Accessibility Of Substances, Accommodation Status & Extracurricular Activities' Influence On Undergraduates In Kenya

 Introduction: Institutional factors such as; Accessibility of Substances, Accommodation status, Extracurricular activities etc., had the capacity to influence and modify a student's behaviour by exposing or protecting them from substance use. The purpose of this study was to find out, to what extent these factors influence some undergraduate students into substance use in Kenya. Methodology: Descriptive cross sectional survey and qualitative research designs were used for this study. Self - administered questionnaires were distributed to 1500 participants who were selected using Multistage Sampling Technique from 12 chartered universities with twelve university counsellors in Kenya were also interviewed. Results: The type of accommodation was a factor that determined the current use of Substance among undergraduates. High prevalence of Substance use was reported within students residing in hostels outside the universities. Accessibility of substance (β = .25, p=.000) and extracurricular activities (β = .13, p<.001) were strong predictors of Substance use. Alcohol, tobacco and cannabis were easily accessible and their use was higher compared to other types of Substance use. Students who were engaged in extracurricular activities had lower risk of Substance use in colleges. University counsellors who were interviewed agreed that the Institutional factors played a vital role in determining the use of Substance among undergraduates. Conclusions: Accessibility of Substance, type of Accommodation and Student engagement in extracurricular activities plays a major role in determining the undergraduate student's use of Substance in our modern Institutions. Majority of Parents / Guardians whose students reside outside the universities need to collaborate with the private accommodation facility caretakers to curb Substance use in our institutions.  Some university students use their external connection mainly outside the university to get substances for personal use and also as a source of income. The main source of substances in the university environment is fellow students  Key words: Institutional Factors, Substance Use, Accessibility, Type Of Accommodation, Extracurricular Activities, And Undergraduate Students

Family practices that influence the uptake of the Intergrated Management of Childhood Illnesses (IMCI) strategy among mothers at the MCH/FP clinic at Pumwani Maternity Hospital, Kenya

Background: Since 1999 the Government of Kenya has introduced the Integrated Management of Childhood Illness (IMCI) in an attempt to reduce child mortality. The IMCI strategy, developed by WHO and UNICEF, aims to improve the management of childhood illness at the primary health care level. The aim of this study was to determine the family practices that influence the uptake of the IMCI strategy among mothers in the MCH/FP clinic at Pumwani Maternity Hospital. Methods: A cross sectional survey was conducted at Pumwani Maternity Hospital MCH/FP clinic. A sample size of 385 mothers at the MCH/FP clinic was interviewed for quantitative data. All independent variables identified to significantly associate with ‘uptake of IMCI’ at bivariate analysis was considered together in a multivariate analysis. SPSS version 22 was used for statistical analysis. Results: Out of the 385 respondents interviewed, 78.4% children were well, 74.3% were of normal weight and 88.6% had been fully immunized. At multivariate analysis, statistically significant predictor family practices of IMCI uptake were fever experience, cough experience, living in Nairobi and giving iron supplements to the children.Conclusion: The uptake of the IMCI strategy, though high, was not optimal. There were many children who were underweight, had illnesses and were not fully immunized. These findings highlight the need for continuous strengthening of the IMCI strategy in health facilities

Leishmaniasis in northern and western Africa: a review

Leishmaniasis, one of the highly neglected diseases is currently a significant health problem in northern Africa with a rising concern in western Africa because of co-infection with the Human Immunodeficiency Virus (HIV). In this review, we present a summarized analysis of the epidemiology, infective species, parasites reservoirs, diagnosis, treatment and control measures of leishmaniasis in northern and western Africa region. In northern Africa, the disease is prevalent in Morocco, Algeria, Tunisia, Egypt and Libya. Comparatively, there are low prevalence rates of the disease in West African countries including Cameroon, Ghana, Burkina Faso, Niger, Mali, Nigeria and Senegal. In North Africa, visceral leishmaniasis (VL) is caused by L. infantum and transmitted by Phlebotomus perniciosus and P. longicuspis. On the other hand, cutaneous leishmaniasis (CL) is mainly caused by L. major and transmitted by P. papatasi, P. duboscqi and P. pedifer with L. infantum and L. tropica causing lower incidences of the disease. Notably, Algeria is one of the countries that constitute 90% of CL cases worldwide. In Western Africa; CL is caused by L. major while VL is caused by L. donovani. In these regions, zoonotic and anthroponotic cutaneous and visceral leishmaniasis is a health problem that should be addressed urgently.Key words: Leishmaniasis; cutaneous leishmaniasis, visceral leishmaniasi

In vivo efficacy of oral and intraperitoneal administration of extracts of Warburgia ugandensis (Canellaceae) in experimental treatment of old world cutaneous leishmaniasis caused by Leishmania major.

The antileishmanial activity of extracts of Warburgia ugandensis Spraque (Canellaceae), a known traditional therapy in Kenya was evaluated in vivo. Treatment of infected BALB/c mice with W. ugandensis extracts orally resulted in a reduction of the size of lesions compared to the untreated control. The lesion sizes differed significantly for the four extracts (p=0.039) compared to the untreated control. For mice treated by intraperitoneal injection, the lesion sizes increased initially for the hexane, dichloromethane and ethyl acetate extracts and healed by day 42. The lesion sizes for mice treated with methanol increased steadily from 2.47mm to 3.57mm. The parasitic burden was significantly higher (

A Fatal Outbreak of Campylobacter jejuni Enteritis in a Colony of Vervet Monkeys in Kenya

In a group of 50 wild-caught vervet monkeys trapped for experimental studies, 23 developed severe diarrhoea  during the quarantine period. While 10 of these responded well to routine treatment with metronidazole,  kaomycin and oral electrolytes, 13 initially showed slight improvement but later relapsed. Five of  these failed to respond altogether and were euthanised. Fresh faecal samples were collected from the surviving  eight monkeys and analysed for microbiology and drug sensitivity. Campylobacter jejuni, sensitive  to erythromycin, was isolated from all the faecal samples. Following treatment with erythromycin, seven  monkeys recovered fully within ten days but one died before the end of therapy. This study indicates that  wild non-human primates may play a significant role as a reservoir of C. jejuni, whereby they may act as  natural carriers of this human pathogen. Screening for Campylobacter sp in newly acquired monkeys is  advisable as part of the quarantine procedures.

Giant condyloma acuminatum of the scrotum in a man with AIDS: a case report

Abstract Introduction Giant condyloma acuminatum, also called a Buschke-Löwenstein tumor, first described in 1925, is a slow-growing, locally aggressive, destructive tumor of the ano-genital region. Scrotal tumors are rare. Reports on giant condyloma acuminatum lesions in patients with HIV and AIDS are surprisingly even rarer. Case presentation In this report, we present the case of a 42-year-old African man with AIDS who was undergoing anti-retroviral therapy. He was found to have a giant condyloma acuminatum of the scrotum. Wide surgical excision and scrotal reconstruction with a pedicled anterolateral thigh flap was performed, significantly improving his quality of life. Conclusion Decision making regarding the goals of surgical intervention in the terminally ill is a complex process. The options include conservative medical palliation or palliative excision versus a curative excision that has the potential for significant morbidity. Wide surgical excision with local flap reconstruction significantly improved the quality of life of the patient described herein. The challenges presented by emerging or unusual presentations of surgical pathology secondary to HIV and AIDS in patients who are on anti-retroviral therapy provide an opportunity for research and the establishment of guidelines for the use of adjuvant chemotherapy in these patients.</p

Molecular epidemiology of Klebsiella pneumoniae invasive infections over a decade at Kilifi County Hospital in Kenya.

Multidrug resistant (MDR) Klebsiella pneumoniae is a common cause of nosocomial infections worldwide. Recent years have seen an explosion of resistance to extended-spectrum ?-lactamases (ESBLs) and emergence of carbapenem resistance. Here, we examine 198 invasive K. pneumoniae isolates collected from over a decade in Kilifi County Hospital (KCH) in Kenya. We observe a significant increase in MDR K. pneumoniae isolates, particularly to third generation cephalosporins conferred by ESBLs. Using whole-genome sequences, we describe the population structure and the distribution of antimicrobial resistance genes within it. More than half of the isolates examined in this study were ESBL-positive, encoding CTX-M-15, SHV-2, SHV-12 and SHV-27, and 79% were MDR conferring resistance to at least three antimicrobial classes. Although no isolates in our dataset were found to be resistant to carbapenems we did find a plasmid with the genetic architecture of a known New Delhi metallo-?-lactamase-1 (NDM)-carrying plasmid in 25 isolates. In the absence of carbapenem use in KCH and because of the instability of the NDM-1 gene in the plasmid, the NDM-1 gene has been lost in these isolates. Our data suggests that isolates that encode NDM-1 could be present in the population; should carbapenems be introduced as treatment in public hospitals in Kenya, resistance is likely to ensue rapidly

Animal-related factors associated with moderate-to-severe diarrhea in children younger than five years in western Kenya: A matched case-control study

Background Diarrheal disease remains among the leading causes of global mortality in children younger than 5 years. Exposure to domestic animals may be a risk factor for diarrheal disease. The objectives of this study were to identify animal-related exposures associated with cases of moderate-to-severe diarrhea (MSD) in children in rural western Kenya, and to identify the major zoonotic enteric pathogens present in domestic animals residing in the homesteads of case and control children. Methodology/Principal findings We characterized animal-related exposures in a subset of case and control children (n = 73 pairs matched on age, sex and location) with reported animal presence at home enrolled in the Global Enteric Multicenter Study in western Kenya, and analysed these for an association with MSD. We identified potentially zoonotic enteric pathogens in pooled fecal specimens collected from domestic animals resident at children’s homesteads. Variables that were associated with decreased risk of MSD were washing hands after animal contact (matched odds ratio [MOR] = 0.2; 95% CI 0.08–0.7), and presence of adult sheep that were not confined in a pen overnight (MOR = 0.1; 0.02–0.5). Variables that were associated with increased risk of MSD were increasing number of sheep owned (MOR = 1.2; 1.0–1.5), frequent observation of fresh rodent excreta (feces/urine) outside the house (MOR = 7.5; 1.5–37.2), and participation of the child in providing water to chickens (MOR = 3.8; 1.2–12.2). Of 691 pooled specimens collected from 2,174 domestic animals, 159 pools (23%) tested positive for one or more potentially zoonotic enteric pathogens (Campylobacter jejuni, C. coli, non-typhoidal Salmonella, diarrheagenic E. coli, Giardia, Cryptosporidium, or rotavirus). We did not find any association between the presence of particular pathogens in household animals, and MSD in children. Conclusions and significance Public health agencies should continue to promote frequent hand washing, including after animal contact, to reduce the risk of MSD. Future studies should address specific causal relations of MSD with sheep and chicken husbandry practices, and with the presence of rodents

Towards progressive regulatory approaches for agricultural applications of animal biotechnology.

Traditional breeding techniques, applied incrementally over thousands of years, have yielded huge benefits in the characteristics of agricultural animals. This is a result of significant, measurable changes to the genomes of those animal species and breeds. Genome editing techniques may now be applied to achieve targeted DNA sequence alterations, with the potential to affect traits of interest to production of agricultural animals in just one generation. New opportunities arise to improve characteristics difficult to achieve or not amenable to traditional breeding, including disease resistance, and traits that can improve animal welfare, reduce environmental impact, or mitigate impacts of climate change. Countries and supranational institutions are in the process of defining regulatory approaches for genome edited animals and can benefit from sharing approaches and experiences to institute progressive policies in which regulatory oversight is scaled to the particular level of risk involved. To facilitate information sharing and discussion on animal biotechnology, an international community of researchers, developers, breeders, regulators, and communicators recently held a series of seven virtual workshop sessions on applications of biotechnology for animal agriculture, food and environmental safety assessment, regulatory approaches, and market and consumer acceptance. In this report, we summarize the topics presented in the workshop sessions, as well as discussions coming out of the breakout sessions. This is framed within the context of past and recent scientific and regulatory developments. This is a pivotal moment for determination of regulatory approaches and establishment of trust across the innovation through-chain, from researchers, developers, regulators, breeders, farmers through to consumers

Regional Differences in Prevalence of HIV-1 Discordance in Africa and Enrollment of HIV-1 Discordant Couples into an HIV-1 Prevention Trial

Background: Most HIV-1 transmission in Africa occurs among HIV-1-discordant couples (one partner HIV-1 infected and one uninfected) who are unaware of their discordant HIV-1 serostatus. Given the high HIV-1 incidence among HIV-1 discordant couples and to assess efficacy of interventions for reducing HIV-1 transmission, HIV-1 discordant couples represent a critical target population for HIV-1 prevention interventions and prevention trials. Substantial regional differences exist in HIV-1 prevalence in Africa, but regional differences in HIV-1 discordance among African couples, has not previously been reported. Methodology/Principal Findings: The Partners in Prevention HSV-2/HIV-1 Transmission Trial (“Partners HSV-2 Study”), the first large HIV-1 prevention trial in Africa involving HIV-1 discordant couples, completed enrollment in May 2007. Partners HSV-2 Study recruitment data from 12 sites from East and Southern Africa were used to assess HIV-1 discordance among couples accessing couples HIV-1 counseling and testing, and to correlate with enrollment of HIV-1 discordant couples. HIV-1 discordance at Partners HSV-2 Study sites ranged from 8–31% of couples tested from the community. Across all study sites and, among all couples with one HIV-1 infected partner, almost half (49%) of couples were HIV-1 discordant. Site-specific monthly enrollment of HIV-1 discordant couples into the clinical trial was not directly associated with prevalence of HIV-1 discordance, but was modestly correlated with national HIV-1 counseling and testing rates and access to palliative care/basic health care (r = 0.74, p = 0.09). Conclusions/Significance: HIV-1 discordant couples are a critical target for HIV-1 prevention in Africa. In addition to community prevalence of HIV-1 discordance, national infrastructure for HIV-1 testing and healthcare delivery and effective community outreach strategies impact recruitment of HIV-1 discordant couples into HIV-1 prevention trials