Cardiovascular physical examination as a screening tool for congenital heart disease in newborns at a teaching hospital in Ghana

Objectives: To determine the usefulness of cardiovascular physical examination (CPE) as a screening tool in a lowresource setting for detecting congenital heart disease (CHD) in newborns delivered at the Maternity Unit of Korle Bu Teaching Hospital (KBTH), Accra, Ghana. Design: A hospital-based cross-sectional study with a comparison group component. Setting: Maternity Unit of the KBTH, Accra, Ghana. Participants: Over eight months, newborns aged 1-14 days delivered at ≥ 34 weeks' gestation at the Maternity Unit, KBTH, were recruited into the study. Intervention: Each newborn was examined using a set of CPE parameters for the presence of congenital heart disease. Those with suggestive features of CHD had a confirmatory echocardiogram test. Main Outcome Measure: Abnormal CPE features and their corresponding echocardiogram findings. Results: A total of 1607 were screened, with 52 newborns showing signs of CHD on CPE, of which 20 newborns were proven on echocardiogram to have congenital heart disease. Abnormal CPE parameter that was associated with CHD was murmur (P=0.001), dysmorphism (p=0.01), newborns with chest recessions (p=0.01) and lethargy (p=0.02). CPE's sensitivity, specificity, and positive and negative predictive values were 95%, 60.7%, 36.5% and 98,1%, respectively. The most common acyanotic CHD found was isolated atrial septal defect (ASD), followed by patent ductus arteriosus (PDA). The only cyanotic CHD found was a case of tricuspid atresia. Conclusion: Cardiovascular physical examination at birth is an effective and inexpensive screening tool for detecting CHD in newborns, which can easily be utilised in low-resource settings.

Prevalence of pneumonia by chest x-ray, associated demographic characteristics and health risk factors among COVID-19 patients in Ghana

Objective: The study was conducted to determine the prevalence of radiologically diagnosed pneumonia among COVID-19 patients and associated factors. Design, setting, and participants: A retrospective manual data extraction of 275 medical records of COVID-19 patients was conducted at two COVID-19 national treatment centres in Accra from March to May 2020. All patients had a chest x-ray done. Main outcome and analysis: The main outcome was the presence of pneumonia. Descriptive statistics and Chi-square test of independence were employed to determine the associations between independent variables and the presence of pneumonia. All analysis was performed using Stata 16, and a p-value ≤ 0.05 was deemed significant Results: The prevalence of pneumonia was 44%(95%CI) =38.2-50.0). Chi-square independent test indicated that pneumonia in the COVID-19 patients was associated with educational level, history of domestic and international travel, mass gathering in the past 14 days before diagnosis, and discharge plan (p-value< 0.05). Patients classified as secondary cases (61.5%) and those discharged as fully recovered from the health facility (61.2%) had a higher prevalence of pneumonia. In addition, COVID-19 patients with hypertension (32.1%) and asthma (5.2%) had a significantly higher prevalence of pneumonia. Conclusion: Overall, the prevalence of pneumonia was 44% and was associated with the demographic and personal characteristics of the patients. Early detection through contact tracing and community surveillance should be intensified to pick up more asymptomatic cases. The role of the chest x-ray for triaging patients and for clinical management of symptomatic patients remains key

Middle-age Spread of Overweight and Obesity in Ghana; Myth or Reality? Evidence from WHO SAGE Wave 2 Data

Aims: The aim of this study is to describe the age-related risk of overweight/obesity among Ghanaians using data from the WHO Study on global AGEing and adult health (SAGE) Wave 2.Study Design:Cross sectional study.Place and Duration of Study:Ghana; 2014-2015. Methodology:Primary study variables were extracted onto Microsoft Excel 14.0 spreadsheet. Secondary variables were generated through grouping, recategorization and combination of primary variables. Descriptive statistics were calculated for age and BMI. Associations between respondents’ characteristics and BMI were evaluated with chi square(χ2) and odds ratio (OR) at 95% confidence level.Results:Data of 1322 respondents were included in data analysis. In all, 520 (39.3%) of the respondents were overweight/obese and nearly half (46.62%) were middle-aged adults. Middle-aged adults were nearly twice as likely to be overweight/obese compared with old adults (AOR=1.62; CI: 1.25-2.10) and the risk was higher for middle-aged females (AOR=2.38; CI: 1.84-3.09). Overall, beingmiddle-aged (OR=1.73; CI: 1.35-2.21); living in an urban community (OR=2.01; CI: 1.61-2.52); being a female (OR=2.69; CI: 2.1-3.44); not engaging in regular physical activity (OR=1.49; CI: 1.18-1.88); and being an occasional drinker of alcoholic beverage (OR=1.58; CI: 1,12-2.22) were significantly associated with overweight/obesity.Conclusion:Obesity/overweight are lifestyle driven phenomenon and can be controlled by risk modification. Public sensitization, imposition of special taxes on sugary beverages, promotion of healthy local staples and creation of enabling community environments to encourage physical activity may be useful approaches in controlling the epidemic

An evaluation of tuberculosis surveillance system in a health district in Ghana

Background: Tuberculosis remains a major global health problem. It is one of the top 10 causes of death worldwide. In Africa, there were estimated 2.7 million new cases of tuberculosis and 450 thousand deaths in 2014. In Ghana, incidence rate of TB was estimated to be 152 per 100,000 populations in 2017 according to the WHO estimates. We evaluated a health district (Ejisu-Juaben) Tuberculosis surveillance system to describe its operations, attributes, determine its usefulness and whether its objectives were being met.Methods: This descriptive study was conducted using the Center for Disease Control and Prevention updated guidelines for evaluating public health surveillance systems and the Ghana Health Service Standard Operating Procedures for priority diseases and conditions (2012). Study participants who were purposively sampled were interviewed with a semi-structured questionnaires and dataset from January 2016 to December 2018 were reviewed at various levels of the surveillance system. Data was collected and analyzed with Epi Info 7.2 between 1st February, 2019 and 30th April, 2019.Results: The surveillance system was useful and partially met its objectives and targets. It was well structured, simple, stable, flexible and of good data quality. It was also averagely acceptable and representative. However, it recorded poor sensitivity of 15.12% and poor predictive value positive (PVP) of 12.27% in 2018. The yearly total cost of operation of the TB surveillance system was ¢79,950.76 ($16,316.44 USD).Conclusions:The surveillance system was useful and met its objectives partially. The sensitivity, PVP, acceptability and representativeness need improvement in order to justify its relevance.

COVID-19 pandemic and dental practice in Ghana

With the advent of the COVID-19 pandemic, healthcare systems and their provision of care has globally been challenged, including the delivery of Oral healthcare. In Ghana, it has become imperative that healthcare delivery including the practice of Dentistry and its sub-specialties be re-oriented in our peculiar setting to ensure minimal risk of spread of the infection. This article discusses the impact of COVID-19 on the practice of Dentistry in the country

Sociodemographic and clinical characteristics of the first cohort of COVID-19 recoveries at two national treatment centres in Accra, Ghana

Introduction:COVID-19 is a new disease, knowledge on the mode of transmission and clinical features are still evolving, new tests are being developed with inherent challenges regarding interpretation of tests results. There is generally, a gap in knowledge on the virus globally as the pandemic evolves and in Ghana, there is dearth of information and documentation on the clinical characteristics of the virus. With these in mind, we set out to profile the initial cohort of COVID-19 patients who recovered in Ghana. Methods: We reviewed clinical records of all confirmed cases of COVID-19 who had recovered from the two main treatment centres in Accra, Ghana. Descriptive data analysis was employed and presented in simple and relational tables. Independent t-test and ANOVA were used to determine differences in the mean age of the sexes and the number of days taken for the first and second retesting to be done per selected patient characteristics. Results: Of the 146 records reviewed, 54% were male; mean age of patients was 41.9 ± 17.5 years, nearly half were asymptomatic, with 9% being severely ill. The commonest presenting symptoms were cough (22.6%), headache (13%) and sore throat (11%) while the commonest co-morbidities were hypertension (25.3%), diabetes mellitus (14%) and heart disease (3.4%). Conclusion: COVID-19 affected more males than females; nearly half of those infected were asymptomatic. Cough, headache and sore throat were the commonest symptoms and mean duration from case confirmation to full recovery was 19 days. Further research is required as pandemic evolves

Clinical features of COVID-19 in Ghana: symptomatology, illness severity and comorbid non-communicable diseases

Objective: This analysis described the clinical features of COVID-19 in the early phase of the pandemic in Ghana. Methods: Data were extracted from two national COVID-19 treatment centers in Ghana for over 11 weeks(from March to May 2020). Descriptive and inferential statistics were performed. Modified Ordered Logistic and Negative Binomial Regression analysis were applied to establish factors associated with illness severity and Non-communicable Disease (NCDs) counts respectively. All analysis was conducted at the 95% confidence level (p-value ≤ 0.05) using Stata 16. Results: Among the 275 patients, the average age was 40.7±16.4, with a preponderance of males (54.5%). The three commonest symptoms presented were cough (21.3%), headache (15.7%), and sore throat (11.7%). Only 7.6% of the patients had a history of fever. Most patients were asymptomatic (51.65). Approximately 38.9% have an underlying co-morbid NCDs, with Hypertension (32.1%), Diabetes (9.9%), and Asthma (5.2%) being the three commonest. The odds of Moderate/severe (MoS) was significantly higher for those with unknown exposures to similar illness [aOR(95%CI) = 4.27(1.12-10.2)] compared with non-exposure to similar illness. An increased unit of NCD's count