Browsing by Author "Kamiya, H."
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Item High CD4/CD45RO+ and CD8/CD45RO+ frequencies in children with vaccine-modified measles(Pediatrics International, 2006) Addae, M.M.; Tetteh, J.K.A.; Ishiwada, N.; Komada, Y.; Yamaguchi, S.; Ofori-Adjei, D.; Kamiya, H.; Akanmori, B.D.BACKGROUND: Despite availability and wide vaccine coverage, measles infections still occur especially in developing countries. An outbreak of measles occurred among previously immunized older Ghanaian children who had milder clinical symptoms with measles-specific IgG antibodies that could have been attributed to secondary vaccine failure, suggesting that the infection was vaccine-modified measles (VMM). METHODS: Two-color immunophenotyping of the peripheral blood mononuclear cells was performed at acute, recovery and convalescence phases for 19 VMM patients (mean age 6.2 +/- 3.5 years) using flow cytometry, and compared with that of 20 healthy, sex- and age-matched controls. RESULTS: The results showed a significantly higher memory helper (CD4(+)/CD45RO(+)) cell frequency and increased suppressor cell (CD8(+)/CD45R0(+)) frequency in VMM patients compared to healthy controls. There were no complications and all the patients recovered completely. CONCLUSIONS: These findings show that the mild symptoms in patients with VMM may have correlated with the increase of memory T cells, which is in sharp contrast with previous reports on acute measles infection. This may suggest that the intact immunologic memory cells could have been crucial for the resolution of VMM.Item Immunological background in children with persistent diarrhea in Ghana(Pediatrics International, 1999) Taniguchi, K; Rikimaru, T; Yartey, J.E.; Akpedonu, P.; Armar-Klemesu, M.A.; Nkrumah, F.K.; Kamiya, H.; Kishi, K.; Armar, D.A.BACKGROUND: Persistent diarrheal diseases have become one of the most serious medical problems in developing countries, but few studies have been conducted to determine the risk factors. In the present study, we investigated the nutritional and immunological background in children with persistent diarrhea in comparison with those with acute diarrhea. METHODS: Children with diarrhea who were brought to the Oral Rehydration Salt Clinic of Princess Marie Louise Children's Hospital in Accra were evaluated from an immunological and nutritional aspect. In the follow-up visit, the cases whose diarrhea stopped within 2 weeks after onset were classified into the acute diarrhea group; those with diarrhea lasting more than 2 weeks were classed in the persistent group. Nutritional and immunological data at the initial visit were compared between these two groups. RESULTS: In general, the diarrhea cases had a tendency to undernutrition and impaired cellular immunity compared with healthy control. Persistent cases had lower values for longer half-life, rapid turn-over proteins. Persistent cases had a higher percentage of CD8+ cells and lower CD4/CD8 ratio. CD25 expression in CD4+ cells stimulated by anti-CD3 antibody was lower in the persistent diarrhea group. CONCLUSION: These results appear to support the hypothesis that more severe nutritional status and impairment of cellular immunity is related to the persistence of diarrhea.Item The Role of Street Food Vendors in the Transmission of Enteric pathogens in Accra(Ghana Medical Journal, 1999-03) Mensah, P.; Owusu-Darko, K.; Yebooh-Manu, D.; Ablordey, A.; Nkrumah, F.K.; Kamiya, H.The role of street food vendors in the transmission of diarrhoeal pathogens was evaluated by assessing their knowledge on the definition of diarrhoea and transmission of diarrhoeal pathogens. Stool and blood cultures as well as the Widal test was carried to deterĀ· mi ne their carrier status on a number of bacterial enteropathogens. All the vendors were female which emphasises the Important role women play in the provision of food through street food vending activities. They provide useful Service to the community by selling food to school children. market women, traders and workers. The level of education of these females was low and this reflected in their knowledge on the definition.. causes and transmission of enteric pathogens. Their personal hygiene was however good but the environment was often littered with garbage. A number of diarrhoeal pathogens were isolated from 66(37.5%) of these individuals. Salmonella '\P was isolated from 6(3.4%), Shigella from 2(1. 1%). Enteropathugenic E.coli (EPEC) from 59 (33.5%) and enteroaggressive E.coli (EPEC) from 34( 19.3%). Mixed enteric infection was common: seventeen had two different bacteria. Six had three and one had four different bacteria and another one had five. A total of 176 blood samples were cultured for bacteria and out of these only 1(0.6%) tested positive for Pasteurella gallinarium. In the Widal test only 153 serum samples were tested for antibodies to S typhi and 15(9.8%) titre of 1:80 to the somatic antigen. These were positive according to the manufacturers specifications but comparison with the stool and blood culture results showed that only one subject among this group actually had confirmed S typhi infection The screening of food handlers for enteric pathogens may be difficult to monitor SO food and personal hygiene education is recommended. Although the effectiveness of the Widal as a diagnostic tool for typhoidfever was not included in the initial objectives. the study showed that the Widal test cannot be used in isolation from laboratory results. This is even more difficult in the absence of a National Cut-Off Point. A survey to provide such data is also obviousItem Survey of enteropathogenic agents in children with and without diarrhoea in Ghana.(Ghana Medical Journal, 1990-03) Nakano, T.; Sakatoku, H.; Binka, F.N.; Afari, E.A.; Agbodaze, D.; Aryeetey, M.E.; Mingle, J.A.A.; Kamiya, H.; Sakurai, M.A survey was carried out over a period of one year in a rural setting in Ghana on isolation, detection and/or identification of enteric pathogens from children under five years of age with and without diarrhea. The isolation and detection rates of Shigella flexneri, Giardia lamblia and Rotavirus were significantly higher in children with diarrhea than in controlsItem Vaccine-modified measles in previously immunized children in Accra, Ghana: Clinical, virological and serological parameters.(2001) Ishiwada, N.; Addae, M.M.; Tetteh, J.K.A.; Yempewu, S.M.; Ofori-Adjei, D.; Kamiya, H.; Akanmori, B.D.Despite rapidly increasing measles immunization coverage, epidemics of measles occurred from January to March 2000 in some parts of Accra, the capital of Ghana. 44 cases of acute measles were diagnosed at three health facilities during the outbreaks, which we examined clinically and serologically. The peak incidence occurred among 6-12-year-olds, clinical symptoms were milder than the typical symptoms of measles, and fever was significantly less common. None of the cases developed complications and all recovered completely. Thirty-eight (86.4%) were tested serologically; IgM antibodies were detected in 73.7% and IgG antibodies in 84.2% during the acute phase. Milder symptoms in a significant number of cases with measles IgG antibodies suggest that these are vaccine-modified measles, attributable to waning antibodies and low circulation of wild type virus in an area of high vaccine coverage. Serological confirmation will be required for accurate diagnosis, if measles is to be eradicated or kept under control. It also seems likely that multiple dose immunization schedules will be needed in the future to maintain protective antibody levels and to protect children against measles in Ghana. This will eliminate the frequent outbreaks of measles involving immunized children.