RESUMO
Background: Scientific information on the impact of malaria on the risk of developing type 2 diabetes mellitus (T2DM) after recovery from the coronavirus disease 2019 (COVID-19) is limited in the Ghanaian context. The purpose of this study was to examine the association between selected risk markers of T2DM in falciparum malaria patients post-COVID-19 or not at a tertiary hospital in Ghana. Methodology: This was a descriptive cross-sectional comparative study of 38-recovered COVID-19 adult participants with malaria and 40 unexposed COVID-19 adults with malaria at the Tamale Teaching Hospital, Ghana. Demographic, anthropometric and levels of glucose, insulin, C-reactive protein and lipid profiles were measured in the two groups of participants under fasting conditions. Parasitaemia was assessed microscopically but insulin resistance and beta-cell function were assessed by the homeostatic model. Results: The COVID-19 exposed participants were older (p=0.035) with lower parasitaemia (p=0.025) but higher mean levels of insulin, insulin resistance, and beta-cell function compared with their unexposed counterparts (p<0.05). Parasitaemia correlated positively with a number of the measured indices of diabetogenic risk markers in the COVID-19 exposed group only, and predicted (Adjusted R2=0.751; p=0.031) by beta-cell function, C-reactive protein and triglycerides with the model explaining about 75% of the observed variation. Parasitaemia could only be predicted (Adjusted R2=0.245; p=0.002) by C-reactive protein with the model explaining just about a quarter of the observed variation in the COVID-19 unexposed group. Insulin resistance and sub-optimal beta-cell function were detected in both groups of participants. Conclusion: Falciparum malaria is associated with risk markers for development of T2DM irrespective of COVID-19 exposure. Insulin resistance, inflammation and sub-optimal beta-cell secretory function may drive the risk. The observed diabetogenic risk is higher in the recovered COVID-19 participants.
Assuntos
Humanos , Masculino , Feminino , Malária Falciparum , Diabetes Mellitus Tipo 2 , COVID-19 , Inflamação , Fatores de RiscoRESUMO
The objective of this study was to determine the rate of ossification of the medial epiphysis of the clavicle and some of the different factors that may influence the rate of ossification in the Ghanaian population. The study was a retrospective study and was conducted at the University of Cape Coast hospital, Cape Coast, Ghana. Chest x-rays of 1035 first year University of Cape Coast students admitted, for the 2008/2009 academic year were used. Statistically significant differences were produced for some of the stages when sex comparisons were done using the t-test for two independent groups with a 95 percent confidence level. Stages 2 (p=0.001), stage 3 (p<0.001) and stage 4 (p=0-001). The age of onset of ossification of the medial clavicle appeared generally to be earlier in females than in males. The stage of partial ossification of the medial clavicular epiphysis also lasted longer than in other studies indicating a delay in the ossification at this stage. In conclusion conventional x-ray of the medial clavicle can be an effective tool in assessing forensic age of subjects for any purpose; however there is a need to develop reference values that are specific for particular geographical areas.
El objetivo de este estudio fue determinar la tasa de osificación de la extremidad esternal de la clavícula y determinar algunos de los diferentes factores que pueden influir en la tasa de osificación en la población de Ghana. Se efectuó un estudio retrospectivo en el hospital de la Universidad de Cape Coast, Cape Coast, Ghana. Se utilizaron 1035 radiografías de tórax de estudiantes admitidos al primer año de la Universidad de Cape Coast, el año académico 2008/2009. Se observaron diferencias estadísticamente significativas para algunas de las etapas en que se realizan comparaciones de sexo mediante el t-test para dos grupos independientes con un nivel de confianza del 95 por ciento. Etapas 2 (p = 0,001), la etapa 3 (p <0,001) y la etapa 4 (p = 0-001). La edad de inicio de la osificación de la extremidad esternal de la clavícula aparecía generalmente antes en las mujeres que en los hombres. La etapa de osificación parcial de las extremidad esternal de la clavícula también duró más tiempo que lo relatado en otros estudios los cuales indican un retraso en la osificación en esta etapa. En conclusión la radiografía convencional de la extremidad esternal de la clavícula puede ser una herramienta eficaz en la evaluación forense de la edad de los sujetos, sin embargo existe necesidad de definir valores de referencia que sean específicos para determinadas zonas geográficas.
