College of Health Sciences
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Item Ghana Medical Journal (Index of 1962-2013)(Ghana Medical Journal, 2014) Sackey, A.H.The Ghana Medical Journal (GMJ), a product of the Ghana Medical Association (GMA), was first published in September 1962. The first edition contained a message from Osagyefo Dr Kwame Nkrumah, President of Ghana and GMA patron, in which he expressed the hope that the “GMJ will afford the means of disseminating medical knowledge among yourselves and your colleagues throughout Africa and beyond”, and “May the pages of the Journal demonstrate the tireless efforts of medical men all over the world in the crusade against disease and ill health.”Item Highly Prevalent Hyperuricaemia Is Associated With Adverse Clinical Outcomes Among Ghanaian Stroke Patients: an Observational Prospective Study(Ghana Medical Journal, 2015-09) Sarfo, F.S.; Akassi, J.; Antwi, N.K.B.; Obese, V.; Adamu, S.; Akpalu, A.; Bedu-Addo, G.Background: Although a direct causal relationship between hyperuricaemia and stroke continues to be debated, strong associations between serum uric acid (SUA) and cerebrovascular disease exist. Very few studies have been conducted to evaluate the frequency and association between this potentially modifiable biomarker of vascular risk and stroke in sub-Saharan Africa. Therefore the aim of this study was to examine the association between hyperuricaemia and the traditional risk factors and the outcomes of stroke in Ghanaian patients. Methods: In this prospective observational study, 147 patients presenting with stroke at a tertiary referral centre in Ghana were consecutively recruited. Patients were screened for vascular risk factors and SUA concentrations measured after an overnight fast. Associations between hyperuricaemia and stroke outcomes were analysed using Kaplan-Meier and Cox proportional hazards regression analysis. Results: The frequency of hyperuricaemia among Ghanaian stroke patients was 46.3%. Non-significant associations were observed between hyperuricaemia and the traditional risk factors of stroke. SUA concentration was positively correlated with stroke severity and associated with early mortality after an acute stroke with unadjusted hazards ratio of 2.3 (1.4 - 4.2, p=0.001). A potent and independent dose-response association between increasing SUA concentration and hazard of mortality was found on Cox proportional hazards regression, aHR (95% CI) of 1.65 (1.14-2.39), p=0.009 for each 100μmol/l increase in SUA. Conclusions: Hyperuricaemia is highly frequent and associated with adverse functional outcomes among Ghanaian stroke patients. Further studies are warranted to determine whether reducing SUA levels after a stroke would be beneficial within our setting.Item Knowledge and use of information and communication technology by health sciences students of the University of Ghana(Ghana Medical Journal, 2016-09) Dery, S.; Vroom, F.D.; Godi, A.; Afagbedzi, S.; Dwomoh, D.Background: Studies have shown that ICT adoption contributes to productivity and economic growth. It is therefore important that health workers have knowledge in ICT to ensure adoption and uptake of ICT tools to enable efficient health delivery. Objective: To determine the knowledge and use of ICT among students of the College of Health Sciences at the University of Ghana. Methods: This was a cross-sectional study conducted among students in all the five Schools of the College of Health Sciences at the University of Ghana. A total of 773 students were sampled from the Schools. Sampling proportionate to size was then used to determine the sample sizes required for each school, academic programme and level of programme. Simple random sampling was subsequently used to select students from each stratum. . Results: Computer knowledge was high among students at almost 99%. About 83% owned computers (p < 0.001) and self-rated computer knowledge was also 87 % (p <0.001). Usage was mostly for studying at 93% (p< 0.001). Conclusions: This study shows students have adequate knowledge and use of computers. It brings about an opportunity to introduce ICT in healthcare delivery to them. This will ensure their adequate preparedness to embrace new ways of delivering care to improve service delivery.Item Changing landscape of public health and medical education curriculum(Ghana Medical Journal, 2018-09) Ofori-Adjei, D.The landscape of public health in many sub-Saharan African countries has been changing rapidly over the past few decades. Marked changes have been seen in the demographic structure of populations, economics, lifestyle changes, social upheavals (war and migration) and these have impacted disease patterns. The population structure indicates that the workforce age band is showing a bulge and life expectancy is ris-ing with an increasingly elderly population. The eco-nomic status of many of these sub-Saharan countries are said to be improving with changes in status from low income to low middle income status. Newer health technologies have influenced the diagnos-ing, assessment and treatment of health problems. Pub-lic health challenges are transitioning from communica-ble diseases to non-communicable diseases, with no discernible reduction in infections, such that sub-Saharan African countries are said to be suffering from the double burden of disease. This change has risen to such levels that non-communicable diseases are rapidly becoming major causes of morbidity and mortality. While some communicable diseases remain endemic, several strategies exist for minimising their health ef-fects. Outbreaks of new and emerging infections have exposed the inadequacies of the health systems, such as occurred with the recent outbreak of Ebola virus disease in West Africa.Item Hearing impairment among chronic kidney disease patients on haemodialysis at a tertiary hospital in Ghana(Ghana Medical Journal, 2019-09) Boateng, J.O.; Boafo, N.; Osafo, C.; Anim-Sampong, S.Background: Chronic kidney disease is a major public health challenge, globally. Inadequate excretion of metabolic waste products by the kidneys results in circulation of these toxic materials in the body. This can cause damage to tissues and organ systems including the auditory system which can lead to hearing loss. Aim: The study was aimed at determining the prevalence, degrees and types of hearing impairment among Chronic kidney disease patients on haemodialysis in Ghana. Methods: A case-control study involving 50 Chronic Kidney disease patients and 50 age and gender-matched control group was carried out at the Korle Bu Teaching Hospital (KBTH). A structured questionnaire was administered to obtain basic socio-demographic data and case history of the participants. Audiological assessment was performed using a test battery comprising otoscopy, tympanometry and pure tone audiometry in a soundproof booth. Results: Higher hearing thresholds were recorded across all the frequencies tested among the case group than the control group (p < 0.05) in both ears. Only sensorineural hearing loss was identified among the cases. The prevalence of hearing loss was 32% among the case group and 12% among the control group. No significant association was observed between hearing loss and duration of Chronic kidney disease (p = 0.16), gender of Chronic kidney disease patient and hearing loss (p = 0.88), and duration of Chronic kidney disease and degree of hearing loss (p=0.31). Conclusion: Our study showed that Chronic Kidney disease patients on haemodialysis are at higher risk of experiencing hearing loss.Item Massive Inguino-scrotal Hernia(Management of Abdominal Hernias: Fifth Edition, 2018-04) Ohene-Yeboah, M.Introduction Inguinal hernia is very common worldwide. In low- and middle-income countries, the estimated repair rate is 30 per 100,000 population per year. Inguino-scrotal Hernia Definition. Kingsnorth H3 and H4 hernias that are 20–30 cm below the pubic crest are massive. Massive hernias are associated with loss of domain as abdominal contents lie in the hernia sac over time. These massive hernias often cause difficulty in walking, sitting or lying down, with mobility dramatically restricted. These hernias are repaired with the patient in the standard prone position with general anaesthesia and endotracheal intubation. The standard oblique groin incision that is extended 1 or 2 cm beyond the pubic tubercle onto the crest adequately exposes the mass of tissue entering the scrotum. Operative steps: The inguinal canal is opened in the standard manner. The internal ring is extended lateral, and the hernia is reduced. If this fails, an omentectomy and/or a colectomy is performed. The posterior wall is repaired with the Lichtenstein procedure. Preoperative progressive pneumoperitoneum and plastic techniques or procedures may be used to increase the capacity of the abdominal cavity and prevent postreduction intra-abdominal hypertension. Closure: The groin and the lower abdominal incisions are closed in the standard manner. Post-operative management: In the immediate post-operative hours, the blood pressure, the urine output and the nasogastric aspirate have to be closely monitored.Item Financing reproductive health services in Africa: The role of aid, insurance, user fees and general taxation(Reproductive Health, Economic Growth and Poverty Reduction in Africa: Frameworks of Analysis, 2010) Enyimayew, N.Financing Reproductive Health Services in Africa: The Role of Aid, Insurance, User fees and General Taxation Nana Enyimayew Without appropriate financial resources, scaling up effective reproductive health interventions in order to achieve the Millennium Development Goal for maternal health (MDG 5)1 will be virtually impossible. Yet little is known about how much is currently being invested in reproductive health services within African countries or whether levels of funding are changing. Estimates place the additional funding requirements to attain universal coverage at a minimum of US$7 billion per year. Other estimates suggest that even greater investments are needed. Irrespective of the precise figure, the conclusion is clear: the financing gap represents a substantial sum in relation to domestic budgets. Adequate, well-managed financing of public health systems in general continues to elude most countries. The difficulty is especially severe in low-income countries, most of which are in Africa, whose health systems struggle with meagre and inequitably distributed resources. Additionally, access to services for the most disadvantaged is usually very poor, further reducing the benefit of already scarce resources for those most in need. Success or otherwise of different health financing strategies is critical in determining the fate of such populations and therefore needs to be documented and presented to inform the development of right policies. Filling the information gaps requires appropriately designed and executed research. At minimum, reproductive health (RH) services may be defined as those activities whose primary purpose is to restore, improve and maintain the health of women and their newborns during pregnancy, childbirth and the seven-day postnatal period. This chapter provides an update of the current knowledge of financing of RH services in Africa and suggests a framework for further research in these areas. It also presents examples of national and regional efforts to adopt and implement financing policies that aim to address national objectives of access, equity, quality and appropriate utilisation of RH services to meet MDG 5 by 2015. Issues of exemptions, subsidies and efficiency are also discussed within the scope of financing RH services. A review of basic services is presented in Table 5.1. Reproductive Health, Economic Growth and Poverty Reduction in Africa 108 Table 5.1: Range of reproductive health services Category of care Interventions Antenatal care Basic antenatal care Management of severe anaemia Treatment of malaria Management of syphilis, gonorrhoea and Chlamydia Normal delivery care Clean and safe delivery Post-partum care Basic newborn care Essential obstetric care Management of eclampsia, sepsis, haemorrhage and abortion complications, plus provision of emergency caesarean section Family planning Family planning information and services Other Prevention and treatment of HIV/AIDS How Much Do Reproductive Health Services Cost? Information from various sources suggests that the per capita cost of providing a package of reproductive health services ranges between US$0.5 and US$6.0 (Weissman et al., 1999; World Bank, 1993). Global costs for reproductive health are estimated at US$7 billion dollars per year till 2015 while analyses done using the methodology of the UN Millennium Project suggest that family planning programmes in Africa alone would increase from US$270 million in 2006 to nearly US$500 million by 2015 (Cleland et al., 2006). A selection of per capita cost estimates is presented in Table 5.2. Table 5.2: Per capita cost estimates for reproductive health services Service Cost (US$) Mother and Baby package (1) 0.5 (current level of service provision) Uganda 1999 1.4–1.8 (standard level of service) WDR Global 1993 (2) 4.0 Making Motherhood Safe (3) 2.0–6.0 Range 0.5–6.0 Sources: (1) Weissman et al. (1999); (2) World Development Report (World Bank, 1993); (3) Ransom and Yinger (2002). Making Motherhood Safer. The wide range of costs reflects the practical difficulty facing service providers, researchers, policy makers and society in general in meeting the requirements for accurate estimates of reproductive health care costs. These include defining the boundaries of RH, and standardising the content and quality of a given package of care. Questions that continue to engage service providers and policy makers are; How much do reproductive health services at household, community and country level Financing Reproductive Health Services in Africa 109 cost? How much must governments and society spend on RH services to achieve national and global targets. What should be the minimum content of a standard package of care if countries in resource-constrained environments are to meet their targets? Global estimates provide a useful guide to...Item Infectious Disease Control in Ghana: Government's Interventions and Challenges to Malaria Eradication(Water and Sanitation-Related Diseases and the Environment: Challenges, Interventions, and Preventive Measures, 2011-10) Fobil, J.N.; May, J.; Kraemer, A.Introduction Ghana Malaria Control Initiatives-Past and Present Successes, Challenges, and Weaknesses of Control Strategies Conclusion and Recommendations References