Assessment of Hypertension-Induced Deaths in Ghana: A Nation-Wide Study from 2012 to 2016

Globally, hypertension is one of the leading causes of death. It can potentially lead to heart disease and stroke, among others, that could result to premature death. In Ghana, hypertension is considered as a disease that contributes to an increase in outpatients’ attendance. To assess the trend differentials of hypertension-induced deaths in Ghana, Chi-square test for equal proportions and Marascuilo procedure for pairwise comparison were performed using surveillance data on reported number of deaths from 2012 to 2016 across the then ten regions. The results show that incidence of hypertension-induced mortality was significantly different for almost all the regions and over the years. The incidence of hypertension-induced mortality has significantly reduced from 2012 to 2016. However, Volta Region recorded the highest incidence of mortality cases (p-value less of 0.0001) than the other regions during the period under review, while the Upper East Region recorded continuous increase in incidence of mortality cases with the highest in 2016. The Eastern Region, Central Region, and Greater Accra Region recorded significantly (p-value less of 0.0001) higher incidence of hypertension-induced mortality than the Ashanti Region, Brong Ahafo Region, Northern Region, Western Region and Upper West Region. The Upper West Region and Western Region had the lowest incidence of mortality. The decline in trend of hypertension-induced mortality could be attributed to some healthcare interventions put in place during the period. One of these interventions was the introduction of health insurance in 2003, a development which has been shown to affect the health seeking behaviors of the people. It is, therefore, important to investigate factors affecting these spatial and temporal dynamics in order to determine appropriate ways to actively control the hypertension-induced deaths in the country. Public education on health should be intensified so as to totally curb hypertension and its attendant risks.

Atypical eclampsia at primary health care in a remote area:A case report

BACKGROUND Eclampsia is a generalized tonic-clonic seizure induced by pregnancy.It contributes to a high rate of maternal and neonatal morbidity and mortality worldwide.Eclampsia is characterised by classic signs such as elevated blood pressure,proteinuria,and seizures.However,it may occur in the absence of hypertension and/or proteinuria.The uncommon appearance of eclampsia makes it difficult to immediately assess and treat it.In addition,the occurrence of this case in a remote area makes it more challenging to handle.The objective of this case report is to increase awareness of uncommon manifestations of eclampsia,particularly in limited-resource settings.CASE SUMMARY A young primigravida experienced a generalised seizure without hypertension and/or proteinuria.Sudden hearing loss,blurred vision,and vomiting were complained about before the seizure attack.The patient was diagnosed with eclampsia.A loading dose of magnesium sulphate was administered immediately.The patient was referred from community healthcare to a hospital and discharged without any complications.CONCLUSION Atypical eclampsia may be a diagnostic challenge.However,other symptoms may be beneficial,such as awareness of eclampsia signs.