Background Malaria vector control is dependent on chemical insecticides applied to walls by indoor residual spraying or on long-lasting insecticidal nets. The emergence and spread of insecticide resistance in major malaria vectors may compromise malaria control and elimination efforts. The aim of this study was to estimate a diagnostic dose for chlorfenapyr (class: pyrrole) and clothianidin (class: neonicotinoid) and assess the baseline susceptibility of three major Anopheles malaria vectors of western Kenya to these two insecticides. Methods The Centers for Disease Control and Prevention (CDC) bottle assay was used to determine the diagnostic doses of chlorfenapyr and clothianidin insecticides against the susceptible Kisumu strain of Anopheles gambiae . Probit analysis was used to determine the lethal doses at which 50% (LD50) and 99% (LD99) of the susceptible mosquitoes would be killed 24, 48 and 72 h following exposure for 1 h. Insecticidal efficacy of chlorfenapyr, clothianidin and the pyrethroid deltamethrin was then evaluated against field collected female Anopheles mosquitoes sampled from Nyando, Bumula and Ndhiwa sub-Counties in western Kenya. Members of Anopheles funestus and An. gambiae complexes were identified using polymerase chain reaction (PCR). Results The determined diagnostic doses of chlorfenapyr and clothianidin insecticides were 50 µg/bottle and 150 µg/bottle, respectively, for An. gambiae , Kisumu strain. When exposed to the diagnostic dose of each insecticide, Anopheles malaria vector populations in western Kenya were susceptible to both insecticides with 100% mortality observed after 72 h. Mortality of mosquitoes exposed to deltamethrin increased over time but did not reach 100%. Mortality of Anopheles arabiensis from Nyando exposed to deltamethrin was 83% at 24 h, 88% at 48 h and 94.5% at 72 h while An. funestus from Ndhiwa was 89% at 24 h, 91.5% at 48 h and 94.5% at 72 h. Conclusion Mosquitoes of western Kenya, despite being resistant to pyrethroids, are susceptible to chlorfenapyr and clothianidin. Field evaluations of the formulated product are needed. Electronic supplementary material The online version of this article (10.1186/s12936-019-2858-z) contains supplementary material, which is available to authorized users.

ObjectiveSince the implementation of a series of blood donation safety improvements in Kenya, information about seroprevalence and determinants of transfusion transmissible infections among voluntary blood donors especially in high HIV burden regions of Homabay, Kisumu and Siaya counties remain scanty. A cross-sectional study examining HIV, syphilis, hepatitis B and C virus sero-markers and associated determinants was conducted among voluntary blood donors. Their demographic characteristics and previous risk exposure were recorded in a pre-donation questionnaire, while blood samples collected were screened for hepatitis B, hepatitis C, human immunodeficiency viruses by ELISA and RPR (syphilis), then confirmed using CMIA.ResultsOverall TTIs seroprevalence was 114 (9.4%), distributed among HIV, HBV, HCV and syphilis at 14 (1.15%), 42 (3.46%), 39 (3.21%) and 19 (1.56%), respectively, with co-infections of 3 (0.25%). There were no significant differences in proportions distributions among demographic variables. However, high risk sex was significantly associated with higher odds of HBV infections [> 1 partner vs. 0–1 partner; odd ratio (OR) 2.60; 95% confidence interval (CI) 1.098–6.86; p = 0.046]. In conclusion, a substantial percentage of blood donors still harbor transfusion transmissible infections despite recent safety improvements with greater majority cases caused by HBV infections arising from previous exposure to high risk sex.Electronic supplementary materialThe online version of this article (10.1186/s13104-018-3276-y) contains supplementary material, which is available to authorized users.

Severe malarial anemia (SMA) and cerebral malaria (CM) are two of the most serious manifestations of Plasmodium falciparum malaria and are important causes of childhood mortality and morbidity in sub-Saharan Africa. However, the pathogenesis of these complications remains unclear. A better understanding of the factors involved in the pathogenesis of severe malaria is essential for the identification of at-risk populations and the development of effective prophylactic and therapeutic measures.There is abundant evidence to suggest that destruction of uninfected red cells plays an important role in the development of SMA. Uninfected red cells of humans and mice infected with P. falciparum or rodent malaria have a reduced life span (26,27,48), and the life span is more reduced in patients with splenomegaly (26), a common finding in children with SMA.

Introduction: Uropathogenic Escherichia coli (UPECs) are a significant cause of urinary tract infections (UTIs). In Kenya, UTIs are typically treated with b-lactam antibiotics without antibiotic susceptibility testing, which could accelerate antibiotic resistance among UPEC strains. Aim: This study determined the occurrence of UPEC producing extended-spectrum b-lactamases (ESBLs), the genes conferring resistance to b-lactams, and the phylogenetic groups associated with ESBLs in Kenyan UPECs. Methodology: Ninety-five UPEC isolates from six Kenyan hospitals were tested for ESBL and plasmidmediated AmpC b-lactamase (pAmpC) production by combined disk diffusion and disk approximation tests, respectively. Real-time and conventional polymerase chain reactions (PCRs) were used to detect three ESBL and six pAmpC genes, respectively, and phylogenetic groups were assigned by a quadruplex PCR method. Results: Twenty-four percent UPEC isolates were ESBL producers with bla CTX-M (95.6%), bla TEM (95.6%), and bla SHV (21.7%) genes detected. Sixteen isolates had bla CTX-M/TEM , whereas five had bla TEM/CTX-M/SHV . A total of 5/23 ESBLs were cefoxitin resistant, but no AmpC genes were detected. The UPECs belonged predominantly to phylogenetic groups B2 (31/95; 32.6%) and D (30/95; 31.6%), while groups B2 and A had the most ESBL producers. Conclusions: b-Lactam antibiotics have reduced utility for treating UTIs as a quarter of UPECs were ESBL producing. Single or multiple ESBL genes were present in UPECs, belonging primarily to phylogenetic groups B2 and A.

Background Cervical cancer screening is slowly transitioning from Pappanicolaou cytologic screening to primary Visual Inspection with Acetic Acid (VIA) or HPV testing as an effort to enhance early detection and treatment. However, an effective triage tests needed to decide who among the VIA or HPV positive women should receive further diagnostic evaluation to avoid unnecessary colposcopy referrals is still lacking. Evidence from experimental studies have shown potential usefulness of Squamous Cell Carcinoma Antigen (SCC Ag), Macrophage Colony Stimulating Factor (M-CSF), Vascular Endothelial Growth Factor (VEGF), MicroRNA, p16INKa / ki-67, HPV E6/E7/mRNA, and DNA methylation biomarkers in detecting premalignant cervical neoplasia. Given the variation in performance, and scanty review studies in this field, this systematic review described the diagnostic performance of some selected assays to detect high-grade cervical intraepithelial neoplasia (CIN2+) with histology as gold standard. Methods We systematically searched articles published in English between 2012 and 2020 using key words from PubMed/Medline and SCOPUS with two reviewers assessing study eligibility, and risk of bias. We performed a descriptive presentation of the performance of each of the selected assays for the detection of CIN2 + . Results Out of 298 citations retrieved, 58 articles were included. Participants with cervical histology yielded CIN2+ proportion range of 13.7–88.4%. The diagnostic performance of the assays to detect CIN2+ was; 1) SCC-Ag: range sensitivity of 78.6–81.2%, specificity 74–100%. 2) M-CSF: sensitivity of 68–87.7%, specificity 64.7–94% 3) VEGF: sensitivity of 56–83.5%, specificity 74.6–96%. 4) MicroRNA: sensitivity of 52.9–67.3%, specificity 76.4–94.4%. 5) p16INKa / ki-67: sensitivity of 50–100%, specificity 39–90.4%. 6) HPV E6/E7/mRNA: sensitivity of 65–100%, specificity 42.7–90.2%, and 7) DNA methylation: sensitivity of 59.7–92.9%, specificity 67–98%. Conclusion Overall, the reported test performance and the receiving operating characteristics curves implies that implementation of p16ink4a/ki-67 assay as a triage for HPV positive women to be used at one visit with subsequent cryotherapy treatment is feasible. For the rest of assays, more robust clinical translation studies with larger consecutive cohorts of women participants is recommended.

An understanding of the immunogenetic basis of naturally acquired immunity to

Background: Schistosomiasis due to Schistosoma mansoni remains a major public health problem and cause of morbidity and mortality in sub-Saharan Africa despite the implementation of control programmes. More than 6 million Kenyans are at risk of infection. Regarding control measures, Biomphalaria snail species, which are the obligatory intermediate hosts for transmission of S. mansoni, have been neglected. Mbita subcounty in Homa Bay County, western Kenya, along Lake Victoria basin, has a high prevalence of S. mansoni infection despite mass drug administration. This study aimed to determine the abundance of Biomphalaria, with their associated vegetation and schistosome infection rates, along Mbita shoreline. Methods: Sixteen purposively selected sites along the Mbita shoreline were sampled for Biomphalaria snails using a 30-minute scooping technique. Global positioning system technology was used to map selected sites. The associated vegetation at sampling sites were collected and identified. Schistosome infection status among the snails was determined via the detection of cercaria shedding. Results: A total of 3,135 Biomphalaria sudanica snails were collected. The number of snails collected differed significantly between the 16 sites (F=11.735; degrees of freedom [df]=15.836; P<.001). Significant mean differences (MD) were also observed in terms of the number of snails collected per vegetation type (F=7.899; df=5.846; P<.001). The mean number of snails collected from Cyprus gracilis was significantly higher than that from Enydra fluactuants (MD= 2.03; P<.001), Eichhornia crassipes (MD=4.15; P<.010), and E. fluactuants mixed with E. crassipes (MD=2.516; P<.010). A total of 21 (0.67%) snails shed human cercariae, while 27 (0.86%) snails shed nonhuman cercariae, despite 14 sites having human faeces contamination. Conclusion: Although the schistosome infection prevalence among the snails was low, these sites may still be important exposure sites. C. gracilis is the main vegetation type associated with a high abundance of Biomphalaria snails. Molecular techniques are necessary for verification of schistosome positivity among the snails.

Substance abuse is a worldwide public health challenge with college youth being among those affected. An estimated 10-15 % of students in medical training institutions risk substance abuse in their lifetime as they are not immune to the predisposing factors associated with the abuse. The conduct and efficiency of medical training college (MTC) students as future healthcare professionals may be impacted negatively by substance abuse; consequently, the patients are at risk. In Kenya, substance abuse is prevalent among college youth though data on the factors associated substance abuse by students in MTCs are still unclear. South Nyanza, the study area lies within marijuana transit route along Kisii -Migori road from Tanzania to Nairobi, Kenya. The objective of the study was to determine the factors associated with substance abuse by students in MTCs in South Nyanza Region. Cross-sectional descriptive study design was used.