Isolation, Identification and Antibiotic Susceptibility Profiles of Diarrheagenic Bacteria Associated with Food Handlers in Kericho Town, Kenya

Background: Diarrhea as a result of food contamination from food handlers continues to pose serious public health concern. Food handlers as reservoirs of diarrheagenic bacteria are a constant source of infection to clientele visiting food establishments within both urban and rural settings. Isolating diarrheagenic bacteria from food handlers is necessary for accurate prediction on the frequency of these pathogens and potential changes in antibiotic resistance patterns.Methods: A cross sectional study was conducted in Kericho town to determine the burden of diarrheagenic bacteria among food handlers. A total of 384 stool samples were collected from January 2015 to March 2015.Bacterial pathogens were identified by conventional microbiological methods; antibiotic susceptibility of bacterial isolates was ascertained using the disk diffusion and agar dilution methods.Results: Significant isolates were the Escherichia coli (Enteroinvasive Escherichia coli 5.7%, Enteroaggregative Escherichia coli 2.1%, Enteropathogenic Escherichia coli 2.1%, and Enterotoxigenic Escherichia coli 1.6%), Salmonella isolates 3.1% and Shigella isolates 1.0%. Conclusions: The study findings emphasize the importance of food handlers as potential sources of infections and suggest appropriate hygienic and sanitary control measures. Accurate epidemiologic information on diarrheagenic bacteria associated with food handlers in Kericho town will be critical for augmenting existing diarrhea management policies in terms of treatment and to strengthen future awareness and health promotion programs. Keywords: Diarrheagenic bacteria, antimicrobial resistance, food handlers, Kericho town

Influence of Legal Requirements on Environmental Concern and sustainability Practices in Small and Medium-size Manufacturing Enterprises in Nairobi, Kenya.

Until recently it has been too easy to overlook Small and Medium-size Enterprises in the analysis of environmental impact of particularly the manufacturing sector (ibid 2003). SMEs continue to grow, so do their environmental impacts. SMEs are faced by such challenges as difficulty in raising capital, limited managerial skills, regulatory constraints, limited extension services and difficulty in getting access to technology The study found out that SMEs where copies of environment related laws existed and staffs were aware of the laws, respondents indicated involvement in environmental management practices. It is thus concluded that legal provisions influenced adoption of good environmental management practices by Small and Medium-size Manufacturing enterprises. Key words: Legal Requirements. Environmental Concern. Sustainability Practice

Women, poverty and HIV/AIDS : a challenge to women's spirituality : a case study of Mpererwe Township, Kampala-Uganda.

Thesis (M.Th.)-University of KwaZulu-Natal, Pietermaritzburg, 2006.This study is designed to assess the causes and the effects of poverty and HIV/AIDS on women's spirituality. A case study of Mpererwe Township in Kampala, Uganda was chosen because this researcher has been staying in this township now for 7 years; and has seen most women experiencing difficulties in their daily lives. Poverty and HIV/AIDS among women of Mpererwe Township is a much-needed area of study because the majority of women's lives and their contribution to development have been hampered by economic, religious, political, social and cultural structures. However, all in all, the purpose of this social analysis was first, to identify the factors that render Mpererwe women to be vulnerable to ill situations that pave the way to poverty and HIV/AIDS conditions. Then thereafter, to suggest strategies that may transform the physical, political, religious, economic and social life of women in Mpererwe Township

Characterization and factors associated with diarrhoeal diseases caused by enteric bacterial pathogens among children aged five years and below attending Igembe District Hospital, Kenya

Introduction: Diarrhoea remains a major public health problem in East African nations such as Kenya. Surveillance for a broad range of entericpathogens is necessary to accurately predict the frequency of pathogens and potential changes in antibiotic resistance patterns.Methods: A cross sectional study was conducted in Igembe District Hospital in Meru County to determine the burden and factors associated enteric  bacterial infection among children aged five years and below. Stool  samples were collected between March and July 2012. Bacterial pathogens were identified and antibiotic susceptibility of bacterial isolates was  ascertained. Questionnaire was administered to the 308 study participants to identify the modifiable risk factors. Data was entered and analyzed  using Epi Info version 3.5.3.Results: The study recruited 308 children. The mean age was 27.25  months, median of 26.0 months and age range  between 2-60 months. The bacterial isolation rates were ETEC 9.1%, EPEC 6.8% and EAEC 12.3%, Salmonella paratyphoid (10.4%), Shigella flexineri (1.9%) and Shigella dysentriae (0.9%). Over 95 %, of the isolates were resistance to  amoxicillin, sulphinatozole, cotrimoxazole. Six factors were independently associated with diarrhoeal diseases, occupation of the parent/guardian (miraa business) (OR=1.8, CI:1.44-4.99),care taker not washing hands after changing napkins (OR= 1.6, CI:1.2-19.7), child drank untreated water from the river (OR= 2.7, CI:2.4-9.9) child not exclusively breastfed (OR= 2.4, CI:2.1-10.5),child did not Wash hands before eating (OR=2.2, CI:1.91-16.3) and after visiting toilet (OR=3.7,CI:2.8-39.4).Eating of mangoes was found to be protective against diarrhoea (OR=0.5, CI:0.03-0.89).Conclusion: The bacterial pathogens were found to be a significant cause of diarrhoea in the study participants. We established higher resistance to several commonly prescribed antibiotics.Several  factors were significantly association with diarrhoea illness. We recommend multifaceted approach that acknowledges the public health aspects that would reduce the  burdenof diarrhoea infectious as identified in this study

Potential health-care associated respiratory syncytial virus in three referral Hospitals in Kenya, 2009-2011

Background: Respiratory syncytial virus (RSV) is a major cause of community acquired severe respiratory illness in infants, immunocompromised individuals and the elderly. Limited information exists on the contribution of RSV in respiratory Hospital Associated Infection (rHAI) in developing countries.Objective: To characterize Respiratory Syncytial Virus in the three Kenyan referral setting as a potential contributor to respiratory hospital acquired infection.Methods: The study targeted all patients whose samples tested positive for RSV from the ongoing surveillance on healthcare associated respiratory infections. The study collected nasal and oropharyngeal samples from patients who developed new-onset axilla fever and influenza like illness, in patients who had been afebrile for at least three (3) days in the wards and tested them for different respiratory pathogens (Influenza A and B, Parainfluenza, Human metapneumovirus and adenovirus) alongside RSV. During this period A total of 37 samples tested RSV positive. These were characterized as RSV-A and -B using RT-PCR. Those that typed successfully were then sequenced in the attachment G protein and phylogenetically analyzed.Results: Of the 37 samples, 13(35%) were RSV A, 6 (16%) RSV B, 1 (3%) was AB and 17 (46%) did not type. Twenty out of the 37 attained the sequencing criteria and only seventeen gave successful sequences. Three RSV- A and 2 RSV-B sequenced samples from KNH were 100% identical in the G ectodomain sequences. One RSV-A specimen from MDH and one RSV-A positive from NNPGH had 100% identity. Three sequences from KNH clustered with high nucleotide sequence identity. Children below 2years were significantly more at risk of RSV than those aged 5years and above (aOR=0.21,p=0.012).Conclusions: The study inferred possibility of spread of RSV within the hospitals especially the paediatric ward. Any interventions to curb the spread should specifically target all children ≤ 2 years.Afr J Health Sci. 2016; 29(1):1-1

Teachers’ Perceptions of Students’ Mathematics Guidance and Counselling Needs: A Case of Secondary Schools in Maara District, Kenya

School counsellors collaborate with teachers, parents, school administrators and the local community in an attempt to influence students’ academic, social, personal and career domains. Basically, mathematics teachers hold key information necessary for identifying pertinent guidance and counselling needs related to students’ achievement in the subject. Therefore, to facilitate school counsellors’ role in providing comprehensive mathematics counselling services to students, this study sought to assess teachers’ perceptions of students’ mathematics guidance and counselling needs in secondary schools within Maara District, Kenya. The study utilized the descriptive survey research design on a sample comprising Heads of Mathematics Departments from 48 secondary schools in the District. Questionnaires were used for the collection of desired data which was analyzed by use of Statistical Package for Social Sciences version 17.0. The findings indicated that secondary school students needed mathematics guidance and counselling services regarding attitude, study habits and test orientation. Thus, it was recommended that guidance and counselling programmes emphasize treatment of students’ negative attitude, study habits and test orientation in order to enhance progress in mathematics achievement. Key Words: Counselling, Mathematics, Perceptions, Assessment

Assessment of Gender Differences in Mathematics Counselling Needs among Secondary School Students in Maara District, Kenya

School counsellors have been instrumental in assisting students to overcome barriers towards excellent mathematics achievement. However, boys seem to outperform girls in spite of both genders being exposed to similar mathematics learning conditions and intervention measures. Thus, to enhance school counsellors’ efforts in narrowing the gender gap in mathematics achievement, this study sought to determine gender differences in mathematics counselling needs among secondary school students in Maara district, Kenya. The descriptive survey research design was adapted for the study whose respondents were derived from a target population of 12,371 students and teachers in the district. Additionally, questionnaires were used for data collection. The findings indicated that there existed statistically significant gender differences in mathematics counselling needs among secondary school students. Therefore, it was recommended that gender specific mathematics counselling strategies, programmes and advocacy services be used in order to narrow the gender gap and improve overall achievement in the subject. Key Terms: Gender, Counselling, Mathematics, Achievement

Public health laboratory systems development in East Africa through training in laboratory management and field epidemiology

Laboratories are integral to the delivery of quality health care and for public health functions; however laboratory systems and services are often neglected in resource-poor settings such as the East African region. In order to sustainably strengthen national laboratory systems in resource-poor countries, there is a need to train laboratory personnel to work in clinical as well as public health laboratories. In 2004,Kenya, Uganda, Tanzania, and South Sudan began training public health laboratory workers jointly with field epidemiologists in the Kenya Field Epidemiology and Laboratory Training Program (FELTP), and later through the Tanzania FELTP, as a strategy to strengthen public health laboratories. These programs train laboratory epidemiologists through a two-year public health leadership development course, and also offer various types of short course training for frontline staff. The FELTP laboratory graduates in Kenya, Tanzania, Uganda, and South Sudan are working in their respective countries to strengthen public health laboratory systems while the short course participants provide a pool of frontline implementers with the capacity to support the lower tiers of health systems, as well as serve as surge capacity for the regions and the national level. Through training competent public health laboratory workers, the East African ministries of health, in collaboration with other regional partners and stakeholders are now engaged in developing and implementing a holistic approach that will guarantee an overall strengthening of the health system by using well-trained public health laboratory leaders to drive the process. Strengthening public health laboratory medicine in East Africa is critical to improve health-care systems. The experience with the FELTP model in East Africa is a step in the right direction towards ensuring a stronger role for the laboratory in public health

Community perceptions affecting uptake & retention on antiretroviral therapy by PLHIV: a qualitative study among residents of an urban informal settlement in Kenya

Introduction: Lack of HIV treatment and loss of follow up measures is associated with high mortality among persons living with HIV (PLHIV) in sub-Saharan Africa. Especially in resource-limited populations. Respondents diagnosed with HIV through a home-based testing and counseling program in an informal settlement in Kenya, were referred to health facilities of their choice for antiretroviral therapy (ART). This qualitative study explored the community’s experiences and perceptions on factors associated with ART uptake and retention.Methodology: Using convenient purposive sampling, we recruited 46 adults (21 women and 25 men) among them HIV infected and non-infected residents of the Kibera informal settlement in Nairobi, Kenya. Using a standardized discussion guide, six focus group discussions of 6-9 individuals were conducted. Discussions were recorded verbatim and complimented by tape recording to ensure accuracy. Transcription was done and coding done using a Priori codes. Thematic content analysis was done using Atlas 3.0.Results: Availability of many health facilities offering HIV services in Kibera informal settlement facilitated access to and uptake of ART. Respondents preparation procedures that prevented same-day ART enrolment were often perceived as denial of treatment.“They talk too much of treatment and when you go you are turned away” Said one respondent. Reported perceived poor staff attitude, Rudeness, Judgmental behaviours and Delays, were often perceived as lack of respect for Participants were reported to hinder retention in ART services.“He will look at your physical appearance, put your card aside and ask his colleague whether tea is ready” Participants disliked adherence counseling with written commitments after missed appointments and often felt that these measures too reflected lack of respect by health care providers. They wanted to cancel treatment because they said we had to commit ourselves by signing….”Conclusion: Individuals diagnosed with HIV generally accessed HIV treatment facilities following referral after HBTC. Participants perceived some standard treatment procedures. Reckoning Staff behavior and Communication as barriers hindering retention on ART. Supportive interpersonal relationship strategies between Respondents, providers and innovative patientcentered treatment plans and adherence counseling models should be adopted in treatment programs. This will promote uptake and retention of ART in communities.Keywords: HIV infection, retention in ART, adherence counseling, psychosocial and communication barriers, Responded satisfactio

Fog and low level stratus forecasting using satellite products; a case study of Jomo Kenyatta International Airport, Kenya

The occurrence of fog and low level stratus at airports causes a number of negative impacts ranging from delays, diversions, cancellations, extra fuel leading to reduced loading capacity and customer discomfort. Some of the impacts can be greatly minimized if the occurrence of fog and low level stratus are accurately, reliably and timely forecasted. The study aimed at investigating the utilization of METAR and satellite products, as well as their performance in issuance of Terminal Aerodrome Forecast at the Jomo Kenyatta International Airport. The study is based on a case study of 20th and 21st August 2012,utilizing TAFs, Water Vapour imagery of satellite and METARs, High Resolution Visible, Infra-red channels. The fog and low level stratus were observed to form at around 0100 and 0500 UTC and dissipate at around 0500 UTC. The dissipation is mainly attributed to the incoming solar radiation. The satellite observations replicated the METARs issued. The study therefore recommends further utilization of satellite products and METAR reports in the issuance of Terminal Aerodrome Forecasts to help in minimizing the impacts associated with fog and low level stratus at the airport. However, the study calls for quantitative verification of the performance of the satellite products is however recommended to ascertain the accuracy of the products