Department of Medicine and Therapeutics
http://ugspace.ug.edu.gh:8080/handle/123456789/3566
2024-03-28T21:53:34ZTerrorism’s impact on low and middle-income countries’ healthcare services: A perspective
http://ugspace.ug.edu.gh:8080/handle/123456789/41432
Terrorism’s impact on low and middle-income countries’ healthcare services: A perspective
Adebusoye, F.T.; Awuah, W.A.; Tenkorang, P.O; et al.
Terrorism has emerged as an increasingly pressing global issue, giving rise to escalating casualties and devastating
implications for peace and security. The low- and middle-income countries (LMICs), already grappling with inadequate
healthcare services and an estimated annual mortality toll ranging from 5.7 to 8.4 million, face further setbacks as
terrorism exacerbates their prevailing healthcare deficiencies. Among the aspects of how terrorism affects healthcare
in LMICs are high morbidity, mortality, and treatment wait times. The four principal areas of reverberation encompass
amplified vulnerabilities in healthcare systems, financial shortfalls in LMIC healthcare systems, and worsened personnel
shortages in healthcare, and the devastating impact on healthcare facilities. In response to these challenges, international
organizations and countries have played a pivotal role in mitigating the impact of terrorism on healthcare systems.
Additionally, to improve healthcare in these regions, invest in infrastructure, support healthcare workers, and
ensuring safety is paramount. Implementing mobile health interventions, traditional medicine, and mobile laboratories
may enhance healthcare accessibility. Further, employing blockchain technology for data security and supply chain
management may strengthen healthcare systems in these areas
Research Article
2024-01-01T00:00:00ZTerrorism’s impact on low and middle-income countries’ healthcare services: A perspective
http://ugspace.ug.edu.gh:8080/handle/123456789/41429
Terrorism’s impact on low and middle-income countries’ healthcare services: A perspective
Adebusoye, F.T.; Awuah, W.A.; Tenkorang, P.O.; et al.
Terrorism has emerged as an increasingly pressing global issue, giving rise to escalating casualties and devastating
implications for peace and security. The low- and middle-income countries (LMICs), already grappling with inadequate
healthcare services and an estimated annual mortality toll ranging from 5.7 to 8.4 million, face further setbacks as
terrorism exacerbates their prevailing healthcare deficiencies. Among the aspects of how terrorism affects healthcare
in LMICs are high morbidity, mortality, and treatment wait times. The four principal areas of reverberation encompass
amplified vulnerabilities in healthcare systems, financial shortfalls in LMIC healthcare systems, and worsened personnel
shortages in healthcare, and the devastating impact on healthcare facilities. In response to these challenges, international
organizations and countries have played a pivotal role in mitigating the impact of terrorism on healthcare systems.
Additionally, to improve healthcare in these regions, invest in infrastructure, support healthcare workers, and
ensuring safety is paramount. Implementing mobile health interventions, traditional medicine, and mobile laboratories
may enhance healthcare accessibility. Further, employing blockchain technology for data security and supply chain
management may strengthen healthcare systems in these areas
Research Article
2024-01-01T00:00:00ZUse Of The Urine Determine LAM Test In The Context Of Tuberculosis Diagnosis Among Inpatients With HIV In Ghana: A Mixed Methods Study
http://ugspace.ug.edu.gh:8080/handle/123456789/41207
Use Of The Urine Determine LAM Test In The Context Of Tuberculosis Diagnosis Among Inpatients With HIV In Ghana: A Mixed Methods Study
Åhsberg, J.; Puplampu, P.; Kenu, E.; et al.
Background: The urine Determine LAM test has the potential to identify
tuberculosis (TB) and reduce early mortality among people living with HIV.
However, implementation of the test in practice has been slow. We aimed
to understand how a Determine LAM intervention was received and worked
in a Ghanaian in-hospital context.
Design/Methods: Nested in a Determine LAM intervention study,
we conducted a two-phase explanatory sequential mixed-methods study
at three hospitals in Ghana between January 2021 and January 2022.
We performed a quantitative survey with 81 healthcare workers (HCWs),
four qualitative focus-group discussions with 18 HCWs and 15 in-depth
HCW interviews. Integration was performed at the methods and analysis
level. Descriptive analysis, qualitative directed content analysis, and mixed
Methods of joint display were used.
Results: The gap in access to TB testing when relying on sputum GeneXpert
MTB/Rif alone was explained by difficulties in obtaining sputum samples
and an in-hospital system that relies on relatives. The Determine LAM test
procedure was experienced as easy, and most eligible patients received a test.
HCWs expressed that immediate access to Determine LAM tests empowered
them in rapid diagnosis. The HCW survey confirmed that bedside was the
most common place for determining LAM testing, but qualitative interviews
with nurses revealed concerns about patient confidentiality when performing and disclosing the test results at the bedside. Less than half of Determine
LAM-positive patients were initiated on TB treatment, and qualitative
data identified a weak link in the communication of the Determine LAM
results. Moreover, HCWs were reluctant to initiate the determination of LAM-positive
patients on TB treatment due to test-specificity concerns. The Determine
LAM intervention did not have an impact on the time to TB treatment as
expected, but patients were, in general, initiated on TB treatment rapidly.
We further identified a barrier to accessing TB treatment during weekends
and that treatment, by tradition, is administered early in the morning.
Conclusion: The Determine LAM testing was feasible and empowered
HCWs in the management of HIV-associated TB. Important gaps in routine
care and Determine LAM-enhanced TB care were often explained by the.
context. These findings may inform in-hospital quality improvement work
and scale-up of Determine LAM in similar settings.
Research Article
2024-01-01T00:00:00ZClinical And Neuroimaging Factors Associated With 30-Day Fatality Among Indigenous West Africans With Spontaneous Intracerebral Hemorrhage
http://ugspace.ug.edu.gh:8080/handle/123456789/41147
Clinical And Neuroimaging Factors Associated With 30-Day Fatality Among Indigenous West Africans With Spontaneous Intracerebral Hemorrhage
Komolafe, M.A.; Akpalu, A.; Calys-Tagoe, B.; et al.
Background: Spontaneous intracerebral hemorrhage (ICH) is associated with a high case fatality rate in resource-limited settings. The independent predictors of poor outcome after ICH in sub-Saharan Africa remains to be
characterized in large epidemiological studies. We aimed to determine factors associated with 30-day fatality
among West African patients with ICH.
Methods: The Stroke Investigative Research and Educational Network (SIREN) study is a multicentre, case-control
study conducted at 15 sites in Nigeria and Ghana. Adults aged ≥18 years with spontaneous ICH confirmed with
neuroimaging. Demographic, cardiovascular risk factors, clinical features and neuroimaging markers of severity
were assessed. The independent risk factors for 30-day mortality were determined using a multivariate logistic
regression analysis with an adjusted odds ratio (OR) and 95% confidence interval (CI).
Results: Among 964 patients with ICH, 590 (61.2%) were males with a mean age (SD) of 54.3 (13.6) years and a
case fatality of 34.3%. Factors associated with 30-day mortality among ICH patients include: Elevated mean
National Institute of Health Stroke Scale (mNIHSS); (OR 1.06; 95% CI 1.02–1.11), aspiration pneumonitis; (OR
7.17; 95% CI 2.82–18.24), ICH volume > 30 mls; OR 2.68; 95% CI 1.02–7.00), and low consumption of leafy vegetables (OR 0.36; 95% CI 0.15–0.85).
Conclusion: This study identified risk and protective factors associated with 30-day mortality among West Africans with spontaneous ICH. These factors should be further investigated in other populations in Africa to enable
the development of ICH mortality prediction models among indigenous Africans.
Research Article
2023-01-01T00:00:00Z