Background. Metabolic syndrome (MS) is a collection of cardiovascular risk factors comprising insulin resistance, dyslipidemia, obesity, and hypertension, which may cause further complications in diabetes. Although metabolic syndrome (MS) is increasing in incidence in diabetics and leading to significant cardiovascular diseases and mortality, there is dearth of data in Ghana. This study investigated metabolic syndrome, its prevalence, and its associated risk factors in type 2 diabetes at the Komfo Anokye Teaching Hospital, Kumasi, Ghana. Methods. The study involved 405 diabetic patients attending the Diabetic Clinic of the Komfo Anokye Teaching Hospital (KATH) Kumasi, in the Ashanti Region of Ghana. A well-structured questionnaire was used to obtain demographic background such as their age and gender. Anthropometric measurements were obtained using the Body Composition Monitor (Omron ® 500, Germany) which generated digital results on a screen and also by manual methods. Fasting venous blood was collected for the measurement of biochemical parameters comprising fasting plasma glucose (FPG), glycated haemoglobin (HbA1c), high density lipoprotein cholesterol (HDL-c), and triglyceride (TG). Metabolic syndrome was defined according to the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III). Results. Out of the total of 405 participants, 81 were males and 324 were females, and the estimated mean age was 58.5 ± 9.9 years. The female patients exhibited higher mean waist circumference (WC) and mean hip circumference (HC) as well as an approximately higher body mass index than males (28.3 ± 5.1, 26.5 ± 4.2 for the female and male respectively). Overall, the prevalence of metabolic syndrome observed among the study population was 90.6%. Conclusions. The prevalence of metabolic syndrome observed among the study population was 90.6%, with a higher percentage in females than males. High triglyceride levels and high waist circumference were the main risk factors for MS in the diabetic population.
Background: In the absence of microscopy, Plasmodium falciparum histidine-rich proteins 2 (PfHRP2)-based rapid diagnostic tests (RDTs) are recommended for the diagnosis of falciparum malaria, particularly in endemic regions. However, genetic variability of the pfhrp2 gene threatens the usefulness of the test due to its impact on RDT sensitivity. This study aimed to investigate the diversity of pfhrp2 in malaria cases among children in Ghana. Methods: A cross-sectional study was conducted at the Adidome Government Hospital in the Volta Region of Ghana. A total of 50 children with mean age of 6.6 ± 3.5 years and diagnosed falciparum malaria were included. Blood samples were collected for complete blood count, malaria parasite identification and counting using auto analyzer and microscopy, respectively. DNA was isolated from blood-spotted Whatman filters, amplified and sequenced. Nucleotide sequences were translated in silico to corresponding amino acids and the deduced amino acids sequences were analyzed for diversity using Mega X. Results: The number of repeats and number of each repeat within PfHRP2 varied between isolates. Twelve rare PfHRP2 repeat types, two of which are previously unreported, were identified in this study. The HRP2 sequence obtained in this study shared high similarities with isolates from Kenya. Using Baker's regression model, Group B was the highest occurring type (58.0%). Screening of all sequences for epitopes recognized by PfHRP2-specific monoclonal antibodies (mAbs), the predominant motif was AHHAADAHH, which is recognized by the C1-13 mAbs. Conclusion: This study reports diversity of P. falciparum HRP2 in samples from Ghanaian children with symptomatic malaria. The findings of this study highlight the existence of extra amino acid repeat types which adds to the PfHRP2 antigenic variability.
Background: Although visceral fat (VF) and its influence on cardiovascular diseases have been extensively studied among diabetic patients, there is a need for an easier, and less expensive but equally good predictor for VF. This study was conducted to assess potential anthropometric measurements that can be directly linked to visceral fat levels among diabetic patients. Method: 405 diabetic patients attending the Diabetic clinic of the Komfo Anokye Teaching Hospital (KATH) in Kumasi-Ghana were recruited. A well-structured questionnaire was used to obtain the demographic background and brief medical history. Anthropometric measurements were obtained by direct measurement and visceral fat levels was measured using the Body Composition Monitor (Omron ® 500, Germany) which generated digital results on a screen. Results: The total participants comprised 81 males and 324 females, with an average age of 58.5 ± 9.9 years. The females exhibited a higher mean waist circumference (101.4 ± 12.3 cm) and average hip circumference (104.6 ± 9.9 cm) than the males. The female participants also had higher body mass index (BMI) (28.3 ± 5.1 kg/m 2) compared to males (26.5 ± 4.2 kg/m 2). The association between VF and waist circumference was r = 0.631, p ˂ 0.001, followed by hip circumference (r = 0.536; p < 0.001). The significant predictive abilities of waist circumference and hip circumference to identify diabetic patients with high visceral fat were AUC = 0.787; p ˂ 0.001 and AUC = 0.786; p ˂ 0.001, respectively. Conclusion: Waist circumference and hip circumference promise to be potential alternative predictors of visceral fat accumulation in type 2 diabetes.
Background: In the absence of microscopy, Plasmodium falciparum histidine-rich proteins 2 (PfHRP2)-based rapid diagnostic tests (RDTs) are recommended for the diagnosis of falciparum malaria, particularly in endemic regions. However, genetic variability of the PfHRP2 gene threatens the usefulness of the test. This study aimed to investigate the diversity of PfHRP2 in malaria cases among children in Ghana. Methods:A cross-sectional study was conducted at the Adidome Government Hospital in the Volta Region of Ghana. A total of 50 children with mean age of 6.6±3.5 years and diagnosed of falciparum malaria were included. Blood samples were collected for complete blood count, malaria parasite identification and counting. DNA samples were amplified and sequenced. Nucleotide sequences were translated in silico to corresponding amino acids and the deduced amino acids sequences were analyzed for diversity. Results:The number of repeats and number of each repeat within PfHRP2 varied between isolates.Twelve rare PfHRP2 repeat types, two of which are previously unreported, were identified in this study. Our HRP2 sequence shared high similarity with isolates from Kenya. Using Baker's regression model, Group B was the highest occurring type (58.0%). Screening of all sequences for epitopes recognized by PfHRP2-specific monoclonal antibodies (mAbs), we found the predominant motif to be AHHAADAHH, which is recognized by the C1-13 mAbs. Conclusion:This study reports diversity of P. falciparum histidine-rich proteins 2 in samples from Ghanaian children with symptomatic malaria. We highlight the existence of extra amino acid repeat types which adds to the PfHRP2 antigenic variability. The findings of this study will contribute to the understanding of the performance of PfHRP2-based RDTs in the Ghanaian setting.accounting for not less than 20% of child deaths, 40% of child hospital admissions, and more than 50% of outpatient attendances [4][5][6][7].Although, microscopic examination of stained blood smears remains the gold standard for malaria diagnosis, its benefit is limited by the absence of adequate skilled personnel, and infrastructural and logistic resources, particularly in resource-poor areas [8]. To overcome this problem, the World Health Organization (WHO) included rapid diagnostic tests (RDTs), a relatively less expensive and easily accessible test, as one of the alternative testing systems for malaria diagnosis prior to the prescription of antimalarial drugs.Since its development in the 1990s, and with more than 200 currently available brands, there has been consistent reports of observable increase in malaria RDT sales worldwide [9,10]. Most of the malaria RDTs exploit the presence of P. falciparum Histidine-Rich Protein-2 (PfHRP2) for the detection of Plasmodium falciparum [11]. The presence of repetitive epitopes, that enable their detection by multiple antibodies, and their abundance in blood during the blood-stage of malaria infections has made the PfHRP2 protein a common antigenic target for RDTs [12,13].In 2010, Gh...
Type 2 diabetes mellitus (T2DM) continues to increase in incidence within the ageing population of the globe. Patients with T2DM have a 2-4 times higher risk of experiencing an adverse cardiovascular event than their non-diabetic counterparts. Total cholesterol, low-density lipoprotein (LDL), triglycerides and high-density lipoprotein (HDL) cholesterol levels have been the routine biomarkers for lipid-based cardiovascular disease diagnostic and prognostic decisions in clinical practice. Recent evidence elsewhere suggests remnant cholesterol (RC) and Non-HDL cholesterol (Non-HDL-c) can serve as biomarkers with a higher predictive power for cardiovascular disease (CVD) than the aforementioned routine ones. In our context, there is limited information on the suitability and superiority of these emerging biomarkers for the assessment of CVD risk in T2DM. The current study therefore sought to examine the relationship between RC and non-HDL-c for predicting CVD in T2DM patients in the context of the obesity paradox. Apart from adiponectin level which was lower (P < 0.05), overweight/obese respondents exhibited higher (P < 0.05) mean levels for all the measured indices. Insulin resistance was independently predicted (R2 = 0.951; adjusted R2 = 0.951; P < 0.001) by RC, duration and fasting plasma glucose. However, Non-HDL-c predicted CVD risk (AOR = 4.31; P <0.001), hypertension (AOR = 2.24; P <0.001), resistin (AOR = 2.14; P <0.001) and adiponectin (AOR = -2.24; P <0.001) levels. Our findings point to different mechanisms by which RC and non-HDL-c contribute to the development of CVD.
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