Integrated Health Research Journal

Gaps in Glaucoma Diagnosis and Management in Low-Resource Settings: Evidence, Challenges, and Practical Solutions for West Africa

Samuel Kyei — 2026-02-01

Glaucoma remains a leading cause of irreversible blindness in West Africa, where prevalence among adults aged ≥40 years far exceed global norms. Despite the availability of effective medical and surgical interventions, late presentation and advanced disease at diagnosis persist, driven by systemic, socioeconomic, and cultural barriers. This review synthesizes evidence on epidemiological burden, risk factors, diagnostic capacity, and care pathway challenges in low-resource settings. Key findings include aggressive disease phenotypes, thin corneal profiles, and high familial risk, compounded by deficits in diagnostic infrastructure, particularly gonioscopy, and workforce shortages. Barriers span awareness, access, adherence, and follow-up, with cost and health literacy as dominant constraints. Practical solutions emphasize community-based screening, task-shifting to optometrists, integration of glaucoma care into primary health systems, cost-containment strategies for medications, and telemedicine for remote monitoring. Implementation science approaches and policy reforms, including insurance coverage and workforce upskilling, are critical to reducing glaucoma-related blindness. Addressing these gaps through coordinated, context-specific interventions offers a pathway to preserve vision and improve quality of life across West Africa.

Patient Perceptions of the Impact of the National Health Insurance Scheme on Healthcare Service Delivery in Ghana: A Systematic Review

Nathan Mensah — 2026-02-01

Background: Patients in Ghana have conflicting perceptions about the impact of the National Health Insurance Scheme (NHIS) on service delivery. While some acknowledge the scheme’s beneficial effects, others draw attention to its drawbacks. The objective of this study was to investigate how patients perceive the impact of the National Health Insurance Scheme on service delivery in Ghana.

Results: A total of 300 articles were downloaded from various databases: 40 from Science Direct, 20 from Google Scholar, 160 from PubMed, 50 from ProQuest, and 30 from Scopus. The review findings were categorized into financial access, fairness of care, effectiveness of treatment, attitudes of healthcare professionals, waiting time, and availability of drugs.

Conclusion: The study highlights the perceived benefits of NHIS in Ghana, including improved access to care, enhanced continuity of care, and alleviated financial burden on patients. However, challenges cast shadows on patient perception, such as negative attitudes of healthcare personnel, delays in accessing care, lack of coverage for critical services, unavailability of drugs, and concerns about service quality.

Biosafety of Beauveria Bassiana as a biopesticide: No effects on sex hormones in experimental rats

Oluwatayo Ayotunde Makinde — 2026-02-01

This study evaluates the possible antagonistic effects of challenging wistar rats with the entomopathogenic fungi (Beauvaria bassiana) on their reproductive hormones. The fungus was isolated from diseased African grasshoper (Zonocerus variegatus) picked from cassava plantation within Adekunle Ajasin University Akungba-Akoko University farm. The insects were brought to the laboratory and watched for the onset of disease symptoms. Veen’s media was used in the isolation of the entomopathogenic fungus from the insect cadavers after surface-sterilization and humid-incubation. Spore and conidia suspension of the entomopathogenic fungus was then prepared from a 14-day old culture of the microbe and used to infect another batch of the insect to confirm entomopathogenicity. An inoculum of the fungus was prepared and the concentration was adjusted to 10⁶ sfu/ml. The inoculum was used to challenge the laboratory rats and watched for a period of 7days before being sacrificed. A control experiment was set up where the animals were not challenged with any microbe. Blood were collected into heparin bottles through ocular puncture and analysed for selected reproductive hormones using immunoassay kit. The rats were examined to ascertain they are in uniform reproductive cycle to minimize the spiking or reduction in hormonal concentration as a result of a varying phase before being sacrificed. Results showed a change in some hormonal levels in challenged rats compared to rats within the control group. Progesterone level was 6.67±1.16ng/mL in challenged rats while it was 6.33±0.58ng/mL in rats within the control group. Testosterone level was 3.40±0.20ng/mL and 3.50±0.17ng/mL respectively in rats within the challenged and control group respectively. However, Follicle Stimulating Hormone level was 2.00±0.10 mIU/mL and 1.93±0.12mIU/mL in challenged and control rats respectively. Despite the reduction, the values were still within the acceptable range with the exception of testosterone. This shows that usage of B. bassiana as an entomopathogenic fungus in the formulation of biopesticides pose less risk to the handler and the environment upon its deliberate release or accidental exposure.

Exploration of Histone H2B and Some Biochemical Markers in Sudanese Women with Breast Cancer

Ahmed Ibrahim Mohamed Ahmed — 2026-02-01

Background: Despite the existence of breast cancer biomarkers, their analysis techniques are not simple. H2B protein is associated in breast cancer and thought to be effective and simple biomarker.

Materials and methods: A total of 121 Sudanese breast cancer patients with different stages of the disease and 31 healthy individuals as the control group were included in this study. A pretested structured data sheet containing closed questions was used to classify the patients into different stages and to identify the age, sex, district, and the type of therapy. Blood samples were collected for laboratory investigation. H2B protein was measured by ELISA, and biochemical tests such as blood glucose, total cholesterol, total protein, and lactate dehydrogenase were measured by a spectrophotometer.

Results and conclusion: Most cases were prevalent in Khartoum, Darfur, Kordofan, and Gezira, respectively. In Sudan, the most common types of therapy are surgery, chemotherapy, and radiation therapy. H2B protein was investigated, and the mean value was found to have significant differences (p< 0.05) compared to control group. Regarding the disease stages, the mean values in the late stages (stages II and III) were found to have significant differences (p< 0.01 and < 0.001, respectively) compared to the control group. However, there is no significant difference (p > 0.05) between the mean value in the early stage (stage I) and the control group. This result showed that the H2B protein can be used as a prognostic biomarker for breast cancer. Moreover, the H2B mean values were positively associated with cholesterol and LDH, and negatively correlated with blood glucose levels.

The Association of Polysomnographic Variables with BMI, Gender, and Age in Sudanese Adults with Obstructive Sleep Apnea

Kamal Awad — 2026-02-01

Obstructive sleep apnea (OSA) is a prevalent sleep-related breathing disorder characterized by repetitive upper airway collapse during sleep. This study examines the relationship between polysomnographic variables and body mass index (BMI), gender, and age in 251 Sudanese adults with OSA, a population that has been underrepresented in prior research. Using overnight polysomnography, OSA severity was classified based on the apnea-hypopnea index (AHI). Results revealed a significant positive correlation between BMI and key polysomnographic parameters, including AHI, arousal index, and desaturation index, while sleep efficiency was negatively correlated with BMI. Severely obese individuals (BMI ≥ 40 kg/m²) exhibited the highest AHI values (53.2 ± 36.3), with significant declines in sleep efficiency observed in obese participants. Age was negatively correlated with sleep efficiency, with older adults (≥65 years) showing the lowest values (74.9 ± 17.3). Gender differences were observed, with males exhibiting higher sleep efficiency (81.2 ± 15.6 vs. 75.6 ± 16.7, p = 0.010) and snoring intensity (29.0 ± 16.4 vs. 23.9 ± 13.8, p = 0.008), though AHI did not differ significantly between genders. This study provides novel insights into the multifactorial nature of OSA severity, highlighting the critical influence of BMI, age, and gender. However, the cross-sectional design limits causal inferences, and the omission of certain anthropometric measures, such as neck circumference and waist-to-hip ratio, may have influenced the findings. These results underscore the need for targeted interventions addressing obesity and age-related changes in sleep physiology, particularly in understudied populations such as Sudanese adults.

Edible Insect Phobia and Associated Factors Among Women of Reproductive Age in the Central Region of Ghana

Safianu Osman Aleboko — 2026-02-01

Objective: To identify factors associated with edible insect phobia among women of reproductive age in the Central Region of Ghana.

Design: A cross-sectional study design was employed.

Setting: The study was conducted in a tertiary hospital in the Central Region of Ghana, between March and June 2024.

Participants: A total of 340 women of reproductive age (15–49 years) were recruited from outpatient clinics to participate in the study.

Results: Edible insect phobia was significantly associated with level of education (p = 0.016), ethnic group (p < 0.001), pregnancy status (χ²(2) = 6.46, p = 0.040, Cramer’s V = 0.151, 95% Confidence Interval [CI] = 0.064–0.252), awareness of insects as food (χ²(2) = 17.45, p < 0.001, Cramer’s V = 0.234, 95% CI = 0.138–0.330), and prior insect consumption (χ²(2) = 16.54, p < 0.001, Cramer’s V = 0.228, 95% CI = 0.123–0.334). Edible insect phobia was negatively correlated with age (r = -0.223, 95% CI = -0.325 to -0.116, p < 0.001) and number of pregnancies (r = -0.163, 95% CI = -0.270 to -0.053, p = 0.003), but not with food neophobia score (r = 0.097, 95% CI = -0.020 to 0.209, p = 0.074).

Conclusions: A higher phobia of edible insects among women of reproductive age was associated with younger age, fewer pregnancies, lower educational level, certain ethnicities, pregnancy status, unawareness, and no previous history of consuming edible insects. Interventions targeting these factors may help reduce edible insect phobia and increase acceptance of edible insects as dietary proteins among similar populations.

Mental Health Literacy and Stigma among Pharmacists toward Patients with Mental Illness: A Cross-Sectional Survey in Sudan

Mohamed K. Suliman — 2026-02-01

Background: Pharmacists, as the most accessible healthcare providers, play a significant role in disease management, yet their involvement in mental health services is limited by stigma, inadequate training, and negative perceptions. The ongoing conflict in Sudan has exacerbated mental health challenges, thus making it essential to assess pharmacists' readiness to address these issues. This study aimed to evaluate the mental health literacy, stigma, and comfort levels of Sudanese pharmacists in providing care to patients with mental health disorders.

Methods: A descriptive cross-sectional study was conducted using an online questionnaire that was distributed to Sudanese pharmacists via social media platforms. The questionnaire, adapted from a previously validated tool, measured knowledge, attitudes, stigma, and comfort in managing mental health conditions versus cardiovascular diseases. SPSS version 29 was used to analyze the data with a significance level of P < 0.05.

Results: A total of 413 pharmacists participated (73% female; most aged 25–30). Pharmacists demonstrated a high recognition of depressive disorders 94%, but moderate awareness of anxiety 62% and obsessive-compulsive disorder 68%. While pharmacists showed good knowledge of common psychiatric medications, with amitriptyline 76% and haloperidol 65% being the most recognized drugs, they viewed pharmacist consultation negatively. Pharmacists predominantly associated mental health patients with negative outcomes, such as an increased likelihood of suicide 76.8%, violence 75.8%, and illegal drug use 70.0%. Comfort levels in discussing psychiatric symptoms and providing medication counseling were significantly lower compared to those for cardiovascular conditions.

Conclusion: The study revealed significant gaps in pharmacists' knowledge, comfort, and attitudes toward mental health disorders, as well as persistent stigma regarding mental health patients. Integrating mental health education into pharmacy curricula and providing continuing training are essential to addressing these gaps and improving pharmacists’ readiness to provide care to patients with mental health disorders.

Knowledge, Attitude And Practices towards Sugar-Sweetened Beverages amongst Adolescents in Senior High Schools in the Cape Coast Metropolis, Ghana.

Jessica Ayensu — 2026-02-01

ABSTRACT

Background: The escalating consumption of sugar-sweetened beverages (SSBs) has emerged as a pivotal contributor to the rise in diet-related health issues, particularly affecting young adults and adolescents in developed and developing nations. Despite the acknowledged impact of attitudes and nutritional knowledge on food choices, a substantial data gap persists in understanding their association with the consumption behaviour of Ghanaian adolescents, particularly in the context of SSBs. This study aimed to investigate the types and frequencies of SSBs consumed by secondary school students in Cape Coast, Ghana, while concurrently assessing their nutritional knowledge and attitudes toward SSBs consumption.

Methods: A descriptive cross-sectional study was conducted, involving 393 randomly selected students from three different second cycle schools. Data was collected through a structured questionnaire, encompassing SSBs consumption patterns, nutritional knowledge, and attitudes. Statistical Package for Social Sciences (SPSS) version 21 facilitated data analysis, employing descriptive and chi-square analysis. Statistical significance was set at p < 0.05.

Results: Descriptive statistics unveiled a proportion (57.5%) of respondents exhibiting a high level of SSBs consumption. Concerning nutritional knowledge, 55.7% displayed moderate knowledge of SSBs consumption, while 52.9% held positive attitudes toward SSBs consumption. Bivariate correlation analysis indicated no significant association between BMI-for-age, knowledge level, and SSBs consumption levels.

Conclusions: Despite a moderate level of nutritional knowledge among students, the evidence showed a high prevalence of SSBs consumption. concerted actions, including restricting SSBs availability in schools and public places, coupled with initiatives promoting healthier beverage choices, are warranted and should involve government, organizations, and the community.

Keywords: Sugar-Sweetened Beverages, Adolescents, Knowledge, Attitudes and Practices