Browsing by Author "Balogun, O."
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Item Biobanking in a Challenging African Environment: Unique Experience from the SIREN Project(Mary Ann Liebert Inc., 2018-05) Akinyemi, R.O.; Akinwande, K.; Diala, S.; Adeleye, O.; Ajose, A.; Issa, K.; Owusu, D.; Boamah, I.; Yahaya, I.S.; Jimoh, A.O.; Imoh, L.; Fakunle, G.; Akpalu, A.; Sarfo, F.; Wahab, K.; Sanya, E.; Owolabi, L.; Obiako, R.; Osaigbovo, G.; Komolafe, M.; Fawale, M.; Adebayo, P.; Olowoyo, P.; Obiabo, Y.; Sunmonu, T.; Chukwuonye, I.; Balogun, O.; Adeoye, B.; Oladele, F.; Olowoniyi, P.; Adeyemi, F.; Lezzi, A.; Falayi, A.T.; Fasanya, M.; Ogunwale, K.; Adeola, O.; Olomu, O.; Aridegbe, O.; Laryea, R.; Uvere, E.; Faniyan, M.; Melikam, E.; Tagge, R.; Akpa, O.; Akinyemi, J.; Arulogun, O.; Tiwari, H.K.; Ovbiagele, B.; Owolabi, M.O.Africa was previously insufficiently represented in the emerging discipline of biobanking despite commendable early efforts. However, with the Human, Heredity, and Health in Africa (H3Africa) initiative, biorepository science has been bolstered, regional biobanks are springing up, and awareness about biobanks is growing on the continent. The Stroke Investigative Research and Educational Network (SIREN) project is a transnational, multicenter, hospital and community-based study involving over 3000 cases and 3000 controls recruited from 16 sites in Ghana and Nigeria. SIREN aims to explore and unravel the genetic and environmental factors that interact to produce the peculiar phenotypic and clinical characteristics of stroke as seen in people of African ancestry and facilitate the development of new diagnostics, therapeutics, and preventative strategies. The aim of this article is to describe our experience with the development of the procedure for collection, processing, storage, and shipment of biological samples (blood, serum, plasma, buffy coat, red cell concentrates, and DNA) and brain imaging across coordinating and participating sites within the SIREN Project. The SIREN network was initiated in 2014 with support and funding from the H3Africa Initiative. The SIREN Biobank currently has 3015 brain images, 92,950 blood fractions (serum, plasma, red cell concentrates, and buffy coat) accrued from 8450 recruited subjects, and quantified and aliquoted good-quality DNA extracts from 6150 study subjects. This represents an invaluable resource for future research with expanding genomic and trans-omic technologies. This will facilitate the involvement of indigenous African samples in cutting-edge stroke genomics and trans-omics research. It is, however, critical to effectively engage African stroke patients and community members who have contributed precious biological materials to the SIREN Biobank to generate appropriate evidence base for dealing with ethical, legal, and social issues of privacy, autonomy, identifiability, biorights, governance issues, and public understanding of stroke biobanking in the context of unique African culture, language, and belief systems. © Rufus O. Akinyemi et al. 2018.Item Estimating HIV incidence in the Akwa Ibom AIDS indicator survey (AKAIS), Nigeria using the limiting antigen avidity recency assay(Journal of the International AIDS Society, 2021) Negedu-Momoh, O.R.; Balogun, O.; Torpey, K.; et al.Introduction: HIV incidence estimates are important to characterize the status of an epidemic, identify locations and popula tions at high risk and to guide and evaluate HIV prevention interventions. We used the limiting antigen avidity assay (LAg) as part of a recent infection testing algorithm to estimate HIV incidence in the Akwa Ibom AIDS Indicator Survey (AKAIS), Nige ria. Methods: In 2017, AKAIS, a cross-sectional population-based study was conducted at the household (HH) level in 31 local government areas (LGAs) of Akwa Ibom state. Of the 8963 participants aged ≥15 years who were administered question naires for demographic and behavioural data, 8306 consented to HIV rapid testing. Whole-blood specimens were collected from 394 preliminary HIV-seropositive individuals for CD4+ cell count determination and plasma storage. Samples were shipped to a central quality laboratory for HIV confirmatory testing and viral load determination. A total of 370 HIV-positive specimens were tested for the recent HIV infection using the LAg assay. Results: Of the 8306 consenting adults, the HIV prevalence was 4.8%. Of the 370 HIV-positive samples tested for HIV recency, the median age was 35 years, 48.8% had CD4+ cell count >500/mm3 and 81.3% was not virally suppressed. Viral suppression was greater among females (21%) than for males (13%). A total of 11 specimens were classified as recent based on the LAg assay and HIV viral load ≥1000 copies/mL. The weighted, adjusted HIV-1 incidence was 0.41/100 person-years (95% CI 0.16 to 0.66); translating to 13,000 new cases of HIV infections annually in Akwa Ibom, a state with a population of 5.5 million. The HIV incidence rate was similar in females and males (0.41% and 0.42% respectively). The incidence rate was the highest among participants aged 15 to 49 years (0.44%, 95% CI 0.15 to 0.74) translating to 11,000 new infections annu ally, about 85% of all new infections in the state. Conclusions: The finding of the high HIV incidence among the 15 to 49-year age group calls for renewed and innovative efforts to prevent HIV infection among young adults in Akwa Ibom state.Item Frequency and factors associated with post-stroke seizures in a large multicenter study in West Africa(Journal of the Neurological Sciences, 2021) Sarfo, F.S.; Akinyemi, J.; Akpalu, A.; Wahab, K.; Yaria, J.; Adebayo, O.; Komolafe, M.; Obiako, R.; Owolabi, L.; Osaigbovo, G.O.; Jenkins, C.; Mensah, Y.; Ogbole, G.; Calys-Tagoe, B.; Adebayo, A.; Appiah, L.; Singh, A.; Fakunle, A.; Uvere, E.; Hemant, T.; Balogun, O.; Adeleye, O.; Fawale, F.; Abdulwasiu, A.; Ogunjimi, L.; Akinola, O.; Arulogun, O.; Donna, A.; Ogah, O.; Akinyemi, R.; Ovbiagele, B.; Owolabi, M.O.Background: Post-stroke seizures (PSS) are associated with significant morbidity and mortality across the globe. There is a paucity of data on PSS in Africa. Purpose: To assess the frequency and factors associated with PSS by stroke types across 15 hospitals in Nigeria and Ghana. Methods: We analyzed data on all stroke cases recruited into the Stroke Investigative Research and Educational Network (SIREN). We included adults aged ≥18 years with radiologically confirmed ischemic stroke (IS) or intracerebral hemorrhage (ICH). PSS were defined as acute symptomatic seizures occurring at stroke onset and/ or during acute hospitalization up until discharge. We used logistic regression to estimate adjusted odds ratios (aOR) with 95% Confidence Interval. Results: Among 3344 stroke patients, 499 (14.9%) had PSS (95% CI: 13.7–16.2%). The mean duration of admission in days for those with PSS vs no PSS was 17.4 ± 28.6 vs 15.9 ± 24.7, p = 0.72. There were 294(14.1%) PSS among 2091 ischemic strokes and 159(17.7%) among 897 with ICH, p = 0.01. The factors associated with PSS occurrence were age < 50 years, aOR of 1.59 (1.08–2.33), National Institute of Health Stroke Score (NIHSS), 1.29 (1.16–1.42) for each 5 units rise and white cell count 1.07 (1.01–1.13) for each 10^3 mm3 rise. Factors associated with PSS in ischemic were NIHSS score, aOR of 1.17 (1.04–1.31) and infarct volume of 10–30 cm3 aOR of 2.17(1.37–3.45). Among ICH, associated factors were alcohol use 5.91 (2.11–16.55) and lobar bleeds 2.22 (1.03–4.82). Conclusion: The burden of PSS among this sample of west Africans is substantial and may contribute to poor outcomes of stroke in this region. Further longitudinal studies are required to understand the impact on morbidity and mortality arising from PSS in Africa.Item H3Africa partnerships to empower clinical research sites to generate high-quality biological samples(African Journal of Laboratory Medicine, 2020-03-18) Ovbiagele, B.; Owolabi, M.; Melikam, S.E; Ajayi, S.; Mamven, M.; Lawal, S.; Onyemata, E.; Ozumba, P.J.; Balogun, O.; Jonathan, E.; Agala, N.; Croxton, T.; Adu, D.; Ojo, A.; Beiswanger, C.M.; Abimiku, A.Background: The Institute of Human Virology Nigeria (IHVN) – Human Heredity and Health in Africa (H3Africa) Biorepository (I-HAB) seeks to provide high-quality biospecimens for research. This depends on the ability of clinical research sites (CRS) – who provide biospecimens – to operate according to well-established industry standards. Yet, standards are often neglected at CRSs located in Africa. Here, I-HAB reports on its four-pronged approach to empower CRSs to prepare high-quality biospecimens for research. Objectives: I-HAB sought (1) to assess a four-pronged approach to improve biobanking practices and sample quality among CRSs, and (2) to build human capacity. Methods: I-HAB partnered with two H3Africa principal investigators located in Nigeria and Ghana from August 2013 through to May 2017 to debut its four-pronged approach (needs assessment, training and mentorship, pilot, and continuous quality improvement) to empower CRSs to attain high-quality biospecimens. Results: Close collaborations were instrumental in establishing mutually beneficial and lasting relationships. Improvements during the 12 months of engagement with CRSs involved personnel, procedural, and supply upgrades. In total, 51 staff were trained in over 20 topics. During the pilot, CRSs extracted 50 DNA biospecimens from whole blood and performed quality control. The CRSs shipped extracted DNA to I-HAB and I-HAB that comparatively analysed the DNA. Remediation was achieved via recommendations, training, and mentorship. Preanalytical, analytical and post-analytical processes, standard operating procedures, and workflows were systematically developed. Conclusion: Partnerships between I-HAB and H3Africa CRSs enabled research sites to produce high-quality biospecimens through needs assessment, training and mentorship, pilot, and continuous monitoring and improvement.Item Performance evaluation of BD FACSPresto™ point of care CD4 analyzer to enumerate CD4 counts for monitoring HIV infected individuals in Nigeria(Public Library of Science, 2017) Negedu-Momoh, O.R.; Jegede, F.E.; Yakubu, A.; Balogun, O.; Abdullahi, M.; Badru, T.; Oladele, E.A.; Agbakwuru, C.; Khamofu, H.; Torpey, K.Background: Despite the upsurge in support and intervention of donor agencies in HIV care and treatment programing in Sub-Sahara African, antiretroviral (ART) programs are still confronted with access and coverage challenges which influence enrolment of new patients. This study investigated the validity of point of care BD FACSPresto™ CD4 analyzer for CD4+ cell count, overall agreement, correlation, sensitivity, and specificity in comparison to a reference standard flow cytometry method. We also assessed the feasibility of use among nonlaboratorians. Methods Blood samples from 300 HIV infected individuals were analyzed for CD4+ T cell and CD4%, using finger prick capillary sample from 150 PMTCT clients and 150 ART clients at Murtala Mohammed Specialist Hospital, Kano, Nigeria. Their venous samples were compared on a flow cytometry reference method using BD FACSCount CD4+ count system. The accuracy of the BD FACSPresto machine in comparison to BD FACSCount was evaluated. Statistical analysis was carried out using STATA (version 12). Bland-Altman method and correlation analysis were used to analyze agreement between both measurements. In addition, sensitivity and specificity of both measurements were determined. Statistical significance was set at p-value <0.05. Results The mean bias and limit of agreement for CD4+ count between BD FACSPresto and BD FACS count machine were 7.49 (95% CI: 2.44 to 12.54) and -8.14 to 96.39 respectively. Further analysis revealed close agreement between BD FACSPresto and BD FACSCount with no significant difference between the two methods (p = .0.95). Using a threshold of 500 cells/μL, sensitivity and specificity of BD FACSPresto were 95.1% and 97.1% respectively, compared to BD FACSCount. There was no statistically significant difference in the misclassification between BD FACSPresto and BD FACSCount results (p = 0.23). Furthermore, sensitivity and specificity were similar when BD FACSPresto machine was operated by a nurse or laboratory scientist, there was no substantial difference in testing variability observed between laboratory and non-laboratory operators using the BD FACSPresto analyzer. Conclusions Overall, BD FACSPresto Point of Care CD4+ count finger stick capillary blood results is a reliable method in comparison to venous sample cytometry method and no significant difference variability observed between laboratory personnel and non-laboratory operators. The BD FACSPresto is simple, more robust and easy to use equipment without significant variability in reliability by non-laboratory health care workers hence will be a valuable instrument in increasing access and coverage of CD4 estimations in developing countries. The introduction of the BD FACSPresto POC analyzer has a high potential in reducing patients waiting time and improving the overall quality of ART service and clients' satisfaction especially in rural settings. © 2017 Negedu-Momoh et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.