Browsing by Author "Owusu, Michael"

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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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    Aetiological agents of pneumonia among HIV and non-HIV infected children in Ghana: A case-control study
    (plos one, 2024-03) Owusu, Michael; Adu, Eric; Kalu, , Lotenna Elsie; Martey, Eugene; Acheampong, Godfred; Enimil, Anthony; Appiah, John Adabie; Badu-Peprah, Augustina; Sylverken, Justice; Sylverken, Augustina Angelina; Nguah, Samuel Blay; Westeel, Emilie; Pouzol, Stephane; Drosten, Christian; Adu-Sarkodie, Yaw; 0000-0003-0979-4006
    Pneumonia is the leading cause of death in children, however, the microbial aetiology of pneumonia is not well elucidated in low- and middle-income countries. Our study was aimed at determining the microbial aetiologies of childhood pneumonia and associated risk factors in HIV and non-HIV infected children. We conducted a case-control study that enrolled chil dren with pneumonia as cases and non-pneumonia as controls from July 2017 to May 2020. Induced sputum and blood samples were investigated for microbial organisms using stan dard microbiological techniques. DNA/RNA was extracted from sputum samples and tested for viral and bacterial agents. Four hundred and four (404) subjects consisting of 231 (57.2%) cases and 173 (42.8%) controls were enrolled. We identified a significant (p =0.011) proportion of viruses in cases (125; 54.1%, 95%CI: 47.4–60.7) than controls (71;33.6%, 95%CI: 33.6–48.8) and these were mostly contributed to by Respiratory Syncytial Virus. Staphylococcus aureus (16; 4.0%), Klebsiella spp. (15, 3.7%) and Streptococcus pneumoniae (8, 2.0%) were the main bacterial agents identified in sputum or induced spu tum samples. HIV infected children with viral-bacterial co-detection were found to have verysevere pneumonia compared to those with only viral or bacterial infection. Indoor cooking (OR = 2.36; 95%CI:1.41–3.96) was found to be associated with pneumonia risk in patients. This study demonstrates the importance of various microbial pathogens, particularly RSV, in contributing to pneumonia in HIV and non-HIV paediatric populations. There is a need to accelerate clinical trials of RSV vaccines in African populations to support improvement of patient care
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    Budget and budgetary control practices of some selected credit unions within the Ashanti chapter
    (SEPTEMBER, 2015) Owusu, Michael
    According to Elliott (1986), Credit Unions essentially reverse the normal corporate financial objective of maximizing profit since they are expected to pay so much on savings and charge so little on loans. Therefore for Credit Unions to achieve a high level of organizational performance there should be effective and efficient use of resources. Budget and budgetary controls has been emphasized as a viable tool for ensuring effective and efficient use of organizational resource. The problem that normally arises is whether the budget and budgetary control practices of the Credit Unions comply with the best practices of budgeting. This study is a multiple case study, exploratory and descriptive research. The instrument used in gathering the data for this study is an interview guide. After data collection, analysis and processing was done by the use of computer programmes such as Microsoft Word and Excel. The research reveals that, the 60% of the Credit Unions have strategic plans which makes them more proactive than reactive in dealing with issues, ensures effective allocation of resources and inspires the budget. Also, annual budget was common to all the Unions and the bottom-up approach to budgeting was mostly used. Incremental budgeting was mostly prepared by the selected Unions, and budget committees as well as budget manuals were almost non-existent. Comparing budget figures with actual, and conducting variance analysis were the two most carried out monitoring and control activities. The selected Credit Unions comply fairly with the best standards in budget and budgetary control. The major challenges faced by the Unions were poor forecasting, time consuming, inability to achieve targets, difficulty in determining the cause of variance and identifying who to reward and who to punish. The Credit Unions should do more in motivating their management to produce budgets that are credible and challenging, educating the staff on the purpose of budgets, engaging dedicated budget specialist as well as tying people to specific budget target.
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    Burden of respiratory viral infections among inmates of a Ghanaian prison
    (Research Gate Publication, 2019-09-08) Sylverken, Augustina Angelina; El-Duah, Philip; Owusu, Michael; Yeboah, Richmond; Kwarteng, Alexander; Ofori, Linda; Gorman, Richmond; Obiri-Danso, Kwasi; Owusu-Dabo, Ellis; 0000-0002-7691-914X; 0000-0003-1671-0755; 0000-0003-1671-0755; 0000-0002-2765-6179; 0000-0002-0893-2908; 0000-0002-6831-3375; 0000-0002-5497-1684; 0000-0003-4232-4292
    Respiratory viral infections are important causes of morbidity and mortality worldwide. Information on circulating respiratory viruses among prisoners is lacking, although this is of public health importance and knowledge would assist in putting in place preventive measures to forestall disease outbreaks. The aim of this study therefore was to get the footprint of such diseases that have epidemic potential to be described and quantified for control. Prisoners on remand numbering 203 in a prison in Kumasi, the Ashanti Regional capital, were interviewed using prevalidated questionnaire, nasopharyngeal samples taken and screened by real-time PCR for common respiratory viruses in February, 2018. Of the total number of 203 participants enrolled, majority were males (n = 198, 97.54%). The modal age unsurprisingly was in the active working class of 18 to 35 years (n = 155, 76.36%) with 48 (23.65%) of participants older than 35 years. Inmates reported nasal congestion (n = 83, 40.89%), cough with or without pharyngitis (n =108, 53.20%) and fever (n = 74, 39.48%). Viruses detected in throat samples were Infl uenza A (n = 1, 0.49%) and Rhinovirus (n = 8, 3.94%). There was no statistically significant association between respiratory virus positivity and age (p = 0.118), gender (p > 0.900), duration of incarceration (p = 0.239) and reported symptoms (p = 0.724). The prison population may have a lower prevalence of respiratory viruses circulating in them. This may be dominated by those with high antigenic diversity.
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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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    Risk factors and human coronaviruses associated with upper respiratory tract infections in three rural areas of Ghana
    (May 2014) Owusu, Michael
    Acute respiratory tract infections (ARI) are the leading cause of morbidity and mortality in developing countries, especially in Africa. In spite of its importance, information on the viral aetiology and risk factors associated with ARI are limited in Ghana. Even though human coronaviruses (HCoVs) are known to be associated with respiratory disease outbreaks and severe infections in some developed countries, their epidemiological role is understudied in many African countries including Ghana. It is therefore not known whether HCoVs are pathogenic viruses associated with ARI or only exist as normal commensals of the upper respiratory tract. The aim of this study was to find the association between HCoVs and ARIs, describe the sero-molecular epidemiology of HCoVs and identify the risk factors associated with upper respiratory tract infection. An unmatched case control study was conducted in Buoyem, Forikrom and Kwamang communities of Ghana. Subjects were interviewed on various socio-demographic factors and hygienic practices using structured questionnaires. Nasal/Nasopharyngeal swabs were taken from older children and adults, and tested for Middle East respiratory syndrome coronavirus (MERS-CoV), HCoV-229E, HCoV-OC43, HCoV-NL63 and HCoV-HKU1 using Reverse Transcriptase Real-Time Polymerase Chain Reaction. A total of 1272 subjects were recruited comprising of 662 (52%) controls and 610 (48%) cases. Risk factors associated with upper respiratory tract infections were school attendance to the level of Senior High and tertiary education, and being a health worker. Out of 322 subset of cases interviewed, 212 (66%) covered their nose with handkerchiefs when they sneezed, 52 (16%) covered with their hands upon xix sneezing and 79 (25%) sneezed in the open. Self-administered drugs such as herbs (2%), analgesics (25%) and antibiotics (16%) were used to manage upper respiratory tract infections. Out of the 1,272 subjects recruited, nasal swabs were taken from 1,213. Of the 1,213, 150 (12.4%) subjects were positive for one or more viruses. Of these, single virus detections occurred in 146 subjects (12.0%) and multiple detections occurred in 4 (0.3%). Compared with control subjects, infections with HCoV-229E (OR = 5.15, 95% CI = 2.24 – 11.78), HCoV-OC43 (OR = 6.16, 95% CI = 1.77 – 21.65) and combine HCoVs (OR = 2.36, 95% CI = 1.5 = 3.72) were associated with upper respiratory tract infections. Significant median virus concentration difference was observed for only HCoV- NL63 (cases: 2.41 x 106 copies per PCR reaction; IQR = 1.96 x 104 - 2.3 x 106 vrs controls: 1876.5 copies per PCR reaction; IQR =387.2 – 8.6 x 104, P=0.003) and the clinically relevant cut-off viral concentration was determined to be 7,510 copies per PCR reaction. HCoVs were found to be seasonally dependent with high proportions identified in the harmattan season (54/215, 25.1%) compared to the wet (80/516, 15.5%) seasons. The most frequent viruses detected in the harmattan and wet seasons were HCoV-229E and HCoV-NL63 respectively. HCoV-OC43 and HCoV-HKU1 were almost distributed equally throughout the year. Sequencing of the partial spike region was successful for 53 out of 146 samples (36.3%). Of the 53, 12 (22.6%) were HCoV-OC43, 14 (26.4%) were HCoV-NL63, 24 (45.3%) were HCoV-229E and 3 (5.7%) were HCoV-HKU1. A comparison of the obtained sequences resulted in no differences to sequences already published in GenBank. xx This study has identified risk factors of URTI and also demonstrated that HCoVs could play significant role in causing upper respiratory tract infections among adults and older children in rural arrears of Ghana. This information could be useful to policy makers, public health practitioners and other stakeholders in Ghana.