Browsing by Author "Neequaye, J.E."
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Item Bone marrow in sickle cell anaemia at time of anaemic crisis.(Archives of Disease in Childhood, 1984) Nkrumah, F.K.; Neequaye, J.E.; Ankra-Badu, G.Samples of bone marrow from 33 Ghanaian children with homozygous sickle cell anaemia who presented with profound anaemia (haemoglobin less than 5 g/dl) were studied. The principal finding was depression of erythropoiesis (aplastic crisis) in 14 children and erythroid hyperplasia in 17. A splenic sequestration crisis was clinically diagnosed in the remaining two children. Stainable iron was absent in the marrow of 14 children and reduced in another five. Megaloblastic changes compatible with folate deficiency were present in 8 children. It is suggested that iron and folate deficiencies may complicate sickle cell anaemia in children living in geographical areas where nutritional deficiencies are prevalent.Item The changing clinical pattern of endemic Burkitt lymphoma in Western Africa: Experience from a tertiary center in Ghana(Pediatric Blood and Cancer, 2018-10) Offor, U.T.; Akyea, R.K.; Neequaye, J.E.; Renner, L.A.; Segbefia, C.I.BACKGROUND: Burkitt lymphoma (BL) is the most common childhood cancer in Ghana, where the endemic variant is the predominant subtype and historically presents as a highly chemo-sensitive jaw tumor. This study aimed to update the current epidemiological characteristics of childhood BL in our institution. PROCEDURE: Patient data for all children diagnosed with BL and seen at Korle Bu Teaching Hospital between January 2007 and December 2012 were retrospectively analyzed. RESULTS: BL was diagnosed in 173 children (<13 years) during the study period, with the abdomen as the most common tumor site (46%) followed by the jaw (31%). Abdominal tumors were associated with advanced/disseminated disease (P = 0.002), and were more likely to occur in females irrespective of tumor stage (relative risk = 1.56 [95% CI; 1.1-12.3]). Twenty-five percent (43/173) of the study cohort died and mortality was influenced by increasing age (P = 0.02) and advanced disease (P = 0.03). Treatment delay was experienced by nine in ten patients primarily due to familial financial constraint (75%). Treatment abandonment was observed as a first event in 94% of patients and two thirds of children in the study were eventually lost to follow-up. CONCLUSION: The predominance of primary abdominal tumors in our study cohort may indicate a changing epidemiological pattern of BL in Ghana. High rates of treatment delay and abandonment were evident and are likely to be contributing factors to the poor childhood cancer survival outcomes seen in resource-limited countries in Africa.Item Falciparum Malaria not sensitive to Chloroquine Emerges in Accra in 1987.(Ghana Medical Journal, 1988-03) Neequaye, J.E.; Ofori-Adjei, D.; Odame, I.; Coker, L.; Mensa-Annan, B.In late 1987. there was all increase in the numbers of children with severe malaria seen at the Korle Bu Teaching Hospital. Thirteen children with falciparum malaria suspected to be resistant to chloroquine were studied. Resistance at the RII level was demonstrated in 2. and at the RI Ievel in one. RI resistance to amodiaquine in one child was also seen. The factors Leading to antimalarial drug resistance arc discussed.Item Ghanaian children of women infected with human immuno- deficiency virus (HIV).(Ghana Medical Journal, 1988-09) Neequaye, J.E.; Neequaye, A.R.; Mingle, J.A.A.; Ankra- Badu, G.A.; Asamoah-Adu, A.Seven children of HIV-I .infected Ghanaian women are described including one pair of twins. They were detected because the mothers gave a history of high risk behaviour in La Cote d’Ivoire. The twins and 2 others were seen at birth; 2 others were diagnosed under the age of 1 year; and one was 6 years old. Six of the 7 children and 3 of the mothers have died. The twins died from prematurity, and the other 4 died of disease due to HIV infection. One child with AIDS related complex (A.R.C) is still alive. Infection was diagnosed either because of the presence of active production by the child of anti HIV-I antibody (3 cases), or on the basis of clinical criteria consistent with the WHO clinical definition. These are the first known cases of AIDS in the paediatric age group in Ghana.Item Intrathecal chemoprophylaxis in the prevention of central nervous system relapse in burkitt's lymphoma(1985-07) Nkrumah, F.K.; Neequaye, J.E.; Biggar, R.A retrospective review of patients treated for endemic Burkitt's lymphoma in Ghana was undertaken to evaluate the efficacy of intrathecal (IT) chemoprophylaxis in preventing central nervous system (CNS) relapse. Patients treated before 1974 received no IT chemoprophylaxis and those treated between 1974 and 1979 received IT methotrexate in addition to systemic chemotherapy. In patients presenting with facial disease only (Stages I-II), there was no significant difference in the frequency of CNS relapse between those receiving IT chemoprophylaxis and those not receiving any. CNS relapse was, however, significantly reduced in patients presenting with abdominal disease (Stage III) who received IT chemoprophylaxis in addition to systemic combination therapy. This was associated with an improved survival.Item Patterns of chromosomal breakpoint locations in burkitt's lymphoma: Relevance to geography and epstein-barr virus association.(1991) Shiramizu, B.; Barriga, F.; Neequaye, J.E.; Jafri, A.; Dalla-Favera, R.; Neri, A.; Magrath, I.We have examined, by Southern blotting, the patterns of chromosomal breakpoint locations in 55 cases of Burkitt's lymphoma (BL) with respect to geography and Epstein-Barr virus (EBV) association. We have confirmed the association between chromosome 8 breakpoint and geography: 74% of endemic (eBL) but only 9% of sporadic BL (sBL) had breakpoints outside the HindIII fragment encompassing the c-myc gene (P2 less than .00001). Conversely, not only did 91% of sBL manifest a rearranged HindIII fragment, but at least 56% of these cases, in contrast to 17% of eBL cases, had a breakpoint within the first exon or intron of c-myc (P2 less than .004). Breakpoints outside the switch mu (S mu) region (ie, the HindIII fragment encompassing S mu) on chromosome 14 were twice as common overall (73%) as those within S mu (27%), but in the 15 tumors with S mu breakpoints, 13 (87%) had a rearranged c-myc gene. Breakpoints outside the HindIII fragment encompassing c-myc on chromosome 8 were predominantly associated with non-S mu breakpoints on chromosome 14 (85%) and this was the combination most frequently associated with eBL (65%; 6% of sBL, P2 less than .00001). In sBL, the most frequent breakpoint combination was a rearranged c-myc gene with a non-S mu breakpoint (63%; 13% of eBL). Twenty-eight percent of sBL and 13% of eBL had breakpoints both within c-myc and within S mu. EBV DNA was present in 19 of 20 tumors with breakpoints outside c-myc, in none of 7 with a breakpoint in the immediate 5' region of c-myc, in 4 of 5 tumors with breakpoints in the first exon, and in 7 of 12 tumors with breakpoints in the first intron. These data suggest that the pathogeneses of eBL and sBL differ with regard to the mechanism of c-myc deregulation, and probably also with regard to the state of differentiation of the target cell for malignant transformation. We have formulated a testable hypothesis regarding the potential role of EBV in pathogenesis: that it is required to contribute to the deregulation of c-myc in the presence of some, but not all, types of c-myc damage arising from the chromosomal translocations.Item A report on Human Immuno- deficiency virus (HIV) Infection in Ghana up to December 1986(Ghana Medical Journal, 1987-09) Neequaye, A.R.; Mingle, J.A.A.; Neequaye, J.E.; Agadzi, V.K.; Nettey, V.; Osei-Kwasi, M.; Hayami, M.; Ishikawa, K,; Ankra-Badu, G.; Bentsi, C.; Asamoah-Adu, A.; Aggrey, S.E.; Ampofo, W.; Brandful, J.A.; Grant, F.; Biggar, R.J.One hundred and fifteen people detected to be seropositive for HIV infection in Ghana in 1986 are described. Ninety per cent were female, most were of the sexually active age group. Ninety-six per cent had recently resided abroad, particularly in Cote d'lvoire. and many had worked abroad as prostitutes. They had most probably acquired infection there. Seventy-six per cent were ill with AIDS or AIDS related complex. Random sampling of groups of the general population revealed no seropositives, although 4 prostitutes working in Accra/ Tema were infected. Of attendants at an Accra venereal disease clinic 3 were infected all of whom had been to Cote d’Ivoire recently. Our results show that the AIDS virus has now spread into Ghana and urgent measures are described to try to prevent the spread of AIDS throughout the community.Item A review of salmonella group G septicaemia in children at the korle bu teaching hospital (1973-1978).(1980) Neequaye, J.E.; Twum- Danso, K.; Nkrumah, F.K.Item Use of buffy-coat smears in the diagnosis of septicaemia in children(1983-12) Nkrumah, F.K.; Neequaye, J.E.; Twum- Danso, K.Gram-stained buffy-coat smears from venous and capillary blood samples in 105 children suspected of septicaemia were examined for the presence of bacteria and the results compared with blood culture isolates. Gram-positive and Gram-negative bacteria were identified in 18 venous (44%) and 19 capillary (46%) buffy-coat preparations in 41 instances where bacterial organisms were isolated from the blood cultures. It is concluded that the examination of buffy-coat smears for bacteria in children suspected of septicaemia is a useful adjunct to blood cultures and, in areas where no facilities exist for culture of blood, may be a simple and rapid method of establishing the diagnosis of bacteraemia in suspected patients.