Nairobi was established more than 100 years ago as a transit point for the Uganda
Railway. The Uganda railway was built by the British Colonial Administration, to link Mombasa on the
Indian Ocean coast with Lake Victoria in the interior of East Africa, in order to extract natural resources. In
1900 commissioner Charles Eliot introduced hut tax, and encouraged European settlement based upon a
policy of integrated development. However the advent of the first European settlers swiftly changed this
vision, and separate development was established as policy. These were the beginnings of social, economic
and spatial exclusions. By the end of the Second World War, most of the land in Nairobi had been
privatised, making it almost impossible for any inclusive civic development to take place.
At independence in 1963, the restriction of the movement of Africans was relaxed, creating a large influx
of people into the city. These people were excluded from main stream formal operations of the city, and
had to survive from their own `wits’. In recent times, neo-liberal policies have had no meaningful impact
on the provision of urban services to the poor. The reduced role of the state has created a haven for
privateers to exploit the urban poor. In the process an informal modernism has emerged in Nairobi, where
moneyed developers build 8-10 storey rental business cum residential blocks, further marginalising the
poor. This paper further argues that for there to be any meaningful progress, the state should provide
subsidised rental housing for the poor, as they are unable to get into the home ownership bracket based on
market rates.

Catechol O-methyltransferase (COMT) inactivates neurotransmitters, hormones and drugs such as levodopa. COMT activity is inherited in an autosomal recessive manner and individuals with low activity have thermolabile COMT protein. A low activity allele has been demonstrated at codon 108/158 of the soluble and membrane bound COMT protein, respectively, whereby a G to A transition results in a valine to methionine substitution, rendering the protein more thermolabile. As ethnic differences in erythrocyte COMT activity have been previously demonstrated, the frequency of low activity alleles were investigated in 265 British Caucasian, 99 British South-west Asian and 102 Kenyan individuals. Genotyping of COMT codon 108/158 was performed using a minisequencing method. Erythrocyte COMT activity was measured in 60 British Caucasian individuals by radiochemical assay. The frequency of low activity alleles was 0.54 in Caucasians, 0.49 in South-west Asians, and 0.32 in Kenyans. There was a much lower frequency of individuals with homozygous low activity allele in the Kenyan population (9%) than in Caucasians (31%) or South-west Asians (27%). Erythrocyte COMT activity was lower and less thermostable in individuals with homozygous low activity alleles. The data provide molecular evidence that low COMT is less common in African individuals than the Caucasian population. PMID: 9682265 [PubMed - indexed for MEDLINE]

Burning refuse, especially plastics and other hazardous waste that affect air quality has been a common practice. Authorities point to a well balanced environmental past. During those good old days, people used to be able to throw garbage away. And garbage actually went "away." As they pose, Where is "away" now? "Away" is here. "Away" is someone's back yard. There is no place to go from here. We now see that we inhabit a smaller and smaller planet. "Away" has become very close indeed. Based on preliminary findings of a continuing research, and having used case study approaches to isolate pertinent issues, secondary data obtained through stratified random sampling points to unsustainable livelihoods. This papers objective was to highlight this problem from an eco-ethical perspective. The effect of lack of eco-ethics is numerous. From the very cradle of evolution, nature has been propagating to man in subtle ways the message 'use but don't abuse'. The ancient Bible has a message: After God created the Garden of Eden, Adam and Eve, He took the two of them around and told them 'See the world I created, it is all for you, don't spoil it because no one will be there to restore it', (Genesis 2:15). This is probably the first and strongest statement, based upon which Humankind later developed ideas of nature and ecological ethics. Data reveals that humanity and designers, the case of this study, has ignored their responsibility to nurture their environment. This paper concludes that mankind has got a responsibility to future generations in the process of their current development endeavours.

The idea of the existence of an African Architecture has been problematic over the years since the onset of European occupation. Early scholars of non-Western built forms saw them as not constituting architecture but as shelter or mere dwellings (Oliver, 1987). Others classed these built forms as primitive or indigenous architecture (Guidoni, 1987 Gardi, 1973)while others have classed built forms on the African continent as African Architecture (Kultermann, 1969).Globally, most indigenous societies build their structures using local resources and quite often adapted to the climate of the locality. In addition, traditional built forms tend to respect historical precedents and local customary practices. In this regard, it can be argued that traditional architecture is green architecture without the benefits of sophisticated technologies. The above notwithstanding, most Western architecture imported to the continent, had little regard for local practices and quite often ignored local climate. In attempting to train architects for contemporary practice, this paper argues for hybrid architecture. This is because there is no current pure African architecture in existence. What happened over time was the Africanisation of Western and Eastern architectural models to suit the African condition. The resultant architecture has been a hybrid of these various architectures, what Mazrui refers to as the Triple African Heritage. This architecture is a spatial counter form for the contemporary African society and can be seen to be authentic

OBJECTIVE: To determine the levels of both TSA and HD antibody in sera of patients with various malignancies and evaluate their potential role as diagnostic and/ or prognostic markers. DESIGN: Laboratory based analysis. SETTINGS: Kenyatta National Hospital, Kenya Medical Research Institute and the Department of Biochemistry, University of Nairobi. SUBJECTS: A total of 909 serum samples, 420 from cancer patients recruited at Kenyatta National Hospital and 509 from normal blood donors recruited at Nairobi Hospital. RESULTS: The mean age for the patients and controls was 36 and 37 years respectively. Carcinoma patients constituted 54%, sarcoma 12.1%, lymphoma 16.4% and 17.4% had other types of tumours. The mean TSA in patients was 0.86 mg/ml +/- 0.026 compared to 0.82 mg/ml +/- 0.014 in controls. The TSA level was significantly higher in patients compared to controls (Student's t-test p = 0.031 at 0.05 confidence level). The TSA increased with age in both study groups. In patient sera, both gender gave the same mean of 0.83 mg/ml while it was 0.82 mg/ml and 0.83 mg/ml in control females and in males respectively. Sarcomas had the highest amount of 0.93 mg/ml but there was no significant statistical variation between tumour types (p = 0.076). The HD antibody mean readings were 0.004 in pathologic sera compared to 0.011 in controls. The values were significantly elevated in patients (p = 0.03) with females giving a higher value for both study groups (p = 0.628). HD antibody readings was significantly higher in carcinomas (p = 0.017) compared to those of sarcomas and lymphomas. There was no association between antibody readings and age of patient (p = 0.601). CONCLUSION: Both TSA and HD antibody values were significantly elevated in patients compared to clinically healthy controls and while TSA levels increased with age and was independent of gender, HD antibody levels were independent of age, gender and also tumour type. The study demonstrates that although TSA is normally elevated in malignancy, most of the sialic acid shed is of N-acetyl type as some patients do not express HD antibody directed to the N-glycolyl sialic acid. The reason why some tumours would express Neu5Gc at any one time needs further evaluation.

OBJECTIVE: To determine the levels of both TSA and HD antibody in sera of patients with various malignancies and evaluate their potential role as diagnostic and/ or prognostic markers. DESIGN: Laboratory based analysis. SETTINGS: Kenyatta National Hospital, Kenya Medical Research Institute and the Department of Biochemistry, University of Nairobi. SUBJECTS: A total of 909 serum samples, 420 from cancer patients recruited at Kenyatta National Hospital and 509 from normal blood donors recruited at Nairobi Hospital. RESULTS: The mean age for the patients and controls was 36 and 37 years respectively. Carcinoma patients constituted 54%, sarcoma 12.1%, lymphoma 16.4% and 17.4% had other types of tumours. The mean TSA in patients was 0.86 mg/ml +/- 0.026 compared to 0.82 mg/ml +/- 0.014 in controls. The TSA level was significantly higher in patients compared to controls (Student's t-test p = 0.031 at 0.05 confidence level). The TSA increased with age in both study groups. In patient sera, both gender gave the same mean of 0.83 mg/ml while it was 0.82 mg/ml and 0.83 mg/ml in control females and in males respectively. Sarcomas had the highest amount of 0.93 mg/ml but there was no significant statistical variation between tumour types (p = 0.076). The HD antibody mean readings were 0.004 in pathologic sera compared to 0.011 in controls. The values were significantly elevated in patients (p = 0.03) with females giving a higher value for both study groups (p = 0.628). HD antibody readings was significantly higher in carcinomas (p = 0.017) compared to those of sarcomas and lymphomas. There was no association between antibody readings and age of patient (p = 0.601). CONCLUSION: Both TSA and HD antibody values were significantly elevated in patients compared to clinically healthy controls and while TSA levels increased with age and was independent of gender, HD antibody levels were independent of age, gender and also tumour type. The study demonstrates that although TSA is normally elevated in malignancy, most of the sialic acid shed is of N-acetyl type as some patients do not express HD antibody directed to the N-glycolyl sialic acid. The reason why some tumours would express Neu5Gc at any one time needs further evaluation.

Bull.Anim.Hlth.Prod.Afr.,(2007),55,292-295

A specific, relatively sensitive, quantitative and standardized enzyme-linked immunosorbent assay (ELISA) procedure was developed for the detection of heterophile Hanganutziu and Deicher (HD) antibodies which are occasionally elevated in pathologic human sera. The HD antigen-active molecule used for the assay was a ganglioside (N-glycolylneuraminyllactosylceramide, abbreviated as NeuGc-LacCer) previously purified from horse erythrocyte membranes. The test used antigen-coated plastic microtiter plates and anti-human immunoglobulin G (IgG, Fab fragment) conjugated with alkaline phosphatase. Fifty-four normal human sera gave ELISA values ranging from -2 to 2%. Random sera from hospitalized patients were first screened by the horse erythrocyte hemagglutination (HA) test, whereby 5.7% (76 cases) gave abnormal HA titers of 128-4096 compared to titers in normal sera equal to or less than 64. Ninety-seven % of the patients' sera gave abnormal ELISA values (3-200%). They were classified into 3 groups: cancer (42 cases), infection (10 cases), and others (24 cases). The potential value of this ELISA method is discussed.

In present times, the use of DG systems in large amounts in different power distribution systems has become very popular and is growing on with fast speed. Although it is considered that DG reduces losses and improves system voltage profile, this paper shows that this is not always true. The paper presents a GA-IPSO based approach which utilizes combined sensitivity factor analogy to optimally locate and size a multi-type DG in IEEE 57-bus test system with the aim of reducing power losses and improving the voltage profile. The multi-type DG can operate as; type 1 DG (DG generating real power only), type 2 DG (DG generating both real and active power) and type 3 DG (DG generating real power and absorbing reactive power). It further shows that though the system losses are reduced and the voltage profile improved with the location of the first DG, as the number of DGs increases this is not the case. It reaches a point where any further increase in number of DGs in the network results to an increase in power losses and a distortion in voltage profile.

Hepatocellular carcinoma results when cancerous cells are localized in the liver. It is distributed globally with high prevalence in sub-Saharan African, southern Asia, China and Japan. Diagnosis is experimental and in many cases inaccurate due to unreliability of markers. Prognosis is poor and the cost of treatment prohibitive. Conventional radiation and chemotherapy lead to loss of hair, fertility and general weakening of the body`s immune system increasing a patient`s risk to infection. These observations underscore the need for improved, or additional methods of cancer diagnosis and management. We investigated the effect of polysaccharide rich Pleurotus pulmonarius fruit body extracts on progression of chemically induced hepatocellular carcinoma in CBA mice. Addition of Pleurotus pulmonarius extracts in diet delayed progression of carcinogenesis suggesting

OBJECTIVE: To determine the levels of both TSA and HD antibody in sera of patients with various malignancies and evaluate their potential role as diagnostic and/ or prognostic markers. DESIGN: Laboratory based analysis. SETTINGS: Kenyatta National Hospital, Kenya Medical Research Institute and the Department of Biochemistry, University of Nairobi. SUBJECTS: A total of 909 serum samples, 420 from cancer patients recruited at Kenyatta National Hospital and 509 from normal blood donors recruited at Nairobi Hospital. RESULTS: The mean age for the patients and controls was 36 and 37 years respectively. Carcinoma patients constituted 54%, sarcoma 12.1%, lymphoma 16.4% and 17.4% had other types of tumours. The mean TSA in patients was 0.86 mg/ml +/- 0.026 compared to 0.82 mg/ml +/- 0.014 in controls. The TSA level was significantly higher in patients compared to controls (Student's t-test p = 0.031 at 0.05 confidence level). The TSA increased with age in both study groups. In patient sera, both gender gave the same mean of 0.83 mg/ml while it was 0.82 mg/ml and 0.83 mg/ml in control females and in males respectively. Sarcomas had the highest amount of 0.93 mg/ml but there was no significant statistical variation between tumour types (p = 0.076). The HD antibody mean readings were 0.004 in pathologic sera compared to 0.011 in controls. The values were significantly elevated in patients (p = 0.03) with females giving a higher value for both study groups (p = 0.628). HD antibody readings was significantly higher in carcinomas (p = 0.017) compared to those of sarcomas and lymphomas. There was no association between antibody readings and age of patient (p = 0.601). CONCLUSION: Both TSA and HD antibody values were significantly elevated in patients compared to clinically healthy controls and while TSA levels increased with age and was independent of gender, HD antibody levels were independent of age, gender and also tumour type. The study demonstrates that although TSA is normally elevated in malignancy, most of the sialic acid shed is of N-acetyl type as some patients do not express HD antibody directed to the N-glycolyl sialic acid. The reason why some tumours would express Neu5Gc at any one time needs further evaluation.

Hepatocellular carcinoma results when cancerous cells are localized in the liver. It is distributed globally with high prevalence in sub-Saharan African, southern Asia, China and Japan. Diagnosis is experimental and in many cases inaccurate due to unreliability of markers. Prognosis is poor and the cost of treatment prohibitive. Conventional radiation and chemotherapy lead to loss of hair, fertility and general weakening of the body's immune system increasing a patient's risk to infection. These observations underscore the need for improved, or additional methods of cancer diagnosis and management. We investigated the effect of polysaccharide rich Pleurotus pulmonarius fruit body extracts on progression of chemically induced hepatocellular carcinoma in CBA mice. Addition of Pleurotus pulmonarius extracts in diet delayed progression of carcinogenesis suggesting that these extracts may be useful as adjuvants to conventional cancer therapies.

A specific, relatively sensitive, quantitative and standardized enzyme-linked immunosorbent assay (ELISA) procedure was developed for the detection of heterophile Hanganutziu and Deicher (HD) antibodies which are occasionally elevated in pathologic human sera. The HD antigen-active molecule used for the assay was a ganglioside (N-glycolylneuraminyllactosylceramide, abbreviated as NeuGc-LacCer) previously purified from horse erythrocyte membranes. The test used antigen-coated plastic microtiter plates and anti-human immunoglobulin G (IgG, Fab fragment) conjugated with alkaline phosphatase. Fifty-four normal human sera gave ELISA values ranging from -2 to 2%. Random sera from hospitalized patients were first screened by the horse erythrocyte hemagglutination (HA) test, whereby 5.7% (76 cases) gave abnormal HA titers of 128-4096 compared to titers in normal sera equal to or less than 64. Ninety-seven % of the patients' sera gave abnormal ELISA values (3-200%). They were classified into 3 groups: cancer (42 cases), infection (10 cases), and others (24 cases). The potential value of this ELISA method is discussed.

Post-colonial Nairobi has experienced a rapid urbanization rate averaging 5 per cent per annum from 1963 to the present. The planning framework inherited from the colonial regime and little changed after Independence has not been able to cope with the increased demand for urban goods and services. This has made it necessary for Nairobi residents to seek and source these through informal processes. The informal processes have in turn generated an informal urban process, but since these processes are not homogenous this paper argues for the case of informal urbanisms. The paper traces the origins of informality and argues that informality is not illegal. The paper then examines the informalization of Buru Buru a middle-income estate built in the 1970s and early 1980s. The under provision of social facilities/amenities in this estate has resulted in the residents making alterations and extensions to their dwellings as a mitigating intervention.

OBJECTIVE: To determine the levels of both TSA and HD antibody in sera of patients with various malignancies and evaluate their potential role as diagnostic and/ or prognostic markers. DESIGN: Laboratory based analysis. SETTINGS: Kenyatta National Hospital, Kenya Medical Research Institute and the Department of Biochemistry, University of Nairobi. SUBJECTS: A total of 909 serum samples, 420 from cancer patients recruited at Kenyatta National Hospital and 509 from normal blood donors recruited at Nairobi Hospital. RESULTS: The mean age for the patients and controls was 36 and 37 years respectively. Carcinoma patients constituted 54%, sarcoma 12.1%, lymphoma 16.4% and 17.4% had other types of tumours. The mean TSA in patients was 0.86 mg/ml +/- 0.026 compared to 0.82 mg/ml +/- 0.014 in controls. The TSA level was significantly higher in patients compared to controls (Student's t-test p = 0.031 at 0.05 confidence level). The TSA increased with age in both study groups. In patient sera, both gender gave the same mean of 0.83 mg/ml while it was 0.82 mg/ml and 0.83 mg/ml in control females and in males respectively. Sarcomas had the highest amount of 0.93 mg/ml but there was no significant statistical variation between tumour types (p = 0.076). The HD antibody mean readings were 0.004 in pathologic sera compared to 0.011 in controls. The values were significantly elevated in patients (p = 0.03) with females giving a higher value for both study groups (p = 0.628). HD antibody readings was significantly higher in carcinomas (p = 0.017) compared to those of sarcomas and lymphomas. There was no association between antibody readings and age of patient (p = 0.601). CONCLUSION: Both TSA and HD antibody values were significantly elevated in patients compared to clinically healthy controls and while TSA levels increased with age and was independent of gender, HD antibody levels were independent of age, gender and also tumour type. The study demonstrates that although TSA is normally elevated in malignancy, most of the sialic acid shed is of N-acetyl type as some patients do not express HD antibody directed to the N-glycolyl sialic acid. The reason why some tumours would express Neu5Gc at any one time needs further evaluation.

OBJECTIVE: To determine whether herpes simplex virus type 2 (HSV-2) infection was associated with risk of intrapartum human immunodeficiency virus type 1 (HIV-1) transmission and to define correlates of HSV-2 infection among HIV-1-seropositive pregnant women. METHODS: We performed a nested case control study within a perinatal cohort in Nairobi, Kenya. Herpes simplex virus type 2 serostatus and the presence of genital ulcers were ascertained at 32 weeks of gestation. Maternal cervical and plasma HIV-1 RNA and cervical HSV DNA were measured at delivery. RESULTS: One hundred fifty-two (87%) of 175 HIV-1-infected mothers were HSV-2-seropositive. Among the 152 HSV-2-seropositive women, nine (6%) had genital ulcers at 32 weeks of gestation, and 13 (9%) were shedding HSV in cervical secretions. Genital ulcers were associated with increased plasma HIV-1 RNA levels (P=.02) and an increased risk of intrapartum HIV-1 transmission (16% of transmitters versus 3% of nontransmitters had ulcers; P = .003), an association which was maintained in multivariable analysis adjusting for plasma HIV-1 RNA levels (P=.04). We found a borderline association for higher plasma HIV-1 RNA among women shedding HSV (P=.07) and no association between cervical HSV shedding and either cervical HIV-1 RNA levels or intrapartum HIV-1 transmission (P=.4 and P=.5, [corrected] respectively). CONCLUSION: Herpes simplex virus type 2 is the leading cause of genital ulcers among women in sub-Saharan Africa and was highly prevalent in this cohort of pregnant women receiving prophylactic zidovudine. After adjusting for plasma HIV-1 RNA levels, genital ulcers were associated with increased risk of intrapartum HIV-1 transmission. These data suggest that management of HSV-2 during pregnancy may enhance mother-to-child HIV-1 prevention efforts. LEVEL OF EVIDENCE: II

Centre for Clinical Research, Kenya Medical Research Institute, Nairobi, Kenya. walson@u.washington.edu
BACKGROUND: Much of the burden of morbidity affecting women of childbearing age in sub-Saharan Africa occurs in the context of HIV-1 infection. Understanding patterns of illness and determinants of disease in HIV-1-infected mothers may guide effective interventions to improve maternal health in this setting. METHODS: We describe the incidence and cofactors of comorbidities affecting peripartum and postpartum HIV-1-infected women in Kenya. Women were evaluated by clinical examination and standardized questionnaires during pregnancy and for up to 2 years after delivery. RESULTS: Five hundred thirty-five women were enrolled in the cohort (median CD4 count of 433 cells/mm) and accrued 7736 person-months of follow-up. During 1-year follow-up, the incidence of upper respiratory tract infections was 161 per 100 person-years, incidence of pneumonia was 33 per 100 person-years, incidence of tuberculosis (TB) was 11 per 100 person-years, and incidence of diarrhea was 63 per 100 person-years. Immunosuppression and HIV-1 RNA levels were predictive for pneumonia, oral thrush, and TB but not for diarrhea; CD4 counts <200 cells/mm(3) were associated with pneumonia (relative risk [RR] = 2.87, 95% confidence interval [CI]: 1.71 to 4.83), TB (RR = 7.14, 95% CI: 2.93 to 17.40) and thrush. The risk of diarrhea was significantly associated with crowding (RR = 1.86, 95% CI: 1.19 to 2.92) and breast-feeding (RR = 1.71, 95% CI: 1.19 to 2.44). Less than 10% of women reported hospitalization during 2-year follow-up; mortality risk in the cohort was 1.9% and 4.8% for 1 and 2 years, respectively. CONCLUSIONS: Mothers with HIV-1, although generally healthy, have substantial morbidity as a result of common infections, some of which are predicted by immune status or by socioeconomic factors. Enhanced attention to maternal health is increasingly important as HIV-1-infected mothers transition from programs targeting the prevention of mother-to-child transmission to HIV care clinics.
PMID: 17667334 [PubMed - indexed for MEDLINE]

OBJECTIVES: To describe the early response to World Health Organization (WHO)-recommended nonnucleoside reverse transcriptase inhibitor (NNRTI)-based first-line highly active antiretroviral therapy (HAART) in HIV-1-infected Kenyan children unexposed to nevirapine. DESIGN: Observational prospective cohort. METHODS: HIV-1 RNA level, CD4 lymphocyte count, weight for age z score, and height for age z score were measured before the initiation of HAART and every 3 to 6 months thereafter. Children received no nutritional supplements. RESULTS: Sixty-seven HIV-1-infected children were followed for a median of 9 months between August 2004 and November 2005. Forty-seven (70%) used zidovudine, lamivudine (3TC), and an NNRTI (nevirapine or efavirenz), whereas 25% used stavudine (d4T), 3TC, and an NNRTI. Nevirapine was used as the NNRTI by 46 (69%) children, and individual antiretroviral drug formulations were used by 63 (94%), with only 4 (6%) using a fixed-dose combination of d4T, 3TC, and nevirapine (Triomune; Cipla, Mumbai, India). In 52 children, the median height for age z score and weight for age z score rose from -2.54 to -2.17 (P<0.001) and from -2.30 to -1.67 (P=0.001), respectively, after 6 months of HAART. Hospitalization rates were significantly reduced after 6 months of HAART (17% vs. 58%; P<0.001). The median absolute CD4 count increased from 326 to 536 cells/microL (P<0.001), the median CD4 lymphocyte percentage rose from 5.8% before treatment to 15.4% (P<0.001), and the median viral load fell from 5.9 to 2.2 log10 copies/mL after 6 months of HAART (P<0.001). Among 43 infants, 47% and 67% achieved viral suppression to less than 100 copies/mL and 400 copies/mL, respectively, after 6 months of HAART. CONCLUSION: Good early clinical and virologic response to NNRTI-based HAART was observed in HIV-1-infected Kenyan children with advanced HIV-1 disease.
PMID: 17356470 [PubMed - indexed for MEDLINE]

Department of Epidemiology, University of Washington, Seattle, Washington 98104, USA. jbalkus@u.washington.edu
OBJECTIVES: The objectives of this study were to determine patterns of contraceptive utilization among sexually active HIV-1-seropositive women postpartum and to identify correlates of hormonal contraception uptake. GOAL: The goal of this study was to improve delivery of family planning services to HIV-1-infected women in resource-limited settings. STUDY DESIGN: HIV-1-infected pregnant women were followed prospectively in a perinatal HIV-1 transmission study. Participants were referred to local clinics for contraceptive counseling and management. RESULTS: Among 319 HIV-1-infected women, median time to sexual activity postpartum was 2 months and 231 (72%) women used hormonal contraception for at least 2 months during follow-up, initiating use at approximately 3 months postpartum (range, 1-11 months). Overall, 101 (44%) used DMPA, 71 (31%) oral contraception, and 59 (25%) switched methods during follow-up. Partner notification, infant mortality, and condom use were similar between those using and not using contraception. CONCLUSIONS: Using existing the healthcare infrastructure, it is possible to achieve high levels of postpartum hormonal contraceptive utilization among HIV-1-seropositive women.
PMID: 16691159 [PubMed - indexed for MEDLINE]

Objective: Benign prostatic hyperplasia (BPH) incidence and progression has been shown to vary by race, geography and ethnicity with African-Americans having a more aggressive disease than other races. Combination drug therapy has been shown to be a favorable option for medical therapy of symptomatic BPH but data is lacking on the effects of this therapy in black race patients locally. This study aims to assess the early (six months) response, by both International-Prostate Symptom Score (IPSS) and peak urinary flow rate (QMax), to combination drug therapy of Tamsulosin and Dutasteride for management of symptomatic BPH in a predominantly African black race population cohort as a pilot study.
Patients and Methods: Dutasteride 0.5mg and Tamsulosin 0.4mg once daily were administered orally to 52 patients aged 45years and above of black race with confirmed BPH for six months. The main outcome measures of change in mean QMax and IPSS were assessed at three months and six months. Secondary outcome measures were mean Total Prostate Specific Antigen (tPSA) and Prostate Volume (PV) changes. Drug compliance by Modified Morisky Scores (1) and adverse/side effects reported were documented. Paired sample t test and Pearson correlation as well as ANOVA were used to analyze the data.
Results: There was a statistically and clinically significant increase in mean QMax by 13.3ml/sec and decrease in mean IPSS by 14.5 points at six months. There was a fairly rapid reduction in mean Total PSA of 0.9ng/ml as early as two months and a slower fall in mean PV of 10.224mls most evident at the last follow-up. Safety and tolerability of the drugs was consistent with previous experience and majority of the patients portrayed an excellent drug compliance profile.
Conclusion: These results suggest the efficacy of combination drug therapy of Dutasteride and Tamsulosin for moderate-to-severe BPH in the black race. These patients seem to have a more drastic and rapid mean IPSS, QMax and PV response to therapy than reported for other races but their mean total PSA decrease was less. Combination drug therapy is therefore recommended as a useful alternative to surgery in management of BPH in the black race.
Key Words: Benign Prostatic Enlargement, Urinary flow rate, Prostate Specific Antigen, IPSS
Corresponding Author: Professor J.S. Oliech Professor of General Surgery/Urology
Department Of Surgery, University Of Nairobi, Nairobi, Kenya.Email:

A composite thin film consisting of TiO2 (binder), uniformly mixed CuFeMnO4 paint (solar absorber) was coated on textured aluminum sheets by dip coating. The film’s elemental analysis was done using energy dispersive x-ray (EDX) and the surface of the film characterized using scanning electron microscope (SEM). Optical properties of the TiO2/CuFeMnO4 composite film were also studied using computerized double beam solid-spec 3700 DUV Shimadzu Spectrophotometer. Reflectance was obtained by spectrophotometric measurements, and thermal emmittance was determined using heat flux- based technique respectively. Reflectance measurement values less than 0.03 in the solar wavelength (290 nm < λ < 2500 nm) and low thermal emmittance less than 0.016 for temperatures between 24°C and 100°C were obtained.