Nutrition and health status of HIV-infected adults on ARVs at AMREF clinic Kibera Urban Slum, Kenya

The health of people living with HIV and AIDS (PLWHA) is nutritionally challenged in many nations of the world. The scourge has reduced socio-economic progress globally and more so in sub-Saharan Africa (SSA) where its impact has been compounded by poverty and food insecurity. Good nutrition with proper drug use improves the quality of life for those infected but it is not known how PLWHA exposed to chronic malnutrition and food shortages from developing nations adjust their nutrition with use of Anti-Retro-viral Drugs (ARVs). This study assessed nutritional status, dietary practices, and dietary management of common illnesses that hinder daily food intake by the patients and use of ARVs with food recommendations provided by the health care givers. A descriptive case study design was used to sample 120 HIV-infected patients using systematic sampling procedure. These patients sought health care from an urban slum, Kibera AMREF clinic. Data were collected by anthropometric measurements, bio-chemical analysis, semi-structured questionnaire and secondary data. The Statistical Package for Social Sciences (SPSS) and the Nutri-Survey software packages were used to analyze data. Dietary intakes of micro-nutrients were inadequate for >70% of the patients when compared to the Recommended Daily Requirements. When Body Mass Indices (BMI) were used, only 6.7% of the respondents were underweight (BMI<18.5kg/m2) and 9.2% were overweight (BMI> 25kg/m2), serum albumin test results (mean 3.34+0.06g/dl) showed 60.8% of the respondents were protein deficient and this was confirmed by low dietary protein intakes. The BMI was not related to dietary nutrient intakes, serum albumin and CD4 cell counts (p>0.05). It appeared that there was no significant difference in BMI readings at different categories of CD4 cell count (p>0.05) suggesting that the level of immunity did not affect weight gain with ARV as observed in many studies from developed countries. Malnutrition was, therefore, evident among the 60.8% of the cases as identified by serum albumin tests and food intake was not adequate (68%) for the patients as they ate once a day due to lack of food. National food and nutrition policy should incorporate food security boosting guidelines for the poor people infected with HIV and using ARVs.Keywords: Diet, Nutrition, HIV/AIDs, Serum albumin, CD4 cell count

Identification of a Type IV-A CRISPR-Cas System Located Exclusively on IncHI1B/IncFIB Plasmids in Enterobacteriaceae

Clustered Regularly Interspaced Short Palindromic Repeats (CRISPR) are diverse immune systems found in many prokaryotic genomes that target invading foreign DNA such as bacteriophages and plasmids. There are multiple types of CRISPR with arguably the most enigmatic being Type IV. During an investigation of CRISPR carriage in clinical, multi-drug resistant, Klebsiella pneumoniae, a Type IV-A3 CRISPR-Cas system was detected on plasmids from two K. pneumoniae isolates from Egypt (isolated in 2002–2003) and a single K. pneumoniae isolate from the United Kingdom (isolated in 2017). Sequence analysis of all other genomes available in GenBank revealed that this CRISPR-Cas system was present on 28 other plasmids from various Enterobacteriaceae hosts and was never found on a bacterial chromosome. This system is exclusively located on IncHI1B/IncFIB plasmids and is associated with multiple putative transposable elements. Expression of the cas loci was confirmed in the available clinical isolates by RT-PCR. In all cases, the CRISPR-Cas system has a single CRISPR array (CRISPR1) upstream of the cas loci which has several, conserved, spacers which, amongst things, match regions within conjugal transfer genes of IncFIIK/IncFIB(K) plasmids. Our results reveal a Type IV-A3 CRISPR-Cas system exclusively located on IncHI1B/IncFIB plasmids in Enterobacteriaceae that is likely to be able to target IncFIIK/IncFIB(K) plasmids presumably facilitating intracellular, inter-plasmid competition

High ethionamide resistance in Mycobacterium tuberculosis strains isolated in Kenya

Background: Increasing development of tuberculosis (TB) resistance to the currently available drugs including second-line anti-TB drugs that are being used for treatment of Multi-Drug Resistant TB (MDR-TB) patients has frustrated efforts to control TB worldwide. Ethionamide (Eth) is one of the drugs used in the regimen for treatment of these patients. Objective: To determine level of Ethionamide resistance among second-line anti-tuberculosis drugs in Mycobacterium tuberculosis (MTB) strains isolated in Kenya. Design: A retrospective lab-based study involving archived strains from previous studies carried out at the Centre for Respiratory Diseases Research (CRDR), Kenya Medical Research Institute (KEMRI) from 2002 to 2007. Setting: Centre for Respiratory Diseases Research (CRDR), Kenya Medical Research Institute (KEMRI). Methods: A total of 216 MTB strains with pre-determined first-line drug susceptibility testing (DST) results were used including 78 first-line resistant to individual and combined drugs, and 138 susceptible to streptomycin, rifampicin, isoniazid and ethambutol. The strains were subjected to DST to ethionamide among other second-line. Results: Thirty two [32/216 (14.8%)] strains showed resistance to second-line drugs. Resistance to Eth was the highest [18/32 (56.3%)] including co-resistance with isoniazid [8/18 (44.4%)]. Nine [9/18 (50%)] strains were fully resistant and 9 [9/18 (50%)] were intermediate resistant to Eth. Conclusion: Unexplainable high levels of Eth resistance is a cause for concern. This will impact negatively on the outcome of management of MDR-TB especially in Kenya where the use of this drug is almost mandatory. Close monitoring of Eth before initiating individual patient management may be necessary. Keywords: Ethionamide, Resistant, MDR-TB

Blockchain in Supply Chain Trading

© 2018 IEEE. The emergence of blockchain technology has created a frenzy and a mind shift for organizations and industries. Governments and international bodies are increasingly discussing the potential implications of blockchain\u27s distributed ledgers on business, governments and the economy. The intended purpose of the blockchain technology is to connect business network members in a decentralized way. The technology enables exchange and sharing of information without the involvement of intermediaries acting as arbitrators. Powered by its decentralized nature, the network will not have any single point of failure and will not rely on any single entity. Hence, blockchain eliminates the risks of centralization. This paper discusses a scenario of a blockchain technology in distributed ledgers to manage a well function and secure supply chain

Increasing Fiber and Protein Contents of Baked Products Using Local Produce

Consumers are increasingly opting for healthier food products, and two current trends are high fiber and high protein options. Using locally available produce or their manufacturing by-products may lower ingredient cost when making these products. Durian rind, which is generally thrown away, comprises 60% of a durian fruit and has about 27% crude fiber. Mung bean has about 23% protein and is relatively inexpensive. In this study, durian rind was cleaned, dried, ground, and added to muffins while mung beans were oven-roasted, ground, and added to crackers. Quality and acceptability of the products were evaluated. Among the ratios tested, the most preferred formulation for muffins had 10% durian rind powder, while that of crackers had 50% mung bean flour. Consumer acceptability of the products was tested using a 9-point hedonic scale. The control and fiber-fortified muffins had similar mean consumer acceptability scores of 8 (liked highly) for color, texture, taste, and overall acceptability. Crackers with mung bean flour had significantly higher mean scores than the control (7.5–8.0 vs. 6.8–7.4) for appearance, texture, flavor, and overall acceptability. The fiber-fortified muffin had 6.26% crude fiber while the mung bean crackers had 9.98% crude protein. The addition of durian rind powder and mung bean flour to baked products may adversely affect some quality parameters like texture, but there are ways to lessen these effects. The improvement in nutrition profile of the products shows the market potential of durian rind powder and mung bean flour

Resource Use Conflicts and Biodiversity Conservation in Jozani Ecosystem, Zanziba

Resource Conflicts are the major challenge to the responsible Institutions in the management and conservation of biodiversity in Zanzibar due to the existence of multiple and interactive reasons that lead to conflicts. This paper intends to reveal the less known current status of resource conflicts in the management of biodiversity in Jozani ecosystem, Zanzibar. The study employed descriptive survey research design of the causal comparative research design to collect data from 280 respondents which constitute the study population. Descriptive statistics such as percentages, mean, frequency, standard deviation and Pearson correlation were used for data analysis. The outcome of the study showed that there is significant relationship existed between resource conflicts and the management of biodiversity conservation in Jozani ecosystem. The study has implications for environmental policy makers. The study concludes by asserting that unemployment, poverty and scarcity of environmental resources are the major causes of conflict, therefore the call is directed to policy makers to strengthen efforts on resolving conflicts by establishing overall strategies such as establishment of participatory community-based approaches to natural resource management, conflict resolution capacity building measures among the stakeholders, amendment of Laws and expansion of employment to reduce direct relying on using natural resource assets for livelihood

Reproducibility of Results and Performance of TB Diagnostics in East Africa Public Health Laboratories Networking Project - in Kenya

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Enteropathogen antibody dynamics and force of infection among children in low-resource settings.

Little is known about enteropathogen seroepidemiology among children in low-resource settings. We measured serological IgG responses to eight enteropathogens (Giardia intestinalis, Cryptosporidium parvum, Entamoeba histolytica, Salmonella enterica, enterotoxigenic Escherichia coli, Vibrio cholerae, Campylobacter jejuni, norovirus) in cohorts from Haiti, Kenya, and Tanzania. We studied antibody dynamics and force of infection across pathogens and cohorts. Enteropathogens shared common seroepidemiologic features that enabled between-pathogen comparisons of transmission. Overall, exposure was intense: for most pathogens the window of primary infection was <3 years old; for highest transmission pathogens primary infection occurred within the first year. Longitudinal profiles demonstrated significant IgG boosting and waning above seropositivity cutoffs, underscoring the value of longitudinal designs to estimate force of infection. Seroprevalence and force of infection were rank-preserving across pathogens, illustrating the measures provide similar information about transmission heterogeneity. Our findings suggest antibody response can be used to measure population-level transmission of diverse enteropathogens in serologic surveillance

The Straight Talk Campaign in Uganda: Impact of mass media initiatives—Summary report

This Horizons study in Uganda found that exposure by adolescents to Straight Talk, a mass media initiative focused on adolescent sexual and reproductive health (ASRH), was associated with greater ASRH knowledge, a greater likelihood of having been tested for HIV, and more communication with parents about ASRH issues