Cardiovascular disease prevention in Ghana: feasibility of a faith-based organizational approach

Objective To examine the feasibility of using community health workers (CHWs) to implement cardiovascular disease (CVD) prevention programmes within faith-based organizations in Accra; Ghana. Methods Faith-based organization capacity; human resources; health programme sustainability/barriers and community members' knowledge were evaluated. Data on these aspects were gathered through a mixed method design consisting of in-depth interviews and focus groups with 25 church leaders and health committee members from five churches; and of a survey of 167 adult congregants from two churches. Findings The delivery of a CVD prevention programme in faith-based organizations by CHWs is feasible. Many faith-based organizations already provide health programmes for congregants and involve non-health professionals in their health-care activities; and most congregants have a basic knowledge of CVD. Yet despite the feasibility of the proposed approach to CVD prevention through faith-based organizations; sociocultural and health-care barriers such as poverty; limited human and economic resources and limited access to health care could hinder programme implementation. Conclusion The barriers to implementation identified in this study need to be considered when defining CVD prevention programme policy and planning

The use of Doppler ultrasound in the clinical management of acute testicular pain.

OBJECTIVE: To evaluate the reliability and the clinical application of the use of a hand-held Doppler ultrasound flowmeter probe as an aid to differential diagnosis in the assessment of cases with acute testicular pain presenting to a district general hospital. PATIENTS AND METHODS: Over a period of 1 year, testicular Doppler ultrasonic assessment was performed on 56 patients admitted with acute scrotal pain. A hand-held Doppler ultrasound probe was used, with a transducer operating at 8 MHz. All the patients were assessed pre-operatively by a single operator in the Accident and Emergency department before transfer to theatre. The decision to explore the testis was made purely on clinical grounds by which ever emergency surgical team was on duty. The operating surgeons were not informed of the result of Doppler examinations before surgical exploration. RESULTS: Twenty-two patients were subsequently shown to have torsion of the testis at surgical exploration, all of whom had no Doppler signal over the affected side. Of the remaining 34 patients, who were subsequently shown not to have torsion at operation, normal testicular blood flow and cord-compression tests were demonstrated confidently in 33 patients when examined pre-operatively. Thus the sensitivity was 100% (22/22) and the specificity 97% (33/34). CONCLUSION: Testicular Doppler examination using an 8 MHz probe in conjunction with the cord-compression test is a useful, simple and highly accurate clinical tool which can differentiate between testicular torsion and other conditions presenting with acute testicular pain. It is also inexpensive and readily available in the district general hospital situation.