West African Centre for Cell Biology of Infectious Pathogens
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Item The health-trash nexus in challenging environments: A spatial mixed methods analysis of Accra, Ghana(Applied Geography, 2022) Bempah, S.; Awandare, G.; Curtis, A.; et al.Increasing urbanization in Ghana has led to a waste management crisis with multiple public health consequences. The contextualized mapping of what is dumped, where and why might provide vital on-the-ground support to address the problem itself as well as the spillover disease impacts. One of the biggest challenges, however, are the required spatial and temporal granular data. In this paper, we employ a spatial mixed methods approach to investigate the issue of waste management through the lens of health and disparity in Teshie, a suburb of Accra, Ghana.Item Traditional medicinal plants used in the management of cutaneous Leishmaniasis diseases in Sokoto State, Northern Nigeria(Ethnobotany Research and Applications, 2022) Jumare, A.I.; Amlabu, W.E.; Dogara, A.M.Background: Cutaneous leishmaniasis (CL) is a serious public health problem in Nigeria, with a high prevalence in the northern part of the country. Plants with therapeutic value are still the only way forward, as their acceptance and acknowledgment grow all over the world. There is vast traditional knowledge and use of medicinal plant species in Sokoto state and the country at large. However, because cultural systems are dynamic, skills are fragile and often forgotten, as most indigenous knowledge is passed down through the generations by oral transmission. This study documented traditional medicinal plants used by the traditional practitioners for the treatment of CL in Sokoto State, Northern Nigeria. Methods: The method of non-random probability and the strategy of master sampling were applied in this research. A total of 23 informants were interviewed. Results: The ethnobotanical survey revealed 48 plant species, trees accounting for 57.9%, of which 84.1 % of the reported plants are wild. For therapy, leaves are the most utilized (43.7%), with topical and oral remedies (72.2%) as the most preferred form of administration. Quantitatively, Bauhinia reticulata DC was found to be effective in the treatment of CL with Fidelity Level (FL) 93%. Conclusion: Plants with therapeutic value are still the most promising, as their acceptance and acknowledgment keeps growing all over the world. This study provides useful information for various fields, especially in exploring the plant parts as a source of lead for future chemotherapeutics against CL and possible development of plant monographs for biodiversity conservation.Item Appreciating the complexity of localized malaria risk in Ghana: Spatial data challenges and solutions(Health and Place, 2020) Bempah, S.; Curtis, A.; Awandare, G.; Ajayakumar, J.Various factors have been associated with the ongoing high prevalence of malaria in Ghana. Among these are poor sanitation, low socioeconomic status (SES), building construction and other proximate micro environmental risks, and individual behaviors. What makes the curbing of malaria more challenging, is that for many of the most impacted areas there is little data for modeling or predictions, which are needed, as risk is not homogenous at the sub-neighborhood scale. In this study we use available local surveillance data combined with novel on-the ground fine scale environmental data collection, to gain an initial understanding of malaria risk for the Teshie township of Accra, Ghana. Mapped environmental risk factors include open drains, stagnant water and trash. Overlaid onto these were clinical data of reported malaria cases collected between 2012 and 2016 at LEKMA hospital. We then enrich these maps with local context using a new method for malaria research, spatial video geonarratives (SVGs). These SVGs provide insights into the underlying spatial-social patterns of risks, to reveal where traditional data collection is lacking, and how and where to develop local intervention strategies.Item Klebsiella pneumoniae ST147 harboring blaNDM-1, multidrug resistance and hypervirulence plasmids(Microbiology Spectrum, 2024) Ofosu-Appiah, F.; Acquah, E.E.; Mohammed, J.; et al.The spread of hypervirulent (hv) and carbapenem-/multidrug-resistant Klebsiella pneumoniae is an emerging problem in healthcare settings. The New Delhi metallo-β-lactamase-1 (blaNDM-1) is found in Enterobacteriaceae including K. pneumo niae. The blaNDM-1 is capable of hydrolyzing β-lactam antibiotics which are used for treatment of severe infections caused by multidrug-resistant Gram-negative bacteria. This is associated with the unacceptably high mortality rate in immunocompromised burn injury patients. This study reports on the characterization of blaNDM-1 gene and virulence factors in hv carbapenem-/multidrug-resistant K. pneumoniae ST147 in the burns unit of a tertiary teaching hospital during routine surveillance. Two K. pneumoniae strains were obtained from wounds of burn-infected patients from May 2020 to July 2021. The hypervirulence genes and genetic context of the blaNDM-1 gene and mobile genetic elements potentially involved in the transposition of the gene were analyzed. We identified a conserved genetic background and an IS26 and open reading frame flanking the blaNDM-1 gene that could suggest its involvement in the mobilization of the gene. The plasmid harbored additional antibiotic resistance predicted regions that were responsible for resistance to almost all the routinely used antibiotics. To ensure the identification of potential outbreak strains during routine surveillance, investigations on resistance genes and their environment in relation to evolution are necessary for molecular epidemiology.Item Identification and management of co-infections in people with malaria(BMJ, 2024) Cunnington, A.J.; Abbara, A.; Bawa, F.K.; Achan, J.A 16 year old Ugandan girl is brought to the emergency department with a three day history of fever, headache, cough, and myalgia. She has had several episodes of malaria in the past. On admission, she is febrile, tachycardic, tachypnoeic, and has oxygen saturations of 90% in air. A malaria rapid antigen test is positive for Plasmodium falciparum and a chest radiograph shows left sided pneumonia. She is admitted and treated with antimalarials, antibiotics, and oxygen. She makes a full recovery over five days. At discharge, the cause of the pneumonia and the contribution of malaria to the illness remain unresolved.Item Pre-vaccination seroprevalence of SARS-CoV-2 antibodies in the Volta Region, Ghana(IJID Regions, 2024) Aninagyei, E.; Ayivor-Djanie, R.; Ampofo, W. K.; et alObjectives: Before administration of the first dose of the AstraZeneca 2019 SARS-CoV-2 vaccine to selected pri oritized groups in the Volta regional capital of Ghana, we determined the pre-vaccination status of prospective recipients and established the baseline exposure status 1 year after the first case was reported. Methods: After informed consent, blood samples were collected for the detection of SARS-CoV-2 immunoglobulin (Ig) M/IgG antibodies using rapid diagnostic test kits. A total of 409 individuals (mean age 27 years) consented and participated in the study, comprising 70% students and others were health staff and educators who presented themselves for vaccination. Results: The overall exposure rate of SARS-CoV-2 was 12.7% (95% confidence interval [CI] 9.6-16.3). The preva lence of SARS-CoV-2 IgM and IgG were 4.2% (95% CI 2.4-6.6) and 5.6% (95% CI 3.6-8.3), respectively. IgM and IgG were detected in 2.9% (95% CI 1.5-5.1) of the respondents. The exposure rates were higher in participants over 40 years old (15.5%). Participants without a history of COVID–19–like symptoms had an exposure rate of 13.0% and those without any chronic diseases were 13.2%. Conclusion: Pre-vaccination exposure was relatively low and underscored the need for vaccination i to increase protection in communities and disease outcomes.Item Upper Airway Epithelial Tissue Transcriptome Analysis Reveals Immune Signatures Associated with COVID-19 Severity in Ghanaians(Journal of Immunology Research, 2024) Sandi, J.D.; Tapela, K.; Yeboah, J.A.; et al.The immunological signatures driving the severity of coronavirus disease 19 (COVID-19) in Ghanaians remain poorly understood. We performed bulk transcriptome sequencing of nasopharyngeal samples from severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2)-infected Ghanaians with mild and severe COVID-19, as well as healthy controls to characterize immune signatures at the primary SARS-CoV-2 infection site and identify drivers of disease severity. Generally, a heightened antiviral response was observed in SARS-CoV-2-infected Ghanaians compared with uninfected controls. COVID-19 severity was associated with immune suppression, overexpression of proinflammatory cytokines, including CRNN, IL1A, S100A7, and IL23A, and activation of pathways involved in keratinocyte proliferation. SAMD9L was among the differentially regulated interferon-stimulated genes in our mild and severe disease cohorts, suggesting that it may play a critical role in SARS-CoV-2 pathogenesis. By comparing our data with a publicly available dataset from a non-African (Indian) population (GSE166530), an elevated expression of antiviral response-related genes was noted in COVID-19-infected Ghanaians. Overall, the study describes immune signatures driving COVID-19 severity in Ghanaians and identifies immune drivers that could serve as potential prognostic markers for future outbreaks or pandemics. It further provides important preliminary evidence suggesting differences in antiviral response at the upper respiratory interface in sub-Saharan Africans (Ghanaians) and non-Africans, which could be contributing to the differences in disease outcomes. Further studies using Larger datasets from different populations will expand on these findings.Item Knowledge, attitude and perception towards COVID-19 among representative educated sub-Saharan Africans: A cross-sectional study during the exponential phase of the pandemic(Plos One, 2024) Dzabeng, F.; Udoakang, A. J.; Nganyewo, N. N.; et alCoronavirus disease 2019 (COVID-19) pandemic, caused by the Severe Acute Coronavirus 2 (SARS-CoV-2), is a global health threat with extensive misinformation and conspiracy theories. Therefore, this study investigated the knowledge, attitude and perception of sub- Saharan Africans (SSA) on COVID-19 during the exponential phase of the pandemic. In this cross-sectional survey, self-administered web-based questionnaires were distributed through several online platforms. A total of 1046 respondents from 35 SSA countries completed the survey. The median age was 33 years (18–76 years) and about half (50.5%) of them were males. More than 40% across all socio-demographic categories except the Central African region (21.2%), vocational/secondary education (28.6%), student/unemployed (35.5%), had high COVID-19 knowledge score. Socio-demographic factors and access to information were associated with COVID-19 knowledge. Bivariate analysis revealed that independent variables, including the region of origin, age, gender, education and occupation, were significantly (p < 0.05) associated with COVID-19 knowledge. Multivariate analysis showed that residing in East (odds ratio [OR]: 7.9, 95% confidence interval (CI): 4.7–14, p<0.001), Southern (OR: 3.7, 95% CI: 2.1–6.5, p<0.001) and West (OR: 3.9, 95% CI: 2.9–5.2, p<0.001) Africa was associated with high COVID-19 knowledge level. Apart from East Africa (54.7%), willingness for vaccine acceptance across the other SSA regions was <40%. About 52%, across all socio-demographic categories, were undecided. Knowledge level, region of origin, age, gender, marital status and religion were significantly (p < 0.05) associated with COVID-19 vaccine acceptance. About 67.4% were worried about contracting SARS-CoV-2, while 65.9% indicated they would consult a health professional if exposed. More than one-third of the respondents reported that their governments had taken prompt measures to tackle the pandemic. Despite high COVID-19 knowledge in our study population, most participants were still undecided regarding vaccination, which is critical in eliminating the pandemic. Therefore, extensive, accurate, dynamic and timely education in this aspect is of ultimate priority.Item HPV18 L1 and long control region sequences variation and E6/E7 diferential expression in nasopharyngeal and cervical cancers: a comparative study(Infectious Agents and Cancer, 2023) Santa, S.; Brown, C.A.; Quaye, O.Background The role of high-risk human papillomaviruses (hr-HPVs) in cervical cancer (CC) pathogenesis has long been established. Knowledge about the involvement of hr-HPVs in the etiology of nasopharyngeal cancers (NPC) was not well appreciated until the early 2000s when a clear link began to emerge. However, it is not clear whether HPV oncogenesis in the diferent epithelial cancers is associated with L1 gene and long-control region (LCR) sequences variation. This study aimed to investigate the HPV18 L1 gene and LCR sequences variation in cervical and nasopharyngeal biopsies, and assessed E6 and E7 genes expression level in both cancers. Method Four-hundred and three (403) formalin-fxed parafn-embedded tissues originating from nasopharyngeal (NPC) (279) and cervical (CC) (124) sites were collected from a pathology laboratory, Pathologist Without Borders, Accra, Ghana. Haematoxylin and eosin staining was carried out to confrm the presence of cancer on prepared biopsy sections. DNA was extracted from the confrmed cancer biopsies, followed by PCR using MY09/GP5+/6+primers to detect the presence of HPV and specifc primers for the amplifcation of L1 gene and LCR. Sanger sequencing was carried out to determine HPV genotypes, and L1 and LCR sequences variant of HPV18s in CC and NPC biopsies. The HPV18 E6/E7 mRNA expression pattern in both cancers was determined using RT-qPCR. Results Most of the NPC (45%) and CC (55%) biopsies were HPV18 positive. Comparison of HPV18 L1 sequences obtained from cervical and nasopharyngeal cancer tissues, the L1 sequences from the NPC were highly dissimilar with a 59–100% variation among themselves, and in relation to the reference strains. However, the L1 sequences from the CC were more similar with a 91.0–100% variation among the amplifed sequences. Also, the LCR sequences from CC were quite diferent relative to that of NPC. Results for the diferential expression of E6/E7 in the two cancers showed a higher fold change in E6 expression in the CC tissues than the NPC tissues while a reverse expression pat tern was found for E7 gene. Conclusion The current study reports for the frst-time variations in HPV18 L1 and LCR sequences, and diferential expression of E6/E7 genes in NPC compared to CC, suggesting a possible adaptation mechanism of the virus at difer ent cancer sites.Item Early-onset diabetes in Africa: A mini-review of the current genetic profile(European Journal of Medical Genetics, 2023) Adadey, S.M.; Mensah, J.A.; Acquah, K.S.; Abugri, J.; Osei-Yeboah, R.Early-onset diabetes is poorly diagnosed partly due to its heterogeneity and variable presentations. Although several genes have been associated with the disease, these genes are not well studied in Africa. We sought to identify the major neonatal, early childhood, juvenile, or early-onset diabetes genes in Africa; and evaluate the available molecular methods used for investigating these gene variants. A literature search was conducted on PubMed, Scopus, Africa-Wide Information, and Web of Science databases. The retrieved records were screened and analyzed to identify genetic variants associated with early-onset diabetes. Although 319 records were retrieved, 32 were considered for the current review. Most of these records (22/32) were from North Africa. The disease condition was genetically heterogenous with most cases possessing unique gene variants. We identified 22 genes associated with early-onset diabetes, 9 of which had variants (n = 19) classified as pathogenic or likely pathogenic (PLP). Among the PLP variants, IER3IP1: p.(Leu78Pro) was the variant with the highest number of cases. There was limited data from West Africa, hence the contribution of genetic variability to early-onset diabetes in Africa could not be comprehensively evaluated. It is worth mentioning that most studies were focused on natural products as antidiabetics and only a few studies reported on the genetics of the disease. ABCC8 and KCNJ11 were implicated as major contributors to early-onset diabetes gene networks. Gene ontology analysis of the network associated ion channels, impaired glucose tolerance, and decreased insulin secretions to the disease. Our review highlights 9 genes from which PLP variants have been identified and can be considered for the development of an African diagnostic panel. There is a gap in early-onset diabetes genetic research from sub-Saharan Africa which is much needed to develop a comprehensive, efficient, and cost-effective genetic panel that will be useful in clinical practice on the continent and among the African diasporas.