Browsing by Author "Samba, A."
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Item Adherence to the recommended timing of focused antenatal care in the Accra Metropolitan Area, Ghana(Pan African Medical Journal (PAMJ), 2019-06-18) Asah-Opoku, K.; Ameme, D.K.; Yawson, A.; Guure, C.B.; Aduama, D.E.M.; Mumuni, K.; Samba, A.; Maya, E.T.Introduction: the proportion of antenatal attendants in Ghana who had at least four antenatal visits increased from 78% in 2008 to 87% in 2014. However, it is not known whether these visits followed the recommended timing of focused antenatal clinic attendance in Ghana. We sought to assess the adherence to the clinic schedule and its determinants in the Accra Metropolis. Methods: a cross-sectional study was conducted. Face-to-face interviews were conducted with postpartum women. Multiple logistic regression was used in the analysis of determinants of adherence to the recommended timing of clinic attendance. A p-value of <0.05 was considered statistically significant. Results: among 446 focused antenatal care clinic attendants, 378 (84.8%) had four or more visits. Among these, 101 (26.7%) adhered to the recommended clinic schedule. Women who adhered were more likely to have had education up to Junior High School [AOR=3.31, 95%CI (1.03-10.61)] or Senior High School [AOR=4.47, 95%CI (1.14-17.51)], or have history of abortion [(AOR=3.36, 95%CI (1.69-7.96)]. For every week increase in gestational age at booking at the antenatal clinic, respondents were 34% less likely to complete all four antenatal visits at the recommended times. [(AOR=0.66, 95% (0.60-0.73)]. Conclusion: majority of women receiving focused antenatal care in the Accra Metropolis have four or more visits but only about a quarter of them adhered to the recommended clinic schedule. Having high school education, history of abortion and early initiation of antenatal care were predictors of adherence to clinic schedule. Women should be educated on early initiation of antenatal care to enhance adherence.Item Associations between malaria in pregnancy and neonatal neurological outcomes(International Journal of Infectious Diseases, 2021) Lawford, H.L.S.; Nuamah, M.A.; Liley, H.G.; Griffin, A.; Lekpor, C.E.; Botchway, F.; Oppong, S.A.; Samba, A.; Badoe, E.V.; Kumar, S.; Lee, A.CC.; Gyasi, R.K.; Adjei, A.A.; Bora, S.Objective: To compare neurological functioning of neonates born to mothers with and without malaria in pregnancy. Methods: Pregnant women presenting at Korle Bu Teaching Hospital, Ghana were recruited into this prospective observational study. Malaria exposure was determined by clinically documented antenatal malaria infection; parasitemia in maternal, placental, or umbilical cord blood; or placental histology. Neu- rological functioning was assessed using the Hammersmith Neonatal Neurological Examination within 48 hours of birth. Performance was classified as "optimal" or "suboptimal" by subdomain and overall. Results: Between November 21, 2018 and February 10, 2019, a total of 211 term-born neonates, of whom 27 (13%) were exposed to malaria in pregnancy, were included. In the reflexes subdomain, exposed neonates tended to score lower (adjusted mean difference -0.34, 95% confidence interval -0.70 to 0.03), with an increased risk (adjusted risk ratio 1.63, 95% confidence interval 1.09 to 2.44) of suboptimal per- formance compared with unexposed neonates. There were no significant between-group differences in scores or optimality classification for the remaining subdomains and overall. Conclusions: Malaria-exposed neonates had similar neurological functioning relative to unexposed neonates, with differences confined to the reflexes subdomain, suggesting potential underlying neuro- logical immaturity or injury. Further studies are needed to confirm these findings and determine the significance of malaria in pregnancy on long-term neurological outcomes.Item Chlamydia trachomatis infection among Ghanaian women undergoing hysterosalpingography for suspected tubal factor infertility(International Journal of Gynecology and Obstetrics, 2019-06-19) Beyuo, T.; Oppong, S.T.; Samba, A.; Beyuo, V.M.OBJECTIVE: To determine the prevalence of Chlamydia trachomatis infection and the correlates of tubal pathology among Ghanaian women undergoing hysterosalpingography for suspected tubal factor infertility. METHODS: A cross-sectional study was conducted among 189 women with infertility who underwent hysterosalpingography at Korle Bu Teaching Hospital, Ghana, from September 1 to November 30, 2016. Demographic data; obstetric and gynecologic history; and hysterosalpingography findings were collected using a structured questionnaire. Endocervical swabs were tested for the presence of Chlamydia trachomatis using a rapid antigen-based diagnostic kit. Associations between the variables were assessed using bivariate analysis. RESULTS: Positive test results for Chlamydia trachomatis were recorded among 15 participants, giving an overall prevalence of 7.9% (95% confidence interval [CI] 4.1%-11.7%). In all, 67 (35.4%) participants had abnormal findings on hysterosalpingography, with 40 (21.2%) displaying bilateral tubal occlusion. The remaining 122 (64.6%) women had normal findings on hysterosalpingography. Eight participants with normal tubal appearance tested positive for Chlamydia trachomatis (prevalence 6.6%, 95% CI 2.2%-11.0%), whereas seven participants with abnormal tubal appearance tested positive (prevalence 10.4%, 95% CI 3.1%-17.7%; P=0.402). No associations were found between participant characteristics and tubal pathology. CONCLUSION: The prevalence of Chlamydia trachomatis did not differ by hysterosalpingography findings.Item Determinants of sexual dysfunction in pregnancy in a large tertiary hospital in Ghana(PLOS ONE, 2023) Maya, E.T.; Boamah, M.O.; Agyabeng, K.; Srofenyoh, E.; Mumuni, K.; Samba, A.Objective To determine the factors associated with sexual dysfunction in pregnancy. Methods A cross-sectional facility-based study using quantitative methods was carried out among pregnant women attending antenatal clinic of the Greater Accra Regional Hospital from 14th May to 25th June 2018. Four hundred and twenty-seven married or cohabiting women who were at least eight weeks pregnant and have been living together with their partners for at least four weeks prior to the survey were consecutively recruited. The Female Sexual Func tion Index (FSFI) tool was used to assess their sexual function. Pearson’s Chi Square, Fischer’s exact, Mann Whitney and Student’s t-tests were used for bivariate analysis where appropriate between sexual dysfunction (dependent variable) and demographic, obstetrics and gynecologic factors (independent variables). Multiple logistic regression was done. Sta tistical significance was set at p-value of less than 0.05 at bivariate and multivariable analyses. Results The mean age of the respondents was 30.8 ± 4.8 years. Their mean gestational age was 32.3 ± 7.1 weeks. Marital status and duration of stay in marriage or cohabitation were signifi cantly associated with sexual dysfunction with adjusted odds ratios of 1.88 (p-value < 0.05) and 1.08 (p-value < 0.05) respectively. Conclusion Cohabiting and increasing length of stay with spouse are significantly associated with sexual dysfunction in pregnancy.Item Effect of one-to-one versus group counseling on uptake of postpartum contraception in selected hospitals in Ghana: A prospective cohort study(International Journal of Gynecology and Obstetrics, 2023) Asah-Opoku, K.; Mumuni, K.; Ameme, D.K.; Mohammed, A.G.; Samba, A.; Nkyekyer, K.Objective: To compare the effect of one provider to one client counseling and one provider to a group client counseling on the uptake of postpartum contraception. Methods: This was a hospital-based prospective cohort study among women attending a postpartum clinic at Korle-Bu Teaching Hospital and Greater Accra Regional Hospital. Postpartum mothers were recruited daily from April 1, 2017 to November 28, 2017. Mothers from this cohort that used a contraceptive method within a year postpartum were determined at 3, 6, 9, and 12 months after recruitment. A P value of less than 0.05 was considered statistically significant for all analyses. Results: Of 982 women surveyed, contraceptive uptake among women who received one-to-one counseling was 306/600 (51.0%) and that for women who received group counseling was 48/382 (12.6%) (P < 0.001). Factors associated with contraceptive uptake during postpartum period were: one-to-one counseling (adjusted odds ratio [aOR] 7.05, 95% confidence interval [CI] 4.94–10.07), mothers' age (aOR 0.95, 95% CI 0.91–0.98), being single (aOR 0.54, 95% CI 0.35–0.85), cohabiting (aOR 0.39, 95% CI 0.22–0.69), and previous use of contraception (aOR 1.55, 95% CI 1.12–2.15). Conclusion: One-to-one counseling was associated with a significantly greater uptake of contraception during the postpartum period compared with group counseling. Other factors associated with uptake were age, marital status, and history of contraceptive use.Item Modern contraceptive use among women living with HIV/AIDS at the Korle Bu Teaching Hospital in Ghana(International Journal of Gynecology and Obstetrics, 2018-01) Samba, A.; Mumuni, K.; Adu, J.A.; Sefogah, P.E.; Kudzi, W.; Nartey, E.T.OBJECTIVE: To examine factors influencing contraceptive use among women living with HIV/AIDS. METHODS: The present cross-sectional study included a randomly selected sample of sexually active females aged 15-60 years who were living with HIV/AIDS and receiving care at the HIV Clinic, Korle Bu Teaching Hospital, Accra, Ghana, between September 1 and November 31, 2016. Data were collected via a structured interviewer-administered questionnaire. RESULTS: Among 202 women who completed the survey, 50 (24.7%) were using contraceptives. Of the women using contraception, 39 (78%) were married and 6 (12%) were cohabiting. Twenty-eight (56%) reported that their primary sexual partners were HIV-positive, 14 (28%) had HIV-negative partners, and 8 (16%) did not know their partner's HIV status. Condoms were used by 42 (84%) women and the majority (41 [82%]) wanted to have more children; almost all (47 [94%]) had received counseling on contraceptive use. Overall, 133 (65.8%) and 45 (22.3%) women reported that they would prefer to share their family planning concerns with a doctor and nurse, respectively, at the HIV clinic. CONCLUSION: Women living with HIV/AIDS desired more children but preferred to share their family planning concerns with their clinician at the HIV clinic. Integrating HIV care and reproductive health services could help these women achieve childbearing goals safely. © 2018 International Federation of Gynecology and Obstetrics.Item Obstetric capacity strengthening in Ghana results in wide geographic distribution and retention of certified Obstetrician/ Gynaecologists: A quantitative analysis(BJOG, 2022) Kekulawala, M.; Samba, A.; Braunschweig, Y.; Plange-Rhule, J.; Turpin, C.; Johnson, T.R.B.; Anderson, F.W.J.Objectives: To determine the cumulative retention of Obstetricians/Gynaecologists (Ob/Gyns) since the inception of the Ghana postgraduate Ob/Gyn programmes, to determine the demographic and practice characteristics of all Ob/Gyns who have been trained, and to compare the geographic distribution of Ob/Gyns throughout Ghana between 2010, when a previous study was conducted, and the current practice locations of all graduates in 2017. Design: Cross-sectional, quantitative investigation. Setting: Fieldwork for this study was conducted in Ghana between 21 June 2017 and 20 August 2017. Methods: A roster of certified Ob/Gyns, year certified and email contact information was obtained from the Ghana College of Physicians and Surgeons, a roster of practice locations was obtained from Ghana Medical Board. Main outcome measures: Retention of Ob/Gyns, geographic distribution of providers and comparison of geographic spread between 2010 and 2017 practice locations. Results: Significant geographic spread and increase in in-country medical programmes have occurred over the 7-year period. In recent years, Ob/Gyn certifications through the Ghana College of Physicians and Surgeons have significantly increased. Conclusion: The establishment of the Ghana College of Physicians and Surgeons created a national certification opportunity that made Ob/Gyn certification more accessible. This provides a cadre of certified Ob/Gyns that can be trained and retained in low-income settings, and allows for long-term commitment in multiple relevant sectors that may serve to establish a comprehensive obstetric and gynaecology capacity beyond urban centres.Item Overview of preparedness and response to COVID-19 in Ghana(Ghana Med j, 2021) Sarkodie, B.; Asiedu-Bek, F.; Laryea, D.O.; Ampofo, W.K.; Philips, R.O.; Samba, A.; Aboagye, D.; Nsiah-Asare, A.; Asamoah-Baah, A.; Odame, E.; Ohene, S.; Amoako, Y.A.; Kuma-Aboagye, P.The Coronavirus disease 2019 (COVID-19) outbreak in Ghana is part of an ongoing pandemic caused by the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2). The first two cases of COVID-19 were confirmed in Ghana on 12th March 2020. COVID-19 was consequently declared a Public Health Emergency of National Concern, triggering several response actions, including enhanced surveillance, case detection, case management and contact tracing, closure of borders, suspension of international flights, ban on social gatherings and closure of schools. Pre paredness and response plans were activated for implementation at the national, regional, district and community levels. Ghana’s Strategic approaches were to limit and stop the importation of cases; detect and contain cases early; expand infrastructure, logistics and capacity to provide quality healthcare for the sick; minimise disruption to social and economic life and increase the domestic capacity of all sectors to deal with existing and future shocks. The health sector strategic frame focused on testing, treatment, and tracking. As of 31st December 2020, a total of 535,168 cases, including 335 deaths (CFR: 0.61%), have been confirmed with 53,928 recoveries and 905 active cases. All the regions have reported cases, with Greater Accra reporting the highest number. The response actions in Ghana have seen high level political commitment, appropriate and timely decisions, and a careful balance of public health interventions with economic and socio-cultural dynamics. Efforts are ongoing to intensify non-pharmaceutical interventions, sustain the gains made so far and introduce COVID-19 vaccines to reduce the public health burden of the disease in GhanaItem Preference of Ghanaian Women for Vaginal or Caesarean Delivery Postpartum(Ghana Medical Journal, 2009-03) Danso, K.A.; Schwandt, H.M.; Turpin, C.A.; Seffah, J.D.; Samba, A.; Hindin, M.J.Objective: To determine Ghanaian women’s preferred mode of delivery and opinion of caesarean section after caesarean delivery. Design: A cross sectional study of women who recently delivered by caesarean section prior to hospital discharge. Setting: Two teaching hospitals in Ghana: Komfo Anokye Teaching Hospital, Kumasi, and Korle-Bu Teaching Hospital, Accra. Respondents: 154 patients who delivered by caesarean section between the 1st and 31st August, 2003 were interviewed. Of the 154 initiating the interview, 151 completed, and 145 had complete data. Main Outcome Measures: Delivery preference and general opinion of caesarean delivery. Results: The majority of women interviewed indicated that they preferred vaginal delivery (55%). Despite preference for vaginal delivery among these women who had delivered by caesarean section, the majority had a generally positive opinion of caesarean section (53%). Conclusion: Ghanaian women with experience of caesarean delivery prefer vaginal delivery.Item Prevalence of pneumonia by chest x-ray, associated demographic characteristics and health risk factors among COVID-19 patients in Ghana(Ghana Med J, 2021) Oliver-Comme, J.A.; Puplampu, P.; Owoo, C.; Asare-Boateng, K.; Yawson, A.O.; Tetteh, J.; Calys-Tagoe, B.N.L.; Udofia, E.; Kenu, E.; Samba, A.; Yawson, A.E.; Lartey, M.Objective: The study was conducted to determine the prevalence of radiologically diagnosed pneumonia among COVID-19 patients and associated factors. Design, setting, and participants: A retrospective manual data extraction of 275 medical records of COVID-19 patients was conducted at two COVID-19 national treatment centres in Accra from March to May 2020. All patients had a chest x-ray done. Main outcome and analysis: The main outcome was the presence of pneumonia. Descriptive statistics and Chi-square test of independence were employed to determine the associations between independent variables and the presence of pneumonia. All analysis was performed using Stata 16, and a p-value ≤ 0.05 was deemed significant Results: The prevalence of pneumonia was 44%(95%CI) =38.2-50.0). Chi-square independent test indicated that pneumonia in the COVID-19 patients was associated with educational level, history of domestic and international travel, mass gathering in the past 14 days before diagnosis, and discharge plan (p-value< 0.05). Patients classified as secondary cases (61.5%) and those discharged as fully recovered from the health facility (61.2%) had a higher preva lence of pneumonia. In addition, COVID-19 patients with hypertension (32.1%) and asthma (5.2%) had a significantly higher prevalence of pneumonia. Conclusion: Overall, the prevalence of pneumonia was 44% and was associated with the demographic and personal characteristics of the patients. Early detection through contact tracing and community surveillance should be intensi fied to pick up more asymptomatic cases. The role of the chest x-ray for triaging patients and for clinical management of symptomatic patients remains key.Item Sickle cell education: A survey of antenatal healthcare givers(The American Journal of Tropical Medicine and Hygiene, 2019-06-02) Torto, M.; Aboagye, S.; Asah-Opoku, K.; Nuamah, M.A.; Oppong, S.A.; Samba, A.To explore the educational practices of antenatal care providers toward pregnant women with sickle cell disease (SCD) and sickle cell trait (SCT), a survey was conducted among selected doctors and midwives who provide antenatal care at the outpatient clinic of the Obstetric Department of the Korle-Bu Teaching Hospital, Accra, Ghana. The study explored their practices of screening for and patient education about SCD and SCT. Of the 102 respondents, 100(98%) stated that they were knowledgeable in the medical and genetic aspects of the disease. Regarding screening, 82(80.4%) reported mandatory screening for SCD, 9(8.8%) did not offer screening as routine, and 11(10.8%) gave patients the choice. The majority (93.1%) always informed patients when the test was positive but health-care providers less than six years experience were less likely to communicate SCT status to patients without the trait (odds ratio [OR] = 0.41, 95% CI [0.18-0.93]). Nurses/midwives were less likely to tell patients their carrier status (OR = 0.25, 95% CI [0.10-0.59]). There was also variation in referral practices for genetic counseling, with 26.5% always referring, 28.4% never doing so, and 45.1% only referring if the patient had questions. This may affect patients' awareness of this genetic condition. Therefore, continuous medical education on SCD/SCT and standardization of counseling may help inform couples' family planning choices and reduce the burden of the disease on future generation and health care.