MR. MESHACK JUMA OMOLO

Title: Assessment of knowledge and attitude on antiretroviral therapy among nursing students. Objective: To assess the knowledge and attitude of final year nursing students at Kenyatta National Hospital. Specific Objectives were to establish the knowledge of nursing students on Anti-retroviral therapy and to determine the attitude of students towards patients who are on Anti-retroviral therapy Method: The study done at Kenyatta National hospital administered questionnaires to 150 students and 138 were found eligible. Data collected was analyzed using STATA. Results: The findings of the study showed that 39.8% of the nursing students had knowledge about Anti-Retroviral drugs; 42% of the students had some ideas while 18% of the students did not have adequate knowledge. Married and older students seemed to have better knowledge on ART compared to young and single Nurses significant at a P-value of 0.033. Attitude towards ART was positive from 34.8% of the students while 65.2% of the nursing students had not expressed their feeling. There was significant association between attitude and sex. Conclusion: This study confirmed lack of adequate knowledge on Antiretroviral therapy among newly qualified nursing students. The study recommended inclusion of HIV/AIDS based units in the basic training of nurses

Background: Africa has one of the highest incidences of gonorrhea. Neisseria gonorrhoeae is gaining resistance to most of the available antibiotics, compromising treatment across the world. Whole-genome sequencing (WGS) is an efficient way of predicting AMR determinants and their spread in the population. Recent advances in next-generation sequencing technologies like Oxford Nanopore Technology (ONT) have helped in the generation of longer reads of DNA in a shorter duration with lower cost. Increasing accuracy of base-calling algorithms, high throughput, error-correction strategies, and ease of using the mobile sequencer MinION in remote areas lead to its adoption for routine microbial genome sequencing. To investigate whether MinION-only sequencing is sufficient for WGS and downstream analysis in resource-limited settings, we sequenced the genomes of 14 suspected N. gonorrhoeae isolates from Nairobi, Kenya.

Methods: Using WGS, the isolates were confirmed to be cases of N. gonorrhoeae (n = 9), and there were three co-occurrences of N. gonorrhoeae with Moraxella osloensis and N. meningitidis (n = 2). N. meningitidis has been implicated in sexually transmitted infections in recent years. The near-complete N. gonorrhoeae genomes (n = 10) were analyzed further for mutations/factors causing AMR using an in-house database of mutations curated from the literature.

Results: We observe that ciprofloxacin resistance is associated with multiple mutations in both gyrA and parC. Mutations conferring tetracycline (rpsJ) and sulfonamide (folP) resistance and plasmids encoding beta-lactamase were seen in all the strains, and tet(M)-containing plasmids were identified in nine strains. Phylogenetic analysis clustered the 10 isolates into clades containing previously sequenced genomes from Kenya and countries across the world. Based on homology modeling of AMR targets, we see that the mutations in GyrA and ParC disrupt the hydrogen bonding with quinolone drugs and mutations in FolP may affect interaction with the antibiotic.

Conclusion: Here, we demonstrate the utility of mobile DNA sequencing technology in producing a consensus genome for sequence typing and detection of genetic determinants of AMR. The workflow followed in the study, including AMR mutation dataset creation and the genome identification, assembly, and analysis, can be used for any clinical isolate. Further studies are required to determine the utility of real-time sequencing in outbreak investigations, diagnosis, and management of infections, especially in resource-limited settings.