Browsing by Author "Gyasi, R. K."
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Item Human Immunodeficiency Virus among Elderly Medical Patients at the Korle Bu Teaching Hospital, Accra, Ghana(2014-07) Agyemang, S.; Adjei, A.A.; Gyasi, R. K.; Ofei, F.; University Of Ghana, College of Health Sciences, School of Public HealthHuman immunodeficiency virus (HIV) has now spread to all parts of the world with rates particularly high in young people (15-49 years) than older people (>50 years). Despite the global attention being paid to the epidemic of infection with HIV, the rates among older people in the sub-Saharan Africa has been a neglected area of study. This cross-sectional study carried out between the months of November, 2012 and January 2014 sought to determine the prevalence of HIV among elderly patients on admission at the Korle Bu Teaching Hospital and also the correlates of HIV infection among the patients (1,100 patients on admission at the SME and Medical Wards of KBTH). Of the total consenting elderly patients (aged 50 years and above) 60% were females and 40% were males. The patients voluntarily completed a risk-factor questionnaire and provided blood specimen for HIV testing. The data was analyzed using univariate analysis and the median age of the patients was 63 years (range age 50-100 years). HIV sero-prevalence was 4.18% and the main determinants of HIV in the study population were, homosexuality (OR: 47.86; 95% CI: 4.27-537.91), long distance trading (OR 2.28; 95% CI 0.85-6.12), multiple sexual partners (OR: 1.25 95% CI: 0.69-2-28) and chewing tobacco (OR: 1.57; 95% CI 0.69-3.64). The knowledge and awareness of HIV transmission among the study population was also very low. Consistent with the few studies worldwide, these results may suggest high prevalence of HIV infections among the elderly population in Ghana.Item Pregnancy Related Causes of Deaths in Ghana: A 5-Year Retrospective Study(2013-12) Der, E. M.; Moyer, C.; Gyasi, R. K.; Akosa, A. B.; Tettey, J.; Akakpo, P. K.; Blankson, A.; Anim, J. T.Objective Data on maternal mortality varies by region and data source. Accurate local-level data are essential to appreciate its burden. This study uses autopsy results to assess maternal mortality causes in southern Ghana. Methods Autopsy log books of the Department of Pathology, Korle-Bu Teaching Hospital Mortuary were reviewed from 2004 through 2008 for pregnancy related deaths. Data were entered into a database and analyzed using SPSS statistical software (Version 19). Results Of 5,247 deaths among women aged 15–49, 12.1% (634) were pregnancy-related. Eighty one percent of pregnancy-related deaths (517) occurred in the community or within 24 hours of admission to a health facility and 18.5% (117) occurred in a health facility. Out of 634 pregnancy-related deaths, 79.5% (504) resulted from direct obstetric causes, including: haemorrhage (21.8%), abortion (20.8%), hypertensive disorders (19.4%), ectopic gestation (8.7%), uterine rupture (4.3%) and genital tract sepsis (2.5%). The remaining 20.5% (130) resulted from indirect obstetric causes, including: infections outside the genital tract, (9.2%), anemia (2.8%), sickle cell disease (2.7%), pulmonary embolism (1.9%) and disseminated intravascular coagulation (1.3%). The top five causes of maternal death were: haemorrhage (21.8%), abortion (20.7%), hypertensive disorders (19.4%), infections (9.1%) and ectopic gestation (8.7%). Conclusion Ghana continues to have persistently high levels of preventable causes of maternal deaths. Community based studies, on maternal mortality are urgently needed in Ghana, since our autopsy studies indicates that 81% of deaths recorded in this study occurred in the community or within 24 hours of admission to a health facility.Item Prevalence of Antibodies to Human Tlymphotropic Virus Type I Among Blood Donors at the 37th Military Hospital, Accra, Ghana.(University of Ghana, 2004-06) Narter-Olaga, E.G.; Adjei, A.A.,; Wiredu, E.K.; Tettey, Y.; Gyasi, R. K.; Wadhwani, J. M.; University of Ghana, College of Health Sciences School of Biomedical and Allied Health Sciences Department of PathologySeveral infectious diseases have been found to be associated with transfusion o f whole blood or blood components. Reports from studies conducted in many African countries indicate a high incidence of blood-borne pathogens such as human T-lymphotropic virus type-I (HTLV-I) among healthy blood donors. Experimental data indicate that a r. ajor route for transmission o f the HTLV-I is through blood transfusion. The prevalence o f HTLV-I antibodies among blood donors in Ghana is not well documented. Population surveys cannot be conducted for financial reasons and therefore sentinel studies are the only means for providing information on the transmissions of infections such as HTLV-I, as well as monitoring the changes over time. The study was therefore undertaken to determine the prevalence o f HTLV-I antibodies among blood donors, between the months of January to April 2004 at the 37th Military Hospital Blood Transfusion Service, Accra, Ghana. A combination o f particle agglutination test and enzyme-linked immunosorbent assay (ELISA) was used to assess the prevalence and distribution of antibodies to HTLV-I. A structured questionnaire was also administered to the blood donors after an informed oral and written consent was taken. This involved questions on personal information, knowledge about HTLV-I transfusion, sexual behaviour, lifestyle and histories o f transfusion-transmitted diseases. Beginning from January to April 2004, blood samples were collected from blood donors, serum separated and analysed for the presence of antibodies to HTLV-I. A total o f 1225 samples (1158 males and 67 females) were analysed. Their ages ranged from 20-69 years; with majority (75.5%; 925/1225) of the blood donors studied between the 30-^9 years age group. Ofth e 1225 samples tested, 1196 were negative and 29 were positive lor HTLV-I antibodies giving a prevalence rate of 2.4%. Two females were positive out o f 67 (2.9%) and 27 males were positive out o f 1158 (2.3%) male donors. Majority of the donors were married (914; 74.6%) and the rest (311; 25.4%) were not married. Of the married donors, 21 were positive for HTLV-I antibodies, giving a prevalence rate o f 2.3% among married donor. Most ofItem Soluble factors from plasmodium falciparum-infected erythrocytes induce apoptosis in human brain vascular endothelial and neuroglia cells(2008-12) Wilson, N. O.; Huang, M.; Anderson, W.; Gyasi, R. K.; Powell, M.; Thompson, W. E.; Stiles, J. K.The severity of malaria is multi-factorial. It is associated with parasite-induced alteration in pro-inflammatory and anti-inflammatory cytokine and chemokine levels in host serum and cerebrospinal fluid. It is also associated with sequestration and cytoadherence of parasitized erythrocytes (pRBCs) in post-capillary venules and blood-brain barrier (BBB) dysfunction. The role of these factors in development of vascular injury and tissue damage in malaria patients is unclear. While some studies indicate a requirement for pRBC adhesion to vascular endothelial cells (ECs) in brain capillaries to induce apoptosis and BBB damage, others show no role of apoptosis resulting from adhesion of pRBC to EC. In the present study, the hypothesis that soluble factors from Plasmodium falciparum-infected erythrocytes induce apoptosis in human brain vascular endothelial (HBVEC) and neuroglia cells (cellular components of the BBB) was tested. Apoptotic effects of parasitized (pRBC) and non-parasitized erythrocyte (RBC) conditioned medium on HBVEC and neuroglia cells were determined in vitro by evaluating nuclear DNA fragmentation (TUNEL assay) in cultured cells. Soluble factors from P. falciparum-infected erythrocytes in conditioned medium induced extensive DNA fragmentation in both cell lines, albeit to a greater extent in HBVEC than neuroglia, indicating that extended exposure to high levels of these soluble factors in serum may be associated with vascular, neuronal and tissue injury in malaria patients. © 2008 Elsevier B.V. All rights reserved.