Bio

Dr JK Wanjeri's profile

Dr Wanjeri is a Plastic & Reconstructive surgeon and a lecturer in the Department of Surgery of the University of Nairobi (UoN). In January 2015 he was appointed as head of the Plastic Surgery Unit of Kenyatta National Hospital (KNH) the teaching hospital of UoN. He has served Operation Smile as a volunteer surgeon for several years and is a Smile Train partner and founder of the Metropolitan Hospital Smile Train project. He is also a Director/Board member of Metropolitan Hospital, a 100 bed private private hospital in the Eastlands of Nairobi.

Publications


2014

and D.K. KIBOR, NYAIMWANJERIOEK.  2014.  EFFECTS OF ENTERAL GLUTAMINE SUPPLEMENTATION ON REDUCTION OF INFECTION IN ADULT PATIENTS WITH SEVERE BURNS. East African Medical Journal . 91(No.1) Abstract

EFFECTS OF ENTERAL GLUTAMINE SUPPLEMENTATION ON REDUCTION OF INFECTION IN ADULT PATIENTS WITH SEVERE BURNS
D.K. KIBOR, O.E. NYAIM and K. WANJERI
ABSTRACT
Objective: To determine the effect of enteral glutamine in reducing the incidence of post burn infections in patients with severe burns.
Design: A double blind randomised clinical trial.
Setting: Burns unit and ward 4D of Kenyatta National Hospital, Kenya
Subjects: Sixty patients with severe burns who were randomised to two arms of treatment: (1) the glutamine group and (2) isonitrogenous arm acting as the control.
Results: Patients’ demographic and baseline clinical characteristics were similar in both arms of treatment. For the entire four-week treatment period, the odds ratio of a positive blood culture was almost three-fold higher among patients in the control group compared to those in the Glutamine group (p = 0.04). There was also a higher incidence of positive swab cultures from the non glutamine group.
Conclusion: Enteral glutamine supplementation in severely burnt adult patients reduces blood infection by a factor of three. It also significantly reduces the incidence of burn wound infections.

2012

Ghadially, H, Keynan Y, Kimani J, KIMANI M, Ball TB, Plummer FA, Mandelboim O, Meyers AF.  2012.  Altered Dendritic Cell-natural Killer Interaction In Kenyan Sex Workers Resistant To Hiv-1 Infection. AbstractWebsite

BACKGROUND:

Natural killer (NK) cells are members of the innate immune system that play an important role in the defense against viral infection. They are also involved in the regulation of adaptive immune responses through cytokine secretion and the interaction with antigen-presenting cells. However, their role in HIV infection is only partially understood.
OBJECTIVE:

Here we studied the phenotype and function of NK cells of highly HIV-exposed but seronegative (HESN) uninfected commercial sex workers from Kenya who can be epidemiologically defined as relatively resistant to HIV infection.
DESIGN:

The purpose of this study was to gain insight into the role of NK cells in mediating resistance to HIV-1. This information can be used to better understand protection from infection which can be used for informing future design of effective prophylactics and therapeutics for HIV.
METHODS:

Whole blood samples were collected from study participants and isolated NK cells and dendritic cells were used in assays for phenotyping and cell function.
RESULTS:

Activated NK cells from resistant women killed autologous immature dendritic cells more efficiently and also secreted more interferon (IFN)-γ than those of uninfected, susceptible women. Interestingly, NK cells from HIV-resistant women were significantly more effective in inducing secretion of IL-12 in immature dendritic cells.
CONCLUSIONS:

These data suggest that an altered NK cell-dendritic cell interaction plays an important role in the protection from infection with HIV-1.

KIMANI, DRWANJERIJOSEPH.  2012.  Reconstruction of a large sacral decubitus ulcer using bilateral gluteal rotational flaps: A case presentation.. 2nd annual International Scientific Conference of the Kenya Society of Plastic, Reconstructive & Aesthetic Surgeons.. : ELSEVIER Abstract
Malaria is a major public health problem that is presently complicated by the development of resistance by Plasmodium falciparum to the mainstay drugs. Thus, new drugs with unique structures and mechanism of action are required to treat drug-resistant strains of malaria. Historically, compounds containing a novel structure from natural origin represent a major source for the discovery and development of new drugs for several diseases. This paper presents ethnophytotherapeutic remedies, ethnodiagnostic skills, and related traditional knowledge utilized by the Digo community of the Kenyan Coast to diagnose malaria as a lead to traditional bioprospecting. The current study was carried out in three Digo villages of Diani sub-location between May 2009 and December 2009. Data was collected using semi-structured interviews, and open and close-ended questionnaires. A total of 60 respondents (34 men and 26 women) provided the targeted information. The results show that the indigenous knowledge of Digo community on malaria encompasses not only the symptoms of malaria but also the factors that are responsible for causing malaria, attributes favoring the breeding of mosquitoes and practices employed to guard against mosquito bites or to protect households against malaria. This knowledge is closely in harmony with scientific approaches to the treatment and control of the disease. The Digo community uses 60 medicinal plants distributed in 52 genera and 27 families to treat malaria. The most frequently mentioned symptoms were fever, joint pains, and vomiting while the most frequently mentioned practices employed to guard against mosquito bites and/or to protect households against malaria was burning of herbal plants such as Ocimum suave and ingestion of herbal decoctions and concoctions. The Digo community has abundant ethnodiagnostic skills for malaria which forms the basis of their traditional bioprospecting techniques. Keywords: malaria, antimalarials, ethnopharmacology, ethnodiagnostic skills, Digo community, bioprospecting
KIMANI, DRWANJERIJOSEPH.  2012.  Article title: Risk factors for kerosene stove explosion burns seen at Kenyatta National Hospital in Kenya Journal title: Burns Dr. Alex N Dr.Ombati, Dr.P.L.W.Ndaguatha, Dr.J.K.Wanjeri (Correspnding author) Online publication complete: 19-SEP-2012. BURNS. : ELSEVIER Abstract
Malaria is a major public health problem that is presently complicated by the development of resistance by Plasmodium falciparum to the mainstay drugs. Thus, new drugs with unique structures and mechanism of action are required to treat drug-resistant strains of malaria. Historically, compounds containing a novel structure from natural origin represent a major source for the discovery and development of new drugs for several diseases. This paper presents ethnophytotherapeutic remedies, ethnodiagnostic skills, and related traditional knowledge utilized by the Digo community of the Kenyan Coast to diagnose malaria as a lead to traditional bioprospecting. The current study was carried out in three Digo villages of Diani sub-location between May 2009 and December 2009. Data was collected using semi-structured interviews, and open and close-ended questionnaires. A total of 60 respondents (34 men and 26 women) provided the targeted information. The results show that the indigenous knowledge of Digo community on malaria encompasses not only the symptoms of malaria but also the factors that are responsible for causing malaria, attributes favoring the breeding of mosquitoes and practices employed to guard against mosquito bites or to protect households against malaria. This knowledge is closely in harmony with scientific approaches to the treatment and control of the disease. The Digo community uses 60 medicinal plants distributed in 52 genera and 27 families to treat malaria. The most frequently mentioned symptoms were fever, joint pains, and vomiting while the most frequently mentioned practices employed to guard against mosquito bites and/or to protect households against malaria was burning of herbal plants such as Ocimum suave and ingestion of herbal decoctions and concoctions. The Digo community has abundant ethnodiagnostic skills for malaria which forms the basis of their traditional bioprospecting techniques. Keywords: malaria, antimalarials, ethnopharmacology, ethnodiagnostic skills, Digo community, bioprospecting

2011

KIMANI, DRWANJERIJOSEPH.  2011.  A massive abdominal wall desmoid tumor occurring in a laparotomy scar: A case report. 1st International Scientific Conference of UoN CHS. : UoN College of Health Sciences
KIMANI, DRWANJERIJOSEPH.  2011.  A massive abdominal wall desmoid tumor occurring in a laparotomy scar: A case report Joseph K Wanjeri* and Collins JO Opeya. World Journal of Surgical Oncology. : BioMed Central Abstract
  Abstract Introduction Desmoid tumors are benign but locally aggressive tumors of mesenchymal origin which are poorly circumscribed, infiltrate the surrounding tissue, lack a true capsule and are composed of abundant collagen. History of trauma to the site of tumor origin is elicited in up to 1 in 4 cases and they most commonly develop in the anterior abdominal wall and shoulder girdle but they can arise in any skeletal muscle. The clinical behavior and natural history of desmoid tumors are unpredictable and management is difficult with many issues remaining controversial, mainly regarding early detection, the role, type and timing of surgery and the value of non-operative therapies. Case presentation We report a case of a 23 year old male referred from a district hospital to a national referral hospital in Kenya, after developing a huge abdominal wall desmoid tumor following laparotomy for a blunt abdominal injury fourteen months earlier. The tumor was successfully excised and the abdominal wall defect reconstructed using a vicryl/prolene mesh and a unilateral groin flap. The patient had a non-eventful recovery and was discharged through radiotherapy clinic. Conclusion Wide margin tumor excision alone is a reasonable option in the management of desmoid tumors.  

2008

Peters, HO;, Mendoza MG;, Capina RE;, Luo M;, Mao X;, Gubbins M;, Nagelkerke NJ;, Macarthur I;, Sheardown, BB;, Kimani J;, Wachihi C;, Thavaneswaran S;, Plummer FA.  2008.  An Integrative Bioinformatic Approach For Studying Escape Mutations In Human Immunodeficiency Virus Type 1 Gag In The Pumwani Sex Worker Cohort.. Abstract

Human immunodeficiency virus type 1 (HIV-1) is able to evade the host cytotoxic T-lymphocyte (CTL) response through a variety of escape avenues. Epitopes that are presented to CTLs are first processed in the presenting cell in several steps, including proteasomal cleavage, transport to the endoplasmic reticulum, binding by the HLA molecule, and finally presentation to the T-cell receptor. An understanding of the potential of the virus to escape CTL responses can aid in designing an effective vaccine. To investigate such a potential, we analyzed HIV-1 gag from 468 HIV-1-positive Kenyan women by using several bioinformatic approaches that allowed the identification of positively selected amino acids in the HIV-1 gag region and study of the effects that these mutations could have on the various stages of antigen processing. Correlations between positively selected residues and mean CD4 counts also allowed study of the effect of mutation on HIV disease progression. A number of mutations that could create or destroy proteasomal cleavage sites or reduce binding affinity of the transport antigen processing protein, effectively hindering epitope presentation, were identified. Many mutations correlated with the presence of specific HLA alleles and with lower or higher CD4 counts. For instance, the mutation V190I in subtype A1-infected individuals is associated with HLA-B*5802 (P = 4.73 x 10(-4)), a rapid-progression allele according to other studies, and also to a decreased mean CD4 count (P = 0.019). Thus, V190I is a possible HLA escape mutant. This method classifies many positively selected mutations across the entire gag region according to their potential for immune escape and their effect on disease progression.

KIMANI, DRWANJERIJOSEPH.  2008.  Cleft Lip and Palate: A Descriptive Comparative, Retrospective, and Prospective Study of Patients With Cleft Deformities Managed at 2 Hospitals in Kenya. pg. 1352-1355 DOI: 10.1097/SCS.0b013e3181ae41fe Wanjeri, Joseph Kimani MB ChB, MMed (Surg); Wachira,. Journal of Craniofacial Surgery. : UoN College of Health Sciences Abstract

This was a combined retrospective and prospective study in which 2 sets of results from 2 hospitals in Nairobi were analyzed and compared. The retrospective study was conducted at Kenyatta National Hospital, whereas the prospective study was conducted at Metropolitan Hospital.The main objective of the study was to establish the presentation and pattern of patients with cleft lip and palate and complications of repair at the 2 hospitals.In the retrospective arm of the study, files of all patients presenting with clefts at Kenyatta National Hospital between January 1998 and December 2007 were retrieved, and a questionnaire was filled out for each of them, whereas all patients seen and operated on for clefts at the Metropolitan Hospital from January 2007 to October 2008 were recruited into the prospective study.There was a predominance of male participants in both studies, and most clefts were on the left side. The retrospective and prospective studies had positive family history in 3.5% and 30.9%, respectively. Associated congenital malformations were 8.2% for the retrospective study and 25% for the prospective study. In both studies, the central province had the largest number of clefts, whereas the coast province had very few.Cleft lip and palate is a significant congenital malformation in Kenya, and there seems to be a higher incidence of familial tendency and associated congenital malformations than that reported elsewhere

2007

Ngugi, EN, Chakkalackal M, Sharma A, Bukusi EA, Njoroge B, Kimani J, MacDonald KS, Bwayo JJ, Cohen CR, Moses S, Kaul R.  2007.  Sustained changes in sexual behavior by female sex workers after completion of a randomized HIV prevention trial. Abstractsustained_changes_in_sexual_behavior_by_female_sex.16.pdf

Behavioral interventions in female sex workers (FSWs) are associated with changes in sexual behavior and reduced rates of sexually transmitted infections (STIs) and HIV We examined the sustainability of such interventions. METHODS: HIV-uninfected Kenyan FSWs were enrolled in a clinical trial that provided free male condoms, community and clinic-based counseling, and STI management. After trial completion, scaled-back community-based resources remained in place. More than a year later, women were invited to complete a follow-up behavioral questionnaire and to undergo STI/HIV counseling and testing. Individual changes in sexual behavior were assessed by paired analysis. RESULTS: One hundred seventy-two women participated in the resurvey 1.2 years after trial termination. Client numbers had risen (paired t test, P < 0.001), but condom use had also increased (P < 0.001); both remained substantially lower than at enrollment. Regular partners accounted for a greater proportion of unprotected FSW sexual encounters (35% vs. 10%; P < 0.001). Only 9 (5.2%) of 172 women had a conventional STI, and the follow-up HIV incidence of 1.6 per 100 person-years (PYs) was similar to that during the trial period (3.7 per 100 PYs). Incident STIs and HIV were associated with the frequency of unprotected sex and younger age. CONCLUSIONS: Less intensive community-based risk reduction services after clinical trial termination may support ongoing reductions in STIs and HIV among high-risk FSWs

2006

Makadzange, AT; Gillespie, KKEJJ; R-JSL; BJJG; J; P;.  2006.  Identification of a novel HLA B*57 restricted cytotoxic T-lymphocyte epitope within HIV-1 rev. Abstract

HLA-B5701 and its related allele B5703 have been shown to be strongly associated with slow HIV-1 disease progression. To elucidate the effect of these alleles fully on disease progression it is essential to identify key HIV-1 epitopes that are restricted by these alleles. Here we describe the identification of a novel HLA-B5701, B5703 restricted epitope within HIV-1 rev, which accounted for up to 25 and 40% of the total cytotoxic T-lymphocyte responses in two patients

2004

Fang, G; Kuiken, WR-JPCCH; KAAO; BJJ; KPSM;C; B; S;.  2004.  Long-term survivors in Nairobi: complete HIV-1 RNA sequences and immunogenetic associations.

2000

Anzala, AO, Simonsen JN, Kimani J, Ball TB, Ngugi EN, Bwayo JJ, Nagelkerke N, Kakai NJD, Plummer FA.  2000.  Role of Sexually Transmitted Infections in Accelerated HIV-1 Disease Progression.

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