Ghana medical journal最新文献

Objectives: This study aimed to detect the presence of SARS-CoV-2 genetic material on frequently touched surfaces in Accra and assess its potential infectivity. It evaluated whether detected viruses were viable, providing insights into the possible role of environmental surfaces in COVID-19 transmission.

Design: A cross-sectional study with a convenient sampling approach.

Setting: Conducted in clinical (two COVID-19 isolation centres and a testing laboratory) and non-clinical (two schools and two banks) settings in Accra, Ghana, from May to September 2022.

Intervention: Frequently touched surfaces were sampled at two points: morning (before disinfection) and afternoon (after work). Sterile oropharyngeal swabs moistened in Universal Transport Medium were used to swab surfaces like door handles, tables, handrails, taps, benches, washrooms, classrooms, and banking halls. RT-qPCR was used to detect viral RNA, and Vero E6 cells were used to attempt virus isolation from positive samples.

Results: SARS-CoV-2 RNA was detected on 6.29% (37/588) of surfaces. Morning samples showed a positive rate of 4.08% (12/294), while afternoon samples showed a rate of 8.50% (25/294). Clinical settings had higher detection rates (7.5%) than non-clinical (3.41%), though not statistically significant (p = 0.060). The testing lab showed a significant difference between morning (2.08%) and afternoon (8.05%) detections. Positive samples were most commonly found on plastics (14/37) and metals (14/37).

Conclusion: SARS-CoV-2 RNA was identified on frequently touched surfaces in selected areas of Accra, Ghana. This highlights the need for thorough hygiene and disinfection practices to prevent the spread of potential viruses.

Funding: Study was funded by the Noguchi Memorial Institute for Medical Research (NMIMR) through the NMIMR Office for Research Support Fund (Fund ID EC/P25421/03).

Background: Knee osteoarthritis is a chronic degenerative condition often viewed as an inevitable aspect of aging. It leads to the progressive deterioration of articular cartilage, resulting in pain and significant limitations in global movement. Intra-articular steroid injections are effective for pain control and functional improvement. This study focuses on Betamethasone Dipropionate and Methylprednisolone Acetate, both of which have shown promising outcomes, evaluated at the Korle Bu Teaching Hospital.

Objective: The study aimed to compare the effectiveness of betamethasone dipropionate and methylprednisolone acetate in managing Kellgren Lawrence (KL) stage 2 to 4 primary knee osteoarthritis.

Design: This was a single-blinded comparative study conducted at the Orthopaedic Clinic of a tertiary hospital.

Participants: Patients with osteoarthritis in one or both knees, presenting with a pain score of ≥4 on a 0-10 Visual Analogue Scale (VAS), were included.

Main outcome measure: Effectiveness in controlling pain and improving function.

Results: The average age of participants was 60 years. At two weeks, the P-values for VAS and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores between groups A and B were 0.495 and 0.927, respectively. At four weeks, these values were 0.810 and 0.372. However, by twelve weeks, the P-values for VAS and WOMAC scores were 0.026 and 0.0235, indicating significant differences.

Conclusions: Both steroid injections provided symptom relief; however, Betamethasone Dipropionate demonstrated superior long-term effectiveness compared to Methylprednisolone Acetate, offering better sustained pain relief beyond eight weeks.

Funding: None declared.

Hypertrophic pachymeningitis (HP) is characterised by thickening of the cranial or spinal dura mater, and it encompasses idiopathic and secondary forms. Later is linked to infections, inflammatory conditions, and autoimmune disorders. This rare condition presents with a myriad of neurological manifestations, including headaches, cranial nerve palsies, and visual disturbances. A South-Asian woman in her mid-thirties presented with a three-month history of left-sided headache, double vision, and facial numbness. Neuroimaging revealed diffuse thickening of the dura mater, suggestive of hypertrophic pachymeningitis (HP). Diagnostic workup excluded infectious and autoimmune causes, categorising the condition as idiopathic. Treatment with corticosteroids led to significant improvement in her symptoms. HP is a rare cause of headache in young patients, and diagnosis relies on neuroimaging and CSF analysis, necessitating the exclusion of secondary causes through comprehensive evaluation. Treatment varies based on the underlying aetiology. Corticosteroids remain the first-line drug for idiopathic cases.

Funding: None declared.

Objective: This study determined the burden and trend of Hepatitis B Virus (HBV) infection in individuals who visited Agona Government Hospital in Ghana.

Design: A retrospective study.

Setting: A single-centre study conducted at Agona Government Hospital.

Participants: Clients who visited Agona Government Hospital.

Main outcome measure: A hospital-based retrospective study was conducted. Data generated between January 2016 and December 2020 were extracted, cleaned, and validated using Microsoft Excel version 2019. Analysis was done using the Statistical Package for Social Sciences version 26.

Results: A total of 2440 records from individuals who were tested for HBV were analysed. The records indicated varying numbers of tests each year, with 28.9% in 2016, 23.1% in 2017, 20.6% in 2018, 13.6% in 2019, and 13.7% in 2020. Most of the clients were aged 25-44 (46.3%). The majority of the clients were married (53.2%) and females (65.3%). The cumulative crude prevalence of HBV infection was 57.44 per 10,000. The prevalence of HBV varied across age categories and genders. A decline in prevalence was observed from 2016 to 2017, with a trough in 2018, followed by a rise through 2019 and peaking in 2020. The crude prevalence exhibited a peak in February and a trough in September, with inconsistent patterns throughout the year.

Conclusion: The high burden of HBV underscores its significance as a pressing public health issue. There is therefore an urgent need for public health interventions to curb the spread of the infection.

Funding: None declared.

Objectives: To determine the mortality of patients admitted and managed for Diabetic ketoacidosis (DKA) at a teaching hospital.

Design: A cross-sectional study of the medical records of all 70 patients 18 years and older, managed for DKA in the adult emergency room of Korle-Bu Teaching Hospital in Ghana from March to July 2019.

Setting: The study was conducted among adult patients managed for diabetic ketoacidosis in the adult emergency room and adult medical wards of Korle-Bu Teaching Hospital.

Participants: The participants were patients aged 18 years or older who were admitted with diabetic ketoacidosis.

Interventions: Patients managed for diabetic ketoacidosis in the adult emergency room of Korle-Bu Teaching Hospital in Ghana had their outcomes assessed.

Main outcome measures: Outcomes of DKA management, including mortality, discharge, duration to either of these outcomes and associations were measured.

Results: The mortality rate from DKA in this study was 15.7%. Mean age, duration of diabetes, and blood glucose at admission were 44.06(±16.23) years, 7.19(±6.04) years, and 26.37(±6.70) mmol/L, respectively. Female gender and pulse rate >100 or <60 beats/minute were independently associated with mortality. Only 2 out of 70 (2.85%) patients were managed in the Intensive Care Unit (ICU).

Conclusion: The Mortality of DKA management in this hospital was high (15.7%). Most of these patients (97.15%) were not managed in the ICU or HDU; to improve this high mortality, there is a need to use the guidelines in the diagnosis, categorisation and management of DKA and to make the ICU and HDU available, accessible and affordable in our centre and elsewhere in Ghana.

Funding: None declared.

Objectives: This study determined the profile of spontaneous bacterial peritonitis (SBP) and its variants in patients with decompensated liver cirrhosis and hepatocellular carcinoma (HCC).

Design: A descriptive cross-sectional study.

Setting: The study was conducted in a tertiary hospital.

Participants: Patients with decompensated liver cirrhosis and HCC above 18 years.

Interventions: Ascitic fluid (AF) samples were taken for cell count and culture using a BACTEC culture bottle. Sensitivity patterns and ascitic fluid total protein and albumin levels were also assessed.

Main outcome measures: Clinical profile of SBP, organisms isolated from the ascitic fluid and sensitivity of isolated organisms to antibiotics.

Results: One hundred and six (106) participants were recruited. Seventy (66%) had liver cirrhosis, and 36 (34%) had HCC. The mean age was 50.08±12.66 years. Eighty-nine (84%) were males and 17(16%) were females. The overall prevalence of SBP was 29.2% (n = 31). Classical SBP was 5(4.7%), CNNA 20(18.9%) and monobacterial ascites 6(5.7%). The Gram-positive isolates were Staphylococcus aureus 5(45.5%) - [2(18.2%) MRSA, 3(27.3%) MSSA] while the Gram-negative organisms were E. coli 3(27.3%), Acinectobacter 2(18.2%) and Bulkholderia cepacia 1 (9.1%). Gram-negative bacteria showed absolute resistance to cephalosporins but were all susceptible to meropenem. Gram-positive bacteria showed 100% susceptibility to linezolid, vancomycin and daptomycin. Gram-positive bacteria also showed low resistance to fluoroquinolones (20%). Multi-drug resistance pattern was reported for MRSA, Acinetobacter baumannii and Bulkholderia cepacia.

Conclusion: SBP is a common complication in patients with decompensated CLD. Guided antibiotic treatment should be encouraged, particularly in light of the emergence of multidrug resistance patterns.

Funding: None declared.

Giant prostate hyperplasia is defined as prostate hyperplasia with a weight greater than 500 grams. This condition is rare. We present the management of a case of giant prostate hyperplasia (541 grams on CT scan) with a surgical enucleated volume of 800 grams in a patient who presented with haematuria. An abdominal-pelvic CT scan was required to differentiate it from a suspected bladder tumour. This case was successfully managed with a favourable outcome following open transvesical prostatectomy, ensuring minimal blood loss. This case report and review provide an update on the management of giant prostate hyperplasia, with emphasis on the prevention and management of haemorrhage.

Funding: None declared.

Objective: This study aimed to investigate the prevalence, pattern, and predictors of elder abuse in two rural communities in Edo State, Nigeria.

Design: A cross-sectional study.

Setting: Individuals residing in rural communities in Edo state were studied.

Participants: Two hundred and thirty-two participants aged ≥ 60 years.

Main outcome measures: The prevalence and pattern of elder abuse, and predictors of abuse.

Results: The mean age of participants was 73.2±9.1 years, and the prevalence of elder abuse was 79.3%. The pattern of abuse observed was neglect (73.4%), financial abuse (64.1%) and emotional abuse (53.8%), with many of the perpetrators being children of the victims. Risk factors associated with abuse in this study included sex (p = 0.009), marital status (p = 0.028), employment status (p = 0.002), educational qualification (p = 0.001), living arrangement (p = 0.001), financial status (p = 0.017), and dependency level (p = 0.015). The top barriers to help-seeking by the elderly were stigmatisation (24.4%), fear of retaliatory assault (19.3%) and abandonment (19.4%) respectively.

Conclusion: Elder abuse is prevalent in the study area, with neglect being the most typical form of abuse and children of the victims are the major perpetrators. Consequently, concerted efforts to respect and care for the elderly should be directed by all stakeholders at the International, Federal, State, and Local Levels (including the community and family).

Funding: None declared.

Objective: This study aimed to describe the patient demographics, clinical presentation and histological subtypes of central nervous system (CNS) tumours in a tertiary facility.

Design: Retrospective review of all the histopathological and medical records available for patients with tumours of the CNS operated on.

Setting: Neurosurgical Unit, Department of Surgery, Korle-Bu Teaching Hospital.

Participants: All adult and paediatric patients with histopathologically diagnosed CNS tumours.

Main outcome measures: Frequency of histopathological subtypes of CNS tumours.

Results: This study of 338 patients with CNS tumours showed a slight female predominance (183 females, 155 males). The mean age was 38.1 years. Brain tumours were more common (290 cases) than spinal tumours (48 cases), with symptoms like headaches (44.44%) and visual disturbance (24.31%) prevalent in brain cases, and paraparesis (35.42%) and low back pain (16.67%) in spinal cases. Certain symptoms were strongly indicative of specific tumour types, such as seizures (OR: 3.3, CI: 1.6 - 6.9, p = 0.005) with meningiomas and visual disturbances with sellar tumours (OR: 6.7, CI: 3.6 - 12.9, p<0.001). Most tumours were low-grade (78.69%). Meningiomas were the most common (33.14%), particularly meningothelial (38.39%). Gliomas, glioneuronal, and neuronal tumours were next in prevalence (28.40%), followed by sellar tumours (18.93%). Astrocytomas (60.42%) were the predominant glioma subtype.

Conclusion: Low-grade tumours predominate in our setting. It is prudent that we channel efforts towards prompt diagnosis and treatment of such cases.

Funding: None declared.