Determinants of unintended pregnancy among women attending antenatal clinic at Kenyatta National Hospital.

Background:  Unintended pregnancy predisposes women of child-bearing age to risk factors like maternal deaths, poor child outcomes, mental illness because of stress, risky abortion, and vertical transmission of HIV. According to the Kenya Demographic Health Survey in 2014, 34% of the pregnancies were unintended and in the year 2020 it rose to 41.9% (Monitoring, 2020).  Determinants of unintended pregnancy among women attending antenatal clinics in Kenya is diverse and is poorly understood due to no representative information. The objective of the study was to determine the factors associated with unintended pregnancy among women attending antenatal clinic particularly their individual factors, family planning practices and health facility-based factors. Method:  A cross-sectional study design. Data was collected using a structured administered questionnaire from 227 participants. The proportion and determinants of unintended pregnancy was derived using bivariate analysis and multivariate logistic regressions.  Results: In this study, a third (29.9%) of the pregnant women reported that their existing gravidity was unintended. Individual factors such as age less than 25 years [AOR 8.1 (95% CI 1.4-48.6)), p=0.001], use of contraceptive method [AOR 7.9 (95% CI 2.5-25.0), p<0.001] and the woman being the sole decision-maker on when to get pregnant [AOR 3.8 (95% CI 1.3-11.2), p=0.014] were significantly associated with unintended pregnancy. Conclusion: The study area had quite a significant proportion of unintended pregnancy underscoring the need for health facilities to enhance targeted contraceptive counselling during antenatal and postnatal clinics. Reinforcing effective utilization of family planning services in the pursuit to decrease unintended pregnancy not only in Nairobi but also in Kenya.

Design and immunological evaluation of two-component protein nanoparticle vaccines for East Coast fever.

Nanoparticle vaccines usually prime stronger immune responses than soluble antigens. Within this class of subunit vaccines, the recent development of computationally designed self-assembling two-component protein nanoparticle scaffolds provides a powerful and versatile platform for displaying multiple copies of one or more antigens. Here we report the generation of three different nanoparticle immunogens displaying 60 copies of p67C, an 80 amino acid polypeptide from a candidate vaccine antigen of Theileria parva, and their immunogenicity in cattle. p67C is a truncation of p67, the major surface protein of the sporozoite stage of T. parva, an apicomplexan parasite that causes an often-fatal bovine disease called East Coast fever (ECF) in sub-Saharan Africa. Compared to I32-19 and I32-28, we found that I53-50 nanoparticle scaffolds displaying p67C had the best biophysical characteristics. p67C-I53-50 also outperformed the other two nanoparticles in stimulating p67C-specific IgG1 and IgG2 antibodies and CD4+ T-cell responses, as well as sporozoite neutralizing capacity. In experimental cattle vaccine trials, p67C-I53-50 induced significant immunity to ECF, suggesting that the I53-50 scaffold is a promising candidate for developing novel nanoparticle vaccines. To our knowledge this is the first application of computationally designed nanoparticles to the development of livestock vaccines.