Prevalence of human papillomavirus genotypes among women with cervical cancer in Ghana.

BACKGROUND: Human Papillomavirus (HPV) infections have been shown to be a necessary risk factor for the development of cervical cancer. However, HPV genotype distribution varies geographically, both in type and relative prevalence. In order to ensure a successful introduction of available vaccines, there is the need to identify pre-vaccination HPV genotype prevalence in Ghana and the extent of single and multiple-infections. METHODS: Paraffin-embedded cervical tissues of 256 confirmed cervical cancer cases diagnosed at the Korle-Bu Teaching Hospital during the period January 2004 to December 2006 were selected after hematoxylin and eosin staining and confirmation. Following a heat-proteinase K-based tissue lysis, HPV was detected and typed by a nested-multiplex PCR assay using an E6/E7 consensus primer and type-specific primers. RESULTS: Of the 256 cases, 230 (89.8 %, 95 % CI 85.7-93.4 %) were positive for HPV DNA. HPV18 (47.4 %), HPV59 (42.2 %), HPV45 (37.4 %) and HPV16 (9.0 %) were the four common HPV genotypes detected. A total of 110 (47.8 %) of the 230 HPV DNA positive tissues, were infected by a single HPV genotype while the other 120 (52.2 %) were infected by multiple HPV genotypes. A significant association was determined between each of the following HPV genotypes and multiple-infection; HPV18 (OR = 6.97; 95 % CI, 3.89-12.50), HPV59 (OR = 9.56; 95 % CI, 5.57-20.02) and HPV45 (OR = 1.94; 95 % CI, 1.12-3.35). CONCLUSION: The prevalence of the following high risk HPV genotypes (HPV18, HPV59, HPV45) were relatively high among the cases of cervical cancers reported at this hospital in Ghana during the study period. Additionally, there was a high frequency of HPV multiple-infections among these cases.

The impact of blood glucose and cholesterol levels on the manifestation of psychiatric disorders.

This study examined possible association of fasting glucose and lipid abnormalities in psychiatric patients on conventional antipsychotic medications. A total of 305 subjects were used for the study, comprising 203 clinically diagnosed psychiatric patients and 102 non-psychiatric subjects used as control at the psychiatric clinic at Komfo Anokye Teaching Hospital (KATH). Questionnaires were administered, blood pressure and anthropometric measurements undertaken. Fasting blood samples were taken for glucose and total cholesterol. The patients included those treated with conventional antipsychotic agents. It was noted, that there were higher rates of diabetes (22.17%) and lipid abnormalities (42.43%) with lower rate of hypertension (5.91%) and obesity (5.91%) across the sample as compared to control. This finding suggests that the high prevalence of diabetes and lipid abnormalities, in a young, psychiatrically ill population makes the case for aggressive screening.

Previous help sought by patients presenting to mental health services in Kumasi, Ghana.

OBJECTIVE: There are four services providing mental health care to the people of Kumasi, Ghana. This study aimed to identify previous help sought by patients presenting to the services for an initial assessment. METHOD: New patients presenting to each of the four services were asked about distance travelled, previous help sought and time since symptoms of illness started. Staff also recorded basic demographic details and clinical diagnoses. RESULTS: Of the 322 patients presenting to the four sites,only 6% had seen a traditional healer whereas 14% had seen a pastor before presentation. There was a greater delay in presenting to that service if the patient had seen a traditional healer or pastor. Many patients had previously used one of the other mental health units in Kumasi. CONCLUSION: It is possible that fewer patients with mental health problems present to traditional healers in modern, urban Africa compared to rural areas. More patients consult with pastors than traditional healers and liaison with these groups may improve mental health care. It is important to maintain liaison between the four services as patients presenting to one clinic may have presented previously to another local clinic.

Novel Plasmodium falciparum clones and rising clone multiplicities are associated with the increase in malaria morbidity in Ghanaian children during the transition into the high transmission season.

A survey of Plasmodium falciparum infection and clone multiplicity in Ghanaian children was carried out to study the effect of the onset of the malaria transmission season on disease incidence. Fortnightly blood samples were collected from 40 children living in the rural town of Dodowa, between February and August 1998. P. falciparum parasite densities were calculated and PCR genotyping was carried out using the polymorphic MSP-1 and MSP-2 genes as target loci for the estimation of the number of parasite clones in each sample. The average clone number was estimated using maximum likelihood techniques and the minimum number of clones per patient was analysed for the effects of age, sex, season, minimum number of clones per child, level of parasitaemia and parasite genotype. The statistical analysis indicated that the more clones a child carried, the more likely they were to have a clinical malaria episode. This was true after adjusting for age and season effects and for the measured circulating parasitaemia. The probability of clinical disease also increased if the MSP-1 MAD 20 and the MSP-2 FC 27 alleles were present. This longitudinal analysis thus indicates that the probability of a Ghanaian child having a symptomatic malaria episode is positively associated with both increasing numbers and novel types of P. falciparum clones.

Screening and sequence determination of a cDNA encoding the human brain 4-aminobutyrate aminotransferase.

A human brain cDNA library constructed in the lambda ZAP II vector was screened using a fragment of pig brain cDNA encoding 4-aminobutyrate aminotransferase (pGaba-t). A cDNA that encodes the human brain Gaba-t (hGaba-t) has been isolated from the library and sequenced. Using the GenBank and EMBL databases, comparison of the predicted amino-acid sequence of hGaba-t with the pig enzyme revealed 95.4% homology.

Characterization of monomeric 4-aminobutyrate aminotransferase at low pH.

4-Aminobutyrate aminotransferase undergoes a reversible process of association/dissociation at low pH. At pH 5.0, monomeric species exist predominantly in solution as revealed by FPLC and time-dependent emission anisotropy measurements. The observed rotational correlation time at pH 5.0, phi obs = 25 ns, corresponds to a compact spherical unit of 52 kDa. An increase in the net charge of the macromolecule at pH 5.0 is responsible for destabilization of the dimeric structure, (WEL approximately 41.84 kJ/mol), but the dissociation of the protein does not perturb the secondary structure as revealed by CD measurements. The fluorescent probe 1-anilinonaphthalene-8-sulfonate (ANS), bound to hydrophobic sites of the enzyme, was used to monitor the kinetics of protein dissociation by stopped-flow spectroscopy. The dissociation of the dimeric structure at pH 5.0 was characterized by a relaxation time of 18 ms. The rate of association of monomeric subunits at pH 7.0 was too fast to be detected in the stopped-flow instrument. These observations have some bearing on the mechanism of reconstitution of dimeric structures of 4-aminobutyrate aminotransferase in the cell.

Isolation and characterization of recombinant mitochondrial 4-aminobutyrate aminotransferase.

4-Aminobutyrate aminotransferase, which catalyzes the conversion of 4-aminobutyrate to succinic semialdehyde, is a key enzyme of the 4-aminobutyrate shunt. The amino acid sequence predicted from the cDNA sequence shows that the precursor protein consists of the mature enzyme of 473 amino acid residues and an amino-terminal segment of 27 amino acids (Kwon, O. S., Park, J., and Churchich, J. E. (1992) J. Biol. Chem. 267, 7215-7216). A recombinant 4-aminobutyrate aminotransferase has been expressed in Escherichia coli using pETIId as expression vector. The protein has been purified and characterized as a dimer (2 x 55 kDa). NH2-terminal sequence analysis has revealed the presence of an extra amino-terminal segment (signal peptide) predicted from the cDNA sequence. The isolated precursor of 4-aminobutyrate aminotransferase contains pyridoxal 5-phosphate and exhibits catalytic activity (18 units/mg) comparable to that of the mature enzyme (20 units/mg). The presequence peptide of the precursor of mitochondrial 4-aminobutyrate aminotransferase does not interfere with the folding and functional properties of the mature moiety of the aminotransferase.

Undergraduate teaching of the behavioural sciences at a new medical school in Ghana.

A programme of teaching in the behavioural sciences at a new medical school in Ghana is described. Students are introduced to problems in their first year and these are used as a means of working in small groups, for self-directed learning and the collection of data. The course continues for 5 years and leads on to a residential posting at a psychiatric hospital, and embodies a close association between 'clinical' medicine and psychological medicine. The programme has only been running for 2 years and so an adequate objective evaluation cannot yet be made, but judged subjectively it is enjoyed by students.

Psychosomatic illness concept and psychotherapy among the Akan of Ghana.

The example of the Akan in Ghana shows that western medicine has no psychotherapeutic alternative to offer the so-called "developing countries". The traditional healing methods existing in such countries must be preserved and researched in order to maintain them at least at their present standard (9). This task, as well as that of developing these methods over the coming decades to keep pace with the cultural development process, is one that devolves upon the young scientists and doctors of such countries. This in turn requires further study of socialization values and norms, the potential resultant conflicts, the psychotherapeutic conflict-solving processes designed to obviate them and the forces at work in such psychotherapy.