Browsing by Author "Archampong, T.N.A."
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Item Epidemiology of helicobacter pylori infection in dyspeptic Ghanaian patients(Pan African Medical Journal, 2015-02) Archampong, T.N.A.; Asmah, R.H.; Wiredu, E.K.; Gyasi, R.K.; Nkrumah, K.N.; Rajakumar, K.Introduction: Helicobacter pylori is a gram-negative urease-producing bacterium causally linked with gastritis, peptic ulcer disease and gastric adenocarcinoma. Infection is more frequent and acquired at an earlier age in developing countries compared to European populations. The incidence of Helicobacter pylori infection in dyspeptic Ghanaian patients was 75.4%. However, epidemiological factors associated with infection vary across populations. Methods: This study used a cross-sectional design to consecutively sample dyspeptic patients at the Endoscopy Unit of the Korle-Bu Teaching Hospital, Accra between 2010 and 2012. The study questionnaire elicited their epidemiological clinical characteristics. Helicobacter pylori infection was confirmed by rapid-urease examination of antral biopsies at upper Gastro-intestinal endoscopy. Results: The sample population of dyspeptic patients attending the Endoscopy Unit for upper GI endoscopy yielded 242 patients of which 47.5% were females. The age distribution of H. pylori-infection was even across most age – groups, ranging from 69.2% (61 – 70) years to 80% (21 – 30) years. Helicobacter pylori prevalence decreased across areas mapping to the three residential classes in accordance with increasing affluence with rural areas having the highest prevalence. The unemployed and patients in farming had relatively high Helicobacter pylori infection rates of 92.3% and 91.7% respectively. Conclusion: Helicobacter pylori is endemic in Ghana but the persistently high prevalence across age groups despite significant community anti-microbial use suggests likely re-crudescence or re-infection from multiple sources in a developing country. Socio-cultural factors such as residential class and farming may be facilitating factors for its continued prevalence. © Timothy Nii Akushe Archampong et al.Item Human pegivirus (HPgV) infection in Ghanaians co-infected with human immunodeficiency virus (HIV) and hepatitis B virus (HBV)(Springer New York LLC, 2018) N’Guessan, K.F.; Boyce, C.; Kwara, A.; Archampong, T.N.A.; Lartey, M.; Sagoe, K.W.; Kenu, E.; Obo-Akwa, A.; Blackard, J.T.Human pegivirus (HPgV) is a positive single-stranded RNA virus in the Flaviviridae family. Phylogenetic analysis reveals the presence of multiple HPgV genotypes with distinct geographic locations. HPgV is of interest because of its potential beneficial impact on HIV disease progression. Despite this, the effects of HPgV in the context of other viral infections, such as hepatitis B virus (HBV), are poorly understood, and data from resource-limited settings are scarce. Therefore, we conducted a cross-sectional analysis of HPgV in HIV/HBV co-infected patients in Ghana. Sera from 100 HIV/HBV co-infected individuals were evaluated for HPgV RNA, and the genotype determined by sequencing the 5′ untranslated region. HPgV RNA was detected in 27 samples (27%). Of these, 26 were genotyped successfully with 23 belonging to HPgV genotype 1 and 3 belonging to HPgV genotype 2. The presence of HPgV RNA had no statistically significant impact on CD4 cell count or HBV DNA titers in the HIV/HBV co-infected patients. However, there was a trend towards decreased HBV DNA levels in HPgV RNA-positive patients with CD4 cell count < 200 (p = 0.0626). HPgV co-infection is common in Ghana. The effect of HPgV on HIV or HBV disease among HIV/HBV co-infected patients was minimal. However, decreased HBV DNA levels in HPgV RNA-positive patients with low CD4 cell counts highlight the need for prospective studies of HPgV in HIV and hepatitis co-infected patients, especially in those with advanced HIV disease, to study further the effects of HPgV on liver disease. © 2018, Springer Science+Business Media, LLC, part of Springer Nature.Item Identification and Comparative Analysis of Hepatitis B Virus Genotype D/E Recombinants in Africa(Virus Genes, 2017-05) Boyce, C.L.; Ganova-Raeva, L.; Archampong, T.N.A.; Lartey, M.; Sagoe, K.W.; Obo-Akwa, A.; Kenu, E.; Kwara, A.; Blackard, J.T.Globally, there are approximately 240 million people chronically infected with hepatitis B virus (HBV)-a major cause of hepatocellular carcinoma. Ten different HBV genotypes (A-J) have been identified with distinct geographic distributions. Novel variants generated by recombination between different HBV genotypes have been documented worldwide and represent an important element of genetic variability with possible clinical implications. Here, the complete genome sequence of an HBV genotype D/E recombinant from Ghana is reported. The full-length sequence was obtained using rolling circle amplification followed by PCR and sequenced using next-generation sequencing (NGS). A consensus sequence was extracted from the NGS data and underwent phylogenetic analysis to determine genotype, as well as the recombination pattern. Subsequently, the sequence was compared to recombinants described previously in Africa. Based on MCMC phylogenetic analysis, SimPlot recombination analyses, and intragroup genetic distance, the isolate 007N full-length genome is unique compared to other reported D/E recombinants in Africa.Item Identification of Hepatitis B Virus Genotype A/E Recombinants in Ghana(Virus Genes, 2019-07) Boyce, C.L.; Willis, S.; Archampong, T.N.A.; Lartey, M.; Sagoe, K.W.; Obo-Akwa, A.; Kenu, E.; Kwara, A.; Blackard, J.T.Hepatitis B virus (HBV) exhibits a high degree of heterogeneity with at least 10 genotypes (A-J) identified to date. Intergenotypic recombination is relatively common. Previously, we investigated HBV drug resistance in HIV/HBV co-infected individuals in Ghana. After identifying multiple circulating genotypes and a novel D/E recombinant, we sought to determine if additional individuals were also infected with recombinant HBV. Partial genome sequences from three individuals were initially identified as genotype A4. Full-length HBV genomes were obtained using rolling circle amplification followed by PCR and shown to cluster with known A/E recombinant viruses. Similar recombination breakpoints were observed in these three individuals suggesting local spread of this novel recombinant HBV in Ghana.Item Inflammatory bowel disease in Accra: What new trends? [Maladie Inflammatoire Intestinale: Quelles sont les nouvelles tendances?](West African Journal of Medicine, 2013-03) Archampong, T.N.A.; Nkrumah, K.N.BACKGROUND: Inflammatory bowel disease (IBD) has been more common in Western Europe and North America. Initially IBD had been thought to be low in incidence among Sub- Saharan Africans. However, it is now being increasingly recognised in patients of African descent. OBJECTIVE: A comparative assessment of the patterns of IBD in Accra from 1997 to 2011. METHODS: This study used a retrospective design to access clinical details of follow-up patients attending the Gastroenterology Unit of the Korle-Bu Teaching Hospital, Accra between February, 1997 and May, 2011. It was a comparative seven-year review of clinical presentations of IBD between April, 2004 – August, 2011 (t2) and February, 1997 – March, 2004 (t1) for changing patterns of disease in tertiary care. RESULTS: Twenty-eight (28) new IBD patients were seen in the Gastroenterology Clinic, KBTH with IBD during 2004 – 2011 (t2) in comparison to 17 patients over1997 – 2004 (t1). Presentations of severe diarrhoea were 70.4% and 55.6% in (t1) and (t2) respectively. Eighty-two percent (82%) of patients with IBD in (t2) had a severely inflamed colon on the index colonoscopy. Most patients (70–80%) responded to medical therapy (steroids, sulfasalazine) with no colon resections for steroid-refractory colitis. CONCLUSION: Although relatively uncommon, IBD recorded a 65% rise in incidence over the study periods with a male preponderance. Most patients with IBD were presenting late with severe clinical and endoscopic features of disease yet medically responsive. Non-specific (indeterminate) colitis gained prominence in (t2). © 2013, West African Journal of Medicine. All rights reserved.Item Irritable bowel syndrome and related functional bowel disorders in an urban gastroenterology practice(Changing Trends in Mental Health Care and Research in Ghana, 2014) Archampong, T.N.A.; Nkrumah, K.N.Item Proportion and factors associated with Hepatitis B viremia in antiretroviral treatment naïve and experienced HIV co-infected Ghanaian patients(BioMed Central Ltd., 2016) Archampong, T.N.A.; Lartey, M.; Sagoe, K.W.; Obo-Akwa, A.; Kenu, E.; Gillani, F.S.; Yang, H.; Boamah, I.; Flanigan, T.; Kwara, A.Background: The global burden of Hepatitis B virus (HBV) and HIV co-infection is enormous. The risk of developing cirrhosis and hepatocellular cancer is associated with HBV DNA levels. The main objective of the study was to determine proportion of Hepatitis B viremia in ART-naïve and ART-experienced co-infected Ghanaian patients and factors associated with HBV viremia after at least 36 weeks of lamivudine with or without tenofovir containing ART. Methods: Hepatitis B and HIV co-infected patients who were ART-naïve or had received at least 9 months of lamivudine-containing ART were enrolled in a cross-sectional study at Korle-Bu Teaching Hospital. Demographic and clinical data were collected and samples obtained for Hepatitis B serology, liver function tests and HBV DNA. Factors associated with viremia were determined using univariate and multivariate logistic regression analysis. Results: Of 3108 HIV-infected patients screened, 257 (8.3 %) were HBsAg-positive, of which 235 enrolled. Overall, 152 (64.7 %) were ART-experienced and 83 (35.3 %) were ART-naïve. Eighty-nine-percent of ART-naïve and 42.1 % of ART-experienced patients had HBV DNA > 20 IU/mL. In multivariate analysis of all patients, being ART-naïve (OR 10.1, 95 % CI 4.6 - 21.9) and elevated ALT (OR 3.7, 95 % CI 1.8 - 7.9) were associated with Hepatitis B viremia. In treatment experienced patients, elevated ALT (OR 4.8 CI 2.0 - 12.1) and male sex (OR 2.1, 95 % CI 1.0 - 4.2) were associated with Hepatitis B viremia. Conclusions: Majority of ART-naïve (89 %) and 42 % of ART-experienced patients had detectable hepatitis B viremia > 20 IU/mL. An abnormal serum ALT was significantly associated with hepatitis B viremia in HBV and HIV co-infected patients irrespective of treatment status. Baseline and on-treatment ALT may be a useful non-invasive predictor of Hepatitis B viremia in resource-constrained countries in sub-Saharan Africa where infection is endemic and viral load tests are not widely available.