Seventeen paediatric patients with immunodeficiency syndromes (10 with selective IgA deficiency, four with panhypogammaglobulinaemia, and three with selective T cell deficiency) were investigated for bacterial overgrowth of the small intestine and gut permeability to macromolecules. Five of 12 patients showed viable bacterial counts of more than 2 x 105/ml in jejunal fluid. Bacterial overgrowth was also confirmed indirectly by breath hydrogen determination, which was higher than 10 ppm in four of the five patients with positive jejunal culture. Gut permeability to lactulose and L-rhamnose was abnormal in 16 of the 17 immunodeficient patients, who also had higher mean urinary excretion ratios than control subjects -mean (SD) values were 0216 (0.160) and 0-029 (0.002), respectively. These studies indicate that bacterial overgrowth of the small intestine is a common feature in immunodeficient patients, regardless of the immunological abnormality. Moreover, these patients have an increased gut permeability to macromolecules.

BackgroundParasitic infections are of public health concern globally, particular among at risk groups such as pregnant women in developing countries. The presence of these parasites during pregnancy potentiate adverse effects to both the mother and the unborn baby. This study sought to establish the prevalence of some parasitic agents among antenatal attendees in the Dangme East District of Ghana. A cross-sectional prospective study was conduct between April and July, 2012. Venous blood specimens were collected from each participant for haemoglobin estimation and malaria microscopy. In addition participants’ early morning mid-stream urine and stool specimens were analyzed microscopically for parasitic agents.ResultsA total of 375 pregnant women were involved in the study, of which anaemia was present in 66.4% (249/375). However, parasitic infections associated anaemia prevalence was 49.6% (186/375). In all, 186 cases of parasitic infections were observed; 171 (44.0%) were single isolated infections while 15 (4.0%) were co-infections. Plasmodium species were significantly associated with anaemia (13.3%, χ2 = 23.290, p < 0.001). Also, the presence of Schistosoma haematobium (3.7%, χ2 = 7.267, p = 0.008), Schistosoma mansoni (5.3%, χ2 = 5.414, p = 0.023) and hookworm (3.7%, χ2 = 11.267, p = 0.008) were significantly associated with anaemia in pregnancy. Except where co-infections exist (3.7%, χ2 = 11.267, p = 0.001), the rest of the single infections were insignificantly associated with anaemia. Collectively, intestinal helminthes were predominantly significant with anaemia in pregnancy (p = 0.001, χ2 = 107.800).ConclusionThe study revealed relatively high prevalence of parasitic infections among the study population, suggesting that about three-quarters of the anaemic mothers are either single or co-infected with parasitic agents.

Background This study was aimed at evaluating the seroprevalence and trend of blood-borne pathogens (HIV, HCV, HBV, and Syphilis) among asymptomatic adults at Akwatia during a four-year period (2013–2016). Materials and Methods The study was a retrospective analysis of secondary data of blood donors who visited the hospital from January 2013 to December 2016. Archival data from 11,436 prospective donors was extracted. Data included age, sex, and place of residence as well as results of infectious markers (HIV, HBV, HCV, and Syphilis). Results The prevalence of blood-borne pathogens in the donor population was 4.06%, 7.23%, 5.81%, and 10.42% for HIV, HBV, HCV, and Syphilis infections, respectively. A significant decline in HBV and HCV infections was observed in the general donor population and across genders. HIV infection rate remained steady while Syphilis infections recorded a significantly increasing trend, peaking in the year 2015 (14.20%). Age stratification in HBV infection was significant, peaking among age group 40–49 years (8.82%). Conclusion Asymptomatic blood-borne pathogen burden was high among the adult population in Akwatia. Gender variations in HBV, HCV, and Syphilis infections in the cumulative four-year burden were observed. Awareness needs to be created, especially in the older generation.

The study was aimed at comparing the estimation of the burden and trends (2012–2016) of Human Immunodeficiency Virus (HIV) and Syphilis infections by the national Sentinel Survey vis-à-vis the use of population-based studies at a single urban site (Municipal Hospital) in Ho, the Volta Region of Ghana. Using blood donors as a proxy of the asymptomatic adult population, a retrospective analysis of secondary data on HIV and Syphilis testing was conducted using Ho Municipal Hospital's archives comprising 4,180 prospective blood donors. Published reports from the National Sentinel Survey for the Ho Sentinel Site comprising 2,452 pregnant women from 2012 to 2016 were used. The cumulative prevalence of HIV and Syphilis infections in the population-based survey was 4.78% and 2.58% while the epidemiology was estimated at 2.75% and 0.24% by the Sentinel Survey for the five-year under review. The new HIV and Syphilis infections were 3.78% and 2.46% in the population-based survey compared to 2.64% and 0.23% in the Sentinel Survey. Gender cumulative prevalence and the yearly trend was found to be higher in the general population compared to the pregnant women. The use of pregnant women to estimate the HIV and Syphilis epidemiology might not be representative of the general population.

23Introduction 24 Malaria and sickle cell disease (SCD) co-morbidity have previously been reported in Ghana. 25 However, there is paucity of data on haematological profiles and oxidative stress in co-26 morbidity states. This study identified novel inflammatory biomarkers associated with malaria 27 in SCD and analyzed the levels of 8-iso-prostaglandin F2α oxidative stress biomarker in malaria-28 SCD co-morbidity in Ghanaian patients. 29 Methods 30 Blood (5ml) was collected from malaria patients into K 3 -EDTA tube. Malaria parasites speciation 31 and quantification were then done according WHO guidelines. All eligible samples were assayed 32 for haematological profile, sickle cell phenotyping, infectious markers (hepatitis B, hepatitis C, 33 syphilis and HIV 1&2) and plasma levels of 8-epi-prostaglandin F2α. . 35 Results 36Prevalence of malaria in SCD (malaria-SCD) was 13.4% (45/335). Male: female ratio was 0.8:1 37 (X 2 =1.43, p=0.231). Mean ages for malaria in normal haemoglobin type (malaria-HbAA) and 38 malaria-SCD were 12.79±4.91 and 11.56±3.65 years respectively (p=0.048). Geometric mean of 39 parasite density was higher in malaria-HbAA (20394 parasites/µl vs. 9990 parasites/µl, p=0.001) 40 whilst mean body temperature was higher in malaria-SCD (39.0±0.87°C vs. 37.9±1.15°C, 41 p=0.001). Mean leukocytes, lymphocytes, eosinophils, monocytes, platelets and platelet indices 42 values were significantly elevated in malaria-SCD. Significant reduction in RBC and RBC indices 3 43 in malaria-SCD were also observed. Eosinophils-to-basophils ratio (EBR) and monocytes-to-44 basophils ratio (MBR) were novel cellular inflammatory biomarkers which could predict malaria 45 in SCD. The sensitivities of cut-off values of EBR>14, MBR>22 and combined use of EBR>14 and 46 MBR>22 were 79.55%, 84.09% and 91.11% respectively. Mean 8-iso-prostaglandin F2α was 47 338.1pg/ml in malaria-HbAA and 643.8pg/ml in malaria-SCD (p=0.001). 8-iso-prostaglandin F2α 48 correlated with parasite density (r=0.787, p=0.001), temperature (r=0.566, p=0.001) and 49 leucocytes (r=0.573, p=0.001) and negatively correlated with RBC (r=-0.476, p=0.003), 50 haemoglobin (r=-0.851, p=0.001) and haematocrit (r=-0.735, p=0.001). 51 52 Conclusion 53 Plasmodium falciparum parasitaemia increases oxidative damage and causes derangement 54 haematological parameters. Cut of values of EBR>14 and MBR>22 could predict malaria in SCD. 55 Keywords: 8-epi-prostaglandin F2α, oxidative stress, haematological profile, malaria-SCD co-56 morbidity, eosinophils-to-basophils ratio, monocytes-to-basophils ratio 57 58 59 4 63 as level of malaria endemicity, presence of haemoglobinopathies, nutritional status and level of 64 malaria immunity [5, 6]. Malaria is meso-endemic in Ghana with recent nationwide prevalence 65 of 43.4% [7]. Sickle cell disease (SCD) resulting from two haemoglobin S (HbS) haplotypes 66 (HbSS) and heterozygote sickle cell phenotype resulting from one HbS haplotype and one 67 haemoglobin C (HbC) haplotype (HbSC) is also prevalent in Ghana [...