Hospital In Ghana Research Articles

Assessment of average glandular dose in mammography practice of a teaching hospital in Ghana.

above the age of 40, women are advised to begin breast examinations and screenings for early detection of breast cancer. The average glandular dose (AGD) provides dosimetric information about the quantity of radiation received by the mammary glands during mammographic exposures. There is, therefore, the need to analyse the radiation dose received by patients presenting for mammography examinations. a retrospective cross-sectional design was carried out on the data of 663 participants, conveniently sampled between the months of July 2021 and June 2022. Paired T-test was used to compare imaging parameters for cranio-caudal (CC), medio-lateral (ML), automatic exposure control (AEC), manual exposure control (MEC), and left and right breast. Pearson´s correlation was used to test for relationship between imaging parameters and AGD. the mean AGD per exposure was 1.9 ± 0.7 mGy for CC projections and 2.3 ± 1.2 mGy for ML projections. The mean AGD per examination for the study was 4.1 ± 1.4 mGy. A positive correlation was found between AGD per examination and exposure factors (tube loading and tube voltage), compressed breast thickness, and compression force. Patient age had no statistically significant relationship with the AGD per examination. average glandular dose (AGD) was consistent with other findings in literature studies. It was also observed that MEC yielded lower AGD per exposure values than AEC. There was no significant difference in the mean AGD per exposure for left and right breasts.

Institutional drivers for integrating palliative care services in a hospital in a sub-Saharan African military hospital context.

The growing burden of life-threatening illnesses and advancements in care interventions call for the intentional integration of palliative care services into existing care systems. The absence of active, functioning palliative care services in most hospitals in Ghana is a major concern. This study explored the factors influencing the integration of palliative care services in one of such institutions. The aim of the study was to explore the institutional drivers of palliative care integration in a military health facility. Exploratory qualitative study. We employed a qualitative exploratory study design situated within a constructivist paradigm. A purposive sampling method was used to select and interview 11 healthcare professionals. A semistructured interview was used to conduct face-to-face, in-depth interviews with participants between April and May 2022. A thematic data analysis was done based on the Braun and Clarke analysis process with the aid of QSR NVivo-12. The six themes that describe the institutional driving factors for integrating palliative care services were cognitive restructuring, supportive logistics and infrastructure, staffing, healthcare professional skills, institutional policies and priorities, and utilization of focal persons. It was observed that a paradigm shift in the mindset of healthcare professionals and administrators was a major driver that would determine the integration of palliative care services. A cognitive restructuring will facilitate a more aggressive integration of palliative care services because logistics, staffing, and medication access will be prioritized. Institutions have the responsibility of aligning with the WHO policy on palliative care service access and must invest in training, staffing, prioritizing palliative care needs and policies, procurement of essential drugs, and the provision of logistics and supportive infrastructure to scale up the implementation of palliative care services.

Perspectives of Family Caregivers on Healthcare Provided to Older Adults With Hypertension and/or Diabetes Mellitus in Ghana.

This study explored the perspectives of family caregivers of older adults with hypertension and/or diabetes mellitus on the care provided to their kin when they visit the hospital. A qualitative research approach was used to conduct the study using family members providing informal care for older adults with hypertension and/or diabetes mellitus at a teaching hospital in Ghana. A total of 20 participants were purposively sampled, interviewed, and data was analyzed using reflexive thematic analysis. Family caregivers mainly had perceptions that their older adult kin had poor interactions with the healthcare system because of some healthcare workers' negative attitudes, inadequate facilities at the clinics, and lack of geriatric care services at the facility. This notwithstanding, family caregivers also derived some benefits from accompanying their kin to the hospital. Practice and education in gerontological nursing must be employed to pragmatically meet the unique healthcare needs of older adults in Ghana with a focus on geriatrics units and standalone programs of study to prepare specialized healthcare professionals to provide comprehensive services to older adults. For a thorough understanding of issues of older adult care in the country, their perspectives on this subject should also be explored in future studies.

Characterization of Helicobacter pylori iceA and babA2 virulence genes in dyspeptic patients at a teaching hospital in Ghana.

Helicobacter pylori (H. pylori) infection is endemic in Africa. It is a major aetiological factor in the development of peptic ulcer disease and distal gastric cancers. Existing data shows that clinical outcomes are dependent on the virulence of the infecting strain, host´s susceptibility, and environmental factors. In Ghana, a previous study showed that the majority of symptomatic individuals harboured cagA and vacA virulent strains. The main objective of this study was to characterize and assess the significance of other virulence factors, specifically iceA and babA2 in Ghana. H. pylori iceA and babA2 genes were investigated in dyspeptic patients at the Korle Bu Teaching Hospital (KBTH), Accra, Ghana. The study employed a cross-sectional design consecutively recruiting patients with upper gastrointestinal symptoms for endoscopy. Nucleic acid was extracted from gastric biopsies using a commercial kit (QIAGEN DNeasy tissue kit). H. pylori babA2 and iceA genes were amplified using extracted deoxyribonucleic acid (DNA) and primers by polymerase chain reaction (PCR). majority, (71.1%), of the study participants, were H. pylori positive when tested with urease-campylobacter-like organism (CLO). In total, 46 H. pylori urease CLO-positive samples were randomly analyzed by PCR for iceA, of which, 12 (26%) and 7 (15%) were found to have iceA1 and iceA2 respectively. Of the CLO-positive samples, 9 were randomly analysed for babA2 by PCR. Three samples were babA2 positive and 6 were babA2 negative. in Ghana, although H. pylori is endemic, iceA prevalence is rather low and probably exerts a limited effect on bacterial virulence. Further evaluation would be required, not only to determine association with other virulence factors but more importantly, inter-relationships with wider host and environmental factors that impact on disease pathogenesis.

Exposure to workplace bullying and wellbeing among Ghanaian nurses: The role of personal resources

The present study examined the effect of workplace bullying on employee wellbeing, and the moderating effects of psychological capital and emotional intelligence in the workplace bullying and employee wellbeing relationship. Data was collected from 224 nurses in a teaching hospital in Ghana. The results of the analysis showed that workplace bullying has a negative effect on the psychological wellbeing of employees. Furthermore, the results showed that psychological capital and emotional intelligence moderated workplace bullying and psychological wellbeing relationship. The present study makes some contributions to theory and practice. Theoretically, the study extends the literature on the JD-R by highlighting the significant effect of personal resources in mitigating the effects of workplace bullying on employee wellbeing.

The relationship between organisational culture and employee engagement in private hospitals

This study investigates the relationship between organisational culture and employee engagement in private hospitals in Ghana, thus creating a culture of perceptions that are favorable to increasing employee engagement. The construct of organisational culture has received extensive recognition as a way to apprehend human systems (Zhong et al., 2016). The study adopted a mixed-method approach using both qualitative and quantitative data. This study was carried out on a sample of 155 respondents using a simple random sampling approach and 15 respondents were selected using a purposive sampling approach from selected private hospitals located in Accra, a region in Ghana. Data were collected electronically (closed-ended questionnaires and semi-structured interviews). The psychometric properties (validity and reliability) of the measuring instrument that was used to collect the quantitative data were statistically assessed using factor analysis and Cronbach’s coefficient alpha respectively. The quantitative data was examined using both descriptive and inferential statistics and the qualitative data was evaluated using thematic analyses. Employees held positive perceptions of the organisational culture (involvement, consistency, adaptability, mission) and employee engagement (vigour, absorption, dedication). This study specifies that there is a significant relationship between organisational culture and employee engagement. It also revealed that there exist significant intercorrelations between organisational culture (involvement, consistency, adaptability, mission) and employee engagement (vigour, absorption, dedication) respectively.

Examining the enabling and barrier factors to nursing staff involvement of children in care activities

BackgroundChildren’s rights to participate in decisions and activities of their lives have been well documented. Due to varied challenges, the implementation of children’s rights to healthcare involvement has not been fully achieved. The unsuccessful implementation could be attributed to factors originating from parents/caregivers, health professionals, children, policymakers, and the healthcare system. Therefore, investigating the barriers and enabling factors to the implementation of children’s rights to healthcare involvement is critical. ObjectiveThis study therefore examined the enabling and barrier factors to nursing staff involvement of children in care activities. MethodsAn institutional-based cross-sectional design was used to conduct the study at the Evangelical Church of Ghana Hospital, Kpandai. With a total census sampling technique, all nursing staff members providing care to paediatric patients were invited to participate in the study due to the relatively small number of nursing staff. A total of 97 nursing staff members finally participated. An adapted Patient Participation Questionnaire was used for the data collection. Descriptive and inferential analyses were done at p < 0.05 and considered statistically significant. ResultsOut of 116 nursing staff, 97 (83.6% response rate) participated. The frequently reported barrier factors to nurses' involvement of children in care activities were staff uncertainty about children’s competence (78.4%), nurses’ limited knowledge about children’s rights (66%), and children’s age and maturity (65%). On the other hand, regular sensitization of nurses about children’s rights recorded more than 90% of responses as an enabling factor. Nurses who perceived children not to be mature were -1.175 (AOR = 0.309; 95% CI: 0.145–0.658) times less likely to involve children in their care. Nurses who frequently communicated with children were 0.660 (AOR = 1.935; 95% CI: 1.098–3.411) times more likely to involve children in their care. ConclusionNurses' involvement of children in care is largely influenced by their limited knowledge about children’s rights and policies. Therefore, training modules involving children’s rights should be included in the curricula of students in the medical field, while in-service training seminars organized regularly for practicing nurses.

Adherence to COVID-19 protocols: A comparative study of public and private hospitals in Ghana

ObjectiveThis study aimed to comparatively examine how public and private hospitals adhered to the COVID-19 safety protocols, and the factors associated with, and barriers to adherence in Ghana. Study designA case study design drawing on quantitative and qualitative methods to determine adherence to, and barrier of adherence to the COVID-19 protocols. MethodA sample of 283 staff participated in the quantitative study, while in-depth interviews were conducted among management staff across the public and private hospitals. Data were analyzed using descriptive statistics, independent t-test to compare differences in adherence and logistic regression model to identify the factors associated with adherence to the COVID-19 protocols. ResultsThe regression results showed that adherence to the COVID-19 protocols in public and private hospitals were significantly associated with staff training on adherence in public (OR = 2.08; p < 0.01) and private (OR = 1.44; p < 0.05), and knowledge on adherence in public (OR = 3.12; p < 0.01) and private (OR = 11.45; p < 0.01) hospitals. Adherence to the protocol varied significantly between public and private hospitals (0.001 > p < 0.05), with an effect size ranging from small to large. Clients’ behavioural factors and poor stocking of PPEs due to financial challenges were reported as barriers to adherence in both hospital types. ConclusionAdherence to the COVID-19 protocols was more pronounced in public hospitals than private hospitals suggesting the need for interventions targeting the latter to promote client and staff safety.

Bacteriological Evaluation of Indoor Air Quality in Some Selected Units at the University of Cape Coast Hospital in Ghana

A hospital is an environment solely for diagnosing and treating patients. Contemporary research, however, reveals the possibility of users contracting diseases due to many factors, such as poor air quality. This research, therefore, delves into the critical indoor air quality assessment domain, focusing on selected units within the University of Cape Coast Hospital, Ghana. The study’s primary objective was to conduct a comprehensive microbial assessment of indoor air quality in eight different units (emergency room, operating theater, out-patient department, consulting rooms, laboratory, male ward, female ward, and ear, nose, and throat unit) of the hospital, shedding light on potential airborne bacteria present. Indoor and outdoor air were sampled using Koch’s sedimentation method. Colony forming units per cubic meter of air (cfu/m3) were determined with the Omeliansky formula. The bacteriological load within the units revealed that the out-patient department had the highest bacterial concentration (139.2±60.32×102 cfu/m3), immediately followed by Outdoor (135.1±43.63×102 cfu/m3), whereas ear, nose, and throat unit recorded the least concentration (0.4±0.57×102 cfu/m3). The remaining units range between 135.1±43.63×102 cfu/m3 and 0.4±0.57×102 cfu/m3. The morphological characteristics of the seven observed bacterial isolates (GSB 1-7) showed the presence of two cocci and five rods. Isolates 1 and 4 had a rhizoid form, isolates 2,3, and 5 had a circular form, while isolates 6 and 7 had filamentous forms. All isolates showed positive gram tests, and endospores were detected in isolates 1, 4, and 6. Bacterial isolates were identified as Bacillus mycoides, Micrococcus luteus, Staphylococcus epidermidis, Bacillus circulans, Staphylococcus saprophyticus, Bacillus subtilis, and Micrococcus sp. These outcomes indicate bacterial contaminations in the indoor environment, likely to pose a significant risk to patients, workers, and visitor’s safety. Therefore, rigorous monitoring and mitigation strategies are essential to ensure a safer environment in healthcare settings.

Examining the Utilization of Social Capital by Ghanaians When Seeking Care for Chronic Diseases: A Personal Network Survey.

Objectives: With limited social security and health protection in Ghana, intergenerational support is needed by those living with NCDs, who incur recurrent costs when seeking NCD care. We measured the level of informal support received by NCD patients and identified factors that influence support provision. Methods: We surveyed 339 NCD patients from three hospitals in Ghana, who listed their social ties and answered questions about their relationship and support frequency. We analyzed the relationship between social support, demographic and health information, characteristics of social ties, and network characteristics. Results: Participants described 1,371 social ties. Nearly 60% of respondents reported difficulties in their usual work or household duties due to chronic illness, which was also the strongest predictor of support. Patients with higher wellbeing reported less social support, while older age and having co-habitant supporters were negatively associated with support, indicating caregiver burnout. Conclusion: Ghanaian NCD patients receive support from various caregivers who may not be able to handle the increasing healthcare and social needs of an aging population. Policies should therefore enhance resource pooling and inclusiveness for old age security.

Polypharmacy and its associated factors among patients with co-morbid hypertension and diabetes in a municipal hospital in Ghana

Background/aimPatients with co-morbid hypertension and diabetes may take several medicines. Although multiple medications may aid in the management of their condition, they also raise the likelihood of drug interactions and unfavorable drug reactions. This study therefore evaluated polypharmacy and its associated factors in patients with co-morbid hypertension and diabetes. MethodologyThis was a cross-sectional study with data collection spanning a 3-months period. Patients attending their review clinic in a municipal hospital in Ghana were interviewed with a pre-tested semi-structured questionnaire to collect data on socio-demographic characteristics, prescription medicines, therapeutic lifestyle changes, blood pressure management and fasting blood glucose. Polypharmacy was defined as the use of five or more medicines in a single day. ResultsOf the 338 patients with co-morbid hypertension and diabetes, (18 %, n = 61) were men and (82 %, n = 277) were women. Most of the study participants (40.2 %, n = 136) were between 55 and 64 years. Polypharmacy (≥5 medications) was observed in (64.8 %, n = 219) of the participants and being male [cOR = 2.29, 95 % CI (1.18 – 4.42), p = 0.014] and living in a rural setting [cOR = 2.46, 95 % CI (1.13 - 5.34), p = 0.023] were significantly associated with more than the two-fold increased risk of having polypharmacy compared to being female and living in an urban setting respectively. Most patients were on biguanides (89.1 %, n = 301), angiotensin receptor blockers (68.6 %, n = 232), calcium channel blockers (66.6 %, n = 225) and sulphonylurease (53.8 %, n = 182). ConclusionPolypharmacy is common in patients with co-morbid hypertension and diabetes, and is associated with sex, marital status, and residential status. Healthcare providers must carefully consider these associated factors when prescribing or modifying treatment plans for their patients.

Analysis, treatment modality and demographic characteristics of urolithiasis patients visiting Korle-Bu Teaching Hospital in Ghana.

Globally urolithiasis is on the rise and gradually becoming a public health concern due to the associated complications. This study reviewed the demographic characteristics, the chemical composition of stones, treatment modality and duration of hospitalisation of urolithiasis patients at Korle-Bu Teaching Hospital, Accra, Ghana. This was a retrospective study conducted between March 2019 and April 2022. Data from consecutive patients treated for urolithiasis were used for this study. Data on demographic characteristics, stones chemical composition, urine factors, urolithiasis treatment modality and duration of hospital stay after therapy were collated and analysed using descriptive and inferential approaches. The age of the patients ranged from 2 to 75 years with a mean of 45 (±13.4). The predominant age group for stone formation was 30-39 years - 52(26.3%). Urolithiasis was common among patients in the formal employment sector: 81(40.9%). All stones had two or more chemical compositions, with the combination of calcium oxalate monohydrate, calcium oxalate dihydrate and uric acid being the predominant stone type: 88(57.5%). Ureteroscopy with semi-rigid and Percutaneous nephrolithotomy were the predominant treatment modalities: 105(53.0%) and 74(37.4%), respectively. Escherichia coli was responsible for most urinary tract infections in urolithiasis patients 8(4.0%) and the least duration of hospital stay after the procedure was associated with the use of semi-rigid ureteroscope as the treatment modality with a median duration of 2 days (1-2 days) with P < 0.0001. Urolithiasis was predominant among professionals in the formal sector. All stones were mixed with Calcium oxalate monohydrate, calcium oxalate dihydrate, and uric acid combination being the majority. Ureteroscopy with semi-rigid and percutaneous nephrolithotomy were the common treatment modality.

Obturator hygiene among patients with maxillary defects at two teaching hospitals in Ghana

Background: An obturator may be defined as the component of a prosthesis that fits into and closes a defect within the oral cavity or other body defects. Cleaning one’s obturator is essential to prevent offensive odour, poor aesthetics, the accumulation of plaques, and damage to both natural and prosthetic teeth due to bacteria contamination in the oral cavity.Aim: The study aimed to determine how palatal obturator wearers practice good obturator cleaning habits.Method: A cross-sectional study design was used for this study. A sample size of 40 palatal obturator wearers was used. Data was collected using a well-structured questionnaire. The questionnaire included demographic data (age, sex, educational level, occupation and years of wearing a prosthesis, obturator cleaning habits, obturator cleaning methods, and obturator wearing habits. The data were summarized using Descriptive statistics with tables and charts and analyzed using a chi-square test from Statistical Package for Social Sciences (SPSS version 22.0) and Microsoft Office Excel 2016 at p-value&lt; 0.05.Results: Sixteen (40%) of the total number were males, and 24(60%) were females giving a male-to-female ratio of 2:3. Twelve (30%) of the participants fell between the ages 31-40 years. Participants with tertiary education have better cleaning habits and knowledge of cleaning agents used. Fifteen (37.5%) participants who had worn a palatal obturator between 1-2 years frequently visited the dental clinic for a check-up; however, this number gradually decreased.Conclusion: The majority of the patients evaluated had good clean habits with their prostheses and the cleaning agents used. However, participants with tertiary education had better prosthesis hygiene and maintenance methods.

Factors associated with helmet use among motorcyclists presenting with maxillofacial injuries to a tertiary hospital in Ghana

Background: Although mandatory helmet laws exist in many countries, compliance has been reported to be poor in some countries in Sub-Saharan Africa. The success of programs aimed at increasing the use of helmets by motorcyclists depends on the identification of the factors associated with helmet usage. Sociodemographic factors have been reported to differ between motorcyclists who consistently wear a helmet and those who do not. The identification of the factors associated with helmet usage would enable the institution of targeted measures to enhance compliance with mandatory helmet laws.Methods: The study examined factors associated with wearing helmets by motorcyclists to inform policies geared towards reducing the burden of motorcycle-related road traffic crashes. This analytical cross-sectional study was conducted at the 37 Military Hospital, Accra, Ghana. Demographic data of patients presenting with maxillofacial injuries secondary to motorcycle crashes were consecutively collected and analyzed. The use of a helmet was compared among sex, age category, occupation, and patient role. Statistical significance was inferred at an alpha level of 0.05.Results: There was no statistically significant difference in the use of helmet by male and female motorcyclists. (P=0.537). Middle-aged adults were more likely to wear a helmet as compared with young adults and minors. (P=0.043). Also, 62% of formally employed participants wore helmets, while a disparate 46% and 30% of informally employed and unemployed participants wore helmets at the time of injury. The difference was statistically significant (P=0.019), likewise the comparison of helmet wearing between riders and pillion passengers (P=0.002).Conclusion: The use of helmets by motorcyclists is associated with age, occupation, and role of the motorcyclists. The implementation of mandatory helmet laws needs to consider the attitude of particular population groups to ensure its success.

Short-term evaluation of the AIDET communication framework at a tertiary teaching hospital in Ghana

Short-term evaluation of the AIDET communication framework at a tertiary teaching hospital in Ghana

Physiotherapy practice in women’s health: awareness and attitudes of obstetricians and gynecologists in Ghana

BackgroundPhysiotherapy is relatively well integrated into women’s health in many high-income countries (HICs) as compared to low- and middle- countries (LMICs) like Ghana. Suboptimal integration of physiotherapy in modern obstetrics and gynecology especially in low resource settings is partly due to issues related to the awareness and attitudes of referring physicians. This study assessed the awareness and attitude levels towards physiotherapy in women’s health among obstetricians/gynecologists and factors associated with its utilization in Ghana.MethodsA cross-sectional study was conducted among obstetricians/gynecologists working at a tertiary hospital in Ghana using an “Awareness and Attitude Questionnaire” adapted from a standardized questionnaire. Chi-square test or Fisher exact test was performed and logistic regression was used to assess the association between doctors’ awareness level of physiotherapy’s role in women’s health and years of clinical practice.ResultsSixty-one (61) respondents comprising 7 consultants, 20 senior residents and 34 junior residents, with age median age of 35 years (range: 29–65 years) were recruited. There were more males than females (82% versus 18%) with a mean (SD) duration of practice of (9.41 ± 4.71) years. The participants reported a considerable awareness of physiotherapists’ role in obstetrics (between 72.1% for intrapartum to 91.8% for postnatal) but wide variation in gynecology (from 19.7% in PID to 95. 1% in uterine prolapse). Consultants were more (71.4%) aware of the role of physiotherapy in antenatal care and gynecology while senior residents had more awareness in intrapartum and postnatal care. Junior residents generally showed lowest awareness levels. Duration of clinical practice (≥ 10years) was not significantly associated with doctors’ awareness regarding the importance of physiotherapy in childbirth. There were mixed findings concerning doctors’ attitudes toward physiotherapy: (1) 41% indicated that physiotherapists have been effective in their inter-professional relationship; (2) none of the doctors strongly agreed that physiotherapy may not contribute significantly to the complete well-being of gynecological patients. The main factors influencing utilization of physiotherapy were the perceived notion of non-availability of physiotherapists to cover various wards and physiotherapists not attending ward rounds with doctors to facilitate more education on the scope of physiotherapy practice.ConclusionAlthough obstetricians/gynecologists showed appreciable awareness and attitudes towards physiotherapy, there remains a considerable gap in provider education to ensure optimal utilization of physiotherapy in contemporary obstetrics and gynecology. Further research is recommended to assess implementation challenges associated with regular utilization of physiotherapy services in women’s health in the hospital.

Care of Injured Children Compared to Adults at District and Regional Hospitals in Ghana and the Impact of a Trauma Intake Form: A Stepped-Wedge Cluster Randomized Trial

BackgroundThis study aimed to determine the effectiveness of a standardized trauma intake form (TIF) to improve achievement of key performance indicators (KPIs) of initial trauma care among injured children, compared to adults, at non-tertiary hospitals in Ghana. MethodsA stepped-wedge cluster randomized trial was performed with research assistants directly observing the management of injured patients before and after introducing the TIF at emergency units of 8 non-tertiary hospitals for 17.5 months. Differences in outcomes between children and adults in periods before and after TIF introduction were determined with multivariable logistic regression. Differences in outcomes among children after TIF introduction were determined using generalized linear mixed regression. ResultsManagement of 3889 injured patients was observed; 757 (19%) were children <18 years. Trauma care KPIs at baseline were lower for children compared to adults. Improvements in primary survey KPIs were observed among children after TIF introduction. Examples include airway assessment [279 (71%) to 359 (98%); adjusted odds ratio (AOR): 74.42, p = 0.005)] and chest examination [225 (58%) to 349 (95%); AOR 53.80, p = 0.002)]. However, despite these improvements, achievement of KPIs was still lower compared to adults. Examples are pelvic fracture evaluation [children: 295 (80%) vs adults: 1416 (88%), AOR: 0.56, p = 0.001] and respiratory rate assessment (children: 310 (84%) vs adults: 1458 (91%), AOR: 058, p = 0.030). ConclusionsWhile the TIF was effective in improving most KPIs of pediatric trauma care, more targeted education is needed to bridge the gap in quality between pediatric and adult trauma care at non-tertiary hospitals in Ghana and other low- and middle-income countries. Type of StudyStepped-wedged cluster randomized controlled trial. Level of EvidenceI.

Enteric Protozoan Parasitosis and Associated Factors among Patients with and without Diabetes Mellitus in a Teaching Hospital in Ghana.

Enteric protozoa infections (EPIs) could worsen clinical outcomes in patients with diabetes mellitus and therefore requires prompt and accurate diagnosis and attention. This study aimed to determine the burden of EPIs and their associated factors among patients with and without diabetics at the Komfo Anokye Teaching Hospital (KATH) in Ghana. Again, the diagnostic performance of parasitological techniques routinely used for diagnosis was assessed. A total of 240 participants (made up of 140 patients with diabetes and 100 patients without diabetes) were recruited into the study by simple random sampling from November 2020 to May 2021. Stool samples of participants were collected, along with their demographic information, and examined using the saline direct wet mount (DWM), formol-ether concentration (FEC), and modified Ziehl-Neelsen staining (ZNS) techniques for the presence of enteric protozoans. Enteric protozoa were found among 62/140 (44.3%) diabetic patients and 13/100 (13.0%) nondiabetic patients. The predominant protozoa identified were Cryptosporidium spp. (17.86%) among patients with diabetes and Blastocystis hominis (7.0%) among patients without diabetes. EPI was associated with diabetes mellitus status (AOR = 3.48, 95% CI, 1.55-7.79), having diabetes for more than five years (AOR = 3.83, 95% CI, 1.65-8.86) and having comorbidity (AOR = 2.93, 95% CI, 1.33-6.45). The FEC technique had the highest sensitivity (100.0%), specificity 94.3% (95% CI, 91.35-97.22), and accuracy 95.0% (95% CI, 88.54-98.13) when compared to other techniques for diagnosis. EPIs are a significant health problem among patients with diabetes at KATH, and therefore antiparasitic drugs should be included in their treatment protocols for better health outcomes. Again, the FEC technique has demonstrated better performance in detecting EPIs and is therefore recommended to achieve early and accurate diagnosis of EPIs.

Healthcare provider cost ofantimicrobial resistance intwo teaching hospitals inGhana.

Understanding the healthcare provider costs of antimicrobial resistance (AMR) in lower-middle-income countries would motivate healthcare facilities to prioritize reducing the AMR burden. This study evaluates the extra length of stay and the associated healthcare provider costs due to AMR to estimate the potential economic benefits of AMR prevention strategies. We combined data from a parallel cohort study with administrative data from the participating hospitals. The parallel cohort study prospectively matched a cohort of patients with bloodstream infections caused by third-generation cephalosporin-resistant enterobacteria and methicillin-resistant Staphylococcus aureus (AMR cohort) with two control arms: patients infected with similar susceptible bacteria and a cohort of uninfected controls. Data collection took place from June to December 2021. We calculated the cost using aggregated micro-costing and step-down costing approaches and converted costs into purchasing power parity in international US dollars, adjusting for surviving patients, bacterial species and cost centres. We found that the AMR cohort spent a mean of 4.2 extra days (95% CI: 3.7-4.7) at Hospital 1 and 5.5 extra days (95% CI: 5.1-5.9) at Hospital 2 compared with the susceptible cohort. This corresponds to an estimated mean extra cost of $823 (95% CI: 812-863) and $946 (95% CI: US$929-US$964) per admission, respectively. For both hospitals, the estimated mean annual extra cost attributable to AMR was approximately US$650 000. The cost varies by organism and type of resistance expressed. The result calls for prioritization of interventions to mitigate the spread of AMR in Ghana.

Predictors of multidrug-resistant tuberculosis in a teaching hospital in Ghana: A case-control study.

Multidrug-resistant Tuberculosis (MDR-TB) remains a global health concern. The disease results in a prolonged treatment and hence, poses a financial burden to affected individuals and their families. The Ghana National TB Control Programme (NTP) has made extensive efforts to control the menace, however, it remains a concern. This study, therefore, aimed to determine the predictors of multidrug-resistant TB in the Cape Coast Teaching Hospital of Ghana. An unmatched case-control study involving 37 cases and 111 controls was conducted using data of TB cases registered for treatment between January 2018 and December 2020 at the Cape Coast Teaching Hospital. Socio-demographic, individual level and social characteristics information were collected from respondents through telephone surveys, face-to-face interviews and review of records using a structured questionnaire built in the Kobo Collect Toolbox. The data was exported to Stata version 16.0 for analysis. Chi-square test and multiple logistic regression were used to determine the predictors of MDR-TB. Associations were considered statistically significant at a 95% confidence interval with a p-value of less than 0.05. The results revealed that the majority (25 [67.6%]) of MDR-TB cases and controls (76 [68.5%]) were aged 30 years and above with a median age of 36.5 (IQR: 28-50) years for all respondents, while 20 (54.1%) of MDR-TB cases and 33 (29.7%) of controls lived in households with one room residences for their families. The following predictors for MDR-TB were identified: BCG vaccination status (AOR = 0.17,95% CI:0.07-0.45), long distance to health facility (AOR = 4.11, 95% CI: 1.55-10.87), number of rooms in residence (AOR = 0.37,95% CI: 0.14-0.99) and first place of visit upon noticing TB symptom (AOR = 4.22,95% CI:1.31-13.64). Predictors of MDR-TB in the current study were multi-faceted. Measures to control MDR-TB should target socio-demographic, health-seeking behaviour and social-related concerns.