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1.
JMIR Res Protoc ; 10(1): e21440, 2021 Jan 06.
Artigo em Inglês | MEDLINE | ID: mdl-33404517

RESUMO

BACKGROUND: Diabetes is associated with premature morbidity and mortality from its many complications. There are limited data on the chronic complications of diabetes in children and adolescents in sub-Saharan Africa. OBJECTIVE: The study aims to determine the (1) burden and related factors of chronic systemic complications of diabetes, including diabetic and nondiabetic ocular conditions in children and adolescents, and (2) quality of life (QoL) of participants compared to healthy controls. This manuscript describes the study methodology. METHODS: Demographic information, medical history, anthropometric measurements, and laboratory characteristics were collected, and the participants were screened for microvascular and macrovascular complications as well as nondiabetic ocular disease. QoL questionnaires were administered to participants, their caregivers, and controls. Participants were followed up annually up to 3 years to determine the natural history of and trends in these conditions. SPSS Version 25.0 will be used for data analysis. Continuous and categorical data will be presented as mean (SD) and as percentages (%), respectively. t tests and analysis of variance will be used to compare means, and chi-square tests will be used to compare categorical data. Correlation, regression, and logistic regression analyses will be employed to establish linear associations and causal associations as appropriate. Relative risk and odds ratios will be used to estimate risk. QoL outcomes in Ghanaian children and adolescents with diabetes mellitus compared with caregivers and healthy controls will be assessed using the Pediatric Quality of Life inventory. Significance will be set at α=.05. RESULTS: Institutional approval from the Ethical and Protocol Review Committee of the University of Ghana Medical School was received on August 22, 2014 (Protocol Identification Number: MS-Et/M.12-P4.5/2013-2014). Funding for the project was received from the University of Ghana Research Fund (#UGRF/9/LMG-013/2015-2016) in March 2016. Patient recruitment, clinical examination, and data collection commenced in August 2016 and was completed in September 2019. A total of 58 children and adolescents with diabetes mellitus have been recruited. Blood samples were stored at -80 °C for analysis, which was completed at the end of July 2020. Data analysis is ongoing and will be completed by the end of December 2020. Investigators plan to submit the results for publication by the end of February 2021. CONCLUSIONS: The prevalence, natural history, trends in diabetic complications and nondiabetic ocular disease, and QoL will be provided. Our data may inform policies and interventions to improve care given to children and adolescents with diabetes. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/21440.

2.
Vox Sang ; 116(3): 324-335, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33161604

RESUMO

OBJECTIVE: This study seeks to identify factors that are predictive of intention to return to donate blood among first-time blood donors. METHODS: A cross-sectional survey of 505 first-time blood donors, selected from blood donation sessions across three regions in Ghana. Data were obtained on their intention to donate blood in the next four months, factors that would influence this decision. Logistic regression models were used to test factors that were predictive of intention to return. RESULTS: First-time donors were young with 87·4% below 35 years of age, male (72·5%), single (73·3%), Christian (93·7%), employed (58·8%), with at least a basic education (98%). Factors that positively predicted intention to return included: motivational incentives (OR = 1·67, 95%CI: 1·01-2·78; P = 0·045); ease of access to the donation site (OR = 2·65, 95%CI: 1·48-4·73; P = 0·001); SMS and email reminders (OR = 2·84, 95%CI: 1·60-5·06; P < 0·001); and television, radio or newspaper advertisements (OR = 2·97, 95%CI: 1·66-5·31; P < 0·001). Factors that negatively predicted intention included preferential access to transfusions (i.e. 'blood credits') (OR = 0·43, 95%CI: 0·23-0·83; P = 0·012); getting to know test results (OR = 0·40, 95%CI: 0·20-0·80; P = 0·010); and not knowing and/or trusting what happens to the blood after donating (OR = 0·50, 95%CI: 0·28-0·88; P = 0·016). CONCLUSION: Motivational incentives, convenient access to donation sessions, reminders and mass media advertisements appear to positively influence intention to return to donate. Conversely not knowing what happens to the blood after donation negatively influenced intention to return. Interventions to promote repeat blood donation should consider the identified factors.


Assuntos
Doadores de Sangue/psicologia , Motivação , Adolescente , Adulto , Doadores de Sangue/estatística & dados numéricos , Estudos Transversais , Feminino , Gana , Humanos , Intenção , Masculino , Pessoa de Meia-Idade , Adulto Jovem
3.
Pan Afr Med J ; 33: 236, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31692655

RESUMO

Introduction: Acute kidney injury (AKI) is a challenging problem in developing countries due to late presentation of its victims to health care facilities. Data on the pattern of AKI, its outcome and factors associated with its recovery is scanty in developing countries therefore impeding AKI management. Aim: to study AKI recovery rate and its associated factors. Methods: An observational study conducted from September 2013 to June 2014 at Korle-Bu Teaching Hospital (KBTH). Participants were adults, admitted with AKI at KBTH. Kidney Disease: Improving Global Outcomes (KDIGO) criteria was used to diagnose and stage AKI. Results: Mean age (SD) of the participants was 41.9 (± 19.2) years. About a third of the patients (34.6%) were less than 29 years with 30-39 years and 40-60 years constituting 23.0% and 23.6% respectively. Females were in the majority (56.0%). AKI stages I, II and III accounted for 11.0%, 6.8% and 70.7% respectively. Majority, 82.2% of the patients recovered their kidney function. Stage III AKI was significantly associated with decreasing odds of recovery [OR = 0.4, 95%CI = 0.4-2.6, p = 0.002]. In addition, normal blood sodium was associated with recovery from AKI [OR, 95%CI = 2.3, (1.1-5.3), p = 0.043]. Almost half (45.5%) presented with fever whereas 32.5% and 22.5% presented with peripheral oedema and pulmonary oedema respectively. Conclusion: The study demonstrated high kidney function recovery following AKI. Dominant clinical features were fever, peripheral and pulmonary oedema. Advanced stage was associated with poor recovery whereas normal serum sodium level improves kidney function recovery.


Assuntos
Injúria Renal Aguda/fisiopatologia , Edema/epidemiologia , Febre/epidemiologia , Edema Pulmonar/epidemiologia , Injúria Renal Aguda/diagnóstico , Adulto , Edema/etiologia , Feminino , Febre/etiologia , Gana , Humanos , Testes de Função Renal , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Edema Pulmonar/etiologia , Recuperação de Função Fisiológica , Sódio/sangue , Centros de Atenção Terciária , Adulto Jovem
4.
Ghana Med J ; 53(1): 13-19, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31138939

RESUMO

Background: Prior to 1973, West African citizens completed postgraduate medical and surgical training abroad, particularly in the United Kingdom. In 2003, the Ghana College of Physicians and Surgeons were established respectively and began to offer specialized training locally. The aim of this study was to obtain and evaluate the views of Medical and Surgical Residents of the GCPS on their training in Ghana. Method: A descriptive cross-sectional study was undertaken whereby a 25 item, self-administered questionnaire, was distributed to 170 residents of Korle Bu and Komfo Anokye Teaching Hospitals in Ghana. Information regarding the residents' sociodemographic characteristics, level of residency, and satisfaction with the programs in terms of clinical supervision, didactic teaching, program duration and research training was collected. Results: 117 residents completed the survey, yielding a response rate of 68.8%. 59.8% were males and 40.2% females. The age of the residents ranged from 25 to 40 years with a mean age of 32.7+1.4 years. Majority of residents (92.3%) were satisfied with the duration of the programs . Slightly more than half of the residents (50.4%) were satisfied with the clinical supervision, however only a third of the respondents (33.3%) were satisfied with the didactic teaching and an even smaller percentage (17.1%) with research training. Conclusion: Whilst majority of residents were satisfied with the duration of the residency program, the perspective of the respondents was that trainees would benefit from additional didactic teaching and increased research exposure. Funding: None.


Assuntos
Internato e Residência , Medicina , Adulto , Atitude do Pessoal de Saúde , Estudos Transversais , Currículo , Feminino , Gana , Humanos , Masculino , Satisfação Pessoal , Inquéritos e Questionários
5.
Adv Hematol ; 2019: 1783240, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31057625

RESUMO

Background: Abnormalities in lung function tests have been shown to commonly occur in a majority of patients with sickle cell disease (SCD) even at steady state. The prevalence and pattern of these lung function abnormalities have been described in other populations but this is unknown among our sickle cell cohort. There is generally little information available on risk factors associated with the lung function abnormalities and its relevance in patient care. Method: This was an analytical cross-sectional study involving 76 clinically stable, hydroxyurea-naive adult Hb-SS participants and 76 nonsickle cell disease (non-SCD) controls. A structured questionnaire was used to obtain sociodemographic data and clinical history of the participants. Investigations performed included spirometry, pulse oximetry, tricuspid regurgitant jet velocity (TRV) measurements via echocardiogram, complete blood counts, free plasma haemoglobin, serum urea, and creatinine. Results: Weight, BMI, mean FVC, and FEV1% predicted values were comparatively lower among the Hb-SS patients (p < 0.001). Abnormal spirometry outcome occurred in 70.4% of Hb-SS patients, predominantly restrictive defects (p < 0.001), and showed no significant association with steady-state Hb, WBC count, free plasma haemoglobin, frequency of sickling crisis, chronic leg ulcers, and TRV measurements (p > 0.05). The mean oxygen saturation was comparatively lower among Hb-SS patients (p < 0.001). Conclusion: Measured lung volumes were significantly lower in Hb-SS patients when compared to non-SCD controls and this difference was not influenced by anthropometric variance. Lung function abnormalities, particularly restrictive defects, are prevalent in Hb-SS patients but showed no significant association with recognized markers of disease severity.

6.
Ethiop J Health Sci ; 29(1): 895-902, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30700957

RESUMO

Background: Craniotomy and transphenoidal microsurgery are surgical options for treatment of pituitary adenoma at Korle Bu Teaching Hospital(KBTH). Despite major advances and reported success rates of transphenoidal resection globally, paucity of local data regarding visual outcome of either procedure exists. We evaluated the visual outcome of patient with pituitary adenoma following surgery in a tertiary hospital in Ghana. Methods: This is a prospective study of 18 of 45 consecutive new patients with pituitary adenoma seen from November 2010 to July 2013 at Korle-Bu Teaching Hospital(KBTH), Accra, Ghana. Sixteen (88.9%) of the 18 had surgery by transphenoidal route and 2(11.1%) by craniotomy. All patients had macroadenoma (tumour size >1cm) and histological confirmation of diagnosis. Pre-operative and post-operative visual acuity and its relationship to tumour size and duration of symptoms before diagnosis were evaluated. Results: Data on 18 patients aged 33-60 years, mean (SD) 45.9±8.5, was analysed. Eleven (61.1%) were females. Visual blur, 15(83.3%), and headache,13(72.2%), were predominant presenting complaints. Common neuro-ophthalmic signs included unilateral or bilateral optic atrophy, 17(94.4%), Relative Afferent Pupillary Defect (RAPD) in 8(44.4%) and impaired colour vision in 32 of 36(88.9%) eyes. Preoperatively, 8(22.2%) and 13(36.1%) of 36 eyes were visually impaired or blind respectively. Postoperatively, 6(16.7%) eyes were visually impaired and 17(47.2%) eyes blind. Blindness was associated with late presentation (p<0.005) and larger tumour width (p<0.036). Conclusions: More than a third of eyes of patients with pituitary adenoma were blind before and after surgery. Blindness was associated with late presentation and larger tumours. Transphenoidal surgery may be beneficial following early diagnosis to avoid irreversible blindness/visual impairment.


Assuntos
Adenoma/cirurgia , Neoplasias Hipofisárias/cirurgia , Complicações Pós-Operatórias/epidemiologia , Transtornos da Visão/epidemiologia , Acuidade Visual , Adenoma/epidemiologia , Adulto , Causalidade , Comorbidade , Feminino , Gana/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Hipofisárias/epidemiologia , Estudos Prospectivos , Centros de Atenção Terciária , Resultado do Tratamento
7.
Ghana Med J ; 51(1): 13-19, 2017 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-28959067

RESUMO

OBJECTIVES: The knowledge about outcomes of infant vaccination against HBV infections using the DPT-HepB-Hib vaccine in Ghana is limited. This study therefore investigated the levels of immunity to HBV among children who received the DPT-HepB-Hib vaccine and HBsAg carriage in non-responders. Correlates for non-response or poor response were also investigated. METHODS: Cross-sectional study. A major paediatric hospital in Accra. Four hundred and twenty four children between the ages of 5 to 32 months who had completed the full vaccination schedule for the DPT-HepB-Hib vaccine. RESULTS: Of the 424 children, 358 (84.4%) developed anti-HBs while 340 (80.2%) developed ≥10 mIU/ml anti-HBs (sero-protection) and 3 had HBsAg. A binary logistic regression analysis showed that younger children were associated with sero-conversion (p=.022) and sero-protection (p=.021). For anti-HBs titres ≥100 mIU/ml age was a weaker but significant contributor (p=.041), as compared to the number of vaccines from different manufacturers the child used (p=.028). The mean age of those who used a single type of vaccine was higher (14.75 ± 6.056 months; n=268) than those who used vaccines from two or more manufacturers (11.96 ± 4.645 months; n=156), p= <.001 (CI: -3.897 - 1.688), an indication that efforts to procure vaccine from same source when it was initially introduced are waning. CONCLUSIONS: There is still a residual possibility of infection with HBV in spite of infant vaccination. In the light of possible loss of anamnestic response over time, there is the need to consider a birth dose for HBV vaccination for all neonates or booster dose for infants who may not have received the vaccine at birth. Using vaccines from a single manufacturer is recommended. FUNDING: None declared.


Assuntos
Vacina contra Difteria, Tétano e Coqueluche/administração & dosagem , Vacinas Anti-Haemophilus/administração & dosagem , Anticorpos Anti-Hepatite B/sangue , Vacinas contra Hepatite B/administração & dosagem , Vacinação/estatística & dados numéricos , Anticorpos Antibacterianos/sangue , Pré-Escolar , Estudos Transversais , Feminino , Gana , Antígenos de Superfície da Hepatite B/imunologia , Hospitais Pediátricos , Humanos , Esquemas de Imunização , Lactente , Modelos Logísticos , Masculino
8.
Ghana Med J ; 51(2): 50-55, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28955100

RESUMO

OBJECTIVES: Given the introduction in 2008 of undergraduate family medicine in the University of Ghana, the study aimed to identify the perceptions of medical students in Ghana about family medicine with regard to knowledge and relevance as well as specialty preferences. DESIGN: A cross-sectional survey. METHOD: Investigators conducted yearly surveys of first clinical year students at the University of Ghana School of Medicine and Dentistry over a 5-year period (2008-2012) using a semi-structured questionnaire. Data was analysed using the first class group as baseline for comparison. MAIN OUTCOME MEASURES: Trends in respondents' awareness of different aspects of family medicine, their attitudes towards the specialty and their expressed preference or lack of preference for family medicine as a potential specialty for themselves. RESULTS: Over the five-year period, 748 of 893 eligible first year students participated which comprised 84% of students. Awareness of family medicine as a medical specialty remained high but insignificantly declined over the period of study (88% to 80%, p=0.058). Preference for family medicine as career choice remained low at 4%, but an increase from 2% baseline though insignificant (p=0.397). The primary reason for not listing family medicine as career choice was unfamiliarity with the specialty (80%). CONCLUSION: Although awareness of family medicine among medical students in Ghana remains relatively high, their knowledge is insufficient to influence their career decisions for family medicine. This is a wake-up call! FUNDING: None declared.


Assuntos
Escolha da Profissão , Educação de Graduação em Medicina , Medicina de Família e Comunidade/educação , Estudantes de Medicina/estatística & dados numéricos , Adulto , Estudos Transversais , Feminino , Gana , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Modelos Logísticos , Masculino , Análise Multivariada , Inquéritos e Questionários , Adulto Jovem
9.
BMC Nutr ; 3: 67, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-32153847

RESUMO

Background: Lysine is one of the essential amino acids and in cereal based diets it is known to be the most limiting and therefore determines the quality of dietary protein in such diets. This study investigated the effect of lysine supplementation on blood pressure of hypertensive adults in selected peri-urban community in Accra, Ghana. Methods: The study was a randomized double-blind controlled study made up of adults men and women assigned to a lysine supplemented group and a placebo-supplemented (control) group. The subjects aged between 18 - 45 years and totaling 180. Results: Total of 50 (28%) of the participating were hypertensive defined as Systolic Blood Pressure (SBP) ≥140 mmHg. The mean SBP of lysine-supplemented group significantly dropped from 146.11 ± 11.92 to 128.95 ± 10.44 mmHg (p = 0.02). That of women also dropped from 144.12 ± 10.41 to 132.28 ± 10.69 mmHg, (p = 0.06 while the control group had there SBP remained fairly constant after 112 days of intervention with changes in men from 145.79 ± 12.56 to 142.79 ± 11.07 mmHg (p = 0.32) and women in the control had very little drop from 145.15 ± 14.79 to 145.00 ± 17.93 mmHg (p = 0.96). Conclusion: Lysine supplementation resulted in normalization/reduction of blood pressure of hypertensive subjects who have suboptimal lysine intake.

10.
Malar J ; 9: 232, 2010 Aug 12.
Artigo em Inglês | MEDLINE | ID: mdl-20704742

RESUMO

BACKGROUND: In malaria-endemic areas, reliably establishing parasitaemia for diagnosis of malaria can be difficult. A retinopathy with some features unique to severe malaria with a predictive value on prognosis, has been described. Detection of this retinopathy could be a useful diagnostic tool. This study was designed to determine the diagnostic usefulness of retinopathy on ophthalmoscopy in severe malaria syndromes: Cerebral malaria (CM) and non-cerebral severe malaria (non-CM), i.e. malaria with respiratory distress (RD) and malaria with severe anaemia (SA), in Ghanaian children. Secondly, to determine any association between retinopathy and the occurrence of convulsions in patients with CM. METHODS AND SUBJECTS: A cross-sectional study of consecutive patients on admission with severe malaria who were assessed for retinal signs, at the Department of Child Health, Korle-Bu Teaching Hospital, Accra, from July to August 2002 was done. All children had dilated-fundus examination by direct and indirect ophthalmoscopy. RESULTS: Fifty-eight children aged between six months and nine years were recruited. Twenty six(45%) had CM, 22 with convulsion; 26(45%) had SA and six(10%) had RD.Any retinopathy was seen in: CM 19(73%), SA 14(54%), RD 3(50.0%), CM with convulsion 15(68%) and CM without convulsion 4(100%). Comparison between CM versus non-CM groups showed a significant risk relationship between retinal whitening and CM(OR = 11.0, CI = 2.2- 56.1, p = 0.001). There was no significant association with papilloedema(OR = 0.9, CI = 0.3 - 3.0, p = 0.9), macular whitening(OR = 1.6, CI = 0.5 - 4.8, p = 0.4), macular haemorrhage(OR = 0.28, CI = 0.03 - 2.7 p = 0.2), retinal haemorrhage(OR = 1.9, CI = 0.6 - 5.6, p = 0.3), vessel abnormality(OR = 1.9, CI = 0.6 - 6.1, p = 0.3) and cotton wool spots(OR not calculated, p = 0.08).Tortuous and engorged retinal veins, not previously described as a feature of CM, was the most common vascular abnormality(15/58 = 26%) and was detected even in the absence of papilloedema. CONCLUSION: Retinal whitening, a sign suggestive of retinal ischaemia, was significantly more common in CM than in non-CM syndromes. However, the high prevalence of any retinopathy in the latter suggests that the brain and the retina may be suffering from ischaemia in both CM and non-CM.


Assuntos
Malária Cerebral/diagnóstico , Parasitemia/fisiopatologia , Doenças Retinianas/etiologia , Grupo com Ancestrais do Continente Africano , Antimaláricos/uso terapêutico , Isquemia Encefálica/complicações , Isquemia Encefálica/etiologia , Criança , Pré-Escolar , Estudos Transversais , Feminino , Seguimentos , Gana , Humanos , Lactente , Malária/complicações , Malária/diagnóstico , Malária/tratamento farmacológico , Malária Cerebral/complicações , Malária Cerebral/tratamento farmacológico , Masculino , Oftalmoscopia , Parasitemia/tratamento farmacológico , Parasitemia/parasitologia , Plasmodium falciparum/isolamento & purificação , Prognóstico , Quinina/uso terapêutico , Doenças Retinianas/parasitologia , Doenças Retinianas/patologia , Índice de Gravidade de Doença
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