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Phillips R.O.,Komfo Anokye Teaching Hospital KATH | Phillips R.O.,Kwame Nkrumah University Of Science And Technology | Sarfo F.S.,Komfo Anokye Teaching Hospital KATH | Abass M.K.,Agogo Presbyterian Hospital | And 7 more authors.
Antimicrobial Agents and Chemotherapy | Year: 2014

Buruli ulcer, an ulcerating skin disease caused by Mycobacterium ulcerans infection, is common in tropical areas of western Africa. We determined the clinical and microbiological responses to administration of rifampin and streptomycin for 2 weeks followed by administration of rifampin and clarithromycin for 6 weeks in 43 patients with small laboratory-confirmed Buruli lesions and monitored for recurrence-free healing. Bacterial load in tissue samples before and after treatment for 6 and 12 weeks was monitored by semiquantitative culture. The success rate was 93%, and there was no recurrence after a 12-month follow-up. Eight percent had a positive culture 4 weeks after antibiotic treatment, but their lesions went on to heal. The findings indicate that rifampin and clarithromycin can replace rifampin and streptomycin for the continuation phase after rifampin and streptomycin administration for 2 weeks without any apparent loss of efficacy. Copyright © 2014, American Society for Microbiology. All Rights Reserved.

Adjei E.K.,University of Tromso | Owusu-Afriyie O.,University of Tromso | Awuah B.,Komfo Anokye Teaching Hospital KATH | Stalsberg H.,University of Tromso
Breast Journal | Year: 2014

Hormonal treatment of breast cancer is effective only in patients whose tumors express estrogen and/or progesterone receptors (ER, PR). Receptor assessment is often not available in low-resource areas, and the choice may be to apply endocrine therapy to all or none of breast cancer patients, depending on the proportion of patients that can be expected to respond. Fifty-one invasive breast cancers from Ghana and 100 from Norway diagnosed in the same laboratory during the same time period were reexamined in a blinded slide review. Of Ghanaian tumors, 76% were ER+ (≥1% ER+ tumor cells). Of Norwegian tumors, 85% were ER+. Triple-negative tumors were seen in 22% of Ghanaian patients and in 7% of Norwegian patients. A review of previous similar studies in sub-Saharan patients shows very discrepant results. Standardization and quality control of receptor assessment and well-designed clinical trials in sub-Saharan African breast cancer patients are needed to give a sound basis for endocrine treatment in this area. © 2014 Wiley Periodicals, Inc.

Agyei-Baffour P.,Kwame Nkrumah University Of Science And Technology | Sekyere K.B.,Komfo Anokye Teaching Hospital KATH | Addy E.A.,Kwame Nkrumah University Of Science And Technology
BMC Research Notes | Year: 2013

Background: Food borne diseases claim more lives and are growing public health concerns. Simple preventive techniques such as adoption and adherence to hazard analysis and critical control point (HACCP) policy can significantly reduce this disease burden. Though food screening and inspection are done, the ultimate regulation, Hazard Analysis and Critical Control Point, which is known and accepted worldwide, appears not to be popular among food operators in Ghana. This paper examines the level of awareness of the existence of policy on hazard analysis and critical control point (HACCP) and its adherence to food preparation guidelines among food service providers in Ghana. Results: The results revealed the mean age of food providers as 33.1 years with a standard deviation of 7.5, range of 18-55 years, more females, in full time employment and with basic education. Of the fifty institutional managers, 42 (84%) were senior officers and had worked for more than five years. Education and type of food operator had strong statistically significant relationship with the implementation of HCCP policy and adherence with food preparation guidelines. The enforcement of HACCP policy and adherence with food safety guidelines was led by the Ghana Tourist Board, Public Health officers, and KMA, respectively. While a majority of food operators 373/450 (83.3%) did not know HACCP policy is part of food safety guidelines, staff of food safety law enforcement 44/50 (88%) confirmed knowing that food operators were not aware of the HACCP policy. Conclusion: The study documents evidence on the practice of food safety principles or HACCP policy or adherence to food preparation guidelines. Existing food safety guidelines incorporate varying principles of HACCP, however, awareness is low among food operators. The implication is that food production is likely to fall short of acceptable standards and not be wholesome putting consumers at health risk. Repeating this study in rural and urban areas in Ghana is necessary to provide much more evidence to inform food safety guidelines. Further studies on chemical analysis of food and implementing training modules on HACCP policy for food producers and law enforcement agencies may be helpful to improve existing situation. © 2013 Agyei-Baffour et al.; licensee BioMed Central Ltd.

Whiteside L.K.,University of Michigan | Oteng R.,University of Michigan | Carter P.,University of Michigan | Amuasi J.,Komfo Anokye Teaching Hospital KATH | And 5 more authors.
International Journal of Emergency Medicine | Year: 2012

Background: According to the World Health Organization (WHO), injuries represent the largest cause of death among people ages 140 -and contribute to a large burden of disease worldwide. The aims of this study were to characterize the prevalence and relative mechanism of injury among children seeking emergency care and describe the demographics at time of presentation among these children to inform further research in Ghana and sub-Saharan Africa. Methods: A prospective cross-sectional survey of pediatric patients (n = 176) was conducted between 13 July 2009 and 30 July 2009 in the Accident and Emergency Center at Komfo Anoche Teaching Hospital (KATH) in Kumasi, Ghana. Participants were asked questions regarding demographics, insurance status, overall health, and chief complaint. Results: Of the 176 patients surveyed, 66% (n = 116) presented for injuries. The mean age was 4.7 years (range 1.5 months to 17 years), and 68% (n = 120) were male. Of those presenting with injury, 43% (n = 50) had road traffic injuries (RTI). Of the RTIs, 58% (n = 29) were due to being an occupant in a car crash, 26% (n = 13) were pedestrian injuries, and 14% (n = 7) were from motorcycles. There was no significant difference in demographics, health status or indicators of socioeconomic status between injured and non-injured patients. Conclusions: Among pediatric patients presenting for acute care at KATH during the study time frame, the majority (n = 116, 66%) presented for injuries. To date, there are no studies that characterize pediatric patients that present for acute care in Ghana. Identifying injury patterns and collecting epidemiologic data are important to guide future research and educational initiatives for Emergency Medicine. © 2012 Whiteside et al.; licensee Springer.

Obirikorang C.,Kwame Nkrumah University Of Science And Technology | Osakunor D.N.M.,Kwame Nkrumah University Of Science And Technology | Ntaadu B.,Kwame Nkrumah University Of Science And Technology | Adarkwa O.K.,Komfo Anokye Teaching Hospital KATH
PLoS ONE | Year: 2014

Background: HAART is anticipated to result in an increase in long-term survival, but may present with the development of associated complications. The aim of this study was to assess the renal function of HIV-infected patients on antiretroviral therapy. Methods: A case-control study (January to May 2013) conducted at the Suntreso Government Hospital, Kumasi, Ghana. A total of 163 HIV-infected patients (mean age 39.9±10.22) were studied, of which 111 were on HAART (HIV-HAART) and 52 were not (HIV-Controls). Serum urea, creatinine, potassium, sodium, chloride and CD4 counts were measured with the determination of eGFR (CKD-EPI and MDRD). Data was analysed using GraphPad Prism. The Chi-square, t-test, one-way ANOVA and Spearman's correlation were used. P values <0.05 were considered significant. Results: Mean CD4 count of HIV-Controls was higher than that of HIV-HAART but was not significant (p = 0.304). But for sodium levels which were higher in HIV-Controls (p = 0.0284), urea (p = 0.1209), creatinine (p = 0.7155), potassium (p = 0.454) and chloride (p = 0.6282) levels did not differ significantly between both groups. All serum biochemical parameters did not differ significantly, irrespective of duration on therapy and CD4 counts. Based on regimen, sodium, chloride, urea and creatinine did not differ significantly between TDF, EVF and NVP-based therapies. Prevalence of CKD (eGFR <60 ml/min/1.73 m2) in the total population was 9.9% and 3.7% with the MDRD and EPI-CKD equations respectively. Conclusions: Renal insufficiency remains prevalent in HIV patients. Changes in renal function occur in HIV infection and over the course of HAART but the difference at either stage is not significant. This suggests the role of HIV infection, HAART and the presence of traditional risk factors but not HAART in itself, in renal dysfunction. We however recommend a close monitoring of patients before and during HAART, to aid in evaluating drug combinations and implement dose modifications when necessary. © 2014 Obirikorang et al.

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