Ghana medical journal最新文献

{"title":"Equity of access to free maternal and child health services among reproductive-age women in Delta State, Nigeria.","authors":"Christie A Enuku, Obinna Onwujekwe","doi":"10.4314/gmj.v58i3.6","DOIUrl":"https://doi.org/10.4314/gmj.v58i3.6","url":null,"abstract":"<p><strong>Objective: </strong>The study aimed to assess the equity of access to free maternal and child health services among reproductive-age women in Delta State, Nigeria.</p><p><strong>Design: </strong>the study adopted a descriptive cross-sectional survey design.</p><p><strong>Participants: </strong>The population for the study were 368 women of reproductive age (15-49 years) who had given birth between April 2015 and December 2015 in two randomly selected senatorial districts of Delta State. Data were collected using a pre-tested interviewer-administered questionnaire.</p><p><strong>Results: </strong>368 women were recruited for the study, consisting of 73.3% (N =270) from the urban setting and 26.7% (N=98) from the rural setting. 54.1% (N=199) had completed secondary school, while 28.8% (N=106) had completed tertiary education. Most respondents were aged 21 to 30 years 217(59.0%). 20% of respondents belonged to the poorest, poor and least poor socioeconomic status (SES) groups and 19.8% to average poor and rich SES groups. The results showed equity between different SES (0.014) and educational (0.027) backgrounds, as indicated in concentration curves. However, the concentration index between the geographical areas (-0.0200) indicates inequity in access in favour of urban dwellers.</p><p><strong>Conclusion: </strong>Free maternal and child health services (FMCHS) were equitable across the different SES groups and educational levels. However, there was inequity in access due to distance to the hospitals among the women of childbearing age in the communities. This study is relevant to all healthcare professionals, especially those in public health, because it will encourage them to exercise their energy towards home care to reduce maternal and child mortality.</p><p><strong>Funding: </strong>None declared.</p>","PeriodicalId":94319,"journal":{"name":"Ghana medical journal","volume":"58 3","pages":"215-223"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11465724/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142485038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nocturnal blood pressure dipping and left ventricular hypertrophy among hypertensive outpatients in a Ghanaian hospital.","authors":"Frederick A Akoto, Abdul-Subulr Yakubu, Francis Agyekum, Alfred Doku, Joseph A Akamah","doi":"10.4314/gmj.v58i3.7","DOIUrl":"https://doi.org/10.4314/gmj.v58i3.7","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the association between the extent of nocturnal systolic blood pressure decline and left ventricular hypertrophy in patients with primary hypertension who were receiving antihypertensive drug therapy.</p><p><strong>Design: </strong>This was a cross-sectional hospital-based study from November 2020 to March 2021.</p><p><strong>Setting: </strong>The study was conducted at the Polyclinic of Korle Bu Teaching Hospital, Ghana.</p><p><strong>Participants: </strong>Outpatients ≥18 years old with primary hypertension who were receiving antihypertensive drug therapy.</p><p><strong>Interventions: </strong>Each participant underwent a 24-hour ambulatory blood pressure monitoring and a transthoracic echocardiogram.</p><p><strong>Main outcome measures: </strong>Left ventricular hypertrophy and the extent of mean systolic blood pressure decline during sleep.</p><p><strong>Results: </strong>180 participants were recruited, comprising 110 (61.1%) females. The participants' mean (±SD) age was 57.6 ± 11.0 years. 80% had a non-dipping blood pressure pattern, and 43.9% had left ventricular hypertrophy. Uncontrolled office blood pressure was an independent predictor of left ventricular hypertrophy in these patients (AOR 2.010, 95% CI 1.048-3.855, p=0.036); however, a non-dipping nocturnal systolic blood pressure status was not (AOR 1.849, 95% CI 0.850-4.022, p=0.121). 61.1% had abnormal left ventricular geometry, with concentric hypertrophy being the predominant geometric pattern.</p><p><strong>Conclusion: </strong>Left ventricular hypertrophy and non-dipping nocturnal blood pressure were common in these hypertensive Ghanaian patients on antihypertensive therapy. Left ventricular hypertrophy was associated with uncontrolled office blood pressure but not the extent of nocturnal systolic blood pressure declines during a single 24-hour ambulatory blood pressure recording.</p><p><strong>Funding: </strong>None declared.</p>","PeriodicalId":94319,"journal":{"name":"Ghana medical journal","volume":"58 3","pages":"224-230"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11465717/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142485041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multiple gouty tophi in a six-year-old.","authors":"Imri G Adefokun, Gbemi H Ano-Edward, Stephen A Adesina, Peter K Uduagbamen, Samuel U Eyesan","doi":"10.4314/gmj.v58i3.10","DOIUrl":"https://doi.org/10.4314/gmj.v58i3.10","url":null,"abstract":"<p><strong>Introduction: </strong>Gouty tophus in a child is an extremely rare presentation. Only very few cases have been documented in literature in contemporary times.</p><p><strong>Case presentation: </strong>We present this index case of a 6-year-old child who was brought to the clinic by her parents on account of multiple subcutaneous swelling of two years' duration on her lower limbs before she presented at our outpatient clinic. The swellings started from the knee joints and were associated with difficulty in walking. A provisional diagnosis of multiple soft tissue swelling was made before some of the swellings were excised. An excisional biopsy of some of the masses on the lower extremities was done, and histological examination revealed gouty tophus. She was then placed on oral febuxostat. Her clinical condition has improved significantly; she is on continuous follow-up at our facility's paediatric orthopaedic outpatient clinic. Hitherto, gouty tophus has been recorded in juveniles and young adults, but it may present in any child below the age of five years.</p><p><strong>Conclusion: </strong>A high index of suspicion is needed in managing subcutaneous swellings in the paediatric age group (particularly pre-school) to identify and manage gouty tophus early enough to minimise its complications.</p><p><strong>Funding: </strong>None declared.</p>","PeriodicalId":94319,"journal":{"name":"Ghana medical journal","volume":"58 3","pages":"245-248"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11465722/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142485040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antibiotic use in surgical infections at a tertiary teaching hospital in Ghana.","authors":"Josephine Mensah, Antoinette A Bediako-Bowan, Amos Amoako-Adusei, Franklin Acheampong, Mohammed Sheriff, Nii A Adu-Aryee","doi":"10.4314/gmj.v58i3.5","DOIUrl":"https://doi.org/10.4314/gmj.v58i3.5","url":null,"abstract":"<p><strong>Objective: </strong>The study aimed to assess antibiotic prescribing and use patterns at the Department of Surgery, Korle Bu Teaching Hospital.</p><p><strong>Design: </strong>A cross-sectional study design was employed in this study.</p><p><strong>Setting: </strong>The study was conducted at the Department of Surgery, Korle Bu Teaching Hospital.</p><p><strong>Participants: </strong>Forty-two prescribers out of 63 (67%) at the Department of Surgery responded to questionnaires. Over the study period, prescriptions and medical records of 1715 patients from the general surgery, neurosurgery, and urology units were reviewed.</p><p><strong>Main outcome measures: </strong>Percentage of prescriptions with antibiotics, percentage of prescribers using guidelines for antibiotic prescriptions, and percentage using culture and sensitivity to inform antibiotic prescriptions.</p><p><strong>Results: </strong>Of the 1715 prescriptions assessed, 75% (1294/1715) were from inpatients, and 45% (772/1715) included an antibiotic. Ciprofloxacin and metronidazole constituted 54% of antibiotic prescriptions from general surgery. Amoxicillin/clavulanic acid and ceftriaxone constituted 64.7% of antibiotic prescriptions from neurosurgery, and ceftriaxone and ciprofloxacin made up 37.7% of antibiotic prescriptions from urology. Microbiology testing was done for only 14.5% (9/62) of inpatients who received antibiotics for treatment. The choice of antibiotics was influenced mainly by doctors' previous experience (37/42, 88.1%).</p><p><strong>Conclusion: </strong>Antibiotics are widely used. About half of all prescriptions had antibiotics, with ciprofloxacin and metronidazole constituting more than half of antibiotic prescriptions from general surgery. Doctors mainly based their antibiotic prescriptions on previous experience and occasionally on microbiological investigations.</p><p><strong>Funding: </strong>None declared.</p>","PeriodicalId":94319,"journal":{"name":"Ghana medical journal","volume":"58 3","pages":"207-214"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11465725/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142485036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A systematic review on the effect of the COVID-19 pandemic on childhood immunisation programmes of West African countries","authors":"Osamudiamen C. Obasuyi, Veronica A. Obasuyi","doi":"10.4314/gmj.v58i2.8","DOIUrl":"https://doi.org/10.4314/gmj.v58i2.8","url":null,"abstract":"Objectives: To investigate the effects of the COVID-19 pandemic on childhood immunisation programmes in West African Countries.Design: The study was a systematic review of available evidence of the impact of the COVID-19 pandemic on childhood immunisation programmes in West AfricaSetting: An online literature search was conducted using PubMed, Embase, Scopus and Web of Science for all peer-reviewed longitudinal, descriptive, observational, prospective and retrospective studies on childhood immunisation programmes in West Africa published between January 2020 and May 2022Participants: All West African childhood immunisation programmes.Interventions: NoneMain Outcome Measures: Change in immunisation volumes during the COVID-19 pandemicResults: 353 studies were identified during the literature search, and eight were included in this review. The studies comprised six quantitative studies, one mixed-method (quantitative/qualitative) study and one qualitative study. Changes to immunisation services ranged between 53% and 52% for MCV and Penta3 vaccines in Guinea, lasting longer than August 2020, to 0.3% and 1% in Liberia for BCG and MCV vaccines lasting no longer than May 2020. Factors contributing to the observed disruptions in vaccine coverage during the pandemic included the fear of contracting the virus expressed by caregivers and healthcare workers and general misinformation about the COVID-19 virus.Conclusion: While the changes were greater than 50% and lasted longer in some countries, they were brief and short-lived in others, emphasising that the COVID-19 pandemic's effect in each country differed.","PeriodicalId":94319,"journal":{"name":"Ghana medical journal","volume":" 42","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141678958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sexual behaviours and contraceptive use among undergraduates in a Nigerian University.","authors":"Olufunmilola O. Abolurin, Oluwabusola A. Akinbajo, Olusoji J. Daniel, Adesola O. Adekoya, Akinkunmi E. Akinbajo, Abiola O. Adekoya","doi":"10.4314/gmj.v58i2.5","DOIUrl":"https://doi.org/10.4314/gmj.v58i2.5","url":null,"abstract":"Objectives: The study was conducted to describe the sexual behaviours and contraceptive use, as well as factors associated with being engaged in sex among Nigerian undergraduates.Design: A descriptive cross-sectional study.Setting: The study was conducted in a university of education in Ogun State, Nigeria.Participants: Four hundred undergraduates were selected sequentially through a stratified sampling method.Main outcome measures: Being sexually active, multiple sexual partners, and contraceptive use.Results: Participants’ ages ranged from 16 to 24 years. Nearly two-thirds (65.5%) were females. About a quarter of them (24.5%) were using psychoactive substance(s). More than two-fifths (44.5%) of them had engaged in sexual intercourse, of which 36% had a history of multiple sexual partners. The mean age at sexual debut was 18.7 ± 2.7 years, significantly lower among males than females (p <0.001). About half (218; 54.5%) of the students were cognisant of contraceptives, and 39.3% of sexually active participants had used contraceptives at some time, with condoms being the most commonly used. Male sex (p = 0.042), older age (p <0.001), higher monthly allowance (p = 0.025), and substance abuse (p <0.001) were factors that made undergraduates more likely to have engaged in sex.Conclusion: Engagement in sexual activity and unsafe sex were common practices among the Nigerian undergraduates studied. It is recommended that deliberate efforts be made to increase contraceptive awareness and usage.","PeriodicalId":94319,"journal":{"name":"Ghana medical journal","volume":"51 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141688372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Helicopter research: A persistent drawback to equitable collaborative research","authors":"Samuel Blay Nguah, Margaret Lartey","doi":"10.4314/gmj.v58i2.1","DOIUrl":"https://doi.org/10.4314/gmj.v58i2.1","url":null,"abstract":"Collaboration in research has increased over the years with many advances in medical knowledge. With understanding and good faith, many of these partnerships have yielded remarkable results and significantly improved our world. The inequity has resulted in many untoward effects since much of this collaborative research is between persons from richer or high-income countries and poorer or lower-income ones. Helicopter Research or “parachute research” refers to the situation where a more resourced partner in a research collaboration goes into the less resourced partner's location, conducts research, exports the data, and publishes the findings, often with no or very little input from or acknowledgement of the less resourced counterpart. This does not only occur between richer and poorer nations but also even within the same country where the relationship is asymmetrical.","PeriodicalId":94319,"journal":{"name":"Ghana medical journal","volume":"41 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141687661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recurrent ischemic stroke post-thrombolysis in an older Ghanaian woman","authors":"Kwadwo F. Gyan, Priscilla A. Opare-Addo, Moses Siaw-Frimpong, Kwasi Ankomah, Fred S. Sarfo","doi":"10.4314/gmj.v58i2.9","DOIUrl":"https://doi.org/10.4314/gmj.v58i2.9","url":null,"abstract":"Acute ischemic stroke management has evolved through several paradigms. Currently, thrombolysis is recommended for patients who present within 4.5 hours of acute ischemic stroke. Early neurological deterioration post-thrombolysis, however, may occur through several mechanisms. We report a case of a 66-year-old Ghanaian woman with multiple co-morbidities who presented with sudden onset right-sided weakness and aphasia of 2 hours duration. A diagnosis of acute ischemic stroke was made based on clinical examination and a computerised tomography scan of the brain. She underwent successful thrombolysis with recovery of full neurological function. She, however, developed a second ischemic stroke within 72 hours, with the likely aetiology being large vessel occlusion. This was subsequently managed conservatively. Extensive evaluation and control of specific stroke aetiologies is required for the prevention of stroke recurrence post thrombolysis. Also, the establishment of comprehensive stroke centres which provide neurovascular interventions in sub-Saharan Africa can help reduce stroke mortality and morbidity in eligible patients.","PeriodicalId":94319,"journal":{"name":"Ghana medical journal","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141687112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors associated with dual sensory impairment in older persons attending the Geriatric Centre in Southwest Nigeria","authors":"Abiola O. Obadare, Lawrence A. Adebusoye, Eniola O. Cadmus","doi":"10.4314/gmj.v58i2.3","DOIUrl":"https://doi.org/10.4314/gmj.v58i2.3","url":null,"abstract":"Objective: This study examined the prevalence of hearing impairment, visual impairment and Dual Sensory Impairment (DSI) and the risk factors among older personsDesign: A Cross-sectional study where respondents were recruited by systematic random sampling.Setting: A tertiary institution at the Geriatric Centre, University College Hospital, Ibadan, Nigeria.Participants: A total of 388 older persons aged more than 60 years were recruitedInterventions: A semi-structured pretested questionnaire was used over three months.Main outcome measures: Association between ageing, low income, poor quality of life, functional disability, and dual sensory impairment.Results: The mean age of the respondents was 70.2±6.3 years. The point prevalence of HI, VI and DSI were 14.9%, 8.0%, and 1.5% respectively. On logistic regression analysis, the most significant factors associated with HI were having no formal education OR=2.564(1.091-6.024) and previous hospital admission OR=3.473(1.856-6.499), for VI; increasing age OR=1.080(1.022-1.141) and poor income OR=2.941(1.263-6.897) and DSI; increasing age OR=1.224(1.054-1.421).Conclusion: Few (1.5%) older adults experienced DSI in our setting. The association between sensory impairments, age, and socioeconomic factors of poor education and income suggests the need for visual and hearing screening in older adults, particularly those with medical and socioeconomic issues, for early detection.","PeriodicalId":94319,"journal":{"name":"Ghana medical journal","volume":"345 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141686514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adherence to routinely prescribed medications among paediatric sickle cell disease patients in Kumasi, Ghana","authors":"Merlene A. Agyekum, Samuel B. Nguah, Joseph Attakorah, Gustav K. Nettey, Kwaku G. Oppong, Vivian Paintsil, Alex O. Akoto, Kwame O. Buabeng","doi":"10.4314/gmj.v58i2.2","DOIUrl":"https://doi.org/10.4314/gmj.v58i2.2","url":null,"abstract":"Objective: To measure the adherence to routinely prescribed medications among Sickle Cell Disease (SCD) patients in Kumasi, GhanaDesign: A cohort study involving paediatric SCD patients presenting to the outpatient clinic at the Komfo Anokye Teaching Hospital (KATH).Setting: The Pediatric SCD Outpatient Clinic of KATH.Participants: Two hundred SCD patients visiting the outpatient clinicIntervention: NoneMain Outcome Measure: Cost and adherence to Penicillin V, Folic Acid, Hydroxyurea and Vitamins prescribed to SCD patients on routine outpatient visits.Results: Of the 200 participants, the highest and lowest phenotypes were Hb-SS (162, 80.1%) and Sβ-thal (3, 1.5%), respectively. The adherence rate to routine medications was 13.5% (95%CI: ut9.1% to 19.0%). Patient factors that affect adherence included forgetfulness 98(49%), cost 54(27%), and side effects 28(14%) of medication, and improvement in health 7(3.5%). Hydroxyurea was the costliest to the patients with a median (IQR) cost of GHc 75 (0, 450) or USD12 (0, 73), and the least was folic acid with a median of GHc 6 (0, 42) or USD 1 (0, 7). 44.5% of all medications prescribed were not obtained in full. 83% of those who did not purchase all the medicines attributed this to cost, with 13% indicating they had some at home.Conclusion: There is low adherence to routine medications used by SCD patients in Kumasi, and this could be because of their relatively high cost. Further studies should be made to assess the non-adherent effects of SCD medications on patients' health.","PeriodicalId":94319,"journal":{"name":"Ghana medical journal","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141684436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}