Browsing by Author "Sagoe, K.W.C."

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Correlates of non -transmission of human immuno deficiency virus type 1 in serologically discordant couples in Accra, Ghana.
(2009) Osei, K; Pollakis, G.; Sagoe, K.W.C.; Barnor, J.; Ampofo, W.; Paxton, W.
Correlates of non-transmission of human immunodeficiency virus type 1 in serologically discordant couples in Accra, Ghana
(2009) Mingle, J.A.A.; Osei, Y.; Kissi, W.A.; Pollakis, G.; Sagoe, K.W.C.; Barnor, J.; Ampofo, W.; Paxton, W.
Cost-Effectiveness of HIV Screening of Blood Donations in Accra (Ghana)
(International Society for Pharmacoeconomics and Outcomes Research (ISPOR), 2008) Hulst, M.V; Sagoe, K.W.C.; Torpey, K.; et al.
Objectives: Areas with high HIV-incidence rates compared to the developed world may benefit from additional testing in blood banks and may show more favorable cost-effectiveness ratios. We evaluated the cost-effectiveness of adding p24 antigen, mini pool nucleic acid amplification testing (MP NAT), or individual donation NAT (ID-NAT) to the HIV antibody screening at the Korle Bu Teaching Hospital (Accra, Ghana), where currently only HIV-antibody screening is undertaken. Methods: The residual risk of HIV transmission was derived from blood donations to the blood bank of the Korle Bu Teaching Hospital in 2004. Remaining life expectancies of patients receiving blood transfusion were estimated using the World Health Organization life expectancies. Cost effectiveness ratios for adding the tests to HIV-antibody screening only were determined using a decision tree model and a Markov model for HIV. Results: The prevalence of HIV was estimated at 1.51% in 18,714 donations during 2004. The incremental cost per disability-adjusted life-year (DALY) averted was US$1237 for p24 antigen, US$3142 for MP-NAT and US$7695 com pared to the next least expensive strategy. HIV-antibody screening itself was cost-saving compared to no screening at all, gaining US$73.85 and averting 0.86 DALY per transfused patient. Up to a willingness-to-pay of US$2736 per DALY averted, HIV-antibody screening without additional testing was the most cost-effective strategy. Over a willingness-to pay of US$11,828 per DALY averted, ID-NAT was signifi cantly more cost-effective than the other strategies. Conclusions: Adding p24 antigen, MP-NAT, or ID-NAT to the current antibody screening cannot be regarded as a cost effective health-care intervention for Ghana
Diagnosis of dual human immunodeficiency virus types 1 and 2 infections in a resource-limited setting.
(2009) Sagoe, K.W.C.; Agyei, A.A.; Lartey, M.; Adiku, T.K.; Mingle, J.A.A.; Arens, M.
Background: The presence of dual HlV-l/HIV-2 infection in Ghana and the different drug requirements for the treatment of HlV-1 and HIV-2 presents difficulties for the treatment of dual infections with both viruses. Objectives: To determine the prevalence of the dual sero-positive profile in treatment naive patients at a principal ART Clinic in Accra, Ghana and to investigate if rapid screening assays could be useful for diagnosis. Design: A cross-sectional study. Setting: A principal antiretroviral treatment centre in Accra, Ghana. Subjects: Three hundred and twenty eight antiretroviral treatment naive patients. Results: A total of 12 (3.7%) of patients seen were dual seropositive. There was a slight tendency of dual seropositive females being older than their HIV-l counterparts (p=0.088, CI=-l 0.833 to 0.753). Eight of the 12 of the dual seropositives were reactive for Genie II and were considered as possibly infected with both HIV-I and HIV-2. Seven (87.5%) of Genie II dual seropositives had strong intensities (> 1+) on both HIV-2 specific bands (sgp105 and gp36) on Innolia. CD4 counts were not significantly different in dual seropositives as compared to HIV-1 infected patients. Conclusions: Dual HIV-l/HIV-2 seropositives (and possibly infections) may be common especially in older women. The Genie II will be useful as a supplemental rapid test for rapid and accurate differentiation of HIV-l and HIV-2 antibodies at treatment centres.
Drug resistance mutations and viral load in human immunodeficiency virus type 2 and dual HIV-1/HIV-2 infected patients in Ghana
(Medicine, 2019-02) Abana, C.Z.; Sagoe, K.W.C.; Bonney, E.Y.; Maina, E.K.; Aziati, I.D.; Agbosu, E.; Mawuli, G.; Styer, L.M.; Ishikawa, K.; Brandful, J.A.M.; Ampofo, W.K.
Antiretroviral therapy (ART) and drug resistance studies worldwide have focused almost exclusively on human immunodeficiency virus type 1 (HIV-1). As a result, there is limited information on ART and drug resistance in HIV-2 patients. In Ghana, the HIV epidemic is characterized by the domination of HIV-1, with cocirculating HIV-2. We, therefore, sought to determine viral load and drug resistance mutations in HIV-2 patients to inform the clinical management of such individuals in Ghana. We used purposive sampling to collect blood from 16 consented patients, confirmed as HIV-2 or HIV-1/2 dual infections by serology. A 2-step real-time RT-PCR assay was used to determine plasma HIV-2 RNA viral loads. For drug resistance testing, nucleic acids were extracted from plasma and peripheral blood mononuclear cells. The reverse transcriptase and protease genes of HIV-2 were amplified, sequenced and analyzed for drug resistance mutations and HIV-2 group. HIV-2 viral load was detected in 9 of 16 patients. Six of these had quantifiable viral loads (range: 2.62–5.45 log IU/mL) while 3 had viral loads below the limit of quantification. Sequences were generated from 7 out of 16 samples. Five of these were classified as HIV-2 group B and 2 as HIV-2 group A. HIV-2 drug resistance mutations (M184V, K65R, Y115F) were identified in 1 patient. This study is the first to report HIV-2 viral load and drug resistance mutations in HIV-2 strains from Ghana. The results indicate the need for continuous monitoring of drug resistance among HIV-2- infected patients to improve their clinical management.
Drug Resistance Mutations in Human Immunodeficiency Virus Type 2 Strains from Patients in Two Treatment Centers in Ghana
(University of Ghana, 2015-07) Abana, C.Z.; Ampofo, W.K.; Sagoe, K.W.C.; University of Ghana, College of Health Sciences, School of Biomedical and Allied Health Sciences, Department of Medical Microbiology
Antiretroviral therapy (ART) and drug resistance studies have focused almost exclusively on human immunodeficiency virus type 1 (HIV-1). Thus there is limited information on patients infected with HIV type 2 (HIV-2). In Ghana, the HIV epidemic is characterized by the domination of HIV-1 with the co-circulation of HIV-1 and HIV-2. HIV-2 is known to be naturally resistant to some antiretroviral drugs including non-nucleoside reverse transcriptase inhibitors (NNRTIs) and protease inhibitors, due to natural polymorphisms in the viral genes. However, these drugs are used to treat patients irrespective of their HIV type resulting in situations where patients infected with HIV-2 will develop resistance to the ART regimen. Thus, the monitoring of drug resistance against HIV in patients with HIV-2 only or dual HIV-1/2 infections is necessary for the effective clinical management of such patients. Aim The aim of this study was to describe drug resistance mutations in HIV-2 strains in patients in Ghana. Method In this cross sectional study, venous blood was obtained from treatment naive and treatment-experienced HIV-2- and dual HIV-1/2 infected persons from two treatment centers in Southern Ghana. Ribonucleic acid (RNA) and DNA was extracted from plasma and peripheral blood mononuclear cells (PBMC) and used in polymerase chain reaction (PCR) assays to amplify the reverse transcriptase (RT) and the protease (PR)-coding domains of the pol gene. The amplicons were sequenced, and analyzed for drug resistance mutations and subtype information. Results In this study, 18 patients, 11 infected with HIV-2 only and 7 dually HIV-1/2 infected, were enrolled. Sequences were successfully obtained from 4 treatment- naïve and one treatment-experienced patient. There were no drug resistance mutations in the patients that were ART- naïve. The ART-experienced patient however had M184V, K65R and Y115F, which confer resistance against the NRTI drug class. All three mutations were observed in both plasma and PBMC of the patient. Conclusion The results clearly show the presence of drug resistance mutations in HIV-2 strains circulating in Ghana and illustrate the need for regular monitoring of drug resistance to improve clinical management of patients.
Effectiveness of first-line antiretroviral therapy and correlates of longitudinal changes in CD4 and viral load among HIV-infected children in Ghana
(BMC Infectious Diseases, 2013) Barry, O.; Powell, J.; Renner, L.; Bonney, E.Y.; Prin, M.; Ampofo, W.; Kusah, J.; Goka, B.; Sagoe, K.W.C.; Shabanova, V.; Paintsil, E.
Background: Antiretroviral therapy (ART) scale-up in resource-limited countries, with limited capacity for CD4 and HIV viral load monitoring, presents a unique challenge. We determined the effectiveness of first-line ART in a real world pediatric HIV clinic and explored associations between readily obtainable patient data and the trajectories of change in CD4 count and HIV viral load. Methods: We performed a longitudinal study of a cohort of HIV-infected children initiating ART at the Korle-Bu Teaching Hospital Pediatric HIV clinic in Accra, Ghana, aged 0-13 years from 2009-2012. CD4 and viral load testing were done every 4 to 6 months and genotypic resistance testing was performed for children failing therapy. A mixed linear modeling approach, combining fixed and random subject effects, was employed for data analysis. Results: Ninety HIV-infected children aged 0 to 13 years initiating ART were enrolled. The effectiveness of first-line regimen among study participants was 83.3%, based on WHO criteria for virologic failure. Fifteen of the 90 (16.7%) children met the criteria for virologic treatment failure after at least 24 weeks on ART. Sixty-seven percent virologic failures harbored viruses with ≥ 1 drug resistant mutations (DRMs); M184V/K103N was the predominant resistance pathway. Age at initiation of therapy, child's gender, having a parent as a primary care giver, severity of illness, and type of regimen were associated with treatment outcomes. Conclusions: First-line ART regimens were effective and well tolerated. We identified predictors of the trajectories of change in CD4 and viral load to inform targeted laboratory monitoring of ART among HIV-infected children in resource-limited countries. © 2013 Barry et al.; licensee BioMed Central Ltd.
The effects of co-infection with human parvovirus B19 and plasmodium falciparum on type and degree of anaemia in Ghanaian children
(Asian Pacific Journal of Tropical Biomedicine, 2013) Duedu, K.O.; Sagoe, K.W.C.; Ayeh-Kumi, P.F.; Affrim, R.B.; Adiku, T.
Objective To determin the extent to which parvovirus B19 (B19V) and co-infection of B19V and malaria contribute to risk of anaemia in children. Methods B19V DNA and malaria parasites were screened for 234 children at the PML Children's Hospital in Accra. The role of B19V and co-infection with B19V and malaria in anaemia was evaluated by analysing full blood cell counts, malaria and B19V DNA results from these children. Results The prevalence of B19V, malaria and co-infection with B19V and malaria was 4.7%, 41.9% and 2.6%, respectively. Malaria posed a greater risk in the development of mild anaemia compared to severe anaemia (OR=5.28 vrs 3.15) whereas B19V posed a higher risk in the development of severe anaemia compared to mild anaemia (OR=4.07 vrs 1.00) from a non-anaemic child. Persons with co-infection with B19V and malaria had 2.23 times the risk (95% CI=0.40-12.54) of developing severe anaemia should they already have a mild anaemia. The degree of anaemia was about three times affected by co-infection (Pillai's trace=0.551, P=0.001) as was affected by malaria alone (Pillai's trace=0.185, P=0.001). B19V alone did not significantly affect the development of anaemia in a non-anaemic child. Microcytic anaemia was associated with B19V and co-infection with B19V and malaria more than normocytic normochromic anaemia. Conclusions B19V was associated with malaria in cases of severe anaemia. The association posed a significant risk for exacerbation of anaemia in mild anaemic children. B19V and co-infection with B19V and malaria may be associated with microcytic anaemia rather than normocytic normochromic anaemia as seen in cases of B19V infection among persons with red cell abnormalities.
Hepatitis B and human immunodeficiency virus infections within correctional facilities in Ghana
(PLOS ONE, 2023) Sagoe, K.W.C.; Ayiku, A.N.A.; Atuahene, K.; et al.
Previous studies have suggested high Immunodeficiency Virus (HIV) and hepatitis B virus (HBV) prevalence in prisons in Ghana. However, this study was part of a nationally representative bio-behavioural survey that determined the prevalence of HIV and HBV among prison inmates and identified factors associated with these infections. Both biomedical and Behavioral data were collected from a total of 2,443 prison inmates from 19 prison stations During 2013 in Ghana, 12 male prisons and 7 female prisons were selected across the country. The national HIV screening algorithm was used for HIV testing, while two rapid detection Tests were used to confirm HBV infections. HIV and HBV prevalence among prisoners in Ghana was approximately 2.34% and 12.38%, respectively. Only five inmates had a co-infection with both viruses. The prevalence of HIV was significantly lower among male inmates (1.5%) compared to the female inmates (11.8%). Age, sex, and marital status were significantly associated with both HIV and HBV infections. However, BMI category, IDU, and time spent in prison were associated with HIV infections. The educational level was significantly associated with HBV infections. After binary logistic regression, being female (AOR: 0.18, 95% CI: 0.07–0.45, p<0.001) and having a stay of 5 years or more (AOR: 0.07, 95% CI: 0.01–0.60, p = 0.016), increased the risk of having HIV infection. While those with no formal education (AOR: 0.65, 95% CI: 0.45–0.95, p = 0.024) and are underweight (AOR: 0.51, 95% CI: 0.27–0.99, p = 0.046), were more likely to have HBV infection. Forced penetrative Sex may be a problem in prisons. The need to have and strengthen an integrated screening, treatment, and vaccination plan for the prison is emphasized. The prison does not serve as an exceptionally high risk to the general population. The findings support a critical look at the issue of forced penetrative sex in prisons.
HIV virological non-suppression and its associated factors in children on antiretroviral therapy at a major treatment centre in Southern Ghana: a cross-sectional study
(BMC Infectious Diseases, 2021) Afrane, A.K.A.; Goka, B.Q.; Renner, L.; Yawson, A.E.; Alhassan, Y.; Owiafe, S.N.; Agyeman, S.; Sagoe, K.W.C.; Kwara, A.
Background: Children living with human immunodeficiency virus (HIV) infection require lifelong effective antiretroviral therapy (ART). The goal of ART in HIV-infected persons is sustained viral suppression. There is limited information on virological non-suppression or failure and its associated factors in children in resource limited countries, particularly Ghana. Methods: A cross-sectional study of 250 children aged 8 months to 15 years who had been on ART for at least 6 months attending the Paediatric HIV clinic at Korle Bu Teaching hospital in Ghana was performed. Sociodemographic, clinical, laboratory and ART Adherence related data were collected using questionnaires as well as medical records review. Blood samples were obtained for viral load and CD4+ count determination. Viral load levels > 1000 copies/ml on ART was considered virological non-suppression. Logistic regression was used to identify factors associated with virological non-suppression. Results: The mean (±SD) age of the study participants was 11.4 ± 2.4 years and the proportion of males was 53.2%. Of the 250 study participants, 96 (38.4%) had virological non-suppression. After adjustment for significant variables, the factors associated with non-suppressed viral load were female gender (AOR 2.51 [95% CI 1.04–6.07], p = 0.041), having a previous history of treatment of tuberculosis (AOR 4.95 [95% CI 1.58–15.5], p = 0.006), severe CD4 immune suppression status at study recruitment (AOR 24.93 [95% CI 4.92–126.31], p < 0.001) and being on a nevirapine (NVP) based regimen (AOR 7.93 [95% CI 1.58–1.15], p = 0.005). Conclusion: The prevelance of virological non-suppression was high. Virological non-suppression was associated with a previous history of TB treatment, female gender, severe CD4 immune suppression status at study recruitment and being on a NVP based regimen. Early initiation of ART and phasing out NVP-based regimen might improve viral load suppression in children. In addition, children with a history of TB may need focused measures to maximize virological suppression.
Immune Response of Ghanaian Children to the Hepatitis B Antigen in the Pentavalent (DPT-HepB-Hib) Vaccine in Accra
(University of Ghana, 2013-07) Thomas, A.; Sagoe, K.W.C.; Mingle, J.A.A.
Background: There is no data on the hepatitis B surface antibody responses (anti- HBs) in children after the introduction of the pentavalent (DPT-HepB-Hib) vaccine in Ghana. Method: Sera from 424 children aged 5 months to 32 months were tested for anti- HBs using an ELISA, (Antisurase B-96, General Biological Corp., Taiwan). A cross- section of those positive for anti-HBs were tested for hepatitis B core antibody (HBcAb) using Foresight® ELISA (Acon laboratories Inc., USA), and those negative for anti-HBs were tested for hepatitis B surface antigen (HBsAg) using Surase B-96 ELISA (General Biological Corp., Taiwan) and Wondfo ® rapid screening test (Guangzhou Wondfo Biotech Ltd., China). The primary outcomes of the study were the ability of children to develop a minimum of 10 and 100mIU /ml of anti-HBs. A questionnaire was used to obtain data to determine the correlates for anti-HBs responses. Results: Of the 424 children, 358 (84.4%) developed anti-HBs while 340 (80.2%) and 205 (48.3%) developed ≥10 and ≥100 mIU/ml anti-HBs titres respectively. A total of 308 (87.0%) of the 354 out of 358 who developed some level of anti-HBs were non-reactive to the test for anti-HBc. Of the 66 who were anti-HBs negative, 3 (4.6%) were HBsAg positive. The use of vaccines from different manufacturers for one individual and the ages of the children, had significant effect on anti-HBs titre (p <0.050). The most significant differences in correlates were seen when a minimum anti-HBs protection of ≥100 mIU/ml was assumed. Conclusion: There is a need to consider giving a booster hepatitis B vaccine at 9 months and to adhere to protocols for hepatitis B virus prophylaxis in exposed neonates.
Implications for antiretroviral therapy of dual HIV-1/HIV-2 serologic profiles in Accra, Ghana, West Africa
(HIV and AIDS Review, 2005) Sagoe, K.W.C.; Lartey, M.; Afrakoma Agyei, A.; Boamah, I.; Addo Mingle, J.A.; Arens, M.
Background: Dual HIV-1/HIV-2 seropositivity (dual seropositivity) is common in West African countries, including Ghana. Treatment of such patients with antiretroviral drugs active only against HIV-1 may result in end-stage HIV-2 disease for those infected with both viruses. This study determined the current prevalence of dual seropositivity in an HIV/AIDS clinic in Accra, Ghana, and its implications for the currently instituted treatment program. Material/Methods: Blood was obtained from 337 individuals known to be HIV(+) attending an HIV/AIDS clinic at the teaching hospital in Accra. Plasma samples were serially screened for HIV-1 and HIV-2 antibodies using three simple/rapid assays capable of discriminating between HIV-1 and HIV-2 antibodies. Duals were defined as those who had reactivities of 1+ to 3+ for both HIV-1 and HIV-2 spots or bands on rapid tests; those dual in least one but not all three tests were considered indeterminate duals. Behavioral and demographic data were also obtained. Results: HIV-1, indeterminate dual, dual, and HIV-2 seropositivity were found in 272 (80.7%), 57 (16.9%), 7 (2.1%), and 1 (0.3%) persons, respectively. Those who had multiple sexual partners did not have a higher risk of being indeterminate dual (OR = 1.32, CI: 0.71, 2.46; p = .05) or dual (OR = 0.29, CI: 0.05, 1.57; p = > .05). All the dual seropositives seen were women between the ages of 30 and 53, except for one 47-year-old male. Conclusions: As dual seropositivity is common in Accra, there is a need for those who are dually infected to be identified and antiretroviral drugs active against both HIV-1 and HIV-2 to be used in therapy.
Prevalence and impact of hepatitis B and C virus co-infections in antiretroviral treatment naïve patients with HIV infection at a major treatment center in Ghana
(Journal of Medical Virology, 2012-01) Sagoe, K.W.C.; Agyei, A.A.; Ziga, F.; Lartey, M.; Adiku, T.K.; Seshi, M.; Arens, M.Q.; Mingle, J.A.A.
Data on the effects of the presence of hepatitis B virus (HBV) and hepatitis C virus (HCV) in patients co-infected with these viruses and HIV in West Africa are conflicting and little information is available in Ghana. A cohort of 138 treatment naïve individuals infected with HIV was screened for HBV and HCV serologic markers; HBsAg positive patients were tested for HBeAg, anti-HBe, and anti-HBc IgM. The viral load of HIV-1 in the plasma was determined in 81 patients. Eighteen of the 138 patients (13%) and 5 (3.6%) had HBsAg and anti-HCV, respectively. None of the patients had anti-HBc IgM, but 10 (55.6%) and 8 (44.4%) of the 18 patients who were HBsAg positive had HBeAg and anti-HBe, respectively. In patients with measurement of CD4 + undertaken within 1 month (n=83), CD4 + count was significantly lower in patients with HBeAg (median [IQR], 81 [22-144]) as compared to those with anti-HBe (median [IQR], 210 [197-222]) (P=0.002, CI: -96.46 to 51.21). However, those with HIV mono-infection had similar CD4 + counts (median [IQR], 57 [14-159]) compared to those with HBeAg (P=1.0, CI: -71.75 to 73.66). Similar results were obtained if CD4 + count was measured within 2 months prior to initiation of HAART (n=119). Generally, HBV and anti-HCV did not affect CD4 + and viral loads of HIV-1 in plasma but patients with HIV and HBV co-infection who had HBeAg had more severe immune suppression as compared to those with anti-HBe. This may have implication for initiating HAART in HBV endemic areas. © 2011 Wiley Periodicals, Inc.
Prevalence of severe acute rotavirus gastroenteritis and intussusceptions in Ghanaian children under 5 years of age
(Journal of Infection in Developing Countries, 2012-02) Enweronu-Laryea, C.C.; Sagoe, K.W.C.; Glover-Addy, H.; Asmah, R.H.; Mingle, J.A.; Armah, G.E.
Introduction: Vaccination is the most effective preventive strategy against rotavirus disease. Regional differences in prevalent rotavirus genotypes may affect vaccine efficacy. Pre-vaccine surveillance for burden of rotavirus disease, prevalent rotavirus genotypes, and association between rotavirus disease and intussusceptions helps in monitoring the impact of vaccination. Methodology: A prospective study was conducted from January 2008 to December 2009 in children younger than five years hospitalized for longer than 24 hours with acute gastroenteritis. Data on confirmed cases of intussusception were collected retrospectively. Stools were tested by enzyme immunoassay, reverse-transcriptase polymerase chain reaction and nucleotide sequencing. Results: Acute gastroenteritis (AGE) caused 13.1% (2,147/16,348) of hospitalizations among children under five years. Stools were tested for 50.2% (1077/2147) of AGE cases. Of these, 49% (528/1077) were rotavirus positive. Rotavirus gastroenteritis, non-rotavirus gastroenteritis, and intussusceptions were most prevalent in children under 15 months [80.3%, 74% and 91% respectively]. Rotavirus was detected from more than 60% of acute gastroenteritis cases during peak months. The prevalence of intussusception showed no seasonal pattern. The peak ages of six to twelve months for acute gastroenteritis and five to eight months for intussusception overlapped. G1, G2 and mixed G/P genotypes were common in the isolated rotaviruses. Conclusion: Rotavirus gastroenteritis causes significant morbidity in children younger than five years of age in Ghana. Although the peak age of rotavirus gastroenteritis and intussusceptions overlapped, there was no seasonal correlation between them. The high prevalence of mixed G/P genotypes in Ghanaian children may affect the effectiveness of vaccination. © 2012 Enweronu-Laryea et al.
Seropsitivity among treatment naïve patients in a resource limited setting
(East African Med. Journal, 2009) Sagoe, K.W.C.; Agyei, A.A.; Lartey, M.; Adiku, T.K.; Mingle, J.A.A.; Arens, M.Q.
Severe acute rotavirus gastroenteritis in children less than 5 years in southern Ghana: 2006-2011
(2014) Enweronu-Laryea, C.C.; Sagoe, K.W.C.; Mwenda, J.M.; Armah, G.E.
Rotavirus is a major cause of acute gastroenteritis (AGE) globally. Local data on disease burden will guide recommendations for rotavirus vaccination and monitoring impact of the intervention. METHODS:: Prospective surveillance for rotavirus gastroenteritis was conducted in 3 hospitals in southern Ghana during the period August 2006 to December 2011, as part of the African Rotavirus Surveillance Network. Clinical data and stool specimens were collected from children <5 years of age and hospitalized with AGE (defined as 3 or more watery stools for up to 7 days). Stool was tested for rotavirus by enzyme immunoassay and rotavirus genotype identified by reverse-transcriptase polymerase chain reaction. RESULTS:: We tested 3044 stool samples from 3939 children. Rotavirus was detected in 45.6%, 51.3% and 48.5% of cases at the primary, secondary and tertiary care hospital, respectively. Both genders were equally affected; 75% (2954/3939) of the cohort were aged 3-18 months. Overall, rotavirus was detected in 49.4% (1504/3044) of cases, caused over 30% of AGE hospitalizations all year round and up to 70% of cases during peak seasons. Peak season occurred during cool dry months in 2008, 2010 and 2011 and the rainy season in 2009. Mortality from AGE occurred in 1.5% (45/3044) of cases and 48.9% (22/45) of these were rotavirus positive. CONCLUSIONS:: Rotavirus causes significant morbidity and mortality in young Ghanaian children. As Ghana introduced rotavirus vaccination in the national immunization program in 2012, continued surveillance is required to monitor the impact of this intervention. © 2013 Lippincott Williams and Wilkins.
Short-term treatment outcomes in human immunodeficiency virus type-1 and hepatitis B virus co-infections
(2016-06-02) Sagoe, K.W.C.; Duedu, K.O.; Ziga, F.; Agyei, A.A.; Adiku, T.K.; Lartey, M.; Mingle, J.A.A.; Arens, M.
Abstract Background Co-infection of HIV with HBV is common in West Africa but little information is available on the effects of HBV on short-term therapy for HIV patients. A 28 day longitudinal study was conducted to examine short-term antiretroviral therapy (ART) outcomes in HIV infected individuals with HBV co-infection. Methods Plasma from 18 HIV infected individuals co-infected with HBV and matched controls with only HIV infection were obtained at initiation, and 7 and 28 days after ART. HIV-1 viral load changes were monitored. Clinical and demographic data were also obtained from patient folders, and HIV-1 drug resistance mutation and subtype analysis performed. Results The presence of HBV co-infection did not significantly affect HIV-1 viral load changes within 7 or 28 days. The CD4+ counts on the other hand of patients significantly affected the magnitude of HIV-1 viral load decline after 7 days (ρ = −0.441, p = 0.040), while the pre-ART HIV-1 VL (ρ = 0.844, p = <0.001) and sex (U = 19.0, p = 0.020) also determined HIV-1 viral load outcomes after 28 days of ART. Even though the geometric sensitivity score of HIV-1 strains were influenced by the HIV-1 subtypes (U = 56.00; p = 0.036), it was not a confounder for ART outcomes. Conclusions There may be the need to consider the confounder effects of sex, pre-ART CD4+, and pre-ART HIV-1 viral load in the discourse on HIV and HBV co-infection.
Similar HIV-1 subtype a V3 loop sequences are found in dual HIV-1/HIV-2 and HIV-1-only seropositives in Ghana
(AIDS Research and Human Retroviruses, 1999) Sagoe, K.W.C.; Britton, S.; Mingle, J.A.A.; Affram, K.; Djokoto, A.; Sönnerborg, A.
Transmission of Hepatitis B Virus among Prison Inmates in Ghana
(University of Ghana, 2015-07) Ayiku, A.N.A.; Sagoe, K.W.C.; University of Ghana, College of Health Sciences School of Biomedical and Allied Health Sciences Department of Medical Microbiology
Background: Data on the transmission of hepatitis B virus (HBV) within correctional facilities is limited in Ghana, even though the prevalence suggests intra-prison transmission. Aim: This study determined the level of transmissibility, new infections, and intra-prison transmission of HBV among inmates in Ghana Methodology: Immunoglobulin M antibodies to hepatitis B core antigen (anti-HBc IgM) and Hepatitis B e antigen (HBeAg) were determined for 323 archived plasma samples obtained from a nationwide prison survey. Risk factors for high HBV transmissibility and recent infections were determined using Pearson‟s chi square test, t test and a binary logistic regression analysis. The Surface (S) gene was sequenced for 17 plasma samples, 9 of which were from one prison and 8 with recent infections from other prisons. Phylogenetic analysis and sequence identity matrix were used to establish possible transmission within a selected prison. Results: Out of the 323 HBsAg positive samples screened, 91(28.2%) were HBeAg positive and 16 (5.0%) were anti-HBc IgM positive. HBeAg was found to be strongly associated with the type of prison (p< 0.001) and the length of stay within the prison (p= 0.033). Fever, genital pain and discharge were also found to be significantly associated with recent infections (p=0.040) and transmissibility (p= 0.005, p=0.010), respectively. Majority (62.5%) of the anti-HBc IgM positive inmates had been incarcerated for more than one year. Although there was no specific intra-prison clustering of sequences, an identity matrix revealed a narrower similarity range for intra-prison sequences than for inter-prison sequences. All sequences clustered with HBV genotype E with the exception of two which clustered with subgenotypeA3/genotype E recombinant. Conclusion: Recent infections suggest that there is on-going transmission within the prisons. The high HBeAg prevalence may be attributed to lack of adequate nutrition and poor healthcare due to long duration of stay.
Variability of the human immunodeficiency virus type 1 polymerase gene from treatment naïve patients in Accra, Ghana
(Journal of Clinical Virology, 2007-10) Sagoe, K.W.C.; Dwidar, M.; Lartey, M.; Boamah, I.; Agyei, A.A.; Hayford, A.A.; Mingle, J.A.A.; Arens, M.Q.
Background: Little is known about the HIV-1 drug resistance mutations in Ghana. Objectives: To determine the background protease (PR) and reverse transcriptase (RT) mutations of HIV-1 from treatment naïve patients in Ghana. Study design: Twenty-five plasma samples randomly selected were analyzed for drug resistance mutations. The molecular phylogeny and recombinant patterns of the polymerase gene of HIV-1 were also analysed. Results: No major drug-resistance mutations were seen in protease or reverse transcriptase genes. The L10I, L10V, V11I and E35G minor mutations were seen in four patients, while the V179E was observed in a patient with subtype G. An insertion of lysine was found at codon 36 of the protease gene of one patient. The predominant subtype was the CRF02_AG strain (n = 22), but 3 (13.6%) of these were recombinants with HIV-1 subtype K and/or A1. Two patients harboured unclassified/complex strains with D/CRF01_AE and G/CRFAG_02 subtypes for the PR and RT, respectively, using the Stanford Database. Viral loads (VL) ranged from 2290 to >1,500,000 c/ml (mean = 339,065 c/ml). Conclusions: Treatment naïve patients in Ghana before scale-up may have minor but not major PR mutations and high viral loads. The clinical effects of minor mutations/polymorphisms in the PR and RT genes and recombinants need to be investigated. © 2007 Elsevier B.V. All rights reserved.