Different Regions Of Kenya Research Articles

A Study on the Geophylogeny of Clinical and Environmental Vibrio cholerae in Kenya

Cholera remains a significant public health challenge in many sub-Saharan countries including Kenya. We have performed a combination of phylogenetic and phenotypic analysis based on whole genome DNA sequences derived from 40 environmental and 57 clinical V. cholerae from different regions of Kenya isolated between 2005 and 2010. Some environmental and all clinical isolates mapped back onto wave three of the monophyletic seventh pandemic V. cholerae El Tor phylogeny but other environmental isolates were phylogenetically very distinct. Thus, the genomes of the Kenyan V. cholerae O1 El Tor isolates are clonally related to other El Tor V. cholerae isolated elsewhere in the world and similarly harbour antibiotic resistance-associated STX elements. Further, the Kenyan O1 El Tor isolates fall into two distinct clades that may have entered Kenya independently.

Use of next‐generation sequencing for the identification and characterization of Maize chlorotic mottle virus and Sugarcane mosaic virus causing maize lethal necrosis in Kenya

The diagnosis of novel unidentified viral plant diseases can be problematic, as the conventional methods such as real‐time PCR or ELISA may be too specific to a particular species or even strain of a virus, whilst alternatives such as electron microscopy (EM) or sap inoculation of indicator species do not usually give species level diagnosis. Next‐generation sequencing (NGS) offers an alternative solution where sequence is generated in a non‐specific fashion and identification is based on similarity searching against GenBank. The conventional and NGS techniques were applied to a damaging and apparently new disease of maize, which was first identified in Kenya in 2011. ELISA and TEM provided negative results, whilst inoculation of other cereal species identified the presence of an unidentified sap transmissible virus. RNA was purified from material showing symptoms and sequenced using a Roche 454 GS‐FLX+. Database searching of the resulting sequence identified the presence of Maize chlorotic mottle virus and Sugarcane mosaic virus, a combination previously reported to cause maize lethal necrosis disease. Over 90% of both viral genome sequences were obtained, allowing strain characterization and the development of specific real‐time PCR assays which were used to confirm the presence of the virus in material with symptoms from six different fields in two different regions of Kenya. The availability of these assays should aid the assessment of the disease and may be used for routine diagnosis. The work shows that next‐generation sequencing is a valuable investigational technique for rapidly identifying potential disease‐causing agents such as viruses.

Short Communication: High Prevalence of Transmitted Antiretroviral Drug Resistance Among Newly HIV Type 1 Diagnosed Adults in Mombasa, Kenya

Abstract In view of the recent antiretroviral therapy (ART) scale-up in Kenya, surveillance of transmitted HIV drug resistance (TDR) is important. A cross-sectional survey was conducted among newly HIV-1 diagnosed, antiretroviral-naive adults in Mombasa, Kenya. Surveillance drug resistance mutations (SDRMs) were identified according to the 2009 WHO list. HIV-1 subtypes were determined using REGA and SCUEAL subtyping tools. Genotypic test results were obtained for 68 of 81 participants, and SDRMs were identified in 9 samples. Resistance to nonnucleoside reverse transcriptase inhibitors (K103N) occurred in five participants, yielding a TDR prevalence of 7.4% (95% confidence interval 2.4-16.3%). Frequencies of HIV-1 subtypes were A (70.6%), C (5.9%), D (2.9%), and unique recombinant forms (20.6%). The TDR prevalence found in this survey is higher than previously reported in different regions in Kenya. These findings justify increased vigilance with respect to TDR surveillance in African regions where ART programs are scaled-up in order to inform treatment guidelines.

Tuberculosis and oral <i>Candida</i> species surveillance in HIV infected individuals in Northern Kenya, and the implications of tuberculin skin test screening for DOPT-P

To determine the pattern of opportunistic infections such as TB and Candida species in HIV infected patients in Northern Kenya. Cross-sectional study. Five health facilities in Moyale (n=224), Mandera (n=121) and Turkana Kakuma; (n=83), Lopiding; (n=94) districts during different periods in 2003. Five hundred and fifty two patients. In total 94 (18%) patients were found to be HIV positive (Moyale=42, Mandera=13, Turkana; Kakuma=8, Lopiding=31). Only 65 of 94 HIV positive patients provided saliva samples. Of these, 11 (17%) were TB smear positive and 19 (29.2%) were colonized by oral Candida species. The Candida isolates were as follows; Co-infection of Candida species and TB (n=4), C. albicans only (n=12), C. tropicalis only (n=1), C. albicans and C. glabarata (n=1) and C. albicans, C. glabarata and C. tropicalis. co-infection (n=1). The findings provides an important insight into the differences in mucosal susceptibility to bacteria (TB) infection and fungal (Candida species) colonization during HIV immunosuppression, based on collected blood, sputum and saliva specimens. Further studies are needed to elucidate the comparative transmission dynamics and pathogenetic mechanisms of these opportunistic infections-in different regions of Kenya. Such studies would improve the efficiency of directly observed preventive therapy programme (DOPT-P) whose implementation involves screening by tuberculin skin testing.

Multidrug resistant Salmonella typhi and antimicrobial agent quality and bioavailability

Increasing incidence of multidrug resistant Salmonella typhi has been a scourge for those afflicted with enteric fever all over the world. Recently Gautam et al. [1] reported decreased Salmonella typhi susceptibility to ciprofloxacin. The minimum inhibitory antibiotic concentration for third generation cephalosporin and aminoglycosides was above the cut-off level. Plasmid and DNA genomic characterization of 102 Salmonella enterica serovar Typhi isolates from different regions of Kenya was intriguing. There were only 13.7% fully susceptible isolates, with 82.4% being resistant to five commonly available drugs [2]. In all probability, more expensive and not readily available antimicrobials will be required to address future episodes of multi-drug resistant S. enterica serovar Typhi strains. For rational use of these, as well as the commonly available antibiotics, it is essential to examine bioavailability and field quality as well as the types of antibiotics offered to patients. The efficacy of intramuscularly given benzathine penicillin G and oral penicillin V for the eradication of streptococci from children with acute pharyngitis has been known for a while. Recently, however, there was a warning from Minneapolis, Minnesota, where the recommended penicillin doses applied to children with group A streptococci infection were accompanied by 35% to 37% failures. A carrier state and inadequate bioavailability of intramuscularly given benzathine penicillin were responsible for this poor therapeutic response [3]. Different brands of orally administered antibiotics vary remarkably in their in vivo bioavailability Dissolution efficiencies of different brands of film coated ciprofloxacin tablets were monitored in acetic acid and phosphate buffer pH7.4. Five of the six brands with a 60-70% fall in 30 minutes were adequately bioavailable in vivo. The sixth brand had less than a 40% fall in ciprofloxacin content and was less bioavailable [4]. Poor bioavailability would result in therapeutic failures and would promote the emergence of multi drug resistant S. enterica serovar Typhi. Assays made in Nigeria, of the active ingredients of common therapeutic agents, including antibiotics offered to patients with various ailments in pharmacies, gave astounding results. As many as 48% of the samples of common medicines were found outside the limits prescribed by the British Pharmacopoeia [5]. Similar scenarios with common or not so common antimicrobials offered against S. enterica serovar Typhi episodes would favor the selection, propagation and dissemination of multi drug-resistant isolates. Certainly, surveillance of antimicrobial potency and bioavailability of prescriptions against typhoid would reduce therapeutic failures attributed to poor quality medicines or any inadequate bioavailability.

Genetic characterization of cultivated bananas and plantains in Kenya by RAPD markers

A polymerase chain reaction (PCR)-based approach, namely, random amplified polymorphic DNA (RAPD) was used to estimate the genetic relationships among 20 selected banana cultivars from different regions of Kenya. Nineteen random primers were used. The polymorphisms in PCR amplification products were subjected to the unweighted pair group method for arithmetic averages (UPGMA) and plotted in a phenogram. The dendogram constructed from the similarity data showed that all the 20 cultivars analysed were related. The highly related cultivars included Ng’ombe, Nusu Ng’ombe, Ntobe, Sialamule, Kimuga, Kibuzi, Sibusi, Bukamba, Mfupi and Gitigi whose genome was AAA. The cultivars Manyatta, Mokoya, Murure and Horn plantain whose genome was AAB were less similar while Pekera, Muraru, Spambia, Matumbo, Nyar Sausett and Mtama formed the least related group.

Occurrence of plant parasitic nematodes and non‐pathogenic species ofFusariumin tomato plants in Kenya and their role as mutualistic synergists for biological control of root‐knot nematodes

Abstract The occurrence of plant parasitic nematodes and endophytic fungi in tomato plants was determined from different regions in Kenya. In areas with regular cultivation of tomatoes, the population densities of all species of nematodes, regardless of trophic group, were high. Meloidogyne incognita was the predominant plant parasitic nematode in the regions investigated. Apparently endophytic fungi were frequently isolated from tomato roots, with Fusarium oxysporum being the most common endophyte detected. In contrast, irregular cultivation of tomato resulted in lower overall nematode densities and the absence of Meloidogyne infestation. F. oxysporum occurred only sporadically. Four isolates of F. oxysporum which were tested in subsequent greenhouse experiments, reduced M. incognita populations without adversely affecting plant health. Non‐pathogenic isolates of F. oxysporum with mutualistic symbiotic behaviour are potential biological control agents for plant parasitic nematodes.

A study of head lice among primary schoolchildren in Kenya

Of 1270 schoolchildren (651 girls and 619 boys) from 33 urban and rural primary schools in different regions of Kenya who were examined for head lice, 17·1% were infested (8% with living lice or nits, 9·1% with dead nits). The over-all difference between infestation rates in urban and rural schools was not significant, but there was considerable variation in the five different regions selected. Infestation was not sex-related. Infestation rates tended to be higher in older children and in children with longer hair. Negroid children had lower infestation rates than non-Negroid children. The criterion-seems to be hair type. Prevalence of infestation was higher in private schools because non-Negroid children predominate in these schools. There was no correlation between infestation and the sharing of a towel or comb, but infestation tended to be higher in those who wash less, in those who share their bed, and in those who sleep with room-mates. Levels of infestation were low, with most harbouring only one or two lice.

Regional variation in prevalence of antibody against human T-lymphotropic virus types I and III in Kenya, East Africa.

The prevalence of antibodies against HTLV-III and -I was studied among populations of 6 distinctly different regions of Kenya, an equatorial African country in which AIDS has rarely been observed. Overall, 21% of subjects had ELISA reactions suggesting the presence of antibody against HTLV-III. The frequency of HTLV-III antibodies was highest among the Turkana people (50%) and lowest among the Masai (8%). Prevalence increased with age but was not related to sex. The pattern of ELISA-detected antibody against HTLV-I was similar. The specificity of these antibodies was supported by Western blot analysis of a subset of sera with high and low ELISA ratios, in which 66% and 73% of those with ELISA ratios considered positive (= greater than 5.0 in this study) also had a profile of bands consistent with HTLV-III and HTLV-I respectively. The antibodies detected were not cross-reactive between HTLV-III and HTLV-I on Western blot analysis. In a series of subjects with various parasitic and infectious diseases, patients with idiopathic splenomegaly and with schistosomiasis had a high proportion of antibodies against both HTLV-III and HTLV-I. This survey shows that reactivity in the ELISA HTLV-III and HTLV-I assays are common among Kenyans but vary considerably by region.