Biosafety practices and biomedical hazards among the support staff of Kenyatta national hospital, Mbagathi district hospital and Kiambu district hospital in Kenya

Biomedical hazards, also known as infectious hazards or medical hazards are defined as hazards generated during the diagnosis, testing, treatment, research or production of biological products for humans or animals. This study aimed at determining biosafety practices and biomedical hazards among the support staff from Kenyatta National Hospital, Mbagathi District Hospital and Kiambu District Hospital. A descriptive study design was employed for this study to sample the support staff working in the three hospitals. The respondents were strictly the hospital support staff in cleaning, mortuary and handling of health care waste. Probability sampling method was used to select out the 400 respondents. Structured questionnaire was used for data collection which was analyzed using SPSS. Blood and blood products, tissues, sharps and used materials by patients were identified as the major biohazards to hospital support staff. Approximately 33 (63.5%) hospital support staff from Mbagathi District hospital, 35 (67.3%) from Kiambu District hospital and 195 (66.7%) from Kenyatta hospital agreed that they handled blood, sharps and other materials used by patients in the hospitals. The Pearson Chi‐Square Tests χ2 (8) =15.546; P=0.046 implied that the Handling blood, sharp or any other materials used by patients in hospital had association with the hospital the respondents came from. In conclusion the study has demonstrated that hospital support staff needs to be trained on biosafety issues especially medical waste management because their practices are below standards. Hospitals used in the study are facing many challenges because this sector is almost ignored in terms of safety of support staff, segregation, collection, transport, treatment and final disposal. The study recommends that all staff and waste handlers in each hospital should agree on responsibilities towards biosafety policy in Kenya.Key words: Biomedical hazards, biological products, biosafety, waste management

Plasmodium falciparum Hep1 is required to prevent the self aggregation of PfHsp70-3

The majority of mitochondrial proteins are encoded in the nucleus and need to be imported from the cytosol into the mitochondria, and molecular chaperones play a key role in the efficient translocation and proper folding of these proteins in the matrix. One such molecular chaperone is the eukaryotic mitochondrial heat shock protein 70 (Hsp70); however, it is prone to self-aggregation and requires the presence of an essential zinc-finger protein, Hsp70-escort protein 1 (Hep1), to maintain its structure and function. PfHsp70-3, the only Hsp70 predicted to localize in the mitochondria of P. falciparum, may also rely on a Hep1 orthologue to prevent self-aggregation. In this study, we identified a putative Hep1 orthologue in P. falciparum and co-expression of PfHsp70-3 and PfHep1 enhanced the solubility of PfHsp70-3. PfHep1 suppressed the thermally induced aggregation of PfHsp70-3 but not the aggregation of malate dehydrogenase or citrate synthase, thus showing specificity for PfHsp70-3. Zinc ions were indeed essential for maintaining the function of PfHep1, as EDTA chelation abrogated its abilities to suppress the aggregation of PfHsp70-3. Soluble and functional PfHsp70-3, acquired by co-expression with PfHep-1, will facilitate the biochemical characterisation of this particular Hsp70 protein and its evaluation as a drug target for the treatment of malaria

Early surgical management outcomes of children with Wilms’ tumour at Moi Teaching and Referral Hospital in Eldoret Kenya

Background: Paediatric cancers such as Wilms’ tumour are a major cause of morbidity and mortality while also interfering with the quality of life among affected children. This creates a need for early detection and intervention to improve management outcome. Purpose: To evaluate the early surgical outcomes of children with Wilms’ Tumour at a resource constrained teaching hospital in Western Kenya. Materials and Methods: A prospective study among children with Wilms’ tumour who underwent radical nephroureterectomy at Moi Teaching and Referral Hospital. They were reviewed prior to surgery while diagnostic and neoadjuvant chemotherapy sessions data were obtained through chart reviews. Clinical staging was determined using diagnostic radiology while sociodemographic data was collected using a questionnaire. Statistical associations between patient characteristics and surgical outcomes were determined. Results: Of the 30 children studied; 19 (63.3%) were females with an overall mean age of 3.8 (SD± 1.5) years. All the children presented with abdominal mass with 66% of the masses being on the left side. Majority (53.3%) of them received 6 cycles of neoadjuvant chemotherapy. The early postoperative complications were intestinal obstruction (6.7%), surgical site infection (3.3%) and tumour rupture (3.3%). Averagely, the children stayed in the post-operative surgical ward for 6.5 (SD±1.6) days. There was a statistically significant association between duration of symptoms and duration of surgical ward stay (p=.044). No perioperative deaths were observed over the 12-day follow-up duration in the surgical ward. Conclusions: This study reports favourable early surgical outcomes among children with Wilms’ tumour who underwent radical nephrouretectomy

Delayed diagnosis of foreign body aspiration in a child: A case report

Accidental inhalation of foreign bodies continues to cause childhood morbidity and mortality. There is need for prompt recognition and treatment to avoid serious adverse outcomes. We present a case of a four-year old female who aspirated a metallic foreign body into the left main bronchus. The child was unsuccessfully treated over four months for recurrent chest infection. Chest X-ray showed a foreign body lodged in the left main bronchus while bronchoscopy was unsuccessful due to the impacted foreign body. Left thoracotomy was done to extract the umbrella head of a roofing nail 20 mm in diameter

Serum tumour necrosis factor in children suffering from Plasmodium falciparum infection in Kilifi District, Kenya.

Tumour necrosis factor-alpha (TNF alpha) levels were measured by bioassay and immunoassay in sera of children infected with Plasmodium falciparum and uninfected children in the same community in Kilifi District, Kenya. Seventy-one children, mean age 2.9 years (range 4 months-6.8 years), were enrolled; 34 children had severe malaria, 23 had mild (non-severe) malaria and 14 had no malaria. TNF alpha levels were significantly elevated in children with severe malaria compared with those with non-severe malaria and the uninfected group (P < 0.001 and P < 0.00001, respectively). The levels correlated directly with parasite densities (r = 0.54, P < 0.002). Among the children with severe malaria, TNF alpha levels correlated directly with the degree of anaemia but inversely with age. High tumour necrosis factor levels were associated with manifestations of severe malaria infection but declined to normal levels after effective antimalarial treatment

Serum tumour necrosis factor in children suffering from Plasmodium falciparum infection in Kilifi District, Kenya.

Tumour necrosis factor-alpha (TNF alpha) levels were measured by bioassay and immunoassay in sera of children infected with Plasmodium falciparum and uninfected children in the same community in Kilifi District, Kenya. Seventy-one children, mean age 2.9 years (range 4 months-6.8 years), were enrolled; 34 children had severe malaria, 23 had mild (non-severe) malaria and 14 had no malaria. TNF alpha levels were significantly elevated in children with severe malaria compared with those with non-severe malaria and the uninfected group (P < 0.001 and P < 0.00001, respectively). The levels correlated directly with parasite densities (r = 0.54, P < 0.002). Among the children with severe malaria, TNF alpha levels correlated directly with the degree of anaemia but inversely with age. High tumour necrosis factor levels were associated with manifestations of severe malaria infection but declined to normal levels after effective antimalarial treatment

Serum tumour necrosis factor in children suffering from Plasmodium falciparum infection in Kilifi District, Kenya.

Tumour necrosis factor-alpha (TNF alpha) levels were measured by bioassay and immunoassay in sera of children infected with Plasmodium falciparum and uninfected children in the same community in Kilifi District, Kenya. Seventy-one children, mean age 2.9 years (range 4 months-6.8 years), were enrolled; 34 children had severe malaria, 23 had mild (non-severe) malaria and 14 had no malaria. TNF alpha levels were significantly elevated in children with severe malaria compared with those with non-severe malaria and the uninfected group (P < 0.001 and P < 0.00001, respectively). The levels correlated directly with parasite densities (r = 0.54, P < 0.002). Among the children with severe malaria, TNF alpha levels correlated directly with the degree of anaemia but inversely with age. High tumour necrosis factor levels were associated with manifestations of severe malaria infection but declined to normal levels after effective antimalarial treatment

VISCERAL LEISHMANIASIS WITH CONCOMITTANT POST KALA-AZAR DERMAL LEISHMANIASIS RESPONDS TO ORAL SITAMAQUINE: CASE REPORT

SUMMARYWe report a rare case of visceral leishmanisis with concomitant post kala-azar dermalleishmaniasis as the initial presentation in a female patient from Baringo district, Rift valleyprovince, Kenya