Assessment of knowledge on self-care practices by Diabetes Mellitus Type II attending Diabetes clinic at Kakamega County Referral Hospital

Introduction: In 2012, more than 371 million people presented with Diabetes Mellitus Type II worldwide. Approximately 4.8 million people died in 2012 due to the complications of Diabetes Mellitus Type II (American Diabetes Association 2013). In 2012, in sub-Saharan Africa, Diabetes Mellitus Type II was estimated at 6 percent of total mortality, this reflects an increase from 2.5 percent in 2000. Rapid urbanization leading to sedentary lifestyle and diet changes is a big contributing factor to the rapid increase of Diabetes Mellitus Type II in Sub-Saharan Africa.Kenya presents with heavy disease burden with life expectancy averaging 56 years. Despite the commendable successes to curb CDs (Communicable Diseases), health problem status has stagnated as a result of increase in NCDs causing 28% of all patients deaths in 2010; Diabetes Mellitus Type II accounting for 2% of the total death.Study area: Kakamega County Referral Hospital is approximately 400 kilometers from Nairobi the capital city of Kenya. It is the main referral hospital in western Kenya and receives referrals from neighboring counties e.g. Vihiga County, Bungoma County and various hospitals within the County. Target Population: Diabetes Mellitus Type II patients attending Kakamega County Referral HospitalAim: To assess adequate self-care practice by Diabetes Mellitus Type II patients attending the Diabetes clinic at Kakamega County Referral Hospital.Methods and Materials: This was a descriptive cross-sectional study. Researcher administered questionnaires based on W.H.O Diabetes Mellitus Type II self-care guidelines were used to collect data. Questionnaires that were filled were screened and carefully scrutinized for completeness, relevance and correctness before storage. Qualitative data was analyzed manually and Quantitative data was organized, coded, and standardized then descriptive statistics were used to analyze aided by statistical package for social scientists (SPSS) version 22. Descriptive analysis was carried out to provide simple summaries about the sample and the measures. Tables were used to present the data. Models of statistical analysis were done to validate the findings of the study.Results: The study found out that, only 22.02% of the participants gave correct signs and symptoms of high blood sugars. Only 13% of the participants demonstrated knowledge of signs and symptoms of low blood sugar. On low blood sugar management 84.52% gave correct responses. Frequency of feet checking was poor with only 16.67% of the participants giving correct responses. Majority (93.45%) of the participants were well versed with the complications of Diabetes Mellitus Type II. Frequency of eye examination had 90.48% of the participants giving the correct responses.Conclusion: The spoken knowledge in low literacy patient with Diabetes Mellitus Type II (SKILLD) scale was poorly scored with majority of the participants demonstrating low knowledge regarding common complications of Diabetes Mellitus Type II. Keywords: Diabetes Mellitus Type II, Self-care and Patient

Vehicle exhaust emissions inspection system for roadworthiness enforcement

The conference aimed at supporting and stimulating active productive research set to strengthen the technical foundations of engineers and scientists in the continent, through developing strong technical foundations and skills, leading to new small to medium enterprises within the African sub-continent. It also seeked to encourage the emergence of functionally skilled technocrats within the continent.Air pollution has been a growing concern as Kenya tries to industrialize. Increase in the number of vehicles and factories as well as constructions in Nairobi make this all the more critical. This polluted air has far reaching consequences which include illnesses that lead to death. Measuring the concentration of air pollutants is necessary to establish the quality of air in the city. By extension, measuring the concentration of pollutants being emitted through vehicle exhaust fumes can help establish if the vehicle is worthy to be on the road. To best measure the degree of these pollutants, random on-the-road inspection of vehicle inspection of vehicle exhaust emissions is key. However, this has not been achieved by the Kenyan law enforcement agencies. The ability to inspect the emissions from cars on the road will help law enforcement remove unroadworthy vehicles from the roads and thus minimize air pollution caused by vehicles. Conventional inspection methods are done in controlled environments such as laboratories. Vehicles are driven in and are inspected while they remain stationary. These controlled tests fall short of revealing the true state of a vehicle’s exhaust emissions: the fumes emitted while a car is on open road are different in composition from those emitted in such a controlled environment. In addition, manufacturers can tweak their vehicles to emit gases that are within the prescribed thresholds as was done by Volkswagen in order to meet and exceed the US Environment Protection Agency standards. This study will present a model that utilizes sensors to assess the level of pollutants produced from a vehicle exhaust to the air and register these to back-end server hosted on the cloud. The model will have an LCD screen on which law enforcement can view levels of pollutants as measured by the sensors. The information will be stored inStrathmore University; Institute of Electrical and Electronics Engineers (IEEE

Rhizoctonia in ameliorated and non-ameliorated soils

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Using pneumococcal and rotavirus surveillance in vaccine decision-making: A series of case studies in Bangladesh, Armenia and the Gambia.

Pneumonia and diarrhea are the leading causes of child morbidity and mortality globally and are vaccine preventable. The WHO-coordinated Global Rotavirus and Invasive Bacterial Vaccine-Preventable Disease Surveillance Networks support surveillance systems across WHO regions to provide burden of disease data for countries to make evidence-based decisions about introducing vaccines and to demonstrate the impact of vaccines on disease burden. These surveillance networks help fill the gaps in data in low and middle-income countries where disease burden and risk are high but support to sustain surveillance activities and generate data is low. Through a series of country case studies, this paper reviews the successful use of surveillance data for disease caused by pneumococcus and rotavirus in informing national vaccine policy in Bangladesh, Armenia and The Gambia. The case studies delve into ways in which countries are leveraging and building capacity in existing surveillance infrastructure to monitor other diseases of concern in the country. Local institutions have been identified to play a critical role in making surveillance data available to policymakers. We recommend that countries review local or regional surveillance data in making vaccine policy decisions. Documenting use of surveillance activities can be used as advocacy tools to convince governments and external funders to invest in surveillance and make it a priority immunization activity

Simian immunodeficiency viruses (SIVs) from eastern and southern Africa : detection of a SIVagm variant from a chacma baboon

Simian immunodeficiency viruses (SIVs) have been shown to infect many old world African primate species. Thus far, no work has been published on southern African primates. In this study we investigated the genetic diversity between SIV strains from Kenyan and South African vervets (Cercopithecus aethiops pygerythrus). We amplified and sequenced a 1113 bp region of the env gene. Phylogenetic analysis of these sequences showed that all strains clustered with members of the vervet subgroup of SIVagm. The SIVs from South African vervets differed by 7% from each other and by 8–14% from the Kenyan SIV strains, while the Kenyan SIV strains differed by 10–21% from SIVagm of other east African vervets. We also isolated and sequenced, for the first time, a SIV strain from a healthy chacma baboon (Papio ursinus), caught in South Africa. Phylogenetic analysis of the env region showed the virus to be closely related to the South African vervet SIV strains, while analysis of its pol region confirmed the virus to be a SIVagm variant

Etiology of Pediatric Bacterial Meningitis Pre- and Post-PCV13 Introduction Among Children Under 5 Years Old in Lomé, Togo.

BACKGROUND: Pediatric bacterial meningitis (PBM) causes severe morbidity and mortality within Togo. Thus, as a member of the World Health Organization coordinated Invasive Bacterial Vaccine Preventable Diseases network, Togo conducts surveillance targeting Streptococcus pneumoniae (pneumococcus), Neisseria meningitidis (meningococcus), and Haemophilus influenzae, at a sentinel hospital within the capital city, Lomé, in the southernmost Maritime region. METHODS: Cerebrospinal fluid was collected from children <5 years with suspected PBM admitted to the Sylvanus Olympio Teaching Hospital. Phenotypic detection of pneumococcus, meningococcus, and H. influenzae was confirmed through microbiological techniques. Samples were shipped to the Regional Reference Laboratory to corroborate results by species-specific polymerase chain reaction. RESULTS: Overall, 3644 suspected PBM cases were reported, and 98 cases (2.7%: 98/3644) were confirmed bacterial meningitis. Pneumococcus was responsible for most infections (67.3%: 66/98), followed by H. influenzae (23.5%: 23/98) and meningococcus (9.2%: 9/98). The number of pneumococcal meningitis cases decreased by 88.1% (52/59) postvaccine introduction with 59 cases from July 2010 to June 2014 and 7 cases from July 2014 to June 2016. However, 5 cases caused by nonvaccine serotypes were observed. Fewer PBM cases caused by vaccine serotypes were observed in infants <1 year compared to children 2-5 years. CONCLUSIONS: Routine surveillance showed that PCV13 vaccination is effective in preventing pneumococcal meningitis among children <5 years of age in the Maritime region. This complements the MenAfriVac vaccination against meningococcal serogroup A to prevent meningitis outbreaks in the northern region of Togo. Continued surveillance is vital for estimating the prevalence of PBM, determining vaccine impact, and anticipating epidemics in Togo

Impact of routine vaccination against Haemophilus influenzae type b in The Gambia: 20 years after its introduction

Background: In 1997, The Gambia introduced three primary doses of Haemophilus influenzae type b (Hib) conjugate vaccine without a booster in its infant immunisation programme along with establishment of a population-based surveillance on Hib meningitis in the West Coast Region (WCR). This surveillance was stopped in 2002 with reported elimination of Hib disease. This was re-established in 2008 but stopped again in 2010. We aimed to re-establish the surveillance in WCR and to continue surveillance in Basse Health and Demographic Surveillance System (BHDSS) in the east of the country to assess any shifts in the epidemiology of Hib disease in The Gambia. Methods: In WCR, population-based surveillance for Hib meningitis was re-established in children aged under-10 years from 24 December 2014 to 31 March 2017, using conventional microbiology and Real Time Polymerase Chain Reaction (RT-PCR). In BHDSS, population-based surveillance for Hib disease was conducted in children aged 2-59 months from 12 May 2008 to 31 December 2017 using conventional microbiology only. Hib carriage survey was carried out in pre-school and school children from July 2015 to November 2016. Results: In WCR, five Hib meningitis cases were detected using conventional microbiology while another 14 were detected by RT-PCR. Of the 19 cases, two (11%) were too young to be protected by vaccination while seven (37%) were unvaccinated. Using conventional microbiology, the incidence of Hib meningitis per 100 000-child-year (CY) in children aged 1-59 months was 0.7 in 2015 (95% confidence interval (CI) = 0.0-3.7) and 2.7 (95% CI = 0.7-7.0) in 2016. In BHDSS, 25 Hib cases were reported. Nine (36%) were too young to be protected by vaccination and five (20%) were under-vaccinated for age. Disease incidence peaked in 2012-2013 at 15 per 100 000 CY and fell to 5-8 per 100 000 CY over the subsequent four years. The prevalence of Hib carriage was 0.12% in WCR and 0.38% in BHDSS. Conclusions: After 20 years of using three primary doses of Hib vaccine without a booster Hib transmission continues in The Gambia, albeit at low rates. Improved coverage and timeliness of vaccination are of high priority for Hib disease in settings like Gambia, and there are currently no clear indications of a need for a booster dose

Pediatric Bacterial Meningitis Surveillance in Nigeria From 2010 to 2016, Prior to and During the Phased Introduction of the 10-Valent Pneumococcal Conjugate Vaccine

Background: Historically, Nigeria has experienced large bacterial meningitis outbreaks with high mortality in children. Streptococcus pneumoniae (pneumococcus), Neisseria meningitidis (meningococcus), and Haemophilus influenzae are major causes of this invasive disease. In collaboration with the World Health Organization, we conducted longitudinal surveillance in sentinel hospitals within Nigeria to establish the burden of pediatric bacterial meningitis (PBM). Methods: From 2010 to 2016, cerebrospinal fluid was collected from children <5 years of age, admitted to 5 sentinel hospitals in 5 Nigerian states. Microbiological and latex agglutination techniques were performed to detect the presence of pneumococcus, meningococcus, and H. influenzae. Species-specific polymerase chain reaction and serotyping/grouping were conducted to determine specific causative agents of PBM. Results: A total of 5134 children with suspected meningitis were enrolled at the participating hospitals; of these 153 (2.9%) were confirmed PBM cases. The mortality rate for those infected was 15.0% (23/153). The dominant pathogen was pneumococcus (46.4%: 71/153) followed by meningococcus (34.6%: 53/153) and H. influenzae (19.0%: 29/153). Nearly half the pneumococcal meningitis cases successfully serotyped (46.4%: 13/28) were caused by serotypes that are included in the 10-valent pneumococcal conjugate vaccine. The most prevalent meningococcal and H. influenzae strains were serogroup W and serotype b, respectively. Conclusions: Vaccine-type bacterial meningitis continues to be common among children <5 years in Nigeria. Challenges with vaccine introduction and coverage may explain some of these finding. Continued surveillance is needed to determine the distribution of serotypes/groups of meningeal pathogens across Nigeria and help inform and sustain vaccination policies in the countr

Rotavirus symptomatic infection among unvaccinated and vaccinated children in Valencia, Spain

BACKGROUND: Human group A rotavirus is the leading cause of severe acute gastroenteritis in young children worldwide. Immunization programs have reduced the disease burden in many countries. Vaccination coverage in the Autonomous Region of Valencia, Spain, is around 40%, as the rotavirus vaccine is not funded by the National Health System. Despite this low-medium vaccine coverage, rotavirus vaccination has substantially reduced hospitalizations due to rotavirus infection and hospital-related costs. However, there are very few studies evaluating symptomatic rotavirus infections not requiring hospitalization in vaccinated children. The objective of this study was to investigate symptomatic rotavirus infections among vaccinated children in the health area served by the Hospital Clínico Universitario of Valencia, Spain, from 2013 to 2015. METHODS: A total of 133 children younger than 5 years of age with rotavirus infection were studied. Demographic and epidemiological data were collected and informed consent from their caretakers obtained. Rotavirus infection was detected by immunological methods and G/P rotavirus genotypes were determined by RT-PCR, following standard procedures from the EuroRotaNet network. RESULTS: Forty infants (30.1%; 95% CI: 22.3-37.9) out of 133 were diagnosed with symptomatic rotavirus infection despite having been previously vaccinated, either with RotaTeq (85%) or with Rotarix (15%). Children fully vaccinated against rotavirus (24.8%), partially vaccinated (5.3%) and unvaccinated (69.9%) were found. The infecting genotypes showed high G-type diversity, although no significant differences were found between the G/P genotypes infecting vaccinated and unvaccinated children during the same time period. G9P[8], G12P[8] and G1P[8] were the most prevalent genotypes. Severity of gastroenteritis symptoms required 28 (66.6%) vaccinated and 67 (73.6%) unvaccinated children to be attended at the Emergency Room. CONCLUSION: Rotavirus vaccine efficacy in reducing the incidence of severe rotavirus infection has been well documented, but symptomatic rotavirus infection can sometimes occur in vaccinees