ghanaopendata/ghanaian-research-english huggingface dataset:
Hepatitis B virus vaccination post serological testing and antibody levels of vaccinated health care workers in Accra, Ghana

Introduction: Hepatitis B Virus (HBV) infection is an important occupational hazard to Health Care Workers (HCWs) all over the world. International health organizations have strongly recommended the use of the HBV vaccine, especially among individuals at risk of HBV infection. A laboratory test aimed at measuring Anti-HBs concentration (titer) 1–2 months following a 3-dose vaccination schedule is the most reliable approach for diagnosing seroprotection against HBV. This study sought to assess post-vaccination serological testing, seroprotection against HBV, and associated factors among vaccinated HCWs in Ghana. Methods: A hospital-based analytical cross-sectional study involving 207 HCWs. Pretested questionnaires were used to collect data. 5mls of venous blood were collected from consenting HCWs under strict aseptic conditions and quantitatively analyzed for Anti-HBs using ELISA procedures. SPSS Version 23 was used to analyze data with the level of significance set at 0.05. Results: Median age; 33, IQR of 29–39. The post-vaccination serological testing rate was 21.3 %. HCWs with high-risk perception and working at the regional hospital had lower odds of adherence to post vaccination serological testing (aOR = 0.2; 95 % CI = 0.1–0.7) and (aOR = 0.1; 95 % CI = 0.1–0.6) p < 0.05. The seroprotection rate was 91.3 % (95 % CI = 87 %-95 %). Minority, 18 (8.7 %) of the 207 vaccinated HCWs had antibody titers below 10mIU/mL and were not seroprotected against HBV. Geometric Mean Titers (GMTs) were higher in those who received three doses, took a booster, and were less than 25 kg/m2 . Conclusion: The post-vaccination serological testing practice was sub-optimal. The seroprotection rate was higher with higher GMTs in those who adhered to the 3-dose vaccination regimen, took a booster dose, and had BMI < 25 kg/m2 . It may be inferred that those with Anti-HBs below 10 IU/ml had their anti-bodies diminishing or waning off with time or they are true vaccine non-responders. This observation calls for strict adherence to post-vaccination serological testing, especially for HCWs who are at high risk of percutaneous and mucocutaneous exposures that could result in HBV infection.

Source: UG
Hepatitis C Prevalence and Validation of a Clinical Prediction Score for Targeted Screening among People Living with HIV in Ghana

WHO recommends hepatitis C (HCV) screening for all people living with HIV (PLHIV). Yet, HCV coinfection was shown to be rare in some Sub-Saharan HIV cohorts, and targeted testing was suggested more efficient for such settings. We studied HCV prevalence among Ghanaian PLHIV, and assessed the external validity of a score to guide targeted testing. This score was initially derived from a Cambodian HIV cohort, and uses as predictors: age, household member/partner with liver disease, diabetes, generalized pruritus, AST, platelets, and AST-to-platelet ratio index. We enrolled 4,023 PLHIV, most from Greater Accra and Central regions, 28.4% were male, median age was 47 years, and high-risk behavior was reported to be rare. HCV seroprevalence was 0.57%, and HCV-RNA was detectable in 0.5%. Sequencing revealed genotype 1(b) and 2(q/r) infections. The discriminatory performance of the score was suboptimal in the Ghanaian setting. The area under the curve was 0.69 (95% CI 0.59-0.79). HCV coinfection prevalence was very low in this Ghanaian PLHIV cohort with reported low-risk of onward transmission. To avoid the cost of screening all PLHIV in similar cohorts in resource-constrained settings, further research to develop better tools/scores to guide targeted HCV testing is needed.

Source: UG
Hepatitis C virus infection in Ghana: time for action is now

Chronic hepatitis C virus (HCV) infection is a blood borne infection just like hepatitis B virus (HBV) and Human Immunodeficiency Virus (HIV) with a significant global health impact. Since the discovery of the HCV, several developments including a better understanding of the clinical epidemiology, availability of diagnostics and approval of newer therapies over the last decade have occurred and changed the frontiers of HCV management. Many nations now place HCV infection as a priority public health issue. In Ghana however, awareness, advocacy and treatment of HCV still plays a second fiddle to HBV and HIV. This must change and the time to act is now. The WHO estimates there has been a decline in the in the number of persons living with chronic HCV infections from about 130–150million to about 80million currently.1 This decline is due partly to the fall in new infections since the discovery of the HCV virus in 1989. Ironically, deaths from HCV are on the increase.2 A large number of persons infected 30–60 years ago are now dying from HCV-related cirrhosis and hepatocellular carcinoma (HCC), as these complications often take decades to develop.2 This mortality trend is projected to continue for several more decades unless treatment is scaled up considerably. In Ghana, the most recent estimates of HCV infection from a systematic review by Agyeman et al is 3%.3 Given that HCV transmission is highest amongst intravenous drug users, HIV infected individuals and homosexuals and that majority of the studies in that review were in low risk individuals; blood donors and pregnant women, this is likely an underestimation. Since HCV infection is clinically silent in majority of carriers until late, the true prevalence and the burden it imposes on the Ghanaian health care system is likely to remain unknown unless a comprehensive national screening policy is implemented. Blankson et al reports that 1 in 14 cases of cirrhosis is caused by HCV in Ghana.4 Also, Yang et al, reports that HCC occurs at an early age in Sub-Saharan Africa including Ghana and HCV is an important cause.5 Therefore, it is most likely that HCV is afflicting mainly the workforce of Ghana. This should be a concern to all, and for stakeholders to commit to interventions that will tackle this disease. In the absence of an HCV vaccine, treatment of infected individuals is a major intervention to control this menace. Pre-treatment evaluation includes determination of HCV viral load, HCV genotype and degree of liver fibrosis either via liver biopsy or fibroscan. These evaluations are expensive and often limit the initiation of treatment in Ghanaians.

Source: UG
Hepatitis C virus seroprevalence, testing, and treatment capacity in public health facilities in Ghana, 2016–2021; A multi-centre cross sectional stud

The current burden of Hepatitis C virus infection and the availability of HCV-related services in Ghana are not well described. Previous estimates on HCV seroprevalence in the country are outdated. This study investigated the HCV seroprevalence and testing and treatment capacity in Ghana. A multi-centre cross-sectional study was conducted in which laboratory and blood bank registers from 17 public healthcare institutions in Ghana were reviewed. A survey on cost and availability of HCV-related testing and treatment was also performed. Crude and pooled estimates of HCV seroprevalence, frequency and median cost of avail able diagnostic tests and medicines were described. The crude HCV seroprevalence was 2.62% (95% CI 2.53–2.72) and the pooled estimate was 4.58% (95% CI 4.06–5.11) among 103,609 persons tested in laboratories. Age (OR 1.02 95% CI 1.01–1.02) and male sex (OR 1.26 95% CI 1.08–1.48) were predictors of a positive anti-HCV RDT test. Northern adminis trative regions in Ghana had the highest HCV seroprevalence ranging from 8.3–14.4%. Among 55, 458 potential blood donors, crude HCV seroprevalence was 3.57% (95% CI 3.42–3.72). Testing was through Rapid Diagnostic Test (RDT) kits in most facilities, and only 2 of 17 centres were performing HCV RNA testing. The median cost of an anti-HCV RDT test was $0.97 (0–1.61) and $3.23 (1.61–7.58) for persons with and without govern ment health insurance respectively. The median cost of a 12-week course of the pan-geno typic direct-acting antiviral therapy sofosbuvir-daclatasvir was $887.70. In conclusion, there are significant regional differences in HCV burden across Ghana. Limited access to and cost of HCV RNA and DAA therapy hinders testing and treatment capability, and conse quently HCV elimination efforts. A national HCV program supported with a sustainable financing plan is required to accelerate HCV elimination in Ghana.

Source: UG
Hepatitis C virus seroprevalence, testing, and treatment capacity in public health facilities in Ghana, 2016–2021; A multi-centre crosssectional study

Abstract The current burden of Hepatitis C virus infection and the availability of HCV-related services in Ghana are not well described. Previous estimates on HCV seroprevalence in the country are outdated. This study investigated the HCV seroprevalence and testing and treatment capacity in Ghana. A multi-centre cross-sectional study was conducted in which laboratory and blood bank registers from 17 public healthcare institutions in Ghana were reviewed. A survey on cost and availability of HCV-related testing and treatment was also performed. Crude and pooled estimates of HCV seroprevalence, frequency and median cost of available diagnostic tests and medicines were described. The crude HCV seroprevalence was 2.62% (95% CI 2.53–2.72) and the pooled estimate was 4.58% (95% CI 4.06–5.11) among 103,609 persons tested in laboratories. Age (OR 1.02 95% CI 1.01–1.02) and male sex (OR1.26 95% CI 1.08–1.48) were predictors of a positive anti-HCV RDT test. Northern administrative regions in Ghana had the highest HCV seroprevalence ranging from 8.3–14.4%. Among 55, 458 potential blood donors, crude HCV seroprevalence was 3.57% (95% CI 3.42–3.72). Testing was through Rapid Diagnostic Test (RDT) kits in most facilities, and only 2 of 17 centres were performing HCV RNA testing. The median cost of an anti-HCV RDT test was $0.97 (0–1.61) and $3.23 (1.61–7.58) for persons with and without government health insurance respectively. The median cost of a 12-week course of the pan-genotypic direct-acting antiviral therapy sofosbuvir-daclatasvir was $887.70. In conclusion, there are significant regional differences in HCV burden across Ghana. Limited access to and cost of HCV RNA and DAA therapy hinders testing and treatment capability, and consequently HCV elimination efforts. A national HCV program supported with a sustainable financing plan is required to accelerate HCV elimination in Ghana.

Source: UG
Hepatitis E seroprevalence and risk factors in humans and pig in Ghana

Background: Although Hepatitis E virus (HEV) infection has signifcant negative impact on the health and wellbeing of underprivileged populations, the burden of HEV in Ghana is still unclear, despite widespread water, sanitation, and hygiene (WASH) related conditions that predispose people to the risk of infection. Methods: A cross-sectional study was conducted to explore rates of HEV seroprevalence and HEV prevalence, as well as risk factors in humans and domestic pigs in Ghana. These were determined using ELISAs manufactured by Wantai Beijing Biopharmaceuticals, China. The study involved 1365 community members, 105 pig farmers and 474 domestic pigs from four administrative regions of Ghana. Results: Results showed overall seroprevalence and prevalence of 12.4% and 0.7% in community members and 15.2% and 2.9% in pig farmers respectively. There was no signifcant diference in the seroprevalence between the two groups (Z=0.851; p=0.3953). However, the prevalence in pig farmers was signifcantly higher than in commu nity members (Z=2.412; p=0.016). Age (OR=1.369, CI=1.243 – 1.508; p=0.0000), gender (OR=1.419, CI=1.101 – 1.991; p=0.043), and the region of residence (OR=1.569, CI=1.348 – 1.827; p=0.0000) were signifcant risk factors for HEV seroprevalence in a multivariate regression model. In pigs, overall seroprevalence and prevalence of 62.4% and 5.5% were recorded respectively. A signifcant diference in seroprevalence was found between confned (6.7%) and free-range pigs (88.3%), (Z=7.492; p<0.00001) in the Volta Region. Multivariate logistic regression showed a signifcant association between seroprevalence and husbandry (OR=7.051, CI=3.558– 13.972; p=0.0000) and region (OR=4.602, CI=2.300 – 9.205; p=0.0000) in pigs in the Volta and Greater Accra Region. Conclusion: From this study, HEV is endemic in Ghana with high seroprevalence in humans and pig populations. This underscores the need for awareness creation and action for prevention and control.

Source: UG
Hepatitis E seroprevalence and risk factors in humans and pig in Ghana

Background: Although Hepatitis E virus (HEV) infection has significant negative impact on the health and wellbeing of underprivileged populations, the burden of HEV in Ghana is still unclear, despite widespread water, sanitation, and hygiene (WASH) related conditions that predispose people to the risk of infection. Methods: A cross-sectional study was conducted to explore rates of HEV seroprevalence and HEV prevalence, as well as risk factors in humans and domestic pigs in Ghana. These were determined using ELISAs manufactured by Wantai Beijing Biopharmaceuticals, China. The study involved 1365 community members, 105 pig farmers and 474 domestic pigs from four administrative regions of Ghana. Results: Results showed overall seroprevalence and prevalence of 12.4% and 0.7% in community members and 15.2% and 2.9% in pig farmers respectively. There was no significant difference in the seroprevalence between the two groups (Z = 0.851; p = 0.3953). However, the prevalence in pig farmers was significantly higher than in community members (Z = 2.412; p = 0.016). Age (OR = 1.369, CI = 1.243 – 1.508; p = 0.0000), gender (OR = 1.419, CI = 1.101 – 1.991; p = 0.043), and the region of residence (OR = 1.569, CI = 1.348 – 1.827; p = 0.0000) were significant risk factors for HEV seroprevalence in a multivariate regression model. In pigs, overall seroprevalence and prevalence of 62.4% and 5.5% were recorded respectively. A significant difference in seroprevalence was found between confined (6.7%) and free-range pigs (88.3%), (Z = 7.492; p < 0.00001) in the Volta Region. Multivariate logistic regression showed a significant association between seroprevalence and husbandry (OR = 7.051, CI = 3.558– 13.972; p = 0.0000) and region (OR = 4.602, CI = 2.300 – 9.205; p = 0.0000) in pigs in the Volta and Greater Accra Region. Conclusion: From this study, HEV is endemic in Ghana with high seroprevalence in humans and pig populations. This underscores the need for awareness creation and action for prevention and control.

Source: UG
Hepatitis E virus infection among pig handlers in Accra, Ghana

Objective: To determine the correlates of hepatitis E virus infection (HEV) in a sample of persons who work with pigs. Design: Cross-sectional study. Setting: Three pig farms in the Greater Accra Region of Ghana. Subjects: Persons who work with pigs seen at the selected pig farms between the months of January and May 2008. Results: One hundred and five persons who work with pigs voluntarily completed a risk-factor questionnaire and provided blood samples for unlinked anonymous testing for the presence of antibodies to HEV. The median age of participants was 36.5 ± 15.0 years (range 12-65 years). Of the 105 subjects tested, HEV seroprevelance was 38.1%. On multivariate analysis, the independent determinants of HEV infection were being employed on the farm for less than six months (odds ratio (OR) 9.1; 95% confidence interval (95% CI) 1.0-81.4 and having piped water in the household and/or on the farm (OR 3.9; 95% CI 0.4-90.8). Conclusion: Consistent with similar studies worldwide, the results of our studies revealed a high prevalence of HEV infection in persons who work with pigs. Further studies need to be done to isolate, characterise the virus and define the clinical and epidemiological significance of HEV infection in this population.

Source: UG
Hepatitis E virus infection is highly prevalent among pregnant women in Accra, Ghana

Abstract Background Hepatitis E virus (HEV) is highly endemic in several African countries with high mortality rate among pregnant women. The prevalence of antibodies to HEV in Ghana is not known. Therefore we evaluated the prevalence of anti-HEV IgG and anti-HEV IgM among pregnant women seen between the months of January and May, 2008 at the Obstetrics and Gynaecology Department, Korle-Bu Teaching Hospital, Accra, Ghana. Results One hundred and fifty-seven women provided blood samples for unlinked anonymous testing for the presence of antibodies to HEV. The median age of participants was 28.89 ± 5.76 years (range 13–42 years). Of the 157 women tested, HEV seroprevelance was 28.66% (45/157). Among the seropositive women, 64.40% (29/45) tested positive for anti-HEV IgM while 35.60% (16/45) tested positive to HEV IgG antibodies. HEV seroprevalence was highest (46.15%) among women 21–25 years of age, followed by 42.82% in = 20 year group, then 36.84% in = 36 year group. Of the 157 women, 75.79% and 22.92% were in their third and second trimesters of pregnancy, respectively. Anti-HEV antibodies detected in women in their third trimester of pregnancy (30.25%) was significantly higher, P < 0.05, than in women in their second trimester of pregnancy (25.0%). Conclusion Consistent with similar studies worldwide, the results of our studies revealed a high prevalence of HEV infection in pregnant women.

Source: UG
Hepatitis E virus infection is highly prevalent among pregnant women in Accra, Ghana.

Abstract Background Hepatitis E virus (HEV) is highly endemic in several African countries with high mortality rate among pregnant women. The prevalence of antibodies to HEV in Ghana is not known. Therefore we evaluated the prevalence of anti-HEV IgG and anti-HEV IgM among pregnant women seen between the months of January and May, 2008 at the Obstetrics and Gynaecology Department, Korle-Bu Teaching Hospital, Accra, Ghana. Results One hundred and fifty-seven women provided blood samples for unlinked anonymous testing for the presence of antibodies to HEV. The median age of participants was 28.89 &#177; 5.76 years (range 13&#8211;42 years). Of the 157 women tested, HEV seroprevelance was 28.66% (45/157). Among the seropositive women, 64.40% (29/45) tested positive for anti-HEV IgM while 35.60% (16/45) tested positive to HEV IgG antibodies. HEV seroprevalence was highest (46.15%) among women 21&#8211;25 years of age, followed by 42.82% in = 20 year group, then 36.84% in = 36 year group. Of the 157 women, 75.79% and 22.92% were in their third and second trimesters of pregnancy, respectively. Anti-HEV antibodies detected in women in their third trimester of pregnancy (30.25%) was significantly higher, P &lt; 0.05, than in women in their second trimester of pregnancy (25.0%). Conclusion Consistent with similar studies worldwide, the results of our studies revealed a high prevalence of HEV infection in pregnant women.

Source: UG
Hepatitis E virus infection is highly prevalent among pregnant women in Accra. Ghana.

Background. Hepatitis E virus (HEV) is highly endemic in several African countries with high mortality rate among pregnant women. The prevalence of antibodies to HEV in Ghana is not known. Therefore we evaluated the prevalence of anti-HEV IgG and anti-HEV IgM among pregnant women seen between the months of January and May, 2008 at the Obstetrics and Gynaecology Department, Korle-Bu Teaching Hospital, Accra, Ghana. Results. One hundred and fifty-seven women provided blood samples for unlinked anonymous testing for the presence of antibodies to HEV. The median age of participants was 28.89 5.76 years (range 13-42 years). Of the 157 women tested, HEV seroprevelance was 28.66% (45/157). Among the seropositive women, 64.40% (29/45) tested positive for anti-HEV IgM while 35.60% (16/45) tested positive to HEV IgG antibodies. HEV seroprevalence was highest (46.15%) among women 21-25 years of age, followed by 42.82% in = 20 year group, then 36.84% in = 36 year group. Of the 157 women, 75.79% and 22.92% were in their third and second trimesters of pregnancy, respectively. Anti-HEV antibodies detected in women in their third trimester of pregnancy (30.25%) was significantly higher, P < 0.05, than in women in their second trimester of pregnancy (25.0%). Conclusion. Consistent with similar studies worldwide, the results of our studies revealed a high prevalence of HEV infection in pregnant women.

Source: UG
Hepatocellular carcinoma caused by iron overload: A possible mechanism of direct hepatocarcinogenicity.

BACKGROUND/AIMS: Excess hepatic iron may be both directly and indirectly carcinogenic. The aim of this study was to determine if generation of reactive oxygen species and the resulting oxidative damage induced by free hepatic iron is directly hepatocarcinogenic. METHODS: Sixty male Wistar albino rats were iron-loaded by ferrocene supplementation of their diet. Biochemical parameters of oxidative damage and lipid peroxidation, DNA unwinding and strand breaks, and the Ames Mutagenesis Test were measured at 4 monthly intervals and correlated with the degree of hepatic iron overload, the presence of iron-free preneoplastic foci in the liver, and the development of hepatocellular carcinoma in comparison with 60 control rats. RESULTS: Levels of lipid hydroperoxides, malonaldehyde, 8-isoprostane and 8-hydroxy-2'-deoxyguanosine increased, reaching peak concentrations at 20-24 months, and correlating with an increase in the rate of DNA unwinding, strand breaks, and positive Ames Tests. Iron-free neoplastic foci became evident at 16 months and thereafter increased in number. Preneoplastic foci were present in five of eight rats remaining at 32 months and HCC had developed in one of the five. CONCLUSIONS: Our findings are compatible with the hypothesis that the direct hepatocarcinogenic effect of free iron is mediated by the generation of oxygen reactive species and oxidative damage that are mutagenic and carcinogenic.

Source: UG
Hepatocellular Carcinoma Occurs at an Earlier Age in Africans, Particularly in Association With Chronic Hepatitis B

To the Editor: Hepatocellular carcinoma (HCC) is highly endemic in Africa (1). There is a general anecdotal consensus that persons with HCC induced by viral hepatitis or other causes in Africa present at younger ages than in other regions of the World. This has resulted in recommended guidelines that surveillance of African-born persons at risk for HCC should begin at the age of 20 years (2). However, a more comprehensive description of the current status of liver cancer epidemiology in Africa is still lacking. We aim to develop a consortium of collaborating centers to establish a database of HCC cases in order to describe the clinical features of patients with HCC in Africa with the objective of providing a representative perspective from the entire African continent.

Source: UG