Prognostic Significance of Nuclear Factor Kappa B (p65) among Breast Cancer Patients in Cape Coast Teaching Hospital.

Breast cancer is the most prevalent cancer among African women, with high mortality rates in Ghana. Nuclear factor kappa B (NF-kB) has been associated with tumor progression in breast cancer. However, its clinical validation is controversial and understudied with no known published data on NF-kB (p65) among breast cancer patients in Ghana and other African countries. This study assessed the prognostic significance of NF-kB (p65) expression and its association with various clinicopathological features in breast cancer patients. Ninety formalin-fixed breast cancer tissues and 15 normal breast tissues were used to determine the expression of NF-kB (p65) using immunohistochemistry. We explored the correlation between expression of NF-kB (p65) and clinicopathological features. NF-kB (p65) was expressed in 86.7% of breast cancer tissues. There was a significant relationship between NF-kB (p65) expression and tumor grade, proliferation index (Ki67), and molecular subtype. High NF-kB (p65) expression in tumor grade 3 was about 10 times that of grade 1 (54.2% vs. 5.1%), and Ki67 > 20 was 79.7% compared to 20.3% for Ki67 ≤ 20. Patients with triple-negative breast cancer (TNBC) had 49.1% overexpression of NF-kB (p65) compared to 17%, 25.4%, and 8.5% for luminal A, luminal B, and HER2 cases, respectively. This study demonstrates that NF-kB (p65) was highly expressed among breast cancer patients at Cape Coast Teaching Hospital, Ghana, especially in TNBC. NF-kB (p65) could serve as a biomarker for cancer stage, progression, prognosis and as a therapeutic target.

Assessing the role of eosinophil-mediated immune response markers in detecting hookworm infection: A case-control study in Kintampo, Ghana.

Background and Aim: Human hookworm disease caused by Ancylostoma duodenale and Necator americanus is a serious public health problem. Hookworm infection activates eosinophil-mediated tissue inflammatory responses, involving the production of the eosinophil-specific chemokine (eotaxin), recruitment of eosinophils, secretion of the cationic protein, and production of antiparasite immunoglobulin E (IgE). We investigated eosinophil-mediated immune response as markers (CCL11, eosinophil cationic protein [ECP], and IgE) for detecting hookworm infection. Methods: This case-control study was carried out in hookworm endemic areas within the Kintampo North Municipality.Forty hookworm-positive subjects and 36 apparently healthy individuals were recruited as cases and controls, respectively. Stool samples were collected for hookworm detection by the Kato-Katz technique and speciation by polymerase chain reaction. Approximately, 5 ml of intravenous blood was used to obtain plasma for the immunological assays. Results: Of eosinophil-mediated immune response markers studied, ECP and CCL11 were significantly higher among hookworm patients compared to controls. Increasing CCL11 (ß = -0.81, p = 0.015) was associated with a significant decrease hookworm intensity. However, increasing eosinophil count (ß = 0.62, p = 0.027) was associated with significant increase in hookworm intensity. In receiver operator characteristics analysis, ECP could significantly detect hookworm infection with a very high area under the curve (AUC) (AUC = 0.97, p < 0.0001). At a cutoff of 39.05, ECP was the best eosinophil-mediated immune response marker for detecting hookworm infection with a sensitivity of 97.2%, specificity of 87.8%, a positive predictive value of 89.7%, and a negative predictive value of 96.6%. Conclusion: ECP best predicts eosinophil-mediated immune response for detecting hookworm infection, while CCL11 and eosinophil count better predict the intensity of hookworm. Moreover, the ECP level is a good indicator of hookworm infection and intensity and may require additional investigations to augment current hookworm diagnostic techniques.

Cryptosporidium Infection and Associated Risk Factors among Cattle in the Central Region of Ghana.

Cryptosporidium species infects a wide number of animals including livestock all over the world. The current study was done to determine the prevalence and risk factors of Cryptosporidium infection among cattle in the Central Region of Ghana. Two hundred and eighty-seven (287) faecal samples were randomly collected from animals on eight cattle farms in four districts across two agroecological zones. A commercial enzyme-linked immunosorbent assay kit (CoproELISA, Savyon® Diagnostics Ltd., Israel) for Cryptosporidium was used in the detection of Cryptosporidium antigens in faecal samples. Characteristics of the animals such as age, sex, and location, as well as consistency of faecal samples, were collected. Pearson's chi-square or Fisher's exact test was used to determine the association between explanatory variables and Cryptosporidium infection while a logistic regression model was also used to determine the risk of infection. The overall prevalence of Cryptosporidium infection was 23.7% (95% CI, 18.7-28.6). Prevalence was significantly higher (p = 0.049) among cattle aged 12-month old and above compared to those under 12 months of age. Among the four districts in the study area, Cape Coast metropolis recorded a significantly higher prevalence (60.5%; CI, 49.3-71.8), (p < 0.001) compared to the other three. Furthermore, a significant association was observed between the consistency of faecal samples and Cryptosporidium infection (p = 0.042). The prevalence of Cryptosporidium infection was also significantly higher among cattle from the coastal savanna zone (26.9%; 95% CI, 21.0-32.8) compared to those from the semideciduous forest area (p = 0.017). Cattle in the forest zone had a lower risk of being infected with the parasite compared to those from the coastal savanna zone (OR 0.408; 95% CI, 0.182-0.915). In conclusion, Cryptosporidium was prevalent among cattle in the Central Region of Ghana. A higher prevalence of Cryptosporidium infection occurred in older animals and among animals in the coastal agroecological zone. The area of location and age of animals were identified as risk factors for Cryptosporidium infection in the Central Region of Ghana.

Occurrence of Cryptosporidium Infection and Associated Risk Factors among HIV-Infected Patients Attending ART Clinics in the Central Region of Ghana.

Cryptosporidium species are intestinal protozoan parasites that infect and cause diarrhoea in animals and humans. The current study was conducted to determine the prevalence and risk factors of Cryptosporidium infection among HIV-infected patients in the Central region of Ghana. In this cross-sectional study, four hundred eighteen documented HIV-infected participants from four health facilities that provide antiretroviral therapy (ART) services across the Central region of Ghana were selected by systematic random sampling. An enzyme-linked immunosorbent assay (CoproELISATM, Cryptosporidium Savyon® Diagnostics Ltd., Ashdod, Israel) was used to detect Cryptosporidium antigens in stool samples obtained from participants. Information regarding participants' sociodemographic characteristics and clinical symptoms as well as potential environmental and behavioral risk factors were collected using a structured questionnaire. Chi-square or Fisher's exact tests were used to determine associations between Cryptosporidium infections and explanatory variables, while risk factors were assessed using multivariate logistic regression analysis. The overall prevalence of Cryptosporidium infection among HIV-infected participants in this study was 6.2% (95% CI: 3.90-8.54). Cryptosporidium was not significantly associated with any of the sociodemographic variables, patient clinical symptoms, and environmental factors. However, the prevalence of the parasite was significantly higher 25% (95% CI: 1.17-48.83; p = 0.013) among participants who did not always wash their hands before meals and those who did not always wash vegetables before eating them, 23.5% (95% CI: 1.05-46.01; p = 0.016). Multivariate logistic regression analysis showed that participants who used public water closet facilities were approximately 9 times more likely to become infected with the parasite than those who practised open defecation (OR: 8.83; 95% CI: 1.22-64.13; p = 0.031). In conclusion, Cryptosporidium is prevalent among HIV-infected patients in the Central region of Ghana. An important risk factor identified was the use of the public water closet toilet facility. More attention should be given to ensuring cleanliness at shared water closet facilities in addition to adequate disinfection of hands after using such facilities.

Parasitic Profile of Fresh Vegetables Sold in Selected Markets of the Cape Coast Metropolis in Ghana

Background: Vegetable consumption is a major source of vitamins, minerals and dietary fibre for the body. While fresh vegetables play a key role in the prevention of some chronic diseases, cancers, and alleviation of micronutrient deficiencies, some have been associated with foodborne parasitic infections. Objectives: We investigated the parasitic contamination of fresh vegetables sold in three market places in the Cape Coast Metropolis in Ghana. Materials and Methods: In this study conducted over a period of three (3) months, a total of one hundred and twenty-six (126) vegetable samples were obtained from three (3) selected markets in the Metropolis. Six (6) different species of vegetables namely tomato (Solanum lycopersicum), cabbage (Brassica oleracea var capitata), carrot (Daucus carota), lettuce (Lactuca sativa), spring onion (Allium fistulosum) and green pepper (Capsicum annuum) were subjected to parasitological examination for the detection of parasite forms such as larvae, ova and cysts. Results: The overall prevalence of parasitic contamination of vegetables in this study was 52.4%. Five different parasites were detected namely Strongyloides spp, Hookworm, Trichuris trichiura, Ascaris lumbricoides and Entamoeba coli. The prevalence of parasitic contamination was higher in leafy vegetables such as spring onions (90.5%), lettuce (76.2%) and cabbage (66.7%). Multiple parasitic contaminations were a common feature of leafy vegetables than smoothly surfaced ones such as green pepper and tomatoes. Conclusion: The study revealed that most vegetables purchased from the markets in the metropolis were highly contaminated with intestinal parasites. It is therefore recommended that vegetables should be subjected to thorough disinfection processes before being served for food to reduce the transmission of intestinal parasites.

Seroprevalence of Syphilis Infection in Individuals at Cape Coast Metropolis, Ghana.

Background: Syphilis is a sexually transmitted infection caused by Treponema pallidum. The disease becomes very common among individuals with multiple sexual partners without protection. Aim: This research aimed at assessing the prevalence of syphilis infection in Cape Coast Metropolis and the factors associated with the transmission of the disease Methodology: 200 participants from Cape Coast were sampled and assessed for syphilis infection using Venereal Disease Research Laboratory syphilis test strips (a nontreponemal test) and positive samples were confirmed with Treponema palladium haemagglutination (TPHA) test. Questionnaires, reflecting the participant’s sociodemographic data were also administered. The results were analysed, to assess the relationship between various risk factors and syphilis infection. Results: The prevalence of syphilis infection in Cape Coast was found to be 8.5%, mainly associated with participants having multiple sexual partners and having unprotected and indiscriminate sex. Other factors found to be indirectly affecting the rate of infection were illiteracy, lack of knowledge and information concerning the disease. Conclusion: The seroprevalence of syphilis infection in the Cape Coast Metropolis is an indication that the disease is endemic.

Intestinal Parasitosis among Primary School Pupils in Coastal Areas of the Cape Coast Metropolis, Ghana.

Malaria caused 350 to 500 million clinical episodes in the year 2000 and remains the fifth most deadly infectious disease worldwide after respiratory infections, HIV/AIDS, diarrhoeal diseases, and tuberculosis. Though malaria remains a global health concern in developing nations, the approximate malaria-infected cases reduced from 227 million cases in 2000 to 198 million cases in 2013 globally. Notably in Africa over the last decades, malaria eradication programmes have received greater international attention leading to reduction of parasite-infected cases by 26%, with a decrease in cases from 173 million in 2000 to 128 million in 2013. Nevertheless malaria remains a global health concern in developing nations. The World Health Organization (WHO) South-East Asia Region (SEAR) comprises of 11 member states (Bangladesh, Bhutan, Democratic People's Republic of Korea, India, Indonesia, Maldives, Myanmar, Nepal, Sri Lanka, Thailand, Timor-Leste) of which 10 countries are malaria endemic while Maldives has been declared malaria-free nation since 1984. Presently no licensed malaria vaccine is available and vaccine developers are working on several novel approaches to make a breakthrough as these vaccines would probably be crucial factor to prevent the transmission and onset of malaria. Further due to excessive dependence on artemisinin-based combination therapy (ACTs), emergence of drug resistant parasites, malaria coinfection in immunocompromised patients and newer P. knowlesi strains are fuelling this severe public health problem. Effective measures such as routine surveillance of the antimalarial drug efficacy, newer rapid diagnostic tools (RDTs) and appropriate treatment regimes will help to monitor and limit this deadly disease especially in the malaria-endemic countries. In this review, the various intertwined factors leading to malaria burden – a continuing problem for global health- specially in South-East Asia region are highlighted.