Tamale

This research aims to evaluate and improve how appendicitis, the most common emergency surgery, is managed worldwide. Appendicitis requires timely diagnosis and treatment to prevent complications and reduce healthcare costs. By using appendicitis as a "tracer condition," the study examines emergency care systems across different countries, focusing on access to care, treatment quality, and efficiency. The goal is to find gaps in emergency surgical care, especially in low- and middle-income countries, to guide future improvements. The study will collect data from about 500 hospitals globally between February 3 and May 25, 2025. Each hospital will gather information over 14 days on patients undergoing appendicectomy, which includes open, laparoscopic, and robotic surgeries, as well as cases converted from minimally invasive to open surgery. The study also includes two sub-studies: one exploring sustainability and waste management in operating rooms, and another examining the financial impact of appendicectomy on patients, particularly in lower-income settings. Participants include all patients having appendicectomy for suspected or confirmed appendicitis during the study period. Data will be collected from routine health records without additional follow-up. Researchers will measure key outcomes such as time to surgical assessment, rates of laparoscopic surgery, postoperative complications, length of hospital stay, and financial costs to patients. The study aims to capture data on about 14,000 patients to understand how differences in hospital resources affect care and outcomes worldwide.

Researchers are studying the ADHINCRA Program, which aims to improve the control of high blood pressure in Africa by addressing factors related to patients, healthcare providers, and health systems. This program hopes to reduce the risk of serious health problems like heart disease, stroke, and kidney disease by helping people manage their hypertension better. The study focuses on adults aged 18 to 70 years who have high blood pressure but do not have diabetes. The ADHINCRA Program is a nurse-led approach that includes home blood pressure monitoring, a mobile health app for support, lifestyle counseling, and a simplified treatment plan for hypertension. Participants either have not been treated for hypertension before or are on a single medication. The program is delivered through primary care centers at participating sites. Participants will be monitored for changes in their blood pressure over 12 months, with the main measure being the number of people whose systolic blood pressure falls below 140 mmHg. The study includes regular assessments and uses technology to support treatment adherence. The total participation period involves baseline measurements and follow-up at 12 months after starting the program.

Obstetric fistula is a serious condition causing severe urinary incontinence, leading to stigma and reduced quality of life for affected women, mostly in sub-Saharan Africa. This research aims to evaluate and compare two insertable vaginal device models as non-surgical options to manage fistula-related urinary leakage, especially for women awaiting surgery or those whose surgery was unsuccessful. The study also explores user and implementer acceptance of these devices and estimates the costs involved in non-surgical fistula management. The trial compares a silicone vaginal cup alone ('cup') and the cup connected by rubber tubing to a leg-secured urine collection bag ('cup+') for increased urine capacity. Participants use each intervention as well as a no-device leaking period in a crossover design over four days, with each treatment used for 24 hours including day and night. After this, participants are re-randomized to use either the cup or cup+ at home for three months to assess longer-term use and acceptability. Participants will be closely monitored during the study with urine leakage measurements over six hours and self-reported quality of life assessments over one to three months. Data collection includes clinical checklists, interviews, and surveys to assess effectiveness, acceptability, and cost. The total observation includes four days of crossover use followed by three months of home use, aiming to provide a practical and acceptable non-surgical management option for fistula urinary incontinence.

This research investigates whether wearable wireless sensors can help detect early signs of patient deterioration after surgery. Patients who become critically unwell after operations often experience delayed recognition of complications, which can lead to harm or death. The study focuses on surgical inpatients undergoing major open surgery across various countries and aims to see if data from wearable monitors is acceptable to patients and healthcare staff while potentially improving early detection of problems. Participants will wear wireless sensors placed on their chest and fingers before, during, and after surgery for up to 10 days. These sensors record vital signs like heart rate, oxygen levels, and body temperature continuously but do not affect patient care, as clinical teams will not have access to the sensor data during the study. The study is device-agnostic but initially uses the Sibel ANNEae One device, a wireless dual sensor system that stores real-time physiological data. During the study, researchers will collect and analyze physiological data alongside clinical event information to explore links between vital sign changes and patient deterioration. Participants will be monitored through wearable sensors for up to 10 days postoperatively, with no changes to standard care. The study takes place in general surgery departments in several countries and includes usability assessments and baseline monitoring practice evaluations in earlier stages.

This research aims to evaluate a specialized nutrition education program designed for pregnant women in northern Ghana. The study focuses on first-time mothers with low body weight during their second trimester, aiming to improve their knowledge about nutrition and health and assess how this impacts their babies' health. The program was developed with input from local pregnant women and health professionals to ensure it addresses community needs effectively. Participants in the treatment group will receive nutrition education and counseling six times throughout pregnancy. The first and last sessions, held at health facilities during weeks 21-22 and 31-32, will be conducted by a registered dietitian. Four bi-weekly follow-up sessions will occur at the participants' homes between these two counseling visits, focusing on dietary diversity, protein and energy intake, iron-rich foods, pregnancy weight gain guidelines, and healthy food preparation methods. During the study, pregnant women will attend antenatal visits and receive counseling either at health facilities or their homes. Researchers will measure changes in health literacy after 10 to 12 weeks and assess dietary diversity between weeks 15 and 17. The study monitors participants' nutrition knowledge, dietary habits, and pregnancy outcomes to understand the program's effects on maternal and infant health.

Researchers are evaluating how income instability affects the mental and physical health of poor women living in northern Ghana. The study focuses on understanding the impact of predictable and unpredictable changes in income on conditions like depression, anxiety, and blood pressure. This research aims to distinguish the effects of income variability from the overall income level while exploring how factors like age and baseline mental health may influence these outcomes. Participants will be involved in a cash-for-work program creating new job opportunities during the lean season. Women in the study will be assigned to one of three groups: a fixed work schedule with steady earnings, a schedule with income fluctuations known in advance, or a schedule with unpredictable income changes. A control group will be surveyed but not offered additional work. All groups will have similar average income levels to isolate the effects of income instability. Women in the study will be assessed after six two-week intervention periods, with measurements taken for depression, anxiety, dietary diversity, and blood pressure. Respondents will evaluate their experiences over the past 10 days for psychological and dietary outcomes. The study includes monitoring of physical and mental health outcomes to understand how income volatility influences well-being over the intervention period.

Researchers are evaluating whether giving surfactant using a less invasive technique can help treat respiratory distress in preterm infants born in low- and middle-income African countries where invasive ventilators are not available. This trial focuses on infants born weighing between 750 and 2000 grams or with a gestational age of 24 to 35 weeks who have respiratory distress and are breathing on their own while receiving continuous positive airway pressure (CPAP). The study aims to see if this less invasive surfactant administration (LISA) improves survival and to monitor any medical problems that occur during treatment. In this study, preterm infants with respiratory distress will receive surfactant therapy through a thin catheter inserted into their windpipe during laryngoscopy while continuing CPAP support. This method is compared to the standard care of CPAP and caffeine citrate without surfactant. The surfactant is given shortly after birth, ideally within 24 hours, and participants are closely monitored for any complications or side effects related to the treatment. Participants will be followed throughout their hospital stay, which is on average about six months, to determine survival rates and safety outcomes. Researchers will assess the infants' response to surfactant therapy, monitor for respiratory and other medical complications, and track overall hospital survival. The study collects detailed data on the infants' health status and treatment progress to understand how well the less invasive method works in these settings.

This research aims to address the urgent issue of increasing unaccompanied child migration from rural areas to urban centers in developing countries, focusing on adolescent girls in Ghana. These girls often face hazardous child labor conditions, including risks to their mental, physical, social, and moral well-being, which interfere with their schooling and health. The study targets girls aged 11 to 14 at risk of school dropout, exploring ways to reduce unaccompanied migration for labor and improve developmental and health outcomes through a family-based intervention. The study will compare two groups of adolescent girls and their caregivers across 32 public junior high schools in Ghana's Northern region. One group will receive the ANZANSI Family Program, which includes financial literacy training, matched savings accounts (CDA), and training on family income-generating activities. It also provides a 16-session Multiple Family Group intervention focused on family rules, responsibility, relationships, communication, stress, and social support. The other group will receive bolstered usual care. The intervention lasts 12 months, with assessments at baseline, 12, 24, and 36 months. Participants will be involved through school enrollment and family living arrangements, completing assessments related to unaccompanied migration, academic progress, and psychosocial outcomes. The study will also evaluate mechanisms of change at individual, family, and community levels, as well as the cost-effectiveness of the interventions. Follow-ups continue for up to 36 months, with data collected on migration incidence and other health and development measures.