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Bockarie AS, Nartey YA, Nsiah P, Edzie EKM, Tuoyire D, Acquah S, Eliason S, Nkum B. Fatty liver biomarkers and insulin resistance indices in the prediction of non-alcoholic fatty liver disease in Ghanaian patients. Endocrinol Diabetes Metab 2023; 6:e456. [PMID: 37814510 PMCID: PMC10638625 DOI: 10.1002/edm2.456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 09/28/2023] [Accepted: 09/30/2023] [Indexed: 10/11/2023] Open
Abstract
BACKGROUND Scant West African data on non-alcoholic fatty liver disease (NAFLD) means there is little representation of this population in the modelling used to derive biomarkers and predictive indices for risk stratification of patients for the presence of hepatic steatosis. This study evaluates the performance of the fatty liver index (FLI), hepatic steatosis index (HSI) and triglyceride-glucose (TyG) index and its derivatives in predicting ultrasound detected NAFLD in a locally resident population of Ghanaian participants. METHODS AND FINDINGS A post hoc analysis of data from a cross sectional assessment of NAFLD and cardiovascular risk was performed. Data from 210 participants without significant alcohol intake, or secondary causes of fatty liver and not on steatogenic drugs was evaluated. A structured questionnaire had been used to collect demographic data, medical and drug history. Anthropometry, blood sampling for liver chemistry and fasting lipids were performed. Hepatic steatosis was detected by ultrasonography. A retrospective analysis involving multivariate binary logistic regression assessed FLI, HIS, TyG (and its derivatives) as predictors of NAFLD with p < .05 considered statistically significant. Sensitivity, specificity, predictive values, likelihood ratios were calculated and accuracy of the proxies evaluated from area under the receiver operating characteristics curve (AUROC). All the biomarkers and indices were significantly associated with NAFLD (p ≤ .001). All the lipid and fatty liver indices assessed performed acceptably as predictors of NAFLD. FLI (AUC = 0.8, 95% CI [0.74-0.87]), TyG-WC (AUC = 0.81, 95% CI [0.75-0.88]) and TyG-WHtR (AUC = 0.81, 95% CI [0.74-0.88]) performed best at predicting NAFLD. Whilst in all cases the markers had good specificity (>90%) they lacked sufficient sensitivity with FLI having the highest sensitivity of 36.7%. Their overall accuracy was greater than 70% in each case. CONCLUSION The overall accuracy of HSI, FLI, TyG index and its derivatives (TyG WHtR, TyG BMI, TyG WC) was acceptable for predicting NAFLD in this population. Given their performance in this study and in light of their low cost, accessibility, easy interpretation and non-invasive nature; they are suitable tools for screening in the Ghanaian population.
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Affiliation(s)
- A. S. Bockarie
- Department of Internal Medicine & TherapeuticsUniversity of Cape CoastCape CoastGhana
- Department of MedicineCape Coast Teaching HospitalCape CoastGhana
| | - Y. A. Nartey
- Department of Internal Medicine & TherapeuticsUniversity of Cape CoastCape CoastGhana
- Department of MedicineCape Coast Teaching HospitalCape CoastGhana
| | - P. Nsiah
- Department of Chemical PathologyUniversity of Cape CoastCape CoastGhana
| | - E. K. M. Edzie
- Department of RadiologyUniversity of Cape CoastCape CoastGhana
| | - D. Tuoyire
- Department of Community MedicineUniversity of Cape CoastCape CoastGhana
| | - S. Acquah
- Department of Medical BiochemistryUniversity of Cape CoastCape CoastGhana
| | - S. Eliason
- Department of Community MedicineUniversity of Cape CoastCape CoastGhana
| | - B. Nkum
- Department of MedicineKwame Nkrumah University of Science and TechnologyKumasiGhana
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Kyei S, Owusu-Afriyie B, Tagoh S, Kwarteng MA, Nsiah P, Guramatunhu S. Clinical and sociodemographic characteristics of glaucoma patients at a tertiary referral facility in Zimbabwe. Malawi Med J 2021; 33:15-20. [PMID: 34422229 PMCID: PMC8360285 DOI: 10.4314/mmj.v33i1.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Purpose To evaluate the clinical and socio-demographic profile of patients living with glaucoma and receiving care in a tertiary eye center in Zimbabwe. Method A hospital-based retrospective study of clinical records of glaucoma patients from January 2014 to December 2018. The study involved collating demographic information of patients, visual acuities, (VA) intraocular pressure, (IOP), cup-to-disc ratios, (CDRs), average retinal nerve fibers thickness, (RNFL), cup volume, cup-to-disc area, vertical cup-to-disc ratio, (VCDR), rim area, disc area, glaucoma hemifield test, visual field indices and the management of glaucoma. Results Nine thousand one hundred and eighty-five (9,185) folders were retrieved. Out of these, 432 (4.7%) qualified for the study and were analyzed. There were 267 (61.8%) males and 165 (38.2%) females. The mean age (± Standard deviation, SD) of the patients was 62.66 ± 15.94 years, (range 10 - 110 years). The means visual acuity (VA): OD =1.30 ± 1.06 Logarithm of the Minimum Angle of Resolution, (logMAR), OS = 1.33 ± 1.06 logMAR; IOP: OD = 29.51 ± 12.89 mmHg, OS: 29.17 ± 12.59 mmHg; CDRs: OD = 0.91 ± 0.14 D, OS = 0.92 ± 0.14 D; and the average RNFL thickness was 72.76 ± 18.26 µm and 71.24 ± 23.17 µm in the right and left eye respectively. The mainstay of treatment was medication only. Conclusion There were more males than females receiving glaucoma care at the tertiary level. Glaucoma cases included juveniles but the mean age was mostly the elderly. It was characterized by high IOPs, large CDRs, and thin RNFL suggestive of late presentation.
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Affiliation(s)
- Samuel Kyei
- Department of Optometry and Vision Science, School of Allied Health Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana.,Department of Optometry, Faculty of Science and Engineering, Bindura University of Science Education, Bindura, Zimbabwe
| | - Bismark Owusu-Afriyie
- Department of Optometry, Faculty of Science and Engineering, Bindura University of Science Education, Bindura, Zimbabwe.,Optinova Eye Care Services, 125 Leopold Takawira Street, Harare, Zimbabwe.,Greenwood Park Eye Center, 175 Fife Avenue, Harare, Zimbabwe
| | - Selassie Tagoh
- Department of Optometry, Faculty of Science and Engineering, Bindura University of Science Education, Bindura, Zimbabwe
| | - Michael Agyemang Kwarteng
- Department of Optometry, Faculty of Science and Engineering, Bindura University of Science Education, Bindura, Zimbabwe.,Discipline of Optometry, College of Health Sciences, University of KwaZulu-Natal, South Africa
| | - Peter Nsiah
- Optinova Eye Care Services, 125 Leopold Takawira Street, Harare, Zimbabwe
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Obiri-Yeboah D, Charwudzi A, Baidoo IK, Botchway ET, Addo SA, Nsiah P, Ekem I. Haematological Changes among HIV-Positive Persons on Antiretroviral Therapy at a Tertiary Hospital in Ghana. West Afr J Med 2020; 37:40-47. [PMID: 32030710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
BACKGROUND Haematological abnormalities such as anaemia, leucopenia, and thrombocytopenia are common complications of Human Immunodeficiency Virus (HIV) infection. Few researchers have studied the changes in HIV positive patients before and during antiretroviral therapy (ART) in Ghana. This study is aimed at determining the haematological profile of people living with HIV (PLHIV) at baseline and whilst on ART in a tertiary facility in Cape Coast, Ghana. METHODS This was an analytical cross-sectional study with a retrospective component among PLHIV assessing ART services at the Cape Coast Teaching Hospital, Ghana. Full blood count (FBC) test was performed on blood samples and the results were analyzed and categorized based on WHO definitions. RESULTS A total of 440 participants were included. The mean haemoglobin level (g/dL) for females at baseline, 6 months after ART and during this study were 9.6 (±1.8), 10.9 (±1.4) and 11.6 (±1.4); and 10.2 (±2.1), 11.6 (±1.7) and 11.8 (±1.6) for males. At baseline, the commonest type of anaemia for both females and males was microcytic hypochromic anaemia. The mean platelet count was 382 x 109/l at baseline but reduced to 298 x 109/L after 6 months on ART. Among male participants in this study, the main factor associated with being anaemic after 6 months on ART was the ART regimen with non-Zidovudine based regimen, having reduced odds of anaemia of OR 0.3 (95%CI 0.1 - 0.9), p-value of 0.04. Among females, having plasma viral load >1000 copies per ml was found to have increased odds of being anaemic (OR 1.4, 95%CI 0.7 - 2.6), though not statistically significant (P-value of 0.32). CONCLUSION The prevalence of anaemia, though improved on ART, was high among PLHIV. It is essential to ensure that full blood count of PLHIV in Ghana are done regularly, at all levels of service provision, with appropriate referral systems in place. The change to the current TDF based preferred first line ART regimen must also be enforced to reduce the potential risks associated with AZT use. This will improve outcome for PLHIV.
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Affiliation(s)
- D Obiri-Yeboah
- Department of Microbiology and Immunology, School of Medical Sciences, University of Cape Coast, Ghana
| | - A Charwudzi
- Department of Haematology, School of Medical School Sciences, University of Cape Coast, Ghana
| | - I K Baidoo
- Public Health Unit, Cape Coast Teaching Hospital, Cape Coast, Ghana
| | - E T Botchway
- Department of Internal Medicine, Cape Coast Teaching Hospital, Cape Coast, Ghana
| | - S A Addo
- National AIDS Control Programme, Accra, Ghana
| | - P Nsiah
- Department of Chemical Pathology, School of Medical Sciences,University of Cape Coast, Ghana
| | - I Ekem
- Department of Haematology, School of Medical School Sciences, University of Cape Coast, Cape Coast, Ghana
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Abokyi S, Ilechie A, Nsiah P, Darko-Takyi C, Abu EK, Osei-Akoto YJ, Youfegan-Baanam M. Visual impairment attributable to uncorrected refractive error and other causes in the Ghanaian youth: The University of Cape Coast Survey. J Optom 2016; 9:64-70. [PMID: 26025809 PMCID: PMC4705321 DOI: 10.1016/j.optom.2015.04.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2014] [Revised: 04/07/2015] [Accepted: 04/07/2015] [Indexed: 06/04/2023]
Abstract
PURPOSE To determine the prevalence of visual impairment attributable to refractive error and other causes in a youthful Ghanaian population. METHODS A prospective survey of all consecutive visits by first-year tertiary students to the Optometry clinic between August, 2013 and April, 2014. Of the 4378 first-year students aged 16-39 years enumerated, 3437 (78.5%) underwent the eye examination. The examination protocol included presenting visual acuity (PVA), ocular motility, and slit-lamp examination of the external eye, anterior segment and media, and non-dilated fundus examination. Pinhole acuity and fundus examination were performed when the PVA≤6/12 in one or both eyes to determine the principal cause of the vision loss. RESULTS The mean age of participants was 21.86 years (95% CI: 21.72-21.99). The prevalence of bilateral visual impairment (BVI; PVA in the better eye ≤6/12) and unilateral visual impairment UVI; PVA in the worse eye ≤6/12) were 3.08% (95% CI: 2.56-3.72) and 0.79% (95% CI: 0.54-1.14), respectively. Among 106 participants with BVI, refractive error (96.2%) and corneal opacity (3.8%) were the causes. Of the 27 participants with UVI, refractive error (44.4%), maculopathy (18.5%) and retinal disease (14.8%) were the major causes. There was unequal distribution of BVI in the different age groups, with those above 20 years having a lesser burden. CONCLUSION Eye screening and provision of affordable spectacle correction to the youth could be timely to eliminate visual impairment.
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Affiliation(s)
- Samuel Abokyi
- Department of Optometry, School of Physical Sciences, University of Cape Coast, Cape Coast, Central Region, Ghana.
| | - Alex Ilechie
- Department of Optometry, School of Physical Sciences, University of Cape Coast, Cape Coast, Central Region, Ghana
| | - Peter Nsiah
- Department of Optometry, School of Physical Sciences, University of Cape Coast, Cape Coast, Central Region, Ghana
| | - Charles Darko-Takyi
- Department of Optometry, School of Physical Sciences, University of Cape Coast, Cape Coast, Central Region, Ghana
| | - Emmanuel Kwasi Abu
- Department of Optometry, School of Physical Sciences, University of Cape Coast, Cape Coast, Central Region, Ghana
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Ephraim R, Nsiah P, Osakunor D, Adoba P, Sakyi S, Anto E. Seroprevalence of Hepatitis B and C Viral Infections among Type 2 Diabetics: A Cross-sectional Study in the Cape Coast Metropolis. Ann Med Health Sci Res 2014; 4:719-22. [PMID: 25328781 PMCID: PMC4199162 DOI: 10.4103/2141-9248.141529] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Type 2 diabetes comes with various complications and this may be compounded by morbidities of hepatitis B virus (HBV) and hepatitis C virus (HCV) infections. AIMS This study examined the prevalence of HBV and HCV infectionst among type 2 diabetics as well as its associated factors. This randomized cross-sectional study was conducted at the Diabetic Clinic of the Central Regional Hospital, Cape Coast between December 2012 and April 2013. SUBJECTS AND METHODS A well-structured questionnaire was used to recruit 110 type 2 diabetics. Venous blood samples were collected for the estimation of blood glucose and to screen for HBV and HCV infections. Data analysis was carried out using SPSS Version 17.0. Descriptive analysis was performed and results expressed as means (SD) and n (%). P < 0.05 was considered significant. RESULTS Prevalence of HBV in type 2 diabetics was 5.5% (6/110). No type 2 diabetic was positive for HCV. The prevalence of HBV infection in the type 2 diabetes mellitus (T2DM) participants was higher (5.5% [6/110]) than that of HCV (0/110). A total of 69.1% (76/110) T2DM patients had poor glycemic control. Mean waist and hip circumference was higher among HBV-negative T2DM participants (99.3; 106.9) than HBV-positive participants (87.2; 101.8). CONCLUSIONS The seroprevalence of HBV was higher than that of HCV in T2DM patients. T2DM patients would require necessary preventive measures like prophylaxis, to reduce the risk of HBV infection and its ramifications.
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Affiliation(s)
- Rkd Ephraim
- Department of Laboratory Technology, Medical Laboratory Division, University of Cape Coast, Cape Coast, Ghana
| | - P Nsiah
- Department of Chemical Pathology, School of Medical Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Dnm Osakunor
- Department of Molecular Medicine, School of Medical Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - P Adoba
- Department of Laboratory Technology, Medical Laboratory Division, University of Cape Coast, Cape Coast, Ghana
| | - Sa Sakyi
- Department of Molecular Medicine, School of Medical Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Eo Anto
- Department of Molecular Medicine, School of Medical Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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