Oxacillin resistant Staphlococcus aureus among HIV infected and non-infected Kenyan patients

Background: Infections due to methicillin resistant S. aureus (MRSA) present global challenges to clinicians since therapeutic options are limited and suboptimal dosing contributes to heightened mortality and increased length of hospital stay particularly among the HIV infected patients.Objectives: To assess the prevalence and relative risk of MRSA infections in HIV infected patients.Design: Cross sectional analytical study.Setting: Kenya Medical Research Institute, Opportunistic Infection Laboratories in Nairobi.Subjects: Four hundred and thirty six male and female patients aged one to 65 years, of whom 220 were HIV-infected and 216 were non-infected.Results: There was 436 male (57.1%) and female (42.9%) respondents. The prevalence of MRSA was 26.3% with majority infecting the HIV infected patients (P=0.046). Likewise, the overall Staphylococcal infections were more common in HIV patients (

Molecular characterisation of echinococcus granulosus species/strains in human infections from Turkana, Kenya

Background: Cystic echinococcosis (CE) or hydatid disease is a neglected, economically important zoonotic disease endemic in pastoralist communities, in particular the Turkana community of Kenya. It is caused by the larval stage of the highly diverse species complex of Echinococcus granulosus sensu lato (s.l). The situation on the genetic diversity in humans in Kenya is not well established.Objective: To characterise Echinococcus granulosus (s.l) species/strains isolated from humans undergoing surgery in Turkana, Kenya.Design: A Cross sectional study.Setting: The Kakuma Mission Hospital and Centre for Microbiology Research, Kenya Medical Research InstituteSubjects: Eighty (80) parasite samples from 26 subjects were analysed by Polymerase chain reaction – Restriction fragment length polymorphism (PCR-RFLP) targeting the nad 1 gene for molecular characterizationResults: Two different genotypes of E. granulosus were identified from the samples analysed: E. granulosus sensu stricto (G1-G3) 85% of the samples analysed and E. canadensis G6/7 (15%). Most of the hydatid cysts (35%) were isolated from the liver. Other sites where cysts were isolated from include: kidney, abdomen, omentum, retroperitonium and the submandibular. Majority of cysts presented as CE1 (50%) and CE3B (42%) images according to WHO ultrasound classification. Both males and females were infected with E. granulosus s.s but only the females showed infection with E. canadensis G6/7. Chi-square test revealed significant difference between age of individuals and cysts classification by ultrasound. In addition, there was an association between cyst presentation (single or multiple) and genotype whereby all the E. canadensis G6/7 cases presented as single cysts in the infected persons.Conclusion: This study corroborates previous reports that E. canadensis G6/7 strain is present in Turkana, a place where initially only E. granulosus s.s (G1-G3) was known to be present and that E. granulosis (G1-G3) remains the most widespread genotype infecting humans in the Turkana community

The geographical distribution of lymphatic filariasis infection in Malawi

Mapping distribution of lymphatic filariasis (LF) is a prerequisite for planning national elimination programmes. Results from a nation wide mapping survey for lymphatic filariasis (LF) in Malawi are presented. Thirty-five villages were sampled from 23 districts excluding three districts (Karonga, Chikwawa and Nsanje) that had already been mapped and Likoma, an Island, where access was not possible in the time frame of the survey. Antigenaemia prevalence [based on immunochromatographic card tests (ICT)] ranged from 0% to 35.9%. Villages from the western side of the country and distant from the lake tended to be of lower prevalence. The exception was a village in Mchinji district on the Malawi-Zambia border where a prevalence of 18.2% was found. In contrast villages from lake shore districts [Salima, Mangochi, Balaka and Ntcheu (Bwanje valley)] and Phalombe had prevalences of over 20%

Accuracy of clinical pallor in the diagnosis of anaemia in children: a meta-analysis

BACKGROUND: Anaemia is highly prevalent in children of developing countries. It is associated with impaired physical growth and mental development. Palmar pallor is recommended at primary level for diagnosing it, on the basis of few studies. The objective of the study was to systematically assess the accuracy of clinical signs in the diagnosis of anaemia in children. METHODS: A systematic review on the accuracy of clinical signs of anaemia in children. We performed an Internet search in various databases and an additional reference tracking. Studies had to be on performance of clinical signs in the diagnosis of anaemia, using haemoglobin as the gold standard. We calculated pooled diagnostic likelihood ratios (LR's) and odds ratios (DOR's) for each clinical sign at different haemoglobin thresholds. RESULTS: Eleven articles met the inclusion criteria. Most studies were performed in Africa, in children underfive. Chi-square test for proportions and Cochran Q for DOR's and for LR's showed heterogeneity. Type of observer and haemoglobin technique influenced the results. Pooling was done using the random effects model. Pooled DOR at haemoglobin <11 g/dL was 4.3 (95% CI 2.6–7.2) for palmar pallor, 3.7 (2.3–5.9) for conjunctival pallor, and 3.4 (1.8–6.3) for nailbed pallor. DOR's and LR's were slightly better for nailbed pallor at all other haemoglobin thresholds. The accuracy did not vary substantially after excluding outliers. CONCLUSION: This meta-analysis did not document a highly accurate clinical sign of anaemia. In view of poor performance of clinical signs, universal iron supplementation may be an adequate control strategy in high prevalence areas. Further well-designed studies are needed in settings other than Africa. They should assess inter-observer variation, performance of combined clinical signs, phenotypic differences, and different degrees of anaemia

Prevalence and Intensity of Gastrointestinal Parasites in Wild -trapped Pabio anubis and Cercopithecus aethiops in Kenya

Gastrointestinal parasite infections by multiple parasite species involving helminths and protozoans occur in non-human primates. The objective of the study was to screen for gastrointestinal parasite infections from sixty five wild-trapped Pabio anubis (olive baboons) and sixty four Cercopithecus aaethiops (African green monkeys) from various locations in Kenya and at the Institute of Primate Research (IPR), Nairobi, in March 2008 to June 2009 to obtain preliminary data as baseline for proposed further study on coccidian parasites. Four faecal samples per individual animal were collected on Mondays and Thursdays for two consecutive weeks and processed for parasitological examination for gastrointestinal parasites. The animals were asymptomatic at the time of faecal sampling. Twelve taxa of intestinal parasites, 5 helminth and 7 protozoan parasites were identified. The helminth genera observed were Oesophagostomum, Trichuris, Strongyloides, Trichostrongylus and Enterobius with species prevalence of 33.6%, 30.4%, 26.2%, 8.8%, 0.8%, 0.4%, and 10.0%, 47.6%, 16.0%, 3.2%, 0.4% for olive baboons and African green monkeys, respectively. The intensity of infections ranged from 0-2350 eggs per gram (epg). Most individuals (56.2%) had mild infections of 1-300 epg and only 8% had egg counts greater or equal to 400. The protozoan parasites identified in this study were Entamoeba coli, Entamoeba histolytica, Cyclospora spp, Cryptosporidia spp, Isospora spp, Iodamoeba butschilii and Paramecium spp with prevalence of 77.3%, 23.1%, 3.8%, 2.7%, 2.2%, 1.2%, 0%, and 76.8%, 23.6%, 63.6%, 6.2%, 0.4%, 0%, 0.4% for olive baboons and African green monkeys, respectively. Majority (63.1%) of the animals had 2-3 parasite infections. Though the infections were asymptomatic in these non-human primates, they harbour important parasites that pose potential danger to public health, livestock and wildlife animals

The African Green Monkey (Cercopithecus aethiops) as a non-human primate model for infections with Cyclospora Cayetanensis

Clinical epidemiology and pathogenesis of Cyclospora species was studied in 64 wild-trapped Cercopithecus aethiops at the Institute of Primate  Research, Nairobi, Kenya. The monkeys were screened for Cyclospora parasites using conventional microscopy, examination of hot Safranin stained faecal smears, Cyclospora specific antibody responses and  molecular characterization of DNA following nested Polymerase Chain Reaction (PCR) amplification. Efficacy of Trimethoprim-Sulphamethoxazoletherapy for Cyclospora positive monkeys was evaluated. Experimental Cyclospora infections were established by oral inoculation. Oocyst shedding was used to confirm establishment and duration of infection. Gross and histopathological characteristics were  described . The animals remainedasymptomatic. Cyclospora parasites were identified in 41 (64%) of animals with infections mostly in male adults. Incubation period was 14-17 days, the duration of infection one to two months. A PCR product of 294 base pair was visualized, confirming Cyclospora species in the natural and  experimental infections. Cyclospora specific antibody responses were  recorded in positive monkeys. Response to treatment was evaluated by cessation Cyclospora oocyst shedding by D17 post-treatment anddecreased Cyclospora specific antibody levels. Relapse infections occurred in 33% of the treated animals but responded to second TMP-SMX therapy.Pathological findings recorded were moderate haemorrhagic enteritis, parasites vacuoles in the enterocytes, mild lymph node enlargement,lymphocytic infiltrations, focal necrosis and granulomas in the liver. In conclusion, the study demonstrated that AGM may offer a suitable modelfor study of cyclosporiasis

Gross and histopathological findings in Cercopithecus aethiops with experimental Cyclospora infection in Kenya

Purity N Nguhiu1, Claire N Wamae2,3, Japheth K Magambo4, Paul G Mbuthia5, Daniel C Chai6, Dorcas S Yole61Department of Veterinary Services, Kabete, Ministry of Livestock Development, Nairobi, 2Directorate of Research and Development, Kenya Methodist University, Meru, 3Kenya Medical Research Institute, Nairobi, 4Meru University College of Science and Technology, Meru, 5Department of Veterinary Pathology, Microbiology and Parasitology, University of Nairobi, 6Department of Tropical Infectious Diseases, Institute of Primate Research, Karen, Nairobi, KenyaAbstract: In 2009, experimental Cyclospora infections were established in two juvenile female and two adult male Cercopithecus aethiops (African green monkeys) at Nairobi&amp;#39;s Institute of Primate Research (IPR). The study animals were humanely sacrificed, and gross and histopathological evaluation was done at seven weeks post-infection. On gross examination, the juveniles had no abnormalities except for a slight enlargement of the mesenteric lymph nodes, while the adults displayed more pathology of enlarged lymph nodes, hemorrhagic gastrointestinal tracts, widespread necrotic foci of the liver, and enlarged spleens. Significant histopathological findings were observed in both the juveniles and adults, which ranged from mild inflammatory reactions in the stomach and intestines to intense cellular infiltrations with mitotic activity and lymphocytic infiltrations around the periportal area of the livers. The lymph nodes had extensive hyperplasia with many mitotic cells.Keywords: Cyclospora spp., cyclosporiasis, nonhuman primates, pathological findings, histopathological findings, African green monkey

The Influence of Socio-economic, Behavioural and Environmental Factors on Taenia spp. Transmission in Western Kenya: Evidence from a Cross-sectional Survey in Humans and Pigs (People, Animals and their Zoonoses - PAZ - project)

This project deals with zoonotic infections amongst livestock and the farmers who keep them. Zoonotic diseases are infections transmitted between animals and humans; they are a major group of pathogens (approximately 60% of all human-infective organisms), with a diversity of animal hosts including wildlife, pets and domestic animals. Domestic livestock (especially cattle and pigs) are an important source of zoonotic infections to humans, due in part to the close interactions between these agricultural animals and the people who keep them. While keeping domestic stock is an important source of rural livelihoods in many countries, these animals may also expose the families who keep them to disease risks. Understanding the interactions between people and their domestic animals, and the transmission of zoonoses between them, is of vital importance in creating the evidence-based disease control policies that are required to protect both human and animal health. The dataset relates to a paper published in an open access journal, relating to the influence of socio-economic, behavioural and environmental factors on Taenia spp. transmission in western Kenya. Taenia, of cysticercosis, is a zoonotic disease. These data were collected in a cross-sectional epidemiological study carried out between 2010 and 2013. Funding was from the Wellcome Trust and the Medical Research Council

Epidemiology of COVID-19 infections on routine polymerase chain reaction (PCR) and serology testing in Coastal Kenya

Background: There are limited studies in Africa describing the epidemiology, clinical characteristics and serostatus of individuals tested for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. We tested routine samples from the Coastal part of Kenya between 17th March 2020 and 30th June 2021. Methods: SARS-CoV-2 infections identified using reverse transcription polymerase chain reaction (RT-PCR) and clinical surveillance data at the point of sample collection were used to classify as either symptomatic or asymptomatic. IgG antibodies were measured in sera samples, using a well validated in-house enzyme-linked immunosorbent assay (ELISA). Results: Mombasa accounted for 56.2% of all the 99,694 naso-pharyngeal/oro-pharyngeal swabs tested, and males constituted the majority tested (73.4%). A total of 7737 (7.7%) individuals were SARS-CoV-2 positive by RT-PCR. The majority (i.e., 92.4%) of the RT-PCR positive individuals were asymptomatic. Testing was dominated by mass screening and travellers, and even at health facility level 91.6% of tests were from individuals without symptoms. Out of the 97,124 tests from asymptomatic individuals 7,149 (7%) were positive and of the 2,568 symptomatic individuals 588 (23%) were positive. In total, 2458 serum samples were submitted with paired naso-pharyngeal/oro-pharyngeal samples and 45% of the RT-PCR positive samples and 20% of the RT-PCR negative samples were paired with positive serum samples. Symptomatic individuals had significantly higher antibody levels than asymptomatic individuals and become RT-PCR negative on repeat testing earlier than asymptomatic individuals. Conclusions: In conclusion, the majority of SARS-CoV-2 infections identified by routine testing in Coastal Kenya were asymptomatic. This reflects the testing practice of health services in Kenya, but also implies that asymptomatic infection is very common in the population. Symptomatic infection may be less common, or it may be that individuals do not present for testing when they have symptoms