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Marinda PA, Chalula F, Khayeka-Wandabwa C, Audain K, Thilsted SH. Dietary diversity and nutritional status of children aged 6-59 months from rural fishing and non-fishing communities in Zambia. Scientific African 2022. [DOI: 10.1016/j.sciaf.2022.e01527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
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2
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Ngomi N, Khayeka-Wandabwa C, Egondi T, Marinda PA, Haregu TN. Determinants of inequality in health care seeking for childhood illnesses: insights from Nairobi informal settlements. Global Health Journal 2022. [DOI: 10.1016/j.glohj.2022.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
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3
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Khayeka-Wandabwa C, Ma X, Jia Y, Bureik M. Monitoring of autoantibodies against CYP4Z1 in patients with colon, ovarian, or prostate cancer. Immunobiology 2022; 227:152174. [PMID: 34999392 DOI: 10.1016/j.imbio.2021.152174] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Revised: 12/27/2021] [Accepted: 12/30/2021] [Indexed: 12/09/2022]
Abstract
We have previously monitored the detection of autoantibodies (aAbs) directed against CYP4Z1 in the sera of breast and lung cancer patients. In the present study, the occurence of anti-CYP4Z1 aAbs in patients suffering from colon (n = 100), ovarian (n = 72), or prostate (n = 85) cancer was examined. Determination of aAbs was done using our previously established ELISA method. On average, the levels of anti-CYP4Z1 aAbs detected in sera from all cancer patients were not significantly higher than controls. No correlations were found with respect to gender or tumor stage. However, a subgroup of colon cancer patients with increased anti-CYP4Z1 aAb titers exhibited positive fecal occult blood test (FOBT) results and higher levels of both carbohydrate antigen 19-9 (CA19-9) and carcinoembryonic antigen (CEA). These results do not suggest that anti-CYP4Z1 aAbs have value as an independent biomarker for the detection of either colon, ovarian, or prostate cancer. However, they might be useful in combination with other biomarkers for the identification of a subset of colon cancers. Investigations involving a more powered sample size of this subgroup are needed to support this notion.
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Affiliation(s)
| | - Xiaoshuang Ma
- School of Pharmaceutical Science and Technology, Tianjin University, Tianjin 300072, China
| | - Yingjie Jia
- Dept. of Oncology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300193, China
| | - Matthias Bureik
- School of Pharmaceutical Science and Technology, Tianjin University, Tianjin 300072, China.
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Khayeka-Wandabwa C, Zhao J, Pathak JL, Wu H, Bureik M. Upregulation of estrogen receptor alpha (ERα) expression in transgenic mice expressing human CYP4Z1. Breast Cancer Res Treat 2021; 191:319-326. [PMID: 34725776 DOI: 10.1007/s10549-021-06435-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 10/25/2021] [Indexed: 12/22/2022]
Abstract
PURPOSE CYP4Z1 is a human cytochrome P450 enzyme involved in breast cancer progression and prognosis, but its functional role in these processes is not understood. In order to gain more insight into CYP4Z1's properties it was recombinantly expressed in a host animal that does not have an endogenous homologue. METHODS We generated a transgenic mouse model that specifically expresses human CYP4Z1 in breast tissue under the control of the whey acidic protein promoter. Complementary experiments were done using cell lines derived from human breast cell. RESULTS Induction of CYP4Z1 expression led to reduction of body weight, activity, and birth rates. Histological analysis revealed no evidence for tumor formation. However, a strong increase in estrogen receptor alpha was observed by immunohistochemistry; weaker but significantly increased immunoreactivity was also detected for collagen I and fibronectin. Overexpression of CYP4Z1 in the human breast cancer cell line MCF7 also led to increased ERα expression. Moreover, increased expression of both CYP4Z1 and ERα was observed in MCF-10A normal breast cells upon cocultivation with MCF-7 cells (with or without overexpression of CYP4Z1). CONCLUSION These data suggest that CYP4Z1 facilitates breast cancer development by induction of ERα expression via an as yet undefined mechanism.
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Affiliation(s)
| | - Jie Zhao
- School of Pharmaceutical Science and Technology (SPST), Tianjin University, Tianjin, China
| | - Janak L Pathak
- School of Pharmaceutical Science and Technology (SPST), Tianjin University, Tianjin, China.,Guangzhou Institute of Oral Disease, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou, China
| | - Huiyuan Wu
- School of Pharmaceutical Science and Technology (SPST), Tianjin University, Tianjin, China
| | - Matthias Bureik
- School of Pharmaceutical Science and Technology (SPST), Tianjin University, Tianjin, China.
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Khayeka-Wandabwa C, Ma X, Jia Y, Bureik M. Concomitant occurence of multiple autoantibodies against human cytochromes P450. Int Immunopharmacol 2021; 100:108087. [PMID: 34464888 DOI: 10.1016/j.intimp.2021.108087] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 08/16/2021] [Accepted: 08/18/2021] [Indexed: 12/17/2022]
Abstract
Cytochromes P450 (CYPs) are a large superfamily of heme-containing enzymes that are essential for the metabolism of a variety of endogenous and xenobiotic compounds. The role and the possible diagnostic or prognostic value of the occurrence of anti-CYP autoantibodies (aAbs) in cancer patients are essentially unclear. Recently we reported the monitoring of aAbs against CYP4Z1 and CYP19A1 in breast cancer patients and healthy controls. In the present study, we extended this investigation by screening the sera of 47 lung cancer patients (17 female and 30 male; age range 49-84) and 119 healthy controls (60 female and 59 male; age range 21-72) for the presence of aAbs directed against CYP2D6, CYP4Z1, or CYP17A1, respectively. Determination of anti-CYP aAb levels was done using our previously established ELISA method. Most sera gave low signals while a small fraction showed stronger responses; however, there were no statistically significant differences between the different test groups. Also, there was no significant difference in aAb signals between the various subtypes of lung cancer. Unexpectedly, sera from two female lung cancer patients (age 67 (adenocarcinoma) and 70 (small cell carcinoma)) and from four healthy controls (one female and three male; age range 34-48) showed significantly elevated signals for more than one of the three CYPs tested. These findings corroborate earlier reports that anti-CYP aAbs occur with low frequency in the general population and, moreover, suggest that the simultaneous presence of multiple aAbs targeting different CYPs should be taken into consideration when evaluating anti-CYP aAbs as biomarkers.
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Affiliation(s)
- Christopher Khayeka-Wandabwa
- School of Pharmaceutical Science and Technology, Health Sciences Platform, Tianjin University, Tianjin 300072, China
| | - Xiaoshuang Ma
- School of Pharmaceutical Science and Technology, Health Sciences Platform, Tianjin University, Tianjin 300072, China
| | - Yingjie Jia
- Dept. of Oncology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300193, China
| | - Matthias Bureik
- School of Pharmaceutical Science and Technology, Health Sciences Platform, Tianjin University, Tianjin 300072, China.
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Karani LW, Musyoki S, Orina R, Khayeka-Wandabwa C, Nyagaka B. Cytological physiognomies and genotype distribution of human papillomaviruses among HPV/HIV co-infected and HPV mono-infected women. Afr Health Sci 2021; 21:254-262. [PMID: 34394305 PMCID: PMC8356618 DOI: 10.4314/ahs.v21i1.33] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Co-infection of High Risk Human Papillomavirus (HR-HPV) and HIV is thought to favour initiation of intraepithelial squamous cell lesion and subsequent progression to cervical carcinoma. OBJECTIVES Evaluation of cytological physiognomies in relation to possible age influence and the genotype distribution of human papillomaviruses among HPV/HIV co-infected and HPV monoinfected women in Kisii, Kenya. METHODS The case-control study enrolled 42 HPV/HIV co-infected and 42 HPV monoinfected women. Cervical swabs were collected in ThinPrep vials for HPV tying and cytological analysis. HPV subtypes were assayed by Xpert® HPV system (GXHPV-CE-10). RESULTS Mono-infected women aged 30-39 years had the highest proportion of low grade squamous intraepithelial lesion (LSIL) at 14 (16.67%) while the co-infected aged 50-59 years had the highest proportion of high grade squamous intraepithelial lesion (HSIL) at 9 (10.71%). HPV-16 genotype was the most predominant and it increased with age rise. Older coinfected and mono-infected women (>40 years) had HSIL and LSIL as the most predominant cytological grade respectively. CONCLUSION The predominance of HPV-16 and HPV-18/45 genotypes in the study setting is a consideration that would benefit targeted prophylactic vaccination programs. HPV testing and cervical cancer screening for young and older women on a regular basis ought to be reinforced.
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Affiliation(s)
| | | | - Robert Orina
- School of Health Science, Kisii University, Kenya
| | - Christopher Khayeka-Wandabwa
- School of Pharmaceutical Science and Technology (SPST), Health Science Platform, Tianjin University, Tianjin 300072, China
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Wanjohi MN, Ogada I, Wekesah FM, Khayeka-Wandabwa C, Kimani-Murage EW. Relationship between maternal body composition during pregnancy and infant's birth weight in Nairobi informal settlements, Kenya. BMJ Nutr Prev Health 2020; 3:151-161. [PMID: 33521524 PMCID: PMC7841839 DOI: 10.1136/bmjnph-2019-000060] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 05/20/2020] [Accepted: 05/28/2020] [Indexed: 11/04/2022] Open
Abstract
Background Maternal nutrition depletion during pregnancy compromises fetal programming, and is a cause of adverse birth outcomes. Maternal body composition measurement using direct body composition assessment methods such as the deuterium dilution technique provides better prediction of birth outcomes as compared with commonly used techniques like anthropometry. This study assessed body composition of pregnant mothers in urban informal settlements in Nairobi, Kenya, and established the relationship between maternal body composition and infant birth weight. Methods Deuterium dilution technique was used to determine body composition, including total body water (TBW), fat-free mass (FFM) and fat mass (FM), among 129 pregnant women who were enrolled into the study in their first or second trimester. Descriptive statistics and regression analysis were applied using Stata V.13. Results The mean TBW, FFM and FM were 33.3 L (±4.7), 45.7 kg (±6.5) and 17.01 kg (±7.4), respectively. Both TBW and FFM were significantly related to maternal age and gestation/pregnancy stage during body composition assessment while FM was significantly associated with gestation stage during body composition assessment. TBW and FFM were significantly lower in younger mothers (<20 years) compared with older mothers (≥20 years). The mean birth weight was 3.3 kg±0.42 kg. There was a positive association between infant birth weight and maternal TBW (p=0.031) and FFM (p=0.027), but not FM (p=0.88). Conclusion Non-fat components of the body (TBW and FFM) have a positive association with birth weight. Therefore, interventions to improve optimal maternal feeding practices, to enhance optimal gains in FFM and TBW during pregnancy are recommended, especially among young mothers.
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Affiliation(s)
- Milkah Njeri Wanjohi
- Maternal and Child Wellbeing, African Population and Health Research Center, Nairobi, Kenya
| | - Irene Ogada
- Department of Human Nutrition, St Francis Xavier University, Antigonish, Nova Scotia, Canada.,Department of Food Nutrition and Dietetics, Kenyatta University, Nairobi, Kenya
| | - Frederick Murunga Wekesah
- Health and Systems for Health Unit, African Population and Health Research Center, Nairobi, Kenya.,Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht University, Utrecht, Netherlands
| | - Christopher Khayeka-Wandabwa
- School of Pharmaceutical Science and Technology (SPST), Health Science Platform, Tianjin University, Tianjin, China
| | - Elizabeth W Kimani-Murage
- Maternal and Child Wellbeing, African Population and Health Research Center, Nairobi, Kenya.,Wellcome Trust, London, UK
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Karani LW, Musyoki S, Orina R, Nyamache AK, Khayeka-Wandabwa C, Nyagaka B. Human papillomavirus genotype profiles and cytological grades interlinkages in coinfection with HIV. Pan Afr Med J 2020; 35:67. [PMID: 32537071 PMCID: PMC7250203 DOI: 10.11604/pamj.2020.35.67.21539] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 02/23/2020] [Indexed: 01/03/2023] Open
Abstract
Introduction The study aimed to examine and characterize human papilloma virus (HPV) cytological grade trends and genotypes among HPV/HIV co-infected/cases and HPV monoinfected/control women attending Kisii Teaching and Referral Hospital, Kenya. Methods HIV positive co-infected with HPV (HPV/HIV) and HIV negative women monoinfected with HPV profiled as co-infected/cases and monoinfected/control arms respectively were enrolled. HPV subtypes were assayed by Xpert® HPV system (GXHPV-CE-10) alongside pathological cytology analysis of cervical tissue samples. Results Low grade intraepithelial lesion (LSIL) was the most predominant cytological grade across cases and controls with a prevalence of 32 (38.1%) while high grade squamous intraepithelial lesion (HSIL) was highest among HPV/HIV co-infected with a prevalence of 23 (27.38%). Among the monoinfected (controls) the predominant lesion was low grade intraepithelial lesions (LSIL) with a prevalence of 23 (27.38%). HPV type 16 had the highest prevalence 26 (30.8%) among the VIA positive women in the overall study participants followed by combinations of HPV types (16, 18/45) at 19 (22.6%). Conclusion High risk HPV types 16 and 18/45 were the most predominant in the established cytological grades and among the co-infected women. Routine screening using both cytological and HPV testing should be embraced and/or reinforced as early screening and preventive strategies in the covered geographical region population. Provision of the currently available vaccines to these women at an early age would provide effective protection since the HPV type profiles in this population are covered by such vaccines.
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Affiliation(s)
| | | | - Robert Orina
- School of Health Science, Kisii University, Kisii, Kenya
| | | | - Christopher Khayeka-Wandabwa
- School of Pharmaceutical Science and Technology (SPST), Health Science Platform, Tianjin University, Tianjin 300072, China
| | - Benuel Nyagaka
- School of Health Science, Kisii University, Kisii, Kenya
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Gong E, Lu H, Shao S, Tao X, Peoples N, Kohrt BA, Xiong S, Kyobutungi C, Haregu TN, Khayeka-Wandabwa C, Van Minh H, Hanh TTD, Koirala S, Gautam K, Yan LL. Feasibility assessment of invigorating grassrooTs primary healthcare for prevention and management of cardiometabolic diseases in resource-limited settings in China, Kenya, Nepal, Vietnam (the FAITH study): rationale and design. Glob Health Res Policy 2019; 4:33. [PMID: 31742234 PMCID: PMC6849318 DOI: 10.1186/s41256-019-0124-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Accepted: 10/10/2019] [Indexed: 01/27/2023] Open
Abstract
Background Cardiometabolic diseases are the leading cause of death and disability in many low- and middle-income countries. As the already severe burden from these conditions continues to increase in low- and middle-income countries, cardiometabolic diseases introduce new and salient public health challenges to primary health care systems. In this mixed-method study, we aim to assess the capacity of grassroots primary health care facilities to deliver essential services for the prevention and control of cardiometabolic diseases. Built on this information, our goal is to propose evidence-based recommendations to promote a stronger primary health care system in resource-limited settings. Methods The study will be conducted in resource-limited settings in China, Kenya, Nepal, and Vietnam using a mixed-method approach that incorporates a literature review, surveys, and in-depth interviews. The literature, statistics, and document review will extract secondary data on the burden of cardiometabolic diseases in each country, the existing policies and interventions related to strengthening primary health care services, and improving care related to non-communicable disease prevention and control. We will also conduct primary data collection. In each country, ten grassroots primary health care facilities across representative urban-rural regions will be selected. Health care professionals and patients recruited from these facilities will be invited to participate in the facility assessment questionnaire and patients’ survey. Stakeholders – including patients, health care professionals, policymakers at the local, regional, and national levels, and local authorities – will be invited to participate in in-depth interviews. A standard protocol will be designed to allow for adaption and localization in data collection instruments and procedures within each country. Discussion With a special focus on the capacity of primary health care facilities in resource-limited settings in low- and middle-income countries, this study has the potential to add new evidence for policymakers and academia by identifying the most common and significant barriers primary health care services face in managing and preventing cardiometabolic diseases. With these findings, we will generate evidence-based recommendations on potential strategies that are feasible for resource-limited settings in combating the increasing challenges of cardiometabolic diseases.
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Affiliation(s)
- Enying Gong
- 1Global Health Research Center, Duke Kunshan University, No. 8 Duke Avenue, Kunshan, 215316 Jiangsu China
| | - Hongsheng Lu
- 1Global Health Research Center, Duke Kunshan University, No. 8 Duke Avenue, Kunshan, 215316 Jiangsu China
| | - Shuai Shao
- 1Global Health Research Center, Duke Kunshan University, No. 8 Duke Avenue, Kunshan, 215316 Jiangsu China
| | - Xuanchen Tao
- 1Global Health Research Center, Duke Kunshan University, No. 8 Duke Avenue, Kunshan, 215316 Jiangsu China
| | - Nicholas Peoples
- 1Global Health Research Center, Duke Kunshan University, No. 8 Duke Avenue, Kunshan, 215316 Jiangsu China
| | - Brandon A Kohrt
- 2Global Health Institute, Duke University, Durham, NC USA.,3Department of Psychiatry, George Washington University, Washington, DC USA
| | - Shangzhi Xiong
- 1Global Health Research Center, Duke Kunshan University, No. 8 Duke Avenue, Kunshan, 215316 Jiangsu China
| | | | | | | | | | | | - Suraj Koirala
- Transcultural Psychosocial Organization Nepal, Kathmandu, Nepal
| | - Kamal Gautam
- Transcultural Psychosocial Organization Nepal, Kathmandu, Nepal
| | - Lijing L Yan
- 1Global Health Research Center, Duke Kunshan University, No. 8 Duke Avenue, Kunshan, 215316 Jiangsu China.,2Global Health Institute, Duke University, Durham, NC USA
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Khayeka-Wandabwa C, Zhou G, Magak NG, Choge JK, Kemei WK, Makwali JA, Karani LW, Kisavi MP, Ndulu JV, Anjili CO. Combined chemotherapy manifest less severe immunopathology effects in helminth-protozoa comorbidity. Exp Parasitol 2019; 204:107728. [PMID: 31348915 DOI: 10.1016/j.exppara.2019.107728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2018] [Revised: 07/15/2019] [Accepted: 07/22/2019] [Indexed: 11/24/2022]
Abstract
BACKGROUND Co-infection with Leishmania major and Schistosoma mansoni may have significant consequences for disease progression, severity and subsequent transmission dynamics. Pentavalent antimonials and Praziquantel (PZQ) are used as first line of treatment for Leishmania and Schistosoma infections respectively. However, there is limited insight on how combined therapy with the standard drugs impacts the host in comorbidity. The study aimed to determine the efficacy of combined chemotherapy using Pentostam (P) and PZQ in murine model co-infected with L. major and S. mansoni. METHODS A 3 × 4 factorial design with three parasite infection groups (Lm, Sm, Lm + Sm to represent L. major, S. mansoni and L. major + S. mansoni respectively) and four treatment regimens [P, PZQ, P + PZQ, and PBS designating Pentostam (GlaxoSmithKline UK), Praziquantel (Biltricide®, Bayer Ag. Leverkusen, Germany), Pentostam + Praziquantel and Phosphate buffered saline] as factors was applied. RESULTS Significant changes were observed in the serum Interferon gamma (IFN-γ), and Macrophage inflammatory protein-one alpha (MIP-1α) levels among various treatment groups between week 8 and week 10 (p < 0.05). There was increased IFN-γ in the L. major infected mice subjected to PZQ and PBS, and in L. major + S. mansoni infected BALB/c mice treated with P + PZQ. Subsequently, MIP-1α levels increased significantly in both the L. major infected mice under PZQ and PBS and in L. major + S. mansoni infected BALB/c mice undergoing concurrent chemotherapy with P + PZQ between 8 and 10 weeks (p < 0.05). In the comorbidity, simultaneous chemotherapy resulted in less severe histopathological effects in the liver. CONCLUSION It was evident, combined first line of treatment is a more effective strategy in managing co-infection of L. major and S. mansoni. The findings denote simultaneous chemotherapy compliments immunomodulation in the helminth-protozoa comorbidity hence, less severe pathological effects following the parasites infection. Recent cases of increased incidences of polyparasitism in vertebrates call for better ways to manage co-infections. The findings presented necessitate intrinsic biological interest on examining optimal combined chemotherapeutic agents strategies in helminth-protozoa concomitance and the related infections abatement trends vis-a-vis host-parasite relationships.
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Affiliation(s)
- Christopher Khayeka-Wandabwa
- School of Pharmaceutical Science and Technology (SPST), Health Science Platform, Tianjin University, Tianjin, 300072, China; Centre for Biotechnology Research and Development (CBRD), Kenya Medical Research Institute (KEMRI), P.O Box 54840, Nairobi, 00200, Kenya.
| | - Guan Zhou
- School of Pharmaceutical Science and Technology (SPST), Health Science Platform, Tianjin University, Tianjin, 300072, China.
| | | | - Joseph K Choge
- University of Kabianga, P.O. Box 2030, Kericho, 20200, Kenya.
| | - William Kipchirchir Kemei
- Institute of Tropical Medicine and Infectious Diseases (ITROMID), Jomo Kenyatta University of Agriculture and Technology (JKUAT), P.O. Box 62000-00200, Nairobi, Kenya.
| | - Judith Alice Makwali
- Department of Biological Science, University of Eldoret, P.O Box 1125, Eldoret, 30100, Kenya.
| | | | - Mutila Phoebe Kisavi
- School of Health Science, Machakos University, Kenya; Public Health Intervention Research Group, The Kirby Institute for Infection and Immunity in Society, University of New South Wales, Sydney, NSW 2052 Australia.
| | - James V Ndulu
- African Population and Health Research Center (APHRC), P .O. Box 10787-00100, Nairobi, Kenya.
| | - Christopher O Anjili
- Centre for Biotechnology Research and Development (CBRD), Kenya Medical Research Institute (KEMRI), P.O Box 54840, Nairobi, 00200, Kenya.
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11
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Ramsay M, Crowther NJ, Agongo G, Ali SA, Asiki G, Boua RP, Gómez-Olivé FX, Kahn K, Khayeka-Wandabwa C, Mashinya F, Micklesfield L, Mukomana F, Nonterah EA, Soo C, Sorgho H, Wade AN, Wagner RG, Alberts M, Hazelhurst S, Kyobutungi C, Norris SA, Oduro AR, Sankoh O, Tinto H, Tollman S. Regional and sex-specific variation in BMI distribution in four sub-Saharan African countries: The H3Africa AWI-Gen study. Glob Health Action 2019; 11:1556561. [PMID: 30845902 PMCID: PMC6407581 DOI: 10.1080/16549716.2018.1556561] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Background: African populations are characterised by diversity at many levels including: demographic history, genetic ancestry, language, wealth, socio-political landscape, culture and behaviour. Several of these have a profound impact on body fat mass. Obesity, a key risk factor for cardiovascular and metabolic diseases, in the wake of the epidemiological and health transitions across the continent, requires detailed analysis together with other major risk factors. Objective: To compare regional and sex-specific body mass index (BMI) distributions, using a cross-sectional study design, in adults aged 40–60 years across six study sites in four sub-Saharan African (SSA) countries and to compare the determinants of BMI at each. Methods: Anthropometric measurements were standardised across sites and BMI calculated. Median BMI and prevalence of underweight, lean, overweight and obesity were compared between the sexes and across sites. Data from multivariable linear regression models for the principal determinants of BMI were summarised from the site-specific studies. Results: BMI was calculated in 10,702 participants (55% female) and was significantly higher in women than men at nearly all sites. The highest prevalence of obesity was observed at the three South African sites (42.3–66.6% in women and 2.81–17.5% in men) and the lowest in West Africa (1.25–4.22% in women and 1.19–2.20% in men). Across sites, higher socio-economic status and educational level were associated with higher BMI. Being married and increased dietary intake were associated with higher BMI in some communities, whilst smoking and alcohol intake were associated with lower BMI, as was HIV infection in the regions where it was prevalent. Conclusion: In SSA there is a marked variation in the prevalence of obesity both regionally and between men and women. Our data suggest that the drive for social upliftment within Africa will be associated with rising levels of obesity, which will require the initiation of targeted sex-specific intervention programmes across specific African communities.
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Affiliation(s)
- Michèle Ramsay
- a Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences , University of the Witwatersrand , Johannesburg , South Africa.,b Division of Human Genetics , National Health Laboratory Service and School of Pathology, Faculty of Health Sciences, University of the Witwatersrand , Johannesburg , South Africa
| | - Nigel J Crowther
- c Department of Chemical Pathology, National Health Laboratory Service, Faculty of Health Sciences , University of the Witwatersrand , Johannesburg , South Africa
| | - Godfred Agongo
- a Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences , University of the Witwatersrand , Johannesburg , South Africa.,d Navrongo Health Research Centre , Navrongo , Ghana
| | - Stuart A Ali
- a Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences , University of the Witwatersrand , Johannesburg , South Africa
| | - Gershim Asiki
- e African Population and Health Research Center , Nairobi , Kenya
| | - Romuald P Boua
- a Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences , University of the Witwatersrand , Johannesburg , South Africa.,b Division of Human Genetics , National Health Laboratory Service and School of Pathology, Faculty of Health Sciences, University of the Witwatersrand , Johannesburg , South Africa.,f Clinical Research Unit of Nanoro, Institut de Recherche en Sciences de la Sante , Nanoro , Burkina Faso
| | - F Xavier Gómez-Olivé
- g MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences , University of the Witwatersrand , Johannesburg , South Africa
| | - Kathleen Kahn
- g MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences , University of the Witwatersrand , Johannesburg , South Africa.,h School of Public Health, Faculty of Health Sciences , University of the Witwatersrand , Johannesburg , South Africa.,i INDEPTH Network , Accra , Ghana
| | | | - Felistas Mashinya
- j Department of Pathology and Medical Science, School of Health Care Sciences, Faculty of Health Sciences , University of Limpopo , Polokwane , South Africa
| | - Lisa Micklesfield
- k MRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences , University of the Witwatersrand , Johannesburg , South Africa
| | - Freedom Mukomana
- a Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences , University of the Witwatersrand , Johannesburg , South Africa
| | | | - Cassandra Soo
- a Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences , University of the Witwatersrand , Johannesburg , South Africa.,b Division of Human Genetics , National Health Laboratory Service and School of Pathology, Faculty of Health Sciences, University of the Witwatersrand , Johannesburg , South Africa
| | - Hermann Sorgho
- f Clinical Research Unit of Nanoro, Institut de Recherche en Sciences de la Sante , Nanoro , Burkina Faso
| | - Alisha N Wade
- g MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences , University of the Witwatersrand , Johannesburg , South Africa
| | - Ryan G Wagner
- g MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences , University of the Witwatersrand , Johannesburg , South Africa
| | - Marianne Alberts
- j Department of Pathology and Medical Science, School of Health Care Sciences, Faculty of Health Sciences , University of Limpopo , Polokwane , South Africa
| | - Scott Hazelhurst
- a Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences , University of the Witwatersrand , Johannesburg , South Africa.,l School of Electrical & Information Engineering, University of the Witwatersrand , Johannesburg , South Africa
| | | | - Shane A Norris
- k MRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences , University of the Witwatersrand , Johannesburg , South Africa
| | | | - Osman Sankoh
- h School of Public Health, Faculty of Health Sciences , University of the Witwatersrand , Johannesburg , South Africa.,i INDEPTH Network , Accra , Ghana.,m Statistics Sierra Leone , Freetown , Sierra Leone.,n Department of Community Medicine, College of Medicine and Allied Health Sciences , University of Sierra Leone , Freetown , Sierra Leone
| | - Halidou Tinto
- f Clinical Research Unit of Nanoro, Institut de Recherche en Sciences de la Sante , Nanoro , Burkina Faso
| | - Stephen Tollman
- g MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences , University of the Witwatersrand , Johannesburg , South Africa.,h School of Public Health, Faculty of Health Sciences , University of the Witwatersrand , Johannesburg , South Africa.,i INDEPTH Network , Accra , Ghana
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12
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Khayeka-Wandabwa C, Ma X, Cao X, Nunna V, Pathak JL, Bernhardt R, Cai P, Bureik M. Plasma membrane localization of CYP4Z1 and CYP19A1 and the detection of anti-CYP19A1 autoantibodies in humans. Int Immunopharmacol 2019; 73:64-71. [PMID: 31082724 DOI: 10.1016/j.intimp.2019.05.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2019] [Revised: 04/14/2019] [Accepted: 05/02/2019] [Indexed: 12/15/2022]
Abstract
It is thought that autoantibody (aAb) production can be caused by (aberrant) protein targeting to the plasma surface of cells. We recently demonstrated the presence of the human cytochrome P450 enzyme CYP4Z1 on the plasma membrane of MCF-7 breast cancer cells and the detection of high titers of anti-CYP4Z1 aAbs in breast cancer patients, but not in healthy controls. In the present study we show that cells of the normal breast cell line MCF-10A do not display CYP4Z1 on their surface. By contrast, we detected CYP19A1 (aromatase) on the plasma membrane of both cell lines. Interestingly, the presence of CYPs on the cell surface did not correlate with their relative expression levels in these cell lines. Indirect ELISA experiments demonstrated the presence of anti-CYP19A1 aAbs in female breast cancer patient sera as well as in male and female controls, respectively; aAb titers in all three groups varied considerably and overall, the results obtained for each group were not significantly different from those of either of the other two groups. Based on these data we propose the hypothesis that CYP translocation to the plasma membrane, but not the intracellular expression level, is the crucial precondition for the generation of anti-CYP aAbs.
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Affiliation(s)
- Christopher Khayeka-Wandabwa
- School of Pharmaceutical Science and Technology (SPST), Health Science Platform, Tianjin University, Tianjin, China
| | - Xiaoshuang Ma
- School of Pharmaceutical Science and Technology (SPST), Health Science Platform, Tianjin University, Tianjin, China
| | - Xiaolin Cao
- School of Pharmaceutical Science and Technology (SPST), Health Science Platform, Tianjin University, Tianjin, China
| | - Venkatrao Nunna
- School of Pharmaceutical Science and Technology (SPST), Health Science Platform, Tianjin University, Tianjin, China
| | - Janak L Pathak
- School of Pharmaceutical Science and Technology (SPST), Health Science Platform, Tianjin University, Tianjin, China
| | - Rita Bernhardt
- Institute of Biochemistry, Saarland University, Saarbruecken, Germany
| | - Pengcheng Cai
- Department of Clinical Laboratory, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| | - Matthias Bureik
- School of Pharmaceutical Science and Technology (SPST), Health Science Platform, Tianjin University, Tianjin, China.
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13
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Mohamed SF, Haregu TN, Khayeka-Wandabwa C, Muthuri SK, Kyobutungi C. Magnitude and predictors of normal-weight central obesity- the AWI-Gen study findings. Glob Health Action 2019; 12:1685809. [PMID: 31694493 PMCID: PMC6844381 DOI: 10.1080/16549716.2019.1685809] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Accepted: 10/23/2019] [Indexed: 11/24/2022] Open
Abstract
Background: Normal-weight central obesity is associated with higher mortality than general obesity as defined by body mass index, particularly in the absence of central fat distribution.Objective: The aim of this study was to examine the magnitude and predictors of normal-weight central obesity in an urban informal settlement setting in Kenya.Methods: We used data from the AWI-Gen study, a cross-sectional survey targeting randomly selected consenting adults between the ages of 40-60 in two urban informal settlements of Nairobi between 2014 and 2016. Central obesity was determined using waist circumference, waist to hip ratio, visceral fat thickness, and subcutaneous fat thickness. General obesity was determined using body mass index (BMI).Results: About 20.0% of participants in the study had general obesity. The prevalence of central obesity as measured by waist circumference was 52.0%, by waist-to-hip ratio was 53.5%, by visceral fat thickness was 32.4% and by subcutaneous fat thickness was 49.2%. The prevalence of normal-weight central obesity in the study population was highest when measured by waist to hip ratio (38.1%) and lowest when measured by visceral fat thickness (18.1%). Factors associated with normal-weight central obesity as assesses by waist circumference were being female, of older age, and in full-time employment. Older age was associated with normal-weight central obesity as assessed by waist to hip ratio.Conclusion: The findings highlight a significant prevalence of normal-weight central obesity among adults in a poor urban setting in Kenya, pointing to women as a key target group for focused interventions. Longitudinal studies are needed to establish whether there is a link between normal-weight central obesity and mortality in such settings as has been found in other settings.
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Affiliation(s)
- Shukri F. Mohamed
- Health and Systems for Health Unit (HSH), African Population and Health Research Center (APHRC), Nairobi, Kenya
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Tilahun Nigatu Haregu
- Health and Systems for Health Unit (HSH), African Population and Health Research Center (APHRC), Nairobi, Kenya
- Non-Communicable Disease Unit, School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Christopher Khayeka-Wandabwa
- School of Pharmaceutical Science and Technology (SPST), Health Science Platform, Tianjin University, Tianjin, China
| | - Stella Kagwiria Muthuri
- Health and Systems for Health Unit (HSH), African Population and Health Research Center (APHRC), Nairobi, Kenya
| | - Catherine Kyobutungi
- Health and Systems for Health Unit (HSH), African Population and Health Research Center (APHRC), Nairobi, Kenya
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14
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Marinda PA, Genschick S, Khayeka-Wandabwa C, Kiwanuka-Lubinda R, Thilsted SH. Dietary diversity determinants and contribution of fish to maternal and under-five nutritional status in Zambia. PLoS One 2018; 13:e0204009. [PMID: 30248126 PMCID: PMC6152956 DOI: 10.1371/journal.pone.0204009] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2017] [Accepted: 08/31/2018] [Indexed: 01/03/2023] Open
Abstract
Background This study examines socio-economic determinants of food consumption patterns amongst women of reproductive age and children aged 6–59 months from urban poor settlements of Lusaka and their implications for nutritional status. Particular emphasis was placed on the role of fish in their diets and nutritional status. Methods A cross-sectional survey design was applied, in which 714 mother-child dyads, with children aged 6–59 months were enrolled. A three-stage randomized cluster sampling approach was applied. Results The mean dietary diversity score among children aged 6–23 and 24–59 months was 2.98 (±1.27) and 3.478 (±1.07), respectively. In children aged 6–23 months, there was a significant difference in their nutritional status, based on fish consumption (χ2 = 10.979, df = 2, p = 0.004). Children from poorer households consumed mostly small fish (Kapenta). The quantity of fish consumed by children was significantly associated with stunting in both age groups, odds ratio = 0.947 (95% CI: 0.896, 1.000) for children aged 6–23 months and odds ratio = 1.038 (95% CI: 1.006, 1.072) for children aged 24–59 months old. Other significant risk factors for stunting in children aged 6–23 months were the child’s age, mother’s body mass index, access to treated water and child morbidity. Child’s age, mother’s educational level and wealth status were determinants of dietary diversity in children aged 6–59 months as shown by the Poisson regression. Conclusion Nutritional status of children aged 6–23 months is associated with fish consumption, with children consuming fish less likely to be stunted. Small fish (Kapenta) is an animal-source food that is particularly important in the diet of children in urban poor households in Zambia and contributes to better nutritional outcomes. As all small fish stem from capture fisheries, sustainable one health environmental integration, monitoring and management strategies are desirable.
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Affiliation(s)
- Pamela A. Marinda
- The University of Zambia, School of Agricultural Sciences, Department of Food Science and Nutrition, Lusaka, Zambia
- * E-mail:
| | | | - Christopher Khayeka-Wandabwa
- School of Pharmaceutical Science and Technology (SPST), Health Science Platform, Tianjin University, Tianjin city, Nankai District, China
| | - Rebecca Kiwanuka-Lubinda
- The University of Zambia, School of Agricultural Sciences, Department of Agricultural Economics and Extension, Lusaka, Zambia
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15
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Kisiangani J, Baliddawa J, Marinda P, Mabeya H, Choge JK, Adino EO, Khayeka-Wandabwa C. Determinants of breast cancer early detection for cues to expanded control and care: the lived experiences among women from Western Kenya. BMC Womens Health 2018; 18:81. [PMID: 29859095 PMCID: PMC5984781 DOI: 10.1186/s12905-018-0571-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/17/2016] [Accepted: 05/18/2018] [Indexed: 01/24/2023]
Abstract
Background Estimately, 70–80% of cancer cases are diagnosed in late stages in Kenya with breast cancer being a common cause of mortality among women where late diagnosis is the major ubiquitous concern. Numerous studies have focused on epidemiological and health policy dynamics essentially underestimating the determining factors that shape people’s choices and cues to health care service uptake. The study sought to evaluate the knowledge, attitude and health seeking behavior towards breast cancer and its screening in a quest to explain why women present for prognosis and treatment when symptomatic pointers are in advanced stages, impeding primary prevention strategies. Methods Eight focus groups (6–10 members per group) and four key informant interviews were conducted among adult participants from rural and urban settings. Sessions were audio-recorded and transcribed. A thematic analysis of the data was based on the concepts of the health belief model. Data analysis was conducted using NVIVO10. Results Most women perceived breast cancer as a fatal disease and conveyed fear of having early screening. Rural women preferred self-prescribed medications and the use of alternative medicine for long periods before presenting for professional care on suspicion that the lump is cancerous. Accessibility to equipped health facilities, lack of information to establish effective follow-up treatment and low-income status were underscored as their major health seeking behavior barriers whereas, urban women identified marital status as their main barrier. Key informant interviews revealed that health communication programs emphasized more on communicable diseases. This could in part explain why there is a high rate of misconception and suspicion about breast cancer among rural and urban women in the study setting. Conclusions Creating breast cancer awareness alongside clear guidelines on accessing screening and treatment infrastructure is critical. It was evident, a diagnosis of breast cancer or lump brings unexpected confrontation with mortality; fear, pain, cultural barriers, emotional and financial distress. Without clear referral channels to enable those with suspicious lumps or early stage disease to get prompt diagnosis and treatment, then well-meaning awareness will not necessarily contribute to reducing morbidity and mortality. Electronic supplementary material The online version of this article (10.1186/s12905-018-0571-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Joyce Kisiangani
- The Aquaya Institute, Nairobi, 00505, Kenya.,School of Public Health, Department of Epidemiology and disease control, Moi University, P.O. Box 3900, Eldoret, Kenya
| | - Joyce Baliddawa
- School of Public Health, Department of Epidemiology and disease control, Moi University, P.O. Box 3900, Eldoret, Kenya
| | - Pamela Marinda
- Department of Food Science and Nutrition, School of Agricultural Sciences, The University of Zambia, Lusaka, Zambia
| | - Hillary Mabeya
- Gynocare Fistula Centre, Eldoret Hospital Lane, P.O. BOX 2326-30100, Eldoret, Kenya
| | - Joseph K Choge
- University of Kabianga, P.O. Box 2030-20200, Kericho, Kenya
| | | | - Christopher Khayeka-Wandabwa
- School of Pharmaceutical Science and Technology (SPST), Health Science Platform, Tianjin University, 92 Weijin road, Nankai District, Tianjin, 300072, People's Republic of China. .,African Population and Health Research Center (APHRC), P .O. Box 10787-00100, Nairobi, Kenya.
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16
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Asiki G, Shao S, Wainana C, Khayeka-Wandabwa C, Haregu TN, Juma PA, Mohammed S, Wambui D, Gong E, Yan LL, Kyobutungi C. Policy environment for prevention, control and management of cardiovascular diseases in primary health care in Kenya. BMC Health Serv Res 2018; 18:344. [PMID: 29743083 PMCID: PMC5944159 DOI: 10.1186/s12913-018-3152-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Accepted: 04/25/2018] [Indexed: 11/11/2022] Open
Abstract
Background In Kenya, cardiovascular diseases (CVDs) accounted for more than 10% of total deaths and 4% of total Disability-Adjusted Life Years (DALYs) in 2015 with a steady increase over the past decade. The main objective of this paper was to review the existing policies and their content in relation to prevention, control and management of CVDs at primary health care (PHC) level in Kenya. Methods A targeted document search in Google engine using keywords “Kenya national policy on cardiovascular diseases” and “Kenya national policy on non-communicable diseases (NCDs)” was conducted in addition to key informant interviews with Kenyan policy makers. Relevant regional and international policy documents were also included. The contents of documents identified were reviewed to assess how well they aligned with global health policies on CVD prevention, control and management. Thematic content analysis of the key informant interviews was also conducted to supplement the document reviews. Results A total of 17 documents were reviewed and three key informants interviewed. Besides the Tobacco Control Act (2007), all policy documents for CVD prevention, control and management were developed after 2013. The national policies were preceded by global initiatives and guidelines and were similar in content with the global policies. The Kenya health policy (2014–2030), The Kenya Health Sector Strategic and Investment Plan (2014–2018) and the Kenya National Strategy for the Prevention and Control of Non-communicable diseases (2015–2020) had strategies on NCDs including CVDs. Other policy documents for behavioral risk factors (The Tobacco Control Act 2007, Alcoholic Drinks Control (Licensing) Regulations (2010)) were available. The National Nutrition Action Plan (2012–2017) was available as a draft. Although Kenya has a tiered health care system comprising primary healthcare, integration of CVD prevention and control at PHC level was not explicitly mentioned in the policy documents. Conclusion This review revealed important gaps in the policy environment for prevention, control and management of CVDs in PHC settings in Kenya. There is need to continuously engage the ministry of health and other sectors to prioritize inclusion of CVD services in PHC. Electronic supplementary material The online version of this article (10.1186/s12913-018-3152-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Gershim Asiki
- African Population and Health Research Center, P.O Box 10787-00100, Nairobi, Kenya. .,Karolinska Institutet, Department of Women's and Children's Health, Stockholm, Sweden.
| | - Shuai Shao
- African Population and Health Research Center, P.O Box 10787-00100, Nairobi, Kenya.,ACCESS Health International, Shanghai, China.,Global Health Research Center, Duke Kunshan University, Kunshan, China
| | - Carol Wainana
- African Population and Health Research Center, P.O Box 10787-00100, Nairobi, Kenya
| | - Christopher Khayeka-Wandabwa
- African Population and Health Research Center, P.O Box 10787-00100, Nairobi, Kenya.,School of Pharmaceutical Science and Technology, Health Science Platform, Tianjin University, Tianjin, 300072, China
| | - Tilahun N Haregu
- African Population and Health Research Center, P.O Box 10787-00100, Nairobi, Kenya
| | - Pamela A Juma
- African Population and Health Research Center, P.O Box 10787-00100, Nairobi, Kenya
| | - Shukri Mohammed
- African Population and Health Research Center, P.O Box 10787-00100, Nairobi, Kenya
| | - David Wambui
- African Population and Health Research Center, P.O Box 10787-00100, Nairobi, Kenya
| | - Enying Gong
- Global Health Research Center, Duke Kunshan University, Kunshan, China
| | - Lijing L Yan
- Global Health Research Center, Duke Kunshan University, Kunshan, China.,Duke Global Health Institute, Duke University, Durham, NC, USA
| | - Catherine Kyobutungi
- African Population and Health Research Center, P.O Box 10787-00100, Nairobi, Kenya
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Ali SA, Soo C, Agongo G, Alberts M, Amenga-Etego L, Boua RP, Choudhury A, Crowther NJ, Depuur C, Gómez-Olivé FX, Guiraud I, Haregu TN, Hazelhurst S, Kahn K, Khayeka-Wandabwa C, Kyobutungi C, Lombard Z, Mashinya F, Micklesfield L, Mohamed SF, Mukomana F, Nakanabo-Diallo S, Natama HM, Ngomi N, Nonterah EA, Norris SA, Oduro AR, Somé AM, Sorgho H, Tindana P, Tinto H, Tollman S, Twine R, Wade A, Sankoh O, Ramsay M. Genomic and environmental risk factors for cardiometabolic diseases in Africa: methods used for Phase 1 of the AWI-Gen population cross-sectional study. Glob Health Action 2018; 11:1507133. [PMID: 30259792 PMCID: PMC6161608 DOI: 10.1080/16549716.2018.1507133] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Accepted: 07/12/2018] [Indexed: 01/20/2023] Open
Abstract
There is an alarming tide of cardiovascular and metabolic disease (CMD) sweeping across Africa. This may be a result of an increasingly urbanized lifestyle characterized by the growing consumption of processed and calorie-dense food, combined with physical inactivity and more sedentary behaviour. While the link between lifestyle and public health has been extensively studied in Caucasian and African American populations, few studies have been conducted in Africa. This paper describes the detailed methods for Phase 1 of the AWI-Gen study that were used to capture phenotype data and assess the associated risk factors and end points for CMD in persons over the age of 40 years in sub-Saharan Africa (SSA). We developed a population-based cross-sectional study of disease burden and phenotype in Africans, across six centres in SSA. These centres are in West Africa (Nanoro, Burkina Faso, and Navrongo, Ghana), in East Africa (Nairobi, Kenya) and in South Africa (Agincourt, Dikgale and Soweto). A total of 10,702 individuals between the ages of 40 and 60 years were recruited into the study across the six centres, plus an additional 1021 participants over the age of 60 years from the Agincourt centre. We collected socio-demographic, anthropometric, medical history, diet, physical activity, fat distribution and alcohol/tobacco consumption data from participants. Blood samples were collected for disease-related biomarker assays, and genomic DNA extraction for genome-wide association studies. Urine samples were collected to assess kidney function. The study provides base-line data for the development of a series of cohorts with a second wave of data collection in Phase 2 of the study. These data will provide valuable insights into the genetic and environmental influences on CMD on the African continent.
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Affiliation(s)
- Stuart A. Ali
- Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Cassandra Soo
- Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Faculty of Health Sciences University of the Witwatersrand, Division of Human Genetics, National Health Laboratory Service and School of Pathology, Johannesburg, South Africa
| | - Godfred Agongo
- Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Navrongo Health Research Centre, Navrongo, Ghana
| | - Marianne Alberts
- Department of Pathology and Medical Science, School of Health Care Sciences, Faculty of Health Sciences, University of Limpopo, Polokwane, South Africa
| | | | - Romuald P. Boua
- Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Faculty of Health Sciences University of the Witwatersrand, Division of Human Genetics, National Health Laboratory Service and School of Pathology, Johannesburg, South Africa
- Clinical Research Unit of Nanoro, Institut de Recherche en Sciences de la Sante, Nanoro, Burkina Faso
| | - Ananyo Choudhury
- Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Nigel J. Crowther
- Department of Chemical Pathology, National Health Laboratory Service, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | | | - F. Xavier Gómez-Olivé
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Issa Guiraud
- Clinical Research Unit of Nanoro, Institut de Recherche en Sciences de la Sante, Nanoro, Burkina Faso
| | | | - Scott Hazelhurst
- Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- School of Electrical & Information Engineering, University of the Witwatersrand, Johannesburg, South Africa
| | - Kathleen Kahn
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- INDEPTH Network, Accra, Ghana
| | | | | | - Zané Lombard
- Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Faculty of Health Sciences University of the Witwatersrand, Division of Human Genetics, National Health Laboratory Service and School of Pathology, Johannesburg, South Africa
| | - Felistas Mashinya
- Department of Pathology and Medical Science, School of Health Care Sciences, Faculty of Health Sciences, University of Limpopo, Polokwane, South Africa
| | - Lisa Micklesfield
- MRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | | | - Freedom Mukomana
- Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Seydou Nakanabo-Diallo
- Clinical Research Unit of Nanoro, Institut de Recherche en Sciences de la Sante, Nanoro, Burkina Faso
| | - Hamtandi M. Natama
- Clinical Research Unit of Nanoro, Institut de Recherche en Sciences de la Sante, Nanoro, Burkina Faso
| | - Nicholas Ngomi
- African Population and Health Research Center, Nairobi, Kenya
| | - Engelbert A. Nonterah
- Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Navrongo Health Research Centre, Navrongo, Ghana
| | - Shane A. Norris
- MRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | | | - Athanase M. Somé
- Clinical Research Unit of Nanoro, Institut de Recherche en Sciences de la Sante, Nanoro, Burkina Faso
| | - Hermann Sorgho
- Clinical Research Unit of Nanoro, Institut de Recherche en Sciences de la Sante, Nanoro, Burkina Faso
| | | | - Halidou Tinto
- Clinical Research Unit of Nanoro, Institut de Recherche en Sciences de la Sante, Nanoro, Burkina Faso
| | - Stephen Tollman
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- INDEPTH Network, Accra, Ghana
| | - Rhian Twine
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Alisha Wade
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Osman Sankoh
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- INDEPTH Network, Accra, Ghana
- Statistics Sierra Leone, Tower Hill, Freetown, Sierra Leone
- Department of Community Medicine, College of Medicine and Allied Health Sciences,University of Sierra Leone, Freetown, Sierra Leone
| | - Michèle Ramsay
- Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Faculty of Health Sciences University of the Witwatersrand, Division of Human Genetics, National Health Laboratory Service and School of Pathology, Johannesburg, South Africa
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18
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Marango SN, Khayeka-Wandabwa C, Makwali JA, Jumba BN, Choge JK, Adino EO, Anjili CO. Experimental therapeutic assays of Tephrosia vogelii against Leishmania major infection in murine model: in vitro and in vivo. BMC Res Notes 2017; 10:698. [PMID: 29208030 PMCID: PMC5718069 DOI: 10.1186/s13104-017-3022-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Accepted: 11/29/2017] [Indexed: 12/19/2022] Open
Abstract
Background Conventional targeted leishmanicidal chemotherapy has persistently remained prohibitive for most economically deprived communities due to costs, associated time to accessing health services and duration for successful treatment programme. Alternatives are bound to be incorporated in rational management of leishmaniasis by choice or default due to accessibility and cultural beliefs. Therefore, there is need to rigorously investigate and appraise the activity of medicinal compounds that may have anti-leishmanicidal activity especially in the context of products that are already being utilized by the populations for other ailments but have limited information on their therapeutic value and possible cytoxicity. Hence, the study examined both in vivo and in vitro response of L. major infection to Tephrosia vogelii extracts in BALB/c mice as the mouse model. Methods A comparative study design was applied for the in vivo and in vitro assays of the extract with Pentostam (GlaxoSmithKline, UK) and Amphotericin B [Fungizone™, X-Gen Pharmaceuticals (US)] as standard drugs. Results In BALB/c mice where the chemotherapeutic extract was administered intraperitoneally, there was significantly (p < 0.05) larger reduction in lesion size and optimal control of parasite burden than those treated orally. However, standard drugs showed better activity. Tephrosia vogelii had 50% inhibitory concentration (IC50) and IC90 of 12 and 68.5 μg/ml respectively, while the standard drugs had IC50 and IC90 of 5.5 and 18 μg/ml for Pentostam and 7.8 and 25.5 μg/ml for Amphotericin B in that order. In the amastigote assay, the infection rates decreased with increase in chemotherapeutic concentration. The multiplication indices for L. major amastigotes in macrophages treated with 200 µg/ml of the standard drugs and extract were significantly different (p < 0.05). 200 µg/ml of T. vogelii extract showed a multiplication index of 20.57, 5.65% for Amphotericin B and 9.56% for Pentostam. There was also significant difference (p < 0.05) in levels of Nitric oxide produced in the macrophages. Conclusions The findings demonstrated that T. vogelii extract has anti-leishmanial activity and further assays should be done to ascertain the active compounds responsible for anti-leishmanial activity.
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Affiliation(s)
- Sylvia Naliaka Marango
- Department of Biological Science (Parasitology), University of Eldoret, P.O Box 1125, Eldoret, 30100, Kenya
| | - Christopher Khayeka-Wandabwa
- School of Pharmaceutical Science and Technology (SPST), Health Sciences Platform, Tianjin University, Tianjin, 300072, China. .,African Population and Health Research Center (APHRC), P.O. Box 10787, Nairobi, 00100, Kenya. .,Centre for Biotechnology Research and Development (CBRD), Kenya Medical Research Institute (KEMRI), P.O Box 54840, Nairobi, 00200, Kenya.
| | - Judith Alice Makwali
- Department of Biological Science (Parasitology), University of Eldoret, P.O Box 1125, Eldoret, 30100, Kenya
| | - Bernard Ngoitsi Jumba
- Department of Biological Science (Parasitology), University of Eldoret, P.O Box 1125, Eldoret, 30100, Kenya.,Applied Science Department, Sigalagala National Polytechnic, Kakamega, Kenya.,Department of Medical Laboratory Sciences, MasindeMuliro University of Science and Technology, Kakamega, Kenya
| | - Joseph K Choge
- University of Kabianga, P.O. Box 2030, Kericho, 20200, Kenya
| | | | - Christopher O Anjili
- Centre for Biotechnology Research and Development (CBRD), Kenya Medical Research Institute (KEMRI), P.O Box 54840, Nairobi, 00200, Kenya
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Hassan J, Wangai L, Borus P, Khayeka-Wandabwa C, Karani LW, Kithinji M, Kiptoo M. Vaccine-related poliovirus shedding in trivalent polio vaccine and human immunodeficiency virus status: analysis from under five children. BMC Res Notes 2017; 10:555. [PMID: 29100529 PMCID: PMC5670520 DOI: 10.1186/s13104-017-2843-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Accepted: 10/23/2017] [Indexed: 11/10/2022] Open
Abstract
Background Poliomyelitis is an acute viral infection caused by poliovirus and transmitted via the fecal–oral route. The causative agent is one of the three serotypes of poliovirus (serotypes 1, 2, 3) that differ slightly in capsid protein. Prolonged vaccine-related poliovirus shedding in human immunodeficiency virus (HIV) positive individuals has been linked to possible reservoir for reintroduction of polioviruses after eradication. The study therefore aimed at estimating the duration for vaccine-related poliovirus shedding among potentially and HIV-infected persons. Methods Poliovirus excretion was studied following vaccination of children aged ≤ 59 month per human immunodeficiency virus status after national immunization days. Their medical records were reviewed to identify the child’s HIV status, demographic and immunization data. Sequential stool samples were collected at site 2nd, 4th and 8th week after trivalent oral poliovirus vaccine (tOPV) was administered. To isolate suspected polioviruses and non-polio enteroviruses, characterize poliovirus subtypes by intratypic differentiation and Sabin vaccine derived poliovirus, real time polymerase chain reaction was applied. Shedding for ≥ 24 weeks was defined as long-term persistence. Results The mean age of the study population was 28.6 months, while the median age was 24 months. Of the children recruited, majority were in the 25–48 months (n = 12; 46.2%) age category. All the HIV-positive children (n = 10) had mild symptomatic HIV status and did shed vaccine-related polioviruses between weeks 2 and 4 respectively. No participant shed polioviruses for ≥ 6 weeks. Conclusions It was evident mildly symptomatic HIV+ children sustain the capacity to clear vaccine-related poliovirus. The oral poliovirus vaccine-2 (Sabin like) that was detected in one HIV-infected child’s stool 6 weeks after the national immunization days was predominantly non revertant. There was no evident prolonged poliovirus shedding among the participants enlisted in the present study. High powered studies are desired to further corroborate these findings.
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Affiliation(s)
- Joanne Hassan
- Institute of Tropical Medicine and Infectious Diseases (ITROMID), Jomo Kenyatta University of Agriculture and Technology (JKUAT), Juja, Kenya. .,Kenya Medical Research Institute (KEMRI), P.O. Box 54628-00200, Nairobi, Kenya.
| | | | - Peter Borus
- World Health Organization (WHO), Nairobi, Kenya
| | - Christopher Khayeka-Wandabwa
- Health Sciences Platform, School of Pharmaceutical Science and Technology (SPST), Tianjin University, 92 Weijin road, Nankai District, Tianjin, 300072, People's Republic of China. .,African Population and Health Research Center (APHRC), Nairobi, Kenya.
| | - Lucy Wanja Karani
- Institute of Tropical Medicine and Infectious Diseases (ITROMID), Jomo Kenyatta University of Agriculture and Technology (JKUAT), Juja, Kenya
| | | | - Michael Kiptoo
- Institute of Tropical Medicine and Infectious Diseases (ITROMID), Jomo Kenyatta University of Agriculture and Technology (JKUAT), Juja, Kenya.,South Eastern Kenya University (SEKU), Kwa Vonza, Kenya
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20
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Tambo E, Madjou G, Khayeka-Wandabwa C, Olalubi OA, Chengho CF, Khater EIM. Ethical, legal and societal considerations on Zika virus epidemics complications in scaling-up prevention and control strategies. Philos Ethics Humanit Med 2017; 12:3. [PMID: 28841899 PMCID: PMC5574124 DOI: 10.1186/s13010-017-0046-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2016] [Accepted: 08/15/2017] [Indexed: 06/07/2023] Open
Abstract
Much of the fear and uncertainty around Zika epidemics stem from potential association between Zika virus (ZIKV) complications on infected pregnant women and risk of their babies being born with microcephaly and other neurological abnormalities. However, much remains unknown about its mode of transmission, diagnosis and long-term pathogenesis. Worries of these unknowns necessitate the need for effective and efficient psychosocial programs and medical-legal strategies to alleviate and mitigate ZIKV related burdens. In this light, local and global efforts in maintaining fundamental health principles of moral, medical and legal decision-making policies, and interventions to preserve and promote individual and collectiveHuman Rights, autonomy, protection of the most vulnerable, equity, dignity, integrity and beneficence that should not be confused and relegated by compassionate humanitarian assistance and support. This paper explores the potential medical and ethical-legal implications of ZIKV epidemics emergency response packages and strategies alongside optimizing reproductive and mental health policies, programs and best practice measures. Further long-term cross-borders operational research is required in elucidating Zika-related population-based epidemiology, ethical-medical and societal implications in guiding evidence-based local and global ZIKV maternal-child health complications related approaches and interventions. Core programs and interventions including future Zika safe and effective vaccines for global Zika immunization program in most vulnerable and affected countries and worldwide should be prioritized.
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Affiliation(s)
- Ernest Tambo
- Department Biochemistry and Pharmaceutical Sciences, Higher Institute of Health Sciences, Université des Montagnes, Bangangté, Cameroon.
- Africa Disease Intelligence and Surveillance, Communication and Response (Africa DISCoR) Institute, Yaoundé, Cameroon.
- Public Health Pests Laboratory (PHPL) of Jeddah Governorate, Jeddah, Saudi Arabia.
| | - Ghislaine Madjou
- Africa Disease Intelligence and Surveillance, Communication and Response (Africa DISCoR) Institute, Yaoundé, Cameroon
| | - Christopher Khayeka-Wandabwa
- Schoolof Pharmaceutical Science and Technology (SPST), Health Sciences Platform, Tianjin University, 92 Weijin road, Nankai District, Tianjin, 300072, People's Republic of China
- Africa Population and Health Research Center (APHRC), Nairobi, Kenya
| | - Oluwasogo A Olalubi
- Department of Public Health, Kwara State University (KWASU), Malete, Nigeria
| | | | - Emad I M Khater
- Public Health Pests Laboratory (PHPL) of Jeddah Governorate, Jeddah, Saudi Arabia
- Department of Entomology, Faculty of Science, Ain Shams University, Cairo, Egypt
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Marinda P, Chibwe N, Tambo E, Lulanga S, Khayeka-Wandabwa C. Challenges and opportunities of optimal breastfeeding in the context of HIV option B+ guidelines. BMC Public Health 2017; 17:541. [PMID: 28578686 PMCID: PMC5457578 DOI: 10.1186/s12889-017-4457-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2016] [Accepted: 05/21/2017] [Indexed: 11/25/2022] Open
Abstract
Background In 2013, the World Health Organization released a new set of guidelines widely known as Option B+. Prior to that there were guidelines released in 2010. Option B+ recommends lifelong antiretroviral treatment for all pregnant and breastfeeding women living with Human Immunodeficiency Virus. The study aimed at investigating challenges and opportunities in implementing Infant and Young Child Feeding in the context of Prevention of Mother To Child Transmission (PMTCT) guidelines among HIV positive mothers of children aged 0–24 months. The study also examined implications presented by implementing the 2013 PMTCT consolidated guidelines in the transition phase from the 2010 approach in Zambia. Methods A mixed methods approach was employed in the descriptive cross sectional study utilizing semi structured questionnaires and Focused Group Discussions. Further, data was captured from the Health Information Management System. Results During the PMTCT transition, associated needs and challenges in institutionalizing the enhanced guidelines from option A and B to option B+ were observed. Nonetheless, there was a decline in Mother to Child Transmission (MTCT) of HIV rates with an average of 4%. Mothers faced challenges in complying with optimal breastfeeding practices owing to lack of community support systems and breast infections due to poor breast feeding occasioned by infants’ oral health challenges. Moreover, some mothers were hesitant of lifelong ARVs. Health workers faced programmatic and operational challenges such as compromised counseling services. Conclusion Despite the ambitious timelines for PMTCT transition, the need to inculcate new knowledge and vary known practice among mothers and the shift in counseling content for health workers, the consolidated guidelines for PMTCT proved effective. Some mothers were hesitant of lifelong ARVs, rationalizing the debated paradigm that prolonged chemotherapy/polypharmacy may be a future challenge in the success of ART in PMTCT. Conflicting breast feeding practices was a common observation across mothers thus underpinning the need to strongly invigorate Infant and Young Child Feeding information sharing across the continuum of heath care from facility level to community and up to the family; for cultural norms, practices and attitudes enshrined within communities play a vital role in child care.
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Affiliation(s)
- Pamela Marinda
- Department of Food Science and Nutrition, The University of Zambia, School of Agricultural Sciences, Lusaka, Zambia
| | - Nkandu Chibwe
- Department of Food Science and Nutrition, The University of Zambia, School of Agricultural Sciences, Lusaka, Zambia.,Choma District Hospital, Choma, Zambia
| | - Ernest Tambo
- Africa Disease Intelligence and Surveillance, Communication and Response (Africa DISCoR) Foundation, Yaoundé, Cameroon.,Department Biochemistry and Pharmaceutical Sciences, Higher Institute of Health Sciences, Université des Montagnes, Bangangté, Cameroon
| | - Sidney Lulanga
- International University of Management, Faculty of Humanities, HIV/AIDS and Sustainable Development, 21-31 Hercules Street, Private Bag: 14005 Bachbrecht, Windhoek, Namibia
| | - Christopher Khayeka-Wandabwa
- African Population and Health Research Center (APHRC), P.O. Box 10787-00100, Nairobi, Kenya. .,School of Pharmaceutical Science and Technology (SPST), Health Sciences Platform, Tianjin University, 300072, Tianjin, China.
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22
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Etyang AO, Khayeka-Wandabwa C, Kapesa S, Muthumbi E, Odipo E, Wamukoya M, Ngomi N, Haregu T, Kyobutungi C, Tendwa M, Makale J, Macharia A, Cruickshank JK, Smeeth L, Scott JAG, Williams TN. Blood Pressure and Arterial Stiffness in Kenyan Adolescents With α +Thalassemia. J Am Heart Assoc 2017; 6:JAHA.117.005613. [PMID: 28381468 PMCID: PMC5533038 DOI: 10.1161/jaha.117.005613] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Background Recent studies have discovered that α‐globin is expressed in blood vessel walls where it plays a role in regulating vascular tone. We tested the hypothesis that blood pressure (BP) might differ between normal individuals and those with α+thalassemia, in whom the production of α‐globin is reduced. Methods and Results The study was conducted in Nairobi, Kenya, among 938 adolescents aged 11 to 17 years. Twenty‐four‐hour ambulatory BP monitoring and arterial stiffness measurements were performed using an arteriograph device. We genotyped for α+thalassemia by polymerase chain reaction. Complete data for analysis were available for 623 subjects; 223 (36%) were heterozygous (−α/αα) and 47 (8%) were homozygous (−α/−α) for α+thalassemia whereas the remaining 353 (55%) were normal (αα/αα). Mean 24‐hour systolic BP ±SD was 118±12 mm Hg in αα/αα, 117±11 mm Hg in −α/αα, and 118±11 mm Hg in −α/−α subjects, respectively. Mean 24‐hour diastolic BP ±SD in these groups was 64±8, 63±7, and 65±8 mm Hg, respectively. Mean pulse wave velocity (PWV)±SD was 7±0.8, 7±0.8, and 7±0.7 ms−1, respectively. No differences were observed in PWV and any of the 24‐hour ambulatory BP monitoring‐derived measures between those with and without α+thalassemia. Conclusions These data suggest that the presence of α+thalassemia does not affect BP and/or arterial stiffness in Kenyan adolescents.
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Affiliation(s)
- Anthony O Etyang
- KEMRI-Wellcome Trust Research Program, Kilifi, Kenya .,London School of Hygiene and Tropical Medicine, London, United Kingdom
| | | | | | | | - Emily Odipo
- KEMRI-Wellcome Trust Research Program, Kilifi, Kenya
| | | | - Nicholas Ngomi
- African Population and Health Research Centre, Nairobi, Kenya
| | - Tilahun Haregu
- African Population and Health Research Centre, Nairobi, Kenya
| | | | | | | | - Alex Macharia
- KEMRI-Wellcome Trust Research Program, Kilifi, Kenya
| | | | - Liam Smeeth
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - J Anthony G Scott
- KEMRI-Wellcome Trust Research Program, Kilifi, Kenya.,London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Thomas N Williams
- KEMRI-Wellcome Trust Research Program, Kilifi, Kenya.,Imperial College, London, United Kingdom
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Yah CS, Tambo E, Khayeka-Wandabwa C, Ngogang JY. Impact of telemonitoring approaches on integrated HIV and TB diagnosis and treatment interventions in sub-Saharan Africa: a scoping review. Health Promot Perspect 2017; 7:60-65. [PMID: 28326285 PMCID: PMC5350551 DOI: 10.15171/hpp.2017.12] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Accepted: 01/22/2017] [Indexed: 11/09/2022] Open
Abstract
Background: This paper explores telemonitoring/mhealth approaches as a promising real time and contextual strategy in overhauling HIV and TB interventions quality access and uptake, retention,adherence and coverage impact in endemic and prone-epidemic prevention and control in sub-Sahara Africa. Methods: The scoping review method was applied in acknowledged journals indexing platforms including Medline, Embase, Global Health, PubMed, MeSH PsycInfo, Scopus and Google Scholar to identify relevant articles pertaining to telemonitoring as a proxy surrogate method in reinforcing sustainability of HIV/TB prevention/treatment interventions in sub-Saharan Africa. Full papers were assessed and those selected that fosters evidence on telemonitoring/mhealth diagnosis, treatment approaches and strategies in HIV and TB prevention and control were synthesized and analyzed. Results: We found telemonitoring/mhealth approach as a more efficient and sustained proxy in HIV and TB risk reduction strategies for early diagnosis and prompt quality clinical outcomes. It can significantly contribute to decreasing health systems/patients cost, long waiting time in clinics, hospital visits, travels and time off/on from work. Improved integrated HIV and TB telemonitoring systems sustainability hold great promise in health systems strengthening including patient centered early diagnosis and care delivery systems, uptake and retention to medications/services and improving patients' survival and quality of life. Conclusion: Telemonitoring/mhealth (electronic phone text/video/materials messaging)acceptability, access and uptake are crucial in monitoring and improving uptake, retention,adherence and coverage in both local and national integrated HIV and TB programs and interventions. Moreover, telemonitoring is crucial in patient-providers-health professional partnership, real-time quality care and service delivery, antiretroviral and anti-tuberculous drugs improvement, susceptibility monitoring and prescription choice, reinforcing cost effective HIV and TB integrated therapy model and survival rate.
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Affiliation(s)
- Clarence S Yah
- WITS Reproductive & HIV Institute, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Department of Biochemistry & Microbiology, Nelson Mandela Metropolitan University, South Africa
| | - Ernest Tambo
- Department Biochemistry and Pharmaceutical Sciences, Higher Institute of Health Sciences, Université des Montagnes, Bangangté, Cameroon; Africa Disease Intelligence and Surveillance, Communication and Response (Africa DISCoR) Institute, Yaoundé, Cameroon
| | | | - Jeanne Y Ngogang
- Department Biochemistry and Pharmaceutical Sciences, Higher Institute of Health Sciences, Université des Montagnes, Bangangté, Cameroon
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Tambo E, Khayeka-Wandabwa C, Olalubi OA, Adedeji AA, Ngogang JY, Khater EI. Addressing knowledge gaps in molecular, sero-surveillance and monitoring approaches on Zika epidemics and other arbovirus co-infections: A structured review. Parasite Epidemiol Control 2017; 2:50-60. [PMID: 29774281 PMCID: PMC5952677 DOI: 10.1016/j.parepi.2017.01.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Revised: 01/29/2017] [Accepted: 01/29/2017] [Indexed: 01/02/2023] Open
Abstract
Globalization, with consequent increased travel and trade, rapid urbanization and growing weather variation events due to climate change has contributed to the recent unprecedented Zika virus (ZIKV) pandemic. This has emphasized the pressing need for local, national, regional and global community collaborative proactiveness, leadership and financial investment resilience in research and development. This paper addresses the potential knowledge gaps and impact of early detection and monitoring approaches on ZIKV epidemics and related arboviral infections steered towards effective prevention and smart response strategies. We advocate for the development and validation of robust field and point of care diagnostic tools that are more sensitive, specific and cost effective for use in ZIKV epidemics and routine pathophysiology surveillance and monitoring systems as an imperative avenue in understanding Zika-related and other arbovirus trends and apply genomic and proteomic characterisation approaches in guiding annotation efforts in order to design and implement public health burden mitigation and adaptation strategies.
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Affiliation(s)
- Ernest Tambo
- Department Biochemistry, Higher Institute of Health Sciences, Universite des Montagnes, Bangangté, Cameroon.,Africa Disease Intelligence and Surveillance, Communication and Response (Africa DISCoR) Foundation, Yaoundé, Cameroon
| | - Christopher Khayeka-Wandabwa
- African Population and Health Research Center (APHRC), Nairobi, Kenya.,Health Sciences Platform, School of Pharmaceutical Science and Technology (SPST), Tianjin University, China
| | - Oluwasogo A Olalubi
- Department of Public Health, Kwara State University (KWASU), Malete, Nigeria
| | - Ahmed A Adedeji
- Department of Pharmacology, Faculty of Health Sciences, Habib Medical School, Islamic University, Kibuuli, Kampala, Uganda
| | - Jeanne Y Ngogang
- Department Biochemistry, Higher Institute of Health Sciences, Universite des Montagnes, Bangangté, Cameroon.,Service de Biochimie, Centre Hospitalier Universitaire (CHU), Yaoundé, Cameroon
| | - Emad Im Khater
- Medical Entomology Department, Faculty of Science, Ain Shams University, Cairo, Egypt.,Public Health Pests Laboratory of Jeddah Governorate, Jeddah, Saudi Arabia
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Mbaika S, Lutomiah J, Chepkorir E, Mulwa F, Khayeka-Wandabwa C, Tigoi C, Oyoo-Okoth E, Mutisya J, Ng'ang'a Z, Sang R. Vector competence of Aedes aegypti in transmitting Chikungunya virus: effects and implications of extrinsic incubation temperature on dissemination and infection rates. Virol J 2016; 13:114. [PMID: 27357190 PMCID: PMC4928303 DOI: 10.1186/s12985-016-0566-7] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2016] [Accepted: 06/20/2016] [Indexed: 11/10/2022] Open
Abstract
Background Aedes aegypti is a competent arthropod vector of chikungunya virus (CHIKV). The rate at which the virus disseminate in the vector is limited by temperature of their environment which can be an important determinant of geographical and seasonal limits to transmission by the arthropods in the tropics. This study investigated the vector competence of Ae. aegypti for CHIKV at ambient temperature of 32 and 26 °C (Coastal and Western Kenya respectively) reared at Extrinsic Incubation Temperature (EIT) of 32 and 26 °C that resembles those in the two regions. Methods Ae. aegypti eggs were collected from coastal and Western Kenya, hatched in the insectary and reared to F1 generation. Four-day old mosquitoes were exposed to CHIKV through a membrane feeding. They were then incubated in temperatures mimicking the mean annual temperatures for Trans-Nzoia (26 °C) and Lamu (32 °C). After every 7, 10 and 13 days post infection (DPI); one third of exposed mosquitoes were sampled and assayed for virus infection and dissemination. Results The midgut infection rates (MIR) of Ae. aegypti sampled from Coastal Region was significantly (p < 0.05) higher than those sampled from Western Kenya, with no statistical differences observed for the coastal Ae. aegypti at EIT 26 and at 32 °C. The MIR of Ae. aegypti from the Western Region was significantly (p < 0.05) affected by the EIT, with mosquito reared at EIT 32 °C exhibiting higher MIR than those reared at EIT 26 °C. There was a significant (p < 0.05) interactive effects of the region, EIT and DPI on MIR. The disseminated infection rates for the CHIKV in Ae. aegypti in the legs (DIR-L) was higher in mosquitoes sampled from Coast regardless of the EIT while those from Western Kenya, dissemination rates were significantly higher at higher EIT of 32 °C. Conclusions Vector competence was higher in mosquito populations reared under high temperatures which weakens the midgut infection barrier. Hence, suggesting Lamu population is more susceptible to CHIKV therefore having a weaker mid gut infection barrier than the Trans Nzoia population. These underscores importance of examining the course of infection at various ambient temperatures and EIT between regions mosquito populations. Electronic supplementary material The online version of this article (doi:10.1186/s12985-016-0566-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Sophiah Mbaika
- Institute of Tropical Medicine and Infectious Diseases (ITROMID), Jomo Kenyatta University of Agriculture and Technology (JKUAT), P.O. Box 62000-00200, Nairobi, Kenya.
| | - Joel Lutomiah
- Centre for Virus Research (CVR), Kenya Medical Research Institute (KEMRI), P.O. Box 54628-00200, Nairobi, Kenya
| | - Edith Chepkorir
- International Centre of Insect Physiology and Ecology (ICIPE), P.O. Box 30772-00100, Nairobi, Kenya
| | - Francis Mulwa
- International Centre of Insect Physiology and Ecology (ICIPE), P.O. Box 30772-00100, Nairobi, Kenya
| | | | - Caroline Tigoi
- International Centre of Insect Physiology and Ecology (ICIPE), P.O. Box 30772-00100, Nairobi, Kenya
| | - Elijah Oyoo-Okoth
- Department of Natural Resource, School Natural Resources and Environmental Studies, Karatina University, P.O Box 1957-10101, Karatina, Kenya
| | - James Mutisya
- Centre for Virus Research (CVR), Kenya Medical Research Institute (KEMRI), P.O. Box 54628-00200, Nairobi, Kenya
| | - Zipporah Ng'ang'a
- Institute of Tropical Medicine and Infectious Diseases (ITROMID), Jomo Kenyatta University of Agriculture and Technology (JKUAT), P.O. Box 62000-00200, Nairobi, Kenya
| | - Rosemary Sang
- Centre for Virus Research (CVR), Kenya Medical Research Institute (KEMRI), P.O. Box 54628-00200, Nairobi, Kenya.,International Centre of Insect Physiology and Ecology (ICIPE), P.O. Box 30772-00100, Nairobi, Kenya
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Tambo E, Madjou G, Khayeka-Wandabwa C, Tekwu EN, Olalubi OA, Midzi N, Bengyella L, Adedeji AA, Ngogang JY. Can free open access resources strengthen knowledge-based emerging public health priorities, policies and programs in Africa? F1000Res 2016; 5:853. [PMID: 27508058 PMCID: PMC4955019 DOI: 10.12688/f1000research.8662.1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/27/2016] [Indexed: 11/20/2022] Open
Abstract
Tackling emerging epidemics and infectious diseases burden in Africa requires increasing unrestricted open access and free use or reuse of regional and global policies reforms as well as timely communication capabilities and strategies. Promoting, scaling up data and information sharing between African researchers and international partners are of vital importance in accelerating open access at no cost. Free Open Access (FOA) health data and information acceptability, uptake tactics and sustainable mechanisms are urgently needed. These are critical in establishing real time and effective knowledge or evidence-based translation, proven and validated approaches, strategies and tools to strengthen and revamp health systems. As such, early and timely access to needed emerging public health information is meant to be instrumental and valuable for policy-makers, implementers, care providers, researchers, health-related institutions and stakeholders including populations when guiding health financing, and planning contextual programs.
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Affiliation(s)
- Ernest Tambo
- Department of Biochemistry and Pharmaceutical Sciences, Universite des Montagnes, Bangangté, Cameroon; Africa Disease Intelligence and Surveillance, Communication and Response (Africa DISCoR) Foundation, Yaoundé, Cameroon
| | - Ghislaine Madjou
- Africa Disease Intelligence and Surveillance, Communication and Response (Africa DISCoR) Foundation, Yaoundé, Cameroon
| | | | - Emmanuel N Tekwu
- Noguchi Memorial Institute for Medical Research (NMIMR), College of Health Science, University of Ghana, Greater Accra Region, Ghana
| | - Oluwasogo A Olalubi
- Department of Public Health, Kwara State University (KWASU), Malete, Kwara State, Nigeria
| | - Nicolas Midzi
- National Institute of Health Research, Harare, Zimbabwe
| | - Louis Bengyella
- Department of Biomedical Sciences, School of Basic and Biomedical Sciences, University of Health and Allied Sciences (UHAS), Ho, Volta Region, Ghana
| | - Ahmed A Adedeji
- Department of Pharmacology and Therapeutics, Kampala International University, Kansaga, Kampala, Uganda
| | - Jeanne Y Ngogang
- Service de Biochimie, Centre Hospitalier Universitaire (CHU), Yaoundé, Cameroon
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Kijogi CM, Khayeka-Wandabwa C, Sasaki K, Tanaka Y, Kurosu H, Matsunaga H, Ueda H. Subcellular dissemination of prothymosin alpha at normal physiology: immunohistochemical vis-a-vis western blotting perspective. BMC Physiol 2016; 16:2. [PMID: 26932824 PMCID: PMC4774093 DOI: 10.1186/s12899-016-0021-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/22/2015] [Accepted: 02/16/2016] [Indexed: 11/10/2022]
Abstract
BACKGROUND The cell type, cell status and specific localization of Prothymosin α (PTMA) within cells seemingly determine its function. PTMA undergoes 2 types of protease proteolytic modifications that are useful in elucidating its interactions with other molecules; a factor that typifies its roles. Preferably a nuclear protein, PTMA has been shown to function in the cytoplasm and extracellularly with much evidence leaning on pathognomonic status. As such, determination of its cellular distribution under normal physiological context while utilizing varied techniques is key to illuminating prospective validation of its distinct functions in different tissues. Differential distribution insights at normal physiology would also portent better basis for further clarification of its interactions and proteolytic modifications under pathological conditions like numerous cancer, ischemic stroke and immunomodulation. We therefore raised an antibody against the C terminal of PTMA to use in tandem with available antibody against the N terminal in a murine model to explicate the differences in its distribution in brain cell types and major peripheral organs through western blotting and immunohistochemical approaches. RESULTS The newly generated antibody was applied against the N-terminal antibody to distinguish truncated versions of PTMA or deduce possible masking of the protein by other interacting molecules. Western blot analysis indicated presence of a truncated form of the protein only in the thymus, while immunohistochemical analysis showed that in brain hippocampus the full-length PTMA was stained prominently in the nucleus whereas in the stomach full-length PTMA staining was not observed in the nucleus but in the cytoplasm. CONCLUSION Truncated PTMA could not be detected by western blotting when both antibodies were applied in all tissues examined except the thymus. However, immunohistochemistry revealed differential staining by these antibodies suggesting possible masking of epitopes by interacting molecules. The differential localization patterns observed in the context of nucleic versus cytoplasmic presence as well as punctate versus diffuse pattern in tissues and cell types, warrant further investigations as to the forms of PTMA interacting partners.
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Affiliation(s)
- Caroline Mwendwa Kijogi
- Department of Molecular Microbiology and Immunology, Division of Immunology, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan. .,Institute of Tropical Medicine and Infectious Diseases-KEMRI (ITROMID-KEMRI), Nairobi, Kenya.
| | - Christopher Khayeka-Wandabwa
- African Population and Health Research Center (APHRC), P. O. Box 10787-00100, Nairobi, Kenya. .,Institute of Tropical Medicine and Infectious Diseases-KEMRI (ITROMID-KEMRI), Nairobi, Kenya.
| | - Keita Sasaki
- Department of Pharmacology and Therapeutic Innovation, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan.
| | - Yoshimasa Tanaka
- Department of Pharmacology and Therapeutic Innovation, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan.
| | - Hiroshi Kurosu
- Department of Pharmacology and Therapeutic Innovation, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan.
| | - Hayato Matsunaga
- Department of Pharmacology and Therapeutic Innovation, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan.
| | - Hiroshi Ueda
- Department of Pharmacology and Therapeutic Innovation, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan.
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Haregu TN, Oti S, Ngomi N, Khayeka-Wandabwa C, Egondi T, Kyobutungi C. Interlinkage among cardio-metabolic disease markers in an urban poor setting in Nairobi, Kenya. Glob Health Action 2016; 9:30626. [PMID: 26864740 PMCID: PMC4749862 DOI: 10.3402/gha.v9.30626] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Revised: 01/18/2016] [Accepted: 01/19/2016] [Indexed: 12/21/2022] Open
Abstract
Introduction The main cardio-metabolic diseases – mostly cardiovascular diseases such as stroke and ischemic heart disease – share common clinical markers such as raised blood pressure and blood glucose. The pathways of development of many of these conditions are also interlinked. In this regard, a higher level of co-occurrence of the main cardio-metabolic disease markers is expected. Evidence about the patterns of occurrence of cardio-metabolic markers and their interlinkage in the sub-Saharan African setting is inadequate. Objective The goal of the study was to describe the interlinkage among common cardio-metabolic disease markers in an African setting. Design We used data collected in a cross-sectional study from 5,190 study participants as part of cardiovascular disease risk assessment in the urban slums of Nairobi, Kenya. Five commonly used clinical markers of cardio-metabolic conditions were considered in this analysis. These markers were waist circumference, blood pressure, random blood glucose, total blood cholesterol, and triglyceride levels. Patterns of these markers were described using means, standard deviations, and proportions. The associations between the markers were determined using odds ratios. Results The weighted prevalence of central obesity, hypertension, hyperglycemia, hypercholesterolemia, and hypertriglyceridemia were 12.3%, 7.0%, 2.5%, 10.3%, and 17.3%, respectively. Women had a higher prevalence of central obesity and hypercholesterolemia as compared to men. Blood glucose was strongly associated with central obesity, blood pressure, and triglyceride levels, whereas the association between blood glucose and total blood cholesterol was not statistically significant. Conclusions This study shows that most of the common cardio-metabolic markers are interlinked, suggesting a higher probability of comorbidity due to cardio-metabolic conditions and thus the need for integrated approaches.
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Affiliation(s)
| | - Samuel Oti
- African Population and Health Research Center, Nairobi, Kenya.,Department of Global Health, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.,Amsterdam Institute for Global Health and Development, Amsterdam, The Netherlands
| | - Nicholas Ngomi
- African Population and Health Research Center, Nairobi, Kenya
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Jumba BN, Anjili CO, Makwali J, Ingonga J, Nyamao R, Marango S, Choge JK, Khayeka-Wandabwa C. Evaluation of leishmanicidal activity and cytotoxicity of Ricinus communis and Azadirachta indica extracts from western Kenya: in vitro and in vivo assays. BMC Res Notes 2015; 8:650. [PMID: 26541197 PMCID: PMC4635543 DOI: 10.1186/s13104-015-1605-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Accepted: 10/19/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Despite advances to targeted leishmanicidal chemotherapy, defies around severe toxicity, recent emergence of resistant variants and absence of rational vaccine still persist. This necessitates search and/or progressive validation of accessible medicinal remedies including plant based. The study examined both in vivo and in vitro response of L. major infection to combined therapy of Ricinus communis and Azadirachta indica extracts in BALB/c mice as the mouse model. A comparative study design was applied. RESULTS BALB/c mice, treated with combination therapy resulted in significantly (p < 0.05) larger reduction of lesion than those treated with monotherapies. The spleno-somatic index was found to be significantly low with combination therapy than monotherapies. Antiparasitic effect of A. indica and R. communis on amastigote with a 50 % inhibitory concentration (IC50) was of 11.5 and 16.5 µg mL(-1) respectively while combination therapy gave 9.0 µg ml(-1) compared to the standard drugs, Pentostam and amphotericin B which had an IC50 of 6.5 and 4.5 µg ml(-1) respectively. Optimal efficacy of A. indica and R. communis was 72 and 59.5 % respectively, combination therapy gave 88 %, while Pentostam and amphotericin B had 98 and 92 % respectively against amastigotes. Against promastigotes A. indica and R. Communis gave an IC50 of 10.1, 25.5 µg mL(-1) respectively, while combination, 12.2 µg mL(-1) against 4.1 and 5.0 µg ml(-1) for Pentostam and amphotericin B respectively. The optimal efficacy of the compounds against promastigotes was 78.0, 61.5 and 91.2 % (A. indica, R. communis and A. indica + R. communis respectively) against 96.5 and 98 % for Pentostam and amphotericin B respectively. The concentrations at optimal efficacy were significantly different (p < 0.05) among the test compounds. An evaluation of the IC50 values of the combination therapies clearly reveals synergistic effects. CONCLUSION Combination therapy of A. indica and R. communis had best antileishmanial activity than the monotherapies. The active ingredients of both R. communis and A. indica need to be fractionated, and studied further for activity against Leishmania parasites.
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Affiliation(s)
- Bernard N Jumba
- Department of Biological Science (Parasitology), University of Eldoret, P.O Box 1125-30100, Eldoret, Kenya. .,Applied Science Department, Sigalagala National Polytechnic, P. O. Box 2966, Kakamega, Kenya. .,Department of Medical Laboratory Sciences, Masinde Muliro University of Science and Technology, P.O Box 190, Kakamega, 50100, Kenya.
| | - Christopher O Anjili
- Centre for Biotechnology Research and Development (CBRD), Kenya Medical Research Institute (KEMRI), P.O Box 54840-00200, Nairobi, Kenya.
| | - Judith Makwali
- Department of Biological Science (Parasitology), University of Eldoret, P.O Box 1125-30100, Eldoret, Kenya.
| | - Johnstone Ingonga
- Centre for Biotechnology Research and Development (CBRD), Kenya Medical Research Institute (KEMRI), P.O Box 54840-00200, Nairobi, Kenya.
| | - Rose Nyamao
- Zoology Department, Jomo Kenyatta University of Agriculture and Technology (JKUAT), P.O. Box 62000-00200, Nairobi, Kenya.
| | - Sylvia Marango
- Department of Biological Science (Parasitology), University of Eldoret, P.O Box 1125-30100, Eldoret, Kenya.
| | - Joseph K Choge
- University of Kabianga, P.O. Box 2030-20200, Kericho, Kenya.
| | - Christopher Khayeka-Wandabwa
- Centre for Biotechnology Research and Development (CBRD), Kenya Medical Research Institute (KEMRI), P.O Box 54840-00200, Nairobi, Kenya. .,Institute of Tropical Medicine and Infectious Diseases-KEMRI (ITROMID-KEMRI), Jomo Kenyatta University of Agriculture and Technology (JKUAT), P.O. Box 62000-00200, Nairobi, Kenya. .,African Population and Health Research Center (APHRC), P.O. Box 10787-00100, Nairobi, Kenya.
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Choge JK, Magak NG, Akhwale W, Koech J, Ngeiywa MM, Oyoo-Okoth E, Esamai F, Osano O, Khayeka-Wandabwa C, Kweka EJ. Symptomatic malaria diagnosis overestimate malaria prevalence, but underestimate anaemia burdens in children: results of a follow up study in Kenya. BMC Public Health 2014; 14:332. [PMID: 24712340 PMCID: PMC3996101 DOI: 10.1186/1471-2458-14-332] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2014] [Accepted: 04/04/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The commonly accepted gold standard diagnostic method for detecting malaria is a microscopic reading of Giemsa-stained blood films. However, symptomatic diagnosis remains the basis of therapeutic care for the majority of febrile patients in malaria endemic areas. This study aims to compare the discrepancy in malaria and anaemia burdens between symptomatic diagnosed patients with those diagnosed through the laboratory. METHODS Data were collected from Western Kenya during a follow-up study of 887 children with suspected cases of malaria visiting the health facilities. In the laboratory, blood samples were analysed for malaria parasite and haemoglobin levels. Differences in malaria prevalence between symptomatic diagnosis and laboratory diagnosis were analysed by Chi-square test. Bayesian probabilities were used for the approximation of the malaria and anaemia burdens. Regression analysis was applied to: (1) determine the relationships between haemoglobin levels, and malaria parasite density and (2) relate the prevalence of anaemia and the prevalence of malaria. RESULTS The prevalence of malaria and anaemia ranged from 10% to 34%, being highest during the rainy seasons. The predominant malaria parasite was P. falciparum (92.3%), which occurred in higher density in children aged 2‒5 years. Fever, high temperature, sweating, shivering, vomiting and severe headache symptoms were associated with malaria during presumptive diagnosis. After conducting laboratory diagnosis, lower malaria prevalence was reported among the presumptively diagnosed patients. Surprisingly, there were no attempts to detect anaemia in the same cohort. There was a significant negative correlation between Hb levels and parasite density. We also found a positive correlation between the prevalence of anaemia and the prevalence of malaria after laboratory diagnosis indicating possible co-occurrence of malaria and anaemia. CONCLUSION Symptomatic diagnosis of malaria overestimates malaria prevalence, but underestimates the anaemia burden in children. Good clinical practice dictates that a laboratory should confirm the presence of parasites for all suspected cases of malaria.
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Affiliation(s)
| | | | | | | | | | - Elijah Oyoo-Okoth
- School Natural Resources and Environmental Studies, Karatina University, P,O, Box 1957-10101, Karatina, Kenya.
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Kiige SG, Mutiso JM, Laban LT, Khayeka-Wandabwa C, Anjili CO, Ingonga J, Gicheru MM. F₁ cross-breed between susceptible BALB/c and resistant Swiss mice infected with Leishmania major exhibit an intermediate phenotype for lesion sizes and type 1 cytokines but show low level of total IgG antibodies. Scand J Immunol 2014; 79:283-91. [PMID: 24498914 DOI: 10.1111/sji.12159] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2013] [Accepted: 01/24/2014] [Indexed: 12/01/2022]
Abstract
Our current understanding of the host immune response during leishmaniases largely derives from studies performed in mice due to the intrusive techniques required to study infected human patients. Swiss mice are highly resistant to Leishmania infections in concordance with observed response in humans, while BALB/c mice indicate a high-susceptibility phenotype. Developing a cross-breed between BALB/c and Swiss mice may have important consequences on disease development, immune responses and parasite killing, as yet, response of the cross-breed to Leishmania infection is superficial. The aim of the present study was to determine disease course and immune responses in F₁ cross-breed between BALB/c and Swiss albino mice infected with L. major. Three mice groups were infected intradermally with stationary-phase L. major parasites with parental strains (BALB/c and Swiss albino) as controls. Lesion development was monitored weekly for 8 weeks and monocyte chemotactic protein (MCP-1), macrophage inflammatory protein (MIP-1α), interferon-gamma (IFN-γ) and IgG antibody quantified by enzyme-linked immunosorbent assay. The data were analysed using one-way analysis of variance and Tukey-Kramer test. Results indicated F₁ mice having intermediate lesion sizes, type 1 cytokine levels and footpad parasite loads as compared to the parental strains. However, the F₁ mice had low levels of IgG antibodies and parasite burden in the spleen. (P < 0.05). This study concludes that the F₁ cross-breed between resistant and susceptible mice may be used as a requisite model to study the role of genetics in leishmaniases and perhaps other intracellular parasites.
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Affiliation(s)
- S G Kiige
- Department of Zoological Sciences, Kenyatta University, Nairobi, Kenya
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Ngemu EK, Khayeka-Wandabwa C, Kweka EJ, Choge JK, Anino E, Oyoo-Okoth E. Effectiveness of option B highly active antiretroviral therapy (HAART) prevention of mother-to-child transmission (PMTCT) in pregnant HIV women. BMC Res Notes 2014; 7:52. [PMID: 24447387 PMCID: PMC3898637 DOI: 10.1186/1756-0500-7-52] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2013] [Accepted: 01/15/2014] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Ensuring that no baby is born with HIV is an essential step towards achieving an AIDS-free generation. To achieve this, strategies that decouple links between childbirth and HIV transmission are necessary. Traditional forms of prevention of mother-to-child transmission of HIV (PMTCT), has been recommended. Recognizing the importance and challenges of combination of methods to achieve rapid PMTCT, the World Health Organization (WHO) recommended option B Highly Active Antiretroviral Therapy (HAART) for all HIV-positive pregnant women. This study aimed to evaluate the effectiveness of the HAART in PMTCT. A cohort of HIV-infected pregnant women in Kenya were obtained from the DREAM Center, Nairobi. The study participants underwent adherence counselling and Option B of HAART [Nevirapine(NVP) + Lamivudine + Zidovudine] at the fourth week of gestation followed by an intravenous NVP administration intrapartum and postpartum NVP syrup to the respective infants for six weeks. Absolute pre-HAART and post-HAART CD4 counts and viral loads counts were determined. Comparison of the CD4 counts and viral loads before and after administration of HAART were done using Wilcoxon's Matched Pairs Signed-Ranks Test. FINDINGS The mean absolute CD4 cell counts in mothers after administration of HAART was significantly higher (Z = 15.664, p < 0.001) than before the administration of HAART). Also the viral load of the mothers significantly (Z = 11.324, p < 0.001) reduced following HAART treatment. Following the HAART administration in mothers, up to 90% of children were confirmed to be HIV negative. CONCLUSION Administration of HAART to mothers and children demonstrated an effective mechanism of PMTCT. However, other aspects of HAART such as adherence, costs, mothers behaviour during HAART, and the child feeding programme during the therapy should further be evaluated and ascertained how they can affect the overall efficacy of option B HAART in PMTCT.
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Affiliation(s)
- Erastus K Ngemu
- School of Science, Department of Biochemistry, University of Eldoret, PO Box 1125, Eldoret, Kenya
| | - Christopher Khayeka-Wandabwa
- Institute of Tropical Medicine and Infectious Diseases (ITROMID), Jomo Kenyatta University of Agriculture and Technology (JKUAT), Nairobi, Kenya
| | - Eliningaya J Kweka
- Tropical Pesticides Research Institute, Division of Livestock and Human Diseases Vector Control, Mosquito Section, Ngaramtoni, Off Nairobi road, PO Box 3024, Arusha, Tanzania
| | - Joseph K Choge
- School of Health Sciences, University of Eastern Africa, Baraton, PO Box 2500-30100, Eldoret, Kenya
| | - Edward Anino
- School of Science, Department of Biochemistry, University of Eldoret, PO Box 1125, Eldoret, Kenya
| | - Elijah Oyoo-Okoth
- School Natural Resources and Environmental Studies, Karatina University, PO Box 1957-10101, Karatina, Kenya
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Khayeka-Wandabwa C, Kutima H, Nyambati VCS, Ingonga J, Oyoo-Okoth E, Karani L, Jumba B, Githuku K, Anjili CO. Combination therapy using Pentostam and Praziquantel improves lesion healing and parasite resolution in BALB/c mice co-infected with Leishmania major and Schistosoma mansoni. Parasit Vectors 2013; 6:244. [PMID: 23968249 PMCID: PMC3765423 DOI: 10.1186/1756-3305-6-244] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2013] [Accepted: 08/20/2013] [Indexed: 01/09/2023] Open
Abstract
Background Most natural host populations are exposed to a diversity of parasite communities and co-infection of hosts by multiple parasites is commonplace across a diverse range of systems. Co-infection with Leishmania major and Schistosoma mansoni may have important consequences for disease development, severity and transmission dynamics. Pentavalent antimonials and Praziquantel (PZQ) have been relied upon as a first line of treatment for Leishmania and Schistosoma infections respectively. However, it is not clear how combined therapy with the standard drugs will affect the host and parasite burden in concomitance. The aim of the current study was to determine the efficacy of combined chemotherapy using Pentostam and PZQ in BALB/c mice co-infected with L. major and S. mansoni. Methods The study used BALB/c mice infected with L. major and S. mansoni. A 3 × 4 factorial design with three parasite infection groups (Lm, Sm, Lm + Sm designated as groups infected with L. major, S. mansoni and L. major + S. mansoni, respectively) and four treatment regimens [P, PZQ, P + PZQ and PBS designating Pentostam®(GlaxoSmithKline UK), Praziquantel (Biltricide®, Bayer Ag. Leverkusen, Germany), Pentostam + Praziquantel and Phosphate buffered saline] as factors was applied. In each treatment group, there were 10 mice. Lesion development was monitored for 10 weeks. The parasite load, body weight, weight of the spleen and liver were determined between week 8 and week 10. Results Chemotherapy using the first line of treatment for L. major and S. mansoni reduced the lesion size and parasite loads but did not affect the growth response, spleen and liver. In the co-infected BALB/c mice, the use of Pentostam or PZQ did not result in any appreciable disease management. However, treatment with P + PZQ resulted in significantly (p < 0.05) larger reduction of lesions, net increase in the body weight, no changes in the spleen and liver weight and reduced Leishman-Donovan Units (LDU) and worm counts than BALB/c mice treated with Pentostam or PZQ alone. Conclusions The present study demonstrated that the combined first line of treatment is a more effective strategy in managing co-infection of L. major and S. mansoni in BALB/c mice.
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