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Expectations of Caregivers of Patients with Cleft Lip and Palate Attending the Cleft Clinic of KATH for the First Time

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Surgical Science 2022年第10期13卷 449-459页

作者： Emile Kouakou Tano Priscilla Felicia Tano Paa Ekow Hoyte-Williams alexander Oti Acheampong Peter Donkor Solomon Obiri Yeboah Department of Surgery Komfo Anokye Teaching Hospital Kumasi Ghana School of Medicine and Dentistry Kwame Nkrumah University of Science and Technology Kumasi Ghana

Background: Cleft lip and palate (CLP) is one of the most prevalent congenital malformations affecting the face worldwide, with high prevalence in Asians, Americans, and Caucasians and low in Africans. Orofacial Clefts (OFCs) are among the causes of perinatal death in Ghana. The children often experience difficulties in swallowing, feeding, and speaking. These children often face problems in cognition, education, and communication. Caregivers’ ignorance of treatment, poverty, and noncompliance with follow-up schedules are obstacles to optimal cleft care. Most studies focus on the incidence of cleft, but not much is known about caregivers’ expectations. Methodology: An exploratory qualitative study design was used for this research between October and November 2020. The study site was the Komfo anokye Teaching Hospital, (KATH), Kumasi, Ghana. The respondents were recruited from the oral health clinic. Included in the study were all CLP caregivers attending the cleft clinic for the first time. Purposive sampling was used to select fifteen caregivers who met the inclusion criteria. Face-to-face interviews with a semi-structured interview guide were used to collect data. The data were analyzed using NVivo software. Three major themes and six sub-themes emerged from the data analysis using thematic analysis. Ethical clearance was obtained for data collection. Results: Most caregivers were expecting their babies to be operated on, and they were certain that the cleft would be repaired at the end of the treatment, but they were unfamiliar with the process and cost of treatment. Less than half of the caregivers reported that they were oblivious to what to expect the first time visiting but had hopes that the healthcare professionals would be able to close the cleft for their babies. Conclusion: The majority of the caregivers expressed fear and disappointment at the diagnosis of their child. Some caregivers were very scared to the level where they had to hide the babies from

关键词： Cleft Lip and Palate Caregivers Congenital Abnormalities Malformation

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Bacteriology and Antibiotic Sensibility Associated with Extracted Carious Teeth: A Cross Sectional Study at Komfo anokye Teaching Hospital, Kumasi, Ghana

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Open Journal of Stomatology 2020年第5期10卷 87-96页

作者： Ama Agyeibea Amuasi alexander Oti Acheampong Collins Kokuro Alex Ofori Kpedekpo Yayra Joseph Abu-Sakyi Francis Adu-Ababio School of Medicine and Dentistry Kwame Nkrumah University of Science and Technology Kumasi Ghana Komfo anokye Teaching Hospital Kumasi Ghana

Background: Many oral bacterial species forming the normal flora present as a biofilm in the oral cavity. Dental caries results when there is an imbalance of pathogenic bacteria within these biofilms. Aim: This study sought to isolate and identify the bacterial species associated with extracted carious teeth and their susceptibility pattern towards commonly employed antimicrobial agents used at the Komfo anokye Teaching Hospital (KATH). Methodology: A descriptive cross-sectional study carried out on thirty-three extracted carious teeth samples collected by convenient sampling from patients attending the Oral Health Directorate-KATH. All samples were collected from the 11th of March 2019 to the 6th of April 2019. Data was collected using 5 ml peptone water and a case study form. Analysis was done using SPSS version 25 and Microsoft Excel version 10. Results: Twenty (61%) samples were obtained from female patients and thirteen samples (39%) from male patients. Streptococcus spp had the highest occurrence (32.25%) with the least isolated being Pseudomonas and E. coli spp (6.45%). Antibiotic susceptibility test revealed Pseudomonas spp was resistant to all the eight antibiotics used in this study. All bacterial isolates were resistant to Cefuroxime and penicillin except Staphylococcus and Streptococcus spp. Conclusion: The commonest isolates associated with dental caries in KATH were Streptococcus, Bacillus and Staphylococcus spp. In this study most of the isolated species were resistant to common antibiotics employed in the Oral Health Directorate in KATH (amoxicillin/clavulanic, ampicillin and penicillin). From the current study the most effective antibiotic observed was meropenem (23%) with penicillin (3%) being least effective in treating infections of caries.

关键词： Caries Bacteria Teeth Antibiotic Resistance

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Evaluation of the Golden Proportion in Patients Visiting the Oral Health Directorate of the Komfo anokye Teaching Hospital, Kumasi

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Journal of Biosciences and Medicines 2020年第8期8卷 116-126页

作者： Ama Agyeibea Amuasi alexander Oti Acheampong Shadrack Owusu Robert Larmie Daniel K. Sabbah Angela-Ruth Buabeng David Edem Dompey School of Medicine and Dentistry Kwame Nkrumah University of Science and Technology Kumasi Ghana Komfo anokye Teaching Hospital Kumasi Ghana The Greater Accra Regional Hospital Ridge Ghana

Background: Aesthetics is a primary consideration for patients seeking dental treatment. The size and shape of the maxillary anterior teeth have significant effects not only on the dental aesthetics, but also on the complete facial aesthetics of a person. To satisfy this expressed need, the “Golden Proportion” is a numerical value that is used as a rule in achieving dental aesthetics. In the last two decades, several studies have questioned the application of this rule in dentistry. Aim: The aim of this study is to evaluate the presence of “The Golden Proportion in the maxillary anterior teeth widths of clients visiting the Komfo anokye Teaching Hospital’s (KATH) Oral Health Directorate, Kumasi”. Materials and methods: A total of 100 dentulous subjects comprised of 50 males and 50 females, with ages ranging between 18 and 37 years were chosen using convenience sampling. Their dental casts were evaluated for apparent width by digital calliper. Results: The results of the study were expressed in relation to gender and tooth laterality. The results revealed that the golden proportion existed in 14% and 20% for the left and right respectively between the central incisor and the lateral incisor for males, 12% and 16% respectively for the left and right sides of females, 8% and 20% for the left and right sides respectively for males between the lateral incisor and canine and 16% and 20% for the left and right respectively for females. Conclusion: Comparison of our results with the established golden value shows differences between 1.618 and from the range that was acquired from this study. The results suggest that the rule of the golden proportion should not be strictly applied when restoring anterior teeth of patients in the dental clinic.

关键词： Golden Proportion Dental Cast Analysis Smile Aesthetics

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Immunisation Status of Children Born with Orofacial Clefts Who Visited the Komfo anokye Teaching Hospital (KATH) Multidisciplinary Cleft Clinic

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Open Journal of Immunology 2016年第4期6卷 148-153页

作者： alexander Oti Acheampong Alex Ansah Owusu Ama Amuasi Philippe Pare Sandra Oyakhilome Baffour Gyau-Darko Gyikua Plange-Rhule Peter Donkor Dental School Kwame Nkrumah University of Science and Technology Kumasi Ghana School of Medical Sciences Kwame Nkrumah University of Science and Technology Kumasi Ghana Komfoanokye Teaching Hospital Kumasi Ghana

Background: The Ghana Expanded Programme on Immunisation recommends that children receive Bacillus Calmette-Guerin (BCG) and Oral Polio Vaccine (OPV) at birth;three doses of Penta vaccine and OPV at 6, 10 and 14 weeks of age;and measles vaccine at 9 months of age. Aim/Objective: To evaluate the immunisation status of children born with orofacial clefts who visited the KATH multidisciplinary Cleft clinic. Methodology/Statistics: The study was a descriptive study with a cross-sectional design. The methodology consisted of in-person interviews of mothers of children born with cleft lip and palate reporting at KATH Cleft clinic. Interview guides were used for mothers who could not read. Mothers who were literate and as such could answer the questions directly were given questionnaires to fill. Result: It was reported that of the 83 children included, 47 (57%) had been fully vaccinated and on time, 24 (29%) had been fully vaccinated but delayed and 12 (14%) had not been vaccinated at all. Children with isolated cleft palate and macrostomia were fully vaccinated on time (77.3% and 100%, respectively) as compared to those with combined cleft lip and palate (43.3%) and isolated cleft lip (50.0%). The majority (77%) of the mothers who either had not vaccinated their children or had delayed in vaccinating them attributed stigmatisation as the main cause. Most of the mothers (95%) had knowledge of immunisation. About two-thirds of the mothers (65%) agreed that establishing an immunisation centre at the cleft clinic is the best way to improve immunisation rate among children with orofacial clefts. Conclusion: The study showed that the percentage of children with orofacial cleft who visited the KATH Cleft Clinic and were vaccinated on time was above the national average. Cleft palates were more vaccinated and on time than cleft lips. According to the children’s mothers, lack of timely vaccination was mainly due to the stigma associated with clefts in their societies.

关键词： Cleft Lip Cleft Palate Combined Cleft Lip and Palate Immunisation Vaccination Stigma

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Non-Random Distribution of Human Orofacial Clefts in Ghana: Gene-Environment Interactions

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Open Journal of Stomatology 2018年第2期8卷 35-52页

作者： Lord Jephthah Joojo Gowans Solomon Obiri-Yeboah alexander Acheampong Oti Fareed Kow Nanse Arthur Peter Twumasi Pius Agbenorku Gyikua Plange-Rhule Peter Donkor Department of Biochemistry and Biotechnology Kwame Nkrumah University of Science and Technology (KNUST) Kumasi Ghana Department of Oral and Maxillofacial Surgery Dental School KNUST Kumasi Ghana Cleft-Craniofacial Clinic Komfo Anokye Teaching Hospital (KATH) Kumasi Ghana Department of Surgery School of Medical Sciences KNUST Kumasi Ghana Department of Child Health School of Medical Sciences KNUST Kumasi Ghana

Human orofacial clefts (OFCs) are congenital anomalies that result from the breakdown of normal mechanisms that regulate the formation of the human face. They could be syndromic or non-syndromic, with a global incidence of 1:700 per live births. Environmental and genetic factors are thought to play various roles in the aetiology of OFCs. This study seeks to establish the diversity, distribution and pattern of inheritance of OFCs as well as environmental and other risk factors associated with OFCs in a Ghanaian population. A family-based, descriptive cross-sectional study that employed an interview-based survey questionnaire was used to obtain information from 467 families with history of OFCs. We employed chi-square statistics to analyse the data and used graphs to interpret the data. All previously reported subphenotypes of OFCs were observed by the present study. Clinically, about 12% of clefts in the study population were syndromic. The most common syndromic forms observed were Pierre Robin Sequence, cleft-with-club foot abnormalities and Van der Woude Syndrome. Only about 5% of clefts in the study cohort were familial. The study also established that lower level of education of parents, poverty, late antenatal care and dietary folate deficiency are major environmental factors associated with clefts in the Ghanaian population. In conclusion, OFCs are non-randomly distributed in Ghana and folate deficiency could likely be a source of genetic mutations and “epimutations” that cause OFCs, since folate is essential for DNA methylation, replication and repair as well as histone modification.

关键词： Orofacial Clefts (OFCs) Folate Deficiency Low Socio-Economic Status Non-Random Distribution Pattern of Inheritance

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Surgical Science 2019年第3期10卷 106-112页

作者： alexander Oti Acheampong Merley Newman-Nartey Solomon Obiri-Yeboah Jonathan Mensah Ama Amuasi Daniel Sabbah Jonathan Olesu Elijah Ebenezer Asamoah Robert Nii Lamy Larmie Peter Donkor School of Medicine and Dentistry Kwame Nkrumah University of Science and Technology Kumasi Ghana School of Medicine and Dentistry University of Ghana Accra Ghana Komfoanokye Teaching Hospital Kumasi Ghana

Background: Motorcycle related injuries have become a major public health problem because the increased use of motorcycles has been accompanied with a corresponding increase of road traffic accidents. Objective: The purpose of this study was to evaluate the occurrence of oral and maxillofacial injuries associated with motorcycles as seen at the second largest Teaching Hospital in Ghana, the Komfo anokye Teaching Hospital (KATH). Method and Materials: The compiled data that were reviewed for this retrospective study were obtained from the Accident and Emergency unit of KATH. These comprised 135 successive maxillofacial trauma patient records entered from August 2017 to August 2018. Results: Total number of road traffic related injuries seen at OMFS was 135 during the study period. Out of this number, 66 were related to motorcycle injuries. This represented 48.7% of the Road Traffic Accidents seen at oral and maxillofacial surgery department (OMFS). The age range was from 3 to 64 years. The average age was 26.7 years. 62 (93.9%) were males and 4 (6.1%) were females. 16 (24.2%) of the motorcycle injuries were caused by the “Okada”, 2 (3.0%) by “Pragia” and 48 (72.8%) by the “Aboboyaa”. 46 (69.7%) of the motorcycles victims were themselves the riders, 12 (18.2%) were pedestrians and 8 (12.1%) were passengers. There were 8 deaths. 6 (75.0%) of the deaths were caused by the “Aboboyaa”. “Okada” accounted for only 2 (15.0%) deaths. Concerning the riders and the passengers, only 8 (14.8%) of the victims were helmeted. The majority were unhelmeted (85.2%). Conclusion: Motorcycle transportation is the cause of many oral and maxillofacial injuries. Majority of the victims suffered multiple facial bone fractures. Males were more often affected than females and the majority were unhelmeted.

关键词： Motorcycle Oral Maxillofacial Injuries Kumasi

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Informed Consent under the Ghana Health Service Patients Charter: Practice and Awareness

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Journal of Biosciences and Medicines 2016年第4期4卷 63-67页

作者： alexander Acheampong Oti Ernest Owusu-Dapaah Chris Adomako-Kwaakye Daniel Kwesi Sabbah Solomon Obiri-Yeboah Ama Amuasi Adu Tutu Amankwa Ebenezer Adjei-Bediako Eva Adu-Boakye Dental School Kwame Nkrumah University of Science and Technology Kumasi Ghana School of Medical Sciences Kwame Nkrumah University of Science and Technology Kumasi Ghana Faculty of Law Kwame Nkrumah University of Science and Technology Kumasi Ghana Family Medicine Directorate Komfo Anokye Teaching Hospital Kumasi Ghana

Background: Every human being of adult years and sound mind has a right to determine what shall be done with his/her own body. Patient autonomy and the practice of informed patient consent are now pivotal in medical practice. Aim: To assess patient’s knowledge of Patients’ Rights Charter and whether patients receive adequate information to enable them make an informed consent to a particular treatment. Methodology: Patients who were undergoing elective surgery from selected surgical departments of Komfo anokye teaching hospital in Kumasi were randomly selected and assisted to answer structured questionnaire without the knowledge of their doctors. The study period was in June to December (2014). Descriptive analysis was done using SPSS (II) of the results. Results: 84.7% (144) had no idea about the Patients’ Rights Charter of the Ghana Health Service. 75% (128) did not know or had not heard of informed patient consent. Of those who knew of the charter, 85% (37) had ever stayed in a developed country. 60% (102) did not know of their diagnosis. 79% (134) said the doctor only asked them to either sign or thumb print the consent document without giving them treatment options or possible complications. Conclusion: Most of respondents undergoing various surgical procedures at the Komfo anokye Teaching Hospital were not aware of the existence of the Patients’ Rights Charter of the Ghana Health Service. Again, practitioners did not provide sufficient information to patients for them to make an informed decision about their health.

关键词： Informed Consent Patient Charter Autonomy

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Etiology, Prevalence, and Management of Oral and Maxillofacial Soft Tissue Injuries in Children at the Komfo anokye Teaching Hospital, Kumasi-Ghana

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Open Journal of Stomatology（口腔学期刊） 2023年第8期

作者： Robert Nii Lamy Larmie Ama Agyeibea Amuasi Solomon Obiri-Yeboah alexander Oti Acheampong Peter Donkor

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Maxillofacial Injuries at the Komfo anokye Teaching Hospital, Kumasi, Ghana: A Preliminary Study

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Open Journal of Stomatology（口腔学期刊） 2021年第3期

作者： Solomon Obiri-Yeboah Robert Nii Lamy Larmie Nana Tuffour Ampem Gyimah alexander Oti Acheampong Elijah Asomaoh Peter Donkor

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