Month: June 2019

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APOC in Ghana 2019: May 24th

In this series of posts, University of Pennsylvania students who took the spring 2019 APOC (Appropriate Point of Care Diagnostics) course write about their experience traveling to Ghana in May-June 2019.

Suntreso Hospital

We started off our day with another visit to Suntreso Hospital to observe the treatment and handling of their HIV/AIDS patients. We spoke to the resident pharmacist who showed us the different types of ARV’s the hospital keeps in stock. We also met with an HIV/AIDS treatment counselor who allowed some of us to observe a counseling session with a newly diagnosed patient after receiving their consent.

We found that many patients suffering from communicable diseases often go undiagnosed and untreated for extended periods of time. This is due to the effort it takes to make a hospital visit in addition to the lack or underdevelopment of referral systems for patients found to be exhibiting symptoms of other ailments after screening. We learned that patients also tend to commute large distances from other regions to seek treatment in areas where they are less likely to be recognized by friends, family or co-workers. We learned that this is usually done to avoid the implications of stigma surrounding many diseases, especially HIV/AIDS.

Ghana National Cultural Museum

We then went to the Ghana National Cultural Museum where we were introduced to just a few of the many facets of Ghanaian culture that we had time for. We were told what each of our day names meant and learned about a host of traditional practices and items such as the talking drum, traditional dress, and stories about the fight against colonial rule. Unfortunately, no pictures were allowed inside the museum.

After a day inspired by Ghanaian culture we stopped for a meal at Ike’s Café. This restaurant is near the museum and we very quickly found ourselves enjoying a night full of Ghanaian delicacies to match the history we’d learned about as well as some breathtaking live music. We shared a host of local dishes which included fufu, banku, jollof, plantain, rice balls, and more.

Princess & Dr. David Issadore enjoying one of his favorite meals – fufu

The live band gave us a shout-out midway through their performance. A particular saxophonist managed to capture the attention of some of our team members. All-in-all we had an educational and relaxing day.

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APOC in Ghana 2019: May 23rd

In this series of posts, University of Pennsylvania students who took the spring 2019 APOC (Appropriate Point of Care Diagnostics) course write about their experience traveling to Ghana in May-June 2019.

by Aime Bienfait Igiraneza (Computer Science, ’20)

The morning was fantastic! Several group members were having a slightly enhanced digestion, which turned out not so great. It did not help that we also saw at least three guys peeing on the street, a serious public health issue that should be looked into. Nonetheless, we were excited for the day and we were not disappointed. We were about to visit one of the regional hospitals. If I were to summarize the day, there were two main takeaways: First, the hospital has an amazing system that works. Second, the potential of the system in place is not fully explored.

We started by meeting the medical director of the hospital along with another doctor specializing in tuberculosis. The main methods used to diagnose TB are microscopy and GeneXpert when the patient can produce sputum. Otherwise, the use of X-rays test is the remaining option. Although patients with TB can be diagnosed within two hours, it is still challenging to catch all cases due to stigma and the fact that testing is only ever done in the morning. Even the detected cases are more likely to be very advanced as people tend to first try other medicines when they encounter symptoms such as coughing, thinking that it will simply go away. However, an interesting program to collect sputum from pharmacies has been initiated which allows professionals to catch those who simply buy cough medicines from drug stores. After being diagnosed, patients are prescribed TB pills and these patients are re-checked after six months, which unfortunately is not always followed up on. When possible, patients are also followed up on at home by special health workers who ensure that pills are taken as prescribed. Even better, injectables are administered once in four months, thus reducing the burden of taking pills every day.

A few technical challenges were mentioned. The first one is that medical records for every patient are still saved in books, which pile up over time making it difficult to manage. A software called Health Administration Management System (HAMS) is used to save patients’ identifications and registration book numbers. When this book is updated, so is the HAMS account corresponding to the particular patient. All this is done in real time. Then, at the end of the day, staff from the Health and Information office use a software called District Health Management System (DHMS) to collect the information about the types of patients seen that day. This information is drawn from HAMS as well as record books. Thus, the challenge is how to automate the uploading of data from HAMS to DHMS in real time without waiting until the end of the day to manually do it. This has not been possible in part because HAMS does not contain all the necessary details.

Overall, it’s impressive how well everything works, given the current structure and workflow. At least, we learned about a few challenges, which by the way, were not always revealed to us. As usual, a ridiculously delicious lunch was provided. We also passed by the mall and bought a few fabrics. When we came back from the hospital, we picked up some KFC chickens for dinner and kept enjoying the incredible Ghanaian hospitality until we called it a day.

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APOC in Ghana: May 22nd

In this series of posts, University of Pennsylvania students who took the spring 2019 APOC (Appropriate Point of Care Diagnostics) course write about their experience traveling to Ghana in May-June 2019.

We started the day very early at 7:00 am with a drive to the Suntreso General Hospital where we were to visit Dr. Agyarko-Poku, a venerologist who would help us understand more about mother-to-child transmission of HIV/AIDS to aid in our study of noncommunicable diseases.

We arrived at the hospital, where the in-charge for the STI-OPD unit welcomed us and gave us a general overview of how events are run at the hospital’s HIV clinic which occurs on Wednesdays for adults and on Fridays for children. She gave us also an overview of how viral testing, data collection, and drug dispensary and treatment occur for the confirmed patients in the hospital. We got to see the relevant data points that were collected on each patient visit to help us better understand how well to modify our machine learning system.

We then went to the Disease Control Unit where the professionals there have the job of collating all hospital cases at the end of the week to identify diseases that are on the rise and have the potential to become public health concerns. We also got to understand more about how tuberculosis is diagnosed in the clinics and how treatment occurs for the disease. We found out also that drug-resistant tuberculosis has not been much of a problem for that particular hospital, contrary to what we thought. After this, we split into teams and went to visit the ART center, the counseling center, the dispensary, the data management room, as well as the consulting room where we got to interact more with the health professionals (i.e. nurses and pharmacists) in order to understand the processes that the patients have to go through from entrance into the hospital facility to diagnosis and the reception of their medication.

We left the Suntreso hospital and came back to KNUST where we had lunch before meeting with the civil engineers to discuss writing a report and making possible recommendations for the communities that we visited in order to improve their sanitation and water supply. We arrived at the Komfo Anokye Teaching Hospital’s Nursing Training School at about 2.30pm where we presented our Tuberculosis Triaging system to the students and received their questions which ranged from the usefulness of our algorithm and project to concerns about data contamination and invalidation. From KATH, we made a final run through KFC to grab dinner before making our way back to the guest house to enjoy our meal and conclude the day.