Prevalence of Dengue virus among healthy blood donors in Mombasa County, Kenya

Introduction: Dengue fever (DF) is a viral infection caused by a flavivirus called Dengue virus. The virus has four known serotypes (named DENV 1-4) that circulate between humans and Aedes mosquitoes throughout the tropical region of the world. The virus is transmitted primarily by the bite of an infected Aedes aegypti or, to a lesser extent, Aedes albopictus. Current evidence from published case studies shows that blood transfusions can transmit Dengue infection in hyperendemic regions in the tropics. It is important to note that 75% of people infected with DENV show no symptoms. Therefore, an infected individual could be accepted as a blood donor and spread the disease. In Kenya, frequent Dengue outbreaks have been reported in the coastal counties of Mombasa, Kilifi, and Kwale in recent years. This study aimed to determine the seroprevalence of Dengue virus among blood donors in a selected endemic region of the Republic of Kenya. Methods: the researchers used a cross-sectional research design to collect data from blood donors in two selected counties in Kenya in 2023. A self-directed questionnaire was used to collect sociodemographic data and risk factors associated with Dengue fever from consenting participants. Additionally, a 5-ml sample of blood was collected and serologically analyzed for anti-Dengue IgG, IgM, and NS1 using a commercial rapid Dengue testing duo kit (Bioline™ DENGUE DUO (Dengue NS1 Ag + IgG/IgM)). The data were summarized and presented using tables and bar graphs. Results: at the end of the study, the researchers recruited 103 participants from the selected study sites in Mombasa County. Most of the research participants were men between 20 and 30 years of age. The prevalence of Dengue virus seromarkers was 24%, 11%, and 2% for IgG, IgM, and NS1, respectively. These were detected among young adult donors between the ages of 20 and 30 years. Statistically, there was an association between anti-Dengue IgM positivity with a history of admission (p-value = 0.0015), fever in the last 6 months (p-value = 0.0015) and a history of living with a DF infected person in the last 6 months (p-value = 0.011). Similarly, there was a statistically significant association between anti-Dengue IgG positivity and length of stay in Mombasa County (p-value = 0.005), history of admission in the last 6 months (p-value =0.003), history of fever in the last 6 months (p-value = 0.004) and lived with a victim of Dengue fever in the last 6 months (p-value = 0.02) in a 95% confidence interval. Conclusion: according to the study findings, a sizeable proportion of eligible blood donors in Mombasa are Dengue virus-infected, some possibly carrying the virus without showing symptoms. The study identified IgG and IgM as the most prevalent serological markers. To protect blood recipients in Mombasa County and other Dengue-endemic counties such as Kilifi, Kwale, Lamu, and Taita Taveta, it is recommended that blood donors in these regions undergo regular screening, particularly during Dengue outbreaks

Dengue virus and blood safety: a mini-review of research publications

The growing demand for donated whole blood and blood products to save lives has both health benefits and health risks for blood recipients at the same time. Dengue virus, a re-emerging viral disease poses a threat to blood safety, and it has spread to over 128 countries in the world. Several studies have documented transfusion-transmitted (TT) dengue, with the first cases being reported in China in 2002 and Singapore in 2008. To understand the magnitude and broader picture of the dengue virus and blood safety, we conducted a mini-review of published literature from the Scopus database. The review focused on the number of publications related to the dengue virus among blood donors. Using keywords ‘Dengue virus’ AND ‘Blood safety’, ‘ Dengue virus’ AND ‘Blood donors’ and ‘Emerging infectious diseases’ AND “Blood safety” were used to extract data from the Scopus database which was downloaded as a CSV Excel file covering a period 2004 to 2021. This was followed by a data-cleaning exercise and a descriptive analysis to generate the frequency of the number of publications. Most studies, as can be seen in the review, were concentrated in tropical regions of the world. Globally, South America and the Asian regions had the largest number of publications; while at the country level, Brazil and India had the highest number. More research output was witnessed during the years 2014 and 2018. The regions that experienced more frequent outbreaks of the disease, with the exception Africa, published most of the research work. Therefore, much more research work is needed to protect the safety of blood donors in Africa

Antimicrobial Resistance Patterns of bacterial Septicaemia infecting infants in Mbita Subcounty, Western region of Kenya

Background: Gram positive bacteria such Escherichia coli, Group B Streptococcus coagulase-negative staphylococci, Staphylococcus aureus, and Gram-negative bacteria such as Klebsiella and Pseudomonas species are listed as some of the bacteria etiologies for pediatric septicemia. These bacteria are rapidly becoming multi drug resistant to penicillin (or aminopenicillin), gentamicin, the pragmatic antibiotic treatment regimens.  Further, the ever-increasing burden of bacteria septicemia infection due to extended-spectrum β-lactamase (ESBL) producing Gram negative bacteria cumulatively presents a major health concern in the management and treatment of bacterial septicemia. In this study we present data on the prevalence and type of antimicrobial resistant patterns among children with bacterial septicemia in Mbita Sub county Hospital, Western region of Kenya. Methods: Blood samples were obtained from 248 children whose parents/guardian consented. The bacterial isolation and characterization were done using the automated BACTEC 9240 system, conventional culture using morphology, Gram stain and biochemical identification. Further identification and resistant gene detection were determined using Polymerase Chain Reaction (PCR). Descriptive statistics were used to present data. Results: Eighty-four (33.9%) patients had septicemia where Staphylococcus epidermidis (28.6%), S. aureus (13.1%), Escherichia coli (13.1%) and single Salmonella Paratyphi B, Citrobacter freundii, Gemella morbillorum, Klebsiella pneumoniae, Lactococcus lactis cremoris, Pantoea spp, and Pseudomonas putida were implicated. The majority of gram-negative bacteria were resistant to penicillin (Ampicillins) 100%, 96.1% to tetracyclin, 84.6% to sulphonamides (Trimethoprim/sulfamethoxazole), 73.1% Aminoglycosides (Gentamicin) 73.1% and 19.2% to Quinolone (Ciprofloxacin). For gram positive bacteria majority 96.7% were resistant to sulphonamides (Trimethoprim/sulfamethoxazole) followed by tetracycline 76.7%, penicillin (Oxacilline) 73.3% and least resistant to Quinolone (Ciprofloxacin) 30%. Various antimicrobial resistant genes mecA, SulII, blaTEM, TetA aac (3) were identified. Conclusion. In this geographically defined region of Kenya, of the 33.9% children with septicemia, gram positive bacteria were the leading cause septicemia. High level resistance due to various resistant genes were seen all type of antibiotics by both Gram positive and negative bacteria. Rapid antibiotic resistant testing is encouraged for appropriate treatment and management of septicemia infection. Keywords: bacterial Septicemia, Epidemiology, Children under five, South Nyanza, Kenya DOI: 10.7176/JNSR/10-10-07 Publication date:May 31st 202

Epidemiology of bacterial Septicemia among children under five in Mbita Subcounty, South Nyanza, Kenya

Background: Septicaemia is a major cause of mortality and morbidity, especially in sub-Saharan Africa leading to complications marked by bodily inflammation referred as sepsis. This is a systemic disease associated with presence of pathogenic microorganisms (viral, parasitic and bacterial) or their toxins in the blood. Bacterial septicaemia is the most fatal and prevalent in hospitalised cases. Globally, 76% of children under five years die due to septicaemia. In East Africa a mortality rate of 40% have been reported. In Kenya, South Nyanza regions have reported higher morbidity and mortality cases among children. We hypothesis that apart from immunosuppressive diseases, septicaemia could contribute significantly to this prevalence in the region. Methods: Blood samples were obtained from 248 children whose guardian consented and a detailed sociodemographic questionnaire was administered. Bacterial isolation and characterization were done using the automated BACTEC 9240 system. Results: The mean age of the participants was 27.9 (SD ±20.7) months. The majority (30.6%) were aged between 1 to 12 months, 50.8% were males, 58.9% had body temperatures above 37.6 OC while only 8.1% were HIV seropositive. The mean white blood cells (WBC) of the participants were 17720.9 (SD 8929.1) cells/ml with 5.2% had leucopenia. A total of 84 of the 248 (33.9%) of the children had septicaemia with the majority (28.6%) caused by Staphylococcus epidermidis followed by Staphylococcus aureus and Escherichia coli each at 13.1%. Bacteria that were reported singly included Salmonella Paratyphi B, Citrobacter freundii, Gemella morbillorum, Klebsiella pneumoniae, Lactococcus lactis cremoris, Pantoea spp, and Pseudomonas putida. In multivariate regression analysis, female gender (OR 0.6; 95% confidence interval (CI) 0.4 to 0.9), co-infection with malaria (OR 2.7; 95% CI 1.1 to 6.7) and gastrointestinal disorders (OR 2.9, 95% CI 1.3 – 7.3) were independently associated with bacterial septicemia infection. Conclusion: Significantly higher proportion of the children in this region are infected with septicaemia. Majority of the cases were caused by Gram positive bacteria. Age and other c-infection contribute significantly to septicaemia infection in this region. Rapid testing and etiological characterisation of children with suspected symptoms of septicaemia is key in this region in order to institute appropriate treatment and management. Keywords: bacterial Septicemia, Epidemiology, Children under five, South Nyanza, Kenya DOI: 10.7176/JNSR/10-10-06 Publication date:May 31st 202

Dengue Virus Surveillance and Blood Safety: A One Health Perspective

The provision of blood products to save a life is a noble undertaking for any organization tasked with the duty. In addition to saving millions of lives, blood products pose health risks associated with adverse events. Much has been done to mitigate these challenges, but emerging new infectious diseases pose a public health challenge to both the safety of blood and its availability. The dengue virus an arbovirus is one such virus that is endemic in tropical and subtropical countries. The data emerging from the published papers show that dengue could be a major threat to blood safety and availability in the future. To address these threats, a collaborative approach through one health system is the only avenue to provide a last solution. One health has been implemented as a strategy to mitigate zoonotic diseases and its results are very impressive. This piece of work is a fraction of our larger project that aims to address threats to the dengue virus and blood safety in Kenya and the rest of Africa. In conclusion, adopting one health in the fight against the dengue virus in blood safety will be the best approach to ensure a safer supply of blood products

Infection with soil-transmitted helminths and their impact on coinfections

The most important soil-transmitted helminths (STHs) affecting humans are roundworms, whipworms, and hookworms, with a large proportion of the world’s population infected with one or more of these intestinal parasites. On top of that, concurrent infections with several viruses, bacteria, protozoa, and other helminths such as trematodes are common in STH-endemic areas. STHs are potent immunomodulators, but knowledge about the effects of STH infection on the direction and extent of coinfections with other pathogens and vice versa is incomplete. By focusing on Kenya, a country where STH infections in humans are widespread, we provide an exemplary overview of the current prevalence of STH and co-occurring infections (e.g. with Human Immunodeficiency Virus, Plasmodium falciparum, Giardia duodenalis and Schistosoma mansoni). Using human data and complemented by experimental studies, we outline the immunomechanistic interactions of coinfections in both acutely STH transmigrated and chronically infected tissues, also highlighting their systemic nature. Depending on the coinfecting pathogen and immunological readout, STH infection may restrain, support, or even override the immune response to another pathogen. Furthermore, the timing of the particular infection and host susceptibility are decisive for the immunopathological consequences. Some examples demonstrated positive outcomes of STH coinfections, where the systemic effects of these helminths mitigate the damage caused by other pathogens. Nevertheless, the data available to date are rather unbalanced, as only a few studies have considered the effects of coinfection on the worm’s life cycle and associated host immunity. These interactions are complex and depend largely on the context and biology of the coinfection, which can act in either direction, both to the benefit and detriment of the infected host

Prevalence of Post COVID-19 Condition among Healthcare Workers: Self-Reported Online Survey in Four African Countries, December 2021–January 2022

The impact of Post COVID-19 Condition (PCC) is ongoing despite the declaration that the 2019 COVID-19 pandemic has ended. In this study, we explore the prevalence of PCC among healthcare workers (HCWs) in four African Countries and its influence on their professional performance. This study was conducted as an online cross-sectional survey of healthcare workers from four African countries (Cameroon, Egypt, Nigeria, and Somalia) between the 20th of December 2021 to 12th of January 2022. We determined the prevalence of PCC based on the WHO case definition and assessed variables associated with a higher prevalence of PCC in these countries using univariable and multivariable logistic regression analyses. A total of 706 HCWs from four African countries were included in this survey. Most of the HCWs were aged between 18–34 years (75.8%, n = 535). Our findings showed that 19.5% (n = 138) of the HCWs had tested positive for SARS-CoV-2. However, 8.4% (n = 59) were symptomatic for COVID-19 but tested negative or were never tested. Two-thirds of the HCWs (66.4%, n = 469) have received a COVID-19 vaccine and 80.6% (n = 378) of those vaccinated had been fully vaccinated. The self-reported awareness rate of PCC among the HCWs was 16.1% (n = 114/706) whereas the awareness rate of PCC among COVID-19-positive HCWs was 55.3% (n = 109/197). The prevalence of PCC among HCWs was 58.8% (n = 116). These changes include the self-reported symptoms of PCC which included headache (58.4%, n = 115), fatigue (58.8%, n = 116), and muscle pain (39.6%, n = 78). Similarly, 30% (n = 59) and 20.8% (n = 41) of the HCWs reported the loss of smell and loss of taste long after their COVID-19 infection, respectively. Some HCWs (42%, n = 83) believed that their work performance has been affected by their ongoing symptoms of PCC. There was no significant difference in the prevalence of PCC among the vaccinated and unvaccinated HCWs (p > 0.05). Of the socio-demographic variables, age (older HCWs between 45–54 years; OR:1.7; 95% CI: 1.06, 10.59; p = 0.001) and location (Egypt; OR:14.57; 95% CI: 2.62, 26.76; p = 0.001) were more likely to have experienced PCC than other age groups and countries respectively. The study revealed a low prevalence of PCC among the surveyed HCWs. In addition, it observed the need for adequate medical and psychological support to HCWs with PCC and improved mass advocacy campaigns on PCC

Public Health Surveillance for Adverse Events Following COVID-19 Vaccination in Africa

Local, national, and international health agencies have advocated multi-pronged public health strategies to limit infections and prevent deaths. The availability of safe and effective vaccines is critical in the control of a pandemic. Several adverse events have been reported globally following reception of different vaccines, with limited or no data from Africa. This cross-sectional epidemiological study investigated adverse events following COVID-19 vaccination in Africans from April–June, 2021 using a structured online questionnaire. Out of 1200 participants recruited, a total of 80.8% (n = 969) respondents from 35 countries, including 22 African countries and 13 countries where Africans live in the diaspora, reported adverse events. Over half of the vaccinees were male (53.0%) and frontline healthcare workers (55.7%), respectively. A total of 15.6% (n = 151) reported previous exposure to SARS-CoV-2, while about one-fourth, 24.8% (n = 240), reported different underlying health conditions prior to vaccination. Fatal cases were 5.1% (n = 49), while other significant heterogenous events were reported in three categories: very common, common, and uncommon, with the latter including enlarged lymph nodes 2.4% (n = 23), menstrual disorder 0.5% (n = 5), and increased libido 0.2% (n = 2). The study provided useful data for concerned authorities and institutions to prepare plans that will address issues related to COVID-19 vaccines

Dengue Virus Surveillance and Blood Safety: A One Health Perspective

The provision of blood products to save a life is a noble undertaking for any organization tasked with the duty. In addition to saving millions of lives, blood products pose health risks associated with adverse events. Much has been done to mitigate these challenges, but emerging new infectious diseases pose a public health challenge to both the safety of blood and its availability. The dengue virus an arbovirus is one such virus that is endemic in tropical and subtropical countries. The data emerging from the published papers show that dengue could be a major threat to blood safety and availability in the future. To address these threats, a collaborative approach through one health system is the only avenue to provide a last solution. One health has been implemented as a strategy to mitigate zoonotic diseases and its results are very impressive. This piece of work is a fraction of our larger project that aims to address threats to the dengue virus and blood safety in Kenya and the rest of Africa. In conclusion, adopting one health in the fight against the dengue virus in blood safety will be the best approach to ensure a safer supply of blood products

Assessing antigenic drift and phylogeny of influenza A (H1N1) pdm09 virus in Kenya using HA1 sub-unit of the hemagglutinin gene.

Influenza A (H1N1) pdm09 virus emerged in North America in 2009 and has been established as a seasonal strain in humans. After an antigenic stasis of about six years, new antigenically distinct variants of the virus emerged globally in 2016 necessitating a change in the vaccine formulation for the first time in 2017. Herein, we analyzed thirty-eight HA sequences of influenza A (H1N1) pdm09 strains isolated in Kenya during 2015-2018 seasons, to evaluate their antigenic and molecular properties based on the HA1 sub-unit. Our analyses revealed that the A (H1N1) pdm09 strains that circulated in Kenya during this period belonged to genetic clade 6B, subclade 6B.1 and 6B.2. The Kenyan 2015 and 2016 isolates differed from the vaccine strain A/California/07/2009 at nine and fourteen antigenic sites in the HA1 respectively. Further, those isolated in 2017 and 2018 correspondingly varied from A/Michigan/45/2015 vaccine strain at three and fifteen antigenic sites. The predicted vaccine efficacy of A/California/07/2009 against Kenyan 2015/2016 was estimated to be 32.4% while A/Michigan/45/2015 showed estimated vaccine efficacies of 39.6% - 41.8% and 32.4% - 42.1% against Kenyan 2017 and 2018 strains, respectively. Hemagglutination-inhibition (HAI) assay using ferret post-infection reference antiserum showed that the titers for the Kenyan 2015/2016 isolates were 2-8-fold lower compared to the vaccine strain. Overall, our results suggest the A (H1N1) pdm09 viruses that circulated in Kenya during 2015/2016 influenza seasons were antigenic variants of the recommended vaccine strains, denoting sub-optimal vaccine efficacy. Additionally, data generated point to a swiftly evolving influenza A (H1N1) pdm09 virus in recent post pandemic era, underscoring the need for sustained surveillance coupled with molecular and antigenic analyses, to inform appropriate and timely influenza vaccine update