The influence of host and pathogen genotypes on symptom severity in banana streak disease

Banana is the fourth most important food crop worldwide. However, its production has been threatened by banana streak disease, caused by banana streak virus (BSV). Despite this situation, little is known about the inter-relationships between symptom severity and cultivar/virus genotypes. Symptom severity assessment for sixty five symptomatic samples was carefully done. The rolling circle amplification technique was used to identify the virus species (isolate) infecting each sample. The Mysore virus isolates (BSMysV) and the banana cultivars containing the balbisiana (B) component were associated with the most severe banana streak disease symptoms.Key words: Banana streak disease, symptom severity, banana streak virus (BSV) isolate, rolling circle amplification

Refining a questionnaire to assess breast cancer knowledge and barriers to screening in Kenya: Psychometric assessment of the BCAM

Background Our study objective was to determine the validity and reliability of the breast module of a cancer awareness measure (BCAM) among adult women in western Kenya. Methods The study was conducted between October and November 2012, following three breast cancer screening events. Purposive and systematic random sampling methods were used to identity 48 women for cognitive focus group discussions, and 1061 (594 who attended vs. 467 who did not attend screening events) for surveys, respectively. Face and psychometric validity of the BCAM survey was assessed using cognitive testing, factor analysis of survey data, and correlations. Internal reliability was assessed using Cronbach’s alpha. Results Among survey participants, the overall median age was 34 (IQR: 26–44) years. Compared to those women who did not attend the screening events, women attendees were older (median: 35 vs. 32 years, p = 0.001) more often married (79% vs. 72%, p = 0.006), more educated (52% vs. 46% with more than an elementary level of education, p = 0.001), more unemployed (59% vs. 11%, p = 0.001), more likely to report doing breast self-examination (56% vs. 40%, p = 0.001) and more likely to report having felt a breast lump (16% vs. 7%, p = 0.001). For domain 1 on knowledge of breast cancer symptoms, one factor (three items) with Eigen value of 1.76 emerged for the group that did not attend screening, and 1.50 for the group that attended screening. For both groups two factors (factor 1 “internal influences” and factor 2 “external influences”) emerged among domain 4 on barriers to screening, with varied item loadings and Eigen values. There were no statistically significant differences in the factor scores between attendees and non-attendees. There were significant associations between factor scores and other attributes of the surveyed population, including associations with occupation, transportation type, and training for and practice of breast self-examination. Cronbach’s alpha showed an acceptable internal consistency. Conclusion Certain subpopulations are less likely than others to attend breast screening in Kenya. A survey measure of breast cancer knowledge and perceived barriers to screening shows promise for use in Kenya for characterizing clinical and community population beliefs, but needs adaptation for setting, language and culture

Genetic diversity study of Kenyan cassava germplasm using simple sequence repeats

Cassava (Manihot esculenta Cranzt) is an important food security crop for resource poor rural communities particularly in Africa. Little is however known about molecular diversity of Kenyan cassava germplasm. This led to a study whose objective was to identify genetic constitution of cassava accessions from different regions of Kenya using molecular tools. Seven pairs of micro satellite (SSR) primers previously developed from cassava were used to detect polymorphic 21 alleles in a sample of 69 accessions. The cluster analysis of similarity matrix obtained at 68% with SSR data showed that the 69 accessions were grouped into five marker based groups. This study proved that SSRs could be used to identify cassava accessions as well as in the assessment of level of genetic relatedness among accessions.Keywords: Cassava, simple sequence repeat (SSR) markers, genetic diversity

Impact of an Educational Intervention on Breast Cancer Knowledge in Western Kenya

Our objective was to assess the effectiveness of educational sessions that accompanied breast cancer screening events in three communities in western Kenya between October and November 2013. Five hundred and thirty-two women were recruited to complete a test of breast cancer-relevant knowledge and randomly allocated to ‘pre-test’ or ‘post-test’ groups that immediately preceded or followed participation in the educational sessions. The education was organized as a presentation by health professionals and focused mainly on causes of breast cancer, early and late cancer presentation signs, high-risk groups, screening methods to find early-stage breast cancer, self-breast exam procedures and treatment options for this disease. Participants were invited to ask questions and practice finding nodules in silicone breast models. The median age was 35 years (interquartile range: 28–45), and 86% had not undergone breast cancer screening previously. Many individual items in our test of knowledge showed statistically significant shifts to better-informed responses. When all items in the assessment questionnaire were scored as a ‘test’, on average there was a 2.80 point (95% CI: 2.38, 3.22) significant improvement in knowledge about breast cancer after the educational session. Our study provides evidence for the effectiveness of an educational strategy carefully tailored for women in these communities in Kenya

Uptake of home-based voluntary HIV testing in sub-Saharan Africa: a systematic review and meta-analysis

Improving access to HIV testing is a key priority in scaling up HIV treatment and prevention services. Home-based voluntary counselling and testing (HBT) as an approach to delivering wide-scale HIV testing is explored here

Decreasing incidence of pregnancy among HIV-positive adolescents in a large HIV treatment program in western Kenya between 2005 and 2017: a retrospective cohort study

Background: The objective of this study was to estimate the prevalence, incidence and risk factors for pregnancy among HIV-positive adolescents in a large HIV treatment program in western Kenya. Methods: The Academic Model Providing Access to Healthcare (AMPATH) program is a partnership between Moi University, Moi Teaching and Referral Hospital and a consortium of 11 North American academic institutions. AMPATH currently provides care to 85,000 HIV-positive individuals in western Kenya. Included in this analysis were adolescents aged 10-19 enrolled in AMPATH between January 2005 and February 2017. Socio-demographic, behavioural, and clinical data at baseline and time-updated antiretroviral treatment (ART) data were extracted from the electronic medical records and summarized using descriptive statistics. Follow up time was defined as time of inclusion in the cohort until the date of first pregnancy or age 20, loss to follow up, death, or administrative censoring. Adolescent pregnancy rates and associated risk factors were determined. Results: There were 8565 adolescents eligible for analysis. Median age at enrolment in HIV care was 14.0 years. Only 17.7% had electricity at home and 14.4% had piped water, both indicators of a high level of poverty. 12.9% (1104) were pregnant at study inclusion. Of those not pregnant at enrolment, 5.6% (448) became pregnant at least once during follow-up. Another 1.0% (78) were pregnant at inclusion and became pregnant again during follow-up. The overall pregnancy incidence rate was 21.9 per 1000 woman years or 55.8 pregnancies per 1000 women. Between 2005 and 2017, pregnancy rates have decreased. Adolescents who became pregnant in follow-up were more likely to be older, to be married or living with a partner and to have at least one child already and less likely to be using family planning. Conclusions: A considerable number of these HIV-positive adolescents presented at enrolment into HIV care as pregnant and many became pregnant as adolescents during follow-up. Pregnancy rates remain high but have decreased from 2005 to 2017. Adolescent-focused sexual and reproductive health and ante/postnatal care programs may have the potential to improve maternal and neonatal outcomes as well as further decrease pregnancy rates in this high-risk group

Use of Maerua Decumbens as a Natural Coagulant for Water Purification in the Dry Lands of Kenya

ABSTRACT: Indigenous management and utilization of naturally occurring tree species and shrubs/lianas is not a new culture worldwide. Various communities in the world use their indigenous tree /shrub / liana species to meet their needs for food (human and livestock), shelter and medicine among other diverse wood and non-wood forest products. Introduction of new exotic species has eroded the importance of some of these important indigenous plant species to great extends. It is however, important to consider that while these exotic species have multiple uses, most of them are not well adapted to our arid and semi-arid regions hence the need to promote the management and sustainable use of the indigenous species. Maerua decumbens is a shrub or woody herb species in the Capparaceae family and grows to a height of 0.5 to 3m with a large swollen root. It mostly occurs naturally in the arid and semiarid areas in Kenya and is used traditionally by rural communities for medicinal and water purification purposes. Members of the Mearua species are indicated as poisonous and probably a health risk and yet some of the communities chew the roots of Mearua decumbens against thirst and also use them for purifying water (Beenje H.1994). The study was done to enhance the use of Maerua decumbens as a natural coagulant for water purification by determining whether the plant used for water purification in Mutha in Kitui County is toxic or not. A reconnaissance survey was done to confirm its use for water purification and toxicity tests were done to determine the safety of the plant for human utilization as a natural coagulant for water purification. The results of the study revealed that M.decumbens is completely safe for human consumption and does not have any heavy metals that pose a risk to human health

Healthcare workers' perspectives and practices regarding the disclosure of HIV status to children in Malawi: A cross-sectional study

Background: In 2011 the World Health Organisation recommended that children with a diagnosis of HIV be gradually informed about their HIV status between the ages of 6 and 12 years. However, to date, literature has focused mainly on primary caregiver and child experiences with HIV disclosure, little is known about healthcare workers' perspectives and practices of HIV status disclosure to children. The aim of this study was to assess healthcare workers' perspectives and practices regarding the disclosure of HIV status to children aged between 6 and 12 years in Malawi. Methods: A cross-sectional survey was used to collect data from 168 healthcare providers working in antiretroviral clinics in all government District and Tertiary Hospitals in Malawi. Participants were asked questions regarding their knowledge, practice, and barriers to HIV disclosure. Data were analysed using binary logistic regression. Results: Almost all healthcare workers (98%) reported that it was important to disclose HIV status to children. A significant proportion (37%) reported that they had never disclosed HIV status to a child and about half estimated that the rate of HIV disclosure at their facility was 25% or less. The main barriers to disclosure were lack of training on disclosure (85%) and lack of a standard tool for disclosure (84%). Female healthcare workers (aOR) 2.4; 95% CI: 1.1-5.5) and lack of training on disclosure (aOR 7.7; 95% CI: 3.4-10.7) were independently associated with never having disclosed HIV status to a child. Conclusions: This study highlights the need for providing appropriate training in HIV disclosure for healthcare workers and the provision of standardised disclosure materials