Browsing by Author "Duda, R.B."
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Item Contraceptive use by women in Accra, Ghana: results from the 2003 Accra Women's Health Survey(African journal of reproductive health, 2009-03) Adanu, R.M.K.; Seffah, J.D.; Hill, A.G.; Darko, R.; Duda, R.B.; Anarfi, J.K.The study was to determine the predictors of use of modern contraception among women in Accra, Ghana. Data were collected by trained interviewers using questionnaires. Complete data for 2199 women were analysed using Stata 8.2. The study showed that educational status was the most significant predictor of contraceptive use. Women with no formal education had a 48% reduction in the odds of having ever used contraception and a 66% reduction in the odds of currently using contraception. Regular use of health facilities did not affect contraceptive use. Female education should continue to be a priority of the Ghanaian government. Education about family planning and the effects of having large families should be integrated into the school curriculum. Ghanaian health workers need to be active in promoting the use of modern contraceptive methods.Item The Health of Adult Women in Accra, Ghana: Self-Reporting and Objective Assessments 2008-2009(Ghana Medical Journal, 2012-06) Darko, R.; Adanu, R.M.; Duda, R.B.; Douptcheva, N.; Hill, A.G.Objectives: The study provides a full description of the state of women’s health in Accra, Ghana using selfreported as well as objective health measures. Using data from the Women’s Health Survey of Accra, Wave 2 (WHSA-2), the authors a) examine the consistency of the objective measures of health status (anthropometry and blood pressures) with self-report measures, including the Short Form 36 indices for 8 separate domains of health; and b) describe the main socio-economic differentials in morbidity. Methods: Cross-sectional household survey with field measurements. 2814 women aged 18 and over were interviewed and measured in their homes in late 2008 and early 2009. The physical measurements included height, weight, waist and hip measurement and 3 or more measures of resting blood pressure. Results: Using the 8 domains of self-reported health captured by the Short Form 36 instrument, we find that physical health worsens more sharply with age than mental health. Social class differentials are narrow in the younger cohorts but widen amongst the elderly. The physical measurements reveal unhealthy levels of obesity and hypertension, worsening steadily with rising age. Age and the wealth of the household influence women’s health more than their individual characteristics such as education. Conclusions: Younger women appear to be in good health with steady declines in physical and mental health with age. The major threat to women’s health appears to be the rising levels of obesity and hypertension with mean BMIs for all women over age 45 in excess of 30, producing elevated blood pressures and associated high risks of heart attacks and stroke rising sharply amongst the elderly.Item The health of adult women in Accra, Ghana: Self-reporting and objective assessments 2008-2009(Ghana Medical Journal, 2012) Darko, R.; Adanu, R.M.K.; Duda, R.B.; Douptcheva, N.; Hill, A.G.Objectives: The study provides a full description of the state of women's health in Accra, Ghana using self-reported as well as objective health measures. Using data from the Women's Health Survey of Accra, Wave 2 (WHSA-2), the authors a) examine the consistency of the objective measures of health status (anthropometry and blood pressures) with self-report measures, including the Short Form 36 indices for 8 separate domains of health; and b) describe the main socio-economic differentials in morbidity. Methods: Cross-sectional household survey with field measurements. 2814 women aged 18 and over were interviewed and measured in their homes in late 2008 and early 2009. The physical measurements included height, weight, waist and hip measurement and 3 or more measures of resting blood pressure. Results: Using the 8 domains of self-reported health captured by the Short Form 36 instrument, we find that physical health worsens more sharply with age than mental health. Social class differentials are narrow in the younger cohorts but widen amongst the elderly. The physical measurements reveal unhealthy levels of obesity and hypertension, worsening steadily with rising age. Age and the wealth of the household influence women's health more than their individual characteristics such as education. Conclusions: Younger women appear to be in good health with steady declines in physical and mental health with age. The major threat to women's health appears to be the rising levels of obesity and hypertension with mean BMIs for all women over age 45 in excess of 30, producing elevated blood pressures and associated high risks of heart attacks and stroke rising sharply amongst the elderly.Item The Health of the "Older Women" in Accra, Ghana: Results of the Women's Health Study of Accra(Journal of Cross-Cultural Gerontology, 2011-06) Duda, R.B.; Anarfi, J.K.; Adanu, R.M.K.; Seffah, J.; Darko, R.; Hill, A.G.The health of women residing in the developing countries is not limited to reproductive health conditions or infectious diseases. While these illnesses remain serious threats to a healthy life, as the population ages, the prevalence of illnesses considered to be of significance only in industrialized nations also increasingly afflicts the residents of the developing worlds. The health and well-being of the older women was evaluated in the 2003 Women's Health Study of Accra. This community based survey and clinical and laboratory examination of 1,328 women identified a significantly high prevalence of malaria and chronic, non-communicable diseases in all age groups without regard to education level or income. Hypertension, diabetes and obesity are significantly prevalent in women age 50 years and older. The prevalence of conditions which adversely affect health and quality of life, including impaired visual acuity, poor dentition, pain and limitations with mobility is significant in the women age 50 years and older. While these data are specific to Ghana, they have the potential to be generalizable to women in other urban areas in transition. As the life expectancy is increasing in developing countries, an increased awareness and treatment of chronic health conditions in the older women is critical to ensure a healthy life as they enter their golden years. © 2011 Springer Science+Business Media, LLC.Item Health of urban Ghanaian women as identified by the women's health study of Accra.(International Journal of Gynecology and Obstetrics, 2007-11) Hill, A.G.; Darko, R.; Seffah, J.; Adanu, R.M.K.; Anarfi, J.K.; Duda, R.B.Objective: The purpose of the Women's Health Study of Accra was to provide an assessment of the prevalence of communicable and non-communicable illnesses. Method: This was a prospective, community-based study that included an interview for medical illnesses, a comprehensive physical examination, and laboratory testing. A total of 1328 women were examined at Korle Bu Teaching Hospital, University of Ghana. Results: Prevalent conditions included poor vision (66.8%), malaria (48.7%), pain (42.8%), poor dentition (41.6%), hypertension (40.2%), obesity (34.7%), arthritis (27.1%), chronic back pain (19.4%), abnormal rectal (16.0%) and pelvic examinations (12.7%), HIV in women age 24-29 (8.3%), and hypercholesterolemia (22.7%). Increasing age, lack of formal education, and low-income adversely affected health conditions. Conclusion: The high prevalence of preventable illnesses in this expanding urban population indicates that the health care services are obligated to develop and provide screening, preventive strategies and treatment for both general health and gynecologic health conditions. © 2007 International Federation of Gynecology and Obstetrics.Item HIV prevalence and risk factors in women of Accra, Ghana: Results from the women's health study of Accra(American Journal of Tropical Medicine and Hygiene, 2005) Duda, R.B.; Darko, R.; Adanu, R.M.K.; Seffah, J.; Anarfi, J.K.; Gautam, S.; Hill, A.GThe Women’s Health Study of Accra is a cross-sectional study designed to measure the burden of communicable and noncommunicable diseases in adult women residing in Accra, Ghana. This study assessed the prevalence rate of HIV and risk factors associated with HIV infection in 1,328 women age 18 years and older. The weighted overall HIV prevalence rate for women residing in Accra is 3.1%. The highest prevalence rate of HIV infections was identified in women age 25 to 29 years at 8.3%, OR (95%CI) 3.8 (1.68–8.33), P = 001. In addition to young age, other significant risk factors included sexually transmitted infection (STI) symptoms (OR 1.81 [1.14–2.87], P = 0.012) and mean number of lifetime sexual partners (P < 0.001). All HIV-positive women were sexually active. Other findings significantly associated with HIV-positive status included chills, oral lesions, tuberculosis, bloody sputum production, and intestinal parasite infections. There was a significant association with HIV-positive status and locality of residence in the city. There was no association with reported use of condoms, blood transfusions, surgery, reproductive health history including pregnancy or number of sexual partners, symptoms suggestive of AIDS, or self-perception of health. There was also no association with education level, religion, ethnicity, marital status, or socioeconomic level. This community-based study confirms the need to target young, sexually active women for HIV educational and preventive initiatives. A strong Ghanaian public health initiative to increase awareness of the risks of HIV and the link to STIs is critical at this time to prevent the further increase in HIV prevalence and the resultant HIV-associated illnesses.Item Interest in healthy living outweighs presumed cultural norms for obesity for Ghanaian women(Health and Quality of Life Outcomes, 2006) Duda, R.B.; Jumah, N.A; Hill, A.G.; Seffah, J.; Biritwum, R.Background: Cultural norms indicate that obesity reflects increased wealth and prosperity. Yet obesity is linked to serious medical illnesses. The purpose of this study was to determine if Ghanaian women would change their body image if it meant a healthier life. Methods: A questionnaire was administered to 305 Ghanaian women waiting for clinic appointments at Korle Bu Teaching Hospital, Accra Ghana. This survey included questions on current health, selection of figural stimuli, decision making on health and social determinants and 5 questions on self-perception of health from SF-36. Anthropometric measures were taken and body mass index calculated. Women were also provided with health related information at the conclusion of the interview. Results: The majority of all women surveyed would reduce their current body image if it meant that they would have an overall healthier life and reduce the risks of obesity-linked illnesses and complications. Currently obese women were significantly more likely than non-obese women to reduce their body image to reduce the risk of hypertension (OR 2.03 [1.64 - 2.51],<0.001); cardiovascular accident (OR 1.96 [1.61 - 2.38],<0.001); diabetes (OR 2.00 [1.63 - 2.44],<0.001); myocardial infarction (OR 2.27 [1.80 - 2.86],<0.001); if requested by a spouse(OR 2.64 [1.98 - 3.52],<0.001); and to improve overall health (OR 1.95 [1.60 - 2.37], <0.001). There was no association with current body image and responses to SF-36. The decision to select a new body image was not influenced by education, income, marital status or parity. Age 50 years old and less was significantly associated with the body image size reduction to reduce the risk of hypertension, diabetes, and a cardiovascular accident. Conclusion: The Ghanaian women interviewed in this study are interested in living a healthy life and are willing to reduce their body size to reduce the risk of obesity-linked illnesses. The target group for any interventional studies and measures to reduce obesity appears to be women age 50 and younger. © 2006 Duda et al; licensee BioMed Central Ltd.Item Locally advanced breast cancer (LABC)(Surgical Oncology a Practical and Comprehensive Approach, 2015) Chu, Q.D.; Adjepong-Tandoh, E.K.; Duda, R.B.Locally advanced breast (LABC) consists of inflammatory breast cancer (IBC) and non-IBC locally advanced breast cancer (non-IBC LABC).Although the diagnostic work-ups and management are similar, there are subtle differences in terms of biology and surgical management. Some of the topics in this chapter overlapped those in the early breast cancer chapter, Chap. 4. Therefore, readers are encouraged to review the early breast cancer chapter in order to have a more comprehensive understanding of managing patients with LABC © Springer Science+Business Media New York 2015.Item Results of the women's health study of Accra: Assessment of blood pressure in urban women(International Journal of Cardiology, 2007) Duda, R.B.; Kim, M.P.; Darko, R.; Adanu, R.M.K.; Seffah, J.; Anarfi, J.K.; Hill, A.G.Background: The Women's Health Study of Accra was conducted to determine the burden of illness in a representative sampling of adult urban women. Methods: This community-based survey selected study participants by a 2-stage cluster probability sample stratified by socioeconomic status based on the 2000 Ghanaian census data. It included a comprehensive household survey and medical and laboratory examination for 1328 women. Hypertension was defined as systolic blood pressure measurement ≥ 140 mm Hg or a diastolic of ≥ 90 mm Hg.= Results:A positive review of systems for hypertension was reported in 309 (23.7%) with only 52.5% using anti-hypertensive medication and only 4.4% had a normal blood pressure. The blood pressure measurement was elevated in 712/1303 (54.6%). Significant risk factors for an elevated blood pressure included age ≥ 50 years (OR = 14.24 [10.74,18.8], p < 0.001); BMI ≥ 30.00 (OR = 2.89 [2.26,3.70], p < 0.001); parity of three or more children (OR = 5.16 [2.90,9.19], p < 0.001); menopause before age 50 years (OR = 5.88 [1.11,31.17], p = 0.037); elevated fasting blood glucose (OR = 3.98 [2.38,6.64], p < 0.001); elevated fasting cholesterol (OR = 1.69 [1.24, 2.30], p = 0.001); no formal education (OR = 2.75 [1.70,4.43], p < 0.001) and first degree family history of hypertension (p < 0.001). There was no association with income level, diet or activity. Significant protective factors include young age, nulliparity, normal BMI, and a lower than normal fasting LDL-cholesterol. Conclusion:The prevalence of presumptive hypertension is greater than anticipated. Public health initiatives to increase awareness of hypertension and to initiate and maintain treatment regimens will serve to improve the health of the women and the urban community.Item Secular trends in menarcheal age among Ghanaian women in Accra(Journal of Obstetrics and Gynaecology, 2006-09) Adanu, R.M.K.; Hill, A.G.; Seffah, J.D.; Darko, R.; Anarfi, J.K.; Duda, R.B.The Women's Health Study of Accra is a population-based cross-sectional survey that was conducted between March and September 2003 to assess the burden of disease in women in Accra. In addition to data relating to general health and living conditions, data on age at first menstruation was collected during the survey. A retrospective cohort analysis of the reported age at menarche was conducted using data from 2,644 women aged between 18 and 100 years. The median age of first menstruation of the entire cohort was 15.5 years and the median age of first menstruation among those aged <20 was 14.5 years. There was a statistically significant difference in median age at menstruation among the different age and socioeconomic groups. Multiple linear regression showed a significant decline of 0.2 years per decade in the mean age at menarche among Ghanaian women. © 2006 Informa UK Ltd.Item Sexually transmitted infections and health seeking behaviour among Ghanaian women in Accra.(African journal of reproductive health, 2008-12) Adanu, R.M.K.; Hill, A.G.; Seffah, J.D.; Darko, R.; Anarfi, J.K.; Duda, R.B.The study was to measure the prevalence of sexually transmitted infection (STI) symptoms among women in Accra, Ghana, to identify characteristics that predispose to STI symptoms and to identify factors that influence health-seeking behaviour of women with STI symptoms. Data were collected by trained interviewers through questionnaire interviews of 3183 women. Data analysis was restricted to 1329 women with complete data. Only 19% of our study group had STI symptoms. Only 35% of the women with STI symptoms received care. Having high wealth index, being older and having no history of condom use were protective factors for experiencing STI symptoms. Seeking care was associated with increased by high wealth index and the presence of an offensive vaginal odour. Income level on its own did not affect health seeking behavior. Wealth index is the most significant determinant of a woman having STI symptoms and seeking care in Accra.