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CARE OF INJURED CHILDREN COMPARED TO ADULTS AT DISTRICT AND REGIONAL HOSPITALS IN GHANA AND THE IMPACT OF A TRAUMA INTAKE FORM: A STEPPED-WEDGE CLUSTER RANDOMIZED TRIAL

2026-06-22T12:39:31Z

Title: CARE OF INJURED CHILDREN COMPARED TO ADULTS AT DISTRICT AND REGIONAL HOSPITALS IN GHANA AND THE IMPACT OF A TRAUMA INTAKE FORM: A STEPPED-WEDGE CLUSTER RANDOMIZED TRIAL Authors: Gyedu, A.; Issaka, A.; Appiah, A. B.; Donkor, P.; Mock, C. Abstract: Background: This study aimed to determine the effectiveness of a standardized trauma intake form (TIF) to improve achievement of key performance indicators (KPIs) of initial trauma care among injured children, compared to adults, at non-tertiary hospitals in Ghana. Methods: A stepped-wedge cluster randomized trial was performed with research assistants directly observing the management of injured patients before and after introducing the TIF at emergency units of 8 non-tertiary hospitals for 17.5 months. Differences in outcomes between children and adults in periods before and after TIF introduction were determined with multivariable logistic regression. Results: Management of 3,889 injured patients was observed; 757 (19%) were children <18 years. Trauma care KPIs at baseline were lower for children compared to adults. Improvements in primary survey KPIs were observed among children after TIF introduction. Examples include airway assessment [279 (71%) to 359 (98%); adjusted odds ratio (AOR):74.42, p=0.005)] and chest examination [225 (58%) to 349 (95%); AOR 53.80, p=0.002)]. However, despite these improvements, achievement of KPIs was still lower compared to adults. Examples are pelvic fracture evaluation [children:295 (80%) vs adults:1,416 (88%), AOR: 0.56, p=0.001] and respiratory rate assessment (children:310 (84%) vs adults:1,458 (91%), AOR: 058, p=0.030). Conclusions: While the TIF was effective in improving most KPIs of pediatric trauma care, more targeted education is needed to bridge the gap in quality between pediatric and adult trauma care at non-tertiary hospitals in Ghana and other low- and middle-income countries.

SILICOSIS, PERSISTENT PNEUMOTHORAX, AND RESPIRATORY FAILURE: GRIM CONSEQUENCES OF GALAMSEY

2026-06-22T12:38:59Z

Title: SILICOSIS, PERSISTENT PNEUMOTHORAX, AND RESPIRATORY FAILURE: GRIM CONSEQUENCES OF GALAMSEY Authors: ISSAKA, A.; YAKUBU, M.; ADJESO, T. JK Abstract: Illegal small-scale gold mining (galamsey) is often plagued with a deleterious working environment and a lack of proper safety protocols. In this case report, a 32-year-old male galamsey miner presented with progressive shortness of breath, cough, chest pain and weight loss. He was suspected of having silicosis and persistent pneumothorax. Surgery could not be done due to the poor state of the lungs. Despite immediate medical intervention, including chest tube insertion, the patient’s condition deteriorated rapidly, and he succumbed to respiratory failure. This case report is highly representative of the medical condition of many galamsey workers. There is an urgent need for intensified safety measures, regulatory enforcement, and improved healthcare access. Concerted efforts of various stakeholder collaborations are key to creating a safer and more sustainable mining industry.

ANTIMICROBIAL RESISTANCE OF CLINICAL BACTERIAL ISOLATES ACCORDING TO THE WHO’S AWARE AND THE ECDC-MDR CLASSIFICATIONS: THE PATTERN IN GHANA’S BONO EAST REGION

2026-06-22T12:35:33Z

Title: ANTIMICROBIAL RESISTANCE OF CLINICAL BACTERIAL ISOLATES ACCORDING TO THE WHO’S AWARE AND THE ECDC-MDR CLASSIFICATIONS: THE PATTERN IN GHANA’S BONO EAST REGION Authors: Walana, W.; Vicar, E. K.; Kuugbee, E. D.; Sakida, F.; Yabasin, I. B.; Faakuu, E.; Amfoabegyi, S.; Ziem, J. B. Abstract: Introduction: Antimicrobial resistance (AMR) remains a significant health challenge globally and nations have the responsibility to maintain a constant surveillance of AMR, particularly for the emergence of multidrug-resistant (MDR) isolates to existing antibiotics. Against this backdrop, we applied the WHO’s AWaRe (ACCESS, WATCH, and RESERVE) antibiotics classification and the European Centre for Disease Prevention and Control (ECDC)’s multidrug resistance definition for AMR isolates from clinical specimens. Method: This study reviewed bacterial culture and antibiotic sensitivity test outcomes. These results were then grouped according to the AWaRe and ECDC-MDR classifications. Results: In all, the culture and sensitivity results of the 3,178 clinical specimens were investigated, of which 59.5% were from female patients. The pathogens were isolated from 1,187 specimens (37.4%). The WHO’s ACCESS antibiotics, tetracycline, showed a relatively high level of insusceptibility, particularly among Gram-positive (GP) isolates (ranging from 66.7% to 76.7%), along with augmentin (ranging from 44.7% to 81.3%) and cloxacillin (ranging from 50.0% to 78.1%). However, the Gram-negative (GN) isolates showed a relatively high level of susceptibility to amikacin, augmentin, and nitrofurantoin. The WHO’s WATCH antibiotics, cefuroxime, ceftriaxone, cefotaxime, and ciprofloxacin showed a relatively high level of non-responsiveness among the GN isolates, particularly Proteus (ranging from 31.4% to 78.4%), Pseudomonas (ranging from 21.4% to 96.4%), and Enterobacter (ranging from 62.5% to 100%) spp. Among the WHO’s RESERVE antibiotics, resistance to ceftazidime was commonly associated with the GN coliform isolates: Eschericha coli, Klebsiella, and Citrobacter spp. Insusceptibility to meropenem was frequently observed in Staphylococcus spp., E. coli, coliforms, and Proteus spp. Out of the 1,187 isolates, 15.5% (184) were GAT(gentamycin, ampicillin, and tetracycline) MDR, of which 61% (112/184) were from specimens of female patients. The most predominant GAT-MDR isolates were Staphylococcus spp., E. coli, coliforms, and Klebsiella spp. Conclusion: In conclusion, the study revealed a relatively high level and diverse range of AMR. However, MDR in accordance with the ECDC definition was relatively low. There is, therefore, a need to have further research on AMR to inform national criteria for MDR in Ghana.

THE DISTRIBUTION OF HRHPV GENOTYPES AMONG CERVICAL CANCER CASES DIAGNOSED ACROSS GHANA: A CROSS-SECTIONAL STUDY

2026-06-22T12:34:42Z

Title: THE DISTRIBUTION OF HRHPV GENOTYPES AMONG CERVICAL CANCER CASES DIAGNOSED ACROSS GHANA: A CROSS-SECTIONAL STUDY Authors: Akakpo, P. K.; Emmanuel Gustav Imbeah, E. G.; Ulzen‑Appiah, K.; Darkwa‑Abrahams, A.; Adjei, E.; Amo‑Antwi, K.; Amo, E. O.; Der, E. M.; Wiredu, E. K. Abstract: Background The burden of cervical cancer in Ghana is high due to a lack of a national screening and vaccination program. Geographical variations in high-risk Human Papilloma Virus incidence and type should be considered for vaccine improvement and screening in LMICs. Methods A descriptive, multi center cross sectional study with purposive sampling of cases with cervical cancer diagnosed from January 2012 through to December 2018 was employed relying on archived Formalin Fixed Paraffin Embedded (FFPE) tissues from four (4) Teaching Hospitals. Cervical cancers were assessed for histopathological features following WHO guidelines. In addition, the novel Tumour Budding and Nest Size Grade (TBNS) for SCC, SILVA pattern of invasion for EAC and Tumour Infiltrating Lymphocytes (TILs) were assessed. High Risk HPV testing was performed using an isothermal, multiplex nucleic acid amplification method from ATILA biosystem (Mountain View California, USA). The FFPE blocks were tested for 15 hrHPV genotypes. Results were analyzed using SPSS v.26.0, with descriptive statistics and cross tabulation and chi square tests done with significance established at p < 0.05. Results A total of 297 cases were identified for the study with ages ranging from 20 to 95 years. The peak age group for cervical cancer was 46 to 55 years. For those tested, hrHPV positivity rate was 85.4% [EAC (84.6%) and SCC (85.6%)]. The top five hrHPV serotypes for both histological cancers were 59 (40.0%), 35 (32.0%), 18 (30.0%), 16 (15.0%), and 33 (10.0%) respectively. Approximately, 58.2% of infections were multiple. Single hrHPV infections were mostly caused by hrHPV 59 (28.9%), and 16 (26.3%). TBNS grade for SCC, SILVA pattern of invasion for EAC and TILs did not show any statistically significant relationship with hrHPV. Conclusion We affirm reported differences in hrHPV types associated with cervical cancer in Ghana with hrHPV types such as 59, 35, and 33 forming a significant proportion of hrHPV types associated with cervical cancer. This difference in hrHPV types should guide vaccine improvement and triaging of hrHPV positives. Though multiple infections are more common, some hrHPV types such as hrHPV 16 and 59 are responsible for most single infections associated with cervical cancer. Simple haematoxylin and eosin based morphological assessments can improve the prognostication of patients with cervical cancer.