Molecular characterization of rotavirus group A strains circulating prior to vaccine introduction in rural coastal Kenya, 2002-2013

Background Kenya introduced the monovalent Rotarix® rotavirus group A (RVA) vaccine nationally in mid-2014. Long-term surveillance data is important prior to wide-scale vaccine use to assess the impact on disease and to investigate the occurrence of heterotypic strains arising through immune selection. This report presents baseline data on RVA genotype circulation patterns and intra-genotype genetic diversity over a 7-year period in the pre-vaccine era in Kilifi, Kenya, from 2002 to 2004 and from 2010 to 2013. Methods A total of 745 RVA strains identified in children admitted with acute gastroenteritis to a referral hospital in Coastal Kenya, were sequenced using the di-deoxy sequencing method in the VP4 and VP7 genomic segments (encoding P and G proteins, respectively). Sequencing successfully generated 569 (76%) and 572 (77%) consensus sequences for the VP4 and VP7 genes respectively. G and P genotypes were determined by use of BLAST and the online RotaC v2 RVA classification tool. Results The most common GP combination was G1P[8] (51%), similar to the Rotarix® strain, followed by G9P[8] (15%) , G8P[4] (14%) and G2P[4] (5%). Unusual GP combinations—G1P[4], G2P[8], G3P[4,6], G8P[8,14], and G12P[4,6,8]—were observed at frequencies of <5%. Phylogenetic analysis showed that the infections were caused by both locally persistent strains as evidenced by divergence of local strains occurring over multiple seasons from the global ones, and newly introduced strains, which were closely related to global strains. The circulating RVA diversity showed temporal fluctuations both season by season and over the longer-term. None of the unusual strains increased in frequency over the observation period. Conclusions The circulating RVA diversity showed temporal fluctuations with several unusual strains recorded, which rarely caused major outbreaks. These data will be useful in interpreting genotype patterns observed in the region during the vaccine er

Molecular characterization of rotavirus group A strains circulating prior to vaccine introduction in rural coastal Kenya, 2002-2013 [version 1; peer review: 2 approved, 1 approved with reservations]

Background: Kenya introduced the monovalent Rotarix® rotavirus group A (RVA) vaccine nationally in mid-2014.  Long-term surveillance data is important prior to wide-scale vaccine use to assess the impact on disease and to investigate the occurrence of heterotypic strains arising through immune selection. This report presents baseline data on RVA genotype circulation patterns and intra-genotype genetic diversity over a 7-year period in the pre-vaccine era in Kilifi, Kenya, from 2002 to 2004 and from 2010 to 2013. Methods: A total of 745 RVA strains identified in children admitted with acute gastroenteritis to a referral hospital in Coastal Kenya, were sequenced using the di-deoxy sequencing method in the VP4 and VP7 genomic segments (encoding P and G proteins, respectively). Sequencing successfully generated 569 (76%) and 572 (77%) consensus sequences for the VP4 and VP7 genes respectively. G and P genotypes were determined by use of BLAST and the online RotaC v2 RVA classification tool. Results: The most common GP combination was G1P[8] (51%), similar to the Rotarix® strain, followed by G9P[8] (15%) , G8P[4] (14%) and G2P[4] (5%).  Unusual GP combinations—G1P[4], G2P[8], G3P[4,6], G8P[8,14], and G12P[4,6,8]—were observed at frequencies of <5%. Phylogenetic analysis showed that the infections were caused by both locally persistent strains as evidenced by divergence of local strains occurring over multiple seasons from the global ones, and newly introduced strains, which were closely related to global strains. The circulating RVA diversity showed temporal fluctuations both season by season and over the longer-term. None of the unusual strains increased in frequency over the observation period.   Conclusions: The circulating RVA diversity showed temporal fluctuations with several unusual strains recorded, which rarely caused major outbreaks.  These data will be useful in interpreting genotype patterns observed in the region during the vaccine era

Effectiveness of monovalent rotavirus vaccine against hospitalization with acute rotavirus gastroenteritis in Kenyan children

Rotavirus remains a leading cause of diarrheal illness and death among children worldwide. Data on rotavirus vaccine effectiveness in sub-Saharan Africa are limited. Kenya introduced monovalent rotavirus vaccine (RV1) in July 2014. We assessed RV1 effectiveness against rotavirus-associated hospitalization in Kenyan children. Between July-2014 and December-2017, we conducted surveillance for acute gastroenteritis (AGE) in three hospitals across Kenya. We analysed data from children age-eligible for ≥1 RV1 dose, with stool tested for rotavirus and confirmed vaccination history. We compared RV1 coverage among those who tested rotavirus-positive (cases) versus rotavirus-negative (controls) using multivariable logistic regression; effectiveness was 1-adjusted odds ratio for vaccination x100%. Among 677 eligible children, 110 (16%) were rotavirus-positive. Vaccination data were available for 91 (83%) cases; 51 (56%) had received 2 RV1 doses and 33 (36%) 0 doses. Among 567 controls, 418 (74%) had vaccination data; 308 (74%) had 2 doses and 69 (16%) 0 doses. Overall 2-dose effectiveness was 64% (95% confidence interval [CI]: 35-80%); for children aged <12 months 67% (95%CI: 30-84%) and children aged ≥12 months 72% (95%CI: 10-91%). Significant effectiveness was seen in children with normal weight-for-age (84% [95%CI: 62-93%]), length/height-for-age (75% [95%CI: 48-88%]) and weight-for-length/height (84% [95%CI: 64-93%]); however, no protection was found among underweight, stunted nor wasted children. RV1 in the routine Kenyan immunization program provides significant protection against rotavirus AGE hospitalization. Protection was sustained beyond infancy. Malnutrition appears to diminish vaccine effectiveness. Efforts to improve rotavirus vaccine uptake and nutritional status are important to maximize vaccine benefit. [Abstract copyright: © The Author(s) 2019. Published by Oxford University Press for the Infectious Diseases Society of America.

Hypothermia amongst neonatal admissions in Kenya: a retrospective cohort study assessing prevalence, trends, associated factors, and its relationship with all-cause neonatal mortality

BackgroundReports on hypothermia from high-burden countries like Kenya amongst sick newborns often include few centers or relatively small sample sizes.ObjectivesThis study endeavored to describe: (i) the burden of hypothermia on admission across 21 newborn units in Kenya, (ii) any trend in prevalence of hypothermia over time, (iii) factors associated with hypothermia at admission, and (iv) hypothermia's association with inpatient neonatal mortality.MethodsA retrospective cohort study was conducted from January 2020 to March 2023, focusing on small and sick newborns admitted in 21 NBUs. The primary and secondary outcome measures were the prevalence of hypothermia at admission and mortality during the index admission, respectively. An ordinal logistic regression model was used to estimate the relationship between selected factors and the outcomes cold stress (36.0°C–36.4°C) and hypothermia (&lt;36.0°C). Factors associated with neonatal mortality, including hypothermia defined as body temperature below 36.0°C, were also explored using logistic regression.ResultsA total of 58,804 newborns from newborn units in 21 study hospitals were included in the analysis. Out of these, 47,999 (82%) had their admission temperature recorded and 8,391 (17.5%) had hypothermia. Hypothermia prevalence decreased over the study period while admission temperature documentation increased. Significant associations were found between low birthweight and very low (0–3) APGAR scores with hypothermia at admission. Odds of hypothermia reduced as ambient temperature and month of participation in the Clinical Information Network (a collaborative learning health platform for healthcare improvement) increased. Hypothermia at admission was associated with 35% (OR 1.35, 95% CI 1.22, 1.50) increase in odds of neonatal inpatient death.ConclusionsA substantial proportion of newborns are admitted with hypothermia, indicating a breakdown in warm chain protocols after birth and intra-hospital transport that increases odds of mortality. Urgent implementation of rigorous warm chain protocols, particularly for low-birth-weight babies, is crucial to protect these vulnerable newborns from the detrimental effects of hypothermia

Corrosion propagation in cracked and uncracked concrete

Thesis (M.Sc. (Civil Engineering))--University of Cape Town, 2008. Includes bibliographical references

The development of empirical chloride-induced corrosion rate prediction models for cracked and uncracked steel reinforced concrete structures in the marine tidal zone

Includes bibliographical references.Empirical chloride-induced corrosion rate prediction models for cracked and uncracked reinforced concrete (RC) structures in the marine tidal exposure zone are proposed in this study. The data used to develop the models were obtained from parallel corrosion experiments carried out by exposing half of 210 beam specimens to accelerated laboratory corrosion (cyclic 3 days wetting with 5% NaCl solution followed by 4 days air-drying) while the other half were left to undergo natural corrosion in a marine tidal zone in Cape Town (Table Bay). The main experimental variables were pre-corrosion flexural cover cracking, cover depth and concrete quality (binder type and w/b ratio). Corrosion rate, half-cell potential and concrete resistivity were monitored bi-weekly throughout the experimental period. The experimental results show that even though each of the variables investigated affects corrosion rate in a certain manner, their combined influence is complex. In general, regardless of the exposure environment (laboratory or marine tidal zone), for a given concrete quality and cover depth, pre-corrosion cover cracking was found to result in higher corrosion rates than in uncracked concrete, but with the field corrosion rates being much lower than the corresponding laboratory ones. Even though corrosion rates in both the field and laboratory specimens increased with an increase in crack width, the influence of concrete quality and cover depth was still evident. However, the effect of cover cracking on corrosion rate diminished with increasing concrete quality. In the blended cement concretes, the effect of concrete quality is further diminished by the inherent high resistivities of these concretes. The increase in corrosion rate due to increase in crack width, regardless of w/b ratio and cover depth, was generally higher in the 100% CEM I 42.5N concrete specimens than in the blended ones. A framework is proposed that can be used to objectively compare predicted corrosion rates for specimens with similar concrete quality (influenced by binder type and w/b ratio) but different cover depths and crack widths. The framework, which incorporates the combined influence of cover depth, crack width and concrete quality (quantified using chloride diffusion coefficient) on corrosion rate, is the basis of the proposed corrosion rate prediction models for cracked concrete. Sensitivity analyses on the proposed models show that if any two of the three input parameters (cover depth, crack width and concrete quality) are simultaneously varied, their effect on corrosion rate is dependent on the value of the third (unchanged) parameter. Furthermore, (i) the initial cover depth was found to have no effect on the extent to which a change in cover depth affects corrosion rate; a similar trend was found in the case of sensitivity of corrosion rate to change in crack width , and (ii) the extent to which a change in either crack width or cover depth affects corrosion rate is dependent mainly on the concrete quality. In general, the sensitivity analyses showed that corrosion rate is more sensitive to change in concrete quality than crack width and cover depth. The proposed models can be used to (i) quantify the propagation phase with respect to a given performance limit using relevant corrosion-induced damage prediction models, and (ii) select suitable design combinations of cover depth, concrete quality and crack width to meet the desired durability performance of a given RC structure in the marine environment

Coal gasification ash and Weathered fly ash, as partial replacement of Portland cement – effect on selected durability properties of concrete

This study uses Sasol ashes as cement extenders to contribute to the technology of partially replacing Portland cement by mass. There are two types of Sasol ashes; coal gasification ash (CGA) and weathered fly ash (WFA) produced from low grade coal. These ashes are disposed of by Sasol with no specific utilisation. In this investigation, PC will be partially replaced by mass with WFA, CGA and FA at 10%, 15% and 30% proportions for each type of ash. The durability indices will be measured and compared for all blended specimen (PC/WFA, PC/CGA and PC/FA). A 100% Portland cement specimen will be used as a control. The durability properties will be used to determine the potential of Sasol ashes being used as a cement extender

Citizen Journalism in Kenya as a Contested “Third Space”

Outside the formal media structures, Kenya has always had a broad range of vibrant alternative sites for public expression and deliberation. As a reaction to successive post-independence governments’ domination and control of mainstream media, Kenya’s “cultural workers”, through music, drama, comedy and “new journalism”, have routinely developed a powerful oppositional narrative that constantly punctures the majesty of power, offering the “margins” not only a space but also a language with which to confront the excesses of the state. This was particularly so in the 1990s, during the clamour for political pluralism. Because the broader communication infrastructure was not radically changed despite political pluralism and media liberalisation in the 1990s (see Ogola, 2015), these spaces and expressive forms for alternative political narratives have remained profoundly relevant. Broadly conceived, citizen journalism, as one of these alternative expressive forms, has been instrumental for ensuring executive accountability and public participation in national debates

Corrosion of steel in concrete due to one and two dimensional chloride ingress

This paper presents results of an ongoing research of the effect of 1D and 2D chloride ingress on concrete resistivity and corrosion rate of steel reinforcement. 12 concrete beams made with concrete of binder blend PC(50)/GGBS(50), w/b = 0.40, 10 mm steel reinforcement rods at concrete cover of 20 mm were used in this laboratory based experiment. The steel reinforcement bars were placed at the middle or at an orthogonal corner of the concrete beams subjected to 1D and 2D chloride ingress respectively. A single crack was induced using 3-point bending on one-half of the beams. The beams were exposed to a repeated cycle of 2 weeks ponding in 5% NaCl and then air drying in ambient laboratory condition for 2 weeks. The corrosion rate of both cracked and uncracked specimens exposed to 2D chloride ingress was significantly higher than that of beams exposed to 1D chloride ingress. The uncracked specimens had lower concrete resistivity values compared to the cracked specimens even though higher corrosion rates were measured

Early-age effect of corn cob ash as a partial replacement for Portland cement in concrete

One of the effects of supplementary cementitious materials (SCMs) in concrete is the dilution effect which is as a result of partially replacing Portland cement with SCMs. The dilution effect of corn cob ash (CCA) with respect to strength gain and transport properties of concrete is the focus of this study. 100 mm concrete cubes were prepared with corn cob ash partially replacing Portland cement at 15% and 30% using w/b ratio of 0.4 and 0.6. The effect of CCA replacement level on the compressive strength development between 3 and 28 days, and transport properties at 28 days of curing was done. This was compared to the effect of fly ash at the same replacement level and 100% Portland cement content. The results showed that compressive strength decreases with increasing ash content and increases with increasing curing age. The dilution effect of CCA was more pronounced at the two replacement levels than fly ash with a marginal gain or strength loss compared to w/c ratio corresponding to each w/b ratio. The oxygen permeability index obtained for CCA concrete were lower compared to that of fly ash concrete at the same replacement levels and PC concrete at the same w/b ratio. Also, the water sorptivity index and chloride conductivity index for CCA concrete were higher than that of fly ash and PC concrete at the same w/b ratio