Theses

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A long essay or dissertation or thesis involving personal research, written by postgraduates of University of Ghana for a university degree.

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    Human Papillomavirus (HPV) Infection And Its Association With Cervical Dysplasia Among HIV Positive Women Attending Art Clinic, Korle-Bu Teaching Hospital, Accra
    (University Of Ghana, 2019-07) Amelor, D.K.
    Globally, about 35 million people are living with HIV of which 16 million are women aged 15 years and above, 80% of whom live in the Sub-Saharan African region These women living with HIV (WLHIV), especially those having low CD4 T-cell counts are more likely to be infected with human papillomaviruses (HPV), which are the major cause of cervical cancer and it’s precursor lesions. But less is known about the prevalence of HPV infection and the specific types involved in this particular population of women in Ghana. A cross-sectional study was carried out to establish the distribution of genital HPV genotypes among an unscreened population of WLHIV attending a special HIV outpatient clinic at the Korle-Bu Teaching hospital (KBTH) Accra, Ghana. Cervical swabs were available for 538 eligible women. A nested multiplex PCR (NMPCR) assay was conducted for the detection and typing of HPV genotypes 6/11, 16,18, 31, 33, 35, 39, 42, 43, 44, 45, 51, 52, 56, 58, 59, 66, and 68. Cervical smears were also prepared and examined independently for cytologic abnormalities by two cytologists and confirmed by a pathologist. HPV DNA was detected in 52.0% of all cervical swabs tested, the prevalence of LR (Low Risk) HPV was 10.2% (95% CI: 11.3 – 17.6). while that of HR (High Risk) HPV was 29.7% (95% CI: 27.4 – 35.7). The commonest HR types were, HPV-35 (14.1%), HPV-18 (13.0%;), HPV-58 (7.4%;), HPV-52 (7.2%;), HPV-45 (4.8%;) and HPV 42, a low-risk type, was also common (7.8%;). The frequency of HPV 16 was 2.4%. Cytologicaly, 2.8% had ASCUS, 3.9% LGSIL and 2.8% HGSIL, None of the women was found to have atypical glandular cells or adenocarcinoma. There is a high burden of HPV in women living with HIV attending clinic at the KBTH. I recommend that screening for cervical dysplasia should be done for WLHIV routinely as part of their comprehensive care.
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    Knowledge of Patients with Diabetes Mellitus on Nutritional Management: A Study at the Korle-Bu Teaching Hospital, Accra
    (University of Ghana, 2019-07) Opoku-Addai, K.
    The rising mortality rate of diabetes mellitus and the upsurge in diabetes complications is very alarming. This has been attributed to the poor knowledge patients living with diabetes have on diabetes and its management, especially the nutritional management. This study sought to explore the knowledge on nutritional management of diabetes mellitus among patients living with diabetes mellitus who attended clinic at the National Diabetes Management and Research Centre of the Korle-Bu Teaching Hospital. An exploratory descriptive qualitative research design was used for this study. Purposive sampling was used to recruit fifteen participants for the study. The participants were interviewed using a semi-structured interview guide which was developed using the Information-Motivation-Behavioural Skills model which defined the research objectives and served as the organizing framework for the study. Data was analyzed using thematic content analysis approach, out of which five main themes emerged. The main themes identified were knowledge on nutritional management of diabetes, motivation to undertake nutritional management of diabetes, support systems relied on in the care and management of diabetes, skills or practices on nutritional management of diabetes, and challenges to adherence of optimal nutritional management of diabetes. The study revealed that the participants have adequate knowledge on the nutritional management of diabetes, they are well motivated and have varied support systems that enable them to engage in healthy eating. They also have adequate meal planning skills, and generally engage in optimal nutritional management of their condition due to their healthy dietary practices. In addition, the study found that the participants have poor knowledge on diabetes peer support groups and do not participate in such groups, as well as have deficient knowledge and skills in the reading and usage of food labels. There is the need to equip patients with diabetes with the needed knowledge and skills on food label reading, educate them on diabetes peer support groups, and integrate them into these groups. It is therefore suggested that health care professionals such as nurses and doctors should find practical and robust ways to factor these elements into patients care and management in general. It is also recommended that future research should be considered in multiple sites in order to generalize the findings. It is concluded that patients with diabetes mellitus may be able to engage in optimal nutritional management if they are motivated and offered the needed and reliable information by health care professionals such as nurses on the nutritional care of their condition.
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    The Impact of Aphasia Education on Families of Stroke Survivors: A Case Study of the Stroke Unit of Korle-Bu Teaching Hospital, Accra, Ghana
    (University of Ghana, 2018-07) Agbeko, G.A.
    Background: Aphasia is an acquired language impairment which is the result of a scratch of the focal brain even when other cognitive, motor or sensory impairment is not present. It often follows a stroke. Globally, about 30-35% of stroke patients suffer aphasia after they have been hospitalized for stroke. The resulting aphasia leads to difficulties with reading, writing, and expressive and receptive language. The provision of standard education to stroke inpatients, and providing further education support to their caregivers in follow-up home visits after hospital discharge, is standard practice. In Ghana, community awareness of the risk of stroke is unsatisfactory. Nurses at the Stroke Unit at Korle Bu Teaching Hospital (KBTH) educate aphasia caregivers on communication with persons with aphasia. Sometimes nurses counsel caregivers as well. Aim: The aim of the study is to investigate the nature, effectiveness and benefits of aphasia education, provided to family caregivers of persons with aphasia at the Stroke Unit of KBTH. Methods: In this study, caregivers of 20 randomly selected stroke and aphasia patients, who previously reported at the Stroke Unit of KBTH were recruited and interviewed, using an interview guide. Questionnaires were administered to elicit data from the Stroke unit of KBTH, about how family caregivers are educated to improve communication with patients. Outcome: The study has shown that education given to family caregivers at the Stroke Unit of KBTH helps to improve communication for persons with aphasia at home after hospitalization. Conclusion: A formalized and well-structured aphasia education for patients who report at the Stroke Unit will help facilitate patient communication if aphasia sets in after the stroke.
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    Viral Agents In The Cerebrospinal Fluid Of Hospitalized HIV Patients With Meningitis At The Fevers Unit, Korle- Bu Teaching Hospital
    (University of Ghana, 2016-07) Adjei, E.A.
    Introduction: Meningitis is one of the leading causes of death among patients living with HIV in sub-Saharan Africa. Based on clinical presentations, the different types of meningitis may not be distinguished from each other therefore, accurate laboratory diagnosis is extremely essential. Viruses such as Enteroviruses, Mumps virus and Herpes Simplex Virus-1 are implicated in cases of meningitis. Aim: The aim of the study was to determine the prevalence of viral meningitis among hospitalized HIV patients at the Fevers Unit (FU) of Korle Bu Teaching Hospital (KBTH). Method: This was a cross-sectional study in which cerebrospinal fluid (CSF) specimens were collected from hospitalized HIV patients at the FU of KBTH with clinical features of meningitis but yet to be confirmed. Specimens were tested by Real-time PCR for Enteroviruses, Mumps Virus and Herpes Simplex Virus-1. Clinical and laboratory tests data on patients were analyzed and CSF parameters were also ascertained. Results: A total of 80 CSF specimens were collected from patients. Thirty- seven (37) of the subjects were males and 43 were females. Majority (81.25%) of the patients were between the ages of 30 and 49 years. The major clinical symptoms seen in the patients were headache and fever with 35% exhibiting meningismus. Lymphocytic pleocytosis was observed in 30 while neutrophilic predominance was observed in 7 of the subjects. About two-thirds (53) of the patients had CD4 count less than 200cells/mm3 and most were in Stage III and IV of HIV (68). Patients within normal range of glucose accounted for 71.25% while patients with elevated glucose level were 5 (6.25%). Fifty-four (67.50%) of the subjects had an elevated CSF protein level while 26(32.50%) had a CSF protein level less than 0.45. Most (68.75%) of the patients were not on ART. The study was unable to detect Enteroviruses, Mumps virus and HSV-1 in the CSF of patients with suspected meningitis by real time PCR. Conclusion: None of the viruses (EV, MuV, HSV-1) investigated in this study was implicated in the suspected cases of meningitis. However, lymphocytic pleocytosis, normal glucose and elevated protein levels were observed in majority of study participants