Profile and outcomes of hospitalized patients with COVID-19 at a tertiary institution hospital in Ghana

Background: In high-income countries, mortality related to hospitalized patients with the Coronavirus disease 2019 (COVID-19) is approximately 4-5%. However, data on COVID-19 admissions from sub-Saharan Africa are scanty.Objective: To describe the clinical profile and determinants of outcomes of patients with confirmed COVID-19 admitted at a hospital in Ghana.Methods: A prospective study involving 25 patients with real time polymerase chain reaction confirmed COVID-19 admitted to the treatment centre of the University Hospital, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana from 1st June to 27th July, 2020. They were managed and followed up for outcomes. Data were analysed descriptively, and predictors of mortality assessed using a multivariate logistic regression modelling.Results: The mean age of the patients was 59.3 ± 20.6 years, and 14 (56%) were males. The main symptoms at presentation were breathlessness (68%) followed by fever (56%). The cases were categorized as mild (6), moderate (6), severe (10) and critical (3). Hypertension was the commonest comorbidity present in 72% of patients. Medications used in patient management included dexamethasone (68%), azithromycin (96%), and hydroxychloroquine (4%). Five of 25 cases died (Case fatality ratio 20%). Increasing age and high systolic blood pressure were associated with mortality.Conclusion: Case fatality in this sample of hospitalized COVID-19 patients was high. Thorough clinical assessment, severity stratification, aggressive management of underlying co-morbidities and standardized protocols incountry might improve outcomes

The prevalence and correlates of depression among older adults in greater kumasi of the ashanti region

Abstract Background Approximately two million Ghanaians suffer from mental disorders including depression. The WHO defines it as an illness characterized by constant sadness and loss of interest in activities that a person usually enjoys doing and this condition is the leading cause of mental disorders; however, the burden of depression on the aged population is fairly unknown. A better appreciation of depression and its predictors is necessary to design appropriate policy interventions. Therefore, this study aims to assess the prevalence and correlates of depression among older people in the Greater Kumasi of the Ashanti region. Methods A cross-sectional study design with a multi-stage sampling approach was employed to recruit and collect data from 418 older adults aged 60 years and above at the household level in four enumeration areas (EAs) within the Asokore Mampong Municipality. Households within each EAs were mapped and listed by trained resident enumerators to create a sampling frame. Data was collected electronically with Open Data Kit application over 30 days through face-to-face interaction using the Geriatric Depression Scale (GDS). The results were summarized using descriptive and inferential statistics. A multivariable logistics regression using a forward and backward stepwise approach was employed to identify the predictors of depression in the study sample. All analyses were performed using STATA software version 16, and the significance level was maintained at a p-value  80 years), and lower economic class respondents. The rate was 43.4% for both consumers of alcohol and smokers with a history of stroke (41.2%) and taking medication for chronic conditions (44.2%). The predictors of depression in our study were being single, low class [aOR = 1.97; 95% CI = 1.18–3.27] and having other chronic conditions [aOR = 1.86; 95% CI = 1.59–4.62], and the inability to manage ones’ own affairs [aOR = 0.56; 95% CI = 0.32–0.97]. Conclusion The study provides data that can inform policy decisions on the care of the elderly with depression in Ghana and other similar countries, confirming the need to provide support efforts towards high-risk groups such as single people, people with chronic health conditions, and lower-income people. Additionally, the evidence provided in this study could serve as baseline data for larger and longitudinal studies

Effect of Cocoa Beverage and Dark Chocolate Intake on Lipid Profile in People Living with Normal and Elevated LDL Cholesterol: A Systematic Review and Meta-Analysis

Cocoa beverage and dark chocolate are important dietary sources of polyphenol and have been hypothesised to improve the lipid profile. This systematic review and meta-analysis aimed to investigate the effect of cocoa beverage and dark chocolate intake on lipid profile in individuals living with normal and elevated LDL cholesterol. The question on whether cocoa beverage and chocolate differentially modify the lipid profile was also explored. A systematic literature search was conducted on PubMed and Cochrane Library on 26 February 2022 following the PRISMA guideline. Cocoa beverage and chocolate consumption had no significant effect on circulating concentrations of total cholesterol, LDL cholesterol, and triglycerides (p > 0.05, all), but favourably and significantly increased circulating concentration of HDL cholesterol by 0.05 (95% CI [0.02, 0.09]) mmol/L (p = 0.002). Changes in lipid profile were similar when comparing populations with normal vs. elevated LDL cholesterol (p > 0.05, all). When considering the food matrix, cocoa beverage intake significantly increased HDL cholesterol by 0.11 (95% CI [0.06, 0.17]) mmol/L (p p = 0.10) or a combination of cocoa beverage and chocolate (p = 0.19) (subgroup differences, p = 0.03) was administered. Cocoa consumption could be recommended as part of a healthy diet in the general population with normal and elevated LDL cholesterol

Effect of Cocoa Beverage and Dark Chocolate Consumption on Blood Pressure in Those with Normal and Elevated Blood Pressure: A Systematic Review and Meta-Analysis

Cocoa is a major dietary source of polyphenols, including flavanols, which have been associated with reduced blood pressure (BP). While earlier systematic reviews and meta-analyses have shown significant effects of cocoa consumption on systolic BP, limitations include small sample sizes and study heterogeneity. Questions regarding food matrix and dose of polyphenols, flavanols, or epicatechins remain. This systematic review and meta-analysis aimed to investigate the effects of ≥2 weeks of cocoa consumption as a beverage or dark chocolate in those with normal or elevated (p < 0.05, all). Compared with cocoa, chocolate lowered the weighted mean of resting systolic BP (−3.94 mmHg, 95% CI [−5.71, −2.18]) more than cocoa beverage (−1.54 mmHg, 95% CI [−3.08, 0.01]). When the daily dose of flavanols was ≥900 mg or of epicatechin ≥100 mg, the effect was greater. Future, adequately powered studies are required to determine the optimal dose for a clinically significant effect

Frailty syndrome and associated factors among patients with hypertension: A cross‐sectional study in Kumasi, Ghana

Abstract Background and Aim Frailty is a condition marked by accumulation of biological deficits and dysfunctions that come with aging and it is correlated with high morbidity and mortality in patients with cardiovascular diseases, particularly hypertension. Hypertension continues to be a leading cause of cardiovascular diseases and premature death globally. However, there is dearth of literature in sub‐Saharan Africa on frailty syndrome among hypertensives on medication. This study evaluated frailty syndrome and its associated factors among Ghanaian hypertensives. Methods This cross‐sectional study recruited 303 patients with hypertension from the University Hospital, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana. Data on sociodemographic, lifestyle and clinical factors were collected using a well‐structured questionnaire. Medication adherence was measured using Adherence in Chronic Disease Scale, and frailty was assessed by Tilburg Frailty Indicator. Statistical analyses were performed using SPSS Version 26.0 and GraphPad prism 8.0. p‐value of < 0.05 and 95% confidence interval (CI) were considered statistically significant. Results The prevalence of frailty was 59.7%. The proportion of high, medium and low medication adherence was 23.4%, 64.4% and 12.2%, respectively. Being ≥ 70years (adjusted odds ratio [aOR]: 8.33, 95% CI [3.72–18.67], p < 0.0001), unmarried (aOR: 2.59, 95% CI [1.37–4.89], p = 0.0030), having confirmed hypertension complications (aOR: 3.21, 95% CI [1.36–7.53], p = 0.0080), medium (aOR: 1.99, 95% CI [1.05–3.82], p = 0.0360) and low antihypertensive drug adherence (aOR: 27.69, 95% CI [7.05–108.69], p < 0.0001) were independent predictors of increased odds of developing frailty syndrome. Conclusion Approximately 6 out of 10 Ghanaian adult patients with hypertension experience frailty syndrome. Hypertension complications, older age, being unmarried, and low antihypertensive drug adherence increased the chances of developing frailty syndrome. These should be considered in intervention programmes to prevent frailty among patients with hypertension