Journal Article > ResearchFull Text
East Afr Med J. 2017 March 31; Volume 6 (Issue 2); 383.; DOI:10.4102/ajlm.v6i2.383
Orikiriza P, Nyehangane D, Atwine D, Kisakye JJ, Kassaza K, et al.
East Afr Med J. 2017 March 31; Volume 6 (Issue 2); 383.; DOI:10.4102/ajlm.v6i2.383
BACKGROUND
To confirm presence of Mycobacterium tuberculosis complex, some tuberculosis culture laboratories still rely on para-nitrobenzoic acid (PNB), a traditional technique that requires sub-culturing of clinical isolates and two to three weeks to give results. Rapid identification tests have improved turnaround times for mycobacterial culture results. Considering the challenges of the PNB method, we assessed the performance of the SD Bioline TB Ag MPT64 assay by using PNB as gold standard to detect M. tuberculosis complex from acid-fast bacilli (AFB) positive cultures.
OBJECTIVES
The aim of this study was to determine the sensitivity, specificity and turnaround time of the SD MPT64 assay for identification of M. tuberculosis complex, in a setting with high prevalence of tuberculosis and HIV.
METHODS
A convenience sample of 690 patients, with tuberculosis symptoms, was enrolled at Epicentre Mbarara Research Centre between April 2010 and June 2011. The samples were decontaminated using NALC-NaOH and re-suspended sediments inoculated in Mycobacterium Growth Indicator Tubes (MGIT) media, then incubated at 37 °C for a maximum of eight weeks. A random sample of 50 known negative cultures and 50 non-tuberculous mycobacteria isolates were tested for specificity, while sensitivity was based on AFB positivity. The time required from positive culture to reporting of results was also assessed with PNB used as the gold standard.
RESULTS
Of the 138 cultures that were AFB-positive, the sensitivity of the SD MPT64 assay was 100.0% [95% CI: 97.3 - 100] and specificity was 100.0% (95% CI, 96.4 - 100). The median time from a specimen receipt to confirmation of strain was 10 days [IQR: 8-12] with SD MPT64 and 24 days [IQR: 22-26] with PNB.
CONCLUSION
The SD MPT64 assay is comparable to PNB for identification of M. tuberculosis complex and reduces the time to detection.
To confirm presence of Mycobacterium tuberculosis complex, some tuberculosis culture laboratories still rely on para-nitrobenzoic acid (PNB), a traditional technique that requires sub-culturing of clinical isolates and two to three weeks to give results. Rapid identification tests have improved turnaround times for mycobacterial culture results. Considering the challenges of the PNB method, we assessed the performance of the SD Bioline TB Ag MPT64 assay by using PNB as gold standard to detect M. tuberculosis complex from acid-fast bacilli (AFB) positive cultures.
OBJECTIVES
The aim of this study was to determine the sensitivity, specificity and turnaround time of the SD MPT64 assay for identification of M. tuberculosis complex, in a setting with high prevalence of tuberculosis and HIV.
METHODS
A convenience sample of 690 patients, with tuberculosis symptoms, was enrolled at Epicentre Mbarara Research Centre between April 2010 and June 2011. The samples were decontaminated using NALC-NaOH and re-suspended sediments inoculated in Mycobacterium Growth Indicator Tubes (MGIT) media, then incubated at 37 °C for a maximum of eight weeks. A random sample of 50 known negative cultures and 50 non-tuberculous mycobacteria isolates were tested for specificity, while sensitivity was based on AFB positivity. The time required from positive culture to reporting of results was also assessed with PNB used as the gold standard.
RESULTS
Of the 138 cultures that were AFB-positive, the sensitivity of the SD MPT64 assay was 100.0% [95% CI: 97.3 - 100] and specificity was 100.0% (95% CI, 96.4 - 100). The median time from a specimen receipt to confirmation of strain was 10 days [IQR: 8-12] with SD MPT64 and 24 days [IQR: 22-26] with PNB.
CONCLUSION
The SD MPT64 assay is comparable to PNB for identification of M. tuberculosis complex and reduces the time to detection.
Journal Article > ReviewFull Text
East Afr Med J. 2016 October 1; Volume 93 (Issue 10); S55-S57.
Gituma KS, Hussein S, Mwitari J, Kizito W, Edwards JK, et al.
East Afr Med J. 2016 October 1; Volume 93 (Issue 10); S55-S57.
Journal Article > ResearchFull Text
Trends of reported outpatient malaria cases to assess the Test, Treat and Track (T3) policy in Kenya
East Afr Med J. 2016 October 1
Mbuli CW, Waqo E, Owiti P, Tweya H, Kizito W, et al.
East Afr Med J. 2016 October 1
Journal Article > ResearchFull Text
East Afr Med J. 2016 October 1; Volume 93 (Issue 10); Supplement.
Karoki S, Kariuki L, Owiti P, Takarinda KC, Kizito W, et al.
East Afr Med J. 2016 October 1; Volume 93 (Issue 10); Supplement.
BACKGROUND
Malaria in pregnancy is a preventable disease which results in poor pregnancy outcomes. The use of intermittent preventive treatment in pregnancy (IPTp) and long-lasting insecticide treated nets (LLINs) have been shown to reduce maternal malaria episodes.
OBJECTIVES
To describe i) The proportion receiving first and second dose (IPTp1 and 2) in malaria endemic zones, ii) proportion receiving IPTp 1 and 2 stratified by coast and lake endemic zones iii) proportion receiving LLINs, stratified by coastal and lake endemic zones.
DESIGN
A retrospective descriptive study.
SETTING
Lake and Coast region malaria endemic zones.
SUBJECTS
Pregnant women.
RESULTS
IPTp2 dose during an ANC revisit fell by 29% between 2012 and 2015, with 76% receiving an IPTp2 in 2012 and only 47% receiving it in 2015. More pregnant women in Coastal endemic areas received IPTp2 compared to Lake, with 88% versus 73% in 2012, and 53% versus 44% in 2015, respectively.There was steady increase in bed net usage from 69% and 54% in 2012 to 96% and 95% in 2015 for lake and coast endemic zones respectively. The uptake of LLINs was 15% higher in the lake region compared to the coastal endemic region in 2012 and significantly declined over the five years to 6%, 7% and 1% in 2013, 2014 and 2015, respectively.
CONCLUSION
Our study found that there has been a significant decline from 2012 through 2015, in the number of pregnant women in Kenya receiving recommended malaria prophylaxis in the regions of highest malaria burden. However, the coverage of LLIN has consistently improved over the same period.
Malaria in pregnancy is a preventable disease which results in poor pregnancy outcomes. The use of intermittent preventive treatment in pregnancy (IPTp) and long-lasting insecticide treated nets (LLINs) have been shown to reduce maternal malaria episodes.
OBJECTIVES
To describe i) The proportion receiving first and second dose (IPTp1 and 2) in malaria endemic zones, ii) proportion receiving IPTp 1 and 2 stratified by coast and lake endemic zones iii) proportion receiving LLINs, stratified by coastal and lake endemic zones.
DESIGN
A retrospective descriptive study.
SETTING
Lake and Coast region malaria endemic zones.
SUBJECTS
Pregnant women.
RESULTS
IPTp2 dose during an ANC revisit fell by 29% between 2012 and 2015, with 76% receiving an IPTp2 in 2012 and only 47% receiving it in 2015. More pregnant women in Coastal endemic areas received IPTp2 compared to Lake, with 88% versus 73% in 2012, and 53% versus 44% in 2015, respectively.There was steady increase in bed net usage from 69% and 54% in 2012 to 96% and 95% in 2015 for lake and coast endemic zones respectively. The uptake of LLINs was 15% higher in the lake region compared to the coastal endemic region in 2012 and significantly declined over the five years to 6%, 7% and 1% in 2013, 2014 and 2015, respectively.
CONCLUSION
Our study found that there has been a significant decline from 2012 through 2015, in the number of pregnant women in Kenya receiving recommended malaria prophylaxis in the regions of highest malaria burden. However, the coverage of LLIN has consistently improved over the same period.
Journal Article > ResearchFull Text
East Afr Med J. 2016 October 1; Volume 93 (Issue 10); Supplement.
Nganga M, Matendechero S, Kariuki L, Omondi W, Makworo N, et al.
East Afr Med J. 2016 October 1; Volume 93 (Issue 10); Supplement.
BACKGROUND
Soil-transmitted helminthiases cause a substantial yet under-appreciated public health burden. School age children harbour the heaviest burden. Infected children experience growth stunting and diminished physical fitness as well as impaired memory and cognition. These adverse health consequences impair educational performance, and reduce school attendance. Determination of the burden is central to designing and implementing appropriate interventions.
OBJECTIVE
To determine the burden of soil-transmitted helminthiases among primary school children in Migori County, Kenya.
DESIGN
Descriptive cross-sectional study.
SETTING
Primary schools in Migori County.
SUBJECTS
Children aged between seven and fourteen years.
RESULTS
Overall, 17% of the children were diagnosed with soil-transmitted helminthiases. Ascaris lumbricoides infections were the most common (9%) followed by hookworm (7%) and Trichuris trichiura infections (3%). Hookworm prevalence was highest in the older children while A. lumbricoides infections were highest in younger children. Further, more boys than girls harboured hookworm infections (p<0.001). Hookworm-A. lumbricoides, hookworm-T. trichiura and A. lumbricoides-T. trichiura coinfections were observed in 2, 3 and 7% of the children respectively. Two children (1%) were infected with all three helminth infections. Majority of the infection were of light intensity. In 12 (39%) of the 31 sampled schools, the prevalence of helminthiasis was above 20%.
CONCLUSION
Soil transmitted helminthiases is still prevalent in the study area. Our findings also strongly suggest that deworming alone will not eliminate these infections. This may suggest a need to take a more comprehensive approach that incorporates, among other activities, improvement in sanitation and intensification of public health campaigns.
Soil-transmitted helminthiases cause a substantial yet under-appreciated public health burden. School age children harbour the heaviest burden. Infected children experience growth stunting and diminished physical fitness as well as impaired memory and cognition. These adverse health consequences impair educational performance, and reduce school attendance. Determination of the burden is central to designing and implementing appropriate interventions.
OBJECTIVE
To determine the burden of soil-transmitted helminthiases among primary school children in Migori County, Kenya.
DESIGN
Descriptive cross-sectional study.
SETTING
Primary schools in Migori County.
SUBJECTS
Children aged between seven and fourteen years.
RESULTS
Overall, 17% of the children were diagnosed with soil-transmitted helminthiases. Ascaris lumbricoides infections were the most common (9%) followed by hookworm (7%) and Trichuris trichiura infections (3%). Hookworm prevalence was highest in the older children while A. lumbricoides infections were highest in younger children. Further, more boys than girls harboured hookworm infections (p<0.001). Hookworm-A. lumbricoides, hookworm-T. trichiura and A. lumbricoides-T. trichiura coinfections were observed in 2, 3 and 7% of the children respectively. Two children (1%) were infected with all three helminth infections. Majority of the infection were of light intensity. In 12 (39%) of the 31 sampled schools, the prevalence of helminthiasis was above 20%.
CONCLUSION
Soil transmitted helminthiases is still prevalent in the study area. Our findings also strongly suggest that deworming alone will not eliminate these infections. This may suggest a need to take a more comprehensive approach that incorporates, among other activities, improvement in sanitation and intensification of public health campaigns.
Journal Article > ResearchFull Text
East Afr Med J. 2016 October 1
Owiti P, Kosgei RJ, Ogutu O, Kizito W, Edwards JK, et al.
East Afr Med J. 2016 October 1
Journal Article > ResearchFull Text
East Afr Med J. 2000 July 1; Volume 327 (Issue 7416); 650.; DOI:10.1136/bmj.327.7416.650
Legros D, McCormick M, Mugero C, Skinnider M, Bek'Obita DD, et al.
East Afr Med J. 2000 July 1; Volume 327 (Issue 7416); 650.; DOI:10.1136/bmj.327.7416.650
OBJECTIVE
To provide epidemiological description of the cholera outbreak which occurred in Kampala between December 1997 and March 1998. DESIGN: A four-month cross-sectional survey.
SETTING
Kampala city, Uganda.
MAIN OUTCOME MEASURES
Number of cases reported per day, attack rate per age group and per parish, case fatality ratio.
RESULTS
The cholera outbreak was due to Vibrio cholerae O1 El Tor, serotype Ogawa. Between December 1997 and March 1998, 6228 cases of cholera were reported, of which 1091 (17.5%) were children under five years of age. The overall attack rate was 0.62%, similar in the under-fives and five and above age groups. The case fatality ratio among hospitalised patients was 2.5%. The peak of the outbreak was observed three weeks after the report of the first case, and by the end of January 1998 (less than two months after the first case), 88.4% of the cases had already been reported. The occurrence of cases concentrated in the slums where the overcrowding and the environmental conditions resembled a refugee camp situation.
CONCLUSION
The explosive development of the cholera outbreak in Kampala, followed by a rapid decrease of the number of cases reported is unusual in a large urban setting. It appeared that each of the affected slums developed a distinct outbreak in a non immune population, which did not spread to contiguous areas. Therefore, we believe that, a decentralised strategy, that would focus the interventions on each heavily affected area, should be considered in these circumstances.
To provide epidemiological description of the cholera outbreak which occurred in Kampala between December 1997 and March 1998. DESIGN: A four-month cross-sectional survey.
SETTING
Kampala city, Uganda.
MAIN OUTCOME MEASURES
Number of cases reported per day, attack rate per age group and per parish, case fatality ratio.
RESULTS
The cholera outbreak was due to Vibrio cholerae O1 El Tor, serotype Ogawa. Between December 1997 and March 1998, 6228 cases of cholera were reported, of which 1091 (17.5%) were children under five years of age. The overall attack rate was 0.62%, similar in the under-fives and five and above age groups. The case fatality ratio among hospitalised patients was 2.5%. The peak of the outbreak was observed three weeks after the report of the first case, and by the end of January 1998 (less than two months after the first case), 88.4% of the cases had already been reported. The occurrence of cases concentrated in the slums where the overcrowding and the environmental conditions resembled a refugee camp situation.
CONCLUSION
The explosive development of the cholera outbreak in Kampala, followed by a rapid decrease of the number of cases reported is unusual in a large urban setting. It appeared that each of the affected slums developed a distinct outbreak in a non immune population, which did not spread to contiguous areas. Therefore, we believe that, a decentralised strategy, that would focus the interventions on each heavily affected area, should be considered in these circumstances.
Journal Article > ResearchFull Text
East Afr Med J. 2016 October 1
Machini B, Waqo E, Kizito W, Edwards JK, Owiti P, et al.
East Afr Med J. 2016 October 1
Journal Article > ResearchFull Text
East Afr Med J. 2002 February 1
Zachariah R, Harries AD, Nkhoma W, Arendt V, Spielmann M P, et al.
East Afr Med J. 2002 February 1
OBJECTIVES: To estimate HIV prevalence in various blood donor populations, to identity sociodemographic risk factors associated with prevalent HIV and to assess the feasibility of offering routine voluntary counselling services to blood donors. DESIGN: Cross-sectional study. SETTING: Thyolo district, Malawi. METHODS: Data analysis involving blood donors who underwent voluntary counselling and HIV testing between January 1998 and July 2000. RESULTS: Crude HIV prevalence was 22%, while the age standardised prevalence (>15 years) was 17%. Prevalence was lowest among rural donors, students and in males of the age group 15-19 years. There was a highly significant positive association of HIV prevalence with increasing urbanisation. Significant risk factors associated with prevalence for both male and female donors included having a business-related occupation, living in a semi-urban or urban area and being in the age group 25-29 years for females and 30-34 years for males. All blood donors were pre-test counselled and 90% were post test counselled in 2000. CONCLUSIONS: HIV prevalence in blood donors was alarmingly high, raising important concerns on the potential dangers of HIV transmission through blood transfusions. Limiting blood transfusions, use of a highly sensitive screening test, and pre-donation selection of donors is important. The experience also shows that it is feasible to offer pre and post test counselling services for blood donors as an entry point for early diagnosis of asymptomatic HIV infection and, broader preventive strategies including the potential of early access to drugs, for the prevention of opportunistic infections.
Journal Article > ResearchFull Text
East Afr Med J. 2016 January 1
Nganga M, Matendechero S, Kariuki L, Omondi W, Makworo N, et al.
East Afr Med J. 2016 January 1