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Baidoo B, Ankomah E, Alhassan M, Benya G, Obike E, Benfo A, Boachie J, Adu P. Mixed-methods exploration of the knowledge of young adults about blood donation processes; a one-center cross-sectional study in a tertiary institution. PLoS One 2024; 19:e0295600. [PMID: 38180974 PMCID: PMC10769017 DOI: 10.1371/journal.pone.0295600] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 11/25/2023] [Indexed: 01/07/2024] Open
Abstract
Ghana is a majority youthful population, but is only able to meet 60% of its annual blood donation requirements. Although tertiary students in Ghana may serve as important blood donor resource by virtue of their higher educational attainment, data about their blood donation processes-specific knowledge are scarce. This study therefore explored the perspectives, and experiences of young adults regarding blood donation processes. This exploratory study employed mixed-methods approach (semi-structured questionnaire and focus group discussion, [FGD]). Data collection was sequential; the questionnaire distribution was completed before FGD commenced; themes that emerged from the questionnaire responses guided FGDs. Convenience sampling technique was used to recruit 382 young adults (15-49 years). All statistical analyses were undertaken using the two-tail assumptions; p<0.05 was considered statistically significant. Majority (79.3%) of the participants were in their twenties, with only 1.3% being 40-49 years old. Although two-thirds of participants expressed willingness to donate blood, less than a-third (31.7%; 127/382) had previously donated blood. Overall, less than one-third of participants could correctly identify the minimum weight (26.4%), or the inter-donation interval (14.7%); 37.4% and 58.1% could respectively indicate the required donor age or ≥3 infectious agents screened for prior to blood collection. Among previous donors, 37.2%, 28.1% and 43.0% could identify the required weight, acceptable inter-donation period, and donor age respectively. Two-thirds and a-third of participants preferred voluntary unrelated, and paid donations respectively. Whereas 42.4% of participants indicated intrinsic health benefits of blood donation, 17.0% suggested that blood donation was associated with disease risks. Both previous donors and non-donor groups considered lack of education, fear of post-donation health issues and lack of privacy at blood collection centers as main hindrances to donor recruitment. Targeted intentional blood donation-specific educational campaigns are warranted to address the blood donation processes knowledge gap among the study population.
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Affiliation(s)
- Belinda Baidoo
- Department of Medical Laboratory Sciences, School of Allied Health, Sciences College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Elizabeth Ankomah
- Department of Medical Laboratory Sciences, School of Allied Health, Sciences College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Mohammed Alhassan
- Department of Medical Laboratory Sciences, School of Allied Health, Sciences College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Godfred Benya
- Department of Medical Laboratory Sciences, School of Allied Health, Sciences College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Emmanuella Obike
- Department of Medical Laboratory Sciences, School of Allied Health, Sciences College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Audrey Benfo
- Department of Medical Laboratory Sciences, School of Allied Health, Sciences College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Joseph Boachie
- Department of Medical Laboratory Sciences, School of Allied Health, Sciences College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Patrick Adu
- Department of Medical Laboratory Sciences, School of Allied Health, Sciences College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
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Benfo A, Zumesew F, Akoto EB, Ahiakwah E, Baidoo B, Agyapong NAF, Boachie J, Adu P. Exploring the perspective of young adults about anaemia prevention; the contributions of knowledge about at-risk groups and consequences of anaemia. BMC Public Health 2023; 23:2081. [PMID: 37875836 PMCID: PMC10598987 DOI: 10.1186/s12889-023-16980-2] [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: 03/16/2023] [Accepted: 10/12/2023] [Indexed: 10/26/2023] Open
Abstract
BACKGROUND Anaemia persistently remains a grave public health challenge in most sub-Saharan African countries. Understanding the perspectives of young adults concerning the multi-factorial nature of anaemia may be an important step towards meeting the 2025 global nutrition target of halving anaemia since these individuals might be in the process of reproductive decisions. AIM To explore the relationship between students' knowledge about individuals at risk of developing anaemia, and anaemia consequences, and anaemia prevention strategies in a tertiary student cohort. METHODS This sequential exploratory study adopted a mixed-methods approach to triangulate the data collection. A semi-structured questionnaire was used to gather baseline data regarding students' perspective on anaemia. Themes that emerged from the initial questionnaire data analyses guided a focus group discussion (FGD) to further explore students' perspectives on anaemia. FGD data was thematically analysed to unearth reasons behind questionnaire item selection. Structural equation modeling (SEM) was used to explore the relationship between constructs in the anaemia knowledge questionnaire. RESULTS Overall, 543 students participated in the initial questionnaire data acquisition compared to 16 in the FGD. Our latent variable structural model showed that knowing the causes of anaemia did not significantly (p > 0.05) associate with either knowledge about anaemia consequences (b = 0.113) or knowledge about anaemia prevention strategies (b = 0.042). However, knowledge about individuals at-risk of anaemia was significantly positively associated with both anaemia prevention strategies (b = 0.306, p < 0.05) and knowledge about consequences of anaemia (b = 0.543, 95%). Moreover, knowing the consequences of anaemia seemed to significantly positively mediate the association between knowledge about at-risk groups and preventive measures that could be adopted (b = 0.410, p < 0.05). CONCLUSIONS Systems thinking public health educational campaigns that highlight the consequences of anaemia and at-risk groups are more likely to inspire the adoption of preventive strategies among young adults.
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Affiliation(s)
- Audrey Benfo
- Department of Medical Laboratory Sciences, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Francis Zumesew
- Department of Medical Laboratory Sciences, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Ebenezer Bugyei Akoto
- Department of Medical Laboratory Sciences, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Edward Ahiakwah
- Department of Medical Laboratory Sciences, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Belinda Baidoo
- Department of Medical Laboratory Sciences, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Nana Ama Frimpomaa Agyapong
- Department of Clinical Nutrition and Dietetics, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Joseph Boachie
- Department of Medical Laboratory Sciences, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Patrick Adu
- Department of Medical Laboratory Sciences, School of Allied Health Sciences, University of Cape Coast, Cape Coast, 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 Res Int 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] [What about the content of this article? (0)] [Affiliation(s)] [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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Selleh PK, Anto EO, Boadu WIO, Sackey B, Boateng LA, Nkansah C, Nsafoah F, Saasi AR, Mintaah S, Wiafe YA, Derigubah C, Korsah EE, Frimpong J, Ansah E, Tamakloe VCKT, Adu P, Boachie J, Addai‐Mensah O. Quality of glycemic control in type 2 diabetes mellitus (T2DM) and its association with markers of coagulation and inhibitors of fibrinolysis: A case-control study in the Upper West Region, Ghana. Health Sci Rep 2023; 6:e1297. [PMID: 37292102 PMCID: PMC10246457 DOI: 10.1002/hsr2.1297] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 04/17/2023] [Accepted: 04/18/2023] [Indexed: 06/10/2023] Open
Abstract
Background and Aims Type 2 diabetes mellitus (T2DM) individuals are at a higher risk of developing diabetes complications, with approximately 80% complication-related mortality. The increased morbidity and mortality among T2DM patients are partly due to dysregulated hemostasis. This study determined the quality of glycemic control in T2DM and its association with markers of coagulation and inhibitors of fibrinolysis. Methods This case-control study recruited 90 participants involving: 30 T2DM patients with good glycemic control, 30 with poor glycemic control, and 30 nondiabetic subjects as controls at a Municipal Hospital in Ghana. Fasting blood glucose, glycated hemoglobin, activated partial thromboplastin time (APTT), prothrombin time (PT), calculated international normalized ratio (INR), and full blood count (FBC) were determined for each respondent. Plasma levels of plasminogen activator inhibitor-1 (PAI-1) and thrombin activatable fibrinolysis inhibitor (TAFI) were determined using the solid-phase sandwich enzyme-linked immunosorbent assay method. Data were analyzed using R language software. Results Plasma PAI-1 antigen levels were significantly higher in the participants with poor glycemic control as compared to participants with good glycemic control (p < 0.0001). There was no significant difference in plasma TAFI levels between the participants with poor glycemic control as compared to participants with good glycemic control (p = 0.900). T2DM patients had significantly shorter APTT, PT, and INR than controls (p < 0.05). At a cut-off of ≥161.70 pg/μL, PAI was independently associated with increasing odds (adjusted odds ratio = 13.71, 95% confidence interval: 3.67-51.26, p < 0.0001) of poor glycemic control and showed the best diagnostic accuracy for poor glycemic control (area under the curve = 0.85, p < 0.0001). Conclusion PAI-1 levels were significantly increased in T2DM with poor glycemic control and emerged as the best predictor for poor glycemic control. Good glycemic management to control the plasma levels of PAI-1 is required to prevent hypercoagulability and thrombotic disorders.
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Affiliation(s)
- Peter K. Selleh
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, College of Health SciencesKwame Nkrumah University of Science and TechnologyKumasiGhana
| | - Enoch O. Anto
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, College of Health SciencesKwame Nkrumah University of Science and TechnologyKumasiGhana
- School of Medical and Health SciencesEdith Cowan UniversityJoondalupWestern AustraliaAustralia
- Centre for Precision Health, ECU Strategic Research CentreEdith Cowan UniversityJoondalupWestern AustraliaAustralia
| | - Wina I. O. Boadu
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, College of Health SciencesKwame Nkrumah University of Science and TechnologyKumasiGhana
| | - Benedict Sackey
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, College of Health SciencesKwame Nkrumah University of Science and TechnologyKumasiGhana
| | - Lilian A. Boateng
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, College of Health SciencesKwame Nkrumah University of Science and TechnologyKumasiGhana
| | - Charles Nkansah
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, College of Health SciencesKwame Nkrumah University of Science and TechnologyKumasiGhana
| | - Frederick Nsafoah
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, College of Health SciencesKwame Nkrumah University of Science and TechnologyKumasiGhana
| | - Abdul R. Saasi
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, College of Health SciencesKwame Nkrumah University of Science and TechnologyKumasiGhana
| | - Selina Mintaah
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, College of Health SciencesKwame Nkrumah University of Science and TechnologyKumasiGhana
| | - Yaw A. Wiafe
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, College of Health SciencesKwame Nkrumah University of Science and TechnologyKumasiGhana
| | - Charles Derigubah
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, College of Health SciencesKwame Nkrumah University of Science and TechnologyKumasiGhana
| | - Emmanuel E. Korsah
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, College of Health SciencesKwame Nkrumah University of Science and TechnologyKumasiGhana
| | - Joseph Frimpong
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, College of Health SciencesKwame Nkrumah University of Science and TechnologyKumasiGhana
| | - Ezekiel Ansah
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, College of Health SciencesKwame Nkrumah University of Science and TechnologyKumasiGhana
| | - Valentine C. K. T. Tamakloe
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, College of Health SciencesKwame Nkrumah University of Science and TechnologyKumasiGhana
| | - Patrick Adu
- Department of Medical Laboratory Science, School of Allied Health SciencesUniversity of Cape CoastCape CoastGhana
| | - Joseph Boachie
- Department of Medical Laboratory Science, School of Allied Health SciencesUniversity of Cape CoastCape CoastGhana
| | - Otchere Addai‐Mensah
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, College of Health SciencesKwame Nkrumah University of Science and TechnologyKumasiGhana
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Gbadago BK, Antiaye J, Boachie J, Adu P. Drinking recommended daily water significantly alters haemato-biochemical parameters in prospective blood donors; a one-center quasi-experimental study in a tropical setting. Blood Cells Mol Dis 2023; 102:102757. [PMID: 37267697 DOI: 10.1016/j.bcmd.2023.102757] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 05/15/2023] [Accepted: 05/17/2023] [Indexed: 06/04/2023]
Abstract
BACKGROUND In sub-Saharan Africa, the prevailing high ambient temperatures should warrant increased daily water intake (DWI) to prevent haemo-concentration and its potential to confound patients' laboratory data. AIM To assess the impact that the recommended DWI has on the haemato-biochemical variables in a tropical setting. MATERIALS AND METHODS This quasi-experimental study recruited 101 apparently healthy individuals (18-60 years) in the Bawku municipality. DWI, anthropometrics, and haemato-biochemical variables were assessed at baseline. Participants were encouraged to increase their DWI to ≥4 L over a 30-day period; haemato-biochemical variables were re-evaluated. Total body water (TBW) was anthropometrically estimated. RESULTS The median post-treatment DWI significantly increased; consequently, anaemia cases increased by >20-fold (2.0 % vs 47.5 % post-treatment). RBC count, platelet count, WBC count, and median haemoglobin significantly decreased compared to baseline (p < 0.0001). Biochemically, median plasma osmolality (p < 0.0001), serum sodium (p < 0.0001), serum potassium (p = 0.0012) and random blood sugar (p = 0.0403) significantly decreased. Compared to baseline, significantly higher proportion of participants classified as thrombocytopenic (8.9 % vs 3.0 %), hyponatraemia (10.9 % vs 2.0 %), or normal osmolarity (77.2 % vs 20.8 %). There were differential bivariate correlations between pre- and post-treatment haemato-biochemical variables. CONCLUSION Sub-optimal DWI is a likely confounder in haemato-biochemical data interpretation in the tropics.
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Affiliation(s)
- Bright Kekeli Gbadago
- Bawku Presbyterian Hospital, Bawku, Upper East Region, Ghana; Department of Medical Laboratory Sciences, School of Allied Health, Sciences College of Health and Allied Sciences, University of Cape Coast, Ghana
| | - Juliet Antiaye
- School of Medical Sciences, College of Health and Allied Sciences, University of Cape Coast, Ghana
| | - Joseph Boachie
- Department of Medical Laboratory Sciences, School of Allied Health, Sciences College of Health and Allied Sciences, University of Cape Coast, Ghana.
| | - Patrick Adu
- Department of Medical Laboratory Sciences, School of Allied Health, Sciences College of Health and Allied Sciences, University of Cape Coast, Ghana.
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Simpong NL, Afefa CT, Yimpuri L, Akum B, Safo A, Edziah SJ, Simpong DL, Adu P. Establishing pregnancy-specific haematological reference intervals in Ghana; a three-center cross-sectional study. PLoS One 2023; 18:e0274422. [PMID: 36735666 PMCID: PMC9897535 DOI: 10.1371/journal.pone.0274422] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 08/30/2022] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Abnormal intra-pregnancy haematological variables are associated with adverse feto-maternal outcomes. However, the reference intervals (RIs) employed in sub-Saharan Africa to inform clinical decisions are generally imported. Since RIs are influenced by age, geographical location, and race, we hypothesized that context specific RIs should be established in Ghana to contextualize intra-pregnancy decision making. METHODS This cross-sectional study retrospectively retrieved data of 333 pregnant women with no known clinically determined intra-pregnancy complications; 22 participants in their first trimester (T1; 1-13 weeks), 177 in their T2 (14-27 weeks), and 132 in T3 (28-41 weeks). RIs for haematological parameters were non-parametrically determined at 2.5th and 97.5th percentiles in accordance with CLSI guidance document EP28-A3c. Two-sample comparisons were undertaken using Wilcoxon rank-sum tests whereas more than two-sample comparisons were undertaken using Kruskal-Wallis test. Statistical significance was set at p <0.05 under the two-tailed assumptions. RESULTS In accordance with WHO trimester-specific haemoglobin cutoffs, anaemia prevalence was a moderate (T1: 36.4%; 8/22 & T2: 31.6%; 56/177) to severe (T3:68.0%; 90/132) public health problem. Additionally, 9.3% (31/333) individuals had high gestational haemoglobin levels (Hb >13.0 g/dL). Moreover, haemoglobin (T2: 8.6-14.3 vs T3: 7.5-13.6 g/dL), MCH (T2: 22.5-69.8 vs T3: 21.6-31.9 pg), MCHC (T2: 30.2-51.8 g/L vs T3: 30.5-37.9 g/L), TWBC (T2: 4.0-13.4 vs T3: 4.1-13.0 x 109/L) required trimester specific RIs, compared to RBC (2.8-5.1 x 1012/L), MCV (66.2-100.2 fL), and platelet counts (106.3-388.3 x 109/L) that each required combined reference intervals. CONCLUSIONS The intra-pregnancy haematological RIs determined have appreciable lower limits; there is the need to determine context-specific thresholds for haematological variables predictive of positive and/or adverse maternal and infant health outcomes.
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Affiliation(s)
| | - Charity Tenu Afefa
- Department of Medical Laboratory Science, School of Allied Health Science, University of Cape Coast, Cape Coast, Ghana
| | - Leander Yimpuri
- Department of Medical Laboratory Science, School of Allied Health Science, University of Cape Coast, Cape Coast, Ghana
| | - Betty Akum
- Department of Medical Laboratory Science, School of Allied Health Science, University of Cape Coast, Cape Coast, Ghana
| | - Afia Safo
- Department of Medical Laboratory Science, School of Allied Health Science, University of Cape Coast, Cape Coast, Ghana
| | - Simon-Junior Edziah
- Department of Medical Laboratory Science, School of Allied Health Science, University of Cape Coast, Cape Coast, Ghana
| | - David Larbi Simpong
- Department of Medical Laboratory Science, School of Allied Health Science, University of Cape Coast, Cape Coast, Ghana
| | - Patrick Adu
- Department of Medical Laboratory Science, School of Allied Health Science, University of Cape Coast, Cape Coast, Ghana
- * E-mail:
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Mintaah S, Anto EO, Boadu WIO, Sackey B, Boateng LA, Ansah E, Korsah EE, Frimpong J, Tamakloe VCKT, Selleh PK, Afrifa DA, Saasi AR, Senu E, Duah LA, Opoku S, Amoah JP, Adu P, Boachie J, Nyamekye DA, Sackey DS, Wiafe YA, Addai-Mensah O. Coagulation Factors and Natural Anticoagulants as Surrogate Markers of Preeclampsia and Its Subtypes: A Case-Control Study in a Ghanaian Population. Clin Appl Thromb Hemost 2023; 29:10760296231204604. [PMID: 37787124 PMCID: PMC10548802 DOI: 10.1177/10760296231204604] [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] [Indexed: 10/04/2023] Open
Abstract
Preeclampsia (PE) is associated with endothelial injury and hemostatic abnormalities. However, the diagnostic role of coagulation parameters and natural anticoagulants in predicting PE has not been explored in Ghana. This study assessed plasma levels of these factors as surrogate markers of PE and its subtypes. This case-control study included 90 women with PE (cases) and 90 normotensive pregnant women (controls). Blood samples were drawn for the estimation of complete blood count and coagulation tests. The prothrombin time (PT), activated partial thromboplastin time (APTT), and the calculation of the international normalized ratio (INR) were determined by an ACL elite coagulometer while the levels of protein C (PC), protein S (PS), antithrombin III (ATIII), and D-dimers were also measured using the solid-phase sandwich enzyme-linked immunosorbent assay (ELISA) method. All statistical analyses were performed using the R Language for Statistical Computing. Results showed significantly (p < .05) shortened APTT (28.25 s) and higher D-dimer levels (1219.00 ng/mL) among PE women, as well as low levels of PC (1.02 µg/mL), PS (6.58 µg/mL), and ATIII (3.99 ng/mL). No significant difference was found in terms of PT and INR. From the receiver operating characteristic analysis, PC, PS, and ATIII could significantly predict PE and its subtypes at certain cutoffs with high accuracies (area under the curve [AUC] ≥0.70). Most women with PE are in a hypercoagulable state with lower natural anticoagulants. PC, PS, and ATIII are good predictive and diagnostic markers of PE and its subtypes (early-onset PE [EO-PE] and late-onset PE [LO-PE]) and should be explored in future studies.
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Affiliation(s)
- Selina Mintaah
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Enoch Odame Anto
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- School of Medical and Health Sciences, Edith Cowan University, Perth, Australia
- Centre for Precision Health, ECU Strategic Research Centre, Edith Cowan University, Perth, Australia
| | - Wina Ivy Ofori Boadu
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Benedict Sackey
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Lilian Antwi Boateng
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Ezekiel Ansah
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Emmanuel Ekow Korsah
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Joseph Frimpong
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | | | - Peter Kuugemah Selleh
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - David Amoah Afrifa
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Abdul-Razak Saasi
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Ebenezer Senu
- Department of Molecular Medicine, School of Medicine and Dentistry, College of Health Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Lawrence Agyemang Duah
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Stephen Opoku
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - John Paul Amoah
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Patrick Adu
- Department of Medical Laboratory Science, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Joseph Boachie
- Department of Medical Laboratory Science, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana
| | | | - David Sebbie Sackey
- Department of Haematology, Laboratory Service Directorate, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Yaw Amo Wiafe
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Otchere Addai-Mensah
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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Adu P, Binka M, Iyaniwura S, Ringa N, Irvine M, Otterstatter M, Janjua N. Contact patterns during the COVID-19 pandemic: findings from British Columbia, Canada. Int J Infect Dis 2022. [PMCID: PMC8884786 DOI: 10.1016/j.ijid.2021.12.069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Purpose Interpersonal interaction between infectious and uninfected individuals facilitates the spread of COVID-19. Physical distancing measures could prevent COVID-19 transmission by reducing the contacts among individuals in the population. In this study, we describe contact rates of residents of British Columbia, Canada to assess the impact of COVID-19 related physical distancing measures in the province. Methods & Materials We used data from the BC COVID-19 Population Mixing Patterns survey (BC-Mix) to investigate the contact patterns of residents of British Columbia from September 2020 to July 12, 2021. The BC-Mix is an ongoing repeated online survey with approximately 60,000 participants. Survey respondents provided the number of close contacts made in a single day in response to the question "How many people did you have in-person contact with between 5 am yesterday and 5am today?” In-person contact was defined as “face-to-face two-way conversation with three or more words, or physical skin-to-skin contact such as a handshakes, hugs, kisses and contact sports”. Survey weights were applied in the estimation of overall contact rates and contact rates stratified by age, sex and health region. Results A total of 31, 696 respondents were eligible for analysis. Overall average daily contacts decreased by about 28% in response to the physical distancing measures that went into effect on November 19, 2020 (from an average of 6.42 contacts per person prior to this date to 4.62 contacts per person after this date). From September 2020 to February 2021, the average number of daily contacts were higher among female respondents compared to male respondents. However, no notable difference in the average number of daily contact rates was observed between male and female respondents in subsequent weeks. Over the study period, younger age groups (< 55 years) reported higher daily contact overall than older age groups (≥ 55years years). There was also a marked difference in contact rates by health regions over the study period. Conclusion Contact patterns in British Columbia varied between September 2020 and July 2021, with a marked decline in average daily contacts noted immediately following the introduction of stricter physical distancing measures in November 2020.
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Osei-Boakye F, Wiafe YA, Nkansah C, Serwaa D, Saasi AR, Ganiwu A, Duku-Takyi R, Adu P, Derigubah CA, Appiah SK, Mensah K, Antwi LN, Duneeh RV, Addai-Mensah O. Haematological Profile in Pre-Surgery Hernia Patients: A Case-Control Study in Ghana. SciMed J 2022. [DOI: 10.28991/scimedj-2022-0401-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023] Open
Abstract
Introduction: The burden of hernia is disproportionately high in low-to-middle-income countries, due to the lack of fundamental resources needed to effectively diagnose and manage cases. The patterns of hernia, the haematological profile, and the predictive ability of blood cell indices were all investigated in this study. Methods: Fifty-four subjects: 27 hernia patients and 27 healthy controls were included in this single-centre, unmatched case-control study. Hernia was diagnosed using physical examination and ultrasound scan. Haematological indices of each subject were measured with an automated blood cell counter. Results: Herniae recorded were 92.59% inguinal, and 3.27% each epigastric and uterine prolapse. Hernia was prevalent in males (85.2%, p=0.008) and older subjects ≥53 years (48.1%, p=0.004). HgB (p=0.006), MCHC (p≤0.001), and RDW-CV (p=0.042) levels were significantly elevated in strangulated than non-strangulated hernia and controls respectively, while Abs GRAN (p=0.024) was decreased in non-strangulated than strangulated hernia and control groups respectively. MCHC (AUC=0.947 [0.895-0.999], p≤0.001) was the most sensitive predictor for herniation followed by age (AUC=0.750 [0.610-0.889], p=0.002); HgB (AUC=0.718 [0.580-0.857], p=0.006); and RDW-CV (AUC=0.700 [0.559-0.840], p=0.012). Also, MCHC (AUC=0.831 [0.723-0.938], p≤0.001); HgB (AUC=0.738 [0.590-0.887], p=0.005); and RBC (AUC=0.671 [0.502-0.840], p=0.045) respectively, were significant predictors of strangulation. Conclusion: Gender and age were significantly associated with hernias. Inguinal hernia and strangulation were common in the study setting, especially, among males. Also, there were significant variations in erythrocyte- and leucocyte indices across the groups, but not platelets. Erythrocyte indices were significant predictive biomarkers for hernia and strangulation. The CBC is a useful test for the early detection of herniation and strangulation. Doi: 10.28991/SciMedJ-2022-0401-1 Full Text: PDF
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Adu P, Binka M, Mahmood B, Jeong D, Buller-Tylor T, Damascene MJ, Iyaniwura S, Ringa N, Velasquez H, Wong S, Yu A, Bartlett S, Wilton J, Irvine M, Otterstatter M, Janjua N. Quantifying Contact Patterns: Development and Characteristics of the British Columbia COVID-19 Population Mixing Patterns Survey. Int J Infect Dis 2022. [PMCID: PMC8884815 DOI: 10.1016/j.ijid.2021.12.073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Purpose Several non-pharmaceutical interventions such as physical distancing, self-isolation, a stay-at-home order, hand washing, and schools and businesses closures were implemented in British Columbia (BC) following the first lab-tested case of COVID-19 on January 26, 2020. These interventions were aimed at minimizing in-person contacts that could potentially lead to new COVID-19 infections. The BC COVID-19 Population Mixing Patterns survey (BC-Mix) was established as a surveillance system to measure behaviour and contact patterns in BC over time to inform the timing of the easing/re-imposition of control measures. We describe the BC-Mix survey design and the demographic characteristics of respondents. Methods & Materials The ongoing repeated online survey was launched in September 2020. Participants are recruited through a variety of social media platforms including Instagram, Facebook, YouTube, and community group mailing lists. A follow up survey is sent to participants two to four weeks after completing the first iteration. Survey responses are weighted to BC's population by age, sex, geography, and ethnicity to obtain generalizable estimates. A survey completion rate of at least 33% AND a valid response for the sex questionnaire item AND a valid response for age questionnaire item were required for inclusion in weighting and further analysis. Additional indices such as material and social deprivation index, and residential instability are generated using census and location data. Results As of June 14, 2021, over 58,000 residents of BC had participated in the survey of which 31,007 survey responses were eligible for analysis. Of the eligible participants, about 60% provided consent for monthly follow up and about 26% provided their personal health numbers for linkage with other healthcare utilization databases. Approximately 51% were females 39% were 55 years or older, 63% identified as white or not a visible minority and 48% had at least a university degree. Conclusion The pandemic response is best informed by surveillance systems capable of timely assessment of behaviour patterns. BC-Mix survey respondents represented a large cohort of British Columbians providing near real-time information on behavioural and contact patterns in BC. Data from the BC-Mix survey continues to inform provincial COVID-19-related control measures.
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Aninagyei E, Adu P, Rufai T, Ampomah P, Kwakye-Nuako G, Egyir-Yawson A, Acheampong DO. Effect of Asymptomatic Plasmodium falciparum Parasitaemia on Platelets Thrombogenicity in Blood Donors. Indian J Hematol Blood Transfus 2021; 37:632-639. [PMID: 34690456 DOI: 10.1007/s12288-020-01390-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2019] [Accepted: 11/27/2020] [Indexed: 10/22/2022] Open
Abstract
Currently, blood donors in Ghana are not screened for malaria parasites. Therefore, this study assessed platelet thrombogenicity in blood donors infected asymptomatically with Plasmodium falciparum and the relationship between tumour necrosis factor alpha (TNF-α), 8-iso-prostaglandin F2α oxidative stress biomarker (8-iso-PG2α), C-reactive protein (hs-CRP) and D-dimer, and platelet thrombogenes levels. Haematology analyser was used to enumerate platelet count and platelet indices in 80 P. falciparum infected blood donors and 160 matched non-infected controls. Replicate serum levels of von Willebrand Factor (vWF), platelet factor 4 (PF4), P-selectin thrombogenic factors as well as TNF-α and 8-iso-PG2α were determined using enzyme immuno-assay while high sensitive hs-CRP and D-dimer concentrations were determined by fluorescent immunoassay. The geometric mean of parasite density in malaria infected donors was 1784 parasites/µL (505-2478 parasites/µL). This led to significant increase in the mean levels of 8-iso-PG2α, hs-CRP, TNF-α and D-dimer. However, PF4, P-selectin were significantly lower in infected donors while vWF levels did not differ significantly among the groups even though lower levels were observed in the infected donors. Significant direct relationship existed between both P-selectin and PF4 and platelet count, and plateletcrit and platelet large cell ratio whereas these thrombogenic factors varied inversely to 8-iso-PG2α, TNF-α and hs-CRP. Relative thrombocytopaenia was associated with significant reduction in P-selectin and platelet factor 4 levels together with increased 8-iso-PG2α, hs-CRP, TNF-α and D-dimer levels. Taken together, it is recommended that all P. falciparum infected blood donors should be deferred.
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Affiliation(s)
- Enoch Aninagyei
- School of Basic and Biomedical Sciences, Department of Biomedical Sciences, University of Health and Allied Sciences, PMB 31, Ho, Ghana
| | - Patrick Adu
- Department of Medical Laboratory Science, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Tanko Rufai
- Ghana Field Epidemiology and Laboratory Programme, School of Public Health, University of Ghana, Legon, Accra, Ghana
| | - Paulina Ampomah
- Department of Biomedical Sciences, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Godwin Kwakye-Nuako
- Department of Biomedical Sciences, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Alexander Egyir-Yawson
- Department of Biomedical Sciences, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Desmond Omane Acheampong
- Department of Biomedical Sciences, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana
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Acheampong DO, Adu P, Ampomah P, Duedu KO, Aninagyei E. Immunological, haematological, and clinical attributes of rural and urban malaria: a case-control study in Ghana. J Parasit Dis 2021; 45:806-816. [PMID: 34475663 DOI: 10.1007/s12639-021-01363-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 02/10/2021] [Indexed: 10/22/2022] Open
Abstract
To compare clinical presentations, haematological and immunological parameters in urban and rural malaria patients. Clinically suspected malaria patients, resident in either rural or urban communities, were selected from seven health facilities in the Greater Accra region of Ghana. For each suspected malaria patient, parasites were detected microscopically and quantified subsequently. In each study site, an equal number of cases and age-matched controls were selected. In both cases and controls, clinical presentations, nutritional status, haematological, and immunological parameters were profiled. A total of 149 malaria patients and 149 nonmalaria controls were selected. Compared to rural dwellers with malaria, parasitaemia was significantly higher in both males and females and in the various age groups in urban dwellers with malaria. Additionally, mean lymphocytes, haemoglobin, haematocrit, mean cell haemoglobin, platelets, and mean platelet volume levels were significantly lower in urban dwellers with malaria. However, TNF-α, IL-6, and IL-12 levels in urban dwellers with malaria were significantly higher, while IL-10, CD4+, CD3+, CD8+ T-cells levels and CD4+/ CD3+ ratio were significantly lower in urban dwellers with malaria. Furthermore, chills, diarrhoea, fever, and pallor were significantly associated with urban dwellers with malaria. This study concluded that urban dwellers are more prone to severe malaria while rural dwellers tend to have more measured immune response against malaria infection, and therefore experienced better controlled inflammatory processes associated with mild form of the disease.
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Affiliation(s)
- Desmond Omane Acheampong
- Department of Biomedical Sciences, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Patrick Adu
- Department of Medical Laboratory Sciences, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Paulina Ampomah
- Department of Biomedical Sciences, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Kwabena Obeng Duedu
- Department of Biomedical Sciences, School of Basic and Biomedical Sciences, University of Health and Allied Sciences, Volta Region, PMB 31, Ho, Ghana
| | - Enoch Aninagyei
- Department of Biomedical Sciences, School of Basic and Biomedical Sciences, University of Health and Allied Sciences, Volta Region, PMB 31, Ho, Ghana
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Ali-Baya G, Zenile E, Aikins BO, Amoaning RE, Simpong DL, Adu P. Poor haemoglobin-haematocrit agreement in apparently healthy adult population; a cross-sectional study in Cape Coast Metropolis, Ghana. Heliyon 2021; 7:e07720. [PMID: 34401592 PMCID: PMC8353477 DOI: 10.1016/j.heliyon.2021.e07720] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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] [Received: 05/11/2021] [Revised: 06/21/2021] [Accepted: 08/02/2021] [Indexed: 01/08/2023] Open
Abstract
Background This study estimated total body water (TBW), daily water intake (DWI) and haemoglobin-haematocrit relationship in adults in a tropical environment where active lifestyles could precipitate plasma volume contraction. Methods This cross-sectional study recruited 170 participants, and was carried out between February 2018 and May 2018 at University of Cape Coast. Semi-structured questionnaires were used to obtain demographic data and DWI. Five ml of venous blood sample was drawn for full blood count, haemoglobin variant determination, serum sodium and potassium levels. TBW was estimated using Chumlea's anthropometric equation. Statistical significance was set at p < 0.05 under two-tail assumption. Results Whereas 72.3% had low haematocrit, only 22.4% were anaemic per haemoglobin cut-off demonstrating a poor haemoglobin-haematocrit correlation. Also, whereas 30% of participants had low TBW, 22.9% had hypernatraemia, with 97.1% reporting DWI of <3 L. Bland-Altman plot showed that calculated haematocrit (HCT = Hb∗3) underestimated HCT by a factor of 1.788 (p = 0.0314). A scatter-plot showed a trend towards higher haematocrit-haemoglobin deviations as haemoglobin increased. Furthermore, 32.6% of participants with normal haemoglobin levels had low TBW. Moreover, whereas haemoglobin and serum K+ significantly positively correlated to TBW, serum Na+ was inversely related to TBW. Conclusion The low DWI is suggestive that measuring plasma volume and/or haemoglobin mass may be required to correctly diagnose anaemia.
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Krampah C, Nyanzu F, Quaye A, Adu P, Asiamah EA, Aboagye B, Simpong DL. Crude extracts from Allium cepa skin and Sorghum bicolor seed can provide as non-toxic and eco-friendly cytoplasmic stains. Pract Lab Med 2021; 26:e00239. [PMID: 34150969 PMCID: PMC8193152 DOI: 10.1016/j.plabm.2021.e00239] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 05/19/2021] [Accepted: 05/21/2021] [Indexed: 11/08/2022] Open
Abstract
Introduction Staining is an important histological process; however, the use of non-toxic and environmentally friendly products is generally required. We explored the staining quality of two natural plants, Allium cepa skin and Sorghum bicolor seed extract on the cytoplasm. Materials and methods Distilled water at 37 °C and 1% acid-ethanol were respectively used to extract the dyes from Allium cepa skin and Sorghum bicolor seed. Result The application of these two dyes on rodent tissue showed an excellent cytoplasmic histomorphology. Conclusion Allium cepa skin and Sorghum bicolor seed extracts are good cytoplasmic dyes when used as counterstain for haematoxylin. At acidic pH (3.5), Allium cepa skin extract stains cytoplasm and shows comparable result to eosin application. Similarly, at a pH of 7.0, crude extract from Sorghum bicolor seed stains the cytoplasm with clear cellular features. These extracts can serve as non-toxic and eco-friendly natural dyes for the demonstration of cellular and tissue morphology.
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Affiliation(s)
- Cecilia Krampah
- Department of Medical Laboratory Science, School of Allied Health Sciences, University of Ghana, Ghana
| | - Franklin Nyanzu
- Department of Medical Laboratory Science, School of Allied Health Sciences, University of Ghana, Ghana
| | - Abraham Quaye
- Department of Medical Laboratory Science, School of Allied Health Sciences, University of Ghana, Ghana
| | - Patrick Adu
- Department of Medical Laboratory Science, School of Allied Health Sciences, University of Cape Coast, Ghana
| | | | | | - David Larbi Simpong
- Department of Medical Laboratory Science, School of Allied Health Sciences, University of Cape Coast, Ghana
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Adu P. A cross-case analyses of laboratory professionals-patients interaction for patients accessing laboratory services at University of Cape Coast hospital and Ewim Polyclinic in the Cape Coast Metropolis, Ghana. BMC Health Serv Res 2021; 21:520. [PMID: 34049548 PMCID: PMC8160390 DOI: 10.1186/s12913-021-06560-8] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 05/07/2021] [Indexed: 11/19/2022] Open
Abstract
Background There is scarcity of data on experiences of patients who access laboratory services during hospital visits in sub-Saharan Africa. This study sought to evaluate the depth of laboratory professionals-patient interactions during pre- and post-sampling period at two hospitals in Ghana. Methods This study used real time observations of patient-laboratory staff interactions to collect first-hand data. Additionally, two separate sets of semi-structured questionnaires were used to collect data on the experiences of patients and laboratory professionals. Data were entered into Microsoft Excel and analysed using SPSS version 25. Results Inadequate laboratory space is a major factor limiting adequacy of patients-laboratory professionals’ interactions. Overall, even though the laboratory professionals (93.3%) overwhelmingly agreed to the need to inform patients about the turnaround time of the respective laboratory testing, this was not routinely done. Irrespective of patients’ educational attainment, patients were poorly informed about their respective laboratory tests. Although both patients and laboratory professionals (60.0% vs 63.6% respectively) indicated that the test requester has responsibility to inform patients about their laboratory testing, only 29.1% of patients indicated having received such explanations. Furthermore, although 28.1% of patients indicated knowing the specifics of their respective test requisition, only 15% could correctly identify their requested laboratory testing. Conclusion There is the need for standard operating protocols to standardize practitioner-patient interaction at the two facilities. Moreover, there is the need for laboratory staff-test requester engagement to clearly delineate who has what responsibilities regarding informing patients about laboratory testing. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-021-06560-8.
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Affiliation(s)
- Patrick Adu
- Department of Medical Laboratory Science, School of Allied Health Science, University of Cape Coast, Cape Coast, Ghana. .,Lancaster University Management School, Lancaster, UK.
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Adu P, Bennin D, Edzie RA, Owusu-Poku AG, Hakeem TU, Baba GO, Edzie EKM. Depleted iron stores in voluntary blood donors: A three-center cross-sectional study in Ghana. Asian J Transfus Sci 2021; 14:149-157. [PMID: 33767542 PMCID: PMC7983149 DOI: 10.4103/ajts.ajts_112_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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] [Received: 09/10/2018] [Accepted: 04/14/2019] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Blood donation is frequently associated with iron deficiency. Although iron deficiency is endemic in Ghana, there is a scarcity of data on iron stores in blood donors to inform donor recruitment policy. This study determined the prevalence and factors predictive of depleted iron stores in blood donors. MATERIALS AND METHODS This cross-sectional study recruited 287 blood donors from three regions in Ghana. Venous blood samples were collected for estimation of C-reactive protein, full blood count, and serum ferritin. Questionnaires were used to capture sociodemographic data. Data were analyzed using SPSS or GraphPad Prism. Multivariate logistic regression and receiver operator characteristics (ROC) analyses were, respectively, used to determine the factors associated with depleted iron stores or sensitivities of calculated red cell indices in predicting depleted iron stores in the participants. RESULTS Whereas 27.4% of the blood donors had depleted iron stores (ferritin <15 ng/dL), only 11% took iron supplementation. While ferritin levels significantly increased with age, 49.5% of the blood donors were aged 20-29 years. Whereas 39.5% of participants had never donated blood, 24.9% had donated ≥3 units of whole blood in the past 2 years. Female (adjusted odds ratio [aOR]: 7.407, P = 0.005), multiple previous donations (1-2 [aOR: 1.846, P = 0.431]; ≥3 [aOR: 6.297, P = 0.016]), no iron supplementation (aOR: 17.553, P = 0.078), or platelet count ≥150 × 109/L (aOR: 2.689, P = 0.354) significantly associated with iron depletion. ROC analyses showed that whereas mean cell hemoglobin (MCH) density (area under the curve [AUC]: 0.735, P < 0.01), MCH (AUC: 0.772, P < 0.01) or Shine and Lal (AUC: 0.736, P < 0.01) fairly predicted iron depletion, combined cell index (AUC: 0.660, P < 0.01) or Green and King (AUC: 0.603, P < 0.01) indices poorly predicted iron depletion. CONCLUSIONS More than quarter of voluntary blood donors suffers postdonation sideropenia. Calculated red cell indices should be investigated in different settings to validate usefulness in detecting iron depletion.
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Affiliation(s)
- Patrick Adu
- Department of Medical Laboratory Sciences, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana
| | - David Bennin
- Department of Medical Laboratory Sciences, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Richard Ato Edzie
- Department of Medical Laboratory Sciences, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Ama Gyasiwaah Owusu-Poku
- Department of Medical Laboratory Sciences, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Toniah Umar Hakeem
- Department of Medical Laboratory Sciences, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Glory Obadiah Baba
- Department of Medical Laboratory Sciences, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana
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Pfeffer DA, Ley B, Howes RE, Adu P, Alam MS, Bansil P, Boum Y, Brito M, Charoenkwan P, Clements A, Cui L, Deng Z, Egesie OJ, Espino FE, von Fricken ME, Hamid MMA, He Y, Henriques G, Khan WA, Khim N, Kim S, Lacerda M, Lon C, Mekuria AH, Menard D, Monteiro W, Nosten F, Oo NN, Pal S, Palasuwan D, Parikh S, Pitaloka Pasaribu A, Poespoprodjo JR, Price DJ, Roca-Feltrer A, Roh ME, Saunders DL, Spring MD, Sutanto I, Ley-Thriemer K, Weppelmann TA, von Seidlein L, Satyagraha AW, Bancone G, Domingo GJ, Price RN. Quantification of glucose-6-phosphate dehydrogenase activity by spectrophotometry: A systematic review and meta-analysis. PLoS Med 2020; 17:e1003084. [PMID: 32407380 PMCID: PMC7224463 DOI: 10.1371/journal.pmed.1003084] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 04/13/2020] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND The radical cure of Plasmodium vivax and P. ovale requires treatment with primaquine or tafenoquine to clear dormant liver stages. Either drug can induce haemolysis in individuals with glucose-6-phosphate dehydrogenase (G6PD) deficiency, necessitating screening. The reference diagnostic method for G6PD activity is ultraviolet (UV) spectrophotometry; however, a universal G6PD activity threshold above which these drugs can be safely administered is not yet defined. Our study aimed to quantify assay-based variation in G6PD spectrophotometry and to explore the diagnostic implications of applying a universal threshold. METHODS AND FINDINGS Individual-level data were pooled from studies that used G6PD spectrophotometry. Studies were identified via PubMed search (25 April 2018) and unpublished contributions from contacted authors (PROSPERO: CRD42019121414). Studies were excluded if they assessed only individuals with known haematological conditions, were family studies, or had insufficient details. Studies of malaria patients were included but analysed separately. Included studies were assessed for risk of bias using an adapted form of the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool. Repeatability and intra- and interlaboratory variability in G6PD activity measurements were compared between studies and pooled across the dataset. A universal threshold for G6PD deficiency was derived, and its diagnostic performance was compared to site-specific thresholds. Study participants (n = 15,811) were aged between 0 and 86 years, and 44.4% (7,083) were women. Median (range) activity of G6PD normal (G6PDn) control samples was 10.0 U/g Hb (6.3-14.0) for the Trinity assay and 8.3 U/g Hb (6.8-15.6) for the Randox assay. G6PD activity distributions varied significantly between studies. For the 13 studies that used the Trinity assay, the adjusted male median (AMM; a standardised metric of 100% G6PD activity) varied from 5.7 to 12.6 U/g Hb (p < 0.001). Assay precision varied between laboratories, as assessed by variance in control measurements (from 0.1 to 1.5 U/g Hb; p < 0.001) and study-wise mean coefficient of variation (CV) of replicate measures (from 1.6% to 14.9%; p < 0.001). A universal threshold of 100% G6PD activity was defined as 9.4 U/g Hb, yielding diagnostic thresholds of 6.6 U/g Hb (70% activity) and 2.8 U/g Hb (30% activity). These thresholds diagnosed individuals with less than 30% G6PD activity with study-wise sensitivity from 89% (95% CI: 81%-94%) to 100% (95% CI: 96%-100%) and specificity from 96% (95% CI: 89%-99%) to 100% (100%-100%). However, when considering intermediate deficiency (<70% G6PD activity), sensitivity fell to a minimum of 64% (95% CI: 52%-75%) and specificity to 35% (95% CI: 24%-46%). Our ability to identify underlying factors associated with study-level heterogeneity was limited by the lack of availability of covariate data and diverse study contexts and methodologies. CONCLUSIONS Our findings indicate that there is substantial variation in G6PD measurements by spectrophotometry between sites. This is likely due to variability in laboratory methods, with possible contribution of unmeasured population factors. While an assay-specific, universal quantitative threshold offers robust diagnosis at the 30% level, inter-study variability impedes performance of universal thresholds at the 70% level. Caution is advised in comparing findings based on absolute G6PD activity measurements across studies. Novel handheld quantitative G6PD diagnostics may allow greater standardisation in the future.
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Affiliation(s)
- Daniel A. Pfeffer
- Global and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, Australia
- * E-mail:
| | - Benedikt Ley
- Global and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, Australia
| | - Rosalind E. Howes
- Malaria Atlas Project, Big Data Institute, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
- Foundation for Innovative New Diagnostics, Geneva, Switzerland
| | - Patrick Adu
- Department of Medical Laboratory Sciences, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Mohammad Shafiul Alam
- Infectious Diseases Division, International Centre for Diarrheal Diseases Research, Bangladesh, Mohakhali, Dhaka, Bangladesh
| | - Pooja Bansil
- Diagnostics Program, PATH, Seattle, Washington, United States of America
| | - Yap Boum
- Médecins sans Frontières Epicentre, Mbarara Research Centre, Mbarara, Uganda
- Mbarara University of Science and Technology, Mbarara, Uganda
| | - Marcelo Brito
- Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Amazonas, Brasil
| | - Pimlak Charoenkwan
- Division of Hematology and Oncology, Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Archie Clements
- Faculty of Health Sciences, Curtin University, Bentley, Australia
- Telethon Kids Institute, Nedlands, Australia
| | - Liwang Cui
- Department of Entomology, Pennsylvania State University, University Park, Pennsylvania, United States of America
| | - Zeshuai Deng
- Department of Cell Biology and Medical Genetics, Kunming Medical University, Kunming, Yunnan Province, China
| | - Ochaka Julie Egesie
- Department of Hematology and Blood Transfusion, Faculty of Medical Sciences, University of Jos and Jos University Teaching Hospital, Jos, Plateau State, Nigeria
| | - Fe Esperanza Espino
- Department of Parasitology, Research Institute for Tropical Medicine, Department of Health, Alabang, Muntinlupa City, Philippines
| | - Michael E. von Fricken
- Department of Global and Community Health, George Mason University, Fairfax, Virginia, United States of America
| | - Muzamil Mahdi Abdel Hamid
- Department of Parasitology and Medical Entomology, Institute of Endemic Diseases, University of Khartoum, Khartoum, Republic of the Sudan
| | - Yongshu He
- Department of Cell Biology and Medical Genetics, Kunming Medical University, Kunming, Yunnan Province, China
| | - Gisela Henriques
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Wasif Ali Khan
- Infectious Diseases Division, International Centre for Diarrheal Diseases Research, Bangladesh, Mohakhali, Dhaka, Bangladesh
| | - Nimol Khim
- Malaria Molecular Epidemiology Unit, Institut Pasteur du Cambodge, Phnom Penh, Cambodia
| | - Saorin Kim
- Malaria Molecular Epidemiology Unit, Institut Pasteur du Cambodge, Phnom Penh, Cambodia
| | - Marcus Lacerda
- Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Amazonas, Brasil
| | - Chanthap Lon
- Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | | | - Didier Menard
- Malaria Genetics and Resistance Group, Institut Pasteur, Paris, France
| | - Wuelton Monteiro
- Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Amazonas, Brasil
| | - François Nosten
- Shoklo Malaria Research Unit, Mahidol–Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand
- Centre for Tropical Medicine & Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Nwe Nwe Oo
- Department of Medical Research, Lower Myanmar, Yangon, Myanmar
| | - Sampa Pal
- Diagnostics Program, PATH, Seattle, Washington, United States of America
| | - Duangdao Palasuwan
- Oxidation in Red Cell Disorders and Health Research Unit, Department of Clinical Microscopy, Faculty of Allied Health Sciences, Chulalongkorn University, Bangkok, Thailand
| | - Sunil Parikh
- Yale School of Public Health, New Haven, Connecticut, United States of America
| | | | | | - David J. Price
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
- The Peter Doherty Institute for Infection and Immunity, The University of Melbourne and Royal Melbourne Hospital, Melbourne, Australia
| | | | - Michelle E. Roh
- Global Health Group, Malaria Elimination Initiative, University of California, San Francisco, San Francisco, United States of America
| | - David L. Saunders
- Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
- F. Edward Hebert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, United States of America
- US Army Medical Materiel Development Activity, Fort Detrick, Maryland, United States of America
| | - Michele D. Spring
- Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | | | - Kamala Ley-Thriemer
- Global and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, Australia
| | - Thomas A. Weppelmann
- Herbert Wertheim College of Medicine, Florida International University, Miami, Florida, United States of America
| | - Lorenz von Seidlein
- Shoklo Malaria Research Unit, Mahidol–Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | | | - Germana Bancone
- Shoklo Malaria Research Unit, Mahidol–Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand
- Centre for Tropical Medicine & Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Gonzalo J. Domingo
- Diagnostics Program, PATH, Seattle, Washington, United States of America
| | - Ric N. Price
- Global and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, Australia
- Centre for Tropical Medicine & Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
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Adu P, Attivor W, Nartey ST, Ephraim RKD, Awuku YA. Low iron stores in preconception nulliparous women; a two-center cross-sectional study in peri-urban Ghana. Nutrition 2019; 71:110604. [PMID: 31811997 DOI: 10.1016/j.nut.2019.110604] [Citation(s) in RCA: 6] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 09/25/2019] [Accepted: 09/25/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVES The nutritional status of women affects pregnancy outcomes. Preconception care adequately prepares women for the demands of pregnancy. The aim of this study was to evaluate the prepregnancy iron status of nulliparous women in Ghana to provide empirical data to inform policy formulation. METHODS We recruited 336 nulliparous women of reproductive age from Denkyembour District and Ejura Municipal assemblies, respectively, in the Eastern and Ashanti regions of Ghana. Serum ferritin was estimated to assess the women's iron stores. Hemoglobin (Hb) variants and fecal occult blood were determined for participants using cellulose acetate electrophoresis and lateral flow chromatographic immunoassay, respectively. Logistic regression analysis was used to determine factors associated with depleted iron stores (ferritin < 15 ng/dL). RESULTS Whereas 41.5% of the women were anemic (Hb <11.5 g/dL), 34.5% were iron depleted (serum ferritin <15 g/mL; C-reactive protein <5 ng/dL). Also, 17.1% suffered from iron deficiency anemia (concomitant Hb <11.5 g/dL and serum ferritin <15 ng/dL). Serum ferritin significantly differed among the participants with anemia (P < 0.001). Multivariate regression analysis showed that age (<20 y: adjusted odds ratio [AOR], 13.916, P = 0.002; 20-30 y: AOR, 4.304, P = 0.023), moderate anemia (AOR, 3.045, P = 0.004), Ashanti region (AOR, 3.984, P = 0.002), and mean cell volume <80 fL (AOR, 2.546, P = 0.003) were significantly associated with increased odds of having depleted iron stores. However, body mass index, waist-to-hip ratio >0.85, educational status, or inherited Hb type were not significantly associated with depleted iron stores. CONCLUSION The high prevalence of depleted iron stores in nulliparous women is a severe public health problem that requires attention.
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Affiliation(s)
- Patrick Adu
- Department of Medical Laboratory Science, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana.
| | - Waldemer Attivor
- Department of Medical Laboratory Science, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana.
| | - Sampson Takyi Nartey
- Department of Medical Laboratory Science, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana.
| | - Richard K D Ephraim
- Department of Medical Laboratory Science, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana.
| | - Yaw A Awuku
- Department of Medicine and Therapeutics, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana.
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Aninagyei E, Doku ET, Adu P, Egyir-Yawson A, Acheampong DO. Storage related haematological and biochemical changes in Plasmodium falciparum infected and sickle cell trait donor blood. BMC Hematol 2018; 18:30. [PMID: 30450212 PMCID: PMC6220467 DOI: 10.1186/s12878-018-0128-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Accepted: 10/28/2018] [Indexed: 01/05/2023]
Abstract
Background In sub-Saharan Africa where sickle cell trait (SCT) and malaria is prevalent, significant proportions of blood donors may be affected by one or more of these abnormalities. The haemato-biochemical properties of SCT and asymptomatic malaria in donor blood have not been evaluated. This study evaluated the haemato-biochemical impact of SCT and asymptomatic malaria infections in citrate-phosphate-dextrose-adenine (CPDA-1) stored donor blood units. Methods Fifty-milliliters of sterile CPDA-1 anti-coagulated blood were drained into the sample pouch attached to the main blood bag. Ten units each of sickle cell/malaria negative, sickle cell and malaria positive blood were analyzed. Baseline and weekly haematological profiling and week 1, 3 and 5 concentrations of plasma haemoglobin, % haemolysis, sodium, potassium and chloride and lactate dehydrogenase (LDH) were assayed. Differences between baseline and weekly data were determined using one-way analysis of variance (ANOVA) and Kruskal-Wallis test, whereas differences between baseline parameters and week 1-3 data pairs were determined using paired t-test. P-value < 0.05 was considered statistically significant. Results Storage of SCT and malaria infected blood affected all haematological cell lines. In the SCT donors, red blood cells (RBC) (4.75 × 1012/L ± 1.43baseline to 3.49 × 1012/L ± 1.09week-5), haemoglobin (14.45 g/dl ± 1.63baseline to 11.43 g/dl ± 1.69week-5) and haematocrit (39.96% ± 3.18baseline to 33.22% ± 4.12week-5) were reduced. In the asymptomatic malaria group, reductions were observed in RBC (5.00 × 1012/L ± 0.75baseline to 3.72 × 1012/L ± 0.71week-5), haemoglobin (14.73 g/dl ± 1.67baseline to 11.53 g/dl ± 1.62week-5), haematocrit (42.72% ± 5.16baseline to 33.38% ± 5.80week-5), mean cell haemoglobin concentration (35.48 g/dl ± 1.84baseline to 35.01 g/dl ± 0.64week-5) and red cell distribution width coefficient of variation (14.81% ± 1.54baseline to 16.26% ± 1.37week-5). Biochemically, whereas plasma LDH levels significantly increased in asymptomatic malaria blood donors (319% increase at week 5 compared to baseline), SCT blood donors had the most significant increase in plasma potassium levels at week 5 (382% increase). Sodium ions significantly reduced in SCT/malaria negative and sickle cell trait blood at an average rate of 0.21 mmol/L per day. Moreover, elevations in lymphocytes-to-eosinophils and lymphocytes-to-neutrophils ratios were associated with SCT and malaria positive blood whilst elevation lymphocytes-to-basophils ratio was exclusive to malaria positive blood. Conclusion Severe storage lesions were significant in SCT or malaria positive donor blood units. Proper clinical evaluation must be done in prospective blood donors to ensure deferral of such donors.
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Affiliation(s)
- Enoch Aninagyei
- 1Department of Biomedical Sciences, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana
| | | | - Patrick Adu
- 3Department of Medical Laboratory Technology, University of Cape Coast, Cape Coast, Ghana
| | - Alexander Egyir-Yawson
- 1Department of Biomedical Sciences, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Desmond Omane Acheampong
- 1Department of Biomedical Sciences, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana
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Ephraim RK, Awuku YA, Adu P, Ampomah LT, Adoba P, Panford S, Ninnoni JP, Agbodzakey H. High risk of coagulopathy among Type-2 Diabetes Mellitus clients at a municipal hospital in Ghana. Ghana Med J 2018; 51:101-107. [PMID: 29622820 DOI: 10.4314/gmj.v51i3.2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Persistent hyperglycaemia in diabetes mellitus causes coagulopathies due to glycation of haemoglobin, prothrombin, fibrinogen and other proteins involved in the clotting mechanism. Shortened activated partial thromboplastin time (APTT) and prothrombin time (PT) reflect hypercoagulable state, which is associated with an increased thrombotic risk and adverse cardiovascular effects. This study assessed the coagulation profile of type 2 diabetes mellitus (T2DM) clients at a municipal hospital in Ghana. Methods A hospital-based case-control study was conducted from January to April 2015 at the Agona Swedru Municipal Hospital. Sixty (60) persons with T2DM and 40 without were recruited and screened using appropriate protocols. Blood samples were collected for coagulation and biochemical tests. Demographic and clinical information were collected using pre-tested questionnaire. Data was analyzed with GraphPad Prism version 5. Results APTT and PT were significantly shorter among patients with T2DM compared to those without (20.88 ± 5.19 v 31.23 ± 5.41, P=0.0001; and 11.03 ± 2.06sec v 14.46 ± 1.86, P=0.0001 respectively). INR was decreased among patients with T2DM compared to those without (0.83 ± 0.18 v 1.13 ± 0.17, P=0.0001). No significant difference was found in platelet count between T2DM and non-diabetics (179.85 ± 66.15×103 /mm3 v 168.55 ± 35.77×103 /mm3, P=0.326). Serum magnesium was lower among the T2DM patients compared to the non-diabetics, while serum ionized calcium was significantly higher among the T2DM patients (P<0.05). Conclusion Clients with T2DM may have a high coagulation risk evidenced by shortened APTT, PT and a high ionized calcium compared with controls. Funding Study was funded by Lord Ampomah and Solomon Panford.
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Affiliation(s)
- Richard Kd Ephraim
- Department of Medical Laboratory Science, School of Allied Health Sciences, University of Cape Coast, Cape Coast
| | - Yaw A Awuku
- Department of Internal Medicine and Therapeutics, University of Cape Coast, Cape Coast
| | - Patrick Adu
- Department of Medical Laboratory Science, School of Allied Health Sciences, University of Cape Coast, Cape Coast
| | - Lord Tw Ampomah
- Department of Medical Laboratory Science, School of Allied Health Sciences, University of Cape Coast, Cape Coast
| | - Prince Adoba
- Department of Molecular Medicine, School of Medical Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Solomon Panford
- Department of Medical Laboratory Science, School of Allied Health Sciences, University of Cape Coast, Cape Coast
| | - Jerry Pk Ninnoni
- Department of Mental Health, School of Nursing, University of Cape Coast, Cape Coast, Ghana
| | - Hope Agbodzakey
- Department of Medical Laboratory Science, School of Allied Health Sciences, University of Cape Coast, Cape Coast.,Department of Internal Medicine and Therapeutics, University of Cape Coast, Cape Coast.,Department of Molecular Medicine, School of Medical Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.,Department of Mental Health, School of Nursing, University of Cape Coast, Cape Coast, Ghana
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Spiegel JM, Jones D, Darwin L, Adu P, Yassi A. 847 Successfully implementing information systems to improve occupational health and safety performance – 1: challenges and opportunities. Health Serv Res 2018. [DOI: 10.1136/oemed-2018-icohabstracts.521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Jones D, Darwin L, Wilson K, Kisting S, Spiegel JM, Adu P, Yassi A. 861 Successfully implementing information systems to improve occupational health and safety performance – 2: case studies. Health Serv Res 2018. [DOI: 10.1136/oemed-2018-icohabstracts.522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Dadzie Ephraim RK, Ahadzie JE, Adu P, Boachie J, Agbodzakey H, Adoba P, Cudjoe O. Abnormal coagulation profile in people living with HIV-AIDS on combined Antiretroviral Therapy: findings from a case-control study in the Ho municipality, Ghana. Pan Afr Med J 2018. [DOI: 10.11604/pamj.2018.29.121.7811] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Abstract
Haemoglobinopathies are common in sub-Saharan Africa. As such haemoglobin electrophoresis are required to inform clinical decision making. However, haemoglobin electrophoresis is an assay that detects protein at either alkaline or acidic pH. Such assays do not interrogate gene sequences but rather the product of a gene. As many post-transcriptional and post-translational modifications impact the final output of the gene (i.e. protein), presentation of such protein-based assay must accurately reflect the technique employed. It is grossly misleading and scientifically inaccurate to report cellulose acetate and/or citrate agar haemoglobin electrophoresis results as 'haemoglobin genotype'. We propose a new paradigm in which haemoglobin electrophoresis data would be presented as 'haemoglobin phenotype' at a specified pH. FUNDING None declared.
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Affiliation(s)
- Patrick Adu
- Department of Medical Laboratory Technology, School of Allied Health Sciences, University of Cape Coast, Ghana
| | | | - Kate Kontor
- Medical OPD, Cape Coast Teaching Hospital, Cape Coast, Ghana
| | - Richrd Kd Ephraim
- Department of Medical Laboratory Technology, School of Allied Health Sciences, University of Cape Coast, Ghana
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Awuku YA, Simpong DL, Alhassan IK, Tuoyire DA, Afaa T, Adu P. Prevalence of helicobacter pylori infection among children living in a rural setting in Sub-Saharan Africa. BMC Public Health 2017; 17:360. [PMID: 28438158 PMCID: PMC5404296 DOI: 10.1186/s12889-017-4274-z] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Accepted: 04/20/2017] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Helicobacter pylori infection affects more than half of the world's population. It is generally acquired during childhood with no symptoms but has long- term clinical sequelae. This study estimated the prevalence of H. pylori infection amongst children in a rural environment in Africa. METHODS We conducted a cross-sectional study over a four (4)-month period within two rural communities. 240 asymptomatic children were tested using lateral flow immunochromatographic assay for the qualitative detection of H. pylori antigen in a fecal specimen. Statistical analysis and processing was done using Stata version 11. RESULTS The mean age of the participants was 10.5 ± 2.7 years with the predominant age range being 8-10 years (34.6%), and a mean household size of 7.1 ± 1.7. The study population showed a female preponderance of 57.1%. 88% of the H. pylori positive children lacked pipe and borehole drinking water. All of the positive H. pylori children practiced open-air defecation. The overall prevalence of H. pylori infection among children in this study was at least 14.2%. CONCLUSION Our study demonstrated a high prevalence of H. pylori infection among children in a rural setting. Educational status of parents did not affect H. pylori prevalence but increasing household numbers, female gender, source of drinking water other than pipe and borehole, open-air defecation and younger age were associated with a higher H. pylori prevalence.
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Affiliation(s)
- Yaw Asante Awuku
- Department of Medicine and Therapeutics, University of Cape Coast, Cape Coast, Ghana.
| | - David Larbi Simpong
- Department of Medical Laboratory Technology, University of Cape Coast, Cape Coast, Ghana
| | | | | | - Taiba Afaa
- Department of Child Health, University of Ghana, Accra, Ghana
| | - Patrick Adu
- Department of Medical Laboratory Technology, University of Cape Coast, Cape Coast, Ghana
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Simpong DL, Adu P, Bashiru R, Morna MT, Yeboah FA, Akakpo K, Ephraim RKD. Assessment of iodine status among pregnant women in a rural community in ghana - a cross sectional study. Arch Public Health 2016; 74:8. [PMID: 26904197 PMCID: PMC4762158 DOI: 10.1186/s13690-016-0119-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Accepted: 01/11/2016] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Pregnancy is associated with parallel increase in both iodine, and thyroid hormone requirements suggesting that, there may be the need for additional iodine intake during this period to prevent potential iodine insufficiency. Medically, an excess or reduced intake of this micronutrient has negative effects on the individual's health. This study aimed at identifying the pattern of iodine levels among pregnant women at Kissi, Ghana. METHOD A cross-sectional study was carried out among pregnant women on antenatal care at Kissi Health Centre (KHC) which serves the rural town with a population of about 4,500, located in the Komenda/Edina/Eguafo/Abirem (KEEA) municipality in the Central Region of Ghana. Demographic information, iodated salt usage and other pertinent information such as tobacco use were captured using a questionnaire. In addition, urine iodine concentration was estimated through the Ammonium per sulfate method after collecting on-the-spot urine samples. RESULTS Prevalence of iodine deficiency in pregnant women was 42.5 %. Of the 80 participants who were on iodized salt, only 16.25 % had mild iodine deficiency with none suffering from moderate or severe iodine deficiency. Of the 40 participants who did not use iodized salt, 35 %, 30 %, and 30 % suffered from severe, moderate and mild iodine deficiency respectively. CONCLUSION The high prevalence of iodine deficiency reported in this study suggests that urgent national measures are required to correct iodine insufficiency in pregnant women in these communities.
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Affiliation(s)
- David L. Simpong
- />Department of Laboratory Technology, School of Allied Health Science, University of Cape Coast, Cape Coast, Ghana
| | - Patrick Adu
- />Institute of Infection and Inflammation, University of Glasgow, Glasgow, UK
| | - Rashid Bashiru
- />Department of Laboratory Technology, School of Allied Health Science, University of Cape Coast, Cape Coast, Ghana
| | - Martin T. Morna
- />School of Medical Sciences, University of Cape Coast, Cape Coast, Ghana
| | | | - Kafui Akakpo
- />School of Medical Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Richard K. D. Ephraim
- />Department of Laboratory Technology, School of Allied Health Science, University of Cape Coast, Cape Coast, Ghana
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Ephraim RKD, Tashie W, Agbodzakey H, Sakyi SA, Essien-Baidoo S, Adoba P, Adu P, Ampong J. Dipstick urinalysis findings in children with Plasmodium falciparum in the South Tongu District: A case-control study. Niger Med J 2016; 56:292-6. [PMID: 26759517 PMCID: PMC4697220 DOI: 10.4103/0300-1652.169748] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 12/02/2022] Open
Abstract
Background: Malaria ranks among the major health and developmental challenges facing some of the poorest countries in tropical and sub-tropical regions across the globe. We determined urinary abnormalities and its relationship with parasite density in children ≤12 years with Plasmodium falciparum infection. Materials and Methods: From December 2013 to March 2014, we randomly recruited 116 participants comprising 58 malaria patients (cases) and 58 healthy controls from the Comboni Mission and the Sogakope District Hospitals both in the South Tongu district. Blood was collected for the estimation of hemoglobin and total white blood cells; thick and thin blood films were used for the determination of malaria parasite density. Urine was collected for the measurement of the various biochemical components using the automated urine analyzer. A pretested questionnaire was used to obtain demographic and clinical data. Results: Urine protein (P < 0.001), blood (P < 0.001), bilirubin (P < 0.001), urobilinogen (P < 0.001), and ketones (P = 0.001) were significantly higher in individuals with P. falciparum infection than in healthy controls. Proteinuria (P = 0.247; r = 0.155), hematuria (P = 0.142; r = 0.195), bilirubinuria (P = 0.001; r = 0.438), urobilinogenuria (P = 0.876; r = 0.021), and ketonuria (P = 0.136; r = 0.198) were positively correlated with malaria parasite density; however, only bilirubinuria was significantly higher at higher parasitemia. Conclusion: Malaria has a significant effect on the chemical composition of urine with bilirubin positively correlated with parasite density. Dipstick urinalysis can be used together with light microscopy in resource-limited malaria-endemic areas to accurately diagnose falciparum malaria infection.
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Affiliation(s)
- Richard K D Ephraim
- Department of Medical Laboratory Technology, University of Cape Coast, Cape Coast, Ghana
| | - Worlanyo Tashie
- Department of Medical Laboratory Technology, University of Cape Coast, Cape Coast, Ghana
| | - Hope Agbodzakey
- Department of Medical Laboratory Technology, University of Cape Coast, Cape Coast, Ghana
| | - Samuel Asamoah Sakyi
- Department of Molecular Medicine, School of Medical Science, Kwame Nkrumah University of Science and Technology, Kumasi, Legon, Ghana; Department of Bacteriology, Noguchi Memorial Institute for Medical Research, Legon, Ghana
| | - Samuel Essien-Baidoo
- Department of Medical Laboratory Technology, University of Cape Coast, Cape Coast, Ghana
| | - Prince Adoba
- Department of Medical Laboratory Technology, University of Cape Coast, Cape Coast, Ghana
| | - Patrick Adu
- Department of Medical Laboratory Technology, University of Cape Coast, Cape Coast, Ghana
| | - Joyce Ampong
- Department of Medical Laboratory Technology, University of Cape Coast, Cape Coast, Ghana
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