Genetic characterization of influenza A(H3N2) viruses circulating in coastal Kenya, 2009-2017

Background Influenza viruses evolve rapidly and undergo immune driven selection, especially in the hemagglutinin (HA) protein. We report amino acid changes affecting antigenic epitopes and receptor‐binding sites of A(H3N2) viruses circulating in Kilifi, Kenya, from 2009 to 2017. Methods Next‐generation sequencing (NGS) was used to generate A(H3N2) virus genomic data from influenza‐positive specimens collected from hospital admissions and health facility outpatients presenting with acute respiratory illness to health facilities within the Kilifi Health and Demographic Surveillance System. Full‐length HA sequences were utilized to characterize A(H3N2) virus genetic and antigenic changes. Results From 186 (90 inpatient and 96 outpatient) influenza A virus‐positive specimens processed, 101 A(H3N2) virus whole genomes were obtained. Among viruses identified in inpatient specimens from 2009 to 2015, divergence of circulating A(H3N2) viruses from the vaccine strains A/Perth/16/2009, A/Texas/50/2012, and A/Switzerland/9715293/2013 formed 6 genetic clades (A/Victoria/208/2009‐like, 3B, 3C, 3C.2a, 4, and 7). Among viruses identified in outpatient specimens from 2015 to 2017, divergence of circulating A(H3N2) viruses from vaccine strain A/Hong Kong/4801/2014 formed clade 3C.2a, subclades 3C.2a2 and 3C.2a3, and subgroup 3C.2a1b. Several amino acid substitutions were associated with the continued genetic evolution of A(H3N2) strains in circulation. Conclusions Our results suggest continuing evolution of currently circulating A(H3N2) viruses in Kilifi, coastal Kenya and suggest the need for continuous genetic and antigenic viral surveillance of circulating seasonal influenza viruses with broad geographic representation to facilitate prompt and efficient selection of influenza strains for inclusion in future influenza vaccines

Knowledge and attitude as determinant factors in HIV care among pregnant women in Rachuonyo North, Homa-Bay County, Kenya

Background: Mothers knowledge and attitude on PMTCT is a highly effective intervention with enormous potential to enhance access and utilization of PMTCT services Objective: To assess knowledge, attitude and practices of HIV infected women on Prevention of mother to child transmission attending antenatal care clinics in Rachuonyo North, Homa- Bay County, Kenya. Design: A cross sectional study Setting: Twenty antenatal care clinics in Rachuonyo North, Homa-Bay County, Kenya Subjects: HIV infected pregnant women.Results: PMTCT coverage and utilization was 77%. Majority (71.2%, 95% CI: 66.7 – 75.7) of the respondents had positive health seeking behaviours. Approximately 65.5%, of respondents understood four prong approach of PMTCT whereas, 64.9% of the respondents attended ANC clinics > 4 visits which is standard with WHO. The reasons cited by respondents for PMTCT interventions included ARV prophylaxis with EBF (42.1%, 95% CI: 37.2 – 47.1) ARV prophylaxis with BM substitute (22.9%, 95% CI:18.9 - 27.3) among others. There was significant association between attitude on PMTCT and health seeking behaviour, (AOR = 1.57, 95%CI: 1.09 – 4.15) and p=0.004<0.05. Willingness to test for HIV had a significant association with attitude on PMTCT (AOR =1.90, 95% CI: 1.08 – 8.21) with p - value<0.001. Conclusion: There was significant association between attitude on PMTCT and health seeking behaviour. Knowledge on when MTCT occurs in pregnancy and delivery is critical and key determinant to influence access and utilization of PMTCT services. Accurate information on the PMTCT service access and utilization significantly addresses psychosocial support services

Nutritional Characteristics of \u3ci\u3eBrachiaria ruziziensis\u3c/i\u3e (Germain & Evrard) Subjected to Different Doses of Gamma Rays

Appropriate methods of mutation induction are of high importance in pastures for increased genetic variability and improved forage performance. The objective of this research was to improve agronomic and nutritive performance of mutant lines through induced mutagenesis to seeds of a local landrace Brachiaria ruziziensis. The seeds were irradiated with 0, 10, 20, 30, and 40Gy doses of gamma radiation from Cobalt 60 (60Co). Treatments were; KE 0Gy, KE 10Gy, KE 20Gy, KE 30Gy, and KE 40Gy resulting into M1 seeds. The seeds were planted in the greenhouse in germination pots then transplanted to the field. Seeds of M6 plants (M7 seeds) were used to establish field experiment in a completely randomized block design, with three replications. Parameters measured included; tillering, leaf-stem ratio, dry matter, mineralogy, digestibility, and crude protein. Data collected was analyzed using Genstat version 18 software. Growth parameters that were affected by radiation included tillering and days to 50% flowering. Radiation increased neutral detergent fiber (NDF), acid detergent fiber (ADF), and crude protein (CP). NDF had high positive correlation with ADF, CP had high positive correlation with leaf length. Results from agronomic performance, nutrient profiles indicated that the mutant lines differed from their parents. The mutant lines could be selected, multiplied and used in feeding trials to determine reproductive performance of dairy cattle fed on the mutant lines. Future studies should focus on total mixed ration formulation using the mutant lines, designed feeding trials, fractionation of amino and fatty acids from the lines for incorporation in poor forages and national performance trials of mutant lines with an aim of forage variety release. Application of nuclear technology to other grasses would lead to increased biomass and improved nutrition for increased animal productivity leading to food and nutrition security

A Viewpoint of Tanzania E-Commerce and Implementation Barriers

The growing rate of ICT utilization particularly the Internet and mobile phones has influenced at an exponential rate online interaction and communication among the generality of the populace. However, with the enormity of businesses on the Internet, Tanzania is yet to harness the opportunities for optimal financial gains. This study is exploratory in nature as it attempts to unveil the prospects of e-commerce implementation, participation, motivation and opportunity to the developing countries like Tanzania where by the domestic market is very big to ensure the growth of agricultural sector. The paper proposes to investigate the ability of consumers to purchase online, the available motivation to do so, and the opportunities for Internet access. We argue the Government and central bank to encourage innovative new technological developments by pre-regulating electronic money to familiarize itself with electronic money schemes generally. Findings revealed that Tanzanians have the ability to participate in e-commerce, but there is need for improved national image to bring in the element of trust and discipline within, and before the international communities. Currently, consumers source for information online but make purchases the traditional way

Determinants of Capital Flight in the East African Community

The region has lost an immense amount of capital that has led to sluggish regional integration in terms of capital formation and productive capabilities. Albeit most of these countries are in the ranking list of the huge volumes of capital flight, East Africa has never been considered as a sub-region in the capital-related studies. Cognizant of this, this paper intends to contribute to this body of knowledge by filling a noticeable gap. This paper examined the determinant of capital flight from East African Community countries that include Kenya, Tanzania, Uganda, Rwanda, and Burundi using panel data for the years 1988 to 2018 using the real gross domestic product, interest rate differential, external debt, corruption index, and exchange rate as explanatory variables. Secondary data obtained from EAC member countries National Bureau of Statistics. Levin-Lin-Chu panel unit root test was carried out and capital flight and Exchange rate found to be stationary at level. The fixed effect regression results showed that corruption, external debt, and the exchange rate had a positive and statistically significant effect on capital flight while real GDP had a negative and statistically significant effect on capital flight. Thus, policymakers should endeavor to achieve a broad investor base for its domestic and foreign obligations, with due regard to cost and risk, and should treat investors equally. In addition, there is a need to harmonize the judiciary and the executives in EAC to facilitate the fight against corruption which is a major concern for a capital flight. Keywords: Capital flight, External debt, Exchange rate, GDP, Corruption, EAC DOI: 10.7176/JESD/12-10-01 Publication date:May 31st 2021

Predictors of HIV Antiretroviral Treatment Failure among Patients Attending a Semi - Urban HIV Clinic– Kenya, 2012: Can Social Support Help?

Background: HIV antiretroviral treatment [ART] failure increases morbidity and mortality. In Kenya, use of treatment supporter, HIV serostatus disclosure, and support groups are believed to reduce the risk of treatment failure by improving adherence. Methods: We conducted a case-control study to identify factors associated with clinical or immunologic indicators of treatment failures. Cases and controls were adult patients attending a semi-urban HIV clinic who initiated ART at least six months prior to the study. Cases were patients who had a] a decline in CD4 count [below baseline or 30% from highest value since ART initiation] or b] unimproved CD4 counts or c] a World Health Organization [WHO] stage III or IV opportunistic infection. Controls did not meet either immunologic or clinical criteria for treatment failure. Information was obtained through face-to-face interviews medical chart reviews. Results: We enrolled 52 cases and 104 controls. Twenty-eight [53%] cases and 71 [70%] controls were women, and median age was 44 years [range: 38-50 years] among cases and 43 years [range: 38-49 years] among controls. Discontinued ART for 2 weeks or more [adjusted odds ratio [AOR] 8.9, 95% confidence interval [CI] 1.4-57.4] and alcohol use [AOR 7.2, 95% CI 1.1-45.5] were found to significantly increase the risk of ART failure. Compared to men who discontinued ART for less than 2 weeks, women who discontinued ART for less than 2 weeks had reduced risk [AOR 0.4, 95% CI 0.2-0.9] while those who discontinued for two weeks or more had a greater risk [AOR 12.97, 95% CI 1.5-111.8] of developing ART failure. Social support factors were not associated with treatment failure. Conclusions: Discontinuing ART and alcohol use were identified to be modifiable factors associated with clinical or immunologic criteria of ART failure. Interventions with proven efficacy at reducing alcohol use and increasing continuous ART should be implemented.Key words: Antiretroviral treatment failure, HIV, AIDS, adherence, alcohol, Keny

Health Implications of Sexual Violence Among Survivors in Selected Health Facilities in Kenya: Are There Gender Disparities?

Sexual based violence (SBV) is a serious public health problem with profound impact on physical, social and mental health, both immediately and many years after the assault. The global statistics on sexual assault against women indicates that, at least one in every three (34%) has been beaten and/or coerced into sex. A World Health Organisation (WHO) multi-country study reports that between 16% and 59% women from Africa had ever experienced sexual violence. In Kenya, about 24% of women have been raped at least once. Nairobi women Hospital alone receives an average of 230 survivors per month, with approximately 45% being children, 49% women and 6% men respectively. The main aim of this study was to investigate the gender disparities in health implications of SBV among survivors in three health facilities in Kenya. This was a cross-sectional study involving 236(84.3%) female and 44(15.7%) male survivors were enrolled in the study. The study established that sexual based violence resulted into health consequences (76.8%) including psychological trauma 143(51%), physical injuries 75(27%), STIs 38(14%), gynaecological disorders 35(12%), Human Immunodeficiency Virus (HIV) 32(11%), gastrointestinal disorders 21(7%) and unwanted pregnancies 17(6%). The results showed that females and males who developed health complications were not significantly different (χ2=0.223; df=1; p= 0.637). Males were more likely to suffer from psychological trauma, physical injuries and gastrointestinal injuries compared to females (OR= 1.2, CI= 0.6- 2.2; OR= 0.2, CI= 0.1- 5.0; and OR= 0.7, CI= 0.4- 1.5). On the hand, the study established that females were more likely to suffer from Sexually Transmitted Infection (STIs) (OR= 1.4, CI= 0.3- 6.0), gynaecological disorders (OR= 1.5, CI=0.5- 4.5), HIV (OR= 1.9, CI= 0.6- 6.6), and unwanted pregnancies (OR= 2.3, CI= 0.7- 8.1) compared to males. There is an urgent need to deal with the problems of SBV by preventing and stopping it. There should be a collaborative approach between all the stakeholders including the community, ministries of Medical Services and Public Health & Sanitation, private and non-governmental organization in dealing with sexual based violence and health implications resulting from it. Keywords: Sexual based violence, health implications, survivors, males DOI: 10.7176/JHMN/66-03 Publication date:September 30th 201