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- ItemAcceptance of HIV Counselling & Testing Among Pregnant Women in the Kumasi Metropolis(2008-07-13) Sakyi, Kwofie GabrielIn Ghana, as in most parts of Africa, south of the Sahara, HIV/AIDS account for a lot of mortality and morbidity in children. Children born to infected mothers acquire infection and progress to clinical diseases. This mother-to-child-Transmission (MTCT), accounts for most of the cases in children less than 15 years. To help address this problem, the Ghana National Policy on HIV/AIDS and STIs has come out with strategies that include the use of routine Counseling and Testing (CT) as a tool for the prevention of MTCT (PMTCT). The main objective of this study was to determine the level of acceptance of this routine HIV CT, as well as factors associated with acceptance among pregnant women in Kumasi Metropolis. The study was a descriptive cross-sectional type, with structured questionnaire as the data collection tool served on 200 pregnant women attending Antenatal Clinic (ANC) in the Kumasi Metropolis. The sampling frame was pregnant women attending ANC at the three hospitals in the metropolis. The 200 ANC attendants were selected by a systematic random sampling technique. Findings include a high level of acceptance, with 87.5% of respondents accepting to undergo HIV testing either before or after counseling. The effects of socio-demographic characteristics on acceptance of HIV CT were not statistically significant. The knowledge level of pregnant women on HIV/AIDS and Prevention of mother to Child transmission (PMTCT) significantly affected HIV CT acceptance (p = 0.000): Those with adequate knowledge levels were twenty four times more likely to accept HIV CT than those with inadequate knowledge levels. Seeking Spousal permission did not significantly affect acceptance (p= 0.86). However, spousal involvement significantly encouraged HIV CT (p = 0.04) Given the high, level of acceptance which is consistent with high acceptance levels in some African studies, the existing strategy of routine HIV CT, as a tool for PMTCT of HIV, should be sustained, and if possible improved upon.
- ItemAddressing domestic violence against women: a case study of Navio traditional council in Kasena-Nankan West District of the Upper East Region, Ghana.(November, 2019) Thomas, Amibase;Background:Domestic violence against women has been recognized both globally and locally(Ghana) as a major violation of a woman’s human rights.Despite the enactment of Domestic Violence Act(Act 732) and establishment of Domestic Violence and Victims Supports Unit (DOVVSU), the problem still lingers. To adequately address the problem, calls are made to consider other alternatives systems of disputes resolution such as the traditional authorities. The study assesses the effectiveness of traditional authorities’ intervention in addressing domestic violence against women in the Navio traditional area. Methods:A cross sectional research design wasadopted for the study.Simple random sampling technique was used for the selection of the study sample.The study participants were interviewed using a pre-tested structured close and open-ended questionnaire.The data wasthen analyzed using descriptive statistics such as percentages, frequency, mean, standard deviation and presented on tables and graphs. Results:The study reveals that domestic violence occasionally occurs in the community (74.7%) and remains largely unreported (60.9%). The study further found that respondents preferred the traditional authorities in resolving domestic violence cases to the police and victims felt safe under the interventions put in place by the traditional head. Conclusion: The study concludes that victims of domestic violence are aware of interventions put in place and prefer the traditional leaders over the police in dealing with reported cases.
- ItemAdherence to anti-hypertensive medication regimens among patients attending the G.P.H.A. Hospital in Takoradi - Ghana.(2006-08-08) Jambedu, Haruna AhmedBackground: Adherence is the extent to which a person’s medication-taking behaviour coincides with the healthcare providers’ medical advice. It includes both dosing regularity and timing of intake. Many physicians face the problem of non-adherence among their hypertensive patient population. During the first year of treatment 16 – 50% of patients stop taking their high blood pressure medications. Overall, it is estimated that only about 30 – 50% of patients with hypertension adhere precisely to their hypertension medication regimens. Adherence is important in the treatment of hypertension Objectives: The objective of this study was to assess the extent of non-adherence to hypertensive medication regimen in G.P.H.A. Hospital, Takoradi. The reasons for non-adherence in the study were also evaluated. Methods: A prospective study of 150 hypertensive patients on medication for at least 6 months, who reported at the OPD of this hospital, was carried out. The Morisky questionnaire was administered to the patients and reasons for non-adherence sought. Pregnancy related hypertensive patients were excluded in this study. Results: The study revealed that total adherence to anti-hypertensive medications regimens was 19.3% and partial or medium adherence was 49.3%. Hence the adherence rates (i.e. those who took their medications ≥ 75%) to anti-hypertensive medicines in the institution was 68.6% and the non-adherence rate was 31.4%. The major reasons for non-adherence were forgetfulness (45.4%) by the patient to take medications on time or missed doses and side effects of the medications (20.8%). Finance (10.4% was also a problem for the paying patients who have to make up-front payment to re-fill their medicines. Conclusion: The prevalence of adherence among hypertensive patients in this health facility was 68.6%. Thus, indicating the need for adherence counselling.
- ItemAnti-inflammatory, antimicrobial and antioxidant properties of margaritaria nobilis, stylochiton lancifolius, drypetes principum, crescentia cujete and albizia glaberrima(September, 2015 ) Jato, JonathanThis research work scientifically evaluated and validated the anti-inflammatory, antioxidant, antimicrobial activities and the acute oral toxicity profile of five (5) selected plants that find use in Ghanaian traditional medicine as agents for treating inflammatory condition s and infections. Ethanolic extracts of the rhizomes of Stylochiton lancifolius Pyer and Kotchy (Araceae), the stem barks of Margaritaria nobilis L.f (Müll Arg.) (Euphorbiaceae), Drypetes principum (Müll Arg.) Hutch (Putranjivaceae), Crescentia cujete Linn (Bignoniaceae), and Albizia glaberrima (Schum. & Thonn.) Benth (Leguminosae) were each assessed for their biological activities. The carrageenan-induced oedema in chicks model for in vivo anti-inflammatory activity indicated that the extracts and reference drugs significantly (p<0.0001) and dose-dependently inhibited oedema at all doses. The extract of C. cujete had the least ED50 value of 23.30±0.43 mg/kg body weight followed by D. principum, M. nobilis, A. glaberrima and S. lancifolius with ED50 of 37.25±1.22, 90.54±0.73, 164.90±1.63, and 181.50±1.06 mg/kg body weight respectively. The percentage inhibition of total oedema of each extract was comparable to Diclofenac, Dexamethasone and compound EMN1 (betulinic acid; isolated from M. nobilis stem bark). At doses of 300 mg/kg body weight, the percentage inhibition of total oedema of all the extracts ranged from 77.49 - 83.59% comparable with EMN1, Diclofenac and Dexamethasone which inhibited oedema at 67.83%, 81.62, and 82.47 (doses of 100, 30, and 10 mg/kg body weight) respectively. In vitro anti-inflammatory assays using human RBC membrane and egg albumin stabilisation models indicated that the extracts were comparable to the reference drugs; Diclofenac and Dexamethasone in terms of activity. Four Gram positive and four Gram negative bacteria and a fungus were employed in antimicrobial assays using the agar well diffusion and iv broth micro dilution models. The 70% ethanol extract of M. nobilis and C. cujete were the most active in the agar well diffusion assay showing activity against eight of the microorganisms. M. nobilis extract produced the highest zone of growth inhibition (22.93±0.27 mm) against Candida albicans at 10 mg/mL concentration. The activities of all the extracts at 10 mg/mL were comparable to Amoxicillin and ketoconazole at 5 mg/mL. Minimum inhibitory concentrations (MICs) of the extracts ranged from 100 to over 1000 µg/mL. The 70% ethanol extract of M. nobilis yielded the least MIC of 100 µg/mL against S. aureus and C. albicans, whereas that of C. cujete had the highest MIC of 1500 µg/mL against E. coli. Antioxidant activity was investigated using DPPH bioautography, DPPH radical scavenging assay, total antioxidant capacity and total phenol content. The IC 50 values in the radical scavenging assay indicated that the extracts of M. nobilis and S. lancifolius (9.96±0.03 and 31.58±0.17 µg/ml respectively) were more active than Ascorbic acid (38.30±0.00 µg/ml). The extracts of D. principum, A. glaberrima and C. cujete respectively inhibited 50% of DPPH at 49.09±0.39, 53.60±0.32, and 168.80±1.06 µg/ml. The Ascorbic acid and the Tannic acid equivalences had a repeated pattern as the radical scavenging assay. Stem bark extract of M. nobilis yielded the highest antioxidant capacity and phenol content. Acute oral toxicity studies according to the Organization for Economic Cooperation and Development (OECD) 2001 guidelines concluded that none of the extracts produced significant observational acute toxicity in the study animals. About 395 mg of compound (EMN1) characterized as betulinic acid was isolated from the 70% ethanol extract of M. nobilis. Based on these observed activities, the folkloric claims of effectiveness of these plants as safe anti -inflammatory, antioxidant and antimicrobial agents may be justified.
- ItemAnti-nociceptive effects of an aqueous extract of the aerial parts of phyllanthus muellerianus (kuntze) exell. And its main constituent, geraniin, in rodents(JULY, 2016.) Anle Kasanga, EllaPhyllanthus muellerianus has been used in folk medicine for several ailments including toothache, dysmenorrhea and general body pains. However, there is little scientific data supporting its use in pain management. This study therefore evaluated the antinociceptive potential and the acute toxicological profile of the aqueous extract of the aerial parts of Phyllanthus muellerianus (PME) as well as its dominant secondary metabolite, geraniin. Acetic acid-induced abdominal writhing and formalin–induced nociception tests were used to assess the anti-nociceptive effects of PME and geraniin. The involvement of the opioidergic, adrenergic, muscarinic, adenosinergic, serotonergic and nitric oxide pathways in anti-nociception were evaluated in vivo by selective antagonism of these pathways in ICR mice. An isobolographic analysis was performed using geraniin and the conventional analgesics; morphine and diclofenac. The formalin test was used to determine whether tolerance develops to the anti-nociceptive activity of PME and geraniin after chronic administration. The effect of the agents on naloxoneprecipitated morphine withdrawal signs was also evaluated. The acute toxicological profile of the extract was also assessed after both single and multiple administrations in mice and rats respectively. Oral administration of PME (30, 100, 300 mg kg-1) and geraniin (3, 10, 30 mg kg-1) produced significant anti-nociceptive effects in all models used. The anti-nociceptive effects of both the extract and geraniin were not antagonized by all the antagonists except naloxone which reversed the anti-nociceptive effects of only geraniin. Also, isobolographic analysis of geraniin/morphine as well as geraniin/diclofenac combinations indicated synergistic effects. PME and geraniin did not produce any tolerant effects. PME and geraniin did not induce withdrawal signs and significantly produced a reduction in the number of jumps of morphine dependent mice. In the toxicological study, acute administration of high doses of the extract did not produce any lethality with the Lethal Dose 50 (LD50) of PME estimated to be above 5000 mg kg-1. There were also no significant differences found in almost all of the hematological and serum biochemical parameters as well as organ/body weight ratio. In conclusion, the aqueous extract of the aerial parts of P. muellerianus and geraniin possess anti-nociceptive effects justifying the use of the plant in traditional use as an analgesic
- ItemAntibiotic Resistance Patterns of Pseudomonas Aeruginosa and Escherichia Coli Isolates from Three Hospitals In Kumasi(2011-10) Duredoh, Freeman GeorgeNosocomial infections are worrying situations in health care delivery across the world. Every year, millions of people report of contracting one form of nosocomial infections which are difficult to treat due to the level of antibiotic resistance exhibited by these microorganisms. In this study, a total of 600 samples including swabs of door handles, benches, beds, and floors, and waste water from drainages were collected from Tafo, Kumasi-South, and Suntreso Hospitals all in the Kumasi Metropolis between January and June, 2010 and cultured. By morphological and biochemical reactions, 57 strains of Pseudomonas aeruginosa and 97 strains of Escherichia coli were isolated, identified and tested for their antibiotic sensitivities using the Kirby-Bauer agar disc diffusion assay against ampicillin (10μg), gentamicin (10μg), ceftriaxone (30μg), ciprofloxazole (5μg), and co-trimoxazole (25μg) on Mueller-Hinton agar. E. coli was present in all the samples while P. aeruginosa was mainly present in samples from the floor, beds, drainages and door handles. All the P. aeruginosa isolates and about 90% of the E. coli isolates were resistant to ampicillin. For gentamicin, 46% of the P. aeruginosa isolates exhibited resistance while 21% and 33% showed intermediate and sensitive responses respectively. For ciprofloxacin, 36.84% of these isolates were resistant while equal proportions (31.58%) exhibited intermediate and sensitive responses. About 40% of the P. aeruginosa isolates also showed intermediate response to ceftriaxone while 39% and 21% were respectively resistant and sensitive. For gentamicin, many of the resistant P. aeruginosa isolates (34.6%) were obtained from door handle samples while majority of the sensitive isolates (47.4%) came from drainage samples. In the case of ceftriaxone, high proportions of drainage isolates were resistant (45.5%). Almost equal proportions of the drainage sample isolates recorded the various activities to ciprofloxacin: 38.9% sensitive, 38.1% resistant and 33.3% intermediate isolates. The study has also shown that out of 52 E. coli isolates from hospital beddings, 53.85% were resistant to gentamicin, 25% to ceftriaxone and 61.5% to ciprofloxacin. Similarly, out of 21 P. aeruginosa isolates from drainage samples, 28.57% were resistant to gentamicin, 47.62% to ceftriaxone and 28.57% to ciprofloxacin. Out of 97 E. coli isolates, 78(80.41%) were resistant to at least three different classes of antibiotics while 32(56.14%) out of 57 P. aeruginosa isolates were also resistant to at least three different classes of the antibiotics. vii This study has therefore highlighted the presence of antibiotic resistant pathogens in our hospital environments including more especially, hospital beddings. It has also provided data on these resistant pathogens which will be useful in health care policy planning in Ghana and the sub-region at large.
- ItemAntimalarial usage in pregnancy: a cross-sectional study in selected health facilities in the Brong Ahafo Region of Ghana(2015-07-11) Fordjour, FrancisBack ground: Malaria in pregnancy could be life threatening and has serious health implication for both the mother and the foetus if not managed well. In search of effective therapeutic regimen for malaria in pregnancy, the medicines used should be able to treat the disease without inducing any harm on the mother or developing foetus. Ghana has gone through policy changes regarding malaria treatment in pregnancy with a shift from chloroquine to quinine since 2004. The current policy recommendation faces an implementation challenge, because some prescribers are sceptical and thus reluctant to use quinine during pregnancy because of the reported risk of bleeding and abortions associated with its use. This study was aimed at assessing prescribers’ awareness of the national policy for malaria in pregnancy, the depth of knowledge of the prescribers on the policy and the pattern of use of antimalarials in pregnancy. Material and methods: This was a cross-sectional study involving three selected health facilities in the Brong Ahafo region of Ghana that were purposively selected. These include: the Regional hospital in Sunyani, the Holy Family hospital in Techiman and the Nkoranza Health Centre. Sixty prescribers from these facilities were systematically sampled to complete a structured questionnaire designed for data. The prescribers answered questions related to their knowledge on the national policy for malaria treatment in pregnancy and their experience with the use of quinine and the Artemisinin Combined Therapies (ACTs) in pregnancy. In addition, 310 prescriptions issued to pregnant women at the study sites with malaria were also reviewed and documented. The data obtained was coded, stored and analysed using SPSS version 16. Results: Eighty-five percent of prescribers (n=51) knew that quinine was a policy recommended medicine for malaria in the 1st trimester of pregnancy. Only 5% (n=3) vi identified both oral quinine with clindamycin as an alternative. Forty-three percent (n=26) knew that both oral quinine and the ACTs are recommended for malaria in the 2nd trimester of pregnancy. Thirty-seven percent (n=22) also knew that oral quinine and the ACTs are recommended medicines for malaria in the 3rd trimester of pregnancy. Fifty-one percent (n=31) had observed bleeding in early pregnancy and associated it with the use of quinine. Fifty-three percent (n=31) refused to prescribe quinine for malaria in pregnancy. Fifty-six percent (n=34) indicated that artemether-lumefantrine is tolerable and safer than quinine for uncomplicated malaria in pregnancy. Seventy-six percent of 1st trimester pregnant women with malaria (n=62) were prescribed artemether-lumefantrine. Ten percent in their 1st trimester (n=8) were prescribed quinine. 86.4% of pregnant women with malaria (n=197) in their 2nd and 3rd trimesters were prescribed artemether-lumefantrine. 3% (n=7) in their 2rd and 3rd trimesters were also prescribed quinine. Conclusion: Prescribers were aware of the national policy for malaria therapy in pregnancy but few knew that oral quinine plus clindamycin is also endorsed for malaria in early pregnancy. Reports of quinine induced bleeding in early pregnancy was confirmed by most of the prescribers interviewed. More than half of the prescribers refused to give quinine for malaria in pregnancy due to the risk of quinine induced bleeding or abortion (p=0.003). There was widespread use of parenteral artemisinins and artemether-lumefantrine in early pregnancy for uncomplicated malaria. To reduce non-adherence to quinine treatment regimen in pregnancy, prescribers should be educated and encouraged to use the 3-days treatment of quinine-clindamycin combination for uncomplicated malaria in pregnancy.
- ItemAntimicrobial and wound healing activities of Clerodendron Splendens G. Don(2008-08-09) Kisseih, EmeliaClerodendron splendens G. Don (Fam. Verbanaceae) is a well known plant in Ghanaian folklore medicine for treating various skin infections and in wound healing. Based on its traditional use, this plant was evaluated for its antimicrobial, wound healing and antioxidant properties. Juice expressed from the fresh leaves and ethanol, acetone and chloroform extracts of the dried leaves, stem and root, all exhibited various degrees of antimicrobial activity against the test microorganisms: Pseudomonas aeruginosa (NCIMB1042), Escherichia coli (NCTC9002), Staphylococcus aureus(NCTC4163), Bacillus subtilis (NCTC10073), Proteus mirabilis (NCTC13376), Klebsiella pneumonia (NCTC5055) and Candida albicans (NCTC3255), with minimum inhibitory concentrations ranging from 0.15 to 7mg/ml. The time-kill kinetics studies conducted suggested microbistatic activity of the various extracts against these test microorganisms employed. The extracts (fresh juice, 3, 30, 300 and 1000 mg/ml) were topically applied twelve hourly to excision wounds created on the back of Sprague Dawley rats in groups of seven. Two more groups serving as the controls were also treated with 1%w/w Silver sulphurdiazine cream and the vehicle (normal saline + tween80). The extracts showed faster rate of wound contraction in the first 5 days than the controls. Higher breaking strengths were recorded, especially in the 300mg/ml treated group, suggesting the possibility of higher collagen content of the repaired tissues than in the control groups. C. splendens also exhibited antioxidant activity in the DPPH (1-diphenyl-2- picrylhydrazyl) radical scavenging assay with IC50 value of 5.61± 0.04 mg/ml. Thus this study provides a scientific rationale for the traditional use of this plant in the management of wounds and other infectious conditions.
- ItemAntimicrobial, Antibiotic Modulation and Wound Healing Activities of Entandrophragma Angolense(2012-7-8) Ugboduma, Ogheneruno AnthoniaEntandrophragma angolense (Welw.) C.DC. (Meliaceae)is a deciduous plant commonly found on the West African Coast. This study was undertaken to evaluate the antimicrobial, antioxidant and wound healing activities of methanol stem bark extract of E. angolense. Phytochemical screening for secondary metabolites was carried out on the crude extract of the plant...
- ItemAssessing the dropout rate of the expanded programme on immunisation in Asutifi District.(2008-07-12) Akutteh, Hanson MensahThe induction of an immune response to infectious disease by vaccination has become a widely applied and acceptable public health intervention. For immunisation to be effective as a long-term global childhood disease control strategy, it is essential that parents continue to present their children for vaccination. A recent study in assessing the dropout rate of immunization has shown that, immunization coverage in Asutifi District has been high with percentage of fully vaccinated children ranging between 95% in the district and 90% to 97% in the sub-districts. There is an account of high dropout rate of eligible children receiving the vaccines in the sub-district above the National and WHO, recommended level of dropout rate less than 10% (WHO, 2005). The aim of the study was to determine the dropout rate of the Expanded Program on Immunization to assess the ability of the service to hold on to the number of children who started the vaccination. A descriptive cross-sectional survey among a representative sample of 300 children between the ages of 12-23 months from households with varying socio-economic status from both urban and rural sub-districts was done to illicit information on the immunization coverage. Approximately 95% of children under the age of two had been completely vaccinated. Averagely about 40% of eligible children in the district had timely received vaccines during EPI programme. Seventy seven percent of children receive their vaccination at the outreach post. The vaccination schedule showed that 4.4% who started BCG vaccination dropped out as at the time of receiving measles vaccine. The dropout rate for DPT1 and DPT 3 was 0.67%. More than 62% of mothers do not present their children for vaccination because they are busy with their economic activities and 31.25% of household are unaware of the need to return for subsequent doses. These shortcomings are affecting the sustainability of routine immunisation programmes and are promoting the growth of a large number of partially immunised children. To protect the continued operations and to enhance the coverage of routine vaccination programmes, it is important that the dropout rate and these difficulties be addressed. The dropout rates for children in the sub-district are between 5% and 10% signifying differences in how each sub-district is able to hold the number of eligible children who were targeted for vaccination. Generally the dropout rate indicates that the efficiency of the service delivered during EPI programme in the sub-district differ from one sub-district to another. The difference that exist in the dropouts within the sub-districts demonstrate a service delivery gap and suggest that greater efforts are required by government and the district health management team to rethink of resource allocation and strengthening processes to improve immunization coverage among rural poor.
- ItemAssessment of financial control system in Nifa Senior High School in North Akuapem Municipality in the Eastern Region Of Ghana(2016-10-05) Asamoah, SamuelReport has shown that there have been persistent financial malfeasances in most second circle schools in Ghana in recent times due to absent of proper financial control system and non compliance with financial rules and regulations. Organizations use financial tools like, cash flows, income statements, budget and other financial instruments to undertake financial controls in the form of using policies and procedures established by institutions for managing, documenting and reporting on financial activities. The research was conducted to investigate the financial control system in Nifa Senior High School in Akuapem North Municipality. Actually, it assesses the sources of funds, challenges, effectiveness of financial controls and strategies to improve the control system. Information was gathered, using questionnaires to collect data, from a sample of 1 Headmaster, 3 Assistant Headmasters, 8 Bursar and Account Clerks, 35 Teaching Staff and 40 Student leaders. Four set of questionnaires were designed to determine financial control system in the School, Data obtained from the research instrument was then statistically analyzed and presented in tables, graphs and percentages. The researcher used descriptive statistics to study in detail the financial control system in Nifa Senior High School since the study is exploratory in nature. The study revealed two sources of funds for the schools, from government budgetary allocations and internally generated funds. The school funds are mostly spent on administrative activities and other important items. The students pay their school fees through bank draft and postal order while a few students are allowed to pay cash. The staff of account section should be urged to attend conferences, seminars and workshops regularly to upgrade their knowledge and skills. It is recommended that the school should establish its own audit committee to check the spending rate of the school in order to make sure that the school spends within the budgeted estimates.
- ItemAssessment of the capacity of health facilities in the early detection of disabilities in children in the Brong Ahafo Region of Ghana(November, 2016) Yinbil, Joseph BabaAdvances in medical technology have improved on the health of many infants who have sustained injuries during intrauterine development or birth, giving them a better chance of improved quality of life. Nevertheless, some conditions still create overwhelming consequences causing lifelong disabilities. Many infants injured during the birth process or born with congenital anomalies have long term effects from their conditions. Their families may have long-term effects as well. There is therefore the need for early detection and prevention measures to curb the incidence of disabilities in newborns. This study is therefore aimed at assessing the capacity of health facilities to facilitate the early detection and intervention of disabilities in infants and children in order to prevent the debilitating effects of such disabilities on children. Findings confirmed that Pediatricians, midwives and other health professionals employed various techniques including physical examination or assessment to determine if they have any defect. They did this by listening to the cry of the newborn child, the color of the eye, the physical appearance of the baby, and the color of the skin. The findings of the study indicated that most of these examinations were conducted between the first hour and 48 hours after birth and detection usually occurred during this examination period. The results of the study also showed that most of the facilities lacked modern screening equipment. To improve on the effectiveness of health facilities to detect disabilities in newborns and infants, there is need to create a unit for early detection and treatment of disabilities in every health facility, provide enough screening tools and modern equipment for every unit/facility, and pregnant women should be encouraged to take antenatal care seriously.
- ItemBiochemical and Anthropometric Characterisation of hypertension in Kumasi(January, 2016 ) Aryee, ChristianaThe surge in prevalence of chronic non-communicable diseases like hypertension and chronic kidney disease has been linked with modifiable lifestyle practices and increased body fat. This study sought to evaluate the association between different modifiable lifestyle practices, adiposity indices, biochemical parameters and target cardiac and kidney organ damage among hypertensives in Kumasi. Using a hospital-based case–control study design, 241 Ghanaian indigenes from the Kumasi metropolis were recruited for this study. The case group was made up of, 180 hypertensives and 61 normotensives served as controls. In addition to socio-demographic data, all participants underwent standard haemodynamic, anthropometric, biochemical and cardiac organ damage assessment. In general, the case group presented with a significantly poorer atherogenic lipid profile compared to their counterparts in the control group. Increasing atherogenic dyslipidaemia was more prevalent with the presence of cardiac target organ damage. The prevalence of chronic kidney disease (CKD) ranged between 13.3% to 16.6% depending on the equation used in estimating the glomerular filtration rate (eGFR). Chronic kidney disease was significantly higher among self-reported smoker and alcoholic hypertensives. Among the commonly used athropometric measures, a population-specific threshold for waist circumference of >75cm for females and >80cm for male were the best adiposity indices for discriminating hypertension. However significant improvement in prediction was achieved with the use of conicity index (>1.08 female, >1.05 male). The sole reliance on body mass index in the determination of obesity and associatd health risks must be discontinued to incorporate more sensitive anthropometric markers.
- ItemBiochemical effect of the Ethanolic root extract of Croton Membranaceus on the treatment of benign prostatic hyperplasia(NOVEMBER, 2016) Anang-Quartey, YvonneBenign prostatic hyperplasia (BPH) is one of the most common diseases of aging men, characterized by noncancerous enlargement of the prostate gland which is often associated with lower urinary tract symptoms (LUTS) and poses a threat to the quality of life (QoL). The prevalence of BPH is age-dependent, with the initial development usually after 40 years. The condition accounts for 80% of prostate disorders in Ghana with a peak age of 65 years. Treatment options are basically by orthodox or traditional means. Due to the fear of loss of libido in men as a result of the use of orthodox medicine, BPH patients have resorted to complementary and alternative medicine (CAM) for treatment. An ethanolic extract of Croton membranaceus (CMERE) has been used over four decades for the management of BPH based on anecdotal evidence. However, no scientific study exists to back this practice. The study therefore aimed at investigating the effect of CMERE on BPH patients. Thirty (30) clinically diagnosed BPH patients were recruited by a convenience sampling technique. Baseline information on LUTS and sexual function was obtained using the International Prostate Symptom Score (IPSS) and the International Index of Erectile Function (IIEF) questionnaires, respectively. Blood samples were also obtained from subjects for biochemical assays [PSA, renal function tests (RFTs), liver function tests (LFTs), lipid profile and Apo proteins A1 and B] using spectrophotometric and ELISA techniques. Treatment outcome on glutathione s-transferase T1 and M1 (GSTT1 and GSTM1) genotypes was determined by molecular techniques. Abdomenopelvic ultrasonography was also performed to determine the prostate volume. These parameters were again measured 3 months after administration with 60 mg per day CMERE in capsule form. The average age was 66 ±11 years. At the end of the study, no patient had severe prostate symptoms compared to baseline data of 37%. Furthermore, improvement in IPSS and QoL was significant (p = 0.0005 and 0.0001, respectively). CMERE did not adversely affect systemic organs generally. No significant differences were observed in RFTs, and the lipid profile except for Apo A1 which increased indicating an increase in high density lipoprotein cholesterol (HDL) (p=0.0248), LFT parameters were normal except for increases in total and indirect bilirubins (p = 0.0008, p = 0.0007, respectively). However, these were within the normal reference intervals and could be as a result of bilirubin functioning as an antioxidant. PSA decreased significantly by 40.87% (p = 0.0015), accompanied by a significant decrease of 39.71% in prostate volume (p = 0.0008) after treatment. Thirty-three percent (33%) and 67% of the subjects were GSTT1 negative and GSTT1 positive, respectively, whiles 20% of the subjects were GSTM1 negative and 80% GSTM1 positive, respectively. There was a significant reduction of PSA levels (p<0.05) in both GSTT1(+)/GSTM1(+) subjects but not GSTT1(-)/GSTM1(+) and GSTT1(+)/GSTM1(-) subjects. In conclusion, C. membranaceus use is safe and a highly desirable alternative for men with BPH. IPSS, QoL, PSA and prostate volume improved significantly. GSTT1(+)/GSTM1(+) polymorphism subjects also showed a significant and better response to treatment. This is the first evidence backing the anecdotal claims for the use of C. membranaceus in the management of BPH.
- ItemCharacteristics of women presenting with abortion at the Komfo Anokye Teaching Hospital, Kumasi, Ghana(2014-12-10) Agyei, HelenaTo accelerate progress towards achieving the Millenium Development Goal 5 there must be a substantial reduction in abortions, particularly self-induced abortions alongside increased contraceptive uptake. This study describes the characteristics of women presenting with abortion at KATH in Kumasi, Ghana. A better understanding of the relationship between abortion particularly, induced abortion and women's background characteristics can improve our ability to identify subgroups in a population who are in the greatest need of effective contraceptive and post-abortion care services. Such information is valuable to program planners and policymakers in their efforts to facilitate women's ability to plan pregnancies. Systematic random sampling was used to select 420 participants aged 15-49 years presenting with abortion at KATH in a cross-sectional study. The data collected at two points: using a questionnaire from June to August, 2011 while on admission and a telephone conversation (follow-up interview from September to November, 2011) after discharge from KATH were analysed with SPSS version 16 using logistic regression. Majority, 252 (60%) of women who had self-induced abortion were younger than 30, single, unemployed with low education and of low socio-economic status as compared with those with spontaneous abortion who were 30 years or with at least three children, married and had high socio-economic status. It was revealed that, 253 (60.2%) of the respondents did not plan for the index pregnancy and about 64.9% terminated the pregnancy in pursuit of a career and for economic reasons. Also, 280(66.7%) did not use any modern contraceptive prior to the index pregnancy. Reasons gathered from the respondents showed that the fear of side effects contributed to a high rate of 55% post-abortion contraceptive non-use. Of the 420 respondents, only 58 (13.8%) used contraceptives: three months after their discharge from the hospital even though they had been counselled on contraceptive use and had wanted to prevent unintended pregnancies, postpone or delay childbearing. Out of these 58 respondents, 54(93.1%) presented with induced abortion while 4(6.9%) had spontaneous abortion. The study recommemded the sensitisation of all women of reproductive age particularly the youth to use post-abortion contraceptives to help prevent unplanned pregnancies, repeat abortions and maternal mortality. Also, they are to secure safe abortion services in a medical hospital or seek procedure for terminating an unintended pregnancy either by individuals with the necessary skills or in an environment that conforms to minimum medical standards, or both.
- ItemCharacterization of Biochemical Risk Factors of Senile Cataract Among Adults Visiting Komfo Anokye Teching Hospital, Kumasi, Ghana.(2013-06-04) Antwi, Amos OseiSenile Cataract, the opacity of the lens due to age is a major public health problem which if not detected and treated early could lead to blindness and other morbidities. It is the leading cause of avoidable blindness in Ghana. However, there are few repo rts on the biochemical risk factors elsewhere and no such study report could be found in Ghana. The study seeks to identify and characterized the biochemical risk factors for senile cataract among Ghanaian adults and to elucidate the association between serum biochemical indices and senile cataract for future cataract prognosis, screening program and to develop appropriate preventive strategies. This was a case-control study of outpatients attending eye clinic department of the Komfo Anokye Teaching Hospital (KATH) between February 2009 and July 2010. A total of 200 outpatients above 40 years comprising 100 cases (clinically newly diagnosed adult cataract patients) and 100 controls (patients who are clinically without the condition) were sampled for the study. Laboratory test values in cases and controls were compared and expressed as odds ratio and 95% confidence interval. The study found mean concentration of fasting blood glucose (4.92±2.09 mmol/L) of the cases was lower than the control grouping but within the normal reference ranges and was associated with senile cataract (ORs (95% CI) 1.3; 1.O6-1.49; p=0.008). There was elevated serum Na + level in those suffering from senile cataract (143.2±6.76 mmol/L) than the controls (139.3±1.96; p=0.0000). It was significant factor associated with the senile cataract (ORs (95% CI) 0 6 95% CI (0.47-0.72; p=0.000)). vi The mean serum K + level (4.21±0.50 mmol/L) of senile cataract patients was lower than the controls (4.38±0.45) and also associated with senile cataract with ORs (95% CI) 2.48 (1.47-0.72; p=0.010). Persons with low HDL C abnormalities have ORs (95% CI) 3.17 (1.79-5.61; p=0.000) and were significantly associated with senile cataract among the study population. The mean uric acid concentrations level was (210.0±113.8μmol L-1) lower in the cases compared with (311.1±117μmol L-1) controls and was significantly associated with senile cataract among the study population (ORs (95% CI) 1.01 (1.01-1.02) P=0.000). After adjusting for potential confounders, fasting blood glucose (ORs (95% CI) 1.O6 -1.49 ;p=0.008), sodium (Na + ) ORs (95% CI) 0 6 (0.47-0.72; p=0.000), potassium (K + ) ORs (95% CI) 2.48 (1.47-0.72; p=0.010), triglyceride (TG) ORs (95% CI) 0.58 (0.35-0.98) p=0.040), uric acid (UA) ORs (95% CI) 1.01 (1.01-1.02) P=0.000) and high density lipoprotein-Cholesterol ( HDL-c) ORs (95% CI) 3.17 (1.79-5.61; p=0.000) were identify and characterized as a significantly human biochemical indices associated with development of senile cataract among the study population. In log Likelihood-ratio test (LRTEST) controlling for age and sex, e levated serum Na+ level in those suffering from senile cataract was significant factor associated with senile cataract ORs (95% CI) 0.60 (0.45 - 0.80), P=0.001). Persons with lower serum potassium (K + ) ORs (95% CI) 2.48 (1.47-0.72; p=0.010) are twice likely to develop senile cataract. Persons with low HDL CHOL abnormalities were twice likely to develop senile cataract (ORs (95% CI), 2.52 p=0.095). The trend LRTEST indicated a very strong association between increasing order of level of exposure to (Na + ), HDL-c, UA, FBG and the probability of developing the senile cataract.The studies clearly established a half (50%) of any study population with the age of ≥70 years especially women are most likely to develop senile cataract. This study strongly suggests an association between serum biochemical indices and senile cataract. The association exist between low levels of High Density Lipoprotein-cholesterol (HDL) , low levels uric acid, Fasting blood Glucose(FBG), Serum sodium ( Na+), serum potassium ( K+), Triglyceride (TG) and Senile cataract. Our findings add to an evolving biochemical and laboratory animal based hypothesis that changes observed in the blood level constituent raised or lowered can be used for diagnostic and prognostic purposes and their detection makes up a large part of routine clinical chemistry especially in an elective cataract surgery procedure. It is essential to have access to the biochemical picture of such a patient prior to, during and immediately after surgery in order to effectively treat adverse reactions and that further studies may be necessary to ascertain whether or not certain dietary habit has a part to play in the aetiogenesis of Senile Cataract in various regions of Ghana.
- ItemChlamydia trachomatis prevalence in the Greater Accra region and the Western region of Ghana(2015-11-05) Dela, HelenaChlamydia trachomatis is one of the most prevalent Sexually Transmitted infections (STIs) worldwide due to its frequent asymptomatic nature and is normally tested alongside Niesseria gonorrhoeae which is also a bacterial pathogen. It is known to cause infections which can lead to ectopic pregnancy and neonatal conjunctivitis among pregnant women and Pelvic Inflammatory diseases (PID) in women when left untreated. C. trachomatis can also lead to infertility among males. Five sites in two regions were selected for the study. These included the 37 Military hospital and Adabraka STI clinic, Accra (Greater Accra region) and the three clinics at Sekondi/Takoradi (2 Medical Reception Station (2MRS), the Naval Health Center and the Air Force Medical Center) in the Western region. Patients who met the eligibility criteria provided consent, filled out a questionnaire and were made to provide urine samples which were transported to the Noguchi Memorial Institute for Medical Research (NMIMR) at 4˚C for Nucleic Acid Amplification Testing (NAAT).A total of 35 C. trachomatis positives out of 340 (151 males and 189 females) patients were detected during the study, giving a prevalence of 10.3%. The prevalence of chlamydia was higher (19.8%, 14/73) among the Takoradi clinics than the Greater Accra clinics (7.9%, 21/267). The males showed higher percentages in all the risk factors analyzed than the females. The risk factors included burning during urination, discharge and bleeding from penis/vagina, foul smell from urine, pain in penis/vagina, pain when having sex, ulcers and warts on genital parts. Burning during urination showed a relationship of a patient testing positive for the disease in both males and females. Most of the symptoms presented did not have any association in testing positive for C. trachomatis. It is recommended that more innovative ways be found to test sexually active young people, since the disease remain subclinical in many people. Health authorities and Clinicians should be encouraged to use NAATs as a diagnostic tool and in the absence of laboratory testing, syndromic approach could be used for diagnosis.
- ItemClinical utilization of Chondroitin Sulphate-A to determine the susceptibility of pregnant women to malaria(AUGUST, 2015) Lamptey, TheodoraPeople living in areas with stable transmission of Plasmodium falciparum parasites acquire protective immunity to malaria following multiple disease episodes. Immunity acquired this way is mediated by IgG with specificity for parasite-encoded, clonally variant surface antigens (VSA) on the surface of infected erythrocytes (IEs). However, women in endemic areas become susceptible to P. falciparum infection during pregnancy, particularly for the first time, regardless of acquired protective immunity. Aggregation of erythrocytes infected by P. falciparum in the intervillous spaces of the placenta using chondroitin sulphate A (CSA) as the dominant placental adhesion receptor has been identified. Chondroitin sulfate A is a sulfated glycosaminoglycan (GAG) composed of a chain of alternating sugars. It is usually found attached to proteins as part of a proteoglycan. This study sought to investigate the role of chondroitin sulphate A in malaria susceptibility in pregnant women. A total of 160 clients attending two selected health facilities, namely Kaneshie Polyclinic and Our Lady of Grace Hospital, were recruited. They were stratified into three groups: Pregnant women with malaria (n=80), non-pregnant women with malaria (n=40) and pregnant women without malaria (n=40). Full blood count (FBC), malaria RDT, thick film for malaria parasites and ELISA for chondroitin sulphate-A concentration were conducted for each volunteer. The mean haemoglobin count in pregnant women with malaria was 9.6 ± 1.4 g/dl and that of non-pregnant women with malaria was 10.3 ± 1.6 g/dL and the pregnant women without malaria was 11.5 ± 1.1 g/dL. The median CSA concentration in non-pregnant women with malaria was 2.24 ng/mL; that of pregnant women with malaria was 50.76 ng/mL, and pregnant women without malaria was 44.94 ng/mL. There were significant differences between non-pregnant women with malaria and pregnant women with malaria (P=0.0001) and also between non-pregnant with malaria and pregnant women with no malaria (P=0.0001) but no difference between pregnant women with malaria and pregnant women without malaria (P=0.084). Haemoglobin and haematocrit concentrations were significantly associated with malaria infection. The parasite count in pregnant women with malaria compared with that in non-pregnant women with malaria was significantly lower (P=0.0001). Malaria infection was associated with reduction in haemoglobin concentration, which worsened when pregnancy was present. In conclusion, CSA was elicited in pregnant women but had inverse correlation with peripheral malaria parasitaemia.
- ItemA comparative analysis on the use of organic and inorganic fertilizers in cocoa production and their impact on the soil: (a case study of selected cocoa farms in Tafo in the East- Akim District in the Eastern Region)(2016-03-23) Koranteng, Victoria AsiamahIn sustainable agricultural systems, recycling of nutrients is a major component of nutrient management. Cocoa as a perennial crop requires high nutritional supply for its proper growth and development. The continual uptake of nutrients from the soil by cocoa results in a likely degradation of soil nutrients overtime, hence there is the need to apply fertilizers in cocoa production to replenish the lost nutrients. A case study was conducted on ten cocoa farms in Tafo in the East-Akim District in the Eastern Region to investigate the use of organic and inorganic fertilizer application and their effects on soilphysico-chemical and biological properties and howthe effects impact cocoa production. Treatments included organic fertilization, inorganic fertilizer application and these were compared to control plots, which were plots of virgin forest. The treatments were fitted in a Completely Randomized, Design (CRD), each with five (5), replications. The inorganic farms showed increased levels of the plants’ major + nutrients such as available phosphorus, total nitrogen, exchangeable potassium (K ), 2+ 2+ Calcium (Ca ) and magnesium (Mg ). However these farms recorded reduced values for soil pH, organic matter content and reduction in soil biofauna both in biomass and diversity. Soil from the organic farms on the other hand recorded increased values in soil pH, organic matter content and more soil microbes were contained in such farms both in diversity and in biomass. The organic farms recorded low levels of soil major nutrients such as nitrogen, phosphorus and exchangeable bases. The control plots (forests) on the other hand recorded the highest values in almost all the parameters considered. Additions of amendments did not significantly (p 0.05) influence the levels of the major soil nutrients that were measured, however subsequent application of chemical fertilizers was likely to render the soil acidic on the bases of the results obtained for soil pH. There were also significant differences between the values recorded for all the species of bacteria and fungi and also some species of Nematodes, with the three treatments. Results of the study suggested that integrating organic and inorganic fertilizers would be effective in restoring the productivity of degraded soils and enhance the growth and development of Cocoa.
- ItemA comparative study of Typhidot and Widal tests for the detection and diagnosis of Typhoid fever in patients.(MAY, 2016 ) Mensah, Lydia KesewaaTyphoid fever continues to be a public health issue in most developing countries. In Ghana, Typhoid Fever ranks among the first twenty causes of outpatient illness. Among the numerous challenges in addressing the disease burden of Typhoid is the quest to secure a more reliable and standardized laboratory diagnoses of Salmonella infections to be able to win the surveillance battle on Typhoid fever. The purpose of this study was to compare the specificity and sensitivity of Typhidot and Widal serological tests for the detection of typhoid fever in the Bekwai Municipality. A prospective hospital based longitudinal study was conducted by gathering samples of 292 potential patients who showed features of Typhoid infection. Adopting a purposive sampling technique, patients who met the inclusion criteria were conveniently sampled and enrolled. Blood culture was used as the standard protocol after which sensitivity, specificity and positive predictive values were compared between Typhidot and Widal serological test kits. Data was analyzed using SPSS version 20 to process after which results were presented descriptively. Chi square test of association was performed for categorical variables .The study on 292 individuals recorded sensitivity of widal (95%) and typhidot (85.8%) with the specificity of widal (54.0%) and Typhidot (90.1%). This observation indicates Widal test is much more sensitive than the typhidot in the study area. The study established that both tests could be equally, sensitive and specific in diagnosing typhoid since they both had an equal accuracy (98.0) making them suitable for rapid diagnosis. The study found high detection of S. typhi by blood culture diagnosis, with S. paratyphi and S. typhimurun occurring least. This study has implication for further study to be carried out for confirmatory purposes as well as to determine prevalence of infection and antigenic variants that were not captured in the present study.