Browsing by Author "Opare, J.K.L."
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Item Detection of vaccine-derived poliovirus circulation by environmental surveillance in the absence of clinical cases(Taylor & Francis Group, 2021) Odoom, J.K.; Obodai, E.; Boateng, G.; Diamenu, S.; Attiku, K.; Avevor, P.; Duker, E.; Boahene, B.; Eshun, M.; Gberbie, E.; Opare, J.K.L.Background: On August 25, 2019, the Noguchi Memorial Institute for Medical Research notified the confirmation of a circulating-vaccine-derived poliovirus type-2 (cVDPV2) from the Agbogbloshie environ mental surveillance (AES) site, in the Greater Accra Region. A field investigation of the outbreak was conducted to describe the results of epidemiological and laboratory investigations, and control efforts. Methods: We conducted a descriptive investigation, records review, and active-case-search. Caregivers were interviewed on the vaccination status of their children; knowledge, attitude, and practices on polio prevention; water, sanitation and hygiene practices, and health-seeking behaviors. Stool from healthy children <5 y and sewage samples were taken for laboratory diagnosis. Results: cVDPV2 genetically similar to the cVDPV2 diagnosed recently in the Northern Region of Ghana and Nigeria was identified. 2019 half-year coverage of OPV and IPV was 22%. Fully immunized children were 49% (29/59). Most health workers (70%) had a fair knowledge of polio and acute flaccid paralysis (AFP). Forty-six percent of care-givers admitted to using the large drain linked to the site where the cVDPV2 was isolated as their place of convenience and disposing of the fecal matter of their children. No AFP case was identified. Stool samples from 40 healthy children yielded non-polio enteroviruses while 75% (3/4) of the additional sewage samples yielded cVDPV2. Conclusion: cVDPV2 was isolated from the AES site. No AFP or poliovirus was identified from healthy children. There is a need to improve health workers’ knowledge on AFP and to address the dire sanitation conditions in the Agbogbloshie market and its environs.Item Outbreak Of Cholera in the East Akim Municipality of Ghana Following Unhygienic Practices by Small-Scale Gold Miners, November 2010(Ghana medical journal, 2012-09) Opare, J.K.L.; Ohuabunwo, C.; Afari, E.; Wurapa, F.; Sackey, S.D.; Der, J.; Afakye, K.; Odei, E.Background: In October 2010 an outbreak of cholera began among a group of small-scale gold miners in the East-Akim Municipality (EAM), Eastern Region. We investigated to verify the diagnosis, identify risk factors and recommend control measures. Methods: We conducted a descriptive investigation, active case-search and an unmatched case-control study. A cholera case-patient was a person with acute watery diarrhoea, with or without vomiting in EAM from 1st October to 20th November, 2010. Stool from case-patients and water samples were taken for laboratory diagnosis. We performed univariate and bivariate analysis using epi-info version 3.3. Results: Of 136 case-patients, 77 (56.6%) were males, of which 40% were miners or from miners households. Index case, a 20 yr-old male miner from Apapam village reported on October 13th, and case-patients peaked (18.4%) 20 days later. Attack rate was 2/1000 population with no fatality. Ages ranged from 1-84 years; mean of 34±18 yrs. Age-group 20-29 yrs was mostly affected (30.1%) with Apapam village having most case-patients (19.9%). Vibrio cholera serotype ogawa was isolated from stool samples. The main water source, Birim river was polluted by small-scale miners through defecation, post-defecation baths and sand-washings. Compared to controls, case-patients were more likely to have drunk from Birim-River [OR= 6.99, 95% CI: 2.75-18]. Conclusion: Vibrio cholera serotype ogawa caused the EAM cholera-outbreak affecting many young adultmales. Drinking water from contaminated communitywide -River was the major risk factors. Boiling or chlorination of water was initiated based on our recommendations and this controlled the outbreak.Item Poliovirus antibody levels and lameness among individuals in three regions of Ghana(HUMAN VACCINES & IMMUNOTHERAPEUTICS, 2019-07-25) Opare, J.K.L.; Odoom, J.K.; Akweongo, P.; Afari, E.A.; Pappoe, M.Introduction: Ghana recorded the last case of poliomyelitis caused by wild poliovirus in 2008 and the country was declared polio-free in 2015. Polio-neutralizing-antibody levels in the population of three geographically representative regions of Ghana was determined, to identify possible immunity gaps. Methods: Cross-sectional, hospital (1–70 years old) and school (primary, 1–15 years old)-based studies were undertaken in three regions in 2016. Individuals who visited the three teaching hospitals of the regions and were referred for haematology investigations were invited to participate in our study. Neutralizing-antibody titers to polio serotypes P1, P2, and P3 were assayed by WHO-standards. Antibody titers of ≥8 were considered protective. In the school lameness survey, clinical and epidemiological data were obtained from parents and their lamed children. Bivariate and multivariate analyses were conducted on subject characteristics, to assess potential factors for failure to seroconvert. P-values < 0.05 were considered statistically significant. Results: Neutralizing-antibodies against poliovirus types 1, 2 and 3 were detected in 86% (264/307), 84% (258/307) and 75% (230/307) of the samples, respectively. Overall, 60.1% (185/307) were seropositive for the three polio serotypes and 2.9% (9/307) were seronegative. Polio neutralizing-antibodies (P1and P2) decreased with age (p < .001). Low seroprevalence of polio-neutralizing-antibodies was significantly associated with low school attendance of mothers (p < .001). Prevalence of residual paralysis was <1.0/ 1,000 among the school children. Conclusion: Our study population is moderately protected against the three poliovirus serotypes. However, immunity appears to be lower with a higher age and low mother’s education. This may suggest the need for young-adult booster-dose to minimize the risk of wild poliovirus infectionItem Poliovirus neutralizing antibody levels among individuals in three regions of Ghana(Ghana medical journal, 2019-06-02) Afari, E.A.; Opare, J.K.L.; Akweongo, P.; Odoom, J.K.INTRODUCTION: Ghana was declared polio-free in 2015 after the last polio case in 2008. We determined the poliovirus neutralizing antibody levels among individuals to identify possible immunity gaps. METHODS: A cross-sectional, hospital-based study was undertaken in Northern, Ashanti and Greater Accra regions of Ghana. Individuals referred for haematology at the teaching hospitals' laboratories were invited to participate in our study. Neutralizing-antibody titers to poliovirus serotypes 1,2 & 3 were assayed by WHO-standards. Antibody titers of ≥8 were considered protective. Bivariate and multivariate analyses were conducted on subject characteristics to assess potential factors for failure to seroconvert. P-values < 0.05 were considered statistically significant. RESULTS: Poliovirus (PV) neutralizing-antibody serotypes 1, 2 and 3 were detected in 86.0% (264/307), 84% (258/307) and 75% (230/307) of samples respectively. 60.1% (185/307) were seropositive for the three poliovirus serotypes. Neutralizing poliovirus antibodies for PV1 and PV2 were higher than for PV3. Seroprevalence of poliovirus-neutralizing antibodies among males (PV1=51.9%, PV2= 51.6% and PV3= 52.6%) were higher than in females. Seroprevalence rates of poliovirus-neutralizing antibodies (PV1, PV2, and PV3) were highest in the Northern region (90%, 81%, and 77%). Poliovirus neutralizing-antibodies (PV1and PV2) decreased with age [p< 0.001]. Low seroprevalence of poliovirus-neutralizing antibodies was significantly associated with low school attendance of mothers (p<0.001). CONCLUSION: Our study population has some protection from polio. However, immunity appears to be lower with a higher age or low Mother's education. This may suggest the need for young-adult booster-dose to minimize the risk of wild poliovirus infection.Item Polivirus Antibody and Lameness among Individuals in the Three regions ogf Ghana(University of Ghana, 2017-07) Opare, J.K.L.Introduction: In 2008, Ghana recorded the last case of poliomyelitis or polio and the causative agent was the wild polio virus. The country has been certified free of polio and it is at the verge of polio eradication. High levels of polio neutralizing antibodies (immunity) must be maintained to prevent the importation of wild poliovirus. We determined the seroprevalence of polio viruses (P1, P2, and P3) antibodies and the risk factors for seronegativity in Greater Accra, Ashanti and Northern regions of Ghana in order to identify any gaps for system improvement. Methods: A cross-sectional, hospital-based seroprevalence study supplemented by a school lameness survey was undertaken in the three study regions in 2016. Individuals, who visited the three teaching hospitals of the regions and needed to give out blood samples for laboratory investigation, were invited to partake in the survey. Micro-neutralization test for poliovirus serotypes, 1, 2 and 3 antibodies was performed following WHO-standard procedures. Antibody titers of ≥ 1:8 were considered positive. Bivariate and multivariate analyses were conducted on subject characteristics to assess for potential factors for failure to sero-convert. Statistical significance was set at P -values <0.05 In the school lameness survey, clinical and epidemiological data were obtained from parents and their lamed children using a semi-structured questionnaire in the same three regions. School lameness data was descriptively analysed by person, place and time by employing frequency distributions, percentages, means, standard deviation and rates. Data was analysed using STATA version 13. Results: Neutralizing-antibodies against poliovirus types 1, 2 and 3 were detected in 86.0% (264/307), 84% (258/307) and 75% (230/307) of samples respectively. Overall, 60.1% (185/307) were seropositive and 2.9% (9/307) were seronegative for the three polio serotypes. Seroprevalence of polio-neutralizing antibodies among males (P1=51.9%, P2=51.6% and P3=52.6%) were higher than females. Seroprevalence rates of polio neutralizing antibodies (P1, P2 and P3) were highest in the Northern Region (91.8%, 82.4%, and 77.4%). Polio neutralizing-antibodies (P1 and P2) decreased with age [p<0.001]. Low seroprevalence of polio-neutralizing antibodies was significantly associated with low school attendance of mothers [p=0.003 for PV1 and p<0.001 for PV2]. Prevalence of residual paralysis was 0.58/1,000 or 5.8/10,000 children aged 0-15years in schools of the study regions. Conclusion: This study revealed a moderate level of seroprevalence of neutralizing antibodies to the three polio serotypes with some regional differences. Seropositivity was generally low with increasing age and the mother’s education level was crucial to seronegativity. The drastic reduction of paralytic poliomyelitis may be attributed to the moderate level of polio-neutralizing antibodies. To further strengthen the gains made in polio eradication, the Ghanaian government needs to increase and sustain budgetary allocation on polio eradication awareness and mass immunizations. The Expanded Programme on Immunization (EPI), Ghana, may consider young-adult booster-dose of polio vaccine, introduce inactivated polio vaccine (IPV) to supplement the oral polio vaccine and conduct a nationwide seroprevalence and community based lameness survey to gauge programme performance. Female child education and career counseling for Junior High School pupils and those older may be intensified by all District Assemblies and by churches