Ghana medical journal最新文献

Objective: To assess the sexual functioning of Nigerians with T2DM in comparison to healthy controls.

Design: Comparative descriptive cross-sectional survey.

Setting: Olabisi Onabanjo University Teaching Hospital.

Participants: A Consecutive sample of 210 adult Nigerians with T2DM and 121 without diabetes.

Main outcome measures: Sexual functioning was assessed with the Changes in Sexual Functioning Questionnaire.

Results: Participants with diabetes had a higher prevalence of SD than those without diabetes (76.2% vs 34.7%). This remained unchanged when stratified by gender and sexual response cycles. Increasing age and female gender were significantly associated with SD among participants with diabetes. A one-year increase in age has 1.09 odds of increased SD among participants with diabetes (OR = 1.09, CI = 1.05 - 1.13), while the female participants demonstrated higher SD when compared with males, irrespective of diabetes status, [with diabetes (80.7% vs 65%) and without diabetes (60% vs 20.6%)]. They were also three times as likely to have SD as their male counterparts (OR = 3.39, CI = 1.59-7.24, p = 0.002).

Conclusion: People with diabetes reported lower sexual functioning compared with those without diabetes, with a more than double the prevalence. Females had a higher prevalence of SD than males, irrespective of diabetes status, associated with age among participants with diabetes.

Funding: None declared.

Objective: To determine the quality of selected frequently used medicines in CHAG facilities in a LMIC country setting.

Design: Quality testing of collected samples of generic medicines in health facility pharmacies.

Setting and participating facilities: The study evaluated the quality of 639 representative samples of 14 generic products using a TruScan Raman (RM) analyser and Minilab in 62 CHAG facilities across five administrative regions of Ghana.

Results: Out of 639 samples of various branded generics of the 14 product samples tested in the field using the Truscan RM analyser, 210 products (32.8%) failed the test. All samples from ceftriaxone injection 1 g, ciprofloxacin 500 mg, metronidazole 200 mg, and metformin 500 mg passed the Truscan RM test. High passes were also recorded for paracetamol 500 mg (96.6%), artemether/lumefantrine 80/480 mg (95.8%), and oral rehydration salts (94%). Conversely, all the forty-two (42) samples obtained and tested for flucloxacillin 250 mg failed the Truscan analyser test. Relatively high failures were also recorded for lisinopril 10 mg (90.5%) and albendazole 400 mg (89.8%). All samples submitted for secondary screening using Minilab analysis showed the presence of their respective active pharmaceutical ingredients as indicated on their respective labels.

Conclusion: The Truscan/Minilab combination is reasonably affordable and efficient for undertaking post-market monitoring of the quality of essential medicines in Ghanaian health facilities. For future application of Truscan, a check of standard spectra is essential, and the choice of tracer medicines should include those with limited fluorescence materials in formulations and a relatively high percentage of active ingredients.

Funding: This study was funded by Pharmaccess Foundation Ghana and the Netherlands.

Objectives: This study audited the Medical Certification of Cause of Death (MCCD) forms issued at Korle-Bu Teaching Hospital, assessing their accuracy, completeness, and consistency while analysing trends in mortality causes.

Design: Retrospective review of completed MCCD forms.

Setting: Korle-Bu Teaching Hospital, Department of Medicine.

Participants: All duplicate MCCD forms issued between January 1^st, 2019, and December 31^st, 2023, were included.

Interventions: No intervention.

Main outcome measures: Frequency of major and minor errors in completing the MCCD forms and leading causes of death in the department.

Results: Of 4,544 MCCD forms audited, 4,460 (98.17%) contained errors. Major errors were observed in 4,028 (88.64%) forms; the commonest being incorrect reporting of the underlying cause of death (3,483; 76.65%). Minor errors were nearly universal (99.82%), with omission of the full address of the deceased (4,530; 99.69%) being most frequent. Over half of the recorded deaths each year were attributable to non-communicable diseases (NCDs), with cardiovascular-related conditions being the leading cause of death.

Conclusions: There was a high prevalence of errors in MCCD forms, highlighting the need for regular training of healthcare professionals to improve accuracy in death certification. Additionally, the high burden of NCD-related deaths emphasises the need to address modifiable risk factors, strengthen health systems, and foster multisectoral collaboration to mitigate the growing NCD epidemic.

Funding: None declared.

Objectives: To explore patient rights outcomes in nurse-patient clinical interactions in the Yendi Hospital and promote patients' rights in Ghana using a proposed Caring Space Model.

Design: An ethnographic research design was implemented, and purposive sampling was used to recruit participants. Data were gathered across nine inpatient units through in-depth individual interviews (n = 39), ethnographic participant observations (over 400 hours), and a focus group discussion from December 2021 to April 2022. A reflexive thematic analysis was conducted to explore participants' knowledge, experiences, and barriers to upholding patient rights in clinical interactions.

Setting: The study was conducted in the Yendi Municipal Hospital.

Participants: Included Nurses (n=11), patients (n=21), and caregivers (n=11) who were 18 years of age or older and provided voluntary consent. Additionally, nurses must have at least three years of experience in a hospital setting.

Results: The study found that most patients and caregivers are unaware of the Ghanaian Patients' Charter. Nurses who were familiar with the Charter failed to educate patients and caregivers because they feared that doing so would cause undue stress. Poor patient rights outcomes were rooted in human and material resource constraints, affecting nurse-patient and nurse-nurse manager relationships. Patient rights education, transformative nursing leadership practices, and effective communication during clinical interactions can enhance patient rights and safety.

Conclusion: To promote patient-centred care, a model of the Caring Space has been developed to advance ethical nursing and caring practices that elevate patient rights in patient-provider clinical interactions.

Funding: No funding.

Objectives: Responsible use of over-the-counter (OTC) drugs requires accurate knowledge of the drugs and when to seek professional help. The study assessed knowledge, sources and use of OTC medicines by secondary school teachers.

Design: A descriptive cross-sectional survey was conducted using a multistage sampling method that involved systematic sampling.

Setting: Ten secondary schools in Benin City, Nigeria.

Participants: Three hundred secondary school teachers who were either casual or permanent staff and who gave informed consent were included.

Outcome measures: Respondents' knowledge of OTC drugs, their sources of OTC drugs, and the most commonly used OTC drugs, among the respondents.

Results: Among the 300 study participants, the majority, 185 (61.7%), practised in public schools and more than a quarter, 82 (27.3%), had good knowledge of OTC drugs. Advertisement was the most frequently reported source of information 57(19.0%). Type of school (P=0.001), educational qualification (P=0.024) and reading of enclosed drug information leaflets (P=0.001) were significantly associated with level of knowledge. The major source of OTC medicines was pharmacies (158, 52.7%), and analgesics were mainly used (216, 72.0%), followed by vitamin supplements (172, 57.0%). Ability to recognise and treat minor ailments 132(44.0%,) was the major reason for OTC drug use.

Conclusion: Poor knowledge of OTC medicines was common among the teachers; their major source of knowledge was advertisements, and analgesics were most used.

Funding: None declared.

Objectives: To determine the prevalence of Intimate partner violence (IPV) in a secondary health facility.

Design: A cross-sectional study.

Setting: Antenatal clinic of a secondary Health facility in Delta state, Nigeria, between July 1st, 2023, and June 30^th, 2024.

Participants: 244 women presenting for fertility management within the period of the study.

Main outcome measures: The proportion of women who suffered IPV due to infertility.

Results: The prevalence of IPV was 44.7%. Factors that were significantly associated with IPV were alcohol intake by the male partner [OR=2.74, 95% CI (1.25 - 6.01)], and male partner smoking habit [OR=5.90, 95% CI (2.50 - 14.00)]. Women in monogamous relationships were less likely to experience IPV [OR=0.12, 95% CI (0.02 - 0.60)]. Additionally, women who had given birth to one or more children with their partner were also less likely to suffer from IPV [OR=0.24, 95% CI (0.10 - 0.54)]. Psychological 40(16.4%), verbal 35(14.3%), and multiple 28 (11.5%) abuses were the most common forms of IPV. The majority of the participants, 110 (45.1%), would keep IPV a secret, while 54(22.1%) and 39(16.0%) would report to the family or resort to prayer.

Conclusions: Overall, the study underscores the urgent need for targeted interventions addressing male substance abuse and societal attitudes towards infertility, particularly in polygamous households, to mitigate IPV against infertile women. Women should be educated on the importance of speaking up in the event of IPV.

Funding: None declared.

Objective: The interchangeability of Goldmann Applanation Tonometry (GAT) with or without fluorescein requires clarification among African populations. The present study aimed to determine the agreement between IOP measurement using GAT with and without fluorescein in consecutive patients in Ghana.

Design: A prospective cross-sectional clinic-based study design.

Setting: The study was conducted at the Ophthalmology and Optometry units of the UCC Eye Clinic, Cape Coast, Ghana.

Participants: A convenient sample of 104 consecutive patients who visited the clinic. The participants were randomised into two groups, where those in the first had their IOPs first measured without fluorescein and later with fluorescein on GAT; participants in the second group had their IOPs first measured with fluorescein and later without fluorescein after a 10-minute washout period. The central corneal thickness was measured using the Anterior Segment model of Zeiss Cirrus HD-OCT.

Results: There was no agreement between the unadjusted IOP measures with and without fluorescein with GAT using the Bland Altman analysis (p < 0.0001, Lower limit: -0.9433, Upper limit: 6.8914; 95% CI = -1.6097 to -.02769). There were no statistically significant differences in gender between unadjusted IOP measurements with (Mann Whitney U test, p = 0.110) and without (Mann-Whitney U test, p = 0.083) fluorescein.

Conclusion: Unadjusted IOP measurement without fluorescein was approximately 3 mmHg significantly lower than with fluorescein. We recommend practitioners maintain the gold standard GAT with fluorescein to guide accurate glaucoma diagnosis and management decision-making.

Funding: Self-funded.

Objective: This study aimed to determine the prevalence of anaemia and associated factors among type 2 diabetic patients.

Design: This research utilised a hospital-based cross-sectional study design.

Setting: The research was conducted at the Diabetic Clinic of Ho Municipal Hospital.

Participants: The study involved 180 type 2 diabetic patients, aged 20 years or older, who had been on anti-diabetic medications for a minimum of three months before the study. Premenopausal women who had not menstruated in the two weeks before recruitment were also included in the study. Participants were excluded if they were receiving haematinics, had undergone a blood transfusion in the preceding month, were undergoing treatment for malaria or helminthiasis, or had any other chronic complications such as renal failure, liver disease, or stroke. Individuals with type 1 diabetes and pregnant women were excluded from the study.

Results: Approximately a quarter [44 (24.4%)] of the study population had anaemia, with a slight male preponderance [15(25.0%)]. Mild and moderate anaemia were 31 (70.5%) and 13(29.5%), respectively. Microcytic hypochromic anaemia [16 (36.4%)] was the most frequent morphological type of anaemia, followed by normocytic normochromic anaemia [12(27.3%)]. High BMI and low platelet counts were independently associated with reduced odds of developing anaemia in patients with type 2 diabetes mellitus.

Conclusion: Anaemia is a common finding in patients with type 2 diabetes mellitus in the Ho municipality. Mild anaemia and microcytic hypochromic anaemia were predominant among the anaemic patients. High BMI and low platelet count were significant predictors of reduced probability of anaemia.

Funding: None declared.

Objectives: The study determined the knowledge of Hepatitis B vaccine, vaccination status and associated factors among healthcare workers in public secondary health facilities in the Delta Central Senatorial District, Nigeria.

Design: A cross-sectional study.

Settings: Healthcare workers employed in public secondary health facilities in the Delta Central District.

Participants: Four hundred and sixteen participants.

Main outcome measures: Knowledge of the Hepatitis B vaccine, vaccination status, and predictors of vaccine uptake.

Results: Majority of the participants (78.0%) had good knowledge about the Hepatitis B vaccine. One hundred and seventeen participants (42.6%) were fully vaccinated. Age, sex, marital status, education level, cadre, and knowledge of HBV were significantly associated with vaccination status (p < 0.05). Factors associated with low uptake included being female [adjusted odds ratio (AOR) 1.884; 95% CI 1.128-3.147], being a nurse (AOR 0.228; 95% CI: 0.071-0.737) and poor knowledge (AOR: 0.404; 95% CI: 0.184-0.889).

Conclusion: This study showed a high level of knowledge about Hepatitis B vaccine, and a suboptimal vaccination rate among healthcare workers.

Funding: No funding was acquired for the present research.