Browsing by Author "Ogutu, James O."

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    Development of a multiplex PCR system and its application in detection of blaSHV, blaTEM, blaCTX-M-1, blaCTX-M-9 and blaOXA-1 group genes in clinical Klebsiella pneumoniae and Escherichia coli strains
    (2015) Ogutu, James O.
    Resistance to β-lactam antibiotics through β-lactamase production by Enterobacteriaceae continues to burden the health-care sector worldwide. Traditional methods for detection of β-lactamases are time-consuming and labor-intensive and newer methods with varying capabilities continue to be developed. The objective of this study was to develop a multiplex PCR (M-PCR) system for the detection of blaSHV, blaTEM, blaCTX-M-1, blaCTX-M-9 and blaOXA-1 group genes and to apply it in clinical Klebsiella pneumoniae and Escherichia coli strains. To do this, we used group-specific PCR primers in singleplex reactions followed by optimization into multiplex reactions. Specificity and sensitivity of the M-PCR were then evaluated using 58 reference strains before its application to detect bla group genes in 203 clinical Enterobacteriaceae strains. PCR amplicons were sequenced to determine the β-lactamase subtypes. The M-PCR system exhibited 100% specificity and sensitivity. In all, 83.7% of K. pneumoniae and 89.8% of E. coli clinical strains harbored bla group genes with 46.9%, 40.1%, 15.0%, 21.1% and 6.1% of K. pneumoniae having blaSHV, blaTEM, blaCTX-M-1, blaCTX-M-9 and blaOXA-1 group genes, respectively, whereas 12.2%, 77.6%, 22.4%, 36.7% and 8.2% of E. coli had blaSHV, blaTEM, blaCTX-M-1, blaCTX-M-9 and blaOXA-1 group genes, respectively. BlaSHV-1, blaSHV-11, blaSHV-27, blaSHV-33, blaSHV-144, blaTEM-1, blaTEM-135, blaOXA-1, blaCTX-M-3, blaCTX-M-9, blaCTX-M-14, blaCTX-M-15, blaCTX-M-27, blaCTX-M-55, blaCTX-M-65 and blaCTX-M-104 were detected. In conclusion, the M-PCR system was efficient and versatile with an advantage of simultaneously detecting all the targeted bla group genes. Hence, it is a potential candidate for developing M-PCR kits for the screening of these genes for clinical or epidemiological purposes.
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    Uptake of Intrauterine Contraceptive Device among HIV Positive Women at Selected Health Facilities in Nairobi City County, Kenya
    (International Academic Journal of Health, Medicine and Nursing (IAJHMN), 2022-01) Asava, Diana Navalya; Ochieng, James Otieno; Ogutu, James O.
    The increased maternal and neonatal mortality in Kenya among women living with HIV and AIDS can be attributed to high unmet needs of family planning at 52%. In Kenya there are approximately 1.5 million people living with HIV and 36000 people die annually due to HIV related diseases. In Kenya the uptake of intrauterine device in the general population is 3.4% compared to other modern methods. The study therefore aims at improving Intra-uterine contraceptive device uptake among women living with HIV/AIDS in selected health facilities in Nairobi City County, Kenya. The study specifically focuses on knowledge and barriers associated with intra-uterine device uptake in Nairobi City County. The study adopted a cross sectional-descriptive study design to collect data through a researcher administered questionnaires through research assistants. A total of 353 participants were interviewed from the selected facilities of Mathare North health Center, Huruma Lions Health Center and Pumwani Majengo Health Center which were purposively chosen. The study used quantitative collection methods. Systematic random sampling was used to select primary respondents at a predetermined interval of 8. Quantitative data was cleaned and entered into a Microsoft excel database before being analyzed by SPSS version 22.0. Descriptive statistics were presented using percentages, frequency tables, graphs and pie-charts. Inferential statistics were calculated to establish the association between study variables using chi-square tests done at 95% confidence interval. The results revealed that only 4.8% of respondents utilized intra-uterine contraceptive device. The study established low knowledge levels on intrauterine device among women living with HIV/AIDS in Nairobi City County. Knowledge levels were significantly associated with utilization intra-uterine contraceptive device (p=0.047). A number of factors were identified as possible barrier which hindered intra-uterine contraceptive device uptake which included facility reception (p=0.026), provision of information (p=0.002), culture/religion (p=0.004) and spouse allows use (p=0.002). The study concludes that there were low utilization rates and low knowledge levels on intra-uterine contraceptive device. The study further concludes that other barriers were possible reasons for low uptake of intra-uterine uptake among women living with HIV/AIDS in Nairobi City County. The findings of this study would help relevant stakeholders in structuring programs and strategize on interventions to improve intra-uterine contraceptive uptake among women living with HIV/AIDS in the Nairobi City County and the country at large. This will discourage reliance on wrong knowledge on IUCD so as to reduce the unmet needs of family planning and reduce unintended pregnancies that crop up in the long run