The Prevalence of the Metabolic Syndrome in Ghanaian Psychiatric Patients on Antipsychotic (First versus Second Generation) Treatment in the Kumasi Metropolis

Metabolic syndrome (MetS), a predominant public health problem linked to cardiovascular and other morbidities, has acquired a significant precedence in clinical settings and patients with severe mental illnesses who are at higher risk for deviant components of this syndrome due to their illness and its treatment require careful and regular monitoring in this regard. Even though MetS has been established to be more prevalent among psychiatric patients than among any other population group, no data exist on its prevalence in Ghanaian psychiatric patients. This study seeks to find the prevalence of the MetS, in Ghanaian psychiatric patients on antipsychotics (first or second generation) compared to newly diagnosed psychiatric patients. This cross-sectional study of patients attending psychiatric department of the Komfo Anokye Teaching Hospital (KATH) in Kumasi, Ghana between February 2009 and July 2010.  A total of 200 psychiatric patients comprising 100 newly diagnosed antipsychotic naïve patients and 100 patients on antipsychotic medication were sampled for the study. Prevalence of MetS diagnosed using the World Health Organization (WHO), International Diabetes Federation (IDF) and the National Cholesterol Education Programme, Adult Treatment Panel III (NCEP ATP III) criteria for defining MetS was employed.The prevalence was significantly higher among psychiatric patients on treatment in comparison with the treatment naïve group using NCEP ATP III (21.0% vs. 2.0%; p < 0.0001) and IDF (29.0% vs. 2.0%; p < 0.0001) criteria but not WHO (13.0% vs. 14.0%; p = 0.8372). Irrespective of the criteria used, the prevalence of MetS was higher among patients on second generation versus first generation antipsychotic medication (i.e. 44.4% vs. 18.7% for NCEP ATP III; 22.2% vs. 12.1% for WHO and 56.6% vs. 27.5% for IDF), however these did not reach a significant levelPrevalence of MetS was not only highly prevalent among Ghanaian patients treated with antipsychotic drugs, it was also higher among patients on second generation versus first generation antipsychotic medication. Keywords: Diabetes, hypertension, dyslipidaemia, mental illness, antipsychotics.

Effect of 12 weeks consumption of palm weevil larvae and orange-fleshed sweet potato fortified biscuit on nutritional status and cognitive performance of school children in Kumasi, Ghana

Micronutrients are important for improving the physical growth and cognition of school-aged children. Food fortification strategies using locally available and consumed micronutrient rich foods such as edible insects can be cost effective and sustainable in improving nutritional and cognitive outcomes in school children. The study evaluated the impact of biscuits fortified with palm weevil larvae and orange-fleshed sweet potato on cognitive performance and nutritional status of school children from low income families in an urban setting in Ghana. A 12-week randomized, blinded controlled trial was conducted. 102 school children aged 6-11 years were assigned to consume either the fortified biscuits or non-fortified biscuits. Raven’s cognition test, anthropometrics, hematological and biochemical parameters were assessed at baseline and at the end of the study. After 12 weeks of intervention, there were no statistically significant differences in the means of the nutritional outcomes and cognitive performance between the treatment and control groups (p>0.05). However, significant increase in mean levels of serum ferritin (Baseline: 26.15 ± 18.42 µg/L, Endline: 42.63 ± 19.54 µg/L, mean increase: +16.48 µg/L, p=0.001), weight-for-age (Baseline: -0.37 ± 0.97, Endline: -0.11 ± 0.91, mean increase: +0.26, p<0.0001), and Raven’s cognition test score (Baseline: 14.22 ± 4.93, Endline: 16.35 ± 4.40, mean increase: +2.13, p<0.0001) were observed within the treatment group compared to the control group where significant increase was observed in only the Ravens cognition test score (Baseline: 14.79 ± 4.57, Endline: 15.95 ± 5.32, mean increase: +1.16, p<0.029). Moreover, the mean increase in cognition score was higher in intervention (+2.13) than control (+1.16) children. Results from binary logistic regression showed that although statistically insignificant, children in the treatment group had lower odds of iron deficiency (AOR= 0.7, p = 0.545, 95%CI= 0.2-2.4). In conclusion, consumption of the fortified biscuit significantly improved serum ferritin and weight-for-age in the school-aged children within the treatment group. Improvement in cognitive test score was also higher in the treatment group than the control group