Nomogram for predicting the probability of the positive outcome of prostate biopsies among Ghanaian men

Introduction and objectives: Several existing models have been developed to predict positive prostate biopsy among men undergoing evaluation for prostate cancer (PCa). However, most of these models have come from industrialized countries. We therefore, developed a prostate disease nomogram model to provide a basis for predicting a prostate biopsy outcome by correlating clinical indicators and diagnostic parameters among Ghanaian men.Subjects and methods: The study was a hospital-based cross-sectional prospective one which was under- taken at the Department of Surgery (Urology Unit) Komfo Anokye Teaching Hospital (KATH) from December, 2014 to March, 2016. In all a total of 241 patients suspected of having a prostate disorder due based on an abnormal digital rectal examination (DRE) findings and, or elevated prostate specific antigen (PSA) level underwent Trans-Rectal Ultrasonography (TRUS) guided biopsy of the prostate. Stepwise logistic regression was used to determine the independent predictors of a positive initial biopsy. Age, prostatespecific antigen (PSA), digital rectal examination (DRE) status, prostate specific antigen density (PSAD), history of alcohol consumption and history of smoking findings were included in the analysis. Two nomogram models were developed that were based on these independent predictors to estimate the probability of a positive initial prostate biopsy. Receiver-operating characteristic curves (ROC) were used to assess the accuracy of using the nomograms and PSA and PSAD levels for predicting positive a prostate biopsy outcome. Results: Prostate cancer was diagnosed in 63 out of 241 patients (26.1%). Benign prostatic hyperplasia was diagnosed in 172 (71.4%) of patients and the remaining 6 patients (2.48%) had chronic inflammation. Significantly elevated levels of PSA and PSAD were observed among patients with PCa compared to patients without PCa (p < 0.05). Furthermore, it was observed that age, DRE, PSA, PSAD, history of smoking, and history of alcohol consumption were significantly independent predictors (p < 0.05) of prostate cancer. The area under the receiver operating characteristic curve (AUC) of nomogram I and II were 87.3 and 84.8 respectively which were greater than that of total PSA (AUC = 75.8) and PSAD (AUC = 77.8) alone for predicting a positive initial prostate biopsy. Conclusion: We conclude that, nomograms offer a better and accurate assessment for predicting a positive outcome of prostate biopsies than the use of traditional tools of PSA, DRE and PSAD alone

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

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

Isoforms of purified methyltransferase from human blood platelets

A membrane-bound protein with N-methyltransferase activity, associated with phospholipid metabolism, has been isolated from purified human blood platelet plasma membranes. The activity of this enzyme has been detected in crude platelet preparations. However, the nature and properties of this enzyme and its purification from normal human blood platelets have not been investigated, hence, the aim of this study was to purify, characterise the enzyme from human blood platelets and determine its possible role in phospholipid transmethylation. The plasma membranes were purified by velocity and sucrose gradient centrifugation and solubilized in buffer containing 0.5% Triton-X 100. The partially purified extracts were further purified using a combination of ion-exchange chromatographic procedures, preparative IEF and preparative SDS-PAGE. The preparative rotorfor electrofocusing, using pH 3-10 ampholyte at 40EC, yielded activities at both acidic and basic pHs of approximately 3.5 and 8.5, respectively. The pH 8.5 activity yielded predominantly a single 67 KDa band on SDS-PAGE gel and the pH 3.5 activity also gave a similar band and a few lighter bands at 35 KDa and 50 KDa. The acidic and basic fractions catalysed the transfer of methyl groups from S-adenosyl inethionine to PE with a predominant formation of PME (ca 90%). The fraction purified by preparative SDS-PAGE also yielded a major methylating activity that eluted between 60-70 KDa. This latter protein was washed free of SDS and its activity measured; it, too yielded predominaly the monomethylated PE. These data are consistent with the hypothesis that several SAM-dependent isozymes also exist in human blood platelets that convert PE to PC. JOURNAL OF THE GHANA SCIENCE ASSOCIATION Volume 2 No. 3 (2000) pp. 98-10

IRON DEFICIENCY IN RURAL GHANAlAN CHILDREN

Objectives: To compare the prevalence d iron deficiency among Ghanaian cbidren indifferent residential settings and to see whether 200n1g ferrous fumerate B.P. could correctiron deficiency anaemia in observed cases of iron deficiency.Design: Prospcctivc case-tinding study using an Iron-deficiency society questionnaire,laboratory data add general practice records. Crude prevalence was calcl~lated using thehospital's mid-year estimates.Setting: Nkoranza in the Brong Ahafo Rcgionof Ghana, Komfo Anokye Teaching Hospital.Kumasi, GhanaSubject: Rural-dwelling children entering as ou t-patienh, urban-dwelling children enteringas controls and new-ly diagnosed iron-deficient children cntering as in-patients.hfuit~ outconic mearirres: Crudc prevalence rates (per quinquennia) for three grnups ofchildren. Correctud deficiencies espresscd as percentage aftcr management. Age,haernoglobin, iron status, residential status, svmptoms at entry and after therapy.Results: Following u 30-day adminbtration d ferrous furnarvte, the mcan serum iron for therural children increased significantly by 3.3 p o V l representing an improved iron status uf20.09 I P<O.U(101). Iron deficiency anacmia defined by serum Hh<lZ.Og/dl and Fed2.5mmoY 1 decreased by 10%: in the rural subjects. Comparatively. iron deficielicy among [henewly diagnosed anaemia group, fell by 17.6% whilst their ambulant urban counterpartsemployed as the control Croup had an iron deficiency anocmiu of O.D%.Conclusion: l'he study clearly indicates that the prevalence of iron deficiency anaemiaamong children in rural Ghana is about ten times that of the urban-dwelling children andthat iron-deficiency anaemia accounts for a greater percentage of all anaemic cases amongchildren in n ~ ~ r hrlspitals. It was alsushownthnt taking appropriate iran supplen~ents like 204mg of ferruw fumcrate for thirty days can subs tan ti all^ improve the iron status of irondeficientchildre

Coronavirus disease vaccination among persons with disabilities : understanding vaccine perceptions and hesitancy in Ghana

The effects of coronavirus disease 2019 (COVID-19) have been felt globally and in all spheres of life. Developing vaccines was an important milestone in ensuring the protection of lives, but there are concerns about vaccine availability in sub-Saharan African (SSA) countries. The living conditions of persons with disabilities, in particular, in SSA societies have been described as deplorable and unsustainable, and they are at risk of discrimination. Such persons appear to be already struggling to obtain other basic services, and the extent of vaccine accessibility to this population remains unknown. This study aimed to assess the perceptions of persons with disabilities in Ghana of COVID-19 vaccines. Between July 2021 and December 2021, 336 persons with disabilities (hearing, visual, and physical) were recruited from two regions in Ghana. The attitude toward the COVID-19 vaccination scale was adapted for this study. The results showed that persons with disabilities were ambivalent toward vaccination, and differences were observed between participant groups. The background variables found to influence attitude were age, place of residence, educational qualification, gender, and COVID-19 acquisition status. The study concludes with a clarion call to policymakers to expedite public education for persons with disabilities

Nomogram for predicting the probability of the positive outcome of prostate biopsies among Ghanaian men

Introduction and objectives: Several existing models have been developed to predict positive prostate biopsy among men undergoing evaluation for prostate cancer (PCa). However, most of these models have come from industrialized countries. We therefore, developed a prostate disease nomogram model to provide a basis for predicting a prostate biopsy outcome by correlating clinical indicators and diagnostic parameters among Ghanaian men. Subjects and methods: The study was a hospital-based cross-sectional prospective one which was undertaken at the Department of Surgery (Urology Unit) Komfo Anokye Teaching Hospital (KATH) from December, 2014 to March, 2016. In all a total of 241 patients suspected of having a prostate disorder due based on an abnormal digital rectal examination (DRE) findings and, or elevated prostate specific antigen (PSA) level underwent Trans-Rectal Ultrasonography (TRUS) guided biopsy of the prostate. Stepwise logistic regression was used to determine the independent predictors of a positive initial biopsy. Age, prostate-specific antigen (PSA), digital rectal examination (DRE) status, prostate specific antigen density (PSAD), history of alcohol consumption and history of smoking findings were included in the analysis. Two nomogram models were developed that were based on these independent predictors to estimate the probability of a positive initial prostate biopsy. Receiver-operating characteristic curves (ROC) were used to assess the accuracy of using the nomograms and PSA and PSAD levels for predicting positive a prostate biopsy outcome. Results: Prostate cancer was diagnosed in 63 out of 241 patients (26.1%). Benign prostatic hyperplasia was diagnosed in 172 (71.4%) of patients and the remaining 6 patients (2.48%) had chronic inflammation. Significantly elevated levels of PSA and PSAD were observed among patients with PCa compared to patients without PCa (p < 0.05). Furthermore, it was observed that age, DRE, PSA, PSAD, history of smoking, and history of alcohol consumption were significantly independent predictors (p < 0.05) of prostate cancer. The area under the receiver operating characteristic curve (AUC) of nomogram I and II were 87.3 and 84.8 respectively which were greater than that of total PSA (AUC = 75.8) and PSAD (AUC = 77.8) alone for predicting a positive initial prostate biopsy Conclusion: We conclude that, nomograms offer a better and accurate assessment for predicting a positive outcome of prostate biopsies than the use of traditional tools of PSA, DRE and PSAD alone. Keywords: Nomogram, Prostate biopsy, Prostate specific antigen (PSA), Prostate specific antigen density (PSAD