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Eur J Orthop Surg Traumatol ; 33(3): 449-457, 2023 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-36780012


INTRODUCTION: Globally, injuries account for about 5 million deaths every year out of which 90% occur in low- and middle-income countries. Injuries, particularly trauma, place a lifelong burden on affected individuals, families and society. In Ghana and most African countries particularly in sub-Saharan Africa, there is no effective surveillance system or registry of trauma. Where they exist, they are often poorly developed and incomplete. OBJECTIVE: The study was set out to document long bone fracture injuries which will be used for research, education, policy and public health prevention programmes as well as documenting the experience in setting up trauma registries in a LMIC. METHODS: The study is being conducted at the four Teaching Hospitals in Ghana which are situated in Cape Coast, Kumasi, Accra and Tamale. Persons of any age (from birth) who reports to any of the sentinel sites with an incident of trauma to long bones are eligible for recruitment into the surveillance data collection. Data were captured using the Research Electronic Data Capture (REDCap), cleaned and exported to Stata for analysis. RESULTS: Cumulatively, the sites had enrolled 3493 cases at one year of implementation. A total of 678 (19.41%) paediatric and 2815 (80.59%) adult cases were recorded over the period. In the establishment of the TRANET, we identified challenges in the planning, during data collection, data entry, follow-ups, support from local health authorities, and administrative issues. Quality improvement interventions were put in place, and it resulted in improved data quality. CONCLUSION: The established trauma registry of Ghana is assuring as it offers a timely, accurate, and comprehensive data source which will be useful for continuous monitoring of trauma care in Ghana. This first-year review information/findings will serve as a relevant information for stakeholders working to strengthen the health system.

Exactitud de los Datos , Fuentes de Información , Adulto , Humanos , Niño , Ghana/epidemiología , Sistema de Registros , Mejoramiento de la Calidad
Clin Med Insights Cardiol ; 16: 11795468221120092, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36060113


Introduction: Hypertension is an important public health menace globally and in sub-Saharan Africa. The prevalence of hypertension is on the rise in low- and lower-middle-income countries (LMIC) such as Ghana. This rise led to the adoption of the May Measurement Month (MMM) initiative, a global blood pressure screening campaign. We aimed to create awareness and present the findings of the 2019 MMM screening campaign in the Ashanti region of Ghana. Methods: Ghana was 1 of 92 countries that participated in this global community-based cross-sectional study in May 2019. Participants (⩾18 years) were recruited by opportunistic sampling. The blood pressures of participants were measured 3 times and the mean of the last 2 was used for the analysis. Summary statistics were used to describe the data. Simple and multiple logistic regression models were used to determine the predictors of hypertension. Results: We screened 3080 participants with a mean age of 39.8 ± 16.8 years. The prevalence of hypertension was 27.3% among participants. Two-thirds of the hypertensives were unaware of their condition and only 49.5% of participants with a history of hypertension on medication were controlled. Predictors of hypertension in a multiple logistic regression were increasing age (OR = 1.05 (CI 1.04-1.06), P < .001) and high body mass index (OR = 1.06 (1.02-1.10), P = .005). Conclusion: The MMM initiative is highly commendable and of huge public health importance in LMICs like Ghana. Population-based health programs such as the MMM initiative is encouraged to shape appropriate public health policies to reduce the prevalence of hypertension.

Front Genet ; 13: 802355, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35281803


Sickle cell disease (SCD) is the most common clinically significant hemoglobinopathy, characterized by painful episodes, anemia, high risk of infection, and other acute and chronic complications. In Africa, where the disease is most prevalent, large longitudinal data on patients and their outcomes are lacking. This article describes the experiences of the Kumasi Center for SCD at the Komfo Anokye Teaching Hospital (KCSCD-KATH), a Sickle Pan-African Research Consortium (SPARCO) site and a SickleInAfrica Consortium member, in establishing a SCD registry for the evaluation of the outcomes of patients. It also provides a report of a preliminary analysis of the data. The process of developing the registry database involved comprehensive review of the center's SCD patient medical records, incorporating data elements developed by the SickleInAfrica Consortium and obtaining ethical clearance from the local Institutional Review Board. From December 2017 to March 2020, 3,148 SCD patients were enrolled into the SCD registry. Enrollment was during the SCD outpatient clinic visits or through home visits. A significant proportion of the patients was from the newborn screening cohort (50.3%) and was males (52.9%). SCD-SS, SCD-SC, and Sß +thalassemia were seen in 67.2, 32.5, and 0.3% patients, respectively. The majority of the patients were in a steady state at enrollment; however, some were enrolled after discharge for an acute illness admission. The top two clinical diagnoses for SCD-SS patients were sickle cell painful events and acute anemia secondary to hyperhemolysis with incidence rates of 141.86 per 10,000 person months of observation (PMO) and 32.74 per 10,000 PMO, respectively. In SCD-SC patients, the top two diagnoses were sickle cell painful events and avascular necrosis with incidence rates of 203.09 per 10,000 PMO and 21.19 per 10,000 PMO, respectively. The SPARCO Kumasi site has developed skills and infrastructure to design, manage, and analyze data in the SCD registry. The newborn screening program and alternative recruitment methods such as radio announcement and home visits for defaulting patients were the key steps taken in enrolling patients into the registry. The registry will provide longitudinal data that will help improve knowledge of SCD in Ghana and Africa through research.

JRSM Cardiovasc Dis ; 11: 20480040221075521, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35111304


OBJECTIVES: Hypertension is a major risk factor for cardiovascular mortality globally and in Ghana. May Measurement Month (MMM) is a global awareness and screening campaign initiated by the International Society of Hypertension. METHODS: Participants were recruited by opportunist sampling in the Ashanti region of Ghana. The blood pressures of participants were measured three times and the mean of the last two readings was used for the analysis. Simple and multiple logistic regression was used to determine the predictors of hypertension. RESULTS: The MMM 2018 awareness and screening campaign enrolled 5054 participants with a mean age of 39.4 ± 14.7 years. There were 2553 (50.6%) males, 987 (20.1%) of respondents had never checked their blood pressure and 676 (13.9%) had a prior history of hypertension. The prevalence of hypertension was 37.4%. We found that 589(66.8%) of 822 respondents with high blood pressure did not have a history of hypertension. Respondents with a known history of hypertension on medication were 442 (65.9%) and 219(68.0%) of 322 respondents on medication had uncontrolled hypertension. The predictors of high blood pressure in a multiple logistic regression were increasing age (OR = 1.05 CI 1.05-1.06, p < 0.001), history of alcohol intake (OR = 1.33 CI 1.04 -1.70, p = 0.02), overweight (OR = 1.4 CI 1.14-1.76, p = 0.001) and obesity (OR = 1.32, CI 1.01-1.74, p = 0.047). CONCLUSION: There is a high prevalence of hypertension in the Ashanti region in Ghana. Most participants with hypertension were not aware and the majority of those with hypertension on medications were uncontrolled. This calls for more education and screening of hypertension to decrease cardiovascular mortality.

Parasite Epidemiol Control ; 16: e00235, 2022 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-35024476


INTRODUCTION: Achieving high Mass Drug Administration (MDA) coverage and drug uptake are pivotal in the efforts to eradicate onchocerciasis. The present study investigated the extent and predictors of ivermectin MDA coverage and uptake from the individual and healthcare providers' perspectives. The extent of ivermectin distribution and uptake, and the predictors of distribution and uptake were investigated in endemic communities in the Ashanti Region of Ghana. METHODS: A cross-sectional survey was conducted from August to October 2019 in communities within the Atwima Nwabiagya North District. A total of 2008 respondents were interviewed. Data was collected with REDCap mobile App which had an electronic version of the structured questionnaire. Descriptive data was presented in frequency tables, and bivariate and multivariate logistics regression analysis were performed to measure the associations between exposure variables and outcome variables which were received and uptake of MDA drugs. RESULTS: A total of 1284 (63.9%) respondents did not receive ivermectin during the 2019 MDA programme and more than half of them were not aware of the drug distribution (53.3%). The most common reasons for not ingesting the drug were fear of side effects (47.7%) and not trusting the drug distributors (20.0%). Respondents in the age group 48-57 years (AOR = 1.37; 95%CI: 1.01-2.67), Persons in the high wealth index (AOR = 1.40; 95%CI: 1.11-1.77), Being aware of the MDA programme (AOR = 6.67: 95%CI: 4.76-9.35), MDA being beneficial (AOR = 2.12; 95%CI: 1.54-2.92) participating in previous MDA (AOR = 5.44; 95%CI: 4.25-6.98) and having stayed in the communities for 10 years and above significantly increased the odds of receiving MDA drugs. Previous uptake of MDA drugs (AOR = 10.58; 95%CI: 5.78-19.38) and perception of the MDA drug as beneficial (AOR = 5.25; 95%CI: 2.55-10.82) increased the likelihood of ingesting drugs when received. CONCLUSION: The main health system challenge was limited awareness creation regarding MDA. This seems to affect the optimal utilization of the ivermectin MDA intervention. MDA programmes against onchocerciasis eradication should be designed taking into account specific contextual factors to improve implementation outcomes.

Int Sch Res Notices ; 2017: 7052583, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-28781995


OBJECTIVE: This study sought to describe the trend of sputum organism density and the rate of bacteriological conversion among smear positive TB patients assessing care at the Komfo Anokye Teaching Hospital (KATH), Kumasi, Ghana. METHODS: We conducted a retrospective patient folder review from January 2013 to March 2016 at the KATH, a tertiary hospital in Ghana. The data was entered into Microsoft Access database and exported into STATA for analysis. We applied basic descriptive statistics to study variables. Sputum conversion rate (SCR) was estimated using the number of negative tests recorded over a period (numerator) and the number of patients reported in the same period (denominator) and expressed as a percentage. RESULTS: A total of 278 patient records with sputum smear positive at onset were studied. Before treatment sputum density detected in smear microscopy was as follows: 1 acid-fast bacillus (+) (n = 114), scanty (n = 19), ++ (n = 67), and +++ (n = 78). We recorded sputum conversion rate of 80.90%, 94.56%, and 98.31% in the intensive, continuation, and completion phases, respectively. CONCLUSION: This study has shown an increasing trend in sputum conversion of smear positive pulmonary tuberculosis and an increasing trend in loss to follow-ups among tuberculosis patients on treatment.