The diverse influence of liver function on drug disposition can lead health-care practitioners to inappropriate drug selection, inappropriate drug dosing, or some level of therapeutic negativism. The aim of this study was to assess how drug prescribing in patients with liver cirrhosis at the Tamale Teaching Hospital comply with recommendations of pharmacotherapy and safety guidelines. A prospective cross-sectional study was conducted from February to July, 2019, at the medical ward of the Tamale Teaching Hospital. A total of 152 liver cirrhotic patients were included in this study. Common etiologies for liver cirrhosis were chronic hepatitis B 80 (52.6%) and chronic hepatitis C 30 (19.7%); about 12.5% of etiologies were unknown. Of the 1842 prescription issued, 69% (1270/1842) were compliant. Of the 572 noncompliant prescriptions, about 32% (183/572) were due to pharmacotherapy and 68% (389/572) due to safety guideline recommendations. There was a substantial number (31%) of prescription noncompliance with recommendations for pharmacotherapy and safety guidelines in liver cirrhotic patients at the tertiary hospital in northern Ghana. Prescribers need to be conscious of the role of the liver in drug elimination and prescribe as recommended by guidelines.

There is dearth of data on the epidemiology of chronic liver diseases (CLDs) in northern Ghana. To this extent, we intended to investigate the distribution and determinants of the etiologies and complications of CLDs at the Tamale Teaching Hospital, a referral hospital of northern Ghana. The medical records of patients with CLDs admitted at the medical ward of Tamale Teaching Hospital from June to December 2019 were reviewed in a retrospective cross-sectional study. Out of 180 patients reviewed, 130 (72.2%) were males; the age range was 18-86 years, with a mean age of 41 43 years. Etiologies of CLDs comprised hepatis B viral infection (53.3%), hepatitis C viral infection (21.7%), unknown (9.4%), hepatocellular carcinoma (8.9%), and alcoholic liver disease (6.7%). Among the complications of CLDs; cirrhosis (71.1%), hypoalbuminemia (59.4%), ascites (58.3%) and jaundice (52.2%) occurred in more than half of the patients. Age (p=<0.001), education (p=0.005) and intake of herbal medicine (p=0.001) were associated with the etiologies of CLDs. There was a significant association between the etiologies of CLDs and complications; cirrhosis (p=<0.001), hypoalbuminemia (p=0.003), ascites (p=<0.001), and jaundice (p=0.009). Hepatitis B and hepatitis C viral infections were the main etiologies of CLDs. Young/middle age, noneducation and intake of herbal medicine were risk factors for the main etiologies of CLDs. Cirrhosis, hypoalbuminemia, ascites, and jaundice were the major complications of CLDs. Chronic hepatitis B and C viral infections were risk factors for developing the major complications of CLDs. Implementation of integrated public health strategies targeted at risk groups (young/middle age adults, illiterates, consumers of herbal medicine, patients with hepatitis B and C viral infections) may help curtail the burden of CLDs in northern Ghana.

Background Information on the quality of acute ischemic stroke care provided in lower-to-middle income countries is limited. Objective This study was undertaken to examine the quality of acute ischemic stroke care provided at Tamale Teaching Hospital in Ghana. Methods The medical records of patients admitted into the medical ward of the hospital between January to October 2021 were reviewed retrospectively. Extent of compliance to 15 stroke performance indicators were determined. Results Under the study period, 105 patients were admitted at the hospital with acute ischemic stroke. The mean (±SD) age was 65 ± 12 years; 38.1% were males; 65.7% had National Health Insurance Scheme coverage. Glasgow Coma Scale was the only functional stroke rating scale used by physicians to rate stroke severity. About a quarter of the patients had CT scan performed within 24 h of admission. Less than a quarter of the patients had a last known well time documented. Rate of thrombolytic administration was 0%. Less than a quarter of the patients were prescribed venous thromboembolism prophylaxis on the day of admission or day after. Only 13.8% of patients had documented reasons for not being prescribed venous thromboembolism prophylaxis. Antiplatelet therapy was prescribed to 33.3% of the patients by the end of day 2 of admission. Anticoagulation was prescribed to all patients who had comorbid condition of atrial fibrillation as part of the discharge medications. More than half of the patients were discharged to go home with statin medications. Documented stroke education was provided to 31.4% caretakers or patients. Slightly less than half of the patients were assessed for or received rehabilitation. Less than a quarter had documented dysphagia screening within 24 h of admission. None of the patient had their stroke severity rated with National Institutes of Health Stroke Scale on arrival. No patient obtained carotid imaging assessment by end of day 2. Conclusion There were several gaps in the quality of acute ischemic stroke care provided to patients at the Tamale Teaching Hospital. With the exception of discharging patients on statin medications, there was poor adherence to all other stroke performance indicators.