Prevalence and risk factors of obesity among undergraduate student population in Ghana: an evaluation study of body composition indices.

BACKGROUND: Obesity is a classified risk factor for several of the world's leading causes of death. In this study, we combined information contained in body mass index (BMI), total percentage body fat (TPBF) and relative fat mass (RFM) to estimate obesity prevalence and examine the risk factors associated with obesity. METHODS: The study recruited 1027 undergraduate students aged between 16 and 25 years using a cross-sectional study design and two-stage stratified random sampling between January and April 2019 from the Kwame Nkrumah University of Science and Technology, Kumasi, Ghana. Demographic, lifestyle, and family history of chronic disease data, were collected using a structured questionnaire. Bioelectrical impedance, along with height, weight, age, and gender, were used to estimate BMI and TPBF. The RFM was calculated using a published equation. The TPBF and RFM ranges were evaluated based on standard BMI thresholds and an informative combined obesity prevalence estimated in a Bayesian framework. Multiple logistic regression analysis was used to evaluate potential risk factors of overweight/obesity. RESULTS: Concordance between BMI, TPBF and RFM for obesity classification was 84% among female and 82.9% among male students. The Bayesian analysis revealed a combined prevalence means of obesity of 9.4% (95%CI: 6.9-12.2%) among female students and 6.7% (95%CI:4.3-9.5%) among male students. The odds of obesity were increased between 1.8 and 2.5 for females depending on the classification index. A significant increasing trend of obesity was observed with university-level. A family history of obesity was associated with a high estimate of general, central, and high TPBF. CONCLUSION: Using multiple adiposity indicators conjointly in a Bayesian framework offers a greater power to examine obesity prevalence. We have applied this and reported high obesity prevalence, especially among female students. University level and family history of obesity were key determinants for obesity among the student population.

The relevance of knowledge, perception, and factors that influence contraceptive use among married women living in Uaddara Barracks, Ghana.

Background: Contraceptive use has many advantages for personal growth and societal advancement, but there is still the problem of unmet needs for women, which highlights the gap between women's reproductive intentions and contraceptive use. This study investigated knowledge, perceptions, and factors that influence contraceptive use among married women living in a military base in Ghana. Methods: This cross-sectional study involved 350 married women between the ages of 20 and 58 years at the Uaddara Barracks, Kumasi. A structured questionnaire was used to collect information on the background, knowledge, perceptions on contraceptive use, and contraceptive methods used by participants. Data was entered into an Excel sheet and analysed using R version 4.2.1. Results: Most of the participants were between the age range of 36 and 40 years (25.5%). Almost all study participants (97.4%), had heard about contraceptives with 80.6% showing a high level of knowledge on contraceptives. The majority of the women (84.6%) had previously used some form of contraceptives and 53.1% presently do. More than half of the participants (69.4%) had a positive perception of contraceptive use; 80.6% responded it was their own decision to use contraceptives, and 80.3% had the support of their husbands. Husbands' support of contraception resulted in a 5 times higher usage of contraceptives among women (aOR = 5.35; p < 0.001) while women who were married to military men were 45% (aOR = 0.45; p = 0.007) less likely to use contraceptive when compared to civilian wives. Demographic characteristics like being above 40 years (aOR = 0.25; p = 0.014), being a housewife (aOR = 0.42; p = 0.043) and working in the private sector (aOR = 0.33; p = 0.015) were significantly linked with less contraceptive use. Conclusion: The study showed that women used contraceptives at a rate that was much higher than the national norm at the Uaddara Barracks, demonstrating the beneficial influence men had on women's contraceptive use. This thereby underscores the need for interventional policies that prioritized the male as much as women, while emphasizing the benefits of contraceptive use to the family and not just as an awareness program only.

Predictors of medication nonadherence among hypertensive clients in a Ghanaian population: Application of the Hill-Bone and Perceived Barriers to Treatment Compliance Scale.

Background and Aim: Nonadherence to antihypertensive medication impairs optimal blood pressure and is influenced by multiple interrelating factors. Knowing the complexity of medication nonadherence and its associated factors is essential for intervention strategies. This study evaluated the predictors of medication nonadherence among hypertensive clients in a Ghanaian population. Methods: This was a hospital-based cross-sectional study conducted at the Hypertensive Clinic of the Kwame Nkrumah University of Science and Technology (KNUST) Hospital, Kumasi, Ghana. A self-designed questionnaire, the Hill-Bone Compliance to High Blood Pressure Therapy and Perceived Barriers to Treatment Compliance Scales, were used for data collection from 246 hypertensives. Data were analyzed using Statistical Package for Social Sciences, version 25. Results: Medication nonadherence was observed among 8.5% of the study participants. In a multivariate regression model perceived noneffectiveness of medication (odds ratio [OR] = 1.76, 95% confidence interval [CI]: 1.34-2.31, p < 0.001) and barriers to alcohol and smoking cessation (OR = 2.83, 95% CI: 1.31-6.13, p = 0.008) were associated increased odds of antihypertensive medication nonadherence. Also, patients who do not know their total prescription (OR = 8.81, 95% CI: 2.28-34.0, p = 0.002) were more likely to be nonadherent to their antihypertensive medications. Moreover, clients who associate signs/symptoms of palpitations (OR = 5.82, 95% CI: 1.31-25.80, p = 0.021), poor sleep (OR = 3.92, 95% CI: 1.09-14.12, p = 0.036) and decreased sexual drive (OR = 4.74, 95% CI: 0.96-23.28, p = 0.055), were more likely to be nonadherent to antihypertensive medication. Conclusion: In conclusion, we observed a lower nonadherence rate among hypertensive clients in a Ghanaian population with correlates being medication-related factors. Most importantly, perceived noneffectiveness of medication, barriers to smoking and alcohol cessation, palpitations, poor sleep, and decreased sexual drive significantly predicted lower adherence and could serve as indicators for high risk of nonadherence to antihypertensive medications.

Nexus between constructs of social cognitive theory model and diabetes self-management among Ghanaian diabetic patients: A mediation modelling approach.

The promotion of Diabetes Self-Management (DSM) practices, education, and support is vital to improving the care and wellbeing of diabetic patients. Identifying factors that affect DSM behaviours may be useful to promote healthy living among these patients. The study assessed the determinants of DSM practices among Type 2 diabetes mellitus (T2DM) patients using a model-based social cognitive theory (SCT). This cross-sectional study comprised 420 (T2DM) patients who visited the Diabetic Clinic of the Komfo Anokye Teaching Hospital (KATH), Kumasi-Ghana. Data was collected using self-structured questionnaires to obtain socio-demographic characteristics, T2DM-related knowledge, DSM practices, SCT constructs; beliefs in treatment effectiveness, level of self-efficacy, perceived family support, and healthcare provider-patient communication. Path analysis was used to determine direct and indirect effects of T2DM-related knowledge, perceived family support, and healthcare provider service on DSM practices with level of self-efficacy mediating the relationships, and beliefs in treatment effectiveness as moderators. The mean age of the participants was 53.1(SD = 11.4) years and the average disease duration of T2DM was 10 years. Most of the participants (65.5%) had high (>6.1mmol/L) fasting blood glucose (FBG) with an average of 6.93(SD = 2.41). The path analysis model revealed that age (p = 0.176), gender (p = 0.901), and duration of T2DM (p = 0.119) did not confound the relationships between the SCT constructs and DSM specified in the model. A significant direct positive effect of family and friends' support (Critical ratio (CR) = 5.279, p < 0.001) on DSM was observed. Self-efficacy was a significant mediator in this relationship (CR = 4.833, p < 0.001). There were significant conditional indirect effects (CIE) for knowledge of T2DM and family and friends' support at medium and high levels of belief in treatment effectiveness (p < 0.05) via level of self-efficacy on DSM practices. However, no evidence of moderated-mediation was observed for the exogenous variables on DSM. Diabetes-related knowledge of T2DM, family and friends' support, level of self-efficacy, and belief in treatment effectiveness are crucial in DSM practices among Ghanaian T2DM patients. It is incumbent to consider these factors when designing interventions to improve DSM adherence.

Predictors of Noncompliance to Antihypertensive Therapy among Hypertensive Patients Ghana: Application of Health Belief Model.

This study determined noncompliance to antihypertensive therapy (AHT) and its associated factors in a Ghanaian population by using the health belief model (HBM). This descriptive cross-sectional study conducted at Kintampo Municipality in Ghana recruited a total of 678 hypertensive patients. The questionnaire constituted information regarding sociodemographics, a five-Likert type HBM questionnaire, and lifestyle-related factors. The rate of noncompliance to AHT in this study was 58.6%. The mean age (SD) of the participants was 43.5 (±5.2) years and median duration of hypertension was 2 years. Overall, the five HBM constructs explained 31.7% of the variance in noncompliance to AHT with a prediction accuracy of 77.5%, after adjusting for age, gender, and duration of condition. Higher levels of perceived benefits of using medicine [aOR=0.55(0.36-0.82),p=0.0001] and cue to actions [aOR=0.59(0.38-0.90),p=0.0008] were significantly associated with reduced noncompliance while perceived susceptibility [aOR=3.05(2.20-6.25), p<0.0001], perceived barrier [aOR=2.14(1.56-2.92), p<0.0001], and perceived severity [aOR=4.20(2.93-6.00),p<0.0001] were significantly associated with increased noncompliance to AHT. Participant who had completed tertiary education [aOR=0.27(0.17-0.43), p<0.0001] and had regular source of income [aOR=0.52(0.38-0.71), p<0.0001] were less likely to be noncompliant. However, being a government employee [aOR=4.16(1.93-8.96), p=0.0002)] was significantly associated increased noncompliance to AHT. Noncompliance to AHT was considerably high and HBM is generally reliable in assessing treatment noncompliance in the Ghanaian hypertensive patients. The significant predictors of noncompliance to AHT were higher level of perceived barriers, susceptibility, and severity. Intervention programmes could be guided by the association of risk factors, HBM constructs with noncompliance to AHT in clinical practice.

Association of Wrist Circumference and Waist-to-Height Ratio with Cardiometabolic Risk Factors among Type II Diabetics in a Ghanaian Population.

The study determined the association of wrist circumference (WrC) and waist-to-height ratio (WHtR) with cardiometabolic risk factors among diabetics in a Ghanaian population. This cross-sectional study involved 384 diabetic patients at Begoro District Hospital, Ghana. Blood pressure, anthropometrics, and biochemical indices were measured. The overall prevalence of dyslipidaemia, metabolic syndrome (MetS), and hypertension was 42.4%, 76.3%, and 39.8%, respectively. The optimum cut-off range of WrC to identify individuals at increased cardiometabolic risk was 17.5 to -17.8 cm for men and 16.0 to 16.7 cm for women while that of WHtR was 0.52 to 0.61 for men and 0.53 to 0.59 for women. WrC for women was a significant independent predictor for MetS [aOR = 3.0 (1.39-6.72), p = 0.005] and systolic blood pressure [aOR = 2.08 (1.17-3.68), p = 0.012]. WHtR was a significant positive predictor for triglycerides [aOR = 3.23 (0.10-3.82), p = 0.001] for women. Using Framingham risk scores, 61% of the subjects had elevated 10-year risk of developing cardiovascular diseases (CVDs), with no significant difference in gender prevalence. WrC [aOR = 6.13 (0.34-111.4), p = 0.107] and WHtR [aOR = 2.52 (0.42-15.02), p = 0.309] were associated with statistically insignificant increased odds of moderate-to-high risk of developing CVDs in 10 years. The use of gender-specific cut-offs for WrC and WHtR may offer putative markers for early identification of CRFs.

Knowledge of bloodless medicine among nurses at the Medical/Surgical Directorate of Komfo Anokye Teaching Hospital, Ghana; a descriptive cross sectional study.

OBJECTIVE: This study assessed the knowledge of bloodless medicine (BM) among nurses at the medical and surgical directorate of Komfo Anokye Teaching Hospital. A paper questionnaire was administered to 322 nurses to obtain information on socio-demographic characteristics and knowledge of BM. RESULTS: More than half (52.1%) of the nurses were aware of BM. The major source of information on BM was from the internet. Out of the study population, 90.1% knew iron therapy as BM strategy. The largest proportions of the participants (51.2%) had witnessed BM treatment at the medical and surgical directorate with the Tot'hema (44.6%) being the major used drug. Flu-like symptoms (37.0%) and organ damage (50.0%) were the commonly known side effects of BM respectively. Most of the participants (97.5%) knew that doctors request for blood transfusion. The major known reason for demand of BM was religious beliefs (53.7%). Higher percentages (71.9%) of the participants were not aware of bloodless surgery although the few who were aware, had heard of this through an internet search. Participants were generally aware of BM but less knowledgeable of specific components of BM. There is the need for prompt hospital and public health education through workshops and in-service training.

Knowledge of complications of diabetes mellitus among patients visiting the diabetes clinic at Sampa Government Hospital, Ghana: a descriptive study.

BACKGROUND: Diabetes mellitus (DM) appears to be a global epidemic and an increasingly major non-communicable disease threatening both affluent and non-affluent society. The study aimed to determine the knowledge of diabetic complications among diabetes mellitus clients visiting the Diabetic Clinical at Sampa Government Hospital, Ghana. METHOD: This questionnaire-based descriptive study recruited a total 630 patients visiting the Diabetes Clinic at the Sampa Government Hospital. Structured questionnaire was used to obtain information such as socio-demographic and knowledge on complications of diabetes. RESULTS: Out of a total of 630 participants, 325 (51.5 %) knew diabetic foot as the most common complication followed by hypertension 223(35.4 %), neuropathy 184 (29.2 %), hypoactive sexual arousal 160(25.4 %), arousal disorder 135(21.5 %), eye diseases 112(17.7 %), heart disease 58(9.2 %), and renal disease 34(5.4 %). Comprehensive assessment of level of knowledge on the complications showed that majority 378(60.0 %) of T2D patients did not have knowledge on diabetes complications, 169(26.9 %) had inadequate knowledge on diabetics complication while 82(13.1 %) had adequate knowledge. The risk factors associated with the level of knowledge of diabetic complications were female gender adjusted odd ratio (AOR) =2.31 (1.56-3.41) married participants AOR = 3.37 (1.44-7.93), widowed AOR = 2.98 (1.10-8.08), basic level of education AOR =0.18 (0.082-0.50), Junior High School (JHS) and above of education level AOR = 0.035(0.017-0.75), 5-9 years of T2D duration AOR = 0.31(0.018-0.57), ≥10 years T2D duration AOR = 0.042 (0.02-0.10) and urban dwellers AOR = 0.36 (0.22-0.68) respectively. CONCLUSION: Participants knew the individual complication of diabetic mellitus but lack an in-depth knowledge on the complications. Further expansion of diabetic educative programs like using mass media and involving national curriculum of education can improve self-regulatory awareness of diabetic complications which may reduce the morbidity and mortality of diabetic patients.

Knowledge and Lifestyle-Associated Prevalence of Obesity among Newly Diagnosed Type II Diabetes Mellitus Patients Attending Diabetic Clinic at Komfo Anokye Teaching Hospital, Kumasi, Ghana: A Hospital-Based Cross-Sectional Study.

This study aimed to determine the knowledge and prevalence of obesity among Ghanaian newly diagnosed type 2 diabetics. This cross-sectional study was conducted among diagnosed type 2 diabetics. Structured questionnaire was used to obtain data. Anthropometric measurements and fasting blood sugar levels were also assessed. Participants had adequate knowledge about the general concept of obesity (72.0%) and method of weight measurement (98.6%) but were less knowledgeable of ideal body weight (4.2%). The commonly known cause, complication, and management of obesity were poor diet (76.9%), hypertension (81.8%), and diet modification (86.7%), respectively. The anthropometric measures were higher among females compared to males. Prevalence of obesity was 61.3% according to WHR classification, 40.8% according to WHtR classification, 26.1% according to WC, and 14.8% according to BMI classification. Being female was significantly associated with high prevalence of obesity irrespective of the anthropometric measure used (p < 0.05). Taking of snacks in meals, eating meals late at night, physical inactivity, excessive fast food intake, and alcoholic beverage intake were associated with increased prevalence of obesity (p < 0.05). Prevalence of obesity is high among diabetic patient and thus increasing effort towards developing and making education programs by focusing on adjusting to lifestyle modifications is required.