Background High prevalence of malaria and hepatitis B has been reported among pregnant women in Ghana. In endemic areas, the diagnoses of malaria and hepatitis B among pregnant women on antenatal visits are done using histidine-rich protein 2 (HRP2) and hepatitis B surface antigen (HBsAg) rapid diagnostic tests (RDTs), respectively, which are, however, reported to give some false positive results. Also, socioeconomic determinants have been drawn from these RDTs results which may have questionable implications. Thus, this study was aimed at evaluating the prevalence of malaria and hepatitis B by comparing RDTs with polymerase chain reaction (PCR) outcomes, and relating the PCR prevalence with socioeconomic status among pregnant women in Northern Ghana. Methods We screened 2071 pregnant women on their first antenatal visit for Plasmodium falciparum and hepatitis B virus (HBV) using HRP2 and HBsAg RDTs, and confirming the infections with PCR. Socioeconomic and obstetric information were collected using a pre-tested questionnaire, and associations with the infections were determined using Pearson's chisquare and multinomial logistic regression analyses at a significance level of p<0.05. Results The prevalence of the infections by RDTs/PCR was: 14.1%/13.4% for P. falciparum monoinfection, 7.9%/7.5% for HBV mono-infection, and 1.9%/1.7% for P. falciparum/HBV coinfection. No statistical difference in prevalence rates were observed between the RDTs and PCRs (χ 2 = 0.119, p = 0.73 for malaria and χ 2 = 0.139, p = 0.709 for hepatitis B). Compared with PCRs, the sensitivity/specificity of the RDTs was 97.5%/99.1% and 97.

Background The overlap of malaria and chronic hepatitis B (CHB) is common in endemic regions, however, it is not known if this co-infection could adversely influence clinical and immunological responses. This study investigated these interactions in pregnant women reporting to antenatal clinics in Ghana. Methods Clinical parameters (hemoglobin, liver function biomarker, peripheral malaria parasitemia, and hepatitis B viremia) and cytokine profiles were assayed and compared across four categories of pregnant women: un-infected, mono-infected with Plasmodium falciparum (Malaria group) , mono-infected with chronic hepatitis B virus ( CHB group ) and co-infected ( Malaria+CHB group ). Results Women with Malaria+CHB maintained appreciably normal hemoglobin levels (mean±SEM = 10.3±0.3 g/dL). That notwithstanding, Liver function test showed significantly elevated levels of alanine aminotransferase, aspartate aminotransferase and total bilirubin [P<0 . 001 for all comparisons] . Similarly, the Malaria+CHB group had significantly elevated pro-inflammatory cytokines, including tumour necrosis factor alpha (TNF-α), interleukin (IL)-1β, and IL-6 [P<0 . 05 for all comparisons] . In women with Malaria+CHB , correlation analysis showed significant negative association of the pro-inflammatory cytokines responses with malaria parasitemia [IL-1β (P<0 . 001; r = -0 . 645) , IL-6 (P = 0 . 046; r = -0 . 394) and IL-12 (P = 0 . 011; r = -0 . 49)] . On the other hand, the pro-inflammatory cytokine levels positively correlated with HBV viremia [TNF-α (P = 0 . 004; r = 0 . 549) , IL-1β (P<0 . 001; r = 0 . 920) , IL-6 (P<0 . 001; r = 0 . 777) , IFN-γ (P = 0 . 002; r = 0 . 579) , IL-2 (P = 0 . 008; r = 0 . 512) and IL-12 (P<0 . 001; r = 0 . 655)] . Also, for women in the Malaria+CHB group , parasitemia was observed to diminish HBV viremia [P = 0 . 003 , r = -0 . 489] . Conclusion ...

gh or yaniweh@ug. edu.gh.Plasmodium malariae and Plasmodium ovale are increasingly gaining public health attention as the global transmission of falciparum malaria is decreasing. However, the absence of reliable Plasmodium species-specific detection tools has hampered accurate diagnosis of these minor Plasmodium species. In this study, SYBR Greenebased real-time PCR assays were developed for the detection of P. malariae and P. ovale using cooperative primers that significantly limit the formation and propagation of primersdimers. Both the P. malariae and P. ovale cooperative primer-based assays had at least 10-fold lower detection limit compared with the corresponding conventional primers. More important, the cooperative primer-based assays were evaluated in a cross-sectional study using 560 samples obtained from two health facilities in Ghana. The prevalence rates of P. malariae and P. ovale among the combined study population were 18.6% (104/560) and 5.5% (31/560), respectively. Among the Plasmodium-positive cases, P. malariae and P. ovale mono-infections were 3.6% (18/499) and 1.0% (5/499), respectively, with the remaining being co-infections with Plasmodium falciparum. The study demonstrates the public health importance of including detection tools with lower detection limits in routine diagnosis and surveillance of nonfalciparum species. This will be necessary for comprehensively assessing the effectiveness of malaria interventions and control measures aimed toward global malaria elimination.