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Survey of magnetic resonance imaging availability in West Africa
(Ajol.Info, 2018-07) Ogbole, Godwin Inalegwu; Adeyomoye, Adekunle Olakunle; Badu-Peprah, Augustina; Mensah, Yaw; Nzeh, Donald Amasike; Badu-Peprah, Augustina; 0000-0003-0979-4006
Introduction: The availability and utilization of MRI units across sub-Saharan Africa countries remain poor and its distribution is largely unknown. A cross-sectional survey was conducted to determine the distribution and utilization of MRI facilities across the West African sub-region. Methods: An interview and online search survey was conducted from September 2015 to September 2016, to determine the MRI facilities (Government/Public and Private) available in the West African sub-region. In Nigeria and Ghana, face-to-face interviews were conducted while for other West African countries, telephone interviews with radiologists and other health professionals as well as a Google online search were conducted to ascertain the distribution of the MRI facilities in the region. The number of MRI units in West Africa per million population was calculated and compared with other parts of the world from available published data. Results: Eighty-four MRI units serve a combined population of 372,551,411 in the West African sub-region at the time of this report. Nigeria accounted for more than two-thirds (58 (69%)) of the available units. Of these, 45 (77.6%) of the units were low-field strength systems. Ghana's 14 MRI units were fairly equally distributed between the private (57%) and the public sectors (43%). Ghana with 0.48 units/million population had the highest number of MRI units/ million population followed by Nigeria with 0.30 units/million population. Conclusion: Though there is an increase in the number of available MRI units in the West African sub region in the last decade, the numbers remain appallingly small for the population. Infrastructural and maintenance limitations constitute a major impediment to the use of high filed systems in the region. There may be need for greater cooperation between public and private enterprises for future improvement of MRI utilization in the region.
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Successful surgical management of intralobar pulmonary sequestration in Ghana
(Journal of Surgical Case Reports, 2022-02) Okyere, Isaac; Kwarteng, Sandra Owusu; Bempah, Atta Owusu; Okyere, Perditer; Badu-Peprah, Augustina; Gyasi Brenu, Samuel; 0000-0003-0979-4006
Pulmonary sequestration occurs when a portion of lung tissue receives its blood supply from an anomalous systemic artery. Three main presentations, intralobar, extralobar and communicating bronchopulmonary foregut malformations, have been described. It is the second most common congenital lung anomaly. The intralobar variant is the most common type seen in 75% of cases, especially in late childhood. Imaging of choice for diagnosis are computed tomography scan and magnetic resonance imaging. Management involves surgical resection with ligation of the aberrant blood supply via thoracotomy or thoracoscopy. Endovascular therapy with coil embolization of the aberrant anomalous systemic artery as a standard therapy or as a hybrid therapy is an option. We present our successful surgical management of an infant diagnosed prenatally with congenital lung abnormality and confirmed postnatally as intralobar pulmonary sequestration.
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Sonohysterography: Time to Step up its Use in Gynaecologic Imaging in West Africa
(Ajol.Info, 2011-09) Badu-Peprah, Augustina; Odoi, Alexander T.; Dassah, Edward T.; Amo-Wiafe, Yaw; 0000-0003-0979-4006
Sonohysterography is a simple, safe and convenient technique that is easily and rapidly performed in the ultrasound room; yet the technique seems to be underutilized in West Africa. We present two cases that were successfully carried out in our centre followed by detailed description, uses and challenges of the technique, with the hope of encouraging clinicians and sonographers in the sub-region to step up its use. Two women were referred for evaluation of their endometrial cavities on account of increasingly heavy menstrual bleeding. Sonohysterography revealed intracavity uterine masses with hyper-echoic focal thickening highly suggestive of endometrial polyps; histology confirmed the diagnosis of endometrial polyps. Sonohysterography is an affordable and feasible diagnostic modality for evaluating the endometrial cavity. Where equipment and skill permit, the technique should be used more often in the West African sub-region. Sonohysterography, Tansvaginal sonography, Gnaecologic imaging, West Africa (Afr J Reprod Health 2011; 15[3]:133-139). Sonohystérographie: Temps d’augmenter son emploi dans la visualisation gynécologique en Afrique de l’Ouest : La sonohystérographie est une technique simple, non dangereuse et commode, qui est accomplie dans la salle d’ultrason ; pourtant, il semble que la technique est sous utilisée en Afrique de l’Ouest. Nous présentons deux cas qui ont été accomplis dans notre centre, suivi d’une description détaillée, l’emploi et les défis de la technique, avec l’espoir d’aider des cliniciens et des sonographes de la sous–région à augmenter son emploi. Deux femmes nous ont été envoyées pour l’évaluation de leurs cavités endométriales à cause dune hémorragie menstruelle excessive. La sonohystérographie a révélé des masses utérines d’intra cavité, ayant un épaissement focaux hyper résonnant qui indique la présence des polypes endométriales; l’histologie a confirmé le diagnostic de polypes endométriales. La sonohystérographie est une modalité diagnostique faisable et abordable pour évaluer la cavité endométriale. Là ou l’on se dispose des équipements et le savoir- faire, il faut se servir de la technique plus souvent dans la sous-région ouest africaine (Afr J Reprod Health 2011; 15[3]:133-139).
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Prevalence of cholelithiasis among persons undergoing abdominal ultrasound at the Komfo Anokye Teaching Hospital, Kumasi, Ghana.
(Ajol.Info, 2015-03) Gyedu, Adam; Adae-Aboagye, Kwadwo; Badu-Peprah, Augustina; 0000-0003-0979-4006
Background: The prevalence of gallstones among Ghanaians is unknown. We aimed to determine the prevalence of gall stones among persons undergoing abdominal ultrasound at the Komfo Anokye Teaching Hospital (KATH). Methods: We performed a cross-sectional study of patients aged ≥14years presenting to KATH for abdominal ultrasound between 2009 and 2012. Patient demographics were recorded. The gallbladder was assessed by ultrasonography. Cholelith iasis was defined as presence of gallstones or absence of gallbladder. Data was expressed as descriptive and inferential statistics. Results: There were 2824 participants. 55% were females. Mean age was 47±18 years. Mean body mass index (BMI) was 24.0±5.5. Mean parity among females was 3±3. Prevalence of cholelithiasis was 5.9 (95%C.I:5.0,6.8). Females had a high prevalence compared to males (6.8 vs 4.7). Prevalence increased steadily by age. Prevalence was 6.6, 5.1 and 8.8 for patients with BMI <18.5, 18.5-24.9 and ≥30 respectively. Prevalence among women with parity of 0,1-5 and >5 was 3.1, 6.7 and 6.4 respectively.On multivariate regression analysis, female sex (AOR=1.55;p<0.05), age≥40 years (AOR=2.05;p<0.01), BMI<18.5 (AOR=1.25;p>0.05) or BMI≥30 (AOR=1.39;p>0.05) and family history of gallstones (AOR=11.9;p<0.01) increased the odds of cholelithiasis. Conclusions: Prevalence of cholelithiasis among patients undergoing ultrasonography at KATH was 5.9. Patient age, sex and family history significantly influenced the prevalence.
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National population-based tuberculosis prevalence survey in Ghana, 2013
(INT J TUBERC LUNG DIS, 2020-10) Addo, K. K.; Bonsu, F.; Alebachew, Z.; Gyapong, J.; Badu-Peprah, Augustina; Gockah, R.; Hanson-Nortey, H. N.; Law, I.; Tadolini, M.; Onozaki, I.; Sismanidis, C.; Owusu-Dabo, Ellis; 0000-0003-0979-4006
BACKGROUND: The prevalence of tuberculosis (TB) disease is one of the three main indicators used to assess the epidemiological burden of TB and the impact change of TB control; the other two are incidence and mortality. OBJECTIVE: To estimate the prevalence of TB disease among adults in Ghana. METHODS: A nationally representative cross-sectional survey was conducted. Participants were screened for TB using interview and chest X-ray (CXR). For those participants with cough 2 weeks and/or abnormal CXR, spot and morning sputum specimens were collected and examined by smear microscopy and culture. RESULTS: The study revealed that the prevalence of smear-positive TB among adults (age 15 years) was 111 (95%CI 76–145) and that of bacteriologically confirmed TB was 356 (95%CI 288–425) per 100 000 population. Males and older people had a higher prevalence than their counterparts. The majority of TB cases were smear-negative and had an abnormal CXR without reported chronic cough. CONCLUSION: The survey revealed much higher TB disease burden than previously estimated. This implies that the programme needs more effort and resources to find undiagnosed and unreported cases. The higher proportion of smear-negative and asymptomatic TB cases suggests the need to revise the existing screening and diagnostic algorithms.
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Dorsal Onlay Oral Mucosa Graft Urethroplasty: A Case Report and Review of Literature
(Hindawi, 2020-10) Appiah, Kwaku Addai Arhin; Gyasi-Sarpong, Christian Kofi; Yenli, Edwin M. T.; Maison, Patrick Opoku Manu; Adofo, Charles Kwame; Amoah, George; Azorliade, Roland; Mintah, Dominic Annor; Badu-Peprah, Augustina; 0000-0003-0979-4006
Urethral strictures in children are uncommon. They may present as lower urinary tract symptoms or acute urine reten tion [1]. The causes could be congenital, iatrogenic, posthy pospadias repair, or traumatic [2, 3]. The diagnosis involves a detailed history, physical examination, and appropriate radiological and endoscopic investigations [4]. Retrograde urethrography (RUG) with or without mictu rating cystourethrogram (MCUG) is the gold standard con firmatory test. In some situations, urethroscopy may berequired for confirmation and treatment. Penile and long bulbar urethral strictures are generally regarded as complexstrictures. This is because they do not lend themselves to simple excision and primary anastomosis [5]. They require tissue transfer in the form of grafts, flaps, or staged repair. Since the 1990s, the use of the buccal mucosal grafts to repair such complex anterior strictures has gained enormous popularity and acceptance due to its reproducibil ity and durable long term success rates of 85% and beyond [6–8]. Of significant debate is whether to place the graft ven trally or dorsally on the urethra. The dorsal approach seems cumbersome but the outcome is definitely better due to the mechanical support offered to the graft by the ventral aspect of the corporeal bodies [9–11]. We report on the successful application of the use of the oral mucosa graft dorsal onlay urethroplasty technique as described by Guido Barbagli [12] in a 14-year-old boy with a 7 cm Peno-bulbar urethral stricture at the Komfo Anokye
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Chest radiography patterns of COVID-19 pneumonia in Kumasi, Ghana
(Ajol.Info, 2020-12) Badu-Peprah, Augustina; Anyitey-Kokor, Ijeoma; Ackon, Allswell; Otoo, Obed K.; A. K., Nana; 0000-0003-0979-4006
Objectives: To document the pattern of chest radiographic findings in coronavirus disease 2019 (COVID-19) pa tients with moderate to severe disease. Design: Retrospective cross-sectional study. Setting: The study site was Komfo Anokye Teaching Hospital (KATH) located at Bantama in Kumasi, the capital town of the Ashanti Region. It is the second largest hospital in the country and the major referral site for Ashanti region and the northern part of the country. The hospital hosts a highly infectious isolation unit (HIIU) for COVID 19 patients with moderate to severe infections and receives referred cases from the region and within the hospital. Participants: The study involved 27 patients admitted to the HIIU at KATH with COVID-19 infection who under went chest X-ray as part of their investigations. Results: The study enrolled 12 males and 15 females. The common comorbidities were hypertension and diabetes. Chest x-ray findings in most of the patients (81.5%) revealed ground-glass opacities while a few of them (18.5%) had lung consolidations without ground-glass opacities. For those with ground-glass opacities, eight (29.6%) had superimposed consolidation. All the participants had positive chest x-ray findings. Conclusion: The chest x-ray findings in the 27 COVID-19 positive patients with moderate to severe disease on ad mission at the KATH HIIU enrolled in this study showed significant pulmonary abnormalities. The predominant pulmonary abnormalities were bilateral peripheral ground-glass opacities with the lower lung zones being mostly affected.