Hospital In Ghana Research Articles

Accuracy of Weight Estimation in Children Using the Broselow, PAWPER XL, PAWPER XL-MAC, and Mercy Tapes.

Quick and accurate estimate of a child's weight is often required for medical interventions like drug dose calculation when scale measured weights cannot be obtained safely. Length-based methods of weight estimation are more accurate than age-based methods, with the most accurate being the length-based, habitus-modified methods. This study sought to determine and compare the accuracies of the 2017 Broselow tape, Paediatric Advanced Weight Prediction in the Emergency Room Extra-Long (PAWPER XL) tape, Paediatric Advanced Weight Prediction in the Emergency Room Extra-Long Mid-Arm Circumference (PAWPER XL-MAC) tape, and the 2-dimensional (2D) Mercy tape in Ghanaian children. A cross-sectional study was conducted at the Tamale Teaching Hospital in Ghana. Eight hundred forty children between 2 months and 13 years had their weights estimated by the 2017 Broselow, PAWPER XL, PAWPER XL-MAC, and 2D Mercy tapes. Accuracy of the methods was determined by percentage of weight estimated to within 10% and 20% of actual weight. Mean percentage error and the Bland-Altman analysis were used to assess bias and precision. The proportion of weight estimates within 10% and 20% of actual weight for Broselow tape were 47.5% and 82.3%, for 2D Mercy tape were 73.1% and 96.3%, for PAWPER XL-MAC were 77.6% and 97.5%, and for PAWPER XL were 81.7% and 96.8%, respectively. The Broselow tape had the greatest bias and least precision among the 4 methods. The Mercy, PAWPER XL-MAC, and PAWPER XL tapes had similar performance, but all performed significantly better than the Broselow tape in pairwise comparison. The best weight estimation method overall was the PAWPER XL tape as it also had the least bias and greatest precision. The Mercy, PAWPER XL-MAC, and PAWPER XL tapes were more accurate than the 2017 Broselow tape and should be used in preference in Ghana and countries with similar population structure.

Surgical site infections following caesarean sections in the largest teaching hospital in Ghana

SummaryBackgroundSurgical site infections complicate up to 15% of all surgical procedures depending on surgery type and underlying patient status. They constitute 14–31% of all hospital-acquired infections, placing huge financial burdens on patients, healthcare institutions and the nation.ObjectiveTo determine the incidence, risk factors, microbiological aetiology and antibiotic susceptibility patterns of surgical-site infections following caesarean sections (CSs) at Korle Bu Teaching Hospital (KBTH), Accra, Ghana.MethodsThis prospective study involved 500 women who underwent CS from April to July 2017 at KBTH. Overall, 474 women completed the study with 26 women lost to follow-up or opting out of the study. Women were recruited on the first postoperative day and followed-up postnatally. Sociodemographic and obstetric data were obtained using a structured questionnaire. Swabs of infected surgical wounds were taken for culture and sensitivity testing using the Kirby–Bauer disk diffusion technique. Data was analysed using SPSS version 22.ResultsSixty-one (61/474) women (12.8%) had SSIs after CS. Of these, 41 (67.2%) were superficial, 18 (29.5%) were deep incisional and 2 (3.3%) were organ space SSIs. Significant risk factors for SSI were: emergency CS after 8 h of active labour, midline incisions, use of stored water for surgeon's pre-operative scrubbing, maternal status being single and alcohol consumption during pregnancy. Staphylococcus aureus was the commonest pathogen isolated with 6 (9.8%) being meticillin resistant (MRSA). Antibiotic susceptibility was mostly to quinolones.ConclusionSSI occurred in 12.8% of CS wounds at the KBTH, commonly caused by S. aureus.

Insights and genetic features of extended-spectrum beta-lactamase producing Escherichia coli isolates from two hospitals in Ghana

Recently, the emergence and rapid dissemination of extended-spectrum beta-lactamase (ESBL)-producing bacteria, particularly of the family Enterobacteriaceae, has posed serious healthcare challenges. Here, we determined the antimicrobial susceptibility and genetic characteristics of 164 Escherichia coli strains isolated from infected patients in two hospitals in Ghana. In total, 102 cefotaxime-resistant isolates (62.2%) were identified as ESBL-producers. Multilocus sequence typing of the ESBL-producers identified 20 different sequence types (STs) with ST131 (n = 25, 24.5%) as the dominant group. Other detected STs included ST410 (n = 21, 20.6%) and ST617 (n = 19, 18.6%). All identified ESBL-producers harbored blaCTX-M-14, blaCTX-M-15, or blaCTX-M-27, with blaCTX-M-15 (n = 96, 94.1%) being the most predominant ESBL allele. Further analysis showed that the immediate genetic environment around blaCTX-M-15 is conserved within blaCTX-M-15 containing strains. Five of the 25 ST131 isolates were clustered with clade A, one with sub-clade C1, and 19 with the dominant sub-clade C2. The results show that fluoroquinolone-resistant, blaCTX-M-14- and blaCTX- M-15-producing ESBL E. coli ST131 strains belonging to clade A and sub-clades C1 and C2 are disseminating in Ghanaian hospitals. To the best of our knowledge, this is the first report of the ST131 phylogeny in Ghana.

Accessing specialist healthcare: experiences of women diagnosed with advanced cervical cancer in Ghana

Background/Aims Cervical cancer is a leading cause of death in women in Ghana, and is often only diagnosed at the advanced stage. This study explored the experiences of women diagnosed with advanced cervical cancer as they access specialist healthcare in Ghana. Methods The study was conducted at a radiotherapy centre in a teaching hospital in Ghana. Purposive sampling technique was used to select 15 women aged between 33 and 67 years with advanced cervical cancer. Face-to-face in-depth interviews were conducted to gather information from participants regarding their experiences of services. Interviews were audio recorded with participants' consent. Data were analysed using content analysis. Results Content analysis revealed three themes: diagnostic process, information concerns and healthcare staff's attitudes. The following subthemes were also identified: delays, misdiagnosis, information gaps, perceived lack of knowledge from healthcare staff, positive attitudes from healthcare staff and breaking bad news. Conclusions The findings highlight the need to educate healthcare professionals about the symptoms of cervical cancer to allow early and accurate diagnosis. Training is also needed to equip healthcare staff with the therapeutic communication skills and strategies required for communicating bad news to patients.

Predictors of Medication Adherence Among Adults With Hypertension in Ghana

Background: Uncontrolled or suboptimal treatment of high blood pressure may negatively affect the cardiovascular, cerebrovascular, or renal systems. This condition may contribute to high rates of morbidity and mortality. This study assessed the sociodemographic predictors of medication adherence among adult patients with hypertension at the Hypertension Clinic of the Bawku Presbyterian Hospital in Ghana. Methods: This study has a descriptive cross-sectional design. The study setting was the Hypertension Clinic of the Bawku Presbyterian hospital in the Upper East region of Ghana. A total of 269 adults with hypertension referring to the clinic were recruited using a convenience sampling method in 2020. The Hill-Bone medication adherence scale was used to measure medication adherence, and a researcher-made questionnaire was used to gather demographic variables and contributory factors. The obtained data were analyzed in SPSS software v. 22. Regression analysis was done to identify predictors of medication adherence. P<0.05 were considered statistically significant for all analyses. Results: Most patients scored high on imperfect adherence (59.5%) to antihypertensive medication. The predictors of medication adherence were income (P=0.003), duration of being on antihypertensive (P=0.021), and level of education (P=0.0001). Among the perceived factors influencing medication adherence, most patients agreed upon forgetfulness (92.6%) and inadequate knowledge on antihypertensive drugs (82.6%). Conclusion: It is recommended that in dealing with patients with hypertension, the healthcare team, especially nurses, investigate the predictive and influencing factors found in this study and take appropriate measures to ensure that patients adhere to their medications.

Malaria and Urinary Tract Infections among Children Under five Years with Malnutrition at a District Hospital in Ghana

Malaria and Urinary Tract Infections among Children Under five Years with Malnutrition at a District Hospital in Ghana

Molecular Analysis of HBV in Histologically Confirmed Hepatocellular Carcinoma in a Tertiary Hospital in Ghana.

Hepatocellular carcinoma (HCC) is a leading cause of death in Africa. Viral hepatitis B is a leading cause of hepatocellular cancer in Ghana and most African countries except Egypt where hepatitis C virus is more prevalent. This study aims at reviewing the histopathological patterns of HCC and its association with hepatitis B virus in our environment. Demographics and histological diagnosis were retrieved from the surgical daybook and archival FFPE tissue samples with histopathologically confirmed HCC were used for this study. Sections (10μm) were taken from the tissues and digested to obtain DNA lysates. The DNA lysates were used in polymerase chain reaction (PCR) to determine the prevalence of HBV in the biopsies. Of the 24 confirmed cases of HCC seen in the 5-year period, there were 17 males and 7 females with M:F ratio of 2.4:1. The mean age of our patients was 39.92 ± 1.98 years with age range 13-85 years. 50% of the cases were moderately differentiated while 25% each were well and poorly differentiated. Out of the 24 archival HCC biopsies screened, HBV DNA PCR amplification was achieved in 11 (45.83%) after the restriction fragment length polymorphism PCR reaction. Out of the 24 archival HCC biopsies screened, HBV DNA PCR amplification was achieved in 11 (45.83%) after the restriction fragment length polymorphism PCR reaction. Eight of the 11 cases were found in the male and 3 in females. Of the 11 (45.83%) samples that were positive for HBV DNA, 3 were above 40 years and 8 were 40 years and younger. The overall prevalence of HBV DNA in our study was 45.83% and a greater proportion seen in ≤ 40 years. This suggests that most of our patients are infected with HBV early in life in our environment.

POS-877 Acute kidney injury and in-hospital mortality among patients with COVID-19 in Ghana

Acute kidney injury(AKI) occurs in patients with Coronavirus Disease 2019 (COVID-19) but this has not yet been described in Ghana. We therefore set out to describe the proportion of COVID-19 patients with AKI and determine the in-patient mortality in a tertiary hospital in Ghana.

Profile Of Childhood Cancer Cases Seen At The Paediatric Oncology Unit Of A Tertiary Hospital In Ghana - A 10 Year Review

Introduction
 Childhood cancers though curable have inequalities in outcomes between low- and middle-income countries and high-income countries. The World Health Organisation (WHO) Global initiative on Childhood cancer (GICC) has a goal of increasing survival rate at least by 60% by 2030 while reducing suffering and improving quality of life for children with cancer globally.
 The main aim for this study was to assess the trends in yearly proportions and numbers of cases seen and to evaluate the survival patterns and also to serve as a baseline as interventions are implemented in tandem with the WHO GICC.
 MethodsA retrospective study was conducted to review secondary data from the paediatric cancer registry of all patients diagnosed with cancer from 2011-2020. Demographic and clinical data stored in excel was exported to Stata and analyzed. Outcome data included death or alive.
 ResultsTotal number of patients diagnosed were 1,094 with the lowest number of new patients (n=84) seen in 2012 and the highest (n=132) seen in 2014. There was a Male: Female ratio of 1.4:1. The commonest cancers seen was lymphomas forming about 38.1% of the new diagnosis made. The incidence of lymphomas reduced from 62.8% in 2011 to 23.0% in 2020. Proportions for Acute leukaemia’s also increased from 11.3% in 2011 to 23.8% in 2020. Number of patients alive in reference to the year of diagnosis was lowest in 2016 with 29% of patients being alive. Subsequent years have higher survival with 53% of patients in 2019 still alive. Leukaemia treatment is expensive and unaffordable and translated to poor outcomes as patients tend to abandon treatment.
 ConclusionThis baselines preliminary data showed a reducing trend in the incidence of lymphomas with an increase in the number of leukaemia patients seen but poor outcomes in patients with leukaemia. This calls for concerted effort with interventions to improve on the outcome and be able to reach the 60% survival goal for the WHO GICC.

Empyema and Parapneumonic effusions in children admitted to a teaching hospital in Ghana. -A retrospective review

Background
 Parapneumonic effusions (PPE) and Empyema are serious complications of pneumonia in children that are associated with higher morbidity and prolonged hospital stay. The introduction of the pneumococcal conjugate vaccines (PCV 13) have led to a reported decline in the episodes of complicated pneumonia in children. The organisms commonly associated with PPE and Empyema are Streptococcus pneumoniae and Staphylococcus aureus though Mycobacterium tuberculosis has also been reported. There is paucity of data on children with PPE and Empyema in Ghana. We aimed to describe the profile, mode of presentation and outcomes in children admitted with PPE and Empyema to the Komfo Anokye Teaching Hospital.
 Methods
 A retrospective review of medical records (folders) and electronic data on children with PPE and Empyema admitted to the pulmonology unit from January 2018 to December 2020 were retrieved. Demographic records, immunization status, clinical presentation, length of hospital stay and outcome of admission were extracted using a Microsoft Excel. Data was then analysed with STATA version 16.
 Results
 Records were available for 51 children; the median age was 42 months IQR (22.5-96) and 68.6% (n=35) were males. In all 84.2% (n=38), had received all immunisations up to date for age. At presentation, 9.5% (n=4/42) had oxygen saturation <90%, whilst 43.9% (n=18/41) had axillary temperature > 38oC. The median respiratory rate was 47.5 IQR (32.8-57). The Median white cell count was 15.84 X10 9/l IQR (11.9-24.73) and median hemoglobin was 9.6 g/dl IQR (8.6-11.7). Pleural aspirate culture isolated Staphylococcus aureus for 6 patients. The rest were either not available or had no bacterial growth. Amoxicillin clavulanic acid and ceftriaxone were the most commonly used antibiotics. The median length of hospital stay was 9 days IQR (7-12) while the median length of chest tube insertion was 7 days IQR (5.5-9). In all 7.8 (n-4/51) patients died.
 Conclusion
 Both young and older children are affected with PPE/empyema. There is a good uptake of vaccines among children admitted for PPE/empyema, Staphylococcus aureus is the most common bacterial isolated from pleural aspirate culture. Most children admitted with complicated PPE/Empyema survived.

Mortality pattern within twenty-four hours of admission to a pediatric emergency room in a teaching hospital in Ghana

BackgroundChildhood mortality in sub-Saharan Africa still remains high despite a reduction in global trends. Although several strategies have been instituted to help reduce this, the progress is slow which can affect the achievement of the Sustainable Development Goal 3 (SDG). Majority of these deaths occur within the first twenty-four hours of admission due to delay in seeking medical care and inability to identify and adequately resuscitate the critically ill patients. The aim of the study was to describe the pattern of mortality within the first twenty-four hours in children presenting to the Paediatric Emergency Unit (PEU) of Komfo Anokye Teaching Hospital (KATH) in Kumasi, Ghana.
 Methods
 This was a retrospective review of mortalities in children aged 2 months to 13 years admitted to PEU from January to December 2020. The bio-data, duration of illness, diagnoses, duration of hospital stay and admission outcome were extracted from their health records and analysed.
 Results
 There were 2,145 admissions during the study period of which 59.3% (n=1272) were males, and 38.5% (n=825) were under-five years of age. Out of the 171 (7.9%) that died, 31.5% (n=54) occurred during the first 24 hours with 51.8% (n=28) being males and 77.7% (n=42) under-five years of age.
 The months with the highest recorded mortality occurring within 24 hours were January 16.6% (n=9), March 14.8% (n=8), and February 12.9% (n=7) with sepsis/septic shock 18.5% (n=10), Pneumonia 12.9% (n=7), surgical conditions 9% (n=5), Severe acute malnutrition 7% (n=4), and diarrhoea diseases 7% (n=4) being the leading causes of death.
 Conclusion
 Sepsis/septic shock and pneumonia are top two causes of mortality within 24-hours of admission with the highest mortality occurring in the first quarter. In order to end preventable deaths in under-fives and achieve the SDG 3.2, early health care seeking behaviour, quality and timely interventions for critically ill children as well as appropriate development and deployment of disease commodity packages will be key.

Prevalence and determining factors of HIV infection among HIV exposed infants in a teaching hospital in Ghana

BackgroundAlthough there has been a decrease in mother to child transmission (MTCT) of HIV, new pediatric infections still occur especially during the postnatal period. Prevention of vertical transmission is a key strategy in reducing the incidence which is 15-30% during pregnancy and delivery and 5-20% during breastfeeding. Early infant diagnosis and prompt initiation of antiretroviral are among some of the interventions that help to reduce the risk of transmission.ObjectivesThe purpose of the study is to assess the prevalence of HIV infection and the socio-demographic characteristics of HIV exposed infants presenting to KATH infectious disease clinic.
 MethodsA retrospective review of folders of exposed infants presenting to the infectious disease clinic from September 2019 to September 2021 was done. Data was entered onto excel sheet and exported to SPSS version 20 for analysis. Descriptive statistics were used.
 ResultsA total of 245 HIV exposed infants were seen within study period of which 54.35 (133/245) were males. The mean (SD) of birth weight was 3.07 (0.50). The median (IQR) age in months were 2.3 (1.5-3.3) at first visit to the HIV exposed clinic. Mode of delivery was by spontaneous vaginal delivery for 50.6% (124/245) and by caesarian section for 36.3% (89/245).
 Exclusive breastfeeding was initiated in 72.7% (178/245), formula feeding in 6.1% (15/245), and mixed feeding in 4.1% (10/245). Antiretroviral were initiated at birth for 95.9% (235/245) of infants. Septrin prophylaxis was initiated at 6 weeks for 60% (147/245).
 A major limitation of this records review was high level of data missingness. Most of the early infant diagnosis results were missing. The very few recorded were negative making it impossible to evaluate the true status of the exposed infants.ConclusionEven though infants exposed to mothers with HIV are seen regularly at KATH, the quality of the data collections must improve to estimate accurately the prevalence and determinants of HIV infection in exposed infants.

Implications of resource constraints and high workload on speaking up about threats to patient safety: a qualitative study of surgical teams in Ghana

BackgroundAlthough under-resourcing of healthcare facilities and high workload is known to undermine patient safety, there is a dearth of evidence about how these factors affect employee voice and silence about...

Quality of acute ischemic stroke care at a tertiary Hospital in Ghana

BackgroundInformation on the quality of acute ischemic stroke care provided in lower-to-middle income countries is limited.ObjectiveThis study was undertaken to examine the quality of acute ischemic stroke care provided at Tamale Teaching Hospital in Ghana.MethodsThe medical records of patients admitted into the medical ward of the hospital between January to October 2021 were reviewed retrospectively. Extent of compliance to 15 stroke performance indicators were determined.ResultsUnder the study period, 105 patients were admitted at the hospital with acute ischemic stroke. The mean (±SD) age was 65 ± 12 years; 38.1% were males; 65.7% had National Health Insurance Scheme coverage. Glasgow Coma Scale was the only functional stroke rating scale used by physicians to rate stroke severity. About a quarter of the patients had CT scan performed within 24 h of admission. Less than a quarter of the patients had a last known well time documented. Rate of thrombolytic administration was 0%. Less than a quarter of the patients were prescribed venous thromboembolism prophylaxis on the day of admission or day after. Only 13.8% of patients had documented reasons for not being prescribed venous thromboembolism prophylaxis. Antiplatelet therapy was prescribed to 33.3% of the patients by the end of day 2 of admission. Anticoagulation was prescribed to all patients who had comorbid condition of atrial fibrillation as part of the discharge medications. More than half of the patients were discharged to go home with statin medications. Documented stroke education was provided to 31.4% caretakers or patients. Slightly less than half of the patients were assessed for or received rehabilitation. Less than a quarter had documented dysphagia screening within 24 h of admission. None of the patient had their stroke severity rated with National Institutes of Health Stroke Scale on arrival. No patient obtained carotid imaging assessment by end of day 2.ConclusionThere were several gaps in the quality of acute ischemic stroke care provided to patients at the Tamale Teaching Hospital. With the exception of discharging patients on statin medications, there was poor adherence to all other stroke performance indicators.

Maternal near-miss and mortality associated with hypertensive disorders of pregnancy remote from term: a multicenter observational study in Ghana

BACKGROUNDMaternal death rates remain high in many low- and middle-income countries. Hypertensive disorders of pregnancy account for 18% of maternal mortality in Ghana. The maternal near-miss approach was designed to evaluate severe (acute) complications in pregnancy, which is useful to detect potential areas for clinical care improvement.OBJECTIVEThis study aimed (1) to determine the incidence of severe maternal complications, maternal near-miss cases, and mortality cases associated with hypertensive disorders of pregnancy remote from term and (2) to assess the health system's performance indicators for the management of hypertensive disorders of pregnancy remote from term in middle-income country referral hospitals.STUDY DESIGNThis study was nested in the ongoing Severe Preeclampsia adverse Outcome Triage study, a multicenter observational cohort study, and included women recruited from December 1, 2017, to May 31, 2020, from 5 referral hospitals in Ghana. Women aged >16 years, admitted to the hospital with hypertensive disorders of pregnancy, with gestational age between 26 and 34 weeks were eligible. Near miss was defined according to the World Health Organization and sub-Saharan African near-miss criteria. Descriptive statistics of pregnancy and maternal and perinatal outcomes up to 6 weeks after delivery of women with severe maternal outcomes were presented for maternal deaths and maternal near-miss casigurees and compared with that of women without severe maternal outcomes. The health system's maternal and perinatal performance indicators were calculated.RESULTSOverall, 447 women with hypertensive disorders of pregnancy were included in the analyses with a mean maternal age of 32 (±5.8) years and mean gestational age at recruitment of 30.5 (±2.4) weeks. Of these patients, 46 (10%) had gestational hypertension, 338 (76%) had preeclampsia, and 63 (14%) had eclampsia. There were 148 near-miss cases (33.1%) and 12 maternal deaths (2.7%). Severe maternal outcomes constituted complications from severe preeclampsia (80/160 [50%]) and eclampsia (63/160 [39.4%]). Concerning organ dysfunction, hematologic and respiratory dysfunctions constituted 59/160 [38.6%] and 23/160 [14.8%] respectively. Nearly all women had a cesarean delivery (347/447 [84%] and 140/160 [93%] in the severe maternal outcome group) and delivered prematurely (83%, with 178/379 [93%] at <32 weeks of gestation). Stillbirth and neonatal deaths occurred in 63 of 455 women (14%) and 81 of 392 women (19%), respectively, constituting a stillbirth ratio of 161 per 1000 live births and neonatal mortality rate of 207 per 1000 live births as there were 392 live births in this cohort. Overall, the intensive care unit admission rate was 12.7% (n=52/409); moreover, 45 of 52 women (86.5%) admitted to the intensive care unit had severe maternal outcomes. The maternal death ratio was 3100 per 100,000 live births, the maternal near-miss–to–mortality ratio was 12.3, and the mortality index was 8%.CONCLUSIONMaternal near miss and maternal and perinatal mortalities were common in women with hypertensive disorders of pregnancy remote from term in referral hospitals in Ghana. Providing appropriate patient-centered and multidisciplinary quality care for these women is crucial in improving pregnancy outcomes. Context-tailored interventions should be considered in the clinical management of complications associated with hypertensive disorders of pregnancy in resource-limited settings. Further research on interventions to improve timely referral and reduce in-hospital delays in care provision is recommended to facilitate emergency care services for women with hypertensive emergencies.

Genetic identification of three exhumed human remains at a hospital in Ghana: a forensic case report

DNA identification is very important in cases of high decomposition of dead bodies, in which the bodies cannot be identified by physical means. To compare the results of DNA typing, it is necessary to have related subjects with which to perform comparative analyses. Such tests are normally performed by comparing DNA profiles from people known to be immediate family members of the presumptive victim, such as parents or children because they share half of their genetic material with the unidentified. We report on how DNA analysis was used to solve a case of mixed-up bodies at a local mortuary in Ghana, West Africa. Two families and three buried human remains were in contention in this case. The first body (E9) was buried three months before exhumation. The second body (E11) was buried two and a half months before exhumation whiles the third body (E10) was buried a month before exhumation. Exhibit E5 was taken from an alleged child of the deceased, E11. Toenails of the exhumed bodies were sampled by a pathologist and used for DNA extractions using the QIAamp DNA Investigator Kit. Profiles from relatives were generated for comparison purposes. All samples gave a quality amount of genomic DNA after quantification. DNA was amplified with a GlobalFiler PCR amplification kit. Profiles from relatives were generated for comparison purposes. The human remains (exhibit E11) cannot be excluded as the biological father of the child (exhibit E5) because they share common alleles at all 23 genetic loci. The applicable combined paternity index was 17218125604.492 assuming a prior probability of 0.5. The probability of paternity is 99.99999999%. Based on this relationship testing, one of the bodies was successfully identified and handed over to the family for re-burial.

Prevalence of and maternal factors associated with anaemia in pregnant women at antenatal care booking in Tamale, Ghana: a cross-sectional study

Background/AimsAnaemia in pregnancy is a severe public health problem in low- and middle-income countries with consequences for both pregnant women and babies. Prevalence rates and associated factors in most Ghanaian communities are unknown. This study was conducted to determine the prevalence of anaemia and related factors at antenatal care booking among pregnant Ghanaian women in an urban setting.MethodsThis facility-based cross-sectional study was conducted among pregnant women reporting for booking at the antenatal clinic of the Tamale Central Hospital in Ghana. A self-designed data collection tool was used and the anaemic status of participants was determined using packed cell volume cut-off (&lt;30.0%). Univariate and multivariate logistic regression analyses were conducted to determine the association between participants' study variables and anaemia.ResultsA total of 606 pregnant women with a mean age of 27.7±5.4 years took part in the study. The prevalence of anaemia was 39.6%. Univariate analysis revealed that pregnant women aged 26–30 years (P=0.01) or &gt;30 years (P&lt;0.001), those who reported for booking in their first trimester of pregnancy (P=0.0043) and those who reported for booking during their second trimester (P=0.0011) were significantly associated with anaemia. In multivariate analysis, only women reporting for booking in their second trimester of pregnancy were significantly associated with anaemia (adjusted odds ratio: 1.8, P&lt;0.001).ConclusionsThe prevalence of anaemia at booking among pregnant Ghanaian urban dwellers remains relatively high and calls for improved education on maternal health, most notably on the need to report early for booking at antenatal facilities to improve both maternal and infant birth outcomes.

Clinically significant endoscopic findings and its relation to alarm features and age in patients undergoing upper gastrointestinal endoscopy at Regional Hospital in Ghana

Symptoms of upper gastrointestinal (UGI) disorders are among the commonest complaints for which patients seek medical care. Upper gastrointestinal endoscopy (UGIE) is one of the most commonly performed diagnostic procedures and offers valuable information in patients with UGI disorders. Age and alarm symptoms have been shown to be predictive of clinically significant endoscopic findings (CSEFs) in some studies, but not in others. This study was to examine the prevalence of CSEFs and utility of alarm features and age in predicting CSEFs in patients undergoing UGIE at a regional hospital in Ghana. A retrospective analysis of patients undergoing UGIE at a regional hospital in Ghana. Demographic variables, alarm features, and endoscopic findings were recorded. CSEFs were defined as peptic ulcer disease, oesophagitis, malignancy, stricture, or findings requiring specific therapy. A total of 555 patients had UGIE during the study period. Of those, 323 (58.2%) were females. Their ages ranged from age 4 to 94 years with a median age of 52 (IQR 35, 63). One hundred and forty-two (25.59%) patients were found to have CSEFs. Clinically significant endoscopic findings were more likely present in patients with alarm features (12.6% versus 5.4%, p = 0.004). Age ≥50 years (aOR 1.71), male sex (aOR 1.81) and presence of any alarm feature (aOR 0.21) were associated with CSEFs. Clinically significant endoscopic findings were relatively common in our patients. The presence of any alarm feature, age ≥50 years and male sex were associated with higher risk of CSEFs. Endoscopy in young patients with no alarm features had a low yield.

Indications and findings of oesophagogastroduodenoscopy in patients with symptoms of upper gastrointestinal disease in Eastern Regional Hospital, Koforidua, Ghana

INTRODUCTION: Prevalence of upper gastrointestinal (UGI) symptoms in the general population is very high. Indications and findings of patients undergoing upper gastrointestinal endoscopy (UGIE) at the regional hospitals in Ghana are largely unknown. This study was to document the indications and endoscopic findings of patients undergoing UGIE at the regional hospital in Ghana. METHODS: this was a retrospective study of patients who had UGIE between January 2019 and February 2020 at the Eastern Regional Hospital, Koforidua in Ghana. Indications and findings of 571 patients who had undergone UGIE and their H. pylori test results were retrieved. RESULTS: there were 244 (42.73%) males out of the 571 patients. The age ranged from 7 to 94 years, with a median age of 50.24 ± 18.07 years. Dyspepsia was the commonest indication, occurring in 399 (69.88%) patients. The commonest endoscopic diagnosis was gastritis, which occurred in 408 (71.45%) patients. Amongst the 399 dyspeptic patients, gastritis was the commonest finding in 315 (78.95%) followed by duodenitis in 264 (66.17%). The commonest cause of upper gastrointestinal bleeding (UGIB) was found to be gastritis (29.50%). The prevalence of H. pylori obtained was 41.06%. CONCLUSION: the main indication for UGIE in the studied patients was dyspepsia, and most of these patients had gastritis on endoscopy. Gastritis was the commonest cause of UGIB in the patients that presented. The prevalence of H. pylori in this population was low compared with most of the previous studies done in the country. There is a need to identify the common causes of gastritis in the community and implement community-based interventions to prevent them.

Cost-effectiveness analysis of an active 30-day surgical site infection surveillance at a tertiary hospital in Ghana: evidence from HAI-Ghana study

ObjectiveTo assess the cost-effectiveness of an active 30-day surgical site infection (SSI) surveillance mechanism at a referral teaching hospital in Ghana using data from healthcare-associated infection Ghana (HAI-Ghana) study.DesignBefore and...