Medicine and Health Sciences Commons^™

Epidemiology And Antimicrobial Resistance Of Staphylococci Other Than Staphylococcus Aureus From Domestic Animals And Livestock In Africa: A Systematic Review, Remous Ocloo, Justin Nyasinga, Mohammed Munshi, Aisha Hamdy, Tessa Marciniak, Manonmani Soundararajan, Mae Newton-Foot, Wilma Ziebuhr, Manonmani Soundararajan, Gunturu Revathi

Pathology, East Africa

Introduction: Staphylococci other than Staphylococcus aureus (SOSA) in animals are becoming more pathogenic and antibiotic resistant and can potentially disseminate to humans. However, there is little synthesized information regarding SOSA from animals in Africa. This systematic review provides a comprehensive overview of the epidemiology and antimicrobial resistance of SOSA in companion animals (pets) and livestock in Africa.

Method: This systematic review (PROSPERO-CRD42021252303) was conducted according to the PRISMA guidelines, and 75 eligible studies from 13 countries were identified until August 2022. Three electronic databases (Pubmed, Scopus and Web of Science) were employed.

Results: The frequently isolated SOSA …

High Prevalence Of Multidrug-Resistant Clostridioides Difficile Following Extensive Use Of Antimicrobials In Hospitalized Patients In Kenya, Winnie C. Mutai, Marianne W. Mureithi, Omu Anzala, Gunturu Revathi, Brian Kullin, Magdaline Burugu, Cecilia Kyany’A, Erick Odoyo, Peter Otieno, Lillian Musila

Pathology, East Africa

Introduction: Clostridioides difficile is a neglected pathogen in many African countries as it is generally not regarded as one of the major contributors toward the diarrheal disease burden in the continent. However, several studies have suggested that C. difficile infection (CDI) may be underreported in many African settings. The aim of this study was to determine the prevalence of CDI in hospitalized patients, evaluate antimicrobial exposure, and detect toxin and antimicrobial resistance profiles of the isolated C. difficile strains.

Methods: In this cross-sectional study, 333 hospitalized patients with hospital-onset diarrhoea were selected. The stool samples were collected and cultured on …

Vitamin D Status In Healthy Black African Adults At A Tertiary Hospital In Nairobi, Kenya: A Cross Sectional Study, Elizabeth Kagotho, Geoffrey Omuse, Nancy Okinda, Peter Ojwang

Pathology, East Africa

Background: Vitamin D has been known since the twentieth Century for its benefits in bone health. Recent observational studies have demonstrated its benefits in infectious diseases such as tuberculosis and non-communicable diseases such as diabetes mellitus, cardiovascular diseases and cancer. This has led to a dramatic increase in testing among adults. The cut-offs for vitamin D deficiency have been debated for decades and the current cut off is derived from a Caucasian population. Studies done among black African adults in Africa are few with vitamin D deficiency ranging from 5 to 91%. A few cut- offs have correlated vitamin D …

Metabolic Syndrome And Its Predictors In An Urban Population In Kenya: A Cross Sectional Study, Geoffrey Omuse, Daniel Maina, Mariza Hoffman, Jane Mwangi, Caroline Wambua, Elizabeth Kagotho, Angela Amayo, Peter Ojwang, Zul Premji, Kiyoshi Ichihara, Rajiv Erasmus

Pathology, East Africa

Background: The metabolic syndrome (MetS) is a clustering of interrelated risk factors which doubles the risk of cardio-vascular disease (CVD) in 5–10 years and increases the risk of type 2 diabetes 5 fold. The identification of modifiable CVD risk factors and predictors of MetS in an otherwise healthy population is necessary in order to identify individuals who may benefit from early interventions. We sought to determine the prevalence of MetS as defined by the harmonized criteria and its predictors in subjectively healthy black Africans from various urban centres in Kenya.

Method: We used data collected from healthy black Africans in …

Prevalence And Determinants Of Human Papillomavirus Infection And Cervical Lesions In Hiv-Positive Women In Kenya, H De Vuyst, N R. Mugo, M H. Chung, K P. Mckenzie, E Nyongesa-Malava, V Tenet, J W. Njoroge, S R. Sakr, C Jlm Meijer, P Jf Snijders, Farzana Rana, S Franceschi

Pathology, East Africa

Background: We assessed the association of human papillomavirus (HPV) infection and cervical intraepithelial neoplasia (CIN) with various characteristics, CD4 count and use of combination antiretroviral therapy (cART) among HIV-positive women.

Methods: Cross-sectional study of 498 HIV-positive women who underwent HPV PCR-based testing, cytology, and systematic cervical biopsy.

Results: In all, 68.7% of women were HPV-positive, 52.6% had high-risk (hr) HPV, and 40.2% multiple type infections. High-risk human papillomavirus-positivity did not vary significantly by age but it was negatively associated with education level. The most frequent types in 113 CIN2/3 were HPV16 (26.5%), HPV35 (19.5%), and HPV58 (12.4%). …

Efficacy And Safety Of Artemether-Lumefantrine (Coartem®) Tablets (Six-Dose Regimen) In African Infants And Children With Acute, Uncomplicated Falciparum Malaria, C. Falade, M. Makanga, Zul Premji, C.E. Ortmann, M. Stockmeyer, P. Ibarra De Palacios

Pathology, East Africa

Approximately one million children die from malaria each year. A recently approved artemisinin-based tablet, Coartem (co-artemether), comprising artemether 120 mg plus lumefantrine 20 mg, given in four doses, provides effective antimalarial treatment for children in many sub-Saharan countries. However, this regimen is considered insufficient for non-immune infants and in areas where multidrug-resistant Plasmodium falciparum predominates. This open-label study assessed the efficacy and safety of co-artemether administered to 310 African children weighing 5-25 kg, with acute, uncomplicated falciparum malaria. Six doses of co-artemether were given over 3 days, with follow-up at 7, 14 and 28 days. Treatment rapidly cleared parasitemia and …

Averting A Malaria Disaster In Africa - Where Does The Buck Stop?, C.J.M. Whitty, R. Allan, V. Wiseman, S. Ochola, M.V. Nakyanzi-Mugisha, B. Vonhm, M. Mwita, C. Miaka, A. Oloo, Zul Premji, C. Burgess, T.K. Mutabingwa

Pathology, East Africa

The serious threat posed by the spread of drug-resistant malaria in Africa has been widely acknowledged. Chloroquine resistance is now almost universal, and resistance to the successor drug, sulfadoxine-pyrimethamine (SP), is growing rapidly. Combination therapy has been suggested as being an available and potentially lasting solution to this impending crisis. However, the current cost of combination therapy, and especially that of artemisinin combination therapy (ACT), is potentially a serious drawback, even if a significant part of its cost is passed on to the end-user. If the question of cost is not successfully addressed this could lead to adverse results from …

Age, Temperature, And Parasitaemia Predict Chloroquine Treatment Failure And Anaemia In Children With Uncomplicated Plasmodium Falciparum Malaria, D.H. Hamer, W.B. Macleod, E. Addo-Yobo, C.P Duggan, B. Estrella, W.W. Fawzi, J.K. Konde-Lule, V. Mwanakasale, Zul Premji, F. Sempertegui, F.P. Ssengooba, K. Yeboah-Antwi, J.L. Simon

Pathology, East Africa

The prevalence of chloroquine-resistant Plasmodium falciparum malaria has been increasing in sub-Saharan Africa and parts of South America over the last 2 decades, and has been associated with increased anaemia-associated morbidity and higher mortality rates. Prospectively collected clinical and parasitological data from a multicentre study of 788 children aged 6-59 months with uncomplicated P. falciparum malaria were analysed in order to identify risk factors for chloroquine treatment failure and to assess its impact on anaemia after therapy. The proportion of chloroquine treatment failures (combined early and late treatment failures) was higher in the central-eastern African countries (Tanzania, 53%; Uganda, 80%; …

Effect Of Zinc On The Treatment Of Plasmodium Falciparum Malaria In Children: A Randomized Controlled Trial, F. Sempertegui, B. Estrella, F.R. Toapanta, D.S. Torres, D.E. Calahorrano, K. Yeboah-Antwi, E. Addo-Yobo, P. Arthur, S. Newton, Zul Premji, M. Hubert, C.S. Makwaya, F. Ssengooba, J. Konde-Lule, E. Mukisa, D.H. Hamer, W. Macleod, C. Duggan, W. Fawzi, J. Simon, V. Mwanakasale, M. Mulenga, T. Sukwa, J. Tshiula

Pathology, East Africa

Background: Zinc supplementation in young children has been associated with reductions in the incidence and severity of diarrheal diseases, acute respiratory infections, and malaria.

Objective: The objective was to evaluate the potential role of zinc as an adjunct in the treatment of acute, uncomplicated falciparum malaria; a multicenter, double-blind, randomized placebo-controlled clinical trial was undertaken.

Design: Children (n = 1087) aged 6 mo to 5 y were enrolled at sites in Ecuador, Ghana, Tanzania, Uganda, and Zambia. Children with fever and ≥ 2000 asexual forms of Plasmodium falciparum/μL in a thick blood smear received chloroquine and were randomly assigned to …