Multicenter Study of Buruli Ulcer Disabilities in the Head and Neck Region

Objective. To identify disabilities caused by Buruli Ulcer Disease (BUD) when it affects the Head and Neck Region (HNR) of patients in endemic areas and suggest possible ways to overcome the complications involved. Methods. Data for the study was collected from six different hospitals in the central part of Ghana from 2004–2009. Diagnosis of BUD was based on clinical findings and confirmed by positive result of Ziehl-Neelson Test for Acid Fast Bacilli, Polymerase Chain Reaction, or Histopathology. Treatment of BUD involved a combination of surgical interventions and antimycobacterial chemotherapy for 8 weeks. Results. The age of the 38 patients ranged from 0–56 years (mean age of 14.3 years), with males outnumbering females. Most (55.3%, N = 21) of the patients reported to the facilities with developed BUD deformities. Patients who lost their eyeball (N = 5) recorded the highest in terms of functional disability. A mean total hospital stay of 52 days and follow-up period of 2.3 years were recorded for the study. Conclusion. Visual impairment was the commonest form of disability recorded in the HNR. Management difficulties and BUD disabilities could be avoided by early detection of the disease and training of health professionals at district levels

A study of cleft lip/palate in a community in the South East of Ghana

The previous study in Wudoaba villages suggested that cleft lip and cleft palate (CL/CP) may be endemic in the Wudoaba cluster of villages in the Ketu South District of the Volta Region in South East Ghana. The study was to detect the prevalence of CL/CP in the Wudoaba communities and to investigate the factors associated with the causes of this malformation in the area. Two different interview-based questionnaires were designed to collect data over a period of 3 days from March 27 to 29, 2006. A purposive and accidental random sampling technique was used in the administering of the various questionnaires to the respondents. Data collected were recorded and analyzed with SPSS version 17.0. A total 99 respondents, with a mean age of 55.0 years, were interviewed. Out of it, 57.6% (n = 57) were related to their spouses: 54 first cousins and three other family relations. The prevalence of CL/CP is at least 6.3 per 1,000 people (i.e., 25/4,000). Majority (56.0%, n = 14) of the cleft cases were unilateral. Interviews revealed that genetic homogeneity and vitamin deficiencies in this community may be a causal factor for the high prevalence of CL/CP. This community provides clues suggesting that the magnitude of CL/CP may be larger than other studies and identifies the Wudoaba population as one that could be further studied to explore the underlying factors causing this congenital malformation

Comparative Study of the Sensitivity of Different Diagnostic Methods for the Laboratory Diagnosis of Buruli Ulcer Disease

Background. Several diagnostic laboratory methods are available for case confirmation of Buruli ulcer disease. This study assessed the sensitivity of various diagnostic tests in relation to clinical presentation of the disease, type of diagnostic specimen, and treatment history. Methods. Swab samples, 3-mm punch biopsy tissue specimens, and surgically excised tissue specimens from 384 individuals with suspected Buruli ulcer disease were obtained at 9 different study sites in Ghana and were evaluated with dry reagent-based polymerase chain reaction (PCR), microscopic examination, culture, and histopathological analysis. The study subjects presented with nonulcerative and ulcerative lesions and were divided into 3 treatment groups: (1) previously untreated patients scheduled for antimycobacterial treatment, (2) patients treated with surgery alone, and (3) patients treated with surgery in combination with previous antimycobacterial treatment. Results. Of 384 suspected cases of Buruli ulcer disease, 268 were confirmed by at least 1 positive test result. The overall sensitivity of PCR (85%) was significantly higher than that of microscopic examination (57%) and culture (51%). After data were stratified by treatment group, type of lesion, and diagnostic specimen type, analysis revealed that PCR of 3-mm punch biopsy tissue specimens (obtained from previously untreated nonulcerative lesions) and of swab samples (obtained from previously untreated ulcers) had the highest diagnostic sensitivity (94% and 90%, respectively). Although duration of the disease did not significantly influence the sensitivity of any test, previous antimycobacterial treatment was significantly associated with decreased sensitivity of PCR and culture. Conclusions. Across all subgroups, PCR had the highest sensitivity. PCR assessment of 3-mm punch biopsy tissue specimens proved to be the best diagnostic tool for nonulcerative lesions, and PCR assessment of swab samples was the best diagnostic tool for ulcerative lesions. For monitoring of antimycobacterial treatment success within controlled trials, however, only culture is appropriat

Multidisciplinary approach to genomics research in Africa:the AfriCRAN model

This article is an outcome of the African Craniofacial Anomalies Research Network (AfriCRAN) Human Hereditary and Health (H3A) grant planning meeting in 2012 in Lagos, Nigeria. It describes the strengths of a multidisciplinary team approach to solving complex genetic traits in the craniofacial region. It also highlights the different components and argues for the composition of similar teams to fast track the discovery of disease genes, diagnostic tools, improved clinical treatment and ultimately prevention of disease

Novel <i>GREM1 </i>Variations in Sub-Saharan African Patients With Cleft Lip and/or Cleft Palate

Objective: Cleft lip and/or cleft palate (CL/P) are congenital anomalies of the face and have multifactorial etiology, with both environmental and genetic risk factors playing crucial roles. Though at least 40 loci have attained genomewide significant association with nonsyndromic CL/P, these loci largely reside in noncoding regions of the human genome, and subsequent resequencing studies of neighboring candidate genes have revealed only a limited number of etiologic coding variants. The present study was conducted to identify etiologic coding variants in GREM1, a locus that has been shown to be largely associated with cleft of both lip and soft palate. Patients and Method: We resequenced DNA from 397 sub-Saharan Africans with CL/P and 192 controls using Sanger sequencing. Following analyses of the sequence data, we observed 2 novel coding variants in GREM1. These variants were not found in the 192 African controls and have never been previously reported in any public genetic variant database that includes more than 5000 combined African and African American controls or from the CL/P literature. Results: The novel variants include p.Pro164Ser in an individual with soft palate cleft only and p.Gly61Asp in an individual with bilateral cleft lip and palate. The proband with the p.Gly61Asp GREM1 variant is a van der Woude (VWS) case who also has an etiologic variant in IRF6 gene. Conclusion: Our study demonstrated that there is low number of etiologic coding variants in GREM1, confirming earlier suggestions that variants in regulatory elements may largely account for the association between this locus and CL/P. </jats:sec

Evolution of burn injury management in KATH, Kumasi-Ghana, 1954–2017

Introduction: Burns management worldwide has evolved over the decades with remarkable improvement, especially in High Income Countries. Knowledge about the various eras; challenges encountered, strategies to overcome them and other vital information are very necessary for underdeveloped and developing countries who hope to attain the best level of burns management. Aim: This paper presents a report on the evolution of burn injury management at the Komfo Anokye Teaching Hospital (KATH)-Ghana, since the hospital’s commissioning in 1954 till present (63 years). Method: The evolution of burns management at KATH was categorized into 5 phases: Phase 1, 2, 3, 4 and 5. Each phase provides information on the extent of development spanning from the “all-in-one” inclusive ward through to the new Burns Intensive Care Unit (BICU) at the new Accident and Emergency Centre. Results: There has been significant reduction in burns mortality and other negative burns sequelae. There has also been effective records keeping which has led to effective research work and improved burns care. There is a new BICU, an improvement from the old Burns Ward D2C and is stocked with ultra-modern equipment for burns management. Conclusion: Evolution of the KATH Burns Unit has led to great improvement in burn patient’s care. The experience gained so far has better equipped us to mentor upcoming burn centers and healthcare providers across the globe; most importantly in Africa. The goal to put up special burn centers is challenging, but perseverance brings success, and the results are invaluable. Keywords: Burns management, Burns, KATH, BICU, Occupational Therap

Breast Developmental Anomalies: A Review of the Problem

The breast is a sign of female sexual identity. However, there are some anomalies that affect normal breast development. These abnormalities could have physiological, psychological and psychosocial effects on an individual and could result in the person developing a negative self image. Not much study on these anomalies has been carried out even though most people are likely to suffer from any one of these breast developmental abnormalities (BDA) than breast cancer. Awareness on these abnormalities is very low unlike breast cancer. Due to low awareness, people with this form of condition are not aware of measures available. Incidence of these anomalies could be high hence the need to educate people on these abnormalities. This review seeks to create the awareness on BDAs and the necessary interventions available