Schistosoma Mansoni Infections Occurring in School Children in a Non-Endemic Area as a Result of Associated Activities in a Neighboring Endemic Area in Kenya

Schistosomiasis, a chronic parasitic disease is caused by a blood fluke (Schistosoma). 200 million people are infected worldwide, 85% in sub-Saharan Africa. In Kenya coastal region and irrigation schemes are endemic. Mwea irrigation scheme is endemic with 47% prevalence. Close proximity of Kagio area to the irrigation scheme offers labor opportunities to the population including school children posing a transmission threat. This study investigated Schistosoma mansoni infections among school children aged 8-15 years. Kagio and Kang’aru schools (Kagio area) and Kandongu (Mwea irrigation scheme) were selected. 322 pupils were tested for the presence of S. mansoni eggs by direct wet smears and Karto Katz. 263 questionnaires were administered to pupils from Kagio and Kang’aru schools. Data was analysed using Chi square and t-test statistics. Results showed that 7.2% of pupils from Kagio area had Schistosoma mansoni compared to 22% sampled from Mwea irrigation scheme. Mean number of eggs was 56 epg and 104 epg for the pupils who had light infection and those with moderate infection respectively. No pupils had heavy infestation. Pupils from Kagio area who worked in the farms in Mwea irrigation scheme were more prone to infection. 7.9% of those infected worked in rice paddies compared to 4% of infected pupils who did not. There was a significant relationship between labor migration and occurrence of Schistosoma mansoni infection among school children in Kagio area (x2=1.267; df=1; P=0.2604). There was no significant difference in infection rates between pupils from Kagio and Mwea areas (t=5.33, cl=95%, df=1, P=0.118). Schistosoma mansoni was present in both endemic and non-endemic areas. Labor migration was a significant transmission risk factor. The results indicate a need for the policymakers to institute programs that are designed to eliminate or minimize child labor migration from non-endemic to endemic areas as a way of preventing spread of Schistosoma mansoni, regular testing and treatment of the entire population and extend control interventions to neighboring non endemic area

Ownership and Utilization of Insecticide Treated Nets among Primary School Children Following Universal Distribution of Insecticide Treated Nets in Kasipul, Homa-Bay County, Kenya

Insecticide treated nets (ITNs) have become the preferred vector control tool for malaria.  Studies indicate that even after universal net distribution, primary school children were significantly less likely to use ITNs compared to other age groups. The objective of this study was to examine the ownership and utilization of ITNs among primary school children living in Kasipul, one year after mass distribution of ITNs in Kasipul, Homa-Bay County. A cross-sectional study of 398 primary school pupils was conducted in Kasipul. Data on insecticide net use was collected using a questionnaire. The study established that only 51.0 % of the study population owned ITN, which is below the 80% target set by the Kenya Ministry of Health. Among 203 pupils who reported having ITN at home, 189 (93.1%) obtained them free from the government during 2014, mass distribution campaign. ITNs use among pupils in the area increased from 33% in 2015 to 75% in 2016. Age significantly influenced net ownership (χ2=7.549, df =3, p=0.054). The difference in ITNs ownership per school was significant (χ2=37.191, DF =8, p =0.000), indicating that net distribution was not done uniformly within Kasipul. The study concludes that a relatively high ITNs use in this survey, despite moderate coverage (51%) of nets and indicates an overall desire to deploy the nets by the pupils when they are available. Lack of educational campaigns accompanying universal net distributions was evident as 20.7% of net were not in regular use

Reduced Plasmodium Infection in Primary School Children Following Universal Distribution of Insecticide Treated Bed Nets in Kasipul, Homa-Bay County, Kenya

Malaria is endemic in areas bordering Lake Victoria basin of Kenya. Untreated malaria in school children, result in reduced ability to concentrate and learn in school. Available data show that the overall prevalence of Plasmodium among primary school children in Kasipul was 25.8 % in 2013. There was a need to establish the current status of Plasmodium prevalence in Kasipul following mass distribution of insecticide treated nets (ITNs) in 2014. This study assessed the prevalence of Plasmodium infection among school children living in Kasipul and their reported use of bed nets, one year after mass distribution of ITN in Kasipul, Homa-Bay County. A cross-sectional study of 398 primary school pupils was conducted in the area. Pupil’s finger prick blood was used for malaria parasite detection by microscopy. Data on ITNs use was collected using a questionnaire. The overall prevalence of Plasmodium among children was 10.05%. The association between net ownership and Plasmodium prevalence among pupils was significant (c2= 14.46, df =1, p = 0.000). The study observed a significant decline in Plasmodium prevalence from 25.8% in 2011 to 10.05% in 2016, providing evidence that ITNs, which was the major control strategy implemented in Kasipul reduced Plasmodium infection in the study population. Overall pupil net ownership increased from 33% in June 2014 to 51% in 2016. In conclusion, the prevalence of Plasmodium infections reduced significantly following distribution of free ITNs in Kasipul. The study demonstrates that universal distribution of free ITNs is an effective strategy in reducing the prevalence of Plasmodium infection among school children

Prevalence of Amoebiasis Among Patients Attending Longisa County Hospital, Bomet County, Kenya

Amoebiasis is a common life-threatening parasitic disease affecting 12% of the world population and the third leading cause of mortality due to parasitic infections worldwide, after malaria and schistosomiasis. It is estimated that about 500 million people are at risk of infection with amoebiasis yearly. In under-developed and developing countries, infection occurs more commonly in areas of low socio-economic status, poor sanitation and nutrition. In Kenya, there is no continuous surveillance system to combat amoebiasis hence its real prevalence remains unknown in most parts of the country despite majority of the rural population living in areas at risk of infection due to inadequate sanitation and lack of save water for domestic use. The study aimed at determining amoebiasis prevalence at Longisa County Hospital at Bomet County Kenya located within the Rift Valley. A retrospective survey was used through evaluation of data from hospital records for a period of five years. The study revealed that out of 5480 stool samples examined at the hospital laboratory during the period January 2009 to December 2013, 1574 (28.72%) stool tests were positive for amoebiasis of which 10.47% were males while 15.76% were females. The least affected age group was children under age five years at 2.37% based on hospital laboratory data. The disease prevalence was at its peak during the month of February (47%) cumulatively for the five years of study. There is need for routine stool examination for amoebiasis in patients presenting with diarrhea and treatment given to control the disease. Understanding the extent of amoebiasis in the region adds valuable information needed for planning and policy making towards minimizing the effects of the disease

Organ Pathology and Associated IFN-γ and IL-10 Variations in Mice Infected with Toxoplasma gondii Isolate from Kenya

Toxoplasma gondii is an important foodborne opportunistic pathogen that causes a severe disease in immunocompromised patients. The pathology and immune responses associated with the ensuing disease have not been well described in strains from different parts of the world. The aim of the present study is to determine the IFN-γ and IL-10 variations and organ pathology in immunocompetent and immunocompromised mice infected with T. gondii isolated from a Kenyan chicken. Two groups of BALB/c mice were infected with T. gondii cysts and administered with dexamethasone (DXM) in drinking water. Other two groups: infected untreated and uninfected mice were kept as controls. The mice were euthanized at various time points: blood collected for serum and assayed for IFN-γ and IL-10 variations. After infection, significant (p<0.05) elevated levels of IFN-γ and IL-10 were observed. A significant decline in IFN-γ and IL-10 levels (p<0.05) was observed after dexamethasone treatment. Histological sections in the liver, heart, and spleen of the mice administered with DXM revealed various degrees of inflammation characterized by infiltration of inflammatory cells. The dexamethasone-treated mice presented with progressively increased (p<0.001) inflammatory responses is compared with the infected untreated mice

Synergistic Antiplasmodial Activity of Artemisia annua fractions against in vitro cultures of Plasmodium falciparum

Background: Artemisia annua has a very rich phytochemistry comprising several classes of compounds, mainly monoterpenes, sesquiterpenes, and flavonoids.  It has been used in China for about 2000 years in the treatment of fever. Objective: The aim was to determine if there is any synergistic effect on the Artemisia annua phytochemicals. Materials and methods: Artemisia annua used in this study was obtained from a hybrid of the plant grown in the Tanzania highlands (2000-2200 m altitude) in Arusha by Natural Uwemba System for Health (N.U.S.Ag). The dried leaves were ground, and sequentially extracted with hexane, dichloromethane (DCM), methanol and water and the extracts were then combined. The extract was then fractionated using high performance liquid chromatography (HPLC). The effect of the combined crude extract was tested at different doses on in-vitro cultures (a CQ sensitive isolate D6 and CQ resistant isolate W2) of Plasmodium falciparum. The fractions and different blends of these were tested at different doses to determine their role, if any, on the activity of the full blend of the plant. Results: Of nine fractions thus tested against D6 and W2, four had activities of less than 3.9µg /ml, three fractions had activities of between 4.77-14.76 µg/ml and the remaining two had activities above 250g/µml. The seven more active fractions were re-evaluated in a subtractive bioassay procedure, in which one of each fraction was excluded at a time from the full 7-component blend. The activity of the combined seven active compounds was 10.40+0.50 µg/ml against W2.  Of these, one showed IC50 of less than 3.9 µg/ml and all blends showed IC50 at below 27µg/ml. Conclusion: The results show that different components of A. annua contribute to the synergistic anti-Plasmodium activity. The results constitute a useful basis for identifying the components of the plant other than artemisinin that contribute to the activity of herb. Key words- Artemisia annua, malaria, Plasmodium falciparum, artemisinin, synergy

DIGOXIN AND RISK OF DEATH IN ADULTS WITH ATRIAL FIBRILLATION: THE ATRIA-CVRN STUDY

PCR primer sequences for each gene marker amplified and their corresponding annealing temperatures. (DOCX 15 kb

Host choice and multiple blood feeding behaviour of malaria vectors and other anophelines in Mwea rice scheme, Kenya

<p>Abstract</p> <p>Background</p> <p>Studies were conducted between April 2004 and February 2006 to determine the blood-feeding pattern of <it>Anopheles </it>mosquitoes in Mwea Kenya.</p> <p>Methods</p> <p>Samples were collected indoors by pyrethrum spay catch and outdoors by Centers for Disease Control light traps and processed for blood meal analysis by an Enzyme-linked Immunosorbent Assay.</p> <p>Results</p> <p>A total of 3,333 blood-fed <it>Anopheles </it>mosquitoes representing four <it>Anopheles </it>species were collected and 2,796 of the samples were assayed, with <it>Anopheles arabiensis </it>comprising 76.2% (n = 2,542) followed in decreasing order by <it>Anopheles coustani </it>8.9% (n = 297), <it>Anopheles pharoensis </it>8.2% (n = 272) and <it>Anopheles funestus </it>6.7% (n = 222). All mosquito species had a high preference for bovine (range 56.3–71.4%) over human (range 1.1–23.9%) or goat (0.1–2.2%) blood meals. Some individuals from all the four species were found to contain mixed blood meals. The bovine blood index (BBI) for <it>An. arabiensis </it>was significantly higher for populations collected indoors (71.8%), than populations collected outdoors (41.3%), but the human blood index (HBI) did not differ significantly between the two populations. In contrast, BBI for indoor collected <it>An. funestus </it>(51.4%) was significantly lower than for outdoor collected populations (78.0%) and the HBI was significantly higher indoors (28.7%) than outdoors (2.4%). Anthropophily of <it>An. funestus </it>was lowest within the rice scheme, moderate in unplanned rice agro-ecosystem, and highest within the non-irrigated agro-ecosystem. Anthropophily of <it>An. arabiensis </it>was significantly higher in the non-irrigated agro-ecosystem than in the other agro-ecosystems.</p> <p>Conclusion</p> <p>These findings suggest that rice cultivation has an effect on host choice by <it>Anopheles </it>mosquitoes. The study further indicate that zooprophylaxis may be a potential strategy for malaria control, but there is need to assess how domestic animals may influence arboviruses epidemiology before adapting the strategy.</p

Socializing One Health: an innovative strategy to investigate social and behavioral risks of emerging viral threats

In an effort to strengthen global capacity to prevent, detect, and control infectious diseases in animals and people, the United States Agency for International Development’s (USAID) Emerging Pandemic Threats (EPT) PREDICT project funded development of regional, national, and local One Health capacities for early disease detection, rapid response, disease control, and risk reduction. From the outset, the EPT approach was inclusive of social science research methods designed to understand the contexts and behaviors of communities living and working at human-animal-environment interfaces considered high-risk for virus emergence. Using qualitative and quantitative approaches, PREDICT behavioral research aimed to identify and assess a range of socio-cultural behaviors that could be influential in zoonotic disease emergence, amplification, and transmission. This broad approach to behavioral risk characterization enabled us to identify and characterize human activities that could be linked to the transmission dynamics of new and emerging viruses. This paper provides a discussion of implementation of a social science approach within a zoonotic surveillance framework. We conducted in-depth ethnographic interviews and focus groups to better understand the individual- and community-level knowledge, attitudes, and practices that potentially put participants at risk for zoonotic disease transmission from the animals they live and work with, across 6 interface domains. When we asked highly-exposed individuals (ie. bushmeat hunters, wildlife or guano farmers) about the risk they perceived in their occupational activities, most did not perceive it to be risky, whether because it was normalized by years (or generations) of doing such an activity, or due to lack of information about potential risks. Integrating the social sciences allows investigations of the specific human activities that are hypothesized to drive disease emergence, amplification, and transmission, in order to better substantiate behavioral disease drivers, along with the social dimensions of infection and transmission dynamics. Understanding these dynamics is critical to achieving health security--the protection from threats to health-- which requires investments in both collective and individual health security. Involving behavioral sciences into zoonotic disease surveillance allowed us to push toward fuller community integration and engagement and toward dialogue and implementation of recommendations for disease prevention and improved health security

RESOURCE USE EFFICIENCY AMONG RICE FARMERS AROUND FRAGILE ECOSYSTEMS: EVIDENCE FROM KILOMBERO WETLAND, TANZANIA

Farmers have been encroaching fragile wetlands as a strategy to increase their rice production thus threatening wetlands’ existence and capacity to other critical ecosystem services. This calls for efficient production to strike the balance between food rice production and wetlands’ sustainable existence. The current study sought to provide assess rice farmers’ technical efficiency of resource use by detecting the determinants of rice yield and further identify the determinants of technical efficiency of the resources used by rice farmers in Kilombero wetland. A cross-sectional survey of 145 randomly sampled farmers aided in achieving the study objective. A stochastic frontier analysis (SFA) model was used to analyze data. The mean technical efficiency among farmers was at 60.54% level. The positive determinants of rice yield were land and fertilizers while labor influenced it negatively. Age, education, farming experience, group membership, and credit access reduced inefficiency while the distance to the extension agent and off-farm income increased farmers’ inefficiency. The study concludes that there is a possibility of expanding rice production without threatening the wetland’s existence. It recommends that government and other stakeholders to ensure that rice farmers are up-to-date with optimal use of fertilizers in rice production since it will assist in improving rice yield while the rate of expansion of rice lands in the wetlands will lower. Policy implementers ought to establish initiatives that inspire rice farmers to capitalize on farmer groups and join education programs to take full advantage of their potential efficiency and might participate in community development activities