Assessing Knowledge of Community Pharmacists on Cancer: A Pilot Study in Ghana

Background: GLOBOCAN estimates that 16,600 cases of cancer occur annually in Ghana. Community pharmacists are the first point of contact to the public due to their accessibility, wide spread and credibility. They are often looked upon to provide first aid and treatment of common illness. They provide health information and support on diseases, e.g., cancer. Their role also extends to the patients' relatives. Thus, the level of knowledge and awareness of community pharmacists are of paramount importance in order to assure best healthcare advice is provided to the public. Goals of this pilot study were; (1) to collect a preliminary data on knowledge of risk factors, signs, and symptoms of cancer, (2) to ascertain the adequacy of the research survey in determining their level of knowledge, (3) to assess the viability of a full-scale study on community pharmacists.Methods: A cross-sectional survey was conducted using a self-administered questionnaire to assess the knowledge of signs and symptoms and risk factors of cancer among 150 community pharmacists.Key Findings: Score for knowledge on cancer among community pharmacists indicated that 76.7% had poor knowledge. Responses of community pharmacists toward a list of warning signs and symptom of cancer indicated poor level of knowledge (82%). Community pharmacists recorded poor level of knowledge (65.3%) on causes and risk factors for cancer. Correlation analysis shows that age has a relation with level of knowledge on signs and symptoms of cancer.Conclusion: This pilot study provided a valuable data which indicated that community pharmacists in Ghana have poor level of knowledge on cancer. The findings obtained from the study agree with findings of other studies conducted in this area which suggest that survey instrument was adequate to assess the knowledge level of community pharmacist in Ghana. Though the response was low, data obtained indicate a viability and need of conducting a full-scale research in this workforce to get a better assessment of the level of knowledge of community pharmacists on cancer in Ghana

Natural Products as Therapeutic Option for Echinococcossis

Until the 1980s surgery remained the only treatment option for cystic echinococcosis, a neglected tropical disease caused by infection with tapeworms of the genus Echinocococcus. Following the development of the benzmidazoles, there has been an increase in the use of chemotherapy over the years, especially as an adjunct to surgery or in the management of inoperable cysts. In spite of their usefulness, both surgery and chemotherapy are associated with significant limitations that warrants the search for or consideration of alternative treatment options such natural products. This chapter aims to discuss the scolicidal activity of different species of medicinal plants and their active metabolites in the treatment of echinococcosis. Excerpta Medica Database, Google Scholar, PubMed Central and Scopus were electronic databases used to retrieve the relevant literature. Medicinal plants used commonly and effectively against protoscoleces were Zataria multiflora, Nigella sativa, Berberis vulgaris, Zingiber officinale, and Allium sativum. Only Z. multiflora and A. sativum were shown to effective against Echinococcus granulosus protoscoleces in vivo. In addition, these natural products have not been associated with any significant adverse effect. In animal models Thus, natural products with demonstrated activity against E. granulosus may serve as alternative therapy in the management of echinococcosis

Evaluating essential medicines for treating childhood cancers: availability, price and affordability study in Ghana

Abstract Introduction Access to childhood cancer medicines is a critical global health challenge. There is a lack of sufficient context-specific data in Ghana on access to essential medicines for treating childhood cancers. Here, we present an analysis of essential cancer medicine availability, pricing, and affordability using the pediatric oncology unit of a tertiary hospital as the reference point. Method Data on prices and availability of 20 strength-specific essential cancer medicines and eight non-cancer medicines were evaluated using the modified World Health Organization (WHO)/Health Action International method. Two pharmacies in the hospital and four private pharmacies around the hospital were surveyed. We assessed their median price ratio using the WHO international reference price guide. The number of days wages per the government daily wage salary was used to calculate the affordability of medicines. Results The mean availability of essential cancer medicines and non-cancer medicines at the hospital pharmacies were 27 and 38% respectively, and 75 and 84% respectively for private pharmacies. The median price ratio of cancer medicines was 1.85, and non-cancer medicines was 3.75. The estimated cost of medicines for treating a 30 kg child with Acute lymphoblastic leukaemia was GHȻ 4928.04 (US$907.56) and GHȻ 4878.00 (US$902.62) for Retinoblastoma, requiring 417 and 413-days wages respectively for the lowest-paid unskilled worker in Ghana. Conclusion The mean availability of cancer medicines at the public and private pharmacies were less than the WHO target of 80%. The median price ratio for cancer and non-cancer medicines was less than 4, yet the cost of medicines appears unaffordable in the local setting. A review of policies and the establishment of price control could improve availability and reduce medicines prices for the low-income population

Cancer awareness among community pharmacist: a systematic review

Abstract Background The WHO recognises that community pharmacists are the most accessible healthcare professionals to the general public. Most patients regularly visit community pharmacies for health information and also seek advice from pharmacists with respect to signs and symptoms of cancer. As readily accessible health care professionals, community pharmacists are also in the best position to include cancer-screening initiatives into their practice. Pharmacists are therefore in a good position to raise awareness when they counsel people who buy over-the-counter medication for the control of possible cancer-related symptoms. The aim of this review was to critically appraise evidence gathered from studies that; (1) explore or assess knowledge of community pharmacist on signs and symptoms of cancer, (2) explore or assess knowledge of community pharmacist on cancer screening. Methods EMBASE (ovid), CINAHL (EBSCOhost) and MEDLINE (EBSCOhost) were systematically searched for studies conducted between 2005 to July 2017. Studies that focused on knowledge of community pharmacist in cancer screening, signs and symptoms were included. Results A total of 1538 articles were identified from the search, of which 4 out of the 28 potentially relevant abstracts were included in the review. Findings of the selected studies revealed lack of sufficient knowledge on breast cancer screening, signs and symptoms. Both studies attributed knowledge limitation as the cause of reason for the key findings of their studies. Conclusion The selected studies focused largely on breast cancer, which hinder the generalizability and transferability of the findings. Hence there is a need for more studies to be conducted in this area to draw a better conclusion

A pilot study of the knowledge, awareness and perception of prostate cancer in Ghanaian women.

BackgroundThe African prostate cancer epidemiological trend has reported the late detection of the disease and resultant high mortality rate. Considering the economic position of the African continent, which often contributes to high mortality, it has become imperative to investigate cost-effective means of improving the timely detection of prostate cancer. This study, the third developmental phase of a robust Akan tool, aimed at conducting an external pilot survey to investigate the practicability of the tool in studying prostate cancer awareness in women.MethodThe study was conducted in one of the biggest markets in Ghana employing a quantitative approach and recruiting 400 females from the age of 18 years. Post-ethical approval and study subjects' consent, the participants randomly responded to the Akan tool and the data was electronically entered in the presence of the participants. The data, entered in the Microsoft Excel spreadsheet, were analysed with the SPSS software (version 25). The results were presented as frequencies and percentages, with an assessment of the tool's reliability.ResultsA Cronbach's alpha reliability coefficient of 0.9030 was calculated. The majority (83.50%) of the participants belonged to the Akan tribe and were fluent in the Akan language. None of the knowledge items on the signs and symptoms, and risk factors of the disease had correct responses from more than 25.00% and 20.00% of the participants respectively whilst knowledge items on the causes of prostate cancer received varied responses. The participants were aware of the disease and had a positive perception.ConclusionsThe pilot survey adequately tested the Akan tool and suggested various modifications to the tool and the study methodology. The tool exhibited acceptable reliability and could be applied to targeted populations to investigate the awareness of prostate cancer in women

Caregiving motivations and experiences among family caregivers of patients living with advanced breast cancer in Ghana.

INTRODUCTION:Significant number of women present with advanced-stage breast cancer in Ghana. These women usually depend on family caregivers for their multi-dimensional needs. Yet, there are gaps in research about what motivates family caregivers to assume the caring role and their experiences with caregiving within the Ghanaian context. AIM:To explore and describe the caregiving motivations and experiences among family caregivers of patients living with advanced breast cancer. METHODS:In-depth, semi-structured qualitative interviews were conducted with 15 family caregivers who were providing unpaid care for women living with advanced breast cancer. Colaizzi's thematic analysis was used to analyze the data. RESULTS:Family relationship normally prescribed the caregiving role among family caregivers. Due to the lack of home-based palliative services in Ghana, findings suggest that family caregivers are the main managers of advanced breast cancer-related symptoms in the home. These findings are discussed under three major themes: (i) motivation for assuming the caregiving role; (ii) meeting self-care and psychosocial needs of the patient; and (iii) symptom management and monitoring. CONCLUSION:Socio-cultural values influence the role of family caregivers in Ghana. This presents opportunities for health professionals and relevant stakeholders to develop a culturally-appropriate intervention to support informal caregivers in their home-based care for women living with advanced breast cancer in Ghana

Assessment of adherence to pre-vaccination precautions and AEFI reporting practices during BCG vaccination in 4 hospitals in Ghana

The BCG vaccine, like all other vaccines, is associated with adverse events following immunization (AEFI). Reducing the incidence of AEFI is crucial in reposing confidence in BCG vaccination and reducing hesitancy associated with the vaccine. This requires safety precautions before and during vaccinations, as well as reporting AEFIs after vaccination. This study assessed the adherence of health-care professionals to pre-vaccination precautions and adverse events following immunization (AEFI) reporting practices during BCG vaccination in four hospitals in Ghana. It is hoped that the findings of the study will serve as a baseline to identify gaps for further studies to generate a stronger evidence for policy formulation aimed at improving BCG vaccine safety in Ghana and other tuberculosis endemic countries. A cross-sectional study design was employed, and Statistical Package for Social Sciences, IBM® SPSS version 25 (SPSS Inc. USA) software was used for analysis. Chi-square and binary logistic regression tests were used to test the association between categorical variables and predictors of adherence to pre-BCG vaccination precautions, respectively, and a p-value of <.05 was considered statistically significant. The AEFIs commonly reported by mothers included abscess, injection site pain, injection site redness, fever, rash, muscle weakness, diarrhea, vomiting, coughing and rhinitis. Ninety-three participants (73.2%) were adherent to pre-BCG vaccination precautions. Ninety-two participants (72.4%) informed mothers to report all AEFIs encountered. Adherence to pre-BCG vaccination precautions and AEFI reporting were generally good; however, there is still room for improvement

Impact of childhood and adolescence cancer on family caregivers: a qualitative analysis of strains, resources and coping behaviours

Abstract Background The physical demands of caring for children and adolescents diagnosed with cancer, over a lengthy period, exert significant strain on the health and well-being of family caregivers. The capacity of family caregivers to surmount and cope with the various strains they experience due to the diagnosis and treatment trajectory is essential to the quality of life of the child and adolescent who has been diagnosed with cancer. However, the experiences of family caregivers have been under-explored. This study explored the strains, resources, and coping strategies of family caregivers of children and adolescents diagnosed with cancer in Ghana. Methods Guided by a descriptive phenomenological design, 20 semi-structured interviews with family caregivers were conducted at a tertiary health facility that provides paediatric oncology services. The study was conducted between June and October 2022. The interviews were transcribed verbatim, translated and coded using NVivo software. An inductive thematic analysis approach using Vaismoradi et al.’s thematic analysis framework was followed in analysing the data. Results The study revealed that family caregivers of children diagnosed with cancer experienced three main strains: somatic strains (poor sleep quality, loss of appetite, and unintended weight loss), economic strains (financial burden and loss of economic livelihood), and psychosocial strains (isolation from social activities and network, frustration and helplessness, and balancing multiple family needs). The following themes emerged as coping resources: family cohesiveness, community support, and support from health care providers. Coping strategies that emerged included trusting in God and being self-motivated. Conclusion The study concludes that family caregivers experience somatic, economic, and psychosocial strains. However, they can leverage available resources (family cohesiveness, community support, and support from healthcare providers) to cope with these strains. There is a need to educate and sensitize family caregivers about the potential strains that they are likely to experience prior to the assumption of care roles. Also, the formal inclusion of non-governmental organizations and religious bodies will ensure that family caregivers receive sufficient community support to cope with the strains of caregiving

A psychometric analysis of a Ghanaian tool (PCaKAB-Gh) for studying prostate cancer knowledge, attitudes and beliefs amongst women

Several Ghanaian studies have examined prostate cancer knowledge, attitudes and beliefs. However, none of these studies was conducted in women except our previous study which served as the third stage in the development of a local robust tool, PCaKAB-Gh, to assess women's knowledge about prostate cancer. Although the subject had previously been studied in Ghana, none of the studies utilized a psychometrically valid tool and focused on involving women in the early detection of prostate cancer. For this purpose, we performed a psychometric study on a 41-item tool to improve robustness. The study which was the final stage of the tool development process employed a cross-sectional approach and conveniently recruited 500 participants. Statistical analysis to assess the reliability and construct validity of the tool was performed. The factors of the tool had Cronbach's alpha and McDonald's omega coefficients of 0.53 – 0.78 and reflected favourable internal consistency. The Exploratory Factor Analysis, using the Principal Component Analysis with Varimax with Kaiser Normalization, generated 5 factors with itemized factor loadings of 0.44 – 0.80, Kaiser-Meyer-Olkin Measure of Sampling Adequacy of 0.857, and a significant Bartlett's Test of Sphericity (2293.448, p-value < 0.001). A variance of 55.3% was explained. The Confirmatory Factor Analysis had a Root Mean Square Error of Approximation and a Standardized Root Mean Square Residual below 0.050, and a Comparative Fit Index and a Tucker-Lewis Index above 0.900 which indicated satisfactory fit indices (p-value < 0.001). The study successfully developed a 24-item psychometrically valid tool, with 5 factors, to be used to study the knowledge, attitudes, and beliefs about prostate cancer among Ghanaian women. The availability of the PCaKAB-Gh tool, the first of its kind, would permit the active involvement of women in improving the early detection of prostate cancer to reduce the cost of therapy and improve management outcomes