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Mothers' knowledge on malaria and vector management strategies in Nyamira District, Kenya.
(East Afr Med J, 200-09) Osero, O.J.S.; Otieno, Micheal Frederick; Orago, A. S.
BACKGROUND: Maternal knowledge on malaria and vector control measures are important because they enable mothers make an informed choice on the method of malaria control to use for their children under five years. OBJECTIVE: To determine the mothers' knowledge on malaria and vector control measures particularly use of insecticide treated nets. DESIGN: Cross sectional, descriptive study. SETTING: Eight health centres in Nyamira District, Kenya. SUBJECTS: Four hundred mothers bringing their children aged five years and below to the child health clinics. RESULTS: Mothers had a problem of defining malaria. Majority of them (91.8%) recognised mosquitoes as causing malaria. About 30% associated malaria with dirt, dirty compounds, dirty food/utensils, unboiled water and uncooked food. Many mothers identified basic malaria symptoms such as headache (70%), fever (68.8%), cold (65%), body or joint pain (65.5%) and abdominal pain/ vomiting (0.5%). Mothers (40.8%)were less knowledgeable on most vulnerable groups to malaria. A large number of mothers (55.5%) used nothing to protect themselves and their children under five years from mosquito bites. The radio (69%) tuned in the local language, played a very important role in the mothers' knowledge about the use of mosquito nets and insecticide treated nets. CONCLUSION: By virtue of the fact that majority of mothers (91.8%) recognised that mosquitoes caused malaria, it was an indicator that they were knowledgeable of its existence. Mothers were also informed of most of the malaria vector control measures particularly use of bed nets and insecticide treated nets. However, the general usage of those measures was very low.
Topography as a modifier of breeding habitats and concurrent vulnerability to malaria risk in the western Kenya highlands
(Parasites & Vectors, 201-12) Mwanzo, I.; Atieli, H.E.; Zhou, G.; Lee, M.; Kweka, E. J.; Afrane, Y.; Githeko, A.K.; Yan, G.
BACKGROUND: Topographic parameters such as elevation, slope, aspect, and ruggedness play an important role in malaria transmission in the highland areas. They affect biological systems, such as larval habitats presence and productivity for malaria mosquitoes. This study investigated whether the distribution of local spatial malaria vectors and risk of infection with malaria parasites in the highlands is related to topography. METHODS: Four villages each measuring 9 Km2 lying between 1400-1700 m above sea level in the western Kenya highlands were categorized into a pair of broad and narrow valley shaped terrain sites. Larval, indoor resting adult malaria vectors and infection surveys were collected originating from the valley bottom and ending at the hilltop on both sides of the valley during the rainy and dry seasons. Data collected at a distance of ≤ 500 m from the main river/stream were categorized as valley bottom and those above as uphill. Larval surveys were categorized by habitat location while vectors and infections by house location. RESULTS: Overall, broad flat bottomed valleys had a significantly higher number of anopheles larvae/dip in their habitats than in narrow valleys during both the dry (1.89 versus 0.89 larvae/dip) and the rainy season (1.66 versus 0.89 larvae/dip). Similarly, vector adult densities/house in broad valley villages were higher than those within narrow valley houses during both the dry (0.64 versus 0.40) and the rainy season (0.96 versus 0.09). Asymptomatic malaria prevalence was significantly higher in participants residing within broad than those in narrow valley villages during the dry (14.55% vs. 7.48%) and rainy (17.15% vs. 1.20%) season. Malaria infections were wide spread in broad valley villages during both the dry and rainy season, whereas over 65% of infections were clustered at the valley bottom in narrow valley villages during both seasons. CONCLUSION: Despite being in the highlands, local areas within low gradient topography characterized by broad valley bottoms have stable and significantly high malaria risk unlike those with steep gradient topography, which exhibit seasonal variations. Topographic parameters could therefore be considered in identification of high-risk malaria foci to help enhance surveillance or targeted control activities in regions where they are most needed.
Risk of transfusion malaria in Nairobi.
(East Afr Med J., 1987-12) Kabiru, Ephantus W.; Kaviti, JN
Female labour participation in agricultural production and the implications for nutrition and health in rural Africa
(Elsevier, 1992-04) Lado, C.
The broad objectives of this paper are: firstly, to examine the initial impact of colonialism on food production by women, by considering their role and activity patterns within the household in terms of rights, obligations, exchanges, allocation of resources and responsibilities and the division of labour in the selected African Societies of the Luo, Kikuyu and Luhya (Kenya), Ewe and Kusasi (Ghana), Mandinka (The Gambia), Yoruba (Nigeria) and Azande (Sudan). These ethnic groups used as examples were mainly selected on the basis of their predominance and availability of data in these countries lying in the Sub-Saharan Africa having similar historical roots of the British colonial policies. Secondly, some of the possible social, economic and biological effects or implications on the changes in rural women's work in the chosen case studies in Africa are elucidated. It has been hypothesized that the development process in rural Africa has marginalized women (with varying degrees) in the subsistence sector, reducing their productivity and control over resources; and that women's total work burden has relatively increased, a phenomenon which can be understood as an integral process of capital penetration and accumulation. These changes may have significant implications for nutrition and health affecting the overall levels of food production. Although the selected illustrations do not represent the full range of possibilities in Sub-Saharan Africa, the data on the gender roles and workpatterns and the different changing ways do indicate that the women's role in food production has profound implications for socio-economic development in general and nutrition and health in particular with much wider applicability. In fact no such cross-sectional study has been conducted in rural Africa. It is generally concluded that any consideration of women's agricultural production should not neglect the structural bases of their inequality, and the policies can be inadequate if they overlook the relationship between the subsistence and commercial sectors and the women's role in each. In effect, the relative and absolute losses in women's food production and incomes bear immediately on the food crisis of many of the Sub-Saharan African countries, and that the current policies for the food crisis are likely to fail unless there is an improvement of the data base in women's and men's specific food production activities, processing and marketing for use in policy formulation and implementation. Indeed, the integration of women into the development process should be sensitive to and cognizant of their needs, contributions and potentials in Sub-Saharan Africa.
Bloodfeeding behavior of Anopheles gambiae s.l. and Anopheles funestus in Kilifi District, Kenya.
(J Am Mosq Control Assoc., 1993-06) Mbogo, C. M.; Kabiru, Ephantus W.; Muiruri, S. K.; Nzovu, J. M.; Ouma, J. H.; Githure, J. I.; Beier, J. C.
Blood meal samples were tested by ELISA for 534 Anopheles gambiae s.l. and 76 Anopheles funestus collected from 25 sites in Kilifi District, Kenya. Human IgG was detected in 94.4% of the An. gambiae s.l. and in 90.8% of the An. funestus. No samples were positive for cow and only a few were positive for goat. Both species fed predominantly on humans irrespective of host availability. At these sites on the Kenyan coast, the high degree of human-feeding by malaria vectors contributes to the efficiency of malaria parasite transmission and the high incidence of severe malaria.
Low-level Plasmodium falciparum transmission and the incidence of severe malaria infections on the Kenyan coast.
(Am J Trop Med Hyg., 1993-08) Mbogo, C.N.; Snow, R.W; Kabiru, Ephantus W.; Ouma, J. H.; Githure, J.I.; Marsh, K.; Beier, J.C.
The transmission of Plasmodium falciparum was studied in relation to the incidence of severe malaria infections at Sokoke and Kilifi town, Kilifi District, Kenya. Intensive mosquito sampling during a one-year period yielded Anopheles gambiae s.l., An. funestus, and An. coustani. Anopheles gambiae s.l. was the predominant vector, comprising 87.9% and 97.9% of the total anophelines collected in Sokoke and Kilifi town, respectively. The proportion of An. gambiae s.l. with P. falciparum sporozoite infections was 4.1% (20 of 491) in Sokoke and 2.2% (3 of 138) in Kilifi town; no infections were detected in An. funestus or in An. coustani. Entomologic inoculation rates indicated that residents were exposed to only 8.0 infective bites per year in Sokoke and 1.5 in Kilifi town. Transmission was detected during only six months in Sokoke and three months in Kilifi town despite low-level, year-round vector activity. The yearly incidence of severe P. falciparum infections in children, 1-4 years of age was 24.1 per 1,000 in Sokoke and 4.2 per 1,000 in Kilifi town. Monthly patterns of transmission corresponded closely with the incidence of severe infections. At these sites on the coast of Kenya, the spatial and temporal incidence of severe malaria infections is associated with low-level P. falciparum transmission by vector populations
Utilisation of antenatal and maternity services by mothers seeking child welfare services in Mbeere District, Eastern Province, Kenya.
(Kenya Medical Association, 2002) Mwaniki, P.K.; Kabiru, Ephantus W.; Mbugua, G.G.
Background: Utilisation of antenatal and maternity services is an important maternal health indicator. Increasing the proportion of mothers who are cared for in health facilities during pregnancy, childbirth and puerperium reduces the health risks to mothers and their children. Objective: To determine the utilisation of antenatal and maternity services by mothers of Mbeere District bringing their children to the child welfare clinic. Design: Cross-sectional, descriptive study. Setting: Four rural health centres in Mbeere district. Subjects: Two hundred mothers bringing their children aged one year and below to the child welfare clinic between September and December 2000. Results: The proportion of mothers who utilised health facilities for antenatal and maternity services was 97.5% and 52%, respectively. Utilisation of health facilities for maternity services was significantly influenced by number of children and distance to health facility in that, as number of children increased, utilisation of maternity services reduced (chi2=8.99; p=0.027; df=1). Mothers living less than 5 km to a health facility utilised the services better than those living 5 km and beyond (chi2=7.57; p=0.0059; df=1). Among the reasons given by the mothers (individual respondents and through Focus Group Discussions) regarding dissatisfaction with the services offered included shortage of drugs and essential supplies, lack of commitment by staff, poor quality of food and lack of cleanliness in the health facilities. Conclusion: Coverage for antenatal services was high among mothers during their last pregnancy. However, only about half of the mothers interviewed utilised health facilities for maternity services (labour and delivery). The major constraints experienced by the mothers as they sought for the services (as reported by individual respondents and through Focus Group Discussions) included lack of transport, lack of money for transport and hospital fee and delay in admission to health facility once mothers report in labour. Lack of satisfaction with quality of care given could be the major demotivating factor in the use of health facilities for maternity services.
Child Morbidity and Mortality in Slum Environments along Nairobi River
(Organization for Social Science Research in Eastern and Southern Africa, 2003) Keraka, M.; Wamicha, W. N.
The problem that guided this study was that child mortality and morbidity disparities continue to be observed in the era of improved expansion of the provision of health care services. Some areas have low mortality and morbidity while others such as the slums of Nairobi have high. Various factors may account for this scenario. On the one hand, this would be because of uneven distribution of health facilities. On the other hand, environmental factors may be the major contributors to this high rate of morbidity and mortality. Environmental factors have been analysed in thecontext of socio-economic, socio-cultural and health environments. The aim of this study was therefore to examine the impact of slum environments on morbidity and mortality profile in slum environments along Nairobi River. The main objectives were: first, to assess the influence of environmental factors on child morbidity and mortality, and second, to analyse the influence of the perception and behaviour patterns of slum dwellers on child mortality and morbidity. The data used in this study was collected using in-depth interviews and extensive literature review. The key findings of the study included the fact that poverty is a major factor in child morbidity and mortality. It is because of low-income levels that the families concerned were not able to improve the sanitation that was in turn going to improve the health status of the children. The study therefore recommended that the government should give small loans to slum dwellers, which they can use to start income- generating activities. This can help generate some money that may improve childcare practices.
Food Security Problems in Borabu Division, Nyamira District
(2004) Keraka, M.
This paper highlights the food security problems in Borabu Division, Nyamira District. It focuses on the concept of the relationship between population growth and land use. Secondly, it examines the influence of changing patterns of land ownership on land use and its impact on food availability. Thirdly, the paper investigates the impact of population growth on land use highlighting such issues as land devoted to food crop production, pasture and cash crop. The paper further examines the impact o~ male out-migration on land use. Finally, the paper highlights some of the major problems associated with land use for instance, labour shortages, lack of credit facilities, type of farm implements used, overutilization of land, limited extension services, and extinction of indigenous crops. Last but not least the paper endeavours to come up with valid conclusions and recommendations regarding these problems. The data for this paper was derived from observations as a member of the Abagusii community, an intensive review of recent studies carried out in the area, and some key informants. This information has been critically examined in this paper hence it gives us a clear picture of the problems of food production in this part of Nyamira District
Food Security Problems in Borabu Division, Nyamira District
(Food Security Problems in Borabu Division, Nyamira District, 2005-09-13) Keraka, M.
This paper highlights the food security problems in Borabu Division, Nyamira District. It focuses on the concept of the relationship between population growth and land use. Secondly, it examines the influence of changing patterns of land ownership on land use and its impact on food availability. Thirdly, the paper investigates the impact of population growth on land use highlighting such issues as land devoted to food crop production, pasture and cash crop. The paper further examines the impact o~ male out-migration on land use. Finally, the paper highlights some of the major problems associated with land use for instance, labour shortages, lack of credit facilities, type of farm implements used, overutilization of land, limited extension services, and extinction of indigenous crops. Last but not least the paper endeavours to come up with valid conclusions and recommendations regarding these problems. The data for this paper was derived from observations as a member of the Abagusii community, an intensive review of recent studies carried out in the area, and some key informants. This information has been critically examined in this paper hence it gives us a clear picture of the problems of food production in this part of Nyamira District.
Factors Influencing Diffusion of Electronic Medical Records: A Case Study in Three Healthcare Institutions in Japan
(The Health Information Management Association of Australia Limited, 2006) Otieno, G. O.; Hosoi, R.
This study examines the effect of three factors: information technology (IT) skills of healthcare workers, present status of computerisation in their organisations, and workers' attitudes on the diffusion of electronic medical records (EMRs) in the healthcare environment. Data were obtained from a self-questionnaire distributed to 390 healthcare workers. The study finds that respondents need an expanded EMR capability to include decision support systems and reminder systems, and that diffusion of EMR is heavily influenced by attitudes of healthcare workers. However, targeted training of healthcare workers is needed to foster positive attitudes about EMR, and build confidence in the benefits of these systems
Role of child health clinics in promoting use of insecticide-treated nets among children under five years in Nyamira district, Kenya.
(East Afr Med J., 2006-08) Osero, O.J.S.; Otieno, Micheal Frederick; Orago, A. S.
BACKGROUND: Maternal child health clinics are the ideal places to meet and sensitise all the mothers with children under five years on the use of insecticide-treated nets in the prevention of malaria. OBJECTIVE: To determine whether child health clinics are promoting the use of insecticide-treated nets in malaria prevention among children. DESIGN: Cross-sectional, descriptive study. SETTING: Eight health centres in Nyamira District. SUBJECTS: Four hundred mothers bringing their children aged five years and below to the child health clinics between August and October 2003. RESULTS: Two hundred and eighty four mothers (71%) had not received any information on the use of insecticide-treated nets while at the MCH clinics. Only 50% of the clinics had bed nets/ITNs posters mounted on their premises. Out of those clinics with posters, only in 50% of them had bed net posters seen. Very few mothers (36.2%) had seen the bed net/ITNs posters. None of the healthcare providers used bed net/ITNs posters to educate the mothers. None of the insecticide-treated net leaflets were issued. CONCLUSION: Despite the fact that maternal child health clinics were well placed in promoting the use of insecticide-treated nets to the mothers who brought their under five year children, very little was being done to this effect. MCH clinics need to be more aggressive in motivating mothers to use insecticide-treated nets.
Nurses' views on the use, quality and user satisfaction with electronic medical records: questionnaire development.
(Journal of Advanced Nursing, 2007) Otieno, OG; Toyama, H; Asonuma, M; Kanai - Pak, M; Naitoh K
AIM: This paper is a report of the development of an instrument to measure nurses' views on the use, quality and user satisfaction with electronic medical records systems. BACKGROUND: Use of electronic medical records systems in hospitals is steadily increasing, yet no validated instruments have assessed the effectiveness of these systems from the viewpoint of nurses. METHOD: Items were designed following a literature review based on three main constructs: use, quality and user satisfaction with electronic medical records. Reliability and validity were examined based on responses from 1,666 nurses from 42 hospitals in Japan in February 2006. Exploratory factor analysis was conducted to determine the degree to which each item within a construct was associated. The reliability of each resultant factor was computed using Cronbach's alpha coefficient. Content validity was addressed by basing the items on previous surveys and review of the instrument by a panel of nurses experienced in nursing informatics. Construct validity was examined through factor analysis and correlational analyses. FINDINGS: Extent of 'use' of electronic medical records resulted into three factors with good factor loadings, but only two had acceptable reliability. 'Quality' of electronic medical records had two factors with good factor loadings and reliability. 'User satisfaction' with electronic medical records had three factors, but only one had acceptable reliability. 'Use' and 'quality' constructs were positively correlated with 'user satisfaction'. CONCLUSION: The final instrument incorporates 34 items from the original 44-item pool. Initial validity results were positive and therefore the instrument can be used in evaluating electronic medical records in hospitals.
Sophistication of information technology in healthcare: a comparison among a sample of hospitals in Japan
(Electronic Journal of Health Informatics, 2007) Otieno, George Ochieng; Toyama, Hinako; Asonuma, Motohiro; Koide, Daisuke; Naitoh, Keiko
This study examines the level of clinical sophistication of information technology (IT) in a sample of hospitals in Japan and benchmarks the extent of clinical sophistication in Japan with the findings from similar surveys conducted at different points in time in the State of Iowa in the US and two provinces in Canada. Data for the study were collected using a validated instrument assessing three dimensions of IT sophistication: functional, technological and integration levels. Clinical areas that were assessed include patient management, patient care activities and clinical support activities. The results show that the majority of processes and activities that have been computer-ised in Japan are the basic patient management processes, such as admission, registrations and order entry systems. Telemedicine, expert systems and voice recognition systems for notes tran-scriptions were only available in less than 5% of the sample hospitals. Overall, there were no differences between the small hospitals and large hospitals in terms of functional and integration sophistication. However, large hospitals had higher technological sophistications than small hospitals. Functional sophistication was higher in Japan than Canada and the US. Technological sophistication in Japan was somewhat better than that of Canada but lower than that of the US. The results demonstrated that there exists substantial room for expanding clinical IT systems in the hospitals in Japan. Keywords: Hospital information systems, information technology, computerised medical records, system integration, medical informatics, medical technology
Malaria vector control practices in an irrigated rice agro-ecosystem in central Kenya and implications for malaria control
(Malaria Journal, 2008) Ng'ang'a, Peter Njoroge; Shililu, Josephat; Jayasinghe, Gayathri; Kimani, Violet; Kabutha, Charity; Kabuage, Lucy W.; Kabiru, Ephantus W.; Githure, John; Mutero, Clifford
Background Malaria transmission in most agricultural ecosystems is complex and hence the need for developing a holistic malaria control strategy with adequate consideration of socio-economic factors driving transmission at community level. A cross-sectional household survey was conducted in an irrigated ecosystem with the aim of investigating vector control practices applied and factors affecting their application both at household and community level. Methods Four villages representing the socio-economic, demographic and geographical diversity within the study area were purposefully selected. A total of 400 households were randomly sampled from the four study villages. Both semi-structured questionnaires and focus group discussions were used to gather both qualitative and quantitative data. Results The results showed that malaria was perceived to be a major public health problem in the area and the role of the vector Anopheles mosquitoes in malaria transmission was generally recognized. More than 80% of respondents were aware of the major breeding sites of the vector. Reported personal protection methods applied to prevent mosquito bites included; use of treated bed nets (57%), untreated bed nets (35%), insecticide coils (21%), traditional methods such as burning of cow dung (8%), insecticide sprays (6%), and use of skin repellents (2%). However, 39% of respondents could not apply some of the known vector control methods due to unaffordability (50.5%), side effects (19.9%), perceived lack of effectiveness (16%), and lack of time to apply (2.6%). Lack of time was the main reason (56.3%) reported for non-application of environmental management practices, such as draining of stagnant water (77%) and clearing of vegetations along water canals (67%). Conclusion The study provides relevant information necessary for the management, prevention and control of malaria in irrigated agro-ecosystems, where vectors of malaria are abundant and disease transmission is stable.
Association analysis of the FTO gene with obesity in children of Caucasian and African ancestry reveals a common tagging SNP
(Public Library of Science, 2008-03) Grant, S.F.; Li, M.; Bradfield, J.P.; Kim, C.E.; Annaiah, K.; Santa, E.; Glessner, J.T.; Casalunovo, T.; Frackelton, E.C.; Otieno, George Ochieng; Shaner, J.L.; Smith, R.M.; Imielinski, M.; Eckert, A. W.; Chiavacci, R. M.; Berkowitz, R.I.; Hakonarson, H.
Recently an association was demonstrated between the single nucleotide polymorphism (SNP), rs9939609, within the FTO locus and obesity as a consequence of a genome wide association (GWA) study of type 2 diabetes in adults. We examined the effects of two perfect surrogates for this SNP plus 11 other SNPs at this locus with respect to our childhood obesity cohort, consisting of both Caucasians and African Americans (AA). Utilizing data from our ongoing GWA study in our cohort of 418 Caucasian obese children (BMI$95th percentile), 2,270 Caucasian controls (BMI,95th percentile), 578 AA obese children and 1,424 AA controls, we investigated the association of the previously reported variation at the FTO locus with the childhood form of this disease in both ethnicities. The minor allele frequencies (MAF) of rs8050136 and rs3751812 (perfect surrogates for rs9939609 i.e. both r2 = 1) in the Caucasian cases were 0.448 and 0.443 respectively while they were 0.391 and 0.386 in Caucasian controls respectively, yielding for both an odds ratio (OR) of 1.27 (95% CI 1.08–1.47; P = 0.0022). Furthermore, the MAFs of rs8050136 and rs3751812 in the AA cases were 0.449 and 0.115 respectively while they were 0.436 and 0.090 in AA controls respectively, yielding an OR of 1.05 (95% CI 0.91–1.21; P = 0.49) and of 1.31 (95% CI 1.050–1.643; P = 0.017) respectively. Investigating all 13 SNPs present on the Illumina HumanHap550 BeadChip in this region of linkage disequilibrium, rs3751812 was the only SNP conferring significant risk in AA. We have therefore replicated and refined the association in an AA cohort and distilled a tag-SNP, rs3751812, which captures the ancestral origin of the actual mutation. As such, variants in the FTO gene confer a similar magnitude of risk of obesity to children as to their adult counterparts and appear to have a global impact.
Distribution of mosquito larvae within the paddy and its implication in larvicidal application in Mwea rice irrigation scheme, Central Kenya.
(International Centre for Insect Physiology and Ecology, 2008-03) Mwangangi, J.M; Muturi, E. J.; Shililu, J. I.; Jacob, B.; Kabiru, Ephantus W.; Mbogo, C.M.; Githure, J.I.; Novak, R.J.
Distribution of mosquito larvae in inundated rice fields is poorly known despite its profound implications in implementation of vector control programs. Based on oviposition behavior of gravid females and biotic and abiotic conditions of the rice field, distribution of mosquito larvae within the paddy may vary greatly. As a guide to implementation of mosquito vector control program targeting the aquatic stages in the rice fields in Mwea, studies were conducted to determine the distribution of mosquito larvae within the paddy. Twenty-eight cages measuring 50 cm3 were distributed randomly within the paddy during the transplanting stage of the rice growth cycle, and were examined twice per week up to the flowering stage to determine mosquito oviposition pattern. A total of 17,218 mosquito larvae were collected at the periphery and a further 17,570 at the center of the paddy. These comprised 7,461 larvae from the genus Anopheles and 27,327 from genus Culex. The number of pupae collected at the periphery was 1,004 and 1.5 times greater than the number collected at the center. Significantly higher counts of Anopheles larvae were collected at the center (1.00 +/- 0.11) than at the periphery (0.55 +/- 0.05) of the paddy during transplanting stage, but the difference was not significant during the tillering stage. In contrast, significantly higher numbers of Culex larvae were collected from the periphery (3.09 +/- 0.39) than at the center (2.81 +/- 0.24) of the paddy. More pupae were also collected at the center than at the periphery of the paddy. These findings indicate the distribution of Anopheles and Culex larvae in rice fields to be nonrandom; however, for successful achievement of an integrated vector control program targeting the diverse mosquito fauna occurring in rice fields, there is need to target the whole paddy for larvicidal application.
A Novel Susceptibility Locus for Type 1 Diabetes on Chr12q13 Identified by a Genome-Wide Association Study
(American Diabetes Association, 2008-04) Hakonarson, H.; Qu, H.; Bradfield, J. P.; Marchand, L.; Kim, C. E.; Glessner, J. T.; Grabs, R.; Casalunovo, T.; Taback, S. P.; Frackelton, E. C.; Eckert, A. W.; Annaiah, K.; Lawson, M. L.; Otieno, George Ochieng; Santa, E.; Shaner, J. L.; Smith, R. M.; Onyiah, C. C.; Skraban, R.; Chiavacci, R. M.; Robinson, L. J.; Stanley, C. A.; Kirsch, S. E.; Devoto, M.; Monos, D. S.; Grant, S. F. A.; Polychronakos, C.
OBJECTIVE—In stage 1 of our genome-wide association (GWA) study for type 1 diabetes, one locus at 16p13 was detected (P = 1.03 × 10−10) and confirmed in two additional cohorts. Here we describe the results of testing, in these additional cohorts, 23 loci that were next in rank of statistical significance. RESEARCH DESIGN AND METHODS—Two independent cohorts were studied. The Type 1 Diabetes Genetics Consortium replication cohort consisted of 549 families with at least one child diagnosed with diabetes (946 total affected) and DNA from both parents. The Canadian replication cohort consisted of 364 nuclear family trios with one type 1 diabetes–affected offspring and two parents (1,092 individuals). RESULTS—One locus at 12q13, with the highest statistical significance among the 23, was confirmed. It involves type 1 diabetes association with the minor allele of rs1701704 (P = 9.13 × 10−10, OR 1.25 [95% CI 1.12–1.40]). CONCLUSIONS—We have discovered a type 1 diabetes locus at 12q13 that is replicated in an independent cohort of type 1 diabetic patients and confers a type 1 diabetes risk comparable with that of the 16p13 locus we recently reported. These two loci are identical to two loci identified by the whole-genome association study of the Wellcome Trust Case-Control Consortium, a parallel independent discovery that adds further support to the validity of the GWA approach
The risk of pathogenic intestinal parasite infections in Kisii Municipality, Kenya
(BMC Public Health, 2008-07-14) Nyarango, R. M.; Aloo, P. A.; Kabiru, Ephantus W.; Nyanchongi, B. O.
Background: Intestinal parasitic infections are among the most common Infections worldwide.Various epidemiological studies indicate that the prevalence of intestinal parasites is high especially in developing countries, although in many of these, the environmental risk factors have not been clearly elucidated. The objective of this study was to determine the risk of pathogenic intestinal parasites infections in Kisii Municipality. Methods: Random sampling was used in the selection of the study samples. Stool parasitological profiles of food handlers were done by direct smear and formalin-ethyl acetate sedimentation method. Both vegetable and meat samples were examined for the presence of intestinal parasites. The storage and meat handling practices of the various butcheries were observed. Results: Types of samples examined for occurrence of intestinal parasites includes, a total of 84 vegetable, 440 meat and 168 stool samples. Fifty five (65.5%) vegetable,334 (75.9%) meat and 69 (41.1%) of the stool samples were found positive for intestinal parasites indicating a high overall risk (66.18%) for intestinal parasite infections. Of the parasites detected, the most common parasites infesting the foodstuffs and infecting the food handlers were Ascaris lumbricoides and Entamoeba histolytica. Parasites were significantly less likely to be present on meat that was refrigerated during display than meat that was displayed at ambient temperature. Conclusion: There is a high risk of infection with intestinal parasites in the sampled Municipal markets. About half of the food handlers surveyed (41.1 %) at the Municipal Hospital had one or more parasitic infections. Furthermore, meat (65.5%) and vegetables (75.9%) sold at the Municipal market were found to be contaminated with parasites hence the inhabitants requires a need for education on food safety, good distribution practices and improvement on sanitary conditions.
ORMDL3 variants associated with asthma susceptibility in North Americans of European ancestry
(Elsevier, 2008-12) Sleiman, P. M. A.; Annaiah, K.; Imielinski, M.; Bradfield, J. P.; Kim, C. E.; Frackelton, E. C.; Glessner, J. T.; Eckert, A. W.; Otieno, F. G.; Santa, E.; Thomas, K.; Smith, R. M.; Glaberson, W.; Garris, M.; Gunnlaugsson, S.; Chiavacci, R. M.; Allen, J.; Spergel, J.; Grundmeier, R.; Grunstein, M. M.; Magnusson, M.; Bisgaard, H.; Grant, S. F. A.; Hakonarson, H.

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