ghanaopendata/ghanaian-research-english huggingface dataset:
Hypertension in Ghana: a cross-sectional community prevalence study in greater Accra

Objectives: To determine the prevalence of hypertension, and the extent to which it is treated and controlled, among adult Ghanaians. Design: 6300 adults, aged 25 years and older, were selected by random cluster sampling, using electoral enumeration areas and listings of adults. Setting: Three communities in the greater Accra region of Ghana. Subjects and Methods: A total of 4733 subjects (male to female ratio=1:1.5) participated, representing a response rate of 75%. The analysis used the mean of 2 blood pressure readings, taken with a mercury sphygmomanometer after a 10-minute rest. Hypertension was defined as having blood pressure ≥140/90 mm Hg, or currently undergoing anti-hypertensive treatment. Results: The mean ages for males and females were 44.9 ± 14.7 years, and 44.0 ± 14.6 years, respectively. The crude prevalence of hypertension was 28.3%. The age-standardized prevalence, to the new standard world population, was 28.4%. Mean systolic and diastolic blood pressures increased with age. Of 1337 subjects with hypertension, 34% were aware of their condition, 18% were treated, and 4% were controlled (blood pressure <140/90 mm Hg). Conclusion: Hypertension is a major public health problem, and is associated with relatively low levels of awareness, drug treatment, and blood pressure control. Population-based prevention strategies, such as reduction in salt intake and integration of hypertension care into primary care, may prove beneficial; however, the determinants of hypertension remain to be ascertained.

Source: UG
Hypertension in older adults in Africa: A systematic review and meta-analysis

Background Hypertension is the leading driver of cardiovascular disease deaths in Africa. Its prevalence is highest in older populations. Yet, this group has received little attention in many African countries. We conducted a systematic review and meta-analysis (PROSPERO registration: CRD42017056474) to estimate the prevalence of hypertension in older adults living in Africa. Methods We searched grey literature and major electronic databases including PubMed and Embase for population-based studies and published between 1 January 1980 to 28 May 2018 reporting the prevalence of hypertension for adults aged ≥50 years living in Africa. We employed a random effects model to estimate the pooled prevalence across included studies. Findings We screened 10,719 articles and retrieved 103 full-text articles to evaluate for inclusion in the review. Thirty-four unique studies providing 37 data points on 43,025 individuals in 15 African countries were analyzed. The prevalence of hypertension ranged from 22.3% to 90.0% from the individual studies while the overall pooled prevalence was 57.0% (95% CI 52%-61%). The prevalence was not statistically significantly different by sex, residence, or African sub-region. In individual studies, older age and overweight/obesity were independently associated with hypertension. Twenty-nine (78%) data points were deemed to be of low- or moderate-risk of bias. Eliminating high-risk bias studies made little difference to the pooled estimate of hypertension. Sensitivity analyses, omitting one study at a time, identified three studies with significant but relatively small impact on the pooled estimate. We observed substantial heterogeneity (I2 = 98.9%) across the studies which was further explored by meta-regression analyses. Overall, the GRADE assessment suggested moderate quality evidence in the results. Conclusion The persistent high prevalence of hypertension among older adults in Africa, even in rural populations warrants more attention to the cardiovascular health of this group by public health authorities.

Source: UG
Hypertension management in rural primary care facilities in Zambia: A mixed methods study

Background: Improved primary health care is needed in developing countries to effectively manage the growing burden of hypertension. Our objective was to evaluate hypertension management in Zambian rural primary care clinics using process and outcome indicators to assess the screening, monitoring, treatment and control of high blood pressure. Methods: Better Health Outcomes through Mentoring and Assessment (BHOMA) is a 5-year, randomized stepped-wedge trial of improved clinical service delivery underway in 46 rural Zambian clinics. Clinical data were collected as part of routine patient care from an electronic medical record system, and reviewed for site performance over time according to hypertension related indicators: screening (blood pressure measurement), management (recorded diagnosis, physical exam or urinalysis), treatment (on medication), and control. Quantitative data was used to develop guides for qualitative in-depth interviews, conducted with health care providers at a proportional sample of half (20) of clinics. Qualitative data was iteratively analyzed for thematic content. Results: From January 2011 to December 2014, 318,380 visits to 46 primary care clinics by adults aged ≥ 25 years with blood pressure measurements were included. Blood pressure measurement at vital sign screening was initially high at 89.1% overall (range: 70.1-100%), but decreased to 62.1% (range: 0-100%) by 48 months after intervention start. The majority of hypertensive patients made only one visit to the clinics (57.8%). Out of 9022 patients with at least two visits with an elevated blood pressure, only 49.3% had a chart recorded hypertension diagnosis. Process indicators for monitoring hypertension were <10% and did not improve with time. In in-depth interviews, antihypertensive medication shortages were common, with 15/20 clinics reporting hydrochlorothiazide-amiloride stockouts. Principal challenges in hypertension management included 1) equipment and personnel shortages, 2) provider belief that multiple visits were needed before official management, 3) medication stock-outs, leading to improper prescriptions and 4) poor patient visit attendance. Conclusions: Our findings suggest that numerous barriers stand in the way of hypertension diagnosis and management in Zambian primary health facilities. Future work should focus on performance indicator development and validation in low resource contexts, to facilitate regular and systematic data review to improve patient outcomes. Trial registration: ClinicalTrials.gov, Identifier NCT01942278. Date of Registration: September 2013.

Source: UG
Hypertension prevalence, awareness, treatment and control in Ghanaian population: Evidence from the Ghana demographic and health survey

Hypertension is a major cause of cardiovascular disease morbidity and mortality in Ghana. This study examines the prevalence, awareness, treatment and control of hypertension among Ghanaian aged 15–49 years. This cross-sectional study retrieved data from the 2014 Ghana Demographic and Health Survey (GDHS). The sample, comprising of 13,247 respondents aged 15–49 years, was analysed using descriptive statistics, Chi-Square tests, independent sample t-tests and binary logistic regressions. The overall prevalence of hypertension was 13.0% (12.1% for males and 13.4% for females). Among respondents who had hypertension, 45.6% were aware of their hypertension status; 40.5% were treating the condition while 23.8% had their blood pressure controlled (BP <140/90 mmHg). Socio-economic and demographic factors, health insurance coverage and recent visit to health facilities played significant roles in hypertension prevalence and awareness. While region of residence and health facility visits were predictors of hypertension treatment, age and region of residence predicted hypertension control in this population. This study suggests that in order to address the increasing burden of hypertension in Ghana, there should be an expansion of the National Health Insurance Scheme and development of measures to reduce health inequities. Also, some of the determining factors such as age, gender, marital status are similar to other cultures; therefore, existing interventions from those cultures could be adapted in addressing hypertension prevalence, awareness, treatment and control in Ghana.

Source: UG
Hypertension, cerebral vascular changes and stroke in Ghana. 1. Microaneurysm formation and stroke

A modification of the post-mortem arteriographic technique of Ross Russell was used to study the brains of 284 consecutive autopsy cases dying from non-traumatic causes; and made up of 159 hypertensives and 125 normotensives. Microaneurysms were demonstrated in 30.8 per cent of the hypertensives compared with 9.6 per cent normotensives. Haemorrhagic stroke was the cause of death in 37.6 per cent of the hypertensives, the majority of which were in younger age groups compared with hypertensive strokes in whites. The much lower incidence of microaneurysms in the brain of black hypertensives (even those with haemorrhagic strokes) compared with that found by workers among white hypertensives further emphasized the different nature of hypertension in blacks. It is suggested that, in the absence of significant structural differences in the cerebral vasculature between blacks and whites, the high incidence of haemorrhagic strokes occurring in the relatively younger subjects in Ghana may be due to the direct effect of high blood pressures on small intracerebral vessels and that microaneurysm formation may not be as important as in the much older white subjects dying of haemorrhagic strokes.

Source: UG
Hypoglycaemic activity of Oleanonic acid, a 3-oxotriterpenoid isolated from Aidia Genipiflora (DC.) Dandy, involves inhibition of carbohydrate metabolic enzymes and promotion of glucose uptake

The present study evaluated the antidiabetic activities of the 70% ethanol stem bark extract of Aidia genipiflora (AGB) and one of its constituents, oleanonic acid in streptozotocin (40 mg/kg)-induced diabetic rats. In vitro assays of glucose uptake and inhibition of carbohydrate metabolizing enzymes were then used to investigate their mechanism(s) of hypoglycaemic action. In silico evaluation of the pharmacokinetic and toxicity properties of the compound was also carried out. Administration of AGB (100–400 mg/kg) and oleanonic acid (15 – 60 mg/ kg) resulted in significant reductions (p < 0.001) in the blood glucose and considerable decrease (p < 0.05) in the elevated lipid parameters of the diabetic animals. AGB activity at 200 and 400 mg/kg; and oleanonic acid at 60 mg/kg were comparable to glibenclamide (5 mg/kg). The extract and its isolate strongly inhibited α-glucosidase and α-amylase activity with IC50 values of (10.48 ± 1.39 µg/mL and 14.51 ± 1.26 µg/mL) and (36.52 ± 1.95 µM and 105.84 ± 1.08 µM) respectively. The glucose uptake assays showed that AGB and oleanonic acid exerted both insulin-dependent and independent promotional effect of glucose transport into the periphery by upregulating the expression of PI3K and PPARγ transcripts with a concomitant increase in GLUT-4 transcripts. Although oleanonic acid was predicted to be teratogenic, it was found to be generally non-lethal with favourable pharmacokinetics properties making it suitable for further studies. The study has shown that the stem bark of A. genipiflora is a source of new hypoglycaemic agents and that oleanonic acid possesses hypoglycaemic and anti-hyperlipidaemic activities.

Source: UG
Hypoglycaemic activity of tragia tennifolia (euphorbiaceae) extract in rats

The hypoglycaemic effect of the ethanolic Tragia tennifolia Extract (TTE) was studied in Sprague-Dawley rats subjected to Oral Glucose Tolerance Test (OGTT), Fasting Plasma Glucose Test (FPGT) and alloxan-induced diabetes mellitus. Acute toxicity studies were also conducted on Sprague-Dawley rats. TTE (53 mg kg-1, p.o.) significantly (p≤0.01) reduced the peak plasma glucose concentration and the AUC of the OGTT curve, by 47.0 and 44.9%, respectively 1 h after its administration and this was comparable to that produced by glibenclamide (0.14 mg kg-1) and metformin (12.14 mg kg-1). TTE like glibenclamide, significantly (p≤0.01) reduced the fasting plasma glucose by 29.1% after 5 h compared to control groups. The AUC for TTE-treated rats was reduced by 14.8%. In alloxan-induced DM rats, insulin (8.5 unit/kg/day) significantly (p≤0.01) reduced hyperglycaemia by 68.6% whereas TTE, glibenclamide and metformin had no significant effects. Acute toxicity studies showed no evidence of toxicity after an oral administration of TTE (0.1-0.5 g kg-1). These results indicate that TTE may be potentially useful in Non-insulin Dependent Diabetes Mellitus (NIDDM) but not for Insulin Dependent Diabetes Mellitus (IDDM).

Source: UG
“I always think about tomorrow what I'll eat” an exploration of the experiences of adolescents in poor urban contexts in Accra, Ghana

Poverty deprives children and adolescents of good sanitation, nutrition, shelter, education, quality water, health services and negatively lead to poor physical and mental health. However, limited studies exist on the experiences of adolescents in poor urban contexts in Ghana. Using 20 adolescents from James Town, Accra, findings show adolescents look beyond money when conceptualizing poverty. They also encounter both pleasant and negative experiences in their context while remaining determined to pursue education for a better future. Implications are discussed considering the need to promote communal support because of its relevance to the well-being of the adolescents within poor urban contexts.

Source: UG
&quot;I Am Happy Because Of God&quot;: Religion and Spirituality for Well-Being in Ghanaian Orphanage-Placed Children

Although religion and spirituality were not the main focus of the broader study, 4 pathways through which religion and spirituality fostered well-being in a sample of Ghanaian orphaned children placed in orphanages emerged strongly. In follow-up interviews, we sampled 20 orphaned children aged between 7 and 17 years who were placed in 4 orphanages in Accra, Ghana. All participants had previously participated in a survey. Through thematic analyses, we found that religion promoted well-being by encouraging positive emotions and aided in the coping process as well as fostered resilience and a hopeful and optimistic outlook in orphans. The implications of the findings are discussed in light of the need for psychoeducation of the orphaned children to continuously identify and strengthen social ties that enable them to make positive meaning out of orphanage placement, promote well-being, and facilitate adjustment to orphanhood.

Source: UG
‘I Am on a Family Planning Program, but I Have Not Told My Husband’: Contraceptive Decision-Making of Child Brides in Ghana

This study explores the factors that influence child bride’s decision-making. either independently or jointly on modern contraceptive use in Ghana. The findings of this study are based on qualitative data collected through in-depth interviews with 15 child brides aged 15–24 years from four administrative regions in Ghana. It was observed that knowing about contraceptives, quality of the knowledge, attitude and sociocultural influences that affected child brides’ decision to use contraception. Thus, autonomy in decision-making requires first, making the decision to access contraceptives and secondly, whether the decision can be implemented alone, with permission or in consultation with their spouses. It can be concluded from this study that child brides are not always as vulnerable and unable to exercise agency as it sometimes suggested because they sometimes used contraceptives without informing their partners, although there is the possibility of a negative backlash from their partners when it is known.

Source: UG
“I AM SPEAKING FRENCH BUT I AM THINKING IN ENGLISH”: AN ANALYSIS OF ERRORS BY STUDENTS OF THE FRENCH LANGUAGE AT THE UNIVERSITY OF GHANA

This paper is in the domain of language acquisition and more particularly foreign language learning using the theoretical framework of Error Analysis but also taking into account the concept of the development of Interlanguage during the learning of a foreign language. We consider how learners of French as a Foreign Language in the University of Ghana seem to fall, either consciously or unconsciously, on the English Language during their oral and written productions. For this study, first and second year students of French from the University of Ghana were given a series of images and asked either to describe what they saw and/or to use the images to tell a story or form a dialogue. It was observed that there was evidence of English structures, transpositions, transliterations, etc. in their productions. We consider that these interferences are part of the development of the Interlanguage of the learners and we examine some of the types of errors identified in the production of the students. We conclude that this is a natural process for the learner of a foreign language in a multilingual context and we consider how the teacher of a foreign language class can take advantage of these productions to improve his teaching and also improve learning by his/her students.

Source: UG
I am speaking French but I am thinking in English: Another source of errors in foreign language learning

This paper is in the domain of language acquisition and more particularly foreign language learning using the theoretical framework of Error Analysis but also taking into account the concept of the development of Interlanguage during the learning of a foreign language. We consider how learners of French as a Foreign Language in the University of Ghana seem to fall, either consciously or unconsciously, on the English Language during their oral and written productions. For this study, first and second year students of French from the University of Ghana were given a series of images and asked either to describe what they saw and/or to use the images to tell a story or form a dialogue. It was observed that there was evidence of English structures, transpositions, transliterations, etc. in their productions. We consider that these interferences are part of the development of the Interlanguage of the learners and we examine some of the types of errors identified in the production of the students. We conclude that this is a natural process for the learner of a foreign language in a multilingual context and we consider how the teacher of a foreign language class can take advantage of these productions to improve his teaching and also improve learning by his/her students.

Source: UG
‘I decided to attend to him because it’s my duty’: Student Nurses perception and attitude towards care of older adults

Background and Aim: Nurses perception and attitude towards an older patient can positively or negatively influence the quality rendered. As students under training, the views of this population needs to be sought and shaped to improve the quality of care the older patients receive. This is because life expectancy is on the rise. The study aimed to explore students’ perception of ageing and their attitude towards care of the older adults. Methods and materials: An exploratory descriptive design was used. Data form containing the sociodemographic attributes of the students and a semi-structured interview form developed by the researchers in line with the literature. The participants interviewed were student nurses who had been in clinical practice for at least one semester. Four focus group discussions (FGD) were held. Results: Average age of the participants was 22.30 years. An equal number of males and females (15 each) were recruited to have a balance in gender. Students expressed that they saw the older adults as their grandparents so they try to accord them respect and care. However, older adults are perceived not receptive to nurses in training. The students stated that registered nurses neglected the basic care of older adults such as diaper changes, bathing, and feeding, and would rather beckon student nurses to attend to the older adults. Conclusion: Gerontology as a stand-alone course is necessary for early years of training to give an in-depth education to nursing students and instill a positive attitude towards older adult patients.

Source: UG
“I Did Not Choose to Be Obese”-Experiences of Stigma among Market Women in Kaneshie, Ghana

Excess body fat is associated with impaired physical and socio-emotional health outcomes. There is limited evidence on stigma and discrimination associated with overweight and obesity in developing country settings like Ghana where the rate of overweight is rapidly increasing. This current study explored the experiences of obesity-related stigma and discrimination among adult female vendors in the Kaneshie Market in Accra, Ghana. Employing a mixed concurrent method, both qualitative and quantitative data were collected. Quantitatively, about half (56%) of the survey respondents were obese, however, most of them misperceived their weight. Using Pearson Chi-square test of association, respondent age, marital status, educational level, ethnicity, and parity were significantly associated with BMI status. Multiple (adjusted) ordered logistic regression model showed age, ethnicity marital status, and parity to be significant demographic characteristics predictive of weight status. Single women had about four times lesser odds of having a higher weight status compared to those who were either married, divorced/separated/widowed, or cohabiting. Educational status was not significantly associated with BMI status in the adjusted model. The qualitative findings revealed derogatory name-calling, limitations to the use of public spaces, and denial of opportunities as stigmatizing and discriminatory attitudes experienced by obese respondents.

Source: UG
I don’t experience any insults but my wife does”: The blame game of male infertility in Ghana

Background. African men with infertility appear to be concerned about the blame for male infertility falling on their wives. Objective. To explore the concerns of men with infertility about the blame for male infertility falling on their wives. Methods. Participants were recruited through their wives, who were receiving treatment for infertility from the obstetrics and gynaecology unit of a public hospital in Ghana. The men had been identified as having male factor infertility. A semi-structured interview guide was designed and used to conduct in-depth interviews. Each participant was interviewed twice. The first interview lasted ~20-30 minutes. The second was by telephone, for validation of the findings, and lasted ~10 minutes per participant. Each interview was transcribed verbatim for conventional content analysis. Results. The findings revealed that the men described three main concerns: traditional influences, emotional disturbances and pressure on wives. Conclusion. The men’s narrations of their experiences indicated that they were very concerned about the blame for male infertility falling on their wives. There is a need for health education on male infertility in Ghana. © 2018, South African Medical Association. All rights reserved.

Source: UG