Research Articles
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A research article reports the results of original research, assesses its contribution to the body of knowledge in a given area, and is published in a peer-reviewed scholarly journal. The faculty publications through published and on-going articles/researches are captured in this community
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Item Primary Carcinoma of the Liver and Post Necrotic Cirrhosis in a Ghanaian Child with Non-hepatic Bilharziasis(Ghana Medical Journal, 1964-09) Nkrumah, F.K.Item A Survey of Anaemia in Children in the Korle Bu Hospital, with Special Reference to Malaria(Ghana Medical Journal, 1964-09) Jilly, P.; Nkrumah, F.K.Item Prevalence of hepatitis G virus and characterization of viral genome in Ghana.(Hepatology Research, 1999) Saito, T.; Ishikawa, K.; Osei-Kwasi, M.; Kaneko, T.; Brandful, J.A.M.; Nuvor, V.; Aidoo, S.; Ampofo, W.; Apeagyei, F.A.; Ansah, J.E.; Adu-Sarkodie, Y.; Nkrumah, F.K.; Abe, K.The prevalence of hepatitis G virus (HGV) infection was investigated in 85 human immunodeficiency virus (HIV)-infected and 30 uninfected individuals' sera obtained from Ghanaians. HGV RNA in serum was identified by a nested reverse transcription polymerase chain reaction (RT-PCR) using primers derived from the 5′-noncoding region. We also tested for hepatitis C virus by nested RT-PCR and for hepatitis B surface antigen (HBsAg) by passive hemagglutination method. HGV RNA was detected in 17 of 85 (20%) HIV sero-positive and three of 30 (10%) sero-negative Ghanaians, respectively. The prevalence of HGV infection was much greater than hepatitis C (0.9%) and hepatitis B virus (7.8%) infections in the present study. Ninety four percent of HGV infected patients were seronegative for hepatitis B and C virus infections. The nine different Ghanaian isolates in the 5′-untranslated region of the HGV genome had one nucleotide deletion at the same position when compared with other HGV isolates. Phylogenetic analysis showed that all Ghanaian isolates belonged to type 1 (West Africa type) of the HGV genotypes. Moreover, we determined nearly full-length nucleotide sequence of the HGV genome (denoted HGV-GA128) recovered from a Ghanaian infected with HIV. The HGV-GA128 was composed of 9231 nucleotides and had a single open reading frame, encoding 2843 amino acid residues. This isolate differed from previously reported HGV/GBV-C isolates by 10–15% of the nucleotide sequence and 2–5% of the amino acid sequence. Our data indicate a high prevalence of HGV, especially genotype 1, in Ghana.Item Risk factors for the prevalence of malnutrition among urban children in Ghana.(Journal of Nutritional Science and Vitaminology, 1998) Rikimaru, T.; Yartey, J.E.; Taniguchi, K.; Kennedy, D.O.; Nkrumah, F.K.A case-control study was completed at the Princess Marie Louise Hospital in Accra, Ghana, to identify risk factors for the prevalence of underweight and severe malnutrition in urban African children. A total of 170 children, aged 8 to 36 mo, with normally nutritional status (≥80% W/A of NCHS reference), underweight (moderate malnutrition) (60-80% W/A), or severe malnutrition (<80% W/A and presence of edema, or <60% of W/A) were recruited at the clinical ward and at the public health service section of the hospital. Anthropometric measurements and physical examinations were completed, and the guardians were interviewed about their children's health status, birth weight, child care, and household conditions. The severely malnourished children were more likely to have young mothers (p<0.05) and low weight at birth (p<0.05). The under-weight children were also observed to have low birth weight (p<0.05). The severely malnourished group showed the tendencies of less feeding frequency (p<0.01), less access to breast-feeding (p<0.01), and less support by both parents (p<0.05). Moreover, the parents of the severely malnourished children had lower educational levels and lower-income jobs, compared with those of the normal children (mother's education, p<0.001; father's education, p<0.001; mother's occupation, p<0.05; father's occupation, p<0.001). No significant differences in most variables existed between the normal and underweight groups. Multivariable analysis resulted in the conclusion that the Z-score of weight-for-age, birth weight, and mother's educational level were highly associated with one another. We conclude that low birth weight is one of the important risk factors for the prevalence of underweight and severe malnutrition and that the lack of a mother's education is also a risk factor for the prevalence of severe malnutrition in the urban children in Ghana.Item Seasonal profiles of malaria infection, anaemia, and bednet use among age groups and communities in northern Ghana.(Tropical Medicine and International Health, 2003) Koram, K.A.; Owusu-Agyei, S.; Fryauff, D.J.; Anto, F.; Atuguba, F.; Hodgson, A.; Hoffman, S.L.; Nkrumah, F.K.We conducted all-age point prevalence surveys to profile the severity and seasonality of malaria and anaemia in Kassena-Nankana District of northern Ghana. Random cross-sectional surveys were timed to coincide with the end of low (May 2001) and high (November 2001) malaria transmission seasons and to yield information as to the potential value of haemoglobin (Hb) levels and parasitaemia as markers of malaria morbidity and/or malaria vaccine effect. Parasitaemia was found in 22% (515 of 2286) screened in May (dry-low transmission), and in 61% of the general population (1026 of 1676) screened in November (wet-high transmission). Malaria prevalence in May ranged from 4% (infants <6 months and adults 50–60 years) to 54% (children 5–10 years). Age-specific malaria prevalence in November ranged from 38% (adults 50–60 years) to 82% (children 5–10 years). Differences between low- and high-transmission periods in the prevalence of severe anaemia (SA) among young children (6–24 months) were unexpectedly comparable (low, 3.9%vs. high, 5.4%; P = 0.52) and greatly reduced from levels measured in this same community and age group in November 2000 (12.5%) and November 1996 (22.0%). Despite the lower frequency of anaemia/SA in young children surveyed in 2001, it was still clear that this condition was strongly associated with parasitaemia and that children under 5 years of age experienced a significant drop in their mean Hb levels by the end of the high transmission season. Prevalence of parasitaemia was significantly lower (P < 0.01) among infants and young children (<2 years) whose parents reported the use of bednets. There was a significantly lower risk of parasitaemia among infants [odds ratio (OR) 6–8] and young children (OR 3–4) living in the central, more urbanized sector of the study area.Item Single-dose treatment of wuchereria bancrofti infections with ivermectin and albendazole alone or in combination: Evaluation of the potential for control at 12 months after treatment.(Transactions of the Royal Society of Tropical Medicine and Hygiene, 2000) Dunyo, S.K.; Nkrumah, F.K.; Simonsen, P.E.The effect of single-dose ivermectin (150–200 μg/kg) and albendazole (400 mg) treatment alone and in combination on Wuchereria bancrofti microfilaraemia, antigenaemia and clinical manifestations was compared 12 months after treatment in a double-blind placebo-controlled field trial carried out in Ghana in 1996–1998, to evaluate the potential of these treatments for control. Both ivermectin and combination treatments resulted in pronounced reductions in microfilaraemia among individuals who were microfilaria positive before treatment. Among individuals who were positive for circulating filarial antigen before treatment, antigen levels increased considerably over the 1-year period after treatment in the placebo group, whereas they decreased in the ivermectin and combination groups. However, the post-treatment difference reached statistical significance in neither microfilaraemia nor antigenaemia between the ivermectin and the combination groups. Albendazole treatment alone showed only a minor effect on microfilaraemia and antigenaemia. No effect of the treatments on the incidence of new cases of microfilaraemia or antigenaemia, or on clinical manifestations, was observed. Both ivermectin and combination treatment thus appeared effective for control of W. bancrofti infections, but the difference in efficacy between the 2 treatments after 12 months appeared to be minimal.Item A study on the provocative day test effect of ivermectin and albendazole on nocturnal periodic wuchereria bancrofti microfilaraemia.(Transactions of the Royal Society of Tropical Medicine and Hygiene, 1999) Dunyo, S.K.; Nkrumah, F.K.; Simonsen, P.E.We conducted a randomized double-blind placebo-controlled study, in the Ahanta West District of Ghana, on the provocative day test effect of ivermectin and albendazole alone and in combination on nocturnal periodic Wuchereria bancrofti microfilaraemia. Sixty-three individuals with high night-time microfilaria (mf) intensities were identified in 1997 or 1998 and randomized into 4 groups. Blood samples for mf were then collected from the same individuals in the daytime (between 09:00 and 15:00) immediately before and 30–50 min after treatment. Groups 1–4 were treated with ivermectin alone (150–200 μg/kg), albendazole alone (400 mg), the combination of ivermectin and albendazole, and placebo, respectively. Intensities of mf in daytime samples were considerably lower than in night-time samples. Neither ivermectin or albendazole alone nor their combination provoked significant liberation of W. bancrofti mf into the peripheral circulation after the daytime treatment.Item A randomized double-blind placebo-controlled field trial of ivermectin and albendazole alone and in combination for the treatment of lymphatic filariasis in Ghana.(Transactions of the Royal Society of Tropical Medicine and Hygiene, 2000) Dunyo, S.K.; Nkrumah, F.K.; Simonsen, P.E.The efficacy and safety of single-dose ivermectin (150-200 micrograms/kg) and albendazole (400 mg) treatment administered separately or in combination for Wuchereria bancrofti infections were assessed in 1996-98 in a randomized double-blind placebo-controlled field trial in Ghana: 1425 individuals from 4 lymphatic filariasis-endemic villages, 340 of whom were microfilaria (mf)-positive before treatment, were randomized into 4 groups to receive albendazole alone, ivermectin alone, combination of albendazole and ivermectin, or placebo, respectively. Individuals were followed for 5 days after treatment to record any adverse reactions, and the effect of treatment on microfilaraemia was monitored in night-blood samples after 3, 6 and 12 months. Treatment efficacy was analysed for 236 mf-positive individuals who had > or = 100 mf/mL of blood and who were also present for examination at 12 months after treatment. Compared to the placebo group, the ivermectin and combination groups both showed statistically significant reductions in geometric mean mf intensities at the follow-up examinations (to 6.7% and 0.9%, 9.9% and 6.9%, and 21.7% and 11.4% of pre-treatment levels, respectively, at 3, 6 and 12 months after treatment). Compared to the ivermectin group, however, the reduction in the combination group was significantly greater only at 3 months after treatment, but not after 6 or 12 months. The albendazole group showed a slow but non-significant reduction over the same period. Adverse reactions were few and mostly mild (no severe reactions were recorded), and no significant differences were observed between the treatment groups. Both ivermectin and combination treatment thus appeared effective and safe for treatment of lymphatic filariasis, but the difference in efficacy was minor and the study did not provide clear evidence for the combination drug therapy, as compared to ivermectin therapy alone, to be superior for control of lymphatic filariasis.Item Lymphatic filariasis on the coast of Ghana.(Transactions of the Royal Society of Tropical Medicine and Hygiene, 1996) Dunyo, S.K.; Appawu, M.; Nkrumah, F.K.; Baffoe-Wilmot, A.; Pedersen, E.M.; Simonsen, P.E.Parasitological, clinical and entomological surveys for lymphatic filariasis were carried out in 6 villages and 3 towns on the coast of Ghana. Few or no filarial infections were observed in the towns or in the villages east of Accra. However, Wuchereria bancrofti microfilaraemia was common in the 4 western villages, with overall prevalences of 9.2%–25.4% and overall microfilariae (mf) geometric mean intensities of 321–1172 mf/mL of blood. In the same villages, hydrocele affected 8.5%–27.9% of adult males (aged ⩾20 years), and 5.6%–6.6% of adult individuals had elephantiasis (mainly of the legs). In general, the patterns of filarial infection and disease in the endemic villages resembled those observed in endemic villages in the coastal part of East Africa, with the exception that in the Ghanaian focus more females than males were affected by elephantiasis. Entomological surveys revealed that Anopheles gambioe s.l. and A. funestus were vectors of filariasis in the endemic villages. Only negligible prevalences of microfilaraemia were observed in town communities located close to highly endemic villages. Control of filariasis in this area is difficult with presently available measures, and new control tools, especially development of new drug regimens for mass treatment, are greatly needed.Item Type-I HTLV antibody in urban and rural Ghana, West Africa.(International Journal of Cancer, 1984) Biggar, R.J.; Saxinger, C.; Gardiner, C.; Collins, W.E.; Levine, P.H.; Clark, J.W.; Nkrumah, F.K.; Blattner, W.A.The prevalence of antibodies against the newly described human T-cell lymphoma virus, type I (HTLV-I) in two communities in Ghana, West Africa, is described. There was no difference by community (urban, 3.6% and rural, 4.0%). Prevalence increased with age, being 5.9% among persons greater than 10 years old, but did not differ by sex. There was no difference when data were analysed by housing status or crowding. Non-confirmed reactions in the assay system were frequent and correlated with both prevalence and titer of antibody against malaria. Possible explanations include vector-borne transmission like that of malaria, but the relationship is more probably due to a polyclonal stimulation of B cells, enhancing the potential for detecting reactivity in the assay. Because assay systems vary and because most laboratories do not routinely use a confirmation assay, results presented by different groups must be interpreted cautiously.