Browsing by Author "Botchway, F."
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Item 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.Item Effects of factor v Leiden polymorphism on the pathogenesis and outcomes of preeclampsia(BMC Medical Genetics, 2019-11-27) Ababio, G.K.; Adu-Bonsaffoh, K.; Abindau, E.; Narh, G.; Tetteh, D.; Botchway, F.; Morvey, D.; Neequaye, J.; Quaye, I.K.Background: Factor V Leiden polymorphism is a well-recognized genetic factor in the etiology of preeclampsia. Considering that Ghana is recording high incidence of preeclampsia, we examined if factor V Leiden is a contributory factor to its development and pregnancy outcomes. Methods: STROBE consensus checklist was adopted to recruit eighty-one (81) consenting subjects after ethical clearance. Subjects were followed up till delivery to obtain outcomes of PE. Routine blood chemistry and proteinuria were done on all samples. Factor V Leiden was characterized by polymerase chain reaction and restriction fragment length polymorphism (RFLP). The data was captured as protected health information (PHI) and analyzed with SPSS version 22. Results: Overall allelic frequencies found in FVL exon 10 were 0.67 and 0.33 for G and A alleles respectively. The FVL mutation was more in PE and hypertensive patients. Increased white blood cells, increased uric acid and a three – fold increment of AST / ALT ratio was observed in PE cases when stratified by FVL exons (exon 8 and 10). Significant differences were also observed between FVL and age, systolic blood pressure (SBP), diastolic blood pressure (DBP), liver enzymes, white blood cells (wbc), hemoglobin levels. Conclusion: FVL mutation allele frequency was 0.33, a first report. The mutation was associated with increased uric acid, liver enzymes and blood cell indices suggestive of acute inflammation.Item Gestational Age-Specific Distribution of the Hammersmith Neonatal Neurological Examination Scores Among Low-Risk Neonates in Ghana(Early Human Development, 2021) Lawford, H.L.S.; Nuamah, M.A.; Liley, H.G.; Lee, A.CC.; Botchway, F.; Kumar, S.; Group, I.S.; Adjei, A.A.; Boraa, S.Objective: To describe gestational age-specific distribution of scores for the Hammersmith Neonatal Neurological Examination (HNNE) up to 48 h after birth in a low-risk, term-born, single-center sample in Ghana. Study design: This is a nested substudy of a larger prospective study (IMPRINT: Impact of Malaria in Pregnancy on Infant Neurodevelopment) comprising 140 low-risk, term-born neonates at Korle Bu Teaching Hospital in Accra, Ghana, between November 2018 and February 2019. The sample was stratified into three gestational age groups: early-term (37 + 0–38 + 6, weeks + days; n = 61), full-term (39 + 0–40 + 6, weeks + days; n = 52), and late/post-term (41 + 0–42 + 6, weeks + days; n = 27). Neonates were administered the 34-item HNNE by trained physicians. As per the original British scoring system, raw scores for the Ghanaian sample were plotted and scores > 10th centile were assigned a score of 1, 5th–10th centile 0.5, and < 5th centile 0. Results: The range of raw scores for 16/34 HNNE items varied with gestational age. Specifically, 100% (7/7), 50% (5/10), 33% (1/3), 33% (1/3), 20% (1/5), and 14% (1/7) of items within the orientation and behavior, tone, abnormal signs/patterns, movements, tone patterns, and reflexes subdomain, respectively showed a different distribution of scores above the 10th centile across the three gestational age groups. Conclusion: Differences in gestational age-specific results within our sample in comparison to the original British sample could be, albeit unlikely, due to misclassification of gestational age, unmeasured maternal or fetal morbidity, or perhaps more likely, variation in testing or test conditions, or some combination of these. Genetic variation in neurological development is also a possibility. Further research is warranted to determine the reasons for differences. Our findings highlight the need to determine the accuracy and reliability of standardized neurologic assessments in predicting neurodevelopmental risk for infants in low- and middle-income countries.Item Haematological Indices and Antioxidant Enzyme Activity in Ghanaian Stroke Patients(Hindawi, 2022) Asmah, R.H.; Sackey, P.; Adjei, P.; Archampong, T.N.; Attoh, S.; Doku, D.; Quarchie, M.; Botchway, F.; Adedia, D.; Donkor, E.S.Background. Stroke is a cardiovascular disorder causing mortality globally and long-lasting harm worldwide. The disease occurs when the blood flow to the brain is either interrupted or blocked. This disruption leads to the increase in reactive oxygen species (ROS), especially superoxide free radicals, resulting in oxidative stress. The superoxide radicals are removed by superoxide dismutase (SOD), a key antioxidant enzyme. In this work, we investigated haematological indices and superoxide dismutase enzyme activity in Ghanaian patients with stroke and healthy control participants. Materials and Methods. Thirty stroke patients attending a stroke clinic and thirty apparently healthy control participants were recruited into the study. Blood samples were collected to determine haematological indices and SOD enzyme activity in red blood cells. Results. The stroke patients had significantly high blood parameters such as white blood cell (p < 0:001), neutrophil (p < 0:001), lymphocyte (p = 0:003), and eosinophil (p < 0:001) comparing with study participants without stroke, who were the control group in the study. Other blood parameters such as red blood cell, (p < 0:001), haemoglobin (p < 0:001), and haematocrit (p < 0:001) levels and mean cell haemoglobin concentration (p = 0:030), platelet (p = 0:010), and plateletcrit (p = 0:027) were high in stroke patients comparing with study control participants and statistically significant. Blood lymphocyte levels observed in stroke patients correlated negatively and significantly with SOD activity levels. SOD activity levels were significantly lower in stroke patients compared with the control group (p < 0:001). Low values of the antioxidant enzyme SOD activity levels, lymphocytes, and high values of plateletcrit were significant predictors of stroke. Conclusion. Haematological parameters such as WBC, lymphocyte, platelet levels, and red cell indices were significantly different in the stroke patients being studied. There was negative correlation between lymphocyte significantly with SOD activity and high oxidative stress in stroke patients compared with the control group. Lymphocytes and plateletcrit levels were also good predictors of the occurrence of stroke.Item Hematological differences among malaria patients in rural and Urban Ghana(Oxford University Press, 2016) Iqbal, S.A.; Botchway, F.; Badu, K.; Wilson, N.O.; Dei-Adomakoh, Y.; Dickinson-Copeland, C.M.; Chinbuah, H.; Adjei, A.A.; Wilson, M.; Stiles, J.K.; Driss, A.Background: Scarce studies have addressed hematological differences of malaria in urban and rural regions. Methods: Full or complete blood cell counts from 46 and 75 individuals (age range from <1to92 years) with uncomplicated malaria infection living in urban (Accra) and rural (Dodowa) Ghana, respectively, were assessed. Sickle cell trait and patients were excluded from the study. Results: Between overall groups, patients from Accra had significantly lower parasite count (p <0.0001) and granulocyte number (p = 0.026). Children in Accra had a significantly lower parasitemia (p = 0.0013), hemoglobin (p = 0.0254), platelet count (p = 0.0148) and red blood cell levels (p = 0.0080) when compared with the children of Dodowa. In adults, mean cell hemoglobin (p = 0.0086) and parasite count (p <0.0001) were significantly higher in Dodowa. Conclusion: These results indicate that children living in urban setting may experience a greater anemic effect to malaria as compared with those living in a rural setting. © The Author 2016. Published by Oxford University Press.Item Heme-mediated induction of CXCL10 and depletion of CD34+ progenitor cells is toll-like receptor 4 dependent(Public Library of Science, 2015) Dickinson-Copeland, C.M.; Wilson, N.O.; Liu, M.; Driss, A.; Salifu, H.; Adjei, A.A.; Wilson, M.; Gyan, B.; Oduro, D.; Badu, K.; Botchway, F.; Anderson, W.; Bond, V.; Bacanamwo, M.; Singh, S.; Stiles, J.K.Plasmodium falciparum infection can cause microvascular dysfunction, cerebral encephalopathy and death if untreated. We have previously shown that high concentrations of free heme, and C-X-C motif chemokine 10 (CXCL10) in sera of malaria patients induce apoptosis in microvascular endothelial and neuronal cells contributing to vascular dysfunction, blood-brain barrier (BBB) damage and mortality. Endothelial progenitor cells (EPC) are microvascular endothelial cell precursors partly responsible for repair and regeneration of damaged BBB endothelium. Studies have shown that EPC's are depleted in severe malaria patients, but the mechanisms mediating this phenomenon are unknown. Toll-like receptors recognize a wide variety of pathogen-associated molecular patterns generated by pathogens such as bacteria and parasites. We tested the hypothesis that EPC depletion during malaria pathogenesis is a function of heme-induced apoptosis mediated by CXCL10 induction and toll-like receptor (TLR) activation. Heme and CXCL10 concentrations in plasma obtained from malaria patients were elevated compared with non-malaria subjects. EPC numbers were significantly decreased in malaria patients (P < 0.02) and TLR4 expression was significantly elevated in vivo. These findings were confirmed in EPC precursors in vitro; where it was determined that heme-induced apoptosis and CXCL10 expression was TLR4- mediated. We conclude that increased serum heme mediates depletion of EPC during malaria pathogenesis.Item Medication Adherence and Its Association with Glycaemic Control, Blood Pressure Control, Glycosuria and Proteinuria among People Living with Diabetes (PLWD) in the Ho Municipality, Ghana(Open Public Health Journal, 2018-12) Osei-Yeboah, J.; Lokpo, S.Y.; Owiredu, W.K.B.A.; Johnson, B.B.; Orish, V.N.; Botchway, F.; Ussher, F.A.; Avorkliyah, R.Background: Adherence is the active, voluntary, and collaborative involvement of the patient in a mutually acceptable course of behaviour to produce a therapeutic result. The study is aimed at assessing adherence to medication and its relation to therapeutic outcomes among people living with diabetes in the Ho Municipality. Methodology: A cross-sectional study was conducted involving 150 diabetic patients attending the diabetic clinic at the Ho Municipal Hospital. Urine glucose and urine protein were measured using a two-parameter dipstick. The current fasting blood glucose and blood pressure, as well as the measurements of two previous visits, were documented. A semi-structured questionnaire including the Diabetes Complication Checklist and the Morisky, Green and Levine Adherence Scale were used to capture biodata, clinical information and medication adherence. Results: Optimal medication adherence was 60.67%. Glycaemic control and controlled blood pressure were 33.33% and 58.67%, respectively. The prevalence of glycosuria and proteinuria was 10.67% and 3.3%, respectively. Percentage glycaemic control and controlled blood pressure were found to be higher among the medication adherent group, while glycosuria and proteinuria were the highest among participants presenting with low medication adherence. Conclusion: In this group of patients living with diabetes in the Ho Municipality, high level of uncontrolled glycaemia and blood pressure exist. However, these two treatment outcomes may be modulated by optimal medication adherence.Item MicroRNAs miR-451a and Let-7i-5p Profiles in Circulating Exosomes Vary among Individuals with Different Sickle Hemoglobin Genotypes and Malaria(MDPI, 2022) Harp, K.O.; Bashi, A.; Botchway, F.; Dei-Adomakoh, Y.; Iqbal, S.A.; Wilson, M.D.; Adjei, A.A.; Stiles, J.K.; Driss, A.Sickle cell disease (SCD) occurs when two alleles of mutated hemoglobin (HbS or HbC) are inherited (HbSS and HbSC) rather than one (HbAS or HbAC), which indicates a person carries the sickle cell trait. The high prevalence of these two alleles in Africa have been associated with reduced malaria susceptibility. Recent in vitro research has been shown that microRNAs (miRNAs) miR-451a and let-7i-5p are differentially expressed in HbSS erythrocytes compared to healthy controls (HbAA) and are overexpressed in Plasmodium-infected malaria erythrocytes. However, these miRNAs have not been fully examined in the plasma of people with different sickle hemoglobin genotypes. Plasma circulating miRNAs are commonly encapsulated in extracellular vesicles, such as exosomes, and are thought to play a role in disease development. Circulating exosomal miR-451a and let-7i-5p were quantified from individuals with various hemoglobin genotypes (HbAA, HbAS, HbAC, HbSS, HbSC, and HbCC) with (+) and without (��) malaria. The results showed a higher level of exosomal let-7i-5p and miR-451a in HbSS-. Exosomal let-7i-5p and miR-451a levels were lower in HbSS+ compared to other genotypes. Based on the area under the curve (AUC) of the Receiver Operating Characteristics (ROCs), both exosomal miRNAs may be useful disease biomarkers for SCD with malaria. Finally, miR-451a and let-7i-5p modulate genes involved in inflammation, making them potential biomarkers of pathogenesis for both diseases.Item Serum Uric acid is a better indicator of kidney impairment than serum uric acid to creatine ratio ; a cross sectional study of type 2 diabetes mellitus patients(Springer, 2021) Ephraim, R.K.D.; Awuku, Y.A.; Numekevor, P.; Botchway, F.; Adoba, P.; Dadzie, E.K.; Abrefa, C.A.; Abaka-Yawson, A.Background Type 2 diabetes mellitus (T2DM) patients are likely to develop kidney disease. The need to identify more accessible and cheaper diagnostic biomarkers cannot be overemphasized. This study investigated the ability of serum uric and uric acid to creatinine ratio in assessing the kidney function of T2DM patients and determined the relationship between serum uric acid to creatinine ratio and estimated glomerular filtration rate (eGFR). Methods One hundred and fifty-five (155) consented T2DM patients were recruited from the diabetes clinic of the Cape Coast Teaching hospital. Anthropometric variables and blood pressure were measured. Serum uric acid (SUA), serum creatinine and urine protein were estimated using standard protocols. Uric acid to creatinine ratio (UA:CR), eGFR were then calculated. Results From the receiver operator characteristic (ROC) curve obtained, serum uric acid was found to be a better predictor of impaired renal function than UA:CR at p = 0.0001. The uric acid levels of participants in the fourth quartile of each category was found to be significant at p = 0.010 and can be used as indicators of kidney function in these participants. According to the odds ratio, the UA:CR will not be suitable to be used as an indicator of kidney function in any of the participants because their odds ratios were all less than 1. A total of 29(18.7 %) participants were found to have CKD with their eGFR falling below 60 ml/mins per 1.73 m2 . A significant positive relationship was found between serum uric acid and the staging of CKD according to eGFR whiles a negative relationship was found with UA:CR and CKD (p < 0.0001). Conclusions Serum uric acid is a better indicator of renal impairment (eGFR < 60 ml/mins per 1.73 m2 ) than UA:CR in patients with type 2 diabetes mellitus.