In Plasmodium falciparum malaria, CD8 + T cells play a double-edged role. Liver-stage specific CD8 + T cells can confer protection, as has been shown in several vaccine studies. Blood-stage specific CD8 + T cells, on the other hand, contribute to the development of cerebral malaria in murine models of malaria. The role of CD8 + T cells in humans during the blood-stage of P. falciparum remains unclear. As part of a cross-sectional malaria study in Ghana, granzyme B levels and CD8 + T cells phenotypes were compared in the peripheral blood of children with complicated malaria, uncomplicated malaria, afebrile but asymptomatically infected children and non-infected children. Granzyme B levels in the plasma were significantly higher in children with febrile malaria than in afebrile children. CD8 + T cells were the main T cell subset expressing granzyme B. The proportion of granzyme B + CD8 + T cells was significantly higher in children with complicated malaria than in uncomplicated malaria, whereas the activation marker CD38 on CD8 + T cells showed similar expression levels. This suggests a pathogenic role of cytotoxic CD8 + T cells in the development of malaria complications in humans.

Introduction: Hypertension (HPT) is a significant public health challenge worldwide and is the single most important risk factor for cardiovascular disease. As life expectancy rates improve in Ghana and the prevalence of risk factors increase, the burden of non-communicable diseases such as HPT is also expected to increase. However, little is known about the specific factors that predispose of Ghanaians to a higher risk of HPT. Methods: A cross-sectional study was conducted in the Dormaa Municipality in Ghana using the World Health Organization STEPwise approach to investigate risk factors for HPT. Study participants were recruited by probability proportional sampling technique. In all, 202 males and 198 females participated in this study. Results: The mean age of the participants was 50.06 years (95% confidence interval [CI]: 48.46–51.66). In all, 40% of all participants in this study had elevated blood pressure (BP) (BP ≥140/90 mmHg). Further, the rate of isolated systolic HPT was 11.2% among the study population (12.9% in males and 9.6% in females). Risk factors as measured in the population were advancing age >45 years (odds ratio [OR] = 2.745, CI 1.20–6.30, p = 0.017), gender (44.6% males versus 35.4% females with elevated BP, male OR = 0.492, CI 0.28–0.86, p = 0.012), and tobacco use (OR = 2.66, CI 1.41–5.04, p = 0.003). Males reported higher mean portions of fruits (p = 0.036) and vegetable servings than females (p = 0.009) and spent more time each day on physical activities compared to females (p = 0.000). Conclusion: The results of the present study provide useful data on HPT prevalence and associated risk factors in the Dormaa Municipality and the Brong-Ahafo Region of Ghana. To be able to control HPT in the municipality, health practitioners and policymakers should focus on these modifiable risk factors.

Under-five mortality rate is an important indicator of a community's social development. TheUpper East region, one of the most poverty-stricken regions in Ghana, has however recorded a dramatic decline in its under-five mortality rate since 1993; from 180 per 1000 live births to 79 per 1000 live births in 2003. The aim was to identify the determinants of under-five mortality in Builsa district. A case-control study was used to collect data from mothers of 60 cases and 120 controls matched for age, sex and place of residence. Even though 70% of mothers were illiterate, the educational level of mothers did not influence the child's risk of death (OR 1.1). Children of mothers who had had previous child deaths were about 8 times more likely to die (OR 7.45,) while those who had not had vitamin A supplementation were about 10 times more likely to die (OR 9.57). Over 90% of mothers had an insecticide-treated bednet and more than 50% of them exclusively breastfed their children for the first 6 months of life. Protective risk factors identified included: exclusive breastfeeding (OR 0.72), use of an insecticide-treated bednet (OR 0.12), the number of live children a mother had (OR 0.54) and immunization (OR 0.53). Even in poverty, it is possible to improve the child health status of communities. Health staff should be equipped to pay special attention to mothers with previous child deaths in order to assist them to prevent further deaths.

Background Cervical cancer is the most common gynaecologic cancer in Ghana where it is also the second most common cause of all female cancers. A number of vaccines are available to provide both individual and population-level protection against persistent infection with high-risk human papillomaviruses (HR-HPV) and reduce the burden of cervical cancer. Data on the epidemiology of vaccine-preventable papillomaviruses in Ghana is scant. Methods A cross-sectional observational study was implemented from May 2011 to November 2014 to understand the epidemiology of genital human papillomavirus (HPV) genotypes and cervical dysplasia in the Greater Kumasi area of Ghana. A nested multiplex polymerase chain reaction (NMPCR) assay incorporating degenerate E6/E7 consensus primers and type-specific primers was used for the detection and typing of eighteen (18) HPV genotypes among women who had never attended cervical screening prior to this study. Results The general prevalence of HPV infection in Kumasi was 37.2%. The age-standardized prevalence was 40.9% overall. The frequency of HR-HPV genotypes present in decreasing order were HPV-52, -56, -35, -18, -58, -68, -51, -39, -45, -16, -59, -33 and -31. Low-risk HPVs were also detected in the following order: HPV-42, -43, -66, -6/11 and -44. Conclusions The study shows that currently available prophylactic vaccines have the potential to be useful in the primary prevention of HPV infections in the country. This study strengthens the belief that prophylactic HPV vaccination could be a long-term strategy to reduce the burden of HPV infections and potentially reduce the burden of HPV-associated cancers and epithelial cell abnormalities among health-seeking women in Kumasi. Efforts to make vaccines available to young girls should be prioritized.

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