Identifying barriers and potential solutions to improve equitable access to community eye services: an exploratory sequential mixed methods study protocol.

Introduction: Access to care varies by sociodemographic group, with some groups facing higher barriers to care than others. This study will use novel methods to explore barriers and potential solutions as perceived by members of the population groups who are least able to access care. We aim to use rapid yet robust mixed methods that allow us to identify generalisable findings within each programme and testable service modifications to improve equitable access to care; delivering non-tokenistic findings within a matter of weeks.

Cost-effectiveness of leveraging existing HIV primary health systems and community health workers for hypertension screening and treatment in Africa: An individual-based modeling study.

Background: Cardiovascular disease (CVD) morbidity and mortality is increasing in Africa, largely due to undiagnosed and untreated hypertension. Approaches that leverage existing primary health systems could improve hypertension treatment and reduce CVD, but cost-effectiveness is unknown. We evaluated the cost-effectiveness of population-level hypertension screening and implementation of chronic care clinics across eastern, southern, central, and western Africa.

Detection and analysis of Serpin and RP26 specific antibodies for monitoring Schistosoma haematobium transmission.

Background: Schistosoma haematobium is the causative pathogen for urogenital schistosomiasis. To achieve progress towards schistosomiasis elimination, there is a critical need for developing highly sensitive and specific tools to monitor transmission in near-elimination settings. Although antibody detection is a promising approach, it is usually unable to discriminate active infections from past ones.

Metabolic resistance to pyrethroids with possible involvement of non-coding ribonucleic acids in Anopheles funestus, the major malaria vector in western Kenya.

Background: The resurgence of Anopheles funestus, a dominant vector of human malaria in western Kenya was partly attributed to insecticide resistance. However, evidence on the molecular basis of pyrethroid resistance in western Kenya is limited. Here, we reported metabolic resistance mechanisms and demonstrated that multiple non-coding Ribonucleic Acids (ncRNAs) could play a potential role in An.

Factors Influencing Iron Levels Among Women of Reproductive Age and Children 6-48 Months in Livestock-Keeping Communities in Narok County, Kenya.

Proper nutrition is vital for maintaining good health for all people across their lifespan, especially children and mothers, who are especially vulnerable due to their specific nutrient needs. Despite the necessity of improved nutrition for these groups, some members do not fully meet their recommended daily micronutrient needs, a challenge exacerbated by different socioeconomic, cultural, and communal constraints resulting in malnutrition. Iron deficiency anaemia is a major concern among children and mothers, especially in pastoralist communities, due to poor nutrition and other related factors.

Geographic origin and evolution of dengue virus serotypes 1 and 3 circulating in Africa.

Despite the increasing burden of dengue in Kenya and Africa, the introduction and expansion of the virus in the region remain poorly understood. The objective of this study is to examine the genetic diversity and evolutionary histories of dengue virus (DENV) serotypes 1 and 3 in Kenya and contextualize their circulation within circulation dynamics in the broader African region. Viral RNA was extracted from samples collected from a cohort of febrile patients recruited at clinical sites in Kenya from 2013 to 2022.

Community Perspectives on Optimizing Community Health Volunteer Roles for HIV Prevention Services in Kenya and Uganda.

Community health workers (CHWs) play a significant role in supporting health services delivery in communities with few trained health care providers. There has been limited research on ways to optimize the role of CHWs in HIV prevention service delivery. This study explored CHWs' experiences with offering HIV prevention services [HIV testing and HIV pre- and post-exposure prophylaxis (PrEP and PEP)] during three pilot studies in rural communities in Kenya and Uganda, which aimed to increase biomedical HIV prevention coverage via a structured patient-centered HIV prevention delivery model.

Intersection between individual, household, environmental and system level factors in defining risk and resilience for children in Kenya's ASAL: A qualitative study.

Introduction: Children growing up in arid and semi-arid regions of Sub-Saharan Africa (SSA) face heightened risks, often resulting in poor developmental outcomes. In Kenya, the arid and semi-arid lands (ASAL) exhibit the lowest health and developmental indicators among children. Despite these risks, some children grow up successfully and overcome the challenges.

Detection of low frequency artemisinin resistance mutations, C469Y, P553L and A675V, and fixed antifolate resistance mutations in asymptomatic primary school children in Kenya.

Background: To understand the emergence and spread of drug-resistant parasites in malaria-endemic areas, accurate assessment and monitoring of antimalarial drug resistance markers is critical. Recent advances in next-generation sequencing (NGS) technologies have enabled the tracking of drug-resistant malaria parasites.

Methods: In this study, we used Targeted Amplicon Deep Sequencing (TADS) to characterise the genetic diversity of the Pfk13, Pfdhfr, Pfdhps, and Pfmdr1 genes among primary school-going children in 15 counties in Kenya (Bungoma, Busia, Homa Bay, Migori, Kakamega, Kilifi, Kirinyaga, Kisii, Kisumu, Kwale, Siaya, Tana River, Turkana, Vihiga and West Pokot).

Development of a rapid and highly sensitive nucleic acid-based diagnostic test for schistosomes, leveraging on identical multi-repeat sequences.

Introduction: Schistosomiasis (Bilharzia), a neglected tropical disease caused by parasites, afflicts over 240 million people globally, disproportionately impacting Sub-Saharan Africa. Current diagnostic tests, despite their utility, suffer from limitations like low sensitivity. Polymerase chain reaction (PCR) and quantitative real-time PCR (qPCR) remain the most common and sensitive nucleic acid amplification tests.

Interventions and implementation considerations for reducing pre-treatment loss to follow-up in adults with pulmonary tuberculosis: A scoping review.

Background: Tuberculosis (TB) is a leading cause of death worldwide with over 90% of reported cases occurring in low- and middle-income countries (LMICs). Pre-treatment loss to follow-up (PTLFU) is a key contributor to TB mortality and infection transmission.

Objectives: We performed a scoping review to map available evidence on interventions to reduce PTLFU in adults with pulmonary TB, identify gaps in existing knowledge, and develop a conceptual framework to guide intervention implementation.

Derivation and validation of a clinical predictive model for longer duration diarrhea among pediatric patients in Kenya using machine learning algorithms.

Background: Despite the adverse health outcomes associated with longer duration diarrhea (LDD), there are currently no clinical decision tools for timely identification and better management of children with increased risk. This study utilizes machine learning (ML) to derive and validate a predictive model for LDD among children presenting with diarrhea to health facilities.

Methods: LDD was defined as a diarrhea episode lasting ≥ 7 days.

Larviciding for malaria control and elimination in Africa.

Background: Global progress toward malaria elimination and eradication goals has stagnated in recent years, with many African countries reporting increases in malaria morbidity and mortality. Insecticide-treated nets and indoor residual spraying are effective, but the emergence and increased intensity of insecticide resistance and the challenge of outdoor transmission are undermining their impact. New tools are needed to get back on track towards global targets.

Development and optimization of a new competitive ELISA using recombinant (rPSA D15 and rCag11) antigens for the detection of Helicobacter pylori infection.

H. pylori (Hp) is highly causative agent of chronic gastritis, gastric cancer and human death worldwide. To address the challenge of H.

Predictors of Length of Hospitalization for Neonatal Sepsis at Kenyatta Nation Hospital, Kenya: A Prospective Cross-Sectional Study.

Background And Aims: Neonatal sepsis is a major cause of neonatal mortality worldwide. It remains a detrimental bottleneck to the WHO goal of eradicating preventable deaths for children below 5 years of age by 2030. Though the risk factors for adverse clinical outcomes for neonatal sepsis have been widely studied there is no universal consensus.

Albendazole-ivermectin co-formulation for the treatment of Trichuris trichiura and other soil-transmitted helminths: a randomised phase 2/3 trial.

Background: Treatments for soil-transmitted helminthiases face challenges, especially in addressing Trichuris trichiura. Combination regimens, particularly of ivermectin and albendazole, are promising. We aimed to assess the safety, efficacy, and palatability of a combination tablet for the treatment of T trichiura, hookworm, and Strongyloides stercoralis infections among school-aged children in Ethiopia, Kenya, and Mozambique.

Applicability of TB-LAMP test for diagnosis of pulmonary TB among HIV-positive individuals.

Background: The loop-mediated isothermal amplification for TB (TB-LAMP) assay is more cost-effective and accessible than the Xpert MTB/RIF assay. This study aimed to evaluate the diagnostic performance of the TB-LAMP assay in individuals with and without HIV infection.

Methods: Patients aged ≥15 years presenting with symptoms of TB were included in the study.

Immune targets for schistosomiasis control identified by a genome-wide association study of African snail vectors.

Schistosomiasis, a neglected tropical disease, is transmitted by freshwater snails. Interruption of transmission will require novel vector-focused interventions. We performed a genome-wide association study of African snails, , exposed to in an endemic area of high transmission in Kenya.

Malaria prevalence, transmission potential and efficacy of artemisinin-based combination therapy in the Kenyan Central highlands: a zone previously characterized as malaria-free.

Background: The current study sought to re-evaluate malaria prevalence, susceptibility to artemisinin-based combination therapy (ACT), transmission patterns and the presence of malaria vectors in the Kikuyu area of the Kenyan Central highlands, a non-traditional/low risk malaria transmission zone where there have been anecdotal reports of emerging malaria infections.

Methods: Sampling of adult mosquitoes was done indoors, while larvae were sampled outdoors in June 2019. The malaria clinical study was an open label non-randomized clinical trial where the efficacy of one ACT drug, was evaluated in two health facilities.

Water, sanitation, handwashing, and nutritional interventions can reduce child antibiotic use: evidence from Bangladesh and Kenya.

Antibiotics can trigger antimicrobial resistance and microbiome alterations. Reducing pathogen exposure and undernutrition can reduce infections and antibiotic use. We assess effects of water, sanitation, handwashing (WSH) and nutrition interventions on caregiver-reported antibiotic use in Bangladesh and Kenya, longitudinally measured at three timepoints among birth cohorts (ages 3-28 months) in a cluster-randomized trial.

Event-driven PrEP beyond cisgender men who have sex with men.

Despite advancements in existing antiretroviral-based prevention strategies, including daily oral, locally acting, and injectable options, there is a pressing need for more inclusive and flexible event-driven pre-exposure prophylaxis (PrEP) strategies for all. Event-driven or intermittent dosing of PrEP in populations beyond cisgender men who have sex with men would offer a promising alternative by fitting prevention into the diverse lifestyles of affected populations and thereby advancing health equity. Evidence from PrEP clinical trials, pharmacokinetic studies, modelling studies, and real-world observational research suggests that event-driven PrEP could be a flexible and inclusive option, yet optimal dosing has not been established across sex and gender spectrums.

Impact of water, sanitation, and hygiene indicators on enteric viral pathogens among under-5 children in low resource settings.

Poor water, sanitation, and hygiene (WASH) are the primary risks of exposure to enteric viral infection. Our study aimed to describe the role of WASH conditions and practices as risk factors for enteric viral infections in children under 5. Literature on the risk factors associated with all-cause diarrhea masks the taxa-specific drivers of diarrhea from specific pathogens, limiting the application of relevant control strategies.

Enhancing engagement in HIV care among adolescents and young adults: A focus on phone-based navigation and relationship building to address barriers in HIV care.

Structural, psychological, and clinical barriers to HIV care engagement among adolescents and young adults living with HIV (AYAH) persist globally despite gains in HIV epidemic control. Phone-based peer navigation may provide critical peer support, increase delivery flexibility, and require fewer resources. Prior studies show that phone-based navigation and automated text messaging interventions improve HIV care engagement, adherence, and retention among AYAH.

Educate, Advocate, Act Now: a sustainable approach to combating antimicrobial resistance TODAY.

Antimicrobial resistance (AMR) poses a great challenge to health systems all over the world. It is exacerbated by the abuse, misuse and overuse of antimicrobials in humans, animals, plants and the environment. This viewpoint emphasizes the critical need to address the challenges of AMR through an integrated, long-term approach that focuses on education, advocacy and collective action.

Preferences for and acceptability of long-acting HIV prevention products among pregnant and lactating women accessing health services in Kenya: a mixed method cross-sectional analysis.

Background: Increased risk of HIV acquisition during pregnancy and lactation among women is evident, necessitating their inclusion in the evaluation of new HIV prevention interventions. Pregnant and postpartum women specifically face challenges with oral PrEP associated with stigma, and the burden of using other tablets. Long-acting products may address challenges related to oral PrEP, however, there is limited data on product-specific preferences and acceptability among pregnant and lactating women.