Effects of mixed hardwoods dust on respiratory function and blood immunoglobulin levels in wood workers.

Background: Occupational exposure to wood dust, generated by various individual wood species, both softwood and hardwood, has been extensively documented as a causative factor for reduced lung function, frequent respiratory symptoms, and increased immunological responses in wood workers. This study explores the impact of wood dust from mixed tropical hardwood species on lung function, respiratory symptoms, and Immunoglobulin (Ig) E and G levels. Methods: A cross-sectional study was conducted among wood workers at the Accra Timber Market and a control group from the University of Ghana. Particulate matter (PM) was sampled using a Minivol Sampler set to a flow rate of 5 l/min. Respiratory symptoms were assessed using questions adapted from the British Medical Research Council (MRC) questionnaire (1960). Lung volumes and airflow rates were measured using a spirometer. Total serum IgE and IgG levels were quantified using ELISA. Results: No significant differences were observed between the wood workers and the controls for demographic variables. Wood workers exhibited a significantly higher prevalence of respiratory symptoms, particularly rhinitis, with many reporting the absence of symptoms during holidays. Lung function parameters (VC, FEV1, FEV1%, PEFR, and FEF25-75%) were significantly reduced (p < 0.05) in wood workers. A significant negative correlation was noted between lung function parameters and years of exposure to wood dust. Wood workers showed significantly elevated levels (p < 0.05) of IgG and IgE. Conclusion: The study findings suggest that exposure to mixed tropical hardwood dust induces elevated blood IgE and IgG levels, along with non-allergic respiratory function abnormalities.

Assessing the vibration perception threshold in a community sample of adult Ghanaians.

BACKGROUND: The vibration perception threshold (VPT) helps evaluate human somatosensory function and diagnose peripheral neuropathy. To optimize its use as a primary neurologic tool, it is imperative to establish its typical values in healthy subjects and assess the factors affecting its variability in an individual to ensure consistency in its application. METHODS: Demographic data and a brief medical history were collected from 391 non-diabetic adults aged 30-80 at Kpone-on-Sea in Ghana. The VPT was measured at the tip of the big toe, the medial malleolus, the tip of the middle finger, and the head of the ulna of each participant using a Horwell Neurothesiometer. The variability of VPT was assessed vis-à-vis the following factors: gender, age, fasting plasma sugar and body mass index. RESULTS: The mean age of participants was 48.4 ± 0.7 years, and the female-to-male ratio was 1.46. The overall VPT values ranged from 5.74 ± 0.14 volts to 8.55 ± 0.18 volts in the lower limbs and 3.61 ± 0.06 volts to 5.00 ± 0.08 volts in the upper limbs. Age was found to be the only factor that could predict VPT for both the lower and upper limbs (P < 0.001). One-Way Analysis of Variance with Tukey's posthoc showed that the VPT in the feet was significantly higher than that in the hands. CONCLUSIONS: Generally, the VPT was high on proximal sites and low on distal sites indicating that the vibration sensation increased from proximal to distal direction. Therefore, distal areas should be used for VPT testing with a Neurothesiomer. Age was found to be the only factor that affected VPT variability. Hence, the practical application of VPT will require age-specific reference ranges to cater for older adults.

Socioeconomic Risk Factors for Plasmodium falciparum Infection in Primary School Children in Three Districts of the Volta Region Of Ghana.

BACKGROUND: Socioeconomic factors influence the prevalence of malaria infection in endemic areas. This study evaluated the socioeconomic risk factors for Plasmodium falciparum infection in primary school children in the Volta region of Ghana. METHODS: This cross-sectional study involved selected primary school children from the region; questionnaires were administered, and blood samples were collected for malaria detection using a rapid diagnostic test (RDT) and microscopy. RESULTS: A total of 550 primary school children were enrolled in this study. The predominant occupation of the parents was trading (mothers, 334, 60.73%; fathers, 254, 46.18%) and farming (mothers, 156, 28.36%; fathers, 170, 30.91%). Three hundred and five (305; 55.45%) children tested positive for malaria with RDT and microscopy. Male sex (AOR=1.53), rural area (Afegame school) (AOR=4.01) and parental farming occupation (AOR=6.39), were independently associated with P. falciparum infection. CONCLUSIONS: Plasmodium falciparum infection was significantly found in children in rural areas of Ghana with low socioeconomic status in this study.

Prevalence of Polyparasitic Infection Among Primary School Children in the Volta Region of Ghana.

BACKGROUND: Polyparasitic infection is a possibility in areas where parasites are endemic, especially among children. This study looked at the prevalence of polyparasitic infections among children in the Volta Region of Ghana. METHODS: This was a cross-sectional study, among 550 primary school children (aged 6-14 years) in 3 districts in the Volta Region. Questionnaires were administered, and blood, stool, and urine samples were collected. Blood samples were screened for Plasmodium falciparum with rapid diagnostic test and microscopy, together with hemoglobin estimation. Stool and urine samples were microscopically examined using wet mount and sedimentation methods to detect intestinal parasites and Schistosoma haematobium, respectively. Pearson χ2 test was used to evaluate the association between parasitic infections and socioeconomic variables, and multivariate logistic regression to evaluate paired associations among parasites. RESULTS: The most prominent infection among the children was P. falciparum (present in 383 children [69.6%]), followed by S. haematobium (57 [10.36%]). There was low prevalence of intestinal protozoa (present in 11 children [2%]), Ascaris lumbricoides (7 [1.27%]), and hookworm (5 [0.91%]). A total of 62 children had polyparasitic infection, with P. falciparum and S. haematobium having significant paired association (both present in 46 children [74.19%]; adjusted odds ratio, 2.45; P = .007). CONCLUSION: The prevalence of polyparasitic infection was low in this study, and significant coinfection was seen with P. falciparum and S. haematobium.

Asymptomatic Plasmodium falciparum infection and poor school performance in primary school children in the Volta Region of Ghana.

BACKGROUND: This study aimed to evaluate the association between asymptomatic Plasmodium falciparum infection and poor intellectual development in primary school children in the Volta Region of Ghana. METHODS: This was a cross-sectional study conducted among children from 5 primary schools in 3 districts in the Volta region of Ghana. Questionnaires were administered, and blood samples collected for malaria investigation using Rapid diagnostic test (RDT) and microscopy. School performance was used to assess intellectual development in the children. Arithmetic was the subject of choice for the standardized test. Pearson chi square test was used to evaluate the association between Plasmodium falciparum and poor school performance. Multivariate analysis was used to identify factors independently associated with risk of poor school performance. RESULTS: Out of 550 children, 305(55.45%) tested positive for malaria with RDT and 249(45.27%) positive with microscopy. Children from the Evangelical Presbyterian (EP) primary school in Afegame had the highest prevalence of Plasmodium falciparum infection with both RDT (92, 74.80%) and microscopy (73, 59.35%). Two hundred and fifteen students (39.09%) failed the arithmetic school test. EP primary school in Afegame recorded the highest frequency of poor school performance among the children (53.66%). School performance was significantly associated with RDT malaria diagnosis with failure rate higher among children who were RDT positive (135, 62.79%, p=0.005). Lower mean scores were seen in children with positive RDT result (47.35, [SD 30.85], p=0.021). Plasmodium falciparum infection (RDT) was independently associated with increased risk of poor school performance (AOR, 1.92, p=0.003). CONCLUSION: An urgent scale-up of malaria control program targeting school-going children in this region is needed to mitigate the possible negative impact of Plasmodium falciparum infection on their intellectual development.

Comparison of malaria diagnostic methods in four hospitals in the Volta region of Ghana.

Background: Rapid diagnostic tests (RDTs) and microscopy are routinely used for the diagnosis of malaria in Ghana. DNA-based polymerase chain reaction (PCR) is not yet used routinely. We compared diagnostic methods and tested the sensitivities of different malaria diagnostic methods against PCR. Materials and methods: Study participants from four hospitals with a suspicion of malaria donated finger -prick blood for RDT and blood film examination. In addition, a blood spot was collected for PCR analysis, prior to treatment. Retrospective species-specific PCR was performed on all samples collected. Results: Using PCR we found an overall malaria prevalence of 39% among the 211 evaluable blood spots (83/211) and this ranged between 6-61% across the four hospitals. Of the 164 participants with RDT data, malaria prevalence was 57% (94/164), ranging from 3-100% from the four hospitals. Microscopy was the least sensitive with a parasite prevalence of 21% (25/119) of the evaluable 119 participants, varying from 9 to 35% across three health facilities. By comparison, we found the sensitivities and specificities of RDT results when compared to PCR to be slightly higher than microscopy compared to PCR. These were 56.4% versus 41.7% and 90% versus 81.9%, respectively, but generally lower than expected. Ninety-five percent of the PCR-detected infections were P. falciparum, while 4% were mixed species infections of P. falciparum and P. malariae, with the remaining being a mono-infection of P. malariae. Conclusions: While using PCR as a gold standard, we found RDT to be more reliable in diagnosing malaria than microscopy. In addition, a majority of malaria-treated cases were not supported by PCR diagnosis, leading to possible overtreatment. Pragmatic strategies are needed to ensure suspected malaria cases are accurately diagnosed before treatment.

Impaired renal function and increased urinary isoprostane excretion in Ghanaian women with pre-eclampsia.

BACKGROUND: The cause of pre-eclampsia remains largely unknown, but oxidative stress (an imbalance favoring oxidant over antioxidant forces) has been implicated in contributing to the clinical symptoms of hypertension and proteinuria. Assessment of oxidative stress in pre-eclampsia using urinary isoprostane has produced conflicting results, and it is likely that renal function may affect isoprostane excretion. The aim of this study was to determine the role of oxidative stress in the pathophysiology of pre-eclampsia and to assess the effect of renal function on isoprostane excretion in pre-eclampsia in the Ghanaian population. METHODS: This was a case-controlled study, comprising 103 pre-eclamptic women and 107 normal pregnant controls and conducted at the Korle-Bu Teaching Hospital between December 2006 and May 2007. The study participants were enrolled in the study after meeting the inclusion criteria and signing their written informed consent. Oxidative stress was determined by measuring urinary excretion of isoprostane and total antioxidant capacity using an enzyme-linked immunosorbent assay technique. Renal function was assessed by calculating the estimated glomerular filtration rate using the Modification of Diet in Renal Disease formula. RESULTS: The pre-eclampsia group had significantly (P = 0.0006) higher urinary isoprostane excretion (2.81 ± 0.14 ng/mg creatinine) than the control group (2.01 ± 0.18 ng/mg creatinine) and a significantly (P = 0.0008) lower total antioxidant power (1.68 ± 0.05 mM) than the control group (1.89 ± 0.04 mM). Urinary isoprostane excretion showed a positive correlation with both mean arterial pressure (r = 0.261) and microalbuminuria (r = 0.510) in the pre-eclampsia cases. The pre-eclampsia group had a significantly lower estimated glomerular filtration rate than the control group (P < 0.001), indicating more renal impairment. CONCLUSION: The increased urinary excretion of isoprostanes and decreased total antioxidant power in the in pre-eclampsia group suggest increased production of oxidants and depletion and/or reduction of maternal antioxidants. Increased oxidative stress may be important in the pathophysiology of pre-eclampsia by contributing to endothelial dysfunction, proteinuria, and hypertension.