Poor hygiene might be a risk factor for early childhood development (ECD). This study investigated the associations of three hygiene practices (‘wash hands before a meal,’ ‘wash hands after going to the toilet,’ and ‘brush teeth’), separately and combined, with ECD. Six thousand six hundred ninety-seven children (4 [0.8] years) from the East Asia-Pacific Early Child Development Scales validation study were included in this cross-sectional analysis. The hygiene variables were recoded to have comparable values as ‘always,’ ‘sometimes,’ and ‘never.’ These variables were then grouped to create combined categories. The binary outcome variables, poor ECD, were defined as a score < age-specific 25th centile. Modified Poisson regression models were used to analyse the associations. Data collection was performed between 2012 and 2014, and the analyses were conducted in April 2022. Compared with children who ‘always’ washed their hands before a meal, those who did it ‘sometimes’ (Prevalence Ratio [PR]: 1.30 [95% CI: 1.16–1.46]) or ‘never’ (PR: 1.35 [1.18–1.55]) had a higher likelihood of poorer overall development. Comparable results were identified for the other two hygiene practices and the other four domain-specific outcomes (p < 0.05). Compared with children who always followed the three hygiene practices, the likelihood of poor overall ECD increased as the combined hygiene practice decreased among children with poor hygiene practices (PR_never: 1.67 [1.40–2.00]; PR_rarely: 1.49 [1.30–1.71]; PR_sometimes: 1.30 [1.14–1.49]). Children who did not always follow good hygiene practices had a higher likelihood of poor ECD independently of sociodemographic factors. Considering these findings, future hygiene practice interventions and trials should consider including ECD outcomes.

Objectives. Staphylococcus aureus is one of the most common pathogens attributed to hospital infections. Although S. aureus infections have been well studied in developed countries, far less is known about the biology of the pathogen in sub-Saharan Africa. Methods. Here, we report on the isolation, antibiotic resistance profiling, whole genome sequencing, and genome comparison of six multi-drug resistant isolates of S. aureus obtained from a referral hospital in Kakamega, Western Kenya. Results. Five of the six isolates contained a 20.7 kb circular plasmid carrying blaZ (associated with resistance to β-lactam antibiotics). These five strains all belonged to the same sequence type, ST152. Despite the similarity of the plasmid in these isolates, whole genome sequencing revealed that the strains differed, depending on whether they were associated with hospital-acquired or community-acquired infections. Conclusion. The intriguing finding is that the hospital-acquired and the community-acquired isolates of S. aureus belonging to the same genotype, ST152, formed two separate sub-clusters in the phylogenetic tree and differed by the repertoire of accessory virulence genes. These data suggest ongoing adaptive evolution and significant genomic plasticity.

Objective: To identify ways of improving antimicrobial stewardship at Kakamega County Teaching and Referral Hospital (KCTRH) in western Kenya. Methods: A knowledge and awareness test was conducted among surgical ward healthcare workers to assess their understanding of how to counter antimicrobial resistance. In parallel, the global Point Prevalence Survey (PPS) was used to understand antibiotic prescription practices at the referral facility. Patient records from the adult surgical and pediatric surgical wards were examined for information on antibiotic prescription and usage. A total of 47 healthcare workers and 106 patient records were examined. Results: Healthcare workers showed the highest competence when tested on the appropriate use of antimicrobials, with a mean score of 78.7%. However, their understanding of surveillance and monitoring was lower, with a mean score of 60.2%, followed by awareness and education (which achieved a mean score of 64.5%). The majority of prescriptions (62.3%) were for empiric treatment, with a lack of laboratory data to support targeted therapies. Prolonged antibiotic courses were noted for surgical prophylaxes with over 83% of patients being administered antibiotics for more than 1 day. The survey also revealed over-prescription of broad-spectrum agents such as ceftriaxone at 36.7%. Conclusion: There is a high use of antibiotics, but a weakness in AMR monitoring at KCTRH. Better use of laboratory testing (AMR profiles for infecting bacteria, etc) is recommended as the best way to improve patient management and deployment of antibiotics.

The metabarcoding of prokaryotic and fungal (Ascomycota only) ribosomal DNA was used to describe the microbial communities in soils of a remnant equatorial rainforest, maize–bean intercrop, and sugarcane in western Kenya. Cropping systems influenced the microbial community composition and functional traits (energy source and nutrient cycling) of bulk soil in each crop. Microbial richness and diversity tended to increase with cultivation intensity. The soil of the maize–bean intercrop had lower percentages and sugarcane had higher percentages of unique amplicon sequence variants of both bacteria and fungi compared to the remnant forest. Functional traits were altered by cultivation intensity. Compared to remnant forest soils, maize–bean intercrop soil had lower percentages of aerobic chemoheterotrophic bacteria and higher percentages of N-cycling bacteria, while sugarcane had higher percentages of aerobic chemoheterotrophic bacteria and lower percentages of N-cycling bacteria. In the face of increasing forest loss and pressures for agricultural productivity, this landscape provides a rich site for studying the impacts of cropping systems on soil health.

Staphylococcus aureus is one of the most common pathogens associated with hospital infections. Although S. aureusinfections have been well studied in developed countries, far less is known about the biology of the pathogen in sub-Saharan Africa. Here, we report on the isolation, antibiotic resistance profiling, whole genome sequencing, and genome comparison of six multi-drug resistant isolates of S. aureus obtained from a referral hospital in Kakamega, western Kenya. Five of the six isolates contained a 20.7-kb circular plasmid carrying blaZ (associated with resistance to b-lactam antibiotics). These five strains all belonged to the same sequence type, ST152. Despite the similarity of the plasmid these isolates, whole genome sequencing revealed that the strains differed, depending on whether they were associated with hospital-acquired or community-acquired infections. The most striking difference was the larger number of horizontally-acquired genomic islands (GIs) in the nosocomial isolates. The data indicate that adaptation to the hospital environment may also be linked with mutations in the uvrAB genes.

Objectives. Staphylococcus aureus is one of the most common pathogens attributed to hospital infections. Although S. aureus infections have been well studied in developed countries, far less is known about the biology of the pathogen in sub-Saharan Africa. Methods. Here, we report on the isolation, antibiotic resistance profiling, whole genome sequencing, and genome comparison of six multi-drug resistant isolates of S. aureus obtained from a referral hospital in Kakamega, Western Kenya. Results. Five of the six isolates contained a 20.7-kb circular plasmid carrying blaZ (associated with resistance to b-lactam antibiotics). These five strains all belonged to the same sequence type, ST152. Despite the similarity of the plasmid these isolates, whole genome sequencing revealed that the strains differed, depending on whether they were associated with hospital-acquired or community-acquired infections. Conclusion. The intriguing finding is that the hospital acquired and the community acquired isolates of S. aureusbelonging to the same genotype ST152 formed two separate sub-clusters in the phylogenetic tree and differed by the repertoire of accessory virulence genes suggesting an ongoing adaptive evolution and significant genomic plasticity.