ghanaopendata/ghanaian-research-english huggingface dataset:
Hematological parameters in Ghanaian sickle cell disease patients

Background: Effective treatment and management of sickle cell disease (SCD) has been a challenge in Africa over the years. Hematological parameters are very useful profiles in the effective management of the disease. However, there is scarcity of studies on the hematological parameters of SCD in Ghana. This study aimed at determining hematological parameters among SCD patients with vaso-occlusion, those in the steady state as well as healthy controls at a teaching hospital in Ghana. Methodology: This was a cross-sectional study involving a total of 628 subjects, including 148 HbAA controls, 208 HbSS patients in steady state, 82 HbSC patients in steady state, 156 HbSS patients in vaso-occlusive crises (VOC), and 34 HbSC patients in VOC. Venous blood sample was collected from all study participants. A full blood count was done within 2 hours of collection, and hemoglobin (Hb) concentration, packed cell volume, red blood cell (RBC) concentration, mean corpuscular Hb, mean cell volume, mean corpuscular Hb concentration, and white blood cells (WBC) and platelet (PLT) counts were recorded. Results: WBC and PLT counts were significantly higher in both female and male patients with SCD, compared with their healthy counterparts (P<0.05). The level of WBC was, however, significantly higher in patients with HbSS VOC among the SCD patients (P<0.001). Levels of Hb, RBC, and hematocrit were significantly higher in the controls (P<0.001). There was no significant difference in mean cell Hb among male patients with SCD (P=0.274) and female patients with SCD (P=0.5410). Conclusion: The SCD patients had lower Hb and RBC than the controls; however, higher PLT and WBC are noted in various status of SCD, possibly reflecting spleen effect in these patients. Further studies are needed to confirm these findings.

Source: UG
Heme-mediated induction of CXCL10 and depletion of CD34+ progenitor cells is toll-like receptor 4 dependent

Plasmodium falciparum infection can cause microvascular dysfunction, cerebral encephalopathy and death if untreated. We have previously shown that high concentrations of free heme, and C-X-C motif chemokine 10 (CXCL10) in sera of malaria patients induce apoptosis in microvascular endothelial and neuronal cells contributing to vascular dysfunction, blood-brain barrier (BBB) damage and mortality. Endothelial progenitor cells (EPC) are microvascular endothelial cell precursors partly responsible for repair and regeneration of damaged BBB endothelium. Studies have shown that EPC's are depleted in severe malaria patients, but the mechanisms mediating this phenomenon are unknown. Toll-like receptors recognize a wide variety of pathogen-associated molecular patterns generated by pathogens such as bacteria and parasites. We tested the hypothesis that EPC depletion during malaria pathogenesis is a function of heme-induced apoptosis mediated by CXCL10 induction and toll-like receptor (TLR) activation. Heme and CXCL10 concentrations in plasma obtained from malaria patients were elevated compared with non-malaria subjects. EPC numbers were significantly decreased in malaria patients (P < 0.02) and TLR4 expression was significantly elevated in vivo. These findings were confirmed in EPC precursors in vitro; where it was determined that heme-induced apoptosis and CXCL10 expression was TLR4- mediated. We conclude that increased serum heme mediates depletion of EPC during malaria pathogenesis.

Source: UG
Hemispheric brain abscess: A review of 46 cases

BACKGROUND: Brain abscess is a space occupying lesion that still prevails in many developing countries but less common in developed countries. It can be a preventable cause of fatal illness if diagnosed and treated appropriately. There is little or no information of the condition in Ghana. In this review we report our experience at the Neurosurgical unit of Korle Bu Teaching Hospital (KBTH) over a four year period. STUDY DESIGN: A retrospective study of 46 patients with brain abscess(es) seen between January 1994-December 1998 was carried out at the Neurosurgical unit of KBTH, Accra, Ghana. Using hospital records of 46 patients an evaluation of computerized tomography (CT) scans of brain abscesses and the different methods of surgical treatment were made. RESULTS: 33 (72%) were male and 13 (28%) were female. 32 (70%) of the patients were aged 20 years or younger. Brain C.T. Scan was the main diagnostic imaging study performed on all the patients. In all but one case the diagnosis was a solitary abscess (98%). 38 patients (83%) had burr hole drainage under sedation and local anaesthesia and 12 under general anaesthesia. All patients were managed with appropriate antibiotics and steroids. There were 5 fatalities. CONCLUSION: Simple burr hole drainage combined with appropriate medical treatment was found to be satisfactory in managing these patients.

Source: UG
Henceforth, We Will Never Walk Alone: Empirical Study on the Benefits of Participatory Governance and Leadership

Moving beyond the ‘great man’ view of the organization which had regarded leaders as all-knowing and repository of knowledge and tactics, this study empirically examines how a flexible system of management (networked approach) provides benefits for organizations in terms of decisional breakthroughs and practical problem resolution in society. The study is underpinned by the system approach to leadership and a transdisciplinary framework which, strives for a flexible management system through greater interaction between lead ers and their relevant stakeholders in organizational decision processes. Seventeen (17) cases were drawn from diverse organizational settings within public and private sectors of Ghana (Africa) to empirically demonstrate how networks in leadership profer solutions to “ill-structured” and “moderately structured” challenges that confront organizations. The study observes that wicked problems are inevitable in organizations. We conclude that eforts at building bridges between leaders and their environment are not only good for human relations per se but remain the “lifeblood” for organizational breakthroughs, especially, in situations of critical challenges that involve complex decisions. The study concludes that although leaders may be well endowed in knowledge, skills, and abilities (KSAs), organizational issues in most cases go beyond familiar issues and from the ‘ordi nary’ to ones that are subtle, complex, extraordinary, and sophisticated in nature and in most cases requiring social capital to liaise between the organization and other actors for successful negotiations and resolutions, not ‘quick-fx solutions’.

Source: UG
Hepatic venous occlusion during cardiopulmonary bypass in patients with heterotaxy syndrome: A safe but underutilized option.

Direct intracardiac drainage of separate right and left hepatic veins remote from each other (independent hepatic veins) in heterotaxy patients complicates procedures requiring cardiopulmonary bypass (CPB). Temporary occlusion of such independent hepatic veins during CPB is an alternative to cannulation but is rarely used because of concerns about acute congestive hepatopathy. Consequently, temporary single hepatic venous occlusion has not been well described as a safe and simple alternative to hepatic venous cannulation during CPB. We report 2 patients with the polysplenia variant of heterotaxy in whom independent hepatic veins were safely occluded for 55 and 86 minutes, respectively, in the course of intracardiac repair. Temporary hepatic venous occlusion simplified the CPB technique and minimized clutter of the operative field. The intrahepatic hemodynamics during CPB using temporary hepatic venous occlusion is illustrated.

Source: UG
Hepatitis B and human immunodeficiency virus infections within correctional facilities in Ghana

Previous studies have suggested high Immunodeficiency Virus (HIV) and hepatitis B virus (HBV) prevalence in prisons in Ghana. However, this study was part of a nationally representative bio-behavioural survey that determined the prevalence of HIV and HBV among prison inmates and identified factors associated with these infections. Both biomedical and Behavioral data were collected from a total of 2,443 prison inmates from 19 prison stations During 2013 in Ghana, 12 male prisons and 7 female prisons were selected across the country. The national HIV screening algorithm was used for HIV testing, while two rapid detection Tests were used to confirm HBV infections. HIV and HBV prevalence among prisoners in Ghana was approximately 2.34% and 12.38%, respectively. Only five inmates had a co-infection with both viruses. The prevalence of HIV was significantly lower among male inmates (1.5%) compared to the female inmates (11.8%). Age, sex, and marital status were significantly associated with both HIV and HBV infections. However, BMI category, IDU, and time spent in prison were associated with HIV infections. The educational level was significantly associated with HBV infections. After binary logistic regression, being female (AOR: 0.18, 95% CI: 0.07–0.45, p<0.001) and having a stay of 5 years or more (AOR: 0.07, 95% CI: 0.01–0.60, p = 0.016), increased the risk of having HIV infection. While those with no formal education (AOR: 0.65, 95% CI: 0.45–0.95, p = 0.024) and are underweight (AOR: 0.51, 95% CI: 0.27–0.99, p = 0.046), were more likely to have HBV infection. Forced penetrative Sex may be a problem in prisons. The need to have and strengthen an integrated screening, treatment, and vaccination plan for the prison is emphasized. The prison does not serve as an exceptionally high risk to the general population. The findings support a critical look at the issue of forced penetrative sex in prisons.

Source: UG
Hepatitis B Infection among Parturient Women in Peri-Urban Ghana

Global evidence suggests that hepatitis B viral (HBV) infection is endemic in Africa and perinatal transmission remains one of the most important modes of HBV transmission in this area. This cross-sectional survey examined the seroprevalence and knowledge of hepatitis B among pregnant women attending antenatal clinic (ANC) in a mission hospital in Ghana. Systematic sampling technique was used to recruit 196 pregnant women. The level of statistical significance was set at 0.05 alpha level. The hepatitis B prevalence estimate (hepatitis B surface antigen) was 10.2% (N = 20) and the entirety of the participants were aware of HBV infection. Majority cited media (radio) as their main source of information. Approximately 86% of the participants (N = 168) associated HBV infection with a curse and 88.8% (N = 174) indicated witches and wizards as possible causes of the infection. Those with higher level of school education had high hepatitis B knowledge score (P < 0.01). Implementation of a health education program on the route of hepatitis B transmission is required in the study setting. Also, inclusion of hepatitis B education as part of ANC activities will enable HBV-positive pregnant women to appreciate the need for hepatitis B vaccination of their newborns at birth.

Source: UG
Hepatitis B infection outcome is associated with novel human leukocyte antigen variants in Ghanaian cohort

Chronic hepatitis B infection is an important medical problem in sub-Saharan Africa. With increasing concerns of dwindling access to needed care, increasing cost of treatment, and rising prevalence of dire outcomes like liver cirrhosis and hepatocellular cancer, the need to determine the genetic associations underpinning hepatitis B virus persistence or clearance in a population comes to the fore. Genetic association studies have suggested a variation in human leukocyte antigen alleles associated with hepatitis B virus outcome along geo-ethnic lines. We investigated the association of human leukocyte antigen alleles to hepatitis B virus outcome against this backdrop. We used targeted next generation sequencing to type the human leukocyte antigen class I and II alleles of 173 study participants. These comprised of 92 cases with chronic hepatitis B infection and 81 healthy controls with serological evidence of naturally cleared hepatitis B virus infection. We have identified human leukocyte antigen alleles associated with hepatitis B virus clearance and persistence for the first time in a Ghanaian population. The class 1 allele C*16:01 (odds ratio (OR) = 3.4, confidence interval (CI) = 1.6–7.0, P-value = 0.01) was associated with hepatitis B virus persistence. Four class I alleles and one class II allele: A*34:02 (OR = 0.1, CI = 0.04–0.2, P-value = 3.4e-05), A*74:01 (OR = 0.3, CI = 0.2–0.7, P-value = 0.0135), B*13:02 (OR = 0.04, CI = 0.01–0.2, P-value = 0.000172), C*08:04 (OR = 0.06, CI = 0.01–0.2, P-value = 7.83e-05), and DRB1*08:04 (OR = 0.2, CI = 0.03–0.27, P-value = 0.000252) were associated with hepatitis B virus clearance. Our data show that previously reported human leukocyte antigen alleles associations to hepatitis B virus outcome are not found in this Ghanaian study. This study has therefore identified human leukocyte antigen types that are associated with either hepatitis B virus persistence or clearance and highlights the importance of geo-ethnic pivoted studies in determining the genetic associations to acute hepatitis B virus infection outcome.

Source: UG
Hepatitis B infection prevention: Audit of selected healthcare facilities in the Greater Accra Region, Ghana

Introduction: The risk of occupational exposure to Hepatitis B Virus (HBV) is high among healthcare workers (HCWs), especially in developing countries like Ghana where the prevalence of HBV is high. Unfortunately, in such regions, HCW protection does not appear to be a priority, and healthcare facilities (HFs) have been reported to have unsatisfactory levels of implementing preventive strategies to protect HCWs from blood-borne infections including HBV. Methods: A cross-sectional and Q audit was performed involving 255 HFs selected by proportional allocation and systematic random sampling. Data was collected using a structured pretested questionnaire with HF managers being the respondents. Data were analysed using IBM SPSS (Statistical Package for the Social Sciences, version 21.0) where univariate, bivariate, and multivariate analysis was done with the level of sig nificance set at <0.05. Results: Overall adherence to recommended strategies, structures, and programs for HBV prevention among the HFs was generally low, with a mean score of 37.02 (95% CI ¼ 33.98 e40.05). There was a statistically significant difference in the level of adherence between the HF categories (F ¼ 9.698; P ¼ <0.001). Being a hospital (OR ¼ 3.9: CI ¼ 1.68e9.29), possessing infection, prevention and control (IPC) guidelines (OR ¼ 6.69: CI ¼ 3.29e13.63) as well as having functional IPC committees in place (OR ¼ 7.9: CI ¼ 3.59e17.34) were associated with good adherence to HF-level HBV preventive strategies. Conclusion: Overall adherence to HF-level prevention of HBV is sub-optimal. Higher-level facilities were better resourced with HBV vaccine and Hepatitis B immunoglobulin (HBIG). Adherence to HBV prevention strategies depends on the type of HF and the availability of IPC committees and their respective IPC coordinators.

Source: UG
Hepatitis B vaccine uptake among healthcare workers in a referral hospital, Accra

Introduction: hepatitis B vaccination among healthcare workers (HCWs) in Ghana has not been actively pursued despite the endemicity of the infection. This study measures the hepatitis B vaccine uptake among HCWs at the University of Ghana Hospital, Legon (UGHL) and identifies the factors associated with vaccination. Methods: an analytical cross-sectional study involving all staff who have direct contact with patients was conducted. Self-administered questionnaires were used to collect data on vaccination status, age, sex, type of staff, duration of work in the facility, exposure to blood or blood products, blood stained linens/waste, sharp instruments and performance of invasive procedures. Data was analysed using STATA 14. Continuous variables were described using median values and interquartile ranges (IQR) and categorical variables as proportions. Bivariate and multivariate analysis were conducted to identify the factors associated with hepatitis B vaccination status. Results: of the 161 participants interviewed, 63.4% were females with median age 35 years (IQR: 27-45). Eighty-six (53.4%) of the respondents had taken the hepatitis B vaccine with 79.1% of them having completed the vaccination schedule. Factors associated with vaccination were working for more than 16 years (OR: 3.8, CI: 1.02-12.72), daily exposure to blood/blood products (OR: 4.1, CI: 1.43-11.81) and sharp instruments (OR: 4.45, CI: 1.39- 14.24), performing invasive procedures daily (OR: 3.0, CI: 1.07-8.45) and frequent exposure to blood stained linens/waste (OR: 6.1, CI: 1.41-26.51). Conclusion: the lack of hepatitis B vaccination among some HCWs at UGHL puts them at risk of contracting hepatitis B infection.

Source: UG
Hepatitis B virus genotypes among chronic hepatitis B patients reporting at Korle-Bu teaching hospital, Accra, Ghana

INTRODUCTION: Knowledge of hepatitis B virus (HBV) genotype is an important predictive variable which might have an impact in management and treatment of patients with chronic hepatitis B infection. In Ghana very little information is available on hepatitis B genotypes. This study was conducted to determine the distribution of HBV genotypes circulating among chronic hepatitis B patients reporting at the Korle-Bu Teaching Hospital (KBTH), Accra, Ghana.METHODS: Blood samples (10 ml) were collected from 250 consenting patients. DNA was extracted and amplified using polymerase chain reaction technique. Restriction fragment length polymorphism (RFLP) was used for the detection of genotypes.RESULTS: Out of the 250 chronic hepatitis B patients who were HBsAg positive, 91 (36.4%) were males aged 29.8 ± 9.1 and 159 (63.6%) females aged 33± 12.1 years. HBV DNA was detected in 111 (44.4%) but only 58 (52%) of these were typeable. These were classified as genotype A, 8 (7.2%); genotype D, 3 (2.7%) and genotype E, 47 (42.3%). Our results did not show any association between the infecting genotype and age (X2= 0.923; p-value=0.623) or gender (X2= 0.283, p= 0.579).CONCLUSION: Consistent with similar studies worldwide, the results suggest that genotypes A, D and E were the genotypes circulating among chronic hepatitis B patients who reported to the Korle-Bu Teaching Hospital with genotype E being the most predominant and therefore constitutes an important public health concern. We recommend further epidemiological studies to understand the implication of genotype E in terms of disease progression and treatment.

Source: UG
Hepatitis B virus sero-prevalence amongst pregnant women in the Gambia

BACKGROUND: Infection with Hepatitis B virus (HBV) is a serious public health problem worldwide, with over 360 million carriers. Sixty million of these are resident in Sub-saharan Africa. Hepatitis B infection is the cause of Hepatocellular carcinoma (HCC), which is the second commonest cause of death from cancers among women in The Gambia. Vertical transmission is the commonest route of spread of Hepatitis B Virus in many endemic areas. The main aim of the study was to determine the sero-prevalence of Hepatitis B surface antigen (HBsAg) among pregnant women attending antenatal clinic at the Edward Francis Small Teaching Hospital, Banjul, The Gambia. METHODS: Four hundred and twenty six pregnant women were recruited from our antenatal clinics and tested for HBsAg. Serum Hepatitis B surface antigen (HBsAg) was tested using commercial rapid diagnostic Elisa kits at the point of care. RESULTS: A prevalence rate of 9.20% among all pregnant women studied was found. Women who were likely to have been vaccinated had a prevalence rate of 2.30% whiles those unlikely to have been vaccinated had a prevalence of 13.71%. There was a statistically significant difference between those likely to have been vaccinated and those unlikely to have been vaccinated. CONCLUSION: The prevalence of hepatitis B infection is very high among pregnant women at EFSTH as in the high endemic zone that is more than 8%. However the prevalence rate is lower than the national average of 15%. The prevalence is of moderate endemicity among the women who likely received vaccination during childhood. More interventions during pregnancy need to be undertaken if more successes are to be registered.

Source: UG
Hepatitis B virus surface antigen and antibody markers in children at a major paediatric hospital after the pentavalent DTP-HBV-Hib vaccination

Objectives: The knowledge about outcomes of infant vaccination against HBV infections using the DPT-HepB-Hib vaccine in Ghana is limited. This study therefore investigated the levels of immunity to HBV among children who received the DPT-HepB-Hib vaccine and HBsAg carriage in non-responders. Correlates for non-response or poor response were also investigated. Methods: Cross-sectional study. A major paediatric hospital in Accra. Four hundred and twenty four children between the ages of 5 to 32 months who had completed the full vaccination schedule for the DPT-HepB-Hib vaccine. Results: Of the 424 children, 358 (84.4%) developed anti-HBs while 340 (80.2%) developed ≥10 mIU/ml anti-HBs (sero-protection) and 3 had HBsAg. A binary logistic regression analysis showed that younger children were associated with sero-conversion (p=.022) and sero-protection (p=.021). For anti-HBs titres ≥100 mIU/ml age was a weaker but significant contributor (p=.041), as compared to the number of vaccines from different manufacturers the child used (p=.028). The mean age of those who used a single type of vaccine was higher (14.75 ± 6.056 months; n=268) than those who used vaccines from two or more manufacturers (11.96 ± 4.645 months; n=156), p= <.001 (CI: -3.897 – 1.688), an indication that efforts to procure vaccine from same source when it was initially introduced are waning. Conclusions: There is still a residual possibility of infection with HBV in spite of infant vaccination. In the light of possible loss of anamnestic response over time, there is the need to consider a birth dose for HBV vaccination for all neonates or booster dose for infants who may not have received the vaccine at birth. Using vaccines from a single manufacturer is recommended.

Source: UG