The prevalence and determinants of non-communicable diseases among Ghanaian adults: A survey at a secondary healthcare level.

The current epidemiological transition of diseases in Ghana necessitates understanding their burden and the associated context-specific risk factors to inform disease prevention strategies. To determine the prevalence and determinants of selected Non-Communicable Diseases (NCDs) among patients seeking healthcare services in a secondary health facility in Ghana. A facility-based survey was conducted among adult patients 18 years and above between May and July 2021, using a multi-stage sampling approach. Data regarding the prevalence of NCDs, participants' socio-demographics and lifestyle factors of NCDs were obtained using Modified STEPwise Approach to NCD Risk Factor Surveillance (STEPS). The Chi-square test and regression analysis were performed to identify the risk factors of NCDs at P < 0.05. The participants comprised 480 patients with a mean age of 37.7±16.5 years, and 57.7% (277/480) of them were females. The overall prevalence of the selected NCDs was 26.7% (CI = 0.23-0.31), of which hypertension (22.7%) was the most prevalent. More than half (54.2%) of the participants engaged in alcohol consumption and 54% were physically inactive. The odds of developing NCDs were higher in females (CI = 1.32-4.10, P = 0.004), older adults (CI = 4.11-20.68, P <0.001), overweight/obese adults (CI = 1.65-4.70, P < 0.001), family history (CI = 0.15-0.46, P<0.001), and alcohol consumption (CI = 0.12-0.40, P < 0.001). There was an overall high prevalence of NCDs, strongly influenced by the participants' age, sex, BMI, alcohol consumption, and family history. These determinants should be highlighted as part of the campaign for preventive action plans.

Patterns of ethical issues and decision-making challenges in clinical practice among Ghanaian physiotherapists.

OBJECTIVES: To determine the patterns of ethical issues and decision-making challenges encountered by practicing physiotherapists in Ghana. DESIGN: This is a cross-sectional study in which the stratified sampling technique was adopted to sample the participants. SETTING: The study involved physiotherapists at the private healthcare setting and from different levels of public healthcare facilities. PARTICIPANTS: Eighty-two duly registered physiotherapists who were practising in Ghana participated in the study. INTERVENTIONS: Participants completed a 30-item questionnaire related to ethical issues and challenges encountered in making ethical decisions. Data analysis was premised on the frequency of occurrence of ethical tensions and difficulty in decision making which were dichotomized as 'high' and 'low' issues, and 'extreme' and 'low' difficult decisions, respectively. RESULTS: The age range of the participants was 21-49 years (mean 31.5 ± 1.4years). 18 (22%), 31 (37.8%) and 33 (40.2%) physiotherapists practice in the primary, secondary and tertiary healthcare settings respectively. 56 (68.3%) and 43 (52.4%) of the participants affirmed that 'establishing priorities for patient's treatment amidst limited time resources' was the most frequently encountered and the most extremely difficult ethical issue to make a decision on respectively. Whereas, limiting physical therapy services for personal or organizational gains sub-theme was the least occurred issue which was also the least difficult to make a decision on as indicated by the respective 16 (19.5%) and 18 (22.0%) physiotherapists. CONCLUSION: A wide range of primary and secondary ethical issues were reported by the sampled physiotherapists, which tend to pose difficulty during the decision-making process in practice. FUNDING: The research work was self-funded by the authors.

Physical fitness of Ghanaian physiotherapists and its correlation with age and exercise engagement: a pilot study.

BACKGROUND: The physical job demands of physiotherapists require optimal level of physical fitness (PF), which is often not evaluated in practice. In this study, we assessed selected components of physical fitness of Ghanaian physiotherapists in relation to their sex, age and frequency of exercise participation. METHODS: Physiotherapists practicing in four major hospitals within the Accra Metropolis of Ghana were enrolled into this cross-sectional survey. Three major components of physical fitness (flexibility, cardiorespiratory endurance and body composition) were assessed with sit and reach test, 3-min step test and BMI respectively. Unpaired sample t-test was used to determine differences in means of the three components of physical fitness betwwen males and females. Pearson correlation coefficient showed that frequency of exercise engagement and age of the participants correlated with the three components of physical fitness at p < 0.05. RESULTS: The study sample consisted of 40 participants, out of which 23 (58 %) were females. The mean age was (31.5 ± 1.4) years and majority 21 (52.5 %) was within the age range of 20-29 years. Respective mean scores for cardiorespiratory endurance, flexibility and BMI were (98.2 ± 12.9 beat/min), (4.03 ± 6.15 cm) and (23.3 ± 3.4 kg/m2). Female participants were significantly more flexible than their male counterparts (5.7 ± 5.3; 1.6 ± 6.6, p = 0.034). There was a positive and significant correlation between the age of the participants and BMI (r = 0.614 and p = 0.017). However, cardiorespiratory endurance was not significantly correlated with age and frequency of exercise engagement. CONCLUSIONS: The sampled physiotherapists had relatively low physical fitness compared to the age adjusted values. Age and sex are therefore crucial determinants whilst designing programmes aimed at promoting physical fitness in this group.

Erratum to: Physical fitness of Ghanaian physiotherapists and its correlation with age and exercise engagement: a pilot study.

[This corrects the article DOI: 10.1186/s40945-016-0016-2.].

Variation in percentage weight bearing with changes in standing posture during water immersion: implication for clinical practice.

BACKGROUND: The degree of weightlessness during water immersion is usually estimated through percentage weight bearing (PWB). However, variations in PWB in different standing postures have not been documented. The study was designed to investigate the PWB of apparently healthy individuals in four standing postures at the anterior superior iliac spine level of immersion. METHODS: One hundred and ninety-three consenting undergraduates were purposively enlisted in this study. Participants' body weight (BW) was measured on land as well as in Erect Standing (ES), Grasp-Inclined-Prone-Standing (GIPS), Half-Grasp-Inclined-Towards-Side Standing (HGITSS) and Inclined-Standing with Head Support (ISHS) postures in hydro pool, using a specially designed water-proof weighing scale. PWB was calculated by dividing BW in water by BW on land and multiplying by 100. Data were analyzed using mean, standard deviation and ANOVA at α = 0.05. RESULTS: The mean age and BW (on land) of the participants were 22.4 years and 60.7 kg respectively. Participants' PWB were significantly different (p < 0.05) across the four standing postures. PWB was highest in ES and lowest in ISHS; PWB in ES (52.3 ± 5.8) being significantly higher (p < 0.001) than that observed in the derived standing postures. Further, PWB in GIPS (43.3 ± 5.6) and ISHS (43.2 ± 7.3) were significantly lower than in HGITSS (47.4 ± 5.2) posture while PWB in GIPS and ISHS postures were not significantly different (p > 0.05). CONCLUSION: Changes in standing posture have significant effect on PWB in hydro pool. The finding has implication for partial weight bearing exercises in hydro pool.

Assessment of the level of agreement in the interpretation of plain radiographs of lumbar spondylosis among clinical physiotherapists in Ghana.

BACKGROUND: Objective physical assessment of patients with lumbar spondylosis involves plain film radiographs (PFR) viewing and interpretation by the radiologists. Physiotherapists also routinely assess PFR within the scope of their practice. However, studies appraising the level of agreement of physiotherapists' PFR interpretation with radiologists are not common in Ghana. METHOD: Forty-one (41) physiotherapists took part in the cross-sectional survey. An assessment guide was developed from findings of the interpretation of three PFR of patients with lumbar spondylosis by a radiologist. The three PFR were selected from a pool of different radiographs based on clarity, common visible pathological features, coverage body segments and short post production period. Physiotherapists were required to view the same PFR after which they were assessed with the assessment guide according to the number of features identified correctly or incorrectly. The score range on the assessment form was 0-24, interpreted as follow: 0-8 points (low), 9-16 points (moderate) and 17-24 points (high) levels of agreement. Data were analyzed using one sample t-test and fisher's exact test at α = 0.05. RESULTS: The mean score of interpretation for the physiotherapists was 12.7 ± 2.6 points compared to the radiologist's interpretation of 24 points (assessment guide). The physiotherapists' levels were found to be significantly associated with their academic qualification (p = 0.006) and sex (p = 0.001). However, their levels of agreement were not significantly associated with their age group (p = 0.098), work settings (p = 0.171), experience (p = 0.666), preferred PFR view (p = 0.088) and continuing education (p = 0.069). CONCLUSIONS: The physiotherapists' skills fall short of expectation for interpreting PFR of patients with lumbar spondylosis. The levels of agreement with radiologist's interpretation have no link with year of clinial practice, age, work settings and continuing education. Thus, routine PFR viewing techniques should be made a priority in physiotherapists' continuing professional education.

Screening for developmental delay among children attending a rural community welfare clinic in Ghana.

BACKGROUND: Periodic screening for developmental delays (DD) could avert the incidence of disability among children. However, such routine programme is yet to take off in rural welfare clinics in Ghana. METHOD: Mothers of under-5 children who were attending rural child welfare clinic participated in this study. The socio-demographic data of the mothers and their children were recorded. The children were screened to assess their gross motor skills, fine motor skills, communication skills, problem solving/cognition and social/personal interaction using Ages and Stages Questionnaire. Score below the threshold points on a developmental domain defines DD for a child. Data analysis involved percentages and frequency while Chi-square was performed to determine the associations between the selected socio-demographic risk factors and DD. Alpha value was set at p < 0.05. RESULTS: Three hundren and thirty (330) children were screened and majority 60(18%), were found within the age range 3 months 1 day to 5 months 0 day. 251(76%) had normal weight (2.5 kg-3.5) while 26(7.6%) were underweight (<2.5 kg). Generally, 147(44.6%) of the children had DD in the different domains of the questionnaires. 41(12.4%) had DD in social/personal interaction while 19(5.8%) were delayed in the communication domain. Birth weight and duration of gestation were significantly associated with communication domain while the level of education of the mothers and duration of gestation were significantly associated with gross motor domain. CONCLUSION: An appreciable proportion of the children were found to experience developmental delays and the most prevalent occurence was in personal/social interaction. Birth weight, gestational age and maternal educational level provide insight into a link with communication and gross motor skills.

Health related quality of life amongst people affected by leprosy in South Ghana: a needs assessment.

AIM: This study examined Health Related Quality of Life (HRQOL) among leprosy-affected elderly people at three leprosoria located in South Ghana. METHODS: Seventy elderly people who have been cured of leprosy but were undergoing socio-economic rehabilitation at three selected Leprosaria in the southern part of Ghana, were involved in this study. They comprised 31 female and 39 male adults with leprosy-related residual impairment and disability. The main outcome measure was a standardised HRQOL questionaire which comprised physical functioning, role functioning, social functioning, cognitive functioning, health perception and pain. Descriptive statistics of mean and standard deviation were used to summarize the data whilst relationships and comparisons among and between the variables were evaluated using linear regression analysis and independent t-test respectively. Alpha level was set at P < 0.05. RESULTS: The mean age of the participants was 59.7 +/- 13-5 years. The overall mean score of the subjects (40.9 +/- 7.6) on the six domains of the questionnaire was below average. The highest and lowest mean scores were obtained in social functioning (56.9 +/- 20.1) and physical functioning (15.0 +/- 25.1) domains respectively. All the domains were significantly and positively correlated (P < 0.05) with the overall HRQOL scores. Age had no significant relationship (P > 0.05) on any of the domains and the overall HRQOL scores. Male participants scored signicantly higher (P < 0.05) than their female peer on cognitive functioning and HRQOL. CONCLUSION AND IMPLICATION: This study demonstrated low QOL among the sampled elderly people affected by leprosy at the selected leprosoria, thus stressing the need for measures that could improve their health and socio-economic status within the settlements.

Knowledge of pregnant women about birth defects.

BACKGROUND: Occurrence of birth defects (BD) remains an important public health issue. Inadequate knowledge about the defects among prospective mothers could result in delayed interventions. The study determined the knowledge of BD among pregnant women in relation to their socio-demographic profile. METHOD: Four hundred and forty-three (443) pregnant women gave their consent to participate in this study. A researcher-administered questionnaire was used to obtain information on socio-demographic characteristics from the participants and their knowledge about BD. The questionnaire was assessed for test re-test reliability before been administered. The possible scores on the knowledge domain of the questionnaire were categorized into three levels: low knowledge (0-4), moderate knowledge (5-8) and high knowledge (9-12) levels. Data were analyzed using percentages while Spearman's rank correlation was used to determine the relationship between the knowledge of BD among the participants and their socio-demographic profile. Alpha level was set at p < 0.05. RESULTS: A greater proportion of the participants, 235(53.0%) were found in the age range 21 to 30 years, and 234(52.8%) attained secondary level of education. Majority of the participants, 205(46.3%) had high knowledge on the risk factors while 213(48.1%) and 224(50.6%) had moderate overall knowledge and specific knowledge about BD respectively. Most of the participants (48.1%) believed that BD were of supernatural origin. The age, level of education, number of antenatal visits and parity of the participants were not significantly correlated (p > 0.05) with their specific and overall knowledge. CONCLUSIONS: Particpants generally had moderate knowledge about BD. However, this had no bearing on their socio-demographic profile. The knowledge base about BD seems to be influenced by traditional belief of the participants. This finding should therefore serve as a guide for health care providers while planning awareness campaign about BD.

Effects of aerobic exercise on selected physiological parameters and quality of life in patients with type 2 diabetes mellitus.

BACKGROUND: The aim of this study was to evaluate the effects of an 8-week aerobic exercise program on physiological parameters and quality of life in patients with type 2 diabetes mellitus. METHODS: Patients attending a diabetes clinic participated in this randomized control trial. They were randomly assigned to an intervention or control group by ballot. The intervention group, in addition to regular conventional treatment, received individually prescribed aerobic exercise for 30 minutes, at 50%-75% of maximum heart rate three times weekly. Main outcome measures included fasting blood sugar, glycosylated hemoglobin (HbA(1c)), high-density lipoprotein, low-density lipoprotein, and a World Health Organization quality of life questionnaire (WHOQoL-BREF). Data analysis involved paired and unpaired t-tests and mixed-design two-way analysis of variance. RESULTS: Eighteen patients with type 2 diabetes and of mean age 46.22 ± 9.79 years participated in the study. Mean duration since onset of diabetes in the intervention and control groups was 4.44 ± 3.33 years and 3.92 ± 2.66 years, respectively. Both groups were similar for duration since onset, baseline physiological parameters, and quality of life. Within-group comparison did not show any significant differences (P > 0.05) for HbA(1c), fasting blood sugar, low-density lipoprotein, or high-density lipoprotein. The intervention group improved significantly (P < 0.05) in their postexercise quality of life compared with baseline. Between-group comparison did not show any significant differences in physiological parameters or quality of life. CONCLUSION: Patients with type 2 diabetes improved in fasting blood sugar, low-density lipoprotein, high-density lipoprotein, and quality of life following 8 weeks of aerobic exercise training. These perceived improvements were not reflected by statistically significant differences in between-group comparison for any parameters.

Nosocomial infections: knowledge and source of information among clinical health care students in Ghana.

BACKGROUND: This study determined and compared the knowledge of nosocomial infections among clinical health care students at the College of Health Sciences, University of Ghana. METHODS: Two hundred undergraduate health care students from four academic programs participated in the study. The study sample was drawn from each academic program by a simple random sampling technique using the class directory from each course. The Infection Control Standardized Questionnaire (ICSQ) was used to assess the knowledge of students about three main domains, ie, hand hygiene, nosocomial infections, and standard precautions. A maximum score of 50 was obtainable, and respondents with scores ≥70% were classified as having a satisfactory knowledge. The response on each item was coded numerically to generate data for statistical analysis. Comparison of knowledge on the domains among categories of students was assessed using the Kruskal-Wallis test, while associations between courses of study and knowledge about nosocomial infections were determined using the Chi-square test. All statistical tests had a significant level of 5% (P < 0.05) RESULTS: Overall mean percentage score of the participants on ICSQ was 65.4 ± 2.58, with medical, physiotherapy, radiography, and nursing students recording mean percentage scores of 70.58 ± 0.62, 65.02 ± 2.00, 64.74 ± 1.19, and 61.31 ± 2.35, respectively. The main source of information about the prevention of nosocomial infections as cited by participants was their routine formal training in class. There was no significant association (P > 0.05) between course of study and knowledge of students about preventive measures for nosocomial infections. CONCLUSION: The students sampled demonstrated moderate knowledge of nosocomial infections and this was acquired largely through formal classroom training. These findings underscore the need for more emphasis on education about this important source of infection in the clinical training curriculum.