Occurrence and distribution of extended-spectrum β-lactamase in clinical Escherichia coli isolates at Ho Teaching Hospital in Ghana.

Objective: This study determined the occurrence and distribution of Extended Spectrum β-Lactamase (ESBL) genotypes of E. coli isolates in Ho Teaching Hospital, Ghana.Design: A cross-sectional study.Setting: A single centre study was conducted at Ho Teaching Hospital of Ghana.Participants: Patients who visited Ho Teaching Hospital Laboratory with the request for culture and susceptibility testing.Main outcome measure: Escherichia coli were isolated, and Extended-Spectrum β-Lactamase genes were detected.Results: Of the 135 isolates, 56(41.5%,95% CI: 33.1% – 50.3%) were ESBL producers. More males, 14(58.3%), produced ESBL than females, 42(37.8%). The ESBL prevalence was highest among the elderly who were 80 years and above 3(100.0%), with the least prevalence among patients within 50-59 years and 0-9 years age bracket, representing 4(25.0%) and 3(27.3%), respectively. The total prevalence of ESBL was marginally higher among out-patients (41.8% 95% CI: 31.9% - 52.2%) compared to in-patients [40.5% 95% CI: 24.8% - 57.9]. BlaTEM-1 was the predominant ESBL genotype obtained from 83.9% (47/56) of the confirmed ESBL producing isolates, with the least being TOHO-1 4(7.1%). The co-existence of 2 different ESBL genes occurred in 19(33.9%) of the isolates. The single and quadruple carriage were 16(28.6%) and 3(5.4%), respectively. The highest co-existence of the ESBL genotypes was recorded for blaTEM-1 and blaCTXM-1 15(26.8%), followed by blaTEM-1, blaCTXM-1 and blaSHV-73 [12(21.4%)].Conclusion: The high prevalence of ESBL-producing E. coli isolates with multiple resistant gene carriage is a threat to healthcare in the study area

Hepatitis B and C infections in HIV-1 patients on combination antiretroviral therapy (cART) in Ghana: implications for immunologic recovery, clinical response to treatment, and hepatotoxicity

Background: Viral hepatitis could have an impact on the treatment response in HIV patients. In this study, we sought to determine the prevalence of hepatitis B and C infections and examine the effect on the treatment response in HIV-1 patients attending antiretroviral therapy (ART) centers in the Volta and Oti Regions of Ghana. Method: A longitudinal study design was employed. A cohort of 200 newly diagnosed HIV-1 positive adults who met the inclusion criteria (CD4 count ≤350 cells/μl) were enrolled at three ART Centers and initiated on the combination Antiretroviral Therapy (cART) from January 2014 to December 2015. Blood samples obtained from each participant were subsequently screened for the presence of hepatitis B surface antigen (HBsAg) and hepatitis C antibody. Out of the 200 study respondents recruited, 93 HIV mono-infected were randomly selected plus all 17 HIV co-infected were prospectively followed for twelve months. Using standard methods, three consecutive measurements of CD4 cells, haemoglobin, and liver enzymes [(aspartate aminotransferase (AST), alanine aminotransferase (ALT), and alkaline phosphatase (ALP)] as well as weight measurements were performed at baseline, six months and twelve months, respectively, after treatment initiation. Result: The overall HIV-viral hepatitis sero-positivity was 8.5%. HBV and HCV co-infections were 7.0% and 1.5% respectively. Among HIV mono-infected CD4 cell count, haemoglobin, and weight significantly increased from baseline to the twelfth month while levels remained statistically comparable in the HIV co-infected patients. The levels of AST, ALT, and ALP were more pronounced (hepatotoxicity) in the HIV co-infected compared to the HIV mono-infected at various time points within the twelve month. Conclusion: The frequency of HIV-hepatitis co-infection was high. This correlates with poor immunological outcome, clinical response to treatment and pronounced hepatotoxicity. The findings, therefore, underscore the need for regular screening of HIV patients for early detection and appropriate management

Assessment of estimated low-density lipoprotein-cholesterol (LDL-c) equations: a systematic review and meta-analysis

Abstract Background Low-density lipoprotein cholesterol (LDL-c) is the major determinant of cardiovascular disease burden. This study critically reviewed the published literature and performed a meta-analysis to compare and to determine which other equations provide the best means of estimating LDL-c in clinical settings. Method English articles indexed in PubMed, Science Open, Biomed central and SpringerLink databases were searched with searches being conducted in or after 2001 up to date. According to the predefined inclusion and exclusion criteria, 22 articles out of the 17,970 retrieved were eligible for quantitative analysis. Data were pooled and meta-analysis performed using a random-effects model, and the results are described as event rates (pooled correlation coefficient). Main body of the abstract All the twelve equations showed positive correlation with the respective direct low-density lipoprotein-cholesterol measurements. The pooled estimates showed a stronger positive correlation between Martin’s low-density lipoprotein-cholesterol equation and the direct low-density lipoprotein-cholesterol measurement [0.96 (95% CI 0.94–0.98)] as compared to Friedewald’s equation and the direct method [0.94 (95% CI 0.92–0.96)]. At triglycerides levels > 400 mg/dl, Martin’s low-density lipoprotein-cholesterol equation established better performance (77.78%) than the Friedewald’s equation. In studies where triglycerides levels > 400 mg/dl were excluded Martin’s low-density lipoprotein-cholesterol equation still established better performance (83.33%) than the Friedewald’s equation. Short conclusion Our data suggest that Martin’s equation showed a better performance than Friedewald equation. Martin’s equation can serve as a more accurate method to estimate low-density lipoprotein cholesterol as compared to Friedewald’s equation especially in situations of the same racial background

Haematological Profile of Adults with Malaria Parasitaemia Visiting the Volta Regional Hospital, Ghana

Background. Malaria is known to cause severe health consequences due to its marked effects and alteration on the haematological parameters of infected individuals. This study evaluated the haematological profile of adult individuals infected with the malaria parasite. Methods. A retrospective study was conducted using archived data of malaria positive cases from January 2017 to March 15, 2019. Data retrieved included subjects’ demographics, malaria parasite count, malaria parasite species, and full blood count parameters. A total of 236 malaria positive subjects were included in the study. Results. The study showed that more females were infected with the malaria parasite than males (69.07% and 30.93%, respectively). A total of 87.3% of the study population were infected with Plasmodium falciparum as compared to 12.7% infected with Plasmodium malariae. The commonest haematological abnormalities that were seen in this study were lymphopenia (56.78%), anaemia (55.51%), thrombocytopenia (47.46%), eosinopenia (45.76%), neutropenia (29.24%), monocytosis (21.19%), and leucocytosis (17.37%) in the infected subjects. The mean platelet count of P. falciparum-infected subjects was decreased as compared to the mean platelet count of P. malariae-infected subjects. There was a significant (P value <0.05) decrease in the number of platelet count with every unit increase in parasite density. Conclusion. Study participants infected with malaria demonstrated vital changes in haematological parameters with anaemia, thrombocytopenia, lymphopenia, monocytosis, and eosinopenia being the most important predictors of malaria infection especially with P. falciparum species