Characterisation of community acquired non-typhoidal Salmonella from bacteraemia and diarrhoeal infections in children admitted to hospital in Nairobi, Kenya

BACKGROUND: In sub-Saharan Africa community-acquired non-typhoidal Salmonella (NTS) is a major cause of high morbidity and death among children under 5 years of age especially from resource poor settings. The emergence of multidrug resistance is a major challenge in treatment of life threatening invasive NTS infections in these settings. RESULTS: Overall 170 (51.2%) of children presented with bacteraemia alone, 28 (8.4%) with gastroenteritis and bacteraemia and 134 (40.4%) with gastroenteritis alone. NTS serotypes obtained from all the cases included S. Typhimurium (196; 59%), S. Enteritidis (94; 28.3%) and other serotypes in smaller numbers (42; 12.7%); distribution of these serotypes among cases with bacteremia or gastroenteritis was not significantly different. A significantly higher proportion of younger children (< 3 years of age) and those from the slums presented with invasive NTS compared to older children and those from upper socio-economic groups (p < 0.001). One hundred and forty-seven (44.3%) NTS were resistant to 3 or more antibiotics, and out of these 59% were resistant to ampicillin, chloramphenicol and tetracycline. There was no significant difference in antibiotic resistance between the two serotypes, S. Typhimurium and S. Enteritidis. Ceftriaxone and ciprofloxacin were the only antibiotics tested to which all the NTS were fully susceptible. Using Pulsed Field Gel Electrophoresis (PFGE) there were 3 main patterns of S. Typhimurium and 2 main patterns of S. Enteritidis among cases of bacteraemia and gastroenteritis. CONCLUSION: Serotype distribution, antibiotic susceptibility and PFGE patterns of NTS causing bacteraemia and gastroenteritis did not differ significantly. The high prevalence of NTS strains resistant to most of the commonly used antimicrobials is of major public health concern

Pheochromocytoma in pregnancy: Case report

This is a case presentation of a 32 year old woman with pheochromocytoma diagnosed at 27 weeks of gestation, she was managed till term, induced and had assisted vaginal delivery. The pheochromocytoma was surgically re-sected successfully at six weeks postpartum

Heat Release Imaging in Turbulent Premixed Ethylene-Air Flames Near Blow-off

The focus of this work is to visualise the regions of CH2O and heat release (HR) of an unconfined turbulent premixed bluff body stabilised ethylene-air flame at conditions approaching lean blow-off using simultaneous imaging of OH- and CH2O-PLIF. The HR regions are estimated from the product of the OH and CH2O profiles. At conditions near blow-off, wide regions of CH2O are observed inside the recirculation zone (RZ). The presence of CH2O and HR inside the RZ is observed to follow fragmentation of the downstream flame parts near the top of the RZ. The presence of wide regions void of both OH and CH2O inside the RZ at conditions very close to blow-off indicates the possible entrainment of un-reacted gases into the RZ. The behaviour of the lean ethylene-air flame with Lewis number (Le) greater than 1 is compared to that of a lean methane-air flame with Le of approximately 1. For both fuels, qualitatively similar observations of flame fragmentation downstream followed by build-up of CH2O and HR inside the RZ are observed at conditions near lean blow-off. Also, a similar trend of flame front curvature conditioned on HR was observed for both the ethylene-air and methane-air flames, where the magnitude of HR was observed to increase with the absolute value of curvature.Funding of this study was obtained from the Engineering and Physical Sciences Research Council (EPSRC), research grant EP/G063788/1, and the UCL/EPSRC Doctoral Training Account.This is the final version of the article. It first appeared from Springer via http://dx.doi.org/10.1007/s10494-016-9720-

The Dantu blood group prevents parasite growth in vivo: Evidence from a controlled human malaria infection study

Background: The long co-evolution of Homo sapiens and Plasmodium falciparum has resulted in the selection of numerous human genetic variants that confer an advantage against severe malaria and death. One such variant is the Dantu blood group antigen, which is associated with 74% protection against severe and complicated P. falciparum malaria infections in homozygous individuals, similar to that provided by the sickle haemoglobin allele (HbS). Recent in vitro studies suggest that Dantu exerts this protection by increasing the surface tension of red blood cells, thereby impeding the ability of P. falciparum merozoites to invade them and reducing parasite multiplication. However, no studies have yet explored this hypothesis in vivo. Methods: We investigated the effect of Dantu on early phase P. falciparum (Pf) infections in a controlled human malaria infection (CHMI) study. 141 sickle-negative Kenyan adults were inoculated with 3.2 × 103 aseptic, purified, cryopreserved Pf sporozoites (PfSPZ Challenge) then monitored for blood-stage parasitaemia for 21 days by quantitative polymerase chain reaction (qPCR)analysis of the 18S ribosomal RNA P. falciparum gene. The primary endpoint was blood-stage P. falciparum parasitaemia of ≥500/μl while the secondary endpoint was the receipt of antimalarial treatment in the presence of parasitaemia of any density. On study completion, all participants were genotyped both for Dantu and for four other polymorphisms that are associated with protection against severe falciparum malaria: α+-thalassaemia, blood group O, G6PD deficiency, and the rs4951074 allele in the red cell calcium transporter ATP2B4. Results: The primary endpoint was reached in 25/111 (22.5%) non-Dantu subjects in comparison to 0/27 (0%) Dantu heterozygotes and 0/3 (0.0%) Dantu homozygotes (p=0.01). Similarly, 49/111 (44.1%) non-Dantu subjects reached the secondary endpoint in comparison to only 7/27 (25.9%) and 0/3 (0.0%) Dantu heterozygotes and homozygotes, respectively (p=0.021). No significant impacts on either outcome were seen for any of the other genetic variants under study. Conclusions: This study reveals, for the first time, that the Dantu blood group is associated with high-level protection against early, non-clinical, P. falciparum malaria infections in vivo. Learning more about the mechanisms involved could potentially lead to new approaches to the prevention or treatment of the disease. Our study illustrates the power of CHMI with PfSPZ Challenge for directly testing the protective impact of genotypes previously identified using other methods

Breeding management strategies adopted for dairy production under low-input smallholder farming systems of East Africa

Designing and implementing sustainable breeding management programmes is one of the most practical means of improving efficiency in livestock production, particularly in developing countries. The success or failure of an improvement programme hinges strongly on the compatibility of the programme with the objectives of the farming community targeted. This report contributes to a better understanding of the pre-existing breeding management strategies within cattle-keeping communities of the EADD project sites, and will help in the definition of appropriate breeding objectives and the design and implementation of a sustainable breeding programme for the small holder farmers. The farmers in the three countries rear a variety of cattle, classified into two broad categories as exotic and indigenous breed-types. More exotic breed-types are reared in Kenya than in Rwanda and Uganda. Among the exotic breed-types reared, the Holstein-Friesian is most popular in all the countries. The Ayrshire breed-type is also very popular in Kenya. In Uganda, the most common type of cattle are the indigenous Ankole, while in Rwanda, various crosses are popular. There are no written records available on individual animals. The breed-type of animal raised on a farm is significantly influenced by the age and level of education of the head of the household. On average, in households headed by older and more educated people, there are more exotic breed-types of animals reared. These households also live in areas with higher human population density. Farmers implement some form of controlled mating, either to minimize inbreeding, or to seek better mates among the population available. There is also some degree of planned cross-breeding taking place in all the countries. On most farms, animals calved down for the first time when they were above 27 months old, with exotic animals calving at a younger age than indigenous ones. Calving intervals were on average longer in Kenya than in the other countries. Indigenous animals tended to calve for the first time at close to four years of age in Uganda where malnutrition was noted as a key factor requiring to be addressed. More than 10% of the animals on farms within the three countries were culled in a 12 month period with a replacement rate of less than 5%, implying an overall reduction in herd size over time. The most desirable traits in exotic animals raised in all three countries were high milk production and good body conformation. In the indigenous breed-types reared, adaptability was the most important trait in all the countries. An interesting observation was that not all farmers raised the breed-type of animal that they admired most. It was clear that the farmers were knowledgeable to some degree on several aspects related to selective breeding of animals. To effect change in the existing production systems, in addition to availing improved breeding materials at an affordable cost, capacity development using simplified messages targeted to address specific knowledge gaps concerning breed choice, reproduction and selection decisions is required

Rapid assembly of highly-functionalised difluorinated cyclooctenones via ring-closing metathesis

Building block methodology from trifluoroethanol and ringclosing metathesis using a Fürstner modification of Grubbs’ conditions allows the rapid synthesis of novel difluorinated cyclooctenones

Genotypic analysis of multidrug-resistant Salmonella enterica Serovar typhi, Kenya.

We report the emergence in Kenya during 1997-1999 of typhoid fever due to Salmonella enterica serovar Typhi resistant to ampicillin, tetracycline, chloramphenicol, streptomycin, and cotrimoxazole. Genotyping by pulsed-field gel electrophoresis of XbaI-digested chromosomal DNA yielded a single cluster. The multidrug-resistant S. Typhi were related to earlier drug- susceptible isolates but were unrelated to multidrug-resistant isolates from Asia

Feeds and feeding practices

The East Africa Dairy Development (EADD) project is a regional industry development program implemented by a consortium of partners led by Heifer International. It is currently being piloted in 18 sites in Kenya, 8 in Rwanda and 27 in Uganda. The overall goal of the project is to transform the lives of 179,000 families, or about 1 million people, by doubling household dairy income in 10 years through integrated interventions in dairy production, market access and knowledge application. This brief highlights key results of a baseline survey that was carried out with the objective of providing information on cattle production systems and the current feeding practices in smallholder households in selected sites in Kenya, Rwanda and Uganda. Details are available in the baseline survey report No. 3