Browsing by Author "Sylverken, Augustina Angelina"

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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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    Blood collection tubes impact expression of activated CD4+ and CD8+ T cells in human whole blood assay
    (Scientific African, 2023) Kwarteng, Alexander; Osei-Poku, Priscilla; Antwi-Berko, Daniel; Sylverken, Augustina Angelina; Larbi, Amma; Nsiah, Kwabena; 0000-0002-0893-2908; 0000-0002-9187-2503; 0000-0001-8994-1349; 0000-0002-7691-914X; 0000-0002-3814-6924; 0000-0001-8500-0963
    Background T-lymphocyte subsets CD4 and CD8 play important role in host immune responses. However, little attention has been given to the impact of time lapse and the various anticoagulant blood collection tubes on the expression frequency and activation status of CD4+ and CD8+ T cells. To this end, we explore the impact of time (t<1 h and t=4 h) and collection tubes (EDTA and heparin) on the expression frequency and activation status of CD4+ and CD8+ T cells among healthy Ghanaian individuals. Methods A cohort of healthy individuals (n=9) is recruited, and blood samples obtained in Ghana for the frequency of CD4+and CD8+ T cells at various time points (<1 h and 4 h). The proportions of activation of these immune markers were profiled using immunophenotyping. Results Significant statistical differences in the activation frequency of CD69 expressing CD4+T cells (t < 1 h and t=4 h; p=0.02) and CD69 expressing CD8+ T cells from EDTA tubes at times (t < 1 h and t=4 h; p=0.05) was observed. No significant difference were observed with CD69 expressing cells in Heparin tubes. Notably, CD8+ T cell activation frequency was observed to be consistently higher than that of CD4+ T cell at the various study time points and in the collection tubes used. No marked alterations were observed witth the proportion of CD4+ and CD8+ T cells in the samples collected at the time points; <1 h and at 4 h. Conclusion The study shows that activation of CD4+ and CD8+ T cells in EDTA tubes differed significantly between both time points (t <1 h and t=4 h) but not in the heparin collection tubes. Therefore, it is important to take into account the elapsed time and the type of blood collection tubes when performing phenotypic characterization of activated immune markers.
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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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    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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    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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    Molecular characterization of interactions between the D614G variant of SARS-CoV-2 S-protein and neutralizing antibodies: A computational approach
    (Infection, Genetics and Evolution, 2021) Kwarteng, Alexander; Asiedu, Ebenezer; Sylverken, Augustina Angelina; Larbi, Amma; Sakyi, Samuel Asamoah; Asiedu, Samuel Opoku; 0000-0002-0893-2908; 0000-0003-2867-1984; 0000-0002-7691-914X; 0000-0002-3814-6924; 0000-0001-5168-4762; 0000-0002-0352-3195
    The D614G variant of SARS-CoV-2 S-protein emerged in early 2020 and quickly became the dominant circulating strain in Europe and its environs. The variant was characterized by the higher viral load, which is not associated with disease severity, higher incorporation into the virion, and high cell entry via ACE-2 and TMPRSS2. Previous strains of the coronavirus and the current SARS-CoV-2 have demonstrated the selection of mutations as a mechanism of escaping immune responses. In this study, we used molecular dynamics simulation and MM-PBSA binding energy analysis to provide insights into the behaviour of the D614G S-protein at the molecular level and describe the neutralization mechanism of this variant. Our results show that the D614G S-protein adopts distinct conformational dynamics which is skewed towards the open-state conformation more than the closed-state conformation of the wild-type S-protein. Residue-specific variation of amino acid flexibility and domain specific RMSD suggest that the mutation causes an allosteric conformational change in the RBD. Evaluation of the interaction energies between the S-protein and neutralizing antibodies show that the mutation may enhance, reduce or not affect the neutralizing interactions depending on the neutralizing antibody, especially if it targets the RBD. The results of this study have shed insights into the behaviour of the D614G S-protein at the molecular level and provided a glimpse of the neutralization mechanism of this variant.
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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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    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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    This disease is not meant for the hospital, it is Asram’: Implications of a traditionally-defined illness on healthcare seeking for children under-5 in rural Ashanti, Ghana
    (PLOS Glob Public Health, 2022-09-08) Acheampong, Princess Ruhama; Mohammed, Aliyu; Twumasi-Ankrah, Sampson; Sylverken, Augustina Angelina; Owusu, Michael; Acquah-Gyan, Emmanuel; Adjei, Timothy Kwabena; Otupiri, Easmon; Owusu-Dabo, Ellis; 0000-0001-8986-1648
    Every child has the right to survive, grow and develop. However, in spite of the considerable global gains that have been made in child survival, Sub-Saharan Africa still has the highest child mortality rates and accounts for the greatest burden of mortality globally. The majority of these children die without ever reaching a health facility. The practice of appropriate healthcare-seeking behaviour has a great potential to reduce the occurrence of severe and life-threatening childhood illnesses. Several factors, however, influence healthcare-seeking behaviour, including perceptions of the cause of illness and socio-cultural perspectives.This study seeks to understand local concepts of a traditionally-defined illness complex,Asram, and its influence on healthcare seeking behavior of mothers/caregivers. This qualitative study was conducted from October 2019 to February 2020. Four Focus Group Discus sions were conducted with mothers/caregivers of children under-5 and 22 Key Informant Interviews with mothers/caregivers of children who had Asram, health workers at district, facility, and community levels, and Asram healers. Participants were selected from two rural communities, Akutuase and Wioso of the Asante Akim North district in the Ashanti region of Ghana. Data analysis was carried out iteratively throughout data collection, using a thematic analysis approach. The study shows that Asram is a childhood illness complex that is perceived to have been acquired spiritually and/or inherited. Nine types of Asram were described. This childhood illness was said to be treatable by Asram healers who had subspecialties in treatment approaches that were determined by the Asram type reported. Mothers/caregivers trusted Asram healers and preferred to call on them first. This was found to be the main reason for delays in seeking healthcare for children under-5 who showed symptoms of Asram. Asram is a childhood illness complex that is believed to be bet ter managed outside the health facility setting. This study complements existing knowledge and creates opportunities for further research and the introduction of more effective interventions in the effort to improve child survival in rural communities.
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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.