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Abstract Background Extrapulmonary tuberculosis (EPTB) is a major component of the total tuberculosis cases reported by the World Health Organization. This is a study conducted to compare microscopy and molecular techniques to determine the prevalence of Mycobacterium tuberculosis complex (MTBC) in EPTB patients. Methods Smear microscopy and genotype MTBDRplus line probe assay (LiPA) were applied to concentrated extrapulmonary clinical specimens from different anatomic sites to determine the presence of M. tuberculosis and their susceptibility to isoniazid (INH) and/or rifampin (RIF). Results A total of 251 specimens comprising 108 (43%) ascitic fluid, 54 (21.5%) pleural aspirate, 24 (9.6%) gastric lavage, 15 (6.0%) pus, 9 (3.6%) synovial fluid, 5 (2%) cerebrospinal fluid, 2 (0.8%) breast aspirate and 34 (13.5%) aspirates from unindicated sites obtained from patients with suspected EPTB attending the Tamale Teaching Hospital were analysed. Microscopically, acid fast bacilli (AFB) were detected in one ascitic fluid and a pus specimen. Using the LiPA, MTBC was observed in four (2.6%) samples; three (3) ascitic fluid and one aspirate. Conclusion M. tuberculosis complex was confirmed in four (2.6%) patients. The most common specimens suspected of EPTB were ascitic fluid, pleural aspirate and gastric lavage. However, MTBC was predominantly detected in ascitic fluid. This result indicates that the LiPA can improve the detection of EPTB in the region and similar settings globally.

A hearing aid is a small electronic device that is worn in or behind the ear. It makes some sounds louder for a person with hearing loss to hear, communicate and participate more fully in daily activities. This study aimed to assess the knowledge and use of hearing aids among hearing impaired persons visiting ENT clinic at Tamale Teaching Hospital. A quantitative crosssectional design was used and 52 hearing impaired persons were selected using a purposive sampling. Data was collected through a self-administered questionnaire and analyzed using descriptive statistics. The findings suggest a significant proportion of respondents (36.5%) reported being slightly knowledgeable about the benefits of using hearing aids, (28.8%) considered themselves moderately knowledgeable about the benefits of hearing aids was whiles a small proportion (15.4%) of respondents claimed to be very knowledgeable about the benefits of hearing aids. Surprisingly, (19.3%) of respondents indicated that they had no knowledge at all about the benefits of hearing aids. However, there are challenges related to access, affordability (19.2%), and sustained use of hearing aids that need to be addressed. The deductions and inferences drawn from the results of the findings suggest that ENT Specialists, Audiologist in collaboration with management of TTH should develop and implement educational programs and awareness campaigns targeted at the hearing-impaired patients/clients visiting the clinic to improve their knowledge and understanding on the benefits of using hearing aids. [ABSTRACT FROM AUTHOR]

Background: A variety of clinically important pathogens have developed multidrug resistance (MDR), which threatens global public health. This study aimed to determine the incidence, patterns, and trends of MDR of gram-negative bacterial isolates in clinical specimens in the Tamale Teaching Hospital, Ghana. Methods: This retrospective study analyzed gram-negative bacterial isolates and antimicrobial susceptibility test (AST) results of patients who visited the Tamale Teaching Hospital laboratory between 2017 and 2019. Results: A total of 2,779 gram-negative bacterial isolates and their phenotypic AST results were analyzed. From these, 1,297 gram-negative bacteria (46.7%) were isolated from urine samples, while the rest were isolated from sputum (20.9%), wound (14.3%), and swabs (11.7%) samples, etc. Escherichia coli (23.8%) was the most common gram-negative pathogen found predominantly in the urine samples (33.2%). All gram-negative bacteria isolated between 2017 and 2019 showed high MDR. Klebsiella pneumoniae gradually increased its MDR from 84.0% in 2017, 89.5% in 2018, to 95.1% in 2019. On the other hand, the MDR rates in Pseudomonas aeruginosa were approximately 65.8%, varying from 59.5% in 2017 to 78.7% in 2019. Among tested antimicrobials, amikacin was the most effective. Resistance to amikacin in Enterobacter spp., E. coli, and K. pneumoniae in vitro were 16.2%, 11.8%, and 17.7%, respectively. Conclusion: The study has shown that the high levels of MDR in gram-negative bacteria isolated may be associated with the infections recorded at the Tamale Teaching Hospital. The major gram-negative pathogens isolated have resistance to penicillins, cephalosporins, and fluoroquinolones. Aminoglycosides can offer high antibiotic activity to overcome gramnegative bacterial resistance. Further studies will be needed to decide policy direction on infection prevention and control, and antimicrobial stewardship programs

Background: The nursing process is an evidenced-based tool that guides the sequence of clinical reasoning and the delivery of quality nursing care. Nursing practice authorities worldwide, including Ghana, make it a standard of practice in the clinical setting for professional nurses. Despite this, only a few studies have attempted to assess the use of the nursing process in the country. This study, sought to assess the knowledge level, extent of use, as well as, barriers associated with the use of the nursing process at the Tamale Teaching Hospital in Ghana. Method: A quantitative cross-sectional survey of 286 registered nurses and midwives, chosen by stratified random sampling, was undertaken using a questionnaire with a Cronbach’s alpha of 0.83. Data was fed into SPSS version 24 for analysis. A questionnaire return rate of 98.6% was realized. Descriptive statistics, as well as, Kruskal-Wallis H test of association was used to check for the presence of statistically significant associations between some selected independent variables and the use of the nursing process. Results: Knowledge level of the nursing process was high (71.0%), while use of the nursing process was low (32.3%). Major barriers were stressful work environment (96.8%), absence of nursing process policy (94.7%), lack of further nursing process training (91.5%), inadequate supply of consumables (81.2%) and lack of nursing process clinical skills (42.9%). Participants age (p = 0.020), academic qualification (p = 0.038), work experience (p = 0.033), rank (p = 0.011) and the possession of nursing process clinical skills (p = 0.016) were significantly associated with the use of the nursing process for patient care. Conclusion: A nursing process theory–practice gap exist in the hospital, occasioned by a high level of theoretical knowledge but low level of use of the nursing process in the hospital. Barriers such as stressful work environment, absence of nursing process policy, lack of further nursing process training, inadequate supply of consumables and lack of nursing process clinical skills also existed in the hospital. There is the need for the hospital management and health authorities to develop a nursing process policy, supply adequate quantities of consumables and conduct periodic nursing process clinical skills training for all nurses to enhance its use for improved patient outcomes.

INTRODUCTION: antibiotic misuse is the paramount factor for antibiotic resistance. Tamale Teaching Hospital (TTH), located in Ghana´s Northern Region, is the biggest tertiary hospital in the Northern half of the country and consequently one of the biggest prescribers of antibiotics. Understanding the use of antibiotics in the TTH and providing information that could be inferred to develop strategies for antibiotic prescription is of extreme importance in this era of multiple and pan-resistant strains of pathogenic microorganisms. METHODS: a cross-sectional study on the use of antibiotics at TTH in the Northern region of Ghana was performed. Data were collected by reviewing 10% of patients´ files from January to June 2015 and then assessed for its appropriateness against the criteria based on the British National Formulary (BNF) 2015 and BNF children 2013-2014. Results were expressed in frequencies and percentages. RESULTS: a total of 617 patients´ records were included in this study. Up to 385 cases of different antibiotic misuse were found, comprising of 335 errors in prescriptions and 50 non-completed treatments. The most common prescription error was made on treatment duration (29.6%). The potential interactions were (16.7%). CONCLUSION: the study revealed a high burden of antibiotics misuse in TTH. This suggests a need for the development of an antibiotic stewardship programme for the hospital.

Introduction: antibiotic misuse is the paramount factor for antibiotic resistance. Tamale Teaching Hospital (TTH), located in Ghana's Northern Region, is the biggest tertiary hospital in the Northern half of the country and consequently one of the biggest prescribers of antibiotics. Understanding the use of antibiotics in the TTH and providing information that could be inferred to develop strategies for antibiotic prescription is of extreme importance in this era of multiple and pan-resistant strains of pathogenic microorganisms. Methods: a cross-sectional study on the use of antibiotics at TTH in the Northern region of Ghana was performed. Data were collected by reviewing 10% of patients' files from January to June 2015 and then assessed for its appropriateness against the criteria based on the British National Formulary (BNF) 2015 and BNF children 2013-2014. Results were expressed in frequencies and percentages. Results: a total of 617 patients' records were included in this study. Up to 385 cases of different antibiotic misuse were found, comprising of 335 errors in prescriptions and 50 non-completed treatments. The most common prescription error was made on treatment duration (29.6%). The potential interactions were 16.7%. Conclusion: the study revealed a high burden of antibiotics misuse in TTH. This suggests a need for the development of an antibiotic stewardship programme for the hospital. [ABSTRACT FROM AUTHOR]

Background: This research determined the rates of perinatal mortality among infants delivered under Ghana's national health insurance scheme (NHIS) compared to infants delivered under the previous "Cash and Carry" system in Northern Region, especially as the country takes stock of its progress toward meeting the Millennium Development Goals (MDG) 4 and 5. Methods: The labor and maternity wards delivery records of infants delivered before and after the implementation of the NHIS in Northern Region were examined. Records of available daily deliveries during the two health systems were extracted. Fisher's exact tests of non-random association were used to examine the bivariate association between categorical independent variables and perinatal mortality. Results: On average, 8% of infants delivered during the health user-fee (Cash & Carry) died compared to about 4% infant deaths during the NHIS delivery fee exemption period in Northern Region, Ghana. There were no remarkable difference in the rate of infant deaths among mothers in almost all age categories in both the Cash and Carry and the NHIS periods except in mothers age 35 years and older. Infants born to multiparous mothers were significantly more likely to die than those born to first time mothers. There were more twin deaths during the Cash and Carry system (p = 0.001) compared to the NHIS system. Deliveries by caesarean section increased from an average of 14% in the "Cash and Carry" era to an average of 20% in the NHIS era. Conclusion: The overall rate of perinatal mortality declined by half (50%) in infants born during the NHIS era compared to the Cash and Carry era. However, caesarean deliveries increased during the NHIS era. These findings suggest that pregnant women in the Northern Region of Ghana were able to access the opportunity to utilize the NHIS for antenatal visits and possibly utilized skilled care at delivery at no cost or very minimal cost to them, which therefore improved Ghana's progress towards meeting the MDG 4, (reducing under-five deaths by two-thirds). [ABSTRACT FROM AUTHOR]

This research determined the levels and odds ratios for low birth weight (LBW) infants delivered under the National Health Insurance Scheme (NHIS) compared to LBW infants delivered under the previous 'Cash and Carry' system in Northern Ghana. Birth records of infants delivered before and after implementation of the NHIS in Northern Ghana were examined. Records of each day's births during the identified periods were abstracted. Days with fewer or no births were accommodated by oversampling from days before or after. Chi squared tests of independence were used to examine the bivariate association between categorical independent variables and LBW. Multiple logistic regression models were used to examine the relationships among selected variables for mothers and infants and the odds ratios for LBW. Infants delivered under NHIS had lower rates of LBW (16.8 %) compared to infants born under Cash and Carry (23.3 %). Mothers who delivered under NHIS were significantly less likely to have infants at LBW (unadjusted OR 0.65; 95 % CI 0.49, 0.86). The rate of LBW among infants delivered under NHIS is significantly lower than among infants delivered under Cash and Carry. The rate of LBW under Cash and Carry in 2000 fell by 27 % in relation to the NHIS in 2010. These findings confirm that the NHIS, which gives pregnant women in Northern Ghana four antenatal visits and access to skilled health professionals for delivery at no cost to the mother, significantly improved birth weight outcomes. [ABSTRACT FROM AUTHOR]

Objective: To determine the prevalence, social demographic characteristics and types of pelvic organ prolapse that patients present with at the Tamale Teaching Hospital (TTH). Methods: A descriptive study of pelvic organ prolapses at the Tamale Teaching Hospital from 1st January 2010 to 31st December 2011. Results: The 118 pelvic organ prolapse cases constituted (2.68%) of the 4403 gynaecological out-patient cases seen during the two year study period. The mean age and standard deviation was (45.9±15.1) and the modal age group was 30-39 years with 32 (27.1%) of cases. There were 112 (94.9%) cases of uterine prolapse, 95 (80.5%) had cystocele, 16 (13.5%) patients had rectoceles and 3 (2.5%) had enterocele. Their main occupations were trading 66 (55.9%) and farming 44 (37.3%), seventy (62.5%) of the patients with uterine prolapse were premenopausal while (10) 14.3% of the premenopausal cases had an ongoing pregnancy. The parity ranged from zero to 13 with mean and standard deviation of (4.4±1.7). Fifty five (46.6%) were from the Tamale metropolis and only 12 (10.5%) had all their deliveries in hospital. The commonest complication was decubitus ulcer present in 20 (16.9%) patients, 16(80%) of it in patients with procedentia. Conclusion: Pelvic organ prolapse is not a rare gynaecological condition at the Tamale Teaching Hospital. The patients are relatively young and are from various districts in the northern region. Some occupational, socio-cultural practices and reproductive characteristics may be contributory to severity of pelvic organ prolapse. [ABSTRACT FROM AUTHOR]

Background: Blood transfusion is an essential component of the health care system of every country and patients who require blood transfusion service as part of the clinical management of their condition have the right to expect that sufficient and safe blood will be available to meet their needs. However, this is not always the case, especially in developing countries. To recruit and retain adequate regular voluntary non-remunerated blood donors the motivators and barriers of donors must be understood. Equally important to this goal is the knowledge of blood donors. Methodology: A cross-sectional study was conducted at the donor clinic of Tamale Teaching Hospital in the Northern Region of Ghana from 06 January to 02 February 2018. Purposive sampling technique was used to sample 355 eligible first-time and repeat whole blood donors. Data were collected face-to-face with a 27-item self-administered questionnaire. Chi-square test was used to determine the association between donor status and the motivators of blood donation, barriers to blood donation and the socio-demographic characteristics of donors. Results: Out of the 350 donors, 192(54.9%) were first-time blood donors while 158 (45.1%) were repeat donors. Nearly all the donors, 316(90.3%), indicated they were motivated to donate when someone they know is in need of blood. Over four-fifths of the donors endorsed good attitude of staff (n = 291, 83.4%) and the desire to help other people in need of blood (n = 298, 85.1%) as motivators. Approximately two-thirds, 223(63.7%), of the donors endorsed poor attitude of staff as a deterrent to blood donation. More than half of the donors considered the level of privacy provided during pre-donation screening (n = 191, 54.6%) and the concern that donated blood may be sold 178(50.9%) as deterrents. Only a little over one-third of the donors knew the minimum age for blood donation (n = 126, 36.0%) and the maximum number of donations per year (n = 132, 37.7%). Conclusion: Our findings suggest that public education on blood donation, regular prompts of donors to donate when there is a shortage, and friendly attitude of staff have the potential to motivate donors and eliminate barriers to blood donation. [ABSTRACT FROM AUTHOR]

Background: Transfusion of bacterially contaminated blood can result in sepsis and will constitute a substantial health burden to the patient., Objective: To assess the level of transfusion related sepsis and the bacterial types responsible for the contamination at the Tamale Teaching Hospital in Ghana., Method: We sampled 80 refrigerated donor blood at the blood bank and cultured them for bacteria. The antimicrobial sensitivities of the isolates were also determined., Results: 14 blood bags representing 17.5% grew isolates of various bacteria. Ten (10) of the 14 isolates were Gram positive cocci representing 71.42% making it the commonest contaminant. 50% of the gram positive cocci were identified to be coagulase negative staphylococci and 21.42% were Staphylococcus aureus. There were 14.28% isolates which were Gram positive rods, and were identified to be Corynebacterium diphtheroids. There were two isolates which were Gram negative rods; one was identified as Escherichia coli and the other one Klebsiella pneumoniae. Sensitivity among the organisms were varied; as all the 14 (100%) of the organisms isolated were sensitive to amikacin, only 14.28% of the coagulase negative staphylococci were sensitive to co-trimoxazole, 28.5% were sensitive to ampicillin, 42.8% were sensitive to cefuroxime and 71.4% were sensitive to ciprofloxacin. Sensitivity to gentamicin was observed to be 85.7% and 28.5% were sensitive to Tetracycline. Only the 10 Gram positive cocci were tested against erythromycin and Cloxacillin; where 70.00% were sensitive to cloxacillin and 90% were sensitive to erythromycin., Conclusion: All the Staphylococcus aureus isolated were resistant to both ampicillin and cotrimoxazole. Potential dangers and consequences of transfusing multidrug resistance bacteria have been discussed.