Browsing by Author "Ntim, N.A.A."

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Emergence of HIV-1 drug resistance mutations in mothers on treatment with a history of prophylaxis in Ghana
(Virology Journal, 2018-09) Martin-Odoom, A.; Brown, C.A.; Odoom, J.K.; Bonney, E.Y.; Ntim, N.A.A.; Delgado, E.; Lartey, M.; Sagoe, K.W.; Adiku, T.; Ampofo, W.K.
Background Antiretrovirals have been available in Ghana since 2003 for HIV-1 positive pregnant women for prevention of mother-to-child transmission (PMTCT). Suboptimal responses to treatment observed post-PMTCT interventions necessitated the need to investigate the profile of viral mutations generated. This study investigated HIV-1 drug resistance profiles in mothers in selected centres in Ghana on treatment with a history of prophylaxis. Methods Genotypic Drug Resistance Testing for HIV-1 was carried out. Subtyping was done by phylogenetic analysis and Stanford HIV Database programme was used for drug resistance analysis and interpretation. To compare the significance between the different groups and the emergence of drug resistance mutations, p values were used. Results Participants who had prophylaxis before treatment, those who had treatment without prophylaxis and those yet to initiate PMTCT showed 32% (8), 5% (3) and 15% (4) HIV-1 drug resistance associated mutations respectively. The differences were significant with p value < 0.05. Resistance Associated Mutations (RAMs) were seen in 14 participants (35%) to nucleoside reverse transcriptase inhibitors (NRTIs) and non-nucleoside reverse transcriptase inhibitors (NNRTIs). The most common NRTI mutation found was M184 V; K103 N and A98G were the most common NNRTI mutations seen. Thymidine Analogue Mutations (TAMs) such as M41 L, K70R and T215Y were found in all the groups; the most common of the TAMs found were M41 L and T215Y. Majority of the subtypes were CRF02_AG (82%). Conclusion In Ghana initiation of uninterrupted treatment upon diagnosis, coupled with drug resistance testing, would produce a better treatment outcome for HIV-1 positive pregnant women.
Evaluation of AFP surveillance indicators in polio-free Ghana, 2009¿2013
(2014-07-05) Odoom, J.K.; Ntim, N.A.A.; Sarkodie, B.; Addo, J.; Minta-Asare, K.; Obodai, E.; Eshun, M.; Ahove, V.V.; Diamenu, S.; Adjabeng, M.; Arthur-Quarm, J.; Barnor, J.S.
Abstract Background Ghana recorded the last case of indigenous wild poliovirus in 1999 but suffered two more outbreaks in 2003 and 2008. Following the World Health Organization (WHO) guidelines, transmission was interrupted through high routine immunisation coverage with live-attenuated oral polio vaccine (OPV), effective acute flaccid paralysis (AFP) surveillance and supplementary immunisation activities (SIA). This article describes the results of a five-year surveillance of AFP in polio-free Ghana, evaluate the surveillance indicators and identify areas that need improvement. Methods We investigated 1345 cases of AFP from children aged less than 15 years reported to the Disease Surveillance Department from January 2009 to December 2013. Data on demographic characteristics, vaccination history, clinical presentation and virological investigation on stool specimens collected during investigation were analysed. Results Of the specimens analysed, 56% were from males and 76.3% were from children less than 5 years of age. Twenty-four percent of the children received up to 3 doses of OPV, 57% received at least 4 doses while the status of 19% was unknown. Core AFP surveillance indicators were partly met for non-polio AFP rate while the WHO target for stool adequacy and timeliness was exceeded over the period of study. All the cases were classified virologically, however no wild polio was found. Sixty-day follow-up was conducted for 56.3% of cases and 8.6% cases classified as compactible with polio. Conclusion Both laboratory and epidemiological surveillance for AFP were efficient and many WHO targets were met. However, due to the risk of poliovirus importation prior to global eradication, longterm surveillance is required to provide a high degree of confidence in prevention of poliovirus infection in Ghana. Thus, efforts should be made to strengthen regional performance and to follow–up on all AFP cases in order to establish proper diagnoses for the causes of the AFP leading to proper care.
Low Level Of Transmitted HIV Drug Resistance At Two HIV Care Centres In Ghana: A Threshold Survey
(Ghana medical journal, 2013-06) Bonney, E.Y.; Addo, N.A.; Ntim, N.A.A.; Addo-Yobo, F.; Bondzie, P.; Aryee, K.; Barnor, J.; Brandful, J.; Bekoe, V.; Ohene, S.A.; Ampofo, W.
Background: As access to antiretroviral therapy (ART) increases, the emergence and transmission of HIV drug resistant strains becomes a major problem. The World Health Organization (WHO) therefore recommends an initial minimum-resource method to signal when transmitted HIV drug resistance (HIVDR) requires action. Objective: This survey sought to generate information on the presence of HIV drug-resistant strains in the locality where Ghana’s ART for HIV was first introduced. Methods: The Ghana HIVDR threshold survey (TS) was conducted and analyzed according to WHO strategy for surveillance of HIVDR in the Eastern Region of Ghana. Sixty (60) plasma specimens were collected from 2007 to 2009 by an unlinked anonymous method from HIV seropositive pregnant women, aged between 15 to24 years, who were with their first pregnancy and ART naive. Genotyping was done as follows; Ribonucleic acid (RNA) was extracted from the samples and the protease (PR) and reverse transcriptase (RT) genes amplified and sequenced. The sequences were then analyzed for HIV drug resistance mutations using Stanford University HIV Drug Resistance Database. Results: Only two individuals were found with major HIVDR mutations: one each in the PR and RT genes. Thus the level of HIVDR in the study population in 2009 was classified as low (< 5%). Conclusion: As at February 2009, transmitted drug resistance was not a serious problem in the Eastern Region of Ghana. However, it is important to continue monitoring tHIVDR in order to understand the dynamics of the evolution of HIV drug resistance in the country.
Quality Audit Of Rapid HIV Diagnostic Processes And Outcomes In Selected Health Facilities In The Central Region Of Ghana
(University of Ghana, 2013-07) Ntim, N.A.A.
Introduction Human immunodeficiency virus (HIV) is one of the leading infectious killers worldwide. An estimated 34.2 million people worldwide were living with HIV in 2011 with about 60% of the HIV infections occur in sub-Saharan Africa. Testing to know an individual‟s HIV status is a key intervention to the prevention and early management of cases. These notwithstanding, an estimated 50% of persons living with the virus have not tested for HIV. The introduction of rapid HIV test kits has increased access to HIV testing. The decentralised testing approach to tackling the HIV epidemic also comes with a need of an increased number of personnel to perform the task. The rapid HIV test although easy to do after proper training, by both laboratory and non-laboratory persons, requires a quality assurance system in place to prevent errors and ensure the accuracy and reliability of rapid test results. This study set out to compare HIV test results from both laboratory and non-laboratory staff, to assess the knowledge of the testing staff on the dry tube specimen proficiency testing (DTSPT) scheme and to assess the competency of the testing staff. Method A convenience selection of 240 pregnant women who had already been tested for HIV in four antenatal clinics in the Central Region of Ghana and who consented to take part in this study were enrolled. Venous blood sample (3ml) was taken from these women and retested in the laboratory. A questionnaire on the dry tube specimen proficiency testing scheme was administered to all testing staff available during the time of the study. A site audit checklist was also used to assess staff competency. Results There was a 99.6% concordance between the laboratory and non-laboratory HIV test results. There was one (0.4%) discordant test result between the two testing groups. The non-laboratory group reported an HIV negative result which was HIV positive when it was re-tested in the laboratory. Majority (80%) of both group of testing staff did not know of DTSPT. Those who knew (20%) of the DTSPT had actually participated in the DTSPT training workshop. All the staff were competent to perform and interpret test results. Three (75%) of the health facilities did not have rapid test kits to provide voluntary counselling and testing services to PMTCT clients. Conclusion There was no significant difference between rapid HIV test done by laboratory and non-laboratory persons. Staff knowledge of the dried tube specimen proficiency testing scheme was poor. Staff were competent to use the rapid HIV test kits correctly and test outcome was accurate and reliable. However, periodic staff training and quality control testing, and on-sites visits should be maintained.
Strengthening laboratory surveillance of viral pathogens: Experiences and lessons learned building next-generation sequencing capacity in Ghana
(International Journal of Infectious Diseases, 2019-02) Marine, R.L.; Ntim, N.A.A.; Castro, C.J.; Attiku, K.O.; Pratt, D.; Duker, E.; Agbosu, E.; Ng, T.F.F.; Gatei, W.; Obodai, E.et.al.
Objective To demonstrate the feasibility of applying next-generation sequencing (NGS) in medium-resource reference laboratories in Africa to enhance global disease surveillance. Methods A training program was developed to support implementation of NGS at Noguchi Memorial Institute for Medical Research (NMIMR), University of Ghana. The program was divided into two training stages, first at the Centers for Disease Control and Prevention (CDC) in Atlanta, GA, followed by on-site training at NMIMR for a larger cohort of scientists. Results Self-assessment scores for topics covered during the NGS training program were higher post-training relative to pre-training. During the NGS Training II session at NMIMR, six enterovirus isolates from acute flaccid paralysis cases in Ghana were successfully sequenced by trainees, including two echovirus 6, two echovirus 11 and one echovirus 13. Another genome was an uncommon type (EV-B84), which has not been reported in Africa since its initial discovery from a Côte d’Ivoire specimen in 2003. Conclusions The success at NMIMR provides an example of how to approach transferring of NGS methods to international laboratories. There is great opportunity for collaboration between institutes that have genomics expertise to ensure effectiveness and long-term success of global NGS capacity building programs.