Seroprevalence of anti-SARS-CoV-2 IgG antibodies in Kenyan blood donors.

The spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Africa is poorly described. The first case of SARS-CoV-2 in Kenya was reported on 12 March 2020, and an overwhelming number of cases and deaths were expected, but by 31 July 2020, there were only 20,636 cases and 341 deaths. However, the extent of SARS-CoV-2 exposure in the community remains unknown. We determined the prevalence of anti-SARS-CoV-2 immunoglobulin G among blood donors in Kenya in April-June 2020. Crude seroprevalence was 5.6% (174 of 3098). Population-weighted, test-performance-adjusted national seroprevalence was 4.3% (95% confidence interval, 2.9 to 5.8%) and was highest in urban counties Mombasa (8.0%), Nairobi (7.3%), and Kisumu (5.5%). SARS-CoV-2 exposure is more extensive than indicated by case-based surveillance, and these results will help guide the pandemic response in Kenya and across Africa

Temporal trends of SARS-CoV-2 seroprevalence during the first wave of the COVID-19 epidemic in Kenya.

Observed SARS-CoV-2 infections and deaths are low in tropical Africa raising questions about the extent of transmission. We measured SARS-CoV-2 IgG by ELISA in 9,922 blood donors across Kenya and adjusted for sampling bias and test performance. By 1st September 2020, 577 COVID-19 deaths were observed nationwide and seroprevalence was 9.1% (95%CI 7.6-10.8%). Seroprevalence in Nairobi was 22.7% (18.0-27.7%). Although most people remained susceptible, SARS-CoV-2 had spread widely in Kenya with apparently low associated mortality

Adolescent’s self efficacy and attitude towards HIV/AIDS prevention in Yogyakarta, Indonesia

Acquired Immunodeficiency Syndrome (AIDS) was the eighth leading cause of death among adolescents worldwide. A third of these them  were  infected  during  the  adolescence  period.  Without  investing  in  adolescent health and well-being, the current global target of ending HIV as a public health threat by 2030 may not be realized. HIV prevention in adolescents is particularly important as it not only benefits then now, but also as future adults as well as future generations. Attitude is one indicator of a person's behavior or action. However, little is known about the factors that influence adolescent’s attitudes towards prevention of HIV/AIDS. The aim of this study was to establish the determinants of adolescents’ attitude towards prevention of HIV AIDS among adolescents. This  was  a  descriptive  cross-sectional  study  conducted  among  370  high school students in Yogyakarta, Indonesia. Quantitative data was analyzed using SPSS and involved univariate and multivariate analysis. The internet and television were the major sources of information on reproductive health and HIV among the adolescents (98.9%) and (98.4%) respectively. The significant determinants of adolescents attitude towards HIV/AIDS prevention were the level of knowledge (p=0.028) and self-efficacy (p=0.007). Multivariate analysis showed that those respondents with positive self-efficacy were 1.8 times more likely to have a positive attitude towards HIV/AIDS prevention than those who had a negative self-efficacy. Programs which target mass media strategy for prevention can leverage the television and internet. Stakeholders can target on interventions that can improve adolescent’s self-efficacy so as to achieve HIV prevention goals

Midwife’s Role in the Mother-to-Child Transmission Prevention Program in Primary Health Care in Yogyakarta

Curing and eradicating Human Immunodeficiency Virus (HIV)/Acquired Immunodeficiency Syndrome (AIDS) are to the core principles of the United Nations’ Sustainable Development Goals (SDGs). The incidence of HIV in the world remains high. Although midwives play a pivotal role in PMTCT implementation, the factors associated with midwives’ role in its implementation are not well understood. The aim of this study was to determine factors associated with midwives’ role in implementation of PMTCT. This study used a cross-sectional design. The subjects were 80 midwives at 14 primary health care in Yogyakarta City, Indonesia. The study was conducted from April to August 2017. Data were analyzed through univariate, bivariate with chi-square and Fisher’s exact test, multivariate with logistic regression. The results showed that 47.5% of midwives were in the poor category regarding implementation of PMTCT. Information availability through socialization (p-value = 0.047) and knowledge level (p-value = 0.016) were found to be related to PMTCT implementation. There was no relationship between age, length of work, education level, marital status, availability of information, midwife’s attitude, perception of the availability of facilities and institutional support with midwife behavior in PMTCT implementation. Multivariate analysis showed that level of knowledge was the most dominant factor affecting PMTCT implementation (OR:6.2; CI 95% = 1.8-21.4). We recommend that efforts should be made to continuously improve the knowledge of midwives on PMTCT implementation through peer support and training in order to achieve sustainable development goals

Family Support as a Factor Influencing the Provision of Exclusive Breastfeeding among Adolescent Mothers in Bantul, Yogyakarta

The number of adolescent pregnancies in Indonesia is still very high. Sewon Subdistrict had the highest number of adolescent deliveries in Bantul District in 2015-2016. This study aimed to determine factors influencing exclusive breastfeeding among adolescent mothers in Sewon Subdistrict, Bantul District. This study used cross-sectional study design and a sample size of 45 that were adolescent mothers of 6-24-month-old infants. Data was collected using a structured questionnaire. Data analysis involved bivariate analysis using chi-square test and fisher’s exact test, while multivariate analysis used logistic regression.Results showed that 53.3% of adolescent mothers did not practice exclusive breastfeeding. Bivariate analysis showed that pregnancy status (p value = 0.029), perception of childbirth experience (p value = 0.045), perception of breastfeeding (p value = 0.005), husband support (p value = 0.009) and family support (p value = 0.000) were correlated to exclusive breasfeeding. Multivariate analysis showed that perception of breastfeeding (p value = 0.015; OR = 9.746) and family support (p value = 0.014; OR = 7.637) as the most influential factors to exclusive breastfeeding among adolescent mothers with a probability of 72.7%.There is low practice of exclusive breastfeeding among adolescent mothers in Bantul, Yogyakarta and family support is the most dominant factors influencing exclusive breastfeeding.AbstrakKehamilan remaja di Indonesia cukup tinggi. Kecamatan Sewon memiliki angka persalinan remaja tertinggi di Kabupaten Bantul pada tahun 2015-2016. Penelitian ini bertujuan untuk mengetahui faktor-faktor yang memengaruhi pemberian ASI eksklusif pada ibu usia remaja di Kecamatan Sewon, Kabupaten Bantul. Penelitian ini menggunakan desain potong lintang dan sampel penelitian berjumlah 45 orang ibu usia remaja yang mempunyai bayi usia 6-24 bulan. Pengumpulan data menggunakan kuesioner terstruktur. Analisis bivariat menggunakan kai kuadrat dan fisher’s exact test, sedangkan analisis multivariat menggunakan regresi logistik. Hasil penelitian menunjukkan bahwa 53.3% ibu usia remaja tidak memberikan ASI eksklusif. Analisis bivariat menunjukkan faktorstatus kehamilan (nilai p = 0.029), persepsi pengalaman melahirkan (nilai p= 0.045), persepsi menyusui (nilai p= 0.005), dukungan suami (nilai p= 0.009), dukungan keluarga (nilai p = 0,000) berhubungan dengan pemberian ASI eksklusif. Hasil analisis multivariat menunjukkan persepsi menyusui (nilai p = 0.015; RP = 9.746) dan faktor dukungan keluarga (nilai p = 0,014; RP = 7,637) sebagai faktor yang paling berpengaruh terhadap pemberian ASI eksklusif dengan probabilitas sebesar 72.7%. Masih rendahnya pemberian ASI ekslusif pada ibu remaja di Bantul, Yogyakarta, dan dukungan keluarga merupakan faktor paling dominan yang memengaruhi pemberian ASI eksklusif pada ibu usia remaja

Determinants of contraceptive use among postpartum women in a county hospital in rural KENYA

Abstract Background There is a high unmet need for limiting and spacing child births during the postpartum period. Given the consequences of closely spaced births, and the benefits of longer pregnancy intervals, targeted activities are needed to reach this population of postpartum women. Our objective was to establish the determinants of contraceptive uptake among postpartum women in a county referral hospital in rural Kenya. Methods Sample was taken based on a mixed method approach that included both quantitative and qualitative methods of data collection. Postpartum women who had brought their children for the second dose of measles vaccine between 18 and 24 months were sampled Participants were interviewed using structured questionnaires, data was collected about their socio-demographic characteristics, fertility, knowledge, use, and access to contraceptives. Chi square tests were used to determine the relationship between uptake of postpartum family planning and: socio demographic characteristics, contraceptive knowledge, use access and fertility. Qualitative data collection included focus group discussions (FDGs) with mothers and in-depth interviews with service providers Information was obtained from mothers’ regarding their perceptions on family planning methods, use, availability, access and barriers to uptake and key informants’ views on family planning counseling practices and barriers to uptake of family planning Results More than three quarters (86.3%) of women used contraceptives within 1 year of delivery, with government facilities being the most common source. There was a significant association (p ≤ 0.05) between uptake of postpartum family planning and lower age, being married, higher education level, being employed and getting contraceptives at a health facility. One third of women expressing no intention of having additional children were not on contraceptives. In focus group discussions women perceived that the quality of services offered at the public facilities was relatively good because they felt that they were adequately counseled, as opposed to local chemist shops where they perceived the staff was not experienced. Conclusion Contraceptive uptake was high among postpartum women, who desired to procure contraceptives at health facilities. However, there was unmet need for contraceptives among women who desired no more children. Government health facility stock outs represent a missed opportunity to get family planning methods, especially long acting reversible contraceptives, to postpartum women

Discovery of a novel class of benzimidazoles as highly effective agonists of bone morphogenetic protein (BMP) receptor signaling

Abstract Increasing or restoring Bone Morphogenetic Protein receptor signaling is an effective therapy for conditions such as bone fracture and pulmonary arterial hypertension. However, direct use of recombinant BMPs has encountered significant obstacles. Moreover, synthetic, full agonists of BMP receptor signaling have yet to be identified. Here, we report the discovery of a novel class of indolyl-benzimidazoles, synthesized using a one-pot synthetic methodology, which appear to mimic the biochemical and functional activity of BMPs. The first-in-series compounds, SY-LB-35 and SY-LB-57, stimulated significant increases in cell number and cell viability in the C2C12 myoblast cell line. Cell cycle analysis revealed that these compounds induced a shift toward proliferative phases. SY-LB-35 and SY-LB-57 stimulated canonical Smad and non-canonical PI3K/Akt, ERK, p38 and JNK intracellular signaling pathways, similar to BMP2-stimulated responses. Importantly, increases in Smad phosphorylation and cell viability were dependent on type I BMP receptor activity. Thus, these compounds robustly activate intracellular signaling in a BMP receptor-dependent manner and may signify the first known, full agonists of BMP receptor signaling. Moreover, discovery of small molecule activators of BMP pathways, which can be efficiently formulated and targeted to diseased or damaged areas, could potentially substitute recombinant BMPs for treatment of BMP-related pathologies

"We are called the et cetera": Experiences of the poor with health financing reforms that target them in Kenya

Background: Through a number of healthcare reforms, Kenya has demonstrated its intention to extend financial risk protection and service coverage for poor and vulnerable groups. These reforms include the provision of free maternity services, user-fee removal in public primary health facilities and a health insurance subsidy programme (HISP) for the poor. However, the available evidence points to inequity and the likelihood that the poor will still be left behind with regards to financial risk protection and service coverage. This study examined the experiences of the poor with health financing reforms that target them. Methods: We conducted a qualitative cross-sectional study in two purposively selected counties in Kenya. We collected data through focus group discussions (n = 8) and in-depth interviews (n = 30) with people in the lowest wealth quintile residing in the health and demographic surveillance systems, and HISP beneficiaries. We analyzed the data using a framework approach focusing on four healthcare access dimensions; geographical accessibility, affordability, availability, and acceptability. Results: Health financing reforms reduced financial barriers and improved access to health services for the poor in the study counties. However, various access barriers limited the extent to which they benefited from these reforms. Long distances, lack of public transport, poor condition of the roads and high transport costs especially in rural areas limited access to health facilities. Continued charging of user fees despite their abolition, delayed insurance reimbursements to health facilities that HISP beneficiaries were seeking care from, and informal fees exposed the poor to out of pocket payments. Stock-outs of medicine and other medical supplies, dysfunctional medical equipment, shortage of healthcare workers, and frequent strikes adversely affected the availability of health services. Acceptability of care was further limited by discrimination by healthcare workers and ineffective grievance redress mechanisms which led to a feeling of disempowerment among the poor. Conclusions: Pro-poor health financing reforms improved access to care for the poor to some extent. However, to enhance the effectiveness of pro-poor reforms and to ensure that the poor in Kenya benefit fully from them, there is a need to address barriers to healthcare seeking across all access dimensions

Additional file 1: of Determinants of contraceptive use among postpartum women in a county hospital in rural KENYA

Respondents’ Questionnaire. (DOCX 16 kb

Additional file 2: of Determinants of contraceptive use among postpartum women in a county hospital in rural KENYA

Focus Group Discussion Guide. (DOCX 12 kb