Immune checkpoint molecules B7-1 and B7-H1 as predictive markers of pre-eclampsia: A case-control study in a Ghana.

BACKGROUND/AIM: Immune tolerance in the fetal-maternal junction is maintained by a balance in the Th1/Th2 system. Th1-type immunity is associated with pro-inflammatory cytokines and immune checkpoint molecules (ICMs) such as B7-H1, while Th2-type immunity is characterized by anti-inflammatory cytokines and ICMs such as B7-1. Any imbalance in the Th1/Th2 immune system may lead to adverse pregnancy outcomes such as pre-eclampsia (PE). Hitherto, the potential of serum B7-1 and B7-H1 proteins as early markers of PE has not been explored in the Ghanaian population. MATERIALS AND METHODS: This was a case-control study from May 2020 to April 2022 at the War Memorial and the Upper East Regional Hospitals. The study involved 291 women, including 180 (61.9%) with normotensive pregnancy and 111 (38.1%) with PE. Venous blood samples were collected and assayed for blood cell count, serum interleukins (ILs)-4, -6, -12, -18, and TNF-α as well as serum B7-1 and B7-H1 proteins. RESULTS: The monocyte count (p = .007), the serum levels of IL-18 (p = .035), TNF-α (p = .001), and B7-H1 (p = .006) were significantly higher in PE than in normotensive pregnancy. In addition, the monocyte count (p = .002), the serum levels of IL-12 (p = .029), TNF-α (p = .016), and B7-1 (p = .009) levels were significantly higher in the third trimester than the second trimester PE. In predicting PE, the area under the curve of cytokines and ICMs ranged from 0.51 for IL-6 to 0.62 for TNF-α. CONCLUSION: PE may be characterized by a dominant Th1-type immunity with higher levels of pro-inflammatory cytokines and B7-H1 proteins, but these variables may not be suitable for predicting PE.

Are sex differences in blood cell count and hemoglobin moderated by the 2D:4D ratio? A cross-sectional study in a Ghanaian population.

Background and Aims: There are sex differences in blood cell count and hemoglobin (HGB) in adulthood due to differences in the levels of circulating sex hormones. The second-to-fourth digit ratio (2D:4D) is the putative marker of prenatal hormone exposure. The 2D:4D or the right-left difference (Dr-l) are sexually dimorphic and are correlates of sex hormones in adulthood. The study sought to determine whether sex differences in adult blood cell count and HGB can be partly explained by the 2D:4D or Dr-l. Methods: The study was cross-sectional between June and December 2021 at the University for Development Studies. The study involved 207 healthy participants (females = 113) aged from 18 to 32 years. The right-hand (2D:4DR), and the left-hand (2D:4DL) digit ratio and their difference (Dr-l) were measured using Computer-assisted analysis. Blood cell count, HGB, testosterone, and estradiol were measured from venous blood samples using an automated HGB analyzer and ELIZA technique. Results: The platelet count was inversely related to the 2D:4DR in the total sample with the 2D:4DR accounting for about 0.2% (adjR 2 = 0.002) of the variability in platelet count. However, there was a sex difference as indicated by the significant interaction between sex and the 2D:4DR on platelet count (p = 0.03). The relationship between platelet count and the 2D:4DR was negative in females but positive in males. Also, there was a positive relationship between HGB concentration and the Dr-l in the total study sample, where the Dr-l accounted for about 0.6% (adjR 2 = 0.006) of the variability in HGB concentration. Sex interacted significantly with the Dr-l on HGB concentration (p = 0.01) such that the relationship between HGB and the Dr-l was positive in females but negative in males. Conclusion: Prenatal hormone exposure, as indexed by the 2D:4D ratio, may partly account for the observed sex differences in platelet count and HGB levels in adulthood.

Insulin Resistance in relation to Hypertension and Dyslipidaemia among Men Clinically Diagnosed with Type 2 Diabetes.

Pathophysiologically, type 2 diabetes can result from insulin resistance or insulin insufficiency alone. It is unclear whether relative insulin shortage or pronounced insulin resistance is linked to poor cardiometabolic problems like obesity. Therefore, the objective of this study was to evaluate the relationship between insulin resistance (IR), hypertension, and dyslipidaemia, in men with type 2 diabetes mellitus. One hundred and twenty-one (121) type 2 diabetic men participated in this cross-sectional study, which was conducted between September 2018 and September 2019. Sociodemographic information was collected using a self-designed questionnaire. Anthropometric data were also taken and blood samples collected for estimation of insulin, glucose, and lipid concentrations. HOMA-IR was calculated from the fasting insulin and glucose values, and a HOMA - IR ≥ 2 was considered to indicate insulin resistance. Of the 121 participants, 39.7% were classified as insulin-resistant. Levels of total cholesterol (4.82 ± 1.2 mmol/L; p = 0.007 vs. 4.25 ± 1.1 mmol/L), LDL cholesterol (3.17 ± 0.9 mmol/L; p = 0.001 vs. 2.52 ± 0.8 mmol/L), and TC/HDL-C ratio (3.93 ± 0.9; p = 0.042 vs. 3.58 ± 0.9) and the prevalence of abnormal LDL-C (14.6%; p = 0.015 vs. 2.7%) and elevated BP (83.3%; p = 0.048 vs. 67.1%) were higher in the insulin-resistant group. LDL cholesterol (AUC = 0.670; p = 0.001) better classified subjects as being insulin-resistant compared to other lipid markers. The odds of insulin resistance in dyslipidaemia were not statistically significant after adjusting for obesity. The link between insulin resistance and dyslipidaemia and hypertension in male diabetics may thus be mediated by obesity.

Sex-moderated relationship between the 2D:4D ratio and circulating hormones in an adult Ghanaian population.

The second-to-fourth digit ratio (2D:4D) is the putative marker of prenatal hormone exposure. The 2D:4D ratio or the right-left difference (Dr-l) are said to be negative and positive correlates, respectively, of circulating testosterone and estrogen in both adult males and females. However, previous studies on the subject have reported mixed results. This study aimed to determine the sex-moderated relationship between the 2D:4D ratio and adult circulating testosterone, estradiol, testosterone-to-estradiol ratio and the free androgen index. This was a cross-sectional study from January to June 2021 at the University for Development Studies, Ghana. The study involved 62 participants (Female = 28; Male = 34), aged between 20 and 26 years. The right (2D:4DR), the left (2D:4DL), and their difference (Dr-l) were measured by computer-assisted analysis. Fasting venous samples were assayed for total testosterone (T), estradiol (E2 ), and sex hormone-binding globulin (SHBG) using ELISA. The free androgen index (FAI) was then calculated (T/SHBG) and the data were analyzed using moderated and/or weighted regression. Males had significantly higher T and FAI than females while females had significantly higher E2 than males, which were independent of age and body mass index (p < 0.001). There was a significant SEX*Dr-l interaction on FAI (p = 0.007). The Dr-l correlated negatively with FAI in males but positively in females and accounted for about 94.0% of the variability of FAI in males (adjR2  = 0.940) and only 0.2% in females (adjR2  = 0.002). The 2D:4D ratio, a putative marker of prenatal hormone exposure, may have an impact on sex differences in adult free androgen index.

Changes in testicular arterial hemodynamic, gonadotropin levels, and semen parameters among varicocele patients randomized to varicocelectomy or observed in Tamale, Ghana.

OBJECTIVE: A randomized trial to compared testicular blood flow parameters, gonadal hormones, and semen characteristics among three groups; surgery group (n = 127); observed group (n = 114); and healthy controls (n = 33). METHODS: The blood flow parameter selected was resistive index (RI) measured using color Doppler ultrasonography. Serum total testosterone, FSH, LH were measured, and semen analysis performed at baseline and repeated 12 months of follow-up. The data was computed using GraphPad Prism (v8.0) at an alpha of 0.05. RESULTS: In the observed group, increased +0.0060 in the right (R_RI) and in the left (L_RI) +0.0026 capsular arteries from baseline measurement to 12 months follow-up. Surgery group, reduced -0.079 in the right (R_RI) and -0.0731 in the left (L_RI) capsular arteries (p < 0.0001). At 12 months, the changes for both left and right RIcap in the surgery group did not reach the values of the controls. In the surgery group, L_RIcap (r = -0.63; p < 0.0001) and R_RIcap (r = -0.49; p = 0.004) correlated with total testosterone, FSH (r = 0.57; p = 0.001 for left; r = 0.52; p = 0.002 for right), and LH (r = 0.61; p = 0.0002 for left; r = 0.41; p = 0.020 for right). Furthermore, L_RIcap correlated with changes in sperm count (r = -0.46; p = 0.008) and sperm concentration (r = -0.35; p = 0.011) in the surgery group. CONCLUSION: Microsurgical sub-inguinal varicocelectomy improves blood supply to the testicular tissues evidenced by reduced resistive index in the surgery group. Resistive index in the left capsular artery can be used to evaluate the success of surgery because it correlates with total testosterone, FSH, LH, and semen quality.

Does sex interact with the 2D:4D ratio or adult circulating hormones on the estimated glomerular filtration rate? A cross-sectional study in Ghana.

The 2D:4D ratio is the putative marker of prenatal hormone exposure and has been suggested as a correlate of adult circulating testosterone and estrogen. The study aimed to determine whether sexual dimorphism in the estimated glomerular filtration rate (eGFR) can be partly explained by the 2D:4D ratio or adult circulating testosterone or estrogen. The study was cross-sectional from June to December 2021 at the University for Development Studies. The study involved 206 healthy adults (Female = 93, Male = 113) between 18 and 30 years. The 2D:4D ratio was measured using computer-assisted analysis. Venous blood samples were collected and analyzed for testosterone, estradiol and creatinine using the ELISA technique and routine biochemical analysis. The adjusted eGFR was calculated using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) creatinine equation (2021). The eGFR and the testosterone-to-estradiol ratio (TT:E2 ) were significantly higher in males than in females (p < 0.001). There was a significant interaction between sex and the TT:E2 on the eGFR (p < 0.001). Although the relationship between the eGFR and the TT:E2 was negative in both males and females, a unit change in the TT:E2 had a greater impact on the eGFR in females (B = -1.38) than in males (B = -0.01). Sexual dimorphism in the eGFR is influenced by both testosterone and estradiol. Although the sex difference in the eGFR may be influenced by the TT:E2 , estrogen seems to account for more variability in the eGFR than testosterone.

Sexual Dimorphism and Sex-2D : 4D Interactions on Fasting Lipid Variables in an Adult Ghanaian Population.

Prenatal hormone exposure has been suggested as a correlate of adult circulating estrogen and testosterone. If this observation is true, then prenatal hormone exposure may have an association with lipid homeostasis in adulthood. The study sought to investigate sexual dimorphism and the interactions between the putative marker of prenatal hormone exposure (2D : 4D) and sex on adult fasting plasma lipid variables. The study was cross-sectional from June to December 2021 at the University for Development Studies. The participants were between 18 and 30 years of age and consisted of 206 healthy persons (female = 93, male = 113). The right hand (2D : 4DR), the left hand (2D : 4DL), and the right-left 2D : 4D difference (Dr-l) were measured using computer-assisted analysis. Fasting venous blood samples were collected and analyzed for lipid variables including total cholesterol (TCHOL) and high-density lipoprotein cholesterol (HDL-C). There were no significant differences in the 2D : 4D ratio and lipid variables between males and females. However, after adjusting for age and BMI, the 2D : 4DR (P = 0.014) and the 2D : 4DL (P = 0.007) increased with increasing fasting plasma HDL-C on average. Moreover, there were significant interactions between sex and the 2D : 4DR (P = 0.002) and also, the 2D : 4DL (P = 0.005) on fasting plasma HDL-C. The relationship between HDL-C and the 2D : 4D ratio was positive in females but negative in males. The 2D : 4DR accounted for about 54.9% and 46.0% while the 2D : 4DL accounted for about 48.2% and 14.0% of the variabilities in fasting plasma HDL-C in females and males, respectively. Prenatal hormone exposure may partly account for the sexual dimorphism in adult lipid homeostasis.

The association between the 2D:4D ratio and offspring sex at birth: A cross-sectional study in Ghana.

OBJECTIVES: The 2D:4D ratio is the putative marker of prenatal androgen exposure. Low maternal 2D:4D ratio has been associated with high or male-biased secondary sex ratio. Hitherto, there has not been any study in Ghana regarding the maternal 2D:4D ratio and sex ratio at birth. This study sought to investigate this observation in a Ghanaian population. METHOD: The study was cross-sectional from December 2020 to April 2021 involving 272 first-time mothers. The mean ± SD age of the mothers was 23.9 ± 3.67 years. The right (2D:4DR), the left (2D:4DL), the mean (M2D:4D) digit ratios and the right-left difference (Dr-l) of the mothers were measured using computer-assisted analysis. The mothers were stratified by their digit ratios, and the cohort sex ratio (CSR) for each stratum was then calculated as the proportion of sons. RESULTS: The mean ± SD of the 2D:4DR of mothers-with-daughters and mothers-with-sons were 0.941 ± 0.032 and 0.933 ± 0.037, respectively. The mean ± SD of the 2D:4DL of mothers-with-daughters was 0.934 ± 0.034, while that of mothers-with-sons was 0.931 ± 0.039. The offspring sex at birth and the CSR was not associated with either the mother's right, left, mean 2D:4D ratio or their difference (Dr-l). However, mothers-with-daughters showed rightward asymmetry in their 2D:4D ratios as the Dr-l significantly and positively deviated from zero (p < .010). CONCLUSION: The maternal 2D:4D ratio may not be associated with their offspring sex at birth among first-time mothers. This study adds to the limited data on studies regarding offspring sex at birth and the 2D:4D ratio in Ghana and Sub-Saharan Africa.

The relationship between offspring's 2D:4D ratio and postpartum maternal circulating testosterone, estradiol, and their indices in a Ghanaian population.

OBJECTIVES: The 2D:4D ratio is influenced by prenatal testosterone (PT) and estrogen (PE) exposure in utero. This study sought to determine whether evidence of Manning's hypothesis can still be observed even in the postpartum period. We hypothesize that the offspring 2D:4D ratios will be inversely correlated with maternal postpartum circulating testosterone but positively correlated with estradiol. METHODS: This study was conducted between December 2020 and April 2021 and was cross-sectional in nature. There were 272 mother-offspring pairs; the mothers were aged between 18 and 36 years while the median (IQR) age of their offspring was 111 (44-210) days. Offspring right (2D:4DR) and left (2D:4DL) digit ratios were measured using computer-assisted analysis. Sampling was done at 111 (44-210) days postpartum and blood was analyzed for total testosterone (TT), estradiol (E2) and sex hormone-binding globulins using the enzyme-linked immunosorbent assay technique. RESULTS: The 2D:4DR of sons was significantly lower compared to daughters (p = .031). Mothers with sons had significantly increased levels of serum TT (p = .001) while mothers with daughters had significantly increased levels of E2 (p = .000). As hypothesized, the maternal serum free testosterone (FT%) was inversely correlated with their daughters' (r = -0.320, p = .003), and also with their sons' (r = -0.213, p = .047), 2D:4DL. Unexpectedly, daughters' 2D:4DL was inversely correlated with maternal circulating free E2 (r = -0.255, p = .015). CONCLUSIONS: In humans, evidence of the relationship between maternal testosterone levels and their offspring's 2D:4D ratio may persist even into the postpartum period.

The relationship between 2D:4D ratio and postpartum adult female variables in a Ghanaian population.

OBJECTIVES: Postpartum hematological and anthropometric assessment is a requirement for optimal maternal and child health. The study aimed to determine the relationship between the 2D:4D ratio and postpartum hematological and anthropometric variables in adult females. METHODS: The study was cross-sectional from December 2020 to April 2021 involving 272 postpartum adult females, aged between 18 and 36 years. The right (2D:4DR) and the left (2D:4DL) digit ratios were measured using computer-assisted analysis. Fasting venous samples were collected at a median (interquartile range) of 111 (44-210) days postpartum and analyzed for total testosterone (TT), estradiol, sex hormone-binding globulin, and complete blood count. RESULTS: The mean ± standard deviation 2D:4DR and 2D:4DL were 0.94 ± 0.04 and 0.93 ± 0.04, respectively. As expected, the TT (r = -0.198, p = .015) and the free androgen index (FAI: r = -0.186, p = .019) were inversely correlated with the 2D:4DL while free testosterone (FT%: r = -0.157, p = .038) was inversely correlated with the 2D:4DR. The absolute basophile count (BASO: r = -0.124, p = .040) and the Platelet-lymphocyte ratio (PLR: r = -0.153, p = .016) were inversely correlated with the 2D:4DL and the 2D:4DR respectively. In addition, the mean cell volume was inversely correlated with the 2D:4DR (r = -0.139, p = .024) and the 2D:4DL (r = -0.122, p = .045). Moreover, the 2D:4DR was inversely correlated with height (r = -0.164, p = .007). Unexpectedly, the red blood cell count (RBC: r = 0.138, p = .025) was positively correlated with the 2D:4DR. CONCLUSION: There are significant relationships between the 2D:4D ratio and postpartum female variables. These findings are useful preliminary reference data for postpartum research and subsequent 2D:4D ratio studies.

Second to fourth (2D:4D) digit ratio and their relationships among a mother and child population in Ghana.

The study aimed to determine the relationship between digit ratios among a mother-child population in Ghana. This was a cross-sectional study from December 2020 to April 2021 involving 272 mothers, their daughters (n = 132) and their sons (n = 140). The right (2D:4DR) and the left (2D:4DL) digit ratios were measured using computer-assisted analysis. The data were analysed in SPSS (v23) and GraphPad Prism (v8) at an alpha value of 0.05. The mean ± SD age of the mothers was 23.9 ± 3.67 years while the median (IQR) age of daughters was 116(54-240) days and sons, 134(54-240) days. The mean ± SD 2D:4DR were 0.94 ± 0.04, 0.91 ± 0.04 and 0.90 ± 0.04 respectively for mothers, daughters and sons. The mean ± SD 2D:4DL was 0.93 ± 0.04, for mothers, 0.92 ± 0.05 for daughters and 0.92 ± 0.05 for sons. The daughters and sons showed leftward asymmetry while the mothers showed rightward asymmetry in digit ratios. The 2D:4DR of sons was significantly lower than daughters (P = 0.031). There were negative correlations between the 2D:4DL and age of daughters (r = -0.182, P = 0.043) and sons (r = -0.221, P = 0.012). The 2D:4DR of mothers was positively correlated with that of daughters (r = 0.332, P = 0.000) and that of sons (r = 0.233, P = 0.008). There are significant relationships between digit ratios in a mother-child population.

Comparative Abilities of Body Mass Index, Waist Circumference, Abdominal Volume Index, Body Adiposity Index, and Conicity Index as Predictive Screening Tools for Metabolic Syndrome among Apparently Healthy Ghanaian Adults.

The prevalence of the metabolic syndrome (MetS) continues to increase. There is therefore the need for early detection to avert possible adverse outcomes. Several anthropometric methods have been suggested to predict MetS, but no consensus has been reached on which is best. The aim of the study was to explore the comparative abilities of conicity index, body adiposity index, abdominal volume index, body mass index, and waist circumference in predicting cardiometabolic risk among apparently healthy adults in the Tamale metropolis. This study was a cross sectional study conducted from September 2017 to January 2018, among one hundred sixty (160) apparently healthy normoglycemic normotensive adults. A self-designed questionnaire was administered to gather sociodemographic data. Anthropometric and haemodynamic measurements were also taken. Blood samples were collected for fasting blood glucose (FBG) and lipid profile. MetS was classified using the harmonised criteria as indicated by the joint interim statement (JIS). Of 160 participants, 42.5% were male and 57.5% were female. Body mass index (BMI) and waist circumference (WC) associated better with MetS and other cardiovascular risk factors. Generally, BMI and WC showed largest area under curves (AUCs) than abdominal volume index (AVI), body adiposity index (BAI), and conicity index (CI) in predicting MetS and its components. Upon gender stratification, AVI and CI had the larger AUCs in females whiles BMI remained the superior index in males. Whiles BMI and WC remained useful parameters, they were not useful in predicting MetS and its components in the female population in this study.

Comparative Abilities of Fasting Plasma Glucose and Haemoglobin A1c in Predicting Metabolic Syndrome among Apparently Healthy Normoglycemic Ghanaian Adults.

There are arguments as to whether haemoglobin A1c (HbA1c) better predicts Metabolic syndrome (MetS) than fasting plasma glucose. The aim of the study was to explore the comparative abilities of HbA1c and Fasting plasma glucose (FPG) in predicting cardiometabolic risk among apparently healthy adults in the Tamale metropolis. This study was a cross-sectional study conducted in the Tamale metropolis from September, 2017, to January, 2018, among one hundred and sixty (160) apparently healthy normoglycemic adults. A self-designed questionnaire was administered to gather sociodemographic data. Anthropometric and haemodynamic data were also taken and blood samples collected for haemoglobin A1c (HbA1c), fasting plasma glucose (FPG), and lipid profile. MetS was classified using the harmonised criteria as indicated in the joint interim statement (JIS). Out of the 160 participants, 42.5% were males and 57.5% were females. FPG associated better with MetS and other cardiovascular risk markers, compared to HbA1c. FPG had the largest area under curve for predicting MetS and its components. This study shows a stronger association between FPG and MetS compared with haemoglobin A1c; it also provides evidence of a superior ability of FPG over HbA1c in predicting MetS and other adverse cardiovascular outcomes in apparently heathy normoglycemic individuals.

Diagnosis of bacterial meningitis in Ghana: Polymerase chain reaction versus latex agglutination methods.

Bacterial meningitis is a public health crisis in the northern part of Ghana, where it contributes to very high mortality and morbidity rates. Early detection of the causative organism will lead to better management and effective treatment. Our aim was to evaluate the diagnostic accuracy of Pastorex and Wellcogen latex agglutination tests for the detection of bacterial meningitis in a resource-limited setting. CSF samples from 330 suspected meningitis patients within the northern zone of Ghana were analysed for bacterial agents at the zonal Public Health Reference Laboratory in Tamale using polymerase chain reaction (PCR) and two latex agglutination test kits; Pastorex and Wellcogen. The overall positivity rate of samples tested for bacterial meningitis was 46.4%. Streptococcus pneumoniae was the most common cause of bacterial meningitis within the sub-region, with positivity rate of 25.2%, 28.2% and 28.8% when diagnosed using Wellcogen, Pastorex and PCR respectively. The Pastorex method was 97.4% sensitive while the Wellcogen technique was 87.6% sensitive. Both techniques however produced the same specificity of 99.4%. Our study revealed that the Pastorex method has a better diagnostic value for bacterial meningitis than the Wellcogen method and should be the method of choice in the absence of PCR.

Validity and Reliability of the Golombok-Rust Inventory of Sexual Satisfaction (GRISS) in Patients With Type 2 Diabetes.

Despite the wide use of the Golombok-Rust Inventory of Sexual Satisfaction (GRISS) in several populations, the instrument has yet to be validated among patients with type 2 diabetes. The aim of this study was to evaluate the validity and reliability of the GRISS for the estimation of clinically relevant sexual dysfunction among type 2 diabetes patients under clinical management. This cross-sectional study was conducted among a total of 136 and 126 type 2 diabetic males and females, respectively, using GRISS for male and female. Internal consistency, test-retest reliability, and scores of discriminant validity were calculated. Cronbach's alpha coefficient ranged from 0.71 to 0.90 in total samples of males and females. The values obtained were similar between the chronic diabetic patients with self-reported sexual problems and normal samples. Test-retest reliability gave fair scaling results of 0.94 overall for males and 0.97 for females using Pearson's correlation coefficient. GRISS subscales differentiated multivariately between men (F7,122 = 19.308; p = 0.000; eta2 = 0.721; power = 0.993) and women (F7,118 = 18.705; p = 0.000; eta2 = 0.526; power = 0.928) with and without sexual problems. GRISS appears to be valuable and reliable for use among the Ghanaian population. Regular use of the GRISS for the screening of sexual problems among diabetic patients appears warranted.

Acquired immune responses to three malaria vaccine candidates and their relationship to invasion inhibition in two populations naturally exposed to malaria.

BACKGROUND: Malaria still represents a major cause of morbidity and mortality predominantly in several developing countries, and remains a priority in many public health programmes. Despite the enormous gains made in control and prevention the development of an effective vaccine represents a persisting challenge. Although several parasite antigens including pre-erythrocytic antigens and blood stage antigens have been thoroughly investigated, the identification of solid immune correlates of protection against infection by Plasmodium falciparum or clinical malaria remains a major hurdle. In this study, an immuno-epidemiological survey was carried out between two populations naturally exposed to P. falciparum malaria to determine the immune correlates of protection. METHODS: Plasma samples of immune adults from two countries (Ghana and Madagascar) were tested for their reactivity against the merozoite surface proteins MSP1-19, MSP3 and AMA1 by ELISA. The antigens had been selected on the basis of cumulative evidence of their role in anti-malarial immunity. Additionally, reactivity against crude P. falciparum lysate was investigated. Purified IgG from these samples were furthermore tested in an invasion inhibition assay for their antiparasitic activity. RESULTS: Significant intra- and inter- population variation of the reactivity of the samples to the tested antigens were found, as well as a significant positive correlation between MSP1-19 reactivity and invasion inhibition (p < 0.05). Interestingly, male donors showed a significantly higher antibody response to all tested antigens than their female counterparts. In vitro invasion inhibition assays comparing the purified antibodies from the donors from Ghana and Madagascar did not show any statistically significant difference. Although in vitro invasion inhibition increased with breadth of antibody response, the increase was not statistically significant. CONCLUSIONS: The findings support the fact that the development of semi-immunity to malaria is probably contingent on the development of antibodies to not only one, but a range of antigens and that invasion inhibition in immune adults may be a function of antibodies to various antigens. This supports strategies of vaccination including multicomponent vaccines as well as passive vaccination strategies with antibody cocktails.

Perceptions of normal and abnormal ejaculatory latency times: an observational study in Ghanaian males and females.

BACKGROUND: This cross-sectional study aimed at quantifying the perceptions of Ghanaian men and women on how long they thought sex should last, from intromission until ejaculation. METHOD: A random sample of 568 heterosexual men and women within the Kumasi Metropolis was surveyed from December 2009 to February 2010. The question of primary interest in the present study includes perceived intravaginal ejaculatory latency (IELT), in minutes, for four different conditions: "adequate," "desirable," "too short," and "too long" IELT. RESULTS: The interquartile range for the respondent's judgment of an "adequate" length for IELT was from 7.0 to 20.3 min; "desirable" from 10.0 to 25.0 min; "too short" from 2.0 to 5.0 min; "too long" from 10.5 to 60.0 min. However, the "actual" IELT (i.e. what the respondents are capable of doing) as found in this study was from 6 to 15 min. Ghanaian perceptions about ejaculatory latencies were in part consistent with data from Germany and contrary to data from the USA on ejaculatory latency and were not affected by age or educational level. CONCLUSION: These results suggest that the average Ghanaian believes that intercourse that lasts 7.0-25.0 min is normal. Dissemination of the present finding to the public may modify their expectations for IELT which will lead to a realistic replica of sexuality and hence help prevent sexual disappointments and dysfunctions. It will also be beneficial to couples who are being treated for sexual problems by normalizing their expectations.

Sexual dysfunction and sexual quality of life among the physically challenged in the Kumasi metropolis, Ghana.

BACKGROUND: Despite the fact that the physically disabled have difficulties in many aspects of their lives, including sexuality, society often ignores these needs or assume that they have no such needs. This cross-sectional study therefore seeks to determine the prevalence of sexual dysfunction (SD) and its impact on the quality of life among persons with physical disability residing in the Kumasi metropolis, Ghana. METHOD: This study was conducted among 235 persons with physical disability dwelling in communities within the Kumasi metropolis, Ghana between September 2011 and April 2012. All participants were evaluated by using a semi-structured questionnaire, the Golombok Rust Inventory of Sexual Satisfaction (GRISS) questionnaire and the Sexual Quality of Life questionnaire (SQoL). Self-designed semi-structured questionnaire was also administered to each consented study participant for socio-demographic information. RESULTS: The response rates were 72% and 63.6% for male and female respectively. The age range of the male was 19-74 years with 61.1% being married whilst the age range of the female was 20-66 years with 54.3% being married. 30% and 7.1% of the male and female respectively consumed alcohol beverage. The mean Sexual quality of life (SQoL) score was slightly higher in the females (57.7 ± 15.8), ranging from 25.6 to 97.8. Univariate analysis of the male data showed that the only significant factor that tends to increase the male SD was alcohol (OR: 24.6; CI: 1.4 - 14.9; p = 0.0071). The prevalence of SD was higher among the female populace (65.7%) compared to the 64.4% for the male populace though very closely comparable. Except for non-communication (NC) and anorgasmia (impotence in males), all other areas of difficulty had higher percentages in males than females. CONCLUSION: The prevalence of sexual dysfunction among the physically challenged is comparable to prevalence rates in the able male and female population. This could impact significantly on their self-esteem and quality of life via avoidance, impotence and vaginismus thereby causing emotional distress leading to relationship problems. Alcohol increases the risk of developing SD by five-fold in physically challenged men.

Association between metabolic syndrome and sexual dysfunction among men with clinically diagnosed diabetes.

BACKGROUND: The worldwide epidemic of diabetes and obesity has resulted in a rapid upsurge in the prevalence of metabolic syndrome (MetS). MetS makes the individual liable to endothelial dysfunction which can initiate sexual dysfunction (SD). This study assessed the association between MetS and SD among clinically diagnosed diabetic subjects in Tema, Greater Accra Region of Ghana. METHOD: Sexual functioning was assessed using Golombok Rust Inventory of Sexual Satisfaction in 300 consecutive diabetic men visiting the diabetic clinic of Tema General Hospital between November, 2010 and March, 2011. Anthropometric data including waist and hip circumference as well as blood pressure were measured. The levels of fasting blood glucose and serum lipid profile were assessed. All the men had a steady heterosexual relationship for at least 2 years before enrolment in the study. RESULTS: The response rate was 91.3% out of the 300 subjects recruited for the study. Those with SD were significantly older and had diabetes for a longer period as compared to those without SD. The prevalence of MetS as defined by the various criteria was 78.8%, 43.4% and 51.8% for WHO, NCEP ATP III and IDF respectively. Central obesity (p = 0.0482) and raised blood pressure (p = 0.0309) are the significant MetS components when the studied population was stratified according to sexual functioning. Generally, SD as well as its sub-scales correlate positively with age, blood pressure, duration of diabetes and MetS score. Whereas TC and LDL-c correlated positively with non-communication, TG correlates positively with avoidance and infrequency. CONCLUSION: SD and its sub-scales have a direct relationship with duration of diabetes, blood pressure and MetS score from this study. Central obesity and raised blood pressure seem to be the link between MetS and SD among this clinically diagnosed diabetic subjects.

Oxidative stress and dyslipidaemia among ghanaian HAART-Naive HIV Patients and those on HAART

"Background: Pharmacogenomics/pharmacogenetics has the potential to mitigate adverse drug reactions and optimize pharmacotherapy in individuals. Over the past several years; there has been increasing attention towards the characterization of pharmacogenomic biomarkers in African populations; both locally and internationally. However; the perceptions of the African health care community towards pharmacogenomic testing have not been studied. Objectives: To assess knowledge and perceptions of pharmacogenomics among health care professionals in Benin City; Nigeria. Methods: In this preliminary and pilot investigation; we used a semi-structured qualitative survey methodology to understand the perceptions of pharmacists and pharmacologists towards pharmacogenomics in an academic care centre in Benin City; Nigeria. Three themes were explored: Knowledge and experience with pharmacogenetics; Expectations about how a pharmacogenetic testing service could be used; and Capacity building for pharmacogenetic service delivery.Results: Though none of the participants had received training or undertaken research in pharmaco-genomics; all participants were familiar with the field and listed beneficial outcomes associated with pharmacogenetic testing. Participants identified factors such as lack of funding; infrastructure; and manpower for limitations of pharmacogenomic testing in Nigeria. Participants listed numerous ethical issues and concerns in recruiting participants for research and introducing pharmacogenetics in the clinic; including the need to ""win the confidence of the people."" Conclusion: Pharmacists and pharmacologists in an academic centre in Nigeria are aware of the benefits of pharmacogenomics; but cite many hurdles to overcome before this field can become a routine part of patient care in their communities."