Lifestyle habits, macronutrient intake, and obesity prevalence among adolescents in rural-periurban community senior high schools in the Ho municipality of Ghana.

Background: Adolescence is a critical stage in the life cycle that presents a window of opportunity for the formation of lifetime habits or an aversion to childhood malnutrition effects. This study assessed the lifestyle habits, macronutrient intakes, and obesity prevalence among adolescents in some selected Senior High Schools in rural communities in Ho Municipality. Materials and methods: A cross-sectional survey was conducted among 272 adolescents aged 13-19 years and attending senior high schools in the Ho Municipality of Ghana. Data on sociodemographic, physical activity levels, dietary habits, and anthropometrics were obtained. A body mass index (BMI) and waist circumference (WC) were determined, while a repeated 24-h dietary recall was used to collect the dietary intakes of the participants. Results: The majority of the adolescents did not meet the Recommended Dietary Allowances (RDA) for calories (94.5%), dietary protein (68.8%), and fibre (91.5%). Adolescent boys consumed more calories (1,969.7 ± 579.9 Kcal) on average than adolescent girls (1,658.0 ± 458.7 Kcal) (p = 0.001). Overweight and obesity prevalence were 15.8 and 8.5%, respectively. About 90.4% of the adolescents did not meet the WHO recommended 150 min per week of physical exercise. On sedentary, 97.6% of adolescents spent half an hour to 5 h per day watching television when at home. Breakfast was the most frequently skipped meal (47.9%), and 59.6% of adolescents consumed fast foods such as pizza, burgers, and ice cream one to three times per week. Adolescent girls also had higher odds of being overweight or obese compared with adolescent boys (AOR = 2.4, p = 0.094, 95% CI = 0.9-6.4). Adolescents who did not meet the RDA for calories had lower odds of being overweight or obese compared with those who did (UOR = 0.3, p = 0.045, 95% CI = 0.1-0.9). Conclusion: Poor dietary habits and intake, sedentary lifestyle, and obesity prevalence were observed among the adolescents. Being an adolescent girl was associated with obesity risk, while not meeting caloric intake showed a protective effect. Efficient and effective nutrition and lifestyle education programme should be promoted in communities to improve the dietary intake and lifestyle habits of adolescents.

Evaluation of red blood cell count as an ancillary index to hemoglobin level in defining the severe falciparum malarial anemia among Ghanaian children in low-resource communities.

Our study evaluated red blood cell count as supporting hematological index to hematocrit level in predicting severe malarial anemia instead of the hemoglobin levels among malaria-infected children in Ghana. This case-control study was conducted at the Komfo Anokye Teaching Hospital (KATH) in Kumasi, Ghana. The study recruited 139 children, of which 45 were Controls (C), 43 with severe malaria (SM), and 51 with mild malaria (MM). Validated questionnaires were administered to obtain the socio-demographic data from each respondent. Venous blood was obtained for parasitemia count and to determine the hematological profile of each participant. With point of observation, data analysis was done. The mean age of the children was 4.22 ± 2.65 years. Median levels of hemoglobin (Hb) decreased in the order; C > MM > SM (P < 0.0001). There was a reduction in median levels of hematocrit (HCT) (P < 0.0001), RBC (red blood cells count) (<0.0001), from the MM to the SM. Among patients with severe malaria, there were a positive significant spearmen's co-efficient correlations between median levels of RBC (r = 0.652, P = 0.005) and HB (r = 0.640, P = 0.006) individually against HCT. However among the mild malaria patients only RBC (r = 0.884, P < 0.001) was positively correlated against HCT. At a cut-off of <4.0×106/uL for RBC and <8.8 g/dL for Hb, RBC (90.4%) recorded a slightly high accuracy in predicting severe falciparum malarial anemia than Hb (86.9%) among the cases. Red blood cell count may be a promising indicator to support hematocrit (<15%) in defining severe malarial anemia than hemoglobin level (<5 g/dL) among malaria-infected children from endemic areas in Ghana.

Parasitic infections among pregnant women at first antenatal care visit in northern Ghana: A study of prevalence and associated factors.

BACKGROUND: Parasitic infections remain widespread in developing countries and constitute a major public health problem in many parts of sub-Saharan Africa. It is prevalent among children under 5 years and pregnant women; however, studies among the later high risk group is limited in the northern part of Ghana. Here, we evaluated the prevalence and associated factors of parasitic infections among pregnant women at first antenatal care visit in northern Ghana. METHODS: This was a cross-sectional study conducted at the Department of Obstetrics and Gynecology, Bolgatanga Regional Hospital, Upper East Region-Ghana. A total of 334 consecutive consenting pregnant women were included. Questionnaires were administered to obtain socio-demographic data. Venous blood, stool and urine samples were collected for parasite identification using microscopy. Factors associated with parasitic infections were evaluated using regression models. Statistical analysis was performed using R. RESULTS: Parasitic infections identified were giardiasis (30.5%), P. falciparum malaria (21.6%) and schistosomiasis (0.6%). Polyparasitic infection was identified in 6.6% of the population. Increasing age [Age of 20-29 years: AOR = 0.16, 95% CI (0.06-0.38); Age of 30-39 years: AOR = 0.21, 95% CI (0.08-0.50); Age >39 years: AOR = 0.30, 95% CI (0.11-0.83)] was associated with lower odds whiles presence of domestic animals [AOR = 1.85, 95% CI (1.01-3.39)], being in the second trimester of pregnancy [AOR = 2.21, 95% CI (1.17-4.19)], having no formal education [AOR = 3.29, 95% CI (1.47-7.35)] and basic education as the highest educational level [AOR = 6.03, 95% CI (2.46-10.81)] were independent predictors of increased odds of giardiasis. Similarly, having no formal education [AOR = 2.88, 95% CI (1.21-8.79)] was independently associated with higher odds of P. falciparum malaria. The use of insecticide treated net (ITN) [AOR = 0.43, 95% CI (0.21-0.89)] and mosquito repellent [AOR = 0.09, 95% CI (0.04-0.21)] were independent predictors of lower odds of P. falciparum malaria. CONCLUSION: Giardiasis and P. falciparum malaria are common among pregnant women in northern Ghana. The major associated factors of giardiasis are lack of or low level of formal education, the presence of domestic animals and being in the second trimester of pregnancy. Increasing age confers protection against giardiasis. Likewise, lack of formal education is an associated factor for P. falciparum malaria among pregnant women in northern Ghana. The use of ITN and mosquito repellents reduce the risk of P. falciparum malaria. Given the possible role of parasitic infections in adverse pregnancy outcomes, our findings highlight the need for regular screening and treatment of infected women in the northern parts of Ghana. Public health education and improving socio-economic status could help reduce the risk of parasitic infections among pregnant women in the region.

Nutritional risk markers among stroke out-patients at the neurology clinic of a teaching hospital in Ghana.

INTRODUCTION: stroke survivors are at risk of malnutrition due to inadequate dietary intake, as a result of neurological disorders causing dysphagia, depression and impaired ability to self-feed. There is paucity of information on nutritional status of stroke survivors after discharge from hospital care, hence, this study sought to determine the nutritional risk markers among stroke out-patients at the Neurology Clinic of Komfo Anokye Teaching Hospital, Kumasi, Ghana. METHODS: a cross-sectional study was conducted among 106 stroke survivors at Komfo Anokye Teaching Hospital, Kumasi, Ghana. Nutritional status of stroke survivors was assessed, using body mass index (BMI) and mid upper arm circumference (MUAC). Biochemical and haematological nutrition indicators including total serum protein, serum albumin, total lymphocyte count, uric acid and haemoglobin were also determined. Independent t-test and ANOVA were used to test differences between mean values. RESULTS: the mean age of study participants was 58.47±14.2 years, with 56% being females. Overall, 96 (88.7%) of the participants had malnutrition, of whom 66 (68.8%) were undernourished, while 30 (31.2%) had overnutrition. It was also found that 38.7% of the participants were anaemic, based on haemoglobin levels. Using mean BMI, stroke survivors who had been discharged over five years were significantly overweight (p = 0.010). CONCLUSION: there was high level of malnutrition among stroke out-patients in this study. The most common nutrition-related problem in the stroke survivors studied was anaemia. Findings from this study suggest the need for nutrition intervention strategies to address the high burden of malnutrition among the stroke survivors.

Oxidative Stress and Hemoglobin Level of Complicated and Uncomplicated Malaria Cases among Children: A Cross-Sectional Study in Kumasi Metropolis, Ghana.

INTRODUCTION: Malaria is a leading cause of mortality among children below 5 years in Ghana. Its parasites are known to cause the degradation of hemoglobin, resulting in the production of reactive oxygen species and hence oxidant stress. Therefore, this study was carried out to compare the levels of oxidative stress between children with complicated and uncomplicated malaria infection in Kumasi, Ghana. METHOD: Subjects were recruited from hospitals in the Kumasi Metropolis. This was a cross-sectional study, involving 17 complicated malaria subjects, 51 uncomplicated malaria subjects, and 15 nonparasitemic subjects. The rapid diagnostic test (RDT) was used to determine presence or absence of falciparum malaria among the study participants. Blood samples from subjects were used to determine hemoglobin, malondialdehyde (MDA), and vitamin C levels. RESULTS: Majority of the subjects (67.5%) were within the age of 0-5 years. The mean age (±SD) of uncomplicated malaria subjects was 4.32 (±2.81) years, while that of complicated malaria was 4.27 (±2.96). Mean levels of HB decreased significantly in the following order: control subjects > uncomplicated malaria subjects > complicated malaria subjects (p<0.0001). Mean levels of MDA were significantly lower in control subjects compared to complicated malaria subjects (4.62±1.85 versus 6.68±0.70, p=0.0008) and also lowered in uncomplicated malaria subjects compared to complicated malaria (4.50±1.58 versus 6.68±0.70, p<0.0001). There was a statistically significant reduced mean level of vitamin C (p=0.036) in the following order: control subjects > uncomplicated malaria > complicated malaria subjects. However, for the complicated malaria cases, there were significantly higher mean vitamin C levels in females than in males (p<0.001). CONCLUSION: Malaria progression increases MDA levels and decreases the ascorbate (vitamin C) and hemoglobin levels. It is recommended that future studies should investigate changes in other antioxidant vitamins, like vitamins A and E.

Biochemical and hematological changes among anemic and non-anemic pregnant women attending antenatal clinic at the Bolgatanga regional hospital, Ghana.

BACKGROUND: Anemia in pregnancy may not only be associated with maternal morbidity and mortality but can also be detrimental to the fetus. A definitive diagnosis of anemia is a pre-requisite to unravelling possible cause(s), to allow appropriate treatment intervention. It is hypothesised that measured hemoglobin (HGB), complemented by biochemical and other hematological parameters would enhance anemia diagnosis. METHODS: This was a cross-sectional study among 400 pregnant women comprising 253 anemic and 147 non-anemic pregnant women, attending an antenatal clinic at Bolgatanga Regional Hospital, Ghana. Venous blood was collected and hemoglobin genotype, complete blood count and biochemical parameters [ferritin, iron, total iron binding capacity (TIBC), transferrin saturation (TfS), C-reactive protein (CRP) and bilirubin] were determined. Thick blood films were prepared for malaria parasitemia, while early morning stool and midstream urine samples were examined for enteric and urogenital parasites, respectively. RESULTS: There were significantly reduced levels of HGB (p < 0.0001), HCT (p < 0.0001), MCV (p < 0.0001), iron (0.0273), ferritin (p = 0.018) and transferrin saturation (0.0391) and increased WBC (p = 0.006), RDW (p = 0.0480), TIBC (p = 0.0438) and positivity of CRP in anemic, compared to non-anemic pregnant women. Anemic women were associated with increased proportion of hemoglobinopathies (AS, SS and SC), Plasmodium falciparum, Schistosoma hematobium and intestinal parasite infections. CONCLUSION: Anemic pregnant women are associated with a significant derangement in hematological and iron indices that implicate iron deficiency. This was influenced by hemoglobinopathies and parasitic infections.

Relation of unsupported and unsupervised exercise with anthropometric and biochemical indices among type 2 diabetic patients.

BACKGROUND/AIM: Type 2 diabetes is a lifestyle-related condition. Lifestyle modification in the management of type 2 diabetes incorporates exercise. The aim of this study was to find out how unsupported and unsupervised exercise relates to anthropometric indices and biochemical indices in type 2 diabetes patients. MATERIALS AND METHODS: In the cross-sectional study, a structured questionnaire was used to access data on the exercise history of patients. Subjects were classified according to exercise intensity. The dietary intake of patients was obtained by 24-h recall. Standard measurements were taken of waist circumference and blood pressure. Blood samples were also collected to measure biochemical parameters. RESULTS: Waist circumference, body mass index, and triglycerides were significantly lower (P < 0.05) in type 2 diabetics who engaged in high-intensity exercise than in those who engaged in low-intensity exercise. Systolic blood pressure was significantly lower (P < 0.05) in the moderate-intensity exercise group than in the low-intensity exercise group. CONCLUSION: Unsupported exercise was found to be related to favorable anthropometric indices (waist circumference and body mass index), blood pressure, and triglycerides.

Sociodemographic and Obstetric Characteristics of Anaemic Pregnant Women Attending Antenatal Clinic in Bolgatanga Regional Hospital.

The study determined the sociodemographic and obstetric characteristics of pregnant women which contribute to the risk of developing anaemia. A cross-sectional study was conducted among 400 pregnant women attending their first antenatal visit at the Bolgatanga Regional Hospital Antenatal Clinic. Anaemia was significantly associated (p < 0.05) with younger maternal age, parity, gravidity, trimester of pregnancy, and source of drinking water. Multivariate logistic regression identified the following factors with adjusted odds ratios (aOR) and 95% confidence intervals (CI): unemployment (aOR = 4.76 (CI: 2.26-11.33); p < 0.0001), rural dwelling (aOR = 3.10 (CI: 2.16-4.91); p = 0.0071), primigravida (aOR = 2.13 (CI: 1.34-3.18); p = 0.0201), nulliparity (aOR = 1.92 (CI: 1.23-2.86); p = 0.0231), first antenatal visit at second trimester (aOR = 1.71 (CI: 1.33-3.12); p = 0.0149) and first antenatal visit at third trimester (aOR = 2.73 (CI: 1.24-4.35); p = 0.0017), drinking from well and boreholes (aOR = 2.78 (CI: 2.27-5.21); p < 0.0001), and the presence of domestic livestock (aOR = 2.15 (CI: 1.33-3.68); p = 0.0019). This study has shown the various sociodemographic and obstetric factors which significantly contribute to anaemia in pregnancy.

Prevalence of metabolic syndrome in type 2 diabetes mellitus patients.

BACKGROUND: The diabetic condition is influenced by several factors, some of which can accelerate the disease's progression to various complications that aggravate the morbidity. AIMS: This study aimed at determining the prevalence of metabolic syndrome (MetS) and its individual components and the most critical predictive risk factors of MetS in type 2 diabetic patients. MATERIALS AND METHODS: This cross-sectional study involved 150 type 2 diabetes mellitus patients and was conducted at the Diabetes Centre of the Komfo Anokye Teaching Hospital in Kumasi, the Ashanti Region of Ghana, from February, 2013 to April, 2013. The study involved the use of a questionnaire to obtain some information on the diabetics, undertaking anthropometric measurements, as well as collecting blood samples for the measurement of some biochemical parameters; fasting blood glucose and lipid profile. MetS was defined according to the National Cholesterol Education Program/Adult Treatment Panel III criteria. RESULTS: The prevalence of MetS was 58% in the studied Ghanaian population. Hypertension was the commonest risk factor (60%), followed by central obesity (48.67%) and dyslipidemia (37%). Female type 2 diabetics had a higher prevalence of MetS, and carried more components than their male counterparts. Regression analysis showed three factors; femininity, high body mass index and low educational status were the most critical predictive risk factors of MetS, according to this study. CONCLUSION: With hypertension being the commonest component, future cardiovascular disease prevention strategies should focus attention on its management and prevention, through education.

Comparative haematological parameters of HbAA and HbAS genotype children infected with Plasmodium falciparum malaria in Yemen.

BACKGROUND: Sickle haemoglobin (HbS) is known to offer considerable protection against falciparum malaria. However, the mechanism of protection is not yet completely understood. In this study, we investigate how the presence of the sickle cell trait affects the haematological profile of AS persons with malaria, in comparison with similarly infected persons with HbAA. This study is based on the hypothesis that the sickle cell trait plays a protective role against malaria. METHODS: Children from an endemic malaria transmission area in Yemen were enrolled in this study. Hematological parameters were estimated using manual methods, the percentage of parasite density on stained thin smear was calculated, haemoglobin genotypes were determined on paper electrophoresis, ferritin was measured using enzyme-linked immunosorbent assay, serum iron and TIBC were assayed using spectrophotometer, transferrin saturation index was calculated by dividing serum iron by TIBC and expressing the result as a percentage. Haematological parameters were compared in HbAA- and HbAS-infected children. RESULTS: Falciparum malaria parasitaemia was confirmed in the blood smears of 62 children, 44 (55.7%) of AA and 18 (37.5%) AS, so there was higher prevalence in HbAA children (P = 0.047). Parasite density was lower in HbAS- than HbAA-infected children (P = 0.003). Anaemia was prominent in malaria-infected children, with high proportions of moderate and severe forms in HbAA (P = 0.001). The mean levels of haemoglobin, packed cell volume, reticulocyte count, platelets count, lymphocytes, eosinophils, and serum iron were significantly lower while total leukocytes, immature granulocytes, monocytes, erythrocyte sedimentation rate, transferrin saturation, and serum ferritin were significantly higher in HbAA-infected children than HbAS-infected children. CONCLUSION: Infection with Plasmodium falciparum malaria caused more significant haematological alterations of HbAA children than HbAS. This study supports the observation that sickle cell trait seems to be a beneficial genetic factor that resists malaria, since inheriting it protects against significant haematological consequences of malaria.

The incidence of malaria and the comparison of hematological and biochemical indices of Plasmodium falciparum-parasitemic and aparasitemic sickle cell disease (SCD) patients.

Hemolytic anemia is common in sickle cell disease (SCD), but the course and extent differ, depending on genetic, epigenetic, and environmental factors. In the malaria-endemic tropical environment, some vulnerable subjects would be infected and the impact of infection would vary. Therefore, this study was to find malaria incidence and the associated changes in some laboratory indices in 330 SCD subjects. Following blood smear preparation for falciparum detection, hematological and biochemical indices were measured for a comparison of parasitemic and age-matched, genotype-matched, and sex-matched nonparasitemics. For sixty-nine parasitemics, constituting about 21% of all subjects studied, and sixty-six matched nonparasitemics, hematological indices (hemoglobin, white-cell count, red-cell count, mean cellular volume, reticulocyte count, and HbF) as well as biochemical indices (LDH, total bilirubin, AST, and ALT) were determined. For all quantities, except the reticulocyte count (12.3% ± 12.4% for parasitemics and 23.6% ± 17.7% for nonparasitemics), no statistically significant differences were observed. Classification of both cohorts according to their genotypes showed some intergenotypic differences for hemoglobin and WBC counts. Mathematical modeling of the reticulocyte counts shows the distribution in the parasitemics followed an exponential pattern, while the nonparasitemic showed a polynomial distribution, with each model characterized by an equation of best fit. The study has shown about 21% incidence of parasitemia. All differences in the indices can be seen as normal variations, unattributable to the malaria infection. However, the lower reticulocyte count in the parasitemic is a reflection of lowered erythropoietic activity because of the infection.