Komfo Anokye Teaching Hospital (KATH) in Kumasi, Ghana. Method: The designs of the study was retrospective, in which medical records of the children 14 years and below with SCD and at least an episode of ACS were retrieved and assessed at the Sickle Cell Clinic of KATH. One hundred and seven cases among 1336 children with sickle cell disease met the criteria for inclusion in the study. The ages of the patients ranged from 8 months to 14 years with a mean of 5.7 ± 3.5 years. The prevalence of ACS was 8%, with a 2.2 episodes/ month rate of occurrence. Forty percent of the patients were between the ages of 5 to 9 years. Seventy five percent (n=80) presented with fever and 65% (n=70) presented with cough. Other symptoms like rhinorrhoea and irritability were common in younger patients (< 5 years), p = 0.012 and 0.001 respectively. Abdominal pain and chest pain occurred mostly in the older patients (≥ 5 years), p = 0.024 and < 0.001 respectively. Bacteria isolates were found in 12 of 79 cases (15.2%) that had blood culture information. Eighty four patients (80.7%) received cefuroxime and gentamicin dual therapy for empiric treatment of infection in ACS. The dose range of gentamicin used in the hospital was 3 to 9 mg/kg body weight as opposed to the recommended 5 to 7 mg/kg, as a single daily dose. The empiric antibiotic therapy for infections in ACS patients did not cover for atypical bacteria as recommended in standard guidelines. Forty seven patients received paracetamol alone for pain management and 47 received paracetamol and ibuprofen. Morphine was the preferred opioid prescribed, which is in line with recommendation by WHO guidelines for pain management in SCD patients. The prevalence of ACS was 8%. The majority of patients were between the ages 2 to 9 years. Fever and cough were among the common clinical symptoms presented. Other clinical features like rhinorrhoea, irritability, chest pain and abdominal pain varied with age. Treatment regimen for ACS in the hospital included pharmacotherapy for infections, pain management, hydration with IV fluids and blood transfusion in patients with severe anaemia. All of these were in conformity with standard guidelines and literature.
Adaptation of the Broadloom for Pile Weaving
(September, 2010.) Agbo Jones B., Harry
The production of pile fabrics has been limited to the big textile establishments which make use of power and sophisticated looms that are capable of producing complex or intricate designs. This situation has been in existence since the development of the dobby and jacquard looms which scope has gone beyond the simple plain, twill and satin / sateen weaves to the production of complex or intricate designs. An adapted broadloom has been designed and constructed to increase the scope of the local industry. This project is therefore an attempt to adapt the broadloom such that it can be used for pile fabric production, thereby increasing the scope of the local textile industry and reducing the unemployment situation in the country. A sample has been produced, after the adaptation, as proof that the adapted loom is capable of producing such type of fabric. The whole process and mode of production of the sample have been explained and illustrated in the text. Pictures of the sample weave and the adapted loom have been provided in the report to substantiate the fact that, the broadloom can easily be adapted to suit that purpose.
Addressing domestic violence against women: a case study of Navio traditional council in Kasena-Nankan West District of the Upper East Region, Ghana.
(November, 2019) Thomas, Amibase;
Background:Domestic violence against women has been recognized both globally and locally(Ghana) as a major violation of a woman’s human rights.Despite the enactment of Domestic Violence Act(Act 732) and establishment of Domestic Violence and Victims Supports Unit (DOVVSU), the problem still lingers. To adequately address the problem, calls are made to consider other alternatives systems of disputes resolution such as the traditional authorities. The study assesses the effectiveness of traditional authorities’ intervention in addressing domestic violence against women in the Navio traditional area. Methods:A cross sectional research design wasadopted for the study.Simple random sampling technique was used for the selection of the study sample.The study participants were interviewed using a pre-tested structured close and open-ended questionnaire.The data wasthen analyzed using descriptive statistics such as percentages, frequency, mean, standard deviation and presented on tables and graphs. Results:The study reveals that domestic violence occasionally occurs in the community (74.7%) and remains largely unreported (60.9%). The study further found that respondents preferred the traditional authorities in resolving domestic violence cases to the police and victims felt safe under the interventions put in place by the traditional head. Conclusion: The study concludes that victims of domestic violence are aware of interventions put in place and prefer the traditional leaders over the police in dealing with reported cases.
Adherence to anti-diabetics a case study of out-patients attending the diabetic clinic of the Komfo Anokye Teaching Hospital, Kumasi.
(AUGUST 2016 ) Owusu-Danso, Henrietta
Non-adherence to diabetes treatment leads to poor glucose control and increases the risk of disease complications. The prevalence and factors associated with non-adherence in resource limited settings should be determined so as to lower the impact of diabetes that is on the increase, on the health systems which are already overburdened with communicable diseases. The purpose of this study is to assess the level of adherence to antidiabetic medicines among patients attending the diabetic clinic and factors contributing to non-adherence at Komfo Anokye Teaching Hospital A cross-sectional study was conducted at the diabetic clinic of the KATH. A list of all patients attending the diabetic clinic for at least the past two years was obtained. A simple random method of sampling was used to select the desired sample size from the patient list. Data was collected via personal interviews using a structured questionnaire and also from the patient medical records. The structured questionnaire was administered to each patient after consenting to participate in the study. The questionnaire was in the form of exit interviews. Information provided by the respondents was counter checked with their medical records. The level of adherence to anti-diabetic medication among the respondents revealed that majority of them; constituting 64.2% had a high adherence level. The correlation between patients’ socio-demographic and adherence rate to anti diabetic therapy indicated that adherence among women was high represented by 69.6%. Adherence was high among participants less than 55 years (54.9%), among participants living with their family (90.1%), among participants who were knowledgeable about their disease condition and the effect of defaulting their anti-diabetic medication (64.5%) and high among participants who have been diagnosed of diabetes for less than 3 years (47.04%). This study revealed a high level of adherence among the participants. Also patients with knowledge of default consequences are more likely to adhere to their antidiabetic medications (p=0.046).
Adherence to anti-hypertensive medication regimens among patients attending the G.P.H.A. Hospital in Takoradi - Ghana.
(2006-08-08) Jambedu, Haruna Ahmed
Background: Adherence is the extent to which a person’s medication-taking behaviour coincides with the healthcare providers’ medical advice. It includes both dosing regularity and timing of intake. Many physicians face the problem of non-adherence among their hypertensive patient population. During the first year of treatment 16 – 50% of patients stop taking their high blood pressure medications. Overall, it is estimated that only about 30 – 50% of patients with hypertension adhere precisely to their hypertension medication regimens. Adherence is important in the treatment of hypertension Objectives: The objective of this study was to assess the extent of non-adherence to hypertensive medication regimen in G.P.H.A. Hospital, Takoradi. The reasons for non-adherence in the study were also evaluated. Methods: A prospective study of 150 hypertensive patients on medication for at least 6 months, who reported at the OPD of this hospital, was carried out. The Morisky questionnaire was administered to the patients and reasons for non-adherence sought. Pregnancy related hypertensive patients were excluded in this study. Results: The study revealed that total adherence to anti-hypertensive medications regimens was 19.3% and partial or medium adherence was 49.3%. Hence the adherence rates (i.e. those who took their medications ≥ 75%) to anti-hypertensive medicines in the institution was 68.6% and the non-adherence rate was 31.4%. The major reasons for non-adherence were forgetfulness (45.4%) by the patient to take medications on time or missed doses and side effects of the medications (20.8%). Finance (10.4% was also a problem for the paying patients who have to make up-front payment to re-fill their medicines. Conclusion: The prevalence of adherence among hypertensive patients in this health facility was 68.6%. Thus, indicating the need for adherence counselling.
Adherence To Antiretroviral Therapy And Its Impact On Clinical And Immunologic Outcomes
(2015-11-03) Boakye, Dorothy Serwaa
Adherence to highly active antiretroviral therapy (HAART) has been associated with achieving success in virologic suppression, CD4 cell recovery, and improved patient well-being. Most of these researches reporting on the impact of adherence to HAART on treatment outcomes are published works from resource rich setting with little or no literature from Ghana. This study was therefore conducted to assess the impact of adherence to HAART on clinical and immunologic outcomes at two nationally designated HIV treatment centers in Kumasi, Ghana. The study was a prospective non- randomised study of HIV- infected patients at Aniwaa medical center and Bomso specialist hospital, private health facilities in the Kumasi metropolis. The patients were recruited to initiate antiretroviral therapy. A total of 86 patients were enrolled and 85 completed. Data collection lasted for 1 year 1 month. Patients were assessed for their level of adherence to HAART over a nine month period during interviews and pill counts. Patients who took ≥95% of their medication were classified as adherent whiles those who took ≤ 95% of their regimen were described as non- adherent. Data regarding clinical outcomes were collected at baseline, 3 month, 6 month and 9 th month, whereas data on immunologic outcomes were collected at baseline, 6 month and 9 month respectively. The data obtained was coded, entered into SPSS version 20.0 and analyzed. Over 90% of the participants were adherent to their therapy. Common reasons for missing medications were side effect (44.7%), forgetfulness (42.4%), being away from home (42.4%). The mean CD4 count at baseline was 235cells/uL, 6 th month (394cells/uL) and 9 th month (469cells/uL). Mean number of opportunistic infections and signs and symptoms was 3.34 and 4.79 at baseline, 1.56 and 2.03 at 3 rd month, v 1.12 and 1.16 at 6 th month and 1.00 and 1.13 at 9 th month. Overall physical health of patients improved from poor at baseline to good at the 9 th month. Adherence to HAART was a strong predictor of immune recovery, growth and clinical progression but adherence was seen not to be the only predictor of treatment outcomes. Baseline CD4 count was also found to predict outcomes for HIV infected patients. The most frequently used ARV in combination therapies was Tenofovir. Majority of patients in the study were adherent. After the nine months of study, both immunologic and clinical outcomes of patients significantly improved.
Adverse ocular outcomes in the management of allergic conjunctivitis and the efficacy of a herbal intervention
(2015) Abokyi, Samuel
Allergic conjunctivitis (AC) is on the rise and pharmacological intervention is the mainstay of its treatment. However, reports on adverse ocular effects have been observed in the use of orthodox medicines in managing AC. This study, therefore, sought to investigate the outcomes of conventional anti-allergic medications use and the efficacy of a herbal intervention in management of AC. A cross-sectional study was first conducted to determine the prevalence, prescription pattern and ocular complications in AC management, followed by a retrospective cohort study to determine the underlying cause of the commonest ocular complication observed in the management of AC by reviewing medical records of cases of AC diagnosed from January to December 2010. The results indicated a high prevalence 9.1% of AC, with the acute forms of AC accounting for 82.5% of the total AC cases. The commonest prescribed medications were topical steroids 69.7% (1198) mainly prescribed for atopic keratoconjunctivitis (P = 0.002), and systemic antihistamines 48% (839) for the acute types of AC (P ≤ 0.001). Dry eyes was the commonest disorder (5.2%) found accompanying AC, and the use of systemic antihistamines in managing AC was the most significant risk factor (OR: 2.79; P ≤ 0.001) to this condition after adjusting for patient‘s age and occupation. Anecdotal reports suggests P. stratiotes, a traditional medicinal plant, is potent in managing allergies. There is, therefore, the need to confirm or otherwise the efficacy of this herb in treating AC since conventional orthodox treatment is ineffective and/or associated with adverse ocular effects. Ovalbumin-sensitized ICR mice were pretreated with different doses (10, 50 and 100 mg/kg) of an aqueous leaf extract of P. stratiotes (ALPS) 1h before v multiple topical challenges in eyes by instillation of ovalbumin to induce AC. ALPS significantly and dose-dependently lowered (P ≤ 0.05-0.001) ocular signs of AC (including conjunctival redness, lid edema, tearing and lid scratching), serum ovalbumin-specific IgE, and mast cell infiltrations and degranulations in ocular tissue of mice. Managing AC with conventional orthodox drugs results in decreased tear secretion and stability (i.e. dry eyes). It was hence important to evaluate the effect of P. stratiotes on tear secretion and tear film stability. Phenol red thread test and fluoresceine tear breakup time, for the assessment of tear secretion and tear film stability respectively, were performed before and after oral administration of ALPS for 7 consecutive days. No significant change (P > 0.05) in tear secretion and tear film stability was found following treatment with ALPS, while mice treated with prednisolone and cetirizine showed significant decline in tear secretion and/or stability (P ≤ 0.05- 0.001). AC is a prevalent eye disorder in Ghana and caution should be exercised in the use of systemic antihistamines as it could precipitate dry eyes. ALPS exhibited potent anti-allergic activity and did not affect tear secretion and tear film stability; hence may be useful in managing AC in humans.
AmpC Beta-Lactamase Production Among Pseudomonas Aeruginosa and proteus Mirabilis Clinical Isolates at the Komfo Anakye Teaching hospital in Kumasi, Ghana
(2013-01-17) Opoku, Solomon
Studies report high prevalence of Extended-Spectrum beta-lactamase but reports on AmpC beta-lactamase-producing bacteria in Ghana are scanty...
Analgesic Use at the Polyclinic OPD of Komfo Anokye Teaching Hospital
( 2009) Owusu-Ansah, Sarah Arthur
Objective: This study was conducted to determine which analgesics were commonly prescribed at a busy polyclinic as well as to document the conditions for which they were prescribed, their availability at the polyclinic pharmacy and also to pick out any cautionary cases. Method: The study was a descriptive prospective cross-sectional study over a period of 4 weeks from mid December 2006 to mid January 2007. A purposeful sampling method was employed, i.e. twenty consecutive prescriptions containing analgesics for each day were included in the data collection. Data was extracted from the prescription forms and filled on the data collection form. Numbers and percentages of the data were calculated using the electronic data processing software SPSS (version 12). Setting: The general out-patient consulting rooms and pharmacy of the polyclinic of Komfo Anokye Teaching Hospital, Kumasi. Key Findings: A total number of three hundred and forty analgesic prescriptions were collected during the period of study. The most commonly prescribed analgesic was paracetamol (52.8%). NSAIDs followed at 40.1%. Diclofenac was the most common NSAID prescribed at 68.9% of all NSAIDs prescribed. The commonest documented indication for NSAIDs was malaria (34.5%) followed by hypertension at 25%. The rationale for the use of NSAIDs in hypertension was however not clear. Malaria was the most common indication for analgesic prescribing in all age groups at 67.5%. The majority (34.1%) of all the prescriptions were for age groups of 15-45 years but the age group 45-65 years followed at 23.3%. In addition 62.7% of all paediatric prescriptions under five years were for males. Malaria was the commonest indication in children under five at 83.1% and the mean duration of therapy was found to be approximately 5 days. Generic prescribing was generally good at 79.1% whiles 95.7% of all drugs were available at the pharmacy. Also 94.3% of all drugs prescribed were in line with the hospitals Drugs and Therapeutic Committee’s recommended list. Conclusions: A high percentage of NSAID prescriptions were going to hypertensive patients over 45 years. The mean duration of days for paracetamol use in paediatric patients may need to be examined. Generic prescribing, drug availability and adherence to Drug and Therapeutic Committee drug list were however very high and thus commendable.
Analgesic use at the Polyclinic OPD of Komfo Anokye Teaching Hospital
(2009-08-14) Owusu-Ansah, Sarah Arthur
Objective: This study was conducted to determine which analgesics were commonly prescribed at a busy polyclinic as well as to document the conditions for which they were prescribed, their availability at the polyclinic pharmacy and also to pick out any cautionary cases. Method: The study was a descriptive prospective cross-sectional study over a period of 4 weeks from mid December 2006 to mid January 2007. A purposeful sampling method was employed, ie. twenty consecutive prescriptions containing analgesics for each day were included in the data collection. Data was extracted from the prescription forms and filled on the data collection form. Numbers and percentages of the data were calculated using the electronic data processing software SPSS (version 12). Setting: The general out-patient consulting rooms and pharmacy of the polyclinic of Komfo Anokye Teaching Hospital, Kumasi. Key Findings: A total number of three hundred and forty analgesic prescriptions were collected during the period of study. The most commonly prescribed analgesic was paracetamol (52.8%). NSAIDs followed at 40.1%. Diclofenac was the most common NSAID prescribed at 68.9% of all NSAIDs prescribed. The commonest documented indication for NSAIDs was malaria (34.5%) followed by hypertension at 25%. The rationale for the use of NSAIDs in hypertension was however not clear. Malaria was the most common indication for analgesic prescribing in all age groups at 67.5%. The majority (34. 1%) of all the prescriptions were for age groups of 15-45 years but the age group 45-65 years followed at 23.3%. In addition 62.7% of all paediatric prescript ions under five years were for males. Malaria was the commonest indication in children under five at 83.1% and the mean duration of therapy was found to be approximately 5 days. Generic prescribing was generally good at 79.1% whiles 95.7% of all drugs were available at the pharmacy. Also 94.3% of all drugs prescribed were in line with the hospitals Drugs and Therapeutic Committee’s recommended list. Conclusions: A high percentage of NSAID prescriptions were going to hypertensive patients over 45 years. The mean duration of days for paracetamol use in paediatric patients may need to be examined. Generic prescribing, drug availability and adherence to Drug and Therapeutic Committee drug list were however very high and thus commendable.
Analyzing the lived experiences of primary caregivers of children with cerebral palsy attending the Korle-Bu Teaching Hospital in the Greater Accra Region, Ghana.
(September, 2016 ) Tandoh, Joana Dorothy
Cerebral palsy presents in early childhood as a set of functional limitations that stem from disorders of the developing central nervous system. It is a non-progressive disorder that results from an anoxic brain injury to the foetal or new born brain. Because this disorder can cause disability ranging from mild to severe effects on motor and cognitive functioning, the diagnosis can vary from one child to another, causing family stress due to vague and unknown predicted outcomes of the disorder. The diagnosis of cerebral palsy affects families in different ways depending on coping mechanisms, support systems, and age and level of functioning of the child among other factors, it is therefore important to assess the experiences of their caregivers. This study reports on the lived experiences of primary caregivers of children with cerebral palsy attending the Korle Bu Teaching Hospital in the Greater Accra Region of Ghana. The study utilized a phenomenological approach to look at primary caregivers as the best-informed authority to explore and describe their lived experiences of caring for their child with cerebral palsy. In this qualitative study, forty (40) primary caregivers of children with cerebral palsy were interviewed regarding their experiences before the diagnosis of the condition, during the diagnostic process and post diagnostic experiences. Semi-structured, in-depth, face to face interviews and participant observation were the methods used for data collection. Narratives of 40 participants were transcribed and analysed using thematic coding. The themes and categories that resulted from the content analysis were under three broad fields of experiences namely: Experiences before the diagnosis of the condition, experiences during the diagnosis of the condition and experiences after the diagnosis of the condition. In terms of experiences before the diagnosis, two themes emerged: (1) Confronted with a situation of a child with an abnormality as a new mother, (2) Breaking out of the superstitious beliefs. Regarding experiences during the diagnostic process, three themes emerged: (1) Issues of blame and responsibility (2) Confusion and mistrust with helping professionals (3) mixed feelings about the diagnosis. Four themes emanated from the experiences after the diagnosis of the condition namely: (1) strained family relations (2) Experience of poverty (3) Experience of loss of social life (4) The challenge with finding educational resources and day-care. It is recommended that future research should expand beyond the scope of this work and include caregivers of children with different types of disability.
Angiogenic factors and oxidative stress biomarkers in gestational hypertension and preeclampsia
(2015-11-04) Anto, Enoch Odame
Hypertensive disorders of pregnancy are multisystemic disorders whose etiology is still unknown. An Imbalance in angiogenic factors and oxidative stress (OS) biomarkers levels has been implicated. It is against this background that this study prospectively evaluated angiogenic factors and oxidative biomarkers and the role they play in the pathogenesis of gestational hypertension (GH) and preeclampsia (PE). This prospective study recruited 235 pregnant women at 20-40 week gestation from the Obstetrics and Gynaecology (O&G) department of the Komfo Anokye Teaching Hospital (KATH). Finally 150 (50 GH, 50 PE and 50 normal pregnant) gave informed consent and their course of pregnancy were followed until delivery. Serum levels of placental growth factor (PLGF), soluble fms-like tyrosine kinase 1 (sFlt-1) and 8-epi-prostaglandin F2alpha (8-epi-PGF2α) levels were estimated by ELISA and total antioxidant capacity (T-AOC) was measured spectrophotometrically. Median levels of sFlt-1, 8-epi-PGF2α and sFlt-1/PLGF ratio were significantly elevated while PLGF, T-AOC and PLGF/sFlt-1 ratio were significantly reduced in GH and PE compared to normal pregnant (NP) controls (p<0.05) at baseline. Conversely, levels of sFlt-1, 8-epi-PGF2α and sFlt-1/PLGF significantly decreased while PLGF and T-AOC were significantly increased after 48 hours delivery in all studied participant (p<0.05). Levels of sFlt-1, 8-epi-PGF2α and sFlt-1/PLGF tend to peak in the third trimester of pregnancy specifically at 32-36week gestation. Advanced maternal age (35-40 year) pregnant women were significantly associated with angiogenic and oxidative stress imbalance compared to age group 18-24 year (p<0.05). Increased proportion of adverse maternal and fetal outcomes such as preterm delivery, emergency caesarean section, placental previa, placental abruption, stillbirth, intrauterine growth restriction (IUGR), intrauterine fetal death (IUFD), and postpartum hemorrhage (PPH), low birth weight (LBW), fetal distress, birth asphyxia and Apgar score below 7 after 5 minutes were significantly associated with preeclamptic pregnancies compared to normal control groups (p<0.05). A significant positive correlation (PIGF vs T-AOC; and sFlt-1 vs 8-epi-PGF2α) and a negative correlation (PLGF vs sFlt-1, sFlt-1 vs T-AOC, PLGF vs 8-epi-PGF2α, and T-AOC vs 8-epi-PGF2α) was observed among studied groups after adjusting for maternal age, BMI, gestational age and parity (p<0.05). Angiogenic profile and oxidative stress biomarkers were significantly associated with systolic and diastolic blood pressure, gestational BMI and adverse pregnancy outcomes such as IUGR, placental abruption, stillbirth, IUFD, and PPH after adjusting for maternal age and pregestational BMI (p<0.05). The best area under the curve obtained on analysis using ROC curve indicated that ratio of PLGF/sFlt-1 followed by sFlt-1/PLGF ratio and PLGF could be used as predictive markers for early onset third trimester pregnancy in PE. GH and thus PE create an imbalance in the levels of angiogenic factors and oxidative biomarkers as depicted by elevated levels anti-angiogenic factors and pro-oxidants and a reduced concentration of pro-angiogenic factors and antioxidants. Pharmacologic remedies of exogenous pro-angiogenic molecules, antioxidant supplements and inhibiting the action of anti-angiogenic molecules could provide inventive approaches to the management of GH and PE and potentially alleviate the adverse complications suffered by these patients

Browse

Browsing College of Health Sciences by Title

Results Per Page

Sort Options