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Eastern Region, Ghana

Objective To assess the accuracy of point-of-care testing for circulatory cathodic antigen in the diagnosis of schistosome infection. Methods We searched MEDLINE, EMBASE, LILACS and other bibliographic databases for studies published until 30 September 2015 that described circulatory cathodic antigen testing compared against one to three Kato–Katz tests per subject – for Schistosoma mansoni – or the filtration of one 10-ml urine sample per subject – for S. haematobium. We extracted the numbers of true positives, false positives, true negatives and false negatives for the antigen testing and performed meta-analyses using a bivariate hierarchical regression model. Findings Twenty-six studies published between 1994 and 2014 met the inclusion criteria. In the detection of S. mansoni, a single antigen test gave a pooled sensitivity of 0.90 (95% confidence interval, CI: 0.84–0.94) and a pooled specificity of 0.56 (95% CI: 0.39–0.71; n = 7) when compared against a single Kato–Katz test. The corresponding values from comparisons with two to three Kato–Katz tests per subject were 0.85 (95% CI: 0.80–0.88) and 0.66 (95% CI: 0.53–0.76; n = 14), respectively. There appeared to be no advantage in using three antigen tests per subject instead of one. When compared against the results of urine filtration, antigen testing for S. haematobium showed poor sensitivity and poor specificity. The performance of antigen testing was better in areas of high endemicity than in settings with low endemicity. Conclusion Antigen testing may represent an effective tool for monitoring programmes for the control of S. mansoni. © 2016, World Health Organization. All rights reserved. Source

Asare G.A.,University of Ghana | Afriyie D.,Ghana Police Hospital | Ngala R.A.,Kwame Nkrumah University Of Science And Technology | Appiah A.A.,Center for Plant Medicine Research | And 8 more authors.
Evidence-based Complementary and Alternative Medicine

Benign prostatic hyperplasia (BPH) is an enlargement of the prostate. The study aimed at validating the use of freeze-dried Croton membranaceus ethanolic root extract for BPH management. Thirty-three patients were observed before and after 3-month administration of 20 mg t.i.d orally. The International Prostate Symptom Score (IPSS), and the International Index of Erectile Function (IIEF) questionnaires were used. Total/free PSA (tPSA, fPSA), renal, liver function, lipid tests, and ultrasonographic imaging were performed. Thirty (30) patients (66 ± 11 years) completed the study. IPSS results showed 37% had severe, 40% moderate, and 23% mild symptoms before; 57% and 43% had moderate and mild symptoms, respectively, after treatment. IIED of patients' results showed 30% with severe, 40% moderate, 24% mild-moderate, 3% mild, and 3% no erectile dysfunction before treatment and 20% severe, 43% moderate, and 37% mild-moderate dysfunction, after treatment. Quality of life (QoL) improved (P = 0.001). Significant but non-pathological increases in total and indirect bilirubin as well as apolipoprotein A occurred. Mean tPSA reduced from 27.9 ± 19.0 to 16.2 ± 11.8 ng/mL (P = 0.002); fPSA from 6.1 ± 4.8 to 3.9 ± 2.9 ng/mL (P = 0.045); and prostate volume from 101.8 ± 41.3 to 54.5 ± 24.8 cm3 (P = 0.023). C. membranaceus shrinks the prostate and improves QoL. © 2015 George Awuku Asare et al. Source

Thomford A.K.,University Of Cape Coast | Thomford K.P.,Center for Plant Medicine Research | Ayertey F.,Center for Plant Medicine Research | Edoh D.A.,Center for Plant Medicine Research | And 5 more authors.
Journal of Applied Pharmaceutical Science

Poor lipid and glucose regulation increases the risk for the development of major cardiovascular diseases and other organ damage. The study evaluated the serum glucose and lipid lowering effects of the 70% (v/v) ethanolic leaf extract of Alchornea cordifolia (ALC) using the dexamethasone-induced diabetic rat model. Thirty six female Sprague-Dawley rats (180-200g; n=6) were rendered hyperglycaemic with dexamethasone (10 mg/kg, sc) once daily for 8 days except the normal control. Each group received either normal saline 0.5 ml/rat, ALC (250 mg/kg, p.o. or 500 mg/kg, p.o.), glibenclamide (5 mg/kg, p.o.) or atorvastatin (5mg/kg, p.o.) as treatment once daily for 8 days. Fasting blood glucose (FBS) readings were recorded at baseline, day 4, 6 and 9. Blood was collected for the estimation of serum triglycerides (TG), total cholesterol (TC), low density lipoproteins (LDL), very low density lipoproteins (VLDL) and high density lipoprotein (HDL) on day 9. The diabetic control group had significantly raised FBS levels (8.20 ± 1.04 mmol/l; ***p<0.001). Glibenclamide (5.20 ± 0.29; ***p<0.001) and the extracts [(ALC 250 mg/kg, p.o.; (5.35 ± 0.95 mmol/l); *p<0.05); ALC 500 mg/kg, p.o.; (5.98 ± 1.12 mmol/l); *p<0.05)] prevented an increase in FBS level. The herbal extracts also reduced the level of serum lipids of rats treated. The 70% (v/v) ethanolic leaf extract of Alchornea cordifolia has some potential for use in lipid and glucose control. © 2015 Ama Kyeraa Thomford et al. Source

Thomford K.P.,Center for Plant Medicine Research | Sarfo B.S.,Center for Plant Medicine Research | Edoh D.A.,Center for Plant Medicine Research
Journal of Herbal Medicine

A prospective randomised double blind parallel controlled trial was conducted to evaluate the safety and clinical effectiveness of a standardised Ghanaian polyherbal product EAF-2011 comprising: Alchornea cordifolia, Eugenia caryophyllata, Psidium guajava, Tridax procumbens and Zanthoxylum zanthoxyloides, used in the management of skin diseases. A total number of 84 participants aged between 8 and 45 years who were clinically diagnosed with superficial mycoses were recruited into the study and followed up for 4 months. Participants were randomised to receive 2%, 5% or 10% (w/w) concentrations of the finished herbal product or the control treatment of Whitfield ointment. Primary efficacy outcome (complete cure): defined as total signs and symptoms score (TSSS) of zero and where applicable mycological cure also defined as a negative mycological culture and microscopic examination was achieved by 30.0%, 34.78%, 75.0% and 91.30% of the control, 2%, 5% and 10% (w/w) EAF-2011 treatments respectively. Safety analyses using urine, biochemical and haematological parameters were normal at the end of the study. Also, no adverse reactions were recorded during the study. The study thus showed all the treatments to be safe and effective for the management of dermatophytes with 10% (w/w) finished herbal product being the most effective treatment. © 2015 Elsevier GmbH. All rights reserved. Source

Ocloo A.,University of Ghana | Ocloo A.,University of Cambridge | Appiah-Opong R.,University of Ghana | Chama M.A.,University of Ghana | And 2 more authors.
Journal of Food Biochemistry

Taraxacum officinale leaves are popular among Ghanaians as vegetable and/or beverage while extracts of Taraxacum officinale,Paulliniia pinnata and Thonningia sanguinea are present in common herbal remedies widely available without prescription in Ghana. This study was therefore aimed to identify possible interactions between these medicinal plant extracts and mitochondrial respiratory chain activity. The effects of these extracts on mitochondrial oxygen consumption were therefore investigated in situ using permeabilized mouse cardiac muscle fiber preparations and a substrate-inhibitor titration. The results showed that the ethanolic fraction of T.officinale leaves significantly increased the respiration rate in presence of rotenone and the state 3/state 2 ratio (respiratory control ratio) while the ethanolic extract of P.pinnata stem significantly decreased succinate-stimulated respiration. The aqueous extract of T.sanguinea also significantly decreased respiration in presence of rotenone. Practical Applications: The present study revealed that the extracts from Taraxacum officinale, Paulliniia pinnata and Thonningia sanguinea exhibited the potential to influence mitochondrial respiratory chain function. The result presented in this study provides evidence that T.officinale offers an opportunity to be explored as a natural energy booster. The decrease in succinate-stimulated respiration caused by the extract from P.pinnata provides further evidence for its use as a fish poison and strongly suggests that its use in herbal remedies may be detrimental. Furthermore, information about similar effects caused by traditional remedies would be useful not only in the discovery of novel therapeutic agents but also identification of extracts with the potential for long term toxicity. Copyright © 2015 Wiley Periodicals, Inc. Source

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