E. coli and Salmonella Contamination of Tomato Marketed and Consumed in Nairobi Metropolis

Tomato, a worldwide consumed commodity for its nutritive values can harbour Salmonella and E.coli. Tomato can contribute to diarrheal illnesses; and associated burden in households. Seasonal bacterial analyses to detect enterobacteria were conducted from January to June 2017 in Nairobi. The study shows that, the vegetable during the study period is 94% contaminated with E. coli and 28% with Salmonella. February had the highest contamination during the dry season (2.37 log10cfu.ml-1 >2; p≤ 0.05) and May (2.8 log10cfu.ml-1 >2; p≤ 0.05) the highest in wet season. Thus, seasons have influence on microbial contamination in tomato. Bacteria multiplication slows in dry period and increases in wet season. Increase of bacteria from March (end of dry season or beginning of rains) to high presence in May (end of rains) might come with more health concerns if attention is not paid to ready-to-eat vegetables. Consumers purchasing from open air markets seem more at risk of bacterial infection (Kangemi 1.84±0.159; Githurai 2.02±0.1815; Wakulima 1.97±0.24 of E. coli contamination) compared to those who use supermarkets (Nakumatt W. 1.54±0.134; Uchumi Sarit C. 1.27±0.105). Although most tomatoes were washed and cleaned, bacteria levels were still a threat to health. Surfactants from pesticides might contribute to tomatoes infection as they are able to wound skins of crops and open ways to bacterial contamination. With sudden bacterial increase in wet seasons (Kangemi 2.98±0.225kl; Githurai 2.75±0.157efghi; Wakulima 2.69±0.067ghijk; Nakumatt 1.78±0.092bcd; Uchumi 1.54±0.215cde), consumers might experience more symptoms of enteric bacteria. Special attention should be paid in wet times as best quality of tomato at sight is not necessarily safe for direct consumption without further processing. These findings might help in understanding why consumers of salad might be exposed to symptoms of enteric bacteria in wet times. Food handlers, health workers, consumers and policy designers should be informed of this risk. Keywords: E. coli, Salmonella spp, bacteria, season, contaminatio

Seasonal variation and prevalence of tuberculosis among health seekers in the south western Cameroon

Objectives: To determine the prevalence of tuberculosis (TB) in Fako health District, to assess the effects of seasonal variation on the incidence of TB in the study area and to use sentinel analysis to predict areas of greatest infection. Design: A prospective cross sectional study based on laboratory investigations. Setting: Fako health District, South Western Carneroon. Results: The prevalence of TB was 23.3%.Tuberculosis was significantly more prevalent in males (12.6%) as compared with females (10.7%) (P = 0.034). TB prevalence was significantly different between age groups, with the highest number of cases recorded in the age group 21-30 (P = 0.002). When the health areas were compared, TB prevalence varied significantly (P = 0.001), with Limbe Town recording the highest number of TB cases. We recorded more TB cases in the wet season compared with the dry season and the difference was statistically significant (P = 0.000). There was a significant drop in the prevalence of TB over the study period (P = 0.000). Conclusion: This study is the first to report on the effects of season on the prevalence of TB in Cameroon. These findings will therefore provide additional useful base line data for setting up TB control strategies in Cameroon. The East African Medical Journal Vol. 83 (11) 2006: pp. 588-59

SEROPREVALENCE OF BOVINE BRUCELLOSIS IN CENTRAL CAMEROON

Brucellosis is a zoonotic disease with a significant economic and public health impact, which particularly affects humans and animal species in developing countries relying on livestock production. This study was conducted to provide asero-prevalence of bovine brucellosis in the central part of Cameroon. Sera from randomly collected blood samples were screened for Brucella antibodies using the rapid Rose Bengal Plate Test (RBPT) and the indirect Enzyme Linked Immuno­-Sorbent Assay(i-ELISA). A questionnaire was administered to butchers to trace the origin of each animal sampled and know the age and sex of these animals. Statistical significance was determined by Chi-Square test using SPSS v 20 software. A total of 460 cattle (both male and female) were screened. RBPT detected Brucella antibodies in 67 (14.63%) With iELISA, 41 (9, 4%) samples tested positive for detecting Brucella LPS antibodies for confirmation. Data such as animal ageand their origin were not significant; however, the sexwas statistically significant. Animals from Ngaoundere were found to be more affected than animals from Bertoua. Therefore, the overall sero-prevalence obtained was 67 (14.63%) for RBPT and 41 (9, 4%) for i-ELISA.

Current practice of epidemiology in Africa: highlights of the 3rd conference of the African epidemiological association and 1st conference of the Cameroon society of epidemiology, Yaoundé, Cameroon, 2014

As the study of disease occurrence and health indicators in human populations, Epidemiology is a dynamic field that evolves with time and geographical context. In order to update African health workers on current epidemiological practices and to draw awareness of early career epidemiologists on concepts and opportunities in the field, the 3rd African Epidemiology Association and the 1st Cameroon Society of Epidemiology Conference was organized in June 2-6, 2014 at the Yaoundé Mont Febe Hotel, in Cameroon. Under the theme«Practice of Epidemiology in Africa: Stakes, Challenges and Perspectives», the conference attracted close to five hundred guest and participants from all continents. The two main programs were the pre-conference course for capacity building of African Early Career epidemiologists, and the conference itself, providing a forum for scientific exchanges on recent epidemiological concepts, encouraging the use of epidemiological methods in studying large disease burden and neglected tropical diseases; and highlighting existing opportunities

World Antimalarial Resistance Network (WARN) III: Molecular Markers for Drug Resistant Malaria

Molecular markers for drug resistant malaria represent public health tools of great but mostly unrealized potential value. A key reason for the failure of molecular resistance markers to live up to their potential is that data on the their prevalence is scattered in disparate databases with no linkage to the clinical, in vitro and pharmacokinetic data that are needed to relate the genetic data to relevant phenotypes. The ongoing replacement of older monotherapies for malaria by new, more effective combination therapies presents an opportunity to create an open access database that brings together standardized data on molecular markers of drug resistant malaria from around the world. This paper presents a rationale for creating a global database of molecular markers for drug resistant malaria and for linking it to similar databases containing results from clinical trials of drug efficacy, in vitro studies of drug susceptibility, and pharmacokinetic studies of antimalarial drugs, in a World Antimalarial Resistance Network (WARN). This database will be a global resource, guiding the selection of first line drugs for treating uncomplicated malaria, for preventing malaria in travelers and for intermittent preventive treatment of malaria in pregnant women, infants and other vulnerable groups. Perhaps most important, a global database for molecular markers of drug resistant malaria will accelerate the identification and validation of markers for resistance to artemisinin-based combination therapies and, thereby, potentially prolong the useful therapeutic lives of these important new drugs

World Antimalarial Resistance Network (WARN) III: Molecular markers for drug resistant malaria

Molecular markers for drug resistant malaria represent public health tools of great but mostly unrealized potential value. A key reason for the failure of molecular resistance markers to live up to their potential is that data on the their prevalence is scattered in disparate databases with no linkage to the clinical, in vitro and pharmacokinetic data that are needed to relate the genetic data to relevant phenotypes. The ongoing replacement of older monotherapies for malaria by new, more effective combination therapies presents an opportunity to create an open access database that brings together standardized data on molecular markers of drug resistant malaria from around the world. This paper presents a rationale for creating a global database of molecular markers for drug resistant malaria and for linking it to similar databases containing results from clinical trials of drug efficacy, in vitro studies of drug susceptibility, and pharmacokinetic studies of antimalarial drugs, in a World Antimalarial Resistance Network (WARN). This database will be a global resource, guiding the selection of first line drugs for treating uncomplicated malaria, for preventing malaria in travelers and for intermittent preventive treatment of malaria in pregnant women, infants and other vulnerable groups. Perhaps most important, a global database for molecular markers of drug resistant malaria will accelerate the identification and validation of markers for resistance to artemisinin-based combination therapies and, thereby, potentially prolong the useful therapeutic lives of these important new drugs

Likely Health Outcomes for Untreated Acute Febrile Illness in the Tropics in Decision and Economic Models; A Delphi Survey

BACKGROUND: Modelling is widely used to inform decisions about management of malaria and acute febrile illnesses. Most models depend on estimates of the probability that untreated patients with malaria or bacterial illnesses will progress to severe disease or death. However, data on these key parameters are lacking and assumptions are frequently made based on expert opinion. Widely diverse opinions can lead to conflicting outcomes in models they inform. METHODS AND FINDINGS: A Delphi survey was conducted with malaria experts aiming to reach consensus on key parameters for public health and economic models, relating to the outcome of untreated febrile illnesses. Survey questions were stratified by malaria transmission intensity, patient age, and HIV prevalence. The impact of the variability in opinion on decision models is illustrated with a model previously used to assess the cost-effectiveness of malaria rapid diagnostic tests. Some consensus was reached around the probability that patients from higher transmission settings with untreated malaria would progress to severe disease (median 3%, inter-quartile range (IQR) 1-5%), and the probability that a non-malaria illness required antibiotics in areas of low HIV prevalence (median 20%). Children living in low transmission areas were considered to be at higher risk of progressing to severe malaria (median 30%, IQR 10-58%) than those from higher transmission areas (median 13%, IQR 7-30%). Estimates of the probability of dying from severe malaria were high in all settings (medians 60-73%). However, opinions varied widely for most parameters, and did not converge on resurveying. CONCLUSIONS: This study highlights the uncertainty around potential consequences of untreated malaria and bacterial illnesses. The lack of consensus on most parameters, the wide range of estimates, and the impact of variability in estimates on model outputs, demonstrate the importance of sensitivity analysis for decision models employing expert opinion. Results of such models should be interpreted cautiously. The diversity of expert opinion should be recognised when policy options are debated

Possible association between ABCC8 C49620T polymorphism and type 2 diabetes in a Nigerian population

The association between ABCC8 gene C49620T polymorphism and type 2 diabetes (T2D) in populations of diverse ethnic backgrounds has been reported. However, such occurrence in an African population is yet to be established. This case-control study involving 73 T2D and 75 non-diabetic (ND) patients investigated the occurrence of this polymorphism among T2D patients in Nigeria and assessed its relationship with body lipids of patients. Demographic and clinical characteristics of patients were collected and lipid profile indices including total cholesterol (TC), triglyceride (TG), low density lipoprotein (LDL) and high density lipoprotein (HDL) were assayed. Restriction fragment length polymorphism-PCR (RFLP-PCR) was employed to genotype the ABCC8-C49620T polymorphism using PstI restriction enzyme. This study revealed significantly (p 0.05) of T2D for the unadjusted codominant, dominant and recessive models. Following age adjustment, the mutant genotypes (CT and TT) showed significant (p<0.05) risk of T2D for all the models with the recessive model presenting the greatest risk of T2D (OR: 2.39, 95% CI: 1.16-4.91, p<0.018). The TT genotype significantly (p<0.05) associated with high level of HDL and reduced levels of TC, TG and LDL in non-diabetic patients but was not associated with any of the demographic and clinical characteristics among T2D patients. ABCC8 C49620T polymorphism showed possible association with T2D marked by predominance of the mutant TT genotype in T2D patients. However, the relationship between TT genotype and lipid abnormalities for possible beneficial effect on people suffering from T2D is unclear

Promoter regions of Plasmodium vivax are poorly or not recognized by Plasmodium falciparum

BACKGROUND: Heterologous promoter analysis in Plasmodium has revealed the existence of conserved cis regulatory elements as promoters from different species can drive expression of reporter genes in heterologous transfection assays. Here, the functional characterization of different Plasmodium vivax promoters in Plasmodium falciparum using luciferase as the reporter gene is presented. METHODS: Luciferase reporter plasmids harboring the upstream regions of the msp1, dhfr, and vir3 genes as well as the full-length intergenic regions of the vir23/24 and ef-1α genes of P. vivax were constructed and transiently transfected in P. falciparum. RESULTS: Only the constructs with the full-length intergenic regions of the vir23/24 and ef-1α genes were recognized by the P. falciparum transcription machinery albeit to values approximately two orders of magnitude lower than those reported by luc plasmids harbouring promoter regions from P. falciparum and Plasmodium berghei. A bioinformatics approach allowed the identification of a motif (GCATAT) in the ef-1α intergenic region that is conserved in five Plasmodium species but is degenerate (GCANAN) in P. vivax. Mutations of this motif in the P. berghei ef-1α promoter region decreased reporter expression indicating it is active in gene expression in Plasmodium. CONCLUSION: Together, this data indicates that promoter regions of P. vivax are poorly or not recognized by the P. falciparum transcription machinery suggesting the existence of P. vivax-specific transcription regulatory elements