Joseph Boakye Danquah (1895-1965): The First African Theologian and Pan Africanist

The research that is culminating into this paper was undertaken to explore the way three West African theological educators were influenced by Joseph Boakye Danquah, himself not a Christian theologian, but a Pan Africanist, in their theological presuppositions. These three theological educators are Harry Sawyerr (Sierra Leone), Bolaji Idowu (Nigeria), and Kwesi Dickson (Ghana). Danquah’s significance lies in helping the reader not only to understand but also to appreciate the possibility of an African theologian and a Pan Africanist informing and inspiring the theology of church theologians. In this they provided intellectual reflections on a range of issues—the doctrine of God, ancestorhood, clan relations, the belief in things African, the important place of mother tongue in theology, culture, and financial independence among others. To describe Danquah as the first African theologian is not out of place, then influencing pioneer Christian theologians

Foreign body in scrotum following a boat engine blast accident

Male genital injuries, demand prompt management to prevent long-term  sexual and psychological damage. Injuries to the scrotum and contents may produce impaired fertility.We report our experience in diagnosing and managing a case of a foreign body in the scrotum following a boat engine blast accident. This case report highlights the need for a good history and thorough general examination to establish the mechanism of injury in order to distinguish between an embedded penetrating projectile injury and an injury with an exit wound. Prompt surgical exploration with hematoma evacuation limits complications.Keywords: Blast Injury, Scrotal Haematoma, Ischaemia, Laceration, Penetrating injur

BREAST CANCER RISK IN PATIENTS WITH BREAST PAIN IN ACCRA, GHANA

Objective: To determine the risk of breast cancer in patients presenting with breast pain in Accra,Ghana.Design: Retrospective clinical study.Setting: A self-referral breast clinic in Accra, Ghana.Subjects: Patients with breast pain as a presenting complaint, between January 2001 and December2005.Interventions: Patients were investigated by triple assessment.Results: There were 447 patients with pain, 322 as the only symptom and 125 in addition to othersymptoms like breast lump and nipple discharge. Patients with pain only were found to have nodetectable abnormality 203 (63%) and fibroadenosis 78 (24.2%) as the most common diagnoses.Breast cancer was found in four (1.24%) of them, all of whom had abnormality on clinical breastexamination. In patients with pain as well as other symptoms the common diagnoses werefibroadenosis 25 (20%), breast cancer 20 (16%) and normal 18 (14.4%).Conclusion: The risk of breast cancer is significantly higher in patients presenting with breast painin addition to other symptoms, compared to patients with breast pain as the only symptom (16%and 1.24% respectively P<0.0001). Patients with breast pain should always have breast examinationand not simply reassured. Women should be encouraged to do breast self examination

Breast cancer risk in patients with breast pain in Accra, Ghana

No Abstract. East African Medical Journal Vol. 84 (5) 2007: pp. 215-21

Real-world challenges for patients with breast cancer in sub-Saharan Africa: a retrospective observational study of access to care in Ghana, Kenya and Nigeria

Objective: To evaluate medical resource utilisation and timeliness of access to specific aspects of a standard care pathway for breast cancer at tertiary centres in sub-Saharan Africa. Design: Data were retrospectively abstracted from records of patients with breast cancer treated within a prespecified 2-year period between 2014 and 2017. The study protocol was approved by local institutional review boards. Setting: Six tertiary care institutions in Ghana, Kenya and Nigeria were included. Participants: Health records of 862 patients with breast cancer were analysed: 299 in Ghana; 314 in Kenya; and 249 in Nigeria. Interventions: As directed by the treating physician. Outcome measures: Parameters selected for evaluation included healthcare resource and use, medical procedure turnaround times and out-of-pocket (OOP) payment patterns. Results: Use of mammography or breast ultrasonography was \u3c45% in all three countries. Across the three countries, 78%-88% of patients completed tests for hormone receptors and human epidermal growth factor receptor 2 (HER2). Most patients underwent mastectomy (64%-67%) or breast-conserving surgery (15%-26%). Turnaround times for key procedures, such as pathology, surgery and systemic therapy, ranged from 1 to 5 months. In Ghana and Nigeria, most patients (87%-93%) paid for diagnostic tests entirely OOP versus 30%-32% in Kenya. Similarly, proportions of patients paying OOP only for treatments were high: 45%-79% in Ghana, 8%-20% in Kenya and 72%-89% in Nigeria. Among patients receiving HER2-targeted therapy, the average number of cycles was five for those paying OOP only versus 14 for those with some insurance coverage. Conclusions: Patients with breast cancer treated in tertiary facilities in sub-Saharan Africa lack access to timely diagnosis and modern systemic therapies. Most patients in Ghana and Nigeria bore the full cost of their healthcare and were more likely to be employed and have secondary or postsecondary education. Access to screening/diagnosis and appropriate care is likely to be substantively lower for the general population

Real-world challenges for patients with breast cancer in sub-Saharan Africa: a retrospective observational study of access to care in Ghana, Kenya and Nigeria

Objective To evaluate medical resource utilisation and timeliness of access to specific aspects of a standard care pathway for breast cancer at tertiary centres in sub-Saharan Africa.Design Data were retrospectively abstracted from records of patients with breast cancer treated within a prespecified 2-year period between 2014 and 2017. The study protocol was approved by local institutional review boards.Setting Six tertiary care institutions in Ghana, Kenya and Nigeria were included.Participants Health records of 862 patients with breast cancer were analysed: 299 in Ghana; 314 in Kenya; and 249 in Nigeria.Interventions As directed by the treating physician.Outcome measures Parameters selected for evaluation included healthcare resource and use, medical procedure turnaround times and out-of-pocket (OOP) payment patterns.Results Use of mammography or breast ultrasonography was <45% in all three countries. Across the three countries, 78%–88% of patients completed tests for hormone receptors and human epidermal growth factor receptor 2 (HER2). Most patients underwent mastectomy (64%–67%) or breast-conserving surgery (15%–26%). Turnaround times for key procedures, such as pathology, surgery and systemic therapy, ranged from 1 to 5 months. In Ghana and Nigeria, most patients (87%–93%) paid for diagnostic tests entirely OOP versus 30%–32% in Kenya. Similarly, proportions of patients paying OOP only for treatments were high: 45%–79% in Ghana, 8%–20% in Kenya and 72%–89% in Nigeria. Among patients receiving HER2-targeted therapy, the average number of cycles was five for those paying OOP only versus 14 for those with some insurance coverage.Conclusions Patients with breast cancer treated in tertiary facilities in sub-Saharan Africa lack access to timely diagnosis and modern systemic therapies. Most patients in Ghana and Nigeria bore the full cost of their healthcare and were more likely to be employed and have secondary or postsecondary education. Access to screening/diagnosis and appropriate care is likely to be substantively lower for the general population

Access to care and financial burden for patients with breast cancer in Ghana, Kenya, and Nigeria

Background: Breast cancer is the most frequently diagnosed malignancy and the most common cause of cancer-related death in women in Ghana, Kenya, and Nigeria. We evaluated healthcare resource use and financial burden for patients treated at tertiary cancer centers in these countries. Methods: Records of breast cancer patients treated at the following government/private tertiary centers were included – Ghana: Korle-Bu Teaching Hospital and Sweden Ghana Medical Centre; Kenya: Kenyatta National Hospital and Aga Khan University Hospital; Nigeria: National Hospital Abuja and Lakeshore Cancer Center. Patients presenting within a prespecified 2-year period were followed until death or loss to follow-up. Results: The study included 299 patient records from Ghana, 314 from Kenya, and 249 from Nigeria. The use of common screening modalities (eg, mammogram, breast ultrasound) was \u3c 45% in all 3 countries. Use of core needle biopsy was 76% in Kenya and Nigeria, but only 50% in Ghana. Across the 3 countries, 91-98% of patients completed blood count/chemistry, whereas only 78-88% completed tests for hormone receptor and human epidermal growth factor receptor 2 (HER2). Most patients underwent surgery: mastectomy (64-67%) or breast-conserving Most patients in Ghana and Nigeria (87-93%) paid for their diagnostic tests entirely out of pocket (OOP) compared with 30-32% in Kenya. Similar to diagnostic testing, the proportion of patients paying OOP only for treatments was high: 72-89% in Nigeria, 45-79% in Ghana, and 8-20% in Kenya. Among those receiving HER2-targeted therapy, average number of cycles was 5 for patients paying OOP only vs 14 for patients with some level of insurance coverage. Conclusions: Patients treated in tertiary facilities in sub-Saharan African countries lack access to common imaging modalities and systemic therapies. Most patients in Ghana and Nigeria bore the full cost of their breast cancer care, suggestive of privileged financial status. Access to screening/diagnosis and appropriate care is likely to be substantively lower for the general population