Serological Surveillance Development for Tropical Infectious Diseases Using Simultaneous Microsphere-Based Multiplex Assays and Finite Mixture Models

Background:A strategy to combat infectious diseases, including neglected tropical diseases (NTDs), will depend on the development of reliable epidemiological surveillance methods. To establish a simple and practical seroprevalence detection system, we developed a microsphere-based multiplex immunoassay system and evaluated utility using samples obtained in Kenya.Methods:We developed a microsphere-based immuno-assay system to simultaneously measure the individual levels of plasma antibody (IgG) against 8 antigens derived from 6 pathogens: Entamoeba histolytica (C-IgL), Leishmania donovani (KRP42), Toxoplasma gondii (SAG1), Wuchereria bancrofti (SXP1), HIV (gag, gp120 and gp41), and Vibrio cholerae (cholera toxin). The assay system was validated using appropriate control samples. The assay system was applied for 3411 blood samples collected from the general population randomly selected from two health and demographic surveillance system (HDSS) cohorts in the coastal and western regions of Kenya. The immunoassay values distribution for each antigen was mathematically defined by a finite mixture model, and cut-off values were optimized.Findings:Sensitivities and specificities for each antigen ranged between 71 and 100%. Seroprevalences for each pathogen from the Kwale and Mbita HDSS sites (respectively) were as follows: HIV, 3.0% and 20.1%; L. donovani, 12.6% and 17.3%; E. histolytica, 12.8% and 16.6%; and T. gondii, 30.9% and 28.2%. Seroprevalences of W. bancrofti and V. cholerae showed relatively high figures, especially among children. The results might be affected by immunological cross reactions between W. bancrofti-SXP1 and other parasitic infections; and cholera toxin and the enterotoxigenic E. coli (ETEC), respectively.Interpretation:A microsphere-based multi-serological assay system can provide an opportunity to comprehensively grasp epidemiological features for NTDs. By adding pathogens and antigens of interest, optimized made-to-order high-quality programs can be established to utilize limited resources to effectively control NTDs in Africa

Market Orientation and Business Performance in Kenyan SME’s

A Project Report Submitted to the School of Business in Partial Fulfillment of the Requirement for the Degree of Masters of Science in Organizational Development for Executives (MODE)Micro and Small Enterprises have been acknowledged as very important in economic development for job creation and poverty reduction. The government of Kenya has also acknowledged that these firms face a lot of challenges and that there is need to enhance their performance and competitiveness. This study examined market orientation in Micro and Small Enterprises in Kenya in relation to their performance. Micro and Small Enterprises are faced with many problems that include stiff competition by multinationals and government owned organizations and this has implication on their performance. With their large resource base and support from their parent organizations and the government, subsidiaries of multinationals and government organizations are a force to reckon with in the marketplace. Market Orientation is a strategy that firms can use to gain competitive advantage and enhance their performance. Dimensions of market orientation include innovativeness, competitive aggressiveness, pro-activeness and information sharing. The study was conducted in Nairobi where most of these SMEs are found and the target population was all the SMEs which have been in existence for 3 or more years. A list of SMEs was obtained from the Kenya Business directory whereby out of the target population of1600 employees, a sample population of 160 employees (10%) were selected after cross-checking the 2013 and 2015 directories to ensure that only those firms that are 3 years and above are in the study. The study used the explanatory and descriptive approach to examine the relationship between the dimensions of Market Orientation (innovation, information sharing, pro-activeness and competitive aggressiveness) and the performance of Micro and Small Enterprises in Nairobi County using a questionnaire. The study established a positive relationship between Market Orientation and the performance of Micro and Small Enterprises in Nairobi County. All the four dimensions of market orientation were positively related to performance and the regression analysis indicated that an increase in each of them would result into an increase in performance. The study recommends the integration of Market Orientation posture into the SME’s strategic behavior so as to be more competitive and improve their performance. The study also established that education, and firm age had moderating influence on the relationship between market orientation and performance. These findings are of importance to policy makers who can come up with different programs aimed at improving the competitiveness of these firms through creativity, experimentation and development of wholesome market orientation strategies. The Micro and Small Enterprises sector will further be enriched if further research is carried on in the other counties in Kenya as recommended in this study, thus establishing other market orientation factors that can increase the competitiveness and performance of these firms

Enhancing the Supervision of Community Health Workers With WhatsApp Mobile Messaging: Qualitative Findings From 2 Low-Resource Settings in Kenya

An estimated half of all mobile phone users in Kenya use WhatsApp, an instant messaging platform that provides users an affordable way to send and receive text messages, photos, and other media at the one-to-one, one-to-many, many-to-one, or many-to-many levels. A mobile learning intervention aimed at strengthening supervisory support for community health workers (CHWs) in Kibera and Makueni, Kenya, created a WhatsApp group for CHWs and their supervisors to support supervision, professional development, and team building. We analyzed 6 months of WhatsApp chat logs (from August 19, 2014, to March 1, 2015) and conducted interviews with CHWs and their supervisors to understand how they used this instant messaging tool. During the study period, 1,830 posts were made by 41participants. Photos were a key component of the communication among CHWs and their supervisors: 430 (23.4%) of all posts contained photos or other media. Of the remaining 1,400 text-based posts, 87.6% (n = 1,227) related to at least 1 of 3 defined supervision objectives: (1) quality assurance, (2) communication and information, or (3) supportive environment. This supervision took place in the context of posts about the roll out of the new mobile learning intervention and the delivery of routine health care services, as well as team-building efforts and community development. Our preliminary investigation demonstrates that with minimal training, CHWs and their supervisors tailored the multi-way communication features of this mobile instant messaging technology to enact virtual one-to-one, group, and peer-to-peer forms of supervision and support, and they switched channels of communication depending on the supervisory objectives. We encourage additional research on how health workers incorporate mobile technologies into their practices to develop and implement effective supervisory systems that will safeguard patient privacy, strengthen the formal health system, and create innovative forms of community-based, digitally supported professional development for CHWs

A creative approach to participatory mapping on climate change impacts among very young adolescents in Kenya

Adolescent perspectives are crucially important for developing sustainable solutions to address climate change yet remain overlooked in the literature, particularly in low and middle-income contexts. Kenya is an important context to explore youth climate solutions, as youth constitute the fastest growing population facing climate change-related challenges, such as extreme weather events (e.g., droughts) and issues of water, food, and sanitation security. This manuscript details a methodology for participatory mapping on climate-related issues that was co-developed with Kenyan youth and community-based organizations in Kenya. The aim of this paper is to describe the design of a multi-media participatory mapping tool to identify and address the interconnections between social, health, and environmental well-being with very young adolescents (aged 10-14 years) in six geographically-diverse, climate-affected regions of Kenya (Nairobi, Kisumu, Kilifi, Naivasha, Isiolo, and Kalobeyei Refugee Settlement). The authors describe methods used to develop a strengths-based multi-media participatory mapping approach that combines user-friendly geographic information system (GIS) technology with arts-based methods (dance, drawing, music, video). The aim is to share these methods and process of co-development to inform future participatory mapping approaches with youth climate-related issues