College of Health Sciences

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Abortion in Bosomtwe District, Ashanti, Ghana: a Case Control Study at St. Michael’s Hospital, Jachie – Pramso
(2009-07-12) Momo Lokko, Christiana Naa
Strategies for preventing unsafe abortion have been unyielding as a result of which many women die and develop complications from unsafe abortion including those resulting in induced abortion ending up as incomplete abortion. There is increase in incidence of death due to abortion at Bosomtwe district. This study was an un-matched case-control study with the objective of assessing the specific differences in the socio-demographic, economic and reproductive health characteristic of incomplete abortion clients (cases) and normal delivery clients (controls) attending St. Michael’s Hospital, Bosomtwe district. A comparative analysis of 61 cases and 129 controls revealed that, there is no significant difference in their age (p=0.61), marital status (p=0.11), educational level (p=0.63) and their religious background (p=0.61). There was also no difference in their occupation (p=0.52), income earned (p=0.96) and partners employment status (p=0.40). There was a statistical difference in the reproductive history between the groups in terms of the number of children (p=0.000), age of last child (p=0.000), and number pregnancies lost (p=0.000). Cases were 12.7 times more likely to have had abortion; 19.0 times more likely to have attempted to stop the index pregnancy; and 6 times more likely to have self induced the index pregnancy as a means of termination as compared to controls. It is recommended that stakeholders, especially the district health directorate should use specific predictors for incomplete abortion among women to educate and encourage them to live a healthy reproductive life.
Acceptance and use of insecticide treated net (ITN) by mothers for malaria control in children under five years in the Sunyani Municipality
(2005-11-09) Agyei, Samuel Kofi
Malaria continues to remain a major burden of morbidity and mortality in most parts of developing world, more so in Sub-Saharan Africa. The World Health Organization (WHO) estimated that about 90% of the deaths associated with Malaria occurred in Africa, South of the Sahara (WHO 2003). But, what is more distressing is that children under-five years are disproportionately affected by the incidence of Malaria, especially in Ghana (GHS, 2001). The study sought to assess the context of acceptability and utilization of Insecticide Treated bed nets (ITNs) among children under five years in the Sunyani Municipality aimed at contributing towards the improvement of reducing malaria incidence. A descriptive cross-sectional survey was adopted, using multistage random sampling method to select study participants. The study was limited to mothers of children under five years. Three hundred (300) mothers with children under five were interviewed using structured survey questionnaire. The main findings, indicated that most (89.3%) of mothers interviewed had adequate knowledge about the causes and prevention of malaria. The respondents knew that the use of JTNs was the best method of malaria prevention. Few mothers however mentioned eating balanced diet (7.7%) and consulting herbalists (0.6%) as the best way to prevent malaria. Respondents’ knowledge about sources of information on ITNs was generally high with hospitals (75.3%) and television (60.7%) as the main sources of information about the net. • Despite their high knowledge about the ITNs, a little more than one-third (3 5%) own the nets. Majority (76.7%) of respondents who own the nets used them the night before the study. Those respondents, who did not have nets, expressed their willingness to buy them when they get money. Based on the key findings, it is recommended that: • Education on the use of ITNs should be intensified. • The Municipal Health Directorate should effectively collaborate with the Municipal Assembly and identifiable groups and organizations to educate the community on Malaria prevention methods through seminars. • The Municipal Assembly should embark on programmes on environmental cleanliness and good hygienic practices to eradicate mosquito breeding sites. • More ITNs to be produced and highly subsidized. • Public and Private Sector participation should be encouraged in the production and distribution of permanently treated ITNs.
The acceptance of family planning in the Tamale Metropolis
(2005-11-08) Salifu, Abukari
Every minute of every day at least one woman dies from complications of pregnancy and child birth, more than 585,000 deaths every year 99% of this is from the developing countries. Family planning can prevent at least 25% of all maternal deaths by allowing women to delay motherhood. Family planning can prevent improve the health and survival of adolescent girls by allowing them to postponed childbearing. Globally, three quarters of the World population do not plan their families A cross sectional study using both quantitative and qualitative approaches was used in Tamale Metropolis to investigate family planning acceptance among couples of reproductive age group. The study also sought to find out if there were any power relations in deciding family planning, fertility preference of the couples and their knowledge and opinion about the subject. Among the 100 people sampled 19% had never heard of family planning. Among those who had heard about family planning, 87% of both male and female knew at least one modern method of contraception but many did not approve of it. 61% reported not discussing family planning with their partners. 40% of the sampled population was using contraception at the time of the interview. Frequencies and percentages showed men disapproval of family planning. Over 58% of the population disapproved of the use of contraceptives, though they have the knowledge. Women realized that males have a dominant role in the family and makes decisions regarding most family matters including family planning. So they go behind their husbands for family planning services. Socio-economic and cultural factors affect contraceptive use. Of 100 sampled, 17% are not using contraceptives for religious reasons and 15% are not using because of socio-cultural reasons. However, some men and women showed interest for family planning for economic reasons. The family planning acceptor rate was 40% from this study indicating that there is improvement in the practice of family planning among respondents. In the nutshell family planning practice is very low among couples in Tamale. It is recommended here that community gate keepers should join hands with the government to ensure the practice of family planning. Also, MHMT should work with PPAG, population council and others to ensure family planning practice.
Acceptance of HIV Counselling & Testing Among Pregnant Women in the Kumasi Metropolis
(2008-07-13) Sakyi, Kwofie Gabriel
In 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.
Acceptance of HIV Counselling and Testing Among Pregnant Women in the Kumasi Metropolis
(2008) Kwofie, Gabriel Sakyi (Dr.)
In 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.
Access and coverage of healthcare among health staff in the Sunyani Municipality: Implications for the realization of universal health coverage
(NOVEMER, 2019) Abu, Juliet;
Universal Health Coverage seeks to ensure that everybody has access to quality healthcare without financial challenges. It is one of the global strategies towards the realization of the Sustainable Development Goals. Countries therefore need to track progress of universal health coverage not just across the national population but within different groups (e.g. by occupation, income level, sex, age, place of residence, migrant status and ethnic origin). The role of health workers in the realization of the universal health coverage cannot be overemphasized. Health workers are vulnerable to varying risks inherent in their profession, as they are exposed to infections, injuries, stress, violence, allergies, contact diseases and many others). There is a dearth of knowledge on access and coverage of healthcare among health staff who are the forefront of the effort at the realization of universal health coverage. It is this regard that access and coverage of health care among health Workers was investigated. The main objective of the study was to assess the access and coverage of healthcare among health Workers in the Sunyani Municipal. An analytic study type using a cross-sectional design was carried out in the Sunyani municipal. Data was collected using self-administered questionnaires, structured interview guide and subjected to univariate, bivariate and multivariate regression analysis. The study found that 52% of health staff had a degree,66% of health staff had worked for a period less than 5years, 57.1% monthly income was 1,500 Ghana cedis and above and 90% had a valid National Health Insurance Scheme card. Out of the four access and coverage areas the Occupational Health and Safety policy addresses, 71.5% of health staff were assisted during referral, 63.5% supported to access specialist care while 54.1% of health staff did not benefit from the health staffvi screening and 55.6% did not benefit from free Hepatitis B vaccination due to financial challenges as alluded to by Health Managers. Physical access and availability to healthcare by Health staff was highly encouraging as 95.9% of health staff had healthcare always available to them when needed and 83.2% of health staff usually visited the hospital, health centre or community Health Planning and Service Compound when ill. In terms of access to healthcare there was a significant association between income (p=0.017) and possession of valid National Health Insurance Scheme card (p=0.006). Coverage wise, 62% of health staff were moderately satisfied with their volume of healthcare needed and there was a significant association between income status (p=0.006) of health staff and quality of healthcare provided to them. A multivariate regression analysis indicated a highly significant association between volume of care health staff received (p=0.001), quality of Healthcare provided (p=0.001) and health staff healthcare needs satisfaction. The study concludes though health staffs of the Sunyani Municipal moderately accessed their needed health care and received moderate volume of their expected healthcare, one needed to be financially sound to access and obtained optimal healthcare needed. This study recommends effective implementation of the OHS policy and institution of special health package for health staff regardless of their income status to ensure health staffs are universally covered.
Access and utilization of family planning services among males in the Ga-East municipality of the Greater Accra Region of Ghana
(2009-08-08) Ababio, Selina
Family planning is a voluntary prevention of pregnancy and it entails the interruption of a chain of events that leads to conception. Family planning has been an age long practice, mostly among women. Although men are also included in the utilization of family planning services, practically, most men do not utilize the service. It is important to note that, increase in the usage of the service by men will help guard against unwanted pregnancy, improve child spacing and prevent sexually transmitted infections including HIV by using the appropriate contraceptive. Men’s support and commitment to the utilization of family planning is of importance in Africa. This is because of its contribution to the achievement of the millennium development goals (MDG) 5 and 6, which is to improve maternal health, by preventing both maternal and child mortality and also to combat HIV/AIDS, malaria and other diseases. The study was done in all the four (4) sub-districts in the Ga East District. The topic for the study is access and utilization of family planning among males in the Ga East Municipality. The study design was descriptive cross-sectional. The Sample size was 120 males with ages between 19-59 years. In addition, views about utilization of family planning among men from twenty (20) service providers were obtained to support the study. Interview was the data collection method used and questionnaires, the main tool for data collection. From the study it was discovered that: • Educational background was a significant predictor of ones knowledge about family planning. In other words, the higher one moves along the educational ladder, the more his knowledge about family planning • Generally, across the age groups, more people have knowledge about family planning than those who do not have any idea. (80%). • The majority of the respondents were within the age 19-39years (76.7%). • The respondents with some level of education are in the majority (91.5%), compared to those without any form of education, among others.
Access to health care services in Ghana sports: a case study of the Kintampo District
(2004) Boateng, Foster Antwi
This study was undertaken to assess the state of and access to health care services in Ghana sports with particular reference o the Kintampo District professional sports in recent times is characterized by extreme physical and mental exertions where things are stretched beyond the Limits of the ordinary. Against this background, it is one of the most fundamental duties of every sports administrator to ensure good health care of his sportsmen and women. Good health care of the sportsman and woman can take the form of a. periodic medical examination, regular health monitoring measures, provision of quality and quantity diet, provision of medical care services and also opportunity to have access to information and education on personal health issues. Issues relating to the health of sports performers are most often relegated to the back ground at the expense of other issues This phenomenon has caused man sports talents fail to realize their full potentials through incapacitation and sometimes death. The study method includes interviews of retired sportsmen and women who had been victims of sports injuries. Sports administrators were interviewed. The sample size was ninety (90), made up of fifty (50) sportsmen, victims of sports injuries and other health related problems, and forty (40) sports administrators. Closed and open — ended questionnaire were used after pre-testing them. The respondents were conveniently and purposively sampled. Results and findings indicate that there is a 1 00% awareness response from respondents on the risks associated with sports However, sports administrators are not doing much to cater for the health needs of their sportsmen and women. Further findings indicate that no sports administrator for instance has ever taken his Sportsmen and women through any form of medical examination since 1st January, 2002. The findings on health personnel situation in the Teams indicate that no Team administrator enjoys the services of Team Physicians, Team Psychologist, Team Nutritionist, Team Physiotherapist. among others, as each position recorded 100% non availability. Results of the study concluded that access to health care services in Ghana sports is poor. It was therefore recommended that all stakeholders in sports development in the District should come out with policies that would make health care service affordable and accessible to sportsmen and women in the District and the Country at large.
Access to quality health care among the poor in Asante Mampong, Ghana: a prospective view through the National Health Insurance Scheme
(2005-11-09) Gyasi, Sampson Kofi
The introduction of the “cash and Carry’ system in 1992 compounded the problem of financial access to quality health care created financial barrier to quality health care and thus led to lo utilization of health services especially, by the poor. This led to deteriorating health status. To reduce this problem of financial access to health, Ghana government is committed, and has introduced a convenient, affordable and sustainable health financing arrangement to protect the people, especially the poor, through the National Health insurance Scheme (NHIS). Though laudable, little is known about the efficacy of the health insurance in improving access to quality health in developing countries with Ghana not being an exception. A cross-sectional analytic study design aimed at investigating whether the NHIS is a feasible option for improving access to quality health care, and to identify strategies to improve access to quality health care in Asante Mampong was undertaken between the periods. May- August 2005. A sample of 240; consisting of 200 community members (individual respondents) aged 18 years and above and 40 key informants also in the same age group were selected for the study. Data collection tools were pre-tested at Agona, with similar characteristics as Mampong before data collection. Data was collected mainly through quantitative means with structured questionnaire and face-to-face interviews with respondents while secondary data from the Sekyere West District Health Administration, District Assembly, and the National Health Insurance district office at Mampong were also used. Data was analysed by computer using Special programme for Social Science (SPSS) and Epi Info sofiwares as well as manual. Key findings from the study indicated that the NI-ITS has the potential of increasing access to quality health care. This was confirmed by the key informants all of whom have access to quality health care because they belong to the civil servants health insurance scheme. On the contrary, because the individual respondents do not belong to any form of health insurance (HI), their access to quality health care is low (2 1.5%). Financial barrier was identified as the major cause of access to quality health care. Access to quality health care was dominated by more married couples (69.8%) and Christians (88.4%). The dominant health care financing mechanism in Asante Mampong is the ‘cash and carry’ system, though unpopular. Notably, awareness of the NH1S was identified as high in Asante Mampong as public education and advertisements have gone to the grassroots level. Acceptability of the scheme was also noticed as high 90% for both respondents. Coverage was however low but promising for community members Informal sector respondents (1R) (40.5% but high for the K1-forflial sector (920%). The following strategies are suggested to improve access to quality health care through an improved coverage provision of quality health care; intensive public education; expedite implementation process; convenient premium paying mechanism; door-to door registration; compulsory membership for all residents in Ghana and stop politicising the scheme. The role of HI in improving access to quality of health care cannot be overemphasized. The establishment of a district-wide health insurance schemes nationwide is a welcome idea. Since the scheme is new in the country, there are bound to be challenges such as pertain in Asante Mampong. There are however, opportunities such as high level of awareness and acceptability of the NHIS in Asante Mampong. These should therefore be tapped and through proper scheme management and government continuous commitments, the full benefits of the NHIS could be realised. From all indications, the NHIS is capable of improving access to quality health care, despite the teething problems. It is therefore recommended that further studies into its sustainability should be undertaken.
Accessibility to Tourism by Persons with disabilities in the Ashanti Region of Ghana
(2015-07-02) Aggrey Mensah, Susanna
Introduction: People continuously move from Europe, Asia, America, Africa and Australia to tour around the world leading to increased participation in tourism which brings individuals together. However, it appears persons with disabilities (PWDs) are underrepresented in the industry particularly in the Ghanaian tourism setting due to inaccessible tourism services and other provisions. Accessibility and participation of PWDs in tourism will, however, ensure a social inclusion of PWDs. The study aimed at assessing the accessibility to tourism for PWDs in Ashanti Region. Methods: Across-sectional study using both qualitative and quantitative data collection methods was conducted with workers at tourist centres and Persons with Disabilities in the Ashanti region, Ghana. Both voice recorded interview and structured questionnaires were used in collecting data for the study. Results were generated through thematic analysis for qualitative data and descriptive statistics for quantitative data using SPSS version 20. Results: The finding showed that although all participants have ever accessed tourism as consumers, they only paid occasional visit to tourist sites. The average expenditure on a single tourist visit was GHC 14.92 (equivalent of US$ 4.5), which majority (90.8%) said it comes from their personal income. This seems to put financial burden on PWDs who tried to access tourism services. The results further showed that PWDs faced barriers to facilities at tourist destinations since bath chairs, toilet raisers, wheel chair accessible vehicles, Braille format text and facility to climb walk ways were not available to ensure their access. Again, PWDs faced barriers to adapted tables and chairs. Some of the respondents (42.5%) therefore expressed dissatisfaction at the facilities and indicated that they depended on support from their care givers to access tourist services. Most (66.7%) of the respondents faced barriers to structures. These barriers were as a result of providers’ inability to factor the needs of PWDs into the design of such tourist sites. Conclusion: Participants’ suggestions in respect of the structures were that the drains should be covered; there should be proper walk-ways, ramps and elevators. Respondents again suggested that the Ghana Tourism Authority (GTA) should design specific disability-friendly tourist sites, and there should be a subsidy on gate fee for PWDs, whilst at the same time tourist workers should be given education and orientation on disability education
Accuracy of Diagnosis of Intestinal Helminth Parasites, and Relative Prevalence of Necator Americanus and Ancylostoma Duodenale Infections at the Komfo Anokye Teaching Hospital, Kumasi.
(2009-08-14) Gyampomah, Thomas Kwabena
There is a growing concern that stool reports from the Komfo Anokye Teaching Hospital (KATH) parasitology laboratory are frequently negative for intestinal helminth parasites. Over the years the wet mount technique has been the only method used at the KATH laboratory for diagnosis of intestinal parasites. The study evaluated the diagnostic sensitivity of the traditional direct wet mount technique using the formol-ether concentration as the gold standard method. After approval from the Committee on Human Research, Publications and Ethics, School of Medical Sciences, Kwame Nkrumah University of Science and Technology and Komfo Anokye Teaching Hospital, Kumasi, and with the permission of the hospital management, 2000 stool samples were collected from out-patients who visited the KATH parasitology laboratory between May and October, 2008 to do stool routine examination. Each stool sample was processed within 2 hours after collection using the direct saline wet mount, Kato-Katz and formol-ether concentration methods in accordance with standard protocols. All hookworm positive stool samples were cultured using the modified Harada-Mori test-tube technique and the isolated hookworm filariform larvae were identified by their morphological features in accordance with established criteria. Formol-ether concentration, gave the highest overall prevalence of 11.1% of helminth parasites made up of hookworm (2.9%), Dicrocoelium dendriticum (2.1%), Strongyloides stercoralis (2.1%), Schistosoma mansoni (1.8%), Hymenolepis nana (1.4%), Taenia species (0.6%) and Trichuris trichiura (0.1%). The direct wet mount and Kato-Katz detected total prevalence of 3.2% and 5.1% respectively. Direct wet mount was found to be 29.3% sensitive. Kato-Katz showed good agreement with the ether concentration for detection of hookworms, T. trichiura and S. mansoni infections (99.1% sensitivity; 95.0% CI, 97.1%-100%, with positive and negative predictive values of 100% (95% CI, 100%-100%) and 99.5% (95% CI, 99.0%-100%), respectively. Interestingly, no Ascaris lumbricoides eggs were detected using any of the three methods employed. EPG (eggs per gram) of feces counted by Kato-Katz method showed that most patients (89.9%) harboured low intensity infections of the parasites found. All 58 (100%) hookworm positive cases were identified as Necator americanus. This study reconfirmed reports that the direct wet mount has low sensitivity. It is recommended that stool samples that are negative for parasites by the wet mount method should be re-examined using the formol-ether concentration technique as the confirmatory test. This approach will improve the detection of helminths from stool specimens for accurate diagnosis of intestinal helminth infections, for effective management of patients and ultimately improve the quality of life of individuals in the communities.
Accuracy of Urine Microalbumin and Serum Uric Acid in the diagnosis of Preeclampsia
(APRIL, 2015 ) Kankam-Agyiri, Mabel
Preeclampsia (PE), a multisystemic disorder of pregnancy characterized by proteinuria and hypertension after 20 weeks of gestation, is one of the leading causes of maternal morbidity and mortality worldwide. Its aetiology is not fully understood though several studies attribute it to a widespread endothelial dysfunction originating from the placenta. The increasing prevalence of PE coupled with the need to identify and institutionalize more sensitive diagnostic tools has necessitated this study. This study sought to evaluate the diagnostic accuracy of urine microalbumin and serum uric acid as early markers of preeclampsia among Ghanaian women attending antenatal care at the Komfo Anokye Teaching Hospital (KATH). This case-control study was conducted among pregnant women at the Obstetrics and Gynaecology (O&G) department of the KATH, Kumasi-Ghana from October 2011 to May 2012. A total of 146 participants were recruited for this study. Written informed consent was obtained from the participants, and information on socio-demographic characteristics, medical history and previous obstetric history were obtained through medical records of the eligible participants. Blood pressure and anthropometrics were measured according to standard procedure; urine samples were collected for estimation of spot urine protein and microalbuminuria; and venous blood sample was taken for biochemical analysis and platelet count. The percentage of married participants with preeclampsia was significantly lower than the controls (p=0.004). More control participants had formal education compared to the participants with preelampsia (p=0.008), however, more preelamptics had informal education compared to the controls (p=0.004). The prevalence of abortion and blood pressure were higher in the preelamptics than the controls. Serum uric acid and hepatic enzymes (ALT and AST)] and urine microalbumin (p=0.005) were significantly elevated in the preeclamptic participants compared to the controls. The mean platelets count and serum albumin levels were however lower in the preelamptics than the controls (p>0.001). A significant positive linear correlation was observed between spot urine protein and urine microalbumin (r=0.324, p=0.006). A negative linear correlation was observed between uric acid and spot urine micro albumin (r=0.033, p=0.786). A urinary micro albumin value of 75.45 mg/g was identified as the best threshold to 2 detect a spot urine protein of > +2 with a sensitivity of 92.7% and a specificity of 80.0%, PPV of 81.03% and NPV of 33.3%. Area under the curve = 0.835; asymptomatic p-value of 0.0001 at 95% CI (0.678-0.991). In contrast, serum uric acid level of 263.5 mg/g was identified as the best cut-off point to detect a spot urine protein of > +2 with sensitivity and specificity of 89.1% and 33.3% respectively (PPV of 77.2% and NPV) of 20.8%. Area under the curve = 0.552; asymptotic p-value of 0.538 at 95% CI (0.364-0.740). Urine levels of microalbumin, as a measure of proteinuria are elevated in preeclamptics and can be used in place of spot macro protein estimation to diagnose preeclampsia especially in the early stages.
Acute chest syndrome in sickle cell disease: clinical presentation and pharmacological management
(AUGUST, 2016 ) Ansere, Afriyie Victor
Acute chest syndrome (ACS) is a common cause of hospitalization and mortality in sickle cell patients across the globe. There appears to be paucity of data concerning ACS and its pharmacological management in Ghana and Africa as a whole. This study was aimed at assessing the prevalence and clinical presentation of ACS, and its pharmacotherapy in children with Sickle Cell Disease (SCD) at Komfo Anokye Teaching Hospital (KATH) in Kumasi, Ghana. Method: The designs of the study was retrospective, in which medical records of the children 14 years and below with SCD and at least an episode of ACS were retrieved and assessed at the Sickle Cell Clinic of KATH. One hundred and seven cases among 1336 children with sickle cell disease met the criteria for inclusion in the study. The ages of the patients ranged from 8 months to 14 years with a mean of 5.7 ± 3.5 years. The prevalence of ACS was 8%, with a 2.2 episodes/ month rate of occurrence. Forty percent of the patients were between the ages of 5 to 9 years. Seventy five percent (n=80) presented with fever and 65% (n=70) presented with cough. Other symptoms like rhinorrhoea and irritability were common in younger patients (< 5 years), p = 0.012 and 0.001 respectively. Abdominal pain and chest pain occurred mostly in the older patients (≥ 5 years), p = 0.024 and < 0.001 respectively. Bacteria isolates were found in 12 of 79 cases (15.2%) that had blood culture information. Eighty four patients (80.7%) received cefuroxime and gentamicin dual therapy for empiric treatment of infection in ACS. The dose range of gentamicin used in the hospital was 3 to 9 mg/kg body weight as opposed to the recommended 5 to 7 mg/kg, as a single daily dose. The empiric antibiotic therapy for infections in ACS patients did not cover for atypical bacteria as recommended in standard guidelines. Forty seven patients received paracetamol alone for pain management and 47 received paracetamol and ibuprofen. Morphine was the preferred opioid prescribed, which is in line with recommendation by WHO guidelines for pain management in SCD patients. The prevalence of ACS was 8%. The majority of patients were between the ages 2 to 9 years. Fever and cough were among the common clinical symptoms presented. Other clinical features like rhinorrhoea, irritability, chest pain and abdominal pain varied with age. Treatment regimen for ACS in the hospital included pharmacotherapy for infections, pain management, hydration with IV fluids and blood transfusion in patients with severe anaemia. All of these were in conformity with standard guidelines and literature.
Adaptation of the Broadloom for Pile Weaving
(September, 2010.) Agbo Jones B., Harry
The production of pile fabrics has been limited to the big textile establishments which make use of power and sophisticated looms that are capable of producing complex or intricate designs. This situation has been in existence since the development of the dobby and jacquard looms which scope has gone beyond the simple plain, twill and satin / sateen weaves to the production of complex or intricate designs. An adapted broadloom has been designed and constructed to increase the scope of the local industry. This project is therefore an attempt to adapt the broadloom such that it can be used for pile fabric production, thereby increasing the scope of the local textile industry and reducing the unemployment situation in the country. A sample has been produced, after the adaptation, as proof that the adapted loom is capable of producing such type of fabric. The whole process and mode of production of the sample have been explained and illustrated in the text. Pictures of the sample weave and the adapted loom have been provided in the report to substantiate the fact that, the broadloom can easily be adapted to suit that purpose.
Addressing 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.
Adherence to anti-diabetics a case study of out-patients attending the diabetic clinic of the Komfo Anokye Teaching Hospital, Kumasi.
(AUGUST 2016 ) Owusu-Danso, Henrietta
Non-adherence to diabetes treatment leads to poor glucose control and increases the risk of disease complications. The prevalence and factors associated with non-adherence in resource limited settings should be determined so as to lower the impact of diabetes that is on the increase, on the health systems which are already overburdened with communicable diseases. The purpose of this study is to assess the level of adherence to antidiabetic medicines among patients attending the diabetic clinic and factors contributing to non-adherence at Komfo Anokye Teaching Hospital A cross-sectional study was conducted at the diabetic clinic of the KATH. A list of all patients attending the diabetic clinic for at least the past two years was obtained. A simple random method of sampling was used to select the desired sample size from the patient list. Data was collected via personal interviews using a structured questionnaire and also from the patient medical records. The structured questionnaire was administered to each patient after consenting to participate in the study. The questionnaire was in the form of exit interviews. Information provided by the respondents was counter checked with their medical records. The level of adherence to anti-diabetic medication among the respondents revealed that majority of them; constituting 64.2% had a high adherence level. The correlation between patients’ socio-demographic and adherence rate to anti diabetic therapy indicated that adherence among women was high represented by 69.6%. Adherence was high among participants less than 55 years (54.9%), among participants living with their family (90.1%), among participants who were knowledgeable about their disease condition and the effect of defaulting their anti-diabetic medication (64.5%) and high among participants who have been diagnosed of diabetes for less than 3 years (47.04%). This study revealed a high level of adherence among the participants. Also patients with knowledge of default consequences are more likely to adhere to their antidiabetic medications (p=0.046).
Adherence to anti-hypertensive medication regimens among patients attending the G.P.H.A. Hospital in Takoradi - Ghana.
(2006-08-08) Jambedu, Haruna Ahmed
Background: 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.
Adherence To Antiretroviral Therapy And Its Impact On Clinical And Immunologic Outcomes
(2015-11-03) Boakye, Dorothy Serwaa
Adherence to highly active antiretroviral therapy (HAART) has been associated with achieving success in virologic suppression, CD4 cell recovery, and improved patient well-being. Most of these researches reporting on the impact of adherence to HAART on treatment outcomes are published works from resource rich setting with little or no literature from Ghana. This study was therefore conducted to assess the impact of adherence to HAART on clinical and immunologic outcomes at two nationally designated HIV treatment centers in Kumasi, Ghana. The study was a prospective non- randomised study of HIV- infected patients at Aniwaa medical center and Bomso specialist hospital, private health facilities in the Kumasi metropolis. The patients were recruited to initiate antiretroviral therapy. A total of 86 patients were enrolled and 85 completed. Data collection lasted for 1 year 1 month. Patients were assessed for their level of adherence to HAART over a nine month period during interviews and pill counts. Patients who took ≥95% of their medication were classified as adherent whiles those who took ≤ 95% of their regimen were described as non- adherent. Data regarding clinical outcomes were collected at baseline, 3 month, 6 month and 9 th month, whereas data on immunologic outcomes were collected at baseline, 6 month and 9 month respectively. The data obtained was coded, entered into SPSS version 20.0 and analyzed. Over 90% of the participants were adherent to their therapy. Common reasons for missing medications were side effect (44.7%), forgetfulness (42.4%), being away from home (42.4%). The mean CD4 count at baseline was 235cells/uL, 6 th month (394cells/uL) and 9 th month (469cells/uL). Mean number of opportunistic infections and signs and symptoms was 3.34 and 4.79 at baseline, 1.56 and 2.03 at 3 rd month, v 1.12 and 1.16 at 6 th month and 1.00 and 1.13 at 9 th month. Overall physical health of patients improved from poor at baseline to good at the 9 th month. Adherence to HAART was a strong predictor of immune recovery, growth and clinical progression but adherence was seen not to be the only predictor of treatment outcomes. Baseline CD4 count was also found to predict outcomes for HIV infected patients. The most frequently used ARV in combination therapies was Tenofovir. Majority of patients in the study were adherent. After the nine months of study, both immunologic and clinical outcomes of patients significantly improved.
Adolescent reproductive health (ARH) in the Ejisu-Juaben District - a baseline survey of information, education and communication (IEC) activities
(2002) Nkansah-Asamoah, Patricia Dr. (Mrs.)
Adolescent Reproductive Health is current major concern and alt nation’s including Ghana, are initiating or strengthening programmes to better meet reproductive health needs. A base line survey of adolescent reproductive health needs assessment carried out in 1998 revealed that there were no Information, Education and Communication Activities (IEC) or materials specific for adolescents. This is crucial if health needs of adolescents are to be met. This study attempts to find out existing IEC activities on adolescent health in Ejisu-Juaben District of the Ashanti Region. One hundred and sixteen (116) adolescents were involved in the study. An in-depth key informant interview revealed organisations and individuals involved in adolescent reproductive health. The Health Workers and Queen Mothers Association was identified as the most active organisation which is trying to revive the traditional puberty rites in its modified form as a measure of curbing Teenage Pregnancy and HIV/AIDS. There were no adolescent specific JEC activities and there were no programmes initiated and managed by adolescents. A good number of respondent’s would not like to participate in adolescent health activity. However, given communication skills and adequate information, adolescents were willing to participate in reproductive health activities. The media ranked highest as the channel for information dissemination though drama was the preferred IEC. Unemployment was the top problem adolescent’s face and therefore programmes on reproductive health should be linked with s ill training and job opportunities. Policies or legislation should be enacted to give traditional rulers the authority to impose sanctions n defaulters of puberty rites if instituted. Family laws that compel fathers to provide support for their children should be enforced. In educating adolescent, a pluralistic approach should be adopted that is both tradition I and modern methods of IEC should be used. Finally, adolescents should be encouraged to initiate and manage a greater majority of adolescent reproductive health activities for sustainability.
Adolescent reproductive health; knowledge and practices in Ejisu-Juaben
(2005) Adugu, Florence Akpene
Good reproductive health is vital to the prospects of the individual as well as the community. With accurate information, an adolescent can complete her education, a couple can choose the size of their family and a community can prevent outbreaks of sexually transmitted diseases. The objective of the research was to find out adolescent knowledge and practices on their reproductive health in Ejisu-Juaben district. The study had a current cross-sectional descriptive design, which utilized both quantitative and qualitative methods to assess adolescent reproductive health; knowledge and practices among in school and out-of school adolescents in Ejisu-Juaben District. Focus Group Discussions (FGDS) were conducted within the study area from mid June to mid August 2005. Information collected was transcribed and used to develop a structured questionnaire comprising both open and close-ended questions which were used to conduct person —to-person interviews. In all, 256 adolescents (15-24 years) took part in the interviews and FGDs. It was found that 74% of in-school respondents and 65% out -of -school adolescents had lapses in understanding sexuality. Nearly all respondents 83% stated poverty as one of the causes of adolescent pregnancy. The prevalence of abortion as stated by in-school and out-of-school adolescents were the same; 53% in both cases. Adolescents had a fairly good knowledge about the existence of STIs. Almost all, 95% in school and 83% out-of school adolescents had heard of at least one STI, the most common infections mentioned were HIV/AIDS (84%) and gonorrhea (65%) correspondingly. In adding up the percentages of both groups, the main sources of information mentioned were the mass media (65%) and peer discussion (5 8%) respectively. Three percent (3%) of in-school adolescents indicated they have ever been treated for STI, 2 % was at the hospital and 1% was by self-medication. In out-of-school respondents 9% claimed they were treated of an STI. Five percent had treatment at the hospital, 1% was by an herbalist, 2% at a drug store and the remaining 1% by self- medication. Virtually all respondents’ 48% in- school, 34% out-of-school adolescents knew the condom as a contraceptive method. Contraceptive usage among in-school adolescents was 45% for users while among out- of-school respondents contraceptive users were only 23%. The condom was the most frequently used contraceptive method mentioned by in-school and out-of-school respondents. Knowledge on where to obtain contraceptives was very high 84% and 96% was indicated for in-school out-of-school adolescents respectively. Pharmacy shops were regular places for the purchase of contraceptives, in-school adolescents recorded 36% and out-of-school adolescents recorded 47%. Also mentioned were the hospitals, which had 27% among in- school adolescents and as low as 6% in out-of school-adolescent respondents. The study concluded that sexual health knowledge and practices among in- school adolescent respondents was fairly good. However, there is the need to intensify education especially among out-of-school adolescents.

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