Publications by authors named "Muloi D"

Antimicrobial resistance (AMR) data from agroecosystems in low- and middle-income countries is limited. We surveyed chicken (n = 52) and pig (n = 47) farms in Kenya to understand AMR in animal-environment pathways. Using LC-MS/MS, we validated the methods for analyzing eight common antibiotics and quantified the associated risks.

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Peri-urban environments, characterized by dense human populations, cohabiting livestock, and complex food systems, serve as hotspots for food contamination and infectious diseases. Children aged 6-24 months are particularly vulnerable, as they often encounter contaminated food and water, increasing their risk of food-borne disease, with diarrhea being a common symptom. We investigated the prevalence of antimicrobial resistance (AMR) in pathogenic Escherichia coli from children 6-24 months of age, their food, and cohabiting livestock, in Dagoretti South subcounty in Nairobi, Kenya.

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Introduction: Veterinary antibiotics are essential for maintaining animal health and welfare, however, small-scale farmers in Malawi face challenges in accessing them due to limited availability, affordability, and long distances to rural drug retailers.

Methods: This study mapped the veterinary antibiotic distribution chain, examined the governance structure of the chain, and analyzed access and usage practices among stakeholders in Malawi. Data were collected through focus group discussions ( = 15), key informant interviews ( = 6) and individual interviews ( = 189).

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Rabies vaccination in domestic dog populations has increased globally in a bid to protect human health. Surveillance efforts, however, are inconsistent in endemic regions such as in sub-Saharan Africa, due to fragmented reporting and limited diagnostic capacity for suspected cases, limiting successful monitoring and evaluation of vaccination campaigns. Here, we conducted a pilot study aiming to strengthen rabies surveillance by combining community-based surveillance with field-based diagnostic testing in pastoral and agro-pastoral communities in central Kenya; communities which are frequently marginalised from health systems.

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Reducing the inappropriate use of antibiotics in food animals is a global priority to address antimicrobial resistance (AMR). We investigated practices and factors associated with antibiotic use in small-scale commercial broiler farms in Lilongwe district, Malawi. We used structured questionnaires to collect data on recent antibiotic use practices among 128 broiler farmers, who kept between 50 and 1 000 birds, from December 2022 to March 2023.

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Livestock associated antimicrobial resistance (AMR) can reduce productivity and cause economic losses, threatening the livelihoods of poor farming communities in low-income settings. We investigated the practices and risk factors for increased antibiotic use, and AMR in including resistance to human critically important antibiotics like cefotaxime and colistin in semi-intensive and free-range poultry farms in Uganda. Samples and farm management data were collected from 402 poultry farms in two districts between October 2021 to March 2022.

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The COVID-19 pandemic has significantly impacted healthcare systems, including antibiotic use practices. We present data on patterns of antibiotic dispensing and use in community and hospital settings respectively in Nairobi, Kenya during the pandemic. We conducted interviews with 243 pharmacies in Nairobi using a standardised questionnaire from November to December 2021.

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Introduction: To effectively regulate and reduce antibiotic use, in the livestock sector, a thorough understanding of the flow of veterinary antibiotics will help to identify key nodes in the chain for targeted interventions. The aim of this study was to understand the flow of antibiotics from import to end-user, and identify relevant governance mechanisms.

Methods: A mixed methods approach was used to collect data in three Kenyan counties (Nairobi, Kiambu, and Kajiado).

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Understanding antibiotic use in dairy systems is critical to guide antimicrobial stewardship programs. We investigated antibiotic use practices in small-holder dairy farms, antibiotic quality, and antimicrobial resistance (AMR) awareness among veterinary drug retailers in a mixed farming community in the central Kenyan highlands. Data were collected from 248 dairy farms and 72 veterinary drug stores between February 2020 and October 2021.

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Understanding antibiotic use in livestock systems is key in combating antimicrobial resistance (AMR) and developing effective interventions. Using a standardised questionnaire, we investigated the patterns and drivers of antibiotic use in 165 cattle farms across the three major cattle production systems in Kenya: intensive, extensive, and semi-intensive systems across in three counties: Machakos, Makueni and Narok in Kenya. We used a causal diagram to inform regression models to explore the drivers of antibiotic use in the study farms.

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Escherichia coli commonly inhabits the gut of humans and animals as part of their microbiota. Though mostly innocuous, some strains have virulence markers that make them pathogenic. This paper presents results of a cross-sectional epidemiological study examining prevalence of diarrheagenic E.

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The intersection of human, animal, and ecosystem health at One Health interfaces is recognised as being of key importance in the evolution and spread of antimicrobial resistance (AMR) and represents an important, and yet rarely realised opportunity to undertake vital AMR surveillance. A working group of international experts in pathogen genomics, AMR, and One Health convened to take part in a workshop series and online consultation focused on the opportunities and challenges facing genomic AMR surveillance in a range of settings. Here we outline the working group's discussion of the potential utility, advantages of, and barriers to, the implementation of genomic AMR surveillance at One Health interfaces and propose a series of recommendations for addressing these challenges.

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Nearly a century after the beginning of the antibiotic era, which has been associated with unparalleled improvements in human health and reductions in mortality associated with infection, the dwindling pipeline for new antibiotic classes coupled with the inevitable spread of antimicrobial resistance (AMR) poses a major global challenge. Historically, surveillance of bacteria with AMR typically relied on phenotypic analysis of isolates taken from infected individuals, which provides only a low-resolution view of the epidemiology behind an individual infection or wider outbreak. Recent years have seen increasing adoption of powerful new genomic technologies with the potential to revolutionise AMR surveillance by providing a high-resolution picture of the AMR profile of the bacteria causing infections and providing real-time actionable information for treating and preventing infection.

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Urbanization is predicted to be a key driver of disease emergence through human exposure to novel, animal-borne pathogens. However, while we suspect that urban landscapes are primed to expose people to novel animal-borne diseases, evidence for the mechanisms by which this occurs is lacking. To address this, we studied how bacterial genes are shared between wild animals, livestock, and humans (n = 1,428) across Nairobi, Kenya-one of the world's most rapidly developing cities.

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Background: Livestock systems have been proposed as a reservoir for antimicrobial-resistant (AMR) bacteria and AMR genetic determinants that may infect or colonise humans, yet quantitative evidence regarding their epidemiological role remains lacking. Here, we used a combination of genomics, epidemiology and ecology to investigate patterns of AMR gene carriage in Escherichia coli, regarded as a sentinel organism.

Methods: We conducted a structured epidemiological survey of 99 households across Nairobi, Kenya, and whole genome sequenced E.

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A disease with clinical and post-mortem presentation similar to those seen in heartwater, a tick-borne disease of domestic and wild ruminants caused by the intracellular bacterium Ehrlichia ruminantium, was first reported in dromedary camels in Kenya in 2016; investigations carried out at the time to determine the cause were inconclusive. In the present study, we screened sera from Kenyan camels collected before (2015) and after (2020) the 2016 disease outbreak for antibodies to Ehrlichia spp. using an E.

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The COVID-19 pandemic has underscored the need to strengthen national surveillance systems to protect a globally connected world. In low-income and middle-income countries, zoonotic disease surveillance has advanced considerably in the past two decades. However, surveillance efforts often prioritise urban and adjacent rural communities.

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Quantitative evidence for the risk of zoonoses and the spread of antimicrobial resistance remains lacking. Here, as part of the UrbanZoo project, we sampled Escherichia coli from humans, livestock and peri-domestic wildlife in 99 households across Nairobi, Kenya, to investigate its distribution among host species in this rapidly developing urban landscape. We performed whole-genome sequencing of 1,338 E.

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A study was carried out in Kamuli and Hoima districts in Eastern and Western regions of Uganda to determine the Taenia solium porcine cysticercosis (PCC) and gastrointestinal (GI) parasites co-infection status in pigs. One hundred sixty-one households were selected randomly and visited between November and December 2019. A household questionnaire was administered, and faecal and blood samples were collected from at least one pig older than 3 months per household.

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The Nairobi pork food system is a growing livestock sub-sector which serves as a source of food and livelihood to its inhabitants. The study aimed to map Nairobi's pork value chains, assess their governance, operational challenges and their impacts on food safety risks and management practices. Qualitative data were collected in seven focus group discussions and 10 key informants' interviews on animal movements and product flows, stakeholders' interactions, perceptions on system governance and challenges, and on their potential impact on food safety management.

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Urbanization can have profound impacts on the distributional ecology of wildlife and livestock, with implications for biodiversity conservation, ecosystem services and human health. A wealth of studies have assessed biotic responses to urbanization in North America and Europe, but there is little empirical evidence that directly links human activities to urban biodiversity in the tropics. Results from a large-scale field study conducted in Nairobi, Kenya, are used to explore the impact of human activities on the biodiversity of wildlife and livestock with which humans co-exist across the city.

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Background: Livestock have been implicated as a reservoir for antimicrobial resistance (AMR) that can spread to humans. Close proximity and ecological interfaces involving livestock have been posited as risk factors for the transmission of AMR. In spite of this, there are sparse data and limited agreement on the transmission dynamics that occur.

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Article Synopsis
  • An estimated 59,000 people die from rabies each year, primarily due to bites from domestic dogs, particularly affecting rural populations in Africa; mass dog vaccinations are essential but resource-intensive.
  • The Laikipia Rabies Vaccination Campaign in Kenya (2015-2017) successfully vaccinated over 13,000 dogs, increasing vaccination coverage from 2% to 24%, although only a few communities met the 70% target needed for effective rabies control.
  • The campaign highlighted both achievements in dog vaccination and challenges such as inadequate post-vaccination monitoring, financial constraints, and the diversity of communities involved, which complicated efforts to reach the target coverage levels.
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Background: Antimicrobial resistance (AMR) driven by antibiotic consumption is a growing global health threat. However, data on antimicrobial consumption patterns in low- and middle-income countries (LMICs) is sparse. Here, we investigate the patterns of antibiotic sales in humans and livestock in urban Nairobi, Kenya, and evaluate the level of awareness and common behaviours related to antibiotic use and AMR amongst human and veterinary pharmacists.

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Article Synopsis
  • * The study found high levels of resistance among E. coli isolates, with 47.6% of human and 21.1% of livestock samples resistant to multiple antibiotic classes, indicating a serious public health concern.
  • * Human AMR was linked to factors like human population density and livestock waste, while the act of keeping livestock alone had no substantial impact on human AMR levels.
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