Safety of intravitreal ziv-aflibercept in choroido-retinal vascular diseases: A randomised double-blind intervention study.

AIM: To evaluate the safety of 1.25mg and 2mg intravitreal ziv-aflibercept (IVZ) in Ghanaian eyes with choroido-retinal vascular diseases. DESIGN: Prospective, randomised, double blind, interventional study. METHODS: Twenty patients with centre involving macular oedema in diabetic retinopathy, retinal vein occlusion, and neovascular age-related macular degeneration were assigned to 2 groups receiving 3 doses of 1.25mg/0.05ml (group 1) and 2mg/0.08ml IVZ (Group 2) at 4 weekly intervals. Safety data was collected after 30 minutes, 1 and 7 days, and 4, 8 and 12 weeks after injection. Changes in continuous variables were compared using paired t-test and categorical variables were compared using chi-square test of proportions. Repeated-Measures ANOVA with nesting test was used to compare variations in continuous variables by IVZ dose over time. Primary outcome measures were ocular and systemic adverse events at 4 weeks. RESULTS: Eleven females and nine males, with mean age of 63.2± 7.3 years were included. Ocular adverse events included subconjunctival haemorrhage in 1 eye, intraocular pressure (IOP) >21mmHg at 30 minutes in 6 eyes and mild pain in 3 eyes at 1-day. There was no significant difference in IOP rise between the 2 groups at 30 minutes (p = 0.21). No other ocular or systemic adverse events were observed. There was significant improvement in the best corrected visual acuity (LogMAR) from 0.95±0.6 to 0.6±0.4 (p<0.01) and 0.47±0.3 (p<0.01), reduction in central subfield foveal thickness from 405.9±140 um at baseline to 255.6±75 um (p<0.01) and 238±88 um (p<0.01) at 4 and 12 weeks respectively, although no difference was observed between the 2 groups (p = 0.34). CONCLUSION: IVZ at 1.25mg and 2mg had similar safety profiles, and did not have any major unexpected adverse events. Further studies with larger cohorts are required to confirm efficacy.

Knowledge and occupational hazards of barbers in the transmission of hepatitis B and C was low in Kumasi, Ghana.

INTRODUCTION: Blood borne viral hepatitis transmission still ranges between 4-20% in many Ghanaian communities. Hepatocellular carcinoma (HCC) also called liver cancer is reported as the leading cause of cancer mortality among males in Ghana. We studied the knowledge and risk factors associated with barbers' occupation in the transmission of hepatitis B virus (HBV) and hepatitis C virus (HCV). METHODS: A randomized cross-sectional survey of 200 barbershops was conducted in Kumasi between January and August 2013. Barbershops, which operated continuously for more than 8 months, were selected for the study. Structured questionnaires were administered to the study participants. Data was entered and analysed in Microsoft Excel spread sheet and SPSS v12. The percentage value of each question was calculated. RESULTS: All the barbers involved in this study used a new razor blade on every client and claimed to sterilize the hair trimmers after use on every client. The methods of sterilization; 46.5% of the barbers used the ultraviolet radiation sterilizer cabinet, 29% used 70% alcohol and 23% used antiseptic solutions. More than thirty-six percent (36.5%) and 5% of the barbers had heard of HBV and HCV respectively. Only 7% and none knew the route of transmission of HBV and HCV respectively, whereas 7% knew sharing razor blade or hair trimmer could transmit both HBV and HCV. More so, 2% knew HBV and HCV could cause cancer and 2% had received the HBV vaccine. The majority of barbers (63%) had education up to the junior secondary school level. None of the barbers used a new apron nor washed their hands after work on each client. CONCLUSION: Awareness of barbers about HBV or HCV and job-related factors contributing to spread of infections was very poor among the vast majority of the barbers studied. Thus, giving training for the barbers is required toward prevention of blood- borne infections associated to their profession.

The prevalence of hepatitis B virus E antigen among Ghanaian blood donors.

Hepatitis B viral infection is an important clinical problem due to its worldwide distribution and potential of adverse sequelae, including hepatocellular carcinoma (HCC). We studied the prevalence of hepatitis B virus 'e' antigen (HBeAg) among individuals determined to be hepatitis B virus (HBV) surface antigen-positive and analyzed the gender/age category associated with more active HBV infection and whether alteration in the levels of alanine aminotransferase could be associated with HBeAg positivity. A total of 150 prospective blood donors who tested positive for hepatitis B surface antigen (HBsAg) at the blood transfusion center of the Komfo Anokye Teaching Hosptital (KATH), Kumasi were randomly selected for the study. The serum samples were further tested for HBsAg and HBeAg using a lateral flow immunochromatographic assay. Twenty (20) individuals were found to be HBeAg-positive giving an overall prevalence of 13.3%, of which 18 (15.5%) were males and 2 (5.9%) were females. Our results also revealed that the prevalence of HBeAg was higher in patients between the age group of 10-20 years and appeared to decrease with increase in age. There was no statistical difference between the HBeAg positive and negative individuals with respect to alanine aminotransferase (ALT) levels. We show for the first time that approximately 1/10 of HBV-infected individuals are HBeAg positive in the Ashanti Region of Ghana, suggestive of active viral replication and liver-cell infectivity thereby contributing to an increased HBV-transmission pool within the Ghanaian population.