Research Articles

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A research article reports the results of original research, assesses its contribution to the body of knowledge in a given area, and is published in a peer-reviewed scholarly journal. The faculty publications through published and on-going articles/researches are captured in this community

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Now showing 1 - 10 of 12
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    Inflammatory bowel disease at Korle-bu teaching hospital: case reports
    (Ghana Medical Journal, 2000-03) Nkrumah, K.N.
    Inflammatory bowel disease is regarded as uncommon or even rare in Sub-Saharan Africa. Four cases documented at The Korle Bu Teaching Hospital between June 1997 and May 1998 are described and the literature briefly reviewed.
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    The role of intergenerational transfers, land, and education in fertility transition in rural Kenya: The case of Nyeri district
    (Population and Environment, 2009-02) Shreffler, K.M.; Nii-Amoo Dodoo, F.
    This qualitative study reveals how population pressures, land availability, inheritance norms, and educational opportunities intertwine to influence fertility decline in rural Kenya. Focus group discussions with men and women whose childbearing occurred both before and after the onset of rapid, unexpected fertility transition in Nyeri, Kenya allowed individuals who actually participated in, or witnessed, the fertility transition to "voice" their perceptions as to the mechanisms underlying the transition. Findings suggest that, since land inheritance is a cultural norm, land scarcity and diminishing farm size often influence fertility decision-making and behavior via preferences for fewer children. Further, education does not appear to be the driving cause of fertility behavior change, but rather is adopted as a substitute for land inheritance when land resources are scarce. These findings have implications for our understanding of fertility behavior as well as for improving predictions of fertility transition in other rural sub-Saharan African contexts. © Springer Science+Business Media, LLC 2009.
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    The exodus of health professionals from sub-Saharan Africa: Balancing human rights and societal needs in the twenty-first century
    (Nursing Inquiry, 2007-07) Ogilvie, L.; Mill, J.E.; Astle, B.; Fanning, A.; Opare, M.
    OGILVIE L, MILL JE, ASTLE B, FANNING A and OPARE M. Nursing Inquiry 2007; 14: 114-124The exodus of health professionals from sub-Saharan Africa: balancing human rights and societal needs in the twenty-first century Increased international migration of health professionals is weakening healthcare systems in low-income countries, particularly those in sub-Saharan Africa. The migration of nurses, physicians and other health professionals from countries in sub-Saharan Africa poses a major threat to the achievement of health equity in this region. As nurses form the backbone of healthcare systems in many of the affected countries, it is the accelerating migration of nurses that will be most critical over the next few years. In this paper we present a comprehensive analysis of the literature and argue that, from a human rights perspective, there are competing rights in the international migration of health professionals: the right to leave one's country to seek a better life; the right to health of populations in the source and destination countries; labour rights; the right to education; and the right to nondiscrimination and equality. Creative policy approaches are required to balance these rights and to ensure that the individual rights of health professionals do not compromise the societal right to health. © 2007 The authors. Journal compilation © 2007 Blackwell Publishing Ltd.
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    Cohabitation, marriage, and 'sexual monogamy' in Nairobi's slums
    (Social Science and Medicine, 2007-04) Hattori, M.K.; Dodoo, F.N.A.
    The current study investigates the extent to which sexual exclusivity-the restriction of one's sexual engagements to a single partner-prevails across various marital status, union type, and co-residence categories among Nairobi's poorest residents, slum dwellers. This question is central to the spread of HIV in the increasingly urban and poor, high prevalence countries of sub-Saharan Africa, where transmission is primarily via heterosexual sex. In many circles, sexual exclusivity is considered a prominent feature of the marriage institution. Yet, marriage and cohabitation are often not easily distinguishable in sub-Saharan Africa, meaning that the frequent use, as a proxy, of the "in union" category, which includes married as well as cohabiting persons can, at best, be considered tenuous. Using the 2000 Nairobi Cross-Sectional Slum Survey (NCSS), this paper confirms that marriage is associated with higher reports of sexual exclusivity even in settings where poverty provokes risky behavior. The finding, here, is of lower risk of HIV infection for married respondents, with a smaller effect observed among non-married cohabiters. Converse to the implied benefits of marriage, though, women with co-wives are more likely to report multiple partners. The implications of these findings are discussed. © 2006 Elsevier Ltd. All rights reserved.
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    Familial roles and social transformations: Older men and women in sub-Saharan Africa
    (Research on Aging, 2006-11) Oppong, C.
    By focusing on old people in sub-Saharan Africa, the author illustrates the need for comparative analyses of how culture, sociopolitical systems, and sweeping social change shape lives, interconnections, opportunities, and constraints among older people. In such work, gender contrasts are critical. Because of their position in reproduction and marital patterns, women in sub-Saharan Africa have tended to use lineal strategies, focused on children and grandchildren, in contrast to the more lateral, partner-oriented strategies followed by men. Migration into urban areas and the AIDS pandemic have left many older women in charge of grandchildren in rural areas with inadequate resources and infrastructure. Shaped by traditional values, norms, and roles in their early lives, they currently find many expectations unmet. Indeed, some of the traditional norms that ensured respect, support, reciprocity, and embeddedness may now leave many older people, especially women, isolated, weakened, and victims of illness and violence. © 2006 Sage Publications.
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    The HIV/AIDS epidemic in sub-Saharan Africa: Homogeneity or heterogeneity?
    (Norsk Geografisk Tidsskrift, 2005-03) Agyei-Mensah, S.
    This article examines the geography of HIV/AIDS in sub-Sabaran Africa in a time and space perspective. Drawing on a variety of sources, an interesting picture of HIV/AIDS spread emerges, one that is quite at odds with the popular perception of an increasing HIV prevalence in most of the region. A significant decline has been underway in Uganda. There has also been stability or levelling off in countries such as Zambia, Rwanda, Burundi, and Cote d'Ivoire. In sharp contrast, prevalence is increasing in Tanzania, Swaziland and Central African Republic (CAR). The article heeds the important point that transmission of HIV/AIDS in sub-Saharan Africa not only displays differing patterns but differing reasons for those patterns between countries and regions proximate to each other. Thus, no single policy can be adopted for all countries. © 2005 Taylor & Francis.
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    Marital Choice in Sub-Saharan Africa: Comparing Structural and Cultural Influences in Contemporary Ghana
    (Comparative Sociology, 2003-06) Takyi, B.; Miller, N.B.; Kitson, G.C.; Oheneba-Sakyi, Y.
    A transformation is underway in family and marital processes in many parts of sub-Saharan Africa. With the exception of recent research with an emphasis on childbearing issues, few researchers have analyzed these on-going developments. Using Ghana as a case study, this article examines the context of mate selection among men and women. We also compare the effect of structural as opposed to cultural factors on contemporary mate selection patterns. Findings from our analysis indicate an increasing propensity for Africans to self-select their partners. At the same time, women are more likely than men to consider the family's input in selecting their partners. Individual reports and concordance in couples' replies reflect this observation. Our overall results support the thesis that worldwide family processes in Africa may be converging to patterns in other parts of the world.
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    Hypertension in Ghana: a cross-sectional community prevalence study in greater Accra
    (Ethnicity & Disease, 2003-06) Amoah, A.G.
    Objectives: To determine the prevalence of hypertension, and the extent to which it is treated and controlled, among adult Ghanaians. Design: 6300 adults, aged 25 years and older, were selected by random cluster sampling, using electoral enumeration areas and listings of adults. Setting: Three communities in the greater Accra region of Ghana. Subjects and Methods: A total of 4733 subjects (male to female ratio=1:1.5) participated, representing a response rate of 75%. The analysis used the mean of 2 blood pressure readings, taken with a mercury sphygmomanometer after a 10-minute rest. Hypertension was defined as having blood pressure ≥140/90 mm Hg, or currently undergoing anti-hypertensive treatment. Results: The mean ages for males and females were 44.9 ± 14.7 years, and 44.0 ± 14.6 years, respectively. The crude prevalence of hypertension was 28.3%. The age-standardized prevalence, to the new standard world population, was 28.4%. Mean systolic and diastolic blood pressures increased with age. Of 1337 subjects with hypertension, 34% were aware of their condition, 18% were treated, and 4% were controlled (blood pressure <140/90 mm Hg). Conclusion: Hypertension is a major public health problem, and is associated with relatively low levels of awareness, drug treatment, and blood pressure control. Population-based prevention strategies, such as reduction in salt intake and integration of hypertension care into primary care, may prove beneficial; however, the determinants of hypertension remain to be ascertained.
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    Pathogenesis of type 1 and type 2 diabetes mellitus in sub-Saharan Africa: implications for transitional populations
    (Journal of Cardiovascular Risk, 2003-04) Osei, K.; Schuster, D.P.; Amoah, A.G.; Owusu, S.K.
    The increasing prevalence and incidence of diabetes and its long-term complications in sub-Saharan Africa (SSA) could have devastating human and economic toll if the trends remain unabated in the future. Approximately 90% or majority of patients with diabetes belongs to the adult onset, type 2 diabetes category while 10% have type 1 diabetes in SSA. However, because of the paucity of metabolic and clinical data, a clear understanding of the natural history of both diseases and the classification of diabetes subtypes has been hampered. Nevertheless, we have attempted to provide a concise review of the pathophysiology of both type I and type 2 diabetes as well as phenotypic and clinical variations in patients residing in SSA. The limited metabolic data, (albeit increasing), from high-risk and diabetic individuals in the SSA, have contributed significantly to the understanding of the pathogenetic mechanisms of diabetes and the variations in the presentation of the disease. Sub-Saharan African patients with type I diabetes have essentially absolute insulin deficiency. In addition, patients with type 2 diabetes in SSA region also manifest severe insulin deficiency with varying degrees of insulin resistance. Although the exact genetic markers of both diseases are unknown, we believe studies in patients of SSA origin who reside in diverse geographic environments (African diaspora) could potentially contribute to our understanding of the genetic and environmental mediators of both diseases. However, many intrinsic, individual and societal obstacles such as poor education and illiteracy, low socio-economic status and lack of access to health care make uncertain the translation of diabetes research in SSA. In this regard, effective management and/or prevention of diabetes in SSA individuals should adopt multidisciplinary approaches. Finally, innovative health care delivery and educational models will be needed to manage diabetes and its long-term complications in SSA.
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    High blood pressure: the foundation for epidemic cardiovascular disease in African populations
    (BMC Endocrine Disorders, 2003-06) Cooper, R.S.; Amoah, A.G.; Mensah, G.A.
    High blood pressure is a powerful independent risk factor for death from heart disease and stroke. It is also a common clinical condition affecting more than 600 million persons worldwide and seen in nearly all populations. Although reliable, large-scale, population-based data on high blood pressure in sub-Saharan Africa (SSA) are limited, recent studies provide important and worrisome findings in both epidemiology and clinical outcomes. Although overall hypertension prevalence is between 10%-15%, prevalence rates as high as 30%-32% have been reported in middle-income urban and some rural areas. Importantly, hypertension awareness, treatment, and control rates as low as 20%, 10%, and 1%, respectively have also been found. Stroke has been by far the most common clinical sequela. In most SSA settings, hypertension control assumes a relatively low priority and little experience exists in implementing sustainable and successful programs for drug treatment. Rapid urbanization and transition from agrarian life to the wage-earning economy of city life continue to fuel increases in average blood pressure levels and prevalence of hypertension. Although the true burden of high blood pressure in sub-Saharan Africa remains largely unmeasured, compelling preliminary evidence suggests that it is the foundation for epidemic cardiovascular disease in Africa and already contributes substantively to death and disability from stroke, heart failure, and kidney failure in this region. Success in limiting this epidemic in SSA will depend heavily on the implementation of sustainable and aggressive population-based programs for high blood pressure awareness, prevention, treatment, and control. It will be critical to obtain investments in improved surveillance and program-relevant research to provide the evidence base for policy development and effective hypertension prevention and control.