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Evaluation of the protective efficacy of Olyset®Plus ceiling net on reducing malaria prevalence in children in Lake Victoria basin, Kenya: study protocol for a cluster-randomized controlled trial
No full textIn the Lake Victoria basin of western Kenya, malaria remains highly endemic despite high coverage of interventions such as insecticide-impregnated long-lasting insecticidal nets (LLIN). The malaria-protective effect of LLINs is hampered by insecticide resistance in Anopheles vectors and its repurposing by the community. Ceiling nets and LLIN with synergist piperonyl butoxide (PBO-LLIN) are novel tools that can overcome the problems of behavioral variation of net use and metabolic resistance to insecticide, respectively. The two have been shown to reduce malaria prevalence when used independently. Integration of these two tools (i.e., ceiling nets made with PBO-LLIN or Olyset®Plus ceiling nets) appears promising in further reducing the malaria burden.
Methods
A cluster-randomized controlled trial is designed to assess the effect of Olyset®Plus ceiling nets on reducing malaria prevalence in children on Mfangano Island in Homa Bay County, where malaria transmission is moderate. Olyset®Plus ceiling nets will be installed in 1,315 residential structures. Malaria parasitological, entomological, and serological indicators will be measured for 12 months to compare the effectiveness of this new intervention against conventional LLIN in the control arm.
Discussion
Wider adoption of Olyset®Plus ceiling nets to complement existing interventions may benefit other malaria endemic counties and be incorporated as part of Kenya's national malaria elimination strategy
Factors associated with personal protective equipment use among pesticide handlers in Mwea irrigation Scheme, Kenya
No full textBackground: Pesticide use among small scale rice farmers has drastically increased over time globally. Evidence shows
that majority of pesticide handlers do not regard PPE use during pesticide application, hence low PPE compliance.
Methods: This study explored factors associated with PPE use among pesticide handlers in Mwea Irrigation Scheme,
Kenya. The study was cross-sectional involving 246 respondents.
Results: There was low level of PPE use among pesticide handlers with none using full PPE and only 25.2% using 4-
6 PPE items out of 7 possible items. The most used PPE were trousers (74.4%), long-sleeved shirt/jacket (65.9%) and
hat (60.6%). The least worn PPE were gumboots (1.6%), gloves (2.8%) and goggles (9.8%). Chi- square tests of
independence revealed that sex, age, crop ownership, pesticide safety training, pesticide application experience,
pesticide safety knowledge, attitude towards PPE use, perceived environmental health risk and Perceived PPE
importance were significantly associated with PPE use. However, level of education, land tenure status and size of the
farm were found not to have any association with PPE use.
Conclusions: The results provide insights for future interventions and inform focus areas by health and safety
enforcement agencies and policy developers. More training on pesticide safety and PPE use will enhance compliance
and promote pesticide handlers’ healt
Uptake and Associated Factors of Male Contraceptive Method Use: A Community-Based Cross-Sectional Study in Northern Uganda
No full textBackground: Uganda has one of the highest fertility rates in Sub-Saharan Africa (SSA). Improving contraceptive uptake in all genders, including males, may be critical to meeting family planning goals in such a setting. Yet, data on male contraception uptake and associated factors in SSA, including Uganda, are limited. We determined the uptake and associated factors of male contraception use in Lira City, Northern Uganda.
Methods: We conducted a community-based cross-sectional study from November 12, 2022, to December 12, 2022, among men aged ≥ 18 years. We used multi-stage sampling to select participants from 12 cells of Lira City divisions of East and West. Data were collected using interviewer-administered structured questionnaires. We defined uptake in males who had used any contraceptive method, including periodic abstinence, withdrawal, condoms, and vasectomy in the previous four weeks. We performed modified Poisson regression to identify associated factors of male contraception uptake.
Results: We recruited 401 participants with mean age of 30.4 (± 9.3) years. Male contraceptive uptake was 46.4%, 95% CI: 41.5– 51.3%. Ever heard about male contraception (adjusted prevalence ratio [aPR] =1.73, 95% CI: 1.172– 2.539, p=0.006), willingness to use novel methods (aPR=2.90, 95% CI: 1.337– 6.293, p=0.007), both partners being responsible for contraception (aPR: 1.53, 95% CI: 1.113– 2.119, p=0.009) were the factors associated with male contraception uptake.
Conclusion: We found that nearly half of the men surveyed had used male contraceptive methods in Lira City. Factors associated with the uptake of male contraception included having heard about male contraception, joint couple decision regarding contraception, and the use of novel methods of male contraception. We recommend comprehensive education and awareness campaigns to promote male contraception, with a particular emphasis on encouraging shared decision-making within couples and introducing innovative contraceptive options
Determinants Of Breastfeeding Practices Among Women With Children Aged 6 - 12 Months Attending Well-Baby Clinic at Nairobi Women’s Hospital, Kenya
No full textThere are several advantages for women, families, and communities when breast milk is the only source of nourishment for new-borns. Among mothers with infants between the ages of 6 and 12 months, the study's goal was to discover what influences their decision to breastfeed. The study's goal was to identify the variables affecting breastfeeding among mothers of children between the ages of 6 and 12 months who visited the Well-Baby clinic at Nairobi Women's Hospital. The specific objectives of the study were as follows; To establish the influence of maternal knowledge on breastfeeding practices among mothers attending Nairobi Women's Hospital's Well-Baby Clinic with children aged 6 to 12 months, to establish the influence of socio-demographic characteristics on breastfeeding practices among these mothers, and to evaluate the impact of cultural factors on breastfeeding practices among these mothers. Self-care theory of Dorothea Orem was applied in the study. 206 volunteers in all were needed for the study. The study used a cross-sectional survey design with 206 moms who visited the Well-Baby Clinic at the Nairobi Women's Hospital. 82.6 percent of infants were exclusively breastfed at 6 months, while 17.4 percent received a mix of foods. Significant Chi squared results (p 0.05) were found for maternal age (X2 = 10.78), education level (X2 = 11.42), employment (X2 = 14.23), and family income (X2 = 12.03). In logistic regression, it was discovered that age above 30 (AOR = 1.89; 95 percent CI [1.12, 4.02]) and tertiary education level (AOR = 2.02; 95 percent CI [1.06, 2.06]) were both favourable predictors of exclusive breastfeeding. Optimal breastfeeding practices are influenced by socio-demographic factors, maternal awareness, and information access. Nairobi private hospitals need to boost knowledge and access to information for nursing mothers who frequent well-baby clinics in order to encourage exclusive breastfeeding. To avoid stigmatizing mothers who breastfeed, the Ministry of Health should support and encourage community-based initiatives that engage religious leaders. The study concluded that; socioeconomic characteristics of mothers such as age, level of education, occupation and household income are determinants of exclusive breastfeeding among mothers attending Well-Baby Clinic of Nairobi Women’s Hospital. The following recommendations were made that there is need to involve private hospitals in national breastfeeding campaigns so as to share some of the lessons learned in promotion of exclusive breastfeeding
High throughput human genotyping for variants associated with malarial disease outcomes using custom targeted amplicon sequencing
No full textMalaria has exhibited the strongest known selective pressure on the human genome in recent history and is the evolutionary driving force behind genetic conditions, such as sickle-cell disease, glucose-6-phosphatase deficiency, and some other erythrocyte defects. Genomic studies (e.g., The 1000 Genomes project) have provided an invaluable baseline for human genetics, but with an estimated two thousand ethno-linguistic groups thought to exist across the African continent, our understanding of the genetic differences between indigenous populations and their implications on disease is still limited. Low-cost sequencing-based approaches make it possible to target specific molecular markers and genes of interest, leading to potential insights into genetic diversity. Here we demonstrate the versatility of custom dual-indexing technology and Illumina next generation sequencing to generate a genetic profile of human polymorphisms associated with malaria pathology.For 100 individuals diagnosed with severe malaria in Northeast Tanzania, variants were successfully characterised on the haemoglobin subunit beta (HBB), glucose-6-phosphate dehydrogenase (G6PD), atypical chemokine receptor 1 (ACKR1) genes, and the intergenic Dantu genetic blood variant, then validated using pre-existing genotyping data. High sequencing coverage was observed across all amplicon targets in HBB, G6PD, ACKR1, and the Dantu blood group, with variants identified at frequencies previously observed within this region of Tanzania. Sequencing data exhibited high concordance rates to pre-existing genotyping data (> 99.5%). Our work demonstrates the potential utility of amplicon sequencing for applications in human genetics, including to personalise medicine and understand the genetic diversity of loci linked to important host phenotypes, such as malaria susceptibility.AO is supported by a Nagasaki University—LSHTM PhD studentship funded by the WISE programme of MEXT. SC is funded by the Medical Research Council UK (Grant no. MR/M01360X/1). AK received support from JSPS KAKENHI (Grant No. JP18KK0248 & JP19H01080) and JICA/AMED joint research project (SATREPS) (Grant no. 20JM0110020H0002) and Hitachi fund. TGC is supported by the Medical Research Council UK (Grant nos. MR/M01360X/1, MR/N010469/1, MR/R020973/1, MR/X005895/1). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript
Electronic and ring size effects of N-heterocyclic carbenes on the kinetics of ligand substitution reactions and DNA/protein interactions of their palladium(II) complexes
No full textThe synthesis, substitution kinetics and DNA/BSA interactions of four cationic Pd(II) complexes [Pd(1)Cl]BF4 (Pd1), [Pd(2)Cl]BF4 (Pd2), [Pd(3)Cl]BF4 (Pd3) and [Pd(4)Cl]BF4 (Pd4), derived from the reaction of [PdCl2(NCCH3)2] with ligands 2,6-bis(3-methylimidazolium-1-yl)pyridine dibromide (1), 2,6-bis(3-ethylimidazolium-1-yl)pyridine dibromide (2), 2,6-bis(1-methylimidazole-2-thione)pyridine (3), and 2,6-bis(1-ethylimidazole-2-thione)pyridine (4), respectively are reported. The complexes were characterised by various spectroscopic techniques and single crystal X-ray diffraction for compound Pd2. Kinetic reactivity of the complexes with the biologically relevant nucleophiles thiourea (Tu), L-methionine (L-Met) and guanosine 5′-monophosphate sodium salt (5’-GMP) was in the order: Pd1 > Pd2 > Pd3 > Pd4, which was largely dependent on the electronic and ring size of the chelate ligands, consistent with Density functional theory (DFT) simulations. The interactions of the complexes with calf thymus DNA (CT-DNA) and bovine serum albumin (BSA) binding titrations showed strong binding. Both the experimental and in silico data reveal CT-DNA intercalative binding mode.
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Bis(triazinyl)pyridine complexes of Pt(II) and Pd(II): studies of the nucleophilic substitution reactions, DNA/HSA interactions, molecular docking and biological activity
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Guanidine- and purine-functionalized ligands of FeIIIZnII complexes: effects on the hydrolysis of DNA
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COORDINATION OF AN AMINO ALCOHOLIC SCHIFF BASE LIGAND TOWARD THE ZINC(II) ION: SPECTRAL, STRUCTURAL, THEORETICAL, AND DOCKING STUDIES
Article 01 December 2021Open access funding provided by University of KwaZulu-Natal
Predictors of low birth weight in pregnant women with malaria: a prospective cohort facility-based 1 study in Webuye-Kenya
No full textMalaria is caused by protozoa of the genus Plasmodium and remains a major public health burden in Sub-Saharan Africa. Its prevalence varies between 9 to 18% with harmful consequences to both the mother and her baby, including adverse pregnancy outcomes such low birth weight, high morbidity, and mortality. However, effective antenatal strategies for improving maternal and child health outcomes through the prevention, early detection, and treatment of malaria in pregnancy, are still lacking in resource-constrained settings. Here, we sought to determine the predictors of low birth weight in pregnant women with malaria in a cohort study in Webuye hospital. Prior to the enrollment of 140 participants, permission was sought from relevant institutions and consent from the participants. Malaria test was conducted either with microscopy or rapid test, and then the cohort splits into malaria positive and negative followed up from the first antenatal visit (March 2022) and delivery (December 2022). Before data collection, training, pre-testing and quality control were duly observed. Data were fed into SPSS 27 version, Chi-square and Fischer’s Exact were used for bi-variate analysis at a p-value less or equal 0.05 (95%). Our results revealed that birth cohort with malaria did not result in significant low birth weight with a relative risk of 0.999, confidence level of 0.926-1.077. The prevalence of low birth weight was 4.6% with 6 cases of which 3 (4.5%) in the negative cohort and 3 (4.7%) in the positive cohort. Anemic pregnant women were 41 (31.5%), HIV were 5 (3,8%), pre-eclampsia was 5 (3.8%), gestational diabetes was 2 (1.5%). Confounding factors, such as anemia, HIV, preeclampsia, and gestational diabetes did not influence low birthweight (p-value >0.923). Otherwise, most of the participants were aged 18–25 years, were primigravida, were married, had secondary school level education, earned between 20-30 thousand shillings, were resident in rural areas, and were in their second trimester. Marital status, gestational age and area of residence were associated with malaria with a p-value less than 0.001 and 0.028 respectively
Improving Gonorrhoea Molecular Diagnostics: Genome Mining-Based Identification of Identical Multi-Repeat Sequences (IMRS) In Neisseria Gonorrhoeae Genome
No full textBackground: Curable sexually transmitted infections (STIs) such as Neisseria gonorrhoeae (N. gonorrhoeae) is a major cause of poor pregnancy outcome. The infection is often asymptomatic in pregnant women and a syndrome-based approach of testing leads to missed diagnosis. Culture followed by microscopy is inadequate and time-consuming. The gold standard Nucleic Acid Amplification Tests require advanced Binfrastructure settings whilst point of care tests are limited to immunoassays with sensitivities and specificities insufficient to accurately diagnose asymptomatic cases. This necessitates the development and validation of assays that are fit for purpose. Methods: Here, we have identified new diagnostic target biomarker regions for N. gonorrhoeaeusing an algorithm for genome mining of identical multi repeat sequences (IMRS). These were then developed as DNA amplification primers to design better diagnostic assays. To test the primer pair, genomic DNA was 10-fold serially diluted (100pg/L to 1×10-3pg/L) and used as DNA template for PCR reactions. The gold standard PCR using 16S rRNA primers was also run as a comparative test, and both assay products resolved on 1% agarose gel. Results: Our newly developed N. gonorrhoeae IMRS-PCR assay had an analytical sensitivity of 6 fg/L representing better sensitivity compared to the 16S rRNA PCR assay with analytical sensitivity of 4.3096 pg/L. The assay was also successfully validated with clinical urethral swab samples. We further advanced this technique by developing an iso-thermal IMRS, which was both reliable and sensitive for detecting cultured N. gonorrhoeae isolates at a concentration of 38 ng/L. Combining the iso-thermal IMRS with a low-cost Lateral Flow Assay, we were able to detect N. gonorrhoeae amplicons at a starting concentration of 100 pg/L. Conclusion: Therefore, there is a potential to implement this concept within miniaturized, isothermal, microfluidic platforms, and laboratory-on-a-chip diagnostic devices for highly reliable point-of-care testing
Integrated microscale immiscible phase extraction and isothermal amplification for colorimetric detection of Neisseria gonorrhoeae
No full textGonorrhea is the second most common sexually transmitted infection (STI) with around 87 million cases worldwide estimated in 2016 by the World Health Organization. With over half of the cases being asymptomatic, potential life-threatening complications and increasing numbers of drug-resistant strains, routine monitoring of prevalence and incidence of infections are key preventive measures. Whilst gold standard qPCR tests have excellent accuracy, they are neither affordable nor accessible in low-resource settings. In this study, we developed a lab-on-a-chip platform based on microscale immiscible filtration to extract, concentrate and purify Neisseria gonorrhoeae DNA with an integrated detection assay based on colorimetric isothermal amplification. The platform was capable of detecting as low as 500 copies/mL from spiked synthetic urine and showed no cross-reactivity when challenged with DNAs from other common STIs. The credit card–size device allows DNA extraction and purification without power or centrifuges, and the detection reaction only needs a low-tech block heater, providing a straightforward and visual positive/negative result within 1 h. These advantages offer great potential for accurate, affordable and accessible monitoring of gonorrhea infection in resource-poor settings.Open access funding provided by Stockholm University. This work was partially funded by the University of Hull’s Quality Related Global Challenges Research Fund (QR GCRF) allocation. The authors also acknowledge Stockholm University for supporting this work through the start-up grant awarded to NP and for providing Open Access funding
Institutionalizing the Management of Sick Young Infants:Kenya’s Experience in Revising National Guidelines onIntegrated Management of Newborn and Childhood Illnesses
No full textIntroduction:
In 2015, the World Health Organization (WHO) developed guidelines for the management of sick young infants (SYIs) with possible serious bacterial infection (PSBI) where referral is not feasible. The Ponya Mtoto project was designed as an implementation research project to demonstrate how to adopt the WHO PSBI guidelines in the Kenyan context.
Ponya Mtoto Project Description:
Between October 2017 and June 2021, Ponya Mtoto was implemented in 4 Kenyan counties with higher infant and newborn mortality rates than the national mean. A total of 48 health facilities stratified by level of services were selected as study sites.
Implementation Approach:
The following activities were done to institutionalize the management of SYIs with PSBI where referral is not feasible in Kenya’s health system: (1) participating in a cocreation workshop and development of a theory of change; (2) revising the national integrated management of newborn and childhood illnesses guidelines to incorporate the management of PSBI where referral is not feasible; (3) improving availability of essential commodities; (4) strengthening provider confidence in the management of SYIs; (5) strengthening awareness about PSBI services for SYIs at the community level; and (6) harmonizing the national integrated management of newborn and childhood illnesses guidelines to address discrepancies in the content on the management of PSBI. In addition, the project focused on strengthening quality of care for SYIs and using implementation research to track progress in achieving project targets and outcomes.
Conclusion:
Using an implementation research approach to introduce new WHO guidelines on PSBI where referral is not feasible into Kenya’s health care service was critical to fostering engagement of a diverse range of stakeholders, monitoring provider skills and confidence-building, strengthening provision of key commodities for managing SYIs with PSBI, and sustaining community-facility linkages.Funding for this project was made possible by the generous support of the American people through the United States Agency for International Development (USAID) under the terms of AID-OAA-A-17-00031