Family APGAR and treatment outcomes among HIV patients at two ART Centers in Kumasi, Ghana

objectives: This study aimed to examine the association between Family Adaptability, Partnership, Growth, Affection and Resolve (Family APGAR) and HIV treatment outcomes. Design: A cross-sectional study using the Family APGAR questionnaire Setting: The study was conducted in Kumasi, Ghana, at the Komfo Anokye Teaching Hospital and the Kwame Nkrumah University of Science and Technology Hospital Participants: Consenting HIV-positive patients who had been on treatment for at least 12 months were recruited. Main outcome measures: The Family APGAR questionnaire was administered, and relevant data were extracted from hospital records and analysed using STATA® software. The relationship between Family APGAR and treatment outcomes was determined using Chi-squared tests or Fisher's exact test. Results: Approximately 70.1% of 304 participants were females with a mean age of 41.8 years (±9.9). At treatment initiation, 47.4% of the patients presented at World Health Organisation (WHO) clinical stages I and II and had a CD4 count ≥ 200 cells/mm3 . Females were less likely (Odds Ratio= 0.52; 95% CI=0.31 ­ 0.90, p = 0.018) to report late for treatment compared with the males. After 12 months of treatment, approximately 70% recorded undetectable viral load. Patients with functional families constituted 70.4%, which had a statistically significant relationship with viral load (p = 0.041). Conclusion: HIV care providers should incorporate family functionality evaluation into clinical practice and provide early essential support to enhance treatment outcomes

Predictors of family functionality amongst human immunodeficiency virus-serodiscordant couples in two major hospitals in Kumasi, Ghana

Background: Family instability and partner conflicts are reportedly common in serodiscordant relationships. To date, the family adaptability, partnership, growth, affection and resolve (Family APGAR), a standardised tool for assessing family function, has not been used in any published literature involving this peculiar group. Aim: The aim of this study was to determine the predictors of family functionality and its association with human immunodeficiency virus (HIV) serodiscordance. Setting: The study was undertaken at the Kwame Nkrumah University of Science and Technology Hospital and Komfo Anokye Teaching Hospital in Kumasi, Ghana. Method: This was a cross-sectional study. A systematic sampling method was used to select HIV-positive clients whose partners were seropositive (concordant) or seronegative (discordant). A standardised format was used to extract relevant data. All data were analysed using STATA® (version 14). Results were reported as odds ratios with 95% confidence intervals for study and outcome variables. Results: The study recruited 374 respondents, of which 52% (195) were in HIV-discordant relationships. Approximately 68% (254) of the respondents rated their families as functional, 15% (57) rated as moderately dysfunctional and 17% (63) rated as severely dysfunctional. A statistically significant relationship was found between family functionality and gender, as well as between family functionality and HIV status disclosure to the partner. No association was found between the Family APGAR and HIV serodiscordance. Conclusion: Amongst HIV couples, the strongest predictors of family functionality are gender and status disclosure. Healthcare providers should invest efforts into addressing gender-based challenges, utilise the Family APGAR and support disclosure of HIV status, especially amongst discordant couples

A cross-sectional self-assessment of burnout amongst a sample of doctors in Ghana

Background: The occurrence of burnout amongst African health professionals has been widely anticipated, but there is a dearth of published data, especially amongst doctors. Burnout has been reported to be as high as 53% amongst doctors in the United States. If not detected, it can result in prescription errors, work-related accidents, substance abuse and depression. Aim: The aim of this study was to determine the prevalence of burnout and its associated factors amongst a sample of physicians in Ghana. Setting: This study was conducted in Kumasi amongst physicians attending a conference organised by the West African College of Physicians, Ghana Chapter. Method: A cross-sectional study. Of the 90 physicians who registered for the conference, 60 responded to a self-administered Maslach Burnout Inventory questionnaire. Data were analysed descriptively and inferentially using STATA® version 14. Results: Approximately 52% of respondents had been in medical practice for 10­19 years (mean 15.4 years). All the major medical specialties were represented. Internal Medicine had the highest number of participants (48.3%). With respect to the components of burnout, 5.5% of respondents experienced depersonalisation, 7.8% had a lack of personal achievement and 10.8% experienced emotional exhaustion. The association between burnout and age, sex, years of practice and clinical specialty was not found to be statistically significant. Conclusion: This pilot study has shown burnout to be common amongst physicians in Ghana. It is recommended that further studies are conducted, involving a larger cross-section of doctors in various parts of Africa