Prevalence of Refractive errors among Primary School Pupils in Kilungu Division of Makueni District, Kenya

Objective: To determine the magnitude and pattern of significant refractive errors in primary school children in Kilungu division of Makueni District, Kenya.Design: A cross – sectional primary school based study.Setting: Eight (8) Primary school in Kilungu division of Makueni District, Kenya.Target population: 1439 Primary school pupils aged between 12 and 15 years.Results: The prevalence of significant refractive error was 5.2%, 75/1439, (95% CI) being responsible for 92.6 % of all causes of poor eyesight. Hypermetropia accounted for 3.2% (95% CI), myopia 1.7% (95% CI) and astigmatism 0.3% (95% CI) of refractive errors. Myopia was more likely to be present in the pupils aged 14 to 15 years than those aged 12 to 13 years with OR 2.9 (0.1 – 9.2) which was statistically significant (p = 0.022).Conclusion: The overall prevalence of significant refractive errors in pupils aged 12 to 15 years in Makueni's Kilungu division at 5.2% (95% CI) was high enough to justify a regular school eye screening in primary schools in Kenya.Keywords: Refractive errors, Children, Prevalence, Keny

Molecular screening for Plasmodium falciparum resistance markers for artemisinins in Mbita, Kenya

Artemisinins-based combination therapies (ACTs) are being recommended against uncomplicated malaria in endemic areas of Africa. However, in these areas data on their long term usefulness is limited. It has been demonstrated that ACTs resistance may be due to single nucleotide polymorphisms (SNPs) in the chemotherapeutic target, the SERCA-type ATPase protein (PfATPase6). This study analyzed PfATPase6 mutations in asymptomatic infections from samples collected from Mbita, a malaria endemic region in Kenya. Mutations in A623E and S769N residues were screened with gene specific primers followed by sequencing. The study demonstrates that there is no mutation in Mbita, Kenya because neither A623E nor S769N PfATPase6 mutations were detected. Resurgence of infections in this area could be due to re-infections and not drug failure. The study recommends that other sites be assessed for PfATPase 6 mutations to verify the long-term usefulness of ACT and monitor any emergency of resistance.Keywords: ACT (Artemisinins-based Combination Therapy), Molecular, Mutations, PfATPase 6doi: 10.4314/ajcem.v12i3.

In vitro anti-viral activity of aqueous extracts of Kenyan Carissa edulis Prunus africana and Melia azedarach against human cytomegalovirus.

The aqueous extracts of three medicinal plants, Carissa edulis (Forssk.) Vahl (Apocynaceae), Prunus africana (Hook.f.) Kalkm (Rosaceae) and Melia azedarach L. (Meliaceae) have shown significant reduction in the replication of human cytomegalovirus (HCMV) in human embryonic lung (HEL) fibroblasts cells in vitro. Using the plaque inhibition assay for the determination of anti-viral activity, the HEL fibroblast cells cultured in 24 well plates were infected with 1 x 102 PFU 91S HCMV and treated with various concentrations of the extracts. The plaques formed were counted after 7 days incubation at 370C in 5% CO2 and the percent plaques inhibited were calculated against infected untreated control. The effective concentrations inhibiting plaque formation by 50% (EC50) was found between 40 to 80 μg/ml for all the extracts. The cell cytotoxic concentrations (CC50) for each of the three extracts, by the trypan blue exclusion test, gave a safe therapeutic index. These results have demonstrated the potential anti-viral activities of the extracts of the three medicinal plants at non-cytotoxic concentrations. African Journal of Health Sciences Vol. 14 (3-4) 2007: pp. 143-14

Malaria vector control practices in an irrigated rice agro-ecosystem in central Kenya and implications for malaria control

<p>Abstract</p> <p>Background</p> <p>Malaria transmission in most agricultural ecosystems is complex and hence the need for developing a holistic malaria control strategy with adequate consideration of socio-economic factors driving transmission at community level. A cross-sectional household survey was conducted in an irrigated ecosystem with the aim of investigating vector control practices applied and factors affecting their application both at household and community level.</p> <p>Methods</p> <p>Four villages representing the socio-economic, demographic and geographical diversity within the study area were purposefully selected. A total of 400 households were randomly sampled from the four study villages. Both semi-structured questionnaires and focus group discussions were used to gather both qualitative and quantitative data.</p> <p>Results</p> <p>The results showed that malaria was perceived to be a major public health problem in the area and the role of the vector <it>Anopheles </it>mosquitoes in malaria transmission was generally recognized. More than 80% of respondents were aware of the major breeding sites of the vector. Reported personal protection methods applied to prevent mosquito bites included; use of treated bed nets (57%), untreated bed nets (35%), insecticide coils (21%), traditional methods such as burning of cow dung (8%), insecticide sprays (6%), and use of skin repellents (2%). However, 39% of respondents could not apply some of the known vector control methods due to unaffordability (50.5%), side effects (19.9%), perceived lack of effectiveness (16%), and lack of time to apply (2.6%). Lack of time was the main reason (56.3%) reported for non-application of environmental management practices, such as draining of stagnant water (77%) and clearing of vegetations along water canals (67%).</p> <p>Conclusion</p> <p>The study provides relevant information necessary for the management, prevention and control of malaria in irrigated agro-ecosystems, where vectors of malaria are abundant and disease transmission is stable.</p

Understanding the Potential Impact of Different Drug Properties On SARS-CoV-2 Transmission and Disease Burden: A Modelling Analysis

Background The public health impact of the COVID-19 pandemic has motivated a rapid search for potential therapeutics, with some key successes. However, the potential impact of different treatments, and consequently research and procurement priorities, have not been clear. Methods Using a mathematical model of SARS-CoV-2 transmission, COVID-19 disease and clinical care, we explore the public-health impact of different potential therapeutics, under a range of scenarios varying healthcare capacity, epidemic trajectories; and drug efficacy in the absence of supportive care. Results The impact of drugs like dexamethasone (delivered to the most critically-ill in hospital and whose therapeutic benefit is expected to depend on the availability of supportive care such as oxygen and mechanical ventilation) is likely to be limited in settings where healthcare capacity is lowest or where uncontrolled epidemics result in hospitals being overwhelmed. As such, it may avert 22% of deaths in high-income countries but only 8% in low-income countries (assuming R=1.35). Therapeutics for different patient populations (those not in hospital, early in the course of infection) and types of benefit (reducing disease severity or infectiousness, preventing hospitalisation) could have much greater benefits, particularly in resource-poor settings facing large epidemics. Conclusions Advances in the treatment of COVID-19 to date have been focussed on hospitalised-patients and predicated on an assumption of adequate access to supportive care. Therapeutics delivered earlier in the course of infection that reduce the need for healthcare or reduce infectiousness could have significant impact, and research into their efficacy and means of delivery should be a priority

Healthcare seeking practices and barriers to accessing under-five child health services in urban slums in Malawi: a qualitative study

BACKGROUND: Access to child health services is an important determinant of child health. Whereas, child health indicators are generally better in urban than rural areas, some population groups in urban areas, such as children residing in urban slums do not enjoy this urban health advantage. In the context of increasing urbanisation and urban poverty manifesting with proliferation of urban slums, the health of under-five children in slum areas remains a public health imperative in Malawi. This paper explores healthcare-seeking practices for common childhood illnesses focusing on use of biomedical health services and perceived barriers to accessing under-five child health services in urban slums of Lilongwe, Malawi’s capital city. METHODS: Qualitative data from 8 focus group discussions with caregivers and 11 in-depth interviews with key informants conducted from September 2012 to April 2013 were analysed using conventional content analysis. RESULTS: Whereas, caregivers sought care from biomedical health providers, late care-seeking also emerged as a major theme and phenomenon. Home management was actively undertaken for childhood illnesses. Various health system barriers: lack of medicines and supplies; long waiting times; late facility opening times; negative attitude of health workers; suboptimal examination of the sick child; long distance to health facility; and cost of healthcare were cited in this qualitative inquiry as critical health system factors affecting healthcare-seeking for child health services. CONCLUSIONS: Interventions to strengthen the health system’s responsiveness to expectations are essential to promote utilisation of child health services among urban slum populations, and ultimately improve child health and survival. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12913-016-1678-x) contains supplementary material, which is available to authorized users

Enhanced future changes in wet and dry extremes over Africa at convection-permitting scale

African society is particularly vulnerable to climate change. The representation of convection in climate models has so far restricted our ability to accurately simulate African weather extremes, limiting climate change predictions. Here we show results from climate change experiments with a convection-permitting (4.5 km grid-spacing) model, for the first time over an Africa-wide domain (CP4A). The model realistically captures hourly rainfall characteristics, unlike coarser resolution models. CP4A shows greater future increases in extreme 3-hourly precipitation compared to a convection-parameterised 25 km model (R25). CP4A also shows future increases in dry spell length during the wet season over western and central Africa, weaker or not apparent in R25. These differences relate to the more realistic representation of convection in CP4A, and its response to increasing atmospheric moisture and stability. We conclude that, with the more accurate representation of convection, projected changes in both wet and dry extremes over Africa may be more severe