Prevalence of dysmenorrhea among University students in Northern Ghana; its impact and management strategies.

BACKGROUND: The period of menstruation is an eventful one for a significant number of post-pubescent females as they experience lower abdominal pains referred to as dysmenorrhea. This study conducted among female students of the Tamale campus of the University for Development Studies assessed the prevalence of dysmenorrhea, its impact on the students and treatment methods applied. METHODS: A cross-sectional study using a self-administered questionnaire was used to obtain data from 293 randomly selected female students. Data was analyzed using Graph Pad 5.01. Association between different variables was tested. RESULTS: The prevalence rate of dysmenorrhea was 83.6% with more than half describing their pain which lasts less than 3 days as moderate. This dysmenorrhea during menstruation affects the daily activities of up to 61.2% of respondents. Lower chronological age (χ2 = 8.28; df = 2; p = 0.016) and gynecological age (χ2 = 10.09; df = 2; p = 0.006) were the factors that were significantly associated with the presence of dysmenorrhea. Chronological and gynecological ages, age at menarche, menstrual duration or flow level do not influence the severity of dysmenorrhea but irregular menstrual flow is significantly associated with severe dysmenorrhea (χ2 = 10.54; df = 2; p = 0.005). Only 16.3% ever reported their dysmenorrhea to the hospital but increasing pain level is significantly associated with respondents visiting a hospital (χ2 = 65.61; df = 2; p < 0.0001) or use an allopathic medication (χ2 = 32.77; df = 2; p < 0.0001). Paracetamol preparation was the most common medication used notwithstanding the severity of the pain. CONCLUSIONS: There is high prevalence of dysmenorrhea among the female students of the Tamale campus of the University for Development studies which negatively affects the daily activity of majority of them. Although, bed rest was the most common treatment method practised, paracetamol preparation was the most common allopathic drug used in self- management of their dysmenorrhea.

Seroprevalence of Malaria and Hepatitis B Coinfection among Pregnant Women in Tamale Metropolis of Ghana: A Cross-Sectional Study.

BACKGROUND: Coinfections are becoming common risk factors that may contribute to the increased burden of morbidity in pregnancy. The aim of this study was to assess the seroprevalence of coinfections of malaria, hepatitis B (HBV), human immunodeficiency virus (HIV), and syphilis among pregnant women attending antenatal clinics (ANC) in the Tamale Metropolis. METHODS: By means of rapid diagnostic tests (RDTs), pregnant women attending the Tamale Teaching Hospital (TTH) were screened for malaria, HBV infection, HIV infection, and syphilis from March 2013 to February 2015. Haemoglobin (Hb) values, sickling, and glucose-6-phosphate dehydrogenase deficiency (G6PDd) statuses were also assessed using full blood count (FBC), sodium metabisulphite, and methaemoglobin reduction tests, respectively. Logistic regression analysis was performed to estimate the risks/odds ratios (ORs) for the coinfections and other variables (age, gravidity, and time of the first ANC visit) with 95% confidence intervals (CIs) and set p values for accepting any differences at <0.05. RESULTS: Within the two-year study period, data were collected from 3,127 pregnant women. The mean age (SD) of the pregnant women was 28.5 (±5.0) years. Of the total number, seroprevalence was high for malaria (11.6%) and HBV infection (4.2%) and low for HIV infection (1.0%) and syphilis (0.4%) monoinfections. Mal/HBV coinfection was higher (0.7%) when compared with Mal/HIV (0.1%), Mal/syphilis (0.0%), HBV/HIV (0.0%), HBV/syphilis (0.1%), and HIV/syphilis (0.0%) coinfections. The mean Hb (g/dl) for the women with the four monoinfections was significantly different from one another (p=0.009). Pregnant women with malaria infection were about 2 times more likely to be coinfected with HBV even after adjusting for potential confounders (adjusted odds ratio (AOR) = 1.66, 95% CI = 1.04-2.65, p=0.031). Those in their third trimester and visiting the ANC for the first time were significantly less likely to be infected with HBV (AOR = 0.45, 95% CI = 0.28-0.73, p=0.001), with malaria/HBV coinfection (AOR = 0.09, 95% CI = 0.01-0.68, p=0.020), and with any coinfection (AOR = 0.19, 95% CI = 0.06-0.63, p=0.007). CONCLUSION: A comparatively high seroprevalence of malaria and its coinfection with HBV in pregnant women was observed in this study. Considering the effects that both malaria and HBV have on the liver, it would be expedient to conduct further studies to assess liver function among malaria/HBV-infected individuals, while interventions to prevent coinfections among pregnant women are intensified.

Preterm Delivery and Neonatal Deaths among Anaemic Pregnant Women in the Bolgatanga Metropolis of Ghana.

Preterm deliveries and neonatal deaths as functions of anaemia in pregnancy are of major public health interest. However, data on the prevalence of preterm deliveries and their association with mortality in anaemic pregnant women in the study area are scanty. Thus, the study sought to investigate the prevalence of preterm delivery and neonatal deaths among anaemic pregnant women in the Bolgatanga Regional Hospital in the Upper East Region of Ghana during the past five years. A retrospective study design was adopted, and data were gathered between March and May 2016. Records of women who were anaemic during any trimester of their pregnancy and delivered in the hospital within the last five years were included in the study. In all, two hundred (200) cases were reviewed. Data on the sociodemographic characteristics, health status, and birth outcome of participants were captured, and analyses were conducted using SPSS version 21 while considering significant differences at p < 0.05. The study revealed that more than half of the anaemic women (52.5%, n = 105) had preterm deliveries, while neonatal mortality was 8.5% (n = 17). The proportion of mothers who received dietary or medical intervention for the treatment of anaemia and the number of attendances to antenatal clinics were comparable between preterm and normal-term mothers (p > 0.05). Mothers with preterm deliveries had a higher risk of neonatal mortality (AOR = 13.66, 95% CI = 1.65-113.30, and p=0.015). This study has shown that anaemia in pregnancy increases the risk of preterm delivery and neonatal death. It is recommended that extra care be given to pregnant women with anaemia, while further studies are conducted with a larger sample size to substantiate the claims made in this study.

Dyslipidemias: Prevalence and Associated Factors among Lactating Women in a Lower- and Middle-Income Country, Ghana.

Background: Dyslipidemia, an abnormally high level of lipids in the blood, has a negative impact on the health status of the individual and has lately emerged as a major public health concern, especially for low- and middle-income countries (LMIC) globally, including Ghana. However, it is still unclear what the burden and drivers of these lipid abnormalities are, especially among lactating women in the Upper West of Ghana. Thus, this study is aimed at determining the prevalence of dyslipidemia and its associated factors among lactating mothers in the Wa Municipality of Ghana. Methodology. A cross-sectional study was conducted from May to June 2020 in 8 health facilities within the Wa Municipality. Multistage and simple random sampling methods were used to select the facilities and the 200 study subjects. Sociodemographic data were collected using questionnaires, while blood samples were taken to determine the lipid profile of participants. Dietary patterns were also assessed using the Food Frequency Questionnaire (FFQ). Data were processed and analyzed using SPSS 17 software (SPSS, Inc., Chicago, IL). The chi-square test and multiple regression analysis were performed to determine the predictors associated with the various types of dyslipidemia, with statistical significance set at a p value < 0.05. Results: The prevalence of hypercholesterolemia (LDL-C), hypo-HDL-cholesterolemia, and hypertriglyceridemia (TG) was 57%, 59%, and 22%, respectively. Chi-square and multinomial regression analysis revealed that duration of lactation (X2 = 3.95, p = 0.047), religion (AOR = 0.375, 95% CI 0.144-0.978, p = 0.045), low income (AOR = 0.116, 95% CI 0.026-0.514, p = 0.005), middle income (AOR = 0.163, 95% CI 0.044-0.600, p = 0.006), and alcohol intake (AOR = 6.312, 95% CI 1.108-35.949, p = 0.038) were associated with LDL-C, while age (AOR = 0.963, 95% CI 0.910-1.019, p < 0.001) and educational status (AOR = 0.365, 95% CI 0.140-0.954, p = 0.040) predicted HDL status. Conclusion: Dyslipidemia is common among lactating mothers of Wa Municipality, and it is predicted by lifestyle factors. Furthermore, future research to look at a larger sample size on dyslipidemia during lactation is recommended.

Drug Treatment of Patients with Liver Cirrhosis in a Tertiary Hospital in Northern Ghana: Does It Comply with Recommended Guidelines?

The diverse influence of liver function on drug disposition can lead health-care practitioners to inappropriate drug selection, inappropriate drug dosing, or some level of therapeutic negativism. The aim of this study was to assess how drug prescribing in patients with liver cirrhosis at the Tamale Teaching Hospital comply with recommendations of pharmacotherapy and safety guidelines. A prospective cross-sectional study was conducted from February to July, 2019, at the medical ward of the Tamale Teaching Hospital. A total of 152 liver cirrhotic patients were included in this study. Common etiologies for liver cirrhosis were chronic hepatitis B 80 (52.6%) and chronic hepatitis C 30 (19.7%); about 12.5% of etiologies were unknown. Of the 1842 prescription issued, 69% (1270/1842) were compliant. Of the 572 noncompliant prescriptions, about 32% (183/572) were due to pharmacotherapy and 68% (389/572) due to safety guideline recommendations. There was a substantial number (31%) of prescription noncompliance with recommendations for pharmacotherapy and safety guidelines in liver cirrhotic patients at the tertiary hospital in northern Ghana. Prescribers need to be conscious of the role of the liver in drug elimination and prescribe as recommended by guidelines.

Routine haematinics and multivitamins: Adherence and its association with haemoglobin level among pregnant women in an urban lower-middle-income country, Ghana.

In low- and middle-income countries, medications are routinely prescribed for maternal and foetal well-being. The objective of this study was to assess the adherence with routine haematinics and multivitamins among pregnant women in a lower-middle-income country, Ghana. A questionnaire was used to collect data from 350 pregnant women utilizing the antenatal clinic of the Tamale Teaching Hospital. Adherence was about 63% for folic acid, 63% for ferrous sulphate and 58% for multivitamins. For folic acid, younger age, secondary and tertiary education had about 31%, 46% and 41%, respectively, less likelihood of non-adherence. Second trimester of pregnancy was associated with two times more likelihood of adherence with folic acid. For ferrous sulphate, younger age had about 30% less likelihood of non-adherence, and second trimester linked to twice more likelihood of adherence. Secondary education had about 40% less likelihood of non-adherence with multivitamins. More of those who adhered with folic acid (89%), ferrous sulphate (89%) and multivitamins (91%) had their haemoglobin level increased. Adherence with routine haematinics was adequate; age, education and trimester of pregnancy predicted folic acid and ferrous sulphate adherence. Education predicted adherence with multivitamins. Adherence was associated with change in level of haemoglobin during antenatal visits.

Prevalence and determinants of uptake of folic acid in peri-conceptional period in a rural lower-middle-income country, Ghana.

Folate is a vitamin B-related substance needed by expectant mothers during the period right before and after conception (peri-conceptional period) to help protect foetuses against neural tube defects (NTDs). Despite efforts to promote the peri-conceptional uptake of folic acid (FA), adherence remains low. The aim of this study was to assess the prevalence and determinants of peri-conceptional FA uptake among childbearing women in northern Ghana. In a cross-sectional study, data from 303 women accessing antenatal care services in the Upper East Region of Ghana between February and July 2017 were collected and analysed in Stata (Version 12.1). Chi-square and logistic regression analysis were used to identify the independent determinants of peri-conceptional uptake of FA. The mean age of the study population was 27.4 (±5.73) years. The prevalence of uptake of peri-conceptional FA was 28.7% (95% confidence interval: 26.7%-34.2%); 66% of the women were aware of FA and 52% had acceptable knowledge about FA. Initiating ANC after 3 months of pregnancy was associated with 91% less chance of peri-conceptional FA use [adjusted odds ratio (AOR) 0.09; 95% confidence interval (CI) 0.04-0.22; P < .001]. Not knowing the frequency of dosing of FA was associated with a 58% less likelihood of uptake of peri-conceptional FA (AOR 0.42; 95% CI 0.23-0.76; P = .004). There is low uptake of peri-conceptional FA among women of childbearing age accessing antenatal services in Northern Ghana, and this uptake is determined by the time of initiation of ANC visit and knowledge of dosage regimen of FA.

Medical students' knowledge and attitude towards complementary and alternative medicine - A survey in Ghana.

Interest, use of and research into Complementary and Alternative Medicine (CAM; bǔ chong yǔ tì dài yi xué) is on the increase in recent times even in developed countries. It may therefore be appropriate if medical students who would become future physicians possess adequate knowledge and better attitude towards CAMS. This study assessed medical students' knowledge of, attitude towards, and usage of CAM as well as their opinion about integrating CAMs into the medical curriculum. In a cross-sectional study, 203 medical students in 2nd, 3rd and 4th year classes completed a questionnaire. Data was analyzed using SPSS 18 and GraphPad 5.01. Association between different variables was tested. The overall mean knowledge score was 19.6%. Students in higher years of study were significantly more knowledgeable in CAMs (p = 0.0006). The best known CAM was herbal medicine (63.6%), with relatives and friends being their main source of information. Students' attitude towards CAM was good (75.1%) with majority (71.5%) favouring introduction of CAM into the medical curriculum; preferably at the preclinical level (67.5%). Year of study, gender and locality where student grew up did not significantly affect attitude towards CAM use. Up to 117 (59.0%) of the students had ever used CAM especially herbal medicine. Although students in this study were deficient in knowledge on CAMs, their attitude and usage was good. Herbal medicine was the best known and used CAM. Majority of the students believed knowledge on CAM would be beneficial to their practice hence, desirous of its introduction into their medical curriculum.

Reducing the breast cancer menace: the role of the male partner in Ghana.

BACKGROUND: Breast cancer continues to be the most common type of cancer afflicting many women worldwide. Presently, educational campaigns and research target only women as if men have no role in the management of this disease. The study examined the willingness of male partners to assist in early female breast cancer detection as well as their awareness and knowledge levels. MATERIALS AND METHODS: Using a semi-structured questionnaire, data was collected from 500 public servants within the Tamale Metropolis and analyzed in SPSS. RESULTS: The level of awareness of breast cancer was very high (98.8%) but there was a low level of knowledge of breast cancer among the male population. Marital status and religion had no effect on attitude, but increasing educational status significantly increased knowledge and positive attitude towards breast cancer examination (χ2=4.255, p=0.0391). The majority (92.0%) agreed that men can assist in early breast cancer detection and 96.2% were willing to be provided with breast examination skills. CONCLUSIONS: Although level of awareness on female breast cancers among the men was high, they generally lack knowledge of the disease. Majority of male partners want to assist in early breast cancer detection if provided with the necessary skills.