Tamale

This research aims to improve how appendicitis, a common emergency surgery condition, is managed worldwide by studying different emergency care systems. Appendicitis requires quick diagnosis and treatment to avoid complications. Using appendicitis as a marker, the study looks at access, quality, and efficiency across hospitals in various countries, including low- and middle-income regions, to find ways to enhance emergency surgical care. The study collects data from about 500 hospitals globally between February and May 2025, focusing on patients undergoing appendicectomy using any surgical method, including open, laparoscopic, or robotic approaches. Hospitals will record information for consecutive patients over 14-day periods. The study includes two sub-studies one on sustainability and waste management in operating rooms and another on the financial impact of surgery on patients, especially in resource-limited settings. Participants will have their care observed through routine health records without extra follow-up visits. Researchers will measure key factors such as time from symptoms to surgical assessment, rates of minimally invasive surgery, complications within 30 days, and hospital stay length. This data will help identify gaps and guide improvements in emergency surgical care worldwide, aiming to make treatment safer, faster, and more affordable.

Researchers are evaluating the ADHINCRA Program, a package of evidence-based interventions aimed at improving the control of hypertension among adults aged 18 to 70 in Africa. The program targets factors related to patients, healthcare providers, and health systems to help reduce risks of cardiovascular disease, stroke, and kidney disease. This interventional study is sponsored by Johns Hopkins University and focuses on managing high blood pressure using a nurse-led approach. The ADHINCRA Program includes home blood pressure monitoring, a mobile health application, nurse-led lifestyle counseling, and treatment using a simplified hypertension control protocol. Participants are divided into four cohorts starting the program at staggered intervals immediately, and 3, 6, and 9 months thereafter. All cohorts receive the same intervention to assess its effectiveness and implementation over time. Participants will be monitored for blood pressure control at baseline and at 12 and 24 months after starting the program. Assessments include systolic and diastolic blood pressure measurements, medication adherence via the Hill-Bone Medication Adherence Scale, and evaluation of how well the program is adopted and maintained at clinical sites. Researchers will also compare the cost of this intervention to usual care. The study is planned to end in September 2028, with ongoing safety and adherence monitoring throughout.

This research aims to evaluate two insertable vaginal devices for managing urinary leakage caused by obstetric fistula, a condition that severely impacts quality of life and carries social stigma. The study compares a vaginal cup alone and the cup connected to a leg-attached urine collection bag to increase urine holding capacity. It involves women awaiting fistula surgery or those with unsuccessful surgery, addressing the need for a non-surgical management option in settings with limited access to repair. Participants will use each intervention and a period of leaking freely in a crossover design over four days, with each condition lasting 24 hours, including day and night use. After this short-term phase, participants are re-randomized to use either the cup or the cup device at home for three months. Data collection includes self-reports and clinical checklists to assess device effectiveness, acceptability, and costs. Throughout the study, participants will undergo assessments of urine leakage volume, quality of life, stigma, sleep satisfaction, coping skills, empowerment, safety perception, and device acceptability at multiple time points up to three months. The study also examines material and opportunity costs associated with fistula management. The total observation includes intensive short-term monitoring followed by longer-term home use and follow-up evaluations.

This research aims to find out if wearable sensors can help detect early signs of health problems after major surgery. The study focuses on surgical patients who might become critically ill after their operations. It evaluates if continuous monitoring of vital signs like heart rate and oxygen levels using wearable devices can identify patient deterioration sooner than standard care. The study is observational and involves multiple countries including Benin, Ghana, Guatemala, India, Mexico, Nigeria, Rwanda, and the United Kingdom. Participants will wear wireless sensors on their chest and fingers before, during, and after surgery for up to 10 days. These sensors record vital signs continuously but do not affect patient care, as clinical teams will not access the data during the study. The first two stages of the study involved testing device usability with healthcare workers, while this third stage collects real-time sensor and clinical event data to explore links between physiological changes and patient complications. During the study, participants will have their vital signs monitored with wearable devices while also receiving standard clinical observations. Researchers will collect cardiovascular, respiratory, and temperature data alongside routine care information and clinical events. They will follow patients for 10 days of monitoring plus an additional 30-day follow-up to observe complications. The goal is to gather data to help design future algorithms for early detection of postoperative problems without changing current treatment practices.

Researchers are evaluating a nutrition education program designed for pregnant women in northern Ghana to help them eat a wider variety of foods and increase their intake of protein, energy, and iron-rich foods. The program aims to promote healthy weight gain during pregnancy and improve mothers knowledge about nutrition and health. This intervention was developed with input from local pregnant women and health professionals to address maternal health and pregnancy outcomes. The study includes two groups a treatment group that will receive six nutrition education and counseling sessions and a control group that will receive education on personal hygiene only. The first and last counseling sessions are given by a registered dietitian at a health facility during weeks 21-22 and 31-32 of pregnancy, while four bi-weekly follow-ups are conducted at the participants home by field assistants. All participants continue to receive standard care from their primary providers. Participants will be involved in visits and assessments throughout their pregnancy, including evaluations of health literacy at 10-12 weeks and dietary diversity at 15-17 weeks. Researchers will also measure nutrition knowledge at 15-17 weeks and infant birth weight around 20 weeks. The study monitors participant progress and outcomes to understand the impact of the nutrition education on both mothers and their babies during pregnancy.

This research investigates how income instability affects the mental and physical health of poor women, focusing on issues like depression, anxiety, and blood pressure. It aims to understand the causal effects of different types of income instabilitypredictable and unpredictablewhile separating these effects from the impact of income level itself. The study is designed to advance knowledge on economic instabilitys role in health disparities among vulnerable populations. Participants are randomly assigned to one of four groups a control group that is surveyed but not offered work a stable income group with fixed work hours and earnings a predictable instability group with varied but known work hours and earnings and an unpredictable instability group with fluctuating work hours and earnings that are unknown in advance. The study involves a cash-for-work program creating new job opportunities during a lean season, with careful design to ensure no participant is worse off. Participants will be involved for six periods of two weeks each, during which they will complete work assignments or be surveyed depending on group assignment. Assessments include measures of depression, anxiety, dietary diversity, and blood pressure taken at the studys end. The study monitors how income patterns influence psychological and physiological health outcomes, with all data collected under the supervision of researchers. The total duration includes the intervention period followed by outcome measurement at endline.

Researchers are evaluating the use of surfactant given by a less invasive surfactant administration LISA technique to treat respiratory distress syndrome in preterm infants in low- and middle-income African countries. This pragmatic clinical trial aims to determine whether this method improves survival compared to standard care, especially where invasive ventilators are not available. The study focuses on preterm neonates with respiratory distress who are managed with continuous positive airway pressure CPAP and caffeine citrate. The trial compares two groups one receiving standard care with CPAP and caffeine citrate, and the other receiving surfactant therapy administered through the LISA technique, which involves instilling surfactant into the lungs via a thin catheter during laryngoscopy while on CPAP. Participants are preterm infants born between 24 and 35 weeks gestation or weighing between 750 and 2000 grams with respiratory distress defined by a Silverman Anderson Score of 5 or greater. The study includes monitoring for complications and follows infants throughout hospitalization. Participants will be observed during their hospital stay, which averages about six months, to assess survival and other health outcomes such as incidence of major preterm neonatal morbidity and pneumothorax. Researchers will monitor participants from admission within 24 hours of life until discharge, evaluating hospital survival and complications related to respiratory distress and surfactant treatment. The primary outcome is all-cause in-hospital survival.

This research aims to evaluate a family-based intervention called ANZANSI to improve developmental and health outcomes for female adolescent migrants at risk of school dropout in Ghana. It focuses on unaccompanied minors migrating from rural to urban areas for work, a group vulnerable to hazardous child labor and related risks to schooling, health, and wellbeing. The study will assess the interventions impact on unaccompanied migration, academic progress, psychosocial outcomes, and mechanisms of change at individual, family, and community levels. The trial will randomly assign 32 public junior high schools in Ghanas Northern region to either receive bolstered usual care or the ANZANSI Family Program. Bolstered care includes standard school services plus school supplies. The ANZANSI program combines family economic empowerment, consisting of financial literacy training, a matched savings account called the Child Development Account, and family income-generating activity support, with a multiple family group intervention focused on relationships, communication, stress, and social support. The intervention will last 12 months. Participants will include 960 adolescent girls aged 11 to 14 and their caregivers. Assessments will occur at baseline, then 12, 24, and 36 months after starting the intervention. Researchers will measure outcomes such as unaccompanied migration, school attendance, grade progress, self-esteem, family cohesion, saving behaviors, and caregiver relationships. The study also includes qualitative analysis and cost-effectiveness evaluation. Participation involves completing surveys and attending intervention sessions over the study period.