Publications by authors named "Mbae C"

Although typhoid fever has largely been eliminated in high-income countries, it remains a major global public health concern especially among low- and middle-income countries. The causative agent, serovar Typhi ( Typhi), is a human restricted pathogen with a limited capacity to replicate outside the human host. Human carriers, 90% of whom have gallstones in their gallbladder, continue to shed the pathogen for an ill-defined period of time after treatment.

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Background: Invasive non-typhoidal (iNTS) disease continues to be a major public health problem, especially in sub-Saharan Africa (SSA), where incidence rates are 227 cases [range 152-341] per 100,000 populations. Populations at risk of iNTS include adults with human immunodeficiency virus (HIV) infection, malnourished children, and those with recent malaria or sickle-cell anaemia (SCA). In Kenya, iNTS disease is particularly a major challenge in poor informal settlements, with infants and young children less than 5 years of age being the most affected.

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Article Synopsis
  • - The study focused on investigating the genotypic diversity of multidrug-resistant (MDR) *Typhi* in symptomatic and asymptomatic children in Nairobi, Kenya, specifically targeting those below 16 years old through testing at four health facilities.
  • - Out of 90 *Typhi* isolates sequenced, 67% were confirmed as *Typhi*, with the most common genotype being 4.3.1 (sequence Type 1), and 65% of these strains carried plasmids associated with antibiotic resistance.
  • - The findings revealed a high prevalence of point mutations that reduce susceptibility to quinolones, highlighting the urgency of implementing typhoid conjugate vaccines in vulnerable populations to combat the spread of MDR *
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Background: The emergence and persistence of multidrug-resistant (MDR) Salmonella Typhi (S. Typhi) infections is a significant global health problem. The carrier state of typhoid makes it prudent to conduct routine surveillance for both acute cases and carriers especially those caused by MDR S.

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Article Synopsis
  • Nontyphoidal Salmonella (NTS) is a major cause of invasive infections among children under 5 in sub-Saharan Africa, with asymptomatic fecal shedding possibly facilitating human-to-human transmission, particularly in low-resource areas.
  • This study involved 3,293 children and healthy individuals in Nairobi, revealing a 1.52% prevalence of NTS, and 31% of children with a previous NTS infection exhibited asymptomatic shedding post-treatment, with some shedding the same strain as during their illness.
  • The findings suggest a likely connection between asymptomatic shedding and the transmission of NTS, supporting the idea that introducing a vaccine could help mitigate these infections in vulnerable populations.*
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  • Typhoid fever, caused by the pathogen Typhi, poses a significant global health threat, with 3-5% of treated patients becoming chronic carriers, often linked to gallstones and biofilm formation.
  • The study in Kenya aimed to find asymptomatic typhoid carriers and compare acute and chronic bacterial isolates by following up on patients and their household contacts after treatment.
  • Results showed a longer duration of Typhi shedding in those with gallstones, with a notable presence of multidrug-resistant strains, highlighting the importance of understanding chronic carriers for better public health strategies.
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Cholera is a diarrhoeal disease caused by Vibrio cholerae (V. cholerae) bacterium, with strains belonging to serogroups 01 and 0139 causing a huge proportion of the disease. V.

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The causative agent of typhoid fever, serovar Typhi, is a human restricted pathogen. Human carriers, 90% of whom have gallstones in their gallbladder, continue to shed the pathogen after treatment. The genetic mechanisms involved in establishing the carrier state are poorly understood, but .

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Background: Shigellosis mainly affects children under 5 years of age living in low- and middle-income countries, who are the target population for vaccination. There are, however, limited data available to define the appropriate timing for vaccine administration in this age group. Information on antibody responses following natural infection, proxy for exposure, could help guide vaccination strategies.

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Background: Despite the importance of non-Typhoidal Salmonella (NTS) disease in Africa, epidemiologic data on carriage and transmission are few. These data are important to understand the transmission of NTS in Africa and to design control strategies.

Method: To estimate the prevalence of stool carriage of NTS in Kenya, we conducted a cross-sectional study in Kilifi, Nairobi, and Siaya, sites with a low, moderate and high incidence of invasive NTS disease, respectively.

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Non-typhoidal Salmonella (NTS) infections remain a significant public health challenge especially in sub-Saharan Africa. NTS disease is endemic in Kenya and is associated with sporadic fatal outbreaks in several regions of the country with poor resource setting. Data is limited on background exposure of NTS in the population in endemic areas and the general immune status of the community most affected by NTS.

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Cystic echinococcosis (CE) is endemic in humans and domestic animals in eastern Africa. All the species of the sensu lato complex have been reported in this region except for , possibly due to the small number of studies involving equids. This study reports the frequency of different species in donkeys from eastern Africa.

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Introduction: Although antimicrobials have traditionally been used to treat infections and improve health outcomes, resistance to commonly used antimicrobials has posed a major challenge. An estimated 700,000 deaths occur globally every year as a result of infections caused by antimicrobial-resistant pathogens. Antimicrobial resistance (AMR) also contributes directly to the decline in the global economy.

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Resistance to commonly available antimicrobials is a major threat to the fight against endemic bacterial diseases in sub-Saharan Africa, with a majority of the population unable to afford alternative effective antimicrobial options for management of these diseases. Diseases such as typhoid, cholera, and invasive nontyphoidal Salmonella are among the key enteric infections endemic in most parts of sub-Saharan Africa, especially in displaced populations and among the urban populations living in overcrowded informal settlements. Here, we explore the prevalence and the genomic epidemiology of these infections and the growing problem of multidrug resistance, including emerging resistance to the last line of treatment for these infections.

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Article Synopsis
  • Understanding the dynamics of typhoid infection and carriage is essential for developing effective prevention strategies in endemic areas like Nairobi, Kenya.
  • A study involving 4,670 cases and 8,549 controls identified a carriage frequency of 1% among children under 16, with most cases linked to multidrug-resistant strains of Salmonella Typhi.
  • The results suggest that asymptomatic carriers significantly contribute to the spread of typhoid in the community, highlighting the need for targeted interventions.
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  • - The study investigates the presence of specific
  • protozoan species responsible for diarrhea and abdominal discomfort in patients from Mukuru, Nairobi, focusing on the difficulty in differentiating these species morphologically.
  • - Out of 895 examined fecal samples, microscopy detected 12.7% positivity for these protozoans, while nested PCR confirmed the presence of two specific species, with prevalence rates of 7.5% and 8.2%, respectively.
  • - The findings indicate that infections were more common in those aged 21-30 and showed an unexpected pattern relating to diarrhea, emphasizing the importance of molecular diagnostics for effective treatment of amoebiasis.
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  • - Invasive Non-typhoidal Salmonella (iNTS) disease poses a significant health risk in Sub-Saharan Africa, with high mortality rates in Kenya due to delayed treatment, primarily caused by two common serotypes: S. Typhimurium and S. Enteritidis.
  • - A study in Nairobi's Mukuru informal settlement analyzed blood and fecal samples, revealing 133 S. Typhimurium and 120 S. Enteritidis isolates, highlighting distinct lineages and a common source of infection among cases and controls.
  • - The finding of high multidrug resistance, including resistance to critical antibiotics, coupled with a concerning rate of asymptomatic carriers, underscores the need for preventive measures, like vaccination, especially
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Taenia species of domestic dogs can cause cysticercosis and coenurosis in a wide range of intermediate hosts including humans. Most taeniids of dogs are globally distributed, but some wildlife-transmitted species can be specific for certain regions. Generally, little information exists on the species composition and frequency in most regions of the world, which impairs risk assessment and control strategies.

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Article Synopsis
  • The study focuses on the high rates of typhoid fever and non-typhoidal salmonellosis in a poor-resource area in Nairobi, Kenya, from 2013 to 2017, aiming to assess the disease burden and identify risk factors.
  • A census of 150,000 in the Mukuru informal settlement collected data on socioeconomic and healthcare access, while also sampling children under 16 for Salmonella infections.
  • Results showed 1.3% of children had infections from Non-Typhoidal Salmonella and 1.4% had Salmonella Typhi, with significant links to domestic animal rearing, water storage practices, and sanitation methods.
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Cystic Echinococcosis (CE) is a widespread neglected zoonotic disease and is caused by the larval stage of the dog tapeworm sensu lato. CE is more frequent in livestock-rearing areas and where people live a nomadic or seminomadic lifestyle such as in Kajiado County, Kenya. There is limited data on CE disease situation in the county of Maasailand; the present study, therefore, reports on the prevalence of CE in cattle, sheep, and goats and their relative importance in CE transmission in Kajiado County.

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All canine hookworms are known to be zoonotic, causing infections ranging from transient skin irritations to prolonged 'creeping eruptions', eosinophilic enteritis and even patent intestinal infections. There is little information on canine hookworm species and their public health significance in sub-Saharan Africa. This study determined the prevalence and species of hookworms in dogs from different climatic zones of Kenya.

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Background: Salmonella infections cause a disproportionately high number of deaths in Africa, especially among poor urban populations. The increasing level of multidrug-resistant (MDR) infections is a major cause of concern in these settings where alternative effective treatment is unavailable. Other options for management of these infections must be sought.

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Article Synopsis
  • Cystic echinococcosis, caused by Echinococcus species, is common in both livestock and humans in Kenya, but data on infections in dogs and their role in transmission is scarce.
  • A study analyzed 1,621 dog fecal samples from four regions to determine the prevalence of Echinococcus, finding that 4.4% contained Echinococcus spp. eggs, with variations across regions.
  • E. granulosus sensu stricto was the most common species detected, alongside other taxa, including a rare finding of E. felidis, indicating dogs may bridge the gap between domestic and wildlife Echinococcus transmission cycles.
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Cystic echinococcosis (CE) is a zoonotic disease caused by the larval stage of Echinococcus granulosus species (sensu lato, s.l.).

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is a protozoan parasite and a major cause of diarrhea in children and immunocompromised patients. Current diagnostic methods for cryptosporidiosis such as microscopy have low sensitivity while techniques such as PCR indicate higher sensitivity levels but are seldom used in developing countries due to their associated cost. A loop-mediated isothermal amplification (LAMP) technique, a method with shorter time to result and with equal or higher sensitivity compared to PCR, has been developed and applied in the detection of species.

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