Resistance patterns of Mycobacterium tuberculosis isolates from pulmonary tuberculosis patients in Nairobi

Introduction: In Kenya, which ranks thirteenth of 27 high tuberculosis burden countries, diagnosis is based on Ziehl-Neelsen staining alone and patients are treated without information on sensitivity patterns. This study aimed to determine resistance patterns of Mycobacterium tuberculosis isolated from pulmonary samples. Methodology: Pulmonary tuberculosis patients in Nairobi were randomly sampled after informed consent and recruited into the study using a structured questionnaire. Specimens were cultured in liquid and solid media, and drug susceptibility tests were performed for first-line drugs including (isoniazid, rifampin, streptomycin, ethambutol and pyrazinamide). Results: Eighty-six (30%) of 286 isolates were resistant to at least one of five antibiotics tested. Thirty-seven (30.2%) isolates were resistant to isoniazid; 15 (11.6%) to streptomycin; 13 (4.5%) to ethambutol; four (1.4%) to rifampin ; and 30 (10.4%) to pyrazinamide. Double resistance was seen as follows: four (1.4%) isolates were resistant to both isoniazid and pyrazinamide; four (1.4%) to streptomycin and isoniazid; and one (0.3%) to rifampin and streptomycin. Two isolates (0.7%) were multidrug resistant, and one was triple resistant with an additional resistance to ethambutol. Results also showed 88.7% of patients were below the age of 40 years, while 26.3% were HIV positive. The majority of the patients (66.5%) were unemployed or self-employed in small businesses, with 79.4% earning less than 100 USD per month. Conclusion: The high resistance observed in isoniazid, which is a first-line drug, could result in an increase in multidrug resistance unless control programs are strengthened. Poverty should be addressed to reduce infection rates

Isolation and Cryopreservation of Trypanosomes and their Vectors for Research and Development in Resource‐ Constrained Settings

Biorepositories for biological samples have increasingly become very important in supporting biomedical research since the 1990s. The Kenya Trypanosomiasis Research Institute Cryo‐bank for trypanosomes and their vectors was established in the 1970s with the aim of providing research materials to scientists. Over 2000 trypanosome isolates have been collected and stored in dewars under liquid nitrogen. Recent collections include tsetse flies—vectors of human and animal trypanosomiasis. Challenges encountered include distances to remote field sites and impassable roads and the cost of collection, preparation, storage, and maintenance under resource‐constrained settings. Under these settings, the challenges can be overcome through strategic leadership that ensures availability and sustainability of resources, appropriate institutional policies, adoption of multidisciplinary approach where appropriate, working with different sectors such as human health, livestock, and wildlife, and environmental conservation in order to leverage on capacities in these sectors, and acknowledging the role of communities from which materials are collected

Influence of age on gallbladder morphometry

Morphometric properties of the gallbladder such as length, diameter and volume are determinants of gallbladder function. These parameters are altered with age and may explain the age-related reduction in gallbladder contractility associated with gallstone formation. Ninety-two gallbladder specimens of subjects aged between 21 and 84 were sourced from City mortuary and the Department of Human anatomy during autopsy. For each gallbladder specimen, measurements of length and circumference were taken to the accuracy of 0.1millimetres (mm) and used to calculate the gallbladder volume. These measurements were standardized using measurements of liver length and weight. Data were recorded by age categories in age groups of 21-30, 31-40, 41-50, 51-60 and 61 or more years. The mean gallbladder volume was 47.948 (±19.080) cm3 and showed a statistically significant increase with age (p <0.001). There was also a significant increase of gallbladder length (p =0.01) and diameter (p <0.001). A positive correlation was observed between gallbladder length, diameter and volume; 0.282, 0.485 and 0.480 respectively (p = 0.01). The gallbladder volume which is a function of length and diameter, shows a statistically significant increase with age. Notably, there is a marked increase in these parameters after the fifth decade. This could explain the exponential increase in prevalence of cholelithiasis by 4 to 10 times after the fifth decade of life.Keywords: Gallbladder volume, Contractility, Age, Cholelithiasi

<i>Trypanosoma evansi</i>: Genetic variability detected using amplified restriction fragment length polymorphism (AFLP) and random amplified polymorphic DNA (RAPD) analysis of Kenyan isolates

We compared two methods to generate polymorphic markers to investigate the population genetics of Trypanosoma evansi; random amplified polymorphic DNA (RAPD) and amplified restriction fragment length polymorphism (AFLP) analyses. AFLP accessed many more polymorphisms than RAPD. Cluster analysis of the AFLP data showed that 12 T.evansi isolates were very similar (‘type A’) whereas 2 isolates differed substantially (‘type B’). Type A isolates have been generally regarded as genetically identical but AFLP analysis was able to identify multiple differences between them and split the type A T. evansi isolates into two distinct clades

Enabling the Development and Deployment of Next Generation Point-of-Care Diagnostics

<p>Enabling the Development and Deployment of Next Generation Point-of-Care Diagnostics</p

Molecular characterization of group A rotaviruses in Mukuru slums Kenya: detection of novel strains circulating in children below 5 years of age

Abstract Background Gastroenteritis is a public health concern due to high morbidity and mortality among children. Rotaviruses are the leading etiological agents of severe gastroenteritis in children and accounts for more than half a million deaths per year in Africa. The study aimed at investigating the rotavirus genotypes that were circulating in children aged 5 years and below in and around Mukuru slums in Nairobi County Kenya. Methods A purposive cross sectional sampling method was applied where 166 samples were collected from children below 5 years of age and taken to Kenya Medical Research Institute virology laboratory. Presence of rotaviruses was determined using reverse transcription polymerase chain reaction, while extraction was done using ZR Soil/Fecal RNA MicroPrep™ extraction kit. This was followed by reverse transcription and genotyping using various group A rotavirus primers. Results The G type was successfully determined in 37 (92.5%), while the P type was successfully determined in 35 (87.5%) of the 40 (24%) page positive samples. Type G1 was the most predominant of the G types (40.5%), and the incidences of G3 and G9 were 21.6 and 32.4% respectively. Mixed types G3/G9 were detected at 5.4%. Three P types existed in Mukuru slums, P[8] (60%), P[6] (22.9%), P[4] (11.4) and their relative incidence varied over the 15 months of this study. Conclusions The G types and P types detected in this study are important causes of acute gastroenteritis in Mukuru slums Nairobi Kenya. An indication that the prevalence of certain genotypes may change over a rotavirus season is significant and mirrors observations from studies in other tropical climates. Thus monitoring of the genotypic changes among circulating viruses should be encouraged over the coming years

Differential virulence and tsetse fly transmissibility of <i>Trypanosoma congolense</i> and <i>Trypanosoma brucei</i> strains

African animal trypanosomiasis causes significant economic losses in sub-Saharan African countries because of livestock mortalities and reduced productivity. Trypanosomes, the causative agents, are transmitted by tsetse flies (Glossina spp.). In the current study, we compared and contrasted the virulence characteristics of five Trypanosoma congolense and Trypanosoma brucei isolates using groups of Swiss white mice (n = 6). We further determined the vectorial capacity of Glossina pallidipes, for each of the trypanosome isolates. Results showed that the overall pre-patent (PP) periods were 8.4 ± 0.9 (range, 4–11) and 4.5 ± 0.2 (range, 4–6) for T. congolense and T. brucei isolates, respectively (p < 0.01). Despite the longer mean PP, T. congolense–infected mice exhibited a significantly (p < 0.05) shorter survival time than T. brucei–infected mice, indicating greater virulence. Differences were also noted among the individual isolates with T. congolense KETRI 2909 causing the most acute infection of the entire group with a mean ± standard error survival time of 9 ± 2.1 days. Survival time of infected tsetse flies and the proportion with mature infections at 30 days post-exposure to the infective blood meals varied among isolates, with subacute infection–causing T. congolense EATRO 1829 and chronic infection–causing T. brucei EATRO 2267 isolates showing the highest mature infection rates of 38.5% and 23.1%, respectively. Therefore, our study provides further evidence of occurrence of differences in virulence and transmissibility of eastern African trypanosome strains and has identified two, T. congolense EATRO 1829 and T. brucei EATRO 2267, as suitable for tsetse infectivity and transmissibility experiments

Devices demonstrated at the workshop.

<p>(*Devices were produced on site)</p><p>Devices demonstrated at the workshop.</p

Value chain of point-of-care diagnostics.

<p>The top part displays the stakeholders that are involved in the development, commercialization, roll out, and integration of point-of-care diagnostic tests into control and surveillance programs</p