Graves Disease in Central Ghana: Clinical Characteristics and Associated Factors

Background Graves disease (GD) has increased in prevalence over the past decade in Africa. Despite this, the condition is not well described, especially in sub-Saharan Africa. Objective We have described the clinical characteristics and associated factors of GD in a cohort of patients attending a resource-limited setting tertiary hospital. Methods Patients were examined thoroughly and systematically tested for the degree of clinical and biochemical thyroid status. Thyroid volume, characteristics, and blood flow were assessed at presentation using ultrasonography. Factors associated with an inability to achieve clinical and biochemical thyroid remission were evaluated using multiple logistic regression analysis. Results Overall, 182 patients were studied, 152 (83.5%) were women with a female:male ratio of 5.1:1.0. The mean age at presentation was 39.9 ± 14.7 years with women significantly older than men. Thyroid-associated orbitopathy (TAO) was observed in 56% of the participants and pretibial myxoedema in 6%. About 84% of the participants were hyperthyroid at presentation, 9% were euthyroid, 4% were hypothyroid, and 3% had subclinical hyperthyroidism. Inability to achieve biochemical and clinical remission at 24 months was associated with increased thyroid volume (odds ratio [OR]: 2.35, 95% confidence interval [CI]: 1.85-2.52, P < .001), presence of TAO (OR: 2.15, 95% CI: 2.12-2.33, P < .001), increased FT3/FT4 ratio (OR: 1.33, 95% CI: 1.24-2.56, P = .004), and missed clinic appointment (OR: 5.2, 95% CI: 4.55-7.89, P < .001). Conclusions Graves disease among Ghanaians is associated with significant signs at presentation. Inability to achieve remission within the first 24 months is associated with increased thyroid volume, TAO, an increased FT3/FT4 ratio, as well as missed clinic appointment.

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Suicidal ideation and associated factors among school-going adolescents in rural Ghana

Current Psychology ◽

10.1007/s12144-021-01378-3 ◽

2021 ◽

Author(s):

Emmanuel Nii-Boye Quarshie ◽

Samuel Kofi Odame

Keyword(s):

Suicidal Ideation ◽

Associated Factors ◽

Attempted Suicide ◽

Sub Saharan Africa ◽

Rural Adolescents ◽

African Countries ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Rural Ghana ◽

Sub Saharan

AbstractSuicidal ideation is a critical risk for attempted suicide and eventual suicide. Little is known about suicidal ideation among rural adolescents in most sub-Saharan African countries. We aimed to estimate the 12-month prevalence of suicidal ideation and to describe some of the common and gender-specific associated factors among in-school adolescents in rural Ghana. We conducted a cross-sectional survey involving a random sample of 1101 in-school adolescents aged 10–19 years in a rural district in Eastern Ghana. The Suicidal Behavior Questionnaire-Revised was used to assess suicidal ideation. Overall, 25.1% participants (95% CI = 22.5–27.7), representing 28.3% females (95% CI = 24.7–32.2) and 21.5% males (95% CI = 18.0–25.2) reported suicidal ideation during the previous 12 months. Females who experienced personal and interpersonal adversities mainly outside the family context were likely to report suicidal ideation, while suicidal ideation among males was associated with conflict with parents. Regardless of gender, adolescents who reported exposure to a friend’s attempted suicide were about two times more likely to report suicidal ideation. The prevalence of suicidal ideation among adolescents in rural Ghana compares with in-school estimates from other countries within sub-Saharan Africa, but also underscores the need for targeted and universal prevention programmes and intervention efforts to mitigate the potential transition from suicidal ideations to suicidal attempts and eventual deaths by suicide among rural adolescents.

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Drowsiness and associated factors in long distance transport drivers in sub-Saharan Africa

Archives of Cardiovascular Diseases Supplements ◽

10.1016/j.acvdsp.2020.10.280 ◽

2021 ◽

Vol 13 (1) ◽

pp. 132

Author(s):

C. Nganou-Gnindjio ◽

F. Tsasse Fokou ◽

A. Menanga

Keyword(s):

Associated Factors ◽

Sub Saharan Africa ◽

Long Distance ◽

Long Distance Transport ◽

Sub Saharan ◽

Distance Transport

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Multiple sclerosis in Kenya: Demographic and clinical characteristics of a registry cohort

Multiple Sclerosis Journal - Experimental Translational and Clinical ◽

10.1177/20552173211022782 ◽

2021 ◽

Vol 7 (2) ◽

pp. 205521732110227

Author(s):

Imran Jamal ◽

Jasmit Shah ◽

Peter Mativo ◽

Juzar Hooker ◽

Mitchell Wallin ◽

...

Keyword(s):

Multiple Sclerosis ◽

Symptom Onset ◽

Clinical Characteristics ◽

Age Of Onset ◽

Sub Saharan Africa ◽

University Hospital ◽

Tertiary Referral Hospital ◽

Female Ratio ◽

Sub Saharan ◽

Neuro Imaging

Background Multiple Sclerosis (MS) is the leading cause of non-traumatic neurological disability in young adults. There is limited literature regarding the burden of MS in sub-Saharan Africa (SSA). Objective To describe the demographic and clinical characteristics of patients with MS (PwMS) presenting to a tertiary referral hospital in Nairobi. Methods We conducted a retrospective descriptive study for PwMS presenting to Aga Khan University Hospital, Nairobi from 2008–2018. Results 99 cases met the diagnostic criteria for MS with a male to female ratio of 1:4. Majority (68.7%) of PwMS were indigenous Africans with a mean age of onset of 30.7 years. Mean duration from symptom onset to first neuro-imaging was 5.04 years. Only 33% of patients had sensory symptoms at onset whereas 54.5% had vitamin D deficiency/insufficiency. Majority (79.5%) had relapsing remitting MS (RRMS) and 56.6% were initiated on disease modifying therapy (DMT). Only 21.2% of patients on DMT were non-compliant. Patients with RRMS were more likely to be initiated on DMT at our hospital (p < 0.001). Conclusion Clinical characteristics of these patients largely resemble those of other SSA cohorts and African American patients. There was a delay between symptom onset and neuroimaging. There were also issues with DMT compliance.

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