The level and duration of RSV-specific maternal IgG in infants in Kilifi Kenya

Background Respiratory syncytial virus (RSV) is the major cause of lower respiratory tract infection in infants. The rate of decay of RSV-specific maternal antibodies (RSV-matAb), the factors affecting cord blood levels, and the relationship between these levels and protection from infection are poorly defined. Methods A birth cohort (n = 635) in rural Kenya, was studied intensively to monitor infections and describe age-related serological characteristics. RSV specific IgG antibody (Ab) in serum was measured by the enzyme linked immunosorbent assay (ELISA) in cord blood, consecutive samples taken 3 monthly, and in paired acute and convalescent samples. A linear regression model was used to calculate the rate of RSV-matAb decline. The effect of risk factors on cord blood titres was investigated. Results The half-life of matAb in the Kenyan cohort was calculated to be 79 days (95% confidence limits (CL): 76–81 days). Ninety seven percent of infants were born with RSV-matAb. Infants who subsequently experienced an infection in early life had significantly lower cord titres of anti-RSV Ab in comparison to infants who did not have any incident infection in the first 6 months (P = 0.011). RSV infections were shown to have no effect on the rate of decay of RSV-matAb. Conclusion Maternal-specific RSV Ab decline rapidly following birth. However, we provide evidence of protection against severe disease by RSV-matAb during the first 6–7 months. This suggests that boosting maternal-specific Ab by RSV vaccination may be a useful strategy to consider

Evaluation of a lateral flow device for in-field detection of Banana Xanthomonas Wilt and its application in tracking the systemicity of Xanthomonas campestris pv. musacearum

Early detection of Banana Xanthomonas Wilt (BXW) in the field and immediate destruction of infected plants or plant tissue are key control methods to prevent the introduction and spread of BXW. This requires rapid, cost effective and an on-site diagnostic tool to detect the bacterium, Xanthomonas campestris pv musacearum (Xcm). Polymerase chain reaction (PCR) detection technique for BXW is efficient but requires expensive equipment and knowledgeable expertise; this limits PCR application to the laboratory. This study therefore was carried out to evaluate the enzyme - linked immunosorbent assay (ELISA) tool configured as a lateral flow device (LFD) for detection of Xcm. Studies on the systemicity of Xcm in banana were carried out using the BXW - LFD in a field trial of 300 banana plants of Pisang Awak inoculated with the Xcm at Kiifu Forest, Mukono District, Uganda. Pseudo-stem samples from symptomatic and asymptomatic suckers were collected and tested with the LFD and the results compared with conventional PCR using the GspDm BXW primers. The LFD was able to detect Xcm3

Coffee-Banana Intercropping: Implementation guidance for policymakers and investors

Coffee-Banana Intercropping (VBI) addresses all 3 pillars of CSA in a multifaceted way. CBI in both Arabica nad Robusta generates 50% more revenue then either coffee or banana monocrop. Farmers' risk is reduced by practising CBI, making them more resilient to climate change impacts. Transformational changes are needed in the attitude towards CBI, to support scaling up of the practice

The incidence and clinical burden of respiratory syncytial virus disease identified through hospital outpatient presentations in Kenyan children

There is little information that describe the burden of respiratory syncytial virus (RSV) associated disease in the tropical African outpatient setting. Methods We studied a systematic sample of children aged <5 years presenting to a rural district hospital in Kenya with acute respiratory infection (ARI) between May 2002 and April 2004. We collected clinical data and screened nasal wash samples for RSV antigen by immunofluorescence. We used a linked demographic surveillance system to estimate disease incidence. Results Among 2143 children tested, 166 (8%) were RSV positive (6% among children with upper respiratory tract infection and 12% among children with lower respiratory tract infection (LRTI). RSV was more likely in LRTI than URTI (p<0.001). 51% of RSV cases were aged 1 year or over. RSV cases represented 3.4% of hospital outpatient presentations. Relative to RSV negative cases, RSV positive cases were more likely to have crackles (RR = 1.63; 95% CI 1.34–1.97), nasal flaring (RR = 2.66; 95% CI 1.40–5.04), in-drawing (RR = 2.24; 95% CI 1.47–3.40), fast breathing for age (RR = 1.34; 95% CI 1.03–1.75) and fever (RR = 1.54; 95% CI 1.33–1.80). The estimated incidence of RSV-ARI and RSV-LRTI, per 100,000 child years, among those aged <5 years was 767 and 283, respectively. Conclusion The burden of childhood RSV-associated URTI and LRTI presenting to outpatients in this setting is considerable. The clinical features of cases associated with an RSV infection were more severe than cases without an RSV diagnosis

Epidemiology of Subpatent Plasmodium Falciparum Infection: Implications for Detection of Hotspots with Imperfect Diagnostics.

At the local level, malaria transmission clusters in hotspots, which may be a group of households that experience higher than average exposure to infectious mosquitoes. Active case detection often relying on rapid diagnostic tests for mass screen and treat campaigns has been proposed as a method to detect and treat individuals in hotspots. Data from a cross-sectional survey conducted in north-western Tanzania were used to examine the spatial distribution of Plasmodium falciparum and the relationship between household exposure and parasite density. Dried blood spots were collected from consenting individuals from four villages during a survey conducted in 2010. These were analysed by PCR for the presence of P. falciparum, with the parasite density of positive samples being estimated by quantitative PCR. Household exposure was estimated using the distance-weighted PCR prevalence of infection. Parasite density simulations were used to estimate the proportion of infections that would be treated using a screen and treat approach with rapid diagnostic tests (RDT) compared to targeted mass drug administration (tMDA) and Mass Drug Administration (MDA). Polymerase chain reaction PCR analysis revealed that of the 3,057 blood samples analysed, 1,078 were positive. Mean distance-weighted PCR prevalence per household was 34.5%. Parasite density was negatively associated with transmission intensity with the odds of an infection being subpatent increasing with household exposure (OR 1.09 per 1% increase in exposure). Parasite density was also related to age, being highest in children five to ten years old and lowest in those > 40 years. Simulations of different tMDA strategies showed that treating all individuals in households where RDT prevalence was above 20% increased the number of infections that would have been treated from 43 to 55%. However, even with this strategy, 45% of infections remained untreated. The negative relationship between household exposure and parasite density suggests that DNA-based detection of parasites is needed to provide adequate sensitivity in hotspots. Targeting MDA only to households with RDT-positive individuals may allow a larger fraction of infections to be treated. These results suggest that community-wide MDA, instead of screen and treat strategies, may be needed to successfully treat the asymptomatic, subpatent parasite reservoir and reduce transmission in similar settings

Challenges in Diagnosing Paediatric Malaria in Dar es Salaam, Tanzania.

Malaria is a major cause of paediatric morbidity and mortality. As no clinical features clearly differentiate malaria from other febrile illnesses, and malaria diagnosis is challenged by often lacking laboratory equipment and expertise, overdiagnosis and overtreatment is common. Children admitted with fever at the general paediatric wards at Muhimbili National Hospital (MNH), Dar es Salaam, Tanzania from January to June 2009 were recruited consecutively and prospectively. Demographic and clinical features were registered. Routine thick blood smear microscopy at MNH was compared to results of subsequent thin blood smear microscopy, and rapid diagnostics tests (RDTs). Genus-specific PCR of Plasmodium mitochondrial DNA was performed on DNA extracted from whole blood and species-specific PCR was done on positive samples. Among 304 included children, 62.6% had received anti-malarials during the last four weeks prior to admission and 65.1% during the hospital stay. Routine thick blood smears, research blood smears, PCR and RDT detected malaria in 13.2%, 6.6%, 25.0% and 13.5%, respectively. Positive routine microscopy was confirmed in only 43% (17/40), 45% (18/40) and 53% (21/40), by research microscopy, RDTs and PCR, respectively. Eighteen percent (56/304) had positive PCR but negative research microscopy. Reported low parasitaemia on routine microscopy was associated with negative research blood slide and PCR. RDT-positive cases were associated with signs of severe malaria. Palmar pallor, low haemoglobin and low platelet count were significantly associated with positive PCR, research microscopy and RDT. The true morbidity attributable to malaria in the study population remains uncertain due to the discrepancies in results among the diagnostic methods. The current routine microscopy appears to result in overdiagnosis of malaria and, consequently, overuse of anti-malarials. Conversely, children with a false positive malaria diagnosis may die because they do not receive treatment for the true cause of their illness. RDTs appear to have the potential to improve routine diagnostics, but the clinical implication of the many RDT-negative, PCR-positive samples needs to be elucidated.\u

Farmers’ awareness and perceived benefits of agro-ecological intensification practices in banana systems in Uganda

Declining soil fertility and pests and diseases are major constraints to banana productivity in smallholder farming systems in Uganda. This study explored farmers’ awareness and perceptions on agro-ecological  intensification (AEI) practices for addressing these constraints in five banana-growing districts in Uganda. Stratified random sampling procedure was used to select 60 households for a survey from different agro-ecological zones and banana production systems. The household survey was complemented with focus group discussions to obtain qualitative data on farmer perceptions on benefits and constraints to AEI application on-farm. Thematic content analysis and descriptive statistics were used to analyze data. Results of the study show that most of the interviewed farmers were aware of the AEI practices although not all those aware had adopted the practices. Farmers were motivated to apply AEI practices perceived to offer multiple benefits: pest and disease management, enhanced productivity, soil fertility improvement and ecological adaptability. Major constraints to application of AEI practices by farmers include insufficient knowledge, labour intensiveness and limited access to markets. A transition towards intensification of smallholder banana systems requires that the full range of ecosystem services provided by AEI practices are recognized and valued by farmers. Therefore, empowering farmers with knowledge on their agro-ecological systems and locally adapting AEI practices is essential for realization of benefits and wider adoption of AEI practices.Keywords: Agro-ecological intensification (AEI), awareness, banana, perceived benefits, smallholder, UgandaAfrican Journal of Biotechnology Vol. 12(29), pp. 4603-461

Household dynamics influencing effective eradication of Xanthomonas wilt in smallholder banana systems in Ugunja division-Kenya

Declines in banana (Musa spp.) productivity in western Kenya since 2006 have been exacerbated by Xanthomonas wilt, caused by Xanthomonas campestris pv. musacearum.This study provided insight of household dynamics influencing efforts to eradicate the disease from Ugunja, Lunjre, Sidindi and Sigomere. Surveyed households (N = 120) were purposively selected from villages with and without banana-based farmer field schools (FFS). Results showed limited banana experience, noted by the irregularities in timing and frequency of essential agronomic practices. In addition, a rampant tendency to replant sword suckers obtained from own production or farmer-to-farmer exchange. Even though farmers were sensitized on correct diagnosis and control measures, significant disparities between awareness and actual application of control options seem to prevail over the impact of recent massive eradication campaigns. Selective deployment of elements of Avoid introduction, Break-off male bud, Cut infected plants and Clean cutting tools (ABCC) intervention strategy was evident. Dismantling the ABCC package interferes with complementarities embedded within, which ultimately leads to disease upsurge or resurgence. Repeated exposure and demonstrable efficacy of the practices to halt disease spread may have profound bearing on farmer adoption of Xanthomonas wilt control measures. Therefore, the ABCC package should be validated and fine-tuned within the local context of smallholder

Time To Move from Presumptive Malaria Treatment to Laboratory-Confirmed Diagnosis and Treatment in African Children with Fever

Background to the debate: Current guidelines recommend that all fever episodes in African children be treated presumptively with antimalarial drugs. But declining malarial transmission in parts of sub-Saharan Africa, declining proportions of fevers due to malaria, and the availability of rapid diagnostic tests mean it may be time for this policy to change. This debate examines whether enough evidence exists to support abandoning presumptive treatment and whether African health systems have the capacity to support a shift toward laboratory-confirmed rather than presumptive diagnosis and treatment of malaria in children under five