RP-Department of Pathology

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Association of FCgamma receptor IIA (CD32) polymorphism with malarial anemia and high-density parasitemia in infants and young children.
(American Journal of Tropical Medicine and Hygiene, 2006-04) Ouma, C.; Keller, C.C.; Opondo, D.A.; Were, T.; Otieno, Richard O.; Otieno, Micheal Frederick; Orago, A. S.; Ong'echa, J. M.; Vulule, JM; Ferrell, RE; Perkins, D. J.
Suppression of RANTES in children with Plasmodium falciparum malaria.
(Haematologica, 2006-10) Were, T.; Hittner, James B.; Ouma, C.; Otieno, Richard O.; Orago, A. S.; Ong'echa, J. M.; Vulule, J. M.; Keller, C. C.; Perkins, D. J.
Severe malarial anemia (MA) is the primary manifestation of severe malaria among children in areas of holoendemic Plasmodium falciparum transmission. Although overproduction of inflammatory-derived cytokines are implicated in the immunopathogenesis of severe MA, chemokines such as regulated on activation, normal T-cell expressed and secreted (RANTES, CCL5) are largely unexplored in childhood malaria. We found that RANTES is decreased during severe MA (p<0.01), and associated with suppression of erythropoiesis (p<0.05) and malaria-induced thrombocytopenia (p<0.05). These findings suggest that thrombocytopenia may be a source of reduced RANTES which may contribute, at least in part, to suppression of erythropoiesis in children with malarial anemia.
Trypanosoma brucei rhodesiense transmitted by a single tsetse fly bite in vervet monkeys as a model of human African trypanosomiasis.
(Public Library of Science, 2008-05-14) Thuita, John Kibuthu; Kagira, John Maina; Mwangangi, David Mumo; Matovu, E.; Turner, C. M.; Masiga, D.
We have investigated the pathogenicity of tsetse (Glossina pallidipes)-transmitted cloned strains of Trypanosoma brucei rhodesiense in vervet monkeys. Tsetse flies were confirmed to have mature trypanosome infections by xenodiagnosis, after which nine monkeys were infected via the bite of a single infected fly. Chancres developed in five of the nine (55.6%) monkeys within 4 to 8 days post infection (dpi). All nine individuals were successfully infected, with a median pre-patent period of 4 (range = 4–10) days, indicating that trypanosomes migrated from the site of fly bite to the systemic circulation rapidly and independently of the development of the chancre. The time lag to detection of parasites in cerebrospinal fluid (CSF) was a median 16 (range = 8–40) days, marking the onset of central nervous system (CNS, late) stage disease. Subsequently, CSF white cell numbers increased above the pre-infection median count of 2 (range = 0–9) cells/µl, with a positive linear association between their numbers and that of CSF trypanosomes. Haematological changes showed that the monkeys experienced an early microcytic-hypochromic anaemia and severe progressive thrombocytopaenia. Despite a 3-fold increase in granulocyte numbers by 4 dpi, leucopaenia occurred early (8 dpi) in the monkey infection, determined mainly by reductions in lymphocyte numbers. Terminally, leucocytosis was observed in three of nine (33%) individuals. The duration of infection was a median of 68 (range = 22–120) days. Strain and individual differences were observed in the severity of the clinical and clinical pathology findings, with two strains (KETRI 3741 and 3801) producing a more acute disease than the other two (KETRI 3804 and 3928). The study shows that the fly-transmitted model accurately mimics the human disease and is therefore a suitable gateway to understanding human African trypanosomiasis (HAT; sleeping sickness).
Haplotypes of IL-10 promoter variants are associated with susceptibility to severe malarial anemia and functional changes in IL-10 production.
(Human Genetics, 2008-11) Ouma, C.; Davenport, G. C.; Were, T.; Otieno, Micheal Frederick; Hittner, James B.; Vulule, J. M.; Martinson, J.; Ong'echa, J. M.; Ferrell, R. E.; Perkins, D. J.
Naturally acquired hemozoin by monocytes promotes suppression of RANTES in children with malarial anemia through an IL-10-dependent mechanism.
(Microbes and Infection, 2009) Were, T.; Davenport, G. C.; Yamo, EO; Hittner, James B.; Awandare, GA; Otieno, Micheal Frederick; Ouma, C; Orago, A. S.; Vulule, JM; Ong'echa, J. M.; Perkins, D. J.
Regulated upon activation, normal T-cell expressed, and secreted (RANTES, CCL-5) is an important immunoregulatory mediator that is suppressed in children with malarial anemia (MA). Although proinflammatory (e.g. TNF-α, IL-1β and IFN-γ) and anti-inflammatory (e.g., IL-4, IL-10 and IL-13) cytokines regulate RANTES production, their effect on RANTES in children with MA has not been determined. Since intraleukocytic malarial pigment, hemozoin (Hz), causes dysregulation in chemokine and cytokine production, the impact of naturally-acquired Hz (pfHz) on RANTES and RANTES-regulatory cytokines (TNF-α, IFN-γ, IL-1β, IL-4, IL-10, and IL-13) was examined. Circulating RANTES levels progressively declined with increasing levels of pigment-containing monocytes (PCM) (P=0.035). Additional experiments in cultured peripheral blood mononuclear cells (PBMC) showed that monocytic-acquisition of pfHz (in vivo) was associated with suppression of RANTES under baseline (P=0.001) and stimulated conditions (P=0.072). Although high PCM levels were associated with decreased circulating IFN-γ (P=0.003) and IL-10 (P=0.010), multivariate modeling revealed that only PCM (P=0.048, β=-0.171) and IL-10 (P<0.0001, β=-0.476) were independently associated with RANTES production. Subsequent in vitro experiments revealed that blockade of endogenous IL-10 significantly increased RANTES production (P=0.028) in PBMC from children with naturally-acquired Hz. Results here demonstrate that monocytic-acquisition of Hz suppresses RANTES production in children with MA through an IL-10-dependent mechanism. Keywords: Malaria, Hemozoin, Monocytes, Rantes, IL-10
A novel functional variant in the stem cell growth factor promoter protects against severe malarial anemia.
(Infection and Immunity, 2010-01) Ouma, C.; Keller, C.C.; Davenport, G. C.; Were, T.; Konah, S.; Otieno, Micheal Frederick; Hittner, James B.; Vulule, J. M.; Martinson, J.; Ong'echa, J. M.; Ferrell, R.E.; Perkins, D. J.
Plasmodium falciparum malaria is a leading global cause of infectious disease burden. In areas in which P. falciparum transmission is holoendemic, such as western Kenya, severe malarial anemia (SMA) results in high rates of pediatric morbidity and mortality. Although the pathophysiological basis of SMA is multifactorial, we recently discovered that suppression of unexplored hematopoietic growth factors that promote erythroid and myeloid colony development, such as stem cell growth factor (SCGF) (C-type lectin domain family member 11A [CLEC11A]), was associated with enhanced development of SMA and reduced erythropoietic responses. To extend these investigations, the relationships between a novel SCGF promoter variant (-539C/T, rs7246355), SMA (hemoglobin [Hb] < 6.0 g/dl), and reduced erythropoietic responses (reticulocyte production index [RPI], <2.0) were investigated with Kenyan children (n = 486) with falciparum malaria from western Kenya. Circulating SCGF was positively correlated with hemoglobin levels (r = 0.251; P = 0.022) and the reticulocyte production index (RPI) (r = 0.268; P = 0.025). Children with SMA also had lower SCGF levels than those in the non-SMA group (P = 0.005). Multivariate logistic regression analyses controlling for covariates demonstrated that individuals with the homologous T allele were protected against SMA (odds ratio, 0.57; 95% confidence interval [95% CI] 0.34 to 0.94; P = 0.027) relative to CC (wild-type) carriers. Carriers of the TT genotype also had higher SCGF levels in circulation (P = 0.018) and in peripheral blood mononuclear cell culture supernatants (P = 0.041), as well as an elevated RPI (P = 0.005) relative to individuals with the CC genotype. The results presented here demonstrate that homozygous T at -539 in the SCGF promoter is associated with elevated SCGF production, enhanced erythropoiesis, and protection against the development of SMA in children with falciparum malaria.
Functional promoter haplotypes of interleukin-18 condition susceptibility to severe malarial anemia and childhood mortality.
(PubMed, 2011) Were, T.; Gichuki, C.W.; Ong'echa, J. M.; Ouma, Collins; Anyona, S.B.; Kempaiah, P.; Raballah, E.; Davenport, G. C.; Konah, S.N.; Vulule, J.M.; Hittner, James B.; Perkins, D. J.
Severe malarial anemia (SMA) is a leading cause of morbidity and mortality in children residing in regions where plasmodium falciparum transmission is holoendemic. Although largely unexplored in children with SMA, interleukin-18 (Il-1S) is important for regulating innate and acquired immunity in inflammatory and infectious diseases. As such, we selected two functional single-nucleotide polymorphisms (SNPS) in the Il-18 promoter (-137G-C [rs187238J and -607-CA [rs1946518J) whose haplotypes encompass significant genetic variation due to the presence of strong linkage disequilibrium among these variants. The relationship between the genotypes/haplotypes, SMA (hemoglobin [HbJ, <5.0 g/dlJ, and longitudinal clinical outcomes were then investigated in Kenyan children (n =719). Multivariate logistic regression analyses controlling for age, gender, sickle cell trait, glucose-6-phosphate dehydrogenase (G6PD) deficiency, HIV-1, and bacteremia revealed that carriage of the -607AA genotype was associated with protection against SMA (odds ratio [ORJ = 0.440 [95% confidence interval {CI} =0.21 to 0.90J, P = 0.031) in children with acute infection. In contrast, carriers of the -137G/-607C (GC) haplotype had increased susceptibility to SMA (OR =2.050 [95% CI = 1.04 to 4.05J, P = 0.039). Measurement of IL-18 gene expression in peripheral blood leukocytes demonstrated that elevated IL-18 transcripts were associated with reduced hemoglobin concentrations (p = -0.293, P = 0.010) and that carriers of the "susceptible" GC haplotype had elevated IL-18 transcripts (p= 0.026). Longitudinal investigation of clinical outcomes over a 3-year follow-up period revealed that carriers of the rare CC haplotype (-1% frequency) had 5.76 times higher mortality than noncarriers (p = 0.001). Results presented here demonstrate that IL-18 promoter haplotypes that condition elevated IL-18 gene products during acute infection are associated with increased risk of SMA. Furthermore, carriage of the rare CC haplotype significantly increases the risk of childhood mortallty.
Assessment of voiding function in inhabitants infected with Schistosoma haematobium.
(Tropical Pediatrics, 2011-08) Muhoho, ND; Watanabe, K; Mutua, WR; Kiliku, FM; Awazawa, T; Moji, Kazuhiko; Aoki, Y
Voiding function of Schistosoma haematobium infected students was evaluated in 45 schoolboys in Kwale district, Coast province, Kenya, using a questionnaire and uroflowmetry. Sixty-eight schoolboys who were S. haematobium negative were also examined. Symptoms related to the lower urinary tract were qualitatively assessed using the International Prostate Symptoms Score (I-PSS) questionnaire. The I-PSS showed that S. haematobium infected boys felt the need to strain to urinate and post voiding some urine still remained. To examine the disturbances revealed by I-PSS quantitatively, voiding was assessed by a portable uroflowmeter and a bladder scanner. Unexpectedly, no significant residual urine post voiding and no decline in urine flow rates were found in S. haematobium infected boys. However, volume-corrected maximum and average flow rates in S. haematobium infected boys were higher than in those not infected. These results suggest that cystitis associated with S. haematobium infection causes irritation and hypercontraction of the bladder.
Tethered Cord Syndrome Secondary to the Unusual Constellation of a Split Cord Malformation, Lumbar Myelomeningocele, and Coexisting Neurenteric Cyst
(Hindawi Publishing Corporation, 2012) Nzioka, A.; Okechi, H.; Albright, A.L.
We describe a seminal case report of a child with a tethered cord syndrome secondary to the unusual constellation of a split cord malformation, lumbar myelomeningocele, and coexisting neurenteric cyst. A 17-year-old adolescent girl with a several-month history of myelopathy and urinary incontinence was examined whose spinal MRI scan demonstrated a type II split cord malformation with a large bone spur and an intradural neurenteric cyst in addition to lumbar myelomeningocele. Untethering of the spinal cord was achieved via a lumbar laminectomy. Pathological examination confirmed the intradural cyst to be a neurenteric cyst. Postoperatively there was stabilization of the neurological symptoms. Prophylactic surgery with total resection of the neurenteric cyst when feasible and spinal cord un-tethering appears to be associated with excellent outcomes.
Relationship between inflammatory mediator patterns and anemia in HIV-1 positive and exposed children with Plasmodium falciparum malaria
(Wiley Periodicals, Inc., 2012) Davenport, G. C.; Hittner, James B.; Were, T.; Ong'echa, J. M.; Perkins, D. J.
Anemia is the primary hematological manifestation of both Plasmodium falciparum malaria and HIV-1 in pediatric populations in sub-Saharan Africa. We have previously shown that HIV-1 positive and exposed children have greater risk of developing severe anemia (hemoglobin, Hb <6.0 g dL⁻¹) during acute malaria. However, enhanced severity of anemia was unrelated to either erythropoietic suppression or parasite-driven red blood cell hemolysis. To further explore mechanisms of anemia, circulating inflammatory mediators (IMs) were determined using a 25-plex bead array in P. falciparum-infected (Pf[+]) children (3-36 month, n = 194) stratified into three groups: HIV-1 negative (HIV-1[-]/Pf[+]); HIV-1 exposed (HIV-1[exp]/Pf[+]); and HIV-1 infected (HIV-1[+]/Pf[+]). IL-12, MIG/CXCL9, eotaxin/CCL11, and GM-CSF differed significantly and progressively increased across the groups (HIV-1[-] →HIV-1[exp] →HIV-1[+]). To further explore the relationship between the inflammatory milieu (i.e., cytokines, chemokines, and growth factors) and HIV-1 status, the large panel of IMs was reduced into discrete groups by principal component factor analysis. Of the six principal components that emerged, three components were significantly higher in the HIV-1 [+]/pf [+] and HIV [exp]/Pf [+] groups, demonstrating that inflammatory profiles differ according to HIV-1 status. Additional analyses exploring the relationship between the components and anemia revealed significant positive correlations between Hb and Component 3 (IL-1Ra, IL-7, IL-17, IFN-α, IFN-γ, MIG/CXCL9) in the HIV-1[-]/Pf [+] group, and Component 4 (IL-4, IL-5, IL-12, Eotaxin/CCL11) in HIV-1[+]/Pf [+] children. Further analyses of the HIV-1[+]/Pf [+] group revealed that IL-12 had the strongest association with anemia. Results presented here demonstrate that there are unique relationships between the inflammatory environment and anemia in HIV-1 positive and exposed children with malaria.
Reduced interferon (IFN) –α conditioned by IFNA2 (-173) and IFNA8 (-884) haplotypes is associated with enhanced susceptibility to severe malarial anaemia and longitudinal all-cause mortality
(PubMed, 2012-08) Were, T.; Kempaiah, P.; Anyona, S. B.; Raballah, E.; Davenport, G. C.; Hittner, James B.; Ong'echa, J. M.; Perkins, D. J.
Severe malarial anemia (SMA) is a leading cause of pediatric morbidity and mortality in holoendemic Plasmodium falciparum transmission areas. Although dysregulation in cytokine production is an important etiology of SMA, the role of IFN-α in SMA has not been reported. As such, we investigated the relationship between IFN-α promoter polymorphisms [i.e., IFNA2 (A-173T) and IFNA8 (T-884A)], SMA, and functional changes in IFN-α production in children (n = 663; <36 months) residing in a holoendemic P. falciparum transmission region of Kenya. Children with SMA had lower circulating IFN-α than malaria-infected children without severe anemia (P = 0.025). Multivariate logistic regression analyses revealed that heterozygosity at -884 (TA) was associated with an increased risk of SMA [OR 2.80 (95 % CI 1.22-6.43); P = 0.015] and reduced IFN-α relative to wild type (TT; P = 0.038). Additional analyses demonstrated that carriage of the -173T/-884A (TA) haplotype was associated with increased susceptibility to SMA [OR 3.98 (95 % CI 1.17-13.52); P = 0.026] and lower IFN-α (P = 0.031). Follow-up of these children for 36 months revealed that carriers of TA haplotype had greater all-cause mortality than non-carriers (P < 0.001). Generation of reporter constructs showed that the IFNA8 wild-type -884TT exhibited higher levels of luciferase expression than the variant alleles (P < 0.001). Analyses of malaria-associated inflammatory mediators demonstrated that carriers of TA haplotype had altered production of IL-1β, MIG, and IL-13 compared to non-carriers (P < 0.050). Thus, variation at IFNA2 -173 and IFNA8 -884 conditions reduced IFN-α production, and increased susceptibility to SMA and mortality
Health Seeking Behavior, Practices of TB and Access to Health Care among TB Patients in Machakos County, Kenya. A Cross-Sectional Study
(IISTE, 2014) Mutinda, Kasusu A.; Kabiru, Ephantus W.; Mwanik, Peter .K.
Despite efforts to implementation of the DOTS programme in Kenya since the year (1993) and achieving 100% coverage by the year 1996; new TB cases continue to emerge in communities, a significance of TB transmission. The success of the DOTS programne require total adherence to treatment for those infected with TB and appropriate control measures as stipulated in TB treatment guidelines, trained manpower to manage the infected patients and surveillance. The main objective of this study was to examine the health seeking behavior of TB patients, practices of TB and access to health care. A cross- sectional survey of TB patients was done in AthiRiver, Machakos level 5 and Mutituni TB treatment health facilities in Machakos County. A pre-tested self administered questionnaire/ interviews was used to collect data. The data was analyzed by use of statistical package for social sciences (SPSS) version 16. Pearson Chi-Square analysis was used to determine the relationships between variables. Level of significance was fixed at 0.05 (p=0.05).The results of this study reveal TB is affecting more males than females (60.4%).Most of the TB patients are young below 40 years accounting for (71.8%), are poor and unemployed (65%).When the TB patient realized they were sick, most of them (81.4%) sought informal remedies from private practioners or self medicated. This delayed early opportunity to seek heath care for more than one month by (82%) of the respondents. Failure of the informal treatment and unbearable pains in advanced disease forced the majority (96.8%) to seek health care in designated TB treatment facilities. There is secrecy in TB status disclosure as (75.5%) declined to openly disclose. For those who disclosed (78%) was to a selected family member mainly to seek assistance (90.7%). Across age groups, educational level, marital status, disclosure of TB status was of no statistical significance p=0.462 and openness of status p=0.112 respectively as the majority remained secret. Health education received by (52.8%) in the TB clinics was observed to significantly influence clinic attendance p=0.014 and adherence to treatment p=0.008 as 78.5% attended regularly and 85.5% adhered respectively. Treatment in public facilities is free with the majority (89.9%) reporting attendance. TB patients care in the community is mainly by family members (74.8%), there is no follow up by heath workers and social support group is minimal at (11.4%).The ministry of health needs to address control measures by initiating strict surveillance of TB, initiate community education on best practices of TB and to distigmatize the disease.
Incidence of perineural invasion in prostate adenocarcinoma: Rural Kenyan population experience
(Kenyatta University, 2014) Nzioka, A.l.; Onyuma, T.; Gakinya, S.
Introduction: Prostate cancer appears to be more aggressive amongst patients of African descent, a condition which could be associated with the presence of perineural invasion and higher Gleason scores of the cancer. Objective: This study evaluated the incidence of perineural invasion in previously diagnosed prostate cancer cases in a rural hospital which receive numerous cases of prostate cancer annually. Setting: This was a retrospective cross sectional study conducted at a busy mission referral hospital in rural Kenya. A total of 151 cases were included in the study. Patients' biodata was retrieved from the laboratory information system. Hematoxylin and eosin stained slides of previously diagnosed cases of prostate cancer over a period of one year (January 2012 to December 2012) were retrieved. These slides were microscopically examined for perineural invasion and the tumour grade determined using Gleason sconng. Results: Specimens from 151 patients were examined for perineural invasion. The patients' ages ranged from 46 to 93, mean age 73.77 (SD 9.474).Tumours in high grade category were 75.5% of the total number of cases while the rest (24.5%) were intennediatellow grade tumours. Out of these, 55.6% of the biopsies had perineural invasion. There was no significant relationship between the patients' age and the grade of tumour. Data on comparison of the cancers with perineural invasion and those without perineural invasion for grade demonstrated significant association between the tumour grade and the presence of perineural invasion (p:::;O.OOOI).
Cross-sectional Survey of Rift Valley Fever Virus Exposure in Bodhei Village Located in a Transitional Coastal Forest Habitat in Lamu County, Kenya.
(American Society of Tropical Medicine and Hygiene, 2015) Muiruri, S.; Kabiru, Ephantus W.; Muchiri, E. M.; Hussein, H.; Kagondu, F.; LaBeaud, A. D.; King, C. H.
Few studies have focused on Rift Valley fever virus (RVFV) transmission in less arid, transitional landscapes surrounding known high-risk regions. The objective of this study was to identify evidence of RVFV exposure in Bodhei Village in a forested area at the edge of the RVFV-epidemic Garissa region. In a household cluster-based survey conducted between epidemics in early 2006, 211 participants were enrolled. Overall seroprevalence for anti-RVFV was high (18%) and comparable with rates in the more arid, dense brush regions farther north. Seroprevalence of adults was 28%, whereas that of children was significantly lower (3%; P < 0.001); the youngest positive child was age 3 years. Males were more likely to be seropositive than females (25% versus 11%; P < 0.01), and animal husbandry activities (birthing, sheltering, and butchering) were strongly associated with seropositivity. The results confirm that significant RVFV transmission occurs outside of recognized high-risk areas and independent of known epidemic periods.
Mammary analogue secretory carcinoma of the salivary gland of a recently described tumour: A case report
(Kenyatta University School of Medicine, 2015) Nzioka, A.; Onyuma, P.; Gakinya, S.
Mammary Analogue Secretory Carcinoma (MASC) is a recently described tumour of the salivary gland, characterized by the t (12; 15) (p13; q25) translocation. We report a case from a 40 year old female who presented with a tumour in the right parotid gland at Social Service League, MP Shah Hospital in Kenya. Histological evaluation, immunohistochemical staining and fluorescent in situ hybridization (FISH) were done. The findings were consistent with mammary analogue secretory carcinoma of the salivary gland. It is important to distinguish this tumour from its morphological mimics. At the time of writing of this paper, we believed that this is the first case of mammary analogue secretory carcinoma described in Kenya.
Impact of sanitation improved school latrine on latrine-related practices, perceptions attitude and occurrence of diarrhoea in children in Mwea Division, Kirinyaga District, Central Kenya
(Kenyatta University School of Medicine, 2015) Ng'ethe, Muhoho; Mitsui, Y.; Mwandawiro, C.
Background: School latrines in Mwea irrigation regions are unsanitary and unhygienic. School children who are the end point users of the latrines are exposed to the unhygienic conditions of the latrines and are likely to contract sanitation related diseases. School children have their outlook on the sanitation of the school latrines and they can play an important role towards programmes for improvement of sanitation in the school latrines. Objective: To determine children's perception attitude and practices about the school latrines in relation to their health experiences. Methods: A self-administered questionnaire was conducted from 215 Grade Three children in three primary schools in Mwea Division of Central Kenya. Questions about washing hands after latrine use, cleaning of latrines, avoiding use of latrines and perceptions about dirty latrines in relation to occurrence of diarrhea were asked. Occurrence of diarrhoea was based on child's recall of the experience during the one week preceding the day of the test. Results: Diarrhoea was experienced by 23% of children occuring more often in boys (29%) than in girls (17%). Children who perceived school latrine to be dirty developed diarrhoea (29%) more often than those who did not (18%). Diarrhoea occurrence was reported more frequently by children whose response was negative for washing hands after latrine use (28%) than those who did (15%). Children who felt that cleaning school latrines was a punishment developed diarrhoea (41%) more often than those who did not (18%). On the other hand, there was no Significance difference in occurrence of diarrhoea in association with avoidance of usage of school latrines, cleaning of school latrines, and willingness to clean the school latrines. Conclusion: The school children have given a low rating of the sanitatary condition of the school latrines.They are the end point users of school latrines and their outlok on the condition of the latrine in relation to their health is important for implementation of disease intervention measures.
Prevalence and Correlates of Alcohol Use among Underage High-School Students in Murang’a and Kajiado Counties, Kenya
(Researchjournali’s Journal of Public Health, 2015-07) Okwarah, Patrick; Gakunju, Richard; Kabiru, Ephantus; Malla, Lucas; Okedi, William; Mutham, Lawrence; Karanja, Simon
Background: Alcohol use during adolescence is an important risk factor for a host of physical and social problems affecting the young people globally. There is limited data on the prevalence of alcohol use among the underage in Kenya. Aim: To determine the prevalence and correlates of alcohol use among underage high-school students in Murang‟a and Kajiado Counties in Kenya Methods: A random sample of 938 respondents (61.9% males and 38.1% females) below 18 years was obtained from Kajiado and Murang‟a on proportionate to stratum size. A multilevel logistic regression was used to investigate potential correlates to alcohol use. Results: The prevalence of current alcohol use was 37% and was significantly associated with being male (AOR = 1.58; 95% CI 1.40, 2.42) ;ease of getting an adult to buy alcohol (AOR=2.20; 95% CI 1.57, 3.10); cigarette use (AOR = 3.8; 95% CI 1.86, 8.28) and having multiple sexual partners (AOR =1.17; 95% 1.15, 1.20). Conclusion: There is a high prevalence of underage alcohol use in Murang‟a and Kajiado. A joint program targeting parents and teachers could be initiated so as to heighten the level of interventions required to avert further escalation of the problem.
Expression of p53 and HER2/Neu in Kenyan Women with Primary Ovarian Carcinoma
(Lippincott, Williams & Wilkins, 2016) Mutuiri, A.P.; Nzioka, A.; Busarla, S.V.; Sayed, S.; Moloo, Z.
Ovarian carcinomas are a leading cause of cancer mortality among women. Two of the more commonly described markers of prognostic significance in primary ovarian carcinomas are p53 and HER2/neu. Overexpression of both markers is associated with poor prognosis. This study aimed to determine the frequency and pattern of p53 and HER2/neu expression in primary ovarian carcinomas in Kenyan women and to describe the clinical and pathologic features of ovarian carcinomas diagnosed at 3 different hospitals in Kenya. Primary ovarian carcinomas diagnosed at the Departments of Pathology at Aga Khan University Hospital, Nairobi; the Aga Khan Hospital, Kisumu; and the AIC Kijabe Hospital in Kenya over a period of 3 years from January 2009 to December 2011 were recorded. Sixty-seven ovarian carcinomas were identified and blocks retrieved from archives. Hematoxylin-eosin-stained slides of these were reviewed and appropriate sections were stained for p53 and HER2/neu using standard immunohistochemical techniques. The primary outcome was presence and intensity of staining for p53 and HER2/neu. The most frequent malignancy was serous carcinoma. A total of 43.3% (95% confidence interval, 32.1%-55.2%) of carcinomas were positive for p53, and 13.4% (95% confidence interval, 7.2%-23.6%) were positive for HER2/neu. Serous carcinoma and adenocarcinoma, not otherwise specified were more likely to be positive for p53. There was no association noted between the histologic grade or pathologic stage and positivity for either p53 or HER2/neu. The expression of p53 and HER2/neu in primary ovarian carcinomas in Kenyan women is not different from that described in the literature.
Schistosoma mansoni Infection Can Jeopardize the Duration of Protective Levels of Antibody Responses to Immunizations against Hepatitis B and Tetanus Toxoid
(Public Library of Science, 2016) Riner, D. K.; Ndombi, E. M.; Carter, J. M.; Omondi, A.; Kittur, N.; Kavere, E.; Korir, H. K.; Flaherty, B.; Karanja, D.; Colley, D. G.
Multilocus sequence types and virulence determinants of hypermucoviscosity-positive Klebsiella pneumoniae isolated from community-acquired infection cases in Harbin, North China
(National Institute of Infectious Diseases, 2016) Zhao, Jizi; Chen, Jie; Zhao, Ming; Qiu, Xiaohong; Chen, Xiaobei; Zhang, Wenli; Sun, Rui; Ogutu, James Opiyo; Zhang, Fengmin

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