Seroprevalence of Chikungunya, West Nile Virus and Dengue Virus in Febrile Patients visiting selected health facilities in Trans Nzoia County

Introduction: Arboviruses of the families Flaviviridae, Togaviridae and Bunyaviridae are suspected to be an important cause of morbidity in Western Kenya. However, literature on the exact burden of disease is scanty. Methods: We collected 1578 serum samples collected from febrile adults with no evidence of malaria or typhoid exposure visiting Andersen Medical Clinic, Endebess Sub District Hospital and Kitale District Hospital. We used indirect ELISAs to screen for exposure to Dengue, Chikungunya and West Nile Viruses, and Plaque Reduction Neutralisation Tests to confirm the status of those samples that were ELISA positive. Results: Data on gender was available for 899 samples. Of those, 63.3% were female while 36.7% were male. The median age was 28 years, while the mean temperature was 39.1°C. Common symptoms included rash (29.7%), headache (74.1%) jaundice (15.0%) and eye infection (20.9%). Bleeding diatheses were uncommon (0.8%). Of the samples we tested, 8.1% (127/1578) were CHIKV PRNT positive, 0.4% (6/1379) Dengue PRNT positive and 0.9% (12/1370) WNV Positive. Conclusion: Exposure to Chikungunya virus is common in Trans Nzoia and may be an important cause of febrile illness

Prevalence of Transmitted Drug Resistance Mutations in HIV-1-Infected Drug-Naive Patients from Urban and Suburban Regions of Kenya

HIV was first described in Kenya in 1984-1985. Currently, Kenya has an estimated HIV-1 prevalence of 6.2%. With the introduction of antiretroviral drugs, the survival of most HIV patients has been prolonged markedly. However, this is greatly threatened by increasing rates of antiretroviral dug resistance, which may eventually lead to suboptimal treatment outcomes. The objective of this study was to characterize currently occurring antiretroviral drug resistance mutations among drug-naive patients visiting two referral hospitals in Kenya. Using polymerase chain reaction, the HIV protease gene was amplified from blood samples of 63 study participants. The sequences were used to determine HIV-1 subtype and presence/prevalence of mutations associated with resistance to protease inhibitors. Finally, the protease gene was variably measured using Shannon entropy analysis. Analysis of frequency of HIV-1 subtypes revealed subtype A to be the predominant subtype, while the analysis of drug resistance mutations revealed the presence of four minor drug resistance mutations associated weakly with resistance to protease inhibitors. Among these mutations, L33I was the most prevalent mutation. Shannon entropy analysis revealed high genomic variability, especially in region spanning nucleotides 1-55, 113-170, and 205-240. This study warrants the need for dedicated efforts to improve compliance to antiretroviral therapy and reduce transmitted resistance rates, which will greatly ensure the therapeutic efficacy of antiretroviral drugs