BREATHER Plus clinical trial design: A randomised non-inferiority trial evaluating the efficacy, safety and acceptability of short cycle (five days on, two days off) dolutegravir/tenofovir-based triple antiretroviral therapy (ART) compared to daily ART in virologically suppressed adolescents living with HIV aged 12 to <20 years in sub-Saharan Africa

Background: Novel strategies to improve ART adherence, retention in care and quality of life among adolescents living with HIV (ALHIV) are needed. Short-Cycle Therapy (SCT) with 4/5 sequential days on ART, 2/3 days off ART per week has shown non-inferior virological outcomes and high acceptability, but most data are in adults and are very limited for dolutegravir (DTG)-based SCT. Methods: BREATHER Plus is an ongoing 96-week non-inferiority randomised trial evaluating efficacy, safety and acceptability of SCT (5 sequential days on, 2 days off at the weekend) with DTG/tenofovir (TNV)-based triple ART versus continuous (daily) therapy (CT) in ALHIV. Participants are aged 12 to <20 years in Kenya/South Africa/Uganda/Zimbabwe, virologically suppressed (Viral Load (VL) <50copies/mL) for ≥12 months at enrollment, with no prior treatment failure. Randomisation is 1:1 to SCT versus CT. VL monitoring for clinical management is 6–12 monthly aligning with standard-of-care. The primary outcome is confirmed virological rebound ≥50 copies/mL by 96 weeks. The trial employs the Smooth Away From Expected (SAFE) non-inferiority frontier, where the non-inferiority margin depends on the observed event risk in the CT arm. Secondary outcomes include HIV resistance, toxicities, patient-reported outcomes and cost-effectiveness. Enrolment of 470 participants completed in June 2023. Discussion: BREATHER Plus is the first randomised trial specifically evaluating DTG/TNV-triple based SCT. Rapid roll-out of DTG and a pragmatic approach to VL monitoring mean results will be generalisable to ALHIV across sub-Saharan Africa. If SCT provides non-inferior virological suppression to CT, it may offer choice for ALHIV on how they take their ART

Efficacy of aqueous plant extract in disinfecting water of different physicochemical properties

This study explored the possibility of disinfecting water using aqueous extracts of medicinal plants. Seven medicinal plants used by Samburu herbalists for the treatment of stomach illnesses were investigated for water disinfection. Aqueous extracts of the dried powdered plant material were directly used to treat the water samples collected. Efficacy of water treatment with medicinal plants expressed as percentage reduction in bacterial colonies revealed that Acacia nilotica extract with a mean percentage reduction of 99.86% was the most effective at reducing the number of bacterial colonies. Albizia anthelmintica extract with a mean of 9.47% was the least effective at reducing the number of bacterial colonies. The study also revealed a possible interaction between plant extracts and water source (P &amp;lt; 0.05, df = 54). The results obtained in this study point out a possibility of using aqueous extracts from A. nilotica in disinfecting water of different physicochemical properties.</jats:p

Participatory forestry improves mangrove forest management in Kenya

Participatory forestry has been recognized as a tool for improving tropical forest management. The current study assessed the impacts of participatory forest management (PFM) on the structure and regeneration of a mangrove forest at Gazi Bay, Kenya. Data were collected along belt transects perpendicular to the waterline in both co-managed and state-managed mangrove forests. Basal area and standing density were significantly higher in the co-managed mangrove forests (16 m2/ha and 4 341 tree/ha) as compared to the state forests (eastern block 10.3 m2/ha and 2 673 trees/ha; western block 6.2 m2/ha and 2 436 trees/ha). There were significantly higher (p = 0.0068) densities of merchantable poles in community-managed as compared to state-managed forests. Natural regeneration patterns in community-managed and state-managed forests were deemed adequate to support the recovery of both forests. The results demonstrate that community participation contributes to improved management of mangrove forests and is in agreement with the principles of sustainable forest management.</jats:p

Changes of phytoplankton communities in Lakes Naivasha and Oloidien, examples of degradation and salinization of lakes in the Kenyan Rift Valley

Increasing degradation of the water quality, caused by overuse and salinization, leads to considerable changes of the phytoplankton composition in Kenyan Rift Valley lakes. Exemplarily, the phytoplankton communities and biomasses of deteriorating freshwater Lake Naivasha and salinizing Lake Oloidien were studied between 2001 and 2005, accompanied by physico-chemical measurements (pH, total phosphorus and nitrogen, alkalinity, conductivity). Over the last three decades, the ecology of these two water basins has been subjected to dramatic changes, caused by excessive use of water and catchment area by man. In L. Naivasha a shift in the dominance of coccoid cyanobacteria towards dominance of ChLorophyceae (Botryococcus terribilis) was observed. Lake Oloidien exhibited a shift in the dominance of coccoid ChLorophyceae towards dominance of cyanobacteria (Arthrospira fusiformis, Anabaenopsis elenkinii). Phytoplankton findings and chemical data demonstrate that L. Naivasha has developed towards a eutrophic freshwater lake while L. Oloidien has progressed towards a hypereutrophic alkaline-saline lake

Molecular detection of uncultured cyanobacteria and aminotransferase domains for cyanotoxin production in sediments of different Kenyan lakes

Abstract PCR-based denaturing gradient gel electrophoresis (DGGE) analysis of 16S rRNA gene fragments was used to identify the cyanobacterial phylotypes in sediments and plankton of saline-alkaline and freshwater lakes of Kenya. The detection of the aminotransferase domain located on modules mcyE and ndaF using specific molecular markers confirmed the presence of potential toxin-producing cyanobacteria. The eight nucleotide sequences obtained from DGGE bands were placed in three divergent cyanobacterial clusters. Five nucleotide sequences were close to members of the genera Anabaenopsis and Umezakia (Nostocales), two sequences fell in the cluster with Arthrospira sp. (Oscillatoriales) and one sequence was related to Chroococcidiopsis sp. (Pleurocapsales). The presence of the latter taxon was demonstrated de novo in the investigated lakes. All nine attained nucleotide sequences of the aminotransferase region belonged to the mcyE module. Five sequences of the aminotransferase domain were included in the cluster having the nucleotide sequence of Anabaena sp. but showed a separate lineage. Other four aminotransferases were placed in the cluster represented by nucleotide sequence of Microcystis aeruginosa. To our knowledge, this is the first report on molecular detection of cyanobacterial phylotypes in sediments of African lakes and aminotransferase domains for cyanotoxin production from sediment samples in general