http://ir.mu.ac.ke:8080/jspui/handle/123456789/7 2026-07-21T01:20:50Z http://ir.mu.ac.ke:8080/jspui/handle/123456789/10376 Estimating SARS-CoV-2 exposure in asymptomatic hospitalized children with cancer in Western Kenya: A retrospective analysis of serological data DiLillo, Katarina M.; Forconi, Catherine S.; Matta, Angela; Melo, Jeni; McNamara, Ryan P.; Tonui, Ronald; N’juguna, Festus; Otieno, Juliana A.; Odwar, Boaz; Kinyua, Ann; Lauffenburger, Douglas A.; Moormann, Ann M. Background During the COVID-19 pandemic, concerns emerged that hospital-based care could increase the risk of SARS-CoV-2 infection among pediatric patients with cancer, especially in resource-limited settings where the capacity to isolate patients would be challenging. Yet, infection rates in this population remain poorly documented, and it is unclear whether prior common human coronavirus (HCoV) exposures influence SARS-CoV-2 antibody responses. Here, we used serology to estimate SARS-CoV-2 exposure in children with and without cancer from Western Kenya and evaluated responses to common HCoVs to explore cross-reactivity. Methods We performed multiplex antibody profiling to assess SARS-CoV-2 and HCoV-specific responses in plasma from children with and without cancer sampled between 2014 and 2022. Unsupervised clustering identified participants with elevated SARS-CoV-2 seroreactivity relative to pre-pandemic samples. Seropositivity was further defined using a multi-antigen approach based on IgG levels to nucleocapsid and receptor- binding domain antigens to improve specificity. Cross-reactivity and cross-boosting by common HCoVs were evaluated through correlation analyses and groupwise com- parisons of antibody levels, respectively. Results Of 564 children, 474 were healthy (184 pre-pandemic; 290 post-pandemic) and 90 had cancer (16 pre-pandemic; 74 post-pandemic). Post-pandemic, 69% (200) of healthy controls exhibited elevated SARS-CoV-2 seroreactivity, with 51% (148) meeting the criteria for seropositivity. Children with cancer showed similar rates of seroreactivity (67%) and seropositivity (57%) after adjusting for sampling year, with incidence increasing annually from 2020 to 2022. Pre-pandemic samples exhibited weak cross-reactivity to HCoV-OC43 which increased following SARS-CoV-2 infec- tion; however, no significant boosting of HCoV antibodies was observed. Conclusions These findings indicate widespread SARS-CoV-2 exposure among children in Western Kenya and provide no evidence that hospitalization heightened infection risk for pediatric patients with cancer. 2026-07-01T00:00:00Z http://ir.mu.ac.ke:8080/jspui/handle/123456789/10375 Trends in the incidence of kaposi sarcoma among adults attending hiv care facilities in East Africa and Latin America in the Treat-All era Semeere, Aggrey S.; Slone, Joshua; Amorim, Gustavo; Musick, Beverly; Crabtree-Ramírez, Brenda; Diero, Lameck; Otero, Larissa; Riley, Hilary Vansell; Ngeresa, Antony; Nsumba, Mark Background In resource-rich regions, such as the U.S. and Europe, the incidence of Kaposi sarcoma (KS) amongst persons living with HIV (PWH) has dramatically declined with the advent of combination antiretroviral therapy (ART). In contrast, in low- and middle-income countries (LMICs), much less is known, particularly since the World Health Organization’s recommendation in late 2015 to use ART in all PWH. We take advantage of the coincident electronic clinical data capture at HIV care facilities to estimate the incidence of KS among PWH in care with ready access to ART, piloting a data validation approach to address errors in these routine clinic data. Methods We evaluated PWH enrolled from January 2010 to December 2019 in 13 HIV care clinics in 8 countries participating in the East Africa (EA-IeDEA) and Caribbean, Central and South America (CCASAnet) regions of the International Epidemiology Databases to Evaluate AIDS (IeDEA) consortium. Selected measurements were validated via chart review on a subset of PWH, and we estimated KS incidence in both unvalidated and validated data via generalized raking techniques. Results A total of 235,474 PWH from EA-IeDEA and 19,683 from CCASAnet gave rise to 719 and 103 incident cases of KS, respectively. A total of 824 eligible records were validated. ART use was substantially lower in EA-IeDEA than CCASAnet in 2010 but equalized by 2019. From 2010 to 2019, KS incidence decreased on average 21% per year (incidence rate ratio [IRR] 0.79; 95% CI 0.75-0.82) in EA-IeDEA but only 6% (IRR=0.94; 95% CI 0.83-1.06) in CCASAnet. Conclusions Among PWH attending HIV care facilities in East Africa, we observed a trend suggesting a reduction in KS incidence that paralleled increased Treat All era ART use in these clinics. In the Caribbean, Central and South America, there was hardly a change in the incidence, despite high-frequency ART use in the region as well. 2026-06-01T00:00:00Z http://ir.mu.ac.ke:8080/jspui/handle/123456789/10374 Action for access: equity for children with disabilities in lowand middle-income countries Flynn, Emilee; McHenry, Megan S.; Kigen, Barnabas; Kapeller-Libermann, Dana; Fernandez, Jessica De Curtis; Rule, Amy R. L. Sixteen percent of the world's population experiences significant disability. This is likely an underestimation, as there is not a uniformly accepted definition of disability and there are limited validated tools to support clinicians in their diagnoses, especially in low- and middle-income nations. Even when a diagnosis is made, access to specialized health care and community resources is limited, with increased travel distances and high cost of services presenting additional challenges for patients and families. The World Health Organization and the United Nations have provided additional frameworks for supporting physical access and social inclusion for people living with disabilities. However, these frameworks remain inequitably applied with individuals living in low- and middle-income countries experiencing both the largest burden of disease and the fewest resources. Pediatricians can take action to ensure adequate access to health care, education, assistive technology, psychosocial support, and policy action for children with disabilities around the world. 2026-01-01T00:00:00Z http://ir.mu.ac.ke:8080/jspui/handle/123456789/10372 Prevalence and factors associated with diabetes screening uptake among adults in Zambia: evidence from the 2024 Zambia demographic and health survey Okombo, Norah Awuor; Mutuku, Daniel Muli; Nyakundi, Caleb; Ngina, Lilian; Mulei, Irene; Nyaga, Nancy; Oguta, James Odhiambo; Akoth, Catherine; Kanini, Dorcas Background The prevalence of diabetes has been on the rise over the years, posing global public health concerns. The World Health Organization (WHO) recommends screening for early detection of prediabetes to prevent complications. Uptake of screening services is, however, still low in Africa, attributed to socioeconomic and health infrastructure disparities in the region. This study examined the prevalence and factors associated with diabetes screening uptake in Zambia. Methods We conducted a secondary analysis of the 2024 Zambia Demographic and Health Surveys (ZDHS) involving 26,508 respondents. Diabetes screening was defined based on self-reported history of blood glucose measurement by a doctor or other healthcare worker. A weighted analysis was performed to determine the prevalence and factors associated with screening. Descriptive statistics, including frequencies and percentages, were used to summarise sample characteristics, and prevalence estimates with 95% confidence intervals (CIs) were computed. Both univariable and multivariable logistic regression analyses were performed to identify factors associated with diabetes screening uptake. Results The weighted prevalence of diabetes screening was 14.7% (95% CI: 13.9–15.4). Screening prevalence was higher among females (15.3%), respondents aged 45 years and above (28.9%), those with higher education (37.5%), those in the richest wealth quintile (26.1%), respondents with health insurance (38.1%), urban residents (19.9%), and individuals with hypertension (31.4%). From the multivariable analysis, respondents aged 45 years and above (aOR = 3.32, 95% CI: 2.84–3.90), those with higher education (aOR = 1.89, 95% CI: 1.45–2.47), living with hypertension (aOR = 1.70, 95% CI: 1.49–1.94), and those in the richest wealth quintile (aOR = 1.44, 95% CI: 1.11–1.85), had higher odds of screening. Conversely, males (aOR = 0.75, 95% CI: 0.65–0.85) and smokers (aOR = 0.84, 95% CI: 0.71–1.00) had lower odds of screening. Residents of all other regions had lower odds of screening compared to those in Lusaka. Conclusion Diabetes screening uptake in Zambia remains low at approximately 15%, indicating gaps in preventive service utilisation. We found out that diabetes screening is associated with socioeconomic status, health system access, and health risk profiles. Strengthening integration of diabetes screening into primary healthcare services, expanding health insurance coverage, and improving targeted awareness campaigns may improve screening uptake. 2026-01-01T00:00:00Z