Drivers of change in farming systems and forest cover in Ghana

Emmanuel Acheampong examined how Ghanaian farming practices influence farmers' livelihoods and forest cover. He found that farmers who adopt agricultural inputs are less likely to encroach forest reserves. Emmanuel hopes that Ghana's Forestry Commission and Ministry of Food and Agriculture will adopt his recommendations to enhance agricultural and forest sustainability

Deforestation is driven by agricultural expansion in Ghana's forest reserves

Ghana's protected forest reserves have suffered average annual deforestation rates of 0.7%, 0.5%, 0.4%, and 0.6% for the periods 1990–2000, 2000–2005, 2005–2010 and 2010–2015, respectively. The Ashanti region has recorded the second highest deforestation rates. Despite the government's efforts to maintain and protect Ghana's forest reserves, deforestation continues. We observed deforestation patterns in the Ashanti region of Ghana from 1986 to 2015 using Landsat imagery to identify the main causes of deforestation. We obtained and processed two adjacent Landsat images from the United States Geological Survey's (USGS) National Centre for Earth Resources Observation and Science at 30 m spatial resolution for 1986, 2002, and 2015. We then supported the results with findings from 291 farm household surveys in communities fringing the forest reserves. By 2015, dense forest covered 53.3% of the land area of the forest reserves, and the remaining area had been disturbed. Expansion of annual crop farms and tree crops caused 78% of the forest loss within the 29-year period. Afforestation projects are ongoing some of which employ the participation of farmers, yet agricultural expansion exerts more pressure on the remaining dense forest. Agricultural intensification on existing farmlands may reduce farm expansion into the remaining forest areas. Strengthening and enforcing forest protection laws could minimise the extent of agricultural encroachment into forests. Mixed tree-crop systems could reduce the effects of arable farming on deforestation, limit the clearance of trees from farmlands, enhance the provision of ecosystem services, and improve the soil's fertility and moisture content. A forest transition may be underway leading to more trees in agricultural systems and better protection of residual natural forests

Provider-Client Perception and Experiences on the National Health Insurance Scheme (NHIS) Medicines List in Both Public and Private Pharmacy in the Bantama Sub-Metro of Ashanti Region of Ghana

Background: Health insurance schemes are formed in both developed and developing countries as a result of the existing challenges in the health care financing system stemming from uneven social and economic distribution. This study was conducted to find out the perception and experience of providers and clients in both public and private facilities on NHIS medicines list. Methods: A quantitative descriptive study was conducted  through systematic random sampling to recruit 455 participants from both Nimo Pharmacy (Private facility) and Komfo Anokye Teaching Hospital (Public facility). Results: Majority of the clients were aware of NHIS medicines or generics medicines and branded medicines. However, most of them preferred NHIS medicines to branded medicines. The reasons provided for opting for NHI medicines were effective (p-value= 0.088) affordability (p-value= 0.001) availability (p-value= 0.001), safety (p-value=0.645) and less side effects (p-value=0.012). Again, factors that might influence providers’ prescription patterns of NHIS medicines list were; provider’s personal preference, clients’ preference, confidence in the generic company and advertisement by generic company.Conclusion: A database of all generic medicines should be created as well as their inventory level be maintained for every accredited NHIS facility by the Ministry of Health and National Health Insurance Authority. This will make information on NHIS medicines readily available and clients can easily be directed to another accredited facility by the provider to access NHIS medicines if they are not available at the visiting facility. Keywords: Health Insurance, medicines list, client-provider-perceptions, Branded and generic medicines

Evaluation of serum iron overload, AST:ALT ratio and log10ferritin:AST ratio among schizophrenia patients in the Kumasi Metropolis, Ghana: A case-control study

Objective: The association between unbalanced iron indices and the conditions of schizophrenia are not well understood. Liver dysfunction which has been linked to iron metabolism might be a contributing factor. This case–control study evaluated serum iron indices and liver function in treatment-naïve schizophrenia patients and those already on treatment at the Psychiatric Department of the Komfo Anokye Teaching Hospital (KATH), Kumasi-Ghana. Results: The mean age of the respondents was 39.6 ± 0.8 years. Increased levels of serum iron, TS, AST, ALT and AST:ALT ratio and lower levels of UIBC, TIBC, Transferrin, and log Ferritin:AST ratio levels were observed among the treatment-naïve group compared to the control. The treatment-naïve and treatment groups showed significantly higher serum AST:ALT ratio, and lower log10ferrtin:AST ratio than the healthy controls. There was a significant correlation between log10ferritin and AST, and log10ferritin and GGT in both treatments (r = 0.343; p = 0.003, and r = 0.502; p = 0.001 respectively) and treatment-naïve groups (r = 0.348; p = 0.002, and r = 0.614; p \u3c 0.001 respectively). Percentage transferrin saturation correlated significantly with GGT only, in the treatment-naïve group (r = 0.667; p \u3c 0.001), and ALT and GGT in the treatment group (r = 0.252; p = 0.030 and r = 0.646; p = 0.014 respectively)

Prevalence, knowledge, and lifestyle-associated risk factors of dyslipidemia among Ghanaian type-2 diabetes mellitus patients in rural and urban areas: A multicenter cross-sectional study

Background and Aims: Dyslipidemia in diabetes mellitus has been linked to unhealthy lifestyle and bad eating habits. However, this association has not been well studied among rural and urban Ghanaian populations. In this study, we determined the prevalence, knowledge, and lifestyle-associated risk factors of dyslipidemia among Ghanaian type-2 diabetes mellitus (T2DM) patients in rural and urban areas. Methods: This comparative multicentre-cross-sectional study recruited 228 T2DM outpatients attending the St. Michael Hospital, Pramso (rural) and Kumasi South Regional Hospital (urban), Ghana for routine check-ups. Self-structured questionnaire was used to collect sociodemographic, knowledge, and lifestyle characteristics. Fasting blood samples were taken to measure lipid profiles. Dyslipidemia was defined per the American Diabetes Association criteria. All p \u3c 0.05 were considered statistically significant. Results: The overall prevalence of dyslipidemia was 79/228 (34.7%). Dyslipidemia was more prevalent among urban participants 43 (18.9%) than rural participants 36 (15.8%). Twenty-seven (11.7%) had adequate knowledge about the risk factors, complications, and management of diabetes. Eating supper after 7 p.m. [adjusted odds ratio = 3.77, 95% confidence interval (1.70–8.37), p = 0.001] significantly increased one\u27s risk of having dyslipidemia by 3.8-fold compared to eating supper earlier (before 5 p.m.). Conclusion: Dyslipidemia is increasing among T2DM patients in both urban and rural areas and it\u27s independently influenced by eating supper after 7 p.m. Most participants were ignorant of the risk factors, complications, and management of diabetes. Adjusting eating habits and increasing diabetes awareness programs to sensitize the general public can mitigate the increasing prevalence of dyslipidemia in both urban and rural areas

Predictors of noncompliance to antihypertensive therapy among hypertensive patients Ghana: Application of health belief model

This study determined noncompliance to antihypertensive therapy (AHT) and its associated factors in a Ghanaian population by using the health belief model (HBM). This descriptive cross-sectional study conducted at Kintampo Municipality in Ghana recruited a total of 678 hypertensive patients. The questionnaire constituted information regarding sociodemographics, a five-Likert type HBM questionnaire, and lifestyle-related factors. The rate of noncompliance to AHT in this study was 58.6%. The mean age (SD) of the participants was 43.5 (±5.2) years and median duration of hypertension was 2 years. Overall, the five HBM constructs explained 31.7% of the variance in noncompliance to AHT with a prediction accuracy of 77.5%, after adjusting for age, gender, and duration of condition. Higher levels of perceived benefits of using medicine [aOR=0.55(0.36-0.82),p=0.0001] and cue to actions [aOR=0.59(0.38-0.90),p=0.0008] were significantly associated with reduced noncompliance while perceived susceptibility [aOR=3.05(2.20-6.25),

Cardiometabolic syndrome among general adult population in Ghana: The role of lipid accumulation product, waist circumference-triglyceride index, and triglyceride-glucose index as surrogate indicators

Background: Visceral obesity and insulin resistance contribute to developing cardiometabolic syndrome (MetS). We investigated the predictive abilities of lipid accumulation product (LAP), waist circumference-triglyceride index (WTI), and triglyceride-glucose (TyG) index for MetS screening among the general Ghanaian adults. Methods: The final prospective analysis included 4740 healthy adults aged 30–90 years from three communities comprising Ejisu, Konongo, and Ashanti Akim Agogo in Ghana. Self-structured questionnaire pretested was used to collect sociodemographic, anthropometric, and clinical data. Blood samples were taken after fasting to measure glucose and lipid levels. LAP, WTI, and TyG were calculated from standard equations. MetS was defined by the International Diabetes Federation criteria. Receiver operating characteristic (ROC) curves and multivariable logistic regression were utilized to evaluate the potential of the three indices in identifying MetS. Results: Of the 4740 participants, 39.7% had MetS. MetS was more common in females (50.3%) than in males (22.2%). Overall, LAP ≥ 27.52 yielded as the best index for MetS with the highest area under the ROC curve (AUC) (0.866). At cut-off LAP point of ≥ 23.87 in males and ≥ 33.32 in females, an AUC of 0.951 and 0.790 was identified in MetS prediction, respectively. LAP was an independent risk measure of MetS for both males (45.6-fold) and females (3.7-fold) whereas TyG was an independent risk measure for females (3.7-fold) only. Conclusions: MetS is increasing among the general adult population. LAP and TyG are important sex-specific risk measures to screen for MetS among the general adult population in our cohort

Unrecognized hypertension among a general adult Ghanaian population: An urban community-based cross-sectional study of prevalence and putative risk factors of lifestyle and obesity indices

Hypertension (HTN) is the leading cause of cardiovascular diseases. Nevertheless, most individuals in developing countries are unaware of their blood pressure status. We determined the prevalence of unrecognized hypertension and its association with lifestyle factors and new obesity indices among the adult population. This community-based study was conducted among 1288 apparently healthy adults aged 18–80 years in the Ablekuma North Municipality, Ghana. Sociodemographic, lifestyle characteristics, blood pressure and anthropometric indices were obtained. The prevalence of unrecognized HTN was 18.4% (237 / 1288). The age groups 45–54 years [aOR = 2.29, 95% CI (1.33–3.95), p = 0.003] and 55–79 years [aOR = 3.25, 95% CI (1.61–6.54), p = 0.001], being divorced [aOR = 3.02 95% CI (1.33–6.90), p = 0.008], weekly [aOR = 4.10, 95% CI (1.77–9.51), p = 0.001] and daily alcohol intake [aOR = 5.62, 95% CI (1.26–12.236), p = 0.028] and no exercise or at most once a week [aOR = 2.25, 95% CI (1.56–3.66), p = 0.001] were independently associated with HTN. Among males, the fourth quartile (Q4) of both body roundness index (BRI) and waist to height ratio (WHtR) [aOR = 5.19, 95% CI (1.05–25.50), p = 0.043] were independent determinants of unrecognized HTN. Among females, the third quartile (Q3) [aOR = 7.96, 95% CI (1.51–42.52), p = 0.015] and Q4 [aOR = 9.87 95% CI (1.92–53.31), p = 0.007] of abdominal volume index (AVI), the Q3 of both BRI and WHtR [aOR = 6.07, 95% CI (1.05–34.94), p = 0.044] and Q4 of both BRI and WHtR [aOR = 9.76, 95% CI (1.74–54.96), p = 0.010] were independent risk factors of HTN. Overall, BRI (AUC = 0.724) and WHtR (AUC = 0.724) for males and AVI (AUC = 0.728), WHtR (AUC = 0.703) and BRI (AUC = 0.703) for females yielded a better discriminatory power for predicting unrecognized HTN. Unrecognized hypertension is common among the apparently healthy adults. Increased awareness of its risk factors, screening, and promoting lifestyle modification is needed to prevent the onset of hypertension

Thyroid dysfunction and glycaemic control among Type 2 diabetes mellitus patients in Ghana: A comparative cross-sectional study

Introduction: Thyroid disorders and diabetes mellitus coexist and are prevalent endocrinopathies among adult population. Thyroid dysfunction contributes to metabolic imbalances, increase beta-cell apoptosis and glucose intolerance. There is paucity of data and contradicting findings on how thyroid dysfunction influence glycaemic control. Therefore, we evaluated thyroid dysfunction and glycaemic control among Type 2 diabetes mellitus (T2DM) patients in Ghana. Methods: A comparative cross-sectional study was conducted among 192 T2DM patients from Effia Nkwanta Regional Hospital. Three consecutive monthly fasting plasma glucose (FBG) and glycated haemoglobin (HbA1c) were analysed and the results were classified as, moderate hyperglycaemia (MH) (FBG = 6.1–12.0 mmol/L, HbA1c \u3c 7%), severe hyperglycaemia (SH) (FBG ≥ 12.1 mmol/L, HbA1c \u3e 7%) and good glycaemic controls (GC) (FBG = 4.1–6.0 mmol/L, HbA1c \u3c 7%). Thyroid-stimulating hormone (TSH), free triiodothyronine (FT3) and free thyroxine (FT4), body mass index (BMI) and other clinical parameters were measured. Data analysis was done using R language version 4.0.2 and p \u3c.05 was considered statistically significant. Results: There were no significant differences in age (years) between patients in the various glycaemic groups (p =.9053). The overall prevalence of thyroid disorders was 7.8% among T2DM patients. The prevalence of thyroid disorders was higher in patients with SH (11.7%) followed by those with MH (7.5%) and then those with GC (5.4%). Serum levels of TSH and FT3/FT4 ratio were significantly lower in T2DM patients with SH compared to those with MH and the GC (p \u3c.0001). However, FT4 was significantly higher in SH patients compared to the good glycaemic controls (p \u3c .01). The first tertiles of TSH [aOR = 10.51, 95% CI (4.04–17.36), p \u3c .0001] and FT3 [aOR = 2.77, 95% CI (1.11–6.92), p =.0290] were significantly and independently associated with increased odds of hyperglycaemia. Conclusion: The prevalence of thyroid dysfunction is high in T2DM and increases with hyperglycaemia. Reduced TSH and T3 may worsen glycaemic control. Periodic monitoring of thyroid function should be incorporated into management guidelines among T2DM patients in Ghana

Prevalence of preeclampsia and algorithm of adverse foeto-maternal risk factors among pregnant women in the central region of Ghana: A multicentre prospective cross-sectional study

Background: Preeclampsia is a leading cause of foeto-maternal deaths especially in Sub-Saharan Africa. However, the prevalence and risk factors of preeclampsia are scarce in the Central region of Ghana with previous study assessing individual independent risk factors. This study determined the prevalence and algorithm of adverse foeto-maternal risk factors of preeclampsia. Methods: This multi-centre prospective cross-sectional study was conducted from October 2021 to October 2022 at the Mercy Women’s Catholic Hospital and Fynba Health Centre in Central region, Ghana. A total of 1,259 pregnant women were randomly sampled and their sociodemographic, clinical history, obstetrics and labour outcomes were recorded. Logistic regression analysis using SPSS version 26 was performed to identify risk factors of preeclampsia. Results: Of the 1,259 pregnant women, 1174 were finally included in the study. The prevalence of preeclampsia was 8.8% (103/1174). Preeclampsia was common among 20–29 years age group, those who had completed basic education, had informal occupation, multigravida and multiparous. Being primigravida [aOR = 1.95, 95% CI (1.03–3.71), p = 0.042], having previous history of caesarean section [aOR = 4.48, 95% CI (2.89–6.93), p \u3c 0.001], foetal growth restriction [aOR = 3.42, 95% CI (1.72–6.77), p \u3c 0.001] and birth asphyxia [aOR = 27.14, 95% CI (1.80–409.83), p = 0.017] were the independent risk factors of preeclampsia. Pregnant women exhibiting a combination of primigravida, previous caesarean section and foetal growth restriction were the highest risk for preeclampsia [aOR = 39.42, 95% CI (8.88–175.07, p \u3c 0.001] compared to having either two or one of these factors. Conclusion: Preeclampsia is increasing among pregnant women in the Central region of Ghana. Pregnant women being primigravida with foetal growth restriction and previous history of caesarean section are the highest risk population likely to develop preeclampsia with neonates more likely to suffer adverse birth outcome such as birth asphyxia. Targeted preventive measures of preeclampsia should be created for pregnant women co-existing with multiple risk factors