The strain dynamics of methicillin-resistant Staphylococcus aureus (MRSA) isolates from people and the household dog were investigated. The isolates were identified in the context of a randomized controlled trial that tested household-wide decolonization of people. Genotypic comparison of MRSA isolates obtained from two household members, the dog, and home surfaces over a three-month period failed to implicate the pet or the home environment in recurrent colonization of the household members. However, it did implicate the pet’s bed in exposure of the dog prior to the dog’s infection. Whole genome sequencing was performed to differentiate the isolates. This report also describes introduction of diverse strains of MRSA into the household within six weeks of cessation of harmonized decolonization treatment of people and treatment for infection in the dog. These findings suggest that community sources outside the home may be important for recurrent MRSA colonization or infection.

Background: Hypertension is both public health and medical problem worldwide. Compliance to antihypertensive therapy is key in avoiding hypertension complications. The purpose of this study was to establish compliance to antihypertensive therapy and associated factors among adults’ hypertensive patients in Kilifi county Kenya.Methods: A facility-based cross-sectional was undertaken in four public health facilities in Kilifi County Kenya. Two hundred and thirteen hypertensive patients were recruited in the study. Data was collected using a pretested questionnaire and analyzed using Statistical package for social sciences (SPSS) version 23 software. Chi-square test was utilized in establishing the relations, while logistic regression was adopted to determine independent risk factors for compliance.Results: Compliance to antihypertensive therapy was recorded in 31 (14.6%) of the patients. A statistically significant association was established between compliance to antihypertensive therapy and patients knowledge (p<0.001); age (p=0.024); education (p=0.04); income (p=0.013); duration on treatment (p=0.005); cost (p=0.029); health care provider advice (p=0.009); consistency of therapy (p=0.002); medicines availability (p=0.021); and health facility distance (p=0.013). Independent risk factors for compliance to antihypertensive therapy were the duration on treatment of (OR=0.383; 95%CI 0.151-0.972); Knowledge on hypertension (OR=2.715; 95%CI 1.598-4.615); Health care worker follow-ups (OR=0.452; 95%CI 0.282-0.726); and cost of medication (OR=2.682; 95%CI 1.134-6.345).Conclusions: Anti-hypertensive therapy compliance among patients was low. This could be attributed to factors that are socio-demographic, patient, and health service-related in nature. Prompt public health interventions that are patient-community centred are necessary to improve compliance to antihypertensive therapy.

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