RESUMO
Background: More than 95% of the population in sub-Saharan Africa (S.S.A.) does not have ready access to safe, affordable surgical care, and there is a desperate need for E.N.T. (ear, nose, and throat), audiology, and speech therapy services. Therefore, from an international outlook, the most significant challenge confronting hearing and cancer care delivery is not high-technology and high-cost medicine but the lack of access to even the most elementary E.N.T. care Materials and Methods: A literature search for studies on the analysis of trends and outcomes of otorhinolaryngology practices in sub-Saharan Africa was performed using Google Scholar search database, PubMed, Medline, and ScienceDirect. The bibliographies of included studies were also searched for additional references. About 95 articles were identified. Twenty-one articles were considered suitable for the review. The whole residents of the 22Results: countries illustrated in a study reviewed were 720,500,000; this symbolizes 75% of the population of sub-Saharan Africa. Among the 22 countries that were tested, 847 ENT surgeons, 580 audiologists, 906 speech therapists, 264 ENT clinical officers, and 320 oncologists were reported. When data have combined the sample, the regional ratio was 1.2 million people per E.N.T. surgeon, 0.8 million people per audiologist, and 1.3 million people per speech therapist. Conclusion: Basic E.N.T. and airway-related interventions are possible in most countries that responded; life-saving procedures such as tracheostomy (and tracheostomy tubes), bronchoscopy, and balloon dilatation were not readily available in all countries. Access to hearing screening was very poor in most countries, highlighting the undocumented burden of disease of hearing loss in Africa and other LMICs, estimated at 5% of the world's population
RESUMO
Objective: Although all marketed antiretrovirals (ARVs) have proven efficacy, genetic differences can result in varied effectiveness. This study was conducted to determine the effectiveness of different Highly Active Antiretroviral Therapy (HAART) combinations among patients attending HIV clinic at a Major Teaching Hospital in Ghana. Methods: The study was a retrospective study involving 500 patients at an HIV clinic in the Ashanti Region of Ghana. Results: Twelve major antiretroviral combinations for HAART were prescribed at the study center. The most prescribed drug combinations were AZT+3TC+EFV and AZT+3TC+NVP. The study identified that HAART, irrespective of the kind of drug combination used, was effective at increasing CD4 count within the first 6 mo of therapy initiation in the study population. However, the magnitude of the increases differed from combination to combination. All HAART combinations with zidovudine as one of the drugs resulted in higher CD4 counts compared with combinations containing stavudine. HAART with nevirapine also resulted in a higher CD4 count than those with efavirenz. However, efavirenz-based combinations appeared to be more effective in critically ill patients and patients with mean CD4+T helper cells count below 100 cell/mm3. More importantly, efavirenz was common among all HAART combinations that resulted in treatment failure. Conclusion: There was significant variation in response to different HAART combination among Ghanaian HIV patients. However, there was no statistically significant difference in mean CD4 count between the two most predominately used HAART i. e AZT+3TC+EFV and AZT+3TC+NVP.