Prevalence Of Anemia Among Teenage Pregnant Girls Attending Antenatal Clinic In Two Health Facilities In Bungoma District, Western Kenya

Severe anemia is an important cause of maternal morbidity and mortality among teenage pregnant girls who are susceptible because of their rapid growth and associated high iron requirements. Teenage girls often enter pregnancy with less adequate stores of nutrients and are thus unable to withstand the demands imposed by pregnancy. The aim of the study was to determine the prevalence of anemia and associated factors among teenage pregnant girls. The study was conducted at Maternal Child Health Clinic of   Bungoma district hospital and Bumula Health Centre. This was a cross section study. Teenage pregnant girls attending ANC were recruited. Food frequency questionnaires were used to assess the dietary intake and factors associated with anemia. Blood sample and stool were used to determine the hemoglobin levels and presence of intestinal worms. The prevalence of anemia was 61% (Hemoglobin < 110 g/L). 20.5% had severe anemia, (hemoglobin < 60 g/L), 31.2% had moderate anemia (hemoglobin < or = 90 g/L), and 48.3% had mild anemia.  Iron intake was significantly associated with perceived food shortage (OR: 2.548; 95% CI: 1.632 – 3.980). Hookworm affected calcium intake (OR: 3.074; 95% CI: 1.089 – 8.698) and malaria parasites affected folate intake (OR: 0.355; 95% CI: 0.226 – 0.557). Those with hookworm were 3 times more likely to have inadequate calcium intake as compared to those without. Anemia was high in the study population. Parasitic infestation and food intake were associated with anemia. De-worming with correction of anemia should be encouraged. Keywords:Anemia, teenage girls, pregnancy, nutrient intake, iro

Genotyping for point mutations in selected codons of pfcrt and pfmdr-1 genes of Plasmodium falciparum among patients with uncomplicated malaria in Mbita district Kenya.

Background Malaria remains a leading cause of morbidity and mortality in Kenya, especially in young children and pregnant women. Due to widespread resistance of Plasmodium falciparum to drugs such as Chloroquine (CQ) and Sulfurdoxine-Pyrthamine (SP), Artemisisnin Combination Therapy (ACT) was adopted in Africa as a means of improving treatment efficacy and slowing the spread of resistance. The development of drug resistance by the parasites for the various malaria drug regimens that have been in use before has been attributed to point mutations within the parasite genome. Therefore this study investigated the prevalence of point mutations in selected codons of the pfcrt and pfmdr-1 genes of Plasmodium falciparum. It is however unclear whether ACT will be effective in preventing the selection of resistant parasites in Africa, where parasite transmission rates are generally much higher with parts of Asia and Africa already reporting a reduction in sensitivity to ACT. Methods The dot-blot/probe hybridization technique was used to identify point mutations in codons 74, 75 and 76 of the pfcrt gene and codons 1034, 1042 and 1246 of the pfmdr-1 gene in Mbita a malaria holoendemic site in Kenya. In the pfcrt gene, 76T mutation was found to be in 91 (79.83% CI 63.1-88.5) of 114 samples while the, the wild type allele 76K was present in 23 (20.17% CI 9.0-22.0) samples. Codons 1246 showed allelic variation with 1246D the wild type allele being 72.8% (CI 52.0-89.1). This was a significant increase in the 76K allele (p=0.001) in comparison to the year 2005 where prevalence of 76K was 6%.   Conclusion There’s an expansion of the wild-type allele 76K of the pfcrt gene and no significant difference in the 1246D allele of the pfmdr1 gene, moreover the prevalence of 76T allele is still high in Mbita hence it’s beneficial to continue using AL as treatment for uncomplicated malaria. Keywords: Malaria, Drug Resistance, Point Mutations

Association between thrombocytes count and Plasmodium falcipurum infection among children under five years attending Kombewa Sub-County Hospital

Malaria is a leading cause of morbidity and mortality especially among children, expectant women and continues to be a global health burden. Haematological changes mark some of the most common complications in malaria as they play a major role in malaria pathology. Thrombocytes in particular, have been shown to bind infected erythrocytes and kill intracellular malaria parasites thereby indicating a protective function of platelets in the early stages. However, the mechanism that leads to low thrombocytes count in malaria infected individuals is not clear. Understanding the mechanism of platelet reduction during pathogenesis of malaria infection will be fundamental in malaria severity classification, monitoring of platelet count during infection and prompt initiation of anti-malarial therapy. In trying to understand these facts, this study sort to establish the association between platelet count and P. falciparum infection amongst children less than five years. This was a retrospective case-control study, n=549. Children below the age of five years that attending Kombewa Sub -County Hospital were recruited. Study participants were identified using the inclusion criteria and followed horizontally to retrieve platelet count from complete blood count results. The respective malaria blood film reads were then recorded, stratified to give case and control from which random sampling was done. Chi-square test and Tukey’s multiple comparison tests from Graph pad prism 5 were used in the analysis. The odds of exposure to low platelet count were then established with a confidence level of 95%. We found significant difference between the cases and controls in regard to parasite density (Chi square=157.5, p value <0.05), mean parasite density in controls =2042.1/?l compared to cases= 142880/?l. The odds of cases being exposed to malaria was 12 times more than controls (OR=12.382, 95%). We also found no variation in thrombocytes counts in relation to gender, children with thrombocytopenia were having higher parasite density, parasite density as a result of P.falciparum infection is not dependent on gender and children that suffered malarial infection were twelve times likely to develop thrombocytopenia. Further studies are then recommended to establish the effects of incorporation of platelet aggregation inhibitors such as aspirin in malaria treatment.Key Words: Plasmodium falciparum, thrombocytopenia, infectio