RP-Deparment of Medical Laboratory Sciences

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Antibiotic Susceptibility Profile of the Klebsiella Pneumoniae Isolated from Africa Inland Church Hospital Kijabe, Kenya
(International Journal of Advanced Multidisciplinary Research, 2019) Mwangi, Joseph Kibuchi; Mathenge, Scholastica; Njoroge, Wachuka
The emergence of antimicrobial resistance is primarily due to excessive and often unnecessary use of antibiotics in humans and animals. A study done in low and middle income countries showed a considerable increasing resistance in Enterobacteriaceae (Ashley et al., 2011). The data revealed that affordable first line agents such as ampicillin and gentamicin are unlikely to be clinically efficacious in a substantial proportion of infections. This results in increasing reliance on the third generation cephalosporins for empirical treatment of serious infections. However, the spread of extended-spectrum beta-lactamase producing strains into the community (Ashley et al., 2011), probably accelerated by this increased consumption, is eroding the usefulness of these drugs. Alternative agents for treating multi-resistant coliform infections, such as the carbapenems, are unaffordable for treatment of community- acquired infections in low-income countries. The clinical specimens which were used included; urine, aspirates, blood, cerebral spinal fluid (CSF), swabs of wound, device swabbing. The design was a prospective observational. Ethical approval was sought from the Kenyatta University ethical review committee and the Ethical committee in AIC Kijabe hospital as attached. antimicrobial susceptibility among the 55 blood samples infected with K. pneumoniae showed that 100% was resistant to Ampicillin, 98% was resistant to Ceftadime, 86% was resistant to Ceftriaxone, 83% was resistant to Cefazolin, and none of the isolates was resistant to Meropenem. To test whether the difference in means in relation to antibiotics resistance in Klebsiella pneumoniae isolates was significant, analysis of variance (ANOVA) statistic was used. This parametric test was used to test the hypothesis that there is no antibiotics resistance in Klebsiella pneumoniae isolates from AIC Kijabe hospital. The result of analysis indicated that there was statistically significant difference among the means scores 5.547 at 0.05. It was concluded that use of antibiotics has influence on effective management in Klebsiella pneumoniae isolates from AIC Kijabe hospital. This study through its findings recommends that; Regular antimicrobial audits and reviews of laboratory data (surveillance) should be done so as to have proper documentation of drug resistance patterns and timely updates of antibiotic formularies. The study focused on AIC Kijabe Hospital Kiambu County only, therefore, the same study can be extended in other hospitals and other counties for comparison purposes
Arboviruses and Blood Meal Sources in Zoophilic Mosquitoes at Human-Wildlife Interfaces in Kenya
(Mary Ann Liebert, 2020) Musa, Ali A.; Muturi, Margaret W.; Musyoki, Abednego M; Ouso, Daniel O.; Oundo, Joseph W.; Makhulu, Edward E; Wambua, Lillian; Villinger, Jandouwe; Jeneby, Maamun M.
Background: Zoophilic mosquitoes play an important role in the transmission of arboviruses of medical importance at human-wildlife interfaces, yet arbovirus surveillance efforts have been focused mostly on anthropophilic mosquitoes. Understanding the diversity of zoophilic mosquitoes and their associated feeding patterns and arboviruses can inform better vector control strategies. Materials and Methods: We morphologically identified mosquitoes collected from two game reserves in Kenya, the Maasai Mara National Reserve (MMNR) and locations near the Shimba Hills National Reserve (SHNR). Representative mosquitoes were also identified by cytochrome c oxidase subunit 1 (COI) barcode sequencing. In addition, we identified the vertebrate hosts of mosquito blood meals from the contents of each mosquito’s abdomen by high-resolution melting (HRM) analysis and sequencing of COI, 16S ribosomal RNA, and cytochrome b gene PCR products. Similarly, mosquito arbovirus infections were identified by HRM analysis and sequencing of Alphavirus- and Flavivirus-specific RT-PCR products. Results: Of 2858 mosquitoes collected, 51 were engorged with blood meals from seven different vertebrate hosts, including humans, birds, domestic, and peridomestic animals and wildlife. Culex was the most abundant mosquito genus, with Culex pipiens being the most abundant species in both study regions. Among MMNR samples, we detected dengue serotype-2 virus (DENV-2) for the first time in Aedes tarsalis and Aedes tricholabis, as well as Sindbis virus in male Cx. pipiens.We also detected DENV-2 in Aedes aegypti sampled from locations near the SHNR. Human and diverse wildlife blood meals were identified, including bushbuck blood in the dengue-infected Ae. tarsalis and both human and hippopotamus blood in a single Eretmapodites chrysogaster mosquito. Conclusions: Our findings highlight the potential risk of sylvatic dengue and Sindbis transmission to humans by zoophilic mosquitoes at human-wildlife interfaces in Africa. Of specific importance, we provide evidence of sylvatic DENV-2 in Ae. tarsalis and Ae. tricholabis, representing potential new dengue vectors.
Assessment of electrolyte imbalance among benign prostate hyperplasia patients in Western Kenya
(International Journal of Research in Medical Sciences, 2023) Ongong’a, Royronald O.; Menza, Nelson; Demba, Rodgers N.
Background: Benign prostate hyperplasia (BPH) results in the enlargement of the gland and ultimately obstructs the bladder and the kidney. The effect on the kidney results in the dysregulation of the electrolyte causing electrolyte imbalance. Methods: An analytical cross-sectional study conducted at a tertiary teaching hospital aimed at assessing the levels and severity of electrolyte imbalance among BPH patients. The blood samples were analyzed for electrolytes and PSA levels for both patients and control group. An Independent t-test was used to compare the means of the BPH patients and healthy control subjects. Chi-square was used to determine the association between the electrolyte imbalance and the PSA levels of the BPH patients. Results: The mean age of the BPH patients and the healthy individuals was 65.47±12.55 and 64.52±12.19 years respectively. Hyponatremia, and hypernatremia were observed in 26.08% (n=104) and 4.22% (n=8) of the BPH patients respectively. There was a statistical significance positive correlation between potassium (K) and sodium (Na) concentrations (r=0.350, p<0.01) as well as a notable positive association between chloride (Cl) and magnesium (Mg) levels (r=0.288, pp<0.01). PSA biomarker levels varied among the patients. There was a statistical significance (<0.0001*) difference in PSA levels between the BPH patients and the control group. Conclusions: With high prevalence of electrolyte imbalance among BPH patients there is a need to monitor the electrolytes and PSA levels in the management of BPH aiming at restoration of kidney function.
Association between transient receptor potential melastatin genotypes and the prostate surface antigen levels in BPH patients
(International Journal of Research in Medical Sciences, 2024) Ongong’a, Royronald Ochieng; Menza, Nelson; Demba, Rodgers Norman
Background: Benign Prostate Hyperplasia (BPH) is a prevalent condition among older males, characterized by an enlarged prostate gland leading to lower urinary tract symptoms and impacting quality of life. Transient receptor potential melastatin (TRPM) genes regulate various physiological processes. Methods: We studied 194 BPH patients and 194 healthy controls, genotyping six selected TRPM gene SNPs. PSA levels were measured using the Cobas® e411 analyzer. Results: Prostate-specific antigen (PSA) levels were significantly higher in BPH patients (135.76±578.03 ng/mL) than in controls (2.01±1.09 ng/mL). TRPM2 (rs168355) and TRPM7 (rs2362295) genotypes were significantly associated with elevated PSA levels. The TRPM2 GG genotype was associated with decrease in the likelihood of severe PSA levels (OR=0.34, 95% CI: 0.12-0.96, P=0.034), while the TRPM7 CC genotype showed increased odds for severe PSA levels (OR=1.48, 95% CI: 1.08-3.56, P=0.041). Conclusions: Our findings suggest a potential link between TRPM gene variants and the severity of prostatic changes reflected in PSA secretions, indicating the need for further research to understand the underlying mechanisms and clinical implications.
Asymptomatic Gastrointestinal Carriage of Multidrug-Resistant Carbapenemase-Producing Enterobacteriaceae among Children Under Five Years in a Kenyan Hospital
(Elsevier, 2023-07) Mutuma, Caroline Kirito; Maingi, John; Maina, Anthony Karoki; Njeru, John; Musyoki, Abednego Moki
Objectives: Asymptomatic gastrointestinal carriage of carbapenem-resistant Enterobacteriaceae (CRE) is a threat to global health in developing countries with inadequate safe drinking water, poor hygiene, and weak antimicrobial stewardship; however, epidemiological data to guide CRE infection prevention and control is limited in these settings. We assessed asymptomatic CRE and carbapenem-producing Enterobacteriaceae (CPE) fecal carriage rates and associated risk factors among hospitalized children aged under 5 years. Methods: We adopted a cross-sectional study at Mama Lucy Kibaki Hospital in Nairobi-City County, Kenya, between June and September 2022. We collected demographic and clinical characteristics using a structured questionnaire and clinical reports and analyzed stool/rectal swab samples by standard and automated bacteriological methods. Results: Asymptomatic CRE and CPE fecal carriage rate was 2.25% (6/267), with six isolates recovered, predominated by Escherichia coli (33.33%) and Enterobacter cloacae subsp dissolvens (33.33%). Third-generation cephalosporin and ciprofloxacin resistance were highest in Citrobacter farmer and E. cloacae subsp cloacae. All CRE and CPE were multidrug-resistant, and except E. cloacae subsp cloacae, were 100% colistin-resistant. Conclusions: Asymptomatic gastrointestinal carriage of multidrug-resistant-CRE among hospitalized children under 5 years, presents a substantial public health threat. This calls for continuous surveillance including molecular characterization of isolates, to inform infection prevention and antimicrobial stewardship adherence in line with local and global plans on AMR.
Bacterial Agents Causing Food Poisoning among Patients Attending Thika Level 5 Hospital, Kiambu County, Kenya
(Scientific Research Publishing, 2019) Esther, Karanja N.; Nelson, Menza C.; Ephantus, Kabiru W.
Food poisoning is caused by the ingestion of contaminated food or water that contains microbial agents that cause illness or release their toxins onto the food. Examples of these microbial agents are Staphylococcus aureus, Listeria monocytogens, Clostridium botulinum, Salmonella typhiridium, and Salmonella enteritidis. Epidemiological monitoring of food poisoning is highly desirable for continuous determination of the existing causative species and disease trends. The study was conducted at Thika level 5 hospital. The objective of the study was to establish the prevalence of food poisoning at Thika level 5 hospital. A cross-sectional study design and purposive sampling technique was adopted in this study. Interview scheduled questionnaires and collection of stool samples from in-patients presenting with suspected food poisoning at Thika level 5, hospital was used for data collection. Stool culture tests were used to identify the bacterial causative agents of food poisoning. Statistical package for social sciences (SPSS) was used in the analysis of the data. Ethical approval was sought from Kenyatta University Ethical Review Committee, the Ministry of Education Science and Technology and Kiambu County Government. Informed consent was sought from the respondents after they had been informed about the study. The study findings showed that of the sample taken 28 (26.4%) were positive of Cholera while 78 (73.6%) were positive of Salmonella. The study recommends early set-up of emergency wards to contain outbreaks of infectious diseases together with well-equipped diagnostic labs for prompt response.
Burden of Human Rhinovirus Infections in Influenza like Illnesses in Kenya
(Elsevier, 2014) Kaburu, S. M.; Bulimo, W.; Maina, G. G.; Ongus, J.
Background: There have been several recent reports of respiratory outbreaks with associated mortality due to human rhinovirus (HRV) infection. Studies on viral etiologies of Influenza-like illness have shown that many patients are infected with more than one viral agent with frequencies of co-infection being as high as 20%. From these studies, human rhinovirus has been shown as one of the most prominent respiratory viruses that co-infect patients with influenza. In Kenya, the ongoing Influenza surveillance has provided data that now allows for exploration of other respiratory viruses that cause influenza-like illnesses. Currently, there is scanty information on the patterns of HRV circulation throughout the country. Methods & Materials: This study utilized a retrospective cross-sectional descriptive design. It involved the use of 517 archived samples from the ongoing country-wide influenza Surveillance protocol. The archived nasopharyngeal specimens were collected from a study population comprising persons from two months of age onwards who attended outpatient clinics in the year 2008, in hospitals located in 8 different regions in Kenya presenting with influenza like illnesses. Viral RNA was extracted from the samples followed by real-time RT-PCR assays with HRV-specific primers for screening for HRV. Results: A total of 131 (25%) of the samples were positive for HRV. The highest prevalence (33%) was recorded from samples obtained from the Coast region of the country, followed by Western region (32.7%) while Eastern region had the lowest prevalence (11%). Children aged between 2 months -7 years were mostly infected while the age group ≥60 years was least affected. There was no significant difference in HRV infection in relation to gender. Conclusion: The study notes that HRV infection is a significant viral etiology of morbidity throughout the country. However, disparities were observed between different regions. The more humid regions in the country (Western and Coast) had the highest HRV prevalence. At the same time, children below 7 years were at a greater risk of HRV infection. Determination of the molecular characteristics of the rhinovirus strains to enable specific identification of the species and the evolutionary relationships is ongoing.
Carbapenem-Resistant Gram-Negative Bacterial Infections and Risk Factors for Acquisition in a Kenyan Intensive Care Unit
(BMC, 2024-05) Maina, Jane Wairimu; Mutua, Jeniffer Munyiva; Musyoki, Abednego Moki
Background Carbapenem-resistant Gram-negative bacteria (CR-GNB) are a critical public health threat globally; however, there are inadequate surveillance data, especially in intensive care units (ICU), to inform infection prevention and control in many resource-constrained settings. Here, we assessed the prevalence of CR-GNB infections and risk factors for acquisition in a Kenyan ICU. Methods A hospital-based cross-sectional study design was adopted, recruiting 162 patients clinically presenting with bacterial infection after 48 h of ICU admission, from January to October 2022 at the Nairobi West Hospital, Kenya. Demographics and clinical data were collected by case report form. The type of sample collected, including blood, tracheal aspirate, ascitic tap, urine, stool, and sputum depended on the patient’s clinical presentation and were transported to the hospital Microbiology laboratory in a cool box for processing within 2 h. The samples were analyzed by cultured and BD Phoenix system used for isolates’ identity and antimicrobial susceptibility. Results CR-GNB infections prevalence was 25.9% (42/162), with Klebsiella pneumoniae (35.7%, 15/42) and Pseudomonas aeruginosa (26.2%, 11/42) predominating. All isolates were multidrug-resistant (MDR). P. aeruginosa and A. baumannii were 100% colistin-resistant, while K. pneumoniae (33.3%) was tigecycline-resistant. History of antibiotics (aOR=3.40, p=0.005) and nasogastric tube (NGT) use (aOR=5.84, p=<0.001) were the risk factors for infection. Conclusion Our study highlights high MDR- and CR-GNB infections in ICU, with prior antibiotic exposure and NGT use as risk factors, and diminishing clinical value of colistin and tigecycline. In this study setting and beyond, strict implementation of antimicrobial stewardship programs and adherence to infection prevention and control through monitoring, evaluation and feedback are warranted to curb CR-GNB infections, especially among the risk groups.
Characterization of occult hepatitis B in highrisk populations in Kenya
(PLOS ONE, 2020) Kiptoon, Beatrice Jepkemei; Missiani, Ochwoto; Swidinsky, Ken; Day, Jacqueline; Gebrebrhan, Henok; McKinnon, Lyle R.; Andonov, Anton; Oyugi, Julius; Kimani, Joshua; Gachara, George; Songok, Elijah Maritim; Osiowy, Carla
Occult hepatitis B infection (OBI) is defined as the presence of hepatitis B virus (HBV) DNA in the liver or serum in the absence of detectable HBV surface antigen (HBsAg). OBI poses a risk for the development of cirrhosis and hepatocellular carcinoma. The prevalence of OBI in Kenya is unknown, thus a study was undertaken to determine the prevalence and molecular characterization of OBI in Kenyan populations at high risk of HBV infection. Sera from two Nairobi cohorts, 99 male sex workers, primarily having sex with men (MSM-SW), and 13 non-MSM men having HIV-positive partners, as well as 65 HBsAg-negative patients presenting with jaundice at Kenyan medical facilities, were tested for HBV serological markers, including HBV DNA by real-time PCR. Positive DNA samples were sequenced and MSMSW patients were further tested for hepatitis C virus (HCV) infection. Of the 166 HBsAg-negative samples tested, 31 (18.7%; 95% confidence interval [CI] 13.5–25.3) were HBV DNA positive (i.e., occult), the majority (20/31; 64.5%) of which were HBV core protein antibody positive. HCV infection was not observed in the MSM-SW participants, although the prevalence of HBsAg positivity was 10.1% (10/99; 95% CI 5.6–17.6). HBV genotype A was predominant among study cases, including both HBsAg-positive and OBI participants, although the data suggests a non-African network transmission source among MSM-SW. The high prevalence of HBV infection among MSM-SW in Kenya suggests that screening programmes be instituted among high-risk cohorts to facilitate preventative measures, such as vaccination, and establish entry to treatment and linkage to care.
Characterization of occult hepatitis B virus infection among HIV positive patients in Cameroon
(BioMed Central, 2017) Gachara, George; Magoro, Tshifhiwa; Mavhandu, Lufuno; Lum, Emmaculate; Kimbi, Helen K.; Ndip, Roland N.; Bessong, Pascal O.
Purpose: Occult hepatitis B infection (OBI) among HIV positive patients varies widely in different geographic regions. We undertook a study to determine the prevalence of occult hepatitis B infection among HIV infected individuals visiting a health facility in South West Cameroon and characterized occult HBV strains based on sequence analyses. Methods: Plasma samples (n = 337), which previously tested negative for hepatitis B surface antigen (HBsAg), were screened for antibodies against hepatitis B core (anti-HBc) and surface (anti-HBs) antigens followed by DNA extraction. A 366 bp region covering the overlapping surface/polymerase gene of HBV was then amplified in a nested PCR and the amplicons sequenced using Sanger sequencing. The resulting sequences were then analyzed for genotypes and for escape and drug resistance mutations. Results: Twenty samples were HBV DNA positive and were classified as OBI giving a prevalence of 5.9%. Out of these, 9 (45%) were anti-HBs positive, while 10 (52.6%) were anti-HBc positive. Additionally, 2 had dual anti-HBs and anti-HBc reactivity, while 6 had no detectable HBV antibodies. Out of the ten samples that were successfully sequenced, nine were classified as genotype E and one as genotype A. Three sequences possessed mutations associated with lamivudine resistance. We detected a number of mutations within the major hydrophilic region of the surface gene where most immune escape mutations occur. Conclusions: Findings from this study show the presence of hepatitis B in patients without any of the HBV serological markers. Further prospective studies are required to determine the risk factors and markers of OBI. Keywords: Hepatitis B virus, Occult hepatitis B infection, HIV, Cameroon
Coagulation Factors Level in Fresh Frozen Plasma in Rwanda
(Kenya Medical Association, 2014) Nyamache, A. K.; Uwamungu, S; Masaisa, F.; Njoki, S.K.; Abdalah, F.; Saibu, K.; Ndahiriwe, O.; Agwata, D.
Objectives: To determine the level of coagulation factors and inherited inhibitors in Fresh Frozen Plasma (FFP) and to evaluate Prothrombin Time and activated partial thrombin time in fresh frozen plasma. Design: Cross-sectional study. Setting: Jomo Kenyatta University of Agriculture and Technology in Medical Laboratory Sciences. Subjects: Eighteen blood bags collected from voluntary blood donors. Main outcome measures:Coagulation factors and inhibitors levels, Prothrombin Time (PT) and Activated Partial thrombin Time (APTT)remained within the reference range requested by quality assurance regulations after three months of storage. Results: APTT and PT show an increase from baseline to one month then remain constant up to three months, while, Fibrinogen, Factor II, Factor V, Factor VII, Factor X, Von Willbrand Factor, Protein C and Antithrombin decreased from baseline up to three months and then Factor VIII, Factor IX, Factor XI, Factor XII and Protein S, remained constant from baseline up to one month and decreased up to three months. Conclusion: There is good retention of all coagulation factors and inhibitors in plasma produced from whole blood within eight hours of collection, stored at minus 18ºC for three months
Combining Evidence of Natural Selection with Association Analysis Increases Power to Tetect Malaria-Resistance Variants.
(PubMed, 2007) Otieno, Micheal Frederick; Ayodo, G.; Price, A. L.; Keinan, A.; Ajwang, A.; Orago, A. S.; Patterson, N.; Reich, D.
Statistical power to detect disease variants can be increased by weighting candidates by their evidence of natural selection. To demonstrate that this theoretical idea works in practice, we performed an association study of 10 putative resistance variants in 471 severe malaria cases and 474 controls from the Luo in Kenya. We replicated associations at HBB (P=.0008) and CD36 (P=.03) but also showed that the same variants are unusually differentiated in frequency between the Luo and Yoruba (who historically have been exposed to malaria) and the Masai and Kikuyu (who have not been exposed). This empirically demonstrates that combining association analysis with evidence of natural selection can increase power to detect risk variants by orders of magnitude--up to P=.000018 for HBB and P=.00043 for CD36.
Datasets on how misinformation promotes immune perception of COVID-19 pandemic in Africa
(Elsevier, 2020) Akintande, Olalekan; Olubusoye, Olusanya
The dataset investigates the magnitude of the misinforma- tion content influencing scepticisms about the novel COVID- 19 pandemic in Africa. The data is collected via an electronic questionnaire method and twenty-one Africa countries ran- domly participated. Responses were received from all the five regions of Africa. The data is structured to identify some leading misinformation been propagated in the media. For data, in brief, we performed a descriptive analysis of the data and also examine the degree of each selected misinforma- tion contents on the immune perception of respondents us- ing Confirmatory Factor Analysis. Another research can use the dataset to investigate how misinformation and religion misconception promote ignorance about disease or pandemic in Africa or the dataset could serve as supplementary mate- rial for further investigation of COVID-19 pandemic in Africa.
Dengue Virus and Blood Safety: A Mini-Review of Research Publications
(EAHRC, 2023-03-30) Mulakoli, Festus; Gachara, George; Ndombi, Eric; Khamadi, Samoel
The growing demand for donated whole blood and blood products to save lives has both health benefits and health risks for blood recipients at the same time. Dengue virus, a re-emerging viral disease poses a threat to blood safety, and it has spread to over 128 countries in the world. Several studies have documented transfusion-transmitted (TT) dengue, with the first cases being reported in China in 2002 and Singapore in 2008. To understand the magnitude and broader picture of the dengue virus and blood safety, we conducted a mini-review of published literature from the Scopus database. The review focused on the number of publications related to the dengue virus among blood donors. Using keywords ‘Dengue virus’ AND ‘Blood safety’, ‘ Dengue virus’ AND ‘Blood donors’ and ‘Emerging infectious diseases’ AND “Blood safety” were used to extract data from the Scopus database which was downloaded as a CSV Excel file covering a period 2004 to 2021. This was followed by a data-cleaning exercise and a descriptive analysis to generate the frequency of the number of publications. Most studies, as can be seen in the review, were concentrated in tropical regions of the world. Globally, South America and the Asian regions had the largest number of publications; while at the country level, Brazil and India had the highest number. More research output was witnessed during the years 2014 and 2018. The regions that experienced more frequent outbreaks of the disease, with the exception Africa, published most of the research work. Therefore, much more research work is needed to protect the safety of blood donors in Africa
Diagnostic Performance of Saliva Samples in Asymtomatic COVID-19 Infected Patients in Kakamega Kenya
(EASJID, 2024-01) Njue, Lilian G.; Ali, Iddah M.; Menza, Nelson C.
Abstract: The pandemic coronavirus SARS‐CoV‐2 in the world has caused a large infected population suffering from COVID‐19. To curb the spreading of the virus, WHO urgently demanded an extension of screening and testing; thus, a rapid and simple diagnostic method is needed which is non-invasive. Use of self-collected saliva can minimize healthcare worker exposure and expand testing capabilities for symptomatic and asymptomatic patients. The main aim of this study was to document the ability of patients to self-collect sufficient saliva specimens for SARS-CoV-2 in the quantitative detection by Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) in asymptomatic patients by themselves under observation by a healthcare provider. The researcher recorded whether the patients were confident and the suitability of the specimen for laboratory testing that would inform clinical decision making. Seventy-one patients aged from 13 years and above were included between December 2020 and July, 2021. Saliva samples and Nasopharyngeal samples were taken from each patient. Quantitative PCR was performed to detect SARS-CoV-2 viral load in the nasopharyngeal samples and qualitative Reverse Transcriptase Loop-mediated isothermal amplification (RTLAMP) was used to detect the presence of the virus in saliva samples. Results of saliva vs. nasopharyngeal samples testing using the two different methods were compared. Statistical analyses were performed. Out of the 350 samples tested, 314 samples were found to be Covid 19 positive. Result of the test was validated by the RT-PCR test. This showed that only 314 samples were tested both by saliva rapid test and PCR test while the rest 36 samples were not tested using RT-PCR method but were tested using saliva test. Thus, the salivary test based on pure oral saliva samples easily obtained by noninvasive techniques using RT-LAMP has the same agreement with the nasopharyngeal technique using RT-PCR one in asymptomatic COVID-19 patients.
Evolutionary Pattern of the Hemagglutinin Gene of Influenza B Viruses Isolated in Kenya 2005-2009
(African Journal of Health Sciences, 2011-06-17) Gachara, George; Bulimo, W.; Magana, J.; Simwa, J.; Symekher, S.
Background: In humans, the inability to provide lasting protection against influenza B virus infection is due, in part, to the rapid evolution of the viral surface glycoprotein, haemagglutinin (HA), which leads to a change in its antigenic nature. Therefore, the evolution of the haemagglutinin (HA) an important influenza antigen has and continues to be a subject of intensive research. In this study, we analyzed the evolution occurring in the haemagglutinin of influenza B viruses from Kenya since virological surveillance began in 2005. Methods: Thirty (30) influenza B haemagglutinin sequences of viruses isolated from different parts of the country between 2005-2009 at the NIC were analyzed. Nucleotide sequences, prediction of amino acid sequences, alignments, and phylogenetic tree construction were completed using BioEdit and MEGA® software Results: During the five year study period, the two influenza B lineages B/Yamagata and B/Victoria have co-circulated in two years (2005 and 2007) while B/Yamagata viruses exclusively circulated in 2008 and B/Victoria viruses in 2006 and 2009. The nucleotide sequence identity ranged from 92.9% – 97.0% among the B/Yamagata lineage viruses and 90.6% – 98.5% among the B/Victoria lineage viruses. There was generally noted more amino acid substitutions among the B/Yamagata lineage than the B/Victoria lineage. Substitutions were observed in all the epitope regions among B/Yamagata viruses compared to three epitopes in the B/Victoria viruses. Both lineages showed substitutions at position HA1 165. Conclusions: These results demonstrate that distinct viruses within the two lineages have been co-circulating in the country every year and that there has been a greater evolution of the B/Yamagata viruses. At the same time it is noted that like elsewhere, influenza B viruses in the country have continually been evolving by antigenic drift. In-order to understand whether reassortments have occurred, the study suggests periodic complete genomic sequencing of select.
Hematological Profiles of Eligible Blood Donors at Kenyatta National Hospital, Kenya
(International Blood Research & Reviews, 2022-03) Njenga, John K.; Menza, Nelson C.; Mathenge, Scholastica G.; Githanga, Jesse N.
Aim: To determine hematological profile of eligible blood donors at Kenyatta National Hospital (KNH), Kenya. Study Design: Adopted a cross-sectional study. Place and Duration of Study: Kenyatta National Hospital, between March 2021 and August 2021. Methodology: This study recruited 202 eligible blood donors comprising of 173 males and 29 females aged 18-57 years. Blood samples (4ml) were drawn from donated units into ethylene diamine tetraacetic acid (EDTA) tube. Hematological parameters were estimated using a complete blood count (CBC) analyzer (Humacount 5D®). A total of eighteen hematological parameters were analyzed. These parameters included; red blood cell (RBC) count, hemoglobin concentration, RBC indices, white blood cell (WBC) count, absolute and differential WBC and platelet (PLT) count. Results were presented in medians and 95% interquartile ranges and compared using Mann– Whitney U test. Results: The median counts for all hematological parameters were within the accepted reference ranges for the adult urban population in Kenya. The median and interquartile range for total red cell count was 4.9×106/µL [0.74], hemoglobin level was 14.3g/dL[1.8], hematocrit was 44.9% [5.1], white blood count was 4.9×103/µL [1.4] and platelet was 234×103/L [64]. Among the red cell parameters analyzed, male donors had a significantly higher RBC count (P<0.001), hematocrit (P=0.001) and hemoglobin (P<0.001) than female donors. Among white blood cell parameters analyzed, only lymphocytes (P=0.011) were significantly higher in female donors than male donors. Platelet count (P<0.001) was also significantly higher in females than male donors. Conclusion: This study showed eligible donors at KNH had significant differences in red cell count, hematocrit, hemoglobin, lymphocytes and platelets between male and female donors. Additionally, it highlighted that some blood donors had hematological parameters below and above the recommended reference ranges. These findings support the need to review the current donor recruitment criteria recommending the inclusion of complete blood count in screening.
HIV type 1 drug resistance patterns among patients failing first and second line antiretroviral therapy in Nairobi, Kenya
(BioMed Central, 2014) Nyamache, A. K.; Koigi, P.; Ngayo, Musa Otieno; Khamadi, Samoel; Ngugi, Caroline
Background: The ever-expanding rollout of antiretroviral therapy in poor resource settings without routine virological monitoring has been accompanied with development of drug resistance that has resulted in limited treatment success. Methods: A cross-sectional study with one time viral load was conducted during the period between 2012 and 2013 to determine treatment failure and drug resistance mutations among adults receiving first-line (44) (3TC_d4T/ AZT_NVP/EFV) and second-line (20) (3TC/AZT/LPV/r) in Nairobi, Kenya. HIV-1 pol-RT genotyping for drug resistance was performed using an in-house protocol. Results: A total of 64 patients were recruited (mean age 36.9 yrs.) during the period between 2012 and 2013 of the 44 adult patients failing first-line 24 (40.9%) had drug resistance mutations. Eight (8) patients had NRTI resistance mutations with NAMS M184V (54.2%) and K65R (8.4%) mutations being the highest followed by TAMs T215Y and K70R (12.5%). In addition, among patients failing second-line (20), six patients (30%) had NNRTI resistance; two patients on K103N and G190A mutations while V106A, Y184V, A98G, Y181C mutations per patient were also detected. However, for NRTI two patients had TAM T215Y. M184V mutation occurred in one patient. Conclusions: The study findings showed that HIV-1 drug resistance was significantly high in the study population. The detected accumulated resistance strains show that emergence of HIV drug resistance will continue to be a big challenge and should be given more attention as the scale up of treatment in the country continues
Human Bocavirus Infection in Children with Acute Respiratory Infection in Nairobi, Kenya
(Scientific Research Publishing, 2013-12) Gachara, George; Symekher, S.L.; Simwa, J.; Gichogo, J.; Rotich, M.; Ng’ayo, M.O.; Magana, J.
Background: Acute respiratory infection (ARI) is a leading cause of morbidity and mortality in children under five years of age in developing countries with viruses contributing significantly to this problem. The recently identified par-vovirus, Human Bocavirus (HBoV), has also been associated with ARI. Objective: To determine the frequency of HBoV in patients with ARI. Materials and Methods: Samples from 125 consenting patients with influenza like illness signs and symptoms were collected. DNA was extracted from these samples using the QIAamp DNA blood mini kit (Qiagen, Germany). Conventional PCR was carried out and the amplicons were examined in 2% agarose gels stained with ethidium bromide. This was followed by sequencing of the HBoV positive samples. Results: Twenty one (16.8%) patients were found to have HBoV infection. Males (n = 61.9%) were mainly infected with HBoV. Local HBoV strains had 98.9% - 100% similarities and were found to cluster together with other strains obtained elsewhere. Conclusion: These findings suggest that HBoV plays a role in respiratory tract infections in children in Kenya just like it has been found elsewhere. It also sheds light on multiple infections associated with HBoV infections in Kenya
Human Papillomavirus Types Associated with Cervical Dysplasia among HIV- and Non-HIV-Infected Women Attending Reproductive Health Clinics in Eastern Kenya
(Hindawi, 2021) Njue, James Kinoti; Muturi, Margaret; Kamau, Lucy; Lwembe, Raphael
Background. Human papillomavirus (HPV) causes over 99% of all cervical cancer globally. In 2019, it was responsible for 3286 deaths in Kenya. Data on the epidemiological distribution of HPV genotypes by cervical dysplasia and HIV-infected women which is important in designing prevention strategy monitoring treatment and management of cervical cancer is lacking in Eastern Kenya. Objective. To determine HPV genotype prevalence and their association with cervical dysplasia among HIVinfected (cases) and noninfected (control) women aged 18-48 years seeking reproductive healthcare. Methods. A cervical broom was softly rotated 360 degrees five times to exfoliate cells from the region of the transformation zone, squamocolumnar junction, and endocervical canal for HPV genotyping. Social-demographic and risk factors responsible for HPV acquisition were collected using a questionnaire. Laboratory outcome and questionnaire data statistical relationships were computed using Pearson chi-square test. Results. 317 women (cases: 161 (50.8%), control 156 (49.2%), mean age: 34.3,SD ± 10:4, range 18-46 years) were recruited from Embu (85/317 (26.8%)), Isiolo (64/317 (20.2%)), Kirinyaga (56/317 (17.7%)), Meru (81/317 (25.6%)), and Tharaka-Nithi (31/317 (9.8%)). The frequency HPV genotypes detected by cervical dysplasia were CIN1 (cases: HPV81 (12/317 (3.8%)), HPV11 (2/317 (0.6%)); control: HPV53 and 66 coinfection (1/317 (0.3%)), CIN2 (cases: HPV11, HPV16, HPV66 ((1/317 (0.3%) each), HPV81 (6/317 (1.9%)), and single case (1/317 (0.3%)) of HPV11 and 66, HPV81 and 44, HPV81 and 88, HPV9 and 53, and HPV16 and 58 coinfection; control: HPV81 (2/317 (0.6%)) and invasive cervical cancer (cases: HPV16 (1/317 (0.3%)) and HPV81 (3/317 (0.9%)); control: HPV16 and 66 (1/317 (0.3%))).Conclusions. There was a higher frequency of both high-risk and low-risk HPV genotypes associated with cervical dysplasia among HIV-infected than HIV-uninfected women seeking reproductive health care. This study provides epidemiological data on the existence of nonvaccine HPV types associated with cervical dysplasia in the region.

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