Ghana medical journal最新文献

Objective: Identification of dietary patterns and their association with socio-demographic factors.

Design: Community-based cross-sectional study design.

Setting: Urban and rural communities in Abia State, Nigeria.

Participants: Eight hundred and sixty-eight (868) male and female adults aged 20 to 59 years.

Methods: Identification of Dietary patterns (DP) by Principal Component Analysis (PCA) based on the consumption of 10 food groups, assessed using a 7-day qualitative food frequency questionnaire. Bivariate and multivariate logistic regression analyses evaluated the association between identified patterns and socio-economic factors.

Results: Two dietary patterns 'traditional and convenience DPs were identified, explaining 52% of the total variance. The traditional DP was loaded with starchy staples, vegetable soups/sauces, and animal proteins. The convenience DP was characterised by high factor loading of processed cereals, carbonated drinks and alcoholic beverages. Larger households (>3) had lower odds of adhering to high traditional DP [AOR =0.633; 95% CI (0.429-0.934); p = 0.021]. Females [AOR =1.586; 95% CI (1.104-2.279); p = 0.013] and middle-aged adults (AOR = 1.750; 95% CI (1.075-2.848);p = 0.024] were more likely to adhere to the convenience DP, whereas, the odds of adhering to the convenience pattern was lower among adults residing in rural areas [AOR =0.3161.586; 95% CI (0.219-0.456); p = 0.001].

Conclusion: Socio-economic variables (age, gender, household size and place of residence) were associated with dietary patterns among community dwellers in Nigeria.

Funding: None declared.

Objective: To assess the inter-laboratory comparability and intra-assay reproducibility of full blood count (FBC) results.

Design: Exploratory cross-sectional study.

Setting: Three and two selected medical laboratories in the northern and southern zones, respectively.

Participants: Forty-nine individuals per zone; 16 type 2 diabetes mellitus, 16 with HbAS haemoglobin type and 17 normal samples.

Intervention: Each sample was run eleven times through the analysers in the participating laboratories to evaluate intra-laboratory reproducibility and comparability of FBC results.

Main outcome measure: Intra-laboratory reproducibility was evaluated using %coefficient variation (%CV). Interlaboratory comparisons were assessed through t-test or One-Way ANOVA for two-sample and three-sample tests. All statistical testing was undertaken using the two-tailed assumption.

Result: Statistically significantly different haemoglobin levels were estimated in both northern and southern zones (mean difference 0.00 g/dL to 3.75 g/dL vs 0.18 g/dL to 1.92 g/dL respectively). Also, total WBC counts significantly differed across laboratories in both northern and southern zones (mean difference 0.15 ×10⁹/L - 3.86 ×10⁹/L vs 0.02 ×10⁹/L to 1.39 ×10⁹/L respectively). Furthermore, platelet counts significantly differed across the participating laboratories in the northern and southern zones (mean difference 0.40 ×10⁹/L to 299.76 ×10⁹/L vs 5.7 ×10⁹/L to 76.9 ×10⁹/L respectively). Moreover, there was evidence of non-reproducibility of results within the respective laboratories in each zone as the respective %CV were outside the acceptable limits.

Conclusion: The intra-laboratory non-reproducibility and inter-laboratory non-comparability of FBC results highlight the need to establish a national quality assessment scheme to harmonise laboratory practices nationwide.

Funding: This study was funded by the University of Cape Coast Individual-Led Research Support Grant (RSG-INDI-CoHAS-2019-107).

Objective: To determine if the number of vaso-occlusive events in SCD relates to plasma concentration of fucosyltransferase 7 (FUT7), which catalyses the synthesis of selectin ligands.

Design: A prospective, analytical study.

Setting: Haematology and Chemical Pathology Departments of tertiary healthcare centres.

Participants: Steady state HbSS individuals aged 13-45 years, 20 had 3 or more vaso-occlusive crises that required hospital admission in the previous year (with or without complications of SCD); 17 other HbSS persons had 0-1 vaso-occlusive crisis that required hospital admission in the previous year and no disease complications.

Intervention: Steady-state plasma concentrations of FUT7 measured by ELISA were compared between SCD patients who had one vaso-occlusive crisis requiring hospital treatment in the previous year but no disease complications and those who had >3 crises with or without complications.

Main outcome measures: Plasma level of FUT7and the number of vaso-occlusive events in each HbSS patient.

Results: Mean + standard deviation plasma concentration of FUT7 was 8.6 + 2.7 ng/ml in patients with >3 vasoocclusive crises in the previous year and 7.3 + 1.7 ng/ml in those with 0-1 crisis and no complications; independent sample t-test, p > 0.05, not significantly different.

Conclusion: Plasma concentration of fucosyltransferase7 is not associated with the number of vaso-occlusive events in sickle cell disease.

Funding: None declared.

Objective: To assess and compare how private and public health facilities patients cope with the economic burden of non-communicable diseases.

Design: Comparative cross-sectional study.

Setting: Thirty-nine private and eleven public health facilities in Ado-Ekiti, Nigeria.

Participants: Three hundred and forty-eight (Private:173; Public:175) patients with hypertension or diabetes, or both were recruited.

Main outcome measures: Specific coping methods and numbers of coping strategies used by participants, as well as the perceived ability of participants to cope with the economic burden of non-communicable diseases.

Results: Majority of participants paid through out-of-pocket (OOP) than through health insurance(HI) (Private:OOP:90.2% HI:9.8%; Public:OOP:94.3% HI:5.7%; p=0.152). More participants in private used instalment payments(p<0.001). However, other coping strategies showed no significant difference in both groups(p>0.05). Delayed treatment (Private:102; Public:95) was the most used strategy in both arms, and the number of strategies used by the participants showed no significant difference(p=0.061). Lower levels of education, out-of-pocket payment, increasing number of clinic visits, and hospital admission were associated with the use of higher numbers of coping strategies in both groups while being female and retired/unemployed were associated with the private arm.

Conclusion: Although most patients in both groups pay out-of-pocket and use detrimental coping strategies, more patients in private arm use instalment payment, a non-detrimental method. Healthcare providers, especially public providers, should adopt policies encouraging patients to use non-detrimental coping strategies to meet their healthcare expenditures.

Funding: None declared.

Objective: To compare the cardiovascular features of patients with sickle cell anaemia (SCA) in steady-state with those in vaso-occlusive crisis (VOC) at the Wesley Guild Hospital (WGH).

Design: A descriptive cross-sectional, matched, case-control study among children with SCA at the WGH, a tertiary health facility in southwest Nigeria.

Setting: The participants were recruited from the children's emergency unit and paediatric haematology clinic of the WGH.

Participants: Consisted of 93 children with VOC (cases) and 93 age and sex-matched in steady state (controls), aged 5 - 15 years.

Main outcome measures: Cardiovascular parameters, including pulse rate, blood pressure, and electrocardiographic profile, were assessed and compared using the appropriate statistical tests.

Results: The mean (SD) age of the cases and controls were 8.8 (3.2) years and 9.0 (3.1) years, respectively (p= 0.106). There was no significant difference in the mean height of the groups. The mean pulse rate, diastolic, systolic, and mean arterial pressures were significantly higher in the cases than in the controls. A significantly higher proportion of the cases than the controls also had a higher frequency of heart blocks, prolonged QTc interval, ST elevation or depression, and T wave abnormality (p = 0.018, 0.039, 0.041, 0.009, respectively). The prevalence of chamber enlargements was not significantly different between the two groups.

Conclusion: Cardiovascular dysfunction is worse during VOC when compared with steady state. Physicians should look for these dysfunctions in SCA children with VOC to reduce mortality from the disease.

Funding: None declared.

Objectives: To determine the clinical presentation, imaging features and outcomes of children with adenoid hypertrophy in our setting.

Design: A retrospective study.

Setting: The paediatric clinic of a private hospital in Enugu.

Participants: 51 children, aged 2 to 108 months, with suggestive clinical features and radiographic report of adenoid hypertrophy who presented over 3 years.

Interventions: Clinical information was obtained from the patient's medical records. Data was analysed for the clinical characteristics of the patients, the relationship between the degree of airway narrowing on a postnasal space (PNS) radiograph and treatment outcomes.

Main outcome measures: Degree of airway narrowing as measured on a PNS radiograph, the type of and outcomes of treatment.

Results: There was an almost equal male (54.7%): female (45.1%) ratio in the occurrence of adenoid hypertrophy, with a mean age of occurrence of 31.50 ± 3.64 months. Noisy breathing was the commonest symptom (94.1%); history of atopic rhinitis in 64.7% of cases and hyperactive airway disease in 45.1% more than 50% of cases with airway narrowing resolved with medical management only.

Conclusion: Adenoid hypertrophy should be considered in evaluating the upper airway in children under five. Paediatricians should be conversant with diagnosing and managing this common cause of upper airway obstruction.

Funding: None declared.

Objective: To describe the clinical characteristics and identifiable risk factors for Chronic Obstructive Pulmonary Disease (COPD) in a real-world clinical setting.

Design: Cross-sectional study among patients with COPD.

Setting: The Respiratory clinic of the Lagos University Teaching Hospital.

Participants: Consecutive patients with spirometry confirmed COPD on follow-up for ≥3 months. There were 79 participants.

Intervention: None.

Main outcome measure: COPD risk factors, disease severity, comorbidities, and the severity of airflow limitation.

Results: The mean age of the participants was 63.3± 12.4 years, and 47 (59.5) were male. There was a high symptom burden (73.4% had COPD assessment test (CAT) score >10), 33 (41.8%) and 4 (5.1%) had GOLD 3 and GOLD 4 airflow limitation, respectively. Risk factors were identified for 96.2% of the participants: history of asthma in 37 (46.8%), tobacco smoking 22 (27.8%), occupational exposure 15 (19%), biomass exposure 5 (6.6%), post-tuberculosis 3 (3.8%), old age (3.8%), and prematurity 1 (1.3%). Fifty-nine (74.7%) had Asthma COPD Overlap (ACO). There were no significant associations between the risk factors and disease severity. Participants with ACO had lower lung function and a high frequency of allergic rhinitis.

Conclusion: Asthma was the most commonly identifiable risk factor for COPD, underscoring asthma risk reduction and management optimisation as priorities toward COPD burden mitigation. Future studies need to validate these findings and identify the predominant COPD phenotypes in our setting.

Funding: None declared.