To evaluate the potential use of competency scales related to dietitians as a monitoring tool for students, we conducted a study on changes in dietitian competency scales over time within the progression of the curriculum. A self-administered questionnaire was conducted on 167 second-year students enrolled in the Registered Dietitian Training Program during their second and third years. The total scores for all competencies were significantly high during the transition period from the second to the third year of the program when students were transitioning from basic to applied professional courses. This indicates that Dietitian Competency Scale scores improved as the curriculum progressed. These findings suggest the potential use of the scale as a comprehensive assessment tool for regularly monitoring the qualities and competencies students should acquire by the time they graduate.

Background: Most children access early human immunodeficiency virus type 1 (HIV-1) diagnosis in Kenya. However, the detection frequency of HIV-1 drug-resistance mutations (DRMs) among the children, main cause of their antiretroviral therapy (ART) failure, has not been well known. This study aimed at investigating the DRM trends in newly HIV-1-diagnosed Kenyan children between 2014 and 2018.

Methods: Dried blood spots (DBS) were collected from children with HIV-1 under 18 months of age through the Kenya Early Infant Diagnosis program in 2014, 2017 and 2018 (n = 57, 70, and 50, respectively). HIV-1 proviral DNA was extracted from the DBS and analyzed genetically. DRMs were checked following the IAS-USA list and/or Stanford HIV-1DB PROGRAM algorithm.

Results: Among the Kenyan children with HIV-1, DRMs were detected in 57.9% [nucleoside reverse transcriptase inhibitors (NRTI)-DRM/non-NRTI (NNRTI)-DRM: 22.8%/57.9%] in 2014, 54.3% (11.4%/54.3%) in 2017, and 58.0% (14.0%/58.0%) in 2018. All children who had NRTI-DRMs had NNRTI-DRMs. As for NNRTI-DRMs, Y181C was found more in 2014 than 2017/2018 (28.1% vs. 7.1%/6.0%, p = 0.0002), whereas K103N/S more in 2017/2018 than 2014 (37.1%/34.0% vs. 17.5%, p = 0.026). Among the children with DRMs, 94.9% and 67.7% showed high-level resistance to nevirapine and efavirenz (NNRTI), respectively. The mother’s PMTCT history was significantly associated with the NNRTI-DRMs in all years.

Conclusion: Majority of newly HIV-1-diagnosed Kenyan children continuously harbored DRMs between 2014 and 2018, which probably originated from their mothers’ PMTCT. Checking DRMs before starting ART and/or using non-NNRTI-containing regimen for ART should be considered in children with HIV-1 in Kenya.