Search

Objective: To determine the prevalence of pain symptoms suggestive of Endometriosis among adolescent Kenyans and their impact on quality of life. Study Design: Analytical cross- sectional study. Setting: Dual centered study at Githunguri Girls High School (Rural) and Moi Girls High School Nairobi (Urban). Subjects: Three hundred and thirteen adolescents were interviewed with even distribution between rural (50.8%) and urban (49.2%) schools. Outcome Measure: The primary outcome measure was the prevalence of pain symptoms suggestive of endometriosis. Results: Dysmenorrhea was the most prevalent symptom at 72% with severe dysmenorrhea reported at 29%. Regular absenteeism was reported at 4% in those with dysmenorrhea, 1% was due to acyclic pelvic pain and 1% reported intermenstrual pain limiting their daily activities. In the students' interviewed, 94% had not heard of endometriosis, of whom 70% were interested to know more about it. The dysmenorrhea and pelvic pain that interfered with ordinary chores was most likely due to endometriosis. Conclusion: Majority of adolescent girls with chronic pelvic pain, not corresponding to conventional therapy have endometriosis. Endometriosis appearing in adolescence is more likely to progress and if not treated, may progress beyond pain to infertility. Endometriosis in adolescence is a hidden progressive and severe disease that deserves attention, not just compassion. [ABSTRACT FROM AUTHOR]

Water scarcity in Kenya is a significant issue that cannot be overlooked. Despite numerous efforts by Water Service Providers to deliver water services to Kenyan residents, the high demand for accessible water across the country remains unmet. In addition, the service provider’s ability to meet this demand is further impeded by various obstacles including inadequate control over water usage, insufficient resources to manage and conserve water, and the dilapidated water infrastructure within the nation. While attempts have been made to try and address these concerns, they’ve been largely manual and expensive hence lacking the potential for scalability. Globally, water resources continue to decline rapidly due to the impact of climate change and water overuse, therefore action must be taken to conserve this resource. This study investigates the development of a smart water management system using water flow sensors connected directly to the water appliances that integrate with the existing water system, Node MCU microcontrollers and a cloud-based application. The solution focuses on monitoring household water usage frequency to inform users of their consumption and alert them via mobile notifications of potential water leaks to reduce wastage. Management and control of household water consumption is a positive contribution towards water conservation efforts.

Microsporidia MB is a promising candidate for developing a symbiont-based strategy for malaria control because it disrupts the capacity of An. arabiensis to transmit the Plasmodium parasite. The symbiont is predominantly localized in the reproductive organs and is transmitted vertically from mother to offspring and horizontally (sexually) during mating. Due to the contribution of both transmission routes, Microsporidia MB has the potential to spread through target vector populations and become established at high prevalence. Stable and efficient vertical transmission of Microsporidia MB is important for its sustainable use for malaria control, however, the vertical transmission efficiency of Microsporidia MB can vary. In this study, we investigate the mechanistic basis of Microsporidia MB vertical transmission in An. arabiensis. We show that vertical transmission occurs through the acquisition of Microsporidia MB by Anopheles cystocyte progenitors following the division of germline stem cells. We also show that Microsporidia MB replicates to increase infection intensity in the oocyte of developing eggs when mosquitoes take a blood meal suggesting that symbiont proliferation in the ovary is coordinated with egg development. The rate of Microsporidia MB transmission to developing eggs is on average higher than the recorded (mother to adult offspring) vertical transmission rate. This likely indicates that a significant proportion of An. arabiensis offspring lose their Microsporidia MB symbionts during development. The stability of germline stem cell infections, coordination of symbiont proliferation, and very high rate of transmission from germline stem cells to developing eggs indicate that Microsporidia MB has a highly specialized vertical transmission strategy in An. arabiensis, which may explain host specificity., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Onchuru et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Koinobiont endoparasitoids regulate the physiology of their hosts through altering host immuno-metabolic responses, processes which function in tandem to shape the composition of the microbiota of these hosts. Here, we employed 16S rRNA and ITS amplicon sequencing to investigate whether parasitization by the parasitoid wasps, Diachasmimorpha longicaudata (Ashmaed) (Hymenoptera: Braconidae) and Psyttalia cosyrae (Wilkinson) (Hymenoptera: Braconidae), induces gut dysbiosis and differentially alter the gut microbial (bacteria and fungi) communities of an important horticultural pest, Bactrocera dorsalis (Hendel) (Diptera: Tephritidae). We further investigated the composition of bacterial communities of adult D. longicaudata and P. cosyrae to ascertain whether the adult parasitoids and parasitized host larvae share microbial taxa through transmission. We demonstrated that parasitism by D. longicaudata induced significant gut perturbations, resulting in the colonization and increased relative abundance of pathogenic gut bacteria. Some pathogenic bacteria like Stenotrophomonas and Morganella were detected in both the guts of D. longicaudata-parasitized B. dorsalis larvae and adult D. longicaudata wasps, suggesting a horizontal transfer of microbes from the parasitoid to the host. The bacterial community of P. cosyrae adult wasps was dominated by Arsenophonus nasoniae, whereas that of D. longicaudata adults was dominated by Paucibater spp. and Pseudomonas spp. Parasitization by either parasitoid wasp was associated with an overall reduction in fungal diversity and evenness. These findings indicate that unlike P. cosyrae which is avirulent to B. dorsalis, parasitization by D. longicaudata induces shifts in the gut bacteriome of B. dorsalis larvae to a pathobiont-dominated community. This mechanism possibly enhances its virulence against the pest, further supporting its candidacy as an effective biocontrol agent of this frugivorous tephritid fruit fly pest., (© 2024. The Author(s).)

Background: Microsporidia MB, an endosymbiont naturally found in Anopheles mosquitoes inhibits transmission of Plasmodium and is a promising candidate for a transmission-blocking strategy that may involve mosquito release. A rapid assessment was carried out to develop insight into sociodemographic factors, public health concerns, and malaria awareness, management, and prevention practices with the willingness to accept and participate in Microsporidia MB-based transmission-blocking strategy to develop an informed stakeholder engagement process., Methods: The assessment consisted of a survey conducted in two communities in western Kenya that involved administering a questionnaire consisting of structured, semi-structured, and open questions to 8108 household heads., Results: There was an overall high level of willingness to accept (81%) and participate in the implementation of the strategy (96%). Although the willingness to accept was similar in both communities, Ombeyi community was more willing to participate (OR 22, 95% CI 13-36). Women were less willing to accept (OR 0.8, 95% CI 0.7-0.9) compared to men due to fear of increased mosquito bites near homes. Household heads with incomplete primary education were more willing to accept (OR 1.6, 95% CI 01.2-2.2) compared to those educated to primary level or higher. Perceiving malaria as a moderate or low public health issue was also associated with a lower willingness to accept and participate. Experience of > 3 malaria cases in the family over the last six months and knowledge that malaria is transmitted by only mosquito bites, increased the willingness to accept but reduced the willingness to participate. Awareness of malaria control methods based on mosquitoes that cannot transmit malaria increases the willingness to participate., Conclusion: The study showed a high level of willingness to accept and participate in a Microsporidia MB-based strategy in the community, which is influenced by several factors such as community, disease risk perception, gender, education level, knowledge, and experience of malaria. Further research will need to focus on understanding the concerns of women, educated, and employed community members, and factors that contribute to the lower disease risk perception. This improved understanding will lead to the development of an effective communication strategy., (© 2024. The Author(s).)

Importance: Microsporidia MB is a symbiont with a strong malaria transmission-blocking phenotype in Anopheles arabiensis . It spreads in mosquito populations through mother-to-offspring and sexual transmission. The ability of Microsporidia MB to block Plasmodium transmission, together with its ability to spread within Anopheles populations and its avirulence to the host, makes it a very attractive candidate for developing a key strategy to stop malaria transmissions. Here, we report tissue tropism and localization patterns of Microsporidia MB , which are relevant to its transmission. We find that Microsporidia MB accumulates in Anopheles arabiensis tissues, linked to its sexual and vertical transmission. Its prevalence and intensity in the tissues over the mosquito life cycle suggest adaptation to maximize transmission and avirulence in Anopheles arabiensis . These findings provide the foundation for understanding the factors that may affect Microsporidia MB transmission efficiency. This will contribute to the development of strategies to maximize Microsporidia MB transmission to establish and sustain a high prevalence of the symbiont in Anopheles mosquito populations for malaria transmission blocking., Competing Interests: The authors declare no conflict of interest.

Parasitoids are promising biocontrol agents of the devastating fruit fly, Bactrocera dorsalis . However, parasitoid performance is a function of several factors, including host-associated symbiotic bacteria. Providencia alcalifaciens , Citrobacter freundii , and Lactococcus lactis are among the symbiotic bacteria commonly associated with B. dorsalis , and they influence the eco-physiological functioning of this pest. However, whether these bacteria influence the interaction between this pest and its parasitoids is unknown. This study sought to elucidate the nature of the interaction of the parasitoids, Fopius arisanus , Diachasmimorpha longicaudata , and Psyttlia cosyrae with B. dorsalis as mediated by symbiotic bacteria. Three types of fly lines were used: axenic, symbiotic, and bacteria-mono-associated ( Lactococcus lactis , Providencia alcalifaciens , and Citrobacter freundii ). The suitable stages of each fly line were exposed to the respective parasitoid species and reared until the emergence of adult flies/parasitoids. Thereafter, data on the emergence and parasitoid fitness traits were recorded. No wasps emerged from the fly lines exposed to P. cosyrae . The highest emergence of F . arisanus and D. longicaudata was recorded in the L. lactis fly lines. The parasitoid progeny from the L. lactis and P. alcalifaciens fly lines had the longest developmental time and the largest body size. Conversely, parasitoid fecundity was significantly lower in the L. lactis lines, whereas the P. alcalifaciens lines significantly improved fecundity. These results elucidate some effects of bacterial symbionts on host-parasitoid interactions and their potential in enhancing parasitoid-oriented management strategies against B. dorsalis .

Background: Symbiotic interactions between insects and bacteria have been associated with a vast variety of physiological, ecological and evolutionary consequences for the host. A wide range of bacterial communities have been found in association with the oriental fruit fly, Bactrocera dorsalis (Hendel) (Diptera: Tephritidae), an important pest of cultivated fruit in most regions of the world. We evaluated the diversity of gut bacteria in B. dorsalis specimens from several populations in Kenya and investigated the roles of individual bacterial isolates in the development of axenic (germ-free) B. dorsalis fly lines and their responses to the entomopathogenic fungus, Metarhizium anisopliae., Results: We sequenced 16S rRNA to evaluate microbiomes and coupled this with bacterial culturing. Bacterial isolates were mono-associated with axenic B. dorsalis embryos. The shortest embryonic development period was recorded in flies with an intact gut microbiome while the longest period was recorded in axenic fly lines. Similarly, larval development was shortest in flies with an intact gut microbiome, in addition to flies inoculated with Providencia alcalifaciens. Adult B. dorsalis flies emerging from embryos that had been mono-associated with a strain of Lactococcus lactis had decreased survival when challenged with a standard dosage of M. anisopliae ICIPE69 conidia. However, there were no differences in survival between the germ-free lines and flies with an intact microbiome., Conclusions: These findings will contribute to the selection of probiotics used in artificial diets for B. dorsalis rearing and the development of improved integrated pest management strategies based on entomopathogenic fungi.

Background: The invasive fall armyworm, Spodoptera frugiperda (J.E. Smith) is a polyphagous pest that causes widespread damage particularly to maize and sorghum in Africa. The microbiome associated with S. frugiperda could play a role in the insects' success and adaptability. However, bacterial communities in S. frugiperda remain poorly studied., Methods: We investigated the composition, abundance and diversity of microbiomes associated with larval and adult specimens of S. frugiperda collected from four maize growing regions in Kenya through high throughput sequencing of the bacterial 16S rRNA gene. The population structure of S. frugiperda in Kenya was assessed through amplification of the mitochondrial cytochrome oxidase subunit I gene., Results: We identified Proteobacteria and Firmicutes as the most dominant bacterial phyla and lesser proportions of Bacteroidetes and Actinobacteria. We also observed differences in bacterial microbiome diversity between larvae and adults that are a likely indication that some prominent larval bacterial groups are lost during metamorphosis. However, several bacterial groups were found in both adults and larvae suggesting that they are transmitted across developmental stages. Reads corresponding to several known entomopathogenic bacterial clades as well as the fungal entomopathogen, Metarhizium rileyi , were observed. Mitochondrial DNA haplotyping of the S. frugiperda population in Kenya indicated the presence of both "Rice" and "Corn" strains, with a higher prevalence of the "Rice" strain., Competing Interests: The authors declare that they have no competing interests., (© 2020 Gichuhi et al.)

Bactrocera dorsalis (Hendel) is an important pest of fruit-bearing plants in many countries worldwide. In Africa, this pest has spread rapidly and has become widely established since the first invasion report in 2003. Wolbachia is a vertically transmitted endosymbiont that can significantly influence aspects of the biology and, in particular, the reproduction of its host. In this study, we screened B. dorsalis specimens collected from several locations in Africa between 2005 and 2017 for Wolbachia using a PCR-based assay to target the Wolbachia surface protein wsp . Of the 357 individuals tested, 10 were positive for Wolbachia using the wsp assay. We identified four strains of Wolbachia infecting two B. dorsalis mitochondrial haplotypes. We found no strict association between the infecting strain and host haplotype, with one strain being present in two different host haplotypes. All the detected strains belonged to Super Group B Wolbachia and did not match any strains reported previously in B. dorsalis in Asia. These findings indicate that diverse Wolbachia infections are present in invasive populations of B. dorsalis .

Objective: To determine the effect of two levels of counselling on the provision of Intrauterine Contraceptive Device (IUCD) at six weeks post-partum of the post-placental intrauterine device., Setting: Embu Provincial General Hospital, Kenya., Subjects: One hundred and thirty seven pregnant women at the gestation of 36 weeks to term, who attended Antenatal clinic and were followed until delivery and at six weeks post-partum., Design: A randomised "open-label" clinical trial., Results: One hundred and twenty seven study participants were enrolled and randomised to intensive (64 women) or routine FP counselling (63 women). Seventy eight per cent of women in the intensive FP counselled group and 66% in the routine FP counselled group accepted to have the post-placental IUCD inserted. There was no significant difference in uptake in the two-randomisation arms (p-value 0.232). Complications included expulsion (3.7%), allergic reaction (1.8%), pelvic infection (1.8%) and abdominal pain (1.8%).The post-placental IUCD is a favourable method with continuation rates (91%), client (88%) and reported partner (77%) satisfaction were notably high at six weeks. The most critical barrier to uptake was lack of trained medical personnel to insert the post-placental IUCD, which occurred in (60%) clients who had consented., Conclusion: The post-placental IUCD is an acceptable method among women irrespective of level of counselling. Intensive counselling did not significantly increase acceptance and uptake rates of post-placental IUCD insertion in comparison to routine counselling.

Tuberculosis (TB) is caused by mycobacterium tuberculosis. It remains a public health concern especially in developing country. Pulmonary infection is the main presentation. However, genitourinary TB is common especially with the increase in Human Immunodeficiency virus (HIV) infection. Genitourinary TB is one of the most common causes of extrapulmonary tuberculosis which affects 12% patients with pulmonary tuberculosis. It is common in women less than 40 years of age and rarely occurs in post-menopausal. Therefore it is more likely to affect women in reproductive years leading to infertility. Fallopian tube involvement in genital TB is at least 95-100% of cases and is mainly from haematological spread and this leads to infertility. This is a case of a woman who presented a diagnosis of primary infertility and tuberculous endometritis with endometrial calcification.

Objectives: To establish the prevalence of cervical cytology abnormalities, determine the correlation between CD4+ cell count and abnormal Pap smear, determine the correlation between WHO-HIV staging and abnormal pap smear among HIV infected women attending HIV clinic at Rwanda Military Hospital., Design: Cross-sectional descriptive study., Setting: Rwanda Military Hospital Kigali, Rwanda., Subjects: All HIV-positive women, 18-69 years who had been or were sexually active and were attending the HIV-clinic and consented to participate in the study., Results: Two hundred and ninety three women infected with HIV had cervical smear taken for cytology. Of the 293 women who were recruited for the study, cervical Squamous Intra epithelial Lesion (SIL) were present in 58 (20%). Of those with cervical SIL, 33 (56.89%) women had low-grade SIL, 15 (25.86%) had Atypical Squamous Cells of Undetermined Significance (ASCUS), six (10.34%) had high-grade SIL, three (5.17%) had Squamous cell carcinoma (SCC) and one (1.72%) had Atypical Glandular Cells of Undetermined Significance (AGUS). In the current study, use of ARV drugs was not associated with a reduction in the risk of cervical SIL., Conclusion: A high prevalence of cervical SIL was found among HIV-infected women at Rwanda Military Hospital. Increased immune suppression was significantly associated with cervical SIL.

Objective: The role of Biophysical Profile Score and resistive index of the umbilical artery for monitoring pre-eclampsia patients., Design: Descriptive prospective study., Setting: Kenyatta National Hospital and Mater Hospital, Nairobi, Kenya., Subjects: One hundred and ten cases during a three month period., Results: Normal biophysical profile scores were found in 93 (84.5%), and 17 (17.5%) cases had abnormal scores ranging from mild to severe foetal distress. Resistive index of umbilical artery (RI-UA) were normal in 72 (66.1%) and high resistive index accounted for 33.9%. Intra-Uterine Growth Restriction (IUGR) was a prominent finding accounting for 30.5%. A positive relationship was shown to exist between IUGR and RI-UA and also with severity of hypertension with P-values < 0.05. Resistive index of umbilical artery was positively related to the duration of illness confirming its dependence on chronicity (P = 0.004). Resistive index of umbilical artery proved to be an earlier indicator of foetal compromise before any foetal distress becomes obvious., Conclusion: Regular obstetrical ultra sound foetal surveillance in pre-eclampsia patients is important for foetal wellbeing. Doppler evaluation of high risk patients is more sensitive test than the biophysical profile score.

Objective: To determine the incidence of post-caesarean wound infection., Design: Prospective descriptive study., Setting: Maternity unit of Kiambu District Hospital in Central Province of Kenya., Subjects: All women undergoing caesarean delivery during the study period., Main Outcome Measures: Overall incidence of post-caesarean wound infection, relationship between incidence and socio-demographic characteristics, pre-operative labour events, intrapartum events as well as HIV status., Results: The caesarean delivery rate was 7.8%. The overall post-caesarean wound infection rate was 19%. The incidence was 32% among single women as compared to 16% among married women, but this difference is not statistically significant. Among the 35% of women who laboured for more than 12 hours, the incidence of wound infection was 33% compared to 15% among those who laboured for 12 hours or less (p < 0.01). Rupture of membranes (ROM) for more than 12 hours was associated with high incidence of wound infection than among women in whom ROM was 12 hours or less (38% and 14% respectively, p < 0.001). Also duration of operation exceeding 60 minutes was associated with much higher incidence of wound infection (71%) compared to when the operation lasted 60 minutes or less (16%, p < 0.001). The incidence of post-caesarean wound infection does not appear to be significantly affected by HIV status or whether caesarean delivery was emergency or elective., Conclusion: The overall post-caesarean wound infection rate is quite high. Prolonged pre-operative duration of labour, prolonged ROM and long duration of operation are associated with significantly higher incidence of wound infection. This should be seen against a background of a relatively low caesarean delivery rate and high incidence of prolonged labour. Strict labour management policies need to be inculcated in labour wards in District Hospitals in order to ensure timely caesarean delivery interventions, and hence, reduce post-caesarean wound infection rates.