MST-Department of Medical Laboratory Sciences

Permanent URI for this community

https://repository.ku.ac.ke/handle/123456789/9106

Browse

Now showing 1 - 20 of 76

Access to Reproductive Health Services by Female Survivors of Sexual Gender-Based Violence in Selected Hospitals in Nairobi City County, Kenya.
(Kenyatta University, 2025-04) Oredo, Pascal Onyango
Women and girls ages 15-49 years married are estimated to form 30% of the victims of Sexual Gender Based Violence. World Health Organization reports that women who have experienced SGBV are at a higher risk of gynecological morbidities, miscarriages, unsafe abortions, pregnancy complications, HIV, and unwanted pregnancies. This study therefore aimed to determine the access to reproductive health services by female survivors of sexual gender-based violence in Nairobi City County, Kenya. The study used a descriptive cross-sectional design with pretested questionnaires. The study involved female survivors of sexual gender-based violence. The sample size comprised 269 survivors and 10 key informants. A pretest of research tools was carried out at the Mathare sub-county hospital. Data analysis was done by use of thematic content and quantitative data presented by use of percentages and frequency distribution tables. For inferential quantitative analysis, a binary logistic regression was used to determine the availability of reproductive health services, knowledge, attitude, and type of reproductive health services predictors of access to reproductive health services by female survivors of sexual gender-based violence. Odds Ratios were evaluated for significance by considering the 95% Confidence Interval or at a p-value
Acute Viral Respiratory Infections in Intensive Care Unit and Ventilator Support Patients in Moi Teaching and Referral Hospital, Uasin-Gishu County, Kenya.
(Kenyatta University, 2022) Kipsang, K. Amos; Washingtone Arodi; Marion Burugu
Acute respiratory tract infections (ARTIs) are among the five most common causes of morbidity and mortality globally, accounting for approximately 3.9 million deaths annually. Most of these deaths occur among young children in developing countries Mechanical ventilation supports the breathing system but does not change any pre-existing condition. Associated challenges include viral and bacterial infections. The prevalence of these infections is high, however these infections mimic bacterial infections. There is no documentation of these infections in many healthcare facilities In Africa. This study aimed at assessing the prevalence rates of Influenza virus, HRV, RSV, HPIV, hMPV, Human Adenovirus and HCoV in study subjects on ventilator support as well as those on critical care in the intensive care unit. The study was done at MTRH in Uasin Gishu County. Samples were collected from April 2017 to August 2017. 200 samples of bronchoalveolar lavage were collected. The samples were then transported to KEMRI Nairobi at 2-8°C for analysis. The RNA/DNA of the viruses was detected using real time PCR and multiplex PCR. Data analysis as well as coding and entry were done using statistical package for social studies (SPSS). The results were log-transformed to obtain equal distribution. The results were also expressed as mean±standard deviation. The results were then compared with respect to whether in ICU or on mechanical ventilation as well age using ANOVA with Bonferroni’s post-test using GenStat Release 14.1 (PC/Windows). Presentation of the data was done using graphs, pie charts and tables/figures. The samples that tested positive for Influenza A virus, HPIV-1, HPIV-2, HPIV-3, RSV, Adenovirus, HRV Human Metapneumovirus and HCoV was 33 (16.5%) 12 (6%), 8 (4%), 11 (5.5%), 19 (9.5%), 5(2.5%), 42(21%), 22 (11%) and 9(4.5%) respectively. However significant difference in viral infection among study participants in the intensive care unit and those on ventilator support in the different age groups of the patients analyzed was noted. There was noted difference among the patients in different age categories based on whether in ICU or ventilator support by Influenza A Virus, HPIV-1, HRV and hMPV viral infections at P-Value ≤0.05. Highest infection means were indicated in age group >65 for Influenza A Virus, HPIV-1 and HRV and age group <5 for hMPV in both ICU and those on ventilator support. Lowest infection means were also observed only in age group 20-34 for Influenza A Virus HPIV-1, HRV and Human metapneumovirus in the intensive care unit and also those on ventilator support. There were 34 cases of multiple viral infections. 20 cases were in those on ventilator support while 14 cases were present in those in the intensive care unit. It is evident that these infections are common in patients in ICU and those under ventilator support at MTRH. It is also clear that these infections are common in the various age categories. Those below 5 years and those above 50 years have higher prevalence of majority of the infections in comparison to other age groups. Surveillance for viral respiratory infections should be improved in order to implement treatment and also understand seasonality of these viruses and other new respiratory viruses. Co-infections should be closely monitored especially in mechanical ventilation in order to understand the impact of ventilator support on infection rates by these viruses. More studies needs to be done focusing on nosocomial respiratory viral infections.
Antibiotic Prescribing Practices of Clinical Officers for Patients with Upper Respiratory Tract Infection at Kiambu County, Kenya
(Kenyatta University, 2024-11) Murigi, Kevin Wambua
According to the World Health Organization (WHO), over 50% of all medicines are prescribed, dispensed or sold inadvertently, and more than half of all patients take them incorrectly. Antibiotics are the most routinely prescribed medications. Antibiotics are incorrectly prescribed for viral illnesses and broad-spectrum antibiotics are being used in place of narrow-spectrum antibiotics. Antibiotic resistance has emerged because of incorrect antimicrobial treatment and misuse of antibiotics. Findings from studies have shown an association between prescriber factors, patient factors, institutional factors and antibiotic prescribing. There is scarce data in Kenya about antibiotic prescribing practices, factors affecting antibiotic prescribing, how it varies between different healthcare workers and the mechanism by which interventions are effective. The goal of this study was to figure out antibiotic use among patients with upper respiratory tract infections in Kiambu County. The study design was a cross-sectional hospital-based study. The study area was one public level 5 hospital, five public level 4 hospitals and 14 public health centers within Kiambu County. Data was collected in the form of a modified WHO prescribing indicators checklist and using questionnaires. The WHO prescribing indicators checklist on rational use of medicine was used to collect data from 600 patient encounters. The questionnaire was used to collect data from 36 clinicians working in the outpatients. The data from the checklist included the total number of medications prescribed per encounter, the number of encounters with antibiotics, the proportion of generic antibiotics prescribed, the proportion of antibiotics prescribed from the Kenya Essential Medicines List (KEML), the antibiotic prescribed, its dose, frequency, duration and indication. The data from the questionnaire included prescriber age, gender, level of education, work experience, laboratory availability, availability of antibiotics and availability of guidelines. An Open Data Kit (ODK) was used to collect the WHO data collection checklist. Data was imported into a Microsoft Excel sheet from the ODK server then exported to a Statistical Package for Social Science (SPSS) version 22.0 for further cleaning and analysis. Descriptive statistics of frequencies and percentages were used to summarize categorical variables, and median (interquartile range) was used in case of continuous variables. Logistic regression was employed to find the association between antibiotic prescribing and the prescribing factors. Odds ratio with 95% confidence interval was reported in the logistic regression analysis. All analysis were considered significant when p < 0.05. Antibiotics were prescribed in 78% of patient encounters, 96.8% of encounters with an antibiotic had a generic antibiotic, and 96.6% of antibiotics prescribed were from the KEML. Over 91% of antibiotics prescribed were the right dose, 98.3% were the right frequency, 75.2% were the right duration, only 23.8% was the right indication. Availability of antibiotics p=0.026 and availability of hospital guidelines p=0.012 were significantly associated with rational antibiotic prescribing. Patient fever significantly affected rational antibiotic prescribing (OR 4.7, 95% CI 2.49, 8.89, p=<0.001), patient age and gender did not significantly affect antibiotic prescribing. Prescriber gender, p=0.63, age, p=0.92, education level, p=0.99 and work experience, p=0.22 did not significantly affect antibiotic prescribing.
Antibiotic Susceptibility Patterns of Bacteria Isolated from Wards, Operating Room and Post-Operative Wound Infections among Patients Attending Mama Lucy Hospital, Kenya.
(Kenyatta University, 2021) Auna, Amulioto Johnstone; Margaret Muturi; Scholastica Mathenge
Surgical site infections are a worldwide problem in the field of surgery contributing to increased mortality and morbidity. However, despite advances in the control of surgical site infections, the risk of acquiring these infections has not fully been eliminated due to the emergence and spread of resistant bacteria pathogens. In Kenya, there were scanty published reports on the antibiogram of surgical site infection pathogens lurking in the hospitals. The objective of this research was to determine the prevalence and antibiotic susceptibility patterns of bacteria isolated from the wards, operating room, and surgical site infections among patients attending Mama Lucy Hospital. This was a cross-sectional descriptive study of patients with post-operative wound infections in the hospital wards. Purposive sampling was employed and a total of 126 samples collected. Of these, 58 came from surgical site infected patients and 68 were obtained from predefined areas of the wards and operating room of the facility. The samples were processed through Gram stain, culture, and an array of biochemical tests. Subsequently, antibiotic susceptibility tests by Kirby bauer disc diffusion technique were performed on the isolated bacteria. Data collected was analyzed using a statistical package for the social sciences (SPSS) version 20 and chi-square (p<0.05). A total of 137 bacteria were isolated from the culture positive swabs, 78 of these came from the wound pus swabs while 59 were recovered from the hospital surface swabs. Among the SSI bacteria, Staphylococcus aureus (28.2%) was the preponderant bacteria followed by E.coli (15.4%). In the wards and operating room, the main bacterial contaminant was Staphylococcus aureus. Based on the sensitivity report, all the SSI bacteria isolates were sensitive to Chloramphenicol (69.2%). Wherease the environmental bacteria isolates had sensitivity to Ciprofloxacin (86.4%), Doxycycline (88.1%), Chloramphenicol (93.2%) and Vancomycin (100%). Majority of the environmental isolates were highly resistant to Ampicillin/cloxacillin. In conclusion, the most prevalent SSI bacteria was Staphylococcus aureus, while Chloramphenicol was seen as the best drug for treating SSI at the hospital. The facility therefore needs to identify the most frequent bacteria associated with SSI. In addition, they need to monitor the bacteria that frequently contaminate the wards and operating room. The current antibiogram profile will help policy makers in the healthcare sector and the current setting to improve the current local guidelines on antibiotic prophylaxis for treatment of surgical site infection. The profiling will also assist in monitoring bacteria resistance trends within the institution and the country. Information generated from the hospital environment will help the infection control team at the current set-up to improve on the prevention of healthcare associated infections by carrying out active monitoring of hospital contaminants.
Antibiotic Susceptibility Profile of Enteric Bacterial Isolates from Stool in Children below Five Years with Diarrhoeal Disease in Muranga County, Kenya
(Kenyatta University, 2019-06) Mbuthia, Oliver Waithaka
Diarrhoea is a major cause of morbidity and mortality in developing countries. Bacterial agents are among pathogens implicated to cause diarrhoea in children and are of major concern in public health. Antibiotic use has paradoxically led to bacterial resistance and the situation continues to worsen. The main objective of the study, therefore, was to determine enteric bacterial isolates and their susceptibility to antibiotics from diarrhoeal stool samples among children below five years in Murang`a County. A hospital-based cross-sectional study approach was applied to 163 randomly selected diarrhoeal stool samples from children below five years in Murang`a and Muriranja`s hospitals. Enteric bacterial pathogens were cultured and identified using polymerase chain reaction and biochemical methods. A questionnaire was used to collect information from the guardian. Statistical analyses were performed using STATA v.13. Fisher’s exact test was used to check for evidence of relationship (p<0.05). Regression model analysis was used to estimate the association between pathogenic bacterial isolates and demographic, clinical, and hygienic factors. There were nearly equal distributions in gender 86(52.8%) female vs. 77(47.2%) male, the majority (35.6%) aged within 1 day - 12 months. Clinically, 153(93.9%) had a fever, while 117(71.8%) had a nutritional problem. A total of 188 enteric bacterial isolates belonging to 11 genera were recovered from stool samples of children under investigation. Predominant bacteria from stool samples was nonpathogenic Escherichia coli 85(43.8%), while 13(7.0%) E. coli were positive for virulence genes, including 8(4.3%) positive for both LT and STp Shiga-like or Enterotoxigenic E. coli, 3(1.6%) for eae Enteropathogenic E. coli and 2(1.1%) for Enteroaggregative E. coli gene. Others included: Salmonella 21(10.8%), Pseudomonas 14(7.2%), Shigella 14(7.2%), Klebsiella 12(6.2%), Aeromonas 8(4.1%), Enterobacter 7(3.6%), Proteus 8(4.1%), Citrobacter 3(1.6%), Yersinia 2(1.1%) and Vibrio species 1(0.5%). Children between 1 day - 12 months (OR 0.3, 95% CI 0.1-0.8) were more likely to be infected with pathogenic bacteria than those between 49-60 months. Enteric bacterial isolates were highly diverse in female and among those aged 49-60 months. Female participants (OR 1.8, 95% CI 1.1-3.4) were nearly twice likely to be infected with pathogenic bacteria. Those who presented with watery stool (OR 0.4, 95% CI 0.2-0.9) or mucoid stool (OR 0.3, 95% CI 0.2-0.7) remained associated with pathogenic bacterial infection but less likely to be infected compared to those who presented with watery-blood stained stools. Piped water and storing water with a lid were associated with a less bacterial infection. Almost all the isolates were resistant to Ampicillin, Amoxicillin, Chloramphenicol, Ciprofloxacin, Ceftriaxone, Kanamycin and Cotrimoxazole. Bacterial identification and subsequent antibiotic susceptibility testing from stool samples should be scaled up to confirm and guide therapeutic use thereby minimizing bacterial resistance
Antifungal Activities of Camellia Sinensis Crude Extract on Selected Pathogenic and Mycotoxic Fungi
(2014-02-26) Sigei, Erolls Cheruiyot; Muturi, Margret; Bii, Christine
Human fungal infections pose serious medical issues. Up to now, more than a hundred thousand fungal species are considered as natural contaminants. During the last decade, the incidence of superficial and deep mycotic infections has continued to increase explosively. There is a general consensus among researchers, clinicians and pharmaceutical companies that new, potent, effective and safe antifungal drugs are needed. Majority of work has been conducted on Camellia sinensis extracts against bacterial agent’s activity but little work for antifungal activity. In this study, in vitro antifungal activities of Camellia sinensis crude extracts compared with azole group of compounds on selected pathogenic and mycotoxic fungi were determined. That was done by evaluating the difference in antifungal activities of green and black tea crude extracts having a concentration of 100mg mL-1. Quantitative bioassay was done using disc diffusion method and Minimum Inhibition Concentration was done using broth dilution methods. The fungal isolates used for bioactivity testing were yeasts; Candida famata, C. lusitaniae, C. tropicalis ATCC 750, C. parapsilosis ATCC 22019, C. glabrata ATCC 24433, C. krusei ATCC 6258 and Cryptococcus neoformans ATCC 66031; and moulds, Trichophyton mentagrophytes, Microsporum gypseum, Fusarium monilliforme, Aspergillus spp and Penicillium chrysogeneum. ATCC standard fungal strains and clinical isolates were included. Green tea crude extract showed stronger inhibitory effect against the fungal strains tested than black tea crude extract. There was a significant difference in zone of inhibitions (T=4.09, P<0.05). Zone of inhibition exhibited by green tea crude extracts (11.92±0.00mm) were higher than black tea crude extracts (8.14±0.56mm). The pattern of activity by tea crude extracts against ATCC standard fungal strains and clinical isolates strains were similar. C. famata, C. lusitaniae, C. tropicalis ATCC 750 and dermatophyte, T. mentangrophyte were inhibited by green tea crude extract (IZD≥15mm). Clinical isolates of Candida albicans (strain 4 and strain 5); Cryptococcus neoformans (strain 3, 5 and 12), showed susceptibility to Camellia sinensis green crude extracts. The MIC of Camellia sinensis crude extracts against fungal isolates tested ranged from 50 mg mL-1 to 1.6 mg mL-1. Hot green tea crude extract (mean MIC 12.25mg mL-1) had a higher MIC on clinical fungal isolates than cold green tea crude extract (Mean MIC 12.167 mg mL-1). The concentrates of aqueous Camellia sinensis crude extracts showed synergistic activity with conventional antifungal drug. However, level of synergism differed as observed in difference in inhibitory effect. The difference in inhibitory effect was significant (P<0.05). The crude tea extract restored the activity of lower concentration of antifungal, Fluconazole below MIC to susceptible breakpoints. Generally, the MFC (Minimum Fungicidal Concentration) of Mixture crude extracts were slightly higher as compared to that of green tea crude extract. These results are suggestive that addition of milk to blend the crude extracts altered the bioactive ingredients resulting to higher concentration for its MFC as compared to crude extracts alone. The studies on Camellia sinensis crude extracts (green and black) have shown remarkable antifungal activity against different strains of fungi and highlighted its significance to humans as potential health products.
Arthritis Risk Factors among Adults in Tombe Location, Nyamira County, Kenya; a Community-Based Study
(Kenyatta University, 2025-05) Kinara, Shem Nyarunda
Arthritis is a significant global health problem, with osteoarthritis being the most common type worldwide. The increasing prevalence of arthritis leads to substantial societal and personal costs. In Nyamira County, Arthritis is the second of morbidity as per the county integrated development plan 2018-2022. This study therefore, aimed assess arthritis risk factors among adults in Tombe Location, Nyamira County, Kenya. The specific objectives included: to establish the prevalence of arthritis among adults in Tombe location, Nyamira County, Kenya, to assess the risk factors associated with arthritis among adults in Tombe location, Nyamira County, Kenya, and to determine the association between level of knowledge and arthritis among adults in Tombe location, Nyamira County, Kenya. A cross-sectional research technique with multistage random sampling was used to select the study area through random balloting. Simple random sampling was used to select participants above 40 years from the selected households in the two sub-locations in Tombe location. Inclusion criteria was for those above 40 years who were willing to be part of the study. Those mental ill were excluded from the study. Data was collected used a structured interviewer based questionnaire. A self-reported doctor diagnosis and symptom-based screening criterion were used to identify participants with arthritis. Descriptive and inferential statistics were used in the data analysis. The level of significance for this study was set at 95% confidence level with variables having a p value of ≤ 0.05 being considered significant. Ethical clearance and other approvals were obtained from relevant authorities. A total of 307 participants from 258 households were included in this study. The prevalence of arthritis was 44.6%. Knee arthritis was the most common type (76.0%). Among the participants with arthritis, 88.3% experienced activity limitation. Joint injury/infection [AOR=2.74; 95% CI=1.59-4.77; p<0.01)], being unemployed [AOR=2.77; 95% CI=1.50-5.21; p = 0.00], staying in a town center [AOR=2.02; 95% CI=1.08-3.83; p=0.03), age 51+ years, and hypertension [AOR=1.90; 95% CI=1.03-3.53; p=0.04] were associated with an increased risk of developing arthritis. Conversely, being male [AOR=0.42; 95% CI 0.23-0.75; p=0.01], standing for > 2 hours [AOR=0.48; 95% CI 0.29-0.81; p=0.01)], and constant shifting from sit to stand positions [AOR=0.45; 95% CI=0.26-0.76; p<0.01)] were correlated with a lower risk of arthritis. The level of knowledge of arthritis was 71.8%. The Kaplan-Meier analysis showed that the estimated median age for having arthritis in this population was about 67 years, with females having a shorter median age of 63 years compared to 75 years in males. In conclusion, residents in this study area experienced a high rate of arthritis. Modifiable and non-modifiable risk factors were found to be statistically significant thus the need to address them to avoid further disability at the community level. This is despite there being a high level of knowledge. Further study is need to address differences in arthritis and its impact, with adequate control of confounders, and assess multiple arthritis risk factors.
Bacterial Flora as Determinants of Ventilator Associated Pneumonia in Intubated Patients in an Intensive Care Unit
(Kenyatta University, 2015-01-14) Nkoroi, Beatrice Nkirote
Infection is a major cause of morbidity and mortality in intensive care units (ICUs) worldwide. Of these, ventilator associated pneumonia (VAP), a common complication of endotracheal intubation and subsequent mechanical ventilatory support in critically ill ICU patients is a major concern for intensivists and other health care players. The issue of concern is whether the microbial agent present in the respiratory tract of patients at the time of intubation is likely to cause VAP in the intubated and mechanically ventilated patient. Studies done internationally have established a profile of some of the common bacterial agents responsible for VAP, however no studies have been done in Kenya to profile the common pathogens responsible for VAP and therefore, relatively little information is available about the Kenyan epidemiology of such infections. The purpose of this study was to provide an up-to-date picture of the demographic characteristics of patients who develop VAP, the prevalence of VAP and the common bacterial causative agents and the antimicrobial sensitivity patterns in a mixed medical – surgical ICU of the Aga Khan University Hospital, Nairobi Kenya. One hundred patients admitted into the ICU who were intubated during the study period were enrolled. Endotracheal aspirates were taken at the time of intubation and repeated when a clinical suspicion of VAP was made. Data was collected using preprinted case report forms and analyzed using chi-square and Pearson’s correlation as appropriate using the statistical software for social sciences (SPSS) version 17. Data was presented in tables, histograms, and other pictorial presentations as appropriate. The mean age of the patients was 55.86 years (95 % CI: 52.15, 59.67). Males were 57(57 %) and females were 43 (43 %).Most of the patients were admitted to ICU via A and E (35 %). Patients with medical conditions were (57) 57 %, those with surgical conditions were 25 (25 %) while 18 (18 %) had both a medical and surgical condition. A total of 78 (78 %) patients had chronic comorbidities while twenty two (22) patients did not have any comorbidity. Among the 78 who had comorbidities only 9 (12 %) had respiratory related comorbidities. A total of 21 (21 %) patients had a history of respiratory infection at the time of admission into ICU. Sixteen patients developed VAP, giving the prevalence of VAP at the AKUH, N ICU of 16 % (95 % CI: 14.0-23.6 %).The most common bacterial pathogens isolated from the patients with VAP were Acinetobacter baumanii (37.5 %), Pseudomonas aeruginosa (12.5 %), Klebsiella pneumoniae (6.3 %). Candida albicans was isolated in 12.5 % of patients with VAP. Thirty two percent (32 %) of the pathogens isolated demonstrated high resistance and MDR patterns to the antibiotics commonly prescribed in this ICU. Meronem (26 %), Tazopipril and Rocephine each at 12 % were the most commonly prescribed antimicrobial agents. Further studies are recommended to establish the susceptibility patterns of the individual antimicrobial agents and evaluate the clinical outcomes of patients with VAP
Barriers and Facilitators to Human Immunodeficiency Virus Self-Testing among Undergraduate Students in Kenyatta University, Kenya
(Kenyatta University, 2024-10) Muendo, Nicholas Kyalo
Over 36.9 million people worldwide live with HIV, with 21.7 million receiving ART. In Africa, 1.5 million individuals aged 15-24 are affected, with teenage girls and young women being disproportionately affected. KENPHIA Preliminary Report revealed a nationwide HIV prevalence rate of 4.9%, with women having a higher rate of 6.6% compared to men at 3.1%. HIVST aims to increase accessibility to testing services for at-risk populations. The WHO has preapproved three HIV self-testing kits for Kenya, including OraQuick®, Atomo®, and INSTI®. However, only 62% of young individuals are aware of their HIV-positive status, with university students at a higher risk due to risky sexual behaviors and cross-generational relationships. The UNAIDS aims to achieve 95% HIV status awareness by 2030, but current conventional HIV testing has not effectively ensured widespread availability of HIV prevention, treatment, and care. This cross-sectional analytical study targeted undergraduate students, utilizing multi-stage cluster sampling and self-administered questionnaires to collect comprehensive data on their demographic characteristics, HIV testing practices, and factors influencing HIVST uptake. The results revealed that 24.4% of participants had ever used HIVST, with 65.3% having tested for HIV overall. Among those who had tested, 44.6% had last done so more than a year ago, with facility-based testing being the most common method (71.2%). Age and gender were significant determinants of HIVST uptake; females (50.8%) and older students aged 22-25 years had higher odds of using HIVST. Awareness of HIV prevention methods like PrEP was a particularly strong facilitator, with participants aware of PrEP being 2.4 times more likely to use HIVST. Additionally, 69.1% of participants found HIVST kits affordable, though 57.7% reported difficulty accessing them. Social media emerged as the primary source of information for 56.7% of participants, while 86.6% found the instructions on the kits easy to understand. Despite these barriers, 78.4% of participants were confident in interpreting their HIV status at home, and 88.7% agreed that HIVST kits should be made available free of charge in public health facilities. The study underscored the importance of addressing persistent barriers such as stigma, cost, and accessibility to significantly increase HIVST uptake. Key recommendations include enhancing HIV prevention education, leveraging successful media campaigns like "Chukua Selfie," integrating HIVST into campus health services, and tailoring interventions to specific demographic groups such as young adults. The study provided a nuanced understanding of the determinants affecting HIVST uptake and offered actionable strategies to enhance HIV prevention and control efforts among young adults in Kenya.
Biochemical Markers Analysis for Sars-Cov-2 Infected Patients in Kakamega County, Kenya
(Kenyatta University, 2024-07) Njue, Gatavi Lilian
Aims and objectives: Severe Acute respiratory syndrome corona virus 2(SARS-CoV-2) is a type of coronavirus that first emerged in Wuhan, China late 2019. Once this virus infects any person, it causes Coronavirus disease 2019 (COVID-19) capable of causing death. Since then, hundreds of thousands of deaths have been reported as a result of COVID-19 globally. It is critical to detect the people with the potential of becoming very sick with COVID-19 early enough in order to save their lives by testing blood for certain chemicals known as biomarkers. This study aimed to determine biochemical markers in SARS-COV-2 infected patients in Kakamega County, Kenya. The Selected biochemical markers LFT, RFT, electrolytes, blood glucose level C-reactive protein (CRP), lactate dehydrogenase (LDH), were also evaluated for correlation with disease severity. Materials and methods: A cross-sectional study was conducted on 350 patients with COVID 19 attending Kakamega County general teaching and Referral Hospital. Ethical approval was sought from Kenyatta University Ethical and research committee and permission was obtained from Kakamega county general teaching and referral hospital administration. Socio-demographic, clinical characteristics of covid-19 among admitted patients in Kakamega Country Referral hospital was collected using a questionnaire. Five (5ml) of venous blood was collected and analyzed using standard hematological parameters profile, assessment of liver, renal and cardiac functions tests and evaluation of High-sensitivity C-Reactive protein. Results: A total of 350 patients were enrolled in the study. Majority of the participants were male (52.9%, 185/350) while 165(47.1%) were female. Out of the 350 patients recruited, 296 (84.6%) were Covid-19 positive while 44 (15.1%) were negative. This indicated a high prevalence of 84.6% of Covid-19 among patents who attended the facility during the study period. Data presentation was done using tables and figures and analyzed using formula of Le and Boen, Chi square and Correlation tests. Conclusions: Out of the 350 patients recruited, 296 (84.6%) were Covid-19 positive while 44 (15.1%) were negative. This indicated a high prevalence of 84.6% of Covid-19 among patents who attended the facility during the study period. Biochemical markers of the liver (ALT, AST), Total bilirubin, blood protein were elevated among Covid-19 positive patients, while albumin was low among Covid-19 negative patients.
Biochemical Markers Analysis for Sars-Cov-2 Infected Patients in Kakamega County, Kenya
(Kenyatta University, 2024-07) Njue, Gatavi Lilian
Aims and objectives: Severe Acute respiratory syndrome corona virus 2(SARS-CoV-2) is a type of coronavirus that first emerged in Wuhan, China late 2019. Once this virus infects any person, it causes Coronavirus disease 2019 (COVID-19) capable of causing death. Since then, hundreds of thousands of deaths have been reported as a result of COVID-19 globally. It is critical to detect the people with the potential of becoming very sick with COVID-19 early enough in order to save their lives by testing blood for certain chemicals known as biomarkers. This study aimed to determine biochemical markers in SARS-COV-2 infected patients in Kakamega County, Kenya. The Selected biochemical markers LFT, RFT, electrolytes, blood glucose level C-reactive protein (CRP), lactate dehydrogenase (LDH), were also evaluated for correlation with disease severity. Materials and methods: A cross-sectional study was conducted on 350 patients with COVID 19 attending Kakamega County general teaching and Referral Hospital. Ethical approval was sought from Kenyatta University Ethical and research committee and permission was obtained from Kakamega county general teaching and referral hospital administration. Socio-demographic, clinical characteristics of covid-19 among admitted patients in Kakamega Country Referral hospital was collected using a questionnaire. Five (5ml) of venous blood was collected and analyzed using standard hematological parameters profile, assessment of liver, renal and cardiac functions tests and evaluation of High-sensitivity C-Reactive protein. Results: A total of 350 patients were enrolled in the study. Majority of the participants were male (52.9%, 185/350) while 165(47.1%) were female. Out of the 350 patients recruited, 296 (84.6%) were Covid-19 positive while 44 (15.1%) were negative. This indicated a high prevalence of 84.6% of Covid-19 among patents who attended the facility during the study period. Data presentation was done using tables and figures and analyzed using formula of Le and Boen, Chi square and Correlation tests. Conclusions: Out of the 350 patients recruited, 296 (84.6%) were Covid-19 positive while 44 (15.1%) were negative. This indicated a high prevalence of 84.6% of Covid-19 among patents who attended the facility during the study period. Biochemical markers of the liver (ALT, AST), Total bilirubin, blood protein were elevated among Covid-19 positive patients, while albumin was low among Covid-19 negative patients.
Blood Cell Count Changes and Haemoglobin Genotypes in Children with Malaria and Bacteraemia in Siaya County Referral Hospital, Kenya
(Kenyatta University, 2022) Ogulla, Godfrey Adongo; Margaret Muturi; Collins Ouma
Malaria and bacteraemia co-infection in children, normally produce changes in blood cellular components. Full blood count results from children whose haemoglobin genotypes and bacteraemia is not known can greatly influence the reporting of the cellular components results from automated cell counter and this formed the aim of the on the clinical management and interpretation of the results. Nevertheless, there was missing information on the role of malaria and bacteraemia co-infection on cellular components of normal haemoglobin and sickle cell trait in children. A total number of 384 children were recruited and complete blood count test were analyzed by automated cell counter machine. Other tests done included malaria smear microscopy, blood culture by Bactec 9050 machine and haemoglobin genotype determined by Helena Haemoglobin electrophoresis method. Children were stratified into two study groups; Malaria positive and bacteraemia negative and malaria positive and bavteraemia positive. Across groups analysis against region established normal ranges, showed lymphocytopnia and thrombocytopenia. Bacteria isolated were all from children with Hb genotype AS with malaria and bacteraemia co-infection with bacteraemia prevalence of 8.1% (31,of 384). The isolated bacteria species included non-typhi salmonella (NTS) (32%), Escherichia coli (3%) Enterobacter cloacae (6.5%), Staphylococcus aureus (39), Listeria monocytogenes (10%), Streptococcus pyogenes (3%) and viridans streptococci (6.5%). Obtained results indicated that salmonella species and staphylococcus aureus bacteria as the most prevalent isolates associated with bacteraemia in children with haemoglobin genotype AS with malaria infection. Haemoglobin genotypes AS children are seen to be prone to malaria and bacteraemia co-infection and lymphocytopenia and thrombocytopenia being the common cellular changes seen in full blood count results. Staphylococcus aureus and salmonella spp were the most prevalent bacterial isolates. Recommended that haemoglobin electrophoresis should be considered for all paediatric patients admitted with malaria and bacteraemia co-infection with complete blood count indicating lymphocytopenia.
Cardiovascular Disease Risk Factors and Prevalence among People Living with Human Immunodeficiency Virus in Nairobi City County, Kenya.
(2024-09) Nyabera, Roseanne Aloo Ogola
The life expectancy of people with HIV living in developed countries is fast approaching general population norms. While this is because of better treatments, this optimism is tempered by a range of other conditions that are appearing as people living with human immunodeficiency virus (PLHIV), get older and live longer predisposing them to nonmodifiable risk factors for cardiovascular diseases. (CVDs). The dual burden of CVDs and HIV in sub–Saharan Africa is of public concern. People living with HIV are 1.5-2fold increased risk of coronary artery diseases mechanism based on a pro-inflammatory state due to HIV diseases and more likely to develop CVD risk factors compared to the non-infected individuals. Studies on associations between ARVs and CVD risk factors prevalence are mainly from developed countries thus need to get data from this region and document. This survey determined the CVD risk factors among PLHIV in Nairobi City County. Further, the study determined the relationship between the sociodemographic characteristics associated with CVD, biological CVD risk factors, the relationship between behavioural factors and CVD risk factor, and the relationship between the use of ARVs and biological and behavioural CVD risk factors among PLHIV. A descriptive cross-sectional study design, conducted in four (4) comprehensive care clinics, purposively selected, sampling technique used to determine the sample size of 405 participants. A data collection form with measurable elements used. The prevalence of CVD was found to be higher in male than female (7.2: 4.0), mean age at 47 years compared to the older population. Prevalence of 25.2% was found compared with the national data of 25.4%. The results indicated that 25.2% were overweight, 35.8% had elevated RBS, and 20.3% had 200 mg/dL and above, 48.1% of PLHIV had Prehypertension (Stage 1)130-139 <90 and 12.8% had stage 2 hypertension (>140 or >90). Gender and age significant at (P<.05), Frequency of BP measurements resulted in CVD risk factor at 0.010, CD4 count levels significant at 0.04. (Lower levels below 500cells/mm). Regression analysis results indicated that with other factors held constant at 7.744, then a .310 change in socio-demographic characteristics, .419 change in Use of ARVs factors and a .360 change in behavioural factors will contribute to a unit change in the CVD risk factors. In conclusion prevalence of CVD risk factors was high in PLHIV. Male patients at a higher risk than female and Mean age of 47years. The prevalence of Pre-hypertension Stage I and Stage II, obesity and elevated blood sugar levels was significant, but no association was observed with ART regime or duration of ARV use. There is a need to integrate CVD management into regular HIV care.
Comparative Study of Hepatitis B and Hepatitis C Viruses Among Hiv-1 Infected Intravenous Drug Users and Non-Users in Mombasa County
(Kenyatta University, 2017-09) Kinya, Caroline Mercy
HIV/AIDS is a debilitating disease associated with high mortality and morbidity globally. In Kenya, it is the major cause of mortality across all gender and age groups, in effect, putting a huge demand on the healthcare system and the economy. The HIV 1 positive population faces major challenges such as the drug resistance, severe hepatic coupled with immunological deficiencies and toxicity. The problems are aggravated by co-infection with blood borne diseases, varied responses to the infection and therapy among vulnerable groups. This study purposed to determine and compare; the CD4 counts, HIV viral loads, liver enzyme markers and the prevalence of viral hepatitis among the HIV- 1 positive IDUs and NDUs. A cross-sectional study was carried out in Mombasa County. A structured questionnaire was used to collect information on HIV AIDS, Hepatitis and social demographics. Blood samples were collected, screened and analyzed for HIV, HBV and HCV, CD4+ cell, HIV viral load and liver enzyme markers. Pearson’s Chi square, Student T test and one way Anova were used to analyze data. A P value ≤ 0.05 was considered statistically significant. A total of 200 participants consisting of 78 males and 122 females were recruited. Sero-prevalence of Hepatitis B and Hepatitis C was at 16% and 20% respectively among the IDUs and 11% and 8% respectively among the NDUs. The sero-prevalence of HIV+HBV+/HCV infection among IDUs and NDUs was 6% and 4% respectively. The liver enzyme markers (Alkaline phosphate, Aspartate aminotransferase and Alanine transferase) were markedly elevated among the co-infected participants than the mono-infected in both the NDU and IDU groups. IDUs showed elevated mean liver enzymes than the NDUs. The IDUs had a lower mean CD4+ cell count of 350.2 (±225.27) cells/μl than the NDUs 485.9 (±243.38) cells/μl (P˂0.0001). Participants who were co-infected showed remarkably low mean CD4+ cell counts of 192. 91(±84.08) cells/μl than the mono-infected with mean count of 536.79 (±218.76) cells/μl (P=˂0.0004). A statistically significant high mean viral load of 153392.97(±395699.65) copies/ml was reported among co-infected participants than the mono-infected at 2435.05(±5596.88) copies/ml (P˂0.0001) across the study population. The study established that the co-infection rates with HBVand HCV was higher among the IDUs than the NDUs. The liver profile indices indicated elevated liver enzymes among IDUs than NDUs. Co-infected participants had statistically significant higher liver enzyme markers than the mono-infected. Immunologically, CD4+ cell counts were lower among IDUs than the NDUs. Co-infected individuals had a lower mean CD4+ cell count than the mono-infected. IDUs had a statistically significant higher HIV viral load than the NDUs. The co-infected also indicated a statistically significant higher mean viral load than the mono-infected. This study proposes routine baseline screening of HBV and HCV for IDUs and NDUs owing to the high frequency of co-infections. A people driven campaign is also necessary to create awareness on the effects of the use of substances of abuse in relation to viral infections and treatment. Also the campaign is necessary to create awareness on the HBV vaccination.
Comparative Study of Hepatitis B and Hepatitis C Viruses among HIV-1 Infected Intravenous Drug Users and Non-Users In Mombasa County
(Kenyatta University, 2017) Kinya, Caroline Mercy
HIV/AIDS is a debilitating disease associated with high mortality and morbidity globally. In Kenya, it is the major cause of mortality across all gender and age groups, in effect, putting a huge demand on the healthcare system and the economy. The HIV 1 positive population faces major challenges such as the drug resistance, severe hepatic coupled with immunological deficiencies and toxicity. The problems are aggravated by co-infection with blood borne diseases, varied responses to the infection and therapy among vulnerable groups. This study purposed to determine and compare; the CD4 counts, HIV viral loads, liver enzyme markers and the prevalence of viral hepatitis among the HIV- 1 positive IDUs and NDUs. A cross-sectional study was carried out in Mombasa County. A structured questionnaire was used to collect information on HIV AIDS, Hepatitis and social demographics. Blood samples were collected, screened and analyzed for HIV, HBV and HCV, CD4+ cell, HIV viral load and liver enzyme markers. Pearson’s Chi square, Student T test and one way Anova were used to analyze data. A P value ≤ 0.05 was considered statistically significant. A total of 200 participants consisting of 78 males and 122 females were recruited. Sero-prevalence of Hepatitis B and Hepatitis C was at 16% and 20% respectively among the IDUs and 11% and 8% respectively among the NDUs. The sero-prevalence of HIV+HBV+/HCV infection among IDUs and NDUs was 6% and 4% respectively. The liver enzyme markers (Alkaline phosphate, Aspartate aminotransferase and Alanine transferase) were markedly elevated among the co-infected participants than the mono-infected in both the NDU and IDU groups. IDUs showed elevated mean liver enzymes than the NDUs. The IDUs had a lower mean CD4+ cell count of 350.2 (±225.27) cells/μl than the NDUs 485.9 (±243.38) cells/μl (P˂0.0001). Participants who were co-infected showed remarkably low mean CD4+ cell counts of 192. 91(±84.08) cells/μl than the mono-infected with mean count of 536.79 (±218.76) cells/μl (P=˂0.0004). A statistically significant high mean viral load of 153392.97(±395699.65) copies/ml was reported among co-infected participants than the mono-infected at 2435.05(±5596.88) copies/ml (P˂0.0001) across the study population. The study established that the co-infection rates with HBVand HCV was higher among the IDUs than the NDUs. The liver profile indices indicated elevated liver enzymes among IDUs than NDUs. Co-infected participants had statistically significant higher liver enzyme markers than the mono-infected. Immunologically, CD4+ cell counts were lower among IDUs than the NDUs. Co-infected individuals had a lower mean CD4+ cell count than the mono-infected. IDUs had a statistically significant higher HIV viral load than the NDUs. The co-infected also indicated a statistically significant higher mean viral load than the mono-infected. This study proposes routine baseline screening of HBV and HCV for IDUs and NDUs owing to the high frequency of co-infections. A people driven campaign is also necessary to create awareness on the effects of the use of substances of abuse in relation to viral infections and treatment. Also the campaign is necessary to create awareness on the HBV vaccination.
Comparison of Pap-Smear and Modified-Amsel’s Criteria in Screening for Bacterial Vaginosis among Women at Kiambu Level-V Hospital, Kiambu County, Kenya
(Kenyatta University, 2025-02) Omwono, Susan Akinyi
Bacterial vaginosis is a commonly experienced vaginal infection in reproductive age group women between 15 and 44 years old. Globally, 5-70% of women are affected. In Kenya the prevalence is between 10-50%. Bacterial vaginosis is a public health concern implicated in premature rupture of membranes, low birth weight, pelvic inflammatory disease, infertility and urogenital infections. Several methods exist for BV screening, among them Gram staining, Amsel‘s criteria, Papanicolaou smear, and Polymerase Chain Reaction. These methods require highly skilled microscopists, are not easily accessible, and they are expensive. The study’s’ main objective was to compare performance of the Modified Amsel‘s criteria and Pap smear to the gold standard method, Gram stain, to determine if the former which is simple and readily available is more suitable for bacterial vaginosis screening. A cross-sectional study involving 196 females between 18-55 years old was undertaken at the gynaecology Clinic in Kiambu level-V hospital, Kenya. A Pap smear and two high vaginal swabs were obtained from each participant. The Pap smear was evaluated as per the Bethesda system 2014 and smears positive for BV reported. In modified Amsel‘s criteria, the vaginal discharge was evaluated for homogeneity, pH, existence of clue cells and a fishy odour. For Gram stain method, smears were made on a slide and Gram-stained. Ten microscopic fields were observed for lactobacillus and Gardnerella morphotypes and rounded Gram rods. The bacteria were counted, scored and summed to get a full score within the range of 0-10. Purposive sampling method was used to recruit participants. The inclusion criteria was females between 18-55 years old who signed consent to be involved in the study. Exclusion criteria was pregnancy, menstruation and failure to give consent. Nominal and categorical data of the two methods was compared using Chi-square test. Statistical significance was determined by a p-value less than 0.05 at 95 percent Confidence Interval. Cohen’s Kappa statistics was used to determine the level of agreement of the two methods. Out of the 196 participants 46 (23.5%) were positive for BV by the Gram’s standard method, 60 (30.6%) by Modified Amsel’s criteria and 18 (9.2%) by Pap smear method. Sensitivity, Specificity, Positive Predictive Value and Negative Predictive Value of Pap smear was 32.6%, 98.0%, 83.3% and 82.5% respectively, while that of modified Amsel’s criteria was 82.6%, 85.3%, 63.3% and 94.1% respectively. There was slight agreement between Pap smear and modified Amsel’s criteria k=0.195 and p=0.063. Out of the analysed risk factors for Bacterial vaginosis, only age had a statistical association with BV (p=0.03). Prevalence of BV was 23.5%. Modified Amsel’s criteria was more accurate in screening for BV than Pap smear. These findings will inform policy makers on the most reliable method for BV screening in the absence of the gold standard.
Compliance to Food Hygiene Practice Standards among Food Handlers in Selected Restaurants in Nairobi City County, Kenya.
(Kenyatta University, 2024-02) Mosota, Lilian K.
Like any other food establishment or catering operation, there is a risk of getting food borne diseases after consuming contaminated restaurant foods. Food service establishments are expected to implement food hygiene practice requirements in all food handling processes including receiving, storage, preparation, processing, cooking and service of food. Restaurants which operate as food establishments therefore have a responsibility in ensuring food is protected from contamination or deterioration and should implement food hygiene practice requirements that will ensure food safety to the consumer. In efforts to mitigate the risk of food borne diseases, food handlers should observe food hygiene practice and should also have food hygiene knowledge since they are involved in all food handling processes. The already developed Kenya Standard - KS 2573:2015 outlines hygiene requirements for food service establishments including restaurants. The broad objective of the study was to establish compliance to food hygiene practice standards among food handlers in selected restaurants in Nairobi City County. This was a descriptive, cross-sectional study design. The study targeted 39 purposively and proportionately sampled restaurants and 316 food handlers in the selected restaurants in Nairobi City County. Data was collected using observation checklist, interview guide and questionnaire on self-reported practices measured using a 4-point Likert scale. Data to establish the food hygiene knowledge by food handlers was collected using a knowledge score questionnaire. Statistical Package for Social Sciences (SPSS) version 26 was used to analyze the data and these findings are reported in a descriptive and inferential manner. Qualitative method was used to analyze content from interviews for themes. The gap identified in restaurant food hygiene practice standards was on maintenance of building and facilities in matters cleanliness, repair of damaged building and facilities and compliance to personnel hygiene requirements. Major gaps were noted in food time and temperature control practices for high risk foods. Food handlers consistently reported poor food hygiene practice in aspects analyzed under food time and temperature control. The mean knowledge score of all food handlers was 55.33%. Food handlers’ knowledge was significantly lower than the minimum acceptable score of 70%. In accordance with food hygiene practice standards requirements, restaurants should implement prerequisite programmes regarding maintenance and repair of established restaurant building and facilities and adhere to personnel hygiene requirements. Restaurants should also implement food hygiene requirements regarding food time and temperature monitoring in all food handling critical control points. Restaurant food handlers should be continuously trained by qualified food hygiene trainers and their practice monitored in order to realize improvement in food hygiene knowledge and practice thus reduced transmission of food borne diseases.
Correlation between an early 6 and early 7 oncogenes detection method and conventional cytology for cervical cancer screening at Kenyatta National Hospital, Kenya
(Kenyatta University, 2016-10) Muyabwa, Cosmas
The oncogenic potential of human papilloma virus (HPV) early genes E6 and E7 is of interest in HPV testing for cervical carcinoma. The current study included women less than 40 years attending the Kenyatta National Hospital family planning clinic, with an objective of comparing the performance of cytological tests done in Kenya with the Pretect SEE assay developed by Norchip AS (Norway). Two hundred and four (204) samples were obtained in which the HPV E6 and E7 HPV mRNA was evaluated using the Pretect SEE assay for detection of high risk HPV types 16, 18 and 45. The HPV 35 and 52 may not be involved as the cause of invasive cervical cancer in Kenya. The real-time nucleic acid sequence-based on amplification was also included. The Pap test and cytological analysis were done locally at the Kenyatta National Hospital and the results were recorded and compared to the Pretect SEE results. Three (3) out of two hundred and four (203) women were positive with Pretect SEE (samples that expressed E6 and E7 HPV oncogenes), whereas only one sample(1) out of two hundred and three 203 samples was positive with Pap test. One sample (1) was rejected due to lack of cells. The overall diagnostic prevalence of HPV was 1.47% (3/203) after testing with pretect SEE and 0.5% (11203) after testing the pap smears. The Pretect SEE showed a specificity of 100% and a sensitivity of 100% using Pap smear as Gold standard. The PreTect SEE showed a positive predictive value (PPV) of 33 % and a 99% negative predictive value using Pap smear as the gold standard. The Pap smear showed a specificity of 100% and a sensitivity of 33% when using PreTect SEE as the gold standard. If all the PreTect SEE contains CIN2+ cases, the sensitivity, specificity, PPV and NPV would be 100%. In conclusion, the Pretect SEE™ assay was found to be more sensitive than the Pap smear. Therefore the use of PreTect SEE as a primary screening method with a high coverage rate may reduce the incidence of cervical pre-cancer to a minimum in Kenya. Using a very sensitive and specific method in a very representative female population in Kenya has strongly indicated that the prevalence of cervical cancer in Kenya may be lower due to false positive and lack of differentiation between transient and transforming infections. The estimated number of annual cervical cancer cases may be around 1000 and not 4800 as indicated by the IeO HPV Information (2012). The estimated prevalence of HPV 16 and/or HPV 18 DNA (2012) reported by ICO HPV Information Centre among cytological women in Kenya, may be less than 2,5%and not 9.1%. Around 40% of the HPV 16 and 18 HPV DNA in cytological normal cases may not express E6 and E7 mRNA. This also show that the prevalence of HIV in the whole Kenya population may not be 6.2% but rather less than 2%. The study showed that it is important to perform national screening in more than 3.2% of typical national population's in Africa.
Culicine Mosquito Species Diversity, Host Feeding Preferences and Insecticide Resistance Status in Taita-Taveta County, Kenya
(Kenyatta University, 2020) Ngami, Munyao Vanessa
Culicine mosquitoes are vectors of human disease-causing pathogens like lymphatic filariasis and several arboviruses such as dengue fever, chikungunya virus and so on. Due to intensifying land use land cover (LULC) with increasing pressure on natural environments because of urbanization and agricultural activities, there has been an increasing risk of mosquito-human contact leading to transmission of vector borne diseases. In recent years, along the coastal region, Kenya, there have been increased occurrences of emerging and re-emerging vector borne diseases, with subsequent social -economic concerns implications. Therefore, this study determined Culicine mosquito species abundance, diversity and their host feeding preferences in Taita -Taveta County, Coastal Kenya. A Cross sectional study design was adopted in this study. Entomological sampling was done in the months of March and October 2018, which are dry and wet season respectively. Adult mosquitoes were collected indoors and outdoors using CDC light traps and Backpack aspiration. The collected mosquitoes were sorted according to their sub-families as Anopheline and Culicine. The Culicine mosquitoes were identified morphologically into species and categorized according to their physiological status. The fully blood fed mosquitoes were tested for blood meal sources using Enzyme Linked Immunosorbent Assay (ELISA) for different hosts found within the peri -domestic environment mainly human, goat, chicken and bovine. For insecticide resistance characterization, mosquito larvae were collected using dipping sampling method, the mosquito larvae were reared into adults. The 3-5 old emergent mosquitoes were exposed to pyrethroids using WHO protocol. Three thousand two hundred and seventy-eight (3,278) mosquitoes were collected indoors (22.5%, n=738) and outdoors (77.5%, n=2,540). The collected Culicine mosquitoes were identified to be consisting of eighteen (18) species including; Aedes (7 species), Culex (8 species), Mansonia (2 species), Coquilletadia (1 species). Culex quinquefasciatus (69.1%) was the predominant species observed in all the six sites, though varied across the sites (χ2=85.5, df=5, P<0.001). Culex straitipes and Cx. Culicioma (0.03%) had the lowest numbers of mosquitoes. Overall, there was high mosquito species diversity (H) in outdoors (H = 2.4339) than in indoors (H =2.2523) with even distribution (EH) being higher in indoors (EH =0.9064) than outdoors (EH =0.8266). Of the mosquitoes collected, 1,241 mosquitoes were tested for blood meal sources. Majority of the blood meals sources identified were from multiple blood meal sources (51.6%), single hosts (41.3%) and least were unidentified (7.2%). There was significant difference of Human Blood Index between indoor and outdoor for Cx. Quinquefasciatus species (χ2=19.40, df=1, P<0.0001). Culex quinquefasciatus showed some existence of resistance to bediocarb, deltamethrin, DDT and fenitrothion, but were found to be susceptible to Permethrin. The study demonstrated that Culicine mosquitoes were highly zoophilic. It is therefore essential to evaluate the impact of zooprophylaxis on arboviruses transmission. There is a need for more studies on species distribution and abundance beyond what this study has accomplished and conduct vector competence and blood meal assays for a comprehensive assessment of lymphatic filariasis and arboviruses risk to public health in Taita-Taveta, Kenya.
The Cytokine Profile and Prostate Specific Antigen Levels in Prostate Cancer Patients at Kenyatta National Hospital
(Kenyatta University, 2015-08) Mwirigi, Liza Kiende
Prostate cancer (PCa) is Kenya‘s most frequently diagnosed cancer of men with an incidence rate of 32 per 100,000 and mortality rate of 12 per 100,000. It is also the leading cancer in terms of incidence and mortality in men from Africa and the Caribbean and the numbers may double by 2030. Prostate Specific Antigen (PSA) is the main diagnostic biomarker used for screening patients currently. Biopsy histology is the only confirmatory test, but it is invasive and tedious to perform. There is an urgent need to develop other accurate biomarkers that can be used for screening and diagnosis. Cytokines have potential but have not been extensively studied as biomarkers. The objectives of this study were to evaluate the cytokine profile, determine the PSA levels in PCa patients and the risk factors that lead to the development of PCa. The study profiled six cytokines (interleukin-2 (IL-2), interleukin-4 (IL-4), interleukin-6 (IL-6), interleukin-10 (IL-10), interferon gamma (IFN-Gamma) and tumor necrosis factor alpha (TNF-Alpha) and the total PSA levels in the serum of 45 PCa patients, 7 benign prostate enlargement (BPE) patients and 7 healthy males as controls. Cytokines were measured using a highly sensitive cytometric bead array technique. PSA levels were determined using enzyme linked immunosorbent assay (ELISA) technique. A questionnaire was used to determine the demographic and risk factors that lead to the development of PCa. Statistical analysis was performed using statistical package for social sciences (SPSS) version 21. Analysis of variance (ANOVA) was used to compare the means of the cytokines and PSA levels in the different Gleason scores of the PCa patients. Pearson correlation was used to correlate the six individual cytokines and PSA levels. Statistical significance was set at the level of p<0.05 for both the ANOVA and the Pearson correlation test. The results showed that serum levels of all cytokines and PSA were significantly (p<0.05) higher in the PCa and the BPE patients. The PCa patients with a Gleason score of 8-10 had the highest levels of all the cytokines followed by those with a Gleason score of 5-7, then those with a Gleason score of 2-4. TNF-Alpha and IL-6 were the cytokines with the highest levels while IL-4 and IL-10 had the lowest levels. The cytokine levels among the BPE patients were less than those of the PCa patients. The PSA levels were also significantly higher (p=0.002) in the BPE and PCa patients and they were significantly correlated (p=0.01) with the six cytokines in the two study groups. Kenyan men who are above 50 years are at risk of suffering from PCa. These results indicated that cytokine profiles in PCa patients are distinct by the stage of the disease. TNF-Alpha, IL-6, IFN-Gamma, IL-2 and IL-4 may be potential early diagnostic biomarkers for prostate cancer. The current data forms a basis for further investigations.

Browse

Browsing MST-Department of Medical Laboratory Sciences by Title

Results Per Page

Sort Options