Putative factors influencing knowledge and behavioural practices of health science undergraduate students towards COVID-19 infection ahead of re-opening universities in Ghana

Background: The coronavirus disease 2019 (COVID-19) virus is a global pandemic affecting daily activities and delaying the reopening of several institutions such as universities. As a result, precautionary and preventive measures are being implemented to curtail the spread of the virus. However, knowledge and compliance measures are essential for adequate preparedness to reopen the universities amidst the pandemic. Methods: This cross-sectional study evaluated knowledge, attitudes, and practices (KAP) along with factors influencing Health Science undergraduate students toward the COVID-19 infection pandemic in Ghana. A total of 606 students provided information regarding KAP of COVID-19 infection using an online questionnaire designed via Google forms. Results: Majority of the students \u27mostly\u27 obtained information on COVID-19 infection from social media (69.4%) followed by Television/radio/newspaper (60.4%). Majority of the students\u27 population had adequate knowledge (92.7%), showed a good attitude (90.9%) and positive cues (90.8%) towards COVID-19 infection. Students that more often obtained information about COVID-19 infection from the news media were 2.86 and 4.01 increased odds of having a positive attitude and good practices towards COVID-19 infection, respectively. Those who obtained information from social media were significantly more likely to have adequate knowledge [OR=2.32 (1.10-7.19] but non-significantly less likely to have good practices [OR=0.57 (0.22-1.51)]. Male students had 0.53 decreased odds of having adequate knowledge of COVID-19 infection compared with female students. When compared with the sixth year students, students in the first year [OR =0.25 (95% CI: 0.10-0.62)] and second year [OR =0.33 (95% CI: 0.14-0.81)] were significantly less knowledgeable about COVID-19 infection. Students from urban settings were significantly associated with higher positive attitude towards COVID-19 infection [OR =2.04 (1.29-3.23)]. Conclusions: Increasing public health education on COVID-19 infection would increase knowledge and awareness, and create an opportunity for compliance with precautionary measures, thereby ensuring continuity of university education amidst the pandemic

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

Association between micronutrients, oxidative stress biomarkers and angiogenic growth mediators in early and late-onset preeclamptic Ghanaian women

Objectives: Micronutrients, especially calcium (Ca) and magnesium (Mg) are reported to reduce preeclampsia events via several factors such as endothelial cell control, optimal oxidative stress and a balanced angiogenic growth mediator. We evaluated the association of micronutrients with oxidative stress biomarkers, and angiogenic growth mediators in early-onset preeclampsia and late-onset preeclampsia. Methods: This case-control study recruited 197 preeclampsia (early-onset preeclampsia = 70 and late-onset preeclampsia = 127) as cases and 301 normotensive pregnant women as controls from the Komfo Anokye Teaching Hospital, Ghana. Samples were collected after 20 weeks of gestation for both cases and controls and estimated for Ca, Mg, soluble fms-like tyrosine kinase-1, placental growth factor, vascular endothelial growth factor-A, soluble endoglin, 8-hydroxydeoxyguanosine, 8-epiprostaglandinF2-alpha and total antioxidant capacity. Results: Early-onset preeclampsia women had significantly lower levels of Ca, Mg, placental growth factor, vascular endothelial growth factor-A and total antioxidant capacity but higher levels of soluble fms-like tyrosine kinase-1, soluble endoglin, 8-epiprostaglandinF2-alpha, 8-hydroxydeoxyguanosine, soluble fms-like tyrosine kinase-1/placental growth factor ratio, 8-epiprostaglandinF2-alpha /placental growth factor ratio, 8-hydroxydeoxyguanosine/placental growth factor ratio and soluble endoglin/placental growth factor ratio than late-onset preeclampsia and normotensive pregnant women (p \u3c 0.0001). Among the early-onset preeclampsia women, the first and second quartile for serum placental growth factor, first quartile for vascular endothelial growth factor-A and total antioxidant capacity and the fourth quartiles for serum sEng, serum sFlt-1, 8-epiPGF2 and 8-OHdG were independently associated with low Ca and Mg (p \u3c 0.05). Among late-onset preeclampsia women, the fourth quartile for soluble fms-like tyrosine kinase-1 was independently associated with low Ca and Mg (p \u3c 0.05). Conclusion: Magnesium and calcium are associated with an imbalance in angiogenic growth mediators and oxidative stress biomarkers among preeclampsia women, particularly early-onset preeclampsia. Serial and routine measurement of these micronutrients would allow the monitoring of poor placental angiogenesis while enabling an understanding of the triggers of increased oxidative stress and reduced antioxidant in preeclampsia