Browsing by Author "Adjei, A.A."

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A - 61C and C - 101G hp gene promoter polymorphisms are, respectively, associated with ahaptoglobinaemia and hypohaptoglobinaemia in Ghana
(Clinical Genetics, 2003) Teye, K.; Quaye, I.K.E.; Koda, Y.; Adjei, A.A.; Tsuneoka, M.; Pang, H.; Kimura, H.
We have investigated the genetic basis for the Hp0 phenotype amongst 123 randomly selected Ghanaians. A total of 17 individuals were determined to be Hp0 phenotype, based on the classical method for Hp phenotyping of Hb-supplemented plasma. Out of the 17 Hp0 individuals, nine subjects were further classified as ahaptoglobinaemic and eight as hypohaptoglobinaemic by Western blots and double immunodiffusion. We identified three previously known base substitutions (A-55G, A-61C and T-104A) and three new ones (C-101G, T-191G and C-242T) within the 5' flanking region of the Hp gene. The A-61C base substitution significantly decreased transcriptional activity and was associated strongly with Hp2 allele and ahaptoglobinaemia. The C-101G substitution was similar in transcriptional activity to the wild-type and was associated with Hp1S allele and hypohaptoglobinaemia. The Hpdel allele seen in Asian populations was absent. We conclude that the Hp0 phenotype in Ghana has a genetic basis that differs significantly from that seen in Asia.
Aetiology of acute lower respiratory infections among children under five years in Accra, Ghana
(Pathogens, 2015-01) Adiku, T.K.; Asmah, R.H.; Rodrigues, O.; Goka, B.; Obodai, E.; Adjei, A.A.; Donkor, E.S.; Armah, G.
The study aimed to investigate the aetiological agents and clinical presentations associated with acute lower respiratory infections (ALRI) among children under five years old at the Korle-Bu Teaching Hospital in Ghana. This was a cross-sectional study carried from February to December 2001. Nasopharyngeal aspirates and venous blood specimens obtained from 108 children with features suggestive of ALRI, were cultured and the isolated bacterial organisms were identified biochemically. Nasopharyngeal aspirates were also tested for Respiratory Syncitial Virus (RSV) antigen using a commercial kit (Becton Dickinson Directigen RSV test kit). A multiplex reverse transcription-PCR (RT-PCR) was also used to detect and characterize RSV using extracted RNA. Socio-demographic and clinical data were also obtained from the study subjects. Bronchopneumonia (55.5%), bronchiolitis (25%), lobar pneumonia (10.2), non-specific ALRI (4.6%), TB, bronchitis and respiratory distress (0.67%) were diagnosed. The prevalence of septicaemia was 10% and bacteria isolated were Staphylococcus aureus, Streptococcus pneumoniae and enteric bacteria, including Salmonella spp., Enterobacter spp and Klebsiella spp, were isolated. Out of the 108 cases, 18% tested positive for RSV, with two cases having RSV as the only aetiological pathogen detected. The subtyping analysis of RSV strains by a multiplex RT-PCR showed that subgroups A and B circulated in the season of analysis. © 2015 by the authors
Assessment of anthropometric measurements, blood analytes and liver enzymes in Ghanaian alcoholics
(West African Journal of Medicine, 1992) Quaye, I.K.; Nyame, P.K.; Dodoo, D.K.; Gyan, B.; Adjei, A.A.
Anthropometric measurements of alcoholics and non alcoholics of similar economic background were compared and the results reveal that there are no marked differences between the two. However, the biochemical analyses indicates that alcohol predisposes to fat storage, may contribute to iron deficiency and plays a direct etiologic role in liver disease.
Assessment of the Viability of Adult Onchocerca Volvulus in Tissue Sections using Enzyme Histochemical Demonstration of Lactate Dehydrogenase Activity
(University of Ghana, 2003) Abdulai, S.M.; Wiredu, E.K.; Adjei, A.A.; University of Ghana, College of Health Sciences, School of Medicine and Dentistry, Department of Oral Pathology and Medicine
Current methods of assessing the viability of adult Onchocercs volvulus in drug evaluations are mainly based on in-vitro and histological techniques. The in-vitro method is efficient in detecting live and dead worms while the histological method is more efficient in determining the number of worms in the nodules. Despite their capabilities in some areas, these techniques have certain methodical deficiencies which often lead to inaccurate interpretation of results or marked variations between individuals assessing the viabilities of worms in the same nodules.The deficiencies associated with these techniques are partly responsible for the delay in developing safe and effective drugs for the treatment of onchocerciasis. Based on principles underlying lactate production and tetrazolium reduction tests used in in-vitro techniques for testing the viabilities of adult worms, an enzyme histochemical staining technique was employed to determine the presence of lactate dehydrogenase (LDH) in adult O. volvulus tissue sections and then used to determine their viabilities. Eleven onchocerciasis infected volunteers donated a total of sixty-one O. volvulus nodules for this study. Out of the total number of nodules donated, unfixed cryostat sections were obtained from thirty-two of the nodules (including two nodules which were heated in distilled water at 60°C to obtain heat-killed worms). The sections were incubated in a substrate containing sodium DL-lactate, nicotinamide adenine dinucleotide (NAD), magnesium chloride and nitro blue tetrazolium compound (NBT) at 37°C for an hour. The same nodules were fixed in phosphate buffered formalin after the cryostat sections were obtained from them and processed by the paraffin method to obtain paraffin processed sections which were stained by the haematoxylin and eosin technique. The other twenty-nine O. Volvulus nodules from the total number of nodules obtained from the volunteers (including two heat-killed nodules) were fixed in phosphate-buffered formalin and paraffin processed sections obtained from them and stained by the haematoxylin and eosin technique. Light microscopic examination of the three sets of sections revealed that worm-sections which were morphologically well preserved in their paraffin sections showed the presence of LDH activity in their corresponding cryostat sections and therefore were adjudged to be sections of live worms. On the other hand worm-sections which were morphologically degenerated in paraffin sections did not show any LDH activity in their cryostat sections and were adjudged to be sections of dead worms. This observation implied that the presence of LDH activity in worm sections were indications that the sections belonged to live worms and those sections which did not show enzyme activity belonged to dead worms.There was no significant difference between the enzyme technique and histology in determining the number of adult worms in the nodules examined. This suggested that the enzyme histochemical method has the same advantage that the histological method have over the in-vitro technique in determining the number of worms in the nodules. All the three worms detected in the heat-killed nodules were morphologically well preserved in their paraffin sections while their cryostat sections did not show enzyme activity. They were therefore alive histologically but declared dead by the enzyme technique indicating that the enzyme method is capable of detecting dead worms which are unable to maintain the activity of their enzymes even without any significant morphological degenerations. Since degenerative processes that must show on histology to determine dead worms occur several months after the death of the worm, the study indicates that the enzyme method may be able to detect the death of adult worms much earlier than the histological method. This is regarded as a possible advantage of the enzyme technique over the histological method, however, this assertion needs to be confirmed on a larger sample size. The results showed that, the enzyme histochemical technique can be used as a more reliable alternative to the histological technique in determining the viability of adult 0. volvulus during drug evaluations. It can also be used along with the histological technique in order to obtain early results during drug trials to be followed by histological results which often takes several weeks to process. Comparative analysis of the two sets of paraffin processed sections confirmed that statistical comparisons of the results from different groups of nodules are acceptable for drug investigations.
Associations between malaria in pregnancy and neonatal neurological outcomes
(International Journal of Infectious Diseases, 2021) Lawford, H.L.S.; Nuamah, M.A.; Liley, H.G.; Griffin, A.; Lekpor, C.E.; Botchway, F.; Oppong, S.A.; Samba, A.; Badoe, E.V.; Kumar, S.; Lee, A.CC.; Gyasi, R.K.; Adjei, A.A.; Bora, S.
Objective: To compare neurological functioning of neonates born to mothers with and without malaria in pregnancy. Methods: Pregnant women presenting at Korle Bu Teaching Hospital, Ghana were recruited into this prospective observational study. Malaria exposure was determined by clinically documented antenatal malaria infection; parasitemia in maternal, placental, or umbilical cord blood; or placental histology. Neu- rological functioning was assessed using the Hammersmith Neonatal Neurological Examination within 48 hours of birth. Performance was classified as "optimal" or "suboptimal" by subdomain and overall. Results: Between November 21, 2018 and February 10, 2019, a total of 211 term-born neonates, of whom 27 (13%) were exposed to malaria in pregnancy, were included. In the reflexes subdomain, exposed neonates tended to score lower (adjusted mean difference -0.34, 95% confidence interval -0.70 to 0.03), with an increased risk (adjusted risk ratio 1.63, 95% confidence interval 1.09 to 2.44) of suboptimal per- formance compared with unexposed neonates. There were no significant between-group differences in scores or optimality classification for the remaining subdomains and overall. Conclusions: Malaria-exposed neonates had similar neurological functioning relative to unexposed neonates, with differences confined to the reflexes subdomain, suggesting potential underlying neuro- logical immaturity or injury. Further studies are needed to confirm these findings and determine the significance of malaria in pregnancy on long-term neurological outcomes.
Bacterial contamination of blood and blood components in three major blood transfusion centers, Accra, Ghana
(Japan Journal Infect Dis., 2009) Adiku, T.K.; Adjei, A.A.; Kuma, G.K.; Tettey, Y.; Ayeh-Kumi, P.F.; Opintan, J.; Apeagyei, F.; Ankrah, J.O.; Narter-Olaga, E.G.
Reports from studies conducted in several countries indicate a high incidence of bacterial contamination of donor blood. The prevalence of bacterial contamination of blood and its products in Ghana is not known. This study was conducted to determine the prevalence of bacterial contamination of blood and its products at the three major blood transfusion centers in the Greater Accra Region of Ghana. Stored whole blood and its products were cultured on different media, and isolates were identified using standard biochemical and bacteriological methods. The susceptibility of the isolates to selected antimicrobial agents was also determined by the disc diffusion method. The overall prevalence rate was 9% (28/303; whole blood, 13% [24/192]; plasma, 3% [2/79]; platelet, 9% [2/22]). The Gram-positive bacteria isolated were coagulase-negative Staphylococcus, S. aureus, and Bacillus spp., and the Gram-negative organisms were Yersinia enterocolitica, Citrobacter freundii, Escherichia coli, Pseudomonas aeruginosa, and Klebsiella pneumoniae. The Gram-positive bacteria were sensitive to cloxacillin, erythromycin, tetracycline, and gentamicin but resistant to penicillin, ampicillin, cefuroxime, and cotrimoxazole, while the Gram-negative bacteria were sensitive to amikacin and gentamicin but resistant to chloramphenicol, tetracycline, ampicillin, cefuroxime, cefotaxime (except Y. enterocolitica), and cotrimoxazole. Our results suggest that bacterial contamination of blood and its products is prevalent in Ghana.
Biochemical and haematological markers of alcohol intake in Ghanaians
(West African Journal of Medicine, 1992) Quaye, I.K.; Nyame, P.K.; Dodoo, D.; Gyan, B.; Adjei, A.A.
The serum gamma-glutamyltransferase (GGT), aspartate aminotransferase (AST), urate and triglyceride and mean cell volume (MCV) were determined in 60 total abstainers, 56 social drinkers and 100 alcoholics. Both enzymes and urate showed progressive rise with increasing alcohol intake. The mean cell volume was only moderately elevated. Gamma-glutamyltransferase (GGT), aspartate aminotransferase (AST), and urate are sensitive enough to detect people who take in alcohol regularly and yet may be regarded as normal and not alcohol dependent.
The cerebral-malaria-associated expression of RANTES, CCR3 and CCR5 in post-mortem tissue samples
(Annals of Tropical Medicine and Parasitology, 2004) Sarfo, B.Y.; Singh, S.; Lillard, J.W.; Adjei, A.A.; Gyasi, R.K.; Armah, H.; Stiles, J.K.
Cerebrospinal fluid and serum biomakers and cerebral malaria mortality in Ghanaian children
(Malaria Journal, 2007) Armah, H.B.; Wilson, N.O.; Sarfo, B.Y.; Powell, M.D.; Bond, V.C.; Anderson, W.; Adjei, A.A.; Gyasi, R.K.; Tettey, Y.; Wiredu, E.K.; Tongren, J.E.; Udhayakumar, V.; Stiles, J.K.
Background Plasmodium falciparum can cause a diffuse encephalopathy known as cerebral malaria (CM), a major contributor to malaria associated mortality. Despite treatment, mortality due to CM can be as high as 30% while 10% of survivors of the disease may experience short- and long-term neurological complications. The pathogenesis of CM and other forms of severe malaria is multi-factorial and appear to involve cytokine and chemokine homeostasis, inflammation and vascular injury/repair. Identification of prognostic markers that can predict CM severity will enable development of better intervention. Methods Postmortem serum and cerebrospinal fluid (CSF) samples were obtained within 2–4 hours of death in Ghanaian children dying of CM, severe malarial anemia (SMA), and non-malarial (NM) causes. Serum and CSF levels of 36 different biomarkers (IL-1β, IL-1ra, IL-2, IL-4, IL-5, IL-6, IL-7, IL-8, IL-9, IL-10, IL-12 (p70), IL-13, IL-15, IL-17, Eotaxin, FGF basic protein, CRP, G-CSF, GM-CSF, IFN-γ, TNF-α, IP-10, MCP-1 (MCAF), MIP-1α, MIP-1β, RANTES, SDF-1α, CXCL11 (I-TAC), Fas-ligand [Fas-L], soluble Fas [sFas], sTNF-R1 (p55), sTNF-R2 (p75), MMP-9, TGF-β1, PDGF bb and VEGF) were measured and the results compared between the 3 groups. Results After Bonferroni adjustment for other biomarkers, IP-10 was the only serum biomarker independently associated with CM mortality when compared to SMA and NM deaths. Eight CSF biomarkers (IL-1ra, IL-8, IP-10, PDGFbb, MIP-1β, Fas-L, sTNF-R1, and sTNF-R2) were significantly elevated in CM mortality group when compared to SMA and NM deaths. Additionally, CSF IP-10/PDGFbb median ratio was statistically significantly higher in the CM group compared to SMA and NM groups. Conclusion The parasite-induced local cerebral dysregulation in the production of IP-10, 1L-8, MIP-1β, PDGFbb, IL-1ra, Fas-L, sTNF-R1, and sTNF-R2 may be involved in CM neuropathology, and their immunoassay may have potential utility in predicting mortality in CM.
Cerebrospinal fluid and serum biomarkers of cerebral malaria mortality in Ghanaian children
(2007-11-12) Armah, H.B.; Wilson, N.O.; Sarfo, B.Y.; Powell, M.D.; Bond, V.C.; Anderson, W.; Adjei, A.A.; Gyasi, R.K.; Tettey, Y.; Wiredu, E.K.; Tongren, J.E.; Udhayakumar, V.; Stiles, J.K.
Abstract Background Plasmodium falciparum can cause a diffuse encephalopathy known as cerebral malaria (CM), a major contributor to malaria associated mortality. Despite treatment, mortality due to CM can be as high as 30% while 10% of survivors of the disease may experience short- and long-term neurological complications. The pathogenesis of CM and other forms of severe malaria is multi-factorial and appear to involve cytokine and chemokine homeostasis, inflammation and vascular injury/repair. Identification of prognostic markers that can predict CM severity will enable development of better intervention. Methods Postmortem serum and cerebrospinal fluid (CSF) samples were obtained within 2–4 hours of death in Ghanaian children dying of CM, severe malarial anemia (SMA), and non-malarial (NM) causes. Serum and CSF levels of 36 different biomarkers (IL-1β, IL-1ra, IL-2, IL-4, IL-5, IL-6, IL-7, IL-8, IL-9, IL-10, IL-12 (p70), IL-13, IL-15, IL-17, Eotaxin, FGF basic protein, CRP, G-CSF, GM-CSF, IFN-γ, TNF-α, IP-10, MCP-1 (MCAF), MIP-1α, MIP-1β, RANTES, SDF-1α, CXCL11 (I-TAC), Fas-ligand [Fas-L], soluble Fas [sFas], sTNF-R1 (p55), sTNF-R2 (p75), MMP-9, TGF-β1, PDGF bb and VEGF) were measured and the results compared between the 3 groups. Results After Bonferroni adjustment for other biomarkers, IP-10 was the only serum biomarker independently associated with CM mortality when compared to SMA and NM deaths. Eight CSF biomarkers (IL-1ra, IL-8, IP-10, PDGFbb, MIP-1β, Fas-L, sTNF-R1, and sTNF-R2) were significantly elevated in CM mortality group when compared to SMA and NM deaths. Additionally, CSF IP-10/PDGFbb median ratio was statistically significantly higher in the CM group compared to SMA and NM groups. Conclusion The parasite-induced local cerebral dysregulation in the production of IP-10, 1L-8, MIP-1β, PDGFbb, IL-1ra, Fas-L, sTNF-R1, and sTNF-R2 may be involved in CM neuropathology, and their immunoassay may have potential utility in predicting mortality in CM.
Comparison of Oestrogen Receptor, Progesterone Receptor, and Human Epiderman Growth Factor Receptor-2 Expression in Primary Breast Cancer and Lymph Node Metastasis at the Korle-Bu Teaching Hospital, Accra, Ghana
(University of Ghana, 2013-07) Mawuli, B.A.; Tettey, Y.; Adjei, A.A.
Introduction: Determination of oestrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor-2 (Her-2/neu) has become part of the diagnostic tests for breast cancer. Results of ER and PR are used to select breast cancer patients who are most likely to respond to hormonal therapy whereas Her-2/neu results are used to select patients with invasive breast cancer most likely to respond to targeted therapy. Immunohistochemical (IHC) determination of ER, PR and HER-2/neu is usually done on the primary breast cancer tissue. Re-evaluation of ER, PR and HER-2/neu on metastatic breast tumour is sometimes done when metastasis occurs. The axillary lymph nodes are the most common site of metastasis of breast cancer. Characteristics of primary breast cancer may change when metastasis occurs. This may affect the expression of proteins including ER, PR and HER-2/neu. The choice of the appropriate sample for the IHC determination of ER, PR and HER-2/neu when metastasis occurs may therefore be clinically relevant. Aim: The aim of this research was to compare the expression of ER, PR and the over- expression of HER- 2/neu between primary breast cancer and metastatic deposits in corresponding lymph nodes in women with breast cancer at the Korle-Bu Teaching Hospital. Methodology: The study involved 54 archived tissue blocks of primary breast cancer tissue and corresponding metastatic deposits in lymph nodes of women with invasive breast cancer. The cases were submitted to the Pathology Department of The Korle-Bu Teaching Hospital between January and December 2009. Sections were taken from the tissue blocks and stained immunohistochemically with antibodies for ER, PR and HER- 2/neu. Stained sections were reported as either positive or negative according to the guidelines of the American Society of Clinical Oncology/College of American Pathologists (ASCO/CAP). Results: The mean age ± SD of women diagnosed with breast cancer with lymph node metastases was 49.89 ± 10.70 years with a median age of 51 years. The percentage of retrieved axillary lymph nodes that were involved with breast cancer cells ranged from 8% to 100%. The mean percentage of lymph nodes retrieved from the axilla was 57.87 with a median of 62.71 and a range of 92. About 22% (12 out of 54) of the cases had 100% lymph nodes involved with breast cancer cells and 3.7% (2 out of 54) had 8% of retrieved lymph nodes involved with breast cancer cells. About 20% (11 out of 54) had grade I, 42.6% (23 out of 54) had grade II, and 37% (20 out of 54) had grade III breast tumours respectively. In the primary breast cancer tumour, 31.5% (17 out of 54) of the cases were ER positive, 68.5% (37 out of 54) were ER negative, 25.9% (14 out of 54) were PR positive and 74.1% (40 out of 54) were PR negative. HER-2/neu was positive in 25.9% (14 out of 54) and negative in 74.1% (40 out of 54) of the cases. In the corresponding lymph nodes, 33.3% (18 out of 54) were ER positive, 66.7% (36 out of 54) were ER negative, 29.6% (16 out of 54) were PR positive, and 70.4% (38 out of 54) were PR negative. HER-2/neu was positive in 29.6% (16 out of 54) and negative in 70.4% (38 out of 54) of the cases. There was 94.4% and 92.5% concordance for ER and PR respectively between primary tumour and lymph nodes. The concordance rate for HER-2/neu was 96.3%. There was no statistical difference (p> 0.05) in ER, PR and HER- 2/neu between primary breast cancer and metastatic deposits in lymph nodes. Conclusion: There were minor changes in the expression of ER, PR and HER-2/neu between primary breast tumour and metastatic deposits in lymph nodes.
Coping strategies of HIV-affected households in Ghana
(BioMed Central Ltd., 2015) Laar, A.; Manu, A.; Laar, M.; El-Adas, A.; Amenyah, R.; Atuahene, K.; Quarshie, D.; Adjei, A.A.; Quakyi, I.
Background: HIV and negative coping mechanisms have a cyclical relationship. HIV infections may lead to the adoption of coping strategies, which may have undesired, negative consequences. We present data on the various coping mechanisms that HIV-affected households in Ghana resort to. Methods: We collected data on coping strategies, livelihood activities, food consumption, and asset wealth from a nationally representative sample of 1,745 Ghanaian HIV-affected households. We computed coping strategies index (CSI), effective dependency rate, and asset wealth using previously validated methodologies. Results: Various dehumanizing coping strategies instituted by the HIV-affected households included skipping an entire day's meal (13%), reducing portion sizes (61.3%), harvesting immature crops (7.6%), and begging (5.6%). Two-thirds of the households were asset poor. Asset-poor households had higher CSI than asset-rich households (p <0.001). CSI were also higher among female-headed households and lower where the education level of the household head is higher. Households caring for chronically ill members recorded higher CSI in comparison with their counterparts without the chronically ill (p < 0.05). Conclusions: Institution of degrading measures by HIV-affected households in reaction to threat of food insecurity was prevalent. The three most important coping strategies used by households were limiting portion size (61.3%), reducing number of meals per day (59.5%) and relying on less expensive foods (56.2%). The least employed strategies included household member going begging (5.6%), eating elsewhere (8.7%) and harvesting immature crop (7.6%). Given that household assets, and caring for the chronically ill were associated with high CSI, a policy focusing on helping HIV-affected households gradually build up their asset base, or targeting households caring for chronically ill member(s) with conditional household-level support may be reasonable.
Correlates of hepatitis C virus infection among incarcerated Ghanaians: a national multicentre study
(Journal of Medical Microbiology 56(3): 391-397, 2007) Adjei, A.A.; Armah, H.B.; Gbagbo, F.; Ampofo, W.K.; Quaye, I.K.; Hesse, I.F.; Mensah, G.
A national multicentre cross-sectional study was undertaken on the correlates of hepatitis C virus (HCV) infection in a sample of inmates from eight Ghanaian prisons. A total of 1366 inmates from eight of the ten regional central prisons in Ghana were enrolled between May 2004 and December 2005. Subjects voluntarily completed a risk-factor questionnaire and provided blood specimens for unlinked anonymous testing for the presence of antibodies to HCV. These data were analysed using both univariate and multivariate techniques. The median age of participants was 36.5 years (range 16-84 years). Of the 1366 inmates tested, HCV seroprevalence was 18.7%. On multivariate analysis, the independent determinants of HCV infection were being incarcerated for longer than the median time served of 36 months [odds ratio (OR) 5.8; 95% confidence interval (95% CI) 5.0-6.9], history of intravenous drug use (OR 4.5; 95% CI 3.8-5.4) and homosexuality (OR 3.1; 95% CI 2.5-3.9). Consistent with similar studies worldwide, the prevalence of HCV in prison inmates was higher than the general population in Ghana, suggesting probable transmission in prisons in Ghana through intravenous drug use and unsafe sexual behaviour.
Correlates of HIV, HBV, HCV and syphilis infections among prison inmates and officers in Ghana: A national multicenter study
(BMC Infectious Diseases (5): 33, 2008) Adjei, A.A.; Armah, H.B.; Gbagbo, F.; Ampofo, W.K.; Boamah, I.; Adu-Gyamfi, C.; Asare, I.; Hesse, I.F.; Mensah, G.
Background: Prisons are known to be high-risk environments for the spread of bloodborne and sexually transmitted infections. Prison officers are considered to have an intermittent exposure potential to bloodborne infectious diseases on the job, however there has been no studies on the prevalence of these infections in prison officers in Ghana. Methods: A national multicenter cross-sectional study was undertaken on correlates of human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), and syphilis infections in sample of prison inmates and officers from eight of ten regional central prisons in Ghana. A total of 1366 inmates and 445 officers were enrolled between May 2004 and December 2005. Subjects completed personal risk-factor questionnaire and provided blood specimens for unlinked anonymous testing for presence of antibodies to HIV, HCV and Treponema pallidum; and surface antigen of HBV (HBsAg). These data were analyzed using both univariate and multivariate techniques. Results: Almost 18% (1336) of 7652 eligible inmates and 21% (445) of 2139 eligible officers in eight study prisons took part. Median ages of inmates and officers were 36.5 years (range 16-84) and 38.1 years (range 25-59), respectively. Among inmates, HIV seroprevalence was 5.9%, syphilis seroprevalence was 16.5%, and 25.5% had HBsAg. Among officers tested, HIV seroprevalence was 4.9%, HCV seroprevalence was 18.7%, syphilis seroprevalence was 7.9%, and 11.7% had HBsAg. Independent determinants for HIV, HBV and syphilis infections among inmates were age between 17-46, being unmarried, being illiterate, female gender, being incarcerated for longer than median time served of 36 months, history of homosexuality, history of intravenous drug use, history of sharing syringes and drug paraphernalia, history of participation in paid sexual activity, and history of sexually transmitted diseases. Independent determinants for HIV, HBV, HCV and syphilis infections among officers were age between 25-46, fale gender, being unmarried, being employed in prison service for longer than median duration of employment of 10 years, and history of sexually transmitted diseases. Conclusion: The comparably higher prevalence of HIV, HBV, HCV and syphilis in prison inmates and officers in Ghana suggests probable occupational related transmission. The implementation of infection control practices and risk reduction programs targeted at prison inmates and officers in Ghana is urgently required to address this substantial exposure risk.
Correlates of HIV, HBV, HCV and syphilis infections among prison inmates and officers in Ghana: a national multicenter study
(2008-03-07) Adjei, A.A.; Armah, H.B.; Gbagbo, F.; Ampofo, W.K.; Boamah, I; Adu-Gyamfi, C.; Asare, I.; Hesse, I.F.A; Mensah, G.
Abstract Background Prisons are known to be high-risk environments for the spread of bloodborne and sexually transmitted infections. Prison officers are considered to have an intermittent exposure potential to bloodborne infectious diseases on the job, however there has been no studies on the prevalence of these infections in prison officers in Ghana. Methods A national multicenter cross-sectional study was undertaken on correlates of human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), and syphilis infections in sample of prison inmates and officers from eight of ten regional central prisons in Ghana. A total of 1366 inmates and 445 officers were enrolled between May 2004 and December 2005. Subjects completed personal risk-factor questionnaire and provided blood specimens for unlinked anonymous testing for presence of antibodies to HIV, HCV and Treponema pallidum; and surface antigen of HBV (HBsAg). These data were analyzed using both univariate and multivariate techniques. Results Almost 18% (1336) of 7652 eligible inmates and 21% (445) of 2139 eligible officers in eight study prisons took part. Median ages of inmates and officers were 36.5 years (range 16–84) and 38.1 years (range 25–59), respectively. Among inmates, HIV seroprevalence was 5.9%, syphilis seroprevalence was 16.5%, and 25.5% had HBsAg. Among officers tested, HIV seroprevalence was 4.9%, HCV seroprevalence was 18.7%, syphilis seroprevalence was 7.9%, and 11.7% had HBsAg. Independent determinants for HIV, HBV and syphilis infections among inmates were age between 17–46, being unmarried, being illiterate, female gender, being incarcerated for longer than median time served of 36 months, history of homosexuality, history of intravenous drug use, history of sharing syringes and drug paraphernalia, history of participation in paid sexual activity, and history of sexually transmitted diseases. Independent determinants for HIV, HBV, HCV and syphilis infections among officers were age between 25–46, fale gender, being unmarried, being employed in prison service for longer than median duration of employment of 10 years, and history of sexually transmitted diseases. Conclusion The comparably higher prevalence of HIV, HBV, HCV and syphilis in prison inmates and officers in Ghana suggests probable occupational related transmission. The implementation of infection control practices and risk reduction programs targeted at prison inmates and officers in Ghana is urgently required to address this substantial exposure risk.
Cryptosporidiosis in HIV/AIDS Patients and Children with Diarrhoea in Accra
(University of Ghana, 2003-06) Borketey, P.B.; Anteson, R.K.; Adjei, A.A.; University of Ghana, College of Health Sciences, School of Biomedical and Allied Health Sciences, Department of Medical Microbiology
Although Cryptosporidium spp. infections in acquired immunodeficiency syndrome patients (AIDS) and children with diarrhoea have been reported in several African countries, there is scanty information regarding cryptosporidial diarrhoea in Ghana. This study investigated occurrence of C. parvum in HIV/AIDS patients and children up to five years with diarrhoea in the Greater Accra Region. It was a cross sectional study, with Fevers Unit, Child Health Department in the Korle-Bu Teaching Hospital and Korle-Bu Polyclinic as the settings. A total of 278 samples were taken. Sixty-two (62) of these were clinically diagnosed HIV/AIDS patients with diarrhoea controlled by 96 HIVseronegative patients also with diarrhoea. Among the children up to 5years, 63 had diarrhoea while 57 were without diarrhoea. Cryptosporidium oocysts were stained using the Kiyoung’s modified Ziehl Neelsen staining technique, examined microscopically and confirmed by the ELISA Technique. Analysis of stool specimen from clinically diagnosed HIV/AIDS (n=62) and HIV-seronegative patients (n=96) patients revealed C. parvum in 16 (25.8%) of HTV/AIDS and 0 (0%) of the HIV-seronegative patients, respectively. For the children under five, analysis of the 63 patients with diarrhoea and 57 without diarrhoea showed a prevalence of 15.9% and 3.5% respectively. There was no concomitant association between C. parvum and any other parasite found. In conclusion, this study demonstrates a higher prevalence of Cryptosporidium sp. in HIV/AIDS and children less than five years with diarrhoea in Accra. The prevalence of Cryptosporidium was found to be more prevalent in HIV/AIDS patients (25.8%) more than the control group who were HIV-seronegative but with diarrhoea (π2=21.69, p value =0.0000032). With the children under five years it was found that prevalence was more in those children with diarrhea (15.8%) than those without diarrhoea (π2=4.20, p value =0.00405). However when the prevalence found in children with diarrhoea is compared to that in HIV/AIDS with diarrhoea, it was realized that statistically, there was no significant difference in prevalence ( π2=1.23, p value =0.2677). Among the children the most vulnerable group was those under 2 years.
Cryptosporidium Spp., a Frequent Cause of Diarrhea among Children at the Korle-Bu Teaching Hospital, Accra, Ghana
(Japanese Journal of Infectious Diseases, 2004) Adjei, A.A.; Armah, H.; Rodrigues, O.; Renner, L.; Borketey, P.; Ayeh-Kumi, P.; Adiku, T.K.; Sifah, E.; Lartey, M.
This report presents the results of a study conducted at the Child Health Department, Korle-Bu Teaching Hospital, Accra, Ghana, between the months of October 2001 and June 2002. Stool samples from 227 children with diarrhea and 77 children without diarrhea, aged less than 5 years, were tested for Cryptosporidium spp. Prevalence rates were 27.8 and 15.6% in children with and without diarrhea, respectively. Cryptosporidium infection was found to be high in children between the ages of 6 and 24 months. Cryptosporidium spp. was more common in malnourished children, but was not isolated in children under 6 months of age who were exclusively breastfed. Neither the presence of domestic animals, abdominal pain, blood in stool, nausea, vomiting, nor the consumption of untreated water was associated with Cryptosporidium spp. infection. Shigella, Salmonella, and yeast-like organisms were the most frequently identified enteropathogenic bacteria. In summary, this study demonstrates the prevalence of Cryptosporidium spp. among Ghanaian children.
Cytokines and adhesion molecules expression in the brain in human cerebral malaria
(International Journal of Environmental Research and Public Health, 2005) Armah, H.; Wired, E.K.; Dodoo, A.K.; Adjei, A.A.; Tettey, Y.; Gyasi, R.
Although the role of systemic proinflammatory cytokines, IL-1beta and TNF-alpha, and their up-regulation of adhesion molecules, ICAM-1, VCAM-1 and E-Selectin, in the pathogenesis of cerebral malaria (CM) is well established, the role of local cytokine release remain unclear. Immunohistochemistry (IHC) was used to compare the expression of ICAM-1, VCAM-1, E-Selectin, IL-1beta, TNF-a and TGF-beta at light microscopic level in cerebral, cerebellar and brainstem postmortem cryostat sections from 10 CM, 5 severe malarial anemia (SMA), 1 purulent bacterial meningitis (PBM), 2 non-central nervous system infections (NCNSI) and 3 non-infections (NI) deaths in Ghanaian children. Fatal malaria and Salmonella sepsis showed significantly higher vascular expression of all 3 adhesion molecules, with highly significant co-localization with sequestration in the malaria cases. However, there was negligible difference between CM and SMA. TGF-beta showed intravascular and perivascular distribution in all cases, but expression was most intense in the PBM case and CM group. TNF-alpha and IL-1beta showed prominent brain parenchymal staining, in addition to intravascular and perivascular staining, in only the PBM case and CM group. The maximal expression of all 6 antigens studied was in the cerebellar sections of the malaria cases. Endothelial activation is a feature of fatal malaria and Salmonella sepsis, with adhesion molecule expression being highly correlated with sequestration. IL-1beta and TNF-alpha are upregulated in only cases with neurodegenerative lesions, whilst TGF-beta is present in all cases. Both cytokines and adhesion molecules were maximally upregulated in the cerebellar sections of the malaria cases.
Detection of Human Papillomavirus Genotypes and Epstein-Barr Virus in Nasopharyngeal Carcinomas at the Korle-Bu Teaching Hospital, Ghana
(Scientific World Journal, 2017-03) Asante, D.-B.; Asmah, R.H.; Adjei, A.A.; Kyei, F.; Simpong, D.L.; Brown, C.A.; Gyasi, R.K.
Nasopharyngeal carcinomas (NPC) are endemic in Far East Asia and commonly harbour Epstein-Barr virus (EBV) which is known to serve as a key oncogenic promoter. Human papillomavirus (HPV) is known to contribute to the pathogenesis of NPC. However, in Ghana these two viruses have not been linked to NPC prevalence. This study was designed to determine the HPV genotypes and EBV involved in NPC tissue biopsies. A retrospective study design involving 72 formalin-fixed paraffin-embedded tissue (FFPET) samples of NPC from 2006 to 2012 were retrieved from the Department of Pathology, University of Ghana School of Biomedical and Allied Health Sciences. Sections were taken for histological analysis and for DNA lysate preparation. The DNA lysates were subjected to polymerase chain reaction (PCR) analysis to determine the presence of HPV genotypes and EBV. HPV specific primers were used to type for fourteen HPV genotypes (HPV-16, 18, 6/11, 31, 33, 35, 44, 42, 43, 45, 56, 52, 58, and 59). Out of the 72 NPC biopsies analyzed by PCR, EBV DNA was present in 18 (25%) cases and HPV DNA in 14 (19.23%). High risk HPV (HR-HPV) genotypes 18 and 31 were associated with the NPC. There were 3 (4.2%) cases of coinfection by both viruses. The EBV DNA present in the undifferentiated variant of the NPC and the histopathology of the NPC in Ghana is similar to the type described in endemic areas. © 2017 Du-Bois Asante et al.
Detection of Plasmodium falciparum Histidine-rich Protein II in Saliva of Malaria Patients
(American Journal of Tropical Medicine and Hygiene, 2008) Wilson, N.O.; Adjei, A.A.; Anderson, W.; Baidoo, S.; Stiles, J.K.
Detection of Plasmodium falciparum parasites in patients with malaria necessitates drawing blood, which increases the risk of accidental infections and is poorly accepted in communities with blood taboos. Thus, non-invasive, cost-effective malaria tests that minimize the need for blood collection are needed. Plasmodium falciparum histidine-rich protein II (PfHRP II) levels in plasma and saliva were compared in malaria-positive and -negative patients in Ghana. Plasma and saliva obtained from 30 thick-film positive and 10 negative children were evaluated for PfHRP II by ELISA. Among the 30 children with positive blood smear, 16 (53%) were PfHRP II positive in plasma and 13 (43%) had PfHRP II positive saliva. The sensitivity of PfHRP II detection was 53% for plasma and 43% for saliva. The specificity was 100% with no false positive for both plasma and saliva when compared with blood smear. Thus, rapid detection of PfHRP II antigen in saliva may be a useful non-invasive and cost-effective malaria diagnostic technique.