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Joe D Piper, Salim Mwarumba, Moses Ngari, Benedict Mvera, Susan Morpeth, James A Berkley
For children with acute malnutrition, ready-to-use therapeutic foods (RUTF) are lifesaving treatments. In 2012, detailed testing detected Enterobacteriaceae including Cronobacter species at low levels in RUTF from all UNICEF-approved producers. Cronobacter in milk feeds has previously been associated with severe neonatal infections. Thus, given the susceptibility of severely malnourished children to invasive bacterial infections, concerns arose about the potential for Cronobacter infections from RUTF. This led to widespread production and supply problems in emergency feeding programmes...
March 13, 2018: Paediatrics and International Child Health
Nyaguara O Amek, Annemieke Van Eijk, Kim A Lindblade, Mary Hamel, Nabie Bayoh, John Gimnig, Kayla F Laserson, Laurence Slutsker, Thomas Smith, Penelope Vounatsou
BACKGROUND: Malaria transmission reduction is a goal of many malaria control programmes. Little is known of how much mortality can be reduced by specific reductions in transmission. Verbal autopsy (VA) is widely used for estimating malaria specific mortality rates, but does not reliably distinguish malaria from other febrile illnesses. Overall malaria attributable mortality includes both direct and indirect deaths. It is unclear what proportion of the deaths averted by reducing malaria transmission are classified as malaria in VA...
January 18, 2018: Malaria Journal
Lucas Malla, Rafael Perera-Salazar, Emily McFadden, Mike English
INTRODUCTION: WHO treatment guidelines are widely recommended for guiding treatment for millions of children with pneumonia every year across multiple low-income and middle-income countries. Guidelines are based on synthesis of available evidence that provides moderate certainty in evidence of effects for forms of pneumonia that can result in hospitalisation. However, trials have included fewer children from Africa than other settings, and it is suggested that African children with pneumonia have higher mortality...
September 18, 2017: BMJ Open
Bernadette Kombo, Salla Sariola, Evanson Gichuru, Sassy Molyneux, Eduard J Sanders, Elise van der Elst
Kenya is a generally homophobic country where homosexuality is criminalised and people who engage in same sex sexuality face stigma and discrimination. In 2013, we developed a 16 min documentary entitled "Facing Our Fears" that aimed at sharing information on how and why men who have sex with men (MSM) are involved in on-going KEMRI HIV prevention research, and associated community engagement. To consider the film's usefulness as a communication tool, and its perceived security risks in case the film was publicly released, we conducted nine facilitated viewings with 122 individuals representing seven different stakeholder groups...
2017: Cogent Medicine
Sydney Rosen, Matthew P Fox, Bruce A Larson, Alana T Brennan, Mhairi Maskew, Isaac Tsikhutsu, Margaret Bii, Peter D Ehrenkranz, Wd Francois Venter
INTRODUCTION: African countries are rapidly adopting guidelines to offer antiretroviral therapy (ART) to all HIV-infected individuals, regardless of CD4 count. For this policy of 'treat all' to succeed, millions of new patients must be initiated on ART as efficiently as possible. Studies have documented high losses of treatment-eligible patients from care before they receive their first dose of antiretrovirals (ARVs), due in part to a cumbersome, resource-intensive process for treatment initiation, requiring multiple clinic visits over a several-week period...
May 28, 2017: BMJ Open
Collins Okoyo, Birgit Nikolay, Jimmy Kihara, Elses Simiyu, Joshua V Garn, Mathew C Freeman, Mariam T Mwanje, Dunstan A Mukoko, Simon J Brooker, Rachel L Pullan, Sammy M Njenga, Charles S Mwandawiro
BACKGROUND: In 2012, the Kenyan Ministries of Health and of Education began a programme to deworm all school-age children living in areas at high risk of soil-transmitted helminths (STH) and schistosome infections. The impact of this school-based mass drug administration (MDA) programme in Kenya is monitored by the Kenya Medical Research Institute (KEMRI) as part of a five-year (2012-2017) study. This article focuses on the impact of MDA on STH infections and presents the overall achieved reductions from baseline to mid-term, as well as yearly patterns of reductions and subsequent re-infections per school community...
July 25, 2016: Parasites & Vectors
Lucas Otieno, Martina Oneko, Walter Otieno, Joseph Abuodha, Emmanuel Owino, Chris Odero, Yolanda Guerra Mendoza, Ben Andagalu, Norbert Awino, Karen Ivinson, Dirk Heerwegh, Nekoye Otsyula, Maria Oziemkowska, Effua Abigail Usuf, Allan Otieno, Kephas Otieno, Didier Leboulleux, Amanda Leach, Janet Oyieko, Laurence Slutsker, Marc Lievens, Jessica Cowden, Didier Lapierre, Simon Kariuki, Bernhards Ogutu, Johan Vekemans, Mary J Hamel
BACKGROUND: Malaria remains a major global public health concern, especially in sub-Saharan Africa. The RTS,S/AS01 malaria candidate vaccine was reviewed by the European Medicines Agency and received a positive scientific opinion; WHO subsequently recommended pilot implementation in sub-Saharan African countries. Because malaria and HIV overlap geographically, HIV-infected children should be considered for RTS,S/AS01 vaccination. We therefore aimed to assess the safety of RTS,S/AS01 in HIV-infected children at two sites in western Kenya...
October 2016: Lancet Infectious Diseases
Christina Riley, Stephanie Dellicour, Peter Ouma, Urbanus Kioko, Feiko O ter Kuile, Ahmeddin Omar, Simon Kariuki, Ann M Buff, Meghna Desai, Julie Gutman
BACKGROUND: Although prompt, effective treatment is a cornerstone of malaria control, information on provider adherence to malaria in pregnancy (MIP) treatment guidelines is limited. Incorrect or sub-optimal treatment can adversely affect the mother and fetus. This study assessed provider knowledge of and adherence to national case management guidelines for uncomplicated MIP. METHODS: We conducted a cross-sectional study from September to November 2013, in 51 health facilities (HF) and a randomly-selected sample of 39 drug outlets (DO) in the KEMRI/CDC Health and Demographic Surveillance System area in western Kenya...
2016: PloS One
Suellen Miller, José M Belizán
The death of a woman in pregnancy and childbirth is globally considered an individual tragedy and a human rights violation. Given the inequities in death that occur to marginalized, poor, and vulnerable women in low and middle income countries, there is no doubt that maternal death is a horrific injustice. However, the long term global burden of disease goes far beyond this tragedy. Recent research is demonstrating that there are disastrous consequences in infant and child mortality, loss of economic opportunities, spiraling cycles of poverty in the families and communities where women die giving birth...
June 17, 2015: Reproductive Health
Dorcas M Kamuya, Sally J Theobald, Vicki Marsh, Michael Parker, Wenzel P Geissler, Sassy C Molyneux
Consent processes have attracted significant research attention over the last decade, including in the global south. Although relevant studies suggest consent is a complex negotiated process involving multiple actors, most guidelines assume consent is a one-off encounter with a clear 'yes' or 'no' decision. In this paper we explore the concept of 'silent refusals', a situation where it is not clear whether potential participants want to join studies or those in studies want to withdraw from research, as they were not actively saying no...
2015: PloS One
Maquins Sewe, Joacim Rocklöv, John Williamson, Mary Hamel, Amek Nyaguara, Frank Odhiambo, Kayla Laserson
Malaria is among the leading causes of mortality in the younger under-five group of children zero to four years of age. This study aims at describing the relationship between rainfall and temperature on under-five malaria or anaemia mortality in Kenya Medical Research Institute and United States Centers for Disease Control (KEMRI/CDC) Health and Demographic Surveillance System (HDSS). This study was conducted through the ongoing KEMRI and CDC collaboration. A general additive model with a Poisson link function was fit to model the weekly association of lagged cumulative rainfall and average temperature on malaria/anemia mortality in KEMRI/CDC HDSS for the period 2003 to 2008...
February 2015: International Journal of Environmental Research and Public Health
Nyaguara Amek, Penelope Vounatsou, Benson Obonyo, Mary Hamel, Frank Odhiambo, Laurence Slutsker, Kayla Laserson
Continuous monitoring in health and demographic surveillance sites (HDSS) allows for collection of longitudinal demographic data, health related, and socio-economic indicators of the site population. We sought to use household survey data collected between 2002 and 2006 in the Kenya Medical Research Institute in collaboration with Centers for Disease Control and prevention (KEMRI/CDC) HDSS site in Asembo and Gem Western Kenya to estimate socio-economic status (SES) and assess changes of SES over time and space...
April 2015: Acta Tropica
Martin Bundi, Gabriel Miring'u, Shingo Inoue, Betty Muriithi, Salame Ashur, Ernest Wandera, Cyrus Kathiiko, Erick Odoyo, Chika Narita, Allan Kwalla, Amina Galata, Angela Makumi, Sora Huka, Mohammed Shah, Mohammed Karama, Masaaki Shimada, Cristine Bii, Samuel Kariuki, Masahiro Horio, Yoshio Ichinose
Pathogens handled in a Biosafety Level 3 (BSL-3) containment laboratory pose significant risks to laboratory staff and the environment. It is therefore necessary to develop competency and proficiency among laboratory workers and to promote appropriate behavior and practices that enhance safety through biosafety training. Following the installation of our BSL-3 laboratory at the Center for Microbiology Research-Kenya Medical Research Institute in 2006, a biosafety training program was developed to provide training on BSL-3 safety practices and procedures...
December 2014: Tropical Medicine and Health
Henry N Njuguna, Deborah L Caselton, Geoffrey O Arunga, Gideon O Emukule, Dennis K Kinyanjui, Rosalia M Kalani, Carl Kinkade, Phillip M Muthoka, Mark A Katz, Joshua A Mott
BACKGROUND: For disease surveillance, manual data collection using paper-based questionnaires can be time consuming and prone to errors. We introduced smartphone data collection to replace paper-based data collection for an influenza sentinel surveillance system in four hospitals in Kenya. We compared the quality, cost and timeliness of data collection between the smartphone data collection system and the paper-based system. METHODS: Since 2006, the Kenya Ministry of Health (MoH) with technical support from the Kenya Medical Research Institute/Centers for Disease Control and Prevention (KEMRI/CDC) conducted hospital-based sentinel surveillance for influenza in Kenya...
2014: BMC Medical Informatics and Decision Making
Moses M Ngari, Naomi Waithira, Roma Chilengi, Patricia Njuguna, Trudie Lang, Greg Fegan
BACKGROUND: Clinical trials data management (CTDM) remains one of the many challenges in running state of the art trials in resource-poor settings since most trials do not allocate, or have available, sufficient resources for CTDM and because of poor internet connectivity. Open-source software like OpenClinica could be a solution in such scenarios. FINDINGS: In 2007, the KEMRI-Wellcome Trust Research Programme (KWTRP) adopted OpenClinica (OC) community edition, an open-source software system and we share our experience and lessons learnt since its adoption...
November 26, 2014: BMC Research Notes
Jacklyn Wong, Mary J Hamel, Chris J Drakeley, Simon Kariuki, Ya Ping Shi, Altaf A Lal, Bernard L Nahlen, Peter B Bloland, Kim A Lindblade, Vincent Were, Kephas Otieno, Peter Otieno, Chris Odero, Laurence Slutsker, John M Vulule, John E Gimnig
BACKGROUND: Monitoring local malaria transmission intensity is essential for planning evidence-based control strategies and evaluating their impact over time. Anti-malarial antibodies provide information on cumulative exposure and have proven useful, in areas where transmission has dropped to low sustained levels, for retrospectively reconstructing the timing and magnitude of transmission reduction. It is unclear whether serological markers are also informative in high transmission settings, where interventions may reduce transmission, but to a level where considerable exposure continues...
2014: Malaria Journal
Pamela K Kohler, Kenneth Ondenge, Lisa A Mills, John Okanda, John Kinuthia, George Olilo, Frank Odhiambo, Kayla F Laserson, Brenda Zierler, Joachim Voss, Grace John-Stewart
While global scale-up of prevention of mother-to-child transmission of HIV (PMTCT) services has been expansive, only half of HIV-infected pregnant women receive antiretroviral regimens for PMTCT in sub-Saharan Africa. To evaluate social factors influencing uptake of PMTCT in rural Kenya, we conducted a community-based, cross-sectional survey of mothers residing in the KEMRI/CDC Health and Demographic Surveillance System (HDSS) area. Factors included referrals and acceptability, HIV-related stigma, observed discrimination, and knowledge of violence...
December 2014: AIDS Patient Care and STDs
Pamela K Kohler, John Okanda, John Kinuthia, Lisa A Mills, George Olilo, Frank Odhiambo, Kayla F Laserson, Brenda Zierler, Joachim Voss, Grace John-Stewart
INTRODUCTION: Facility-based assessments of prevention of mother-to-child HIV transmission (PMTCT) programs may overestimate population coverage. There are few community-based studies that evaluate PMTCT coverage and uptake. METHODS: During 2011, a cross-sectional community survey among women who gave birth in the prior year was performed using the KEMRI-CDC Health and Demographic Surveillance System in Western Kenya. A random sample (n = 405) and a sample of women known to be HIV-positive through previous home-based testing (n = 247) were enrolled...
2014: PloS One
Pauline Bakibinga, Remare Ettarh, Abdhalah K Ziraba, Catherine Kyobutungi, Eva Kamande, Nicholas Ngomi, Jane Osindo
INTRODUCTION: Rapid urbanisation in Kenya has resulted in growth of slums in urban centres, characterised by poverty, inadequate social services and poor health outcomes. The government's initiatives to improve access to quality healthcare for mothers and children are largely limited to public health facilities, which are few and/or inaccessible in underserved areas such as the slums. The 'Partnership for Maternal, Newborn and Child Health' (PAMANECH) project is being implemented in two Nairobi slums, Viwandani and Korogocho, to assess the impact of strengthening public-private partnerships for the delivery of healthcare on the health of mothers, newborns and young children in two informal settlements in Kenya...
2014: BMJ Open
Meghna Desai, Ann M Buff, Sammy Khagayi, Peter Byass, Nyaguara Amek, Annemieke van Eijk, Laurence Slutsker, John Vulule, Frank O Odhiambo, Penelope A Phillips-Howard, Kimberly A Lindblade, Kayla F Laserson, Mary J Hamel
Recent global malaria burden modeling efforts have produced significantly different estimates, particularly in adult malaria mortality. To measure malaria control progress, accurate malaria burden estimates across age groups are necessary. We determined age-specific malaria mortality rates in western Kenya to compare with recent global estimates. We collected data from 148,000 persons in a health and demographic surveillance system from 2003-2010. Standardized verbal autopsies were conducted for all deaths; probable cause of death was assigned using the InterVA-4 model...
2014: PloS One
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