The bacteriology department in Mbita Diarrheal diseases have been a major public health problem in the Lake Region mostly due to poor sanitation and lack of clean water They are transmitted through the fecal-oral route and are among the leading causes of death especially in children under five years and adults with weak immune system The most prev-alent diarrheal diseases in this region are cholera and dysentery The need for re-search on these diseases became apparent during the 2007-2008 outbreaks which resulted to 53 deaths in 10 districts within Nyanza This problem was complicated by lack of proper diagnosis facility in the major health facilities especially Mbita District Hospital To manage this problem Nagasaki University began assisting the hospital in diag-nosis of these diseases through laboratory analysis of stool samples for identifica-tion of causative agent and appropriate drug for treatment Initially samples were transported to the Nairobi laboratory before a small lab was set up in ICIPE and later establishment of the bacteriology laboratory at Mbita Research Site in 2010

Currently Nagasaki University runs a fully equipped bacteriology laboratory and is presently carrying out research on diarrheal diseases and septicemia Its main objective is to provide accurate diagnosis to enable proper treatment and manage-ment of these diseases and to identify core causative agents for their long-term management The team also identifies and tracks possible outbreaks especially of diarrheal diseases hence preventing major outbreaks

NAGASAKI UNIVERSITY NEWSLETTER MBITAVOL 2 ISSUE 1 Januaryndash April 2014

HEALTH AWARENESS FIVE KEYS TO FOOD HYGIENE AND SAFETY

Preveot bacterial cootamioatioo of food through these five steps

Nagasaki University welcomes you to the

second volume of the Nagasaki Newsletter We are glad to continue sharing with you

our research findings and updates as we work together to develop our community

In 2013 Nagasaki University through its Nai-robi Research Station initiated a number of

new projects towards its mission of improv-ing health and livelihoods In September

the oral health project was started It will first establish the overall status of dental

health in this area and make re commenda-tions on dental services needed in the area

In Kisumu the Lake Victoria Development Project was initiated though it was launched

in February this year The project will devel-op innovations that will improve fisheries

and water health for communities living around Kisumu and later all lakeshore com-

munities Lastly our Kwale Research Site also initiated the Aging Study aimed at im-

proving the health of old people In this issue we will focus on bacteriology

research This research group is involved in the study of bacterial diseases with specific

focus on diarrheal and septicemia diseases

and works in collaboration with Mbita Dis-trict Hospital

Contact details

Nagasaki University

Institute of Tropical

Medicine- Kenya Medi-

cal Research Institute

PO Box 19-40305

Mbita

Email

Nagasakiugmailcom

We welcome your com-

ments and suggestions

Together let us develop

our society

Bacteriology research overview Diarrheal diseases and septicemia studies are the two researches that are currently being undertaken by the bacteriology team The diarrheal diseases study was designed due to the need to manage diarrheal diseas-es outbreaks that the region had been experiencing Septicemia a disease caused by infection of the blood by bacteria is also a public health problem in the area though it is less common The diarrheal study examines diar-rheal diseases which are caused by infection of the intestines by virus-es bacteria and protozoans causing

one to pass watery stool three or more times a day Infections are transmitted via the oral-fecal route and are transmitted through consumption of contaminated water or food Diarrheal disease research is carried out based on the scheme below Results are fed back to the hospital and used to prescribe medication for patients alongside general manage-ment of diarrheal diseases Diarrhea can however be prevented through proper sanitation and observing proper hygiene In case of an infection it is advisable to take a lot of fluids or an Oral Rehydration Solution (ORS) and seek treatment immediately

Bacteriology Research Group ndashMbita District Hospital Partnership Since its establishment the bacteriology team has been working closely with Mbita District Hospital towards improving disease diagnosis and supporting the hospital to improve health care delivery and hence raise the overall health status of the people of Mbita

To support achievement of the above goals Nagasaki Univer-sity Kenya Research Station first supported the hospital to apply for a grant from the Embassy of Japan Using this fund the laboratory was expanded and diagnostic equipment such as the FACS count haemogram and blood chemistry machine among others purchased Additionally Nagasaki University put in extra funds to purchase more equipment for microbiol-

ogy research and diagnosis Laboratory technicians were also trained at Nagasaki Universityrsquos Nairobi labor-atory on how to use these equipment and also on mod-ern concepts of diagnostics The bacteriology team also collaborates with the hospital in providing more specialized diagnosis of bacterial dis-eases and provides feedback on disease causing agents and best treatment options which the hospital uses to inform treatment This partnership has been very useful in managing diar-rheal disease outbreaks and especially cholera as these are detected early enough even before they spread over larger areas Generally this partnership has yielded efficiency in deliv-ery of health care services while continuously contrib-uting to improvement of health status of the people of Mbita

Impact of the bacteriology project on the hospital The bacteriology department has had a good working relationship with the hospital which has yielded benefits for both the hospital and the community Among these benefits has been management of diarrheal diseases for which the project has continued to support the hospital through diagnosis and testing of the causative agent for the most effective treatment Consequently there hasnt been an outbreak of cholera since 2008 and there hasnt been a rapid increase in the number of cases since 2011 as shown in the graph below

Further the project has increased preparedness of the hospital in man-agement of diarrheal diseases outbreaks such that it is able to identify and manage a would-be outbreak and is well prepared to diagnose and treat patients incase of an actual outbreak The project has also in-creased awareness of diarrhea diseases and septicemia among the clini-cians and laboratory technicians hence improving their capacity to diag-nose and manage these diseases Additionally data provided by the bacteriology team has facilitated planning and management through the public health office Subsequent-ly Community Health Workers have been trained on treatment of acute diarrheal disease cases in community poor hygiene and sanitation named as the core contributing factors for diarrheal disease and identi-fied the following as the main preventive measures

Use of toilets for disposal of human wastes Treatment of water for domestic consumption Hygienic food handling practices

Wash haods thoroughly aod cleao food prepara-tioo surface

Wash vegetables with pleoty of water aod preserve meats appropriately

Separate raw foods from ready-to eat foods to avoid cross-cootamioatioo

Cook food thoroughly to kill gerns

Store cooked food io a cool dry place io a cov-ered cootaioer-do oot store cooked food for so loog to preveot food spoilage

Trend of diarrheal diseases in health facilities within Mbita Sub-County and the Mbita Dis-

Washing hands with soap after visiting the toilet changing the babyrsquos diapers and before eating or handling food

By Dancan Aloo

1 Mbita District Hospital Maternity wing ndash one of the renovated hospital facilities 2 Lab Technologists working in the hospital lab 3 The plaque laid during official opening of the renovated laboratory

Research methodology of the bacteriology study

Mbita Research Site main building inset the administration block (L) The bacteriology laboratory

3

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acte

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