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Nkrumah B.,Kumasi Center for Collaborative Research in Tropical Medicine | Nguah S.,Komfo Anokye Teaching Hospital
Parasites and Vectors | Year: 2011

Background: Acute childhood diarrhoea remains one of the leading causes of childhood morbidity and mortality in developing countries. The WHO has accordingly underlined the need for epidemiological surveys of infantile diarrhoea in all geographical areas. This study was conducted to determine the incidence of intestinal parasites among stool samples from children examined at a secondary health care facility in a rural area of Ghana. Method. A retrospective study was conducted to investigate the incidence of intestinal parasites among children who had their stools examined at the Agogo Hospital laboratory. Stool microscopy results from January 2006 through May 2009 were obtained from archived records of the laboratory. Results for children less than 18 years were transcribed unto a standardized datasheet, entered into an electronic database designed using Microsoft access 2007 and analyzed using Stata/SE11.1 statistical software. The incidences of the parasites were determined and presented with their Poisson exact 95% confidence intervals for the various ages. Results: The median age of the 1080 children included in the study was 5 years (IQR: 2-12 years) with 51.9% being females. The overall incidence of all parasites was 114 per 1000 with Giardia lamblia being the most common (89.5%). Children aged less than a year had the lowest parasite incidence of 13 per 1000 with all being Giardia lamblia, while those aged 15-17 years had the highest of 169 per 1000. The incidence for Giardia lamblia only was lowest at 13 per 1000 for those under a year old, highest at 152 per 1000 for the 15-17 year group and 97 per 1000 for all ages combined. There was a significant rise in incidence of Giardia lamblia with age (Trend x 2 = 18.6, p < 0.001). Five (4.3%) of the 118 positive stool samples had mixed parasites infection. Enterobius vermicularis, Taenia spp and Trichuris trichiura were not seen in any of the stool samples. Conclusion: Giardia lamblia is the most prevalent intestinal parasite in examined stool samples of children within the Ashanti Akim North Municipality and its prevalence significantly increases with age. Measures must be put in place to educate the community on proper personal hygiene to reduce giardiasis. © 2011 Nkrumah and Nguah; licensee BioMed Central Ltd.


Asenso-Mensah K.,Komfo Anokye Teaching Hospital
Transfusion | Year: 2014

In sub-Saharan Africa (SSA) confirmed viral marker prevalence between family donors (FDs) and first-time volunteer nonremunerated donors (VNRDs) is similar. In a blood service collecting 10 units/1000 inhabitants, a questionnaire examined FD donation conditions and willingness of becoming repeat VNRDs. Four areas were explored: circumstances of visit to hospital, external pressure, experience of donating, and potential repeat donation. After donation and consent, research assistants administered 25 questions and, according to literacy, helped with translation and completion. Of 513 FDs, three-fourths were males (median age, 27 years). Only 1.3% were unemployed and more than 50% were students or teachers. Ties with hospitalized patient were family (76%), friends (13%), colleagues, or sharing place of worship (10%). Donating blood was the reason for visiting in 16.8% and 20.9% had previously donated blood probably as FDs. In one-third of FDs, the family asked for donation of which 10% was pressured by the unjustified reason that not donating was endangering the patient's life. For two-thirds of FDs, donation was given "because individuals were asked." Donation was a positive experience for 77% of donors, 62% being interested in predonation testing. Repeating donation was acceptable for 99% of 79% FDs answering. FDs are active in the population, are willing to donate blood if asked, are submitted to little pressure, do not receive incentives, and accept repeat donation. Except for circumstances of donation, FDs are not different from VNRDs and more directly motivated. They constitute a legitimate and important source to improve the blood supply in SSA. © 2013 American Association of Blood Banks.


Laryea D.O.,Komfo Anokye Teaching Hospital | Abbeyquaye Parbie E.,37 Military Hospital | Frimpong E.,Komfo Anokye Teaching Hospital
BMC Public Health | Year: 2014

Background: Childhood immunisation is a cost-effective activity in health. Immunisation of children has contributed to reducing child morbidity and mortality. In the last two decades, global deaths from vaccine-preventable illnesses have decreased significantly as a result of immunisation. Similar trends have been observed in Ghana following the introduction of the Expanded Programme on Immunisation. The administration of vaccines is based on the period of highest susceptibility among others. Ghana has long used the proportion of children receiving vaccines and the trends in vaccine preventable illness incidence as performance indicators for immunisation. The addition of timeliness of vaccine uptake as an additional performance indicator has been recommended. This study evaluated the timeliness of vaccine uptake among children immunised at the Komfo Anokye Teaching Hospital, Kumasi, Ghana. Methods. The study was conducted at the Maternal and Child Health clinic of the hospital between February and March 2012. A representative sample of 259 respondents was selected by simple random sampling. Data collection was by a structured questionnaire and included the examination of Child Health records booklet. Data was entered into a Microsoft Office Access database and analysed using Epi Info Version 3.5.1 2008. Results: The majority of mothers attended antenatal clinics during pregnancy. An overwhelming majority of babies (98.8%) were delivered in a hospital. About 85% of babies were less than 12 months of age. Mean time taken to reach the clinic was 30 minutes. Vaccine uptake was generally timely for initial vaccines. The proportion of children receiving the vaccines later increased with latter vaccines. Overall, 87.3% of babies received vaccines on time with only 5.3% receiving vaccines beyond 28 days of the scheduled date. Children receiving immunisations services in the same facility as they were born were more likely to receive the BCG vaccine on time. Conclusions: Vaccine uptake is mostly timely among respondents in the study. The BCG vaccine in particular was received on time among children born in the same facility as the immunisation clinic. There is the need to further examine the timeliness of vaccine uptake among children delivered outside health facilities in Ghana. © 2014 Laryea et al.; licensee BioMed Central Ltd.


Antwi S.,Komfo Anokye Teaching Hospital
Blood Purification | Year: 2015

Introduction: Renal replacement therapy (RRT) in the form of dialysis and kidney transplantation is a life-saving intervention for patients with kidney disease in failure for both acute and chronic cases. Ghana is an emerging economy in West Africa with close to 27 million people. The limited data that is available indicates a significant burden of kidney disease in Ghana. I analyzed the state of RRT in Ghana in this report. Method: A situational analysis report conducted to establish the availability and type of renal replacement therapy services across the country. Information was obtained from records at dialysis centers and also by interview of staff at these centers. Results: Haemodialysis services are available in 3 public and 3 private health institutions for adults in kidney failure both acute and chronic. These centers are located in the southern half of the country leaving the northern two-thirds uncovered. National Health Insurance Scheme pays for the cost of acute dialysis for up to GHC 850 (∼USD 265). However, there is no insurance cover for any aspect of chronic RRT putting huge financial constraints on families, which sometimes plunge entire extended families into serious financial crisis. Kidney transplantation is available on a limited scale at the national capital. Children only benefit from peritoneal dialysis for acute kidney injury, thanks to the partnership with Sustainable Kidney Care Foundation. There is no rescue intervention as of now for children with end stage renal failure. Conclusion: The current state of RRT services in Ghana is inadequate and calls for serious national consideration. © 2015 S. Karger AG, Basel.


Asiedu K.,Komfo Anokye Teaching Hospital
Eye and Contact Lens | Year: 2016

BACKGROUND:: This study sought to investigate, if the Standard Patient Evaluation of Eye Dryness (SPEED) questionnaire acts as a measure of dry eye severity and whether it is unidimensional using Rasch analysis. METHODS:: This is a hospital-based cross-sectional study. The study included 127 patients with glaucoma with either a clinical diagnosis of dry eye or an Ocular Surface Disease Index score of ≥13. Participants completed questionnaires (SPEED) delivered directly to them. RESULTS:: A total of 127 participants met the inclusion criteria and were included in the analysis. Category response analysis revealed that the average logit measures for the response category increased with higher response category from −4.93 to +5.41 logit. Item infit mean square statistics of the individual items ranged from 0.57 to 1.33, with a mean of 0.99±0.2. The individual item outfit mean square ranged from 0.58 to 1.36, with a mean of 1.02±0.0. The person separation index (PSI) and separation reliability of the SPEED were 2.23 and 0.83, respectively. Principal component analysis (PCA) of the standardized model residuals revealed evidence of multidimensionality, with first contrast eigenvalue of 2.5 and the second contrast eigenvalue of 1.7. Because fit statistics of all items were within 0.5 to 1.7 and considered adequate for clinical observations, no item was removed. However, the six items of the SPEED that asked about the commonest dry eye symptoms as reported by patients with dry eye were analyzed separately to determine how they behaved. The item fit statistics of these six items were within the range of 0.6 to 1.4. The outfit statistics range from 0.62 to 1.26, with a mean of 1.00±0.1. The infit statistics range from 0.61 to 1.24, with a mean of 0.99±0.2. The PSI and reliability were 2.2 and 0.83, respectively. Finally, PCA of the standardized model residuals revealed no evidence of multidimensionality, with first contrast eigenvalue of 2.0. CONCLUSION:: In summary, this study showed that the SPEED had an ordered response category and was a measure of dry eye severity. However, PCA of the standardized model residuals revealed evidence of multidimensionality. A proposed six-item SPEED was unidimensional and was also a measure of disease severity. Hence, the SPEED questionnaire score may be used as a measure of dry eye severity in clinical practice and epidemiological studies. © 2016 Contact Lens Association of Ophthalmologists, Inc.


Owusu-Ofori A.K.,Komfo Anokye Teaching Hospital | Parry C.,University of Oxford | Bates I.,Disease Control Strategy Group
Clinical Infectious Diseases | Year: 2010

Although international policies recommend that blood for transfusion should be screened for transfusion-transmitted infections, malaria screening is not performed in most malaria-endemic countries in sub-Saharan Africa. Our literature review identified 17 relevant studies from the period 1980-2009 and indicated that the median prevalence of malaria among 33,029 blood donors was 10.2% (range, 0.7% in Kenya to 55.0% in Nigeria). Malaria screening methods, including microscopy (used in 16 of 17 studies), are either insensitive or impractical for donor screening in resource-poor countries. Even if a suitable screening method were available, rejection of malaria-positive donors would jeopardize the blood supply. Only 1 study established the prevalence of parasitemia among transfusion recipients. This review highlights the need for more evidence about the clinical impact of transfusion-transmitted malaria to justify the policy of screening for blood for malaria in areas of endemicity and for a critical analysis of the feasibility of implementing such a policy and its effect on blood supply. © 2010 by the Infectious Diseases Society of America. All rights reserved.


Allain J.-P.,University of Cambridge | Owusu-Ofori A.K.,Kwame Nkrumah University Of Science And Technology | Assennato S.M.,University of Cambridge | Marschner S.,Terumo BCT | And 2 more authors.
The Lancet | Year: 2016

Background Transfusion-transmitted malaria is a frequent but neglected adverse event in Ghana. We did a randomised controlled clinical trial to assess the efficacy and safety of a whole blood pathogen reduction technology at preventing transfusion transmission of Plasmodium spp parasites. Methods For this randomised, double-blind, parallel-group clinical trial, eligible adult patients (aged ≥18 years) with blood group O+, who required up to two whole blood unit transfusions within 3 days of randomisation and were anticipated to remain in hospital for at least 3 consecutive days after initial transfusion, were enrolled from Komfo Anokye Teaching Hospital in Kumasi, Ghana. The main exclusion criteria were symptoms of clinical malaria, antimalaria treatment within 7 days before randomisation, fever, and haemorrhage expected to require transfusion with up to two units of whole blood during the 3 days following study entry. Eligible patients were randomly assigned 1:1 by computer-generated permuted block randomisation (block size four) list to receive transfusion with either pathogen-reduced whole blood (treated) or whole blood prepared and transfused by standard local practice (untreated). Patients, health-care providers, and data collectors were masked to treatment allocation. Patients in both groups received up to two whole blood unit transfusions that were retrospectively tested for parasitaemia. Pre-transfusion and post-transfusion blood samples (taken on days 0, 1, 3, 7, and 28) were tested for presence and amount of parasite genome, and assessed for haematological and biochemical parameters. The primary endpoint was the incidence of transfusion-transmitted malaria in non-parasitaemic recipients exposed to parasitaemic whole blood, defined as two consecutive parasitaemic post-transfusion samples with parasite allelic matching, assessed at 1-7 days after transfusion. Secondary endpoints included haematological parameters and a safety analysis of adverse events in patients. This study is registered with ClinicalTrials.gov, number NCT02118428, and with the Pan African Clinical Trials Registry, number PACTR201406000777310. Findings Between March 12, 2014, and Nov 7, 2014, 227 patients were enrolled into the study, one of whom was subsequently excluded because she did not meet the inclusion criteria. Of the 226 randomised patients, 113 were allocated to receive treated whole blood and 113 to receive standard untreated whole blood. 223 patients (111 treated and 112 untreated) received study-related transfusions, whereas three patients (two treated and one untreated) did not. 214 patients (107 treated and 107 untreated) completed the protocol as planned and comprised the per-protocol population. Overall, 65 non-parasitaemic patients (28 treated and 37 untreated) were exposed to parasitaemic blood. The incidence of transfusion-transmitted malaria was significantly lower for the pathogen-reduced (treated) patients (1 [4%] of 28 patients) than the untreated group (8 [22%] of 37 patients) in this population (p=0·039). Overall, 92 (41%) of 223 patients reported 145 treatment-related emergent adverse events during the conduct of the study, with a similar incidence of adverse events between groups receiving untreated or treated whole blood. No transfusion-related deaths occurred in the trial. Interpretation Treatment of whole blood with the Mirasol pathogen reduction system for whole blood reduced the incidence of transfusion-transmitted malaria. The primary endpoint of the study was achieved in the population of non-parasitaemic patients receiving parasitaemic whole blood. The safety profile and clinical outcomes were similar across the two treatment groups. Funding Terumo BCT Inc. © 2016 Elsevier Ltd.


Owusu-Ofori S.,Komfo Anokye Teaching Hospital
The Cochrane database of systematic reviews | Year: 2013

Acute splenic sequestration crises are a complication of sickle cell disease, with high mortality rates and frequent recurrence in survivors of first attacks. Splenectomy and blood transfusion, with their consequences, are the mainstay of long-term management used in different parts of the world. To assess whether splenectomy (total or partial), to prevent acute splenic sequestration crises in people with sickle cell disease, improved survival and decreased morbidity in people with sickle cell disease, as compared with regular blood transfusions. We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group Haemoglobinopathies Trials Register, which comprises of references identified from comprehensive electronic database searches and handsearching relevant journals and abstract books of conference proceedings.Additional trials were sought from the reference lists of the trials and reviews identified by the search strategy.Date of the most recent search: 06 December 2012. All randomized or quasi-randomized controlled trials comparing splenectomy (total or partial) to prevent recurrence of acute splenic sequestration crises with no treatment or blood transfusions in people with sickle cell disease. No trials of splenectomy for acute splenic sequestration were found. No trials of splenectomy for acute splenic sequestration were found. Splenectomy, if full, will prevent further sequestration and if partial, may reduce the recurrence of acute splenic sequestration crises. However, there is a lack of evidence from trials showing that splenectomy improves survival and decreases morbidity in people with sickle cell disease. There is a need for a well-designed, adequately-powered, randomized controlled trial to assess the benefits and risks of splenectomy compared to transfusion programmes, as a means of improving survival and decreasing mortality from acute splenic sequestration in people with sickle cell disease.


Kingham T.P.,Sloan Kettering Cancer Center | Alatise O.I.,Obafemi Awolowo University | Vanderpuye V.,Korle Bu Teaching Hospital | Casper C.,Fred Hutchinson Cancer Research Center | And 6 more authors.
The Lancet Oncology | Year: 2013

Cancer is rapidly becoming a public health crisis in low-income and middle-income countries. In sub-Saharan Africa, patients often present with advanced disease. Little health-care infrastructure exists, and few personnel are available for the care of patients. Surgeons are often central to cancer care in the region, since they can be the only physician a patient sees for diagnosis, treatment (including chemotherapy), and palliative care. Poor access to surgical care is a major impediment to cancer care in sub-Saharan Africa. Additional obstacles include the cost of oncological care, poor infrastructure, and the scarcity of medical oncologists, pathologists, radiation oncologists, and other health-care workers who are needed for cancer care. We describe treatment options for patients with cancer in sub-Saharan Africa, with a focus on the role of surgery in relation to medical and radiation oncology, and argue that surgery must be included in public health efforts to improve cancer care in the region. © 2013 Elsevier Ltd.


News Article | April 3, 2016
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Komfo Anokye Teaching Hospital , the nation's second largest referral facility, is increasingly shifting to the use of solar power to cut down its energy bill. There is the additional advantage of uninterrupted power supply for its operations. Start the conversation, or Read more at GhanaWeb.

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