PAID ADVERTISEMENTS

MEETING SCHEDULE DAY 1 Tuesday 30th July 2019 07:00 – 09:15 hrs Registration and Poster Set-up 09:15 – 10.00 hrs Opening Ceremony 10:00 – 11:00 hrs Keynote Address 11:00 – 11:10 hrs Chairman’s closing remarks & Vote of Thanks 11:10 – 11:50 hrs Break 11:50 – 12:50 hrs Parallel Sessions A1 & B1 – Oral Presentation 13:00 – 14:00 hrs Parallel Sessions A2 & B2 – Oral Presentation 14:00 – 14:50 hrs Lunch 14:50 – 15.50 hrs Parallel Sessions C1 & C2 – Oral Presentation

DAY 2 Wednesday 31st July 2019 07:00 – 08:50 hrs Registration 08:50 – 09:00 hrs Announcements 09:00 – 10:00 hrs Keynote Address 10:00 – 10:50 hrs Break 11:00 – 12:00 hrs Parallel Session D1 & E1 – Oral Presentation 12:10 – 13:10 hrs Parallel Session D2 & E2 – Oral Presentation 13:10 – 14:10 hrs Lunch 14:10 – 15:10 hrs Session F 16:00 – 17:30 hrs POSTER SESSION 17:30 – 18:00 hrs CHS Closing Ceremony 18:00 hrs Cocktail and Networking

DAY 3 Thursday 1st August 2019 07:00 – 08:50 hrs Registration 08:50 – 09:00 hrs Announcements 09:00 – 10:00 hrs Keynote Address 11:00 – 12:30 hrs Session G1 – Oral Presentation 11.00 – 12.30 hrs Session G2 – Oral Presentation 12.30 – 13:15 hrs Lunch 13.30 – 14:30 hrs Bussiness meeting 14:30 – 14:50 hrs Closing Ceremony 15.00 hrs Board Meeting

CONFERENCE ANNOUNCEMENTS Preconference workshops (Sunday 28th & Monday 29th July): i. PCR & post amplification techniques ii. Liquid handling techniques Venue: Department of Clinical Microbiology, SMS-KNUST iii. Tour of the KNUST Central Laboratory & Satellite Labs Venue: KNUST Central Laboratory Registration: Registration begins on Monday 30th July from 15:00hrs onwards at the KNUST Business School, and will continue from Tuesday, 30th July to Wednesday, 1st August 2019. Transport: Participants will bear their own cost of transportation to and from . Transport arrangements will be made to transport participants arriving and departing at the Kumasi Airport and the Bus terminal, and also to and from their Hotels at no extra cost. Catering: Teas/cocoa/coffee breaks and Lunch will be served within the conference venue during the breaks. You will be required to produce a meal coupon before you will be served. Cocktail & Networking events: This will take place from 18:00hrs on Wednesday night. Information Desk: A registration and information desk will be situated in the KNUST Business School. This will be opened for registration and queries at the following times: Tuesday 30th July – 1st August between the hours of 08:00hrs and 17:00hrs. All information related to accommodation and travels should be lodged there. First Aid: This will be available on site. Indemnity: While every effort will be made to take care of every conference participant, the organizers will not be held responsible for any mishaps during the conference period. Delegates must make their own personal insurance arrangement. Delegates must also take responsibility for any precious item lost during the conference. CPD Accreditation: Continuous Professional development accreditation has been applied for. Delegates will be required to sign the attendance register on a daily basis, and delegates’ CPD Certificates will be given. Scientific Sessions/Commissions: Each day begins with a 1-hour Keynote presentation for all participants. Following the break, there will be parallel sessions in conference rooms 1 and 2. The poster sessions will be held in the foyer on Tuesday and Wednesday after lunch. Photographs: The University’s accredited Photographers will be around to take pictures of events and conference moments. Participants can arrange to take pictures at their own cost.

SOLIDARITY/GOODWILL MESSAGES

WELCOME ADDRESS BY THE PROVOST OF THE COLLEGE OF HEALTH SCIENCES, KNUST On behalf of the Board of the College of Health Sciences, KNUST, I welcome you all to the 8th Biennial Conference of the College. This year, the Conference is being held jointly with the Convention of Biomedical Research, (CoBReG). Both CoBReG and the CHS have agreed on the conference theme “Universal Access to Health Care – The role of the Health Scientist”. Presentations at this conference will showcase what we, as health scientists, bring to the table to complement the work of the health service in addressing issues of universal health care in the country. As a College of Health Sciences, our traditional role has been to produce the necessary human resources for health, engage in extension services within and without the country and undertake research to address important health issues in the country and globally to address SDG 3. It is my hope that this conference will enable us network with COBREG and the Ghana Health Service to address health research challenges to support Universal health care. Do enjoy our hospitality and our beautiful campus.

Prof. Yaw Adu-Sarkodie

WELCOME ADDRESS BY THE PRESIDENT OF CoBReG

It is my pleasure to welcome you to the 2019 annual conference of the Convention for Biomedical Research, Ghana (CoBReG). This is our first ever conference where we are partnering with the KNUST College of Health Sciences to organize a joint conference. The theme this year is ‘Universal Access to Healthcare – the role of the Health Scientist’. This year’s conference features exceptional keynote lectures, oral and poster presentations of original research and promises to provide an expanded platform for creating new, as well as strengthening existing collaborations with researchers and colleagues from local and international institutions. The lineup of presentations promises to provide an avenue for creative thinking as well as provides the opportunity for researchers to share their amazing experiences and results. For delegates who are not members, this is an excellent opportunity to join the CoBReG in order to contribute to advancing biomedical and health developments in Ghana in particular and Africa as a whole. The continuing support from Inqaba Biotech, WACCBIP, and other sponsors is acknowledged, and very well appreciated. The hard work of the Board of Directors together with the Scientific and the Local Organising Committees in planning and putting the conference program together is also acknowledged. This conference promises to be amazing, don't miss out on the fun. I look forward to your enthusiastic participation and wish you a successful conference.

Linda E Amoah, PhD (NMIMR-UG)

MESSAGES FROM SCIENTIFIC COMMITTEE

It is with great pleasure that I welcome you all to CoHS/CoBReG 2019. This is the first time CoBReG is having a joint Conference and we are hoping for more of such to foster collaborations especially between Scientists and Clinicians. It is our desire that the collaborative and interactive discussions will go beyond this meeting and next year, we will see joint abstracts from many faculties. We also hope that this meeting will lay the foundation where our discussions can translate into scientific policies for regional and national development.

Akwasi Anyanful

This year we have three renowned keynote speakers who will highlight accomplishments in their areas of expertise. We also had over 140 abstracts for review and we therefore had to use the parallel session system to accommodate the numerous requests for oral presentations. Public Health talks will thus partner with Bioinforatics/Genomics on the first day and Clinical Research will partner with Plant Medicine/Chemistry on the second day. Due to the proximity of the Conference halls, one can easily move from a particular talk to the other depending on one’s interest. Daniel Ansong

We are still maintaining strictly the allotted time slot of 12 minutes oral presentation with 3 minutes questioning. We insist oral presenters stick strictly to this time to enable the successful progression of the meeting. There will be two interactive poster sessions and if all show up we will have over 80 posters. To this effect, all should be mounted on the first day before the meeting. Poster presenters with an even number should be by their posters on Tuesday during the poster session and all those with odd numbers on Wednesday. Posters can be mounted on the first day and kept for the duration of the program. The Committee also encourages students to seek out mentors and should be bold to approach such persons and we also respectfully request our Senior Members to be open to students so we can inspire and mentor the next batch of Scientists, impressing on the difficulty and often non- rewarding nature of our work. Finally, our heartfelt gratitude goes out to everyone for making the time to be with us and your support and encouragement is very much appreciated. Please interact during the breaks and socialization to establish collaborations. It is our hope that we will all leave this conference with refined ideas and new collaborations that will further enhance our collective output and proceed forward as one team.

WELCOME ADDRESS FROM THE CONFERENCE CHAIR

It gives me great pleasure to welcome you to the 8th edition of the Biennial Scientific Conference of the College of Health Science (CHS), of the Kwame Nkrumah University of Science and Technology (KNUST), Kumasi. This year’s conference focuses on an important aspect of Health Care that is pivotal for improving Global Health Care Delivery but most importantly countries in our sub-region that are bedevilled with limited resources including financial, human, material and technological. This year’s theme; “Achieving Universal Health Care, the Role of Health Scientists” has been carefully chosen to reflect the need to go back in history to the original ideals of primary health care (PHC) following the Alma Atta declaration of 1978. We bring together scientists with varying backgrounds from across the divide of academia and service industry. In 1948, the World Health Organisation declared health care access as a fundamental human right and has since followed up with series of indicators and programmes for achieving this right. Three key areas that are critical in achieving UHC, include equity in access to health services - everyone who needs services should get them, not only those who can pay for them; The quality of health services should be good enough to improve the health of those receiving services; and People should be protected against financial-risk, ensuring that the cost of using services does not put people at risk of financial harm. This conference will accept scientific communication that seeks to tackle each of these areas while focusing on the unique role of health scientists. The uniqueness of this year’s conference is that the College of Health Sciences is organising this year’s conference in collaboration with colleagues from the Convention for Biomedical Research Ghana (CoBReG). These are a conglomerate of scientists (Biomedical Scientists, Laboratory experts, biologists, clinicians etc.,), some of whom are based in the diaspora and will be sharing their experience and expertise in their unique vantage positions and respective contributions to the attainment of universal health care. Finally, we shall seek at this conference to elucidate in particular the role of the health scientists at improving universal health care. Therefore, the College of Health Sciences with its six schools and faculties will attempt to showcase the contribution of various experts in the field and their respective roles that they do and can play in achieving all the pillars of universal health care. UHC cuts across all of the health-related Sustainable Development Goals (SDGs) and brings hope of better health and protection for the world’s poorest. That means you have a very unique opportunity as a scientist with healthcare background to make a contribution to the attainment of universal health care. Our expectation is to draw on your depth of experience to make this conference a memorial. I do count on your active participation and thank all sub-committee organisers, students and faculty as well as donors for making this conference a success.

Akwaaba! Welcome! Bienvenue! De Rien! Graag Gedaan!

Ellis Owusu-Dabo, (KNUST, School Public Health)

Organizing Committee Members

Chair: Ellis Owusu-Dabo Daniel Ansong, Adam Gyedu, Mohamed Mutocheluh, Alexander Yaw Debrah, Otchere Addai- Mensah, Berko Panyin Anto, David Darko Obiri, Cynthia Amaning Danquah, Tony Opoku- Agyemang, Kofi A. Karikari, Felix Obeng Boateng, Harley Anane, Ofeibea Asare

SUB COMMITTEE MEMBERSHIP I. Scientific Daniel Ansong (Chair) Berko Panyin Anto, George Acquah-Mensah, Mohamed Mutocheluh, Edmund Ekuadzi, John Amuasi, Akwasi Anyanful, Veronica M. Dzomeku, George Kwaw Ainooson, Steven Sarfo, M. Babatunde Duduyemi, Linda Batsa Debrah, Paul P. Adade

II. Finance /Sponsorships David Darko Obiri (Chair) Anthony Kwaku Edusei, Alexander Oti Acheampong, Cynthia Amaning Danquah, Michael Owusu, Joseph Atawlana, Christian Birikorang, Nicholas Titiloye, Felix Obeng Boateng, Kofi Appiah Koranteng III. Publicity, Logistics and Protocol Alex Yaw Debrah (Chair) Chrissie S. Abaidoo, Tony Opoku- Agyemang, Yaa Asantewaa Osei, Linda A. Fondjo, Max Efui Annani-Akollor, Mariam El Boakye-Gyasi, Adwoa Bimah Bonsu, Mary Agyemang, Ofeibea Asare, Clara Sam- Woode

Editors: Ofeibea Asare, Linda Batsa Debrah and Akwasi Anyanful Chief Editor: Mohamed Mutocheluh

KEYNOTE SPEAKER [1] PROFILE

Dr. Anarfi Asamoa Baah was the Deputy Director General of the World Health Organisation from 2007 to 2017. Prior to his appointment as Deputy Director General, he held many senior positions in WHO. He served as Assistant Director General of four different clusters (HIV, TB, Malaria; Communicable Diseases, Health Technology and Pharmaceutical and Governing Bodies, Partnership and Country Support between 1998 and 2006. Dr Anarfi Asamoa Baah or AB as is well known was the Director of Medical Services and Pioneer Director of the Policy, Planning, Monitoring and Evaluation Directorate of the Ministry of Health in the 1990s. He was instrumental in the health reforms that led to the establishment of the Ghana Health Service, National Health Scheme, strengthening district health systems, and the first five-year programme of work with the sector wide budget support with direct disbursements to districts. Though retired, he is currently a member of the Presidential Advisory Committee on Science, Technology and Innovation; Chairman of the Interim Management Committee of the University of Ghana Medical Centre; Chairman of the Drugs Committee of the Food and Drugs Authority and Standards Ambassador of the Ghana Standards Authority.

KEYNOTE SPEAKER [2] PROFILE Professor Evans Afriyie-Gyawu is currently an Associate Professor in the Department of Biostatistics, Epidemiology and Environmental Health Sciences, Division Coordinator of Environmental Health Sciences, Jiann-Ping Hsu College of Public Health at Georgia Southern University (GSU). He completed his Ordinary and Advanced Levels Secondary education at Kumasi Academy, . Prof. Afriyie-Gyawu started his University education in Poland, and after two academic years, he moved to the United States where he completed his Undergraduate degree in Biomedical Science, Master of Public Health (Epidemiology and Biostatistics) and PhD in Toxicology at Texas A&M University in College Station, Texas. Prof. Afriyie-Gyawu has been able to combine his backgrounds in Public Health and Toxicology to conduct research activities including those that involved human and animal subjects. He has presented his research at various scientific conferences and meetings in Ghana, many states in the U.S, Bangkok (Thailand), and Istanbul (Turkey). In fact, activities of the conference were featured as Health News on Ghana News Agency, and received coverage on the National Television Station (GTV). Overall, he has published and co-authored 21 peer-reviewed articles, three (3) book chapters and over 60 abstracts and proceedings to major scientific conferences and meetings. Prof. Afriyie-Gyawu’s current research involves a combination of his professional backgrounds in Toxicology and Public Health, which has led to multiple Environmental/Occupational Health and Food Safety/Toxicology studies in Ghana and the U.S.

KEYNOTE SPEAKER [3] PROFILE Professor Winfried Amoaku is a Clinical Academic in Ophthalmology, whose research complements his clinical practice, and described as an international expert on retinal diseases [including age-related macular degeneration (AMD) and diabetic retinopathy], and medical retinal services design. His research is recognised nationally and internationally as indicated by publications and membership of advisory boards to different pharmaceutical companies, expert advice to DH, NICE and Horizon Scanning, and invitations to speak at different meetings and conferences. He has developed research collaborations with colleagues from other Universities in the UK, US and Ghana. He has supervised, and examined research theses from different universities, and led on guidelines for The Royal College of Ophthalmologists (RCOphth) that are appreciated and referred to internationally. Professor Winfried Amoaku serves on the editorial boards and review panels of several international journals. He is Associate Editor for Eye, BMC Ophthalmology. He leads undergraduate ophthalmology teaching in Nottingham University (UoN), and Chair the Dermatology, Ophthalmology and ENT Module Committee of UoN, and was external examiner for Cardiff and Sheffield Medical Schools. Professor Winfried Amoaku provided leadership in The RCOphth, including Acting President (2010-11), Vice President and Chairman of Scientific Committee (2007-11). He went on to serve as Chair, The RCOphth Medical Retinal Service Provisions Subcommittee, Chair, RCOphth Equality and Diversity Committee and Member Examinations, Professional Standards, Training, Education and Finance Committees. He was the founding Vice President, and President of the Ghana Biomedical Convention (GBC) as well President of the Convention for Biomedical Research Ghana (CoBReG) (2014-16). Professor Winfried Amoaku served as Medical Advisor, Member of Scientific Committee of Macular Society UK, Chair of VISION 2020 UK Macular Group (2008-date) (consisting professionals, patient and voluntary groups) supporting change and advocacy, developments in treatments for macular disease, aimed at reducing preventable vision loss, as well as served as External AMD Service Reviewer for NHS Trusts. Last but not the least, he served as General Medical Council Associate (Appeals) since 2009. Professor Winfried Amoaku attended Mawuli School at Ho and later the University of Ghana Medical School. He completed his House Officer programme at Korle-Bu Teaching Hospital in 1980 and was immediately employed as Medical Officer (Ophthalmology), Korle-Bu Teaching Hospital & Hon Demonstrator in Anatomy, UGMS. He presented his PhD thesis titled: ‘The effects of Ionising Radiation on the retina (clinical and experimental)’ in 1990 and was admitted into the British Council for the Prevention of Blindness Research Fellowship based at the Queen’s University of Belfast in the same year.

PROGRAMME OVERVIEW

PRE-CONFERENCE ACTIVITIES 28 – 29 July 2019

Sunday 28 July 2019 10:00 – 17:00 hrs Amplifying yeast gene (S. cerevisiae BMH1). Registered participants only Extract DNA from S. cerevisiae colonies on agar plate, PCR amplify using standard protocol, stain PCR amplicons with ethidium bromide and resolve on 2% agarose gel. Capture images and analyse using the DigiGenius Image software package.

Monday 29 July 2019: 10:00 hrs Recapitulations of the previous day’s work and start of the day’s work. 12:30 hrs Visit to KNUST Central Laboratory facilities.

16:00 –18:00 hrs Chairpersons and planning committee members meet

PROGRAMME LINE-UP DAY 1 TUESDAY, 30 JULY 2019 07.00 – 09.15 hrs Registration and Poster Set-up

09:15 – 10:00 hrs OPENING CEREMONY Charles Ansah, Chair

WELCOME AND INTRODUCTION Ellis Owusu-Dabo, Chair, Organising Committee Linda Amoah, President, Convention of Biomedical Research Daniel Ansong, Dean, School of Medicine and Dentistry Yaw Adu-Sarkodie, Provost, College of Health Sciences Kwasi Obiri-Danso, Vice Chancellor, KNUST

10:00 – 11:00 hrs KEYNOTE ADDRESS Yaw Adu-Sarkodie, Chair Anarfi Asamoa Baah, Board Chair, University of Ghana Medical Centre,

“Universal access to health care – The role of the health scientist”

11:00 – 11:10 hrs Chairman’s closing remarks and vote of thanks 11:10 – 11:30 hrs Photographs 11:10 – 11:50 hrs Break

11:50 – 12:50 hrs PARALLEL SESSION A1 – PUBLIC HEALTH Conference Room 1 Chairs: Frances Thelma Owusu Daako and John Amuasi 11:50 – 12:05 hrs Agbedinu, K Department of Surgery, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana Improving access to universal health care-role of local surgical mission [1] 12:05 – 12:20 hrs Peasah, B.S.O Counseling Center, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana

Subjective wellbeing and psychosocial support among cancer patients in a Ghanaian setting [2]

12:20 – 12:35 hrs Asare, A Department of Optometry and Visual Science, Kwame Nkrumah University of Science Technology, Kumasi, Ghana Prevalence and pattern of amblyopia among patients attending the Westphalian Medical Centre, Ghana: a retrospective study [3] 12:35 – 12:50 hrs Gyamfi, P. A. Department of Clinical Microbiology, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana

Impact of 15 Years of Mass Drug Administration on Lymphatic Filariasis Control Efforts in the Kassena Nankana East Municipal [4] 13:00 – 14:00 hrs PARALLEL SESSION A2 – PUBLIC HEALTH Conference room 1 Chairs: Peter Donkor and Linda Batsa Debrah 13:00 – 13:15 hrs Ofosu, D. N Department of Clinical Microbiology, School of Medical Sciences, KNUST, Kumasi, Ghana Haematological profile of HIV patients in relation to immune status in Kumasi, a case study in Ashanti Region [5] 13:15 – 13:30 hrs Acquah-Gyan, E School of Public Health- Kwame Nkrumah University of Science and Technology, Kumasi, Ghana. Usefulness and challenges of an mhealth intervention in rural communities in the Asante Akim North of Ghana: A qualitative study [6] 13:30 – 13:45 hrs Kpiinfoor, T Department of Community Medicine and Health, Anglican University College of Technology, Nkoranza.

Factors influencing contraceptive use among adolescents in the Techiman municipality, Ghana [7]

13:45 – 14:00 hrs Osei, F. A School of Medical Sciences, KNUST, Kumasi, Ghana. Mobile app to support efficient hospital communication and patient care in tertiary hospitals in Ghana - Proof of concept study in Komfo AnokyeTeaching Hospital [8]

11:50 – 12:50 hrs PARALLEL SESSION B1 – BIOINFORMATICS & GENOMICS Conference Room 2 Chairs: Pandam Salifu and Patrick W. Narkwa 11:50 – 12:05 hrs Adabor, E School of Technology, GIMPA, Accra, Ghana;

Restricted-derestricted dynamic Bayesian Network inference of transcriptional regulatory relationships among genes in cancer [9] 12:05 – 12:20 hrs Anninagyei, E Department of Biomedical Sciences, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana

Transfusing malaria-infected donor blood stored beyond 7 days may be equivalent to infusing undesirable quantities of IL-6, IL-12 and TNF-α to recipients [10]

12:20 – 12:35 hrs Acquaah-Mensah, G Massachusetts College of Pharmacy and Health Sciences, USA Missense Mutations of the E3 Ubiquitin Ligase HUWE1 and Prognosis in Younger Breast Cancer Patients [11] 12:35 – 12:50p hrs Barnes, P Department of Physician Assistant, School of Allied Health Sciences, University of Cape Coast

Expression of Ras and Rab Interactor 1 (RIN1), EGFR and NOTCH1 in Head and Neck Tumours at selected hospitals in Ghana [12] 13:00 – 14:00 hrs PARALLEL SESSION B2 BIOINFORMATICS & GENOMICS Conference room 2 Chairs: Theophius Benjamin Kwofie and Emmanuel Ntim 13:00 – 13:15 hrs Darko-Boateng, A Dept. of Physiology and Cellular Biophysics, Columbia University, New York, USA.

Molecular Determinants of Low voltage-activated Calcium Channel Ubiquitination [13]

13:15 – 13:30 hrs Addo-Fordjour, F Kumasi Centre for Collaborative Research in Tropical Medicine (KCCR).Department of Clinical Microbiology, School of Medicine and Dentistry/ Kwame Nkrumah University of Science and Technology Assessing the Involvement of Nuclear Kappa Light Chain Enhancer of Activated B cell Inhibitor-Alpha in Filarial Lymphedema Development [14] 13:30 – 13:45 hrs Acheampong, G Kumasi Centre for Collaborative Research in Tropical Medicine, Kumasi, Ghana

Chromosomal and Plasmid-Mediated Fluoroquinolone Resistance in Human Salmonella enterica Infection in Ghana [15]

14:45 – 14:00 hrs Donu, D Malaria Group Consortium- University of Ghana

Probing into the composition of Plasmodium parasites contained in asymptomatic malaria infections in the Eastern Region of Ghana [16]

14:00 – 14:50 hrs Lunch 14:50 – 15:50 hrs PARALLEL SESSION C1– CLINICAL RESEARCH Conference Room 1 Chairs: Patrick Feglo and Linda Ahenkorah Fondjo 14:50 – 15:05 hrs Ofosu, D. N Department of Clinical Microbiology, School of Medical Sciences, KNUST, Kumasi, Ghana. Evaluating the efficacy of Giemsa stain used for malaria parasite detection; a case study of selected diagnostic laboratory facilities in Ashanti region of Ghana [17]

15:05 – 15:20 hrs Bedu, K Department of Theoretical and Applied Biology- KNUST, Kumasi HIV and Toxoplasma gondii Co-Infection among Pregnant Women and Children in the Ashanti Region, Ghana [18]

15:20 – 15:35 hrs Anninagyei, E Department of Biomedical Sciences, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana

Detecting asymptomatic P. falciparum in blood donors: evaluation of microscopy, rapid test, 18s-rRNA LAMP and selective whole genome amplicon sequencing assays [19] 15:35 – 15:50 hrs Annani-Akollor, M. E Department of Molecular Medicine, School of Medicine and Dentistry, KNUST, Kumasi, Ghana Population-specific cut-off for HbA1c improves identification of metabolic syndrome among non-diabetic population in Ghana [20]

14:50 – 15:50 hrs PARALLEL SESSION C2– DISABILITY AND FOOD SCIENCE Conference room 2 Chairs: Pius Agbenoku and Kwadwo Asamoah - Kusi 14:50 – 15:05 hrs Gyaase, D Department Community Health, KNUST, Kumasi Perceived causes of Epilepsy among Community Members in the Berekum Municipality [21] 15:05 – 15:20 hrs Vampere, H Center for disability and rehabilitation studies, CEDRES-KNUST

Understanding the causes of Autism: Perceptions among parents of children with autism in the Tamale Metropolis [22]

15:20 – 15:35 hrs Kwarteng, J. O Department of Applied Biology, Faculty of Applied Sciences, University for Development Studies, Navrongo campus, Ghana.

Characterization of Bacteriocin of Lactic Acid Bacteria Originating from Traditional African Fermented Milk Product, Nunu [23]

15:50 – 15:05 hrs Sarfo, J Department of Biochemistry, School of Biological Sciences, University of Cape Coast, Ghana Mitigating the adverse effects of nutrition transition associated with urbanization. New perspectives of rural Ghana nutrition [24]

DAY 2 WEDNESDAY 31ST JULY 2019 07:30 – 08:50 hrs Registration 08:50 – 09:00 hrs Announcements KEYNOTE ADDRESS Akwasi Anyanful, Chair 09:00 – 10:00 hrs Afriyie-Gyawu, E Department of Biostatistics, Epidemiology and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, USA Addressing Environmental/Occupational Health Challenges to Improve Quality of Healthcare in Ghana and other African Countries 10:00 – 10.:50 hrs Break 11:00 – 12:00 hrs PARALLEL SESSION D1 – CLINICAL RESEARCH Conference Room 1 Chairs: Tsiri Agbenyega and Linda Amoah 11:00 – 11:15 hrs Manu, E. A Department of Physiology and Pathology, SMD, KNUST, Kumasi, Ghana.

Expression of MUC1 is a poor prognostic marker in breast cancer in Kumasi, Ghana [25]

11:15 – 11:30 hrs Ameh-Mensah, C Department of Physiology and Pathology, SMD, KNUST, Kumasi, Ghana.

The expression of Bcl2 among breast cancer patients in a tertiary hospital in sub-Saharan Africa [26] 11:30 – 11:45 hrs Addai- Mensah, O Dept of Medical Diagnostics, Faculty of Allied Health Sciences, KNUST Fetal Rhesus D Genotyping from Rhesus D Negative Antenatal Population at Komfo Anokye Teaching Hospital, Ghana [27] 11:45 – 12:00 hrs Ankoh, S.E Department of Restorative dentistry, Komfo Anokye Teaching Hospital, Kumasi Ghana Autotransplantation of a Maxillary Incisor Tooth to Improve Aesthetics and Occlusal Setting at a Minimal Cost. [28]

12:10 – 13:10 hrs PARALLEL SESSION D2 – PUBLIC HEALTH Conference Room 1 Chairs: Alex Yaw Debrah and Ama Amuasi 12:10 – 12:25 hrs Kyei-Frimpong, F Department of Pharmacy Practice, Kwame Nkrumah University of Science and Technology

Adherence to Guidelines for Severe Malaria Therapy in Children and Patient Outcomes at New Edubiase Government Hospital. [29]

12:25 – 12:40 hrs Mohamed, A Kwame Nkrumah University of Science and Technology, School of Public Health, Kumasi, Ghana

Mobile Phone Short Message Service (SMS) as a Malaria Control Tool: a Quasi-Experimental Study [30]

12:40 – 12:55 hrs Dassah, S Department of Biomedical Sciences, Navrongo Health Research Centre, Navrongo, Ghana.

Antibody responses against GMZ2 Vaccine Antigens in Relation to the Risk of Malaria in Burkinabe and Ghanaian Children [31].

12:55 – 13:10 hrs Opoku, F. Department of Physiology and Pathology, SMD, KNUST, Kumasi, Ghana Tumour Suppressor gene P53 and its regulator MDM2 among breast cancer patients in a tertiary hospital in Ghana [32].

11:00 – 12:00 hrs PARALLEL SESSION E1 – PLANT MEDICINE & CHEMISTRY Conference Room 2 Chairs: Marcel Tunkumgnen Bayor and Marian El Boakye Gyakye 11:00 – 11:30 hrs Kombian, S Department of Pharmacology & Therapeutics. Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Kuwait University, Kuwait.

Screening of oxazolidinone derivatives for anticonvulsant activity [33]

11:30 – 11:45 hrs Okine, M Department of Chemistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana Antimicrobial, Antioxidant and Anthelmintic Activities of Alchornea cordifolia [34] 11:45 – 12:00 hrs Domfeh, S West African Centre for Cell Biology of Infectious Pathogens, University of Ghana, Legon, Ghana

Cryptolepine activates type 1 interferon response pathway through STAT1 suggesting a potential substitute for interferon-based therapy [35]

12:10 – 13:10 hrs PARALLEL SESSION E2 – PLANT MEDICINE & CHEMISTRY Conference Room 2 Chairs: David Darku Obiri and James Oppong - Kyekyeku 12:10 – 12:40 hrs Annang, F Fundación MEDINA, Avda. del Conocimiento 34, 18016, Armilla, Granada, Spain

Bioassay-Guided Isolation of Four New Antiprotozoal Compounds from Two Ghanaian Mushrooms [36].

12:40 – 12:55 hrs Wireko, B. M Department of Physiology, KNUST, Kumasi.

Potential Aphrodisiac Effect of Khaya Senegalensis on Male Wistar Rats. [37] 12:55 – 13:10 hrs Edusei, E. B. A Department of Pharmaceutical Chemistry, Faculty of Pharmacy and Pharmaceutical Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana Resistance Modulation effects And Time-Kill Kinetics Assay of Plumbagin from Plumbago Zeylanica Linn [38] 13:10 – 14:10 hrs Lunch 14:10 – 15:10 hrs SESSION F - CLINICAL RESEARCH Conference Room 1 Chair: Francis Agyeman Yeboah and Adwoa Bemah Bonsu 14:15 – 14:30 hrs Asamoah-Sakyi, S Department of Molecular Medicine. School of Medical Sciences, Kwame Nkrumah University of Science and Technology

Profiling immuno-metabolic and biochemical risk factors in metformin treated type 2 diabetes patients in Ghana [39] 14:30 – 14:45 hrs Kusi, S Department of Immunology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Ghana

Antigenic interaction between P. falciparum sexual stage antigens Pfs230.pro and Pfs48/45.6C in combined immunization alters the antibody kinetics in favour of anti-Pfs230.pro antibodies [40] 14:45 – 15.00 hrs Amissah, G Department of Medical Laboratory Technology, KNUST, Kumasi Urinary Iodine Concentration and Thyroid Volume of pregnant women attending Antenatal Care in two selected hospitals in Ashanti Region, Ghana: A Comparative Cross-Sectional Study [41].

16:00 – 17:30 hrs POSTER SESSION

17:30 – 18:00 hrs CHS Closing Ceremony 18:00 pm Cocktail and Networking

DAY 3 THURSDAY 1ST AUGUST 2019 07:30 – 08:50 hrs Registration 08.50 – 09.00 hrs Announcements KEYNOTE ADDRESS Chair: George Acquaah-Mensah 09:00 – 10:00 hrs Winfried Amoaku Department of Ophthalmology, School of Medicine and Dentistry, University of Nottingham, UK. The Window of an Eye in Diabetes 10:00 – 11:00 hrs Break 11:00 – 12:30 hrs PARALLEL SESSION G-CLINICAL RESEARCH AN DISABILITY Chair: Isaac Owusu and Yeetey Enuameh 11:00 – 11:15 hrs Conference room 1 Braimah, I School of Medicine and Dentistry, University of Ghana, Eye Centre, Korle- Bu Teaching Hospital. Korle- Bu Baseline prospective study of the incidence and risk factors for retinopathy of prematurity in Korle-Bu Teaching Hospital [42] 11:15 – 11:30 hrs Kyei-Baafour, E Immunology Deparment, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana Naturally acquired IgG to Plasmodium falciparum MSP3 is associated with protection against febrile malaria in a cohort of Ghanaian children living in a low transmission area [43] 11:30 – 11:45 hrs Agyemang, A. O Dept. of Pharmacognosy, KNUST, Kumasi; Quality Assessment and Clinical Evaluation of the Safety and Effectiveness of a Ghanaian Hepatorestorative Polyherbal Product (Hpk) at the Wa Regional Hospital [44] 12:00 – 12:15 hrs Asamoah-Sakyi, S Department of Molecular Medicine. School of Medical Sciences, Kwame Nkrumah University of Science and Technology Assessment of biochemical and neurological risk factors among metformin-treated type 2 diabetes in Ghana [45] 12:15-12:30 hrs Dangyi, P Centre for Disability and Rehabilitation Studies Kwame Nkrumah University of Science and Technology, Kumasi

Perception of Health Workers on the reproductive health of women with disabilities in Jirapa, Ghana [46]

11:00 – 12:30 hrs PARALLEL SESSION H - PUBLIC HEALTH Conference room 2

Chairs: Samuel Newton and Emmanuel Appiah Brempong

11:00 – 11:15 hrs Abnory, M School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana Implementation challenges of Quality Assurance (QA) initiatives: a qualitative assessment in Public University Hospitals in Ghana [47] 11:15 – 11:30 hrs Adu, P Department of Medical Laboratory Sciences, School of Allied Health Sciences, University of Cape Coast, Ghana

Depleted iron stores in voluntary blood donors: a three-centre cross- sectional study in Ghana [48]

11:30 – 11:45 hrs Darko, E Dept. of Clinical Microbiology, School of Medical Sciences and Dentistry, KNUST, Ghana

Methicillin Resistant Staphylococcus aureus carriage among Healthcare workers at the Komfo Anokye Teaching Hospital in Ghana [49] 12:00 – 12:15 hrs Nkrumah, M Department of Clinical Microbiology, KNUST, Kumasi Evaluation of the Dynamiker® Cryptococcal Antigen Lateral Flow Assay (CrAg LFA) in the diagnosis of Cryptococcosis in HIV patients in Ghana [50]

12:15 – 12:30 hrs Dzomeku, V. M Department of Nursing, Faculty of Allied Health Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana,

“When I [hit]…I tell the mother, I am sorry…I wouldn’t have hit you if not for your baby's life:” Exploring Midwives’ views on Disrespect and Abusive Care. [51] 12:30 – 13:15 hrs Lunch 13:30 – 15:00 hrs Business Meeting 14:30 – 14.50 hrs Closing Ceremony and Farewell 15:00 hrs Board Meeting

KEYNOTE [I] Universal Access to Health Care – The Role of the Health Scientist Anarfi Asamoa Baah Board Chair, University of Ghana Medical Centre, Legon, Accra. Email. [email protected] Universal Health Coverage is defined by the World Health Organisation as where all people, regardless of who and where they live, are able to access high quality essential health services without suffering financial hardship. The philosophy underpinning UHC is not completely new. It builds on the primary health care concept and the Health for All movement of the 1970s. But it also emphasizes a number of new concepts and lessons from decades of implementing Health for all and in recent times, the Milliniuem Development Goals. Some of these concepts and implementation lessons challenge current and existing health orthodoxy and conventional wisdom. Key among them is the concept of universality (leaving no one behind); the need to give more practical meaning to the broader definition of health; the need to move from a disease centred to a people centred health system and the need to ensure paying for health care does not push people into poverty. Implementing UHC therefore cannot be just about doing more of the same. It calls for a new paradigm shift, a change in mindset, a new culture and a new way of business model. The achievement of UHC is dependent on national governments taking ownership and establishing policies, plans, systems and appropriate programmes. Ghana has committed itself to achieving universal health coverage by 2030 and has redefined universal health coverage in the Ghanaian context, where all people in Ghana have timely access to high quality interventions and services, irrespective of the ability to pay at the point of use. Of the major health threats that Ghana faces, none challenges the very foundations of the health system as profoundly as the rise of chronic non communicable diseases. The traditional approach to health that relies on the biomedical model, focussed on the cure of individual diseases is inadequate. The essential emphasis on prevention requires a greater reliance on the social and life sciences. Science is crucial to the achievement of universal health coverage. Health Scientists/Academia are already contributing to Ghana's health objectives through training, research and consultancy support. Health Scientists/ Academia in Ghana have a special leadership role to play in bringing about the new paradigm shift required for successful implementation of universal health coverage in Ghana. In the area of training of future leaders, more cross disciplinary and experiential learning is called for. Academia need to get more involved in the policy making process, in helping to design, shape, influence and advocate for evidence based UHC inspired policies. The pursuit of research should help solve problems and not just for publishing or academic promotion.

Academia can incubate new businesses such as hosting start up high tech companies. Academic institutions are powerful convening platforms for fostering multi-stakeholder engagements. These enhanced and/or new roles will require strong, meaningful, institutionalized partnership and dialogue between academia and governments, local communities and industry and more sustainable funding for health scientists/academia.

KEYNOTE [II] Addressing Environmental/Occupational Health Challenges to Improve Quality of Healthcare in Ghana and other African Countries Evans Afriyie-Gyawu Department of Biostatistics, Epidemiology and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, USA Email. [email protected] Life expectancy for Ghanaians has been increasing since 1960 (~46 years) compared to 2017 (~63 years) (World Bank, 2017). This suggests perhaps Ghana has been working hard to improve quality of healthcare delivery and reduce health risks. However, environmental hazards present persistent challenges to clinicians and public health professionals. WHO estimates that 12.6 million (~23%) of all global deaths are attributable to the environment – air, water, and soil pollution; chemical exposures; etc. (WHO, 2016). Additionally, about 90–95% of all cancer cases are linked to the environment and lifestyle; e.g., diet (30-35%), tobacco (25-30%) and infections (15-20%) (Anand et al., 2008). The objective of this presentation is to emphasize the role of health scientists in addressing environmental/occupational health challenges, reducing preventable illnesses/injuries/deaths, and improving quality of healthcare in Ghana and beyond. One challenge is the utilization of scrap automobile tires for meat singeing at slaughter houses/slabs (SLH/SLS). Our recent study on “scrap tire burning-meat singeing” practice has recently been completed. Levels of CO, benzene, SO2, and particulate matter emitted from liquefied petroleum gas (LPG- control), firewood, and tire-derived smoke during meat singeing were quantified in real-time. Also, workers’ urine samples were analyzed (using HPLC-MS) for 1-hydroxypyrene (1-OHP), biomarker of short-term exposure to polycyclic aromatic hydrocarbons (PAHs). Results indicated the “tire burning-meat singeing” practice generates pollutant levels significantly higher (p<0.001) vs. LPG. Urinary 1-OHP measurements showed the SLH/SLS workers using tires were exposed to higher levels of PAHs vs. LPG, but not significant (p= 0.246). Results suggest that SLH/SLS operators and nearby residents may be at high risk for adverse health outcomes linked to emitted pollutants. Thus, all stakeholders must come together to sustainably address this issue by promoting comprehensive research, creating awareness among academicians and clinicians, intensify educational interventions, and ultimately improving quality of healthcare in Ghana and other African countries.

KEYNOTE [III] The Window of an Eye in Diabetes Winfried Amoaku Department of Ophthalmology, School of Medicine and Dentistry, University of Nottingham, UK. Email. [email protected], [email protected] Diabetes mellitus is a disease of glucose metabolism by the body. Previous estimates diabetes occurred in 5% of the Ghanaian population. Recent evidence suggests that diabetes is more common in Sub-Saharan Africa (including Ghana) than previously reported. This increased prevalence of diabetes may be associated with changing lifestyles e.g. diet, and reduced physical exertion/exercise. Diabetes is the commonest cause of preventable visual loss in the working age population, and was previously thought to be problematic in the developed, western world. Emerging evidence suggests that this is not the case, and that visual loss due to diabetes is common and severe in Sub-Saharan Africa, including Ghana. Diabetes effects all tissues of the eye, although the most common devastating complication is diabetic retinopathy. Uncontrolled diabetes results in reduced turnover of vascular endothelial cells in the retinal vasculatures (as in other tissues). This leads to retinal vascular closure, vascular leakage or both, with consequences, including the paradoxical abnormal blood vessel growth. Associated risks of cardiovascular disease influence progression of diabetic eye disease. An overview of diabetic eye disease and visual loss, and how common it is will be discussed. A summary of how diabetic eye disease develops (mechanisms/pathways), and manifests will be provided, as well how it relates to state of the individual’s general health and wellbeing and society. Protection against the devastating consequences of diabetic eye disease, and management of diabetic eye disease (especially retinopathy) and diabetic retinopathy screening will be discussed.

ORAL PRESENTATIONS

[#1] Improving Access to Universal Health Care-Role of Local Surgical Mission A. Gyedu1, K. Agbedinu2 , C. E. Gaskill3, G. Boakye4, F. Abantanga5

1Department of Surgery, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana. 2Department of Surgery, Komfo Anokye Teaching Hospital, Kumasi, Ghana. 3Department of Surgery, University of Washington, Seattle, WA, USA. 4School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana 5School of Medicine and Health Sciences, University for Developmental Studies, Tamale, Ghana.

Email: [email protected] Many low- and middle-income countries (LMICs) have a high prevalence of unmet surgical need as a result of barriers to surgical care that many LMIC communities face. Until the resources required to adequately meet this need are realized, one method to ensure that affected communities receive the surgical care they need is the provision of operations through outreach missions. A large majority of these missions are spearheaded by foreign organizations with international travel and logistics adding to the cost of such efforts thereby decreasing their overall cost-effectiveness. Alternatively, local outreach groups may be able to address the problem in an equally effective manner. We sought to assess the cost-effectiveness of surgical outreach missions provided by a wholly local organization in Ghana to highlight the role local groups might play in reducing the unmet surgical need of their communities. Outreach missions to northern Ghana by ApriDec Medical Outreach Group (AMOG), from December 2011 to April 2016, were analyzed for total number of surgeries, disability-adjusted life years (DALY) averted, and total cost of the missions. Assessment of cost-effectiveness of the missions was then made. We analyzed 2008 patients who had been operated upon by AMOG. Operations performed included hernia repairs (824 patients, 41%) and excision biopsy of soft tissue masses (364 patients, 18%). More specialized operations included thyroidectomy (103 patients, 5.1%), urological procedures (71 patients, 3.5%), and plastic surgery (26 patients, 1.3%). Total cost of the outreach trips was $283,762, and 2079 DALYs were averted; cost per DALY averted was $136.49. The mission trips were ‘‘very cost-effective’’ per WHO parameters. Our findings suggest that providing surgical services through wholly local surgical mission trips to underserved LMIC communities might represent a cost-effective and viable option for countries seeking to reduce the growing unmet surgical needs of their populations.

[#2] Subjective Wellbeing and Psychosocial Support Among Cancer Patients in a Ghanaian Setting. F. E. Owusu-Ansah1,2 B. S. O. Peasah1, A. A. Addae 1, B.Wiafe-Addae3 1Counseling Center, Kwame Nkrumah University of Science and Technology, Kumasi, 2Department of Behavioral Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, 3Breast Care International (BCI) & Peace and Love Hospitals, Kumasi, Ghana.

Email: [email protected]; [email protected] Cancer patients experience emotional distress including depression and anxiety which are moderated or alleviated by familial and psychosocial support interventions. Patients who receive counselling and adequate socioemotional support report less distress, improved mood and better pain management. The objectives of this study were twofold: First, the study examined the levels of psychological distress and subjective wellbeing among the patients. Two, it investigated the sources and availability of familial, psycho-social and emotional support for patients with a prediction of greater subjective wellbeing and less psychological distress among those who received more support. A total of hundred (100) patients, within the ages of 25 to 80 (SD = 10.7) participated in the study. A mixed method approach (quantitative measures plus interviews) was used to collect data. Correlational analyses were performed on the quantitative data while thematic content analysis was used for the qualitative data. As predicted, there was a significant negative correlation between psychological distress and subjective wellbeing (r = -.50, p<.001). Other results showed that a significant number of patients perceived lack of support from their social networks. In addition, there was a general report of severe financial constraints for which many patients received no support from expected sources such as immediate family and faith communities. However, majority of the patients reported positive benefits from the counselling they had received. Our findings corroborate previous works that breast cancer patients in Ghana are not receiving satisfactory emotional support; a situation with potential negative impact on patients’ emotional health and physical recovery. Adequate context-specific psychosocial interventions need to be implemented to address these issues and thus facilitate greater patient wellbeing and speedy recovery.

[#3] Prevalence and pattern of amblyopia among patients attending the Westphalian Medical Centre, Ghana: a retrospective study A. K. Asare, K. O. Akuffo, D. B. Kumah, E. Agyei-Manu, E. Addo, C. K. Darko Department of Optometry and Visual Science, Kwame Nkrumah University of Science Technology, Kumasi. Email: [email protected] Childhood blindness affects 1.4 million children globally. Amblyopia is the leading cause of monocular visual impairment in children, affecting about 1% to 5% of the general population. The presence of amblyopia, predominantly in children, is mainly due to refractive errors and strabismus (misalignment of the eyes). The management of amblyopia is expected to be take place within an age window (from birth till age 9) after which treatment may no longer be effective. It is of global public health concern because of the reduced quality of life and relatively long number of blind person-years that it presents. This study aimed to determine the pattern of amblyopia in patients attending the Westphalian Medical Centre, Oyoko, Ghana. In this retrospective study, clinical folders were reviewed for patients who visited the clinic between January 2014 and December 2018. Of the 12,860 records reviewed, 258(2.04%) amblyopic cases were identified. In persons with amblyopia, 185(71.7%) and 73(28.3%) had unilateral and bilateral amblyopia, respectively. The overall mean age of amblyopic patients was 24.27±16.11 years, with majority being females (52.3%). There was no statistically significant difference (p>0.05) in the prevalence of amblyopia by age or sex. The highest (2.57%) and lowest (1.96%) point prevalence were recorded in 2014 and 2018 respectively. Refractive amblyopia (1.42%) was the most prevalent form of amblyopia. Spectacle correction (54.3%) was the most common treatment regimen for amblyopia. Amblyopia affects 1 in 50 patients visiting the Westphalian Medical Centre. Proper management of refractive errors may reduce the prevalence of amblyopia and its contribution to childhood blindness in the Ghanaian population.

[#4] Impact of 15 Years of Mass Drug Administration on Lymphatic Filariasis Control Efforts in the Kassena Nankana East Municipal P. A. Gyamfi1, 3, A.Y. Debrah1, 2, J. Osei-Mensah3, V. S. Opoku1, 3, D. Adu-Mensah1, 3, Y. Mubarik3, A. Horeauf 4, L. B. Debrah1, 3

1Department of Clinical Microbiology, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi , Ghana, 2Faculty of Allied Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi , Ghana, 3Kumasi Centre for Collaborative Research in Tropical Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana. 4Institute of Medical Biometry, Informatics and Epidemiology, University of Bonn, Germany

Email: [email protected]

Lymphatic filariasis (LF) is a cause of chronic morbidity, which manifests usually as lymphedema and hydrocele. It is estimated that between five to six rounds of mass drug administration (MDA) in endemic districts should lower circulating filarial antigen (CFA) and/ or microfilariae (Mf) prevalence to less than 2% and 1%, respectively. MDA with 150µg/kg of Ivermectin (IVM) and 400mg Albendazole (ALB), which began in the Kassena Nankana East Municipal (KNEM) in the year 2000, was stopped about 3 years ago. This cross-sectional study evaluates the impact of 15 years of MDA on control of LF as determined by CFA and Mf prevalence in KNEM. Participants were screened for CFA using the Alere Filariasis Test Strip®, and assessment of microfilariae was done using night blood samples. A total of 4,604 participants aged between five and 91 years from three sub-districts in KNEM were recruited for the study out of which 65.1% were females. The overall CFA prevalence was 19.64% and the prevalence increased with age. Manyoro, a sub- district on the border with Burkina Faso recorded the highest CFA prevalence of 26.01%. MDA compliance among participants was low. Only 31.36% of study participants had taken at least five rounds of MDA. Assessment of microfilariae was done from 694 antigen-positive individuals. Overall mf prevalence was 3.03% (0%- 8.18%) with a geometric mean of 4.44 mf/ml (1mf/ml- 120mf/ml). There was no significant correlation between mf prevalence and the number of MDA rounds participants had taken. CFA and microfilariae prevalence in the study exceeded WHO thresholds required for elimination. The results from this study therefore indicate ongoing low- level transmission of LF in the study communities. This could be due to poor compliance of MDA. With less than 2 years to reach the global elimination target, there is the need to step up MDA that has been stopped, in addition to implementing alternative treatment strategies to eliminate the disease.

[#5] Haematological profile of HIV patients in relation to immune status in Kumasi, a case study in Ashanti Region D. N. Ofosu1, Y. Marfo-Debrekyei2, J. Duah2, L. Donkor2

1Department of Basic and Applied Biology, University of Energy and Natural Resource, 2Department of Medical Laboratory, Garden City University College, Email: [email protected] Human immunodeficiency virus (HIV) infection represents the most common cause of acquired immune deficiency and leads to Acquired Immune Deficiency Syndrome (AIDS). CD4 is a type of protein found on certain immune cells like T cells, macrophages and monocytes in contrast, CD4 cells are T helper cells that do not neutralize infection but rather triggers the body’s response to infections. HIV infects CD4 cells and in the absence of suitable therapy leads to insightful CD4 cell lymphopenia. The progressive decline in CD4 cells eventually leads to the development of haematological abnormalities which is the most common as well as opportunistic infections, wasting, cancer and death. The study compared the haematological profiles to the CD4 count among HIV patients attending ART at Komfo Anokye Teaching Hospital and Obuasi Government Hospital. A cross sectional analytical study involving 385 selected patients with HIV in Ashanti Region was done. CD4 count and Full blood count were performed to determine the immune status of the patients and haematological parameters. Out of 385 HIV patients enrolled in the study, the mean age, weight, and duration of therapy was 40.62 years old, 58.33 kg, and 6.17 years respectively. A higher proportion of the study participants were females (73.7%), married (42.7%), had HIV-1 (97.7%), and informal education (83.0%). CD4 count was directly associated with haemoglobin levels (r=0.32), WBC count (r= 0.23) especially with neutrophils. However,CD4 count was negatively associated with lymphocyte count (r= -0.14). : This study revealed that there is a strong association between CD4 counts and the severity of anemia and neutropenia in HIV/AIDS patients. Anemia and neutropenia in HIV patients can be considered as good clinical indicators to predict and access the underlying immune status.

[#6] Usefulness and Challenges of an mhealth Intervention in Rural Communities in the Asante Akim North of Ghana: A Qualitative Study. E. Acquah-Gyan, E. Owusu-Dabo, P. R. Acheampong, M. Aliyu, T. Adjei School of Public Health- Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.

Email: [email protected]

The rapid growth of the use of mobile devices has influenced the creation of mobile Health (mhealth) interventions to contribute to healthcare development and child survival in underserved communities. Mhealth interventions can help to timely and accurately determine the state of health within vulnerable populations, widen healthcare coverage, and also improve on quality of healthcare for deprived communities. It can again contribute to surveillance of childhood diseases for children living in rural communities to inform decisions and also build the capacities of caregivers on child survival tips. Despite the numerous prospects of mhealth interventions in promoting health, scaling-up and sustenance have been challenging as many are not able to progress past the pilot stage of implementation and often cover a small targeted scope. This study seeks to assess the usefulness and challenges of an mhealth intervention (Mobchild project) in rural communities in the Asante Akim North of Ghana. The ‘Mobchild’ mhealth intervention is a multi-dimensional intervention project that utilizes the packages of voice reminders to caregivers on vaccination schedules and follow-ups after health-care seeking, a theory-based weekly health education voice messages to participating caregivers, and a toll-free call system to caregivers to call and report illness of their child for early guidance. The District Health Authorities (DHAs) are also given access to accumulated data from the mhealth system and expected to use the data. This study will therefore adopt a qualitative approach and conduct focused group discussions and in- depth interviews among caregivers and the DHAs in Asante Akim North to determine the benefits and barriers associated with the use of the system and the data generated from the system. The findings from this study will help to device effective evidenced-based strategies to help develop, deploy, scale-up and sustain future mhealth interventions in Ghana and beyond.

[#7] Factors Influencing Contraceptive Use among Adolescents in Techiman Municipality, Ghana T.N. Kpiinfaar1, E.T. Dassah2

1Department of Community Medicine and Health, Anglican University College of Technology, Nkoranza. 2School of Public Health, Kwame Nkrumah University of Science Technology, Kumasi.

Email: [email protected]

Adolescent fertility regulation and pregnancy prevention are critical health-care issues due to low contraceptive uptake and increasing adolescent birth rates. This study aimed to determine factors influencing contraceptive use among sexually active adolescents in Techiman Municipality, Bono East Region. An analytical cross-sectional study conducted among 16-19-year-old sexually active adolescents from July-September, 2017. Participants were selected through multi-stage sampling and data collected using a structured questionnaire. Data were analyzed using chi-squared test and logistic regression to generate crude and adjusted odds ratios (AORs) with 95% confidence intervals (CIs). P<0.05 was considered statistically significant. Altogether, 298 sexually active adolescents were studied. The mean age was 17.5 years (standard deviation 1.1 years). About 68% lived in urban areas and 53% were out-of-school adolescents. Overall, 43.6% of adolescents had ever had sex with adolescent boys having an earlier sexual debut (15.3 years vs. 15.7 years; p=0.25). Out-of-school adolescents were more likely to be sexually active compared to in-school adolescents (53.8% vs. 32.1%; p<0.001). Contraceptive knowledge and ever use were 75.0% and 65% respectively. The most commonly used contraceptives were condoms (54%) and emergency contraception (31%). Significant factors influencing ever use of contraceptives were; adolescent educational level (AOR 4.38; 95% CI 0.64-0.84; p=0.02), father’s educational level (AOR 6.32; 95% CI 0.06-0.39; p<0.001) and discussing contraceptive use before sex (AOR 4.78; 95% CI 0.08- 0.75; p=0.01). The main reasons for not wanting to use contraceptives were fear of side effects and perceived inability to conceive in the future. Although contraceptive knowledge and use were higher than the national average, almost a third of adolescents relied on emergency contraception. Educational campaigns to improve contraceptive uptake should discourage the use of emergency contraception as regular contraceptive methods.

[#8] Mobile app to support efficient hospital communication and patient care in tertiary hospitals in Ghana - Proof of concept study in Komfo Anokye Teaching Hospital

D. Ansong1, E. K. Akowuah2, K. Lartey2, J. Bonney3, F. A. Osei4, E. X. Amuzu4, A. Amuzu5, M. Dongyele6, D. Adjei4, B. A. Dankwa4, A. K. Owusu4, N. K. Mensah4 1School of Medicine and Dentistry, KNUST, Kumasi, 2Department of Computer Engineering, Kwame Nkrumah University of Science and Technology, Kumasi, 3Emergency Medicine Department, KATH, Kumasi, 4Research and Development Unit, KATH, Kumasi, 5Nandimobile, Accra, Ghana, 6School of Public Health, KNUST, Kumasi.

Email: [email protected]

The effective running of a hospital depends on several factors, with one key factor being communication among the staff, and with the general public. For a large tertiary institution like Komfo Anokye Teaching Hospital (KATH), important information like standard operating procedures and protocols, personnel on duty and their contact numbers, and service availability are very difficult to access. In this work, we propose a digital hospital service information management and communication framework to meet the complex and dynamic communication and information sharing demands of tertiary hospital institutions. The proposed system incorporates an intelligent scheduling algorithm, a content access controller and a public information dissemination service. The entire system is structured as a 3-layered platform, with a front-end mobile app serving users, a web-based backend for administrative operations, and a database backbone - a remote server which hosts all the data. The design of the system also takes into consideration poor data service by the provision of a data synchronization feature to allow the system to work even in the absence of reliable data connectivity.

[#9] Restricted-Derestricted Dynamic Bayesian Network Inference of Transcriptional Regulatory Relationships among Genes in Cancer E. S. Adabor1, G. Acquaah-Mensah2 1School of Technology, GIMPA, Accra, Ghana; 2Pharmaceutical Sciences Department, Massachusetts College of Pharmacy and Health Sciences University, USA. E-mail: [email protected] Understanding transcriptional regulatory relationships among genes is important for gaining etiological insights into diseases such as cancer. To this end, high-throughput biological data have been generated through advancements in a variety of technologies. These rely on computational approaches to discover underlying structures in such data. Among these computational approaches, Bayesian networks (BNs) stand out because their probabilistic nature enables them to manage randomness in the dynamics of gene regulation and experimental data. Feedback loops inherent in networks of regulatory relationships are more tractable when enhancements to BNs are applied to them. Here, we propose Restricted-Derestricted dynamic BNs with a novel search technique, Restricted-Derestricted Greedy Method, for such tasks. This approach relies on the Restricted- Derestricted Greedy search technique to infer transcriptional regulatory networks in two phases: restricted inference and derestricted inference. An application of this approach to real data sets reveals it performs favourably well compared to other existing well performing dynamic BN approaches in terms of recovering true relationships among genes. In addition, it provides a balance between searching for optimal networks and keeping biologically relevant regulatory interactions among variables.

[#10] Transfusing Malaria-Infected Donor Blood Stored beyond 7 Days may be Equivalent to Infusing Undesirable Quantities of IL-6, IL-12 and TNF-α to RSecipients E. Aninagyei1, P. Adu2, B. Amoani1, A. Egyir-Yawson1, D. O. Acheampong1 1 Department of Biomedical Sciences, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana 2 Department of Medical Laboratory Technology, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana

E-mail: [email protected]

Although malaria infection of donor units has been reported, the impact of parasitaemia on cytokinaemia in stored blood has not been explored. This study evaluated the impact of malaria parasitaemia in donor blood on circulating cytokines and haematological parameters. In this study, two groups of donor blood units were studied; those infected with falciparum malaria parasites (range: 115–877 parasites/µL) and donor units with no malaria infection (control). At day 0 (baseline), 7, 14, 21, 28 and 35, absolute leukocytes and erythrocytes counts and concentrations of circulating tumor necrosis factor alpha (TNF-α), interleukin (IL)-12, IL-10 and IL-6 levels in citrate-phosphate-dextrose-adenine (CPDA-1) anticoagulated donor blood were assessed using automated haematology analyzer and sandwich enzyme-linked immunosorbent assay (ELISA) respectively. At baseline, the mean TNF-α (33.81pg/mL vs 22.70pg/mL), IL-12 (28.39pg/mL vs 16.15pg/mL), IL-10 (51.04pg/mL vs 18.95pg/mL), and IL-6 (71.03pg/mL vs 30.89pg/mL) levels were significantly higher in malaria-infected donor units. Significant rate of increases was observed in TNF-α (192.0%day-7 to 433.3%day-35), IL-12 (94.0%day-7 to 419.47%day-35) and TNF- α/IL-10 ratio (429.11%day 7 to 1883.54%day 35) in infected donor blood. Conceptually, transfusing a single 500 ml unit of malaria-infected blood stored for 21 days could lead to infusing 190 ng, 71.6 ng, or 48.2 ng of IL-6, TNF-α and IL-12 respectively. Significant changes in TNF-α, IL-12, IL-10, and IL-6 and TNF-α/IL-10 ratio in infected donor blood were observed at day 7. Whereas, TNF-α and IL-12 negatively correlated significantly with total absolute leukocytes, neutrophils and lymphocytes counts, it was positively related to monocytes at day 7 to day 35. Moreover, in malaria infected units, at days 7, 14, 21, 28, and 35, TNF-α and IL-12 were significantly inversely related to RBC and RBC indices. Banking of malaria-infected donor units may lead to infusion of large quantities of undesirable inflammatory cytokines with potential adverse immunological response in recipients

[#11] Missense Mutations of the E3 Ubiquitin Ligase HUWE1 and Prognosis in Younger Breast Cancer Patients G. K. Acquaah-Mensah Massachusetts College of Pharmacy and Health Sciences, USA Email: [email protected] Breast cancer is the most common cause of cancer deaths among women. There are, however, disparities in molecular biological and clinical presentations, racial distribution, and incidences of aggressive types of breast cancer. The object of this study was to characterize the disease in patients diagnosed at relatively young ages. Interrogations of somatic mutation and RNASeq version 2 data of breast cancer samples from patients as deposited in the Cancer Genome Atlas were conducted. Prognosis was decidedly poorer for Black/ African-American stage II breast invasive carcinoma patients diagnosed at age 50 years or younger (B/AA50), compared to White patients of similar age (W50). An immortalization gene set, and a gene set overlapping with a BRCA1-PCC network of transcripts, were found to be enriched in that same group. Transcriptional regulatory networks generated via the Algorithm for the Reconstruction of Accurate Cellular Networks identified a number of master regulators differentially active between the two groups. With increased activity were PQBP1, TAF6L, DDIT3, HES4, HES7, EEF1D, DRAP1, E4F1, and ZNF628. With suppressed activity were ARID4A, RB1, GTF2A1, GABPA, SP1, RBPJ, CREB1, DENND4A, DDX3X, and CCNT1. Regarding missense mutations, the gene encoding E3 ubiquitin ligase HUWE1, which binds to the BRCA1 tumor suppressor and promotes its degradation via the ubiquitin proteasome pathway, is significantly more frequently mutated in the B/AA50 compared to the W50 group, and BRCA1 gene expression is lower in stage II black patients. On the other hand, mutations of the PIK3CA the gene which are known to counter the poor-prognosis associated with loss of the tumor suppressor gene PTEN, occur significantly more frequently in the W50 group compared to the B/AA50 group. In those B/AA50 patients with HUWE1 missense mutations, expression of the PTEN gene is distinctly suppressed compared to those W50 patients with PIK3CA missense mutations. Further, among B/AA50 patients with HUWE1 missense mutations, master regulators PQBP1, DRAP1, and TAF6L have higher gene expression, while SP1, ARID4A, and CCNT1 have lower gene expression compared to those W50 patients with PIK3CA missense mutations. In addition, genes encoding upstream mitogen- activated kinases, the oncogene ERAS, Ras-association domain family of tumor suppressor proteins RASSF1 and RASSF8, as well as RASA1, and RASEF are all dysregulated in B/AA50 patients with HUWE1 missense mutations compared to those W50 patients with PIK3CA missense mutations. These findings suggest participatory roles for HUWE1 mutations and the PI3 kinase/Akt pathways in events associated with poorer prognosis in younger black breast cancer patients.

[#12] Expression of Ras and Rab Interactor 1 (Rin1), Egfr and Notch1 in Head and Neck Tumours at Selected Hospitals in Ghana P. Barnes1, F.A Yeboah2, J. Zhu3, R. O. Saahene4, P. Akakpo5 Y. A. Awuku6, C. Obirikorang7, R. K.D Ephraim8

1Department of Physician Assistant, University of Cape Coast, Ghana. 2Department of Molecular Medicine, Kwame Nkrumah University of Science and Technology, Ghana. 3Department of Biology, Jiamusi University China. 4 Jiamusi University, China. 5Department of Pathology, University of Cape Coast 6Department of Physician Assistant Studies, University of Cape Coast, Ghana 7Department of Molecular Medicine, Kwame Nkrumah University of Science and Technology, Ghana. 8Department of Medical Laboratory, University of Cape Coast, Ghana.

Email: [email protected] Head and neck tumours (HNT) are tumours of the paranasal sinuses, the salivary glands and the upper aerodigestive tract. It constitutes the sixth most common tumours. Studies show factors such as tobacco and alcohol intake and viral infections mainly increase the relative risk to the tumour. RIN1 is a Ras effector protein regulating epithelial cell properties and has been implicated in a number of tumours. EGFR can stimulate cell proliferation, cell differentiation, cell growth, migration, and inhibit apoptosis when it is highly expressed. Notch1 pathways are frequently altered in many tumours however, the clinical significance of NOTCH1 dysregulation in head and neck tumours is poorly understood. The aim of this study was to investigate the expression of RIN1, EGFR and NOTCH1 in head and neck tumour and also the various anatomical pattern of the head and neck tumours in some selected hospitals in Ghana. RIN1, EGFR and NOTCH1 expression were analyzed using quantitative real-time PCR (qRT-PCR) and immunohistochemical staining on tissue samples from a consecutive series of 150 head and neck tumour patients and 150 normal head and neck tissues who underwent tumor resections between 2014 and 2018. The relationship between RIN1, EGFR and NOTCH1 expressions, clinicopathological factors, was investigated. The oral cavity was the most frequent anatomical site for the head and neck tumours comprising of 34.0%. It was followed by tumour of the respiratory (25.2%), mandible (24%) and the least anatomical site seen in both salivary gland (0.76%) and the eye (0.76%). qRT-PCR results show that RIN1expression were low as compared with the normal head and neck tissues. High and low Rin 1 was compared with ages between ≤40,>40 in the head and neck malignant tumours with p- value 0.02. There was a significant difference between the histological differentiation of the malignant tumour with p values of 0.001, when poor and well moderate was compared. qRT-PCR results showed that the EGFR expression was high in tumor tissue samples than in the normal head and neck tissues. High and low EGFR was compared with ages ≤40,>40 in the head and neck cancer of p- value 0.03. There was a significant difference between the histological differentiation of the malignant tumour with p values of 0.001, when poor and well moderate was compared. There was a significant difference (p-value 0.012) between the I-II and III-IV tumour stages when the high level and low expression of EGFR were compared. The staining patterns of Notch1 were seen in the nucleus and cytoplasm. The percentage of low expression of Notch1 were 71.4% in the malignant tissue (n=98) and 76.9% (n=52) in the benign tissue. The anatomical site with majority low expression of the NOTCH1 was found in oral cavity (37.1%) followed by respiratory (27.1%) followed by mandible (14.3%). Our data suggest that there is a low expression RIN1 in head and neck tumours but high expression of RIN1 in the normal head and neck tissues but EGFR were highly expressed in the head and neck tumours. High expression of EGFR plays an important role in head and neck tumour progression and that its expression will provide baseline data to facilitate identification of new molecular targeting therapeutics. There was a low expression of NOTCH1 in head and neck tumour tissues. This suggest that NOTCH1is considered as tumor suppressor gene. NOTCH1 can also be considered as a target in the development of therapies for head and neck tumours.

[#13] Molecular Determinants of Low Voltage-Activated Calcium Channel Ubiquitination

A. Darko-Boateng, H. M. Colecraft

Dept. of Physiology and Cellular Biophysics, Columbia University, New York, USA.

E-mail: [email protected]

Voltage-gated calcium channels (VGCCs) are membrane proteins which are expressed in electrically excitable cells where they open and close in response to changes in membrane potential to allow for calcium influx. The sub-family of low voltage-activated (LVA) calcium channels comprises three distinct genes that encode the pore-forming alpha-1 subunit of the channel. LVA calcium channels open at near-resting potentials, and are physiologically relevant in neuronal firing, cardiac pacemaking, hormone secretion, smooth muscles contraction, and fertilisation. To elicit their physiological functions, LVA calcium channels undergo dynamic synthesis, processing, sorting, trafficking, and degradation. The covalent attachment of ubiquitin to proteins is an important regulatory mechanism which has been shown to affect different aspects of protein lifecycle. However, ubiquitination is incompletely understood due to complications such as the involvement of multiple players in the ubiquitination of a particular target; the potential for a particular ubiquitination enzyme to regulate multiple targets; and a plethora of distinct ubiquitination signatures that can differentially modulate target proteins. In the present studies, we seek to provide mechanistic clarity to the complicated nexus of protein ubiquitination by focusing on the family of E3 ubiquitin ligases which mediate substrate recognition and ubiquitin transfer. Using a flow cytometry screen, we identify E3 ligases that differentially modulate LVA calcium channel stability and membrane expression. Using engineered E3 ligases that have specificity for YFP-tagged LVA channels, we provide evidence that functionally inert full-length E3 ligases are able to modulate target substrates provided there is direct physical interaction between ligase and target. Our data from electrophysiology experiments demonstrate that E3 ligases differentially modulate the biophysical properties of LVA channels. Overall, these studies reveal fundamental aspects of LVA calcium channel ubiquitination, and provide the grounds for further studies to identify E3 ligase factors that may be important for substrate ubiquitination.

[#14] Assessing the Involvement of Nuclear Kappa Light Chain Enhancer of Activated B cell Inhibitor-Alpha in Filarial Lymphedema Development F. A. Fordjour1, L. B. Debrah1, 2, J. Osei-Mensah1, Y. Mubarik1, P. A. Gyamfi1,2, A.Y. Debrah3

1Kumasi Centre for Collaborative Research in Tropical Medicine, KNUST 2Department of Clinical Microbiology, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, 3Faculty of Allied Health Sciences, College of Health Sciences, KNUST,

Email: [email protected]

Lymphatic filariasis (LF) is one of the World Health Organization (WHO) neglected tropical diseases (NTDs) with major social and public health problems. It is transmitted by the mosquitoes of the genera Aedes, Anopheles, Culex or Mansonia. Estimates indicate that about 1.1 billion people live in endemic areas and are at risk of infection and more than one third of these are in Sub-Saharan Africa. Since investigations concerning host genetic contributions to acquisition of secondary lymphedema is relatively lacking, a candidate gene approach (Single nucleotide polymorphism genotyping) has been employed to understand the different outcomes of pathologies such as filarial lymphedema (LE). Ongoing studies have found associations of LE with 5 single nucleotide polymorphisms in 4 genes namely: vascular endothelial growth factor receptor 3 (VEGFR-3), matrix metallopeptidase 2 (MMP-2), carcinoembryonic antigen-related cell adhesion molecule 1 (CEACAM-1) and Nuclear factor kappa light chain enhancer of activated B cells (NF- kappaB). This study explores the association between NF-kappaB /inhibitor kappa B (IkappaB) levels and LE development. The study was conducted in 26 communities in the Ahanta West and Nzema East districts in the Western Region of Ghana. A total of 194 study participants were involved in the study, out of which 94 were LE patients, 51 were infected (INF) patients and 50 were endemic normal (EN). Phosphorylated and total IkappaB levels were measured in each group using a commercial ELISA kit. From this study it was observed that IkappaB levels were elevated in LE patients, followed by INF patients and the least recorded in EN. From the results, upregulation of NF-kappaB/IkappaB (phosphorylated and total) in LE progression could be due to accelerated frequency of inflammatory response triggered by filarial antigens. Therefore, NF- kappaB/IkappaB could be a prognostic biomarker in the diagnosis and therapeutics of LE.

[#15] Chromosomal and Plasmid-Mediated Fluoroquinolone Resistance in Human Salmonella enterica Infection in Ghana G. Acheampong1, M. Owusu1,2, A. Owusu-Ofori3,8, I. Osei1, N. Sarpong4, A. Sylverken1,5, H. Kung6, S. Cho6, C. Kuo6, S. Park7,10, F. Marks7, Y. Adu-Sarkodie3, E. Owusu-Dabo9 1Kumasi Centre for Collaborative Research in Tropical Medicine, Kumasi, 2Department of Medical Laboratory Technology, KNUST, Kumasi 3Department of Clinical Microbiology, KNUST, Kumasi, 4Agogo Presbyterian Hospital, Agogo, 5Department of Theoretical and Applied Biology, KNUST, Kumasi 6Institute of Plant and Microbial Biology, Academia Sinica, Taiwan. 7Department of Epidemiology, International Vaccine Institute, South-Korea. 8Komfo Anokye Teaching Hospital, Kumasi, 9Department of Global and International Health, SPH, KNUST, Kumasi 10 Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Programme, 764 Vo Van Kiet, Quant 5, Ho Chi Minh City, Vietnam

E-mail: [email protected]

Salmonella infection poses significant public health threat globally, especially in resource-limited countries. Emergence and spread of antibiotic resistant strains to fluoroquinolones have led to treatment failures and increased mortality in Salmonella infection. However, there is dearth of information regarding mechanisms of resistance to fluoroquinolones in Ghana. This study therefore sought to identify chromosomal mutations and plasmid-mediated resistance as possible mechanisms of fluoroquinolone resistance from clinical isolates in Ghana. This was a retrospective study of archived isolates biobanked at Kumasi Centre for Collaborative Research in Tropical Medicine, Ghana. Isolates were obtained from blood, stool and oropharynx samples at two hospitals, between May, 2016 and January, 2018. Salmonella identification was done using standard microbiological protocols and antibiotic susceptibility testing performed by Kirby-Bauer disc diffusion method. Isolates with intermediate susceptibility and/or resistance to nalidixic acid and/or ciprofloxacin were selected and examined for chromosomal mutations by Sanger sequencing and plasmid-mediated resistance by PCR. Of 133 biobanked isolates cultured, 68 (51.1%) and 16 (12%) were identified as Salmonella Typhi and non-typhoidal Salmonella (NTS), respectively. Sequence analysis of gyrA gene revealed the presence of 5 different nonsynonymous mutations, with the most frequent mutation (Ile203Ser) occurring in 12 out of 13 isolates tested. Gyrase B (gyrB) gene had 1 nonsynonymous mutation in 3 out of 13 isolates, substituting phenylalanine with leucine at codon 601 (Phe601Leu). No mutation was observed in parC and parE genes. Two NTS isolates were found to harbour qnrS plasmid-mediated resistant gene of molecular size 550bp with high ciprofloxacin MIC of 0.5µg/ml. This study reports for the first time in Ghana plasmid-mediated fluoroquinolone resistant gene qnrS in Salmonella clinical isolates. Nonsynonymous mutations of gyrA and gyrB genes likely to confer Salmonella reduced susceptibility to ciprofloxacin were also reported.

[#16] Probing into the Composition of Plasmodium Parasites Contained in Asymptomatic Malaria Infections in the Eastern Region of Ghana

D. Donu

Malaria Group Consortium- University of Ghana

Email: [email protected] Malaria, a parasitic disease caused in humans by five different species of the Plasmodium genus namely P. falciparum, P. malariae, P. ovale, P. vivax and P. knowlesi, remains a devastating public health problem in the tropical and subtropical regions worldwide. In this study we sought to determine whether the contribution of non-falciparum malaria parasites such as P. malariae and P. ovale to the overall asymptomatic population in the Eastern Region of Ghana could be accurately predicted without the use of molecular tools, especially as numerous community surveys are carried out without the use of molecular tools. As such we used microscopy, RDT kits and species-specific PCR to assess the extent and composition of asymptomatic malaria carriage in consenting individuals living in seven closely linked communities in the Eastern Region of Ghana. The cross sectional study recruited 723 participants aged between 0- 91 years old from 7 closely linked communities. Finger pricked blood was used to prepare thick and thin blood smears as well as filter paper dried blood spot (DBS) and an HRP2 rapid diagnostic test (RDT) conducted. Genomic DNA was extracted from the DBS and used in PCR to amplify the Plasmodium 18S rRNA gene using species specific PCR. PCR identified 66% of the participants to be asymptomatic, with P. malariae and P. ovale mono-infections accounting for 2.2% and mixed species infections 13.3%. Parasite prevalence by microscopy (34%) was similar to the RDT positivity rate (33%). No differences were observed in falciparum and non-falciparum parasite carriage at the community level, however older children aged between 6 and 15 years had the highest prevalence of falciparum and non-falciparum parasite carriage compared to young children (0-5 years) and adults (16 years and above). A high prevalence of asymptomatic Plasmodium parasites was identified with a similar distribution of falciparum and non-falciparum parasites across closely linked communities in the Eastern Region of Ghana. Children aged between 6-15 years harbored the highest prevalence of falciparum (asexual stage parasites and gametocytes) and non-falciparum parasites, whilst children 5 years and below had infections with the highest parasite densities.

[#17] Evaluating the Efficacy of Giemsa Stain Used for Malaria Parasite Detection; A Case Study of Selected Diagnostic Laboratory Facilities in Ashanti Region of Ghana

D. N. Ofosu1, C. Nkrumah3, A. Asamoah4, O. S. Benfield2 , M. K. Addai2, Y. Marfo-Debrekyei2

1Department of Basic and Applied Biology, University of Energy and Natural Resource, 2Department of Medical Laboratory, Garden City University College, 3Wenchi Methodist Hospital, 4National Malaria Control Programme

Email: [email protected]

Malaria, a major cause of child death in Africa, is currently diagnosed with microscopy in Ghana. Microscopy remains the gold standard for malaria diagnosis globally and for Ghana which is endemic for malaria. Slide preparation involves the use of quality stains for quality smears. Giemsa is the routine stain used for malaria microscopy largely in Ghana. However several Giemsa stains have flooded the market which may not meet the required standard for malaria microscopy. The study was to determine the efficacy of some types Giemsa stains used in laboratories for malaria detection in Ashanti region (using WHO standard criteria in the assessment of the stains). The study was undertaken from November 2018 to April 2019. Control malaria smears ranging from a high to low malaria parasitaemia were used in the assessment. A Giemsa stock (GURR Giemsa staining solution, VWR chemicals, PROLABO, European C) was obtained from the National Malaria Control Program (NMCP) as our control and reference stain for the study. Slides were observed under the microscope for the staining characteristics of the malaria parasites, parasite density and the staining characteristics of white cells. Over 75% of Giemsa used in the laboratory facilities were from unbranded or unknown sources. Many of these Giemsa stained smears could only demonstrate 60% staining characteristics of the nuclear and cytoplasmic details of malaria parasite, and 70% on the staining characteristics of the white cells. Over 83% of the lab facilities never used a buffer tablet or solution for the smear preparation leading to poor results. About 73% rather used tap water as a source of diluents for preparation of Giemsa working solution which did not provide the optimal pH for the reaction. It was observed that the tap water resulted in a lower parasite count as compared to buffered water. A highly significant association was observed with freshly prepared working Giemsa solution and the quality of malaria parasites and morphology of neutrophils (p<0.0001). The study demonstrated that about 70% of the Giemsa being used were not efficient in providing 100% of the morphological characteristics of parasites and white cells needed to be demonstrated from the Giemsa stains used from the laboratory facilities in the study.

[#18] HIV and Toxoplasma gondii Co-Infection among Pregnant Women and Children in the Ashanti Region, Ghana

S.K. Agordzo, M. Abdul-Hakim, D.A. Abbas, A. Tweneboa, C. Owusu, M.G. Addo, K. Badu Department of Theoretical and Applied Biology- KNUST, Kumasi Email: [email protected]

Toxoplasmosis is an important opportunistic zoonotic disease caused by Toxoplasma gondii. Infection acquired in pregnancy can be transmitted congenitally, which may result in severe damage or death of fetus. In immune compromised individuals such as HIV/ AIDS patients, the reactivation of a latent infection may lead to life-threatening encephalitis. There is a dearth of information regarding co-infections in pregnant women and children in the Greater Accra region, Ghana. This study therefore determines HIV-Toxoplasmosis co-infection among pregnant women and children in the Ashanti region of Ghana. A total of 138 HIV seronegative individuals were recruited in the initial study. Out of this number, 110 were pregnant women aged between 16-45 years and 38 children aged from 8 months-14 years. Venous blood samples were taken into EDTA- anticoagulant tubes and Toxo IgG/IgM RDT were used to test for the presence of anti-T. gondii IgG and IgM. Preliminary results on T. gondii infection indicated an overall prevalence of 56.4% (62/110) for the pregnant women. Out of these, 18/62 (29.0%) who were in their first trimester and 22/62 (35.5%) in both second and third trimesters were seropositive. Overall seroprevalence of 8/38 (21.1%) was observed for neonates, of which 2/38 (5.3%) were under 5 years, 2/38 (5.3%) from 5 to 10 years and 4/38 (10.5%) from 11 to 14. Seroprevalence of anti T. gondii IgM and IgG among the children were 1/38 (2.6%) and 7/38 (18.4%) respectively. P-values >0.05 was obtained for being a neonate, pregnancy and seropositivity. Ownership of cat and contact with cat litter with p values < 0.05 has been associated with infection. Immunocompromised individuals; HIV/AIDS patients, neonates and pregnant women are at high risk of life-threatening toxoplasmosis. The next phase of this study seeks to determine prevalence of toxoplasmosis in HIV/AIDS patients to ascertain active infection.

[#19] Detecting Asymptomatic P. falciparum in Blood Donors: Evaluation of Microscopy, Rapid Test, 18s-rRNA LAMP and Selective Whole Genome Amplicon Sequencing Assays E. Aninagyei, A. Egyir-Yawson, D. O. Acheampong Department of Biomedical Sciences, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana

E-mail: [email protected]

High prevalence of asymptomatic Plasmodium spp in healthy adults is common in Africa and some part of Asia. Due to the negative effect of donor parasitaemia on stored blood, it is imperative that all prospective blood donors are screened for malaria parasites using sensitive and user-friendly diagnostic technique. Therefore, this study assessed the diagnostic sensitivity of microscopy, rapid test kit, loop-mediated isothermal amplification (LAMP) assay and selective whole genome amplicon sequencing (sWGA) technique. This study screened randomly selected healthy blood donors from randomly selected districts in Greater Accra Region, Ghana. Each donor sample was screened with SD Bioline rapid test kit and sWGA. Each positive sample was further confirmed by LAMP using both crude DNA (crDNA-LAMP) and purified DNA (pDNA-LAMP) extract. In order to reduce cost, negative rapid test and microscopy samples were screened with crDNA- LAMP and pDNA-LAMP in pools of 10 samples. Positive pools were resolved individually. Total of 771 blood donors were screened. The overall prevalence of P. falciparum by microscopy was 7.4%, rapid test 11.8%, crDNA-LAMP 16.9%, pDNA-LAMP 17.5% and sWGA18.0%. Using sWGA as the reference test, the respective sensitivities (95%CI) of microscopy, rapid test, crDNA- LAMP and pDNA-LAMP were 41.0% (32.7-49.7), 65.5% (56.9-73.3), 82.6% (75.8-88.3) and 95.7% (90.1-98.4). While perfect agreement was observed between crDNA-LAMP and pDNA- LAMP (κ=0.91) and almost perfect agreement was observed between crDNA-LAMP and sWGA (κ=0.87), pDNA-LAMP agreed perfectly with sWGA (κ=0.96). The two variant LAMP assays agreed well with the reference assay. Therefore, it is recommended that LAMP based assays are employed to detected asymptomatic Plasmodium infections in healthy donors.

[#20] Population-Specific Cut-Off for HbA1c Improves Identification of Metabolic Syndrome among Non-Diabetic Population in Ghana

M. E. Annani-Akollor1, E. F. Laing1, H. Osei1, E. O.Anto1,3, E. Mensah3 E-W. Owiredu2,

1 Dept of Molecular Medicine, School of Medicine and Dentistry, KNUST, Kumasi, Ghana 2 Dept of Medical Laboratory Technology, Faculty of Allied Health Sciences, KNUST, Kumasi, Ghana. 3 School of Medical and Health Science, Edith Cowan University, Perth, Western Australia

Email: [email protected]

Metabolic syndrome (MetS) is a multifactorial disorder and a predisposing factor for diabetes and cardiovascular disease. Glycated haemoglobin (HbA1c) has recently received considerable attention as a potential marker to identify subjects at risk of MetS. This study aimed at assessing the performance of fasting plasma glucose (FPG), the American Diabetes Association (ADA) HbA1c cut-off, and a population-specific HbA1c (pHbA1c) cut-off values as the glycaemic criterion for MetS in a Ghanaian non-diabetic population. In this cross-sectional study, we recruited 364 non-diabetic Ghanaian adults. Venous blood sample was obtained and fasting plasma insulin and glucose, HbA1c, and lipid profile, blood pressure and anthropometric measurement was performed for each respondent. The prevalence of MetS using the FPG, ADA HbA1c and pHbA1c criteria were 35.2%, 38.5% and 41.8%. The pHbA1c cut-off identified 6.6% and 3.3% more subjects with MetS when compared with FPG and the ADA HbA1c cut-offs while the ADA HbA1c cut-off identified 3.3% more subjects with MetS compared with the FPG criterion. The ADA HbA1c criterion showed a substantial agreement (ĸ = 0.79) with the FPG criterion while pHbA1c showed an almost perfect concordance (ĸ = 0.82) with the FPG criterion and an excellent sensitivity and specificity for identifying subjects with MetS in the study population. Screening of MetS by introduction of the ADA HbA1c criterion in addition to the traditional FPG criterion enhances the detection of more people with MetS. We conclude that the use of population-specific cut-off for HbA1c could identify even more high-risk subjects in that specific population.

[#21] Perceived Causes of Epilepsy among Community Members in the Berekum Municipality. D. Gyaase, Y. Enuameh Department Community Health, SMD, KNUST, Kumasi Email: [email protected]

Epilepsy is a chronic non-communicable disease of the brain that affects more than 50 million people worldwide. It is characterized by recurrent seizures, which could be brief episodes of involuntary movement involving parts of the body or the entire body. Epilepsy is a widely recognized health condition, but is very poorly understood, even by people who know someone with the disorder. Lack of knowledge about the causes of epilepsy has resulted in negative perceptions, beliefs and the stigma associated with it. Determining community’s knowledge of the causes of epilepsy is a first step in forming strategies to dispel the myths and misconceptions regarding the disease. The study sought to determine the perceive cause of epilepsy among community members. The study employed qualitative methods of data collection principally in- depth interviews using an interview guide. The study population was persons who had interacted with persons with epilepsy during seizures. Snowball and purposive sampling techniques were used. Thematic content analysis was used in analyzing the data. Analyzes of the data pointed out seven main themes; epilepsy as a manifestation of an evil spirit, epilepsy is the result of family curse or a family disease, epilepsy is a punishment from ancestors or gods of a land, evil spirits as the cause of epilepsy, foam from an epileptic can induce epilepsy in a non-epileptic, bite from person living with epilepsy, phlegm as a cause of epilepsy. Study findings point to community’s predominant perception of supernatural causes of diseases (epilepsy). This indicates that, causes of neurological disorders such as epilepsy are based on the social causation theory of disease which attributes diseases to the supernatural. Health professionals and health advocates should undertake health education on epilepsy and seizures to change the myths and misconceptions regarding the disease.

[#22] Understanding the Causes of Autism: Perceptions among Parents of Children with Autism in the Tamale Metropolis.

Z.Y. Zuliaha, H. Vampere, I. Owusu, P. Prudence

Center for Disability and Rehabilitation Studies, CEDRES-KNUST

E-mail: [email protected]

Autism is a bio-neurological developmental disability which appears in childhood and persist through adolescence and adulthood. It is a complex disorder characterized by impaired social skills/interactions, communication skills and behavioral problems (American psychiatric Association, 2000). Data on its prevalence is diverse, though WHO (2018) provides estimates of 1 in 160 children. The issues on autism are more conflicting and raise arguments about its causes among Africans (Bakara MO et al, 2011). The varied perceptions and paucity of knowledge on the causes of autism worsen the plight of autistic children as it affects intervention measures, upbringing and treatment. This study investigated the perspectives of parents with autistic children on the causes of autism. A qualitative descriptive study was conducted involving fifteen parents obtained by the snowballing method. Data was collected through interviewing and analyzed by thematic content analysis method. Many respondents attributed the causes of autism to witchcraft/curse or broken taboo and genetic/hereditary. Others believed it is a test from God to confirm steadfastness of faith. Few others attributed the cause to brain malfunction or prenatal malnutrition whilst others believe it has unknown causes. These confirm the diverse perceptions and little knowledge on the causes of autism. Autistic children may therefore likely to receive little attention in seeking healthcare. Educating parents on autism is recommended.

[#23] Characterization of Bacteriocin of Lactic Acid Bacteria Originating from Traditional African Fermented Milk Product, Nunu.

J. Bakuru 1, A-M. Donkor 1, F. Akabanda 2, G. Motey 2, J. Owusu-Kwarteng 2,

1Department of Applied Chemistry and Biochemistry, Faculty of Applied Sciences, University for Development Studies, Navrongo campus, Ghana 2Department of Applied Biology, Faculty of Applied Sciences, University for Development Studies, Navrongo campus, Ghana,

E-mail: [email protected]

The purpose of this study was to screen 39 lactic acid bacteria (LAB) originating from traditional fermented milk product, nunu, for bacteriocins production and to partially characterize these bacteriocins. Neutralised cell free supernatants (CFS) of LAB isolates were, initially, tested for their inhibitory activities against pathogenic bacterial strains of Salmonella Typhimurium, Bacillus cereus, Staphylococcus aureus and Escherichia coli. Subsequently, bacteriocins produced by two LAB strains identified by MALDI-TOF mass spectrometry as Lactobacillus lactis (L. lactis) and Leuconostoc pseudomesensteroides (Leu. pseudomesenteroides) were characterized on the basis of their stability under different pH conditions, heat and enzymatic treatments. Peptides of the bacteriocin produced by L. lactis were, subsequently, purified and separated by column chromatography. The antimicrobial property of bacteriocins of L. lactis and Leu. Pseudomesensteroides were retained when subjected to acidic pH but were significantly (P < 0.05) reduced at alkaline pH conditions. Similarly, antimicrobial activity of both bacteriocins were significantly (P < 0.05) reduced with increasing temperature treatments, with complete loss of activity at 121 °C. The antimicrobial activities of both bacteriocins were lost when subjected to the actions of proteolytic enzymes but remained active under the actions of catalase, lipase and α- amylase which confirms the proteinaceous nature of the bacteriocins. A total of 13 fractions were obtained from purified peptides of bacteriocin produced by L. lactis. However, only 9 fractions showed antimicrobial activities against the pathogenic bacteria. The bacteriocin-producing L. lactis presents good potentials that can be exploited for application in novel drug development and food applications to ensure safety.

[#24] Mitigating the Adverse Effects of Nutrition Transition Associated with Urbanization. New Perspectives of Rural Ghana nutrition. J.K. Sarfo, M. B. Adinortey Department of Biochemistry, School of Biological Sciences, University of Cape Coast, Ghana Email: [email protected] The pattern of urbanization in Ghana can be described as urban sprawl whereby cities, towns, and sometimes villages rapidly grows spatially to annex nearby farming villages. During this annexation the peasant farmers lose their farms, livelihood, and therefore their source of income and food supply. The Ghana Statistical Service current estimate shows that rural dwellers constitute about 50% of the Ghanaian population down from over 70% in the 80’s. This trend can also be contributed to direct migration of rural dwellers to urban areas for jobs and better standard of living. Since farming is the main livelihood of rural communities in Ghana, urbanization will have ripple effects on the nutrition and health of indigenes of the affected communities. The rapid change in the food environment due to loss of farming lands, and therefore sources of income of the indigenous farmers causes them to transit into a socio-economic status of the Urban Poor, and malnutrition. The dire consequences of transition of nutrition and health of the urban poor stem from their efforts to cope with the high cost of new food items, which are now obtained from supermarkets, provision shops, open market places and fast-food vendors to supplement their nutritional requirement. Transition from full traditional cuisines to refined grains, animal source, processed and sugar-laden foods can also have implications for the functions of the gut microbiota predisposing the affected individuals to metabolic disorders and the associated complications such as infections, diabetes, overweight, obesity and cardiovascular diseases. Unfortunately, the dynamics of the contiguous stages of nutrition transition, gut microbiota and degenerative diseases have been grossly underrated in the Ghanaian healthcare delivery system. The paper presents unique characteristics of rural urbanization in Ghana, and the new perspectives of mitigation strategies against the metabolic and health negative outcomes of nutrition transition in the Ghanaian rural areas under urban stress.

[#25] Expression of MUC1 is a Poor Prognostic Marker in Breast Cancer in Kumasi, Ghana.

E. A. Manu1, K. Bedu-Addo1, N. A.Titiloye2, C. Ameh-Mensah1, F. Opoku1, B. M. Duduyemi2

1Departments of Physiology, SMD, KNUST, Kumasi, Ghana 2Department of Pathology, SMD, KNUST, Kumasi, Ghana

Email: [email protected] Immunohistochemical assessment of breast cancer and stratification into the basic molecular subtypes afford a much deeper insight into the biology of breast cancer, while presenting with opportunities to exploit personalized, targeted treatment. Traditionally, the oestrogen, progesterone and epidermal growth factor receptors are assessed. MUC1, a transmembrane mucin has been demonstrated a potential prognostic and metastatic marker in breast cancer. However, there have been a limited number of studies addressing the predictive and prognostic features of MUC1 in African breast cancer. This study aims at addressing the expression profiles of MUC1 and other biomarkers in Ghanaian breast cancer, and determines its predictive and prognostic characteristics, in relation to other clinicopathological features. Haematoxylin and Eosin (H&E) slides of 475 breast cancer cases were reviewed and 203 suitable cases were selected for tissue microarray (TMA) construction and immunohistochemistry. Anti-ER, PR, HER2, Ki-67 and MUC1 antibodies were used. Results from the immunostaining analysed using SPSS version 23. About 59% of cases expressed MUC1. Majority of cases in the study showed a lack of expression of all three traditional markers (29% expressed ER, 10.9% PR and 20.7% HER2). Ki-67 index were 62.1% (low), 16.5% (moderate) and 21.4% (high). MUC1 expressions among the molecular classes were; Luminal A (60.7%), Luminal B (68.8%), Her2 Overexpression (87.5%) and Triple negative (56.6%). There were significant associations between MUC1 and Her2 overexpression (p=0.01) and triple negative (p<0.01). The high proportion of breast cancer cases expressing MUC1, as well as its association with the two most aggressive molecular classes indicate a substantial role in the biology of breast cancer in our cohort and it is an indication of poor prognosis.

[#26] The Expression of Bcl2 among Breast Cancer Patients in a Tertiary Hospital In Sub- Saharan Africa C. Ameh-Mensah1, B. M. Duduyemi2, K. Bedu-Addo1, E. A. Manu1, F. Opoku 1, N. A Titiloye2

1Departments of Physiology SMD, KNUST, Kumasi, Ghana. 2Departments of Pathology, SMD, KNUST, Kumasi, Ghana.

Email: [email protected] Studies on Bcl2 expression in African breast cancer are scanty. Little is known about the role of apoptosis in the tumorigenesis and prognosis of breast cancer in our environment. Ki67 and p53 are also known to play a role in apoptosis. The aim of our study is to determine the role of Bcl2 in association with p53 and Ki 67 in our breast cases. A retrospective cross-sectional study on archival FFPE tissue blocks over a 9-year period with abstraction of clinico-pathologic data. 203 suitable cases were selected for tissue micro array (TMA) construction and IHC (Bcl2, Ki-67, p53, ER, PR and HER2/neu) was done. Expressions of Bcl2, p53 and Ki-67 were related to age, grade and molecular subtypes. Most of our cases were in the fifth decade of life (31%); invasive carcinoma NST was predominant (87%); Histological grade III (38%) was the highest and Luminal A (19.8%), Luminal B (9.9%), Her2 (16%) and TNBC (54.3%) constituted the molecular classes. Bcl2 expression was found in 42.5% of the cases. Our cases also showed mutation in p53 (36.7%) and Ki67 expression (62.5%). Bcl2 and p53 significantly correlated with Luminal B and TNBC (p<0.01). Ki-67 also correlated significantly with Luminal A & B and Her2 over expression (p<0.01). Pre-menopausal age (40-49) and histological grade inversely correlated with Bcl-2 expression. Our result shows high expression of Bcl2 suggesting an important role of apoptosis in our breast cancer cases. Expression patterns of p53, Ki67 and Bcl2 are independent predictors of prognosis in our cohort.

[#27] Fetal Rhesus D Genotyping from Rhesus D Negative Antenatal Population at Komfo Anokye Teaching Hospital, Ghana

O. Addai- Mensah1,, E. Y. Afriyie1 , M. E. Annani-Akollor2, D. Gyamfi1, L. Boateng1, S. A.Sakyi2, C. Obirikorang2, C. Opoku-Okrah1, K. Owusu-Danquah1, R. Asare1, F. Agyei-Amponsah3, R.V. Dunneh2

1Dept of Medical Diagnostics, Faculty of Allied Health Sciences, KNUST, 2Dept of Molecular Medicine, SMD, KNUST, 3Komfo Anokye Teaching Hospital, Kumasi.

Email: [email protected]

Management of RhD (-) women for hemolytic disease of the fetus or neonate assumes that the fetus or neonate is RhD (+) depending on the paternal RhD status. Such pregnancies are considered high risk with maternal-fetal RhD antigen incompatibility being responsible for approximately 50% of clinically significant alloimmunization cases. RhD genotyping in RhD (-) pregnant women has been suggested to ensure appropriate use of anti-D immunoglobulin in antenatal prophylaxis. This study genotyped fetal RhD and sex-determining region Y (SRY) from maternal plasma in an RhD (-) antenatal population at the Komfo Anokye Teaching Hospital, Kumasi, Ghana. This prospective cohort design analyzed 30 RhD (-) pregnant women with median gestational age of 33 weeks and correlated the RhD status with serological analysis of fetal blood RhD after delivery. Polymerase Chain reaction was used for amplification of RhD exon 5, 7 and 10 and the results compared with serologically phenotyped fetal blood as the gold standard. The median concentration of DNA levels obtained from clinical sample was 27.66 ng/µl with an average purity of 1.08 ± 0.42. Out of 30 samples analyzed, 86.7% were RhD (+), whiles 13.3% were RhD (-). There was complete (100.0%) concordance between maternal blood RhD genotyping (exon 5 and 7) and fetal RhD phenotyping after delivery whiles exon 10 indicated 92.3% concordance. Diagnostic concordance and accuracy of the test was 100.0% for RhD5 and RhD7 (Cohen’s kappa=1.00, accuracy= 100.0%) and 76.2% consistency and 93.3% accuracy for RhD10. We confirm the precision of fetal RhD genotyping in maternal plasma using conventional PCR. A larger sample size in a similar study across the country could allow the implementation of this procedure in clinical routine antenatal testing for all RhD negative pregnant women, in order to minimize the risk of hemolytic Disease of the fetus and Newborn.

[#28] Autotransplantation of a Maxillary Incisor Tooth to Improve Aesthestics and Occlusal Setting at a Minimal Cost. S. E. Ankoh1, Y. A. Adu-Arko1, R. Y. Goka1, R. L. Larmie2, A. Nyarko1, E. E. Siale2 1Department of Restorative Dentistry, Komfo Anokye Teaching Hospital, Kumasi, 2Department of Oral and Maxillofacial Surgery, Komfo Anokye Teaching Hospital, Kumasi.

Email: [email protected] Impacted maxillary permanent central incisor is not a frequently reported case but its treatment poses a challenge because of its importance to facial aesthetics and speech. Impacted permanent maxillary anterior tooth is usually caused by one of these local factors; an odontome, loss of arch space and the presence of supernumerary tooth. An odontome is a growth in which both epithelial and mesenchymal cells exhibit complete differentiation with the result that functional ameloblasts and odontoblasts form enamel and dentin which are usually laid down in an abnormal pattern. Autotransplantation is the surgical transfer of a vital or endodontically treated tooth from its original location to another site in the same mouth of an individual. A 22-year old lady sought for a more aesthetic replacement of her missing maxillary left central incisor which had been replaced for a year with an acrylic cantilever bridge in 2015. Radiographical examination revealed an impacted maxillary left central incisor apical to an odontome. Autotransplantation of the impacted tooth was done after surgical removal of the odontome. An aesthetic and functional outcome was achieved, and the patient is very satisfied with the treatment. Autotransplantation is an alternate means of replacing a missing tooth. It results in the maintenance and regeneration of the alveolar bone. Autotransplantation should be considered in patients who are not economically sound and unwilling to undergo lengthy orthodontic treatment.

[#29] Adherence to Guidelines for Severe Malaria Therapy in Children and Patient Outcomes at New Edubiase Government Hospital. F. Kyei-Frimpong, K. O. Buabeng

Department of Pharmacy Practice, Kwame Nkrumah University of Science and Technology, Kumasi, . Email: [email protected] Severe malaria is a condition with serious fatalities in children especially those below five years of age because of their weak immune status. Clinical Practice Guidelines (CPG) on severe malaria has been developed to help clinicians manage the condition appropriately. Clinicians are known not to adhere to CPGs and total adherence (both anti-malarial and supportive therapy) to these guidelines and its effects on clinical outcomes has not been assessed. A data collection instrument was developed and used to obtain data on 142 patients who were diagnosed of severe malaria at the pediatric and emergency wards at the study site. The data included patients’ age, sex, weight, complications presented, comorbidities and outcomes to therapy. One hundred and thirty-two patients were diagnosed of severe malaria-based WHO criteria for diagnosis. All the patients were managed with parenteral Artesunate but 5 were given sub-optimal doses. Seventy (49.6%) had therapy switched from parenteral to oral Artemisinin base Combination Therapy (ACT) when conditions improved as required by the guidelines. The ACTs that were used were Artemether plus Lumefantrine (87.2%) and Artesunate plus Amodiaquine (12.8%). Regarding anti-malarial and supportive therapy only 29 patients were treated strictly according to standard treatment guidelines and their conditions improved within 3 to 4 days and were discharged. Those who were treated without adhering to the guidelines had longer duration of hospital stay. Anemia was present in 83.6% of the children who had their hemoglobin assessed; 47 were severely anemic and appropriate management of severe anemia led to better clinical outcomes. The study revealed that strict adherence to the standard treatment guideline in the management of severe malaria in children leads to better outcomes, early resolution of symptoms and shorter length of hospital stay but any form of non-adherence leads to poor outcomes.

[#30] Mobile Phone Short Message Service (SMS) as a Malaria Control Tool: a Quasi- Experimental Study A. Mohammed1, P. R. Acheampong1, E. Otupiri1, F. A. Osei1,2 R. Larson-Reindorf1,2 E. Owusu- Dabo1

1School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana. 2Komfo Anokye Teaching Hospital, Kumasi, Ghana.

Email: [email protected]

Despite extensive implementation of control measures and achievements in morbidity reductions, malaria continues to contribute to substantial morbidity and mortality in children under-five. Innovative approaches involving the use of mobile phones have been suggested to improve health outcomes. However, evidence of its effect on reducing the prevalence of malaria is limited. This study aimed to assess the effect of a theory-driven mHealth intervention on the prevalence of malaria among children under-five living in rural districts of Ghana. We conducted a quasi- experimental study of a 12-month intervention using a random sample of 332 caregivers with children under-five from two rural districts, assigned to either an intervention or a control group. Caregivers in the intervention group received voice short message service (SMS) on malaria prevention based on a behavior change theory to improve their health behaviors and practice, once a week for twelve months, while caregivers in the control group received none. Pre- and post- intervention assessment of the treatment effect (ATT) on malaria in children under-five was conducted using propensity score and difference-in-difference (DiD) analyses. Among children whose caregivers received the intervention, the prevalence of malaria decreased from 58.4% at baseline to 37.8% at endline (difference: -20.6%; 95% CI: -31.1, -10.1) compared with children in the control group, where a reduction of 65.0% to 59.9% (difference -5.1%; 95% CI: -15.5, 5.4) was observed. The post-intervention treatment effect revealed a statistically significant reduction in malaria prevalence (ATT: -0.214; 95% CI: -0.36, -0.07) among the intervention group. Overall, the intervention effect showed a significant reduction in the prevalence of malaria among children under-five was positive (DiD: -0.154; p=0.043). The findings provide support for the use of mHealth approaches as an intervention tool for improving health behaviors and reducing the burden of malaria in children under-five.

[#31] Antibody Responses against GMZ2 Vaccine Antigens in Relation to the Risk of Malaria in Burkinabe and Ghanaian Children. S. Dassah1, 2, 5, B. Adu2, R. W. Tiendrebeogo3, F. Atugubah1, T. A. Gerds4, F. K. N. Arthur 5, D. Dodoo2, M. Theisen3, 6 1Department of Biomedical Sciences, Navrongo Health Research Centre, Navrongo, Ghana, 2Noguchi Memorial Institute of Medical Research, University of Ghana, Legon, 3Centre of Medical Parasitology, University of Copenhagen, Denmark, 4Department of Biostatistics, University of Copenhagen, Denmark, 5Department of Biochemistry and Biotechnology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana, 6Department for Congenital Disorders, Statens Serum Institut, Denmark.

Email:

GMZ2 vaccine candidate is a bivalent recombinant fusion protein between glutamate rich protein (GLURP) and merozoite surface protein 3 (MSP3) adsorbed on alum. Here we investigated GMZ2 antibody response in relation to the risk of malaria in a multi-centre efficacy trial in African children. This study analysed samples from 728 children from Burkina Faso (Banfora, n=453 and Sapone, n=192) and Ghana (Navrongo, n=83) in the GMZ2 phase 2b trial. Children were randomized to receive either GMZ2 (n=367) or the control rabies vaccine (n=361) on days 0, 28 and 56 respectively. Antibody titres against the vaccine components, GMZ2, GLURP R0 and MSP3 were measured in a Luminex multiplex assay on days 0, 84 and 252 respectively. Antibody functionality was assessed by THP-1 cells phagocytosis of antibody opsonised GMZ2-coupled microsphere beads. At both days 84 and 252 IgG, IgG1 and IgG3 levels against GMZ2, GLURP R0 and MSP3 were all significantly (p<0.001) higher in the GMZ2 group compared to the rabies control group. Total IgG, IgG1 and IgG3 antibody levels were significantly associated with reduce risk of febrile malaria at day 252 but not at day 84. IgG (p <0.001), IgG1 (p <0.001) and IgG3 (p <0.001) antibody levels against GMZ2, GLURP R0 and MSP3 were associated with opsonic phagocytosis (OP). OP in the GMZ2 vaccine group at day 252 [HR = 0.80 (95%CI: 0.70; 0.90), p < 0.001] but not at day 84 [HR = 0.94 (95%CI: 0.82; 1.07), p = 0.36] was significantly associated with reduced multiple febrile malaria episodes. High levels of vaccine-specific antibodies were induced but the functional immune effect on the risk of febrile malaria appears delayed. Functional quality of antibodies is recommended in evaluating potential malaria vaccine candidates.

[#32] Expression of MUC1 is a Poor Prognostic Marker in Breast Cancer in Kumasi, Ghana.

E. A. Manu1 K. Bedu-Addo1, N. A Titiloye2, C. Ameh-Mensah1, F. Opoku1, B.M. Duduyemi2

1Department of Physiology, SMD, KNUST, Kumasi, Ghana 2Department of Pathology, SMD, KNUST, Kumasi, Ghana

Email: [email protected] Immunohistochemical assessment of breast cancer and stratification into the basic molecular subtypes afford a much deeper insight into the biology of breast cancer, while presenting with opportunities to exploit personalized, targeted treatment. Traditionally, the oestrogen, progesterone and epidermal growth factor receptors are assessed. MUC1, a transmembrane mucin has been demonstrated a potential prognostic and metastatic marker in breast cancer. However, there have been a limited number of studies addressing the predictive and prognostic features of MUC1 in African breast cancer. This study aims at addressing the expression profiles of MUC1 and other biomarkers in Ghanaian breast cancer, and determines its predictive and prognostic characteristics, in relation to other clinicopathological features. Haematoxylin and Eosin (H&E) slides of 475 breast cancer cases were reviewed and 203 suitable cases were selected for tissue microarray (TMA) construction and immunohistochemistry. Anti-ER, PR, HER2, Ki-67 and MUC1 antibodies were used. Results from the immunostaining analysed using SPSS version 23. About 59% of cases expressed MUC1. Majority of cases in the study showed a lack of expression of all three traditional markers (29% expressed ER, 10.9% PR and 20.7% HER2). Ki-67 index were 62.1% (low), 16.5% (moderate) and 21.4% (high). MUC1 expressions among the molecular classes were; Luminal A (60.7%), Luminal B (68.8%), Her2 Overexpression (87.5%) and Triple negative (56.6%). There were significant associations between MUC1 and Her2 overexpression (p=0.01) and triple negative (p<0.01). The high proportion of breast cancer cases expressing MUC1, as well as its association with the two most aggressive molecular classes indicate a substantial role in the biology of breast cancer in our cohort and it is an indication of poor prognosis.

[#33] Screening of Oxazolidinone Derivatives for Anticonvulsant Activity S. B. Kombian, M. G. Qaddoumi, O. A. Phillips. Departments of Pharmacology & Therapeutics, Pharmaceutical Chemistry, Faculty of Pharmacy, Kuwait University, Kuwait. Email: [email protected] Pharmacotherapy of seizure disorders is not optimal as most anticonvulsant drugs have side effects that may limit their use. Also, only ~80% of responders are seizure-free while up to about 40% of patients do not response to currently available drugs. As such, the need for novel anticonvulsant agents that may cover non-responders with minimal side-effects is warranted. We used in vitro models to screen oxazolidinones to identify those with potential for anticonvulsant activity. This enabled lead compound identification which were then screened on in vivo epilepsy models in mice and rats. The oxazolidinone derivatives PH084 and PH027 produced concentration- dependent suppression of evoked fast, non-NMDA receptor-mediated excitatory postsynaptic currents (EPSCs), with 10M causing reduction of -36.9±4.0% (n=9) and -19.4±4.0% (n=5), respectively. On the other hand, PH036, PH108 and linezolid (PH001) did not produce a significant suppression of the evoked EPSC. In vivo anticonvulsant and toxicity screening of selected oxazolidinones identified PH192 as the most active and least toxic congener. When mice were pretreated intraperitoneally (IP) with 100 mg/kg PH192 for 30 minutes, 75% of mice were protected from 6 Hz-induced seizures while 66.6% of rats were protected compared to untreated mice. About 83.3% of rats were protected when seizure was induced using the maximal electroshock (MES) protocol. Pentylenetetrazole (PTZ; 50 mg/kg; IP) injection produced stage 5 seizures in all rats. Thirty minutes IP pretreatment of rats with 100 mg/kg PH192 protected 80% from the PTZ-induced seizures, a level of protection similar to that obtained with a reference antiepileptic drug (AED) phenytoin (40 mg/kg). These data reveal that some neuroactive oxazolidinones suppress excitation in the brain via a GABAergic mechanism and protect rodents from chemically- and electrically-induced seizures at levels similar to clinically used AEDs. Supported by Kuwait University research grants PT02/06 and PT02/14 to SBK.

[#34] Antimicrobial, Antioxidant and Anthelmintic Activities of Alchornea cordifolia M. Okine, D. Akwata, A. Acheampong, C. O.Akoto

Department of Chemistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana Email: [email protected]

Alchornea cordifolia has ethnomedicinal use in the treatment of wounds, gonorrhea, conjunctivitis, diarrhea, urinary disorder and gastrointestinal disorder. The main focus of this study was to verify the biological activities (antimicrobial, antioxidant and anthelmintic) and isolate some of the components in the leaf extracts. The leaves of the plant was extracted using chloroform, methanol, and petroleum ether by means of soxhlet extraction. The phytochemical investigation revealed the presence of secondary metabolites such as terpenoids, flavonoids, steroids, saponins, carotenoids, phenols, and tannins. The antimicrobial activities of the extracts were tested against the following microbes: Staphylococcus aureus, Enterococcus faecalis, Escherichia coli, Pseudomonas aeruginosa and Candida albicans by using the in vitro methods, agar well diffusion and broth microdilution. All three extracts showed better activity against Escherichia coli with Minimum Inhibitory Concentration (MIC) of 1.56 mg/mL. The antioxidant activity was determined by employing DPPH radical scavenging, Total Antioxidant Content (TAC) and Hydrogen Peroxide (H2O2) scavenging assays. The IC50 recorded for methanol, chloroform and pet ether extract in the DPPH assay were 35.22 ppm, 94.77 ppm and 93.02 ppm respectively. The TAC (gAAE/100 g) for chloroform, pet ether and methanol extracts were 25.85 g, 40.0 g and 40.08 g respectively. The IC50 value of 272.0 ppm for the methanol extract showed better antioxidant activity compared to the chloroform and the pet ether of 626.5 ppm and 898.4 ppm respectively. The anthelmintic assay was carried out on all the three extracts with albendazole as the standard drug. Lower concentrations of the extracts recorded better paralysis and death time than higher concentration of the standard. The result indicates that the plant extract shows promising anthelmintic activity when compared with the standard. Thin layer and column chromatography were carried out and two spots have been purified. The Infrared spectroscopic analysis of the purified fractions showed the functional groups, carbonyl (C=O), (sp3) -C-H, (sp2) =C-H, C=C, C-C and C-O stretching confirming the presence of some of the phytochemicals identified in the screening test. The findings of this study suggest that Alchornea cordifolia leaves could be exploited as potential therapeutic candidate for the treatment of helminthic infections, bacterial infections and oxidative- stress diseases as used by some ethnomedicinal practitioners.

[#35[Cryptolepine activates type 1 interferon response pathway through STAT1 suggesting a potential substitute for interferon-based therapy

S. A. Domfeh1, 2, P.W. Narkwa3, O. Quaye1, 2, K. A. Kusi4, M. Mutocheluh3

1West African Centre for Cell Biology of Infectious Pathogens, University of Ghana, Legon, 2Department of Biochemistry, Cell and Molecular Biology, University of Ghana, Legon, 3Department of Clinical Microbiology, Kwame Nkrumah University of Science and Technology, Kumasi, 4Noguchi Memorial Institute for Medical Research, University of Ghana, Legon.

E-mail: [email protected]

Type 1 interferons (IFN-1, mainly IFN-α/β) through the activation of the Janus kinase-signal transducer and activator of transcription (JAK-STAT) pathway leads to the expression of a plethora of anticancer and antiviral genes. Hence, recombinant IFN alpha (rIFN-α) is used in the treatment and management of viral infections including chronic hepatitis B and C, as well as some cancers including hairy cell leukaemia. However, the high cost associated with rIFN-α has limited its clinical use in sub-Saharan Africa, where chronic viral hepatitis B is endemic. There is, therefore, a huge demand for small molecules or natural products that could activate the IFN-1 response pathway but cheaper and readily available to replace rIFN-α. Cryptolepine is the main bioactive alkaloid in Cryptolepis sanguinolenta, a West African medicinal plant that has been used in Ghana and other settings for the management of varied ailments including malaria. The current work, as part of an on-going study, tested the hypothesis that cryptolepine activates the IFN-1 response pathway. Human liver cancer (HepG2) and human embryonic kidney (HEK293) cell lines were transiently transfected with a plasmid expressing the IFN-1 responsive luciferase reporter gene (pISRE-luc) using the TransIT-2020 Transfection Reagent. A control plasmid (pRLSV40-luc) was co-transfected in order to normalise for transfection efficiency. Cryptolepine (0.5 - 4 µM) activated the IFN-1 response pathway in a dose-dependent fashion, with over two- fold increase in the pathway activity starting from 1 µM cryptolepine in both cell lines. The cryptolepine-activated pathway activity was over 80% inhibited when the cell lines were pre- treated with 10 µM fludarabine, a STAT1 inhibitor, before cryptolepine treatment. Our results suggest that cryptolepine activates the IFN-1 response pathway through STAT1, and this makes the bioactive alkaloid a potential substitute for IFN-based therapy in the future.

[#36] Bioassay-Guided Isolation of Four New Antiprotozoal Compounds from Two Ghanaian Mushrooms.

F. Annang 1, I. Pérez-Victoria1, T. Appiah2, G. Pérez-Moreno3, E. Domingo-Contreras1, J. Martín1, T. Mackenzie1, L. Ruiz-Pérez3, D. González-Pacanowska3, O. Genilloud1, F. Vicente1, C. Agyare2, F. Reyes1.

1Fundación Medina, Avda. del Conocimiento 34, 18016, Armilla, Granada, Spain, 2Department of Pharmaceutics, Faculty of Pharmacy and Pharmaceutical Sciences, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana , 3Instituto de Parasitología y Biomedicina "López-Neyra", Consejo Superior de Investigaciones Científicas (CSIC) Avda. del Conocimiento s/n, 18016, Armilla, Granada, Spain

E-mail: [email protected]

Malaria and kinetoplastid diseases remain global health issues that affect close to half of the world´s population. With the persisting problems of resistance, toxicity and cumbersome administration of current drugs against these protozoan diseases, there is an urgent need for the discovery of the next-generation antiprotozoal compounds against these debilitating diseases. We report here the bioassay-guided discovery of two new scalarane sesterterpenes and two new triterpenes from two Ghanaian mushroom species, Pleurotus ostreatus (edible) and Scleroderma areolatum. The structures and configurations of the four new compounds were established by spectroscopic methods and by comparing them to closely-related members of these compound families described in literature. The four compounds exhibited IC50 values of 1.65-7.63 µM against Plasmodium falciparum 3D7 and 5.04-13.65 µM against Trypanosoma cruzi Tulahuen C4 parasites and were also non-cytotoxic against HepG2 tumoral human liver cells. Interestingly, this is the first report describing the isolation of sesterterpenes belonging to the scalarane structural class from a terrestrial source. The four compounds isolated provide new starting scaffolds for further exploration in antiprotozoal drug discovery and confirm once again the usefulness of natural sources for new bioactive molecules.

[#37] Potential Aphrodisiac Effect of Khaya senegalensis on Male Wistar Rats

L. Sallah1, M. E. Ananni-Akollor2, B. M. Duduyemi3, N. A. Titiloye 3, B. M. Wireko 1

1Dept of Physiology, SMD, KNUST, Kumasi, 2Dept of Molecular Medicine,SMD, KNUST, Kumasi, 3Dept of Pathology,SMD, KNUST Kumasi.

Email: [email protected] The Global increase in men suffering from reduced libido calls for investigation into new and existing plants used for folkloric aphrodisiac practices. The study aimed at examining the effect of Khaya senegalensis Extract (KSE) on sexual behavior, some serum hormones (Testosterone, Luteinizing and Follicle Stimulating Hormone) of male Wistar rats and the histology of the testis. Twenty matured male rats were grouped into five with four rats in each group. Group four and five (controls) received distilled water and sildenafil respectively, while group one (1) to three received KSE at a dose of 100mg/kg, 500mg/kg and 1000mg/kg respectively. Each male rat was placed in a transparent cage for about ten minutes to acclimatize to its new environment. A female rat in estrous was then put in the same cage with a mini camera and recorder in situ. Sexual behaviors monitored on the seventh and fourteenth day included mounting, genital and non-genital grooming. Hormones were assayed with hormone ELISA kits. Their organs (right testis and epididymis) harvested after sacrifice were prepared for histological studies. KSE caused higher mounting behavior in the group that received 500mg/kg and 100mg/kg as compared to the group that received KSE at 1000mg/kg. These mounting behaviors were associated with increase self- grooming. There were also significant differences in their serum LH (F=3.69, p= 0.038). There were no significant differences in their serum FSH and Testosterone (F= 0.86, p= 0.517 and F= 1.55, p= 0.267) respectively. Histological sections of the testes showed mild to moderate inflammation and hyalinization (1000mg/kg, 500mg/kg, 100mg/kg) with reduced spermatogenesis in dose dependent manner. Khaya senegalensis may have aphrodisiac properties at 500mg/kg as the perceived sexual behaviors increased with this dose of the KSE. Khaya senegalensis can adversely affect the morphology of the testis in a dose dependent manner.

[#38] Resistance Modulation Effects AND Time-Kill Kinetics Assay of Plumbagin from Plumbago zeylanica Linn

E. B. A Adusei 1, R.K Adosraku 1, J Oppong-Kyekyeku1, C.D Amengor2 1Department of Pharmaceutical Chemistry, Faculty of Pharmacy and Pharmaceutical Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, 2Department of Pharmaceutical Chemistry, School of Pharmacy, University of Health and Allied Sciences Ho. Email: [email protected] Antimicrobial resistance is a threat to the prevention and treatment of the increasing range of infectious diseases. Modulation of the activities of these agents by phytochemicals and other natural products may reverse the mechanism of resistance developed by microbes against them. The modulation effect of plumbagin isolated from the roots of Plumbago zeylanica Linn on commonly used antibiotics and an antifungal was investigated in this study. The Micro-broth dilution method was used to obtain the Minimum inhibitory concentrations (MICs) of plumbagin and the standard drugs. The MICs of the standard agents were re-determined in the presence of sub-inhibitory concentration of plumbagin (4 µg/µL). Plumbagin showed activity against Staphylococcus aureus, Escherichia coli, Klebsiella pneumonia, Pseudomonas aeruginosa, and Candida albicans with MICs of 0.5, 8, 2, 8, and 4 µg/µL respectively. The MICs of the standard drugs namely ciprofloxacin, ampicillin, amoxicillin, and ketoconazole ranged from 2 - 64 µg/µL. Ciprofloxacin’s activity potentiated by 2- folds and 4-folds against Staphylococcus aureus, and Escherichia coli respectively, decreased by 4-folds against Klebsiella pneumonia and remained the same against Pseudomonas aeruginosa. Activity of amoxicillin potentiated by 2-folds, 2-folds, and 6-folds against Staphylococcus aureus, Escherichia coli, and Klebsiella pneumonia respectively, it decreased by 2-folds against Pseudomonas aeruginosa. Ampicillin’s activity potentiated by 6- folds, 2- folds, and 6-folds against Staphylococcus aureus, Escherichia coli, and Klebsiella pneumonia respectively, and decreased by 2-folds against Pseudomonas aeruginosa. Ketoconazole’s activity potentiated by 12-folds against Candida albicans in the presence of sub- inhibitory concentration of plumbagin. Time-kill kinetics assay has established plumbagin to be bacteriostatic and fungistatic. Plumbagin has been proven through this study to be a suitable lead compound in antimicrobial resistance drug development

[#39] Profiling Immuno-Metabolic and Biochemical Risk Factors in Metformin Treated Type 2 Diabetes Patients in Ghana.

S. A. Sakyi1, R. Mantey1, E. F. Laing1, O. S. Kantanka2, S. O. Asibey 2, D. Boakye3, E. Anto1, 4 J. Boachie5

1Department of Molecular Medicine. School of Medical Sciences, Kwame Nkrumah University of Science and Technology, 2Diabetes Unit, Komfo Anokye Teaching Hospital (KATH) 3Department of Cancer Epidemiology, German Research Center, 4School of Medical and Health Sciences, Edith Cowan University, Perth 6027, Western Australia, 5Department of Allied Health Sciences, Radford University College.

E-mail: [email protected]

Gastric parietal cells secret intrinsic factor which plays a vital role in the absorption of vitamin B12 in the human. Metformin use has been linked to vitamin B12 deficiency among type 2 diabetes mellitus patients (T2DM) .Even though accumulating evidence suggest that patients with positive gastric parietal cell antibodies( PCA) usually have low serum B12 levels, there is limited attempt to explore this association among metformin –treated type 2 diabetes patients who are thought to actively these exhibit autoantibodies. This study determined the immuno-metabolic and biochemical risk factors of vitamin B12 deficiency among type 2 diabetes patients (T2DM) patients on metformin. In a hospital-based cross-sectional study design, 209 participants were recruited from the diabetic clinic of Komfo Anokye Teaching Hospital, (KATH). Serum vitamin B12, gastric parietal cell antibodies (PCA), Intrinsic factor antibodies (AIF) and calcium were measured using immunoassay (Sandwich and direct ELISA assay). Logistic regression analysis was used to assess the independent risk factors associated with vitamin B12 deficiency and dosage of metformin. The overall prevalence of vitamin B12 deficiency and gastric parietal cell antibody among the study participants were 27.3% (57/209) and 6.2% (12/209) respectively. After adjusting for possible confounding factors in a logistic regression model, participants with high levels of gastric parietal cell antibodies had over 8-fold higher risk of developing vitamin B12 deficiency {OR=8.0, CI= (2.2-29.2) p=(0.002)}. Current smokers among the participants had 90% lower odds of developing vitamin B12 deficiency compared to never smokers {OR=0.1 CI= (0.0-0.8) p=(0.017)}. PCA and smoking were independent significant risk factors associated with vitamin B12 deficiency. Metformin -treated T2DM patents with vitamin B12 deficiency may exhibit positivity to PCA, hence physicians should assess these patients both clinically and serologically in order to improve treatment outcomes.

[#40] Antigenic Interaction between P. falciparum Sexual Stage Antigens Pfs230.pro and Pfs48/45.6C in Combined Immunization Alters the Antibody Kinetics in Favour of anti- Pfs230.pro antibodies S. Kusi1, 2, T. Sarkodie-Addo1, C.K. Sinclear1, S.K. Singh3, M.T. Frempong2, D. Dodoo1, M. Theisen3, B. Adu1 1Department of Immunology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Ghana, 2Department of Molecular Medicine, SMD, Kwame Nkrumah University of Science and Technology, Kumasi, 3Centre for Medical Parasitology, University of Copenhagen, Copenhagen, Denmark Email: [email protected] Plasmodium falciparum sexual stage antigens Pfs230 and Pfs48/45 are promising transmission- blocking (TB) vaccine candidates. Growing evidence suggests that the concentrations of antibodies against these antigens correlate with their efficacies at reducing human infectivity to mosquitoes. Thus, an understanding of the vaccine parameters that influence the antibody output of these antigens will aid TB vaccine design. Here, we tested the hypothesis that the antibody kinetics varies between single and combined immunizations in a dose-dependent manner. Wistar rats, 5 per group, were immunized with 1.5µg/mL of the recombinant subunits of the antigens (designated as Pfs230.pro and Pfs48/45.6C) both in separate and combined formulations using alum as adjuvant. This formulation series was repeated at 6.0µg/mL dose level in separate groups. Booster shots were administered on days 21 and 42. Rats were pre-bled 8 days prior to immunization and antisera were collected on days 20, 41, 63, 102, 125 and 151 post-immunization. Application of the Bliss independence model revealed a Pfs230.pro-biased, dose-dependent, synergistic interaction between Pfs230.pro and Pfs48/45.6C at the 1.5µg dose level but not at the 6µg dose level. Modeling of the antibody kinetics showed significant differences in the antibody growth and decay rates among the different formulations. The anti-Pfs230.pro antibodies from the combined formulation (1.5 µg) peaked earliest (day 37) but was about two-fold less in magnitude than the response from the Pfs230.pro (6.0µg) single formulation, which, while yielding the strongest antibody response, nonetheless peaked latest (day 59). Our results imply that TB vaccines prioritizing rapid anti-Pfs230.pro antibody responses will benefit from the strategy of combining low doses of Pfs230.pro and Pfs48/45.6C.

[#41] Urinary Iodine Concentration and Thyroid Volume of Pregnant Women Attending Antenatal Care in Two Selected Hospitals in Ashanti Region, Ghana: A Comparative Cross-Sectional Study. D. Gyamfi1, Y.A. Wiafe2, K.O. Danquah1, E. Adankwah1, G. A. Amissah1, A. Odame2 1Dept of Medical Diagnostics, Faculty of Allied Health Sciences, KNUST 2Department of Sonography, Faculty of Allied Health Sciences, KNUST, Email: [email protected] Iodine deficiency is a major public health problem affecting people worldwide, particularly pregnant women. Iodine requirements increase substantially during pregnancy, making pregnant women vulnerable to iodine deficiency and its disorders such as abortions, stillbirths and pregnancy goitre as well as congenital abnormalities in their children. The primary aim of this study was to evaluate the prevalence of iodine deficiency and goitre among pregnant women attending antenatal sessions. A cross-sectional study was carried out in 239 pregnant women who attended the antenatal clinic at Kwame Nkrumah University of Science and Technology (KNUST) Hospital or Ejura District Hospital. Sociodemographic data and information related to iodine were captured using a questionnaire. Urinary iodine concentration (UIC) was determined on spot urine samples using the Sandell-Kolthoff reaction with ammonium persulfate as digesting agent. Each woman’s thyroid volume was also measured by ultrasonography.The overall median UIC was 155.9µg/L, indicating adequate iodine intake in the study population. However, goitre prevalence in the pregnant women was 11.3%, denoting mild iodine deficiency. The median UIC for pregnant women who attended KNUST Hospital was higher (163.8 µg/L) than that of Ejura District Hospital (149.0 µg/L). The proportion of women who did not consume iodised salt was significantly higher (p<0.001) in Ejura District Hospital (71.2%) than KNUST Hospital (28.0%). In total, 47.3% of the pregnant women studied had a UIC < 150 µg/L. Only 16.3% knew about the increase in iodine requirement during pregnancy. Iodine deficiency and goitre still exist among some pregnant women. Thus, assessment and continuous monitoring of iodine nutritional status in pregnant women in the country are warranted.

[#42] Baseline Prospective Study of the Incidence and Risk Factors for Retinopathy of Prematurity in Korle-Bu Teaching Hospital.

I.Z. Braimah 1,2, V.A. Essuman 1,2, A.H. Sackey 1,3, I.D.B. Ofori-Adjei 2, E. Kenu4, A. Oku, V. Beyuo, C. Enweronu-Laryea1,3.

1School of Medicine and Dentistry, University of Ghana, 2 Eye Centre, Korle- Bu Teaching Hospital. Korle- Bu, 3Department of Child Health, Korle-Bu, 4Department of Epidemiology, School of Public Health, University of Ghana.

Email: [email protected]; [email protected]

New technologies and improvements in neonatal care have led to increasing survival of premature babies in low- and middle- income countries. However, survivors are at increased risk of morbidities associated with prematurity and complications of hospital care such as blindness from retinopathy of prematurity (ROP). Early diagnosis of these morbidities improves long-term outcome. There is no data on incidence of ROP, and limited data on the risk factors for retinopathy of prematurity in preterm babies in Ghana.The aim of this study is to determine the incidence and associated risk factors of ROP among preterm babies at the Neonatal Intensive Care Unit (NICU) of Korle-Bu Teaching Hospital (KBTH). We undertook this prospective study on preterm babies (birth weight less than 2Kg or gestational age less than 37 weeks) admitted to the NICU of KBTH from June 2018 to February 2019. Eligible babies were examined at scheduled interval until full maturity of their retina. The incidence rate for ROP and frequencies of ROP, type 1 ROP, and risk factors were computed. Four hundred and one preterm babies [222 (55.4%) females] were included in this study. The mean gestational age (GA) of the babies was 32.26±2.39 weeks and their mean birth weight was 1.61±0.43Kg. Fifty-five (13.7%) of babies examined had ROP and 7 (1.75%) had type 1 ROP. The cumulative incidence of ROP over the study period was 13.7% (95%CI: 10.5, 17.5%). Length of admission more than 4 weeks, GA less than 32 weeks, female sex , birth weight less than 1.5kg, delivery by caesarian section, confirmed sepsis, tube feeding and poor pupil dilatation were significantly predictive of the risk of ROP (p<0.05).

[#43] Naturally Acquired IgG to Plasmodium falciparum MSP3 is Associated with Protection against Febrile Malaria in a Cohort of Ghanaian Children Living in a Low Transmission Area. E. Kyei-Baafour1, K. A. Kusi1, S. K Singh2 F.K.N. Arthur3, E. Owusu-Yeboa1, M. Theisen2,4, D. Dodoo1, B. Adu1 1Immunology Department, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon Accra, 2Centre for Medical Parasitology at Department of International Health, Immunology and Microbiology, University of Copenhagen and Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark 3Department of Biochemistry and Biotechnology, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, 4Department for Congenital Disorders, Statens Serum Institut, Copenhagen, Denmark.

E-mail: [email protected] Malaria continues to be the biggest challenge to public health systems in sub-Saharan Africa. Efforts to create potent blood stage vaccine have been unsuccessful though antibodies confer protective immunity in individuals naturally exposed to Plasmodium falciparum. This study sought to investigate association between naturally acquired antibody to merozoite antigens and protection against febrile malaria. Ghanaian children (N=973, aged 0.5 to13 years) were enrolled in a 50-week longitudinal malaria cohort study with both active and passive case detection. At the end of the follow up children were classified as either, protected, susceptible or uninfected based on infection status. Total IgG responses in their baseline plasma samples against five recombinant antigens (MSP3, N-MSP3, C-MSP3, GLURP-R0, and GLURP-R2) were measured using indirect ELISA to assess associations with malaria. Children in the protected group were significantly (p<0.0001) older (8.7 ± 3.1 years) than those in the susceptible group (6.7 ± 3.2 years) and IgG levels increased with age. Baseline asymptomatic parasitemia was significantly higher in the protected children (2567 parasites/ul of blood) than the susceptible group (559 parasites/ul, p=0.026). After adjusting for age and ABO blood groups, only IgG against MSP3 (IRR, 0.67; CI95%, 0.49-0.92; p=0.013), and N-MSP3 (IRR, 0.62; CI95%, 0.42-0.94; P=0.024) were significantly associated with reduced incidence of febrile malaria. Our data supports further development of MSP3-based vaccines or their inclusion in future multi-antigen vaccines with other important candidates.

[#44] Quality Assessment and Clinical Evaluation of the Safety and Effectiveness of a Ghanaian Hepatorestorative Polyherbal Product (Hpk) at the Wa Regional Hospital A. O. Agyemang1, M.L.K. Mensah2, R. C. Yamile3, A. Ocloo4, A.A. Appiah4, A.Y. Mensah1, K.P. Thomford2

1Dept. of Pharmacognosy, KNUST, Kumasi, 2Dept. of Herbal Medicine, KNUST, Kumasi; 3Dept. of Medicine, Upper West Regional Hospital, Wa, 4Centre for Plant Medicine Research, Mampong-Akuapem

E-mail: [email protected] Liver diseases are increasing globally and many clients in developing countries like Ghana tend to use herbal products for their treatment but most of these products have not been studied scientifically. The study aimed at establishing product quality, safety and effectiveness outcomes from the treatment of patients with deranged liver functions using a Ghanaian polyherbal product, HPK. HPK is a decoction prepared from three medicinal plants: Bidens pilosa, Citrus aurantifolia and Trema orientalis. Quality parameters of HPK were assessed through physicochemical, microbiological, spectroscopic and chromatographic analysis. Atomic Absorption Spectroscopy (AAS) was used for heavy metals analysis. Fifty clients were recruited for the clinical study at the Upper West Regional Hospital. Participants took HPK 30 ml 8 hourly for 28 days. Laboratory investigations (LFT, RFT, FBC and Urine R/E) were undertaken at day 0 (baseline), 14 and 28 to assess for safety and effectiveness of HPK. The product contains alkaloids, tannins, saponins, coumarins, flavonoids and phytosterols. HPLC, TLC, UV and FTIR fingerprints were established. Microbiological cultures did not show any observable contamination of the HPK. Lead, Mercury, Nickel, Cadmium and Arsenic content levels were within safe WHO reference ranges. Compared to baseline values, HPK showed no detectable toxicity on renal function, haematological parameters and urinalysis in the patients after the 28-day period. However, HPK significantly improved the liver function of the participants: AST (p - 0.0001), ALT (p < 0.0001), GGT (p - 0.0017), total bilirubin (p - 0.0146), direct bilirubin (p < 0.0001) and alkaline phosphates (p - 0.0295). The other parameters showed no significant differences within the study period. Within the limits of the study, HPK had hepatorestorative action with no observable toxicity and can be used with confidence as indicated as a liver tonic.

[#45] Assessment of biochemical and neurological risk factors among metformin-treated type 2 diabetes in Ghana S. A. Sakyi1, R. Mantey1, E. F. Laing 1, O. S. kantanka2, S. O. Asibey 2, D. Boakye3, E. Anto1,4 and J. Boachie5 1Department of Molecular Medicine. Kwame Nkrumah University of Science and Technology 2Diabetes unit, Komfo Anokye Teaching Hospital (KATH), 3Department of cancer Epidemiology, German Research Center, 4School of Medical and Health Sciences, Edith Cowan University, Perth 6027, Western Australia, 5Department of allied health sciences, Radford University College E-mail: [email protected] Diabetes mellitus (DM) is a metabolic disorder characterized by persistent elevation of blood glucose due to insulin insufficiency or resistance. Metformin is the recommended drug for the management of type 2 diabetes mellitus (T2DM). Its use however, is associated with several adverse effects including vitamin B12 deficiency and peripheral neuropathy (PN). Even though metformin-induced vitamin B12 deficiency has been researched and reported, routine screening of B12 is not done among T2DM patients. This study determined the prevalence of vitamin B12 deficiency, peripheral neuropathy and its biochemical implications in the management of T2DM patients on metformin. Using a hospital-based cross-sectional study design, 209 participants were recruited from the diabetic clinic of Komfo Anokye Teaching Hospital, (KATH). The Michigan Neuropathy screening instrument (MNSI) 2001 version was used to assess evidence of peripheral neuropathy among the subjects. Serum vitamin B12, holotranscobalamin (holo TC), Homocysteine (HCy) and methyl malonic acid (MMA), were measured using immunoassay (Sandwich and direct ELISA assay). Logistic regression analysis was used to assess the

[#46] Perception of Health Workers on the Reproductive Health of Women with Disabilities in Jirapa, Ghana. P. Dangyi, W. K. Mprah, I. Owusu, Centre for Disability and Rehabilitation Studies Kwame Nkrumah University of Science and Technology, Kumasi Email: [email protected]

Women with disabilities seem to have a higher risk for sexually-related abuses either by their partners or misguided persons. Socio-cultural beliefs and perceptions play important roles in exposing these women to such abuses. Inspite of these, most of them are denied support services that would facilitate their access to sexual and reproductive health information and services, sometimes, by healthcare workers. This study examined perceptions of healthcare providers towards the sexual and reproductive health of women with disabilities. It also assessed challenges women with disabilities encounter in their quest to access sexual and reproductive health services and information. The study was quantitative and used using questionnaires to collect data from respondents. A total of 45 health professionals were selected based on convenience sampling for the study. Results showed that health workers generally have negative perception about sexual reproductive health of women with disability. Among the views expressed by most respondents included the fact that women with disability are not sexually active; should have separate consulting rooms; should not be allowed to get married. Most were also of the opinion that they feel uncomfortable treating women with disabilities. Also, inaccessibility of healthcare facilities, high-cost maternity care and lack of specificity of health information in addressing the sexual and reproductive health needs of women with disability were identified as potential challenges women with disability could face in assessing sexual and reproductive health services. The study among others recommends the introduction of disability studies as part of the curriculum of health training institutions and or the organisation short courses, seminars, workshops, periodically for health care professionals to update their knowledge on disability issues.

[#47] Implementation challenges of Quality Assurance (QA) initiatives: a qualitative assessment in Public University Hospitals in Ghana

M. Abnory, K. A. Mensah, E. Owusu-Dabo

School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi,

Email: [email protected]

Quality assurance (QA) initiatives in hospitals are diverse and iterative in nature requiring various inputs and interactions to produce the expected quality standards. Quality assurance initiatives in hospitals is an absolute imperative because the quality of the service standards is a function of the kinds and quality of inputs and processes. This means that quality assurance initiatives and outcomes in hospitals heavily rely on the compatibility with the inputs and processes. The study sought to find out the implementation challenges of QA initiatives in two university hospitals in Ghana. A qualitative approach was adopted using semi-structured interview guide to collect data from 11 management team members of the two university hospitals; the University of Ghana and the Kwame Nkrumah University of Science and Technology. The interviews were conducted using English language, were audio recorded and transcribed verbatim. The data were analysed thematically facilitated by manual analysis. The qualitative findings were based on four themes which demonstrated enormous challenges. These included; availability of human resources to support QA initiatives, Attitudes of staff towards QA initiatives, financial support for QA initiatives and availability of equipment for QA initiatives. Majority of the respondents mentioned inadequate human resource, inadequate financial support and inadequate equipment as major challenges to the implementation of QA initiatives. Also, poor attitudes of staff and management, and lack of motivations for both staff and management were identified as minor challenges impeding successful implementation of QA initiatives in the hospitals. The study demonstrated the benefits of QA initiatives in both hospitals. However, over reliance on subsidies and undue delay of reimbursement of claims from the National Health Insurance Scheme Authority (NHIA) were identified as key challenges impeding successful implementation of QA initiatives.

[#48] Depleted Iron Stores in Voluntary Blood Donors: A Three-Centre Cross-Sectional Study in Ghana.

1 1 1 1 1 1 P. Adu , D. Bennin , R. A. Edzie , A. G. Owusu-Poku , T. U. Hakeem , G. O. Baba , E. K. M. Edzie2

1Department of Medical Laboratory Sciences, School of Allied Health Sciences, University of Cape Coast, Ghana. 2Department of Radiology, School of Medical Sciences, University of Cape Coast, Ghana.

Email: [email protected]

Blood donation is frequently associated with iron deficiency. Although iron deficiency is endemic in Ghana, there is scarcity of data on iron stores in blood donors to inform donor recruitment policy. This study determined the prevalence and factors predictive of depleted iron stores in blood donors. This cross-sectional study recruited 287 blood donors from three regions in Ghana. Venous blood samples were collected for estimation of C-reactive protein, full blood count and serum ferritin. Questionnaires were used to capture socio-demographic data. Data was analysed using SPSS or GraphPad Prism. Multivariate logistic regression and receiver operator characteristics (ROC) analyses were respectively used to determine the factors associated with depleted iron stores or sensitivities of calculated red cell indices in predicting depleted iron stores in the participants. Whereas 27.4% of the blood donors had depleted iron stores (ferritin <15 ng/dL), only 11% took iron supplementation. While ferritin levels significantly increased with age, 49.5% of the blood donors were aged 20 – 29 years. Whereas 39.5% of participants had never donated blood, 24.9% had donated ≥3 units of whole blood in the past 2 years. Female (aOR: 7.407, p = 0.005), multiple previous donations [1 – 2 (aOR: 1.846, p = 0.431); ≥3 (aOR: 6.297, p = 0.016)], no iron supplementation (aOR: 17.553, p = 0.078), or platelet count ≥150 x 109/L (aOR: 2.689, p = 0.354) significantly associated with iron depletion. ROC analyses showed that whereas MCHD (AUC: 0.735, p<0.01), MCH (AUC: 0.772, p <0.01) or Shine and Lal (AUC: 0.736, p <0.01) fairly predicted iron depletion, CCI (AUC: 0.660, p <0.01) or Green & King (AUC: 0.603, p <0.01) indices poorly predicted iron depletion. More than quarter of voluntary blood donors suffer post- donation sideropenia and must be addressed. Calculated red cell indices should be investigated in different settings to validate usefulness in detecting iron depletion.

[#49] Methicillin Resistant Staphylococcus aureus Carriage among Healthcare Workers at the Komfo Anokye Teaching Hospital in Ghana E. Darko1, A. Owusu-Ofori1, 2, K. G. Boahen3, M. Heinemann4, C. Vinnemier4, 5 1Dept. of Clinical Microbiology, School of Medical Sciences and Dentistry, KNUST, Ghana, 2Dept. of Clinical Microbiology Laboratory, KATH, Ghana, 3Kumasi Centre for Collaborative Research in Tropical Medicine, Ghana, 4Dept. of Medicine, University Medical Center Hamburg-Eppendorf, Germany, 5Bernhard Nocht Institute for Tropical Medicine, Clinical Research Group, Hamburg, Germany. Email: [email protected] Nosocomial infection is a worldwide problem and Methicillin-resistant Staphylococcus aureus (MRSA) is one of the causative pathogens. MRSA carriage among healthcare workers (HCW’s) is a significant risk factor for patients. This study sought to determine the carriage of MRSA among HCW’s at the Komfo Anokye Teaching Hospital (KATH). A cross-sectional study was conducted from January 2017 to December 2018. Paired nasal and interdigital swabs taken from 360 HCW’s in three clinical directorates of KATH, namely child health, surgery and diagnostics were cultured on mannitol salt agar. MRSA isolates that were phenotypically identified by their resistance to cefoxitin discs by Kirby Bauer’s discs diffusion method were confirmed through the detection of mecA using conventional PCR. To identify risk factors, participants were made to respond to a self-administered questionnaire. Nurses (59.7%), doctors (19.2%), lab scientists (11.1%), healthcare assistants (7.8%) and research assistants (2.2%) were recruited into the study. Hand and nasal carriage of MRSA among HCW’s were 3.3% and 8.6% respectively. The overall prevalence of MRSA among HCW’s was 11.1% (40/360). Midwives (16.0%) and lab scientists (5.0%) recorded the highest and lowest prevalence respectively (p>0.05). The frequency of PVL positives among MRSA isolates was 27.9% (12/43) respectively. Apart from penicillin, against which a 100% resistance was recorded, MRSA isolates also showed high resistance against ampicillin (95.3%), sulfamethoxazole (93.0%) and tetracycline (93.0%). Imipenem (23.3%) recorded the lowest resistance. HCW’s with chronic condition (76.7%), antibiotic usage over the past one month (32.45%), hospitalization (82.5%) and surgical procedure (90.9%) within past one year were found to have significant association with the carriage of MRSA (p < 0.05) and likely to be MRSA carriers (Odd Ratio > 1). Data obtained indicate a high risk of MRSA transmission to patients. Therefore, there is a need for constant monitoring, screening and decolonization of MRSA carriers among HCW's

[#50] Evaluation of the Dynamiker® Cryptococcal Antigen Lateral Flow Assay (CrAg LFA) in the Diagnosis of Cryptococcosis in HIV Patients in Ghana M. A. Nkrumah1, A. Owusu-Ofori1, 2 1Department of Clinical Microbiology, SMD, KNUST, Kumasi. 2Komfo Anokye Teaching Hospital, Kumasi. Email: [email protected] Disseminated cryptococcosis has recently been identified as the leading invasive fungal disease (IFD) in HIV/AIDS patients in Sub-Saharan Africa, with mortality rates as high as 15% of HIV/AIDS deaths. However, there are no definite records of such information in recent times in Ghana. Recently, the Dynamiker® Cryptococcal Antigen (CrAg) Lateral Flow Assay (LFA) was introduced as a rapid diagnostic test for Cryptococcosis. Our purpose for this study was thus to evaluate its performance in the diagnosis of Cryptococcosis, especially in HIV/AIDS patients in Ghana. The study was conducted from August to September, 2018 and included 80 historical serum samples from HIV seropositive patients reporting at the Komfo Anokye Teaching Hospital (KATH), Kumasi-Ghana. A qualitative test for the CrAg was done using the Dynamiker® CrAg LFA as per the manufacturer’s recommendations. The LFA results were recorded as positive (++), weakly positive (+) and negative (--). Testing was also categorized as per HIV seropositive patients receiving Antiretroviral Therapy (ART) regimen (50) and ART-naïve (30) to actualize possible inferences. An incidence rate of 11.25% (9/80) for disseminated Cryptococcosis was obtained, with 7 showing as positive, 2 as weakly positive and 71 as negative. 10.00% (5/50) of patients on ART tested positive, with 13.00% (4/30) ART-naïve patients testing positive for Cryptococcosis; proving no significant association between ART regimen and positive test for Cryptococcosis (p<0.05). No significant association was seen in age or sex distribution and infection. This highlighted the low limit of detection of the Dynamiker® CrAg LFA in testing for Cryptococcosis; a good parameter in clinical diagnoses. The study identified a likely case for Cryptococcosis in HIV/AIDS patients in Ghana (11.25% incidence), while showing that ART is not significantly associated with the present incidence of Cryptococcosis in Ghana. Further studies would now be conducted to evaluate the sensitivity and specificity of the assay.

[#51] “When I [hit]…I tell the mother, I am sorry…I wouldn’t have hit you if not for your baby's life:” Exploring Midwives’ Views on Disrespect and Abusive Care.

V. M. Dzomeku1, A. B. Bonsu1, Emmanuel K. Nakua2, P. Agbadi1, P. Donkor3, 4, J. R. Lori5 1Department of Nursing, Faculty of Allied Health Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana. 2Department of Epidemiology and Biostatistics, School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana. 3Department of Surgery, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana. 4Komfo Anokye Teaching Hospital, Kumasi, Ghana. 5School of Nursing, University of Michigan, USA. Email: [email protected] Caregivers’ disrespect and abuse of childbearing women have deleterious consequences on maternal and neonatal health. Thus, understanding stakeholders’ views on the subject are critical to addressing the threat. Views of many stakeholders, except midwives, on disrespect and abusive care are common. This paper, therefore, explored the views of midwives on disrespect and abusive care and their occurrences in professional practice at in a tertiary health facility in Kumasi, Ghana. Phenomenological qualitative research design was employed in the study. Data were generated through face-to-face in-depth interviews. Data saturation was reached with fifteen midwives. The interviews were audio-recorded and transcribed verbatim. Open Code 4.03 was used to manage and analyze the data. The midwives understood disrespect and abusive care. They also confirmed meting out or witnessing colleagues engage in disrespect and abusive care in their professional practice. Socioeconomic inequalities and health system structures and processes emerged as facilitators of disrespect and abusive care. Frequent in-service training on respectful maternity care and monitoring of care provision in healthcare facilities are needed to eliminate the incidence of disrespect and abusive care.

POSTER PRESENTATIONS P001 - A Field-Deployable Recombinase Polymerase Amplification Assay for the Rapid Diagnosis of Buruli Ulcer in Endemic Communities. H. S. Ahor1,2, F. Michael1, A. Abd El Wahed3, S. A. Sakyi2, B. Agbavor1, F. Sarpong1, K. Laing4, M. Wansbrough-Jones4, R. Phillips1,2 1Kumasi Centre for Collaborative Research in Tropical Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana. 2School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana. 3Division of Microbiology and Animal Hygiene, Georg-August University, Goettingen, Germany. 4Institute for Infection and Immunity, St. George’s University of London, London, United Kingdom.

Email: [email protected]

Access to accurate diagnostic test for Buruli ulcer (BU), a necrotic skin disease, is a research priority according to the World Health Organization. Nucleic acid amplification of the insertion sequence IS2404 of Mycobacterium ulcerans, the causative agent of BU, by polymerase chain reaction (PCR) is the gold standard diagnostic tool. However, PCR is not always available in endemic communities in Africa due to its cost and technological sophistication. Recombinase polymerase amplification (RPA), an Isothermal DNA amplification system, has emerged as a molecular diagnostic tool with similar accuracy to PCR but having the advantage of amplifying DNA template at a constant lower temperature in a shorter time. This study aimed to develop an RPA assay for the detection of M. ulcerans and evaluate its use in Buruli ulcer diagnosis. A specific fragment of M. ulcerans IS2404 was amplified within 15 minutes at a constant 42 oC using RPA. The detection limit was 45 copies of IS2404 molecular DNA standard per reaction. The assay was highly specific as all 7 strains of M. ulcerans tested were detected, and no cross reactivity was observed to other mycobacteria or clinically relevant bacterial species. The diagnostic performance of the M. ulcerans-RPA (Mu-RPA) assay was evaluated using retrospective DNA extracted from clinical samples of 79 BU suspected patients and non-BU lesions. The clinical specificity of the Mu-RPA assay was 100% (95% CI, 84 – 100), whiles the sensitivity was 88% (95% CI, 77- 95) when compared to PCR. The Mu-RPA assay has been combined with a mobile suitcase laboratory platform which allows a quick DNA extraction of patient samples for rapid diagnosis of Buruli ulcer (Bu) cases at point of need. This format provided timely results to health workers at Buruli ulcer treatment clinics in endemic districts and represents an alternative to PCR in resource limited setting.

P002 - Antibiotic Resistant Bacteria Isolated from Infected Wounds in Rural Community Dwellers in Northern Ghana.

E. K. Vicar1, S. E. K. Acquah1, W. Williams1, E. D. Kuugbee1, C. S. Saba2, J. B. Ziem1, G. I. Mensah3,4.

1Clinical Microbiology Department, University for Development Studies, Tamale, 2Biotechnology Department, University for Development Studies, Tamale, Ghana. 3Bacteriology Department, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana. 4Afrique One-ASPIRE (African Science Partnership for Intervention Research) Consortium.

Email: [email protected]

Wound infections are a major health problem worldwide, particularly in rural communities with limited access to primary healthcare. In most cases, wounds are reported to healthcare facilities in their advanced state. This study determined the prevalence, aetiology and susceptibility profile of bacterial agents of wound infection in rural community dwellers in Northern Ghana. We conducted a prospective study in four (4) health facilities from August 2017 to July 2018. Patients that reported with any form of infected wound were recruited after consenting to be part of the study. Wounds were aseptically swabbed and cultured. API 20E and API 20NE were used to identify gram negative bacteria while Catalase, coagulase and other agglutination test kits were used to identify gram positive bacteria. Antimicrobial susceptibility tests were performed on all the isolates using agar disc diffusion method according to Clinical and Laboratory Standards Institute CLSI 2007 guidelines. A total of 165 bacteria isolates were obtained from the 93 wound swabs. The most predominant species were Staphylococcus aureus 38(23.0%) followed by Pseudomonas aeruginosa 27(19.7%), Klebsiella pneumoniae 15(9.1%), Enterococcus Faecalis 13(7.9%), Proteus mirabillis 12(7.3%), Acinetobacter sp. 12(7.3%), Escherichia coli 10(6.1%), Streptococcus pyogenes 10(6.1%), Enterobacter cloacae 8(4.8%), Citrobacter fruendii 5(3.0%), Klebsiella oxytoca 5(3.0%), Proteus vulgaris 4(2.4%), Providencia stuaris 3(1.8%) and Serratia sp. 3(1.8%). Majority of the isolates were from burns 61(37.0%) and diabetic wounds 33 (20.0%), with few from motor traffic wounds 5(3.0%). Most of the isolates were resistant to third generation cephalosporins. Notably, all (100%) of the Acinetobacter and Providencia species and 75% of Proteus species were resistant to ceftazidime and ceftriaxone. High Resistance to ceftazidime and ceftriaxone was also observed in K. pneumoniae (53.3% and 53.3%) and E. coli (60.0% and 50.0%) respectively Resistance to Streptococcus pyogenes was 60% and 70% to penicillin and erythromycin respectively while 10.5 % of the Staphylococcus aureus isolates were methicillin resistant (MSRA). Our study reveals a wide range of bacterial agents associated with wound infection are resistant to the commonly used antimicrobial agents. Additionally, the study suggests relatively high antimicrobial resistance is associated with community acquired infection.

P003 - Cyclooxygenase and Lipoxygenase Gene Expression in Preeclampsia and Placental Malaria Co-Morbidity

R. Darko1, D. Obiri2, 3, E. Tagoe2, D. Amoako-Sakyi1, K. A. Kusi2, 3, B. Gyan3

1College of Health and Allied Sciences, School of Medical Sciences, Department of Microbiology and Immunology, University of Cape Coast, Cape Coast, 2West African Centre for Cell Biology of Infectious Pathogens, Department of Biochemistry, Cell and Molecular Biology, University of Ghana, Legon, 3Department of Immunology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon.

Email: [email protected]

Despite the decrease in maternal deaths globally, pregnancy-related complications remain a challenge. Though unskilled health personnel and pregnancy-related complications such as sepsis, severe bleeding and unsafe abortions have been implicated for this high maternal mortality rate, placental malaria and hypertensive diseases such as preeclampsia are also major complications of pregnancy in malaria endemic regions. Several researchers have established an association between placental malaria and preeclampsia development in Africa. Expressions of COX and LOX that metabolize arachidonic acids into prostaglandins are reported to be involved in pregnancy- related pathology such as preeclampsia and placental malaria. This study sought to assess whether the association between preeclampsia and placental malaria is through induction of either COX-1, COX-2, or 15-LOX by malaria infection. A total of 134 pregnant women comprised of 69 patients diagnosed with preeclampsia and 65 normotensive women of gestational age ≥20 weeks and attending antenatal clinic at the Korle-Bu Teaching Hospital in Accra were recruited into the study. Placental tissues were collected after delivery and fixed in 10% buffered formalin and embedded in paraffin (FFPE). Placental malaria parasites were detected by PCR. FFPE blocks from 25 patients and 25 controls were randomly retrieved and sections prepared for extraction of total mRNA. The mRNA expression levels for COX-1, COX-2, and 15-LOX in the placental tissues were determined using RT-qPCR. The study reports for the first time an overexpression of COX-2 in Ghanaian women with concurrent placental malaria and preeclampsia compared to those with normotensive pregnancies (p<0.05). Placental malaria increased the risk of developing preeclampsia (OR=2.1, 95% IC=1.09-4.18, p=0.039). There were no significant differences in levels of COX-1 and 15-LOX between patients diagnosed with preeclampsia and normotensive women. Malaria parasite infection of the placenta is associated with preeclampsia, and overexpression of COX-2 may explain the pathophysiological condition.

P004 - Impact of Allelic Polymorphisms in Plasmodium Falciparum Apical Membrane Antigen 1 on the Induction of Potent T-Cell Responses in Malaria Endemic Communities in Ghana.

E. A. Ofori1, 2, J. K. A. Tetteh2, M. F. Ofori1, 2, K. A. Kusi1, 2

1West Africa Centre for Cell Biology of Infectious Disease, Department of Biochemistry, Cell and molecular Biology, College of Applied Sciences; University of Ghana, Legon, Accra, 2Department of immunology, Noguchi Memorial Institute for Medical Research, College of Health Science, University of Ghana, Legon, Accra.

Email: [email protected]

The eradication of malaria requires a combined effort involving all available control tools, and these efforts would be complemented by an effective vaccine. For a malaria vaccine to be effective, it should be capable of inducing protective immune responses against variant forms of the malaria parasite and in a genetically diverse population. Allelic polymorphisms in antigens that are targets of protective immune responses are a major drawback to the development of vaccines. This study investigated the influence of allelic polymorphisms in peptide sequences from the Apical Membrane Antigen 1 (AMA-1) of three strains of P. falciparum (3D7, 7G8 and FVO) on their function as targets of immunodominant T cell responses. PBMCs were obtained from subjects from low and high malaria transmission areas and tested against 15 synthetic PfAMA-1 peptides using ELISpot assay. The 15 peptides represent six groups of allelic peptides from the three parasite strains. A single subject from the high transmission zone responded positive to 4 peptides out of the 15 peptides used which belongs to 3 allelic sets. Assays with CD4+ or CD8+ depleted PBMCs showed that, four (4) subjects had positive CD8+ T cell-specific responses to at least a single peptide while one subject had a positive CD4+ T cell-specific response to two peptides belonging to the same allelic set. Three out of the four subjects with positive CD8+ T cells response, responded to the same single peptide (DVYRPINEHR) and one subject responding positive to the corresponding variants (DVYHPINEHR) within allelic set. Overall, 7 study subject responded positive to 9 of 15 peptides used. Four (4) of the 9 peptides (44.4%) belong to the 3D7 strain while 3 (33.3%) belong to the 7G8 strain. On the basis of this data, polymorphism in PfAMA-1 affects the induction of T- cell response from malaria exposed subjects.

P005 - Observations on Pregnancy Rates Following Cattle Artificial Insemination: The Toll of Late Return to Estrus and Clarion Call for Reproductive Health Screening O. O. Leigh1, L. C. Agbugba1, A. O. Oyewunmi1, J. Atawalna2

1Dept. of Theriogenology, Faculty of Veterinary Medicine, University of Ibadan, Oyo, Nigeria. 2Veterinary Reproduction, School of Veterinary Medicine, College of Health Sciences, KNUST Kumasi, Ghana.

Email: [email protected]

Artificial insemination is an assisted reproduction technique that has been used for decades as a management tool to maximize reproductive efficiency and reduce the risk of disease spread in livestock production. The technique relies on the numerous available protocols of estrus/ovulation synchronization. The ensuing pregnancy rate, which is often used as a yardstick of successful insemination among livestock population, has not been consistent with available literature. Variation in pregnancy rates occur from farm to farm and this may be due to the multifactorial aetiologies of infertility with common symptoms such as early embryonic death, late embryonic death and abortion. We report our observations following artificial insemination of seventy-five apparently healthy cows, from three different farms (n=25 per farm)- FMA, FMB and FMC, that were subjected to ovulation synchronization protocol. Cows were treated using 100 µg Lecirelin® (i/m on d0, d9) with 25 mg Lutalyse® (i/m on d7) and were inseminated at 8th and 16th hours after all treatments. A 60-day non-return to estrus was used as tentative diagnosis of pregnancy which was confirmed via rectal examination on day 90 post-insemination. Between days 36 and 47 post- insemination, 36%, 100% and 20% of cows returned to estrus at FMA, FMB and FMC, respectively. Similarly, 64%, 0% and 80% were pregnant at day 90 post-insemination. The difference between cows which returned to estrus and those pregnant was not significant (P>0.05). These results indicate comparability and competitiveness between incidences of late return to estrus and pregnancy rates on these farms, suggesting the need for pre-breeding and prenatal reproductive health screening, even in apparently healthy cows, in order to improve pregnancy rate and profit margin in livestock husbandry.

P006 - The Impact of Malaria Parasite Diversity on Antibody Titres in Children Living in Endemic Communities in Ghana

Q. A. Issahaque1, S. M. Kumordjie1, E. Owusu-Yeboa1, J. Asante2 E. K Baffour, T.Sarkodie1, D. Dodoo1, B. Adu1

1Department of Immunology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Accra, 2School of Public Health, University of Ghana, Legon, Accra. Email: [email protected]

Malaria remains a major cause of morbidity and mortality globally. However, the development of a potent malaria vaccine is still a challenge. Data on parasite diversity from different geographical areas is crucial to vaccine development. This study aimed at determining the impact of malaria parasite genetic diversity on anti-malarial humoral immune responses in children living in Danfa, a malaria endemic community in Southern Ghana. Healthy children (N=973, aged 0.5-12 years) were recruited into a 50 week longitudinal malaria cohort study in January 2016 to January 2017. Enzyme Immuno-sorbent Assay (ELISA) was used to measure antibody titers against the Plasmodium falciparum merozoite surface protein 1 (MSP1) hybrid antigen and crude antigens of the schizonts stage parasite in baseline plasma samples of the subjects. Plasmodium parasites detection was by both microscopy and polymerase chain reaction (PCR) for species and strain identification. The prevalence of P. falciparum asymptomatic infection at baseline was 6.7% by microscopy and 11.2%. The multiplicity of infection (MOI) due to msp1 (KI, MAD20, RO33) and msp2 (3D7, FC27) allelic families were 2.1 and 1.7 respectively. These findings show that there is a high prevalence of asymptomatic malaria in the study group and a high MOI of the parasite in this community. The study found no association between parasite diversity and antibody titres. Findings from this study provide baseline information for future malaria vaccine development studies

P007 - Sero-Prevalence of Hepatitis B and C Virus Co-Infections and Their Effect on Immuno-Virological Profile in Hiv-1 Positive Pregnant Women in the Brong-Ahafo Region, Ghana. M. T. Frempong1, P. Ntiamoah3, M. E. Annani-Akollor1, W. K. B. A. Owiredu1, O. Addai- Mensah2, E.W. Owiredu3, D. Adu-Gyasi3, E. O. Agyapong4, L. Sallah5

1Dept of Molecular Medicine, SMD, KNUST, Kumasi, 2Dept of Medical Diagnostics, FAHS, KNUST, Kumasi, 3Kintampo Health Research Centre, Kintampo, 4St. Elizabeth Hospital, Hwidiem, Brong-Ahafo Region, 5Dept of Physiology, SMD, KNUST, Kumasi, Ghana

Email: [email protected] Hepatitis B (HBV) and hepatitis C (HCV) virus co-infections in HIV are alarming in pregnancy due to the risk of vertical transmission. This study ascertained the sero-prevalence of HIV/HBV and HIV/HCV co-infections, evaluated the effect of the co-infections on the immunological and virological characteristics and assessed the association between some demographic and lifestyle characteristics and risk of HIV/HBV and HIV/HCV co-infections among pregnant women. In a cross-sectional study conducted at the Anti-Retroviral Therapy clinics of the St. Elizabeth Hospital, Sunyani and the Holy Family Hospital, Techiman, Ghana, 248 consenting pregnant Ghanaian women, 148 diagnosed with HIV [HIV (+)] and 100 HIV negative [HIV (-)], were recruited. A validated questionnaire was used to obtain demographic and lifestyle data. Venous blood samples were obtained and HCV status, hepatitis B profile, CD4+ T cell count, HIV-1 RNA load determined. The sero-prevalence of HIV (+) /HBV, HIV (+) /HCV, HIV (-)/HBV, and HIV (-)/HCV infections were 14.9%, 4.1%, 10.0%, and 12.0% respectively. HIV-1 viral load was not significantly different between HIV/HBV, HIV/HCV co-infection and HIV mono-infection. However, CD4+ T lymphocyte count (364 vs 512 vs 514 cells/µl; p= 0.0009) was significantly lower in HIV/HBV co-infection compared to HIV/HCV and HIV mono-infection respectively. There was no significant association between demographic and lifestyle characteristics and risk of HBV and HCV infections in HIV positive and negative subjects except for late diagnosis of HIV and history of sharing razors blades and pins. The prevalence of HIV (+)/HBV, HIV (+)/HCV, HIV (-)/HBV and HIV (-)/HCV are high among pregnant women in the Brong Ahafo Region of Ghana. HIV/HBV is associated with reduced CD4+ T lymphocyte count but not HIV-1 viral load. Early diagnosis and antenatal education on HIV, HBV and HCV are essential to abate the risk of maternal to child transmission.

P008 - Nasopharyngeal Carriage of Streptococcus pneumoniae among School Children in The Kassena Nankana Districts of Northern Ghana

D. K. Narwortey1, 2, A. Ofori1, A. R. Oduro2

1Dept. of Clinical Microbiology, SMD, KNUST, Kumasi, 2Navrongo Health Research Centre, Navrongo.

Email: [email protected]

Streptococcus pneumoniae is a pathogen which contributes to major health issues worldwide, particularly among children. Persistent increase in pneumococcal disease burden warrants constant monitoring and research surveillance. The study therefore aimed at determining the nasopharyngeal pneumococcal carriage rate and the impact of the 13-valent pneumococcal conjugate vaccine (PCV-13) vaccine on circulating serotypes among school children. Nasopharyngeal swabs were collected from 193 recruited participants, aged between 5-12 years and analyzed per standard microbiological protocols. The overall rate of pneumococcal carriage detected was high, (32%). The prevalence of carriage for vaccine eligible cohort was lower among vaccinated (35%) than unvaccinated children, (75%). Antimicrobial susceptibility analysis revealed the following resistance rates: Ampicillin (1.6%), Ceftriaxone (1.6%), Erythromycin (4.8%), Tetracycline (55.5%) and Trimethoprim (96.8%). Serotyping analysis of pneumococcal isolates revealed 20 distinct serotypes among the study population. These included both vaccine serotypes (VT), 35% and non-vaccine serotypes (NVT), 65%. Predominant serotypes (34 and 11A), both of which were NVT, accounted for a prevalence of 12.8% whilst other serotypes (including both VT and NVT) accounted for three prevalence categories of 7.7% (13, 17F, 18C, 6A), 5.1% (16F, 3, 19F) and 2.6% (10A, 14, 15A, 19B, 28F, 33B, 35B, 4, 40, 6B, 9A). Prevalence of VT observed among vaccinated children was remarkably low (30%) relative to prevalence of NVT (70%). This could be attributable to the drift in serotypes due to the vaccination effect which may risk emergence of non-vaccine type pneumococcal epidemics. Pneumococcal carriage among study population is quite high and may bear major health implications. Moreover, the higher prevalence of the NVT observed may translate into undesirable health challenges and therefore should be of concern to public health.

P009 - Assessment of Endothelial Dysfunction in Ghanaian Women with Preeclampsia

L. A. Fondjo1, W. K. B. A. Owiredu1, W. Tashie1, R. K. D. Ephraim2, L. Asare3, G. K. Peprah4, S. A. Sakyi1, L. Seidu3.

1Department of Molecular Medicine, SMD, KNUST, Kumasi, 2Department of Medical Laboratory Technology, University of Cape Coast, Cape Coast, 3Comboni Hospital, Ho, 4Laboratory Department, Ho Municipal Hospital, Ho.

Email: [email protected]

Preeclampsia (PE) is a major cause of maternal and neonatal morbidity and mortality in sub- Saharan Africa. Evidence indicates that endothelial dysfunction is central to the pathogenesis of PE. Altered nitric oxide (NO·) bioavailability has been implicated in the pathogenesis of endothelial dysfunction. This study assessed the levels and correlations between markers of endothelial dysfunction and adverse pregnancy outcomes in PE to investigate the roles of these factors in this disorder. This case-control study was conducted among pregnant women visiting Comboni Hospital from January 2017 to May 2018. A total of 180 pregnant women comprised of 88 preeclamptic women and 92 healthy normotensive pregnant (NP) women were recruited. Socio- demographic, clinical and obstetric history were obtained. Blood pressure and anthropometrics were measured, and blood samples were collected for the estimation of NO·, L-arginine, asymmetric dimethylarginine (ADMA), 3-nitrotyrosine and vitamin D (25[OH]D) using ELISA technique. Mean NO·, L-arginine/ADMA ratio and 25 (OH)D levels were significantly lower in PE compared to NP (p<0.05), while mean L-arginine, ADMA and 3-nirotyrosine levels were significantly higher in PE than NP (p<0.05). ADMA showed a positive correlation with SBP (β= 0.454, p=0.009) and DBP (β= 0.469, p=0.007) in PE. 81.7% of the study participants had vitamin D deficiency; 88.6% in PE compared to 75.0% in NP. PE was significantly associated with intrauterine growth restriction, low birth weight neonates and preterm birth compared to NP (p<0.05). PE is associated with endothelial dysfunction, evidenced by decreased levels of NO·, L- arginine/ADMA ratio, 25(OH)D and elevated levels of ADMA, 3-nitrotyrosine. The L- arginine/ADMA ratio is a better determinant of eNOS activity than L-arginine or ADMA alone. Combined measurement of these biomarkers in pregnancy, as well as L-arginine supplementation to increase the L-arginine/ADMA ratio in preeclamptic women and women at risk of developing preeclampsia are vital for prevention, early diagnosis and management of PE.

P010 - Association between Viral Pathogens and Pnuemonia in HIV Infected Children in Ghana; A Case Control Study

E. Adu1,2, M. Owusu1,2, S. B. Nguah3, L. Kalu3, E. Martey3, J. Sylverken3, J. Adaebi4, A. Badu- Peprah5 , Y. Adu-Sarkodie2.

1Kumasi Centre for Collaborative Research in Tropical Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, 2Department of Clinical Microbiology, SMD, Kwame Nkrumah University of Science and Technology, Kumasi, 3Department of Child Health, Komfo Anokye Teaching Hospital, Kumasi, 4Paediatric Emergency Unit, Komfo Anokye Teaching Hospital, Kumasi, 5Department of Radiology, Komfo Anokye Teaching Hospital, Kumasi.

Email: [email protected] Pneumonia remains the leading cause of morbidity and mortality among children globally. This burden is increased further for those living with HIV. An estimated 90% of children living with HIV are in the sub- Saharan Africa (SSA) region. About 60% of death associated with pneumonia in this region occur in children living with HIV infection. This makes the HIV epidemic an important risk factor for pneumonia morbidity and mortality in the region. There are very few studies which over the years have attempted to ascertain the viral aetiology of pneumonia among children living with HIV in SSA. This study is being conducted to determine the viruses associated with viral pneumonia among HIV infected children and further give informed suggestions on the development of effective diagnostic, preventive and treatment strategies. This study is being conducted at the Child Health Unit of the Komfo Anokye Teaching Hospital. It is a 1:1 case- control study with cases being clinically diagnosed and radiologically confirmed pneumonia subjects infected with HIV and controls being HIV infected subjects without pneumonia. Sputum or induced sputum samples are collected from both cases and controls and tested for 13 different respiratory viruses using real-time PCR. A total of one hundred and twenty- two patients have so far been recruited into the study. Of this number, seventy (70) were cases and fifty two were controls. At least one sample tested positive for a virus except human metapneumovirus which was negative for all samples tested. Thirty seven cases (37; 53%) and twenty controls (20; 40%) tested positive for at least one virus. Coronaviruses were the most common viruses detected (11, 30%) among the cases and Adenovirus was the most common virus among the controls (10, 50%). Based on preliminary analysis done, there was no association between a particular viral pathogen identified and exposure to pneumonia.The lack of association could be due to the limited samples analyzed. We expect confirm the role of viruses in pneumonia with larger sample collection.

P011 - Achieving Short Length of Stay with Good Outcomes is Feasible after Surgery for Acute Appendicitis: Experience from the Knust Hospital V. A. Appiah1, D. D. Nkrumah1, E. F. Boateng1, H. P. Boateng1, A. Gyedu1,2 1Surgery Unit, University Hospital, KNUST. 2Dept. of Surgery, School of Medicine and Dentistry, KNUST, Ghana. Like many low- and middle-income countries (LMICs), Ghana is focused on achieving universal health coverage (UHC), a concept supporting the belief that all people should have access to the health services they need. However, the concept of UHC stands to be undermined if patients requiring admission are denied because of lack of bed space at hospitals. One potential solution to this lack of bed space is to achieve better hospital bed turnover rate by reducing patient length of stay (LOS) without compromising quality of patient care. We aimed to describe how the Surgery Unit of the University Hospital, KNUST has achieved short LOS for patients presenting with acute appendicitis. The University Hospital, KNUST, is a 120-bed facility that serves the university community and surrounding areas. General surgical services are provided by one surgeon and rotating House Officers. Data on patients undergoing appendectomies from December 2016 to May 2019 were retrieved from a prospectively maintained database for information on in-hospital management and postoperative information. The data were expressed as descriptive statistics. 66 patients were admitted with acute appendicitis over the period. Median age was 24 (range 13-71) years. 46 (70%) underwent surgery; 22 (48%) within 12 hours of admission and 37 (80%) within 24 hours. All patients received prophylactic antibiotics. 38 (83%) were clean contaminated and eight (17%) were contaminated/dirty. Median duration of surgery was 50 (IQR: 42-70) minutes. Length of postop stay was 1 (IQR: 0.8-1.8) day. 30-day surgical site infection rate 9%; there were no other complications. Our results show that short LOS and minimal complications after surgery for acute appendicitis is feasible at district hospitals in Ghana. This represents an opportunity to improve hospital bed turnover thereby freeing up beds, for the many patients who need in-hospital care, without compromising quality of care.

P012 - Microfilaridermia Assessment of the Efficacy of Ivermectin Alone and Ivermectin Plus Albendazole against Onchocerciasis. Y. Mubarik1, L. B. Debrah1, 2, J. Osei-Mensah1, F. A. Fordjour1, A. Y. Debrah3

1Kumasi Centre for Collaborative Research in Tropical Medicine KNUST, 2Department of Clinical Microbiology, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, 3Faculty of Allied Health Sciences, Kwame Nkrumah University of Science and Technology.

Email: [email protected] Onchocerciasis, commonly known as river blindness is a vector-borne parasitic disease which affects approximately 37 million people world wide, mostly in sub-Saharan African countries. In Ghana, the standard treatment of onchocerciasis is annual mass drug administration with ivermectin at a dose of 150-200µg/kg. However, this regimen kills only microfilariae and therefore repopulation of microfilariae by adult female worms resumes 3 to 6 months after ivermectin treatment. In this study, an open labelled clinical trial was conducted to assess the efficacy of ivermectin alone and ivermectin plus albendazole given annually and semi-annually using microfilariae levels. A total of 272 onchocerciasis infected volunteers were randomised into ivermectin alone annually, ivermectin alone semi-annualy, ivermectin plus albendazole annually and ivermectin plus albendazole semi-annually treatment arms. Participants in the annual treatment arms received vitamin C at 6 months. Microfilariae loads of all study volunteers were monitored at pre-treatment, 6 months and 18 months using skin biopsies. All four treatment arms significantly (p=0.0001) reduced microfilariae loads but the bi-annual treatment arms was the most effective regimen for clearing skin microfilariae. However, there was no significant difference in the microfilariae geometric mean load of volunteers between all the treatment arms at each time point (p=0.7505 at pre-treatment, p=0.6824 at 6 months and p=0.3484 at 18months). Ivermectin is therefore still effective in clearing microfilariae among participants in the Adansi South District of Ghana. Bi-annual treatment of ivermectin alone and ivermectin plus albendazole was found to have additional benefit in reducing microfilariae loads compared to annual treatment. However, co-administration of ivermectin (200µg/kg) and albendazle (800µg/kg) did not have additional effect of reducing microfilariae loads.

P013 - Onchocerca volvulus Microfilaria Impacts Haematological Indices in Infected Individuals J. K. Labadah1, 2, K. A. Kusi1, 3, M. D. Wilson1, 3

1West African Centre for Cell Biology of Infectious Pathogens, University of Ghana, Legon. 2University of Health and Allied Sciences, Ho. 3Noguchi Memorial Institute of Medical Research, University of Ghana, Legon.

Email: [email protected] Onchocerciasis is a neglected tropical disease of the skin and eye caused by Onchocerca volvulus, a helminth nematode parasite that is transmitted by blackflies. The pathology of the disease is largely attributed to the microfilaria. Full blood counts are almost always routinely requested by physicians in the diagnosis and management of diseases. We sought to identify full blood count parameters differentially associated with microfilaremic onchocerciasis. Participants aged 18-70 were recruited from the Nkwanta North District in Ghana based on the presence of onchocercoma, seropositivity by onchocerciasis rapid diagnostic test, ivermectin intake three months prior and the presence of microfilaria in skin snips. Hematological parameters for 124 adults; 53 (57% male, 43% female) microfilaremic and 71 (55 % male, 45% female) ivermectin treated seropositive amicrofilaremic individuals were measured and compared by Mann-Whitney U test at 0.05 α. The geomean and range for microfilaria density/milligram skin snip is 22.5 (5.8-56.3). Microfilaremic individuals had lower: basophil count (p=0.0001); haematocrit (p<0.0001); red blood cell, RBC (p=0.0125); mean corpuscular haemoglobin MCH (p=0.0001); mean platelet volume, MPV (p<0.0001); Platelet distribution width, PDW (p<0.0001); plateletcrit, PCT (p=0.0022); platelet larger cell ratio, P-LCR (p<0.0001) an red cell distribution width, RDW (p<0.0001).These indices were not different; total white blood cell count (p=0.5982), neutrophils count (p=0.3856), monocytes count (p= 0.5873), lymphocyte count (p=0.0858), haemoglobin (p=0.5873) and platelets count (p=0.4576) and mean corpuscular volume, MCV (p=0.2065). Microfilaremic individuals had comparatively higher levels of mean cell haemoglobin concentration, MCHC (p<0.0001) and eosinophils count (p=0.0176). Onchocerca volvulus microfilaria has an impact on hematological parameters of its human host and this knowledge is important for better understanding the disease mechanism, diagnosis, treatment and surveillance towards disease elimination.

P014 - Assessing the Involvement of Nuclear Kappa Light Chain Enhancer of Activated B cell Inhibitor-Alpha in Filarial Lymphedema Development F. A. Fordjour1, L. B. Debrah1, 2, J. Osei-Mensah1, Y. Mubarik1, A.Y. Debrah3

1Kumasi Centre for Collaborative Research in Tropical Medicine, KNUST, Kumasi, 2Department of Clinical Microbiology, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, 3Faculty of Allied Health Sciences, College of Health Sciences, KNUST.

Email: [email protected]

Lymphatic filariasis (LF) is one of the World Health Organization (WHO) neglected tropical diseases (NTDs) with major social and public health problems. It is transmitted by the mosquitoes of the genera Aedes, Anopheles, Culex or Mansonia. Estimates indicate that about 1.1 billion people live in endemic areas and are at risk of infection and more than one third of these are in Sub-Saharan Africa. Since investigations concerning host genetic contributions to acquisition of secondary lymphedema is relatively lacking, a candidate gene approach (Single nucleotide polymorphism genotyping) has been employed to understand the different outcomes of pathologies such as filarial lymphedema (LE). Ongoing studies have found associations of LE with 5 single nucleotide polymorphisms in 4 genes namely: vascular endothelial growth factor receptor 3 (VEGFR-3), matrix metallopeptidase 2 (MMP-2), carcinoembryonic antigen-related cell adhesion molecule 1 (CEACAM-1) and Nuclear factor kappa light chain enhancer of activated B cells (NF- kappaB). This study explores the association between NF-kappaB /inhibitor kappa B (IkappaB) levels and LE development. The study was conducted in 26 communities in the Ahanta West and Nzema East districts in the Western Region of Ghana. A total of 194 study participants were involved in the study, out of which 94 were LE patients, 51 were infected (INF) patients and 50 were endemic normals (EN). Phosphorylated and total IkappaB levels were measured in each group using a commercial ELISA kit. From this study it was observed that IkappaB levels were elevated in LE patients, followed by INF patients and the least recorded in EN. From the results, upregulation of NF-kappaB/IkappaB (phosphorylated and total) in LE progression could be due to accelerated frequency of inflammatory response triggered by filarial antigens. Therefore, NF- kappaB/IkappaB could be a prognostic biomarker in the diagnosis and therapeutics of LE.

P015 - 16S Rdna Analysis of Microbiome Isolated from Neonates with Sepsis in Accra R. H. Asmah1, E. Appiagyei1, M. Quarchie1, G. Amegatcher1, 2, F. Botchway 3

1Dept of Medical Laboratory Sciences, School of Biomedical and Allied Health Sciences, University of Ghana, Korle-Bu, Accra, 2West Africa Centre for Cell Biology of Infectious Pathogens, UG, Legon, Accra 3Department of Chemical Pathology, School of Biomedical and Allied Health Sciences University of Ghana, Korle-Bu, Accra.

Email: [email protected]

The major cause of morbidity and mortality in neonates is sepsis. Neonatal sepsis have a multifactorial causes from risk factors of premature delivery, very low birth weight, contamination from health care providers to real infections resulting from bacterial ,viruses and fungi. Rapid diagnostic procedures are necessary to reduce the menace associated with sepsis. Detecting the microbiome in such infections, aids in the proper management of neonatal sepsis. The objective of this study was to determine the microbiome present in neonatal sepsis infection. About 50 neonates diagnosed of sepsis at the Princess Louis Marie Hospital in Accra, but have not begun antibiotic therapy were involved in the study. Aseptically collected venous blood was cultured and characterised using biochemical and microbiological methods. DNA from the isolated obtained was extracted and amplified by PCR. The amplified products were then restricted to determine differences between isolates obtained. Organisms isolated included, Staphylococcus aureus (40%), Enterobacter species (4%), Pseudomonas Species (4%), Coagulase Negative Staphylococci (28%). 16s rDNA analysis showed different restriction patterns for the different isolates. Staphylococcus aureus was the predominant organism isolated. There is the need to thoroughly characterize the microbiome involved in neonatal sepsis to improve treatment and management of these children.

P016 - Helicobacter Pylori Icea and Babs Gene Variants in Ghanaian Patients with Peptic Ulcer R. H. Asmah1, T. N. A. Archampong2, A. K. Teye1, B. Eyison1, F. Botchway3

1Dept of Medical Laboratory Sciences, School of Biomedical and Allied Health Sciences, University of Ghana, Korle-Bu, Accra, 2Dept. of Medicine and Therapeutics, School of Medicine and Dentistry, University of Ghana, Korle-Bu, Accra, 3Department of Chemical Pathology, School of Biomedical and Allied Health Sciences University of Ghana, Korle-Bu, Accra.

Email: [email protected]

Helicobacter pylori; infects the gastric mucosa of at least half of the world’s population. Infection of the gastric mucosa eventually leads to cancer via superficial gastritis, atrophic gastritis, intestinal metaplasia, and dysplasia. The developing of this gastro duodenal disease is dependent on virulence of the infecting strain, host susceptibility and environmental factors. Helicobacter pylori cagA, vacA, bab A and IceA gene variation induce inflammation, ulceration and oncogenesis in the bacteria. The aim of the study was to determine risk factor gene babA and IceA in Helicobacter pylori causing gastric infection at the Korle-Bu Teacing Hospital. Antral biopsies were obtained from 95 patients with dyspeptic symptoms going through upper endoscopy. H. pylori infections were confirmed by rapid-urease campylobacter like-organism (CLO) examination of antral biopsies. Genomic DNAs were extracted from the biopsies using QIAGEN DNeasy tissue kit and PCR was performed to amplify the babA gene and IceA from extracted DNA. From the CLO test, 74% (n=93) were positive. Endoscopic analysis revealed gastritis (42%), gastric ulcer (29%), duodenal ulcer (26%), gastric cancer (9%). BabA2 and IceA 1 and 2 genes were amplified among patients screened. The study affirms observations that gastric related infections of dyspeptic patients are also caused by BabA2 and Ice A1 and 2 genes in Helicobacter pylori. The data generated will help categorize and risk stratify symptomatic patients thereby prioritising and promoting optimum treatment strategies against Helicobacter pylori disease in Ghana.

P017 - Herpes Simplex Virus Gene Variants in the Reproductive Tract of a Population of Women from Southern Ghana. R. H. Asmah1, G. Essuman1 O. Debrah2, 3, F. Agyemang-Yeboah4

1Dept of Medical Laboratory Sciences, School of Biomedical and Allied Health Sciences, University of Ghana, Korle-Bu, Accra. 2Laboratory Department, Greater Accra Regional Hospital, Accra, 3Clinical Laboratory Unit, Institutional Care Division, Ghana Health Service, Accra, 4Department of Molecular Medicine, Kwame Nkrumah University of Science and Technology, Kumasi.

Herpes Simplex Virus (HSV) causes infections worldwide. The serotype HSV-1 mostly causes orofacial infections, while HSV-2 usually causes genital ulcer diseases. Although about 60% to 95% of human adults are reported to be infected globally with HSV, the prevalence rate is higher in females due to the anatomy of the female genital tract. HSV infected females thus have a high probability of acquiring other sexually transmitted infections in addition to causing neonatal infections during pregnancy and delivery. The aim of this study was to determine herpes simplex virus type 1 and type 2 gene variants among infected women attending a routine healthcare clinic in Accra, Ghana. The study was a cross-sectional study which involved 100 women attending a reproductive health Clinic at the Ridge Regional Hospital in Accra. Genomic DNA was extracted from cervical smears taken from these women. Polymerase chain reaction (PCR) was then used to amplify the extracted DNA with the use of primers published by Blankson et al., 2019. The amplified DNA was analyzed using agarose gel electrophoresis. The mean age of study participants was 34.5 years. Our result showed the prevalence of HSV-1 (12%) and HSV-2 infection (3%) among the women. There is the need to develop appropriate interventional strategies to manage and counsel patients presenting with asymptomatic genital herpes.

P018 – Long-Term Effect of Antihypertensive Medication on Bone Mineral Density among Ghanaian Adults at Komfo Anokye Teaching Hospital

L. Sallah1, M. E. Annani-Akollor2, B. M. Duduyemi3, N. A. Titiloye3, O. Addai-Mensah4, I. Boateng1 1Department of Physiology, Kwame Nkrumah University of Science and Technology, Kumasi. 2Department of Molecular Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, 3Department of Pathology, Kwame Nkrumah University of Science and Technology, Kumasi, 4Department of Medical Diagnostics, Kwame Nkrumah University of Science and Technology, Kumasi

Email: [email protected] Hypertension and osteoporosis have both been known to be two major public health conditions that places a burden on the general population of both developed and developing countries. In Ghana, several surveys conducted have reported cases of hypertension with high prevalence coupled with low degrees of early detection, treatment as well as control with the adult population at risk of osteoporosis and increased fracture risk. Etiologically, bone and cardiovascular health have been known to be interrelated. The similar risk factors and mechanism of genesis of these two diseases suggests a possibility that therapy for one condition can modulate the other positively or negatively. The study was aimed at investigating the long-term effects of antihypertensive therapy with ACE inhibitors, Beta blockers, Calcium-channel blockers, diuretics (Thiazide, Potassium sparing and loop), Angiotensin II receptor agonists, Alpha- 2 adrenergic receptor agonists, and arterial vasodilators on the Bone Mineral Density of Ghanaian adult population. A retrospective cohort study was conducted at KATH among hypertensive patients aged 40 years and older. BMD for each patient was measured with Dual Energy X-ray Absorptiometry. Biochemical markers for osteoporosis were measured for hypertensive patients on antihypertensive medication for more than a year. Mean age of patients in the study was 61.6 years (±11.5). A higher percentage of the sample population (41.7%) had osteoporosis with the highest risk of fracture, 36% had osteopenia and only 27% had normal bone health. 84.4% of the patients were on a combination therapy with antihypertensive medication. A statistically significant association (Sig. value = 0.000) between long-term antihypertensive therapy and BMD was identified with patients on the medication for more than 20 years having the lowest BMD. There was a statically significant (Sig. value = 0.017) association between long-term use of antihypertensive medication and onset of osteoporosis. Alkaline phosphatase had a positive correlation with long-term therapy with antihypertensive medication with the highest mean ALP levels, 145.36 U/L (±89.39) in patients who have been on the medication for 21-30 years. Mean calcium levels however was lowest 2.57 g/L (±0.41) in patients on the medication for 21 – 30 years. CCBs, ACEIs, BB, ARAs, AV, and Diuretics (Thiazide, loop and potassium) was not significantly associated with BMD. ARBs however had a negative statistically significant relation with BMD. This study found out that long-term use of antihypertensive medication modulates bone mineralization. Since hypertensive patients may be on the medication for a lifelong period, suitable medication should be considered with emphasis on bone health.

P019 - Fc Gamma Receptor Iiia Polymorphism and Plasmodium falciparum Infection Outcome in Ghanaian Children Living in a Low Malaria Endemic Region of Ghana

B. Adu 1, Q. Mohktar2, T. S. Addo1, Q. A. Issahaque1, D. Oduro1,2, D. Dodoo1 1Department of Immunology, Noguchi Memorial institute for Medical Research, University of Ghana, Legon, 2 Department of Animal Biology and Conservation science, University of Ghana, Legon.

Email: [email protected]

Immunity to Plasmodium falciparum malaria develops after prolonged exposure to the parasite and is thought to be mediated by immunoglobulin (Ig) G antibodies. Fc gamma receptors (FcγRs) recognise and binds to the Fc portion of the IgG antibodies to activate cells to destroy pathogens. FcγRs thus provide a crucial link between humoral and cell mediated immune responses. Polymorphisms in FcγRs that affect the binding affinities to IgG subclasses may influence disease risk. This study aimed to assess associations between the functional polymorphism FcγRIIIA- 176F/V-rs396991which influences IgG binding and phagocytic efficiency of effector cells and P. falciparum infection outcome in Ghanaian children. The FcγRIIIA-176F/V polymorphism was genotyped by multiplex PCR and associations with either protection or susceptibility to malaria was studied in a longitudinal cohort of children (n =122; aged 0.5-13yrs) living in an area of low malaria transmission in the greater Accra region of Ghana. None of the FcγRIIIA-176F/V genotypes was associated with febrile malaria in this cohort under any of the genetic models of inheritance tested (dominant-model, p=0.23, recessive-model p=0.49 and additive-model, p=0.24). Genotypes of FcγRIIIA-176F/V did not significantly (Log-rank test p=0.44) affect time to first malaria episode during the study period. There was a trend of high levels of parasitaemia in individuals with the FcγRIIIA-176F/F genotype compared to FcγRIIIA-176V/V genotype individuals. The study revealed that the genotypes of FcγRIIIA are not associated to febrile malaria in children in this cohort. Given the central role of FcγRIIIA in effector cell response, further studies in a larger cohort is recommended.

P020 - Malaria in Pregnancy: The Impact of Parasitaemia and Anaemia on Birth Outcome D. A. Abbas, K. Badu, B. W. L. Lawson, S. K. Agordzo, A. H. Mutala, A. Tweneboah. Department of Theoretical and Applied Biology, KNUST, Kumasi Email: [email protected] Malaria is one of the major public health problems during pregnancy with high risk to the pregnant woman, her foetus and her neonate. This study was carried out to investigate malaria in pregnancy, its adverse effects on the pregnant women and its impact on birth outcome. A longitudinal study was conducted in four hospitals in Ashanti region of Ghana. One hundred (100) pregnant women were recruited during their routine Antenatal clinic visits as participants after informed consent. Questionnaires were administered to investigate their knowledge on the infection effects, ITN usage and Intermittent Preventive Treatment (IPT) information. Venous blood was also taken to test for malaria (RDT and microscopy) and anaemia statuses during pregnancy period. The birthweights of their babies were also taken at delivery. The prevalence of malaria and anaemia was 15% and 22% respectively at registration. 72% of participants had ITN but 59.7% slept under them. Seventy percent (70%) of pregnant women attended ANC for the recommended number of times but none took the recommended dosage of Sulfadoxine-pyrimethamine (SP). Though none took the recommended dosage of SP, there only one case of low birthweight and it was not associated with malaria. The prevalence of malaria and anaemia in the last month was 20.8% and 35.4% respectively. Low birthweight occurred in 2% of babies. Both malaria and anaemia during pregnancy had no impact on birthweight of the babies. Malaria parasitaemia and low birthweight were low but the prevalence of anaemia was high during pregnancy. This could be improved when pregnant women attend ANC and take SP at the recommended number of times.

P021 - Prevalence and Antimicrobial Susceptibility Patterns of Oxidase Producing Bacteria among In-Patients at the Komfo Anokye Teaching Hospital, Ghana.

M. Owusu1, A. Owusu-Ofori2, A. Sylverken3, Y. A.Boaitey4, I. Steinmetz5, Y. Adu-Sarkodie2. 1Department of Medical Diagnostics, Kwame Nkrumah University of Science and Technology, 2Department of Clinical Microbiology, Kwame Nkrumah University of Science and Technology, 3Department of Theoretical and Applied Biology, Kwame Nkrumah University of Science and Technology, 4Department of Microbiology, Komfo Anokye Teaching Hospital, 5de Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Universitätsplatz Email: [email protected]

Gram-negative oxidase producing bacteria are recognised as medically important members of the phylum Proteobacteria because of their ubiquitous and versatile nature, propensity to cause wide range of infections and inherent resistance to many broad-spectrum antibiotics. Although important, information on their occurrence and antimicrobial susceptibility patterns is limited in many developing countries including Ghana. The aim of this study was to identify Gram-negative oxidase producing bacteria causing wide range of infections and determine their antibiotic susceptibility pattern. From January 1, 2016 to June 31st, 2016, we prospectively processed 7,979 clinical samples that were submitted to the Microbiology Department of the Komfo Anokye Teaching Hospital for bacteria culture and antimicrobial susceptibility testing. All samples were processed and Gram-negative oxidase producing bacteria were followed up and further identified using Analytical Profile Index. Of the 7,979 samples analysed, 230 were positive for oxidase producing bacteria. Of the 230 samples, the most predominant was wound swab (113; 49.1%), followed by urine (48; 20.9%). Pseudomonas aeruginosa and other Pseudomonas spp were more common in older children aged above 5 years compared to those below 5 years. Wound infections had the highest number of multi-drug resistant Pseudomonas aeruginosa (7; 12.3%). No case of Burkholderia pseudomallei was identified. This study has provided valuable information on the prevalence and antimicrobial susceptibility patterns of oxidase producing non-fermenting Gram- negative bacteria. This information will guide clinicians and public health practitioners in implementing interventions that will reduce their occurrence and resistance levels.

P022 - Histopathologic report of breast biopsies in a referral hospital in Ghana: A 9-year audit

N. A. Titiloye 2, K. Bedu-Addo1, B. M. Duduyemi2, E. A. Manu1, C. Ameh-Mensah1, F Opoku1.

1Department of Physiology, SMD, KNUST, Kumasi, Ghana 2Department of Pathology, SMD, KNUST, Kumasi, Ghana Email: [email protected] Background: Histological diagnosis is crucial to the management of breast diseases. It determines the kind of disease, the treatment modalities and the outcome of management. Our department receives breast biopsies from the Northern sector of Ghana constituting over 50% of the Ghanaian population. This study aims at elucidating the pattern of disease and associated traditional prognostic indices of breast cases in our department over a period of 9 years. Methods: Information on the demographic characteristics and the histological diagnoses made on all breast cases received and processed in the department were accessed and entered into an Excel spreadsheet. Slides were reviewed and IHC was done on suitable cases. Descriptive statistics were generated using IMB-SPSS version 23. Results: A total of 4,276 breast cases were received by the department within the study period, with 97.6% being female. Age range (female/male) from 10-98/13-102 years, with mean ages of 38.2 years (SD ±16.7) and41.15 years (SD±21.6) respectively. Cases were evenly distributed in both left and right breasts and 4.3% were bilateral. Inflammatory conditions were seen in 7.5% of cases. The most diagnosed benign tumour was fibroadenoma (54%), followed by fibrocystic change (8.1%). Gynaecomastia was diagnosed in 66.3% of males. Malignant cases were 38.6%, with invasive carcinoma NST being the most frequent (87.1%) and rarely, medullary carcinoma (0.4%). Histological grades were I=9.4%, II = 41.6% and III = 49%. Molecular subtypes were Luminal A (19.8%), Luminal B (9.9%), Her2 (16%) and TNBC (54.3%) Conclusion: Our findings show an increase in breast cancer cases compared to previous studies in our centre, suggesting increased awareness and improved diagnosis. However, this increase is consistent with most studies in sub-Saharan Africa.

P023 - Development and performance evaluation of earthenware filters for point of use water purification

L. J. L.Michael, P. K. Feglo.

Department of Clinical Microbiology, School of Medicine and Dentistry, KNUST, Kumasi

Email: [email protected]

Diarrheal diseases due to unsanitary water are one of the most important leading causes of morbidity and mortality in low and middle-income countries around the world especially Sub- Sahara African countries in which Ghana is not excluded. Due to the very high demand for good quality and clean water by the society, various means to meet this demand have been constructed. However, many of these means are not easily accessible by some communities due to unavailability, high cost or complexity of usage. One potential solution to this problem is widespread access to point-of-use earthenware water filters made from universally-available materials. This has led to the design and construction of water filters which can be accessed by all communities affected by waterborne disease crisis. In this work, a low-cost earthenware filter for point-of-use water purification was designed using locally available materials such as clay and sawdust. The filters are then tested to evaluate their performance in retaining bacteria and filtering water to the World Health Organization (WHO) standards. After analyzing water samples obtained after filtration, results showed that the earthenware filter produced is effective in removing microbes resulting in waterborne diseases by 99.9 % and turbidity to 99.4 %. It is also effective in removing colour by 75% and conductivity and total dissolved solids (TDS) by about 37.1 and 36.9 % respectively. Comparison of the results with the WHO standards for drinking water showed that the earthenware water filter can provide potable drinking water of required standards.

P024 - Lipid Accumulation Product (LAP) Index as a Potential Risk Assessment for cardiovascular risk stratification among Type II Diabetes Mellitus in a Ghanaian population: A Cross-Sectional Study

C. Obirikorang1, E. A. Adu1, E. Acheampong1,2, A. S. Kwakye3, F. Fokuoh4, E. O. Anto1,2, E. N.Batu1, B.Y. Amoah5, P. N. Ansong6

1Department of Molecular Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana. 2School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia. 3Medical Laboratory Department, Eastern Regional Hospital, Koforidua, Ghana. 4Physician Specialist, Eastern Regional Hospital, Koforidua, Ghana. 5Chemical Pathology Unit, Department of Medical Laboratory Sciences, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana. 6Department of Physiology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.

Email: [email protected]

The study determined the comparative usefulness of Lipid Accumulation Product (LAP) index, for identifying individuals at immediate risk of cardiovascular diseases in a Ghanaian population. A cross-sectional study that involved 324 T2DM patients attending the Eastern Regional Hospital, Koforidua, Ghana, were selected using a simple random sampling method. Height, body weight and waist circumference (WC) of all study participants were measured; Body Mass Index (BMI) was derived from the measurements of height and weight. Fasting blood samples were collected for lipids and glucose measurements. Lipid accumulation product index was estimated from waist circumference and plasma triglycerides concentration. Ten-year risk of general CVD morbidity was estimated using the Framingham risk estimation criteria. Mean age of the study participants was 57.2 (7.2 SD). LAP index (z-scores) was significantly associated and predictive of Metabolic Syndrome (MetS) by IDF [OR= 11.91 (4.76-29.75), p-value <0.0001], MetS by WHO [OR= 2.19 (1.50-3.21), p-value <0.0001], coronary risk index [OR= 2.58 (1.79-3.70), p-value <0.0001] and high probability outcome of 10-year CVD events [OR=1.97 (1.42-2.74), p-value =0.001], independent of BMI and WC. The covariate-adjusted area under the curve (AUC) for LAP was excellent in predicting MetS defined by IDF (0.920). The adjusted AUC for LAP proved very good in predicting MetS defined by WHO criteria [0.811) and elevated probability outcome of 10-year CVD events (0.889). Findings from this study suggest that LAP index could be considered as a routine assessment tool in T2DM patients since it is a better predictor than the clustering of BMI and WC.

P025 - Association of wrist circumference and waist-to-height ratio with cardiometabolic risk factors among type II diabetics in a Ghanaian population

C. Obirikorang1, Y. Obirikorang3, E. Acheampong1, E. O. Anto1,4, E. Toboh5, E. A. Asamoah2, B. Amakwaa1, E. N. Batu1, P. Brenya1 1Department of Molecular Medicine, School of Medical Sciences, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana 2Department of Medical Laboratory Technology, Faculty of Allied Health Sciences, KNUST, Kumasi 3Department of Nursing, Faculty of Health and Allied Sciences, Garden City University College (GCUC), Kenyasi, Kumasi, Ghana 4School of Medical and Health Sciences, Edith Cowan University, Western Australia . 5 Diagnostic Unit, Dansoman Polyclinic, Ghana Health Service, Accra Email: [email protected] The study determined the association of wrist circumference (WrC) and waist-to-height ratio (WHtR) with cardiometabolic risk factors among diabetics in a Ghanaian population. This cross- sectional study involved 384 diabetic patients at Begoro District Hospital, Ghana. Blood pressure, anthropometrics, and biochemical indices were measured. The overall prevalence of dyslipidaemia, metabolic syndrome (MetS), and hypertension was 42.4%, 76.3%, and 39.8%, respectively. The optimum cut-off range of WrC to identify individuals at increased cardiometabolic risk was 17.5 to –17.8 cm for men and 16.0 to 16.7 cm for women while that of WHtR was 0.52 to 0.61 for men and 0.53 to 0.59 for women. WrC for women was a significant independent predictor for MetS [aOR = 3.0 (1.39–6.72),] and systolic blood pressure [aOR = 2.08 (1.17–3.68),]. WHtR was a significant positive predictor for triglycerides [aOR = 3.23 (0.10– 3.82),] for women. Using Framingham risk scores, 61% of the subjects had elevated 10-year risk of developing cardiovascular diseases (CVDs), with no significant difference in gender prevalence. WrC [aOR = 6.13 (0.34–111.4),] and WHtR [aOR = 2.52 (0.42–15.02),] were associated with statistically insignificant increased odds of moderate-to-high risk of developing CVDs in 10 years.The use of gender-specific cut-offs for WrC and WHtR may offer putative markers for early identification of Cardiovascular risk factors.

P026 An Evaluation of the effect of ethanolic extract of Zingiber officinale (ginger) and acetylsalicylic acid (aspirin) on the coagualtion profile of male wistar rats. L. Sallah1, B. M. Duduyemi2, N.A. Titiloye2, M. E. Annani-Akollor3, E. Anokye-Kumi1 1. Department of Physiology, School of Medicine and Dentistry, KNUST 2. Department of Pathology, School of Medicine and Dentistry, KNUST 3. Department of Molecular Medicine, School of Medicine and Dentistry, KNUST.

Platelets play a significant role in the balance of hemostasis through primary hemostasis and the coagulation cascade. Acquired platelet and inherited platelet disorders could be life threatening. The most common cause of acquired platelet disorders are medications, although certain foods and natural products contain elements that impair platelet function. Aspirin, an antipyretic and mild analgesic and ginger, a commonly used spice, are known to have anti-inflammatory effects. Both are known to impair the function of platelets by inhibiting cyclooxygenase. This study investigated the effects of aspirin and ginger on the function of platelets. 35 male wistar rats were divided into 7 groups designated as A, B, C, D, E, F and G as the control group. 75 mg/kg of aspirin, 50 mg/kg, 300 mg/kg and 500 mg/kg of ginger extract were administered to groups A, B, C and D respectively. 75 mg/kg of aspirin and 50 mg/kg of ginger was administered to group E while 500 mg/kg of ginger and 75 mg/kg of aspirin was administered to group F. 1ml of normal saline was administered to the control group G. The dosing was carried out daily for 10 consecutive days after which blood samples were taken from the animals and was analyzed to obtain the bleeding time, prothrombin time, activated partial thromboplastin time and clotting time. One way analysis of variance (ANOVA) was used to analyze the data and were at a significant level of 5%. Ethanolic extract of ginger and aspirin, administered separately caused a significant (p < 0.05) increase in bleeding time and again caused a significant (p<0.05) increase in activated thromboplastin time tests in the rats. We conclude that aspirin and ginger extracts have the potential of challenging coagulation and hemostasis even in doses that are supposed to be safe.

P027 - Assessing Vitamin D and Nitric Oxide levels in Ghanaian women with Preeclampsia

L. A. Fondjo1, W. K. B. A. Owiredu1, W. Tashie1,3, R. K. D. Ephraim2, L. Asare3, K. G. Peprah3, L. Seidu4 1Kwame Nkrumah University of Science and Technology, Kumasi, Ghana, 2University of Cape Coast, Ghana, 3Comboni Hospital, Ho, Volta Region, 4 Ho Municipal Hospital, Ho. Email: [email protected] Preeclampsia (PE) is a major cause of maternal and neonatal morbidity and mortality in sub- Saharan Africa. Evidence indicates that endothelial dysfunction is central to the pathogenesis of PE. Altered nitric oxide (NO·) synthesis and uptake has been implicated in the pathogenesis of endothelial dysfunction. This study assessed the levels and correlations between markers of endothelial dysfunction to explore the roles of these factors in the disorder and evaluated adverse pregnancy outcomes in PE. This case-control study was conducted among pregnant women visiting Comboni Hospital from January 2017 to May 2018. A total of 180 pregnant women comprising of 88 preeclamptic women and 92 healthy normotensive pregnant (NP) women were recruited. Socio-demographic, clinical and obstetric history were obtained. Blood pressure and anthropometrics were measured, and blood samples were collected for the estimation of NO·, L- arginine, asymmetric dimethylarginine (ADMA), 3-nitrotyrosine and vitamin D (25[OH]D) using enzyme-linked immunosorbent assay (ELISA) technique. Mean NO· (p<0.010), L- arginine/ADMA ratio (p<0.0001), were significantly lower in PE compared to NP while mean L- arginine (p<0.034), ADMA (p<0.0001) and 3-nirotyrosine (p<0.0001), levels were significantly higher in PE than NP. ADMA showed a positive correlation with SBP (β= 0.454, p=0.009) and DBP (β= 0.469, p=0.007) in PE. 81.7% of the study participants had vitamin D deficiency; 88.6% in PE compared to 75.0% in NP. With increasing severity, PE was significantly associated with intrauterine growth restriction (p<0.0001) and low birth weight of infants (p<0.0001), when compared to NP. Preeclampsia is associated with endothelial dysfunction evidenced by reduced NO· bioavailability, L-arginine/ADMA ratio, 25(OH)D and an elevated concentration of ADMA and 3-nitrotyrosine. Combined measurements of NO·, vitamin D, ADMA, L-arginine, L- arginine/ADMA ratio during pregnancy would be instructive for prevention, early diagnosis and management of preeclampsia. Exogenous supplementation with L-arginine could improve endothelial function in Preeclampsia.

P028 Improving cervical cancer screening and HPV vaccination rates among native Ghanaian women, and Ghanaian immigrant women living in Georgia, U.S.A. C. Palmer, A. Blackwell, B. Apenteng, E. Afriyie-Gyawu

Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA. USA

Email: [email protected]

Cervical cancer is the 4th most common gynecological cancer worldwide, with 85% of new cases occurring in lesser developed regions such as many Asian and African countries. In 2012, the incidence, mortality, and 5-year prevalence estimated rates were approximately four times greater in Africa, compared to North America and Europe. Recent data indicated that Ghana has a high incidence of cervical cancer, with mortality rates three times that of the global average. This disparity in Ghana has been attributed to cervical cancer screening rates as low as 2.7%, sociocultural beliefs, lack of a national HPV vaccination and cervical cancer screening programs, and late diagnosis of the disease. This research aimed at exploring the barriers to Pap smear and HPV vaccination among immigrant women from Ghana living in Georgia, and Ghanaian women still living in the country of their birth. The study was intended to gain insight into the comparison of these cultural views toward preventive services, and the impact if any, of community partnerships in improving health outcomes. Eighty semi-structured interviews (Kumasi, Ghana; 35 females, 15 males) and (Georgia, USA; 20 females, 10 males) were utilized to conduct a cross- sectional qualitative study. Results indicate that the major barriers to screening in Ghana include availability, accessibility, knowledge, awareness and affordability of cervical cancer screening, and HPV vaccination. Cultural and religious beliefs were inconsequential in determining Ghanaian natives’ pursuit of preventive care, as their constraints were more related to cost and knowledge. Immigrants living in the U.S. reported significant reduction of these barriers, with virtually full access and acceptance of regular Pap smears, and more than 70% of HPV vaccine approval rates. Awareness, cost, and accessibility to these services were the major facilitators. Further studies are needed to fully explore the impact of immigration and acculturation on these screening and vaccination rates.

P029 - Fc gamma receptor IIIA polymorphism and Plasmodium falciparum infection outcome in Ghanaian children living in a low malaria endemic region of Ghana

B. Adu1, Q. Mohktar2, T. S. Addo1, Q. A Issahaque1, D. Oduro1,2, D. Dodoo1

1 Department of Immunology, Noguchi Memorial institute for Medical Research, University of Ghana, 2 Department of Animal Biology and Conservation science, University of Ghana.

Email: [email protected]

Immunity to Plasmodium falciparum malaria develops after prolonged exposure to the parasite and is thought to be mediated by immunoglobulin (Ig) G antibodies. Fc gamma receptors (FcγRs) recognise and binds to the Fc portion of the IgG antibodies to activate cells to destroy pathogens. FcγRs thus provide a crucial link between humoral and cell mediated immune responses. Polymorphisms in FcγRs that affect the binding affinities to IgG subclasses may influence disease risk. This study aimed to assess associations between the functional polymorphism FcγRIIIA- 176F/V-rs396991which influences IgG binding and phagocytic efficiency of effector cells and P. falciparum infection outcome in Ghanaian children. The FcγRIIIA-176F/V polymorphism was genotyped by multiplex PCR and associations with either protection or susceptibility to malaria was studied in a longitudinal cohort of children (n =122; aged 0.5-13yrs) living in an area of low malaria transmission in the greater Accra region of Ghana. None of the FcγRIIIA-176F/V genotypes was associated with febrile malaria in this cohort under any of the genetic models of inheritance tested (dominant-model, p=0.23, recessive-model p=0.49 and additive-model, p=0.24). Genotypes of FcγRIIIA-176F/V did not significantly (Log-rank test p=0.44) affect time to first malaria episode during the study period. There was a trend of high levels of parasitaemia in individuals with the FcγRIIIA-176F/F genotype compared to FcγRIIIA-176V/V genotype individuals. The study revealed that the genotypes of FcγRIIIA are not associated to febrile malaria in children in this cohort. Given the central role of FcγRIIIA in effector cell response, further studies in a larger cohort is recommended.

P030 - Pharmacognostic Studies of the Leaves, Stem and Root of Capparis erythrocarpos isert (capparaceae)

M. A. Twumasi1, E. Ekuadzi1, P. K. Mante2, M. El Boakye-Gyasi3, M. L. K. Mensah1, E. Woode2

1Department of Pharmacognosy,Kwame Nkrumah University of Science and Technology, Kumasi, 2Department of Pharmacology, Kwame Nkrumah University of Science and Technology, Kumasi, 3Department of Pharmaceutics, Kwame Nkrumah University of Science and Technology, Kumasi,

Email: The roots of Capparis erythrocarpos are used traditionally across Africa for the management of arthritis and other inflammatory conditions. Owing to its proven efficacy, it has gained commercial value, particularly as a key ingredient in several herbal products. The increased scarcity owing to demand outstripping supply lend the roots of C. erythrocarpos to adulteration. This paper presents a detailed pharmacognostic evaluation of the leaf, stem and root of C. erythrocarpos which will be used in its identification and consequent standardization. The leaf, stem and root were evaluated for their macroscopic and microscopic features as were the physicochemical parameters and phytochemical screening done. Leaves are alternately arranged, have a collateral vascular bundle and crystal sheaths. Actinocytic stomata and secretory cells were contained in powdered leaves. The stem showed lenticels and thorns, stellate and branched trichomes which leave off cicatrices in older stems. The powdered stem and roots contained stone cells, secretory cells and vessels. However, the roots lacked thorns, trichomes and had smaller secretory cells. Aqueous and ethanolic extracts of the leaves, stem and roots were slightly acidic to neutral. Ash values of leaves, stem and roots are 16.58 ± 0.09, 5.01 ± 0.09 and 6.53 ± 0.19 respectively. Preliminary phytochemical screening of the leaves, stem and roots showed the presence of glycosides, flavonoids and tannins. The determined parameters of C. erythrocarpos constitute quality parameters for their unequivocal identification.

No adverse effects on serum haematolog y, liver and kidney function P031 - Mobile phones as tools for health promotion and improved child survival in rural communities of Ghana: A quasi-experimental study

P. R. Acheampong, E. Owusu-Dabo, E. Otupri

School of Public Health- Kwame Nkrumah University of Science and Technology

Email: [email protected]

Despite considerable efforts and progress made in the last decades, under five mortality remains a pressing health issue in Sub-Saharan Africa. The current challenges in child survival are therefore to improve access to basic knowledge and appropriate quality services for those who need them most. Mobile health presents one of the potential solutions to maximize health promotion in an effort to reach the Sustainable Development Goals 3.1 and 3.2, particularly in sub-Saharan African countries. Mobile phone technology in the context of health promotion is a relatively new area of public health research and studies emerging in this area may be relevant to future work related to health promotion. This study seeks to assess the effect of a mobile-phone based health promotion and education intervention package on key practices of caregivers related to child survival. This will be a community-based quasi-experimental study, which will employ a cross-sectional design at baseline and end line at intervention and control sites. The study will use quantitative and qualitative approaches. The three-dimensional intervention package will be made up of voice reminders to caregivers in the Asante Akyem North and South Districts on vaccination schedules and follow-ups after health-care seeking; a theory-based health education to caregivers as weekly voice messages and caregivers of participants calling a toll-free system to report any child illness for guidance. The results of the effect of the health promotion intervention will be evaluated to generate evidence-based recommendations for the use of mobile phone technology as a tool for health promotion and improved child survival in Ghana and other West African countries. This research will guide the development of community-based interventions aiming to reduce the occurrence of child morbidity and mortality in rural areas of Ghana.

P032- Utilising uric acid as alternate measure for oxidative stress and poor maternal vascular remodeling among normotensive and preeclampsia women visiting the Komfo Anokye Teaching Hospital, Kumasi, Ghana: case-control study

E. O. Anto1,3, P. Roberts1, D. Coall1, C. A.Turpin2, A.Tawiah2, W. K. B. A. Owiredu3, M. Mutocheluh4, E. Adua1, Y. Wang5, W. Wang1,6

1School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia. 2Department of Obstetrics and Gynaecology, Komfo Anokye Teaching Hospital, Kumasi, Ghana, 3Department of Molecular Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana, 4Department of Clinical Microbiology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana, West-Africa. 5Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China. 6School of Public Health, Taishan Medical University, Taian, China

Email: [email protected]

Preeclampsia (PE), a condition characterised by hypertension and proteinuria after 20 weeks of gestation is the leading cause of maternal morbidity and mortality in developing countries. Oxidative stress and poor maternal vascular remodeling are central to the pathophysiology of PE, although their biomarkers are expensive, required long turnaround time, and are not routinely available to women in resource-limited countries. Uric acid may be applied as an alternative marker for oxidative stress and poor maternal vascular remodeling. We explored an association of uric acid (UA) with biomarkers of oxidative stress (BOS): 8-epiprostaglandinF2 alpha (8-epi- PGF2α), 8-hydroxy-2-deoxyguanosine (8-OHdG), and total antioxidant capacity (TAC), and indicators of maternal vascular remodeling like angiogenic growth factors (AGFs): vascular endothelial growth factor (VEGF), soluble vascular endothelial growth factor receptor-1 (sVEGFR-1), placenta growth factor (PIGF) and soluble endoglin (CD105) among normotensive pregnant women and preeclampsia. This case-control study included 498 participants comprising 301 normotensive pregnant women, 70 early-onset PE [(EO-PE) (˂34 weeks gestation)] and 127 late-onset PE [(LO-PE) (≥34 weeks gestation). BOS and AGFs were measured using highly sensitive immunoassays. Serum uric acid was measured using automatic clinical chemistry analyser. Partial correlation was perform to test association between markers after adjusting for possible confounding factors. Benjamini Hochberg correction was performed to reduce false discovery rate in correlation matrix. Statistical analyses were performed using R. Levels of 8-epi-PGF2α, 8-OHdG, sVEGFR-1 and CD105 were significantly (p <0.0001) increased and positively associated with UA whereas TAC, VEGF and PIGF were significantly (p <0.0001) reduced and negatively associated with UA among EO-PE but not in LO-PE and normotensive pregnant women. UA may be used as a risk stratification measure for early signs of OS and imbalance in AGFs among pregnant women who develop early onset PE, thus creating a window of opportunity for preventive and personalised therapeutic options.

P033 Analysis of Haematological Parameters as Predictors of Malaria Infection Using a Logistic Regression Model: A Case Study of a Hospital in the Ashanti Region of Ghana

E. K. Paintsil1., A. Y. Omari-Sasu2, M. G. Addo3, M. A. Boateng4 1Kumasi Centre of Collaborative Research, KNUST, Kumasi, 2Dept. of Mathematics, KNUST, 3Dept. of Theoretical and Applied Biology, KNUST, 4Faculty of Engineering, Ghana Technology University College

E-mail: [email protected]

Malaria is the leading cause of morbidity in Ghana representing 40-60% of outpatient hospital attendance with about 10% ending up on admission. Microscopic examination of peripheral blood film remains the most preferred and reliable method for malaria diagnosis worldwide. But the level of skills required for microscopic examination of peripheral blood film is often lacking in Ghana. This study determined the extent to which haematological parameters and demographic characteristics of patients could be used to predict malaria infection using logistic regression. The overall prevalence of malaria in the study area was determined to be 25.96%; nonetheless, 45.30% of children between the ages of 5 and 14 tested positive. The binary logistic model developed for this study identified age, haemoglobin, platelet, and lymphocyte as the most significant predictors. The sensitivity and specificity of the model were 77.4% and 75.7%, respectively, with a PPV and NPV of 52.72% and 90.51%, respectively. Similar to RDT this logistic model when used will reduce the waiting time and improve the diagnosis of malaria.

P034 - Effect of Sub-Chronic Administration of Low Dose Phenobarbitone on the Analgesic Activity of Acetaminophen in Rats M.A. Mahdi, H.Y. Waziri Department of Pharmacology and Therapeutics, Faculty of Pharmaceutical Sciences, Ahmadu Bello University, Zaria-Nigeria. Email: [email protected] Acetaminophen is the international non-proprietary name for paracetamol recommended as the first-line treatment of pain and stiffness associated with osteoarthritis because of its assumed low toxicity on gastrointestinal and cardiovascular systems compared to other Non-Steroidal Anti- Inflammatory Drugs. The aim of this study was to demonstrate the effect of twenty-eight (28) days administration of 5 mg/kg phenobarbitone on the analgesic activities of graded doses of acetaminophen using hot plate test in rats. Albino rats of either sex weighing 120-225 g were used for the study. They were divided into five (5) groups of five (5) rats each. All the rats except standard acetaminophen group were pretreated daily with 5 mg/kg phenobarbitone orally for twenty (28) days. On the 29th day group 1 were administered 5 mg/kg acetaminophen through the oral route. Group 2, 3 and 4 rats were orally administered with 10, 15 and 20 mg/kg acetaminophen respectively. While group five (5) were also given 20 mg/kg acetaminophen standard orally. The analgesic effects of acetaminophen in all the groups were evaluated by determining the latency period for reaction to thermal-induced pain at 60, 90, 120 and 150 minutes. The results obtained has shown that after 60 minutes of acetaminophen administration there was no significant change in reaction time of all groups compared to the standard acetaminophen group. However, at 90 and 120 minutes there were significant decreases in reaction times at 5, 10, and 15 mg/kg acetaminophen groups. There was a significant decrease in reaction time to thermal-induced pain at 5 mg/kg acetaminophen only after 150 minutes. It can be suggested that acetaminophen show dose and time dependent decrease in analgesic latency period in microsomal enzyme-induced rats.

P035 - Health Risk Assessment and Levels of Toxic Metals in Fishes (Oreochromis noliticus and Clarias anguillaris) from Ankobrah and Pra Basins: Impact of Illegal mining Activities on Food Safety.

N. K. Kortei1, M. E. Heyman1, E. K. Essuman1, F. Kpodo1, P. T. Akonor2,3, C. Tettey4

1Department of Nutrition and Dietetics, School of Allied Health Sciences, University of Health and Allied Sciences, Ho, 2Department of Food Processing and Engineering, CSIR- Food Research Institute, Accra, 3Department of Nutrition and Food Science, School of Biological Sciences, College of Basic and Applied Sciences, University of Ghana, Accra, 4Department of Biomedical Sciences, School of Basic and Biomedical Sciences, University of Health and Allied Sciences, Ho.

Email: [email protected] Arsenic (As), mercury (Hg), Cadmium (Cd) and lead (Pb) are toxic heavy metals that occur naturally in the environment. Their levels are on the rise due to anthropogenic activities posing threat to aquatic wildlife and humans. In Ghana, pollution of these water bodies has led to shortages of treated potable water across the country making the cost of treating polluted water expensive. The aim of this study was to assess the As, Hg and Pb and Cd concentrations in water and fishes from rivers Pra and Ankobrah where activities of artisanal gold mining were carried out resulting in gross pollution of the water bodies. An experimental study was conducted to determine the concentration of As, Hg, Pb and Cd in fish species of Nile tilapia (Oreochromis noliticus) and mudfish (Clarias anguillaris) and aquatic media (water) from the Pra and River Ankobrah basins using the Atomic Absorption Spectrophotometer (AAS) (Varian AA2240FS). Both river water samples recorded ranges of 0- 0.0040, 0.0060- 0.0387, 0 - 0.0020, 0.006-0.0093 mg/L for Cadmium, Lead, Arsenics and Mercury respectively. For Cadmium and Arsenics, there was no significant difference (p>0.05) observed in their concentrations. However, there were statistical differences (p<0.05) observed for Lead and Mercury. Toxic metals concentrations in the rivers decreased in the order of Hg> Pb> Cd> As. For the fish samples, values ranged 0-0.08, 0.04-0.42, 0-0.04, and 0.40- 0.60 mg/kg for Cadmium, Lead, Arsenics and Mercury respectively. Generally, appreciably high values were obtained for Mercury. Toxic metals concentrations in the rivers decreased in the order of Hg> Pb> Cd> As. Human health risk assessment from heavy metal exposure through fish consumption from the Rivers for both children and adults showed no significant non-carcinogenic adverse health risk to humans since all calculated values for Hazard Quotient (HQ) were <1. Nonetheless, Target Harzard Quotient (THQ) values calculated for children and adult exposure to Cadmium and Mercury were >1 which implied a likely cause of adverse effects during a person’s lifetime.

P036 - Phytochemical, Nutritional, and Physicochemical Properties of Sesame Seeds (Sesamum indicum l.) Grown in Ghana.

N. K. Kortei1, E. E. Dravie1, E. K. Essuman1, F. Kpodo1, P. T. Akonor2,3, C. Tettey4

1Department of Nutrition and Dietetics, School of Allied Health Sciences, University of Health and Allied Sciences, Ho. 2Department of Food Processing and Engineering, CSIR- Food Research Institute, Accra. 3Department of Nutrition and Food Science, School of Biological Sciences, College of Basic and Applied Sciences, University of Ghana, Accra. 4Department of Biomedical Sciences, School of Basic and Biomedical Sciences, University of Health and Allied Sciences, Ho.

Email: [email protected] Sesame (Sesamum indicum L.) is commonly referred to as Benniseed. It is a flowering plant belonging to the genus Sesamum and species indicum. Sesame seed has been found to contain 40- 50% oil, 20-25% protein, 20-25% carbohydrate and 5-6% ash. The objective of this study was to determine the phytochemical, nutritional and physicochemical properties of Sesame seeds (Sesamum indicum L.) grown in Ghana. Two different categories of sesame seed were used in this experiment based on geographical location. Sesame seed sample A was bought from Navrongo and sesame seed sample B was bought from Garu Tempane. Each category was extracted in three different solvents (methanol, ethanol or acetone). The study was an experimental research design. Proximate composition of the seed was determined by method of the Association of Official Analytical Chemists (AOAC, 2005). Spectrophotometric ABTS, FRAP and DPPH or free radical scavenging methods were also used to determine the total antioxidant activity and total phenolic content was determined using the Folin-Ciocalteu method. Proximate analysis indicated that significant difference between sample A (sesame seeds harvested in Navrongo) and sample B (sesame seeds harvested in Garu Tempane) was observed in the moisture (3.49% and 2.31% respectively) and protein content (15.67 and 18.04 respectively). Fat content of the seed was the highest in both samples A and B (56.56% and 55.30% respectively), and moisture content of the seed was the least (3.49% and 2.31%) in samples A and B respectively. In terms of phytochemicals, the seed had high polyphenols, flavonoid and exhibited good antioxidant ability with the highest contents resulting from acetone extract and lowest from the methanol extract. From this study, it was found that Sesame seed is a rich source of dietary fat, carbohydrate and protein and as such serves as a cheap source of these nutrient. It also possesses high phytochemicals and bioactive component which could also contribute to health and biological activities.

P037 - Potential Health Risk Assessment of Toxic Metals Contamination in Clay Eaten as Pica (geophagia) among Pregnant Women of Ho in the Volta Region of Ghana. N. K. Kortei1, P. T. Akonor2,3 N. O. Boadi 4

1Department of Nutrition and Dietetics, School of Allied Health Sciences, University of Health and Allied Sciences, Ho, 2Department of Food Processing and Engineering, CSIR- Food Research Institute, Accra, 3Department of Nutrition and Food Science, School of Biological Sciences, College of Basic and Applied Sciences, University of Ghana, Accra, 4Department of Chemistry, Kwame Nkrumah University of Science and Technology, Kumasi.

Email: [email protected] eophagia although pleasurable and somewhat a necessity among pregnant women, also comes along with its own attendant problems such as exposure to potentially hazardous substances like bacteria, fungi, helminthes and ova, radioactive materials, and toxic elemental minerals in the soil depending on the geographical location. This study evaluated the potential health risk involved during the exposure of pregnant women to toxic elemental minerals via the consumption of clay as pica (geophagia). Elemental mineral analysis was carried out using Buck Scientific 210VGP Flame Atomic Absorption Spectrophotometer (Buck Scientific, Inc. East Norwalk, USA). Risk assessment methods were also used to ascertain the various risks factors and the overall risk level. Concentrations of the macro elements investigated were 1.38 ± 1.5, 2.40± 1.5, 7.74± 1.5, 4.01± 1.0, 13.24± 2.2 and 13.76± 2.1 mg/Kg for Fe, Cu, Zn, K, Mg and Na respectively. While that for the micro elements were 1.63± 0.03 µg/Kg, 4.72±0.8, 0.53±0.02 and 1.85±0.3 mg/kg respectively for Arsenic, Manganese, Lead and Nickel. Estimated Daily Intake (EDI), Hazard Quotient (HQ), Target Hazard Quotient (THQ) and Total Target Hazard Quotient (TTHQ) values ranged 0.611- 5.44 (mg/kg Bw/day), 6.26x10-4 – 106.5, 0.067-10.34 and 15 respectively. Clay samples from Anfoega in the Volta region of Ghana is likely to pose adverse health problems when consumed since the HQ’s of these elemental minerals were >1 which point to high content of Manganese (Mn) and Nickel (Ni). It is also likely to cause adverse health problems in an individual’s lifetime since THQ for Arsenic, Lead and Nickel were above 1. Ultimately, the cumulative effect of these toxicants was exceedingly great ≤15 which implied a high level of unsafety associated with this clay. Per the results from this study, it is not safe for pregnant women to consume clay as pica since these toxic elements may cause detrimental effects on the foetus of the unborn child.

P038 - Investigating the Pharmacological Activities of Ocimum Bacillicum SEEDS D. H. Adomah, N. A. Abdulai, A. Acheampong, C. O. Akoto Department of Chemistry, Kwame Nkrumah University of Science and Technology, Kumasi- Ghana Email: [email protected]

Basil (Ocimum basilicum Linn.) is a plant that has found use in traditional medicine and is being used for household remedy against human ailments from ancient times. The present study was aimed to investigate hexane and ethanol fruit extracts of Ocimum basilicum Linn for their phytoconstituents, antiinflammatory, antioxidant, antimicrobial and anthelminthic activities. Phytochemical screenings were performed using standard protocols. Antiinflammatory activities were assessed using egg albumin denaturation assay. The antioxidant activities of the extracts were determined using DPPH scavenging, total antioxidant capacity (TAC) and hydrogen peroxide (H2O2) assays. Antimicrobial activity of the extract was assessed using broth dilution assay. In- vitro anthelminthic activity of both extracts was investigated against Eudrilus eugeniae (Earthworms), with Mebendazole as a reference standard. Column chromatography was employed to isolate a single component which was analysed using FTIR. The preliminary phytochemical screening revealed the presence of alkaloids, phenols, saponins, glycosides, steroids, tannins, terpenoids and flavonoids. The hexane and ethanol extracts exhibited higher concentration- dependent antiinflammatory activities than the aspirin (standard) employed. Their percentage inhibitions were 34.0 ppm, 17.6 ppm, and 11.8 ppm for hexane extract, ethanol extract and aspirin respectively. The hexane extract showed the most concentration-dependent antioxidant activity (IC50 of 13.19 ppm), then the standard drug ascorbic acid (IC50 of 39.17 ppm) and ethanol extract (IC50 of 572.5 ppm) for the DPPH assay. The extracts showed significant concentration-dependent antimicrobial properties comparable to the standards. The ethanol and hexane extracts showed higher concentration-dependent anthelmintic activity compared to the standard mebendazole. The results indicate that both hexane and ethanol extracts of Ocimum basilicum Linn, exhibit antiinflammatory, antioxidant, antimicrobial and anthelminthic activities.

P040 - Anti-Helminthic, Anti-Inflammatory and Antioxidant Activities of Sclerocarya birrea Root. G. Kwarteng, B. K. Kokloku, A. Acheampong, C. O. Akoto Department of Chemistry, Kwame Nkrumah University of Science and Technology, Kumasi- Ghana

Email: [email protected]

For centuries, Sclerocarya birrea, has been an important food, cultural, commercial and ethnomedicinal plant in Africa and exhibits a plethora of ethnotherapeutic properties and pharmacological actions. The present study was aimed to investigate the in vitro anti-helminthic, anti-inflammatory and antioxidant activities of ethanol and aqueous root extracts (ERE and ARE) of Sclerocarya birrea. The phytochemical screening was performed using standard methods. In- vitro anti-helminthic activity of both extracts was investigated against Eudrilus eugeniae (Earthworms), with albendazole as a reference standard drug and time of paralysis and time of death was determined. In vitro anti-inflammatory activity of both extracts was evaluated using egg albumin denaturation method with diclofenac sodium as a reference standard drug. The antioxidant activity was determined by employing hydrogen peroxide (H2O2) scavenging assay with gallic acid as reference standard, 1,1-diphenyl-2-picryl-hydrazyl (DPPH) radical scavenging assay and total antioxidant capacity (TAC) phosphomolybdenum assay method with ascorbic acid as reference standard. FTIR analysis was conducted on both the crude and the purified ethanol extracts. Column Chromatographic separation was performed on the ERE using three different solvent systems of increasing polarity (chloroform, methanol and water) and seven fractions (A to G) were collected. The extracts exhibited superior concentration-dependent anti-helminthic activity at concentrations of 12.00 to 0.75 mg/mL compared to 10.00 mg/mL of albendazole the standard drug. The anti-inflammatory activity of both extracts determined using egg albumin denaturation produced concentration-dependent values comparable to that of diclofenac sodium. The IC50 values of ascorbic acid (standard drug), ERE and ARE were 13.34, 24.66, 87.15 µg/mL, respectively for DPPH radical scavenging assay. The IC50 values of gallic acid (standard drug), ERE and ARE were 203.00, 142.50 and 881.90 µg/mL respectively for H2O2 scavenging assay. The TAC assay method with ascorbic acid (standard drug) had ascorbic acid equivalents (AAE) of 14.862 and 21.676 gAAE/100g for ERE and ARE respectively. The phytochemical screening revealed the presence of saponins and terpenoids in both extracts, but only steroids in the ethanolic extract. FTIR analysis indicated the presence of various functional groups in the crude and purified fractions of ERE that confirms the presence of the phytochemicals identified in the screening test. The results suggest that both extracts could be exploited as potential therapeutic candidate for the treatment of helminthic infections, inflammatory diseases and oxidative-stress diseases.

P041- In Vitro Analysis of Locally Combined Analgesics: Paracetamol, Aspirin and Caffeine on the Ghanaian Market E. J. Dwamena, A. Acheampong, C. O. Akoto Department of Chemistry, Kwame Nkrumah University of Science and Technology, Kumasi- Ghana Email: [email protected] A combined analgesic which contains aspirin, paracetamol (acetaminophen) and caffeine has been used successfully to treat different kinds of pain including minor headache and migraine attacks. The study sought to access the quality of some selected brands of combined analgesic tablets on the market using monographs from the British Pharmacopoeia. Four brands randomly selected from licensed pharmacies within the country were used for the study. These brands were identified using infra-red spectroscopy and thin layer chromatography. Pharmacopoeia tests such as weight uniformity, hardness, friability, disintegration, assay and dissolution were used to evaluate the quality of these analgesic tablets sampled on the market. UV-VIS spectrophotometric method was used for the assay analysis of the tablets where the maximum (λ) used for aspirin, paracetamol and caffeine were 299 nm, 257 nm and 273 nm respectively. In vitro dissolution was conducted using a paddle dissolution apparatus (phosphate buffer of pH 5.8 as the medium) with a dissolution time of 50 minutes. All the brands of analgesic tablets sampled conformed to specifications stated in the British Pharmacopoeia for weight uniformity, hardness, friability and disintegration tests. However, the paracetamol content in brand A failed to meet the specified range of assay in the British Pharmacopoeia. Brand A also failed to meet the pharmacopoeia criterion for dissolution test with a dissolution percentage of 76.91% instead of the required 80% and above. From this research, it can be concluded that brands B, C and D conformed to all the pharmacopoeia tests they were subjected to whiles A failed to meet some of these tests. This provides the need for regulatory bodies such as the Food and Drugs Authority and Ghana Standard Authority to monitor the quality of drugs on the market to safeguard the health of patients in the country.

P043 - Barriers and Facilitators to Healthcare Access for People with Intellectual Disability (PWIDs) In Kumasi, Ghana I. Owusu, D. Addo Centre for Disability and Rehabilitation Studies, Kwame Nkrumah University of Science and Technology, Kumasi Email: [email protected] People with intellectual disabilities are at higher risk of developing preventable diseases due to challenges they encounter in accessing healthcare. Such challenges have led to shorter life expectancy than the general public. The aim of this study was to assess the barriers and facilitators that influence access to healthcare services for People with Intellectual Disability (PWIDs) in Kumasi metropolis. This study was qualitative and used purposive sampling to select participants from the Asokore Mampong and Oforikrom Districts. Data was collected by means of semi- structured interviews, focus group discussions and unstructured observation. Findings showed that specific health needs of PWIDs included epilepsy, sensory issues, chest infection and limited mobility. Challenges they encounter in accessing health included, among others, misdiagnoses, high cost of medication and the inability of healthcare providers to communicate effectively with PWIDs. It however emerged that the introduction of sign language in various health training institutions has contributed to positively shaping the attitude of some healthcare providers towards issues of disability and has served as a major factor that has enhanced access to health for PWIDs. The study recommends the need for some of the medications prescribed for PWIDS to be covered by the National Health Insurance Scheme. It also recommends continuous training of healthcare providers about issues of disability, especially those with intellectual disability as this has the potential to promote the socio-environmental understanding of disability and health care.

P044 - Using Assistive Tools to Improve Health-Care Access for the Intellectually Disabled in Oforikrom and Asokore Mampong Municipalities, Ghana.

A.D. Odongo, J. B. Forkuor

Dept. of Sociology & Social Work, KNUST, Kumasi.

Email: [email protected] According to the World Health Organisation (WHO), Persons living with disabilities (PwDs) constitute one of the most marginalized and vulnerable populations in the world (WHO, 2018). On the other hand, goal 3 and goal 10 of the Sustainable Development Goals (SDGs) emphasize healthy lives and promotion of wellbeing, and reduced inequality for all persons, respectively. As such, these goals can only be attained, if all persons, including Persons with Intellectual Disabilities (PwIDs), have access to quality healthcare that meets their needs. Though Ghana has formulated the Disability Act to cater for the needs of the PwDs in general, the health provisions for PwIDs in particular are limited. Reports on health-care access by PwIDs in Ghana revealed unsatisfied healthcare resulting from communication barriers, inadequate understanding by health professionals and attitudinal problems. The qualitative and participatory research approach has been adopted by the researchers to investigate the healthcare needs of PwIDs. The aim of this study is to develop an intervention for carers of the Intellectually Disabled, health professionals, and health trainees to help Ghana achieve the sustainable development goals 3 and 10 through the adoption of technology. Thus, by enhancing access to quality healthcare for the Intellectually Disabled, not only will their physical wellbeing be secured and promoted, but also their social inclusion will be enhanced. This will complement Ghana’s effort at achieving the Sustainable Development Goal 3(good health and wellbeing), as well as the goal 10 (reduced inequality).

P045 - Access to Health Care by Disabled Persons in the Ejisu Municipality.

E. Acheampong, D. Okyere, I. Owusu, A. Nadutey, A. K. Edusei

Centre for Disability and Rehabilitation Studies, School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.

Email: [email protected]

Access to healthcare is crucial in healthcare systems performance. The concept of access presents access as the result of a relationship/ an interplay between individual factors and health system factors. Although the United Nations’ Convention on the Rights of Persons with Disabilities guarantees persons with disabilities the same level of right to access quality and affordable healthcare as persons without disability, disabled people in Ghana are still one of the most marginalised and socially excluded groups facing various barriers in accessing healthcare. This study aims to ascertain the experiences of persons with physical disability in accessing healthcare in the Ejisu Municipality. A descriptive, quantitative approach was employed. Sixty (60) registered members of the social welfare with physical disability were selected using simple random technique. A quantitative method using structured questionnaire was employed for the data collection. Respondents were given questionnaires with the questions having multiple choices from which they were to choose their responses from. The data was organized and later entered the SPSS software v23 and analyzed using frequency and percentage tables. The study revealed that most of the respondents (80%) experience physical barriers. Although quite a sizable number (76.7%) have ever accessed health care services, frequency was minimal. Barriers identified were, inaccessible door entrances (46.7%) inaccessible staircase (61.7%), inaccessible ramps (58.3%), and inaccessible bathroom facilities (60%). It was noted that attitude of service providers was discriminatory. Use of derogatory words is the most common form. To cope with these experiences most of the respondent’s resort to obtaining services from pharmacies or local drugstores whereas others depend on assistance from family members. It is recommended that all stakeholders including the ministry of health, health centers and Non-governmental institutions should help mitigate the barriers at the health centers.

P046 - Challenges in Caring for Children with Mental Disorders by Parents: A Case Study at Komfo Anokye Teaching Hospital.

I. Zakia, W.K. Mprah, I. Owusu Centre for Disability and Rehabilitation Studies Kwame Nkrumah University of Science and Technology, Kumasi Email: [email protected] It is estimated that world-wide, up to 20% of children experience mental disorders. Examples of such disorders include learning disorders, attention deficit hyperactivity disorder (ADHD), pervasive development disorder, anxiety disorder, conduct disorder and eating disorder. Caring for such children can be very stressful for their parents. An assessment of the challenges of caregivers of these children is important as this could lead to finding developing better caregiving practices and providing appropriate support services for such carers. The aim of the study is to explore the psychological and socio-economic challenges that the parents experience while caring for their children with mental disorders. The study also sought to assess how they cope with these challenges and ascertain available support services to help parents overcome these challenges. The study was conducted at the Psychiatric unit of the Komfo Anokye Teaching Hospital. A qualitative study design was employed. 15 parents of children with mental disorders were interviewed by means of an interview guide. Findings indicated that financial constraints, low productive life, isolation from families and stigma were among challenges parents faced in caring for their children with mental disorders. Coping mechanisms included involvements in religious activities and tuning oneself psychology to accept the situation as part of life. The study strongly recommends public education on mental disorders should be by the Ministry of Health in collaboration with the Ministry of Gender and Social Protection to reduce the deep-seated social stigma associated with such conditions.

P047 - Benefits of Community Based Rehabilitation Services in the Managing Substance Abuse: A Case Study of Kumasi Chesire Home and Willingway Rehabilitation Centre.

D. N. Obeng, W. K. Mprah, I. Owusu, E. Acheampong

Centre for Disability and Rehabilitation Studies, Kwame Nkrumah University of Science and Technology, Kumasi

Email: [email protected]

Addiction to substances, such as alcohol, opiates, and cocaine is a growing global burden among adolescents as well as adults of all ages. Substance abuse is an unhealthy pattern of drug usage, often leading to serious problems at home, school, and workplace. Community-based rehabilitation (CBR) has proven to be effective in managing substance abuse. However, the benefits of CBR in managing substance abuse has received less attention in Ghana. This study therefore examined the benefits of CBR in managing substance abuse in two CBR homes in the Ashanti Region. The study employed a case study design and used qualitative data collection method. Fifteen participants, comprising 10 drug addicts and five service providers, were recruited using convenience and purposive sampling techniques respectively. Data were generated through interviews using a semi-structured interview guide and analyzed by performing thematic content analysis. The findings revealed that services offered in the two CBR centres have provided relief to many inmates. According to the participants, the quality of life of addicts improved; their health status improved, and behavioral challenges minimized. It is recommended that the Ministry of Health should support CBR centres to enable them to perform their functions effectively.

P051 - In Vitro Studies of the Effect of Anopheles gambiae Midgut Bacteria on the Development of Plasmodium falciparum.

G. W. Ametsi1, J. E. B. Akorli2, Y. Aniweh1

1West African Centre for Cell Biology of Infectious Pathogens, University of Ghana, Legon, Accra, 2Department of Parasitology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra.

E-mail: [email protected]

During blood meal, female Anopheles mosquitoes ingest gametocytes which undergo transformation in the gut and develop into sporozoites that infect humans. Bacteria inhabit the mosquito gut, and the number and diversity of these bacteria change following blood feeding. The presence of some bacteria species results in the reduced intensity of sporozoites. A small number of molecular mediators have been characterized till date which does not give a comprehensive understanding of the mechanism employed by gut bacteria in parasite killing. This study seeks to identify the biomolecules produced by Enterobacter cloacae and Serratia marcescens and observe their morphological and genetic effects on the development of Plasmodium parasites. Plasmodium falciparum 3D7 and NF54 cultures at 1% parasitaemia were independently exposed to spend Luria-Bertani (LB) from varying concentrations of Enterobacter cloacae and Serratia marcescens. The parasite killing effect of the bacteria were assessed by microscopy and SYBR green fluorescent assay after 48 hours of co-culture. Spent media with final bacteria concentration between 10e+10-10e+20 reduced parasitaemia (P<0.001) compared to without bacteria treatment. Real-time PCR will be used to assess the expression levels of GAMER and HADO parasite developmental genes and characterize the biomolecules in the spent media. These will provide information for further studies on gene and protein targets for transmission blocking interventions.

P052 - Exploring Within-Host Dynamics of the T Helper Cell Response to Schistosomiasis C. K. Owusu1, A. Phythian - Adams2, A. MacDonald2, M. Berriman3 1Vector-borne Infectious Disease Group, Department of Theoretical and Applied Biology, KNUST, Kumasi, Ghana, 2Manchester Collaborative Centre for Inflammation Research, University of Manchester, Manchester, UK, 3Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, UK. E-mail: [email protected] More than 150 years after it was formally described, schistosomiasis still remains one of the most devastating parasitic diseases of humans. While praziquantel significantly reduces morbidity due to the disease, the drug must be administered repeatedly over regular intervals as it does not prevent reinfection. According to the WHO, only 88 out of more than 200 million people requiring preventive anthelmintic treatment were treated in 2016, leaving millions of others at risk of developing potentially serious health complications from long-term from chronic infection. The immune response to Schistosoma mansoni infection has been well-characterised in experimental mouse models. Early in the infection, migrating larvae trigger a mixed type 1 (Th1) and 2 (Th2) inflammatory response. This changes to a dominant Th2 response after mated worm pairs begin producing eggs around five weeks post infection. The Th2 response peaks around week 8, after which the response gradually weakens, corresponding to the chronic phase of the disease. We used a non-a priori single cell RNA-seq approach to explore within-host dynamics of the T helper cell response by comparing the transcriptional profiles of individual CD4+ T cells isolated from the mesenteric lymph nodes of a single S. mansoni-infected mouse to CD4+ T cells isolated from the liver of the same mouse. After quality control, we obtained transcriptome data from 409 single cells. Analysis of T cell receptor sequences revealed several instances of cells derived from the same progenitor, including the massive expansion of a single clonotype. Comparisons between MLN and liver derived CD4+ cells also revealed clear differences in the expression of key cell lineage and immune effector markers.

P053 - Evaluation of Individual and Combined Markers of Urine Dipstick Parameters and Total Lymphocyte Count as a Substitute for CD4 Count in Low-Resource Communities in Ghana.

E. O. Anto1,2, C. Obirikorang1, B. O. Afranie1, E. Acheampong1, B. Amankwaa1, S. Donkor1

1Department of Molecular Medicine, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana, 2School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia.

Email: [email protected] We evaluated the individual and combined levels of urine dipstick and total lymphocyte count (TLC) as surrogate markers for CD4 count in a low-resource community in Ghana. This cross-sectional study recruited 200 HIV-infected patients fromthe Saint Francis Xavier Hospital, Assin Fosu, Ghana. Complete blood count, CD4 count, and urine dipstick analysis were measured for participants. The threshold values were determined as <350 cells/µl for CD4, <1200 cells/µl for TLC, and ≥+ on urine dipstick analysis. The mean age of participants was 43.09 years. Proteinuria ≥ + [aOR = 4.30 (3.0–18.5)], leukocyturia ≥ + [aOR = 2.91 (1.33–12.5)], hematuria ≥ + [aOR = 2.30 (1.08–9.64)], and TLC < 1200 cells/µl [aOR = 3.26 (3.94–15.29)] were significantly associated with increased risk of CD4 count < 350 cells/µl. Using the individual markers, the best substitute marker for predicting CD4 count < 350 cells/µl was proteinuria at a cutoff point ≥ 2++, AUC of 0.973, sensitivity of 97.6%, specificity of 100.0%, PPV of 100.0%, and NPV of 89.1%. A combination of ≤ 1200 TLC + ≥ 2++ (leukocyturia + proteinuria + hematuria) yielded an AUC of 0.980, sensitivity (72.8%), specificity (100.0%), PPV (100.0%), and NPV (97.9%). Proteinuria could serve as a noninvasive screening tool, but the combination of proteinuria, leukocyturia, hematuria, and TLC serves as a better substitute marker for CD4 count in monitoring the disease progression among HIV patients in low-resource communities.

P054 - Fungal Disease Burden: An Underestimated Health Challenge in Cote d’Ivoire. D. Koffi1, B.V. Ira1, A. O. Touré1, R. Jambou1, D. W. Denning2 1Parasitology and Mycology Department, Institut Pasteur de Cote d’Ivoire; 2The University of Manchester and The National Aspergillosis Centre in association with the LIFE program at www.LIFE-Worldwide.org Email: [email protected]

Due to limited access to more powerful diagnostic tools, there are few data on the burden of fungal infections in Cote d’Ivoire, despite a high HIV and TB burden and many cutaneous diseases. Here we estimate the burden of serious fungal infections in this sub-Saharan country. National demographics were used to perform a PubMed search and retrieve all published articles on fungal infections in Cote d’ivoire and countries bordering West Africa. When no data existed, risk populations were used to estimate frequencies of fungal infections, using previously described methodology by LIFE. (www.LIFE-Worldwide.org).The population of Cote d’ivoire is around 23 million; 36.2% are children, and 9% are >65 years. Tinea capitis in children is common, measured at 13,9% in the last epidemiological study (2013). Considering the prevalence of HIV infection (2.7% of the population) and a hospital incidence of 0.6% of cryptococcosis, it is estimated that 3726 patients per year develop cryptococcosis. For pneumocystosis, it is suggested that 1013 new cases occur each year. An estimated 1567 new cases of Chronic Pulmonary Aspergillosis occur after pulmonary tuberculosis (a 5-year prevalence of 4938 cases (20.3/100,000). ABPA and SAFS were estimated in 104/100,000 and 151/100,000 respectively, in 1,100,000 adult asthmatics. Vulvovaginal candidiasis (VVC) is common and recurrent VVC affects ~6% of women in their fertile years - 407,000 women. An unknown number develop candidaemia and invasive aspergillosis. There are no incidence data on fungal keratitis, histoplasmosis and chromoblastomycosis, although some cases of mycetoma and histoplasmosis have been reported. The present study indicates that around to 6.8 % (1.6million) of the population is affected by a serious fungal infection, predominently tinea capitis in children and rVVC in women. These data should be used to inform epidemiological studies, diagnostic needs and therapeutic strategies in Cote d’Ivoire.

P055 - Evaluation of Three Diagnostic Tests for Monitoring of Lymphatic Filariasis Elimination in Ahanta West, Nzema East and Ellembelle Districts, Western Region, Ghana. F. A. McCarthy1, F. Anto2, D. K. de Souza1, M. D. Wilson1 I. O. Owusu1. 1Department of Parasitology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon-Accra, Ghana; 2Department of Epidemiology, School of Public Health, College of Health Sciences, University of Ghana, Legon-Accra, Ghana. Email: [email protected]; [email protected] Wuchereria bancrofti is a filarial parasite which causes one of the most important neglected tropical diseases; Lymphatic filariasis. The disease is known to be responsible for much morbidity and deformity which brings about social and economic burdens on affected persons. The disease requires diagnostic tools that show high specificity and sensitivity in addition to their feasibility in terms of field implementation and efficiency. This study was a community based cross-sectional survey involving persons aged 5 years and above living in Ahanta West, Ellembelle and Nzema East districts which was aimed at evaluating the performance of three diagnostic tools; filarial test strip (FTS), microscopy and Wb123 ELISA for monitoring of LF elimination in the three districts. Day-time finger prick blood samples were obtained from 1371 participants recruited from households in 18 selected communities and tested for W. bancrofti antigen using FTS. Antigenemia positive individuals were followed up for collection of night blood samples to investigate the presence of microfilariae by microscopy. Filter blood spots were obtained for participants aged between 5 to 10 years and antigenemia positive individuals. These samples were tested for the presence of IgG4 antibodies specific for stage L3 of W. bancrofti using Wb123 ELISA. One hundred and thirteen (8.2%) of the tested individuals were antigenemia positive, 12 (12.4%) were mf positive and 14 (14.4%) were positive for IgG4 antibodies for W. bancrofti. The performance of FTS, Wb123 ELISA and microscopy were compared. FTS had 9.0% score over Wb123 ELISA (1.1%) and microscopy (1.0%). FTS was found to be more reliable in terms of diagnosis of LF compared to the other two diagnostics and could therefore be employed for use in areas with low endemicity rates. This study demonstrated the performance of filarial test strip, Wb123 ELISA test and microscopy for point of care monitoring following mass drug administration to reduce time spent in diagnosing in areas where bancroftian filariasis is endemic.

P056 - Prevalence and Risk Factors of Nasal Carriage of Methicillin-Resistant Staphylococcus aureus among hospitalized patients at Komfo Anokye Teaching Hospital, Ghana. E. D. Kutu1, A. Owusu-Ofori1, C. Vinnemier2 1Department of Clinical Microbiology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana, 2 Department of Medicine, University Medical Center, Hamburg-Eppendorf. Email: [email protected] Methicillin-Resistant Staphylococcus aureus (MRSA) is implicated in several nosocomial infections. It is carried asymptomatically in the nasal cavity and other parts of the human body. Asymptomatic carriage serves as an important source of transmission of the organism to other patients, especially within a confined place such as the hospital wards. There is limited data on the prevalence of MRSA among hospitalized patients in Komfo Anokye Teaching Hospital (KATH). This study aimed to establish the prevalence and risk factors of MRSA nasal carriage among hospitalized patients at KATH in Kumasi, Ghana. Questionnaires were used to assess risk factors of MRSA nasal carriage. Nasal swabs were collected from patients and cultured overnight aerobically on mannitol salt agar (MSA) at 37oC. Catalase and coagulase tests were performed on yellow colonies from overnight culture on MSA. Coagulase positive isolates were confirmed as S. aureus by nucA PCR. The Kirby-Bauer disk diffusion method was used to test the antibiotic susceptibility profile, with cefoxitin resistant isolates confirmed as MRSA by PCR identification of the mecA gene. Out of 224 samples, 14 were confirmed as MRSA, resulting in MRSA prevalence of 6.25%. The MRSA isolates showed 100% resistance rate against penicillin and ampicillin. Gentamicin produced the highest activity (79%) against the MRSA isolates. Chronic hepatic disease was identified as the risk factor that significantly affected MRSA nasal carriage (Odds ratio:16.08, p-value:0.010). This study revealed that there is high prevalence of MRSA among the patients and this high prevalence constitutes a transmission risk to other patients. It is recommended that health workers and patients in KATH adhere strictly to infection prevention and control measures to avoid passing on MRSA to other patients. Further studies on genotyping are needed to identify if it is the same MRSA strains that are circulating in the hospital.

P057 - PAH Exposure among Slaughterhouse and Slaughter Slab Workers Who Utilize Scrap Automobile Tires to Singe Meat in Ghana

A. Brown1, C. Grunert1, N. Johnson2, E. Afriyie-Gyawu1 1Department of Biostatistics, Epidemiology & Environmental Health Sciences, JPH College of Public Health, Georgia Southern University, Statesboro, GA, USA, 2Environmental and Occupational Health, School of Public Health, Texas A& M University, College Station, TX, USA Email: [email protected] In Ghana and other African countries, it is common practice for slaughterhouse (SLH) and slaughter slab (SLS) workers to utilize scrap automobile tires as fuel to singe the fur of food animal carcasses intended for human consumption. This practice releases toxic substances including polycyclic aromatic hydrocarbons (PAHs), carbon monoxide, benzene, particulate matter, and other toxicants into the atmosphere via smoke. PAHs are a group of over 100 organic compounds that are released during burning of tires, coal, gasoline, trash, wood, etc. Exposure to PAHs have been associated with health issues such as respiratory impairment; irritation of skin, eyes, and airways; and cancer. Studies show that 1-OHP is a reliable biomarker of exposure to PAHs – as it is a metabolite of pyrene, one of the significant components present in all PAH mixtures (Hu and Hou, 2015; Jongeneelen, 2001). The primary objective of this study was to assess PAH exposure levels among SLS/SLS operators by quantifying their urinary 1-OHP levels using HPLC-MS. Urine samples (n=59) were collected from SLH/SLS operators who use scrap tires versus liquefied petroleum gas (LPG, control) as fuel sources for meat singeing and analyzed for 1-OHP. The average concentration (±SEM) of urinary 1-OHP for individuals who utilize tires versus LPG, and production workers were 383.42±57.31 ng/ml, 301.76±41.88 ng/ml, and 250.79±15.23 ng/ml, respectively. The urinary 1-OHP data were standardized with creatinine (crt) to account for urinary dilution. After adjusting for dilution, the mean concentration of urinary 1-OHP was higher among workers utilizing tires (363.43±61.65 ng/mg crt) compared to production workers (319.75±115.49 ng/mg crt) and those who used LPG (210.47±54.17 ng/mg crt). While the mean urinary 1-OHP level among tire-based meat singeing operators was much higher compared to the controls, the difference was not statistically significant. Thus, future studies (using a larger sample size) are warranted to confirm this trend.

P058 - Impact of Malaria on Haematological Parameters of Urban, Peri-Urban and Rural Patients in the Ashanti Region of Ghana

A. H. Mutala, K. Badu, C. Owusu, S. K. Agordzo, A. Tweneboah, A. Dawood Department of Theoretical and Applied Biology- KNUST, Kumasi

Email: [email protected]

The introduction of malaria parasites into the host peripheral blood by an infected Anopheles mosquito is likely to trigger changes in certain host haematological parameters. These changes may subsequently affect the general physiology of the host, resulting in a number of clinical manifestations. It is, however, possible that factors such as differences in demographic settlements may also influence observed changes. This study aims to investigate the haematological changes that occur in malaria patients across the different demographic settlements. Hospital-based cross- sectional study was conducted from January to November 2018. A total of 598 participants were recruited in the study. Giemsa-stained slides viewed under a microscope were used in the detection and quantification of malaria parasitemia while hematological parameters were measured using hematology analyzer. The rural area significantly (p=0.009) recorded the highest malaria prevalence compared to the other study communities. The difference in parasite density across the three communities was also significant (p=0.0149). There was significant difference in red blood cell (p=0.0170), hemoglobin (p=0.0165), mean corpuscular volume (p=0.0139) and platelets (p<0.0001) counts when the infected population was compared to the uninfected. The difference in median WBC (p-value <0.0001), neutrophil (p-value <0.0001) and lymphocyte (p-value <0.0269) were significantly higher in infected patients from the peri-urban area compared to malaria patients from the rural and urban areas. Patients infected with malaria showed significant difference in hematological parameters with low RBC, Hb and platelets in comparison to uninfected patients. The variation of hematological parameters due to malaria infection can give a hint for a thorough search of the parasite in the peripheral blood and this could help improve malaria diagnosis.

P059 - Studies on Urinary Schistosomiasis in Selected Peri-Urban Communities Around Kumasi, Ghana. P. Adjei-Kusi1,2, O. Maiga-Ascofare1,3, H. K. Hanson1, J. A. Larbi2 E. Owusu-Dabo1,4. 1Kumasi Centre for Collaborative Research, KNUST-Kumasi, Ghana, 2Department of Theoretical and Applied Biology, College of Science, KNUST-Kumasi, , 3Bernhard-Nocht Institute for Tropical Medicine (BNITM), Hamburg, Germany, 4School of Public Health, College of Health Sciences, KNUST, Kumasi, Ghana. E-mail: [email protected] Schistosomiasis is the most prevalent waterborne disease in tropical countries. Freshwater snails serve as intermediate host for the disease transmission. Rivers create suitable environment for breeding of these snails; therefore, an epidemiological survey was conducted in four communities around Kumasi to determine the prevalence of urinary schistosomiasis and the snail species responsible for its transmission. Individuals between the ages of 6-30 years were examined by microscopy for the presence of schistosome eggs in their urine. A total of 1008 individuals were screened for S. haematobium with a prevalence of 8.9%. Deduako recorded the least prevalence (3.6%) while Apromase recorded the highest (17.1%). The risk factors associated with schistosomiasis were gender, age and water contact. The prevalence of the infection among males was 13.1% and females 5.0%. Among the infected individuals, those in the 13-18 years group recorded the highest infection rate (45.6%). Water contact activities showed that individuals swimming in rivers had a higher risk of infection than those who do not swim in rivers (OR = 2.90). Snails were also collected from rivers in the communities and characterised according to their shell morphology. In all, 2305 snails were collected and classified into six different species. The infectivity rate of 1,939 of these snails were investigated by inducing cercariae shedding. Three of the collected snail species successfully shed cercariae (2.1%). A low rate of schistosome infection was recorded among the 387 Bulinus globosus snails collected (0.3%). Lymnaea natalensis which transmits fascioliasis shed both single-tailed and fork-tailed cercariae. Biomphalaria pfeifferi, the most snail species collected (32.3%) and known to transmit S. mansoni shed rather single tailed cercariae (3.4%). It has been established that local transmission of schistosomiasis and fascioliasis is ongoing in the study communities with the risk of S. intercalatum transmission if introduced in the region.

P060 - Parasitism Of Cattle By Ticks on the Transhumance Corridor Between Cote d’Ivoire and Burkina Faso: Case Of Rhipicephalus (Boophilus) Microplus (Canestrini, 1888) D. K. C. Aimée1, 2, A.Y. Louise3,Y. K. Patrick4;

1Institut Pasteur de Côte d’Ivoire, 2Laboratoire de Biologie de la Reproduction et d’Endocrinologie, Université Félix Houphouët- Boigny, Abidjan, Côte d’Ivoire. 3Institut National de la Formation Professionnelle Agricole (INFPA), Ecole de Spécialisation en Elevage et de Métiers de la Viande (ESEMVB), Côte d’Ivoire. 4Laboratoire de Zoologie et Biologie Animale URF de Parasitologie et Ecologie Parasitaire, Université Félix Houphouët- Boigny, Côte d’Ivoire.

Email: [email protected]

Ticks (Ixodidae) cause nuisance to livestock and transmit many diseases to them. Extensive livestock farming in the West African region and cross-border mobility is a risk factor for cattle using the same routes. An investigation was initiated to inventory the ticks that circulate in transhumance tracks on the Ivorian-Burkinabe border and to study the agro-ecological characteristics of their parasitic activity. Thus, from November 2014 to October 2016. Twenty- five (25) sedentary herds distributed in eight departments of northern Côte d'Ivoire crossed by transhumance tracks were visited regularly with one out every two months. At each passage, ticks and blood samples were taken from 15 cattle per herd. During this period, of the 28 368 adult ticks collected, twelve (12) species were identified, including one (1) of the genus Amblyomma, four (4) of the genus Hyalomma and seven (7) of the genus Rhipicephalus. The numerically dominant species was Rhipicephalus (Boophilus) microplus 64.27% followed by Amblyomma variegatum 25.06%. Other species of the genus Rhipicephalus and the genus Hyalomma were found in very small quantities. The species H. impressum, H. marginatum marginatum and H. truncatum are mainly in the department of Ouangolo. The species R. senegalensis, R. sanguineus, A. variegatum, R. (B.) geigyi, R. (B.) decoloratus and R. (B.) microplus occur most in the departments of Niakaramadougou, Kong, Katiola, Dabakala and Ferkéssedougou. R. (B.) microplus is the most abundant tick in both agro-ecological zones (AEZ). The tick samples collected in Côte d'Ivoire for this study indicate that the relatively recent introduction of this species appears to be very successful.

P061 – Use of Vitamin a Monitor Chart and Tally Sheets to Improve Under Five Vitamin a Supplementation at Amuzudeve Chps in Adaklu District of the Volta Region of Ghana

A-M. C. Abdul-Latif1, N. Glover1, B. Kunutsor1, C. K. Azagba2, A. Agbeko1, Y. Ofori-Yeboah1, T. Letsa1

1Volta Regional Health Directorate, Ghana Health Service 2Adaklu District Health Directorate

Email: [email protected]

Vitamin A Supplementation (VAS) still remains one of the key cost effective child survival interventions implemented at a large scale to reduce the number of preventable child deaths each year. The United Nations has advocated the use of this strategy since 1997 and many countries including Ghana with support from UNICEF provided the necessary push to accelerate the national supplementation program for more than 2 decades now. The strategy has always been to ensure that children between 6-59 months receive at least one dosed of Vitamin A in the past six months. Achieving high coverages of this intervention is therefore key not only to eliminate Vitamin A deficiency but to also help reduce under five child mortality. However, for some years the coverage of this indicator in children between 12-59 months has been low. There was therefore the need to test some change ideas to improve this indicator. The study tested, examined and implemented the use of Vitamin A monitor chart and tally sheets capable of improving the coverage of VAS in children between 12-59 months at Amuzudeve CHPS zone in Adaklu District of the Volta Region using Quality improvement tools. The study was descriptive in design. The change idea tested and later implemented is the use of Vitamin A monitor chart at Amuzudeve CHPS to track the uptake of Vitamin A supplements among children between 12-59 months at the facility. Each child tracked was supposed to receive one dose of the Vitamin A capsule once a semester (every six months). Tally sheets to help in tracking these children on a monthly basis were introduced in six communities in the CHPS zone. Data on VAS uptake in the District Health Information System (DHIMS2) database of the Volta Region for the study period (June 2016 to April 2018) was utilized. Data was analyzed and described using numbers and percentages with graphical presentations. Vitamin A supplementation (12-59 months) showed a significant increase from a median of 50% to 80% from August 2014 to April 2018, which represents 60% increase. The monthly median coverage of VAS has also seen an appreciable increase from 42% in 2014 to 86% in 2018, representing 105% rise in coverage. The study revealed that Vitamin A monitor charts and tally sheets are very useful tools that can be used to improve the uptake of VAS in children between 12-59 months in very challenging situations where care givers and their children default from attending Child Welfare Clinics after the completion of their immunization schedule. The use of tally sheets makes the tracking of children due for supplementation easier and for that matter most children are able to get two doses of this supplement in a year. With the use of these tally sheets, health care workers are able to estimate the number of children due for supplementation on a six monthly basis. This strategy can therefore be replicated in other areas to examine the potency of these tools.

P062 - Malaria and Soil Transmitted Helminthes Coinfection and Nutritional Status of Children in Selected Charity Homes in Kumasi Metropolis.

M. Oppong1,2, H. K. Hanson2, D. Tsali1,2 ,N.S. Amoustapha1,2, K.S Marfo1,2 , E. B Ackah4, J. A. Larbi1 , O. Maiga-Ascofare2,3

1Dept. of Theoretical and applied biology, KNUST, Kumasi. 2Kumasi Centre for Collaborative Research into Tropical Medicine, KNUST, Kumasi; 3Bernard Notch Institute for Tropical Medicine, 4School of Public Health, College of Health Sciences, KNUST.

Email: [email protected]

Parasitic diseases such as malaria and helminthiasis also known as neglected tropical diseases (NTD’s) have been found to be amongst the most widespread of all chronic human infections globally especially in developing countries. The study was conducted to determine the prevalence of malaria and soil transmitted helminthes coinfection and nutritional status of children in selected charity homes. A cross-sectional study was conducted in three charity homes thus one government, two private homes in Kumasi metropolis in the month of May 2018. A total of 127 children were enrolled for the study. A structured mobile based questionnaire was administered to ascertain socio-demographic characteristics of children. Children’s anthropometry was taken and converted into Z-score values by following the WHO child’s growth standard in assessment of their nutritional status. Finger prick blood was taken to measure children’s haemoglobin level and also to determine malaria parasitaemia using thick and thin film methods. Stool samples were processed using formol-ether concentration technique and examined microscopically for intestinal parasites. Z score values obtained showed that 66.9% of the children were well nourished, 10.2% were moderately nourished, 17.3% were severely malnourished and 3.9% were obese. The prevalence of malaria was 4.7% whiles the prevalence of intestinal parasites was 7.9%. Hymenolepis nana (3.1%) was the most prevalent intestinal parasite identified followed by Cryptosporidium specie (2.4%), Fasciola specie (1.6%) and Strongyloides stercoralis (0.8%). no statistically significant association was found between malnourished children and intestinal parasitic infection. However, a P value of 0.069 was obtained between anaemic cases and malaria infected individuals which showed a close tendency of an association between those two. Efforts are made in these charity homes to curtail parasitic infections however more intervention tools would be needed for complete eradication of the parasitic infections in these charity homes and in the various communities.

P063 – Susceptibility of the malaria parasite to artesunate amodiaquine (ASAQ) in children at Asante Akyem Agogo.

D. N. Tsali¹, 2, H. K. Hanson ², K. Sarfo-Marfo², M. Oppong¹, 2, N. S. Almoustapha¹,², G. Foli², R. Larbi², J. Osei-Mensah², A. Martey², E. Placca², A. Appiah², J.A. Larbi¹, O. Maiga-Ascofare², ³

¹Department of Theoretical and Applied Biology, KNUST, Kumasi, ²Kumasi Centre for Collaborative Research in Tropical Medicine, KNUST, ³Benhard-Notch Institute for Tropical Medicine, Germany Email: [email protected] Resistance to antimalarial drugs has been a major challenge to malaria control. Artemisinin combination therapy (ACT), was introduced after the development of resistance by the parasite to most single therapies. However, resistance to Artemisinin (ART) in South East Asia, characterized by a mutation in the Plasmodium falciparum K13 propeller domain, poses a great threat to the efficacy of ACT’s. This study was conducted from July to November 2018 to monitor the efficacy of Artesunate Amodiaquine in Asante Akyem Agogo. Children aged 2-10 years were recruited at the Presbyterian hospital and Juansa Health Facility based on a positive RDT result. Drugs were administered under direct observation to ensure compliance. A re-administration of drug was done for children who vomited a particular dose. Hemoglobin (Hb) levels were also monitored on Day 0, 7, 14 and 28 to check for anaemia. Follow ups were conducted for a period of 28 days to monitor parasite clearance and detect any reinfection or recrudescence. Out of the 120 patients recruited, 15 (12.5%) were found to be negative by Microscopy despite a positive RDT. The average parasite load was 144622 parasites /µl. Only 6 (5.7%) of patients remained positive by microscopy after taking the second dose of the drug with average parasite load of 155 parasites/µl. No asexual parasites were detected in any patient after the full course of treatment has been administrated. ASAQ drugs were re-administered to four (3.33%) of the patients. The mean HB at Day 0 was 10.51g/dL, however on Day 7, the mean HB reduced to 9.56g/dL but increased steadily at Day 28 to 11.26g/dL. Haemoglobin levels decreased with intake of ASAQ but haematologic recovery was adequate on Day 28. Rapid parasite clearance was also observed with intake of the drug. Artesunate Amodiaquine is still effective when drug compliance is ensured.

P064 – Experiences of Family Caregivers of Ghanaian Women Diagnosed with Advanced Breast Cancer.

G. Kusi1, 2, A. B. Bonsu1

1Department of Nursing, Faculty of Allied Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana. 2Komfo Anokye Teaching Hospital, Department of Obstetrics and Gynecology, Kumasi, Ghana.

Email: [email protected]; [email protected]

Breast cancer is the most frequently diagnosed cancer among women in Ghana with majority of these women presenting with advanced stage disease. In the Ghanaian context, family caregivers are involved in providing home-based care to women diagnosed with advanced breast cancer due to lack of integrated palliative and oncology care services. The aim of this study was to describe the experiences of family caregivers of Ghanaian women diagnosed with advanced breast cancer receiving care at the oncology unit of Komfo Anokye Teaching Hospital. Qualitative in-depth face –to face interviews employing a descriptive phenomenological approach were conducted using a semi-structured interview guide. Purposive sample approach was used to enroll 15 caregivers into the study. Sample size was determined by data saturation and colaizzi’s (1978) thematic analysis steps was used to analyze the data. Seven themes emerged from the data: “motive for assuming the caregiving role”, “meeting self-care and physical needs of patients”, “symptom management and monitoring”, “providing support for patients”, “struggling with the demands of caregiving”, “religiosity” and lastly, “support”. These theme also had sub-themes. Findings from the study showed that family caregivers were motivated by family and socio-cultural obligation as well as reciprocity to assume their caregiving role. Family caregivers cited series of challenges associated with their caregiving role and these were: social, financial, emotional, and physical challenges. Coping strategies such as sharing responsibilities of caregiving with other family members, getting support from healthcare professionals, faith in God were employed by participants to deal with the challenges associated with their caregiving roles. Family members are important stakeholders in advanced breast cancer management. Health professionals should therefore acknowledge them as significant team members in cancer care. A home-based support system should be developed to assist them in their caregiving role especially in the area of symptom management.

P065 - Food Safety Knowledge and Practice among Pregnant Women in Assin Fosu, Ghana E. Asiedu1,2, S. Y. Ahiabor1 1Dept. Epidemiology and Biostatics, School of Public Health, University of Health and Allied Sciences, Ho. 2Horizon Health GH, Assin Fosu. Email: [email protected] Although foodborne illness is preventable, it has become a growing public health concern worldwide. Foodborne pathogens are more likely to cause infection and to result in serious consequences in vulnerable people than in healthy adults. The occurrence of foodborne illness is highly related to the level of food safety knowledge, consumer practices and household food safety especially among susceptible individuals. Understanding of food safety knowledge and practice is needed to prevent the life-threatening consequences that occur among individuals because of foodborne illness. This study assessed the food safety knowledge and practice among pregnant women in Assin Fosu, Ghana. A cross-sectional descriptive study was carried out involving 170 pregnant women from St Francis Xavier Hospital who met the inclusion criteria. Data was collected via the use of pre-tested questionnaires with the aid of research assistants. The analysis was done using Stata 12. Chi square analysis was used to determine the association between demographic characteristics and food safety knowledge and food safety practice among the pregnant women (P < 0.05). The study showed that the 90.6% of the respondents had high food safety knowledge. Again 69.41% of them were aware of food poisoning but only 58.2% knew how to prevent it and 28.2% had experienced food poisoning before. 66.5% agreed that storing raw and cooked food together could result in food contamination. Moreover, 58.2% adhered to bad food safety practice Also, 60.6% defreeze frozen food at room temperature, 40.6% always wear accessories when washing their hands and cooking and only 8.8% always wear protective clothing when cooking. Age and educational level was found to have significant influence (P < 0.05) on food safety knowledge, whereas educational level and employment status had significant influence on food safety practice. Food safety knowledge was high but food safety practice was bad among the respondents. Educational level was the most important demographic characteristic that had significant influence on both food safety knowledge and food safety practice among pregnant women in this study.

P066 Exploring Midwives’ Understanding of Respectful and Non-abusive Maternal Care

V. M. Dzomeku1, A. B. Bonsu1, E. K.Nakua2, P. Agbadi1, P. Donkor3, 4, R. J. Lori5

1 Department of Nursing, Faculty of Allied Health Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana. 2Department of Epidemiology and Biostatistics, School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana. 3Department of Surgery, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana. 4Komfo Anokye Teaching Hospital, Kumasi, Ghana. 5 School of Nursing, University of Michigan USA

Email: [email protected] Various aspects of disrespect and abusive maternity care have received scholarly attention because of frequent reports of the phenomenon in most healthcare facilities globally, especially in low- and middle-income countries. However, the perspectives of skilled providers on respectful maternal care (RMC) have not been extensively studied. Midwives’ knowledge of respectful maternal care is critical in designing any interventive measures to address the menance of disrespect and abuse in maternity care. Therefore, the present study sought to explore the views of midwives on RMC at a Teaching Hospital in Kumasi, Ghana. Phenomenological qualitative research design was employed in the study. Data were generated through face-to-face in-depth interviews, which were audio-recorded and transcribed verbatim. Data saturation was reached with fifteen midwives. Open Code 4.03 was used to manage and analyse the data. The midwives’ understanding of respectful maternal care comprises of the following components: non-abusive care, consented care, confidential care, non-violation of childbearing women’s basic human rights, and non- discriminatory care. Probing questions to solicit their opinions on the evidenced-based component of respectful maternity care generated little information, suggesting that the midwives have a gap in knowledge regarding this component of respectful maternity care. The midwives have an understanding of most components of respectful maternal care, but their gap in knowledge on evidenced-based care requires policy attention and in-service training. To understand the extent to which this gap in knowledge can be generalized for midwives across Ghana to warrant a redesign of the national midwifery curriculum, the authors recommend a nationwide cross-sectional quantitative study.

P067 - Screening Phytochemicals from Crinum jagus for Anti-infective and Antipyretic Properties.

P. A. B. Minkah, C. A. Danquah

Department of Pharmacology, Faculty of Pharmacy and Pharmaceutical Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi. Email: [email protected] The bulbs of Crinum jagus (J. Thomps.) Dandy commonly known as St. Christopher or Harmattan lily and locally in Akan as “sukooko” is used in Ghana as a decoction to manage infections, asthma and wounds. This current study seeks to evaluate the anti-infective and antipyretic effects of the aqueous, methanol, ethanol and hexane extracts of C. jagus. The High Throughput Spot culture growth inhibition assay (HT-SPOTi) and baker’s yeast induced pyrexia in rat model were used to screen for the anti-infective and antipyretic activities of the various extracts of C. jagus respectively. Broad spectrum antimicrobial activity was shown by the methanol extract of Crinum jagus when tested against Pseudomonas aeruginosa, Staphylococcus aureus, Streptococcus pyrogens, Proteus mirabilis, Salmonella typhi, Klebsiella pneumonia, Escherichia coli, Staphylococcus epidermidis, Mycobacterium smegmatis and Candida albicans with MIC values ranging between 1-125 mg/L. The activity against Mycobacterium smegmatis and the Gram- negative Pathogens S. typhi and P. aeruginosa which are difficult to eradicate was remarkable. All the extracts demonstrated significant antipyretic activity at all doses with the greatest activity seen at a dose of 150 mg/kg. The antipyretic activity of the aqueous and methanol extracts of C. jagus at a dose of 150 mg/kg was comparable to the effect seen with reference standard paracetamol 150 mg/kg (p<0.0001). The anti-infective and antipyretic properties of Crinum jagus are very promising as this study suggests. Isolated compounds from C. jagus could therefore serve as potential leads in drug discovery to manage fever as well as tackle the global concern of antimicrobial resistance.

P068 Choked in Public: Social Anxiety and Self-Esteem among University Students

A. A. Addae 1, F.E. Owusu-Ansah1,2, V. DeGraft-Adjei,1

1 Counselling Center, Kwame Nkrumah University of Science and Technology 2 Department of Behavioural Sciences, Kwame Nkrumah University of Science and Technology Email: [email protected]; [email protected] Social Anxiety (social phobia) is marked by fear of one or more social situations in which the individual is exposed to possible scrutiny by others. This include social interactions like having a conversation or meeting unfamiliar people, being observed; and performing in front of others. It is one of the commonest psychological/psychiatric disorders; and particularly highly prevalent among adolescents and young adults. Social anxiety is associated with negative outcomes like poor academic performance, depression, anxiety, and suicidal ideation and self-harm. Despite being common, there is dearth of literature on the topic in Ghana. This study thus sought to assess the prevalence of social anxiety; and examine its relationship with self-esteem among KNUST students. A descriptive cross-sectional study was conducted with 360 students conveniently sampled from KNUST as participants. The Social Anxiety Questionnaire for Adults (SAQ30) and the Rosenberg Self Esteem questionnaire were used to collect data. The results indicated high levels of social anxiety among the students; with 46.7% of the participants meeting the cut off point for overall measure of social anxiety. Self-esteem was negatively correlated with social anxiety. Thus, the lower one’s self-esteem, the higher the higher the level of social anxiety. The study highlights the need for mental health professionals to create awareness about social anxiety and to develop interventions to boost students’ self-esteem to deal with the disorder; so as to improve academic performance and help students achieve the full potential of other aspects of their lives.

P069 Who is happy and why? Stress among University Lecturers in Ghana

A. A. Addae 1, F. E. Owusu-Ansah1,2, A. Lartey,1

1 Counselling Center, Kwame Nkrumah University of Science and Technology 2 Department of Behavioural Sciences, Kwame Nkrumah University of Science and Technology Email: [email protected]; [email protected] Stress is a common problem affecting many in all spheres of life. It is associated with a number of physical, psychological, social and occupational outcomes. Persons in academia are not exempt. This study sought to assess the level of stress and associated outcomes among academic staff of Kwame Nkrumah University of Science and Technology (KNUST). The study was a cross- sectional correlational study with one hundred and twenty-seven academic staff of the KNUST who were conveniently sampled to participate in the study. Data were collected using a questionnaire comprising demographic information, the Perceived Stress Scale, Subjective Happiness Scale and Needs Satisfaction at Work Scale. The results showed significant negative association between stress, subjective happiness and satisfaction at work, but not workload. Both subjective happiness and satisfaction at work were significantly positively correlated with academic productivity. The academic who finds job satisfying is less stressed and more productive. The results highlight the harmful consequence of stress on the subjective wellbeing and productivity of academic staff. Creation of a happy work environment promotes productivity and wellbeing because when one is happy and satisfied, one could be productive regardless of workload. It is imperative that university management, in concert with mental health professionals, identify aspects of life at work that are stressful for lecturers and design appropriate interventions to alleviate them. A follow-up qualitative study to obtain staff feedback on means of improving job satisfaction would a step in the right direction.

P070 - Anticonvulsant and Antiepileptogenic Effects of Methanol Leaf Extract of Cassia mimosoides Linn in Laboratory Animals

A.M. Kabiru1, M. Yerima2, J. Ya’u1

1Department of Pharmacology and Therapeutics, Ahmadu Bello University, Zaria-Nigeria. 2Department of Pharmacology and Toxicology, Usmanu Danfodiyo University, Sokoto-Nigeria

Email: [email protected]

Cassia mimosoides Linn belongs to the family of Caesalpinioideae. It is an annual herb which is found growing as weeds in Nigeria and spread throughout the sub-Saharan Africa. In Nigeria, C. mimosoides is used as a remedy for ulcer, diarrheal disease and in the management of epilepsy in Zaria, Kaduna State, Nigeria. The study was conducted to evaluate the anticonvulsant potential of the methanol leaf extract of Cassia mimosoides using pentylenetetrazole (PTZ) induced seizure in mice, maximal electroshock (MES) induced seizure in chicks, picrotoxin induced seizure in mice and strychnine induced seizure in mice. Followed by chronic model of epilepsy involving pentylenetetrazole induced kindling in rats. The acute toxicity profile (LD50) and preliminary phytochemical constituents of the extract were determined. The extract (375, 750 and 1500 mg/kg) protected the mice against PTZ-induced seizure by delaying the mean onset of seizure at all doses tested significantly (p<0.05) in a dose depended manner. In the maximal electroshock induced seizure model, the extract did protect the animals against tonic hind limb extension (THLE). However, it also decreases significantly (p<0.05) the mean recovery time of the convulsed chicks. The extract produced protection against both picrotoxin and strychnine-induced seizure in mice by delaying the mean onset of seizure significantly (p<0.05) in the convulsed mice at all doses and there was increase quantal protection against seizure. The extract at all doses tested reduced the severity of seizures induced by kindling significantly (p<0.05). The oral median lethal dose (LD50) values for rats, chicks and mice method was found to be greater than 5000 mg/kg. The preliminary phytochemical screening of the methanol leaf extract of Cassia mimosoides revealed the presence of alkaloids, flavonoids, saponins, tannins, steroids/terpenoids and glycosides. The results suggest that the methanol leaf extract of Cassia mimosoides Linn possess anticonvulsant effects and antiepileptogenic properties.

P071 - Antitumour Activity and Mechanistic Actions of Parquetina nigrescens

O. D. Afolayan1, C. K. Firempong1, G. Komlaga,2, P. Addo-Fordjour3, P. W. Narkwa4, M. Mutocheluh4

1Department of Biochemistry and Biotechnology, Kwame Nkrumah University of Science and Technology, Kumasi, 2Department of Pharmacognosy, Kwame Nkrumah University of Science and Technology, Kumasi, 3Department of Theoretical and Applied Biology, Kwame Nkrumah University of Science and Technology, Kumasi. 4Department of Clinical Microbiology, Kwame Nkrumah University of Science and Technology, Kumasi.

Email: [email protected]

Medicinal plants continue to serve as a great source of drugs for the treatment of cancer and related conditions throughout the world. However, Ghana with its rich and abundant medicinal plants has yet to fully exploit such natural resources for the treatment of abnormal tumour growths. Here, we report on the in vitro antiproliferative activity of Parquetina nigrescens selected from a group of plants recorded in an ethnobotanical studies of plants used traditionally to treat tumours in Ashanti region. Using MTT bioassay, aqueous and ethanol crude extracts of the leaves and stembark of Parquetina nigrescens were preliminary tested on human cervical cancer cell line (HeLa). Ethanol crude extracts of P. nigrescens leaves and stembark showed significant inhibitory activity on HeLa cell line, with IC 50 values of 35.9 and 23.8 µg/mL respectively. However, the aqueous crude extracts had no effect on HeLa cell viability. Ethanol crude extracts of the leaves and stem bark were additionally tested on colorectal carcinoma (RKO) and hepatoma (HepG2) cell lines. The ethanol extracts demonstrated active against all the cell lines tested, with the stem bark extract showing the highest activity when compared to the leaf extract. Against colorectal carcinoma (RKO), the leaf extract has an IC50 value of 46.1 and the stem bark 28.4 µg/mL; against hepatoma (HepG2) the IC50 values were 58.6 and 39.9 µg/mL respectively. These results suggested the suitability of the crude ethanol extract of P. nigrescens stembark as a candidate for bioguided fractionation to isolate the bioactive compounds.

P072 - Antimicrobial and Antioxidant Activities of the Leaf Extracts of Griffonia simplicifolia

K. Bortey, P. D. Tagbor, A. Acheampong, C. O. Akoto Department of Chemistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana Email: [email protected]

Medicinal plants have always been an essential source of diverse therapeutics and have been used in the treatment of various diseases. Griffonia simplicifolia is a member of the Fabaceae family with significant pharmacological activities. The aim of this present study is to investigate the phytochemical content, antimicrobial and antioxidant potential of the leaf extracts of Griffonia simplicifolia. Methanolic and petroleum ether extracts were made from shade dried leaves of G. simplicifolia. The raw pulverized plant sample and methanolic extract showed the presence of saponins, tannins, flavonoids, phenols glycosides, steroids, triterpenoids and coumarins. The petroleum ether extract showed the presence of saponins, steroids, coumarins, and triterpenoids. In evaluating the antimicrobial activity, the extracts were tested against two Gram positive bacteria (Staphylococcus aureus and Enterococcus faecalis), two Gram negative bacteria (Escherichia coli and Pseudomonas aeruginosa) and one fungus (Candida albicans) using two in vitro methods – agar-well diffusion and broth microdilution. The total antioxidant capacity (TAC) phosphomolybdenum method, Hydrogen peroxide (H2O2) scavenging and DPPH scavenging assays were used to examine the antioxidant potential of the extracts. The methanolic leaf extract exhibited the highest activity for both antioxidant assays with an IC50 value of 415 µg/mL and 279.3 µg/mL as compared to 1340 µg/mL and 1590 µg/mL for the petroleum ether extract for the hydrogen peroxide scavenging and DPPH scavenging assays. With the TAC phosphomolybdenum assay, the methanol extract had a TAC of 31.48 gAAE/100 g as compared to 14.16 gAAE/100 g for the petroleum ether extract. Fluorescence TLC and Column chromatography were used in separating the components. It can be concluded that both the methanol and petroleum ether extracts showed antimicrobial and antioxidant activities but the methanol extract was more bioactive.

P073 Pharmacotherapy of Infertility in Ghana: Retrospective Study at the Cape Coast Teaching Hospital. S.M. Arhin1, K. B. Mensah1, E. Agbeno2, V. S. Badii1, C. Ansah1 1Department of Pharmacology, Faculty of Pharmacy and Pharmaceutical Science, Kwame Nkrumah University of Science and Technology, Kumasi, , 2Department of Obstetrics and Gynaecology, Cape Coast Teaching Hospital, Cape Coast, Infertility is a major challenge for couples globally. Due to low income levels and the high cost of other assisted reproductive techniques, pharmacotherapy remain the major first line treatment option for infertility in Sub-Saharan Africa. The aim of this study was to assess the prevalence of infertility as well as the effectiveness and success achieved following infertility pharmacotherapy at the Cape Coast Teaching Hospital in Ghana. This study was a retrospective observational study of 825 couples attending infertility clinic at the hospital. Prevalence of infertility at the study center was estimated to be 12.3%. Treatment mainly involved the use of clomiphene citrate, antioxidants, herbo-mineral drugs (Ayurveda), multivitamin and antibiotics. Pharmacotherapy resulted in successful conception in one out of every five couples (19.4%; n=160). Age, kind of infertility, employment status but not educational level was significantly associated with pharmacotherapy success. In ovulation induction, clomiphene citrate plus folic acid and vitamin E adjuncts improved ovulation rates during cycle treatments compared to clomiphene citrate alone. Pharmacotherapy of idiopathic infertility (39%, n=323) was a major challenge with very limited success rates. Again, 90-day treatment regimen doubled conception rates when compared with corresponding 30-day treatment regimen. However, zinc sulfate even in short term treatment regimens (30 days) enhanced conception rates in idiopathic infertility. Prevalence of infertility was estimated to be about 12.3%. One out of every five infertile couples achieved success with pharmacotherapy. Factors such as age, type of infertility, employment status, but not education were significantly associated with treatment success.

P074 Antimicrobial and Antioxidant Activities of the stem-bark of Psydrax peruviana. S.Takyi, R. Garba, A. Acheampong, C. O. Akoto Department of Chemistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana Email: [email protected] Concoctions of the stem-bark of Pydrax peruviana is used locally in the treatment of gonorrhea and syphilis. In this study, methanol and hexane extracts of P. peruviana were evaluated for their antimicrobial and antioxidant properties. Preliminary phytochemical screening of the pulverized sample, methanol and hexane extracts was performed. The agar well diffusion method was used to determine the antimicrobial activities of the extracts against Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa, Enterococcus faecalis and the fungus, Candida albicans. In addition, the minimum inhibitory concentration of the extracts was evaluated using broth dilution method. The antioxidant activity was determined using the total antioxidant capacity (TAC), hydrogen peroxide scavenging assay and DPPH scavenging assay. The IC50 results from the estimation of hydrogen peroxide assay were 1.143 mg/mL and 2.872 mg/mL for methanol and hexane extracts respectively and from DPPH scavenging assay, the IC50 results were 12.20 µg/mL and 24.26 µg/mL for methanol and hexane extracts respectively. The results from the estimation of the Total Antioxidant Capacity assay were 21.563 gAAE/100g and 17.389 gAAE/100g for methanol and hexane extracts respectively. The preliminary phytochemical analysis revealed the presence of plant secondary metabolites such as; Tannins, Glycosides, Flavonoid, Terpenoids, Steroids and Carotenoids in the extracts and the pulverized sample with the exception of Saponins which was not present in hexane extract. These findings provide scientific justification for the use of P. peruviana in various traditional medicines, for the treatment and management of diseases.

P075 Suicide among University Students: Prevalence, Risks and Protective Factors

F. E. Owusu-Ansah1,2, A. A Addae1, B.S.O. Peasah 1.

1Counselling Center, Kwame Nkrumah University of Science and Technology, Kumasi 2Department of Behavioural Sciences, Kwame Nkrumah University of Science and Technology, Kumasi Email: [email protected]; [email protected] Suicide is a public health concern of great importance given the enduring devastating effects it has on families, friends and communities. Youth and young adults are at high risk. Compared to the depth of knowledge on suicide, risk and prevention, in the western world there is relatively a paucity of suicide research in Africa though in Ghana some efforts have been made in the last decade that shed light on the phenomenon. Yet, in Ghana there is still much to be understood to enhance design of effective context-specific interventions and scrutiny of the research on suicide in Ghana shows a gap in information on suicide among university students is concerned. With a self-report questionnaire, the study sought to examine the prevalence of suicide behaviors among students and the associated factors. It was a cross-sectional survey conducted using a quantitative, non-experimental, correlational design to examine relationship between interested variables. Suicide-related behaviours (ideations, death wishes) were relatively higher than actual attempt of suicide. Prevalence of suicide attempts among students (lifetime, 6.3%) and clear suicidal plans (6.8%) were found. Suicidal attempt was significantly predicted by subjective well-being, psychological distress and gender (female). Positive subjective well-being buffered against suicidal attempt. An inverse relationship existed between levels of self-esteem and suicidal ideation and attempt. In effect, students who were better satisfied with their lives and held stronger sense of self-worth were less psychologically distressed and less likely to engage in suicidal behaviours. Findings inform clinical practice and design of appropriate timely interventions.

P076 – Suicide: Do Empathy and Mode of Exit matter?

F. E. Owusu-Ansah1,2 , A. A. Addae 1

1 Counselling Center, Kwame Nkrumah University of Science and Technology 2 Department of Behavioural Sciences, Kwame Nkrumah University of Science and

Email: [email protected]

Suicide poses a public health concern for all nations. Studies reveal that showing empathy towards suicidal individuals is associated with decreased suicidal attempts. However, not much is known about the association between own empathy, preference of method of death, and suicidal attempts. This study sought to fill this gap. The study was a descriptive cross-sectional survey involving 1003 students (made up of 507 males and 496 females), randomly sampled from the six colleges of KNUST. Data was collected using self-report questionnaires. Findings indicated that females and those less empathetic to the feelings of others were more likely to attempt suicide. Resutls also shows that those who preferred death by suicide had the highest rate of suicidal attempt (28.0%), compared to those who preferred other modes of dying such as accident, illness, old age or homicide. In other words one’s empathy and preference matter in suicidal attempts. The findings highlights the need to pay attention to the suicidal person’s internal factors that puts him or her at risk for suicidal behaviours.

P077 White Blood Cell Differentials, Cytokines, Total Ige And Histamine Distinction Between Ivermectin Treated And Untreated Onchocerca-Infected Individuals J. Labadah, K. A. Kusi, M. D. Wilson West African Centre for Cell Biology of Infectious Pathogens, University of Ghana Onchocerciasis (river blindness) is a neglected tropical disease that affects the skin and the eye. It is caused by a nematode Onchocerca volvulus. Disease pathology is largely attributed to host immune responses to microfilariae. The efficacy of ivermectin (IVM) is defined by its microfilaricidal effects (clearing > 60% of microfilariae within 24 hours, ~ 100% within 7 days) and the ability to temporarily retard adult parasite embryogenesis at least within 90 days. This study sought to identify characteristic immune factors that distinguish between ivermectin-treated and untreated microfilaremic individuals to serve as markers to complement diagnosis and treatment efficacy and understand the disease mechanism. We measured white blood cell differentials for 124 adults; 53 microfilaremic (MF) and 71 ivermectin treated (1-5 rounds) seropositive amicrofilaremic (AMF) individuals 3 months following last treatment at the Nkwanta North district of Ghana. Subgroups (16 ≤ n ≤20) of both MF and first time IVM-treated AMF were assessed for plasma cytokines, total IgE and urine histamine. Comparisons were made by Mann- Whitney U tests. The geometric mean microfilaria density/milligram skin snip was 22.5 (range 5.8-56.3). Basophil count was lower (p=0.0001) while eosinophils counts were higher (p=0.0176) for MF compared to AMF. Out of 13 cytokines, Interleukin (IL)-13 (p=0.0021), IL-8 (p=0.0349) and Interferon-gamma (p=0.0033) were higher among MF compared to first time treated AMF. Histamine and IgE were not different between the two groups. IL-13, IL-8 and interferon-gamma, basophils and eosinophils are associated with the microfilaremic onchocerciasis and may contribute to disease pathology.

P078 Co-mediation of Erythrocyte Haemolysis by Plasma Membrane-Derived Extracellular Vesicles and Complement during Malaria Infection.

R. Kyeremeh1, S. Antwi-Baffour1, M. E. Annani-Akollor2, J. K Adjei1, O. Addai-Mensah3, M.T Frempong2.

1Dept of Medical Laboratory Sciences, School of Allied Health Sciences, UG, 2Dept of Molecular Medicine, SMD, KNUST, Kumasi. 3Dept of Medical Diagnostics, Faculty of Allied health Sciences, KNUST, Kumasi.

Email: [email protected]

Due to the sustained morbidity and mortality that malaria-associated anaemia imposes on patients, malaria is still a global threat, especially to residents in sub-Saharan Africa. Studies have proposed that cytophilic Merozoites rhoptry protein 2/Ring Surface Protein 2 (anti-RSP2antibodies) present in sera enhance phagocytosis of RSP2-tagged Red Blood Cells (RBC) by macrophages either directly or via complement while others have proposed transfer of RSP2 to both infected and uninfected RBCs which may render them susceptible to phagocytosis. Considering the intracellular location of the parasite in the parasitophorous vacuolar membrane and the absence of a transport mechanism like the Golgi apparatus within the mature RBC, this study was aimed at proposing that Plasma Membrane-Derived Extracellular vesicles (PMEVs) are the possible mediators by examining the immunological interactions between PMEVs released during malarial infections and host erythrocytes that may lead to their lyses (the latter) possibly through complement mediation. In this experimental study, malarial PMEVs were isolated by differential centrifugation of pooled malaria positive plasma. In Cell-based in-vitro assays malaria positive PMEVs were added to uninfected blood group ‘O’ Rh negative erythrocytes in the presence of complement and checked for haemolysis. At a fixed volume (50µl) of complement, there were statistically significant (P<0.00) increases in mean percentage haemolysis as the volume of PMEV increased. Similarly, a fixed volume of (50µl) PMEV on the other hand also resulted in statistically significant (P<0.00) increases in mean percentage haemolysis with increasing volumes of complement. We conclude that both complement and PMEVs contribute significantly to uninfected erythrocyte haemolysis during malaria infection. We also assert that the PMEVS definitely carry factors which on exposure to RBCs cause hemolysis.

P079 Plasma Membrane-Derived Extracellular Vesicles from Malaria Infected Mice Induce Increased RBC Haemolysis in Non-Malaria Mice

R. Kyeremeh1, S. Antwi-Baffour1, M. E. Annani-Akollor2, J. K. Adjei1, O. Addai-Mensah3, M. T. Frempong2.

1Dept of Medical Laboratory Sciences, Uuniversity of Ghana, Legon, Accra. 2Dept of Molecular Medicine, School of Medicine and Dentistry, KNUST, Kumasi. 3Dept of Medical Diagnostics, Faculty of Allied health Sciences, KNUST, Kumasi.

Email: [email protected] Increased haemolysis of both parasitized and non-parasitized erythrocytes is seen in malaria infection. This is one of the causes of anaemia frequently seen in malaria infection. The extent of non-parasitized erythrocyte destruction - especially in malaria is much greater than observed in other parasite-induced haemolysis. However, host-parasite immune-mediated interactions offer opportunities for further research to clarify mechanisms that could be explored to fully understand why and how this happens. The purpose of this study was to examine the immunological interactions between plasma membrane derived Extracellular vesicles (PMEVs) released during malarial infections and host erythrocytes in vivo. In this experimental study malarial positive and negative PMEVs were isolated by differential centrifugation of plasma from malaria positive and negative ICR-mice. These PMEVs were intra-peritoneally inoculated into non-malarial mice and blood samples taken via cardiac puncture and checked for haemolysis after 24, 48 and 72 hours. Our results showed statistically significant (P=0.00) increases in mean haemolysis in non-malaria mice after they were inoculated with different volumes of malaria positive PMEVs and monitored over 24, 48 and 72 hours. However, when malaria negative PMEVs were inoculated into the non- malaria mice at the same volume and time periods, very little haemolysis observed. Thin blood films also showed polychromatic RBCs (an indication of bone marrow’s compensation for haemolysis) when the malaria positive PMEVs were inoculated, a phenomenon that was not seen after the inoculation of the malarial negative PMEVs. We propose that PMEVs play a very significant role in red blood cell haemolysis during malaria infection. The association of PMEVs with anaemia in malaria can therefore not be overlooked.

P080 The effectiveness of using public health implementation strategies to improve coverage, acceptability and compliance to Mass Drug Administration against Onchocerciasis at the Owabi catchment area in Ashanti region, Ghana

F. A. Osei1, E. Owusu-Dabo1, S. K. Newton1, N. K. Mensah2, E. X. Amuzu2, M. Dongyele2, D. Adjei2, B. A. Dankwa2, A. K. Owusu2, S. F. Odoom2, I. Nyanor2, C. S.Y. Appiah3, J. M. Dapaah3, S. A. Agyare4, E. Osei – Yeboah4, P. Furu5, D.W. Meyrowitsch5

1Department of International Health, School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana, 2Komfo Anokye Teaching Hospital, Kumasi, Ghana, 3Department of Sociology and Social work, College of Social Science and Humanities, KNUST, 4Ghana Health Service, Ghana, 5Department of Public Health, Global Health Section, University of Copenhagen, Copenhagen, Denmark

Email: [email protected] Onchocerciasis account for significant proportion of infectious blindness and skin morbidities. The prevalence of onchocerciasis in sub-Saharan Africa ranges from 2.1% to 51% in endemic areas. There are implementation challenges to Mass Drug Administration, although it has proven to be safe and efficacious against reducing the burden of onchocerciasis in sub-Saharan Africa. This study seeks to explore the enabling factors and barriers to drug uptake in a Mass Drug Administration (MDA) program in the Owabi catchment area and to develop and build on existing Ghana Health Service structures to increase coverage, acceptability and compliance. A quasi- experimental study with a concurrent mixed method (quantitative and qualitative) approach will be conducted in four communities (2 rural and 2 urban) in Atwima Nwabiagya Municipal. The study will be in three phases; Pre-intervention phase (baseline assessment to assess health literacy on onchocerciasis and the barriers and enablers to MDA implementation), intervention phase (to develop and design the intervention tools which will be mainly IEC materials, school clubs and church groups) and post-intervention phase (to assess effectiveness of the intervention). Quantitative data will be collected using REDCap and analyzed with stata. Descriptive and inferential analysis will be performed to assess the possible association between the outcome variable and the covariates. The qualitative data from different sources will be analyzed using emerging themes as guides with a constant comparative thematic approach and Q sort methodology to identify, categorize, and under- stand the community opinions on barriers to MDA uptake and noncompliance. The strategies being tested such as working with the church groups and school children in onchocerciasis endemic communities will have the snowballing effect towards increasing health literacy and behavioral change among community members. Also, supporting the training and motivating Community Drug Distributors could enhance MDA coverage, acceptability and compliance in the intervention clusters. The study seeks to build on existing Ghana Health Service structures to achieve a national and international health priority on onchocerciasis eradication.

P081 Prevalence and risk factors of hypertension among individuals at the Bantama market E. A. Boateng1, M. Owusu2, P. Abonee1, S. Boakye1 1Department of Nursing, Faculty of Allied Health Sciences, KNUST, Kumasi. 2Department of Medical Diagnostics, Faculty of Allied Health Sciences, KNUST, Kumasi.

Globally, hypertension and its associated complications are on the increase as a result of unawareness and late detection of the condition. Most “healthy” individuals may not know they have hypertension until they develop complications and are hospitalized. In order to assess the magnitude of this problem, we conducted a study to determine the prevalence and risk factors for hypertension among traders at the Bantama market. A cross-sectional study was conducted within a two-week period in March 2019 among traders at the Bantama market using independent random sampling technique. The questionnaire was adapted from “WHO STEPwise approach to chronic disease surveillance (STEPS) and physical measurements such as blood pressure (BP), weight and height were employed to collect data. The data were coded, entered, and analyzed with SPSS version 24 software package. Hypertension was defined as systolic BP greater than or equal to 140 millimeters per mercury (mmHg) and diastolic BP greater than or equal to 90mmHg, according to the eighth Joint National Committee hypertension guidelines. Three hundred and five (305) individuals were recruited into the study. Mean systolic and diastolic blood pressures were 132.79 ± 20.8 mmHg and 83.59 ± 9.63 mmHg, respectively. The overall prevalence of hypertension was 46.2% (141). Almost half (151; 49.2%) of the patients had a family history of hypertension. Females had a higher prevalence of hypertension of 66.7% (94) compared to males 33.3% (47) but the difference was not significant. The risk of hypertension was higher among respondents who take tobacco (p-value = 0.01). This study revealed a higher prevalence of hypertension among seemingly normal populations, with 66% (93) unaware of their likely hypertensive state. Strengthening hypertension awareness programs and regular check of blood pressure would help in early detection and management as well as prevention of complications of hypertension.

P082 Bloodstream infection with Acinetobacter baumanii in a Plasmodium falciparum positive infant. – A case report from Ghana

C.W.Akenten1, K. G. Boahen1, K. S. Marfo1, D. Dekker2, N. Sarpong1, L. Osei-Tutu3, N. Gilberger2, J. May2, J. H. Amuasi1, D. Eibach2

1Kumasi Centre for Collaborative Research in Tropical Medicine, Kumasi Ghana. 2Bernhard-Nocht Institute for Tropical Medicine, Hamburg, Germany. 3Agogo Presbyterian Hospital Asante Akim, Ghana,

Email: [email protected]

The increasing incidence of antimicrobial-resistant infections, coupled with co-infections with other infectious diseases like malaria, increases the cost of treatment and prolongs hospitalization. For treatment of infections, there are challenges regarding the correct choice of antibiotic and the duration of treatment, precipitated by a lack of access to microbial culture facilities in Ghanaian hospitals. The aim of this case report is to highlight the need for blood cultures to be performed routinely in malaria patients, especially when symptoms persist after treatment with parenteral Artesunate. A 6-month old female child presented with fever, diarrhea and cough for 3 days, at the Agogo Presbyterian Hospital. A rapid diagnostic test for malaria (Care Start Malaria, ACCESS BIO, Somerset, USA) result was positive and Malaria microscopy also reveal positive for P. falciparum with a parasitemia of 224 parasites/µl. She was managed with IV Artesunate, parental antibiotics including cefuroxime, gentamycin and oral dispersible zinc tablet in addition to IV fluid for the diarrhea and vomiting. Blood culture revealed Acinetobacter baumanii, and susceptibility test revealed the bacteria was resistant to most of the third-generation antibiotics tested for but sensitive to ciprofloxacin and gentamicin. After treatment with intravenous ciprofloxacin and gentamycin, all symptoms resolved without recurrence. Subsequent blood culture did not yield any bacterial growth. Even though this study cannot confirm whether the bacterial infection was nosocomial or otherwise, the case highlights the need to perform blood cultures on malaria positive patients, especially when fever persist after parasites have been cleared. Antimicrobial test results should guide the treatment options for patients in Ghana to reduce inappropriate use of broad- spectrum antibiotics and limit the development of antimicrobial resistance.

P083 Ambulatory Blood Pressure Monitoring and Management of Hypertension at a Specialist Cardiac Clinic in Kumasi Metropolis, Ghana N. S. Nsutebu1, K. O. Buabeng1, I. K. Owusu2, 3 1Department of Pharmacy Practice, KNUST 2School of Medical Sciences, Kwame Nkrumah University of Science and Technology,Kumasi 3Precise Specialist Clinic Ltd, Kumasi, Ghana.

Email: [email protected]

Ambulatory blood pressure monitoring (ABPM) is the reference standard to avoid misdiagnosis of hypertension and allow a targeted antihypertensive therapy, however, there is limited information on its use in clinical settings in sub-Saharan Africa to inform the management of hypertension to target goals. This study sought to assess the contribution of ABPM on the management of hypertension in terms of confirmation of diagnosis, changes made in pharmaceutical treatment, and achievement of blood pressure control. ABPM to support antihypertensive therapy was reviewed in 97 patients (45 men), aged 18-85 (mean 55.01) years, receiving care in routine clinical practice. A convenience sample method was chosen. Data obtained included patient demographics, ambulatory blood pressure (ABP), clinic blood pressure (CBP) and antihypertensive therapy. CBP and number of medications prescribed pre- and post- ABPM were compared by paired sample t-test and Wilcoxon Signed Rank test respectively. Statistical significance was set at p≤0.05. In the overall population CBP was controlled (<140/90mmHg) in 45.4% of patients whiles 29.9% had controlled ABP (24-hour ABP<130/80mmHg).White-coat hypertension syndrome (CBP≥140/90mmHg and 24-hour ABP<130/80mmHg) was detected in 11.3% whiles 26.8% of patients had masked hypertension (CBP<140/90mmHg and 24-hour ABP≥130/80mmHg). There was a significant reduction in mean systolic CBP (8.9mmHg, p=0.019) between pre- and post-ABPM. Patients with uncontrolled 24- hour ABP were prescribed more medications (p=0.003) whiles those with controlled 24-hour ABP were prescribed fewer medications (p=0.006) after ABPM. It was found that 44% of patients had a change in medication, 4.9% started an antihypertensive therapy with 6.9% having drug therapy discontinued. This study provides useful information on the use of ABPM in a real-world clinical setting in Kumasi, Ghana. ABPM improved clinical decision making and medical management of hypertension and should be used more often in this setting.

P084 Effect of poor glycaemic control on plasma levels and activity of protein C, protein S, and antithrombin III in type 2 diabetes mellitus O. Addai-Mensah1, M. E. Annani-Akollor2, F. O. Nsafoah1, L. A. Fondjo2, E-W.Owiredu2, K.O. Danquah1, R.V. Duneeh3, F. A. Amponsah4

1Department of Medical Diagnostics, Faculty of Allied Health Sciences, KNUST, Kumasi, 2Department of Molecular Medicine, School of Medicine and Dentistry, KNUST Kumasi, 3Department of Haematology, Komfo Anokye Teaching Hospital, Kumasi, 4St. John of God Hospital, Duayaw Nkwanta, Sunyani,

Email: [email protected]

Type 2 diabetes mellitus (T2DM) patients are predisposed to several diabetes-related complications. Dysregulation of the haemostatic mechanisms have been implicated. This study evaluated the effect of poorly-managed T2DM on the levels and activity of PC, PS, and AT III. In a cross-sectional study conducted at the Diabetes Clinic, Cocoa Clinic in Kumasi, Ghana, a total of 242 T2DM patients; 152 patients with poorly-managed diabetes and 90 well-managed diabetes were recruited. Fasting blood glucose, liver function tests and lipid profile were performed for each respondent. Glycated haemoglobin (HbA1c) was estimated by turbidimetric inhibition immunoassay. The levels and activity of PC, PS and AT III were measured by solid phase sandwich ELISA. There was a negative correlation between HbA1c and the levels and activity of PC, PS and AT III. The levels and activity of PC [(5.78 vs 4.64 ug/ml, p<0.0001) and (42.22 vs 36.21 U/ml, p=0.01) respectively], PS [(22.55 vs 20.29 ug/ml, p=0.010) and (235.94 vs 211.67 U/ml, p<0.0001) respectively] and AT III [(16.28 vs 14.41ug/ml, p<0.0001) and (176.01 vs 160.09 U/ml, p=0.03) respectively] were significantly increased in patients with well-managed T2DM compared to the poorly-managed diabetes patients. We conclude that poorly-managed type 2 diabetes mellitus is associated with reduced levels and activity of protein C, protein S and antithrombin III compared to well-managed T2DM. Proper management of diabetes is essential to reduce the likelihood of thrombotic events among T2DM patients.

P085 Potential Fertility abilities of Khaya senegalensis stem bark extract on male wistar rats L. Sallah 1 M. E. Ananni-Akollor2, L. A. Fondjo2, O. Addai-Mensah3, B.M.Wireko1

1Dept of Physiology,SMD, KNUST, Kumasi, 2Dept of Molecular Medicine, SMD, KNUST, Kumasi, 3Department of Medical Diagnostics, Faculty of Allied Health Sciences, KNUST, Kumasi

Email: [email protected] Khaya senegalensis belongs to the family Melaiceae. It is used to remedy many ailments among our community folks in undeveloped and developing countries. Several studies have investigated the pharmacological basis for its ethnobotanical uses, but its effect on non- target organs and systems like the reproductive system are rare. The study aimed at examining effect of the extract on reproductive organ weight of male wistar rat (prostrate, testis, epididymis, and the seminal vesicles) fertility parameters and serum hormones (Testosterone, Luteinizing Hormone and Follicle Stimulating Hormone. Crude extract of KSE, was subjected to qualitative phytochemical analyses. The fertility effect of KSE was assessed on twenty matured male Wistar rats. Rats were randomly assigned to five treatment groups with four rats in each group (5 ml distilled water, sildenafil Citrate 5mg/kg and KSE (100, 500, and 1000 mg/kg respectively) and they were treated for 28 days. On day 30, rats were sacrificed and male fertility parameters were assessed with the aid of improved Neubauer hemocytometer and microscopy. Hormones were also assayed by ELISA. There was a significant increase in epididymal weight with a corresponding increase in motility of sperms in the 1000mg/kg KSE. There were also statistically significant differences between group means in their serum LH as determined by one-way ANOVA (F=3.69, p= 0.038). There was an increase in testosterone in the group that received 1000mg/kg, this not statistically significant (p= 0.267). KSE may have fertility potential at a dose 1000mg/kg as it increased epididymal weight with corresponding increase in motility.