Pathology Commons^™

Spatially Dissecting Drivers Of Inter- And Intra-Tumoral Heterogeneity In Kenyan Breast Cancer, Mustapha Abubakar, Shahin Sayed, Hela Koka, Scott Lawrence, Karun Mutreja, Xing Hua, Petra Lenz, Samuel Anyaso-Samuel, Rosemary Kamau, Beryl Ooro

Pathology, East Africa

Despite growing evidence on the impact of intra-tumoral heterogeneity (ITH) in breast cancer (BC), its biological drivers and clinically relevant mitigation strategies remain poorly characterized, particularly in low-resource settings where spatial profiling is rarely applied. To address this gap, we conducted a comprehensive, multiplatform spatial profiling study of BC in a Kenyan population. Using the NanoString GeoMx™ Digital Spatial Profiler, we quantified 44 protein markers across 707 spatially defined, PanCK-segmented Areas of Illumination (AOIs) from 31 tumors. All tumors exhibited measurable ITH, with one-third showing marked heterogeneity. Sixteen patients exhibited two or more intrinsic subtypes within their tumors, three of …

Low-Abundance And Fragmentary Helicobacter Pylori Dna Detected In Phenotypically Negative Gastric Biopsies Using Targeted Sequencing, Fabien Mbaya-Tshibangu, Alain Cimuanga-Mukanya, Evariste Tshibangu-Kabamba, Nadine Kayiba-Kalenda, Tressy Kalenga-Ngomba, Patrick Ngoma-Kisoko, Gunturu Revathi, Junko Akada, Benoît Mbiya-Mukinayi, Augustin Tshibaka Kabongo

Pathology, East Africa

Accurate detection and monitoring of antimicrobial resistance (AMR) in Helicobacter pylori mainly rely on phenotypic methods and culture, which can sometimes fail when bacterial load is low or after recent treatment. We investigated whether gastric biopsies classified as H. pylori-negative by standard diagnostic techniques still contain detectable bacterial DNA, including regions linked to AMR, and assessed whether selected DNA fragments can mediate allelic exchange in vitro. Gastric biopsies from 46 dyspeptic patients in the Democratic Republic of the Congo (including 23 phenotypically positive and 23 phenotypically negative individuals) were analyzed using long-read amplicon sequencing of seven resistance-associated loci, selective whole-genome …

Fetal Vascular Malperfusion And Other Placental Lesions In Relation To Maternal Sars-Cov-2 Exposure: A Case–Control Study, Irene Mwandoto, Marleen Temmerman, Ingrid Gichere, Patricia Okiro

Pathology, East Africa

Background:

The morphologic characteristics of placentas associated with coronavirus disease-19 (COVID-19) have been described but with varying findings. Studies conducted at the onset of the pandemic reported frequency of Fetal Vascular Malperfusion (FVM), an umbrella term that describes occlusive vasculopathies that affect fetal circulation and their associated sequelae. Morphologic manifestations include thrombosis, avascular villi and vascular stromal karyorrhexis. Associated outcomes include fetal growth restriction, thromboembolic events such as neonatal stroke and fetal demise. Placental lesions associated with a severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2) infection present a unique picture in histology, especially in the attempt to decipher the …

Pseudo-Bartter Syndrome In A Pancreatic Insufficient Infant With Cftr, Dnah9, Lyst And G6pd Variants, Diana Marangu‐Boore, Doris Kinuthia, Janet Maranga, Peter Ngwatu, Joel Lessan, Rita Boateng

Pathology, East Africa

No abstract provided.

World Health Organization Classification Of Tumours Of The Breast 6th Edition 2026, Cecily Quinn, Puay Tan, Kimberly Allison, Edi Brogi, Sunil Lakhani, Stuart Schnitt, Stephen Fox, Shabnam Jaffer, Aysegul Sahin, Shahin Sayed

Pathology, East Africa

The 6th edition of the WHO Classification of Breast Tumours introduces both major and minor changes based on recent advances in our understanding of breast biology, developments in diagnostic modalities, identification of specific molecular targets and new treatment regimens necessitating modifications to pathology reporting and tumour biomarker categorisation. This review summarises the main changes that strive towards a classification of global relevance. In invasive carcinoma, predictive factors increasingly inform modern breast cancer treatment. The 6th edition provides an update on HER2 reporting categories following the DESTINY-Breast 04 and 06 trials. Terminologies used to classify invasive tumours are clarified, with the …

Comparison Of Agar-Based Methodologies To Broth Disc Elution For The Detection Of Aztreonam Susceptibility In The Presence Of Ceftazidime-Avibactam, Teslin Sandstrom, Andra Banete, Alice Kanyua, Kevin Davis, Susan Poutanen

Pathology, East Africa

The combination of aztreonam and ceftazidime-avibactam is a proven treatment option for infections caused by metallo-beta-lactamase (MBL)-expressing gram-negative organisms. Restoration of aztreonam susceptibility in the presence of ceftazidime-avibactam can be determined using the Clinical and Laboratory Standards Institute (CLSI)’s broth disc elution (BDE) method; however, the high manual workload and significant material footprint of this assay make it difficult to implement in a high-throughput clinical microbiology lab. This study evaluates two agar-based methods for the detection of susceptibility to the combination of aztreonam and ceftazidime-avibactam, using BDE as the comparator methodology. Resistant Enterobacterales, Pseudomonas aeruginosa, Stenotrophomonas maltophilia, and Acinetobacter spp. …

Ten-Year Pathology-Based Cancer Registry At A Tertiary Referral Hospital In Kenya (2015–2024): Distribution Of Cancers And Completeness Of Pathology Reporting, Brian Ayara, Samuel Mukono, Rodney Adam, Shahin Sayed

Pathology, East Africa

Background Population-based cancer registries remain limited in low- and middle-income countries (LMICs). In Kenya, their coverage is below the 20% threshold recommended by the International Agency for Research on Cancer. Pathology-based registries can provide complementary data in such contexts. This study describes the distribution of cancers diagnosed at a tertiary referral hospital in Nairobi over ten years, and evaluates the completeness of pathology reporting for selected cancers using College of American Pathologists (CAP) protocols.

Methods We conducted a retrospective review of all histologically confirmed cancers at the Aga Khan University Hospital, Nairobi, from 2015 to 2024. Data were extracted from …

Real-World Prevalence Of Pd-L1 Positivity In Early-Stage/Metastatic Triple-Negative Breast Cancer: Primary Results And Pathology Insights From The Global Retrospective Observational Vanessa Study, Corrado D'Arrigo, Sitki Tuzlali, Romualdo Barroso-Sousa, Nagi El Saghir, Rebecca Dent, Nataša Medić-Milijić, Gyungyub Gong, Shahin Sayed, Tu Anh, Alisan Zirtiloglu

Pathology, East Africa

Aim To understand whether the worldwide implementation of PD-L1 testing in triple-negative breast cancer (TNBC) can be achieved in routine clinical practice.

Methods and results The multicentre retrospective observational VANESSA study consecutively and uniformly enrolled patients treated with systemic therapy for early or metastatic (e/m)TNBC diagnosed between 2014 and 2017. PD-L1 status was retrospectively assessed locally and centrally using the VENTANA PD-L1 (SP142) Assay (PD-L1 expression on tumour-infiltrating immune cells covering ≥1% of the tumour area). The primary objective was to determine the prevalence of PD-L1 positivity assessed locally on primary and/or metastatic tumour tissue. Concordance between local and central …

Who Classification Of Skin Tumours: Key Updates In The Fifth Edition, Gabrielle Goldman-Lévy, Raymond Barnhill, Boris Bastian, Werner Kempf, David Elder, Pedram Gerami, Wayne Grayson, Dmitry Kazakov, Daniela Massi, Shahin Sayed

Pathology, East Africa

The 5th edition of the World Health Organization Classification of Tumours (WCT) serves as a foundation for global diagnostic standards in tumour pathology. Similar to other volumes in this series, the Skin Tumours (Skin5) edition follows a standardized approach. This edition introduces two new chapters: ‘Tumours of the nail unit’ and ‘Metastases to skin’, along with new entities across relevant chapters. This review article provides an overview of the updates in Skin5 based on currently published evidence, with emphasis on newly introduced chapters and newly described entities that involve the skin, in particular, epidermal, melanocytic and appendageal tumours.

Challenges And Opportunities With Providing Genetic Testing And Counseling For Mucopolysaccharidosis Type Ii In Kenya, Lucy Mungai, Charles Njeru, Allan Njoroge, Michuki Maina, Syokau Ilovi, Dalton Wamalwa, Ruth Nduati, Beatrice Odongkara, Danny Miller

Pathology, East Africa

Background Limited or absent genetic counseling and testing resources in low- and medium-income countries lead to missed or late diagnoses for treatable metabolic conditions with irreversible complications. In some communities, misunderstanding about the etiology of a genetic condition may lead women whose children are affected to be viewed as a bad omen and become stigmatized or ostracized from their community. Mucopolysaccharidosis type II (MPS II), or Hunter syndrome, is a lysosomal storage disorder in which deficiency or inactivity of the enzyme iduronate-2-sulfatase leads to accumulation of glycosaminoglycans throughout the body. The diagnosis can be made through clinical assessment, enzyme activity …

Single-Cell-Driven Design Of Logic-Gated Car Circuits For Enhanced Solid Tumor Immunotherapy, Sanna Madan, Tian-Gen Chang, Alexandra Harris, Huaitian Liu, Andrew Martinez, Saugato Dhruba, Binbin Wang, Padma Rajagopal, Sanju Sinha, Shahin Sayed

Pathology, East Africa

Background Chimeric antigen receptor (CAR) T-cell therapy has revolutionized cancer immunotherapy for hematological malignancies but faces critical barriers in solid tumors due to tumor antigen heterogeneity and on-target, off-tumor toxicities. Logic-gated multi-antigen targeting using Boolean operators (AND, OR, NOT) represents an emerging precision immunotherapy engineering approach to overcome these challenges.

Methods We developed LogiCAR designer, a genetic algorithm-based computational framework that systematically identifies optimal logic-gated antigen combinations (i.e., ‘circuits’) from single-cell transcriptomics data. The algorithm identifies CAR circuits consisting of 1-5 antigens from 2,758 cell surface proteins, optimizing tumor-targeting efficacy while maintaining stringent safety requirements in normal tissues. …

Liquid Biopsies Of Lung Cancer And Next Generation Sequencing At Sub-Saharan Africa Sites (Lungs@Africa), Nadia Ghazali, Catherine Brown, Trevor Pugh, Rayjean Hung, Kelechi Okonta, Mansoor Saleh, Shahin Sayed, Richard Khanyile, Zodwa Dlamini

Pathology, East Africa

Introduction: There is a lack of genomic and epidemiologic data regarding lung cancer in Sub-Saharan Africa. Liquid biopsy is a non-invasive and scalable approach for molecular profiling. This pilot study aims to determine the prevalence of actionable genetic alterations (AGAs) of non-small cell lung cancer (NSCLC) using liquid biopsy while establishing a liquid biopsy testing pipeline in Sub-Saharan Africa.

Methods: This is a prospective, cohort study at three sites: Aga Khan University Cancer Centre in Nairobi, Kenya; University of Port Harcourt Teaching Hospital in Port Harcourt, Nigeria; and Steve Biko Academic Hospital, University of Pretoria in Pretoria, South …

Fifth Edition Who Classification: Mature B-Cell Neoplasms, Kikkeri Naresh, Kennosuke Karube, Anita Borges, Wah Cheuk, Sumeet Gujral, Shahin Sayed, Aliyah Sohani, Stefano Lazzi, German Ott, Ming-Qing Du

Pathology, East Africa

We present a review of mature B-cell neoplasms as described in the fifth edition of the WHO classification of haematolymphoid tumours (WHO-HAEM5). Entities have expanded, and definitions are increasingly reliant on genomic and other technologies. However, the WHO-HAEM5 employs a hierarchical structure with family (class)-level definitions that group several specific entities. This approach enables the assignment of a family-level diagnosis when criteria for specific entities cannot be met due to resource constraints. To facilitate application in resource-limited settings, WHO-HAEM5 divides diagnostic criteria into ‘essential’ and desirable criteria for most entities. This review focuses on changes and updates in B-cell lymphoma …

Bridging The Capacity Building Gap For Antimicrobial Stewardship Implementation: Evidence From Virtual Communities Of Practice In Kenya, Ghana, And Malawi, Ana De Lima, Kwame Buabeng, Mavis Sakyi, Hope Chadwala, Nicole Devereaux, Collins Mitambo, Christine Mugo-Sitati, Jennifer Njuhigu, Gunturu Revathi, Emmanuel Tanui

Pathology, East Africa

Background/Objectives: Strengthening antimicrobial stewardship (AMS) programs is an invaluable intervention in the ongoing efforts to contain the threat of antimicrobial resistance (AMR), particularly in low-resource settings. This study evaluates the impact of the Telementoring, Education, and Advocacy Collaboration initiative for Health through Antimicrobial Stewardship (TEACH AMS), which uses the virtual Extension for Community Healthcare Outcomes (ECHO) learning model to enhance AMS capacity in Kenya, Ghana, and Malawi. Methods: A mixed-methods approach was used, which included attendance data collection, facility-level assessments, post-session and follow-up surveys, as well as focus group discussions. Results: Between September 2023 and February 2025, 77 virtual learning …

Comparison Between Acute Leukemia Screening Tube And Lineage-Specific Panels For The Diagnosis Of Acute Leukemia In Kenya, Nancy Okinda, Geoffrey Omuse, Elizabeth Kagotho, Douglas Munga

Pathology, East Africa

Purpose: Acute leukemia is a group of hematologic malignancies categorized according to the immature cells that proliferate and replace the normal bone marrow. Flow cytometry has emerged as a cornerstone in the diagnosis of hematologic malignancies. Staged analysis with a screening tube containing specific lineage markers determines the need for subsequent testing if there is an abnormal population (blasts). The specific lineage panels to be analyzed are determined depending on the positive markers in the screening tube. This study aimed to determine the agreement of diagnosis using the acute leukemia screening tube (ALST) and the lineage-specific panel.

Methods: This was …

Emergence Of Transferable Daptomycin Resistance In Gram-Positive Bacteria, Tessa Marciniak, Lukas Kirchner, Silver A. Wolf, Birgit Walther, Thorsten Bischler, Justin Nyasinga, R Gunturu, Torsten Semmler, Tom Gräfenhan, Andrew Whitelaw

Pathology, East Africa

Daptomycin (DAP) is a last-resort antibiotic to treat infections by multiresistant Gram-positive pathogens, including methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci. DAP resistance and clinical treatment failure has been associated with adaptive chromosomal mutations, but so far not with transmissible resistance traits. Here we report for the first time an acquired DAP-R determinant (named drc) that we detected in a livestock-associated Mammaliicoccus sciuri isolate. drc consists of a two-gene operon (drcAB) that is controlled by an adjacent two-component system (drcRS). The DrcAB proteins, which mediate DAP inactivation, are similar to BceAB-like antimicrobial peptide transporters of Gram-positives, but are distinct from …

Global Guideline For The Diagnosis And Management Of Candidiasis: An Initiative Of The Ecmm In Cooperation With Isham And Asm, Oliver A. Cornely, Rosanne Sprute, Matteo Bassetti, Sharon C-A Chen, Andreas H. Groll, Oliver Kurzai, Cornelia Lass Flörl, Luis Ostrosky Zeichner, Riina Rautemaa Richardson, Gunturu Revathi

Pathology, East Africa

Candida species are the predominant cause of fungal infections in patients treated in hospital, contributing substantially to morbidity and mortality. Candidaemia and other forms of invasive candidiasis primarily affect patients who are immunocompromised or critically ill. In contrast, mucocutaneous forms of candidiasis, such as oral thrush and vulvovaginal candidiasis, can occur in otherwise healthy individuals. Although mucocutaneous candidiasis is generally not life-threatening, it can cause considerable discomfort, recurrent infections, and complications, particularly in patients with underlying conditions such as diabetes or in those taking immunosuppressive therapies. The rise of difficult-to-treat Candida infections is driven by new host factors and antifungal …

Whole Exome-Seq And Rna-Seq Data Reveal Unique Neoantigen Profiles In Kenyan Breast Cancer Patients, Godfrey Wagutu, John Gitau, Kennedy Mwangi, Mary Murithi, Elias Melly, Alexandra R. Harris, Shahin Sayed, Stefan Ambs, Francis Makokha

Pathology, East Africa

Background: The immune response against tumors relies on distinguishing between self and non-self, the basis of cancer immunotherapy. Neoantigens from somatic mutations are central to many immunotherapeutic strategies and understanding their landscape in breast cancer is crucial for targeted interventions. We aimed to profile neoantigens in Kenyan breast cancer patients using genomic DNA and total RNA from paired tumor and adjacent non-cancerous tissue samples of 23 patients.

Methods: We sequenced the genome-wide exome (WES) and RNA, from which somatic mutations were identified and their expression quantified, respectively. Neoantigen prediction focused on human leukocyte antigens (HLA) crucial to cancer, HLA type …

Kinetics Of Naturally Induced Binding And Neutralising Anti-Sars-Cov-2 Antibody Levels And Potencies Among Sars-Cov-2 Infected Kenyans With Diverse Grades Of Covid-19 Severity: An Observational Study, John Kimotho, Yiakon Sein, Shahin Sayed, Reena Shah, Mansoor Saleh, Ann Karanu, Viviane Oluoch, Jasmit Shah, Julius Mutiso, Zaitun Nneka, Alfred Mburu, Peter Betti, Francis M. Ndungu

Pathology, East Africa

Background: Given the low levels of coronavirus disease 2019 (COVID-19) vaccine coverage in sub-Saharan Africa (sSA), despite high levels of natural severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) exposures, strategies for extending the breadth and longevity of naturally acquired immunity are warranted. Designing such strategies will require a good understanding of naturally acquired immunity.

Methods: We measured whole-spike immunoglobulin G (IgG) and spike-receptor binding domain (RBD) total immunoglobulins (Igs) on 585 plasma samples collected longitudinally over five successive time points within six months of COVID-19 diagnosis in 309 COVID-19 patients. We measured antibody-neutralising potency against the wild-type (Wuhan) SARS-CoV-2 …

Neurological Symptoms And Cause Of Death Among Young Children In Low- And Middle-Income Countries, Sara Ajanovic, Zachary Madewell, Shams El Arifeen, Emily Gurley, Mohammad Zahid Hossain, Kazi Munisul Islam, Afruna Rahman, Nega Assefa, Lola Madrid, R Gunturu

Pathology, East Africa

Importance: The emergence of acute neurological symptoms in children necessitates immediate intervention. Although low- and middle-income countries (LMICs) bear the highest burden of neurological diseases, there is a scarcity of diagnostic and therapeutic resources. Therefore, current understanding of the etiology of neurological emergencies in LMICs relies mainly on clinical diagnoses and verbal autopsies.

Objective: To characterize the association of premortem neurological symptoms and their management with postmortem-confirmed cause of death among children aged younger than 5 years in LMICs and to identify current gaps and improve strategies to enhance child survival.

Design, Setting, and Participants: This cross-sectional …

Displacement Of Hospital-Acquired, Methicillin-Resistant Staphylococcus Aureus Clones By Heterogeneous Community Strains In Kenya Over A 13-Year Period, Justin Nyasinga, Zubair Munshi, Collins Kigen, Andrew Nyerere, Lillian Musila, Andrew Whitelaw, Wilma Ziebuhr, Gunturu Revathi

Pathology, East Africa

We determined antibiotic susceptibility and employed Oxford Nanopore whole-genome sequencing to explore strain diversity, resistance, and virulence gene carriage among methicillin-resistant Staphylococcus aureus (MRSA) strains from different infection sites and timepoints in a tertiary Kenyan hospital. Ninety-six nonduplicate clinical isolates recovered between 2010 and 2023, identified and tested for antibiotic susceptibility on the VITEK ID/AST platform, were sequenced. Molecular typing, antibiotic resistance, and virulence determinant screening were performed using the relevant bioinformatics tools. The strains, alongside those from previous studies, were stratified into two periods covering 2010–2017 and 2018–2023 and comparisons were made. Mirroring phenotypic profiles, aac(6′)-aph(2″) [aminoglycosides]; gyrA (S84L) …

Development Of An Online Teaching Platform To Improve Access To Postgraduate Pathology Training In Sub-Saharan Africa, Richard Byers, Anita Byers, Chibamba Mumba, Angela Mutuku, Jennifer Singer-Rupp, Michael Wilson, Kenneth Fleming, Shahin Sayed

Pathology, East Africa

Background: Resource barriers to the provision of accessible training in cancer diagnosis in lower- and middle-income countries (LMICs) limit the potential of African health systems. Long-term provision via teaching visits from senior pathologists and trainee foreign placements is unsustainable due to the prohibitive costs of travel and subsistence. Emerging eLearning methods would allow pathologists to be trained by experts in a cheaper, more efficient, and more scalable way.

Purpose: This study aimed to develop an online teaching platform, starting with hematopathology, for trainee pathologists in sub-Saharan Africa, initially in Nairobi, Kenya, and Lusaka, Zambia.

Methods: Course materials …

Child Deaths Caused By Klebsiella Pneumoniae In Sub-Saharan Africa And South Asia: A Secondary Analysis Of Child Health And Mortality Prevention Surveillance (Champs) Data., Jennifer Verani, Dianna Blau, Emily Gurley, Victor Akelo, Nega Assefa, Vicky Baillie, Quique Bassat, Mussie Berhane, James Bunn, R Gunturu

Pathology, East Africa

Background; Klebsiella pneumoniae is an important cause of nosocomial and community-acquired pneumonia and sepsis in children, and antibiotic-resistant K pneumoniae is a growing public health threat. We aimed to characterize child mortality associated with this pathogen in seven high-mortality settings.

Methods; We analysed Child Health and Mortality Prevention Surveillance (CHAMPS) data on the causes of deaths in children younger than 5 years and stillbirths in sites located in seven countries across sub-Saharan Africa (Ethiopia, Kenya, Mali, Mozambique, Sierra Leone, and South Africa) and south Asia (Bangladesh) from Dec 9, 2016, to Dec 31, 2021. CHAMPS sites conduct active surveillance for …

Image-Based Multiplex Immune Profiling Of Cancer Tissues: Translational Implications. A Report Of The International Immuno-Oncology Biomarker Working Group On Breast Cancer., Shahin Sayed, Chowdhury Arif Jahangir, David Page, Glenn Broeckx, Claudia Gonzalez, Caoimbhe Burke, Clodagh Murphy, Jorge Reis-Filho, Amy Ly, Paul Harms

Pathology, East Africa

Recent advances in thefield of immuno-oncology have brought transformative changes in the management ofcancer patients. The immune profile of tumours has been found to have key value in predicting disease prognosis andtreatment response in various cancers. Multiplex immunohistochemistry and immunofluorescence have emerged aspotent tools for the simultaneous detection of multiple protein biomarkers in a single tissue section, therebyexpanding opportunities for molecular and immune profiling while preserving tissue samples. By establishing thephenotype of individual tumour cells when distributed within a mixed cell population, the identification of clinicallyrelevant biomarkers with high-throughput multiplex immunophenotyping of tumour samples has great potential toguide appropriate treatment …

Prevalence And Missed Cases Of Respiratory Distress Syndrome Disease Amongst Neonatal Deaths Enrolled In The Kenya Child Health And Mortality Prevention Surveillance Network (Champs) Program Between 2017 And 2021, Harun O. Owuor, Victor Akelo, Florence Murila, Dickens Onyango, Magdalene Kuria, Emily Rogena, Gunturu Revathi, Paul Mitei, Solomon Sava, Joyce Were

Pathology, East Africa

Objectives: To describe RDS in neonatal deaths at the CHAMPS-Kenya site between 2017 and 2021.

Methods: We included 165 neonatal deaths whose their Causes of death (COD) were determined by a panel of experts using data from post-mortem conducted through minimally invasive tissue specimen testing, clinical records, and verbal autopsy.

Results: Twenty-six percent (43/165) of neonatal deaths were attributable to RDS. Most cases occurred in low birthweight and preterm neonates. From these cases, less than half of the hospitalizations were diagnosed with RDS before death, and essential diagnostic tests were not performed in most cases. Most cases received suboptimal levels …

Microbiota Dynamics, Metabolic And Immune Interactions In The Cervicovaginal Environment And Their Role In Spontaneous Preterm Birth, Stanely Onyango, Jia Dai Mi, Anjela Koech, Patricia Okiro, Marleen Temmerman, Peter Von Dadelszen, Rachel Marie Tribe, Geoffrey Omuse

Pathology, East Africa

Differences in the cervicovaginal microbiota are associated with spontaneous preterm birth (sPTB), a significant cause of infant morbidity and mortality. Although establishing a direct causal link between cervicovaginal microbiota and sPTB remains challenging, recent advancements in sequencing technologies have facilitated the identification of microbial markers potentially linked to sPTB. Despite variations in findings, a recurring observation suggests that sPTB is associated with a more diverse and less stable vaginal microbiota across pregnancy trimesters. It is hypothesized that sPTB risk is likely to be modified via an intricate host-microbe interactions rather than due to the presence of a single microbial taxon …

Population-Specific Mutation Patterns In Breast Tumors From African American, European American, And Kenyan Patients, Wei Tang, Flora Zhang, Jung S. Byun, Shahin Sayed, Tiffany H. Dorsey, Harris G. Yfantis, Anuoluwapo Ajao, Huaitian Liu, Margaret Pichardo, Catherine Pichardo

Pathology, East Africa

Abstract: Women of African descent have the highest breast cancer mortality in the United States and are more likely than women from other population groups to develop an aggressive disease. It remains uncertain to what extent breast cancer in Africa is reminiscent of breast cancer in African American or European American patients. Here, we performed whole-exome sequencing of genomic DNA from 191 breast tumor and non-cancerous adjacent tissue pairs obtained from 97 African American, 69 European American, 2 Asian American, and 23 Kenyan patients. Our analysis of the sequencing data revealed an elevated tumor mutational burden in both Kenyan and …

Population-Specific Mutation Patterns In Breast Tumors From African American, European American, And Kenyan Patients, Wei Tang, Jung S. Byun, Tiffany H. Dorsey, Harris G. Yfantis, Anuoluwapo Ajao, Huaitian Liu, Margaret S. Pichardo, Catherine M. Pichardo, Alexandra R. Harris, Shahin Sayed

Pathology, East Africa

Women of African descent have the highest breast cancer mortality in the United States and are more likely than women from other population groups to develop an aggressive disease. It remains uncertain to what extent breast cancer in Africa is reminiscent of breast cancer in African American or European American patients. Here, we performed whole-exome sequencing of genomic DNA from 191 breast tumor and non-cancerous adjacent tissue pairs obtained from 97 African American, 69 European American, 2 Asian American, and 23 Kenyan patients. Our analysis of the sequencing data revealed an elevated tumor mutational burden in both Kenyan and African …

P16 Expression And Recurrent Cervical Intraepithelial Neoplasia After Cryotherapy Among Women Living With Hiv, Daniel Maina, Michael H. Chung, Marleen Temmerman, Zahir Moloo, Jonathan Wawire, Sharon A. Greene, Elizabeth Unger, Shahin Sayed, Samah Sakr, Nelly Mugo

Pathology, East Africa

Background: The expression of p16 protein, a surrogate marker for high-risk human papillomavirus (hrHPV), is associated with cervical dysplasia. We evaluated correlates of p16 expression at treatment for high-grade cervical lesions and its utility in predicting the recurrence of cervical intraepithelial lesions grade 2 or higher (CIN2+) following cryotherapy among women with HIV.

Methods: This is a subgroup analysis of women with HIV in Kenya with baseline cervical biopsy-confirmed CIN2+ who were randomized to receive cryotherapy and followed every six-months for two-years for biopsy-confirmed recurrence of CIN2+. P16 immunohistochemistry was performed on the baseline cervical biopsy with a positive result …

Development, Roll-Out And Implementation Of An Antimicrobial Resistance Training Curriculum Harmonizes Delivery Of In-Service Training To Healthcare Workers In Kenya, Josiah Njeru, Joshua Odero, Sheilla Chebore, Mungai Ndung’U, Emmanuel Tanui, Evelyn Wesangula, Romona Ndanyi, Susan Githii, R Gunturu, Willy Mwangi

Pathology, East Africa

Background: Antimicrobial resistance (AMR) is an increasingly severe threat to global public health that requires action across different sectors. Selection of appropriate antimicrobials is an urgent challenge due to the emergence of drug resistance. In 2017, Kenya developed an AMR policy and National Action Plan to drive prevention and containment of AMR. A priority activity under AMR surveillance strategic objective was to develop a national AMR training curriculum for in-service healthcare workers. In this paper we discuss the development process, gains achieved through implementation across the country and lessons learned.

Methods: An initial stakeholders’ forum was convened to …