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 Caregiver Acceptability Of Seasonal Malaria Chemoprevention In Two Districts In The Upper West Region, Ghana: A Cross-Sectional Study.(Springer Nature, 2025-01-14) Diarra, Y.; Bonful, H. A.; et alAbstract Background Acceptability of malaria chemoprevention interventions by caregivers is crucial for overall programme success. This study assessed coverage and acceptability of Seasonal Malaria Chemoprevention (SMC) in selected com munities in the Northern part of Ghana. Methods An analytical cross-sectional design was conducted from“July 23rd to August 4th, 2020—a 12-day period that covered 5 days of the frst SMC implementation cycle and 7 days post-implementation. Using a stratifed multi stage sampling technique, a total of 495 caregivers providing care for 569 eligible children aged 3–59 months from randomly selected households in the study communities were enrolled into the study. Acceptability of SMC was assessed on a set of 19 questionnaire items-8 of the items measured caregivers’ perceptions and 11 items meas ured children’s reaction to administered medicines. Univariable and stepwise multivariable logistic regression analyses were performed to assess the predictors of acceptability of SMC at a 95% confdence interval and a p-value of 0.05. Results SMC coverage was 95.1% (541/569). Caregivers had a good level of knowledge of SMC (n=475; 96.0%; 95% CI 94.2—97.7%) and a good perception of SMC (n=471; 95.2%; 95% CI 93.3–97.0). Seven out of ten caregivers (70.9%; 95% CI 66.9–74.9%) had good acceptability of SMC. For 7 out of 28 children who did not receive the SMC interven tion, their caregivers intentionally refused them the intervention. Of those that received the treatment, 17.2% (n=85; 95%CI 13.8–20.5%) of caregivers had at least one leftover amodiaquine tablet after the third day of treatment. Caregiv ers who practice Christianity or Islam had better acceptability than caregivers who practice African traditional religion (p<0.001). Conclusion Health authorities and stakeholders can work towards bridging the gap between knowledge and SMC treatment practices of caregivers through continuous education, adherence counseling, and efective monitoring of SMC practices in malaria-endemic countries. Keywords SMC, Caregivers, Malaria, Acceptability, Ghana, Upper West region, Amodiaquine–sulfadoxine– pyrimethamineItem Diagnostic accuracy of an automated microscope solution (miLab™) in detecting malaria parasites in symptomatic patients at point-of-care in Sudan: a case–control study(Malaria Journal, 2024) Hamid, M.M.A.; Mohamed, A.O.; Owusu, E.D.A.; et al.Background Microscopic detection of malaria parasites is labour-intensive, time-consuming, and expertise-demand ing. Moreover, the slide interpretation is highly dependent on the staining technique and the technician’s expertise. Therefore, there is a growing interest in next-generation, fully- or semi-integrated microscopes that can improve slide preparation and examination. This study aimed to evaluate the clinical performance of miLab™ (Noul Inc., Republic of Korea), a fully-integrated automated microscopy device for the detection of malaria parasites in symptomatic patients at point-of-care in Sudan. Methods This was a prospective, case-control diagnostic accuracy study conducted in primary healthcare facilities in rural Khartoum, Sudan in 2020. According to the outcomes of routine on-site microscopy testing, 100 malaria-positive and 90 malaria-negative patients who presented at the health facility and were 5 years of age or older were enrolled consecutively. All consenting patients underwent miLab™ testing and received a negative or suspected result. For the primary analysis, the suspected results were regarded as positive (automated mode). For the secondary analysis, the operator reviewed the suspected results and categorized them as either negative or positive (corrected mode). Nested polymerase chain reaction (PCR) was used as the reference standard, and expert light microscopy as the comparator. Results Out of the 190 patients, malaria diagnosis was confirmed by PCR in 112 and excluded in 78. The sensitivity of miLab™ was 91.1% (95% confidence interval [CI] 84.2–95.6%) and the specificity was 66.7% (95% Cl 55.1–67.7%) in the automated mode. The specificity increased to 96.2% (95% Cl 89.6–99.2%), with operator intervention in the corrected mode. Concordance of miLab with expert microscopy was substantial (kappa 0.65 [95% CI 0.54–0.76]) in the automated mode, but almost perfect (kappa 0.97 [95% CI 0.95–0.99]) in the corrected mode. A mean difference of 0.359 was found in the Bland–Altman analysis of the agreement between expert microscopy and miLab™ for quantifying parasite counts. Conclusion When used in a clinical context, miLab™ demonstrated high sensitivity but low specificity. Expert intervention was shown to be required to improve the device’s specificity in its current version. miLab™ in the corrected mode performed similar to expert microscopy. Before clinical application, more refinement is needed to ensure full workfow automation and eliminate human interventionItem Adherence to sulfadoxine-pyrimethamine fve-dose policy among pregnant women in an urban slum in Ghana: a mixed-methods study(Malaria Journal, 2024) Iddrisu, H.; Tagoe, E.A.; Bonful, H.A.Background Malaria in pregnancy (MiP) is a public health concern especially for pregnant women living in slums. The World Health Organization recommends at least three doses of Sulfadoxine-Pyrimethamine (SP) to prevent MiP. In Ghana, it is recommended that pregnant women receive a minimum of fve doses of the medication. This study sought to determine the level of adherence to IPT5 policy and factors associated with adherence among pregnant women in a slum community in Ghana. Methods This was a cross-sectional study involving 232 nursing mothers and four healthcare workers at the St. Martin’s Memorial Hospital, Sukura, Ghana. Sociodemographic characteristics of nursing mothers were obtained using an interview-administered questionnaire. Data on the number of SP doses and other obstetrics characteristics were collected by reviewing the antenatal record books. To obtain information about healthcare and health system factors associated with adherence to the five-dose policy, four healthcare providers were interviewed. A data extraction form was used to obtain information about the availability of SP at the facility. Results The level of adherence to IPT5 was 8.6% (20/232) (95% CI 5.0–12.3) among the participants. Only 8.4% of the participants received their first dose at 16 weeks. Respondents who began ANC in the second trimester were 81% less likely to adhere to IPT5 than those who began in the first trimester (aOR=0.19, 95% CI 90.01–0.65, p<0.008). Healthcare provider and health system factors that influence IPT5 uptake include healthcare providers’ knowledge of IPTp-SP guidelines, the practice of Directly Observed Therapy, education of pregnant women, training of healthcare providers, and availability of water. SP was available at the facility during the period of review. Conclusion Adherence to the IPTp-SP five-dose policy was suboptimal. Pregnant women who started ANC early were more likely to adhere to the policy. Provider knowledge, DOT practice, training, education of pregnant women and water availability were also found to influence adherence. Encouraging early ANC visits and providing healthcare workers with necessary training can substantially improve adherence in slum areas.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 Atypical memory B cell frequency correlates with antibody breadth and function in malaria immune adults(Scientific Reports, 2024) Partey, F.D.; Dowuona, J.N.; Pobee, A.N.; et.alClinical immunity to malaria develops slowly after repeated episodes of infection and antibodies are essential in naturally acquired immunity against malaria. However, chronic exposure to malaria has been linked to perturbation in B-cell homeostasis with the accumulation of atypical memory B cells. It is unclear how perturbations in B cell subsets influence antibody breadth, avidity, and function in individuals naturally exposed to malaria. We show that individuals living in high malaria transmission regions in Ghana have higher Plasmodium falciparum merozoite antigen-specific antibodies and an increased antibody breadth score but lower antibody avidities relative to low transmission regions. The frequency of circulating atypical memory B cells is positively associated with an individual’s antibody breadth. In vitro growth inhibition is independent of the ability to bind to free merozoites but associated with the breadth of antibody reactivity in an individual. Taken together, our data shows that repeated malaria episodes hamper the development of high avid antibodies which is compensated for by an increase in antibody breadth. Our results provide evidence to reinforce the idea that in regions with high malaria prevalence, repeated malaria infections lead to the broadening of antibody diversity and the continued presence of atypical memory B cell populations.Item In vitro antiplasmodial activity, LC-MS analysis, and molecular docking studies of bioactive compounds from Tetrapleura tetraptera (Fabaceae) fruits(Scientific African, 2023) Hamidu, S.; Adams, L.; Oduro, P.K.; et al.Malaria continues to be a major public health concern, particularly for children and pregnant women in areas where the disease is endemic. Developing safe and efficient antimalarial therapies to fight the disease is essential. Medicinal plants represent a potential source for the development of new antimalarial drugs. Tetrapleura tetraptera is a plant native to West Africa and traditionally used to treat several diseases including Malaria. Here, we investigated the antiplasmodial ac tivities of T. tetraptera fruit extracts against the chloroquine-sensitive (Pf3D7) and chloroquine resistant (PfDD2) strains of Plasmodium falciparum in vitro using SYBR green assay. In addition, the antioxidant potential of the fruit extracts was also determined. LC-MS analysis was carried out to identify the bioactive compounds in the extracts. Molecular docking studies provide significant prima facie evidence of inhibition hence, to evaluate the potential inhibition of Plasmodium fal ciparum dihydroorotate dehydrogenase (PfDHODH), a validated malaria drug target, the identi fied compounds were docked against PfDHODH. Strong antiplasmodial activities were demonstrated by the ethyl acetate and ethanolic extracts of T. tetraptera fruit, with IC50 values of 16.12 ± 0.04 µg/mL and 2.06 ± 0.02 µg/mL against the Pf3D7 strain, respectively. In the DPPH radical scavenging experiment, the ethanolic extract revealed considerable antioxidant activity with an EC50 value of 0.21 ± 0.82 mg/mL. Seven bioactive compounds were identified in the extract using LC-MS analysis. N-Methyl-1H-indole-3-propanamide (I), Tazolol (II), and Isopentyl salicylate (III) were identified as potential inhibitors of PfDHODH with high binding affinities ranging from -32.08 to -30.69 kcal/mol. The potential lead compounds also interacted with Gly181, Leu531, and Arg265, which are critical amino acid residues in the catalytic activity of PfDHODH. These findings support the traditional use of T. tetraptera fruit extracts for the treat ment of malaria and as promising avenues for antimalarial drug development.Item Haematological parameters and their correlation with the degree of malaria parasitaemia among outpatients attending a polyclinic(Malaria Journal, 2023) Antwi‑Bafour, S.; Mensah, B.T.; Johnson, G.; Armah, D.N.O.; Ali‑Mustapha, S.; Annison, L.Background Malaria is a parasitic disease caused by various species of the blood parasite Plasmodium; of all the para‑ sitic diseases, malaria has the highest prevalence and mortality with an estimated 247 million cases and 619,000 deaths recorded worldwide as of 2021. Malaria causes febrile illness with several changes in blood cell parameters. Some of these changes include leucopenia, thrombocytopenia, and anaemia. If these changes could be correlated with the degree of parasitaemia, it can serve as a guide to physicians when treating malaria. This study was therefore aimed at correlating haematological parameters with levels of parasitaemia during malaria infection. Methods The study was a cross-sectional study involving 89 malaria positive patients. About 5 ml of blood was col‑ lected from each participant who gave his or her informed consent to partake in the study. A full blood count was performed on their samples to determine their haematological parameters using a haematology auto-analyzer. A parasite count was also performed via microscopy to determine the degree of parasitaemia. The data obtained from the study was entered into a database and statistically analysed using Statistical Package for Social Sciences (SPSS) version 23 and Microsoft Excel 2016. Results The study comprised of 89 participants out of which 35 were males and 54 were females with the mean age of 26.15 years. Secondary education participants were the highest with quaternary education the lowest. The highest parasite count recorded was 398,174 parasites/µl of blood, lowest count was 101 with the average being 32,942.32584. There was also a signifcant positive Pearson’s correlation between total WBC and parasitaemia and with the WBC diferentials, neutrophils, lymphocytes and monocytes had positive correlations while eosinophils and basophils had negative correlations. Furthermore, platelets, total RBC’s, haemoglobin, MCH, MCHC and Hct all showed negative correlations. Linear regression also showed a linear relationship between parasite density and the various haematological parameters. Conclusion The linear relationship (correlation) between WBC and MCH were the only signifcant ones at 95% and 99% confdence interval, respectively based on a two-tail t-test. Also, based on the regression analysis, the changes caused by WBC and PLT were the only signifcant changes at 95% confdence level in a two-tailed t-test.Item Malaria vaccine-related adverse events among children under 5 in sub-Saharan Africa: systematic review and meta analysis protocol(BMJ Open, 2023) Ohene-Adjei, K.; Manu, A.A.; Danso-Appiah, A.; et al.Introduction The RTS,S vaccine has been approved for use in children under 5 living in moderate to high malaria transmission areas. However, clinically important adverse events have been reported in countries in sub Saharan Africa. This systematic review aims to assess the frequency, severity and clinical importance of vaccine related adverse events. Methods and analysis This systematic review protocol has been prepared following robust methods and reported in line with the Preferred Reporting Items for Systematic reviews and Meta-Analyses for protocols guidelines. We will search PubMed, CINAHL, LILACS, Google Scholar, SCOPUS, WEB OF SCIENCE, Cochrane library, HINARI, African Journals Online, Trip Pro and TOXNET from 2000 to 30 September 2023, without language restrictions. We will also search conference proceedings, dissertations, World Bank Open Knowledge Repository, and WHO, PATH, UNICEF, Food and Drugs Authorities and European Medicines Agency databases, preprint repositories and reference lists of relevant studies for additional studies. Experts in the field will be contacted for unpublished or published studies missed by our searches. At least two reviewers will independently select studies and extract data using pretested tools and assess risk of bias in the included studies using the Cochrane risk of bias tool. Any disagreements will be resolved through discussion between the reviewers. Heterogeneity will be explored graphically, and statistically using the I2 statistic. We will conduct random-effects meta-analysis when heterogeneity is appreciable, and express dichotomous outcomes (serious adverse events, cerebral malaria and febrile convulsion) as risk ratio (RR) with their 95% CI. We will perform subgroup analysis to assess the impact of heterogeneity and sensitivity analyses to test the robustness of the effect estimates. The overall level of evidence will be assessed using Grading of Recommendations Assessment, Development and Evaluation. Ethics and dissemination Ethical approval is not required for a systematic review. The findings of this study will be disseminated through stakeholder forums, conferences and peer-review publications.Item In vitro and in silico anti-malarial activity and cytotoxicity of n-hexyl 1-O-rutinoside (a glycoside) isolated from Annickia polycarpa (DC.) Setten and Maas ex I.M. Turner (Annonaceae)(Journal of Ethnopharmacology, 2023) Kumatia, E.K.; Zoiku, F.K.; Asase, A.; Tung, N.H.Ethnopharmacological relevance: Annickia polycarpa leaf is an effective anti-malarial agent. However, its chemical constituents have not been isolated and assayed against any pathogen. Aim of the study: To isolate and characterize anti-malarial compound(s) from the leaf of A. polycarpa. Materials and methods: Bioassay-guided fractionation was employed to isolated the compound (AL1) from the chloroform fraction (ALCF) of the basified ethanol extract of A. polycarpa leaf (ALE). AL1 was characterized by LC-MS, 1D and 2D NMR spectroscopic analysis. Anti-malarial activity was evaluated against drug resistance Dd2 and drug sensitive 3D7 Plasmodium falciparum strains using the SYBR green assay. Cytotoxicity and mechanistic studies were determined using tetrazolium-based colorimetric assay and molecular docking respectively. Results: AL1 was characterized as n-hexyl 1-O-rutinoside. The IC50 values of ALE and ALCF against 3D7 and Dd2 P. falciparum strains ranges from 3.441 (0.3389) - 4.255 (0.2246) μg/mL. The IC50s obtained for n-hexyl 1-O-ruti noside and Artesunate (standard drug) were 7.71 (0.5473) and 0.001 (0.00008) nM against the 3D7 parasite strain respectively. Also, the efficacy of n-hexyl 1-O-rutinoside increased by 24.40% against the chloroquine resistance Dd2 P. falciparum strain whiles that of Artesunate decreased by 98.96%. Furthermore, ALE, ALCF and n-hexyl 1-O-rutinoside were weakly cytotoxic to human RBCs with high selectivity indices. N-hexyl 1-O-rutino side inhibits P. falciparum chloroquine resistance transporter (PfCRT) and dihydrofolate reductase-thymidylate synthase (PfDHFR-TS) better than chloroquine and pyrimethamine respectively. But, produced similar inhibi tion of P. falciparum 2-trans-enoyl -ACP-reductase (PfERN) as triclosan. Conclusion: These results show that A. polycarpa leaf and n-hexyl 1-O-rutinoside possessed profound anti-malarial activity and are not cytotoxic. N-hexyl 1-O-rutinoside could therefore, be developed into a new anti-malarial medicine. This is the first study to report the anti-malarial activity of n-hexyl 1-O-rutinoside and its isolation from the genus Annickia.Item In vitro and in silico anti-malarial activity and cytotoxicity of n-hexyl 1-O-rutinoside (a glycoside) isolated from Annickia polycarpa (DC.) Setten and Maas ex I.M. Turner (Annonaceae)(Journal of Ethnopharmacology, 2023) Kumatia, E.K.; Zoiku, F.K.; Asase, A.; Tung, N.H.Ethnopharmacological relevance: Annickia polycarpa leaf is an effective anti-malarial agent. However, its chemical constituents have not been isolated and assayed against any pathogen. Aim of the study: To isolate and characterize anti-malarial compound(s) from the leaf of A. polycarpa. Materials and methods: Bioassay-guided fractionation was employed to isolated the compound (AL1) from the chloroform fraction (ALCF) of the basified ethanol extract of A. polycarpa leaf (ALE). AL1 was characterized by LC-MS, 1D and 2D NMR spectroscopic analysis. Anti-malarial activity was evaluated against drug resistance Dd2 and drug sensitive 3D7 Plasmodium falciparum strains using the SYBR green assay. Cytotoxicity and mechanistic studies were determined using tetrazolium-based colorimetric assay and molecular docking respectively. Results: AL1 was characterized as n-hexyl 1-O-rutinoside. The IC50 values of ALE and ALCF against 3D7 and Dd2 P. falciparum strains ranges from 3.441 (0.3389) - 4.255 (0.2246) μg/mL. The IC50s obtained for n-hexyl 1-O-ruti noside and Artesunate (standard drug) were 7.71 (0.5473) and 0.001 (0.00008) nM against the 3D7 parasite strain respectively. Also, the efficacy of n-hexyl 1-O-rutinoside increased by 24.40% against the chloroquine resistance Dd2 P. falciparum strain whiles that of Artesunate decreased by 98.96%. Furthermore, ALE, ALCF and n-hexyl 1-O-rutinoside were weakly cytotoxic to human RBCs with high selectivity indices. N-hexyl 1-O-rutino side inhibits P. falciparum chloroquine resistance transporter (PfCRT) and dihydrofolate reductase-thymidylate synthase (PfDHFR-TS) better than chloroquine and pyrimethamine respectively. But, produced similar inhibi tion of P. falciparum 2-trans-enoyl -ACP-reductase (PfERN) as triclosan. Conclusion: These results show that A. polycarpa leaf and n-hexyl 1-O-rutinoside possessed profound anti-malarial activity and are not cytotoxic. N-hexyl 1-O-rutinoside could therefore, be developed into a new anti-malarial medicine. This is the first study to report the anti-malarial activity of n-hexyl 1-O-rutinoside and its isolation from the genus Annickia.