Ghana medical journal最新文献

Objective: To determine the context-specific perceived facilitators and barriers to routine utilisation of standardised outcome measures (SOMs) by physiotherapists (PTs) in Namibia.

Design: Questionnaire-based cross-sectional survey.

Setting: Private or public clinics/hospitals in Namibia.

Participants: Practising physiotherapists.

Main outcome measures: The study evaluated "routine" utilisation of SOMs operationally defined as using SOMs for 70% to 100% of the time in clinical practice. The study also determined the perceived facilitators and barriers to the routine utilisation.

Results: Of the 99 respondents, 96 (96.9%) had complete questionnaires. The majority of participants were female (n=64, 66.7%), had a Bachelor's degree (n=86, 89.6%), trained outside Namibia (n=82, 85.4%), and were practising as private practitioners (n=74, 77.1%). About half of the participants (n=47, 49.0%) "routinely" used SOMs, especially impairment-based tools. The most common reasons for SOMs utilisation were tool affordability and availability. However, about a quarter (n=41, 43.6%) were strongly deterred from using SOMs because of the language of construction of the tool, whilst 36.2% (n=34) highlighted that most SOMs had a higher reading proficiency than the patient population. Time-related barriers were also perceived by 34.0% (n=32) of the participants.

Conclusions: Routine utilisation of SOMs by PTs is below average in Namibia, primarily due to tool-related factors, such as the language of construction.

Funding: None declared.

Objectives: This study assessed the effects of 12-week green tea supplementation on fertility hormones and oxidative stress markers in obese males with varying gonadal statuses.

Design: A 12-week interventional study measuring hormonal and oxidative stress changes pre- and post-supplementation.

Setting: Conducted in Onitsha, Anambra State, involving community-dwelling obese males categorised by gonadal status.

Participants: One hundred obese males (aged 29-50) were categorised into Eugonadism, Compensatory Hypogonadism, and Hypergonadotropic Hypogonadism groups. Normal-weight eugonadic males served as controls. Participants were selected based on BMI and gonadal hormone levels.

Interventions: Participants consumed two bags of green tea infused in 150 mL of boiled water daily for 12 weeks. Blood samples were collected at baseline, 1 month, and 2 months. Hormonal levels: luteinising hormone (LH), Follicle Stimulating Hormone (FSH), prolactin, testosterone, and oestradiol were measured using ELISA, while oxidative stress markers: malondialdehyde (MDA), total antioxidant capacity (TAC), and glutathione peroxidase (GPx) were analysed colourimetrically.

Main outcome measures: changes in oxidative stress markers and reproductive hormone levels post-supplementation.

Results: Obese participants had significantly higher MDA and lower TAC and GPx than controls (p<0.05). Green tea significantly reduced MDA, oestradiol, and prolactin, whereas it increased TAC, GPx, and testosterone (p < 0.05). LH and FSH were normalised in Eugonadic and Compensatory Hypogonadic groups but remained elevated in Hypergonadotropic Hypogonadism.

Conclusions: Green tea supplementation reduced oxidative stress and improved hormonal balance in obese males, suggesting its potential for managing obesity-related reproductive dysfunction. Further studies should explore long-term effects.

Funding:

Objective: To determine the seroprevalence and risk factors associated with hepatitis B (HBV), hepatitis C (HCV) and human immunodeficiency virus (HIV) infection in rural haemodialysis patients at the Franceville haemodialysis centre in Gabon.

Design: Retrospective, descriptive and analytical study using exhaustive sampling.

Setting: Study conducted in a rural setting at the Franceville haemodialysis centre.

Participants: One hundred nineteen records of haemodialysis patients in whom HBV, HCV and HIV serologies were performed. Four incomplete files were excluded.

Main outcome measures: Viral infection, frequency of socioclinical characteristics, and univariate analysis.

Results: One hundred and fifteen haemodialysis patients were included, 70 men and 45 women. The mean age was 46.64±18.74 years. The seroprevalence of infection was 1.74%, 4.35% and 12.17% for HBV, HCV and HIV, respectively. HBV infection was associated with previous dialysis (p=0.000; OR: 36.667; 95% CI [1.825-736.304]), duration of dialysis (p=0.019; OR: 0.055; 95% CI [0.003-11.324]), elevated transaminases (p=0.000; OR:112; 95% CI [3.738-3355.535]), and initial nephropathy (p=0.0157; OR:15.149; 95% CI [0.853-268.535]). HCV infection was associated with elevated transaminases (p=0.001; OR: 27.25; 95% CI [1.432-518.553]) and incident kidney disease (p=0.039; OR: 8.916; 95% CI [0.751-105.791]). HIV infection was associated with incident kidney disease (p=0.000; OR:6.852; 95% CI [1.982-23.689]).

Conclusion: A low seroprevalence of HBV, HCV and a moderate seroprevalence of HIV infection has been reported in haemodialysis patients. Certain factors are associated with these infections. Systematic vaccination against HBV, responsible sexual behaviour and current and future strict hygiene measures will help to reduce viral infections in dialysis.

Funding: None declared.

Objectives: To demonstrate the relationship between adiponectin and insulin resistance among adolescents and young adults.

Design: A cross-sectional descriptive study.

Setting: This study was conducted within a tertiary institution and the medical outpatient department (MOPD) of its adjourning tertiary health-care institution.

Participants: The study was conducted among students of a tertiary institution and patients attending the ABUAD Multi-system Hospital, aged 16-24 years.

Main outcome measure: The mean levels of serum adiponectin in obese adolescents and young adults and its relationship with clinical correlates of insulin resistance.

Results: Mean serum adiponectin level was 6.8 µg/ml, which is comparable to what has been obtained in other studies. Statistically non-significant negative correlations were noted between serum adiponectin and the homeostasis model assessment of insulin resistance (HOMA-IR), as well as with the clinical correlates of insulin resistance such as Body Mass Index and diastolic blood pressure.

Conclusion: This study demonstrated no significant correlation between serum adiponectin and markers of insulin resistance among these participants and may not be a useful marker of insulin resistance among this group of individuals; hence, its routine measurement may not be appropriate. A follow-up study involving more obese subjects may, however, be more revealing.

Funding: None declared.

Objectives: To describe the epidemiology of paediatric ocular trauma (POT) presenting at a tertiary health institution in Ghana and factors influencing visual outcome.

Design: Prospective study.

Setting: Korle-Bu Teaching Hospital, Accra, Ghana.

Participants: Children aged 0-15 years presenting with trauma involving the globe and/or adnexa from January 2022 to February 2023.

Interventions: Clinical management of ocular trauma.

Main outcome measures: best-corrected visual acuity at 6 weeks, and factors influencing visual outcome.

Results: A significant proportion of children (59.2%) presenting with trauma were between ages 6-10 years (mean age 7.2±3.3 years), with the majority being male (70%). There was no caregiver at the time of injury in most cases (76%). Globe injuries were predominant (78.6%), and most (56.3%) were open globe injuries (OGIs). OGIs and organic objects as causes of injury were associated with unfavourable visual outcomes (p < 0.05). Early presentation, an inorganic object as the cause of injury, a favourable presenting visual acuity, a closed-globe injury, and a higher Paediatric Ocular Trauma Score (POTS) were associated with a favourable visual outcome. A third of children were blind (best-corrected visual acuity < 3/60) in the affected eye at follow-up.

Conclusion: Open globe injuries were the most common type of injury and often resulted in poor visual outcomes. Better public awareness, caregiver education, and adult supervision can help prevent these injuries.

Funding: None declared.

Objective: To explore the caregiving burden of caregivers of children with Sickle Cell Disease (SCD) to provide a foundation for policy interventions.

Design: A qualitative study based on convenience sampling.

Setting: The Sickle Cell Clinic of the Paediatric Department of a secondary health facility.

Participants: Primary caregivers of children with SCD who had been attending the clinic for at least one year were included. Caregivers whose children had another chronic illness were excluded to avoid confounding. Eleven care-givers participated in the study.

Interventions: No intervention.

Main outcome measures: Caregiving burden among participants caring for children with Sickle Cell Disease (SCD).

Results: The four main themes that emerged from the study were the financial, psychological, social, and physical burdens of caregiving. The financial and psychological burdens were noted to have the most substantial impact on their quality of life.

Conclusion: Addressing the needs of caregivers of children with SCD goes beyond financial support. Providing psychological interventions is crucial to alleviating the emotional burden of the disease on caregivers. The study revealed the multifaceted challenges faced by caregivers; hence, the need for a holistic approach to support families affected by SCD in Ghana.

Funding: None declared.

Objective: To determine mental health literacy levels and their predictors among primary health care workers across Nigeria's five geopolitical zones, and to identify common patient presentations and rates of suspected psychological illness.

Design: A cross-sectional, mixed-methods study using a census method.

Setting: The National Refresher Course Centre of the National Association of Community Health Practitioners of Nigeria, held at Wesley University, Ondo State.

Participants: 66 members of the National Association of Community Health Practitioners of Nigeria.

Interventions: A semi-structured questionnaire to collect socio-demographic data and Focus Group Discussions were also conducted among Community Health Practitioners in each zone.

Main outcome measures: Mental health literacy and the predictors.

Results: Mental health literacy among primary health care workers was low, with only 12.1% demonstrating above-average knowledge, mainly associated with longer work experience and a family history of mental illness. Patients commonly presented with physical complaints and symptoms such as fever, headache, insomnia, weight loss, and weakness, while underlying mental health conditions like anxiety, depression, and substance use disorders were often unrecognised. Routine mental health assessment was rare, and referrals to psychiatric services were infrequent, with most workers reporting only two to three referrals in the past year.

Conclusion: The mental health literacy of primary health care workers in Nigeria is critically low, highlighting an urgent need for extensive capacity building to improve the detection of psychological illness for comprehensive healthcare delivery.

Funding: None declared.

Objective: To determine the sociodemographic characteristics, risk factors, treatment outcomes and predictors of death of newly diagnosed patients with venous thromboembolism (VTE).

Design: A retrospective study.

Settings: University of Ghana Medical Centre (UGMC) Ltd, a 650-bed quaternary hospital located in Accra, Ghana.

Participants: One hundred and eighty-six adult patients admitted with a diagnosis of deep vein thrombosis and pulmonary embolism (PE), confirmed by Computed tomography pulmonary angiography (CTPA), from January 2022 to April 2024, were included in this study. All patients with a differential diagnosis of DVT or PE for whom confirmation by Doppler USG and CTPA could not be obtained were excluded.

Main outcome measure: Risk factors, treatment outcomes and predictors of death of patients diagnosed with venous thromboembolism.

Results: The mean age of study participants was 62.7 years (±15.5), and a slightly higher proportion were female (n=108, 58.1%). The mortality rate was 16.3%. Close to half of the patients (n=88, 47.3%) had a history of immobilisation as the predominant risk factor for VTE. On multivariate analysis, increasing age (OR 1.04, 95% CI 1.00-1.08), increasing urea level (OR 1.12, 95% CI 1.03 - 1.21) and presence of cancer (OR 6.02, 95% CI 0.003) remained significant predictors of mortality.

Conclusion: Immobilisation was the main risk factor for VTE in this study. In-hospital mortality was relatively high, with death in 1 in 6 patients diagnosed. Patients with advanced age, high urea and malignancy should be monitored closely and early aggressive treatment instituted to reduce mortality.

Funding: None declared.

Objective: The purpose of this study was to assess health staff's knowledge and facility compliance with the World Health Organisation (WHO) treatment guidelines for Severe Acute Malnutrition (SAM) in selected hospitals in the Volta Region of Ghana.

Design: This study employed a cross-sectional design.

Setting: Three hospitals in the Volta Region of Ghana: Ho Municipal Hospital, Ho Teaching Hospital and Adidome Government Hospital.

Participants: All health staff, including doctors, dietitians, nurses, and health assistants/health aides, involved in the treatment of SAM in the pediatric wards of the selected hospitals (70 in all).

Main outcome measure: Health staff's training and knowledge of the WHO protocol for management of SAM, as well as their facility's compliance with the feeding aspect of the WHO protocol.

Results: Majority of respondents (84%) had adequate knowledge of the WHO protocol, whilst only 37.1% graded their facilities as compliant with the feeding aspect of the WHO protocol. Less than half (41.4%) of participants received training on the WHO protocol for SAM management. There were significant associations between the training of participants on the WHO protocol and their knowledge of the WHO treatment guidelines, as well as the facility's compliance with the feeding aspect of the guidelines.

Conclusion: Despite adequate knowledge of the WHO SAM protocol among health professionals, the majority graded their facilities as non-compliant, highlighting the need for targeted training and institutional support to improve adherence and enhance SAM treatment outcomes in Ghana.

Funding: None declared.