Parameters of the attenuated schistosome vaccine evaluated in the olive baboon

Five exposures of baboons to the attenuated schistosome vaccine gave greater protection than three exposures, but this attenuation was not sustained when challenge was delayed. Within the scope of the data collected, fecal egg counts and circulating antigen levels did not accurately predict the observed worm burdens. Levels of immunoglobulin G at challenge correlated best with protection, but there was little evidence of a recall response

Norovirus GII.17 predominates in selected surface water sources in Kenya

In this study, the prevalence and genotypes of noroviruses (NoVs) in selected water sources from rural, urban and refugee settings in Kenya were investigated. Ten litres each of river, household and borehole water was collected in rural (Mboone River), urban (Nairobi and Mutoine River) and refugee (Dadaab refugee camp) settings. NoVs were recovered from the water samples by a glass wool adsorption–elution technique and/or PEG/NaCl precipitation. Nucleic acid was extracted using the automated MagNA Pure platform. NoVs were detected with singleplex real-time reverse transcription-polymerase chain reaction assays and characterised by nucleotide sequence analysis. NoVs were detected in 63 % (25/40) of the selected water samples comprising GII (42.5 %), GI (2.5 %) and mixed GI/GII (17.5 %) positive samples. The prevalence of NoVs in the Mutoine River (urban area) was higher than in the Mboone River (rural area) (P = 0.0013). Noroviruses GI.1, GI.3, GI.9, GII.4, GII.6, GII.12, GII.16 and GII.17 were identified, with GII.17 accounting for 76 % (16/21) of the typed strains. The NoV GII.17 predominance differs to other studies in Africa and further surveillance of NoVs in clinical and environmental settings is required to clarify/elucidate this observation. As information regarding NoVs in Kenyan water sources is limited this report provides valuable new data on NoV genotypes circulating in environmental water sources and the surrounding communities in Kenya.The National Research Foundation, South Africa and the National Council for Science and Technology, Kenya: South Africa/Kenya Research Programme.http://link.springer.com/journal/12560hb2017Medical Virolog

Global surgery, obstetric, and anaesthesia indicator definitions and reporting: An Utstein consensus report

Background Indicators to evaluate progress towards timely access to safe surgical, anaesthesia, and obstetric (SAO) care were proposed in 2015 by the Lancet Commission on Global Surgery. These aimed to capture access to surgery, surgical workforce, surgical volume, perioperative mortality rate, and catastrophic and impoverishing financial consequences of surgery. Despite being rapidly taken up by practitioners, data points from which to derive the indicators were not defined, limiting comparability across time or settings. We convened global experts to evaluate and explicitly define—for the first time—the indicators to improve comparability and support achievement of 2030 goals to improve access to safe affordable surgical and anaesthesia care globally. Methods and findings The Utstein process for developing and reporting guidelines through a consensus building process was followed. In-person discussions at a 2-day meeting were followed by an iterative process conducted by email and virtual group meetings until consensus was reached. The meeting was held between June 16 to 18, 2019; discussions continued until August 2020. Participants consisted of experts in surgery, anaesthesia, and obstetric care, data science, and health indicators from high-, middle-, and low-income countries. Considering each of the 6 indicators in turn, we refined overarching descriptions and agreed upon data points needed for construction of each indicator at current time (basic data points), and as each evolves over 2 to 5 (intermediate) and >5 year (full) time frames. We removed one of the original 6 indicators (one of 2 financial risk protection indicators was eliminated) and refined descriptions and defined data points required to construct the 5 remaining indicators: geospatial access, workforce, surgical volume, perioperative mortality, and catastrophic expenditure. A strength of the process was the number of people from global institutes and multilateral agencies involved in the collection and reporting of global health metrics; a limitation was the limited number of participants from low- or middle-income countries—who only made up 21% of the total attendees. Conclusions To track global progress towards timely access to quality SAO care, these indicators—at the basic level—should be implemented universally as soon as possible. Intermediate and full indicator sets should be achieved by all countries over time. Meanwhile, these evolutions can assist in the short term in developing national surgical plans and collecting more detailed data for research studies.publishedVersio

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Uptake of cervical cancer screening services among nurses working at Thika Level 5 Hospital

Background: Cervical cancer is the second commonest type of cancer among women globally, an estimated 270000 women die annually due to cervical cancer with 85% of this deaths occurring in Sub-Saharan African countries. Nurses are largely involved in screening and treatment of cervical cancer. Studies done in some countries have indicated low utilization of cervical cancer screening services by nurses. According to the National guidelines for prevention and management of reproductive system cancers, the situation of cervical cancer is worse in Kenya with a rate of 2454 new cases and mortality of 1676 annuallyObjective: To determine the proportion of nurses screened for cervical cancer at Thika Level 5 hospital Design: A descriptive cross sectional study design; A systematic sampling technique was used where every 2nd nurse was selected from the sampling frame; data were collected using a semi structured questionnaire. The study was conducted at the Thika Level 5 hospital. Ethical clearance was obtained from Mount Kenya University and Thika Level 5 Hospital. Data was analyzed using SPSS version 22.Population: The study targeted all nurses working at Thika Level 5 Hospital.Outcome Measures: The percentage of nurses screened as per the National guidelines was low.Results: There was a positive correlation factor of (0.33) between knowledge and screening status showing a positive upwards relationship Conclusions: There was low uptake (41%) of cervical cancer screening services mainly due to inadequate knowledge on prevention strategies.Recommendations: Nurses should be encouraged to take the initiative and be screened for cervical cancer

Effects of khat (Catha edulis) consumption on reproductive functions: a review

Objectives: To review research findings on the effects of khat (Catha edulis) chewing on reproductive functions. Data sources: Retrieval and critical review of relevant articles and abstracts cited in international and local journals, literature searches on Medline and Medchem from 1961 to 2002. Data synthesis: Analysis of published data and limited interviews of regular khat users revealed that khat chewing lowers libido in humans and may also lead to sexual impotence following long term use. In pregnant women, consumption of khat affects growth of foetus by inhibiting utero-placental blood flow and as a consequence, impairs foetal growth. Conclusion: Detailed studies on the effects of khat on reproduction are lacking. However, the limited available data reveal that chewing of khat has a negative impact on human reproductive health. Khat is genotoxic and has teratogenic effects on the foetus if regularly consumed by pregnant mothers. Since low birth weight is a well-established risk factor for both perinatal and young infant death, khat chewing during pregnancy may be one of the factors contributing to infant mortality in communities where khat is commonly chewed. Khat consumption affects the potency of male sexuality by affecting spermatogenesis and plasma testosterone concentration. However, the precise mechanisms by which khat may affect the male reproductive physiology have not been elucidated. (East African Medical Journal: 2003 80(6): 318-323

EFFECTS OF KHAT (CATHA EDULIS) CONSUMPTION ON REPRODUCTIVE FUNCTIONS: A REVIEW

ABSTRACTObjectives: To review research findings on the effects of khat (Catha edulis) chewingon reproductive functions.Data sources: Retrieval and critical review of relevant articles and abstracts cited ininternational and local journals, literature searches on Medline and Medchem from 1961to 2002.Data synthesis: Analysis of published data and limited interviews of regular khat usersrevealed that khat chewing lowers libido in humans and may also lead to sexualimpotence following long term use. In pregnant women, consumption of khat affectsgrowth of foetus by inhibiting utero-placental blood flow and as a consequence, impairsfoetal growth.Conclusion: Detailed studies on the effects of khat on reproduction are lacking. However,the limited available data reveal that chewing of khat has a negative impact on humanreproductive health. Khat is genotoxic and has teratogenic effects on the foetus ifregularly consumed by pregnant mothers. Since low birth weight is a well-establishedrisk factor for both perinatal and young infant death, khat chewing during pregnancymay be one of the factors contributing to infant mortality in communities where khatis commonly chewed. Khat consumption affects the potency of male sexuality by affectingspermatogenesis and plasma testosterone concentration. However, the precise mechanismsby which khat may affect the male reproductive physiology have not been elucidated

Human group C rotaviruses identified in Kenya

Background:Rotavirus is associated with acute infantile gastro-enteritis in infants and young children worldwide. Rotavirus is associated with the high cases of morbidity and mortality and it is estimated that up to 650,000 deaths in young children occur annually in the less developed countries. Approximately a quarter of these deaths occur in African children yet minimal data exist on the circulating rotavirus strains in Africa. Objective:To characterise the circulating rotavirus strains in Kenya. Design:A prospective study to investigate rotavirus infection in infants and young children with acute diarrhoea in different areas of Kenya. Between September 2001 and February 2002, 119 faecal specimens were collected from children aged between 1 and 60 months with acute infantile gastro-enteritis. Setting: Faecal samples were collected from clinics around Nairobi and its suburbs including Karen, Ngong, Ongata Rongai Subjects and Methods:Faecal samples were collected from 119 infants and young children with diarrhoea and were analysed by commercial ELISA and polyacrylamide gel electrophoresis (SDS-PAGE) to identify possible non-group A rotaviruses. Extraction of any potential rrotavirus double-stranded RNA from faeces amd characterisation by SDS-PAGE showed the presence of human group C rotaviruses. Results:Examination of these samples with a commercial ELISA assay for the presence of group A rotavirus antigen showed that 13 specimens (11%) were positive. An analysis of all stool specimens was performed by polyacrylamide gel electrophoresis to identify possible non-group A rotaviruses. Extraction of any potential rotavirus double-stranded RNA from faeces and characterisation by SDS-PAGE showed the presence of human group C rotaviruses. Conclusion:This is the first report of group C rotaviruses in Kenya. Further studies are underway to continue the surveillance of rotavirus strains in Kenya; as this information will be useful in planning rotavirus vaccine trials in Africa. (East African Medical Journal: 2003 80(2): 73-76

Human endogenous retrovirus-R (ERV 3) env-like antigens expressed in baboon testes and epididymides

Background: A substantial component of the vertebrate genome comprise of retrovirusrelated sequences named as endogenous retroviruses (ERVs). The role of these ERVrelated sequences in the biological processes of the host species is still unknown. However, they have been associated with tumourigenesis, autoimmune diseases and placental morphogenesis in primates. Objective: To determine the expression of ERVs in male baboon reproductive tissues. Design: The testes and other reproductive tissues from sexually immature and mature male olive baboons (Papio anubis) were investigated for the expression of endogenous retrovirus-related particles. Immunohistochemical staining was performed using antibodies raised against human immunodeficiency virus (HIV)-1/2, simian immunodeficiency virus (SIV) and human ERVs. Biochemical properties were determined by western blot, and reverse transcriptase (RTase) activity in epididymal spermatozoa, ejaculate spermatozoa and seminal fluid was evaluated. Setting: Institute of Primate Research, Nairobi, Kenya. Results: ERV3 env-like antigens were detected on spermatogenic cells in mature baboon testes and on epididymal spermatozoa. Similarly, antigens cross-reactive with antibodies to HIV structural and envelope glycoproteins were expressed in mature and juvenile baboon testes. In addition, reverse transcriptase activity was detected in ejaculate spermatozoa, seminal fluid and epididymal spermatozoa. Conclusion: These results indicate that retroviral-related genes were expressed in normal male baboon testes and spermatozoa, similar to humans. The functions of these ERVs in vertebrates remains unclear. (East African Medical Journal: 2003 80(5): 264-270