Multi-disciplinary stroke care in developing countries – lessons from the Wessex-Ghana Stroke Partnership

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Psychological comorbidities in epilepsy: a cross-sectional survey among Ghanaian epilepsy patients

Objective: To evaluate the prevalence and patterns of psychiatric disorders in epilepsy patients at the Korle-Bu Teaching hospital, Accra, Ghana.Design: The study design was a cross-sectional surveySetting: The study was conducted at the Neurology Clinic of the Department of Medicine and Therapeutics, Korle-nBu Teaching hospital, Accra, Ghana.Participants: A total of one hundred and sixty-six patients diagnosed with epilepsy aged at least 18 years and accessing services at the neurology clinic participated in the study.Main Outcome Measure: Prevalence and patterns of psychiatric disorders among patients diagnosed with epilepsy using the Brief Symptom Inventory.Results: The mean age for onset of epilepsy was 20.1 ± 16.9 years, and generalized epilepsy (73.2%) was the major type of epilepsy identified. The aetiology of the epilepsy condition was unknown in most patients (71.1%). The estimated mean Brief Symptom Inventory scores in all the nine diagnostic psychiatry characteristics (Depression, Anxiety, Somatization, Hostility, Phobic Anxiety, Obsessive Compulsive Disorder, Psychoticism, Interpersonal Sensitivity, and Paranoid Ideation) were higher in the epilepsy patients compared to the normative data scores for non-patients. Global Severity Index scores for females were significantly higher (p=0.002) than the scores for males on all the psychological outcomes except hostility.Conclusion: Psychological disorders were prevalent among epilepsy patients, with females more likely to experience psychological problems than males. The findings call for a holistic approach in managing epilepsy to highlight and manage some exceptional psychological comorbidities

Multi-Disciplinary Stroke Care in Developing Countries – Lessons from the Wessex-Ghana Stroke Partnership

Stroke disease in Ghana has been of increasing concern since the mid to late 20th century, in association with the increasing westernisation of diet and lifestyle [1]. Two thirds of world-wide mortality cases from stroke occur in sub-Saharan Africa [2], and in the Ghanaian capital city region of Accra, stroke is now attributed as the second largest cause of death [1]. The burden of stroke in sub-Saharan Africa is significant [3]. Experts recommend a three-prong approach to dealing with the burden of non-communicable disease (NCD): epidemiological surveillance; primary prevention (preventing disease in healthy populations); and secondary prevention (preventing complications and improving quality of life in affected communities) [4]. This paper outlines the development of a specialist stroke service in Accra, Ghana. This work therefore broadly relates to the secondary prevention aspect, achieved through the development of a dedicated and specialised stroke service. Whilst this project took place in Ghana, the learning could be applied to the development of a stroke service in any resource poor setting, such as South Sudan. Indeed, because the focus is on establishing the fundamentals of organised stroke care, the principles are also entirely relevant to more developed health care systems