211 research outputs found
Professor Jacob Plange-Rhule
No full textThe usual quiet morning of Good Friday, April 10, 2020, was shattered by the spreading news of the death of Professor Jacob Plange-Rhule. For many persons the news elicited sentiments of grief and outpouring of statements on the good natureof the third Rector of the Ghana College of Physicians and Surgeons. Even though he died at the age of 62 years, his footprints will remain in several places where his feet hath trod in academia, medical education, medical ‘politics’, golf andfamily life
A community programme to reduce salt intake and blood pressure in Ghana
No full textBackground
In Africa hypertension is common and stroke is increasing. Detection, treatment and control of high blood pressure (BP) is limited. BP can be lowered by reducing salt intake. In Africa salt is added to the food by the consumer, as processed food is rare. A population-wide approach with programmes based on health education and promotion is thus possible.
Methods
We carried out a community-based cluster randomised trial of health promotion in 1,013 participants from 12 villages (628 women, 481 rural dwellers); mean age 55 years to reduce salt intake and BP. Average BP was 125/74 mmHg and urinary sodium (UNa) 101 mmol/day. A health promotion intervention was provided over 6 months to all villages. Assessments were made at 3 and 6 months. Primary end-points were urinary sodium excretion and BP levels.
Results
There was a significant positive relationship between salt intake and both systolic (2.17 mmHg [95% CI 0.44 to 3.91] per 50 mmol of UNa per day, p < 0.001) and diastolic BP (1.10 mmHg [0.08 to 1.94], p < 0.001) at baseline. At six months the intervention group showed a reduction in systolic (2.54 mmHg [-1.45 to 6.54]) and diastolic (3.95 mmHg [0.78 to 7.11], p = 0.015) BP when compared to control. There was no significant change in UNa. Smaller villages showed greater reductions in UNa than larger villages (p = 0.042). Irrespective of randomisation, there was a consistent and significant relationship between change in UNa and change in systolic BP, when adjusted for confounders. A difference in 24-hour UNa of 50 mmol was associated with a lower systolic BP of 2.12 mmHg (1.03 to 3.21) at 3 months and 1.34 mmHg (0.08 to 2.60) at 6 months (both p < 0.001).
Conclusion
In West Africa the lower the salt intake, the lower the BP. It would appear that a reduction in the average salt intake in the whole community may lead to a small but significant reduction in population systolic BP
Assessment of GFR by four methods in adults in Ashanti, Ghana : the need for an eGFR equation for lean African populations
No full textBackground. Equations for estimating glomerular filtration rate (GFR) have not been validated in Sub-Saharan African populations, and data on GFR are few.
Methods. GFR by creatinine clearance (Ccr) using 24-hour urine collections and estimated GFR (eGFR) using the four-variable Modification of Diet in Renal Disease (MDRD-4)[creatinine calibrated to isotope dilution mass spectrometry (IDMS) standard], Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) and Cockcroft–Gault equations were obtained in Ghanaians aged 40–75. The population comprised 1013 inhabitants in 12 villages; 944 provided a serum creatinine and two 24-hour urines. The mean weight was 54.4 kg; mean body mass index was 21.1 kg/m2.
Results. Mean GFR by Ccr was 84.1 ml/min/1.73m2; 86.8% of participants had a GFR of 60 ml/min/1.73m2. Mean MDRD-4 eGFR was 102.3 ml/min/1.73m2 (difference vs. Ccr, 18.2: 95% CI: 16.8–19.5); when the factor for black race was omitted, the value (mean 84.6 ml/min/1.73m2) was close to Ccr. Mean CKD-EPI eGFR was 103.1 ml/min/1.73m2, and 89.4 ml/min/1.73m2 when the factor for race was omitted. The Cockcroft–Gault equation underestimated GFR compared with Ccr by 9.4 ml/min/1.73m2 (CI: 8.3–10.6); particularly in older age groups. GFR by Ccr, and eGFR by MDRD-4, CKD-EPI and Cockcroft–Gault showed falls with age: MDRD-4 5.5, Ccr 7.7, CKD-EPI 8.8 and Cockcroft–Gault 11.0 ml/min/1.73m2/10 years. The percentage of individuals identified with CKD stages 3–5 depended on the method used: MDRD-4 1.6% (7.2 % without factor for black race; CKD-EPI 1.7% (4.7% without factor for black race), Ccr 13.2% and Cockcroft–Gault 21.0%.
Conclusions. Mean eGFR by both MDRD-4 and CKD-EPI was considerably higher than GFR by Ccr and Cockcroft–Gault, a difference that may be attributable to leanness. MDRD-4 appeared to underestimate the fall in GFR with age compared with the three other measurements; the fall with CKD-EPI without the adjustment for race was the closest to that of Ccr. An equation tailored specifically to the needs of the lean populations of Africa is urgently needed. For the present, the CKD-EPI equation without the adjustment for black race appears to be the most useful
An Assessment of Usual Salt Intake among Older Normotensive Adults in Atonsu, a Suburb of Kumasi in the Ashanti Region of Ghana
No full textBackground. Globally, sodium intake has been found to be far above the normal level required by the body. Within countries, variations in salt intake exist between rural communities and urban communities. Experimental and epidemiological studies as well as studies involving clinical trials show the existence of adverse effect of salt consumption on the blood pressure of adults. The study evaluated salt intake among older normotensive adults in Atonsu, a suburb of Kumasi in the Ashanti region of Ghana. Methods. Participants were randomly selected from five churches which constituted cluster samples. A questionnaire was administered to participants for demographic information and dietary and lifestyle assessments. The study targeted 100 participants, twenty from each of the five churches. Eighty-two individuals gave their informed consent. Out of the 82 who gave their informed consent, 15 withdrew and 67 completed the course. The 67 participants comprised 36 (53.7%) men and 31 (46.3%) women. Systolic and diastolic blood pressure, BMI, urinary sodium, urinary potassium, serum creatinine, serum sodium, and serum potassium concentrations were also measured. Results. Participants’ mean age was 52.3 ± 8.7 years. Participants had 24 hr urinary sodium excretion of 153.0 ± 26.9 mmol/day. All participants indicated that they consume foods high in salt even though none of them added salt to their diet at table. Mean 24 hr urinary potassium was 52.5 ± 12.9 mmol/day. Mean systolic blood pressure was 119.9 ± 10.8 mmHg and mean diastolic blood pressure was 72.5 ± 7.3 mmHg. Their mean BMI was 23.7 ± 3.5 kg/m2. Conclusion. The participants who can be described as quite old and normotensive were high salt consumers, indicated by their dietary assessment and urinary sodium excretion, even though they had normal blood pressure
The Kathmandu Declaration on Global CVD/Hypertension Research and Implementation Science: A Framework to Advance Implementation Research for Cardiovascular and Other Noncommunicable Diseases in Low- and Middle-Income Countries
No full textHighlights NCD represent a serious challenge globally, particularly in LMIC.Implementation research capacity building are critical to inform the prevention and control of NCD in LMIC.Sustainable evidence-based strategies can reduce mortality and prevent avoidable illness from NCD.Strategic change agents (i.e., key stakeholders, institutions, communities, health systems, patients, and families) should work collaboratively to make the necessary advancements to reducing the burden of NCD in LMIC.Fil: Aifah, Angela. No especifíca;Fil: Iwelunmor, Juliet. No especifíca;Fil: Akwanalo, Constantine. No especifíca;Fil: Allison, Jeroan. Massachusetts Institute of Technology; Estados UnidosFil: Amberbir, Alemayehu. No especifíca;Fil: Asante, Kwaku P.. No especifíca;Fil: Baumann, Ana. Washington University in St. Louis; Estados UnidosFil: Brown, Angela. Washington University in St. Louis; Estados UnidosFil: Butler, Mark. No especifíca;Fil: Dalton, Milena. No especifíca;Fil: Davila Roman, Victor. Washington University in St. Louis; Estados UnidosFil: Fitzpatrick, Annette L.. No especifíca;Fil: Fort, Meredith. State University of Colorado at Boulder; Estados UnidosFil: Goldberg, Robert. No especifíca;Fil: Gondwe, Austrida. No especifíca;Fil: Ha, Duc. No especifíca;Fil: He, Jiang. University of Tulane; Estados UnidosFil: Hosseinipour, Mina. No especifíca;Fil: Irazola, Vilma. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; ArgentinaFil: Kamano, Jemima. No especifíca;Fil: Karengera, Stephen. Washington University in St. Louis; Estados UnidosFil: Karmacharya, Biraj M.. No especifíca;Fil: Koju, Rajendra. No especifíca;Fil: Maharjan, Rashmi. No especifíca;Fil: Mohan, Sailesh. No especifíca;Fil: Mutabazi, Vincent. No especifíca;Fil: Mutimura, Eugene. No especifíca;Fil: Muula, Adamson. No especifíca;Fil: Narayan, K.M.V.. University of Emory; Estados UnidosFil: Nguyen, Hoa. No especifíca;Fil: Njuguna, Benson. No especifíca;Fil: Nyirenda, Moffat. No especifíca;Fil: Ogedegbe, Gbenga. No especifíca;Fil: van Oosterhout, Joep. No especifíca;Fil: Onakomaiya, Deborah. No especifíca;Fil: Patel, Shivani. University of Emory; Estados UnidosFil: Paniagua-Ávila, Alejandra. No especifíca;Fil: Ramirez zea, Manuel. No especifíca;Fil: Plange Rhule, Jacob. No especifíca;Fil: Roche, Dina. No especifíca;Fil: Shrestha, Archana. No especifíca;Fil: Sharma, Hanspria. No especifíca;Fil: Tandon, Nikhil. No especifíca;Fil: Thu Cuc, Nguyen. No especifíca;Fil: Vaidya, Abhinav. No especifíca;Fil: Vedanthan, Rajesh. No especifíca;Fil: Weber, Mary Beth. University of Emory; Estados Unido
Sustaining Nurse-Led Task-Shifting Strategies for Hypertension Control: A Concept Mapping Study to Inform Evidence-Based Practice
No full text
Lithium clearance in dogs: effects of water loading, amiloride and lithium dosage
No full textFarmakologi, Amiloride, Lithium clearance, Arginine vasopressin, tubular lithium reabsorptio
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