Healthcare services utilisation among patients with hypertension and diabetes in rural Ghana

Background: Non-communicable diseases (NCDs) remain a global burden and is projected to increase due to aging, rapid urbanization and unhealthy lifestyles. The study was conducted to determine the prevalence of hypertension and diabetes in rural districts in the Ashanti region of Ghana and to determine factors that influence utilization of health care services. Setting: Offinso North, Amansie West, Ahafo Ano South, and Asante Akim South. Methods: A population based prospective cross-sectional study comprising of adults aged 18 years and above was carried out from January 2016 to March 2016. A multistage sampling method was employed to select four rural districts in the Ashanti region of Ghana. A structured questionnaire was used to collect primary data from respondents. Results: A total of 684 participants were recruited in the study. The prevalence of hypertension and diabetes was found to be 16.23% and 5.41% respectively. The prevalence of diabetes and hypertension comorbidity was 1.61%. The public hospital was the most preferred choice of facility (52.56%) for patients with NCDs. Educational level significantly decreased the likelihood of seeking healthcare in OTCMS and Health Centre to Hospitals (RRR = 0.1, 95% CI = 0.011­0.917, p = 0.042) and (RRR = 0.4, 95% CI = 0.198-0.679, p = 0.001) respectively. Conclusion: The prevalence of self -reported hypertension and diabetes observed in this study was relatively lower for hypertension and higher for diabetes as compared to other studies in Ghana. The public hospital is the most preferred choice of health facilities for patients with hypertension and diabetes in the rural districts

Analysis of Atherogenic and Anthropometric Profiles of Normotensive and Hypertensive Ghanaians in the Kumasi Metropolis.

Ghana is undergoing a rapid epidemiological transition from solely communicable to a double burden of infectious and chronic disease such as hypertension. Aims: We aimed to compare the association between different lifestyle practices, adiposity indices, atherogenic dyslipidaemic parameters and hypertension as well as the prognostic implications for the levels of these parameters on target cardiac organ damage among hypertensives. We also determined the optimal threshold points and the discriminative power of these parameters on this urban Ghanaian hypertensive population. Study Design: A hospital-based case–control study was conducted. Methodology: The study purposively recruited 241 Ghanaian indigenes in the Kumasi metropolis, with 180 hypertensives as cases and 61 normotensives as controls. In addition to sociodemographic data captured, all participants underwent standard haemodynamic, anthropometric, atherogenic lipid and cardiac organ damage assessment. Results: In general, the case group presented with a significantly poorer atherogenic lipid profile compared to their counterparts in the control group. Participants presenting with significantly higher multiple atherogenic scores were found to cluster at the upper quartiles of systolic blood pressure, diastolic blood pressure and pulse rate. Population-specific threshold for waist circumference of >75 cm for females and >80 cm for male were the best adiposity indices for discriminating hypertension. Increasing atherogenic dyslipidaemia was more prevalent with the presence of cardiac target organ damage. Conclusion: In this urban population, higher altered lipid scores and abdominal obesity aggravated by lifestyle choices including alcohol consumption, smoking and physical inactivity may constitute significant risk for cardiovascular complications among hypertensives.