College of Health Sciences

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Quality assessment and clinical evaluation of the safety and effectiveness of a Ghanaian hepatorestorative polyherbal product (HPK) at the Wa Regional Hospital
(MAY, 2019) Agyemang, Alfred Ofori;
Liver diseases are increasing globally and many clients in developing countries tend to use herbal products for their treatment but most of these products have not been studied scientifically. The study aimed at assessing quality, safety and effectiveness outcomes of the treatment of patients with deranged liver functions using a Ghanaian polyherbal product, HPK. HPK which is used as a hepatorestorative is a decoction prepared from Bidens pilosa, Citrus aurantifolia and Trema orientalis. Quality parameters of HPK were assessed through physicochemical, microbiological, spectroscopic and chromatographic analysis. Atomic Absorption Spectroscopy (AAS) was used for heavy metals analysis. Fifty clients with laboratory-confirmed deranged liver function gave informed consent and were recruited for the study at the Upper West Regional Hospital. Participants took HPK (30 mL 8 hourly) for 28 days. Laboratory investigations (LFT, RFT, FBC and Urine R/E) were undertaken at day 0 (baseline), 14 and 28 to assess for safety and effectiveness of HPK. HPK exhibited DPPH free radical scavenging activity with IC50 of 23.39µg. HPK contains reducing sugars, alkaloids, tannins, saponins, coumarins, flavonoids and phytosterols. HPLC, TLC, UV and IR fingerprints have been established. Microbiological cultures did not show any observable contamination of the HPK. Heavy metal analysis: Lead, Mercury, Nickel, Cadmium and Arsenic yielded content levels within the safe WHO reference ranges. Compared to baseline values, HPK showed no observable toxicity on renal function, haematological parameters and urinalysis in humans after 28 day period. However, HPK significantly improved the liver function of the participants: AST (p - 0.0001), ALT (p < 0.0001), GGT (p - 0.0017), total bilirubin (p - 0.0146), direct bilirubin (p < 0.0001) and alkaline phosphates (p -0.0295). The other parameters showed no significant differences in 28 days. Within the limits of the study, HPK had hepatorestorative action with no observable toxicity and can be used with confidence as indicated on its label as a liver tonic.
Quality care management of febrile illnesses among children under 5 years in Atwima Kwanwoma district in the Ashanti Region of Ghana
(NOVEMBER, 2019) Asante, Samuel Koranteng;
Introduction Febrile illnesses in children and its management (especially infectious diseases) continue to result in an enormous increase in morbidity and mortality in developing countries causing a global public health concern. However, most low-middle-income countries have failed to institute systematic outcome assessment measures to ensure quality in the management of these conditions at one breadth. This study therefore aimed at assessing the quality care management of febrile illness in under five (5) in health facilities in the Atwima Kwanwoma district of Ashanti Region, Ghana. Methods The study was quantitative using a cross-sectional study design. Data were collected from 58 healthcare providers and 390 folders of children treated for febrile illnesses. Data were analyzed using STATA version 14. Univariate and multivariate analyses were performed to identify socio-demographic, patient and prescribers’ factors influencing the management of febrile illness among children under 5 years. Statistical significance for all testing was set as 0.05. Results More than fifty percent (68.4%) of the overall management of the febrile illnesses were classified as appropriate in accordance with the WHO/UNICEF IMCI guidelines. Issues of Scarcity or shortage of qualified employees; leadership interference; dissatisfaction from health care professionals; location-based challenges, absence of WHO/UNICEF guidelines for fevers management, Artemether Lumefantrine Dosing wall chart, stockout of Artemether Lumefantrine and Amoxicillin in some facilities were identified as some of the challenges inhibiting quality care management. Prescribers’ factors such as belief in superstition (pvalue=0.02) and patients’ socio-demographic factors such as the age of child below 1 year (pvalue= 0.04) and gender (p-value=0.02) were established to influence quality care management of febrile illnesses. Conclusion The study concludes that the quality of management of febrile illnesses was not impressive and required urgent attention. Stakeholders within the healthcare industry should come together and introduce policies that focus on improving the diagnostic and treatment capacity of healthcare facilities.
Prevalence of common bacteria isolates and their susceptibility to antibiotics in malnourished children upto 5 years admitted at the maternal and child health hospital in Kejetia, Kumasi, Ghana
(SEPTEMBER, 2018) Osei, Young Dorcas;
Malnutrition in children is the outcome of factors that are concerned poor food quality, insufficient food intake and recurring of infectious diseases. World Health Organization in 2011 estimated that 178 million children were stunted and 115 million children were underweight. Heikki in (2001) stated that the incidence and impact of life threatening bacterial infections in children across Africa have not been quantified and these bacterial infections can result in severe malnutrition. The study was to determine the prevalence of common bacteria isolates in malnourished children who are upto 5 years admitted at the Maternal and Child Health Hospital. Samples of urine, blood and stool were taken from 200 malnourished children alongside with administration of questionnaires. Samples were subjected to laboratory analysis such as culture and sensitivity and biochemical test for identification of bacteria. Out of 200 malnourished children, severe acute malnutrition (SAM) was found in 71.1% and 27.7% were moderately malnourished. Children (65.0%) were marasmic and 35.0% suffered from kwashiorkor. Of the malnourished children, who 63.5% had diarrhoea, 49.5% presented with vomiting and 40.5% presented with fever. Bacteria isolated from urine were Klebsiella sp (43.3%), Escherichia coli (30.0%), Pseudomonas sp (13.3%), Salmonella sp (6.7%), Enterobacter sp (3.3%) and Proteussp (3.3%). For blood samples, Staphylococcus aureus (53.6%) was the highest isolate, followed by Streptococcus sp (25.0%). Out of 38 stool samples, Escherichia coli (42.1%) was the highest isolated species followed by Klebsiella sp (21.1%) and Proteus sp (18.4%). Escherichia coli, Proteus sp, Salmonella sp and Enterobacter sp were resistant to 100% Ceftriaxone. Pseudomonas sp and Salmonella sp were resistant to 100% Ampicillin. Staphylococcus aureus (100%) was resistant to Ampicillin, Gentamicin and Cefuroxime. Streptococcus sp (100%) was susceptible to Gentamicin, 71.4% was susceptible to Azithromycin and 57.1% was vi susceptible to Chloramphenicol. Breastfeeding, complementary feeding, how the child is fed, daily feeding periods, surrounding where food is bought or prepared and storage of feeding tools of malnourished children were found to be factors that predisposed children to malnourishment.
The effect of certified herbal medicines non - inclusion in the national health insurance scheme (NHIS) on health care delivery within the Kumasi metropolis
(November, 2019) Nketia, Anthony;
Background: Herbal medicine, the most prevalent form of complementary and alternative medicine (CAM), is highly utilized in many countries across the globe. A very large percentage of Africans rely on herbal medicine to meet their primary health needs. In Ghana, herbal medicine has been integrated into the mainstream of health care delivery since 2011. Though eight years into the integration process, not a single certified herbal drug dispensed to clients patronizing the services of the herbal unit at government hospitals is covered by the NHIS. Objectives: To assess the effect of certified Herbal Medicines non-inclusion in the National Health Insurance Scheme (NHIS) on health care delivery within the Kumasi Metropolis. Methods: A cross-sectional study was conducted from July to August, 2019. Primary data was collected from four hundred and thirteen participants using semi-structured questionnaires. Purposive and convenience sampling technique were used to select the participants. Results: Majority of the study respondents were females (54.0%) and the median age was 35 years. It was ascertained that 80.9% of the respondents interviewed preferred Herbal Medicine to Orthodox Medicine. Factors established to influence preference of Herbal Medicine to Orthodox Medicine were occupation, nature/severity of condition and cost of certified herbal drugs dispensed at the herbal unit. A little above half (51.5%) of the respondents described the cost of certified herbal drugs dispensed at the herbal unit as very expensive. As many as 72.1% of the respondents also believed that the cost of certified herbal drugs adversely affect the utilization of the herbal unit at government hospitals. A positive correlation coefficient (r = 0.5498) was obtained for respondents’ rating of cost of certified herbal drugs dispensed at herbal unit within government hospitals and its adverse effect on vi utilization of the herbal unit. Interestingly, 99.5% of respondents recommended for the inclusion of certified herbal drugs in the National Health Insurance Drug List (NHIDL). Conclusion: The study reveals that the cost of certified herbal medicines negatively affects the utilization of the services provided by the herbal unit at government hospitals. It is, to improve the extent of utilization of the herbal units, necessary for certified herbal drugs dispensed at these units to be included in the NHIDL of the country.
Waste disposable methods and challenges among households in selected communities within the Kumasi metropolis
(November, 2019) Appiah, Gilbert Debrah;
Background: Poor waste management remains a major obstacle to many developing countries including Ghana. One of the major environmental problems in Kumasi Metropolis is poor waste management which impede one‟s health. Waste management Department of the Kumasi Metropolitan Assembly and Zoomlion Ghana Limited are usually responsible for waste management in the Metropolis but have challenges to provide an effective and efficient services to the households due insufficient funding and with this, households face many challenges when disposal of waste. It is therefore indisputable the fact that for households to safeguard, control and promote the environment there must be some facilities responsible for waste management. Objectives: To assess waste disposable methods and challenges among households in selected communities within the Kumasi Metropolis. Methods: Case study design and Cross-sectional design was adopted for this study. The sample size of 308 households was estimated for collection of quantitative and qualitative data for this study. Results: All respondents in the three selected communities used house-to-house solid waste collection as their major method of waste disposal as compare to the use of central communal containers. It was recorded that over 70% of the households used house-to-house method of waste collection with less than 30% of the households using central communal containers as a means of disposing their waste due to limited disposing facilities. 78% Households in the selected communities revealed the challenges they faced which includes delay in waste collection, absence of sensitization of the public on issues of management of solid waste, inadequate refuse containers, lack of households‟ awareness on reducing, recycling and sorting of waste, poor attitude of households towards waste handling and ineffective waste management laws. Also over 50% of the respondents bemoaned that the fees charge for disposal of waste was high. Conclusion: The preference of house-to-house solid waste collection to the use of central communal containers as a means of disposing waste was attributed to the fact that house-tohouse waste collectors are experts. Again the patronage of house-to-house service to central communal containers waste collection by households was due to the same amount charge for disposing of waste on daily basis. Moreover, there was a lot of pressure on the central communal containers whidh has lead to improper waste disposal. This confirms the difficulties households face in attempt to dispose of waste.

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