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BACKGROUND: Heart failure (HF) is a leading cause of morbidity and mortality globally, with a high disease burden. The prevalence of HF in Ghana is increasing rapidly, but epidemiological profiles, treatment patterns, and survival data are scarce. The national capacity to diagnose and manage HF appropriately is also limited. To address the growing epidemic of HF, it is crucial to recognize the epidemiological characteristics and medium-term outcomes of HF in Ghana and improve the capability to identify and manage HF promptly and effectively at all levels of care. OBJECTIVE: This study aims to determine the epidemiological characteristics and medium-term HF outcomes in Ghana. METHODS: We conducted a prospective, multicenter, multilevel cross-sectional observational study of patients with HF from January to December 2023. Approximately 5000 patients presenting with HF to 9 hospitals, including teaching, regional, and municipal hospitals, will be recruited and evaluated according to a standardized protocol, including the use of an echocardiogram and an N-terminal pro-brain natriuretic peptide (NT-proBNP) test. Guideline-directed medical treatment of HF will be initiated for 6 months, and the medium-term outcomes of interventions, including rehospitalization and mortality, will be assessed. Patient data will be collated into a HF registry for continuous assessment and monitoring. RESULTS: This intervention will generate the necessary information on the etiology of HF, clinical presentations, the diagnostic yield of various tools, and management outcomes. In addition, it will build the necessary capacity and support for HF management in Ghana. As of July 30, 2023, the training and onboarding of all 9 centers had been completed. Preliminary analyses will be conducted by the end of the second quarter of 2024, and results are expected to be publicly available by the middle of 2024. CONCLUSIONS: This study will provide the necessary data on HF, which will inform decisions on the prevention and management of HF and form the basis for future research. TRIAL REGISTRATION: ISRCTN Registry (United Kingdom) ISRCTN18216214; https:www.isrctn.com/ISRCTN18216214. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/52616.
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The clinical presentation of cardiac sarcoidosis is variable. We report two cases of cardiac sarcoidosis to highlight the varied clinical presentations and diagnostic challenges in our setting, and encourage the consideration of sarcoidosis as a differential in unexplained arrhythmias and heart failure.
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Pulmonary tuberculosis manifesting as a mass lesion, thus, mimicking a lung carcinoma is an unusual radiographic presentation of tuberculosis (TB). The common radiologic patterns and clinical presentations are well known and documented. We report two cases of pulmonary tuberculosis with a neoplastic appearance on chest imaging diagnosed histologically. A 21 - year old female with cough, weight loss, anorexia and an unremarkable physical examination. Chest radiography showed a right apical mass suggestive of lung cancer. Histology of the lesion revealed parenchymal pulmonary tuberculosis. A 49-year old male with left-sided chest pain, cough, anorexia, weight loss, mild pallor with an unremarkable chest examination. Chest imaging showed a left apical mass and mediastinal lymphadenopathy. Microscopic examination of the mass confirmed pulmonary tuberculosis. Pseudotumour pulmonary tuberculosis is a rare clinical entity that can lead to diagnostic challenges and must be considered in the differential diagnosis when mass lesions are seen on chest imaging, especially in TB endemic areas. FUNDING: None declared.