It is an undeniable fact that climate change has negative effects on cocoa production and has thus led to reduced yields in Ghana. This has affected cocoa farmers living standards due to their high dependency on income from sales of cocoa dry beans. The study determined the causes, indicators, effects and mitigative strategies of climate change on cocoa farmers farms. Generally, 71.43 % respondents indicated, climate change was caused by deforestation whereas 26.79 %, especially female farmers, associated it with superstitious connotations. Similarly, 72.86 % of the farmers included shade trees on their farms as a mitigative strategy to climate change's effect. While two farmers abandoned farms, others (17.50 %) sought divine intervention. Marginal effects in M-Logit results revealed that, Education, Variety, Training on Climate Change, Radio and Shade trees were significant (p-value < 0.10), under various dependent variables on causes of climate change. Again, Gender, Education, Household size, Migration status, Credit, Farm age, Variety and Training on Climate Change were also significant (p-value < 0.10), under various dependent variables on farmers mitigative strategies to addressing climate change effects. Results imply the need to intensify climate change education to cocoa farmers, especially females, within the district to help achieve targets of SDG 13 as well as enhancing their living conditions.

Abstract Background Late presentation with advanced HIV disease (LP-AHD) remains a significant challenge to Human Immunodeficiency Virus (HIV) care, contributing to increased morbidity, mortality, and healthcare costs. Despite global efforts to enhance early diagnosis, a considerable proportion of individuals with HIV infection are unaware of being infected and therefore present late for HIV care. For the first time in Ghana, this study assessed the prevalence of LP-AHD and associated factors among people diagnosed with HIV (PDWH). Method This bi-center retrospective cross-sectional study included 315 PDWH at the Aniniwah Medical Centre and Komfo Anokye Teaching Hospital, both in Kumasi, Ghana. A well-structured questionnaire was used to collect data on sociodemographic, clinical, lifestyle and psychosocial factors from the study participants. Statistical analyses were done in SPSS version 26.0 and GraphPad Prism version 8.0 at significant p-value of < 0.05 and 95% confidence interval. Predictors of LP-AHD were assessed using binary logistic regression models. Results This study observed that, 90 out of the 315 study PDWH (28.6%) reported late with advanced HIV disease (AHD). Participants within the age group of 36–45 years (adjusted Odds Ratio [aOR]: 0.32, 95% CI: 0.14–0.69; p = 0.004) showed a significantly decreased likelihood of LP-AHD. However, participants who perceived cost of HIV care to be high (aOR: 7.04, 95% CI: 1.31–37.91; p = 0.023), who were diagnosed based on clinical suspicion (aOR: 13.86, 95 CI: 1.83–104.80; p = 0.011), and missed opportunities for early diagnosis by clinicians (aOR: 2.47, 95% CI: 1.30–4.74; p = 0.006) were significantly associated with increased likelihood of LP-AHD. Conclusion The prevalence of LP-AHD among PDWH in Ghana is high. Efforts to improve early initiation of HIV/AIDS care should focus on factors such as the high perceived costs of HIV care, diagnosis based on clinical suspicion, and missed opportunities for early diagnosis by physicians.

AbstractBackground and AimsAnemia has been a common comorbidity in most chronic diseases, but has not been well monitored in type 2 diabetes mellitus (T2DM) patients. In this study, we investigated the prevalence of anemia and its nexus with iron stores among T2DM patients in health facilities in the Ashanti Region of Ghana.MethodsThis multicenter cross‐sectional study recruited 213 T2DM out‐patients attending the diabetic clinics at the Kumasi South Hospital and St. Michaels Hospital, Jachie Pramso, Ghana, for routine check‐ups. Self‐reported questionnaires were used to collect sociodemographic, lifestyle, and clinical data from study participants. Blood samples were collected to estimate hematological parameters and iron stores. Mann–Whitney U test was used to assess the difference in hematological parameters and iron stores between anemic and nonanemic patients. All p < 0.05 were considered statistically significant.ResultsOf the 213 T2DM participants, the prevalence of anemia was 31.9%. More females 145 (68.1%) were registered than males 68 (31.9%). Anemic patients had significantly lower levels of mean cell volume [79.30/fL vs. 82.60/fL, p = 0.001], mean cell hemoglobin [26.60/pg vs. 27.90/pg, p < 0.0001], and mean cell hemoglobin concentration [33.10/g/dL) vs. 33.80/g/dL, p < 0.0001] than those without anemia. Serum levels of ferritin (p = 0.1140), transferrin (p = 0.5070), iron (p = 0.7950), and total iron binding capacity (p = 0.4610) did not differ significantly between T2DM patients with or without anemia.ConclusionDespite the high prevalence of anemia among the T2DM patients in our cohort, patients present with apparently normal iron stores. This unrecognized mild anemia must be frequently monitored among T2DM patients.

Abstract Background Iron deficiency anemia (IDA) remains a global health concern, and has been associated with cognitive decline. However, very few studies have explored the association between IDA and cognitive function among Ghanaians. We assessed the association between IDA and cognitive function among adolescents in the Ashanti region, Ghana. Methods This cross-sectional study involved 250 adolescents from Kumasi, Ghana. Sociodemographic and dietary data were obtained using a well-structured questionnaire. Blood samples were drawn for estimation of ferritin and complete blood count. The Test of Non-verbal Intelligence (TONI-4) was used to assess cognitive function. Binary logistic regression was used to determine the predictors of cognitive function. Results The prevalence of IDA was 30.4%, which was higher among adolescents with poor cognitive performance test scores (CPTS) (71%). Being female [aOR = 0.32, 95% CI (0.10–0.99), p = 0.0480)], father having junior high education [aOR = 0.08, 95% CI (0.02–0.45), p = 0.0040)], being in a category B school [aOR = 0.26, 95% CI (0.09–0.81), p = 0.0200)] and C [aOR = 0.08, 95% CI (0.02–0.40), p = 0.0020)] and non-fruit consumption [aOR = 0.18, 95% CI (0.06–0.52), p = 0.0010)], were significantly associated with lower likelihood of having very good cognitive function. Moreover, ferritin (r = 0.451, p < 0.001) and hemoglobin (r = 0.402, p < 0.001) demonstrated a moderate positive correlation with CPTS. Conclusion The prevalence of IDA is high in our study population and was linked with poor cognitive function. Adolescents with IDA had low cognitive performance test scores. High levels of hemoglobin and ferritin showed a moderate correlation with higher cognitive performance. These findings suggest that adolescents’ cognitive function may be moderately influenced by IDA, highlighting the potential impact of iron status on cognitive outcomes.

Assessing health promotion among adolescents and young adults is vital to identify healthy and unhealthy behaviours as well as to evaluate health promotion interventions. However, there is no valid and reliable scale to assess health promotion among Ghanaians. For the first time, this study determined the validity and reliability of the original version of the Short‐Form Adolescent Health Promotion (AHP) scale among adolescents and young adults in Ghana. This cross-sectional methodological study included 617 adolescents and young adults within Kwame Nkrumah University of Science and Technology (KNUST) in Kumasi, Ghana. A well-structured questionnaire was used to collect sociodemographic data from study participants. The AHP-Scale was also used to collect data on participants health promoting behaviors. The scale’s validity was evaluated using Kaiser-Meyer-Olkin (KMO), Bartlett’s test of sphericity and Exploratory Factor Analysis (EFA), whilst the reliability was assessed using the Cronbach’s ɑ coefficient. Statistical analysis was performed using SPSS software version 26. The KMO and the Bartlett’s test of sphericity were reported to be 0.899 and χ2 (276) = 6682.338 respectively, allowing for EFA with orthogonal rotation. The EFA revealed five factors covering 54.62

Background. WHO recommends HBV-negative babies in high-prevalence (8%) countries receive anti-HBV vaccination. Ghana initiated mass immunization in 2002, but concerns remain about vaccine effectiveness and long-term protection. We evaluated immune characteristics and factors following hepatitis B vaccination among Ghanaian adolescents who received HBV vaccines. Methods. In this longitudinal cross-sectional study, 74 participants were enrolled from the Kumasi Metropolis, Ghana. Sociodemographic and lifestyle characteristics of participants were obtained using a questionnaire. Blood samples were obtained before and after booster administration for anti-HBsAg, IL-6, and IL-10 estimations using ELISA kit (Shanghai Chemical Ltd., China). Anti-HBsAg titers ≥10 mIU/ml were considered protective. Statistical analyses were done using SPSS version 26.0 and R programming language, p<0.05 was considered statistically significant. Results. We found 100% seroconversion rate, with 25.7% seroprotection rate (anti-HBsAg >10 mIU/ml). Gender (p=0.009), age (p=0.001), and exercising (p=0.044) were significantly associated with seroprotection. Following booster administration, 59.4% were hyporesponders (10 ≤ anti-HBsAg titre ≤99 mIU/ml) whilst 40.6% were good responders (anti-HBsAg titre ≥100 mIU/ml). Exercise (p=0.034) was significantly associated with immune response after booster administration. Moreover, we reported significant positive correlation between cytokines [IL-6 (r = 0.817, p<0.001) and IL-10 (r = 0.928, p<0.001)] and anti-HBsAg titre. Conclusion. Approximately two thirds of adolescents vaccinated at birth lack protective levels of antibodies against hepatitis B virus. Booster vaccines could aid in mounting protective levels of anti-HBsAg. Physical exercise was negatively associated with immune response to hepatitis B vaccinations.

Background:Mother to child transmission of Human Immunodeficiency Virus (HIV), persists despite the availability of effective prevention of mother to child transmission (PMTCT) strategies. In Ghana, there is limited data on prevalence and the associated factors of mother to child transmission of HIV existing. The PMTCT strategies in Ghana has not been evaluated. This study therefore assessed the prevalence, knowledge and factors associated with mother to child transmission of HIV in Kumasi, Ghana. Methods:This retrospective cross-sectional study was conducted at Komfo Anokye Teaching Hospital (KATH) and Aninwaa medical Centre and fertility clinic from May 2023 to September 2023. A total of 103 women living with HIV and have ever given birth were sampled. A well-structured questionnaire was used to collect data on sociodemographic, clinical, lifestyle, knowledge and MTCT transmission rates among study participants. Statistical analysis was performed using Statistical Package for Social Science (SPSS) version 26.0 and GraphPad Prism version 8.0. p-values of < 0.05 and 95% confidence interval were considered significant. Results:The prevalence of mother-to-child transmission of HIV (MTCT) was 21.4%. MTCT was more prevalent among the age group 36-45 years (50.0%), who had primary education (40.9%) and were married (63.6%) with 2-3 children (50.0%). In the logistic regression model, higher age groups 36- 45 (aOR: 20.1, 95% CI (1.45-278.87); p = 0.025), 46-55 (aOR: 18.33, 95% CI (1.03-325.57); p = 0.048) and 56-74 (aOR: 76.42, 95% CI (1.87-3131.45); p = 0.022) were independent predictors of MTCT. Moreover, mothers not knowing their HIV status prior to pregnancy (cOR=9.13) CI; (3.01-27.68), (p < 0.001) and children not receiving ART prophylaxis (cOR=8.25), CI; (2.91-23.40), (p < 0.0001) were significantly associated with MTCT. Conclusion:There is high prevalence of MTCT (21.4%) and is influenced by higher age group of 36-74 years, no knowledge of HIV status prior to pregnancy as well as children who do not receive ART prophylaxis. This study’s findings call for an increased awareness on the knowledge of MTCT, availability of HIV pre-exposure prophylaxis for expectant mothers and enhanced HIV testing and treatment for women of reproductive age, including self-testing.

Background Dermatological diseases are a substantial cause of discomfort, with debilitating effects on the affected person's confidence. However, there is a paucity of data on the prevalence of dermatological diseases and their associated factors in Ghana. We assessed the distribution of dermatological cases, its predictive factors, and common treatment options. Methods This observational study included 460 dermatological cases from dermatology unit of Komfo Anokye Teaching Hospital (KATH), Kumasi, Ghana over 5 years, from January 2016 to December 2020. A data collection sheet was used to extract sociodemographic data, dermatology diseases and drugs for their management. Statistical analyses were done using SPSS Version 26.0 and GraphPad prism version 8.0. P < 0.05 was considered statistically significant. Results The highest proportion of dermatological cases were chronic eczema (14.8%), acne vulgaris (10.2%), atopic eczema (8.3%), folliculitis (6.7%), vitiligo (6.5%) and pityriasis rosea (5.2%). A significant number were also prurigo (3.9%), urticaria (3.7%), epidemic Kaposi sarcoma (3.7%) and infantile seborrhoeic dermatitis (3.0%). The proportion of idiopathic pruritus, alopecia areata, and lichen planus were 2.8%, 2.4% and 2.0% respectively. The proportion of systemic lupus erythematosus (1.7%) and haemangioma (1.7%) were significantly higher among females than compared to males (p = 0.049). Most participants were on cetirizine (43.2%), non-alkali soap (13.5%), ketoconazole cream (12.3%), folic acid/vitamin B12 (9.9%), multivitamin (7.1%), and clindamycin/erythromycin (7.1%). Conclusion The common dermatological diseases were chronic eczema, acne vulgaris, atopic eczema, folliculitis, vitiligo and pityriasis rosea. Some dermatological conditions are commoner among females and adulthood. Further future studies are recommended to augment other risk factors predilection to skin diseases in Ghana.

IntroductionHaemoglobin variants and preeclampsia (PE) are associated with adverse fatal events of which oxidative stress may be an underlying factor. Oxidative stress (OS) among preeclamptic women with haemoglobin variants has been well established. It is, however, unclear whether haemoglobin variants induce OS to aggravate the risk of adverse foeto-maternal outcomes in pregnant women with preeclampsia. We measured the levels of OS biomarkers and determined the association between haemoglobin variants, and adverse foeto-maternal outcomes among pregnant women with PE. MethodsThis multi-centre prospective study recruited 150 PE women from three major health facilities in both Bono and Bono east regions of Ghana from April to December 2019. Haemoglobin variants; HbAS, HbSS, HbSC, HbCC, and HbAC were determined by haemoglobin electrophoresis. OS biomarkers such as malondialdehyde (MDA), catalase (CAT), vitamin C, and uric acid (UA) along with haematological and biochemical parameters were estimated using standard protocol. Adverse pregnancy complications (APCs) such as post-partum haemorrhage (PPH), HELLP (Haemolysis, Elevated liver enzymes, Low platelet count) syndrome, preterm delivery, neonatal intensive care unit (NICU) admission, and neonatal jaundice were recorded. ResultsOf the 150 pregnant women with preeclampsia, the distribution of haemoglobin AA, AS, AC, CC, SS and SC phenotypes were 66.0%, 13.3%, 12.7%, 3.3%, 3.3% and 1.3%, respectively. The most prevalent foeto-maternal outcomes among PE women were NICU admission (32.0%) followed by PPH (24.0%), preterm delivery (21.3%), HELLP syndrome (18.7%), and neonatal jaundice (18.0%). Except for vitamin C level which was significantly higher in patients with at least a copy of Haemoglobin S variant than those with at least a copy of Haemoglobin C variant (5.52 vs 4.55; p = 0.014), levels of MDA, CAT, and UA were not statistically significantly different across the various haemoglobin variants. Multivariate logistic regression model showed that participants with HbAS, HbAC, having at least a copy of S or C and participants with HbCC, SC, SS had significantly higher odds of neonatal jaundice, NICU admission, PPH and HELLP syndrome compared to participants with HbAA. ConclusionReduced levels of vitamin C are common among preeclamptics with at least one copy of the HbC variant. Haemoglobin variants in preeclampsia contribute to adverse foeto-maternal outcomes with Haemoglobin S variants being the most influencing factor for PPH, HELLP, preterm labour, NICU admission, and neonatal jaundice.

Objectives:Micronutrients, especially calcium (Ca) and magnesium (Mg) are reported to reduce preeclampsia events via several factors such as endothelial cell control, optimal oxidative stress and a balanced angiogenic growth mediator. We evaluated the association of micronutrients with oxidative stress biomarkers, and angiogenic growth mediators in early-onset preeclampsia and late-onset preeclampsia.Methods:This case-control study recruited 197 preeclampsia (early-onset preeclampsia = 70 and late-onset preeclampsia = 127) as cases and 301 normotensive pregnant women as controls from the Komfo Anokye Teaching Hospital, Ghana. Samples were collected after 20 weeks of gestation for both cases and controls and estimated for Ca, Mg, soluble fms-like tyrosine kinase-1, placental growth factor, vascular endothelial growth factor-A, soluble endoglin, 8-hydroxydeoxyguanosine, 8-epiprostaglandinF2-alpha and total antioxidant capacity.Results:Early-onset preeclampsia women had significantly lower levels of Ca, Mg, placental growth factor, vascular endothelial growth factor-A and total antioxidant capacity but higher levels of soluble fms-like tyrosine kinase-1, soluble endoglin, 8-epiprostaglandinF2-alpha, 8-hydroxydeoxyguanosine, soluble fms-like tyrosine kinase-1/placental growth factor ratio, 8-epiprostaglandinF2-alpha /placental growth factor ratio, 8-hydroxydeoxyguanosine/placental growth factor ratio and soluble endoglin/placental growth factor ratio than late-onset preeclampsia and normotensive pregnant women (p < 0.0001). Among the early-onset preeclampsia women, the first and second quartile for serum placental growth factor, first quartile for vascular endothelial growth factor-A and total antioxidant capacity and the fourth quartiles for serum sEng, serum sFlt-1, 8-epiPGF2α and 8-OHdG were independently associated with low Ca and Mg (p < 0.05). Among late-onset preeclampsia women, the fourth quartile for soluble fms-like tyrosine kinase-1 was independently associated with low Ca and Mg (p < 0.05).Conclusion:Magnesium and calcium are associated with an imbalance in angiogenic growth mediators and oxidative stress biomarkers among preeclampsia women, particularly early-onset preeclampsia. Serial and routine measurement of these micronutrients would allow the monitoring of poor placental angiogenesis while enabling an understanding of the triggers of increased oxidative stress and reduced antioxidant in preeclampsia.

Background The Coronavirus Infectious Disease 2019 (COVID-19) pandemic has continuously affected human life with several devastating effects. Currently, there are effective vaccines to protect people from COVID‐19 and the World Health Organization (WHO) has highlighted strategies to influence COVID-19 vaccine uptake in hard-to-reach communities in Ghana. However, prior studies on COVID-19 vaccine acceptability in Ghana are online surveys targeting the literates and those in urban areas, leaving residents in far-flung communities. We assessed knowledge, attitude and acceptability of COVID-19 vaccine among residents in rural communities in Ghana. Methods This study was a community-based cross-sectional study and was conducted at three selected regions in Ghana (Northern, Ashanti and Western North) from May to November, 2021. This study included residents 15–81 years, living in the selected rural communities for more than 1 year. Study participants were recruited and questionnaires administered to collect data on knowledge, attitude and acceptance of the COVID-19 vaccine. Statistical analyses were performed using Statistical Package for Social Science (SPSS) version 26.0 and GraphPad Prism Version 8.0 software. Results Of the 764 participants included in this study, more than half had inadequate knowledge (55.0%), poor attitudes (59.4%) and bad perception about COVID-19 vaccine (55.4%). The acceptability of COVID-19 vaccine in this study was 41.9%. The acceptability of COVID-19 vaccine in Ashanti, Northern and Western North regions were 32.5%, 26.2% and 29.6% respectively. In a multivariate logistic regression analysis, receiving recent or previous vaccine such as HBV vaccine [aOR = 1.57, 95% CI (1.23–3.29), p = 0.002], having good attitude towards COVID-19 vaccine [aOR = 61.47, 95% CI (29.55–127.86), p < 0.0001] and having good perception about the COVID-19 vaccine [aOR = 3.87, 95% CI (1.40–10.72), p < 0.0001] were independently associated with higher odds of accepting COVID-19 vaccine. Conclusion More than half of residents in Ghanaian rural communities have inadequate knowledge, poor attitudes and bad perception about COVID-19 vaccine. The acceptability of COVID-19 vaccine is generally low among rural residents in Ashanti, Northern and Western North regions of Ghana. Residents living in hard-to-reach communities must be educated about the benefits of COVID-19 vaccine to achieve effective vaccination program.

Method:In a comparative experimental cross-sectional study, RNA was extracted from oral swabs and blood samples from 25 healthy individuals at the Department of Molecular Medicine, KNUST. RNA was extracted by the manual AGPC extraction method and commercial RNA extraction kits. The quantity (ng/μl) and purities (260/280 nm) of the extracted RNA were measured spectrophotometrically using the IMPLEN NanoPhotometer® N60. The presence of RNA in the extracts was confirmed using 2% agarose gel electrophoresis. Statistical analyses were conducted using R language.Results:The yield of RNA extracted from blood and oral swab samples using modified AGPC was significantly higher compared to the commercial methods (p < 0.0001). However, the purity of RNA extracted by the manual AGPC method from blood was significantly lower than the commercial methods (p < 0.0001). Moreover, the purity from oral swabs using the manual AGPC method was significantly lower compared to QIAamp (p < 0.0001) and the OxGEn kits method (p < 0.001).Conclusion:The modified manual AGPC method has a very high yield of RNA extracts using blood samples, which could serve as an alternate cost-effective method for RNA extraction in resource-limited laboratories; however, its purity may not be suitable for downstream processes. Moreover, the manual AGPC method may not be suitable for extracting RNA from oral swab samples. Future investigation is needed to improve the purity of the manual AGPC RNA extraction method and also confirmation of the obtained results by PCR amplification and RNA purity verification by sequencing.

Preeclampsia (PE) is associated with endothelial injury and hemostatic abnormalities. However, the diagnostic role of coagulation parameters and natural anticoagulants in predicting PE has not been explored in Ghana. This study assessed plasma levels of these factors as surrogate markers of PE and its subtypes. This case–control study included 90 women with PE (cases) and 90 normotensive pregnant women (controls). Blood samples were drawn for the estimation of complete blood count and coagulation tests. The prothrombin time (PT), activated partial thromboplastin time (APTT), and the calculation of the international normalized ratio (INR) were determined by an ACL elite coagulometer while the levels of protein C (PC), protein S (PS), antithrombin III (ATIII), and D-dimers were also measured using the solid-phase sandwich enzyme-linked immunosorbent assay (ELISA) method. All statistical analyses were performed using the R Language for Statistical Computing. Results showed significantly ( p < .05) shortened APTT (28.25 s) and higher D-dimer levels (1219.00 ng/mL) among PE women, as well as low levels of PC (1.02 µg/mL), PS (6.58 µg/mL), and ATIII (3.99 ng/mL). No significant difference was found in terms of PT and INR. From the receiver operating characteristic analysis, PC, PS, and ATIII could significantly predict PE and its subtypes at certain cutoffs with high accuracies (area under the curve [AUC] ≥0.70). Most women with PE are in a hypercoagulable state with lower natural anticoagulants. PC, PS, and ATIII are good predictive and diagnostic markers of PE and its subtypes (early-onset PE [EO-PE] and late-onset PE [LO-PE]) and should be explored in future studies.

Hypertension (HTN) is the leading cause of cardiovascular diseases. Nevertheless, most individuals in developing countries are unaware of their blood pressure status. We determined the prevalence of unrecognized hypertension and its association with lifestyle factors and new obesity indices among the adult population. This community-based study was conducted among 1288 apparently healthy adults aged 18-80 years in the Ablekuma North Municipality, Ghana. Sociodemographic, lifestyle characteristics, blood pressure and anthropometric indices were obtained. The prevalence of unrecognized HTN was 18.4% (237 / 1288). The age groups 45-54 years [aOR = 2.29, 95% CI (1.33-3.95), p = 0.003] and 55-79 years [aOR = 3.25, 95% CI (1.61-6.54), p = 0.001], being divorced [aOR = 3.02 95% CI (1.33-6.90), p = 0.008], weekly [aOR = 4.10, 95% CI (1.77-9.51), p = 0.001] and daily alcohol intake [aOR = 5.62, 95% CI (1.26-12.236), p = 0.028] and no exercise or at most once a week [aOR = 2.25, 95% CI (1.56-3.66), p = 0.001] were independently associated with HTN. Among males, the fourth quartile (Q4) of both body roundness index (BRI) and waist to height ratio (WHtR) [aOR = 5.19, 95% CI (1.05-25.50), p = 0.043] were independent determinants of unrecognized HTN. Among females, the third quartile (Q3) [aOR = 7.96, 95% CI (1.51-42.52), p = 0.015] and Q4 [aOR = 9.87 95% CI (1.92-53.31), p = 0.007] of abdominal volume index (AVI), the Q3 of both BRI and WHtR [aOR = 6.07, 95% CI (1.05-34.94), p = 0.044] and Q4 of both BRI and WHtR [aOR = 9.76, 95% CI (1.74-54.96), p = 0.010] were independent risk factors of HTN. Overall, BRI (AUC = 0.724) and WHtR (AUC = 0.724) for males and AVI (AUC = 0.728), WHtR (AUC = 0.703) and BRI (AUC = 0.703) for females yielded a better discriminatory power for predicting unrecognized HTN. Unrecognized hypertension is common among the apparently healthy adults. Increased awareness of its risk factors, screening, and promoting lifestyle modification is needed to prevent the onset of hypertension.

Obesity is a complex and multifactorial disease marker, which has become a major threat to cardiovascular health. We sought to assess the correlation of obesity and other cardio-metabolic risk factors in patients seen at the outpatient specialist clinic in Ghana. A prospective cross-sectional study was conducted on 395 patients at Precise Specialist Clinic in Kumasi, Ghana. A standardized questionnaire was used to obtain demographic, anthropometric and clinical data of patients. Fisher's exact test for statistical significance at a 95% confidence interval was used to evaluate associations between categorical variables. The associations between obesity indices and cardiovascular disease risk factors were analyzed by Pearson's correlation. Of the 395 participants, 187 were males and 208 were females. The mean (± standard deviation) age of study participants was 59.29 (± 13.93); more than half of the participants were between 50 and 69 years. The mean BMI of male participants was significantly lower than the mean BMI of female participants (28.18 kg/m2 vs 31.16 kg/m2, P-value < 0.0001). Gender was significantly associated with the weight categories (P = 0.0144). Obesity was seen more in females (49.0%) than in males (35.8%). The Pearson correlation analysis also showed a significant positive correlation between obesity, increasing systolic blood pressure (r = 0.1568, P-value = 0.0018) and increasing diastolic blood pressure (r = 0.2570, P-value < 0.0001). Obesity was found to be significantly associated with female gender, increasing age, increasing systolic blood pressure, and increasing diastolic blood pressure. Efforts to step-up preventive measures to reduce the increasing prevalence of obesity in Ghana are highly recommended.

Introduction: This study compares the angiogenic growth mediators (AGMs), oxidative stress (OS) and haematobiochemical profile as well as foeto-maternal outcomes of preeclampsia (PE) with and without foetal growth restriction (FGR) and the discriminative potential of these markers for identifying these conditions.Methods: This hospital-based case-control study recruited a total of 209 women including 109 PE women without FGR and 48 PE women with FGR as cases whereas 52 normotensive pregnant women were recruited as controls. OS and AGMs and haematobiochemical markers were measured for all participants.Results: The rates of foetal complications including intrauterine foetal death and foetal distress were more common in PE with FGR than PE without FGR (p < 0.05) but maternal complications were comparable across these groups (p > 0.05). Of the haematobiochemical markers, placental growth factors (PIGF), PIGF/8-Isoprostane, sFlt-1/PIGF (AUC = 0.87, p < 0.001), soluble FMS-tyrosine kinase receptor-1 (sFlt-1) (AUC = 0.85, p < 0.001), total antioxidant capacity, 8-isoprostane (AUC = 0.83, p < 0.001) and lactate dehydrogenase (AUC = 0.70, p < 0.001) were more associated and showed at least an acceptable discrimination for PE with FGR against PE only.Discussion: The occurrence of FGR in PE patients does not necessarily indicate a severe maternal presentation of the condition but a tendency for adverse foetal outcomes. Cumulative assessment of OS and AGMs may provide diagnostic usefulness for distinguishing PE with and without FGR.

Abstract Background and Aims Female head‐porters are a cohort of women who have migrated from their rural communities into commercial cities in search of better economic opportunities. These young women are vulnerable to untoward reproductive experiences. The study assesses the reproductive experiences of women and the factors influencing contraceptive use among them. Methods A cross‐sectional study was conducted from January to May 2021 in the Kumasi Metropolis (n = 280). The study included 280 female head‐porters within the reproductive age of 15–49 years. Convenience sampling and consecutive recruitment were used to obtain the needed sample size. All statistical significance was declared at a p‐value of <0.05. Results Forty‐two percent of respondents had a history of contraceptive use (all modern or artificial contraception). The study found gravidity (p < 0.0001), parity (p < 0.0001), number of sexual partners post‐migration (p = 0.008), and age of first sex (p = 0.033) to be associated with contraceptive use among female head‐porters. Conclusion Fourteen percent had experienced sexual exploitation post‐migration, the first sexual encounter of one‐third of participants were nonconsensual, 19% had sex at or before 16 years, and 72% were aware of contraception. Reproductive experiences such as gravidity and sexual debut (age at first sex) have a significant influence on the use of contraception.

Abstract Background and Aim Frailty is a condition marked by accumulation of biological deficits and dysfunctions that come with aging and it is correlated with high morbidity and mortality in patients with cardiovascular diseases, particularly hypertension. Hypertension continues to be a leading cause of cardiovascular diseases and premature death globally. However, there is dearth of literature in sub‐Saharan Africa on frailty syndrome among hypertensives on medication. This study evaluated frailty syndrome and its associated factors among Ghanaian hypertensives. Methods This cross‐sectional study recruited 303 patients with hypertension from the University Hospital, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana. Data on sociodemographic, lifestyle and clinical factors were collected using a well‐structured questionnaire. Medication adherence was measured using Adherence in Chronic Disease Scale, and frailty was assessed by Tilburg Frailty Indicator. Statistical analyses were performed using SPSS Version 26.0 and GraphPad prism 8.0. p‐value of < 0.05 and 95% confidence interval (CI) were considered statistically significant. Results The prevalence of frailty was 59.7%. The proportion of high, medium and low medication adherence was 23.4%, 64.4% and 12.2%, respectively. Being ≥ 70years (adjusted odds ratio [aOR]: 8.33, 95% CI [3.72–18.67], p < 0.0001), unmarried (aOR: 2.59, 95% CI [1.37–4.89], p = 0.0030), having confirmed hypertension complications (aOR: 3.21, 95% CI [1.36–7.53], p = 0.0080), medium (aOR: 1.99, 95% CI [1.05–3.82], p = 0.0360) and low antihypertensive drug adherence (aOR: 27.69, 95% CI [7.05–108.69], p < 0.0001) were independent predictors of increased odds of developing frailty syndrome. Conclusion Approximately 6 out of 10 Ghanaian adult patients with hypertension experience frailty syndrome. Hypertension complications, older age, being unmarried, and low antihypertensive drug adherence increased the chances of developing frailty syndrome. These should be considered in intervention programmes to prevent frailty among patients with hypertension.

Introduction: Thyroid disorders and diabetes mellitus coexist and are prevalent endocrinopathies among adult population. Thyroid dysfunction contributes to metabolic imbalances, increase beta- cell apoptosis and glucose intolerance. There is paucity of data and contradicting findings on how thyroid dysfunction influence glycaemic control. Therefore, we evaluated thyroid dysfunction and glycaemic control among Type 2 diabetes mellitus (T2DM) patients in Ghana. Methods: A comparative cross-sectional study was conducted among 192 T2DM patients from Effia Nkwanta Regional Hospital. Three consecutive monthly fasting plasma glucose (FBG) and glycated haemoglobin (HbA1c) were analysed and the re- sults were classified as, moderate hyperglycaemia (MH) (FBG = 6.1- 12.0 mmol/L, HbA1c < 7%), severe hyperglycaemia (SH) (FBG >= 12.1 mmol/L, HbA1c > 7%) and good glycaemic controls (GC) (FBG = 4.1- 6.0 mmol/L, HbA1c < 7%). Thyroid-stimulating hormone (TSH), free triiodothyronine (FT3) and free thyroxine (FT4), body mass index (BMI) and other clinical parameters were measured. Data analysis was done using R language version 4.0.2 and p < .05 was considered statistically significant. Results: There were no significant differences in age (years) between patients in the various glycaemic groups (p = .9053). The overall prevalence of thyroid disorders was 7.8% among T2DM patients. The prevalence of thyroid disorders was higher in pa- tients with SH (11.7%) followed by those with MH (7.5%) and then those with GC (5.4%). Serum levels of TSH and FT3/FT4 ratio were significantly lower in T2DM pa- tients with SH compared to those with MH and the GC (p < .0001). However, FT4 was significantly higher in SH patients compared to the good glycaemic controls (p < .01). The first tertiles of TSH [aOR = 10.51, 95% CI (4.04- 17.36), p < .0001] and FT3 [aOR = 2.77, 95% CI (1.11- 6.92), p = .0290] were significantly and independently associated with increased odds of hyperglycaemia. Conclusion: The prevalence of thyroid dysfunction is high in T2DM and increases with hyperglycaemia. Reduced TSH and T3 may worsen glycaemic control. Periodic monitoring of thyroid function should be incorporated into management guidelines among T2DM patients in Ghana.

Background Preeclampsia is a leading cause of foeto-maternal deaths especially in Sub-Saharan Africa. However, the prevalence and risk factors of preeclampsia are scarce in the Central region of Ghana with previous study assessing individual independent risk factors. This study determined the prevalence and algorithm of adverse foeto-maternal risk factors of preeclampsia. Methods This multi-centre prospective cross-sectional study was conducted from October 2021 to October 2022 at the Mercy Women’s Catholic Hospital and Fynba Health Centre in Central region, Ghana. A total of 1,259 pregnant women were randomly sampled and their sociodemographic, clinical history, obstetrics and labour outcomes were recorded. Logistic regression analysis using SPSS version 26 was performed to identify risk factors of preeclampsia. Results Of the 1,259 pregnant women, 1174 were finally included in the study. The prevalence of preeclampsia was 8.8% (103/1174). Preeclampsia was common among 20–29 years age group, those who had completed basic education, had informal occupation, multigravida and multiparous. Being primigravida [aOR = 1.95, 95% CI (1.03–3.71), p = 0.042], having previous history of caesarean section [aOR = 4.48, 95% CI (2.89–6.93), p<0.001], foetal growth restriction [aOR = 3.42, 95% CI (1.72–6.77), p<0.001] and birth asphyxia [aOR = 27.14, 95% CI (1.80–409.83), p = 0.017] were the independent risk factors of preeclampsia. Pregnant women exhibiting a combination of primigravida, previous caesarean section and foetal growth restriction were the highest risk for preeclampsia [aOR = 39.42, 95% CI (8.88–175.07, p<0.001] compared to having either two or one of these factors. Conclusion Preeclampsia is increasing among pregnant women in the Central region of Ghana. Pregnant women being primigravida with foetal growth restriction and previous history of caesarean section are the highest risk population likely to develop preeclampsia with neonates more likely to suffer adverse birth outcome such as birth asphyxia. Targeted preventive measures of preeclampsia should be created for pregnant women co-existing with multiple risk factors.