Search

Highlights • Unresolved previous infection as major cause of recurring tuberculosis (TB) in Ghana. • Genomic epidemiology identifies high relapse among recurrent TB cases in Ghana. • 15-locus MIRU-VNTR typing is sufficient to predict the cause of TB recurrence. • Evidence of recent household-related TB transmission in Ghana. • Need for increased education by national TB control program., Objective To retrospectively investigate the cause of recurring tuberculosis (rcTB) among participants with pulmonary TB recruited from a prospective population-based study conducted between July 2012 and December 2015. Methods Mycobacterium tuberculosis complex isolates obtained from rcTB cases were characterized by standard mycobacterial genotyping tools, whole-genome sequencing, and phylogenetic analysis carried out to assess strain relatedness. Results The majority (58.3%, 21/36) of study participants with rcTB episodes had TB recurrence within 12 months post treatment. TB strains with isoniazid (INH) resistance were found in 19.4% (7/36) of participants at the primary episode, of which 29% (2/7) were also rifampicin-resistant. On TB recurrence, an INH-resistant strain was found in a larger proportion of participants, 27.8% (10/36), of which 40% (4/10) were MDR-TB strains. rcTB was attributed to relapse (same strain) in 75.0% (27/36) of participants and 25.0% (9/36) to re-infection. Conclusion Our findings indicate that previous unresolved infectiondue to inadequate treatment, may be the major cause of rcTB.

BACKGROUND: Buruli ulcer is a neglected tropical disease caused by Mycobacterium ulcerans infection that damages the skin and subcutis. It is most prevalent in western and central Africa and Australia. Standard antimicrobial treatment with oral rifampicin 10 mg/kg plus intramuscular streptomycin 15 mg/kg once daily for 8 weeks (RS8) is highly effective, but streptomycin injections are painful and potentially harmful. We aimed to compare the efficacy and tolerability of fully oral rifampicin 10 mg/kg plus clarithromycin 15 mg/kg extended release once daily for 8 weeks (RC8) with that of RS8 for treatment of early Buruli ulcer lesions.METHODS: We did an open-label, non-inferiority, randomised (1:1 with blocks of six), multicentre, phase 3 clinical trial comparing fully oral RC8 with RS8 in patients with early, limited Buruli ulcer lesions. There were four trial sites in hospitals in Ghana (Agogo, Tepa, Nkawie, Dunkwa) and one in Benin (Pobè). Participants were included if they were aged 5 years or older and had typical Buruli ulcer with no more than one lesion (caterories I and II) no larger than 10 cm in diameter. The trial was open label, and neither the investigators who took measurements of the lesions nor the attending doctors were masked to treatment assignment. The primary clinical endpoint was lesion healing (ie, full epithelialisation or stable scar) without recurrence at 52 weeks after start of antimicrobial therapy. The primary endpoint and safety were assessed in the intention-to-treat population. A sample size of 332 participants was calculated to detect inferiority of RC8 by a margin of 12%. This study was registered with ClinicalTrials.gov, NCT01659437.FINDINGS: Between Jan 1, 2013, and Dec 31, 2017, participants were recruited to the trial. We stopped recruitment after 310 participants. Median age of participants was 14 years (IQR 10-29) and 153 (52%) were female. 297 patients had PCR-confirmed Buruli ulcer; 151 (51%) were assigned to RS8 treatment, and 146 (49%) received oral RC8 treatment. In the RS8 group, lesions healed in 144 (95%, 95% CI 91 to 98) of 151 patients, whereas lesions healed in 140 (96%, 91 to 99) of 146 patients in the RC8 group. The difference in proportion, -0·5% (-5·2 to 4·2), was not significantly greater than zero (p=0·59), showing that RC8 treatment is non-inferior to RS8 treatment for lesion healing at 52 weeks. Treatment-related adverse events were recorded in 20 (13%) patients receiving RS8 and in nine (7%) patients receiving RC8. Most adverse events were grade 1-2, but one (1%) patient receiving RS8 developed serious ototoxicity and ended treatment after 6 weeks. No patients needed surgical resection. Four patients (two in each study group) had skin grafts.INTERPRETATION: Fully oral RC8 regimen was non-inferior to RS8 for treatment of early, limited Buruli ulcer and was associated with fewer adverse events. Therefore, we propose that fully oral RC8 should be the preferred therapy for early, limited lesions of Buruli ulcer.FUNDING: WHO with additional support from MAP International, American Leprosy Missions, Fondation Raoul Follereau France, Buruli ulcer Groningen Foundation, Sanofi-Pasteur, and BuruliVac.

Background: In high-income countries, mortality related to hospitalized patients with the Coronavirus disease 2019 (COVID-19) is approximately 4-5% However, data on COVID-19 admissions from sub-Saharan Africa are scanty Objective: To describe the clinical profile and determinants of outcomes of patients with confirmed COVID-19 admitted at a hospital in Ghana Methods: A prospective study involving 25 patients with real time polymerase chain reaction confirmed COVID-19 admitted to the treatment centre of the University Hospital, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana from 1st June to 27th July, 2020 They were managed and followed up for outcomes Data were analysed descriptively, and predictors of mortality assessed using a multivariate logistic regression modelling Results: The mean age of the patients was 59 3 ± 20 6 years, and 14 (56%) were males The main symptoms at presentation were breathlessness (68%) followed by fever (56%) The cases were categorized as mild (6), moderate (6), severe (10) and critical (3) Hypertension was the commonest comorbidity present in 72% of patients Medications used in patient management included dexamethasone (68%), azithromycin (96%), and hydroxychloroquine (4%) Five of 25 cases died (Case fatality ratio 20%) Increasing age and high systolic blood pressure were associated with mortality Conclusion: Case fatality in this sample of hospitalized COVID-19 patients was high Thorough clinical assessment, severity stratification, aggressive management of underlying co-morbidities and standardized protocols in-country might improve outcomes © 2021 Bioexcel Publishing LTD All rights reserved

Tuberculosis (TB), an airborne infectious disease caused by Mycobacterium tuberculosis complex (MTBC), remains a global health problem. West Africa has a unique epidemiology of TB that is characterized by medium- to high-prevalence. Moreover, the geographical restriction of M. africanum to the sub-region makes West Africa have an extra burden to deal with a two-in-one pathogen. The region is also burdened with low case detection, late reporting, poor treatment adherence leading to development of drug resistance and relapse. Sporadic studies conducted within the subregion report higher burden of drug resistant TB (DRTB) than previously thought. The need for more sensitive and robust tools for routine surveillance as well as to understand the mechanisms of DRTB and transmission dynamics for the design of effective control tools, cannot be overemphasized. The advancement in molecular biology tools including traditional fingerprinting and next generation sequencing (NGS) technologies offer reliable tools for genomic epidemiology. Genomic epidemiology provides in-depth insight of the nature of pathogens, circulating strains and their spread as well as prompt detection of the emergence of new strains. It also offers the opportunity to monitor treatment and evaluate interventions. Furthermore, genomic epidemiology can be used to understand potential emergence and spread of drug resistant strains and resistance mechanisms allowing the design of simple but rapid tools. In this review, we will describe the local epidemiology of MTBC, highlight past and current investigations toward understanding their biology and spread as well as discuss the relevance of genomic epidemiology studies to TB control in West Africa.

Germ cells are physically coupled to somatic support cells of the gonad during differentiation, but this coupling must be disrupted when they are mature, freeing them to participate in fertilization. In mammalian females, coupling occurs via specialized filopodia that project from the ovarian follicular granulosa cells to the oocyte. Here, we show that signaling through the epidermal growth factor receptor (EGFR) in the granulosa, which becomes activated at ovulation, uncouples the germ and somatic cells by triggering a massive and temporally synchronized retraction of the filopodia. Although EGFR signaling triggers meiotic maturation of the oocyte, filopodial retraction is independent of the germ cell state, being regulated solely within the somatic compartment, where it requires ERK-dependent calpain-mediated loss of filopodia-oocyte adhesion followed by Arp2/3-mediated filopodial shortening. By uncovering the mechanism regulating germ-soma uncoupling at ovulation, our results open a path to improving oocyte quality in human and animal reproduction., Uncoupling of mature oocytes from somatic granulosa cells is required for their fertilization. Here the authors show that activation of EGFR signalling in granulosa cells during ovulation triggers ERK-dependent loss of filopodia oocyte adhesion, and Arp2/3 mediated retraction of granulosa cell filopodia.

Objectives. This study aimed to describe the prevalence of ergonomic factors associated with computer vision syndrome (CVS), and knowledge and practices of computer usage among bank workers in the Cape Coast Metropolis, Ghana. Methods. A comprehensive eye examination was performed for 139 bankers in the Cape Coast Metropolis. Measurements of ergonomic practices at workstations were carried out and self-administered questionnaires were used to collect socio-demographic data, symptoms of CVS and associated factors as well as knowledge, attitudes and practices of the bankers on CVS. Descriptive statistics and logistic regression were carried out to compute the different proportions and relevant associations. Results. Headaches (73.4%), eyestrain (65.5%) and itching (63.3%) were the most common reported symptoms. The prevalence of CVS in the study population was 71.2% with a high level of poor ergonomic practices (78.4%) at computer workstations. With regard to knowledge, attitudes and practices of the participants on CVS, 68.3% of the participants had low levels of knowledge on CVS, while 90.6% had negative attitudes towards CVS and 46.0% of the participants had poor practices. Conclusion. Bankers had a high prevalence of CVS. Ergonomic practices, females and computer usage were all associated significantly with the presence of CVS.

Background: There is limited evidence that syndesmotic implant removal (SIR) is beneficial. However, many surgeons advocate removal based on studies suggesting improved motion. Methodologic difficulties make the validity and applicability of previous works questionable. The purpose of this study was to examine the effect of ankle dorsiflexion after SIR using radiographically measured motion before and after screw removal utilizing a standardized load. Methods: All patients undergoing isolated SIR were candidates for inclusion. Dorsiflexion was measured radiographically: (1) immediately before implant removal intraoperatively, (2) immediately after removal intraoperatively, and (3) 3 months after removal. A standardized torque force was applied to the ankle and a perfect lateral radiograph of the ankle was obtained. Four reviewers independently measured dorsiflexion on randomized, deidentified images. A total of 29 patients met inclusion criteria. All syndesmotic injuries were associated with rotational ankle fractures. There were 11 men (38%) and 18 women (62%). The mean, and standard deviation, age was 50.3 ± 16.9 years (range 19-80). Results: The mean ankle dorsiflexion pre-operatively, post-operatively, and at a 3-month follow-up was 13.7 ± 6.6 degrees, 13.3 ± 7.3 degrees and 11.8 ± 11.3 degrees, respectively ( P = .466). For subsequent analysis, 5 patients were excluded because of the potential confounding effect of retained suture button devices. Analysis of the remaining 24 patients (and final analysis of 21 patients who had complete 3-month follow-up) demonstrated similar results with no statistically significant difference in ankle dorsiflexion at all 3 time points. Conclusion: Removal of syndesmotic screws may not improve ankle dorsiflexion motion and should not be used as the sole indication for screw removal. Level of Evidence: Level II, prospective cohort study.

Background and Objectives: Increasing the number of underrepresented minority (URM) physicians improves access and quality of care. URMs are more likely to practice primary care and work in underserved communities. The racial and ethnic diversity of family physicians lags behind the general population. To create a more diverse residency, the Boston Medical Center Family Medicine Residency Program (BMCFMRP) developed, implemented, and evaluated a strategic plan for diversity recruitment. Methods: In academic year (AY) 2014-2015, we set goals to increase the number of URM applicants and the percentage of matched URMs. From 2014-2017, we implemented an intervention focused on: (1) increasing outreach to URM candidates, (2) revising interviews to minimize bias, and (3) analyzing recruitment data. Results: From 2014-2017, the total number of URM applicants increased by 80% (61 to 110). Evaluating recruitment trends from 2010-2017, there was a statistically significant increase (P

SummaryMost studies examining the association between female education and fertility have reported an inverse association. However, little is known about the consistency of the relationship, or what level of education triggers an inverse association. This study examined the consistency of the association between female education and fertility across the north–south demographic divide in Nigeria. Data on women aged 40–49 were taken from the 2003, 2008 and 2013 Nigerian DHS data sets. The results showed that female education remained significantly and consistently inversely related to fertility in both the north and south of Nigeria. Women with secondary or higher level of education reported a lower number of children ever born (CEB) than those with primary or no education in both the north and south (ppp

Background: Sputum culture is limited to centralized facilities. Thus, samples require transportation from peripheral laboratories to these facilities, compromising specimen quality since it is difficult to maintain cold chain. We evaluated OMNIgene SPUTUM Reagent (OMS) for transporting sputum samples for tuberculosis (TB) testing. The study was carried out at Noguchi Memorial Institute for Medical Research using sputa from Korle Bu Teaching Hospital and La General Hospital in Ghana. Methods: In a laboratory-based controlled experiment (CE), sputum contaminants were determined on blood agar before treatment with OMS and N-acetyl-L-cysteine-sodium hydroxide (NALC-NaOH). TB testing included smear microscopy, culture, and Xpert MTB/RIF. Afterward, two peripheral laboratories were trained to transport sputum samples with OMS without cold chain. Positivity, negativity, and contamination rates were compared between both methods using Chi-square and Fisher's exact tests. Cohen's Kappa was also used to determine agreements. Results: Among 104 sputum samples analyzed in the CE, 93 (89.4%) had bacterial growth on blood agar before decontamination, while 6 (5.8%) and 5 (4.8%) contaminated after NALC-NaOH and OMS treatment, respectively. Contamination was high with NALC-NaOH (12.8%) than OMS (4.3%) on Lowenstein–Jensen media (P < 0.001), but mycobacterial positivity was comparable: NALC-NaOH of 74.5% and OMS of 78.7%. Smear positivity after NALC-NaOH treatment was 89.4% and OMS was 75.9% (P = 0.491). All except one of the samples tested positive by Xpert MTB/RIF after both treatment. Sixteen samples were evaluated in the field experiment and 81.3% yielded positive culture, and no contamination on LJ was observed. Conclusion: Our findings indicate that OMS works well as a transport and decontaminating reagent of samples for TB testing.

The study investigated the implications of large-scale land acquisition for jatropha cultivation on the livelihoods of farming households and the various coping strategies adopted. Three communities namely- Dukusen, Ananekrom and Afrisie in the Asante Akim North District were selected for the study based on their proximity to a large-scale jatropha plantation project and the extent of farming activities in the communities. The study employed the mixed method strategy using a cross-sectional study design. Interviews, focus group discussion and documentary analysis were espoused in gathering data for the study. The simple random sampling procedure was used in selecting 30 farming households whereas the managers of the plantation project and two local chiefs, two District Assemblymen, and the Headmasters of basic schools were purposively selected and interviewed. Correlation and descriptive statistical tools were used to analyze the quantitative data while recursive abstraction was applied in analyzing the qualitative aspects of the data. We found that prior to the large-scale land acquisition by the plantation project, all the respondents (100%) had farming as their livelihood activity and major source of food and income, but this had, however, dropped to 60% after the land acquisition for the jatropha project. The average farm size had also reduced from 3.5 acres per household to about 1.5 acres. These changes have triggered various coping dynamics among farming households within the study communities including all year round cropping, application of fertilizers, and cultivation of high-yielding varieties as well as petty trading activities to support household income and ensure sustainable livelihoods and wellbeing. The paper generally concludes that large-scale land acquisition has higher tendency of pushing farming households into adopting different coping strategies and dynamics. The findings reveal new dimensions of the empirical accounts on households’ coping dynamics in response to large-scale land acquisition.

This study investigated gender differences in the use of traditional and complementary medicine (TCM) in Ghana. Using an interviewer-administered questionnaire, we collected data from March to June 2013 from 324 randomly sampled adults in the Ashanti region. The prevalence of TCM use in the prior 12 months was 86 percent. Females constituted the majority (61 percent) of TCM users. Female TCM users were more likely than male users to have had only a basic education, been traders (p ˂ .0001), and have health insurance (p ˂ .05). Using multiple logistic regression, TCM use was associated with urban residence for females (odds ratio [OR] = 7.82; 95 percent confidence interval [CI]: 1.28-47.83) but negatively related for males (OR = 0.032; 95 percent CI: 0.002-0.63). Being self-employed was associated with TCM use among males (OR = 7.62; 95 percent CI: 1.22-47.60), while females' TCM use was associated with higher income (OR = 3.72; 95 percent CI: 1.21-11.48) and perceived efficacy of TCM (OR = 5.60; 95 percent CI: 1.78-17.64). The African sociocultural structure vests household decision-making power in men but apparently not regarding TCM use, and the factors associated with TCM use largely differed by gender. These findings provide ingredients for effective health policy planning and evaluation. Adoption and modernization of TCM should apply a gendered lens.

Whole genome sequencing (WGS) is progressively being used to investigate the transmission dynamics of; Mycobacterium tuberculosis; complex (MTBC). We used WGS analysis to resolve traditional genotype clusters and explored the spatial distribution of confirmed recent transmission clusters. Bacterial genomes from a total of 452 MTBC isolates belonging to large traditional clusters from a population-based study spanning July 2012 and December 2015 were obtained through short read next-generation sequencing using the illumina HiSeq2500 platform. We performed clustering and spatial analysis using specified R packages and ArcGIS. Of the 452 traditional genotype clustered genomes, 314 (69.5%) were confirmed clusters with a median cluster size of 7.5 genomes and an interquartile range of 4-12. Recent tuberculosis (TB) transmission was estimated as 24.7%. We confirmed the wide spread of a Cameroon sub-lineage clone with a cluster size of 78 genomes predominantly from the Ablekuma sub-district of Accra metropolis. More importantly, we identified a recent transmission cluster associated with isoniazid resistance belonging to the Ghana sub-lineage of lineage 4. WGS was useful in detecting unsuspected outbreaks; hence, we recommend its use not only as a research tool but as a surveillance tool to aid in providing the necessary guided steps to track, monitor, and control TB.

Aim. The aim of this study was to assess the prevalence of computer vision syndrome (CVS) and its associated ergonomic factors among university administrative staff in Ghana. Methods. A cross-sectional survey was conducted among 200 administrative staff of the University of Cape Coast. The procedure included a self-administered questionnaire, comprehensive ocular health examination, and assessment of computer workstation and lighting conditions. The prevalence of CVS among the subjects and the association between CVS and ergonomic practices were determined. Results. The mean age of the study sample was 31.0 ± 4.7 years, and the majority were males (56.0%). The prevalence of CVS was among 103 (51.5%)participants. Over a third of the respondents used computers for 6 or more hours daily. Significant association was found between CVS and poor ergonomic practices (χ = 15.175, p=0.001). Conclusion. In addition to poor ergonomic office setup, university administrative staff spend several hours behind computer screens leading to the development of CVS. Increased awareness of CVS and adherence to recommended ergonomic practices are necessary to reduce the prevalence of CVS and ultimately enhance work satisfaction and productivity.

Cholera remains a major global public health threat and continuous emergence of new Vibrio cholerae strains is of major concern. We conducted a molecular epidemiological study to detect virulence markers and antimicrobial resistance patterns of V. cholerae isolates obtained from the 2012-2015 cholera outbreaks in Ghana. Archived clinical isolates obtained from the 2012, 2014 and 2015 cholera outbreaks in Ghana were revived by culture and subjected to microscopy, biochemical identification, serotyping, antibiotic susceptibility testing, molecular detection of distinct virulence factors and Multi-Locus Variable-Number of Tandem-Repeat Analysis (MLVA). Of 277 isolates analysed, 168 (60.6%) were confirmed to be V. cholerae and 109 (39.4%) isolates constituted other bacteria (Escherichia coli, Aeromonas sobria, Pseudomonas aeruginosa, Enterobacter cloacae and Enterococci faecalis). Serotyping the V. cholerae isolates identified 151 (89.9%) as Ogawa, 3 (1.8%) as Inaba and 14 (8.3%) as non-O1/O139 serogroup. The O1 serogroup isolates (154/168, 91.7%) carried the cholera toxin ctxB gene as detected by PCR. Additional virulence genes detected include zot, tcpA, ace, rtxC, toxR, rtxA, tcpP, hlyA and tagA. The most common and rare virulence factors detected among the isolates were rtxC (165 isolates) and tcpP (50 isolates) respectively. All isolates from 2014 and 2015 were multidrug resistant against the selected antibiotics. MLVA differentiated the isolates into 2 large unique clones A and B, with each predominating in a particular year. Spatial analysis showed clustering of most isolates at Ablekuma sub-district. Identification of several virulence genes among the two different genotypes of V. cholerae isolates and resistance to first- and second-line antibiotics, calls for scaleup of preventive strategies to reduce transmission, and strengthening of public health laboratories for rapid antimicrobial susceptibility testing to guide accurate treatment. Our findings support the current WHO licensed cholera vaccines which include both O1 Inaba and Ogawa serotypes.

Cypermethrin (CYP), a synthetic pyrethroid is a common environmental toxicant owing to its wide usage as a broad-spectrum insecticide. Its exposure to non-target organisms, including man, elicits numerous adverse effects making it a major public health issue. Epicatechin (EC) has proven anti-oxidative and anti-inflammatory properties. The present study was undertaken to evaluate the protective efficacy of epicatechin with regards to altered oxidative and inflammatory parameters subsequent to CYP treatment in rats. Animals were divided into four groups. The first group served as the control, while groups 2, 3, and 4 were orally treated with EC (30 mg kg−1 body weight), CYP (25 mg kg−1 body weight), and CYP plus EC, respectively. Oral administration of CYP for 14 days increased the levels of oxidative stress markers such as malondialdehyde, lipid hydroperoxides, and advanced oxidized protein products in the liver and kidney. These were accompanied by a decrease in glutathione and total antioxidant capacity levels. The activity of the enzyme superoxide dismutase was increased while catalase and glutathione peroxidase activities were decreased in these organs. Moreover, CYP increased plasma levels of the pro-inflammatory cytokines, interleukin-6 and tumor necrosis factor alpha. The plasma content of the nitrative nucleic acid marker, 8-nitroguanine was also markedly elevated by CYP. Administration of EC to CYP-exposed rats mitigated the induced oxidative and inflammatory effects. These data suggest that EC can attenuate the toxic effects induced by CYP exposure.

Background: We aimed to evaluate the whether AFP levels alone is an adequate screening indicator, or a combination of Generally, alpha-fetoprotein (AFP), CA19-9 and CEA could provide a better diagnostic tool in detecting and screening asymptomatic patients with primary hepatic cancer (PHC), and also evaluate the correlation of degree of differentiation with serum biomarker levels. Methods: We retrospectively reviewed the medical records of 1362 patients form 2014-2018 who visited the first Affiliated Hospital of Zhejiang University, Hangzhou, China for health check-ups or were diagnosed with cancer or cirrhosis. We then analyzed preoperative tumor markers level of AFP, CA19-9, and CEA. The standard reference values (AFP ≤20 ng/L CEA ≤ 5 ng/L, and CA19-9 ≤ 37 U/mL) were as positive or negative cut off values. Further, the histological sections of patients were categorized and correlated them with the three serum biomarkers. Results: Serum AFP, CEA, and CA19-9 levels in the PHC group were significantly higher compared to those with liver cirrhosis and healthy control groups (P < 0.03). With AFP as a single tumor marker for PHC diagnosis, it had a sensitivity of 63.3% with a specificity of 80.8%. AFP combined with CA19-9 and CEA showed specificity of 100%, a sensitivity 2.5% with the positive and negative predictive values of 100% and 22% respectively. Furthermore, histological evaluation revealed the highest AFP level of 9366.14±23902.61 ng/L associated with poorly differentiated HCC, while well-differentiated HCC, had the lowest mean AFP level of 45.19±181.27 ng/L. Conclusion: Combined serum levels of AFP, CA19-9 and CEA does not provide a superior advantage over AFP alone as a screening and diagnostic tool for HCC detection.

Context Available molecular epidemiological data from recent studies suggest significant genetic variation between the different lineages of Mycobacterium tuberculosis complex (MTBC) and the MTBC lineages might have adapted to different human populations. Aim This study sought to determine the population structure of clinical MTBC isolates from the Volta Region of Ghana. Methods The MTBC isolates obtained from collected sputum samples were identified by PCR detecting of IS6110 and genotyped using spoligotyping. Non-tuberculous mycobacterial isolates were characterized by amplification of the heat shock protein 65 (hsp65) gene and sequencing. The drug susceptibility profiles of the MTBCs determined using GenoType MTBDRplus. Results One hundred and seventeen (117, 93.6%) out of 125 mycobacterial positive isolates were characterized as members of the MTBC of which M. tuberculosis sensu stricto (MTBss) and M. africanum (MAF) were respectively 94 (80.3%) and 23 (19.7%). In all, 39 distinct spoligotype patterns were obtained; 26 for MTBss and 13 for MAF lineages. Spoligotyping identified 89 (76%) Lineage 4, 16 (13.6%) Lineage 5, 7 (6.0%) Lineage 6, 3 (2.6%) Lineage 2, 1(0.9%) Lineage 3 and 1 (0.9%) Lineage 1. Among the Lineage 4 isolates, 62/89 (69.7%) belonged to Cameroon sub-lineage, 13 (14.7%) Ghana, 8 (9.0%) Haarlem, 2 (2.2%) LAM, 1 (1.1%) Uganda I, 1 (1.1%) X and the remaining two (2.2%) were orphan. Significant localization of MAF was found within the Ho municipality (n = 13, 29.5%) compared to the more cosmopolitan Ketu-South/Aflao (n = 3, 8.3%) (p-value = 0.017). Eight (8) non-tuberculous mycobacteria were characterized as M. abscessus (7) and M. fortuitum (1). Conclusion We confirmed the importance of M. africanum lineages as a cause of TB in the Volta region of Ghana.

Cataracts are the leading cause of blindness worldwide. Current methods for discriminating cataractous lenses from healthy lenses of Sprague-Dawley rats during preclinical studies are based on either histopathological or clinical assessments which are weakened by subjectivity. In this work, both cataractous and healthy lens tissues of Sprague-Dawley rats were studied using multispectral imaging technique in combination with multivariate analysis. Multispectral images were captured in transmission, reflection and scattering modes. In all, five spectral bands were found to be markers for discriminating cataractous lenses from healthy lenses; 470 nm and 625 nm discriminated in reflection mode whereas 435 nm, 590 nm and 700 nm discriminated in transmission mode. With Fisher’s Linear discriminant analysis, the midpoints for classifying cataractous from healthy lenses were found to be 14.718 × 10−14 and 3.2374 × 10−14 for the two spectra bands in the reflection mode and the three spectral bands in the transmission mode respectively. Images in scattering mode did not show significant discrimination. These spectral bands in reflection and transmission modes may offer potential diagnostic markers for discriminating cataractous lenses from healthy lenses thereby promising multispectral imaging applications for characterizing cataractous and healthy lenses.

Summary We spoligotyped and screened 1490 clinical Mycobacterium tuberculosis complex strains from Northern and Greater Accra regions of Ghana against INH and RIF using the microplate alamar blue phenotypic assay. Specific drug resistance associated genetic elements of drug resistant strains were analyzed for mutations. A total of 111 (7.5%), 10 (0.7%) and 40 (2.6%) were mono-resistant to INH, RIF, and MDR, respectively. We found the Ghana spoligotype to be associated with drug resistance (INH: 22.1%; p = 0.0000, RIF: 6.2%; p = 0.0103, MDR: 4.6%; p = 0.0240) as compared to the Cameroon spoligotype (INH: 6.7%, RIF: 2.4%, MDR: 1.6%). The propensity for an isolate to harbour katG S315T mutation was higher in M. tuberculosis (75.8%) than Mycobacterium africanum (51.7%) (p = 0.0000) whereas the opposite was true for inhApro mutations; MAF (48.3%) compared to MTBSS (26.7%) (p = 0.0419). We identified possible novel compensatory INH resistance mutations in inhA (G204D) and ahpCpro (-88G/A and -142G/A) and a novel ndh mutation K32R. We detected two possible rpoC mutations (G332R and V483G), which occurred independently with rpoB S450L, respectively. The study provides the first evidence that associate the Ghana spoligotype with DR-TB and calls for further genome analyses for proper classification of this spoligotype and to explore for fitness implications and mechanisms underlying this observation.

[Background]: Bovine tuberculosis (bTB) caused by Mycobacterium bovis is a re-emerging problem in both livestock and humans. The association of some M. bovis strains with hyper-virulence, MDR-TB and disseminated disease makes it imperative to understand the biology of the pathogen., [Methods]: Mycobacterium bovis (15) among 1755 M. tuberculosis complex (MTBC) isolated between 2012 and 2014 were characterized and analyzed for associated patient demography and other risk factors. Five of the M. bovis isolates were whole-genome sequenced and comparatively analyzed against a global collection of published M. bovis genomes., [Results]: Mycobacterium bovis was isolated from 3/560(0.5%) females and 12/1195(1.0%) males with pulmonary TB. The average age of M. bovis infected cases was 46.8 years (7-72years). TB patients from the Northern region of Ghana (1.9%;4/212) had a higher rate of infection with M. bovis (OR = 2.7,p = 0.0968) compared to those from the Greater Accra region (0.7%;11/1543). Among TB patients with available HIV status, the odds of isolating M. bovis from HIV patients (2/119) was 3.3 higher relative to non-HIV patients (4/774). Direct contact with livestock or their unpasteurized products was significantly associated with bTB (p, [Conclusion]: Our data indicate potential zoonotic transmission of bTB in Ghana and hence calls for intensified public education on bTB, especially among risk groups., This work was supported by the Wellcome Trust Intermediate Fellowship awarded to DYM (Grant Number 097134/Z/11/Z).

BackgroundDiabetes Mellitus (DM) is a known risk factor for tuberculosis (TB) but little is known on TB-Diabetes Mellitus (TBDM) co-morbidity in Sub-Saharan Africa.MethodsConsecutive TB cases registered at a tertiary facility in Ghana were recruited from September 2012 to April 2016 and screened for DM using random blood glucose and glycated hemoglobin (HbA1c) level. TB patients were tested for other clinical parameters including HIV co-infection and TB lesion location. Mycobacterial isolates obtained from collected sputum samples were characterized by standard methods. Associations between TBDM patients' epidemiological as well as microbiological variables were assessed.ResultsThe prevalence of DM at time of diagnosis among 2990 enrolled TB cases was 9.4% (282/2990). TBDM cases were significantly associated with weight loss, poor appetite, night sweat and fatigue (pConclusionOur findings confirms the importance of screening for diabetes during TB diagnosis and highlights the association between genetic diversity and diabetes. in Ghana.

Plasmodium falciparum (P. falciparum) malarial degree of infection, termed as parasite density (PD), estimation is vital for point-of-care diagnosis and treatment of the disease. In this work, we present application of optical techniques: optical absorption and multispectral imaging for P. falciparum malarial byproduct (hemozoin) detection in human‐infected blood samples to estimate PD. The blood samples were collected from volunteers who were tested positive for P. falciparum infections (i-blood), and after treatment, another set of blood samples (u-blood) were also taken. The i-blood samples were grouped based on PD (+, ++, +++, and ++++). Optical densities (ODs) of u-blood samples and i-blood samples at blood absorption bands of 405 nm, 541 nm, and 577 nm showed different optical absorption characteristics. Empirical computation of ratio of the ODs for the blood absorption bands revealed reduction in the ODs with increasing PD. Multispectral images containing uninfected red blood cells (u-RBCs) and P. falciparum‐infected red blood cells (i-RBCs) on unstained blood smear slides exhibited spectrally determined decrease in both reflected and scattered pixel intensities and increase in transmitted pixel intensities with increasing PD. We further propose a linear classification model based on Fisher’s approach using reflected, scattered, and transmitted pixel intensities for easy and inexpensive estimation of PD as an alternative to manual estimation of PD, currently, the widely used technique. Application of the optical techniques and the proposed linear classification model are therefore recommended for improved malaria diagnosis and therapy.

The main aim of the study was to explore the attitudes and health perceptions of faith healing users in Kumasi Metropolis, Ghana. This has become necessary because faith healing practice is an important area but remains neglected in the health care literature. In an age when biowestern medicine is touted as the cure for most diseases, understanding how and why individuals seek alternative treatment, specifically faith healing modalities may help to develop more effective health care interventions.We employed exploratory study design of purely qualitative research approach involving 40 conveniently selected participants from four different purposively selected faith healing centres to get a maximum variation of experiences and opinions on the time of consultation, perceived effectiveness and challenges of faith healing practices in Ghana. In-depth interviews were conducted from 10th June to 30th July, 2017. Data were thematically analysed and presented based on the a posteriori inductive reduction approach.The main findings were that faith healers served as the first port of call for disease curing and prevention for most users. Consumers of faith healing perceived their health status to be good due to the perceived effectiveness of faith healing for curing of health problems. However, users faced challenges such as stigmatisation and victimisation in seeking health care.This study has provided the first baseline evidence in this important area of inquiry that has been neglected in the scholarly discourse in Ghana. By implication, users' positive attitudes and perceptions toward faith healing call for integration policies that allow formal medical services to have open idea to faith healing practices in Ghana.

Background The main aim of the study was to explore the attitudes and health perceptions of faith healing users in Kumasi Metropolis, Ghana. This has become necessary because faith healing practice is an important area but remains neglected in the health care literature. In an age when biowestern medicine is touted as the cure for most diseases, understanding how and why individuals seek alternative treatment, specifically faith healing modalities may help to develop more effective health care interventions. Methods We employed exploratory study design of purely qualitative research approach involving 40 conveniently selected participants from four different purposively selected faith healing centres to get a maximum variation of experiences and opinions on the time of consultation, perceived effectiveness and challenges of faith healing practices in Ghana. In-depth interviews were conducted from 10th June to 30th July, 2017. Data were thematically analysed and presented based on the a posteriori inductive reduction approach. Results The main findings were that faith healers served as the first port of call for disease curing and prevention for most users. Consumers of faith healing perceived their health status to be good due to the perceived effectiveness of faith healing for curing of health problems. However, users faced challenges such as stigmatisation and victimisation in seeking health care. Conclusion This study has provided the first baseline evidence in this important area of inquiry that has been neglected in the scholarly discourse in Ghana. By implication, users’ positive attitudes and perceptions toward faith healing call for integration policies that allow formal medical services to have open idea to faith healing practices in Ghana.

The shoulder is a common area for traumatic injury in the adolescent football player. The most common areas of injury include the acromioclavicular (AC) joint, sternoclavicular joint (SC), and glenohumeral joint. The AC joint is susceptible to sprains, fractures, and dislocations, often termed as “separated shoulder,” most commonly following a direct blow injury such as a fall onto the shoulder. The SC joint is rarely injured, but posterior SC joint dislocations do occur and can be life threatening and thus require accurate and prompt diagnosis and treatment. The glenohumeral joint can dislocate following traction injuries to the outstretched arm which may require sideline reduction and eventual surgical repair. Proper diagnosis and treatment of these injuries requires an understanding of the anatomy and physiology of the adolescent athlete as well as the anticipated outcomes following treatment.

The present study was designed to investigate aluminium phosphide (ALP)-induced testicular toxicity, including its effects on sperm parameters and histological alterations in Wistar rats, and the possible protective role of hesperidin (HSD). Oral administration of ALP at 1.15 mg/kg body weight (1/10 LD50) for 30 days resulted in a significant increase in testicular malondialdehyde, lipid hydroperoxides, and oxidized protein levels. These indicators of oxidative stress were accompanied by decreased activity of the antioxidant enzymes superoxide dismutase, catalase and glutathione peroxidase, followed by a drastic reduction in the non-enzymatic antioxidant indices of glutathione and total antioxidant capacity when compared to control. Furthermore, ALP treatment produced a marked reduction in sperm count, motility and viability while increasing abnormal sperm morphology and adverse histopathological changes in testis. Co-administration with HSD significantly ameliorated ALP-induced testicular damage by suppressing oxidative stress indices and enhancing antioxidant status while also improving the sperm parameters and histological alterations in ALP-treated rats. The results of the present study indicated that testicular toxic effects of ALP are due to oxidative imbalance and that HSD could be a potential therapeutic agent against ALP-induced testicular damage.

C1q/tumor necrosis factor-related protein 6 (CTRP6) is a newly identified adiponectin paralog with modulating effects on metabolism and inflammation. CTRP6 transcript is detected in human ovarian tissue. However, the expression pattern and function of CTRP6 on ovary have been rarely studied. In the present study, we preliminarily examined the structure feature and function of CTRP6 in porcine granulosa cells. The results indicated that the signaling peptide of CTRP6 was located at among positions 21 and 22, and the phosphorylation sites were at 15 (Ser), 4 (Thr) and 4 (Tyr), respectively. Meanwhile, CTRP6 was extremely homologous in livestock and chiropteran. The qPCR results showed that CTRP6 was moderately expressed in porcine follicle. Immunohistochemistry manifested that CTRP6 was presented in various types of ovarian cells. Immunofluorescence revealed that CTRP6 was located in cytoplasm in primary porcine granulosa cells. ELISA results showed that the concentration of CTRP6 in the follicular fluid was gradually decreased with the growth of antral follicle. In addition FSH increased CTRP6 expression levels in a time- and dose-dependent manner in primary porcine granulosa cells, while LH had no effect on CTRP6 basal gene expression, which suggesting CTRP6 is an FSH-responsive gene in porcine granulosa cells. Our findings imply that the CTRP6 may be a candidate gene to regulate folliculogenesis and reproductive performance.

Stephen Osei-Wusu,1,2 Michael Amo Omari,3 Adwoa Asante-Poku,1 Isaac Darko Otchere,1 Prince Asare,1 Audrey Forson,3 Jacob Otu,4 Martin Antonio,4 Dorothy Yeboah-Manu1 1Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana; 2West Africa Centre for Cell Biology of Infectious Pathogens, University of Ghana, Legon, Ghana; 3Department of Chest Diseases, Korle-Bu Teaching Hospital, Accra, Ghana; 4Medical Research Council Unit, Fajara, The Gambia Background: Drug resistance surveillance is crucial for tuberculosis (TB) control. Therefore, our goal was to determine the prevalence of second-line anti-TB drug resistance among diverse primary drug-resistant Mycobacterium tuberculosis complex (MTBC) isolates in Ghana. Materials and methods: One hundred and seventeen MTBC isolates with varying first-line drug resistance were analyzed. Additional resistance to second-line anti-TB drugs (streptomycin [STR], amikacin [AMK] and moxifloxacin [MOX]) was profiled using the Etest and GenoType MTBDRsl version 2.0. Genes associated with resistance to AMK and MOX (gyrA, gyrB, eis, rrs, tap, whiB7 and tlyA) were then analyzed for mutation. Results: Thirty-seven (31.9%) isolates had minimum inhibitory concentration (MIC) values ≥2µg/mL against STR while 12 (10.3%) isolates had MIC values ≥1 µg/mL for AMK. Only one multidrug-resistant (MDR) isolate (Isolate ID: TB/Nm 919) had an MIC value of ≥0.125 µg/mL for MOX (MIC = 3 µg/mL). This isolate also had the highest MIC value for AMK (MIC = 16µg/mL) and was confirmed as resistant to AMK and MOX by the line probe assay GenoType MTBDRsl version 2.0. Mutations associated with the resistance were: gyrA (G88C) and rrs (A514C and A1401G). Conclusion: Our findings suggest the need to include routine second-line anti-TB drug susceptibility testing of MDR/rifampicin-resistant isolates in our diagnostic algorithm. Keywords: tuberculosis, drug resistance, diagnosis, Ghana, XDR

BackgroundUnderstanding transmission dynamics is useful for tuberculosis (TB) control. We conducted a population-based molecular epidemiological study to understand TB transmission in Ghana.MethodsMycobacterium tuberculosiscomplex (MTBC) isolates obtained from prospectively-sampled pulmonary TB patients between July, 2012 and December, 2015 were confirmed as MTBC using IS6110PCR. MTBC lineages were identified by large sequence polymorphism and single nucleotide polymorphism assays and further characterized using spoligotyping and standard 15-loci MIRU-VNTR typing. We used the n-1 method to estimate recent TB transmission and identified associated risk factors using logistic regression analysis.FindingsOut of 2,309 MTBC isolates, we identified 1,082 (46·9%) single cases with 1,227 (53·1%) isolates belonging to one of 276 clustered cases (clustering range; 2-35). Recent TB transmission rate was estimated to be 41·2%. While we see no significant difference in the recent transmission rates between lineages ofMycobacterium africanum(lineage-5 (31·8%); lineage-6 (24·7%), p=0·118), we found that lineage-4 belonging to theM. tuberculosistransmitted significantly higher (44·9%, pInterpretationsOur findings indicate high recent TB transmission suggesting occurrences of unsuspected outbreaks. The observed reduced transmission rate ofM. africanumsuggests other factor(s) may be responsible for its continuous presence in West Africa.FundingWellcome Trust Intermediate Fellowship Grant 097134/Z/11/Z to Dorothy Yeboah-Manu.

Mycobacterium africanum(Maf) causes up to half of human tuberculosis in West Africa, but little is known on this pathogen. We compared the genomes of 253Mafclinical isolates from Ghana, including both L5 and L6. We found that the genomic diversity of L6 was higher than in L5, and the selection pressures differed between both groups. Regulatory proteins appeared to evolve neutrally in L5 but under purifying selection in L6. Conversely, human T cell epitopes were under purifying selection in L5, but under positive selection in L6. Although only 10% of the T cell epitopes were variable, mutations were mostly lineage-specific. Our findings indicate thatMafL5 and L6 are genomically distinct, possibly reflecting different ecological niches.

Objective/Background: Nontuberculous mycobacterial (NTM) species are assuming public health importance in pulmonary diseases; they are increasingly being isolated, and importantly, most NTMs do not respond to routine tuberculosis (TB) drugs. This study aimed to identify NTMs isolated from pulmonary TB cases and also determine their susceptibility to streptomycin (STR), isoniazid (INH), and rifampicin (RIF). Methods: A total of 1755 mycobacterial isolates, obtained between August 2012 and July 2014, from 2036 smear-positive pulmonary cases were identified using polymerase chain reaction amplification of IS6110, and hsp65 gene sequencing analysis. Drug susceptibility testing (DST) was then performed for the identified NTMs against STR, INH, and RIF using microplate Alamar blue assay. The results were analyzed against patients' biodata for statistical associations. Results: Of the 1755 analyzed isolates, we identified 43 (2.5%) NTMs, which included 18 (41.9%) Mycobacterium intracellulare, 13 (30.2%) Mycobacterium avium subs. paratuberculosis, 5 (11.3%) Mycobacterium abscessus, 3 (7.0%) each of Mycobacterium mucogenicum and Mycobacterium colombiense, and 1 (2.3%) Mycobacterium simiae. Patients infected with NTMs (52.0%) were more likely to be human immunodeficiency virus-positive (P = 0.001, odds ratio = 6.6, 95% confidence interval = 2.7–16.2) than those infected with M. tuberculosis complex (5.8%). All the 43 (100%) NTMs were resistant to INH, whereas 32 (74%) and 19 (44%) were resistant to RIF and STR, respectively. Furthermore, 16 (37.2%) NTMs were resistant to all three drugs, 20 were resistant to INH and RIF, and 3 were resistant to STR and INH. All the M. abscessus isolates were resistant to all the three drugs, whereas all the M. avium isolates were resistant to INH and RIF, but only three were resistant to STR. Among the M. intracellulare isolates, 8, 18, and 15 isolates were resistant to STR, INH, and RIF, respectively. Conclusion: The observed high-resistance level to INH and RIF supports the need for rapid species identification and DST of nonresponding TB cases before retreatment.

Epidemiological evidences indicate close association between inorganic arsenic exposure via drinking water and cardiovascular diseases. While the exact mechanism of this arsenic-mediated increase in cardiovascular risk factors remains enigmatic, epidemiological studies indicate a role for paraoxonase 1 (PON1) in cardiovascular diseases. To investigate the association between inorganic arsenic exposure and cardiovascular diseases, rats were exposed to sodium arsenite (trivalent; 50, 100, and 150 ppm As) and sodium arsenate (pentavalent; 100, 150, and 200 ppm As) in their drinking water for 12 weeks. PON1 activity towards paraoxon (PONase) and phenylacetate (AREase) in plasma, lipoproteins, hepatic, and brain microsomal fractions were determined. Inhibition of PONase and AREase in plasma and HDL characterized the effects of the two arsenicals. While the trivalent arsenite inhibited PONase by 33% (plasma) and 46% (HDL), respectively, the pentavalent arsenate inhibited the enzyme by 41 and 34%, respectively. AREase activity was inhibited by 52 and 48% by arsenite, whereas the inhibition amounted to 72 and 67%, respectively by arsenate. The pattern of inhibition in plasma and HDL indicates that arsenite induced a dose-dependent inhibition of PONase whereas arsenate induced a dose-dependent inhibition of AREase. In the VLDL + LDL, arsenate inhibited PONase and AREase while arsenite inhibited PONase. In the hepatic and brain microsomal fractions, only the PONase enzyme was inhibited by the two arsenicals. The inhibition was more pronounced in the hepatic microsomes where a 70% inhibition was observed at the highest dose of pentavalent arsenic. Microsomal cholesterol was increased by the two arsenicals resulting in increased cholesterol/phospholipid ratios. Our findings indicate that decreased PON1 activity observed in arsenic exposure may be an incipient biochemical event in the cardiovascular effects of arsenic. Modulation of PON1 activity by arsenic may also be mediated through changes in membrane fluidity brought about by changes in the concentration of cholesterol in the microsomes. © 2014 Wiley Periodicals, Inc. Environ Toxicol 31: 154–162, 2016.

In mammals, granulosa cell proliferation, differentiation, luteinization, apoptosis, and hormone synthesis are tightly related to oocyte maturation, follicular development and ovarian function. In current study, we investigated the role of the key circadian clock gene, brain and muscle arnt-like protein-1 (Bmal1), on porcine granulosa cell hormone secretion and apoptosis. The transcription levels of circadian clock genes, including Bmal1 and period circadian clock 2 (Per2), were detected by RT-qPCR. We found that the circadian clock genes exhibited rhythmic change and were further enhanced by dexamethasone synchronization in granulosa cells. Bmal1 knockdown reduced transcriptional levels of hormone receptor genes, including follicle stimulating hormone receptor (Fshr), luteinizing hormone/choriogonadotropin receptor (Lhcgr) and estrogen receptor 2 (Esr2), and decreased the mRNA and protein levels of cytochrome P450 family 11 subfamily A member 1 (Cyp11a1), cytochrome P450 family 19 subfamily A member 1 (Cyp19a1) and steroidogenic acute regulatory protein (Star), which are the key enzymes involved in hormone synthesis. Synthesis of progesterone and estradiol were also inhibited by Bmal1 siRNA treatment in granulosa cells. Moreover, flow cytometry analysis demonstrated suppressing Bmal1 promoted granulosa cells apoptosis. Western blot analysis showed that Bmal1 interference inactivated the PI3K/Akt/mTOR signaling pathway. In conclusion, Bmal1 plays a critical role in secretion of hormone and apoptosis of porcine granulosa cells via the PI3K/Akt/mTOR signaling pathway.

Background Mycobacterium africanum comprises two phylogenetic lineages within the M. tuberculosis complex (MTBC) and is an important cause of human tuberculosis (TB) in West Africa. The reasons for this geographic restriction of M. africanum remain unclear. Here, we performed a prospective study to explore associations between the characteristics of TB patients and the MTBC lineages circulating in Ghana. Method We genotyped 1,211 MTBC isolates recovered from pulmonary TB patients recruited between 2012 and 2014 using single nucleotide polymorphism typing and spoligotyping. Associations between patient and pathogen variables were assessed using univariate and multivariate logistic regression. Results Of the 1,211 MTBC isolates analysed, 71.9 % (871) belonged to Lineage 4; 12.6 % (152) to Lineage 5 (also known as M. africanum West-Africa 1), 9.2 % (112) to Lineage 6 (also known as M. africanum West-Africa 2) and 0.6 % (7) to Mycobacterium bovis. Univariate analysis revealed that Lineage 6 strains were less likely to be isoniazid resistant compared to other strains (odds ratio = 0.25, 95 % confidence interval (CI): 0.05–0.77, P

BACKGROUND: There is a perception that genomic differences in the species/lineages of the nine species making the Mycobacterium tuberculosis complex (MTBC) may affect the efficacy of distinct control tools in certain geographical areas. We therefore analyzed the prevalence and spatial distribution of MTBC species and lineages among isolates from pulmonary TB cases over an 8-year period, 2007-2014. METHODOLOGY: Mycobacterial species isolated by culture from consecutively recruited pulmonary tuberculosis patients presenting at selected district/sub-district health facilities were confirmed as MTBC by IS6110 and rpos PCR and further assigned lineages and sub lineages by spoligotyping and large sequence polymorphism PCR (RDs 4, 9, 12, 702, 711) assays. Patient characteristics, residency, and risks were obtained with a structured questionnaire. We used SaTScan and ArcMap analyses to identify significantly clustered MTBC lineages within selected districts and spatial display, respectively. RESULTS: Among 2,551 isolates, 2,019 (79.1%), 516 (20.2%) and 16 (0.6%) were identified as M. tuberculosis sensu stricto (MTBss), M. africanum (Maf), 15 M. bovis and 1 M. caprae, respectively. The proportions of MTBss and Maf were fairly constant within the study period. Maf spoligotypes were dominated by Spoligotype International Type (SIT) 331 (25.42%), SIT 326 (15.25%) and SIT 181 (14.12%). We found M. bovis to be significantly higher in Northern Ghana (1.9% of 212) than Southern Ghana (0.5% of 2339) (p = 0.020). Using the purely spatial and space-time analysis, seven significant MTBC lineage clusters (p< 0.05) were identified. Notable among the clusters were Ghana and Cameroon sub-lineages found to be associated with north and south, respectively. CONCLUSION: This study demonstrated that overall, 79.1% of TB in Ghana is caused by MTBss and 20% by M. africanum. Unlike some West African Countries, we did not observe a decline of Maf prevalence in Ghana.

Intramuscular fat (IMF) has been demonstrated as one of the crucial factors of livestock meat quality. The MAT2B protein with MAT2α catalyzes the formation of methyl donor S- adenosylmethionine (SAMe) to mediate cell metabolism including proliferation and apoptosis. However, the regulatory effect of MAT2B on IMF deposition is still unclear. In this study, the effect of MAT2B on adipogenesis and its potential mechanism during porcine intramuscular preadipocyte differentiation was studied. The results showed that overexpression of MAT2B promoted adipogenesis and significantly up-regulated the mRNA and protein levels of adipogenic marker genes including FASN, PPARγ and aP2, consistently, knockdown of MAT2B inhibited lipid accumulation and down-regulated the mRNA and protein levels of the above genes. Furthermore, flow cytometry and EdU-labeling assay indicated that MAT2B regulate adipogenesis was partly due to influence intracellular SAMe levels and further affect cell clonal expansion. Also, increased expression of MAT2B activated the phosphorylations of AKT and ERK1/2, whereas knockdown of MAT2B blocked AKT signaling and repressed the phosphorylation of ERK1/2. Moreover, the inhibitory effect of LY294002 (a specific PI3K inhibitor) on the activities of AKT and ERK1/2 was partially recovered by overexpression of MAT2B in porcine intramuscular adipocytes. Finally, Co-IP experiments showed that MAT2B can directly interact with AKT. Taken together, our findings suggested that MAT2B acted as a positive regulator through modifying SAMe levels as well as activating AKT/ERK signaling pathway to promote porcine intramuscular adipocyte differentiation.

Objective/background Mycobacterium africanum (MAF) remains an important TB causing pathogen in West Africa; however, little is known about its population structure and actual diversity which may have implications for diagnostics and vaccines. We carried out comparative genomics analysis of candidate Mycobacterium tuberculosis (MTB) and MAF using whole genome sequencing. Methods Clinical MTB complex strains (n = 187) comprising L4 (n = 22), L5 (n = 126), and L6 (n = 39) isolated over 8 years from Ghana were whole genome sequenced. The reads were mapped onto a reference genome for phylogenetic and functional genomics analysis. A maximum likelihood tree with 100 bootstraps was constructed from the single nucleotide polymorphisms (SNPs) found using RAxML and clustered with hierBAPS. A total of 147 (18 L4, 36 L6, and 93 L5) of the genomes were de novo assembled and annotated for comparative pangenome analysis using Roary. Results The population structure of MAF revealed at least five clusters of L5 as compared to three for L6. We also identified a group of three multi-drug-resistants (MDRs) within a single cluster of L5 strains from Southern Ghana isolated in 2013. Among the global collection of MTB complex, there were four Ghana-specific L5 clusters of which one (L5.1.1) had traits of clonal expansion. From the 5947 pan genes extracted from the collection, 3215 (54.1%) were core to all the 147 genomes whereas 719 (12.1%) were found in single genomes. Most of the variable genes were PE-PGRS/PPE (1,281) duplicates of other genes (431). The genome degradation was more pronounced in Lineages 4 and 6 as compared to Lineage 5. We identified the absence of some unique genes among specific lineages and/or clades with possible clinical implications. For example, mpt64 and mlaD encoding respectively an immunogenic protein and a mammalian cell entry protein were missing from all L6 genomes. In addition, all L5 strains had an amino acid substitution I43 N within the mpt64 gene. Analysis of SNPs within some genes encoding proteins for substrate metabolism, ion transport and secretory systems showed higher proportion of SNPs among L6 compared to L5 and L4. We also identified a number of lineage/sublineage specific SNPs and indels that may be utilized in rapid PCR based genotyping of MTB complex. Conclusion This work emphasizes on the possibility that the mpt64-based rapid diagnostic kit would not be effective in MAF endemic settings. More mutations in ESAT-6 secretory system of MAF compared to MTB sensu stricto can affect efficacy of ESAT-6-based vaccines in the future.

Multi-spectral imaging (MSI) has made diagnosis of microscopic samples considerably easier and information abound. Most MSI systems use continuum light sources and filters for imaging purposes. However, these light sources and filters are relatively expensive, unstable due to extreme pressure and temperature and associated with prolong acquisition time. In this work, we present a metallurgical microscope retrofitted with light-emitting diodes (LEDs) as illumination sources for MSI microscopy. This multispectral LED imaging microscope (MSLEDIM) is relatively cheaper and capable of acquiring images in reflection, transmission and scattering modes at thirteen (13) different wavelengths ranging from ultraviolet to near infrared. The microscope has been demonstrated in biomedical and entomological research fields. The MSLEDIM can be used in various scientific research fields for imaging microscopic samples.

Human exposure to metals is a major health concern in the world as a result of increased industrialization. The present study was designed to investigate the toxic effect of lead and manganese alone and in combination on different regions of rat brain, namely cerebellum, cortex and hippocampus. Adult male Wistar rats were exposed to 100 ppm lead as lead acetate, 100 ppm manganese as manganese chloride, and lead and manganese in combination in their drinking water for 4 weeks. Following either lead or manganese exposure, acetylcholinesterase activity and the antioxidant enzymes, superoxide dismutase and catalase activities were inhibited. Likewise, malonylaldehyde level, a marker of lipid peroxidation and protein carbonyl groups used to assess oxidatively modified proteins were markedly increased by exposure to either metals. The non-enzymatic antioxidants, reduced glutathione and total thiol groups were significantly (p < 0.05) depleted by these metals. However, these aspects were more pronounced in animals exposed to the mixture of both lead and manganese. The metals displayed additive, as well as, potentiation effect in their interactions in the brain regions. It can thus, be concluded that the mixture of lead and manganese demonstrated a higher neurotoxic effects than does either metals alone.

Purpose: To investigate the effect of low level cadmium (Cd) exposure on the activity of superoxide dismutase (SOD) in rat. Methods: Thirty-two male albino rats were divided into four groups of eight animals each. Group one received distilled water and served as control. The other three groups were exposed to 100, 200 and 300 ppm cadmium doses, respectively, in their drinking water for 6 weeks. At the end of 6 weeks, blood, brain and liver were removed from the animals and SOD activities were investigated spectrophotometrically at 480 nm. Results: The data revealed a significant (p < 0.05) decrease in organ weight of the exposed rats, and with the highest cadmium accumulation in liver ranging from 2.99 ± 0.20 μg Cd/g tissue in control to 34.57 ± 2.06 μg Cd/g tissue for the 300 ppm dose group. Exposure to cadmium resulted in significant (p < 0.05) decrease in SOD activity in plasma, erythrocytes, brain and liver in a dose-dependent manner compared to control. The data showed a negative correlation between tissue cadmium and SOD in plasma, erythrocyte and brain. While positive associations were observed between blood and tissue (brain and liver) cadmium and SOD, a significant (p < 0.01), negative correlation was found between tissue cadmium and SOD. Conclusion: As Cd dose increase, plasma, erythrocyte, brain and liver SOD activities decrease. This might affect the maintenance of the normal body physiological conditions. Keywords: Cadmium, Superoxide dismutase, Liver, Brain, Toxicity, Environmental contaminant