School of Biomedical and Allied Health Sciences
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Item Brief communication: coagulation profiles of HIV positive patients on antiretroviral therapy (ART) at the Mampong Municipal Hospital, Ashanti-Region, Ghana: a case control study(AIDS Research and Therapy, 2024) Opoku, F. B.; Yalley, A.K.; Nii-Trebi, N.I.; et al.This study aimed to ascertain how the current two ART regimens used in Ghana affected HIV patients’ coagulation profiles. A case-control study was conducted on 102 HIV positive patients at the Mampong Municipal Hospital. Coagulation parameters measured showed APTT was normal in majority of ART-experienced participants but prolonged in majority of ART-naïve participants. The mean platelet count was significantly higher in ART experienced participants. No significant differences were found between the coagulation profiles of ART experienced patients on two different drug regimens. In conclusion, current ART can enhance the coagulation profiles in HIV-infected patients, by improving platelet count and APTT.Item A comprehensive lifestyle index and its associations with DNA methylation and type 2 diabetes among Ghanaian adults: the rodam study(Clinical Epigenetics, 2024) Abidha, C. A.; Meeks, K. A. C.; Hayfron‑Benjamin, C.; et al.Background A series of modifiable lifestyle factors, such as diet quality, physical activity, alcohol intake, and smoking, may drive the rising burden of type 2 diabetes (T2DM) among sub-Saharan Africans globally. It is unclear whether epi genetic changes play a mediatory role in the associations between these lifestyle factors and T2DM. We assessed the associations between a comprehensive lifestyle index, DNA methylation and T2DM among Ghanaian adults. Methods We used whole-blood Illumina 450 k DNA methylation data from 713 Ghanaians from the Research on Obesity and Diabetes among African Migrants (RODAM) study. We constructed a comprehensive lifestyle index based on established cut-offs for diet quality, physical activity, alcohol intake, and smoking status. In the T2DM-fre discovery cohort (n=457), linear models were fatted to identify differentially methylated positions (DMPs) and diferenterally methylated regions (DMRs) associated with the lifestyle index after adjustment for age, sex, body mass index (BMI), and technical covariates. Associations between the identified DMPs and the primary outcome (T2DM), as well as secondary outcomes (fasting blood glucose (FBG) and HbA1c), were determined via logistic and linear regression models, respectively. Results In the present study population (mean age: 52±10 years; male: 42.6%), the comprehensive lifestyle index showed a significant association with one DMP annotated to an intergenic region on chromosome 7 (false discovery rate (FDR)=0.024). Others were annotated to ADCY7, SMARCE1, AHRR, LOXL2, and PTBP1 genes. One DMR was identified and annotated to the GFPT2 gene (familywise error rate (FWER) from bumphunter bootstrap=0.036). None of the DMPs showed significant associations with T2DM; directions of effect were positive for the DMP in the AHRR and inverse for all the other DMPs. Higher methylation of the ADCY7 DMP was associated with higher FBG (p=0.024); LOXL2 DMP was associated with lower FBG (p=0.023) and HbA1c (p=0.049); and PTBP1 DMP was associated with lower HbA1c (p=0.002). Conclusions In this explorative epigenome-wide association study among Ghanaians, we identified one DMP and DMR associated with a comprehensive lifestyle index not previously associated with individual lifestyle factors.Item Radiation therapist education and the changing landscape in Africa(Technical Innovations & Patient Support in Radiation Oncology, 2024-07-19) Kyei, A. K.; Engel-Hills, P.In the changing global landscape, education programs for radiation therapists (RTTs), also known as therapeutic radiographers or radiation therapy technologists, at higher education institutions (HEIs) are non-existent in many African countries. In countries with local RTT education programs, there is evidence of a wide variety of qualification types, including in-house training, diploma and degree offerings. However, what is consistent is the integrated curriculum approach to classroom theory and clinical work-based learning that across the continent follows the general structure of a work-integrated learning (WIL) approach, to enhance clinical competence and meet the needs of the health sector. This study used a qualitative approach with thematic analysis of publicly available documents and reflective writings followed by further analysis through application of the Cultural Historical Activity Theory (CHAT) to explore the changing landscape of oncology in Africa and the impact of this on the education of RTTs. The study was guided by the reflective research question: How can the systemic understanding of RTT training in a changing landscape enable competent and caring practice? The study extends prior research on RTT education in Africa and contributes to debates on the changing role of RTTs in a rapidly changing environment.Item High prevalence of late presentation with advanced HIV disease and its predictors among newly diagnosed patients in Kumasi, Ghana(BMC Infectious Diseases, 2024) Sakyi, S.A.; Kwarteng, S.; Owusu, E.; et al.Background Late presentation with advanced HIV disease (LP-AHD) remains a significant challenge to Human Immunodeficiency Virus (HIV) care, contributing to increased morbidity, mortality, and healthcare costs. Despite global efforts to enhance early diagnosis, a considerable proportion of individuals with HIV infection are unaware of being infected and therefore present late for HIV care. For the first time in Ghana, this study assessed the prevalence of LP-AHD and associated factors among people diagnosed with HIV (PDWH). Method This bi-center retrospective cross-sectional study included 315 PDWH at the Aniniwah Medical Centre and Komfo Anokye Teaching Hospital, both in Kumasi, Ghana. A well-structured questionnaire was used to collect data on sociodemographic, clinical, lifestyle and psychosocial factors from the study participants. Statistical analyses were done in SPSS version 26.0 and GraphPad Prism version 8.0 at significant p-value of <0.05 and 95% confidence interval. Predictors of LP-AHD were assessed using binary logistic regression models. Results This study observed that, 90 out of the 315 study PDWH (28.6%) reported late with advanced HIV disease (AHD). Participants within the age group of 36–45 years (adjusted Odds Ratio [aOR]: 0.32, 95% CI: 0.14–0.69; p=0.004) showed a significantly decreased likelihood of LP-AHD. However, participants who perceived cost of HIV care to be high (aOR: 7.04, 95% CI: 1.31–37.91; p=0.023), who were diagnosed based on clinical suspicion (aOR: 13.86, 95 CI: 1.83–104.80; p=0.011), and missed opportunities for early diagnosis by clinicians (aOR: 2.47, 95% CI: 1.30–4.74; p=0.006) were significantly associated with increased likelihood of LP-AHD. Conclusion The prevalence of LP-AHD among PDWH in Ghana is high. Efforts to improve early initiation of HIV/AIDS care should focus on factors such as the high perceived costs of HIV care, diagnosis based on clinical suspicion, and missed opportunities for early diagnosis by physicians.Item Speaking of Online Learning: Alternative Practice-Based Learning Experiences for Speech Pathologists in Australia, Ghana and Hong Kong(International Journal of Practice-based Learning in Health and Social Care, 2022) Skeat, J.; Bampoe, J.O.; Booth, S.; et al.Speech Pathology programs usually send students to workplaces to learn clinical skills necessary for practice. During COVID-19, programs needed to respond quickly to ensure that students continued to gain the necessary experiences and skills required to progress through their program and graduate as clinicians, while simultaneously complying with COVID-19 requirements. Case studies from seven different universities in Australia and Ghana and Hong Kong described the diverse ways in which placements were adapted to be COVID-safe, taking into account local needs. Some practices which had been included in placement education prior to the pandemic, such as telepractice and simulation-based learning, extended and developed during this time. Educators, students, clinicians and clients responded to the rapidly changing needs of the time with flexibility and innovation, utilising a variety of technologies and tools to support case-based and virtual learning opportunities. Feedback from these diverse stakeholders about the experiences was positive, despite inevitable limitations and less-than-ideal circumstances. The positive findings provided insights for consideration in the future: could strategies implemented in response to the pandemic continue to be incorporated into placement experiences, enhancing current practices and maintaining student performance outcomes? Exceptional circumstances prompted exceptional responses; flexibility and innovation were accelerated in response to the pandemic and may transform future placement-based learning opportunities.Item Dietary patterns associated with body mass index in selected adult populations in Accra, Ghana(HSI Journal, 2024) Alo, B.; Ainuson-Quampah, J.; Towu, R.; Amoako-Mensah, A.; Akuetteh, N.T.; Asante, M.Background: Dietary pattern analysis is more appropriate for explaining diet-disease relationships instead of single nutrients in the treatment and prevention of diet and diseases. Objective: The study aimed to identify dietary patterns and explore their association with body mass index among adults in selected areas in Accra. Methods: This was a retrospective study comprising four (4) cross-sectional studies among healthy adults in the Greater Accra region of Ghana. Appropriately designed/pre-tested questionnaires submitted by 208 respondents were analysed for food patterns using principal component analysis to estimate pattern scores for each food item. Statistical significance was set at p < 0.05. Results: Eight dietary patterns explaining 54.8% of the variation in the dietary intake of the study participants were identified. These were the traditional pattern, combined pattern, major protein pattern, modified pattern, white and red meat pattern, sweets and pastries pattern, rare dietary pattern and vegetables with moisture pattern. The mean BMI of the population was 23.1 ± 3.9 kg/m2 , with the prevalence of underweight, normal weight, overweight and obese observed to be 5.8%, 68.3%, 19.7%, and 6.2%, respectively. The traditional dietary pattern and the sweets and pastries patterns were significantly associated with BMI (p < 0.05 and p ˂ 0.001, respectively). Conclusion: Eight (8) dietary patterns were identified. The traditional sweets and pastries patterns were found to be related to weight gainItem Editorial: Contextualizing psychological assessment in Africa: COVID-19 and beyond(Frontiers in Psychology, 2023) Oppong, S.; Appiah, R.; Hapunda, G.; Kheswa, J.G.Historically, the science of Psychology and the practice of psychological assessment have in Africa have been influenced by Western ideologies and practices (Nsamenang, 2007; Oppong et al., 2022). However, there are vast cultural differences among people of different social structures and value orientations. Therefore, there is a growing need for locally generated and validated tools to assess the strengths, capacities, and mental health of the African people (Oppong, 2017; Laher, 2019; Appiah et al., 2020; Oppong et al., 2022), who are often under-represented in global psychological research (Nielsen et al., 2017; Rad et al., 2018; Thalmayer et al., 2021). The overarching importance of generating and administering context-appropriate measures is that it strengthens the drive toward ensuring valid, reliable, and context-worthy assessment of mental health and psychological wellbeing among individuals, groups, and communities in the context of research and practice.Item Reservoirs of Nosocomial Pathogens in Intensive Care Units: A Systematic Review(Environmental Health Insights, 2024) Osman, A-H.; Darkwah, S.; Kotey, F.C.N.; et al.Background: Nosocomial pathogens are known to exacerbate morbidity and mortality in contemporary critical healthcare. Hospital fomites, which include inanimate surfaces, have been identified as “breeding grounds” for pathogens that cause nosocomial infections. This systematic review aimed to deliver incisive insights on nosocomial pathogens in intensive care units (ICUs) and the role of fomites as potential reservoirs for their transmission. Method: An extensive exploration of electronic databases, including PubMed and Scopus, from 1990 to 2023, was carried out between 25th and 29th May 2023, per standard PRISMA guidelines. Information were extracted from articles that reported on fomites in the ICU. Studies that did not quantitatively report the fomite contamination, and those that exclusively took samples from patients in the ICU were excluded from the analysis. Results: About 40% of the total samples collected on fomites from all the studies yielded microbial growth, with species of Staphylococcus being the most predominant. Other prevalent microbes were Acinetobacter baumannii, Escherichia coli, Klebsiella pneumoniae, Candida spp., Enterococcus sp., and Enterobacter sp. The neonatal intensive care unit (NICU) had the highest proportion of contaminated fomites. Among known fomites, the sphygmomanometer exhibited a 100% detection rate of nosocomial pathogens. This included E. aero genes, Staphylococcus aureus, coagulase-negative Staphylococci (CoNS), E. coli, and K. pneumoniae. Multidrug-resistant (MDR) bacteria, such as methicillin-resistant S. aureus (MRSA), vancomycin-resistant Enterococci (VRE), extended-spectrum beta-lactamase (ESBL)-producing E. coli, and MDR Pseudomonas aeruginosa were commonly isolated on fomites in the ICUs. Conclusion: Many fomites that are readily used in patient care in the ICU harbour nosocomial pathogens. The most common fomite appeared to be mobile phones, sphygmomanometers, and stethoscopes, with Staphylococcus being the most common contaminant. Consequently, the need for rigorous disinfection and sterilization protocols on fomites in the ICU cannot be overemphasized. Additionally, heightened awareness on the subject among health professionals is crucial to mitigating the risk and burden of nosocomial infections caused by drug-resistant bacteria.Item Survival rate of cervical cancer: a five year review at a Major Teaching Hospital in Ghana, West Africa(ecancer, 2024) Daniels, J.; Asante, K.; Tackie, J.N.O.; Kyei, K.A.Cervical cancer (CC) is one of the leading causes of cancer-related deaths among females in Ghana. Despite the magnitude of the public health challenge posed by CC in Ghana, survival data as well as reported incidence and mortality rates are primarily based on studies conducted in the capital city of the country. Even though age at diagnosis is known to affect the overall survival of CC patients, the role of this factor in the prognosis of CC patients in Ghana has not been sufficiently explored. The aim of this study was to determine the 5-year survival rate of Ghanaian woman treated for CC at a large tertiary healthcare facility in Ghana. This research was a single-institution-based quantitative ret rospective cohort study conducted among patients with histopathologically confirmed CC. Clinical and socio-demographic data were retrieved from patients’ medical records. Data analysis was done using the Statistical Package for the Social Sciences software ver sion 23. Kaplan Meier curves were used to present the survival rates and median survival time. The peak age at diagnosis was between 45 and 80 years with the modal age group of patients between 75 and 80 years. The mean age at diagnosis was 63.3 ± 15.7 years ranging from 27 to 104 years. The overall survival rates at 1, 3 and 5 years were 76.5%, 51.5% and 32.4%, respectively. The median survival time was 65.8 months. Age < 50 years was associated with higher survival estimates than age >50 years. The 5-year over all survival rate of CC patients reported in this study (32.4%) is relatively low compared with countries in the developed world but like previous reports at other healthcare facili ties in Ghana as well as in other underdeveloped countriesItem A look back, a path forward: Revisiting the mental health and well-being research and practice models and priorities in sub-Saharan Africa(New Ideas in Psychology, 2022) Appiah, R.Despite the enthusiasm to promote mental health in Ghana and sub-Saharan Africa more generally, the models and frameworks that underpin research and practice in these settings have focused exclusively on understanding and treating mental disorders, to the neglect of the mental health needs of the general, non-clinical population. We discuss the limitations of the bipolar and biomedical models as frameworks for mental health research and practice in the current paradigm. Using Ghana as a case example, we identify gaps in the mental health research priorities in sub-Saharan Africa, and discuss the limitations of the revised Mental Health Policy of Ghana in ensuring a mentally healthy population. Drawing on a consilience of evidence from the literature, we contend that, although important and laudatory, the current research approach and priorities, which remain overwhelmingly fixated on alleviating and treating symptoms of mental disorders, are insufficient to buffer against psychopathology and bolster positive mental health. We argue for the adoption of more global and empirically tested frameworks and population-based approaches to complement clinical approaches to reduce the population burden of mental health problems.