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At least 253 records · Page 14Linked to original sources
PubMed1994

Origin of blood meals in indoor and outdoor resting malaria vectors in western Kenya.

Blood meals were obtained from indoor and outdoor resting malaria vectors in three villages of western Kenya and tested by sandwich ELISA to determine host preferences and their human blood index (HBI). Anopheles gambiae s.s. collected indoors at Kisian village had a HBI of 0.97 while that of Anopheles arabiensis collected at Ahero was 0.23. However, the HBI of A. arabiensis varied depending on the availability of outdoor resting shelters. Most female A. arabiensis (98.9%) collected outdoors in granaries at Ahero had fed on cattle. Indoor-collected female Anopheles funestus had mainly fed on people (93.0%), but taken at least some of their blood (20.2%) from cattle. Although small numbers of A. arabiensis fed on sheep or goats and birds, none of the female A. gambiae s.s. and A. funestus tested had fed on these hosts. The absence of human-fed A. arabiensis in outdoor shelters indicated that exiting after feeding, a behaviour pattern that mitigates indoor insecticidal spraying, is not prevalent in this species in western Kenya.

Animals↗
PubMed1994

A survey of Schistosoma mansoni induced kidney disease in children in an endemic area of Machakos District, Kenya.

The association between Schistosoma mansoni infection and kidney lesions was investigated in school children selected from three primary schools in Machakos District, Kenya, namely Miu (n = 159), Kitengei (n = 160) and Misuuni (n = 99) schools. The children were examined parasitologically for S. mansoni infection, clinically for enlargement of the liver and spleen, and biochemically for proteinuria and serum and urine creatinine. High prevalences of S. mansoni infection, ranging from 84-96%, were seen in all the schools, but the geometric mean intensity of egg excretion varied, being relatively low in Misuuni (31 eggs/g), medium in Miu (182 eggs/g) and high in Kitengei (413 eggs/g). The prevalence of pathological proteinuria (> or = 200 mg/l) in the schools ranged from 10.1% in Miu to 28.8% in Kitengei. No difference in the levels of proteinuria was noted between age or sex groups. No association between intensity of infection and pathological proteinuria was observed in any of the schools, nor was any correlation between organomegaly and proteinuria observed. However, significant correlations between malaria and organomegaly (p < 0.001) and between malaria and proteinuria (p < 0.05) were observed when pooling data from all schools. These findings suggest that S. mansoni induced nephrotic syndromes are not common in children from this highly endemic area of Kenya.

Adolescent↗
PubMed1994

Isolation and preliminary characterisation of a previously unidentified Theileria parasite of cattle in Kenya.

A Theileria parasite was isolated from cattle on a ranch in Kenya where it caused mild theileriosis in approximately one third of the cattle exposed to natural tick challenge. The parasite was isolated by inoculation of blood into two experimental cattle. Blood from one of these cattle was used to infect two splenectomised cattle which developed high piroplasm parasitaemias and severe anaemia. A blood stabilate was prepared from one of the splenectomised cattle and produced high parasitaemias in splenectomised cattle. Immunofluorescence tests showed that the unidentified Theileria species was distinct from other African Theileria and Babesia species of cattle. The Theileria species was shown to be antigenically distinct by means of species-specific monoclonal antibodies. The piroplasma stage was relatively large for a Theileria parasite and erythrocyte infections were usually associated with veils and bars. The salivary glands of Rhipicephalus appendiculatus, R pulchellus, R evertsi and Amblyomma variegatum fed on parasitaemic cattle did not become infected and these ticks failed to transmit the parasite. It was concluded that this parasite represented a new species of cattle Theileria in Kenya.

Animals↗
PubMed1982

Does Pneumocystis carinii occur in Kenya?

An experiment was carried out exposing immunosuppressed mice to the atmosphere to determine if transmission of Pneumocystis carinii occurred in Kenya. Mice were killed at weekly intervals for four months and the lungs examined histologically for the presence of these parasites. None of the mice contracted even light infections and this, together with the lack of clinical evidence of this disease in immunosuppressed or neonatal cases, suggests that this parasite does not occur in Kenya. Possible reasons for this are discussed.

Animals↗
PubMed1983

High-dose sodium stibogluconate treatment of cutaneous leishmaniasis in Kenya.

Cutaneous leishmaniasis caused by Leishmania aethiopica usually responds poorly to conventional doses of pentavalent antimonial drugs. We treated three patients with cutaneous leishmaniasis acquired in Kenya, presumed or documented to be caused by L. aethiopica, with intravenous sodium stibogluconate, 18 to 20 mg Sb/kg body-weight twice daily for 30 days. All patients had a good response to treatment, with disappearance of parasites from skin smears and cultures after 14 to 27 days, clinical healing of the lesions, and no recurrence during a three to 18-month follow-up. Side effects of treatment were minor. We conclude that this high dose sodium stibogluconate regimen is safe and effective for treating cutaneous leishmaniasis caused by L. aethiopica in Kenya.

Adolescent↗
PubMed1983

Serological and parasitological survey of blood donors in Kenya for toxoplasmosis.

322 samples of sera from blood donors in four areas of Kenya were screened for Toxoplasma gondii antibodies by haemagglutination and 54% proved positive. 299 of these were also tested by dye test and 42% were positive, with 5.9% showing high titres indicating possible active infection. Parasitological examination of the buffy coat from donors was also carried out on 100 samples but no Toxoplasma parasites were seen in spite of high antibody incidence. There appears to be little or no clinical toxoplasmosis in Kenya but serological studies indicate a widespread distribution of the parasite in the human population.

Adolescent↗
PubMed1984

Cutaneous leishmaniasis in Kenya: transmission of Leishmania major to man by the bite of a naturally infected Phlebotomus duboscqi.

One leishmanial stock was isolated from a Phlebotomus duboscqi female captured in Baringo District, Kenya, and others from papular lesions that developed at sites where this sandfly had fed on a man. When characterized by cellulose acetate electrophoresis (eight enzymes examined), these isolates proved to be identical to known Leishmania major strains from man and a rodent (Arvicanthis sp.) and different from L. donovani and L. adleri, which also occur in Baringo. This is the first case of human cutaneous leishmaniasis caused by L. major reported from Kenya.

Electrophoresis, Cellulose Acetate↗
PubMed1987

Cutaneous leishmaniasis caused by Leishmania tropica in Kenya.

9 leishmanial strains, isolated from cutaneous papulonodular lesions on 3 patients, were characterized by cellulose acetate electrophoresis using 7 enzymes. The patterns obtained were indistinguishable from those of a Leishmania tropica reference strain and these 9 strains were similar to L. tropica in failing to infect mice. Although these 3 patients were Americans, their only potential exposure to sandflies was in Kenya, and thus they are believed to be the first cases of cutaneous leishmaniasis due to L. tropica in Kenya.

Animals↗
PubMed1987

Cutaneous leishmaniasis caused by Leishmania major in Baringo District, Kenya.

Leishmania major was isolated from lesions of a patient suffering from cutaneous leishmaniasis in Baringo District of Kenya. Isoenzyme mobilities of this strain were compared with those of L. major, L. donovani, L. aethiopica and L. tropica reference strains and also L. major from a sand fly, Phlebotomus duboscqi, and a rodent, Arvicanthis niloticus, trapped in the same region. The patient's isolate had similar banding patterns to the L. major reference strain and also the rodent and the sand fly strains with the 9 enzymes examined. This is the first report in Kenya of an indigenous case with naturally acquired zoonotic cutaneous leishmaniasis.

Animals↗
PubMed1988

Immunodetection of Echinococcus eggs from naturally infected dogs and from environmental contamination sites in settlements in Turkana, Kenya.

A species-specific indirect immunofluorescence test using an anti-Echinococcus oncosphere monoclonal antibody (EgOH6-4E5) was applied to identify Echinococcus oncospheres released from taeniid eggs collected in environmental soil and water samples, and from perianal or faecal samples of naturally infected dogs, in northern Turkana, Kenya. The specificity of immunodetection of Echinococcus eggs by specific fluorescence of Echinococcus oncospheres from naturally infected dogs was 100% when compared to Taenia hydatigena infections, and a sensitivity of 73% was obtained in the detection of dogs infected with Echinococcus using perianal Scotch tape swabs. Taeniid eggs were recovered from various soil samples inside Turkana manyattas (settlements) and from waterhole samples. Some oncospheres obtained from taeniid eggs recovered from all sampled areas, but particularly from inside Turkana huts (akai) and from water samples from open waterholes used by the people and their livestock, reacted positively with the Echinococcus 4E5 monoclonal antibody. The potential importance of contamination of such sites with Echinococcus eggs is discussed in relation to the transmission of echinococcosis in this hyperendemic region of northern Kenya.

Animals↗
PubMedDate not supplied

Treatment of visceral leishmaniasis in Kenya by aminosidine alone or combined with sodium stibogluconate.

The treatment of leishmaniasis, as currently conducted in Kenya with sodium stibogluconate, is unsatisfactory as it is expensive, resistance and relapses may occur, and major adverse effects have been reported. Recently, aminosidine (paromomycin) sulphate has shown good antileishmanial activity on its own as well as synergism with pentavalent antimony, administered concurrently. The present study was designed to assess the effectiveness of parenteral aminosidine, alone or combined with sodium stibogluconate, in visceral leishmaniasis, compared to treatment by stibogluconate alone. 53 patients were allocated to the 3 therapeutic regimes. The presenting signs and symptoms of leishmaniasis were those commonly seen in the visceral form of the disease, particularly in Kenya. At termination, clinical cures were achieved in all 53 patients with no difference between treatment groups. Spleen aspirates revealed the best parasitological results in patients receiving the combined treatment, with only 13% failures (partial cures + relapses), as opposed to 21% failures with aminosidine alone and 45% with stibogluconate alone. Treatment with aminosidine alone was the cheapest and safest regime.

Adolescent↗
PubMedDate not supplied

Human cutaneous leishmaniasis caused by Leishmania donovani s.l. in Kenya.

Our laboratory is characterizing Leishmania stabilates and isolates from active leishmaniasis cases. Smears and cultures from aspirates made on different dates from a single lesion on the bridge of the nose of an 18 years old Kenyan male from Nyandarua District contained Leishmania. The isolates, NLB-271 and NLB-271-IA, were characterized by cellulose acetate electrophoresis (CAE) using 20 enzyme systems and by Southern analysis using 2 deoxyribonucleic acid (DNA) probes (pDK10 and pDK20) from a Dakar strain of L. major (MHOM/SN/00/DK1) and a third probe, p7-059 from L. infantum strain ITMAP-263. Digestion of the two Leishmania DNAs with endonucleases HindIII and PstI, followed by hybridization with the 3 probes, revealed DNA fragment banding patterns indistinguishable from those of the L. donovani species complex. The CAE isoenzyme profiles of these 2 Kenyan isolates were indistinguishable from those of Kenyan L. donovani strains we designated as zymodeme Z6. Excluding post-kala-azar dermal leishmaniasis, this constitutes the first human case of cutaneous leishmaniasis caused by L. donovani s.l. in Kenya. Previously, cutaneous leishmaniasis cases in Kenya have been due to L. aethiopica, L. major and L. tropica only.

Adolescent↗
PubMedDate not supplied

Seroepidemiology and serodiagnosis of schistosomiasis in Kenya using crude and purified egg antigens of Schistosoma mansoni in ELISA.

The performance of antibody detection for the diagnosis of schistosomiasis has been evaluated in Kenya. Approximately 1500 blood samples from 3 areas with endemic schistosomiasis (Schistosoma mansoni only, S. haematobium only, and a mixed infection area), and from a non-endemic control area, were tested for their antibody reactivity in an enzyme-linked immunosorbent assay (ELISA). The results were compared with infection status determined by parasitological examination. Two test antigens were used: unfractionated S. mansoni egg homogenate (SEA), and CEF6, a previously described, partially purified fraction of SEA containing 2 cationic antigens. The antigens prepared from eggs of Kenya and Puerto Rico S. mansoni isolates gave very similar results. Bloods from patients with S. haematobium infection cross-reacted significantly with the two S. mansoni antigen preparations, but reactivity against CEF6 appeared more specifically indicative of S. mansoni infection. Of 254 blood samples from schoolchildren in the non-endemic area, 100% gave ELISA optical density readings at 492 nm (OD492) < 0.20 against SEA, and 98% were < 0.20 against CEF6. With 887 blood samples from subjects of all ages in the area endemic for S. mansoni alone, using an ELISA OD492 cut-off point of 0.20, SEA and CEF6 had sensitivities of 94% and 97% respectively, and specificities of 64% and 59% respectively. Increasing the OD492 cut-off value reduced the sensitivity and increased the specificity of both test antigens. Specificity of both antigens was poor with samples from 234 children in an area endemic for both S. mansoni and S. haematobium (< 20% for both antigens at an OD492 cut-off value of 0.20).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMedDate not supplied

A new focus of kala-azar due to Leishmania donovani sensu lato in Kenya.

Three Masai children from Kekonyokie South Location, Kajiado District were diagnosed with visceral leishmaniasis (kala-azar). Leishmanial isolates from the patients were characterized as Leishmania donovani sensu lato, by cellulose acetate electrophoresis. Case histories indicated that the disease was acquired locally. A survey of 409 children at 7 local primary schools and one nursery school revealed no additional case. Sandfly surveys using light traps and sticky paper traps recovered 10 species of sandfly, including 2 Phlebotomus species. P. martini was prevalent throughout the area. P. orientalis was only rarely encountered, but it was the first collection record of this species in the southern portion of the Rift Valley in Kenya. Although no Leishmania-infected sandfly was found, P. martini is probably the vector of kala-azar in the location, as it is elsewhere in Kenya.

Adolescent↗
PubMedDate not supplied

Visceral leishmaniasis: use of the polymerase chain reaction in an epidemiological study in Baringo District, Kenya.

The polymerase chain reaction was applied to capillary blood spots dried on filter paper from 20 parasitologically proved cases of visceral leishmaniasis (VL), 21 subclinical cases, and 11 healthy controls in a longitudinal study of anthroponotic VL in Baringo District, Kenya. Leishmania deoxyribonucleic acid (DNA) was detected 10.5 months before diagnosis and up to 3 years after diagnosis and apparently successful treatment. Subclinical cases can have detectable circulating parasite DNA in their blood. These findings may indicate that subclinical cases can be a reservoir and formerly treated VL patients can remain a reservoir for a long time. Xenodiagnosis should be performed on subclinical cases and former VL patients to establish their role in transmission of VL in Kenya.

Adolescent↗
PubMed1978

Tuberculosis in Kenya: a second national sampling survey of drug resistance and other factors, and a comparison with the prevalence data from the first national sampling survey. An East African and British Medical Research Council Co-operative Investigation.

A survey was carried out in 1974 in the same random sample of 11 of 30 districts in Kenya that were surveyed in 1964, to obtain information on (a) the proportion of patients with pulmonary and with extra-pulmonary tuberculosis, (b) the prevalence of bacteriologically-positive pulmonary tuberculosis, (c) the prevalence of initial and acquired drug resistance, (d) the radiographic extent and type of pulmonary disease, and (e) the changes that had occurred in the 10-year period. Of 1490 patients, 88.5% had pulmonary tuberculosis only, 3.0% had both extra-pulmonary and pulmonary tuberculosis and 8.6% had extra-pulmonary tuberculosis only. Of the 172 patients with extra-pulmonary tuberculosis, 51% had lymph node involvement, 24% bone and joint disease and 9% a pleural effusion. Of the 1362 patients with pulmonary tuberculosis (with or without extra-pulmonary tuberculosis) 94% had no history of previous chemotherapy, fewer than 1% a history of possible and 6% a history of definite previous chemotherapy. (The proportions for the patients with extra-pulmonary tuberculosis only were 94%, 1% and 5% respectively.) A sputum specimen was produced by 1096 (80%) of the patients with pulmonary tuberculosis; 69% of smear results were positive, as were 74% of the culture results. In 2 (0.25%) of the 807 patients with a positive culture the strain was identified as being neither M. tuberculosis nor M. bovis. Of 702 patients with no history of previous chemotherapy and a sensitivity test result available, 10.1% had a strain resistant to isoniazid and/or streptomycin, 7.3% to isoniazid alone, 1.4% to streptomycin alone and 1.4% to both drugs. Of 1133 patients with chest radiographs available and a diagnosis in Kenya of pulmonary tuberculosis, a lung lesion or a pleural effusion was reported at independent assessment in London for 91%. Gross, extensive or moderate disease was present in 73% of the patients and cavitation was present in 72%. The radiographic disease was classified as acute in 31%, mixed-acute in 52%, mixed in 12% and chronic in 5%. The disease in children was usually less extensive, less often cavitated, and more acute than in adults. A comparison of the prevalence data in 1974 with that in 1964 suggested that there was a modest decline in the incidence of tuberculosis but that the characteristics of the registered patients and their disease were very similar in all respects; the disease was just as extensive radiographically and cavitation was, if anything, more common and more extensive in 1974 than in 1964.

Adolescent↗
PubMed1992

Impact of user fees on attendance at a referral centre for sexually transmitted diseases in Kenya.

We investigated the impact of a short-lived policy of charging fees to patients attending public-sector outpatient health facilities in Kenya by collecting data on attendance at Nairobi's Special Treatment Clinic for sexually transmitted diseases (STDs) before (23 months), during (9 months), and after (15 months) the user-charge period. During the user-charge period, the seasonally adjusted total mean monthly attendance of men decreased significantly to 40% (95% CI 36-45) of that before fees were levied. Attendance rose in the post-user-charge period, but reached only 64% (59-68) of the pre-user-charge level. For women, the adjusted total mean monthly attendance during the user-charge period was reduced significantly to 65% (55-77) of the pre-user-charge level. Mean monthly attendance by women rose in the post-user-charge period to 22% (9-37) above the pre-user-charge level. There was no evidence of an increase in attendance over the course of the user-charge period among either men or women. The introduction of user fees probably increased the number of untreated STDs in the population, with potentially serious long-term health implications. The user-fee experience in Kenya should be carefully evaluated before similar measures are introduced elsewhere.

Community Health Centers↗
PubMed1995

A prevalence study of ear problems in school children in Kiambu district, Kenya, May 1992.

Information on the prevalence of hearing impairment and related ear pathologies in children in sub-Saharan Africa is scarce. A pilot study for a clinical trial of simple treatments for chronic suppurative otitis media (CSOM) in school children in Kiambu district, Kenya, provided information on the prevalence of hearing impairment and ear pathologies. Five-thousand-three-hundred-sixty-eight children from 57 randomly chosen primary schools in Kiambu district were examined. Simple otoscopy was performed by clinical officers with specialty training in ENT, and hering testing was performed by trained nurses, using a hand held field audiometer. Microbiological specimens were obtained from those children with CSOM. Five-point-six percent of the children had a hearing impairment of > 30 dB HL in one or both ears, with 2.2% having bilateral hearing impairment. Two-point-four percent had at least one perforated tympanic membrane, and 1.1% had CSOM. Eight-point-six percent of the children had wax obstructing the tympanic membrane. There is evidence of a relationship between hearing impairment and both CSOM and wax obstructing the tympanic membrane. The most common organisms found were Pseudomonas spp. (34%), Proteus spp. (34%) and Eschericia coli (19%). These results are comparable with other studies in Africa and indicate a considerable burden of ear disease in Kiambu district, Kenya.

Adolescent↗