Symptoms of common mental disorders and their correlates among women in Accra, Ghana: a population-based survey

INTRODUCTION

To comply with its new mental health bill, Ghana needs to integrate mental health within other health and social services. Mental disorders represent 9% of disease burden in Ghana. Women are more affected by common mental disorders, and are underrepresented in treatment settings. This study examines physical and social correlates of mental illness in adult women in Accra, Ghana, so as to inform general clinical practice and health policy.

METHODS

The SF-36 and K6 forms and 4 psychosis questions were administered in three languages to 2,814 adult women living in Accra, as part of a larger cross-sectional population-based survey of women's health. The validity of these tools was assessed through correlations within and between measures. Risk factors for mental distress were analysed using multivariate regression. Health service use was also described using statistical frequencies.

RESULTS

Both the SF36 and K6 appear valid in a female Ghanaian population. Low levels of education, poverty and unemployment are negatively associated with mental health. Physical ill health is also associated with mental distress. No association was found between mental distress and religion or ethnicity. Some additional risk factors were significant for one, but not both of the outcome variables. Only 0.4% of women reported seeing a mental health professional in the previous year, whereas 58.6% had visited a health centre.

CONCLUSION

The implications for women are that marriage is neither good nor bad for mental health, but education and employment are strong protective factors. Researchers should note that the SF36 and K6 can be used in a Ghanaian population, however more research is needed to determine the cut-off point for serious mental illness on the K6, as well as research into mental disorders in a mixed-gender population.

Stroke in Ashanti region of Ghana

OBJECTIVE

To determine the morbidity and mortality in adult in-patients with stroke admitted to the Komfo Anokye Teaching Hospital (KATH).

METHODS

A retrospective study of in-patients with stroke admitted to the KATH, from January 2006 to december 2007 was undertaken. Data from admission and discharge registers were analysed to determine stroke morbidity and mortality.

RESULTS

Stroke constituted 9.1% of total medical adult admissions and 13.2% of all medical adult deaths within the period under review. The mean age of stroke patients was 63.7 (95% ci=62.8, 64.57) years. Males were younger than females. The overall male to female ratio was 1:0.96, and the age-adjusted risk of death from stroke was slightly lower for females than males (relative risk= 0.88; 95% ci=0.79, 1.02, p=0.08). The stroke case fatality rate was 5.7% at 24 hours, 32.7% at 7 days, and 43.2% at 28 days.

CONCLUSION

Stroke constitutes a significant cause of morbidity and mortality in Ghana. Major efforts are needed in the prevention and treatment of stroke. Population-based health education programs and appropriate public health policy need to be developed. This will require a multidisciplinary approach of key players with a strong political commitment. There is also a clear need for further studies on this topic including, for example, an assessment of care and quality of life after discharge from hospital. The outcomes of these studies will provide important information for the prevention efforts.