Francis Ofei - Academia.edu (original) (raw)
Papers by Francis Ofei
Ghana Medical Journal, Sep 1, 1989
Ghana medical journal, 2005
Obesity is a common and preventable disease of clinical and public health importance. It is often... more Obesity is a common and preventable disease of clinical and public health importance. It is often a major risk factor for the development of several non-communicable diseases, significant disability and premature death. There is presently a global epidemic of obesity in all age groups and in both developed and developing countries. The increasing prevalence of obesity places a large burden on health care use and costs. Weight loss is associated with significant health and economic benefits. Effective weight loss strategies include dietary therapy, physical activity and lifestyle modification. Drug therapy is reserved for obese or overweight patients who have concomitant obesity-related risk factors or diseases. Population-wide prevention programmes have a greater potential of stemming the obesity epidemic and being more cost-effective than clinic-based weight-loss programmes. Ghana is going through an economic and nutrition transition and experiencing an increase in the prevalence o...
Ghana Medical Journal, 2010
Ghana medical journal, 2011
BACKGROUND There is evidence linking the Metabolic Syndrome with an increased risk of developing ... more BACKGROUND There is evidence linking the Metabolic Syndrome with an increased risk of developing cardiovascular disease, previously thought to be rare in Africa but now a major public health concern. OBJECTIVES To determine the frequency of occurrence of the Metabolic Syndrome among patients presenting with cardiovascular disease at the Korle Bu Teaching Hospital, Ghana. METHODS This was a case-control study of 100 consecutive cardiovascular disease patients and 100 age- and sex- matched controls who underwent an interview and physical examination. Anthropometric measurements and fasting blood samples for plasma glucose and lipids were taken. The National Cholesterol Education Programme: Adult Treatment Panel III criteria were used for the diagnosis of the Metabolic Syndrome. RESULTS The prevalence of Metabolic Syndrome among cases and controls was 54% and 18% respectively, with the prevalence increasing with advancing age. Hypertension and central obesity were the two components wi...
Health Policy And Planning
Understanding how countries review their national standard treatment guidelines (STGs) and essent... more Understanding how countries review their national standard treatment guidelines (STGs) and essential medicines list (EML) is important in the light of ever-changing trends in public health and evidence supporting the selection and use of medicines in disease management. This study examines the 2017 STGs and EML review process, the actors involved and how the list of medicines and disease conditions evolved between the last two editions. We examined expert committee reports, stakeholder engagement reports and the last two editions (2010, 2017) STGs and EML. The review process occurred in both bureaucratic and public arenas where various actors with varied power and interest engaged in ways to consolidate their influence with the use of evidence from research and practice. In the bureaucratic arena, a national medicines selection committee inaugurated by the Minister of Health assessed the 2010 edition through technical sessions considering the country’s disease burden, hierarchical h...
Ghana Medical Journal, 2010
Although endocrine causes of secondary hypertension are relatively uncommon, medical practitioner... more Although endocrine causes of secondary hypertension are relatively uncommon, medical practitioners must maintain a high index of suspicion for them in certain categories of patients. Such patients include young individuals, those with difficult-to-treat hypertension and those presenting with symptoms, clinical signs and/or laboratory parameters well-known to be associated with Cushing's syndrome, Conn's syndrome or phaeochromocytoma. This paper reports on 5 patients identified over a 2-year period with various hormonally-active adrenal adenomas causing hypertension in an environment where, hitherto, the occurrence of these conditions was generally thought to be rare. Aspects of the patients' histories, examination and laboratory findings that drew attention to the possibility of the diagnosis in each case are highlighted, as are the confirmatory investigations and management methods used by a multidisciplinary team of medical practitioners. The clinical outcome with appropriate treatment of adrenalrelated hypertension is good and can result in significant cost savings in the long term.
Ghana medical journal
There is evidence linking the Metabolic Syndrome with an increased risk of developing cardiovascu... more There is evidence linking the Metabolic Syndrome with an increased risk of developing cardiovascular disease, previously thought to be rare in Africa but now a major public health concern. To determine the frequency of occurrence of the Metabolic Syndrome among patients presenting with cardiovascular disease at the Korle Bu Teaching Hospital, Ghana. This was a case-control study of 100 consecutive cardiovascular disease patients and 100 age- and sex- matched controls who underwent an interview and physical examination. Anthropometric measurements and fasting blood samples for plasma glucose and lipids were taken. The National Cholesterol Education Programme: Adult Treatment Panel III criteria were used for the diagnosis of the Metabolic Syndrome. The prevalence of Metabolic Syndrome among cases and controls was 54% and 18% respectively, with the prevalence increasing with advancing age. Hypertension and central obesity were the two components with the highest frequency among individ...
West African journal of medicine
The blood glucose responses to five Ghanaian carbohydrate sources, unripe plantain, Ga kenkey, Ga... more The blood glucose responses to five Ghanaian carbohydrate sources, unripe plantain, Ga kenkey, Gari, rice and yam, as part of mixed meals were determined in ten healthy young nondiabetic adult males aged 25.6 +/- 2.6 years with a BMI of 20.9 +/- 2.4 kg/m2. Ga kenkey showed the least changes in blood glucose responses as measured by the glycemic index. Yam exhibited the least favourable blood glucose responses. Significant difference were observed between the glycemic indices of kenkey and yam; Kenkey and gari (p < 0.01); rice and yam, plantain and yam (p < 0.05). Further studies of these carbohydrate sources are required in diabetics to ascertain their suitability as carbohydrate sources in Ghanaian diabetics.
Journal of the National Medical Association, 1997
Both diabetes mellitus and hypertension alter lipid and lipoprotein metabolism and increase the r... more Both diabetes mellitus and hypertension alter lipid and lipoprotein metabolism and increase the risk of coronary artery disease. We have reported previously on lipid and lipoprotein levels in healthy Ghanaians, and this study deals with the levels of these biochemical parameters in Ghanaians with diabetes mellitus and hypertension. Fasting serum lipoproteins were determined on blood samples drawn from healthy male and female Ghanaians as well as age-matched individuals with either diabetes or hypertension. Cholesterol, high-density lipoprotein cholesterol (HDL-C), triglycerides, and fasting blood glucose were measured. Low-density lipoprotein cholesterol (LDL-C) and very low-density lipoprotein cholesterol (VLDL-C) were derived. Total serum cholesterol levels were 4.43 +/- 0.22 mmol/L and 4.67 +/- 0.26 mmol/L for diabetic males and females, respectively. High-density lipoprotein was 1.55 +/- 0.09 mmol/L and 1.50 +/- 0.09 mmol/L for male and female diabetics, respectively. Lipid and ...
Pan African Medical Journal
Exp Clin Endocrinol Diabetes, 1996
... O-48: TNFα and insulin sensitivity in humans: effects in vivo of antibody blockade in obese N... more ... O-48: TNFα and insulin sensitivity in humans: effects in vivo of antibody blockade in obese NIDDM patients and in vitro upon human cultured myotubes. Stevn Hurel, Francis Ofei, Ann Wells, José Newkirk, Mark Sopwith, Douglas Turnbull, Roy Taylor. ...
Journal of Internal Medicine, 1994
of4.34f 1.12 mmol L-' was obtained for the females in this study. High-density lipoprotein choles... more of4.34f 1.12 mmol L-' was obtained for the females in this study. High-density lipoprotein cholesterol (HDL-C) in Ghanaian males averaged 1.37 f 0. 4 4 There was no statistically significant difference in low-density-lipoprotein cholesterol (LDL-C) and very-Objectives. To date, no measurement of serum lipid levels in healthy adult Ghanaians have been carried out. This study was undertaken with the objective of providing reference values for serum lipids levels in the Ghanaian population. Design/setting. Fasting serum lipid levels were measured in 79 adult Ghanaians living in an urban setting. Volunteers were randomly selected from the work force of the University of Ghana in Accra. There were 54 males and 25 females in the study population. low-density-lipoprotein cholesterol (VLDL-C) levels between the females and males in this study. Conclusions. Compared to other studies, our results show that populations in Europe and North America have higher levels of total cholesterol and LDL cholesterol than Ghanaians. The levels of HDL cholesterol as well as VLDL cholesterol are higher in Ghanaians than in Europeans and Americans. Further work needs to be done to compare lipid levels in urban and rural Ghanaians as well as in those with cardiovascular disorders. Results. The mean serum cholesterol (SC) for Keywords: coronary artery disease prevention, Ghanaian males was 4.2 7 f 1.00 mmol L-'. A value Ghanaians, lipoprotein, reference values.
Experimental and Clinical Endocrinology & Diabetes, 1996
... O-48: TNFα and insulin sensitivity in humans: effects in vivo of antibody blockade in obese N... more ... O-48: TNFα and insulin sensitivity in humans: effects in vivo of antibody blockade in obese NIDDM patients and in vitro upon human cultured myotubes. Stevn Hurel, Francis Ofei, Ann Wells, José Newkirk, Mark Sopwith, Douglas Turnbull, Roy Taylor. ...
Diabetes, 1996
Inhibition of tumor necrosis factor (TNF)-alpha action has recently been shown to reverse insulin... more Inhibition of tumor necrosis factor (TNF)-alpha action has recently been shown to reverse insulin resistance dramatically and to improve glycemic control in obese rodents. This double-blind study was designed to assess the effects of a recombinant-engineered human TNF-alpha-neutralizing antibody (CDP571) on glucose homeostasis in obese NIDDM patients. Glycemic control and insulin sensitivity were monitored in 21 NIDDM subjects for a 2-week run-in and then for 6 weeks after treatment in a randomized fashion with a single intravenous dose of either CDP571 (5 mg/kg) or an equivalent volume of normal saline. The prolonged half-life of the antibody ensured adequate plasma levels as measured throughout the study. Concentrations of fasting glucose (CDP571: 10.0 +/- 0.8, 10.1 +/- 0.8, 10.0 +/- 1.0; placebo: 8.5 +/- 0.6, 8.1 +/- 0.5, 8.7 +/- 0.8 mmol/l at baseline, day 1, and week 4, respectively), fasting serum insulin (CDP571: 21.2 +/- 2.8, 21.0 +/- 2.8, 24.8 +/- 3.3; placebo: 19.0 +/- 2.8, 20.8 +/- 2.9, 17.5 +/- 2.2 pmol/l, respectively), and C-peptide remained unaffected by the type of treatment throughout the study. The percentage rate of glucose clearance per minute (KITT) during intravenous insulin sensitivity tests was identical in the CDP571 and placebo groups at baseline and also at 1 and 4 weeks after treatment (mean +/- SE; CDP571: 1.33 +/- 0.21, 1.44 +/- 0.25, 1.26 +/- 0.18; placebo: 1.38 +/- 0.15, 1.47 +/- 0.20, 1.52 +/- 0.20; P = 0.85, 0.93, and 0.36, respectively). TNF-alpha neutralization over a period of 4 weeks had no effect on insulin sensitivity in obese NIDDM subjects.
Annals of Emergency Medicine, 1988
Original Article from The New England Journal of Medicine Unrecognized Human Immunodeficiency V... more Original Article from The New England Journal of Medicine Unrecognized Human Immunodeficiency Virus Infection in Emergency Department Patients.
Academic Medicine, 2003
Introduction of more effective and standardized assessment methods for testing students&a... more Introduction of more effective and standardized assessment methods for testing students&amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; performance in Africa&amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s medical institutions has been hampered by severe financial and personnel shortages. Nevertheless, some African institutions have recognized the problem and are now revising their medical curricula, and, therefore, their assessment methods. These institutions, and those yet to come, need guidance on selecting assessment methods so as to adopt models that can be sustained locally. The authors provide a model for selecting assessment methods for testing medical students&amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; performance in African medical institutions. The model systematically evaluates factors that influence implementation of an assessment method. Six commonly used methods (the essay examinations, short-answer questions, multiple-choice questions, patient-based clinical examination, problem-based oral examination [POE], and objective structured clinical examination) are evaluated by scoring and weighting against performance, cost, suitability, and safety factors. In the model, the highest score identifies the most appropriate method. Selection of an assessment method is illustrated using two institutional models, one depicting an ideal situation in which the objective structured clinical examination was preferred, and a second depicting the typical African scenario in which the essay and short-answer-question examinations were best. The POE method received the highest score and could be recommended as the most appropriate for Africa&amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s medical institutions, but POE assessments require changing the medical curricula to a problem-based learning approach. The authors&amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; model is easy to understand and promotes change in the medical curriculum and method of student assessment.
Ghana Medical Journal, Sep 1, 1989
Ghana medical journal, 2005
Obesity is a common and preventable disease of clinical and public health importance. It is often... more Obesity is a common and preventable disease of clinical and public health importance. It is often a major risk factor for the development of several non-communicable diseases, significant disability and premature death. There is presently a global epidemic of obesity in all age groups and in both developed and developing countries. The increasing prevalence of obesity places a large burden on health care use and costs. Weight loss is associated with significant health and economic benefits. Effective weight loss strategies include dietary therapy, physical activity and lifestyle modification. Drug therapy is reserved for obese or overweight patients who have concomitant obesity-related risk factors or diseases. Population-wide prevention programmes have a greater potential of stemming the obesity epidemic and being more cost-effective than clinic-based weight-loss programmes. Ghana is going through an economic and nutrition transition and experiencing an increase in the prevalence o...
Ghana Medical Journal, 2010
Ghana medical journal, 2011
BACKGROUND There is evidence linking the Metabolic Syndrome with an increased risk of developing ... more BACKGROUND There is evidence linking the Metabolic Syndrome with an increased risk of developing cardiovascular disease, previously thought to be rare in Africa but now a major public health concern. OBJECTIVES To determine the frequency of occurrence of the Metabolic Syndrome among patients presenting with cardiovascular disease at the Korle Bu Teaching Hospital, Ghana. METHODS This was a case-control study of 100 consecutive cardiovascular disease patients and 100 age- and sex- matched controls who underwent an interview and physical examination. Anthropometric measurements and fasting blood samples for plasma glucose and lipids were taken. The National Cholesterol Education Programme: Adult Treatment Panel III criteria were used for the diagnosis of the Metabolic Syndrome. RESULTS The prevalence of Metabolic Syndrome among cases and controls was 54% and 18% respectively, with the prevalence increasing with advancing age. Hypertension and central obesity were the two components wi...
Health Policy And Planning
Understanding how countries review their national standard treatment guidelines (STGs) and essent... more Understanding how countries review their national standard treatment guidelines (STGs) and essential medicines list (EML) is important in the light of ever-changing trends in public health and evidence supporting the selection and use of medicines in disease management. This study examines the 2017 STGs and EML review process, the actors involved and how the list of medicines and disease conditions evolved between the last two editions. We examined expert committee reports, stakeholder engagement reports and the last two editions (2010, 2017) STGs and EML. The review process occurred in both bureaucratic and public arenas where various actors with varied power and interest engaged in ways to consolidate their influence with the use of evidence from research and practice. In the bureaucratic arena, a national medicines selection committee inaugurated by the Minister of Health assessed the 2010 edition through technical sessions considering the country’s disease burden, hierarchical h...
Ghana Medical Journal, 2010
Although endocrine causes of secondary hypertension are relatively uncommon, medical practitioner... more Although endocrine causes of secondary hypertension are relatively uncommon, medical practitioners must maintain a high index of suspicion for them in certain categories of patients. Such patients include young individuals, those with difficult-to-treat hypertension and those presenting with symptoms, clinical signs and/or laboratory parameters well-known to be associated with Cushing's syndrome, Conn's syndrome or phaeochromocytoma. This paper reports on 5 patients identified over a 2-year period with various hormonally-active adrenal adenomas causing hypertension in an environment where, hitherto, the occurrence of these conditions was generally thought to be rare. Aspects of the patients' histories, examination and laboratory findings that drew attention to the possibility of the diagnosis in each case are highlighted, as are the confirmatory investigations and management methods used by a multidisciplinary team of medical practitioners. The clinical outcome with appropriate treatment of adrenalrelated hypertension is good and can result in significant cost savings in the long term.
Ghana medical journal
There is evidence linking the Metabolic Syndrome with an increased risk of developing cardiovascu... more There is evidence linking the Metabolic Syndrome with an increased risk of developing cardiovascular disease, previously thought to be rare in Africa but now a major public health concern. To determine the frequency of occurrence of the Metabolic Syndrome among patients presenting with cardiovascular disease at the Korle Bu Teaching Hospital, Ghana. This was a case-control study of 100 consecutive cardiovascular disease patients and 100 age- and sex- matched controls who underwent an interview and physical examination. Anthropometric measurements and fasting blood samples for plasma glucose and lipids were taken. The National Cholesterol Education Programme: Adult Treatment Panel III criteria were used for the diagnosis of the Metabolic Syndrome. The prevalence of Metabolic Syndrome among cases and controls was 54% and 18% respectively, with the prevalence increasing with advancing age. Hypertension and central obesity were the two components with the highest frequency among individ...
West African journal of medicine
The blood glucose responses to five Ghanaian carbohydrate sources, unripe plantain, Ga kenkey, Ga... more The blood glucose responses to five Ghanaian carbohydrate sources, unripe plantain, Ga kenkey, Gari, rice and yam, as part of mixed meals were determined in ten healthy young nondiabetic adult males aged 25.6 +/- 2.6 years with a BMI of 20.9 +/- 2.4 kg/m2. Ga kenkey showed the least changes in blood glucose responses as measured by the glycemic index. Yam exhibited the least favourable blood glucose responses. Significant difference were observed between the glycemic indices of kenkey and yam; Kenkey and gari (p < 0.01); rice and yam, plantain and yam (p < 0.05). Further studies of these carbohydrate sources are required in diabetics to ascertain their suitability as carbohydrate sources in Ghanaian diabetics.
Journal of the National Medical Association, 1997
Both diabetes mellitus and hypertension alter lipid and lipoprotein metabolism and increase the r... more Both diabetes mellitus and hypertension alter lipid and lipoprotein metabolism and increase the risk of coronary artery disease. We have reported previously on lipid and lipoprotein levels in healthy Ghanaians, and this study deals with the levels of these biochemical parameters in Ghanaians with diabetes mellitus and hypertension. Fasting serum lipoproteins were determined on blood samples drawn from healthy male and female Ghanaians as well as age-matched individuals with either diabetes or hypertension. Cholesterol, high-density lipoprotein cholesterol (HDL-C), triglycerides, and fasting blood glucose were measured. Low-density lipoprotein cholesterol (LDL-C) and very low-density lipoprotein cholesterol (VLDL-C) were derived. Total serum cholesterol levels were 4.43 +/- 0.22 mmol/L and 4.67 +/- 0.26 mmol/L for diabetic males and females, respectively. High-density lipoprotein was 1.55 +/- 0.09 mmol/L and 1.50 +/- 0.09 mmol/L for male and female diabetics, respectively. Lipid and ...
Pan African Medical Journal
Exp Clin Endocrinol Diabetes, 1996
... O-48: TNFα and insulin sensitivity in humans: effects in vivo of antibody blockade in obese N... more ... O-48: TNFα and insulin sensitivity in humans: effects in vivo of antibody blockade in obese NIDDM patients and in vitro upon human cultured myotubes. Stevn Hurel, Francis Ofei, Ann Wells, José Newkirk, Mark Sopwith, Douglas Turnbull, Roy Taylor. ...
Journal of Internal Medicine, 1994
of4.34f 1.12 mmol L-' was obtained for the females in this study. High-density lipoprotein choles... more of4.34f 1.12 mmol L-' was obtained for the females in this study. High-density lipoprotein cholesterol (HDL-C) in Ghanaian males averaged 1.37 f 0. 4 4 There was no statistically significant difference in low-density-lipoprotein cholesterol (LDL-C) and very-Objectives. To date, no measurement of serum lipid levels in healthy adult Ghanaians have been carried out. This study was undertaken with the objective of providing reference values for serum lipids levels in the Ghanaian population. Design/setting. Fasting serum lipid levels were measured in 79 adult Ghanaians living in an urban setting. Volunteers were randomly selected from the work force of the University of Ghana in Accra. There were 54 males and 25 females in the study population. low-density-lipoprotein cholesterol (VLDL-C) levels between the females and males in this study. Conclusions. Compared to other studies, our results show that populations in Europe and North America have higher levels of total cholesterol and LDL cholesterol than Ghanaians. The levels of HDL cholesterol as well as VLDL cholesterol are higher in Ghanaians than in Europeans and Americans. Further work needs to be done to compare lipid levels in urban and rural Ghanaians as well as in those with cardiovascular disorders. Results. The mean serum cholesterol (SC) for Keywords: coronary artery disease prevention, Ghanaian males was 4.2 7 f 1.00 mmol L-'. A value Ghanaians, lipoprotein, reference values.
Experimental and Clinical Endocrinology & Diabetes, 1996
... O-48: TNFα and insulin sensitivity in humans: effects in vivo of antibody blockade in obese N... more ... O-48: TNFα and insulin sensitivity in humans: effects in vivo of antibody blockade in obese NIDDM patients and in vitro upon human cultured myotubes. Stevn Hurel, Francis Ofei, Ann Wells, José Newkirk, Mark Sopwith, Douglas Turnbull, Roy Taylor. ...
Diabetes, 1996
Inhibition of tumor necrosis factor (TNF)-alpha action has recently been shown to reverse insulin... more Inhibition of tumor necrosis factor (TNF)-alpha action has recently been shown to reverse insulin resistance dramatically and to improve glycemic control in obese rodents. This double-blind study was designed to assess the effects of a recombinant-engineered human TNF-alpha-neutralizing antibody (CDP571) on glucose homeostasis in obese NIDDM patients. Glycemic control and insulin sensitivity were monitored in 21 NIDDM subjects for a 2-week run-in and then for 6 weeks after treatment in a randomized fashion with a single intravenous dose of either CDP571 (5 mg/kg) or an equivalent volume of normal saline. The prolonged half-life of the antibody ensured adequate plasma levels as measured throughout the study. Concentrations of fasting glucose (CDP571: 10.0 +/- 0.8, 10.1 +/- 0.8, 10.0 +/- 1.0; placebo: 8.5 +/- 0.6, 8.1 +/- 0.5, 8.7 +/- 0.8 mmol/l at baseline, day 1, and week 4, respectively), fasting serum insulin (CDP571: 21.2 +/- 2.8, 21.0 +/- 2.8, 24.8 +/- 3.3; placebo: 19.0 +/- 2.8, 20.8 +/- 2.9, 17.5 +/- 2.2 pmol/l, respectively), and C-peptide remained unaffected by the type of treatment throughout the study. The percentage rate of glucose clearance per minute (KITT) during intravenous insulin sensitivity tests was identical in the CDP571 and placebo groups at baseline and also at 1 and 4 weeks after treatment (mean +/- SE; CDP571: 1.33 +/- 0.21, 1.44 +/- 0.25, 1.26 +/- 0.18; placebo: 1.38 +/- 0.15, 1.47 +/- 0.20, 1.52 +/- 0.20; P = 0.85, 0.93, and 0.36, respectively). TNF-alpha neutralization over a period of 4 weeks had no effect on insulin sensitivity in obese NIDDM subjects.
Annals of Emergency Medicine, 1988
Original Article from The New England Journal of Medicine Unrecognized Human Immunodeficiency V... more Original Article from The New England Journal of Medicine Unrecognized Human Immunodeficiency Virus Infection in Emergency Department Patients.
Academic Medicine, 2003
Introduction of more effective and standardized assessment methods for testing students&a... more Introduction of more effective and standardized assessment methods for testing students&amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; performance in Africa&amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s medical institutions has been hampered by severe financial and personnel shortages. Nevertheless, some African institutions have recognized the problem and are now revising their medical curricula, and, therefore, their assessment methods. These institutions, and those yet to come, need guidance on selecting assessment methods so as to adopt models that can be sustained locally. The authors provide a model for selecting assessment methods for testing medical students&amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; performance in African medical institutions. The model systematically evaluates factors that influence implementation of an assessment method. Six commonly used methods (the essay examinations, short-answer questions, multiple-choice questions, patient-based clinical examination, problem-based oral examination [POE], and objective structured clinical examination) are evaluated by scoring and weighting against performance, cost, suitability, and safety factors. In the model, the highest score identifies the most appropriate method. Selection of an assessment method is illustrated using two institutional models, one depicting an ideal situation in which the objective structured clinical examination was preferred, and a second depicting the typical African scenario in which the essay and short-answer-question examinations were best. The POE method received the highest score and could be recommended as the most appropriate for Africa&amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s medical institutions, but POE assessments require changing the medical curricula to a problem-based learning approach. The authors&amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; model is easy to understand and promotes change in the medical curriculum and method of student assessment.