http://localhost/xmlui/handle/123456789/2161 2026-05-04T20:08:47Z http://localhost/xmlui/handle/123456789/6939 Field evaluation of Yorkool ®, a long-lasting insecticidal net after 12 months of use in Seme, Kisumu County, Kenya Achulu, Mercy Owendy Background: Physical integrity and insecticidal efficacy of long-lasting insecticide-treated nets (LLINs) is influenced by the handling practices during use. This was an evaluation of Yorkool® pyrethroid-based LLINs after 12 months of use to determine the washing and drying practices, physical conditions and bio-efficacy. Methods: This was a cross-sectional household survey in an area where rectangular Yorkool® a pyrethroid LLINs were distributed during national mass net distribution campaign in 2021. Questionnaires were used for data collection and bioassay tests were done from thirty randomly selected nets. Results: 262 household heads were interviewed with their mean age being 46.9 years (SD 17.4 years) and level of education was mainly primary (70.2%). Most households (71.8%) had 1 to 2 sleeping spaces. The households had a total 468 LLINs with 95.1% having been washed at least once. About three-quarters (74.4%) of the LLINs had been washed using local bar soap, with 99.6 % having not been scrubbed on hard surface during washing and 72.1% were dried under a shade. Those evaluated for physical integrity and had at least one hole made up 77.8% of the nets and 57.2% were too torn and requiring replacement. Bio efficacy test recorded a mean KD of 92% after 1 hour, and mean mortality of 86% after 24 hours. The nets that passed the WHO efficacy cut off for mortality (≥80%) after 24 hours were 83.3% and 70% passed the KD (≥95%) cut off after 1 hour. Conclusions: While more than a half of the Yorkool® LLINs needed replacement due to poor physical integrity after one year of use in the households, the bio-efficacy of the LLINs was relatively high with the mortality on vectors meeting the WHO threshold. MSc Research Publication 2026-05-04T00:00:00Z http://localhost/xmlui/handle/123456789/6937 Phenotypic and molecular characterization of β-lactamase-producing Klebsiella species among children discharged from hospital in Western Kenya Rwigi, Doreen Wanjira Background The emergence and spread of β-lactamase-producing Klebsiella spp. has been associated with a sub stantial healthcare burden resulting in therapeutic failures. We sought to describe the proportion of phenotypic resistance to commonly used antibiotics, characterize β-lactamase genes among isolates with antimicrobial resistance (AMR), and assess the correlates of phenotypic AMR in Klebsiella spp. isolated from stool or rectal swab samples col lected from children being discharged from hospital. Methods We conducted a cross-sectional study involving 245 children aged 1–59 months who were being dis charged from hospitals in western Kenya between June 2016 and November 2019. Whole stool or rectal swab samples were collected and Klebsiella spp. isolated by standard microbiological culture. β-lactamase genes were detected by PCR whilst phenotypic antimicrobial susceptibility was determined using the disc diffusion technique fol lowing standard microbiology protocols. Descriptive analyses were used to characterize phenotypic AMR and carriage of β-lactamase-producing genes. The modified Poisson regression models were used to assess correlates of pheno typic beta-lactam resistance. Results The prevalence of β-lactamase carriage among Klebsiella spp. isolates at hospital discharge was 62.9% (154/245). Antibiotic use during hospitalization (adjusted prevalence ratio [aPR] = 4.51; 95%CI: 1.79–11.4, p < 0.001), longer duration of hospitalization (aPR = 1.42; 95%CI: 1.14–1.77, p < 0.002), and access to treated water (aPR = 1.38; 95%CI: 1.12–1.71, p < 0.003), were significant predictors of phenotypically determined β-lactamase. All the 154 β-lactamase-producing Klebsiella spp. isolates had at least one genetic marker of β-lactam/third-generation cepha losporin resistance. The most prevalent genes were blaCTX-M 142/154 (92.2%,) and blaSHV 142/154 (92.2%,) followed by blaTEM 88/154 (57.1%,) and blaOXA 48/154 (31.2%,) respectively. Conclusion Carriage of β-lactamase producing Klebsiella spp. in stool is common among children discharged from hospital in western Kenya and is associated with longer duration of hospitalization, antibiotic use, and access MSc Research Publication 2026-05-04T00:00:00Z http://localhost/xmlui/handle/123456789/6935 Heavy Metal Occurrence within Urban Agriculture Practices in Eastern zones of Nairobi City Njenga, John Ng’ang’a Urban agriculture,although growing in importance,farmer practices have to continually adapt to the dynamics of urbanization having implication on quality of produce and public perception. The objective of this research was to assess heavy metal incidence in inputs and food crops for urban farms in eastern zone of Nairobi, determine differences in element uptake by crops and to examine influence of environmental quality of the surrounding spaces. A quasi research design approach was used to identify farm plots for field survey in three locations. Samples of tomatoes (Lycopersicon esculentum), arrowroots (Colocasia esculenta), and kales (Brassica oleraceae var. Acephala), water and soil samples were obtained according to standard procedures. Contents of cadmium, manganese, zinc and lead were analysed using Atomic Absorption/Flame Emission Spectrophotometer. One way ANOVA was applied to examine differences in means of heavy metals between locations and to compare transfer factor (TF) index of the crops. Elements that were above allowable limits in the crops were Cd, Mn, Pb and Zn in arrowroots; Cd and Mn in kales and Cd, Mn and Pb in tomatoes. Cadmium content was highest in farm plots within Kasarani (2.44±0.86 mg/kg) and was significantly different from other two locations (p<0.05, Tukey HSD test). Between the neighbourhood qualities, heavy metal contents were different but not significant (p>0.05) between classes. The mean TF index for the heavy metals decreased in the order Cd>Pb>Zn>Mn. Transfer factor index of> 1 for cadmium was recorded in arrowroots, kales and tomatoes. Based on FAO/WHO standards, the measured heavy metal contents were high for health concern. Produce from areas designated as of low environmental quality, were not necessarily contaminated as perceived. Urban agriculture producers in Nairobi need technical risk reduction measures and legislative support to guarantee quality produce and valuable participation in the urban food system framework. Key words: urban farming, environmental quality, cadmium, lead, transfer factor, edible produce, health risk MSc Research Publication 2026-05-04T00:00:00Z http://localhost/xmlui/handle/123456789/6928 INSTITUTIONAL FACTORS ASSOCIATED WITH SURGICAL SITE INFECTIONS AMONG POST CAESAREAN SECTION IN THIKA LEVEL 5 HOSPITAL Ndege, Jane Wanjiku Objective: The study aimed at determining the institutional factors that contribute to surgical site infections among post caesarean section in Thika Level 5 Hospital. Materials and Methods: The study employed a mixed unmatched case-control study design which targeted all mothers who had undergone caesarean section in maternity unit at Thika Level 5 Hospital and who had or did not have Surgical Site Infection from delivery up to thirty days post-delivery and nurse in-charges of maternity unit. Result: The sample size of the study was made up of 128 women comprising 32 cases and 96 controls. Qualitative results revealed that poor aseptic technique in theatre during C/S operations led to an increase in Surgical Site Infections (SSIs). Respondents highlighted the significance of maintaining a sterile and clean environment in the theatre to prevent contamination of surgical sites by microorganisms. The study found that mothers who stayed in hospital for more than 24 hours before Caesarian Section (CS) were more likely to get Surgical Site Infection (SSI) as compared those that had stayed in the hospital for less 24 hours before CS (OR=13.05 [95%CI=4.10-41.53]; p<0.001). Mothers who shared beds with other patients were more likely to get SSI as compared to those that did not share beds (OR=3.01 [95%CI=1.28-4.19]; p<0.001). Moreover, mothers who spent more than a week in the hospital were more likely to get SSI than those who stayed in the hospital for less than that period (OR=3.41 [95%CI=1.06-11.38]; p<0.001). Conclusion: The study concludes that there is a potential relationship between the duration of hospital stay prior to CS and the risk of SSI. Also, the institutional factors associated with SSIs are the response of healthcare workers to the needs of the patients, the level of care given at the hospital and facility accessibility. MSc Research Publication 2026-03-31T00:00:00Z