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Akua Abrah (’27) is working in Ghana for nine months on a Fulbright-Fogarty scholarship, studying glucose-6-phosphate dehydrogenase (G6PD) deficiency, a common cause of neonatal jaundice in Ghana. She is contributing to emerging research and clinical practices aimed at improving neonatal outcomes through early identification of at-risk infants for severe jaundice.
Now halfway through the program, she sends us this report:
“Good evening, and happy belated New Year! I wanted to share an update on my experience.
“Research: G6PD deficiency predisposes at-risk infants to severe jaundice, which remains a significant cause of neonatal morbidity and mortality in Ghana. Despite World Health Organization (WHO) recommendations for high-prevalence countries, Ghana does not currently have a standard newborn G6PD screening program. Our study aims to assess whether early screening can serve as a primary step for the prevention of severe neonatal jaundice in at-risk infants.
“In the United States, the prevalence of G6PD deficiency ranges between 0.5-2%, far below the global prevalence of ~5%. There is no standard national newborn screening for this condition unless a baby has specific risk factors such as ancestry or severe jaundice. When babies are screened, blood collected from a heel prick is used.
“In Ghana, G6PD deficiency can be as high as 20% of the population. To screen, we proposed a non-invasive method by using cord blood samples collected from the placenta after delivery. Cord blood screening is not standard practice in Ghana, so there were no ready-made collection kits. Knowing the necessity, I began to review the literature and explore medical supply websites to identify materials needed to assemble my own G6PD screening kits. I also worked with my research assistant to develop workshops for healthcare providers at Suntreso Government Hospital on the collection of samples using these kits. This included hands-on practice session to assess understanding and ensure an efficient workflow.
“Towards the end of last year, we received Institutional Review Board (IRB) approval and have since begun patient enrollment. The results so far are promising, as we have already identified G6PD-deficient newborns requiring phototherapy who developed jaundice in less than 24 hours.
“My fellowship is in partnership with the NIH Fogarty International Center. Through weekly meetings with fellows from around the world, I have had opportunities to discuss my project, exchange feedback and strengthen my writing and presentation skills, which has enriched my research experience.
Image content: This image is available to view online.
View image online (https://assets.clevelandclinic.org/transform/667c137c-773d-4aec-bdce-6dda7166b2fd/Akua-Abrah-Ghana-collage)
A collage of photos of Akua Abrah from her time in Ghana.
“Clinical Work: Suntreso Government Hospital serves as both my research and clinical site. My PI, Dr. Ashura Bakari, is the hospital’s only pediatric attending. Most of my clinical time is spent in the Mother-Baby Unit (similar to a NICU), but I occasionally work in the Children’s Ward. Our medical team includes PAs, nurses, residents and rotating students, creating a highly engaging and diverse learning environment.
“Working in a government hospital, we see a wide variety of cases. I continue to be amazed by the level of care the team delivers despite limited resources. Whether managing neonatal respiratory distress with only a few CPAP machines, facing the constant threat of oxygen shortages or treating neonatal sepsis and metabolic conditions, the team’s skill and commitment are commendable. Integrating research with clinical care has been especially meaningful. For instance, I once assisted with an exchange transfusion for a newborn with kernicterus. Although the baby ultimately did not survive, the experience underscored the clinical challenges, the providers’ dedication to their patients and the urgency of our study.
“Last November, we celebrated World Prematurity Awareness Day with a graduation for the former premature infants who turned a year old. Our hospital follows every premature baby for one year through the Kangaroo Mother Care Clinic. The toddlers in their caps and gowns were absolutely adorable.
“Community Engagement: Returning to Ghana after 14 years to complete my research year has been a joy. The community has been incredibly welcoming, and I’ve enjoyed local cuisines, cultural events and holiday celebrations. While I am fluent in Twi (the local language), my language skills have noticeably improved through daily use.
“I brought my violin with me and joined the instrumentalists at my local church. I was happy to learn that many of the kids there had been learning violin from the church pianist, who had been using books and videos to train the children. Since my arrival, we have been working together to strengthen their skills, and the students are enthusiastic and always eager to learn more. We held an end-of-year performance last December and are currently preparing for another concert in April.
“I created this video compilation that highlights some of the moments described in this report.
“The past five months have been busy but rewarding. I’m excited for what lies ahead in the remainder of my fellowship and look forward to reuniting with my CCLCM family soon!”
