The Impact of Pre-Marital Counseling and Psychological Variables on Marital Satisfaction Among Married Couples in Laterbiokoshie, Accra, Ghana

The study examined the effect of pre-marital counseling on marital satisfaction and the relationship of three psychological variables, intimacy, self-esteem and locus of control among married couples who received marital counseling and married couples who did not receive marital counseling. The study employed a cross-sectional survey. Standardized questionnaires were used to assess all variables of interest. Data entry, validation and analysis was done using the Statistical Product and Services Solution software (SPSS version 25). The total number of study participants were 720. The sample was predominantly female, 430 (60%) and Christian, 675 (94%). Study participants who were married by ordinance comprised 400 (56%) and most of them attended pre-marital counseling 470 (65%) for at least five months (Mean, S.D. = 5.543.44). The results showed that couples who attended pre-marital counseling before marriage were more significantly satisfied with their marriages than those who did not attend pre-marital counseling before marrying [t(718) = 2.050, p<.05]. Intimacy and self-esteem significantly influenced marital satisfaction among married couples who received pre-marital counseling, whereas only intimacy had a significant influence among couples who did not receive pre-marital counseling. Pre-marital counseling should be encouraged in all counseling centers and churches

Prevalence of pneumonia by chest x-ray, associated demographic characteristics and health risk factors among COVID-19 patients in Ghana

Objective: The study was conducted to determine the prevalence of radiologically diagnosed pneumonia among COVID-19 patients and associated factors.Design, setting, and participants: A retrospective manual data extraction of 275 medical records of COVID-19 patients was conducted at two COVID-19 national treatment centres in Accra from March to May 2020. All patients had a chest x-ray done.Main outcome and analysis: The main outcome was the presence of pneumonia. Descriptive statistics and Chi-square test of independence were employed to determine the associations between independent variables and the presence of pneumonia. All analysis was performed using Stata 16, and a p-value ≤ 0.05 was deemed significantResults: The prevalence of pneumonia was 44%(95%CI) =38.2-50.0). Chi-square independent test indicated that pneumonia in the COVID-19 patients was associated with educational level, history of domestic and international travel, mass gathering in the past 14 days before diagnosis, and discharge plan (p-value&lt; 0.05). Patients classified as secondary cases (61.5%) and those discharged as fully recovered from the health facility (61.2%) had a higher prevalence of pneumonia. In addition, COVID-19 patients with hypertension (32.1%) and asthma (5.2%) had a significantly higher prevalence of pneumonia.Conclusion: Overall, the prevalence of pneumonia was 44% and was associated with the demographic and personal characteristics of the patients. Early detection through contact tracing and community surveillance should be intensified to pick up more asymptomatic cases. The role of the chest x-ray for triaging patients and for clinical management of symptomatic patients remains key

Assessment of knowledge and quality of essential newborn care practices in La Dade Kotopon Municipality, Ghana.

Majority of neonatal deaths in developing countries have been associated with inappropriate or poorly practiced newborn care, specifically safe cord care, optimal thermal care and early initiation and practice of exclusive breastfeeding. There is limited information about the quality of these essential newborn care practices in Accra, Ghana. The main objective of this study was to assess the knowledge about and quality of essential newborn care practices (ENC) and determine related factors in La Dade Kotopon Municipal Assembly, Accra, Ghana. A questionnaire-based, cross-sectional study was conducted among 423 mothers and caregivers in two hospitals to assess safe cord care, optimal thermal care and exclusive breastfeeding. Knowledge was assessed using eight statements regarding ENC and categorized as 'Adequate knowledge' and 'Inadequate knowledge' using a composite score. Practices were similarly categorized as 'Good' and 'Poor' ENC. Data were exported from Microsoft Excel into STATA version 15 for statistical analysis. Descriptive statistics were generated and inferential analysis was done using chi-square test and logistic regression to determine factors associated with good ENC at 95% confidence level. All respondents sampled participated in the study. A total of 263 (62%) respondents had adequate knowledge and 308 (73%) respondents practiced appropriate newborn care ('Good' ENC). The likelihood of appropriate newborn care practices was lower among mothers/caregivers who were unemployed (AOR = 0.13, 95% CI: 0.09-0.26), who had a home delivery (AOR = 0.17, 95% CI: 0.11-0.69) and made their first antenatal visit in the third trimester (AOR = 0.02, 95% CI: 0.01-0.35) compared to their counterparts. Knowledge of ENC was not associated with practice in this study. Appropriate newborn care practices were relatively high among the respondents. Improving sources of livelihood and targeted education to encourage early antenatal visits and facility-based births might improve newborn care where it is inadequate

Identifying Obstetrical Emergencies at Kintampo Municipal Hospital: a perspective from Pregnant Women and Nursing Midwives

A hospital based cross-sectional qualitative study was conducted at Kintampo Municipal Hospital in Northern Ghana, to identify obstetric emergencies and barriers to emergency care seeking; examine the perspective of midwives regarding their role in maternity care and management of obstetric emergencies, and explore women’s knowledge and response to obstetric emergencies. Study subjects comprised of 2 emergency obstetric cases, 29 antenatal focus group discussants and 5 midwives at the maternity unit. Data was collected from 23rd March to 9th April, 2012 using in-depth interviews, focus group discussions and record reviews. The most common obstetric emergencies were hemorrhage, eclampsia and anemia. Potential obstetric complications were poorly understood by antenatal women and known barriers limited access to emergency obstetric care. Service challenges included insufficient staffing and well as inadequate equipment and physical space in the maternity ward. Local community efforts can address communication and service access gaps. Government intervention is required to address service provision gaps for improved maternity care in Kintampo (Afr J Reprod Health 2013; 17[2]: 129-140).Nous avons mené une étude qualitative transversale auprès d’un hôpital municipal à Kintampo au nord du Ghana, afin d’identifier les urgences obstétricales et les obstacles a la recherche de soins d&apos;urgence ; pour étudier le point de vue des sages-femmes au sujet de leur rôle dans les soins de maternité et dans la gestion des urgences obstétricales, et pour explorer les connaissances des femmes et la réponse aux urgences obstétricales. Les sujets d&apos;étude comprennent 2 cas obstétricaux d&apos;urgence, 29 commentateurs de groupes de discussion cible prénatals et 5 sages-femmes qui travaillent à la maternité. Les données ont été recueillies à partir du 23 mars au 9 avril, 2012 à l’aide des entrevues en profondeur, groupes de discussion cible et l&apos;examen des dossiers. Les urgences obstétricales les plus courantes étaient l&apos;hémorragie, l&apos;éclampsie et l&apos;anémie. Les complications obstétricales potentielles ont été mal comprises par les femmes enceintes et les obstacles connus ont limité l’accès aux soins obstétricaux d&apos;urgence. Les défis auxquels font face les services comprennent le manque de personnel ainsi que d’équipements et l&apos;espace physique dans la maternité. Les efforts des communautés locales peuvent combler les lacunes d&apos;accès à la communication et au service. L&apos;intervention du gouvernement est nécessaire pour combler les lacunes dans la dispensation de services pour permettre l’amélioration de soins de maternité à Kintampo. (Afr J Reprod Health 2013; 17[2]: 129-140)

Correction to: Factors associated with late presentation of cervical cancer cases at a district hospital: a retrospective study

It has been highlighted, that the original article [1] contained errors in Fig. 1. On the 3rd level, the first box should read “Records with any required information = 157” and the second box should read “Records without any required information = 0”. Those were incorrectly captured as “Records with complete information = 157” and “Records without any required information = 157” respectively in the original article. This Correction article shows the correct Fig. 1

Factors associated with late presentation of cervical cancer cases at a district hospital: a retrospective study

Abstract Background Cervical cancer is the leading and most common female cancer among women in Ghana. Although there are screening methods to detect premalignant lesions for treatment, screening coverage in Ghana is 2.8% and late presentation of cases complicates treatment efforts. This study examined the sociodemographic, clinical and histological characteristics associated with late presentation of cervical cancer cases attending Gynecological Oncology care at Catholic Hospital, Battor. Methods One hundred and fifty-seven medical records of confirmed cases of cervical cancer reporting to the Outpatient Obstetrics and Gynecology Department between 2012 and 2016 were reviewed. Relevant data were retrieved using abstraction forms. Socio demographic variables investigated were level of education attained, marital status, National Health Insurance Scheme membership, employment status, place of residence and distance from hospital. Clinical variables included intermenstrual/postmenopausal bleeding, previous screening history, previous smoking history, age at menarche and number of children. Histological variables included subtypes of tumour and characteristics of tumour. Pearson’s chi-square test and logistic regression analysis were used to determine correlates of late stage at presentation with cervical cancer. Sensitivity analysis was performed to assess the effect of missing data. Results Approximately two-thirds (65.97%) of the cases presented in advanced stages of cervical cancer. Level of education, age at menarche and previous screening history were included in a regression model and adjusted for age. Age at menarche (n = 66) was eliminated from the model after sensitivity analysis. Among the remaining variables, only previous screening history was predictive of late stage at presentation of cervical cancer cases. Previously unscreened cases of cervical cancer were nearly four times more likely to present late, compared to those who had been screened previously (OR 3.91; 95% CI 1.43–10.69). No association was observed with sociodemographic and histological characteristics. Conclusion Lack of previous screening was associated with late presentation of cervical cancer at Catholic Hospital, Battor. Efforts to promote early cervical cancer screening should be intensified and future studies may explore an association with age at menarche

Solid medical waste: a cross sectional study of household disposal practices and reported harm in Southern Ghana

Abstract Background Solid medical waste (SMW) in households is perceived to pose minimal risks to the public compared to SMW generated from healthcare facilities. While waste from healthcare facilities is subject to recommended safety measures to minimize risks to human health and the environment, similar waste in households is often untreated and co-mingled with household waste which ends up in landfills and open dumps in many African countries. In Ghana, the management of this potentially hazardous waste stream at household and community level has not been widely reported. The objective of this study was to investigate household disposal practices and harm resulting from SMW generated in households and the community. Methods A cross-sectional questionnaire survey of 600 households was undertaken in Ga South Municipal Assembly in Accra, Ghana from mid-April to June, 2014. Factors investigated included socio-demographic characteristics, medication related practices, the belief that one is at risk of diseases associated with SMW, SMW disposal practices and reported harm associated with SMW at home and in the community. Results Eighty percent and 89% of respondents discarded unwanted medicines and sharps in household refuse bins respectively. A corresponding 23% and 35% of respondents discarded these items without a container. Harm from SMW in the household and in the community was reported by 5% and 3% of respondents respectively. Persons who believed they were at risk of diseases associated with SMW were nearly three times more likely to report harm in the household (OR 2.75, 95%CI 1.15–6.54). Conclusion The belief that one can be harmed by diseases associated with SMW influenced reporting rates in the study area. Disposal practices suggest the presence of unwanted medicines and sharps in the household waste stream conferring on it hazardous properties. Given the low rates of harm reported, elimination of preventable harm might justify community intervention

Identification et compréhension de la naissance avant terme dans l’Hôpital Municipal à Kintampo : Etude transversale qualitative

Up to 42% of nearly 10 million under five deaths occur in neonates with prematurity being a principal cause. This paper presents the outcome of a cross sectional qualitative study conducted among 14 hospital staff engaged in infant care in Kintampo, Ghana. Confidential interviews were used to evaluate their knowledge and practice of preterm care. Critical steps in caring for normal and preterm infants were ranked as adequate, satisfactory or inadequate if 75% or more, 50% to 74%, or less than 50% of the health workers completed them respectively. For term infants, adequate care was provided in terms of cleaning and wrapping, weighing, and initiating early feeds. Knowledge and practice were inadequate in relation to preterm care. Educational interventions emphasizing preterm care are recommended as an essential package for rural health workers. A newborn assessment tool was designed to address the gap in data collection identified during the study (Afr J Reprod Health 2011; 15[4]: 98-105).Plus de dix million enfants âgés de moins de cinq ans meurent chaque année. Jusqu’à 42% de ces décès-là sont des nouveau-nés et la cause principale du décès des nouveau-nés est la prématurité. Un million enfants nés avant terme meurent chaque année, ce qui est responsable de 27% des décès des nouveau-nés. L’étude avait comme objectif d’évaluer la connaissance du personnel de santé concernant la prématurité et de créer un simple instrument pour le recueil de données pour évaluer le nouveau-né à l’hôpital municipal à Kintampo, Région Brong Ahafo, Ghana. Nous avons mené une étude qualitative transversale au niveau d’une école secondaire dans un milieu rural. Il s’agissait des interviews confidentielles recueillies auprès de 14 membres du personnel soignant directement engagés dans le soin des enfants dans le centre gynécologique-obstétrique. Toutes les interviews ont été recueillies en anglais après avoir obtenu le consentement. Les démarches critiques concernant le soin des enfants normaux et les enfants nés avant terme ont été catégorisées comme adéquates, satisfaisantes ou inadéquates si 75% ou plus, 50% jusqu’à 74% ou moins de 50% du personnel de santé ont les ont rempli respectivement. Nous avons formulé une feuille d’évaluation pour les nouveau-nés afin de collecter des données pour chaque enfant. Pour les enfants nés à terme, on assure un soin adéquat en ce qui concerne le nettoyage et l’emballage, mesurant le poids et l’initiation à la nourriture précoce> Le soin était inadéquat dans toutes les catégories de soin avant terme. On a signalé un soin adéquat dans l’utilisation de l’étuve à incubation et une fréquence augmenté de la nourriture. Le manque de connaissance à l’égard de la prématurité a beaucoup engendré des soins inadéquats pour les enfants nés avant terme. Nous préconisons des interventions éducatives pour améliorer les soins des enfants dans les milieux ruraux, tout en mettant l’accent sur le soin avant terme(Afr J Reprod Health 2011; 15[4]:98-105)

Le Diagnostic de la rupture de la grossesse ectopique demeure toujours un défi au Soudan de l’Est.

This was a cross sectional prospective study carried out in Kassala Maternity Hospital, Eastern Sudan (2008-2011) to investigate the incidence rate and factors associated with delayed presentation in ruptured ectopic pregnancy. The total number of deliveries during the study period was 9578. The total number of ectopic pregnancy was 199 yielding an incidence rate of (1 in 48 deliveries or 20.7 per 1000 deliveries). One hundred eighty six (93.5%) out of these were ruptured ectopic reflecting very low rate of diagnosis (6.5%) before rupture occurred. Maternal education≤ secondary, parity and history of subfertilty were associated with ruptured ectopic pregnancy (P =0.00, 0.003 and 0.00 respectively). The causes of delay reported by the patients include: 64.5 not aware of the pregnancy, 28% have been seen by health provider but reassure and 7.5% regarded the symptoms not serious enough to ask for care (Afr J Reprod Health 2011; 15[4]: 106-108).Il s’agit d’une étude prospective transversale qui a été menée dans la Maternité Kassala, au Soudan de l’Est (20008 -2011) afin d’étudier le taux d’incidence et les facteurs liés à la présentation retardée dans la rupture de la grossesse extra-utérine. Le nombre total des accouchements pendant la période était 199, ce qui a donné un taux d’incidence de 1 accouchement sur 48 soit 20,7 sur 1000 accouchements. 186 (93,5%) parmi eux étaient des ruptures extra-utérines qui reflètent un taux de diagnostic très bas (6,5%) avant la rupture. L’éducation maternelle ≤ secondaire, la parité et un passé de sous stérilité ont été liés à la rupture de la grossesse extra-utérine (P=0,00, 0,003 et 0,00 respectivement)Les causes du retard signalés par les patientes comprennent : 64,5% n’étaient pas conscientes de la grossesse, 28% se sont passer voir le dispensateur de soins et 7,5% n’ont pas considéré que les symptômes étaient assez sérieux pour rechercher le traitement (Afr J Reprod Health 2011; 15[4]: 106-108)

Awareness, use and main source of information on preventive health examinations: a survey of childbearing women in Uyo, Nigeria

The study determined awareness, use and the main source of information about preventive health examinations among 387 childbearing women attending three health facilities in Uyo, Nigeria. Respondents were consenting women aged 15-49 years who had a live birth in the two months preceding the survey. Respondents were interviewed using structured questionnaires during child welfare clinic visits at each facility. Awareness about pap smears and breast self examination was 14.2% and 35.3% respectively. Testing rates were highest for blood pressure checks, HIV and blood sugar and lowest for Pap smears and mammograms. Health workers were the main informants on preventive tests. Awareness and secondary education enhanced women’s uptake of screening services across levels of health care. Secondary education as a minimum and intensified awareness creation about preventive health examinations through media, school based programs, durbars and public health campaigns are vital to the health and well being of women and children.L&apos;étude a déterminé la sensibilisation, l&apos;utilisation et la principale source d&apos;informations sur les examens médicaux préventifs chez 387 femmes en âge de procréer qui fréquentent trois établissements de santé à Uyo, Nigéria. Les interviewées étaient des femmes consentants, âgées de 15-49 ans qui ont eu une naissance vivante au cours des deux mois précédant l&apos;enquête. Les interviewées ont été interrogées à l&apos;aide de questionnaires structurés lors des visites aux cliniques adaptées au bien-être de l&apos;enfant dans chaque établissement. La sensibilisation sur les frottis vaginaux et l&apos;autopalpation du sein était de 14,2% et 35,3% respectivement. Les taux de dépistage étaient plus élevés pour les contrôles de la tension artérielle, le VIH et le sucre sanguin plus faible concernant le test de Papanicolaou et la mammographie. Le personnel sanitaire ont été les principaux informateurs sur les essais de prévention. La sensibilisation et l&apos;éducation secondaire ont amélioré l’adoption des services de dépistage à tous les niveaux des soins sanitaires. L&apos;enseignement secondaire comme un niveau minimum ainsi que la création de la sensibilisation intensifiée par rapport à des examens médicaux préventifs à travers les médias, les programmes scolaires, les durbars et les campagnes de santé publique, sont essentiels à la santé et au bien-être des femmes et des enfant