High blood pressure is surprisingly common, affecting 60% of African adults.

And it’s a serious threat. High blood pressure increases the risk for heart attack, heart failure, stroke, kidney failure, and several other life-threatening health problems. In fact, high blood pressure causes thousands deaths in the Africa PER DAY. Even more disturbing is that most of these deaths are preventable. High blood pressure is almost always treatable with lifestyle changes and inexpensive medication, yet less than half of people with high blood pressure have it under control.

Lifestyle and High Blood Pressure

Experts suggest that 50%-90% of high blood pressure could be successfully lowered with lifestyle change.

In my practice, if a patient’s blood pressure is mildly elevated and there are no high risk factors (such as diabetes, current smoker or history of heart disease, stroke or multiple cardiac risk factors), I will recommend a 3-month trial of lifestyle change as an initial treatment. I let my patients know that many of these changes can be as effective as any single blood pressure medication.

For many of my patients, the potential to avoid being on medication for the rest of their lives is a strong motivator, and they appreciate the sense of control they have over their health.

Here are the specific areas I recommend my patients focus on in order to lower their blood pressure:

Physical Activity: Even a modest level of physical activity, over time, can make a significant difference in your blood pressure. If you’re not used to exercise, start slow. Five or 10 minutes a day of your favorite activity can be just the start you need to build an exercise habit and allow you to build up to the 2 hours and 30 minutes a week of activity recommended by national guidelines.
–
Healthy Diet: I recommend cutting out highly processed food (packaged foods typically high in added sugar and/or refined grains). Watching your salt intake is important if you have high blood pressure, but keep in mind that most of the salt in our diets comes from processed foods and restaurants.
–
Weight Loss: Losing even 5% of your starting body weight has been proven to significantly lower blood pressure; and 10% has been shown to dramatically improve other health conditions such as atrial fibrillation. The weight loss strategy I recommend to my patients is the one that works in the long run. Use the lasting power of creating better habits. Restrictive diets might work in the short run, but their results rarely last.
Limited alcohol intake (less than one drink per day): A recent study showed that people who drank 7-13 drinks per week were 53% more likely to have stage I hypertension. Those who drank more than 14 drinks per week had a 69% higher risk of hypertension.
–
Not smoking: Smoking cessation can modestly lower blood pressure and dramatically lower the risk for future heart disease.
In addition to these lifestyle changes, avoid regular use of anti-inflammatory medications, like ibuprofen and naproxen, and treat sleep apnea if you have it.

One of the more gratifying events in my practice is when a patient is able to lower, or even eliminate, blood pressure medications because of healthier lifestyle choices. If you have high blood pressure, don’t miss out on this powerful therapy.

Dear Cherished Parent and Patient,

 

Because of the ongoing uncertainty related to the COVID-19 pandemic, we have introduced virtual consultations either by telephone or by video. This is available from Monday to Saturday and is either covered by your medical insurance company or payment through Mobile Money. 

 

Clinic consultations and any lab tests can still be done on-site on Mondays, Wednesdays or Fridays from 9:00am to 12:00pm subject to availability. 

 

Call us today to find out more

 

HOW TO BOOK A VISIT:

• Contact the clinic on +233561111782 or +233289543726 to schedule a telemedicine consultation or clinic appointment at any time or day of the week. 
• For Telemedicine, always give us the preferred telephone number or email address and you will be given a specific time when we will contact you.

 Please feel comfortable taking advantage of this service.

The “end” of this pandemic is unfortunately not in sight and the risk will continue for months to come. Hopefully by next year we will have an effective vaccine to prevent infection.

 

Please stay safe and practice social distancing during this unsettling time.

 

The Team is here for you should you need to talk or address a specific concern.

 

All the best.

 

Today is World Malaria day.   What you need to know today about Malaria in Ghana.     The WHO World Malaria reports that:

The West African sub-region, of which Ghana is a part (Figure 1), is estimated to have more than 300 million people at risk of malaria infection. Thus, the sub-region accounts for about half of the global burden. 

The whole of Ghana is at risk of malaria. Malaria in Ghana accounts for 4% of the global burden and 7% of the malaria burden in West Africa. 

Malaria was responsible for 19% of all recorded deaths in Ghana in 2015. 

Malaria-attributable mortality has declined significantly from 19% (2010) to 4.2% (2016).

The health facility case fatality rate among children under five years of age declined from 14 percent in 2000 to less than half a percent in 2016.

Malaria hospital admissions increased from 280,000 to 340,000 persons between 2000 and 2017.

Gains made towards reducing infection rates have stalled since 2015, increase in the rates of infection

There are at least four known types of malaria and at least one –plasmodium falciparum (which can develop into cerebral malaria)- is fatal if not treated.

Malaria parasites in Ghana are chloroquine resistant. Check with your doctor for appropriate diagnosis and treatment.

 

Credit : Dr. Judith Castor / MA PhD

 

 

                       

Covid-19 in Children of Africa                                        

COVID -19 

 

This pandemic has several facets: a Family, Community, Political, and Medical facet. This is solely about family facets and some pertinent medical facets for families of African origin.

 

Based on 2135 children studied in China during the initial Wuhan crisis, 9 out of 10 children will have mild symptoms of fever, fatigue, vomiting, nausea and diarrhoea. Pneumonia heralds increasing severity and should be observed closely in children. In Wuhan, only 1 in 20 children had severe symptoms such as pneumonia. It is important to note the symptoms were almost identical to Malaria in children. The blood count was quite different however with evidence of much inflammation ( C-Reactive Protein elevation, high lymphocyte count  etc). Total white blood cell counts tended to be normal or low. Chest X-rays demonstrated marked changes in severe cases.

 

As with adults, children with chronic illness or conditions tend to fare worse should they contract the Covid -19 virus. A major concern in Africa is Sickle Cell Anemia. Africa is home to 80 percent of all Sickle cell Anemia cases and within the continent 59% of all are found in the Democratic Republic du Congo and Nigeria. Other illnesses that can exacerbate Covid 19 illness include: Heart, Liver or Kidney disease: Diabetes, and Obesity (with a BMR above 40): Chronic lung disease and states of Immunocompromise. Symptomatic medical treatment for 2-4 weeks is usually adequate. Many parents however are worried and wanting information on Prevention and Treatment modalities available in Ghana and the rest of Africa.

Prevention in children:

Children should be placed on a hand washing regimen: a minimum number of times per i inversely proportionate to their age.

They should avoid any child or person coughing/sneezing

High touch surfaces should be cleaned and disinfected several times daily. These include the following:

Tables   Chairs Door knobs   Light switches Remote control switches   Handles Desks   Toilets   Sinks Toys  Bicycles Balls etc.

Launder following items frequently:

Plush Toys  Day and Night clothing

 

Quarantine and Lockdown in Children: 

Be sensitive to effects of using the following 5 tips.

1. 1. Limit exposure Media and TV Covid-19 coverage
   2. Insist on daily routines 
   3. Allow some time for input /agreement on assignments and entertainment 
   4. Maintain connections with family and friends via Face Time regularly
   5. Try fun classes online e.g. Karate

 

Onset of severe anxiety or habits such as bedwetting do require a Pediatrician’s assistance.

 

JM Tuakli, MD MPH     April 2020

 

 

         

 

 

1. BE A KID AGAIN:  Remember our children are also processing this pandemic and it very well may not come in verbal conversation.  Children will not always tell you what they are feeling but we can pretty much get a hint through their play as they often will act out or play out their feelings and emotions with toys, objects and even conversation displayed while playing video games.  Now is the time, since we are sheltered in together to enter their imaginary  world and be part of their play time. Don’t be surprised if you  find that their play focuses on  being sick,  going to the Dr or not being able to see friends and playing alone.  You can help them by communicating with them through play. Bring back some games you played as a child as well as incorporating yourself their games.   You will be surprised at what you may learn.

2. NO MORE TV TODAY:  We are all consumed by news. We watch the number of confirmed cases and more sadly the death tolls as well everyday.  Remember our children are listening as well and can become alarmed at the information coming in.  Give yourself a mental health break.  Limit the amount of news that you are watching online and on the TV.  Definitely limit the amount of time and exposure your children may have to the news.   As a parent and adult, set aside certain times of day that you watch or listen to the news.  Put  yourself on a schedule so that it too becomes part of a healthy routine.  Much of what we hear is repeated information and it will only serve to overwhelm and stress your emotional bank account.

3. GIVE YOURSELF A BREAK TODAY!   As parents you are doing  all the things you normally do but in a social environment that is stressed out to the max.  You may be even doing more than normal because you are working from home and facilitating a virtual classroom for your children.  Because of social distancing the supports that are normally in place may not be there for support at this time , i.e. extended     family members and hired help. Don’t blame yourself for what you may feel like is “poor performance” at parenting.  You cannot fail at this.  We as a human race have not been down this road before and thus there is no roadmap.  SO no one is going to judge you towards  a right and wrong way to parent as well as navigate this crisis.  Practice self acceptance and give yourself a pat on the back each day for a job well done.  Practice communicating with your children each  day for something they did right or how they solved a problem.  This small action will make everyone feel better about themselves.

4. LAUGHTER IS THE BEST MEDICINE:  We are worried each and every day for ourselves, our family and friends.  In short, there more than  one’s fair share of “worry” to go around.  Set aside to put “worry thoughts” on the back burner and watch a movie, binge on your favorite Netflix series or even seek out the comedy show circulating on YouTube.   Make sure you laugh and smile about something at least once or twice a day.

5. GIVE ME MY SPACE:   Even though we are practicing Social Distancing many of us are sheltered in with other family members in small and large spaces.  No matter the size of space you are living in, being cooped up with little physical distance for relief will undoubtedly bring out the best and worst in us all. Arguments, disagreements and even fighting are inevitable at this time. Remember no one is right all the time and compromise is the key. Remember that we are doing our best to get through this ordeal.

6. FCA IS HERE FOR YOU:   Now is not the time to stop seeing your therapist or counsellor if you are already seeking treatment.  Most  Clinicians are all operating in the virtual world – TeleHealth.  We at FCA are doing the same.  If you do not have a therapist and want to  speak with someone, call our office or send an email through our website and we will connect you with one of our clinicians.  Also, if you are on medication, now is not the time  to stop.  Let us know how we can help continue with the medicines that you need.  This global health crisis is making it difficult for many of us to cope in a healthy way.  So many of us are grieving the loss of a loved one, jobs, homes, even our way of life.  Do not feel you are alone,  there is help and support that we can provide.

Credit: Dr. Judith Castor/MA PhD.

Gross as it may be, this is an important topic!Worms inside human bodies are more common than you think. Though worms can infect people of all ages, children are more susceptible to getting them. These infections are caused by a group of parasites, including roundworms, whipworms, and hookworms that are transmitted through soil and water.

If these are left untreated, they can cause many health complications in the future. This is why it is very important to identify the problem and treat it as soon as possible.

This issue is more common in developing world than developed countries but it is still quite a common occurrence in children all over the world.

Let’s start with the most important question:

HOW DO CHILDREN GET WORMS?

In a nutshell—poor hygiene and unclean surroundings. These are the two main reasons of parasite infection. But, there are other ways children can get worms:

• Through human feces. Adult worms live in the intestines of people, feed on the food, and produce thousands of eggs each day. These eggs are released into the soil when the infected person defecates in public. These eggs can get into your child’s body when they play in the soil and put the unwashed hands in the mouth.
• The worms can also get transmitted through vegetables and fruits that are not cleaned properly. So, if you eat out and you had a salad which was not washed properly or washed with contaminated water, then you or your child can get worms.
• Drinking contaminated water or eating food with contaminated hands can also spread the infection.
• Children can acquire worms from others who are unhygienic. Worm eggs are miniscule and can live under fingernails. They can easily be transferred if an infected person has fed your child or handled your food without washing hands.
• Hookworm larvae can enter the body from any part of the body (especially feet) that is exposed to the infected soil or water. They penetrate the skin and travel through the body to the intestine, where they become adults.

Therefore…

if you and your children eat out often;
if your kids play in the dirt;
if you live near a lake, pond, or river and your children play or swim in those waters;
if you take vacations, especially to countries in developing world

your child may be more susceptible to getting worms.

Bottom line is there is no definitive way of saying ‘this is how your child got parasites.’

This brings us to the next point…

WHAT ARE THE SYMPTOMS?

• One of the prominent symptoms of worm infection is an itchy bottom, and sometimes loss of appetite.
• Some worms can cause stomachache.
• Constant scratching of the bottom; this might cause a rash around the anus and lead to an infection.
• Spotting adult worms in the child’s poo. Yep, live, wriggly ones.
• You may find tiny worms around the child’s anus, especially if you check first thing as they wake in the morning.
• Decreased physical performance; a usually active child no longer shows interest in playing or running around and shows signs of fatigue.
• Poor concentration; drop in grades and poor performance in school.
• Vitamin A deficiency that can result in dry eyes and blurry vision.
• Anemia, which is often the result of hookworms.
• Malnutrition and intestinal obstruction; in which case the child will look weak, lethargic, and unhealthy.
• Heavy infection can cause itchy vagina and vaginal discharge in prepubescent girls and adult women.
• Parasites can cause other problems such as nutrient deficiencies, allergies and food sensitivities.
• When parasites enter the digestive system, they release metabolites that have a toxic impact on the body.

I know it’s horrible to imagine your child is carrying parasites who are feeding off of him but there is no need to panic.

If your child displays any of these symptoms, look for worms in your child’s poo, and or do the morning anus test. If you don’t find any worms but still suspect your child may be a carrier, consult a doctor. The standard treatment is deworming tablets. You can take those.

If you prefer to treat them naturally, there are a few things you can do at home.

NATURAL ANTHELMINTIC / DEWORMING TREATMENTS

1. Reset your child’s gut microbiome. Parasites are often a sign of a loss of probiotic species and a healthy gut microbiome. Through promoting balance of the gut microbiome through diet and probiotic supplements you can help your child naturally fight parasites. 5 to 10 billion CFU probiotic supplement is sufficient for children under the age of 10. You should also include probiotics rich food in their regular diet such as unflavored yogurt with live active cultures, sourdough bread, peas, cottage/parmesan/gouda/cheddar and Swiss cheeses.
2. Focus on strengthening your child’s immune system. When the immune system is strong it’s better at fighting off parasites, and other invaders. Be sure your child is getting enough vitamin A, vitamin D, and vitamin K2 to help them resist parasitic infection.
3. Encourage your children to eat lots of colorful fruits and vegetables. Children are a product of their environment. They do what they see. If you model healthy eating and lifestyle habits, they will imitate you. Even if your child has poor eating habits, it is never too late to change. Don’t feel shy in seeking professional help if you are unable to inculcate proper eating habits in your children.
4. I highly recommend giving your children multivitamin and mineral supplement as a regular practice. No matter how well we eat, our diets are lacking essential nutrients and trace minerals. Supplements are a good way to ensure you and your children are receiving all that the body needs.
5. Keep sugar out of their diets as parasites thrive on sugar.
6. There are certain foods you must increase in your child’s diet since these foods are going to work as deworming medicine:⮚Garlic: it is anti-parasitic and works wonder. The trick is concentrated doses on regular basis. You should add garlic to breakfast, lunch and dinner if possible. If you can manage to feed them raw garlic, that would work much more effectively and much faster than cooked garlic.
   
   ⮚Papaya: both the fruit and seeds are fantastic anti-parasitic treatment. A teaspoon of dried papaya seeds mixed with honey daily can produce effective results very quickly.
   
   ⮚Carom seeds: have shown to be effective in expulsion of worms from the gut. You can give half a teaspoon of dried carom seeds to your child to chew. If the taste is too intense for them, you can add a teaspoon of honey to it. You can also powder the seeds, mix them with some coconut powder, oatmeal, and any nut butter to form appetizing energy balls.
   
   ⮚Pumpkin seeds: A community study in China revealed that pumpkin seeds were indicated to be safe and effective in treating human tapeworm infections. Raw green pumpkin seeds are the best. If your child is refusing to chew them, you can crush the seeds and add them to energy balls or bars.
   ⮚Bitter gourd: is also a highly effective treatment. If your child is a saint, you can give them bitter gourd juice, otherwise get the vegetarian capsules and give one capsule daily.
   
   ⮚Neem: is an amazing plant with tremendous health benefits. Neem leaves’ tea is a sure-fire treatment against worms. Neem fruit or flower extract can act as a precautionary measure to prevent worm infections. It would be a good idea to start giving it to your children before you take a vacation, or before the summer months when they might play barefoot in soil and water.
   
   ⮚Turmeric: Mixing 1 teaspoon of turmeric powder in a cup of milk can help in expelling the worms.
   
   ⮚Coconut: 1 to 3 tablespoons of fresh grated coconut daily and juice of tender coconut are both effective deworming treatments.
   

There are a couple of things you want to be careful about:

• If your child is a picky eater and you know will not cooperate with these natural remedies, don’t waste time and give them the deworming tablets. You want to ensure that the worms are properly rid of without any delay.
• If you administer natural remedies and the worms persist after a month, take them to the doctor and get tablets.
• Take precautions when you know you and your children might be vulnerable to worms. Prevention is always better than cure!

Let me know if there is any treatment you have used that works which you would like me to add to this list.

Wishing your child a speedy recovery!

Do you think you may have or have been exposed to corona virus “covid-19” kindly call this numbers. 0203295292 or 0247241447. Ensure to always wash your hands with soap and water. You can also use hand sanitizer also. Make sure you observe social distancing and avoid hand shaking.

Tip for Day

Wash your hands frequently

Regularly and thoroughly clean your hands with an alcohol-based hand rub or wash them with soap and water.

Why? Washing your hands with soap and water or using alcohol-based hand rub kills viruses that may be on your hands.

To all of our Patients, Patrons and Friends
Please note that as of of May 1, 2019, Dr Eleades Frometa Maurelo is no longer affiliated with Family, CHILD & Associates. Any interaction with him clinically or otherwise is fully independent of Dr Juliette Tuakli and her clinic and is done so at your own risk.
We thank you for your support and confidence in clinic and our passion for providing the best health care possible in Ghana.

Sincerely Dr. Juliette Tuakli and Health Care Team