Background: Clinical trials assign subjects to health-related interventions to evaluate the effects on health outcomes. Previous studies have categorized motivators for volunteering in clinical trials as for social and personal benefits. There exists little or no literature on HIV-infected persons' motivation for participation in non-HIV vaccine trials. This study aimed to establish volunteer motivators among HIV-infected persons in a non-HIV experimental study, in this case an Ebola vaccine clinical trial. Method: This study used a cross sectional descriptive design. The study was conducted at the KAVI-Institute of Clinical Research, using a consecutive sample of 48 HIV-infected individuals participating in the Ebola Phase II clinical trial. Inductive approach of content analysis was used to condense raw textual data on motivation factors. Statistical Package for Social Science (SPSS) version 21 was used for descriptive and inferential analysis at 95% confidence interval. Results were presented in form of text, tables and figures. Results: The main motivators for participation in the Ebola clinical trial were social benefits (altruism) (67.3%) and personal health benefits (32.7%). Regression model of respondents' individual factors including gender, age, marital status, number of children, sources and amount of income and volunteering in previous studies on motivators was not significant (χ 2 =25.578, df=20, p value=0.180). Conclusion: Altruism, the main motivator elucidated was mainly defined by respondents' willingness to learn about Ebola, give back to society, and pioneer development of an Ebola vaccine in Kenya. Involvement of HIV-infected individuals in clinical trials is paramount in ensuring the clinical population of sub-Saharan Africa is properly represented thus making certain that the safety and effectiveness of new therapies is all encompassing. Targeting of these individuals to ensure adequate enrolment and retention can be done by educating them on their importance in developing these new therapies and the social benefit it brings about.

Background: Current guidelines for the management of childhood wasting primarily focus on the provision of therapeutic foods and the treatment of medical complications. However, many children with wasting live in food-secure households, and multiple studies have demonstrated that the etiology of wasting is complex, including social, nutritional, and biological causes. We evaluated the contribution of household food insecurity, dietary diversity, and the consumption of specific food groups to the time to recovery from wasting after hospital discharge. Methods: We conducted a secondary analysis of the Childhood Acute Illness Network (CHAIN) cohort, a multicenter prospective study conducted in six low- or lower-middle-income countries. We included children aged 6–23 months with wasting (mid-upper arm circumference [MUAC] ≤ 12.5 cm) or kwashiorkor (bipedal edema) at the time of hospital discharge. The primary outcome was time to nutritional recovery, defined as a MUAC > 12.5 cm without edema. Using Cox proportional hazards models adjusted for age, sex, study site, HIV status, duration of hospitalization, enrollment MUAC, referral to a nutritional program, caregiver education, caregiver depression, the season of enrollment, residence, and household wealth status, we evaluated the role of reported food insecurity, dietary diversity, and specific food groups prior to hospitalization on time to recovery from wasting during the 6 months of posthospital discharge. Findings: Of 1286 included children, most participants (806, 63%) came from food-insecure households, including 170 (13%) with severe food insecurity, and 664 (52%) participants had insufficient dietary diversity. The median time to recovery was 96 days (18/100 child-months (95% CI: 17.0, 19.0)). Moderate (aHR 1.17 [0.96, 1.43]) and severe food insecurity (aHR 1.14 [0.88, 1.48]), and insufficient dietary diversity (aHR 1.07 [0.91, 1.25]) were not significantly associated with time to recovery. Children who had consumed legumes and nuts prior to diagnosis had a quicker recovery than those who did not (adjusted hazard ratio (aHR): 1.21 [1.01,1.44]). Consumption of dairy products (aHR 1.13 [0.96, 1.34], p = 0.14) and meat (aHR 1.11 [0.93, 1.33]), p = 0.23) were not statistically significantly associated with time to recovery. Consumption of fruits and vegetables (aHR 0.78 [0.65,0.94]) and breastfeeding (aHR 0.84 [0.71, 0.99]) before diagnosis were associated with longer time to recovery. Conclusion: Among wasted children discharged from hospital and managed in compliance with wasting guidelines, food insecurity and dietary diversity were not major determinants of recovery.

IntroductionOver 52 million children under 5 years of age become wasted each year, but only 17% of these children receive treatment. Novel methods to identify and deliver treatment to malnourished children are necessary to achieve the sustainable development goals target for child health. Mobile health (mHealth) programmes may provide an opportunity to rapidly identify malnourished children in the community and link them to care.Methods and analysisThis randomised controlled trial will recruit 1200 children aged 6–12 months at routine vaccine appointments in Migori and Homa Bay Counties, Kenya. Caregiver–infant dyads will be randomised to either a maternally administered malnutrition monitoring system (MAMMS) or standard of care (SOC). Study staff will train all caregivers to measure their child’s mid-upper arm circumference (MUAC). Caregivers in the MAMMS arm will be given two colour coded and graduated insertion MUAC tapes and be enrolled in a mHealth system that sends weekly short message service (SMS) messages prompting caregivers to measure and report their child’s MUAC by SMS. Caregivers in the SOC arm will receive routine monitoring by community health volunteers coupled with a quarterly visit from study staff to ensure adequate screening coverage. The primary outcome is identification of childhood malnutrition, defined as MUAC <12.5 cm, in the MAMMS arm compared with the SOC arm. Secondary outcomes will assess the accuracy of maternal versus health worker MUAC measurements and determinants of acute malnutrition among children 6–18 months of age. Finally, we will explore the acceptability, fidelity and feasibility of implementing the MAMMS within existing nutrition programmes.Ethics and disseminationThe study was approved by review boards at the University of Washington and the Kenya Medical Research Institute. A data and safety monitoring board has been convened, and the results of the trial will be published in peer-reviewed scientific journals, presented at appropriate conferences and to key stakeholders.Trial registration numberNCT03967015.

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Background: Hospitals pose a risk of bacterial infections to patients, the environment, and staff. To design Infection Prevention and Control (IPC) programs, facilities need to know the patterns and types of contaminants in various parts of a hospital. The present study aimed to evaluate the prevalence and types of contaminants on hospital surfaces, equipment and healthcare providers’ palms with the aim of informing development and implementation of IPC guidelines at the hospital level. Method: This cross-sectional study was done in Migori County Referral Hospital. A total of 62 swabs were collected from selected surfaces, equipment, and health workers palms in April, 2020. They were cultured and bacterial contaminants were identified using standard microbiological procedures. Results: Of the 62 swabs assessed, 61.3% yielded bacterial growth, from which 46 pathogenic bacteria were identified. The most prevalent isolates in all wards were Acinetobacter species at 41.3% (n=19 of 46 isolates) followed by Enterobacter at 13.0% (n=6/46) and Staphylococcus species at 13.0 %(n=6/46). Conclusion: Contamination of surfaces, equipment, and staff’s hands was high, hence pointing to an elevated risk of Hospital-Acquired Infections (HAIs). Thus, there is a need to leverage IPC guidelines to limit contamination and curtail the spread of HAIs.