Literary scholars in Kenya have recognised that oral literature is a cultural heritage worth preserving and accessing. To this end, they have used traditional information to good effect. In today

The use of traditional and herbal medicines is gaining recognition globally. To
safeguard the patient, there are legitimate demands that all medicines be safe,
efficacious and of good quality. The required parameters for their quality
- --evaluation-indude-assessment-for-inorganic matter-Idustj+absence of-adulterationmicrobial
load, identification and profile of contents and where possible
quantitation of the active compound or marker compounds. Also of importance are
heavy metals, pesticides and product stability. The mixture of portions of herbs in
traditional medicines complicates the quality control tests of these preparations.
The content profile becomes difficult to replicate from batch to batch, while
quantification of the active compound(s) in such multi-component products would
require prior processing to isolate and identify the chemical compounds.

The identification of five novel compounds, pseudo-erythromycin A-6,9-hemiketal, 8,9-anhydro-pseudo-erythromycin A-6,9-hemiketal, 8,9-anhydro-pseudo-N-demethylerythromycin A-6,9-hemiketal, 5-O-beta-D-desosaminylerythronolide A and 15-nor-erythromycin C, in mother liquor concentrates of Streptomyces erythraeus is described. The pseudo-erythromycin derivatives are characterized by a 12-membered macrocyclic ring as a result of C13––C11 trans-lactonization. The five compounds have very little antimicrobial activity.

The identification of five novel compounds, pseudo-erythromycin A-6,9-hemiketal, 8,9-anhydro-pseudo-erythromycin A-6,9-hemiketal, 8,9-anhydro-pseudo-N-demethylerythromycin A-6,9-hemiketal, 5-O-beta-D-desosaminylerythronolide A and 15-nor-erythromycin C, in mother liquor concentrates of Streptomyces erythraeus is described. The pseudo-erythromycin derivatives are characterized by a 12-membered macrocyclic ring as a result of C13––C11 trans-lactonization. The five compounds have very little antimicrobial activity.

During a 4 year period (January 1983 to December 1986), 418 requests for drug analysis were received in the Drug Analysis and Research Unit, Department of Pharmacy, University of Nairobi. Of these requests, 212 were from Medical Supplies Coordination Unit, 190 from Government hospitals and health research institutions, 11 from the Ministry of Health Headquarters (Director of Medical Services and Chief Pharmacist) and 5 came from local pharmaceutical manufacturers. Of the samples analysed, 70.8% were from local manufacturers, 26.1% were imported and 3.1% were from undeclared sources. Failure to comply with test for quality, as set out in official compendia (B.P. Eur. ph. Ip, etc.) were observed at 45.8% for locally manufactured drugs and 31.4% for imported drug products.

During a 4 year period (January 1983 to December 1986), 418 requests for drug analysis were received in the Drug Analysis and Research Unit, Department of Pharmacy, University of Nairobi. Of these requests, 212 were from Medical Supplies Coordination Unit, 190 from Government hospitals and health research institutions, 11 from the Ministry of Health Headquarters (Director of Medical Services and Chief Pharmacist) and 5 came from local pharmaceutical manufacturers. Of the samples analysed, 70.8% were from local manufacturers, 26.1% were imported and 3.1% were from undeclared sources. Failure to comply with test for quality, as set out in official compendia (B.P. Eur. ph. Ip, etc.) were observed at 45.8% for locally manufactured drugs and 31.4% for imported drug products.

The metabolites of erythromycin A, anhydroerythromycin A, Nedemethylervthromycin A and
erythromycin B in the Wister rat were studied by thin-layer chromatography. In some experiments
germ-free rats, rats with a cannulated bile duct and a gastrectomized rat were used. The erythromycins
examined were shown to undergo two principal changes, N-demethylation and acid-catalysed
degradation. It was demonstrated that the stomach and the liver are not the solesites of acid degradation
and demethylation oferythromycins, respectively. Erythromycin A gives three principal metabolites,
anhydroerythromycin A,anhydro-N-demethylerythromycin Aand N-demethylerythromycin
A,and erythromycin A enol ether and N-demethylerythromycin A enol ether are present to a minor
extent. 5-0-Desosaminyleryt.ironolide A was also identified, suggesting the presence of an erythromycin
glycosidase.

Preparative high-performance liquid chromatography on silica gel allows the
isolation of erythromycins and related substances from mother-liquor concentrates.
Three mobile phases were used consecutively: A. ethyl acetate-methanol-25% ammonia
(100:8: I, v v); B. diethyl ether-methanol-25% ammonia (100:7: I. vjv) and C.
dichloromethane-methanol-25% ammonia (100:5:0.5. v v), The separation and purification
was confirmed by thin-layer chromatography. Thirteen pure substances were
isolated among which are erythromycins A. S, C and D. 8,9-anhydroerythromycin
A-6.9-hemiketal. erythromycins A and C-6.9;6.12-spiroketals and N-demethylerythromycin
A-6.9:9,12-spiroketaL

The identification of five novel compounds, pseudo-erythromycin A-6,9-hemiketal, 8,9anhydro-pseudo-erythromycin
A-6,9-hemiketal, 8,9-anhydro-pseudo-N-demethylerythromycin
A-6,9-hemiketal, 5-0-,B-D-desosaminylerythronolide A and 15-nor-erythromycin C, in mother
liquor concentrates of Streptomyces erythraeus is described. The pseudo-erythromycin
derivatives are characterized by a 12-membered macrocyclic ring as a result of CW->Cll
trans-Iactonization. The five compounds have very little antimicrobial activity.
In a study" dealing with the isolation and the identification of compounds present in the mother
liquor concentrates from commercial crystallization of erythromycin, a number of compounds were
obtained. Some of these compounds were identified as erythromycins A, B, C and D, erythromycin
A enol ether, anhydroerythromycin A, anhydroerythrornycin C and anhydro-N-demethylerythromycin
A. Five other compounds denoted Ml to M5 were not identified. The determination of the structure
of the latter group of compounds is the subject of this paper.

The MICs of erythromycins A, B, C, and D and some of their derivatives wcrc determined against 21
gram-positive and 15 gram-negative microorganisms. Antibacterial activity was conlined 10 gram-positive and
very few gram-ncgative bacteria. Erythromycin It was somewhat less active than crythromycin A, and
erythromycin C and D showed about half Ihal activity or even less. Most olher derivatives had negligible
activity. Determination of potency by diffusion and turbidimetric assays were in line with MICs. The
cxuminauon of Ihe results of these assays, however, revealed that Ihere are differences between thc data of
dittcrent laboratories, depending on the microorganisms and conditions used,

When erythromycin A is heated in diethylamine-acetic acid, an erythromycin hemiketal is obtained, which
can be further transformed into a new enol ether and spiroketal. The new enol ether is also obtained in equilibrium
with the normal one on heating erythromycin A or B in pyridine-acetic acid. The novel compounds, which will
be called pseudoerythromycin derivatives, are characterized by a translactonization between the Cwhydroxyl
and the lactone group. Their structure was proved by mass and IHand 13CNMR spectrometry, by acetylation
experiments, and by degradation with lead tetraacetate.

A comparatlve evaluation of •••
alpirln tablets products on the Kenyan
rmlrket found that three of the products
failed to meet compendlal requlntfTMtnts.
A fourth had poor friability. The only
Imported product among' those
evaluated failed weight unlformlry test.
One local product failed In diameter
requirement while another had an
aspirin content of 111'10 of the lable
claim.

Sulfadoxine/Pyrimethamine tablets preparations were recently made the first line
antimalarial drug. In response to reports on falciparum malaria resistance to such
products, sulfadoxinelpyrimetbamine tablets in Kenya were evaluated for their invitro
performance using the parameters of content and dissolution test for the Active
Pharmaceutical Ingredient. One brand product had a content of both sulfadoxioe and
pyrimethamine well below allowed limits. Amongst the brands analysed only 44%
had batches that released more thanQ=60% of labelled dose in 30 minutes. Batches
of some brands bad wide variations in content with some failing the dissolution test.
Other brands released less than 60% in 60 minutes. Most brands failed the
dissolution test for pyrimethamine and 33% for both sulfadoxine and pyrimethamine.
Tbe quality of sulfadoxinelpyrimethamine products on the Kenyan market should be
a cause for concern to the drug regulatory autbority and the Malaria Control
Program.

A comparative in-vitro performance of carbamazepine 200mg tablet products available on the Kenyan market was evaluated. The products which include the innovator product, Tegretol, have similar quality consonant with pharmacopoeial specifications. A batch of one of the products had a carbamazepine content of 106.6% label claim which was outside the upper limits of 105%. One product packaged in multiple-unit containers of a 1000, had an unacceptable high friability of 6.82% loss in weight. All products had good dissolution profiles and released at least 70% of the dose within 45 minutes. Drug dissolution from tablets was found to vary between batches for one product. At each sampling time, most generics had wide variations in amount of dissolved drug. The effect of such variations on tablet efficacy cannot be ascertained in the absence of bioavailability data.

The relative bioavailability of two brands of chlorpropamide, Dibonis, and Diabinese has been evaluated in four healthy male volunteers in a randomized, balanced, cross-over study. No statistically significant differences were observed in the absorption rate constant, ka, time to reach peak serum concentration, tp, maximum serum concentration, Cmax, the overall elimination rate constant, kel, and the area under the curve, AUC, at 95% confidence level.

During a 4 year period (January 1983 to December 1986), 418 requests for drug analysis were received in the Drug Analysis and Research Unit, Department of Pharmacy, University of Nairobi. Of these requests, 212 were from Medical Supplies Coordination Unit, 190 from Government hospitals and health research institutions, 11 from the Ministry of Health Headquarters (Director of Medical Services and Chief Pharmacist) and 5 came from local pharmaceutical manufacturers. Of the samples analysed, 70.8% were from local manufacturers, 26.1% were imported and 3.1% were from undeclared sources. Failure to comply with test for quality, as set out in official compendia (B.P. Eur. ph. Ip, etc.) were observed at 45.8% for locally manufactured drugs and 31.4% for imported drug products.

Seventeen brands of antacid products available on the Kenya market were investigated for their acid neutralising capacity and sodium content. Thirteen tablet products gave neutralising capacity per tablet of between 4.7 to 14.12 mMol hydrochloric acid. The neutralising capacities for the suspensions ranged between 11.97 to 34.32 mMol hydrochloric acid for 10ml suspension. The lowest neutralising capacities were obtained for products based on compound magnesium trisilicate and higher capacities for those containing magaldrate, or magnesium hydroxide or magnesium carbonate in combination with other ingredients. The fastest rate of neutralization was obtained with preparations containing carbonates and the lowest by compound magnesium trisilicate. The sodium content for the preparations was between < 0.001 mEq to 0.732 mEq sodium per minimum recommended dose. The study shows a high degree of variation in both the acid neutralising capacities and the sodium content of the different brands investigated.

Field trips to herbalists' practices in an area about 200 miles around Nairobi (Kenya) enabled us to make a list of medicinal plant species preferentially used to treat malaria. Ajuga remota and Caesalpinia volkensii were further investigated as being the most frequently used species. Aqueous decoctions, ethanol macerates, and petroleum ether, methanol and water Soxhlet extracts of these plants were further tested for their in vitro antimalarial properties in a chloroquine sensitive (FCA/20GHA) and resistant (W2) strain of Plasmodium falciparum. The activity was assessed by the parasite lactate dehydrogenase (pLDH) assay method. There was a concentration-dependent inhibition by the vegetal extracts of both plants. The IC(50) of the most active A. remota extract (ethanol macerate) was 55 and 57 microg/ml against FCA/20GHA and W2, respectively. For C. volkensii, it was the Soxhlet-water extract which was most active against FCA/20GHA with an IC(50) of 404 microg/ml while the petroleum ether extract exhibited the most activity against W2 with an IC(50) of 250 microg/ml. Further phytochemical work is being done in order to identify the active principles.

Field trips to herbalists' practices in an area about 200 miles around Nairobi (Kenya) enabled us to make a list of medicinal plant species preferentially used to treat malaria. Ajuga remota and Caesalpinia volkensii were further investigated as being the most frequently used species. Aqueous decoctions, ethanol macerates, and petroleum ether, methanol and water Soxhlet extracts of these plants were further tested for their in vitro antimalarial properties in a chloroquine sensitive (FCA/20GHA) and resistant (W2) strain of Plasmodium falciparum. The activity was assessed by the parasite lactate dehydrogenase (pLDH) assay method. There was a concentration-dependent inhibition by the vegetal extracts of both plants. The IC(50) of the most active A. remota extract (ethanol macerate) was 55 and 57 microg/ml against FCA/20GHA and W2, respectively. For C. volkensii, it was the Soxhlet-water extract which was most active against FCA/20GHA with an IC(50) of 404 microg/ml while the petroleum ether extract exhibited the most activity against W2 with an IC(50) of 250 microg/ml. Further phytochemical work is being done in order to identify the active principles.

Field trips to herbalists' practices in an area about 200 miles around Nairobi (Kenya) enabled us to make a list of medicinal plant species preferentially used to treat malaria. Ajuga remota and Caesalpinia volkensii were further investigated as being the most frequently used species. Aqueous decoctions, ethanol macerates, and petroleum ether, methanol and water Soxhlet extracts of these plants were further tested for their in vitro antimalarial properties in a chloroquine sensitive (FCA/20GHA) and resistant (W2) strain of Plasmodium falciparum. The activity was assessed by the parasite lactate dehydrogenase (pLDH) assay method. There was a concentration-dependent inhibition by the vegetal extracts of both plants. The IC(50) of the most active A. remota extract (ethanol macerate) was 55 and 57 microg/ml against FCA/20GHA and W2, respectively. For C. volkensii, it was the Soxhlet-water extract which was most active against FCA/20GHA with an IC(50) of 404 microg/ml while the petroleum ether extract exhibited the most activity against W2 with an IC(50) of 250 microg/ml. Further phytochemical work is being done in order to identify the active principles.

The literature on the thin-layer chromatography (TLC) of macrolides has recently
been reviewed'>'. An improved separation of the components of erythromycin
has been reported by Vanderhaeghe and Kerremans '. The use of high-performance
thin-layer chromatography in the analysis of some macrolides has been the subject of
a recent publication".
The best TLC system known, described for the separation of erythromycins,
uses plates coated with silanized silica gel and methanol-water-15 % ammonium
acetate buffer pH 7.0 (50:20:10) as the mobile phase:'. This system (R-VI in Table I)
allows very good separation of erythromycin A (EA), B (EB) and C (EC), but erythromycin
D (ED) is not separated from EA. Small amounts of acid degradation
products of erythromycin such as anhydroerythromycin A (AEA) and erythromycin
A enol ether (EAEN) were found by high-performance liquid chromatography
(HPLC) of commercial samples'': TLC with system R-VI did not separate AEA
from EB. Preparative chromatography of the mother liquors of the erythromycin
purification indicated the presence of des-N-methylerythromycin A (dMeEA). As this
compound was not separated from erythromycin A with TLC system R-VI, other
mobile phases were examined. In the present study a system using silica gel as the
coating material and diisopropyJ ether-methanol-25 % ammonia (75:35:2) as the
mobile phase was found to separate EA, EB, Ee, ED, EAEN, AEA and dMeEA. The
results obtained with several other mobile phases are also discussed, together with
their application in the identification and purity control of other macrolides

The in vitro performance of metronidazole tablet products by different manufacturers available on the Kenyan market was evaluated. It was found that a number of generic metronidazole tablet products have quality performance equal to that of Flagyl–the innovator product. All products confirmed to pharmacopoeial specifications. Three products with percent weight loss of 1.4, 11.08 and 14.93 failed the crucial friability test, for multidose packs. Two products failed the dissolution test releasing 46.8% and 45.8% of drug in 40 minutes. Drug release from tablet was found to vary between batches for one product. Ageing appears to decrease amount of drug released from tablets but longer storage periods and more samples are required before definite conclusions are drawn.

Field trips to herbalists' practices in an area about 200 miles around Nairobi (Kenya) enabled us to make a list of medicinal plant species preferentially used to treat malaria. Ajuga remota and Caesalpinia volkensii were further investigated as being the most frequently used species. Aqueous decoctions, ethanol macerates, and petroleum ether, methanol and water Soxhlet extracts of these plants were further tested for their in vitro antimalarial properties in a chloroquine sensitive (FCA/20GHA) and resistant (W2) strain of Plasmodium falciparum. The activity was assessed by the parasite lactate dehydrogenase (pLDH) assay method. There was a concentration-dependent inhibition by the vegetal extracts of both plants. The IC(50) of the most active A. remota extract (ethanol macerate) was 55 and 57 microg/ml against FCA/20GHA and W2, respectively. For C. volkensii, it was the Soxhlet-water extract which was most active against FCA/20GHA with an IC(50) of 404 microg/ml while the petroleum ether extract exhibited the most activity against W2 with an IC(50) of 250 microg/ml. Further phytochemical work is being done in order to identify the active principles.

During a 4 year period (January 1983 to December 1986), 418 requests for drug analysis were received in the Drug Analysis and Research Unit, Department of Pharmacy, University of Nairobi. Of these requests, 212 were from Medical Supplies Coordination Unit, 190 from Government hospitals and health research institutions, 11 from the Ministry of Health Headquarters (Director of Medical Services and Chief Pharmacist) and 5 came from local pharmaceutical manufacturers. Of the samples analysed, 70.8% were from local manufacturers, 26.1% were imported and 3.1% were from undeclared sources. Failure to comply with test for quality, as set out in official compendia (B.P. Eur. ph. Ip, etc.) were observed at 45.8% for locally manufactured drugs and 31.4% for imported drug products.

Tissue distribution and excretion of radioactively labelled compounds was studied in the Wistar rat after i.v. administration of [N-methyl-14C]-erythromycin A. Whole-body autoradiography and liquid scintillation counting was used to investigate the tissue localization of radioactivity in pregnant and non-pregnant rats. Tissue levels were maximal within 20 min, except for lachrymal glands, thymus and brain. Large amounts of radioactively labelled compounds, partly originating from active secretion, were present in the small intestine and caecum. Marked concentration of radioactively labelled compounds was also observed in the liver, spleen, lachrymal and salivary glands, lymph nodes, mammary glands, skin, bone marrow, and, to a lesser extent, in the lung, kidney and skeletal muscle. During six hours of experimental follow-up, plasma levels remained lower than corresponding tissue levels. At 1 h the radioactivity in fetuses was about three times lower than that in maternal blood. Within 48 h, more than 90% of the administered radioactivity was excreted. The amounts of radioactivity recovered in urine, faeces and expired air were about 19%, 48% and 24% respectively. After 48 h, 8% of the administered radioactivity was found in the carcass.

During a 4 year period (January 1983 to December 1986), 418 requests for drug analysis were received in the Drug Analysis and Research Unit, Department of Pharmacy, University of Nairobi. Of these requests, 212 were from Medical Supplies Coordination Unit, 190 from Government hospitals and health research institutions, 11 from the Ministry of Health Headquarters (Director of Medical Services and Chief Pharmacist) and 5 came from local pharmaceutical manufacturers. Of the samples analysed, 70.8% were from local manufacturers, 26.1% were imported and 3.1% were from undeclared sources. Failure to comply with test for quality, as set out in official compendia (B.P. Eur. ph. Ip, etc.) were observed at 45.8% for locally manufactured drugs and 31.4% for imported drug products.

Field trips to herbalists' practices in an area about 200 miles around Nairobi (Kenya) enabled us to make a list of medicinal plant species preferentially used to treat malaria. Ajuga remota and Caesalpinia volkensii were further investigated as being the most frequently used species. Aqueous decoctions, ethanol macerates, and petroleum ether, methanol and water Soxhlet extracts of these plants were further tested for their in vitro antimalarial properties in a chloroquine sensitive (FCA/20GHA) and resistant (W2) strain of Plasmodium falciparum. The activity was assessed by the parasite lactate dehydrogenase (pLDH) assay method. There was a concentration-dependent inhibition by the vegetal extracts of both plants. The IC(50) of the most active A. remota extract (ethanol macerate) was 55 and 57 microg/ml against FCA/20GHA and W2, respectively. For C. volkensii, it was the Soxhlet-water extract which was most active against FCA/20GHA with an IC(50) of 404 microg/ml while the petroleum ether extract exhibited the most activity against W2 with an IC(50) of 250 microg/ml. Further phytochemical work is being done in order to identify the active principles.

This work investigated the constiw6nts and the efficacy against Fusarium verticillioides infection and fumonisin production of essential oils of Ocimum basilicum L. and Ocimum gratissimum L. from
different locations in Kenya.
The oil of leaves and flowering tops of 0. basilicum from Sagan a contained mainly Iinalool (95%). The flowering tops and leaves from Yatta contained mainly camphor (32.6 and 3 I.0%, respectively) and
linalool (28.2 and 29.3, respectively). Eugenol was the main constituent in the oil of O. gratissimum leaves from both Sagana (95.5%) and Yarta (70.1 %). The oil ofthe flowering tops had significantly less
eugenol. The main component of the oil of flowering tops from Yalta was Z-~-ocim~ne (34.1 %). Oil from both species had some antifungal activity. The oils of 0. basilicum and 0. gratissimum from
different locations showed chemical variation, antifungal activity, free radical scavenging capacity and antimycotoxicogenic property. These properties are attributed to the phenolic compound eugenol.

Sediments on the bottom of Lake Challa, a 92-m deep crater lake on the border of Kenya and Tanzania near Mt. Kilimanjaro, contain a uniquely long and continuous record of past climate and environmental change in easternmost equatorial Africa. Supported in part by the International Continental Scientific Drilling Programme (ICDP), the DeepCHALLA project has now recovered this sediment record down to 214.8 m below the lake floor, with 100% recovery of the uppermost 121.3 m (the last 160 kyr BP) and ca.85% recovery of the older part of the sequence, down to the lowermost distinct reflector identified in seismic stratigraphy. This acoustic basement represents a ca.2-m thick layer of coarsely laminated, diatom-rich organic mud mixed with volcanic sand and silt deposited 250 kyr ago, overlying an estimated 20-30 m of unsampled lacustrine deposits representing the earliest phase of lake development. Down-hole logging produced profiles of in-situ sediment composition that confer an absolute depth- scale to both the recovered cores and the seismic stratigraphy. An estimated 74% of the recovered sequence is finely laminated (varved), and continuously so over the upper 72.3 m (the last 90 kyr). All other sections display at least cm-scale lamination, demonstrating persistence of a tranquil, profundal depositional environment throughout lake history. The sequence is interrupted only by 32 visible tephra layers 2 to 9 mm thick; and by several dozen fine-grained turbidites up to 108 cm thick, most of which are clearly bracketed between a non-erosive base and a diatom-laden cap. Tie points between sediment markers and the corresponding seismic reflectors support a preliminary age model inferring a near-constant rate of sediment accumulation over at least the last glacial cycle (140 kyr BP to present). This great time span combined with the exquisite temporal resolution of the Lake Challa sediments provides great opportunities to study past tropical climate dynamics at both short (inter-annual to decadal) and long (glacial-interglacial) time scales; and to assess the multi-faceted impact of this climate change on the region's freshwater resources, the functioning of terrestrial ecosystems, and the history of the African landscape in which modern humans (our species, Homo sapiens) originally evolved and have lived ever since.

Sediments on the bottom of Lake Challa, a 92-meter deep crater lake on the border of Kenya and Tanzania near Mt. Kilimanjaro, contain a uniquely long and continuous record of past climate and environmental change. The near-equatorial location and exceptional quality of this natural archive provide great opportunities to study tropical climate variability at both short (inter-annual to decadal) and long (glacial-interglacial) time scales; and the influence of this climate variability on the region's freshwater resources, the functioning of terrestrial ecosystems, and the history of the East African landscape in which modern humans (our species, Homo sapiens) evolved and have lived ever since. Supported in part by the International Continental Scientific Drilling Programme (ICDP), the DeepCHALLA project has now recovered the sediment record of Lake Challa down to 214.8 meter below the lake floor, with almost certain 100% cover of the uppermost 121.3 meter (ca.150,000 year BP to present) and estimated 85% cover over the lower part of the sequence, down to the lowermost distinct reflector in the available seismic stratigraphy. This reflector represents a 2 meter thick layer of volcanic sand and silt deposited ca.250,000 years ago, and overlies still older silty lacustrine clays deposited during early lake development. Down-hole logging produced continuous profiles of in-situ sediment composition that confer an absolute depth scale to both the recovered cores and their three-dimensional representation in seismic stratigraphy. As readily observed through the transparent core liners, Lake Challa sediments are finely laminated throughout most of the recovered sequence. Combined with the great time span, the exquisite temporal resolution of these sediments promises to greatly increase our understanding of tropical climate and ecosystem dynamics, and create a long-awaited equatorial counterpart to the high-latitude climate records extracted from the ice sheets of Greenland and Antarctica.

The number concentration and composition of ice nucleating particles (INP) at Mt. Kenya Global Atmosphere Watch (GAW) Station (0 9'S, 37 19'O, 3678 m asl) were measured during August and September 2015. With the ITCZ being located some 1900 km north of the station …

The lack of infrastructure in Africa especially south of the Sahara is widely recognized as one of the continent’s greatest impediments to sustainable development )[(1)]. Even with this challenge, ICT operators in Kenya prefer to invest in own infrastructure despite the availability of underutilized ICT resources from other operators and players. This has led to wastage of scarce resources, high cost of services, poor quality services, environmental degradation and low investment in rural areas among others. The research sought to propose an adoption framework for ICT infrastructure sharing for mobile operators in Kenya after establishing the levels, drivers and challenges of infrastructure sharing. Data was collected from ICT staff of the four mobile operators Safaricom, Airtel, Essar and Telkom Kenya Orange across the country using a questionnaire. To supplement and increase reliability, data was also collected from other ICT stakeholders such CAK, ICTA, submarine operators, ICT vendors, KBC and non ICT related firms Equity, Barclays and Kenya Power Company. The research found out that the level of ICT infrastructure sharing among mobile operators was low at 20.4%. The five key drivers were identified as new market entrants, cost optimization, environmental conservation, operators focus on core business and network deployment to underserved and un served areas. The five main challenges were lack of regulatory framework, high capital, complexity of the sharing process, high charges by infrastructure owners and operators unwillingness to share. The TOE framework can be adopted for ICT infrastructure sharing with organizational factors having a greater influence than technology and external factors. Operator controlled infrastructure rollout had worked previously but due to changes in local and global market, there was need to change the way ICT resources were utilized. To achieve quick wins, operators had to partner with competitors by leasing and undertaking joint ventures. Infrastructure sharing was beneficial hence strategies to promote the same by use of incentives license fee and tax concessions, having a legal framework, government investment in backbone infrastructure and attracting independent firms will ensure competitiveness and a knowledge economy status

Vision 2030 was developed by Kenya government as a roadmap for development. This aims to transform Kenya into a middle-income industrialized country and is anchored on three pillars: economic, social and political. This development is likely to be an illusion unless Kenya is able to achieve its educational goals. Education and training has been isolated in the vision 2030 as the only mechanism that will translate Kenya into a middle-income economy. The vision of education service provision is to have a globally competitive quality education, training and research for Kenya’s sustainable development. Countries that have succeeded in harnessing the potential of ICT have been said to have taken a positive step towards a greatly expanded economic growth, improved human welfare and stronger forms of democratic governance. It is in this regard that the Kenyan government has invested a lot of funds in ICT infrastructure including digitization of educational materials through Kenya Institute of Education. This is geared towards the improvement in the quality of education. The investment is likely not to bear fruits unless the training of teachers is put on the forefront. There should therefore be an emphasis of training teachers in ICT because they are the central forces in tapping the learning potentials created by ICT. Teachers for all levels from pre-primary to university must be trained in ICT if the vision is to be realized. The quality and orientation of education at each level and the link with the demand for skills are critical for mastering technology. Although research has suggested that part of the difficulty in adopting innovation or reform relates to teachers themselves, it is important to find out the part that the government is playing in teacher preparation in ICT in teaching and learning. The purpose of this study was to explore the ICT skills possessed by the ECD teachers. Further, the study explored the integration of ICT in teaching and learning of preschool children selected in Kenyan preschools. A researcher developed questionnaire was used to gather the required information from the ECD teachers who were in their training sessions. The sample consisted of 395 pre-school teachers. The findings indicated that majority (60.83%) of the teachers had no knowledge in ICT. The findings also indicated that only 13.01% of the ECD teachers had attended any seminar related to ICT compared to the majority (86.99) who had never attended. All the teachers felt that their teaching would be highly enhanced by ICT integration in teaching and learning. Based on these findings, it was recommended that there is need for the government to invest more in the training of pre-school teachers in ICT integration.
Key words: Information Communication and Technology, Early Childhood education, Teacher Training, Integration
 

OBJECTIVES

n/a

The study was motivated by the increasing challenges of climate variability and climate change, which create problems, such as food insecurity in Kitui County in Kenya. In the current digital age, ICTs are core to all sectors to facilitate access to and enhance efficiency across various services. Although the role of ICTs in improving life in Kenya is widely acknowledged, the focus of most ICT-related developments has been on human experiences at the level of disease and needs for communication and mobility. Less obvious is how such technological interventions may be used to address seemingly abstract yet grave concerns like climate change and its impact on the quality of human life. This study, therefore, investigated the various scenarios where ICTs were deployed in relaying relevant localized climate information to help rural women farmers in Kitui County to make relevant decisions to improve their farm productivity and their livelihoods by extension. The study incorporated an ICT system to the Sustainable Livelihoods Framework (SLF) that consisted of Digital Capital and ICT Tools, thereby improving on the SLF. This modified SLF, mainstreamed ICT-driven climate information and provided the ideal means by which such information was leveraged to ensure enhanced sustainable livelihoods. Gender and Development (GAD) theory, Bourdieu’s ideas of social capital theory, and the Information Needs Assessment Model (INAM) further strengthened the SLF by addressing household power dynamics and climate information relevance in the rural communities. The research drew from emerging variables to demonstrate that regardless of the context in which the SLF was formulated, its versatility makes it the most appropriate tool for such studies in rural Kenya. The specific objectives of this study were threefold: (1) to assess the extent to which rural women access and use ICT tools in the utilization of climate information including weather, seasonal forecasts and agro-advisories; (2) to analyze the extent to which the use of ICT-based climate information by rural women influence maximize access and utilization of livelihood assets; and (3) to examine the livelihood strategies employed with the increasing availability and use of ICT-based climate information. The author adopted a mixed-methods approach for data collection and analysis that was guided by the SLF. Specific methods used, apart from on-desk review, were a household survey of 419 respondents, 14 key informant interviews, and two focus group discussions. The study merged theoretical and applied research outcomes to narrow the gap between the theory and practice of ICTs use while linking it to climate information and enhanced rural livelihood strategies. The outcome from the research findings highlighted the need for interventions to empower rural women in the use of ICT tools in exploiting the full potential of climate information, the need for tailoring modern scientific climate information to local needs, translated into simple formats and the local Kikamba language, the need for complementary services such as affordable credit, insurance, livelihood diversification opportunities and access to livelihood assets that can further strengthen their household resilience to climate variability. The results show that community radios combined with mobile phones are the most accessible and cost-effective ICT tools for rural women’s access to real-time, relevant climate and agro-advisory information. There is evidence that the women’s livelihood strategies have been enhanced which strengthened their livelihood assets, thereby improving their livelihoods under the wider rubric of the sustainable livelihood framework. The contribution to knowledge for this research was an enhanced SLF where the various responses and systematic analysis made the framework relevant in gaining insights into the link between climate information and livelihood strategies through ICTs among women in ii rural communities in Kitui. The modified framework and the research findings are also timely in light of the increasing realization of ICTs potential in contributing to climate change adaptation and mitigation. Also, the thesis builds on the growing body of literature that generated a rich repository that other researchers can use to advance knowledge, and the outcomes are eight peer-reviewed articles. The output of this study is replicable to other counties in Kenya because rural households depend on agriculture for their livelihood and this economic sector is not exempt to climate change and variability necessitating the need for local specific climate information. The recommendations to the research are that it can be extended to examine outcomes that will look at improved income, sustainable resource utilization, and food security, physical and emotional wellbeing. Further we provide policy recommendations and made suggestions to shape future climate change adaptation policies, plans, and strategies in Kenya that integrates gender equality into ICT and climate change to help farmers adapt to climate change/variability for sustainable development. Keywords: ICT Tools; Digital Capital; Climate Information; Enhanced Sustainable livelihood Framework; Livelihood Strategies

Three fractions were isolated from the venom of Dendroaspis angusticeps by column chromatography on CM-Sephadex C-25. All the three fractions were shown to possess acetylcholinesterase inhibiting activity. The toxicity of the fractions as tested on mice were variable. Although the toxic signs were identical, fraction DaVI was highly lethal (LD50 1.9 microgram/g) whereas fractions DaIV and T39 were less lethal, the LD50 being 3.6 micrograms/g and 4.1 micrograms/g respectively. The three fractions significantly inhibited true acetylcholinesterase to the extent of 91-95%.

Waterbuck (Kobus defassa), an ungulate species endemic to the Eastern African savannah, is suspected of being a wildlife reservoir for tick-transmitted parasites infective to livestock. Waterbuck is infested by large numbers of Rhipicephalus appendiculatus, the tick vector for Theileria parva, and previous data suggests that the species may be a source of T. parva transmission to cattle. In the present study, a total of 86 cattle and 26 waterbuck blood samples were obtained from Marula, a site in Kenya endemic for East Coast fever (ECF) where the primary wildlife reservoir of T. parva the Cape buffalo (Syncerus caffer) is also common. To investigate for the presence of cattle-infective Theileria parasites, DNA specimens extracted from the blood samples were subjected to two diagnostic assays; a nested PCR based on the p104 gene that is specific for T. parva, and a reverse line blot (RLB) incorporating 13 oligonucleotide probes including all of the Theileria spp. so far described from livestock and wildlife in Kenya. Neither assay provided evidence of T. parva or Theileria sp. (buffalo) infection in the waterbuck DNA samples. By contrast, majority of the cattle samples (67.4%) were positive for T. parva using a nested PCR assay. The RLB assay, including a generic probe for the genus Theileria, indicated that 25/26 (96%) of the waterbuck samples were positive for Theileria, while none of the 11 Theileria species-specific probes hybridized with the waterbuck-derived PCR products. Phylogenetic analysis of 18S ribosomal RNA (18S rRNA) and internal transcribed spacer (ITS) sequences within the RLB-positive waterbuck samples revealed the occurrence of three Theileria genotypes of unknown identity designated A, B and C. Group A clustered with Theileria equi, a pathogenic Theileria species and a causative agent of equine piroplasmosis in domestic equids. However, DNA from this group failed to hybridize with the T. equi oligonucleotide present on the RLB filter probe, suggesting the occurrence of novel taxa in these animals. This was confirmed by DNA sequencing that revealed heterogeneity between the waterbuck isolates and previously reported T. equi genotypes. Group B parasites clustered closely with Theileria luwenshuni, a highly pathogenic parasite of sheep and goats reported from China. Group C was closely related to Theileria ovis, an apparently benign parasite of sheep. Together, these findings provided no evidence that waterbuck plays a role in the transmission of T. parva. However, novel Theileria genotypes detected in this bovid species may be of veterinary importance.

a-Galactosidase AgaB from Bacillus stearothermophilus displays a major a(1~6) and a minor a(1~3) regioselectivity in hydrolysis and transglycosylation. Its corresponding gene, agaB, was subjected to saturation mutagenesis at codon 442 in order to change its regioselectivity. The mutant genes were cloned and expressed in Escherichia coli using pBTac2 as vector. The regioselective activity of the mutants was determined using thin layer chromatography and nuclear magnetic resonance spectroscopy. A single point mutation, G442R, resulted in a mutant displaying an a(1~2) regioselectivity. Other amino acid substitutions at this site also gave mutants with altered regioselectivity and transglycosylation profiles. This is the first demonstration that single point mutations can lead to a strong modification of the regioselectivity of a glycosyl hydrolase. The kinetic parameters of the enzyme variants were determined and a preliminary investigation of possible substrates for condensation reactions conducted.

The aim of this study was to identify Aspergillus species isolated from maize kernels and soils of
maize fields of Nandi County using macro and micro morphological characteristics. A cross sectional
research design was used in the study and purposive sampling was employed to determine
districts of Nandi County and sub locations where sampling was done. This study was part of a
larger project whose aim was to survey aflatoxin exposure in the maize value chain. Aspergillus
species were isolated from maize and soil samples using quarter strength potato dextrose agar
and modified Rose Bengal agar respectively. Pure cultures of the isolates were sub cultured and
transferred onto differential media; malt extract agar, czapek yeast extract agar and czapek dox
agar for species identification using macro morphological characteristics. Fungal slides were prepared
from pure cultures on potato dextrose agar media after three days to identify micro morphological
characteristics. Based on morphological characteristics, seven sections of Aspergillus
namely: Flavi, Fumigati, Nigri, Circumdati, Clavati, Nidulantes and Candidi were identified. Aspergillus
section Flavi was the most predominant with 57% followed by section Nigri with 27% from
maize and 58% of section Flavi followed by 26% of section Nigri from the soil across the three locations.
Aspergillus sections Nidulantes and Candidi were rare and only recovered from the soil
samples of Kaptumo location. All the Aspergillius flavus that formed sclerotia both from the soils
or maize kernels were of the L strains. In conclusion Aspergillus section Flavi was most frequent
during the isolation process and dominated with Aspergillus flavus from both the maize and soil.
Morphological characteristics remain the primary tool for detection and identification of Aspergillus
species. The significance for high incidence of Aspergillus section Flavi is in regard to their
aflatoxin production profiles that poses a health threat to the community and it is of public health
concern. Morphological characteristics as a primary tool for Aspergillus identification should be
embraced and more personnel with the knowledge are required since modern and faster techniques
are scarce and expensive.

The BM86 antigen, originally identified in Rhipicephalus (Boophilus) microplus, is the basis of the only commercialized anti-tick vaccine. The long-term goal of our study is to improve BM86 based vaccines by induction of high levels of tick gut binding antibodies that are also cross-reactive with a range of BM86 homologues expressed in other important tick species. Here we have used a BD86 derived synthetic peptide, BD86-3, to raise a series of mouse monoclonal antibodies. One of these mAbs, named 12.1, recognized BM86 homologues in immuno-histochemical analyses in four out of five tick species including R. (B.) microplus, Rhipicephalus (Boophilus) decoloratus, Hyalomma anatolicum anatolicum and Rhipicephalus appendiculatus. Our results indicate that broadly cross-reactive tick gut binding antibodies can be induced after immunization with a synthetic peptide derived from the protein BD86.

Towers are typical structures that can be found in many urban and rural landscapes the world over. From their basic design, they are usually exposed to severe environmental loads. It is therefore prudent to carry out periodic maintenance that includes checking that they are correctly aligned. This paper describes a method that was used for the re-alignment of a guyed tower in Limuru, Kenya. Angular and distance observations, made from two observation points detected a vertical misalignment that was larger than the acceptable tolerance of l/400. An iterative re-alignment procedure was then applied, resulting in an acceptable final misalignment of 1 / 520.

Leucas calostachys is widely used in traditional medicine in Kenya for management of various ailments including malaria. Bio-assay guided fractionation of Leucas calostachys extracts was carried out using in-vitro antiplasmodial and β-hematin inhibition assays with semi-preparative high performance liquid chromatography (HPLC). The active methanol fraction was subjected to liquid chromatography tandem mass spectrometry to identify constituent compounds. A total of twenty compounds consisting of eight flavonoids and 12 phenylethanoids were identified from this fraction. The flavonoids included, isorhamnetin, luteolin-7-O-glucoside, luteolin-4′-O-glucoside, luteolin diglucoside, apigenin-O-glucoside, genistein-O-glucoside, chrysoeriol-7-O-glucoside, and chrysoeriol-7-O-glucuronide. Seven of the phenylethanoids were identified as acteoside, isoactoeside, hydroxyacteoside, forthsoside B, samioside, alyssonoside and leucoseptoside A. The antimalarial activity of Leucas calostachys could be linked to presence of flavonoids and phenylethanoids.

Groundwater is a natural resource of the earth that sustains and supports domestic, agricultural and industrial activities. It is distributed fairly and evenly throughout the world and over half of the world’s population depends on groundwater for drinking water supplies. Its usage is increasing due to rapid population growth, high rate of urbanization, industrial growth and agricultural utilizations. This has resulted to rapid depletion of groundwater which leads to water stress and degradation of these resources. The situation is further worsened by inadequate information on groundwater resource which has been and is still a big obstacle to the proper management of these resources. Remote sensing and GIS techniques have emerged as very effective and reliable tools in the assessment, monitoring and conservation of groundwater resources. This paper has made an attempt to identify and delineate groundwater potential zones in Lake Chala Basin in Kenya using Remote sensing and GIS. In the process of groundwater delineation in the area, different thematic maps on lithology, land use/land cover, drainage density, slope and rainfall were prepared, assigned with different weighting values as per their importance on groundwater occurrence and overlaid using spatial analyst tool in ArcGis 10 to generate groundwater potential map. The generated groundwater potential zone map was classified into four groundwater potential zones namely, very high, high, moderate and low. The study revealed that the area has very high groundwater potential. The generated groundwater potential map will be used for further groundwater exploration, proper planning, sustainable utilization and management of groundwater resources in the Lake Chala Watershed.

Upregulation of hypoxia-inducible factors HIF-1 and HIF-2 is frequent in human cancers and may result from tissue hypoxia or genetic mechanisms, in particular the inactivation of the von Hippel-Lindau (VHL) tumour suppressor gene (TSG). Tumours with VHL inactivation are highly vascular, but it is unclear to what extent HIF-dependent and HIF-independent mechanisms account for pVHL tumour suppressor activity. As the identification of novel pVHL targets might provide insights into pVHL tumour suppressor activity, we performed gene expression microarray analysis in VHL-wild-type and VHL-null renal cell carcinoma (RCC) cell lines. We identified 30 differentially regulated pVHL targets (26 of which were 'novel') and the results of microarray analysis were confirmed in all 11 novel targets further analysed by real-time RT-PCR or Western blotting. Furthermore, nine of 11 targets were dysregulated in the majority of a series of primary clear cell RCC with VHL inactivation. Three of the nine targets had been identified previously as candidate TSGs (DOC-2/DAB2, CDKN1C and SPARC) and all were upregulated by wild-type pVHL. The significance for pVHL function of two further genes upregulated by wild-type pVHL was initially unclear, but re-expression of GNG4 (G protein gamma-4 subunit/guanine nucleotide-binding protein-4) and MLC2 (myosin light chain) in a RCC cell line suppressed tumour cell growth. pVHL regulation of CDKN1C, SPARC and GNG4 was not mimicked by hypoxia, whereas for six of 11 novel targets analysed (including DOC-2/DAB2 and MLC2) the effects of pVHL inactivation and hypoxia were similar. For GPR56 there was evidence of a tissue-specific hypoxia response. Such a phenomenon might, in part, explain organ-specific tumorigenesis in VHL disease. These provide insights into mechanisms of pVHL tumour suppressor function and identify novel hypoxia-responsive targets that might be implicated in tumorigenesis in both VHL disease and in other cancers with HIF upregulation.

von Hippel-Lindau (VHL) disease is a dominantly inherited family cancer syndrome characterized by the development of retinal and central nervous system haemangioblastomas, renal cell carcinoma (RCC) and phaeochromocytoma. Specific germline VHL mutations may predispose to haemangioblastomas, RCC and phaeochromocytoma to a varying extent. Although dysregulation of the hypoxia-inducible transcription factor-2 and JunB have been linked to the development of RCC and phaeochromocytoma, respectively, the precise basis for genotype-phenotype correlations in VHL disease have not been defined. To gain insights into the pathogenesis of RCC in VHL disease we compared gene expression microarray profiles in a RCC cell line expressing a Type 1 or Type 2B mutant pVHL (RCC-associated) to those of a Type 2A or 2C mutant (not associated with RCC). We identified 19 differentially expressed novel VHL target genes linked to RCC development. Eight targets were studied in detail by quantitative real-time polymerase chain reaction (three downregulated and five upregulated by wild-type VHL) and for six genes the effect of VHL inactivation was mimicked by hypoxia (but hypoxic-induction of smooth muscle alpha-actin 2 was specific for a RCC cell line). The potential role of four RCC-associated VHL target genes was assessed in vitro. NB thymosin beta (TMSNB) and proteinase-activated receptor 2 (PAR2) (both downregulated by wt pVHL) increased cell growth and motility in a RCC cell line, but aldehyde dehydrogenase (ALDH)1 and ALDH7 had no effect. These findings implicate TMSNB and PAR2 candidate oncogenes in the pathogenesis of VHL-associated RCC.

The diversity of traditional foods in Kisumu West District of Western Kenya was assessed with an aim to identify the foods with a potential for complementary feeding. Leaves were the most consumed plant part amongst vegetables, while a few fruits were consumed together with their seeds. Amaranthus cruentus L. was found to be consumed as a leafy vegetable while another variety, Amaranthus hybridus L. was found to be consumed as a grain. Four species of winged termites, a grasshopper, black ant and dagaa fish were also identified. Twelve of the traditional foods were found to be associated with nutritional and health benefits as perceived by the locals. Traditional food processing methods such as boiling, fermentation and sun drying were identified. Thus exploitation of the species possessing nutrient, health and processing benefits needs to be explored in complementary feeding.

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J Acquir Immune Defic Syndr. 2012 Feb 1;59(2):185-93. doi: 10.1097/QAI.0b013e31823d8693.
Identifying at-risk populations in Kenya and South Africa: HIV incidence in cohorts of men who report sex with men, sex workers, and youth.
Price MA, Rida W, Mwangome M, Mutua G, Middelkoop K, Roux S, Okuku HS, Bekker LG, Anzala O, Ngugi E, Stevens G, Chetty P, Amornkul PN, Sanders EJ.
Source
Department of Medical Affairs, International AIDS Vaccine Initiative, New York, NY, USA. mprice@iavi.org
Abstract
OBJECTIVE:
To identify and describe populations at risk for HIV in 3 clinical research centers in Kenya and South Africa.
DESIGN:
Prospective cohort study.
METHODS:
Volunteers reporting recent sexual activity, multiple partners, transactional sex, sex with an HIV-positive partner, or, if male, sex with men (MSM; in Kenya only) were enrolled. Sexually active minors were enrolled in South Africa only. Risk behavior, HIV testing, and clinical data were obtained at follow-up visits.
RESULTS:
From 2005 to 2008, 3023 volunteers were screened, 2113 enrolled, and 1834 contributed data on HIV incidence. MSM had the highest HIV incidence rate of 6.8 cases per 100 person-years [95% confidence interval (CI): 4.9 to 9.2] followed by women in Kilifi and Cape Town (2.7 cases per 100 person-years, 95% CI: 1.7 to 4.2). No seroconversions were observed in Nairobi women or men in Nairobi or Cape Town who were not MSM. In 327 MSM, predictors of HIV acquisition included report of genital ulcer (Hazard Ratio: 4.5, 95% CI: 1.7 to 11.6), not completing secondary school education (HR: 3.4, 95% CI: 1.6 to 7.2) and reporting receptive anal
intercourse (HR: 8.2, 95% CI: 2.7 to 25.0). Paying for sex was inversely associated with HIV infection (HR: 0.2, 95% CI: 0.04 to 0.8). 279 (13.0%) volunteers did not return after the first visit; subsequent attrition rates ranged from 10.4 to 21.8 volunteers per 100 person-years across clinical research centers.
CONCLUSIONS:
Finding, enrolling, and retaining risk populations for HIV prevention trials is challenging in Africa. African MSM are not frequently engaged for research, have high HIV incidence, need urgent risk reduction counseling, and may represent a suitable population for future HIV prevention trials.

To identify and describe populations at risk for HIV in 3 clinical research centers in Kenya and South Africa. DESIGN: Prospective cohort study. METHODS: Volunteers reporting recent sexual activity, multiple partners, transactional sex, sex with an HIV-positive partner, or, if male, sex with men (MSM; in Kenya only) were enrolled. Sexually active minors were enrolled in South Africa only. Risk behavior, HIV testing, and clinical data were obtained at follow-up visits. RESULTS: From 2005 to 2008, 3023 volunteers were screened, 2113 enrolled, and 1834 contributed data on HIV incidence. MSM had the highest HIV incidence rate of 6.8 cases per 100 person-years [95% confidence interval (CI): 4.9 to 9.2] followed by women in Kilifi and Cape Town (2.7 cases per 100 person-years, 95% CI: 1.7 to 4.2). No seroconversions were observed in Nairobi women or men in Nairobi or Cape Town who were not MSM. In 327 MSM, predictors of HIV acquisition included report of genital ulcer (Hazard Ratio: 4.5, 95% CI: 1.7 to 11.6), not completing secondary school education (HR: 3.4, 95% CI: 1.6 to 7.2) and reporting receptive anal intercourse (HR: 8.2, 95% CI: 2.7 to 25.0). Paying for sex was inversely associated with HIV infection (HR: 0.2, 95% CI: 0.04 to 0.8). 279 (13.0%) volunteers did not return after the first visit; subsequent attrition rates ranged from 10.4 to 21.8 volunteers per 100 person-years across clinical research centers. CONCLUSIONS: Finding, enrolling, and retaining risk populations for HIV prevention trials is challenging in Africa. African MSM are not frequently engaged for research, have high HIV incidence, need urgent risk reduction counseling, and may represent a suitable population for future HIV prevention trials.

Introduction: Cochrane Eyes and Vision (CEV) is an international network of individuals working to prepare, maintain and promote access to systematic reviews of interventions to treat, prevent or diagnose eye diseases or vision impairment. CEV plans to undertake a priority setting exercise to identify systematically research questions relevant to our scope, and to formally incorporate input from a wide range of stakeholders to set priorities for new and updated reviews.

Methods and analysis: The scope of CEV is broad and our reviews include conditions that are common and have a high global disease burden, for example, cataract and dry eye disease, and conditions that are rare but have a high impact on quality of life and high individual cost such as eye cancer. We plan to focus on conditions prioritised by WHO during the development of the Package of Eye Care Interventions. These conditions were selected based on a combination of data on disease magnitude, healthcare use and expert opinion. We will identify priority review questions systematically by summarising relevant data on research in Eyes and Vision from a range of sources, and compiling a list of 10-15 potential review questions (new and/or updates) for each condition group. We will seek the views of external and internal stakeholders on this list by conducting an online survey. Equity will be a specific consideration.

Ethics and dissemination: The study has been approved by the ethics committee of the London School of Hygiene & Tropical Medicine. We will disseminate the findings through Cochrane channels and prepare a summary of the work for publication in a peer-reviewed journal.

Background
Globally, 15 million infants are born preterm each year, and 1 million die due to complications of prematurity. Over 60% of preterm births occur in Sub-Saharan Africa and south Asia. Care at birth for premature infants may be critical for survival and long term outcome. We conducted a prospective audit to assess whether women giving birth preterm could be identified, and to describe cord clamping and neonatal care at hospitals in Africa and south Asia.

Methods
This prospective audit of livebirths was conducted at six hospitals in Uganda, Kenya, India and Pakistan. Births were considered preterm if between 28+ 0 and 33+ 6 weeks gestation and/or the birthweight was 1.00 to 1.99 kg. A pre-specified audit plan was agreed with each hospital. Livebirths before 28 weeks gestation with birthweight less than 1.0 kg were excluded. Data were collected on estimated and actual gestation and birthweight, cord clamping, and neonatal care.

Results
Of 4149 women who gave birth during the audit, data were available for 3687 (90%). As 107 were multiple births, 3781 livebirths were included, of which 257 (7%) were preterm. Antenatal assessment correctly identified 148 infants as ‘preterm’ and 3429 as ‘term’, giving a positive predictive value of 72% and negative predictive value of 97%. For term births, cord clamping was usually later at the two Ugandan hospitals, median time to clamping 50 and 76 s, compared with 23 at Kenyatta (Kenya), 7 at CMC (India) and 12 at FBH/LNH (Pakistan). At the latter two, timing was similar between term and preterm births, and between vaginal and Caesarean births. For all the hospitals, the cord was clamped quickly at Caesarean births, with Mbale (Uganda) having the highest median time to clamping (15 s ‘term’, 19 ‘preterm’). For preterm infants temperature on admission to the neonatal unit was below 35.5 °C for 50%, and 59 (23%) died before hospital discharge.

Conclusions
Antenatal identification of preterm birth was good. Timing of cord clamping varied between hospitals, although at each there was no difference between ‘term’ and ‘preterm’ births. For premature infants hypothermia was common, and mortality before hospital discharge was high.

An 11-month old male infant presented with dry idiopathic peripheral gangrene (IPG) of both feet. Subsequently spontaneous autoamputation occurred and the stump healed. Including this patient, 8 cases of IPG under 12 years of age seen at the Kenyatta National Hospital between 1978 and 1986 were analysed. 5 were males and 3 were females. All the 8 children except one had an illness preceding IPG. The literature is reviewed and the management is discussed

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