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Human Immunodeficiency Virus, Syphilis Prevalence and Risk Factors among Migrant Workers in Konongo, Ghana  [PDF]
Andrew A. Adjei, James Brandful, Mark Lurie, Margaret Lartey, Francis Krampa, Awewura Kwara, Theophilus K. Adiku, Yao Tettey, Richard K. Gyasi, Aaron L. Lawson, Timothy Flanigan
Advances in Infectious Diseases (AID) , 2014, DOI: 10.4236/aid.2014.43020
Abstract: Migrant workers, particularly gold mining workers, have been identified as a group at risk for HIV and sexually transmitted infections (STI). A cross-sectional study was undertaken on the correlates of human immunodeficiency virus (HIV) and syphilis infections in a sample of migrants (Ghanaian citizens [156] and non-Ghanaian citizens [8]) working in a gold mining centres in Konongo, Ghana. The study was conducted between the months of January 2013 to December 2013. Of a total of 600 eligible migrant workers, only 164 (27.33%; males 114, females 50) of the eligible migrants took part in the study. Subjects voluntarily completed a risk-factor questionnaire and provided blood specimen for testing for the presence of antibodies to HIV and Treponema pallidum, the causative agent of syphilis. These data were analyzed using both univariate and multivariate techniques. The median age of the participants was 29.0 years (range 18 - 62 years). Of the 164 migrant workers tested, HIV and syphilis seroprevalence were 6.7% and 3.7% respectively. On multivariate analysis, the independent determinants for HIV infection were being female [odds ratio (OR) 2.94; 95% confidence interval (95% CI 0.86 - 10.0); unmarried (OR 10.13; 95% CI 1.2 - 81.09); drug use (OR 3.76; 95% CI 0.38 - 36.3); and blood transfusion (OR 2.45; 95% CI 0.27 - 22.37). Similarly, on multivariate analysis, the independent determinants for syphilis infection were having concurrent sexual partners (OR 2.16; 95% CI 0.38 - 12.12); and blood transfusion (OR 5.07; 95% CI 0.51 - 50.37). Consistent with similar studies worldwide, our results suggest high prevalence of HIV and syphilis infections among migrant workers who work in gold mining centres in Ghana.
Seroprevalence of HHV-8, CMV, and EBV among the general population in Ghana, West Africa
Andrew A Adjei, Henry B Armah, Foster Gbagbo, Isaac Boamah, Clement Adu-Gyamfi, Isaac Asare
BMC Infectious Diseases , 2008, DOI: 10.1186/1471-2334-8-111
Abstract: Serum samples from 3275 HIV-seronegative healthy blood donors and 250 HIV-AIDS patients were tested for antibodies specific for HHV-8, CMV and EBV by IgG ELISA assays. Differences in seropositivity rates by gender and age were evaluated using the Chi-square test with Yates correction.Of the 3275 HIV-seronegative healthy blood donors tested, 2573 (78.6%) were males and 702 (21.4%) were females, with ages ranging from 18 to 65 years (median 32.6; mean 31.2; mode 30). Of the 250 HIV-AIDS patients tested, 140 (56%) were males and 110 (44%) were females, with ages ranging from 17 to 64 years (median 30.8; mean 30.3; mode 28). Among the HIV-seronegative healthy blood donors, overall seroprevalence of HHV-8, CMV and EBV was 23.7%, 77.6% and 20.0%, respectively. Among the HIV-AIDS patients, overall seroprevalence of HHV-8, CMV and EBV was 65.6%, 59.2% and 87.2%, respectively. The seroprevalence of HHV-8 (p < 0.005) and EBV (p < 0.001) was statistically significantly higher in HIV-AIDS patients compared to HIV-seronegative healthy blood donors. There was no statistically significant difference (p = 0.24) between CMV seroprevalence in HIV-AIDS patients and HIV-seronegative healthy blood donors. Age and gender were not independent determinants (p > 0.05) for all three infections among HIV-seronegative healthy blood donors and HIV-AIDS patients in Ghana.The results presented herein indicate that HHV-8, CMV and EBV infections are hyperendemic in both HIV-seronegative and HIV-seropositive Ghanaians, and suggest primarily a horizontal route of transmission of these three viral infections in Ghana.There are currently eight known human herpesviruses: cytomegalovirus (CMV), Epstein-Barr virus (EBV), herpes simplex virus 1, herpes simplex virus 2, human herpesvirus 6, human herpesvirus 7, human herpesvirus 8 (HHV-8), and varicella-zoster virus. All eight, except herpesvirus 6 and herpesvirus 7, are known to be pathogenic to humans. HHV-8 is also known as Kaposi's sarcoma-associated he
Unexpected elevated alanine aminotransferase, asparte aminotransferase levels and hepatitis E virus infection among persons who work with pigs in accra, ghana
Andrew A Adjei, Yao Tettey, John T Aviyase, Clement Adu-Gyamfi, Julius A Mingle, Edmund T Nartey
Virology Journal , 2010, DOI: 10.1186/1743-422x-7-336
Abstract: Three hundred and fifty- persons who work with pigs provided blood samples for unlinked anonymous testing for the presence of antibodies to HEV, ALT and AST levels. The median age of participants was 32.85 ± 11.38 years (range 15-70 years). HEV seroprevelance was 34.84%. Anti-HEV IgG was detected in 19.26% while anti-HEV IgM was detected in 15.58% of the persons who tested positive. On multivariate analysis, the independent determinants of HEV infection were, being employed on the farm for less than six months [odds ratio (OR) 8.96; 95% confidence interval (95% CI) 5.43-14.80], having piped water in the household and/or on the farm (OR 13.33; 95% CI 5.23-33.93) and consumption of alcohol (OR 4.91: 95% CI 2.65-9.10). Levels >3× the expected maximum were found for both ALT and AST among individuals who tested positive for anti-HEV IgG (ALT, 210.17 ± 11.64 U/L; AST, 127.18 ± 11.12 U/L) and anti-HEV IgM (ALT, 200.97 ± 10.76 U/L; AST, 120.00 ± 15.96 U/L).Consistent with similar studies worldwide, the results of our studies revealed a high prevalence of HEV infection, ALT and AST values in pig handlers.Hepatitis E virus (HEV) infection is one of the major cause of human viral disease with clinical and pathological features of acute hepatitis. The infection represents an important public health concern in many developing countries, where it is primarily transmitted through the faecal oral route due to contaminated water and food [1], and is often responsible for epidemic outbreaks [2]. The infection affects primarily young adults and is generally mild, except for women in late pregnancy in whom 20% mortality has been reported [3].The first animal strain of HEV was characterised in pigs in the United States of America [4,5] and since then several other strains have been described in pigs worldwide [4,6] suggestive that pigs can represent a reservoir of the infection. The identification of a U.S.A. strain of HEV apparently acquired inside the U.S.A. after the isolation of a
Aetiology of Acute Lower Respiratory Infections among Children Under Five Years in Accra, Ghana
Theophilus K. Adiku,Richard H. Asmah,Onike Rodrigues,Bamenla Goka,Evangeline Obodai,Andrew A. Adjei,Eric S. Donkor,George Armah
Pathogens , 2015, DOI: 10.3390/pathogens4010022
Abstract: The study aimed to investigate the aetiological agents and clinical presentations associated with acute lower respiratory infections (ALRI) among children under five years old at the Korle-Bu Teaching Hospital in Ghana. This was a cross-sectional study carried from February to December 2001. Nasopharyngeal aspirates and venous blood specimens obtained from 108 children with features suggestive of ALRI, were cultured and the isolated bacterial organisms were identified biochemically. Nasopharyngeal aspirates were also tested for Respiratory Syncitial Virus (RSV) antigen using a commercial kit (Becton Dickinson Directigen RSV test kit). A multiplex reverse transcription-PCR (RT-PCR) was also used to detect and characterize RSV using extracted RNA. Socio-demographic and clinical data were also obtained from the study subjects. Bronchopneumonia (55.5%), bronchiolitis (25%), lobar pneumonia (10.2), non-specific ALRI (4.6%), TB, bronchitis and respiratory distress (0.67%) were diagnosed. The prevalence of septicaemia was 10% and bacteria isolated were Staphylococcus aureus, Streptococcus pneumoniae and enteric bacteria, including Salmonella spp., Enterobacter spp and Klebsiella spp, were isolated. Out of the 108 cases, 18% tested positive for RSV, with two cases having RSV as the only aetiological pathogen detected. The subtyping analysis of RSV strains by a multiplex RT-PCR showed that subgroups A and B circulated in the season of analysis.
Microfinance: an alternative means of healthcare financing for the poor
A Ofori-Adjei
Ghana Medical Journal , 2007,
Abstract: No
Elevated Levels of IL-10 and G-CSF Associated with Asymptomatic Malaria in Pregnant Women
Nana O. Wilson,Tameka Bythwood,Wesley Solomon,Pauline Jolly,Nelly Yatich,Yi Jiang,Faisal Shuaib,Andrew A. Adjei,Winston Anderson,Jonathan K. Stiles
Infectious Diseases in Obstetrics and Gynecology , 2010, DOI: 10.1155/2010/317430
Abstract: In sub-Saharan Africa, approximately 30 million pregnant women are at risk of contracting malaria annually. Nearly 36% of healthy pregnant women receiving routine antenatal care tested positive for Plasmodium falciparum HRP-II antigen in Ghana. We tested the hypothesis that asymptomatic HRP II positive pregnant women expressed a unique Th1 and Th2 phenotype that differs from healthy controls. Plasma from healthy ( ) and asymptomatic ( ) pregnant women were evaluated for 27 biomarkers (IL-1b, IL-1ra, IL-2, IL-4, IL-5, IL-6, IL-7, IL-8, IL-9, IL-10, IL-12, IL-13, IL-15, IL- 17, Eotaxin, bFGF-2, G-CSF, GM-CSF, IFN- , IP-10, MCP-1, MIP-1 , MIP-1 , PDGF-bb, RANTES, TNF, and VEGF) associated with Th1 and Th2 cytokine homeostasis. IL-10 and G-CSF levels were elevated in the asymptomatic group when compared with the healthy group ( and .041, resp.). The median ratios of IL-1 :5, IL-1 :10, IL-1 :G-CSF, IL-1 :Eotaxin, IL-12:G-CSF, IL-15:10, IL-17:G-CSF, IL-17:Eotaxin, TNF:IL-4, TNF:IL-5, and TNF:G-CSF were significantly different among the two groups. Thus, asymptomatic malaria carriage may be linked to circulating levels of IL-10 and G-CSF. 1. Introduction The World Health Organization estimates that around 250 million cases of malaria infections and 1–3 million associated deaths globally are reported annually [1]. Infection with Plasmodium falciparum has a wide spectrum of manifestations that are classified into three main clinical groups: asymptomatic (presence of malaria parasite without malaria symptoms), mild, and severe malaria. In malaria-endemic areas, a significant proportion of individuals considered asymptomatic, harbor parasites without presenting signs of clinical malaria [2]. The significance of such asymptomatic infections in the broader context of malaria transmission has been evaluated in diverse situations using complementary approaches [3–6]. Variant-specific immunity has been used to explain the low-grade infection during extended periods without clinical symptoms [7]. Studies suggest that long-term asymptomatic carriage may represent a form of tolerance to parasites in individuals such that asymptomatic carriage may protect these individuals from developing severe malaria [3–5]. Older individuals are more likely to develop uncomplicated malaria or asymptomatic parasitemia [8]. In high malaria endemic areas, protection from severe malaria is acquired early during childhood, although it takes longer to be protected from less severe disease [9]. Although immunoprotective mechanisms clear a large proportion of infected erythrocytes, a subset
Correlates of HIV, HBV, HCV and syphilis infections among prison inmates and officers in Ghana: A national multicenter study
Andrew A Adjei, Henry B Armah, Foster Gbagbo, William K Ampofo, Isaac Boamah, Clement Adu-Gyamfi, Isaac Asare, Ian FA Hesse, George Mensah
BMC Infectious Diseases , 2008, DOI: 10.1186/1471-2334-8-33
Abstract: A national multicenter cross-sectional study was undertaken on correlates of human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), and syphilis infections in sample of prison inmates and officers from eight of ten regional central prisons in Ghana. A total of 1366 inmates and 445 officers were enrolled between May 2004 and December 2005. Subjects completed personal risk-factor questionnaire and provided blood specimens for unlinked anonymous testing for presence of antibodies to HIV, HCV and Treponema pallidum; and surface antigen of HBV (HBsAg). These data were analyzed using both univariate and multivariate techniques.Almost 18% (1336) of 7652 eligible inmates and 21% (445) of 2139 eligible officers in eight study prisons took part. Median ages of inmates and officers were 36.5 years (range 16–84) and 38.1 years (range 25–59), respectively. Among inmates, HIV seroprevalence was 5.9%, syphilis seroprevalence was 16.5%, and 25.5% had HBsAg. Among officers tested, HIV seroprevalence was 4.9%, HCV seroprevalence was 18.7%, syphilis seroprevalence was 7.9%, and 11.7% had HBsAg. Independent determinants for HIV, HBV and syphilis infections among inmates were age between 17–46, being unmarried, being illiterate, female gender, being incarcerated for longer than median time served of 36 months, history of homosexuality, history of intravenous drug use, history of sharing syringes and drug paraphernalia, history of participation in paid sexual activity, and history of sexually transmitted diseases. Independent determinants for HIV, HBV, HCV and syphilis infections among officers were age between 25–46, fale gender, being unmarried, being employed in prison service for longer than median duration of employment of 10 years, and history of sexually transmitted diseases.The comparably higher prevalence of HIV, HBV, HCV and syphilis in prison inmates and officers in Ghana suggests probable occupational related transmission. The implementation of
RAGE (Receptor for Advanced Glycation Endproducts), RAGE Ligands, and their role in Cancer and Inflammation
Louis J Sparvero, Denise Asafu-Adjei, Rui Kang, Daolin Tang, Neilay Amin, Jaehyun Im, Ronnye Rutledge, Brenda Lin, Andrew A Amoscato, Herbert J Zeh, Michael T Lotze
Journal of Translational Medicine , 2009, DOI: 10.1186/1479-5876-7-17
Abstract: The Receptor for Advanced Glycation Endproducts [RAGE] is a member of the immunoglobulin superfamily, encoded in the Class III region of the major histocompatability complex [1-4]. This multiligand receptor has one V type domain, two C type domains, a transmembrane domain, and a cytoplasmic tail. The V domain has two N-glycosylation sites and is responsible for most (but not all) extracellular ligand binding [5]. The cytoplasmic tail is believed to be essential for intracellular signaling, possibly binding to diaphanous-1 to mediate cellular migration [6]. Originally advanced glycation endproducts (AGEs) were indeed thought to be its main activating ligands, but since then many other ligands of RAGE including damage-associated molecular patterns (DAMP's) have been identified [1,7,8]. RAGE is thus considered a pattern-recognition receptor (PRR), having a wide variety of ligands [9-11].RAGE is expressed as both full-length, membrane-bound forms (fl-RAGE or mRAGE, not to be confused with mouse RAGE) and various soluble forms lacking the transmembrane domain. Soluble RAGE is produced by both proteolytic cleavage of fl-RAGE and alternative mRNA splicing. The soluble isoforms include the extracellular domains but lack the transmembrane and cytoplasmic domains [12-15]. Soluble RAGE derived specifically from proteolytic cleavage is sRAGE, although this terminology is not consistent in the literature – sRAGE sometimes refers to soluble RAGE in general. RAGE is expressed at low levels in a wide range of differentiated adult cells in a regulated manner but in mature lung type-I pneumocytes it is expressed at substantially higher levels than in other resting cell types. It is highly expressed in readily detectable amounts in embryonic cells [16]. RAGE is also highly expressed and associated with many inflammation-related pathological states such as vascular disease, cancer, neurodegeneration and diabetes (Figure 1) [17,18]. The exceptions are lung tumors and idiopathic pulmonar
Plasmodium yoelii 17XL infection up-regulates RANTES, CCR1, CCR3 and CCR5 expression, and induces ultrastructural changes in the cerebellum
Bismark Y Sarfo, Henry B Armah, Ikovwaiza Irune, Andrew A Adjei, Christine S Olver, Shailesh Singh, James W Lillard, Jonathan K Stiles
Malaria Journal , 2005, DOI: 10.1186/1475-2875-4-63
Abstract: The alterations in immunomodulator gene expression in brains of Plasmodium yoelii 17XL-infected mice was analysed using cDNA microarray screening, followed by a temporal comparison of mRNA and protein expression of RANTES and its corresponding receptors by qRT-PCR and Western blot analysis, respectively. Plasma RANTES levels was determined by ELISA and ultrastructural studies of brain sections from infected and uninfected mice was conducted.RANTES (p < 0.002), CCR1 (p < 0.036), CCR3 (p < 0.033), and CCR5 (p < 0.026) mRNA were significantly upregulated at peak parasitaemia and remained high thereafter in the experimental mouse model. RANTES protein in the brain of infected mice was upregulated (p < 0.034) compared with controls. RANTES plasma levels were significantly upregulated; two to three fold in infected mice compared with controls (p < 0.026). Some d istal microvascular endothelium in infected cerebellum appeared degraded, but remained intact in controls.The upregulation of RANTES, CCR1, CCR3, and CCR5 mRNA, and RANTES protein mediate inflammation and cellular degradation in the cerebellum during P. yoelii 17XL malaria.Malaria afflicts between 300–500 million people causing up to 2 million deaths globally per year [1]. Cerebral malaria (CM), characterized by seizures and loss of consciousness, is the most severe complication of Plasmodium falciparum infection with mortality rates ranging from 15 to 20% [2,3]. Malaria-induced brain inflammation is known to be mediated partly by complex cellular and immunomodulator interactions, involving co-regulators such as cytokines and adhesion molecules, resulting in the sequestration of parasite-infected erythrocytes in the brain in human CM. Apart from the sequestration of P. falciparum-infected erythrocytes, recent studies [4-7] have revealed significant accumulation of platelets and leukocytes in the distal microvasculature of the brains of human cases of CM, suggesting a role for platelet and leukocyte sequestration i
Hepatitis E virus infection is highly prevalent among pregnant women in Accra, Ghana
Andrew A Adjei, Yao Tettey, John T Aviyase, Clement Adu-Gyamfi, Samuel Obed, Julius AA Mingle, Patrick F Ayeh-Kumi, Theophilus K Adiku
Virology Journal , 2009, DOI: 10.1186/1743-422x-6-108
Abstract: 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%).Consistent with similar studies worldwide, the results of our studies revealed a high prevalence of HEV infection in pregnant women.Hepatitis E virus (HEV) infection is a major cause of human viral disease with clinical and pathological features of acute hepatitis. The infection represents an important public health concern in many developing countries, where it is primarily transmitted through the faecal oral route due to contaminated water and food [1] and is often responsible for epidemic outbreaks [2]. The infection affects primarily young adults and is generally mild [3]; however, the mortality rate is higher among women, especially during the second or third trimesters of pregnancy [4-6]. In Sudan, a case:fatality ratio of 17.8% was found in an outbreak in Darfur, with a ratio of 31.1% among pregnant women [7]. In related studies, Stoszek et al. and Patra et al. reported prevalence rates of 84.3% and 60%, among pregnant women in Egypt and India, respectively [8,9].In Ghana, studies of HEV seroprevalence in pregnant women have not been done previously. However, recently we observed HEV seroprevalence rate of 38.1% among persons who work with
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