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Publication Helminthiasis and Malaria Co-Infection Among Women of Reproductive Age in a Rural Setting of Kilifi County, Coastal Kenya: A Mixed Method Study(PLOS GLOBAL PUBLIC HEALTH, 2024-06-03) Masaku, Janet; Mutuku, Francis; Kihara, Jimmy H.; Mwandawiro, Charles; Okoyo, Collins; Kanyi, Henry; Kamau, Joyce; Kaduka, Lydia; Ng’ang’a, Zipporah; Jeza, Victor T.Soil transmitted helminthiasis (STH), Schistosoma haematobium and malaria co-infection lead to increased susceptibility to other infections and poor pregnancy outcomes among women of reproductive age (WRA). This study sought to establish risk factors, burden of co-infection with STH, S. haematobium and Plasmodium sp. among WRA in Kilifi County, Kenya.A mixed method cross-sectional study was conducted on 474 WRA in 2021. Simple random sampling was used to select WRA from four villages in two purposively sampled sub-counties. Study participants were interviewed, and stool samples collected and analysed using Kato-Katz technique for STH. Urine samples were collected for examination of S. haematobium while malaria microscopic test was done using finger prick blood samples. Further, 15 focus group discussions (FGDs) were conducted with purposively selected WRA and qualitative data analyzed thematically using Nvivo software. Quantitative and qualitative methods were triangulated to comprehensively strengthen the study findings. Prevalence of S. haematobium was 22.3% (95%CI: 13.5–36.9), any STH 5.2% (95%CI: 1.9–14.3) and malaria 8.3% (95%: 3.8–18.2). Co-infections between any STH and S. haematobium was 0.8% (95%CI: 0.2–3.2) and between S. haematobium and malaria 0.8% (95%CI: 0.2–3.1). Multivariable analysis showed increased odds of any STH infections among participants in Rabai Sub-County, (aOR = 9.74; p = 0.026), businesswomen (aOR = 5.25; p<0.001), housewives (aOR = 2.78; p = 0.003), and casual laborers (aOR = 27.03; p<0.001). Qualitative analysis showed that the three parasitic diseases were common and responsible for possible causes of low birth weight, susceptibility to other infections and complications such as infertility and cancer later in life.The study demonstrated that STH, S. haematobium and malaria are still a public health problem to WRA. Some of the associated risks of infection were geographical location, socio-economic and WASH factors. Hence the need to implement integrated control efforts of the three parasitic infection.Publication In Vitro and In Vivo Antimalarial Activity of Nigella Sativa L. Extracts(Journal of Medicinal Plants Research, 2019-12) Oyweri Job; Mohammed Awadh; Udu Rahma; Gathirwa Jeremiah; Too Edwin; Omondi Protus; Kimani Francis; Hashim Suhaila; Abubakar LailaThe Arabs, Asians and, Traditional Health Practitioners in Mombasa county found in Kenya have been using Nigella sativa L. seeds to traditionally manage malaria associated symptoms that is, headache, fever, chills, loss of appetite among others. The present study investigated in vitro antiplasmodial, in vivo antimalarial activities and safety of different extracts of N. sativa. Five extracts obtained via aqueous extraction and sequential extraction using hexane, dichloromethane, ethyl acetate and methanol were tested against in vitro cultures of Plasmodium falciparum. The most active extracts (methanolic and ethyl acetate) were assessed for cytotoxicity and toxicity. The two active extracts were evaluated in vivo against Plasmodium berghei ANKA strain at 500, 250 and 125 mg/kg/day. On in vitro assay, methanolic and ethyl acetate extracts showed good activity with IC50 of 80.48±12.29 and 69.81±5.24 µg/ml against W2 strain and 31.93±4.31 and 53.79±6.02 µg/ml against D6 strain, respectively. The extracts exhibited weak cytotoxicity on Vero cells and high parasitemia suppression of 75.52 and 75.30% at 500 mg/kg dose of methanolic and ethyl acetate extracts respectively. Notably, there was significant decrease (p<0.001) in activity with lower doses of the extracts. The results explain thetraditional use of this plant in the Middle East and Mombasa CountyPublication Prevalence and Risk Factors Associated with Asymptomatic Plasmodium Falciparum Infection and Anemia Among Pregnant Women at the first Antenatal Care Visit: A Hospital Based Cross-Sectional Study in Kwale County, Kenya(PLOS ONE, 2020-10-08) Nyamu, Gibson Waweru; Kihara, Jimmy Hussein; Oyugi, Elvis Omondi; Omballa, Victor; El-Busaidy, Hajara; Jeza, Victor TunjeBackground: Prevalence of Prevalence of malaria in pregnancy (MiP) in Kenya ranges from 9% to 18%. We estimated the prevalence and factors associated with MiP and anemia in pregnancy (AiP) among asymptomatic women attending antenatal care (ANC) visits. Methods: We performed a cross-sectional study among pregnant women attending ANC at Msambweni Hospital, between September 2018 and February 2019. Data was collected and analyzed in Epi Info 7. Descriptive statistics were calculated and we compared MiP and AiP in asymptomatic cases to those without either condition. Adjusted prevalence Odds odds ratios (aPOR) and 95% confidence intervals (CI) were calculated to identify factors associated with asymptomatic MiP and AiP. Results: We interviewed 308 study participants; their mean age was 26.6 years (± 5.8 years), mean gestational age was 21.8 weeks (± 6.0 weeks), 173 (56.2%) were in the second trimester of pregnancy, 12.9% (40/308) had MiP and 62.7% had AiP. Women who were aged ≤ 20 years had three times likelihood of developing MiP (aPOR = 3.1 Cl: 1.3–7.35) compared to those aged >20 years old. The likelihood of AiP was higher among women with gestational age ≥ 16 weeks (aPOR = 3.9, CI: 1.96–7.75), those with parasitemia (aPOR = 3.3, 95% CI: 1.31–8.18), those in third trimester of pregnancy (aPOR = 2.6, 95% CI:1.40–4.96) and those who reported eating soil as a craving during pregnancy (aPOR = 1.9, 95%CI:1.15–3.29). Conclusions: Majority of the women had asymptomatic MiP and AiP. MiP was observed in one tenth of all study participants. Asymptomatic MiP was associated with younger age while AiP was associated with gestational age parasitemia, and soil consumption as a craving during pregnancy.Publication Schistosomiasis, Soil Transmitted Helminthiasis, and Malaria Co-Infections Among Women of Reproductive Age in Rural Communities of Kwale County, Coastal Kenya(BMC Public Health, 2022-01-19) Jeza, Victor Tunje; Francis , Mutuku; Kaduka, Lydia; Mwandawiro, Charles; Masaku, Janet; Okoyo, Collins; Kanyi, Henry; Kamau, Joyce; Ng’ang’a, Zipporah; Kihara, Jimmy HusseinBackground: Schistosoma haematobium, soil transmitted helminthes (STH), and malaria lead to a double burden in pregnancy that eventually leads to poor immunity, increased susceptibility to other infections, and poor pregnancy outcomes. Many studies have been carried out on pre-school and school aged children but very little has been done among the at risk adult population including women of reproductive age (WRA). Our current study sought to establish the risk factors and burden of co-infection with S. haematobium, STH, and Plasmodium sp. among WRA in Kwale County, Coastal Kenya. Methods: A total of 534 WRA between the ages of 15–50 were enrolled in this cross-sectional study from four villages; Bilashaka and Mwaluphamba in Matuga sub-County, and Mwachinga and Dumbule in Kinango sub-County. Socio-demographic information was collected using a pre-tested standardized questionnaire. Parasitological examination was done using urine fltration method for Schistosoma haematobium, Kato Katz for STH (Ascaris lumbricoides, Hookworm, Trichuris trichiura), and standard slide microscopy for Plasmodium sp. Statistical analyses were carried out using STATA version 15.1. Results: The overall prevalence of S. haematobium was 3.8% (95% CI: 2.6–5.4) while that for malaria was 4.9% (95% CI: 2.0–11.7). The prevalence of STH was 5.6% (95% CI: 2.8–11.3) with overall prevalence of 5.3% (95% CI: 2.5–10.9) for hookworm and 0.6% (95% CI: 0.2–1.9) for T. trichiura. The occurrence of co-infection was low and was recorded between S. haematobium and P. falciparum (0.6%), followed by S. haematobium and STH (0.4%). Among pregnant women, 2.6% had co-infection with S. haematobium and P. falciparum. Only 1.3% had co-infection with S. haematobium and hookworm or T. trichiura. Among non-pregnant women, co-infection with S. haematobium and P. falciparum was 0.2%. Similarly, co-infection with S. haematobium and hookworm or T. trichiura was 0.2%. Bed net ownership and usage among pregnant women was 87.8 and 96.6%, respectively. 66.3% of the women reported using improved water sources for drinking while 78.1% reported using improved sanitation facilities. Conclusion: The use of improved WASH activities might have contributed to the low prevalence of STHs and S. haematobium infections. Further, bed net ownership and usage might have resulted in the low prevalence of Plasmodium sp. infections observed.