Influence of Cold Chain Supply Logistics on the Safety of Vaccines. A Case of Pharmaceutical Distributors in Nairobi County

Supply of safe vaccines is very important and appropriate procedures, monitoring and logistics systems need to be put in place to ensure safety. The pharmaceutical supply chain have various global regulatory requirements to be met during transport ,storage, packaging and  handling environmentally sensitive products like biologicals, vaccines and some medicines. This is to ensure that quality and efficacy of cold chain products is not compromised along the supply chain. Global players have regulations and guidelines that address product integrity and safety during the entire supply chain. It was therefore of importance to identify how Pharmaceutical distributors in Nairobi County have developed their cold chain supply systems and how it is able to maintain cold chain for temperature-sensitive pharmaceuticals considering the challenges of; Transport systems, storage facilities, packaging, technical capacity, unreliable electricity supply, weak validation systems, probable poor monitoring of cold chain supply systems. The main objective of the study was to establish the influence of supply chain logistics in supply of safe pharmaceutical cold chain products in Pharmaceutical distributor firms in Nairobi County while the specific objectives were to determine how storage conditions in pharmaceutical distributors in Nairobi influences safety of vaccines; to determine the influence of transport systems on the safety of vaccine; to evaluate the influence of Packaging on the safety of vaccines and finally establish the extent to which technical capacity influence safety of Vaccines in pharmaceutical distributors in Nairobi. Descriptive survey design was considered because it is non-experimental and studies the relationship between non-manipulated variables in a natural setting. The study was carried out in five major pharmaceutical firms out of 16 registered cold chain pharmaceutical distributors in Nairobi County. A sample size of 67 participants was selected out of a population of 211 staff from different firms consisting of the automatically included 5 supply chain managers and 62 employees from procurement and stores department. The data was collected by use of self-administered questionnaires to the sampled respondents by a drop and pick method. The questionnaires were coded and data analyzed using Statistical Package for Social Science (SPSS V-17).Correlation analysis was done to determine the relationship between the dependent and independent variables whereby it was found that technical capacity and storage conditions have the greatest relationship and influence to the safety of vaccines. The findings were presented through figures, tables, and graphs. Keywords: Cold chain, logistics, Pharmaceuticals, Safet

Value chain analysis and sanitary risks of the camel milk system supplying Nairobi city, Kenya

The camel milk trade in Kenya has evolved significantly from a small-scale business undertaken in local villages to its current status involving a large number of different stakeholders supplying urban towns, particularly Nairobi City. Despite the evident growth pattern, the supply of camel milk to Nairobi has largely remained informal, with minimal enforcement of regulations. The aim of this study was to characterise the camel milk system supplying Nairobi and assess its governance, main challenges and the potential food safety risk practices. A value chain analysis framework was used to carry out data collection between August 2014 and July 2015. Qualitative and quantitative data were collected through focus group discussions and key informant interviews with stakeholders operating in different nodes of the value chains. Three milk value chains supplying Nairobi were identified and mapped: the Isiolo chain, the Kajiado chain and the camel milk processing company chain. Overall, the results indicate that 94% of the milk supplied to Nairobi city is informally traded (traded without any effective regulation), while 6% originates from a formal milk processing company. In the informal chains, milk traders (mostly women) were reported to play a pivotal role in the organisation and daily functioning of the chains. The processing company had partly integrated activities and reported exporting 5% of their products to regional and international markets. Food safety themes identified were associated with i) lack of cold chain, ii) gaps in hygiene practices, particularly at farm and market levels, iii) consumption of raw camel milk, and iv) lack of food safety training, among other issues. Low level involvement by government agencies in enforcing stipulated food safety measures were reported in the informal chains, as these concentrate efforts in the regulation of dairy milk chains. Isiolo milk traders were identified as the dominant group, setting milk prices and providing sanctions. The framework and findings obtained can help future research and policy makers to reach informed decision about what to regulate, where to target and importantly how to make the camel milk value chain more efficient and safer

A Comparison of the Reverse Passive Latex Agglutination and Enzyme Linked Immunosorbent Assay Techniques for Detection of Staphylococcal Enterotoxins

A study was carried out to compare the Reverse Passive Latex Agglutination (RPLA) and Enzyme Linked Immunosorbent Assay (ELISA) techniques for detection of staphylococcal enterotoxins (SEs). One hundred and one Staphylococcus aureus (S. aureus) isolates were recovered from milk and meat samples. Isolates were tested for their ability to produce any of the staphylococcal enterotoxin types A, B, C, and D. Sixty seven S. aureus isolates were found to be enterotoxigenic, using ELISA, while 62 isolates were found to be enterotoxigenic with RPLA technique. Staphylococcal enterotoxin C was the most frequent enterotoxin detected by both ELISA and RPLA. This study found no significant difference in the sensitivity of ELISA and RPLA techniques for detection of staphylococcal enterotoxins (t=0.908; df=3; p=0.431). It was concluded that ELISA and RPLA are comparable tests and any of them can be used to test for staphylococcal enterotoxins. However, the RPLA test appears to be most suitable for screening a large number of isolates for staphylococcal enterotoxins because it is less cumbersome, less costly and rapid. Kenya Veterinarian Vol. 31 (1) 2007: pp. 20-2

Detection of staphylococcal enterotoxins in milk and meat in Nairobi Kenya using Enzymes Linked Immunosorbent Assay

Staphylococcus aureus is a cause of food poisoning in humans characterized by vomiting, headache, abdominal pain, and diarrhoea that occur 1-6 hours following consumption of contaminated food. This study was carried to determine the rate of contamination of milk and meat products with enterotoxigenic S. aureus in Nairobi. Analysis was done at the Department of Public Health, Pharmacology and Toxicology, University of Nairobi. A total of 400 milk and meat products were collected around Nairobi. The samples included 200 raw milk, 100 beef carcass swabs, 50 minced meat samples and 50 chicken carcasses. Mannitol salt agar was used as selective and indicator medium for isolation of S. aureus from food samples. Staphylococcus was identified using a number of different diagnostic tests, which included oxidative fermentation, Mannitol fermentation, coagulase production and deoxyribonuclease (Dnase) production assays. Enterotoxin production was detected using Enzyme linked immunosorbent assay (ELISA) using Staphylococcus Enterotoxin Enzyme Immunoassay (SET-EIA) kit. One hundred and one (101) S. aureus were isolated from food samples. Of these, 22 were from chicken, 16 from minced meat, 55 from raw milk and 8 from beef carcasses. Sixty-seven of S. aureus were found to be enterotoxigenic. Staphylococcal enterotoxins SEA, SEB, SEC and SED were tested for, and SEC was the most frequent accounting for 59 (88%). Twenty-four (38.5%) of the enterotoxigenic S. aureus produced single enterotoxins. Chicken carcasses accounted for the highest percentage (44%) of enterotoxigenic S. aureus in foodstuff with SEC producing strains having the highest percentage. Keywords: Staphylococcal enterotoxins among foodstuff > Journal of Tropical Microbiology and Biotechnology Vol. 3(1) 2007: pp. 23-2

IMMUNOASSAY AND POLYMERASE CHAIN REACTION TECHNIQUES FOR DETECTION OF ENTEROTOXIGENIC BACILLUS CEREUS

Objectives: To compare the Reverse Passive Latex Agglutination (RPLA) and Enzyme Linked Immunosorbent Assay (ELISA) techniques with a Polymerase Chain Reaction (PCR) for detection of enterotoxigenic Bacillus cereus.Design: A cross-sectional study.Setting: The Department of Public Health, Pharmacology and Toxicology, Faculty of Veterinary Medicine, University of Nairobi.Subjects: Forty seven Bacillus cereus strains previously isolated from foods.Main outcome measures: Detection of hemolysin BL, non-hemolytic enterotoxin, binding protein gene (hblA) of the hemolysin BL, and binding protein gene (nheA) of nonhemolytic enterotoxin.Results: Twenty five (53.2%) of the isolates produced hemolysin BL, while 81% of them produced non-hemolytic enterotoxin. Thirty eight (38.3%) produced both hemolysin BL and non-hemolytic enterotoxin. A polymerase chain reaction amplification assay detected the presence of hblA gene in all hemolysin BL positive isolates and nheA gene in 91.5% of non-hemolytic enterotoxin positive isolates. There was a strong association between PCRtest and RPLA test (Pearson's X2 = 12.65; p< 0.001) as well as between PCR test and visual immunoassay test(Pearson's chi-square X2 =18.46: p< 0.01).Conclusion: Polymerase chain reaction amplification assay technique for detection of enterotoxigenicity of B. cereus compare well with the immunoassay tests. The technique is sensitive detecting even strains with silent genes, and is rapid with the test complete within 24 hours

Foodborne diseases in Kenya

(East African Medical Journal: 2001 78(1): 40-44

Molecular epidemiology of bacillus cereus food poisoning

(East African Medical Journal 2001 78 (10): 523-525

Relative Occurrence of Fasciola species in cattle, sheep and goats slaughtered at Dagoretti slaughterhouse in Kenya

A cross sectional survey was carried out in Nairobi\'s Dagoretti slaughter house, where routine postmortem meat inspection was done. All liver flukes detected in cattle, sheep and goats were collected and transported to laboratory for analysis to determine the relative occurrence of Fasciola gigantica and Fasciola hepatic in slaughtered cattle, sheep, and goats by observing their size and morphology. The study showed that all the liver flukes collected in Dagoretti were F. gigantica. A total of 1584 cattle, 989sheep and 954 goats originating from five out of the 8 provinces of Kenya were slaughtered at Dagoretti slaughter house, over the study period. 147 (9.3%) cattle, 8 (0.8%) sheep, 4 (0.4%) goats were shown to harbor liver fluke infection. It was concluded that fascioliasis is prevalent in cattle, sheep and goats of Kenya. This may be a cause of great economic losses at slaughter as a result of condemnation of infected livers. The Kenya Veterinarian Vol. 27 2004: pp. 124-12

Prevalence and Economic Importance of Fascioliasis in Cattle, Sheep and Goats in Kenya

A 10 year (1990-1999) retrospective study using post mortem records was carried out at Veterinary Department Headquarters Kabete to determine the prevalence and economic importance of fasciolosis in cattle, goats and sheep in Kenya. Records from abattoirs in 38 districts in 7 provinces of Kenya were examined. Fasciolosis prevalence was calculated. Using an average weight of (3kg) cattle and (0.5) sheep and goats and market price of approximately US $2.0 per Kg, the monetary loss occasioned by condemnation of Fasciola infected livers was calculated. Out of 5,421,188 cattle, 1,700,281 sheep and 2,062,828 goats slaughtered, 427,931 cattle (8$ 2.6million, US$61,995 and US$48,889 respectively. Fasciolosis is prevalent in cattle, sheep and goats in Kenya and a major cause of economic losses, as a result of condemnation of infected livers. The Kenya Veterinarian Vol. 27 2004: pp. 118-12

Antimicrobial resistance in Salmonella serotypes isolated from slaughter animals in Kenya

No Abstract. East African Medical Journal Vol. 84 (5) 2007: pp. 233-23