Browsing by Author "Kumoji, R."
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Item Cause of death among Ghanaian adolescents in Accra using autopsy dat(2011-09-12) Ohene, S.A.; Tettey, Y.; Kumoji, R.BACKGROUND: There is limited data on adolescent mortality particularly from developing countries with unreliable death registration systems. This calls for the use of other sources of data to ascertain cause of adolescent mortality. The objective of this study was to describe the causes of death among Ghanaian adolescents 10 to 19 years in Accra, Ghana utilizing data from autopsies conducted in Korle Bu Teaching Hospital (KBTH). FINDINGS: Out of the 14,034 autopsies carried out from 2001 to 2003 in KBTH, 7% were among adolescents. Of the 882 deaths among adolescents analyzed, 402 (45.6%) were females. There were 365 (41.4%) deaths from communicable disease, pregnancy related conditions and nutritional disorders. Non-communicable diseases accounted for 362 (41%) cases and the rest were attributable to injuries and external causes of morbidity and mortality. Intestinal infectious diseases and lower respiratory tract infections were the most common communicable causes of death collectively accounting for 20.5% of total deaths. Death from blood diseases was the largest (8.5%) among the non-communicable conditions followed by neoplasms (7%). Males were more susceptible to injuries than females (χ2 = 13.45, p = .000). At least five out of ten specific causes of death were as a result of infections with pneumonia and typhoid being the most common. Sickle cell disease was among the top three specific causes of death. Among the females, 27 deaths (6.7%) were pregnancy related with most of them being as a result of abortion. CONCLUSIONS: The autopsy data from the Korle-Bu Teaching Hospital can serve as a useful source of information on adolescent mortality. Both communicable and non-communicable diseases accounted for most deaths highlighting the need for health care providers to avoid complacency in their management of adolescents presenting with these diseases.Item Endoscopic evaluation of the colorectum in patients presenting with haematochezia at Korle-Bu Teaching Hospital, Accra(Ghana Medical Journal 42(1): 33-7, 2008) Dakubo, J. C. B.; Kumoji, R.; Naader, S. B.; Clegg-Lamptey, J. N. A.Background: Colorectal endoscopy is the gold stan- dard investigation of the large bowel in patients with rectal bleeding and is employed as a means of secon- dary prevention of colorectal cancer. Aim: To determine the frequency of benign lesions and carcinomas in patients who underwent colorectal endo- scopy because of rectal bleeding and to evaluate the role of endoscopy in secondary prevention of colorectal carcinoma in our centre. Method: A retrospective study was undertaken on pa- tients who underwent colorectal endoscopy between January 1995 and December 2000 for rectal bleeding. Results: Five hundred and ninety six (596) patients were studied. Males were 403 and females 93, mean age 50.9 (SD 7.07). Three hundred and ten patients (52%) had rigid proctosigmoidoscopy, flexible sigmoi- doscopy 105 (17.6%) and colonoscopy 181 (30.4%). Of those who had colonoscopy complete examination of the colon was achieved in 55 patients (30.4%). Those in whom colonoscopy was incomplete had dou- ble contrast barium enema. Haemorrhoids were the commonest disease diagnosed, 316 patients (53%). Co- lorectal carcinoma 39 patients (6.7%), non-specific co- litis 34 patients (5.7%), diverticular disease 27 patients (4.5%) and adenomatous polyps 17 patients (2.9%) were the next common disease. Less common condi- tions were ulcerative colitis, rectal schistosomiasis and angiodysplasia. In 125 patients (21.0) the cause of bleeding could not be found. Conclusion: An appreciable number of the patients with rectal bleeding had serious pathology that was di- agnosed early by endoscopy confirming the important role of endoscopy in secondary prevention of colorectal carcinoma. The low success rate of full colonoscopy underscores the need for training in this procedure.Item Human pentastomiasis: A case report(West African Journal of Medicine, 2006) Dakubo, J.C.B.; Etwire, V.K.; Kumoji, R.; Naaeder, S.B.We report a case of human pentastomiasis in a 55-year-old farmer whose diagnosis was made incidentally during laparotomy on account of a mechanical small intestinal obstruction caused by adhesions. Encysted parasites and degenerative granulomas were found in the omentum and in the subserosal layer of the small intestine. These parasites were diagnosed as Armillifer armillatus larvae. The patient made an uneventful recovery after the operation and was discharged. He is being followed up.Item Injury-related mortality among adolescents: findings from a teaching hospital's post mortem data(2010-05-05) Ohene, S.; Tettey, Y.; Kumoji, R.Abstract Background Injuries are noted to be an important cause of death among adolescents. There is however limited data on the injury related deaths among adolescents in Ghana. Findings Using data from post-mortem records derived from the Department of Pathology of the Korle-Bu Teaching Hospital (KBTH), Accra Ghana from 2001 to 2003, the causes of injury related deaths among adolescents 10 to 19 years were analyzed by gender and age groups 10 to 14 and 15 to 19 years. There were 151 injury-related deaths constituting 17% of the autopsies performed among adolescents in the study period. The male-to-female ratio was 2.1:1. Drowning was the most common cause of death (37%) in the study population. This was followed by road traffic accidents (RTA) (33%). Over 70% of the RTA victims were pedestrians knocked downed by a vehicle. Deaths from electrocution, poisoning, burns, stab/gunshot, hanging and other miscellaneous causes (example blast injury, traumatic injury from falling debris, fall from height) made up the remaining 30% of the injury related mortality. Among males and in both age categories, drowning was the leading cause of death. In females, the highest mortality was from road traffic accidents accounting for almost half (49%) of the deaths; significantly more than that occurring in males (25%, p = .004). Conclusions Findings from Korle-Bu Teaching Hospital post-mortem data on adolescents show that drowning and road traffic accidents are the leading causes of injury-related mortality. Appropriate injury reducing interventions are needed to facilitate a decrease in these preventable deaths.Item Injury-related mortality among adolescents: findings from a teaching hospital's post mortem data(BMC Res Notes, 2010) Sally-Ann, O.; Kumoji, R.Item Osteometric analysis of sexual dimorphism in the sternal end of the rib in a West African population.(1999) Wiredu, E.K.; Kumoji, R.; Seshadri, R.; Biritwum, R.B.This study, and others, are being carried out in order to establish a Forensic Anthropology databank on age estimation and sex determination of skeletonized remains in Ghana. An osteometric study of sexual dimorphism in the sternal end of the right fourth rib on 346 consecutive coroner's autopsy cases (221 males, 125 females) of known age, sex, and race was conducted. The height and width of the sternal end of the rib were measured in each case. The sample was analyzed in three groups: young (<30 years), old (≥30 years), and total sample (total group). Stepwise discriminant function analysis showed that the accuracy of sex determination varied from 80% in the young and 74% in the old groups to 78% for the total group. Statistical analysis of the results obtained when the functions derived from the study were tested using another batch of ribs showed the functions to be effective and reliable in determining sex. When functions derived from a previous study of American Whites were used to determine sex in our study sample, the vast majority of males were misclassified as females. This is the first time, to our knowledge, that a Black African population has been studied osteometrically to evaluate sexual dimorphism in the sternal end of the fourth rib.Item A study of autopsy procedures in Ghana: Implications for the use of autopsy data in epidemiological analyses(Journal of Public Health in Africa, 2011-03) Fobil, J.N.; Kumoji, R.; Armah, H.B.; Aryee, E.E.; Bilson, F.; Carboo, D.; Rodrigues, F.K.; Meyer, C.G.; May, J.; Kraemer, A.The study of cause of death certification remains a largely neglected field in many developing countries, including Ghana. Yet, mortality information is crucial for establishing mortality patterns over time and for estimating mortality attributed to specific causes. In Ghana, autopsies remain the appropriate option for determining the cause of deaths occurring in homes and those occurring within 48 hours after admission into health facilities. Although these organ-based autopsies may generate convincing results and are considered the gold standard tools for ascertainments of causes of death, procedural and practical constraints could limit the extent to which autopsy results can be accepted and/or trusted. The objective of our study was to identify and characterise the procedural and practical constraints as well as to assess their potential effects on autopsy outcomes in Ghana. We interviewed 10 Ghanaian pathologists and collected and evaluated procedural manuals and operational procedures for the conduct of autopsies. A characterisation of the operational constraints and the Delphi analysis of their potential influence on the quality of mortality data led to a quantification of the validity threats as moderate (average expert panel score = 1) in the generality of the autopsy operations in Ghana. On the basis of the impressions of the expert panel, it was concluded that mortality data generated from autopsies in urban settings in Ghana were of sufficiently high quality to guarantee valid use in health analysis. © D. Omare and A. Kanekar., 2011.Item Tuberculosis associated deaths: a comparative autopsy study in Accra, Ghana(Ghana Medical Journal, 2000-09) Gyasi, R.K.; Kumoji, R.; Akosa, A.B.This study was conducted to find out if there were any changes in the findings at autopsy of deaths associated with tuberculosis (TB) from the period when HIV was first detected in Ghana and to see whether any such changes are correlated with the progression of the mV-AIDS epidemic. A retrospective review or autopsy files of tuberculosis-associated deaths at the Korle Bu Teaching Hospital Mortuary was done and a comparison was made between the calendar years 1987/ 1988 at the beginning of the HIV-AIDS epidemic in Ghana and 1997/98, a decade later. The proportion of deaths associated with TB in, creased significantly (X2 =' 9.17, P < 0.01, 1d.f.) from 3.2% of 4321 autopsies in 1987/88 to 5.1% of 7004 autopsies in 1997/98. The increase was largely due to deaths among patients aged 20-49 years and was more pronounced among females. The proportion of deaths associated with TB among females aged 20-49 years increased from 10% in 1987/88 to 23.9% in 1997/98. The male: female ratio decreased from 3.4: 1 to 1.9: 1 over the period. Systemic miliary TB, more than doubled from 12.9% in 1987/98 to 33.4% in 1997/98. It became the commonest form of TB detected at autopsy in the 20-29 years age group in 1997/98. A significant increase in deaths associated with TB occurred between 1987/88 and 1997/98 and the changes in the characteristics of TB associated deaths were as expected with the progression of the HIV-AIDS epidemic.