Korle-Bu Teaching Hospital (KBTH) is a public teaching hospital located in the Ablekuma South Metropolitan District in Accra, Ghana. It is the only public tertiary hospital in the southern part of the country. It is a teaching hospital affiliated with the medical school of the University of Ghana. Three centres of excellence, the National Cardiothoracic Centre, the National Plastic and Reconstructive Surgery and the Radiotherapy Centres are all part of it. In 2019, the hospital gained a license from the Health Facilities Regulatory Agency (HeFRA), after meeting the requirement.Established on 9 October 1923, Korle-Bu Teaching Hospital has grown from an initial 200-bed capacity to 2,000. It is currently the third largest hospital in Africa and the leading national referral centre in Ghana.Korle-Bu, which means the valley of the Korle Lagoon, was established as a general hospital to address the health needs of the indigenous people under the administration of Sir Gordon Guggisberg, then Governor of the Gold Coast.Population growth and the proven efficacy of hospital-based treatment caused a rise in hospital attendance in Korle-Bu. By 1953, demand for the hospital's services had escalated so high that the government was compelled to set up a task force to study the situation and make recommendations for the expansion of the hospital.The government accepted and implemented the recommendations of the task force which resulted in the construction of new structures, such as the Maternity, Medical, Surgical and Child Health Blocks. This increased the hospital's bed capacity to 1,200.Korle-Bu gained teaching hospital status in 1962, when the University of Ghana Medical School (UGMS) was established for the training of medical doctors.The UGMS and five other constituent schools are now subsumed under the College of Health Sciences to train an array of health professionals. All the institutions of the college however, undertake their clinical training and research in the hospital.The hospital currently has 2,000 beds and 17 clinical and diagnostic Departments/Units. It has an average daily attendance of 1,500 patients and about 250 patient admissions.Clinical and diagnostic departments of the hospital include Medicine, Child Health, Obstetrics and Gynaecology, Pathology, Laboratories, Radiology, Anaesthesia, Surgery, Polyclinic, Accident Centre and the Surgical/Medical Emergency as well as Pharmacy. Other departments include Pharmacy, Finance, Engineering, General Administration.The hospital also provides specialisation in various fields such as Neuro-surgery, Dentistry, Eye, ENT, Renal, Orthopaedics, Oncology, Dermatology, Cardiothoracic, Radiotherapy, Radio diagnosis, Paediatric Surgery and Reconstructive Plastic Surgery and Burns.The Reconstructive Plastic Surgery and Burn Centre, the National Cardiothoracic Centre and the National Centre for Radiotherapy and Nuclear Medicine in particular also draw a sizeable number of their clientele from neighbouring countries such as Nigeria, Burkina Faso and Togo.Korle-Bu Teaching Hospital recently carried out the first ever kidney transplant in Ghana. It is one of the few hospitals in Africa where DNA tests are carried out. Other specialised services the hospital provides include brachytherapy intervention for the treatment of prostate cancer and keyhole surgeries.Plans are underway to venture into molecular testing. All these are part of the grand plan to offer a wider spectrum of specialist care to position Ghana as the hub of health tourism within the West Africa Sub region.
Objective This study assesses the outcomes of patients who underwent repair of skull base defects and cerebrospinal fluid (CSF) leaks via endoscopic endonasal approach (EEA) in a resource-limited tertiary care center in Ghana.Study Design A retrospective cohort study.Setting Korle Bu Teaching Hospital in Accra, Ghana, a tertiary public institution with recent international collaboration.Methods This retrospective cohort study analyzes patients presenting to Korle Bu Teaching Hospital with skull base defects and CSF leaks over a 5-year period treated with single-stage EEA repair. A comprehensive review was conducted to analyze demographics, characteristics of skull base defect, surgical approach, and outcomes.Results Eight patients were included for analysis. All patients underwent multilayer closure using combinations of autologous grafts, including abdominal fat, middle turbinate grafts, and vascularized nasoseptal flaps. Intraoperative lumbar drains and intraoperative fluorescein were not used. There were no postoperative CSF leaks over a follow-up period ranging from 6 months to over 4 years.Conclusion EEA can be adapted safely and effectively in low-resource settings. Keys to successful implementation include meticulous surgical technique, utilization of locally available or autologous graft materials, and rigorous postoperative protocols.
Temporomandibular disorders (TMDs) are common musculoskeletal chronic orofacial pain conditions involving peripheral and central sensitization within trigeminal nociceptive pathways, manifesting as mechanical allodynia and functional impairment. Botulinum toxin type A (BoNT-A) has been explored as a treatment targeting both muscle hyperactivity and nociceptive modulation. Preclinical and clinical evidence demonstrate that BoNT-A reduces peripheral neurotransmitter release, neurogenic inflammation, and central neuronal excitability, leading to attenuation of mechanical allodynia in TMD models and patients. Clinical trials show modest and variable analgesic effects, with patients displaying sensory sensitization appearing to respond more favorably, though methodological heterogeneity limits definitive conclusions. Safety concerns related to muscle weakening, changes in bone density, and structural changes underscore the need for standardized protocols optimizing dosing and monitoring, in addition to prospective studies. These findings suggest that BoNT-A may serve as an adjunctive, mechanism-based therapy within multimodal TMD management. Future research should focus on standardized sensory phenotyping and trial design to clarify BoNT-A’s role in modulating central sensitization and improving patient outcomes.
Migraine imposes a heavy burden on patients and societies. Preventive treatments aimed at reducing the occurrence of migraine attacks and their intensity have been largely underused, leaving a multitude of people with migraine to rely exclusively on acute treatments, which, when used in excess, might even worsen the clinical situation. Large, randomised trials have established the tolerability and efficacy of calcitonin gene-related peptide (CGRP)-targeting drugs, a new class of migraine-specific treatment. The increased adherence to longer treatment cycles with migraine-specific preventive drugs, such as CGRP-targeting therapies, compared with non-migraine specific treatments has the potential to improve control of the disease. These migraine-specific drugs also provide benefits to individuals with migraine who previously did not benefit from non-specific migraine preventive medications. Increased reliance on preventive treatment with migraine-specific options is progressively optimising the management of migraine for mounting numbers of patients disabled by the disease, thereby improving disease control and their quality of life.
The prevalence of type 2 diabetes is rising rapidly across sub-Saharan Africa; however, its epidemiology, clinical phenotypes, and underlying mechanisms remain insufficiently characterised. This first paper in a Series on diabetes in sub-Saharan Africa synthesises current evidence on the burden, distribution, and determinants of diabetes, including emerging phenotypes and the roles of early life adversity, psychosocial stress, and interactions with infectious disease. We also identify major gaps in surveillance systems, research capacity, prevention, and clinical management across the region. Sub-Saharan Africa is experiencing one of the fastest global increases in diabetes, with the highest proportion of undiagnosed cases and a projected steep rise in intermediate hyperglycaemia and diabetes by 2050. Urbanisation, ageing, obesity, and lifestyle transitions are major contributors; however, a substantial proportion of type 2 diabetes occurs in lean individuals (BMI <25 kg/m2), particularly in rural settings, suggesting distinct metabolic and developmental pathways not captured by models derived from high-income countries. Bidirectional interactions between diabetes and malaria, tuberculosis, HIV, or COVID-19 make disease trajectories complex. Persistent gaps in surveillance, a reliance on modelled estimates, low genomic representation, and constrained access to modern diabetes medications hinder progress. Strengthening health system capacity, improving data infrastructure, and investing in regionally driven research are essential to develop effective, context-specific interventions and advance precision medicine tailored to sub-Saharan African populations.
Respectful and disrespectful care profoundly influence communication and collaboration between caregivers and patients, shaping outcomes across the continuum of care. Despite patients being the primary users of healthcare services, their experiences of respectful and disrespectful care remain underexplored in Ghanaian healthcare settings. To address these systemic inadequacies, this study explored patients' understanding and experiences of respectful and disrespectful care. The study employed a qualitative design and was conducted in six healthcare facilities across Ghana. Thirteen focus group discussions were conducted with 90 participants, aged 18-87 years, between October and December 2022. Data were audio-recorded, translated, transcribed, and thematically analyzed. The mean age of participants was 42.7 ± 15.3 years, with a majority (72.2%) being female. Participants associated respectful care with timeliness and quality of patient reception, showing hospitality and friendliness to patients, clarity of communication and patient involvement in decisions, and providing non-discriminatory care. On the other hand, disrespectful care was characterized by long waiting times, poor coordination, poor staff attitudes, privacy violations, neglect of patient priorities, navigational challenges, inadequate infrastructure, and lack of required medicines, equipment, and supplies. These experiences significantly influenced participants' psychological well-being, satisfaction, and future healthcare-seeking behavior. While respectful care fosters trust and well-being, disrespectful care erodes satisfaction and discourages engagement with healthcare services. Systemic inadequacies must be urgently addressed to create a dignified, inclusive, compassionate, and responsive healthcare system in Ghana.
