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BACKGROUND: Late presentation with advanced HIV disease (LP-AHD) remains a significant challenge to Human Immunodeficiency Virus (HIV) care, contributing to increased morbidity, mortality, and healthcare costs. Despite global efforts to enhance early diagnosis, a considerable proportion of individuals with HIV infection are unaware of being infected and therefore present late for HIV care. For the first time in Ghana, this study assessed the prevalence of LP-AHD and associated factors among people diagnosed with HIV (PDWH). METHOD: This bi-center retrospective cross-sectional study included 315 PDWH at the Aniniwah Medical Centre and Komfo Anokye Teaching Hospital, both in Kumasi, Ghana. A well-structured questionnaire was used to collect data on sociodemographic, clinical, lifestyle and psychosocial factors from the study participants. Statistical analyses were done in SPSS version 26.0 and GraphPad Prism version 8.0 at significant p-value of < 0.05 and 95% confidence interval. Predictors of LP-AHD were assessed using binary logistic regression models. RESULTS: This study observed that, 90 out of the 315 study PDWH (28.6%) reported late with advanced HIV disease (AHD). Participants within the age group of 36-45 years (adjusted Odds Ratio [aOR]: 0.32, 95% CI: 0.14-0.69; p = 0.004) showed a significantly decreased likelihood of LP-AHD. However, participants who perceived cost of HIV care to be high (aOR: 7.04, 95% CI: 1.31-37.91; p = 0.023), who were diagnosed based on clinical suspicion (aOR: 13.86, 95 CI: 1.83-104.80; p = 0.011), and missed opportunities for early diagnosis by clinicians (aOR: 2.47, 95% CI: 1.30-4.74; p = 0.006) were significantly associated with increased likelihood of LP-AHD. CONCLUSION: The prevalence of LP-AHD among PDWH in Ghana is high. Efforts to improve early initiation of HIV/AIDS care should focus on factors such as the high perceived costs of HIV care, diagnosis based on clinical suspicion, and missed opportunities for early diagnosis by physicians.
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Infecciones por VIH , Humanos , Ghana/epidemiología , Femenino , Masculino , Infecciones por VIH/epidemiología , Infecciones por VIH/diagnóstico , Adulto , Persona de Mediana Edad , Estudios Transversales , Prevalencia , Estudios Retrospectivos , Diagnóstico Tardío/estadística & datos numéricos , Adulto Joven , Factores de Riesgo , Encuestas y CuestionariosRESUMEN
Background: WHO recommends HBV-negative babies in high-prevalence (8%) countries receive anti-HBV vaccination. Ghana initiated mass immunization in 2002, but concerns remain about vaccine effectiveness and long-term protection. We evaluated immune characteristics and factors following hepatitis B vaccination among Ghanaian adolescents who received HBV vaccines. Methods: In this longitudinal cross-sectional study, 74 participants were enrolled from the Kumasi Metropolis, Ghana. Sociodemographic and lifestyle characteristics of participants were obtained using a questionnaire. Blood samples were obtained before and after booster administration for anti-HBsAg, IL-6, and IL-10 estimations using ELISA kit (Shanghai Chemical Ltd., China). Anti-HBsAg titers ≥10 mIU/ml were considered protective. Statistical analyses were done using SPSS version 26.0 and R programming language, p < 0.05 was considered statistically significant. Results: We found 100% seroconversion rate, with 25.7% seroprotection rate (anti-HBsAg >10 mIU/ml). Gender (p=0.009), age (p=0.001), and exercising (p=0.044) were significantly associated with seroprotection. Following booster administration, 59.4% were hyporesponders (10 ≤ anti-HBsAg titre ≤99 mIU/ml) whilst 40.6% were good responders (anti-HBsAg titre ≥100 mIU/ml). Exercise (p=0.034) was significantly associated with immune response after booster administration. Moreover, we reported significant positive correlation between cytokines [IL-6 (r = 0.817, p < 0.001) and IL-10 (r = 0.928, p < 0.001)] and anti-HBsAg titre. Conclusion: Approximately two thirds of adolescents vaccinated at birth lack protective levels of antibodies against hepatitis B virus. Booster vaccines could aid in mounting protective levels of anti-HBsAg. Physical exercise was negatively associated with immune response to hepatitis B vaccinations.
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Background: Hepatitis B is a potentially life-threatening liver infection caused by the hepatitis B virus (HBV) and major global health problem, affecting millions of people globally. Whilst college or university students could serve as a positive vehicle that may aid in the propagation of education in the communities, there is currently paucity of data on knowledge of HBV and vaccination awareness among university students in Ghana. This study therefore assessed knowledge on hepatitis B virus infection, testing, and vaccination awareness among science and non-science students in Ghana. Method: This cross-sectional study included 386 students from the Garden City University College, Kumasi, Ghana, from February to June 2022. A well-structured questionnaire was used to obtain data on knowledge, testing, HBV vaccination status, and sociodemographic characteristics of participants. All statistical analyses were done using SPSS Version 26.0 and GraphPad prism version 8.0. A Chi-square test statistic and logistics regression analyses were used to determine factors associated with study variables among study participants. p value of <0.05 and 95% confidence interval were considered statistically significant. Results: About half (51.5%) of the participants had adequate knowledge on hepatitis B infection with 22.3% demonstrating poor knowledge on hepatitis B infection. A little more than average (51.6%) previously tested for hepatitis B (HBV) whilst 32.9% were highly aware of hepatitis B vaccination and 33.9% were not aware of hepatitis B vaccination. This study found that ethnicity of students (p=0.0020), family history of hepatitis B infection (p=0.0160), and academic cumulative weighted average (CWA) (p=0.0020) were significantly associated with knowledge about hepatitis B infection. Also, students reading science-related programs had more than twice the odds (aOR = 2.56, 95% CI (1.03-5.08), p=0.0210) of having tested for HBV infections before compared to students who read non-science programs. Furthermore, sex (p < 0.0001), family history of HBV vaccination (p=0.0260), CWA (p=0.0060), and the program of students (p=0.0020) were significantly associated with awareness of HBV vaccination. Conclusion: Knowledge of HBV infection among university students is satisfactory but awareness of HBV vaccination and testing is poor. There is a need to enhance educational interventions to improve the general knowledge of HBV infection, testing, and vaccination in Ghana especially among non-science students.
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Background: Street food is a vital component of cities and towns in developing countries. However, food poisoning has been associated with inadequate knowledge of food safety practices and inappropriate food handling. We examined the knowledge, attitude, and practices of street food sellers in the Takoradi Submetropolis, Ghana, on food safety and hygienic practice. Method: In this descriptive cross-sectional study, 406 street food vendors were recruited based on a simple random sampling technique from the Sekondi-Takoradi Metropolis, Ghana, using a structured questionnaire. Data collected were analyzed with the chi-square test and binary logistic regression using Stata (version 16) software. Statistical significance was set at p < 0.05. Results: The level of knowledge was low among 70.4% of the food vendors, and 51% had negative attitudes towards food safety and hygiene. Food hygiene practices were also poor among 52.3% of the participants. The predictors of low knowledge level were senior high (aOR = 0.37, 95% CI (0.19-0.70), p = 0.002) and junior high education (aOR = 0.52, 95% CI (0.27-0.99), p = 0.047). Having senior high education (aOR = 0.37, 95% CI (0.17-0.82), p = 0.014), prior training on food safety and hygiene (aOR = 0.50, 95% CI (0.29-0.84), p = 0.010), and having high level of knowledge (aOR = 0.33, 95% CI (0.20-0.54), p = 0.001) were associated with lower likelihood of negative attitude towards food safety and hygiene. Moreover, having junior high education (aOR = 6.20, 95% CI (2.78-13.87), p = 0.001), high level of knowledge (aOR = 4.70, 95% CI (2.77-7.98), p = 0.001), and positive attitude towards food safety and hygiene (aOR = 1.76, 95% CI (1.08-2.87), p = 0.023) were associated higher odds of good food practice. Conclusion: Knowledge and attitude regarding food safety and hygienic practices was poor among street food vendors. Future initiatives should focus on establishing training programs for food vendors within the metropolitan assembly to improve their knowledge on food safety and hygienic practices.
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Background and Aim: Frailty is a condition marked by accumulation of biological deficits and dysfunctions that come with aging and it is correlated with high morbidity and mortality in patients with cardiovascular diseases, particularly hypertension. Hypertension continues to be a leading cause of cardiovascular diseases and premature death globally. However, there is dearth of literature in sub-Saharan Africa on frailty syndrome among hypertensives on medication. This study evaluated frailty syndrome and its associated factors among Ghanaian hypertensives. Methods: This cross-sectional study recruited 303 patients with hypertension from the University Hospital, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana. Data on sociodemographic, lifestyle and clinical factors were collected using a well-structured questionnaire. Medication adherence was measured using Adherence in Chronic Disease Scale, and frailty was assessed by Tilburg Frailty Indicator. Statistical analyses were performed using SPSS Version 26.0 and GraphPad prism 8.0. p-value of < 0.05 and 95% confidence interval (CI) were considered statistically significant. Results: The prevalence of frailty was 59.7%. The proportion of high, medium and low medication adherence was 23.4%, 64.4% and 12.2%, respectively. Being ≥ 70years (adjusted odds ratio [aOR]: 8.33, 95% CI [3.72-18.67], p < 0.0001), unmarried (aOR: 2.59, 95% CI [1.37-4.89], p = 0.0030), having confirmed hypertension complications (aOR: 3.21, 95% CI [1.36-7.53], p = 0.0080), medium (aOR: 1.99, 95% CI [1.05-3.82], p = 0.0360) and low antihypertensive drug adherence (aOR: 27.69, 95% CI [7.05-108.69], p < 0.0001) were independent predictors of increased odds of developing frailty syndrome. Conclusion: Approximately 6 out of 10 Ghanaian adult patients with hypertension experience frailty syndrome. Hypertension complications, older age, being unmarried, and low antihypertensive drug adherence increased the chances of developing frailty syndrome. These should be considered in intervention programmes to prevent frailty among patients with hypertension.
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BACKGROUND: T cell receptors play important roles in the development and progression of rheumatoid arthritis (RA). Their involvement has been reported in inflammatory autoimmune diseases. However, their role in predicting RA is still under exploration. This study evaluated the expression of CD183 (CXCR3) receptors on T-cells and other relevant biomarkers for detecting RA and determine their relationship with disease activity. METHODS: This unmatched case-control study included 48 newly diagnosed RA patients and 30 apparent healthy controls from the orthopedic units of Komfo Anokye Teaching Hospital (KATH), Kumasi and Korle-Bu Teaching Hospital (KBTH), Accra, Ghana. Sociodemographic data was obtained, and blood samples were also collected and processed for flow cytometric analysis. Statistical analyses were done using SPSS version 26.0 and R programming language. p < .05 was considered statistically significant. RESULTS: This study found a significant difference in age group (p < .0001), marital status (p = .0210), occupation (p = .0140), educational level (p = .0210) and religion (p = .0100) between RA patients and healthy controls. Moreover, hemoglobin level (p = .0010), waist circumference (p < .0001) and hip circumference (p = .0040) were significantly different between RA patients and controls. RA patients had significantly lower levels of CD4+ CD183+ compared with the control group (p < .001), and was positively correlated with DAS score (r = .0397, p = .789). In Receiver Operator Characteristics analysis, CD4+ CD183+ could significantly detect RA with a high area under the curve (AUC = 0.687, p = .018). At a cut-off of 0.082, CD4+ CD183+ was the best receptor biomarker for detecting RA with a sensitivity of 90.0%, specificity of 25.9%, a positive predictive value of 69.2%, and a negative predictive value of 58.3%. CONCLUSION: CD4+ CD183+ best predict RA and is positively correlated with disease activity. CD4+ CD183+ could serve as diagnostics and disease-monitoring biomarker for RA; however, it demonstrates low specificity. Future studies should be directed on CD4+ CD183+ and other biomarkers to augment their diagnostics performances and routine management in RA.
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Artritis Reumatoide , Enfermedades Autoinmunes , Humanos , Ghana , Estudios de Casos y Controles , Artritis Reumatoide/diagnóstico , Linfocitos T CD4-PositivosRESUMEN
INTRODUCTION: Thyroid disorders and diabetes mellitus coexist and are prevalent endocrinopathies among adult population. Thyroid dysfunction contributes to metabolic imbalances, increase beta-cell apoptosis and glucose intolerance. There is paucity of data and contradicting findings on how thyroid dysfunction influence glycaemic control. Therefore, we evaluated thyroid dysfunction and glycaemic control among Type 2 diabetes mellitus (T2DM) patients in Ghana. METHODS: A comparative cross-sectional study was conducted among 192 T2DM patients from Effia Nkwanta Regional Hospital. Three consecutive monthly fasting plasma glucose (FBG) and glycated haemoglobin (HbA1c) were analysed and the results were classified as, moderate hyperglycaemia (MH) (FBG = 6.1-12.0 mmol/L, HbA1c < 7%), severe hyperglycaemia (SH) (FBG ≥ 12.1 mmol/L, HbA1c > 7%) and good glycaemic controls (GC) (FBG = 4.1-6.0 mmol/L, HbA1c < 7%). Thyroid-stimulating hormone (TSH), free triiodothyronine (FT3) and free thyroxine (FT4), body mass index (BMI) and other clinical parameters were measured. Data analysis was done using R language version 4.0.2 and p < .05 was considered statistically significant. RESULTS: There were no significant differences in age (years) between patients in the various glycaemic groups (p = .9053). The overall prevalence of thyroid disorders was 7.8% among T2DM patients. The prevalence of thyroid disorders was higher in patients with SH (11.7%) followed by those with MH (7.5%) and then those with GC (5.4%). Serum levels of TSH and FT3/FT4 ratio were significantly lower in T2DM patients with SH compared to those with MH and the GC (p < .0001). However, FT4 was significantly higher in SH patients compared to the good glycaemic controls (p < .01). The first tertiles of TSH [aOR = 10.51, 95% CI (4.04-17.36), p < .0001] and FT3 [aOR = 2.77, 95% CI (1.11-6.92), p = .0290] were significantly and independently associated with increased odds of hyperglycaemia. CONCLUSION: The prevalence of thyroid dysfunction is high in T2DM and increases with hyperglycaemia. Reduced TSH and T3 may worsen glycaemic control. Periodic monitoring of thyroid function should be incorporated into management guidelines among T2DM patients in Ghana.
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Diabetes Mellitus Tipo 2 , Hiperglucemia , Adulto , Humanos , Diabetes Mellitus Tipo 2/complicaciones , Diabetes Mellitus Tipo 2/epidemiología , Glándula Tiroides , Estudios Transversales , Pruebas de Función de la Tiroides , Hemoglobina Glucada , Ghana/epidemiología , Control Glucémico , Tirotropina , Hiperglucemia/epidemiología , Hiperglucemia/etiologíaRESUMEN
Method: In a comparative experimental cross-sectional study, RNA was extracted from oral swabs and blood samples from 25 healthy individuals at the Department of Molecular Medicine, KNUST. RNA was extracted by the manual AGPC extraction method and commercial RNA extraction kits. The quantity (ng/µl) and purities (260/280 nm) of the extracted RNA were measured spectrophotometrically using the IMPLEN NanoPhotometer® N60. The presence of RNA in the extracts was confirmed using 2% agarose gel electrophoresis. Statistical analyses were conducted using R language. Results: The yield of RNA extracted from blood and oral swab samples using modified AGPC was significantly higher compared to the commercial methods (p < 0.0001). However, the purity of RNA extracted by the manual AGPC method from blood was significantly lower than the commercial methods (p < 0.0001). Moreover, the purity from oral swabs using the manual AGPC method was significantly lower compared to QIAamp (p < 0.0001) and the OxGEn kits method (p < 0.001). Conclusion: The modified manual AGPC method has a very high yield of RNA extracts using blood samples, which could serve as an alternate cost-effective method for RNA extraction in resource-limited laboratories; however, its purity may not be suitable for downstream processes. Moreover, the manual AGPC method may not be suitable for extracting RNA from oral swab samples. Future investigation is needed to improve the purity of the manual AGPC RNA extraction method and also confirmation of the obtained results by PCR amplification and RNA purity verification by sequencing.