Blood haemoglobin measurement as a predictive indicator for the progression of HIV/AIDS in resource-limited setting

<p>Abstract</p> <p>Background</p> <p>Anaemia is a frequent complication of infection with the human immunodeficiency virus (HIV) and may have multiple causes. The objective of this study was to find out if blood haemoglobin measurement could be used as an indicator for the progression of HIV/AIDS in resource-limited setting.</p> <p>Methods</p> <p>Two hundred and twenty-eight (228) consented People Living with HIV/AIDS (PLWHAs) who were placed in three groups according to their CD4 counts were used in the study. The three groups were those with CD4 counts (1) ≥ 500 mm-³; (2) 200-499 mm-³; and (3) <it><</it>200 mm-³. One hundred (100) sex, age-matched and healthy HIV-seronegative individuals were used as control subjects. Blood haemoglobin, blood haematocrit, Red cell indices which included Mean Cell Volume, Mean Cell Haemoglobin Concentration and Mean Cell Haemoglobin and CD4 count were analysed in all subjects.</p> <p>Results</p> <p>The mean blood haemoglobin concentrations in those with CD4 counts <it><</it>200 mm-³, 200-499 mm-³and ≥ 500 mm-³(8.83 ± 0.22 g/dl, 10.03 ± 0.31 g/dl and 11.3 ± 0.44 g/dl respectively) were significantly lower when compared with the control group (14.29 ± 0.77 g/dl) (<it>p </it>< 0.0001). The mean blood haematocrit levels in those with CD4 counts <it><</it>200 mm-³, 200-499 mm-³and ≥ 500 mm-³(23.53 ± 0.85%, 28.28 ± 0.77% and 33.54 ± 1.35% respectively) were also significantly lower when compared with the control group (41.15 ± 2.15%) (<it>p </it>< 0.0001). The red cell indices were also lower in the subjects when compared with the control group. Using the Pearson's correlation, there was a significant and positive correlation between the blood haemoglobin level and their CD4 counts <it>(</it>r²= 0.1755; <it>p < 0.0001)</it>.</p> <p>Conclusion</p> <p>Anaemia in People Living with HIV/AIDS, if persistent, is associated with substantially decreased survival. From our analysis, there was a decrease in the blood haemoglobin, levels as the HIV infection progressed and our findings are consistent with those of other studies of anaemia as a prognostic factor in HIV infection. Haemoglobin levels could be measured easily where resources for more sophisticated laboratory markers such as viral load or even CD4 lymphocyte count are not available given that measurement of the CD4 lymphocyte count requires flow cytometry, an expensive technique unavailable in many developing countries. Regular measurements could help to determine which patients are at greatest risk of disease progression, allowing these patients to be identified for closer monitoring or therapeutic intervention.</p

The relevance of knowledge, perception, and factors that influence contraceptive use among married women living in Uaddara Barracks, Ghana

Background: Contraceptive use has many advantages for personal growth and societal advancement, but there is still the problem of unmet needs for women, which highlights the gap between women\u27s reproductive intentions and contraceptive use. This study investigated knowledge, perceptions, and factors that influence contraceptive use among married women living in a military base in Ghana. Methods: This cross-sectional study involved 350 married women between the ages of 20 and 58 years at the Uaddara Barracks, Kumasi. A structured questionnaire was used to collect information on the background, knowledge, perceptions on contraceptive use, and contraceptive methods used by participants. Data was entered into an Excel sheet and analysed using R version 4.2.1. Results: Most of the participants were between the age range of 36 and 40 years (25.5%). Almost all study participants (97.4%), had heard about contraceptives with 80.6% showing a high level of knowledge on contraceptives. The majority of the women (84.6%) had previously used some form of contraceptives and 53.1% presently do. More than half of the participants (69.4%) had a positive perception of contraceptive use; 80.6% responded it was their own decision to use contraceptives, and 80.3% had the support of their husbands. Husbands\u27 support of contraception resulted in a 5 times higher usage of contraceptives among women (aOR = 5.35; p \u3c 0.001) while women who were married to military men were 45% (aOR = 0.45; p = 0.007) less likely to use contraceptive when compared to civilian wives. Demographic characteristics like being above 40 years (aOR = 0.25; p = 0.014), being a housewife (aOR = 0.42; p = 0.043) and working in the private sector (aOR = 0.33; p = 0.015) were significantly linked with less contraceptive use. Conclusion: The study showed that women used contraceptives at a rate that was much higher than the national norm at the Uaddara Barracks, demonstrating the beneficial influence men had on women\u27s contraceptive use. This thereby underscores the need for interventional policies that prioritized the male as much as women, while emphasizing the benefits of contraceptive use to the family and not just as an awareness program only

Association of wrist circumference and waist-to-height ratio with cardiometabolic risk factors among type II diabetics in a Ghanaian population

The study determined the association of wrist circumference (WrC) and waist-to-height ratio (WHtR) with cardiometabolic risk factors among diabetics in a Ghanaian population. This cross-sectional study involved 384 diabetic patients at Begoro District Hospital, Ghana. Blood pressure, anthropometrics, and biochemical indices were measured. The overall prevalence of dyslipidaemia, metabolic syndrome (MetS), and hypertension was 42.4%, 76.3%, and 39.8%, respectively. The optimum cut-off range of WrC to identify individuals at increased cardiometabolic risk was 17.5 to –17.8 cm for men and 16.0 to 16.7 cm for women while that of WHtR was 0.52 to 0.61 for men and 0.53 to 0.59 for women. WrC for women was a significant independent predictor for MetS [aOR = 3.0 (1.39–6.72), ] and systolic blood pressure [aOR = 2.08 (1.17–3.68), ]. WHtR was a significant positive predictor for triglycerides [aOR = 3.23 (0.10–3.82), ] for women. Using Framingham risk scores, 61% of the subjects had elevated 10-year risk of developing cardiovascular diseases (CVDs), with no significant difference in gender prevalence. WrC [aOR = 6.13 (0.34–111.4), ] and WHtR [aOR = 2.52 (0.42–15.02), ] were associated with statistically insignificant increased odds of moderate-to-high risk of developing CVDs in 10 years. The use of gender-specific cut-offs for WrC and WHtR may offer putative markers for early identification of CRFs

Putative factors influencing knowledge and behavioural practices of health science undergraduate students towards COVID-19 infection ahead of re-opening universities in Ghana

Background: The coronavirus disease 2019 (COVID-19) virus is a global pandemic affecting daily activities and delaying the reopening of several institutions such as universities. As a result, precautionary and preventive measures are being implemented to curtail the spread of the virus. However, knowledge and compliance measures are essential for adequate preparedness to reopen the universities amidst the pandemic. Methods: This cross-sectional study evaluated knowledge, attitudes, and practices (KAP) along with factors influencing Health Science undergraduate students toward the COVID-19 infection pandemic in Ghana. A total of 606 students provided information regarding KAP of COVID-19 infection using an online questionnaire designed via Google forms. Results: Majority of the students \u27mostly\u27 obtained information on COVID-19 infection from social media (69.4%) followed by Television/radio/newspaper (60.4%). Majority of the students\u27 population had adequate knowledge (92.7%), showed a good attitude (90.9%) and positive cues (90.8%) towards COVID-19 infection. Students that more often obtained information about COVID-19 infection from the news media were 2.86 and 4.01 increased odds of having a positive attitude and good practices towards COVID-19 infection, respectively. Those who obtained information from social media were significantly more likely to have adequate knowledge [OR=2.32 (1.10-7.19] but non-significantly less likely to have good practices [OR=0.57 (0.22-1.51)]. Male students had 0.53 decreased odds of having adequate knowledge of COVID-19 infection compared with female students. When compared with the sixth year students, students in the first year [OR =0.25 (95% CI: 0.10-0.62)] and second year [OR =0.33 (95% CI: 0.14-0.81)] were significantly less knowledgeable about COVID-19 infection. Students from urban settings were significantly associated with higher positive attitude towards COVID-19 infection [OR =2.04 (1.29-3.23)]. Conclusions: Increasing public health education on COVID-19 infection would increase knowledge and awareness, and create an opportunity for compliance with precautionary measures, thereby ensuring continuity of university education amidst the pandemic

Quality of life of colorectal cancer survivors in a Ghanaian population

Objective: We collected data to evaluate the quality of life of patients who have survived between one and 8 years from the diagnosis of colorectal cancer. Data description: We collected quality of life (QoL) data from colorectal patients who were diagnosed between 2009 and 2015 at the Komfo Anokye Teaching Hospital (KATH) and have survived until January 2017. The dataset consists of patients\u27 demographic data, clinicopathological characteristics, and QoL data. The validated QoL instruments for data curation was an adopted version of the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 and the EORTC QLQ-CR29. The QLQ-C30 was a 30-item general cancer instrument with 5 functional subscales, and 9 symptom subscales, whereas the QLQ-CR29 was a 29-item scale that consisted of 3 functional QOL subscales and 14 symptom subscales, that are associated with colorectal cancer and its treatment. The QoL instrument was coded such that higher scores indicated increased function and better QoL, and higher symptom scores represent worse symptoms

The relevance of knowledge, perception, and factors that influence contraceptive use among married women living in Uaddara Barracks, Ghana

BackgroundContraceptive use has many advantages for personal growth and societal advancement, but there is still the problem of unmet needs for women, which highlights the gap between women's reproductive intentions and contraceptive use. This study investigated knowledge, perceptions, and factors that influence contraceptive use among married women living in a military base in Ghana.MethodsThis cross-sectional study involved 350 married women between the ages of 20 and 58 years at the Uaddara Barracks, Kumasi. A structured questionnaire was used to collect information on the background, knowledge, perceptions on contraceptive use, and contraceptive methods used by participants. Data was entered into an Excel sheet and analysed using R version 4.2.1.ResultsMost of the participants were between the age range of 36 and 40 years (25.5%). Almost all study participants (97.4%), had heard about contraceptives with 80.6% showing a high level of knowledge on contraceptives. The majority of the women (84.6%) had previously used some form of contraceptives and 53.1% presently do. More than half of the participants (69.4%) had a positive perception of contraceptive use; 80.6% responded it was their own decision to use contraceptives, and 80.3% had the support of their husbands. Husbands' support of contraception resulted in a 5 times higher usage of contraceptives among women (aOR =  5.35; p &lt; 0.001) while women who were married to military men were 45% (aOR = 0.45; p = 0.007) less likely to use contraceptive when compared to civilian wives. Demographic characteristics like being above 40 years (aOR = 0.25; p = 0.014), being a housewife (aOR = 0.42; p = 0.043) and working in the private sector (aOR = 0.33; p = 0.015) were significantly linked with less contraceptive use.ConclusionThe study showed that women used contraceptives at a rate that was much higher than the national norm at the Uaddara Barracks, demonstrating the beneficial influence men had on women's contraceptive use. This thereby underscores the need for interventional policies that prioritized the male as much as women, while emphasizing the benefits of contraceptive use to the family and not just as an awareness program only

Metabolic syndrome among schizophrenic patients: A comparative cross-sectional study in the middle belt of Ghana

The study determined the prevalence ofMetS in patients with schizophrenia at the Psychiatric Unit of the Komfo Anokye Teaching Hospital (KATH), Kumasi, Ghana. This comparative cross-sectional study recruited 348 schizophrenic patients comprising 236 antipsychotic-treated and 112 newly diagnosed treatment-na¨ıve patients. The MetS prevalence was assessed based on World Health Organization (WHO), International Diabetes Federation (IDF), and the National Cholesterol Education Programme, Adult Treatment Panel III (NCEP ATP III) criteria. The overall prevalence of MetS was 14.1%, 20.4%, and 23.6% using NCEP ATP III, WHO, and IDF criteria, respectively, compared to 7.8%, 3.9%, and 2.2% reported in the generalGhanaian population.The prevalence was significantly higher among treated psychiatric patients compared to treatment-na¨ıve group based on NCEP ATP III (17.8% versus 6.2%; p = 0.0001), WHO (26.2% versus 8.0%; p \u3c 0.0001), and IDF (30.3% versus 10.0%; p \u3c 0.0001). MetS was prevalent among patients on atypical antipsychotics compared to typical antipsychotics irrespective of the criteria used (i.e., 17.1% versus 11.1% for NCEP ATP III; 29.5% versus 25.9% for WHO; and 44.3% versus 18.5% for IDF). Using logistic regression model, obesity, raised fasting blood sugar, raised total cholesterol, and decreased high density lipoprotein were observed to be significant predictors of MetS (p\u3c0.05).The study found high prevalence of MetS in Ghanaians with schizophrenia and higher prevalence rate of MetS associated with monotherapy. Regular monitoring of cardiometabolic parameters should be an important therapeutic objective in the management of these patients

Cardiovascular risk markers in type II diabetes and hypertension at the Battor Catholic Hospital, Volta Region of Ghana

Background:Inflammation has been suugested to be associated with hypertension and type 2 diabetes; inflammation either precedes or is a consequence of the development of these diseases. This study sought to evaluate the role of inflammatory markers as cardiovascular risk factors and also determine their association with other potential risk factor variables among Ghanaian type 2 diabetes and hypertensive study participants undergoing medical care at the Battor Catholic Hospital in the Volta Region.Methods:This hospital-based case-control study was conducted between December 2012 and February 2013, involving 125 participants with hypertension, type 2 diabetes or both. The control group consisted of 62 age-matched healthy individuals. Socio-demographic data was captured  using a semi-structured questionnaire, anthropometric, haematological and biochemical variables were obtained using standard methods.Results:The levels of inflammatory markers (hs-CRP, IL-6, ESR and WBC) with the exception of TNF-α were higher among the case participants  compared to the controls. The case participants were more likely to cluster at higher quartiles of inflammatory biomarkers whilst the reverse was observed among the control group.Conclusion:In this study among Ghanaians presenting with hypertension and type 2 diabetes,low-grade systemic inflammation in association with poor glycaemic control, haemodynamic dysregulation as well as disordered body fat distribution could be playing key roles in predisposing these individuals to future adverse cardiovascular outcomes

Weight management among school-aged children and adolescents: A quantitative assessment in a Ghanaian municipality

BACKGROUND: Childhood and adolescent overweight, obesity and underweight have become an issue of grave concern to both the developed and developing countries in context of global burden of non-communicable diseases. Unhealthy weight status is a significant public health issue for developing countries, of which Ghana is not excluded. This study evaluated the prevalence of overweight, obesity and underweight and its related factors among school-aged children and adolescents. METHODS: A total of 1004 participants were randomly selected from six schools. A structured questionnaire on demography and socioeconomic status of students\u27 parents/guardians was completed by the selected students. Anthropometric parameters were measured, and body mass index (BMI) and waist-to-height ratio (WHtR) were calculated. BMI-for-age z-scores were used to categorize anthropometric data of the children as underweight, normal, overweight or obese. A cut-off value of \u3e 0.50 was used to define obesity by WHtR. RESULTS: Overweight prevalence of 13.8% and 12.6 was observed among basic school and high school students respectively based on BMI classification. Obesity prevalence of 8.8% was found in basic school students and 8.9% among high school students. Underweight was observed in 114 (11.3%) basic school students and 86 (8.6%) high school students. There was a difference in sex prevalence in unhealthy weight-behaviours; with more girls being overweight (19.4% vs 7.6%, p \u3c 0.001) and obese (10.2% vs. 7.3%, p = 0.177) compared to boys. High WHtR found in 10.5% of basic students and 5.0% of high school students, with a statistical difference. Overweight/obesity was significantly associated with taking snacks before bed among basic school students [aOR = 10.45(5.95-18)] and high school students [aOR = 10.23(5.95-18.37)] respectively. Watching TV [aOR = 0.39(0.22-0.70)], sleeping during leisure periods [aOR = 0.43(0.23-0.81)] and bicycling as a means of transport [aOR = 0.37(0.19-0.72)] to school was protective of obesity among basic school students. CONCLUSION: High prevalence of unhealthy weight-related behaviours was observed among school-aged children in the Bekwai Municipality. Snacking before bed was a major factor promoting obesity among school-aged children while leisure behaviours such as TV watching, and sleeping were protective of obesity. Therefore, it is recommended to promote and support healthy eating habits among school-aged children which are likely beneficial in reducing the risk of childhood unhealthy weight-related behaviours