Factors influencing cervical cancer screening in a Kenyan Health Facility: a mixed qualitative and quantitative study

Background: Cervical cancer is the commonest cause of cancer-related morbidity and mortality among women in developing countries in sub-Saharan Africa. Screening for cervical cancer among HIV infected women is crucial as they are more at risk of developing the disease and progressing faster once infected with Human Papilloma Virus (HPV).Methods: We aimed to determine the factors affecting the utilization of cervical cancer screening among HIV infected women above 18 years of age at Kenyatta National Hospital by conducting a cross-sectional mixed quantitative and qualitative methods study. Descriptive and inferential analysis was carried out on quantitative data to determine significant associations with cervical cancer utilization. Qualitative data were analyzed after coding for significant clauses and transcribing to determine themes arising.Results: Three hundred and twenty eight of the total 387 women enrolled reported they had been advised by their health providers to go for screening. However, only 179 (46%) reported cervical cancer screening.  Women were more likely to report cervical cancer screening if recommendation by a staff was made (p <0.001), and prior to joining KNH CCC (p <0.001). Qualitatively the main barrier to screening included fear of screening due to concerns about excessive pain or bleeding, lack of proper communication on screening procedures and long waiting timeConclusions: The utilization of cervical cancer screening services was low despite high rates of health care recommendation. The women were more likely to utilize the service if recommendation from the health care worker was made, and if they had ever screened before

Simulation model for solar energy harnessing by the solar tunnel dryer

Models were developed to predict global solar radiation and the energy harnessed by a solar tunnel dryer, and simulated in Visual Basic 6. &nbsp;In addition, the simulated data were compared with actual data. &nbsp;Using a 10% absolute residual error interval, the developed model achieved 78.4% and 83.3% performance for global solar radiation and energy harnessing, respectively. &nbsp;Further, the relationship between global solar radiation and the ten years mean satellite solar radiation, and that between the actual and simulated plenum chamber temperatures were linear, with coefficients of determination (R2) of 0.788 and 0.962. &nbsp;Thus, it shows that there is the existence of strong correlation between satellite and predicted global solar radiation, and between predicted and actual plenum chamber temperatures. &nbsp;Furthermore, Student&rsquo;s t-test did not show any significant difference between simulated and actual data for solar radiation and energy harnessing. &nbsp;Finally, this study shows that the developed model can be used to predict solar radiation and the energy harnessed by the solar tunnel dryer.Keywords: modeling, tunnel-dryer, global, direct, solar-radiation, plenum-temperature&nbsp;Citation: Kituu G. M., D. Shitanda, C. L. Kanali, J. T. Mailutha, C. K. Njoroge, J. K.Wainaina, and J. S Bongyereire. Simulation model for solar energy harnessing by the solar tunnel dryer. &nbsp;Agric Eng Int: CIGR Journal, 2010, 12(1): 91-98

A comparative study of Multiple versus Single infection doses of Schistosoma haematobium in Golden hamsters ( Mesocricetus auratus )

Schistosoma haematobium is widely distributed in Africa. In Kenya, endemic areas include the upper and the lower regions of the Coast Province, Lake Victoria and the Kano plains. Low infection rates over prolonged periods of time characterize schistosome infections of people living in endemic areas. However, the common laboratory practice is to expose the definitive host to a single high dose. In order to utilize the laboratory results appropriately, it is important to know whether or not a large single infection has similar results to multiple small doses. In this study, immune responses, worm burden, gross and histopathological patterns of multiple infection of S. haematobiumium in the Golden hamster ( Mesocricetus auratus ) were compared with those of single exposure. Multiple infections with low doses of the parasite did not seem to be protective, as suggested by; more worms, worse gross and histopathology in multiple low dose group compared to single high dose group. Most probably there is an antigenic threshold, which needs to be attained before protective mechanisms come into play. Although necessary for protection, there was no direct correlation between IgG levels and degree of protection

Identification and Toxigenicity of Aspergillus spp. from Soils Planted to Peanuts in Eastern Zambia

It is not known which aflatoxigenic species are present in Zambia. Therefore, soil samples were collected during May to June 2012, at the end of the growing season in Eastern Province, from 399 farmers' fields that had been planted to groundnut (Arachis hypogaea L.) in Nyimba, Petauke, Mambwe, and Chipata Districts. Population densities of Aspergillus spp. were estimated by plating 10−3 soil dilutions on modified dichloran rose Bengal (MDRB) media. To test for toxigenicity, colonies were randomly selected from MDRB dilution plates, single-spored, transferred to vials with yeast extract sucrose (YES) liquid media, and grown for a week at room temperature. Agra Strip ® lateral flow cards were then used to test the filtered extracts, from the YES cultures, for total aflatoxin at 4 and 20 parts per billion (ppb). We identified Aspergillus flavus (small and large sclerotia strains), A. parasiticus, A. niger, A. nomius, A. oryzae, A. tamarii, and A. terreus. 100% of the S-strain A. flavus isolates produced aflatoxin at 4 and 20 ppb, whereas 86% and 56% of the L-strain A. flavus isolates produced aflatoxins at 4 and 20 ppb, respectively. All the A. nomius isolates produced aflatoxins at 4 and 20 ppb. 79% and 64% the A. parasiticus isolates produced aflatoxins at 4 and 20 ppb. To our knowledge, this is the first peer reviewed report from Zambia documenting the population densities of A. flavus across different agroecologies. In addition, it is also the first report on the identification of different Aspergillus spp., such as A. nomius, A. terreus, A. oryzae, and A. tamarii from Zambia. This information, taken together with cropping practices, soil characteristics, agroecological and climatic data, can form a basis for developing holistic pre-harvest aflatoxin mitigation strategies

In vitro antiviral activity of SCH446211 (SCH6), a novel inhibitor of the hepatitis C virus NS3 serine protease.

Current hepatitis C virus (HCV) therapies may cure approximately 60% of infections. They are often contraindicated or poorly tolerated, underscoring the need for safer and more effective drugs. A novel, alpha-ketoamide-derived, substrate-based inhibitor of the HCV serine protease (SCH446211) was developed. Compared with earlier reported inhibitors of similar chemical class, it has a P1'-P2' extension which provides extended interaction with the protease active site. The aim of this study was to evaluate the in vitro antiviral activity of SCH446211. Binding constant of SCH446211 to HCV NS3 protease was measured with the chromogenic substrate in vitro cleavage assay. Cell-based activity of SCH446211 was evaluated in replicon cells, which are Huh-7 hepatoma cells stably transfected with a subgenomic HCV RNA as reported previously. After 72 h of incubation with SCH446211, viral transcription and protein expression were measured by real-time RT-PCR (TaqMan), quantitative in situ hybridization, immunoblot and indirect immunofluorescence. The binding constant of SCH446211 to HCV NS3 protease was 3.8 +/- 0.4 nM. HCV replication and protein expression were inhibited by SCH446211 in replicon cells as consistently shown by four techniques. In particular, based on quantitative real-time RT-PCR measurements, the IC50 and IC90 of SCH446211 were estimated to be 40 +/- 20 and 100 +/- 20 nM (n = 17), respectively. Long-term culture of replicon cells with SCH446211 reduced replicon RNA to &lt;0.1 copy per cell. SCH446211 did not show cellular toxicity at concentrations up to 50 microM. SCH446211 is a potent inhibitor of HCV protease in vitro. Its extended interaction with the HCV NS3 protease active site is associated with potent in vitro antiviral activity. This observation is potentially a useful guide for development of future potent inhibitors against HCV NS3 protease

ANTIINFLAMMATORY PROPERTIES OF DICHLOROMETHANE: METHANOLIC LEAF EXTRACTS OF CAESALPINIA VOLKENSII AND MAYTENUS OBSCURA IN ANIMAL MODELS

Objective: Inflammation is the reaction to injury of the living tissues. Conventional medication of inflammation is expensive and arguably associated with various severe adverse effects hence the need to develop herbal agents that are effective as alternative. Caesalpinia volkensii and Maytenus obscura are plants that grow in Mbeere County of Eastern region of Kenya. This study was designed to evaluate the anti-inflammatory activity of C. volkensii and M. obscura plants. Methods: Experimental animals were divided in to four groups; normal group, diseased negative control group, diseased reference group and diseased experimental groups. Inflammation was inducted into the mice using carrageenan. The experimental groups were treated with leaf extracts of the plants at concentration of 50 mg/kg, 100 mg/kg and 150 mg/kg. Anti-inflammatory activities in rats were compared with diclofenac (15 mg/kg) as the standard conventional drug. Results: The leaf extracts of C. volkensii reduced the paw edema by between 6.50%-13.42% while the extracts of M. obscura reduced it by between 4.94%-22.36%. Diclofenac reduced the paw edema by between 4.11%-10.47%. Conclusion: The phytochemical screening results showed that the extracts of C. volkensii had flavonoids, steroids and phenolics while the leaf extracts M. obscura had phenolics, terpenoids and saponins. Flavonoids, saponins and phenolics have been associated with anti-inflammatory activities. Therefore, the study has established that the DCM: methanolic leaf extracts of Caesalpinia volkensii and Maytenus obscura are effective in management of inflammation

Functional Biology and Molecular Mechanisms of Host-Pathogen Interactions for Aflatoxin Contamination in Groundnut (Arachis hypogaea L.) and Maize (Zea mays L.)

Aflatoxins are secondary metabolites produced by soilborne saprophytic fungus Aspergillus flavus and closely related species that infect several agricultural commodities including groundnut and maize. The consumption of contaminated commodities adversely affects the health of humans and livestock. Aflatoxin contamination also causes significant economic and financial losses to producers. Research efforts and significant progress have been made in the past three decades to understand the genetic behavior, molecular mechanisms, as well as the detailed biology of host-pathogen interactions. A range of omics approaches have facilitated better understanding of the resistance mechanisms and identified pathways involved during host-pathogen interactions. Most of such studies were however undertaken in groundnut and maize. Current efforts are geared toward harnessing knowledge on hostpathogen interactions and crop resistant factors that control aflatoxin contamination. This study provides a summary of the recent progress made in enhancing the understanding of the functional biology and molecular mechanisms associated with host-pathogen interactions during aflatoxin contamination in groundnut and maize

A Case for Regular Aflatoxin Monitoring in Peanut Butter in Sub-Saharan Africa: Lessons from a 3-Year Survey in Zambia

A 3-year comprehensive analysis of aflatoxin contamination in peanut butter was conducted in Zambia, sub-Saharan Africa. The study analyzed 954 containers of 24 local and imported peanut butter brands collected from shops in Chipata, Mambwe, Petauke, Katete, and Nyimba districts and also in Lusaka from 2012 to 2014. For analysis, a sample included six containers of a single brand, from the same processing batch number and the same shop. Each container was quantitatively analyzed for aflatoxin B1 (AFB1) in six replicates by using competitive enzyme-linked immunosorbent assay; thus, aflatoxin contamination level of a given sample was derived from an average of 36 test values. Results showed that 73% of the brands tested in 2012 were contaminated with AFB1 levels >20 μg/kg and ranged up to 130 μg/kg. In 2013, 80% of the brands were contaminated with AFB1 levels >20 μg/kg and ranged up to 10,740 μg/kg. Compared with brand data from 2012 and 2013, fewer brands in 2014, i.e., 53%, had aflatoxin B1 levels >20 μg/kg and ranged up to 1,000 μg/kg. Of the eight brands tested repeatedly across the 3-year period, none consistently averaged ≤20 μg/kg. Our survey clearly demonstrates the regular occurrence of high levels of AF B1 in peanut butter in Zambia. Considering that some of the brands tested originated from neighboring countries such as Malawi, Zimbabwe, and South Africa, the current findings provide a sub-Saharan regional perspective regarding the safety of peanut butter

Prevalence and determinants of human papillomavirus infection and cervical lesions in HIV-positive women in Kenya

Background: We assessed the association of human papillomavirus (HPV) infection and cervical intraepithelial neoplasia (CIN) with various characteristics, CD4 count and use of combination antiretroviral therapy (cART) among HIV-positive women. Methods: Cross-sectional study of 498 HIV-positive women who underwent HPV PCR-based testing, cytology, and systematic cervical biopsy. Results: In all, 68.7% of women were HPV-positive, 52.6% had high-risk (hr) HPV, and 40.2% multiple type infections. High-risk human papillomavirus-positivity did not vary significantly by age but it was negatively associated with education level. The most frequent types in 113 CIN2/3 were HPV16 (26.5%), HPV35 (19.5%), and HPV58 (12.4%). CD4 count was negatively associated with prevalence of hrHPV (Po0.001) and CIN2/3 among non-users of cART (P¼0.013). Combination antiretroviral therapies users (X2 year) had lower hrHPV prevalence (prevalence ratio (PR) vs non-users¼0.77, 95% confidence interval (CI): 0.61–0.96) and multiple infections (PR¼0.68, 95% CI: 0.53–0.88), but not fewer CIN2/3. The positive predictive value of hrHPV-positivity for CIN2/3 increased from 28.9% at age o35 years to 53.3% in X45 years. Conclusion: The burden of hrHPV and CIN2/3 was high and it was related to immunosuppression level. Combination antiretroviral therapies (X2 year) use had a favourable effect on hrHPV prevalence but cART in our population may have been started too late to prevent CIN2/3

Aflatoxin B1 contamination of groundnut Arachis hypogaea L. in eastern Zambia

Groundnut is a rich source of protein and it is the second most widely grown crop in eastern Zambia. A survey was conducted in 2012 to determine the incidence of aflatoxin B1 contamination in groundnuts from several districts important in groundnut production in eastern Zambia. Nyimba and Mambwe districts are in the Luangwa Valley and are comparatively hotter and drier than Chipata and Petauke districts which lie in the cooler plateau. 399, 1 kg unshelled groundnut samples were collected from farmers’ fields and also from homesteads upto 1 month after harvest. Aflatoxin B1 was assayed in each shelled sample by weighing and comminuting 100 g subsample and extracting aflatoxin from six 20 g aliquots. ELISA was used to estimate aflatoxin levels and the six values averaged to give the sample contamination. 34 and 27% of samples from Nyimba (maximum=4,980 ppb and arithmetic mean [AM] =1.1) and Mambwe (maximum=69 ppb and AM=0.7), respectively, had aflatoxin levels greater than 20 ppb. In comparison, 38 and 28% of samples from Petauke (maximum=3,258 ppb and AM=0.9) and Chipata (maximum=1,077, and AM= 0.8), respectively, had aflatoxin levels greater than 20 ppb. At the beginning of the season, priority is given to planting maize and cotton, while planting groundnut is delayed, increasing the risk of the crop being exposed to end-of-season drought. The aflatoxin contamination levels we report are a barrier to trade and the well being of consumers