ghanaopendata/ghanaian-research-english huggingface dataset:
Clinical audit of management of asthma in children at Korle Bu teaching hospital

Asthma is now recognized as an important childhood Illness in developing countries. Unnecessary morbidity and mortality are caused by lack of recognition and inadequate treatment of asthma, All audit of the management of children with acute asthma admitted to the Karle Bu Teaching hospital was conducted with the view of making recommendations for the improvement of patient care The case notes of patients \1ho had suffered at least 3 episodes of breathlessness and Wheeze were inspected to assess the drug history, clinical evaluation of the severity of the al1ack. investigations requested and medications prescribed. There were 102 admissions. A drug history was recorded for 60 (58 .8%) admissions. Chest auscultation findings were documented for 98 (96.1%) patients and the ability to complete sentences for 10 (9.8%), The peak expiratory flow rate was not measured for any of the patients. Drugs had to be bought by parents/guardians for 16 (16.3%) admissions before the treatment could be initiated. Treatment was delayed for more than 30 minutes III 20 (20.6%) patie1lls, Nebulised salbutamol and systemic steroids were prescribed for 98 (96, 1 %) and 55(53.80%) patients, respectively. The results showed that the assessment ,and treatment of patients was inadequate and recommendations for improvement are made.

Source: UG
Clinical case definitions for malaria: Clinical malaria associated with very low parasite densities in african infants.

The Epidemiology Department contributes to the mission of the institute through basic and applied epidemiological research on, but not limited to, malaria and other diseases of public health importance. It is also home to the Social Science Unit of the Institute, including the Health Support Centre for HIV/AIDS and other communicable and noncommunicable health problems.

Source: UG
Clinical characteristics of males with systemic lupus erythematosus (SLE) in an inception cohort of patients in Ghana

BACKGROUND: Systemic Lupus Erythematosus (SLE) is said to be rare in Sub-Saharan Africa and even rarer in males worldwide. SLE is mostly considered a disease of women, though men may also be affected, and this may lead to a delay in diagnosis in men. The result is a greater burden of inflammation and subsequent organ damage over time. METHOD: Data from the medical records of 13 male patients diagnosed with SLE at the Rheumatology Clinic of Korle- Bu Teaching Hospital between January 2014 and January 2017 was retrospectively analyzed. RESULTS: A total of 13 male patients out of a total of 134 SLE patients were included in our analysis. The mean age was 30.62 ± SD 8.47 years (range of 17 to 46 years). All of them (100%) presented with constitutional features. The most common ACR criteria observed was 61.5 % rash, 54.5 % oral ulcers, 92.3% arthritis, 61.5 % serositis and 38.5% renal involvement, 46.2 % CNS involvement. Looking at their serological profile, 91.7 % had a positive antinuclear antibody (ANA). 33.3 % had positive anti-dsDNA and 58.3 % extractable nuclear antigens. The mean duration from onset of symptoms to diagnosis was 21.31 months. Five patients were diagnosed with lupus nephritis, all at the time of diagnosis. There were no mortalities. CONCLUSION: Male SLE patients in Ghana are comparable to other populations, with arthritis and constitutional features being predominant early features and lupus nephritis being the main early indicator of organ damage. This should warrant aggressive management in male patients.

Source: UG
Clinical determinants of early parasitological response to ACTs in African patients with uncomplicated falciparum malaria: a literature review and meta-analysis of individual patient data.

BACKGROUND: Artemisinin-resistant Plasmodium falciparum has emerged in the Greater Mekong sub-region and poses a major global public health threat. Slow parasite clearance is a key clinical manifestation of reduced susceptibility to artemisinin. This study was designed to establish the baseline values for clearance in patients from Sub-Saharan African countries with uncomplicated malaria treated with artemisinin-based combination therapies (ACTs). METHODS: A literature review in PubMed was conducted in March 2013 to identify all prospective clinical trials (uncontrolled trials, controlled trials and randomized controlled trials), including ACTs conducted in Sub-Saharan Africa, between 1960 and 2012. Individual patient data from these studies were shared with the WorldWide Antimalarial Resistance Network (WWARN) and pooled using an a priori statistical analytical plan. Factors affecting early parasitological response were investigated using logistic regression with study sites fitted as a random effect. The risk of bias in included studies was evaluated based on study design, methodology and missing data. RESULTS: In total, 29,493 patients from 84 clinical trials were included in the analysis, treated with artemether-lumefantrine (n = 13,664), artesunate-amodiaquine (n = 11,337) and dihydroartemisinin-piperaquine (n = 4,492). The overall parasite clearance rate was rapid. The parasite positivity rate (PPR) decreased from 59.7 % (95 % CI: 54.5-64.9) on day 1 to 6.7 % (95 % CI: 4.8-8.7) on day 2 and 0.9 % (95 % CI: 0.5-1.2) on day 3. The 95th percentile of observed day 3 PPR was 5.3 %. Independent risk factors predictive of day 3 positivity were: high baseline parasitaemia (adjusted odds ratio (AOR) = 1.16 (95 % CI: 1.08-1.25); per 2-fold increase in parasite density, P <0.001); fever (>37.5 °C) (AOR = 1.50 (95 % CI: 1.06-2.13), P = 0.022); severe anaemia (AOR = 2.04 (95 % CI: 1.21-3.44), P = 0.008); areas of low/moderate transmission setting (AOR = 2.71 (95 % CI: 1.38-5.36), P = 0.004); and treatment with the loose formulation of artesunate-amodiaquine (AOR = 2.27 (95 % CI: 1.14-4.51), P = 0.020, compared to dihydroartemisinin-piperaquine). CONCLUSIONS: The three ACTs assessed in this analysis continue to achieve rapid early parasitological clearance across the sites assessed in Sub-Saharan Africa. A threshold of 5 % day 3 parasite positivity from a minimum sample size of 50 patients provides a more sensitive benchmark in Sub-Saharan Africa compared to the current recommended threshold of 10 % to trigger further investigation of artemisinin susceptibility.

Source: UG
Clinical disease activity in autoimmune rheumatic patients receiving COVID-19 vaccines

Background Vaccines are a crucial component of the global efforts to control the spread of COVID-19. Very little is known about COVID-19 vaccine responses in patients living with autoimmune rheumatic conditions in Africa. We examined the clinical reaction to COVID-19 vaccinations in Ghanaians diagnosed with autoimmune rheumatic disease. Methods This was a hospital-based interventional cohort study of systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) patients recruited via regular face-to-face clinic visits. The systemic lupus erythematosus disease activity index Selena modification (SELENA-SLEDAI) and the disease activity score 28-joint count-erythrocyte sedimentation rate (DAS28-ESR) were used to measure changes in disease activity levels. Results Thirty-eight (38) patients of which 21 (55.3%) were diagnosed with SLE and 17 (44.7%) with RA contributed data for analyses. Most (89.5%) of the patients were females, with a mean age of 37.4 years. The SLE patients experienced a notable increase in severe flares during weeks three and six, as well as the third and sixth months, followed by subsequent decreases in the twelfth month, while remission levels increased throughout the same period. Among RA patients, high disease activity decreased during weeks three and six, as well as the third, sixth, and twelfth months, with remission levels increasing during the same time. A low dose (≥50<75 mg) dose of azathioprine was at some point associated with having a severe flare among SLE patients. After both vaccine doses, SLE patients were the majority having experienced both local and systemic reactions, all resolving within 24 h. Approximately 73.7% of the patients were COVID-19 negative at baseline. During post-vaccination visits, this increased to 100% by week six, with no positives thereafter. Conclusion This study explores COVID-19 vaccine responses in Ghanaian autoimmune rheumatic disease patients, revealing disease activity levels in RA patients improved after vaccination compared to SLE patients. Our findings identify a potential link between low-dose azathioprine and severe flares in SLE patients, particularly evident in the third-week post-vaccination. Further research is warranted to clarify these findings and guide tailored treatment approaches in this medically significant population during pandemics and vaccination efforts.

Source: UG
Clinical education in undergraduate nursing in Ghana: a gap analysis

Background Nursing education comprises theory and practice as two complementary parts. In Ghana, the clinical education space is inundated with many challenges, disrupting the intended purpose of clinical education. The multifactorial challenges include student issues, nurse and educator concerns, management and resource issues. To find solutions, there is a need for a critical analysis of the current clinical educational practices to inform the development of feasible and sustainable approaches for nursing education. This article, therefore, reports on a gap analysis of clinical education in Ghana. Method A qualitative descriptive design underpinned the study and was executed through key informant interviews, focus group discussions and document analysis. A total of seventy-three participants, drawn from four nursing education institutions and eight clinical sites located in four administrative regions in Ghana, participated in the study. These participants comprised four principals, four heads of accounts, eight clinical coordinators, eight nurse educators, twelve preceptors, and thirty-seven final-year undergraduate nursing students. Data analysis was done deductively against the Global Pillars for Nursing Education, yielding three themes and eleven sub-themes. Results For theme 1, the study revealed a lack of a comprehensive competency-based assessment, ineffective interprofessional communication, and a non-stimulating clinical education climate. For theme 2, disregard for available admission standards and non-integration of interprofessional education into the undergraduate curriculum was found. In the case of theme 3, insufficient clinical experience of nurse educators was detected, financial resources to support clinical activities optimally were insufficient, and nursing schools lacked independence to support nursing education effectively. Conclusion This study identified gaps in the clinical education of undergraduate nurses in Ghana when measured against the Global Pillars for Nursing Education. Gaps in clinical education compromise competence at graduation, resulting in nursing graduates who negatively impact health outcomes. Implementing targeted strategies could enhance clinical teaching and learning in undergraduate nursing education in Ghana

Source: UG
Clinical features of Burkitt's lymphoma: The African experience.

Most research activities involve the use of molecular methods such as regular PCR (PCR), quantitative PCR (Q-PCR), genomic sequence and analysis using different software, genetic engineering, probe hybridization techniques, biological and molecular cloning, evaluation of immune markers for laboratory diagnosis of infections, serological assays involving the use of rapid tests, ELISA-based evaluations and immunofluorescent assay techniques.

Source: UG
Clinical Features of HIV Infection in Accra

The clinical features of 30 patients with H.I.V. infection have been described. 18 patients had severe disease and satisfied the WHO clinical definition of AIDS in Africa. The usefulness of this definition in underdeveloped countries has been discussed. The remaining 12 patients had milder disease and the importance of identifying this group of patients in the control of HIV infection in the community has also been discussed. In the main, the clinical features of HIV infection in Accra is similar to those found in East and Central Africa.

Source: UG
Clinical Outcomes of Submicroscopic Infections and Correlates of Protection of VAR2CSA Antibodies in a Longitudinal Study of Pregnant Women in Colombia

Background Malaria in pregnancy can cause serious adverse outcomes for the mother and the fetus. However, little is known about the effects of submicroscopic infections (SMIs) in pregnancy, particularly in areas where Plasmodium (P.) falciparum and P. vivax co-circulate. Methods A cohort of 187 pregnant women living in Puerto Libertador in Northwest Colombia was followed longitudinally from recruitment to delivery. Malaria was diagnosed by microscopy, RT-qPCR, and placental histopathology. Gestational age, hemoglobin concentration, VAR2CSA-specific IgG levels and adhesion-blocking antibodies were measured during pregnancy. Statistical analyses were performed to evaluate the impact of SMIs on birth weight and other delivery outcomes. Results Twenty-five percent of women (45/180) were positive for SMIs during pregnancy. Forty-seven percent of infections (21/45) were caused by P. falciparum , 33% by P. vivax , and 20% by mixed Plasmodium spp. Mixed infections of P. falciparum and P. vivax were associated with lower gestational age at delivery (p=0.0033), while other outcomes were normal. Over 60% of women had antibodies to VAR2CSA and there was no difference in antibody levels between those with SMIs or not. The anti-adhesion function of these antibodies was associated with protection from SMI-related anemia at delivery (p=0.0086). Conclusions SMIs occur frequently during pregnancy and while they were not associated with a decrease in birth weight, mixed infections of both P. falciparum and P. vivax were associated with significant risk of pre-term birth. We propose that the lack of adverse delivery outcomes is due to functional VAR2CSA antibodies that can protect pregnant women from SMI-related anemia.

Source: UG
Clinical phase 1 testing of the safety and immunogenicity of an epitope-based DNA vaccine in human immunodeficiency virus type 1-infected subjects receiving highly active antiretroviral therapy

A DNA vaccine encoding sequence-conserved human immunodeficiency virus type 1 (HIV-1)-derived cytotoxic T-lymphocyte (CTL) epitopes from multiple HIV-1 gene products (designated EP HIV-1090) was evaluated in a placebo-controlled, dose escalation phase 1 clinical trial of HIV-1-infected subjects receiving potent combination antiretroviral therapy. Patients received four intramuscular immunizations with EP HIV-1090 over a 4-month period at one of four doses (0.5, 1.0, 2.0, or 4.0 mg) or received a placebo. The vaccine was determined to be safe and well tolerated at all doses tested. CTL responses were measured from cryopreserved peripheral blood mononuclear cells using gamma interferon enzyme-linked immunospot assays, with and without in vitro peptide stimulation (IVS). Responses to one or more vaccine epitopes were detected throughout the course of vaccination in 37.5% (12/32) and 47% (15/32) of vaccine recipients measured without and with IVS, respectively, indicating possible vaccine-induced priming of epitope-specific T cells. However, differences in rates of response to HIV-1 epitopes between vaccine and placebo recipients did not achieve statistical significance. The HIV-1 epitope-specific CTL responses measured in the peripheral blood after vaccination were often low level and short-lived, and therefore, alternative immunization schedules, routes of delivery, or vaccine formulations may be required to increase vaccine potency.

Source: UG
Clinical presentation and persistent symptoms in patients at a post-COVID-19 clinic in Ghana

Introduction: on March 11th, 2020, the World Health Organization recognized COVID-19 as a pandemic. By March 31st, 2021, the Ghana Health Service had recorded a cumulative 90,782 positive cases and 748 deaths in the country. Despite the significant resources and efforts being put into containing and treating individuals with COVID-19, there is a lack of information within sub-Saharan Africa on clinical presentations and factors associated with experiencing persistent symptoms of COVID-19. Methods: in this retrospective study, we collected data obtained from patients with COVID-19 who were discharged from the post COVID-19 clinic at the Ga East Municipal Hospital, Ghana, between April 1st, 2020, and March 31st, 2021, to assess clinical presentations and identify predictors of COVID-19 symptoms that persist beyond 14 days from the onset of the symptom.Results: of the 253 patients who experienced symptoms of COVID-19, 81 (32.0%) experienced symptoms that persisted beyond 14 days. Cough (64.0%), headache (38.7%), and chest pain (28.1%) were the most common symptoms. After adjusting for covariates, the odds of patients presenting with COVID-19 symptoms that persist beyond 14 days are 98% higher among patients who experienced chest pain compared to those who did not and 2% increased for each additional year of their age. Conclusion: patient´s age and experiencing chest pain were significant predictors of symptoms that persist beyond 14 days. The findings of our study highlight the need to continue to monitor and care for individuals with identified predictors of experiencing persistent symptoms of COVID-19.

Source: UG
Clinical presentation of symptomatic human immuno-deficiency virus in children.

Most research activities involve the use of molecular methods such as regular PCR (PCR), quantitative PCR (Q-PCR), genomic sequence and analysis using different software, genetic engineering, probe hybridization techniques, biological and molecular cloning, evaluation of immune markers for laboratory diagnosis of infections, serological assays involving the use of rapid tests, ELISA-based evaluations and immunofluorescent assay techniques.

Source: UG
Clinical spectrum of acute abdominal pain in Accra, Ghana.

In a 12-month prospective study 370 patients with acute abdominal pain were admitted to a single surgical unit of a large teaching hospital. The most common diagnoses were appendicitis (23.5 percent), Non-specific abdominal pain (NSAP) (21.4 percent), acute intestinal obstruction (10.8 percent), gynaecological causes (9.5 percent, and peptic ulcer (9.2 percent). Emergency operations were performed in 146 patients (39.5 percent). Appendicectomy was the commonest operation (77 cases or 52.7 percent) and there was a high incidence of complicated appendicitis (41.6 percent). Eleven patients (3.0 percent) died within 30 days of admission (8 postoperative and 3 non-operative deaths). The clinical spectrum of the acute abdomen in this study shows that surgeons in developing countries are not facing surgical challenges similar to those of their counterparts in developed countries and the most important diagnostic distinction surgeons in both localities have to make is that between acute appendicitis and non-specific abdominal pain.

Source: UG
Clinical utility of squamous and transitional nuclear structure alterations induced by Schistosoma haematobium in chronically infected adults with bladder damage verified by ultrasound in Ghana

The main research focus of the Electron Microscopy and Histopathology Department in the past 20 years has been in the areas of enteric diarrhoeas with special emphasis on rotavirus. Through its diarrhoea surveillance studies, the Department has helped to firmly establish rotaviruses as a major cause of diarrhoea in children, and document the circulation of unusual rotavirus genotypes in Ghana. The Department has also recently expanded its diagnostic repertoire to include the identification and characterization of noroviruses, astroviruses, and other enteric viruses.

Source: UG
Clonal distribution of pneumococcal serotype 19F isolates from Ghana

Streptococcus pneumoniae is a major cause of morbidity and mortality worldwide. Pneumococcal strains are classified according to their capsular polysaccharide and more than 90 different serotypes are currently known.In this project, three distinct groups of pneumococcal carriage isolates from Ghana were investigated; isolates from healthy children in Tamale and isolates from both healthy and children attending the outpatient department at a hospital in Accra. The isolates were previously identified and characterized by Gram staining, serotyping and susceptibility to penicillin. In this study, isolates of the common serotype 19F were further investigated by Multi-Locus Sequence Typing (MLST).Overall, 14 different Sequence Types (STs) were identified by MLST, of which nine were novel based on the international MLST database. Two clones within serotype 19F seem to circulate in Ghana, a known ST (ST 4194) and a novel ST (ST 9090). ST 9090 was only found in healthy children in Accra, whereas ST 4194 was found equally in all children studied. In the MLST database, other isolates of ST 4194 were also associated with serotype 19F, and these isolates came from other West African countries. The majority of isolates were penicillin intermediate resistant.In conclusion, two clones within serotype 19F were found to be dominating in pneumococcal carriage in Accra and Tamale in Ghana. Furthermore, it seems as though the clonal distribution of serotype 19F may be different from what is currently known in Ghana in that many new clones were identified. This supports the importance of continued monitoring of pneumococcal carriage in Ghana and elsewhere when vaccines, e.g., PCV-13, have been introduced to monitor the possible future spread of antimicrobial resistant clones. © 2015.

Source: UG
Closing the Gender Gaps in Ghana

This chapter assesses gender issues in the national discourse and policy agenda since independence and presents evidence on trends in gender gaps in education, employment, time use, and asset ownership. Although progress has been made in introducing legislation and policies to promote gender equality, important legislation remains to be enacted. Gender parity in primary enrolment has been achieved but gender gaps persist in other education levels and in education outcomes. More women are in wage employment, but the proportion of working women classified as unpaid family workers remains stubbornly high. The gender gap in time spent on unpaid domestic work persists despite women’s increased labour force participation and there is a gender gap in asset ownership. Closing the gender gap will require crafting appropriate strategies based on a clear understanding of gender relations in order to change values, norms, and behaviours.

Source: UG
Cloud computing login authentication redesign

Trusted-security is a concern for cloud adoption by many enterprises. The work was to improve login security process at cloud ’ s user-end using biometric to replace secret code generation as step-2 authentication. System development life cycle-revolutionary waterfall method was adapted for the design process and verified the redesign using Delphi technique with security experts. The work alerts authorised user to block domain intrusion on phone at real time as phone is permanently interlinked to access server. On experiment, authorised user must submit cloud username and password on computer workstation as step-1 key. On submission, a text message is generated to a predefined biometric-compatible phone for user to scan bio-feature. As backdoor, if predefined biometric phone is temporarily lost; open the alternative link sent to authorised user e-mail account to capture and resend the scanned bio-feature to server as step-2 key for access privilege. Results indicated rigidity to prevent hacking via user-workstation. We recommended multi-nodal bio-scanning to reduce authentication failure rate and argued conclusively that this work improves user-end login security for cloud clients.

Source: UG