Characterization and factors associated with diarrhoeal diseases caused by enteric bacterial pathogens among children aged five years and below attending Igembe District Hospital, Kenya

Introduction: Diarrhoea remains a major public health problem in East African nations such as Kenya. Surveillance for a broad range of entericpathogens is necessary to accurately predict the frequency of pathogens and potential changes in antibiotic resistance patterns.Methods: A cross sectional study was conducted in Igembe District Hospital in Meru County to determine the burden and factors associated enteric  bacterial infection among children aged five years and below. Stool  samples were collected between March and July 2012. Bacterial pathogens were identified and antibiotic susceptibility of bacterial isolates was  ascertained. Questionnaire was administered to the 308 study participants to identify the modifiable risk factors. Data was entered and analyzed  using Epi Info version 3.5.3.Results: The study recruited 308 children. The mean age was 27.25  months, median of 26.0 months and age range  between 2-60 months. The bacterial isolation rates were ETEC 9.1%, EPEC 6.8% and EAEC 12.3%, Salmonella paratyphoid (10.4%), Shigella flexineri (1.9%) and Shigella dysentriae (0.9%). Over 95 %, of the isolates were resistance to  amoxicillin, sulphinatozole, cotrimoxazole. Six factors were independently associated with diarrhoeal diseases, occupation of the parent/guardian (miraa business) (OR=1.8, CI:1.44-4.99),care taker not washing hands after changing napkins (OR= 1.6, CI:1.2-19.7), child drank untreated water from the river (OR= 2.7, CI:2.4-9.9) child not exclusively breastfed (OR= 2.4, CI:2.1-10.5),child did not Wash hands before eating (OR=2.2, CI:1.91-16.3) and after visiting toilet (OR=3.7,CI:2.8-39.4).Eating of mangoes was found to be protective against diarrhoea (OR=0.5, CI:0.03-0.89).Conclusion: The bacterial pathogens were found to be a significant cause of diarrhoea in the study participants. We established higher resistance to several commonly prescribed antibiotics.Several  factors were significantly association with diarrhoea illness. We recommend multifaceted approach that acknowledges the public health aspects that would reduce the  burdenof diarrhoea infectious as identified in this study

Factors associated with patient and health service delays in the management of TB in Central Equatoria State in 2008

Background: Tuberculosis (TB) is caused by the bacterium Mycobacterium tuberculosis. Delays in diagnosis and treatment increase morbidity and mortality from tuberculosis, and the risk of transmission in the community.Methods: We conducted a cross-sectional survey at three TB treatment centres in Central Equatoria State, South Sudan. Smearpositive TB patients were enrolled in three study sites and interviewed within two days of beginning treatment using a structured questionnaire. This study was conducted to investigate factors that affect patient and health service delays in diagnosis and treatment of pulmonary tuberculosis (PTB) in Central Equatoria State.Results: 129 patients were enrolled in the study. The median patient’s, health provider’s and total pre-treatment periods are 4, 10 and 16 weeks respectively. The health care provider delay for patient diagnosis and start of treatment had the greatest contribution to overall total pre-treatment delayConclusions and recommendations: In Central Equatoria State, health care provider delay was the most frequent type of delay observed and was a major contributor to the overall total delay. This study indicated the need for strengthening the capacity of health workers for early detection and referral of TB patients. Further research is needed to identify reasons for health provider delay.Keywords: Mycobacterium tuberculosis, health service delays, South Suda

Factors associated with superficial mycoses in patients visiting Alupe Clinic and its environs in Busia western Kenya

Background: Globally, Superficial fungal infections are common problems in patients infected human immunodeficiency virus (HIV).The most common, predisposition being unknown HIV status and low socio-economic factors.Objective: The aim of this study was to identify factors associated with Superficial mycoses in patients attending Alupe Outpatient Clinic and its environs. After ethical approval, was obtained from ethical review committee, KEMRI.Methods: A cross-sectional study was conducted in 371 patients from two health facilities in Busia County Kenya. Data was collected using semi structured questionnaire after patients had consented. Quantitative data was analyzed using Statistical Package for Social Sciences (SPSS) version 20.Results: Of 371 respondents; 42.86% (159) were males and 57.14% (212) were females. The mean age for both sexes was 30.8 years with std. dev of 20.0046 and a range of [1,89].The HIV status for respondents were; negative 49.33%, positive 6.20%, unknown status 44.47% respectively.Conclusion: The factors associated with superficial mycoses in patients visiting Alupe Outpatient Clinic and its environs were statistically significant and were majorly associated with; age, gender, HIV status, occupation, site of infection and County. Further research is needed to establish why there is high prevalence of superficial mycoses among; Farmers, business, pupils, students, teachers and those who are unemployed. HIV/AIDS testing and awareness as a predisposition should be prioritized in future studies.Keywords: Superficial mycosis, Human Immunodeficiency Virus, Busi

Rhizobial infection of African landraces of sorghum (Sorghum bicolor L.) and finger millet (Eleucine coracana L.) promotes plant growth and alters tissue nutrient concentration under axenic conditions

Seven strains of infective root-nodule bacteria, ("rhizobia"), namely Rhizobium GHR2,Bradyrhizobium japonicum Tal 110, Sinorhizobium meliloti strain 1, Rhizobium leguminosarum bv. viciae Cn6, R. leguminosarum bv. viciae strain 30, Rhizobium NGR234 and Azorhizobium caulinodans ORS571, were used to study the effects on growth of sorghum and finger millet seedlings cultured aseptically in Leonard jars with 1/2 strength Hoagland nutrient solution containing 1 mM KNO3. The use of scanning electron microscopy on 10-d-old plants revealed the presence of all 6 test strains on root epidermal surfaces as well as inside the tissues of inoculated, but not uninoculated, sorghum and millet roots. Applying root macerate prepared from surface-sterilized inoculated sorghum plant material successfully induced nodule formation and N2 fixation in soyabean seedlings, thus authenticating these internally located root tissue bacteria as rhizobia. Inoculating sorghum seedlings with 4 rhizobial strains (i.e. B. japonicum Tal 110,S. meliloti strain 1, R. l. bv viciae Cn6 and R.l. bv. viciae strain 30) significantly (P<0.05) promoted sorghum shoot growth by 11-51% on fresh weight basis and 8-55% on dry weight basis. There was also 21-32% increase in root length of inoculated sorghum plants compared to uninoculated control. Additionally, root tissue concentrations of P and K were markedly (P<0.05) increased by 17-250% in inoculated sorghum roots relative to uninoculated plants, while in shoots Zn and Cu were significantly (P<0.05) decreased. Bioassays of the test strains for indole acetic acid (IAA) showed that they produced biologically active concentrations of this growth-promoting molecule, which ranged from 0.18 to 2.26 µg IAA per ml culture filtrate. These findings suggest that rhizobial infection of cerals such as sorghum and finger millet can promote an increase in plant growth via improved P and K nutrition and possibly the release of metabolites such as IAA

Evaluating factors influencing heterogeneity in agroforestry adoption and practices within smallholder farms in Rift Valley, Kenya

Understanding the structure, densities and utilization of tree populations in agricultural landscapes is useful in determining the species influencing agroecosystem function. Our study evaluated agroforestry adoption and practices within smallholder farms in a former large-scale maize growing area of Trans Nzoia County, Rift Valley Province, Kenya. This was followed by investigation of factors influencing heterogeneity in the adoption and practices. The factors include: household resource endowment, land tenure and time under current management. Five settlement schemes which were formerly large estates dominated by maize mono-cropping were selected for the current study. Tree inventories of the farms were obtained through transect walks across each settlement. A total of 123 farms were assessed representing households of different resource endowment levels, tenure and number of years under current management. Different analyses were carried out including farm size and tree number, tree density, tree diversity and utilization of the dominant tree species. In total, we identified 44 tree/shrub species, 24 of which were indigenous and the rest exotic. However, the exotic tree species dominated strongly in abundance with Eucalyptus spp. being the most frequent taxon and constituting 34.6% of all trees. Species richness was found to be low compared to other agricultural landscapes in the region. Resource constrained households were found to prefer fruit tree species and maintained high tree diversity on their farms. Households with secure tenure had higher tree diversity than those without who had higherspecies richness and opted for fast growing fodder and fertilizer/firewood trees. Younger farms had fewer trees but higher species richness than older farms. The study, therefore, explains heterogeneity in agroforestry adoption in terms of variation in household resource endowment, land tenure and time under current management levels

Prevalence and Antibiotic Susceptibility Patterns of Shigella and Salmonella Causing Diarrhoea in Children Below 5 Years at Thika Level Five District Hospital

The aim of the study was to isolate and identify the extent of Salmonella and Shigella induced diarrhoea in children under five and to determine their antibacterial susceptibility patterns. The method of investigation was a cross-sectional study. Samples were collected from children less than five years old afflicted with diarrhoea coming for treatment at Thika Level Five Hospital, Kiambu County. A total of 80 stool samples were collected. These were specifically examined for Shigella and Salmonella. In doing so, the samples were cultured in MacConkey and Xylose lactose deoxycholate (XLD) agar. The plates were subsequently incubated aerobically at 37 °C overnight. After incubation, suspected Salmonella and Shigella colonies were identified morphologically, marked and the colonies inoculated to biochemical tests for species identification as described in the Medical Laboratory Manual. Following this, colonies derived from purity plating through biochemical testing were sub-cultured onto nutrient agar to obtain pure colonies. The obtained pure colonies were then used to perform susceptibility tests to commonly prescribed antibacterial drugs, including Gentamicin, Ciproflaxicin and Erythromycin. Results showed 10 (12.5%) confirmed positive isolates, where 6 (60%) were Salmonella and 4 (40%) Shigella. With respect to age, both isolates were found to be concentrated more at ages of 1-4 years. Herein, Salmonella – 1-2 years (33.33%), - 2-3years (50%); Shigella – 1-2 years (50%), - 2-3 years (25%). From the study, sex distribution (male or female) of the host isolates was equal (50-50%). Moreover, Ciprofloxacin and Gentamycin were the most potent antibiotics, whereas Ampicillin, Erythromycin, Cotrimoxazole and Sulfamethoxazole were highly resisted. According to study results, Quinolones and Aminogylcosides are the antibiotics of choice for severe diarrhoea illnesses caused by Salmonella and Shigella