Moi Teaching and Referral Hospital

Abstract Background Precision oncology is dominated by studies focused on nuclear genomic alterations, leaving mitochondrial DNA (mtDNA) variation excluded from routine clinical genomic testing. However, mitochondria regulate oxidative phosphorylation (OXPHOS), reactive oxygen species (ROS) production, apoptosis, and metabolic reprogramming pathways that are central to chemotherapy response. Methods 468 Complete mitochondrial genomes from Kenyan individuals representing diverse ethnic groups were analyzed. Seven variants associated with effect on cancer treatment were identified. These include; m.310T>C(D-loop), m.10398A>G (MT-ND3), m.13708G>A (MT-ND5), m.16189T>C, m.13928G>C, m9055G>A and m.16519T>C (D-loop). Allele frequencies and distribution were assessed. Results The coding-region variants (m.10398A>G and m.13708G>A) occur in Complex I subunits and are associated with altered oxidative phosphorylation efficiency and ROS production. The control-region variants (m.16189T>C and m.16519T>C) influence mtDNA replication and copy number. These variants have been implicated in differential response to chemotherapeutic agents including platinum-based therapies and anthracyclines. m.13928G>C sits in the MT-CYB gene and could possibly affect mitochondrial respiratory function; this variant could influence how tumors respond to therapies that rely on apoptosis or ROS generation.m.9055G>A is a MT-ATP6 variant classified as benign in mitochondrial disease but may represent a marker of haplogroup background rather than a direct cancer driver. While m.310T>C itself does not encode a protein, its location in the regulatory D-loop influences mitochondrial function, which can affect how tumor cells respond to chemotherapies that rely on mitochondrial-mediated apoptosis or oxidative stress. Conclusion Pharmacogenomic relevant mitochondrial variants are present in the Kenyan population. With the rise of cancer burden in Kenya there is a need carry out more studies to understand the impact of these variations on cancer treatment. This can inform the integration of mtDNA analysis into precision oncology strategies in African populations.

Respiratory distress syndrome remains an important cause of neonatal mortality and morbidity worldwide. Early initiation of continuous positive airway pressure is a standard of care for preterm infants with respiratory distress syndrome. Positive end-expiratory pressure reduces the need for invasive ventilation and prevents chronic lung disease. However, the optimum positive end expiratory pressure level to effectively treat respiratory distress syndrome in preterm infants remains unknown. To determine the optimal initial positive end expiratory pressure level in management of preterm infants with respiratory distress syndrome. This prospective descriptive study was conducted from July 2023 to January 2024 in the newborn unit of Moi Teaching and Referral Hospital. A total of 204 preterm infants (28–34 weeks gestational age) with respiratory distress syndrome who required Continuous Positive Airway Pressure treatment were recruited. Data on the maternal and neonatal characteristics, low and high positive end expiratory pressure levels, and outcomes at 72 h were collected and analysed. Descriptive statistics were used for continuous variables, and frequencies were used for categorical data. A p value less than 0.05 was considered statistically significant at the 95

BACKGROUND:Congenital anomalies (CAs) are a major cause of childhood mortality and disability in low- and middle-income countries. Our study explored caregiver experiences of infants with major CAs in Kenya and co-developed interventions using human-centered design (HCD). METHODS:We conducted a qualitative study at Kenya's second largest referral hospital (August 2023 to January 2024). Thirty-one caregivers of 23 infants with major CAs completed interviews on experiences and care needs, analyzed thematically using the socio-ecological model (individual, family, healthcare, and community domains). We conducted three HCD workshops with 19 healthcare providers and 15 caregivers to co-develop interventions to improve CA services. RESULTS:Caregivers reported emotional distress, stigma, and financial and geographic barriers to care. Key healthcare challenges included limited antenatal diagnosis, inadequate provider communication, insufficient peer support, and poor access to CA information. Community stigma contributed to parental isolation and distress, though social and spiritual networks offered coping support. Workshop participants identified stigma and fragmented care as critical issues and proposed feasible interventions, including caregiver support groups, dedicated counselors, provider training, integrated community counseling, improved infrastructure, and stronger support networks to enhance person-centered care. CONCLUSIONS:Engaging caregivers and providers through HCD highlighted major psychosocial and healthcare barriers and generated contextually relevant strategies to improve care for infants with CAs in Kenya. Future research should evaluate the implementation and effects of these interventions on patient- and family-centered outcomes.