Publications by authors named "Vincent Boima"

19 Publications

  • Page 1 of 1

High BMI: an important health risk factor among older adults in Ghana.

Public Health Nutr 2020 Oct 15:1-8. Epub 2020 Oct 15.

Department of Community Health, School of Public Health, College of Health Sciences, University of Ghana, Accra, Ghana.

Objective: We examined BMI as a health risk factor for self-reported diabetes mellitus, angina, strokes and arthritis among older Ghanaians aged 50 years and above.

Design: We analysed the individual-level data from the World Health Organization Study on global AGEing and adult health Ghana Wave 2 (2014/2015). The influence of BMI on self-reported chronic conditions including diabetes, angina, stroke and arthritis was examined.

Setting: Households from all the administrative regions of Ghana.

Participants: Included 3350 adults aged 50 years and older.

Results: The prevalence of overweight and obesity among participants was 22·8 % (95 % CI 20·6, 25·2) and 13·2 %, respectively (95 % CI 11·5, 15·1). With respect to individual chronic conditions, arthritis emerged with the highest prevalence rate of 7·3 (95 % CI 5·3, 9·9), while the prevalence rate of diabetes, angina and stroke was 2·8 % (95 % CI 2·0, 3·9), 1·7 % (95 % CI 1·1, 2·6) and 1·3 % (95 % CI 1·0, 1·8), respectively. The risk of diabetes among overweight and obesity was over three and two times, respectively, higher compared with participants with normal weights. Overweight and obesity were significantly more than two and three times likely to experience angina, respectively, compared with participants with normal weight. Obesity significantly influences arthritis with approximately two times increased odds compared with normal weight participants.

Conclusion: Prevalence of obesity and overweight in Ghana is high and increasing, which poses a health risk at the individual and population levels. Inter-sectorial and multidisciplinary measures in line with the national non-communicable disease policies aimed at curbing this trend are imperative.
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http://dx.doi.org/10.1017/S1368980020003717DOI Listing
October 2020

Older adults with hypertension have increased risk of depression compared to their younger counterparts: Evidence from the World Health Organization study of Global Ageing and Adult Health Wave 2 in Ghana.

J Affect Disord 2020 12 22;277:329-336. Epub 2020 Aug 22.

Department of Community Health, School of Public Health, University of Ghana Medical School, University of Ghana, Accra, Ghana. Electronic address:

Background: Depression and hypertension interact through a complex interplay of social, behavioral and biological factors. Despite the huge burden of hypertension in the African sub-region, very little information exists on depression among hypertensive patients. This study assessed the prevalence and factors associated with depression among young and older adult hypertensive patients in Ghana.

Method: Data from the World Health Organization Study on Global AGEing and Adult Health wave 2 (2014/2015) for Ghana was used. Depression was estimated among participants with blood pressure 140/90mmHg and above. Weighted descriptive statistics and logistic regression with adjusted predictions were carried out. The analysis was performed using Stata 15.

Result: The overall prevalence of depression was 6.3%. Older hypertensive patients had almost twice the prevalence of depression compared with younger patients (8.4% vs 4.5%). The factors which predicted depression among hypertensive patients were educational level, marital status, religion, region of residence, work status, self-rated health (SRH), and unhealthy lifestyle. Participants with no religion were more than 7 times likely to be depressed compared with Christians [aOR(95%CI)=7.52(2.11-26.8)]. Those in the Volta region were more than 8 times likely to be depressed compared to those in the Greater Accra region [aOR(95%CI)=8.58(2.51-29.3)].

Conclusion: Older adult hypertensive patients were more likely to experience depressive symptoms. Multiple factors predicted depression in both young and old hypertensive patients; thus a comprehensive care package including psychological support for patients with hypertension is essential for optimum clinical management.
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http://dx.doi.org/10.1016/j.jad.2020.08.033DOI Listing
December 2020

Association of MYH9-rs3752462 polymorphisms with chronic kidney disease among clinically diagnosed hypertensive patients: a case-control study in a Ghanaian population.

Clin Hypertens 2020 1;26:15. Epub 2020 Aug 1.

Department of Molecular Medicine, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.

Background: Chronic kidney disease (CKD) is a significant comorbidity among hypertensive patients. Polymorphisms in the non-muscle myosin heavy chain 9 gene (MYH9) have been demonstrated to be significantly associated with CKD, among African- and European-derived populations. We investigated the spectrum of MYH9-associated CKD among Ghanaian hypertensive patients.

Methods: The study constituted a total of 264 hypertensive patients. Hypertensive patients with glomerular filtration rate (eGFR) < 60 ml/min/1.73m (CKD-EPI formula) or clinically diagnosed were defined as case subjects ( = 132) while those with eGFR ≥60 ml/min/1.73m were classified as control subjects ( = 132). Demographic data were obtained with a questionnaire and anthropometric measurements were taken. Five (5) millilitres (ml) of venous blood was drawn from study subjects into gel and EDTA vacutainer tubes. Two (2) mL of EDTA anticoagulated blood was used for genomic DNA extraction while three (3) mL of blood was processed to obtain serum for biochemical measurements. Genotyping of MYH9 polymorphisms (rs3752462) was done employing Tetra primer Amplification Refractory Mutation System (T-ARMS) polymerase chain reaction (PCR). Spot urine samples were also collected for urinalysis. Hardy-Weinberg population was assessed. Logistic regression models were used to assess the associations between single nucleotide polymorphisms and CKD.

Results: The cases and control participants differed in terms of age, sex, family history, and duration of CKD (-value < 0.001). The minor allele frequencies of rs3752462 SNP were 0.820 and 0.567 respectively among the control and case subjects. Patients with the heterozygote genotype of rs3752462 (CT) were more likely to develop CKD [aOR = 7.82 (3.81-16.04)] whereas those with homozygote recessive variant (TT) were protective [aOR = 0.12 (0.06-0.25)]. Single nucleotide polymorphism of rs3752462 (CT genotype) was associated with increased proteinuria, albuminuria, and reduced eGFR.

Conclusions: We have demonstrated that MYH9 polymorphisms exist among Ghanaian hypertensive patients and rs3752462 polymorphism of MYH9 is associated with CKD. This baseline indicates that further longitudinal and multi-institutional studies in larger cohorts in Ghana are warranted to evaluate MYH9 SNP as an independent predictor of CKD among hypertensive patients in Ghana.
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http://dx.doi.org/10.1186/s40885-020-00148-wDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7395421PMC
August 2020

Visual impairment and social isolation, depression and life satisfaction among older adults in Ghana: analysis of the WHO's Study on global AGEing and adult health (SAGE) Wave 2.

BMJ Open Ophthalmol 2020 29;5(1):e000492. Epub 2020 Jun 29.

Community Health, University of Ghana Medical School, College of Health Sciences, University of Ghana, Accra, Ghana.

Aim: To estimate the prevalence of visual impairment (VI) and associated factors and further quantify its association with social isolation, depression and life satisfaction among older adults in Ghana.

Methods: WHO Study on Global AGEing and Adult Health Ghana dataset for older adults 50 years and above was used for this study. Social isolation, depression and life satisfaction were our primary outcomes with VI being our secondary outcome. We employed negative binomial, Poisson and generalised negative binomial regression models individually modified with Coarsened Exact Matching method of analysis. All analysis was performed by adopting robust SE estimation using Stata V.15.

Results: The prevalence of VI was 17.1% (95% CI14.3 to 20.2) and the factors associated include age groups, educational level, religion, region, where the participant was born, and difficulty in work/households activity (p<0.05). The inferential analysis shows that the significant log-likelihood score of social isolation and life satisfaction for older adults with VI was 0.25 more (95% CI 0.03 to 0.47) and 0.04 less (95% CI -0.08 to -0.01), respectively, compared with those without VI. The prevalence of depression among older adults with VI was significantly 90% higher compared with non-VI (adjusted prevalence ratio (95% CI) = 1.90 (1.17 to 3.09), p<0.001).

Conclusion: The prevalence of VI is associated with increasing age, educational level and self-rated health. VI was identified to be associated with social isolation, depression and diminishing life satisfaction. In order to achieve sustainable development goal #3, a national focus on geriatric care as part of the implementation of the National Ageing Policy will garner improvement in the quality of life of older adults with visual VI in Ghana. Eye health practitioners at all levels of the health systems should consider the psychosocial consequences of VI for the optimum care of the older adult client.
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http://dx.doi.org/10.1136/bmjophth-2020-000492DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7326267PMC
June 2020

Comparison of neurocognitive changes among newly diagnosed tuberculosis patients with and without dysglycaemia.

BMC Psychiatry 2020 04 3;20(1):143. Epub 2020 Apr 3.

Department of Psychology, School of Social Sciences, College of Humanities, University of Ghana, Accra, Ghana.

Background: Diabetes often occurs together with tuberculosis (TB) and both may affect each other negatively. Diabetes may be associated with neurocognitive dysfunctioning in affected patients and may negatively impact treatment adherence and outcomes. This study compared the neurocognitive status between newly diagnosed smear positive tuberculosis patients with dysglycaemia and those with normoglycaemia.

Methods: The current study was a cross-sectional study involving one hundred and forty-six (146) newly diagnosed smear positive TB patients. Oral glucose tolerance test (OGTT) was performed and the results were categorized as either normoglycaemia, impaired glucose tolerance (IGT), impaired fasting glucose (IFG) or diabetes. Neurocognitive functioning among study participants was assessed at the time of TB diagnosis using Cognitive Failure Questionnaire (CFQ), Montreal Cognitive Assessment tool (MoCA), California Verbal Learning Test (CVLT), Brief Symptom Inventory (BSI) and the Spitzer Quality of Life Index (QLI).

Results: The mean age of the participants (n = 146) was 38.7 years with 78.8% being males and 21.2% females. Using the fasting blood glucose test, the prevalence of impaired fasting glucose and diabetes were 5.5 and 3.4% respectively, both representing a total of 13 out of the 146 participants; whilst the prevalence of impaired glucose tolerance and diabetes using 2-h post-glucose values were 28.8 and 11.6% respectively, both representing a total of 59 out of the 146 participants. There were no significant differences in the mean scores on the neurocognitive measures between the dysglaycaemia and normoglycamic groups using fasting plasma glucose (FPG). However, there were significant differences in the mean scores between the dysglycaemia and normal groups using 2-h postprandial (2HPP) glucose values on Phobic Anxiety (Normal, Mean = 0.38 ± 0.603; dysglycaemia, Mean = 0.23 ± 0.356; p = 0.045), and Montreal Cognitive Assessment (MoCA) scores (17.26 ± 5.981 vs. 15.04 ± 5.834, p = 0.037).

Conclusion: Newly diagnosed smear positive patients with dysglycaemia were associated with significantly lower mean cognitive scores and scores on phobic anxiety than those with normoglyacaemia. The latter finding must be further explored.
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http://dx.doi.org/10.1186/s12888-020-02570-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7119271PMC
April 2020

The Association between Diabetes-Related Distress and Medication Adherence in Adult Patients with Type 2 Diabetes Mellitus: A Cross-Sectional Study.

J Diabetes Res 2020 1;2020:4760624. Epub 2020 Mar 1.

Centre for Science and Health Communication, PMB M71, Ministries, Accra, Ghana.

Background: Type 2 diabetes mellitus (T2DM) is a major public health problem associated with distress. T2DM can affect health outcomes and adherence to medications. Little is however known about the association between diabetes distress and medication adherence among patients with T2DM in Ghana.

Objective: The objective of the present study is twofold: to estimate distress associated with T2DM and to examine its association with medication adherence.

Methods: A hospital-based cross-sectional study was conducted among 188 patients with T2DM recruited from a diabetes specialist outpatient clinic at the Pantang Hospital in Accra, Ghana. Data were obtained using the Problem Areas In Diabetes (PAID) scale and the Medication Adherence Report Scale.

Results: The findings showed that about 44.7% of the patients showed high levels of diabetes-related distress. Poor adherence to medications was recorded in 66.5% of the patients. Patients who were highly distressed had 68% lower odds of adhering to their medications compared to those who were not (OR: 0.32, 95% CI: 0.15-0.65). A principal component analysis revealed four areas of T2DM distress which were conceptualized as negative emotions about diabetes, dietary concerns and diabetes care, dissatisfaction with external support, and diabetes management helplessness.

Conclusion: Our findings suggest that diabetes distress is a significant determinant of medication adherence behaviour in patients with T2DM. Thus, incorporating routine screening for distress into the standard diabetes care within the Ghanaian health system and having health practitioners adopt holistic approaches to diabetes management will be important context-specific interventions to improve adherence and health outcomes of people living and coping with T2DM.
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http://dx.doi.org/10.1155/2020/4760624DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7071811PMC
January 2021

Psycho-behavioural factors associated with medication adherence among male out-patients with hypertension in a Ghanaian hospital.

PLoS One 2020 29;15(1):e0227874. Epub 2020 Jan 29.

Department of Environmental and Occupational Health, School of Public Health, Texas A&M Health Science Center, TAMU, College Station, Texas, United States of America.

Medication adherence is a key health outcome that reflects the health and general well-being of patients with hypertension. Challenges with adherence are common and associated with clinical, behavioural and psychosocial factors. This study sought to provide data on the extent of medication adherence among male patients with hypertension and their biopsychosocial predictors. Patient and clinical characteristics, psychological distress, insomnia and sexual dysfunction were hypothesized to predict outcomes of medication adherence. Utilizing quantitative data from a hospital-based cross-sectional study from 358 male out-patients with hypertension attending a tertiary hospital in Ghana, medication adherence was associated with age, marital status, educational level, income, duration of diagnosis, number of medications taken and sexual dysfunction. These findings support the need for biopsychosocial interventions aiming at promoting adherence while taking these factors into consideration for the benefit of improving the health and general well-being of male patients with hypertension.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0227874PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6988959PMC
April 2020

Examination of Dysglycaemia among Newly Diagnosed Tuberculosis Patients in Ghana: A Cross-Sectional Study.

Tuberc Res Treat 2018 24;2018:1830372. Epub 2018 Sep 24.

Department of Psychiatry, School of Medicine & Dentistry, College of Health Sciences, Korle-Bu, Ghana.

The burden of both tuberculosis (TB) and diabetes mellitus in developing countries including Ghana is high; often, the two coexist and impact each other negatively. . The study aimed to determine the prevalence and predictive factors of dysglycaemia among newly diagnosed smear positive tuberculosis patients at a tertiary tuberculosis treatment centre in Ghana. . Dysglycaemia at diagnosis was determined by the use of oral glucose tolerance test (OGTT), while sputum smear microscopy was used to assess the sputum status. Only smear positive patients were included in the study. Information on sociodemographic, anthropometrical, clinical, and medication history was also obtained. . In all, 146 participants, aged 18 to 75 years with a mean age of 38.7 years comprising 115 (78.8%) males and 31 (21.2%) females, were involved in the analysis. Upon initial screening, using fasting plasma glucose (FPG), 91.1 % had normal fasting level, 5.5 % had impaired fasting, and 3.4% were diagnosed with diabetes. Using 2-hour postprandial values (2HPP), 59.6% had normal plasma glucose, 28.8 % had impaired glucose tolerance (IGT), and 11.6 % were diagnosed with diabetes. Overall, the prevalence of dysglycaemia (i.e., impaired fasting and diabetes) was 8.9% (95% CI: 5.21-14.82%) with FPG test and 40.4% (95% CI: 32.68-48.65%) with 2HPP test. The analysis revealed that 2HPP was associated with high mean age compared to FPG (36.67 ± 13.97 versus 41.69 ± 13.97, p-value = 0.033). In addition, marital status was significantly associated with FPG status of patients (p = 0.028). . The prevalence of dysglycaemia was high among smear positive TB patients in Ghana. Higher mean age and marital status were associated with abnormal glucose tolerance and fasting plasma glucose, respectively. Clinical management of patients with tuberculosis should include screening for diabetes.
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http://dx.doi.org/10.1155/2018/1830372DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6174760PMC
September 2018

Depression and quality of life in patients on long term hemodialysis at a nationalhospital in Ghana: a cross-sectional study.

Ghana Med J 2018 Mar;52(1):22-28

Department of Medicine and Therapeutics, School of Medicine and Dentistry, College of Health Sciences, University of Ghana, Accra.

The study examined quality of life and prevalence of depressive symptoms in patients on long term hemodialysis. Further, it explored the impact of socio-demographic characteristics on depression and quality of life.

Design: Study design was cross-sectional.

Setting: Study was conducted in the two renal dialysis units of the Korle-Bu Teaching hospital in Accra, Ghana.

Participants And Study Tools: One hundred and six participants on haemodialysis were recruited for the study. The Patient Health Questionnaire and the World Health Organization Quality of Life instrument were used to assess depression and quality of life.

Results: Forty five percent of participants screened positive for symptoms of depression. Approximately 19% obtained low scores on overall quality of life. There were significant negative correlations between the following: Depression and overall QoL, Depression and duration of dialysis treatment and Depression and income level. There was positive correlation between overall QoL and duration of dialysis, treatment and income.

Conclusion: Depressive symptoms were common amongst patients on long term hemodialysis. Haemodialysis patients who obtained low scores on quality of life measures were more likely to screen positive for depressive symptoms. Screening for depressive symptoms among these patients is critical as early treatment may improve their general wellbeing.

Funding: Not indicayed.
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http://dx.doi.org/10.4314/gmj.v52i1.5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6026941PMC
March 2018

Circulating Angiogenic Growth Factors in Diabetes Patients with Peripheral Arterial Disease and Exertional Leg Pain in Ghana.

Int J Vasc Med 2017 27;2017:2390174. Epub 2017 Dec 27.

Department of Immunology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana.

Objective: Peripheral arterial disease (PAD) is a common complication of diabetes, associated with impairment in angiogenesis. Angiogenesis is regulated by angiogenic growth factors such as angiopoietin 1 (Ang-1), Ang-2, and vascular endothelial growth factor (VEGF). We studied the association between angiogenic growth factors versus PAD and exertional leg symptoms in diabetes patients in Ghana.

Method: In this cross-sectional study, ankle-brachial index was measured with oscillometrically and exertional leg symptoms were screened with Edinburgh claudication questionnaire in 140 diabetes patients and 110 nondiabetes individuals. Circulating levels of Ang-1, Ang-2, and VEGF were measured with immunosorbent assay.

Results: The prevalence of PAD and exertional leg pain was 16.8% and 24.8%, respectively. Compared to non-PAD participants, PAD patients had higher VEGF levels [85.8 (37.5-154.5) versus 57.7 (16.6-161.1) = 0.032] and lower Ang-1 levels [31.3 (24.8-42.6) versus 40.9 (28.2-62.1), = 0.017]. In multivariable logistic regression, patients with exertional leg pain had increased the odds of plasma Ang-2 levels [OR (95% CI): 2.08 (1.08-6.41), = 0.036].

Conclusion: Diabetes patients with PAD and exertional leg pain have imbalance in angiogenic growth factors, indicating impaired angiogenesis. In patients with exertional leg pains, Ang-2 may be an important biomarker.
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http://dx.doi.org/10.1155/2017/2390174DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5763056PMC
December 2017

The Bidirectional Relationship between Tuberculosis and Diabetes.

Tuberc Res Treat 2017 12;2017:1702578. Epub 2017 Nov 12.

Department of Medicine and Therapeutics, School of Medicine and Dentistry, College of Health Sciences, University of Ghana, Legon, Accra, Ghana.

The burden of tuberculosis (TB) especially in developing countries continues to remain high despite efforts to improve preventive strategies. Known traditional risk factors for TB include poverty, malnutrition, overcrowding, and HIV/AIDS; however, diabetes, which causes immunosuppression, is increasingly being recognized as an independent risk factor for tuberculosis, and the two often coexist and impact each other. Diabetes may also lead to severe disease, reactivation of dormant tuberculosis foci, and poor treatment outcomes. Tuberculosis as a disease entity on the other hand and some commonly used antituberculous medications separately may cause impaired glucose tolerance. This review seeks to highlight the impact of comorbid TB and diabetes on each other. It is our hope that this review will increase the awareness of clinicians and managers of TB and diabetes programs on the effect of the interaction between these two disease entities and how to better screen and manage patients.
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http://dx.doi.org/10.1155/2017/1702578DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5705893PMC
November 2017

Kidney transplantation in Ghana: Is the public ready?

Clin Transplant 2017 Oct 23;31(10). Epub 2017 Aug 23.

Departments of Medicine & Psychiatry, School of Medicine and Dentistry, College of Health Sciences, University of Ghana, Accra, Ghana.

Background: The burden of end stage renal disease (ESRD) is reported to be higher among people of African ancestry. The majority do not have access to kidney transplantation. Africans, in general, are less likely to donate a kidney or receive a transplant.

Aims: This study surveyed public perceptions of kidney transplantation in an inner city and suburban communities in Ghana. It examined people's willingness to either accept or donate a kidney to save a life. In addition, it evaluated factors that influenced their opinion on the issue.

Methods: A cross-sectional survey was conducted in five purposively selected communities in the Greater Accra region in Ghana. Structured questionnaires and standardized instruments were administered to assess participants' socio-demographic characteristics, religiosity and spirituality, and perception of kidney transplantation.

Results: Of the 480 participants, 233 (48.5%) were willing to donate a kidney; 71.6% would only do so after death. Religion, loss of body part, and cultural values influenced participants' willingness to donate a kidney. Uncertainty of health status post-transplantation and uneasiness with the concept of transplantation influenced the participants' willingness to accept a kidney transplant.

Conclusion: The study revealed that almost half of the participants hold positive views toward kidney transplantation.
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http://dx.doi.org/10.1111/ctr.13061DOI Listing
October 2017

Creatinine based equations and glomerular filtration rate: interpretation and clinical relevance.

Authors:
Vincent Boima

Ghana Med J 2016 Sep;50(3):119-121

Department of Medicine, University of Ghana School of Medicine and Dentistry, PO Box 4236, Accra.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5044788PMC
September 2016

Community-acquired acute kidney injury in adults in Africa.

Clin Nephrol 2016 Supplement 1;86 (2016)(13):48-52

Aims: We review recent published data on demographics, causes, diagnoses, treatment, and outcome of acute kidney injury (AKI) in Africa.

Methods: A review of the incidence, etiology, diagnoses, and treatment of AKI in adults in Africa from studies published between the years 2000 and 2015.

Results: The incidence of AKI in hospitalized patients in Africa ranges from 0.3 to 1.9% in adults. Between 70 and 90% of cases of AKI are community acquired. Most patients with AKI are young with a weighted mean age of 41.3 standard deviation (SD) 9.3 years, and a male to female ratio of 1.2 : 1.0. Medical causes account for between 65 and 80% of causes of AKI. This is followed by obstetric causes in 5 - 27% of cases and surgical causes in 2 - 24% of cases. In the reported studies, between 17 and 94% of patients who needed dialysis received this. The mortality of AKI in adults in Africa ranged from 11.5 to 43.5%.

Conclusions: Most reported cases of AKI in Africa originate in the community. The low incidence of hospital-acquired AKI is likely to be due to under ascertainment. Most patients with AKI in Africa are young and have a single precipitating cause. Prominent among these are infection, pregnancy complications and nephrotoxins. Early treatment can improve clinical outcomes.
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http://dx.doi.org/10.5414/CNP86S121DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6103464PMC
January 2017

Peripheral sensory neuropathy in type 2 diabetes patients: A case control study in Accra, Ghana.

J Clin Transl Endocrinol 2016 Sep 20;5:26-31. Epub 2016 Jul 20.

Department of Medicine & Therapeutics, School of Medicine & Dentistry, University of Ghana, Accra, Ghana.

Objective: Peripheral sensory neuropathy (PSN) is a common cause of ulceration and amputation in diabetes (DM) patients. The prevalence of PSN in DM patients is largely undetermined in sub-Saharan African population. We studied the burden of PSN in DM patients using a validated questionnaire and quantitative sensory test.

Methods: In a case-control design, PSN was measured in 491 DM patients and 330 non-DM controls using Michigan neuropathy screening instrument (MNSI) and vibration perception threshold (VPT). PSN was defined as MNSI symptom score ≥7, MNSI examination score ≥2 or VPT ≥25V.

Results: The prevalence of PSN screened by MNSI symptom score, MNSI examination score and VPT was 7.1%, 51.5% and 24.5% in DM patients; and 1.5%, 24.5% and 8.5% in non-DM participants respectively. The major determinants of PSN screened by MNSI examination score were diabetes status [OR (95% CI): 4.31 (2.94-6.31), p < 0.001], age [1.03 (1.01-1.05), p < 0.001], previous [4.55 (2.11-9.82), p < 0.001] and current [8.16 (3.77-17.68), p < 0.001] smoking status. The major determinants of PSN screened by VPT were diabetes status [1.04 (1.02-1.06), p < 0.001], age [1.02 (1.01-1.03), p = 0.047], heart rate [1.78 (1.08-2.92), p = 0.023], second-hand smoking [3.66 (2.26-5.95), p < 0.001] and body height [3.28 (1.65-8.42), p = 0.015].

Conclusion: Our study has shown high burden of PSN in DM patients in Ghana using simple, accurate, and non-invasive screening tools like MNSI and neurothesiometer.
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http://dx.doi.org/10.1016/j.jcte.2016.07.001DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5644439PMC
September 2016

Factors Associated with Medication Nonadherence among Hypertensives in Ghana and Nigeria.

Int J Hypertens 2015 5;2015:205716. Epub 2015 Oct 5.

Department of Public Health Sciences, Stritch School of Medicine, Loyola University Chicago, 2160 South First Avenue, Maywood, IL 60153, USA.

Background. Blood pressure (BP) control is poor among hypertensives in many parts of sub-Saharan Africa. A potentially modifiable factor for control of BP is medication nonadherence (MNA); our study therefore aimed to determine factors associated with MNA among hypertensives in Ghana and Nigeria. Methodology. We conducted a multicenter cross-sectional study. Patients were recruited from Korle-Bu Hospital (n = 120), Ghana; and University of Port Harcourt Teaching Hospital, (n = 73) Apapa General Hospital Lagos (n = 79) and University College Hospital Ibadan (n = 85), Nigeria. Results. 357 hypertensive patients (42.6% males) participated. MNA was found in 66.7%. Adherence showed correlation with depression (r = -0.208, P < 0.001), concern about medications (r = -0.0347, P = 0.002), and knowledge of hypertension (r = 0.14, P = 0.006). MNA was associated with formal education (P = 0.001) and use of herbal preparation (P = 0.014). MNA was found in 61.7% of uninsured participants versus 73.1% of insured participants (P = 0.032). Poor BP control was observed in 69.7% and there was significant association between MNA and poor BP control (P = 0.006). Conclusion. MNA is high among hypertensives in Ghana and Nigeria and is associated with depression, concern about hypertensive medications, formal education, and use of herbal preparations. The negative association between health insurance and MNA suggests interplay of other factors and needs further investigation.
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http://dx.doi.org/10.1155/2015/205716DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4610060PMC
October 2015

Viral decay rates are similar in HIV-infected patients with and without TB coinfection during treatment with an Efavirenz-based regimen.

Clin Infect Dis 2011 Feb 20;52(4):547-50. Epub 2011 Jan 20.

University of Ghana Medical School, Ghana.

Viral decay rates during efavirenz-based therapy were compared between human immunodeficiency virus (HIV)-infected patients without tuberculosis (n = 40) and those with tuberculosis coinfection who were receiving concurrent antituberculous therapy (n = 34). Phase I and II viral decay rates were similar in the 2 groups (P > .05). Overall, concurrent antituberculous therapy did not reduce the efficacy of the HIV treatment.
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http://dx.doi.org/10.1093/cid/ciq196DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3060905PMC
February 2011

Pharmacokinetics of efavirenz when co-administered with rifampin in TB/HIV co-infected patients: pharmacogenetic effect of CYP2B6 variation.

J Clin Pharmacol 2008 Sep;48(9):1032-40

The Miriam Hospital, 164 Summit Avenue, Providence, RI 02906, USA.

The goal of this study was to determine the effect of CYP2B6 genetic variation on the steady-state pharmacokinetics of efavirenz (600 mg/d) in TB/HIV co-infected patients receiving concomitant rifampin, a potent CYP inducer. In the 26 patients studied, CYP2B6 c.516GG, GT, and TT genotype frequencies were 0.27, 0.50, and 0.23, respectively. Mean plasma efavirenz area under the curve was significantly higher in patients with CYP2B6 c.516TT than in those with GT (107 vs 27.6 microg x h/mL, P< .0001) or GG genotype (107 vs 23.0 microg x h/mL, P< .0001). Apparent oral clearance (CL/F) was significantly lower in patients with CYP2B6 c.516TT than in those with GT genotype (2.1 vs 8.4 mL/min/kg, P<0.0001) and GG genotype (2.1 vs 9.9 mL/min/kg, P< .0001). No differences in efavirenz exposure or CL/F existed between patients with CYP2B6 c.516GT and GG genotypes. Our results indicate that CYP2B6 c.516TT genotype can be used to identify efavirenz poor metabolizers in patients co-treated with rifampin.
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http://dx.doi.org/10.1177/0091270008321790DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2679896PMC
September 2008