The Prevalence of the Metabolic Syndrome in Ghanaian Psychiatric Patients on Antipsychotic (First versus Second Generation) Treatment in the Kumasi Metropolis

Metabolic syndrome (MetS), a predominant public health problem linked to cardiovascular and other morbidities, has acquired a significant precedence in clinical settings and patients with severe mental illnesses who are at higher risk for deviant components of this syndrome due to their illness and its treatment require careful and regular monitoring in this regard. Even though MetS has been established to be more prevalent among psychiatric patients than among any other population group, no data exist on its prevalence in Ghanaian psychiatric patients. This study seeks to find the prevalence of the MetS, in Ghanaian psychiatric patients on antipsychotics (first or second generation) compared to newly diagnosed psychiatric patients. This cross-sectional study of patients attending psychiatric department of the Komfo Anokye Teaching Hospital (KATH) in Kumasi, Ghana between February 2009 and July 2010.  A total of 200 psychiatric patients comprising 100 newly diagnosed antipsychotic naïve patients and 100 patients on antipsychotic medication were sampled for the study. Prevalence of MetS diagnosed using the World Health Organization (WHO), International Diabetes Federation (IDF) and the National Cholesterol Education Programme, Adult Treatment Panel III (NCEP ATP III) criteria for defining MetS was employed.The prevalence was significantly higher among psychiatric patients on treatment in comparison with the treatment naïve group using NCEP ATP III (21.0% vs. 2.0%; p < 0.0001) and IDF (29.0% vs. 2.0%; p < 0.0001) criteria but not WHO (13.0% vs. 14.0%; p = 0.8372). Irrespective of the criteria used, the prevalence of MetS was higher among patients on second generation versus first generation antipsychotic medication (i.e. 44.4% vs. 18.7% for NCEP ATP III; 22.2% vs. 12.1% for WHO and 56.6% vs. 27.5% for IDF), however these did not reach a significant levelPrevalence of MetS was not only highly prevalent among Ghanaian patients treated with antipsychotic drugs, it was also higher among patients on second generation versus first generation antipsychotic medication. Keywords: Diabetes, hypertension, dyslipidaemia, mental illness, antipsychotics.

Sexual dysfunction among Ghanaian men presenting with various medical conditions

<p>Abstract</p> <p>Background</p> <p>Several medical conditions can affect and disrupt human sexuality. The alteration of sexuality in these medical conditions often hinder effective communication and empathy between the patients and their sexual partners because of cultural attitudes, social norms and negative feelings such as anxiety and guilt. Validated and standardized sexual inventories might therefore help resolve this problem. The objective of this cross-sectional study was to obtain data on the prevalence of male sexual dysfunction (SD) among Ghanaians with various medical conditions residing in Kumasi.</p> <p>Methods</p> <p>The Golombok Rust Inventory of Sexual Satisfaction (GRISS) was administered to 150 Ghanaian men with various medical conditions between 19 and 66 years old (mean ± standard deviation: 40.01 ± 12.32 years) domiciled in the Kumasi metropolis.</p> <p>Results</p> <p>Out of the total 150 questionnaires administered, 105 (70.0%) men returned the questionnaires. Questionnaires from 3 men were incomplete, leaving 102 complete and evaluable questionnaires, indicating a 68.0% response rate. Of the remaining 102 men, 88.2% were married, 70.6% had attained higher education, 88.2% were non-smokers. Whereas 54.9% were engaged in exercise, 61.8% indulged in alcoholic beverages. The prevalence of the various medical conditions include: diabetes (18%), hypertension (24.5%), migraine (11.8%), ulcer (7.8%), surgery (6.9%), STD (3.9) and others (26.5%). The prevalence of SD among the respondents in the study was 59.8%. The highest prevalence of SD was seen among ulcer patients (100%), followed by patients who have undergone surgery (75%), diabetes (70%), hypertension (50%), STD (50%) and the lowest was seen among migraine patients (41.7%).</p> <p>Conclusions</p> <p>SD rate is high among Ghanaian men with medical conditions (about 60%) and vary according to the condition and age.</p

Incidence of sexual dysfunction: a prospective survey in Ghanaian females

<p>Abstract</p> <p>Background</p> <p>Sexuality is a complex phenomenon that is being influenced by psychological as well as physiological factors. Its dysfunction includes desire, arousal, orgasmic and sex pain disorders. The present study aimed to assess the incidence of sexual dysfunction (SD) and related risk factors in a cohort of Ghanaian women.</p> <p>Method</p> <p>The Golombok Rust Inventory of Sexual Satisfaction (GRISS) was administered to 400 healthy women between 18 and 58 years old (mean +/- SD: 30.1 +/- 7.9) domiciled in the Kumasi metropolis.</p> <p>Results</p> <p>The response rate was 75.3% after 99 were excluded. Of the remaining 301 women, 50% were engaged in exercise, 26.7% indulge in alcoholic beverages and only 2% were smokers. A total of 62.1% of the women had attained high education, whilst, 28.9% were married. After logistic regression analysis, alcohol emerged (OR: 2.0; CI: 1.0 - 3.8; p = 0.04) as the main risk factor for SD. The overall prevalence of SD in these subjects was 72.8%. Severe difficulties with sexual function were identified in 3.3% of the studied population. The most prevalent areas of difficulty were anorgasmia (72.4%), sexual infrequency (71.4%), dissatisfaction (77.7%), vaginismus (68.1%), avoidance of sexual intercourse (62.5%), non-sensuality (61.5%) and non-communication (54.2%). Whereas 8% had severe difficulties with anorgasmia, only 6% had severe difficulties with vaginismus.</p> <p>Conclusion</p> <p>SD affects more than 70% of Ghanaian women who are sexually active. Alcohol significantly influences sexual activity.</p

The Reliability of Using Vitek 2 Compact System to Detect Extended-Spectrum Beta-lactamase-producing Isolates in Escherichia coli and Klebsiella pneumoniae in Accra, Ghana

Extended-spectrum beta-lactamases (ESBLs) are plasmid-mediated beta-lactamases that are capable of hydrolysing ?-lactams except carbapenems and cephamycins. The global increased prevalence of ESBL-producing bacteria creates an urgent need for laboratory diagnostic methods that will accurately and rapidly identify the presence of ESBL phenotypes in clinical isolates. The Vitek 2 System (bioMérieux, France) is a rapid automated microbiological system used for bacteria and yeast identification, antimicrobial susceptibility testing (AST), resistance mechanism detection and epidemiologic trending and reporting using its advanced expert system. This present work sought to determine the reliability of routinely using Vitek 2 System to accurately and rapidly detect ESBL-producing E. coli and K. pneumoniae in Accra. The ESBL phenotypes for 400 E. coli and K. pneumoniae isolates were determined using the Vitek 2 system and combined disc synergy method. The results were used to determine the sensitivity, specificity, negative predictive value and positive predictive value of the Vitek 2 ESBL test through comparative analysis with the combined disk synergy method which is the reference method recommended by CLSI. The findings of this work indicated that the sensitivity, specificity, positive predictive value and negative predictive value of Vitek 2 system was 98.5%, 98.9%, 99% and 98.5% respectively. Consequently, Vitek 2 system is a reliable semi-automated microbiology system which may be used for routine, accurate and rapid detection of ESBL strains in health facilities in Accra, Ghana. Keywords: Vitek 2 Compact System, Extended spectrum beta-lactamase, bioMérieux, E. coli and K.  pneumoni

Phenotypic Characterization of AmpC beta-lactamase among Cefoxitin Resistant Escherichia coli and Klebsiella pneumoniae Isolates in Accra, Ghana

AmpC ?-lactamases hydrolyze penicillins, cephalosporins and cephamycins and resist inhibition by clavulanate, sulbactam, and tazobactam. Strains with AmpC genes are inherently resistant to multiple agents, making the selection of an effective antibiotic difficult. This present work sought to investigate the occurrence of AmpC beta-lactamases-producing phenotypes in E. coli and K. pneumoniae and their antimicrobial sensitivity profile. Four hundred K. pneumoniae and E. coli non-duplicate isolates were collected and their antibiotic sensitivity testing for cefoxitin and other 16 antibiotics were determined using Vitek 2 Compact System (bioMérieux, Marcy I’Etoile, France).  The isolates resistant to cefoxitin were confirmed as AmpC beta-lactamases-producing phenotypes with disk synergy testing (DST) using cefotaxime or ceftazidime with or without boronic acid. An increase in zone diameter of ?5mm in the presence of boronic acid indicates the presence of AmpC beta-lactamases in the test organism. The results showed that of the 50 cefoxitin resistant isolates screened from 400 bacterial isolates, 5(10%) were AmpC beta-lactamase-producers with 60%, 60%, 60%, 80% and 100% multiply antibiotic resistance in gentamicin, ciprofloxacin, norfloxacin, trimethoprim/sulfamethoxazole and tetracycline respectively. Nitrofurantoin which indicated 100% susceptibility with MIC90 of 32µg/ml may be a therapeutic option especially for non-life-threatening urinary tract infection. Imipenem was the antibiotic of choice with 100% susceptibility rates (MIC90 of ?1µg/ml). Though the insignificant (p&gt;0.05) levels of AmpC beta-lactamase phenotypes may not require routine detection in health facilities, there is the need to implement evolutionary antibiotic administration policies and pragmatic infection control measures in the hospitals.      Keywords: AmpC beta-lactamase, Cefoxitin, ?-lactams, E. coli, K. pneumonia

Phenotypic Determination and Antimicrobial Resistance Profile of Extended Spectrum Beta-lactamases in Escherichia coli and Klebsiella pneumoniae in Accra, Ghana

Extended-spectrum beta-lactamases (ESBLs) are plasmid-mediated beta lactamases commonly found in the Enterobacteriaceae that are capable of hydrolysing ?-lactams except carbapenems and cephamycins. ESBLs confer resistance to several non-ß-lactam antibiotics. ESBL-producing organisms appear susceptible to cephalosporins in vitro using conventional breakpoints but ineffective in vivo. This work sought to determine the occurrence of ESBL in E. coli and K. pneumoniae and their antibiotic resistance profile. Four hundred K. pneumoniae and E. coli non-duplicate isolates were collected at the Central Laboratory of Korle Bu Teaching Hospital and Advent Clinical Laboratories. They were definitively identified and their minimum inhibition concentration and antibiotic sensitivity testing for 17 antibiotics were determined using Vitek 2 Compact System (bioMérieux, Marcy I’Etoile, France).  The isolates were confirmed as ESBL-producing strains using the Combination Disk Synergy Method. The results indicated that 202 (50.5%) of the bacterial isolates were ESBL-producing phenotypes with high resistant to gentamicin, ciprofloxacin, tetracycline and trimethoprim/sulfamethoxazole indicating 82.2%, 79.7%, 70.8% and 97% resistant rates respectively. imipenem and amikacin were the antibiotics of choice with 99% and 94.1% susceptibility rates (MIC90 of ?1µg/ml and 4µg/ml respectively). It is imperative to routinely detect ESBL-phenotypes in health facilities, implement appropriate antibiotic administration policy and infection control measures in the hospitals.   Keywords: Extended Spectrum Beta-lactamase, Antimicrobial Resistance, ?-lactams, K. pneumoniae, E. col

Single nucleotide polymorphisms in LCAT may contribute to dyslipidaemia in HIV-infected individuals on HAART in a Ghanaian population

© 2020, The Author(s). Highly active antiretroviral therapy (HAART) is known to cause lipid abnormalities such as dyslipidaemia in HIV-infected individuals. Yet, dyslipidaemia may not independently occur as it may be worsened by single nucleotide polymorphisms (SNPs) in lecithin cholesterol acyltransferase (LCAT) and lipoprotein lipase (LPL). This case–control study was conducted in three-selected hospitals in the Northern part of Ghana. The study constituted a total of 118 HIV-infected participants aged 19–71 years, who had been on HAART for 6–24 months. Dyslipidaemia was defined based on the NCEP-ATP III criteria. HIV-infected individuals on HAART with dyslipidaemia were classified as cases while those without dyslipidaemia were grouped as controls. Lipid profile was measured using an automatic clinical chemistry analyzer and genomic DNA was extracted for PCR (GeneAmp PCR System 2700). Overall, the prevalence of dyslipidaemia was 39.0% (46/118). High levels of low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), and reduced levels of high-density lipoprotein cholesterol (HDL-C) were observed in all cases. A total of 256 selected PCR amplicons comprising 137 LPL (exons 3, 5 and 6) and 119 LCAT (exons 1, 4, and 6) were sequenced in 46 samples (Inqaba Biotech). Six (6) clinically significant SNPs were identified in exons 1 and 4 for LCAT whereas 25 non-clinically significant SNPs were identified for LPL in exons 5 and 6. At position 97 for LCAT exon 1, there was a deletion of the nucleotide, ‘A’ in 32.5% (13/40) of the sampled population while 67.5% (27/40) of the sample population retained the nucleotide, ‘A’ which was significantly associated with dyslipidaemic outcomes in the study population (p = 0.0004). A total of 25 SNPs were identified in exons 5 and 6 of LPL; 22 were substitutions, and 3 were insertions. However, none of the 25 SNPs identified in LPL exon 5 and 6 were statistically significant. SNPs in LCAT may independently contribute to dyslipidaemia among Ghanaian HIV-infected individuals on HAART, thus, allowing genetic and/or functional differential diagnosis of dyslipidaemia and creating an opportunity for potentially preventive options

Association between transcription factor 7-like-2 polymorphisms and type 2 diabetes mellitus in a Ghanaian population

Type 2 diabetes mellitus (T2DM) has been strongly associated with single nucleotide polymorphisms (SNPs) in the TCF7L2 gene. This study investigated the association between rs12255372, rs7903146 in the TCF7L2 gene and T2DM in a Ghanaian population. A case-control study design was used for this study. A total of 106 T2DM patients and 110 control participants were selected. Basic data collected included body mass index, blood pressure and socio-demographics. Fasting blood samples were collected and processed for: serum lipid analysis, plasma glucose estimation and plasma HbA1c estimation. Parts of the whole blood samples were used for DNA extraction using a modified salting-out method. Common and allele-specific primers were designed for genotyping using the Modified Tetra-Primer Amplification assay. Associations were evaluated using logistic regression models. The rs7903146 risk variant was significantly associated with 2.16 vs. 4.06 increased odds for T2DM in patients \u3c60 years vs. ≥60 years. Both rs7903146 and rs12255372 were significantly associated with increased odds of T2DM in women, overweight/obese, T2DM negative family history (T2DM-NFH) and low-HDL-C. In a multivariate model, rs7903146 but not rs12255372 was significantly associated with 2.18, 5.01 and 2.25 increased odds of T2DM, under the codominant, recessive and additive model, respectively (p \u3c 0.05). The association between rs7903146 and rs12255372 with T2DM is more highly associated in a subgroup—women and those with T2DM-NFH, yet who have cardiometabolic risk

Sexual dysfunction among married couples living in Kumasi metropolis, Ghana

<p>Abstract</p> <p>Background</p> <p>Sexuality and its manifestation constitute some of the most complex of human behaviour and its disorders are encountered in community. Sexual dysfunction is more prevalent in women than in men. While studies examining sexual dysfunction among males and females in Ghana exist, there are no studies relating sexual problems in males and females as dyadic units. This study therefore investigated the prevalence and type of sexual disorders among married couples.</p> <p>Method</p> <p>The study participants consisted of married couples between the ages of 19 and 66 living in the province of Kumasi, Ghana. Socio-demographic information and Golombok-Rust Inventory of Sexual Satisfaction (GRISS) questionnaires were administered to 200 couples who consented to take part in the study. All 28 questions of the GRISS are answered on a five-point (Likert type) scale from "always", through "usually', "sometimes", and "hardly ever", to "never". Responses are summed up to give a total raw score ranging from 28-140. The total score and subscale scores are transformed using a standard nine point scale, with high scores indicating greater problems. Scores of five or more are considered to indicate SD. The study was conducted between July and September 2010.</p> <p>Results</p> <p>Out of a total of 200 married couples, 179 completed their questionnaires resulting in a response rate of 89.5%. The mean age of the participating couples as well as the mean duration of marriage was 34.8 ± 8.6 years and 7.8 ± 7.6 years respectively. The husbands (37.1 ± 8.6) were significantly older (p < 0.0001) than their corresponding wives (32.5 ± 7.9). After adjusting for age, 13-18 years of marriage life poses about 10 times significant risk of developing SD compared to 1-6 years of married life among the wives (OR: 10.8; CI: 1.1 - 49.1; p = 0.04). The total scores (6.0) as well as the percentage above the cut-off (59.2) obtained by the husbands compared to the total score (6.2) and the percentage above cut-off (61.5) obtained by the wives, indicates the likely presence of sexual dysfunction. The prevalence of impotence and premature ejaculation were 60.9% and 65.4% respectively from this study and the prevalence of vaginismus and anorgasmia were 69.3% and 74.9% respectively. The highest prevalence of SD subscales among the men was dissatisfaction with sexual act followed by infrequency, whereas the highest among the women was infrequency followed by anorgasmia. Dissatisfaction with sexual intercourse among men correlated positively with anorgasmia and wife's non-sensuality and infrequency of sex.</p> <p>Conclusion</p> <p>The prevalence of sexual dysfunction in married couples is comparable to prevalence rates in the general male and female population and is further worsened by duration of marriage. This could impact significantly on a couple's self-esteem and overall quality of life.</p