Browsing by Author "Dassah, Edward T."

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    Risk Factors for Cervical Cancer in Ghana
    (Wiley, 2024) Nartey, Yvonne; Amo-Antwi, Kwabena; Hill, Philip C.; Dassah, Edward T.; Asmah, Richard H.; Nyarko, Kofi M.; Agambire, Ramatu; Konney, Thomas O.; 0000-0003-0808-5689
    Background: The major burden of cervical cancer occurs in low- and middle-income countries. In Ghana, it is the second most common cancer among women. Infection with high-risk human papilloma virus (HPV) has been established as the cause of cervical cancer. As such, it is important to identify risk factors that may affect progression from HPV infection to cancer. Aims: We assessed the risk factors assocaited with cervical cancer in Ghana. Methods: To identify the risk factors for cervical cancer, we conducted an unmatched case–control study in two hospitals in Ghana where most cervical cancer cases are diagnosed. Women with histologically confirmed cervical cancer were the cases, whereas women without cancer seeking care at the two hospitals were controls. A structured questionnaire was administered to the women, after which cervical samples were sent for HPV deoxyribonucleic acid (DNA) testing. Results: Overall, 206 cases and 230 controls were recruited. After adjusting for possible confounders, women with the highest educational level had a significantly lower risk of cervical cancer than those with no or little formal education. Parity was a major risk factor (odd ratio [OR] for five or more children=7.9; 95% CI: 2.3–27.6), with risk increasing with increasing parity (p for trend <0.001). Women reporting the use of a homemade sanitary towel during menstruation also had an increased risk of cervical cancer compared with women who used a pad (OR: 7.3; 95% CI: 2.5–22.0). Conclusion: In this Ghanaian population, high parity and poor personal hygienic conditions were the main contributing factors to the risk of cervical cancer after adjustment for the presence of high-risk HPV genotypes.
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    Severe morbidities associated with induced abortions among misoprostol users and non-users in a tertiary public hospital in Ghana
    (BMC Women's Health, 2014) Damalie, Francis J. M.K.; Dassah, Edward T.; Morhe, Emmanuel S. K.; Nakua, Emmanuel K.; Tagbor, Harry K.; Opare-Addo S.
    Background: Misoprostol has become a popular over the counter self-administered abortifacient in Ghana. This study aimed to compare the socio-demographic characteristics and clinical complications associated with misoprostol and non-misoprostol induced abortions among patients admitted to a tertiary public health facility in Ghana. Methods: This was a cross sectional study conducted at the gynaecological ward of Komfo Anokye Teaching Hospital (KATH), over a four-month period using a structured pre-tested questionnaire. Data were analysed using Chi-square, Fisher’s exact and student t-tests. Factors associated with severe morbidity were examined using Poisson regression with robust error variance to estimate crude and ad justed relative risks (RRs) with 95% confidence intervals (CIs). P < 0.05 was considered statistically significant. Results: Overall, 126 misoprostol users and 126 misoprostol non-users were recruited into the study. About 71% of the clients had self-induced abortions. Misoprostol users were more likely to be younger (p < 0.001), single (p < 0.001), nulliparous (p = 0.001), of higher educational background (p = 0.001), and unemployed (p < 0.001), than misoprostol non-users. Misoprostol users were more likely than non-users to undergo termination of pregnancy because they wanted to continue schooling (p < 0.001) or were not earning regular income to support a family (p = 0.001). Overall, 182 (72.2%) of the women (79.4% misoprostol users vs. 65.1% misoprostol non-users; p = 0.01) suffered severe morbidity. Nulliparous women (adjusted RR, 1.28; 95% CI, 1.08-1.52) and those who had induced abortion after 12 weeks’ gestation (adjusted RR, 1.36; 95% CI, 1.18-1.57) were at increased risks of experiencing severe morbidity. The association between mode of abortion induction and severe morbidity was not statistically significant (p = 0.06). Conclusion: Self-induced abortions using misoprostol is a common practice among women in this study; nearly three quarters of them suffered severe morbidity. Nonetheless, severe morbidity among misoprostol users and non-users did not differ significantly but was directly related to the gestational age at which the induced abortions occurred. Health education on the dangers of self-induced abortions and appropriate use of medication abortion could help reduce complications associated with induced abortions in Ghana.
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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).