Hospital-Based Surveillance for Viral Hemorrhagic Fevers and Hepatitides in Ghana

Abstract

BackgroundViral hemorrhagic fevers (VHF) are acute diseases associated with bleeding, organ failure, and shock. VHF may hardly be distinguished clinically from other diseases in the African hospital, including viral hepatitis. This study was conducted to determine if VHF and viral hepatitis contribute to hospital morbidity in the Central and Northern parts of Ghana.Methodology/Principal FindingsFrom 2009 to 2011, blood samples of 258 patients with VHF symptoms were collected at 18 hospitals in Ashanti, Brong-Ahafo, Northern, Upper West, and Upper East regions. Patients were tested by PCR for Lassa, Rift Valley, Crimean-Congo, Ebola/Marburg, and yellow fever viruses; hepatitis A (HAV), B (HBV), C (HCV), and E (HEV) viruses; and by ELISA for serological hepatitis markers. None of the patients tested positive for VHF. However, 21 (8.1%) showed anti-HBc IgM plus HBV DNA and/or HBsAg; 37 (14%) showed HBsAg and HBV DNA without anti-HBc IgM; 26 (10%) showed anti-HAV IgM and/or HAV RNA; and 20 (7.8%) were HCV RNA-positive. None was positive for HEV RNA or anti-HEV IgM plus IgG. Viral genotypes were determined as HAV-IB, HBV-A and E, and HCV-1, 2, and 4.Conclusions/SignificanceVHFs do not cause significant hospital morbidity in the study area. However, the incidence of acute hepatitis A and B, and hepatitis B and C with active virus replication is high. These infections may mimic VHF and need to be considered if VHF is suspected. The data may help decision makers to allocate resources and focus surveillance systems on the diseases of relevance in Ghana.

Hepatitis E infection among Ghanaians: a systematic review

“…The majority of the studies (80%, n = 8) were conducted solely among urban dwellers. Of the serological studies, one was conducted exclusively among children [ 17 ], two studies were conducted among pig handlers [ 18 , 19 ], two among blood donors [ 20 , 21 ], one involved adult HIV patients [ 22 ], one involved pregnant women [ 9 ], one involved persons with viral haemorrhagic fever symptoms [ 23 ] and one study involved patients with suspected hepatitis [ 24 ]. The ten studies were published between 1999 and 2016, however, the sampling took place between 1993 and 2013.…”

Determination of Specific Antibody Responses to the Six Species of Ebola and Marburg Viruses by Multiplexed Protein Microarrays

“…An expansion of the antigen probes used in the assay may also be a useful modification to consider. A recent report of hospital-based surveillance in Ghana suggested the importance of distinguishing infections caused by hepatitis viruses that produce symptoms that mimic viral hemorrhagic fevers from the infrequent infections caused by filoviruses (49). Further, the prevailing hypothesis concerning outbreaks of filoviral hemorrhagic fevers is that indigenous human populations occasionally make contact with animal reservoirs of Ebola and Marburg viruses, resulting in rapid spread of disease (50).…”

Development and evaluation of antibody-capture immunoassays for detection of Lassa virus nucleoprotein-specific immunoglobulin M and G

“…From Lassa fever non-endemic areas, 199 samples collected between 2008 and 2011 from patients with suspected viral hemorrhagic fever or viral hepatitis in Ghana, all of whom tested negative by Lassa virus RT-PCR [ 37 ], and 105 diagnostic leftover samples from German patients with various unknown diseases were included in the study. The travel history of the patients from non-endemic areas was not known.…”