ORCID Profile
0000-0001-9023-6612
Current Organisations
Edith Cowan University
,
Kwame Nkrumah University of Science and Technology College of Health Sciences
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Publisher: Authorea, Inc.
Date: 30-03-2022
DOI: 10.22541/AU.164864319.94530620/V1
Abstract: Objective The study used both subjective, Suboptimal Health Status (SHS) concept along with objective, biomarkers of oxidative stress (OS): 8-OHdG, 8-epi-PGF2α and total antioxidant capacity (TAC) and angiogenic growth mediators (AGMs): VEGF-A, sFlt-1, PlGF and soluble endoglin (sEng) for predicting early-onset (EO) and late-onset (LO) preecl sia (PE) Design A hospital-based longitudinal nested case-control study Setting Obstetrics and Gynaecology Department at Komfo Anokye Teaching Hospital, Ghana Population/S le Singleton normotensive pregnancies (NTN-P) at baseline W1 (10-20th week gestation) (n= 593) of which 498 (197 developed PE) completed the study. Methods: The overall health status of the NTN-P participants was assessed at W1 and categorised as SHS and optimal health status (OHS) using a validated SHS questionnaire-25. Participants were followed at W2 (21-31st week, mid-pregnancy) and 32-42nd week. S les were collected and analysed for biomarkers of OS and AGMs at the three-time points. Main Outcome Measures Receiver operative characteristics curve analysis was performed for the single and combined W1 and W2 biomarkers of OS and AGMs for predicting PE and its subtypes (EO-PE and LO-PE) Results Compared to single biomarkers of OS and AGMs, their combined ratios particularly, the W2 8-OHdG/PIGF ratio was a potent biomarker for PE [AUC=0.93]. Additionally, 8-OHdG/PIGF ratio best identified SHS-pregnant women who later developed EO-PE [AUC=0.97] and LO-PE [AUC=0.93]. Moreover, 8-OHdG/PIGF ratio best identified OHS-pregnant women who later developed EO-PE [AUC=0.94] and LO-PE (AUC=0.94). Conclusion Combination of biomarkers of OS and AGMs, particularly, mid-pregnancy 8-OHdG/PlGF ratio is a potent biomarker for PE and its subtypes.
Publisher: Hindawi Limited
Date: 04-04-2019
DOI: 10.1155/2019/1408031
Abstract: Background . Malaria remains an important cause of morbidity and mortality in Africa. Previous studies that assessed C-reactive protein (CRP) have centered on the conventional method. This study evaluated the usefulness of high-sensitivity CRP (hs-CRP) in malaria diagnosis and morbidity in a pediatric population in Ghana. Methodology . A total of 267 subjects (100 microscopically proven nonmalarial parasitaemics as controls and 167 plasmodium parasitaemic subjects as cases), between the ages of 7 months and 18 years, were recruited for this case-control study. Blood s les were collected for malaria parasite density by microscopic examination full blood count, electrolytes, and liver function tests using an automated analyzer and hs-CRP levels by sandwich ELISA method. Results . The median hs-CRP concentration was lowest in the control group and increased significantly from low to high parasitaemia. The median hs-CRP level was significantly higher in high malaria parasitaemia compared to moderate and low malaria parasitaemia. Increasing hs-CRP cutoff (3.12-4.64 mg/L) presented with increasing specificity (79.3-93.1%) and sensitivity (96.4%-97.4%), except for moderate parasitaemia where a decline in sensitivity (80.9%) was observed. However, hs-CRP had relatively lower PPV but high NPV at low parasitaemia while both the PPV and NPV were moderate in moderate parasitaemia. Conclusion . hs-CRP yielded a high sensitivity, specificity, and accuracy for low, moderate, and high-grade malaria, respectively, and thus may serve as an effective supplementary diagnostic and prognostic biomarker for Plasmodium parasite infection. However, hs-CRP might not be readily useful yet for diagnostic purposes in hospitals due to the relatively low PPV and NPV for low and moderate parasitaemia and thus necessitates further studies in larger cohorts.
Publisher: Public Library of Science (PLoS)
Date: 29-06-2023
DOI: 10.1371/JOURNAL.PONE.0288079
Abstract: Preecl sia is a leading cause of foeto-maternal deaths especially in Sub-Saharan Africa. However, the prevalence and risk factors of preecl sia are scarce in the Central region of Ghana with previous study assessing in idual independent risk factors. This study determined the prevalence and algorithm of adverse foeto-maternal risk factors of preecl sia. This multi-centre prospective cross-sectional study was conducted from October 2021 to October 2022 at the Mercy Women’s Catholic Hospital and Fynba Health Centre in Central region, Ghana. A total of 1,259 pregnant women were randomly s led and their sociodemographic, clinical history, obstetrics and labour outcomes were recorded. Logistic regression analysis using SPSS version 26 was performed to identify risk factors of preecl sia. Of the 1,259 pregnant women, 1174 were finally included in the study. The prevalence of preecl sia was 8.8% (103/1174). Preecl sia was common among 20–29 years age group, those who had completed basic education, had informal occupation, multigravida and multiparous. Being primigravida [aOR = 1.95, 95% CI (1.03–3.71), p = 0.042], having previous history of caesarean section [aOR = 4.48, 95% CI (2.89–6.93), p .001], foetal growth restriction [aOR = 3.42, 95% CI (1.72–6.77), p .001] and birth asphyxia [aOR = 27.14, 95% CI (1.80–409.83), p = 0.017] were the independent risk factors of preecl sia. Pregnant women exhibiting a combination of primigravida, previous caesarean section and foetal growth restriction were the highest risk for preecl sia [aOR = 39.42, 95% CI (8.88–175.07, p .001] compared to having either two or one of these factors. Preecl sia is increasing among pregnant women in the Central region of Ghana. Pregnant women being primigravida with foetal growth restriction and previous history of caesarean section are the highest risk population likely to develop preecl sia with neonates more likely to suffer adverse birth outcome such as birth asphyxia. Targeted preventive measures of preecl sia should be created for pregnant women co-existing with multiple risk factors.
Publisher: Informa UK Limited
Date: 06-2022
DOI: 10.2147/IJGM.S366688
Publisher: Public Library of Science (PLoS)
Date: 05-06-2015
Publisher: Hindawi Limited
Date: 19-06-2018
DOI: 10.1155/2018/4701097
Abstract: This study determined noncompliance to antihypertensive therapy (AHT) and its associated factors in a Ghanaian population by using the health belief model (HBM). This descriptive cross-sectional study conducted at Kint o Municipality in Ghana recruited a total of 678 hypertensive patients. The questionnaire constituted information regarding sociodemographics, a five-Likert type HBM questionnaire, and lifestyle-related factors. The rate of noncompliance to AHT in this study was 58.6%. The mean age (SD) of the participants was 43.5 (±5.2) years and median duration of hypertension was 2 years. Overall, the five HBM constructs explained 31.7% of the variance in noncompliance to AHT with a prediction accuracy of 77.5%, after adjusting for age, gender, and duration of condition. Higher levels of perceived benefits of using medicine [aOR=0.55(0.36-0.82),p=0.0001] and cue to actions [aOR=0.59(0.38-0.90),p=0.0008] were significantly associated with reduced noncompliance while perceived susceptibility [aOR=3.05(2.20-6.25), p .0001], perceived barrier [aOR=2.14(1.56-2.92), p .0001], and perceived severity [aOR=4.20(2.93-6.00),p .0001] were significantly associated with increased noncompliance to AHT. Participant who had completed tertiary education [aOR=0.27(0.17-0.43), p .0001] and had regular source of income [aOR=0.52(0.38-0.71), p .0001] were less likely to be noncompliant. However, being a government employee [aOR=4.16(1.93-8.96), p=0.0002)] was significantly associated increased noncompliance to AHT. Noncompliance to AHT was considerably high and HBM is generally reliable in assessing treatment noncompliance in the Ghanaian hypertensive patients. The significant predictors of noncompliance to AHT were higher level of perceived barriers, susceptibility, and severity. Intervention programmes could be guided by the association of risk factors, HBM constructs with noncompliance to AHT in clinical practice.
Publisher: SAGE Publications
Date: 2023
DOI: 10.1177/20503121231175759
Abstract: Micronutrients, especially calcium (Ca) and magnesium (Mg) are reported to reduce preecl sia events via several factors such as endothelial cell control, optimal oxidative stress and a balanced angiogenic growth mediator. We evaluated the association of micronutrients with oxidative stress biomarkers, and angiogenic growth mediators in early-onset preecl sia and late-onset preecl sia. This case-control study recruited 197 preecl sia (early-onset preecl sia = 70 and late-onset preecl sia = 127) as cases and 301 normotensive pregnant women as controls from the Komfo Anokye Teaching Hospital, Ghana. S les were collected after 20 weeks of gestation for both cases and controls and estimated for Ca, Mg, soluble fms-like tyrosine kinase-1, placental growth factor, vascular endothelial growth factor-A, soluble endoglin, 8-hydroxydeoxyguanosine, 8-epiprostaglandinF2-alpha and total antioxidant capacity. Early-onset preecl sia women had significantly lower levels of Ca, Mg, placental growth factor, vascular endothelial growth factor-A and total antioxidant capacity but higher levels of soluble fms-like tyrosine kinase-1, soluble endoglin, 8-epiprostaglandinF2-alpha, 8-hydroxydeoxyguanosine, soluble fms-like tyrosine kinase-1 lacental growth factor ratio, 8-epiprostaglandinF2-alpha lacental growth factor ratio, 8-hydroxydeoxyguanosine lacental growth factor ratio and soluble endoglin lacental growth factor ratio than late-onset preecl sia and normotensive pregnant women ( p 0.0001). Among the early-onset preecl sia women, the first and second quartile for serum placental growth factor, first quartile for vascular endothelial growth factor-A and total antioxidant capacity and the fourth quartiles for serum sEng, serum sFlt-1, 8-epiPGF2α and 8-OHdG were independently associated with low Ca and Mg ( p 0.05). Among late-onset preecl sia women, the fourth quartile for soluble fms-like tyrosine kinase-1 was independently associated with low Ca and Mg ( p 0.05). Magnesium and calcium are associated with an imbalance in angiogenic growth mediators and oxidative stress biomarkers among preecl sia women, particularly early-onset preecl sia. Serial and routine measurement of these micronutrients would allow the monitoring of poor placental angiogenesis while enabling an understanding of the triggers of increased oxidative stress and reduced antioxidant in preecl sia.
Publisher: Springer Science and Business Media LLC
Date: 03-2018
Publisher: Hindawi Limited
Date: 02-07-2020
DOI: 10.1155/2020/3198671
Abstract: Objectives . Sub-Saharan Africa (SSA) is observing an accelerating prevalence rate of type 2 diabetes mellitus (T2DM) influenced by gene-environment interaction of modifiable and nonmodifiable factors. We conducted a systematic review and meta-analysis on the heritability and genetic risk of T2DM in SSA. Methods . We reviewed all published articles on T2DM in SSA between January 2000 and December 2019 and available in PubMed, Scopus, and Web of Science. Studies that reported on the genetics and/or heritability of T2DM or indicators of glycaemia were included. Data extracted included the study design, records of family history, pattern and characteristics of inheritance, genetic determinants, and effects estimates. Results . The pattern and characteristics of T2DM heritability in SSA are preference for maternal aggregation, higher among first degree compared to second-degree relatives early age-onset ( years), and inherited abnormalities of beta-cell function/mass. The overall prevalence of T2DM was 28.2% for the population with a positive family history (PFH) and 11.2% for the population with negative family history (NFH). The pooled odds ratio of the impact of PFH on T2DM was 3.29 (95% CI: 2.40-4.52). Overall, 28 polymorphisms in 17 genes have been investigated in relation with T2DM in SSA. Almost all studies used the candidate gene approach with most (45.8%) of genetic studies published between 2011 and 2015. Polymorphisms in ABCC8 , Haptoglobin , KCNJ11 , ACDC , ENPP1 , TNF-α , and TCF7L2 were found to be associated with T2DM, with overlapping effect on specific cardiometabolic traits. Genome-wide studies identified ancestry-specific signals ( AGMO-rs73284431 , VT11A-rs17746147 , and ZRANB3 ) and TCF7L2-rs7903146 as the only transferable genetic risk variants to SSA population. TCF7L2-rs7903146 polymorphism was investigated in multiple studies with consistent effects and low-moderate statistical heterogeneity. Effect sizes were modestly strong [ odds ratio = 6.17 (95% CI: 2.03-18.81), codominant model 2.27 (95% CI: 1.50-3.44), additive model 1.75 (95% CI: 1.18-2.59), recessive model]. Current evidence on the heritability and genetic markers of T2DM in SSA populations is limited and largely insufficient to reliably inform the genetic architecture of T2DM across SSA regions.
Publisher: Public Library of Science (PLoS)
Date: 21-03-2022
DOI: 10.1371/JOURNAL.PONE.0265717
Abstract: Angiogenic growth mediators (AGMs) and oxidative stress (OS) both play essential roles in normal placental vascular development and as such, placental alterations in these factors contribute to pre-ecl sia (PE). Suboptimal health status (SHS), an intermediate between health and disease, has been associated with imbalanced AGMs and OS biomarkers. Thus, SHS pregnant women may be at increased risk of developing PE and may present abnormal placental alteration and expression of AGMs and OS compared to optimal health status (OHS) pregnant women. We examined the histopathological morphology, immunohistochemical expression of AGMs antibodies and oxidative DNA damage marker in the placentae of SHS and OHS pregnant women who developed early-onset PE (EO-PE) and late-onset (LO-PE) compared to normotensive pregnancy (NTN-P). This nested case-control study recruited 593 singleton normotensive pregnant women at baseline (10–20 weeks gestation) from the Ghanaian Suboptimal Health Status Cohort Study (GHOACS) undertaken at the Komfo Anokye Teaching Hospital, Ghana. Socio-demographic, clinical and obstetrics data were collected, and a validated SHS questionnaire-25 (SHSQ-25) was used in classifying participants into SHS (n = 297) and OHS (n = 296). Participants were followed until the time of PE diagnosis and delivery (32–42 weeks gestation). Blood s les were collected at the two-time points and were assayed for AGMs soluble fms-like tyrosine kinase-1 (sFlt-1), placental growth factor (PIGF), vascular endothelial growth factor-A (VEGF-A), and soluble endoglin (sEng), and OS biomarkers 8-hydroxydeoxyguanosine (8-OHdG), 8-epiprostaglandinF2-alpha (8- epi-PGF2α) and total antioxidant capacity (TAC) using ELISA. Placental s les were collected for histopathological and immunohistochemical analysis. Of the 593 pregnant women, 498 comprising 248 SHS and 250 OHS women returned for delivery and were included in the final analysis. Of the 248 SHS women, 56, 97 and 95 developed EO-PE, LO-PE and NTN-P, respectively, whereas 14, 30 and 206 of the 250 OHS mothers developed EO-PE, LO-PE and NTN-P, respectively. At baseline, SHS_NTN pregnant women had a significant imbalance in AGMs and OS biomarkers compared to OHS_NTN pregnant women (p .0001). At the time of PE diagnosis, SHS_NTN-P women who developed EO-PE, LO-PE, and NTN-P had lower serum levels of P1GF, VEGF-A and TAC and correspondingly higher levels of sEng, sFlt-1, 8-epiPGF2α, and 8-OHdG than OHS-NTN-P women who developed EO-PE and LO-PE, NTN-P ( p .0001). A reduced placental size, increased foetal lacental weight ratio, and a significantly higher proportion of fibrinoid necrosis, infarction, villous fibrin, syncytial knots, calcification, chorangiosis, tunica media/vascular wall hypertrophy and chorioamnionitis was associated with the SHS group who developed PE (EO-PE LO-PE) more than OHS groups who developed PE (EO-PE LO-PE) when all were compared to NTN-P ( p .0001). The intensity of antibody expression of PIGF and VEGF-A were significantly reduced, whereas Flt-1, Eng and 8-OHdG were significantly increased in placentae from SHS-pregnant women who developed EO-PE LO-PE more than OHS- pregnant women who developed EO-PE LO-PE when all were compared to NTN-P ( p .0001). Increased lesions, oxidative DNA damage, and imbalanced expression between pro-and anti-AGMs are associated more with SHS-embodied PE placentae rather than OHS-embodied PE subtypes, thus potentially allowing differential evaluation of PE.
Publisher: Public Library of Science (PLoS)
Date: 19-11-2019
Publisher: Wiley
Date: 07-09-2017
Publisher: Springer Science and Business Media LLC
Date: 20-11-2014
Publisher: Informa UK Limited
Date: 09-12-2019
DOI: 10.1080/10715762.2019.1685668
Abstract: Optimal oxidative stress (OS) is important throughout pregnancy however, an increased OS may alter placental angiogenesis culminating in an imbalanced of angiogenic growth mediators (AGMs). Suboptimal Health Status (SHS), a physical state between health and disease, may be associated with increased OS and unbalanced AGMs. In this study, we explored the association between SHS, biomarkers of OS (BOS) and AGMs among normotensive pregnant women (NTN-PW) in a Ghanaian Suboptimal Health Cohort Study (GHOACS). This comparative GHOACS recruited 593 NTN-PW from the Komfo Anokye Teaching Hospital, Ghana. SHS was measured using a Suboptimal Health Status Questionnaire-25 (SHSQ-25). Along with the subjective SHS measure, objective BOS: 8-hydroxy-2-deoxyguanosine (8-OHdG), 8-epiprostaglandinF2 alpha (8-epi-PGF2α), total antioxidant capacity (TAC), and AGMs: vascular endothelial growth factor-A (VEGF-A), soluble fms-like tyrosine kinase receptor 1 (sFlt-1), placental growth factor (PIGF) and soluble endoglin (sEng) were evaluated. Compared to optimal health NTN-PW, levels of PlGF, VEGF-A and TAC were significantly (
Publisher: Springer Science and Business Media LLC
Date: 17-09-2018
Publisher: Hindawi Limited
Date: 28-06-2018
DOI: 10.1155/2018/6542983
Abstract: The study determined the prevalence of MetS in patients with schizophrenia at the Psychiatric Unit of the Komfo Anokye Teaching Hospital (KATH), Kumasi, Ghana. This comparative cross-sectional study recruited 348 schizophrenic patients comprising 236 antipsychotic-treated and 112 newly diagnosed treatment- naïve patients. The MetS prevalence was assessed based on World Health Organization (WHO), International Diabetes Federation (IDF), and the National Cholesterol Education Programme, Adult Treatment Panel III (NCEP ATP III) criteria. The overall prevalence of MetS was 14.1%, 20.4%, and 23.6% using NCEP ATP III, WHO, and IDF criteria, respectively, compared to 7.8%, 3.9%, and 2.2% reported in the general Ghanaian population. The prevalence was significantly higher among treated psychiatric patients compared to treatment- naïve group based on NCEP ATP III (17.8% versus 6.2% p = 0.0001), WHO (26.2% versus 8.0% p 0.0001), and IDF (30.3% versus 10.0% p 0.0001). MetS was prevalent among patients on atypical antipsychotics compared to typical antipsychotics irrespective of the criteria used (i.e., 17.1% versus 11.1% for NCEP ATP III 29.5% versus 25.9% for WHO and 44.3% versus 18.5% for IDF). Using logistic regression model, obesity, raised fasting blood sugar, raised total cholesterol, and decreased high density lipoprotein were observed to be significant predictors of MetS (p .05).The study found high prevalence of MetS in Ghanaians with schizophrenia and higher prevalence rate of MetS associated with monotherapy. Regular monitoring of cardiometabolic parameters should be an important therapeutic objective in the management of these patients.
Publisher: Wiley
Date: 08-2023
DOI: 10.1002/HSR2.1475
Abstract: Dyslipidemia in diabetes mellitus has been linked to unhealthy lifestyle and bad eating habits. However, this association has not been well studied among rural and urban Ghanaian populations. In this study, we determined the prevalence, knowledge, and lifestyle‐associated risk factors of dyslipidemia among Ghanaian type‐2 diabetes mellitus (T2DM) patients in rural and urban areas. This comparative multicentre‐cross‐sectional study recruited 228 T2DM outpatients attending the St. Michael Hospital, Pramso (rural) and Kumasi South Regional Hospital (urban), Ghana for routine check‐ups. Self‐structured questionnaire was used to collect sociodemographic, knowledge, and lifestyle characteristics. Fasting blood s les were taken to measure lipid profiles. Dyslipidemia was defined per the American Diabetes Association criteria. All p 0.05 were considered statistically significant. The overall prevalence of dyslipidemia was 79/228 (34.7%). Dyslipidemia was more prevalent among urban participants 43 (18.9%) than rural participants 36 (15.8%). Twenty‐seven (11.7%) had adequate knowledge about the risk factors, complications, and management of diabetes. Eating supper after 7 p.m. [adjusted odds ratio = 3.77, 95% confidence interval (1.70–8.37), p = 0.001] significantly increased one's risk of having dyslipidemia by 3.8‐fold compared to eating supper earlier (before 5 p.m.). Dyslipidemia is increasing among T2DM patients in both urban and rural areas and it's independently influenced by eating supper after 7 p.m. Most participants were ignorant of the risk factors, complications, and management of diabetes. Adjusting eating habits and increasing diabetes awareness programs to sensitize the general public can mitigate the increasing prevalence of dyslipidemia in both urban and rural areas.
Publisher: Hindawi Limited
Date: 31-12-2018
DOI: 10.1155/2018/7078409
Abstract: Despite the availability of several homogenous LDL-C assays, calculated Friedewald’s LDL-C equation remains the widely used formula in clinical practice. Several novel formulas developed in different populations have been reported to outperform the Friedewald formula. This study validated the existing LDL-C formulas and derived a modified LDL-C formula specific to a Ghanaian population. In this comparative study, we recruited 1518 participants, derived a new modified Friedewald’s LDL-C (M-LDL-C) equation, evaluated LDL-C by Friedewald’s formula (F-LDL-C), Martin’s formula (N-LDL-C), Anandaraja’s formula (A-LDL-C), and compared them to direct measurement of LDL-C (D-LDL-C). The mean D-LDL-C (2.47±0.71 mmol/L) was significantly lower compared to F-LDL-C (2.76±1.05 mmol/L), N-LDL-C (2.74±1.04 mmol/L), A-LDL-C (2.99±1.02 mmol/L), and M-LDL-C (2.97±1.08 mmol/L) p 0.001. There was a significantly positive correlation between D-LDL-C and A-LDL-C (r=0.658, p .0001), N-LDL-C (r=0.693, p .0001), and M-LDL-C (r=0.693, p .0001). M-LDL-c yielded a better diagnostic performance [(area under the curve (AUC)=0.81 sensitivity (SE) (60%) and specificity (SP) (88%)] followed by N-LDL-C [(AUC=0.81 SE (63%) and SP (85%)], F-LDL-C [(AUC=0.80 SE (63%) and SP (84%)], and A-LDL-C (AUC=0.77 SE (68%) and SP (78%)] using D-LDL-C as gold standard. Bland–Altman plots showed a definite agreement between means and differences of D-LDL-C and the calculated formulas with 95% of values lying within ±0.50 SD limits. The modified LDL-C (M-LDL-C) formula derived by this study yielded a better diagnostic accuracy compared to A-LDL-C and F-LDL-C equations and thus could serve as a substitute for D-LDL-C and F-LDL-C equations in the Ghanaian population.
Publisher: Wiley
Date: 06-2023
DOI: 10.1002/HSR2.1297
Abstract: Type 2 diabetes mellitus (T2DM) in iduals are at a higher risk of developing diabetes complications, with approximately 80% complication‐related mortality. The increased morbidity and mortality among T2DM patients are partly due to dysregulated hemostasis. This study determined the quality of glycemic control in T2DM and its association with markers of coagulation and inhibitors of fibrinolysis. This case–control study recruited 90 participants involving: 30 T2DM patients with good glycemic control, 30 with poor glycemic control, and 30 nondiabetic subjects as controls at a Municipal Hospital in Ghana. Fasting blood glucose, glycated hemoglobin, activated partial thromboplastin time (APTT), prothrombin time (PT), calculated international normalized ratio (INR), and full blood count (FBC) were determined for each respondent. Plasma levels of plasminogen activator inhibitor‐1 (PAI‐1) and thrombin activatable fibrinolysis inhibitor (TAFI) were determined using the solid‐phase sandwich enzyme‐linked immunosorbent assay method. Data were analyzed using R language software. Plasma PAI‐1 antigen levels were significantly higher in the participants with poor glycemic control as compared to participants with good glycemic control ( p 0.0001). There was no significant difference in plasma TAFI levels between the participants with poor glycemic control as compared to participants with good glycemic control ( p = 0.900). T2DM patients had significantly shorter APTT, PT, and INR than controls ( p 0.05). At a cut‐off of ≥161.70 pg/μL, PAI was independently associated with increasing odds (adjusted odds ratio = 13.71, 95% confidence interval: 3.67–51.26, p 0.0001) of poor glycemic control and showed the best diagnostic accuracy for poor glycemic control (area under the curve = 0.85, p 0.0001). PAI‐1 levels were significantly increased in T2DM with poor glycemic control and emerged as the best predictor for poor glycemic control. Good glycemic management to control the plasma levels of PAI‐1 is required to prevent hypercoagulability and thrombotic disorders.
Publisher: Springer Science and Business Media LLC
Date: 26-07-2016
Publisher: Wiley
Date: 07-2023
DOI: 10.1002/HSR2.1419
Abstract: Visceral obesity and insulin resistance contribute to developing cardiometabolic syndrome (MetS). We investigated the predictive abilities of lipid accumulation product (LAP), waist circumference‐triglyceride index (WTI), and triglyceride‐glucose (TyG) index for MetS screening among the general Ghanaian adults. The final prospective analysis included 4740 healthy adults aged 30–90 years from three communities comprising Ejisu, Konongo, and Ashanti Akim Agogo in Ghana. Self‐structured questionnaire pretested was used to collect sociodemographic, anthropometric, and clinical data. Blood s les were taken after fasting to measure glucose and lipid levels. LAP, WTI, and TyG were calculated from standard equations. MetS was defined by the International Diabetes Federation criteria. Receiver operating characteristic (ROC) curves and multivariable logistic regression were utilized to evaluate the potential of the three indices in identifying MetS. Of the 4740 participants, 39.7% had MetS. MetS was more common in females (50.3%) than in males (22.2%). Overall, LAP ≥ 27.52 yielded as the best index for MetS with the highest area under the ROC curve (AUC) (0.866). At cut‐off LAP point of ≥23.87 in males and ≥33.32 in females, an AUC of 0.951 and 0.790 was identified in MetS prediction, respectively. LAP was an independent risk measure of MetS for both males (45.6‐fold) and females (3.7‐fold) whereas TyG was an independent risk measure for females (3.7‐fold) only. MetS is increasing among the general adult population. LAP and TyG are important sex‐specific risk measures to screen for MetS among the general adult population in our cohort.
Publisher: Hindawi Limited
Date: 2018
DOI: 10.1155/2018/7485942
Abstract: We evaluated the in idual and combined levels of urine dipstick and total lymphocyte count (TLC) as surrogate markers for CD4 count in a low-resource community in Ghana. This cross-sectional study recruited 200 HIV-infected patients from the Saint Francis Xavier Hospital, Assin Fosu, Ghana. Complete blood count, CD4 count, and urine dipstick analysis were measured for participants. The threshold values were determined as cells/ μ l for CD4, cells/ μ l for TLC, and ≥+ on urine dipstick analysis. The mean age of participants was 43.09 years. Proteinuria ≥ + [aOR = 4.30 (3.0–18.5)], leukocyturia ≥ + [aOR = 2.91 (1.33–12.5)], hematuria ≥ + [aOR = 2.30 (1.08–9.64)], and TLC 1200 cells/ μ l [aOR = 3.26 (3.94–15.29)] were significantly associated with increased risk of CD4 count 350 cells/ μ l. Using the in idual markers, the best substitute marker for predicting CD4 count 350 cells/ μ l was proteinuria at a cutoff point ≥ 2++, AUC of 0.973, sensitivity of 97.6%, specificity of 100.0%, PPV of 100.0%, and NPV of 89.1%. A combination of ≤ 1200 TLC + ≥ 2++ (leukocyturia + proteinuria + hematuria) yielded an AUC of 0.980, sensitivity (72.8%), specificity (100.0%), PPV (100.0%), and NPV (97.9%). Proteinuria could serve as a noninvasive screening tool, but the combination of proteinuria, leukocyturia, hematuria, and TLC serves as a better substitute marker for CD4 count in monitoring the disease progression among HIV patients in low-resource communities.
Publisher: Wiley
Date: 07-2023
DOI: 10.1002/HSR2.1436
Abstract: Impaired coagulation and fibrinolysis have been implicated in thromboembolism in human immunodeficiency virus (HIV)‐infected in iduals. This study evaluated the plasma levels of plasminogen activator inhibitor‐1 (PAI‐1) and coagulation biomarkers in HIV‐infected in iduals on highly active antiretroviral therapy (HAART). This matched case‐control study from March to December, 2020 comprised 76 participants: 38 HIV‐positive in iduals on HAART and 38 apparently healthy HIV‐negative in iduals as controls. Blood s les were collected for prothrombin time (PT), activated partial thromboplastin time (aPTT), D‐dimers, PAI‐1, and soluble fibrin monomer complex (SFMC) estimations. The data were analysed using SPSS version 22.0 and statistical significance was set at p 0.05. Activated partial thromboplastin time was significantly lower in HIV seropositive in iduals on HAART compared with HIV seronegative controls (25.90 s vs. 29.0 s, p = 0.030) however, PT, SFMC, D‐dimers, and PAI‐1 were significantly higher among the HIV‐seropositive in iduals compared with the controls: PT: (16.29 s ± 2.16 vs. 15.15 s ± 2.60, p = 0.010), SFMC: [8.53 ng/mL (8.03–9.12) vs. 7.84 ng/mL (7.32–8.58), p = 0.005]), D‐Dimer: [463.37 ng/mL (402.70–526.33) vs. 421.11 ng/mL (341.11–462.52), p = 0.015], and PAI‐1: [12.77 ng/mL (10.63–14.65) vs. 11.27 ng/mL (10.08–12.95), p = 0.039]. PAI‐1 showed a moderate positive correlation with D‐Dimer ( r = 0.659, p 0.001) and SFMC ( r = 0.463, p = 0.003) among HIV‐positive in iduals on HAART. There was a strong positive correlation between the plasma PAI‐1 concentration and the HIV viral load ( r = 0.955, p 0.001). HIV‐seropositive in iduals on HAART have deranged coagulation and fibrinolytic markers. Higher HIV viral load correlates strongly with elevated plasma levels of PAI‐1 antigens. Periodic assessment of markers of coagulation and fibrinolysis be included in the management of HIV/AIDS in Ghana.
Publisher: Medknow
Date: 2014
Publisher: MDPI AG
Date: 21-07-2019
Abstract: Background and Objectives: Dyslipidaemia and its associated complications have been reported to increase mortality among type 2 diabetes mellitus (T2DM) patients. However, there is a dearth of data on the incidence of dyslipidemia among Ghanaian patients with T2DM. This study evaluated dyslipidemia among newly diagnosed T2DM patients at Dormaa Presbyterian Hospital, Ghana. Materials and Methods: This cross-sectional study recruited a total of 215 participants at the Presbyterian Hospital, Dormaa-Ghana. A well-structured questionnaire was administered to collect demographic data. Predisposing factors of dyslipidemia such as BMI, hypertension, and family history of diabetes were also obtained. Lipid profile was performed on the serum obtained from each respondent. Dyslipidaemia was defined as total cholesterol (TC) mg/dL, triglyceride (TG) mg/dL, low density lipoprotein cholesterol (LDL-c) mg/dL, and high-density lipoprotein cholesterol (HDL-c) in males and mg/dL in females. Combinations of the in idual parameters of dyslipidaemia were further evaluated. Results: Of the total (215) participants, 86 (40%) were males and 129 (60%) were females, representing a ratio of 1:1.5. High total cholesterol was more prevalent in females (69.0%) than males (53.5%). Generally, dyslipidaemia was predominant among those aged years, with the exception of increased LDL-c (25.1%), which was higher among the 20–40 years age group. The male participants exhibited significantly (p 0.001) higher percentages of all combined measures of dyslipidaemia—such as high TG and reduced HDL-c (77.9%), high TG and elevated LDL-c (75.6%) and high LDL and low HDL (65.1%). BMI was significantly associated with HDL levels (p = 0.02), whereas family history of diabetes was associated with TC (p = 0.004) and TG levels (p = 0.019). Conclusion: Combined dyslipidaemia is relatively high among newly diagnosed T2DM patients in Ghana, and in those years. Gender is significantly associated with combined dyslipidaemia in T2DM, and males may be at a higher risk than females. BMI and family history of diabetes are potential risk factors of dyslipidaemia in T2DM.
Publisher: Medknow
Date: 2017
Publisher: Public Library of Science (PLoS)
Date: 19-04-2019
Publisher: Public Library of Science (PLoS)
Date: 24-05-2023
DOI: 10.1371/JOURNAL.PGPH.0001973
Abstract: Hypertension (HTN) is the leading cause of cardiovascular diseases. Nevertheless, most in iduals in developing countries are unaware of their blood pressure status. We determined the prevalence of unrecognized hypertension and its association with lifestyle factors and new obesity indices among the adult population. This community-based study was conducted among 1288 apparently healthy adults aged 18–80 years in the Ablekuma North Municipality, Ghana. Sociodemographic, lifestyle characteristics, blood pressure and anthropometric indices were obtained. The prevalence of unrecognized HTN was 18.4% (237 / 1288). The age groups 45–54 years [aOR = 2.29, 95% CI (1.33–3.95), p = 0.003] and 55–79 years [aOR = 3.25, 95% CI (1.61–6.54), p = 0.001], being orced [aOR = 3.02 95% CI (1.33–6.90), p = 0.008], weekly [aOR = 4.10, 95% CI (1.77–9.51), p = 0.001] and daily alcohol intake [aOR = 5.62, 95% CI (1.26–12.236), p = 0.028] and no exercise or at most once a week [aOR = 2.25, 95% CI (1.56–3.66), p = 0.001] were independently associated with HTN. Among males, the fourth quartile (Q4) of both body roundness index (BRI) and waist to height ratio (WHtR) [aOR = 5.19, 95% CI (1.05–25.50), p = 0.043] were independent determinants of unrecognized HTN. Among females, the third quartile (Q3) [aOR = 7.96, 95% CI (1.51–42.52), p = 0.015] and Q4 [aOR = 9.87 95% CI (1.92–53.31), p = 0.007] of abdominal volume index (AVI), the Q3 of both BRI and WHtR [aOR = 6.07, 95% CI (1.05–34.94), p = 0.044] and Q4 of both BRI and WHtR [aOR = 9.76, 95% CI (1.74–54.96), p = 0.010] were independent risk factors of HTN. Overall, BRI (AUC = 0.724) and WHtR (AUC = 0.724) for males and AVI (AUC = 0.728), WHtR (AUC = 0.703) and BRI (AUC = 0.703) for females yielded a better discriminatory power for predicting unrecognized HTN. Unrecognized hypertension is common among the apparently healthy adults. Increased awareness of its risk factors, screening, and promoting lifestyle modification is needed to prevent the onset of hypertension.
Publisher: Public Library of Science (PLoS)
Date: 30-12-2015
Publisher: Hindawi Limited
Date: 04-12-2018
DOI: 10.1155/2018/5019215
Abstract: Background. The World Health Organization (WHO) recommends the use of Insecticide Treated Bed-Nets and Intermittent Preventive Treatment (IPT) with Sulphadoxine-Pyrimethamine (SP) as interventions in curbing malaria during pregnancy. However, increasing evidence shows a gap in coverage where not all pregnant women receive the recommended SP dose. This study evaluated the factors influencing uptake of IPTp-SP among pregnant women in Kumasi, Ghana. Methodology. This cross-sectional study was conducted among 280 pregnant women attending the Kwame Nkrumah University of Science and Technology Hospital in Kumasi, Ghana. Validated structured questionnaires were administered to obtain sociodemographic, medical/reproductive information, and IPTp-SP uptake among participants. Statistical analyses were performed using IBM SPSS 25.0 statistics. Results. The mean age of respondents was 29.7±4.9 years. Of the 280 women interviewed, 74.6% attended the antenatal care (ANC) clinic at least four times with only 31.8% completing the recommended doses. Tertiary education [aOR=3.15, 95% CI (0.94 -10.97), and p=0.042] and ≥ 4 ANC visits [aOR=24.6, 95% CI (5.87-103.07), p .0001] had statistically significant higher odds of completing the recommended IPTp-SP dose. However, participants employed by the formal sector [aOR=0.28, 95% CI (0.09 - 0.79), p=0.016] and participants with more than four children [aOR=0.14, 95% CI (0.03 - 0.63), and p=0.011] had statistically significant lower odds of completing the recommended IPT dose. Conclusion. ANC attendance is critical in IPTp uptake. The results emphasize the need for the Health Policy Makers in Kumasi to encourage pregnant women, especially women working in the formal sector and women having more than four children to patronize ANC attendance to ensure high coverage of the recommended IPTp dose.
Publisher: Hindawi Limited
Date: 19-02-2018
DOI: 10.1155/2018/1838162
Abstract: The study determined the association of wrist circumference (WrC) and waist-to-height ratio (WHtR) with cardiometabolic risk factors among diabetics in a Ghanaian population. This cross-sectional study involved 384 diabetic patients at Begoro District Hospital, Ghana. Blood pressure, anthropometrics, and biochemical indices were measured. The overall prevalence of dyslipidaemia, metabolic syndrome (MetS), and hypertension was 42.4%, 76.3%, and 39.8%, respectively. The optimum cut-off range of WrC to identify in iduals at increased cardiometabolic risk was 17.5 to –17.8 cm for men and 16.0 to 16.7 cm for women while that of WHtR was 0.52 to 0.61 for men and 0.53 to 0.59 for women. WrC for women was a significant independent predictor for MetS [aOR = 3.0 (1.39–6.72), p = 0.005 ] and systolic blood pressure [aOR = 2.08 (1.17–3.68), p = 0.012 ]. WHtR was a significant positive predictor for triglycerides [aOR = 3.23 (0.10–3.82), p = 0.001 ] for women. Using Framingham risk scores, 61% of the subjects had elevated 10-year risk of developing cardiovascular diseases (CVDs), with no significant difference in gender prevalence. WrC [aOR = 6.13 (0.34–111.4), p = 0.107 ] and WHtR [aOR = 2.52 (0.42–15.02), p = 0.309 ] were associated with statistically insignificant increased odds of moderate-to-high risk of developing CVDs in 10 years. The use of gender-specific cut-offs for WrC and WHtR may offer putative markers for early identification of CRFs.
Publisher: Hindawi Limited
Date: 2016
DOI: 10.1155/2016/9759241
Abstract: This study aimed to determine the knowledge and prevalence of obesity among Ghanaian newly diagnosed type 2 diabetics. This cross-sectional study was conducted among diagnosed type 2 diabetics. Structured questionnaire was used to obtain data. Anthropometric measurements and fasting blood sugar levels were also assessed. Participants had adequate knowledge about the general concept of obesity (72.0%) and method of weight measurement (98.6%) but were less knowledgeable of ideal body weight (4.2%). The commonly known cause, complication, and management of obesity were poor diet (76.9%), hypertension (81.8%), and diet modification (86.7%), respectively. The anthropometric measures were higher among females compared to males. Prevalence of obesity was 61.3% according to WHR classification, 40.8% according to WHtR classification, 26.1% according to WC, and 14.8% according to BMI classification. Being female was significantly associated with high prevalence of obesity irrespective of the anthropometric measure used ( p 0.05 ). Taking of snacks in meals, eating meals late at night, physical inactivity, excessive fast food intake, and alcoholic beverage intake were associated with increased prevalence of obesity ( p 0.05 ). Prevalence of obesity is high among diabetic patient and thus increasing effort towards developing and making education programs by focusing on adjusting to lifestyle modifications is required.
Publisher: African Journals Online (AJOL)
Date: 07-03-2016
DOI: 10.4314/AHS.V16I4.33
Publisher: Springer Science and Business Media LLC
Date: 25-08-2015
Publisher: Elsevier BV
Date: 03-2019
Publisher: Public Library of Science (PLoS)
Date: 19-12-2018
Publisher: Wiley
Date: 22-03-190728634
DOI: 10.1002/HSR2.1664
Publisher: Public Library of Science (PLoS)
Date: 17-07-2018
Publisher: Springer Science and Business Media LLC
Date: 17-11-2018
Publisher: Public Library of Science (PLoS)
Date: 25-07-2022
DOI: 10.1371/JOURNAL.PGPH.0000736
Abstract: The promotion of Diabetes Self-Management (DSM) practices, education, and support is vital to improving the care and wellbeing of diabetic patients. Identifying factors that affect DSM behaviours may be useful to promote healthy living among these patients. The study assessed the determinants of DSM practices among Type 2 diabetes mellitus (T2DM) patients using a model-based social cognitive theory (SCT). This cross-sectional study comprised 420 (T2DM) patients who visited the Diabetic Clinic of the Komfo Anokye Teaching Hospital (KATH), Kumasi-Ghana. Data was collected using self-structured questionnaires to obtain socio-demographic characteristics, T2DM-related knowledge, DSM practices, SCT constructs beliefs in treatment effectiveness, level of self-efficacy, perceived family support, and healthcare provider-patient communication. Path analysis was used to determine direct and indirect effects of T2DM-related knowledge, perceived family support, and healthcare provider service on DSM practices with level of self-efficacy mediating the relationships, and beliefs in treatment effectiveness as moderators. The mean age of the participants was 53.1(SD = 11.4) years and the average disease duration of T2DM was 10 years. Most of the participants (65.5%) had high ( .1mmol/L) fasting blood glucose (FBG) with an average of 6.93(SD = 2.41). The path analysis model revealed that age ( p = 0 . 176 ), gender ( p = 0 . 901 ), and duration of T2DM ( p = 0 . 119 ) did not confound the relationships between the SCT constructs and DSM specified in the model. A significant direct positive effect of family and friends’ support ( Critical ratio (CR) = 5 . 279 , p 0 . 001 ) on DSM was observed. Self-efficacy was a significant mediator in this relationship ( CR = 4 . 833 , p 0 . 001 ). There were significant conditional indirect effects (CIE) for knowledge of T2DM and family and friends’ support at medium and high levels of belief in treatment effectiveness (p 0 . 05) via level of self-efficacy on DSM practices. However, no evidence of moderated-mediation was observed for the exogenous variables on DSM. Diabetes-related knowledge of T2DM, family and friends’ support, level of self-efficacy, and belief in treatment effectiveness are crucial in DSM practices among Ghanaian T2DM patients. It is incumbent to consider these factors when designing interventions to improve DSM adherence.
Publisher: SAGE Publications
Date: 2023
Publisher: Springer Science and Business Media LLC
Date: 22-03-2019
Publisher: MDPI AG
Date: 26-04-2021
DOI: 10.20944/PREPRINTS202104.0650.V1
Abstract: Type-2 diabetes mellitus (T2DM) have been strongly associated with single nucleotide polymorphisms (SNPs) in the TCF7L2 gene. This study investigated the association between rs12255372, rs7903146 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 s les were collected and used for serum lipid analysis, HbA1c, plasma glucose estimation and DNA extraction. 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
Location: Ghana
No related grants have been discovered for Enoch Anto.