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Postgraduate Medical Journal of Ghana
Volume 7 Number 2

Articles in Volume 7 number 2

The Impact of Rotavirus Vaccine on Diarrheal Diseases Among Children Under Five Years: A Retrospective Analysis of Data From 2012 To 2015 In the Yilo Krobo Municipality of Ghana
Owusu-Sarpong A, Agbeshie K, Teg-Nefaah PT

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THE IMPACT OF ROTAVIRUS VACCINE ON DIARRHEAL DISEASES AMONG CHILDREN UNDER FIVE YEARS: A RETROSPECTIVE ANALYSIS OF DATA FROM
2012 TO 2015 IN THE YILO KROBO MUNICIPALITY OF GHANA

Key Words: Rotavirus vaccines, Diarrhoea, Impact, Yilo Krobo, Ghana

ABSTRACT

Introduction: Diarrhea is an important childhood disease with high morbidity and mortality among children under 5 years of age in developing countries such as Ghana. Rotavirus vaccine was introduced in Ghana in 2012 to reduce the incidence of diarrhea among children in Ghana. The objective of the study is to assess the impact of rotavirus vaccines on the burden of diarrheal diseases among children under five years reported in the Yilo Krobo Municipality from 2012 to 2015.

Methods: A retrospective analysis of routinely collected and reported data on the monthly outpatient department (OPD) morbidity returns and vaccination reports from health facilities in the Yilo Krobo Municipality was done.

Results: The burden of diarrheal diseases in children under five years declined from 2012 to 2014 with a slight increase in 2015. Diarrhea formed 9.71% of OPD cases in children under five years in 2012 with a reduction to 7.73% between 2013 and 2015.

Conclusion: The rotavirus vaccine has had some impact on the incidence of diarrheal diseases reported at the
outpatient departments.

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Maternal and Fetal Outcome of Normal and Abnormal Cardiotocographic Findings at A Tertiary Hospital in Ghana
Coleman J1, Seffah JD2, Oppong SA2, Anderson FJ3

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MATERNAL AND FETAL OUTCOME OF NORMAL AND ABNORMAL
CARDIOTOCOGRAPHIC FINDINGS AT A TERTIARY HOSPITAL IN GHANA

Key Words: Childhood, malignant, tumours, orofacial, Ghana

ABSTRACT

Background: Cardiotocography (CTG) provides important information about the interaction between fetal cerebral and cardiac activities which are both modified by hypoxia. The duration and severity of hypoxia and associated biochemical abnormalities all influence the manifestations of fetal heart rate abnormalities. Antenatal fetal heart rate monitoring with CTG has potential in preventing intrauterine fetal death.

Aim: The aim of the study was to compare the maternal and fetal outcome of pregnancies with normal and abnormal antepartum CTG tracings.

Methodology: This descriptive retrospective review compared 200 consecutive women with normal and 200 with abnormal CTG tracings. The study lasted six months and spanned a period of time from beginning of January to end of June 2011. Demographic, pregnancy and delivery outcome data were retrieved from participants’ charts and simple descriptive analysis was performed. Means and their standard deviations of continuous variables were calculated and difference between group mean were compared using the student ttest. Categorical variables were summarized as proportions and the chi-square test used to test for difference between groups. A p-value < 0.05 was
considered statistically significant.

Results: Women with normal and abnormal CTG tracings were comparable in their demographic characteristics. Abnormal CTG tracings were associated with higher rate of preterm delivery (38.8% vs 18.8%, p= 0.001), caesarean section (77.9% vs 47.0%, p = 0.001) low birth weight (25.5% vs 9.1%, p = 0.001) and NICU admissions (36.5% vs 17.6%, p = 0.001). There was no difference in Apgar score or stillbirth rate between thetwo groups. Pregnancies with abnormal tracing were delivered about a week earlier than those with normal tracing. (37.8±2.9 vrs 38.3±2.6, p=0.001). Longer interval between tracing and delivery was associated with stillbirth.

Conclusion: Abnormal antepartum CTG tracing was associated with higher preterm delivery, caesarean section, low birth weight and NICU admission. Longer interval between abnormal tracing and delivery was associated with higher stillbirth rate. Active and adequate resuscitation of babies with abnormal tracing can reduce perinatal morbidity.

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Mode of Delivery and Caesarean Indications Among Women with Hypertensive Disorders in Pregnancy at Korle Bu Teaching Hospital
Adu-Bonsaffoh K, Seffah JD

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MODE OF DELIVERY AND CAESAREAN INDICATIONS AMONG WOMEN WITH HYPERTENSIVE DISORDERS IN PREGNANCY AT KORLE BU TEACHING HOSPITAL

Key Words: Ccaesarean indications, preeclampsia, eclampsia, chronic hypertension.

ABSTRACT

Objective: To determine the relative proportions of vaginal and caesarean deliveries, and the common caesarean indications among women with hypertensive disorders in pregnancy (HDP).

Materials and methods: A cross sectional study conducted at the Maternity unit of Korle Bu Teaching Hospital in Accra from 1st January to 28th February 2013.

Results: A total of 368 women with HDP were recruited with 168 (45.7%) and 200 (54.3%) having caesarean and
vaginal deliveries respectively. Regarding the caesarean delivery, 31 (18.5%) had gone into labour prior to the surgery whiles 137 (81.5%) were not in labour. Among the 368 women 68 (18.5%) had induction of labour out of which 46 (67.6%) achieved vaginal delivery. The risk of caesarean section was significanty higher in preeclampsia [(adjusted odds ratio 2.898 (1.741-4.824), p-value <0.001] and chronic hypertension [(adjustedodds ratio 2.474 (1.194-5.128), p-value =0.015] with reference to gestational hypertension. The Common caesarean indications among women with HDP were previous caesarean birth (26.2%), unfavourable cervix (22.6%), fetal distress (14.9%), failure to progress
(10.7%), fetal malpresentation (9.5%), failed induction (7.1%) and placental abruption (3.0%). A total of 65 (17.7%) women with HPD had had a prior caesarean birth.

Conclusion: This study has determined a high caesarean birth rate in women with HDP with the highest and lowest caesarean rates occurring in chronic hypertension and gestational hypertension respectively. The common
caesarean indications among women with HDP were previous caesarean birth, unfavourable cervix, fetal distress, failure to progress, fetal malpresentation, failed induction of labour and placental abruption.

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The Geographical Distribution of Gastrointestinal Endoscopy Services Within Government and Faith Based Hospitals in Ghana
Awuku YA, Kuenyefu R, Oduro-Donkor D, Awuku NA, Sarkodie BD

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THE GEOGRAPHICAL DISTRIBUTION OF GASTROINTESTINAL ENDOSCOPY SERVICES WITHIN GOVERNMENT AND FAITH BASED HOSPITALS IN GHANA

Key Words: Gastrointestinal endoscopy, government, faith based and Ghana.

ABSTRACT

Background: Gastrointestinal (GI) endoscopy is generally a very safe and effective diagnostic and interventional modality in the current practice of medicine. To plan a comprehensive equitable gastrointestinal endoscopy service, the geographical distribution of this essential facility needs to be mapped.

Methods: This study was a cross sectional situational survey of gastrointestinal endoscopy services within government and faith based health facilities in Ghana. Information on the availability of GI endoscopy services as at December 2016 was obtained by interviewing doctors from the various regions in Ghana. Five (5) doctors working in different hospitals were interviewed per region.

Results: Gastrointestinal (GI) endoscopy service was available in 3 out of the 4 teaching hospitals and only one regional hospital (Sunyani) in Ghana. The upper east, Upper west and Volta regions have no GI endoscopy services within any government or faith based facility. The Christian Health Association of Ghana (CHAG) complemented government effort with GI endoscopy units at 4 district hospitals located in the Eastern, Central, Brong Ahafo and Volta regions.

Conclusion: The distribution of gastrointestinal endoscopy services within government and faith based facilities is uneven. There is an urgent need to establish these services equitably across Ghana.

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Pattern of Congenital Central Nervous System Anomalies Among Newborns at A Regional Special Care Baby Unit (SCBU) in Makurdi, North Central Nigeria
Eseigbe EE, Ochoga M, Abah R, Dabit O, Eseigbe P, Ekuma G

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PATTERN OF CONGENITAL CENTRAL NERVOUS SYSTEM ANOMALIES AMONG NEWBORNS AT A REGIONAL SPECIAL CARE BABY UNIT (SCBU) IN MAKURDI, NORTH CENTRAL NIGERIA

Key Words: Congenital anomalies, Central Nervous System, Newborn, Nigeria, Myelomeningocele

ABSTRACT

Background: Congenital anomalies of the central nervous system (CNS) are important causes of childhood mortality, chronic illness and disability. They have significant implications for childhood growth and development particularly in resource limited settings. A review of their occurrence is valuable to instituting preventive and curative health care services.
Objective: To document the pattern of congenital CNS anomalies in our practice
Subjects and Method: A retrospective study of all neonatal admissions with congenital anomalies of the CNS (Patients) admitted into the Special Care Baby Unit (SCBU) of Benue State University Teaching Hospital (BSUTH) in Makurdi-Nigeria, between June 2013 and January 2016. The anomalies were classified according to the ICD 10 Classification. Other parameters assessed were: age at admission, gestational age at delivery, family history of congenital anomalies, maternal age, social class, history of ante natal care, and admission outcome.
Results: A total of 73 (9.3%) out of the admitted 785 neonates had congenital anomalies and majority (28,38.4%) were of the CNS. The affected patients had a male preponderance (20, 71.4%). Myelomeningocele was the commonest CNS anomaly (20, 71.4 %). Poor antenatal care, lack of periconceptional folic acid (pFA) intake, late folic acid supplementation, low socio economic class, and late presentation were all associated with the incidence of congenital CNS anomalies. The patients had a neonatal mortality rate of 7.1% over the study period of 30 months (2.8% per year).
Conclusion: Congenital CNS anomalies were the predominant congenital anomalies, andmyelomeningocele was the commonest. The study underscores the need to institute a comprehensive healthcare programme for the prevention and management of congenital anomalies of the CNS in our practice.

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The Pattern of Hip Fractures Over A Ten-Year Period in A Major Referral Centre in Ghana.
Baidoo PK, Ocloo A, Ansu V

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THE PATTERN OF HIP FRACTURES OVER A TEN-YEAR PERIOD IN A MAJOR REFERRAL CENTRE IN GHANA

Key Words: Hip fracture, Ghana, trend, type of fracture, mechanism of injury

ABSTRACT

Background: The incidence of hip fractures is projected to increase worldwide and so are the associated morbidity, mortality, and cost of managing patients with hip fractures. There is, however, scarcity of data on trend and incidence of hip fractures in sub-Saharan Africa making planning and management difficult.
Methods: This is a retrospective study that involves all hip fractures seen and admitted to Korle-Bu Teaching
Hospital in Accra, Ghana from 2007 to 2016. The demographic characteristic (sex and age), mechanism of injury, and the fracture type were documented. Association between age, sex, and mechanism of injury and type of fracture were determined by Chi-square, with p-value< 0.05 as the level of significance.
Results: Nine hundred and twenty-nine patients were admitted over the 10-year period. There were 492 (53%)
females and 437 (47%) males, a ratio of 1.1:1.0. The mean age was 72.2 ± 14.4 years. Falls which mostly were low energy constituted 726 (78.1%) of cases with 203 (21.9%) resulting from road traffic accidents (RTA). There was an increase in patients with hip fractures from 2007 to 2012 followed by a gradual decline. Approximately 490 (52.7%) and 439 (47.3%) of the cases were extracapsular and intracapsular respectively. There was strong association between age and mechanism of injury (X2 (2) =492.10, p < 0.001, Φ=0.73) and moderate association between sex and mechanism of injury (X2 (1) =37.50, p < 0.00, Φ =0.21). There was no significant association between sex or age
and the type of fracture (p>0.05)
Conclusions: This study shows a 10-year trend of hip fractures in a major referral hospital in Ghana. It will serve as a baseline information for a nationwide study on the incidence rate of hip fracture in the country. It also has a great implication for future planning and management.

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Adverse Events Following Immunization (AEFI) Reporting in A Rural District in Ghana.
Twene P, Yawson AE

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ADVERSE EVENTS FOLLOWING IMMUNIZATION (AEFI) REPORTING IN A RURAL DISTRICT IN GHANA

Key Words: Adverse Events Reporting, Immunization, Vaccination, Rural District

ABSTRACT

Background: Even though vaccines used in routine childhood immunization programmes are safe, adverse
events following immunization (AEFI) may occur. These events must be recognized for prompt and effective response. This can contribute to success of the immunization programme and sustain interest of the public in vaccination.
Methods: A descriptive cross-sectional study comprising primary and secondary data collection methods were used for the study at Jaman North District in Ghana. The secondary data was extracted from immunization reports using a Microsoft excel spread sheet. The primary data was obtained from respondents using structured interview questionnaire. Simple random sampling was used to select caregivers and health workers were purposively selected. The data was analyzed using Statistical Package for Social Sciences (SPSS) windows (version 21.0).
Results: A total of 140 mothers or caregivers and 47 health workers were studied, with mean age of 27.8 years in each group. The rates of AEFI ranged from 0.02% for pneumococcal vaccine to 0.14% for pentavalent vaccine. In all, 63.8% of the health workers could not define AEFI, and 91.5% of the health workers do not use anaphylactic pack at immunization sessions. Majority (95.7%) of the participants agreed that poor AEFIs monitoring can lead to reduction in immunization coverage. AEFI training for health workers had a strong association (p<0.001) on their ability to identify AEFIs. The study indicated that mothers or caregivers were knowledgeable in many of the indicators of AEFI. In all, 93.7% of mothers or caregivers indicated that attitude of health workers was very good.
Conclusion: The study revealed low (<1%) AEFI reporting rate by mothers or caregivers. Only 36.2% health workers had knowledge with respect to definition of AFEI. The study indicated that more than a third of mothers (36%) were of the view that reporting of AEFIs can lead to personal consequences. Increased national efforts at surveillance for AEFI is imperative.

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