{ OBJECTIVES To compare sociodemographic profiles, child care, child feeding practices and growth indices of children born to HIV-1 seropositive and seronegative mothers. METHODS: A cohort study of 234 children (seropositive and seronegative) born to HIV-1 seropositive mothers and 139 children born to seronegative mothers in Pumwani Maternity Hospital which serves a low-income population in Nairobi, Kenya from December 1991 and January 1994. RESULTS: With few exceptions, at the time of their birth children in all three cohorts had parents with similar characteristics, lived in similar housing in similar geographical areas, had their mothers as their primary care givers, had similar feeding practices and similar growth status and patterns. However, the HIV-1 seropositive mothers were slightly younger (23.8 years vs. 25.0 years, P < 0.01), if married they were less likely to be their husband's first wife (79% vs. 91%

{ OBJECTIVES To compare sociodemographic profiles, child care, child feeding practices and growth indices of children born to HIV-1 seropositive and seronegative mothers. METHODS: A cohort study of 234 children (seropositive and seronegative) born to HIV-1 seropositive mothers and 139 children born to seronegative mothers in Pumwani Maternity Hospital which serves a low-income population in Nairobi, Kenya from December 1991 and January 1994. RESULTS: With few exceptions, at the time of their birth children in all three cohorts had parents with similar characteristics, lived in similar housing in similar geographical areas, had their mothers as their primary care givers, had similar feeding practices and similar growth status and patterns. However, the HIV-1 seropositive mothers were slightly younger (23.8 years vs. 25.0 years, P < 0.01), if married they were less likely to be their husband's first wife (79% vs. 91%

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{ OBJECTIVES To compare sociodemographic profiles, child care, child feeding practices and growth indices of children born to HIV-1 seropositive and seronegative mothers. METHODS: A cohort study of 234 children (seropositive and seronegative) born to HIV-1 seropositive mothers and 139 children born to seronegative mothers in Pumwani Maternity Hospital which serves a low-income population in Nairobi, Kenya from December 1991 and January 1994. RESULTS: With few exceptions, at the time of their birth children in all three cohorts had parents with similar characteristics, lived in similar housing in similar geographical areas, had their mothers as their primary care givers, had similar feeding practices and similar growth status and patterns. However, the HIV-1 seropositive mothers were slightly younger (23.8 years vs. 25.0 years, P < 0.01), if married they were less likely to be their husband's first wife (79% vs. 91%

Department of Orthopaedic Surgery, University of Nairobi, Kenya. Results of recurrent anterior dislocation of the shoulder are reported. The procedures used were mainly Putti-Plat in 35 patients; Eden-Hybinette in five patients and Webers derotation osteotomy of the humerus in five patients. Recurrence rates in the 45 patients reviewed and followed up at three years post-operatively were: six in Putti-Plat and two in Eden-Hybinette and none in Webers osteotomy patients. Clinically, the functional post-operative results were "excellent" in 32 patients (71%), "satisfactory" in eight patients (18%); while they were "unsatisfactory" in three patients and "poor" in two patients. There were no appreciable differences depending on the operative method used. Radiologically, the Hill-Sachs defect on the posterolateral aspect of the humeral head was seen in 30 patients (67%) while Bankarts lesion of the glenoid rim osteoarthritis was seen in five patients (11%), while rotator cuff calcification was seen in nine patients (20%).

Objectives: To identify the main barriers to utilisation of eye care services among the slum population of Kibera in Nairobi, Kenya.
Design: Community based survey
Setting: Kibera Slums, Nairobi City, Kenya
Subjects: Randomly selected 1,438 Kibera slum dwellers aged over 2 years.
Results: Majority of subjects 83.3% do not utilise the nearby well-established eye clinics. Twenty one percent of those with poor vision do not seek treatment at all. The main barriers to seeking eye care services were lack of money, ignorance, and the problem not causing much discomfort to warrant medical attention. There was significant, association between the level of education and health seeking behaviour (P = 0.008).
Conclusions: Majority of Kibera slum dwellers have no access to eye care.
Recommendation: There is need to establish a comprehensive Primary Eye Care project to provide low cost but quality services affordable to Kibera slum dwellers.

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{ OBJECTIVES To compare sociodemographic profiles, child care, child feeding practices and growth indices of children born to HIV-1 seropositive and seronegative mothers. METHODS: A cohort study of 234 children (seropositive and seronegative) born to HIV-1 seropositive mothers and 139 children born to seronegative mothers in Pumwani Maternity Hospital which serves a low-income population in Nairobi, Kenya from December 1991 and January 1994. RESULTS: With few exceptions, at the time of their birth children in all three cohorts had parents with similar characteristics, lived in similar housing in similar geographical areas, had their mothers as their primary care givers, had similar feeding practices and similar growth status and patterns. However, the HIV-1 seropositive mothers were slightly younger (23.8 years vs. 25.0 years, P < 0.01), if married they were less likely to be their husband's first wife (79% vs. 91%

Department of Orthopaedic Surgery, College of Health Sciences, University of Nairobi, Nairobi. The causes of post operative pyrexia in an orthopaedic unit was studied prospectively in 520 patients who underwent surgery. Two hundred patients (38.4%) developed postoperative pyrexia as defined by having recorded high temperatures of over 38 degrees C on two occasions within 24 hours (excluding the first 24 hours post-operatively). The commonest causes of post-operative pyrexia were wound infection in 70 (13.4%), respiratory tract infections in 40 (7.6%) and malaria in 30 (5.7%) patients, while other causes were urinary tract infection in 20 (3.8%), thrombophlebitis in 15 (2.8%) and deep vein thrombosis in 15 (2.8%) of the patients; while ten (1.9%) patients had pyrexia of undetermined cause despite exhaustive clinical and laboratory workup. The other associated conditions in patients who developed pyrexia were diabetes mellitus in 20 (3.8%), HIV seropositivity and malignancy in 30 (5.7%) and six (1.1%) patients, respectively.

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{ OBJECTIVES To compare sociodemographic profiles, child care, child feeding practices and growth indices of children born to HIV-1 seropositive and seronegative mothers. METHODS: A cohort study of 234 children (seropositive and seronegative) born to HIV-1 seropositive mothers and 139 children born to seronegative mothers in Pumwani Maternity Hospital which serves a low-income population in Nairobi, Kenya from December 1991 and January 1994. RESULTS: With few exceptions, at the time of their birth children in all three cohorts had parents with similar characteristics, lived in similar housing in similar geographical areas, had their mothers as their primary care givers, had similar feeding practices and similar growth status and patterns. However, the HIV-1 seropositive mothers were slightly younger (23.8 years vs. 25.0 years, P < 0.01), if married they were less likely to be their husband's first wife (79% vs. 91%

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{ OBJECTIVES To compare sociodemographic profiles, child care, child feeding practices and growth indices of children born to HIV-1 seropositive and seronegative mothers. METHODS: A cohort study of 234 children (seropositive and seronegative) born to HIV-1 seropositive mothers and 139 children born to seronegative mothers in Pumwani Maternity Hospital which serves a low-income population in Nairobi, Kenya from December 1991 and January 1994. RESULTS: With few exceptions, at the time of their birth children in all three cohorts had parents with similar characteristics, lived in similar housing in similar geographical areas, had their mothers as their primary care givers, had similar feeding practices and similar growth status and patterns. However, the HIV-1 seropositive mothers were slightly younger (23.8 years vs. 25.0 years, P < 0.01), if married they were less likely to be their husband's first wife (79% vs. 91%

{ OBJECTIVES To compare sociodemographic profiles, child care, child feeding practices and growth indices of children born to HIV-1 seropositive and seronegative mothers. METHODS: A cohort study of 234 children (seropositive and seronegative) born to HIV-1 seropositive mothers and 139 children born to seronegative mothers in Pumwani Maternity Hospital which serves a low-income population in Nairobi, Kenya from December 1991 and January 1994. RESULTS: With few exceptions, at the time of their birth children in all three cohorts had parents with similar characteristics, lived in similar housing in similar geographical areas, had their mothers as their primary care givers, had similar feeding practices and similar growth status and patterns. However, the HIV-1 seropositive mothers were slightly younger (23.8 years vs. 25.0 years, P < 0.01), if married they were less likely to be their husband's first wife (79% vs. 91%

{ OBJECTIVES To compare sociodemographic profiles, child care, child feeding practices and growth indices of children born to HIV-1 seropositive and seronegative mothers. METHODS: A cohort study of 234 children (seropositive and seronegative) born to HIV-1 seropositive mothers and 139 children born to seronegative mothers in Pumwani Maternity Hospital which serves a low-income population in Nairobi, Kenya from December 1991 and January 1994. RESULTS: With few exceptions, at the time of their birth children in all three cohorts had parents with similar characteristics, lived in similar housing in similar geographical areas, had their mothers as their primary care givers, had similar feeding practices and similar growth status and patterns. However, the HIV-1 seropositive mothers were slightly younger (23.8 years vs. 25.0 years, P < 0.01), if married they were less likely to be their husband's first wife (79% vs. 91%

{ OBJECTIVES To compare sociodemographic profiles, child care, child feeding practices and growth indices of children born to HIV-1 seropositive and seronegative mothers. METHODS: A cohort study of 234 children (seropositive and seronegative) born to HIV-1 seropositive mothers and 139 children born to seronegative mothers in Pumwani Maternity Hospital which serves a low-income population in Nairobi, Kenya from December 1991 and January 1994. RESULTS: With few exceptions, at the time of their birth children in all three cohorts had parents with similar characteristics, lived in similar housing in similar geographical areas, had their mothers as their primary care givers, had similar feeding practices and similar growth status and patterns. However, the HIV-1 seropositive mothers were slightly younger (23.8 years vs. 25.0 years, P < 0.01), if married they were less likely to be their husband's first wife (79% vs. 91%

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{ OBJECTIVES To compare sociodemographic profiles, child care, child feeding practices and growth indices of children born to HIV-1 seropositive and seronegative mothers. METHODS: A cohort study of 234 children (seropositive and seronegative) born to HIV-1 seropositive mothers and 139 children born to seronegative mothers in Pumwani Maternity Hospital which serves a low-income population in Nairobi, Kenya from December 1991 and January 1994. RESULTS: With few exceptions, at the time of their birth children in all three cohorts had parents with similar characteristics, lived in similar housing in similar geographical areas, had their mothers as their primary care givers, had similar feeding practices and similar growth status and patterns. However, the HIV-1 seropositive mothers were slightly younger (23.8 years vs. 25.0 years, P < 0.01), if married they were less likely to be their husband's first wife (79% vs. 91%

{ OBJECTIVES To compare sociodemographic profiles, child care, child feeding practices and growth indices of children born to HIV-1 seropositive and seronegative mothers. METHODS: A cohort study of 234 children (seropositive and seronegative) born to HIV-1 seropositive mothers and 139 children born to seronegative mothers in Pumwani Maternity Hospital which serves a low-income population in Nairobi, Kenya from December 1991 and January 1994. RESULTS: With few exceptions, at the time of their birth children in all three cohorts had parents with similar characteristics, lived in similar housing in similar geographical areas, had their mothers as their primary care givers, had similar feeding practices and similar growth status and patterns. However, the HIV-1 seropositive mothers were slightly younger (23.8 years vs. 25.0 years, P < 0.01), if married they were less likely to be their husband's first wife (79% vs. 91%

The elderly are predisposed to injuries due to consequences of ageing and presence of disease process commonly seen in the old people. Age-related deterioration of senses such as decrease in hearing capacity, presbyopia, changes in co-ordination, balance, motor strength and postural stability render the elderly vulnerable to environmental hazards. Diseases such as dementia, congestive cardiac failure, postural hypotension, osteoporosis and arthritis further contribute to compound problems of the elderly. Age and chronic factors further blunt the reserves to enable an elderly individual meet the demands of trauma. The challenge to the clinician is to be aware of the subtle changes and deviation from the norm that may suggest development of complications. With careful attention and appropriate physiological support the elderly patient has a good chance of survival. The primary condition must be assessed, necrotic tissues must be debrided by thorough surgical toileting, pus must be drained, wounds sutured and fractures must be set while cardiopulmonary activity must be monitored accurately. The patient should be re-assured, kept warm and adequate analgesia given to relieve pain. Intravascular volume and composition of extracellular fluid must be maintained. Nutritional support should be provided in amounts needed to meet the higher demands of trauma and preferably by oral feeding. Above all multidisciplinary approach to the traumatised elderly is mandatory involving surgeons, physicians, physiotherapists and other paramedical staff and relatives.

California mastitis test (CMT), direct leukocytes counts and bacteriological examination were performed on 630 milk samples from apparently healthy mammary glands of dairy goats comprising a mixed population of German Alpine, Toggenberg, Saanen and Galla crosses to find the prevalence of subclinical mastitis. The prevalence of subclinical mastitis was 9.8% according to CMT, 9.7% according to direct leukocyte counts and 28.7% by bacterial isolation during a 3-month period. The proportion of the bacteriologically positive milk samples was significantly (P <0.01) higher than that positive for CMT and direct leukocyte counts. There was a significant (P < 0.01) correlation between CMT and direct leukocyte counts. There was no significant direct relationship between bacterial isolation and CMT Bacterial organisms were isolated in 22.5% of the 568 CMT-negative milk samples. The results suggest that bacterial organisms isolated from the CMT-negative milksamples were either latent infections or did not stimulate any significant increase in somatic cell counts that could be detected by either the CMT or direct leukocyte counts. The observations of this study indicate that the mere presence of bacteria in goat's milk does not mean that the udder is infected and so does not warrant antibiotic therapy.

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{ OBJECTIVES To compare sociodemographic profiles, child care, child feeding practices and growth indices of children born to HIV-1 seropositive and seronegative mothers. METHODS: A cohort study of 234 children (seropositive and seronegative) born to HIV-1 seropositive mothers and 139 children born to seronegative mothers in Pumwani Maternity Hospital which serves a low-income population in Nairobi, Kenya from December 1991 and January 1994. RESULTS: With few exceptions, at the time of their birth children in all three cohorts had parents with similar characteristics, lived in similar housing in similar geographical areas, had their mothers as their primary care givers, had similar feeding practices and similar growth status and patterns. However, the HIV-1 seropositive mothers were slightly younger (23.8 years vs. 25.0 years, P < 0.01), if married they were less likely to be their husband's first wife (79% vs. 91%

Department of Orthopaedic Surgery, College of Health Sciences, University of Nairobi, Nairobi. The causes of post operative pyrexia in an orthopaedic unit was studied prospectively in 520 patients who underwent surgery. Two hundred patients (38.4%) developed postoperative pyrexia as defined by having recorded high temperatures of over 38 degrees C on two occasions within 24 hours (excluding the first 24 hours post-operatively). The commonest causes of post-operative pyrexia were wound infection in 70 (13.4%), respiratory tract infections in 40 (7.6%) and malaria in 30 (5.7%) patients, while other causes were urinary tract infection in 20 (3.8%), thrombophlebitis in 15 (2.8%) and deep vein thrombosis in 15 (2.8%) of the patients; while ten (1.9%) patients had pyrexia of undetermined cause despite exhaustive clinical and laboratory workup. The other associated conditions in patients who developed pyrexia were diabetes mellitus in 20 (3.8%), HIV seropositivity and malignancy in 30 (5.7%) and six (1.1%) patients, respectively.

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OBJECTIVES:
The main objective was to evaluate the outcome of glaucoma surgeries in a centre for eye care in Kenya.
 
DESIGN:
Retrospective case series.
 
SETTING:
The study was conducted at Mombasa Light House for Christ Eye Centre- Kenya.
 
SUBJECTS:
All patients diagnosed to have glaucoma and managed by surgery between 2004-2007.
 
MATERIALS AND METHODS:
Records from 2004 to 2007 were retrieved and data collected on the surgeries done using a structured questionnaire. 2008 was left for follow up to avail a one year minimum follow up time.
Analysis was done using SPSS version 13.
 
RESULTS:
265 operations were recorded in this period. 213 were retrieved and the outcomes analysed. There was good IOP control over the follow up period with a gradual rise post operation, though the pressures remained within normal. Most of the patients were controlled with no need for medications, or much less medication use.
 
The average intra-ocular pressure at two year follow up was 15.0mmHg against a baseline of 28.7mmHg (p< 0.001). 29 eyes (13.6%) required medication for intra-ocular pressure control. One type of medication was able to control the pressures post operatively. Surgery reduced topical antiglaucoma medication use by 72%.
 
 
CONCLUSION:
Intra-ocular pressure was well controlled surgically for the two year follow up.
 
RECOMENDATIONS:
Surgical intervention can be taken as a first option for glaucoma control in our set up, especially as most of our patients present late.

A field study was undertaken to evaluate pesticide/variety combinations for thrips infestation and damage in Kabete Field Station, University of Nairobi, Kenya. Four French bean varieties (Amy, Monel, Samantha and Impala) and four insecticides (Lambda-cyhalothrin (Karate 1.75 EC), Petroleum spray oil (DC Tron 500 ML), Spinosad (Tracer 480 SC) and Fipronil (Regent 50 SC)) were used for the study. The study revealed that both the varieties and insecticides influenced thrips infestation independently. Tracer 480 SC and Regent 50 SC gave the lowest thrips numbers in all the varieties. The mean number of F. occidentalis in Karate 1.75 EC sprayed plots was higher and significantly different from plots sprayed with Tracer 480 SC and Regent 50 Sc. The mean number of M. sjostedti was not significantly different for all the plots sprayed with Tracer 480 SC, Regent 50 SC and Karate 1.75 EC. DC Tron 500 ML had no significant effect on thrips infestation.

The objective of this study was to establish the prevalence, detection and management of various adverse drug reactions associated with antiretroviral drugs occurring in patients attending Comprehensive Care Centre (CCC) of Kiambu District Hospital. The study was a cross sectional survey where the patients included were those attending the CCC on a monthly basis. The results revealed that 65.2% of the patients had experienced symptoms suggestive of adverse drug reactions (ADRs). Of these, 67.2% did not associate the symptoms to the medicines they were taking but rather to the AIDS syndrome. The most prominent reaction was peripheral neuropathy at 0.395 (0.344-0.447 at 95% confidence interval) while the least common was hepatotoxicity. Whereas 71.5% could tell the frequency of the daily dosage, 92.1% did not know the names of the medicines they were taking but could describe them by shape and colour. There was a significant association between occurrence and reporting of ADRs and age (P<0.001), weight (P=0.001), marital status (P=0.016), occupation (P<0.001), religious participation (P<0.001) and education level (P<0.001). Although the health care providers displayed adequate knowledge in management of these reactions, they complained of inadequacy of the current reporting tool (MOH 257) in capturing ADRs. The patients were ill equipped in recognizing the adverse drug reactions.

The population patterns of eggs, larvae and puparia on bean plants and leaf punctures made by adults were investigated during cropping (March-July; October-January) and noncropping (July-October) seasons at two sites in Kenya. Bean grown in noncropping seasons had more leaf punctures, eggs, larvae and puparia than bean grown in cropping seasons. Bean sown in noncropping seasons attracted unusually high beanfly populations from surrounding weeds as well as previous crops. Under field conditions, the Onhiomyi beanfly species, sencerella Greathead and 0. phasepli Tryon, bean infested plants in all seasons. Both species normally oviposited in punctures on the leavesbut 0. spencerella also oviposited in the stems of bean seedlings.

A field study was undertaken to evaluate pesticide/variety combinations for thrips infestation and damage in Kabete Field Station, University of Nairobi, Kenya. Four French bean varieties (Amy, Monel, Samantha and Impala) and four insecticides (Lambda-cyhalothrin (Karate 1.75 EC), Petroleum spray oil (DC Tron 500 ML), Spinosad (Tracer 480 SC) and Fipronil (Regent 50 SC)) were used for the study. The study revealed that both the varieties and insecticides influenced thrips infestation independently. Tracer 480 SC and Regent 50 SC gave the lowest thrips numbers in all the varieties. The mean number of F. occidentalis in Karate 1.75 EC sprayed plots was higher and significantly different from plots sprayed with Tracer 480 SC and Regent 50 Sc. The mean number of M. sjostedti was not significantly different for all the plots sprayed with Tracer 480 SC, Regent 50 SC and Karate 1.75 EC. DC Tron 500 ML had no significant effect on thrips infestation.

Sorghum (Sorghum bicolorL.), wheat (Triticum aestivumL.), maize(Zea MaysL.), common bean (Phaseolus vulgaris L.) and garden pea (Pisum sativumL.) were tested as border crops for their ability to reduce the number of colonizing aphids and Potato Virus Y (PVY) incidence in seed potatoes (Solanum tuberosumL.). The experiment was done at Tigoni, Central Kenya for two seasons, from 03 May 2002 and from 17 October 2002. Apterae aphids were monitored weekly by picking 15 leaves from 5 randomly selected plants per plot while alate aphids were collected using yellow sticky traps mounted 0.5 m from the ground level at the edge of border crops. Three aphid species were recorded: Aphis gossypii (Glover), Macrosiphum euphorbiae (Thomas) and Myzus persicae (Sulzer). PVY incidence in the inner rows of potatoes surrounded by fallow and the border crops was statistically insignificant (P>0.05) but outer rows in crop-bordered plots had significantly less PVY than outer rows of fallow-bordered plots. The DAS- ELISA test used to confirm presence of PVY showed that the disease had the highest and lowest incidence in fallow and wheat bordered plots, respectively. This study shows that the effective border-crops can be used to manage aphids and PVY disease in potatoes. In addition, since most Kenyan potato growers are low income earners, adoption of border cropping technology can improve immensely the production success of the crop

This is a report of Information, Needs and Resources Analysis, (fNRA) survey carried
out in Kenya in July 200 1. The survey team comprised a Professor of Psychiatry, David
Ndetei from the Nairobi Psychotherapy Services and Institute (NPSI), Dr. Donald A.
Kokonya, Francisca A. Ongecha, Mr. Leonidas Msafiri and Mr. Abel Ndumbu and Ms.
Victoria Mutiso. The UNDep team comprised Dr. Rebecca McKetin and Mr. Mathew
Warner-Smith who provided facilitative support. This survey sought to establish
Kenya's capacity for collecting information on drug abuse. INRA is primarily focussed
on assessment of existing information and sources on drug abuse and the identification
of key needs. It is also expected to propose a development strategy for establishing an
integrated drug information system for monitoring drug abuse trends and associated
problems in Kenya. The purpose of such a drug information system is to provide a
database which can be used to formulate policy and institute intervention programmes
on drug abuse. The information contained in this report was obtained by interviewing a
cross-section of leaders of a number of relevant institutions in Government, the Private
and NGO sectors as well as individual persons - all of whom are stakeholders in matters
of drug abuse. The survey covered Nairobi and its environs only and aimed at providing
a starting point for similar work throughout the country.
The information gathered indicated that drug abuse has been the subject of study for a
number of academic theses, but operational research on the subject has been mute. The
existing information shows that the most abused drugs in Kenya are alcohol and
Cannabis sativa (bhang) which is grown in a few isolated parts of the country. But there
are reports of somewhat isolated cases of cocaine, heroin, mandrax, hallucinogens,
amphetamines and solvents. Khat (miraa) which contains a banned psychotropic
substance (cathinone) is widely consl1med among certain sections of the Kenyan
community has become a major export crop to Somalia and further afield. There have
also been cases of addiction to prescribed analgesics and sedatives. In recent years,
Kenya has become a transit 'zone' (mainly from Pakistan to the west) for traffickers as a
result of its long and porous boundaries; Nairobi being a major communication city and
with a relatively low demand for local consumption.
The survey team identified a number of existing sources of information on illicit drugs
which can make valuable contributions to an integrated drug information system. These
range from treatment data from the national and teaching hospital - Mathari Hospital to
alcohol and drug rehabilitation and detoxification centres run by NGOs and private
companies as well as advocacy agencies involved in counselling and Information,
Education and Communication (lEC) activities. The Central Bureau of Statistics would
be the source of information on drug abuse in its household survey. The Central Bureau
of Statistics is, upon request by NACADA, planning for a national baseline survey to
establish drug abuse prevalence in Kenya. A household survey will follow thereafter.
As elsewhere existing sources of data need to be supplemented with specialized drug
abuse surveys in order to obtain a more comprehensive and reliable assessment of the
situation particularly as regards the abuse of drugs in educational institutions.
Kenya has a very strong manpower base as regards research and studies on drug abuse
information systems. Administratively, Kenya has created a central agency responsible
for coordination of activities on drug abuse - NACADA, the National Agency for the
Campaign Against Drug Abuse. A steering committee for a network on drug abuse has
already been established and is working towards the formation of the network which
will playa supportive role to NACADA.