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Awiah EA, Aabalekuu S, Dun-Dery F, Dun-Dery E, Bayor F, Adokiya MN, Bessing B. Correlates of Hepatitis B infection in pregnant women attending antenatal clinics in Wa Municipality, Ghana. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0002447. [PMID: 39255265 PMCID: PMC11386425 DOI: 10.1371/journal.pgph.0002447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 08/13/2024] [Indexed: 09/12/2024]
Abstract
Despite the availability of an effective vaccine against viral hepatitis B infection, it remains prevalent, highly transmissible especially through mother-to-child, life-threatening, and a major public health challenge. A positive Hepatitis B e-Antigen (HBeAg) mother has a 90% risk of transmitting the virus to the unborn child in the perinatal period. This study sought to determine the prevalence and risk of Hepatitis B infection among pregnant women in the Wa Municipality of Ghana. A cross-sectional study employing systematic random sampling was conducted among 183 consented pregnant women who went for antenatal care in nine health facilities in the Wa Municipality. A structured validated questionnaire was used to collect information about socio-demographic and obstetric characteristics, awareness of Hepatitis B Virus (HBV) transmission and its prevention. Blood samples (3.0 mls) were collected from each participant to test for HBV serum markers using a Wondfo One Step HBV rapid immunochromatographic assay (Catalog number W003) for the Hepatitis B surface antigen (HBsAg). We conducted descriptive statistics including the prevalence and used multivariable logistic regression to determine the risk of Hepatitis B among study participants. Data was analysed using Stata/SE 15. About 20.2% of the 183 pregnant women screened tested positive for HBsAg. Generally, compared with younger pregnant women, older (> = 25) pregnant women were >9 times less likely to test positive for both chronic Hepatitis B core antibody (HBcAb) and (HBeAg) Hepatitis B infections. However, pregnant women in polygamous relationship were more likely to test positive for both (HBcAb) and (HBsAg and HBeAg) Hepatitis B infections compared with those in monogamous relationship. In a multivariable analysis, pregnant women in a polygamous relationships were about 5 times more likely to test positive for HBsAg (AOR = 4.61, 95% CI: 2.06-9.89) and HBcAb (AOR = 4.89, 95% CI:1.52-6.81) and HBeAg (AOR = 4.62, 95% CI:1.21-6.39) compared with those in a monogamous relationship. This study highlights a high HBsAg prevalence among pregnant women with those in polygamous relationship and younger age more likely to test positive. Facility and community-based health services should emphasize the need for regular screening, education, and vaccination of pregnant women, especially those at high risk, to prevent mother-to-child transmission of viral hepatitis B.
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Affiliation(s)
| | - Simon Aabalekuu
- Department of Public Health, Regional Health Directorate, Upper West Region, Wa, Ghana
| | - Frederick Dun-Dery
- Department of Paediatrics, Cumming School of Medicine, University of Calgary, Alberta, Canada
| | - Elvis Dun-Dery
- Department of Public Health, Purdue University, West Lafayette, IN, United States of America
| | - Fidelis Bayor
- Department of Anaesthesiology, Lawra Municipal Hospital, Ghana Health Service, Wa, Ghana
| | - Martin Nyaaba Adokiya
- Department of Epidemiology and Biostatistics, School of Public Health, University for Development Studies, Tamale, Ghana
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Boadu RO, Dankyi E, Apalangya VA, Osei-Safo D. Aflatoxins in maize and groundnuts on markets in Accra and consumers risk. FOOD ADDITIVES & CONTAMINANTS. PART B, SURVEILLANCE 2024; 17:213-222. [PMID: 38778671 DOI: 10.1080/19393210.2024.2351575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 05/01/2024] [Indexed: 05/25/2024]
Abstract
This study presents the results of aflatoxin contamination of maize and groundnuts in major markets in Accra and assesses the population's exposure to aflatoxins. Raw maize and groundnuts from 6 major markets in Accra were sampled and analysed for their aflatoxin content. A total of 92 samples comprising 48 maize and 44 groundnuts were analysed using high-performance liquid chromatography, after extraction with methanol/water and cleanup on an immunoaffinity column. Total aflatoxins were quantified in 98% of the maize samples and 70% of the groundnut samples, with concentrations ranging from 0.60 to 1065 µg/kg and 0.20 to 627 µg/kg, respectively. Exposure assessment showed an estimated daily intake of 0.436 μg/kg bw/day and 0.0632 μg/kg bw/day for maize and groundnut consumption, respectively, suggesting significant health risks for consumers. The high prevalence and concentrations of aflatoxins call for an urgent need for measures to control exposure of the Ghanaian population.
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Affiliation(s)
| | - Enock Dankyi
- Department of Chemistry, University of Ghana, Accra, Ghana
| | - Vitus A Apalangya
- Department of Food Processing Engineering, University of Ghana, Accra, Ghana
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Daniels J, Nartey YA, Djankpa F, Simpore J, Obiri-Yeboah D. Characteristics and antiviral treatment eligibility of patients diagnosed with hepatitis B at a teaching hospital in Ghana: Implications for prevention and management. PLoS One 2024; 19:e0302086. [PMID: 39172867 PMCID: PMC11340950 DOI: 10.1371/journal.pone.0302086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Accepted: 08/07/2024] [Indexed: 08/24/2024] Open
Abstract
Hepatitis B virus (HBV) infection poses a considerable public health challenge in limited-resource settings especially in the sub-Saharan African region. Even though HBV infection is incurable, timely treatment is effective in preventing disease progression to liver cirrhosis or hepatocellular carcinoma. However, not all infected patients require treatment. The aim of the study was to determine the clinical, immunological, and virological profiles of treatment naïve patients with HBV infection, seen at the outpatient clinic of the Cape Coast Teaching Hospital. Additionally, the study sought to determine the antiviral treatment eligibility rate based on the 2015 guidelines of the World Health Organization (WHO) compared with the new 2024 guidelines. A hospital-based cross-sectional study involving total sampling of 220 treatment naïve HBV surface antigen positive clients was carried out. A structured questionnaire was used to collect data that were analyzed with STATA version 16. The median age at diagnosis was 34 years (IQR 26.0-41.5) with a male to female ratio of 1:1.5. A total of 138 participants (62.7%) were diagnosed with HBV infection following voluntary testing. There was a median delay of 8.5 months (IQR 3.0-22.5) between initial diagnosis and patients' presentation for medical care. In all, 24 patients (10.9%) had abnormal clinical examination findings, 172 patients (78.2%) had HBV DNA levels ≤ 2000 IU/ml whereas 8 (3.6%) were seropositive for the HBV envelope antigen. A few patients had concomitant human immunodeficiency virus (2.7%) and hepatitis C virus (1.4%) infections. Treatment eligibility rate based on the WHO 2015 guidelines was 6.4% (n = 14), however, with the updated 2024 guidelines, treatment eligibility was 42.3% (n = 93). Increasing the screening rate among the general population, early linkage to clinical care of screen positives and vaccination of screen negatives will help reduce HBV-related clinical conditions in resource-limited settings.
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Affiliation(s)
- Joseph Daniels
- National Centre for Radiotherapy, Oncology and Nuclear Medicine, Korle Bu Teaching Hospital, Accra, Ghana
- Department of Microbiology and Immunology, School of Medical Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Yvonne A. Nartey
- Department of Internal Medicine and Therapeutics, School of Medical Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Francis Djankpa
- Department of Physiology, School of Medical Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Jacques Simpore
- Centre de Recherche Biomoléculaire Pietro Annigoni (CERBA), Ouagadougou, Burkina Faso
| | - Dorcas Obiri-Yeboah
- Department of Microbiology and Immunology, School of Medical Sciences, University of Cape Coast, Cape Coast, Ghana
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Yirsaw BG, Agimas MC, Alemu GG, Tesfie TK, Derseh NM, Abuhay HW, Alemayehu MA, Yismaw GA. Prevalence of Hepatitis B virus infection and its determinants among pregnant women in East Africa: Systematic review and Meta-analysis. PLoS One 2024; 19:e0307102. [PMID: 38995928 PMCID: PMC11244773 DOI: 10.1371/journal.pone.0307102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2024] [Accepted: 06/28/2024] [Indexed: 07/14/2024] Open
Abstract
INTRODUCTION Hepatitis B virus (HBV) is one of the major public health problems globally and needs an urgent response. It is one of the most responsible causes of mortality among the five hepatitis viruses, and it affects almost every class of individuals. Different studies were conducted on the prevalence of HBV among pregnant women in East African countries, but none of them showed the pooled prevalence of HBV among the pregnant women. Thus, the main objective of this study was to determine the pooled prevalence and its determinants among pregnant women in East Africa. METHODS We searched studies using PubMed, Scopus, Embase, ScienceDirect, Google Scholar and grey literature that were published between January 01/2020 to January 30/2024. The studies were assessed using the Newcastle Ottawa Scale (NOS) quality assessment scale. The random-effect (DerSimonian) model was used to determine the pooled prevalence and associated factors of HBV among pregnant women. Heterogeneity were assessed by I2 statistic, sub-group analysis, and sensitivity analysis. Publication bias was assessed by Egger test, and the analysis was done using STATA version 17. RESULT A total of 45 studies with 35639 pregnant women were included in this systematic review and meta-analysis. The overall pooled prevalence of HBV among pregnant women in East Africa was 6.0% (95% CI: 6.0%-7.0%, I2 = 89.7%). The highest prevalence of 8% ((95% CI: 6%, 10%), I2 = 91.08%) was seen in 2021, and the lowest prevalence 5% ((95% CI: 4%, 6%) I2 = 52.52%) was observed in 2022. A pooled meta-analysis showed that history of surgical procedure (OR = 2.14 (95% CI: 1.27, 3.61)), having multiple sexual partners (OR = 3.87 (95% CI: 2.52, 5.95), history of body tattooing (OR = 2.55 (95% CI: 1.62, 4.01)), history of tooth extraction (OR = 2.09 (95% CI: 1.29, 3.39)), abortion history(OR = 2.20(95% CI: 1.38, 3.50)), history of sharing sharp material (OR = 1.88 (95% CI: 1.07, 3.31)), blood transfusion (OR = 2.41 (95% CI: 1.62, 3.57)), family history of HBV (OR = 4.87 (95% CI: 2.95, 8.05)) and history needle injury (OR = 2.62 (95% CI: 1.20, 5.72)) were significant risk factors associated with HBV infection among pregnant women. CONCLUSIONS The pooled prevalence of HBV infection among pregnant women in East Africa was an intermediate level and different across countries ranging from 1.5% to 22.2%. The result of this pooled prevalence was an indication of the need for screening, prevention, and control of HBV infection among pregnant women in the region. Therefore, early identification of risk factors, awareness creation on the mode of transmission HBV and implementation of preventive measures are essential in reducing the burden of HBV infection among pregnant women.
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Affiliation(s)
- Bantie Getnet Yirsaw
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Muluken Chanie Agimas
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Gebrie Getu Alemu
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tigabu Kidie Tesfie
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Nebiyu Mekonnen Derseh
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Habtamu Wagnew Abuhay
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Meron Asmamaw Alemayehu
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Getaneh Awoke Yismaw
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Basimane Bisimwa P, Koyaweda GW, Bihehe Masemo D, Ayagirwe RBB, Birindwa AB, Bisimwa PN, Kikuni Besulani G, Kashosi TM, Mugisho Matabishi C, Mitima Misuka B, Mukonkole JPM, Bisimwa Nachega J, Mukwege Mukengere D, Komas NPJ. High prevalence of hepatitis B and HIV among women survivors of sexual violence in South Kivu province, eastern Democratic Republic of Congo. PLoS One 2024; 19:e0292473. [PMID: 38959256 PMCID: PMC11221749 DOI: 10.1371/journal.pone.0292473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 05/08/2024] [Indexed: 07/05/2024] Open
Abstract
INTRODUCTION Limited data are available on the prevalence rates of hepatitis B and acquired immunodeficiency syndrome (AIDS) among women survivors of sexual violence (WSSV) in South Kivu province, in the eastern part of the Democratic Republic of Congo (DRC), where armed conflicts persist. Here, we aimed to assess the prevalence of these two infections in this vulnerable local population. METHODS A total of 1002 WSSV, aged from 18 to 70 years old were enrolled from May 2018 to May 2020 at three healthcare facilities (Panzi, Mulamba and Bulenga hospitals), which are called "The One-Stop Centre Care Model" for the management of sexual violence in South Kivu. Blood samples were collected and tested for hepatitis B virus (HBV) and human immunodeficiency virus (HIV) antigens and antibodies using enzyme-linked immunoassay (ELISA) methods. Subsequently, viral load quantification for HBV and HIV were performed using the GeneXpert. Univariate and multivariate logistic regression models were used to assess factors associated with HIV-positive and HBV-positive status. RESULTS For HBV, overall prevalence was 8.9% (95% CI; 7.2-10.8%), 32.1% (95% CI; 29.3-35.0%), and 14.5% (95% CI; 12.3-16.8%) for HBsAg, anti-HBc and anti-HBs antibodies, respectively. Among the 89 HBsAg-positive patients, 17 (19.1%) were HBeAg-positive. The median age of individuals with a positive HBsAg test was higher than those with a negative test (median: 40 years (IQR 30-52) compared to 36 years (IQR 24-48)). Risk factors for HBV infection were age (≥35 years) (AOR = 1.83 [1.02-3.32]; p = 0.041), having no schooling (AOR = 4.14 [1.35-12.62]; p = 0.012) or only primary school-level (AOR = 4.88 [1.61-14.75]; p = 0.005), and multiple aggressors (AOR = 1.76 [1.09-2.84], p = 0.019). The prevalence of HIV was 4.3% [95% CI: 3.1-5.7%]. HIV/HBV co-infection occurred only in 5 individuals (0.5%). The HBV viral load was detectable (> 1 log10 UI/mL) in 61.8% of HBsAg-positive subjects and 64.8% HIV-positive subjects had a high viral load (≥ 3 log10 copies/mL). CONCLUSION This study revealed a high prevalence of HBV and HIV infections among WSSV in South Kivu. The results generated highlight the urgent need for systematic screening of HBV and HIV by integrating fourth-generation ELISA tests in HIV and HBV control programs.
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Affiliation(s)
- Parvine Basimane Bisimwa
- Viral Hepatitis Laboratory, Institut Pasteur de Bangui, Bangui, Central African Republic
- Faculty of Medecine, Université Evangélique en Afrique (UEA), Bukavu, Democratic Republic of Congo
- Panzi General Referral Hospital, Internal Medicine, Bukavu, Democratic Republic of Congo
- Molecular Biology Laboratory, Université Evangélique en Afrique (UEA), Bukavu, Democratic Republic of Congo
- International Center Advanced for Research and Training (ICART)/Panzi Fondation, Bukavu, Democratic Republic of Congo
| | | | - Dieudonné Bihehe Masemo
- Faculty of Medecine, Université Evangélique en Afrique (UEA), Bukavu, Democratic Republic of Congo
- Panzi General Referral Hospital, Internal Medicine, Bukavu, Democratic Republic of Congo
| | | | - Ahadi Bwihangane Birindwa
- Molecular Biology Laboratory, Université Evangélique en Afrique (UEA), Bukavu, Democratic Republic of Congo
| | - Patrick Ntagereka Bisimwa
- Molecular Biology Laboratory, Université Evangélique en Afrique (UEA), Bukavu, Democratic Republic of Congo
| | - Georges Kikuni Besulani
- Faculty of Medecine, Université Evangélique en Afrique (UEA), Bukavu, Democratic Republic of Congo
- Panzi General Referral Hospital, Internal Medicine, Bukavu, Democratic Republic of Congo
| | - Théophile Mitima Kashosi
- Faculty of Medecine, Université Evangélique en Afrique (UEA), Bukavu, Democratic Republic of Congo
| | | | - Bienfait Mitima Misuka
- Faculty of Medecine, Université Evangélique en Afrique (UEA), Bukavu, Democratic Republic of Congo
| | - Jean Paulin Mbo Mukonkole
- Faculty of Medecine, Université Evangélique en Afrique (UEA), Bukavu, Democratic Republic of Congo
- Panzi General Referral Hospital, Internal Medicine, Bukavu, Democratic Republic of Congo
| | - Jean Bisimwa Nachega
- Departments of Epidemiology, Infectious Diseases and Microbiology, University of Pittsburgh School of Public Health, Pittsburgh, Pennsylvania, United States of America
- Departments of Epidemiology and International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
- Department of Medicine, Stellenbosch University Faculty of Medicine and Health Sciences, Cape Town, South Africa
| | - Denis Mukwege Mukengere
- Faculty of Medecine, Université Evangélique en Afrique (UEA), Bukavu, Democratic Republic of Congo
- Panzi General Referral Hospital, Internal Medicine, Bukavu, Democratic Republic of Congo
- Molecular Biology Laboratory, Université Evangélique en Afrique (UEA), Bukavu, Democratic Republic of Congo
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Quintas AE, Cuboia N, Cordeiro L, Sarmento A, Azevedo L. Seroprevalence of human immunodeficiency virus in African blood donors: a systematic review and meta-analysis. EBioMedicine 2024; 105:105210. [PMID: 38941957 PMCID: PMC11260585 DOI: 10.1016/j.ebiom.2024.105210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 05/07/2024] [Accepted: 06/04/2024] [Indexed: 06/30/2024] Open
Abstract
BACKGROUND In developing countries, the safety of blood transfusions remains an important public health concern as it is associated with a higher risk of transfusion-transmissible infections (TTIs). In this study, we aimed to estimate the seroprevalence of HIV among blood donors in Africa and assess the temporal trends and regional differences within the continent through a systematic review and meta-analysis. METHODS Seven electronic databases (PubMed, Web of Science, Cochrane, Scopus, HINARI, Global Index Medicus and Clinical. TRIAL gov) were searched for relevant studies for our research. We included all primary studies that estimated the seroprevalence of HIV among blood donors in Africa with an age population from 16 to 65 years old, without language restrictions, from inception up to March 1st 2024. The pooled seroprevalence was estimated through the DerSimonian-Laird random effects model. The temporal trends and regional differences were assessed through subgroup and meta-regression analysis. FINDINGS We obtained 122 studies that met our inclusion criteria, comprising 7,814,996 blood donors tested for HIV. Sixty-six percent of the studies were from Western and Eastern Africa. The pooled seroprevalence of HIV among blood donors in Africa was 2.66% (95% CI: 2.17-3.20%; I2 = 99.80%, p < 0.01). The highest prevalence was observed in the Central African region, 3.28% (95% CI: 2.57%-4.06%), followed by the Eastern 3.21% (95% CI: 2.12%-4.52%), and the Western 2.66% (95% CI: 1.93%-3.49%) regions. Lower prevalences were observed in the Northern region, 0.57% (95% CI: 0.0%-2.10%), followed by the Southern African region with 0.45% (95% CI: 0.16%-0.86%). We observed a temporal decreased trend of HIV prevalence. INTERPRETATION The prevalence of HIV infection among African blood donors remains high and is not homogeneous across the continent. Efficient measures to strengthen HIV testing and prevent HIV transmission through blood transfusion are needed in Africa. Systematic review protocol registration: PROSPERO CRD42023395616. FUNDING This article was supported by National Funds through FCT - Fundação para a Ciência e a Tecnologia,I.P., within CINTESIS, R&D Unit (reference UIDP/4255/2020).
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Affiliation(s)
- Angelina Edna Quintas
- MEDCIDS, Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine of the University of Porto, Porto, Portugal; CINTESIS@RISE-Center for Health Technology and Services Research (CINTESIS) & Health Research Network Associated Laboratory (RISE) Faculty of Medicine, University of Porto, Porto, Portugal.
| | - Nelson Cuboia
- MEDCIDS, Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine of the University of Porto, Porto, Portugal; CINTESIS@RISE-Center for Health Technology and Services Research (CINTESIS) & Health Research Network Associated Laboratory (RISE) Faculty of Medicine, University of Porto, Porto, Portugal.
| | - Lemuel Cordeiro
- Department of Education Office, Clínica Girassol, Luanda, Angola.
| | - António Sarmento
- CHUSJ, Infectious Diseases Service at the University Hospital Center of São João, Portugal.
| | - Luís Azevedo
- MEDCIDS, Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine of the University of Porto, Porto, Portugal; CINTESIS@RISE-Center for Health Technology and Services Research (CINTESIS) & Health Research Network Associated Laboratory (RISE) Faculty of Medicine, University of Porto, Porto, Portugal.
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Kortei NK, Gillette VS, Wiafe-Kwagyan M, Ansah LO, Kyei-Baffour V, Odamtten GT. Fungal profile, levels of aflatoxin M1, exposure, and the risk characterization of local cheese ' wagashi' consumed in the Ho Municipality, Volta Region, Ghana. Toxicol Rep 2024; 12:186-199. [PMID: 38313814 PMCID: PMC10837644 DOI: 10.1016/j.toxrep.2024.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 01/12/2024] [Accepted: 01/14/2024] [Indexed: 02/06/2024] Open
Abstract
Wagashi is a West African type cottage cheese locally prepared from cow milk. Wagashi like other milk products, is prone to microbial contamination, particularly by fungi. Many of these fungal species produce mycotoxins which are of serious public health concern. This work aimed to update the mycoflora profile and determine the concentrations of aflatoxin M1 and its health risk characterization due to the consumption of wagashi. Culturing the wagashi on mycological media (Oxytetracycline Glucose Yeast Extract OGYE, Dichloran Rose Bengal Chloramphenicol DRBC) caused a de-novo growth of the quiescent spores at 28-30 °C for 5-7 days. The analysis of AFM1 levels in the samples was done using High-Performance Liquid Chromatography connected to a Fluorescence detector (HPLC-FLD). The exposure and risk assessment to the AFMI levels were determined using deterministic models prescribed by the European Food Safety Authority (EFSA). The fungal counts ranged between 2.36-4.30 log10 CFU/g. In total, thirteen (13) fungal species from eight (8) genera were isolated from all wagashi samples. They are; Fusarium oxysporum, Aspergillus flavus, Aspergillus niger, Fusarium verticillioides, Penicillium digitatum, Trichoderma harzianum, Aspergillus terreus, Rhodotorula mucilaginosa, Rhizopus stolonifer, Aspergillus fumigatus, Yeast sp., Mucor racemosus and Fusarium oligosporum belonging to the genera Fusarium, Aspergillus, Penicillium, Trichoderma, Rhodotorula, Rhizopus, Yeast, and Mucor. The AFM1 observed in the wagashi samples' analysis was low, ranging from 0.00 (Not Detected) ± 0.00 - 0.06 ± 0.002 µg/Kg. Risk assessments of AFM1 using deterministic models produced outcomes that ranged between 5.92 × 10-3- 0.14 ng/kg bw/day, 1.42 -44.35, 0-0.0323 ng aflatoxins/kg bw/day, and 1.51 × 10-3 - 9.69 × 10-4 cases/100,000 person/yr for estimated daily intake (EDI), margin of exposure (MOE), average potency, and cancer risks, respectively, for the age categories investigated. Fungal counts were interpreted as medium to high. It was also established that the consumption of wagashi may pose adverse health effects on all age categories in the selected zones of the study since all calculated MOE values were less than 100,000.
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Affiliation(s)
- Nii Korley Kortei
- Department of Nutrition and Dietetics, School of Allied Health Sciences, University of Health and Allied Sciences, PMB 31, Ho, Ghana
- Department of Sports Nutrition, School of Sports and Exercise Medicine, University of Health and Allied Sciences, PMB 31, Ho, Ghana
| | - Valentina Sylvia Gillette
- Department of Nutrition and Dietetics, School of Allied Health Sciences, University of Health and Allied Sciences, PMB 31, Ho, Ghana
| | - Michael Wiafe-Kwagyan
- Department of Plant and Environmental Biology, College of Basic and Applied Sciences, University of Ghana, P. O. Box LG 55, Legon, Ghana
| | - Leslie Owusu Ansah
- Department of Food Laboratory, Food and Drugs Authority, P.O. Box CT 2783, Cantonments, Accra, Ghana
| | - Vincent Kyei-Baffour
- Food Chemistry and Nutrition Research Division, Council for Scientific and Industrial Research, Food Research Institute, P. O. Box M20, Accra, Ghana
| | - George Tawia Odamtten
- Department of Plant and Environmental Biology, College of Basic and Applied Sciences, University of Ghana, P. O. Box LG 55, Legon, Ghana
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Asamoah Sakyi S, Badu Gyapong J, Krampah Aidoo E, Effah A, Koffie S, Simon Olympio Mensah O, Arddey I, Boakye G, Opoku S, Amoani B, Amadu Ngala R. Evaluation of Immune Characteristics and Factors Associated with Immune Response following Hepatitis B Vaccination among Ghanaian Adolescents. Adv Virol 2024; 2024:9502939. [PMID: 38827254 PMCID: PMC11142859 DOI: 10.1155/2024/9502939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Revised: 04/24/2024] [Accepted: 05/16/2024] [Indexed: 06/04/2024] Open
Abstract
Background WHO recommends HBV-negative babies in high-prevalence (8%) countries receive anti-HBV vaccination. Ghana initiated mass immunization in 2002, but concerns remain about vaccine effectiveness and long-term protection. We evaluated immune characteristics and factors following hepatitis B vaccination among Ghanaian adolescents who received HBV vaccines. Methods In this longitudinal cross-sectional study, 74 participants were enrolled from the Kumasi Metropolis, Ghana. Sociodemographic and lifestyle characteristics of participants were obtained using a questionnaire. Blood samples were obtained before and after booster administration for anti-HBsAg, IL-6, and IL-10 estimations using ELISA kit (Shanghai Chemical Ltd., China). Anti-HBsAg titers ≥10 mIU/ml were considered protective. Statistical analyses were done using SPSS version 26.0 and R programming language, p < 0.05 was considered statistically significant. Results We found 100% seroconversion rate, with 25.7% seroprotection rate (anti-HBsAg >10 mIU/ml). Gender (p=0.009), age (p=0.001), and exercising (p=0.044) were significantly associated with seroprotection. Following booster administration, 59.4% were hyporesponders (10 ≤ anti-HBsAg titre ≤99 mIU/ml) whilst 40.6% were good responders (anti-HBsAg titre ≥100 mIU/ml). Exercise (p=0.034) was significantly associated with immune response after booster administration. Moreover, we reported significant positive correlation between cytokines [IL-6 (r = 0.817, p < 0.001) and IL-10 (r = 0.928, p < 0.001)] and anti-HBsAg titre. Conclusion Approximately two thirds of adolescents vaccinated at birth lack protective levels of antibodies against hepatitis B virus. Booster vaccines could aid in mounting protective levels of anti-HBsAg. Physical exercise was negatively associated with immune response to hepatitis B vaccinations.
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Affiliation(s)
- Samuel Asamoah Sakyi
- Department of Molecular Medicine, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Joseph Badu Gyapong
- Department of Molecular Medicine, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | | | - Alfred Effah
- Department of Molecular Medicine, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Simon Koffie
- Department of Molecular Medicine, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Oscar Simon Olympio Mensah
- Department of Molecular Medicine, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Isaac Arddey
- Department of Molecular Medicine, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Godwin Boakye
- Department of Molecular Medicine, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Stephen Opoku
- Department of Neurosurgery, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Benjamin Amoani
- Department of Biomedical Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Robert Amadu Ngala
- Department of Molecular Medicine, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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Balegha AN. Factors influencing the utilisation of anti-HBs titre testing services among nursing students in Northwest Ghana: A cross-sectional study. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003160. [PMID: 38663086 PMCID: PMC11045266 DOI: 10.1371/journal.pgph.0003160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 04/04/2024] [Indexed: 04/29/2024]
Abstract
Understanding the impact of hepatitis B testing, vaccination, the number of vaccine doses, and socio-demographics on post-vaccination anti-HBs titre testing, is essential for hepatitis B prevention. The aim of the study was to determine the prevalence of hepatitis B testing, hepatitis B vaccination, number of vaccine doses received, socio-demographic characteristics, and their impact on anti-HBs titre testing among nursing students in Northwest Ghana. A stratified sample of 402 nursing students from Wa and Lawra nursing colleges in Ghana's Upper West Region was surveyed in November 2020 using an online cross-sectional design. STATA 13 was used to analyse the data, which described socio-demographics, hepatitis B testing, hepatitis B vaccination, and post-vaccination anti-HBs titre testing with frequencies and percentages. Hierarchical binary logistic regression models were used to investigate the relationships between post-vaccination anti-HBs titre testing and hepatitis B testing, vaccination, the number of vaccine doses, and their socio-demographics. The study discovered that while hepatitis B testing was high (89.0%), rates for hepatitis B vaccination (72.1%), obtaining the recommended vaccine doses (59.5%), and post-vaccination anti-HBs titre testing (19.4%) were lower. Nursing students who accepted hepatitis B vaccination were significantly more likely to undergo anti-HBs titre testing [aOR = 12.34; 95% CI = 1.80-84.54; p < 0.05]. Those who received ≥ 3 vaccine doses were over 8 times more likely to utilise anti-HBs titre testing [aOR = 8.31; 95% CI = 2.73-25.34; p < 0.001]. Wa NTC students were 74% less likely to access anti-HBs titre testing [aOR = 0.26; 95% CI = 0.15-0.47; p < 0.001]. Students with parents who had tertiary education were significantly more likely to undergo anti-HBs titre testing [aOR = 2.50; 95% CI = 1.42-4.42; p < 0.01]. The study reveals high hepatitis B testing but low vaccination rates, emphasizing the need for required vaccine doses and post-vaccination anti-HBs testing. Key predictors include hepatitis B vaccination, ≥3 doses, Wa NTC enrollment, and parental education. The study advocates mandatory testing, vaccination, and affordable access to anti-HBs titre testing. Unvaccinated students, those with <3 doses, Wa NTC attendees, and those with lower parental education for nursing school admission should be prioritised.
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Senoo-Dogbey VE, Anto F, Quansah R, Danso-Appiah A. Completion of three-dose hepatitis B vaccination cycle and associated factors among health care workers in the Greater Accra Region of Ghana. PLoS One 2024; 19:e0298771. [PMID: 38626000 PMCID: PMC11020873 DOI: 10.1371/journal.pone.0298771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 01/31/2024] [Indexed: 04/18/2024] Open
Abstract
BACKGROUND Despite the availability of a safe and effective vaccine coupled with the awareness of the potential risk of Healthcare Workers acquiring Hepatitis B Virus infection, some HCWs never get vaccinated. Generally, hepatitis B vaccination coverage globally is below the expected level as adherence has remained poor in various healthcare settings, especially in developing countries. The objective of this study was to assess the completion of a three-dose Hepatitis B virus vaccination cycle and associated factors among healthcare workers in the Greater Accra Region of Ghana. METHODS AND MATERIALS An analytical cross-sectional study was conducted and included 363 healthcare workers selected using probability sampling procedures. The participants were recruited from five facilities within the Greater Accra Region in the first half of 2018. A pretested questionnaire was used to collect data which was analyzed using SPSS version 21. The proportion of healthcare workers receiving the recommended 3 doses of the hepatitis vaccine was computed. The multivariable analysis procedure identified the factors associated with adherence to the receipt of three doses of the hepatitis B vaccine. Odds ratios were estimated with corresponding confidence intervals with the level of significance set at 0.05. RESULTS A total of 340 sample units were included in the analysis. Most of the participants (252/340, 74.1%) were females, mainly nurses/midwives (162/340, 47.6%) with a mean age of 34.5 (SD ±7.7). A high proportion of the participants (82.7%) have tertiary/post-tertiary level education and ever participated in at least one training workshop on the prevention of blood-borne infections (80.6%). Overall vaccination uptake was 60.9% (207/340) (95% CI = 55.7%-66.1%). Complete vaccination coverage (three doses) was 46.8% (159/340). High-risk perception (AOR = 4.0; 95% CI = 1.3-12.5), and previous training in infection prevention (AOR = 2.8; 95% CI = 1.1-7.5) were significantly associated with adherence to receipt of three doses of hepatitis B vaccine. CONCLUSION Adherence to three-dose hepatitis B vaccination cycles is not universal among the healthcare workers in the Greater Accra Region. Receipt of the three-dose regimen is significantly associated with high-risk perception and attendance of training in infectious disease prevention. Interventions to increase risk perception and training in the prevention of blood-borne infections could improve adherence to complete/full vaccination protocol among healthcare workers who are at constant risk of exposure to the hepatitis B virus.
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Affiliation(s)
- Vivian Efua Senoo-Dogbey
- Department of Public Health, School of Nursing and Midwifery, University of Ghana, Legon, Accra, Ghana
| | - Francis Anto
- Department of Epidemiology, School of Public Health, University of Ghana, Legon, Accra, Ghana
| | - Reginald Quansah
- Department of Behavioural, Environmental and Occupational Health, University of Ghana, Legon, Accra, Ghana
| | - Anthony Danso-Appiah
- Department of Epidemiology, School of Public Health, University of Ghana, Legon, Accra, Ghana
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Tamanna SS, Paul KD, Al Banna MH, Zannat Z, Paul AK, Sultana S, Alshahrani NZ, Talukder S, Hassan MN. Assessment of preventive practices towards hepatitis B infection among nursing students in Bangladesh: role of knowledge, attitudes and sociodemographic factors. BMC Nurs 2024; 23:190. [PMID: 38515143 PMCID: PMC10956232 DOI: 10.1186/s12912-024-01870-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 03/14/2024] [Indexed: 03/23/2024] Open
Abstract
BACKGROUND Globally, hepatitis B infection (HBI) poses a substantial public health concern and healthcare workers, including nursing students, are at a higher risk of contracting this disease. Thus, the study aimed to assess how knowledge, attitudes, and sociodemographic factors are associated with HBI prevention among a sample of Bangladeshi nursing students. METHODS A cross-sectional survey was performed among 737 nursing students from the nursing institutes of Khulna and Barishal divisions in Bangladesh from January to April 2023. The data were collected by providing questionnaires (structured questionnaire) in the classroom, following a stratified random sampling process. A model of multinomial logistic regression was used to evaluate the factors linked to HBI prevention practices. RESULT The mean (SD) scores were 11.42 (± 2.88) for knowledge, 4.33 (± 1.91) for attitude and 4.27 (± 2.056) for practice respectively. Participants' low knowledge (adjusted odds ratio, aOR = 2.562, 95% CI: 1.29-5.07) and poor attitude (aOR = 5.730, 95% CI: 3.19-10.28) regarding HBI were significantly associated with higher likelihood of poor practice towards HBI prevention. Moreover, being 2nd year of nursing students (aOR = 2.147, 95% CI: 1.19-3.86), being aged 19-20 years (aOR = 3.038, 95% CI: 1.30-7.09), being married (aOR = 0.320, 95%CI: 0.13-0.82) and having a family history of HBI (aOR = 0.134, 95%CI: 0.05-0.36) were significantly associated with poor practices of HBI prevention among study participants. CONCLUSION The knowledge, attitude and practice scores of the nursing students on HBI prevention were suboptimal. We advocate for implementing regular HBI prevention education and policies, free or subsidized services, skill development, proper HBI prevention enforcement and strict professional ethics within nursing colleges. Such efforts should predominantly focus on second-year, aged 19-20 and unmarried nursing students.
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Affiliation(s)
- Sumaiya Sultana Tamanna
- Faculty of Nutrition and Food Science, Patuakhali Science and Technology University, Patuakhali, 8602, Bangladesh
| | - Kallol Deb Paul
- Faculty of Nutrition and Food Science, Patuakhali Science and Technology University, Patuakhali, 8602, Bangladesh
| | - Md Hasan Al Banna
- Department of Food Microbiology, Faculty of Nutrition and Food Science, Patuakhali Science and Technology University, Patuakhali, 8602, Bangladesh.
- Nutrition Initiative, Kushtia, Bangladesh.
| | - Zamia Zannat
- Faculty of Nutrition and Food Science, Patuakhali Science and Technology University, Patuakhali, 8602, Bangladesh
| | - Anup Kumar Paul
- Faculty of Nutrition and Food Science, Patuakhali Science and Technology University, Patuakhali, 8602, Bangladesh
| | - Sadia Sultana
- Department of Mathematics, University of Barishal, Barishal, 8254, Bangladesh
| | - Najim Z Alshahrani
- Department of Family and Community Medicine, Faculty of Medicine, University of Jeddah, Jeddah, Saudi Arabia
| | - Sohan Talukder
- Department of Environmental Sanitation, Faculty of Nutrition and Food Science, Patuakhali Science and Technology University, Patuakhali, 8602, Bangladesh
| | - Md Nazmul Hassan
- Department of Environmental Sanitation, Faculty of Nutrition and Food Science, Patuakhali Science and Technology University, Patuakhali, 8602, Bangladesh.
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Dzudzor B, Nsowah KK, Agyemang S, Vento S, Amarh V, Boima V, Tachi K. Overt and occult hepatitis B virus infection detected among chronic kidney disease patients on haemodialysis at a Tertiary Hospital in Ghana. PLoS One 2024; 19:e0290917. [PMID: 38437229 PMCID: PMC10911607 DOI: 10.1371/journal.pone.0290917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 02/17/2024] [Indexed: 03/06/2024] Open
Abstract
Hepatitis B virus (HBV) infection is endemic in Ghana and chronic kidney disease patients on haemodialysis are a high-risk group for HBV infection. We determined the prevalence of overt and occult HBV infection among haemodialysis patients at the Korle Bu Teaching Hospital in Ghana. 104 consenting End Stage Renal Disease patients on long-term haemodialysis were recruited for the study and their socio-demographic, clinical and laboratory information were obtained using structured questionnaire. All the participants were tested for the hepatitis B surface antigen (HBsAg). The HBsAg-negative participants were re-tested for hepatitis B surface antibody (HBsAb), hepatitis B core antibody (HBcAb) and HBV DNA using chemiluminescence and Roche COBAS Ampli-Prep/TaqMan analyser and real-time polymerase chain reaction. Eight (7.7%) of the total participants were positive for HBsAg. Among the 96 HBsAg-negative participants, 12.5% (12) were HBcAb-positive, 7.3% (7) had detectable HBV DNA (mean = 98.7±53.5 IU/mL) and 40.6% (39) were positive for HBsAb. Five out of the 7 HBV DNA-positive participants were males and only one participant was negative for HBcAb. Seventy-three out of the 96 HBsAg-negative participants were vaccinated and 37 of these vaccinated individuals had significant HBsAb titres (mean = 423.21± 380.72 IU/mL). Our data demonstrated that the prevalence of overt and occult HBV infection among the haemodialysis (HD) patients was 7.7% and 7.3%, respectively, and only 50.7% of those who showed proof of vaccination were protected from HBV infection.
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Affiliation(s)
- Bartholomew Dzudzor
- Department of Medical Biochemistry, University of Ghana Medical School, Korle-Bu, Ghana
| | - Kingsley Kwame Nsowah
- Department of Medical Biochemistry, University of Ghana Medical School, Korle-Bu, Ghana
| | | | - Sandro Vento
- Faculty of Medicine, University of Puthisastra, Phnom Penh, Cambodia
| | - Vincent Amarh
- Department of Medical Biochemistry, University of Ghana Medical School, Korle-Bu, Ghana
| | - Vincent Boima
- Department of Medicine and Therapeutics, University of Ghana Medical School, Korle-Bu, Ghana
| | - Kenneth Tachi
- Department of Medicine and Therapeutics, University of Ghana Medical School, Korle-Bu, Ghana
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Asgedom YS, Kassie GA, Woldegeorgis BZ, Meskele Koyira M, Kebede TM. Seroprevalence of hepatitis B virus infection and factors associated among pregnant women in Ethiopia: A systematic review and meta-analysis. WOMEN'S HEALTH (LONDON, ENGLAND) 2024; 20:17455057241235881. [PMID: 38444072 PMCID: PMC10916469 DOI: 10.1177/17455057241235881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 01/24/2024] [Accepted: 02/02/2024] [Indexed: 03/07/2024]
Abstract
BACKGROUND Hepatitis B virus infection is a major public health problem among pregnant women worldwide. Hepatitis B virus is highly infectious and is the most common cause of morbidity and mortality among pregnant women, and evidence is scarce on the pooled seroprevalence of hepatitis B virus in Ethiopia. OBJECTIVES This study aimed to investigate the pooled seroprevalence of hepatitis B virus infection and factors associated with pregnant women in Ethiopia. DESIGN A systematic review and meta-analysis was employed in accordance with the Preferred Reporting Items for Systematic Reviews. DATA SOURCES Searches were carried out in biomedical databases such as PubMed/Medline, Science Direct, Web of Science, Google Scholar, Hinari, and the Cochrane Library published in English until June 2023. METHODS Observational study designs were selected. Endnote citation manager was used to collect and organize the search outcomes and remove duplicate articles. The data were extracted using a Microsoft Excel spreadsheet and exported to STATA 16.0 software for the analysis. RESULTS A total of 48 research articles were included in the final analysis. The pooled estimated sero prevalence of hepatitis B virus infection among pregnant women in Ethiopia was 5.78% (95% confidence interval = 5.14, 6.43). History of abortion (odds ratio = 6.56, 95% confidence interval = 4.88, 8.90), history of blood transfusion (odds ratio = 5.74, 95% confidence interval = 4.04, 8.16), history of hospitalization (odds ratio = 5.40, 95% confidence interval = 3.68, 7.94), history of multiple sexual partner (odds ratio = 5.80, 95% confidence interval = 3.71, 9.05), history of surgical procedure (odds ratio = 7.39, 95% confidence interval = 4.16, 13.14), history of tattooing (odds ratio = 4.59, 95% confidence interval = 2.83, 7.43), and history of tooth extraction (odds ratio = 4.46, 95% confidence interval = 2.42, 8.22) were significantly associated with hepatitis B virus infection among pregnant women in Ethiopia. CONCLUSION The overall pooled prevalence of hepatitis B virus infection among pregnant women in Ethiopia is relatively high. Having a history of abortion, blood transfusion, hospitalization, multiple sexual partners, surgical procedures, tattooing, and tooth extraction were found to be risk factors for hepatitis B virus. Therefore, extensive screening programs for hepatitis B virus in all pregnant women in Ethiopia are needed to prevent further infection and decrease the vertical transmission caused by the disease. REGISTRATION NUMBER PROSPERO CRD: 42023438522.
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Vivian Efua SD, Delali Adwoa W, Adiza Atoko M. Adherence to the three-component Hepatitis B virus vaccination protocol among healthcare workers in hepatitis B virus endemic settings in Ghana. Vaccine X 2024; 16:100421. [PMID: 38145015 PMCID: PMC10733635 DOI: 10.1016/j.jvacx.2023.100421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 11/08/2023] [Accepted: 12/08/2023] [Indexed: 12/26/2023] Open
Abstract
Background The WHO and CDC recommend that HCWs who are at risk of HBV infection should vaccinate as adults early in their career by receiving 3 doses of HB vaccine at a schedule of months 0,1,6 and perform post-vaccination serological testing 1-2 months after vaccination. This study assessed adherence to all three components of the HBV vaccination program. Methods The study was a hospital-based analytical cross-sectional study involving 340 HCWs who were randomly selected. A pretested questionnaire was used to collect data which was analyzed using SPSS version 21. The proportion of HCWs adhering to the three components of the HBV vaccination protocol was computed. The multivariable analysis procedure identified the factors associated with overall adherence. Odds ratios were estimated with corresponding confidence intervals with the level of significance set at 0.05. Results HBV vaccination coverage was 60.9 % and adherence to 3-doses, 0,1,6 vaccination schedules and post-vaccination serological testing were 46.8 %, 38 % and 13 % respectively. Overall adherence was intermediate at the population level with only 6.2 % of the study participants adhering to all three components of the HBV vaccination protocol. HCWs who had low-risk perception for HBV had the lowest odds of completely adhering to all three indicators recommended for HBV vaccination (aOR = 0.15; 95 %CI = 0.04-0.58). Also, male HCWs have lower odds of adhering to all three components of HBV vaccination compared to their female counterparts (aOR = 0.65; 95 %CI = 1.17-2.50). Conclusion Adherence to the three components of HBV vaccination recommended for HCWs is low in this study. Failure to receive the recommended three-dose series of HBV vaccine at the recommended 0,1,6 schedule has implications for achieving seroprotection or development of antibodies against HBV. Failure to perform post-vaccination testing 1-2 months after HBV vaccination has implications for timely PEP management following occupational exposures. All three components of an ideal HBV vaccination program are important and should be used collectively to guide facility led HCW vaccination programs. Occupational health and safety programs, Infection prevention and control, as well as health promotion campaigns in health facilities, should promote adherence to all three components of HBV vaccination programs.
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Affiliation(s)
- Senoo-Dogbey Vivian Efua
- Department of Public Health, School of Nursing and Midwifery, University of Ghana, P. O. Box LG 25 Legon, Accra, Ghana
- Ghana Institute of Management and Public Administration, Greenhill Campus, Accra, Ghana
| | - Wuaku Delali Adwoa
- Department of Nursing Research, Nursing, and Midwifery Training School, P. O Box KB 83 Korle-Bu, Accra, Ghana
| | - Mumuni Adiza Atoko
- Department of Maternal and Child Health, School of Nursing and Midwifery, College of Health Sciences, University of Ghana, Ghana
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Lanyo TN, Adjei CA, Ani-Amponsah M. Informational and Practical Needs of Expectant Mothers with Chronic Hepatitis B in Ghana. SAGE Open Nurs 2024; 10:23779608241255183. [PMID: 38828400 PMCID: PMC11141223 DOI: 10.1177/23779608241255183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Revised: 03/24/2024] [Accepted: 04/28/2024] [Indexed: 06/05/2024] Open
Abstract
Hepatitis B virus infection is a global public health problem with disproportionately high endemicity in Africa and Ghana. The current national prevalence of hepatitis B among pregnant women in Ghana stands at 7.44%, highlighting the considerable threat of chronic hepatitis B on pregnant women and their general well-being. The study explored the informational and practical needs of pregnant women with chronic hepatitis B in Ghana. Fourteen pregnant women were selected purposefully using the exploratory descriptive qualitative design. Data were analyzed using thematic analysis. The findings showed that pregnant women with chronic hepatitis B lacked knowledge about the infection and were in great need of hepatitis B-related information. The study also revealed significant financial implications for treating the infection, necessitating policy reforms and stakeholder actions. To achieve effective coping, better health-seeking, and health-promoting behaviors for better health outcomes, it is crucial to provide targeted care that comprehensively covers the specific needs of pregnant women with chronic hepatitis B. It is also essential to consider including hepatitis B management in the National Health Insurance package to improve care quality.
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Affiliation(s)
- Theresa Norpeli Lanyo
- Department of Women and Children, University of Ghana Medical Centre, Accra, Greater Accra, Ghana
| | - Charles Ampong Adjei
- Department of Public Health Nursing, University of Ghana, School of Nursing and Midwifery, Legon, Greater Accra, Ghana
| | - Mary Ani-Amponsah
- Department of Maternal and Child Health, University of Ghana, School of Nursing and Midwifery, Legon, Greater Accra, Ghana
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Nyambah PK, Agjei R, Sarfo B. Seroprevalence and factors associated with Hepatitis B virus infection among students in two senior high schools in the Krachi Nchumuru district in Ghana-A cross-sectional study. BMC Res Notes 2023; 16:358. [PMID: 38042854 PMCID: PMC10693693 DOI: 10.1186/s13104-023-06624-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 11/12/2023] [Indexed: 12/04/2023] Open
Abstract
BACKGROUND There is paucity of hepatitis B virus (HBV) data among student populations although Ghana is HBV endemic. Screening and identification of factors associated with HBV transmission in schools will support the intervention in the elimination of the virus by 2030. This study assessed the seroprevalence and factors associated with HBV among students in two Senior High Schools in the Krachi Nchumuru District in Ghana. METHODS Through cross-sectional design and simple random sampling technique, 300 first-year students were enrolled from selected Senior High Schools. Structured questionnaires were used to collect data on demographic and exposure factors while rapid test kit was used to detect HBV infections. Chi-square/Fisher exact test and multivariable logistic regression were performed to determine the association between the variables at a 95% confidence interval and 0.05 significant level. RESULTS Seroprevalence of HBV was 14% (42/300) among the students. The prevalence was significantly (p = 0.001) higher in males 19.4% (34/175) than females 6.4% (8/125). 77.7% (233/300) were aware of HBV infection. Males who were circumcised were 4 times more likely to be infected with HBV (AOR = 4.09, 95%CI = 1.82-9.19) (p = 0.001) compared with those uncircumcised. CONCLUSION HBV screening and education on hygienic genital circumcision practices must be prioritized in endemic countries.
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Affiliation(s)
- Patrick K Nyambah
- Department of Epidemiology and Disease Control, School of Public Health, University of Ghana, P.O. Box 13, Legon-Accra, Ghana
- Health Directorate, P.O. Box 79, Kyinderi, Krachi Nchumuru District, Ghana
| | - Richard Agjei
- Department of Health Administration and Education, University of Education, Winneba, Central Region, Ghana
| | - Bismark Sarfo
- Department of Epidemiology and Disease Control, School of Public Health, University of Ghana, P.O. Box 13, Legon-Accra, Ghana.
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Nyarko ENY, Obirikorang C, Owiredu WKBA, Adu EA, Acheampong E. Assessment of the performance of haematological and non-invasive fibrotic indices for the monitoring of chronic HBV infection: a pilot study in a Ghanaian population. BMC Res Notes 2023; 16:312. [PMID: 37925465 PMCID: PMC10625242 DOI: 10.1186/s13104-023-06581-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 10/18/2023] [Indexed: 11/06/2023] Open
Abstract
OBJECTIVE Haematological and liver fibrotic markers could be appreciably utilized for effective monitoring of Chronic Hepatitis B viral (HBV) infection, thereby increasing patient's treatment outcome. The objective of this study was to assess the applicability of complete blood count (CBC) and non-invasive liver-fibrotic indices as markers of prognostic outcome and monitoring in HBV infections. RESULTS Significant differences in levels of white cell and differentials counts, red blood cell count, hemoglobin indices, and platelet indices were observed between HBV-infected patients (cases) and uninfected persons (controls). Levels of haemoglobin (Hb), total white blood cells (tWBC), neutrophils, monocytes, platelets, and Platelet Distribution width (PDW) were significantly lower (p < 0.05) in the cases compared to the controls. Total and indirect bilirubin; De-Ritis ratio, Aspartate transaminase to platelet ratio index (APRI) and RDW-to-platelet ratio (RPR) were elevated in cases compared with controls (p-value < 0.05). In a multivariate adjusted model to test the significance of markers, Hemoglobin Index (beta coefficient = - 0.876, p-value < 0.001), NLR (beta coefficient = - 0.839, p-value < 0.001), MPV_10000 (beta coefficient = - 0.333, p-value < 0.001) and Albumin (beta coefficient = - 0.059, p-value = 0.014), were associated with HBV infection status. Receiver operative characteristics curve analysis showed Hemoglobin Index (AUC = 0.744) and MPV_10000 (AUC = 0.730) as better prognostic markers for HBV-infection.
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Affiliation(s)
- Eric N Y Nyarko
- Department of Chemical Pathology, University of Ghana Medical School, University of Ghana, Accra, Ghana.
| | - Christian Obirikorang
- Department of Molecular Medicine, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Global Health and Infectious Diseases Group, Kumasi Centre for Collaborative Research, Kumasi, Ghana
| | - W K B A Owiredu
- Department of Molecular Medicine, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Evans Asamoah Adu
- Department of Molecular Medicine, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Global Health and Infectious Diseases Group, Kumasi Centre for Collaborative Research, Kumasi, Ghana
| | - Emmanuel Acheampong
- Department of Molecular Medicine, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia
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Sagoe KWC, Atuahene K, Ayiku ANA, Pappoe-Ashong PJ, Boamah I, Till H, Hagbe FS, Egyire IK, Nyampong M, Addo SA, Manu A, Noora CL, Tetteh M, Ankomah A, Adanu R. Hepatitis B and human immunodeficiency virus infections within correctional facilities in Ghana. PLoS One 2023; 18:e0293009. [PMID: 37922278 PMCID: PMC10624276 DOI: 10.1371/journal.pone.0293009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 10/03/2023] [Indexed: 11/05/2023] Open
Abstract
Previous studies have suggested high Immunodeficiency Virus (HIV) and hepatitis B virus (HBV) prevalence in prisons in Ghana. However, this study was part of a nationally representative bio-behavioural survey and determined the prevalence of HIV and HBV among prison inmates and identified factors associated with these infections. Both biomedical and behavioural data were collected from a total of 2,443 prison inmates from 19 prison stations during 2013 in Ghana; 12 male prisons and 7 female prisons selected across the country. The national HIV screening algorithm was used for HIV testing while two rapid detection tests were used to confirm HBV infections. HIV and HBV prevalence among prisoners in Ghana were approximately 2.34% and 12.38% respectively. Only 5 inmates, had co-infection with both viruses. The prevalence of HIV was significantly lower among male inmates (1.5%) compared to the female inmates (11.8%). Age, sex, and marital status, were significantly associated with both HIV and HBV infections. However, BMI category, IDU, and time spent in prison were associated with HIV infections. The educational level was significantly associated with HBV infections. After binary logistic regression, being female (AOR: 0.18, 95% CI: 0.07-0.45, p<0.001) and having a stay of 5 years or more (AOR: 0.07, 95% CI: 0.01-0.60, p = 0.016), increased the risk of having HIV infection. While, those with no formal education (AOR: 0.65, 95% CI: 0.45-0.95, p = 0.024) and are underweight (AOR: 0.51, 95% CI: 0.27-0.99, p = 0.046), were more likely to have HBV infection. Forced penetrative sex may be a problem in the prisons. The need to have and strengthen an integrated screening, treatment and vaccination plan for the prison is emphasized. The prison does not serve as an exceptionally high risk to the general population. The findings support a critical look at the issue of forced penetrative sex in the prisons.
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Affiliation(s)
- Kwamena W. C. Sagoe
- Department of Medical Microbiology, University of Ghana Medical School, College of Health Sciences, University of Ghana, Accra, Ghana
| | | | - Angela N. A. Ayiku
- Department of Medical Microbiology, University of Ghana Medical School, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Prince J. Pappoe-Ashong
- Department of Medical Microbiology, University of Ghana Medical School, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Isaac Boamah
- Department of Medical Microbiology, University of Ghana Medical School, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Holger Till
- Deutsche Gesellschaft für Internationale Zusammenarbeit GmbH, Accra, Ghana
| | | | | | | | | | - Adom Manu
- Department of Population, Family and Reproductive Health, School of Public Health, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Charles L. Noora
- Department of Epidemiology and Disease Control, School of Public Health, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Millicent Tetteh
- Deutsche Gesellschaft für Internationale Zusammenarbeit GmbH, Accra, Ghana
| | - Augustine Ankomah
- Department of Population, Family and Reproductive Health, School of Public Health, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Richard Adanu
- Department of Population, Family and Reproductive Health, School of Public Health, College of Health Sciences, University of Ghana, Accra, Ghana
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Walana W, Vicar EK, Kuugbee ED, Dari I, Bichenlib G, Aneba CN, Hinneh KN, Yabasin IB, Issaka KN, Danso MO, Amoatey TN, Ziem JB. Transfusion transmissible infections among blood donors in Ghana: A 3-year multicentered health facility-based retrospective study. Health Sci Rep 2023; 6:e1681. [PMID: 37927541 PMCID: PMC10620378 DOI: 10.1002/hsr2.1681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 10/17/2023] [Accepted: 10/19/2023] [Indexed: 11/07/2023] Open
Abstract
Transfusion transmissible infections (TTIs) remain a major health challenge particularly in developing countries. Here, we present a multicentered hospital-based retrospective study on the prevalence, distribution, and risk factors of TTIs in Ghana. Data on blood donors from four health facilities, namely Nkwanta South Municipal Hospital (Oti region), Weija-Gbawe Municipal Hospital (Greater Accra region), SDA Hospital (Northern region) and Wa Municipal Hospital (Upper West region) were extracted and analyzed. Descriptive statistics and multinomial logistic regression were applied to compare sociodemographic data with TTI status. A total of 6094 blood donors were included in this study, and 2% were females. The overall prevalence of TTIs was 21.0% (1232/5868). Specifically, the prevalence of HBV, HCV, HIV, and Syphilis was 6.6% (385/5868), 4.9% (286/5830), 2.9% (168/5867), and 6.8% (393/5739), respectively. Wa dominated in all the viral agents considered in this study, while the Oti region recorded the highest prevalence in T. pallidum. The odds of HBV infection was 3.1 (p = 0.008) among first-time donors, while that for HCV was 2.8 (p = 0.042). For rural dwellers, donors significantly had T. pallidum (p < 0.001; OR = 2.8), HCV (p < 0.001; OR = 2.9), and HIV (p = 0.028; OR = 1.5) infections. Generally, the recipients of transfused blood were predominantly pregnant mothers, followed by children and accident victims. This study has revealed significant disparities and relatively high prevalence of TTIs in Ghana, specifically HBV, HCV, HIV and T. pallidum infections. The variations suggest the presence of unique health challenges per study area, hence the need for a tailored intervention for each study site.
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Affiliation(s)
- Williams Walana
- Department of Clinical MicrobiologySchool of Medicine, University for Development StudiesTamaleGhana
| | - Ezekiel K. Vicar
- Department of Clinical MicrobiologySchool of Medicine, University for Development StudiesTamaleGhana
| | - Eugene D. Kuugbee
- Department of Microbiology and ImmunologySchool of Medicine and DentistryNavrongoGhana
| | - Isaac Dari
- Community Health and Preventive MedicineSchool of Medicine, University for Development StudiesTamaleGhana
| | - Grace Bichenlib
- Community Health and Preventive MedicineSchool of Medicine, University for Development StudiesTamaleGhana
| | - Christian N. Aneba
- Community Health and Preventive MedicineSchool of Medicine, University for Development StudiesTamaleGhana
| | - Kwasi N. Hinneh
- Community Health and Preventive MedicineSchool of Medicine, University for Development StudiesTamaleGhana
| | - Iddrisu B. Yabasin
- Department of Anaesthesiology and Intensive CareUniversity for Development StudiesTamaleGhana
| | - Koray N. Issaka
- Department of Laboratory ServiceWa Municipal Hospital, Upper West RegionWaGhana
| | - Michael O. Danso
- Department of Laboratory ServiceWeija‐Gbawe Municipal Hospital, Greater Accra RegionAccraGhana
| | | | - Juventus B. Ziem
- Department of Microbiology and ImmunologySchool of Medicine and DentistryNavrongoGhana
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Mpangah RA, Akyereko E, Acheampong GK, Ansah-Nyarko M, Owusu I, Sarfo B. Assessment of knowledge and treatment practices of hepatitis B infection in children among health professionals in Krachi districts in Ghana: a cross-sectional study. J Public Health Afr 2023; 14:2469. [PMID: 37753438 PMCID: PMC10519114 DOI: 10.4081/jphia.2023.2469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 04/12/2023] [Indexed: 09/28/2023] Open
Abstract
Background Hepatitis B virus (HBV) infection remains one of the neglected infectious diseases. Children infected with HBV are at higher risk of becoming chronic carriers. Barriers to measures against HBV in children are attributed to inadequate knowledge by some health professionals. This study assessed knowledge and treatment practices of HBV in children among health professionals. Materials and Methods A cross-sectional survey was conducted among health professionals (185) in three districts in Krachi using a structured questionnaire. Stata version 15 was used to analyze participants' responses on awareness, knowledge, and treatment practices. Pearson's product-moment correlation was used to determine the relationship between knowledge and treatment practices. Multivariate regression analysis assessed the relationships between variables at P<0.05 and 95% confidence interval. Results 20% were not aware of HBV in children and 85% had only fair knowledge about HBV in children. Only 29% indicated good knowledge and treatment practices of HBV in children. A unit increase in knowledge of HBV in children leads to a 1.42 unit increase in awareness (P<0.01), and a 1.3 unit increase in treatment practice (P<0.01) of HBV in children. Conclusions Participants demonstrated only fair knowledge about HBV in children. Seminars and workshops on HBV in children for health professionals must intensify.
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Affiliation(s)
- Rebecca A. Mpangah
- Department of Epidemiology and Disease Control, School of Public Health, University of Ghana, Legon-Accra, Ghana
- Disease Surveillance Department, Ghana Health Service, Head Quarters, Korlebu-Accra, Ghana
| | - Ernest Akyereko
- Disease Surveillance Department, Ghana Health Service, Head Quarters, Korlebu-Accra, Ghana
- Faculty of Geo-Information Science and Earth Observation (ITC), University of Twente, Enschede, The Netherlands
| | - Gideon K. Acheampong
- Disease Surveillance Department, Ghana Health Service, Head Quarters, Korlebu-Accra, Ghana
| | - Michael Ansah-Nyarko
- Research Department, Policy Planning Monitoring and Evaluation (PPME), Legon-Accra, Ghana
| | - Isaac Owusu
- Department of Epidemiology and Disease Control, School of Public Health, University of Ghana, Legon-Accra, Ghana
- Disease Surveillance Department, Ghana Health Service, Head Quarters, Korlebu-Accra, Ghana
| | - Bismark Sarfo
- Department of Epidemiology and Disease Control, School of Public Health, University of Ghana, Legon-Accra, Ghana
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Anabire NG, Quaye O, Helegbe GK. Circulation of multiple hepatitis B virus genotypes in individual pregnant women seeking antenatal care in northern Ghana. Virol J 2023; 20:149. [PMID: 37443015 PMCID: PMC10347747 DOI: 10.1186/s12985-023-02110-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 06/30/2023] [Indexed: 07/15/2023] Open
Abstract
BACKGROUND Identification and monitoring of HBV genotype variations is important, since that can help forecast the likelihood of developing serious liver disease and how well patients respond to antiviral medication. Given that HBV genotyping tests are not widely available in our healthcare system, this study characterized HBV genotypes in pregnant women seeking prenatal treatment in northern Ghana. METHOD By a cross-sectional approach, 2071 pregnant women seeking antenatal care in health facilities in northern Ghana were screened for HBV infection using hepatitis B surface antigen (HBsAg) rapid diagnostic test kit. The women were aged between 17 and 41 years, were of varying gravidae (primigravidae and multigravidae) and gestational age (first, second and third trimesters). A confirmatory PCR assay was used to detect HBsAg, and the distribution of HBV genotypes was determined using a nested PCR assay. RESULTS Three HBV genotypes (A, D and E) were detected among the pregnant women, of which 175 (91.6%) had genotype E, 9 (4.7%) had mixed genotypes A and E, 5 (2.6%) had mixed genotypes D and E, and 2 (1.1) had mixed genotypes A, D and E. The proportions of women with the different HBV genotypes were independent of age (p = 0.925), gravidity (p = 0.193, χ2 = 4.729) and gestational age (p = 0.227, χ2 = 8.152). CONCLUSION This study for the first-time characterized circulating HBV genotypes in pregnant women in northern Ghana, which reveals genotypes A and D are found in mixed infections with genotype E. The findings have clinical implications on the management of chronic HBV infection among pregnant women in northern Ghana.
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Affiliation(s)
- Nsoh Godwin Anabire
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), Department of Biochemistry, Cell & Molecular Biology, University of Ghana, P. O. Box LG 54, Legon- Accra, Ghana
- Department of Biochemistry & Molecular Medicine, School of Medicine, University for Development studies, P. O. Box TL 1883, Tamale, Ghana
| | - Osbourne Quaye
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), Department of Biochemistry, Cell & Molecular Biology, University of Ghana, P. O. Box LG 54, Legon- Accra, Ghana
| | - Gideon Kofi Helegbe
- Department of Biochemistry & Molecular Medicine, School of Medicine, University for Development studies, P. O. Box TL 1883, Tamale, Ghana
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Amoah S, Yartey AN, Fosu Adjei P, Owusu-Akyaw M, Boachie J, Simpong DL, Adu P. HBV Infection Is an Intermediate-Risk Disease, Whereas Anaemia Is a Mild-to-Moderate Public Health Problem in Young Ghanaian Adults: A Four-Year Retrospective Analysis of Students' Medical Records. BIOMED RESEARCH INTERNATIONAL 2023; 2023:9318984. [PMID: 37475793 PMCID: PMC10356218 DOI: 10.1155/2023/9318984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 06/22/2023] [Accepted: 06/26/2023] [Indexed: 07/22/2023]
Abstract
Background In sub-Saharan Africa, malaria, chronic viral diseases, nutritional deficiencies, and haemoglobinopathies are common causes of anaemia. Continual surveillance data is required to situate the anaemia and infectious disease burden within a given population. This study determined the 4-year trends of anaemia, hepatitis B virus (HBV), and HCV infections and factors associated with anaemia in young Ghanaian adults. Methods This retrospective study analysed the medical records of 21,716 fresh students at the University of Cape Coast. Data was presented as percentages and line graphs to show the yearly trends in anaemia, HBV, and HCV infections. Binary logistic regression was used to determine the increased odds of anaemia in participants. Results Although the 4-year anaemia prevalence was 14.2% (95% CI: 0.1403-0.1498), anaemia prevalence in women and men were 24.1% (95% CI: 0.2387-0.2562) and 6.6% (95% CI:0.0616-0.0705), respectively. Anaemia prevalence consistently remained mild (males) and moderate (females) public health problem over the four-year period. Adolescents were more represented in the anaemic group (18.7% prevalence), 70.9% of them being females. The prevalence of HBV and HCV infections were 5.4% (95% CI:0.0506-0.0567) and 0.9% (95% CI: 0.0082-0.0108), respectively; only 0.1% of participants had HBV and HCV coinfection. Males were more represented in both HBV (71.2%) and HCV (63.7%) infection groups. Moreover, 15.8% of the participants who were seropositive for HBsAg self-reported having previously been vaccinated, suggesting a breakthrough infection and/or vaccine nonresponse. Furthermore, female (COR: 4.545; p < 0.001), teenagers (COR: 1.697; p < 0.001), 20-29 years (COR: 1.221; p = 0.035), and positive sickling slide test (COR: 1.176; p = 0.003) were statistically significantly associated with increased odds of anaemia. Conclusion Intentional preventative public health campaigns regarding anaemia, HBV, and HCV infection should, respectively, target females and young adult males to increase chances of making real change in behavioural attitudes in these at-risk groups.
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Affiliation(s)
- Samuel Amoah
- University of Cape Coast Hospital Laboratory, Cape Coast, Ghana
| | | | - Praise Fosu Adjei
- Department of Medical Laboratory Sciences, School of Allied Health Sciences, Cape Coast, Ghana
| | - Margaret Owusu-Akyaw
- Department of Medical Laboratory Sciences, School of Allied Health Sciences, Cape Coast, Ghana
| | - Joseph Boachie
- Department of Medical Laboratory Sciences, School of Allied Health Sciences, Cape Coast, Ghana
| | - David Larbi Simpong
- Department of Medical Laboratory Sciences, School of Allied Health Sciences, Cape Coast, Ghana
| | - Patrick Adu
- Department of Medical Laboratory Sciences, School of Allied Health Sciences, Cape Coast, Ghana
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Kusi KA, van der Puije W, Asandem DA, Baba-Adam R, Agbevey H, Asare B, Segbefia P, Bentum-Ennin L, Annan A, Osei F, Teye-Adjei D, Galevo ES, Odame G, Ansa G, Amoah L, Bonney JHK. World Hepatitis day 2021 -screening and vaccination against Hepatitis B virus in Accra, Ghana. BMC Public Health 2023; 23:1164. [PMID: 37328849 PMCID: PMC10273713 DOI: 10.1186/s12889-023-16108-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 06/12/2023] [Indexed: 06/18/2023] Open
Abstract
BACKGROUND In Ghana, Hepatitis B virus (HBV) infection remains a major public health threat as in many parts of the world. Even with an effective vaccine, there are shortfalls with low vaccine coverage among adults. To create awareness and encourage vaccination, community engagement and public-private partnerships are needed in endemic settings to help fund campaigns and offer screening and vaccinations at no cost to under privileged people. OBJECTIVES An awareness and screening exercise was scheduled by University of Ghana-based Hepatitis-Malaria (HEPMAL) project team to coincide with the World Hepatitis Day (WHD) 2021. It was to engage the community in creating awareness of the menace and offer diagnostic services to ascertain prevalence levels and provide needed clinical support. METHODS Participants from the University of Ghana community and its immediate environs were registered, taken through pre-counselling sessions where they were educated on hepatitis transmission and prevention before consenting. Eligible participants were screened for HBV markers (HBsAg, HBeAg, HBsAb, HBcAb,HbcAg) with a rapid test kit. All HBsAb-negative participants were recommended for initial vaccination at the event, whilst the subsequent shots were administered at the University Hospital Public Health Department. Hepatitis B surface Antigen-positive participants were counselled and referred for appropriate care. RESULTS / Outcomes: A total of 297 people, comprising of 126 (42%) males and 171 (58%) females aged between 17 and 67 years were screened during the exercise. Amongst these, 246 (82.8%) showed no detectable protective antibodies against HBV and all of them agreed to and were given the first dose HBV vaccine. Additionally, 19 (6.4%) individuals tested positive for HBsAg and were counselled and referred to specialists from the University Hospital for further assessment and management. We found that 59 (19.9%) of our participants had previously initiated HBV vaccination and had taken at least one dose of the vaccine more than 6 months prior to this screening, 3 of whom tested positive for HBsAg. For the three-dose HBV vaccines deployed, a little over 20% (50/246) and a further 17% (33/196) did not return for the second and the third doses respectively, resulting in an overall 66% (163/246) of persons who completed all three vaccinations. CONCLUSIONS / Lessons learnt: Our medical campaign exercise established an active case prevalence rate of 6.4% and achieved a full vaccination success rate of 66% which is critical in the induction of long-term immunity in the participants. Aside these achievements, we would like to reiterate the importance of the use of different approaches including educational events and WHD activities to target groups and communities to raise awareness. Additionally, home and school vaccination programmes may be adopted to enhance vaccine uptake and adherence to the vaccination schedule. We plan to extend this screening exercise to deprived and/or rural communities where HBV incidence may be higher than in urban communities.
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Affiliation(s)
- Kwadwo Asamoah Kusi
- Department of Immunology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon Accra, Ghana
- Department of Virology, Noguchi Memorial Noguchi Memorial Institute for Medical Research, University of Ghana, Legon Accra, Ghana
| | - William van der Puije
- Department of Immunology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon Accra, Ghana
| | - Diana A Asandem
- Department of Immunology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon Accra, Ghana
- Department of Biochemistry, Cell and Molecular Biology, University of Ghana, Legon Accra, Ghana
- Department of Virology, Noguchi Memorial Noguchi Memorial Institute for Medical Research, University of Ghana, Legon Accra, Ghana
| | - Rawdat Baba-Adam
- Department of Immunology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon Accra, Ghana
- Department of Virology, Noguchi Memorial Noguchi Memorial Institute for Medical Research, University of Ghana, Legon Accra, Ghana
| | - Hardy Agbevey
- Department of Immunology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon Accra, Ghana
| | - Bright Asare
- Department of Immunology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon Accra, Ghana
- Department of Animal Biology and Conservation Science, University of Ghana, Legon Accra, Ghana
| | - Philip Segbefia
- Department of Immunology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon Accra, Ghana
- Department of Theoretical Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Lutterodt Bentum-Ennin
- Department of Immunology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon Accra, Ghana
| | - Audrey Annan
- Department of Immunology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon Accra, Ghana
| | - Frank Osei
- Department of Immunology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon Accra, Ghana
| | - Doreen Teye-Adjei
- Department of Immunology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon Accra, Ghana
| | - Elsie Sutaya Galevo
- Department of Immunology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon Accra, Ghana
| | - Gifty Odame
- University Hospital, University of Ghana, Legon Accra, Ghana
| | - Gloria Ansa
- University Hospital, University of Ghana, Legon Accra, Ghana
| | - Linda Amoah
- Department of Immunology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon Accra, Ghana
- Department of Biochemistry, Cell and Molecular Biology, University of Ghana, Legon Accra, Ghana
| | - Joseph Humphrey Kofi Bonney
- Department of Biochemistry, Cell and Molecular Biology, University of Ghana, Legon Accra, Ghana.
- Department of Virology, Noguchi Memorial Noguchi Memorial Institute for Medical Research, University of Ghana, Legon Accra, Ghana.
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Senoo-Dogbey VE, Armah D, Wuaku DA. Hepatitis B infection prevention: Audit of selected healthcare facilities in the Greater Accra Region, Ghana. Infect Prev Pract 2023; 5:100284. [PMID: 37223242 PMCID: PMC10200842 DOI: 10.1016/j.infpip.2023.100284] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 04/18/2023] [Indexed: 05/25/2023] Open
Abstract
Introduction The risk of occupational exposure to Hepatitis B Virus (HBV) is high among healthcare workers (HCWs), especially in developing countries like Ghana where the prevalence of HBV is high. Unfortunately, in such regions, HCW protection does not appear to be a priority, and healthcare facilities (HFs) have been reported to have unsatisfactory levels of implementing preventive strategies to protect HCWs from blood-borne infections including HBV. Methods A cross-sectional and Q audit was performed involving 255 HFs selected by proportional allocation and systematic random sampling. Data was collected using a structured pretested questionnaire with HF managers being the respondents. Data were analysed using IBM ® SPSS® (Statistical Package for the Social Sciences, version 21.0) where univariate, bivariate, and multivariate analysis was done with the level of significance set at <0.05. Results Overall adherence to recommended strategies, structures, and programs for HBV prevention among the HFs was generally low, with a mean score of 37.02 (95% CI = 33.98-40.05). There was a statistically significant difference in the level of adherence between the HF categories (F = 9.698; P = <0.001). Being a hospital (OR = 3.9: CI = 1.68-9.29), possessing infection, prevention and control (IPC) guidelines (OR = 6.69: CI = 3.29-13.63) as well as having functional IPC committees in place (OR = 7.9: CI = 3.59-17.34) were associated with good adherence to HF-level HBV preventive strategies. Conclusion Overall adherence to HF-level prevention of HBV is sub-optimal. Higher-level facilities were better resourced with HBV vaccine and Hepatitis B immunoglobulin (HBIG). Adherence to HBV prevention strategies depends on the type of HF and the availability of IPC committees and their respective IPC coordinators.
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Affiliation(s)
- Vivian Efua Senoo-Dogbey
- Department of Public Health, School of Nursing and Midwifery, University of Ghana, P. O. Box LG 25 Legon, Accra, Ghana
- Ghana Institute of Management and Public Administration, School of Public Service and Governance, Ghana
| | - Deborah Armah
- Department of Maternal and Child Health, School of Nursing and Midwifery, University of Ghana, P.O. Box LG 25 Legon, Accra, Ghana
| | - Delali Adwoa Wuaku
- Department of Nursing Research, Nursing, and Midwifery Training College, P. O Box KB 83 Korle-Bu, Accra, Ghana
- Ghana College of Nurses and Midwives, Accra, Ghana
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Vivian Efua SD, Armah D, Delali Adwoa W. Hepatitis B Virus vaccination post serological testing and antibody levels of vaccinated health care workers in Accra, Ghana. Vaccine X 2023; 14:100294. [PMID: 37101844 PMCID: PMC10123245 DOI: 10.1016/j.jvacx.2023.100294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 03/28/2023] [Accepted: 03/29/2023] [Indexed: 04/05/2023] Open
Abstract
Introduction Hepatitis B Virus (HBV) infection is an important occupational hazard to Health Care Workers (HCWs) all over the world. International health organizations have strongly recommended the use of the HBV vaccine, especially among individuals at risk of HBV infection. A laboratory test aimed at measuring Anti-HBs concentration (titer) 1-2 months following a 3-dose vaccination schedule is the most reliable approach for diagnosing seroprotection against HBV. This study sought to assess post-vaccination serological testing, seroprotection against HBV, and associated factors among vaccinated HCWs in Ghana. Methods A hospital-based analytical cross-sectional study involving 207 HCWs. Pretested questionnaires were used to collect data. 5mls of venous blood were collected from consenting HCWs under strict aseptic conditions and quantitatively analyzed for Anti-HBs using ELISA procedures. SPSS Version 23 was used to analyze data with the level of significance set at 0.05. Results Median age; 33, IQR of 29-39. The post-vaccination serological testing rate was 21.3 %. HCWs with high-risk perception and working at the regional hospital had lower odds of adherence to post-vaccination serological testing (aOR = 0.2; 95 % CI = 0.1-0.7) and (aOR = 0.1; 95 % CI = 0.1-0.6) p < 0.05. The seroprotection rate was 91.3 % (95 % CI = 87 %-95 %). Minority, 18 (8.7 %) of the 207 vaccinated HCWs had antibody titers below 10mIU/mL and were not seroprotected against HBV. Geometric Mean Titers (GMTs) were higher in those who received three doses, took a booster, and were less than 25 kg/m2. Conclusion The post-vaccination serological testing practice was sub-optimal. The seroprotection rate was higher with higher GMTs in those who adhered to the 3-dose vaccination regimen, took a booster dose, and had BMI < 25 kg/m2. It may be inferred that those with Anti-HBs below 10 IU/ml had their antibodies diminishing or waning off with time or they are true vaccine non-responders. This observation calls for strict adherence to post-vaccination serological testing, especially for HCWs who are at high risk of percutaneous and mucocutaneous exposures that could result in HBV infection.
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Abaah D, Ohene LA, Adjei CA. Physical and social wellbeing of family caregivers of persons with hepatitis B associated chronic liver disease in Ghana: a qualitative study. BMC PRIMARY CARE 2023; 24:82. [PMID: 36964491 PMCID: PMC10039581 DOI: 10.1186/s12875-023-02041-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 03/20/2023] [Indexed: 03/26/2023]
Abstract
BACKGROUND Hepatitis B is one of the most common viral (HBV)infections that affect the liver. Infection with the virus may result in varying severity of liver disease which may be acute or chronic. Though most people recover from the infection, about 5 - 10% of cases lead to chronic infection. Persons who develop HBV-related debilitating liver disease will likely require informal care from family caregivers. AIM This study sought to explore the physical and social wellbeing of family caregivers of persons with hepatitis B-associated chronic liver disease in a tertiary hospital in the Central region of Ghana. METHODS This study adopted an exploratory, descriptive qualitative research design. We used a purposive sampling technique and a semi-structured interview guide to interview eighteen participants. The Quality of Life (QoL) model applied to family caregivers underpinned the study and guided the formulation of study objectives. Data analysis followed Braun and Clarke's procedure for thematic content analysis. Similar codes were grouped into subthemes, and similar subthemes were grouped into major themes. The consolidated criteria for reporting qualitative research (coreq) checklist was used as a guide for writing the study. RESULTS Two major themes emerged from the study: physical wellbeing and social wellbeing. Seven subthemes were also identified: physical body changes and physiological body changes (physical wellbeing) and role strain, social isolation, financial impact, affection/sexual function, and support social wellbeing). These central themes aligned with two domains of the QoL model applied to family caregivers. CONCLUSION Family caregivers of persons with HB-associated liver disease suffer ill health due to the burden of physical care for their sick relatives and neglect their health due to time constraints. They also experience role strain as they cannot attend to other family responsibilities and feel socially isolated since they spend all their time caring for a sick family member.
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Dzudzor B, Hammond H, Tachi K, Alisi A, Vento S, Gyasi RK, Aheto JMK. Serum 25-hydroxyvitamin D and hyaluronic acid levels as markers of fibrosis in patients with chronic liver disease at the main tertiary referral hospital in Ghana: A case-control study design. Health Sci Rep 2023; 6:e1101. [PMID: 36789398 PMCID: PMC9919473 DOI: 10.1002/hsr2.1101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 01/04/2023] [Accepted: 01/28/2023] [Indexed: 02/13/2023] Open
Abstract
Background and Aims Liver fibrosis leading to chronic liver disease (CLD) is a major cause of morbidity, mortality and health-care expenditure worldwide. The "gold standard" for diagnosis and staging of liver fibrosis is histological analysis of liver tissue obtained by liver biopsy, an invasive procedure. Therefore, there is the need to identify noninvasive and inexpensive markers for diagnosis and staging of liver fibrosis. This study aimed at evaluating the correlation of hyaluronic acid (HA) and 25-hydroxyvitamin D (25-OH vitamin D) serum levels as markers of fibrosis with histologically staged and graded liver biopsies obtained from CLD patients. Methods This was a case-control study involving 40 CLD patients requiring liver biopsies and 40 controls. Liver biopsies were staged to determine the degree of fibrosis. Serum levels of 25-OH vitamin D and HA were determined using ELISA. Statistical analyses were performed to determine differences in HA and 25-OH vitamin D levels between controls and patients as well as to correlate the biomarkers with the stages of fibrosis. Results CLD patients showed significant (p < 0.001) increase in the levels of AST, ALT, GGT, compared to the controls. Patients also had significantly (p < 0.001) lower serum 25-OH vitamin D and higher HA (p < 0.001) levels compared to the controls. Additionally, 25-OH vitamin D levels of the CLD patients were significantly different across the stages of liver fibrosis likewise serum HA levels. Furthermore, 25-OH vitamin D levels inversely correlated with the severity of liver fibrosis. A significant negative correlation (r = -0.33, p < 0.05) between CLD patients' HA and 25-OH vitamin D were found. Conclusion CLD patients had significantly reduced serum 25-OH vitamin D and higher HA. Both markers correlated with the degree of liver fibrosis. These findings have major clinical translatable implication in the use of vitamin D supplementation in the management of CLD in Ghana.
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Affiliation(s)
- Bartholomew Dzudzor
- Department of Medical Biochemistry, University of Ghana Medical School, Korle‐Bu, College of Health SciencesUniversity of GhanaAccraGhana
| | - Harris Hammond
- Department of Medical Biochemistry, University of Ghana Medical School, Korle‐Bu, College of Health SciencesUniversity of GhanaAccraGhana
| | - Kenneth Tachi
- Department of Medicine and Therapeutics, University of Ghana Medical School, Korle‐Bu, College of Health SciencesUniversity of GhanaAccraGhana
| | - Anna Alisi
- Research Unit of Genetics of Complex Phenotypes, Area of Translational Pediatrics and Cinical Genetics, “Bambino Gesù” Children's Hospital IRCCSRomeItaly
| | - Sandro Vento
- Faculty of MedicineUniversity of PuthisastraPhnom PenhCambodia
| | - Richard Kwasi Gyasi
- Department of Pathology, University of Ghana Medical School, Korle‐Bu, College of Health SciencesUniversity of GhanaAccraGhana
| | - Justice Moses K Aheto
- Department of Biostatistics, School of Public Health, College of Health SciencesUniversity of GhanaAccraGhana
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Tagbor S, Ohene LA, Adjei CA, Kyei J. Perceptions and Cues to Action as Predictors of Nurses' Vaccination Intentions at Two Primary Health Care Facilities in Ghana. Am J Trop Med Hyg 2023; 108:433-440. [PMID: 36535250 PMCID: PMC9896321 DOI: 10.4269/ajtmh.21-1335] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 10/13/2022] [Indexed: 12/23/2022] Open
Abstract
Uptake of hepatitis B vaccination by health care providers remains suboptimal in Ghana, although it is considered an effective strategy against the hepatitis B virus. This study aimed to identify the predictors of nurses' hepatitis B vaccination intentions at two municipal health care facilities in Ghana. A descriptive cross-sectional survey was adopted. A section of the health belief model-based questionnaire was administered to 181 nurses conveniently sampled from the two facilities. Data analysis was done using Statistical Product and Service Solutions software version 23.0. Frequencies and percentages were used to assess the demographic characteristics of participants. Pearson r coefficients were used to assess the intercorrelations between individual perceptions, and the cues to action on vaccination intentions. Simple and multiple regression was used to estimate the prediction of individual perceptions, and the cues to action on hepatitis B vaccination intentions of nurses. The findings showed that nurse-perceived benefits and cues to action were positive and significantly related to hepatitis B vaccination intentions of nurses (r = 0.14, P < 0.05; r = 0.17, P < 0.05). Perceived susceptibility and perceived barrier were negative and significantly related to vaccine intentions (r = -0.13, P < 0.05; r = -0.24, P < 0.01). Notably, perceived barrier predicted hepatitis B vaccination intentions (β = -0.22, t = -2.48, P = 0.01). Nurses' vaccination behavioral intentions were positive. It was recommended that perceived barriers to hepatitis B vaccination such as vaccination ineffectiveness, time constraints, high costs, and side effects should be addressed to increase nurses' vaccination uptake.
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Affiliation(s)
- Solomon Tagbor
- Department of Nursing, Nursing and Midwifery Training College, Kete-Krachi, Ghana
| | - Lillian Akorfa Ohene
- Department of Community Health Nursing, School of Nursing and Midwifery, University of Ghana, Accra, Ghana
| | - Charles Ampong Adjei
- Department of Community Health Nursing, School of Nursing and Midwifery, University of Ghana, Accra, Ghana
| | - Josephine Kyei
- Department of Community Health Nursing, School of Nursing and Midwifery, University of Ghana, Accra, Ghana
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29
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Efua SDV, Adwoa WD, Armah D. Seroprevalence of Hepatitis B virus infection and associated factors among health care workers in Southern Ghana. IJID REGIONS 2023; 6:84-89. [PMID: 36814439 PMCID: PMC9939711 DOI: 10.1016/j.ijregi.2023.01.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 01/14/2023] [Accepted: 01/16/2023] [Indexed: 01/22/2023]
Abstract
Introduction The World Health Organization estimates that 37% of Hepatitis B Virus (HBV) infections among Health Care Workers (HCWs) are due to percutaneous occupational exposure to blood and body fluids. In Ghana, occupational exposures are rising; however, the burden of HBV infection in HCWs remains unknown. Our study estimated the prevalence of HBV surface antigens and associated factors among HCWs. Methods We conducted a cross-sectional survey of 340 HCWs using a structured pretested questionnaire and screening for HBV surface antigens. Data were analyzed using SPSS version 20.0 with a level of significance set at <0.05. Results The overall crude prevalence of current HBV infection was 5.9 % (95% CI, 3.0-8.0). Adjusted prevalence by test performance was 5.8%. Prevalence was highest among males 10.2% (95% CI, 4.8-18.5), HCWs other than nurses and doctors 9.2% (95% CI, 4.5-16.2), and those working at lower-level facilities 9.7% (95% CI, 4.8-17.1). Training in the prevention of blood-borne infections was significantly associated with HBV infection (adjusted odds ratio 3.2; 95% CI, 1.1-9.1). Conclusions HBV infection is high in this population. In addition to lifesaving interventions such as vaccination and the use of immunoglobulin, training in blood-borne infections could prevent new HBV infections among Ghanaian HCWs.
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Affiliation(s)
- Senoo-Dogbey Vivian Efua
- Department of Public Health, School of Nursing and Midwifery, University of Ghana, Legon, Accra Ghana, P.O. Box LG 25 Legon Accra, Ghana,Corresponding Author: Senoo-Dogbey Vivian Efua, P.O. Box LG 25, University of Ghana, Accra, Ghana, Phone: +233-244-772-402
| | - Wuaku Delali Adwoa
- Department of Nursing Research, Nursing and Midwifery Training School, Korle-Bu, Accra Ghana, P.O. Box KB 83 Korle-Bu, Accra, Ghana
| | - Deborah Armah
- Department of Maternal and Child Health, School of Nursing and Midwifery, University of Ghana, Legon P.O. Box LG 25 Legon, Accra, Ghana
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30
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Ostankova YV, Shchemelev AN, Boumbaly S, Balde TAL, Zueva EB, Valutite DE, Serikova EN, Davydenko VS, Skvoroda VV, Vasileva DA, Semenov AV, Esaulenko EV, Totolian AA. Prevalence of HIV and Viral Hepatitis Markers among Healthcare Workers in the Republic of Guinea. Diagnostics (Basel) 2023; 13:diagnostics13030378. [PMID: 36766482 PMCID: PMC9914033 DOI: 10.3390/diagnostics13030378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 01/12/2023] [Accepted: 01/14/2023] [Indexed: 01/20/2023] Open
Abstract
Healthcare workers are much more likely to be infected with HIV and hepatitis viruses compared to the general population. Although healthcare workers are more aware of HIV and hepatitis viruses, several countries in Africa lack a comprehensive grasp of disease routes and transmission risks. The aim of this study was to assess the prevalence of the serological and molecular biological markers of HIV and viral hepatitis among healthcare workers in the Republic of Guinea. The study material was 74 blood serum samples collected from healthcare workers who received additional training at the Institute of Applied Biological Research of Guinea (IRBAG, Kindia, Republic of Guinea). The markers examined included HBsAg, HBeAg, anti-HBs IgG, anti-HBcore IgG, anti-HCV qualitative determination, anti-HEV IgM and IgG, anti-HAV IgM and IgG, and anti-HIV. For viral DNA and RNA detection, nucleic acids were extracted from blood serum, and viral presence was inferred using real-time PCR with hybridization fluorescence detection. A high prevalence of viral hepatitis B markers was shown, and significantly fewer cases of viral hepatitis C and HIV were detected. Almost all examined medical workers had anti-HAV IgG antibodies, but no antibodies to hepatitis E virus. Apparently, the identified markers depend on the general prevalence of certain pathogens in the region and are associated with the traditions and characteristics of the country's residents.
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Affiliation(s)
- Yulia V Ostankova
- Saint Petersburg Pasteur Institut of the Federal Service for Surveillance of Consumer Rights Protection and Human Welfare (Rospotrebnadzor), 197101 Saint Petersburg, Russia
| | - Alexander N Shchemelev
- Saint Petersburg Pasteur Institut of the Federal Service for Surveillance of Consumer Rights Protection and Human Welfare (Rospotrebnadzor), 197101 Saint Petersburg, Russia
| | - Sanaba Boumbaly
- Institute of Applied Biological Research of Guinea (IRBAG), Kindia 100 BP 75, Guinea
- Centre International de Recherche sur les Infections Tropicales en Guinée, Nzerekore 400 BP, Guinea
| | - Thierno A L Balde
- Institute of Applied Biological Research of Guinea (IRBAG), Kindia 100 BP 75, Guinea
| | - Elena B Zueva
- Saint Petersburg Pasteur Institut of the Federal Service for Surveillance of Consumer Rights Protection and Human Welfare (Rospotrebnadzor), 197101 Saint Petersburg, Russia
| | - Diana E Valutite
- Saint Petersburg Pasteur Institut of the Federal Service for Surveillance of Consumer Rights Protection and Human Welfare (Rospotrebnadzor), 197101 Saint Petersburg, Russia
| | - Elena N Serikova
- Saint Petersburg Pasteur Institut of the Federal Service for Surveillance of Consumer Rights Protection and Human Welfare (Rospotrebnadzor), 197101 Saint Petersburg, Russia
| | - Vladimir S Davydenko
- Saint Petersburg Pasteur Institut of the Federal Service for Surveillance of Consumer Rights Protection and Human Welfare (Rospotrebnadzor), 197101 Saint Petersburg, Russia
| | - Vsevolod V Skvoroda
- Saint Petersburg Pasteur Institut of the Federal Service for Surveillance of Consumer Rights Protection and Human Welfare (Rospotrebnadzor), 197101 Saint Petersburg, Russia
| | - Daria A Vasileva
- Saint Petersburg Pasteur Institut of the Federal Service for Surveillance of Consumer Rights Protection and Human Welfare (Rospotrebnadzor), 197101 Saint Petersburg, Russia
| | - Alexander V Semenov
- Ekaterinburg Research Institute of Viral Infections, State Research Center of Virology and Biotechnology Vector of the Federal Service for Surveillance of Consumer Rights Protection and Human Welfare (Rospotrebnadzor), 620030 Ekaterinburg, Russia
| | - Elena V Esaulenko
- Saint Petersburg Pasteur Institut of the Federal Service for Surveillance of Consumer Rights Protection and Human Welfare (Rospotrebnadzor), 197101 Saint Petersburg, Russia
| | - Areg A Totolian
- Saint Petersburg Pasteur Institut of the Federal Service for Surveillance of Consumer Rights Protection and Human Welfare (Rospotrebnadzor), 197101 Saint Petersburg, Russia
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31
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Duah A, Nartey YA. Clinical Profile and Limitations in the Management of HBV Patients Attending Clinic at a District Hospital in Ghana. Int J Hepatol 2023; 2023:4424718. [PMID: 36643337 PMCID: PMC9833894 DOI: 10.1155/2023/4424718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 12/05/2022] [Accepted: 12/14/2022] [Indexed: 01/05/2023] Open
Abstract
Background Chronic hepatitis B (CHB) is estimated to cause between 500,000 and 1.2 million deaths worldwide every year through cirrhosis and hepatocellular carcinoma (HCC). Liver cirrhosis and HCC are the commonest liver diseases causing death in Ghana. The most critical problem in the management of CHB in sub-Saharan Africa is the high cost of investigations and antiviral drugs. There is scanty information concerning newly diagnosed CHB patients and their management challenges in Ghana. This study sought to determine the clinical characteristics and management challenges of CHB patients in Ghana. Methodology. A prospective cohort study was conducted involving newly diagnosed CHB patients being managed at St. Dominic Hospital. Patient demographic and clinical features were abstracted using a standardized questionnaire. The proportion of patients able to undertake investigations and treatment were determined, and the limitations to standard management were recorded. The performance of APRI score in the diagnosis of cirrhosis was also investigated. Results Of the 334 patients with newly diagnosed CHB, the median age at diagnosis was 35 (IQR 28-44) years. Less than a quarter (22.2%) were able to undertake viral load testing and 23.4% were eligible for treatment. Of those who were eligible for treatment, only 42.3% were able to initiate treatment. Almost a third of cases (32.1%) reported late with liver-related complications. The sensitivity of APRI score with cut-off value of 2 in the diagnosis of liver cirrhosis was 70.2% and specificity was 97.9%. Conclusion A high proportion of newly diagnosed CHB patients presented late and with liver-related complications. Majority were not able to afford viral load testing and antiviral medication. Screening of hepatitis B among the general population and inclusion of CHB management in the National Health Insurance Scheme should be encouraged.
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Affiliation(s)
- Amoako Duah
- Department of Medicine, University of Ghana Medical Centre LTD, Accra, Ghana
| | - Yvonne A. Nartey
- Department of Medicine, Cape Coast Teaching Hospital, Cape Coast, Ghana
- Department of Internal Medicine, School of Medical Sciences, University of Cape Coast, Ghana
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32
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Kuugbee ED, Maaldu G, Adamu A, Salia N, Walana W, Kampo S, Vicar EK, Ziem JB. Seroprevalence and Risk Factors of Sexually Transmitted Blood-Borne Infections among Pregnant Women Attending Antenatal Care in Jirapa, Upper West Region of Ghana. THE CANADIAN JOURNAL OF INFECTIOUS DISEASES & MEDICAL MICROBIOLOGY = JOURNAL CANADIEN DES MALADIES INFECTIEUSES ET DE LA MICROBIOLOGIE MEDICALE 2023; 2023:3157202. [PMID: 37168817 PMCID: PMC10164872 DOI: 10.1155/2023/3157202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 04/03/2023] [Accepted: 04/20/2023] [Indexed: 05/13/2023]
Abstract
Background Sexually transmitted blood-borne infections (STBBIs) contribute to negative outcomes of pregnancy. Hepatitis B virus (HBV), hepatitis C virus (HCV), human immunodeficiency virus (HIV), and syphilis infections in pregnancy contribute significantly to maternal and child morbidities and mortalities. This study assessed the prevalence, knowledge, and risk factors of STBBIs (HBV, HCV, HIV, and syphilis) among pregnant women attending antenatal clinics in Jirapa. Methods A cross-sectional study design involving 246 pregnant women was employed for the study. A structured questionnaire was used to solicit information about the knowledge, prevalence, and risk factors of STBBIs. Results The overall prevalence of STBBIs was 11.4%; HBV prevalence was 9.8% and 0.8% each for HCV, HIV, and syphilis. About 66% of mothers were aware of mother-to-child transmission of infections during pregnancy. Knowledge of transmission of HIV (93.9%), hepatitis (67.1%), and syphilis (53.7%) in pregnancy was relatively high. Knowledge of risk factors for HIV, hepatitis, and syphilis was 97.6%, 74.4%, and 76.0%, respectively. More than 98% of respondents knew about the prevention of HIV, hepatitis, and syphilis. Significant risk factors associated with and predictive of STBBIs were female genital mutilation (FGM) and gravidity. Conclusion The occurrence of STBBIs among pregnant women was strongly associated with FGM and gravidity. Public health education should be directed at stopping the practice of FGM and improving reproductive health in the study area.
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Affiliation(s)
- Eugene D. Kuugbee
- School of Medical Sciences, C. K. Tedam University of Technology and Applied Sciences, Navrongo, UER, Ghana
| | - Gloria Maaldu
- School of Nursing and Midwifery, University for Development Studies, Tamale, Ghana
- Obstetrics and Gynecology Unit, St Joseph's Hospital, P.O. Box 3, Jirapa, UWR, Ghana
| | - Aseta Adamu
- School of Nursing and Midwifery, University for Development Studies, Tamale, Ghana
| | - Nafisa Salia
- School of Nursing and Midwifery, University for Development Studies, Tamale, Ghana
| | - Williams Walana
- Department of Clinical Microbiology, School of Medicine, University for Development Studies, Tamale, Ghana
| | - Sylvanus Kampo
- School of Medical Sciences, C. K. Tedam University of Technology and Applied Sciences, Navrongo, UER, Ghana
| | - Ezekiel K. Vicar
- Department of Clinical Microbiology, School of Medicine, University for Development Studies, Tamale, Ghana
| | - Juventus B. Ziem
- School of Medical Sciences, C. K. Tedam University of Technology and Applied Sciences, Navrongo, UER, Ghana
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Asori M, Musah A, Gyasi RM. Association of Diabetes with Meningitis Infection Risks: A Systematic Review and Meta-Analysis. Glob Health Epidemiol Genom 2022; 2022:3996711. [PMID: 36570413 PMCID: PMC9757945 DOI: 10.1155/2022/3996711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 11/20/2022] [Accepted: 11/23/2022] [Indexed: 12/14/2022] Open
Abstract
Background The Global Burden of Disease Study in 2016 estimated that the global incident cases of meningitis have increased by 320,000 between 1990 and 2016. Current evidence suggests that diabetes may be a prime risk factor for meningitis among individuals, including older adults. However, findings of prior studies on this topic remain inconsistent, making a general conclusion relatively difficult. This study aimed to quantitatively synthesize the literature on the risk of meningitis associated with diabetes and compare the risk across different global regions. Method Literature search and study design protocol followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The search was conducted in PubMed, Web of Science, African Journal Online, and Google Scholar using relevant MESH terms. A random effect model was used to pull effect sizes. Results Initial search yielded 772 papers but 756 studies were excluded due to duplicity and not meeting inclusion criteria. In all, 16 papers involving 16847 cases were used. The pulled effect size (ES) of the association between diabetes and meningitis was 2.240 (OR = 2.240, 95% CI = 1.716-2.924). Regional-base analysis showed that diabetes increased the risk of developing meningitis in Europe (OR = 1.737, 95% CI = 1.299-2.323), Asia (OR = 2.192, 95% CI = 1.233-3.898), and North America (OR = 2.819, 95% CI = 1.159-6.855). These associations remained significant in the study design and etiological classe-based subgroup analyses. However, we surprisingly found no studies in Africa or South America. Conclusion Diabetes is a risk factor for developing meningitis. Given that no research on this topic came from Africa and South America, our findings should be contextually interpreted. We, however, encourage studies on diabetes-meningitis linkages from all parts of the world, particularly in Africa and South America, to confirm the findings of the present study.
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Affiliation(s)
- Moses Asori
- Department of Geography and Earth Science, University of North Carolina, Charlotte, USA
| | - Ali Musah
- School of Public Health, Department of Epidemiology and Biostatistics, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Ghana Health Service, Department of Public Health, Regional Health Directorate, Upper West, Ghana
| | - Razak M. Gyasi
- African Population and Health Research Center, Nairobi, Kenya
- National Centre for Naturopathic Medicine, Faculty of Health, Southern Cross University, Lismore NSW, Australia
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Kortei NK, Annan T, Dzikunoo J, Agbetiameh D. Exposure assessment and risk characterization of aflatoxins intake through consumption of maize (Zea mays) in different age populations in the Volta Region of Ghana. INTERNATIONAL JOURNAL OF FOOD CONTAMINATION 2022. [DOI: 10.1186/s40550-022-00099-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
AbstractAflatoxin contamination in foods is a vital health challenge for low and middle-income countries in subtropical regions. Maize (Zea mays L.), a staple food most widely grown in Africa including Ghana, and extensively consumed as much as three times per day, is a source of aflatoxin contamination owing to its susceptibility to fungal infection. Aflatoxin levels were checked against international (European Commission, EC) and local (Ghana Standards Authority, GSA) standards, and health risks associated with maize sampled from the Volta Region (Hohoe, Ho, Battor Dugame, and Keta) of Ghana were determined. Total aflatoxins (totalAFs) and the constituent aflatoxins (AFB1, AFB2, AFG1, and AFG2) were measured with High-Performance Liquid Chromatography (HPLC) with a Fluorescence Detector (FLD). Intake and Risk assessments were also conducted using deterministic models prescribed by the Joint FAO/WHO Expert Committee on Additives (JECFA). The degree of occurrence of aflatoxins was observed to be in decreasing order of AFG2 < AFG1 < AFB2 < AFB1 and were within the ranges of 0.78 ± 0.04 $$-$$
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234.73 ± 3.8 µg/kg, 0.47 ± 0.03 $$-$$
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21.6 ± 0.33 µg/kg, 1.01 ± 0.05 $$-$$
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13.75 ± 1.2 µg/kg and 0.66 ± 0.06 $$-$$
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5.51 ± 0.26 µg/kg respectively. Out of the 100 samples analyzed for total aflatoxins (totalAFs), 68 (68%) exceeded the limits of EC and were of range 4.98 ± 0.6 $$-$$
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445.01 ± 8.9 µg/kg whereas 58 (58%) and ranged between 12.12 ± 1.4 $$-$$
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445.01 ± 8.9 µg/kg exceeded GSA limits. Intake and risk assessments of total aflatoxins (totalAFs) for infants, toddlers, children, adolescents, and adults in the Volta Region were; 0.037–1.14 µg/kg bw/day, 0.35–10.81, and 1.47 -45.14 cases/10,000 person/yr respectively for Estimated Daily Intake (EDI), Margin of Exposure (MOE), and Cancer Risks. It was inferred that the consumption of maize posed potential adverse health effects on all age categories studied because all calculated MOE values were less than 10,000.
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35
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Nartey YA, Okine R, Seake-Kwawu A, Ghartey G, Asamoah YK, Senya K, Duah A, Owusu-Ofori A, Amugsi J, Suglo D, Bampoh SA, Hiebert L, Njuguna H, Ward JW, Plymoth A, Roberts LR, Bockarie AS, Awuku YA, Obiri-Yeboah D. A nationwide cross-sectional review of in-hospital hepatitis B virus testing and disease burden estimation in Ghana, 2016 - 2021. BMC Public Health 2022; 22:2149. [PMID: 36419017 PMCID: PMC9686031 DOI: 10.1186/s12889-022-14618-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 11/14/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND AND AIMS Data are needed to inform hepatitis B virus (HBV) testing and treatment policies in Ghana to make progress towards achieving the 2030 WHO elimination targets. This study investigated testing patterns for HBV and described the age, sex, and region-specific prevalence of HBV infection in Ghana using hospital data. METHODS A nationwide multi-centre cross-sectional study was performed where hospital-based registers were reviewed. These included review of 139,966 laboratory, 169,048 blood bank, and 83,920 delivery register entries from 22 healthcare institutions in Ghana. Frequencies and proportions, and crude and pooled estimates reported. Chi squared test was used for tests of independence. Logistic regression was used to identify factors associated with a positive test result. RESULTS The crude HBsAg seroprevalence was 8.48% (95%CI 8.25-8.57%) with pooled estimate of 11.40% (95%CI 10.44-12.35). HBsAg seroprevalence among children under 5 years was 1.87% (95%CI 1.07-3.27) and highest age-specific seroprevalence was in those 40-49 years. The highest region-specific seroprevalences was in the Savannah (22.7%). Predictors of a positive HBsAg RDT test included female sex (OR 0.81 95% CI 0.74-0.88), and age (OR 1.005 95%CI 1.002-1.007). The proportion of parturient women receiving HBsAg testing increased between 2017 (87.2%) and 2020 (94.3%) (p < 0.001). The crude HBsAg seroprevalence in parturient women was 6.14% (95% CI 5.97-6.31). Among blood donors the crude HBsAg seroprevalence was 5.69% (95%CI 5.58-5.80). Data from 2 teaching hospitals indicated that in 2020, although 1500 HBsAg positive tests were recorded only 746 serological profile and 804 HBV DNA tests were performed. HBV e antigen seroprevalence was 6.28% (95%CI 4.73-7.84). CONCLUSION AND RECOMMENDATIONS Ghana remains a country with high HBV burden. There is an unequal distribution, with higher HBsAg seroprevalence in the north of the country. Furthermore, PCR testing is not widely available outside of large teaching hospitals, which limits diagnostic work-up. Hepatitis reporting systems and registers should be improved to facilitate data capture of indicators and standardised across the country to allow for comparability. Furthermore, where gains have been made in testing among pregnant women, there is a need for linkage to appropriate care.
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Affiliation(s)
- Yvonne Ayerki Nartey
- grid.4714.60000 0004 1937 0626Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden ,Department of Internal Medicine, Cape Coast Teaching Hospital, Cape Coast, Ghana
| | - Rafiq Okine
- World Health Organisation, Country Office, Accra, Ghana
| | - Atsu Seake-Kwawu
- grid.434994.70000 0001 0582 2706National Viral Hepatitis Control Program, Ghana Health Service, Accra, Ghana
| | - Georgia Ghartey
- grid.8652.90000 0004 1937 1485Ghana Field Epidemiology and Laboratory Training Programme, School of Public Health, University of Ghana, Legon, Ghana
| | - Yaw Karikari Asamoah
- grid.8652.90000 0004 1937 1485Ghana Field Epidemiology and Laboratory Training Programme, School of Public Health, University of Ghana, Legon, Ghana
| | - Kafui Senya
- World Health Organisation, Country Office, Accra, Ghana
| | - Amoako Duah
- grid.8652.90000 0004 1937 1485Department of Internal Medicine, University of Ghana Medical Centre, Accra, Ghana
| | - Alex Owusu-Ofori
- grid.415450.10000 0004 0466 0719Clinical Microbiology Unit, Komfo-Anokye Teaching Hospital, Kumasi, Ghana
| | - James Amugsi
- Internal Medicine and Out-patient Department, Sandema District Hospital, Sandema, Ghana
| | | | - Sally Afua Bampoh
- Department of Internal Medicine, Greater Accra Regional Hospital, Accra, Ghana
| | - Lindsey Hiebert
- grid.507439.c0000 0001 0104 6164Coalition for Global Hepatitis Elimination, Task Force for Global Health, Decatur, GA USA
| | - Henry Njuguna
- grid.507439.c0000 0001 0104 6164Coalition for Global Hepatitis Elimination, Task Force for Global Health, Decatur, GA USA
| | - John W. Ward
- grid.507439.c0000 0001 0104 6164Coalition for Global Hepatitis Elimination, Task Force for Global Health, Decatur, GA USA
| | - Amelie Plymoth
- grid.4714.60000 0004 1937 0626Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
| | - Lewis Rowland Roberts
- grid.66875.3a0000 0004 0459 167XDepartment of Medicine, Division of Gastroenterology and Hepatology, Mayo Clinic Rochester, Rochester, MN USA
| | - Ansumana Sandy Bockarie
- grid.413081.f0000 0001 2322 8567Department of Internal Medicine, School of Medical Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Yaw Asante Awuku
- grid.449729.50000 0004 7707 5975Department of Medicine, University of Health and Allied Science, Ho, Ghana
| | - Dorcas Obiri-Yeboah
- grid.413081.f0000 0001 2322 8567Department of Microbiology and Immunology, School of Medical Sciences, University of Cape Coast, Cape Coast, Ghana
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Annison L, Hackman H, Eshun PF, Annison S, Forson P, Antwi-Baffour S. Seroprevalence and effect of HBV and HCV co-infections on the immuno-virologic responses of adult HIV-infected persons on anti-retroviral therapy. PLoS One 2022; 17:e0278037. [PMID: 36417469 PMCID: PMC9683579 DOI: 10.1371/journal.pone.0278037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 11/08/2022] [Indexed: 11/27/2022] Open
Abstract
Chronic hepatitis negatively affects persons living with HIV. While varying in their transmission efficiency, HIV, HBV, and HCV have shared routes of transmission. Available data suggest widely variable rates of HBV and HCV infections in HIV-infected populations across sub-Saharan Africa. With prolonged survival rates due to increased accessibility to antiretroviral drugs, HBV and HCV have the potential to complicate the prognosis of HIV co-infected patients by contributing significantly to continued morbidity and mortality. The study sought to determine the seroprevalence of HIV/HBV and HIV/HCV co-infections among HIV patients on antiretroviral therapy and to evaluate the effect of HIV/HBV and HIV/HCV co-infections on the immunologic and virologic responses of patients. A cross-sectional study in which samples were taken from 500 people living with HIV and attending ART clinic at the Fevers unit of the Korle Bu Teaching Hospital and tested for Hepatitis B Surface Antigen (HBsAg) and Hepatitis C virus antibody (HCV). CD4 cell counts and HIV-1 RNA levels were estimated as well. Data generated were analysed using IBM SPSS version 22. The seroprevalence of HIV/HBV and HIV/HCV co-infections among people living with HIV was 8.4% and 0.2% respectively. HIV/HBV coinfection included 15/42 (35.7%) males and 27/42 (64.3%) females out of which the majority (97.6%) were in the 21-60 years old bracket. HIV/HBV and HIV/HCV co-infections have varied effects on the immunological and virological response of HIV patients on ART. The mean CD cell count was 361.0 ± 284.0 in HIV/HBV co-infected patients and 473.8 ± 326.7 in HIV mono-infected patients. The mean HIV-1 RNA level was not significantly different (X2 [df] = .057 [1]; P = .811) among HIV/HBV co-infected patients (Log102.9±2.0 copies/mL), compared to that of HIV mono-infected patients (Log102.8±2.1 copies/mL) although HIV mono-infected patients had lower viral load levels. One-third (14/42) of HIV/HBV co-infected patients had virologic failure and the only HIV/HCV co-infected patient showed viral suppression. 336/500 (67.2%) patients had HIV-1 viral suppression (females [66.1%]; males [33.9%]) while 164/500 (32.8%) had virologic failure (females [67.7%]; males [32.3%]). The mean CD4 count of patients with viral suppression and patients with virologic failure was 541.2 cells/μL (95% CI 508.5-573.8) and 309.9 cell/μL (95% CI 261.9-357.9) respectively.The study concludes that, HIV/HBV and HIV/HCV coinfections do not significantly affect the immunologic and virologic responses of patients who have initiated highly active antiretroviral therapy, and treatment outcomes were better in females than in males. There was no HBV/HCV co-infection among patients.
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Affiliation(s)
- Lawrence Annison
- Department of Medical Laboratory Technology, School of Allied Health Sciences, Narh-Bita College, Tema, Ghana
- Department of Medical Laboratory Technology, Faculty of Applied Sciences, Accra Technical University, Accra, Ghana
- * E-mail:
| | - Henry Hackman
- Department of Medical Laboratory Technology, Faculty of Applied Sciences, Accra Technical University, Accra, Ghana
| | - Paulina Franklin Eshun
- Department of Medical Laboratory Technology, School of Allied Health Sciences, Narh-Bita College, Tema, Ghana
| | - Sharon Annison
- Department of Epidemiology and Disease Control, School of Public Health, University of Ghana, Legon, Accra, Ghana
| | - Peter Forson
- Department of Medical Laboratory Technology, School of Allied Health Sciences, Narh-Bita College, Tema, Ghana
| | - Samuel Antwi-Baffour
- Department of Medical Laboratory Sciences, School of Allied Health Sciences, College of Health Sciences, University of Ghana, Korle-Bu, Accra, Ghana
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Senoo-Dogbey VE, Wauku DA. Risk perception for hepatitis B virus (HBV) infection among health care workers in Accra-Ghana. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2022. [DOI: 10.1016/j.cegh.2022.101189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Thomford NE, Adu F, Gavor-KWashi C, Nyarko SB, Nsiah P, Ephraim RKD, Adjei G, Anyanful A. Treating Hepatitis B Virus in Times of COVID-19: The Case for Clinical Pharmacogenomics Research in Tenofovir-Induced Kidney Toxicity. OMICS : A JOURNAL OF INTEGRATIVE BIOLOGY 2022; 26:583-585. [PMID: 36269614 DOI: 10.1089/omi.2022.0105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
The current pandemic has markedly shifted the focus of the global research and development ecosystem toward infectious agents such as SARS-CoV-2, the causative agent for COVID-19. A case in point is the chronic liver disease associated with hepatitis B virus (HBV) infection that continues to be a leading cause of severe liver disease and death globally. The burden of HBV infection is highest in the World Health Organization designated western Pacific and Africa regions. Tenofovir disoproxil fumarate (TDF) is a nucleoside analogue used in treatment of HBV infection but carries a potential for kidney toxicity. TDF is not metabolized by the cytochrome P450 enzymes and, therefore, its clearance in the proximal tubule of the renal nephron is controlled mostly by membrane transport proteins. Clinical pharmacogenomics of TDF with a focus on drug transporters, discussed in this perspective article, offers a timely example where resource-limited countries and regions of the world with high prevalence of HBV can strengthen the collective efforts to fight both COVID-19 and liver diseases impacting public health. We argue that precision/personalized medicine is invaluable to guide this line of research inquiry. In all, our experience in Ghana tells us that it is important not to forget the burden of chronic diseases while advancing research on infectious diseases such as COVID-19. For the long game with COVID-19, we need to address the public health burden of infectious agents and chronic diseases in tandem.
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Affiliation(s)
- Nicholas Ekow Thomford
- Department of Medical Biochemistry, School of Medical Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
- Pharmacogenomics and Genomic Medicine Group, School of Medical Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
- Division of Human Genetics, Department of Pathology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Faustina Adu
- Department of Medical Biochemistry, School of Medical Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
- Pharmacogenomics and Genomic Medicine Group, School of Medical Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Cyril Gavor-KWashi
- Department of Medical Biochemistry, School of Medical Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Samuel Badu Nyarko
- Department of Medical Biochemistry, School of Medical Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
- Pharmacogenomics and Genomic Medicine Group, School of Medical Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Paul Nsiah
- Department of Chemical Pathology, School of Medical Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Richard K D Ephraim
- Department of Medical Laboratory Sciences, School of Allied Health Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
| | - George Adjei
- Department of Community Medicine, School of Medical Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Akwasi Anyanful
- Department of Medical Biochemistry, School of Medical Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
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Adjei CA, Stutterheim SE, Bram F, Naab F, Ruiter RAC. Correlates of hepatitis B testing in Ghana: The role of knowledge, stigma endorsement and knowing someone with hepatitis B. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e4564-e4573. [PMID: 35701984 PMCID: PMC10083906 DOI: 10.1111/hsc.13860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 04/06/2022] [Accepted: 05/05/2022] [Indexed: 06/15/2023]
Abstract
Hepatitis B testing is the gateway for prevention and care. However, previous studies document low hepatitis B testing uptake in sub-Saharan Africa. This study investigated knowledge, stigma endorsement and knowing someone with hepatitis B as correlates of hepatitis B testing behaviours among people in the Greater Accra and Northern regions of Ghana. A cross-sectional survey was completed by 971 participants (Greater Accra = 503, and Northern region = 468) between October 2018 and January 2019. Approximately 54% of the participants reported having been tested for hepatitis B. The logistic regression analyses showed that having greater hepatitis B knowledge was positively associated with hepatitis B testing (OR = 1.22, 95% CI: 1.14-1.30). Higher hepatitis B stigma endorsement was negatively related to hepatitis B testing (OR = 0.97, 95% CI: 0.96-0.99). Also, participants who knew someone (i.e. parent, sibling and/or friend) with hepatitis B were more likely to have tested compared to those who did not know someone with hepatitis B (OR = 7.15, 95% CI: 5.04-10.14). This study demonstrates that knowing someone with hepatitis B increases the likelihood of testing, highlighting the need to create safe and non-judgmental contexts for people with hepatitis B (PWHB) to disclose if they want to. Also, given that greater hepatitis B knowledge increases testing and hepatitis B stigma endorsement impedes testing, interventions that increase knowledge and reduce stigma should be incorporated in efforts to promote testing in Ghana.
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Affiliation(s)
| | - Sarah E. Stutterheim
- Department of Health PromotionCare and Public Health Research Institute, Maastricht UniversityMaastrichtThe Netherlands
| | - Fleuren Bram
- Department of Work and Social PsychologyMaastricht UniversityMaastrichtThe Netherlands
| | - Florence Naab
- Department of Maternal and Child HealthUniversity of GhanaAccraGhana
| | - Robert A. C. Ruiter
- Department of Work and Social PsychologyMaastricht UniversityMaastrichtThe Netherlands
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Kortei NK, Annan T, Boakye AA, Essuman EK, Tettey CO, Kyei-Baffour V. Aflatoxin M 1 exposure in a fermented millet-based milk beverage 'brukina' and its cancer risk characterization in Greater Accra, Ghana. Sci Rep 2022; 12:12562. [PMID: 35869134 PMCID: PMC9307601 DOI: 10.1038/s41598-022-15157-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 06/20/2022] [Indexed: 12/02/2022] Open
Abstract
Brukina is a millet based fermented milk product which is consumed as a beverage in Ghana. It is however prone to aflatoxin M1 (AFM1) contamination, which is a serious health challenge for low and middle-income countries in subtropical regions. This study aimed at evaluating AFM1 levels and cancer risks associated with brukina (n = 150) sampled from different locations of the Greater Accra Region of Ghana. AFM1 were measured with High-Performance Liquid Chromatography (HPLC) connected to a Fluorescence Detector (FLD).Cancer risk assessments were also conducted using models prescribed by the Joint FAO/WHO Expert Committee on Additives (JECFA). Out of the 150 samples analyzed for AFM1, 80/150 (53%) tested positive between the range 0.00 ± 0.001-3.14 ± 0.77 µg/kg. Cancer risk assessments of AFM1 produced outcomes which ranged between 0.64 and 1.88 ng/kg bw/day, 0.31-9.40, 0.0323, and 1.94 × 10-3-0.06 for cases/100,000 person/yr for Estimated Daily Intake (EDI), Hazard Index (H.I), Average Potency, and Cancer Risks respectively for all age categories investigated. It was concluded that the consumption of brukina posed adverse health effects on the majority of the age categories in the different locations of Greater Accra Region since the calculated H.Is were greater than one (> 1). Therefore, contamination of brukina with AFM1 should be considered a high priority in public health and Ghana's cancer risk management actions.
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Affiliation(s)
- Nii Korley Kortei
- Department of Nutrition and Dietetics, School of Allied Health Sciences, University of Health and Allied Sciences, PMB 31, Ho, Ghana.
| | - Theophilus Annan
- Food Microbiology Division, Council for Scientific and Industrial Research- Food Research Institute, P. O. Box M20, Accra, Ghana
| | - Adjoa Agyemang Boakye
- Department of Biomedical Sciences, School of Basic and Biomedical Sciences, University of Health and Allied Sciences, PMB 31, Ho, Ghana
| | - Edward Ken Essuman
- Department of Nutrition and Dietetics, School of Allied Health Sciences, University of Health and Allied Sciences, PMB 31, Ho, Ghana
| | - Clement Okraku Tettey
- Department of Biomedical Sciences, School of Basic and Biomedical Sciences, University of Health and Allied Sciences, PMB 31, Ho, Ghana
| | - Vincent Kyei-Baffour
- Food Chemistry and Nutrition Research Division, Council for Scientific and Industrial Research-Food Research Institute, P. O. Box M20, Accra, Ghana
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41
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Uche EI, Chukwukaodinaka NE, Akinbami AA, Adeyemi OI, Hassan AO, Bamiro RA, Ibrahim IN, Suleiman AM, Augustine B, Anaduaka DC. Common hepatitis B virus genotypes among blood donors in Lagos, Nigeria. Niger Postgrad Med J 2022; 29:228-235. [PMID: 35900459 DOI: 10.4103/npmj.npmj_19_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
BACKGROUND Hepatitis B virus (HBV) infection is one of the public health diseases causing global health problems. It is a leading cause of cirrhosis and hepatocellular carcinoma. Blood transfusion is a major route of its transmission and screening of blood is suboptimal in our environment. Occult HBV infection describes the presence of HBV DNA in blood or liver tissue in patients who are hepatitis B surface antigen (HBsAg) seronegative. This study documented the common genotypes of HBV a blood-borne infection in the population of blood donors in Lagos. METHODS This was a cross-sectional study carried out at the blood donor clinics of ten Lagos State Government-owned hospitals in Lagos State. A total of 1400 participants were recruited consecutively from November 2020 to June 2021. All participants' samples were screened using Diaspot Rapid Test Kit (RTK) and Dialabenzyme enzyme-linked immunosorbent assay (ELISA) kit. Furthermore, some of the plasma samples were used for HBV DNA extraction and genotyping using the real time-polymerase chain reaction. Statistical analysis was carried out using the Statistical Package for the Social Sciences (SPSS) software version 26 and P value was considered significant at ≤0.05. RESULTS The sero-prevalence of HBsAg using RTK and ELISA was 19.9% and 22.4%, respectively. The prevalence of occult HBV infection was 5.2%. A total of 278 and 313 HBsAg RTK and ELISA positive samples were obtained, respectively. HBV genotype result had A (46.6%) as the most prevalent followed closely by B (44.7%), E (23.8%), D (20.9%) and C (11.2%). CONCLUSION HBV infection has a high prevalence among blood donors. ELISA is a more sensitive screening tool and its use should be advocated nationally. HBV genotype A is the most prevalent genotype from our study.
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Affiliation(s)
- Ebele I Uche
- Department of Haematology and Blood Transfusion, Lagos State University College of Medicine, Lagos, Nigeria
| | - Nwakaego E Chukwukaodinaka
- Department of Haematology and Blood Transfusion, Lagos State University Teaching Hospital, Lagos, Nigeria
| | - Akinsegun A Akinbami
- Department of Haematology and Blood Transfusion, Lagos State University College of Medicine, Lagos, Nigeria
| | - Oluwatosin I Adeyemi
- Department of Haematology and Blood Transfusion, Lagos State University Teaching Hospital, Lagos, Nigeria
| | - Aderonke O Hassan
- Department of Haematology and Blood Transfusion, Lagos State University Teaching Hospital, Lagos, Nigeria
| | - Rafah A Bamiro
- Department of Haematology and Blood Transfusion, Lagos State University Teaching Hospital, Lagos, Nigeria
| | - Ismaila Nda Ibrahim
- Department of Haematology and Blood Transfusion, Ahmadu Bello University, Zaria, Kaduna, Nigeria
| | - Aisha M Suleiman
- Department of Haematology and Blood Transfusion, Ahmadu Bello University, Zaria, Kaduna, Nigeria
| | - Benjamin Augustine
- Department of Haematology and Blood Transfusion, Ahmadu Bello University, Zaria, Kaduna, Nigeria
| | - Doris Chinyelu Anaduaka
- Department of Haematology and Blood Transfusion, Lagos State University Teaching Hospital, Lagos, Nigeria
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Dietary Exposure to Aflatoxins in Some Randomly Selected Foods and Cancer Risk Estimations of Cereals Consumed on a Ghanaian Market. J FOOD QUALITY 2022. [DOI: 10.1155/2022/5770836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Aflatoxins have gained so much reputation among all mycotoxins due to their notoriety in causing countless adverse health effects on humans as well as animals. It continues to be a major concern in food safety globally. In this study, total and constitutive aflatoxins levels as well as the carcinogenic risks posed by 110 food and feed samples (55 cereals, 20 nuts and oils, 18 animal feed, and 18 fruits and vegetables) collected from the Ho Central market in the Volta region, Ghana, were assessed. Using high-performance liquid chromatography connected to a fluorescent detector (HPLC-FLD), levels of total aflatoxins (AFtotal) and aflatoxins constituents, namely, AFB1, AFB2, AFG1, and AFG2, were analyzed. By using the model prescribed by Joint FAO/WHO Expert Committee on Food Additives (JECFA), the risks posed by the food and feed samples were determined. The degrees of toxicity were in the ranges of 0.78–234.73 μg/kg, 0.47–21.6 μg/kg, 1.01–13.75 μg/kg, and 0.66–5.51 μg/kg, respectively, for AFB1, AFB2, AFG1, and AFG2. Out of the samples analyzed for AFtotal, about 51 (46.4%) exceeded the limits of GSA and were in the range 10.63 ± 1.20–236.28 ± 4.2 μg/kg. While for EFSA, 71 (64.54%) exceeded and ranged between 4.72 ± 0.28 and 236.28 ± 4.2 μg/kg. Furthermore, estimated daily intake (EDI) of 27.10–283.70 ng/kg·bw/day, margin of exposure (MOE) of 1.409–14.76, average potency of 0–0.00396 ng aflatoxins/kg·bw/day, and cancer risks with a range of 0.107–1.122 cases/100,000 person/yr were observed. Taken together, it could be concluded that consuming cereals pose adverse effects on human health regardless of the age of the consumer.
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Kolbila L, Adjei CA, Kyei JM, Agyemang-Prempeh C, Fosu PK. Perceived Supportive Care Needs of Adolescents With Chronic Hepatitis B in a Resource-limited Setting. J Patient Exp 2022; 9:23743735221106596. [PMID: 35694016 PMCID: PMC9185008 DOI: 10.1177/23743735221106596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
In Ghana, adolescents are disproportionately affected by hepatitis B. However, studies into adolescents' supportive care needs are lacking. The purpose of this exploratory qualitative study was to explore the supportive care needs of 18 adolescents with chronic hepatitis B who were receiving care at a tertiary hospital in Ghana. The data were processed using QSR Nvivo version 11.0 and analyzed using the Braun and Clarke procedure for thematic data analysis. According to the findings, adolescents with chronic hepatitis B have unmet supportive care needs ranging from information to financial need, psychological support, and social support. Explicitly, participants reportedly had a dilemma as to whether to keep or terminate their pregnancy to prevent transmission of the virus to their newborns. Physicians and nurses were perceived to be preoccupied with medication prescription and laboratory request writing rather than giving pretest and posttest counseling following diagnosis. This study highlights the need to have a tailor-made liver care for adolescents. Pretest and posttest counseling for adolescents with hepatitis B are also required.
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Affiliation(s)
| | | | - Josephine M Kyei
- School of Nursing and Midwifery, University of Ghana, Accra, Ghana
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Antuamwine BB, Herchel ED, Bawa EM. Comparative prevalence of hepatitis B virus infection among pregnant women accessing free maternal care in a tertiary hospital in Ghana. PLoS One 2022; 17:e0263651. [PMID: 35245287 PMCID: PMC8896678 DOI: 10.1371/journal.pone.0263651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 01/24/2022] [Indexed: 11/20/2022] Open
Abstract
Hepatitis B virus infection is endemic in sub-Saharan Africa, and accounts for a significant proportion of morbidities and mortalities in Ghana. Infection with HBV during pregnancy can result in life-threatening complications to both mother and child. To improve their quality of life, the free maternal care was introduced to grant pregnant women cost-free access to antenatal and postnatal services. The study analysed the prevalence of HBV infection among pregnant women receiving free antenatal care in a tertiary hospital in Ghana. This was a retrospective cross-sectional study, where secondary data of pregnant women who accessed free antenatal services at the Trafalga hospital, Ho, from 2016 to 2017 were retrieved from the hospital's database. Data on hepatitis B surface antigen reactivity test, age and period of turnout were analysed with Microsoft Excel and Graph pad prism version 6. A total of 2,634 pregnant women assessed free antenatal care from January 2016 -December 2017, with 10% rise in turnout in 2017. The age of the study population was fairly young, ranging from 13-52 years and mean of 29.87±5.83. The prevalence of HBV infection among pregnant women in the entire study was estimated to be 6.0%, while that of 2016 and 2017 were 5.3% and 6.7% respectively. Turnout for antenatal services peaked in July, which also recorded the highest prevalence of HBV infection among the pregnant women. Our study, first of its kind show an HBV prevalence of 6.0% among a large population of pregnant women who accessed free antenatal services at a tertiary hospital in Ghana. The study evaluates the influence of the free maternal care policy on antenatal attendance and HBV infection rates among pregnant women.
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Affiliation(s)
- Benedict Boateng Antuamwine
- Department of Biomedical Laboratory Sciences, School of Allied Health Sciences, University for Development Studies, Tamale, Ghana
| | - Eddie Delali Herchel
- Department of Biomedical Laboratory Sciences, School of Allied Health Sciences, University for Development Studies, Tamale, Ghana
| | - Eric Mishio Bawa
- Department of Biomedical Laboratory Sciences, School of Allied Health Sciences, University for Development Studies, Tamale, Ghana
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Ghazzawi M, James PB, Massaquoi SP, Yendewa SA, Salata RA, Yendewa GA. Factors Associated with HBsAg Seropositivity among Pregnant Women Receiving Antenatal Care at 10 Community Health Centers in Freetown, Sierra Leone: A Cross-Sectional Study. Pathogens 2022; 11:pathogens11020243. [PMID: 35215186 PMCID: PMC8874792 DOI: 10.3390/pathogens11020243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 02/07/2022] [Accepted: 02/10/2022] [Indexed: 11/20/2022] Open
Abstract
Hepatitis B (HBV) is a major public health threat in Sierra Leone. Pregnant women are disproportionately impacted, yet little is known about the epidemiology of HBV in this group. We conducted a cross-sectional study of pregnant women aged ≥16 years receiving antenatal care across 10 community health centers in Freetown from July to September 2021 to assess the prevalence and associated factors of HBsAg seropositivity. Logistic regression was used to identify the predictors of HBsAg seropositivity. In total, 394 pregnant women were screened. The mean age was 24.4 ± 4.9 years, 78.2% were married, and 47.2% were in the second trimester. Only 1% had received the HBV vaccine. The prevalence of HBsAg was 7.9%, while HIV was 5.8% and HIV/HBV co-infection was 0.3%. Regarding high-risk practices, 76.6% reported female genital circumcision, 41.9% ear piercing, 29.0% endorsed multiple sexual partners, and 23.6% reported sexually transmitted infections. In the logistic regression analysis, having a husband/partner with HBV (adjusted odds ratio (aOR): 6.54; 95% CI: [1.72–24.86]; p = 0.006) and residing in Central Freetown (aOR: 4.00; 95% CI: [1.46–11.00]; p = 0.007) were independently associated with HBsAg seropositivity. Our findings support the scaling up of HBV services to target pregnant women and their partners for screening and vaccination to help reduce mother-to-child transmission rates in Sierra Leone.
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Affiliation(s)
| | - Peter B. James
- Faculty of Health, Southern Cross University, Lismore, NSW 2480, Australia;
- College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Samuel P. Massaquoi
- Ministry of Health and Sanitation, Freetown, Sierra Leone; (S.P.M.); (S.A.Y.)
| | - Sahr A. Yendewa
- Ministry of Health and Sanitation, Freetown, Sierra Leone; (S.P.M.); (S.A.Y.)
| | - Robert A. Salata
- Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA;
- Division of Infectious Diseases and HIV Medicine, University Hospitals Cleveland Medical Center, Cleveland, OH 44106, USA
| | - George A. Yendewa
- Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA;
- Division of Infectious Diseases and HIV Medicine, University Hospitals Cleveland Medical Center, Cleveland, OH 44106, USA
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
- Correspondence:
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Adjei CA, Nachinab GTE, Atibila F, Ansah-Nyarko M, Kyei JM, Fosu PK. Determinants and preventive practices of midwives and physicians toward vertical transmission of hepatitis B in Ghana: a cross-sectional survey. Pan Afr Med J 2022; 43:183. [PMID: 36915413 PMCID: PMC10007700 DOI: 10.11604/pamj.2022.43.183.31794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 07/12/2022] [Indexed: 12/13/2022] Open
Abstract
Introduction countries in sub-Saharan Africa, including Ghana, are disproportionately affected by hepatitis B viral (HBV) infection. In these areas, mother-to-child transmission (MTCT) is an essential mode of HBV transmission. Evidently, timely hepatitis B birth dose vaccination remains an effective preventive intervention against MTCT of HBV. Considering that midwives and physicians are the primary care providers of newborns in Ghana, we sought to examine their preventive practices toward vertical transmission of HBV in the eastern region of Ghana. Methods a cross-sectional survey was conducted with 126 healthcare providers (HCP; midwives and physicians). The participants were conveniently recruited from one regional hospital and four district hospitals. Statistical significance was set at 0.05 alpha level. Results the findings indicate that 42.9% (n = 54) of HCPs' prevention of mother to child transmission (PMTCT) practices for hepatitis B were good (X2 = 2.57, p > 0.05). Explicitly, 79% indicated screening all pregnant women for hepatitis B as part of antenatal care (X2 = 41.14, p < 0.001). Additionally, about half of the participants (52.4%) reported providing pre-test counselling (X2 = 0.29, p > 0.05), whereas one-third (33%) reported routinely administering a birth dose of the hepatitis B vaccine to neonates of mothers with hepatitis B (X2 = 14.00, p < 0.001). However, only 37% reported administering the hepatitis B vaccine to newborns within 12 hours of birth (X2 = 9.18, p < 0.01). The binary logistic regression analyses identified training as the only significant predictor of good practice on PMTCT of hepatitis B at the 5% level (Wald = 3.91, p =0.05). Conclusion given that more than half of the participants in the study area had incorrect PMTCT practices for hepatitis B, it is imperative that a series of workshops on hepatitis B be done for healthcare providers in Ghana. In addition, hepatitis B birth dose vaccine must be incorporated into the ´Expanded Programme on Immunisation´ to remove the cost that acts as a barrier to access.
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Affiliation(s)
- Charles Ampong Adjei
- Department of Community Health Nursing, School of Nursing and Midwifery, University of Ghana, Accra, Ghana
| | | | - Fidelis Atibila
- Department of Nursing, Valley View University, Techiman, Ghana
| | | | - Josephine Mpomaa Kyei
- Department of Community Health Nursing, School of Nursing and Midwifery, University of Ghana, Accra, Ghana
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Kortei NK, Annan T, Kyei-Baffour V, Essuman EK, Okyere H, Tettey CO. Exposure and risk characterizations of ochratoxins A and aflatoxins through maize (Zea mays) consumed in different agro-ecological zones of Ghana. Sci Rep 2021; 11:23339. [PMID: 34857860 PMCID: PMC8639867 DOI: 10.1038/s41598-021-02822-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 11/22/2021] [Indexed: 12/02/2022] Open
Abstract
Mycotoxin contamination of foodstuffs is a serious food safety concern globally as the prolonged ingestion of these toxins has the tendency to worsen the risk of hepatocellular carcinoma. This study aimed at estimating ochratoxin A (OTA) and aflatoxin (AF) levels above international (European Food Safety Authority, EFSA) and local (Ghana Standards Authority, GSA) standards as well as the health risks associated with the consumption of maize (n = 180) sampled from six (6) regions representing the agro-ecological zones of Ghana. OTA and AF were measured with High-Performance Liquid Chromatography with a Fluorescence detector. Out of the 180 samples analyzed for total aflatoxins (AFtotal), 131/180 tested positive and 127 (70.50%) exceeded the limits of EFSA and ranged 4.27-441.02 µg/kg. While for GSA, 116 (64.44%) of samples exceeded this limit and ranged between 10.18 and 441.02 µg/kg. For OTA, 103/180 tested positive and 94 (52.22%) of samples between the range 4.00-97.51 µg/kg exceeded the tolerable limit of EFSA, whereas 89 (49.44%) and were in the range of 3.30-97.51 µg/kg exceeded the limits of GSA. Risk assessment values for total aflatoxins (AFtotal) ranged between 50 and 1150 ng/kg bw/day, 0.4-6.67, 0-0.0323 aflatoxins ng/kg bw/day and 1.62-37.15 cases/100,000 person/year for Estimated Daily Intake (EDI), Margin of Exposure (MOE), Average Potency, and Cancer Risks respectively. Likewise, ochratoxin (OTA) values were in the ranges of 8.6 × 10-3-450 ng/kg bw/day, 0.05-2059.97, 0-0.0323 ochratoxins ng/kg bw/day and 2.78 × 10-4-14.54 cases/100,000 person/year. Consumption of maize posed adverse health effects in all age categories of the locations studied since the calculated MOE values were less than 10,000.
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Affiliation(s)
- Nii Korley Kortei
- Department of Nutrition and Dietetics, School of Allied Health Sciences, University of Health and Allied Sciences, PMB 31, Ho, Ghana.
| | - Theophilus Annan
- Food Microbiology Division, Council for Scientific and Industrial Research- Food Research Institute, P. O. Box M20, Accra, Ghana
| | - Vincent Kyei-Baffour
- Food Chemistry and Nutrition Research Division, Council for Scientific and Industrial Research- Food Research Institute, P. O. Box M20, Accra, Ghana
| | - Edward Ken Essuman
- Department of Nutrition and Dietetics, School of Allied Health Sciences, University of Health and Allied Sciences, PMB 31, Ho, Ghana
| | - Harry Okyere
- Council for Scientific and Industrial Research- Crops Research Institute, P. O. Box 3785, Fumesua, Kumasi, Ghana
| | - Clement Okraku Tettey
- Department of Biomedical Sciences, School of Basic and Biomedical Sciences, University of Health and Allied Sciences, PMB 31, Ho, Ghana
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Adjei Gyimah A, Peprah P, Agyemang-Duah W, Frimpong E, Kwegyir Tsiboe A, Aboagye Darkwa M. Hepatitis B vaccination status and associated factors among university students in Ghana: A cross-sectional survey. COGENT MEDICINE 2021. [DOI: 10.1080/2331205x.2021.2005226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Affiliation(s)
| | - Prince Peprah
- Social Policy Research Centre/ Centre for Primary Health Care and EquityUNSW, Sydney, Australia
| | - Williams Agyemang-Duah
- Department of Geography and Planning,Queen’s University,Kingston, Ontario, Canada K7L 3N6
| | - Eric Frimpong
- Social Policy Research Centre/ Centre for Primary Health Care and EquityUNSW, Sydney, Australia
| | | | - Mercy Aboagye Darkwa
- Social Policy Research Centre/ Centre for Primary Health Care and EquityUNSW, Sydney, Australia
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49
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Ajuwon BI, Yujuico I, Roper K, Richardson A, Sheel M, Lidbury BA. Hepatitis B virus infection in Nigeria: a systematic review and meta-analysis of data published between 2010 and 2019. BMC Infect Dis 2021; 21:1120. [PMID: 34717586 PMCID: PMC8556927 DOI: 10.1186/s12879-021-06800-6] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 10/12/2021] [Indexed: 02/08/2023] Open
Abstract
Background Hepatitis B virus (HBV) is an infectious disease of global significance, causing a significant health burden in Africa due to complications associated with infection, such as cirrhosis and liver cancer. In Nigeria, which is considered a high prevalence country, estimates of HBV cases are inconsistent, and therefore additional clarity is required to manage HBV-associated public health challenges. Methods A systematic review of the literature (via PubMed, Advanced Google Scholar, African Index Medicus) was conducted to retrieve primary studies published between 1 January 2010 and 31 December 2019, with a random-effects model based on proportions used to estimate the population-based prevalence of HBV in the Nigerian population. Results The final analyses included 47 studies with 21,702 participants that revealed a pooled prevalence of 9.5%. A prevalence estimate above 8% in a population is classified as high. Sub-group analyses revealed the highest HBV prevalence in rural settings (10.7%). The North West region had the highest prevalence (12.1%) among Nigeria’s six geopolitical zones/regions. The estimate of total variation between studies indicated substantial heterogeneity. These variations could be explained by setting and geographical region. The statistical test for Egger’s regression showed no evidence of publication bias (p = 0.879). Conclusions We present an up-to-date review on the prevalence of HBV in Nigeria, which will provide critical data to optimise and assess the impact of current prevention and control strategies, including disease surveillance and diagnoses, vaccination policies and management for those infected. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-021-06800-6.
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Affiliation(s)
- Busayo I Ajuwon
- Research School of Population Health, ANU College of Health and Medicine, The Australian National University, Acton, ACT, Australia. .,Department of Biosciences and Biotechnology, Faculty of Pure and Applied Sciences, Kwara State University, Malete, Nigeria.
| | - Isabelle Yujuico
- Research School of Population Health, ANU College of Health and Medicine, The Australian National University, Acton, ACT, Australia
| | - Katrina Roper
- Research School of Population Health, ANU College of Health and Medicine, The Australian National University, Acton, ACT, Australia
| | - Alice Richardson
- Statistical Consulting Unit, The Australian National University, Acton, ACT, Australia
| | - Meru Sheel
- Research School of Population Health, ANU College of Health and Medicine, The Australian National University, Acton, ACT, Australia
| | - Brett A Lidbury
- Research School of Population Health, ANU College of Health and Medicine, The Australian National University, Acton, ACT, Australia.,Department of Health Evidence, Radboud UMC, 6500 HB, Nijmegen, The Netherlands
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50
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Balegha AN, Yidana A, Abiiro GA. Knowledge, attitude and practice of hepatitis B infection prevention among nursing students in the Upper West Region of Ghana: A cross-sectional study. PLoS One 2021; 16:e0258757. [PMID: 34648609 PMCID: PMC8516292 DOI: 10.1371/journal.pone.0258757] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Accepted: 10/04/2021] [Indexed: 01/12/2023] Open
Abstract
Introduction Hepatitis B infection remains a public health threat associated with undesirable statistics of morbidity and mortality. Good knowledge, attitude and practice (KAP) of hepatitis B infection (HBI) prevention are essential for HBI control. However, there is limited evidence concerning the KAP of HBI prevention among nursing students, who are significantly exposed to HBI. We assessed the KAP of HBI prevention and the factors associated with the practice of HBI prevention among nursing students in the Upper West Region of Ghana. Methods We administered an online cross-sectional survey in November 2020 to a stratified random sample of 402 nursing students in two nursing training colleges in the Upper West Region. Using STATA version 13, we computed composite scores of KAP of HBI prevention with maximum scores of 18 for knowledge and 8 each for attitude and practice. A generalised ordered logistic regression model was run to assess the factors associated with the practice of HBI prevention. Results The students had moderate median scores for knowledge (12.00; IQR = 10–13) and attitude (6.00; IQR = 5.00–7.00) but a poor median score (5.00; IQR = 4.00–6.00) for the practice of HBI prevention. High knowledge (aOR = 2.05; p = 0.06), good attitude, being a male, second year student and having parents with tertiary education were significantly associated with higher likelihoods (aOR >1; p < 0.05) of demonstrating good practice of HBI prevention. Students who had never married were significantly (aOR = 0.34; p = 0.010) less likely to exhibit good practice of HBI prevention. Conclusion The KAP scores of HBI prevention among the students were sub-optimal. We recommend institution-based policies and regular education on HBI prevention, free/subsidised HBI prevention services, and the enforcement of proper professional ethics on HBI prevention in nursing training colleges. Such interventions should predominantly target female, non-married and first year nursing students.
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Affiliation(s)
| | - Adadow Yidana
- Department of Behavioural and Social Change, School of Public Health, University for Development Studies, Tamale, Northern Region, Ghana
| | - Gilbert Abotisem Abiiro
- Department of Health Services, Policy, Planning, Management and Economics, School of Public Health, University for Development Studies, Tamale, Northern Region, Ghana
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