RP-Department of Pathology

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    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, Jesse
    Introduction: 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.
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    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.G
    This 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.
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    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, Samuel
    Background: 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 resistance
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    Warburgia Ugandensis: A Potent in Vivo Phytomedicine Against Plasmodium Knowlesi
    (Journal of Pharmacognosy and Phytochemistry, 2020) Were, Patrick Simiyu; Kutima, Helen Lydia; Suba, Hastings Ozwara; Walyambillah, Waudo
    Resistance to artemisinin-based therapies by Plasmodium falciparum and the entry of P. knowlesi as the fifth human malaria parasite present an urgent need for development of safe, affordable and effective therapeutic alternatives. Warburgia ugandensis, commonly used in herbal medicine, has displayed remarkable antiplasmodial properties. To be accepted as viable alternatives, herbal medicines must be subjected to the modern rigorous testing and validation procedures as used in convention medicines. This study was designed to determine the efficacy and safety of extracts from W. ugandensis. Plasmodium knowlesi-infected baboons were treated with an oral dose of 5000 mgkg-1/birth weight. Changes in parasiteamia, heamatology and biochemistry were recorded over a period of 21 days. Data were managed using GraphPad Prism Version 5.00. ANOVA for calculated means between treated and untreated animals (P-value < 0.0001) were separated by Tukeys’ Multiple Comparison for significance. Low parasiteamia and increased survivorship were observed in treated animals.
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    Young Adults in Endemic Areas: An Untreated Group In Need of School-Based Preventive Chemotherapy For Schistosomiasis Control and Elimination
    (PubMed Central, 2018) Korir, Harrison K; Riner, Diana K; Kavere, Emmy; Omondi, Amos; Landry, Jasmine; Kittur, Nupur; Ndombi, Eric M; Ondigo, Bartholomew N; Secor, W Evan; Karanja, Diana M. S; Colley, Daniel G
    Parasitologic surveys of young adults in college and university settings are not commonly done, even in areas known to be endemic for schistosomiasis and soil-transmitted helminths. We have done a survey of 291 students and staff at the Kisumu National Polytechnic in Kisumu, Kenya, using the stool microscopy Kato-Katz (KK) method and the urine point-of-care circulating cathodic antigen (POC-CCA) test. Based on three stools/two KK slides each, in the 208 participants for whom three consecutive stools were obtained, Schistosoma mansoni prevalence was 17.8%. When all 291 individuals were analyzed based on the first stool, as done by the national neglected tropical disease (NTD) program, and one urine POC-CCA assay (n = 276), the prevalence was 13.7% by KK and 23.2% by POC-CCA. Based on three stools, 2.5% of 208 participants had heavy S. mansoni infections ( 400 eggs/gram feces), with heavy S. mansoni infections making up 13.5% of the S. mansoni cases. The prevalence of the soil-transmitted helminths (STH: Ascaris lumbricoides, Trichuris trichiura and hookworm) by three stools was 1.4%, 3.1%, and 4.1%, respectively, and by the first stool was 1.4%, 2.4% and 1.4%, respectively. This prevalence and intensity of infection with S. mansoni in a college setting warrants mass drug administration with praziquantel. This population of young adults is ‘in school’ and is both approachable and worthy of inclusion in national schistosomiasis control and elimination programs.
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    Virus-Induced Cytoplasmic Aggregates and Inclusions are Critical Cellular Regulatory and Antiviral Factors
    (Pubmed Central, 2020) Olasunkanmi, Oluwatayo Israel; Chen, Sijia; Mageto, James; Zhong, Zhaohua
    RNA granules, aggresomes, and autophagy are key players in the immune response to viral infections. They provide countermeasures that regulate translation and proteostasis in order to rewire cell signaling, prevent viral interference, and maintain cellular homeostasis. The formation of cellular aggregates and inclusions is one of the strategies to minimize viral infections and virus-induced cell damage and to promote cellular survival. However, viruses have developed several strategies to interfere with these cellular processes in order to achieve productive replication within the host cells. A review on how these mechanisms could function as modulators of cell signaling and antiviral factors will be instrumental in refining the current scientific knowledge and proposing means whereby cellular granules and aggregates could be induced or prevented to enhance the antiviral immune response in mammalian cells
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    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.
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    Prevalence and Correlates of Alcohol Use among Underage High-School Students in Murang’a and Kajiado Counties, Kenya
    (Researchjournali’s Journal of Public Health, 2015-07) Okwarah, Patrick; Gakunju, Richard; Kabiru, Ephantus; Malla, Lucas; Okedi, William; Mutham, Lawrence; Karanja, Simon
    Background: Alcohol use during adolescence is an important risk factor for a host of physical and social problems affecting the young people globally. There is limited data on the prevalence of alcohol use among the underage in Kenya. Aim: To determine the prevalence and correlates of alcohol use among underage high-school students in Murang‟a and Kajiado Counties in Kenya Methods: A random sample of 938 respondents (61.9% males and 38.1% females) below 18 years was obtained from Kajiado and Murang‟a on proportionate to stratum size. A multilevel logistic regression was used to investigate potential correlates to alcohol use. Results: The prevalence of current alcohol use was 37% and was significantly associated with being male (AOR = 1.58; 95% CI 1.40, 2.42) ;ease of getting an adult to buy alcohol (AOR=2.20; 95% CI 1.57, 3.10); cigarette use (AOR = 3.8; 95% CI 1.86, 8.28) and having multiple sexual partners (AOR =1.17; 95% 1.15, 1.20). Conclusion: There is a high prevalence of underage alcohol use in Murang‟a and Kajiado. A joint program targeting parents and teachers could be initiated so as to heighten the level of interventions required to avert further escalation of the problem.
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    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. W
    The 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.
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    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.
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    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, . Joyce
    Universally, 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.
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    Socio-Demographic, Social economic and Socio-Cultural Factors that Influences Uptake of Cervical Cancer Screening Services in Low Resource Settings
    (IPRJB, 2017) Mwangi, J. H; Gachau, A. G; Kabiru, E. W
    Background: Cervical cancer is the fourth commonest cancer in women and the seventh overall, with estimated 528,000 new cases every year. Around 85% of the global burden occurs in the low resource settings where it accounts for almost 12% of all female cancers. In these areas programmes for screening and treatment are deficient or underutilized. This is even after the services are availed or assumed to be provided. Objectives: To establish socio-demographic, social economic and socio- cultural factors that influences uptake of cervical cancer screening services in Kitui Central Sub County, Kenya. Methodology: A descriptive cross-sectional study design was done; where women of reproductive age attending MCH/FP clinic in public health facilities were systematically randomly selected and exit interview was the main data collection technique. Key informants were also interviewed. Results: A total of 370 women of reproductive age were interviewed. Majority,(69.2%) were aged below 29 years, more than 80% had completed their primary school education,68% were married,57% were protestants,75 % were having three children or less,61% were depending on farm produce and more than 60% were earning less Ksh 5000 per month..There was statistical significant association between utilization of VIA/VILI cervical cancer screening services and the level of education( =21.728,df=3,p= 0.000),main source of income.( = 15.030,df=2,p=0.01),average monthly income, ( =27.942, df=4, p=0.0001), main decision maker in the family, ( =6.908, df=2, p=0.032). Public Health facilities were not well staffed and equipped to adequately offer the VIA/VILI screening services effectively. Conclusion: The level of awareness on cervical cancer prevention was low and this among other factors lead to low VIA/VILI screening tests utilization. We recommend strategies to be put into place to increase awareness on available methods of screening and importance of being screened for cervical cancer among eligible women.
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    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, Ephantus
    Background: 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.
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    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’ethe
    Introduction: 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.
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    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.
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    Roles of DDX5 in the tumorigenesis, proliferation, differentiation, metastasis and pathway regulation of human malignancies
    (Elsevier, 2019) Nyamao, Rose Magoma; Wu, Jing; Yu, Li; Xiao, Xiao; Zhang, Feng-Min
    The DEAD-box RNA helicase DDX5 is a member of a family of highly conserved proteins involved in gene-expression regulation and ATP-dependent RNA helicase activities. Recently, it has been reported to be aberrantly expressed in many tumors, and is linked to the regulation of many cancer-related pathways. It co-activates many transcription factors, with profound implications for cancer development, and the de-regulation of its functions is ultimately associated with tumor formation and progression. Moreover, it is strongly implicated in the tumorigenesis, invasiveness and metastasis, as well as the proliferation of several cancer types. In this review, we seek to elucidate the role of DDX5 in the development and progression of human malignancies and put forward its prospective applications in future cancer research.
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    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 immunoregulatio
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    Schistosoma mansoni Infection Can Jeopardize the Duration of Protective Levels of Antibody Responses to Immunizations against Hepatitis B and Tetanus Toxoid
    (Public Library of Science, 2016) Riner, D. K.; Ndombi, E. M.; Carter, J. M.; Omondi, A.; Kittur, N.; Kavere, E.; Korir, H. K.; Flaherty, B.; Karanja, D.; Colley, D. G.
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    Multilocus sequence types and virulence determinants of hypermucoviscosity-positive Klebsiella pneumoniae isolated from community-acquired infection cases in Harbin, North China
    (National Institute of Infectious Diseases, 2016) Zhao, Jizi; Chen, Jie; Zhao, Ming; Qiu, Xiaohong; Chen, Xiaobei; Zhang, Wenli; Sun, Rui; Ogutu, James Opiyo; Zhang, Fengmin
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    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.