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Item Assessment of voiding function in inhabitants infected with Schistosoma haematobium.(Tropical Pediatrics, 2011-08) Muhoho, ND; Watanabe, K; Mutua, WR; Kiliku, FM; Awazawa, T; Moji, Kazuhiko; Aoki, YVoiding function of Schistosoma haematobium infected students was evaluated in 45 schoolboys in Kwale district, Coast province, Kenya, using a questionnaire and uroflowmetry. Sixty-eight schoolboys who were S. haematobium negative were also examined. Symptoms related to the lower urinary tract were qualitatively assessed using the International Prostate Symptoms Score (I-PSS) questionnaire. The I-PSS showed that S. haematobium infected boys felt the need to strain to urinate and post voiding some urine still remained. To examine the disturbances revealed by I-PSS quantitatively, voiding was assessed by a portable uroflowmeter and a bladder scanner. Unexpectedly, no significant residual urine post voiding and no decline in urine flow rates were found in S. haematobium infected boys. However, volume-corrected maximum and average flow rates in S. haematobium infected boys were higher than in those not infected. These results suggest that cystitis associated with S. haematobium infection causes irritation and hypercontraction of the bladder.Item Association of FCgamma receptor IIA (CD32) polymorphism with malarial anemia and high-density parasitemia in infants and young children.(American Journal of Tropical Medicine and Hygiene, 2006-04) Ouma, C.; Keller, C.C.; Opondo, D.A.; Were, T.; Otieno, Richard O.; Otieno, Micheal Frederick; Orago, A. S.; Ong'echa, J. M.; Vulule, JM; Ferrell, RE; Perkins, D. J.Item Atypical Cervical Cytomorphologic Predictors: a Descriptive Study of Pre-Cervical Cancer Patients of Low Education in Kenya(The Pan African Medical Journal, 2019) Muitta, Esther; Were, Tom; Nyamache, Anthony; Muhoho, Ng’etheIntroduction: high risk HPV is the perpetrator of cervical cancer disease, however screening and vaccination is not included in cervical cancer prevention program within public hospitals in Kenya. This descriptive study assessed the association of specific microbial STI and socio demographic characteristics and practices with cervical cytomorphologic presentations in regards to pre cervical cancer grades amongst health seeking patients attending the reproductive health clinic of Nakuru County referral hospital, a public hospital under newly devolved health services governance. Methods: a total of 142 patients (AGC/AIS, n=8; HSIL, n=59; LSIL, n=35; controls, n=40) whose median age ranged between 20-70 years were purposively sampled. A structured questionnaire with closed and open ended entries was administered and STI screening including Pap smear examination for cytomorphological profiling done according to revised 2014 Bethesda classification. Associations were established using chi square and multivariate logistic regression model to determine prediction of cervical atypia manifestations. Results: a majority of the study participants had only primary education or no education in AGC/AIS (63%) and HSIL (73%) relative to LSIL (49%) and controls (53%) (P=0.017). Koilocyte rates were higher in AGC/AIS (25%), HSIL (52%) and LSIL (77%) compared controls (12.5%) (P<0.0001). ASCUS predominated in HSIL (61%) and LSIL (86%), while almost all AGC/AIS had AGCUS (88%). HR HPV 16/18 infection rates were higher in AGC/AIS (100%), HSIL (80%) and LSIL (83%) relative to controls (10%) (P<0.0001), and was associated with higher risk of having AGC/AIS (OR, 2.0; 95% CI, 1.940-1.947; P<0.0001); HSIL, (OR, 36.3; 95% CI, 9.5-139.5; P<0.0001); and LSIL (OR, 50.1; 95% CI, 12.0-209.0; P<0.0001). Conclusion: altogether, pre cervical cancer in Kenyan women is characterized by koilocytosis and ASCUS probably from the high rates of HPV 16/18 infections. Promoting cancer education and screening for high risk HPV infections and pre-cancerous lesions will improve women's reproductive health.Item Cross-sectional Survey of Rift Valley Fever Virus Exposure in Bodhei Village Located in a Transitional Coastal Forest Habitat in Lamu County, Kenya.(American Society of Tropical Medicine and Hygiene, 2015) Muiruri, S.; Kabiru, Ephantus W.; Muchiri, E. M.; Hussein, H.; Kagondu, F.; LaBeaud, A. D.; King, C. H.Few studies have focused on Rift Valley fever virus (RVFV) transmission in less arid, transitional landscapes surrounding known high-risk regions. The objective of this study was to identify evidence of RVFV exposure in Bodhei Village in a forested area at the edge of the RVFV-epidemic Garissa region. In a household cluster-based survey conducted between epidemics in early 2006, 211 participants were enrolled. Overall seroprevalence for anti-RVFV was high (18%) and comparable with rates in the more arid, dense brush regions farther north. Seroprevalence of adults was 28%, whereas that of children was significantly lower (3%; P < 0.001); the youngest positive child was age 3 years. Males were more likely to be seropositive than females (25% versus 11%; P < 0.01), and animal husbandry activities (birthing, sheltering, and butchering) were strongly associated with seropositivity. The results confirm that significant RVFV transmission occurs outside of recognized high-risk areas and independent of known epidemic periods.Item The Demographic Characteristics of Mothers and their Compliance Levels with Infant and Young Child Feeding Recommendations in Nakuru Municipality, Kenya(Academic Journals, 2017-07) Njeri, Kamau Anne; Kabiru, Ephantus; Mwaniki, . JoyceUniversally, optimal IYCF key indicators are low and current IYCF practices remain far from recommended levels. In Kenya, the National IYCF strategy recommends that infants should be exclusively breast fed for the first six month of life. The study was therefore conducted to explore the level of mothers’ compliance with the IYCF recommendations among children aged 0-24 months in Nakuru Municipality, Kenya. Informed by the study, this paper examines the demographic and socio-economic characteristics and level of compliance with IYCF recommendations among women. Data for the study was collected using interview questionnaire adapted from the WHO questionnaire on the 24-hour recall food diversity. Nine research assistants were trained and used to collect data from 377 mothers with children aged 0-24 months. From the study findings, mothers’ IYCF practice was predominantly early introduction of solids, semi-solid and soft food as early as 2 months. Based on the findings, the study recommended that policy makers need to come up with IYCF policies that would reach the mothers in the community with practical IYCF intervention. In addition, County Health System to ensure the CHEW monitor and evaluate of IYCF compliance at family level. The study established that 37.9% of the mothers were aged 25-29 years, 86% were married, 37% had attained secondary education and 40.6% were housewives. Over half (57%) of the children in the mother-child pair were aged 7-24 months while 62.1% were subsequent birth (second to seventh) with only 37.9% being first-born. The mothers’ level of compliance with IYCF recommendation was rated at 55%. Consequently, it is recommended that IYCF information should be targeted at all mothers who are implementers of IYCF recommendations at family level irrespective of neither demographic nor socioeconomic variables at HF by the CHN.Item Determinants of Disclosure on HIV Sero-Status among People Living With HIV and on Antiretroviral Treatment at Mombasa County Referral Hospital, Kenya(EPRA International Journal of Research and Development (IJRD), 2020) Joshua, K. M.; Alloys, O.; Aggrey, A.It is estimated that Kenya has 1.6 million people living with HIV and 88,000 new adult infections annually. The objective of this study was to explore the level of HIV sero – status disclosure and the disclosure outcomes among PLHIV on ART treatment. A cross-sectional study design was employed. Quantitative and qualitative data was collected. Univariate and multivariate analyses were performed using SPSS version 20, frequencies generated for categorical variables and comparison between proportions examined using Chi– square test. A sample size of 432 was arrived at using Cochrane’s formula. Simple random sampling was used to recruit the subjects and all signed a written informed consent. The quantitative results showed 174 (40.3%) of the subjects were male and 258 (59.7%) female. The mean age was 35.0 years. The overall disclosure rate among PLHIV was 79.2%. Key determinants of disclosure were disease transmission (AOR 21.125; 95% CI 6.942-64.286), unfaithfulness (AOR 7.133; 95% CI 3.713- 13.628) and consistent condom use (AOR 5.619; CI 2.659-11.873). Qualitative findings on disclosure perceptions showed 42.78% good, 32.97% low self esteem, 17.3% quilt and 6.22% shame. The study realized 46% of PLHIV were not aware of their spouse HIV status despite being on care.Item Development of a Rapid and Highly Sensitive Nucleic Acid Based Diagnostic Test for Schistosomes, Leveraging on Identical Multi-Repeat Sequences(Frontiers in Parasitology, 2024-03) Ally, Ombeni; Kanoi, Bernard N.; Kamath, Shwetha; Shiluli, Clement; Ndombi, Eric M.; Odiere, Maurice; Misinzo, Gerald; Ger Nyanjom, Steven; Kumar, Chunduri Kiran; Ochola, Lucy; Lolabattu, Srinivasa Raju; Gitaka, JesseIntroduction: Schistosomiasis (Bilharzia), a neglected tropical disease caused by Schistosoma parasites, afflicts over 240 million people globally, disproportionately impacting Sub-Saharan Africa. Current diagnostic tests, despite their utility, suffer from limitations like low sensitivity. Polymerase chain reaction (PCR) and quantitative real-time PCR (qPCR) remain the most common and sensitive nucleic acid amplification tests. Still, the sensitivity of nucleic acid amplification tests is significantly affected by the copy number of amplification targets, resulting in underestimation of true Schistosoma infections, especially in low transmission settings. Additionally, lengthy qPCR run times pose challenges when dealing with large sample volumes and limited resources. In this study, the identical multi-repeat sequences (IMRS) were used as a novel approach to enhance the sensitivity of nucleic acid-based Bilharzia diagnosis. Methods: To identify novel genomic repeat regions, we utilized the IMRS algorithm, with modifications to enable larger target region (100-200bp) identification instead of smaller sequences (18-30bp). These regions enabled customised primer-probe design to suit requirements for qPCR assay. To lower the qPCR amplification times, the assay was conducted using fast cycling condition. Regression analysis, and qPCR data visualization was conducted using Python programming. Results: Using Schistosoma mansoni and S. haematobium, we found that IMRSbased qPCR, employing genus-specific primers and TaqMan probes, offers exceptional analytical sensitivity, detecting as little as a single genome copy per microliter within 36 minutes. Discussion: The lowest concentration of DNA detected using IMRS-based PCR and qPCR represented tenfold improvement over conventional PCR. As part of further development, there is a need to compare IMRS-based qPCR against other qPCR methods for Schistosoma spp. Nonetheless, IMRS-based diagnostics promise a significant advancement in bilharzia diagnosis, particularly in lowtransmission settings, potentially facilitating more effective control and treatment strategies.Item Drug Susceptibility Profiles of Pulmonary Mycobacterium Tuberculosis Isolates From Patients in Informal Urban Settlements in Nairobi, Kenya(2016) Kerubo, Glennah; Amukoye, Evans; Niemann, Stefan; Kariuki, SamuelBackground: Anti-tuberculosis drug resistance is an emerging health problem in Kenya and especially in slums. Slum environments create a conducive environment for the spread of tuberculosis (TB) due to high population density and lack of basic amenities such as decent housing, access to clean water, lack of drainage and basic sanitation. Furthermore, ineffective health services in crowded and poorer populations, poor patient compliance, a large pool of untreated cases, delayed diagnosis and inappropriate treatment regimens are likely to favour selection and spread of drug resistant Mycobacterium tuberculosis (Mtb) strains in such settings, however, precise data on this problem are only sparsely available. To address this question, this study aimed at determining drug resistance patterns of Mtb strains obtained from pulmonary TB patients who sought health care in randomly selected informal settings. Methods: This is a cross-sectional study conducted between September 2014 and March 2015, sputum samples were collected from 223 consenting adult patients and subjected to primary isolation and drug susceptibility testing. Socio-demographic data was collected and all data analysed using SPSS v20. Results: Drug susceptibility testing against first line drugs was successfully carried out on 184 isolates. Resistance to at-least one drug was observed in 33 % of the isolates. The highest prevalence of resistance to any drug was identified against isoniazid,(INH) (23.9 %) followed by Ethambutol (EMB) (13.6 %). The highest proportion of mono resistance was observed against INH, 25 (13.6 %). Multidrug resistance (MDR) was observed in 4.4 % of the new cases. There was no significant difference in the proportion of any resistance by sex, age or previous treatment. Conclusion: Levels of drug resistance have reached an alarming level in this population. Capacity of laboratories to conduct TB culture and DST should be strengthened in order to adequately manage TB patients and stop further creation and spread of MDR TB. Keywords: Mycobacterium tuberculosis, Informal settlements, Drug resistanceItem Effect of Four Rounds of Annual School-Wide Mass Praziquantel Treatment for Schistosoma Mansoni Control on Schistosome Specific Immune Responses.(Wiley Online Library, 2018) Ndombi, E. M.; Abudho, B.; Kittur, N.; Carter, J. M.; Korir, H.; Riner, D.K; Ochanda, H.; Lee, Y-M; Secor, W.E; Karanja, D.M; Colley, D.GThis study evaluated potential changes in antischistosome immune responses in children from schools that received 4 rounds of annual mass drug administration (MDA) of praziquantel (PZQ). In a repeated cross-sectional study design, 210 schistosome egg-positive children were recruited at baseline from schools in western Kenya (baseline group). Another 251 children of the same age range were recruited from the same schools and diagnosed with schistosome infection by microscopy (post-MDA group). In-vitro schistosome-specific cytokines and plasma antibody levels were measured by ELISA and compared between the 2 groups of children. Schistosome soluble egg antigen (SEA) and soluble worm antigen preparation (SWAP) stimulated higher IL-5 production by egg-negative children in the post-MDA group compared to the baseline group. Similarly, anti-SEA IgE levels were higher in egg-negative children in the post-MDA group compared to the baseline group. Anti-SEA and anti-SWAP IgG4 levels were lower in egg-negative children in the post-MDA group compared to baseline. This resulted in higher anti-SEA IgE/IgG4 ratios for children in the post-MDA group compared to baseline. These post-MDA immunological changes are compatible with the current paradigm that treatment shifts immune responses to higher antischistosome IgE:IgG4 ratios in parallel with a potential increase in resistance to reinfection.Item Effects of Female Genital Schistosomiasis in Reproductive Tract of Women Attending Kwale Hospital in Kwale County, Kenya(International Journal of TROPICAL DISEASE & Health, 2017-06-17) Gitau, Jane M. N.; Muhoho, Ng’ethe; Kabiru, EphantusBackground: Female genital Schistosomiasis (FGS) caused by Schistosoma haematobium is a significant public health problem among women living in endemic areas. An estimated 45 million women in sub-Saharan Africa are infected. Chronic infection is associated with bleeding disturbances, abdominal-pelvic pain, painful sexual intercourse, uterine fibroids, spontaneous abortion, cervical cancer and increased risk for transmission of HIV. Aim: To determine the infection rate, distribution pattern and associated genital pathology in S. haematobium infection among females of reproductive age in endemic area in Kwale County, Kenya. Study Design: Descriptive cross-sectional. Study Area: Kwale level four hospital. Study subjects came from the hospital catchment area. Methodology: Prevalence of S. haematobium was determined through urine filtration and microscopy for S. haematobium eggs and by detection of both haematuria and proteinuria using strip reagent analysis. Intensity of S. haematobium infection was determined by scoring the number of eggs per 10 ml of urine. Signs of genital pathology were determined through visual assessment of the genitalia by a gynaecologist. SPSS version 20.0 was used to analyze data. Results: Overall prevalence of S. haematobium was 23%. Intensity of infection was low with majority of infected participants (15.8%) carrying light intensity infections (≤50 eggs/10 ml of urine). Prevalence and intensity of infection was significantly high in women age group 18-23; (χ 2 = 5.778; P = 0.017). Signs of genital pathology were recorded in 46.7% of infected women. The results of this study indicate that female genital schistosomiasis is an important health problem in Kwale County and there is need for the Ministry of Health and the County government of Kwale to improve diagnosis and treatment of the disease as well as initiate strategies to control this problem.Item Expression of p53 and HER2/Neu in Kenyan Women with Primary Ovarian Carcinoma(Lippincott, Williams & Wilkins, 2016) Mutuiri, A.P.; Nzioka, A.; Busarla, S.V.; Sayed, S.; Moloo, Z.Ovarian carcinomas are a leading cause of cancer mortality among women. Two of the more commonly described markers of prognostic significance in primary ovarian carcinomas are p53 and HER2/neu. Overexpression of both markers is associated with poor prognosis. This study aimed to determine the frequency and pattern of p53 and HER2/neu expression in primary ovarian carcinomas in Kenyan women and to describe the clinical and pathologic features of ovarian carcinomas diagnosed at 3 different hospitals in Kenya. Primary ovarian carcinomas diagnosed at the Departments of Pathology at Aga Khan University Hospital, Nairobi; the Aga Khan Hospital, Kisumu; and the AIC Kijabe Hospital in Kenya over a period of 3 years from January 2009 to December 2011 were recorded. Sixty-seven ovarian carcinomas were identified and blocks retrieved from archives. Hematoxylin-eosin-stained slides of these were reviewed and appropriate sections were stained for p53 and HER2/neu using standard immunohistochemical techniques. The primary outcome was presence and intensity of staining for p53 and HER2/neu. The most frequent malignancy was serous carcinoma. A total of 43.3% (95% confidence interval, 32.1%-55.2%) of carcinomas were positive for p53, and 13.4% (95% confidence interval, 7.2%-23.6%) were positive for HER2/neu. Serous carcinoma and adenocarcinoma, not otherwise specified were more likely to be positive for p53. There was no association noted between the histologic grade or pathologic stage and positivity for either p53 or HER2/neu. The expression of p53 and HER2/neu in primary ovarian carcinomas in Kenyan women is not different from that described in the literature.Item Functional promoter haplotypes of interleukin-18 condition susceptibility to severe malarial anemia and childhood mortality.(PubMed, 2011) Were, T.; Gichuki, C.W.; Ong'echa, J. M.; Ouma, Collins; Anyona, S.B.; Kempaiah, P.; Raballah, E.; Davenport, G. C.; Konah, S.N.; Vulule, J.M.; Hittner, James B.; Perkins, D. J.Severe malarial anemia (SMA) is a leading cause of morbidity and mortality in children residing in regions where plasmodium falciparum transmission is holoendemic. Although largely unexplored in children with SMA, interleukin-18 (Il-1S) is important for regulating innate and acquired immunity in inflammatory and infectious diseases. As such, we selected two functional single-nucleotide polymorphisms (SNPS) in the Il-18 promoter (-137G-C [rs187238J and -607-CA [rs1946518J) whose haplotypes encompass significant genetic variation due to the presence of strong linkage disequilibrium among these variants. The relationship between the genotypes/haplotypes, SMA (hemoglobin [HbJ, <5.0 g/dlJ, and longitudinal clinical outcomes were then investigated in Kenyan children (n =719). Multivariate logistic regression analyses controlling for age, gender, sickle cell trait, glucose-6-phosphate dehydrogenase (G6PD) deficiency, HIV-1, and bacteremia revealed that carriage of the -607AA genotype was associated with protection against SMA (odds ratio [ORJ = 0.440 [95% confidence interval {CI} =0.21 to 0.90J, P = 0.031) in children with acute infection. In contrast, carriers of the -137G/-607C (GC) haplotype had increased susceptibility to SMA (OR =2.050 [95% CI = 1.04 to 4.05J, P = 0.039). Measurement of IL-18 gene expression in peripheral blood leukocytes demonstrated that elevated IL-18 transcripts were associated with reduced hemoglobin concentrations (p = -0.293, P = 0.010) and that carriers of the "susceptible" GC haplotype had elevated IL-18 transcripts (p= 0.026). Longitudinal investigation of clinical outcomes over a 3-year follow-up period revealed that carriers of the rare CC haplotype (-1% frequency) had 5.76 times higher mortality than noncarriers (p = 0.001). Results presented here demonstrate that IL-18 promoter haplotypes that condition elevated IL-18 gene products during acute infection are associated with increased risk of SMA. Furthermore, carriage of the rare CC haplotype significantly increases the risk of childhood mortallty.Item Functional Studies of T Regulatory Lymphocytes in Human Schistosomiasis in Western Kenya(The American Journal of Tropical Medicine and Hygiene, 2018) Ondigo, B. N.; Ndombi, E. M.; Nicholson, S. C.; Oguso, J. K.; Carter, J. M.; Kittur, N.; Secor, W. E.; Karanja, D. M. S.; Colley, D. G.Immunoregulation is considered a common feature of Schistosoma mansoni infections, and elevated levels of T regulatory (Treg) lymphocytes have been reported during chronic human schistosomiasis. We now report that the removal of Treg (CD4+/CD25hi/CD127low lymphocytes) from peripheral blood mononuclear cells (PBMCs) of S. mansoni–infected individuals leads to increased levels of phytohemagglutinin (PHA)-stimulated interferon gamma (IFNγ) production and decreased interleukin-10 (IL-10) responses. Exposure to schistosome antigens did not result in measurable IFNγ by either PBMC or Treg-depleted populations. Interleukin-10 responses to soluble egg antigens (SEA) by PBMC were unchanged by Treg depletion, but the depletion of Treg greatly the decreased IL-10 production to soluble worm antigenic preparation (SWAP). Proliferative responses to PHA increased upon Treg removal, but responses to SEA or SWAP did not, unless only initially low responders were evaluated. Addition of anti-IL-10 increased PBMC proliferative responses to either SEA or SWAP, but did not alter responses by Treg-depleted cells. Blockade by anti-TGF-β increased SEA but not SWAP proliferative responses by PBMC, whereas anti-TGF-β increased both SEA- and SWAP-stimulated responses by Treg-depleted cultures. Addition of both anti-IL-10 and anti-TGF-β to PBMC or Treg-depleted populations increased proliferation of both populations to either SEA or SWAP. These studies demonstrate that Treg appear to produce much of the antigen-stimulated IL-10, but other cell types or subsets of Treg may produce much of the TGF-β. The elevated levels of Treg seen in chronic schistosomiasis appear functional and involve IL-10 and TGF-β in antigen-specific immunoregulatioItem Haplotypes of IL-10 promoter variants are associated with susceptibility to severe malarial anemia and functional changes in IL-10 production.(Human Genetics, 2008-11) Ouma, C.; Davenport, G. C.; Were, T.; Otieno, Micheal Frederick; Hittner, James B.; Vulule, J. M.; Martinson, J.; Ong'echa, J. M.; Ferrell, R. E.; Perkins, D. J.Item Health Seeking Behavior, Practices of TB and Access to Health Care among TB Patients in Machakos County, Kenya. A Cross-Sectional Study(IISTE, 2014) Mutinda, Kasusu A.; Kabiru, Ephantus W.; Mwanik, Peter .K.Despite efforts to implementation of the DOTS programme in Kenya since the year (1993) and achieving 100% coverage by the year 1996; new TB cases continue to emerge in communities, a significance of TB transmission. The success of the DOTS programne require total adherence to treatment for those infected with TB and appropriate control measures as stipulated in TB treatment guidelines, trained manpower to manage the infected patients and surveillance. The main objective of this study was to examine the health seeking behavior of TB patients, practices of TB and access to health care. A cross- sectional survey of TB patients was done in AthiRiver, Machakos level 5 and Mutituni TB treatment health facilities in Machakos County. A pre-tested self administered questionnaire/ interviews was used to collect data. The data was analyzed by use of statistical package for social sciences (SPSS) version 16. Pearson Chi-Square analysis was used to determine the relationships between variables. Level of significance was fixed at 0.05 (p=0.05).The results of this study reveal TB is affecting more males than females (60.4%).Most of the TB patients are young below 40 years accounting for (71.8%), are poor and unemployed (65%).When the TB patient realized they were sick, most of them (81.4%) sought informal remedies from private practioners or self medicated. This delayed early opportunity to seek heath care for more than one month by (82%) of the respondents. Failure of the informal treatment and unbearable pains in advanced disease forced the majority (96.8%) to seek health care in designated TB treatment facilities. There is secrecy in TB status disclosure as (75.5%) declined to openly disclose. For those who disclosed (78%) was to a selected family member mainly to seek assistance (90.7%). Across age groups, educational level, marital status, disclosure of TB status was of no statistical significance p=0.462 and openness of status p=0.112 respectively as the majority remained secret. Health education received by (52.8%) in the TB clinics was observed to significantly influence clinic attendance p=0.014 and adherence to treatment p=0.008 as 78.5% attended regularly and 85.5% adhered respectively. Treatment in public facilities is free with the majority (89.9%) reporting attendance. TB patients care in the community is mainly by family members (74.8%), there is no follow up by heath workers and social support group is minimal at (11.4%).The ministry of health needs to address control measures by initiating strict surveillance of TB, initiate community education on best practices of TB and to distigmatize the disease.Item HIV Prevalence among Secondary School Student Blood Donors in Nairobi County, Kenya(International Journal of Science and Research (IJSR), 2018-07) Lorre, Moses C. O; Gicheru, M. M; Kabiru, E. WThe Human Immune deficiency Virus and the Acquired Immune Deficiency Syndrome situation in Kenya has affected blood collection in the country leading to a decline from 150,000 units to about 70,000 units annually, yet the demand for blood in Kenya exceeds 300,000 units per year. Schools are a major source of blood in all counties of Kenya and more than 60% of blood in Kenya is collected from secondary school students but the data on HIV prevalence in this category of donors is scarce. The objective of this study was to determine the prevalence of HIV among secondary school student blood donors in Nairobi County and to determine their knowledge on blood donation and blood transfusion practices. Four hundred and thirty four (434) student blood donors were screened for anti-HIV antibodies. Two hundred and forty eight (248) of the students were male and 186 were females. The age of the students ranged between 16–28 years with a mean age of 17.25 ±1.057 years. Mean age for male students was 18 ± 1.433 years, while the mean age for the female students was 17 ± 1.057 years. Questionnaires to determine the students’ knowledge on blood donation and blood transfusion practices were given to the students to fill before blood samples were collected from them by a qualified medical laboratory professional. All blood samples collected were tested for HIV antibodies using Vironostika Uni-FormII Ag/Ab ELISA method (Biomerieux, France) and confirmation done by Enzygnost HIV 1&2 4th generation ELISA test (Simens AG, Germany). Three (3) (0.7%) out of the 434 donors were positive for HIV and 431 (99.3%) were negative. Of these, two (0.46%) were males and one (0.23%) was a female. The data was analyzed using the SPSS version 22. Probability (p) value < 0.05 was considered statistically significant. The results showed a low prevalence of HIV among student blood donors in secondary schools compared to the general population. The study also shows there is low knowledge on blood donation and blood transfusion practices among secondary school student blood donors. Recommendation is made for strengthening the recruitment of secondary school students as voluntary unremunerated blood donors as a more effective strategy to reducing the risk of obtaining HIV infe cted blood from donors. Extensive and effective use of information education and communication materials to sensitize the secondary school student donor popula tion on blood donations and blood transfusion practices is also recommended.Item Impact of sanitation improved school latrine on latrine-related practices, perceptions attitude and occurrence of diarrhoea in children in Mwea Division, Kirinyaga District, Central Kenya(Kenyatta University School of Medicine, 2015) Ng'ethe, Muhoho; Mitsui, Y.; Mwandawiro, C.Background: School latrines in Mwea irrigation regions are unsanitary and unhygienic. School children who are the end point users of the latrines are exposed to the unhygienic conditions of the latrines and are likely to contract sanitation related diseases. School children have their outlook on the sanitation of the school latrines and they can play an important role towards programmes for improvement of sanitation in the school latrines. Objective: To determine children's perception attitude and practices about the school latrines in relation to their health experiences. Methods: A self-administered questionnaire was conducted from 215 Grade Three children in three primary schools in Mwea Division of Central Kenya. Questions about washing hands after latrine use, cleaning of latrines, avoiding use of latrines and perceptions about dirty latrines in relation to occurrence of diarrhea were asked. Occurrence of diarrhoea was based on child's recall of the experience during the one week preceding the day of the test. Results: Diarrhoea was experienced by 23% of children occuring more often in boys (29%) than in girls (17%). Children who perceived school latrine to be dirty developed diarrhoea (29%) more often than those who did not (18%). Diarrhoea occurrence was reported more frequently by children whose response was negative for washing hands after latrine use (28%) than those who did (15%). Children who felt that cleaning school latrines was a punishment developed diarrhoea (41%) more often than those who did not (18%). On the other hand, there was no Significance difference in occurrence of diarrhoea in association with avoidance of usage of school latrines, cleaning of school latrines, and willingness to clean the school latrines. Conclusion: The school children have given a low rating of the sanitatary condition of the school latrines.They are the end point users of school latrines and their outlok on the condition of the latrine in relation to their health is important for implementation of disease intervention measures.Item Incidence of perineural invasion in prostate adenocarcinoma: Rural Kenyan population experience(Kenyatta University, 2014) Nzioka, A.l.; Onyuma, T.; Gakinya, S.Introduction: Prostate cancer appears to be more aggressive amongst patients of African descent, a condition which could be associated with the presence of perineural invasion and higher Gleason scores of the cancer. Objective: This study evaluated the incidence of perineural invasion in previously diagnosed prostate cancer cases in a rural hospital which receive numerous cases of prostate cancer annually. Setting: This was a retrospective cross sectional study conducted at a busy mission referral hospital in rural Kenya. A total of 151 cases were included in the study. Patients' biodata was retrieved from the laboratory information system. Hematoxylin and eosin stained slides of previously diagnosed cases of prostate cancer over a period of one year (January 2012 to December 2012) were retrieved. These slides were microscopically examined for perineural invasion and the tumour grade determined using Gleason sconng. Results: Specimens from 151 patients were examined for perineural invasion. The patients' ages ranged from 46 to 93, mean age 73.77 (SD 9.474).Tumours in high grade category were 75.5% of the total number of cases while the rest (24.5%) were intennediatellow grade tumours. Out of these, 55.6% of the biopsies had perineural invasion. There was no significant relationship between the patients' age and the grade of tumour. Data on comparison of the cancers with perineural invasion and those without perineural invasion for grade demonstrated significant association between the tumour grade and the presence of perineural invasion (p:::;O.OOOI).Item Mammary analogue secretory carcinoma of the salivary gland of a recently described tumour: A case report(Kenyatta University School of Medicine, 2015) Nzioka, A.; Onyuma, P.; Gakinya, S.Mammary Analogue Secretory Carcinoma (MASC) is a recently described tumour of the salivary gland, characterized by the t (12; 15) (p13; q25) translocation. We report a case from a 40 year old female who presented with a tumour in the right parotid gland at Social Service League, MP Shah Hospital in Kenya. Histological evaluation, immunohistochemical staining and fluorescent in situ hybridization (FISH) were done. The findings were consistent with mammary analogue secretory carcinoma of the salivary gland. It is important to distinguish this tumour from its morphological mimics. At the time of writing of this paper, we believed that this is the first case of mammary analogue secretory carcinoma described in Kenya.Item Management of Type 2 Diabetes Mellitus by Diabetic Clients In Nyandarua South Sub –County, Kenya(IPRJB, 2017) Muoki, Francis M.; Kabiru, Ephantus W.; Wanyoro, Anthony K.Purpose: Type 2 diabetes mellitus, (T2DM) is the most common form of diabetes, characterized by disorders of insulin resistance, insulin secretion, obesity, lipid abnormalities, hypertension, and cardiovascular diseases. The marked increase of type 2 diabetes mellitus (T2DM) necessitates active development and implementation of efficient prevention programs as the condition is a major public health concern in the world. This study sought to determine management of T2DM by diabetic clients in Nyandarua South sub-County, Kenya. Methods: A descriptive cross-sectional facility based design was used. The study population comprised 294 T2DM clients. Relationship between levels of knowledge on the recommended management interventions, socio-demographic factors and management practices were examined using chi-square and bivariate analyses. A P≤ 0.05 was considered significant. Results: Majority of participants (83.3%) had never been screened for DM except at the point of diagnosis. A small proportion of the participants (28%) had good knowledge on T2DM management interventions. Practices applied by the clients in managing T2DM included diet, exercise, taking diabetic medications and monthly weight monitoring. Conclusions made from the study are that there was low level of knowledge on T2DM management interventions, practices for management of T2DM that participants applied included diabetic diet, exercise, drug therapy and weight monitoring though fairly undertaken. Level of education and income significantly influenced clients’ management of T2DM. Recommendations: The national and Nyandarua County government’s Department of Health to improve on creation of awareness on T2DM management interventions and diversify the media so as to reach most people. This should be standardized across the health facilities in order to improve the level of knowledge on management interventions for T2DM among diabetic clients.