Health Sciences Investigations Journal

Welcome message from the Editor-in-chief 2025

Andrew Anthony Adjei — 2025-06-27

It is with much pleasure that I welcome you to Volume 7 Issue 1 of the Health Sciences Investigations Journal (HSI Journal). The Journal remains committed to reaching the global community with open-access publications from basic and clinical health sciences. HSI Journal therefore places a high premium on the quality of research articles published and the impact of outcomes on health (complete physical, mental and social well-being) and thus consistently provides an avenue for communication of research findings in health, the science of well-being. During the 2023-2024 calendar year, HSI Journal experienced a substantial increase in manuscripts submitted for consideration in publishing and a corresponding rise in requests for indexing from Medical and Health-related Websites. As I reflect on the HSI Journal’s accomplishments in 2024, I am encouraged by the fortitude, passion, dedication and commitment of our Editors, Editorial and Administrative Teams who persevered through economic times for the University of Ghana and The College of Health Sciences.
The current issue of the HSI Journal we have featured 22 manuscripts, comprising 20 original articles, and two case control studies. The substantial increase in the number of articles published in this issue indicates the level of visibility attained and acceptance of the HSI Journal by the scientific and clinical communities. The current issue of the Journal contains a case study on the atypical intestinal serosal granulomatous lesions of Schistosoma haematobium and Schistosoma mansoni coinfection presenting in a surgical unit in an obstructed hernia.

The intraoperative findings pose a clinical dilemma and difficult management decision. This presentation of extensive serosal and omental granulomatous lesions is uncommon. This is a rare condition that surgeons must know in cases of parasitic infestations with schistosomiasis. In this issue, we also present a case of unilateral fused kidney (inferior ectopia). The incidence is said to be 1 in 2000 births and more common in males compared to females. A left-to-right positioning is about three times more common compared to right-to-left. This case of a right-to-left is therefore rarer, and clinically most cases present in the paediatric age group. There is also an interesting article on lessons for future pandemics following the recent COVID-19 episode. The COVID-19 pandemic had overwhelming effects on global health, with a complex interaction between socioeconomic factors and mental health outcomes.

HSI Journal Celebrate College of Health Sciences (CHS) @ 25

Michelle Otuah Antwi — 2025-06-20

The College of Health Sciences (CHS) at the University of Ghana (UG), which hosts and funds the Health Sciences Investigations Journal marks 25 years of impactful contributions to health education, research, and service in Ghana and beyond.
Established in 1999, UG-CHS brought together the University's health-related schools, institutes, and centres to promote interdisciplinary collaboration and drive innovation in health sciences training and research. Over the past two and a half decades, UGCHS has become a hub of academic excellence, nurturing generations of medical, dental, nursing, pharmacy, and allied health professionals. Its institutions - including the University of Ghana Medical School, University of Ghana Dental School, School of Pharmacy, School of Nursing and Midwifery, and Noguchi Memorial Institute for Medical Research - have made significant strides in training world-class professionals and conducting cutting-edge research that addresses national and global health challenges.

About the cover Odikro’s Wife

Koney-Kwaku Nii Koney — 2025-06-27

The painting, Odikro’s Wife, draws inspiration from Ghanaian tradition, where the Odikro, a title bestowed upon a chief in the Ashanti region, serves as the custodian of law and order. The Odikro is often perceived as the ultimate authority, embodying the essence of leadership and ownership within the village.

In the foreground stands a striking figure—the Odikro’s wife. She exudes an aura of elegance and commanding authority, matching the stature of her husband. Her poised and imposing presence speaks volumes, suggesting that her influence and power are undeniable, even in a role traditionally overshadowed by the male figure.

The setting of the painting is stark, almost lifeless, evoking a profound sense of solitude. This atmosphere reflects a deeper truth: as one rises in status and authority, a sense of isolation often follows. Success can create an emotional distance, as others struggle to reconcile themselves with one’s achievements, leaving the individual to navigate an increasingly lonely path.

When Knowledge Isn’t Enough — Rethinking Breast Cancer Screening Among Ghanaian Nurses

Koney-Kwaku Nii Koney — 2025-06-27

The study by Nsaful et al. in this issue of the HSI Journal offers both a sobering and illuminating lens into the complex dynamics of breast cancer screening among health professionals. This reveals a dissonance that is as startling as it is instructive: while knowledge about breast cancer among female nurses in a Ghanaian tertiary hospital was found to be generally adequate, actual screening practices were inconsistent. Even more striking is the reported resistance to mastectomy, with 60% of the participants indicating that they would not accept this life-saving procedure if diagnosed.

This paradox speaks volumes about the nature of cancer care in low- and middle-income countries, not just the limitations of access or training, but also the deep psychosocial and cultural barriers that persist even among the most medically informed segments of the population.

Why does this matter?

Nurses are not just caregivers. In many African settings, they are the primary source of health education, particularly for women. If nurses are hesitant to engage in screening or reluctant to accept definitive treatment, the ripple effects on public health messaging and community behavior are significant. This undermines national screening goals and can contribute to Ghana’s high rate of late-stage breast cancer presentation, a problem that the study indirectly echoes.

Knowledge, attitude and practice on breast cancer screening among female nurses in a tertiary hospital in Ghana

Josephine Nsaful — 2025-06-27

Background: Breast cancer is the most common female malignancy worldwide. In Sub-Saharan African countries, there are no national screening programmes for BC. In the absence of sufficient mammograms, breast self-examination and clinical breast examination play an important role. Nurses educate the general public on BC screening.
Objective: The study aimed to evaluate the knowledge, attitude and practices with regard to BC among female nurses at a tertiary hospital in Ghana.
Methods: This was a cross-sectional descriptive study utilising a self-administered close-ended questionnaire carried out among full-time nurses. This assessed knowledge of BC risk factors, signs and symptoms of BC, the attitude one should develop towards BC and the practice of breast self-examination (BSE), clinical breast examination (CBE) and mammography. The level of knowledge was categorised into good (≥ 75%), satisfactory (50 - 74%) and poor (< 50 %). A logistic regression analysis was carried out to determine factors associated with
inadequate knowledge (level of knowledge < 50%) and the practice of BSE, CBE and agreeing to mastectomy.
Results: This study found that the knowledge of nurses in BC was adequate. A total of 67% of nurses regularly practised BSE, 39% had previously had a CBE, and 85% of those 40 years and above had never had a mammogram. A total of 60% of nurses admitted they would disagree with a mastectomy in the event of being diagnosed with BC.
Conclusion: This study found that the knowledge of BC among nurses did not translate into good BC screening practices, and they had an overwhelming fear of mastectomy. There is a need for training programs to be directed at improving breast screening practices, also focusing on the curability of BC, its treatment options and survivorship to help overcome the fear and stigma associated with mastectomy

Examining prenatal care's predictive role in maternal haemoglobin concentration at childbirth

Brainard Asare — 2025-06-29

Background: Antenatal care (ANC) encompasses clinical assessments, health advice, and medical guidance on maternal changes, nutrition, and supplements to promote maternal and fetal well-being and thus prevent pregnancy-related complications. Despite these efforts, maternal anaemia remains prevalent in resource-limited settings such as the Kwaebibirim district in the eastern region of Ghana.
Objective: This study aimed to explore the link between the frequency of ANC visits and increased maternal haemoglobin concentration (mHgbc) levels.
Methods: This study employed an analytical cross-sectional design using secondary data from birth registers in the district hospital’s labour suite to assess variations in mHgbc levels across different ANC visit frequencies. Statistical analyses included descriptive analysis, one-way ANOVA and unpaired two-sample t-tests.
Results: The mean number of ANC visits was 6.06 (SD 3.23), and the mean mHgbc was 10.34 g/dl (SD 1.42). ANC visits ranged from 0 to 16, while mHgbc levels ranged from 1.6 g/dl to 16.3 g/dl. Most women attended 4 - 8 ANC visits (54.7%), followed by 0 - 3 visits (23.25%) and ≥ 9 visits (22.1%). A higher frequency of ANC visits was associated with higher mHgbc levels. One-way ANOVA revealed significant differences in mean mHgbc among the 0 - 3, 4 - 8, and ≥ 9 ANC visit groups. Post hoc unpaired two-sample t-tests confirmed significant differences in mean mHgbc between 0 - 3 vs. 4 - 8 and 4 - 8 vs ≥ 9 visits. However, no significant differences were observed between 0 - 3 and 4 - 8 visits in women aged 21 – 30 years, those with senior high school education, formal occupations, and multiparae. Similarly, preterm or early-term deliveries and women with blood group A showed no significant differences between 4 - 8 and ≥ 9 visits.
Conclusion: Increased ANC visit frequency is associated with higher mHgbc levels. However, further prospective studies are needed to identify which ANC components underlie this observation and further address the limitations of secondary data.

Quality of life outcomes of head and neck cancer survivors and their family caregivers at the Korle Bu Teaching Hospital

Selina O. Boadu — 2025-06-30

Background: A steady increase in the number of patients diagnosed with head and neck cancer (HNC) has necessitated the need for further studies on the quality-of-life (QOL) outcomes of these patients and their caregivers.
Objective: The study evaluated the QOL of HNC survivors and their family caregivers in a sub-Saharan African tertiary health facility.
Methods: This was a descriptive cross-sectional study at the Ear, Nose and Throat (ENT) Department and the National Radiotherapy, Oncology and Nuclear Medicine Centre at the Korle Bu Teaching Hospital. After consenting to be part of the study, the demographic characteristics of participants were recorded on a data collection form, and their QOL outcomes were evaluated using the World Health Organisation Quality of Life (WHO-QOL) questionnaires. An independent sample t-test was used to analyse the differences in mean score
values in QOL. Logistic regression analysis was used to examine factors associated with the overall QOL of patients with HNC. Odds ratios and 95% confidence intervals were calculated. P-values less than 0.05 were considered statistically significant.
Results: A total of 160 patients with HNC and 160 family caregivers participated in this study. The mean ages of the patients and caregivers were 45.1 (SD 15.9) years and 36.2 (SD 13.1) years, respectively. Both HNC patients and their caregivers had a good QOL overall. However, HNC patients had a better QOL compared with their family caregivers (72.12 (SD 19.30) vs. 62.70 (SD 16.6), p = 0.001) in each domain and the overall QOL, except satisfaction with health. A total of 74.4% (n = 119) of patients with HNC had a QOL outcome. Education and the
type of treatment received were associated with a good quality of life.
Conclusion: Both HNC patients and their caregivers have a good QOL. However, patients with HNC had a better QOL compared with their family caregivers.

Programmed death-ligand 1 (PD-L1) expression in malignant and benign cervical and breast cancers

Victor Ekundina — 2025-06-30

Background: Programmed death-ligand 1 (PD-L1) expression has become a valuable biomarker for guiding immunotherapy selection in various cancers, including breast and cervical malignancies.
Objective: This study aimed to investigate the immunohistochemical expression of PD-L1 in malignant and benign breast and cervical cancers.
Methods: This retrospective study involved the analysis of 40 formalin-fixed paraffin-embedded tissue blocks, with 20 blocks from breast cancer patients and 20 from cervical cancer patients. Immunohistochemical analysis was performed via the avidin-biotin immunoperoxidase method to detect PD-L1 expression. The expression was assessed using a semi-quantitative method, grading the staining intensity and the percentage of stained cells per field. The stained sections were observed under a Leica microscope (Leica DM750, Switzerland) connected to
a digital camera (Leica ICC50).
Results: PD-L1 expression was greater in cervical cancer than in breast cancer. In breast cancer, benign cases mostly presented negative PD L1 expression, with a mean percentage reactivity (MPR) of 14.8%, whereas malignant cases presented mild expression, with an MPR of 46.4%. In cervical cancer, benign cases were mainly negative, with an MPR of 18.4%, whereas malignant cases displayed mild to moderate PD-L1 expression, with an MPR of 71.3%.
Conclusion: PD-L1 expression was more pronounced in cervical cancer than in breast cancer. The elevated levels of PD-L1 in cervical cancer suggest that this type of cancer may be more responsive to immunotherapeutic interventions targeting the PD-L1 pathway compared to breast cancer. Recognising these differences is crucial for tailoring treatment plans and implementing personalised medicine strategies for each specific cancer type.

Prevalence of prediabetes and its risk factors among adults in selected communities in Accra

Kwaku Brobbey Akyea-Boakye — 2025-06-28

Background: Diabetes mellitus is a global health issue, with cases projected to surge from 180,000,000 in 1980 to over 693,000,000 by 2045. Considering that prediabetes precedes type 2 diabetes, early diagnosis and timely intervention are essential to prevent or delay disease progression.
Objective: This study assessed the determinants of prediabetes among adults in selected Accra communities.
Methods: This study investigated prediabetes prevalence in five Accra communities - North Kaneshie, Madina, Teshie, Lapaz, and Legon. A cross-sectional study used multistage sampling to recruit 360 adults (≥ 18 years). Eligibility required Accra residency (≥ 1 year), 10 – 12-hour fasting, and informed consent. Sociodemographic variables, behavioural patterns, dietary intakes, anthropometric measures and clinical indicators were collected. Logistic regression was employed to estimate associations between all variables and prediabetes status.
Results: Prediabetes and diabetes prevalence were 26.7% and 29.4%, respectively. Significant associations were found with prediabetes for female sex (OR: 2.03, 95% CI: 1.02 - 4.59, p = 0.031), age 40 - 59 years (OR: 2.97, 95% CI: 1.10-8.32, p = 0.039), and being single (OR: 2.60, 95% CI: 1.05-6.43, p = 0.038). Behavioral factors linked to prediabetes included salt intake (AOR: 6.25, 95% CI: 1.69-23.02, p=0.006), smoking (AOR: 10.14, 95% CI: 1.21-111.03, p = 0.002), caffeine intake (AOR: 2.51, 95% CI: 1.53 - 11.88, p = 0.012), and low physical activity (AOR: 3.53, 95% CI: 1.83 - 7.89, p < 0.001). Increased consumption of starchy foods (AOR: 3.63, 95% CI: 1.74 - 7.58, p = 0.007),
animal-sourced foods (AOR: 2.54, 95% CI: 1.36 - 4.86, p = 0.015), fats and oils (AOR: 5.87, 95% CI: 2.76 - 12.51, p = 0.001), and legumes (AOR: 2.45, 95% CI: 1.23 - 6.11, p = 0.045) were significantly linked to prediabetes. BMI greater than 25kg/m2 (AOR: 4.55, 95% CI: 2.12 - 18.11, p < 0.001), MAP (AOR: 4.21, 95% CI: 1.50 - 11.81, p = 0.006), and stage 1 hypertension (AOR: 6.74, 95% CI: 1.50 - 30.29, p = 0.015) showed associations with prediabetes.
Conclusion: Prediabetes prevalence was high, driven by sociodemographic, dietary, and behavioural factors. Lifestyle and physiological risks underscore the urgent need for targeted interventions in this population.

Extract of Mallotus oppositifolius ameliorates mercuric chloride-induced neurotoxicity

Benjamin Effah-Oware — 2025-07-02

Background: Mercuric chloride (HgCl2) induces neurotoxicity in both animals and humans, with unclear treatment mechanisms and associated side effects. Mallotus oppositifolius leaf extract, known for its pharmacological properties like antidepressant and anti inflammatory effects, thus suggests potential neuroprotection.
Objective: The study aimed to assess the neuroprotective effect of Mallotus oppositifolius in a mercuric chloride-induced neurotoxicity mouse model.
Methods: Male mice (20 - 25 g) from the Institute of Cancer Research (ICR) were randomly divided into six groups of eight (48 mice). Group 1 received the vehicle (without mercuric chloride) throughout the experimental period. Mice in groups 2, 3, 4, 5 and 6 were pre-treated with HgCl2 orally for 7 days, after which groups 3, 4 and 5 were treated with the oral graded dose of Mallotus oppositifolius leaf extract (MOE 10, 30, 100 mg/kg) while group 6 was treated with the reference drug, piracetam (PCT 150 mg/kg, orally). The various groups were evaluated for neurotoxicity using the open field, catalepsy and novel object recognition (NOR) tests. Cresyl Violet staining was used to assess the neurohistological changes caused in the hippocampus of the brain.
Results: HgCl2-induced catalepsy and decreased posture correction time compared to the vehicle group. However, MOE and PCT significantly reversed this effect. In the novel object recognition (NOR) test, HgCl2 reduced the recognition index and novel object time, while MOE and PCT increased both. Locomotor activity, assessed through line crossing, was significantly reduced with HgCl2 but remained unaffected with
MOE and piracetam. HgCl2 also reduced time in the central compartment, while MOE and PCT reversed this effect. Neurohistological assessment revealed HgCl2-induced reductions in neuronal count in cornu ammonis areas 1 and 3 (CA1 and CA3) and the dentate gyrus (DG) regions, with varied effects observed in MOE- and PCT-treated groups.
Conclusion: This study demonstrates the neuroprotective effect of Mallotus oppositifolius against mercuric chloride-induced neurotoxicity in mice. The leaf extract may have potential in clinical conditions characterised by neurodegeneration.

Optimised formulation of Mallotus oppositifolius extract reverses cognitive decline and beta-amyloid deposition in a murine Alzheimer’s disease-like dementia model

James Tuotally Pewee — 2025-06-30

Background: Mallotus oppositifolius leaf extract (MOE) has potential neuroprotective effects, but no scientific investigation validates its use in mouse models of Alzheimer’s disease (AD).
Objective: The study evaluated the effects of an optimised formulation of MOE in aluminium chloride (AlCl3)-induced AD-like dementia.
Methods: Mice were randomly assigned to 6 groups (n = 10), and AD was induced in groups 2-6 using AlCl3 (175 mg/kg), with group 1 representing the negative control. Optimised formulation of MOE (10, 30 and 100 mg) was administered orally to groups 3, 4 and 5, respectively, while group 2 represented the disease control. The Morris water maze (MWM) test was used to assess cognitive impairment, and the open-field test (OFT) for locomotor and anxiety behaviour. Biochemical and histological changes were also assessed.
Results: AlCl3 caused significant memory and learning disruption in the MWM test, but MOE formulation (10, 30, and 100 mg/kg) reversed these deficits. MOE formulation attenuated the reduction in both locomotion and time spent in the centre of the OFT in comparison to the AlCl3-diseased untreated group. Brain superoxide dismutase (SOD) content was significantly increased while brain and serum malondialdehyde (MDA), as well as acetylcholinesterase (AChE), were reduced by the formulation treatment when compared to the AlCl3 diseased untreated group. The administration of MOE formulation (30 and 100 mg/kg) resulted in a significant reduction in brain concentrations of IL-1β, IL-6, and TNF-α and a significant decrease in serum IL-6 and TNF-α concentrations when compared to the AlCl3 diseased untreated group. Congo red-stained hippocampus CA1 showed that the formulation (30 and 100 mg/kg) significantly decreased amyloid deposition in comparison to the AlCl3-diseased untreated group.
Conclusion: This study reports that an optimised formulation of MOE improves learning and memory, attenuates anxiety, and reduces pro inflammatory cytokines and oxidative stress associated with AD-like dementia. The formulation also ameliorates amyloid deposition.

Haematologic profile of children with laboratory Access diagnosed malaria: A prospective study

Charles Nkansah — 2025-06-29

Background: The high mortality rate of malaria is due, in part, to the associated extensive alterations in haematological indices in affected individuals.
Objective: The study presents the haematological profile of malaria-infected children and determined the predictive values of haematological indices for severe malaria.
Methods: Three hundred and twenty-three children with laboratory-diagnosed malaria, aged 1 - 12 years, were enrolled between March 10 and August 27, 2023, at Tamale Teaching Hospital. Three millilitres of venous blood were collected for malaria diagnosis through microscopy, and a full blood count was taken using an auto-haematology analyser. IBM SPSS version 26.0 was used for the data analysis.
Results: Participants were mostly females (64.7%), aged 5 - 12 years (60.7%), and had high parasitaemia (>10000 malaria parasites). The prevalence of anaemia among the participants was 80.8%, and 44.6%, 18.3%, and 18.0% had mild, moderate, and severe anaemia, respectively. Approximately one-third of the malaria-infected children were thrombocytopaenic, and mild, moderate, and severe thrombocytopaenia occurred in 21.1%, 10.8%, and 3.4% of cases, respectively. Microcytic hypochromic anaemia was the most prevalent (54.5%) form of anaemia among the participants. Total leucocytes (AUC: 0.605, p = 0.021), absolute lymphocyte count (AUC: 0.600, p =
0.040), absolute monocyte count (AUC: 0.699, p < 0.001), absolute eosinophil (AUC: 0.649, p < 0.001), absolute basophil count (AUC: 0.774, p < 0.001) and platelet_large cell ratio (AUC: 0.693, p < 0.001) were fair predictors of severe malaria. Bicytopaenia and pancytopaenia were present in 37.2% and 7.1%, respectively.
Conclusion: Childhood malaria presents with varying haematological abnormalities, notably severe anaemia, thrombocytopaenia and leucocyte disorders. Microcytic hypochromic anaemia is a common picture in children with malaria. Haematological indices may be useful in differentiating severe from uncomplicated malaria in children.

A haematological and biochemical analysis of variability of whole blood across different blood donor groups in Yaoundé, Cameroon: A cross-sectional, descriptive study

Sulem Y I Worti — 2025-07-02

Background: Data on blood donor variability in sub-Saharan Africa is scarce, despite whole blood being the primary transfusion product. Donor-related haematological and biochemical differences may impact storage quality and transfusion outcomes.
Objective: The study aimed to identify associations between blood donor characteristics and baseline haemato-biochemical parameters of blood units in the Yaoundé University Teaching Hospital (YUTH).
Methods: A descriptive cross-sectional study was conducted on blood donors of the YUTH between May and August 2023. A structured questionnaire was used to collect socio-demographic, lifestyle and medical information. Blood samples were taken from donors and analysed for haematological and biochemical parameters. Pearson’s chi-squared test was applied to determine donor characteristics that affect the baseline hemato-biochemistry of blood units. Statistical significance was set at 0.05.
Results: One hundred and five donors were included; 74 (70.5%) were men, 79 (75.2%) were under 35 years old, and 49 (46%) were students. Hemolysis was higher in smokers (OR: 0.30, CI: 0.01 to 0.60, p-value: 0.001). Alcohol consumers had lower red blood cells (OR: 1.14, CI: 1.04 to 1.25, p-value: 0.02). Abnormally shaped red blood cells were more common in overweight donors (OR: 3.11, CI: 1.20 - 8.10, p-value: 0.02).
Conclusion: Baseline haematobiochemical parameters of whole blood vary due to differences in donor lifestyle and medical background. Information from this study could contribute to blood management in SSA, especially in the elaboration of blood donor education programs and in the adjustment of medical selection criteria.

Economic cost of oral conditions to patients attending the dental department of the Korle Bu Teaching Hospital, Ghana

Mensah Tabi-Amankwa

Background: Providing and utilising oral health care services are essential to achieving a high quality of life. However, oral conditions present both physical and economic burdens to individuals, households, and governments.
Objective: This study sought to estimate the economic costs incurred by patients accessing oral health services at the Korle-Bu Teaching Hospital in Ghana.
Methods: A cross-sectional cost-of-illness study was conducted at the Korle Bu Teaching Hospital, involving 224 participants. A structured questionnaire was used to collect data on direct and indirect costs. Intangible costs were assessed using a 5-point Likert scale. Descriptive statistics were employed in summarising the costs. Sensitivity analysis was performed with 3%, 5%, and 7% variations in medication costs and wage rates. Differences in mean costs across socioeconomic statuses were analysed using independent t-tests and one-way ANOVA. P < 0.05 was considered statistically significant.
Results: The estimated total economic cost was GHS 532,154.06 (US$ 44,346.17). The estimated annual average direct and indirect cost of oral health services were approximately GHS 2,129.98 (US$ 177.50) and GHS 245.70 (US$ 20.48), representing 89.7% and 10.3% of the total economic cost, respectively. Sensitivity analysis revealed a varied increase in total costs, with variations in medication costs and wage rates. Intangible cost was found to be low, with many patients experiencing no to mild burden.
Conclusion: The economic burden of oral health on patients is significant, particularly in terms of direct costs. There is a need for policymakers to develop policies and interventions to mitigate the costs of oral health care. The National Health Insurance Authority should consider expanding insurance coverage for more oral conditions to alleviate the economic burden and improve access to care.

Efficacy of anthropometric measures in predicting hypertension among adult Ghanaians: A community based cross-sectional study

Kasim Abdulai — 2025-06-29

Background: As global rates of hypertension continue to rise, especially in developing countries, there is an urgent need for effective screening tools. Anthropometry offers a practical approach to assessing the risks associated with hypertension due to its simplicity and cost effectiveness.
Objective: This study aimed to evaluate the efficacy of waist circumference (WC), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR) and body mass index (BMI) in predicting hypertension among adults in the Cape Coast metropolis in Ghana.
Methods: This analytical cross-sectional study involved 390 adults from three local communities. Anthropometric data were collected usingstandardised equipment, and hypertension was defined based on the WHO blood pressure classification. The validity of the anthropometric measures was assessed using positive predictive value (PPV) and negative predictive value (NPV), as well as specificity and sensitivity. IBM
SPSS version 26 was used for statistical analyses. Chi-square and linear regression models were used to determine the associations between anthropometric measures and hypertension.
Results: Among 390 participants (mean age: 34.6 ± 13.8 years; 50% female), WC and WHtR were significantly associated with hypertension (WC: β = 0.256, 95% Confidence Intervel [CI]: 0.173 - 0.445, p = 0.011; WHtR: β = 0.310, 95% CI: 0.210 - 0.458, p = 0.024), whereas body mass index (BMI) was not (β = 0.034, p = 0.466). WHtR demonstrated the highest sensitivity (88.4%), while WC had the highest specificity (81.7%) for predicting hypertension.
Conclusion: This study highlights the importance of WC and WHtR as valuable and effective anthropometric measures for predicting hypertension in a clinical setting. Incorporating these measures into routine health assessments could enhance the early detection and management of hypertension, thereby contributing to better public health outcomes. Further research is needed to confirm these findings in diverse populations and longitudinal studies.

Female healthcare professionals’ knowledge of vasectomy Access and attitudes toward partner uptake: A cross-sectional analysis of physicians and nurses

Kwaku Asah-Opoku — 2025-06-28

Background: Permanent contraception is a key method used by individuals who have completed their families or do not seek to have children. Common methods include bilateral tubal ligation in females and vasectomy in males. Vasectomy involves cutting and sealing each of the vas deferens to prevent sperm movement, leading to sterilisation. Despite being safer, more effective, relatively cheaper, and associated with fewer complications, vasectomy is not as commonly utilised as bilateral tubal ligation. The reasons for this disparity are unclear.
Objective: The study assessed female doctors and nurses/midwives’ knowledge of vasectomy and determined their acceptance of this procedure as a permanent contraceptive method for their male partners.
Methods: This cross-sectional study involved the completion of self-administered online questionnaires by 308 female doctors and nurses/midwives at the Korle-Bu Teaching Hospital. Data were collected in Microsoft Excel and analysed using IBM SPSS version 25. The data was analysed by using descriptive statistics, Chi-square tests, and multiple logistic regression. A p-value < 0.05 was considered statistically significant.
Results: The 308 participants had a mean age of 32.7 ± 6.6 years. Nurses/midwives comprised 55.8%, and the rest were doctors. Only 33.8% of the participants demonstrated good knowledge of vasectomy (defined as a knowledge score greater than 80%). Thirty-nine percent were willing to allow their partners to undergo a vasectomy. Factors associated with this willingness included their inclination to recommend vasectomy as a contraception method generally, adjusted odds ratio of 13.01 (95% CI 4.66, 36.33), and having family members indifferent about their partners undergoing vasectomy, adjusted odds ratio of 2.01 (95% CI 1.02, 3.97).
Conclusion: There is low knowledge of vasectomy among female doctors, nurses and midwives. Only about two-fifths of female doctors and nurses/midwives were willing to allow their male partners to undergo the procedure, and factors associated with this willingness included their inclination to generally recommend vasectomy as a contraception method and family indifference towards the procedure. More education on vasectomy is needed, including its incorporation into medical and nursing training curricula.

Human Strongyloidiasis in Ghana: A scoping review of prevalence and geographic distribution (2003–2023)

Christopher Yaw Dumevi — 2025-06-27

Background: Human strongyloidiasis is a neglected tropical disease with global public health concerns. Despite several interventions geared towards the prevention, control, and elimination of human strongyloidiasis in Ghana, infection and reinfection continue to occur, negatively impacting the health of affected populations. Lifelong autoinfection and fatal hyperinfection syndrome in immunocompromised individuals are often reported.
Objective: This scoping review aims to map and synthesise existing evidence on the prevalence and geographic distribution of human strongyloidiasis in Ghana between 2003 and 2023, identify research gaps and inform future priorities regarding control and elimination of the infection.
Methods: Original peer-reviewed studies published in English (2003 - 2023) that investigated human strongyloidiasis in Ghana were systematically searched and retrieved from six electronic databases and included in this review. Additional studies were identified from the reference lists of the reviewed articles. Relevant data were extracted from the included articles and presented in narrative and tabular formats.
Results: Twenty (20) articles that met the inclusion criteria were reviewed under broad subthemes: geographic distribution, prevalence, laboratory diagnostic methods, target population, and nature of public health intervention. Ten (50.0%) studies were conducted in the southern, six (30.0%) in the middle belt, and four (20.0%) in the northern sectors. Overall, 17 studies used cross-sectional designs, two retrospective,
and one case-control method. The reported prevalence of human strongyloidiasis in Ghana ranged between 0.1% and 41.1%. However, a prevalence of 0.1% - 2.2% was reported in children, 0.5% - 41.1% in adults, 0.4% in HIV seropositive individuals, and 2.9% in food vendors.
The geographical prevalence of human strongyloidiasis ranged between 0.1% - 21.2%, 0.4% - 2.9%, and 0.3% - 41.1% in the Northern, Middle belt, and Southern sectors, respectively. The direct wet mount and formal-ether concentration technique (70.0%), PCR (15.0%), and culture and other diagnostic techniques (5.0%) were used.
Conclusion: The national prevalence of strongyloidiasis in Ghana, based on this review, is low-to-moderate (median 1.45%), but extreme geographic heterogeneity exists, with localised hyperendemic regions (e.g., 21.2% and 41.1%) accounting for an increase in the mean to 4.5%. Population-weighted studies are essential for accurate national estimates, and targeted interventions are urgently needed to address hightransmission hotspots and underlying drivers of transmission. This review proposes further research and targeted interventions relevant to Ghana’s efforts to meet the WHO’s human strongyloidiasis elimination target by 2030.

Antimicrobial resistance of extended-spectrum beta lactamase-producing bacteria in diabetic foot infections at Korle-Bu Teaching Hospital

Sarkodie Kodom — 2025-07-02

Background: Common complications of diabetes mellitus include foot infections, leading to increased healthcare costs and delayed wound healing. Diabetic foot infections (DFIs) can be caused by Gram-negative, Extended-Spectrum Beta-Lactamase (ESBL)-producing bacteria, which are resistant to a wide range of antibiotics used in clinical medicine. This poses a significant challenge to treating DFIs. Availability of data on such bacterial species is therefore crucial in the management of these infections.
Objective: This study investigated the antimicrobial resistance and molecular characteristics of ESBL-producing bacteria from diabetic foot ulcers at Korle Bu Teaching Hospital (KBTH) using disk diffusion and PCR.
Methods: Tissue samples, aspirates or pus were collected from diabetic patients in the ulcer room at the Department of Surgery, KBTH, from January to September 2018. Patients’ demographics were gathered using a data collection tool. Bacterial culture, antimicrobial susceptibility testing and PCR detection of ESBL genes were performed.
Results: 138 Gram-negative isolates were recovered from the 50 study participants. Among the isolates, 41 (28.9%) were phenotypically positive for ESBL production using CHROMagar ESBL. The antimicrobial resistance profile of ESBL-positive isolates revealed high resistance to cefuroxime in Escherichia coli (84.2%, n = 16/19) and Klebsiella pneumoniae (75.0%, n = 3/4). CTX-M was predominantly identified in E. coli (50.0%, n = 9/18) when PCR detection was done.
Conclusion: ESBL-producing Gram-negative bacteria remain a significant challenge in Ghana, with the CTX-M gene being the most prevalent among the ESBL-positive isolates. However, a higher percentage of isolates were susceptible to meropenem, indicating that it may be an effective therapeutic option.

High antibiotic resistance and elevated plasma IFNγ from type 2 diabetes mellitus (T2DM) patients with uropathogens visiting Cape Coast Teaching Hospital

Richard Kyeremeh — 2025-07-02

Background: Diabetes mellitus (DM) is a polygenic metabolic disorder characterised by persistent elevated plasma glucose levels, which can lead to a range of complications, including an increased susceptibility to infections such as urinary tract infections (UTIs). Studies have shown that DM significantly increases the incidence of UTIs, and this is primarily due to a weakened immune system and the presence of glucosuria.
Objective: The study aimed to determine cytokine profiles in the peripheral blood, identify common uropathogens and analyse their antibiotic susceptibility patterns in DM patients reporting for treatment at Cape Coast Teaching Hospital (CCTH).
Methods: In a prospective study design, midstream urine and peripheral blood samples were collected from 202 known Type 2 diabetic patients recruited for the study. Using standard bacteriological methods, uropathogens were isolated and identified, and antibiogram testing was performed using the Kirby–Bauer disk diffusion method. Plasma concentrations of IL1β, IL6, IL10, IL17, IFNγ, and TNF-α cytokines were measured using an ELISA kit.
Results: This study recorded a 43.1% prevalence of UTIs among diabetic patients, with the main uropathogens identified as Escherichia coli (18.8%), Citrobacter spp. (11.4%), and Enterobacter spp. (5.4%). The study also observed a high level of antibiotic resistance among the uropathogens, particularly to widely used broad-spectrum antibiotics such as Nalidixic Acid, Cefuroxime, Aztreonam, Cefotaxime, Ceftriaxone, Ceftazidime, Cefixime, and Cefdinir. There were significantly higher levels of IFNγ among the diabetic patients with UTI, but
there were no significant changes in the levels of IL1β, IL6, IL10, IL17 and TNF-α cytokines among the diabetes patients with or without uropathogens.
Conclusion: Our findings suggest that patients with diabetes have frequent UTIs, and the isolated uropathogens were highly resistant to antibiotics. Again, there were higher levels of pro-inflammatory cytokine IFNγ in diabetic patients with UTI. Our findings suggest that patients with diabetes experience frequent UTIs, and the isolated uropathogens show high levels of resistance to antibiotics. Additionally, we observed
higher levels of the pro-inflammatory cytokine IFN-γ in diabetic patients with UTI. This elevated cytokine level could play a role in the immune response to infections and may serve as a potential biomarker for identifying UTIs in type 2 diabetic patients. The combination of frequent UTIs and antibiotic resistance highlights the need for improved management strategies and targeted therapies in this population.

Sedative-analgesics use in Intensive Care: A Critical analysis of prescribed analgo-sedatives, treatment outcomes, and adverse drug events in adult patients at Komfo Anokye Teaching Hospital

Joseph Agyeman — 2025-06-30

Background: Studies on the use of sedative-analgesics are limited in Africa and developing countries despite their high usage, benefits, and side effects among patients. Recent evidence on analgo-sedation suggests that protocols considering up-to-date scientific evidence and individual patient characteristics can improve treatment outcomes.
Objective: This study aimed to analyse the prescribed analgo-sedatives, protocols, outcomes and adverse events of sedative-analgesics in the ICU in a teaching hospital in Ghana.
Methods: This retrospective study reviewed data from adult patients admitted to the ICU of KATH from January 2017 to December 2019. Patient characteristics such as socio-demography, sedative-analgesic prescribed, and respondents' outcomes, including length of stay, survival and associated adverse drug events (ADE), were collected for analysis. The chi-square test was used to analyse associations between analgo sedative usage, speciality and ICU stay, with p < 0.05 considered statistically significant.
Results: The most prescribed analgo-sedatives were Morphine+Midazolam (53.24%), Morphine (16.19%) and Midazolam (6.47%). The relative risk of developing an ADE with analgo-sedation use was 2.1 (p < 0.001). The median duration of stay was longer in sedated patients (3 days, IQR: 2-9) compared to non-sedated ones (1 day, IQR: 1-3, p < 0.001). Analgo-sedation also significantly increased the occurrence of adverse events (RR 2.1; p < 0.001). Patients who experienced ADEs had 98% decreased odds of survival compared to those without ADEs
(aOR: 0.02, 95% CI: 0.01 - 0.05, p < 0.001). Critically ill patients had 73% lower odds of survival than severely ill patients (aOR: 0.27, 95% CI: 0.15 - 0.48, p < 0.001).
Conclusion: Analgo-sedation use is associated with prolonged ICU stays due to a significantly higher risk of adverse drug events, and treatment outcomes are associated with sedation protocols and patients' pre-existing medical conditions.

Increased levels of pre-treatment drug resistance of human immunodeficiency virus type 1 subtypes in people living with HIV in Ghana: A cross-sectional study

Darius Nii Kwanum Quansah — 2025-06-30

Background: Antiretroviral therapy (ART) has significantly reduced the burden of human immunodeficiency virus (HIV-1) infection. However, the emergence of drug resistance (DR) during therapy and the transmission of resistant strains contribute to treatment failure and may compromise ART efficiency. Genotypic-DR testing guides the selection of drugs for initiation of therapy or a switch to new regimens. However, such precision medicine practice among persons living with HIV (PLWH) is not available in Ghana, thus creating a critical gap in
knowledge of the contribution of pre-treatment drug resistance to treatment failure.
Objective: The study aimed to determine the presence of drug-resistant HIV-1 strains in ART-naive people living with HIV (PLWH) in Ghana.
Methods: Sixty-nine (69) ART-naive PLWH were enrolled from three hospitals in Accra. Demographics and clinical data were documented, and venous blood samples were collected. HIV-1 protease and reverse transcriptase genes were amplified by conventional polymerase chain reaction (PCR) and directly sequenced. Sequences were assembled and edited and submitted to the Stanford HIV Drug Resistance Database (HIVdb) for subtyping and DR analyses.
Results: The mean viral load and CD4+ counts were 1.38 x 105 copies/ml and 409 cells/µl, respectively. We found 10.8% resistance (K103N, V179I, A98G, E138A) against non-nucleoside reverse transcriptase inhibitors, three accessory protease inhibitors mutations (V32L, V11L, L10LF) in nine participants, but no NRTI mutations. Sixty-four percent (64%) of participants carried HIV-1 subtype CRF02_AG, 26% carried subtype B, and the remaining were subtypes CRF06_cpx, A, C and G.
Conclusion: Our data confirmed CRF02_AG as the predominant HIV-1 subtype in Ghana, with increasing occurrence of subtype B. These findings indicate the need for continuous monitoring of subtype dynamics and drug resistance to guide the national ART program and enhance the clinical management of PLWH.

Neuropsychological assessment of non-fluent variant of primary progressive aphasia in a bilingual French-Arabic speaking patient: A case study

Mohamed Taiebine — 2025-07-02

Background: This case study presents a comprehensive assessment of a Moroccan patient diagnosed with a non-fluent/agrammatic variant of primary progressive aphasia (nfvPPA).
Objective: The study aimed to investigate neuropsychological and neurolinguistic deficits associated with nfvPPA and the potential implications for intervention.
Methods: A thorough neuropsychological exploration was conducted to assess various cognitive domains, including memory, attention, language, perceptual, attentional and executive functions. Regarding neurolinguistic assessment, the Mini-Linguistic State Examination (MLSE) was used to characterise the patterns of PPA.
Results: Neurolinguistic analysis revealed a clear pattern associated with nfvPPA, which includes impairments in the production of speech sounds, articulation, and phonological processing, alongside a reduced use of grammatical structures. Additionally, the patient exhibits challenges in understanding complex sentences, although his overall comprehension abilities remain relatively intact. The patient also presented a significant decline in executive functions, memory, attention, and visual-constructive abilities. Linguistic deficits
included impaired lexical-semantic abilities, phonological alexia, and lexical agraphia. Despite these impairments, the patient maintained some preserved functions, such as autobiographical memory and visuospatial abilities.
Conclusion: This case study highlights the progressive nature of nfvPPA and its impact on multiple cognitive domains. The patient’s presentation aligns with an advanced stage of PPA, characterised by the presence of extralinguistic impairments. Further neuroimaging studies would be beneficial to confirm the underlying pathology and inform targeted interventions.

Impact of plant-derived galactagogues on breast milk production and blood prolactin levels in early postpartum mothers of preterm infants: A double-blind randomised controlled trial

Edward S. Appiagyei — 2025-07-02

Background: Preterm infants require efficient care and provision of adequate nutrition to enhance their survival and minimise complications that may arise during growth and development. Breast milk represents the sole recommended source of nutrition for preterm infants until 6 months after birth.
Objective: This study investigated the effect of plant-derived galactagogues on breast milk production and serum prolactin levels of early postpartum mothers, as well as on the weight of their preterm infants.
Methods: A double-blinded, randomised and controlled study design was used to determine breast milk volume and serum prolactin levels on days 1 and 7 of early postpartum mothers of preterm infants given food products containing plant-derived galactagogues (granola or chocolate drink) or the corresponding placebo food products. The weight of the preterm infants fed on breast milk was also measured on days 1 and 7.
Results: Mean breast milk volume was significantly increased in mothers who received the granola (p < 0.0001), chocolate drink (p < 0.0001), granola placebo (p < 0.0001) and chocolate drink placebo (p = 0.0007) by day 7. Serum prolactin levels of the mothers and the weight of the preterm infants were not significantly different on day 7 compared to the values obtained on day 1. There was no significant correlation between breast milk volume and either serum prolactin levels or infant weight on days 1 and 7 for the intervention and placebo groups.
Conclusion: Plant-based galactagogues had no effect on serum prolactin levels or the amount of breast milk produced in early postpartum mothers with hypogalactia. The molecular processes that control the bioavailability of prolactin, composition and production of breast milk in nursing mothers require further investigation.

Integrating mental health and socioeconomic strategies during the post-COVID-19 era: Lessons for future pandemics

Ama K. Edwin — 2025-07-02

The COVID-19 pandemic had profound and unprecedented effects on global health, with an intricate interplay between socioeconomic factors and mental health outcomes. The pandemic exacerbated existing mental health conditions and introduced new stressors, including economic instability, job loss, and social isolation, disproportionately affecting vulnerable populations. Effective interventions that integrate mental health considerations into socioeconomic policies are crucial for coping with future pandemics. This paper employs a dual approach, combining a literature review and a case study, to apply Tayyib’s five strategic points for community mental health action and delineate strategies for mitigating these impacts. A conceptual model frames socioeconomic disparities as critical leverage points for improving mental health outcomes. Key findings emphasise the importance of integrated strategies that address economic and psychological well-being,
particularly for vulnerable populations. Recommendations include expanding social support networks, enhancing community engagement, and integrating economic support with mental health services to foster inclusive and resilient communities in the post-pandemic era.

Mapping herbal medicine cancer research in Africa: A bibliometric analysis

Samuel Ankamah — 2025-06-28

Herbal medicines have long been a part of the traditional healthcare systems across Africa, and their integration into modern medical practices has been significantly impactful in recent years. In Africa, the potential of herbal medicine as an alternative therapy is increasingly being explored. This is even more relevant to cancer, which remains a significant public health challenge worldwide. Cancer leads to high morbidity and mortality rates globally. This study offers a bibliometric analysis of research on herbal medicines for use in cancer therapy care in Africa.
This is relevant for knowledge mapping to inform research policy regarding herbal medicines in cancer treatment. Using 1,134 datasets from Scopus (Elsevier) up to 2023, the study employed MS Excel, Harzing’s Publish or Perish, and VOSviewer for analysis and visualisation. The results reveal a growing trend in publications on this topic, with the Journal of Ethnopharmacology (JEP) being the most active source, contributing 116 articles (10.23%). South Africa emerged at the forefront in this research area, accounting for 166 publications (9.05%). The most prolific author was Efferth, T., with 31 documents, while the University of Dschang, Cameroon, was the most influential institution, with 36 publications (2.75%). The National Research Foundation was the top funder, supporting 42 publications (3.26%). The most cited article was Chang and Adami (2006), which received 1,097 citations. Keyword analysis revealed that “article”, “human”, and “medicinal
plant” were the most frequently used terms. The co-occurrence analysis identified five thematic clusters centred on “article”, “human”, “human cell”, “in vitro study” and “drug effect”. This study provides valuable insights for policymakers, researchers, and medical professionals by identifying key research areas, emerging trends, and influential contributors to herbal medicine in cancer management in Africa. These results are expected to inform future research and funding strategies to support the advancement of cancer care across the continent.

Crossed-fused renal ectopia: exploring the concerns of the asymptomatic

Mathew Y. Kyei — 2025-06-30

Introduction: Crossed-fused renal ectopia is an anomaly where the kidneys are fused and located on the same side of the midline, with the opposite side empty. This was first described in 1654 by Dominicus Panarolus [1,2]. Another theory indicated that the anomaly may be due to arrest of kidney ascent, causing the kidneys to remain in the pelvis or meet on one side with subsequent fusion. Abnormal position of the umbilical artery influencing the cephalic migration of the kidneys to the contralateral side following a path of least resistance has also been proposed to lead to cross-fused renal-ectopia [3].
It becomes a single renal mass when there is fusion, which occurs in 90% of the cases. However, the urinary collecting systems remain separate. Wilmer is credited with first categorising the fusion anomalies of the kidney (1938).
McDonald and McClellan 1957 modified the classification to include crossed ectopia with fusion, crossed ectopia
without fusion, solitary crossed ectopia and bilateral crossed ectopia [4]. The current classification used comprises (i) Unilateral fused kidney (inferior ectopia), (ii) Sigmoid or S-shaped kidney, (iii) Lump kidney, (iv) L
shaped kidney, (v) Disc kidney and (vi) Unilateral fused kidney (superior ectopia) [4]. The current case is a unilateral fused kidney (inferior ectopia).

An Extraluminal granulomatous manifestation, a rare presentation of mixed intestinal schistosomiasis

Narious Naalane — 2025-07-02

Schistosomiasis is endemic in sub-Saharan Africa. The commonest intestinal pathology is an intestinal polyp. We report an atypical presentation of mixed Schistosoma haematobium and Schistosoma mansoni infestation. A 51-year-old male presented with a strangulated right inguinoscrotal hernia and had laparotomy. The findings at laparotomy were extensive granulomatous lesions on the serosa of the bowel and omentum. A biopsy for histopathology reported as a mixed Schistosoma haematobium and Schistosoma mansoni infestation.