Browsing by Author "Afihene, M.Y."

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Hepatocellular Carcinoma Occurs at an Earlier Age in Africans, Particularly in Association With Chronic Hepatitis B
(The American Journal of Gastroenterology, 2015-11) Yang, J.D.; Gyedu, A.; Afihene, M.Y.; Duduyemi, B.M.; Micah, E.; Kingham, T.P.; Nyirenda, M.; Nkansah, A.A.; Bandoh, S.; Duguru, M.J.; Okeke, E.N.; Kouakou-Lohoues, M.-J.; Abdo, A.; Awuku, Y.A.; Ajayi, A.O.; Omonisi, A.E.; Ocama, P.; Malu, A.O.; Mustapha, S.; Okonkwo, U.; Kooffreh-Ada, M.; Debes, J.; Onyekwere, C.; Ekere, F.; Rufina, I.; Roberts, L.R.
To the Editor: Hepatocellular carcinoma (HCC) is highly endemic in Africa (1). There is a general anecdotal consensus that persons with HCC induced by viral hepatitis or other causes in Africa present at younger ages than in other regions of the World. This has resulted in recommended guidelines that surveillance of African-born persons at risk for HCC should begin at the age of 20 years (2). However, a more comprehensive description of the current status of liver cancer epidemiology in Africa is still lacking. We aim to develop a consortium of collaborating centers to establish a database of HCC cases in order to describe the clinical features of patients with HCC in Africa with the objective of providing a representative perspective from the entire African continent.
Nutritional management of cirrhosis patients: A qualitative study exploring perceptions of patients and health workers in Ghana
(Clinical Nutrition ESPEN, 2019-10-03) Agyei-Nkansah, A.; Nartey, Y.A.; Asem, M.; Awuku, Y.A.; Setorglo, J.; Duah, A.; Bampoh, S.; Ayawin, J.; Asibey, S.O.; Ye, W.; Afihene, M.Y.; Roberts, L.; Plymoth, A.
Background and aims: Malnutrition is common among patients with end stage liver disease including liver cirrhosis and liver cancer. Optimal nutrition is important to reduce morbidity and mortality of these patients. There is limited qualitative data on nutritional status and management of chronic liver disease patients. We aimed to explore the knowledge, opinions and practices of cirrhosis patients and health workers in nutritional management of cirrhosis in Ghana, in order to determine whether there is a need to improve nutritional care for cirrhosis patients. Methods: We conducted a qualitative study using semi-structured interviews of cirrhotic patients (n ¼ 16) and healthcare providers (n ¼ 27) in three academic centers in Accra, Kumasi and Cape Coast (Ghana). Recruitment was by purposive sampling of patients attending specialist liver disease clinics. The recorded data were analyzed using NVivo 11 software, with generation of codes, themes and subthemes. Results: The major themes that emerged from the data included nutrition as part of care delivery during the hospital visit, nutritional recommendations, dietary changes and long-term practice improvement. The results showed that patients and health workers felt dietary recommendations for patients were frequently addressed, but could be significantly improved. We found that in the opinion of study participants, local guidelines are important and necessary in nutritional management of cirrhosis patients, and that participants felt it was difficult to change dietary habits following cirrhosis diagnosis. Conclusions: These results suggest that nutritional management of cirrhosis patients in Ghana requires improvement. Strategies to improve this could include a multi-disciplinary approach to nutritional management, development of local guidelines and continued nutritional assessment, monitoring and follow-up.