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 Differences in Alcohol Consumption and Drinking Patterns in Ghanaians in Europe and Africa: The RODAM Study(PloS one, 2018-11) Addo, J.; Cook, S.; Galbete, C.; Agyemang, C.; Klipstein-Grobusch, K.; Nicolaou, M.; Danquah, I.; Schulze, M.B.; Brathwaite, R.; Mockenhaupt, F.P.; Beune, E.; Meeks, K.; de-Graft Aikins, A.; Bahendaka, S.; Owusu-Dabo, E.; Smeeth, L.BACKGROUND: Little is known about alcohol consumption among Africans living in rural and urban Africa compared to African migrants in Europe. We compared the patterns of alcohol consumption in a group of Ghanaians living in different locations in Ghana and in Europe and examined the factors associated with drinking alcohol. METHODS: Data were from a cross-sectional study (RODAM) of Ghanaians aged 25-70 years living in rural and urban Ghana and in Amsterdam, Berlin and London. Information on how often participants consumed at least one standard alcoholic drink in the preceding 12 months, the type of alcoholic beverage and the average serving size was obtained using a food propensity questionnaire. The associations between drinking alcohol and socio-demographic variables, and frequency of attending religious services were investigated using logistic regression models stratified by site and sex. For Ghanaians living in Europe, the number of years since migration and acculturation were also included in the model as covariates. RESULTS: 4280 participants (62.2% women) were included in the analyses. In both men and women, the prevalence of drinking and amount of alcohol consumed per day was highest in Berlin (prevalence of drinking 71.0% and 61.7%) and lowest in urban Ghana (41.4% and 26.8%). After adjustment for age and education in both men and women in Europe, those attending religious services less frequently reported higher levels of drinking alcohol than non-attendants (never attend/no religion compared to attending service at least once a week men OR 4.60 95% CI 2.85, 7.44; women OR 1.80 95% CI 1.12, 2.90) p-trend with frequency <0.001 in men; 0.002 in women); this association was seen also in men in rural Ghana (p-trend = 0.001) and women in urban Ghana (p-trend = 0.02). The prevalence of drinking was positively associated with years since migration in both men and women in Europe ((OR per years increase in time lived in Europe 1.25 (95% CI 1.02,1.53) test for trend p = 0.03 in women; OR 1.29 (95% CI 1.03, 1.62 p = 0.03 in men) but no association was found with self-reported measures of acculturation (ethnic identity, cultural orientation or social networks). CONCLUSION: There are marked differences in alcohol consumption between Ghanaians living in Europe and in Ghana suggesting migration has an important influence of drinking patterns and also suggesting the possibility of requiring different strategies in alcohol reduction campaigns among Ghanaians in different locations.Item Development of a Language-Independent Functional Evaluation(Archives of Physical Medicine and Rehabilitation, 2009-12) Haig, A.J.; Jayarajan, S.; Maslowski, E.; Yamakawa, K.S.; Tinney, M.; Beier, K.P.; Juang, D.; Chan, L.; Boggess, T.; Loar, J.; Owusu-Ansah, B.; Kalpakjian, C.Haig AJ, Jayarajan S, Maslowski E, Yamakawa KS, Tinney M, Beier KP, Juang D, Chan L, Boggess T, Loar J, Owusu-Ansah B, Kalpakjian C. Development of a language-independent functional evaluation. Objective: To design, validate, and critique a tool for self-report of physical functioning that is independent of language and literacy. Design: Software design and 2 prospective trials followed by redesign. Setting: United States and African university hospitals. Participants: Outpatient and inpatient competent adults with diverse physical impairments. Interventions: (1) Software design process leading to a Preliminary Language-Independent Functional Evaluation (Pre-L.I.F.E.); (2) patient surveys using a printed Pre-L.I.F.E. and a computer-animated Pre-L.I.F.E. tested in random order, followed by a questionnaire version of the standard Barthel Index; and (3) software redesign based on objective and qualitative experiences with Pre-L.I.F.E. Main Outcome Measures: Validation of the general concept that written and spoken language can be eliminated in assessment of function. Development of a refined Language-Independent Functional Evaluation (L.I.F.E.). Results: A viable Pre-L.I.F.E. software was built based on design parameters of the clinical team. Fifty Americans and 51 Africans demonstrated excellent (Cronbach α>0.8 Americans) and good (α>.425 Africans) reliability. In general, the relations between Pre-L.I.F.E. and Barthel scores were excellent in the United States (interclass correlation coefficient for stair climbing, .959) but somewhat less good in Africa, with elimination functions very poorly related. The computer-animated Pre-L.I.F.E. was faster and trended to be more reliable than the printed Pre-L.I.F.E. in both the United States and Africa. Redesign meetings corrected statistical and qualitative challenges, resulting in a new tool, the L.I.F.E. Conclusions: Literacy and language translation can be eliminated from some aspects of functional assessment. The new L.I.F.E., based on solid empirical evidence and design principles, may be a practical solution to assessment of function in the global culture. © 2009 American Congress of Rehabilitation Medicine.Item Out of Africa: What can be learned from the studies of allergic disorders in Africa and Africans?(Current Opinion in Allergy and Clinical Immunology, 2008-10) Obeng, B.B.; Hartgers, F.; Boakye, D.; Yazdanbakhsh, M.Purpose of review Allergic diseases have only recently gained serious attention in Africa. This review discusses recent studies that have focused on allergy among Africans and people of African ancestry. Recent findings Time trend studies of the prevalence of allergies in Africa show a consistent increase over a period of 7-10 years. Recent studies have reported that the link between IgE, skin reactivity to allergens and allergic symptoms increases with increasing gross national income of the country. Association between helminth infections, and allergies seem contradictory, which may be attributed to differences in the length of infection and species studied. Importantly, researchers have identified an 'urban diet' component, which is associated with increased skin reactivity to allergens. Finally, whereas Africans in rural Africa seem to suffer less from allergies, people of African ancestry in affluent countries have higher prevalence and greater severity of allergic symptoms than natives of these host countries, raising important issues on genetic control of allergic diseases. Summary Mechanisms underlying the development of allergy are a complex interaction of genetic susceptibility and environmental exposures. Identification of specific environmental factors, mechanistic pathways and genetic risk factors in sufficiently powered studies will be necessary to better understand and control the allergic march in Africa and elsewhere. © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins.Item Molecular epidemiology of rotavirus infection in Western Cameroon(Journal of Tropical Pediatrics, 2003-06) Esona, M.D.; Armah, G.E.; Steele, A.D.Rotavirus is major viral cause of diarrhoea in children worldwide. In this study, the first from Cameroon, the molecular epidemiology of rotavirus infection was investigated. Eight hundred and ninety diarrhoea stools collected from children under the age of 5 years in Western Cameroon between 1999 and 2000 were analysed for rotaviruses and further characterized by antigenic and genomic methods. Rotaviruses were detected in 21.9 per cent of stools and were highest during the cool dry season. Sixteen different electrophoretic patterns, 13 of long and three of short, were detected in the study area. The predominant subgroup detected was subgroup II (66.9 per cent) and atypical strains with long electropherotype, but subgroup I specificity were also observed. Rotavirus infection was shown to be an important component of diarrhoeal disease in young children in Cameroon. The results of this study in Cameroon reinforces the need to continue with surveillance programmes in Africa.Item Antibodies reactive to Plasmodium falciparum serine repeat antigen in children with Burkitt lymphoma from Ghana(International Journal of Cancer, 2012-04) Guech-Ongey, M.; Yagi, M.; Palacpac, N.M.Q.; Emmanuel, B.; Talisuna, A.O.; Bhatia, K.; Stefan, D.C.; Biggar, R.J.; Nkrumah, F.; Neequaye, J.; Tougan, T.; Horii, T.; Mbulaiteye, S.M.The role of protective immunity to Plasmodium falciparum (Pf) malaria in Burkitt lymphoma (BL) is unknown. We investigated the association between BL and antibodies reactive to SE36 antigen, a recombinant protein based on P. falciparum serine repeat antigen 5 gene, targeted by protective malaria immune responses. Cases were children (0-14 years) enrolled at the Korle-Bu Teaching Hospital, Accra, Ghana, during 1965-1994 with BL confirmed by histology or cytology (92% of cases). Controls were apparently healthy children enrolled contemporaneous to the cases from the nearest neighbor house to the case house and were age,- sex-frequency-matched to the cases. Anti-SE36 IgG antibodies were measured using enzyme-linked absorbent immunoassays (ELISAs). SE36 titers were estimated by extrapolating ELISA optical density readings to a standard fitting curve. Anti-SE36 titers were log-transformed for analysis. Odds ratios (ORs) and two-sided 95% confidence intervals (95% CIs) were estimated using unconditional logistic regression. The mean log endpoint dilution titers were 0.63 logs lower in cases than in controls (8.26 [SD 1.68] vs. 8.89 [SD 1.75], Student's t-test, p = 0.019). Lower titers were observed in cases than controls aged 0-4 years (p = 0.05) and in those aged 5-14 years (p = 0.06). Low and medium tertiles of anti-SE36 IgG antibodies were associated with increased OR for BL ([OR 1.67, 95% CI 1.21-2.31] and [OR 1.33, 95% CI 0.96-1.86], respectively, p trend = 0.002) in analyses adjusting for age, sex, calendar period and test plate. Our findings suggest that compared to similarly aged children enrolled from the same community, children with BL in Ghana have lower antibodies to SE36 antigen. © 2011 UICC.Item The nature and prevalence of disability in a ghanaian community as measured by the language independent functional evaluation(Pan African Medical Journal, 2013-03) Kelemen, B.W.; Haig, A.J.; Goodnight, S.; Nyante, G.Introduction: The current study uses the Language Independent Functional Evaluation (L.I.F.E.) to evaluate disability in a smaller Ghanaian coastal town to characterize the extent and nature of disability. The L.I.F.E. is a video animated, language free equivalent of the standard 10-item verbal/written Barthel Index functional assessment. Methods: Over a four-month period, the L.I.F.E. survey was given to members of the village of Anomabo in a preliminary survey which consisted of recruitment in an un-controlled manner, followed by a systematic, comprehensive survey of three neighborhood clusters. Basic demographics were also collected, along with the observer's assessment of disability. Results: 541 inhabitants (264 in the preliminary survey and 277 in systematic survey) completed the L.I.F.E. Participants ranged from 7-100 years old (mean age 32.88, s.d. 20.64) and were 55.9% female. In the systematic study, 16.6% of participants had a less than perfect score on the L.I.F.E., indicating some degree of impairment. Significant differences were found between age groups, but not between sexes, the preliminary and systematic survey, and study location (α=.05). Conclusion: The L.I.F.E. and this study methodology can be used to measure the prevalence of disability in African communities. Disability in this community was higher than the frequently cited estimate of 10%. African policymakers can use the L.I.F.E. to measure disability and thus more rationally allocate resources for medical rehabilitation. © Benjamin William Kelemen et al.Item Understanding the rise in cardiovascular diseases in Africa: Harmonising H3Africa genomic epidemiological teams and tools(Cardiovascular Journal of Africa, 2014-05) Owolabi, M.O.; Mensah, G.A.; Kimmel, P.L.; Adu, D.; Ramsay, M.; Waddy, S.P.; Ovbiagele, B.; Rabadan-Diehl, C.; Rasooly, R.; Akarolo-Anthony, S.N.; Rotimi, C.Cardiovascular diseases, principally ischaemic heart disease and stroke, are the leading causes of global mortality and morbidity. Together with other non-communicable diseases, they account for more than 60% of global deaths and pose major social, economic and developmental challenges worldwide. In Africa, there is now compelling evidence that the major cardiovascular disease (CVD) risk factors are on the rise, and so are the related fatal and non-fatal sequelae, which occur at significantly younger ages than seen in high-income countries. In order to tackle this rising burden of CVD, the H3Africa Cardiovascular Working Group will hold an inaugural workshop on 30 May 2014 in Cape Town, South Africa. The primary workshop objectives are to enhance our understanding of the genetic underpinnings of the common major CVDs in Africa and strengthen collaborations among the H3Africa teams and other researchers using novel genomic and epidemiological tools to contribute to reducing the burden of CVD on the continent.Item An overview of the effect and epidemiology of viral central nervous system infections in African children(Seminars in Pediatric Neurology, 2014-03) Badoe, E.; Wilmshurst, J.M.Viral infections in Africa are common. Polio still persists in the continent despite vaccination campaigns. Many of the common viral infections, such as by the nonpolio enteroviruses, lack effective therapies and leave devastating sequelae to infected neonates and infants. Rarer conditions, such as by West Nile virus, have generated a fascinating conundrum as to how the virus spread to other parts of the world, such as the United States of America. This infection illustrates that these conditions should not be considered isolated to Africa alone but that they represent examples of potentially lethal infections which, although predominantly found in Africa, have the capacity to spread wider afield. © 2014 Elsevier Inc.Item The burden of stroke in Africa: A glance at the present and a glimpse into the future(Cardiovascular Journal of Africa, 2015-03) Owolabi, M.O.; Akarolo-Anthony, S.; Akinyemi, R.; Arnett, D.; Gebregziabher, M.; Jenkins, C.; Tiwari, H.; Arulogun, O.; Akpalu, A.; Sarfo, F.S.; Obiako, R.; Owolabi, L.; Sagoe, K.; Melikam, S.; Adeoye, A.M.; Lackland, D.; Ovbiagele, B.Objective: Information on the current burden of stroke in Africa is limited. The aim of this review was to comprehensively examine the current and projected burden of stroke in Africa. Methods: We systematically reviewed the available literature (PubMed and AJOL) from January 1960 and June 2014 on stroke in Africa. Percentage change in age-adjusted stroke incidence, mortality and disability-adjusted life years (DALYs) for African countries between 1990 and 2010 were calculated from the Global Burden of Diseases (GBD) model-derived figures. Results: Community-based studies revealed an age-standardised annual stroke incidence rate of up to 316 per 100 000 population, and age-standardised prevalence rates of up to 981 per 100 000. Model-based estimates showed significant mean increases in age-standardised stroke incidence. The peculiar factors responsible for the substantial disparities in incidence velocity, ischaemic stroke proportion, mean age and case fatality compared to high-income countries remain unknown. Conclusions: While the available study data and evidence are limited, the burden of stroke in Africa appears to be increasing.Item Seasonality of rotavirus infection in Ghana.(Annals of Tropical Paediatrics, 1994) Armah, G.E.; Mingle, J.A.A.; Dodoo, A.K.; Anyanful, A.; Antwi, R.; Commey, J.; Nkrumah, F.K.Human rotavirus (HRV) infection and its seasonal distribution was studied over a 12-month period in Ghana. A total of 561 stool samples, 447 diarrhoea stools and 114 non-diarrhoea stools (controls), were obtained from children attending three polyclinics in Accra. Rotavirus was detected during 10 of the 12 months and showed a seasonal trend. It was high during the relatively cool dry months and low during the wet season. Peaks of infection were in February (26.2%) and September (24.5%). HRV was detected in 67 of 447 of the diarrhoea stools (15.0%) and in eight of 114 controls (7.0%). The HRV isolation rate was highest (20.2%) in the under-18-months age group