Browsing by Author "Adjei, G."

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Associations between Red Cell Polymorphisms and Plasmodium falciparum Infection in the Middle Belt of Ghana
(PLoSONE 9(12): e112868., 2014) Amoako, N.; Asante, K.P.; Adjei, G.; Awandare, G.A.; Bimi, L.
Red blood cell (RBC) polymorphisms are common in malaria endemic regions and are known to protect against severe forms of the disease. Therefore, it is important to screen for these polymorphisms in drugs or vaccines efficacy trials. This study was undertaken to evaluate associations between clinical malaria and RBC polymorphisms to assess biological interactions that may be necessary for consideration when designing clinical trials. In a cross-sectional study of 341 febrile children less than five years of age, associations between clinical malaria and common RBC polymorphisms including the sickle cell gene and G6PD deficiency was evaluated between November 2008 and June 2009 in the middle belt of Ghana, Kintampo. G6PD deficiency was determined by quantitative methods whiles haemoglobin variants were determined by haemoglobin titan gel electrophoresis. Blood smears were stained with Giemsa and parasite densities were determined microscopically. The prevalence of clinical malarial among the enrolled children was 31.9%. The frequency of G6PD deficiency was 19.0% and that for the haemoglobin variants were 74.7%, 14.7%, 9.1%, 0.9% respectively for HbAA, HbAC, HbAS and HbSS. In multivariate regression analysis, children with the HbAS genotype had 79% lower risk of malaria infection compared to those with the HbAA genotypes (OR P 0.21, 95% CI: 0.06–0.73, p 5 0.01). HbAC genotype was not significantly associated with malaria infection relative to the HbAA genotype (OR P - 0.70, 95% CI: 0.35–1.42, p - 0.33). G6PD deficient subgroup had a marginally increased risk of malaria infection compared to the G6PD normal subgroup (OR 5 1.76, 95% C ; 0.98–3.16, p - 0.06). These results confirm previous findings showing a protective effect of sickle cell trait on clinical malaria infection. However, G6PD deficiency was associated with a marginal increase in susceptibility to clinical malaria compared to children without G6PD deficiency.
Baseline malaria vector transmission dynamics in communities in Ahafo mining area in Ghana
(Malaria Journal, 2015-04) Dery, D.B.; Asante, K.P.; Zandoh, C.; Febir, L.G.; Brown, C.; Adjei, G.; Antwi-Dadzie, Y.; Mahama, E.; Tchum, K.; Dosoo, D.; Amenga-Etego, S.; Adda, R.; Mensah, C.; Owusu-Sekyere, K.B.; Anderson, C.; Krieger, G.; Owusu-Agyei, S.
Background: Malaria vector dynamics are relevant prior to commencement of mining activities. A baseline entomology survey was conducted in Asutifi and Tano (referred to as Ahafo) in the Brong-Ahafo geo-political region of Ghana during preparatory stages for mining by Newmont Ghana Gold Limited. Methods: Between November 2006 and August 2007, eight Centre for Disease Control light traps were set daily (Monday-Friday) to collect mosquitoes. Traps were hanged in rooms that were selected from a pool of 1,100 randomly selected houses. Types of materials used in construction of houses were recorded and mosquito prevention measures were assessed from occupants. Results: A total of 5,393 mosquitoes were caught that comprised Anopheles gambiae (64.8%), Anopheles funestus (4.2%), as well as Culicines, comprising of Culex (30.4%) and Aedes species (0.6%). The entomological inoculation rate in Asutifi (279 infective bites/person/month) and Tano (487 infective bites/person/month) demonstrate relatively high malaria transmission in Ahafo. The presence or absence of Anopheles vectors in rooms was influenced by the type of roofing material (OR 2.33, 95%CI: 1.29-4.22, p∈=∈0.01) as well as the presence of eaves gaps (OR 1.80, 95%CI: 1.37-2.37, p∈<∈0.01). It was also associated with bed net availability in the room (OR 1.39, 95%CI: 1.08-1.80, p∈=∈0.01). Over 80% of the houses were roofed with corrugated zinc sheets. Over 60% of the houses in Ahafo had no eaves gaps to give access to mosquito entry and exit into rooms and mosquito bed net coverage was over 50%. Other measures used in preventing mosquito bites included; coil (22.1%), insecticide spray (9.4%), repellent cream (4.0%) and smoky fires (1.1%), contributed minimally to individual mosquito preventive measures in impact areas. Similarly, levels of protection; coil (16.9%), insecticide spray (2.8%) and repellent cream (0.3%) for the non-impact areas, depict low individual prevention measures. Conclusions: The survey identified areas where intensified vector control activities would be beneficial. It also demonstrates that transmission in Asutifi and Tano is high even before the commencement of mining operations. This study serves as baseline information to assess impact of mining activities in relation to future vector control interventions. © 2015 Dery et al.; licensee BioMed Central.
Epidemiology of malaria in the forest-savanna transitional zone of Ghana
(2009) Owusu-Agyei, S.; Asante, K.P.; Adjuik, M.; Adjei, G.; Awini, E.; Adams, M.; Newton, S.; Dosoo, D.; Dery, D.; Agyeman-Budu, A.; Gyapong, J.; Greenwood, B.; Chandramohan, D.
Background. Information on the epidemiology of malaria is essential for designing and interpreting results of clinical trials of drugs, vaccines and other interventions. As a background to the establishment of a site for anti-malarial drugs and vaccine trials, the epidemiology of malaria in a rural site in central Ghana was investigated. Methods. Active surveillance of clinical malaria was carried out in a cohort of children below five years of age (n = 335) and the prevalence of malaria was estimated in a cohort of subjects of all ages (n = 1484) over a 12-month period. Participants were sampled from clusters drawn around sixteen index houses randomly selected from a total of about 22,000 houses within the study area. The child cohort was visited thrice weekly to screen for any illness and a blood slide was taken if a child had a history of fever or a temperature greater than or equal to 37.5 degree Celsius. The all-age cohort was screened for malaria once every eight weeks over a 12-month period. Estimation of Entomological Inoculation Rate (EIR) and characterization of Anopheline malaria vectors in the study area were also carried out. Results. The average parasite prevalence in the all age cohort was 58% (95% CI: 56.9, 59.4). In children below five years of age, the average prevalence was 64% (95% CI: 61.9, 66.0). Geometric mean parasite densities decreased significantly with increasing age. More than 50% of all children less than 10 years of age were anaemic. Children less than 5 years of age had as many as seven malaria attacks per child per year. The attack rates decreased significantly with increasing cut-offs of parasite density. The average Multiplicity of Infection (MOI) was of 6.1. All three pyrimethamine resistance mutant alleles of the Plasmodium falciparum dhfr gene were prevalent in this population and 25% of infections had a fourth mutant of pfdhps-A437G. The main vectors were Anopheles funestus and Anopheles gambiae and the EIR was 269 infective bites per person per year. Conclusion. The transmission of malaria in the forest-savanna region of central Ghana is high and perennial and this is an appropriate site for conducting clinical trials of anti-malarial drugs and vaccines. © 2009 Owusu-Agyei et al.
Epidemiology of malaria in the forest-savanna transitional zone of Ghana
(Malaria Journal, 2009) Owusu-Agyei, S.; Asante, K.P.; Adjuik, M.; Adjei, G.; Awini, E.; Adams, M.; Newton, S.; Dosoo, D.; Dery, D.; Agyeman-Budu, A.; Gyapong, J.O.; Greenwood, B.; Chandramohan, D.
Background: Information on the epidemiology of malaria is essential for designing and interpreting results of clinical trials of drugs, vaccines and other interventions. As a background to the establishment of a site for anti-malarial drugs and vaccine trials, the epidemiology of malaria in a rural site in central Ghana was investigated. Methods: Active surveillance of clinical malaria was carried out in a cohort of children below five years of age (n = 335) and the prevalence of malaria was estimated in a cohort of subjects of all ages (n = 1484) over a 12-month period. Participants were sampled from clusters drawn around sixteen index houses randomly selected from a total of about 22,000 houses within the study area. The child cohort was visited thrice weekly to screen for any illness and a blood slide was taken if a child had a history of fever or a temperature greater than or equal to 37.5 degree Celsius. The all-age cohort was screened for malaria once every eight weeks over a 12-month period. Estimation of Entomological Inoculation Rate (EIR) and characterization of Anopheline malaria vectors in the study area were also carried out. Results: The average parasite prevalence in the all age cohort was 58% (95% CI: 56.9, 59.4). In children below five years of age, the average prevalence was 64% (95% CI: 61.9, 66.0). Geometric mean parasite densities decreased significantly with increasing age. More than 50% of all children less than 10 years of age were anaemic. Children less than 5 years of age had as many as seven malaria attacks per child per year. The attack rates decreased significantly with increasing cut-offs of parasite density. The average Multiplicity of Infection (MOI) was of 6.1. All three pyrimethamine resistance mutant alleles of the Plasmodium falciparum dhfr gene were prevalent in this population and 25% of infections had a fourth mutant of pfdhps-A437G. The main vectors were Anopheles funestus and Anopheles gambiae and the EIR was 269 infective bites per person per year. Conclusion: The transmission of malaria in the forest-savanna region of central Ghana is high and perennial and this is an appropriate site for conducting clinical trials of anti-malarial drugs and vaccines.
Malaria epidemiology in the Ahafo area of Ghana
(2011-07-29) Asante, K.P.; Zandoh, C.; Dery, D.B.; Brown, C.; Adjei, G.; Antwi-Dadzie, Y.; Adjuik, M.; Tchum, K.; Dosoo, D.; Amenga-Etego, S.; Mensah, C.; Owusu-Sekyere, K.B.; Anderson, C.; Krieger, G.; Owusu-Agyei, S.
Abstract Background Plasmodium falciparum malaria remains endemic in sub-Saharan Africa including Ghana. The epidemiology of malaria in special areas, such as mining areas needs to be monitored and controlled. Newmont Ghana Gold Limited is conducting mining activities in the Brong Ahafo Region of Ghana that may have an impact on the diseases such as malaria in the mining area. Methods Prior to the start of mining activities, a cross-sectional survey was conducted in 2006/2007 to determine malaria epidemiology, including malaria parasitaemia and anaemia among children < 5 years and monthly malaria transmission in a mining area of Ghana. Results A total of 1,671 households with a child less than five years were selected. About 50% of the household heads were males. The prevalence of any malaria parasitaemia was 22.8% (95% CI 20.8 - 24.9). Plasmodium falciparum represented 98.1% (95% CI 96.2 - 99.2) of parasitaemia. The geometric mean P. falciparum asexual parasite count was 1,602 (95% CI 1,140 - 2,252) and 1,195 (95% CI 985 - 1,449) among children < 24 months and ≥ 24 months respectively. Health insurance membership (OR 0.60, 95% CI 0.45 - 0.80, p = 0.001) and the least poor (OR 0.57, 95% CI 0.37 - 0.90, p = 0.001) were protected against malaria parasitaemia. The prevalence of anaemia was high among children < 24 months compared to children ≥ 24 months (44.1% (95% CI 40.0 - 48.3) and 23.8% (95% CI 21.2 - 26.5) respectively. About 69% (95% CI 66.3 - 70.9) of households own at least one ITN. The highest EIRs were record in May 2007 (669 ib/p/m) and June 2007 (826 ib/p/m). The EIR of Anopheles gambiae were generally higher than Anopheles funestus. Conclusion The baseline malaria epidemiology suggests a high malaria transmission in the mining area prior to the start of mining activities. Efforts at controlling malaria in this mining area have been intensified but could be enhanced with increased resources and partnerships between the government and the private sector.
Malaria epidemiology in the Ahafo area of Ghana.
(2011-06-29) Asante, K.P.; Zandoh, C.; Dery, D.B.; Brown, C.; Adjei, G.; Antwi-Dadzie, Y.; Adjuik, M.; Tchum, K.; Dosoo, David; Amega-Etego, S.; Mensah, C.; Owusu-Sekyere, K.B.; Anderson, C.; Krieger, G.; Owusu-Agyei, S.
Background Plasmodium falciparum malaria remains endemic in sub-Saharan Africa including Ghana. The epidemiology of malaria in special areas, such as mining areas needs to be monitored and controlled. Newmont Ghana Gold Limited is conducting mining activities in the Brong Ahafo Region of Ghana that may have an impact on the diseases such as malaria in the mining area. Methods Prior to the start of mining activities, a cross-sectional survey was conducted in 2006/2007 to determine malaria epidemiology, including malaria parasitaemia and anaemia among children < 5 years and monthly malaria transmission in a mining area of Ghana. Results A total of 1,671 households with a child less than five years were selected. About 50% of the household heads were males. The prevalence of any malaria parasitaemia was 22.8% (95% CI 20.8 - 24.9). Plasmodium falciparum represented 98.1% (95% CI 96.2 - 99.2) of parasitaemia. The geometric mean P. falciparum asexual parasite count was 1,602 (95% CI 1,140 - 2,252) and 1,195 (95% CI 985 - 1,449) among children < 24 months and ≥ 24 months respectively. Health insurance membership (OR 0.60, 95% CI 0.45 - 0.80, p = 0.001) and the least poor (OR 0.57, 95% CI 0.37 - 0.90, p = 0.001) were protected against malaria parasitaemia. The prevalence of anaemia was high among children < 24 months compared to children ≥ 24 months (44.1% (95% CI 40.0 - 48.3) and 23.8% (95% CI 21.2 - 26.5) respectively. About 69% (95% CI 66.3 - 70.9) of households own at least one ITN. The highest EIRs were record in May 2007 (669 ib/p/m) and June 2007 (826 ib/p/m). The EIR of Anopheles gambiae were generally higher than Anopheles funestus. Conclusion The baseline malaria epidemiology suggests a high malaria transmission in the mining area prior to the start of mining activities. Efforts at controlling malaria in this mining area have been intensified but could be enhanced with increased resources and partnerships between the government and the private sector.
"Music, A Tool for Language Revitalization"
(2017-03-09) Ansah, M.A.; Adjei, G.; Agyeman, N.A.
This is a preliminary study which seeks to investigate ways in which music can be used to revitalize less-studied or minority languages. The study focuses on three South Guan languages in Ghana: Leteh, Kyerepong and Efutu. The relationship between language and music has been a subject of interest to a number of interdisciplinary scholars. Studies done in this area have observed that in notable respects, language and music are systematically comparable. For instance, the two are similarly constructed of functional and meaningful units; both possess phonemic and morphemic properties. Furthermore, the phonemic and morphemic units/properties are used to produce utterances by rules of sequencing and re-combination (Faudree 2013; Grant 2014; Kropp-Dakubu 2015; Lerdahl and Jackendoff 1983; Minks 2013). The observation that music and language have noteworthy parallels is therefore significant to this study. This study draws on the Affective Filter Hypothesis (Krashen 1982) which emphasizes the importance of positive emotions in language acquisition. Language surveys were conducted in Winneba, Larteh and Adukrom where the three languages are spoken. The study concludes that the theory behind the use of songs in teaching a second language can be extended to the teaching and learning of less-studied languages/minority languages and ultimately, their revitalization.
Neonatal mortality in the central districts of Ghana: analysis of community and composition factors
(BMC Public Health, 2021) Adjei, G.; Darteh, E.K.M.; Nettey, O.E.A.; Doku, D.T.
Background: Communities and their composition have an impact on neonatal mortality. However, considering the smallest health administrative units as communities and investigating the impact of these communities and their composition on neonatal mortality in Ghana have not been studied. Therefore, this study aimed to investigate the effect of community-, household- and individual-level factors on the risk of neonatal mortality in two districts in Ghana. Methods: This was a longitudinal study that used the Kintampo Health and Demographic Surveillance System as a platform to select 30,132 neonatal singletons with 634 deaths. Multilevel cox frailty model was used to examine the effect of community-, household- and individual-level factors on the risk of neonatal mortality. Results: Regarding individual-level factors, neonates born to mothers with previous adverse pregnancy (aHR = 1.38, 95% CI: 1.05–1.83), neonates whose mothers did not receive tetanus toxoid vaccine (aHR = 1.32, 95% CI: 1.08–1.60) and neonates of mothers with Middle, Junior High School or Junior Secondary School education (aHR = 1.30, 95% CI: 1.02–1.65) compared to mothers without formal education, had a higher risk of neonatal mortality. However, female neonates (aHR = 0.61, 95% CI: 0.51–0.73) and neonates whose mother had secondary education or higher (aHR = 0.37, 95% CI: 0.18–0.75) compared to those with no formal education had a lower risk of mortality. Neonates with longer gestation period (aHR = 0.95, 95% CI: 0.94–0.97) and those who were delivered at home (aHR = 0.56, 95% CI: 0.45–0.70), private maternity home (aHR = 0.45, 95% CI: 0.30–0.68) or health centre/clinic (aHR = 0.40, 95% CI: 0.26–0.60) compared to hospital delivery had lower risk of mortality. Regarding the household-level, neonates belonging to third quintile of the household wealth (aHR = 0.70, 95% CI: 0.52–0.94) and neonates belonging to households with crowded sleeping rooms (aHR = 0.91, 95% CI: 0.85–0.97) had lower risk of mortality. Conclusion: The findings of the study suggest the risk of neonatal mortality at the individual- and household-levels in the Kintampo Districts. Interventions and strategies should be tailored towards the high-risk groups identified in the study.
Non-malaria fevers in a high malaria endemic area of Ghana
(BioMed Central Ltd., 2016) Asante, K.P.; Owusu-Agyei, S.; Cairns, M.; Boamah, E.; Manu, G.; Twumasi, M.; Gyasi, R.; Adjei, G.; Kayan, K.; Mahama, E.; Dosoo, D.K.; Koram, K.; Greenwood, B.; Chandramohan, D.
Background: The importance of fevers not due to malaria [non-malaria fevers, NMFs] in children in sub-Saharan Africa is increasingly being recognised. We have investigated the influence of exposure-related factors and placental malaria on the risk of non-malaria fevers among children in Kintampo, an area of Ghana with high malaria transmission. Methods: Between 2008 and 2011, a cohort of 1855 newborns was enrolled and followed for at least 12 months. Episodes of illness were detected by passive case detection. The primary analysis covered the period from birth up to 12 months of age, with an exploratory analysis of a sub-group of children followed for up to 24 months. Results: The incidence of all episodes of NMF in the first year of life (first and subsequent) was 1.60 per child-year (95 % CI 1.54, 1.66). The incidence of NMF was higher among infants with low birth weight [adjusted hazard ratio (aHR) 1.22 (95 % CI 1.04-1.42) p = 0.012], infants from households of poor socio-economic status [aHR 1.22 (95 % CI 1.02-1.46) p = 0.027] and infants living furthest from a health facility [aHR 1.20 (95 % CI 1.01-1.43) p = 0.037]. The incidence of all episodes of NMF was similar among infants born to mothers with or without placental malaria [aHR 0.97 (0.87, 1.08; p = 0.584)]. Conclusion: The incidence of NMF in infancy is high in the study area. The incidence of NMF is associated with low birth weight and poor socioeconomic status but not with placental malaria.
Placental malaria and the risk of malaria in infants in a high malaria transmission area in Ghana: A prospective cohort study
(Journal of Infectious Diseases, 2013-08) Asante, K.P.; Owusu-Agyei, S.; Cairns, M.; Dodoo, D.; Boamah, E.A.; Gyasi, R.; Adjei, G.; Gyan, B.; Agyeman-Budu, A.; Dodoo, T.; Mahama, E.; Amoako, N.; Dosoo, D.K.; Koram, K.; Greenwood, B.; Chandramohan, D.
Background. Whether the risk of malaria is increased in infants born to mothers who experience malaria during pregnancy is uncertain.Methods. We investigated malaria incidence among an infant cohort born to 355 primigravidae and 1500 multigravidae with or without placental malaria (PM) in a high malaria transmission area of Ghana. PM was assessed using placental histology.Results. The incidence of all episodes of malaria parasitemia or clinical malaria was very similar among 3 groups of infants: those born to multigravidae without PM, multigravidae with PM, and primigravidae with PM. Infants born to primigravidae without PM experienced a lower incidence of malaria parasitemia or clinical malaria than the other 3 groups: adjusted hazard ratio, 0.64 (95% confidence interval [CI],. 48-.86, P <. 01) and 0.60 (95% CI,. 43-.84, P <. 01), respectively. The incidence of malaria parasitemia or clinical malaria was about 2 times higher in most poor infants compared to least poor infants.Conclusions. There was no suggestion that exposure to PM directly increased incidence of malaria among infants of multigravidae. In our study area, absence of placental malaria in primigravidae is a marker of low exposure, and this probably explains the lower incidence of malaria-related outcomes among infants of PM-negative primigravidae. © The Author 2013. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved.
Randomized controlled trial of RTS,S/AS02D and RTS,S/AS01E malaria candidate vaccines given according to different schedules in Ghanaian children
(PLoS ONE, 2009) Owusu-Agyei, S.; Ansong, D.; Asante, K.; Kwarteng Owusu, S.; Owusu, R.; Wireko Brobby, N.A.; Dosoo, D.; Osei Akoto, A.; Osei-Kwakye, K.; Adjei, E.A.; Boahen, K.O.; Sylverken, J.; Adjei, G.; Sambian, D.; Apanga, S.; Kayan, K.; Vekemans, J.; Ofori-Anyinam, O.; Leach, A.; Lievens, M.; Demoitie, M.A.; Dubois, M.C.; Cohen, J.; Ballou, W.R.; Savarese, B.; Chandramohan, D.; Gyapong, J.O.; Milligan, P.; Antwi, S.; Agbenyega, T.; Greenwood, B.; Evans, J.
Background: The target delivery channel of RTS,S candidate malaria vaccines in malaria-endemic countries in Africa is the World Health Organisation Expanded Program on Immunization. As an Adjuvant System, age de-escalation and schedule selection step, this study assessed 3 schedules of RTS,S/AS01E and RTS,S/AS02D in infants and young children 5–17 months of age in Ghana. Methodology: A Phase II, partially-blind randomized controlled study (blind to vaccine, not to schedule), of 19 months duration was conducted in two (2) centres in Ghana between August 2006 and May 2008. Subjects were allocated randomly (1:1:1:1:1:1) to one of six study groups at each study site, each defining which vaccine should be given and by which schedule (0,1-, 0,1,2- or 0,1,7-months). For the 0,1,2-month schedule participants received RTS,S/AS01E or rabies vaccine at one center and RTS,S/AS01E or RTS,S/AS02D at the other. For the other schedules at both study sites, they received RTS,S/AS01E or RTS,S/AS02D. The primary outcome measure was the occurrence of serious adverse events until 10 months post dose 1. Results: The number of serious adverse events reported across groups was balanced. One child had a simple febrile convulsion, which evolved favourably without sequelae, considered to be related to RTS,S/AS01E vaccination. Low grade reactions occurred slightly more frequently in recipients of RTS,S/AS than rabies vaccines; grade 3 reactions were infrequent. Less local reactogenicity occurred with RTS,S/AS01E than RTS,S/AS02D. Both candidate vaccines were highly immunogenic for anti-circumsporozoite and anti-Hepatitis B Virus surface antigen antibodies. Recipients of RTS,S/AS01E compared to RTS,S/AS02D had higher peak anti-circumsporozoite antibody responses for all 3 schedules. Three dose schedules were more immunogenic than 2 dose schedules. Area under the curve analyses for anti-circumsporozoite antibodies were comparable between the 0,1,2- and 0,1,7-month RTS,S/AS01E schedules. Conclusions: Both candidate malaria vaccines were well tolerated. Anti-circumsporozoite responses were greater with RTS,S/AS01E than RTS,S/AS02D and when 3 rather than 2 doses were given. This study supports the selection of RTS,S/AS01E and a 3 dose schedule for further development in children and infants.
Revitalizing minority languages using music: Three South-Guan languages of Ghana in focus
(Research Journal in Advanced Humanities, 2022) Ansah, M.A.; Agyeman, N.A.; Adjei, G.
Several interdisciplinary researchers have been interested in the relationship between language and music, thus producing several works in quest of this interdisciplinary connection. This study, on the other hand, attempted to examine how music may be utilized to reinvigorate the understudied minority languages. It focuses on three South Guan languages: Leteh, Kyerepong and Efutu. Studies done in this area have observed that, in notable respects, language and music are systematically comparable. For instance, the two are similarly constructed of functional and meaningful units; both possess phonemic and morphemic properties. Furthermore, the phonemic and Morphological units/properties are used to produce utterances by rules of sequencing and re-combination. This study draws on on the Affective Filter Hypothesis (Krashen, 1982), which emphasizes the importance of positive emotions in language acquisition. Language surveys were conducted in Winneba, Larteh and Adukrom are where the three languages are spoken. The study concludes that the principle behind the use of songs in teaching a second language, it can be extended to the teaching of learning of less-studied languages/minority languages and ultimately, their revitalization.
Trends in multiplicity of Plasmodium falciparum infections among asymptomatic residents in the middle belt of Ghana
(2013-01-17) Agyeman-Budu, A.; Brown, C.; Adjei, G.; Adams, M.; Dosoo, D.; Dery, D.; Wilson, M.; Asante, K.P.; Greenwood, B.; Owusu-Agyei, S.
Abstract Background Malaria is the most important cause of mortality and morbidity in children living in the Kintampo districts in the middle part of Ghana. This study has investigated the multiplicity of infection (MOI) within asymptomatic residents of the Kintampo districts, and the influence of age and seasonality on MOI, by studying the distribution of the polymorphic Plasmodium falciparum antigen merozoite surface protein 2 (MSP2). Methods DNA was extracted from an asymptomatic cohort of children and adults infected with P. falciparum during the period November 2003 to October 2004. Polymerase chain reaction was carried out and multiplicity of infection (MOI) was determined. Results Children under 10 years of age had an average MOI of 2.3 while adults 18 years and above had an average MOI of 1.4. Children below five years had high and low average MOIs of 2.8 in the March/April survey and 0.9 in the May/June survey respectively. A similar trend in the monthly distribution of MOI was observed for the entire cohort. IC/3D7 strains outnumbered the FC27 strains throughout the year by a ratio of about 4:1 with the difference between the prevalence of the two strains being least marked in the March/April survey, at the beginning of the rainy season. MOI was not linked to the level of malaria transmission as measured by the entomological inoculation rate. Discussion/conclusion The impact of interventions, introduced since this baseline study was carried out on the parasite diversity of asymptomatic residents will be the subject of further investigations.