African American Grandparents Raising Their Grandchildren in Rural Areas: A Phenomenological Investigation in South Georgia

Grandparents are increasingly raising their grandchildren in the United States of America. Those grandparents who live in rural areas face limited resources to help them raise their grandchildren. This phenomenological study is an investigation of the phenomenon of African American grandparents raising their grandchildren in Southeastern rural Georgia and the resources available to them. It looked at what it will take to start a faith-based or community-based support group for these Africa American grandparents raising their grandchildren in a rural setting. The concept of phenomenology served as the theoretical foundation for the study with social ecological model and social support as supporting concepts. The findings show that African American grandparent caregivers in rural South Georgia face many challenges to their health and wellbeing including: legal hurdles, financial difficulties, their own health problems, their grandchildren\u27s health problems, difficulties with educating their grandchildren, worries about the future of their grandchildren. The resources for health and wellbeing available at multiple ecological levels to the grandparent caregivers are inadequate to mitigate the challenges grandparent caregivers in rural areas face. On the basis of the study appropriate recommendations for interventions are made for grandparent caregivers in rural areas

Effect of repeated reading on the reading ability of children with reading difficulties

Utilising the quasi-experimental research design, the study investigated the effect of repeated reading on the reading ability of children with reading difficulties. Simple random and purposive sampling techniques were used to select 22 Basic Three children for the study. The experimental group comprised 12 children while the control group had 10. Running record was used for the data collection. The study revealed that Repeated Reading (RR) is an effective and significant approach that can be used to improve children’s reading abilities. There was a statistically significant difference in the scores of children in the experimental group and children in the control group. The study recommended that school heads, administrators and teachers should make a conscious effort to screen pupils in primary three to ascertain their reading abilities. Ministry of Education (MOE) in collaboration with school heads should provide in-service training for teachers to enable them acquire the requisite skills and strategies to teach pupils who face reading challenges

Neonatal transport practices and effectiveness of the use of low-cost interventions on outcomes of transported neonates in Sub-Saharan Africa: A systematic review and narrative synthesis.

Background and Aims: Neonatal deaths contribute significantly to Under 5 mortality worldwide with Sub-Saharan Africa alone accounting for 43% of global newborn deaths. Significant challenges in the region's health systems evidenced by huge disparities in health facility deliveries and poor planning for preterm births are major contributors to the high neonatal mortality. Many neonates in the region are delivered in suboptimal conditions and require transportation to facilities equipped for specialized care. This review describes neonatal transport across the subregion, focusing on low-cost interventions employed. Methods: We conducted a systematic review of studies on neonatal transport in Sub-Saharan Africa followed by a narrative synthesis. A search in the databases CINAHL, EMBASE, MEDLINE, Web of Science, African Index Medicus and Google Scholar was performed from inception to March 2023. Two authors reviewed the full texts of relevant studies to determine eligibility for inclusion which was subsequently cross-checked by a third reviewer using a random 30% overlay. The quality of the included studies was assessed using the Mixed Methods Appraisal Tool. Results: A total of 20 studies were included in this review involving 11895 neonates from 10 countries. All studies evaluated the transfer of neonates into referral centres from the peripheries. Most neonates were transferred by public transport (n = 12), mostly in the arms of caregivers with little communication between referring facilities. Studies reporting on ambulance transfers reported pervasive inadequacies in both human resources and transport equipment. No study reported on the use of Kangaroo Mother Care (KMC) in the transfer process. Conclusions: The neonatal transport system across the Sub-Saharan African region is poorly planned, poorly resourced and executed with little communication between facilities. Using cost-effective measures like KMC and improved training of community health workers may be key to improving the outcomes of transported neonates

Determinants of preterm survival in a tertiary hospital in Ghana: a ten-year review

Background Prematurity (gestational age <37 completed weeks) accounts for the majority of neonatal deaths worldwide and most of these occur in the low-resource countries. Understanding factors that determine the best chances of preterm survival is imperative in order to enhance the care of neonates and reduce adverse outcomes in such complicated births. Aim This was to find out the proportions of preterm babies who survived at the Special Care Baby Unit (SCBU) in the Cape Coast Teaching Hospital (CCTH) and the factors which influenced their survival. Method This was a retrospective review of data on all the live preterm babies seen at the SCBU of CCTH from 2010 to 2019. Data on 2,254 babies that met the inclusion criteria were extracted. Descriptive statistics were generated and tests of association done with chi-square and multivariable logistic regression. Outcome The main outcome measure was the proportion of live preterm neonates who were discharged after SCBU admissions. Results The CCTH had a total of 27,320 deliveries from 2010 to 2019. Of these, 1,282 were live preterm births, giving a prevalence of live preterm babies over the ten-year period of 4.7% (1,282/27,320). An increasing trend in prevalence was observed with 2019 recording the highest at 9% (271/3027). Most (48.8%) of the deliveries were vaginal, 39.2% were by caesarean section (CS); the mode of birth for 12% of the women were not documented. The mean gestational age was 31.8 (±2.77) weeks. Of the birth weights documented, 2500g made up only 3.7%. The average length of hospital stay was 8.3 (±9.88) days. Regarding the main outcome variable, 67.6% were discharged alive, 27.6% died and 4.9% were unaccounted for due to incomplete documentation. Factors which influenced survival were: birth weight (p <0.001); gestational age (p <0.001); mode and place of delivery (p <0.001 for both); APGAR scores at 1st and 5th minutes (p <0.001); and length of stay at the SCBU (p <0.001). No association was found for sex of the baby, maternal age and parity. Conclusion This study shows the possibility of achieving good preterm survival rates through the provision of specialised neonatal care, even in resource-constrained countries. This provides an updated benchmark for clinical decision-making and antenatal counselling. It also highlights the problem of inadequate data capture in our part of the world, which needs considerable improvement

Association of ABO Blood Group and Body Mass Index: A Cross-Sectional Study from a Ghanaian Population

ABO blood group and body mass index (BMI) have individually been appraised as risk factors for certain diseases. From statistical perspective, it may be important to examine the relationship between the ABO blood antigen and BMI. This cross-sectional study involved 412 participants aged 18 to 46 at the Kwame Nkrumah University of Science and Technology (KNUST), Kumasi. Weight and height of participants were measured for BMI calculation; blood group determination was done using antisera. Blood group O was the most prevalent (51.2%), while Rhesus-positive individuals constituted 90.3%. 6.3% of the participants were obese, while 18.7% were overweight. There was significant (p=0.006) higher prevalence of obesity in females (10.3%) than in males (3.4%). The study did not observe any significant difference by association of ABO blood group with gender (p=0.973), BMI (p=0.307), or Rhesus status (p=0.723). Regarding gender (p=0.400) and BMI (p=0.197), no statistically significant difference was observed between Rhesus blood groups. The prevalence of overweight, obesity, blood type O, and rhesus positive observed among students in this study is largely similar to what has been reported in published studies in Ghana and from other countries. Overweight and obesity were not associated with ABO blood groups or Rhesus in this study

Prevalence, placenta development, and perinatal outcomes of women with hypertensive disorders of pregnancy at Komfo Anokye Teaching Hospital.

BackgroundOne of the most common medical problems associated with pregnancy is hypertension. Hypertensive disorders of pregnancy (HDP), which has been attributable to abnormal placentation may have adverse effects on both mother and foetus if left unchecked. The objective of this study was to determine the prevalence of this condition and its effect on placental morphology as well as maternal and perinatal outcomes.Materials and methodsThis was a prospective case-control study, conducted at Komfo Anokye Teaching Hospital (KATH), Ghana between February 2018 and July 2018. The progression of pregnancy in normotensive and hypertensive pregnant women, and the eventual perinatal outcomes were closely followed. Statistical analysis was performed using IMB-SPSS version 23. Associations were considered significant at p values of ≤ 0.05.ResultsFrom a total of 214 deliveries recorded during the period of study, 84 (39.25%) were hypertensives. Forty four (52%) of the hypertensives had preeclampsia, 28 (33.3%) had gestational hypertension, 6 (7.1%) had eclampsia, 4 (4.8%) had chronic hypertension, and 2 (2.4%) had preeclampsia superimposed on chronic hypertension. The frequency of placental haematoma, placental infarction, and placental calcification in the normotensives were significantly (p = 0.001) lower than that of the hypertensives. The mean placental weight (p = 0.01), placental volume (p = 0.001), placental diameter (p = 0.03), and placental thickness (p = 0.001) of the normotensives were significantly higher than those of the hypertensives. The number of normotensives in whom labour was induced, who had their babies delivered by caesarean section, and who were admitted after they had given birth were significantly (p = 0.001) lower than that of hypertensives who underwent similar procedures. No stillbirths were recorded in the normotensives compared with four in the hypertensives. The number of babies delivered to the normotensives who were admitted to the NICU was significantly (p = 0.001) lower than those delivered by hypertensives.ConclusionThere was a high prevalence of hypertensive disorders of pregnancy in the study site. Pregnant women who developed HDP are at a risk of developing placental abnormalities that adversely affected perinatal outcomes. These adverse effects can be curtailed by embarking on a vigorous health education drive

Higher serum concentrations of vimentin and DAKP1 are associated with aggressive breast tumour phenotypes in Ghanaian women

Breast cancer, the most commonly diagnosed cancer among women and leading cause of cancer-related deaths worldwide, exhibits aggressive behavior in indigenous African women evidenced by high histologic grade tumours with low hormone receptor positivity. Aggressive breast cancers grow quickly, easily metastasize and recur and often have unfavourable outcomes. The current study investigated candidate genes that may regulate tumour aggression in Ghanaian women. We hypothesize that increased expression and function of certain genes other than the widely-held view attributing breast cancer aggression in African populations to their younger population age may be responsible for the aggressive nature of tumours. Employing ELISA, we assayed for vimentin and death-associated protein kinase 1 (DAPK1) from thawed archived (stored at -80 °C) serum samples obtained from 40 clinically confirmed Ghanaian breast cancer patients and 40 apparently healthy controls. Patients' clinical records and tumour parameters matching the samples were retrieved from the database of the hospital. ANOVA was used to compare means of serum protein concentration among groups while Chi-square analysis was used for the categorical data sets with p-value ≤0.05 considered significant. Multiple logistic regression analysis was conducted to determine the association between protein concentration and tumour parameters. Of the 80 samples, 27 (33.8%) and 53 (66.2%) were from young ( <35 years) and old (≥35 years), respectively. Vimentin and DAPK1 concentration were higher in patients than controls with higher levels in "young" age group than "old" age group. Vimentin concentration was highest in grade 3 tumours followed by grade 2 and 1 but that for DAPK1 was not significant. For vimentin, tumour area strongly correlated with tumour grade (r = 0.696, p < 0.05) but weakly correlated with tumour stage (r = 0.420, p < 0.05). Patient's age correlated with DAPK1 concentration (r = 0.393, p < 0.05). DAPK1 serum levels weakly correlated with cancer duration (r = 0.098, p = 0.27) and tumour size (r = 0.40, p < 0.05). Serum concentration of Vimentin and DAPK1 are elevated in Ghanaian breast cancer patients. This may be partly responsible for aggressive nature of the disease among the population. Vimentin and DAPK1 should be explored further as potential breast cancer biomarkers in African

Genetically Different Highly Pathogenic Avian Influenza A(H5N1) Viruses in West Africa, 2015

To trace the evolution of highly pathogenic influenza A(H5N1) virus in West Africa, we sequenced genomes of 43 viruses collected during 2015 from poultry and wild birds in 5 countries. We found 2 co-circulating genetic groups within clade 2.3.2.1c. Mutations that may increase adaptation to mammals raise concern over possible risk for humans

Genetically Different Highly Pathogenic Avian Influenza A(H5N1) Viruses in West Africa, 2015

To trace the evolution of highly pathogenic influenza A(H5N1) virus in West Africa, we sequenced genomes of 43 viruses collected during 2015 from poultry and wild birds in 5 countries. We found 2 co-circulating genetic groups within clade 2.3.2.1c. Mutations that may increase adaptation to mammals raise concern over possible risk for humans.status: publishe