IntroductionThere is increasing urgency to document changing antimicrobial resistance (AMR) patterns of N. gonorrhoea (GC) in different parts of the world. High-level resistance to previously recommended quinolones is widespread and decreased susceptibility to the extended-spectrum (third-generation) cephalosporin. The surveillance for AMR in Kenya and the region was undertaken to determine the frequency and diversity of antimicrobial resistance of gonococcal isolates from Sex Workers Outreach Program (SWOP) Clinic.MethodsThe survey tested 238 isolates over a period of 4 years from participants presenting with cervical/vaginal discharge. Samples collected were inoculated directly on modified Thayer martin media (MTM), transported to GASP Laboratories at KAVI-Institute of Clinical Research and identified by standard bacteriological procedures. Antibiotic susceptibility testing of GC isolates was performed using diffusion gradient method. The MICs of penicillin, tetracycline, ciprofloxacin, spectinomycin, erythromycin, Azithromycin, cefixime and ceftriaxone were determined by the E-test method. The strains were defined as susceptible, intermediate and resistant using the WHO guidelines, all the findings were validates at WHO Collaborating Centre for Gonorrhoea and other STIs, Örebro University Hospital in Sweden.Results41 isolates in 2012,119 isolates in 2013, 24 isolates in 2014 and 54 isolates in 2015 showed 100% susceptaility for cefixime, ceftriaxone and spectinomycin, with a mean susceptibility of 82%, 37.7%, 19.5%, 1.6% and 0% for azithromycin, erythromycin, ciprofloxacin, penicillin and tetracycline respectively. Resistance for ciprofloxacin had rise from 56% in 2012, 58.8% in 2013, 66.7% in 2014 to 68.5% in 2015. ConclusionSpectinomycin, cefixime, ceftriaxone, azithromycin are useful. Ciprofloxacin the most prescribed antibiotic is no longer reliable for treatment of GC. Continuous surveillance is essetial to mordify treatmet guidelies. Worsening GC drug resistance will compromise effective treatment and decrease disease control efforts.

IntroductionSystematic antimicrobial resistance (AMR) surveillance of N. gonorrhoea (GC) from local to global level are being intensified to inform and design a monitoring system for its control. High-level resistance to previously recommended quinolones is widespread and decreased susceptibility to the extended-spectrum (third-generation) cephalosporin has been report. The Gonococcus antimicrobial surveillance program (GASP) in Kenya and the region carried out a study to determine the frequency and diversity of antimicrobial resistance of GC isolates from a Sex Workers Outreach Program (SWOP) Clinic in Nairobi over a period of 4 years.MethodsThe study tested 238 GC isolates from participants presenting with cervical/vaginal discharge. Samples collected were inoculated directly on modified Thayer martin media (MTM), transported to GASP Laboratories at KAVI-Institute of Clinical Research for processing by standard bacteriological procedures. Antibiotic susceptibility testing was performed using diffusion gradient method. The strains were defined as susceptible, intermediate and resistant using E-test as guided by WHO, all the findings were validates at WHO Collaborating Centre for Gonorrhoea and other STIs, Örebro University Hospital in Sweden. ResultsGC isolates, 41 in 2012, 119 in 2013, 24 in 2014 and 54 in 2015 showed 100% susceptibility to cefixime, ceftriaxone and spectinomycin in four years with a mean susceptibility of 82%, 37.7%, 19.5%, 1.6% and 0% for azithromycin, erythromycin, ciprofloxacin, penicillin and tetracycline respectively. Over the period ciprofloxacin showed a rise in resistance from 56% in 2012, 58.8% in 2013, 66.7% in 2014 to 68.5% in 2015. ConclusionSpectinomycin, cefixime, ceftriaxone, azithromycin are useful drugs, while Ciprofloxacin the most prescribed antibiotic is no longer reliable for treatment of GC in the region. Continued surveillance will enables the public health managers to modify the national treatment guidelines. Worsening GC drug resistance will compromise effective treatment and decrease disease control efforts.

Purpose: There are observable improvements in Kenya’s electricity sector since the mid-1990s. Among these are increase in electricity generated and an increase in number of households and institutions connected to the grid. These milestones have been achieved during the reform period.  To find out whether these achievements are attributable to the reforms or not is the subject of this paper. This paper carries out an econometric evaluation of the impact of electricity sector reforms in Kenya relative to other four developing countries using panel data over the period 1993 to 2018. The paper assesses the impact of restructuring, unbundling, competition and private sector participation on electricity access. Methodology: In this study we carried out estimations of the outcome of reforms using panel data. The study period 1993 to 2018 was chosen based on data availability and also the consideration that power sector reforms in Kenya, Uganda, Tanzania and Senegal began after 1993. Findings: Using fixed effect method the study concludes that competition is key in enhancing access to electricity nationally and in both rural and urban areas. On the other hand, restructuring has a negative impact on both electrification in the four countries under study. Unique Contribution to Theory, Practice and Policy: Allowing more players and also in the buying of bulk energy for onward transmission and distribution with the aim of ultimately having a fully competitive marketing the sector would therefore improve the power industry outcomes.