Technical University of Mombasa

Background Global initiatives have emphasized tracking indicators to monitor progress, particularly in countries with the highest maternal and child mortality. Routine data can be used to monitor indicators for improved target setting at national and subnational levels. Our objective was to assess the geographic inequalities in estimates of reproductive, maternal and child health indicators from routine data at the subnational level in Kenya. Methods Monthly data from 47 counties clustered in 8 regions, from January 2018 to December 2021 were assembled from the District Health Information Software version 2 (DHIS2) in Kenya. This included women of reproductive age receiving family planning commodities, pregnant women completing four antenatal care visits, deliveries conducted by skilled birth attendants, fully immunized children at 1 year and number of maternal deaths at health facilities, from which five indicators were constructed with denominators. A hierarchical Bayesian model was used to generate estimates of the five indicators at the at sub-national levels(counties and sub counties), adjusting for four determinants of health. A reproductive, maternal, and child health (RMCH) index was generated from the 5 indicators to compare overall performance across the continuum of care in reproductive, maternal and child health across the different counties. Results The DHIS2 data quality for the selected 5 indicators was acceptable with detection of less than 3% outliers for the Facility Maternal Mortality Ratio (FMMR) and less than 1% for the other indicators. Overall, counties in the north-eastern, eastern and coastal regions had the lowest RMCH index due to low service coverage and high FMMR. Full immunization coverage at 1 year (FIC) had the highest estimate (79.3%, BCI: 77.8—80.5%), while Women of Reproductive age receiving FP commodities had the lowest estimate (38.6%, BCI: 38.2–38.9%). FMMR was estimated at 105.4, (BCI 67.3–177.1)Health facility density was an important determinant in estimating all five indicators. Maternal education was positively correlated with higher FIC coverage, while wealthier sub counties had higher FMMR. Conclusions Tracking of RMCH indicators revealed geographical inequalities at the County and subcounty level, often masked by national-level estimates. These findings underscore the value of routine monitoring indicators as a potential for evidence-based sub-national planning and precision targeting of interventions to marginalized populations.

Accumulation of solid waste is a major global challenge. The conventional waste disposal methods are often ineffective in mitigating solid waste pollution, highlighting the need for other sustainable alternatives. This study is aimed at isolating and identifying potential waste-degrading microorganisms from Mwakirunge dumpsite in Mombasa, Kenya. A total of 16 soil samples were collected using a randomized block design. The samples were inoculated in enriched basal media containing mixed municipal solid waste and incubated at 37°C for 21 days. Microbial identification was conducted using standard morphological, biochemical, and molecular approaches. DNA was extracted using organic isolation methods, and PCR amplification of the 16S rRNA gene for bacteria and the ITS gene for fungi was performed. Phylogenetic analysis grouped bacterial isolates into phylum Bacillota (Firmicutes), Pseudomonadota (Proteobacteria), and Actinomycetota (Actinobacteria) that included members of the genera bacilli, Pseudomonas, brevibacilli, Microbacterium, Ochrobactrum, Paenibacillus, Staphylococcus, Isoptericola, and Streptomyces. Fungal isolates belonged to the genus Aspergillus within the phylum Ascomycota. Three bacterial isolates B4S2 b (MZ571886), B3S1 (MZ571907), and B3S4 B (MZ571915) and one fungal isolate B2S2 a1 (MZ569413) had low sequence similarities with their closely known taxonomic relatives. The ability of the isolates to produce lipase, esterase, cellulase, amylase, and gelatinase enzymes was tested using the agar diffusion method. The results showed a significant level of enzyme production (p<0.05). Bacillus cereus (MZ571899) exhibited the highest esterase activity; Streptomyces thermocarboxydus (MZ571882) exhibited the highest lipase activity, Bacillus subtilis (MZ571887) exhibited the highest amylase activity, and Bacillus licheniformis (MZ571888) exhibited the highest cellulase activity, while Pseudomonas stutzeri (MZ571900) exhibited the highest gelatinase activity. We recommend further studies to characterize the isolates with low sequence percentage similarities to establish their true identities. In addition, further enzymatic studies are required to quantify, characterize, and purify these enzymes for industrial applications.

Mangroves are a critical habitat that provide a suite of ecosystem services and support livelihoods. Here we undertook a global analysis to model the density and abundance of 37 commercially important juvenile fish and juvenile and resident invertebrates that are known to extensively use mangroves, by fitting expert-identified drivers of density to fish and invertebrate density data from published field studies. The numerical model predicted high densities throughout parts of Southeast and South Asia, the northern coast of South America, the Red Sea, and the Caribbean and Central America. Application of our model globally estimates that mangroves support an annual abundance of over 700 billion juvenile fish and invertebrates. While abundance at the early life-history stage does not directly equate to potential economic or biomass gains, this estimate indicates the critical role of mangroves globally in supporting fish and fisheries, and further builds the case for their conservation and restoration.

The incidence of Aedes-borne pathogens has been increasing despite vector control efforts. Control strategies typically target households (HH), where Aedes mosquitoes breed in HH containers and bite indoors. However, our study in Kenyan cities of Kisumu and Ukunda (2019–2022) revealed high Aedes abundance in public spaces, prompting the question: How important are non-household (NH) environments for dengue transmission and control? Using field data and human activity patterns, we developed an agent-based model simulating transmission across HH and five types of NH environments, which was then used to evaluate preventive (before an epidemic) and reactive (after an epidemic commences) vector control scenarios. Our findings estimate over half of infections occurring in NH settings, particularly workplaces, markets and recreational sites. Container removal was more effective in NH than in HH areas, contrasting with the global focus on HH-based management. Greater reductions in dengue cases occurred with early, high-coverage interventions, especially in NH locations. Additionally, local ecological factors, such as uneven water container distribution, influence control outcomes. This study underscores the importance of vector control in both HH and NH environments in endemic settings. It highlights a specific approach to inform evidence-based decision-making to target limited vector control resources for optimal control.

This study investigates the influence of social media on female representation and body image perceptions among young female students in Southwest Nigeria, examining the interplay between global media dynamics and local cultural contexts. Through a de-westernizing lens, the research explores the prevalence of social media usage, perceptions of female representation, and the impact on body image. Findings reveal a pervasive engagement with social media among Nigerian females, while resisting Western beauty ideals and demonstrating satisfaction with body size and skin tone. Drawing from cultural imperialism theory and social comparison theory, the study exposes the complex relationship between social media, cultural influences, and individual agency in shaping female identity. Data was collected through a questionnaire administered to a sample of 400 female students from two universities in Southwest Nigeria: The University of Ibadan and Lead City University. A multi-stage sampling technique was employed, starting with the purposive selection of 24,000 female students. Yamane’s sample size formula was then applied to determine a reliable and representative sample size of 400 participants. The analysis utilized various statistical tools, including descriptive statistics such as frequencies, percentages, and mean distributions, along with inferential statistics like Analysis of Variance (ANOVA), logistic regression, and linear regression models. The data analysis was conducted using the Statistical Package for Social Sciences (SPSS) software. However, despite the existence of online social comparisons among young Nigerian female students, the desire to conform to the idealized body image portrayed by social media or adopt the slim body type of a traditional Western woman is not prevalent among most of the respondents. This finding suggests that young Nigerian female students exhibit a strong sense of body confidence contributing to improved mental wellbeing and fostering a more diverse societal perception of beauty.

Background Trash piles and abandoned tires that are exposed to the elements collect water and create productive breeding grounds for Aedes aegypti mosquitoes, the primary vector for multiple arboviruses. Unmanned aerial vehicle (UAV) imaging provides a novel approach to efficiently and accurately mapping trash, which could facilitate improved prediction of Ae. aegypti habitat and consequent arbovirus transmission. This study evaluates the efficacy of trash identification by UAV imaging analysis compared with the standard practice of walking through a community to count and classify trash piles. Methods We conducted UAV flights and four types of walkthrough trash surveys in the city of Kisumu and town of Ukunda in western and coastal Kenya, respectively. Trash was classified on the basis of a scheme previously developed to identify high and low risk Aedes aegypti breeding sites. We then compared trash detection between the UAV images and walkthrough surveys. Results Across all walkthrough methods, UAV image analysis captured 1.8-fold to 4.4-fold more trash than the walkthrough method alone. Ground truth validation of UAV-identified trash showed that 94% of the labeled trash sites were correctly identified with regards to both location and trash classification. In addition, 98% of the visible trash mimics documented during walkthroughs were correctly avoided during UAV image analysis. We identified advantages and limitations to using UAV imaging to identify trash piles. While UAV imaging did miss trash underneath vegetation or buildings and did not show the exact composition of trash piles, this method was efficient, enabled detailed quantitative trash data, and granted access to areas that were not easily accessible by walking. Conclusions UAVs provide a promising method of trash mapping and classification, which can improve research evaluating trash as a risk factor for infectious diseases or aiming to decrease community trash exposure. Graphical Abstract

Assessing the extent to which the quality of family planning (FP) delivery in facilities makes a difference for key outcomes such as service satisfaction or contraceptive discontinuation is of key interest to the family planning field. However, assessment of this relationship is methodologically challenging due to differences in populations served across facilities. Furthermore, data that connect facilities to the populations served are limited. We use novel data from the Performance Monitoring for Action (PMA) project and a new methodological approach to examine the relationship between facility level characteristics and FP outcomes. The PMA data consist of facility surveys and client exit interviews, and capture women’s FP outcomes and include information on characteristics of the individual woman, the facility where the woman obtained her family planning services, and follow-up information on contraceptive use. We use a design-based direct standardization method to balance the distribution of populations served across facilities while controlling for the additional variability induced by the balancing weights. We find significant evidence of variation in FP outcomes across facilities that cannot be accounted for by differences in women characteristics. The type of facility (e.g., dispensary), their size, the proportion of staff present, and whether the facility was public were associated with more positive service satisfaction. A higher ratio of staff to FP visits was predictive of lower contraceptive discontinuation.

Background: Hyperuricaemia is a risk factor for gout and independently predicts hypertension, diabetes, and chronic kidney disease development. While elevated uric acid levels occur in HIV patients, and weight gain is linked to dolutegravir-based therapy, data on the obesity-hyperuricaemia relationship in this population remain limited.Objective: The objective of our study was to evaluate the association between obesity and hyperuricaemia among HIV-positive patients on antiretroviral therapy in South-Western Uganda.Methods: Between April 2024 and June 2024, this study conducted a secondary analysis of data on uric acid level and factors associated with obesity from a 2023 cross-sectional study of HIV-positive participants. We used logistic regression to assess the factors associated with hyperuricaemia, and receiver operating characteristic curve analysis to assess the predictive performance of body mass index for hyperuricaemia.Results: Among 328 participants, hyperuricaemia prevalence was 23.48% (95% confidence interval [CI]: 19.19–28.39%) higher in male participants (31.6%) than female participants (20.0%, p = 0.023). Overweight (adjusted odds ratio [aOR]: 2.01; 95% CI: 1.01–4.00; p = 0.046), obesity (aOR: 2.50; 95% CI: 1.09–5.73, p = 0.030), and male gender (aOR: 2.31; 95% CI: 1.07–5.01, p = 0.033) were significantly associated with hyperuricaemia.Conclusion: Our findings indicate a relationship between hyperuricaemia and obesity in HIV patients on antiretroviral therapy in Uganda. Nationwide studies using primary data are needed to better understand this relationship’s epidemiological spread.What this study adds: This study is the first to link obesity with hyperuricaemia among HIV-positive Ugandans on antiretroviral therapy, highlighting obesity as a key metabolic complication of HIV treatment.

Chikungunya (CHIKV) and dengue (DENV) are mosquito-borne viruses that cause severe epidemics, often in remote regions. A limitation to our understanding of these pathogens is the difficulty of performing assays of the cellular immune response. To fill this gap, we developed a novel miniaturized automated system capable of processing 250 μl of whole blood for high-throughput cellular analysis. In a field study with a pediatric cohort in Msambweni, Kenya, known for previous exposure to CHIKV and/or DENV, we processed 133 whole blood samples using our system under three conditions: no stimulation, and stimulation with CHIKV or DENV peptide pools. These samples underwent CyTOF or flow cytometry analysis to evaluate virus-specific memory T cell responses and phenotypes. CyTOF analysis of 81 participant samples revealed significant cytokine responses to CHIKV and DENV, particularly IFNγ (P < 0.01 and P < 0.0001, respectively) and TNF-α (P < 0.0001) by γδ T cells. Additionally, a significant TNF-α response was observed in the CD8+ TEMRA memory subset to DENV, albeit to a lesser degree than in γδ T cells. To confirm our CyTOF findings, we employed flow cytometry on the remaining 40 samples using a targeted panel, validating significant TNF-α (P < 0.0001 and P < 0.01) and IFN-γ (P < 0.05) responses by γδ T cells to CHIKV and DENV, respectively. Our study demonstrates that our innovative automated system enables detailed assessment of immune function, particularly beneficial in pediatric populations and resource-limited settings with limited sample volumes. This approach holds promise for advancing our understanding of cellular immune responses to various viral and infectious diseases.

Background Reproductive coercion (RC) is a type of abuse where a partner intentionally attempts to interfere with fertility through deception or violence, often by manipulating one's contraceptive use or reproductive decision-making. Cross-sectional studies on the magnitude of RC across sub-Saharan Africa have noted associations with contraceptive use. No studies have longitudinally examined RC experiences as related to future contraceptive dynamics, including discontinuation or forgoing use altogether.

Objectives Intimate partner violence (IPV) threatens women’s health and safety. Support services can mitigate the impact, yet few survivors seek services in part due to social norms that discourage use. Little agreement exists on how to measure norms and attitudes related to IPV help-seeking. The objectives were to (1) refine an IPV Help-Seeking Attitudes Scale and examine its psychometric properties, (2) explore differences in attitudes between young men and young women, and (3) examine associations of past 6-month IPV among young women with the scale at the individual level (individual attitudes) and the by-gender community-aggregated averages (community norms) among youth in Nairobi, Kenya. Design This cross-sectional, secondary analysis used data from a phone-based survey with a cohort of young men and young women recruited via respondent-driven sampling from April to May 2021. Cross-sectional exploratory factor analysis assessed underlying latent constructs. Multilevel mixed-effects models assessed associations with IPV experience for young women. Setting and participants A youth cohort of 586 men and 591 women aged 15–24 years in Nairobi, Kenya. Primary outcome measure Past 6-month physical and/or sexual IPV among young women. Results The IPV Help-Seeking Attitudes Scale had acceptable internal reliability (Cronbach’s alpha >0.60). IPV prevalence was 17.5%, among whom 21.7% had sought any help for the past 6-month IPV. A one-unit increase in the community aggregate IPV Help-Seeking Attitudes Scale among young women was associated with reduced odds of IPV (aOR: 0.17, 95% CI: 0.03–0.98). However, the individual-level attitudes scale was not associated with IPV nor was the men’s community aggregate scale. Conclusions The IPV Help-Seeking Attitudes Scale had adequate psychometric properties. The results suggest that young women living in a community where the norm among women enables IPV response may have a reduced risk of IPV. Community norms change to better enable IPV response among young people may help reduce IPV and increase help-seeking.

Background The medicinal plant Xerophyta spekei is used among Embu and Mbeere communities to manage diabetes mellitus. However, its efficacy has never been evaluated in vivo. The purpose of this study was to investigate its quantitative phytochemical and antidiabetic potential. Extraction was done using Dichloromethane (DCM). Quantitative phytochemical analysis was conducted using GC-MS. To evaluate antidiabetic activity, groups of mice which included normal control, diabetic control, positive control, and extract-administered groups (50, 100, 150, and 200 mg/kg body weight) were used. Alloxan monohydrate was used to induce diabetes. Blood glucose of the mice was determined hourly for the first six hours, and once after 12 and 24 h on the first day. Thereafter, the blood glucose in mice was determined once a week for three weeks. During the experimental period of three weeks, body weights were determined. After 21 days, lipid profiles, kidney and liver function tests as well as ex vivo antioxidant assays were carried out. Results The phytochemicals classes identified included flavonoids, phenolic compounds, phytosterols, terpenoids, fatty acids, tocopherols and alkaloids. Stigmasterol had the highest concentration (12.99 ± 2.56 mg/g). The extract decreased blood glucose dose-dependently, with 200 mg/kg bw dose resulting in the highest % mean change (40.10 ± 0.95). The extract gradually decreased blood glucose during 21 days of treatment. It attenuated loss of body weight and aberrant biochemical parameters including liver and renal function tests as well as lipid profiles in diabetic mice. Furthermore, it reduced levels of malondialdehyde and enhanced enzymatic antioxidant activities in diabetic mice. Conclusions The study confirms that DCM extract X. spekei contains phytochemicals with antioxidant and antidiabetic properties. The findings authenticate the folkloric use of X. spekei in managing diabetes mellitus. The medicinal plant also serves as a potential source for developing antidiabetic agents.

Purpose: This study aimed to investigate the association between the aspartate aminotransferase-to-alanine aminotransferase (AST/ALT) ratio and metabolic syndrome (MetS) among HIV-infected patients on dolutegravir-based antiretroviral therapy (ART). Patients and methods: A cross-sectional study was conducted on 377 adults on dolutegravir-based ART for at least one year. Data were collected from July 1 to August 15, 2024. Participants were systematically sampled, data were collected using a pre-tested questionnaire, anthropometric measurements were taken, and blood samples were collected for biochemical analysis. A low AST/ALT ratio was defined as ≤ 1 and MetS as the presence of at least three of the following: central obesity, fasting hyperglycemia, elevated triglycerides, low HDL-C, and hypertension (International Diabetes Federation (IDF) Consensus worldwide definition, 2006). Logistic regression was used to assess the association between low AST/ALT ratio and MetS, and receiver operating curve (ROC) analysis was conducted to evaluate its predictive performance. Results: The median age of the participants was 44 years (interquartile range (IQR): 30-59), with 56.2% being female. The prevalence of MetS was 35.3% (133/377, 95%CI: 30.6-40.3). A significant association was found between low AST/ALT ratio and MetS (aOR: 2.19, 95% CI: 1.28-3.73, p = 0.004). Female gender (adjusted odds ratio (aOR): 3.68, 95% CI: 2.07-6.55, p < 0.001) and smoking (aOR: 3.96, 95% CI: 1.77-8.86, p < 0.001) were also significantly associated with MetS. The ALT/AST ratio had a significant predictive power for MetS (AUC = 0.583, 95% CI: 0.523-0.643). Conclusion: The prevalence of MetS is high. A low AST/ALT ratio is significantly associated with MetS, making it a potential biomarker among HIV patients on ART.

Antimicrobial resistant pathogens are a leading cause of morbidity and mortality worldwide, with overuse and misuse of antimicrobials being key contributors. We aimed to identify factors associated with antibiotic prescriptions among patients presenting to clinics in Kenya. We performed a retrospective, descriptive cohort study of persons presenting to outpatient clinics in Western and Coastal Kenya, including symptoms, physical exams, clinician assessments, laboratory results and prescriptions. We reviewed 1,526 visits among 1,059 people who sought care from December 2019-February 2022. Median age was 16 (IQR 6–35) and 22% were under 5. 30% of malaria RDTs were positive and 3% of dengue RT-qPCRs were positive. Antibiotics were prescribed in 73% of encounters overall and in 84% among children under 5. In 48% of visits antibiotics were prescribed without a provisional bacterial diagnosis. In the multivariable model, factors associated with increased odds of an antibiotic prescription were the clinic in Western Kenya (OR 5.1, 95% CI 3.0–8.8), age less than or equal to 18 (OR 2.1, 95% CI 1.4–3.2), endorsement of cardiorespiratory symptoms (OR 5.2, 95% CI 3.2–8.3), a negative malaria RDT (OR 4.0, 95% CI 2.5–6.8), and a provisional diagnosis that could be bacterial in etiology (OR 5.9, 95% CI 3.5–10.3). High rates of antibiotic prescriptions are common even when associated diagnoses are not bacterial. Compared to our 2014–2017 cohort, we found higher rates of antibiotic prescriptions among children. Improved diagnostics to rule in alternative diagnoses as well as stewardship programs are needed.

Background Despite the increasing burden of dengue in Kenya and Africa, the introduction and expansion of the virus in the region remains poorly understood. The objective of this study is to examine the genetic diversity and evolutionary histories of dengue serotypes 1 and 3 in Kenya and contextualize their circulation within circulation dynamics in the broader African region. Methods Viral RNA was extracted from samples collected from a cohort of febrile patients recruited at clinical sites in Kenya from 2013 to 2022. Samples were tested by PCR for dengue virus (DENV) presence. Five DENV positive samples were serotyped, and complete viral genomes for phylogenetic inference were obtained via sequencing on Illumina platforms. Sequences generated in our study were combined with global datasets of sequences, and Bayesian and maximum likelihood methods were used to infer phylogenetic trees and geographic patterns of spread with a focus on Kenya and Africa as a whole. Results Four new DENV-1 and one new DENV-3 genome were successfully sequenced and combined with 328 DENV-1 and 395 DENV-3 genomes from elsewhere for phylogenetic analyses. The DENV-1 sequences from our study formed a monophyletic cluster with an inferred common ancestor in 2019 (MRCA 2019, 95% HPD 2018 – 2019), that was closely related to sequences from Tanzania. The single DENV-3 sequence clustered with sequences from Tanzania and Kenya collected between 2017 and 2019 and related to recent outbreaks in the region. Phylogenetic trees resolved multiple clades of DENV-1 and -3 concurrently circulating in Africa, introduced in the early to mid-2000s. Three DENV-1 and four DENV-3 clades are highlighted, introduced between 2000 and 2015. Phylogeographic models suggest frequent, independent importations of DENV lineages into Kenya and Africa from East and South-East Asia via distinct geographic pathways. Conclusions DENV-1 and -3 evolutionary dynamics in Africa are characterized by co-circulation of multiple recently introduced lineages. Circulating lineages are introduced via distinct geographic pathways that may be centered around regional nexus locations. Increased surveillance is required to identify key regional locations that drive spread, and dengue interventions should focus on interrupting spread at these locations.

Dengue virus (DENV) is the most common arbovirus globally, with its incidence growing dramatically in recent decades. Although the effects of DENV infection during pregnancy are unclear, reported associations with adverse health outcomes include miscarriage, prematurity, and low birth weight. In this study, we used an IgG ELISA to identify mothers exposed to DENV during pregnancy by testing samples obtained from a previous study that followed a cohort of pregnant women in Kenya to investigate parasitic infections during pregnancy. We compared adverse pregnancy and infant health outcomes between seronegative mothers and those who seroconverted. Of the 289 participants tested for DENV exposure during pregnancy, we estimated that ∼12 women (4%) would have been exposed to DENV during their gestation period. However, we found that 34 mothers (11.8%) had been exposed to DENV during pregnancy. None of these mothers were hospitalized during pregnancy because of severe DENV infection, suggesting that many may have undergone asymptomatic seroconversion. The demographic risk factors of socioeconomic status, education level, bed net use, and maternal age were not associated with mild or asymptomatic DENV in pregnancy. Although mild or asymptomatic DENV during pregnancy was not associated with late prematurity, reduced postnatal childhood developmental measures, or adverse maternal pregnancy outcomes, we observed an increased risk of low birth weight. The larger-than-expected burden of DENV in pregnancy in this coastal Kenyan cohort and the observed potential risk of low birth weight provide evidence that a more comprehensive study is warranted to fully understand DENV infection during pregnancy.

Shunt active power filter (SAPF) are often utilized to decrease current harmonics caused by nonlinear grid loads. Whenever the nonlinear loads are uneven, the grid currents corrected by SAPF are still deformed and unbalanced despite adopting efficient current detecting techniques. The justification for this is that the DC-link voltage will comprise a second-order harmonic whenever SAPF modifies the grid's unbalanced loads, which will have an impact on the SAPF's current control loop. Thus, the compensating ranges and effectiveness of SAPFs are directly impacted by DC-link voltage. However, conventional voltage source inverters (VSIs) used in SAPFs can face limitations in DC-link voltage regulation, especially when integrating renewable energy sources with fluctuating power output. This paper proposes exploring the potential of Z-source inverters (ZSIs) as an alternative solution. ZSIs offer inherent boost capability, which can be advantageous for maintaining stable DC-link voltage during renewable energy integration. This paper will discuss and analyze the transition from VSIs to ZSIs to achieve it for SAPFs, focusing on their impact on DC-link voltage regulation and PV solar integration. A comparative analysis of control strategies and circuit topologies for both inverter types will be presented to evaluate their performance and suitability for SAPF applications.

Dengue virus (DENV) and chikungunya virus (CHIKV) are causes of endemic febrile disease among Kenyan children. The exposure risk to these infections is highly multifactorial and linked to environmental factors and human behavior. We investigated relationships between household, socio-economic, demographic, and behavioral risk factors for DENV and CHIKV seropositivity and seroconversion in four settlements in Kenya. We prospectively followed a pediatric cohort of 3,445 children between 2014–2018. We utilized the Kaplan–Meier curves to describe the temporal patterns of seroconversion among tested participants. We employed logistic regression built using generalized linear mixed models, to identify potential exposure risk factors for DENV and CHIKV seroconversion and seropositivity. Overall, 5.2% children were seropositive for DENV, of which 59% seroconverted during the study period. The seroprevalence for CHIKV was 9.2%, of which 54% seroconverted. The fraction of seroconversions per year in the study cohort was <2% for both viruses. Multivariable analysis indicated that older age and the presence of water containers ((OR: 1.15 [95% CI: 1.10, 1.21]), (OR: 1.50 [95% CI: 1.07, 2.10])) increased the odds of DENV seropositivity, whereas higher wealth (OR: 0.83 [95% CI: 0.73, 0.96]) decreased the odds of DENV seropositivity. Multivariable analysis for CHIKV seropositivity showed older age and the presence of trash in the housing compound to be associated with increased odds of CHIKV seropositivity ((OR: 1.11[95% CI: 1.07, 1.15]), (OR: 1.34 [95% CI: 1.04, 1.73])), while higher wealth decreased the odds of CHIKV seropositivity (OR: 0.74[95% CI: 0.66, 0.83]). A higher wealth index (OR: 0.82 [95% CI: 0.69, 0.97]) decreased the odds of DENV seroconversion, whereas a higher age (OR: 1.08 [95% CI: 1.02, 1.15]) and the presence of water containers in the household (OR: 1.91[95% CI: 1.24, 2.95]) were significantly associated with increased odds of DENV seroconversion. Higher wealth was associated with decreased odds for CHIKV seroconversion (OR: 0.75 [95% CI: 0.66, 0.89]), whereas presence of water containers in the house (OR: 1.57 [95% CI: 1.11, 2.21]) was a risk factor for CHIKV seroconversion. Our study links ongoing CHIKV and DENV exposure to decreased wealth and clean water access, underscoring the need to combat inequity and poverty and further enhance ongoing surveillance for arboviruses in Kenya to decrease disease transmission. The study emphasizes the co-circulation of DENV and CHIKV and calls for strengthening the targeted control strategies of mosquito borne diseases in Kenya including vector control, environmental management, public education, community engagement and personal protection.

The wide bandgap oxide semiconductor thin films are synthesized using tetrahydroxogallate (III) ammonium {NH 4 Ga(OH) 4 } precursor at a concentration of 10 at% Ga and varying amounts of hydrated aluminum nitrate between 0.6 and 3.2 at%. Thin films of β‐Ga 2 O 3 :Al are synthesized by spin coating and spray pyrolysis with postannealing in nitrogen ambient at 930 °C. The structural properties of the thin films are investigated using XRD and Raman spectroscopy, while the electrical characteristics are determined using 4‐point probe, current–voltage ( I–V ), and capacitance–voltage ( C–V ) measurements with Ti/Al/Ni/Au Ohmic contacts and Pd/Au Schottky contacts. The β‐Ga 2 O 3 with 2.2 at% Al is found to be the optimal concentration in this study, resulting in ideality factors of 1.10 and 1.09, saturation currents of 3.17 × 10 ⁻⁶ and 3.10 × 10 ⁻⁶ A, Schottky barrier heights of 0.73 and 0.88 eV, and series resistances of 948 and 955 Ω, for the spin‐coated and pyrolytically sprayed samples respectively.

Background Understanding the frequency of violence experienced by female sex workers (FSWs) and how violence contributes to HIV transmission can help improve HIV programs. Methods Using recent recommendations for modelling structural factors and associated causal pathways, we developed a HIV transmission dynamic model for FSWs and their clients in Mombasa, Kenya, mechanistically representing three types of violence (sexual violence, SV; physical violence, PV; police assault and arrest, PAA). Each type of violence affects HIV transmission through key mediators (condom non-use, HIV testing). We parameterized the model using data from a cross-sectional study of FSWs aged 15–24 recruited from a systematic geographical mapping sampling frame in Mombasa, Kenya (Cheuk E et al., Frontiers in Reproductive Health 2(7), 2020). Using this model, calibrated (and cross-validated) to HIV epidemiological and violence outcomes, we estimated the incidence of violence episodes, the contribution of violence to the HIV epidemic measured by the transmission population-attributable fraction, and the potential impact of possible violence interventions. Results The median estimated incidence of PAA in 2023 among FSWs who had not previously experienced that type of violence was 0.20 (95% credible interval: 0.17–0.22) per person-year (ppy), about double the incidence of SV and PV (0.10 (0.09–0.11), 0.11 (0.09–0.12), respectively). The incidence of violence was higher among FSWs who had previously experienced violence: the incidence of recurrent PV was 2.65 (1.82–3.37) ppy, while the incidence of recurrent SV and PAA were 1.26 (0.80–1.67) and 1.37 (0.94–1.74 ppy, respectively. In this setting, we estimated that a median of 35.3% (3.4–55.8%) infections in FSWs and clients combined over the next 10 years may be due to all types of violence (and mediators), mainly through reduced condom use in FSWs who have ever experienced SV (34.6% (2.4–55.5%)). Interventions that prevent future violence without mitigating the effects of past violence may only prevent 8.8% (0.8–14.0%) infections over 10 years. Conclusions FSWs in Mombasa experience violence frequently. In this population, we find that addressing sexual violence, including mitigating the effects of past violence, is potentially important in reducing HIV transmission in this population. However, the wide uncertainty range shows longitudinal studies are needed to strengthen the evidence of the influence of violence on HIV risk behavior. We find that the recommendations for modelling structural factors provide a useful framework for describing the model.