College of Health Sciences
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Item Targeted gene panel sequencing of liquid and tissue biopsies reveals actionable genomic alterations in Ghanaian metastatic breast cancer cases(Translational Oncology, 2024-08-11) Amoako,E.; Amuzu,S.; Ofori,E.O.; Akligoh,S.H.; Tackie,R.; Ibrahim,B.A.; Quaye,E.K.; Akakpo,P.K.; Aniakwo,L.A; Jimah,B.; Appiah,K.U.; Hutchful,D.; Manu,A.; Ngoi,M.J.; Paemka,L.; Alhassan,Y.; Obeng,A.E.; Lim,N.; Rajah,L.; Pek,P.; Challis,J.; Adebisi,G.R.; Tan,H.M.; Bediako,Y.Purpose: Breast cancer is a major cause of cancer-related mortality among African women. The adoption of molecular genomic technologies in the management of cancer cases is limited in Africa. To provide much-needed insights on the feasibility and utility of such precision medicine paradigms in Africa, we conducted a prospective, non-interventional study involving combined tissue and plasma Next-generation sequencing (NGS)-based testing in cancer patients in Ghana. Methods: We recruited 20 newly diagnosed, histologically confirmed, treatment-naïve women with metastatic breast cancer at the Cape Coast Teaching Hospital in Ghana. Tissue (NGS) and cell-free DNA (cfDNA) liquid biopsy analysis were ordered on all 20 patients. Results: All 20/20 (100 %) liquid biopsy samples were acceptable for analysis, whereas only 6/20 (30 %) passed quality control for tissue NGS testing. Liquid biopsy detected 42 cfDNA mutations in 17/20 patients. Of the 17 patients, 3 (17.6 %) had mutations previously associated with African ancestry, including BRCA1 p.K719E, ARAF p.S262I and GATA3 p.G125dup. Eight potentially actionable alterations specific to breast cancer were found in 6/17 (35.3 %) liquid biopsy samples, while potentially actionable mutations non-specific to breast cancer were detected in 12/17 (70.6 %). Tissue biopsy analysis detected mutations in all 6 patients tested, with 3/6 (50 %) patients presenting potentially actionable mutations relevant to breast cancer. Conclusion: Liquid biopsy detected multiple additional actionable variants in Ghanaian women with breast cancer. Plasma cfDNA analysis featured fewer variations in sample preparation which is a key consideration in resource-limited settings. Liquid biopsy presents a great opportunity to improve cancer care in AfricaItem Availability, acceptability, and utilization of micronutrient fortification for children 6-23 months in three districts in Ghana(World Nutrition, 2024) Donkor, W.E.S.; Boadu, I.; Babae, P.; et al.Background Micronutrient deficiencies result from multiple factors, including inadequate intake of micronutrients (vitamins and minerals) from nutrient-rich diverse diets. Point-of-use fortification with a nutritional supplement powder is recommended to address micronutrient deficiencies and anemia among infants and young children (6-23 months), particularly, in low-income countries. In Ghana, about a quarter of children aged 6-59 months are anemic, or deficient in iron and vitamin A. World Vision Ghana (WVG) implemented the integrated Improved Feeding Practices (IFP) project between 2020 and 2023 in three districts in Ghana to improve diet quality and practices of women of reproductive age, and young children below age two years. One component of the project involved the distribution of a nutritional supplement powder (KOKO Plus). This is the second in a series of four papers that document the implementation and outcomes of the IFP project; the other papers are published in this journal. The current paper assessed the availability, acceptability, and utilization of KOKO Plus to households who participated in the IFP project as well as lessons learned from implementing the intervention. Methods A mixed-methods design was used, triangulating primary and secondary data. Secondary data originated from a review of IFP project documents, including project mid-year and annual reports, and implementation plans across the three interdependent components of the IFP project. Primary data were obtained from interviews in six purposively selected communities. Key informants included WVG staff, community volunteers, and local government agency staff from health and agriculture sector agencies, and beneficiaries of the intervention. Interview respondents answered questions on the project’s mechanism for KOKO Plus distribution, participant experiences of purchasing and using KOKO Plus, perceived benefits of using KOKO Plus, and lessons learned about KOKO Plus from the IFP project. Beneficiaries also provided information on their perceptions of KOKO Plus acceptability and adverse outcomes. Results The project distributed KOKO Plus free of charge to almost 14,000 (13,942) children, more than its target (4,900). In addition, Village-Based Entrepreneurs (VBE) sold 192,092 sachets of KOKO Plus in the project communities. The KOKO Plus value chain involved WVG purchased the KOKO Plus from the Ghanaian manufacturer and supplied it to VBEs either in their respective communities or at distribution centers in their respective WVG district office. KOKO Plus promotion and marketing were led by trained VBEs, VBE supervisors, and Community-Based Organizations across multiple settings (homes, child welfare clinics, markets, community durbars, and religious gatherings). There was high acceptability of KOKO Plus. Mothers attributed their acceptance of KOKO Plus to its a Corresponding author: raryeetey@ug.edu.gh 33 potential health and nutrition benefits for children. They also attributed increased child weight, and less frequent illness, to feeding meals that included KOKO Plus to their young children. KOKO Plus was added to the diverse local meals fed to young children. Diarrhea was the only mentioned adverse report, albeit rarely. At the end of the IFP project, WVG established a fund to ensure the sustainable distribution of KOKO Plus in the project communities. Conclusions The IFP project established a KOKO Plus value chain, increasing the availability, accessibility, acceptability, and utilization of KOKO Plus in the project communities. VBE successfully distributed KOKO Plus with support from community volunteers and healthcare workers. This approach to KOKO Plus distribution is feasible and sustainable and is recommended for similar contexts.Item COVID-19 is a trigger for transformation in pharmacy education for West Africa(Pharmacy Education, 2020) Duwiejua, M.The novel coronavirus 2019 (COVID-19) pandemic has irreversibly disrupted key services including education. Terms like the ‘new normal’ reflect the lost hope of returning to pre-COVID times. This editorial describes the challenges and responses of educators and governments in West Africa to COVID-19. To avert further harm posed to pharmacy education and practice, the publication advocates for innovation. Pharmacy leaders in West Africa are challenged to look On the other side of the coin, avoid inefficient panic-driven solutions and seek opportunities for change in the challenges. The paper provides a direction for change and specifically identifies collaboration with partners within the region and beyond including quality continuous professional development programmes for leadership development, re-training of educators and practitioner development.Item Strengthening Applied Epidemiology in West Africa: Progress, Gaps, and Advancing a Regional Strategy to Improve Health Security(Health Security, 2021) Lokossou, V.K.; Kenu, E.; Sombie, I.; et al.The ability to prevent, promptly detect, and appropriately respond to a public health threat is essential for health security. Field epidemiology training has helped increase the quality and quantity of the public health workforce to strengthen disease surveillance, outbreak preparedness and response, and general public health capacity. We conducted a desk review on the status of the Field Epidemiology and Laboratory Training Program model in 16 countries in West Africa. We also developed a questionnaire and shared it with West African Health Organization (WAHO) member states to document their experiences and the status of training in their countries. WAHO organized a regional 3-day consultative meeting with major stakeholders in the region to examine progress, gaps, and challenges, and outline a roadmap to strengthen the Field Epidemiology and Laboratory Training Program. Stakeholders shared their experiences, engaged in discussions to identify strengths and gaps, and made plans for a way forward. Member states are at different levels of implementing field epidemiology and laboratory training programs in their countries, and, therefore, major gaps remain in the number and distribution of trained episode biologists throughout West Africa. Member states implement different variants of the program and in some instances, the same cadre of health workers are trained in different but comparable programs with different funding streams. Two member states had not begun implementing the training program. Developing regional centers of excellence was recommended in the long term while collaboration among member states to train the required number of epidemiologists to fill the acute needs could be helpful in the short and medium term. Curriculum harmonization and expansion, deployment and use of trained epidemiologists, accreditation of training institutions, and generation of indigenous funding streams are recommended to improve the Field Epidemiology and Laboratory Training Program in West Africa.Item The role of nutrition in respiratory disease and COVID-19 management(Mental Health Effects of COVID-19, 2021) Pereko, K.K.A.; Intiful, F.D.; Dai-Kosi, A.D.; et al.The role of nutrition in immune development and disease recovery as well as the impact of infection on one’s nutrition is widely known. However, much other evidence on this relationship is not conclusive, especially for emerging diseases such as coronavirus disease (COVID-19). This chapter will review existing systematic reviews and meta-analysis literature on the subject of nutrition and infection with special emphasis on respiratory infection and COVID-19. The chapter will look at existing relationships between nutrition and respiratory infections, immunity and infection and patient recovery, nutrition and COVID-19, and the role of nutrition in infection control and management.Item Misconceptions, Misinformation and Politics of COVID-19 on Social Media: A Multi-Level Analysis in Ghana(Frontiers in Communication, 2021) Tabong, P.T.N.; Segtub, M.Background: Ghana developed an Emergency Preparedness and Response Plan (EPRP) in response to the Severe Acute Respiratory Syndrome Coronavirus (SARS CoV-2) pandemic. A key strategy in the EPRP is to mobilize national resources and implement strategies for improved risk and behavioral change communication. Nonetheless, concerns have been raised on social media about COVID-19 misinformation and misconceptions. This study used social media content to determine the types, forms, and effects of the myths, misconceptions, and misinformation in Ghana’s COVID-19 containment. Method: The study was conducted in three phases involving the use of both primary and secondary data. A review of social media information on COVID-19 was done. This was complemented by document review and interviews with key stakeholders with expertise in managing public health emergencies and mass communication experts (N = 18). All interviews were transcribed verbatim and analyzed using NVivo 12. Results: The study showed a changing pattern in the misconceptions and misinformation about COVID-19. Initially, myths were largely on causes and vulnerability. It was widely speculated that black people had some immunity against COVID-19. Also, the condition was perceived to cause severe disease among the elderly. These misconceptions served as risk attenuators among Ghanaians, especially the younger generation. As the infection evolved in the country, another misconception emerged that the hot climate in Africa inhibited viral replication and transmission, followed by speculations and conjectures that COVID-19 was being used as a biological weapon to target developed economies. For the management of COVID-19, the use of local remedies such as Neem tree (Azadirachta indica) and herbal preparation also emerged. Myths about the efficacy of locally manufactured gin (akpeteshie) and hydroxychloroquine as prophylaxis led to the abuse of such substances. Interview segments revealed the use of myths to propagate political agendas in the country. Conclusion: The study concludes that COVID-19 misconceptions and misinformation are widespread and cover the course of the condition. These myths necessitate culturally sensitive health communication strategies that take into account local perceptions of COVID-19 to tackle the circulation of misconceived messages about the pandemic in Ghana.Item Alcohol consumption and fruits and vegetable intake among older adults in Ghana: a cross-sectional survey based on WHO-SAGE Wave 2 data(BMJ Nutrition, Prevention & Health, 2020) Tachi, K.; Tetteh, J.; Archampong, T.; et.alBackground Alcohol consumption and inadequate fruits and vegetable (FnV) intake are major reasons for the shift from communicable to non-communicable diseases (NCDs) over the years. The older Ghanaian adult is at high risk of NCD and data on alcohol and FnV consumption are required to guide policy to mitigate its effect. This analysis aimed to determine the factors associated with alcohol consumption and assess the relationship between alcohol consumption and FnV intake among Ghanaians aged 50 years and older. Methods This analysis used WHO Study on Global Ageing and Adult Health (SAGE) Wave 2, Ghana data set conducted between 2014 and 2015. Data on demographic characteristics, FnV intake, and alcohol consumption were collated and analysed. Multivariable Poisson, logistic and probit regression analyses were performed to assess the associations between alcohol consumption and inadequate FnV intake. Results A total of 3533 Ghanaians aged 50 years and older, 41.0% men and 59.0% women, were included in this study. The prevalence of lifetime alcohol consumption was 22.8% (95% CI 20.7% to 25.1%). Alcohol consumption was significantly associated with sex, age group, marital status, religion, place of residence and history of smoking. The prevalence of adequate FnV intake was 52.6% with a mean daily intake of 6.45 servings: 2.98 for fruits and 3.47 for vegetables. There was a significant positive correlation between inadequate FnV intake and alcohol consumption. Inadequate FnV consumption was significantly higher among lifetime alcohol consumers compared with non alcohol consumers. (Poisson estimate; adjusted Prevalence Ratio (aPR) (95% CI)=1.35 (1.12 to 1.63), logistic estimate; adjusted Old Ratio (aOR) (95% CI)=1.13 (1.05 to 1.21) and probit estimate; adjusted normalized coefficient (aβ) (95% CI)=0.19 (0.07 to 0.31)) Conclusion About a quarter and nearly half of older Ghanaian adults consume alcohol and inadequate FnV, respectively. Alcohol consumption is significantly associated with inadequate FnV intake. Interventions to address inadequate FnV intake among older adults in Ghana should also include policies that regulate the use of alcohol in this population.Item The Nurse or Midwife at the Crossroads of Caring for Patients With Suicidal and Rigid Religious Ideations in Africa(Frontiers in Psychology, 2021) Aziato, L.; Pwavra, J.B.P.; Paarima, Y.; Konlan, K.D.Nurses and midwives are the majority of healthcare professionals globally, including in Africa, and they provide care at all levels of the health system including community levels. Nurses and midwives contribute to the care of patients with rigid or dogmatic religious beliefs or those with suicidal ideations. This review paper discusses acute and chronic diseases that have suicidal tendencies such as terminal cancer, diseases with excruciating pain, physical disability, stroke, end-stage renal failure, and diabetics who are amputated. It was reiterated that nurses and midwives taking care of these patients should be alert and observant to identify their suicidal tendencies. The paper also discusses religious or spiritual inclinations that negatively affect healthcare access and adherence, especially to biomedical or Western medicine. It was emphasized that some religious beliefs do not allow their followers to employ biomedical treatment and nurses and midwives should not impose their faith on patients and their families. The paper ends with a discussion on the specific roles of nurses and midwives in the care of patients with suicidal ideations such as assessment, counseling, administering medication, observation, social interaction, ensuring safety measures, and providing an enabling environment for the family to part of the care and for the observation of religious coping strategies. Nurses and midwives should enhance their knowledge and skills on suicide and increase public education on suicide prevention and identification of those at risk.Item Associated factors of diet quality among people living with HIV/AIDS in Ghana(BMC Nutrition, 2024) Abdulai, K.; Torpey, T.; Kotoh, A.M.; Laar, A.Introduction : Nutrition is a very important element of a comprehensive care for people living with HIV/AIDS (PLHIV), especially in resource-constrained settings where malnutrition and food insecurity are common. Dietary diversity is a useful indication of nutritional adequacy (diet quality) in people of all ages. An optimally diverse diet strengthens the body’s immune system. Objective This study aimed to assess diet quality and its associated factors among PLHIV. Methods A facility-based cross-sectional study design was employed to select 440 PLHIV from two hospitals in the Eastern Region of Ghana. Dietary intakes were determined using 24-hour recall. A stadiometer and bioimpedance analysis machine were used to obtain anthropometric and body composition data. Diet quality was assessed using FAO’s individual dietary diversity score (IDDS) as a proxy. SPSS version 20 was used for analysis. Odds ratios and ordinal logistic regression were used to identify factors associated with diet quality among the PLHIV. P-value was set at 0.05. Results Most of the PLHIV (73%) consumed from ‘Starchy staple” food group. Less than 20% of the study sample consumed ‘Fruits’ and ‘Vegetables’ (17% and 14% respectively) a day before the survey. The mean IDDS was 4.11 (SD=1.29). Overall, most of the PLHIV (56%) had medium IDDS which is equivalent to “diet needing improvement’, 14% had higher IDDS (good diet), whiles about 31% of the participants actually had poor diet (lower IDDS). Associated factors of diet quality were age (AOR=0.966: 95%CI: 0.936–0.997: p=0.031), married (AOR=4.634: 95%CI: 1.329– 16.157: p=0.0016), separated (AOR=0.0203: 95%CI: .036–0.994: p=0.049), and daily meal frequency (AOR=0.441: 95%CI: .478–1.948: p=0.020). Overall, the model accounts for about 20% of the variation in diet quality of the participants (pseudo-R square=0.196). Conclusion This study demonstrates that most of the PLHIV did not consume good diet which may have an implication on their immune system, which is already under attack by HIV, and probably emerging infections. Age, marital status, and meal frequency were the variables that predicted diet quality among the study participants.Item Introduction to Foodborne Infections and Intoxications Subtitle: An African Perspective(Office of Research, Innovation and Development, University of Ghana, Legon, 2023) Sampane-Donkor, E.; Kotey, F.C.N.; Darkwah, S.; Owusu, I.A.; Tetteh-Quarcoo, P.B.; Dayie, N.T.K.D.Foodborne infections and intoxications pose a significant global health threat, especially in Africa and other low-income regions. The goal of this book is to explore the intricate web of factors that influence foodborne infections in Africa. It delves into specific aspects of food safety, providing insights into the unique challenges and opportunities that Africa presents. By integrating disciplines such as microbiology, epidemiology, veterinary medicine, public health, and food science, the textbook advocates for a multidisciplinary approach to develop effective preventive measures, surveillance systems, and interventions.