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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    Partnership and collaboration in healthcare delivery in Ghana
    (Journal of Public Affairs, 2020-05-29) Ampong-Ansah, F.B.; Maloreh-Nyamekye, T.; Otchere, L.N.; Boateng, A.K.; Antwi-Boasiako, J.
    The quest of most state or governments to adequately cater for the healthcare needs of its people continue to be a difficult task since many states have experienced, and continue to experience, a reduction in allocation of resources to the health sector. The involvement of the private sector in health care delivery is an option being explored by a number of states to augment resources in the health sector with some partnerships between the public and the private healthcare facilities in the fight against AIDS, Tuberculosis and Malaria. However, not many empirical studies have been conducted to identify and better understand these partnerships between the state agencies and the private sector in Ghana. This study, therefore, sought to answer questions on the range of partnership and collaborative activities existing between public and private healthcare institutions in Ghana, the need for these collaborations and the factors that hinder these collaborations in Ghana. The study adopted the stakeholder theory as various stakeholders come together to ensure the delivery of healthcare in Ghana. The study revealed that there was no direct partnership between these two groups. They, however, collaborated in some instances under the umbrella of their governing organization. The perceived need for collaboration that was identified under the study was for the protection of human lives. The study concluded that this collaboration is necessary to ensure an efficient healthcare delivery.
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    Reversible Binocular Visual Loss in Temporal Association with Artesunate-Amodiaquine Treatment in a Child on Mefloquine Chemoprophylaxis
    (Ghana medical journal, 2012-09) Adjei, G.O.; Adabayeri, V.M.; Annobil, S.H.
    A case of an acute reversible visual loss in a 10-yearold child who was on mefloquine prophylaxis, and was treated with artesunate-amodiaquine for an acute febrile illness diagnosed clinically as uncomplicated malaria, is reported. On admission the patient could not perceive light and had bilateral papilloedema. She was treated with dexamethasone and recovered her sight gradually over a 21-day period. There has been no previous report to our knowledge, of an association between acute visual loss and mefloquine, amodiaquine, or artesunate in the published literature, even though mefloquine is associated with blurring of vision, and antimalarials of the quinoline class have been associated with retinopathy (during long term use). While causality is difficult to ascribe in this case, it may be prudent to avoid the use of quinoline-based antimalarials for treating acute malaria in travelers taking mefloquine prophylaxis, because information on the safety of concurrent use of artemisinin combination therapies and mefloquine, or other recommended prophylactic regimens, is limited.
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    Breadth of Functional Antibodies Is Associated With Plasmodium falciparum Merozoite Phagocytosis and Protection Against Febrile Malaria
    (The Journal of Infectious Diseases, 2019-02-26) Adu, B.; Kana, I.H.; Singh, S.K.; Garcia-Senosiain, A.; Dodoo, D.; Singh, S.; Theisen, M.
    Background. The specific targets of functional antibodies against Plasmodium falciparum merozoites remain largely unexplored and, more importantly, their relevance to naturally acquired immunity in longitudinal cohort studies (LCSs) is yet to be tested. Methods. Functionality of immunoglobulin G (IgG) antibodies against 24 merozoite antigens was determined at the baseline of an LCS in Ghana using a bead-based opsonic phagocytosis assay (BPA). Antigen-specific IgG3 subclass antibodies were quantified in the same samples by the Luminex multiplex system. Results. A wide range of BPA activity was observed across the different antigens. High BPA responses of nMSP3K1, GLURP-R2, MSP23D7, MSP119k, and PfRh2-2030 coupled beads were significantly associated with a higher probability of children not experiencing febrile malaria. Children with high breadth of functional antibodies against these antigens together with cMSP33D7 had a significantly reduced risk of febrile malaria (adjusted hazard ratio, 0.36 [95% confidence interval, .18–.72]; P = .004). Five of the 6 BPA activities significantly (likelihood ratio rest, P ≤ .05) contributed to the protective immunity observed with the IgG3 antibodies. Conclusions. The development of BPA allowed profiling of functional antibodies in an LCS. Identification of targets of opsonic phagocytosis may have implications in the development of a subunit malaria vaccine.
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    Clinical Outcomes of Submicroscopic Infections and Correlates of Protection of VAR2CSA Antibodies in a Longitudinal Study of Pregnant Women in Colombia
    (Infection and Immunity, 2018-01) Gavina, K.; Gnidehou, S.; Arango, E.; Hamel-Martineau, C.; Mitran, C.; Agudelo, O.; Lopez, C.; Karidio, A.; Banman, S.; Carmona-Fonseca, J.; Salanti, A.; Ndam, N.T.; Hawkes, M.; Maestre, A.; Yanow, S.K.
    Background Malaria in pregnancy can cause serious adverse outcomes for the mother and the fetus. However, little is known about the effects of submicroscopic infections (SMIs) in pregnancy, particularly in areas where Plasmodium (P.) falciparum and P. vivax co-circulate. Methods A cohort of 187 pregnant women living in Puerto Libertador in Northwest Colombia was followed longitudinally from recruitment to delivery. Malaria was diagnosed by microscopy, RT-qPCR, and placental histopathology. Gestational age, hemoglobin concentration, VAR2CSA-specific IgG levels and adhesion-blocking antibodies were measured during pregnancy. Statistical analyses were performed to evaluate the impact of SMIs on birth weight and other delivery outcomes. Results Twenty-five percent of women (45/180) were positive for SMIs during pregnancy. Forty-seven percent of infections (21/45) were caused by P. falciparum , 33% by P. vivax , and 20% by mixed Plasmodium spp. Mixed infections of P. falciparum and P. vivax were associated with lower gestational age at delivery (p=0.0033), while other outcomes were normal. Over 60% of women had antibodies to VAR2CSA and there was no difference in antibody levels between those with SMIs or not. The anti-adhesion function of these antibodies was associated with protection from SMI-related anemia at delivery (p=0.0086). Conclusions SMIs occur frequently during pregnancy and while they were not associated with a decrease in birth weight, mixed infections of both P. falciparum and P. vivax were associated with significant risk of pre-term birth. We propose that the lack of adverse delivery outcomes is due to functional VAR2CSA antibodies that can protect pregnant women from SMI-related anemia.
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    Evaluation of hematological indices of childhood illnesses in Tamale Metropolis of Ghana
    (Journal of Clinical Laboratory Analysis, 2018-10) Anabire, N.G.; Aryee, P.A.; Addo, F.; Anaba, F.; Kanwugu, O.N.; Ankrah, J.; Awandare, G.A.; Helegbe, G.K.
    BACKGROUND: Although hematological indices cannot in entirety be used to diagnose diseases or defects, the appropriate interpretation of these indices could complement diagnostics such as microscopy and serology for numerous illnesses in children. This study sought to evaluate distinct hematological indices characterizing different childhood illnesses. METHODS: Full blood counts from 150 children (age range from 1 to 15 year) presenting different disease conditions at the Tamale Central Hospital were assessed. The hematological indices were compared between disease categories, and relationships between disease indicators were determined. RESULTS: The prevalence of the diagnosed childhood illness were: 50.7% malaria, 20.0% diarrhea, 13.3% typhoid fever, 10.0% Sickle Cell Disease (SCD), and 6.0% malaria-typhoid co-infection. Fever was diagnosed in a majority (66.0%) of the children, but was independent of each disease group, (χ2  = 9.18, P = .057). Of the 24 hematological indices analyzed, eight; red blood cell (RBC) (P < .001), hemoglobin (Hb) (P < .001), mean cell volume (MCV) (P = .002), mean cell hemoglobin (MCH) (P < .001; lowest and below normal range for SCD), red cell distribution width (RDW_CV) (P < .001), eosinophil percentage [EOS (%)] (P = .001), eosinophil number [EOS#] (P = .002), and platelets (PLT) (P = .001; lowest for malaria) differed significantly across the different disease groups. Levels of Hb and/or MCV were below the normal reference ranges for most of the diagnosed diseases. In addition, low PLT and MCH were respectively distinct for children with malaria and SCD. CONCLUSION: Hematological indices including Hb, MCV and PLT, or MCH may be useful indices that could incite further diagnostic tests for malaria or SCD among children in Ghana.
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    Characterization of Anopheles gambiae s.l. and insecticide resistance profile relative to physicochemical properties of breeding habitats within Accra Metropolis, Ghana
    (Tanzania Journal of Health Research, 2011-07) Kabula, B.I.; Attah, P.K.; Wilson, M.D.; Boakye, D.A.
    Malaria is endemic in Ghana as in most countries of sub-Saharan Africa. This study was conducted to characterize Anopheles gambiae s.l. and determine pyrethroid resistance profiles relative to physicochemical properties of breeding habitats in Accra, Ghana. Eight aquatic habitats containing Anopheles larvae were identified and from each habitat, larvae and water were sampled. Adult An. gambiae reared from larvae were morphologically identified and tested for permethrin (0.75%) and deltamethrin (0.05%) resistance using WHO bioassay method. An. gambiae s.s. found were identified to their molecular levels and kdr mutation detected using PCR-based methods. Twenty-nine physicochemical parameters of each water sample were measured and their levels connected with pyrethroid resistance and proportions of An. gambiae s.s. molecular forms in habitats. A total of 2,257 mosquitoes were morphologically identified as An. gambiae s.l. and all 224 processed for PCR were identified as An. gambiae s.s., of which 56.46% and 43.54% were M and S-forms, respectively. Both forms occurred in sympatry in all larval habitats and no S/M hybrids were detected. However, M-form larvae were in high proportion in polluted habitats than the S-form. An. gambiae s.s. was highly resistant to both deltamethrin and permethrin with mortality rates of 42.98-70.0% and 6.5-20.0% respectively. The frequency of kdr mutation was 60.5% (n=195). This mutation occurred in both S and M-forms, but was mainly associated with the S-form (X 2=10.92, df =1, P=0.001). Carbonate and pH were both selected in discriminant function analysis as best predictors of high proportion of M-form in the habitats. The adaptation of An. gambiae s.s. in polluted aquatic habitats coupled with occurrence of insecticide resistance is quite alarming particularly for urban malaria control and needs further exploration in a wider context.
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    Human leukocyte antigen class I polymorphisms influence the mild clinical manifestation of Plasmodium falciparum infection in Ghanaian children
    (Human Immunology, 2011-10) Yamazaki, A.; Yasunami, M.; Ofori, M.; Horie, H.; Kikuchi, M.; Helegbe, G.; Takaki, A.; Ishii, K.; Omar, A.H.; Akanmori, B.D.; Hirayama, K.
    A prospective study that included 429 children for active detection of mild malaria was conducted in a coastal region of Ghana to reveal whether the incidence of malaria is affected by human leukocyte antigen (HLA) polymorphism. During 12 months of follow-up, 85 episodes of mild clinical malaria in 74 individuals were observed, and 34 episodes among them were accompanied with significant parasitemia at >5000 infected red blood cells per cubic millimeter. Attributable and relative risks conferred by genetic factors in the HLA region were evaluated by comparison of the incidence in children, stratified by carrier status, of a given allele of HLA-A, -B, -DRB1 and TNFA promoter polymorphism. HLA-B*35:01 reduced the incidence by 0.178 events per person per year (0.060 versus 0.239 for B*35:01-positive and -negative subpopulations, respectively), and a relative risk of 0.25, which remained statistically significant after Bonferroni's correction for multiple testing (p c = 8.2 × 10 -5). Further, HLA-B*35:01 and -B*53:01 exhibited opposite effects on the incidence of malaria with significant parasitemia. When parasite densities in different HLA carriers status were compared, HLA-A*01 conferred an increase in parasite load (p = 6.0 × 10 -7). In addition, we found a novel DRB1 allele that appears to have emerged from DRB1*03:02 by single nucleotide substitution. © 2011 American Society for Histocompatibility and Immunogenetics.
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    Knowledge of malaria prevention and control in a sub-urban community in Accra, Ghana
    (International Journal of Tropical Medicine, 2011-03) Appiah-Darkwah, I.; Badu-Nyarko, S.K.
    Knowledge of community members in malaria is a major factor that can influence malaria prevention and control. The study sought to identify possible relationships between personal characteristics of community members and their knowledge of malaria prevention and control. It was found out that educational level of the people did not relate to their knowledge of malaria prevention (•2 = 2.112, df. 3, p = 0.55). Females had higher knowledge on malaria than males. Both the less educated and highly educated are aware that malaria can be prevented. Formal educational levels might not directly affect ones' knowledge about the causes of malaria. In conclusion, knowledge in malaria prevention and control might not result from formal education only but other sources such as non-formal and informal education. Respondents' knowledge level on matters relating to malaria was high yet their actions towards prevention and control were discouraging. © Medwell Journals, 2011.
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    Cohort trial reveals community impact of insecticide-treated nets on malariometric indices in urban Ghana
    (Transactions of the Royal Society of Tropical Medicine and Hygiene, 2010-07) Klinkenberg, E.; Onwona-Agyeman, K.A.; McCall, P.J.; Wilson, M.D.; Bates, I.; Verhoeff, F.H.; Barnish, G.; Donnelly, M.J.
    The efficacy of insecticide-treated nets (ITNs) in prevention of malaria and anaemia has been shown in rural settings, but their impact in urban settings is unknown. We carried out an ITN intervention in two communities in urban Accra, Ghana, where local malaria transmission is known to occur. There was evidence for a mass or community effect, despite ITN use by fewer than 35% of households. Children living within 300 m of a household with an ITN had higher haemoglobin concentrations (0.5. g/dl higher, P=0.011) and less anaemia (odds ratio 2.21, 95% CI 1.08-4.52, P=0.031 at month 6), than children living more than 300 m away from a household with an ITN, although malaria parasitaemias were similar. With urban populations growing rapidly across Africa, this study shows that ITNs will be an effective tool to assist African countries to achieve their Millennium Development Goals in urban settings. [Registered trial number ISRCTN42261314; http://www.controlled-trials.com/ISRCTN42261314]. © 2010 Royal Society of Tropical Medicine and Hygiene.
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    Ethnopharmacological use of herbal remedies for the treatment of malaria in the Dangme West District of Ghana
    (Journal of Ethnopharmacology, 2010-04) Asase, A.; Akwetey, G.A.; Achel, D.G.
    Aim of study: Malaria is one of the most important diseases in the world. Because of the devastating nature of the disease there is an urgent need to develop new drugs or vaccines for the treatment, prevention and management of the disease. The objective of the present study was to collect and document information on herbal remedies traditionally used for the treatment of malaria in the Dangme West District of Ghana. Methods: Data was collected from 67 indigenous households in ten communities in the district using a validated questionnaire. Results: In total, 30 species of plants belonging to 28 genera in 20 families were reported to be used in the preparation of the herbal remedies. Mature leaves were the most (55%) common plant part used and 73.3% of the herbal remedies involved a single plant. Most of the herbal remedies were prepared by boiling and administered orally. The majority (47%) of the species of plants used were collected from their compounds or home gardens. Conclusions: Knowledge about malaria and treatment practices exists in the study area. Herbal remedies were commonly used by people for the treatment of malaria because they were cost-effective. They are also more accessible. Many of the species of plants used have been documented for the treatment of malaria as well as investigated for their phytochemical and antimalarial and/or antiplasmodial activity confirming the results of previous studies as well as rationalization of their traditional use. Five species of plants used in the study area, namely, Bambusa vulgaris Schrad. ex J.C. Wendl. (Poaceae), Deinbollia pinnata Schum &Thonn. (Sapindaceae), Elaeis guineensis Jacq. (Arecaceae), Greenwayodendron sp. (Annonaceae) and Solanum torvum Sw (Solanaceae), are documented for the first time for their use in the treatment of malaria. " The result of this study provides the basis for further pharmacological studies on the herbal remedies used" © 2010 Elsevier Ireland Ltd.