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Mycobacterial species causing pulmonary tuberculosis At the korle bu teaching hospital, Accra,
K.K Addo, K Owusu-darko, D Yeboah-manu, P Caulley, M Minamikawa, F Bonsu, C Leinhardt, P Akpedonu, D Ofori-adjei
Ghana Medical Journal , 2007,
Abstract: Objective: Characterize mycobacterial species causing pulmonary tuberculosis (PTB) at the Korle-Bu Teaching Hospital in Ghana. Design: Sputum smear positive samples, two (2) from 70 patients diagnosed as having tuberculosis, after they had consented, were collected from the Korle-Bu Teaching Hospital Chest Clinic between January and July 2003. Setting: Korle-Bu Teaching Hospital Chest Clinic, Accra. Results: Sixty-four mycobacterial isolates were obtained and confirmed as members of Mycobacterium tuberculosis complex by colonial morphology and conventional biochemical assays. Fortyseven (73%) were M. tuberculosis, the human strain, 2 (3%) M. bovis, the bovine strain, 13 (20%) M. africanum I (West Africa type), and 2 (3%) M. africanum II (East Africa type). Conclusion: The results indicate that, there are various strains causing PTB at the Korle-Bu Teaching Hospital and of great concern is M. bovis, which mostly causes extra-PTB in humans but found to cause PTB in this study. This calls for the need to conduct a nationwide survey using both conventional and molecular techniques to characterize various mycobacterial species causing TB in Ghana. This will result in better understanding of the various strains circulating in the country and inform individual TB treatment regimen especially the inclusion or exclusion of pyrazinamide.
Nosocomial and Community Acquired Infections in Korle Bu Teaching Hospital, Accra
M.J Newman
West African Journal of Medicine , 2009,
Abstract: BACKGROUND: Nosocomial or hospital acquired infection has been recognized as a serious public health problem in the last twenty years. In most hospitals in Africa-South of the Sahara, although the types of community acquired infections are known, neither the magnitude, nor the common types of nosocomial infections has been documented. OBJECTIVE: This study was carried out to find the prevalence of hospital and community acquired infections in hospitals, and to estimate the overall prevalence of HAI and CAI in Korle Bu Teaching Hospital. METHODS: A one-day prevalence survey of nosocomial and community acquired infection in a tertiary-care hospital in Accra was performed using the 1980 British national protocol and the result was analyzed using computerized gargets. RESULTS: Of the 907 patients on admission (on the day of the study), 61 (6.7%) had hospital-acquired infection and 287 (31.6%) had community acquired infection. The commonest hospital acquired infection was wound infection followed by skin and lower respiratory infections. Of the community infections, the most common cases were lower respiratory and skin infections. Fifty-three percent of all patients were on antimicrobial treatment. Patients on metronidazole were 212 (44%), ampicillin/amoxicillin 199 (41.6%), cloxacillin 163 (34%) and gentamicin 135 (28%). Approximately 20% of patients were on three or more drugs. CONCLUSION: This study has shown that the prevalence of community acquired infections in our hospital is much higher than that from nosocomial infections and that the British national survey protocol can be used in countries with limited resources. WAJM 2009; 28(5): 300–303.
Laparoscopic cholecystectomy at the Korle Bu Teaching Hospital, Accra, Ghana: An initial report
JNA Clegg-Lamptey, G Amponsah
West African Journal of Medicine , 2010,
Abstract: BACKGROUND: Laparoscopic cholecystectomy (LC) the preferred treatment for gallstones was not available in Ghana until 2005. OBJECTIVE: To report experience from Ghana of laparoscopic cholecystectomy in the treatment of galestones. METHODS: In a prospective study of patients with gallstones, information was obtained on demography, duration of various stages of the operation, analgesia and complication of patients with gallstones. All patients had general anaesthesia using endotracheal intubation, muscle relaxant and intermittent positive pressure ventilation. A standard four-trocar technique and maximum pneumoperitoneum pressure of 14mmHg were maintained during surgery. RESULTS: There were 50 women and two men aged 17-72 years (mean 44.2 years). All had symptomatic gallstones treated by interval LC. The main indications were biliary colic 23(44%) and previous cholecystitis 15(29%). There were scars from previous abdominal surgery in 22 (42%), mainly pfannenstiel. The Verres needle was used to obtain pneumoperitoneum in 40 (77%). Only one patient (1.9%) had the operation converted to open cholecystectomy. Most patients, 47/51 (92%), were discharged in 24 hours. The mean durations of various stages were: anaesthesia (110 minutes), pneumo-peritoneum (67.5 minutes) and reverse trendelenburg (47.8 minutes). The mean operating time reduced from 81 to 68 minutes in the last 20 patients. Complications were sore throat 11(21.6%), infection of the umbilical wound 3(5.9%), right shoulder tip pain (3; 5.9%) and bile leak 1(2%). There was no peri-operative mortality. CONCLUSION: Elective laparoscopic cholecystectomy can be performed with good results in patients with symptomatic gallstones in Accra.
Foreign Body Inhalation: A Review of Patients at the Korle Bu Teaching Hospital, Accra, Ghana
E.D Kitcher
West African Journal of Medicine , 2009,
Abstract: BACKGROUND: Foreign body inhalation, a surgical emergency requiring prompt management to avoid morbidity and mortality , poses a diagnostic and management challenge to otolaryngologists. OBJECTIVE: To assess the pattern of foreign body inhalation at the ENT Unit Korle Bu Teaching Hospital Accra, Ghana. METHODS: The theatre records of patients managed for foreign body inhalation from Ist January 2003–31st December 2006 at the ENT Unit of the Korle Bu Teaching Hospital Accra, Ghana were studied with respect to age, sex, clinical presentation, types of foreign bodies removed, location of foreign bodies, and outcomes of the laryngoscopy or bronchoscopy procedures. RESULTS: There were forty patients with an age range of seven months to 15 years with a mean age of 4.78 years and a peak age incidence at zero–four year age group. The commonest inhaled foreign bodies included groundnuts in five (12.5%) patients, fish bones in six (15%) patients, plastic materials in five (12.5%) patients, metal material in five (12.5%) patients and seeds in five (12.5%) patients. The common clinical presentations included respiratory difficulty, irritating cough, choking, painful swallowing and whistling sound during breathing. Foreign bodies were localized in the right main bronchus in 27 (67.5 %) patients, and in the left main bronchus in ten (25%) patients and in the larynx in three (7.5%) patients. One patient died during bronchoscopy and another patient had bronchotomy for failed bronchoscopy. CONCLUSION: The peak age of occurrence of forein body inhalation is in the zero-four year age group. The commonest inhaled foreign bodies are groundnuts, fish bones, plastic materials, metal materials and seeds. Majority of inhaled foreign bodies tend to localise in the right main bronchus. WAJM 2009; 28(6): 368–370.
Trends in eclampsia at Korle Bu Teaching Hospatal, Accra Ghana
R Acquah-Arhin, EY Kwawukuwe
Nigerian Journal of Clinical Practice , 2003,
Abstract: Objectives: The aim of the study was to find out the current trend of eclampsia and the incidence in Korle Bu Teaching hospital Method: Case files of all patients who were managed as eclampsia from 1st January 1998 to 31st December 200 were reviewed Result: The incidence of eclampisa during the study period was 15.82 per 1000 deliveries and the fatality rate for eclampsia was 4.78%. About 36.25 of the patients did not receive any form of magnesium sulphate and about 47.5% of the patients arrived at the hospital in taxicabs Conclusion: The results suggested that the incidence of eclampsia had risen from 11.1to 15.82 per 1000 deliveries. It was concluded that magnesium sulphate should be made available in the district hospitals and the polyclinics. Protocol for its use should be circulated and enforced. In addition the ministry of Health could organize a pool of ambulance services for reasonable fees for the public. KEY WORDS: Eclampsia, Magnesium sulphate, maternal deaths. Nigerian Journal of Clinical Practice Vol.6(1) 2003: 1-4
A review of genitourinary cancers at the Korle-Bu Teaching Hospital Accra, Ghana
GO Klufio
West African Journal of Medicine , 2004,
Abstract: Objective: To determine the frequency and pattern of genitourinary malignancies seen at the Korle-Bu Teaching Hospital, Accra, Ghana Materials and methods: A retrospective review of genitourinary malignancies seen at the Korle-Bu Teaching Hospital from 1980 to 1990 was undertaken. Data was obtained from the operating theatre register, histopathology reports, and patient case notes. Information retrieved included age and sex of patients, organ involved and laterality where appropriate and tumour type. Results: 548 genitourinary malignancies were seen, of which 479 (87.4%) were in males and 69 (12.6%) in females. Adults comprised 93.4% and children 6.6%. The organ-specific distribution was as follows – prostate 349 (63.7%), bladder 117 (21.3%), kidney 57 (10.4%), testis 13 (2.4%), penis 10 (1.8%) and one each of the ureter and urethra. The kidney tumours comprised nephroblatoma (56.1%), adenocarcinoma (35.1%) with the rest being of urothelial origin. Of the bladder tumours, 50.4% and 44.8% were transitional cell and squamous cell carcinoma respectively. Virtually all the prostatic cancers (99%) were adenocarcinomas. Of the testicular tumours 8(61.5%) were of germ cell and 5 (38.5%) non-germ cell origin. The penile cancers were all squamous. The ureteric and urethral tumours were due to transitional cell and squamous cell carcinomas respectively. Conclusion: Prostatic carcinoma was the predominant genitourinary tumour, accounting for nearly two-thirds of cases, followed by the bladder and the kidney. Other tumours were relatively uncommon. Transitional cell carcinoma of the bladder was seen a little more commonly than the squamous type. Key Words: Prostate, Bladder, Kidney, Testis, Penis, Ureter, Urethra, Cancer, Site-specific, Histology. Résumé Objectif: Déterminer la fréquence et la tendance des génito-urinaires maligns vus au centre hospitalier universitaire du Korle-Bu à Accra au Ghana Matériels et Méthodes: Un bilan rétrospectif des génito-urinaires maligns vus au cntre hospitalier universitaire de 1980 au 1990 a été effectué. Des données ont été obtenues du registre de la salle d'operation, rapports histopathologies et dossier médical des patients. Des informations récupereés sont: age, et sexe des patients, organe impliqués et lateralité, si c'est nécessaire et le type de tumeur. Résultats: 548 cas des malignités génito-rinaire ont été vus, dont 479 soit 87, 4% étaient du sexe masculin et 69 soit 12,6% étaient du sexe féminin. Des adultes constituentt 93,4% et des enfants 6.6%. La repartition spécifique des organes sont representées par. prostate 349 (63,7%, la vessie 117 (21,3%), rein 57 (10,4%), testicule 13 (12,4%) penis 10 (1,8%) et chacun de uretere et uretre. Les tumeurs du rein sont representées par néphroblastome (56,1%) adenocarcinome (35,1%) et les autres etant d'origine d'urothélial. Parmi les tumeurs de vessei, 50,4% et 44,8% étaient des cellule transitionnelle et cellule carcinome du squame respectivement. Pratiquement, tous les
Chronic subdural haematoma: review of 96 cases attending the Korle Bu Teaching Hospital, Accra
TK Dakurah, M Iddrissu, G Wepeba, I Nuamah
West African Journal of Medicine , 2005,
Abstract: Background: Chronic subdural haematoma is not uncommon in Africa. Early diagnosis and treatment is satisfying. Simpler operative procedures are generally effective. This review is meant to find out the situation regarding the condition in Ghana. Study design: A retrospective study of patients with chronic subdural haematoma admitted to and treated by the Neurosurgical Unit of Korle Bu Teaching Hospital between January 1995 and December 1998 was undertaken. The case notes, computerise axial tomography (CT) scans and operative records were reviewed and the relevant data extracted. Incomplete records were excluded. Results: 96 patients were involved. The mean age of the patients was 46.9 years, with male to female ratio of 16: 1. The most common presenting feature was headache (64.7%). Time of injury to presentation was about 2 months. 81 were treated using burr hole and drainage and 15 by craniotomy and stripping of membranes. Eighty four were treated under general anaesthesia. Two were reoperated on because of recurrent bleed. There were two (2) deaths. Ninety patients had a Glasgow Outcome Score of good at the time of their last review. Conclusion: The data suggests that burr hole and closed drainage is a very effective method of managing CSDH.
The Role of Human Herpesvirus Type-6 (HHV-6) in Convulsions Seen in Children at Korle-Bu Teaching Hospital, Accra  [PDF]
Ankrah Lennox-Mac, Adiku Theophilus, Badoe Eben, Kwamena William Coleman Sagoe, Anna Aba Kafintu-Kwashie, Makafui Seshie
Open Journal of Medical Microbiology (OJMM) , 2014, DOI: 10.4236/ojmm.2014.41009
Background: Since the isolation of HHV-6 in 1986, extensive investigation has revealed it to be ubiquitous and responsible for the majority of cases of a common febrile rash illness of infants known as roseola. Other clinical associations including seizure disorders, encephalitis and meningitis have also been stated in various publications. Objective: The aim of the study is to find out if there is any association between HHV-6 infection and the convulsions prevailing at the Child Health Department of the Korle-Bu Teaching Hospital, Accra-Ghana. Methods and Results: Children admitted into the Department of Child Health with episode of convulsions were recruited after informed consent had been sought from subjects. Cerebrospinal fluid (CSF) and Plasma were obtained from patients. PCR directed at the detection of the large tegument protein (LTP) gene in the SIE strain of the HHV-6 in Plasma and CSF from patients was done. The mean age of study subjects was 37.44 months with 53 (64.6%) being males. There was a significant relationship between the convulsions and fever (P < 0.05). Based on CSF characteristics gathered, viral infections may be the probable cause of the observed convulsions but not malaria or bacterial infections. None of the samples from the patients had evidence of HHV-6. Conclusion: The study was unable to establish HHV-6 infection in the CSF and Plasma of patients. What role if any HHV-6 has in convulsions seen in children or neurological diseases at large merits further studies. Other neurotropic viruses need to be investigated as possible causes for the convulsions.
Outcome of Hospital Admissions in HIV-infected Children at the Korle Bu Teaching Hospital, Accra, Ghana
A Kwara, D Shah, LA Renner
West African Journal of Medicine , 2010,
Abstract: BACKGROUND: The burden of paediatric HIV infection remains high in resource-poor settings. Information on morbidity leading to hospitalisation as well as outcome is limited. OBJECTIVE: The objective of this study was to determine the reasons for hospital admissions of HIV-infected paediatric patients to a tertiary teaching hospital and the outcome of these admissions. METHODS: Retrospective chart review of inpatient records of all HIV-infected children aged 0 to 13 years admitted to the paediatric unit at Korle-Bu Teaching Hospital from 30 June 2007 to 30 June 2008 was performed. ed data included age, gender, weight, presenting conditions, diagnosis, duration of hospitalisation, antiretroviral treatment, and outcome. RESULTS: A total of 102 admissions occurred among 76 children. The mean age of the children was 4.5 ± 3.79 years and 42 (55%) were males. HIV diagnosis was made during hospitalisation in 23 (30%) of the 76 patients. Overall, 55 (64%) of the 76 patients had a weight for age of < 2nd percentile and 67% were not on antiretroviral therapy at time of admission. Of the 102 admissions, the predominant diagnosis included pneumonia (40%), gastroenteritis (24%), pulmonary tuberculosis (22%), and/or malaria (19%). Death occurred in 12 of the 102 admissions. Age, gender, and admitting diagnosis were not associated with death. CONCLUSIONS: Failure to thrive and common prevalent infections were the predominant reasons for hospitalisation for paediatric HIV/AIDS patients in Accra. Hospitalisations with these conditions should prompt early HIV testing. Efforts should be intensified to prevent maternal to child transmission of HIV infection.
Birth and Emergency Planning: A Cross Sectional Survey of Postnatal Women at Korle Bu Teaching Hospital, Accra, Ghana
EA Udofia, SA Obed, BNL Calys-Tagoe, KP Nimo
African Journal of Reproductive Health , 2013,
Abstract: Birth and emergency planning encourages early decision making, helps overcome barriers to skilled maternity care and reduces preventable maternal and newborn deaths. A facility based postnatal survey of 483 childbearing women in Accra, Ghana determined birth and emergency planning steps, awareness of obstetric danger signs, reported maternal and newborn complications and birth outcome based on length of hospital stay. Supervised antenatal care and delivery were nearly universal. Overall, 62% had a birth plan, 74% had adequate knowledge of danger signs, while 64% and 37% reported maternal and newborn complications respectively. Accompaniment by a birth companion and saving money were considered the most useful planning steps. Knowledge of danger signs was associated with birth and emergency planning, and birth and emergency planning was associated with reported birth outcome. Birth and emergency planning as a critical component of antenatal care can influence birth outcomes and should be extended to all pregnant women. Résumé La planification des naissances et d'urgence encourage la prise de décision rapide, aide à surmonter les obstacles aux soins de maternité qualifiés et réduit les décès maternels et néonatals évitables. Une enquête post-natale qui a été basée sur l’établissement, et auprès des 483 femmes en age de procréer à Accra, au Ghana a déterminé les étapes de planification des naissances et d'urgence, la sensibilisation des signes de danger obstétrical, a rapporté des complications maternelles et néonatales et les résultats des naissances selon la durée du séjour à l'h pital. Les soins prénatals et l'accouchement surveillés étaient presque universels. Dans l'ensemble, 62% avaient un plan de naissance, 74% avaient une connaissance adéquate des signes de danger, tandis que 64% et 37% ont déclaré des complications maternelles et néonatales, respectivement. Le fait d’être accompagné par un compagnon de naissance et d’économiser de l'argent ont été considérés comme les étapes de planification les plus utiles. La connaissance des signes de danger a été associée à la naissance et à la planification d'urgence et la planification des naissances et d'urgence a été associée à des résultats des naissances déclarées. La planification des naissances et d'urgence comme un élément essentiel des soins prénatals peuvent influer sur les résultats de grossesses et devrait être mis a la portée de toutes les femmes enceintes.
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