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Although WHO recommends mass drug administration (MDA) for malaria elimination, further evidence is required for understanding the obstacles for the optimum implementation of MDA. Just before the long rain in 2016, two rounds of MDA with artemisinin/piperaquine (Artequick) and low-dose primaquine were conducted with a 35-day interval for the entire population of Ngodhe Island (~500 inhabitants) in Lake Victoria, Kenya, which is surrounded by areas with moderate and high transmission. With approximately 90% compliance, Plasmodium prevalence decreased from 3% to 0% by microscopy and from 10% to 2% by PCR. However, prevalence rebounded to 9% by PCR two months after conclusion of MDA. Besides the remained local transmission, parasite importation caused by human movement likely contributed to the resurgence. Analyses of 419 arrivals to Ngodhe between July 2016 and September 2017 revealed Plasmodium prevalence of 4.6% and 16.0% by microscopy and PCR, respectively. Risk factors for infection among arrivals included age (0 to 5 and 11 to 15 years), and travelers from Siaya County, located to the north of Ngodhe Island. Parasite importation caused by human movement is one of major obstacles to sustain malaria elimination, suggesting the importance of cross-regional initiatives together with local vector control.
Subject terms: Malaria, Epidemiology
Malaria resurgence after significant reduction by mass drug administration on Ngodhe Island, Kenya
Wataru Kagaya,#1 Jesse Gitaka,#2 Chim W. Chan,1,3,4 James Kongere,5 Zulkarnain Md Idris,3,6 Changsheng Deng,7 and Akira Kanekocorresponding author1,3,8
Although ultrafast laser materials processing has advanced at a breakneck pace over the last two decades, most applications have been developed with laser pulses at near-IR or visible wavelengths. Recent progress in mid-infrared (MIR) femtosecond laser source development may create novel capabilities for material processing. This is because, at high intensities required for such processing, wavelength tuning to longer wavelengths opens the pathway to a special regime of laser-solid interactions. Under these conditions, due to the λ2 scaling, the ponderomotive energy of laser-driven electrons may significantly exceed photon energy, band gap and electron affinity and can dominantly drive absorption, resulting in a paradigm shift in the traditional concepts of ultrafast laser-solid interactions. Irreversible high-intensity ultrafast MIR laser-solid interactions are of primary interest in this connection, but they have not been systematically studied so far. To address this fundamental gap, we performed a detailed experimental investigation of high-intensity ultrafast modifications of silicon by single femtosecond MIR pulses (λ = 2.7-4.2 μm). Ultrafast melting, interaction with silicon-oxide surface layer, and ablation of the oxide and crystal surfaces were ex-situ characterized by scanning electron, atomic-force, and transmission electron microscopy combined with focused ion-beam milling, electron diffractometry, and μ-Raman spectroscopy. Laser induced damage and ablation thresholds were measured as functions of laser wavelength. The traditional theoretical models did not reproduce the wavelength scaling of the damage thresholds. To address the disagreement, we discuss possible novel pathways of energy deposition driven by the ponderomotive energy and field effects characteristic of the MIR wavelength regime.
Subject terms: Materials science, Optics and photonics, Physics
Single-Shot Multi-Stage Damage and Ablation of Silicon by Femtosecond Mid-infrared Laser Pulses
Kevin Werner,corresponding author1,2 Vitaly Gruzdev,3 Noah Talisa,1 Kyle Kafka,1,4 Drake Austin,1,5 Carl M. Liebig,5 and Enam Chowdhury1,6,7
The epidemiology of enteric pathogens has not been well studied in Kenya because of wide disparities in health status across the country. Therefore, the present study describes the prevalence of enteropathogenic bacteria, their seasonal variation, and antibiotic resistance profiles among hospitalized diarrheic children in a suburban region of central Kenya.
Fecal samples were collected between July 2009 and December 2013 from a total of 1410 children younger than 5 years, hospitalized with acute diarrhea in Kiambu County Hospital, Kenya. Conventional culture, biochemical, and molecular methods were conducted to identify causative bacterial pathogens and their virulence factors. Antimicrobial susceptibility tests were performed using E-test strips and VITEK-2 advanced expert system (AES) to evaluate the drug-resistance pattern of the isolates.
Of the 1410 isolates, bacterial infections were identified in 474 cases. Diarrheagenic Escherichia coli (DEC) was the most frequently isolated pathogen (86.5%). Other pathogens such as Aeromonas (5.5%), Shigella (4%), Salmonella (3.4%), Providencia (3.2%), Vibrio spp. (1.1%), Yersinia enterocolitica (1.1%), and Plesiomonas shigelloides (0.2%) were also identified. Mixed bacterial infection was observed among 11.1% of the cases. The highest infection rate was found during the dry season (59.3%, p = 0.04). Most of the DEC was found to be multidrug resistant to trimethoprim/sulfamethoxazole 97.6%, amoxicillin 97.6%, erythromycin 96.9%, ampicillin 96.6%, and streptomycin 89%.
This study suggests that DEC is the leading diarrhea-causing bacterial pathogen circulating in central Kenya, and seasonality has a significant effect on its transmission. Proper antibiotic prescription and susceptibility testing is important to guide appropriate antimicrobial therapy.
Diarrhea, E. coli pathotypes, Seasonal variation, Antimicrobial susceptibility pattern
Prevalence, seasonal variation, and antibiotic resistance pattern of enteric bacterial pathogens among hospitalized diarrheic children in suburban regions of central Kenya
Mohammad Shah,corresponding author1,2,4 Cyrus Kathiiko,1 Akihiro Wada,3 Erick Odoyo,1 Martin Bundi,1 Gabriel Miringu,1 Sora Guyo,1 Mohamed Karama,5 and Yoshio Ichinosecorresponding author1,2,3,4