Anthony Edusei

Epidemiological study of burns in Komfo Anokye Teaching Hospital, 2006-2009

AIMnTo identify and describe the patterns of burns reported at the Komfo Anokye Teaching Hospital (KATH) from 2006 to 2009 and their outcomes on the various age groups and genders.nnnMETHODSnPatients records from admission and discharge books of the Burns Intensive Care Unit, Polyclinic Casualty Consulting Rooms and from the Statistical Department of KATH were reviewed to obtain the necessary data for this retrospective study. Data entry and analysis were done by using SPSS version 17.0.nnnRESULTSnA total of 731 patients records were reviewed, with male to female ratio of 1.2:1. The mean age was 15.83 years; range was 0-79 years. Children less than 10 years were the most frequently admitted group (53.5%). Most of the burns occurred in domestic settings (88.5%), whiles, majority of the burns were accidental (98.8%). Scalds (57.4%) were the most frequent cause of burns followed by open flame (38.2%). The mortality rate was 13.1% for the period under review. Majority (71.4%) of the patients spent less than 10 days on admission. The mean total body surface area (TBSA) was 24.79%, and there was significant correlation between TBSA, age group, outcome and duration of hospital admission.nnnCONCLUSIONnChildren less than 10 years were the most vulnerable victims to burns; males dominated the number of victims. The commonest aetiological factor was scalds, with most of them related to inattention from parents. More dedicated burn surgeons and properly trained nurses are needed at KATH. Ambulance and pre-hospital services should be increased with adequate number of paramedics. Coordination between district hospitals and tertiary burn centres should also be established, for the proper transfer of burn cases to the tertiary burn centres, especially KATH.

Rural and urban differences in blood pressure and pregnancy-induced hypertension among pregnant women in Ghana.

BackgroundGlobally, about 350.000 women die every year from pregnancy related causes and more than half of these deaths occur in sub-Saharan Africa (SSA). Approximately 12% of the maternal deaths are associated with hypertensive disorders in pregnancy such as pregnancy induced hypertension (PIH). However, very little is known about PIH and associated determinants in many SSA countries such as Ghana. We therefore sought to assess rural and urban differences in blood pressure (BP) and PIH among pregnant women in Ghana.MethodsWe conducted a cross-sectional study among 967 rural (677) and urban (290) pregnant women with a gestational age of more than 20xa0weeks. PIH was defined as a systolic blood pressure of ≥140xa0mmHg and/or diastolic blood pressure of ≥90xa0mmHg.ResultsWomen in urban Ghana had a higher mean systolic and diastolic BP than women in rural Ghana (105/66xa0mmHg versus 102/61xa0mmHg, pu2009<u20090.001 for both systolic and diastolic BP). The prevalence of PIH was also higher in urban Ghana (3.1%) than in rural Ghana (0.4%) (pu2009=u20090.014). The urban and rural difference in mean diastolic blood pressure persisted even after adjustments for the study characteristics in a linear regression model. In both rural and urban Ghana, BMI, heart rate and a family history of hypertension were independently associated with BP.ConclusionOur findings suggest higher mean BP levels and PIH in urban Ghana than in rural Ghana. BMI was independently related to high BP. Left unchecked, the increasing prevalence of overweight and obesity in Ghana will exacerbate PIH levels in Ghana.

Buruli-Ulcer Induced Disability in Ghana: A Study at Apromase in the Ashanti Region

Objectives. To describe trends and category of disabilities caused by Buruli ulcer disease. Design. This retrospective study was set up to quantify information on the disability trends caused by Buruli ulcer (BU) using data on patients attending BU and chronic ulcer clinics from 2004 to 2009, at Global Evangelical Mission Hospital, Apromase. Methods. Data was retrieved from the WHO BU1 form, case registry book, surgical theatre register, and BU patients records book of the hospital. Disability was measured as the incapability of patients to perform one or more daily activities due to his/her state of BU disease before treatment. Results. A total of 336 positive BU cases comprising 181 males (53.9%) were recorded of which 113 (33.6%) cases of disabilities were identified. A mean age of 52.5 (±1.32) years was recorded. For the trend of disabilities, the year 2009 recorded the highest (N = 34, 31.0%). The lesions were mostly located at the lower limbs (N = 65, 57.5%) region of the patients. Lesions with diameter >15u2009cm were the major (59.3%) category of lesions. Conclusion. Trend of disability reveals proportional increase over the years from 2004 to 2009. Contracture at the knee and ankle joints was the commonest disability recorded.

Impact of maternal weight on pregnancy outcomes: a systematic review

Purpose n n n n nThe nutritional status of a woman before and during pregnancy is important for a healthy pregnancy outcome. The increasing prevalence of maternal overweight and obesity worldwide has become a problem of concern among public health professionals. The purpose of this paper is to review the evidence regarding the impact of maternal weight on pregnancy outcomes to facilitate the provision of evidence-based information to pregnant women during antenatal clinics in Ghana. n n n n nDesign/methodology/approach n n n n nA search was conducted in PubMed, PLOS ONE, Cochrane, Embase and bibliographies for all studies on maternal weight and pregnancy outcomes published from January 2000 to May 2013. The key words used for the search were: “pre-pregnancy BMI”, “gestational weight gain”, “maternal weight”, “pregnancy outcomes” and “birth outcomes”. n n n n nFindings n n n n nThe search yielded 113 papers; out of these, 35 studies were included in the review after exclusion of duplicates and irrelevant papers. Excluded papers included animal studies and human studies that did not meet inclusion criteria. n n n n nResearch limitations/implications n n n n nThe review only considered papers published from 2000 to 2013 and might have left out other important papers published before 2000 and after 2013. n n n n nPractical implications n n n n nThe origins of the studies included in the review suggest paucity of studies on maternal weight and pregnancy outcomes in developing countries where there is a double burden of malnutrition. There is the need for more studies to be initiated in this area. n n n n nSocial implications n n n n nResults of this review have revealed that the extremes of maternal weight prior to and during pregnancy increase the risk of maternal and fetal complications. n n n n nOriginality/value n n n n nThis paper provides evidential information on the impact of maternal weight on pregnancy outcomes for counseling during antenatal clinics.

Assessment of prison life of persons with disability in Ghana

BackgroundPersons with Disabilities (PWDs) are a unique group that are often overlooked in many developing countries due to systemic weaknesses, lack of political commitment and inadequate support from government and non-governmental agencies. The population of these individuals is however steadily on the increase and currently corresponds to 15xa0% of the world population. Although much data exist on lifestyle and conditions of prisoners with disabilities in the western world, scanty information is available in Africa. In Ghana, there is insufficient data on the occurrence and social characteristics of prisoners with disabilities. The purpose of this current study was therefore to identify the occurrence, types and causes of disabilities among prisoners serving sentences in Ghanaian prisons.MethodsThis study was a descriptive cross-sectional survey conducted in the Male and Female Regional Prisons in Kumasi, Sunyani and the Nsawam Medium Security Prison, from November to December 2011. PWDs were selected by prisons officers and interviewed using structured questionnaires on variables such as socio-demographic characteristics, causes of disabilities and accessibility to recreational facilities. Ethical approval was obtained from the security services and the Committee of Human Research Publications and Ethics (CHRPE) of the School of Medical Sciences, Kwame Nkrumah University of Science and Technology (KNUST).ResultsWe screened 6114 records of prisoners of which 1852 (30.3xa0%) were from the Kumasi Central Prisons, 3483 (57xa0%) from the Nsawam Medium Security and 779 (12.8xa0%) from the Sunyani Central Prisons. A total of 99 PWDs were identified with the commonest disability being physical, followed by visual, hearing, speech, mental and albinism. Most of the disabilities were caused by trauma (68.8xa0%) followed by infection (16.7xa0%), and drug related mental disabilities (6.3xa0%). Fifty (50.5xa0%) out of the 99 PWDs were not provided with assistive devices although they admitted the need for such.ConclusionThe present study has demonstrated the occurrence and conditions of PWDs in Ghanaian prisons. Major stakeholders including government agencies and other organisations could develop policies that would improve the conditions and livelihood of prisoners with disabilities in Ghana.

Perceived control, academic performance and well-being of Ghanaian college students with disability

Background Empirical evidence abounds showing the impact of perceived control on subjective well-being in several spheres of functioning, including academic performance. At tertiary institutions, such as the Kwame Nkrumah University of Science and Technology, Ghana, little is known about the needs of students with disabilities, as very few persons with disabilities attend institutions of higher learning. Objectives This study examined the relationship between perceptions of control and the academic and subjective well-being of students with disabilities. Method A total of 69 students with disabilities participated in this cross-sectional descriptive study. Using trusted control and subjective well-being scales, data were subject to descriptive analyses. Results Consistent with previous works, perceived control increased with increased subjective well-being, moderated by gender. In addition, forms of secondary control appeared to aid primary control in the tenacious pursuit of goals. However, neither perceived control nor self-esteem was predictive of academic performance. Conclusion Limitations of sample size notwithstanding, the findings of the study can be considered provocative. Implications for clinical utility in facilitating context-specific interventions for this marginalised group are discussed. Replication with a larger sample size in other tertiary institutions is suggested for future work.

The accessibility of health services to young deaf adolescents in Ghana

Quality health care is a fundamental human right, which is enshrined in several international and domestic legislative instruments. In the Ghanaian context, there are reports that adults with disabilities encounter barriers in their attempts to access health care. However, scholarly attention is yet to explore the perspectives of young people and adolescents with disabilities. Therefore, this quantitative study was conducted from the perspective of critical disability studies, where young deaf adolescents (YDAs) were regarded as right bearers, and where they shared their perspectives on health accessibility decisions, barriers, and needs. Sixty-seven participants, made up of 44 male and 23 female students, took part in this quantitative study. Although many YDAs who took part in this study indicated that it was not difficult to access health facilities, they claim to have encountered communication barriers. Sign language interpreters in health facilities and introduction of sign language courses in health training institutions to improve communication between health professionals and deaf patients have been suggested as ways of addressing the barriers faced by YDAs in Ghana.

Perspectives in musculoskeletal injury management by traditional bone setters in Ashanti, Ghana

Background The popularity of the services of traditional bone setters (TBS) in Ghana as an alternative health care requires exploration and documentation of the perspectives of providers and users. Objective To explore and document the perspectives of providers and users of the services of TBS in the management of musculoskeletal injuries in the Ashanti region, Ghana. Methods From the social constructivist and qualitative approach, in-depth interviews were used to explore the perspectives of eight TBS and 16 users of their services, selected purposively through snowballing. Thematic content analysis (TCA) was employed. Results High recovery rate, warm reception, prompt attention, and the relatively lower charges, are reported to motivate the patronage of the services of TBS for the management of fractures in the legs, arms, ribs, joint bones dislocations, waist and spinal cord problems. The TBS combined traditional and orthodox procedures, using plant and animal-based materials, beliefs, spirituality (God-given) and physical therapy in the management of musculoskeletal injuries. No adverse experience was reported by either the providers or users of the traditional management methods. Conclusion With plant and animal-based materials, TBS are observed to combine traditional and orthodox procedures to confidently manage musculoskeletal injuries to the satisfaction of their highly motivated patrons. Although over 60% of the TBS attribute the healing power behind their practice to God, the rest do not discount the role of spiritual therapy. Further studies expanded to include the perspectives of non-users of the services of the TBS will authenticate the findings of this study.