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    Aetiological agents of cerebrospinal meningitis: a retrospective study from a teaching hospital in Ghana
    (Annals of Clinical Microbiology and Antimicrobials, 2012) Owusu, Michael; Nguah, Samuel Blay; Boaitey, Yaw Agyekum; Badu-Boateng, Ernest; Abubakr, Abdul-Raman; Lartey, Robert Awuley; Adu-Sarkodie, Yaw; 0000-0001-5066-150X; 0000-0002-2118-7711; 0000-0002-0496-5155
    Background: Meningitis is an important cause of morbidity and mortality in low-resource settings. In sub-Saharan Africa, the meningitis belt has been characterized by particularly high and seasonal incidences of bacterial meningitis extending throughout life. Despite the progress being made in treating the condition, the mortality rates continue to be high, ranging between 2% and 30% globally. In Ghana, the mortality rate of meningitis has been estimated to range from 36% to 50%. However little information is available on the pathogens contributing to meningitis and their antimicrobial susceptibilities. Updated information is essential to adjust the recommendations for empirical treatment or prevention of meningitis which could have immense implications for local and global health. Methods: We retrospectively reviewed laboratory records of all patients suspected of bacterial meningitis who underwent a lumbar puncture from January 1, 2008 to December 31, 2010. Data were retrieved from laboratory record books and double entered into a MicrosoftW excel spreadsheet. Results: Records of 4,955 cerebrospinal fluid samples were analysed. Of these, 163 (3.3%, 95%CI: 2.8% to 3.8%) were confirmed meningitis and 106 (2.1%, 95%CI: 1.7% to 2.6%) were probable meningitis cases. Confirmed meningitis cases were made up of 117 (71.8%) culture positive bacteria, 19 (11.7%) culture positive Cryptococcus neoformans and 27(16.6%) Gram positive bacteria with negative culture. The most prevalent bacteria was Streptococcus pneumoniae 91 (77.7%), followed by E.coli 4 (3.4%), Salmonella species 4 (3.4%), Neisseria meningitidis 3 (2.5%), Pseudomonas species 3(2.5%) and others. Pneumococcal isolates susceptibility to penicillin, chloramphenicol and ceftriaxone were 98.9% (95%CI: 94.0% to 100.0%), 83.0% (95%CI: 73.4% to 90.1%) and 100.0% (95%CI: 95.8% to 100.0%) respectively. Conclusion: Streptococcus pneumoniae is an important cause of meningitis among all age groups and its susceptibility to penicillin and ceftriaxone still remains very high. Ghanaians of all ages and possibly other developing countries in the meningitis belt could benefit from the use of the pneumococcal vaccine. Other bacterial and fungal pathogens should also be considered in the management of patients presenting with meningitis.
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    Characterization of Typhoid Intestinal Perforation in Africa: Results From the Severe Typhoid Fever Surveillance in Africa Program
    (OFID, 2023) Birkhold, Megan; Datta, Shrimati; Pak, Gi Deok; Im, Justin; Ogundoyin, Olakayode O.; Olulana, Dare I.; Lawal, Taiwo A.; Owusu, Michael; 0000-0002-5746-1321; 0000-0001-5066-150X
    Background. Typhoid intestinal perforation (TIP) remains the most serious complication of typhoid fever. In many countries, the diagnosis of TIP relies on intraoperative identification, as blood culture and pathology capacity remain limited. As a result, many cases of TIP may not be reported as typhoid. This study demonstrates the burden of TIP in sites in Burkina Faso, Democratic Republic of Congo (DRC), Ethiopia, Ghana, Madagascar, and Nigeria. Methods. Patients with clinical suspicion of nontraumatic intestinal perforation were enrolled and demographic details, clinical findings, surgical records, blood cultures, tissue biopsies, and peritoneal fluid were collected. Participants were then classified as having confirmed TIP, probable TIP, possible TIP, or clinical intestinal perforation based on surgical descriptions and cultures. Results. A total of 608 participants were investigated for nontraumatic intestinal perforation; 214 (35%) participants had surgically-confirmed TIP and 33 participants (5%) had culture-confirmed typhoid. The overall proportion of blood or surgical site Salmonella enterica subspecies enterica serovar Typhi positivity in surgically verified TIP cases was 10.3%. TIP was high in children aged 5–14 years in DRC, Ghana, and Nigeria. We provide evidence for correlation between monthly case counts of S. Typhi and the occurrence of intestinal perforation. Conclusions. Low S. Typhi culture positivity rates, as well as a lack of blood and tissue culture capability in many regions where typhoid remains endemic, significantly underestimate the true burden of typhoid fever. The occurrence of TIP may indicate underlying typhoid burden, particularly in countries with limited culture capability.
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    Clinical profile and predictors of viral suppression in HIV-infected older adults at a University Hospital in Kumasi, Ghana
    (AIDS Care, 2022) Ayisi-Boateng Nana Kwame; Opoku, Douglas Aninng; Nkrumah, Isaac; Frempong, Bernard; Owusu, Michael; Oduro, Eric; Ampah, Brenda Abena; Konadu, Emmanuel; Norman, Betty; 0000-0002-0961-4434; 0000-0003-2321-387X; 0000-0001-5066-150X
    Availability of effective antiretroviral therapy (ART) has improved patient survival and older adults (≥50 years old) constitute 10% of the world’s HIV population. However, data on this population are lacking, especially in sub-Saharan Africa. To identify the profile of older adults with HIV infection receiving ART and factors associated with viral suppression. A retrospective cross-sectional study involving HIV patients ≥50 years, registered at a University Hospital in Kumasi, Ghana from January 2010 to July 2020. All study participants had been on ARTs for ≥12 months. Data were analysed using STATA® and multivariate logistic regression was done to determine the association between variables. We recruited 132 study participants with a mean age of 58.1 years (±6.8). Non-communicable diseases (NCD) comprised the commonest comorbidity (67.4%;n = 89) and hypertension was the most prevalent (47.2%). The mean duration of ART was 63.2 months (±32.0) and approximately 84.1% (n = 111) achieved viral suppression (≤50 copies/ml). After adjustment, factors independently associated with viral suppression were widow(ed) (aOR = 0.23; 95% CI = 0.07–0.72) and good ART adherence (aOR = 3.51; 95% CI = 1.03–11.99). Hypertension is prevalent among this cohort of HIV patients. Approximately 84% of elderly patients on ARTs achieve viral suppression, influenced by widowhood and good drug adherence.
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    Diagnostics for COVID-19: A case for field-deployable, rapid molecular tests for community surveillance
    (Ghana Med J., 2020) Frimpong, Michael; Amoako, Yaw A.; Anim, Kwadwo B.; Ahor, Hubert S.; Yeboah Richmond; Arthur, Joshua; Dakorah, Justin S.; Gborgblovor, Delphine; Akrofi, Samuel; Owusu, Michael; Sylverken, Augustina Angelina; Binger, Tabea; Phillips, Richard Odame; Djan, Phyllis Sekyi; 0000-0003-1901-6793; 0000-0002-4642-789X; 0000-0001-5066-150X
    Across the globe, the outbreak of the COVID-19 pandemic is causing distress with governments doing everything in their power to contain the spread of the novel coronavirus (SARS-CoV-2) to prevent morbidity and mortality. Actions are being implemented to keep health care systems from being overstretched and to curb the outbreak. Any policy responses aimed at slowing down the spread of the virus and mitigating its immediate effects on health care systems require a firm basis of information about the absolute number of currently infected people, growth rates, and locations/hotspots of infections. The only way to obtain this base of information is by conducting numerous tests in a targeted way. Currently, in Ghana, there is a centralized testing approach, that takes 4-5 days for samples to be shipped and tested at central reference laboratories with results communicated to the district, regional and national stakeholders. This delay in diagnosis increases the risk of ongoing transmission in communities and vulnerable institutions. We have validated, evaluated and deployed an innovative diagnostic tool on a mobile laboratory platform to accelerate the COVID-19 testing. A preliminary result of 74 samples from COVID-19 suspected cases has a positivity rate of 12% with a turn-around time of fewer than 3 hours from sample taking to reporting of results, significantly reducing the waiting time from days to hours, enabling expedient response by the health system for contact tracing to reduce transmission and additionally improving case management.
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    Effect of Pulmonary Tuberculosis on Protein C, S, and Antithrombin-III among Therapy-naïve Ghanaian Adults; A Comparative Cross-Sectional Study
    (Journal of Immunoassay and Immunochemistry, 2020-12-30) Osei-Boakye, Felix; Addai-Mensah, Otchere; Owusu, Michael; Saasi, Abdul-Razak; Appiah, Samuel Kwasi; Nkansah, Charles; Wiafe, Yaw Amo; Debrah, Alexander Yaw; 0000-0001-5126-7424; 0000-0001-9225-5876; 0000-0001-5066-150X; 0000-0003-1855-5840; 0000-0001-6986-9976; 0000-0002-0944-0577; 0000-0001-5721-0891
    Background: Tuberculosis (TB) constitutes a global emergency as it affects one-third of the world’s inhabitants. Although pulmonary Tuberculosis (PTB) is curable, immunological responses to the infection induce several haematological derangements. This study evaluated the effect of PTB on Protein C, Protein S, Antithrombin-III, and blood count parameters. Methods. Ninety adults with ages ≥18 years were purposively recruited: 60 PTB patients and 30 non-TB controls. All patients were diagnosed with sputum GeneXpert MTB/Rif assay. Blood specimens were collected from each participant for Protein C, S, Antithrombin-III and complete blood count. Results: Pulmonary TB was associated with signifi cantly reduced Protein C activity (101.46 [87.61-128.3] vs 121.44 [99.50-149.8] IU/L, p=0.038), RBC (3.88±0.91 vs 4.80±0.55, p<0.0001), HgB (10.24±2.42 vs 11.78±1.42, p=0.0019), HCT (32.21±7.79 vs 42.05±4.97, p<0.0001), MCV (83.80 [79.33-90.08] vs 89.00 [83.75-92.00], p=0.0133) and PDW (12.95 [10.73-15.00] vs 15.30 [14.18-15.93], p<0.0001) compared to controls. Conversely, PTB patients were associated with signifi cantly increased MCH (26.83±4.33 vs 24.59±1.99, p=0.0086), TWBC (7.76 [6.06-9.78] vs 6.50 [4.85-7.50], p=0.0047), Abs. GRAN (5.27 [3.30-6.71] vs 3.75 [2.48-4.75], p=0.0226), RDW-CV (13.70 [13.20-15.43] vs 12.95 [12.50-13.65], p<0.0001), MCHC (32.10 [28.70-35.63] vs 27.85 [27.40-28.53], p<0.0001) and MPV (8.3 [6.7-9.7] vs 7.0 [6.4-7.5], p=0.0027) compared to controls. The PTB patients were disproportionately affected with anaemia (91.7%, p=0.001), erythrocytopenia (75.0%; p≤0.001) and reduced HCT (80.0%, p≤0.001). The frequency of thrombocytosis, leucocytosis, and granulocytosis (50.0%, p=0.013; 23.3%, p=0.013; 18.3%, p=0.025; respectively) in PTB patients were signifi cantly higher than in controls. Conclusion. Our findings suggest that PTB predisposes patients to hypercoagulability, with a significant reduction in Protein C activity but not Protein S and antithrombin-III. The condition causes derangements in erythrocytes, leucocytes, and thrombocytes, and disproportionately causes anaemia. Protein C activity and complete blood count are useful in the management of PTB and should be included in the routine workup for patients.
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    Effects of COVID-19 disease on PAI-1 antigen and haematological parameters during disease management: A prospective cross sectional study in a regional Hospital in Ghana
    (PLOS Glob Public Health, 2023) Nkansah, Charles; Owusu, Michael; Appiah, Samuel Kwasi; Mensah, Kofi; Bani, Simon Bannison; Osei-Boakye, Felix; Agyemang, Lawrence Duah; Ackah, Ezekiel Bonwin; Abbam, Gabriel; Dauda, Samira; Quansah, Yeduah...et.al; 0000-0001-6986-9976; 0000-0001-5066-150X; 0000-0002-2238-2797; 0000-0002-6713-6653; 0000-0001-5126-7424
    Background: Individuals with COVID-19 experience thrombotic events probably due to the associated hypofibrinolysis resulting from the upregulation of plasminogen activator inhibitor-1 (PAI-1) antigen. This study evaluated plasma PAI-1 antigen levels and haematological parameters before treatment and after recovery from severe COVID-19 in Ghana. Materials and methods: This cross-sectional study was conducted at Sunyani Regional Hospital, and recruited 51 patients who had RT-PCR-confirmed SARS-CoV-2. Participants’ sociodemographic data and clinical characteristics were taken from the hospital records. Venous blood was taken before COVID-19 treatment commenced for FBC, PAI-1 and ferritin assays. FBC was assessed using an automated haematology analyzer, whilst plasma PAI-1 Ag and serum ferritin levels were assessed with sandwich ELISA. All the tests were repeated immediately after participants recovered from COVID-19. Results: Of the 51 participants recruited into the study, 78.4% (40) had non-severe COVID-19 whiles 21.6% (11) experienced a severe form of the disease. Severe COVID-19 participants had significantly lower haemoglobin (g/dL): 8.1 (7.3–8.4) vs 11.8 (11.0–12.5), p<0.001; RBC x 1012/L: 2.9 (2.6–3.1) vs 3.4 (3.1–4.3), p = 0.001; HCT%: 24.8 ± 2.6 vs 35.3 ± 6.7, p<0.001 and platelet x 109 /L: 86.4 (62.2–91.8) vs 165.5 (115.1–210.3), p<0.001, compared with the non-severe COVID-19 group. But WBC x 109 /L: 11.6 (9.9–14.2) vs 5.4 (3.7–6.6), p<0.001 and ferritin (ng/mL): 473.1 (428.3–496.0) vs 336.2 (249.9–386.5), p<0.001, were relatively higher in the participants with severe COVID-19 than the non-severe COVID-19 counter parts. Also, the severely ill SARS-CoV-2-infected participants had relatively higher plasma PAI-1 Ag levels (ng/mL): 131.1 (128.7–131.9) vs 101.3 (92.0–116.8), p<0.001, than those with the non-severe form of the disease. Participants had lower haemoglobin (g/dL): 11.4 (8.8–12.3 vs 12.4 (11.5–13.6), p<0.001; RBC x 1012/L: 3.3 (2.9–4.0) vs 4.3 (3.4–4.6), p = 0.001; absolute granulocyte count x 109 /L: 2.3 ± 1.0 vs 4.6 ± 1.8, p<0.001, and platelet x 109 /L: 135.0 (107.0–193.0) vs 229.0 (166.0–270.0), p<0.001 values at admission before treatment commenced, compared to when they recovered from the disease. Additionally, the median PAI-1 Ag (ng/mL): 89.6 (74.9–100.8) vs 103.1 (93.2–128.7), p<0.001 and ferritin (ng/mL): 242.2 (197.1–302.1) vs 362.3 (273.1–399.9), p<0.001 levels were reduced after a successful recovery from COVID-19 compared to the values at admission. Conclusion: Plasma PAI-1 Ag level was higher among severe COVID-19 participants. The COVID-19- associated inflammation could affect red blood cell parameters and platelets. Successful recovery from COVID-19, with reduced inflammatory response as observed in the decline of serum ferritin levels restores the haematological parameters. Plasma levels of PAI-1 should be assessed during the management of severe COVID-19 in Ghana. This will enhance the early detection of probable thrombotic events and prompts Physicians to provide interventions to prevent thrombotic complications associated with COVID-19.
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    Effects of COVID-19 disease on PAI-1 antigen and haematological parameters during disease management: A prospective cross-sectional study in a regional Hospital in Ghana
    (PLOS Glob Public Health, 2023) Nkansah, Charles; Owusu, Michael; Appiah, Samuel Kwasi; Mensah, Kofi; Bani, Simon Bannison; Osei-Boakye, Felix; Agyemang, Lawrence Duah; Ackah, Ezekiel Bonwin; Abbam, Gabriel; Daud, Samira; Quansah, Yeduah; et.al...; 0000-0001-6986-9976; 0000-0001-5066-150X; 0000-0002-2238-2797
    Background Individuals with COVID-19 experience thrombotic events probably due to the associated hypofibrinolysis resulting from the upregulation of plasminogen activator inhibitor-1 (PAI-1) antigen. This study evaluated plasma PAI-1 antigen levels and haematological parameters before treatment and after recovery from severe COVID-19 in Ghana. Materials and methods This cross-sectional study was conducted at Sunyani Regional Hospital, and recruited 51 patients who had RT-PCR-confirmed SARS-CoV-2. Participants’ sociodemographic data and clinical characteristics were taken from the hospital records. Venous blood was taken before COVID-19 treatment commenced for FBC, PAI-1 and ferritin assays. FBC was assessed using an automated haematology analyzer, whilst plasma PAI-1 Ag and serum ferritin levels were assessed with sandwich ELISA. All the tests were repeated immediately after participants recovered from COVID-19. Results Of the 51 participants recruited into the study, 78.4% (40) had non-severe COVID-19 whiles 21.6% (11) experienced a severe form of the disease. Severe COVID-19 participants had significantly lower haemoglobin (g/dL): 8.1 (7.3–8.4) vs 11.8 (11.0–12.5), p<0.001; RBC x 1012/L: 2.9 (2.6–3.1) vs 3.4 (3.1–4.3), p = 0.001; HCT%: 24.8 ± 2.6 vs 35.3 ± 6.7, p<0.001 and platelet x 109 /L: 86.4 (62.2–91.8) vs 165.5 (115.1–210.3), p<0.001, compared with the non-severe COVID-19 group. But WBC x 109 /L: 11.6 (9.9–14.2) vs 5.4 (3.7–6.6), p<0.001 and ferritin (ng/mL): 473.1 (428.3–496.0) vs 336.2 (249.9–386.5), p<0.001, were relatively higher in the participants with severe COVID-19 than the non-severe COVID-19 counter parts. Also, the severely ill SARS-CoV-2-infected participants had relatively higher plasma PAI-1 Ag levels (ng/mL): 131.1 (128.7–131.9) vs 101.3 (92.0–116.8), p<0.001, than those with the non-severe form of the disease. Participants had lower haemoglobin (g/dL): 11.4 (8.8–12.3 vs 12.4 (11.5–13.6), p<0.001; RBC x 1012/L: 3.3 (2.9–4.0) vs 4.3 (3.4–4.6), p = 0.001; absolute granulocyte count x 109 /L: 2.3 ± 1.0 vs 4.6 ± 1.8, p<0.001, and platelet x 109 /L: 135.0 (107.0–193.0) vs 229.0 (166.0–270.0), p<0.001 values at admission before treatment commenced, compared to when they recovered from the disease. Additionally, the median PAI-1 Ag (ng/mL): 89.6 (74.9–100.8) vs 103.1 (93.2–128.7), p<0.001 and ferritin (ng/mL): 242.2 (197.1–302.1) vs 362.3 (273.1–399.9), p<0.001 levels were reduced after a successful recovery from COVID-19 compared to the values at admission. Conclusion Plasma PAI-1 Ag level was higher among severe COVID-19 participants. The COVID-19- associated inflammation could affect red blood cell parameters and platelets. Successful recovery from COVID-19, with reduced inflammatory response as observed in the decline of serum ferritin levels restores the haematological parameters. Plasma levels of PAI-1 should be assessed during the management of severe COVID-19 in Ghana. This will enhance the early detection of probable thrombotic events and prompts Physicians to provide interventions to prevent thrombotic complications associated with COVID-19.
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    Effects of COVID-19 disease on PAI-1 antigen and haematological parameters during disease management: A prospective cross-sectional study in a regional Hospital in Ghana
    (PLOS Glob Public Health, 2023) Nkansah, Charles; Owusu, Michael; Appiah, Samuel Kwasi; Mensah, Kofi; Bani, Simon Bannison; Osei-Boakye, Felix; Agyemang, Lawrence Duah; Ackah, Ezekiel Bonwin; Abbam, Gabriel; Daud, Samira; et.al...; 0000-0001-6986-9976; 0000-0001-5066-150X
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    Haematological Profile and ACE2 Levels of COVID-19 Patients in a Metropolis in Ghana
    (COVID, 2024) Ackah, Ezekiel B.; Owusu, Michael; Sackey, Benedict; Boamah, Justice K.; Kamasah, Japhet S.; Aduboffour, Albert A.; Akortia, Debora; Nkrumah, Gifty; Amaniampong, Andrews; Klevor, Nicholas; Agyemang, Lawrence D.; Ayisi-Boateng, Nana K.; Sylverken, Augustina; Phillips, Richard Odame; Owusu-Dabo, Ellis; 0000-0001-7491-5420; 0000-0001-5066-150X; 0000-0003-1016-7720; 0000-0003-0369-555X; 0000-0002-0961-4434; 0000-0002-7691-914X; 0000-0001-8992-0222; 0000-0003-4232-4292
    Background: Several studies have linked coronavirus disease 2019 (COVID-19) risk to age and ABO blood groups. Variations in plasma angiotensin-converting enzyme 2 (ACE2) levels and blood counts have been reported, suggesting an association between disease severity and low lymphocyte levels. Aim: this study aimed to understand how these factors relate to COVID-19 in Ghanaian patients, considering geographical and demographic differences. Methods: Participants were recruited from six hospitals in Kumasi, Ghana, between June 2020 and July 2021. Nasopharyn geal swabs were taken to test for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and blood samples were collected for complete blood count testing, ABO/Rhesus typing, and assessment of plasma ACE2 levels. Demographic and COVID-19 severity data were gathered, and IBM SPSS version 25.0 was used for analysis. Results: Overall, 515 patients were enrolled, out of which 55.9% (n = 288/515) were males and 50.3% (n = 259/515) tested positive for SARS-CoV-2. The median age was 37 years (IQR = 26–53). Age was significantly associated with SARS-CoV-2 infection (p = 0.002). The severe COVID-19 group was the oldest (70 years, IQR = 35–80) and presented with anaemia (haemoglobin, g/dL: 9.55, IQR = 7.85–11.93), leukocytosis (WBC × 103/µL: 15.87, IQR = 6.68–19.80), neutrophilia (NEUT × 106/µL: 14.69, IQR = 5.70–18.96) and lymphocytopenia (LYMPH × 106/µL: 0.47, IQR = 0.22–0.66). No association was found between SARS-CoV-2 positivity and ABO (p = 0.711) or Rh (p = 0.805) blood groups; no association was also found between plasma ACE2 levels and SARS-CoV-2 status (p = 0.079). However, among COVID-19 participants, plasma ACE2 levels were significantly reduced in the moderate illness group (40.68 ng/mL, IQR = 34.09–48.10) compared with the asymptomatic group (50.61 ng/mL, IQR = 43.90–58.61, p = 0.015). Conclusions: While there may be no real association between the ABO blood group, as well as plasma ACE2 levels, and SARS-CoV-2 infection in Ghanaian patients, older individuals are at a higher risk of severe disease. Anaemia, and leukocytosis with lymphocytopenia may be indicators of poor disease progression.
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    Hepatitis B and C viral infections among blood donors. A retrospective study from a rural community of Ghana
    (BMC Research Notes, 2011) Nkrumah, Bernard; Owusu, Michael; Averu, Paul; 0000-0001-5066-150X
    Background: Infection by Hepatitis B virus (HBV) and Hepatitis C virus (HCV) cause serious mortality, morbidity and financial burden and are thus a major global health problem. The study was conducted to investigate the prevalence of Hepatitis B and C infections and co-infections among blood donors in a rural community of Ghana. This was a retrospective study conducted at the Agogo Presbyterian Hospital in the Asanti Akim North District of Ghana to investigate the prevalence of these infections over a three year period among 2773 blood donors. Males constituted a larger proportion of the study population (92.2%). Majority of the study population (43.9%) were within 26-35 age group. The disease prevalence was calculated at a 95% confidence interval. Findings: The prevalence of Hepatitis B viral (HBV) infection was highest in females- 21.4% (95% CI: 11.6-34.4) in 2006 than males in the same year- 13.2% (95% CI: 10.8-15.9). Hepatitis C viral (HCV) infection was highest among males- 11.6% (95% CI: 9.5-13.8) in 2007. HBV and HCV co-infection was higher in males- 2.6% (95% CI: 1.6-3.8) than females- 1.3% (95% CI: 0-7.0) in 2007. The overall prevalence of HBV and HCV was 13.8% (95% CI: 11.4- 16.4) and 9.4% (95% CI: 7.4-11.6) respectively in 2006. The rate of co-infection of HBV and HCV however increased from 1.6% (95% CI: 0.8-2.7) in 2006 to 2.2% (95% CI: 1.3-3.2) in 2008 in males and from 0% (95% CI: 0-6.4) in 2006 to 1.2% (95% CI: 0-6.5) in 2008 in females. Conclusion: The single infections of HBV and HCV reduced but co-infection of these transfusion transmitted infections increased. Measures such as more sensitive techniques for effective diagnosis and sanitary education to enlighten the population must be implemented.
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    Human defensins and Th-1 cytokines in hepatitis C viral infection
    (Pan African Medical Journal, 2020) Owusu, Dorcas Ohui; Owusu, Michael; Owusu, Bright Afriyie; 0000-0003-4299-5870; 0000-0001-5066-150X
    Introduction: active or chronic exacerbated forms of hepatitis C virus (HCV) infection subsequently progress to liver disease and human defensins has been determined to have some level of anti-viral properties invitro whilst the expression of T helper-1 cytokines is known to promote complete recovery from acute HCV infection. The study sought to determine relationship between these immune responses. Methods: a cross sectional descriptive study design was employed. Hundred and thirty-two individuals were assessed were assessed for to anti-HCV, HCV RNA, serum levels of human alpha defensins 1 (HAD-1) and human beta defensins 1 (HBD-1). T helper 1 cytokines (IL-2, IFN gamma, TNF alpha) secreted in serum were also analyzed using commercial ELISA assay. The study was conducted in Kumasi, Obuasi and Daboya in Ghana. Results: the serum mean concentrations of HAD-1, HBD-1, IL-2, IFN gamma and TNF alpha showed no significant difference in concentrations among participants with chronic, spontaneously recovered or negative to HCV infection (p>0.05). Persons with hepatitis B co-infection were more likely to develop chronic HCV infection (p=0.039). HAD-1 and HBD-1 showed significant positive association with IL-2 (p=0.000) whilst only HAD-1 positively correlated with IL-2 (p<0.000). Conclusion: the immunological markers determined had no association with the status of HCV infection. HAD-1 increased with increasing levels of IL-2. These findings suggest that during HCV infection, inflammatory response through the production of cytokines by IL-2 cells may affect the release of HAD-1 and HBD-1.
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    Infl uenza outbreak among students in Ghana: a report from three time points
    (Research Gate Publication, 2020-09-17) Sylverken, Augustina Angelina; Owusu, Michael; Yeboah, Richmond; El-Duah, Philip; Gorman, Richmond; Bonney, Joseph Kofi; Aryeetey, Sherihane; Adu, Kofi; et. al..; 0000-0002-7691-914X; 0000-0001-5066-150X; 0000-0002-2765-6179; 0000-0003-1671-0755; 0000-0002-6831-3375
    Background: Influenza viruses are known to be responsible for a number of respiratory disease outbreaks worldwide. While there exists documented information on influenza which allows for effective strategic preparedness activities in industrialized countries, the same cannot be said of developing and underdeveloped countries. It therefore behoves on developing countries to document information on circulating strains of influenza. Such information will enable prioritization of prevention and more targeted preparedness strategies. In this paper, we report on three different outbreaks of Influenza A among Ghanaian students in December 2017, May 2019 and December 2019 in the Ashanti region of Ghana. Methods: Throat or nasal samples were collected from all students who presented with signs and symptoms of fl u with flocked swabs, stored in RNAlater and transported to the laboratories of Kumasi Centre for Collaborative Research (KCCR) at ambient temperature. Following viral RNA extraction, detection of viral nucleic acid of both influenza A and its subtypes including H1N1 and H3N2 was done by real-time reverse transcription Polymerase Chain Reaction (RT-PCR). Results: A total of 112 samples were taken. An overall Influenza A prevalence of 51.8% (95% CI = 42.1-61.3) was recorded during the three outbreak time points. Of these, 11 (19.0%) were confirmed to be H1N1 (pdm09) and 47 (81.0%) were H3N2 strains. All the 11 H1N1 (pdm09) were identified during the first outbreak. The H3N2 strains were identified during the second and third outbreaks in May 2019 and December 2019 respectively. Our results show that influenza A virus activity was higher during the months of November and December compared to May. Age, contact with infected subjects, temperature, fever within the last 24 hours and headaches showed signifi cant variations (p-value <0.01) with respect to influenza A. Wald’s test revealed that subjects presenting with headaches had about 5 times odds (95%CI = 1.4-17.7) for infl enza A infection compared to subjects without headache (p = 0.014). Conclusion: Our study provides epidemiological information to better understand the incidence and burden of influenza to allow for prioritisation of prevention and control strategies. Such information would aid in controlling and preparing for future influenza epidemics.
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    Performance of SARS COV-2 IgG Anti-N as an Independent Marker of Exposure to SARS COV-2 in an Unvaccinated West African Population
    (Am. J. Trop. Med. Hyg.,, 2023) Abdullahi, Adam; Frimpong, James; Cheng, Mark T. K.; Aliyu, Sani H.; Smith, Colette; Abimiku, Alash’le; Phillips, Richard Odame; Owusu, Michael; Gupta, Ravindra K.; 0000-0001-9703-8264; 0000-0001-8992-0222; 0000-0001-5066-150X; 0000-0001-9751-1808
    Determination of previous SARS-COV-2 infection is hampered by the absence of a standardized test. The marker used to assess previous exposure is IgG antibody to the nucleocapsid (IgG anti-N), although it is known to wane quickly from peripheral blood. The accuracies of seven antibody tests (virus neutralization test, IgG anti-N, IgG anti-spike [anti-S], IgG anti–receptor binding domain [anti-RBD], IgG anti-N 1 anti-RBD, IgG anti-N 1 anti-S, and IgG anti-S 1 anti RBD), either singly or in combination, were evaluated on 502 cryopreserved serum samples collected before the COVID-19 vaccination rollout in Kumasi, Ghana. The accuracy of each index test was measured using a composite reference standard based on a combination of neutralization test and IgG anti-N antibody tests. According to the composite reference, 262 participants were previously exposed; the most sensitive test was the virus neutralization test, with 95.4% sensitivity (95% CI: 93.6–97.3), followed by 79.0% for IgG anti-N 1 anti-S (95% CI: 76.3–83.3). The most specific tests were virus neutrali zation and IgG anti-N, both with 100% specificity. Viral neutralization and IgG anti-N 1 anti-S were the overall most accu rate tests, with specificity/sensitivity of 100/95.2% and 79.0/92.1%, respectively. Our findings indicate that IgG anti-N alone is an inadequate marker of prior exposure to SARS COV-2 in this population. Virus neutralization assay appears to be the most accurate assay in discerning prior infection. A combination of IgG anti-N and IgG anti-S is also accurate and suited for assessment of SARS COV-2 exposure in low-resource settings.
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    Prevalence and risk factors of virological failure among children on antiretroviral therapy
    (BMG Glob Health, 2017) Owusu, Michael; Mensah, Michael; Enimil, Anthony; Mutocheluh, MOhammed; 0000-0001-5066-150X; 0000-0001-6521-3400
    An unprecedented global effort at scaling up universal access to antiretroviral therapy has decreased the progression of HIV. However, due to challenges with supplies and adherence to intermittent antiretroviral therapy (ART) for mothers, infants continue to be infected, some with resistant viruses. Exposure to these resistant strains leads to non responsiveness to therapy resulting in virological failure. Children are more vulnerable to HIV drug resistance because of their life long treatment, the possible selection of resistant strains as a result of prophylaxis for mothers with HIV enrolled in PMTCT. The objective of the study was to determine the prevalence and risk factors of virological resistance among HIV-1-positive children on antiretroviral therapy.
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    Profile and outcomes of hospitalized patients with COVID-19 at a tertiary institution hospital in Ghana
    (Ghana Med J., 2020) Ayisi-Boateng Nana Kwame; Owusu, Michael; Tawiah, Phyllis; Ampah, Brenda A.; Sylverken, Augustina Angelina; Wusu-Ansah, Owusu K.; Sarfo, Fred S.; Phillips, Richard Odame,; 0000-0002-0961-4434; 0000-0001-5066-150X; 0000-0002-2641-8865; 0000-0003-0588-0337
    Background: In high-income countries, mortality related to hospitalized patients with the Coronavirus disease 2019 (COVID-19) is approximately 4-5%. However, data on COVID-19 admissions from sub-Saharan Africa are scanty. Objective: To describe the clinical profile and determinants of outcomes of patients with confirmed COVID-19 admitted at a hospital in Ghana. Methods: A prospective study involving 25 patients with real time polymerase chain reaction confirmed COVID-19 admitted to the treatment centre of the University Hospital, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana from 1st June to 27th July, 2020. They were managed and followed up for outcomes. Data were analysed descriptively, and predictors of mortality assessed using a multivariate logistic regression modelling. Results: The mean age of the patients was 59.3 ± 20.6 years, and 14 (56%) were males. The main symptoms at presentation were breathlessness (68%) followed by fever (56%). The cases were categorized as mild (6), moderate (6), severe (10) and critical (3). Hypertension was the commonest comorbidity present in 72% of patients. Medications used in patient management included dexamethasone (68%), azithromycin (96%), and hydroxychloroquine (4%). Five of 25 cases died (Case fatality ratio 20%). Increasing age and high systolic blood pressure were associated with mortality. Conclusion: Case fatality in this sample of hospitalized COVID-19 patients was high. Thorough clinical assessment, severity stratification, aggressive management of underlying co-morbidities and standardized protocols in country might improve outcomes.
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    Respiratory viruses in children hospitalized for acute lower respiratory tract infection in Ghana
    (Virology Journal, 2012) Kwofie, Theophilus B.; Anane, Yaw A.; Nkrumah, Bernard; Annan, Augustina; Nguah, Samuel B; Owusu, Michael; 0000-0001-5066-150X
    Background: Acute respiratory tract infections are one of the major causes of morbidity and mortality among young children in developing countries. Information on the viral aetiology of acute respiratory infections in developing countries is very limited. The study was done to identify viruses associated with acute lower respiratory tract infection among children less than 5 years. Method: Nasopharyngeal samples and blood cultures were collected from children less than 5 years who have been hospitalized for acute lower respiratory tract infection. Viruses and bacteria were identified using Reverse Transcriptase Real-Time Polymerase Chain Reaction and conventional biochemical techniques. Results: Out of 128 patients recruited, 33(25.88%%, 95%CI: 18.5% to 34.2%) were positive for one or more viruses. Respiratory Syncytial Virus (RSV) was detected in 18(14.1%, 95%CI: 8.5% to 21.3%) patients followed by Adenoviruses (AdV) in 13(10.2%, 95%CI: 5.5% to 16.7%), Parainfluenza (PIV type: 1, 2, 3) in 4(3.1%, 95%CI: 0.9% to 7.8%) and influenza B viruses in 1(0.8%, 95%CI: 0.0 to 4.3). Concomitant viral and bacterial co-infection occurred in two patients. There were no detectable significant differences in the clinical signs, symptoms and severity for the various pathogens isolated. A total of 61.1% (22/36) of positive viruses were detected during the rainy season and Respiratory Syncytial Virus was the most predominant. Conclusion: The study has demonstrated an important burden of respiratory viruses as major causes of childhood acute respiratory infection in a tertiary health institution in Ghana. The data addresses a need for more studies on viral associated respiratory tract infection.
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    Sero-epidemiology of human coronaviruses in three rural communities in Ghana
    (Pan African Medical Journal, 2021) Owusu, Michael; Sylverken, Augustina Angelina; El-Duah, Philip; Acheampong, Godfred; Mutocheluh,, Mohammed; Adu-Sarkodie, Yaw; 0000-0001-5066-150X; 0000-0002-7691-914X; 0000-0003-1671-0755; 0000-0003-2495-9235; 0000-0002-1396-5085; 0000-0003-2093-1534
    Introduction: acute respiratory tract infections (ARIs) are responsible for significant proportions of illnesses and deaths annually. Most of ARIs are of viral etiology, with human coronaviruses (HCoVs) playing a key role. This study was conducted prior to the outbreak of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) to provide evidence about the sero-epidemiology of HCoVs in rural areas of Ghana. Methods: this was a cross sectional study conducted as part of a large epidemiological study investigating the occurrence of respiratory viruses in 3 rural areas of Ghana; Buoyem, Kwamang and Forikrom. Serum samples were collected and tested for the presence of IgGantibodies to three HCoVs; HCoV-229E, HCoV OC43 and HCoV-NL63 using immunofluorescence assay. Results: of 201 subjects enrolled into the study, 97 (48.3%) were positive for all three viruses. The most prevalent virus was HCoV-229E (23%; 95% CI: 17.2 - 29.3), followed by HCoV-OC43 (17%; 95% CI: 12.4 - 23.4), then HCoV-NL63 (8%, 95% CI: 4.6 - 12.6). Subjects in Kwamang had the highest sero-prevalence for HCoV-NL63 (68.8%). human coronaviruses-229E (41.3%) and HCoV-OC43 (45.7%) were much higher in Forikrom compared to the other study areas. There was however no statistical difference between place of origin and HCoVs positivity. Although blood group O+ and B+ were most common among the recruited subjects, there was no significant association (p = 0.163) between blood group and HCoV infection. Conclusion: this study reports a 48.3% sero-prevalence of HCoVs (OC43, NL63 and 229E) among rural communities in Ghana. The findings provide useful baseline data that could inform further sero-epidemiological studies on SARS-CoV-2 in Africa.
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    Sero-prevalence, cross-species infection and serological determinants of prevalence of Bovine Coronavirus in Cattle, Sheep and Goats in Ghana
    (Veterinary Microbiology, 2020) Burimuaha, Vitus; Sylverken, Augustina; Owusu, Michael; El-Duah, Philip; Yeboah, Richmond; Lamptey, Jones; Frimpong, Yaw Oppong; Agbenyegah, Olivia; Folitse, Raphael; Tasiame, William; Emikpe, Benjamin; et.al...; 0000-0002-7691-914X; 0000-0001-5066-150X; 0000-0003-1671-0755; 0000-0002-2765-6179; 0000-0002-7050-1674
    Cattle, goats and sheep are dominant livestock species in sub-Saharan Africa, with sometimes limited in formation on the prevalence of major infectious diseases. Restrictions due to notifiable epizootics complicate the exchange of samples in surveillance studies and suggest that laboratory capacities should be established domestically. Bovine Coronavirus (BCoV) causes mainly enteric disease in cattle. Spillover to small ruminants is possible. Here we established BCoV serology based on a recombinant immunofluorescence assay for cattle, goats and sheep, and studied the seroprevalence of BCoV in these species in four different locations in the Greater Accra, Volta, Upper East, and Northern provinces of Ghana. The whole sampling and testing was organized and conducted by a veterinary school in Kumasi, Ashanti Region of Ghana. Among sampled sheep (n = 102), goats (n = 66), and cattle (n = 1495), the seroprevalence rates were 25.8 %, 43.1 % and 55.8 %. For cattle, seroprevalence was significantly higher on larger farms (82.2 % vs 17.8 %, comparing farms with > 50 or < 50 animals; p = 0.027). Highest prevalence was seen in the Northern province with dry climate, but no significant trend following the north-south gradient of sampling sites was detected. Our study identifies a considerable seroprevalence for BCoV in Ghana and provides further support for the spillover of BCoV to small ruminants in settings with mixed husbandry and limited separation between species.
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    Use of social media in a national Tuberculosis Drug Resistance Survey: lessons from the first anti-tuberculosis drug resistance survey in Ghana
    (AAS Open Research, 2019) Sylverken, Augustina Angelina; Owusu-Dabo, Ellis; Kwarteng, Alexander; Twumasi-Ankrah, Sampson; Owusu, Michael; Adu-Amoah, Louis; Dumevi, Rexford Mawunyo; Arthur, Rejoice Agyeiwaa; Addofoh, Nicholas; Dzata, Francisca; Bonsu, Frank; 0000-0002-7691-914X; 0000-0003-4232-4292; 0000-0002-0893-2908; 0000-0002-9183-1883; 0000-0001-5066-150X; 0000-0001-6755-2545; 0000-0002-7135-2754
    Background: The widespread use of social media applications on mobile phones indicate that smart phones have become more than just a simple medium for voice calling. Several studies have shown the potential benefit of these social media applications in discussing many health conditions. We report on tracking sample transport by public and private transport providers using WhatsApp during the first nationwide drug resistance tuberculosis (TB) survey in Ghana. Methods: The survey was conducted between February 2016 and June 2017, and involved 33 TB diagnostic sites selected on the basis of a two-stage cluster randomized sampling design on both anticipated yield and probability proportional to size method. We engaged the services of privately and publicly owned vehicles’ union to transport samples to the central laboratories in Kumasi for further laboratory processing.We created a mobile social group platform (‘National TBDRS’) on WhatsApp consisting of two representatives from each site as well as other stakeholders. The purpose was to notify a laboratory team in Kumasi, on the following details of the sample: date and time of dispatch, driver’s name, car number, estimated time of arrival, and bus terminal name.  Results: A total 3077 WhatsApp messages were received during the survey period. Of these, 2879 (93.57%) messages were related to the survey. We observed a positive correlation between the total number of messages received and the total number of well-packaged sputum samples sent (r=0.89, p=0.02). There were no major transport delays (11:44±03:50) and all samples arrived within a 3-day window from the survey sites. Conclusions: Using WhatsApp as a platform of communication can significantly aid in improving tracking of samples, enhance accountability of for example drivers handling the samples over at a road crossing and communication across health facilities.