Ghana medical journal最新文献

Objectives: To assess the knowledge and acceptability of COVID-19 vaccines among HCWs.

Design: A descriptive cross-sectional study was conducted in March 2021 among eligible HCWs using a self-administered questionnaire.

Setting: The study was conducted in a southern Nigerian tertiary hospital.

Participants: All HCWs not on annual or study leave were eligible to participate. The number of HCWs in each occupational category was determined by proportional allocation. HCWs were selected by stratified sampling technique.

Main outcome measures: Knowledge of COVID-19 vaccines was assessed using 25 questions. The minimum and maximum scores were 0 and 25, respectively. Scores were converted to percentages. Scores of 50% and above were rated as good knowledge. Participants were also asked if they were willing to receive the vaccine.

Results: The mean age of 512 participating HCWs was 33.4±7.8 with an M:F ratio of 1:1.1. Overall, 399 (76.6%) had good knowledge. Occupation and exposure to COVID-19 were predictors of knowledge. Three hundred and twenty-eight respondents (63.0%) were willing to take the vaccine. Predictors of willingness to accept vaccination were age, sex, number of years in employment and knowledge about the vaccines (p< 0.05).

Conclusions: Most HCWs had good knowledge and were disposed to accepting the COVID-19 vaccine. Educational interventions are necessary to improve HCWs knowledge as they may provide vaccine-related information to the general public.

Funding: None declared.

Objectives: To compare clinical characteristics of COVID-19 among vaccinated and unvaccinated patients in a major treatment facility in Ghana.

Design: A retrospective study drawing on data from COVID-19 patients' records visiting the facility from March 2021 to December 2021.

Setting: Ghana Infectious Disease Centre, Ga East Municipality, Greater Accra Region, Ghana.

Participants: In-patients and outpatients who reported to the facility from 1st March 2021 to December 2021 were included in the study, and patients with missing data on vaccination were excluded.

Outcome measures: underlying conditions, symptoms, case management information, hospital service rendered (OPD, HDU or ICU), length of hospital stay, treatment outcome.

Results: The study included 775 patient records comprising 615 OPD and 160 hospitalised cases. Less than one-third (26.25%; 42) of the patients hospitalised were vaccinated compared to almost 40.0% (39.02%; 240) of the patients seen at the OPD. Vaccinated individuals were nearly three times (aOR = 2.72, 95%CI:1.74-4.25) more likely to be managed on an outpatient basis as compared to the unvaccinated. The death rate among the vaccinated group and the unvaccinated were (0.71%; 2) and (3.45%; 17), respectively, with a significant reduction in the risk of dying among the vaccinated compared to the unvaccinated (aOR = 0.13, 95%CI: 0.028 0.554).

Conclusions: Less than half of the in-patient and OPD patients were vaccinated. Mild infections, fewer days of hospitalisation, outpatient treatment and higher chances of survival were associated with being vaccinated against SARS-CoV-2. Prudent measures should be implemented to encourage the general public to take up SARS-CoV-2 vaccines.

Funding: None declared.

Objectives: The study assessed gustatory functions in patients with primary hypothyroidism who are euthyroid on supplemental hormone therapy with levothyroxine over six months' duration and to evaluate the association of gustatory dysfunction, if any, with the serum TSH levels.

Design: This analytical community-based cross-sectional study was conducted in April 2021, following participants' ethical approval and written informed consent.

Setting: The study was conducted in a tertiary health care centre in Bangalore, Karnataka, India.

Participants: Sixty-eight subjects participated in this study: 34 primary hypothyroid patients and an equal number of healthy controls.

Interventions: Gustatory sensations were assessed by the triple drop test, and scores were given depending on the identification of the tastants (sweet, sour, salty, and bitter). The taste scores were compared, and the association between TSH levels and gustatory parameters were evaluated.

Results: Overall taste scores were lesser in hypothyroid patients. This finding depicted that their taste thresholds were increased and were statistically significant (p < 0.001), though the association between the degree of hypogeusia and TSH levels was not statistically significant.

Conclusion: Patients with primary hypothyroidism can suffer from hypogeusia, which may revert to normal once they achieve euthyroid status with levothyroxine supplementation. However, this has not been conclusively shown in studies. Our study concluded that hypogeusia was present in primary hypothyroidism despite patients being euthyroid on hormone supplementation, and it was not dependent on the serum TSH levels.

Funding: None declared.

Objective: The main objective of the study was to assess psychological distress and to identify any gender specific differences in the psychological distress among infertile couples after one year of unsuccessful pharmacotherapy.

Design: A descriptive cross-sectional study.

Setting: The study was conducted in four fertility clinics in the Cape Coast Metropolis.

Participants: One hundred and twenty respondents (71 women and 49 men) were recruited by simple random sampling.

Statistical analysis: Statistical analysis was done using SPSS (v. 25). Psychological distress scores were presented as Mean±SD and were analysed using One-way ANOVA, followed by Bonferroni's post hoc test. Associations between exposures and outcomes were measured using relative risk.

Outcome measure: The main outcome measure was the level of depression, anxiety, and stress among infertile couples after unsuccessful pharmacotherapy.

Results: Anxiety was the predominant psychological distress experienced by respondents (60.8%), followed by depression (43.3%) and stress (37.5%). Generally, psychological distress scores increased with age among female respondents but decreased with age for male respondents. The duration of infertility only significantly affected anxiety (p=0.01) but not depression (p=0.51) and stress (p=0.06) levels. Approximately 31.7% of respondents reported experiencing extremely severe anxiety. Male respondents reported higher degree of depressive symptoms than females (46.9 vs. 40.8%).

Conclusion: Unsuccessful pharmacotherapy of infertility is associated with varied degrees of psychological distress among Ghanaian infertile couples, which can be affected by age, duration of infertility and gender.

Funding: None declared.

Objectives: The study aimed to determine the prevalence of self-medication with antibiotics among attendants of the Out-patient Department (OPD) at Madina Polyclinic before seeking medical consultation and associated factors.

Design: Cross-sectional study.

Setting: The study was conducted at Madina Polyclinic.

Participants: The study involved 319 general OPD attendants aged 18 years and above accessing healthcare services at the Madina Polyclinic between May and June 2019.

Main outcome measures: The prevalence of antibiotic self-medication and the factors associated with this practice.

Results: From the study, 46.4% (95% CI 40.8%- 52.0%) had self-medicated with antibiotics before presenting for medical consultation at the hospital. Less than half of the respondents (44.5%) had adequate knowledge about the use of antibiotics. Having a tertiary level of education was significantly associated with self-medication (aOR= 8.09, 95% CI 2.31-28.4, p = 0.001), whilst adequate knowledge on the use of antibiotics reduced the odds of self-medication by 53% (aOR= 0.47, 95% CI 0.23- 0.66, p<0.001). The level of education modified the relationship between knowledge and self-medication with antibiotics.

Conclusion: The practice of antibiotic self-medication is rife among OPD attendants. Therefore, adequate public education on the use of antibiotics and the effects of using them inappropriately must be done. The Antimicrobial Resistance (AMR) policy ought to be reinforced and made known to all, especially among the pharmacies that dispense antibiotics indiscriminately.

Funding: None declared.

The Scimitar syndrome or pulmonary venolobar syndrome is a rare, complex and variable congenital anomaly of cardiopulmonary development characterised by an abnormal right-sided pulmonary venous drainage in the inferior vena cava, malformation of the right lung, abnormal arterial supply and sometimes cardiac malformations. These serious anomalies notwithstanding, their presentation is varied, ranging from asymptomatic to severe symptoms, particularly in the neonatal and early infantile period. Some symptomatic cases are misdiagnosed as recurrent lower respiratory tract infections or as heart failure, missing the underlying congenital anomaly. Considering associated serious complications such as pulmonary hypertension and a high mortality rate, accurate and timely diagnosis is mandatory. This requires a high index of suspicion, not only by clinicians but also by radiologists who encounter suggestive chest radiographs in asymptomatic children. Still, the classic radiological finding for which the condition is named is seen in only about 50% of all cases and only 10% in affected infants. We highlight this case to heighten clinicians' and radiologists' suspicions about Scimitar syndrome.

Funding: None declared.

Objectives: To determine the prevalence and severity of anaemia and assess the relationship between dietary lifestyle, hypoalbuminaemia, and anaemia of older persons.

Design: A cross-sectional hospital-based study.

Setting: This study was conducted in the General Outpatient Clinic, the primary care unit of Aminu Kano Teaching Hospital in Kano, Nigeria.

Participants: A total of 378 patients aged ≥ 60 years who presented to the General Out-patient Clinic.

Main outcome measures: Prevalence and severity of anaemia, relationship between anaemia and hypoalbuminaemia, and dietary lifestyle of the participants.

Results: A total of 348 respondents completed the study. The mean age of respondents was 67.83 ±7.53 years, with female (60.9%) predominance. The prevalence of anaemia and hypoalbuminaemia were 42.2% and 17.8%, respectively. Hypoalbuminaemia (β=0.335, 95%CI=0.131-0.229, P<0.001), long duration of comorbidities (β= -0.179, 95%CI= -0.165-0.047, P<0.001), one full meal/day (β=0.130, 95%CI=0.224-1.879, P=0.013), and low monthly income (β=0.122, 95%CI=0.179-1.543, P=0.026) were the predictors of anaemia among the older persons in this study.

Conclusion: This study revealed a high prevalence of anaemia among older adults. The identified predictors, such as hypoalbuminaemia, long duration of comorbidities, reduced food intake and low monthly income, will be useful in developing guidelines and strategies for managing the condition in primary care settings and other similar sites.

Funding: None declared.

Objective: The study sought to determine clinical characteristics and histologic subtypes of a cohort of lung cancer patients in a tertiary facility.

Design: Retrospective review of the medical records of histology-confirmed lung cancer cases at the respiratory clinic over a 3-year period.

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

Participants: All adult patients with histologically diagnosed lung cancer were enrolled.

Main outcome measures: Lung cancer histological types.

Results: The proportion of lung cancer cases was 12.4%. The majority were women (57.8%) and the mean age at diagnosis was 55.8±16.0 years. The patients were predominantly non-smokers (61%). Common symptoms were chronic cough and chest pain. More than two-thirds of the cases presented in clinical stages III and IV with the predominant histological subtype being adenocarcinoma in smokers and non-smokers. Genetic testing for epidermal growth factor receptor (EGFR) and Anaplastic Lymphoma kinase (ALK) mutations were largely absent.

Conclusions: The majority of lung cancer patients presented late with advanced disease. Adenocarcinoma was the predominant histological subtype in a predominantly non-smoking population, with an increased prevalence among women less than 60 years. This should encourage testing for genetic mutations to improve patient survival.

Funding: None declared.

Objectives: To determine the relationship between postnatal foot lengths and estimated gestational age (EGA) in relation to intrauterine growth patterns determined at birth among Nigerian neonates.

Design: Hospital-based, cross-sectional.

Setting: Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria.

Participants: 260 neonates with EGA 30- 42 weeks within 48 hours of life.

Interventions: Postnatal foot lengths (FL) were measured with Vernier digital calliper in millimetres. The intra-uterine growth pattern was determined using the Lubchenco chart. Pearson correlation and regression analysis tests were performed.

Main outcome measures: Postnatal foot length in relation to Intra-Uterine Growth Pattern.

Results: The mean postnatal FL had a strong positive correlation with the EGA from 30 through 42 weeks (r = 0.855, p < 0.001). The overall mean foot length for preterm neonates was 65.44 (6.92) mm, while that of term neonates was 77.92 (4.24) mm. The linear regression equation was generated as: EGA = 9.43 + (0.37 × FL), p < 0.001. The EGA as measured by FL had the highest positive correlation with Small for Gestational Age (SGA) intra-uterine-growth pattern, followed by Appropriate for Gestational Age (AGA) and least by Large for Gestational Age (LGA) respectively (r = 0.936> 0.861 > 0.666).

Conclusion: The postnatal foot length correlated well with estimated gestational age, and the correlation was best among SGA infants.

Funding: None declared.