As part of a study to assess zoonotic milk-borne health risks, seasonal survey data and unpasteurized milk samples were collected between January 1999 and February 2000 from randomly selected informal milk market agents (220 and 236 samples in the dry and wet seasons, respectively) and from households purchasing raw milk (213 and 219 samples in the dry and wet seasons, respectively) in rural and urban locations in Central Kenya and screened for antibiotics, Brucella abortus (B. abortus) and presence of Escherichia coli (E. coli 0157:H7).The latter was assessed based on samples from consumer households only. Antibodies to B. abortus were screened using the indirect antibody Enzyme Linked Immunosorbent Assay (ELISA) and the Milk Ring Test (MRT). The presence of E. coli 0157:H7 was assessed by culture, biochemical characterization, serological testing for production of verocytotoxin one (VTI) and two (VT2) and polymerase chain reaction (PCR) analysis for the presence of genes encoding for the toxins.                                                                                                         The prevalence of antibodies to B.abortus varied considerably ranging from none in milk sold in small units and originating from intensive production systems to over 10% in samples that were bulked or originating from extensive production systems. E. coli 0157:H7 was isolated from two samples (0.8%), one of which produced VTI. All urban consumers (100%) and nearly all rural consumers (96%) of marketed milk boiled the milk before consumption, mainly in tea, thus reducing chances of exposure to live pathogens and potential health risks.

OBJECTIVE: To determine the pattern and characteristics of patients admitted with firearm injuries (FAIs) and establish the morbidity and mortality associated with these injuries. DESIGN: Retrospective cross-sectional study. SETTING: Kenyatta National Hospital (KNH), January 2004 to December 2005. SUBJECTS: All patients admitted with physically evident firearm injury. RESULTS: There were a total of 717 patients recorded with FAIs constituting 0.6% of the total number of patients seen in the casualty. Of these, 421 (58.7%) were admitted and treated as in- patients. A firearm was used in 6.7% of the 6300 assault cases recorded in 2004 and in 9.7% of the 3079 cases recorded in 2005. The increase from 6.7% in 2004 to 9.7% in 2005 was statistically significant (p < 0.05). There were 370 (87.9%) males and 49 (11.6%) females giving a male to female ratio of 7.5:1. The mean age was 29.7 +/- 10.9 years with a range of 3 to 66 years. At least 262 (62.2%) of the 421 admitted FAI casualties were treated under general anaesthesia (GA). The average duration of operation per patient was 2 +/- 1.5 hours. CONCLUSION: FAIs are on the increase and affect all age groups but is largely a disease of a young male adult in the 3rd and 4th decade of life. Mortality is higher with increasing age while female victims are fewer but on average six years younger than males. The lower extremities are the commonest target among the survivors. However, abdominal wounds tend to be the most lethal, accounting for greater mortality.

OBJECTIVE: To determine the pattern and characteristics of patients admitted with firearm injuries (FAIs) and establish the morbidity and mortality associated with these injuries. DESIGN: Retrospective cross-sectional study. SETTING: Kenyatta National Hospital (KNH), January 2004 to December 2005. SUBJECTS: All patients admitted with physically evident firearm injury. RESULTS: There were a total of 717 patients recorded with FAIs constituting 0.6% of the total number of patients seen in the casualty. Of these, 421 (58.7%) were admitted and treated as in- patients. A firearm was used in 6.7% of the 6300 assault cases recorded in 2004 and in 9.7% of the 3079 cases recorded in 2005. The increase from 6.7% in 2004 to 9.7% in 2005 was statistically significant (p < 0.05). There were 370 (87.9%) males and 49 (11.6%) females giving a male to female ratio of 7.5:1. The mean age was 29.7 +/- 10.9 years with a range of 3 to 66 years. At least 262 (62.2%) of the 421 admitted FAI casualties were treated under general anaesthesia (GA). The average duration of operation per patient was 2 +/- 1.5 hours. CONCLUSION: FAIs are on the increase and affect all age groups but is largely a disease of a young male adult in the 3rd and 4th decade of life. Mortality is higher with increasing age while female victims are fewer but on average six years younger than males. The lower extremities are the commonest target among the survivors. However, abdominal wounds tend to be the most lethal, accounting for greater mortality.

The effect of acqueous extract of the tuber of Adenia globosa on the isolated preparation of the rat uterus was determined. The crude drug caused a dose-dependent contraction of the tissue preparation. This action was enhanced by a small dose of oxytocin. The results are discussed in relation to the traditional uses of this plant.

Normal 0 false false false EN-US X-NONE X-NONE MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin-top:0in; mso-para-margin-right:0in; mso-para-margin-bottom:10.0pt; mso-para-margin-left:0in; line-height:115%; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:Calibri; mso-fareast-theme-font:minor-latin; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;} This study was conducted in two seasons of2002 at Tigoni, Central Kenya to determine effectiveness of insecticides; neern  extract and mineral oil in managing potato aphids and their associated virus diseases. The treatments were arranged in  randomized complete block design (RCBD) with four replications. In each season, the number of aphids in five randomly  selected plants per treatment was recordced in situ. Virus symptoms (i.ncidence) were scored and expressed as a percentage  to the total plant population per plot. Forty-five days after emergence, 10 plants each from guard rows and inner rows were  randomly selected and serologically assayed for Potato Virus Y (PVY) and Potato Leaf Roll Virus (PLRV) using DAS ELISA test. Results showd that three aphid species Aphis gossypii (Glover), Macrosiphum euphorbiae (Thomas) and Myzus persicae (Sulzer) colonized on the variety with A. gossypii being the most dominant while M. persicae was least.  Higher aphid population coincided with the short rains experienced in one of the seasons. Synthetic insecticides (Bifethrin  and dimethoate) were the most effective among the treatments in reducing aphid infestation while the neem extract and mineral oil (DC- Tron) had no significant (P<0.05) difference. However, mineral-oil treated plots recorded the lowest PVY  incidence while bifenthrin-Ireated plots had the lowest PLRV incidence. It is suggested that a combination of synthetic  insecticides and mineral oil could playa major role in reduction of the aphids and their associated vectors. Normal 0 false false false EN-US X-NONE X-NONE MicrosoftInternetExplorer4

Chloris roxburghiana is an important rangeland grass in Kenya. In some areas it has disappeared due to land degradation resulting from overgrazing and drought. Efforts to re-introduce the grass through re-seeding using seeds from research stations have had little success. One possible reason for low establishment is attributed to transplanting since spatially separated populations may represent genetically distinct ecotypes. To test this hypothesis, germplasm diversity within and among four populations of C. roxburghiana from four ecologically distinct sites was analyzed using random amplified polymorphic DNA (RAPD) markers. A total of 131 polymorphic markers were identified using nine RAPD primers. There was significant variation among populations with genetic diversity (He) ranging from 0.142 to 0.193. Twenty four percent of the variation observed was due to differentiation among the populations, compared to 76 percent accounted for by variation within populations. The UPGMA of the population frequency indicated that the four populations of C. roxburghiana were genetically distinct, probably as a result of variation in soil fertility, geographical isolation and socio-ecological history of the study sites. The implication for optimizing future seed collection is discussed and potential areas for further studies identified.

PURPOSE: To build capacity in the resource-poor setting to support the clinical investigation and treatment of AIDS-related malignancies in a region of the world hardest hit by the AIDS pandemic. METHODS: An initial MEDLINE database search for international collaborative partnerships dedicated to AIDS malignancies in developing countries failed to identify any leads. This search prompted us to report progress on our collaboration in this aspect of the epidemic. Building on the formal Uganda-Case Western Reserve University (Case) Research Collaboration dating back to 1987, established NIH-supported centers of research excellence at Case, and expanding activities in Kenya, scientific and training initiatives, research capital amongst our institutions are emerging to sustain a international research enterprise focused on AIDS and other viral-related malignancies. RESULTS: A platform of clinical research trials with pragmatic design has been developed to further enhance clinical care and sustain training initiatives with partners in East Africa and the United States. An oral chemotherapy feasibility trial in AIDS lymphoma is near completion; a second lymphoma trial of byrostatin and vincristine is anticipated and a feasibility trial of indinavir for endemic Kaposi's sarcoma is planned. CONCLUSIONS: In the absence of published reports of evolving international partnerships dedicated to AIDS malignancy in resource constrained settings, we feel it important for such progress on similar or related international collaborative pursuits to be published. The success of this effort is realized by the long-term international commitment of the collaborating investigators and institutions to sustain this effort in keeping with ethical and NIH standards for the conduct of research; the provision of formal training of investigators and research personnel on clinical problems our East African partners are faced with in practice and the development of pragmatic clinical trials and therapeutic intervention to facilitate technology transfer and enhance clinical practice.

PMID: 15829373 [PubMed - indexed for MEDLINE]

PURPOSE: To build capacity in the resource-poor setting to support the clinical investigation and treatment of AIDS-related malignancies in a region of the world hardest hit by the AIDS pandemic. METHODS: An initial MEDLINE database search for international collaborative partnerships dedicated to AIDS malignancies in developing countries failed to identify any leads. This search prompted us to report progress on our collaboration in this aspect of the epidemic. Building on the formal Uganda-Case Western Reserve University (Case) Research Collaboration dating back to 1987, established NIH-supported centers of research excellence at Case, and expanding activities in Kenya, scientific and training initiatives, research capital amongst our institutions are emerging to sustain a international research enterprise focused on AIDS and other viral-related malignancies. RESULTS: A platform of clinical research trials with pragmatic design has been developed to further enhance clinical care and sustain training initiatives with partners in East Africa and the United States. An oral chemotherapy feasibility trial in AIDS lymphoma is near completion; a second lymphoma trial of byrostatin and vincristine is anticipated and a feasibility trial of indinavir for endemic Kaposi's sarcoma is planned. CONCLUSIONS: In the absence of published reports of evolving international partnerships dedicated to AIDS malignancy in resource constrained settings, we feel it important for such progress on similar or related international collaborative pursuits to be published. The success of this effort is realized by the long-term international commitment of the collaborating investigators and institutions to sustain this effort in keeping with ethical and NIH standards for the conduct of research; the provision of formal training of investigators and research personnel on clinical problems our East African partners are faced with in practice and the development of pragmatic clinical trials and therapeutic intervention to facilitate technology transfer and enhance clinical practice.

PMID: 15829373 [PubMed - indexed for MEDLINE]

Department of Haematology and Blood Transfusion, College of Health Sciences, University of Nairobi, Kenya. PMID: 16619688 [PubMed - indexed for MEDLINE]

Department of Haematology and Blood Transfusion, College of Health Sciences, University of Nairobi, Kenya. PMID: 16619688 [PubMed - indexed for MEDLINE]

Department of Haematology and Blood Transfusion, Kenyatta National Hospital and the University of Nairobi College of Health Sciences, Kenya. OBJECTIVES: To describe the clinical characteristics of Burkitt's lymphoma (BL) from three regions in Kenya at different altitudes with a view towards understanding the contribution of local environmental factors. DESIGN: Prospective cross-sectional study. SETTING: Kenyatta National Hospital and seven provincial hospitals in Kenya. METHOD: Histologically proven cases of Burkitt's lymphoma in patients less than 16 years of age were clinically examined and investigated. MAIN OUTCOME MEASURES: For every case the following parameters were documented: chief complaint(s); physical examination, specifically pallor, jaundice, oedema, lymphadenopathy, presence of masses, splenomegaly and hepatomegaly. Reports of evaluation of chest radiograph, abdominal ultrasound/scan, bone marrow aspiration, cerebral spinal fluid cytology, liver and kidney function tests, urinalysis, stool occult blood and full blood count results. Stage of disease was assigned A, B, C or D. Cases of BL from three provinces of Kenya with diverse geographical features were analysed: Central, Coast, and Western. RESULTS: This study documented 471 BL cases distributed as follows: Central 61 (males 39 and 22 females), M:F ratio 1.8:1; Coast 169 (111 males and 58 females), M:F ratio 1.9:1; and Western 241 (140 males and 101 females), M:F ratio 1.4:1. The major presenting complaints were: abdominal swelling–Central 36%, Coast 4% and Western 26%; swelling on the face–Central 31%, Coast 81% and Western 64%; and proptosis–Central 3%, Coast 1% and Western 9%. The mean duration of these complaints in weeks were Central 6.9, Coast 6.08, and Western 5.05. The initial physical finding was a tumour mass in 39%, 72% and 54% of cases for Central, Coast and Western respectively. Tumour stage at diagnosis was: stage A–Central 21%, Coast 43% and Western 34%; stage B–Central 10%, Coast 5% and Western 10%; stage C–Central 41%, Coast 34% and Western 30%; and stage D–Central 28%, Coast 17% and Western 26%. For the age and sex matched cases the results show that commonly involved sites were: abdomen–Central 35%, Coast 9% and Western 14%; jaw (mandible)–Central 24%, Coast 22% and Western 31%; maxilla–Central 6%, Coast 24% and Western 11%; and lymph nodes–Central 10%, Coast 4% and Western 8%. The disease stage was A–Central 33%, Coast 44% and Western 36%; stage B–Central 11%, Coast 10% and Western 27%; stage C–Central 39%, Coast 34% and Western 27%; and stage D–Central 21%, Coast 13% and Western 37%. CONCLUSION: This study shows that clinical features of childhood BL vary with geographical region. The variations are documented in proportion of jaw, maxilla, abdominal and lymph nodal sites involvement. The differences observed are potentially due to the local environmental factors within these provinces. BL cases from Western province had features, intermediate between endemic and sporadic. Coastal province BL cases were similar to endemic BL, while BL cases from Central province resembled more or less sporadic BL subtypes. Strategies to explain and investigate the local environmental factors associated with the observed differences may certainly contribute towards improved understanding and clinical management of BL.

Department of Haematology and Blood Transfusion, Kenyatta National Hospital and the University of Nairobi College of Health Sciences, Kenya. OBJECTIVES: To describe the clinical characteristics of Burkitt's lymphoma (BL) from three regions in Kenya at different altitudes with a view towards understanding the contribution of local environmental factors. DESIGN: Prospective cross-sectional study. SETTING: Kenyatta National Hospital and seven provincial hospitals in Kenya. METHOD: Histologically proven cases of Burkitt's lymphoma in patients less than 16 years of age were clinically examined and investigated. MAIN OUTCOME MEASURES: For every case the following parameters were documented: chief complaint(s); physical examination, specifically pallor, jaundice, oedema, lymphadenopathy, presence of masses, splenomegaly and hepatomegaly. Reports of evaluation of chest radiograph, abdominal ultrasound/scan, bone marrow aspiration, cerebral spinal fluid cytology, liver and kidney function tests, urinalysis, stool occult blood and full blood count results. Stage of disease was assigned A, B, C or D. Cases of BL from three provinces of Kenya with diverse geographical features were analysed: Central, Coast, and Western. RESULTS: This study documented 471 BL cases distributed as follows: Central 61 (males 39 and 22 females), M:F ratio 1.8:1; Coast 169 (111 males and 58 females), M:F ratio 1.9:1; and Western 241 (140 males and 101 females), M:F ratio 1.4:1. The major presenting complaints were: abdominal swelling–Central 36%, Coast 4% and Western 26%; swelling on the face–Central 31%, Coast 81% and Western 64%; and proptosis–Central 3%, Coast 1% and Western 9%. The mean duration of these complaints in weeks were Central 6.9, Coast 6.08, and Western 5.05. The initial physical finding was a tumour mass in 39%, 72% and 54% of cases for Central, Coast and Western respectively. Tumour stage at diagnosis was: stage A–Central 21%, Coast 43% and Western 34%; stage B–Central 10%, Coast 5% and Western 10%; stage C–Central 41%, Coast 34% and Western 30%; and stage D–Central 28%, Coast 17% and Western 26%. For the age and sex matched cases the results show that commonly involved sites were: abdomen–Central 35%, Coast 9% and Western 14%; jaw (mandible)–Central 24%, Coast 22% and Western 31%; maxilla–Central 6%, Coast 24% and Western 11%; and lymph nodes–Central 10%, Coast 4% and Western 8%. The disease stage was A–Central 33%, Coast 44% and Western 36%; stage B–Central 11%, Coast 10% and Western 27%; stage C–Central 39%, Coast 34% and Western 27%; and stage D–Central 21%, Coast 13% and Western 37%. CONCLUSION: This study shows that clinical features of childhood BL vary with geographical region. The variations are documented in proportion of jaw, maxilla, abdominal and lymph nodal sites involvement. The differences observed are potentially due to the local environmental factors within these provinces. BL cases from Western province had features, intermediate between endemic and sporadic. Coastal province BL cases were similar to endemic BL, while BL cases from Central province resembled more or less sporadic BL subtypes. Strategies to explain and investigate the local environmental factors associated with the observed differences may certainly contribute towards improved understanding and clinical management of BL.

This paper investigates the possibilities of applying emerging management theories and techniques to constitutionally created offices in Kenya and East African region. The benefits from application of these theories, particularly in the judicial services are highlighted.

This paper investigates the possibilities of applying emerging management theories and techniques to constitutionally created offices in Kenya and East African region. The benefits from application of these theories, particularly in the judicial services are highlighted.

No abstract available

A study was conducted in fourty randomly selected herds in a peri-urban area in the Central Kenyan highlands to obtain prevalence estimates of sarcoptic mange in pigs kept by smallholder farmers. A total of 476 pigs of various age-group categories were enrolled in the study. Diagnosis was based on physical examination for clinical signs indicative of mange infestation and on direct detection of Sarcoptes scabiei mites. Ninety per cent of the herds had clinical signs suggestive of sarcoptic mange and in 70% of the herds Sarcoptes scabiei var suis was positively identified. The results also indicated that 273 (57.3%) of the 476 pigs had clinical signs indicative of sarcoptic mange and 90 (18.9%) of the 476 pigs were positive for Sarcoptes scabiei var suis. The hypersensitive form of mange was more common than the chronic form. The direct examination technique to detect Sarcoptes scabiei var suis was more effective in weaners than in the other age categories of pigs. The results indicate that sarcoptic mange is a common problem in smallholder pig herds in Kikuyu Division of Kiambu District, Kenya.

A study was conducted in fourty randomly selected herds in a peri-urban area in the Central Kenyan highlands to obtain prevalence estimates of sarcoptic mange in pigs kept by smallholder farmers. A total of 476 pigs of various age-group categories were enrolled in the study. Diagnosis was based on physical examination for clinical signs indicative of mange infestation and on direct detection of Sarcoptes scabiei mites. Ninety per cent of the herds had clinical signs suggestive of sarcoptic mange and in 70% of the herds Sarcoptes scabiei var suis was positively identified. The results also indicated that 273 (57.3%) of the 476 pigs had clinical signs indicative of sarcoptic mange and 90 (18.9%) of the 476 pigs were positive for Sarcoptes scabiei var suis. The hypersensitive form of mange was more common than the chronic form. The direct examination technique to detect Sarcoptes scabiei var suis was more effective in weaners than in the other age categories of pigs. The results indicate that sarcoptic mange is a common problem in smallholder pig herds in Kikuyu Division of Kiambu District, Kenya.

Forty-two pigs in a herd of 117 displayed various clinical signs of progressive atrophic rhinitis. The main signs included sneezing, coughing, lachrymation, serous to mucopurulent nasal discharge, and nasal bleeding in 1 pig. Three pigs had lateral deviation of the snout, while 4 had brachygnathia superior with obvious deformation of the face. Four acutely affected weaner pigs appeared weak, while the 7 chronically-affected pigs appeared smaller than their apparently unaffected penmates of the same age. Treatment of the acutely affected pigs with long-acting oxytetracycline at 20 mg/kg body weight intramuscularly, repeated once after 7 days, reduced the severity but did not clear the sneezing from all the pigs. Fifteen pigs were slaughtered 2 months after the clinical diagnosis was made. The carcasses of the chronically affected pigs were about 15% lighter than those of the apparently normal pigs of the same age and from the same pen, which translated to a loss of 921.00 Kenya shillings per pig (US$13.7). Diagnosis of progressive atrophic rhinitis was confirmed by sectioning the snouts of randomly selected slaughtered pigs with obvious deformation of the snout. Sections were made at the level of the 1st/2nd upper premolar tooth. Varying degrees of turbinate atrophy, from mild to complete, were noted. Histopathology of the turbinates revealed metaplasia of nasal epithelium and fibrosis in the lamina propria.

This case report describes an outbreak of acute dermatophilosis in a large scale dairy herd and highlights that the disease in Kenya could occur in outbreak proportions and in clinically severe form as has been reported in other countries in West and central Africa.We believe that this is the 1st documented outbreak of a severe form of bovine cutaneous dermatophilosis in exotic dairy animals in Kenya.

This report concerns an outbreak that occurred during July/August 1997. Ten pigs from a herd of 181 pigs in a medium-scale, semi-closed piggery in Kiambu District, Kenya, contracted the clinical disease. The main clinical findings in affected pigs included: fever (40.5-41.8 degrees C), prostration, inappetence, dog-sitting posture, abortion, erythema and raised, firm to the touch and easily palpated light pink to dark purple diamond-shaped to square/rectangular spots on the skin around the belly and the back. Based on the pathognomonic skin lesions, a clinical diagnosis of swine erysipelas was made. The diagnosis was confirmed by the isolation of Erysipelothrix rhusiopathiae organisms from the blood and skin biopsies taken from the affected pigs. Response to treatment with a combination of procaine penicillin and dihydrostreptomycin at the dosage rate of 20,000 IU/kg body weight (based on procaine penicillin) for 3 days was good and all the affected pigs recovered fully. The farm was placed under quarantine to prevent spread of the disease

This report concerns an outbreak that occurred during July/August 1997. Ten pigs from a herd of 181 pigs in a medium-scale, semi-closed piggery in Kiambu District, Kenya, contracted the clinical disease. The main clinical findings in affected pigs included: fever (40.5-41.8 degrees C), prostration, inappetence, dog-sitting posture, abortion, erythema and raised, firm to the touch and easily palpated light pink to dark purple diamond-shaped to square/rectangular spots on the skin around the belly and the back. Based on the pathognomonic skin lesions, a clinical diagnosis of swine erysipelas was made. The diagnosis was confirmed by the isolation of Erysipelothrix rhusiopathiae organisms from the blood and skin biopsies taken from the affected pigs. Response to treatment with a combination of procaine penicillin and dihydrostreptomycin at the dosage rate of 20,000 IU/kg body weight (based on procaine penicillin) for 3 days was good and all the affected pigs recovered fully. The farm was placed under quarantine to prevent spread of the disease

Forty-two pigs in a herd of 117 displayed various clinical signs of progressive atrophic rhinitis. The main signs included sneezing, coughing, lachrymation, serous to mucopurulent nasal discharge, and nasal bleeding in 1 pig. Three pigs had lateral deviation of the snout, while 4 had brachygnathia superior with obvious deformation of the face. Four acutely affected weaner pigs appeared weak, while the 7 chronically-affected pigs appeared smaller than their apparently unaffected penmates of the same age. Treatment of the acutely affected pigs with long-acting oxytetracycline at 20 mg/kg body weight intramuscularly, repeated once after 7 days, reduced the severity but did not clear the sneezing from all the pigs. Fifteen pigs were slaughtered 2 months after the clinical diagnosis was made. The carcasses of the chronically affected pigs were about 15% lighter than those of the apparently normal pigs of the same age and from the same pen, which translated to a loss of 921.00 Kenya shillings per pig (US$13.7). Diagnosis of progressive atrophic rhinitis was confirmed by sectioning the snouts of randomly selected slaughtered pigs with obvious deformation of the snout. Sections were made at the level of the 1st/2nd upper premolar tooth. Varying degrees of turbinate atrophy, from mild to complete, were noted. Histopathology of the turbinates revealed metaplasia of nasal epithelium and fibrosis in the lamina propria.

A retrospective study of 42 patients with perforations of the oesophagus during the period 1981-1987 indicated that 57.1% of the perforations were iatrogenic. Diseases of the oesophagus and in contiguous structures and foreign bodies in the oesophagus caused perforations in 31% of the cases. Perforations in 35.7% of the patients were located in the middle third of the oesophagus. The lower and upper thirds were affected in 31% of the patients in each site. The presenting physical signs included tachycardia (78.6%), fever (76.2%) and dyspnoea (59.5%). The main accompanying symptoms were chest pain and coughs in 100% and in 50% of the patients respectively. Radiographic findings showed hydropneumothorax in 40.5% of the cases and consolidation in 38.1% of the patients. Oesophagoscopy was positive in 78% of cases tested while thoracocentesis was positive in all cases that were tested.

Department of Medicine, College of Health Sciences, University of Nairobi. Characteristics of 14 patients above 12 years of age with congenital polycystic liver disease attending liver clinic at KNH were analysed. The diagnosis was mainly based on ultrasonographic findings. The disease was found predominantly among the Kikuyu ethnic group with a female/male ratio of 6:1 and the peak age at presentation was in the 5th decade. The liver function tests were essentially normal in all cases with no complication directly relating to liver disease. Hypertension was found in 78.6% of cases and chronic renal failure in 35.7% of cases. There was an associated polycystic disease in at least one other abdominal organ in all cases.

Bacillus cereus strains were tested for production of diarrheal enterotoxin by the reverse passive latex agglutination test and for presence of B. cereus enterotoxin gene (bceT) by polymerase chain reaction. About 50% of 56 B. cereus strains reacted positive in broth culture in the reverse passive latex agglutination test, while the bceT gene was detected in 41.1 % of the strains. A 741 bp probe prepared from the polymerase chain reaction product detected bceT gene in all strains that were positive with the polymerase chain reaction. This study indicated a likelihood of two or more enterotoxins being produced by B. cereus which may be involved in causing diarrheal type food poisoning.

No abstract available.

ABSTRACTObjective: Dental wastes are material that has been utilized in dental clinics, which are no longerwanted for use and therefore discarded. Improper disposal of these dental wastes can cause harmto the dentist, the people in immediate vicinity of the dentist, waste handlers and general publicand the environment through production of toxins or as by products of the destruction process.This study aims to determine the knowledge, attitudes and practice on management of dentalwastes among dental practitioners in Nairobi, Kenya.Methods: Descriptive cross-sectional study of 70 dental practitioners practicing in Nairobi,Kenya.Results: A total of 50 dental practitioners were included in the study. Majority had graduatedbetween 1991-1995. 47.5% had only a bachelors degree, 25% had masters 7.5% had PhD and12.5% had postgraduate diploma. Forty five percent of the respondents indicated they haveattended training on management of dental waste while 89.5% had been attending continuousdental education. Forty-two percent of the respondents worked in public institution while the restwere in private practice. Only 48.7% of the practitioners were aware of the existence of wastemanagement guidelines. Only 64% felt it was important to follow the set guidelines, 5% thought itwas tedious, 2% said they were not practical and the rest were not interested in the guidelines.Eighty-two percent of the respondents said that amalgam was toxic if disposed improperly withonly 10.7% indicating pollution to be a consequence of improper disposal of amalgam. Seventysevenpercent of the respondents did not know the hazardous effects of improper disposal ofamalgam. Only half of the respondents stored waste amalgam under water, 25% said they did notknow how to dispose amalgam. All (100%) knew about occurrence of cross-infection withimproper disposal of bloody waste but only 56.1% said they incinerated bloody body waste while24.4% disposed off bloody waste with general waste 35.7% of the respondents indicated thatsharps were hazardous if improperly disposed. Only 52.4% incinerated their pathological wasted.On expired drugs, 7.3% disposed them off as part of general wastes.Conclusion: There is need for continuous professional development on waste management amongdentists in Kenya.

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OBJECTIVE–To determine the efficacy of the nonoxynol 9 contraceptive sponge in preventing sexual acquisition of the human immunodeficiency virus (HIV). DESIGN–Prospective, randomized placebo-controlled trial. SETTING–Research clinic for prostitutes in Nairobi, Kenya. PATIENTS AND INTERVENTIONS–One hundred thirty-eight HIV-seronegative women were enrolled, of whom 74 were assigned to nonoxynol 9 sponge use and 64 to placebo use. These two groups did not significantly differ with respect to demographic characteristics, sexual practices, or prevalence of genital infections at enrollment, except for a lower number of sex partners per week and a higher initial prevalence of genital ulcers among women assigned to nonoxynol 9 sponge use. Among the 116 women who returned for follow-up, the mean durations of follow-up were 14 and 17 months for the two groups, respectively. MAIN OUTCOME MEASURE–HIV seroconversion. RESULTS–Nonoxynol 9 sponge use was associated with an increased frequency of genital ulcers (relative risk [RR], 3.3; P less than .0001) and vulvitis (RR, 3.3; P less than .0001) and a reduced risk of gonococcal cervicitis (RR, 0.4; P less than .0001). Twenty-seven (45%) of 60 women in the nonoxynol 9 sponge group and 20 (36%) of 56 women in the placebo group developed HIV antibodies. The hazard ratio for the association between nonoxynol 9 sponge use and HIV seroconversion was 1.7 (95% confidence interval [CI], 0.9 to 3.0). Using multivariate analysis to control for the presence of genital ulcers at enrollment, the adjusted hazard ratio for the association between nonoxynol 9 sponge use and seroconversion was 1.6 (95% CI, 0.8 to 2.8). CONCLUSIONS–Genital ulcers and vulvitis occurred with increased frequency in nonoxynol 9 sponge users. We were unable to demonstrate that nonoxynol 9 sponge use was effective in reducing the risk of HIV infection among highly exposed women.

Routine procedures used to isolate Haemophilus ducreyi in a busy laboratory are reported. Identification was based on colony morphology and nutritional and biochemical properties of 120 fresh isolates of H. ducreyi. These isolates grew very well on Gonococcal Agar and Mueller-Hinton Agar incubated at 34 degrees C in candle extinction jars containing moistened filter paper. Colonies varied in size, giving a polymorphic appearance. They were smooth, dome-shaped, and buff-yellow to grey in colour, and measured 2 mm in diameter. They could be pushed intact across the agar surface. By microscopic examination of gram-stained smears the isolates were gram-negative coccobacilli arranged in short chains, clumps or whorls and occasionally in typical "rail track" arrangements. Individual bacteria showed bipolar staining. Colonies autoagglutinated in saline. All strains were catalase-negative and did not produce indole or H2S. They were oxidase- and beta-lactamase positive and required X but not V factor for growth. Now that reliable techniques have been developed and characteristics established it is possible for most clinical laboratories to isolate and identify this organism from most patients with chancroid.

Department of Paediatrics, College of Health Sciences, University of Nairobi. Causes of death of 239 children below the age of 5 years in a rural community were determined using structured questionnaires. It was found that mortality was highest in infancy, accounting for 63% of all deaths with a trend of decreasing mortality with increasing age. The commonest cause of death was ARI (pneumonia and measles) accounting for 49% of the deaths, followed by diarrhoeal illnesses (8.8%). Only half of the deaths (51.5%) occurred at some health facility, though 77% of all children had been taken to a health facility for treatment during the fatal illness. PMID: 2076684 [PubMed - indexed for MEDLINE]

OBJECTIVE: To determine the impact on neutrophils if adriamycin is administered at 60 mg/m2 and cyclophosphamide at 600/m2 (AC 60/600); and at 50 mg/m2 and 500 mg/m2 (50/500) in the treatment of breast cancer. DESIGN: Restrospective analysis of nadir neutrophil counts in female mammary carcinoma patients treated with adriamycin/cyclophosphamide combination. SETTING: Hurlingham Oncology Clinic, Nairobi and The Nairobi Hospital between March 1995 and August 1999. SUBJECTS: Eighteen patients with breast cancer were treated either for adjuvant purposes or for metastatic disease. INTERVENTION: Chemotherapy with adriamycin and cyclophosphamide at 60/600 or 50/500. Patients were advised to avoid crowded places and given prophylactic broadspectrum antibiotics whenever grade 4 neutropenia occurred at nadir. RESULTS: Grade 3-4 neutropenia occurred in 75.5% of treatments at 60/600 and in 56.8% of the treatments at 50/500. Febrile neutropenia followed only one treatment and did not result in death. CONCLUSION: Neutropenia is frequent and severe at A/C 60/600 and need to be watched out for. Sepsis on the other hand is prevented if meticulous attention is given and corrective measures taken. A/C 50/500 was associated with less occurrences of neutropenia though still very high. Neutropenia should therefore be checked and steps be taken to prevent sepsis even at this dosage.

OBJECTIVES: To estimate the prevalence of radiologically evident pneumonia among children with severe malnutrition and to evaluate the diagnostic utility of commonly used clinical indicators of pneumonia among children with severe malnutrition. METHODS: All children with severe malnutrition and admitted at the then Paediatric Observation Ward without congestive cardiac failure, severe anaemia, or severe dehydration, were clinically evaluated and a posteroanterior chest X-ray taken for each child. Pneumonia was diagnosed on the basis of radiological changes consistent with pneumonia as reported by an experienced radiologist. The performance of the various clinical parameters as diagnostic tests for pneumonia were also evaluated. SETTING: Kenyatta National Hospital, a tertiary level teaching institution for the University of Nairobi. RESULTS: One hundred and seven children comprising 68 males and 39 females were recruited into the study. Of these children, 38 had kwashiorkor, 40 had marasmus, while 29 had marasmic kwashiorkor. Radiological evidence of pneumonia was found in 58% of children with kwashiorkor, 75% with marasmic kwashiorkor, and 82% with marasmus. All the commonly used clinical parameters performed poorly as diagnostic tests for pneumonia among children with severe malnutrition. CONCLUSION: Prevalence of pneumonia was very high among children with severe malnutrition. Available clinical parameters, singly or in combination, are poor diagnostic tools for pneumonia in children with severe malnutrition. It is advisable to treat children with severe malnutrition as if they had pneumonia, even in the absence of suggestive clinical signs.

Mycotoxins are toxic secondary metabolites of fungal origin and contaminate agricultural commodities before or under post-harvest conditions. They are mainly produced by fungi in the Aspergillus, Penicillium and Fusarium genera. When ingested, inhaled or absorbed through the skin, mycotoxins cause lowered performance, sickness or death on humans and animals. Factors that contribute to mycotoxin contamination of food and feed in Africa include environmental, socio-economic and food production. Environmental conditions especially high humidity and temperatures favour fungal proliferation resulting in contamination of food and feed. The socio-economic status of majority of inhabitants of Sub-Saharan Africa pre-dispose them to consumption of mycotoxin contaminated products either directly or at various points in the food chain. The resulting implications include immuno-suppression, impaired growth, various cancers and death depending on the type, period and amount of exposure. A synergistic effect between mycotoxin exposure and some important diseases in the continent such as malaria, kwashiorkor and HIV/AIDS have been suggested. Mycotoxin concerns have grown during the last few decades because of their implications to human and animal health, productivity, economics of their management and trade. This has led to development of maximum tolerated limits for mycotoxins in various countries. Even with the standards in place, the greatest recorded fatal mycotoxin-poisoning outbreak caused by contamination of maize with aflatoxins occurred in Africa in 2004. Pre-harvest practices; time of harvesting; handling of produce during harvesting; moisture levels at harvesting, transportation, marketing and processing; insect damage all contribute to mycotoxin contamination. Possible intervention strategies include good agricultural practices such as early harvesting, proper drying, sanitation, proper storage and insect management among others. Other possible interventions include biological control, chemical control, decontamination, breeding for resistance as well as surveillance and awareness creation. There is need for efficient, cost-effective sampling and analytical methods that can be used for detection analysis of mycotoxins in developing countries.

Normal 0 false false false EN-GB X-NONE X-NONE /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin-top:0cm; mso-para-margin-right:0cm; mso-para-margin-bottom:10.0pt; mso-para-margin-left:0cm; line-height:115%; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin;} Clematis brachiata Thunberg (Ranunculaceae) is used in Kenya for the management of headaches, malaria and other febrile illnesses, abdominal disorders, yaws and for skin disorders.  Old stems and leaves are chewed for the management of toothaches and sore throats.  Extracts of the plant were subjected to tests for antimalarial, antibacterial and antifungal activity.  The toxicity of the extracts was assessed using the brine shrimp lethality bioassay.   The root extract gave the highest in vitro antimalarial activity against a mulitidrug resistant strain, Plasmodium falciparum VI/S (IC50=39.24 mg/ml). The stem and leaf extracts had insignificant antiplasmodial activity.  The leaf, stem and root extracts had bacterial or fungal growth even at very high concentrations of 10 mg/ml. The LD50 values of the stem and leaf methanol extracts against the brine shrimp larvae was 365.60 and 66.5 mg/ml respectively. The in vitro anti malarial activity of the root extract in part supports the ethnobotanical use of the plant to manage malaria.  KEY WORDS Clematis, Ranunculaceae, antimalarial, brine shrimp, antimicrobial

Fusarium culmorum is an important pathogen of wheat causing seedling blight, foot rot, and head blight (FHB) or scab. The pathogen is dominant in cooler areas like north, central and western Europe. The fungus reproduces asexually by means of conidia, which form the main mode of dispersal. Head blight is by far the most serious concern of Fusarium infection on pre-harvest wheat and other small grain cereals. The significance of F. culmorum in wheat production is attributed to both head blight and mycotoxin contamination of the grain harvested from infected ears. Ear infection mainly occurs during anthesis and is favoured by wet weather or high humidity and warm temperatures. The major mycotoxins produced by F. culmorum are deoxynivalenol, nivalenol and zearalenone, which are a potential health hazard for both humans and animals. The mycotoxins, especially deoxynivalenol, are believed to play a role in disease development. Available options of managing Fusarium head blight include use of fungicides, cultural practices, resistant varieties and biological agents. However, no wheat variety is completely resistant to Fusarium head blight while fungicides are at most 70% effective against natural infection. This review seeks to document and infer information on F. culmorum, with special emphasis on wheat head blight infection process, mechanisms of mycotoxin production, the role the mycotoxins play in pathogenesis, and the possible management options.

Fusarium culmorum is an important pathogen of wheat causing seedling blight, foot rot, and head blight (FHB) or scab. The pathogen is dominant in cooler areas like north, central and western Europe. The fungus reproduces asexually by means of conidia, which form the main mode of dispersal. Head blight is by far the most serious concern of Fusarium infection on pre-harvest wheat and other small grain cereals. The significance of F. culmorum in wheat production is attributed to both head blight and mycotoxin contamination of the grain harvested from infected ears. Ear infection mainly occurs during anthesis and is favoured by wet weather or high humidity and warm temperatures. The major mycotoxins produced by F. culmorum are deoxynivalenol, nivalenol and zearalenone, which are a potential health hazard for both humans and animals. The mycotoxins, especially deoxynivalenol, are believed to play a role in disease development. Available options of managing Fusarium head blight include use of fungicides, cultural practices, resistant varieties and biological agents. However, no wheat variety is completely resistant to Fusarium head blight while fungicides are at most 70% effective against natural infection. This review seeks to document and infer information on F. culmorum, with special emphasis on wheat head blight infection process, mechanisms of mycotoxin production, the role the mycotoxins play in pathogenesis, and the possible management options.

Fusarium culmorum is an important pathogen of wheat causing seedling blight, foot rot, and head blight (FHB) or scab. The pathogen is dominant in cooler areas like north, central and western Europe. The fungus reproduces asexually by means of conidia, which form the main mode of dispersal. Head blight is by far the most serious concern of Fusarium infection on pre-harvest wheat and other small grain cereals. The significance of F. culmorum in wheat production is attributed to both head blight and mycotoxin contamination of the grain harvested from infected ears. Ear infection mainly occurs during anthesis and is favoured by wet weather or high humidity and warm temperatures. The major mycotoxins produced by F. culmorum are deoxynivalenol, nivalenol and zearalenone, which are a potential health hazard for both humans and animals. The mycotoxins, especially deoxynivalenol, are believed to play a role in disease development. Available options of managing Fusarium head blight include use of fungicides, cultural practices, resistant varieties and biological agents. However, no wheat variety is completely resistant to Fusarium head blight while fungicides are at most 70% effective against natural infection. This review seeks to document and infer information on F. culmorum, with special emphasis on wheat head blight infection process, mechanisms of mycotoxin production, the role the mycotoxins play in pathogenesis, and the possible management options.

Department of Dental Surgery, University of Nairobi. The prevalence of juvenile periodontitis was studied in a group of young adults aged 18 to 26 years from the National Youth Service. The study group consisted of a random sample of 350 trainees, 250 males and 100 females. The subjects were examined for plaque scores, gingivitis and pocket depths. Radiographs were used to show bone loss and confirm diagnosis of juvenile periodontitis. Only one subject was diagnosed as having juvenile periodontitis. This represents a prevalence of 0.28% which falls within the range of published prevalence of 0.1% to 3.4% among young adults.

Department of Periodontology, University of Nairobi Dental School, Kenya. The gingival health of 201 schoolchildren aged 11-14 years was assessed at 6 sites on all the incisor and first molar teeth by recording separately the presence or absence of redness and bleeding on probing. Crowding of the incisor teeth was recorded as labio-lingual displacement and mesio-distal overlap. A 2nd examiner recorded the presence or absence of plaque at these sites and assessed mouthbreathing, lipseal and upper lip coverage of the maxillary incisors. Mouthbreathing, increased lip separation and decreased upper lip coverage at rest were all associated with higher levels of plaque and gingival inflammation. Multivariate analysis indicated that this association was statistically significant for mouthbreathing and lip coverage but increased lip separation was not independently related to plaque and gingivitis. The relationship of mouthbreathing and decreased upper lip coverage with gingivitis was most evident in the upper anterior segment and was still evident after covariate analysis to take account of variations due to gender, overcrowding and amount of plaque. However, allowance for these factors also suggested that the influence of mouthbreathing was restricted to palatal sites, whereas lip coverage influenced gingival inflammation at both palatal and labial sites.

Department of Dental Surgery, College of Health Sciences, University of Nairobi. Behcet's syndrome is a disease of uncertain aetiology characterised by recurrent oral and genital ulcerations, ocular lesions and skin lesions. Although cases of this syndrome have been reported almost worldwide, the literature did not reveal any reports from this region. Management of this disorder is mainly palliative. However several treatment regimens have been tried. Following are some of the treatments considered effective. Azathioprine, corticosteroids, chlorambucil, transfusions of fresh blood or plasma and fibrinolytic therapy with phenformin and ethyloestrenol. The importance of multi-disciplinary management of such patients is emphasized.

The objectives of this study were to determine the frequency of alveolar osteitis at Kenyatta National Hospital (KNH), most affected age group and the reasons for underlying extractions. Out of 8,393 extractions 273 (3.3%) developed alveolar osteitis. 98.5% of the teeth that developed alveolar osteitis were molars and premolars. 52% of the patients that developed alveolar osteitis were females and 48% were males. The mandible was more affected than the maxilla. The percentage distribution of alveolar osteitis according to age groups 10-19 year, 30-39 years, 40-49 years, 50-59 years and 60-69 years were 6.2%, 53.1%, 23.8%, 5.5%, 4.8% and 2.9% respectively. On the average, patients reported with alveolar osteitis 5.7 days following extraction. Out of 8,393 extractions, 72.5% were due to dental caries, 18% were due to periodontitis and the rest were due to other causes. It was concluded that the frequency and average, patients reported with alveolar osteitis 5.7 days following extraction. Out of 8,393 extractions, 72.5% were due to dental caries, 18% were due to periodontitis and the rest were due to other causes. It was concluded that the frequency and pattern of development of a alveolar osteitis at KNH was similar to that reported in developed countries.

Department of Periodontology/Community and Preventive Dentistry, College of Health Sciences, University of Nairobi, P.O. Box 19676-00202, Nairobi, Kenya. OBJECTIVE: To map out the pattern of periodontal disease in individuals who died before 1957 and were not exposed to formal dental services. DESIGN: Descriptive cross-sectional study. SETTING: National Museums of Kenya. SUBJECTS: The skeletons of people who died before independence are preserved at the National Museums of Kenya in Nairobi. Sixty four out of the 170 dry mandibles stored at the Museum were assessed for periodontal bone loss using a calibrated ruler. RESULTS: All the 64 mandibles assessed were of individuals who died before 1957. Two thousand two hundred and seventy four sites were examined. Most of the subjects were adults aged 30-45 years and the age range was 18-80 years. Majority of the mandibles examined were of the ethnic group from Central Kenya. Of the teeth examined, premolars and molars were the teeth most frequently preserved intact in the sockets. The total mean bone loss for all teeth was 2.51 (SD 1.15) with a range of 0.85-5.80. When the different sites were examined, values for bone loss were 2.59 for mesial surfaces; 2.55 buccal surfaces; 2.38 for distal surfaces. Three categories were identified as follows:- 70% of the individuals had minimal or no bone loss, 26.5% had 3-4 mm or moderate bone loss and 3.5% had >5 mm bone loss or advanced bone loss. Further analysis showed that when bone loss of >3 mm was examined, only 28.12% of the individuals were in this group, 10.93% had >4 mm bone loss and 3.12% had 5 mm or more bone loss. The first molars were the teeth most commonly affected by bone loss of 3mm or more followed by second molars then the premolars. CONCLUSIONS: In this group of individuals mainly from Central Kenya, the bone loss pattern showed that only a small number had experienced periodontal destruction as recorded by bone loss levels. Three groups were identified; those who had no or minimal destruction, those who had experienced moderate destruction and those where obvious bone destruction was evident. Thus susceptibility to periodontal disease is evident in a small proportion of individuals even in populations not exposed to modern diet and formal dental services. Periodontal destruction seems to affect a fraction of the population even when older populations are examined, thus it would save on resources both human and physical if these susceptible individuals could be identified early and treatment provided.

SUMMARY Hereditary gingival hyperplasia (HGF) is a rare condition characterised by hyperplastic, dense fibrous connective tissue with acanthotic gingival epithelium. A family presented at the School of Dental Sciences, University of Nairobi with a complaint that some of the children developed swollen gums very early in life and that this got worse with eruption of the permanent teeth. The first born, a 23- year- old male, had had the swellings for over ten years. Other siblings aged 5,9 and 12 years were also affected. The swellings had affected the appearance, speech and the psychosocial wellbeing of the children. The parents were unaffected with apparently negative family histories. Following oral examination and appropriate investigations, conventional gingivectomy was performed of the maxillary and the mandibular gingivae for the siblings: the 23 -12- and the nine- year olds. The fourth affected child, a five- year- old, was still in primary dentition and had just started showing mild signs of gingival hyperplasia. The histopathological examination of the specimens from the present cases confirmed features consistent with those of HGF. This article highlights a familial presentation of HGF.

Department of Periodontology/ Community and Preventive Dentistry, School of Dental Sciences, University of Nairobi, P.O. Box 19676 - 00202, Nairobi, Kenya. OBJECTIVE: To determine the influence of oral hygiene habits and practices on the risk of developing oral leukoplakia. DESIGN: Case control study. SETTING: Githongo sublocation in Meru District. SUBJECTS: Eighty five cases and 141 controls identified in a house-to-house screening. RESULTS: The relative risk (RR) of oral leukoplakia increased gradually across the various brushing frequencies from the reference RR of 1.0 in those who brushed three times a day, to 7.6 in the "don't brush" group. The trend of increase was statistically significant (X2 for Trend : p = 0.001). The use of chewing stick as compared to conventional tooth brush had no significant influence on RR of oral leukoplakia. Non-users of toothpastes had a significantly higher risk of oral leukoplakia than users (RR = 1.8; 95% confidence levels (CI) = 1.4-2.5). Among tobacco smokers, the RR increased from 4.6 in those who brushed to 7.3 in those who did not brush. Among non-smokers, the RR of oral leukoplakia in those who did not brush (1.8) compared to those who brushed was also statistically significant (95% CL = 1.6-3.8). CONCLUSION: Failure to brush teeth and none use of toothpastes are significantly associated with the development of oral leukoplakia, while the choice of brushing tools between conventional toothbrush and chewing stick is not. In addition, failure to brush teeth appeared to potentiate the effect of smoking tobacco in the development of oral leukoplakia. Recommendations: Oral health education, instruction and motivation for the improvement of oral hygiene habits and practices; and therefore oral hygiene status, should be among the strategies used in oral leukoplakia preventive and control programmes.

Department of Dental Surgery, University of Nairobi. The prevalence of juvenile periodontitis was studied in a group of young adults aged 18 to 26 years from the National Youth Service. The study group consisted of a random sample of 350 trainees, 250 males and 100 females. The subjects were examined for plaque scores, gingivitis and pocket depths. Radiographs were used to show bone loss and confirm diagnosis of juvenile periodontitis. Only one subject was diagnosed as having juvenile periodontitis. This represents a prevalence of 0.28% which falls within the range of published prevalence of 0.1% to 3.4% among young adults.

The objectives of this study were to determine the frequency of alveolar osteitis at Kenyatta National Hospital (KNH), most affected age group and the reasons for underlying extractions. Out of 8,393 extractions 273 (3.3%) developed alveolar osteitis. 98.5% of the teeth that developed alveolar osteitis were molars and premolars. 52% of the patients that developed alveolar osteitis were females and 48% were males. The mandible was more affected than the maxilla. The percentage distribution of alveolar osteitis according to age groups 10-19 year, 30-39 years, 40-49 years, 50-59 years and 60-69 years were 6.2%, 53.1%, 23.8%, 5.5%, 4.8% and 2.9% respectively. On the average, patients reported with alveolar osteitis 5.7 days following extraction. Out of 8,393 extractions, 72.5% were due to dental caries, 18% were due to periodontitis and the rest were due to other causes. It was concluded that the frequency and average, patients reported with alveolar osteitis 5.7 days following extraction. Out of 8,393 extractions, 72.5% were due to dental caries, 18% were due to periodontitis and the rest were due to other causes. It was concluded that the frequency and pattern of development of a alveolar osteitis at KNH was similar to that reported in developed countries.

Department of Periodontology/ Community and Preventive Dentistry, School of Dental Sciences, University of Nairobi, P.O. Box 19676 - 00202, Nairobi, Kenya. OBJECTIVE: To determine the influence of oral hygiene habits and practices on the risk of developing oral leukoplakia. DESIGN: Case control study. SETTING: Githongo sublocation in Meru District. SUBJECTS: Eighty five cases and 141 controls identified in a house-to-house screening. RESULTS: The relative risk (RR) of oral leukoplakia increased gradually across the various brushing frequencies from the reference RR of 1.0 in those who brushed three times a day, to 7.6 in the "don't brush" group. The trend of increase was statistically significant (X2 for Trend : p = 0.001). The use of chewing stick as compared to conventional tooth brush had no significant influence on RR of oral leukoplakia. Non-users of toothpastes had a significantly higher risk of oral leukoplakia than users (RR = 1.8; 95% confidence levels (CI) = 1.4-2.5). Among tobacco smokers, the RR increased from 4.6 in those who brushed to 7.3 in those who did not brush. Among non-smokers, the RR of oral leukoplakia in those who did not brush (1.8) compared to those who brushed was also statistically significant (95% CL = 1.6-3.8). CONCLUSION: Failure to brush teeth and none use of toothpastes are significantly associated with the development of oral leukoplakia, while the choice of brushing tools between conventional toothbrush and chewing stick is not. In addition, failure to brush teeth appeared to potentiate the effect of smoking tobacco in the development of oral leukoplakia. Recommendations: Oral health education, instruction and motivation for the improvement of oral hygiene habits and practices; and therefore oral hygiene status, should be among the strategies used in oral leukoplakia preventive and control programmes.

The role of pastoralist women in conflict resolution and management (study funded by SIDA though IMPACT)

The role of pastoralist women in conflict resolution and management (study funded by SIDA though IMPACT)

The book is a biography of the author. He begins with fundamenbtal question whether we can determine our destiny or we are just fulfiling what has already been ordained. He then explains how he has grown over the yeas experiencing changes.  

Experimentally, two hydatid cyst fluid (HCF) antigens (antigens 4 and 5) were found to be the most immunogenic antigens in HCF.  The two antigens were precipitated together from HCF.  This was done by adding 2M phosphotungstic acid and 2M magnesium chloride pollutions to clarified HCF whilte continuously stirring the mixture.  The precipitate formed was suspend in physiological saline (PS).  This antigens solutions was used to coat microtitre plates fro indirect ELISA.  Indirect ELISA was performed on 180 randomly selected bovine sera. The sensitivity of the test was found to be 98% while the specificity was 70%.  The predictive value was 89%.  Although the specificity of the test was relatively low, the test using these partially purified antigens was found to be useful because of its high sensitivity.

Antisera to thermostable muscle antigens from 13 wild animals: Buffalo, Waterbuck, Bushbuck, Eland, Oryx, Kongoni, Bushpig, Warthog, Topi, Thomson’s gazelle, Grant’s gazelle, Sheep, Pig, Horse, Camel & Dog, were raised in rabbits and/or goats. Absorptions of the antisera with copolymerized pooled serum from the 20 species and the thermostable muscle antigens rendered most of the antisera mmonospecific. It was possible to identify the species of origin of saline extracts of both cooked and fresh meat samples in immunodiffusion tests. The method is promising for use in identification of the species origin of fresh and cooked animal meats.

Experimentally, two hydatid cyst fluid (HCF) antigens (antigens 4 and 5) were found to be the most immunogenic antigens in HCF.  The two antigens were precipitated together from HCF.  This was done by adding 2M phosphotungstic acid and 2M magnesium chloride pollutions to clarified HCF whilte continuously stirring the mixture.  The precipitate formed was suspend in physiological saline (PS).  This antigens solutions was used to coat microtitre plates fro indirect ELISA.  Indirect ELISA was performed on 180 randomly selected bovine sera. The sensitivity of the test was found to be 98% while the specificity was 70%.  The predictive value was 89%.  Although the specificity of the test was relatively low, the test using these partially purified antigens was found to be useful because of its high sensitivity.

Antisera to thermostable muscle antigens from 13 wild animals: Buffalo, Waterbuck, Bushbuck, Eland, Oryx, Kongoni, Bushpig, Warthog, Topi, Thomson’s gazelle, Grant’s gazelle, Sheep, Pig, Horse, Camel & Dog, were raised in rabbits and/or goats. Absorptions of the antisera with copolymerized pooled serum from the 20 species and the thermostable muscle antigens rendered most of the antisera mmonospecific. It was possible to identify the species of origin of saline extracts of both cooked and fresh meat samples in immunodiffusion tests. The method is promising for use in identification of the species origin of fresh and cooked animal meats.

Cerebral venous sinus thrombosis is an uncommon yet potentially life threatening condition which is often under-diagnosed or misdiagnosed because of the variability of the clinical signs and symptoms. The imaging findings are often subtle thus the need for a high index of suspicion. The superior sagittal and transverse sinuses are the most frequently involved. The correct diagnosis of cerebral venous thrombosis relies on neuroimaging studies. The two cases reported highlight the fact that the radiologist may be the first clinician to suspect and diagnose this condition. This ultimately affects prognosis as early diagnosis and treatment reduces morbidity and mortality.

To explore structure and process factors which influence patients' perception of quality inpatient psychiatric nursing care at Mathari hospital. This was a cross-sectional study of 236 inpatients selected by stratified random sampling. Competence to give consent was determined by a minimum score of 24 on Mini Mental State Examination. Patients were interviewed using a semi-structured questionnaire. Differences in proportions of variables were determined by calculating confidence interval and summary chi-squared statistics. P-values of < or =0.05 were considered significant. Majority of patients (87%) were aged 20-49 years with 43% having stayed in the ward for over a month. Structure factors related to patients' perception of care included physical environment, being happy with the way the ward looked was significantly related to satisfaction with care (chi(2) = 5.506, P = 0002). Process factors significantly related to patients' satisfaction with care included nurses providing patients with information on prescribed medicines (chi(2) = 10.50, P = 00012). Satisfaction with care was positively related to ability to recommend someone for admission in the same ward (chi(2) = 20.2, P = 00001). Structure and process factors identified as influencing patients' perception of care were physical environment and nurses' qualities that fit within the characteristics of Peplau's Interpersonal Relations Theory.

To explore structure and process factors which influence patients' perception of quality inpatient psychiatric nursing care at Mathari hospital. This was a cross-sectional study of 236 inpatients selected by stratified random sampling. Competence to give consent was determined by a minimum score of 24 on Mini Mental State Examination. Patients were interviewed using a semi-structured questionnaire. Differences in proportions of variables were determined by calculating confidence interval and summary chi-squared statistics. P-values of < or =0.05 were considered significant. Majority of patients (87%) were aged 20-49 years with 43% having stayed in the ward for over a month. Structure factors related to patients' perception of care included physical environment, being happy with the way the ward looked was significantly related to satisfaction with care (chi(2) = 5.506, P = 0002). Process factors significantly related to patients' satisfaction with care included nurses providing patients with information on prescribed medicines (chi(2) = 10.50, P = 00012). Satisfaction with care was positively related to ability to recommend someone for admission in the same ward (chi(2) = 20.2, P = 00001). Structure and process factors identified as influencing patients' perception of care were physical environment and nurses' qualities that fit within the characteristics of Peplau's Interpersonal Relations Theory.

Although a relationship between Lapiat and post-Lapita ceramic traditions has long been suspected, a systematic and detailed examination of the similarities and differences has not been previously made. An important first step is to determine the nature of change from one to the other by examining pottery from sites which have the full ceramic sequence. My analyses of the assemblages from Manus and New Island demonstrate continuity between the two traditions.

Department of Infectious Disease Epidemiology, Imperial College School of Medicine, London, UK. Previous attempts to determine the interactions between filariasis transmission intensity, infection and chronic disease have been limited by a lack of a theoretical framework that allows the explicit examination of mechanisms that may link these variables at the community level. Here, we show how deterministic mathematical models, in conjunction with analyses of standardized field data from communities with varying parasite transmission intensities, can provide a particularly powerful framework for investigating this topic. These models were based on adult worm population dynamics, worm initiated chronic disease and two major forms of acquired immunity (larval- versus adult-worm generated) explicitly linked to community transmission intensity as measured by the Annual Transmission Potential (ATP). They were then fitted to data from low, moderate and moderately high transmission communities from East Africa to determine the mechanistic relationships between transmission, infection and observed filarial morbidity. The results indicate a profound effect of transmission intensity on patent infection and chronic disease, and on the generation and impact of immunity on these variables. For infection, the analysis indicates that in areas of higher parasite transmission, community-specific microfilarial rates may increase proportionately with transmission intensity until moderated by the generation of herd immunity. This supports recent suggestions that acquired immunity in filariasis is transmission driven and may be significant only in areas of high transmission. In East Africa, this transmission threshold is likely to be higher than an ATP of at least 100. A new finding from the analysis of the disease data is that per capita worm pathogenicity could increase with transmission intensity such that the prevalences of both hydrocele and lymphoedema, even without immunopathological involvement, may increase disproportionately with transmission intensity. For lymphoedema, this rise may be further accelerated with the onset of immunopathology. An intriguing finding is that there may be at least two types of immunity operating in filariasis: one implicated in anti-infection immunity and generated by past experience of adult worms, the other involved in immune-mediated pathology and based on cumulative experience of infective larvae. If confirmed, these findings have important implications for the new global initiative to achieve control of this disease.

Adult female Sprague-Dawley rats were injected with corn oil or 5 mg, 20 mg, 25 mg or 30 mg per kg body weight of heptachlor solution every other day for up to 18 days. The rats were killed at the end of the experimental period, and blood samples were assayed for progesterone and oestrogen by radioimmunoassay. Ovarian cells from the rats were isolated and incubated either on their own, or in the presence of LH or FSH, and production of progesterone and oestrogen determined. Control incubations consisted of cells from corn oil-treated rats. The latter were also incubated on their own or in the presence of LH or FSH. Heptachlor significantly suppressed blood progesterone and oestradiol levels (P < 0.05 to P < 0.001), the degree of suppression depending on the dose and the stage of the oestrous cycle in which samples were obtained. Production of oestradiol by ovarian cells from heptachlor-treated rats was lower than for corn oil-treated controls. Cells from rats treated with low doses of heptachlor (5 mg per kg body weight) showed an increased production of progesterone, while high doses (> 20 mg per kg body weight) suppressed production.

This study investigated the effectiveness of three physical-chemical methods namely; pH adjustment, precipitation with alum and the use of polyelectrolytes. In the treatment of diary wastewater from Brookeside milk processing plant. It also investigated the drainability of the sludge produced by each of the three methods. Laboratory tests were carried out in three different batches, one for each of the three methods. In the alum method enough alum was added to the wastewater samples to cause precipitation by sweep floc. In the pH adjustment method, the pH of samples were lowered to the iso-electric point of the casein proteins of approximately pH 4.5 leading to their precipitation as a result of solubility changes. The polyelectrolytes method involved the use of two polyelectrolytes, Sudfloc 3820 and Sudfloc 3860 each of which was used to coagulate the dirty wastewater. For each of the three methods, the samples were taken in one-litre beakers and subjected to Jar tests to determine the optimum dosages. After one hour of settling the supernatants were decanted and subjected to standard Chemical Oxygen Demand (COD) tests, turbidity and pH measurements. The settled sludge was subjected to drainability studies. Results showed the treatment of dairy wastewater by the three physical-chemical methods to be effective. There were COD removals of between 60% and 90% and turbidity reduction of over 90%. The use of the sudfloc polyelectrolytes was found to be the least demanding in terms of effluent quality control as no pH adjustments of either the wastewater or the effluent was required. The use of polyelectolytes produced the least volumes of sludge and also the better drainability and solids concentration. Sudfloc 3820 was found to achieve better results than Sudfloc 3860 in terms of COD reduction and the drainability of sludge produced although both achieved the same drainability studies. This study showed that each of the three physical-chemical methods can be used effectively to remove the white colour of dairy wastewater as well as the bulk of the proteins and fats, hence, enabling the discharge of the effluents into natural waters to be of good assimilative capacity.

A cross sectional study of 115 patients admitted at the Department of Orthopedics, Kenyatta National Hospital, Nairobi, Kenya was carried out to determine the prevalence and antibiotic susceptibility of Staphylococcus aureus isolated from infected wounds. The prevalence of Staphylococcus aureus was 33.0 %. The drugs tested and their corresponding sensitivity was amoxycillin (13.2 %), co-amoxyclav (39.5 %), oxacillin (55.3 %), erythromycin (44.7 %), gentamicin (60.5 %), ciprofloxacin (62.2 %), minocycline (86.8 %), cefuroxime (57.9 %), and clidamycin (84.2 %). These results show the sensitivity profile of Staphylococcus aureus and can be used to choose suitable drugs in the management of wounds for hospitalized patients.

OBJECTIVE: To determine the accuracy and sensitivity of diagnostic peritoneal lavage in the assessment of intra-abdominal injury using the dipstick method. DESIGN: Prospective study, involving the performance of diagnostic peritoneal lavage in the out patient department and surgical wards prior to surgical intervention. SETTING: Kenyatta National Hospital-General Surgical and Orthopaedic wards and outpatient department. The study was conducted over a duration of six months, starting from January 1995 to July 1995. RESULTS: Ninety six patients with penetrating (68) and blunt (28) abdominal trauma underwent diagnostic peritoneal lavage as evaluation of the severity of abdominal trauma. Dipstick (combur 9 strips) was used to evaluate lavage effluent for red blood cells, white blood cells, protein and bilirubin. Forty three patients had positive diagnostic peritoneal lavage (DPL) results, of which 40 (93%) had positive findings at laparatomy and three (7%) had negative findings at laparatomy. The remaining 53 patients had negative DPL results and were managed conservatively. One patient with a negative DPL result became symptomatic and had a positive laparatomy. Conservatively managed patients were discharged after 24 hours observations without any complications. DPL had an accuracy and sensitivity of 93% and specificity of 98%. CONCLUSION: Diagnostic peritoneal lavage is a cheap, safe and reliable method for assessment of abdominal trauma. The method is easy to perform by trained junior doctors in the OPD, or as a bedside procedure. Use of this method reduced negative laparotomy rate from 50% to 6.9% and average duration of stay from 6.5 days to 1.9 days. This method is recommended as a basic tool in the assessment of abdominal trauma patients.

OBJECTIVE: To determine the accuracy and sensitivity of diagnostic peritoneal lavage in the assessment of intra-abdominal injury using the dipstick method. DESIGN: Prospective study, involving the performance of diagnostic peritoneal lavage in the out patient department and surgical wards prior to surgical intervention. SETTING: Kenyatta National Hospital-General Surgical and Orthopaedic wards and outpatient department. The study was conducted over a duration of six months, starting from January 1995 to July 1995. RESULTS: Ninety six patients with penetrating (68) and blunt (28) abdominal trauma underwent diagnostic peritoneal lavage as evaluation of the severity of abdominal trauma. Dipstick (combur 9 strips) was used to evaluate lavage effluent for red blood cells, white blood cells, protein and bilirubin. Forty three patients had positive diagnostic peritoneal lavage (DPL) results, of which 40 (93%) had positive findings at laparatomy and three (7%) had negative findings at laparatomy. The remaining 53 patients had negative DPL results and were managed conservatively. One patient with a negative DPL result became symptomatic and had a positive laparatomy. Conservatively managed patients were discharged after 24 hours observations without any complications. DPL had an accuracy and sensitivity of 93% and specificity of 98%. CONCLUSION: Diagnostic peritoneal lavage is a cheap, safe and reliable method for assessment of abdominal trauma. The method is easy to perform by trained junior doctors in the OPD, or as a bedside procedure. Use of this method reduced negative laparotomy rate from 50% to 6.9% and average duration of stay from 6.5 days to 1.9 days. This method is recommended as a basic tool in the assessment of abdominal trauma patients.

A cross sectional study of 115 patients admitted at the Department of Orthopedics, Kenyatta National Hospital, Nairobi, Kenya was carried out to determine the prevalence and antibiotic susceptibility of Staphylococcus aureus isolated from infected wounds. The prevalence of Staphylococcus aureus was 33.0 %. The drugs tested and their corresponding sensitivity was amoxycillin (13.2 %), co-amoxyclav (39.5 %), oxacillin (55.3 %), erythromycin (44.7 %), gentamicin (60.5 %), ciprofloxacin (62.2 %), minocycline (86.8 %), cefuroxime (57.9 %), and clidamycin (84.2 %). These results show the sensitivity profile of Staphylococcus aureus and can be used to choose suitable drugs in the management of wounds for hospitalized patients.

A cross sectional study of 115 patients admitted at the Department of Orthopedics, Kenyatta National Hospital, Nairobi, Kenya was carried out to determine the prevalence and antibiotic susceptibility of Staphylococcus aureus isolated from infected wounds. The prevalence of Staphylococcus aureus was 33.0 %. The drugs tested and their corresponding sensitivity was amoxycillin (13.2 %), co-amoxyclav (39.5 %), oxacillin (55.3 %), erythromycin (44.7 %), gentamicin (60.5 %), ciprofloxacin (62.2 %), minocycline (86.8 %), cefuroxime (57.9 %), and clidamycin (84.2 %). These results show the sensitivity profile of Staphylococcus aureus and can be used to choose suitable drugs in the management of wounds for hospitalized patients.

A cross sectional study of 115 patients admitted at the Department of Orthopedics, Kenyatta National Hospital, Nairobi, Kenya was carried out to determine the prevalence and antibiotic susceptibility of Staphylococcus aureus isolated from infected wounds. The prevalence of Staphylococcus aureus was 33.0 %. The drugs tested and their corresponding sensitivity was amoxycillin (13.2 %), co-amoxyclav (39.5 %), oxacillin (55.3 %), erythromycin (44.7 %), gentamicin (60.5 %), ciprofloxacin (62.2 %), minocycline (86.8 %), cefuroxime (57.9 %), and clidamycin (84.2 %). These results show the sensitivity profile of Staphylococcus aureus and can be used to choose suitable drugs in the management of wounds for hospitalized patients.

A cross sectional study of 115 patients admitted at the Department of Orthopedics, Kenyatta National Hospital, Nairobi, Kenya was carried out to determine the prevalence and antibiotic susceptibility of Staphylococcus aureus isolated from infected wounds. The prevalence of Staphylococcus aureus was 33.0 %. The drugs tested and their corresponding sensitivity was amoxycillin (13.2 %), co-amoxyclav (39.5 %), oxacillin (55.3 %), erythromycin (44.7 %), gentamicin (60.5 %), ciprofloxacin (62.2 %), minocycline (86.8 %), cefuroxime (57.9 %), and clidamycin (84.2 %). These results show the sensitivity profile of Staphylococcus aureus and can be used to choose suitable drugs in the management of wounds for hospitalized patients.

A cross sectional study of 115 patients admitted at the Department of Orthopedics, Kenyatta National Hospital, Nairobi, Kenya was carried out to determine the prevalence and antibiotic susceptibility of Staphylococcus aureus isolated from infected wounds. The prevalence of Staphylococcus aureus was 33.0 %. The drugs tested and their corresponding sensitivity was amoxycillin (13.2 %), co-amoxyclav (39.5 %), oxacillin (55.3 %), erythromycin (44.7 %), gentamicin (60.5 %), ciprofloxacin (62.2 %), minocycline (86.8 %), cefuroxime (57.9 %), and clidamycin (84.2 %). These results show the sensitivity profile of Staphylococcus aureus and can be used to choose suitable drugs in the management of wounds for hospitalized patients.

A cross sectional study of 115 patients admitted at the Department of Orthopedics, Kenyatta National Hospital, Nairobi, Kenya was carried out to determine the prevalence and antibiotic susceptibility of Staphylococcus aureus isolated from infected wounds. The prevalence of Staphylococcus aureus was 33.0 %. The drugs tested and their corresponding sensitivity was amoxycillin (13.2 %), co-amoxyclav (39.5 %), oxacillin (55.3 %), erythromycin (44.7 %), gentamicin (60.5 %), ciprofloxacin (62.2 %), minocycline (86.8 %), cefuroxime (57.9 %), and clidamycin (84.2 %). These results show the sensitivity profile of Staphylococcus aureus and can be used to choose suitable drugs in the management of wounds for hospitalized patients.

A cross sectional study of 115 patients admitted at the Department of Orthopedics, Kenyatta National Hospital, Nairobi, Kenya was carried out to determine the prevalence and antibiotic susceptibility of Staphylococcus aureus isolated from infected wounds. The prevalence of Staphylococcus aureus was 33.0 %. The drugs tested and their corresponding sensitivity was amoxycillin (13.2 %), co-amoxyclav (39.5 %), oxacillin (55.3 %), erythromycin (44.7 %), gentamicin (60.5 %), ciprofloxacin (62.2 %), minocycline (86.8 %), cefuroxime (57.9 %), and clidamycin (84.2 %). These results show the sensitivity profile of Staphylococcus aureus and can be used to choose suitable drugs in the management of wounds for hospitalized patients.

A cross sectional study of 115 patients admitted at the Department of Orthopedics, Kenyatta National Hospital, Nairobi, Kenya was carried out to determine the prevalence and antibiotic susceptibility of Staphylococcus aureus isolated from infected wounds. The prevalence of Staphylococcus aureus was 33.0 %. The drugs tested and their corresponding sensitivity was amoxycillin (13.2 %), co-amoxyclav (39.5 %), oxacillin (55.3 %), erythromycin (44.7 %), gentamicin (60.5 %), ciprofloxacin (62.2 %), minocycline (86.8 %), cefuroxime (57.9 %), and clidamycin (84.2 %). These results show the sensitivity profile of Staphylococcus aureus and can be used to choose suitable drugs in the management of wounds for hospitalized patients.

A cross sectional study of 115 patients admitted at the Department of Orthopedics, Kenyatta National Hospital, Nairobi, Kenya was carried out to determine the prevalence and antibiotic susceptibility of Staphylococcus aureus isolated from infected wounds. The prevalence of Staphylococcus aureus was 33.0 %. The drugs tested and their corresponding sensitivity was amoxycillin (13.2 %), co-amoxyclav (39.5 %), oxacillin (55.3 %), erythromycin (44.7 %), gentamicin (60.5 %), ciprofloxacin (62.2 %), minocycline (86.8 %), cefuroxime (57.9 %), and clidamycin (84.2 %). These results show the sensitivity profile of Staphylococcus aureus and can be used to choose suitable drugs in the management of wounds for hospitalized patients.

A cross sectional study of 115 patients admitted at the Department of Orthopedics, Kenyatta National Hospital, Nairobi, Kenya was carried out to determine the prevalence and antibiotic susceptibility of Staphylococcus aureus isolated from infected wounds. The prevalence of Staphylococcus aureus was 33.0 %. The drugs tested and their corresponding sensitivity was amoxycillin (13.2 %), co-amoxyclav (39.5 %), oxacillin (55.3 %), erythromycin (44.7 %), gentamicin (60.5 %), ciprofloxacin (62.2 %), minocycline (86.8 %), cefuroxime (57.9 %), and clidamycin (84.2 %). These results show the sensitivity profile of Staphylococcus aureus and can be used to choose suitable drugs in the management of wounds for hospitalized patients.

A cross sectional study of 115 patients admitted at the Department of Orthopedics, Kenyatta National Hospital, Nairobi, Kenya was carried out to determine the prevalence and antibiotic susceptibility of Staphylococcus aureus isolated from infected wounds. The prevalence of Staphylococcus aureus was 33.0 %. The drugs tested and their corresponding sensitivity was amoxycillin (13.2 %), co-amoxyclav (39.5 %), oxacillin (55.3 %), erythromycin (44.7 %), gentamicin (60.5 %), ciprofloxacin (62.2 %), minocycline (86.8 %), cefuroxime (57.9 %), and clidamycin (84.2 %). These results show the sensitivity profile of Staphylococcus aureus and can be used to choose suitable drugs in the management of wounds for hospitalized patients.

A cross sectional study of 115 patients admitted at the Department of Orthopedics, Kenyatta National Hospital, Nairobi, Kenya was carried out to determine the prevalence and antibiotic susceptibility of Staphylococcus aureus isolated from infected wounds. The prevalence of Staphylococcus aureus was 33.0 %. The drugs tested and their corresponding sensitivity was amoxycillin (13.2 %), co-amoxyclav (39.5 %), oxacillin (55.3 %), erythromycin (44.7 %), gentamicin (60.5 %), ciprofloxacin (62.2 %), minocycline (86.8 %), cefuroxime (57.9 %), and clidamycin (84.2 %). These results show the sensitivity profile of Staphylococcus aureus and can be used to choose suitable drugs in the management of wounds for hospitalized patients.

A cross sectional study of 115 patients admitted at the Department of Orthopedics, Kenyatta National Hospital, Nairobi, Kenya was carried out to determine the prevalence and antibiotic susceptibility of Staphylococcus aureus isolated from infected wounds. The prevalence of Staphylococcus aureus was 33.0 %. The drugs tested and their corresponding sensitivity was amoxycillin (13.2 %), co-amoxyclav (39.5 %), oxacillin (55.3 %), erythromycin (44.7 %), gentamicin (60.5 %), ciprofloxacin (62.2 %), minocycline (86.8 %), cefuroxime (57.9 %), and clidamycin (84.2 %). These results show the sensitivity profile of Staphylococcus aureus and can be used to choose suitable drugs in the management of wounds for hospitalized patients.

A cross sectional study of 115 patients admitted at the Department of Orthopedics, Kenyatta National Hospital, Nairobi, Kenya was carried out to determine the prevalence and antibiotic susceptibility of Staphylococcus aureus isolated from infected wounds. The prevalence of Staphylococcus aureus was 33.0 %. The drugs tested and their corresponding sensitivity was amoxycillin (13.2 %), co-amoxyclav (39.5 %), oxacillin (55.3 %), erythromycin (44.7 %), gentamicin (60.5 %), ciprofloxacin (62.2 %), minocycline (86.8 %), cefuroxime (57.9 %), and clidamycin (84.2 %). These results show the sensitivity profile of Staphylococcus aureus and can be used to choose suitable drugs in the management of wounds for hospitalized patients.

A cross sectional study of 115 patients admitted at the Department of Orthopedics, Kenyatta National Hospital, Nairobi, Kenya was carried out to determine the prevalence and antibiotic susceptibility of Staphylococcus aureus isolated from infected wounds. The prevalence of Staphylococcus aureus was 33.0 %. The drugs tested and their corresponding sensitivity was amoxycillin (13.2 %), co-amoxyclav (39.5 %), oxacillin (55.3 %), erythromycin (44.7 %), gentamicin (60.5 %), ciprofloxacin (62.2 %), minocycline (86.8 %), cefuroxime (57.9 %), and clidamycin (84.2 %). These results show the sensitivity profile of Staphylococcus aureus and can be used to choose suitable drugs in the management of wounds for hospitalized patients.

A cross sectional study of 115 patients admitted at the Department of Orthopedics, Kenyatta National Hospital, Nairobi, Kenya was carried out to determine the prevalence and antibiotic susceptibility of Staphylococcus aureus isolated from infected wounds. The prevalence of Staphylococcus aureus was 33.0 %. The drugs tested and their corresponding sensitivity was amoxycillin (13.2 %), co-amoxyclav (39.5 %), oxacillin (55.3 %), erythromycin (44.7 %), gentamicin (60.5 %), ciprofloxacin (62.2 %), minocycline (86.8 %), cefuroxime (57.9 %), and clidamycin (84.2 %). These results show the sensitivity profile of Staphylococcus aureus and can be used to choose suitable drugs in the management of wounds for hospitalized patients.

A cross sectional study of 115 patients admitted at the Department of Orthopedics, Kenyatta National Hospital, Nairobi, Kenya was carried out to determine the prevalence and antibiotic susceptibility of Staphylococcus aureus isolated from infected wounds. The prevalence of Staphylococcus aureus was 33.0 %. The drugs tested and their corresponding sensitivity was amoxycillin (13.2 %), co-amoxyclav (39.5 %), oxacillin (55.3 %), erythromycin (44.7 %), gentamicin (60.5 %), ciprofloxacin (62.2 %), minocycline (86.8 %), cefuroxime (57.9 %), and clidamycin (84.2 %). These results show the sensitivity profile of Staphylococcus aureus and can be used to choose suitable drugs in the management of wounds for hospitalized patients.

A cross sectional study of 115 patients admitted at the Department of Orthopedics, Kenyatta National Hospital, Nairobi, Kenya was carried out to determine the prevalence and antibiotic susceptibility of Staphylococcus aureus isolated from infected wounds. The prevalence of Staphylococcus aureus was 33.0 %. The drugs tested and their corresponding sensitivity was amoxycillin (13.2 %), co-amoxyclav (39.5 %), oxacillin (55.3 %), erythromycin (44.7 %), gentamicin (60.5 %), ciprofloxacin (62.2 %), minocycline (86.8 %), cefuroxime (57.9 %), and clidamycin (84.2 %). These results show the sensitivity profile of Staphylococcus aureus and can be used to choose suitable drugs in the management of wounds for hospitalized patients.

A cross sectional study of 115 patients admitted at the Department of Orthopedics, Kenyatta National Hospital, Nairobi, Kenya was carried out to determine the prevalence and antibiotic susceptibility of Staphylococcus aureus isolated from infected wounds. The prevalence of Staphylococcus aureus was 33.0 %. The drugs tested and their corresponding sensitivity was amoxycillin (13.2 %), co-amoxyclav (39.5 %), oxacillin (55.3 %), erythromycin (44.7 %), gentamicin (60.5 %), ciprofloxacin (62.2 %), minocycline (86.8 %), cefuroxime (57.9 %), and clidamycin (84.2 %). These results show the sensitivity profile of Staphylococcus aureus and can be used to choose suitable drugs in the management of wounds for hospitalized patients.

A cross sectional study of 115 patients admitted at the Department of Orthopedics, Kenyatta National Hospital, Nairobi, Kenya was carried out to determine the prevalence and antibiotic susceptibility of Staphylococcus aureus isolated from infected wounds. The prevalence of Staphylococcus aureus was 33.0 %. The drugs tested and their corresponding sensitivity was amoxycillin (13.2 %), co-amoxyclav (39.5 %), oxacillin (55.3 %), erythromycin (44.7 %), gentamicin (60.5 %), ciprofloxacin (62.2 %), minocycline (86.8 %), cefuroxime (57.9 %), and clidamycin (84.2 %). These results show the sensitivity profile of Staphylococcus aureus and can be used to choose suitable drugs in the management of wounds for hospitalized patients.

A cross sectional study of 115 patients admitted at the Department of Orthopedics, Kenyatta National Hospital, Nairobi, Kenya was carried out to determine the prevalence and antibiotic susceptibility of Staphylococcus aureus isolated from infected wounds. The prevalence of Staphylococcus aureus was 33.0 %. The drugs tested and their corresponding sensitivity was amoxycillin (13.2 %), co-amoxyclav (39.5 %), oxacillin (55.3 %), erythromycin (44.7 %), gentamicin (60.5 %), ciprofloxacin (62.2 %), minocycline (86.8 %), cefuroxime (57.9 %), and clidamycin (84.2 %). These results show the sensitivity profile of Staphylococcus aureus and can be used to choose suitable drugs in the management of wounds for hospitalized patients.

The book is a biography of the author. He begins with fundamenbtal question whether we can determine our destiny or we are just fulfiling what has already been ordained. He then explains how he has grown over the yeas experiencing changes.  

BACKGROUND: Patients with discoloured teeth frequently present to the dentist requesting restorations designed to improve their appearance. For teeth that are sound, this might include the use of a veneer restoration. The veneer acts as a thin layer of a material covering the labial surface of a tooth and can be applied directly to the tooth, or by using indirect methods. OBJECTIVES: To examine the effectiveness of direct versus indirect laminate veneer restorations. SEARCH STRATEGY: The following electronic databases were searched: The Cochrane Oral Health Group's Trials Register, The Cochrane Central Register of Controlled Trials (CENTRAL), (The Cochrane Library Issue 3, 2002), MEDLINE (1980 to 19/11/2002) and EMBASE (1980 to 19/11/2002). There was no restriction on language. SELECTION CRITERIA: All randomised controlled trials (RCTs) of participants with permanent anterior teeth suitable for restorations using laminate veneers, comparing direct (different composite materials) and indirect techniques for making dental veneers. The indirect restorations may be either composite or porcelain. The primary outcome was restoration failure. DATA COLLECTION AND ANALYSIS: Assessment of relevance and validity and data extraction were conducted in triplicate. Authors of the primary studies were contacted to provide additional information as necessary. MAIN RESULTS: Six full publications were screened as being potentially relevant to the review, only one trial was found to meet the review's inclusion criteria. Although the trial met the review's inclusion criteria with regard to participant characteristics, interventions and outcomes assessed, problems with the reporting of the data prevented any statistical analysis of the results. REVIEWER'S CONCLUSIONS: There is no reliable evidence to show a benefit of one type of veneer restoration (direct or indirect) over the other with regard to the longevity of the restoration.

The dentist is faced with a daunting task in application of clinical skills to achieve maximum cosmetic results when it comes to the management of discoloured and/or hypoplastic dentition. In this paper, an overview is made of the diagnosis and the management of these broadly termed conditions and the cost-effectiveness of the various modalities discussed.

OBJECTIVES: Marginal integrity is a major clinical problem in restorative dentistry. The aim of this study was to evaluate the applicability of an edge strength measurement device in an in vitro test to determine the force required to fracture flakes of material by a Vickers indentation at progressively increasing distances from an interface edge of bulk material. METHODS: Five representative resin-composites were investigated. Fourteen disks of specimens (12mm diameter x 2.5mm thick) were prepared for each material. These were divided into seven sub-groups corresponding to different edge-distances (0.4, 0.5, 0.6, 0.7, 0.8, 0.9 and 1.0mm). An edge strength measurement device (CK10) (Engineering Systems, Nottingham, UK) was used. The mode of the failure of each specimen was examined under the integral microscope of the CK10. RESULTS: The force (N)-to-fracture at a distance of 0.5mm from the edge was defined as the edge strength. The highest failure force (edge strength) was observed for Tetric Ceram (174.2N) and the lowest for Filtek Supreme (enamel) (87.0N). Correlations between the failure-forces to fracture materials with edge-distance were regression analyzed giving coefficients (r) ranging from 0.94 (p=0.02) to 0.99 (p=0.01). Two modes of failure were observed: chipping and–generally at greater distances–cracking. SIGNIFICANCE: Edge strength is a definable and potentially useful parameter to characterize this aspect of clinically related behavior. A standardized distance of 0.5mm from the specimen's edge, when chipping failure prevails, is suitable and convenient as a reference point.

The dentist is faced with a daunting task in application of clinical skills to achieve maximum cosmetic results when it comes to the management of discoloured and/or hypoplastic dentition. In this paper, an overview is made of the diagnosis and the management of these broadly termed conditions and the cost-effectiveness of the various modalities discussed.

OBJECTIVES: The aim was to study dimensional time-dependence of resin/ionomer formulations from 5 min age to one month and to separate out the intrinsic setting shrinkage and hygroscopic expansion effects, by using non-aqueous and aqueous storage media, respectively. METHODS: Materials studied included: A: resin-, B: metal- and C: polyphosphonate-modified glass-ionomer cements [GICs]; and controls of D: poly-acid modified composite [compomer]; and E: resin-composite. Separate specimen groups (n = 5) were stored in different storage-media: (i) silicone fluid; (ii) de-ionized water. Experiments were repeated at 23 and 37 degrees C. Volumetric changes of specimens (4 mm diameter x 6 mm height) were obtained via accurate mass measurements (to 10(-4) g), using Archimedes principle, with silicone or water also used as the Archimedean fluid. These measurements were made periodically over a 30 day period, post fabrication. RESULTS: In silicone at 23 degrees C, all materials underwent further gradual intrinsic shrinkage (after 5 min from mix). This was highly significant (p < 0.05) for the RM-GIC (A). At 37 degrees C, however the RM-GIC expanded, indicating that its cure is temperature-sensitive. In water, at 23 and 37 degrees C, the shrinkage was either partially offset (materials C, D, E), or replaced by appreciable expansions (materials A and B). Differences between RM-GIC (A) and MM-GIC (B) were significant (p < 0.05). SIGNIFICANCE: The deployment of dual storage media made an important contribution to the separate analysis of the volumetric changes due to the on-going setting chemistry in these systems and the time-dependent effects of an aqueous environment.

This study was done to determine the nature of utilization of dental auxiliaries and medical emergencies in private dental surgeries in Kenya. A self administering questionnaire with pre-paid postage was mailed to 138 dentists. 27.5% responded. 81.6% used dental auxiliaries and the main reason was to improve efficiency in managing patients. 93.5% of the auxiliaries were on job trained secondary school graduates. 63.2% of the respondents delegated duties which were mainly non-clinical. 26.3% did not delegate any duties. In a descending order, the reasons for non delegation were: that it would be risky to patients, not allowed by law, they did not find it necessary and that auxiliaries were not held responsible if something went wrong. The main duties delegated to the auxiliaries were cleaning of instruments and sterilization, mixing of restorative materials and preparing amalgam. Delegation was done primarily based on auxiliaries capability to perform the procedure and meet the set standards. 57.9% indicated that they rarely encountered medical emergencies. Syncope was the commonest emergency encountered. 72.7% indicated that auxiliaries could not handle medical emergencies because they were not trained. It is concluded that most dentists did not delegate clinical duties to dental auxiliaries and medical emergencies were rare.

This paper presents an analysis of 568 jaw tumours and tumour-like conditions seen at the Kenyatta National Hospital over a period of fifteen years. For descriptive purposes, the term tumour is used here in its wider context to cover both neoplastic and dysplastic jaw lesions which present primarily as jaw swellings. The study reveals a pattern consistent with other African series and suggests a more aggressive progression and younger age at onset than elsewhere.

The dentist is faced with a daunting task in application of clinical skills to achieve maximum cosmetic results when it comes to the management of discoloured and/or hypoplastic dentition. In this paper, an overview is made of the diagnosis and the management of these broadly termed conditions and the cost-effectiveness of the various modalities discussed.

Measurement of tooth lengths was carried out on 537 extracted human teeth. The teeth were collected from adults aged 17 years and above and preserved in formalin. The tooth lengths were obtained by taking measurements off calibrated graph paper. The lengths obtained in this study were comparable to previous data reported in the literature. However, this new data will provide useful guidelines in Kenya for the management of endodontic patients especially in the purchase and stocking of the most appropriate endodontic instruments.

This study was done to determine the nature of utilization of dental auxiliaries and medical emergencies in private dental surgeries in Kenya. A self administering questionnaire with pre-paid postage was mailed to 138 dentists. 27.5% responded. 81.6% used dental auxiliaries and the main reason was to improve efficiency in managing patients. 93.5% of the auxiliaries were on job trained secondary school graduates. 63.2% of the respondents delegated duties which were mainly non-clinical. 26.3% did not delegate any duties. In a descending order, the reasons for non delegation were: that it would be risky to patients, not allowed by law, they did not find it necessary and that auxiliaries were not held responsible if something went wrong. The main duties delegated to the auxiliaries were cleaning of instruments and sterilization, mixing of restorative materials and preparing amalgam. Delegation was done primarily based on auxiliaries capability to perform the procedure and meet the set standards. 57.9% indicated that they rarely encountered medical emergencies. Syncope was the commonest emergency encountered. 72.7% indicated that auxiliaries could not handle medical emergencies because they were not trained. It is concluded that most dentists did not delegate clinical duties to dental auxiliaries and medical emergencies were rare.

OBJECTIVES: The aim was to study dimensional time-dependence of resin/ionomer formulations from 5 min age to one month and to separate out the intrinsic setting shrinkage and hygroscopic expansion effects, by using non-aqueous and aqueous storage media, respectively. METHODS: Materials studied included: A: resin-, B: metal- and C: polyphosphonate-modified glass-ionomer cements [GICs]; and controls of D: poly-acid modified composite [compomer]; and E: resin-composite. Separate specimen groups (n = 5) were stored in different storage-media: (i) silicone fluid; (ii) de-ionized water. Experiments were repeated at 23 and 37 degrees C. Volumetric changes of specimens (4 mm diameter x 6 mm height) were obtained via accurate mass measurements (to 10(-4) g), using Archimedes principle, with silicone or water also used as the Archimedean fluid. These measurements were made periodically over a 30 day period, post fabrication. RESULTS: In silicone at 23 degrees C, all materials underwent further gradual intrinsic shrinkage (after 5 min from mix). This was highly significant (p < 0.05) for the RM-GIC (A). At 37 degrees C, however the RM-GIC expanded, indicating that its cure is temperature-sensitive. In water, at 23 and 37 degrees C, the shrinkage was either partially offset (materials C, D, E), or replaced by appreciable expansions (materials A and B). Differences between RM-GIC (A) and MM-GIC (B) were significant (p < 0.05). SIGNIFICANCE: The deployment of dual storage media made an important contribution to the separate analysis of the volumetric changes due to the on-going setting chemistry in these systems and the time-dependent effects of an aqueous environment.

This study was done to determine the nature of utilization of dental auxiliaries and medical emergencies in private dental surgeries in Kenya. A self administering questionnaire with pre-paid postage was mailed to 138 dentists. 27.5% responded. 81.6% used dental auxiliaries and the main reason was to improve efficiency in managing patients. 93.5% of the auxiliaries were on job trained secondary school graduates. 63.2% of the respondents delegated duties which were mainly non-clinical. 26.3% did not delegate any duties. In a descending order, the reasons for non delegation were: that it would be risky to patients, not allowed by law, they did not find it necessary and that auxiliaries were not held responsible if something went wrong. The main duties delegated to the auxiliaries were cleaning of instruments and sterilization, mixing of restorative materials and preparing amalgam. Delegation was done primarily based on auxiliaries capability to perform the procedure and meet the set standards. 57.9% indicated that they rarely encountered medical emergencies. Syncope was the commonest emergency encountered. 72.7% indicated that auxiliaries could not handle medical emergencies because they were not trained. It is concluded that most dentists did not delegate clinical duties to dental auxiliaries and medical emergencies were rare.

A survey of 272 University of Nairobi undergraduate students was undertaken to assess their dental chairside experience and what reasons they gave for failing to seek dental treatment. Most respondents considered dental treatment uncomfortable and painful. The cost of treatment and fear arising from information given by other dental patients were important reasons that kept the respondents from visiting a dental clinic. This paper reveals the need for the dental profession to play a greater role in reducing costs of treatment and odontophobia.

An in vitro study of the antinematodal action of two groups of compounds which act on the receptor complex of the inhibitory neurotransmitter, Gamma-aminobutyric acid (GABA) in mammalian systems is described. The compounds, Ivermectin and two benzodiazepines, Diazepam and a water soluble Midazolam were tested singly or in combination against two microfilarial parasites Onchocerca lienalis (closely related to Onchocerca volvulus) and Brugia pahangi. The combination of ivermectin and diazepam at a concentration of 0.1 microgram/ml and 33 micrograms/ml respectively achieved the same effect on microfilarial motility as when ivermectin was given at 1 microgram/ml alone or diazepam at 66 micrograms/ml alone. Similarly when the combination of ivermectin at 0.1 microgram/ml and midazolam at 10 micrograms/ml was used it achieved the same effect as ivermectin at 1 microgram/ml alone or midazolam at 33 micrograms/ml alone. This showed that both benzodiazepines had a synergistic effect on the activity of ivermectin. The microfilariae of B. pahangi were insensitive to both groups of compounds at all concentrations used.

This paper presents an analysis of 568 jaw tumours and tumour-like conditions seen at the Kenyatta National Hospital over a period of fifteen years. For descriptive purposes, the term tumour is used here in its wider context to cover both neoplastic and dysplastic jaw lesions which present primarily as jaw swellings. The study reveals a pattern consistent with other African series and suggests a more aggressive progression and younger age at onset than elsewhere.

A survey of 272 University of Nairobi undergraduate students was undertaken to assess their dental chairside experience and what reasons they gave for failing to seek dental treatment. Most respondents considered dental treatment uncomfortable and painful. The cost of treatment and fear arising from information given by other dental patients were important reasons that kept the respondents from visiting a dental clinic. This paper reveals the need for the dental profession to play a greater role in reducing costs of treatment and odontophobia.

Normal 0 false false false MicrosoftInternetExplorer4 st1:*{behavior:url(#ieooui) } /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman"; mso-ansi-language:#0400; mso-fareast-language:#0400; mso-bidi-language:#0400;} Macrophytes have been shown to perform important ecological roles in Lake Naivasha. Consequently, various studies regarding the impact of biotic factors on the macrophytes have been advanced but related studies on environmental parameters have lagged behind. In an attempt to address this gap, sampling on floating species and submergents was carried out in eight sampling sites in 2003 to investigate how they were influenced by a set of environmental factors. Soil texture (sandy sediments; P < 0.05, regression coefficient = - 0.749) and wind were the most important environmental parameters influencing the distribution and abundance of floating macrophytes. Combination of soil texture and lake-bed slope explained the most (86.3%) variation encountered in the submergents. Continuous translocation of the floating dominant water hyacinth to the western parts by wind has led to displacement of the submergents from those areas. In view of these findings, the maintenance and preservation of the steep Crescent Lake basin whose substratum is dominated by sand thus hosting most submergents remain important, if the whole functional purpose of the macrophytes is to be sustained.

The vision of the Government of Kenya is to facilitate ICT as a universal tool for education and training. In order to achieve this vision every educational institution, teacher, learner and the respective community should be equipped with appropriate ICT infrastructure, competencies and policies for usage and progress. It calls for recognition of the fact that ICT provides capabilities and skills needed for a knowledge-based economy. It also calls for transforming teaching and learning to incorporate new pedagogies that are appropriate for the 21st  century. The Ministry of Education�s (MOE) mission is to facilitate effective use of ICT to improve access, learning and administration in delivery education programmes and services. The principal objective will be to integrate ICT in the delivery of education and training curricula. XML:NAMESPACE PREFIX = O />  Although not exhaustive, the range of ICT that have been used in the delivery of education to improve access, teaching, learning, and administration includes: Electric Board, Audio Cassette, Radio for Interactive Radio Instructions (IRI), Video/TV-Learning, Computer, Integrated ICT infrastructure and Support Application Systems (SAS).These systems are in use, at various degrees, in most parts of Africa (Charp, 1998). This plan envisages use ofthese digital components to improve access and quality in the delivery of education in Kenya.  The major challenge in respect to this component is limited digital equipment at virtually all levels of education. While the average access rate is one computer to 15 students in most of the developed countries, the access rate in Kenya is approximately one computer to 150 students (EMIS, 2005). Whereas most secondary schools in Kenya have some computer equipment, only a small fraction is equipped with basic ICT infrastructure. In most cases equipment of schools with ICT infrastructure has been through initiatives supported by the parents, government, development agencies and the private sector, including the NEPAD E-Schools programme. Attempts to set up basic ICT infrastructure in primary schools are almost negligible.  According to ICTs in Education Options Paper, one of the main problems is limited penetration of the physical telecommunication infrastructure into rural and low-income areas. Specifically, the main challenge is limited access to dedicated phone lines and high-speed systems or connectivity to access e-mail and Internet resources. The EMIS Survey (2003/2004) indicated that over 70% of secondary schools and a much larger proportion of primary schools require functional telephones. Indeed, many parts of Kenya cannot easily get Internet services because of the poor telephone networks. About 90% of secondary schools need to establish standard Local Area Networks (LANs) in order to improve sharing of learning resources.  Alternative and appropriate technologies for access to Internet resources, including wireless systems remain quite expensive. Indeed, a small proportion of schools have direct access, through Internet Service Providers (ISPs), to high-speed data and communication systems. Furthermore, very few schools in the rural areas use wireless technology such as VSAT to access e-mail and Internet resources. Nearly all of the 6 NEPAD e-Schools are in rural areas and are expected to enjoy internet connectivity through VSAT technology.  While other countries have reported up to 41% of integration of ICT to teaching and learning, the proportion remains substantially low in Africa, Kenya included. Integration aims at the use ICT to support teaching and learning in the delivery of the various curricula to achieve improved education outcomes. Because ICT is interactive media, it facilitates students to develop diversified skills needed for industrialization and a knowledge-based economy. It also allows teachers and learners to proceed at different paces depending on the prevailing circumstances. As a first step, the Ministry of Education has initiated a major ICT project in Secondary schools meant to equip over 200 secondary schools with ICT infrastructure for integration of ICT in teaching/learning process ( KESSP, 2004). Three schools have been chosen in every district of Kenya.