Rk Gyasi

Head and neck tumours in Ghanaian children. A 20 year review

Histological reports on tumour specimens recorded at a teaching hospital in Accra, Ghana from 1989 to 2008 were reviewed to determine the incidence of head and neck tumours in children less than 16 years old. There were 4546 reports of head and neck tumours (2041 malignant, 2505 benign). Of these 613 met the study age selection criteria. 186(30.3%) were malignant and 427(69.7%) benign. The male to female ratio for malignant tumours was 1.86:1, benign 0.73:1 and for all tumours 1:1.04. Lymphoma (54.8%), nasopharyngeal carcinoma (19.9%) and rhabdomyosarcoma (14%), together constituted over 88% of malignant neoplasms. The commonest benign neoplasm was squamous papilloma (76/427) 17.8%, and then haemangioma (60/427) 14.05%. The incidence increased with age, peaking in those aged 12-16 years. The commonest site for benign tumours was the larynx and for malignant tumours the neck (cervical lymph nodes). Relative to all head and neck malignancies, the incidence of childhood head and neck malignancies was 11% (186/2041). This study reveals that malignant head and neck tumours are not rare in Ghana compared to benign tumours and the incidence of rhabdomyosarcoma is higher in females.

Non-malaria fevers in a high malaria endemic area of Ghana

BackgroundThe importance of fevers not due to malaria [non–malaria fevers, NMFs] in children in sub-Saharan Africa is increasingly being recognised. We have investigated the influence of exposure-related factors and placental malaria on the risk of non-malaria fevers among children in Kintampo, an area of Ghana with high malaria transmission.MethodsBetween 2008 and 2011, a cohort of 1855 newborns was enrolled and followed for at least 12xa0months. Episodes of illness were detected by passive case detection. The primary analysis covered the period from birth up to 12xa0months of age, with an exploratory analysis of a sub-group of children followed for up to 24xa0months.ResultsThe incidence of all episodes of NMF in the first year of life (first and subsequent) was 1.60 per child-year (95xa0% CI 1.54, 1.66). The incidence of NMF was higher among infants with low birth weight [adjusted hazard ratio (aHR) 1.22 (95xa0% CI 1.04–1.42) pu2009=u20090.012], infants from households of poor socio-economic status [aHR 1.22 (95xa0% CI 1.02–1.46) pu2009=u20090.027] and infants living furthest from a health facility [aHR 1.20 (95xa0% CI 1.01–1.43) pu2009=u20090.037]. The incidence of all episodes of NMF was similar among infants born to mothers with or without placental malaria [aHR 0.97 (0.87, 1.08; pu2009=u20090.584)].ConclusionThe incidence of NMF in infancy is high in the study area. The incidence of NMF is associated with low birth weight and poor socioeconomic status but not with placental malaria.