BackgroundAntimicrobial resistance (AMR) is an increasingly severe threat to global public health that requires action across different sectors. Selection of appropriate antimicrobials is an urgent challenge due to the emergence of drug resistance. In 2017, Kenya developed an AMR policy and National Action Plan to drive prevention and containment of AMR. A priority activity under AMR surveillance strategic objective was to develop a national AMR training curriculum for in-service healthcare workers. In this paper we discuss the development process, gains achieved through implementation across the country and lessons learned.MethodsAn initial stakeholders’ forum was convened to brainstorm on the process for developing the curriculum and some issues deliberated upon include the design approach, development roadmap, curriculum outline and scope, delivery, and evaluation methodologies. A dedicated team of subject matter experts (SMEs), drawn from the project and government ministries, compiled the initial draft of the curriculum and later the training materials. A series of other stakeholders’ meetings were convened to review these materials. The National Antimicrobial Stewardship Interagency Committee (NASIC) of the MOH in Kenya identified a team of experts from academia, research, and government to work with the SMEs in reviewing and providing valuable inputs to the curriculum. Additionally, principles of adult learning and a One Health approach for development were considered as AMR has drivers and impacts across sectors. A validation workshop was held to finalize the documents with a formal launch conducted during the World Antibiotics Awareness Week of 2020.ResultsA multisectoral AMR surveillance training curriculum and facilitator and trainee manuals were developed and endorsed by MOH and Ministry of Agriculture, Livestock, Fisheries and Cooperatives within one year. Over 500 healthcare workers in 19 counties were trained, with overwhelming adoption by other stakeholders in Kenya and beyond.ConclusionThis curriculum was developed to standardize training for AMR detection and surveillance. The central role played by the MOH ensured expeditious development and roll-out of this curriculum. The in-service curriculum, now available on an e-learning platform, provides a ready opportunity to build capacity of healthcare professionals. Additional resources are needed to standardize and scale these efforts to reach all healthcare workers.

Giardia duodenalis is an emerging zoonotic protozoan parasite that is significantly affecting the health and welfare of dogs in Nairobi County, Kenya. There is limited data on canine giardiasis in Kenya. A cross-sectional study was conducted to determine the prevalence, risk factors and molecular identity of G. duodenalis infections in dogs in Nairobi County, Kenya. Four hundred fecal samples were collected from randomly selected dogs and subjected to Giardia SNAP test which is a rapid antigen ELISA test to determine the Giardia antigen in the faeces. Positive fecal samples were subjected to molecular analysis through PCR and thereafter sequencing to determine the circulating Giardia genotypes. A Spatial Bernoulli model in SaTScan was used to investigate clustering of Giardia infection in dogs within Nairobi County. A questionnaire was administered to the dog owners to capture data on risk factors for Giardia infection in dogs. Multivariate analysis was used to determine the association between the occurrence of infection and the predicted risk factors. The overall prevalence of Giardia infection in dogs in Nairobi County, Kenya in this study was 22.3%. The risk of infection was 0.99 times during wet season and 0.22 times in young dogs < 12 months. Roaming/stray or dogs that were never housed in kennels had 3.04 times the chances of contracting the infection. Spatial analysis showed two clusters with a high risk of Giardia infection within Nairobi County. Zoonotic assemblages A and B and a mixed infection of both were also isolated in dogs in Nairobi County, Kenya. In conclusion, young and roaming or stray dogs have a higher risk of Giardia infection with the risk of infection being high during the wet season. Dogs within Nairobi County harbor zoonotic assemblages A and B which could pose a public health risk to humans. Key words: Dogs, Giardia duodenalis, prevalence, risk factors, zoonotic genotypes.

A cross-sectional study was carried out to determine the prevalence and risk factors associated with gastrointestinal parasitism in dromedary camel calves in Isiolo County, Kenya.Data on farm-and calflevels were collected through semi-structured questionnaires.The calves were examined, and a faecal sample was collected per rectum for laboratory analysis.The gastrointestinal parasite eggs and oocysts were estimated using the faecal floatation and McMaster methods in the laboratory.Descriptive analysis was used to summarize the variables, and multilevel mixed-effects logistic regression models were used to explore the association between helminth infection and the farm-and calf-level risk factors.A total of 308 calves in 25 households were recruited for this study.The mean number of calves per herd, age and weight were 38, 7.3 months and 169 kg, respectively, while the age at weaning was about 11 months.The overall prevalence of gastrointestinal parasitism was 42%, while that of nematodes and coccidia were 31 and 3.9%, respectively.In the first model, the factors that were significantly associated with nematode infections were total milk yield per day, calf age, and calf weight.In the second model, the factors that were significantly associated with Nematodirus species infection were the age of the calf, live body weight and average weaning age of the camel calves.The study concludes that gastrointestinal parasitism (especially nematodes) occurs in camel calves in Kenya.It is recommended that the pastoralists should be educated on the impact of gastrointestinal parasitic infections in camel calves, and the importance of strategic deworming.

Background and Aim:The one-humped camels (Camelus dromedarius) adapt very well to arid and semi-arid (ASALs) environments and continue to thrive and produce milk even during severe droughts when cattle, sheep, and goats experience high mortalities. These attributes make the dromedaries very vital for the survival of pastoralists, especially in the ASALs of Africa. Mastitis is among the most important diseases of camels and can cause significant economic losses, thereby endangering the livelihoods of pastoralists. This study aimed to estimate the prevalence, risk factors, and antimicrobial sensitivity of mastitis-causing pathogens in lactating camels in Isiolo County, Kenya.Materials and Methods:This was a cross-sectional study conducted in July and August 2021. A questionnaire was administered to the camel keepers to capture data on herd-level factors. Lactating camels were then examined for any visible signs of clinical mastitis and as well as to capture data on other animal-level factors such as age, weight, and body condition score. A composite milk sample was collected aseptically from randomly selected camels in a herd. The samples were initially tested for somatic cell counts (SCC) using Somatos mini® automatic cell counter. Culture and sensitivity testing was then carried out on any milk sample that had SCC ≥ 200,000 cells/mL. The descriptive analysis was initially used to summarize the continuous and categorical farm and camel factors, while mixed regression models were used to explore the association between/across mastitis and the farm as well as camel-level factors.Results:A total of 210 lactating camels from 23 herds were selected and sampled in this study. The average age of camel keepers was 48.3 ± 16.3 years and they were involved in rearing camels for a mean of about 14.3 ± 8.6 years. The total number of camels in a herd ranged from 10 to 287, with the mean total herd milk production being 34.5 ± 24.9 L/day. The mean daily milk production per camel was 2.8 ± 1.7 L while the range for days in milk was between 21 and 787 days. The average age of camel first calving and the inter-calving interval was 56.3 ± 9.9 and 27.7 ± 9.9 months, respectively. The median parity of the dam was three and the body condition score was two. About 39.7% (83/210) of the sampled camels had clinical mastitis during the current lactation. The overall prevalence of mastitis (SCC ≥ 200,000 cells/mL) in camels was 17.6%. The main pathogens isolated were Streptococcus and Staphylococcus bacteria. Streptococcus isolates were mainly sensitive to ampicillin and resistant to cefaclor. All 18 Staphylococcus isolates were sensitive to tetracycline, while 12/18 isolates were resistant to ampicillin. The factors that were significantly associated with mastitis were the age of the respondent (p = 0.038), the number of years involved in camel rearing (p = 0.024), presence of clinical mastitis since calving (p = 0.039), body condition score (p = 0.040), and age of the dam at the time of examination (p = 0.072).Conclusion:Results from this study revealed that mastitis is an important condition among camels in the pastoral communities of Isiolo County, Kenya. Thus, pastoralists should continue to be aware of and trained on mastitis occurrence and its control in the pastoral ecosystem to reduce potential economic losses.

Background and Aim:Camels have adaptive features to harsh climatic conditions, which make them a valued stable source of livelihood in arid lands. This study estimated the total bacterial and coliform counts (CCs), their associated factors in raw camel milk from the pastoral camel keepers, and the entire milk value chain in Isiolo County and Nairobi, Kenya. This study elucidates the bacterial load in camel milk and its potential risk. Moreover, this study provides recommendations on how to avert a human health hazard.Materials and Methods:This cross-sectional study targeted the camel pastoralists in Isiolo County, in the northern central part of Kenya. The study was conducted in July and August 2021. In addition, camel milk samples were collected along the value chain key points, including the producers, transporters, one bulker, and small traders in Isiolo town, and other retailers in Nairobi City. Eight camel herds were purposively selected and visited for a sample collection from pooled milking containers (10 mL each). In addition, milk was collected from pooled milk through the transporters, two milk bulkers, and several milk retailers in Isiolo town. Milk was further collected from retailers in Eastleigh town, Nairobi City. At each sampling point, 20 mL of milk sample was collected aseptically. The milk samples were assessed for total viable bacterial counts (TVBC) and CCs using the plate count and digital colony count, respectively.Results:A total of 76 respondents were selected and 213 milk samples were collected in this study. The respondents included the 1 (1.3%) bulker, 32 (42.1%) producers, 26 (34.2%) traders, and 17 (22.4%) transporters. Most respondents were male (62%), with most being over 40 years old. Overall, the TVBC had a mean of 2436835 ± 9276636 and a median of 3600. Furthermore, the multivariable multilevel mixed-effects linear regression model indicated that gender and practice of smoking milk-handling containers were positively and negatively associated with high counts of the natural logarithm of total viable bacteria, respectively. Of the milk samples evaluated for the CC, 10.3% (22/213) had counts greater than or equal to (≥) 100,000, where some also indicated extreme outliers of about 9.3 million.Conclusion:This study reports a low proportion of camel milk samples with high total viable bacterial and CCs. The material of the milk container and level of education interactively affected the total viable bacteria.

A case of Trypanosoma congolense savannah type infection in a 4-year old German shepherd dog weighing 26-kg was presented to the Small Animal Clinic, University of Nairobi, Kenya, with the history of anorexia and difficulty in breathing. The clinical manifestations were fever, pale mucous membrane, dyspnea and wasting. Blood examination revealed the existence of trypanosome parasites, and showed mild anemia. Internal Transcribed Spacer (ITS) based polymerase chain reaction confirmed the presence of Trypanosoma congolense savannah type. Along with supporting therapy, the case was successfully managed using diminazene aceturate injection (dosed at 3.5 mg/kg body weight) through intramuscular route. Complete recovery of the case was observed on day 6 of post-treatment.