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Sex differences in concentrations of HMGB1 and numbers of pigmented monocytes in infants and young children with malaria
No full textSex remains a key biological variable affecting human innate and adaptive immune responses to infection and in pathogenesis of diseases. In malaria, females demonstrate higher concentrations of antibodies and rates of severe adverse events and mortality following malaria vaccination. Although monocytes/macrophages play a crucial role in disease and protection in malaria, no studies have investigated sex differences in their functions in production of proinflammatory cytokines and chemokines in malaria-infected subjects. Here, we show significant sex differences in serum concentrations of HMGB1, a non-histone chromatin-associated protein, and numbers of pigmented monocytes, which are both markers of severe malaria, in infants and young children <5 years old from a malaria endemic region in Northern Uganda. Female infants and young children with clinical malaria had significantly higher HMGB1 concentrations than males, and female infants and young children with asymptomatic malaria had significantly lower numbers of pigmented monocytes than males with asymptomatic malaria. There was (1) a significant correlation between HMGB1 concentrations and pigmented monocyte numbers in female but not male infants; and (2) a significant correlation between HMGB1 concentrations and parasite densities in female but not male infants. These findings suggest that female infants and young children with clinical malaria might be at a greater risk of morbidity characterized by higher serum HMGB1 levels
Compliance with CDC guidelines for Catheter associated Urinary tract infection prevention among nurses at Embu level 5 Hospital.
Get PDFUrinary tract infections directly related to catheterization account for approximately 40%
of all healthcare related infections worldwide. Capping the utilization of urinary catheters
and duration of placement, adherence to proper catheter care, and using aseptic technique
have been identified as key interventions in the fight against CAUTI. Nurses thus play a
huge role in preventing CAUTI since they are the primary care givers. In line with this,
the Centers for Disease Control (CDC) developed recommendations to guide prevention
strategies for CAUTI in healthcare facilities worldwide. However, despite demonstration
of the effectiveness of these guidelines in averting CAUTI, uptake of these
recommendations hasn’t been investigated in health care institutions locally. This study
was aimed at assessing compliance with CDC guidelines for prevention of CAUTI
among nurses at Embu Level 5 Hospital in Embu County. Both quantitative and
qualitative data were collected with the use of a descriptive cross-sectional study that
employed the use of a concurrent mixed method design. The study was conducted at
Embu Level 5 hospital in the surgical, medical and gynecological/obstetric wards. The
total population of nursing staff in the hospital is 217 nurses and 130 nurses were sampled
from this population. Systematic random sampling was employed to choose subjects to
be included in the study, where every 2nd nurse was selected. A structured questionnaire
was utilized to collect quantitative data from the nurses and an observation check list for
selected participants to assess catheter insertion technique. Qualitative data was collected
through a key informant interview guide for ward in-charges and their deputies. In order
to safeguard reliability and validity of the research tools a pilot study was carried out at
Thika Level 5 hospital. Thematic analysis was utilized to analyze qualitative data which
was submitted by way of narration. The statistical package SPSS version 21 was utilized
to perform quantitative data analysis. Descriptive statistics that is, frequencies and mean
together with inferential statistics that is, Chi-square test and independent t-test were
utilized for exploration of data and a p-value of < 0.05 was deemed significant. Tables
and charts were then employed to proffer the data. A total of 93 nurses were involved in
the study with an 86% response rate. The study findings revealed that the nurses’ level
of compliance of the CDC guidelines for CAUTI prevention was low (46.7%). There
were no significant associations established between nurse related factors and
compliance with CDC guidelines for CAUTI prevention (p > 0.05). Statistically
significant relationships were however found between institution-related factors that is,
regular training on CAUTI prevention, having adequate staffing and support from ward
in charges and hospital administration and compliance with specific guideline statements
for prevention of CAUTI (p < 0.05). In line with the study’s findings, it is thus proposed
that the hospital management organize regular training for nurses on CAUTI prevention
and provide adequate staffing to improve compliance with guidelines for CAUTI
prevention. Similar studies in other county and sub-county hospitals are recommende
Influence of Health System Determinants on Availability of Medicines in Public Health Facilities in Bungoma County, kenya
Get PDFAvailability of medicines is important in provision of health care. Lack of medicines
has been a major challenge in public health facilities in developing countries including
Kenya. This research aimed at determining the influence of procurement process,
inventory management practices and healthcare financing on availability of medicines
in Bungoma County, Kenya. Descriptive cross sectional research design with mixed
approach methods was applied. The target population included the county pharmacist,
sub county pharmacists, medical superintendents, procurement officers, health
administrative officers, the county procurement officer and the chief officer for health
and sanitation. All the nine sub county hospitals were sampled and a census method
applied to sample four staff from each sub county with one staff being sampled from
each cadre of the target population above hence 36 respondents. This was achieved
through G- power Priori power analysis. Additionally, the county procurement officer,
the chief officer for health and sanitation and the county pharmacist were purposively
sampled. The resulting total number of respondents was 39. A semi structured
questionnaire, an in-depth interview guide, and a checklist were the study data
gathering tools. Data was analyzed qualitatively and quantitatively. Descriptive
statistics were employed in quantitative data analysis while Chi-square was used as
appropriate. The information was then tabulated. Logistic regression was used to
explain relationship between dependent and independent variables. Qualitative data was
categorized into specific themes as per the research objectives and reported in narrative
form together with quantitative presentation. 81.2% of respondents reiterated that
procurement processes were followed as compared to 18.8% where, laid down
procurement procedures were not followed. Health administrative officers were a
majority of those who reported adherence to these procedures while all the pharmacists
and procurement officers said they had full adherence. There was no significant
relationship between adherence to procurement procedures and the cadre of the health
professional involved (χ2 =2.230: p= 0.534). Inadequate funding, inadequate
procurement staff and long procurement process were cited as challenges related to
procurement of medicines. Inadequate funding was the main issue leading to stock out
of medicines with 43.8% of respondents strongly agreeing to this statement while
46.9% plainly agreed. The influence of budgetary allocation was significant where
subjects who said that budgetary allocation influenced availability medicine were
included (OR=2.65, 95% CI, 0.737, 3.123), whereas the adherence to procurement
procedures seemed to have a greater influence on the availability of medicines
(OR=4.194, P=0.002). An average of 72.22 (63.35%) medicines were available, out of
114 that exist in the county’s standard order and reporting form for hospitals. On the
other hand, the county averaged 51.30 days of stock outs in a quarter of a year.
Absence of a county central store, an unreliable inventory management system, and an
insufficient number of pharmaceutical professionals constituted the inventory
management problems. The findings of this study will provide a baseline for further
research in addition to providing insights on determinants of medicine availability. The
government needs to streamline procurement, support inventory management practices
and increase funding for medicines to ensure availability of medicines
Plasmodium yoelii Erythrocyte Binding Like Protein Interacts With Basigin, an Erythrocyte Surface Protein
No full textErythrocyte recognition and invasion is critical for the intra-erythrocytic development of Plasmodium spp. parasites. The multistep invasion process involves specific interactions between parasite ligands and erythrocyte receptors. Erythrocyte-binding-like (EBL) proteins, type I integral transmembrane proteins released from the merozoite micronemes, are known to play an important role in the initiation and formation of tight junctions between the apical end of the merozoite and the erythrocyte surface. In Plasmodium yoelii EBL (PyEBL), a single amino acid substitution in the putative Duffy binding domain dramatically changes parasite growth rate and virulence. This suggests that PyEBL is important for modulating the virulence of P. yoelii parasites. Based on these observations, we sought to elucidate the receptor of PyEBL that mediates its role as an invasion ligand. Using the eukaryotic wheat germ cell-free system, we systematically developed and screened a library of mouse erythrocyte proteins against native PyEBL using AlphaScreen technology. We report that PyEBL specifically interacts with basigin, an erythrocyte surface protein. We further confirmed that the N-terminal cysteine-rich Duffy binding-like region (EBL region 2), is responsible for the interaction, and that the binding is not affected by the C351Y mutation, which was previously shown to modulate virulence of P. yoelii. The identification of basigin as the putative PyEBL receptor offers new insights into the role of this molecule and provides an important base for in-depth studies towards developing novel interventions against malaria
Total flavonoid content and antioxidant Activity of Hydnora Abyssinca flower methanol and Aqueous Extracts
Get PDFAntioxidants a group of compounds that are naturally found in various sources such
as plants and are responsible for preventing or reducing the oxidative stress of the
body. The body constantly produces free radicals as result of regular use of oxygen.
The free radicals cause oxidative damage that may result into cell and tissue death.
The oxidative damage contributes to genesis of many health threatening conditions
such as diabetes and cancer. Plants are abundant source of these antioxidants which
are helpful in preventing the deleterious effect of free radicals. Very few studies on
plants have been conducted. The current study aimed at evaluating the total
flavonoid content and antioxidant activity of methanol and aqueous flower extract
of Hydnora abbyssinica. Total flavonoid content was conducted by the aluminum
chloride method while the antioxidant activity was conducted by 2.2-diphenyl-2-
picryl-hydrazil (DPPH) free radical scavenging assay. L-ascorbic acid and catechin
were used as the standard antioxidant and flavonoid respectively. The methanol and
aqueous extracted recorded total flavonoid content of 7.884±0.025 and
7.940±0.024 mg CE/g dw respectively (p>0.05). The flavonoids were significantly
not different from each other. The antioxidant activity results showed methanol
extracted recorded significantly higher antioxidant activity between 1000 ug/ml to
10 ug/ml as compared to aqueous extract(P<0.05). Between 1 ug/ml to 0.01 ug/ml
no significant difference was noted between methanol and aqueous extract
(P>0.05). L-ascorbic acid recorded significantly higher antioxidant activity of 1000
ug/ml to 1 ug/ml (p<0.05) and significantly lower activity between 0.1 ug/ml and
0.01 ug/ml (p>0.05). The methanol and aqueous extract recorded IC 50 values of
4.50 ug/ml and 5.580 ug/ml respectively while L-ascorbic acid recorded IC 50
values of 4.12 ug/ml. in conclusion, Hydnora abbyssinica flower has antioxidant
activity
Analgesic and antinflammatory activity of phytexponent .
No full textPain and inflammation is unavoidable, despite being protective mechanisms by the body, chronic pain and inflammation can be limiting to a person’s daily activities. Chronic pain and inflammation is associated with inflammatory diseases such as rheumatoid arthritis, crohn’s disease, asthma, cancer, inflammatory bowel syndromes and neurodegenerative diseases ( such as parkinsons disease). The conventional medications used for management of pain and inflammation include non-steroidal antinflammatory drugs (NSAIDS), opiates and corticosteroids among others. These agents are known to have devastating side effects. Due to this more people are opting to use herbal medication as an alternative for management of pain and inflammation. In addition, some inflammatory conditions such as cancer and neurodegenerative disorders such as Parkinson’s disease and Alzheimer’s, do not have medication to stop or reverse these condition. This has raised the interest of finding new medications for such diseases. The interest of this research study is to find a potential drug for these conditions .In this study the analgesic and antinflammatory effects of phytexponent was evaluated. Phytexponent is an herbal extract mixture of various herbal plants that is marketed as an immunomodulatory agent. Methodology used for analgesic activity was using hotplate method on animal model, where the reaction time to thermal stimulus was recorded after administration of the test drug. For the evaluation of anti-inflammatory activity; formalin induced paw edema model on mice was used; where the ability of the test drug to show inhibition of inflammation was measured using vernier calipers. The results obtained showed that phytexponent has significant analgesic and antinflammatory activity
Determinants of immunization coverage among children aged 12 - 23 months in Narok South, Narok County-Kenya
Get PDFChildhood immunization remains one of the fundamental components of primary health care and one of the most cost-effective public health initiatives. Further to that, averting and eliminating vaccine preventable morbidities in the world. As a result, a few children aged 12 to 23 months in Kenya performed below average in respect to immunization coverage among completely immunized children. Procrastination of immunizations would upsurge the menace for inoculation avertible morbidities in the community. In light of that, the information obtained from this study would provide assistance to policymakers formulate sound strategies to increase immunization coverage from 57%- 90%. The broad objective of the research was to determine factors influencing low vaccination coverage between children of ages 12 to 23 months in Narok South subcounty, Narok County in Kenya. This was to contribute in the reduction of morbidity and mortality caused by infectious diseases of public health importance related to vaccinepreventable disease. Methods: This was a cross-sectional descriptive research study. The researcher combined two methods, that was quantitative and qualitative. An organized questionnaire was used to capture data on social demographic factors, maternal health care utilization, and knowledge. Key informative Interviews and Focus Group Discussions were used to capture qualitative data on 454 mothers/caretakers with children aged between 12-23 months reached in Narok South sub-county. Results: The total number of mothers/caregivers who were interviewed were 454, with a response of 100%. Results of immunization coverage; BCG 73%, OPV1 59%, OPV2 51%, OPV3 49%, Penta1 58%, Penta2 51%, Penta3 50%, Measles 54% and Fully Immunized Children 47%. Further to that, 47% of the children in the sub-county were fully immunized and 53%, partially immunized 29% and 24% unimmunized. The SD mean for mothers/caregivers and children 31.4 and 17.0 respectively and over 70% of the mothers/caregivers had no formal education. There were significant association predictors with immunization coverage included maternal education (X2 =11.75, df=4 p value<0.02), distance to health facility (X2 =62.30, df=2 p value <0.00), also, there was strong significant association with childbirth ranking (OR =1.218, p value<0.04). Bivariate analysis, there was an association with mothers/caregivers’ who had more than one visits with fully immunized children (χ2=13.54, df =2 and p value <0.001), source of the immunization information OR=0.75 and p value <0.02 and, ultimately, there was association between mother’s/caregiver place of delivery with non-fully immunized children (X2=74.40, df=1 p value<0.01). Predictors of non-fully immunized children in the study population were; place of delivery, family size, education level, source of income, none attendance of Antenatal clinics, distance to the health facility, source of the vaccination information was associated with incomplete fully immunized children. Conclusion: The immunization coverage for the fully immunized children in the sub county was very low 47%, compared to national 77%. Key players in the immunization sector should identify children who are at risk, deploy reach every child strategy, encourage pregnant mothers to attend ANC. In addition, expand outreach services, increase funds allocation to health sector and build more health facilities to improve immunization coverage
Adapting Social Networking Sites for Scholarly Communication among Postgraduate Students in Kenyan Universities
No full textThe study examines how postgraduate students use Social Networking Sites (SNS) in communicating
scholarly information in Kenyan universities with reference to use of WhatsApp, Twitter, Facebook, LinkedIn and Academia.edu. The objectives of this studies are: to determine how social networking sites are used for scholarly communication and to find out the reasons for using social networking sites by postgraduate students. Descriptive research design was used to guide the study. From four universities with a sample size of 242 postgraduate students who filled the questionnaire. The findings of the study showed that postgraduate students use SNS to share research ideas, class experiences, to know where to meet for lessons, when lectures are starting and updates on deadlines for submitting class assignments; the reasons for using SNS are for academic purposes and group discussion. In conclusion, the findings of the study show that postgraduate students use SNS to share daily experiences within campus rather than sharing information on how and where they can get scholarly information that will enable them to add new body of knowledge
Prevalence and predictors of burnout among nurses during COVID-19: a cross-sectional study in hospitals in central Uganda
No full textObjective To determine the prevalence of burnout and associated factors among nurses during COVID-19 in central Uganda.
Design A cross-sectional design.
Setting Nurse from one referral and four general hospitals. These were reception centres and cared for patients with COVID-19 in central Uganda.
Participants 395 nurses.
Main outcome measures Burnout scores.
Results Of the total 395 participants, 65.1% (n=257) were female; 40% (n=158) had a diploma; 47.1% (n=186) were single; and 39.2% (n=155) had worked for 11–15 years. The results show that 40% (n=158), 41.77% (n=165) and 18.23% (n=77) reported high, average and low levels of burnout, respectively. The results show that the predictors of nurses’ burnout were personal protective equipment (PPE) (OR: 7.1, 95% CI 4.08 to 12.31) and increased workload (OR 4.3, 95% CI 2.43 to 7.93).
Conclusion This study of nurses working in hospitals dealing with patients with COVID-19 in central Uganda reported high rates of burnout, and it was associated with PPE and workload. Interventions like contracting new nurses to reduce workload, the WHO guidelines on PPE, adjusting working hours and ensuring hours of effective rest should be adapted