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Article ; Online: The epidemiology of fecal carriage of nontyphoidal Salmonella among healthy children and adults in three sites in Kenya.

Muthumbi, Esther M / Mwanzu, Alfred / Mbae, Cecilia / Bigogo, Godfrey / Karani, Angela / Mwarumba, Salim / Verani, Jennifer R / Kariuki, Samuel / Scott, J Anthony G

PLoS neglected tropical diseases

2023 Volume 17, Issue 10, Page(s) e0011716

Abstract: Background: Despite the importance of non-Typhoidal Salmonella (NTS) disease in Africa, epidemiologic data on carriage and transmission are few. These data are important to understand the transmission of NTS in Africa and to design control strategies.!## ...

Abstract	Background: Despite the importance of non-Typhoidal Salmonella (NTS) disease in Africa, epidemiologic data on carriage and transmission are few. These data are important to understand the transmission of NTS in Africa and to design control strategies. Method: To estimate the prevalence of stool carriage of NTS in Kenya, we conducted a cross-sectional study in Kilifi, Nairobi, and Siaya, sites with a low, moderate and high incidence of invasive NTS disease, respectively. At each site, we randomly selected 100 participants in each age-group of 0-11 months, 12-59 months, 5-14 years, 15-54 years and ≥55 years. We collected stool, venous blood (for hemoglobin and malaria rapid tests), anthropometric measurements, and administered a questionnaire on Water Access Sanitation and Hygiene (WASH) practices. Stool samples were cultured on selective agar for Salmonella; suspect isolates underwent serotyping and antimicrobial susceptibility testing. Result: Overall, 53 (3.5%) isolates of NTS were cultured from 1497 samples. Age-adjusted prevalence was 13.1% (95%CI 8.8-17.4) in Kilifi, 0.4% (95%CI 0-1.3) in Nairobi, and 0.9% (95%CI 0-2.0) in Siaya. Prevalence was highest among those aged 15-54 years (6.2%). Of 53 isolates; 5 were S. Enteritidis, 1 was S. Typhimurium. No S. Typhi was isolated. None of the risk factors were associated with carriage of NTS. All isolates were susceptible to all antibiotics tested, including ampicillin, chloramphenicol, ciprofloxacin and co-trimoxazole. Conclusion: Prevalence of fecal carriage was high in Kilifi, an area of low incidence of invasive NTS disease and was low in areas of higher incidence in Nairobi and Siaya. The age-prevalence, risk factors, geographical and serotype distribution of NTS in carriage differs from invasive disease.
MeSH term(s)	Humans ; Child ; Adult ; Kenya/epidemiology ; Cross-Sectional Studies ; Salmonella ; Salmonella Infections/epidemiology ; Typhoid Fever/epidemiology ; Anti-Bacterial Agents
Chemical Substances	Anti-Bacterial Agents
Language	English
Publishing date	2023-10-26
Publishing country	United States
Document type	Journal Article
ZDB-ID	2429704-5
ISSN	1935-2735 ; 1935-2735
ISSN (online)	1935-2735
ISSN	1935-2735
DOI	10.1371/journal.pntd.0011716
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Article ; Online: Malaria, climate variability, and interventions: modelling transmission dynamics.

Beloconi, Anton / Nyawanda, Bryan O / Bigogo, Godfrey / Khagayi, Sammy / Obor, David / Danquah, Ina / Kariuki, Simon / Munga, Stephen / Vounatsou, Penelope

Scientific reports

2023 Volume 13, Issue 1, Page(s) 7367

Abstract: Assessment of the relative impact of climate change on malaria dynamics is a complex problem. Climate is a well-known factor that plays a crucial role in driving malaria outbreaks in epidemic transmission areas. However, its influence in endemic ... ...

Abstract	Assessment of the relative impact of climate change on malaria dynamics is a complex problem. Climate is a well-known factor that plays a crucial role in driving malaria outbreaks in epidemic transmission areas. However, its influence in endemic environments with intensive malaria control interventions is not fully understood, mainly due to the scarcity of high-quality, long-term malaria data. The demographic surveillance systems in Africa offer unique platforms for quantifying the relative effects of weather variability on the burden of malaria. Here, using a process-based stochastic transmission model, we show that in the lowlands of malaria endemic western Kenya, variations in climatic factors played a key role in driving malaria incidence during 2008-2019, despite high bed net coverage and use among the population. The model captures some of the main mechanisms of human, parasite, and vector dynamics, and opens the possibility to forecast malaria in endemic regions, taking into account the interaction between future climatic conditions and intervention scenarios.
MeSH term(s)	Humans ; Malaria/epidemiology ; Weather ; Incidence ; Kenya/epidemiology ; Climate Change
Language	English
Publishing date	2023-05-05
Publishing country	England
Document type	Journal Article ; Research Support, U.S. Gov't, P.H.S. ; Research Support, Non-U.S. Gov't
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/s41598-023-33868-8
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Article ; Online: The effect of COVID-19 pandemic on healthcare seeking in an urban informal settlement in Nairobi and a rural setting in western Kenya.

Agogo, George O / Munywoki, Patrick K / Audi, Allan / Auko, Joshua / Aol, George / Oduor, Clifford / Kiplangat, Samuel / Ouma, Alice / Komo, Terry / Herman-Roloff, Amy / Munyua, Peninah / Bigogo, Godfrey

PLOS global public health

2024 Volume 4, Issue 4, Page(s) e0002968

Abstract: The COVID-19 pandemic caused widespread changes and disruptions to healthcare seeking behavior. There are limited studies on the effect of the COVID-19 pandemic on healthcare seeking patterns in low-and middle-income countries (LMICs), especially in ... ...

Abstract	The COVID-19 pandemic caused widespread changes and disruptions to healthcare seeking behavior. There are limited studies on the effect of the COVID-19 pandemic on healthcare seeking patterns in low-and middle-income countries (LMICs), especially in settings with inequitable access to healthcare in rural and urban informal settlements. We investigated the effect of the COVID-19 pandemic on reported healthcare seeking at health facilities and chemists using morbidity data from participants in an ongoing population-based infectious disease surveillance platform in Asembo in Siaya County, a rural setting in western Kenya and Kibera, an urban informal settlement in Nairobi County. We described healthcare seeking patterns before (from 1st January 2016 to 12th March 2020) and during the pandemic (from 13th March 2020 to 31st August 2022) by gender and age for any reported illness and select clinical syndromes using frequencies and percentages. We used a generalized estimating equation with an exchangeable correlation structure to assess the effect of the pandemic on healthcare seeking adjusting for gender and age. Overall, there was a 19% (adjusted odds ratio, aOR: 0.81; 95% Confidence Interval, CI: 0.79-0.83) decline in odds of seeking healthcare at health facilities for any illness in Asembo during the pandemic, and a 30% (aOR: 0.70; 95% CI: 0.67-0.73) decline in Kibera. Similarly, there was a decline in seeking healthcare by clinical syndromes, e.g., for ARI, aOR: 0.76; 95% CI:0.73-0.79 in Asembo, and aOR: 0.68; 95% CI:0.64-0.72 in Kibera. The pandemic resulted in increased healthcare seeking at chemists (aOR: 1.23; 95% CI: 1.20-1.27 in Asembo, and aOR: 1.40; 95% CI: 1.35-1.46 in Kibera). This study highlights interruptions to healthcare seeking in resource-limited settings due to the COVID-19 pandemic. The pandemic resulted in a substantial decline in seeking care at health facilities, and an increase of the same at chemists.
Language	English
Publishing date	2024-04-17
Publishing country	United States
Document type	Journal Article
ISSN	2767-3375
ISSN (online)	2767-3375
DOI	10.1371/journal.pgph.0002968
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Article ; Online: Estimating excess mortality during the COVID-19 pandemic from a population-based infectious disease surveillance in two diverse populations in Kenya, March 2020-December 2021.

Oduor, Clifford / Audi, Allan / Kiplangat, Samwel / Auko, Joshua / Ouma, Alice / Aol, George / Nasimiyu, Carolyne / O Agogo, George / Lo, Terrence / Munyua, Peninah / Herman-Roloff, Amy / Bigogo, Godfrey / K Munywoki, Patrick

PLOS global public health

2023 Volume 3, Issue 8, Page(s) e0002141

Abstract: Robust data on the impact of the COVID-19 pandemic on mortality in Africa are relatively scarce. Using data from two well-characterized populations in Kenya we aimed to estimate excess mortality during the COVID-19 pandemic period. The mortality data ... ...

Abstract	Robust data on the impact of the COVID-19 pandemic on mortality in Africa are relatively scarce. Using data from two well-characterized populations in Kenya we aimed to estimate excess mortality during the COVID-19 pandemic period. The mortality data arise from an ongoing population-based infectious disease surveillance (PBIDS) platform, which has been operational since 2006 in rural western Kenya (Asembo, Siaya County) and an urban informal settlement (Kibera, Nairobi County), Kenya. PBIDS participants were regularly visited at home (2-3 times a year) by field workers who collected demographic data, including deaths. In addition, verbal autopsy (VA) interviews for all identified deaths are conducted. We estimated all-cause and cause-specific mortality rates before and during the height of the COVID-19 pandemic, and we compared associated mortality rates between the periods using incidence rate ratios. Excess deaths during the COVID-19 period were also estimated by modelling expected deaths in the absence of COVID-19 by applying a negative binomial regression model on historical mortality data from January 2016. Overall and monthly excess deaths were determined using the P-score metric. Spearman correlation was used to assess whether there is a relationship between the generated P-score and COVID-19 positivity rate. The all-cause mortality rate was higher during the COVID-19 period compared to the pre-COVID-19 period in Asembo [9.1 (95% CI, 8.2-10.0) vs. 7.8 (95% CI, 7.3-8.3) per 1000 person-years of observation, pyo]. In Kibera, the all-cause mortality rate was slightly lower during the COVID-19 period compared to the pre-COVID-19 period [2.6 (95% CI, 2.2-3.2 per 1000 pyo) vs. 3.1; 95% CI, 2.7-3.4 per 1000 pyo)]. An increase in all-cause mortality was observed (incidence rate ratio, IRR, 1.16; 95% CI, 1.04-1.31) in Asembo, unlike in Kibera (IRR, 0.88; 95% CI, 0.71-1.09). The notable increase in mortality rate in Asembo was observed among persons aged 50 to 64 years (IRR, 2.62; 95% CI, 1.95-3.52), persons aged 65 years and above (5.47; 95% CI, 4.60-6.50) and among females (IRR, 1.25; 95% CI, 1.07-1.46). These age and gender differences were not observed in Kibera. We observed an increase in the mortality rate due to acute respiratory infection, including pneumonia (IRR, 1.45;95% CI, 1.03-2.04), and a reduction in the mortality rate due to pulmonary tuberculosis (IRR, 0.22; 95% CI, 0.05-0.87) among older children and adults in Asembo. There was no statistically significant change in mortality rates due to leading specific causes of death in Kibera. Overall, during the COVID-19 period observed deaths were higher than expected deaths in Asembo (P-score = 6.0%) and lower than expected in Kibera (P-score = -22.3%).Using well-characterized populations in the two diverse geographic locations, we demonstrate a heterogenous impact of the COVID-19 pandemic on all-cause and cause-specific mortality rates in Kenya. We observed more deaths than expected during the COVID-19 period in our rural site in western Kenya contrary to the urban site in Nairobi, the capital city in Kenya.
Language	English
Publishing date	2023-08-23
Publishing country	United States
Document type	Journal Article
ISSN	2767-3375
ISSN (online)	2767-3375
DOI	10.1371/journal.pgph.0002141
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Article ; Online: The relative effect of climate variability on malaria incidence after scale-up of interventions in western Kenya: A time-series analysis of monthly incidence data from 2008 to 2019.

Nyawanda, Bryan O / Beloconi, Anton / Khagayi, Sammy / Bigogo, Godfrey / Obor, David / Otieno, Nancy A / Lange, Stefan / Franke, Jonas / Sauerborn, Rainer / Utzinger, Jürg / Kariuki, Simon / Munga, Stephen / Vounatsou, Penelope

Parasite epidemiology and control

2023 Volume 21, Page(s) e00297

Abstract: Background: Despite considerable progress made over the past 20 years in reducing the global burden of malaria, the disease remains a major public health problem and there is concern that climate change might expand suitable areas for transmission. This ...

Abstract	Background: Despite considerable progress made over the past 20 years in reducing the global burden of malaria, the disease remains a major public health problem and there is concern that climate change might expand suitable areas for transmission. This study investigated the relative effect of climate variability on malaria incidence after scale-up of interventions in western Kenya. Methods: Bayesian negative binomial models were fitted to monthly malaria incidence data, extracted from records of patients with febrile illnesses visiting the Lwak Mission Hospital between 2008 and 2019. Data pertaining to bed net use and socio-economic status (SES) were obtained from household surveys. Climatic proxy variables obtained from remote sensing were included as covariates in the models. Bayesian variable selection was used to determine the elapsing time between climate suitability and malaria incidence. Results: Malaria incidence increased by 50% from 2008 to 2010, then declined by 73% until 2015. There was a resurgence of cases after 2016, despite high bed net use. Increase in daytime land surface temperature was associated with a decline in malaria incidence (incidence rate ratio [IRR] = 0.70, 95% Bayesian credible interval [BCI]: 0.59-0.82), while rainfall was associated with increased incidence (IRR = 1.27, 95% BCI: 1.10-1.44). Bed net use was associated with a decline in malaria incidence in children aged 6-59 months (IRR = 0.78, 95% BCI: 0.70-0.87) but not in older age groups, whereas SES was not associated with malaria incidence in this population. Conclusions: Variability in climatic factors showed a stronger effect on malaria incidence than bed net use. Bed net use was, however, associated with a reduction in malaria incidence, especially among children aged 6-59 months after adjusting for climate effects. To sustain the downward trend in malaria incidence, this study recommends continued distribution and use of bed nets and consideration of climate-based malaria early warning systems when planning for future control interventions.
Language	English
Publishing date	2023-03-15
Publishing country	Netherlands
Document type	Journal Article
ISSN	2405-6731
ISSN (online)	2405-6731
DOI	10.1016/j.parepi.2023.e00297
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Article: Assessment of gestational age at antenatal care visits among Kenyan women to inform delivery of a maternal respiratory syncytial virus (RSV) vaccine in low- and middle-income countries.

Nyiro, Joyce U / Nyawanda, Bryan O / Bukusi, Elizabeth / Mureithi, Marianne W / Murunga, Nickson / Nokes, D James / Bigogo, Godfrey / Otieno, Nancy A / Opere, Victor A / Ouma, Alice / Pecenka, Clint / Munywoki, Patrick K

Wellcome open research

2023 Volume 8, Page(s) 154

Abstract: Background: ...

Abstract	Background:
Language	English
Publishing date	2023-04-03
Publishing country	England
Document type	Journal Article
ISSN	2398-502X
ISSN	2398-502X
DOI	10.12688/wellcomeopenres.19161.1
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Article ; Online: Estimates of the national burden of respiratory syncytial virus in Kenyan children aged under 5 years, 2010-2018.

Nyawanda, Bryan O / Murunga, Nickson / Otieno, Nancy A / Bigogo, Godfrey / Nyiro, Joyce U / Vodicka, Elisabeth / Bulterys, Marc / Nokes, D James / Munywoki, Patrick K / Emukule, Gideon O

BMC medicine

2023 Volume 21, Issue 1, Page(s) 122

Abstract: Background: Respiratory syncytial virus (RSV) is among the leading childhood causes of viral pneumonia worldwide. Establishing RSV-associated morbidity and mortality is important in informing the development, delivery strategies, and evaluation of ... ...

Abstract	Background: Respiratory syncytial virus (RSV) is among the leading childhood causes of viral pneumonia worldwide. Establishing RSV-associated morbidity and mortality is important in informing the development, delivery strategies, and evaluation of interventions. Methods: Using data collected during 2010-2018 from base regions (population-based surveillance studies in western Kenya and the Kilifi Health and Demographic Surveillance Study), we estimated age-specific rates of acute respiratory illness (ARI), severe acute respiratory illness (SARI-defined as hospitalization with cough or difficulty breathing with onset within the past 10 days), and SARI-associated deaths. We extrapolated the rates from the base regions to other regions of Kenya, while adjusting for risk factors of ARI and healthcare seeking behavior, and finally applied the proportions of RSV-positive cases identified from various sentinel and study facilities to the rates to obtain regional age-specific rates of RSV-associated outpatient and non-medically attended ARI and hospitalized SARI and severe ARI that was not hospitalized (non-hospitalized SARI). We applied age-specific RSV case fatality ratios to SARI to obtain estimates of RSV-associated in- and out-of-hospital deaths. Results: Among Kenyan children aged < 5 years, the estimated annual incidence of outpatient and non-medically attended RSV-associated ARI was 206 (95% credible interval, CI; 186-229) and 226 (95% CI; 204-252) per 1000 children, respectively. The estimated annual rates of hospitalized and non-hospitalized RSV-associated SARI were 349 (95% CI; 303-404) and 1077 (95% CI; 934-1247) per 100,000 children respectively. The estimated annual number of in- and out-of-hospital deaths associated with RSV infection in Kenya were 539 (95% CI; 420-779) and 1921 (95% CI; 1495-2774), respectively. Children aged < 6 months had the highest burden of RSV-associated severe disease: 2075 (95% CI; 1818-2394) and 44 (95% CI 25-71) cases per 100,000 children for hospitalized SARI and in-hospital deaths, respectively. Conclusions: Our findings suggest a substantial disease burden due to RSV infection, particularly among younger children. Prioritizing development and use of maternal vaccines and affordable long-lasting monoclonal antibodies could help reduce this burden.
MeSH term(s)	Child ; Humans ; Infant ; Kenya/epidemiology ; Respiratory Syncytial Virus, Human ; Respiratory Syncytial Virus Infections/epidemiology ; Hospitalization ; Population Surveillance ; Respiratory Tract Infections/epidemiology
Language	English
Publishing date	2023-03-31
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2131669-7
ISSN	1741-7015 ; 1741-7015
ISSN (online)	1741-7015
ISSN	1741-7015
DOI	10.1186/s12916-023-02787-w
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Article ; Online: Healthcare-seeking behavior for respiratory illnesses in Kenya: implications for burden of disease estimation.

Emukule, Gideon O / Osoro, Eric / Nyawanda, Bryan O / Ngere, Isaac / Macharia, Daniel / Bigogo, Godfrey / Otieno, Nancy A / Chaves, Sandra S / Njenga, M Kariuki / Widdowson, Marc-Alain

BMC public health

2023 Volume 23, Issue 1, Page(s) 353

Abstract: Background: Understanding healthcare-seeking patterns for respiratory illness can help improve estimation of disease burden and target public health interventions to control acute respiratory disease in Kenya.: Methods: We conducted a cross-sectional ...

Abstract	Background: Understanding healthcare-seeking patterns for respiratory illness can help improve estimation of disease burden and target public health interventions to control acute respiratory disease in Kenya. Methods: We conducted a cross-sectional survey to determine healthcare utilization patterns for acute respiratory illness (ARI) and severe pneumonia in four diverse counties representing urban, peri-urban, rural mixed farmers, and rural pastoralist communities in Kenya using a two-stage (sub-locations then households) cluster sampling procedure. Healthcare seeking behavior for ARI episodes in the last 14 days, and severe pneumonia in the last 12 months was evaluated. Severe pneumonia was defined as reported cough and difficulty breathing for > 2 days and report of hospitalization or recommendation for hospitalization, or a danger sign (unable to breastfeed/drink, vomiting everything, convulsions, unconscious) for children < 5 years, or report of inability to perform routine chores. Results: From August through September 2018, we interviewed 28,072 individuals from 5,407 households. Of those surveyed, 9.2% (95% Confidence Interval [CI] 7.9-10.7) reported an episode of ARI, and 4.2% (95% CI 3.8-4.6) reported an episode of severe pneumonia. Of the reported ARI cases, 40.0% (95% CI 36.8-43.3) sought care at a health facility. Of the74.2% (95% CI 70.2-77.9) who reported severe pneumonia and visited a medical health facility, 28.9% (95% CI 25.6-32.6) were hospitalized and 7.0% (95% CI 5.4-9.1) were referred by a clinician to the hospital but not hospitalized. 21% (95% CI 18.2-23.6) of self-reported severe pneumonias were hospitalized. Children aged < 5 years and persons in households with a higher socio-economic status were more likely to seek care for respiratory illness at a health facility. Conclusion: Our findings suggest that hospital-based surveillance captures less than one quarter of severe pneumonia in the community. Multipliers from community household surveys can account for underutilization of healthcare resources and under-ascertainment of severe pneumonia at hospitals.
MeSH term(s)	Child ; Female ; Humans ; Infant ; Kenya/epidemiology ; Cross-Sectional Studies ; Patient Acceptance of Health Care ; Pneumonia/epidemiology ; Pneumonia/therapy ; Pneumonia/diagnosis ; Cost of Illness
Language	English
Publishing date	2023-02-16
Publishing country	England
Document type	Journal Article
ZDB-ID	2041338-5
ISSN	1471-2458 ; 1471-2458
ISSN (online)	1471-2458
ISSN	1471-2458
DOI	10.1186/s12889-023-15252-3
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Article ; Online: A mixed methods assessment of knowledge, attitudes and practices related to aflatoxin contamination and exposure among caregivers of children under 5 years in western Kenya.

Awuor, Abigael O / Wambura, Gati / Ngere, Isaac / Hunsperger, Elizabeth / Onyango, Clayton / Bigogo, Godfrey / Blum, Lauren S / Munyua, Peninah / Njenga, M Kariuki / Widdowson, Marc-Alain

Public health nutrition

2023 Volume 26, Issue 12, Page(s) 3013–3022

Abstract: Objective: Identifying factors that may influence aflatoxin exposure in children under 5 years of age living in farming households in western Kenya.: Design: We used a mixed methods design. The quantitative component entailed serial cross-sectional ... ...

Abstract	Objective: Identifying factors that may influence aflatoxin exposure in children under 5 years of age living in farming households in western Kenya. Design: We used a mixed methods design. The quantitative component entailed serial cross-sectional interviews in 250 farming households to examine crop processing and conservation practices, household food storage and consumption and local understandings of aflatoxins. Qualitative data collection included focus group discussions ( Setting: The study was carried out in Asembo, a rural community where high rates of child stunting exist. Participants: A total of 250 female primary caregivers of children under 5 years of age and thirteen experts in farming and food management participated. Results: Study results showed that from a young age, children routinely ate maize-based dishes. Economic constraints and changing environmental patterns guided the application of sub-optimal crop practices involving early harvest, poor drying, mixing spoiled with good cereals and storing cereals in polypropylene bags in confined quarters occupied by humans and livestock and raising risks of aflatoxin contamination. Most (80 %) smallholder farmers were unaware of aflatoxins and their harmful economic and health consequences. Conclusions: Young children living in subsistence farming households may be at risk of exposure to aflatoxins and consequent ill health and stunting. Sustained efforts to increase awareness of the risks of aflatoxins and control measures among subsistence farmers could help to mitigate practices that raise exposure.
MeSH term(s)	Child ; Humans ; Female ; Child, Preschool ; Aflatoxins ; Food Contamination/analysis ; Cross-Sectional Studies ; Kenya ; Caregivers ; Health Knowledge, Attitudes, Practice ; Edible Grain/chemistry ; Growth Disorders
Chemical Substances	Aflatoxins
Language	English
Publishing date	2023-03-06
Publishing country	England
Document type	Journal Article
ZDB-ID	1436024-x
ISSN	1475-2727 ; 1368-9800
ISSN (online)	1475-2727
ISSN	1368-9800
DOI	10.1017/S1368980023000150
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Article ; Online: Age-dependent acquisition of IgG antibodies to

Kapulu, Melissa C / Muthumbi, Esther / Otieno, Edward / Rossi, Omar / Ferruzzi, Pietro / Necchi, Francesca / Acquaviva, Alessandra / Martin, Laura B / Orindi, Benedict / Mwai, Kennedy / Kibet, Hillary / Mwanzu, Alfred / Bigogo, Godfrey M / Verani, Jennifer R / Mbae, Cecilia / Nyundo, Christopher / Agoti, Charles N / Nakakana, Usman Nasir / Conti, Valentino /

Bejon, Philip / Kariuki, Samuel / Scott, J Anthony G / Micoli, Francesca / Podda, Audino

Frontiers in immunology

2024 Volume 15, Page(s) 1340425

Abstract: Background: Shigellosis mainly affects children under 5 years of age living in low- and middle-income countries, who are the target population for vaccination. There are, however, limited data available to define the appropriate timing for vaccine ... ...

Abstract	Background: Shigellosis mainly affects children under 5 years of age living in low- and middle-income countries, who are the target population for vaccination. There are, however, limited data available to define the appropriate timing for vaccine administration in this age group. Information on antibody responses following natural infection, proxy for exposure, could help guide vaccination strategies. Methods: We undertook a retrospective analysis of antibodies to five of the most prevalent Results: A total of 474 samples, one for each participant, were analyzed: Nairobi ( Conclusion: Children living in low- and middle-income settings such as Kenya are exposed to
MeSH term(s)	Infant ; Child ; Humans ; Male ; Female ; Child, Preschool ; Kenya/epidemiology ; Serogroup ; Immunoglobulin G ; Retrospective Studies ; Seroepidemiologic Studies ; Cross-Sectional Studies ; Shigella ; Dysentery, Bacillary ; Vaccination
Chemical Substances	Immunoglobulin G
Language	English
Publishing date	2024-02-01
Publishing country	Switzerland
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2606827-8
ISSN	1664-3224 ; 1664-3224
ISSN (online)	1664-3224
ISSN	1664-3224
DOI	10.3389/fimmu.2024.1340425
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