Intermittent preventive treatment for the prevention of malaria during pregnancy in high transmission areas

Malaria in pregnancy is one of the major causes of maternal morbidity and adverse birth outcomes. In high transmission areas, its prevention has recently changed, moving from a weekly or bimonthly chemoprophylaxis to intermittent preventive treatment (IPTp). IPTp consists in the administration of a single curative dose of an efficacious anti-malarial drug at least twice during pregnancy – regardless of whether the woman is infected or not. The drug is administered under supervision during antenatal care visits. Sulphadoxine-pyrimethamine (SP) is the drug currently recommended by the WHO. While SP-IPTp seems an adequate strategy, there are many issues still to be explored to optimize it. This paper reviewed data on IPTp efficacy and discussed how to improve it. In particular, the determination of both the optimal number of doses and time of administration of the drug is essential, and this has not yet been done. As both foetal growth and deleterious effects of malaria are maximum in late pregnancy women should particularly be protected during this period. Monitoring of IPTp efficacy should be applied to all women, and not only to primi- and secondigravidae, as it has not been definitively established that multigravidae are not at risk for malaria morbidity and mortality. In HIV-positive women, there is an urgent need for specific information on drug administration patterns (need for higher doses, possible interference with sulpha-based prophylaxis of opportunistic infections). Because of the growing level of resistance of parasites to SP, alternative drugs for IPTp are urgently needed. Mefloquine is presently one of the most attractive options because of its long half life, high efficacy in sub-Saharan Africa and safety during pregnancy. Also, efforts should be made to increase IPTp coverage by improving the practices of health care workers, the motivation of women and their perception of malaria complications in pregnancy. Because IPTp is not applicable in early pregnancy, which is a period when malaria may also be deleterious for women and their offspring, there is a necessity to integrate this strategy with other preventive measures which can be applied earlier in pregnancy such as insecticide-treated nets

Cost analysis of school-based intermittent screening and treatment of malaria in Kenya

<p>Abstract</p> <p>Background</p> <p>The control of malaria in schools is receiving increasing attention, but there remains currently no consensus as to the optimal intervention strategy. This paper analyses the costs of intermittent screening and treatment (IST) of malaria in schools, implemented as part of a cluster-randomized controlled trial on the Kenyan coast.</p> <p>Methods</p> <p>Financial and economic costs were estimated using an ingredients approach whereby all resources required in the delivery of IST are quantified and valued. Sensitivity analysis was conducted to investigate how programme variation affects costs and to identify potential cost savings in the future implementation of IST.</p> <p>Results</p> <p>The estimated financial cost of IST per child screened is US$6.61 (economic cost US$ 6.24). Key contributors to cost were salary costs (36%) and malaria rapid diagnostic tests (RDT) (22%). Almost half (47%) of the intervention cost comprises redeployment of existing resources including health worker time and use of hospital vehicles. Sensitivity analysis identified changes to intervention delivery that can reduce programme costs by 40%, including use of alternative RDTs and removal of supervised treatment. Cost-effectiveness is also likely to be highly sensitive to the proportion of children found to be RDT-positive.</p> <p>Conclusion</p> <p>In the current context, school-based IST is a relatively expensive malaria intervention, but reducing the complexity of delivery can result in considerable savings in the cost of intervention.</p> <p>(Costs are reported in US$ 2010).</p

The Hominin Sites and Paleolakes Drilling Project:Inferring the environmental context of human evolution from eastern African rift lake deposits

Funding for the HSPDP has been provided by ICDP, NSF (grants EAR-1123942, BCS-1241859, and EAR-1338553), NERC (grant NE/K014560/1), DFG priority program SPP 1006, DFG-CRC-806 “Our way to Europe”, the University of Cologne (Germany), the Hong Kong Research Grants Council (grant no. HKBU201912), the Peter Buck Fund for Human Origins Research (Smithsonian), the William H. Donner Foundation, the Ruth and Vernon Taylor Foundation, Whitney and Betty MacMillan, and the Smithsonian’s Human Origins Program.The role that climate and environmental history may have played in influencing human evolution has been the focus of considerable interest and controversy among paleoanthropologists for decades. Prior attempts to understand the environmental history side of this equation have centered around the study of outcrop sediments and fossils adjacent to where fossil hominins (ancestors or close relatives of modern humans) are found, or from the study of deep sea drill cores. However, outcrop sediments are often highly weathered and thus are unsuitable for some types of paleoclimatic records, and deep sea core records come from long distances away from the actual fossil and stone tool remains. The Hominin Sites and Paleolakes Drilling Project (HSPDP) was developed to address these issues. The project has focused its efforts on the eastern African Rift Valley, where much of the evidence for early hominins has been recovered. We have collected about 2 km of sediment drill core from six basins in Kenya and Ethiopia, in lake deposits immediately adjacent to important fossil hominin and archaeological sites. Collectively these cores cover in time many of the key transitions and critical intervals in human evolutionary history over the last 4 Ma, such as the earliest stone tools, the origin of our own genus Homo, and the earliest anatomically modern Homo sapiens. Here we document the initial field, physical property, and core description results of the 2012–2014 HSPDP coring campaign.Publisher PDFPeer reviewe

A framework for assessing the feasibility of malaria elimination

The recent scale-up of malaria interventions, the ensuing reductions in the malaria burden, and reinvigorated discussions about global eradication have led many countries to consider malaria elimination as an alternative to maintaining control measures indefinitely. Evidence-based guidance to help countries weigh their options is thus urgently needed. A quantitative feasibility assessment that balances the epidemiological situation in a region, the strength of the public health system, the resource constraints, and the status of malaria control in neighboring areas can serve as the basis for robust, long-term strategic planning. Such a malaria elimination feasibility assessment was recently prepared for the Minister of Health in Zanzibar. Based on the Zanzibar experience, a framework is proposed along three axes that assess the technical requirements to achieve and maintain elimination, the operational capacity of the malaria programme and the public health system to meet those requirements, and the feasibility of funding the necessary programmes over time. Key quantitative and qualitative metrics related to each component of the assessment are described here along with the process of collecting data and interpreting the results. Although further field testing, validation, and methodological improvements will be required to ensure applicability in different epidemiological settings, the result is a flexible, rational methodology for weighing different strategic options that can be applied in a variety of contexts to establish data-driven strategic plans

Isolation, Characterization, and Quantification of Bacteria from African Sausages Sold in Nairobi County, Kenya

African sausages are local popular delicacies in Kenya. Demand for these sausages has resulted in this delicacy’s vendors being on the increase. However, health risk posed to unsuspecting consumers of African sausages sold in informal, unhygienic make shift road-side kiosks in major cities of Kenya is largely unknown. A descriptive study was designed to isolate, characterize and quantify bacteria from African sausages sold in Nairobi County. A total of hundred (100) African sausages (62 roasted and 38 nonroasted) were conveniently collected from three meat eatery points of Westlands, Kangemi slum, and Pangani estates. Five genera of bacteria, namely, Staphylococcus spp. at 50.4%, Bacillus spp. at 19.5%, Streptococcus spp. 9.8%, Proteus spp. 2.4%, and E. coli spp. at 1.6%, were isolated from 80 African sausage samples. The total aerobic bacterial count range was between 1.0-9.9x101 and 1.0-9.9x107 log cfu/g with 37 samples having total aerobic bacterial count of between 1.0-9.9 x104 and 1.0-9.9 x107 log cfu/g. There was no significant difference (p>0.05) in distribution of isolates and total aerobic bacterial count across geographical sites studied among the roasted and nonroasted African sausages. This study has demonstrated presence of bacteria in African sausages which are potentially zoonotic to humans. Comprehensive study is needed to sample more eatery meat points in Nairobi and other areas in order to demonstrate pathogenic attributes of these isolates and establish the respective total aerobic bacterial count. There is also need to establish the sources of bacteria due to high total aerobic bacterial count determined in the current study

Gumboro Disease Outbreaks Cause High Mortality Rates in Indigenous Chickens in Kenya

Infectious bursal disease is a disease of economic importance which affects all types of chickens and causes variable mortality. To establish the importance of this disease in the indigenous chickens in Kenya a comparative study of natural outbreaks in flocks of layers, broilers and indigenous chickens was done. Thirty nine outbreak farms (5 keeping broilers, 19 keeping layers and 15 keeping indigenous flock) were visited; vaccination history collected, clinical signs observed, flock size and number of dead birds recorded. Diagnosis was done through Gross pathology and Agar gel precipitation tests (AGPT). Haemorrhages in skeletal muscles and destruction of the bursa of Fabricius were seen in all flock types. Bursa of Fabricius presented with haemorrhage, oedema and necrosis. Indigenous chickens had the highest average mortality rate (39.2%), followed by layers (31.1%) and broilers (13.4%) Difference in average mortality rates between layers, broilers and indigenous flocks was, however, not statistically significant (P&gt;0.05). There was also no association between flock type and level of mortality rate (P&gt;0.05). Effective control strategies should be developed to target the three chicken flock types in Kenya.Keywords: Infectious bursal disease, vaccination failure, disease control, chicken productio

Isolation, Characterization, and Quantification of Bacteria from African Sausages Sold in Nairobi County, Kenya

African sausages are local popular delicacies in Kenya. Demand for these sausages has resulted in this delicacy’s vendors being on the increase. However, health risk posed to unsuspecting consumers of African sausages sold in informal, unhygienic make shift road-side kiosks in major cities of Kenya is largely unknown. A descriptive study was designed to isolate, characterize and quantify bacteria from African sausages sold in Nairobi County. A total of hundred (100) African sausages (62 roasted and 38 nonroasted) were conveniently collected from three meat eatery points of Westlands, Kangemi slum, and Pangani estates. Five genera of bacteria, namely, Staphylococcus spp. at 50.4%, Bacillus spp. at 19.5%, Streptococcus spp. 9.8%, Proteus spp. 2.4%, and E. coli spp. at 1.6%, were isolated from 80 African sausage samples. The total aerobic bacterial count range was between 1.0-9.9x101 and 1.0-9.9x107 log cfu/g with 37 samples having total aerobic bacterial count of between 1.0-9.9 x104 and 1.0-9.9 x107 log cfu/g. There was no significant difference (p&gt;0.05) in distribution of isolates and total aerobic bacterial count across geographical sites studied among the roasted and nonroasted African sausages. This study has demonstrated presence of bacteria in African sausages which are potentially zoonotic to humans. Comprehensive study is needed to sample more eatery meat points in Nairobi and other areas in order to demonstrate pathogenic attributes of these isolates and establish the respective total aerobic bacterial count. There is also need to establish the sources of bacteria due to high total aerobic bacterial count determined in the current study

Appraisal of Village Chickens Potential in Egg Production

A study was carried out on the laying capacities of Village / indigenous and exotic / commercial hens that were brought to the Agricultural Society of Kenya show, Nairobi, over a period of 10 years. The parameter of egg-production capacity was estimated by the pliability of bones, especially the pubic bone spread and the space between the pubic bone and the keel bone; measured as number of fingers that can fit between each space, respectively. The results showed that some of the indigenous birds had good laying capacities, contrary to popular belief. Some indigenous birds were close to, and others had higher laying capabilities than the respective commercial ones. This observation indicates that, with a little extra effort in management and genetic selection, these village birds have a potential of increasing their egg yields. The Kenya Veterinarian Vol. 29 2005: pp. 10-1

A Study on Effectiveness of Seven Disinfectants Against Possible Bacteria Contaminants of Coops and Premises Inhabited by Indigenous Chickens and Ducks

Seven commonly used disinfectants abbreviated as A, B, C, D, E, F and G (A is, Glutaraldehyde and Coco – benzyl dimethyl ammonium chloride; B is, Didecyldimethyl ammonium bromide 50% w\\v; C is, Sodium hypochlorite; D is, pine disinfectant and antiseptic; E is, chloroxylenol; F is, phenol and that for disinfectant G is, cresol and soap solution) were evaluated for their effectiveness in disinfecting coops and premises of indigenous chickens and ducks. Bacterial isolates from 14 samples (each sample comprising of a pharyngeal and a cloacal swab from one bird pooled together) from village chickens and ducks were used in this study. The isolates were taken to represent microorganisms in the birds\' environment. Results showed that effectiveness amongst the disinfectants varied markedly. Two disinfectants were very effective (sensitivity of 80% and 60% respectively), three were moderate (30% sensitivity, each) and two were ineffective. Some of them were effective only at a concentration higher than that recommended by the manufacturer. For effective disinfection occasional sensitivity testing is therefore recommended. The Kenya Veterinarian Vol. 29 2005: pp. 113-11