Vitamin D Deficiency Is Common in Ghana despite Abundance of Sunlight: A Multicentre Comparative Cross-Sectional Study.

BACKGROUND: Vitamin D is a steroid hormone important for the normal functioning of the body. It is produced through skin exposure to sunlight and from the diet. Although Ghana is located in the tropics where sunlight is abundant, factors like culture, diet, skin pigmentation, variation in the ozone layer, and geographical area influence the optimization of vitamin D concentration. It is imperative to evaluate the interplay between sunshine exposure, proinflammatory cytokines, and mediators of vitamin D metabolism and their relationship to vitamin D status in three geographical sections among apparent healthy Ghanaians. METHODS AND RESULTS: In a cross-sectional study, a total of five hundred (500) healthy blood donors from three geographical areas in Ghana were enrolled. Their age ranged from 17 to 55 years with a mean age of 27.97 ± 8.87 years. The overall prevalence rate of vitamin D deficiency was 43.6% (218/500), with 41.2% (91/221), 45.3% (63/139), and 45.7% (64/140) of vitamin D deficiency being recorded in participants from the Northern Sector (NS), Middle Belt (MB), and Southern Sector (SS), respectively. However, there were no significant differences in the proportions of vitamin D deficiency across various geographical sectors. The median 25-hydroxyvitamin D serum levels were compared among geographical areas (NS, MB, and SS) and there were no significant differences (P=0.275) after adjusting for confounding factors. 25-Hydroxyvitamin D correlated positively with corrected ionized calcium (rs = 0.622, P ≤ 0.001) and phosphorus (rs = 0.299, P ≤ 0.001) and negatively correlated with SBP (rs = -0.092, P=0.039), vitamin D binding protein (VDBP) (rs = -0.421, P ≤ 0.001), intact parathyroid hormone (iPTH) (rs = -0.0568, rs ≤ 0.001), IFN-gamma (rs = -0.684, P ≤ 0.001), and TNF-alpha (rs = -0.600, P ≤ 0.001). After adjusting for possible confounders, not having knowledge about vitamin D foods, taking fewer vitamin D foods, and higher levels of IF-γ and IL-10 were associated with a higher risk of having vitamin D deficiency. CONCLUSION: The prevalence of 25-hydroxyvitamin D deficiency is high among the general adult population in Ghana despite the abundance of sunlight. Increasing knowledge on vitamin D diet coupled with a daily intake of vitamin D dietary supplements is likely to reduce the risk of developing 25-hydroxyvitamin D deficiency.

Oxidative Stress and Hemoglobin Level of Complicated and Uncomplicated Malaria Cases among Children: A Cross-Sectional Study in Kumasi Metropolis, Ghana.

INTRODUCTION: Malaria is a leading cause of mortality among children below 5 years in Ghana. Its parasites are known to cause the degradation of hemoglobin, resulting in the production of reactive oxygen species and hence oxidant stress. Therefore, this study was carried out to compare the levels of oxidative stress between children with complicated and uncomplicated malaria infection in Kumasi, Ghana. METHOD: Subjects were recruited from hospitals in the Kumasi Metropolis. This was a cross-sectional study, involving 17 complicated malaria subjects, 51 uncomplicated malaria subjects, and 15 nonparasitemic subjects. The rapid diagnostic test (RDT) was used to determine presence or absence of falciparum malaria among the study participants. Blood samples from subjects were used to determine hemoglobin, malondialdehyde (MDA), and vitamin C levels. RESULTS: Majority of the subjects (67.5%) were within the age of 0-5 years. The mean age (±SD) of uncomplicated malaria subjects was 4.32 (±2.81) years, while that of complicated malaria was 4.27 (±2.96). Mean levels of HB decreased significantly in the following order: control subjects > uncomplicated malaria subjects > complicated malaria subjects (p<0.0001). Mean levels of MDA were significantly lower in control subjects compared to complicated malaria subjects (4.62±1.85 versus 6.68±0.70, p=0.0008) and also lowered in uncomplicated malaria subjects compared to complicated malaria (4.50±1.58 versus 6.68±0.70, p<0.0001). There was a statistically significant reduced mean level of vitamin C (p=0.036) in the following order: control subjects > uncomplicated malaria > complicated malaria subjects. However, for the complicated malaria cases, there were significantly higher mean vitamin C levels in females than in males (p<0.001). CONCLUSION: Malaria progression increases MDA levels and decreases the ascorbate (vitamin C) and hemoglobin levels. It is recommended that future studies should investigate changes in other antioxidant vitamins, like vitamins A and E.

Evaluation of Metabolic Syndrome and Its Associated Risk Factors in Type 2 Diabetes: A Descriptive Cross-Sectional Study at the Komfo Anokye Teaching Hospital, Kumasi, Ghana.

Background. Metabolic syndrome (MS) is a collection of cardiovascular risk factors comprising insulin resistance, dyslipidemia, obesity, and hypertension, which may cause further complications in diabetes. Although metabolic syndrome (MS) is increasing in incidence in diabetics and leading to significant cardiovascular diseases and mortality, there is dearth of data in Ghana. This study investigated metabolic syndrome, its prevalence, and its associated risk factors in type 2 diabetes at the Komfo Anokye Teaching Hospital, Kumasi, Ghana. Methods. The study involved 405 diabetic patients attending the Diabetic Clinic of the Komfo Anokye Teaching Hospital (KATH) Kumasi, in the Ashanti Region of Ghana. A well-structured questionnaire was used to obtain demographic background such as their age and gender. Anthropometric measurements were obtained using the Body Composition Monitor (Omron ® 500, Germany) which generated digital results on a screen and also by manual methods. Fasting venous blood was collected for the measurement of biochemical parameters comprising fasting plasma glucose (FPG), glycated haemoglobin (HbA1c), high density lipoprotein cholesterol (HDL-c), and triglyceride (TG). Metabolic syndrome was defined according to the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III). Results. Out of the total of 405 participants, 81 were males and 324 were females, and the estimated mean age was 58.5 ± 9.9 years. The female patients exhibited higher mean waist circumference (WC) and mean hip circumference (HC) as well as an approximately higher body mass index than males (28.3 ± 5.1, 26.5 ± 4.2 for the female and male respectively). Overall, the prevalence of metabolic syndrome observed among the study population was 90.6%. Conclusions. The prevalence of metabolic syndrome observed among the study population was 90.6%, with a higher percentage in females than males. High triglyceride levels and high waist circumference were the main risk factors for MS in the diabetic population.

Developing a Modified Low-Density Lipoprotein (M-LDL-C) Friedewald's Equation as a Substitute for Direct LDL-C Measure in a Ghanaian Population: A Comparative Study.

Despite the availability of several homogenous LDL-C assays, calculated Friedewald's LDL-C equation remains the widely used formula in clinical practice. Several novel formulas developed in different populations have been reported to outperform the Friedewald formula. This study validated the existing LDL-C formulas and derived a modified LDL-C formula specific to a Ghanaian population. In this comparative study, we recruited 1518 participants, derived a new modified Friedewald's LDL-C (M-LDL-C) equation, evaluated LDL-C by Friedewald's formula (F-LDL-C), Martin's formula (N-LDL-C), Anandaraja's formula (A-LDL-C), and compared them to direct measurement of LDL-C (D-LDL-C). The mean D-LDL-C (2.47±0.71 mmol/L) was significantly lower compared to F-LDL-C (2.76±1.05 mmol/L), N-LDL-C (2.74±1.04 mmol/L), A-LDL-C (2.99±1.02 mmol/L), and M-LDL-C (2.97±1.08 mmol/L) p < 0.001. There was a significantly positive correlation between D-LDL-C and A-LDL-C (r=0.658, p<0.0001), N-LDL-C (r=0.693, p<0.0001), and M-LDL-C (r=0.693, p<0.0001). M-LDL-c yielded a better diagnostic performance [(area under the curve (AUC)=0.81; sensitivity (SE) (60%) and specificity (SP) (88%)] followed by N-LDL-C [(AUC=0.81; SE (63%) and SP (85%)], F-LDL-C [(AUC=0.80; SE (63%) and SP (84%)], and A-LDL-C (AUC=0.77; SE (68%) and SP (78%)] using D-LDL-C as gold standard. Bland-Altman plots showed a definite agreement between means and differences of D-LDL-C and the calculated formulas with 95% of values lying within ±0.50 SD limits. The modified LDL-C (M-LDL-C) formula derived by this study yielded a better diagnostic accuracy compared to A-LDL-C and F-LDL-C equations and thus could serve as a substitute for D-LDL-C and F-LDL-C equations in the Ghanaian population.