RESUMO
BACKGROUND: Lack of adequate sanitation and refuse disposal facilities are among the factors found to contribute to food contamination among street food vendors. Most vending facilities are near crowded places, such as bus terminals or markets to attract consumers, and the few basic amenities, such as toilets, are inadequate. The objective of the study was to determine which sanitation practices were associated with food contamination in Githurai and Gikomba markets in Nairobi County. METHODOLOGY: Using a cross-sectional study design, we systematically randomly sampled 149 street food vendors and used questionnaires to interview them and make observations. RESULTS: A significant negative association was observed between access to a toilet facility and food contamination (P<.001), with a decreased risk of occurrence of food contamination observed where vendors had access to a toilet facility (OR 0.095; 95% confidence interval [CI], 0.039-0.227). Accessibility of running water around the toilet facility was negatively associated with food contamination (P<.001), with vendors who reported access to running water having a lower occur-rence of food contamination (15.9%) compared with those who had no access to running water (30%). Presence of pests/rodents was significantly associated with food contamination (P<.001), with vendors who reported presence of pests/rodents having a 5.9-fold risk (OR 5.921; 95% CI, 2.831-12.383) of contaminated food. Access to fresh running water while preparing food, hand washing before handling food, and use of an apron were the food-handling practices that were negatively associated with food contamination (P<.005). Use of a head cover, hand washing after handling raw food, and the way food was served and stored had no statistically significant association with food contamination (P>.05). CONCLUSIONS: Access to a toilet facility and availability of running water within the toilet facility decreased the likelihood of food contamination. The presence of pests/rodents had a positive association with food contamination. There is a need for more basic amenities, especially toilets and water facilities, within these markets, as well as sensitisation on pest control.
RESUMO
INTRODUCTION: Chemotherapy still is the most effective way to control malaria, a major public health problem in sub-Saharan Africa. The large-scale use of the combination therapy artemether-lumefantrine for malaria treatment in Africa predisposes lumefantrine to emergence of resistance. There is need to identify drugs that can be used as substitutes to lumefantrine for use in combination therapy. Methylene blue, a synthetic anti-methemoglobinemia drug, has been shown to contain antimalarial properties, making it a candidate for drug repurposing. The present study sought to determine antiplasmodial effects of methylene blue against lumefantrine- and pyrimethamine-resistant strains of P. berghei. METHODOLOGY: Activity of methylene blue was assessed using the classical four-day test on mice infected with lumefantrine-resistant and pyrimethamine-resistant P. berghei. A dose of 45 mg/kg/day was effective for testing ED90. Parasitemia and mice survival was determined. RESULTS: At 45 mg/kg/day, methylene blue sustained significant parasite inhibition, over 99%, for at least 6 days post-treatment against lumefantrine-resistant and pyrimethamine-resistant P. berghei (p = 0.0086 and p = 0.0191, respectively). No serious adverse effects were observed. CONCLUSIONS: Our results indicate that methylene blue at a concentration of 45 mg/kg/day confers over 99% inhibition against lumefantrine- and pyrimethamine-resistant P. berghei for six days. This shows the potential use methylene blue in the development of antimalarials against lumefantrine- and pyrimethamine-resistant parasites.