Introduction: Prostate cancer is gradually reaching a very high incidence in Africa, especially in the Sub-saharan region. Understanding the dynamics in occurrence of the disorder is one approach to developing effecti...Introduction: Prostate cancer is gradually reaching a very high incidence in Africa, especially in the Sub-saharan region. Understanding the dynamics in occurrence of the disorder is one approach to developing effective public health programmes and interventions that will help curb the rising incidence. Objective: This study was aimed at reducing the paucity of data on prostate cancer by assessing the incidence, patterns and presentation in the Brong Ahafo Region of Ghana. We sought to provide region-specific hardcore data that will help to assess the issue and provide remedies. Method and Materials: All prostate disease cases recorded from the year 2009 to 2014 were retrospectively reviewed. Subjects from 40 years (based on previous studies) and above were eligible for screening. Diagnostic and screening tools for prostate cancer at the study site were family history, serum prostate specific antigen (PSA) test, digital rectal examination, urological ultrasound scan and histopathology (biopsy). Age, PSA values and year of screening/diagnosis were also retrieved from patient folders/archives for the purposes of the study. Histological findings and parameters considered in the study included diagnosis, carcinoma grading, perineural invasion (PNI) and percentage of affected tissues (%TA). Results: Prostate cancer constituted 236 cases (40.07%) of the 589 prostate diseases reviewed. The highest annual prevalence was recorded in 2014 with an incidence rate of 21.6% (51 cases). The ages of patients ranged from 46 to 101 years with a modal age range of 70 - 79 years and a mean ± SD of 71.7 ± 11.2. The mean PSA value recorded was 37.5 ng/ml (±68.9) with predominance in the 11 - 20.9 ng/ml (61 cases/patients) (27.9%) range. Moderately differentiated adenocarcinoma was the dominant grade of prostate cancer accounting for 61.4% (145 cases) of the 236 cases. There was a significant correlation (p = 0.001) between grading of prostate cancer and perineural invasion. Only 21.2% graded cancer cases had perineural invasion with >50% affected tissues found in half of them. Conclusion: There is a high incidence (40.07%) of prostate cancer in the Brong Ahafo Region of Ghana, presenting mostly with advanced prostatic carcinoma. Reported cases also show high %TA and PNI. Development and implementation of public health interventions are needed to address some of these issues.展开更多
Background:This study assessed the quality,core and support functions of the integrated disease surveillance and response(IDSR)system relating to 18 suspected cases of Ebola virus disease(EVD)in the Brong Ahafo Region...Background:This study assessed the quality,core and support functions of the integrated disease surveillance and response(IDSR)system relating to 18 suspected cases of Ebola virus disease(EVD)in the Brong Ahafo Region,Ghana.Methods:Data was collected on selected indicators of the surveillance system relating to 18 suspected cases of EVD,from epidemiological week 19 to 45 of 2014.We conducted in-depth interviews with seven medical directors and two district directors of health services,and also reviewed documentation on the implementation of the core,support and quality functions of the IDSR system.We also monitored news in the media and rumours about EVD within the community as well as in health facility surveillance registers.Results:The study identified gaps in the implementation of IDSR relating to 18 suspected cases of EVD.Health staff heavily relied on haemorrhage as the only symptom for detection of suspected EVD cases.Twelve blood samples and a swab of secretions from the mouth of the thirteenth patient(who died)tested negative for EVD using PCR assay in laboratory confirmation.The blood samples of three patients were discarded,as they did not fit the case definition for suspected cases,whilst two refused for their blood samples to be taken.The community-based surveillance(CBS)system has not been given a prominent role in EVD surveillance and response,as demonstrated by CBS volunteers and health staff not receiving any training in these processes.There was intense public interest in EVD in August and September 2014.That interest has since waned for reasons that have to be formally ascertained.Unfounded fear of and anxiety about EVD still remain challenges due to a lack of in-depth knowledge about the disease in Ghana.Conclusion:Ghana has been one of the pioneers in the implementation of IDSR in Africa.Despite this,gaps have been identified in the implementation of IDSR relating to EVD in the Brong Ahafo Region.To address these gaps,the CBS system has to actively partner with health facility surveillance to achieve effective IDSR in the region.展开更多
文摘Introduction: Prostate cancer is gradually reaching a very high incidence in Africa, especially in the Sub-saharan region. Understanding the dynamics in occurrence of the disorder is one approach to developing effective public health programmes and interventions that will help curb the rising incidence. Objective: This study was aimed at reducing the paucity of data on prostate cancer by assessing the incidence, patterns and presentation in the Brong Ahafo Region of Ghana. We sought to provide region-specific hardcore data that will help to assess the issue and provide remedies. Method and Materials: All prostate disease cases recorded from the year 2009 to 2014 were retrospectively reviewed. Subjects from 40 years (based on previous studies) and above were eligible for screening. Diagnostic and screening tools for prostate cancer at the study site were family history, serum prostate specific antigen (PSA) test, digital rectal examination, urological ultrasound scan and histopathology (biopsy). Age, PSA values and year of screening/diagnosis were also retrieved from patient folders/archives for the purposes of the study. Histological findings and parameters considered in the study included diagnosis, carcinoma grading, perineural invasion (PNI) and percentage of affected tissues (%TA). Results: Prostate cancer constituted 236 cases (40.07%) of the 589 prostate diseases reviewed. The highest annual prevalence was recorded in 2014 with an incidence rate of 21.6% (51 cases). The ages of patients ranged from 46 to 101 years with a modal age range of 70 - 79 years and a mean ± SD of 71.7 ± 11.2. The mean PSA value recorded was 37.5 ng/ml (±68.9) with predominance in the 11 - 20.9 ng/ml (61 cases/patients) (27.9%) range. Moderately differentiated adenocarcinoma was the dominant grade of prostate cancer accounting for 61.4% (145 cases) of the 236 cases. There was a significant correlation (p = 0.001) between grading of prostate cancer and perineural invasion. Only 21.2% graded cancer cases had perineural invasion with >50% affected tissues found in half of them. Conclusion: There is a high incidence (40.07%) of prostate cancer in the Brong Ahafo Region of Ghana, presenting mostly with advanced prostatic carcinoma. Reported cases also show high %TA and PNI. Development and implementation of public health interventions are needed to address some of these issues.
文摘Background:This study assessed the quality,core and support functions of the integrated disease surveillance and response(IDSR)system relating to 18 suspected cases of Ebola virus disease(EVD)in the Brong Ahafo Region,Ghana.Methods:Data was collected on selected indicators of the surveillance system relating to 18 suspected cases of EVD,from epidemiological week 19 to 45 of 2014.We conducted in-depth interviews with seven medical directors and two district directors of health services,and also reviewed documentation on the implementation of the core,support and quality functions of the IDSR system.We also monitored news in the media and rumours about EVD within the community as well as in health facility surveillance registers.Results:The study identified gaps in the implementation of IDSR relating to 18 suspected cases of EVD.Health staff heavily relied on haemorrhage as the only symptom for detection of suspected EVD cases.Twelve blood samples and a swab of secretions from the mouth of the thirteenth patient(who died)tested negative for EVD using PCR assay in laboratory confirmation.The blood samples of three patients were discarded,as they did not fit the case definition for suspected cases,whilst two refused for their blood samples to be taken.The community-based surveillance(CBS)system has not been given a prominent role in EVD surveillance and response,as demonstrated by CBS volunteers and health staff not receiving any training in these processes.There was intense public interest in EVD in August and September 2014.That interest has since waned for reasons that have to be formally ascertained.Unfounded fear of and anxiety about EVD still remain challenges due to a lack of in-depth knowledge about the disease in Ghana.Conclusion:Ghana has been one of the pioneers in the implementation of IDSR in Africa.Despite this,gaps have been identified in the implementation of IDSR relating to EVD in the Brong Ahafo Region.To address these gaps,the CBS system has to actively partner with health facility surveillance to achieve effective IDSR in the region.
