Factors influencing quality of life among cancer survivors in Kenya

Background: The number of cancer survivors is growing continuously due to advances in treatment of cancer patients. In developed countries, numerous studies on quality of life (QoL) of cancer survivors have been conducted. Little is known regarding the QoL of cancer survivors in Kenya. Therefore, the aim of this study was to explore the factors that contribute to QoL of cancer survivors in Kenya. Methods: A descriptive cross-sectional design was used for the study. Participants were 108 adult cancer survivors. Self and interviewer administered QoL Patient/Cancer Survivor Questionnaire was used. Results: Findings indicate a statistically significant relationship between QoL and age (rs =-.055 p<.05), marital status (rs=.490 p<.01), income (rs =.228 p<.05), stage of cancer diagnosis (rs =-.269. p<.01), year of cancer diagnosis (rs =-.295 p<.01), religious affiliation (rs =-.279, p<.01) and the religion one belonged to (rs =-.198 p<.05). Regression analysis showed that age, stage of cancer diagnosis, time off treatment, educational level, and religious affiliation are significant predictors of QoL in cancer survivors. Conclusions: The findings highlight the importance of key factors associated to QoL in cancer survivors in Kenya. Interventions aimed at early cancer detection, treatment, and spiritual support among cancer survivors will improve QoL. Keywords: Quality of Life (QoL); Kenya; cancer patients

Cross-boundary human impacts compromise the Serengeti-Mara ecosystem

Protected areas provide major benefits for humans in the form of ecosystem services, but landscape degradation by human activity at their edges may compromise their ecological functioning. Using multiple lines of evidence from 40 years of research in the Serengeti-Mara ecosystem, we find that such edge degradation has effectively “squeezed” wildlife into the core protected area and has altered the ecosystem’s dynamics even within this 40,000-square-kilometer ecosystem. This spatial cascade reduced resilience in the core and was mediated by the movement of grazers, which reduced grass fuel and fires, weakened the capacity of soils to sequester nutrients and carbon, and decreased the responsiveness of primary production to rainfall. Similar effects in other protected ecosystems worldwide may require rethinking of natural resource management outside protected areas

Controlled Human Malaria Infection in Semi-Immune Kenyan Adults (CHMI-SIKA): a study protocol to investigate in vivo Plasmodium falciparum malaria parasite growth in the context of pre-existing immunity [version 2; peer review: 2 approved]

Malaria remains a major public health burden despite approval for implementation of a partially effective pre-erythrocytic malaria vaccine. There is an urgent need to accelerate development of a more effective multi-stage vaccine. Adults in malaria endemic areas may have substantial immunity provided by responses to the blood stages of malaria parasites, but field trials conducted on several blood-stage vaccines have not shown high levels of efficacy. We will use the controlled human malaria infection (CHMI) models with malaria-exposed volunteers to identify correlations between immune responses and parasite growth rates in vivo. Immune responses more strongly associated with control of parasite growth should be prioritized to accelerate malaria vaccine development. We aim to recruit up to 200 healthy adult volunteers from areas of differing malaria transmission in Kenya, and after confirming their health status through clinical examination and routine haematology and biochemistry, we will comprehensively characterize immunity to malaria using >100 blood-stage antigens. We will administer 3,200 aseptic, purified, cryopreserved Plasmodium falciparum sporozoites (PfSPZ Challenge) by direct venous inoculation. Serial quantitative polymerase chain reaction to measure parasite growth rate in vivo will be undertaken. Clinical and laboratory monitoring will be undertaken to ensure volunteer safety. In addition, we will also explore the perceptions and experiences of volunteers and other stakeholders in participating in a malaria volunteer infection study. Serum, plasma, peripheral blood mononuclear cells and whole blood will be stored to allow a comprehensive assessment of adaptive and innate host immunity. We will use CHMI in semi-immune adult volunteers to relate parasite growth outcomes with antibody responses and other markers of host immunity. / Registration: ClinicalTrials.gov identifier NCT02739763

Seroprevalence of Antibodies to Severe Acute Respiratory Syndrome Coronavirus 2 Among Healthcare Workers in Kenya.

BACKGROUND: Few studies have assessed the seroprevalence of antibodies against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) among healthcare workers (HCWs) in Africa. We report findings from a survey among HCWs in 3 counties in Kenya. METHODS: We recruited 684 HCWs from Kilifi (rural), Busia (rural), and Nairobi (urban) counties. The serosurvey was conducted between 30 July and 4 December 2020. We tested for immunoglobulin G antibodies to SARS-CoV-2 spike protein, using enzyme-linked immunosorbent assay. Assay sensitivity and specificity were 92.7 (95% CI, 87.9-96.1) and 99.0% (95% CI, 98.1-99.5), respectively. We adjusted prevalence estimates, using bayesian modeling to account for assay performance. RESULTS: The crude overall seroprevalence was 19.7% (135 of 684). After adjustment for assay performance, seroprevalence was 20.8% (95% credible interval, 17.5%-24.4%). Seroprevalence varied significantly (P < .001) by site: 43.8% (95% credible interval, 35.8%-52.2%) in Nairobi, 12.6% (8.8%-17.1%) in Busia and 11.5% (7.2%-17.6%) in Kilifi. In a multivariable model controlling for age, sex, and site, professional cadre was not associated with differences in seroprevalence. CONCLUSION: These initial data demonstrate a high seroprevalence of antibodies to SARS-CoV-2 among HCWs in Kenya. There was significant variation in seroprevalence by region, but not by cadre

Home gardens, household nutrition and income in rural farm households in Odisha, India

Home gardens have been an integral part of the recent food-based interventions aimed at stimulating changes in dietary patterns and improving nutrition. However, evidence of their effects on food security, dietary quality, child anthropometry and incomes is limited, particularly among vulnerable populations groups. Using panel data from a sample of approximately 1900 households from vulnerable population groups in Odisha, India, difference-in-differences and other econometric techniques, we analyse the effects of home gardens on food security, dietary quality, child anthropometry and income. On average, home gardens contribute to better household food security, higher dietary quality of men and women but do not contribute to higher children's dietary quality and anthropometry. Also, home gardens increase monthly per adult equivalent incomes by 37% and reduce the prevalence of poverty by 11.7 percentage points. Quantile regression results suggest that home gardens enhance food security and incomes in all quantiles, but richer farmers benefit more than poorer farmers. Overall, home gardens can enhance household food security, dietary quality of men and women, and income gains among vulnerable farming population groups, but they may not suffice to improve child dietary quality and anthropometry

Adaptation opportunities for smallholder dairy farmers facing resource scarcity: Integrated livestock, water and land management

Dairy intensification is a widely used means of achieving food security, improving farmer incomes and enhancing overall economic growth. However, intensification is dependent upon the availability and suitability of natural resources to sustain growth in production. Here, land and water footprints of milk production in three contrasting agro-ecological zones ranging from humid to semi-arid across nine counties of Kenya are quantified. Water and land use footprints across three potential intensification pathways are also outlined and evaluated against the baseline scenario, the currently prevailing practices or the S1 Futures scenario, treated as the benchmark. Intensification pathways focusing on improving livestock breeds, feed provisioning and milk output per cow and distinguished by contrasting management practices perform differentially across the three agro-ecological zones. Total water and land footprints increase for all scenarios relative to the baseline scenario. In particular, all the breed improvement scenarios, have much larger total water footprints than the baseline scenario. Improvement in breed to pure bred cattle across all production systems has the largest total water footprint across all the production systems. Across all the scenarios, the largest reduction in water footprint of milk production (75%) occurs with improvement in breed and feeding practices from two scenarios in the lowlands. Milk production by the cross-bred cattle is most efficient in the lowlands system whereas milk production by the pure breed Ayrshire is most land use efficient in the midlands system. Across the three agroecological zones, improving breeds, feed provisioning and milk production per cow may achieve production intensification but concurrently exacerbates resource limitation. Consequently, the heterogeneity inherent in resource availability across dairy production zones should be considered when developing strategies for increasing dairy production

Comparative Analysis of Quinolone Resistance in Clinical Isolates of Klebsiella pneumoniae and Escherichia coli from Chinese Children and Adults

The objective of this study was to compare quinolone resistance and gyrA mutations in clinical isolates of Klebsiella pneumoniae and Escherichia coli from Chinese adults who used quinolone in the preceding month and children without any known history of quinolone administration. The antimicrobial susceptibilities of 61 isolates from children and 79 isolates from adults were determined. The mutations in the quinolone resistance-determining regions in gyrA gene were detected by PCR and DNA sequencing. Fluoroquinolone resistance and types of gyrA mutations in isolates from children and adults were compared and statistically analyzed. No significant differences were detected in the resistance rates of ciprofloxacin and levofloxacin between children and adults among isolates of the two species (all P>0.05). The double mutation Ser83→Leu + Asp87→Asn in the ciprofloxacin-resistant isolates occurred in 73.7% isolates from the children and 67.9% from the adults, respectively (P=0.5444). Children with no known history of quinolone administration were found to carry fluoroquinolone-resistant Enterobacteriaceae isolates. The occurrence of ciprofloxacin resistance and the major types of gyrA mutations in the isolates from the children were similar to those from adults. The results indicate that precautions should be taken on environmental issues resulting from widespread transmission of quinolone resistance

Data from: Cross-boundary human impacts compromise the Serengeti-Mara ecosystem

Protected areas provide major benefits for humans in the form of ecosystem services, but landscape degradation by human activity at their edges may compromise their ecological functioning. Using multiple lines of evidence from 40 years of research in the Serengeti-Mara ecosystem, we find that such edge degradation has effectively “squeezed” wildlife into the core protected area and has altered the ecosystem’s dynamics even within this 40,000-square-kilometer ecosystem. This spatial cascade reduced resilience in the core and was mediated by the movement of grazers, which reduced grass fuel and fires, weakened the capacity of soils to sequester nutrients and carbon, and decreased the responsiveness of primary production to rainfall. Similar effects in other protected ecosystems worldwide may require rethinking of natural resource management outside protected areas