Profile of cancer patients’ seen at Korle Bu teaching hospital in Ghana (A cancer registry review)

BACKGROUND: Though cancer has become a major source of morbidity and mortality globally, few countries in Sub Saharan Africa have data on cancer incidence. This study aims to describe the profile of cancers seen at the Korle Bu teaching hospital which is a major referral centre in Ghana for cancers and other health conditions. Data for the study was obtained from the cancer registry of the hospital and covered the period from January 2012 to December 2012. The public health unit actively collects data on all cancer cases presenting to any department/unit of the hospital to feed the cancer registry. RESULTS: A total of 1136 patients with cancer were studied. Their ages ranged from 1 year to 92 years with a mean of 52.3 ± 15.9 years and a median of 54 years. Patients were predominantly female (70.2%) and majority had attained secondary level of education or higher. The most prevalent cancers seen in men were those of prostate, pharynx and colorectal while in the females, the corresponding cancers were breast, cervix and uterus. CONCLUSIONS: Breast and prostate cancers were the commonest among females and males respectively who presented with cancer at the Korle Bu teaching hospital in 2012

Evaluation of the tuberculosis surveillance system in the Ashaiman municipality, in Ghana

Introduction: tuberculosis (TB) was the leading cause of death from an infectious illness globally with an estimated 10.4 million new cases and 1.4 million deaths in 2015. In Ghana, from the 2013 TB prevalence survey conducted by the National Tuberculosis Control Programme, the incidence is estimated as 165 per 100,000 population and a mortality rate of 7.5 per 1,000 infected people. The Tuberculosis surveillance system is part of the general framework of the Integrated Disease Surveillance and Response. This evaluation was to assess whether the system is meeting its set objectives, assess its usefulness and describe its attributes. Methods: the TB surveillance system of the Ashaiman municipality was evaluated using Centre for Disease Control and Prevention updated guidelines for evaluating public health surveillance systems 2006. Records review from 2014 to 2016 was done to assess objectives of the system and surveillance data source of 2016 was used to assess attributes. Interviews were conducted at the various levels using semi-structured questionnaire and data analysis done with Epi info 7 and Microsoft Excel to run frequencies and percentages. Results: the surveillance system is well structured with standardized data collection tools. The system was found to be useful, though it just partially met its objectives. It was also found to be simple, flexible and fairly stable with average timeliness. It had low acceptability and is not geographically representative. It had low sensitivity of 45/100,000 and a low predictive value positive of 6.6%. Conclusion: the surveillance system was found to be useful but partially met its objectives. There is the need to improve the sensitivity, predictive value positive timeliness and acceptability

Evaluation of the measles surveillance system of the Ga West Municipality, Ghana, 2017

Introduction: Over 140,000 people globally died from measles in 2018; most of which occurred in developing countries. In Ghana, measles is one of the diseases earmarked for elimination in the Integrated Disease Surveillance and Response (IDSR) strategy. The measles surveillance system seeks to monitor trends, detect outbreaks and report in a timely manner. In order to improve upon the performance of the Ga West Municipal Measles surveillance system, it was evaluated with the aim of determining its effectiveness. Methods: We used CDC updated guidelines for surveillance system evaluation to assess system attributes. Measles surveillance data from 2012 – 2016 were abstracted from the DHIMS. Case investigation forms, weekly and monthly IDSR reporting forms were reviewed to validate abstracted data. Key surveillance officers were interviewed on system operations. Data was analyzed descriptively to generate frequencies and relative frequencies. Results: The system operated with a reasonable number of disease variables and case definition was simple to apply. The system was found to be integrated with the national IDSR. Government facilities across all seven sub-districts, owned and contributed data to the system. Of the 48 suspected case-patients, 39 (81.0%) were investigated; none of which was positive giving a Predictive value positive (PVP) of 0%. Majority of facilities (though privately owned) did not contribute data to the system. All tested samples were received at the laboratory within the stipulated three (3) days. The system was stable with available case base forms. Over 56% (22/39) of the samples tested had no vaccination records. Data is used to guide routine and supplementary immunization activities. Conclusion: Ga west Municipal measles surveillance system is simple, flexible and generally acceptable. It is sensitive, timely, stable but with low representativeness. It is therefore effective. Municipal health officials have been sensitized on private sector participation and need for quality and timely data

Outbreak investigation and enhanced contact tracing of novel coronavirus disease 2019 (COVID-19), Ablekuma North Municipality, Greater Accra, Ghana

Introduction: After Ghana recorded its first two cases of COVID-19, other cases were subsequently identified in other parts of the country. The Ablekuma North Municipal Health Directorate was notified of a resident who reported to Korle-Bu Teaching Hospital on March 29, 2020 with fever, shortness of breath, general weakness, cough, chest pain. We investigated the report to estimate the magnitude of cases, to determine the secondary infection rate and to institute control and preventive measures. Methods: We conducted active case search using Ghana Health Service interim guideline for COVID-19 case investigation and management in Ablekuma North Municipality from April-July 31, 2020. We interviewed and collected samples of contacts and at-risk groups in affected households using collector for ArcGis and case investigation form. We summarized information of COVID-19 cases on our line list after samples have been confirmed. We analyzed data using Microsoft Excel 2016 and Stata 15, and presented as frequency and proportions. Results: The municipality recorded 213 cases with four deaths (Case fatality Rate=1.88%). The attack rate was 111.47 per 100,000 (213/ 191,075). Males were 135 (63.38%). The median age of case-patients was 27 years (interquartile range: 19 - 36years). Majority were students; 64 (30.05%). Most of the cases 89.20% (190/213) were asymptomatic. The median time between sample collection and release of laboratory results was 15 days (range: 4 - 22days). This response was a multi-sectorial approach, involving the Ministry of Health and the Ghana Health Service, Municipal Assembly, National Security Ministry, Ministry of Communication, Ministry of Information, and other government agencies. Conclusion: All confirmed cases were investigated. The attack rate was relatively high but low case fatality rate in the municipality. Strengthening laboratory capacity to test, to early report results is recommended. Lessons in handling cases indicate the need to sustain multi-sectorial collaboration to fight the outbreak

Epidemiology of COVID-19 outbreak in Ghana, 2020

Coronaviruses are RNA viruses that cause respiratory, hepatic and neurological diseases in domestic and wild animals, and humans. Among humans, six species of coronavirus have been identified to cause disease. Among these, Severe Acute Respiratory Syndrome (SARS-CoV) and Middle East Respiratory Syndrome (MERS-CoV) are of zoonotic origin and have been known to cause severe acute respiratory syndrome outbreaks among humans

Tobacco use in older adults in Ghana: sociodemographic characteristics, health risks and subjective wellbeing

BACKGROUND: Tobacco use over the life-course threatens to increase disease burden in older adulthood, including lower income countries like Ghana. This paper describes demographic, socioeconomic, health risks and life satisfaction indices related to tobacco use among older adults in Ghana. METHODS: This work was based on the World Health Organization’s multi-country Study on global AGEing and adult health (SAGE), conducted in six countries including Ghana. Wave one of SAGE in Ghana was conducted in 2007-2008 as collaboration between WHO and the University of Ghana Medical School through the Department of Community Health. A nationally representative sample of 4305 older adults aged 50 years and above were interviewed. Associations between tobacco consumption and sociodemographic, socioeconomic, health risk and life satisfaction were evaluated using chi-square and odds ratio (OR). Logistic regression analyses, adjusted for age, sex and other variables, were conducted to determine predictors of tobacco consumption in older persons. RESULTS: Overall prevalence of current daily smokers among older adults in Ghana was 7.6%. Tobacco use (i.e. ever used tobacco) was associated with older males, (AOR = 1.10, CI 1.05-1.15), older adults residing in rural locations (AOR = 1.37, CI 1.083-1.724), and older adults who used alcohol (AOR = 1.13, CI 0.230-2.418). Tobacco use was also associated (although not statistically significant per p-values) with increased self-reporting of angina, arthritis, asthma, chronic lung disease, depression, diabetes, hypertension, and stroke. Older adults who used tobacco and with increased health risks, tended to be without health insurance (AOR = 1.41, CI 1.111-1.787). Satisfaction with life and daily living was much lower for those who use tobacco. Regional differences existed in tobacco use; the three northern regions (Upper East, Northern and Upper West) had higher proportions of tobacco use among older adults in the country. Quitting tobacco use was higher in the 70+ years age group, in women, among urban residents and in those with at least secondary education. Quitting tobacco use also increased with increasing income levels. CONCLUSIONS: Tobacco use among older adults in Ghana was associated with older men living in rural locations, chronic ill-health and reduced life satisfaction. A high proportion of older adults have stopped using tobacco, demonstrating the possibilities for effective public health interventions. Health risk reduction strategies through targeted anti-smoking health campaigns, improvement in access to health and social protection (such as health insurance) will reduce health risks among older persons who use tobacco

Sociodemographic and clinical characteristics of the first cohort of COVID-19 recoveries at two national treatment centres in Accra, Ghana

Introduction COVID-19 is a new disease, knowledge on the mode of transmission and clinical features are still evolving, new tests are being developed with inherent challenges regarding interpretation of tests results. There is generally, a gap in knowledge on the virus globally as the pandemic evolves and in Ghana, there is dearth of information and documentation on the clinical characteristics of the virus. With these in mind, we set out to profile the initial cohort of COVID-19 patients who recovered in Ghana. Methods: We reviewed clinical records of all confirmed cases of COVID-19 who had recovered from the two main treatment centres in Accra, Ghana. Descriptive data analysis was employed and presented in simple and relational tables. Independent t-test and ANOVA were used to determine differences in the mean age of the sexes and the number of days taken for the first and second retesting to be done per selected patient characteristics. Results: Of the 146 records reviewed, 54% were male; mean age of patients was 41.9 ± 17.5 years, nearly half were asymptomatic, with 9% being severely ill. The commonest presenting symptoms were cough (22.6%), headache (13%) and sore throat (11%) while the commonest co-morbidities were hypertension (25.3%), diabetes mellitus (14%) and heart disease (3.4%). Conclusion: COVID-19 affected more males than females; nearly half of those infected were asymptomatic. Cough, headache and sore throat were the commonest symptoms and mean duration from case confirmation to full recovery was 19 days. Further research is required as pandemic evolve

Prevalence of pneumonia by chest x-ray, associated demographic characteristics and health risk factors among COVID-19 patients in Ghana

Objective: The study was conducted to determine the prevalence of radiologically diagnosed pneumonia among COVID-19 patients and associated factors.Design, setting, and participants: A retrospective manual data extraction of 275 medical records of COVID-19 patients was conducted at two COVID-19 national treatment centres in Accra from March to May 2020. All patients had a chest x-ray done.Main outcome and analysis: The main outcome was the presence of pneumonia. Descriptive statistics and Chi-square test of independence were employed to determine the associations between independent variables and the presence of pneumonia. All analysis was performed using Stata 16, and a p-value ≤ 0.05 was deemed significantResults: The prevalence of pneumonia was 44%(95%CI) =38.2-50.0). Chi-square independent test indicated that pneumonia in the COVID-19 patients was associated with educational level, history of domestic and international travel, mass gathering in the past 14 days before diagnosis, and discharge plan (p-value< 0.05). Patients classified as secondary cases (61.5%) and those discharged as fully recovered from the health facility (61.2%) had a higher prevalence of pneumonia. In addition, COVID-19 patients with hypertension (32.1%) and asthma (5.2%) had a significantly higher prevalence of pneumonia.Conclusion: Overall, the prevalence of pneumonia was 44% and was associated with the demographic and personal characteristics of the patients. Early detection through contact tracing and community surveillance should be intensified to pick up more asymptomatic cases. The role of the chest x-ray for triaging patients and for clinical management of symptomatic patients remains key

Prevalence and Prognostic Features of ECG Abnormalities in Acute Stroke: Findings From the SIREN Study Among Africans

Background Africa has a growing burden of stroke with associated high morbidity and a 3-year fatality rate of 84%. Cardiac disease contributes to stroke occurrence and outcomes, but the precise relationship of abnormalities as noted on a cheap and widely available test, the electrocardiogram (ECG), and acute stroke outcomes have not been previously characterized in Africans. Objectives The study assessed the prevalence and prognoses of various ECG abnormalities among African acute stroke patients encountered in a multisite, cross-national epidemiologic study. Methods We included 890 patients from Nigeria and Ghana with acute stroke who had 12-lead ECG recording within first 24 h of admission and stroke classified based on brain computed tomography scan or magnetic resonance imaging. Stroke severity at baseline was assessed using the Stroke Levity Scale (SLS), whereas 1-month outcome was assessed using the modified Rankin Scale (mRS). Results Patients\u27 mean age was 58.4 ± 13.4 years, 490 were men (55%) and 400 were women (45%), 65.5% had ischemic stroke, and 85.4% had at least 1 ECG abnormality. Women were significantly more likely to have atrial fibrillation, or left ventricular hypertrophy with or without strain pattern. Compared to ischemic stroke patients, hemorrhagic stroke patients were less likely to have atrial fibrillation (1.0% vs. 6.7%; p = 0.002), but more likely to have left ventricular hypertrophy (64.4% vs. 51.4%; p = 0.004). Odds of severe disability or death at 1 month were higher with severe stroke (AOR: 2.25; 95% confidence interval: 1.44 to 3.50), or atrial enlargement (AOR: 1.45; 95% confidence interval: 1.04 to 2.02). Conclusions About 4 in 5 acute stroke patients in this African cohort had evidence of a baseline ECG abnormality, but presence of any atrial enlargement was the only independent ECG predictor of death or disability

A comparison of licensed and un-licensed artisanal and small-scale gold miners (ASGM) in terms of socio-demographics, work profiles, and injury rates

Abstract Background Artisanal and small-scale gold mining (ASGM) represents one of the most hazardous work environments. While formalization of this sector has been suggested (e.g., Minamata Convention) as a means to improve working conditions, we are unaware of empirical evidence that supports this notion. This study aimed to compare sociodemographic profiles, work profiles, and injury rates among miners working in licensed versus un-licensed ASGM sites. Methods In the Tarkwa mining region of Ghana, 404 small-scale miners were recruited in 2014 and interviewed regarding their occupational injury experiences over the preceding 10 years. Workers were drawn from 9 mining sites, of which 5 were licensed and 4 were not licensed. Results Sociodemographic characteristics of miners from the two groups were relatively similar. Those currently working in an un-licensed mine have spent more time in the ASGM sector than those currently working in a licensed mine (94 vs. 70 months). Miners working in an un-licensed site tended to experience more injury episodes (e.g., 26% vs. 8% had 3 or more injury events) and not use personal protective equipment during the time of an injury (92% indicated to not using vs. 73%) when compared to miners working in a licensed site. A total of 121 injury episodes were recorded for 2245 person years of ASGM work. The injury rate for those working in un-licensed mines was 5.9 per 100 person years (59 injuries in 995 person years) versus 5.0 (62 injuries in 1250 person-years) in the licensed mines. When focusing on the male miners, there was a significant difference in injury rates between those working in a licensed mine (4.2 per 100 person years) versus an un-licensed mine (6.1 per 100 person years). Conclusions These findings advance our understanding of injuries amongst ASGM workers, and help identify important differences in socio-demographics, work profiles, and injury rates between miners working in a licensed versus and un-licensed site. The findings suggest that certain working conditions in a licensed site may be safer