Screening of hypertension, risks, knowledge/awareness in second-cycle schools in Ghana. A national cross-sectional study among students aged 12-22

In Ghana, the management of hypertension in primary health care is a cost-effective way of addressing premature deaths from vascular disorders that include hypertension. There is little or no evidence of large-scale studies on the prevalence, risk, and knowledge/awareness of hypertension in students aged 12-22 years in Ghana. In a cross-sectional study, blood pressure, anthropometric indices, and knowledge/awareness assessment of students at second-cycle schools were recorded from 2018 to 2020 in three regions of Ghana. Multistage cluster sampling was used in selecting regions and the schools. Prevalence of prehypertension and hypertension was categorized by the Joint National Committee 7, where appropriate, chi-square, scatter plots, and correlations were used in showing associations. A total of 3165 students comprising 1776 (56.1%) females and 1389 (43.9%) males participated in this study within three regions of Ghana. The minimum age was 12 years and the maximum age was 22 years. The mean age was 17.21 with standard deviation (SD: 1.59) years. A 95% confidence interval was set for estimations and a P value < 0.05 was set as significant. The prevalence rate of overall hypertension was 19.91% and elevated (prehypertension) was 26.07%. Risk indicators such as weight, BMI, waist circumference, physical activity, and form of the diet were positively correlated with hypertension. Among Ghanaian students currently in second-cycle educational institutions, 19.91% were hypertensive and 26.07% were prehypertensive. This may indicate a probable high prevalence of hypertension in the future adult population if measures are not taken to curb the associated risks.

Prognostic role of SIRT6 in gastrointestinal cancers: a meta-analysis

Sirtuin 6 (SIRT6) plays a critical role in the progression and development of gastrointestinal cancers. However, the association between SIRT6 expression and clinicopathological parameters and prognosis in gastrointestinal cancer patients remains inconclusive. Consequently, we conducted this meta-analysis to evaluate the importance of SIRT6 expression in various types of gastrointestinal cancers. PubMed, EMBASE, and Web of Science databases were systematically searched to screen the relevant literature. The reported or estimated hazard ratio (HR) and odds ratio (OR) and their corresponding 95% confidence interval (CI) were pooled to assess the strength of the association. Nine studies involving 867 patients were included in the meta-analysis. Overall analysis showed that high SIRT6 expression was related to better overall survival in gastrointestinal cancers (HR = 0.62, 95% CI = 0.47–0.82). High SIRT6 expression was also related to a favorable tumor node metastasis (TNM) stage (OR = 0.44, 95% CI = 0.28–0.70) among gastrointestinal cancer patients. Our meta-analysis revealed that high SIRT6 expression might be a potential biomarker predicting better prognosis in gastrointestinal cancers, which may offer options for gastrointestinal cancer treatment.

Infection Prevention and Control Preparedness Level and Associated Determinants in 56 Acute Healthcare Facilities in Ghana

Background

Infection prevention and control (IPC) is a globally relevant aspect of all health systems impacting the health and safety of both patients and healthcare workers. However, best practices remain a challenge in healthcare delivery especially in resource limited situations. The primary objective of this study was to assess the infection prevention and control (IPC) preparedness levels of acute healthcare facilities in Ghana and to determine the factors associated with the overall IPC preparedness levels in acute healthcare facilities.

Methods

A cross-sectional study adapting the IPC assessment framework (IPCAF) developed by the World Health Organization (WHO) was conducted. Five of the core components of the WHO IPCAF were used to assess the IPC level of 56 acute healthcare facilities in Ghana.

Results

Of the 56 facilities surveyed, only 19 had an IPC program with clearly defined objectives. Overall, 8 (14.3%) facilities scored an IPC preparedness level of “Advance”, 18 (32.1%) facilities received an “Intermediate” IPC preparedness score, 23 (41.1%) facilities received an IPC preparedness level of “basic” and 7 (12.5%) facilities scored an IPC preparedness level of “inadequate”. IPC materials like detergents, running water and PPEs were not significantly supplied. Government owned facilities performed better in terms of IPC preparedness as compared to privately owned facilities. A PLUM-ordinal regression analysis revealed that an IPC program with clearly defined objectives (OR= 76; 95% CI; 7.23, 808.19), dedicated IPC budget (OR= 13; 95% CI; 3.8–44.3) and regular mandatory training (OR= 50.9; 95% CI; 6.1–425) were associated with increased IPC preparedness.

Conclusion

Generally, the IPC preparedness levels in a majority of the facilities were low and required significant improvements in several areas. Facilities must make periodic reviews and adjust their objectives based on facility priorities.

Preference for High Dietary Salt Intake Is Associated With Undiagnosed Type 2 Diabetes: The Henan Rural Cohort

Background: Diabetes continues to be a serious disease burden globally. Nutrition plays a vital role in human life and health, and both inadequate and over nutrition have been implicated in cause the of disease. Objective: We explored the role of preference for high dietary salt intake and diabetes in a rural population. We also looked at possible mediating factors in the relationship between diabetes and preference for high dietary salt intake. Methods/Participants: Data from the Henan rural cohort in China were analyzed. Using multinomial regression models, the association between diabetes diagnosis type and reported preference for dietary salt was assessed. Adjusted odds ratios (aORs) with confidence interval (CI) at a 95% level are reported. Mediation analyses using structural equation models in Stata were performed. Results: Of the 39,183 participants included in the analyses, 4.07% were previously diagnosed with diabetes, and 5.80% with undiagnosed diabetes. Eighteen percent had a preference for salty meals, the mean age was 55.45 years, and 60% were women. Preference for salty meals was associated with undiagnosed diabetes (aOR = 1.17, 95% CI 1.03, 1.32), but not with previously diagnosed diabetes. Stratified analysis revealed that the association with undiagnosed diabetes was only significant in men (aOR = 1.36, 95% CI 1.13, 1.70) but not in women (aOR = 1.06, 95% CI 0.81, 1.38). BMI and central obesity fully mediated the association. Dietary salt intake was self-reported and therefore presents a limitation. Conclusion: Our study demonstrated that preference for high dietary salt intake is associated with undiagnosed diabetes but not prevalent diabetes.

Methicillin-resistant Staphylococcus aureus and vancomycin-resistant Enterococci co-colonization in patients: A meta-analysis

BACKGROUND

Co-colonization of methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococci (VRE) may result in the transfer of drug-resistant genes. The aim of this meta-analysis was to estimate the pooled co-colonization prevalence of MRSA and VRE.

METHODS

We searched PubMed, Embase, and Web of Science databases. The co-colonization prevalence of MRSA and VRE was assessed by calculating the proportion and 95% confidence intervals (CI). The random-effects model was used to calculate the pooled prevalence.

RESULTS

Eleven eligible studies were included in this meta-analysis. The pooled co-colonization prevalence of MRSA and VRE in patients was 7% (95% CI, 5.0%-9.0%). The results of regression analysis showed that co-colonization prevalence of MRSA and VRE was related to study design, setting, screening sites, and detection methods. We found that male patients (odds ratio [OR], 1.58; 95% CI, 1.09-2.28), patients with comorbid conditions such as diabetes mellitus (OR, 1.37; 95% CI, 1.05-1.78), chronic obstructive pulmonary disease (OR, 1.88; 95% CI, 1.27-2.79), and use of indwelling devices (OR, 4.08; 95% CI, 2.21-7.53) were risk factors for co-colonization by MRSA and VRE.

CONCLUSIONS

The co-colonization prevalence of MRSA and VRE in the patients was common. Appropriate measures should be adopted to limit the horizontal transmission of MRSA and VRE to minimize the future potential for co-colonization and the transfer of resistance genes among these pathogens.

The relationship between leukemia and TP53 gene codon Arg72Pro polymorphism: analysis in a multi-ethnic population

Aim: Many studies have analyzed the relationship between Arg72Pro polymorphism of TP53 and leukemia; nevertheless, the findings continue to be indeterminate. We, therefore, performed an updated meta-analysis in multi-ethnic groups using specialized software for genome-wide association studies meta-analysis. Materials & methods: PubMed, EMBASE and Google Scholar were searched up to October 2018. An odds ratio (OR) with the corresponding 95% CI was used to evaluate the strength in the association. Results: This meta-analysis included 16 studies with 2337 cases and 9494 controls. In the overall population, significant relationship between Arg72Pro polymorphism of TP53 and leukemia susceptibility was found in two genetic models (recessive model: OR = 1.276, 95% CI = 1.102-1.476; p = 0.01; overdominant model: OR = 0.891, 95% CI = 0.802-0.988; p = 0.03). In stratified studies with ethnicity, a significant association was found in five ethnic groups, including Chinese, Americans, Africans, Japanese and Indians. Conclusion: We demonstrated that an association exist between leukemia risk and TP53 gene codon Arg72Pro polymorphism in the recessive and overdominant genetic models. Also, our findings show that the TP53 Arg72Pro polymorphism may influence leukemia development in different populations.

Evidence of rotavirus vaccine impact in sub-Saharan Africa: Systematic review and meta-analysis

BACKGROUND

Over 34 countries in Africa have introduced rotavirus vaccine to their national immunization programs: monovalent (Rotarix®, RV1) and pentavalent (RotaTeq®, RV5) after South Africa introduced it in 2009. Since then several studies assessing the impact of the vaccine have been conducted. The principal aim of this study was to evaluate the impact of rotavirus vaccine in sub-Saharan Africa.

METHODS

A Literature search was performed using Mendeley, PubMed, ScienceDirect, grey literature and Web of Science databases of published studies from January 1, 2017, as years of recent publications on rotavirus vaccine impact in sub-Saharan Africa. A meta-analysis was conducted for rotavirus infection in children under 5 years using proportions of pre and post-vaccine introduction in these populations. Random-effect estimates were considered since the samples were from universal populations.

RESULTS

Out of the 935 articles identified, 17 studies met the inclusion for systematic review and meta-analysis. The pooled proportion for pre-vaccination period was 42%, 95% (CI: 38-46%), and reduced to 21%, 95% (CI: 17-25%) during post-vaccination period. Rotavirus diarrhea significantly reduced in children < 12 months as compared to children 12-24 months old. Seasonal peaks of rotavirus diarrhea were between June-September. However, data is limited to one year of post-vaccine introduction, and bias may present due to early vaccine impact.

CONCLUSION

We observed that the introduction of the rotavirus vaccine was partly responsible for the significant reduction in the burden of rotavirus-associated diarrhea in sub-Saharan Africa. Therefore, there is a need to encourage the remaining countries to introduce the vaccine to their routine national immunization programs.

A cross-sectional study of risk factors and hypertension among adolescent Senior High School students

INTRODUCTION

Hypertension is among the first five causes of mortality, globally contributing more than 40% to cardiac related deaths worldwide, with almost 70% cardiovascular deaths in the low- and middle-income countries. Its burden is projected to be 150 million by 2025 based on epidemiological data within the Sub-Saharan Africa regions, with Ghana experiencing 505,180 increases in 2007. It is currently among the leading cause of death in the country, with prevalence ranging from 19% to 48%. There is limited data concerning hypertension on Ghanaian youth. Particularly, on those at the Senior High School (SHS) level that represents the immediate workforce of the country on the depth of prevalence, knowledge as well as the risk factors that may predispose them into having prehypertension and hypertension for proper records and interventional measures and that is what this study pursues to do.

MATERIALS AND METHODS

A cross-sectional study was employed in five different SHSs in the Ashanti region of Ghana from December 2018 to February 2019 with structured questionnaires and physical screening of participants. Logistic regression analysis was performed to test for relation knowledge and riskfactors on HTN.

RESULTS

The overall prevalence of pre-HTN within the group was 33.8%, with stages 1 and 2 HTN prevalence of 5.4%. Sixty-three percent do not have an idea of what HTN is, and positive associations were found between no physical exercises, no addition of extra salt, type of food often eaten and family history.

CONCLUSION

This study establishes prevalence in pre-HTN within students at the SHS level with low knowledge and high risk factors on the disease. This indication is beneficial to target the interventional programs on this population at this early stage by inculcating education on HTN prevalence and its risks in the educational curricular by the government.