The Role of Schistosoma Mansoni Eggs in Protection against Plasmodium Berghei Infected Mice

The co-occurrence of malaria and schistosomiasis is common in tropical regions of the world. Malaria remains a global burden with no vaccine discovered yet. These necessitated the need to look at the immune responses that could be triggered in a coinfection setting. Malaria induces a strong Th1 response while schistosomiasis skews the response to a Th2. This study examined the role of Schistosoma mansoni eggs on malaria disease progression in BALB/c mice infected with Plasmodium berghei. The objectives were to determine the immune correlates to protection. Two groups of mice were used: the experimental and control groups. Experimental were injected with a triple dose of S. mansoni eggs at ten day interval before being challenged with P. berghei while controls were infected with P. berghei only. Five mice from both groups at each time point were euthanized and spleen and serum collected. Mice were euthanized at day 3, 6, 9 and 12 post-challenge with P. berghei. Parasitaemia was monitored daily using Giemsa stained blood smears. Results showed that experimental mice exhibited lower levels of P. berghei parasitaemia (15.52%) as compared to the controls (23.06%). IgG levels were high in the experimental mice compared to controls following stimulation by soluble egg antigen (SEA). Differences in IgG levels between the two study groups were not significant (p>0.05). Levels of IFN- ? and IL-4 were high in the experimental mice than the control group though the difference was not significant (p=0.213). S. mansoni eggs did not induce significant differences in cytokine and IgG levels; nevertheless they contributed to delaying death in the experimental mice by two days by enhancing levels of IgG and IL-4. These findings provide grounds for further studies in non-human primates to better understand the immunomodulatory role of schistosome eggs on malaria progression. Keywords: Schistosoma mansoni, Plasmodium berghe, iSoluble egg Antige

The potential of RNA as a target for national screening of pre-cancer

Whole national screening of pre-cancer is done only in some few countries, dominated by The Netherlands, Denmark, UK, Norway and Finland. This national screening are done combining national cancer registry, national public health and national medical bodies or hospitals. Until some few years ago national screening was only done using morphological or visual methods or technology. Today a number of molecular methods have been implemented to serve these national screening programs. Based on all the discussions within this review, it is clear that the main driving engine and the cause of cervical pre-cancer and the main cause of invasive cervical cancer is the expression of E6 and E7 oncoproteins from HPV 16, 18, 31, 33 and 45. However, the main challenge is the role of morphology or imaging based diagnosis in the original definition of pre-cancer disease. This definition is not based on the cause of cervical pre-cancer but based on a complex morphological observation heavily based on subjective matters. The challenge between these two definitions are discussed in this review. The unique discovery done while validating the first standardized detection technology used against mRNA, confirmed that the presence of both abnormal E6 and/or E7 mRNA and protein is the cause of cervical pre-cancer or severe neoplasia and the main cause of invasive cervical cancer. This confirmation was evident even though all these studies were disturbed by the above biases from morphology or imaging based  diagnosis. The presence of the template for high production of the most carcinogenic compounds ever discovered, must cause a more accurate screening program. A number of studies have proved that the detection of E6/E7 mRNA followed-up by indirect or direct treatment in a well-organized national screening program would reduce the incidence of cervical cancer. This review discuss the main studies involved in the scientific, clinical evaluation and how this unique technology could be used as a new medical gold standard for national screening of cervical pre-cancer

Cervical precancerous changes and selected cervical microbial infections, Kiambu County, Kenya, 2014: a cross sectional study

Abstract Background Cervical cancer is the predominant cancer among women in Kenya and second most common in women in developing regions. Population-based cytological screening and early treatment reduces morbidity and mortality associated with the cancer. We determined the occurrence of cervical precancerous changes and cervical microbial infections (Trichomonas vaginalis, Candida albicans, Neisseria gonorrhea and Actinomyces) among women attending Family Health Option Kenya (FHOK) clinic in Thika. Methods This was a hospital based cross sectional study among women attending reproductive health screening clinic from November 2013 to January 2014. Cervical Intraepithelial Neoplasia (CIN) I, II, III, cervical cancer and microbial infection (Actinomyces, Trichomonas vaginalis and Yeast cells) diagnosis was based on Pap smear screening test and High Vaginal Swab wet preparation microscopy. Neisseria gonorrhea was diagnosed through Gram staining. Socio-demographic and reproductive health data was collected using a structured questionnaire administered to the study participants and analyzed using Epi Info version 3.5.1. Results Of the 244 women screened, 238 (97.5%) presented with cervical inflammation, 80 (32.8%) cervical microbial infections and 12 (4.9%) cervical precancerous changes; 10 (83.3%) with CIN I and 2 (16.7%) CIN II. Of the 80 cervical microbial infections, 62 (77.5%) were yeast cell and 18 (22.5%) T. vaginalis. One thirty four (55%) participants had no history of Pap smear screening of which 84 (62.7%) were 20–40 years. Use of IUCDs (OR: 2.47, 95% CI 1.3–4.6) was associated with cervical inflammation. Conclusions CIN I was the predominant cervical precancerous change. There is need to scale up cervical screening test to capture all categories of women

Streptococcus pneumoniae Serotype Epidemiology among PCV-10 Vaccinated and Unvaccinated Children at Gertrude’s Children’s Hospital, Nairobi County: A Cross-Sectional Study [version 2; referees: 2 approved, 1 not approved]

Background: Serotype replacement and emergence of multidrug resistant S. pneumoniae has exacerbated the need for continuous regional serotype surveillance especially in the developing world. We investigated S. pneumoniae serotypes circulating among vaccinated and unvaccinated children ≤5 years in Nairobi County post PCV10 era. Methods: A total of 206 vaccinated and unvaccinated children attending Gertrude’s Children’s Hospital (GCH) were recruited for this study. Nasopharyngeal swabs collected using Copan Flocked Swabs were the main study specimen. Culturing and isolation of S. pneumoniae was done on BA with gentamicin and BA plates respectively at the GCH main laboratory. Serotyping was done using the Quellung reaction at the KEMRI-Wellcome Trust, Kilifi.  Results: Out of the 206 subjects sampled, 20.39% (42) were found to be carriers of S. pneumoniae. About 52% (n=22) of the S. pneumoniae carriers had received the recommended dose of PCV-10, while 48% (n=20) of the carriers had not. Almost all (n=41; 19.90% of subjects) isolates contained non-vaccine type S. pneumoniae serotypes, while n=1 of the serotypes (in 0.49% of subjects) were untypeable. Serotypes 28F, 6A, 11A, 3 and 7C were prevalent in both vaccinated and unvaccinated children, whereas serotypes 23A, 17F, 35F, 48, 13 and 35B, and 23B, 20, 19B, 21, untypeable, 15B and 39 were found among unvaccinated and vaccinated groups, respectively. Conclusions: All S. pneumoniae serotypes isolated from the subjects sampled were non PCV-10 vaccine type. These results therefore highlight the importance of monitoring and evaluation to provide epidemiological information to determine the effectiveness of PCV10 in Kenya’s Public health services

Human Papillomavirus Infection: Molecular Epidemiology and Acceptability of Screening and Vaccination among Women in Eastern Kenya Counties

Background: Human Papillomavirus associated cervical cancer in Kenya caused 3,286 deaths where cervical screening rate was 3.2% in 2018. This study examined knowledge, attitudes, practices, and perceptions (KAPP) on HPV screening and vaccination and how these influenced HPV infections among HIV-infected and uninfected women seeking reproductive health services.Materials and Methods: This was a cross-sectional study where socio-demographic and KAPP data on HPV screening and vaccination data was collected by the use of a questionnaire. Cervical swabs were obtained for HPV DNA-PCR and cytology. Logistic regression and Pearson chi-square tests were used to analyze statistical relationships.Results: Among the 317 women recruited, HPV infections were significantly associated with marital status, number of sexual partners, hormonal-contraceptives use, HIV infection, presence of genital warts, recurrent UTIs, and TB infection. The number of participants with knowledge on HPV screening was significant in Embu County, among those younger than 30 years, with secondary and college level education, marital status, religion, and contraceptives use. Having a relative with a history of any cancer was significantly associated with knowledge and perceiving HPV screening as important. Participants who perceived HPV vaccination as important were significant across age, family planning, and parity. Fear of embarrassment, procedures, and results, lack of time, and cost of the test were reported as reasons for failing to screen for HPV.Conclusion: Knowledge, willingness, and perceiving HPV screening as important as well as willingness to vaccinate against HPV may reduce HPV infections among women seeking reproductive health services in Eastern Keny

How to prevent and address safeguarding concerns in global health research programmes: practice, process and positionality in marginalised spaces

Safeguarding is rapidly rising up the international development agenda, yet literature on safeguarding in related research is limited. This paper shares processes and practice relating to safeguarding within an international research consortium (the ARISE hub, known as ARISE). ARISE aims to enhance accountability and improve the health and well-being of marginalised people living and working in informal urban spaces in low-income and middle-income countries (Bangladesh, India, Kenya and Sierra Leone). Our manuscript is divided into three key sections. We start by discussing the importance of safeguarding in global health research and consider how thinking about vulnerability as a relational concept (shaped by unequal power relations and structural violence) can help locate fluid and context specific safeguarding risks within broader social systems. We then discuss the different steps undertaken in ARISE to develop a shared approach to safeguarding: sharing institutional guidelines and practice; facilitating a participatory process to agree a working definition of safeguarding and joint understandings of vulnerabilities, risks and mitigation strategies and share experiences; developing action plans for safeguarding. This is followed by reflection on our key learnings including how safeguarding, ethics and health and safety concerns overlap; the challenges of referral and support for safeguarding concerns within frequently underserved informal urban spaces; and the importance of reflective practice and critical thinking about power, judgement and positionality and the ownership of the global narrative surrounding safeguarding. We finish by situating our learning within debates on decolonising science and argue for the importance of an iterative, ongoing learning journey that is critical, reflective and inclusive of vulnerable people