Browsing by Author "Nkromah, K."
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Item Beliefs on epilepsy in Northern Ghana(Epilepsy and Behavior, 2013-11) Adjei, P.; Akpalu, A.; Laryea, R.; Nkromah, K.; Sottie, C.; Ohene, S.; Osei, A.Stigma associated with any chronic disease is one of the greatest challenges to the treatment of the disease. Stigma in health is a complex concept, and it causes people with a stigmatizing disease to conceal their disorder. Epilepsy is one such condition with numerous outdated, sometimes inhumane, and sometimes absurd perceptions that tend to fuel its stigma. Health-care workers who participated in an epilepsy training program as part of a World Health Organization/Ghana Health Service collaboration were asked to compile the perceptions associated with epilepsy in their communities. The comments they gathered are presented here. © 2013 Elsevier Inc.Item A cross-sectional comparative study of perceived stigma betweenpatients with epilepsy and patients living with HIV/AIDS in Accra, Ghana(Epilepsy and Behavior, 2018-12) Adjei, P.; Nkromah, K.; Akpalu, A.; Laryea, R.; Osei Poku, F.; Ohene, S.; Puplampu, P.; Twumasi Aboagye, E.Background Health-related stigma is a great challenge to the treatment of diseases. In epilepsy like other conditions, it causes affected individuals to conceal their illness. In this study, we described stigma perceived by patients with epilepsy at the Korle Bu Teaching Hospital (KBTH), a tertiary referral facility, and the Accra Psychiatry Hospital in Ghana (APH). We then compared the perception of stigma in patients with epilepsy to stigma perceived by persons living with human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) (PLWHA), a chronic communicable disease stigmatized in Ghana. Methods A total of 351 patients with epilepsy were recruited from both sites by systematic random sampling and interviewed. The Kilifi Stigma Scale for Epilepsy was used to determine individual patient's stigma score. Statistical analysis was done using multiple logistic regression analysis to control for the effect of measured independent variables that were significant on univariate analysis: age, gender, marital status, income, type of epilepsy, and the frequency of seizures, on the outcome variable. Comparative analysis of the mean stigma score in patients with epilepsy and persons living with HIV/AIDS was done using the Student's t-test and Mann–Whitney U test (Wilcoxon rank sum test). Results The presence of perceived stigma using the Kilifi Stigma Score Estimation was 32.02% (62), 33.33% (49), and 28.88% (54) among respondents from KBTH, APH, and PLWHA respectively. Results from Wilcoxon rank sum test showed that the median stigma score between the three groups was significant; KBTH and APH (p-value; 0.0258), KBTH and PLWHA (p-value; 0.00001), and APH and PLWHA (p-value; 0.0000). Age (< 40 years), seizure frequency, ethnic group (Ewe and Guan), and being divorced showed high odds for perceived stigma among KBTH patients with epilepsy. Having tertiary education led to lower odds for perceived stigma in epilepsy for APH patients with epilepsy. Conclusion This study showed that epilepsy is associated with a high stigma perception. The perceived stigma was greater than stigma in PLWHAs in Accra. Stigma was affected by unemployment, ethnicity (Ewe and Guan), and uncontrolled seizures. Increasing age reduced perceived stigma and the management of patients with epilepsy in a psychiatric facility might have impacted negatively on the perceived stigma.Item Prevalence and Prognostic Features of ECG Abnormalities in Acute Stroke: Findings From the SIREN Study Among Africans(Global Heart, 2017) Adeoye, A.M.; Ogah, O.S.; Ovbiagel, B.; Akinyemi, R.; Shidali, V.; Agyekum, F.; Aje, A.; Adebayo, O.; Akinyemi, J.O.; Kolo, P.; Appiah, L.T.; Iheonye, H.; Kelechukwu, U.; Ganiyu, A.; Olunuga, T.O.; Akpa, O.; Olagoke, O.O.; Sarfo, F.S.; Wahab, K.; Olowookere, S.; Fakunle, A.; Akpalu, A.; Adebayo, P.B.; Nkromah, K.; Yaria, J.; Ibinaiye, P.; Ogbole, G.; Olumayowa, A.; Lakoh, S.; Calys-Tagoe, B.; Olowoyo, P.; Innocent, C.; Tiwari, H.K.; Arnett, D.; Godwin, O.; Ayotunde, B.; Akpalu, J.; Obiora, O.; Joseph, O.; Omisore, A.; Jenkins, C.; Lackland, D.; Owolabi, L.; Isah, S.; Dambatta, A.H.; Komolafe, M.; Bock-Oruma, A.; Melikam, E.S.; Imoh, L.C.; Sunmonu, T.; Gebregziabher, M.; Olabisi, O.; Armstrong, K.; Onyeonoro, U.U.; Sanya, E.; Agunloye, A.M.; Ogunjimi, L.; Arulogun, O.; Farombi, T.H.; Obiabo, O.; Obiako, R.; Owolabi, M.Background Africa has a growing burden of stroke with associated high morbidity and a 3-year fatality rate of 84%. Cardiac disease contributes to stroke occurrence and outcomes, but the precise relationship of abnormalities as noted on a cheap and widely available test, the electrocardiogram (ECG), and acute stroke outcomes have not been previously characterized in Africans. Objectives The study assessed the prevalence and prognoses of various ECG abnormalities among African acute stroke patients encountered in a multisite, cross-national epidemiologic study. Methods We included 890 patients from Nigeria and Ghana with acute stroke who had 12-lead ECG recording within first 24 h of admission and stroke classified based on brain computed tomography scan or magnetic resonance imaging. Stroke severity at baseline was assessed using the Stroke Levity Scale (SLS), whereas 1-month outcome was assessed using the modified Rankin Scale (mRS). Results Patients' mean age was 58.4 ± 13.4 years, 490 were men (55%) and 400 were women (45%), 65.5% had ischemic stroke, and 85.4% had at least 1 ECG abnormality. Women were significantly more likely to have atrial fibrillation, or left ventricular hypertrophy with or without strain pattern. Compared to ischemic stroke patients, hemorrhagic stroke patients were less likely to have atrial fibrillation (1.0% vs. 6.7%; p = 0.002), but more likely to have left ventricular hypertrophy (64.4% vs. 51.4%; p = 0.004). Odds of severe disability or death at 1 month were higher with severe stroke (AOR: 2.25; 95% confidence interval: 1.44 to 3.50), or atrial enlargement (AOR: 1.45; 95% confidence interval: 1.04 to 2.02). Conclusions About 4 in 5 acute stroke patients in this African cohort had evidence of a baseline ECG abnormality, but presence of any atrial enlargement was the only independent ECG predictor of death or disability. © 2017 World Heart Federation (Geneva)Item Psychological comorbidities in epilepsy: a cross-sectional survey among Ghanaian epilepsy patients(Ghana Med J, 2021) Adjei, P.; Nkromah, K.; Akpalu, A.; Ohene, S.; Puplampu, P.; Aboagye, E.T.; Ganu, V.; Nartey, S.; Ae-Ngibise, K.Objective: To evaluate the prevalence and patterns of psychiatric disorders in epilepsy patients at the Korle-Bu Teaching hospital, Accra, Ghana. Design: The study design was a cross-sectional survey Setting: The study was conducted at the Neurology Clinic of the Department of Medicine and Therapeutics, Korle Bu Teaching hospital, Accra, Ghana. Participants: A total of one hundred and sixty-six patients diagnosed with epilepsy aged at least 18 years and ac cessing services at the neurology clinic participated in the study. Main Outcome Measure: Prevalence and patterns of psychiatric disorders among patients diagnosed with epilepsy using the Brief Symptom Inventory. Results: The mean age for onset of epilepsy was 20.1 ± 16.9 years, and generalized epilepsy (73.2%) was the major type of epilepsy identified. The aetiology of the epilepsy condition was unknown in most patients (71.1%). The esti mated mean Brief Symptom Inventory scores in all the nine diagnostic psychiatry characteristics (Depression, Anxi ety, Somatization, Hostility, Phobic Anxiety, Obsessive Compulsive Disorder, Psychoticism, Interpersonal Sensitiv ity, and Paranoid Ideation) were higher in the epilepsy patients compared to the normative data scores for non-pa tients. Global Severity Index scores for females were significantly higher (p=0.002) than the scores for males on all the psychological outcomes except hostility. Conclusion: Psychological disorders were prevalent among epilepsy patients, with females more likely to experi ence psychological problems than males. The findings call for a holistic approach in managing epilepsy to highlight and manage some exceptional psychological comorbidities.Item Stroke Outcome and Determinants among Patients with and without Diabetes in a Tertiary Hospital in Ghana(Stroke Research and Treatment, 2018-09) Akpalu, J.; Yawson, A.E.; Osei-Poku, F.; Atiase, Y.; Yorke, E.; Adjei, P.; Nkromah, K.; Akpalu, A.Background Diabetes mellitus, a well-established independent risk factor for stroke, has varied association with stroke outcome from previous studies. This study investigated stroke outcome and determinants among patients with and without diabetes in a tertiary hospital in Ghana. Methods A prospective study conducted among stroke patients with and without diabetes admitted in a Ghanaian tertiary hospital. Baseline clinical and biochemical data were documented. Functional stroke outcome was evaluated at 1, 3, and 6 months after stroke using the modified Rankin Scale. Results Number of participants enrolled were 326 and 105 (32.20%) had diabetes. Higher proportions of diabetes patients had poor functional stroke outcome at 1, 3, and 6 months (79%, 75.23%, 73.33%) compared with those without diabetes (70.13%, 65.16, 61.99) (p>0.05). Stroke patients with diabetes had lower survival compared with those without diabetes (p=0.0745). Mortality at 6 months was more likely among ischaemic stroke patients with diabetes compared with those without diabetes (Odds Ratio 2.037; CI: 1.058-3.923). Determinants of poor functional stroke outcome for diabetes patients were older age (Adjusted Odds Ratio (AOR)-1.07; CI-1.03-1.12), female gender (AOR-3.74; CI-1.26-12.65), and pneumonia (AOR-11.32; CI-1.93-220.05) whereas the determinants for those without diabetes were unemployment (AOR-4.19; CI-1.24-19.50), speech abnormalities (AOR-1.99; CI1.08-3.73), and pneumonia (AOR-4.05; CI-1.83-9.77). High fasting plasma glucose (HR-1.15; CI-1.07-1.23), elevated temperature (HR-1.41; CI-1.11-1.79), and pneumonia (HR-2.25; CI-1.44-3.50) were determinants of low survival among all stroke patients. Conclusion Trends towards poorer functional outcome and reduced survival were found among Ghanaian stroke patients with diabetes compared with those without diabetes. Older age, female gender, pneumonia, elevated temperature, and fasting plasma glucose were determinants of adverse outcome in stroke patients with diabetes.