Incidence of Epistaxis in a Tertiary Hospital in Ghana

Epistaxis is defined as bleeding from the nasal cavity. It is a very common Otorhinolaryngological problem that often presents as an emergency to the outpatient departments of most hospitals worldwide. Its true incidence is often very difficult to assess. This study was aimed at analyzing aetiology, treatment and management outcome of patients who presented with epistaxis at Komfo Anokye Teaching Hospital (KATH), Kumasi, Ghana. This is a three year retrospective study (Jan2007-Dec 2010). All cases of epistaxis that presented at the Ear, Nose and Throat (ENT) clinic at KATH) or referred from the polyclinics and the district hospitals were included. A total number of 96 cases were seen with epistaxis over a period of three years. There were 63 (66%) males and 33 (34%) females. Their ages ranged from 1-80 years. The commonest cause of epistaxis was idiopathic with 51 (53%) cases followed by nasal trauma with 11 (11.5%) cases and nasopharyngeal carcinoma 8 (8.3).This study supports the clinical usefulness of conservative management in the treatment of patients with epistaxis

Prevalence of Hearing Loss in Patients with Acute Otitis Media

The study was a prospective, cross-sectional type conducted at the Ear, Nose and Throat Department of Komfo Anokye Teaching Hospital (KATH) over a six month period from 1st August 2005 to 31st January 2006. Fifty one patients involving 69 ears (few with bilateral and majority with unilateral hearing loss) were interviewed followed by otoscopic ear examination, pure tone audiometry using AC 30 audiometer and tympanometric test. The hearing loss of participants was thus determined before and after treatment to establish the change in hearing over the period. The results showed that hearing loss occurs in majority of sufferers of acute otitis media. The prevalence of acute otitis media (AOM) is low in adults, but it is quite high in children (91.3%) of reported cases.Keywords: Acute otitis media, hearing loss, tympanometry, Pure-tone  Audiometr

Socioeconomic and demographic correlates of nonenrolment onto the national health insurance scheme among children in Ghana: Insight from the 2017/18 Multiple Indicator Cluster Survey

The goal of Ghana’s health insurance scheme is to achieve universal coverage. Despite NHIS’ benefits to children, not all children in Ghana are covered. This study investigates the sociodemographic covariates of nonenrolment onto the national health insurance scheme among children in Ghana. We used the child dataset of the 2017/18 Ghana Multiple Indicator Cluster Survey (G-MICS). We used STATA version 14 for the data analyses. We described each study variable using frequency and percentages. We used Poisson regression to estimate crude and adjusted prevalence ratios of the relationship between the covariates and the outcome variable. Approximately 57% of children were covered with health insurance in Ghana. In the adjusted multivariable model, male children, children within the ages of 10–14 or 15–17 years, and children who have some form of functional disability and those with no information on their functional disability status, children of mothers with lower than post-secondary education, and children residing in households of less than the fifth quantile on the household wealth index were associated with a higher likelihood of nonenrolment onto the national health insurance scheme. Finally, compared to the children in greater Accra, children in the other nine regions were associated with a lower likelihood of nonenrolment onto the national health insurance scheme. Given the results, improvement in health insurance coverage should be done, taking into consideration variations across the socio-demographic characteristics of the child, mother, and households

Prevalence and sociodemographic factors associated with vision difficulties in Ghana, Gambia, and Togo: a multi-country analysis of recent multiple Indicator cluster surveys.

BACKGROUND: The sense of sight is one of the important human sensory abilities that is required for independent functioning and survival. The highest burden of sight-related problems is recorded in low-and middle-income countries, especially in sub-Saharan Africa. Despite the burden, nationally representative analyses to understand the prevalence and determinants of vision difficulties are hard to find. Therefore, this study addressed this knowledge gap by estimating the prevalence of vision difficulties and its correlates in gender-stratified models in three West African countries: Ghana, Gambia, and Togo. METHODS: The study used the most recent Multiple Indicator Cluster Surveys of Ghana (2017-2018), Gambia (2018), and Togo (2017). Summary statistics were used to describe the participants and logistic regression was used to perform the bivariate and multivariate analyses. The analyses were performed using Stata version 14 and the complex survey design of the datasets was accounted for using the 'svyset' command. RESULTS: Gendered differences were observed for vision difficulties. More women than men reported vision difficulties in Ghana (men: 14.67% vs women: 23.45%) and Togo (men: 14.86% vs women: 23.61%), but more men than women reported vision difficulties in Gambia (men: 11.64% vs women: 9.76%). We also observed gender differences in how age, education, marital status, and region of residence were significantly associated with reported vision difficulties. The direction and magnitude of these relationships were different among men and women across the survey data in Ghana, Gambia, and Togo. CONCLUSION: The findings imply the need to tackle the existing gender inequities that are associated with vision difficulties to promote the quality of life of individuals, especially among older adults

Antioxidant and physicochemical properties of Chrysophyllum albidum fruit at different ripening stages

Chrysophyllum albidum (African Star Apple) fruit is an indigenous African fruit. The African Star Apple plant popularly referred to as the “alasa” tree grows widely in tropical Africa. Ripening influences biochemical processes and subsequently affects the nutritional and bioactive characteristics of the fruits. This study sampled Chrysophyllum albidum fruit of three maturity stages and determined the colour, proximate, total phenol and antioxidant characteristics of the fruits. Spectrophotometric methods were used in the determination of total antioxidant activity using 1,1-diphenyl- 2-picrylhydrazyl (DPPH) radical scavenging activity, 2,2-azinobis,3- ethylbenzothiazoline-6-sulfonic acid (ABTS) and Ferric reducing ability of plasma (FRAP) assay. Significant differences (p<0.05) were observed in the colour of the fruit across all the ripening stages. The ripe stage of the fruit recorded the highest extent of lightness among all the other ripening stages. Both the ripe and over-ripe fruits appeared reddish in colour with the ripe fruit demonstrating a higher red intensity than the over-ripe fruit. The calculated metric chroma of the Chrysophyllum albidum fruits were in the range of 2.33-21.67 for the three ripening stages. Hue angle values recorded were in the range 46.46-92.00. Browning and colour indices for fruits of all the stages of development were of range 6.40-80.30 and -14.30-16.96, respectively. Proximate analysis of the three fruit categories showed that the unripe fruits had higher carbohydrate (69.27 %), crude protein (8.17 %), and crude fat (7.99 %) content relative to fruits which were ripe and over-ripe. The over-ripe fruit had higher crude fibre (7.36 %) and ash (3.86 %) content. Total phenolic content for the unripe fruit (20μg GAE/mg) was also higher than fruits of the other ripening stages. The antioxidant ability of the Chrysophyllum albidum fruit showed that the unripe stage recorded the highest DPPH (29.24 %) and ABTS (99.09 %) radical scavenging activity. The ferric reducing antioxidant potential of the fruit at different ripening stages was significantly different (p<0.05) with the unripe stage recording the highest potential. The unripe fruits demonstrated higher proximate and antioxidant composition than the ripe and over-ripe fruits. Extracts from the unripe fruit can serve as useful nutraceuticals in functional food formulations

Consumption trends of white cassava and consumer perceptions of yellow cassava in Ghana

Open Access JournalVitamin A deficiency has been one of the major nutritional problems for many countries where cassava is eaten as a major source of energy. In an attempt to help reduce the incidence of vitamin A deficiency, bio-fortified cassava which contains more pro-vitamin A carotenoids than the white cassava, has been introduced to such areas. This study therefore endeavored to find out how often Ghanaians ate cassava and its products, as well as what Ghanaian consumers knew about bio-fortified cassava and their willingness to consume it. A survey was done between the month of January and March using 287 participants in the Greater Accra Region of Ghana which gathered information on their demographics, and their frequencies of the consumption of cassava and its products. Data on the knowledge of the participants on yellow flesh cassava, and their willingness to accept it were also gathered. Logistic regression was used to determine the relationship between some demographic characteristics and knowledge and ‘willingness-to-accept’ biofortified cassava. The cassava product which was mostly consumed by the participants was gari. Sixty-three percent of the participants had no knowledge of bio-fortified cassava. About half of them were willing to accept the biofortified cassava, and more than half of the participants perceived that yellow cassava could be used for some white cassava products. Providing nutritional information and sensitizing consumers on the benefits of biofortified cassava can enhance its consumption in Ghana

Assessing the impact of differences in malaria transmission intensity on clinical and haematological indices in children with malaria.

BACKGROUND: Malaria control interventions have led to a decline in transmission intensity in many endemic areas, and resulted in elimination in some areas. This decline, however, will lead to delayed acquisition of protective immunity and thus impact disease manifestation and outcomes. Therefore, the variation in clinical and haematological parameters in children with malaria was assessed across three areas in Ghana with varying transmission intensities. METHODS: A total of 568 children between the ages of 2 and 14 years with confirmed malaria were recruited in hospitals in three areas with varying transmission intensities (Kintampo > Navrongo > Accra) and a comprehensive analysis of parasitological, clinical, haematological and socio-economic parameters was performed. RESULTS: Areas of lower malaria transmission tended to have lower disease severity in children with malaria, characterized by lower parasitaemias and higher haemoglobin levels. In addition, total white cell counts and percent lymphocytes decreased with decreasing transmission intensity. The heterozygous sickle haemoglobin genotype was protective against disease severity in Kintampo (P = 0.016), although this was not significant in Accra and Navrongo. Parasitaemia levels were not a significant predictor of haemoglobin level after controlling for age and gender. However, higher haemoglobin levels in children were associated with certain socioeconomic factors, such as having fathers who had any type of employment (P < 0.05) and mothers who were teachers (P < 0.05). CONCLUSIONS: The findings demonstrate significant differences in the haematological presentation and severity of malaria among areas with different transmission intensity in Ghana, indicating that these factors need to be considered in planning the management of the disease as the endemicity is expected to decline after control interventions

The efficacy and safety of intraoperative acute normovolaemic haemodilution in complex spine surgery in a private surgical facility in Ghana

Objectives: To assess the safety and clinical benefits of intraoperative acute normovolaemic haemodilution (ANH) incomplex spine surgery.&nbsp;Design: Prospective comparative cohort studySetting: A private orthopaedic hospital in GhanaPatients: Seventy-six patients who underwent complex spine deformity surgeryInterventions: Patients were randomly assigned to two groups. 45 patients to the acute normovolaemic haemodilution(ANH) or Group 1 and 31patients to the non-ANH or Group 2. Following anesthetic administration and before incision, autologous blood was collected from patients in Group1 and was reinfused during/shortly after surgery while patients in Group2 were transfused with compatible allogeneic blood intraoperatively.Main Outcome Measures: Changes in haemodynamic parameters and incidence of allogeneic transfusions and related complications.Results: The mean age (years), gender ratio, deformity size and aetiology, fusion levels, and operative times were similar in both groups. Blood loss (ml) of patients in groups 1 and 2 were 1583ml± 830.48 vs 1623ml ± 681.34, p=0.82, respectively. The rate of allogeneic blood transfusion in groups 1 and 2 were 71% vs 80.65%, p=0.88, respectively. Haemoglobin levels (g/dL) in groups 1 and 2 were comparable in both groups at Post-operative Day (POD) 0 and POD 1. Incidence of minor allogeneic transfusion reaction was 1/45 vs 1/31, p=0.80, group-1 and group-2, respectively.Conclusion: Acute normovolaemic haemodilution can be safely performed in complex spine surgery in underserved regions. However, its use does not obviate allogeneic transfusion in patients with complex spine deformities in whom large volumes of blood loss is expected

The modern pollen-vegetation relationship of a tropical forest-savannah mosaic landscape, Ghana, West Africa

Transitions between forest and savannah vegetation types in fossil pollen records are often poorly understood due to over-production by taxa such as Poaceae and a lack of modern pollen-vegetation studies. Here, modern pollen assemblages from within a forest-savannah transition in West Africa are presented and compared, their characteristic taxa discussed, and implications for the fossil record considered. Fifteen artificial pollen traps were deployed for 1 year, to collect pollen rain from three vegetation plots within the forest-savannah transition in Ghana. High percentages of Poaceae and Melastomataceae/Combretaceae were recorded in all three plots. Erythrophleum suaveolens characterised the forest plot, Manilkara obovata the transition plot and Terminalia the savannah plot. The results indicate that Poaceae pollen influx rates provide the best representation of the forest-savannah gradient, and that a Poaceae abundance of >40% should be considered as indicative of savannah-type vegetation in the fossil record

Barriers to formal healthcare utilisation among poor older people under the livelihood empowerment against poverty programme in the Atwima Nwabiagya District of Ghana

Abstract: Background: Even though there is a growing literature on barriers to formal healthcare use among older people, little is known from the perspective of vulnerable older people in Ghana. Involving poor older people under the Livelihood Empowerment Against Poverty (LEAP) programme, this study explores barriers to formal healthcare use in the Atwima Nwabiagya District of Ghana. Methods: Interviews and focus group discussions were conducted with 30 poor older people, 15 caregivers and 15 formal healthcare providers in the Atwima Nwabiagya District of Ghana. Data were analysed using the thematic analytical framework, and presented based on an a posteriori inductive reduction approach. Results: Four main barriers to formal healthcare use were identified: physical accessibility barriers (poor transport system and poor architecture of facilities), economic barriers (low income coupled with high charges, and non-comprehensive nature of the National Health Insurance Scheme [NHIS]), social barriers (communication/language difficulties and poor family support) and unfriendly nature of healthcare environment barriers (poor attitude of healthcare providers). Conclusions: Considering these barriers, removing them would require concerted efforts and substantial financial investment by stakeholders. We argue that improvement in rural transport services, implementation of free healthcare for poor older people, strengthening of family support systems, recruitment of language translators at the health facilities and establishment of attitudinal change programmes would lessen barriers to formal healthcare use among poor older people. This study has implications for health equity and health policy framework in Ghana