Department of Haematology
Permanent URI for this collectionhttp://197.255.125.131:4000/handle/123456789/23047
Browse
49 results
Search Results
Item Fetomaternal hemorrhage among pregnant women in Accra, Ghana(International Federation of Gynecology and Obstetrics, 2019-07-04) Akorsu, E.E.; Acquaye, J.K.; Benneh, A.A.; Oppong, S.A.; Olayemi, E.Objective: To determine the occurrence of and risk factors for fetomaternal hemorrhage (FMH) among pregnant women at Korle Bu Teaching Hospital in Accra, Ghana. Methods: A prospective study of FMH among pregnant women without hemoglobinopathies in the second trimester attending prenatal care between October 2015 and May 2016 performed using the Kleihauer-Betke test. Volume of FMH was estimated; ABO and Rh blood groups of participants were determined. A data extraction form and structured questionnaire were used to collect demographic and clinical information, and data on risk factors. Results: Of 151 participants, 32 (21.2%) had FMH. Almost 18% (n=27) had FMH at baseline (16–24 weeks), 10% (10/100) at 28–32 weeks, and 11.1% (11/99) at 34–37 weeks of pregnancy. Volume of FMH was less than 30 mL in 30 (19.9%) women, whereas it was greater than 30 mL in 2 (1.3%) women. No identifiable patient-specific factors were associated with occurrence of FMH. Conclusion: FMH is common among pregnant women in Ghana and can occur as early as 16 weeks, without identifiable risk factors. RhD negative women who may be pregnant with RhD positive fetuses should be screened early in pregnancy, not only at delivery, for occurrence of FMH.Item Prevalence of potentially zoonotic gastrointestinal parasites in canine faeces in Ibadan, Nigeria(Ghana Medical Journal, 2016-12) Ayinmode, A.B.; Obebe, O.; Olayemi, E.Background: Humans can get infected through direct or indirect contact with infective stages of zoonotic parasites shed to the environment through dog faeces. Objectives: This study was designed to investigate the presence of gastrointestinal parasites present in dog faeces shed on the street of Ibadan metropolis, one of the largest cities in Africa. Methods: Twenty-three locations were randomly selected using grid-sampling method. A total of 203 faecal samples collected from the streets of selected areas were processed for detection of helminth eggs and protozoan oocysts using flotation technique. Eggs/oocysts per gram of faeces was counted using modified McMaster technique. Results: The prevalence of gastrointestinal parasites was 43.3% (88/203). Single and multiple infections were 69 (78.4%) and 19 (21.6%) respectively. The parasites detected were Ancylostoma sp. 24.6% (50/88) Isospora sp. 14.2% (29/88), Toxocara sp. 9.8% (20/88), Uncinaria sp. 2.5% (5/88) and Strongyloides sp, 3.9% (8/88). Ancylostoma sp. (320 x 102 epg) and Uncinaria sp. (5 x 102 epg) had the highest and least intensity respectively. Streets within residential areas having markets had the highest number of positive samples. All the genera of parasites detected in this study have zoonotic potential. Conclusion: The high prevalence of zoonotic parasites detected in dog faeces from Ibadan metropolis showed that infected stray dogs roam the streets and constitute potential risk to human health. This study suggests the need for enforcement of laws restraining roaming or straying dogs and proper veterinary care of dogs.Item Sensorineural Hearing Loss in Ghanaians with Sickle Cell disease.(Ghana Medical Journal, 1989-01) Ankra-Badu, G.; Atsina, K.K.A study seeking to determine whether Sensorineural hearing loss occurs with similar prevalence in sickle cell haemoglobin (Hb) SS and SC disease patients was conducted on 200 subjects comprising 93 Hb SC patients, 55 Hb SS patient. and 52 Hb AA subjects serving as controls. Each subject was given haematological and pure tone audiological examinations. Three out of 93 Hb SC patient (3.2%) showed hearing losses ranging from 30 10 40 dB but 15 out of 55 Hb SS patients (27.3%) exhibited hearing loss ranging from 30 to 60 dB. All hearing losses were in the high frequency range of 4 to 8kHz, Further studies art required to determine why Sensorineural hearing loss is prevalent in Hb SS patients but not so common in Hb SC patients.Item Ten Years of Preoperative Autologous Blood Donation in Accra(Ghana Medical Journal, 2006-12) Ansah, J.K.; Acquaye, J.K.Background - Preoperative autologous blood donation (PABD) is utilized to circumvent the use of allogenic blood for various reasons. Objective - To describe the distribution in terms of demographic characteristic, trends in participation and result of screening test of the PABD programme of the Accra Area Blood Center from 1993-2003. Design and Setting Retrospective descriptive study of PABD in patients scheduled for a variety of elective surgical procedures. Setting- Different levels of institutional health care in Accra, Ghana. Methods Data from existing records of patients who had participated in PABD were collated and analyzed Results Five hundred and forty six (546) females and 89 males participated, with ages ranging between 14-74 years. Majority of the patients (76.7%) underwent gynaecological surgery. A total of 330 (52%) donated one unit only, and 299 (47.1%) donated two units. Majority of the patients (56.4%) had the surgery at the Korle-Bu Teaching Hospital (KBTH). Of the donations, 21 (3.3%), 1 (0.2%), 1 (0.3%) and nil were positive for HBV, HIV I & II, HCV and VDRL respectively. A total of 848 (89.4%) autologous crossmatched units were issued out. There was a steady progressive increase in participation. Conclusion Mainly adult females scheduled for gynaecological surgeries in KBTH participated, while almost equal proportions donated one or two units of blood which meets the blood needs of most elective surgeries. Therefore healthy patients going for elective surgeries in regions with limited blood supply must be encouraged to enter a PABD Programme. Further studies in this field should evaluate motivational factors for participationItem Presentation and survival of multiple myeloma patients in Ghana: a review of 169 cases(Ghana medical journal, 2019-03) Dei-Adomakoh, Y.; Acquah, M.E.; Hsing, A.W.; McGuire, V.; Wang, S.; Birmann, B.Background: Africans have an increased risk for multiple myeloma (MM) compared to other races. Reports from Africa are few and involve small cohorts, but suggest significant epidemiological and clinical differences from Caucasian patients. Objective: This report describes the clinic-pathological features of MM patients in Ghana at diagnosis, and the factors affecting their survival. Methods: A retrospective review of 169 MM cases diagnosed in a Ghanaian tertiary hospital from 2002-2016. Results: Median age was 58 years, with 29% ≤50 years. One-third presented >12 months after onset of symptoms, which included bone pain (96%), anaemia (67%), weight loss (55%) and fractures (44%). Myeloma-related tissue impairment included hypercalcaemia (36%), renal impairment (33%), severe anaemia (52%) and osteolytic lesions (76%); 51.3% of patients were diagnosed in ISS Stage III. Median survival was 33 months; 1-year and 5-year overall survival were 51.6% and 15.5%, respectively. Neither the age at diagnosis nor the duration of symptoms prior to diagnosis correlated with prognosis. Median survival improved with early ISS stage, haemoglobin >8g/dL, plasmacytosis <20%, and normal creatinine and calcium levels. Conclusion: Early onset and late stage presentation are common at diagnosis of MM patients in Ghana, but do not affect survival. Studies into genetic associations are recommended.Item Guidelines in lower-middle income countries(British Journal of Haematology, 2017-03) Olayemi, E.; Asare, E.V.; Benneh-Akwasi Kuma, A.A.Guidelines include recommendations intended to optimize patient care; used appropriately, they make healthcare consistent and efficient. In most lower-middle income countries (LMICs), there is a paucity of well-designed guidelines; as a result, healthcare workers depend on guidelines developed in Higher Income Countries (HICs). However, local guidelines are more likely to be implemented because they are applicable to the specific environment; and consider factors such as availability of resources, specialized skills and local culture. If guidelines developed in HICs are to be implemented in LMICs, developers need to incorporate local experts in their development. Involvement of local stakeholders may improve the rates of implementation by identifying and removing barriers to implementation in LMICs. Another option is to encourage local experts to adapt them for use in LMICs; these guidelines may recommend strategies different from those used in HICs, but will be aimed at achieving the best practicable standard of care. Infrastructural deficits in LMICs could be improved by learning from and building on the successful response to the human immunodeficiency virus/acquired immunodeficiency syndrome pandemic through interactions between HICs and LMICs. Similarly, collaborations between postgraduate medical colleges in both HICs and LMICs may help specialist doctors training in LMICs develop skills required for guideline development and implementation. © 2017 John Wiley & Sons LtdItem Implementation of multidisciplinary care reduces maternal mortality in women with sickle cell disease living in low-resource setting(Social Science Journal, 2017-05) Asare, E.V.; Olayemi, E.; Boafor, T.; Dei-Adomakoh, Y.; Mensah, E.; Ghansah, H.; Osei-Bonsu, Y.; Crabbe, S.; Musah, L.; Hayfron-Benjamin, C.; Covert, B.; Kassim, A.A.; James, A.Sickle cell disease (SCD) is associated with adverse pregnancy outcome. In women with SCD living in low-resource settings, pregnancy is associated with significantly increased maternal and perinatal mortality rates. We tested the hypothesis that implementing a multidisciplinary obstetric and hematology care team in a low-resource setting would significantly reduce maternal and perinatal mortality rates. We conducted a before-and-after study, at the Korle-Bu Teaching Hospital in Accra, Ghana, to evaluate the effect of a multidisciplinary obstetric-hematology care team for women with SCD in a combined SCD-Obstetric Clinic. The pre-intervention period was assessed through a retrospective chart review to identify every death and the post-intervention period was assessed prospectively. Interventions consisted of joint obstetrician and hematologist outpatient and acute inpatient reviews, close maternal and fetal surveillance, and simple protocols for management of acute chest syndrome and acute pain episodes. Primary outcomes included maternal and perinatal mortality rates before and after the study period. A total of 158 and 90 pregnant women with SCD were evaluated in the pre- and post- intervention periods, respectively. The maternal mortality rate decreased from 10 791 per 100 000 live births at pre-intervention to 1176 per 100 000 at postintervention, representing a risk reduction of 89.1% (P50.007). Perinatal mortality decreased from 60.8 per 1000 total births at pre-intervention to 23.0 per 1000 at post-intervention, representing a risk reduction of 62.2% (P50.20). A multidisciplinary obstetric and hematology team approach can dramatically reduce maternal and perinatal mortality in a low-resource setting.© 2017 Wiley Periodicals, Inc.Item Sjögren's and plasma cell variant Castleman disease: a case report(Ghana medical journal, 2018-04) Dei-Adomakoh, Y.A.; Quarcoopome, L.; Abrahams, A.D.; Segbefia, C.I.; Dey, D.I.Castleman disease is a rare cause of lymphoid hyperplasia and may result in localized symptoms or an aggressive, multisystem disorder. It can mimic other diseases like lymphoma or tuberculosis. It classically presents as a mediastinal mass that involves the lymphatic tissue primarily but can also affect extra lymphatic sites including the lungs, larynx, parotid glands, pancreas, meninges, and muscles. In HIV and HHV8-negative patients with idiopathic multi-centric Castleman disease, pathogenesis may involve autoimmune mechanisms. We highlight and report a case of a 34-year-old Ghanaian female who was successfully diagnosed and managed for Sjögren's as well as plasma cell variant Castleman disease with combination chemotherapy and rituximab followed by eighteen months maintenance therapy with pulse chlorambucil and prednisolone and three monthly rituximab.Item Augmented NRF2 activation protects adult sickle mice from lethal acute chest syndrome(British Journal of Haematology, 2018-06) Ghosh, S.; Hazra, R.; Ihunnah, C.A.; Weidert, F.; Flage, B.; Ofori-Acquah, S.F.Acute chest syndrome (ACS) mortality in sickle cell disease (SCD) rises sharply in young adult patients and mechanism-based prophylaxis is lacking. In SCD, haem oxygenase-1 (HO-1) declines with age and ACS is associated with low HO-1. To test if enhanced HO-1 can reduce ACS mortality, young SCD mice were treated with D3T (3H-1,2-dithiole-3-thione), an activator of nuclear-factor erythroid 2 like 2, which controls HO-1 expression, for 3 months. Following haem-induced ACS, all vehicle-treated mice succumbed to severe lung injury, while D3T-treated mice had significantly improved survival. Blocking HO-1 activity abrogated the D3T effect. Thus HO-1 may be targeted to reduce ACS severity in adult patients.Item Lung Function Abnormalities in Sickle Cell Anaemia(Advances in Hematology, 2019-04) Dei-Adomakoh, Y.A.; Afriyie-Mensah, J.S.; Forson, A.; Adadey, M.; Ndanu, T.A.; Acquaye, J.K.Background. Abnormalities in lung function tests have been shown to commonly occur in a majority of patients with sickle cell disease (SCD) even at steady state. The prevalence and pattern of these lung function abnormalities have been described in other populations but this is unknown among our sickle cell cohort. There is generally little information available on risk factors associated with the lung function abnormalities and its relevance in patient care. Method. This was an analytical cross-sectional study involving 76 clinically stable, hydroxyurea-naive adult Hb-SS participants and 76 nonsickle cell disease (non-SCD) controls. A structured questionnaire was used to obtain sociodemographic data and clinical history of the participants. Investigations performed included spirometry, pulse oximetry, tricuspid regurgitant jet velocity (TRV) measurements via echocardiogram, complete blood counts, free plasma haemoglobin, serum urea, and creatinine. Results. Weight, BMI, mean FVC, and FEV1% predicted values were comparatively lower among the Hb-SS patients (p < 0.001). Abnormal spirometry outcome occurred in 70.4% of Hb-SS patients, predominantly restrictive defects (p < 0.001), and showed no significant association with steady-state Hb, WBC count, free plasma haemoglobin, frequency of sickling crisis, chronic leg ulcers, and TRV measurements (p > 0.05). The mean oxygen saturation was comparatively lower among Hb-SS patients (p < 0.001). Conclusion. Measured lung volumes were significantly lower in Hb-SS patients when compared to non-SCD controls and this difference was not influenced by anthropometric variance. Lung function abnormalities, particularly restrictive defects, are prevalent in Hb-SS patients but showed no significant association with recognized markers of disease severity.