The Komfo Anokye Teaching Hospital also known as GEE for it heavy equipments (KATH) in Kumasi, Ashanti Region, Ghana, is the second-largest hospital in Ghana, and the only tertiary health institution in the Ashanti Region.
BACKGROUND:The incidence of spontaneous Intracerebral Hemorrhage (sICH) in Low-Middle-Income Countries (LMICs) has risen steeply over the past decade, with a relatively earlier age of onset and higher rates of adverse outcomes compared to the rest of the world. AIM:To determine the factors associated with in-hospital case fatality among patients aged ≤ 50 years with spontaneous Intracerebral Hemorrhage, admitted to a Ghanaian tertiary Hospital. METHODS:We conducted a prospective cohort study among individuals aged 18-50 years admitted with Intracerebral Hemorrhage to Komfo Anokye Teaching Hospital over 2 years, from 2022 to 2023. Multivariable Logistic regression was performed to determine the factors associated with ICH-related case fatality during hospital admission. Survival was compared across categories of explanatory variables using the Kaplan-Meier curve. Predictors of time to death were identified using the Cox regression model. RESULTS:46.2% (190 out of 411) of all ICH cases were aged ≤ 50 years, with the majority (63.7%) of those affected in this age group being male. The overall case fatality rate among hospitalized patients in this age group was 27.4% (52 out of 190). The factors independently associated with in-hospital case fatality were the presence of aspiration pneumonia (aOR 6.00 (2.47-15.46), p=0.000), NIHSS score at the time of admission (aOR 1.16 (1.08-1.24), p=0.000), and the presence of neuroimaging features of raised intracranial pressure (aOR 2.66 (1.04-7.00), p=0.044). Independent predictors of time to death included the presence of aspiration pneumonia (aOR 3.51 (1.44-8.55), p=0.004) and NIHSS score (aOR 1.07 (1.01-1.13), p=1.27e-08). CONCLUSIONS:Up to 1 in 4 young Ghanaian patients succumb to spontaneous ICH during hospitalization. Prevention, prompt detection, and management of complications, notably aspiration pneumonia during the acute phase of admission, may significantly reduce ICH-related mortality among young individuals in our setting.
Purpose This scoping review synthesised evidence on religious and healthcare considerations in delivering palliative care to Muslim inpatients in tertiary hospital settings. The aim was to inform the development of Islamic-sensitive palliative care guidelines tailored to Ghana and other Sub-Saharan African contexts. Methods The review followed the Joanna Briggs Institute methodology for scoping reviews and was reported in accordance with the PRISMA-ScR checklist. A comprehensive three-step search strategy was implemented across ProQuest, Scopus, PubMed, EBSCOhost, and Web of Science. Two reviewers independently screened and extracted data. A framework synthesis was conducted using Saunders’ Total Pain Model and the WHO Health System Responsiveness Framework. Results Of 706 records screened, 45 studies were included. Findings revealed five key themes: (1) Religious coping practices such as prayer and Qur’an recitation served as essential strategies for spiritual and emotional relief; (2) Family governance shaped care decisions, often at the cost of patient autonomy; (3) Imams played pivotal roles in spiritual care and ethical mediation, though their involvement lacked institutional consistency; (4) System-level barriers including lack of Islamic-sensitive policies, and inadequate training compromised compassionate care; and (5) Sub-Saharan Africa was significantly underrepresented, limiting evidence transferability to African contexts. Conclusions Spiritual care is essential to holistic palliative care for Muslim patients. The development of Islam-sensitive palliative guidelines and the structured integration of imams into care teams is urgently needed. Greater investment in African-led research is critical.
To assess the current state, trends, and benefits of hydroxyurea use in sickle cell disease and identify barriers and facilitators to hydroxyurea use in sickle cell disease patients from the perspectives of patients and caregivers. A hospital-based cross-sectional study was carried out at the sickle cell disease clinic, Komfo Anokye Teaching Hospital, Ghana. A semi-structured questionnaire capturing demographics, socio-economic characteristics, medication adherence, and treatment-related factors was randomly administered to 302 participants. Data was analyzed using Chi-square tests, univariate and multivariate analysis, and ordinal logistic regression. Two hundred and thirty-seven (78.5%) of the patients had SS genotype, 192 (63.58%) patients were on hydroxyurea at the time of the study. One hundred and nineteen (61.98%) patents were adherent. Decreased number of crises (132, 88.59%) and hospital admissions (78.52%) were some benefits cited by participants. However, high cost of the medication was a major challenge for a significant majority (155, 80.73%). Level of education (P = .019) was found to be significantly associated with level of adherence to hydroxyurea. The majority of the patients were on hydroxyurea therapy, with a significant proportion adherent to treatment. Hydroxyurea therapy was associated with a decrease in crises and hospital admissions; however, high cost remained a significant barrier to access and use while perceived benefits of hydroxyurea therapy remained facilitators to hydroxyurea use.
Universal Health Coverage (UHC) remains a critical goal in sub-Saharan Africa (SSA), where healthcare systems face significant challenges. State-Church Partnership have emerged as an innovative strategy to address gaps in healthcare delivery, leveraging the extensive networks of Faith-Based Organizations to provide essential services, particularly in remote areas.This scoping review aimed to examine the existing models of State-Church Partnerships in healthcare delivery within SSA, their impact on UHC advancement, the challenges these partnerships face, and the emerging best practices. This review followed Arksey and O’Malley’s framework and the PRISMA-ScR guidelines. We systematically searched peer-reviewed databases, including PubMed, Web of Science, Scopus, and CINAHL, for relevant studies published from inception until December 2024. Data were extracted and analyzed thematically using NVivo 12 to identify key themes related to state-church partnership models, their impact on UHC, implementation challenges, and emerging best practices. The review included eight studies which revealed that FBOs contribute between 30% and 70% of healthcare services in some regions, improving access, affordability, and equity. They play a critical role in maternal and child health, HIV/AIDS prevention, and health workforce training. However, challenges such as funding constraints, service quality variability, and limited policy integration hinder their effectiveness. Emerging best practices include enhanced government collaboration, community engagement, and capacity-building initiatives. In conclusion, State-Church Partnerships are vital in strengthening healthcare systems and achieving UHC in SSA. To maximize their impact, formalized policy frameworks, sustainable financing mechanisms, and quality assurance measures are essential. Strengthening state-FBO collaboration can bridge healthcare gaps and ensure equitable healthcare access.
Background Chronic liver diseases (CLD) leading to liver fibrosis and cirrhosis are a major cause of morbidity and mortality in sub-Saharan Africa and pose a significant burden on its health care systems. We aimed to elucidate the prevalence of fibrosis/cirrhosis in patients seeking health care in Kumasi, Ghana, and its underlying aetiologies.Methods In this cross-sectional study, we performed sonography, transient elastography as well as biochemical and virological analyses.Results Transient elastography indicated fibrosis/cirrhosis in 24.5% (113/461) of participants. Liver cirrhosis was significantly associated with known hepatitis B virus (HBV) infection, lack of formal education, hospitalisation, and male sex. Prevalence of active hepatitis B was significantly higher in patients with liver cirrhosis compared to controls (54.6% [30/55] vs. 17.1% [19/111]), as was anti-HBc (94.6% [52/55] vs. 80.2% [89/111]). CLD was mainly attributed to HBV (27.3%, 30/110), alcohol abuse (11.8%, 13/110), a combination of both (10.9%, 12/110), and metabolic dysfunction-associated steatotic liver disease (MASLD) (20%, 22/110). Antiviral treatment was indicated in 24 patients with active hepatitis B (number-needed-to-screen: 19.2). Hepatitis C and D viruses were of minor importance (2.7% [3/110] and 0.9% [1/110], respectively).Conclusions We found a high prevalence of CLD, predominantly caused by HBV, MASLD and alcohol. We confirmed the use of transient elastography as a non-invasive and easily applicable tool in resource-limited settings. Our findings underscore the need for systematic screening of hospitalised patients, especially men, in sub-Saharan Africa. Comprehensive screening, treatment, vaccination and prevention programs for HBV, as the leading cause of chronic liver disease, are warranted.
