Ghana Medical Journal

Prevalence of motorcycle accidents and associated factors among road traffic accident victims in Accra, Ghana

2025-03-31T08:49:53+00:00

Objectives: This study determined the prevalence of motorcycle accidents and associated risk factors in Accra, Ghana.
Design: Cross-sectional
Setting: Legon, Pentecost, Madina, and Kekele hospitals, Motor Transport and Traffic Unit offices in Accra, and Kaneshie District Court. Data were collected using structured questionnaires
Participants: Road traffic accident victims (387), aged 15 years and above, were randomly selected from health facilities’ registers and interviewed.
Main outcome measure: Number of road traffic accidents involving motorcycles
Results: The prevalence of motorcycle accidents among road traffic accidents was 37% [95% CI: 32.0-42.0]. Motorcycle accidents predominantly occurred among people aged 15-25 and 26-35 years. The prevalence among men was 38% while women reported 24% [ 95% CI: 85.0-91.0]. Motorcycle accident occurrence was higher (63% vs 10%) among those earning < GH₵349 ($22.37) a month compared to those earning above GH₵3000 ($192.31). After adjusting for all the factors that showed association at the univariate level and potential confounders like sex, followed by post-estimation analysis and a Hosmer-Lemeshow goodness of fit test, factors that were significantly associated with motorcycle accidents included ownership [AOR:2.32, p=0.018 95%CI: 1.16-4.65], education level [AOR=1.48, p=0.020 95%CI: 1.06-2.05], motor license [AOR=132.74, p<0.001 95%CI: 17.56-1003.62], and income level [AOR=0.65, p=0.002 95%CI: 0.50-0.85].
Conclusion: Motorcycle accidents remain prevalent and significantly related to income level, ownership level, education level, and having a motor license. To reduce motorcycle accidents, governments must implement policies that address these factors and support safer road practices.

Causes and clinical presentation of stroke in children in Cameroon

2025-03-31T08:56:25+00:00

Objective: The aim was to determine the aetiological factors and clinical and paraclinical aspects of stroke in children in Cameroon.
Design: retrospective study of the records
Setting: At two university hospitals in the city of Yaoundé (Yaoundé Gynaeco-Obstetric and Paediatric Hospital and the Chantal Biya Foundation Mother and Child Centre)
Participants: 47 children with stroke for seven and half years
Interventions: Data were collected from medical records. The variables studied included clinical and paraclinical data.
Main outcome measures: Key variables were summarised in the form of mean ± standard deviation, frequencies and percentages
Results: The mean age was 6.5+2.8 years. The Male Female sex ratio was 1.8:1. The average consultation time was 31.8 hours. Hemiplegia/hemiparesis (95.7%) was the main clinical manifestation, associated with signs such as convulsions (27.7%), fever (46.8%) and pallor (27.7%). Ischaemic and haemorrhagic stroke accounted for 41 cases (87.2%) and 6 cases (12.8%), respectively. The aetiological factors for ischaemic stroke were sickle cell disease (72.3%), sepsis (4.2%), protein S deficiency (2.1%) and dilated cardiomyopathy with mitral insufficiency (2.1%). The aetiology was not found in 3 patients (6.4%) with ischaemic stroke. Apart from sickle cell disease (66.6%), the aetiological factors for haemorrhagic stroke were idiopathic thrombocytopenic purpura (16.7%) and haemophilia B (16.7%). Ischaemia mainly involved the middle cerebral artery (86.1%). Haemorrhagic attacks were mainly supratentorial.
Conclusion: In urban Cameroon, strokes frequently occur around the age of 6, with a predominance of ischaemic strokes resulting in motor deficits. Sickle cell disease is the most common cause.

Perinatal outcome of pregnant mothers with active rubella infection in a tertiary hospital in Nigeria

2025-03-31T09:07:31+00:00

Objective: To determine the seroprevalence of the rubella virus among pregnant women and the perinatal outcome of neonates of mothers with active rubella virus.
Design: A cross-sectional and longitudinal study
Setting: The study was conducted in the Obstetrics and Gynaecology Department of a teaching hospital in Nigeria.
Participants: Pregnant women at the gestational age of 18-20 weeks.
Intervention: Screening pregnant mothers for immunoglobulin (IgG, IgM) for the rubella virus. Neonates of pregnant mothers with active rubella infection (IgM positive) were screened at birth for rubella IgM to assess for congenital rubella infections and congenital rubella syndrome.
Main outcome measure: Prevalence of rubella immunoglobulin G and active rubella infection IgM, congenital rubella infection, and congenital rubella syndrome.
Results: Of the 327 participants, 68.8% were rubella IgG seropositive, while 7.6% were Rubella IgM seropositive. Fifty-six (56) per cent of neonates of women with active rubella infection were Rubella IgM seropositive at birth, and 14.3% of the neonates of Rubella IgM seropositive pregnant women with active rubella infection had occipitofrontal circumference of less than 10th percentile for gestational age.
Conclusion: Rubella virus is present in our environment with the risk of pregnant mother and neonate of being infected

A retrospective single-centre study on the histological profile of brain and spine tumours at a tertiary hospital in Ghana

2025-03-31T09:27:24+00:00

Objective: This study aimed to describe the patient demographics, clinical presentation and histological subtypes of central nervous system (CNS) tumours in a tertiary facility
Design: Retrospective review of all the histopathological and medical records available for patients with tumours of the CNS operated on.
Setting: Neurosurgical Unit, Department of Surgery, Korle-Bu Teaching Hospital
Participants: All adult and paediatric patients with histopathologically diagnosed CNS tumours
Main outcome measures: Frequency of histopathological subtypes of CNS tumours
Results: This study of 338 patients with CNS tumours showed a slight female predominance (183 females, 155 males). The mean age was 38.1 years. Brain tumours were more common (290 cases) than spinal tumours (48 cases), with symptoms like headaches (44.44%) and visual disturbance (24.31%) prevalent in brain cases, and paraparesis (35.42%) and low back pain (16.67%) in spinal cases. Certain symptoms were strongly indicative of specific tumour types, such as seizures (OR: 3.3, CI: 1.6 – 6.9, p = 0.005) with meningiomas and visual disturbances with sellar tumours (OR: 6.7, CI: 3.6 – 12.9, p<0.001). Most tumours were low-grade (78.69%). Meningiomas were the most common (33.14%), particularly meningothelial (38.39%). Gliomas, glioneuronal, and neuronal tumours were next in prevalence (28.40%), followed by sellar tumours (18.93%). Astrocytomas (60.42%) were the predominant glioma subtype.
Conclusion: Low-grade tumours predominate in our setting. It is prudent that we channel efforts towards prompt diagnosis and treatment of such cases.

Incessant ventricular tachycardia complicating heart failure in pregnancy

2025-03-31T09:48:57+00:00

Cardiovascular diseases in pregnancy increase the risk of adverse maternal and foetal outcomes. Diagnosis and management of cardiovascular diseases, such as arrhythmias and heart failure in pregnancy, in resource-limited settings, is, however, challenging. We present a 31-year-old multiparous woman whose index presentation was for worsening symptoms of acute heart failure at 33 weeks of gestation. She had, however, had a prior history of breathlessness in a previous pregnancy for which she was diagnosed with peripartum cardiomyopathy. During this index clinical presentation, she was found to have dilated cardiac chambers with severe left ventricular systolic dysfunction and monomorphic ventricular tachycardia. Multidisciplinary team management resulted in successful cardioversion and satisfactory maternal and foetal outcomes.

Strangulated right inguinoscrotal hernia with scrotal bowel evisceration

2025-03-31T10:05:23+00:00

Spontaneous bowel evisceration with umbilical hernia is very rare and has been reported in a patient with chronic liver disease with tense ascites. There has been one reported case of spontaneous evisceration in a patient with inguinal hernia and chronic obstructive pulmonary disease. Here, we present a case of a right inguinoscrotal hernia with spontaneous scrotal bowel evisceration in a patient with no apparent underlying chronic conditions. Management of such a case involves stabilising the patient and avoiding further injury to the bowel, with the definitive treatment being surgical repair. Using a nylon darn repair technique seems better than a prosthetic mesh due to the risk of infection of the latter. The principle of surgical treatment is that the bowel is carefully inspected, a thorough saline wash of the abdomen is done and appropriately repairing the hernia defect.

Treatment outcomes of symptomatic internal iliac artery aneurysms

2025-03-31T10:10:53+00:00

Isolated internal iliac artery aneurysm (IIIAA) is a rare condition, with limited information available about its symptoms and surgical treatment outcomes, particularly in Ghana. This case report presents the 4-year surgical treatment outcomes of three patients (aged 42, 58, and 22 years) with IIIAA, each exhibiting different clinical presentations. All patients experienced pelvic pain and difficulty walking but had uneventful post-operative recoveries. They made significant progress with physiotherapy and were able to mobilise with a Zimmer frame before discharge. Currently, all three patients are mobilising unaided, and post-operative Computed Tomography (CT) scans show no complications. This report highlights the importance of early diagnosis to minimise complications and improve the prognosis for IIIAA, which often presents asymptomatically and can manifest with a wide range of clinical findings. The study underscores the effectiveness of open surgical repair in achieving positive outcomes for IIIAA patients in Ghana.

Correspondence: Risk perception of COVID-19 and vaccine uptake among patients with chronic illnesses at a tertiary health facility in Nigeria

2025-03-31T10:19:09+00:00

Dear Editor,
This is a response to published research on " The risk perception of COVID-19 and vaccine uptake among patients with chronic illnesses at a tertiary health facility in Nigeria.1" Studies on the risk perception of COVID-19 vaccination among chronically ill patients in tertiary care centres provide useful information. However, several methodological issues have emerged, limiting its effectiveness, particularly in the Nigerian context. This is especially true for how risk perception affects vaccination uptake. Can the authors explain how they expect to demonstrate causation in future studies? Longitudinal designs may be more suited to tracking changes in attitudes and behaviours over time, particularly if new information on COVID-19 and its vaccines becomes available.