Correction: Dry eye, its clinical subtypes and associated factors in healthy pregnancy: A cross-sectional study.

[This corrects the article DOI: 10.1371/journal.pone.0258233.].

Psychological impact of COVID-19 on diabetes mellitus patients in Cape Coast, Ghana: a cross-sectional study.

INTRODUCTION: COVID-19 pandemic has had a greater psychological impact on patients with chronic ailments such as diabetes mellitus, tuberculosis, and HIV/AIDS compared to those without chronic conditions. We explored the psychological impacts of COVID-19 among people living with diabetes mellitus in Ghana. METHODS: this study employed a hospital-based cross-sectional design involving 157 diabetes mellitus patients aged 20 years and above. We assessed diabetes distress by the seventeen-item diabetes stress (DDS17) scale and COVID-19 worries by 3 specific benchmarks: "worry about overly affected due to diabetes if infected with COVID-19", "worry about people with diabetes characterized as a risk group" and "worry about not able to manage diabetes if infected with COVID-19". A close-ended questionnaire was used in data collection. RESULTS: of 157 diabetic patients interviewed, the majority had type 2 diabetes mellitus with known complications and only 42.7% were managing COVID-19 symptoms. The participants showed moderate to high level of COVID-19 specific worry, moderate fear of isolation, and low level of diabetes-associated distress. About 33.8% of the study population expressed a sense of worry towards the pandemic. The logistic regression showed that age, employment status, and presence of other chronic diseases were significantly associated with worries about being overly affected if infected with COVID-19 due to their diabetes status. Age and sex were associated with worries about people with diabetes being characterized as a risk group and age, sex and employment status were associated with participants who were worried about not being able to manage diabetes if infected with COVID-19. CONCLUSION: the general trend indicates a sense of worry among diabetes patients during the COVID-19 pandemic which is associated with poorer psychological health. Clients' education and counseling on COVID-19 are necessary to address some of their concerns to minimize the level of anxiety and emotional stress in these individuals.

Dry eye, its clinical subtypes and associated factors in healthy pregnancy: A cross-sectional study.

The study determined the frequency of dry eye, its clinical subtypes and risk factors among pregnant women. This study was a hospital-based cross-sectional study of pregnant women visiting the antenatal clinic of the University of Cape Coast hospital. Clinical dry eye tests were performed along with the administration of a symptom questionnaire. Frequencies, chi-square analysis and logistic regression analyses were conducted to determine the frequency of dry eye disease, its clinical subtypes and associated factors. The prevalence of dry eye disease among the cohort of pregnant women was 82/201 (40.8% 95% confidence interval 34.3%-47.3%). Among the 82 pregnant women with dry eye disease, the frequencies of the clinical subtypes of dry eye were: evaporative dry eye [15/82(18.3%; 95% CI, 12.2%-25.2%)], aqueous deficient dry eye [10/82(12.2.%; 95% CI, 7.3%-18.3)], mixed dry eye [6/82(7.3%; 95% CI, 3.7%-11.0%)], and unclassified dry eye [51/82(62.2%; 95% CI, 52.4%-72.0%)]. Binary logistic regression analysis showed that the following factors were not significantly associated with dry eye: age, BMI, lipid profile, prolactin level, testosterone level, ocular protection index and blink rate. Only gestational age was significantly associated with dry eye disease in pregnancy. In conclusion, the current study showed that dry eye disease occurs frequently in pregnant women ranging from the first to the third trimester and it is associated with increasing gestational age. The evaporative dry eye was more common compared to the aqueous deficient dry eye, but most dry eye could not be classified.

Climate change causes changes in biochemical markers of kidney disease.

BACKGROUND: Climate change is a significant threat to the health of the Ghanaian people. Evidence abounds in Ghana that temperatures in all the ecological zones are rising, whereas rainfall levels have been generally reducing and patterns are increasingly becoming erratic. The study estimated the impact of climate variation between seasons on biochemical markers of kidney disease. METHODS: This study conveniently recruited 50 apparently healthy peasant farmers and hawkers at Wa in the Upper West Region of Ghana. A pre-study screening for hepatitis A and C, Diabetes mellitus, hypertension was done. Serum creatinine and urea levels were analyzed to rule out kidney preexisting kidney disease. Baseline data was collected by estimating urea, creatinine, sodium, potassium, eGFR (estimated glomerular filtration rate) as well as for hemoglobin (Hb) and hematocrit (Hct) concentrations. Anthropometric data such as height, weight and blood pressure were measured by trained personnel. The study participants were closely followed and alerted deep in the dry season for the second sampling (urea, creatinine, hemoglobin, hematocrit, blood pressure, anthropometry). RESULTS: This study recruited more males (58.82%) than females (41.15%), majority (52.92%) of which were aged 25-29 years with the youngest being 22 years and the eldest being 35 years. The study found body mass index (p < 0.001), systolic blood pressure (p = 0.019), creatinine (p < 0.001), urea (p = 0.013) and eGFR (p < 0.001) to be significantly influenced by climate change. Stage 1 hypertension was predominant among the study participants during the dry season, 8 (15.69%) than was observed during the rainy season, 4 (7.84%) nonetheless the number of participants with normal BMI rose from 49.02% in the rainy season to 62.75% during the dry reason. Additionally, the study observed that the impact of climate change on systolic blood pressure and urea varied based on age and sex. CONCLUSION: This study revealed that climatic changes cause variations in various biochemical parameters used to assess kidney function. Public health education on climatic changes and its implication including precautionary measures should be done among inhabitants of Wa and its environs to reduce its effect. Additionally, appropriate dietary patterns should also be advised to avoid the development of non-communicable diseases such as hypertension and obesity that are known principal causes of Chronic Kidney Disease (CKD).

Spectrum and Clinical Characteristics of Renal Diseases in Ghanaian Adults: A 13-Year Retrospective Study.

BACKGROUND: Renal diseases over the years have become one of the leading causes of morbidity and mortality worldwide. In this study, we assessed the spectrum and clinical characteristics of Ghanaians with renal diseases at the nephrology unit of Komfo Anokye Teaching Hospital (KATH), Kumasi. METHODS: This was a retrospective hospital-based study conducted at Komfo Anokye Teaching Hospital (KATH) from the years 2005 to 2017. A non-randomized sampling approach was used to include 1426 participants who were diagnosed with AKI, CKD, ESRD, and nephrotic syndrome at the nephrology unit of KATH during the years under review. All the 1426 patients were eligible for the study. Demographic characteristics as well as clinical data such as the kind of renal disease presentation, causes of the renal disease, and the treatment options were also obtained from their records. RESULTS: Overall, 1009 of the total participants had CKD (70.76%), 295 participants had ESRD (20.69%), 72 participants had AKI (5.05%), and 50 participants had nephrotic syndrome (3.51%). Furthermore, 69 (23.4%) participants with ESRD were on dialysis whiles 6 (8.3) and 17 (1.7) participants with only AKI and CKD superimposed AKI, respectively, were on dialysis. 226 (76.6%) participants with ESRD were on conservative therapy. Hypertension emerged as the major cause of renal disease presentation (53.93%) with bilateral leg edema (13.46%) being the major complaint. There was a significant association between CKD and age (p ≤ 0.001). Nephrotic syndrome also showed a significant association with age (p ≤ 0.001). CONCLUSION: This study revealed that patients at the nephrology unit of KATH, Ghana, are mainly adults between ages 46-55. The clinical pattern of renal diseases is dominated by CKD and ESRD. We conclude that hypertension, chronic glomerulonephritis, diabetic nephropathy, and sepsis are the most common causes of renal diseases. The commonest clinical presentations are bilateral leg edema, palpitations, headache, breathlessness, dizziness, and vomiting. Early diagnosis and management of these conditions may prevent or delay the progress to end-stage renal disease.

Evaluation of Renal Function in Pregnant Women with Malaria: A Case-Control Study in a Mesoendemic Area.

Background. Malaria is known to have devastating effects on mortality in tropical and subtropical regions with the effect being magnified in people with weakened immunity such as those in pregnancy. We assessed the effect of malaria on renal function of pregnant women receiving antenatal care in a mesoendemic area of Ghana. Methodology. A case-control study that enrolled a total of 100 pregnant women (50 with confirmed gestational malaria as cases and 50 without malaria as controls). Sociodemographic characteristics, obstetric history (obtained with a questionnaire), urea, creatinine, sodium, and potassium were analyzed using a chemistry automated analyzer. Results. Plasma urea and creatinine were significantly increased (P = 0.0003 and P < 0.0001, resp.) among cases compared to the controls. Also the levels of urea (P = 0.033), creatinine (P = 0.032), and parasitaemia (0.016) were significantly increased with increasing gestational age. Conclusion. Malaria has a significant impact on renal function (most importantly, urea and creatinine) and is also significantly associated with increasing gestational age among our study participants.

Determinants of Crystalluria among Type 2 Diabetes Patients; A Case-Control Study of the Agona West Municipality, Ghana.

BACKGROUND/AIM: Type 2 diabetes mellitus (T2DM) has been implicated as a risk factor for nephrolithiasis. The aim of this study was to determine the prevalence and types of crystalluria among individuals with T2DM. It further sought to identify associated risks, which could influence crystalluria. METHODS: A case-control study with random sampling of 165 diabetes patients (cases) and 40 healthy non-diabetics (controls) was conducted from December 2012 to May 2013 at the Agona Swedru Municipal Hospital, Ghana. Sociodemographic and anthropometric data were obtained from the participants. Blood and urine samples were collected for the estimation of blood glucose (fasting) and urinalysis for the presence of crystals, respectively (light microscopy). RESULTS: Overall frequency of crystalluria was 18.0%. The prevalence of urine crystals in diabetics (17.5%) was more than that in non-diabetics (5.0%). Types of crystals found in the T2DM patients by prevalence were calcium oxalate (12.7%), uric acid (3.6%), and tyrosine (1.2%). Mean age, body mass index, systolic blood pressure, and fasting blood glucose (FBG) were higher among case participants than in controls (P < 0.001; P < 0.001; P = 0.018; P < 0.001). Case participants had a lower urine pH than the controls (P < 0.001). Crystalluria was positively correlated with FBG (P = 0.002) and negatively with urine pH (P = 0.108). On multivariate analysis, FBG was independently associated with crystalluria (P = 0.002), after adjustment for other factors. CONCLUSION: Crystalluria is common in diabetes patients. Acidic urine pH is mostly seen in T2DM and may be a predisposing factor to crystalluria. Good glycemic control may be a helpful in reducing the occurrence of crystalluria among T2DM.

Retinal Microvasculopathy Is Common in HIV/AIDS Patients: A Cross-Sectional Study at the Cape Coast Teaching Hospital, Ghana.

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.

High prevalence of hepatitis B and poor knowledge on hepatitis B and C viral infections among barbers: a cross-sectional study of the Obuasi municipality, Ghana.

BACKGROUND: Barbers, while shaving, may be accidentally exposed to the blood and bodily fluids of their customers increasing their risk of contraction of HBV and HCV infections. Hence, this study aimed at examining the prevalence and knowledge of barbers on HBV and HCV infections in the Obuasi municipality of Ghana. METHODS: A work place based cross-sectional study was conducted from January to April 2015 at the Obuasi municipality in the Ashanti Region of Ghana. Two hundred (200) barbers were conveniently recruited and blood sample of each participant collected for the detection of HBsAg and HCV antibodies. Data on socio demographic characteristics, and knowledge on HBV and HCV infections were collected using a structured and pre-tested questionnaire. Analysis was performed using SPSS version 16.0, and P < 0.05 was considered statistically significant. RESULTS: The prevalence of HBV and HCV among the barbers were 14.5 % and 0.5 % respectively. HBV was highest among barbers within 20-29 years (58.6 %). Majority (90.5 %) of the participants had heard of HBV infection before. The mode of transmission of HBV was unknown by 64.5 % of the participants and 64.0 % did not perceive themselves to be at risk for HBV. Most of the participants had never heard of HCV infection (61.3 %), and unaware of any mode of transmission of HCV (97.0 %). The radio was the major source of information on HBV (57.5 %) and HCV (25.0 %) infections. CONCLUSION: High prevalence of HBV and low knowledge on HBV and HCV infections was found among barbers. Barbers need to be educated on viral hepatitis to reduce the acquisition of HBV and HCV infections.

Chronic kidney disease is common in sickle cell disease: a cross-sectional study in the Tema Metropolis, Ghana.

BACKGROUND: Renal involvement in sickle cell disease (SCD) contributes significantly to morbidity and mortality. The aim of this study was to determine the prevalence of chronic kidney disease (CKD) amongst SCD patients, and how basic clinical variables differ across haemoglobin genotypes. METHODS: A hospital-based cross-sectional study conducted from December 2013 to May 2014 at the Sickle cell clinic of the Tema General Hospital. One hundred and ninety-four (194) participants with SCD, receiving medical care at the outpatient sickle cell clinic were enrolled onto the study. A structured questionnaire was administered to obtain information on demography, clinical history, blood pressure and anthropometry. Blood and urine samples were taken for serum creatinine and proteinuria determination respectively. The estimated GFR (eGFR) was calculated using the CKD-EPI and Schwartz equations. CKD was defined according to the Kidney Disease Improving Global Outcomes (KDIGO) guidelines. Analysis was performed using GraphPad prism and P <0.05 was considered statistically significant. RESULTS: CKD was present in 39.2% of participants. Using KDIGO guidelines, 40.8% of the HbSS participants had stage 1 CKD and none had stage 2 CKD. In addition, 30.8% of the HbSC participants had stage 1 CKD and 3.8% had stage 2 CKD. There was a trend of increasing age across CKD stages and stage 2 CKD participants were oldest (P < 0.001). CONCLUSION: Results from the current study suggest that CKD is common amongst SCD patients and prevalence and intensity increases with age. Proteinuria and CKD was more common in HbSS genotype than in HbSC genotype.

Serum calcium and magnesium levels in women presenting with pre-eclampsia and pregnancy-induced hypertension: a case-control study in the Cape Coast metropolis, Ghana.

BACKGROUND: Hypertensive disorders of pregnancy are important causes of morbidity and mortality. The levels of calcium (Ca2+) and magnesium (Mg2+) in pregnancy may implicate their possible role in pregnancy-induced hypertension. This study assessed serum Ca2+ and Mg2+ levels in women with PIH (pregnancy-induced hypertension) and PE (pre-eclampsia), compared to that in normal pregnancy. METHODS: This case-control study was conducted on 380 pregnant women (≥20 weeks gestation) receiving antenatal care at three hospitals in the Cape Coast metropolis, Ghana. This comprised 120 women with PIH, 100 women with PE and 160 healthy, age-matched pregnant women (controls). Demographic, anthropometric, clinical and obstetric data were gathered using an interview-based questionnaire. Venous blood samples were drawn for the estimation of calcium and magnesium. RESULTS: Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were significantly raised in women with PIH (p < 0.0001) and PE (p < 0.0001). Women with hypertensive disorders (PE and PIH) had significantly lower serum calcium and magnesium levels than those in the control group (p < 0.0001 each). Of those with PIH, SBP correlated positively with BMI (r = 0.575, p < 0.01) and Ca2+ correlated positively with Mg2+ (r = 0.494, p < 0.01). This was similar amongst the PE group for SBP and BMI as well as for Ca2+and Mg2+ but was not significant. Multivariate analysis showed that women aged ≥40 years were at a significant risk of developing PIH (OR = 2.14, p = 0.000). CONCLUSION: In this study population, serum calcium and magnesium levels are lower in PIH and PE than in normal pregnancy. Mineral supplementation during the antenatal period may influence significantly, the occurrence of hypertensive disorders in pregnancy.