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2. HPV DNA Testing and Mobile Colposcopy for Cervical Precancer Screening in HIV Positive Women: A Comparison Between Two Settings in Ghana and Recommendation for Screening

Author

Kofi Effah MBChB, MGCS, Richard Anthony MBBS, FWACP, Ethel Tekpor MPH, Joseph E. Amuah PhD, Comfort M. Wormenor BSc, Georgina Tay, Smith E. Y. Kraa MBChB, Angela M. Katso BSc, Christiana A. Akonnor Dip, Seyram Kemawor BSc, Stephen Danyo B.Ed, Bernard H. Atuguba MBChB, MGCS, Nana Owusu M. Essel MD, MPH, MSc, and Patrick K. Akakpo MBChB, FWACP

Subjects
Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract

Introduction Women living with HIV (WLHIV) have higher prevalence and persistence rates of high-risk human papillomavirus (hr-HPV) infection with a six-fold increased risk of cervical cancer. Thus, more frequent screening is recommended for WLHIV. Objectives This retrospective descriptive cross-sectional study was conducted to investigate and compare the prevalence of hr-HPV infection and abnormal findings on mobile colposcopy in two cohorts of WLHIV following cervical screening in rural and urban settings in Ghana. Methods Through the mPharma 10 000 Women Initiative, WLHIV were screened via concurrent hr-HPV DNA testing (MA-6000; Sansure Biotech Inc., Hunan, China) and visual inspection (Enhanced Visual Assessment [EVA] mobile colposcope; MobileODT, Tel Aviv, Israel) by trained nurses. The women were screened while undergoing routine outpatient reviews at HIV clinics held at the Catholic Hospital, Battor (rural setting) and Tema General Hospital (urban setting), both in Ghana. Results Two-hundred and fifty-eight WLHIV were included in the analysis (rural, n = 132; urban, n = 126). The two groups were comparable in terms of age, time since HIV diagnosis, and duration of treatment for HIV. The hr-HPV prevalence rates were 53.7% (95% CI, 45.3–62.3) and 48.4% (95% CI, 39.7–57.1) among WLHIV screened in the rural vs urban settings ( p -value = .388). Abnormal colposcopy findings were found in 8.5% (95% CI, 5.1–11.9) of the WLHIV, with no significant difference in detection rates between the two settings ( p -value = .221). Three (13.6%) of 22 women who showed abnormal colposcopic findings underwent loop electrosurgical excision procedure (LEEP), leaving 19/22 women from both rural and urban areas with pending treatment/follow-up results, which demonstrates the difficulty faced in reaching early diagnosis and treatment, regardless of their area of residence. Histopathology following LEEP revealed CIN III in 2 WLHIV (urban setting, both hr-HPV negative) and CIN I in 1 woman in the rural setting (hr-HPV positive). Conclusions There is a high prevalence of hr-HPV among WLHIV in both rural and urban settings in this study in Ghana. Concurrent HPV DNA testing with a visual inspection method (colposcopy/VIA) reduces loss to follow-up compared to performing HPV DNA testing as a standalone test and recalling hr-HPV positive women for follow up with a visual inspection method. Concurrent HPV DNA testing and a visual inspection method may also pick up precancerous cervical lesions that are hr-HPV negative and may be missed if HPV DNA testing is performed alone.

Published
2024
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3. Effectiveness of accelerated diagnostic protocols for reducing emergency department length of stay in patients presenting with chest pain: A systematic review and meta-analysis.

Author

Jesse Hill, Nana Owusu M Essel, Esther H Yang, Liz Dennett, and Brian H Rowe

Subjects
Medicine, Science
Abstract

In recent years, there has been an increase in the use of accelerated diagnostic protocols (ADPs) and high-sensitivity troponin assays (hsTn) for the assessment of chest pain in emergency departments (EDs). This study aimed to quantitatively summarize the operational and clinical outcomes of ADPs implemented for patients with suspected cardiac chest pain. To be considered eligible for inclusion, studies must have implemented some form of ADP within the ED for evaluating adult (age ≥18 years) patients presenting with chest pain using Tn assays. The primary outcome was ED length of stay (LOS). Secondary outcomes included the proportion of patients admitted and the proportion with 30-day major adverse cardiac events (MACE). Thirty-seven articles involving 404,566 patients met the inclusion criteria, including five randomized controlled trials (RCTs) and 32 observational studies. A significant reduction in total ED LOS was reported in 22 observational studies and four RCTs. Emergency departments with longer baseline ED LOS showed significantly larger reductions in LOS after ADP implementation. This observed association persisted after adjusting for both the change in serial Tn measurement interval and transition from conventional Tn assay to an hsTn assay (β = -0.26; 95% CI, -0.43 to -0.10). Three studies reported an increase in the proportion of patients admitted after introducing an ADP, one of which was significant while 15 studies reported a significant decrease in admission proportion. There was moderate heterogeneity among the 13 studies that reported MACE proportions, with a non-significant pooled risk ratio of 0.95 (95% CI, 0.86-1.04). Implementation of ADPs for chest pain presentations decreases ED LOS, most noticeably within sites with a high baseline LOS; this decreased LOS is seen even in the absence of any change in troponin assay type. The decrease in LOS occurred alongside reductions in hospital admissions, while not increasing MACE. The observed benefits translated across multiple countries and health regions.

Published
2024
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5. Self-sampling and HPV DNA testing for cervical precancer screening in a cohort of nuns in Ghana: a cross-sectional cohort studyResearch in context

Author

Kofi Effah, Ethel Tekpor, Joseph Emmanuel Amuah, Nana Owusu M. Essel, Seyram Kemawor, Esu Aku Catherine Morkli, Esther Lamptey–Mills, Comfort Mawusi Wormenor, Lawrencia Serwaa Manu, Gifty Belinda Klutsey, Stephen Danyo, and Patrick Kafui Akakpo

Subjects
Nuns, Human papillomavirus DNA testing, Self sampling, Cervical cancer, Cervical precancer screening, Medicine (General), R5-920
Abstract

Summary: Background: The need for cervical cancer screening has been emphasised in at-risk cohorts of women to reduce their risk of cervical cancer. Some women with decreased risk of acquiring human papillomavirus (HPV) infections, such as Catholic nuns, receive less attention and on occasion are missed in cervical cancer screening programmes. This study aimed to determine the high-risk HPV (hr-HPV) prevalence in such a cohort to emphasise the need for cervical precancer screening among all women. To improve compliance, we employed self-sampling. Methods: This descriptive cross-sectional cohort study involved the data of 105 Catholic nuns subjected to cervical screening using self-samples in the Greater Accra, Volta, and Central regions of Ghana between June 4, 2022 and June 30, 2022. hr-HPV testing was performed on self-samples using the MA-6000 HPV DNA platform. Screen-positive nuns underwent follow-up pap smears and EVA colposcopy. In addition to descriptive analysis, univariate and multivariable nominal logistic regression was used to explore the relationship between hr-HPV positivity and selected continuous and categorical factors. Findings: 105 nuns from three convents were screened with hr-HPV DNA testing (MA-6000). Twenty-five tested positive for hr-HPV (prevalence of 23.8% (95% CI, 15.7–32.0) [HPV 18 only (n = 2, 1.9%), non-HPV 16/18 genotypes (others) (n = 22, 21.0%), and mixed infection with HPV 16 and other genotype(s) (n = 1, 1.0%)]. Pap smears for all 25 hr-HPV-positives came in as negative for intraepithelial lesions or malignancy, whereas EVA mobile colposcopy showed minor abnormal findings in two (8.0%; 95% CI, 1.0–26.0), both of whom were managed conservatively. Interpretation: Our findings suggest that the hr-HPV prevalence in this cohort of nuns is similar to that of the general population. To meet the World Health Organization's target for cervical cancer elimination, it is important that all women are given access to cervical cancer screening and preventative services. Further, increasing ‘anonymity’ and privacy among nuns through self-sampling may be crucial to expanding choice, coverage, and uptake of screening in support of their health rights. Funding: None.

Published
2023
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6. Effectiveness of accelerated diagnostic protocols for reducing emergency department length of stay in patients presenting with chest pain: A systematic review and meta-analysis.

Author

Hill, Jesse, Essel, Nana Owusu M., Yang, Esther H., Dennett, Liz, and Rowe, Brian H.

Subjects
*MAJOR adverse cardiovascular events, *CHEST pain, *LENGTH of stay in hospitals, *PAIN measurement, *HOSPITAL emergency services
Abstract

In recent years, there has been an increase in the use of accelerated diagnostic protocols (ADPs) and high-sensitivity troponin assays (hsTn) for the assessment of chest pain in emergency departments (EDs). This study aimed to quantitatively summarize the operational and clinical outcomes of ADPs implemented for patients with suspected cardiac chest pain. To be considered eligible for inclusion, studies must have implemented some form of ADP within the ED for evaluating adult (age ≥18 years) patients presenting with chest pain using Tn assays. The primary outcome was ED length of stay (LOS). Secondary outcomes included the proportion of patients admitted and the proportion with 30-day major adverse cardiac events (MACE). Thirty-seven articles involving 404,566 patients met the inclusion criteria, including five randomized controlled trials (RCTs) and 32 observational studies. A significant reduction in total ED LOS was reported in 22 observational studies and four RCTs. Emergency departments with longer baseline ED LOS showed significantly larger reductions in LOS after ADP implementation. This observed association persisted after adjusting for both the change in serial Tn measurement interval and transition from conventional Tn assay to an hsTn assay (β = -0.26; 95% CI, -0.43 to -0.10). Three studies reported an increase in the proportion of patients admitted after introducing an ADP, one of which was significant while 15 studies reported a significant decrease in admission proportion. There was moderate heterogeneity among the 13 studies that reported MACE proportions, with a non-significant pooled risk ratio of 0.95 (95% CI, 0.86−1.04). Implementation of ADPs for chest pain presentations decreases ED LOS, most noticeably within sites with a high baseline LOS; this decreased LOS is seen even in the absence of any change in troponin assay type. The decrease in LOS occurred alongside reductions in hospital admissions, while not increasing MACE. The observed benefits translated across multiple countries and health regions. [ABSTRACT FROM AUTHOR]

Published
2024
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7. Evaluating operational parameters of the careHPV, GeneXpert, AmpFire, and MA-6000 HPV systems for cervical precancer screening: Experience from Battor, Ghana.

Author

Kofi Effah, Comfort Mawusi Wormenor, Ethel Tekpor, Joseph Emmanuel Amuah, Nana Owusu M Essel, Isaac Gedzah, Seyram Kemawor, Benjamin Tetteh Hansen, Bernard Hayford Atuguba, Gifty Belinda Klutsey, Edna Sesenu, Stephen Danyo, and Patrick Kafui Akakpo

Subjects
Public aspects of medicine, RA1-1270
Abstract

In response to calls by the World Health Organization for cervical precancer screening services in low-resource settings to lean toward HPV DNA testing, a number of testing platforms have been made available. This study aimed to evaluate the operational parameters of four HPV testing systems in previous (careHPV) and current (GeneXpert, AmpFire, and MA-6000) use in a secondary healthcare setting in terms of 'appropriateness', ease of use, throughput, and diagnostic yield. This descriptive retrospective cohort analysis included 6056 women who presented to our facility between June 2016 and March 2022 for cervical precancer screening via HPV testing. A large majority of this cohort underwent AmpFire testing (55.8%), followed by careHPV (23.3%), MA-6000 (14.7%), and GeneXpert (6.1%). MA-6000 showed the highest hr-HPV positivity rate of 26.4% (95% CI, 23.6-29.5), followed by AmpFire (17.2%; 95% CI, 15.9-17.5). GeneXpert and careHPV showed similar hr-HPV positivity rates of 14.8% (95% CI, 11.3-18.8) and 14.8% (95% CI, 13.0-16.8), respectively. For the AmpFire and MA-6000 platforms, which utilize similar detection and reporting formats, we found a significant excess detection rate of 9.2% (95% CI, 6.1-12.4; p-value

Published
2023
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8. HPV DNA Testing and Mobile Colposcopy for Cervical Precancer Screening in HIV Positive Women: A Comparison Between Two Settings in Ghana and Recommendation for Screening

Author

Effah, Kofi, primary, Anthony, Richard, additional, Tekpor, Ethel, additional, Amuah, Joseph E., additional, Wormenor, Comfort M., additional, Tay, Georgina, additional, Kraa, Smith E. Y., additional, Katso, Angela M., additional, Akonnor, Christiana A., additional, Kemawor, Seyram, additional, Danyo, Stephen, additional, Atuguba, Bernard H., additional, Essel, Nana Owusu M., additional, and Akakpo, Patrick K., additional

Published
2024
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10. Evaluating operational parameters of the careHPV, GeneXpert, AmpFire, and MA-6000 HPV systems for cervical precancer screening: Experience from Battor, Ghana

Author

Effah, Kofi, primary, Wormenor, Comfort Mawusi, additional, Tekpor, Ethel, additional, Amuah, Joseph Emmanuel, additional, Essel, Nana Owusu M., additional, Gedzah, Isaac, additional, Kemawor, Seyram, additional, Hansen, Benjamin Tetteh, additional, Atuguba, Bernard Hayford, additional, Klutsey, Gifty Belinda, additional, Sesenu, Edna, additional, Danyo, Stephen, additional, and Akakpo, Patrick Kafui, additional

Published
2023
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15. The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

Author

Tegally, H, San, JE, Cotten, M, Moir, M, Tegomoh, B, Mboowa, G, Martin, DP, Baxter, C, Lambisia, AW, Diallo, A, Amoako, DG, Diagne, MM, Sisay, A, Zekri, A-RN, Gueye, AS, Sangare, AK, Ouedraogo, A-S, Sow, A, Musa, AO, Sesay, AK, Abias, AG, Elzagheid, A, Lagare, A, Kemi, A-S, Abar, AE, Johnson, AA, Fowotade, A, Oluwapelumi, AO, Amuri, AA, Juru, A, Kandeil, A, Mostafa, A, Rebai, A, Sayed, A, Kazeem, A, Balde, A, Christoffels, A, Trotter, AJ, Campbell, A, Keita, AK, Kone, A, Bouzid, A, Souissi, A, Agweyu, A, Naguib, A, Gutierrez, A, Nkeshimana, A, Page, AJ, Yadouleton, A, Vinze, A, Happi, AN, Chouikha, A, Iranzadeh, A, Maharaj, A, Batchi-Bouyou, AL, Ismail, A, Sylverken, AA, Goba, A, Femi, A, Sijuwola, AE, Marycelin, B, Salako, BL, Oderinde, BS, Bolajoko, B, Diarra, B, Herring, BL, Tsofa, B, Lekana-Douki, B, Mvula, B, Njanpop-Lafourcade, B-M, Marondera, BT, Khaireh, BA, Kouriba, B, Adu, B, Pool, B, McInnis, B, Brook, C, Williamson, C, Nduwimana, C, Anscombe, C, Pratt, CB, Scheepers, C, Akoua-Koffi, CG, Agoti, CN, Mapanguy, CM, Loucoubar, C, Onwuamah, CK, Ihekweazu, C, Malaka, CN, Peyrefitte, C, Grace, C, Omoruyi, CE, Rafai, CD, Morang'a, CM, Erameh, C, Lule, DB, Bridges, DJ, Mukadi-Bamuleka, D, Park, D, Rasmussen, DA, Baker, D, Nokes, DJ, Ssemwanga, D, Tshiabuila, D, Amuzu, DSY, Goedhals, D, Grant, DS, Omuoyo, DO, Maruapula, D, Wanjohi, DW, Foster-Nyarko, E, Lusamaki, EK, Simulundu, E, Ong'era, EM, Ngabana, EN, Abworo, EO, Otieno, E, Shumba, E, Barasa, E, Ahmed, EB, Ahmed, EA, Lokilo, E, Mukantwari, E, Philomena, E, Belarbi, E, Simon-Loriere, E, Anoh, EA, Manuel, E, Leendertz, F, Taweh, FM, Wasfi, F, Abdelmoula, F, Takawira, FT, Derrar, F, Ajogbasile, F, Treurnicht, F, Onikepe, F, Ntoumi, F, Muyembe, FM, Ragomzingba, FEZ, Dratibi, FA, Iyanu, F-A, Mbunsu, GK, Thilliez, G, Kay, GL, Akpede, GO, van Zyl, GU, Awandare, GA, Kpeli, GS, Schubert, G, Maphalala, GP, Ranaivoson, HC, Omunakwe, HE, Onywera, H, Abe, H, Karray, H, Nansumba, H, Triki, H, Kadjo, HAA, Elgahzaly, H, Gumbo, H, Mathieu, H, Kavunga-Membo, H, Smeti, I, Olawoye, IB, Adetifa, IMO, Odia, I, Ben Boubaker, IB, Mohammad, IA, Ssewanyana, I, Wurie, I, Konstantinus, IS, Halatoko, JWA, Ayei, J, Sonoo, J, Makangara, J-CC, Tamfum, J-JM, Heraud, J-M, Shaffer, JG, Giandhari, J, Musyoki, J, Nkurunziza, J, Uwanibe, JN, Bhiman, JN, Yasuda, J, Morais, J, Kiconco, J, Sandi, JD, Huddleston, J, Odoom, JK, Morobe, JM, Gyapong, JO, Kayiwa, JT, Okolie, JC, Xavier, JS, Gyamfi, J, Wamala, JF, Bonney, JHK, Nyandwi, J, Everatt, J, Nakaseegu, J, Ngoi, JM, Namulondo, J, Oguzie, JU, Andeko, JC, Lutwama, JJ, Mogga, JJH, O'Grady, J, Siddle, KJ, Victoir, K, Adeyemi, KT, Tumedi, KA, Carvalho, KS, Mohammed, KS, Dellagi, K, Musonda, KG, Duedu, KO, Fki-Berrajah, L, Singh, L, Kepler, LM, Biscornet, L, Martins, LDO, Chabuka, L, Olubayo, L, Ojok, LD, Deng, LL, Ochola-Oyier, L, Tyers, L, Mine, M, Ramuth, M, Mastouri, M, ElHefnawi, M, Mbanne, M, Matsheka, M, Kebabonye, M, Diop, M, Momoh, M, Lima Mendonca, MDL, Venter, M, Paye, MF, Faye, M, Nyaga, MM, Mareka, M, Damaris, M-M, Mburu, MW, Mpina, MG, Owusu, M, Wiley, MR, Tatfeng, MY, Ayekaba, MO, Abouelhoda, M, Beloufa, MA, Seadawy, MG, Khalifa, MK, Matobo, MM, Kane, M, Salou, M, Mbulawa, MB, Mwenda, M, Allam, M, Phan, MVT, Abid, N, Rujeni, N, Abuzaid, N, Ismael, N, Elguindy, N, Top, NM, Dia, N, Mabunda, N, Hsiao, N-Y, Silochi, NB, Francisco, NM, Saasa, N, Bbosa, N, Murunga, N, Gumede, N, Wolter, N, Sitharam, N, Ndodo, N, Ajayi, NA, Tordo, N, Mbhele, N, Razanajatovo, NH, Iguosadolo, N, Mba, N, Kingsley, OC, Sylvanus, O, Femi, O, Adewumi, OM, Testimony, O, Ogunsanya, OA, Fakayode, O, Ogah, OE, Oludayo, O-E, Faye, O, Smith-Lawrence, P, Ondoa, P, Combe, P, Nabisubi, P, Semanda, P, Oluniyi, PE, Arnaldo, P, Quashie, PK, Okokhere, PO, Bejon, P, Dussart, P, Bester, PA, Mbala, PK, Kaleebu, P, Abechi, P, El-Shesheny, R, Joseph, R, Aziz, RK, Essomba, RG, Ayivor-Djanie, R, Njouom, R, Phillips, RO, Gorman, R, Kingsley, RA, Neto Rodrigues, RMDESA, Audu, RA, Carr, RAA, Gargouri, S, Masmoudi, S, Bootsma, S, Sankhe, S, Mohamed, SI, Femi, S, Mhalla, S, Hosch, S, Kassim, SK, Metha, S, Trabelsi, S, Agwa, SH, Mwangi, SW, Doumbia, S, Makiala-Mandanda, S, Aryeetey, S, Ahmed, SS, Ahmed, SM, Elhamoumi, S, Moyo, S, Lutucuta, S, Gaseitsiwe, S, Jalloh, S, Andriamandimby, SF, Oguntope, S, Grayo, S, Lekana-Douki, S, Prosolek, S, Ouangraoua, S, van Wyk, S, Schaffner, SF, Kanyerezi, S, Ahuka-Mundeke, S, Rudder, S, Pillay, S, Nabadda, S, Behillil, S, Budiaki, SL, van der Werf, S, Mashe, T, Mohale, T, Le-Viet, T, Velavan, TP, Schindler, T, Maponga, TG, Bedford, T, Anyaneji, UJ, Chinedu, U, Ramphal, U, George, UE, Enouf, V, Nene, V, Gorova, V, Roshdy, WH, Karim, WA, Ampofo, WK, Preiser, W, Choga, WT, Ahmed, YA, Ramphal, Y, Bediako, Y, Naidoo, Y, Butera, Y, de Laurent, ZR, Ouma, AEO, von Gottberg, A, Githinji, G, Moeti, M, Tomori, O, Sabeti, PC, Sall, AA, Oyola, SO, Tebeje, YK, Tessema, SK, de Oliveira, T, Happi, C, Lessells, R, Nkengasong, J, Wilkinson, E, Tegally, H, San, JE, Cotten, M, Moir, M, Tegomoh, B, Mboowa, G, Martin, DP, Baxter, C, Lambisia, AW, Diallo, A, Amoako, DG, Diagne, MM, Sisay, A, Zekri, A-RN, Gueye, AS, Sangare, AK, Ouedraogo, A-S, Sow, A, Musa, AO, Sesay, AK, Abias, AG, Elzagheid, A, Lagare, A, Kemi, A-S, Abar, AE, Johnson, AA, Fowotade, A, Oluwapelumi, AO, Amuri, AA, Juru, A, Kandeil, A, Mostafa, A, Rebai, A, Sayed, A, Kazeem, A, Balde, A, Christoffels, A, Trotter, AJ, Campbell, A, Keita, AK, Kone, A, Bouzid, A, Souissi, A, Agweyu, A, Naguib, A, Gutierrez, A, Nkeshimana, A, Page, AJ, Yadouleton, A, Vinze, A, Happi, AN, Chouikha, A, Iranzadeh, A, Maharaj, A, Batchi-Bouyou, AL, Ismail, A, Sylverken, AA, Goba, A, Femi, A, Sijuwola, AE, Marycelin, B, Salako, BL, Oderinde, BS, Bolajoko, B, Diarra, B, Herring, BL, Tsofa, B, Lekana-Douki, B, Mvula, B, Njanpop-Lafourcade, B-M, Marondera, BT, Khaireh, BA, Kouriba, B, Adu, B, Pool, B, McInnis, B, Brook, C, Williamson, C, Nduwimana, C, Anscombe, C, Pratt, CB, Scheepers, C, Akoua-Koffi, CG, Agoti, CN, Mapanguy, CM, Loucoubar, C, Onwuamah, CK, Ihekweazu, C, Malaka, CN, Peyrefitte, C, Grace, C, Omoruyi, CE, Rafai, CD, Morang'a, CM, Erameh, C, Lule, DB, Bridges, DJ, Mukadi-Bamuleka, D, Park, D, Rasmussen, DA, Baker, D, Nokes, DJ, Ssemwanga, D, Tshiabuila, D, Amuzu, DSY, Goedhals, D, Grant, DS, Omuoyo, DO, Maruapula, D, Wanjohi, DW, Foster-Nyarko, E, Lusamaki, EK, Simulundu, E, Ong'era, EM, Ngabana, EN, Abworo, EO, Otieno, E, Shumba, E, Barasa, E, Ahmed, EB, Ahmed, EA, Lokilo, E, Mukantwari, E, Philomena, E, Belarbi, E, Simon-Loriere, E, Anoh, EA, Manuel, E, Leendertz, F, Taweh, FM, Wasfi, F, Abdelmoula, F, Takawira, FT, Derrar, F, Ajogbasile, F, Treurnicht, F, Onikepe, F, Ntoumi, F, Muyembe, FM, Ragomzingba, FEZ, Dratibi, FA, Iyanu, F-A, Mbunsu, GK, Thilliez, G, Kay, GL, Akpede, GO, van Zyl, GU, Awandare, GA, Kpeli, GS, Schubert, G, Maphalala, GP, Ranaivoson, HC, Omunakwe, HE, Onywera, H, Abe, H, Karray, H, Nansumba, H, Triki, H, Kadjo, HAA, Elgahzaly, H, Gumbo, H, Mathieu, H, Kavunga-Membo, H, Smeti, I, Olawoye, IB, Adetifa, IMO, Odia, I, Ben Boubaker, IB, Mohammad, IA, Ssewanyana, I, Wurie, I, Konstantinus, IS, Halatoko, JWA, Ayei, J, Sonoo, J, Makangara, J-CC, Tamfum, J-JM, Heraud, J-M, Shaffer, JG, Giandhari, J, Musyoki, J, Nkurunziza, J, Uwanibe, JN, Bhiman, JN, Yasuda, J, Morais, J, Kiconco, J, Sandi, JD, Huddleston, J, Odoom, JK, Morobe, JM, Gyapong, JO, Kayiwa, JT, Okolie, JC, Xavier, JS, Gyamfi, J, Wamala, JF, Bonney, JHK, Nyandwi, J, Everatt, J, Nakaseegu, J, Ngoi, JM, Namulondo, J, Oguzie, JU, Andeko, JC, Lutwama, JJ, Mogga, JJH, O'Grady, J, Siddle, KJ, Victoir, K, Adeyemi, KT, Tumedi, KA, Carvalho, KS, Mohammed, KS, Dellagi, K, Musonda, KG, Duedu, KO, Fki-Berrajah, L, Singh, L, Kepler, LM, Biscornet, L, Martins, LDO, Chabuka, L, Olubayo, L, Ojok, LD, Deng, LL, Ochola-Oyier, L, Tyers, L, Mine, M, Ramuth, M, Mastouri, M, ElHefnawi, M, Mbanne, M, Matsheka, M, Kebabonye, M, Diop, M, Momoh, M, Lima Mendonca, MDL, Venter, M, Paye, MF, Faye, M, Nyaga, MM, Mareka, M, Damaris, M-M, Mburu, MW, Mpina, MG, Owusu, M, Wiley, MR, Tatfeng, MY, Ayekaba, MO, Abouelhoda, M, Beloufa, MA, Seadawy, MG, Khalifa, MK, Matobo, MM, Kane, M, Salou, M, Mbulawa, MB, Mwenda, M, Allam, M, Phan, MVT, Abid, N, Rujeni, N, Abuzaid, N, Ismael, N, Elguindy, N, Top, NM, Dia, N, Mabunda, N, Hsiao, N-Y, Silochi, NB, Francisco, NM, Saasa, N, Bbosa, N, Murunga, N, Gumede, N, Wolter, N, Sitharam, N, Ndodo, N, Ajayi, NA, Tordo, N, Mbhele, N, Razanajatovo, NH, Iguosadolo, N, Mba, N, Kingsley, OC, Sylvanus, O, Femi, O, Adewumi, OM, Testimony, O, Ogunsanya, OA, Fakayode, O, Ogah, OE, Oludayo, O-E, Faye, O, Smith-Lawrence, P, Ondoa, P, Combe, P, Nabisubi, P, Semanda, P, Oluniyi, PE, Arnaldo, P, Quashie, PK, Okokhere, PO, Bejon, P, Dussart, P, Bester, PA, Mbala, PK, Kaleebu, P, Abechi, P, El-Shesheny, R, Joseph, R, Aziz, RK, Essomba, RG, Ayivor-Djanie, R, Njouom, R, Phillips, RO, Gorman, R, Kingsley, RA, Neto Rodrigues, RMDESA, Audu, RA, Carr, RAA, Gargouri, S, Masmoudi, S, Bootsma, S, Sankhe, S, Mohamed, SI, Femi, S, Mhalla, S, Hosch, S, Kassim, SK, Metha, S, Trabelsi, S, Agwa, SH, Mwangi, SW, Doumbia, S, Makiala-Mandanda, S, Aryeetey, S, Ahmed, SS, Ahmed, SM, Elhamoumi, S, Moyo, S, Lutucuta, S, Gaseitsiwe, S, Jalloh, S, Andriamandimby, SF, Oguntope, S, Grayo, S, Lekana-Douki, S, Prosolek, S, Ouangraoua, S, van Wyk, S, Schaffner, SF, Kanyerezi, S, Ahuka-Mundeke, S, Rudder, S, Pillay, S, Nabadda, S, Behillil, S, Budiaki, SL, van der Werf, S, Mashe, T, Mohale, T, Le-Viet, T, Velavan, TP, Schindler, T, Maponga, TG, Bedford, T, Anyaneji, UJ, Chinedu, U, Ramphal, U, George, UE, Enouf, V, Nene, V, Gorova, V, Roshdy, WH, Karim, WA, Ampofo, WK, Preiser, W, Choga, WT, Ahmed, YA, Ramphal, Y, Bediako, Y, Naidoo, Y, Butera, Y, de Laurent, ZR, Ouma, AEO, von Gottberg, A, Githinji, G, Moeti, M, Tomori, O, Sabeti, PC, Sall, AA, Oyola, SO, Tebeje, YK, Tessema, SK, de Oliveira, T, Happi, C, Lessells, R, Nkengasong, J, and Wilkinson, E

Abstract

Investment in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing in Africa over the past year has led to a major increase in the number of sequences that have been generated and used to track the pandemic on the continent, a number that now exceeds 100,000 genomes. Our results show an increase in the number of African countries that are able to sequence domestically and highlight that local sequencing enables faster turnaround times and more-regular routine surveillance. Despite limitations of low testing proportions, findings from this genomic surveillance study underscore the heterogeneous nature of the pandemic and illuminate the distinct dispersal dynamics of variants of concern-particularly Alpha, Beta, Delta, and Omicron-on the continent. Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve while the continent faces many emerging and reemerging infectious disease threats. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century.

Published
2022

16. The cost-effectiveness of accelerated partner therapy (APT) compared to standard contact tracing for people with chlamydia: an economic evaluation based on the LUSTRUM population-based chlamydia transmission model

Author

Owusu M Woode, Nicola Low, Claudia Estcourt, Christian L. Althaus, Ogwulu Cb Okeke, Alison Howarth, Andrew Copas, Fiona Mapp, Merle Symonds, EV Williams, and Tracy E Roberts

Subjects
education.field_of_study, Chlamydia, business.industry, Cost effectiveness, Pelvic pain, Population, Tubal factor infertility, medicine.disease, Economic evaluation, Pelvic inflammatory disease, medicine, medicine.symptom, business, education, Contact tracing, Demography
Abstract

ObjectiveTo investigate the cost-effectiveness of accelerated partner therapy (APT) compared with standard contact tracing for people with sexually transmitted chlamydia infection in the United KingdomDesignEconomic evaluation using a model consisting of two components: a population-based chlamydia transmission component, to estimate the impact of APT on chlamydia prevalence, and an economic component, to estimate the impact of APT on healthcare costs and health outcomes.SettingUnited KingdomParticipantsHypothetical heterosexual population of 50,000 men and 50,000 women aged 16-34 years.Main Outcome MeasuresCost-effectiveness based on quality-adjusted life years (QALYs) gained and major outcomes averted (MOA), defined as mild pelvic inflammatory disease (PID), severe PID, chronic pelvic pain, ectopic pregnancy, tubal factor infertility and epididymitis.ResultsFor a model population of 50,000 men and 50,000 women and an APT intervention lasting 5 years, the intervention cost of APT (£135,201) is greater than the intervention cost of standard contact tracing (£116,334). When the costs of complications arising from chlamydia are considered, the total cost of APT (£370,657) is lower than standard contact tracing (£379,597). Thus, APT yields a total cost saving of approximately £9000 and leads to 73 fewer major outcomes and 21 fewer QALYs lost. Hence, APT is the dominant PN strategy. APT remained cost-effective across the full range of sensitivity analyses.ConclusionsBased on cost-effectiveness grounds APT is likely to be recommended as an alternative to standard contact tracing for chlamydia infection in the United Kingdom

Published
2021

18. The cost-effectiveness of accelerated partner therapy (APT) compared to standard contact tracing for people with chlamydia: an economic evaluation based on the LUSTRUM population-based chlamydia transmission model

Author

Williams, EV, primary, Okeke, Ogwulu CB, additional, Estcourt, CS, additional, Howarth, AR, additional, Copas, A, additional, Low, N, additional, Althaus, C, additional, Mapp, F, additional, Woode, Owusu M, additional, Symonds, M, additional, and Roberts, TE, additional

Published
2021
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20. P281 Explaining experiences of Accelerated Partner Therapy partner notification for people with chlamydia in the LUSTRUM randomised control trial: Process evaluation

Author

Mapp, F, primary, Estcourt, C, additional, Cassell, J, additional, MacQueen, J, additional, Howarth, A, additional, Brice, S, additional, Comer, A, additional, Symonds, M, additional, Nandwani, R, additional, Woode Owusu, M, additional, Saunders, J, additional, Mercer, C, additional, Stirrup, O, additional, Copas, A, additional, Low, N, additional, Roberts, T, additional, Pothoulaki, M, additional, Tostevin, A, additional, Althaus, C, additional, Ogwulu, C, additional, Wayal, S, additional, Johnson, A, additional, and Flowers, P, additional

Published
2021
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21. O18.2 Does Accelerated partner therapy improve partner notification outcomes for people with chlamydia? The LUSTRUM cluster cross-over randomised control trial

Author

Estcourt, C, primary, Mapp, F, additional, Stirrup, O, additional, Copas, A, additional, Howarth, A, additional, Woode Owusu, M, additional, Low, N, additional, Saunders, J, additional, Mercer, C, additional, Flowers, P, additional, Symonds, M, additional, Nandwani, R, additional, Roberts, T, additional, Althaus, C, additional, Ogwulu, C, additional, Brice, S, additional, Comer, A, additional, Tostevin, A, additional, Johnson, A, additional, MacQueen, J, additional, Wayal, S, additional, and Cassell, J, additional

Published
2021
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27. OP31 Towards understanding the ‘partner’ in partner notification for sexually transmitted infection healthcare: moving beyond the dichotomy of ‘regular’ and ‘casual’ partners

Author

Pothoulaki, M, primary, Vojt, G, additional, Mapp, F, additional, Mercer, CH, additional, Estcourt, CS, additional, Woode-Owusu, M, additional, Cassell, J, additional, Wayal, S, additional, Symonds, M, additional, Nandwani, R, additional, Saunders, J, additional, and Flowers, P, additional

Published
2018
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28. Abstracts of the Eighth EDCTP Forum, 6-9 November 2016.

Author

Makanga, M, Beattie, P, Breugelmans, G, Nyirenda, T, Bockarie, M, Tanner, M, Volmink, J, Hankins, C, Walzl, G, Chegou, N, Malherbe, S, Hatherill, M, Scriba, TJ, Zak, DE, Barry, CE, Kaufmann, SHE, Noor, A, Strub-Wourgaft, N, Phillips, P, Munguambe, K, Ravinetto, R, Tinto, H, Diro, E, Mahendrahata, Y, Okebe, J, Rijal, S, Garcia, C, Sundar, S, Ndayisaba, G, Sopheak, T, Ngoduc, T, Van Loen, H, Jacobs, J, D'Alessandro, U, Boelaert, M, Buvé, A, Kamalo, P, Manda-Taylor, L, Rennie, S, Mokgatla, B, Bahati, Ijsselmuiden, C, Afolabi, M, Mcgrath, N, Kampmann, B, Imoukhuede, E, Alexander, N, Larson, H, Chandramohan, D, Bojang, K, Kasaro, MP, Muluka, B, Kaunda, K, Morse, J, Westfall, A, Kapata, N, Kruuner, A, Henostroza, G, Reid, S, Alabi, A, Foguim, F, Sankarganesh, J, Bruske, E, Mfoumbi, A, Mevyann, C, Adegnika, A, Lell, B, Kranzer, K, Kremsner, P, Grobusch, M, Sabiiti, W, Ntinginya, N, Kuchaka, D, Azam, K, Kampira, E, Mtafya, B, Bowness, R, Bhatt, N, Davies, G, Kibiki, G, Gillespie, S, Lejon, V, Ilboudo, H, Mumba, D, Camara, M, Kaba, D, Lumbala, C, Fèvre, E, Jamonneau, V, Bucheton, B, Büscher, P, Chisenga, C, Sinkala, E, Chilengi, R, Chitundu, H, Zyambo, Z, Wandeler, G, Vinikoor, M, Emilie, D, Camara, O, Mathurin, K, Guiguigbaza-Kossigan, D, Philippe, B, Regassa, F, Hassane, S, Bienvenu, SM, Fabrice, C, Ouédraogo, E, Kouakou, L, Owusu, M, Mensah, E, Enimil, A, Mutocheluh, M, Ndongo, FA, Tejiokem, MC, Texier, G, Penda, C, Ndiang, S, Ndongo, J-A, Guemkam, G, Sofeu, CL, Afumbom, K, Faye, A, Msellati, P, Warszawski, J, Vos, A, Devillé, W, Barth, R, Klipstein-Grobusch, K, Tempelman, H, Venter, F, Coutinho, R, Grobbee, D, Ssemwanga, D, Lyagoba, F, Magambo, B, Kapaata, A, Kirangwa, J, Nannyonjo, M, Nassolo, F, Nsubuga, R, Yebra, G, Brown, A, Kaleebu, P, Nylén, H, Habtewold, A, Makonnen, E, Yimer, G, Burhenne, J, Diczfalusy, U, Aklillu, E, Steele, D, Walker, R, Simuyandi, M, Beres, L, Bosomprah, S, Ansumana, R, Taitt, C, Lamin, JM, Jacobsen, KH, Mulvaney, SP, Leski, T, Bangura, U, Stenger, D, De Vries, S, Zinsou, FJ, Honkpehedji, J, Dejon, JC, Loembe, MM, Bache, B, Pakker, N, Van Leeuwen, R, Hounkpatin, AB, Yazdanbakhsh, M, Bethony, J, Hotez, P, Diemert, D, Bache, BE, Fernandes, JF, Obiang, RM, Kabwende, AL, Grobusch, MP, Krishna, S, Kremsner, PG, Todagbe, AS, Nambozi, M, Kabuya, J-B, Hachizovu, S, Mwakazanga, D, Kasongo, W, Buyze, J, Mulenga, M, Geertruyden, J-P, Gitaka, J, Chan, C, Kongere, J, Kagaya, W, Kaneko, A, Kabore, N, Barry, N, Kabre, Z, Werme, K, Fofana, A, Compaore, D, Nikiema, F, Some, F, Djimde, A, Zongo, I, Ouedraogo, B, Kone, A, Sagara, I, Björkman, A, Gil, JP, Nchinda, G, Bopda, A, Nji, N, Ambada, G, Ngu, L, Tchadji, J, Sake, C, Magagoum, S, Njambe, GD, Lisom, A, Park, CG, Tait, D, Sibusiso, H, Manda, O, Croucher, K, Van Der Westhuizen, A, Mshanga, I, Levin, J, Nanvubya, A, Kibengo, F, Jaoko, W, Pala, P, Perreau, M, Namuniina, A, Kitandwe, P, Tapia, G, Serwanga, J, Yates, N, Fast, P, Mayer, B, Montefiori, D, Tomaras, G, Robb, M, Lee, C, Wagner, R, Sanders, E, Kilembe, W, Kiwanuka, N, Gilmour, J, Kuipers, H, Vooij, D, Chinyenze, K, Priddy, F, Ding, S, Hanke, T, Pantaleo, G, Ngasala, B, Jovel, I, Malmberg, M, Mmbando, B, Premji, Z, Mårtensson, A, Mwaiswelo, R, Agbor, L, Apinjoh, T, Mwanza, S, Chileshe, J, Joshi, S, Malunga, P, Manyando, C, Laufer, M, Dara, A, Niangaly, A, Sinha, I, Brodin, D, Fofana, B, Dama, S, Dembele, D, Sidibe, B, Diallo, N, Thera, M, Wright, K, Gil, J, Doumbo, O, Baraka, V, Nabasumba, C, Francis, F, Lutumba, P, Mavoko, H, Alifrangis, M, Van Geertruyden, J-P, Sissoko, S, Sangaré, C, Toure, S, Sanogo, K, Diakite, H, Doumbia, D, Haidara, K, Julé, A, Ashurst, H, Merson, L, Olliaro, P, Marsh, V, Lang, T, Guérin, P, Awuondo, K, Njenga, D, Nyakarungu, E, Titus, P, Sutamihardja, A, Lowe, B, Ogutu, B, Billingsley, P, Soulama, I, Kaboré, M, Coulibaly, A, Ouattara, M, Sanon, S, Diarra, A, Bougouma, E, Ouedraogo, A, Sombie, B, Kargougou, D, Ouattara, D, Issa, N, Tiono, A, Sirima, S, Chaponda, M, Dabira, E, Dao, F, 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Sinywimaanzi, K, Matakala, H, Munachoonga, P, Moss, W, Masenza, IS, Geisenberger, O, Agrea, P, Rwegoshora, F, Mahiga, H, Olomi, W, Kroidl, A, Kayode, G, Amoakoh-Coleman, M, Ansah, E, Uthman, O, Fokam, J, Santoro, M-M, Musolo, C, Chimbiri, I, Chikwenga, G, Deula, R, Massari, R, Lungu, A, Perno, C-F, Ndzengue, G, Loveline, N, Lissom, A, Flaurent, T, Sosso, S, Essomba, C, Kpeli, G, Otchere, I, Lamelas, A, Buultjens, A, Bulach, D, Baines, S, Seemann, T, Giulieri, S, Nakobu, Z, Aboagye, S, Owusu-Mireku, E, Danso, E, Hauser, J, Hinic, V, Pluschke, G, Stinear, T, Yeboah-Manu, D, Elshayeb, A, Siddig, ME, Ahmed, AA, Hussien, AE, Kabwe, M, Tembo, J, Chilukutu, L, Chilufya, M, Ngulube, F, Lukwesa, C, Enne, V, Wexner, H, Mwananyanda, L, Hamer, D, Sinyangwe, S, Ahmed, Y, Klein, N, Maeurer, M, Zumla, A, Bates, M, Beyala, L, Etienne, G, Anthony, N, Benjamin, A, Ateudjieu, J, Chibwe, B, Ojok, D, Tarr, CA, Perez, GM, Omeonga, S, Kibungu, F, Meyer, A, Lansana, P, Mayor, A, Onyango, P, Van Loggerenberg, F, Furtado, T, Boggs, L, Segrt, A, Dochez, C, Burnett, R, Mphahlele, MJ, Miiro, G, Mbidde, E, Peshu, N, Kivaya, E, Ngowi, B, Kavishe, R, Maowia, M, Sandstrom, E, Ayuo, E, Mmbaga, B, Leisegang, C, Thorpe, M, Batchilly, E, N'Guessan, J-P, Kanteh, D, Søfteland, S, Sebitloane, M, Vwalika, B, Taylor, M, Galappaththi-Arachchige, H, Holmen, S, Gundersen, SG, Ndhlovu, P, Kjetland, EF, Kombe, F, Toohey, J, Pienaar, E, Kredo, T, Cham, PM, Abubakar, I, Dondeh, BL, Vischer, N, Pfeiffer, C, Burri, C, Musukwa, K, Zürcher, S, Mwandu, T, Bauer, S, Adriko, M, Mwaura, P, Omolloh, K, Jones, C, Malecela, M, Hamidu, BA, Jenner, TE, Asiedu, LJ, Osei-Atweneboana, M, Afeke, I, Addo, P, Newman, M, Durnez, L, Eddyani, M, Ammisah, N, Abas, M, Quartey, M, Ablordey, A, Akinwale, O, Adeneye, A, Ezeugwu, S, Olukosi, Y, Adewale, B, Sulyman, M, Mafe, M, Okwuzu, J, Gyang, P, Nwafor, T, Henry, U, Musa, B, Ujah, I, Agobé, JCD, Grau-Pujol, B, Sacoor, C, Nhabomba, A, Casellas, A, Quintó, L, Subirà, C, Giné, R, Valentín, A, Muñoz, J, Nikiema, M, Ky-Ba, A, Comapore, KAM, Sangare, L, Oluremi, A, Michel, M, Camara, Y, Sanneh, B, Cuamba, I, Gutiérrez, J, Lázaro, C, Mejia, R, Adedeji, A, Folorunsho, S, Demehin, P, Akinsanya, B, Cowley, G, Da Silva, ET, Nabicassa, M, De Barros, PDP, Blif, MM, Bailey, R, Last, A, Mahendradhata, Y, Gotuzzo, E, De Nys, K, Casteels, M, Nona, SK, Lumeka, K, Todagbe, A, Djima, MM, Ukpong, M, Sagay, A, Khamofu, H, Torpey, K, Afiadigwe, E, Anenih, J, Ezechi, O, Nweneka, C, Idoko, J, Muhumuza, S, Katahoire, A, Nuwaha, F, Olsen, A, Okeyo, S, Omollo, R, Kimutai, R, Ochieng, M, Egondi, T, Moonga, C, Chileshe, C, Magwende, G, Anumudu, C, Onile, O, Oladele, V, Adebayo, A, Awobode, H, Oyeyemi, O, Odaibo, A, Kabuye, E, Lutalo, T, Njua-Yafi, C, Nkuo-Akenji, T, Anchang-Kimbi, J, Mugri, R, Chi, H, Tata, R, Njumkeng, C, Dodoo, D, Achidi, E, Fernandes, J, Bache, EB, Matakala, K, Searle, K, Greenman, M, and Rainwater-Lovett, K

Published
2017

29. Pain Description and Presentation in Children Admitted to a Teaching Hospital in Ghana

Author

Osei-Tutu L, Owusu M, Charles K. Hammond, Paintsil, and Joslin Dogbe

Subjects
Gynecology, medicine.medical_specialty, education.field_of_study, Abdominal pain, business.industry, Population, Attendance, Psycho-oncology, Disease, Gynecologic oncology, Family medicine, Epidemiology of cancer, medicine, medicine.symptom, education, Cancer pain, business
Abstract

Background/Aim: Pain is a cardinal symptom of many disease states and a common reason for hospital attendance. In children, however, it is often undertreated, partly due to the difficulty in its assessment. This study outlines the causes, anatomic locations and verbal descriptions of pain in children admitted to the Pediatric Emergency Unit of the Komfo Anokye Teaching Hospital in Ashanti, Ghana. Methods: This is a cross-sectional study of 273 children aged 5-12 years. Using a structured questionnaire, we obtained information through patient interview and folder review on the causes, locations and verbal descriptions of pain in children hospitalized for non-traumatic medical conditions including cancers. Findings: Sickle cell disease, infections and cancers were the main causes of pain in children admitted to the unit. Abdominal pain was the most frequently reported. Pain description in either English or the local language, Akan was difficult for most children. Conclusion/Recommendations: Pain description is difficult for most Ghanaian children as it requires the use of complex adult language. Therefore, in the management of pain in this population, it is recommended that the clinician places less emphasis on the exact description of pain and rather focus on effective pain relief.

Published
2015

30. Evidence for an ancestral association of human coronavirus 229E with bats

Author

Corman, V. M., Baldwin, H. J., Tateno, A. F., Zerbinati, R. M., Annan, A., Owusu, M., Nkrumah, E. E., Maganga, G. D., Oppong, S., Adu-Sarkodie, Y., Vallo, P., da Silva, Lvrf, Leroy, Eric, Thiel, V., van der Hoek, L., Poon, L. L. M., Tschapka, M., Drosten, C., and Drexler, J. F.

Subjects
viruses, virus diseases
Abstract

We previously showed that close relatives of human coronavirus 229E (HCoV-229E) exist in African bats. The small sample and limited genomic characterizations have prevented further analyses so far. Here, we tested 2,087 fecal specimens from 11 bat species sampled in Ghana for HCoV-229E-related viruses by reverse transcription-PCR (RT-PCR). Only hipposiderid bats tested positive. To compare the genetic diversity of bat viruses and HCoV-229E, we tested historical isolates and diagnostic specimens sampled globally over 10 years. Bat viruses were 5- and 6-fold more diversified than HCoV-229E in the RNA-dependent RNA polymerase (RdRp) and spike genes. In phylogenetic analyses, HCoV-229E strains were monophyletic and not intermixed with animal viruses. Bat viruses formed three large clades in close and more distant sister relationships. A recently described 229E-related alpaca virus occupied an intermediate phylogenetic position between bat and human viruses. According to taxonomic criteria, human, alpaca, and bat viruses form a single CoV species showing evidence for multiple recombination events. HCoV-229E and the alpaca virus showed a major deletion in the spike S1 region compared to all bat viruses. Analyses of four full genomes from 229E-related bat CoVs revealed an eighth open reading frame (ORF8) located at the genomic 3' end. ORF8 also existed in the 229E-related alpaca virus. Reanalysis of HCoV-229E sequences showed a conserved transcription regulatory sequence preceding remnants of this ORF, suggesting its loss after acquisition of a 229E-related CoV by humans. These data suggested an evolutionary origin of 229E-related CoVs in hipposiderid bats, hypothetically with camelids as intermediate hosts preceding the establishment of HCoV-229E. IMPORTANCE The ancestral origins of major human coronaviruses (HCoVs) likely involve bat hosts. Here, we provide conclusive genetic evidence for an evolutionary origin of the common cold virus HCoV-229E in hipposiderid bats by analyzing a large sample of African bats and characterizing several bat viruses on a full-genome level. Our evolutionary analyses show that animal and human viruses are genetically closely related, can exchange genetic material, and form a single viral species. We show that the putative host switches leading to the formation of HCoV-229E were accompanied by major genomic changes, including deletions in the viral spike glycoprotein gene and loss of an open reading frame. We reanalyze a previously described genetically related alpaca virus and discuss the role of camelids as potential intermediate hosts between bat and human viruses. The evolutionary history of HCoV-229E likely shares important characteristics with that of the recently emerged highly pathogenic Middle East respiratory syndrome (MERS) coronavirus.

Published
2015

35. D 5.3.2.1. Initial report on sensory and African consumer acceptance for Group 1. Project AFTER 'African Food Tradition rEvisited by Research'

Author

Adinsi, Laurent, Ahmed, Zahra S., Akissoé, Noël H., Amengor, Mary, Amoa-Awua, Wisdom, Anihouvi, Victor, Annan, Theophilus, Anyebuno, George, Bechoff, Aurélie, Bennett, Ben, Dalodé-Vieira, Générose, Declemy, Anne-Laure, Diako, C., Dzomeku, Matilda, Fliedel, Geneviève, Hassan-Wassef, H., Hounhouigan, Joseph D., Obodai, Mary, Oduro-Yeboah, Charlotte, Ofori, Hayford, Owusu, M., Pallet, Dominique, Sacca, Carole, Aati Shahat, Abdel, Keith, I, Tomlins, Keith I., and Tortoe, C.

Subjects
U30 - Méthodes de recherche, Q04 - Composition des produits alimentaires, E73 - Économie de la consommation
Abstract

The sensory profiles and acceptability of Akpan, Gowe, Akpan and Kishk Sa'eedi were tested using a focus group discussion, a quantitative descriptive panel and consumer panels comprising African and/or European consumers as indicated in the table below. It should be noted that consumer testing of Kishk Sa'eedi was delayed because of the current social unrest in Egypt. The number of consumers interviewed by product and country is summarised in the table below. Consumer Class (and number): Country Benin Product Akpan African: 103Non-African74 Country Ghana Product Kenkey African: 110 Non-African90 Country Benin Product Gowe African: 141Non-African- Country Egypt Product Kishk Sa' eedi : African- Non-African- Sensory testing indicated that for each product, the sensory profiles widely differed. This was influenced by the raw material (Kenkey, Gowe, Akpan, KS), process (Kenkey, Akpan and KS) and addition of sugar/milk (Akpan and Gowe). The products also differed according to acceptance. Akpan - African and non-African consumers behaved differently with respect to acceptability. Europeans generally had a lower acceptability of Akpan products compared to Africans. This was probably due to the fact that most Europeans were not familiar with the product since when Europeans did report consuming Akpan, there were no differences in acceptability. Consumers' acceptance was significantly associated with fermented odour and milky taste. African consumers were more sensitive to the thick/concentrated texture and cereal taste whilst Europeans were more positively influenced by sweet taste but negatively by acidic taste. Kenkey – African and non-African consumers differed in acceptance of Kenkey. Non- African consumers mostly preferred the white kenkey and to a lesser extent banku. Ghanaian consumers generally liked all of the samples or preferred banku. Sensory attributes important for the white likers were whitish colour, fruity odour, smooth and non-sticky texture, a less sour product without a pronounced fermented odour, and a bland taste. Salty taste correlated significantly with acceptance for the banku likers, Gowe - The commonly consumed gowe were sensorially distinct products with differences between the sorghum and maize samples of gowe, but no significant difference was noted with sugar was added. Regarding consumer testing, three distinct patterns of consumer acceptability were observed, which were grouped as 'Sugary Gowe likers' or “Natural sorghum Gowe dislikers” (63.1%) followed by 'Sugary sorghum Gowe likers' (20.6%) and 'Indifferent Gowe likers' (16.3%). Saccharified malted and no-malted sorghum Gowe without sugar were the least preferred. Kishk Sa'eedi (KS) has distinct sensory attributes and variation. Consumer acceptance has still to be completed. The conclusions for reengineering are as follows: Akpan – there are two options being products suited to a) Akpan from Maize Ogi containing Sugar and Milk (OMsm) or b) Akpan from Ogi Sorghum containing Sugar and Milk (OSsm). However, since they are representative of classes of akpan type, any of these two classes could be suited for the reengineering. That is the case of OMs or OSs membership of OMsm and OSsm respectively. Kenkey - Two products should be considered, one adapted to both the European and the Ghanaian consumer 'white likers' and the second adapted to only the Ghanaian consumer 'all likers and 'banku likers'. Important sensory attributes which should guide re-engineering of the first product are whitish colour, fruity odour, smooth and nonsticky texture, a mildly sour product, and a bland taste. This may be achieved by a combination of processing factors including dehulling of maize kernels, use of mixed lactic acid bacteria/yeast starter culture containing high concentration of yeasts cells (for fruity odour), reduced fermentation period (to reduce sourness and fermented odour) and elimination of the aflata step (to reduce sticky texture). The second product should be a refinement of Ga/Fanti Kenkey and should also focus on improved packaging. Gowe - Gowe made from saccharified malted sorghum with sugar (SSaSFs) was the most accepted and appears to be the most promising for reengineering. KS – the consumer testing will take place later in 2012 These findings should be considered in combination with other AFTER deliverables relating to market and regulatory issues and technical feasibility.

Published
2012

37. Collecting standardized urban health indicator data at an individual level for school-aged children living in urban areas: methods from EURO-URHIS 2.

Author

Pope, D., Katreniak, Z., Guha, J., Puzzolo, E., Higgerson, J., Steels, S., Woode-Owusu, M., Bruce, N., Birt, Christopher A., van Ameijden, E., and Verma, A.

Subjects
PUBLIC health, BENCHMARKING (Management), QUESTIONNAIRES, SURVEYS, URBAN health, CITY dwellers
Abstract

Background: Measuring health and its determinants in urban populations is essential to effectively develop public health policies maximizing health gain within this context. Adolescents are important in this regard given the origins of leading causes of morbidity and mortality develop pre-adulthood. Comprehensive, accurate and comparable information on adolescent urban health indicators from heterogeneous urban contexts is an important challenge. EURO-URHIS 2 aimed to develop standardized tools and methodologies collecting data from adolescents across heterogenous European urban contexts. Methods: Questionnaires were developed including (i) comprehensive assessment of urban health indicators from 7 pre-defined domains, (ii) use of previously validated questions from a literature review and other European surveys, (iii) translation/back-translation into European languages and (iv) piloting. Urban area-specific data collection methodologies were established through literature review, consultation and piloting. School-based surveys of 14-16-year olds (400-800 per urban area) were conducted in 13 European countries (33 urban areas). Results: Participation rates were high (80-100%) for students from schools taking part in the surveys from all urban areas, and data quality was generally good (low rates of missing/spoiled data). Overall, 13 850 questionnaires were collected, coded and entered for EURO-URHIS 2. Dissemination included production of urban area health profiles (allowing benchmarking for a number of important public health indicators in young people) and use of visualization tools as part of the EURO- URHIS 2 project. Conclusion: EURO-URHIS 2 has developed standardized survey tools and methodologies for assessing key measures of health and its determinants in adolescents from heterogenous urban contexts and demonstrated the utility of this data to public health practitioners and policy makers. [ABSTRACT FROM AUTHOR]

Published
2017
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45. HEPATITIS B AND C VIRAL INFECTIONS AMONG BLOOD DONORS FROM RURAL GHANA.

Author

NKRUMAH, B., OWUSU, M., FREMPONG, H. O., and AVERU, P.

Subjects
*HEPATITIS, *DISEASE prevalence, *BLOOD donors, *INFECTION
Abstract

Objective: To investigate the prevalence of Hepatitis B and C infections and co-infections among blood donors in a rural community of Ghana. Design: A retrospective study. Method: Samples of blood donated between January 2007 and December 2008 were screen for Hepatitis B and C viruses at the Agogo Presbyterian Hospital. Results: The prevalence of Hepatitis B viral (HBV) infection was highest in females 21.4% (95% CI: 11.6- 34.4) in 2006 than males in the same year 13.2% (95% CI: 10.8-15.9). Hepatitis C viral (HCV) infection was highest among males at11.6% (95% CI: 9.5-13.8) in 2007. HBV and HCV co-infection was higher in males 2.6% (95% CI: 1.6-3.8) than females 1.3% (95% CI: 0-7.0) in 2007. The overall prevalence of HBV and HCV was 13.8% (95% CI: 11.4-16.4) and 9.4% (95% CI: 7.4-11.6) respectively in 2006. The rate of co-infection of HBV and HCV however increased from 1.6% (95% CI: 0.8-2.7) in 2006 to 2.2% (95% CI: 1.3-3.2) in 2008 in males and from 0% (95% CI: 0-6.4) in 2006 to 1.2% (95% CI: 0-6.5) in 2008 in females. Conclusion: The single infections of HBV and HCV reduced but co-infection of these transfusion transmitted infections (TTI) increased. Measures such as more sensitive techniques and education must be employed in these areas. [ABSTRACT FROM AUTHOR]

Published
2011

47. Investigation of fractions present in the stem bark of Annickia kummeriae on their P-glycoprotein inhibitory pump activity.

Author

Owusu, M. K., Kamuhabwa, A. R., Nshimo, C., Van Boven, M., and de Witte, P. A.

Abstract

Using MCF-7R cells and rhodamine 6G as the fluorescent probe, a bioassay-targeted purification process was pursued in order to isolate the active P-gp inhibitory fractions from Annickia kummeriae. Of 24 fractions obtained in the first preparative liquid chromatography (p-LC) run, only fraction 1 exhibited activity. Further p-LC fractionation led to the separation of fraction 1 into fractions 1.1-1.8. Fractions 1.4, 1.5 and 1.6 proved to be active by inducing a significant accumulation of rhodamine 6G by 3.3-, 4.5- and 4.9-fold at 10 microg/mL, and by 5.3-, 6.3- and 6.8-fold at 100 microg/mL, respectively. Fraction 1.6 was separated into several fractions by using an analytical liquid chromatography (a-LC) system. Fractions 1.6.18, 1.6.19 and 1.6.20 were active and they induced an accumulation of rhodamine 6G by 3.0-, 1.8- and 3.5-fold at 1x microg/mL and by 4.8-, 6.7- and 6.8-fold at 10x microg/mL, respectively. Afterwards, 28.3 mg of fraction 1.6 was processed by a-LC, and fractions 1.6.18, 1.6.19 and 1.6.20 were collected separately and dried. The amounts of materials recovered were 6.2, 7.4 and <1 mg, corresponding to 21.9%, 26.1% and <3.5% of fraction 1.6, respectively. From the total amount injected and the relative masses represented by these fractions, it can be calculated that the 1x microg/mL level corresponded to ca. 35, 42 and <5 microg/mL, respectively. Fluorescence microscopy revealed that incubation of the cells with rhodamine 6G alone did not show any fluorescence, whereas cells which were incubated in medium containing rhodamine 6G together with fraction 1.4, 1.6 or reserpine, clearly indicated accumulation of the dye intracellularly. This is an indication that the active compounds effected high intracellular fluorescence by inducing accumulation of the dye in the cells through inhibition of the P-gp pump. [ABSTRACT FROM AUTHOR]

Published
2004
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49. Aetiological agents of cerebrospinal meningitis: a retrospective study from a teaching hospital in Ghana

Author

Owusu Michael, Nguah Samuel, Boaitey Yaw, Badu-Boateng Ernest, Abubakr Abdul-Raman, Lartey Robert, and Adu-Sarkodie Yaw

Subjects
Meningitis, Streptococcus pneumoniae, Cryptococcus neoformans, Ghana, Therapeutics. Pharmacology, RM1-950, Infectious and parasitic diseases, RC109-216, Microbiology, QR1-502
Abstract

Abstracts Background Meningitis is an important cause of morbidity and mortality in low-resource settings. In sub-Saharan Africa, the meningitis belt has been characterized by particularly high and seasonal incidences of bacterial meningitis extending throughout life. Despite the progress being made in treating the condition, the mortality rates continue to be high, ranging between 2% and 30% globally. In Ghana, the mortality rate of meningitis has been estimated to range from 36% to 50%. However little information is available on the pathogens contributing to meningitis and their antimicrobial susceptibilities. Updated information is essential to adjust the recommendations for empirical treatment or prevention of meningitis which could have immense implications for local and global health. Methods We retrospectively reviewed laboratory records of all patients suspected of bacterial meningitis who underwent a lumbar puncture from January 1, 2008 to December 31, 2010. Data were retrieved from laboratory record books and double entered into a Microsoft® excel spreadsheet. Results Records of 4,955 cerebrospinal fluid samples were analysed. Of these, 163 (3.3%, 95%CI: 2.8% to 3.8%) were confirmed meningitis and 106 (2.1%, 95%CI: 1.7% to 2.6%) were probable meningitis cases. Confirmed meningitis cases were made up of 117 (71.8%) culture positive bacteria, 19 (11.7%) culture positive Cryptococcus neoformans and 27(16.6%) Gram positive bacteria with negative culture. The most prevalent bacteria was Streptococcus pneumoniae 91 (77.7%), followed by E.coli 4 (3.4%), Salmonella species 4 (3.4%), Neisseria meningitidis 3 (2.5%), Pseudomonas species 3(2.5%) and others. Pneumococcal isolates susceptibility to penicillin, chloramphenicol and ceftriaxone were 98.9% (95%CI: 94.0% to 100.0%), 83.0% (95%CI: 73.4% to 90.1%) and 100.0% (95%CI: 95.8% to 100.0%) respectively. Conclusion Streptococcus pneumoniae is an important cause of meningitis among all age groups and its susceptibility to penicillin and ceftriaxone still remains very high. Ghanaians of all ages and possibly other developing countries in the meningitis belt could benefit from the use of the pneumococcal vaccine. Other bacterial and fungal pathogens should also be considered in the management of patients presenting with meningitis.

Published
2012
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50. Respiratory viruses in children hospitalized for acute lower respiratory tract infection in Ghana

Author

Kwofie Theophilus B, Anane Yaw A, Nkrumah Bernard, Annan Augustina, Nguah Samuel B, and Owusu Michael

Subjects
Respiratory Viruses, Hospitalized children, Real-Time PCR, Infectious and parasitic diseases, RC109-216
Abstract

Abstract Background Acute respiratory tract infections are one of the major causes of morbidity and mortality among young children in developing countries. Information on the viral aetiology of acute respiratory infections in developing countries is very limited. The study was done to identify viruses associated with acute lower respiratory tract infection among children less than 5 years. Method Nasopharyngeal samples and blood cultures were collected from children less than 5 years who have been hospitalized for acute lower respiratory tract infection. Viruses and bacteria were identified using Reverse Transcriptase Real-Time Polymerase Chain Reaction and conventional biochemical techniques. Results Out of 128 patients recruited, 33(25.88%%, 95%CI: 18.5% to 34.2%) were positive for one or more viruses. Respiratory Syncytial Virus (RSV) was detected in 18(14.1%, 95%CI: 8.5% to 21.3%) patients followed by Adenoviruses (AdV) in 13(10.2%, 95%CI: 5.5% to 16.7%), Parainfluenza (PIV type: 1, 2, 3) in 4(3.1%, 95%CI: 0.9% to 7.8%) and influenza B viruses in 1(0.8%, 95%CI: 0.0 to 4.3). Concomitant viral and bacterial co-infection occurred in two patients. There were no detectable significant differences in the clinical signs, symptoms and severity for the various pathogens isolated. A total of 61.1% (22/36) of positive viruses were detected during the rainy season and Respiratory Syncytial Virus was the most predominant. Conclusion The study has demonstrated an important burden of respiratory viruses as major causes of childhood acute respiratory infection in a tertiary health institution in Ghana. The data addresses a need for more studies on viral associated respiratory tract infection.

Published
2012
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