http://hdl.handle.net/123456789/994 SMS 2026-04-14T23:10:12Z http://hdl.handle.net/123456789/11702 Clinical Sequelae Of Transfusion Of Donor Blood Exposed To Selected Transfusion-Transmissible Parasites And Molecular Confirmation Of Transfusion-Transmissible Malaria ATTOH, JULIANA Transfusion-transmitted parasite infections (TTPI) are potentially underreported. However, still regarded as a public health concern, as they might constitute a major threat, particularly in immunocompromised patients. This study was performed at the Nsawam Government Hospital, Ghana and aimed to identify the presence of Plasmodium falciparum (Pf), Babesia spp., Leishmania spp., and Toxoplasma gondii in donor blood and investigate their potential association with acute transfusion responses (ATR). Transfusion-transmissible malaria (TTM) and the associated Pf chloroquine resistance transporter (Pfcrt), Pf multi-drug resistance (Pfmdr1), Pf dihydropteroate-synthetase (Pfdhps), Pf dihydrofolate-reductase (Pfdhfr) and Kelch 13 mutant genes were further assessed. Remnants of transfused blood were screened for Pf using malaria rapid diagnostic test and microscopy. Enzyme-linked immunosorbent assay was used for the others. Recipients of blood infected with Pf were followed up for 35 days. Selective whole genome amplification was used to determine TTM and gene polymorphisms. Approx. 20% (113/571) of recipients were exposed. The prevalence were: Pf (12.1%), Babesia spp. (1.1%), Leishmania spp. (2.8%), and T. gondii (3.9%). ATR was experienced by recipients of blood exposed (10.6%, 12/113) and unexposed to parasites (5.8%, 19/327) however, there was no significant difference (p = 0.112) between the two groups. Genomic analysis found mutant haplotypes: Pfdhps (14.4%), Pfmdr1 (14.4%), Pfdhfr (12.9%), Kelch 13 (9.4%) and Pfcrt (5.7%). Pfcrt mutant gene, CVINT was identified for the first time in Ghana. Drug-resistant markers were found to be ~20% with a TTM incidence of 7%. Donor blood should be screened for malaria and other haemoparasites and further research to quantify risk of TTM. xiv,252p:, ill. 2023-06-01T00:00:00Z http://hdl.handle.net/123456789/10196 Safety and Efficacy of Calcium Montmorillonite Clay (Novasil) in Children at Risk of Aflatoxin Related Diseases in Ejura Sekyedumase District, Ghana Kumi, Justice The use of novasil clay as an intervention technique to prevent aflatoxin poisoning in animals and humans has proven to be effective. In this study, evaluation of the safety and efficacy of novasil clay was carried out in 60 days in children in the Ejura Sekyedumase District, Ashanti Region, Ghana. Also, the relationship between growth indicators and aflatoxin in children was investigated. Stratified cluster sampling was used to recruit participants into the study. Healthy (200 children) within the age bracket of 2-9 years were put into two arms of study, which include 100 test group and 100 placebo group. One arm received 1.5g of novasil (test material) whiles the other arm received calcium sulphate as placebo. Full blood count, reduced glutathione, liver, kidney biomarkers, aflatoxin M1 and growth indicators were measured. Out of the total population of 200 children, 26 (13%) were Stunting 6 (3 %) were underweight. Change in serum biochemistry parameters and calcium levels between the placebo and novasil groups were not statistically significant (P > 0.05). At the end of the treatment cycle, reduced blood glutathione levels increased significantly in the novasil treated group. Aflatoxin M1 excretion in urine showed a significant reduction (P = 0.033) from a mean of 811.2 AFM1pg/mg creatinine to 329.1AFM1pg/mg creatinine at the end of the novasil treatment, representing a 60.7 % reduction. The placebo group demonstrated a significant increase (P = 0.02) of 44 % AFM1 excretion in urine from a mean of 801.3 to 1801.2 AFM1pg/mg creatinine. At the end of the 60 day intervention study, novasil was safe with no adverse effect and caused a reduction of aflatoxin bioavailability in children. ii, ill:142 2021-12-01T00:00:00Z http://hdl.handle.net/123456789/8605 Epidemiology of Systemic and Ocular Toxoplasmosis and their Associations with Polymorphisms in Human Interferon Gamma and Tumour Necrosis Factor Cytokine Genes Abu, Emmanuel Kwasi The aim was to determine the associations between interferon gamma/tumour necrosis factor gene polymorphisms and Toxoplama infection in a community-based epidemiological survey. Sera were tested for IgG and IgM antibodies using ELISA test kits. Ophthalmic examination included visual acuity, slit lamp biomicroscopy and dilated funduscopy. A serologic criterion was a positive test result for either IgG or IgM antibodies or both. Ocular toxoplamosis was diagnosed based on characteristics retinal lesions. Individuals with ocular infection served as cases and seropositive individuals without ocular disease as controls. There were 390 participants (mean age = 47.0 years), 30.3% males and 69.7% females. Seroprevalence of IgG and/or IgM antibodies was 85%. The study found a statistically significant relationship between Toxoplasma seropositivity and the following factors: contact with soil, presence of cats, older age, sources of drinking water, low levels of education, socioeconomic status, rural dwelling, and occupation (farmers and fishers/fish mongers). Ten (3%) subjects had toxoplasmic ocular lesions, contributing to 5.8% of visual impairment. Blindness occurred in 50% episodes of eye infections. The risk for developing Toxoplasma ocular lesions was old age (p = 0.028). Low prevalence of ocular infection was found in a population of high seropositivity. The results suggested contamination by sporulated oocysts as the major source of transmission. IFN-y +874T allele seemed to increase the risk of developing ocular lesions. Also, the presence of the less common TN F—308 A allelic form was found protective against the development of ocular infection in the present study. xvii, 221p:, ill 2016-05-01T00:00:00Z http://hdl.handle.net/123456789/8463 Host and Parasite Genetic Factors that affect Plasmodium Falciparum Gametocytogenesis and Malaria Transmission in Southern Ghana Ayanful-Torgby, Ruth Several factors affect gametocyte production and are proposed to vary in different endemic settings and seasons. The current study assessed gametocyte production rates in P. falciparum isolates from malaria patients in ex vivo assays. Effect of host (G6PD, HBB and ABO blood groups) and parasite (msp2 and Pfg377 diversity, and drug resistant strains) factors on gametocyte prevalence were assessed in asymptomatic infections. Study participants were children aged one to twelve years living in Obom and Cape Coast. In an ex vivo assay, 54% of the P. falciparum isolates produced gametocytes by day three with the mean production rate of less than 1%. High P. falciparum prevalence was observed, in up to 60% and 86% of children harbouring the parasites at microscopic and submicroscopic levels respectively. The parasite prevalence in Obom exhibited an extensive seasonal variation (P < 0.001) in microscopic and submicroscopic infections. Neither HBB, G6DP variants nor any of the ABO blood groups was associated with gametocyte prevalence; but participants with heterozygous or homozygous HbC had more gametocytes than the other HBB genotypes. Low P. falciparum sexual and asexual diversities (MOI<1.5) were observed and gametocyte positivity was significantly (P = 0.001) higher in individuals with msp2 dimorphic infections. Different levels of drug mutant P. falciparum strains with crt 76T (< 23%), Pfindrl 86Y (< 18%), dhfr S108N (< 40%) and Pfdhps A437G (> 3%) were observed. Low frequencies (2.1%) of K13 (C469C and A558S) mutant parasite strains were recorded. Plasmodium falciparum infections with both the mutant and wild type drug resistant strains also had msp2 dimorphic alleles and this will result in the formation of new parasite strains in the Anopheles vector for onward transmission. xv, 224p:, ill. 2018-09-01T00:00:00Z