http://repository.kemri.go.ke:8080/xmlui/handle/123456789/2 Wed, 26 Aug 2026 02:52:08 GMT 2026-08-26T02:52:08Z http://repository.kemri.go.ke:8080/xmlui/handle/123456789/1732 NTESTINAL PARASITE INFECTIONS IN PRESCHOOL-AGED CHILDREN IN KIBERA INFORMAL SETTLEMENTS IN NAIROBI COUNTY AND ASSOCIATED RISK FACTORS ANIEL NJENGA MUTURI Infections with intestinal parasites are a major public health problem in children in developing countries like Kenya. School-going children are considered more vulnerable to intestinal parasitic infections and thus are included in school-based deworming programmes. Less focus is given to preschool-aged children, and information available on intestinal parasitosis in this age group is both limited and inconsistent. The main objective of this study was to determine the prevalence and intensity of helminth and protozoa infections in preschool-aged children (2 to 5 years old) in Kibera informal settlements in Nairobi County, Kenya, and identify associated risk factors. It was a community-based cross-sectional study conducted between October 2016 and January 2017 among 406 children selected from 7 of 14 villages that comprise the Kibera informal settlements. A structured, interviewer-administered questionnaire was used to collect sociodemographic information and data on risk factors associated with intestinal parasite infections. Stool samples were examined microscopically using formal ether concentration, iodine wet-mounting, modified Ziehl-Neelsen staining, and the Kato-Katz method. Multivariable logistic regression analysis was used to identify factors associated with intestinal parasites. The overall prevalence of any helminth and protozoan infections was 13.1% (53/406) and 22.4% (91/406), respectively. The predominant parasites were Giardia lamblia (13.8%), Ascaris lumbricoides (11.3%), Entamoeba histolytica/dispar (9.4%), Trichuris trichiura (3.9%), Entamoeba coli (1.5%), and hookworm (0.2%). The prevalence of coinfection with any helminths or protozoan was 2.7%. About 10.8% (44/406) and 20.7% (84/406) of children were infected with a single species of helminth and protozoan parasites. All helminth infections were light, with a mean intensity of 592 eggs per gram. The intensity of any protozoan infections was heavy, 62.6% (57/406). Dirt floors in the household (aOR = 2.22, p = 0.046), dirty toilets (aOR = 2.33, p = 0.014), water from communal taps (aOR = 0.27, p = 0.019), parent’s education level (aOR =0.27, p = 0.032) and parent’s earning (aOR =3.34, p = 0.007) were factors found to be significantly associated with intestinal parasites. The study found both helminth and protozoan parasites to be prevalent among preschool-aged children in Kibera. Intervention measures, including education on the improvement of hygiene and health, socio-economic conditions, sanitation, and provision of safe drinking water, could reduce the prevalence of these infections. Wed, 01 Jan 2025 00:00:00 GMT http://repository.kemri.go.ke:8080/xmlui/handle/123456789/1732 2025-01-01T00:00:00Z http://repository.kemri.go.ke:8080/xmlui/handle/123456789/1731 GENERATION OF MONOCLONALANTIBODIES AGAINST SEVERE ACUTE RESPIRATORY SYNDROME - CORONAVIRUS-2 NUCLEOCAPSID PROTEIN FOR ANTIGEN DETECTION MAURINE MUMO MUTUA Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), the causative agent for COVID-19, is a positive-sense enveloped RNA virus belonging to the Betacoronavirus genus and is approximately 30 kilobases long. Since its emergence, SARS-CoV-2 has resulted in over 700 million cases and millions of deaths worldwide, highlighting the critical need for effective diagnostic tools to manage and control the spread of the virus. Testing for COVID-19 was the primary measure implemented by all governments globally, as it allowed for necessary precautions against those exposed, hence preventing community spread. Various methods are being used for SARS-CoV-2 diagnosis, with RT-PCR being the gold standard. Due to RT-PCR limitations, such as the need for qualified personnel and long turnaround time, point-of-care testing is important for mass testing. Different antigen and antibody testing kits with varying sensitivity and specificity have been developed and deployed for SARS-CoV-2 diagnosis. Developing highly sensitive and specific antigen detection kits requires monoclonal antibodies as they are reliable and highly specific. This study leveraged the wheat germ cell-free system (WGCFS) to express SARS-CoV-2 nucleocapsid protein, owing to its ability to express proteins in their native form. After successfully expressing and purifying His-tagged SARS-CoV-2 N protein using WGCFS, BALB/c mice were immunized, and hybridomas were generated and screened. A highly reactive hybridoma against the produced antigen was selected for mAb production. Indirect and sandwich ELISA were used to screen the reactivity of the monoclonal antibody against the recombinant antigen and commercial antigen. The mAbs were also assessed for their performance using RT-PCR confirmed positive samples with varying cycle threshold (CT) values, and their specificity was screened using intracellular fluid (ICF) of other respiratory viruses. The mAb demonstrated high reactivity against the recombinant antigen, commercial antigen, SARS-CoV-2 Beta and Omicron variants. There was no significant difference in the binding affinity of the mAb and commercial mAb against the recombinant (p=0.12) and a commercial (p=0.072) antigen. The mAb detected SARS-CoV-2 from clinical samples with varying CT values ranging from 15.45 to 31.87 and exhibited no cross-reactivity against other respiratory viruses. This study findings highlight that the mAb can be used to detect antigens against SARS-CoV-2 for diagnosis and surveillance. Wed, 01 Jan 2025 00:00:00 GMT http://repository.kemri.go.ke:8080/xmlui/handle/123456789/1731 2025-01-01T00:00:00Z http://repository.kemri.go.ke:8080/xmlui/handle/123456789/1730 ERYTHROCYTE ALLOIMMUNISATION AND THE PHENOTYPIC DIVERSITIES OF CLINICALLY SIGNIFICANT BLOOD GROUP ANTIGENS IN SICKLE CELL ANAEMIA PATIENTS IN KILIFI, KENYA MUSEMBI MICHAEL MUTETI Sickle cell anaemia (SCA) is a severe monogenic disorder that results in abnormal hemoglobin with sub-Saharan Africa bearing 75% of the global burden. Blood transfusion is an integral part of patient management and the lack of alloantibody screening or extended matching beyond ABO and RhD prior to transfusion in Kenya is likely to increase the risk of developing erythrocyte alloantibodies. The burden of alloimmunisation and the phenotypic diversity of clinically significant blood group antigens among individuals with sickle cell anaemia seeking care at the Kilifi County Referral Hospital (KCRH) is unknown. This study aimed to determine the prevalence of alloimmunisation and the diversity of clinically significant blood group antigens in SCA patients in Kilifi. The study included a retrospective cohort of 98 children with SCA aged 0-13 years who were admitted to KCRH between 2003 and 2023, and a cross-sectional survey of 226 regular attendees of the sickle cell clinic between 2023 and 2024. Plasma samples obtained were screened for alloantibodies using standard 3-ID-Diacell, and identification was done using ID-diapanel cells. Participant erythrocytesfor the cross-sectional survey were phenotyped for 22 erythrocyte antigens using commercial reagents, using standard serologic techniques from DiaMed GmbH, Switzerland, Bio-Rad. Alloantibodies were detected in 14/98 (14.3%) participants included in the retrospective study period, while for the cross-sectional survey, alloantibodies were detected in 13/226 (5.8%) participants. Fourteen alloantibodies were identified in both study designs: three anti-E, three anti D, two anti-M, whereas anti-S, anti-s, anti-Lua, anti-Lea, and anti-Leb were found in one individual each. Older age was significantly associated with the development of antibodies (P = 0.02 in the retrospective analysis and P = 0.04 in the cross-sectional analysis). The Rhesus and MNS blood groups exhibited diverse phenotypes, with R0r (ccD.ee) having the highest frequency of 56.4%, with R1R1 (CCD.ee), R1R2 (CcD.Ee), and R2Rz (CCD.EE) as the rarely expressed Rh phenotypes. M+N+S-s+ was expressed (36.7%), and M+N+S+s-, M-N-S-s+ were rarely expressed MNS phenotypes. Other rare phenotypes in Kell, Lewis and Duffy were K+k+, Le(a+b+) and Fy(a+b+), respectively. xv These study results underscore the importance of routine alloantibody screening and the need for extended antigen matching in SCA patients to enhance transfusion safety, particularly those expressing rare phenotypes or are frequently transfused. Wed, 01 Jan 2025 00:00:00 GMT http://repository.kemri.go.ke:8080/xmlui/handle/123456789/1730 2025-01-01T00:00:00Z http://repository.kemri.go.ke:8080/xmlui/handle/123456789/1729 Management Practices Associated with Viral Load Sample Collection among Healthcare Practitioners in Selected Health Facilities in Machakos County Christine Mutewa Kathinzi Effective viral load (VL) sample management is critical for reliable laboratory monitoring, timely clinical decision-making, and improved patient outcomes. Viral load testing is essential for effective HIV management; however, in Machakos County, Kenya, persistent gaps in sample handling, processing, and transportation have led to rejection rates exceeding 2% annually, peaking at 6.28% in 2023. Hemolysis is the leading cause of rejection, delaying patient care and compromising result reliability. Limited local research has examined the operational factors contributing to these challenges. This study aimed to establish management practices associated with viral load sample collection among healthcare practitioners in selected health facilities in Machakos County. A mixed-methods convergent parallel design was employed, integrating quantitative and qualitative approaches. The study was conducted in public and private health facilities across Machakos County, Kenya, including four viral load hub sites Machakos Level 5, Matuu Level 4, Athi River Level 4, and Kangundo Level 4 hospitals and their 71 satellite facilities. A total of 205 healthcare practitioners involved in VL sample collection, storage, and transportation participated, representing a 94.04% response rate. Quantitative data were collected through questionnaires while qualitative data were gathered using semi-structured interviews. Quantitative data were analyzed using descriptive statistics, Fisher’s Exact Test, odds ratios, and multivariate logistic regression, with model assumption checks performed. Predictive modeling compared logistic regression, random forest, gradient boosting, and support vector machine (SVM) algorithms to identify factors influencing sample management effectiveness. Qualitative data were analyzed thematically using NVIVO version 12, following a six-step framework, and integrated with quantitative findings through triangulation. Ethical approval was obtained from the Kenya Medical Research Institute Scientific and Ethics Review Unit (KEMRI-SERU), and informed consent was obtained from all participants. Participation was voluntary, and confidentiality was maintained throughout the study. Quantitative results revealed a significant association between documentation quality and sample management effectiveness (p = 0.01). Training on sample collection showed a weaker, non-significant association with compliance (p > 0.05), indicating that training alone may be insufficient without robust compliance monitoring. Logistic regression achieved the highest predictive accuracy, identifying significant predictors such as training on sample collection (β = -0.35, p = 0.02), barriers to effective management (β = 0.25, p = 0.07), and quality assurance practices (β = 0.15, p = 0.25). Qualitative findings indicated that the majority of participants reported persistent challenges, including inadequate training, insufficient equipment maintenance, inconsistent documentation, reliance on informal skills transfer, and poor calibration of temperature monitoring devices. Several participants emphasized that without consistent quality assurance protocols, training initiatives have limited long-term impact. The study concludes that effective VL sample management requires a combination of structured training, regular equipment calibration, and rigorous quality assurance monitoring. It recommends that the county government prioritize standardized training programs, enforce equipment maintenance schedules, and strengthen quality assurance systems to enhance VL sample management outcomes Wed, 01 Jan 2025 00:00:00 GMT http://repository.kemri.go.ke:8080/xmlui/handle/123456789/1729 2025-01-01T00:00:00Z