Emerging infectious disease preparedness and response in healthcare: perspectives from COVID-19 and the role of College-Learnt Microbiology

Coronavirus disease 2019 (COVID-19) pandemic began in December 2019 in Wuhan City China where it is believed to have been transmitted to humans from an unknown animal species. The public health, social and economic impact of the pandemic world over is detrimental. Health care providers at the frontline in the fight against COVID-19 are at the greatest risk of infection and so far, many have been infected and some have already died from the disease. Thus, it is imperative that healthcare providers have adequate knowledge of infectious diseases and microbial pathogens to comprehend the scale of risk for better recognition and response. Microbiological concepts of infection prevention and control, hand hygiene and aseptic techniques are essential in slowing down the spread of the virus. COVID-19 has proven that infectious agents can emerge from any region in the world and can spread rapidly with ominous consequences to all humanity. This narrative review discusses the role of college-learnt microbiology in health care provider preparedness for emerging infectious diseases in light of the current pandemic. Keywords: Emerging; Infections; Preparedness; Response; Microbiology; COVID-19; Trainin

Characterization and antimicrobial susceptibility pattern to commonly prescribed antimicrobials of diarrheagenic Escherichia coli in patients attending Thika district Hospital - Kenya, 2014.

Background: Diarrheagenic E. coli (DEC) are associated with outbreaks of severe diarrhea and multiple drug resistance. We characterize DEC among diarrhoeal patients attending Thika Hospital and determine their antimicrobial susceptibility patterns.Methods: A cross-sectional study was conducted among patients of all ages seeking diarrhea treatment. Stool samples were collected, inoculated on bacterial differential media for growth of enteric pathogens, characterized and antimicrobial susceptibility of DEC isolates determined.Results: A total of 402 stool samples were cultured. E. coli was isolated from 269, of which 72 (27%) were DEC; 60 (83.3%) enteroaggregative E. coli (EAEC), 6 (8.3%) enteropathogenic E. coli (EPEC) and 6 (8.3%) enterotoxigenic E. coli (ETEC). Of the 72, 58% were female, median age was 8 (IQR: 2-28) years, 75% did not boil water and 100% did not treat water. Twenty five (35%) patients with DEC were under-five years. Drinking un-boiled water (OR: 2.51, 95% CI: 1.36-4.61) was associated with having DEC. All DEC isolates were sensitive to cefoxitin, meropenem, amikacin, gentamicin and ciprofloxacin. They were resistance to ampicillin (92%), trimethoprim-sulfamethoxazole (92%) and amoxicillin-clavulanic acid (85%).Conclusion: The predominant DEC strain was EAEC. High resistant to ampicillin, trimethoprim-sulfamethoxazole and amoxicillin-clavulanic acid were observed. All isolates were sensitive to ciprofloxacin and gentamicin.Keywords: Diarrhea, E. coli, Diarrheagenic E. coli, Characterization, KenyaAfr J Health Sci. 2016; 29(1):25-3

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 (

Recovery of Zn2+, Fe2+ and Mn2+ from Some Selected Edible Vegetables and Pumpkin using Modified Maize Cobs

This study reports on the pre-concentration of some essential trace elements from vegetables using modified maize cobs by sorption. This was enabled by some functional groups anchored within the chemical structure of the material. Modification was achieved by treating the dry powdered material with thionylchloride (SOCl2) which was dispersed in dimethylformaldehyde (DMF) then reacting with ethylenediamine air drying the resultant for 24 hours. The presence of the anchored group was confirmed by FT-IR and it was used for Batch sorption experiments. The effect of pH, concentration, and dosage on the adsorption of zinc, iron and manganese ion by the parent and modified materials were carried out. Using the optimal parameters, the modified material was used for the pre-concentration of the trace metal ions from solutions of some selected vegetables samples. Pre-concentration of nutrients from fermented samples showed significantly high levels than non-fermented samples. This new method of pre-concentrating metal ions shows promising results and can improve the nutrition value in the preparation of dietary supplements. The method is effective and is of low cost

Oyola and Wakesi in Kenya : locals adapting to effects of climate change

Efforts are being made to document how communities are responding to climate vulnerability challenges at the local level. This paper focuses on two communities, the Oyola and Wakesi peoples who reside on the fringes of Lake Victoria (Western Kenya). Researchers and community participants mapped out climate events and the effects on their communities. A summary was drawn of the problems and opportunities that were identified from the historical profile the communities had created. Coping strategies were enumerated along with new strategies, such as construction of water pans and canals for drainage and water storage

Leishmania major infections in Phlebotomus duboscqi fed on murine models immunized with L. major subcellular antigens and sandfly gut antigens

The ability of antibodies in bloodmeals of mice and hamsters immunized with Leishmania major subcellular fractions and sandfly (Phlebotomus duboscqi) gut antigens to inhibit development of L. major in its vector P. duboscqi was examined. Antibodies from animals immunized with either L. major subcellular fractions alone or sandfly gut antigen alone were not very effective in inhibiting development of L. major in the sandfly. When P. duboscqi were fed on blood from animals immunized with both parasite flagella and sandfly gut antigen, development of L. major was significantly inhibited ( P<0.05). Control sandflies fed on naive animals displayed a normal pattern of parasite development to the metacyclic stage. Electron microscopy studies showed that one of the mechanisms through which antisandfly gut antibody can cause inhibition of parasite development is by lysing sandfly gut epithelium. This study has demonstrated that it is possible to reduce transmission of leishmaniosis through immunization against both the parasite and its sandfly vector.The articles have been scanned in colour with a HP Scanjet 5590; 600dpi. Adobe Acrobat v.9 was used to OCR the text and also for the merging and conversion to the final presentation PDF-format.UNDP/WORLD BANK/WHO, Special Programme for Research and Training in Tropical Diseases. Kenya Medical Research Institute (KEMRI).mn201

Esophageal Cancer in Young People: A Case Series of 109 Cases and Review of the Literature

Certain geographically distinct areas of the world have very high rates of esophageal cancer (EC). Previous studies have identified western Kenya as a high risk area for EC with an unusual percentage of cases in subjects 30 years of age or younger. To better understand EC in these young patients, we abstracted available data on all 109 young patients diagnosed with EC at Tenwek Hospital, Bomet District, Kenya from January 1996 through June 2009, including age at diagnosis, sex, ethnicity, tumor histology, residence location, and medical interventions. We also attempted to contact all patients or a family member and obtained information on ethnicity, tobacco and alcohol use, family history of cancer, and survival. Sixty (55%) representatives of the 109 young patients were successfully interviewed. The median survival time of these 60 patients was 6.4 months, the most common tumor histology was esophageal squamous cell carcinoma (ESCC) (98%), the M:F ratio was 1.4∶1, and only a few subjects used tobacco (15%) or alcohol (15%). Seventy-nine percent reported a family history of cancer and 43% reported having a family history of EC. In summary, this case series describes the largest number of young EC patients reported to date, and it highlights the uniqueness of the EC experience in western Kenya

Epidemiological profile and clinico-pathological features of pediatric gynecological cancers at Moi Teaching & Referral Hospital, Kenya

Background: The main pediatric (0–18 years) gynecologic cancers include stromal carcinomas (juvenile granulosa cell tumors and Sertoli-Leydig cell tumors), genital rhabdomyosarcomas and ovarian germ cell. Outcomes depend on time of diagnosis, stage, tumor type and treatment which can have long-term effects on the reproductive career of these patients. This study seeks to analyze the trends in clinical-pathologic presentation, treatment and outcomes in the cases seen at our facility. This is the first paper identifying these cancers published from sub-Saharan Africa. Method: Retrospective review of clinico-pathologic profiles and treatment outcomes of pediatric gynecologic oncology patients managed at MTRH between 2010 and 2020. Data was abstracted from gynecologic oncology database and medical charts. Results: Records of 40 patients were analyzed. Most, (92.5%, 37/40) of the patients were between 10 and 18 years. Ovarian germ cell tumors were the leading histological diagnosis in 72.5% (29/40) of the patients; with dysgerminomas being the commonest subtype seen in 12 of the 37 patients (32.4%). The patients received platinum-based chemotherapy in 70% of cases (28/40). There were 14 deaths among the 40 patients (35%) Conclusion: Surgery remains the main stay of treatment and fertility-sparing surgery with or without adjuvant platinum-based chemotherapy are the standard of care with excellent prognosis following early detection and treatment initiation. LMICs face several challenges in access to quality care and that affects survival of these patients. Due to its commonality, ovarian germ cell cancers warrant a high index of suspicion amongst primary care providers attending to adnexal masses in this age group

Characterising the CI and CI-like carbonaceous chondrites using thermogravimetric analysis and infrared spectroscopy

The CI and CI-like chondrites provide a record of aqueous alteration in the early solar system. However, the CI-like chondrites differ in having also experienced a late stage period of thermal metamorphism. In order to constrain the nature and extent of the aqueous and thermal alteration, we have investigated the bulk mineralogy and abundance of H2O in the CI and CI-like chondrites using thermogravimetric analysis and infrared spectroscopy. The CI chondrites Ivuna and Orgueil show significant mass loss (28.5–31.8 wt.%) upon heating to 1000 °C due to dehydration and dehydroxylation of abundant phyllosilicates and Fe-(oxy)hydroxides and the decomposition of Fe-sulphides, carbonates and organics. Infrared spectra for Ivuna and Orgueil have a prominent 3-μm feature due to bound −OH/H2O in phyllosilicates and Fe-(oxy)hydroxides and only a minor 11-μm feature from anhydrous silicates. These characteristics are consistent with previous studies indicating that the CI chondrites underwent near-complete aqueous alteration. Similarities in the total abundance of H2O and 3 μm/11 μm ratio suggest that there is no difference in the relative degree of hydration experienced by Ivuna and Orgueil. In contrast, the CI-like chondrites Y-82162 and Y-980115 show lower mass loss (13.8–18.8 wt.%) and contain >50 % less H2O than the CI chondrites. The 3-μm feature is almost absent from spectra of Y-82162 and Y-980115 but the 11-μm feature is intense. The CI-like chondrites experienced thermal metamorphism at temperatures >500 °C that initially caused dehydration and dehydroxylation of phyllosilicates before partial recrystallization back into anhydrous silicates. The surfaces of many C-type asteroids were probably heated through impact metamorphism and/or solar radiation, so thermally altered carbonaceous chondrites are likely good analogues for samples that will be returned by the Hayabusa-2 and OSIRIS-REx missions