Anthony Kebira Nyamache

Prevalence of hepatitis B and C viral co-infections among HIV-1 infected individuals in Nairobi, Kenya

BackgroundHepatitis B virus (HBV) and Hepatitis C virus (HCV) co-infections among HIV-1 infected individuals are growing worldwide health problems characterized by lack of effective vaccines, need for expensive treatment, chronicity of morbidity and associated mortality. Their prevalence and distribution patterns continue to vary across geographical locations with high prevalence being detected among high risk populations. To determine the prevalence of HBV and HCV among HIV-1 infected individuals, blood samples were collected from consenting study subjects visiting comprehensive HIV clinics in Nairobi during the period between October and December 2009.MethodsBlood samples from volunteers were screened with ELISA tests for detecting HIV, HBV surface antigen (HBsAg) and anti-HCV antibodies.ResultsIn a total of three (300) hundred infected individuals consisting of 129 (43%) males and 171 (57%) females 15.3% (46/300) were HIV-1 co-infected with either HBV or HCV or both, 10.3% (31/300) with HIV-1 and HCV and 6% (18/300) with HIV-1 and HBV infections. However, only three individuals (1%) were coinfected with the three viruses (HIV/HBV/HCV).ConclusionThough, low levels of co-infection with all three viruses were reported, there could be higher prevalence rates than reported here especially among high risk populations.

Seroprevalence of Cytomegalo Virus (CMV) among pregnant women in Thika, Kenya

BackgroundThe fetal consequences of CMV infection have made it one of the most serious infections contracted during pregnancy. Despite the posed teratogenic risk during pregnancy, there is no national screening test for CMV infection is available during pregnancy in Kenya. Thus little is known on its epidemiological data that is necessary for health planners and care providers.MethodsA cross sectional study was conducted at Thika district level 5 hospital, Kenya to investigate seroprevalence of CMV infections and associated possible risk factors among pregnant women. Structured questionnaires were used to gather socio-demographic data and ELISA was used to detect CMV infections using IgG and IgM.ResultsOut of 260 pregnant women, 201 (77.3%) were CMV IgG 21(8.1%) CMV IgM being on acute stage of the disease. Marital status (OR = 3.7533, 95% CI =3.0231-6.9631, P < 0.0001), parity (OR = 3.7533, 95% CI = 3.0231-6.9631, P < 0.0001), and education (OR = 3.7533, 95% CI = 3.0231-6.9631, P < 0.0001), history of blood transfusion (OR = 0.0374, 95% CI = 0.00120-0.1168, OR = 0.3804) were found to significantly influence seropostivity in univariate analysis.ConclusionThe 88.4% CMV prevalence rate being detected among pregnant women calls for vaccine and routine screening for CMV infections and its associated risk factors in this kind of settings.

Physico-chemical Analysis, Microbial Isolation, Sensitivity Test of the Isolates and Solar Disinfection of Water Running in Community Taps and River Kandutura in Nakuru North Sub-county, Kenya.

Nakuru North sub-county is a peri-urban area which has both dry and wet seasons. Its residents rely mostly on untreated water sources for daily water needs due to unreliable water supply from the urban council. However, this water has not been evaluated on its quality despite residents solely depending on it. This study was aimed at determining the physico-chemical and bacteriological quality of water drawn from River Kandutura and water taps in Nakuru North sub-county. In addition, the study was aimed at carrying out sensitivity test of the isolates to antibiotics and determining effectiveness of solar disinfection in water treatment. A total of 510 water samples; river (255) and taps (255) were collected and analyzed between January and December 2013. Antimicrobial sensitivity test was carried out using Kirby Bauer disk diffusion test. Out of five hundred and ten (510) samples examined for microorganisms, 36.86 % (188/510) were positive for E. coli, Shigella and Salmonella. Water used by Nakuru North sub-county residents is highly contaminated thus posing public health risk. Solar disinfection experiment indicated a possibility of effective decontamination of water up on exposure to sun light for 3-5 h. E. coli showed the highest resistance (26.3 %) followed by Salmonella (17.4 %) while Shigella showed the least (17.1 %). However, there was no significant deference (p=0.98) in resistance among total coliforms, Total heterotrophic and Salmonella at 0.05 level of significant. There is a need to enforce laws and policies on proper waste disposal as part of water pollution control.

Cytokines Associated with Antiretroviral Induced Hepatotoxicity in People Infected With the Human Immunodeficiency Virus Type 1 in the Northwest Region of Cameroon

T acute gouty arthritis (GA) is one most painful acute inflammation induced by monosodium urate (MSU) deposition. The pathogenesis of inflammation remains unclear. Activation of MyD88/ NF-kB signal pathway is involved in acute GA, giving rise to the increase of cytokines including TNF-, IL-1, and IL-6. MicroRNAs(miRNAs), severing as post-transcriptional regulation, is reported to participate in many inflammatory diseases including acute GA. Previous study demonstrated miR920 down-regulated in the peripheral white blood cells of GA which negative regulated target IL-1ß. This may be the role of miR-920 in regulating the production of proinflammatory cytokines in the pathogenesis of GA. To further explore the function of miR-920 in acute GA, we detected miR-920 by qRT-PCR in the peripheral blood mononuclear cells (PBMCs) of 9 acute gouty arthritis patients and 9 healthy controls. However, overexpression of miR-920 was found in PBMCs and MyD88 was predicated as another target gene by bioinformatics. After transfecting the miR-920 mimics or negative control mimics into human monocytic THP-1 cell line, expression of MyD88 decreased. This may hint an opposite role of miR-920 in acute gouty arthritis.A rhinitis is a common heterogeneous chronic upper airway disorder and is an IgE-mediated inflammation characterized by one or more nasal symptoms such as sneezing, itching, nasal discharge, rhinorrhea, post nasal drainage and nasal blockage. In the present study, the effects of Skullcapflavone II (SCFII) on upper airway inflammation, Th2 cytokines, and NF-kb signaling in an ovalbumin (OVA)-induced allergic rhinitis (AR) murine model in vivo were investigated. OVAinduced AR mice increased nasal symptoms, eosinophils and mast cells infiltration into nasal cavity, OVA-specific IgE/ IgG1and histamine in serum, Th2 cytokines including IL-13 and GATA3, and NF-κB signaling in NALF and lung homogenate. Interestingly, treatment of SCFII reduced the levels of OVA-specific IgE/IgG1 and histamine in serum, of Th2 cytokines and of NF-κB signaling in the NALF and the lung homogenate, and histopathological changes in the nasal tissue and the lung. Also, dexamethasone suppressed such increases. The results of this study suggested that SCFII may ameliorate allergic inflammation of upper airway in AR mice model by blocking the Th2 cytokine production, the NF-κB signal pathway and the mast cell histamine release. Taken together, we suggest that SCFII may be used as a therapeutic agent for patients with Th2-mediated or mast cell-mediated allergic diseases.D crassirhizoma (DC) is used as a traditional herbal remedy to treat various diseases, the tapeworm infection, common cold, and cancer in Korea, Japan, and China. DC also has the antioxidant anti-inflammatory and antibacterial activities. However, anti-allergic inflammatory effect of DC and some of its mechanisms in allergic rhinitis model is unknown well. The purpose of this study is to investigate the anti-allergic inflammatory effect of DC on the allergic rhinitis model, mast cell activation and histamine release. Allergic rhinitis was induced in BALB/c mice by sensitization and challenge with OVA. Each various concentration of DC and Dexamethasone was administrated by oral administration on 1 hour before OVA challenge. Mice of control group were treated with saline only. Then mice were evaluated for the presence of nasal mucosa inflammation, the production of allergen-specific cytokine response and the histology of nasal mucosa. DC significantly ameliorated the nasal symptoms and the inflammation of nasal mucosa. DC also reduced the infiltration of eosinophils and mast cells in these tissues and the release of histamine in blood. Meanwhile, DC evidently inhibited the overproduction of Th2 cytokine, and increased reduction of Th1 and Treg cytokines in nasal lavage fluid by OVA. DC also reduced the levels of OVA specific IgE, IgG1 and IgG2a in blood. This study suggests that DC has a significant anti-allergic inflammatory effect in nasal cavity. DC may have the therapeutic effect for allergic rhinitis.V infections are important causes of morbidity and mortality for patients with a hematological malignancy, but the true incidence and consequences of viral infections for these patients who undergo conventional non transplant therapy are inadequately defined. Viral infections in hematological patients may result from reactivation of latent infection or, rarely, from acquisition of a new infection. Thus, screening of patients with hematological malignancies for HHV-6 might be considered mandatory. The aim of this study was to evaluate a possible association between human herpesvirus-6 (HHV-6) infection and acute leukemia in adults after receiving chemotherapy treatment for acute leukemia. The patients were divided into two main groups according to the type of leukemia. All patients with newly diagnosed acute leukemia were subjected to history taking, complete clinical examination and routine laboratory investigations. Peripheral blood samples (whole blood specimens) were collected from all patients for quantitative determination of HHV-6 DNA viral load by Taqman probe technique (real time PCR) at day 0 and day 100 of induction chemotherapy after being extracted on day of sampling. Data were fed to the computer and analyzed using IBM SPSS software package version 20.0. (Armonk, NY: IBM Corp). The results argued against an etiological relationship between HHV-6 infection and the genesis of acute leukemia in adults, however, it supports the hypothesis of viral latency and the possibility of virus reactivation in immune-compromised hosts. The possible presence of HHV-6 as an associated or a putative causative agent in leukemia should however be considered.H (HCQ) is an antimalarial drug that has been used for treating a large variety of diseases for many years. However, its specific mechanism is still not well demonstrated. In this study, we investigated the effects of HCQ on regulating dendritic cells (DC) function. The surface molecule expression, secretion of inflammatory cytokines and ability in promoting naïve CD4+ T cells proliferation and differentiation of bone marrow-derived DCs (BMDCs) were investigated after HCQ treatment. We found that HCQ treatment could significantly reduce the expression level of MHC II, CD86 and CD40. HCQ could also inhibit the production of cytokines including IL-1β, IL-6, IL-23 and TNF-α by LPS (Lipopolysaccharide) stimulated DC. Additionally, the ability of DC in promoting naïve CD4+ T cells proliferation and Th17 cells differentiation was decreased by HCQ. The effect of HCQ on DC may be partly associated to inhibition of phosphorylation of ERK1/2 and p38 MAP kinase proteins. These findings provided new understanding about the mechanism of HCQ in immune regulation.

P2.23 Hepatotoxicity and anaemia co-morbidity in treated aids patients in fundong sub division in the northwest region of cameroon

Introduction Hepatotoxicity and anaemia are relevant adverse effects of ART and can cause interruption of therapy and death. However, there is dearth of information on hepatotoxicity and anaemia co-morbidity especially in rural areas. The aim of the study was to identify the prevalence of Hepatotoxicity and Anaemia co-morbidity among HIV treated patients. Methods A total of 150 drug naïve patients visiting the day hospital in Fundong District Hospital were recruited into the study from January-March 2015 and follow up for 18 months. Baseline and 18 months levels of CD4 counts, alanine transaminase(ALT), and aspartate transaminase(AST) and Haemoglobin concentration(Hb) were determined. HIV was diagnosed using Alere determine HIV rapid test kit and Bioline or Oral Quick test kit for the confirmatory test. CD4 counts were determined using the Alere Pima CD4 cartridge machine. Hb, ALT and AST counts were determined by colometric enzymatic reaction using the urit 3300 machine and classified based on age and sex. Results The majority of patients were female 115 (76.7%) and belonged to the <30 years age range 48 (32%). The prevalence of anaemia decreased from 86 (57.3%) to 69 (45.6%) at the end of the study period. In all 46 (30.7%) patients had hepatotoxicity and anaemia co-morbidity which was higher in the age group <30 years 30 (41.7%) and in female 37 (32.2%). A total of 1 (0.7%) and 10 (6.7%) patients develop severe hepatotoxicity using ALT and AST respectively. The prevalence of hepatotoxicity was higher in male (31.4% and 62.9%) and in the age group 30–39 years (29.5% and 68.2%) for ALT and AST, respectively. The prevalence of anaemia and elevated AST and ALT were higher in persons with CD4 <200 cells/µl. There was a significant correlation between CD4 and Hb (r=0.193), CD4 and ALT(r=−0.149) and CD4 and AST(r=−0.193). Conclusion Hepatotoxicity especially Grades 1–2 and not anaemia is a significant adverse effect of ART upon time.

Isolation of microorganisms and screening of heavy metals from Municipal Council’s treated sewage from Nakuru sewage treatment plant in Nakuru County, Kenya

Diarrhoeal cases due to taking of contaminated water are on the increase Nakuru County. They are a leading cause of human mortality and morbidity. The current study was aimed at isolating microorganisms from Municipal’s council treated sewage and screening it for heavy metals followed by testing the efficacy of Moringa stenopetala in removing the heavy metals and treating the sewage against the microbial isolates. In addition, susceptibility test of the microbial isolates to antibiotics and Moringa stenopetala was also carried out. A total of 492 samples were collected out of which 46 % (226/492) were positive for all the microorganisms isolated and heavy metals. Standard methods were used in isolating microorganisms and screening of the sewage for heavy metals. Antimicrobial susceptibility test was carried out using Karby Bauer’s disk diffusion test. The percentage reduction of heavy metals was Cadmium (97 %), nickel (97 %), lead (83.17 %) and Chromium (88 %) after treatment of the Municipal council’s sewage with Moringa stenopetala. In addition, the microbial isolates reduced by 95.3 % after treatment with Moringa stenopetala. There was significant difference in both heavy metals (p=0.036) and microbial isolates (p=0.02) before and after treatment of Municipals council treated sewage with Moringa stenopetala. There was also a significant difference (p=0.01) in susceptibility patterns of the microorganisms against antibiotics and Moringa stenopetala. Treated municipal council’s sewage is highly contaminated with microorganisms that can cause diseases in addition to having highly harmful heavy metals if ingested in food. There is need for proper sewage treatment in Nakuru town in addition to in cooperating Moringa stenopetala in sewage treatment in the town.