Where are patients missed in the tuberculosis diagnostic cascade? A prospective cohort study in Ghana.
BackgroundGhana's national prevalence survey showed higher than expected tuberculosis (TB) prevalence, indicating that many people with TB are not identified and treated. This study aimed to identify gaps in the TB diagnostic cascade prior to starting treatment.MethodsA prospective cohort study was conducted in urban and rural health facilities in south-east Ghana. Consecutive patients routinely identified as needing a TB test were followed up for two months to find out if sputum was submitted and/or treatment started. The causal effect of health facility location on submitting sputum was assessed before risk factors were investigated using logistic regression.ResultsA total of 428 persons …
Sociodemographic factors associated with time to discharge for hospitalised patients with asthma and asthma exacerbation using the Ghana Health Service District Information Management System 2 (DHIMS-2) database, 2012–2017
ObjectiveData on asthma hospitalisations are a useful source of patient morbidity information. In Ghana, the length of stay (LoS) and sociodemographic factors of patients hospitalised for asthma and its exacerbation are understudied. We aimed to investigate the time to discharge and assessed factors associated with length of hospital stays of asthmatics in Ghana.MethodsRetrospective analysis of hospitalised patient with asthma records between 2012 and 2017 from the nationwide Ghana Health Service District Health Information Management System 2 database. We calculated the cumulative incidence function for discharge stratified by age group and sex. Multivariable Cox regression was used to inv…
Trends in hospitalization of patients with diabetes mellitus in Ghana from 2012 to 2017 with predictions to 2032
Abstract Background This study explores sociodemographic and health factors associated with hospitalizing diabetes mellitus (DM) patients and estimates the number of future hospitalizations for DM in Ghana. Methods We conducted a secondary analysis using nationally representative patient hospitalization data provided by the Ghana Health Service and projected population counts from the Ghana Statistical Service. Data were stratified by year, age, sex and region. We employed Poisson regression to determine associations between sociodemographic and health factors and hospitalization rates of DM patients. Using projected population counts, the number of DM-related hospitalizations for 2018 thro…
Missed opportunities for tuberculosis investigation in a municipal hospital in Ghana: evidence from patient exit interviews
Abstract Background We assessed coverage of symptom screening and sputum testing for tuberculosis (TB) in hospital outpatient clinics in Ghana. Methods In a cross-sectional study, we enrolled adults (≥18 years) exiting the clinics reporting ≥1 TB symptom (cough, fever, night sweats or weight loss). Participants reporting a cough ≥2 weeks or a cough of any duration plus ≥2 other TB symptoms (per national criteria) and those self-reporting HIV-positive status were asked to give sputum for testing with Xpert MTB/RIF. Results We enrolled 581 participants (median age 33 years [IQR: 24–48], 510/581 [87.8%] female). The most common symptoms were fever (348, 59.9%), chest pain (282, 48.5%) and coug…
Time trends, sociodemographic and health factors associated with discharge and length of stay of hospitalised patients with sickle cell disease in Ghana: a retrospective analysis of national routine health database
ObjectivePatients with sickle cell disease (SCD) are prone to multiple episodes resulting in frequent hospital visits. We determined the time trends, sociodemographic and health factors associated with length of stay (LoS) for patients with SCD in Ghana.Design, participants, settingWe retrospectively analysed SCD hospitalisation records of 22 680 patients from a nationwide database of the Ghana Health Service from 2012 to 2017.Outcome measuresFactors associated with LoS were estimated using Cox regression, while the cumulative incidence of being discharged alive was estimated with in-hospital death as a competing risk.ResultsPatients admitted for SCD over 6 years constituted 22 680 (0.8%) o…