Complete genome sequences of dengue virus type 2 strains from Kilifi, Kenya

Dengue infection remains poorly characterized in Africa and little is known regarding its associated viral genetic diversity. Here, we report dengue virus type 2 (DENV-2) sequence data from 10 clinical samples, including 5 complete genome sequences of the cosmopolitan genotype, obtained from febrile adults seeking outpatient care in coastal Kenya

Malaria Rapid Testing by Community Health Workers Is Effective and Safe for Targeting Malaria Treatment: Randomised Cross-Over Trial in Tanzania

Early diagnosis and prompt, effective treatment of uncomplicated malaria is critical to prevent severe disease, death and malaria transmission. We assessed the impact of rapid malaria diagnostic tests (RDTs) by community health workers (CHWs) on provision of artemisinin-based combination therapy (ACT) and health outcome in fever patients. Twenty-two CHWs from five villages in Kibaha District, a high-malaria transmission area in Coast Region, Tanzania, were trained to manage uncomplicated malaria using RDT aided diagnosis or clinical diagnosis (CD) only. Each CHW was randomly assigned to use either RDT or CD the first week and thereafter alternating weekly. Primary outcome was provision of ACT and main secondary outcomes were referral rates and health status by days 3 and 7. The CHWs enrolled 2930 fever patients during five months of whom 1988 (67.8%) presented within 24 hours of fever onset. ACT was provided to 775 of 1457 (53.2%) patients during RDT weeks and to 1422 of 1473 (96.5%) patients during CD weeks (Odds Ratio (OR) 0.039, 95% CI 0.029-0.053). The CHWs adhered to the RDT results in 1411 of 1457 (96.8%, 95% CI 95.8-97.6) patients. More patients were referred on inclusion day during RDT weeks (10.0%) compared to CD weeks (1.6%). Referral during days 1-7 and perceived non-recovery on days 3 and 7 were also more common after RDT aided diagnosis. However, no fatal or severe malaria occurred among 682 patients in the RDT group who were not treated with ACT, supporting the safety of withholding ACT to RDT negative patients. RDTs in the hands of CHWs may safely improve early and well-targeted ACT treatment in malaria patients at community level in Africa.\ud \ud \ud \u

The Impact of Retail-Sector Delivery of Artemether–Lumefantrine on Malaria Treatment of Children under Five in Kenya: A Cluster Randomized Controlled Trial

In a cluster randomized trial, Beth Kangwana and colleagues find that provision of subsidized packs of the malaria therapy artemether-lumefantrine to shops more than doubled the proportion of children with fever who received drugs promptly

Deployment of ACT antimalarials for treatment of malaria: challenges and opportunities

Following a long period when the effectiveness of existing mono-therapies for antimalarials was steadily declining with no clear alternative, most malaria-endemic countries in Africa and Asia have adopted artemisinin combination therapy (ACT) as antimalarial drug policy. Several ACT drugs exist and others are in the pipeline. If properly targeted, they have the potential to reduce mortality from malaria substantially. The major challenge now is to get the drugs to the right people. Current evidence suggests that most of those who need the drugs do not get them. Simultaneously, a high proportion of those who are given antimalarials do not in fact have malaria. Financial and other barriers mean that, in many settings, the majority of those with malaria, particularly the poorest, do not access formal healthcare, so the provision of free antimalarials via this route has only limited impact. The higher cost of ACT creates a market for fake drugs. Addressing these problems is now a priority. This review outlines current evidence, possible solutions and research priorities

The importance of vaginal cytology and challenges encountered when investigating infertility cases of breeding bitches in Kenya

The aim of the investigation was to determine the cause of infertility in 7 previously fertile bitches referred to the Small Animal Clinic University of Nairobi. Clinical, vaginal cytology and bacteriological evaluation of the bitches were performed during proestrus. Based on vaginal cytology, four of the bitches presented with prolonged proestral bleeding and were found to be in the fertile period of the oestrous cycle (80% “superficial” cells) although clinically presenting as being in proestrus based on the nature of vulval discharge. These bitches had been presented for breeding based on vulval discharge and were infertile due to improper timing of mating. Infertility in two other bitches was associated with Brucella canis primarily, and probably beta-hemolytic Streptococci super - infections. Infertility in the remaining bitch was due to the stud dog owner's assumption that mating had occurred after the stud dog and the aggressive bitch were put in the same kennel for the duration of the bitch's fertile period. The authors recognized that most breeders and some veterinarians did not understand the physiology of the canine oestrous cycle resulting in the misdiagnosis of causes of infertility in healthy bitches. This article highlights the challenges met when investigating infertility and the importance of vaginal cytology in breeding of bitches in Kenya. Kenya Veterinarian Vol. 31 (1) 2007: pp. 40-4

Unemployment in women with psychosocial disabilities during the COVID-19 pandemic: Lessons from Tana River County, Kenya

In low-income settings, the informal economy is a practical alternative to work and employment for persons with disabilities. However, the COVID-19 pandemic negatively affected the informal economy. This study aimed to explore the experiences of women with psychosocial disabilities in Kenya during the pandemic. We found that the pandemic worsened their experiences of work and employment, and they did not receive any social welfare or support from the government. Our findings suggest that pandemic management must adopt inclusive and context-sensitive approaches that support persons with psychosocial disabilities. Social welfare and protection for persons with disabilities are relevant for socio-economic empowerment and inclusion

Beyond stereotypes: Working to improve lives and livelihoods of young persons with intellectual disabilities: A qualitative study

Background: Social inclusion of persons with disabilities thrives in societies with reduced cultural beliefs and practices that promote exclusion based on disabilities. Persons with disabilities face several barriers such as inadequate access to basic needs, inaccessible and non-accommodating environments, and attitudinal barriers. In some cultures, disability is perceived as a form of curse or cultural punishment and those living with disabilities seen as outcasts and a burden to the society. These perceptions and attitudes may limit their full participation in the society and have implications for their livelihood and survival. The aim of this case study is to describe the model of care of a community-based organization in Kenya to improve lives and livelihoods of young persons with intellectual disability.Methods: Using a qualitative case study approach, we explored the experience of education and livelihoods for young persons who are beneficiaries of Tuleane Afrika Initiative, a community-based organisation in Nairobi, Kenya.Results: We found that in a supportive and inclusive environment young people with intellectual disability can live and thrive successfully in the community. Socio-economic factors, poor perception of intellectual disability by the society and poor cognitive functioning are the key barriers to success for young persons with intellectual disability.Conclusion: Social inclusion of young people with intellectual disabilities requires active participation of all stakeholders. It is vital that government, policy makers and society show greater commitment and support for programs that promote wellbeing and livelihoods for young persons with intellectual disability