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SICKLE CELL DISEASE AND COVID-19

“What do I need to do (or know) as a person with Sickle cell disease?” The enquirer is health care student. In response I came across nice piece written by Nitin et al published in the Pan African Medical Journal (Vol 36, May -Aug 2020). The World Health Organization (WHO) has identified sickle cell disease (SCD) as a major concern of public health significance. It has been estimated that around 5% of the global population carry Sickle Cell Trait genes. About two-thirds of the sickle cell disease patients of the global burden reside in sub-Saharan Africa. COVID-19 Pandemic caused by Corona virus 2 (SARS COV2) is having a devastating effect on socioeconomic and health indicators in counties worldwide. The additional financial burden of supporting health care management system in tackling COVID-19 impact at the same time preventing mortality rate of COVID-19 deaths is a matter of great concern to all.

The pathogenesis of the sickle cell disease is attributed to the polymerization of the deoxygenated haemoglobin S(HbS). The polymerization leads to alteration in the normal biconcave shape of the red blood cells making them rigid and more prone for intravascular haemolysis. As a consequence of repeated hypoxia driven polymerization of HbS there is development of cyclic cascade leading to blood cell adhesion, vaso-occlusive crisis and ischaemic reperfusion injury. SCD patients may develop complications such as Acute Chest Syndrome, pulmonary embolism and stroke 

About two thirds of new borns born with SCD worldwide are found in sub-Saharan Africa. The sickle cell gene HbSS is commonly identified in Africa in SCD while HbSC and HbS/ beta+thalassemia has been observed in West Africa. SCD had led to the death of about 50-90% of the affected as the disease remained undiagnosed during the childhood. The various studies done in Africa were found that SCD patients have higher mortality rates.  In Ghana-the programme to enhance health care for sickle cell disease is a big relief.

The development of knowledge of understanding the pathology and management protocol of SCD has been helpful in management of the disease. The presence of malaria, undernutrition and other infectious diseases also contribute towards mortality rate in Africa. Of late it has been seen that because of the devoted and dedicated health care services provided by the health personnel the mortality rates are declining and this life-threatening disease of children is now progressing to chronic disease of the adult. 

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It has been observed that pulmonary functions are decreased in SCD. Lung functions are compromised in patients of sickle cell disease and Sickle Cell Trait (SCT). Repeated chest infections in SCD and SCT lead to alteration in geometry of lung parenchyma and physical properties of elastic and collagen fibres thus decreasing pulmonary function parameters such as Forced Vital Capacity, Forced Expiratory Volume and Forced Expiratory Volume 1%. Moreover the pulmonary vasculature is highly sensitive to hypoxia (absence of enough oxygen) driven micro-occlusion of pulmonary vasculature which along with cell adhesive changes may cause pulmonary hypertension and further compromise lung functions]. Persons with SCD have an increased susceptibility to infection. The impaired leucocyte function and humoral and cell-mediated immunity loss have been reported to account for the immunocompromised state in patients with sickle cell disease. The SCD patients being immune compromised are more prone for recurrent chest infections. The major cause of mortality in patients of SCD is acute chest syndrome, pneumonia and acute respiratory distress syndrome.

COVID-19 is the acronym for corona virus disease 19 and has been termed as SARS-COV-2 by International Committee of Taxonomy on Virus (ICTV). The common clinical manifestations observed in patients of sickle cell disease include cough, fever, shortness of breath, loss of smell perception and loss of taste sensation. Most of the patients of COVID-19 may have a mild course of disease while few may develop severe clinical manifestations. The clinical manifestation of severity in COVID-19 patient includes Acute Respiratory Distress Syndrome (ARDS), Pneumonia, Multiple Organ Failure, Septic Shock and Sepsis. The severity of pneumonia manifests with dyspnoea (difficulty or laboured breathing) and tachypnoea (abnormally rapid breathing) 

COVID-19 infection can worsen the pulmonary manifestation in SCD patients especially in those having pulmonary complications such as Acute Chest Syndrome, Pulmonary Hypertension and ARDS. COVID-19 infections in SCD can also increase morbidity and mortality risk in these patients.

The main cause of concern in patients of SCD is that these patients are immunocompromised and may suffer from both acute and chronic complications which require hospitalization and close contact with the medical system. There is overlap in clinical manifestations of fever and lung disease in COVID-19 and SCD. The increased complications will amplify health care utilization-e diagnostic, management and logistic challenges. In view of the above facts it is necessary for health care workers to educate SCD patient registered in their areas regarding care and precautions to be taken during COVID-19 pandemic to prevent getting affected with COVID-19 infection. Although the education applies to everyone, there should be more emphasis for persons with SCD.

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All persons with SCD need to be educated regarding COVID-19 signs, symptoms and mode of spread. They should be explained regarding the increased risk of contracting COVID-19 infections in them due to their immunocompromised state. All patients of SCD should be advised to strictly adhere to social distancing, isolation polices, use of face mask, and frequent hand washing with soap to prevent COVID-19 infections. They should keep adequate medication of SCD such as analgesic and antipyretic drugs, hydroxyurea.  They can be advised regarding use of clinical thermometer at home as fever is common sign in SCD patient and thereby these persons can take appropriate precautions and medication after seeking telephonic consultation with their health care providers. They can use pharmacy home delivery services in case they require medication during emergency situations.

Until then regularly/daily consume polyphenol-rich cocoa. It is been useful for persons with SCD.

DR. EDWARD O. AMPORFUL

CHIEF PHARMACIST

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COCOA CLINIC 

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Artificial Intelligence in Ghanaian workplaces: Opportunities, concerns, and the way forward

Artificial Intelligence (AI) is no more a remote concept for organ­isations in Ghana. Recent research has highlighted the significant impact AI is having in remodelling workplaces in Ghana, unveiling a mix of opportunity, anxiety, and a pressing call for coordinated nation­al response. A study focusing on a Ghanaian service organisation in the advertising industry investigated how AI influences employee skills development. The results paint a picture of a technological shift that is rapidly gaining ground in the local workplace, albeit with mixed impli­cations for the workforce.

AI and employee upskilling: A double-edged sword

The study found a statistically sig­nificant, though moderate, positive relationship between AI deployment and employee upskilling. Employees exposed to AI technologies were more likely to enhance their capa­bilities—particularly in areas such as data analysis, digital literacy, and continuous learning. This find­ing aligns with global trends where AI is facilitating learning adaptation and professional growth.

However, the research also pointed out a sobering reality that AI adoption often comes together with workforce downsizing. The data showed a strong correlation between AI implementation and employee redundancies, raising red flags about job security for many Ghanaians.

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“While AI can help employees do their jobs more effectively, it also automates tasks that previously required human effort”, the author noted. “This duality—simultane­ously empowering and displacing workers—is at the heart of the AI debate.”

Organisational relevance and the AI imperative

Despite these challenges, organ­isations embracing AI are seeing positive results in terms of rele­vance and competitive advantage. The study confirmed a statistically significant relationship between AI adoption and organisational effec­tiveness, though the influence was not overwhelmingly strong. This suggests that while AI can enhance efficiency, it must be strategically integrated into business models to be fully effective.

Yet, many Ghanaian companies, especially SMEs, remain hesitant. Barriers such as lack of technical infrastructure, fears of losing con­trol to algorithms, and low digital literacy rates hamper widespread adoption. This is echoed in South African and broader African con­texts, where similar patterns of resistance and slow uptake prevail.

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Current AI issues in the Ghana­ian workplace

Ghana faces several unique challenges in integrating AI into its workplaces:

Unlike Kenya or Rwanda, Ghana lacks a clear national AI policy or roadmap. This absence of legal frameworks and guidelines hinders sustainable, responsible AI imple­mentation.

The study revealed that while some staff have received training— primarily on Microsoft 365 Copilot— many are limited in their exposure. This creates a lopsided workforce where a few benefit, and many lag behind.

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The largest demographic in the study (27.5 per cent) was aged 18–25. Without deliberate interven­tions, this youth cohort faces a high risk of being left behind by AI-driv­en changes.

Employee sentiment toward AI is mixed—13 per cent expressed enthusiasm, while over 20 per cent were wary or pessimistic. This shows the emotional toll and uncer­tainty surrounding AI’s future role in jobs.

The way forward

To harness AI’s benefits while mi­nimising its risks, Ghana must adopt a strategic, inclusive approach:

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The government should develop a comprehensive AI framework that supports innovation while protect­ing workers’ rights. Such a policy should include data protection laws, ethical AI guidelines, and incentives for private sector adoption.

Organizations must invest heavily in upskilling and reskilling employ­ees. These programmes should not just focus on technical skills but also foster soft skills such as critical thinking, adaptability, and digital literacy.

Educational institutions should embed AI and digital economy top­ics into basic, secondary, and tertia­ry curricula. Producing AI-literate graduates is key to future-proofing the workforce.

Collaboration between govern­ment, industry, and academia is essential to pool resources, share expertise, and drive AI readiness across sectors.

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As AI transforms work, employers must provide psychological support and foster inclusive environments. Change management strategies are essential to guide employees through this transition.

Conclusion

AI is here to stay, and Ghanaian workplaces are beginning to feel its presence. While the promise of enhanced productivity and com­petitiveness is real, so are the threats of job loss and exclusion. The research findings make it clear: the future of work in Ghana must be one where technology and human development evolve togeth­er. Without deliberate, inclusive policies and strategic foresight, the country risks widening inequality and stifling innovation. But with the right investments and political will, Ghana can turn AI from a threat into an engine of inclusive econom­ic growth.

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By Esther J.K. Attiogbe (PhD)

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Obituaristic and marital nonsense

Some churches are not encouraging members to opt for wake- keeping in any event of death of a member

It was a yearly ritual. Every year, on the day her husband died, she dressed up beautifully, went on top of his grave and danced to her satisfac­tion. For several hours, she’d boogie up and down, style after style, until she could dance no more. She’d then de­scend the grave and walk home panting yet contented.

Sikaman Palava
Sikaman Palava

When asked by reporters why she had taken to the yearly open-air disco dancing, the widow said it was in honour of DEATH which took away her husband. “When he was alive. I never had a moment’s peace,” she said.

What an honest confession about a dead person. She minced no words. The man gave her no peace, and that was exactly what she was saying. A widow in Sikaman would dare not say that of her deceased husband. His fam­ily members would procure pick-axes, hoes and cutlasses and descend on her with red eyes and tear her to pieces.

Problems associated with modern-day funerals is the wake-keeping

It is traditionally not proper to speak ill of people when they are dead, but some people are beginning to feel that the custom of speaking well about even dead criminals at funerals is not helping society either.

They claim that if the living know that all their misdeeds will be recount­ed at their funeral when they are dead, they will endeavour not to misconduct themselves while alive. I think that is a valid point, because the dead have had it too easy.

When someone volunteered to say that a deceased fellow died of alcohol, his neck was nearly twisted. What right did he have to air the cause of death even if it was true that the guy had died of too much bitters? In any case, did he perform any post mortem to ascertain the cause of death? And for what earthly or heavenly reason did he have to associate their loved one with an evil called ALCOHOL? “Next time you talk nonsense, we shall physically weaken your jaw.

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It was at a funeral when a pastor undertook to say nice words about a dead common criminal that he was cor­rected by the deceased’s own profes­sional comrade.

He raised his right hand to signify that he wanted to chip in a point of or­der as the resident pastor spoke of how exemplary the dead man’s ways were. When no one bothered to give him the chance, he stood up and raised both hands, meaning that he had the con­stitutional right to slot in a rejoinder before the lies became over-whelming.

He was heavily drunk. Asked what he wanted to say, he broached the sub­ject that first and fore-most, he would recommend that the pastor be ex-com­municated from the church because he was a congenital liar, a quality unbecoming of a clergyman. He then proceeded to say the deceased was a criminal just like himself and deserved no praises in any church.

He intimated that the deceased, when he was alive, cheated him out of a booty, not once or twice, but many times, for which he never forgave him till he died. He said such a person’s body should not be brought to contam­inate the holiness of a church room. Before church elders could drag him out, he had spoken his mind.

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I guess if the dead man had a soul that was present where he was laid in state, the soul would have repented right in the church room.

Well there are many problems associated with modern-day funerals. One of them which is getting solved gradually is the wake-keeping palaver. The Akyem Abuakwa Traditional Council has banned wake-keepings as a means of cutting down cost of funerals in the traditional area. The Presbyteri­an Church is also not encouraging its members to opt for wake- keeping in any event of death of a member.

What are wake-keepings for any­way? When there were no mortuaries in the past, wake was kept because fami­ly members could not leave their dead bodies and go to bed. Keeping wake has, therefore, outlived its usefulness in present day circumstances.

A wake-keeping today is an occasion where you can get a married woman drunk and seduce her, where young girls elope with married men for amo­rous purposes, and where people either get married or lose their spouses. Ev­erything is under the cover of darkness, supervised by Jimmy Satan.

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A funeral that is without an elabo­rate wake-keeping can save at least a lot of money. A funeral that is without frivolous eating and boozing can also save a fortune. The dead must not be a burden for the living, just like getting married shouldn’t be any big deal.

The average Sikaman bride is married at least three times without any sane reason. Her Caucasian or Anglo-Saxon counterpart gets married just once in a very simply ceremony.

Why are many young men unable to marry? The fact is that they can’t. They don’t have the dough. They must KNOCK DOOR, ENGAGE and WED-three in one. By the time they are through, they are in debt to a tune of 5 million. No marriage is stable when the founda­tion is built on a $5 million debt.

I guess my great grandfather mar­ried his loving wife with two bottles of akpeteshie, five tubers of yam and a bottle of zomi. Check out how much I have to spend when I want wife. You can’t get a woman with akpeteshie, yam tubers and palm oil anywhere in Sikaman today. Even in the remotest cottage, they ask you to “do wedding”. It is a command, not a suggestion.

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The result is that the young men can’t get married, and once they are virile and not impotent, they continue impregnating the young and unmarried girls, littering communities with kids born out of wedlock, many ending up as the street kids we see everywhere hawking barefoot instead of studying in school.

This article was first published

on Saturday, April 18, 1998

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