Background The services of most clinical laboratories in Africa regarding the diagnosis of Trichomonas vaginalis are largely dependent on the urine direct wet-mount method. However, the exclusive use of urine-based detection may not be appropriate. The culture method is considered the “gold standard” for the diagnosis of T. vaginalis . However, this method has a relatively longer turn-around time and is limited by non-viable organisms in the specimen. This study assessed the prevalence of T. vaginalis and its associated risk factors and evaluated its diagnosis using urine and vaginal samples from symptomatic female out-patients by culture, direct wet-mount, and ELISA method respectively. Methods This cross-sectional study was conducted at the Obstetrics and Gynaecology department of the Manhyia District hospital (MDH) and Komfo Anokye Teaching Hospital (KATH), Ghana. Ghanaian sexually active female adults between the ages of 18 and 50 years old were recruited for this study. Vaginal (HVS) and urine samples were collected from each participant, and T. vaginalis infection was assessed based on culture, direct wet mount, and ELISA methods. Results The prevalence of T. vaginalis infection based on the ELISA method, HVS culture, and HVS wet mount were 7.2%, 5.0%, and 1.7%, respectively. Urine culture presented with a 0.6% prevalence rate while urine direct wet mount detected no positive case. There was no statistically significant association between demographic and clinical characteristics and T. vaginalis infection, except for subjects presenting with abdominal pain [OR = 5.42, 95% CI (1.35–21.73), p = 0.017]. Using HVS culture as the reference, ELISA performed best compared to the other methods assessed in this study, presenting with the highest sensitivity [88.9%, 95% CI (54.0–99.8)], specificity [97.1%, 95% CI (93.1–98.9)], AUC (93.0%), and accuracy (96.7%). Conclusion The prevalence of T. vaginalis infection is high among women in Ghana. With the exception of abdominal pain, there is no significant association between demographic and clinical characteristics and T. vaginalis infection. In the event where the culture method is unavailable or when rapid diagnosis is required, antigenic detection using ELISA is the most accurate for the diagnosis of T. vaginalis infection in women compared to urine wet-mount/culture and the HVS wet-mount method.

Background The study assessed the hepatitis B virus (HBV) and hepatitis C virus (HCV) co-infection paradigm among the human immunodeficiency virus (HIV) infected patients attending a tertiary hospital in Ghana. Also, the immunological and virological characterisation of these viruses, prior to antiretroviral therapy (ART) initiation was investigated. Method A total of 400 HIV infected (HIV type-1) treatment naïve subjects ≥18 years were enrolled and tested for HBsAg and anti-HCV. Hepatitis B virus serological profile was performed on samples that were HBV positive. CD4+ T-cell count and HIV-1 RNA viral loads were determined using BD FacsCalibur analyzer (USA) and COBAS AmpliPrep/COBAS TaqMan Analyzer (USA) respectively. Results The overall prevalence of HBV/HCV co-infection among the HIV-1 patients was 18.0%. The prevalence of HIV-HBV and HIV-HCV co-infections were 12.5% and 5.5% respectively. The prevalence of active viral hepatitis (HBeAg-positive) among HIV-HBV co-infected patients was 40%. None of the patients had anti-HBc IgM. HIV-HBV co-infection was associated with lower CD4+ T-cell count as well as higher HIV-1 viral load compared to both HIV mono- infection and HIV-HCV co- infection ( p <0.05) respectively. HBeAg positivity was associated with severe immunosuppression and higher HIV viral load. Patients aged 18–33 years [aOR = 9.66(1.17–79.61); p = 0.035], male gender [aOR = 2.74(1.15–6.51); p = 0.023], primary education [aOR = 9.60(1.21–76.08); p = 0.032], secondary education [aOR = 14.67(1.82–118.08); p = 0.012] and being single [aOR = 2.88(1.12–7.39); p = 0.028] were independent risk factors of HIV-HBV co-infections but not HIV-HCV co-infections. Conclusion The present study highlights the predominance of HBV exposure among the HIV infected patients in Ghana. HBV coinfection was associated with severe immunosuppression and higher HIV-1 viral load.

Introduction. The pathophysiology of malaria-related anaemia is not fully understood although increased destruction of parasitized and nonparasitized erythrocytes, as well as inadequate erythropoiesis, has been proposed. Circulating antierythropoietin (anti-EPO) antibodies have also been implicated in malaria and malaria-related anaemia in mice. However, studies on this association have not been investigated in humans. This study therefore determined the prevalence of anti-EPO antibody production and assessed its association with malaria and malaria-related anaemia in humans.Methods. A total of 86 children aged 1-10 years (57 children with malaria serving as the case group and 29 healthy children serving as control), all residents of Duayaw Nkwanta, Ghana, were recruited for this case-control study. Venous blood was collected for thick and thin films for malaria microscopy, full blood count by automated haematology analyzer, and antierythropoietin antibody and erythropoietin estimation by sandwich ELISA method.Results. Out of the 86 participants recruited, only 3 (3.5%) were positive for anti-EPO antibody; 2.3% of the case group; and 1.2% of the control group. There was no association between the cases and the controls in the production of anti-EPO antibodies. Erythropoietin concentration was significantly higher in malaria-related anaemic subjects (p=0.032).Conclusion. Antierythropoietin antibodies are not associated with malaria infection and malaria-related anaemia in humans. Erythropoietin concentration is associated with malaria-related anaemia.

Vulvovaginal candidiasis (VVC) is a common infection among women of childbearing age, and few of these women experience recurrent vulvovaginal candidiasis (RVVC). The study was aimed at determining the virulent factors, and antifungal susceptibility of the Candida species isolated from women with RVVC attending the Nkawie Government Hospital, Ashanti-Region, Ghana. Over a 6–month period (October 2016 to March 2017), a total of 288 women with RVVC were evaluated. Isolation of the yeast was performed after the inoculation of the vaginal specimens onto Sabouraud Dextrose Agar (SDA), and incubated for 24-48 hours at 37oC. The isolates were identified by standardized conventional methods. The enzymatic activities of esterase, phospholipase, haemolysis and biofilm production were evaluated for the identification of the yeast isolates. Susceptibility to antifungal agents was determined by using the Kirby-Bauer disk diffusion method. Azole resistant isolates were further tested for ERG11 gene which encodes the enzyme (cytochrome P450 lanosterol 14-α-demethylase) by the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) analysis. Vaginal swabs cultures of 200 women (64.4) from 288 samples yielded Candida species. Candida albicans was the commonest isolated specie (33.0%), followed by Candida glabrata (29.5 %), Candida tropicalis (23.0%), and Candida krusei (15.5%). Hemolysin production, phospholipase enzyme activity, and biofilms formation were found in 84.5%, 83%, 77.5%.of the isolates respectively. Most phospholipase producing Candida isolates also formed biofilms. All Candida spp isolated were susceptible to itraconazole while majority of them were resistant to voriconazole. ERG11 genes were detected in 11.1% of Azole resistant Candida species. There is a significant increase in the rate of antifungal resistance among the Candida isolates to fluconazole and voriconazole. There is need for continuous surveillance as well as antifungal susceptibility testing on the Candida spp to guide therapy. A larger epidemiological study is also advocated to determining the degree of spread of ERG11 genes.