Epidemiology of Helicobacter pylori infection in dyspeptic Ghanaian patients

Introduction: Helicobacter pylori is a gram-negative urease-producing bacterium causally linked with gastritis, peptic ulcer disease and gastricadenocarcinoma. Infection is more frequent and acquired at an earlier age in developing countries compared to European populations. The incidence of Helicobacter pylori infection in dyspeptic Ghanaian patients was 75.4 %. However, epidemiological factors associated with infection vary across populations. Methods: This study used a cross-sectional design to  consecutively sample dyspeptic patients at the Endoscopy Unit of the Korle-Bu Teaching Hospital, Accra between 2010 and 2012. The study questionnaire elicited their epidemiological clinical characteristics.  Helicobacter pylori infection was confirmed by rapid-urease examination of antral biopsies at upper Gastro-intestinal endoscopy.Results: The sample population of dyspeptic patients attending the Endoscopy Unit for upper GI endoscopy yielded 242 patients of which 47.5 % were females. The age distribution of H. pylori-infection was even across most age – groups, ranging from 69.2% (61 – 70) years to 80% (21 –30) years. Helicobacter pylori prevalence decreased across areas mapping to the three residential classes in accordance with increasing affluence with rural areas having the highest prevalence. The unemployed and patients in farming had relatively high Helicobacter pylori infection rates of 92.3 % and 91.7 % respectively.Conclusion: Helicobacter pylori is endemic in Ghana but the persistently high prevalence across age groups despite significant community anti-microbial use suggests likely re-crudescence or re-infection from multiple sources in a developing country. Socio-cultural factors such as residential class and farming may be facilitating factors for its continued prevalence

Patient age at diagnosis and the clinicopathological features of breast cancer in women

BackgroundBreast cancer (BC) is diagnosed commonly in younger Ghanaian women compared to women in western countries.AimsThe aim of this study was to compare the clinico-pathological features of BC in young women (≤39 years) with older women (≥40 years) and draw conclusions.Methods This was a retrospective review (2001–2014).Results Approximately 19.6per cent of the study population were women aged ≤39 years (Group A). Bilateral BCs were commoner in group A compared to B (women aged 40 years or older), [(1.1per cent vs. 0.6per cent), (p=0.002]. About 60.7 per cent of group A had skin involvement compared to 71.3 per cent for B, (p=0.002). About 75.7 per cent of group A women presented with breast lumps after 3 months of onset (late), compared to 70.1 per cent of group B women (p=0.000). The mean size of primary BC for A was 5.6cm compared to 5.1cm for B, (p=0.004). Positive tumour margins were found in 27.7 per cent of BCs in A and 24.2 per cent in B, (p=0.003). Grade 3 tumours were common in group A than B [(35.8 per cent vs. 31.0 per cent), p=0.002]. Approximately, 70.5 per cent group A women had positive nodes compared to 88.8 per cent of group B (p=0.001). Higher TNM stages were found in group A compared to B [(58.1 per cent vs. 51.1 per cent, p=0.033)].ConclusionThe study found that 19.6 per cent of the women were age 39 years or younger. Features of advanced BC were common in younger women. Routine self-breast examination is recommended for all Ghanaian women to enhance early detection and management of neoplastic lesions

Cervical human papillomavirus infection in accra, Ghana

Background: This study was aimed at estimating the human papillomavirus (HPV) prevalence and its determinants among a sample of Ghanaian women.Design: Cross-sectional observational study.Setting: Gynaecology outpatient clinic of the Korle-Bu Teaching Hospital, Accra, Ghana; the largest tertiary care gynaecology outpatient clinic in Ghana.Participants: Convenient sample of 75 consentingwomen visiting the clinic.Methods: Information was obtained through personal interviews using structured questionnaire, Pap smears obtained, and laboratory testing of cervical exfoliated cells was performed. HPV DNA was detected using aGP5+/6+ polymerase chain reaction assay. These data were analyzed using both univariate and bivariate techniques.Results: The mean age of participants was 33.3 years (standard deviation, 9.2) and the percentage of lifetime monogamy was 21.3%. The crude HPV DNA prevalence was 10.7%. Unlike most populations studied sofar, HPV prevalence was high not only among young women, but also in middle and old age. Independent HPV determinants were being illiterate (prevalence odds ratio [POR], 13.9; 95% confidence interval[95%CI], 1.9-100) and reporting more than three lifetime sexual partners (POR, 4.6; 95% CI, 1.0-22.2).Conclusions: The study indicates a high crude prevalence of HPV in a largely polygamous Ghanaian population with a high crude prevalence in older age groups, which may be a distinctive feature of polygamouspopulations where HPV transmission continues into middle age and cervical cancer incidence is very high

Seroprevalence of HHV-8, CMV, and EBV among the general population in Ghana, West Africa

<p>Abstract</p> <p>Background</p> <p>Human herpesvirus 8 (HHV-8), cytomegalovirus (CMV) and Epstein-Barr virus (EBV) are prevalent in Africa, but less common elsewhere and the modes of transmission are still subject to debate. Generally, they rarely cause disease in the immunocompetent host but are highly oncogenic when associated with immunosuppression. Although the high prevalence of HHV-8, CMV and EBV has been well documented in Africa, such data are sparse from Ghana.</p> <p>Methods</p> <p>Serum samples from 3275 HIV-seronegative healthy blood donors and 250 HIV-AIDS patients were tested for antibodies specific for HHV-8, CMV and EBV by IgG ELISA assays. Differences in seropositivity rates by gender and age were evaluated using the Chi-square test with Yates correction.</p> <p>Results</p> <p>Of the 3275 HIV-seronegative healthy blood donors tested, 2573 (78.6%) were males and 702 (21.4%) were females, with ages ranging from 18 to 65 years (median 32.6; mean 31.2; mode 30). Of the 250 HIV-AIDS patients tested, 140 (56%) were males and 110 (44%) were females, with ages ranging from 17 to 64 years (median 30.8; mean 30.3; mode 28). Among the HIV-seronegative healthy blood donors, overall seroprevalence of HHV-8, CMV and EBV was 23.7%, 77.6% and 20.0%, respectively. Among the HIV-AIDS patients, overall seroprevalence of HHV-8, CMV and EBV was 65.6%, 59.2% and 87.2%, respectively. The seroprevalence of HHV-8 (p < 0.005) and EBV (p < 0.001) was statistically significantly higher in HIV-AIDS patients compared to HIV-seronegative healthy blood donors. There was no statistically significant difference (p = 0.24) between CMV seroprevalence in HIV-AIDS patients and HIV-seronegative healthy blood donors. Age and gender were not independent determinants (p > 0.05) for all three infections among HIV-seronegative healthy blood donors and HIV-AIDS patients in Ghana.</p> <p>Conclusion</p> <p>The results presented herein indicate that HHV-8, CMV and EBV infections are hyperendemic in both HIV-seronegative and HIV-seropositive Ghanaians, and suggest primarily a horizontal route of transmission of these three viral infections in Ghana.</p

Prostate cancer disparities in Black men of African descent: a comparative literature review of prostate cancer burden among Black men in the United States, Caribbean, United Kingdom, and West Africa

<p>Abstract</p> <p>Background</p> <p>African American men have the highest prostate cancer morbidity and mortality rates than any other racial or ethnic group in the US. Although the overall incidence of and mortality from prostate cancer has been declining in White men since 1991, the decline in African American men lags behind White men. Of particular concern is the growing literature on the disproportionate burden of prostate cancer among other Black men of West African ancestry in the Caribbean Islands, United Kingdom and West Africa. This higher incidence of prostate cancer observed in populations of African descent may be attributed to the fact that these populations share ancestral genetic factors. To better understand the burden of prostate cancer among men of West African Ancestry, we conducted a review of the literature on prostate cancer incidence, prevalence, and mortality in the countries connected by the Transatlantic Slave Trade.</p> <p>Results</p> <p>Several published studies indicate high prostate cancer burden in Nigeria and Ghana. There was no published literature for the countries Benin, Gambia and Senegal that met our review criteria. Prostate cancer morbidity and/or mortality data from the Caribbean Islands and the United Kingdom also provided comparable or worse prostate cancer burden to that of US Blacks.</p> <p>Conclusion</p> <p>The growing literature on the disproportionate burden of prostate cancer among other Black men of West African ancestry follows the path of the Transatlantic Slave Trade. To better understand and address the global prostate cancer disparities seen in Black men of West African ancestry, future studies should explore the genetic and environmental risk factors for prostate cancer among this group.</p

Still births at Korle Bu Teaching Hospital: characteristics of parents, pregnancy and labour

No Abstract. Ghana Medical Journal Vol. 38(1) 2004: 15-1

Perceived and experienced restrictions in participation and autonomy among adult survivors of stroke in Ghana

Background: Many stroke survivors do not participate in everyday life activities. Objectives: To assess the perceived and experienced restrictions in participation and autonomy among adult stroke survivors in Ghana. Methods: The "Impact on Participation and Autonomy Questionnaire" (IPAQ) instrument was administered in a survey of 200 adult stroke survivors to assess perceived restrictions in participation and autonomy, followed by in-depth interviews with a sub-sample on the restrictions they experienced in participation. Results: Perceived restrictions in participation were most prevalent in the domains of education and training (3.46±0.79), paid or voluntary work (2.68±0.89), helping and supporting other people (2.20±0.82), and mobility (2.12±0.79). There were significant differences in two domains between survivors who received physiotherapy and those who received traditional rehabilitation. Over half of the survivors also perceived they would encounter severe problems in participation in the domains of paid or voluntary work, mobility, and education and training. The sub-sample of stroke survivors (n=7) mostly experienced restrictions in participation and autonomy in going outside the house, working, and in fulfilling family roles. Conclusions:If these perceptions and experiences are not addressed during rehabilitation, they could further inhibit the full participation and social integration of stroke survivors. promoting practices

Human Papilloma virus Genotypes in Ghanaian women with Cervical Carcinoma

Background: Human papilloma viruses (HPV s) have been considered to be the necessary and central agents of cervical cancer among women with nearly 80% of cases found in developing countries. Objective: To determine HPV genotypes prevalent in Ghanaian women with cervical cancer. Design: Retrospective study. Setting: Pathology Department, University of Ghana Medical School, College of Health Sciences, University of Ghana. Subjects: Ghanaian women 23 to 80 years diagnosed with cervical cancer. Results: Of the 50 samples genotyped, 49 (98%) were determined as positive for HPV DNA. Eight out of 18 different HPV genotypes were detected and all were high-risk types. In decreasing order of prevalence, were HPV 18 in 42 (84%) samples, HPV 16 in 12 (24%) samples, HPV 45 in three (6%) samples, HPV 39 in two (4%) samples and HPV 35, 52,56 and 66 in one (2%) sample each. Multiple infections were detected in 13 (26%) of the 50 samples, the most common co-infections being HPV types 16/18 (18%). Triple infections were found in two (4%) samples with HPV types 16, 18 and 39. HPV type 18 was more relatively frequent in adenocarcinomas and adenosquamous carcinomas than in squamous cell carcinomas. Conclusion: Eight high-risk HPV genotypes: 16, 18, 35, 39, 45, 52, 56 and 66 were typed, with HPV type 18 being the most prevalent in Ghanaian women with cervical cancer. This is contrary to the worldwide prevalence where HPV 16 is the most common type associated with invasive cervical carcinoma.East African Medical Journal Vol. 87 No. 8 August 201