Feasibility and acceptability of frequent vaginal self-sampling at home by Rwandan women at high risk of urogenital tract infections

2021 ◽  
pp. sextrans-2020-054816
Author(s):  
Marijn C Verwijs ◽  
Stephen Agaba ◽  
Marie-Michele Umulisa ◽  
Janneke H H M van de Wijgert
Keyword(s):  
Group Discussion ◽  
Amplicon Sequencing ◽  
Randomised Clinical Trial ◽  
Sub Saharan Africa ◽  
16S Rrna Amplicon Sequencing ◽  
Resource Setting ◽  
Vaginal Swabs ◽  
Sub Saharan ◽  
Tract Infections ◽  
At Home

ObjectivesTo establish temporal links between vaginal microbiota (VMB) data and incident clinical events, frequent longitudinal vaginal sampling is required. Self-collection of swabs at the participant’s home may be useful to avoid overburdening research clinics and participants. One-off vaginal self-sampling for STI or cervical cancer screening programmes has been shown to be feasible and acceptable to women in multiple studies, including in sub-Saharan Africa, but the feasibility and acceptability of frequent longitudinal vaginal sampling in the context of VMB sequencing studies is unknown.MethodsTwelve participants of a randomised clinical trial in Kigali, Rwanda, self-collected vaginal swabs three times a week for a month. We studied feasibility by comparing DNA concentrations, proportions of samples with >1000 16S rRNA amplicon sequencing reads and VMB composition outcomes of self-collected swabs with clinician-collected swabs. We evaluated the acceptability of self-collection using structured face-to-face interviews and a focus group discussion.ResultsThe participants collected vaginal swabs at 131 different time points. One woman stopped self-sampling after one try due to a social harm. All self-sampled swabs generated >1000 rRNA amplicon sequencing reads, and the DNA concentration of self-sampled swabs and clinician-sampled swabs did not differ significantly (Kruskal-Wallis p=0.484). Self-sampled and clinician-sampled swabs generated similar VMB composition data. Participants reported feeling very comfortable during self-sampling (11/12; 91.7%) and that self-sampling had become easier over time (12/12; 100%). They mentioned reduced travel time and travel costs as advantages of self-sampling at home.ConclusionsFrequent longitudinal vaginal sampling at home is feasible and acceptable to participants, even in the context of a low-resource setting, as long as adequate counselling is provided.Trial registration numberNCT02459665.

scholarly journals Loss and Gain of Gut Bacterial Phylotype Symbionts in Afrotropical Stingless Bee Species (Apidae: Meliponinae)

2021 ◽  
Vol 9 (12) ◽  
pp. 2420
Author(s):  
Yosef Hamba Tola ◽  
Jacqueline Wahura Waweru ◽  
Nelly N. Ndungu ◽  
Kiatoko Nkoba ◽  
Bernard Slippers ◽  
...  
Keyword(s):  
Health Management ◽  
Amplicon Sequencing ◽  
Sympatric Species ◽  
Stingless Bee ◽  
Sub Saharan Africa ◽  
Microbial Composition ◽  
16S Rrna Amplicon Sequencing ◽  
Bee Health ◽  
Sub Saharan ◽  
Species Specific

Stingless bees (Apidae: Meliponini) are the most diverse group of corbiculate bees and are important managed and wild pollinators distributed in the tropical and subtropical regions of the globe. However, little is known about their associated beneficial microbes that play major roles in host nutrition, detoxification, growth, activation of immune responses, and protection against pathogens in their sister groups, honeybees and bumble bees. Here, we provide an initial characterization of the gut bacterial microbiota of eight stingless bee species from sub-Saharan Africa using 16S rRNA amplicon sequencing. Our findings revealed that Firmicutes, Actinobacteria, and Proteobacteria were the dominant and conserved phyla across the eight stingless bee species. Additionally, we found significant geographical and host intra-species-specific bacterial diversity. Notably, African strains showed significant phylogenetic clustering when compared with strains from other continents, and each stingless bee species has its own microbial composition with its own dominant bacterial genus. Our results suggest host selective mechanisms maintain distinct gut communities among sympatric species and thus constitute an important resource for future studies on bee health management and host-microbe co-evolution and adaptation.

scholarly journals Characterization of the Kenyan Honey Bee (Apis mellifera) Gut Microbiota: A First Look at Tropical and Sub-Saharan African Bee Associated Microbiomes

2020 ◽  
Vol 8 (11) ◽  
pp. 1721
Author(s):  
Yosef Hamba Tola ◽  
Jacqueline Wahura Waweru ◽  
Gregory D. D. Hurst ◽  
Bernard Slippers ◽  
Juan C. Paredes
Keyword(s):  
Apis Mellifera ◽  
Gut Microbiota ◽  
Honey Bee ◽  
Amplicon Sequencing ◽  
Sub Saharan Africa ◽  
African Region ◽  
16S Rrna Amplicon Sequencing ◽  
Host Interaction ◽  
Sub Saharan

Gut microbiota plays important roles in many physiological processes of the host including digestion, protection, detoxification, and development of immune responses. The honey bee (Apis mellifera) has emerged as model for gut-microbiota host interaction studies due to its gut microbiota being highly conserved and having a simple composition. A key gap in this model is understanding how the microbiome differs regionally, including sampling from the tropics and in particular from Africa. The African region is important from the perspective of the native diversity of the bees, and differences in landscape and bee management. Here, we characterized the honey bee gut microbiota in sub-Saharan Africa using 16S rRNA amplicon sequencing. We confirm the presence of the core gut microbiota members and highlight different compositions of these communities across regions. We found that bees from the coastal regions harbor a higher relative abundance and diversity on core members. Additionally, we showed that Gilliamella, Snodgrassella, and Frischella dominate in all locations, and that altitude and humidity affect Gilliamella abundance. In contrast, we found that Lactobacillus was less common compared temperate regions of the world. This study is a first comprehensive characterization of the gut microbiota of honey bees from sub-Saharan Africa and underscores the need to study microbiome diversity in other indigenous bee species and regions.

scholarly journals Humanitarian Surgical Missions in Times of COVID-19: Recommendations to Safely Return to a Sub-Saharan Africa Low-Resource Setting

2021 ◽  
Author(s):  
Víctor Lopez-Lopez ◽  
Ana Morales ◽  
Elisa García-Vazquez ◽  
Miguel González ◽  
Quiteria Hernandez ◽  
...  
Keyword(s):  
Sub Saharan Africa ◽  
Low Resource ◽  
Resource Setting ◽  
Low Resource Setting ◽  
Sub Saharan

scholarly journals Multi-Strain Probiotic Supplementation with a Product Containing Human-Native S. salivarius K12 in Healthy Adults Increases Oral S. salivarius

Nutrients ◽  
2021 ◽  
Vol 13 (12) ◽  
pp. 4392
Author(s):  
Karina Cernioglo ◽  
Karen M. Kalanetra ◽  
Anna Meier ◽  
Zachery T. Lewis ◽  
Mark A. Underwood ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Amplicon Sequencing ◽  
Healthy Adults ◽  
Oral Microbiome ◽  
Placebo Control ◽  
Upper Respiratory Tract ◽  
Double Blind ◽  
16S Rrna Amplicon Sequencing ◽  
Supplementation Period ◽  
Tract Infections

Streptococcus salivarius (S. salivarius) K12 supplementation has been found to reduce the risk of recurrent upper respiratory tract infections. Yet, studies have not reported the effect of supplementation on oral S. salivarius K12 levels or the salivary microbiome. This clinical trial was designed to determine how supplementation with S. salivarius K12 influences the oral microbiome. In a randomized, double-blind, placebo-controlled trial, 13 healthy adults received a probiotic powder (PRO) containing Lactobacillus acidophilus, Bifidobacterium lactis, and S. salivarius K12 and 12 healthy adults received a placebo-control powder (CON) (n = 12) for 14 consecutive days. Oral S. salivarius K12 and total bacteria were quantified by qPCR and the overall oral microbiome was measured using 16S rRNA amplicon sequencing. Supplementation significantly increased mean salivary S. salivarius K12 levels by 5 logs compared to baseline for the PRO group (p < 0.0005), which returned to baseline 2 weeks post-supplementation. Compared with the CON group, salivary S. salivarius K12 was 5 logs higher in the PRO group at the end of the supplementation period (p < 0.001). Neither time nor supplementation influenced the overall oral microbiome. Supplementation with a probiotic cocktail containing S. salivarius K12 for two weeks significantly increased levels of salivary S. salivarius K12.

scholarly journals Antimicrobial Resistance of Sterile Site Infections in Sub-Saharan Africa: A Systematic Review

2017 ◽  
Vol 4 (4) ◽  
Author(s):  
Meklit Workneh ◽  
Morgan J Katz ◽  
Mohammed Lamorde ◽  
Sara E Cosgrove ◽  
Yukari C Manabe
Keyword(s):  
Antimicrobial Resistance ◽  
Sub Saharan Africa ◽  
Eastern Africa ◽  
World Health ◽  
Fluoroquinolone Resistance ◽  
Mechanisms Of Resistance ◽  
Salmonella Spp ◽  
Sterile Site ◽  
Sub Saharan ◽  
Tract Infections

Abstract Sparse data exist from sub-Saharan Africa (SSA) on the prevalence of antimicrobial resistance (AMR). A prior review of antimicrobial resistance in SSA from 1990 to 2013 showed a high prevalence of AMR to commonly used antibiotics in this setting. We reviewed the literature published since 2013. Four databases (PubMed, EMBASE, Cochrane, and African Journals Online) were searched for articles between February 2013 and March 2016 with a focus on sterile site infections (bacteremia, urinary tract infections [UTIs], and meningitis). We focused on the original World Health Organization–identified priority pathogens and antibiotics, prior to the release of the most recently updated and expanded list in 2017. There were 19 eligible studies: bacteremia (12), UTI (6), and meningitis (1). Eight studies were from Western and Central Africa, 8 from Eastern Africa, and 4 from Southern Africa. Prevalence of Escherichia coli resistance to third-generation cephalosporins ranged from 0% to 75%. No studies reported resistance to carbapenems among Klebsiella spp. Prevalence of fluoroquinolone resistance ranged from 8.3% to 100% among E. coli and 0% to 15% among Salmonella spp. Prevalence of resistance to penicillin among Streptococcus pneumoniae isolates ranged from 25% to 100%. Testing for extended-spectrum beta-lactamase was reported in 7 studies (range, 1.3–60% among tested isolates). Methods for evaluating AMR varied across studies; standardized approaches are needed in the region. Testing for mechanisms of resistance is low even in research settings, but important mechanisms of resistance such as ESBL production are present.

Factors associated with high-risk HPV positivity in a low-resource setting in sub-Saharan Africa

2014 ◽  
Vol 210 (1) ◽  
pp. 81.e1-81.e7 ◽  
Author(s):  
Sheona M. Mitchell ◽  
Musa Sekikubo ◽  
Christine Biryabarema ◽  
Josaphat J.K. Byamugisha ◽  
Malcolm Steinberg ◽  
...  
Keyword(s):  
High Risk ◽  
Sub Saharan Africa ◽  
Factors Associated ◽  
Low Resource ◽  
Resource Setting ◽  
Low Resource Setting ◽  
Sub Saharan ◽  
High Risk Hpv

scholarly journals Antimicrobial Resistance in Gram-negative bacteria from Urinary Specimens: a study of prevalence, risk factors and molecular mechanisms of resistance (ARGUS) in Zimbabwe – a study protocol

2020 ◽  
Vol 5 ◽  
pp. 140
Author(s):  
Ioana D. Olaru ◽  
Shunmay Yeung ◽  
Rashida A. Ferrand ◽  
Richard Stabler ◽  
Prosper Chonzi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Antimicrobial Resistance ◽  
Clinical Outcomes ◽  
Molecular Mechanisms ◽  
Outpatient Setting ◽  
Sub Saharan Africa ◽  
Gram Negative ◽  
Sub Saharan ◽  
Few Data ◽  
Tract Infections

Antimicrobial resistance (AMR) is compromising our ability to successfully treat infections. There are few data on gram-negative AMR prevalence in sub-Saharan Africa especially from the outpatient setting. This study aims to investigate the prevalence of and underlying molecular mechanisms for AMR in gram-negative bacilli causing urinary tract infections (UTIs) in Zimbabwe. Risk factors for AMR and how AMR impacts on clinical outcomes will also be investigated. Adults presenting with UTI symptoms at primary health clinics in Harare will be included. A questionnaire will be administered, and urine samples will be collected for culture. Participants with positive urine cultures will be followed up at 7-14 days post-enrolment. All participants will also be followed by telephone at 28 days to determine clinical outcomes. Bacterial identification and antibiotic susceptibility testing will be performed on positive cultures. The results from this study will be used to inform policy and development of treatment recommendations. Whole genome sequencing results will provide a better understanding of the prevalent resistance genes in Zimbabwe, of the spread of successful clones, and potentially will contribute to developing strategies to tackle AMR.

scholarly journals Powering Jobs: The Employment Footprint of Clean Cooking Solutions in Kenya

2021 ◽  
Author(s):  
CHIH-JUNG LEE ◽  
Rebekah Shirley ◽  
Maureen Otieno ◽  
Hope Nyambura
Keyword(s):  
Group Discussion ◽  
Sub Saharan Africa ◽  
Liquefied Petroleum Gas ◽  
Women's Participation ◽  
Employment Impact ◽  
Sub Saharan ◽  
Data Gap ◽  
Managerial Positions ◽  
One Year ◽  
The Impact

Abstract Background: Delivering clean cooking access to 1.2 billion people who cook with charcoal, kerosene and firewood may have a strong localized employment impact. With the challenge of a rapidly expanding youth population and growing job scarcity in sub-Saharan Africa, understanding the impact of clean cooking on employment as well as the skills gap is timely. However, there is little definitive data on clean cooking jobs. Recognizing this data gap, we sought to conduct a study focused specifically on employment from the clean cooking sectors in Kenya, covering liquefied petroleum gas (LPG), bioethanol, biogas and electric cooking solutions. This study provides an initial baseline and early estimate of clean cooking sectors’ direct formal and informal employment based on one year of company survey data, expert interviews, available literature, and local focus group discussion.Results: In Kenya, the clean cooking sector provided about 19,000 direct, formal jobs and potentially 15,000 to 35,000 direct, informal jobs in 2019. While the clean cooking sector provided many jobs, the level of compensation and retention is low. In the LPG and electric cooking sector, sales and distribution are the biggest part of the workforce, while for bioethanol and biogas, manufacturing and assembling is important. The majority of the direct, formal workforce is reported to be skilled. Management, finance and legal, and product development and research are the most difficult skills to recruit for. Women’s participation is lower than 30% in the clean cooking sectors. Managerial positions have higher women’s participation than non-managerial ones.Conclusion: This research exercise establishes a baseline for understanding the employment impact of the clean cooking sectors. However, a massive data gap persists. Our study shows that while the clean cooking sectors, especially LPG, are already providing tens of thousands of jobs, further studies are critically needed to map the employment impact of delivering universal clean cooking access.

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