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ENOCH DROMONGE. "Acute aflatoxicosis: case report. East Afr Med J. 2005 Jun;82(6):320-4.". In: East Afr Med J. 2005 Jun;82(6):320-4. African Wildlife Foundation. Nairobi; 2005. Abstract
The objective of this presentation is to document the salient clinical findings in a case of aflatoxicosis and to review the literature on the same so as to increase the index of suspicion, enhance early diagnosis and improve management. The case was a 17-year-old schoolboy presenting with vomiting, features of infection and gastrointestinal tract symptoms. Examination revealed a very ill looking pale patient with abdominal distension, tenderness and rectal bleeding and easy bruisability. Investigations showed abnormal liver function tests, pancytopenia and elevated serum levels of aflatoxins. Management consisted of supportive care including antibiotics and antifungal therapy, transfusion of red blood cells and fresh frozen plasma. His recovery was uneventful. The literature on human aflatoxicosis shows that the presentation may be acute, subacute and chronic. The degree of emanating clinical events also conforms to status of the aflatoxicosis. Overall, the features are protean and may masquerade many other forms of toxaemias. In conclusion, the diagnosis of aflatoxicosis takes cognisance of geographical location, past events, staple diet and clinical features to exclude other infections. Also required are high index of suspicion and importantly serum levels of aflatoxin. Treatment strategies involved use of antimicrobials and supporting the damaged multi-organs.
Nyongesa AW, Oduma JA, Nakajima M, Odongo HO, Adoyo A, al'Absi M. "Acute and sub-chronic effects of purified cathinone from khat (Catha edulis) on behavioural profiles in vervet monkeys (Chlorocebus aethiops)." Metabolic Brain Disease. 2014;29(2):441-449.abstract_behavior_paper.pdf
Muthee JK. Acute and Subacute Toxicity of Nicandra physaloides (L) Gaertn in Mice and Calves Respectively. Nairobi; 2008. Abstractabstract.pdf

The plant Nicandra physaloides (L) Gaertn, commonly known as the' apple of Peru' is a member of the solaneceae family. It has been widely associated with livestock poisoning in Kenya and elsewhere. The clinical signs reportedly associated with its poisoning are circling, tremors of the hind limbs, tachycardia, bloat, convulsions, coma and death. In the current study the acute toxicity was determined by intra-peritoneal injections of the aqueous extracts from different plant parts in a total of one hundred and fifty (150) white Swiss mice aged between to and 12 weeks and divided in groups of six (3 males and 3 females) for each dosage level. The median lethal dose (LDso) was then calculated by the method of Reed and Muench (1938). The subacute toxicity was determined by feeding five groups of two male Friesian calves each, aged between 8 and 10 months, at 0 (control), 4, 8, 16 and 32% levels of dried ground whole plant material in wheat bran for 14 weeks. The physiological parameters of rectal temperature, respiration, heart rate and ruminal motility were taken from all the calves every morning for the whole period of the experiment. The blood for hematology (5ml in EDTA) and biochemistry (l5ml without anticoagulant) was collected weekly via the jugular vene-puncture after thorough disinfection of the site with surgical spirit. LDso values for the leaf, fruit and whole plant extracts were 1.82, 2.58 and 3.62 g/kg body weight respectively, therefore, classifying the plant as slightly toxic according to Loomis (1978). The clinical signs showed by the mice were starry coat, slowed movements, fast respiration, gasping for air and leaping into the air before collapsing. The treated calves transiently exhibited muzzle drying, heart beat irregularity, loose feces, staggering gaits and lower growth rate than the control group. The activity of the enzyme gammaglutamyltransferase (GGT) and the mean corpuscular volume (MeV) were significantly lower (P0.05) between the treated and control groups in respect of the other assayed hematological (total protein. hemoglobin, red blood cells, packed cell volume, mean corpuscular hemoglobin concentration, white blood cells, lymphocytes and neutrophils) and biochemical (aspartate aminotransferase, creatinine and blood urea nitrogen) parameters. There were no mortalities, no gross or histopathological lesions in all the groups. The possible reasons for the difference in behaviour between the calves in this experiment and the suspected natural cases were thought to be due to the variations in animal susceptibility or even plant toxin content. It is concluded that the plant Nicandra physaloides growing around the Kabete areas of Kenya may contain toxic phytochemicals that may cause poisoning in livestock if consumed. Nicandra physaloides is known to contain glycosides, steroids and alkaloids from earlier studies. More studies are necessary to determine the nature of these phytotoxins and their exact mode of action. Meanwhile livestock keepers are advised to control this plant in their pastures and avoid its consumption by animals.

Willmore WS, Hill AG. "Acute appendicitis in a {Kenya} rural hospital." East African medical journal. 2001;78:355-357. AbstractWebsite
n/a
Sharma SB, Gupta V. "Acute appendicitis presenting as acute hemiscrotum in a boy." Indian journal of gastroenterology: official journal of the Indian Society of Gastroenterology. 2004;23:150. Abstract

A 6-year-old boy presented with diffuse abdominal pain, nausea and vomiting followed by features of acute scrotum. Laboratory and radiological evaluation suggested presence of infective pathology in the inguinoscrotal region. Surgical exploration revealed patent right processus vaginalis with purulent collection resulting from the presence of perforated tip of appendix in the hernial sac. Appendectomy with drainage of scrotal collection and ligation of hernial sac resulted in satisfactory recovery.

Munyua, S.J.M.;, Williamson P;, Penhale MJ;. "Acute Cellular And Humoral Responses To Equine Streptococcal Endometritis.".; 1984.
Jani PG. "Acute colonic pseudo obstruction (Ogilvie’s syndrome) A case report." East African Medical Journal. 2005;(82):325.
Nguchu HK, JOSHI MD, Otieno CF. "Acute coronary syndromes amongst type 2 diabetics with ischaemic electrocardiograms presenting to accident and emergency department of a Kenyan tertiary institution.". 2009. AbstractWebsite

OBJECTIVE: To determine the prevalence of acute coronary syndromes among type 2 diabetic patients presenting to Accident and Emergency department. DESIGN: Prospective cross-sectional study. SETTING: Kenyatta National Hospital, a tertiary teaching and referral hospital. SUBJECTS: Type 2 diabetic patients with ischaemic electrocardiograms (ECG). MAIN OUTCOME MEASURES: Demographics, clinical symptoms, cardiovascular status and risk factors--central obesity, hypertension, dyslipidaemia, smoking. RESULTS: From 12,307 accident and emergency attendees, 400 (33%) diabetics aged > OR =30 years were screened with a resting ECG and 95 (24%) with ischaemic ECG were recruited; age range 41-87 years, 60% were male; diabetes duration ranged 0-30 years with 8.4% being newly diagnosed. The commonest enrolling ECG feature was nonspecific ST-T changes. The commonest presenting complaint were fatigue and dyspnoea. Majority had three coronary artery disease (CAD) risk factors: obesity 86%, elevated LDL 73% and hypertension 60%. Therapy in use was OHA 43%, insulin 42%, insulin and OHA 1%; prophylactic aspirin 14.7% and statins 8.4%. Thirty four (35.8%) were classified as acute coronary syndrome (ACS); 29 (30.5%) acute myocardial infarction (ACS-AMI) and five (5.2%) unstable angina (ACS-UA). Majority (79.4%) of the ACS presented more than six hours after symptom onset and majority had features of acute left ventricular failure. CONCLUSIONS: Acute coronary syndrome accounted for 35% of the morbidity in type 2 diabetics with ischaemic ECG's presenting to KNH accident and emergency department; patients presented late and 80% were not on CAD prophylactic therapy.

Slyker JA, Lohman-Payne BL, John-Stewart GC, Maleche-Obimbo E, Emery S, Richardson B, Dong T, Iversena AKN, Mbori-Ngacha DA, Overbaugh J, Rowland-Jones SL. "Acute cytomegalovirus infection in Kenyan HIV-infected infants.". 2009. AbstractWebsite

Objective: Cytomegalovirus (CMV) coinfection may influence HIV-1 disease progression
during infancy. Our aim was to describe the incidence of CMV infection
and the kinetics of viral replication in Kenyan HIV-infected and HIV-exposed uninfected
infants.
Methods: HIV-1 and CMV plasma viral loads were serially measured in 20 HIVexposed
uninfected and 44 HIV-infected infants born to HIV-infected mothers.
HIV-infected children were studied for the first 2 years of life, and HIV-exposed
uninfected infants were studied for 1 year.
Results: CMVDNAwas detected frequently during the firstmonths of life; by 3months of
age,CMVDNAwasdetectedin90%ofHIV-exposeduninfectedinfantsand93%of infants
whohadacquiredHIV-1inutero.CMVviral loadswerehighest inthe1–3monthsfollowing
the first detection of virus and declined rapidly thereafter. CMV peak viral loads were
significantlyhigher in theHIV-infectedinfantscomparedwith theHIV-exposeduninfected
infants (mean3.2versus2.7 log10CMVDNAcopies/ml, respectively,P¼0.03).Thedetection
of CMV DNA persisted to 7–9 months post-CMV infection in both the HIV-exposed
uninfected (8/17, 47%) and HIV-infected (13/18, 72%, P¼0.2) children. Among HIVinfected
children, CMV DNA was detected in three of the seven (43%) surviving infants
tested between 19 and 21 months post-CMV infection. Finally, a strong correlation was
found between peak CMV and HIV-1 viral loads (r¼0.40, P¼0.008).
Conclusion: Acute CMV coinfection is common in HIV-infected Kenyan infants. HIV-1
infection was associated with impaired containment of CMV replication.

Slyker JA, Rowland-Jones SL, Dong T, Reilly M, Richardson B, Emery VC, Atzberger A, Mbori-Ngacha DA, Lohman-Payne BL, John-Stewart GC. "Acute cytomegalovirus infection is associated with increased frequencies of activated and apoptosis-vulnerable T cells in HIV-1-infected infants.". 2012. AbstractWebsite

Cytomegalovirus (CMV) coinfection is associated with infant HIV-1 disease progression and mortality. In a cohort of Kenyan HIV-infected infants, the frequencies of activated (CD38(+) HLA-DR(+)) and apoptosis-vulnerable (CD95(+) Bcl-2(-)) CD4(+) and CD8(+) T cells increased substantially during acute CMV infection. The frequency of activated CD4(+) T cells was strongly associated with both concurrent CMV coinfection (P = 0.001) and HIV-1 viral load (P = 0.05). The frequency of apoptosis-vulnerable cells was also associated with CMV coinfection in the CD4 (P = 0.02) and CD8 (P < 0.001) T cell subsets. Similar observations were made in HIV-exposed uninfected infants. CMV-induced increases in T cell activation and apoptosis may contribute to the rapid disease progression in coinfected infants.

Sanderson JE, Namasaka JW, Chek AK, Ojiamdo HP, Watkins HM, Mugambi M. "Acute effects of nifedipine in African hypertensives.". 1984.Website
Shilo S, Werner D, Hershko C. "Acute hemolytic anemia caused by severe hypophosphatemia in diabetic ketoacidosis." Acta Haematologica. 1985;73:55-57. Abstract

Hypophosphatemia in diabetic ketoacidosis is well recognized, but is believed to be usually of moderate severity. We describe 2 patients in whom acute hemolytic anemia secondary to severe (0.19-0.35 mmol/l) hypophosphatemia has developed 1-2 days following treatment for diabetic ketoacidosis. Our experience indicates that severe hypophosphatemia requiring phosphate supplementation does occur in diabetic patients, and calls for increased awareness for the clinical and laboratory manifestations of this complication of diabetic ketoacidosis.

Richardson BA, R W Nduati, Mbori-Ngacha DA, Overbaugh J, John-Stewart GC. "Acute HIV infection among Kenyan infants.". 2008. AbstractWebsite

BACKGROUND:
Clinical signs and symptoms of acute human immunodeficiency virus (HIV) infection in infants are not well characterized.
METHODS:
Serial clinical assessments and HIV PCR assays were conducted in a cohort of children born to HIV-seropositive mothers from birth to 2 years of age. Acute HIV infection visits were defined as those up to 3 months prior to and including the visit at which HIV DNA was first detected. Noninfection visits included all visits at which the child had test results negative for HIV, including the last visit at which a test result negative for HIV DNA was obtained in children who later acquired HIV infection. Differences in the prevalence of symptoms at acute infection versus noninfection visits were determined overall and were stratified by age at infection (<2 months vs. >or=2 months). HIV RNA was measured serially in infected infants and was compared between infants with and infants without symptoms of acute HIV infection.
RESULTS:
There were 125 acute infection visits (among 56 infants) and 3491 noninfection visits (among 306 infants). Acute HIV infection was associated with rash (odds ratio [OR], 1.8; 95% confidence interval [CI], 1.1-2.8), failure to thrive (OR, 1.9; 95% CI, 1.0-3.5), and lymphadenopathy (OR, 2.5; 95% CI, 1.4-4.8). Acute HIV infection was associated with lymphadenopathy (OR, 2.6; 95% CI, 1.3-5.0) in infants <2 months of age and with pneumonia (OR, 3.2; 95% CI, 1.1-9.3) and dehydration (OR, 6.0; 95% CI, 1.9-18.5) in infants >or=2 months of age. Infant peak viral load and mortality were not associated with symptoms of acute HIV infection. However, infants with symptoms had higher viral levels later in the course of infection than did those without symptoms (P=.05).
CONCLUSIONS:
Infants may manifest symptoms early during the course of HIV infection, and symptoms of acute HIV infection may correlate with poor viral control. Rash, failure to thrive, lymphadenopathy, pneumonia, and dehydration may signify acute HIV infection in infants.

MBORI- PROFNGACHADOROTHYA. "Acute HIV infection among Kenyan infants. Clin Infect Dis . 2008 Jan 15; 46 ( 2 ): 289-95 . PMID: 18171265 [PubMed - indexed for MEDLINE] Richardson BA, Nduati R, Mbori-Ngacha D, Overbaugh J, John-Stewart GC.". In: Clin Infect Dis . 2008 Jan 15; 46 ( 2 ): 289-95 . Earthscan, London. 978-1-84407-469-3 (*); 2008. Abstract
Department of Biostatistics, University of Washington, Seattle, Washington, USA. BACKGROUND: Clinical signs and symptoms of acute human immunodeficiency virus (HIV) infection in infants are not well characterized. METHODS: Serial clinical assessments and HIV PCR assays were conducted in a cohort of children born to HIV-seropositive mothers from birth to 2 years of age. Acute HIV infection visits were defined as those up to 3 months prior to and including the visit at which HIV DNA was first detected. Noninfection visits included all visits at which the child had test results negative for HIV, including the last visit at which a test result negative for HIV DNA was obtained in children who later acquired HIV infection. Differences in the prevalence of symptoms at acute infection versus noninfection visits were determined overall and were stratified by age at infection (<2 months vs. >or=2 months). HIV RNA was measured serially in infected infants and was compared between infants with and infants without symptoms of acute HIV infection. RESULTS: There were 125 acute infection visits (among 56 infants) and 3491 noninfection visits (among 306 infants). Acute HIV infection was associated with rash (odds ratio [OR], 1.8; 95% confidence interval [CI], 1.1-2.8), failure to thrive (OR, 1.9; 95% CI, 1.0-3.5), and lymphadenopathy (OR, 2.5; 95% CI, 1.4-4.8). Acute HIV infection was associated with lymphadenopathy (OR, 2.6; 95% CI, 1.3-5.0) in infants <2 months of age and with pneumonia (OR, 3.2; 95% CI, 1.1-9.3) and dehydration (OR, 6.0; 95% CI, 1.9-18.5) in infants >or=2 months of age. Infant peak viral load and mortality were not associated with symptoms of acute HIV infection. However, infants with symptoms had higher viral levels later in the course of infection than did those without symptoms (P=.05). CONCLUSIONS: Infants may manifest symptoms early during the course of HIV infection, and symptoms of acute HIV infection may correlate with poor viral control. Rash, failure to thrive, lymphadenopathy, pneumonia, and dehydration may signify acute HIV infection in infants. PMID: 18171265 [PubMed - indexed for MEDLINE]
O PROFORINDADA. "Acute Intermittent Porphyria in an East Africa Female.A.M. Odonga, J. R. Wambwa and D.A.O. Orinda,E. A. Med. Journal Vol. 57, No. 10 p 716, (1980).". In: East Afr Med J. 1980 Oct;57(10):716-9. Earthscan, London. 978-1-84407-469-3 (*); 1980. Abstract
PMID: 7215256 [PubMed - indexed for MEDLINE]
G.W. K. "The Acute Leukaemias (Review article) ." EAMJ. 1986;(63):756.
KIRTDA DRACHARYAS. "Acute liver failure: prognostic markers. Indian J Gastroenterol. 2003 Dec;22 Suppl 2:S66-8.". In: Indian J Gastroenterol. 2003 Dec;22 Suppl 2:S66-8. The Icfai University Journal of Architecture, Vol. II No.1, February 2010; 2003. Abstract

Acute liver failure (ALF) is defined as liver failure occurring within one month of the occurrence of jaundice. The disease has a grim prognosis, with a mortality of 65% to 85%. The management of ALF has till recently been conservative, and newer therapeutic modalities like bioartificial liver, hepatocyte transplant, and extracorporeal liver assist devices have not yet been proven to be successful. Liver transplant has changed the gloomy outlook of the disease, and post-transplant survival rates of 60%-70% have been reported from most centers. However liver transplant is expensive, necessitates life-long immunosupression, and is limited by a global shortage of available organs. It is thus necessary to select patients who are at greatest risk of death for liver transplantation. Prognostic criteria are based primarily either on clinical and laboratory (coagulation tests, serum bilirubin) parameters, or on other parameters like liver volume. Prognostic criteria have been developed both from the East and the West; these are essentially similar except that the Western criteria take into account etiology (drug overdose being the main cause of ALF there) as well as jaundice-encephalopathy interval as factors for prognostication. The King's College criteria were one of the first prognostic systems; it has two parts for both paracetamol as well as non paracetamol ALF. The criteria from our institute found prothrombin time >25 s, serum bilirubin >15 mg/dL, age >40 years, and cerebral edema to be bad prognostic markers. Criteria from the PGIMER, Chandigarh found age >50 years, raised intracranial pressure, prothrombin time >100 s, and onset of HE more than seven days after the jaundice as poor prognostic markers. All these clinical criteria have similar sensitivity and specificity.

Makworo D, Laving AM. "Acute medical conditions in under five year old children at a public hospital in Kenya.". 2010. AbstractWebsite

OBJECTIVE:
To determine the prevalence of childhood preventable and treatable medical conditions and the parent's/guardian's knowledge about the conditions and their management.
DESIGN:
A descriptive cross-sectional study.
SETTING:
Paediatric medical wards at Kenyatta National hospital
SUBJECTS:
All children aged 0-60 months with preventable conditions (that included pneumonia, malaria, diarrhoea/dehydration, meningitis and malnutrition) in paediatric wards who had stayed in the ward for 24 to 48 hours.
RESULTS:
Two hundred and fifty six parents/guardians staying with their children were recruited into the study. The vast majority (85.5%) of the children were aged less than two years. The prevalence of the acute treatable and preventable medical conditions was 88.6% over a one month period. The leading cause of admission for most children was pneumonia (31.6%) followed by malnutrition (16.8%) and gastro-enteritis (16%). Other conditions included neonatal sepsis (9.1%), measles (6%) and malaria (4.8%). The parents'/guardians' mean and median age was 26 years and the majority (89.8%) were mothers. A great proportion (46.5%) of the parents/guardians had attained at least some primary education. More than 70% of the parents/guardians were found to lack knowledge about their children's health problems and the drugs they were using. This was regardless of the parent's/guardians level of education and the frequency of admission of the child.
CONCLUSION:
Acute preventable and treatable medical conditions at KNH are highly prevalent, and the leading conditions include pneumonia, malnutrition and gastroenteritis. Most parents/guardians did not understand their children's health problems regardless of their level of education.

Othieno-Abinya NA. "Acute myeloid leukaemia in adults.". 1997.
T. PROFKAIMENYIJACOB. "Acute Necrotizing Ulcerative Gingivitis. In Textbook of Periodontology Pg 94. 2nd Edition. T.R. Gururaja Rao. All India Publishers and DistributorsCHENNAI (MADRAS) 2001.". In: Book Chapter. African Meteorological Society; 2001. Abstract
This paper gives general information on the location of Kenya, its demography, economy, organisation of health services, general health policy, health financing, oral health infrastructure, problems that hamper health financing and proposals on how to solve these problems. Further, a summary of health status of the Kenyan people is given based on the results of studies. The mean DMFT for the rural and urban populations is low and there is no evidence of an increase or decrease. Similarly, the prevalence of periodontitis is low (1-10%), with no increase. Ulcerative lesions are rare (0.12%). The most common birth defects are cleft lip and palate. Oral cancer is very low, accounting for 2% of all malignancies. Comparative studies have not demonstrated any dramatic change in the frequency of oral cancer for the last 25 years. Oral candidiasis is the most prevalent oral lesion amongst HIV/AIDS patients. In June 2003, Kenya formulated a National Oral Health Policy, which gives direction on how to improve the oral health status of the citizens.
Ngure RM, Eckersall PD, Jennings FW, Mburu J, Burke J, Mungatana N, MURRAY M. "Acute phase response in mice experimentally infected with Trypanosoma congolense: a molecular gauge of parasite-host interaction.". 2007. AbstractWebsite

Mice infected with Trypanosoma congolense developed a severe anaemia 1 week after infection, which persisted till treatment with diminazine aceturate when the packed cell volume (PCV) recovered to pre-infection levels. This was accompanied by a marked increase in the plasma levels of the acute phase proteins (APP), serum amyloid P-component (SAP) and haptoglobin (Hp). The initial peak levels of Hp and SAP were attained 7 and 12 days post-infection (DPI), respectively. Thereafter SAP levels decreased significantly to near pre-infection levels, but later increased even after treatment to give a second peak 34 DPI after which there was a decline till the study was terminated. The Hp levels on the other hand decreased to an intermediate level after the initial peak increasing to a second peak 22 DPI. Thereafter Hp decreased significantly following diminazine aceturate treatment to reach pre-infection levels within 5 days post-treatment. This indicates that T. congolense-infected mice develop severe anaemia accompanied by an acute phase response leading to an increase in SAP and Hp but that following treatment divergent responses occurred indicating differences in the pathways for stimulation of the APP. Haptoglobin was shown to be an earlier indicator of infection and a better marker in monitoring the response to treatment.

MAINA DRMBURUJOHN. "Acute phase response in mice experimentally infected with Trypanosoma congolense: a molecular gauge of parasite-host interaction.Ngure RM, Eckersall PD, Jennings FW, Mburu J, Burke J, Mungatana N, Murray M.Vet Parasitol. 2008 Jan 25;151(1):14-20. Epub 200.". In: Vet Parasitol. 2008 Jan 25;151(1):14-20. Epub 2007 Oct 22. CHAK Times; 2008. Abstract
Mice infected with Trypanosoma congolense developed a severe anaemia 1 week after infection, which persisted till treatment with diminazine aceturate when the packed cell volume (PCV) recovered to pre-infection levels. This was accompanied by a marked increase in the plasma levels of the acute phase proteins (APP), serum amyloid P-component (SAP) and haptoglobin (Hp). The initial peak levels of Hp and SAP were attained 7 and 12 days post-infection (DPI), respectively. Thereafter SAP levels decreased significantly to near pre-infection levels, but later increased even after treatment to give a second peak 34 DPI after which there was a decline till the study was terminated. The Hp levels on the other hand decreased to an intermediate level after the initial peak increasing to a second peak 22 DPI. Thereafter Hp decreased significantly following diminazine aceturate treatment to reach pre-infection levels within 5 days post-treatment. This indicates that T. congolense-infected mice develop severe anaemia accompanied by an acute phase response leading to an increase in SAP and Hp but that following treatment divergent responses occurred indicating differences in the pathways for stimulation of the APP. Haptoglobin was shown to be an earlier indicator of infection and a better marker in monitoring the response to treatment.
H DRWANJALASAMSON. "Acute pneumonias in adults in Nairobi.". In: East Afr Med J. 1976 Aug;53(8):480-3. Academic Press Elsevier. Int.; 1976. Abstract

PIP: In 1990, the annual population growth rate in Kenya was 3.8%, among the highest rates world wide. The ever growing adolescent fertility rate (111-152/1000 from 1969-1989) contributed to this rapid growth. Further repeat pregnancies among adolescents remained high in the 1980's and ranged from 20%-28.6%, depending on the survey. Even though overall prevalence of pregnancy fell 15.4% between 1978-1984, it remained the same for the 15-19 year old group. Teenage births have made up at least 35% of total deliveries. 1985 data revealed that even though adolescents represent 11-35% of the total obstetric population, problems ranked high among them: 38% of all eclampsia cases and high maternal mortality (102/100,000 vs. 57/100,000 older mothers). Studies showed that adolescents are sexually active, are ignorant about contraception, and do not use contraception. Yet contraceptive and family planning services are free in Kenya. Nevertheless the teenagers are at high risk of an unwanted pregnancy, sexually transmitted diseases (STDs), and AIDS. In the early 1980s, Kenyatta National Hospital reported 53% of 74.1% of septic abortion cases being single women were between 14-20 years old. Similar results emerged from other studies. Health professionals believed these results to be underestimated, however. In the 1980s, 33% of all adolescents between 13-15 years old in a rural area had gonorrhea. In Kenyatta, 36% of pregnant 15-24 year olds had at least 1 STD while,e only 16% of those 24 years old did. Further, teenagers are especially vulnerable to psychological problems when they 1st learn of their pregnancy. Health services should be geared to meet the specific needs of adolescents, such as contraception education and antenatal services. PMID: 12316815 [PubMed - indexed for MEDLINE]

Williamson P;, Penhale JW;, Munyua SJM;, Murray J. "Acute Reaction Of Mares Uterus Of Bacterial Infection."; 1984.
AJ W, LS O. "Acute renal failure as seen at Kenyatta National Hospital." East Afr Med J. 1992;69(2):110-3. Abstract

Forty seven patients with acute renal failure were studied prospectively over a two-year period at the Kenyatta National Hospital. There were 20 males and 27 females. The mortality rate was 40.4%. Most patients had medically oriented problems. Complications that were associated with a high mortality were infections and the presence of neuropsychiatric manifestations.

JW A, AN K, JD M, CM M, DN K. "Acute respiratory distress syndrome due to Babesiosis in a dog." . Res. J. Anim. Sci.. 2011; 5:14-16. Abstract

Abstract: A case of acute respiratory distress syndrome due to babesiosis is reported in a 5 years old male Japanese sptiz. The patient was noticed to have developed sudden dyspnoea. The main presenting clinical signs included laboured breathing, broad-base stance but preferred recumbency, pallour and seizures. Blood smears from the ear tips revealed presence of multiple Babesia parasites in the erythrocytes. Hematology results showed slight leucocytosis, severe anemia and thrombocytopenia. Additionally, urinalysis revealed renal pathology and presence of leucocytes in urine. Despite aggressive measures to stabilize the patient, it died within an hour. Autopsy results also confirmed Babesiosis with generalized icterus.

JW A, AN K, JD M, CM M, DN K. "Acute respiratory distress syndrome due to Babesiosis in a dog." Res. J. Anim. Sci.. 2011;5:14-16.
ALERI DRJOSHUAWAFULA. "An Acute Respiratory Distress Syndrome due to Babesiosis in a dog (2010). Aleri, J. W., Kipyegon, A.N., Mande, J.D., Mulei, C.M. and Karanja, D.N.". In: Faculty of Veterinary Medicine 7th Biennial Scientific Conference 2010. KVA; 2010. Abstract
Description: This book describes four types of indigenous water retention structures used in East Africa. These structures are the Berkad tank, the Charco dam, sand wiers and hillside water retention ditches.
ALERI DRJOSHUAWAFULA. "Acute Respiratory Distress Syndrome due to Babesiosis in a dog (2012). Aleri, J. W., Kipyegon, A.N., Mande, J.D., Mulei, C.M. and Karanja, D.N.". In: Departmental seminar. Departmental seminar; 2012. Abstract
Description: This book describes four types of indigenous water retention structures used in East Africa. These structures are the Berkad tank, the Charco dam, sand wiers and hillside water retention ditches.
Aleri JW, Kipyegon AN, Mande JD, Mulei CM, Karanja DN. "Acute Respiratory Distress Syndrome Due to Babesiosis in a Dog: Case Report.". 2011. AbstractWebsite

Abstract: A case of acute respiratory distress syndrome due to babesiosis is reported in a 5 years old male Japanese sptiz. The patient was noticed to have developed sudden dyspnoea. The main presenting clinical signs included laboured breathing, broad-base stance but preferred recumbency, pallour and seizures. Blood smears from the ear tips revealed presence of multiple Babesia parasites in the erythrocytes. Hematology results showed slight leucocytosis, severe anemia and thrombocytopenia. Additionally, urinalysis revealed renal pathology and presence of leucocytes in urine. Despite aggressive measures to stabilize the patient, it died within an hour. Autopsy results also confirmed Babesiosis with generalized icterus.

Aleri JW, Kipyegon AN, Mulei CM, Karanja DN. "Acute Respiratory Distress Syndrome Due to Babesiosis in a Dog: Case Report.". 2011. AbstractWebsite

Abstract: A case of acute respiratory distress syndrome due to babesiosis is reported in a 5 years old male Japanese sptiz. The patient was noticed to have developed sudden dyspnoea. The main presenting clinical signs included laboured breathing, broad-base stance but preferred recumbency, pallour and seizures. Blood smears from the ear tips revealed presence of multiple Babesia parasites in the erythrocytes. Hematology results showed slight leucocytosis, severe anemia and thrombocytopenia. Additionally, urinalysis revealed renal pathology and presence of leucocytes in urine. Despite aggressive measures to stabilize the patient, it died within an hour. Autopsy results also confirmed Babesiosis with generalized icterus.

Kipyegon AN, Mande JD, Mulei CM, Karanja DN. "Acute Respiratory Distress Syndrome Due to Babesiosis in a Dog: Case Report.". 2011. AbstractWebsite

Abstract: A case of acute respiratory distress syndrome due to babesiosis is reported in a 5 years old male Japanese sptiz. The patient was noticed to have developed sudden dyspnoea. The main presenting clinical signs included laboured breathing, broad-base stance but preferred recumbency, pallour and seizures. Blood smears from the ear tips revealed presence of multiple Babesia parasites in the erythrocytes. Hematology results showed slight leucocytosis, severe anemia and thrombocytopenia. Additionally, urinalysis revealed renal pathology and presence of leucocytes in urine. Despite aggressive measures to stabilize the patient, it died within an hour. Autopsy results also confirmed Babesiosis with generalized icterus.

MASIBO PROFWAFULAEZEKIEL. "Acute respiratory infections. Wafula EM.". In: East Afr Med J. 1995 Oct;72(10):617-8. EM Ngatia, LW Gathece, FG Macigo, TK Mulli, LN Mutara, EG Wagaiyu.; 1995. Abstract
No abstract available.
R W Nduati. Acute Septic Arthritis As It Is Seen In Children At Kenyatta National Hospital.; 1987. Abstract

A nine-month study was done on children with acute septic arthritis admitted to the Paediatric Orthopaedic and general paediatric wards. The aims of the study were to elucidate the clinical characteristics and aetiological agents of septic arthritis in children admitted to Kenyatta National Hospital. Thirty one children were recruited into the study and of these 58% were infants and 32.3% were school age children. There was a striking male predominance in the school age children - 9:1 while male/female ratio was 1.2:1 in the
younger children. Knees and shoulders were the most frequently affected by septic arthritis and together were responsible for
71% of the septic joints. It is of interest that all the septic

shoulder joints occurred in infancy. Non-typhoidal salmonella species especially Salmonella typhimurium, Klebsiella species and Staphylococcus aureus were the most frequently isolated bacteria.

The rate of bacterial isolation was as high as 72.2% when both blood cultures and joint aspirate cultures were done. Salmonella species had 75% sensitivity to the aminoglycosides (Gentamicin,Kanamycin) and Chloramphenicol while only two thirds of the Klebsiella species were sensitive to the same antibiotics. Staphylococcus aureus isolated in this study were sensitive to Erythromycin and uniformly resistant to
Ampicillin,.Cloxacillin and Cotrimoxazole. There was full

recovery in 63.7% of the patients while 23% went home without appropriate follow-up.

The author recommends that blood and joint aspirate cultures should be done in all patients suspected to have septic arthritis. Antibiotic sensitivity testing should be done r~gularly to facilitate appropriate drug therapy. Clinicians should ensure adequate follow-up of patients following discharge from hospital.

"Acute sexually transmitted infections increase human immunodeficiency virus type 1 plasma viremia, increase plasma type 2 cytokines, and decrease CD4 cell counts.". 2000. Abstract

J Infect Dis. 2000 Aug;182(2):459-66. Epub 2000 Jul 12.
Acute sexually transmitted infections increase human immunodeficiency virus type 1 plasma viremia, increase plasma type 2 cytokines, and decrease CD4 cell counts.
Anzala AO, Simonsen JN, Kimani J, Ball TB, Nagelkerke NJ, Rutherford J, Ngugi EN, Bwayo JJ, Plummer FA.
Source
Department of Medical Microbiology, University of Manitoba, Winnipeg, Canada.
Abstract
In Kenya, the median incubation time to AIDS in seroconverting sex workers is 4 years; this incubation time is specific to female sex workers. We studied the influence of acute sexually transmitted infections (STIs) on several immunologic parameters in 32 human immunodeficiency virus type 1 (HIV-1)-positive and 10 HIV-1-negative women sex workers who were followed for 1-5 months. Plasma cytokines, soluble cytokine receptors, CD4 and CD8 T cell counts, and HIV-1 plasma viremia were quantitated before, during, and after episodes of STI. Increases in interleukin (IL)-4, IL-6, IL-10, soluble tumor necrosis factor (TNF)-alpha, and viremia and a decline in CD4(+) T cell counts occurred during gonococcal cervicitis and returned to baseline after treatment. Increases in viremia correlated with increased IL-4 and decreased IL-6 concentrations. Similar changes were seen among women with acute pelvic inflammatory disease. Acute bacterial STI resulted in increased HIV-1 viremia. This may be mediated through increased inflammatory cytokines or through modulation of immune responses that control HIV-1 viremia.
PMID:
10915076
[PubMed - indexed for MEDLINE]
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JOAB PROFBWAYOJOB, N DRMBATIAPAUL, O. PROFANZALAAGGREY. "Acute sexually transmitted infections increase human immunodeficiency virus type 1 plasma viremia, increase plasma type 2 cytokines, and decrease CD4 cell counts. Anzala AO, Simonsen JN, Kimani J, Ball TB, Nagelkerke NJ, Rutherford J, Ngugi EN, Bwayo JJ, .". In: J Infect Dis. 2000 Aug;182(2):459-66. Asian Economic and Social Society; 2000. Abstract
Background. The host immune response against mucosally-acquired pathogens may be influenced by the mucosal immune milieu during acquisition. Since Neisseria gonorrhoeae can impair dendritic cell and T cell immune function, we hypothesized that co-infection during HIV acquisition would impair subsequent systemic T-cell responses.   Methods. Monthly screening for sexually transmitted infections (STIs) was performed in high risk, HIV seronegative Kenyan female sex workers as part of an HIV prevention trial. Early HIV-specific CD8+ T cell responses and subsequent HIV viral load set point were assayed in participants acquiring HIV, and were correlated with the presence of prior genital infections during HIV acquisition.   Results. Thirty-five participants acquired HIV during follow up, and 16/35 (46%) had a classical STI at the time of acquisition. N. gonorrhoeae co-infection was present during HIV acquisition in 6/35 (17%), and was associated with an increased breadth and magnitude of systemic HIV-specific CD8+ T-cell responses, using both interferon- (IFNg) and MIP-1 beta (MIP1b) as an output. No other genital infections were associated with differences in HIV-specific CD8+ T cell response, and neither N. gonorrhoeae nor other genital infections were associated with differences in HIV plasma viral load at set point.   Conclusion. Unexpectedly, genital N. gonorrhoeae infection during heterosexual HIV acquisition was associated with substantially enhanced HIV-specific CD8+ T-cell responses, although not with differences in HIV viral load set point. This may have implications for the development of mucosal HIV vaccines and adjuvants.
JOAB PROFBWAYOJOB, N DRMBATIAPAUL, O. PROFANZALAAGGREY. "Acute sexually transmitted infections increase human immunodeficiency virus type 1 plasma viremia, increase plasma type 2 cytokines, and decrease CD4 cell counts. Anzala AO, Simonsen JN, Kimani J, Ball TB, Nagelkerke NJ, Rutherford J, Ngugi EN, Bwayo JJ, .". In: J Infect Dis. 2000 Aug;182(2):459-66. John Benjamins Publishing Company; 2000. Abstract
OBJECTIVE: To determine the prevalence of HCV infection and HCV/HIV co-infection among voluntary blood donors at the National Blood Transfusion Centre and clients at the Kenyatta National Hospital HIV-Voluntary Counseling and Testing (VCT) Centre. DESIGN: A prospective cross-sectional descriptive study. SETTING: Kenyatta National Hospital, a tertiary referral and teaching hospital and the National Blood Transfusion Services Centre, Nairobi. SUBJECTS: Volunteer blood donors and VCT attendants. RESULTS: The prevalence of HCV/HIV co-infection among 6154 blood donors in the NBTSC was very low, at 0.02. The HIV prevalence among the 353 KNH HIV-VCT clients was 9.3%, none of the clients tested positive for HCV. The incidence of risk factors in the persons with HCV and/or HIV infection(s) was low. CONCLUSION: The prevalence of HCV infection among pre-screened volunteer blood donors was low. However the current practice of screening all donated blood for HCV remains indispensable to prevent its transmission to blood recipients.
JOAB PROFBWAYOJOB, N DRMBATIAPAUL, O. PROFANZALAAGGREY. "Acute sexually transmitted infections increase human immunodeficiency virus type 1 plasma viremia, increase plasma type 2 cytokines, and decrease CD4 cell counts. Anzala AO, Simonsen JN, Kimani J, Ball TB, Nagelkerke NJ, Rutherford J, Ngugi EN, Bwayo JJ, .". In: J Infect Dis. 2000 Aug;182(2):459-66. Elsevier; 2000. Abstract
Ethnopharmacological relevance: Traditional medicines play an important role in the management of chronically painful and debilitating joint conditions, particularly in the rural Africa. However, their potential use as sources of medicines has not been fully exploited. The present study was carried to find the medicinal plants traditionally used to manage chronic joint pains in Machakos and Makueni counties in Kenya. Materials and methods: To obtain this ethnobotanical information, 30 consenting traditional herbal med-ical practitioners were interviewed exclusively on medicinal plant use in the management of chronic joint pains, in a pre-planned workshop. Results and discussion: In this survey, a total of 37 plants belonging to 32 genera and 23 families were cited as being important for treatment of chronic joint pains. The most commonly cited plant species were Pavetta crassipes K. Schum, Strychnos henningsii Gilg., Carissa spinarum L., Fagaropsis hildebrandtii (Engl.) Milve-Redh. and Zanthoxylum chalybeum Engl. Acacia mellifera (Vahl) Benth., Amaranthus albus L., Balanites glabra Mildbr. & Schltr., Grewia fallax K. Schum., Lactuca capensis, Launaea cornuta (Oliv. & Hiern) O. Jeffrey, Lippia kituiensis Vatke, Pappea capensis Eckl. & Zeyh. and Pennisetum glaucum (L.) R. Br. are documented for the first time as being important in the management of chronic joint pains. Conclusions: The findings of this study show that a variety of medicinal plants are used in the management of chronic joint pains and the main mode of administration is oral. Keywords: Ethnobotanical survey; Medicinal plants; Chronic joint pains; Rheumatoid arthritis; Akamba; Machakos-Kenya
Muthee JK, Mbaria JM, Thaiya AG. "Acute Toxicity of Nicandra physaloides (L) Gaertn in Cattle and Mice.". 2009. AbstractWebsite

Nicandra physaloides (L) Gaertn (Solanaceae), commonly known as the ‘apple of Peru’ is widely associated with livestock poisoning. The clinical signs associated with its poisoning in ruminants appear within 6 hours of ingestion and are circling, tremors of the hind limbs, tachycardia, bloat, convulsions, coma and death. However, there is no published information on the toxicology of this plant in Kenya. This study documents Nicandra physaloides toxicity in two different zero-grazed dairy cattle herds that were inadvertently fed on Napier grass contaminated with Nicandra physaloides. In addition to the case studies, the toxicity of the aqueous extracts from the different parts of Nicandra physaloides was studied under experimental conditions in mice. The 24 hour median lethal dose (LD50) was determined after intra-peritoneal injection (i.p.) of the aqueous extracts of the plant into white Swiss mice and found to be 1820, 2580 and 3620 mg/kg body weight for the leaves, fruits and whole plant respectively. The clinical signs in mice appeared within 30 minutes of inoculation and included coat, decreased locomotor activity, increased respiratory rate, gasping for air and leaping into the air before collapsing into coma and death. There were similarities in the symptoms of the spontaneous poisoning in cattle and in the experimentally induced poisoning in mice.

GITAU DRTHAIYAHANDREW. "Acute toxicity of Nicandra physaloides (L) Gaertn in cattle and mice. Muthee, J.K., Mbaria, J.M., Thaiya, A.G. and Gakuya, D.W.". In: kenya veterinarian 33: 1-6. kenya veterinarian 33: 1-6; 2009. Abstract

Fresh blood lymphocytes from nine health donors have been compared with samples from the same donors, recovered after period of 2 to 21 months storage in liquid nitrogen, for the capacity to respond to a range of mitogens in vitro. A microculture assay was used, requireing aliquots of only 25,000 cells. The mean levels of 14C-thymidine uptake for fresh and frozen samples were closely comparable when the cells had been stimulated by PHA, Pokeweed or mitomycin-C-treated allogeneic lymphoblastoid cells. Lymphocytes from six East African donors, frozen by a very simple technique, were recovered after 3 or more years storage in liquid nitrogen. Five of the samples were in good condition as judged by cell viability and the capacity to form spontaneous 'E' rosettes with sheep erythrocytes. These five samples also responded extremely well to PHA, PWM and mitomycin-C-treated allogeneic lymphoblastoid cells using the microculture assay. This study extends the range of applications of cell banks in which small aliquots of blood lymphocytes are stored in liquid nitrogen for periods of several years.

Okumu MO, Mbaria JM, Kanja LW, Gakuya DW, Kiama SG, Ochola FO, Okumu PO. "Acute toxicity of the aqueous methanolic Moringa oleifera(Lam) leaf extract on female Wistar Albino rats." International Journal of Basic Clinical Pharmacology. 2016;5(5):1-6.acute_toxicity_of_the_aqueous_methanolic_moringa_oleiferalam_leaf_extract_on_female_wistar_albino_rats.pdf
Mitchel O. Okumu, James M. Mbaria, Laetitia W. Kanja DGW, Stephen G. Kiama FOO, Okumu PO. "Acute toxicity of the aqueous-methanolic Moringa oleifera (Lam) leaf extract on female Wistar albino rats." international journal of Basic and Clinical pharmacology. 2016;5(5):1856-1861.
Muthee JK, Mbaria JM, Thaiyah AG, Karanja DN, Gakuya DW. "Acute Toxicity Study of Nicandra physaloides(L) Gaertn in mice and cattle." The Kenya Veterinarian. 2009;33:1-6.
Katz MA, Marangu D, Attia EF, Bauwens J, Bont LJ, Bulatovic A, Crane J, Doroshenko A, Ebruke BE, Edwards KM, Fortuna L, Jagelaviciene A, Joshi J, Kemp J, Kovacs S, Lambach P, Lewis KDC, Ortiz JR, Simões EAF, Turner P, Tagbo BN, Vaishnavi V, Bonhoeffer J. "Acute wheeze in the pediatric population: Case definition & guidelines for data collection, analysis, and presentation of immunization safety data." Vaccine. 2019;37(2):392-399.
Maribei JM, Nyaga PN, Ngatia TA, Kamau JPM, Kinyuru JM. "Acute, sub-chronic and chronic toxicity of Solanum incanum L in sheep in Kenya.". 2011. AbstractWebsite

A study was carried out to determine the toxicity of unripe fruits of Solanum incanum L in sheep. The sheep were orally drenched with dried unripe fruits powder of S. incanum L at dose rates varying from 1,200mg to 3,600 mg/Kg /day for 9 weeks. Clinical signs were observed daily while blood with and without anticoagulant was taken weekly for haematological and biochemical analysis. Clinical signs started on day two with bloat. All sheep groups showed bloat and coughing. Signs of cerebellar hyperplasia were manifested in 25%, 75% and 25% of sheep in groups 2, 3, and 4 respectively, manifested by staggering gait, lateral recumbency, leg paddling movements, coma and death. The mortality rate was 25% for group 2 and 100% for groups 3 and 4. All sheep groups had pneumonia, froth in the bronchi, lung emphysema and congestion in the brain, liver and kidneys while groups 3 and 5 had hemorrhagic ulcers on distal abomasum to proximal duodenum and hemorrhagic enteritis from duodenum to colon. On histology, all sheep showed necrosis of the Purkinje cells of the cerebellum and Wallerian degeneration of neurons; lung emphysema and interstitial pneumonia, hemorrhagic enteritis, tubular necrosis in the kidneys and hepatocyte necrosis. The results indicate that S. incanum L is highly toxic to sheep and allowing sheep to graze on the plant is dangerous to their health.

Thaiya AG, Nyaga PN, Maribei JM, Ngatia TA, Kamau JPM, Kinyuru JM. "Acute, sub-chronic and chronic toxicity of Solanum incanum L in sheep in Kenya.". 2011. AbstractWebsite

A study was carried out to determine the toxicity of unripe fruits of Solanum incanum L in sheep. The sheep were orally drenched with dried unripe fruits powder of S. incanum L at dose rates varying from 1,200mg to 3,600 mg/Kg /day for 9 weeks. Clinical signs were observed daily while blood with and without anticoagulant was taken weekly for haematological and biochemical analysis. Clinical signs started on day two with bloat. All sheep groups showed bloat and coughing. Signs of cerebellar hyperplasia were manifested in 25%, 75% and 25% of sheep in groups 2, 3, and 4 respectively, manifested by staggering gait, lateral recumbency, leg paddling movements, coma and death. The mortality rate was 25% for group 2 and 100% for groups 3 and 4. All sheep groups had pneumonia, froth in the bronchi, lung emphysema and congestion in the brain, liver and kidneys while groups 3 and 5 had hemorrhagic ulcers on distal abomasum to proximal duodenum and hemorrhagic enteritis from duodenum to colon. On histology, all sheep showed necrosis of the Purkinje cells of the cerebellum and Wallerian degeneration of neurons; lung emphysema and interstitial pneumonia, hemorrhagic enteritis, tubular necrosis in the kidneys and hepatocyte necrosis. The results indicate that S. incanum L is highly toxic to sheep and allowing sheep to graze on the plant is dangerous to their health.

Thaiyah AG, Nyaga PN, Maribei JM, Ngatia TA, Kamau JPM, Kinyuru JM. "Acute, sub-chronic and chronic toxicity of Solanum incanum L in sheep in Kenya." Kenya Veterinarian. 2011;35:1-8. Abstract
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Wambua L, Agaba M, Kemp SJ, Valentini A. "Acute-phase Trypanosomiasis: Role of parasite surface glycoprotein and DNA in immune response dysregulation.". In: European Science Foundation Conference on Cutting edge Immunology. Netherlands; 2011.abstract_esf-jsps.pdf
Juma FD, Nganga JN, Mathenge SG, Kato A, Tachibana Y, Ichimaru M, Moriyasu M, Nishiyama Y. "Acyclic triterpenoids from Ekebergia capensis.". 1996. AbstractWebsite

From the dried bark of Ekebergia capensis, two novel acyclic triterpenoids, 2,3,22,23-tetrahydroxy-2,6,10,15,19,23-hexamethyl-6,10,14,18-tetracosatetraene and 2-hydroxymethyl-2,3,22,23-tetrahydroxy-6,10,15,19,23-pentamethyl-6,10,14,18-tetracosatetraene were isolated, along with known cyclic triterpenoids. The structures of these two new triterpenoids were determined by spectroscopic and chemical methods.

Celum C, Kiarie, J.W, Wald A, Lingappa JR, Magaret AS, Wang RS, Mugo N, Mujugira A, Baeten JM, Mullins JI, Hughes JP, Bukusi EA, Cohen CR, Katabira E, Ronald A, Farquhar C, Stewart GJ, Makhema J, Essex M, Were E, Fife KH, de Bruyn G, Gray GE, McIntyre JA, Manongi R, Kapiga S, Coetzee D, Allen S, Inambao M, Kayitenkore K, Karita E, Kanweka W, Delany S, Rees H, Vwalika B, Stevens W, Campbell MS, Thomas KK, Coombs RW, Morrow R, Whittington WLH, McElrath MJ, Barnes L, Ridzon R, Corey L. "Acyclovir and transmission of HIV-1 from persons Infected with HIV-1 and HSV-2.". 2010. AbstractWebsite

Most persons who are infected with human immunodeficiency virus type 1 (HIV-1)
are also infected with herpes simplex virus type 2 (HSV-2), which is frequently reactivated
and is associated with increased plasma and genital levels of HIV-1. Therapy to
suppress HSV-2 reduces the frequency of reactivation of HSV-2 as well as HIV-1 levels,
suggesting that suppression of HSV-2 may reduce the risk of transmission of HIV Daily acyclovir therapy did not reduce the risk of transmission of HIV-1, despite a reduction
in plasma HIV-1 RNA of 0.25 log10 copies per milliliter and a 73% reduction in the
occurrence of genital ulcers due to HSV-2. (ClinicalTrials.gov number, NCT00194519

Celum C, Wald A, Lingappa JR, Magaret AS, Wang RS, Mugo N, Mujugira A, Baeten JM, Mullins JI, Hughes JP, Bukusi EA, Cohen CR, Katabira E, Ronald A, Kiarie J, Farquhar C. "Acyclovir and transmission of HIV-1 from persons infected with HIV-1 and HSV-2.". 2010.Website
Celum C, Wald A, Lingappa JR, Magaret AS, Wang RS, Mugo N, Mujugira A, Baeten JM, Mullins JI, Hughes JP, Bukusi EA, Cohen CR, Katabira E, Ronald A, Kiarie J, Farquhar C, Stewart GJ, Makhema J, Essex M, Were E, Fife KH, de Bruyn G, Gray GE, McIntyre JA, Manongi R, Kapiga S, Coetzee D, Allen S, Inambao M, Kayitenkore K, Karita E, Kanweka W, Delany S, Rees H, Vwalika B, Stevens W, Campbell MS, Thomas KK, Coombs RW, Morrow R, Whittington WLH, McElrath MJ, Barnes L, Ridzon R, Corey L. "Acyclovir and transmission of HIV-1 from persons infected with HIV-1 and HSV-2." N. Engl. J. Med.. 2010;362(5):427-39. Abstract

Most persons who are infected with human immunodeficiency virus type 1 (HIV-1) are also infected with herpes simplex virus type 2 (HSV-2), which is frequently reactivated and is associated with increased plasma and genital levels of HIV-1. Therapy to suppress HSV-2 reduces the frequency of reactivation of HSV-2 as well as HIV-1 levels, suggesting that suppression of HSV-2 may reduce the risk of transmission of HIV-1.

M PROFBHATTSHRIKANTBABU. "Adam A.M., Bhatt S.M. Behects syndrome presenting with multiple cerebral and Brainstem infarcts. E. Afr. Med. J. 1987; Vol. 64 No. 8: 558 .". In: E. Afr. Med. J. 1987; Vol. 64 No. 8: 558 . Taylor & Francis; 1987. Abstract
We studied 506 consecutive adult acute medical admissions to hospital in Nairobi; 95 (18.8%) were seropositive for HIV-1, and 43 new cases of active tuberculosis (TB) were identified. TB was clearly associated with HIV infection, occurring in 17.9% of seropositive patients compared with 6.3% of seronegatives [odds ratio (OR) 3.2; 95% confidence limits (CL) 1.6-6.5]. Extrapulmonary disease was more common in seropositive than seronegative TB patients (nine out of 17 versus five out of 26; OR 4.7; 95% CL 1.01-23.6); this accounted for most of the excess cases of TB seen in seropositive patients. Mycobacteraemia was demonstrated in two of eight seropositive TB patients but in none of 11 seronegative TB patients. No atypical mycobacteria were isolated. The World Health Organization (WHO) clinical case definition for African AIDS did not discriminate well between seropositive and seronegative TB cases. Five out of seven seropositive women with active tuberculosis had delivered children in the preceding 6 months and were lactating, compared with only one out of eight seronegative tuberculous women. An association between recent childbirth, HIV immunosuppression and the development of TB is suggested
ADAM PROFADAMMOHAMED. "Adam AM, Bhatt SM, Otieno LS.Beh.". In: Surgical and Radiologic Anatomy. Vol. 9 issue 3, 1987. Gitau, W., Ogallo L. A. and Mutemi, J. N.,; 1987. Abstract

One hundred normal lateral skull radiographs were studied and those of ten patients with basilar impression attending Kenyatta Hospital, Nairobi. The mean shortest distance of the odontoid tip to McGregor's basal line was 1.2 +/- 2.28 mm below the basal line (range 6 mm below to 3 mm above basal line), in normals and 9 +/- 2.7 mm (6-14 mm) above basal line in patients. The mean basal angle was 113 degrees +/- 7 degrees (102 degrees-133 degrees) in normals and 122 degrees +/- 6 degrees (113 degrees-125 degrees) in patients. The mean nasion-basion-opisthion angle was 162 degrees +/- 4 degrees (154 degrees-169 degrees) in normals and 178 degrees +/- 5 degrees (173 degrees-185 degrees) in patients. The mean total length of clivus was 48 +/- 3.7 mm (43-56 mm) in normals and 44 +/- 6.6 (36-48 mm) in patients group. The mean median diameter of the foramen magnum was 39 +/- 5 mm (30-48 mm), atlas 21 +/- 3 mm (18-25 mm) axis 18 +/- 3 mm (14-23 mm), third cervical vertebra 16 +/- 2 mm (13-22 mm) in normals and in patients: 39 +/- 4 mm (36-45 mm), atlas 23 +/- 6 (15-30 mm) axis 19 +/- 4 mm (16-25 mm), third cervical vertebra 16 +/- 3 (14-20). There was a significant difference in the position of the odontoid tip and the nasion-basion-opisthion angle between the normal and patient groups. All the other parameters measured in this work did not differ significantly between the two groups.

ADAM PROFADAMMOHAMED. "Adam AM, Hughes RA, Payan J, McColl I.Peripheral neuropathy and hyperthermia. Lancet. 1987 May 30;1(8544):1270-1. No abstract available.". In: Surgical and Radiologic Anatomy. Vol. 9 issue 3, 1987. Gitau, W., Ogallo L. A. and Mutemi, J. N.,; 1987. Abstract

One hundred normal lateral skull radiographs were studied and those of ten patients with basilar impression attending Kenyatta Hospital, Nairobi. The mean shortest distance of the odontoid tip to McGregor's basal line was 1.2 +/- 2.28 mm below the basal line (range 6 mm below to 3 mm above basal line), in normals and 9 +/- 2.7 mm (6-14 mm) above basal line in patients. The mean basal angle was 113 degrees +/- 7 degrees (102 degrees-133 degrees) in normals and 122 degrees +/- 6 degrees (113 degrees-125 degrees) in patients. The mean nasion-basion-opisthion angle was 162 degrees +/- 4 degrees (154 degrees-169 degrees) in normals and 178 degrees +/- 5 degrees (173 degrees-185 degrees) in patients. The mean total length of clivus was 48 +/- 3.7 mm (43-56 mm) in normals and 44 +/- 6.6 (36-48 mm) in patients group. The mean median diameter of the foramen magnum was 39 +/- 5 mm (30-48 mm), atlas 21 +/- 3 mm (18-25 mm) axis 18 +/- 3 mm (14-23 mm), third cervical vertebra 16 +/- 2 mm (13-22 mm) in normals and in patients: 39 +/- 4 mm (36-45 mm), atlas 23 +/- 6 (15-30 mm) axis 19 +/- 4 mm (16-25 mm), third cervical vertebra 16 +/- 3 (14-20). There was a significant difference in the position of the odontoid tip and the nasion-basion-opisthion angle between the normal and patient groups. All the other parameters measured in this work did not differ significantly between the two groups.

ADAM PROFADAMMOHAMED. "Adam AM, Maritim MC.Pseudoxanthoma elasticum in a patient with sickle cell disease: case report. East Afr Med J. 2008 Feb;85(2):98-101.". In: The Proceedings of the Kenya Society of Anaesthesilogists. Gitau, W., Ogallo L. A. and Mutemi, J. N.,; 2008. Abstract
An 18 year female sickler (HbSS) presented with repeated history of epistaxis and bleeding gums. Features consistent with pseudoxanthoma elasticum were observed, such as hyper-extensile redundant skin folds in the neck, axilla, inguinal areas and abdomen. The skin biopsy showed swollen, clumped and fragmented elastic fibres and calcium deposits in the deep and mid reticular dermis, consistent with pseudoxanthoma elasticum. This is a well recognised complication of sickle cell disease which has not been described in Kenya.
CHERONO DRMARITIMMARYBETH. "Adam AM, Maritim MC.Pseudoxanthoma elasticum in a patient with sickle cell disease: case report.East Afr Med J. 2008 Feb;85(2):98-101.". University of Nairobi.; 2008. Abstract

An 18 year female sickler (HbSS) presented with repeated history of epistaxis and bleeding gums. Features consistent with pseudoxanthoma elasticum were observed, such as hyper-extensile redundant skin folds in the neck, axilla, inguinal areas and abdomen. The skin biopsy showed swollen, clumped and fragmented elastic fibres and calcium deposits in the deep and mid reticular dermis, consistent with pseudoxanthoma elasticum. This is a well recognised complication of sickle cell disease which has not been described in Kenya.

ADAM PROFADAMMOHAMED. "Adam AM.Relations among open-closed mindedness, social desirability and depression in students facing a critical situation involving authority. Nurs Res Conf. 1973;(9):241-76. No abstract available.". In: E.A.M. J. 58: 401-404, 1981. Gitau, W., Ogallo L. A. and Mutemi, J. N.,; 1973. Abstract
Aminoglutethimide (AG) 500 mg was administered orally to four normal volunteers and eight patients undergoing treatment for metastatic breast cancer. In each subject the acetylator phenotype was established from the monoacetyldapsone (MADDS)/dapsone (DDS) ratio. Acetylaminoglutethimide (acetylAG) rapidly appeared in the plasma and its disposition paralleled that of AG. A close relationship (P less than 0.01) was observed between the acetyl AG/AG and MADDS/DDS ratio suggesting that AG may undergo polymorphic acetylation like DDS. AG half-life was 19.5 +/- 7.7 h in seven fast acetylators of DDS and 12.6 +/- 2.3 h in five slow acetylators and its apparent metabolic clearance was significantly (P less than 0.01) related to the acetylAG/AG ratio. Over 48 h the fast acetylators excreted 7.7 +/- 4.4% of the administered AG dose in the urine as unchanged AG as compared to 12.4 +/- 2.8% in slow acetylators. A much smaller fraction of the dose was excreted as acetylAG: 3.6 +/- 1.5% by fast and 1.9 +/- 1.0% by slow acetylators respectively. After 7 days treatment with AG at an accepted clinical dose regimen to the eight patients there were significant reductions in the half-lives of AG (P less than 0.01) and acetylAG (P less than 0.01) and a trend (0.1 greater than P greater than 0.05) towards reduction of the acetylAG/AG ratio which became significant (P less than 0.05) if the one patient on a known enzyme inducer was omitted. The mean apparent volume of distribution was not significantly (P greater than 0.1) altered but the mean apparent systemic clearance of AG was increased (P less than 0.05). These changes are attributed to auto-induction of oxidative enzymes involved in AG metabolism.
ADAM PROFADAMMOHAMED. "Adam AM: Benign positional vertigo and hyperuricaemia. East Afr Med J. 2005 Jul;82(7):376-8.". In: East Afr Med J. 2005 Jul;82(7):376-8. Gitau, W., Ogallo L. A. and Mutemi, J. N.,; 2005. Abstract
OBJECTIVE: To find out if there is any association between serum uric acid level and positional vertigo. DESIGN: A prospective, case controlled study. SETTING: A private neurological clinic. SUBJECTS: All patients presenting with vertigo. RESULTS: Ninety patients were seen in this period with 78 males and 19 females. Mean age was 47 +/- 3 years (at 95% confidence level) with a standard deviation of 12.4. Their mean uric acid level was 442 +/- 16 (at 95% confidence level) with a standard deviation of 79.6 umol/l as compared to 291 +/- 17 (at 95% confidence level) with a standard deviation of 79.7 umol/l in the control group. The P-value was less than 0.001. CONCLUSION: That there is a significant association between high uric acid and benign positional vertigo.
ADAM PROFADAMMOHAMED. "Adam AM:Human genetics in the Holy Qur'an and Sunna.J R Coll Physicians Edinb. 2003;33(1):44-5.". In: J R Coll Physicians Edinb. 2003;33(1):44-5. Gitau, W., Ogallo L. A. and Mutemi, J. N.,; 2003. Abstract
OBJECTIVE: To find out if there is any association between serum uric acid level and positional vertigo. DESIGN: A prospective, case controlled study. SETTING: A private neurological clinic. SUBJECTS: All patients presenting with vertigo. RESULTS: Ninety patients were seen in this period with 78 males and 19 females. Mean age was 47 +/- 3 years (at 95% confidence level) with a standard deviation of 12.4. Their mean uric acid level was 442 +/- 16 (at 95% confidence level) with a standard deviation of 79.6 umol/l as compared to 291 +/- 17 (at 95% confidence level) with a standard deviation of 79.7 umol/l in the control group. The P-value was less than 0.001. CONCLUSION: That there is a significant association between high uric acid and benign positional vertigo.
OLE DRMAPENAYISAACM. "Adaptability of Maasai Zebu/Orma boran calves raised in a trypanosomosis endemic region.". In: Proceedings of the 7th Ketri Annual Internal Scientific Review on 22nd - 26th June 1998, No. 66 Pp 21-22. EAEP; 1998.
Nthakanio NP, Ireri KJ, Munji. KJ, Raphael W. Adaptability of PGMS and TGMS rice lines for hybrid rice seed production in Kenya..; 2012.
Ngugi K, Nabiswa A. "Adaptation of Jatropha curcas L. in the agroecological environments of Kenya: genotype × environment interactions ana lysis.". 2012. AbstractWebsite

Jatropha curcas L. has the potential for becoming an important feedstock for biodiesel and bioenergy in Kenya. The objective of this study was to evaluate the e"ects of genotype X` environment interaction and to determine the stability of performance of the currently grown genotypes. Methodology:A field trial consisting of 49 genotypes was laid out in a lattice design of two replications in two contrasting agroecological environments, namely Thika and Kibwezi, for 2 years. The Eberhart and Russell stability method was used to measure the performance of yield components of the 49 genotypes. Results: Environmental variance in%uenced the performance of genotypes for all the traits measured and genotype#×#environment interactions were important in determining their performance.

Nabiswa A, Kinama J. "Adaptation of Jatropha curcas L. in the agroecological environments of Kenya: genotype × environment interactions ana lysis.". 2012. AbstractWebsite

Jatropha curcas L. has the potential for becoming an important feedstock for biodiesel and bioenergy in Kenya. The objective of this study was to evaluate the e"ects of genotype X` environment interaction and to determine the stability of performance of the currently grown genotypes. Methodology:A field trial consisting of 49 genotypes was laid out in a lattice design of two replications in two contrasting agroecological environments, namely Thika and Kibwezi, for 2 years. The Eberhart and Russell stability method was used to measure the performance of yield components of the 49 genotypes. Results: Environmental variance in%uenced the performance of genotypes for all the traits measured and genotype#×#environment interactions were important in determining their performance.

MUTONGA PENINAH. "Adaptation of Swahili architecture and identity, a case of Lamu and Shela." Africa Habitat Review Journal. Submitted;1(1/2019):50.
Mbwika JM, wa Mberia K, Oduor JAN. "Adaptation Strategies in Rabai Loanwords." Asian Journal of African Studies (AJAS). 2019;46(ISSN 2466- 1821.).
KABUBO-MARIARA J. "Adaptation to Climate Change and Livestock Biodiversity: Evidence from Kenya. .". In: K.N.Ninan (ed.): “Conserving and Valuing Ecosystem Services and Biodiversity: Economic, Social and Institutional Challenges in the New Millennium”. Chapter 16:(345-369. London: Earthscan Publishers; 2009.
Kibugi R. "Adaptation to climate change in smallholder agriculture in Kenya: the role of law.". In: Research Handbook on Climate Change and Agricultural Law. Edward Elgar Publishing; 2017. Abstract
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Kathuri J, Apindi E, Olaka L, L Olago, et al. "Adaptation to Climate Change-Induced Malaria and Cholera in the Lake Victoria Region." AIACC Working Papers. 2018. AbstractWebsite

Abstract
AIACC Working Papers, published on-line by Assessments of Impacts and Adaptations to Climate Change (AIACC), is a series of papers and paper abstracts written by researchers participating in the AIACC project. Papers published in AIACC Working Papers have been peer reviewed and accepted for publication in the on-line series as being (i) fundamentally sound in their methods and implementation, (ii) informative about the methods and/or findings of new research, and (iii) clearly written for a broad, multi-disciplinary audience. The purpose of the series is to circulate results and descriptions of methodologies from the AIACC project and elicit feedback to the authors. The AIACC project is funded by the Global Environment Facility, the Canadian International Development Agency, the U.S. Agency for International Development, and the U.S. Environmental Protection Agency. The project is co-executed on behalf of the United Nations Environment Programme by the global change SysTem for Analysis Research and Training (START) and The Academy of Sciences for the Developing World (TWAS).

Koh K-L, Kelman I, Kibugi R, Osorio R-LE. Adaptation to Climate Change: ASEAN and Comparative Experiences. World Scientific; 2015. Abstract
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Koh K-L, Kelman I, Kibugi R, Osorio R-LE. Adaptation to Climate Change: ASEAN and Comparative Experiences. World Scientific; 2015. Abstract
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Koh K-L, Kelman I, Kibugi R, Osorio R-LE. Adaptation to Climate Change: ASEAN and Comparative Experiences. World Scientific; 2015. Abstract
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Marangu D, Mwaniki H, Nduku S, Maleche-Obimbo E, Jaoko W, Babigumira J, John-Stewart G, Rao D. "ADAPTING A STIGMA SCALE FOR ASSESSMENT OF TUBERCULOSIS-RELATED STIGMA AMONG ENGLISH/SWAHILI-SPEAKING PATIENTS IN AN AFRICAN SETTING." Stigma Health. 2017;2(4):326. Abstract

To adapt a validated instrument that quantitatively measures stigma among English/Swahili speaking TB (tuberculosis) patients in Kenya, a high burden TB country.

et.al. JMI. "Adapting Agriculture to Climate Change: Suitability of Banana Crop Production to Future Climate Change Over Uganda.". In: Limits to Climate Change Adaptation. Springer, Cham; 2018. Abstract

The aim of this study was to determine suitability zones of future banana growth under a changing climate to guide the design of future adaptation options in the banana sub-sector of Uganda. The study used high resolution (~1 km) data on combined bioclimatic variables (rainfall and temperature) to map suitability zones of the banana crop while the Providing Regional Climate for Impacts Studies (PRECIS) regional climate model temperature simulations were used to estimate the effect of rising temperature on banana growth assuming other factors constant. The downscaled future climate projections were based on the Intergovernmental Panel on Climate Change (IPCC) Representative Concentration Pathways (RCPs, 2.6, 4.5, 6.0 and 8.5) and Special Report on Emission Scenarios (SRES, A1B and A2) across the period 2011–2090. The methodology involved identification of banana-climate growth thresholds and developing suitability indices for banana production under the high mitigation (RCP 2.6, less adaptation), medium mitigation (RCP 4.5 and RCP 6.0, medium adaptation), no mitigation (RCP 8.5, very high adaptation) scenarios, SRES A1B and A2 scenarios. The FAO ECO-Crop tool was used to determine and map future suitability of banana growth. Banana production indices were determined using a suitability model in the Geographical Information System (GIS) spatial analyst tool. The non-linear banana-temperature regression model was used to assess the impact of future changes in temperature on banana growth. The results revealed unique and distinct banana production suitability and growth patterns for each climate scenario in the sub-periods. RCPs 2.6 and 6.5 are likely to be associated with higher levels of banana production than RCPs 4.5 and 8.5. The results further showed that projected temperature increase under SRES A1B will promote banana growth. In contrast, expected increases in temperatures under SRES A2 are likely to retard banana growth due to high moisture deficits. There is need to develop adaptation option for farming communities to maximize their agricultural production and incomes. The effectiveness of adaptation options needed to combat the impacts will be influenced by the magnitude of the expected climatic changes associated with each scenario, the timing of expected climate change extremes and sensitivity of the crop to climate. This study has provided critical information that will be useful for planning integrated adaptation practices in the banana farming subsector to promote productivity.

Sabiiti G, et al. "Adapting Agriculture to Climate Change: Suitability of Banana Crop Production to Future Climate Change over Uganda.". In: Limits to Climate Change Adaptation. Springer, Cham; 2018. Abstract

The aim of this study was to determine suitability zones of future banana growth under a changing climate to guide the design of future adaptation options in the banana sub-sector of Uganda. The study used high resolution (~ 1km) data on combined bioclimatic variables (rainfall and temperature) to map suitability zones of the banana crop while the Providing Regional Climate for Impacts Studies (PRECIS) regional climate model temperature simulations were used to estimate the effect of rising temperature on banana growth assuming other factors constant. The downscaled future climate projections were based on the Intergovernmental Panel on Climate Change (IPCC) Representative Concentration Pathways (RCPs, 2.6, 4.5, 6.0 and 8.5) and Special Report on Emission Scenarios (SRES, A1B and A2) across the period 2011-2090. The methodology involved identification of banana-climate growth thresholds and developing suitability indices for banana production under the high mitigation (RCP 2.6, less adaptation), medium mitigation (RCP 4.5 and RCP 6.0, medium adaptation), no mitigation (RCP 8.5, very high adaptation) scenarios, SRES A1B and A2 scenarios. The FAO ECO-Crop tool was used to determine and map future suitability of banana growth. Banana production indices were determined using a suitability model in the Geographical Information System (GIS) spatial analyst tool. The non-linear banana-temperature regression model was used to assess the impact of future changes in temperature on banana growth.

Mwangi N, Gachago M, Gichangi M, Gichuhi S, Githeko K, Jalango A, Karimurio J, Kibachio J, Ngugi N, Nyaga P, Nyamori J, Zindamoyen ANM, Bascaran C, Foster A. "Adapting clinical practice guidelines for diabetic retinopathy in Kenya: process and outputs." Implement Sci . 2018;13(81):https://doi.org/10.1186/s13012-018-0773-2.
N M, M G, M G, Gichuhi S, G K, A J’o. "Adapting clinical practice guidelines for diabetic retinopathy in Kenya: process and outputs." Implementation Science. 2018;13(1):81.
Mwangi N, Gachago M, Gichangi M, Gichuhi S, Githeko K, Jalango A, Karimurio J, Kibachio J, Muthami L, Ngugi N, Nduri C, Nyaga P, Nyamori J, Zindamoyen ANM, Bascaran C, Foster A. "Adapting clinical practice guidelines for diabetic retinopathy in Kenya: process and outputs." Implement Sci. 2018;13(1):81. Abstract

The use of clinical practice guidelines envisages augmenting quality and best practice in clinical outcomes. Generic guidelines that are not adapted for local use often fail to produce these outcomes. Adaptation is a systematic and rigorous process that should maintain the quality and validity of the guideline, while making it more usable by the targeted users. Diverse skills are required for the task of adaptation. Although adapting a guideline is not a guarantee that it will be implemented, adaptation may improve acceptance and adherence to its recommendations.

L MRNDOGONIKINYANJUI. "Adapting Group Interpersonal Psychotherapy for a Develoing Country: Experience in Rural Uganda (co-author).". In: Journal of the World Psychiatric Association (WPA) Vol. 2. No. 2 June 2003. EAMJ; 2003. Abstract
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Nyangito M, Huelsebusch C, Oliver Wasonga, Opiyo F. "Adapting or Coping? An Analysis of Pastoralists.". 2012. Abstract
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Wagacha PW, Chege D. "Adaptive and Optimisation Predictive Text Entry for Short Message Service (SMS) .". In: Special topics in Computing and ICT research: Advances in Systems Modelling and ICT Applications. Kampala: Fountain publishers; 2006.
Mindila A, Rodrigues A, McCormick D, Mwangi RW. "An Adaptive ICT-Enabled Model for Knowledge Identification and Management for Enterprise Development." International Journal of International Journal of System Dynamics Applications. 2014;3(3):19 pp.
S. Z, G. C, I. V, G. B, D.M. H, K.M. M, J.R. B. "Adaptive radiation of the endemic Alcolapia cichlids of the East African soda lakes: genetic and morphological perspectives." Journal of Evolutionary Biology. In Press.
GICHOHI PROFKARURIEDWARD. "Adding value to root and root tuber crops. International Center for Tropical Agriculture.ISBN 958 9439 14 4. Contributed to the development of the manual.". In: Journal of Animal and Plant Sciences, Vol.2, issue 2: 76-84. Kisipan, M.L.; 1995. Abstract
Objective: To determine the pattern of breast disease at Kenyatta National Hospital (KNH) Study design:    Retrospective descriptive study Study setting:    Kenyatta National Hospital, a University teaching and National Referral Hospital Patients: Records of 1172 patients were reviewed. Results: An average 469 new patients per year or 11 new patients per clinic visit were seen at the clinic over a two and a half year period. Females predominated (98.9%) in this series. The mean age was 34.71 years (range 1 to 96 years). The average age at menarche was 14.49 years and the mean duration of symptoms was 6.86 months. Only 2.6% of 843 patients had a positive family history of breast disease. Fibroadenoma was the commonest diagnosis made (33.2%) followed by ductal carcinoma (19.7%). Gynaecomastia was the most common lesion seen in males. Two thirds of patients presenting with tumors had masses measuring more than 5cm.  Overall five conditions (fibroadenoma, ductal carcinoma, breast abscesses, fibrocystic disease and mastalgia) accounted for over 85% of all breast ailments. Surgery formed the main stay of care in over 80% of patients. Conclusions: The pattern of breast diseases at KNH closely mirrors those reported in other studies in the region and beyond. This study indicates that a large proportion of patients presenting with breast disease are treated initially by surgery. It may be wise to consider other alternative forms of therapy where appropriate. The Annals of African Surgery: 2008 June; Vol 2, pg 97-101.
ONJUA PROFOYIEKEJB, OTIENO DRODAWAFRANCISXAVIER. "Addisons Disease in Pregnancy: Two case reports.". In: J. of Ob. Gy. E & Centr Afric. 3(2); 63, 1984. EM Ngatia, LW Gathece, FG Macigo, TK Mulli, LN Mutara, EG Wagaiyu.; 1984. Abstract
PIP: This research report studies several biochemical and histochemical aspects of cervical carcinoma and explores their use in follow-up of patients undergoing radiotherapy. Material came from 19 patients with invasive cervical carcinoma admitted to Kenyatta National Hospital. A control group consisted of 20 women matched for age who attended clinics at the hospital but were not suffering from any malignant disease; control tissue for histological examination was obtained from 3 women who had undergone hysterectomy for uterine fibroids. Biochemical assays for alkaline and acid phosphatases in patients with cervical carcinoma show an increase in alkaline phosphatase in carcinomatous tissue (35.7 umoles/hr/mg) as opposed to normal tissue (7.2). Acid phosphatase values were only moderately raised. Assays of the same enzymes in blood showed a less marked difference between patients and controls (ranges of 7.5-20.8 and 3-14, respectively). When examined histochemically, increased alkaline phosphatase activity was observed in connective tissue, epithelium of the glands and blood capillaries of tumor tissue. 1 section containing normal tissue bordering carcinomatous tissue demonstrated normal alkaline phosphatase activity in the normal tissue and increased activity in the tumor tissue. In summary, there is increased enzyme activity around the tumor areas, but values for serum levels show an overlap of normal and abnormal cases and are therefore not predictive. Results demonstrate a clear difference in activities of these enzymes in carcinomatous tissue and normal tissue, which may be of value in follow-up care.
ONJUA PROFOYIEKEJB, OTIENO DRODAWAFRANCISXAVIER. "Addisons Disease in Pregnancy: Two case reports.". In: J. of Ob. Gy. E & Centr Afric. 3(2); 63, 1984. Elsevier; 1984. Abstract
PIP: The efficacy and complication rate of menstrual regulation with the hand-held Karman cannula was tested on 223 women with amenorrhea up to 56 days in the Dept. of Obstetrics and Gynecology, University of Nairobi, Kenya from October 1982-January 1983. 195 women had positive pregnancy tests, while menstrual regulation was done on the others because of concern over late menses. the procedures were done without anesthesia with a 50 ml vacuum syringe fitted with a self-locking plunger, a rubber adaptor and stop cock, 5-8 mm flexible plastic Karman cannula and a toothless volsellum, using hibitane solution and savlon antiseptic. The average procedure time was 7 minutes. Bleeding lasted over 1 week in 4%, total blood loss was over 50 ml in 3.1%, and immediate side effects were syncope in 1.3%, nausea and vomiting in 1.8% and pain in 5.4%. There were 2 (0.8%) cases of endometritis. In Kenya where 60% of all gynecological hospital admissions are for septic abortions, it is essential to provide safe termination as a backup for family planning method failures.
Odera BO. Addition of vanadium and niobium to platinum-based alloys .; 2013. Abstract

The ternary systems, Pt-Al-V at the Pt-rich corner and Pt-Cr-V were investigated. Phase equilibria data were obtained using scanning electron microscopy with energy dispersive X-ray spectroscopy and X-ray diffraction analyses. The alloys were studied in the as-cast condition, as well as after annealing at 1000°C for 1500 h. Solidification projections were constructed and liquidus surface projections derived for the two systems. Isothermal sections at 1000°C were also determined for the two systems. Two ternary phases were found in the Pt-Al-V system and one in the Pt-Cr-V system. It was concluded that all the phase regions were identified correctly since the results were self-consistent. Four invariant reactions were identified in the Pt-Cr-V system. Four Pt-Al-Cr-Ru-V and two Pt-Al-Cr-Ru-V-Nb alloys were also investigated and data obtained using scanning electron microscopy with energy dispersive X-ray spectroscopy and X-ray diffraction analyses. The alloys were studied in the as-cast condition, as well as after annealing at 1000°C for 1500 h. The compositions of the alloys were based on a quaternary alloy, Pt82:Al12:Cr4:Ru2, which had been identified as one of the alloys having optimum properties in an earlier investigation. Four of the as-cast alloys had a two-phase structure of ~Pt3Al and (Pt), while two had a single phase, ~Pt3Al. Vanadium partitioned more to ~Pt3Al compared to (Pt). There was an improvement in hardness compared to the quaternary alloys which had been identified as having optimum properties. About 64% of as-cast Pt-Al-V alloys had Vickers hardnesses higher than 500 HV0.3 while ~70% of the annealed alloys had hardness higher than 500 HV0.3. More than 60% of both as-cast and annealed Pt-Cr-V alloys had hardness values higher than 600 HV0.3. There was a general increase in hardness after annealing Pt-Cr-V alloys. Hardness increased with V content in the higher order alloys, and also the annealed alloys had higher hardness compared to the as-cast ones.

NZUVE SNM. Addition, Alcohol and Drug Use - A Management problems. Nairobi: University of Nairobi press; 1987.
Njenga M, Karanja N, Karlsson H, Jamnadass R, Iiyama M, Kithinji J, Sundberg C. "Additional cooking fuel supply and reduced global warming potential from recycling charcoal dust into charcoal briquette in Kenya." Journal of cleaner production. 2014;81:81-88. AbstractWebsite

Abstract

Rising demand for energy is one of the major challenges facing the world today and charcoal is a principal fuel in Kenya. Faced with energy poverty many poor households turn to briquette making. This study assessed the additional cooking fuel obtained from recycling charcoal dust into charcoal briquettes. It applied Life Cycle Assessment (LCA) to assess the global warming potential (GWP) from use of charcoal and production of briquettes from charcoal dust and cooking a traditional meal for a standard household of five people. Native vegetation of Acacia drepanolobium and a low efficiency kiln were considered the common practice, while an Acacia mearnsii plantation and a high efficiency kiln was used as an alternative scenario. Charcoal and kerosene were considered as reference fuels. Recovering charcoal dust for charcoal briquettes supplied an additional 16% cooking fuel. Wood carbonization and cooking caused the highest GWP, so there is a need for technologies to improve the efficiency at these two stages of charcoal briquettes and charcoal supply chain. Supplying energy and cooking a traditional meal in a combined system using charcoal and recovering charcoal dust for charcoal briquettes and charcoal alone accounted for 5.3–4.12 and 6.4–4.94 kg CO2 eq. per meal, respectively, assuming trees were not replanted. These amounts declined three times when the carbon dioxide from the carbonization and cooking stages was assumed to be taken up by growing biomass. This requires replanting of trees cut down for charcoal if the neutral impact of biomass energy on GWP is to be maintained.

Ahuya CO;, Cartwright TC;, Ruvuna F;, Okeyo AM. "Additive and heterotic effects from crossbreeding goats in Kenya."; 1987.
Mwololo JK, Muturi PW, Mburu MWK, Njeru RW, Kiarie N, K.Munyua J, Ateka EM, Muinga RW, Kapinga RE. "Additive main effects and multiplicative interaction analysis of genotype x environmental interaction among sweetpotato genotypes. ." Journal of Animal & Plant Sciences. 2009;2(3):148-155.
WAMBUA MUSILI. "Addressing Maritime Security Challenges;Lessons from Kenya’s Model Legislative Framework.". In: Building Local Capacity for Maritime security.; 2011.
M MRNJOKAJOHN. "Addressing Social and Economic Disparities. Kenya Human Development Report 2001. I was a contributor giving the sociological input.". In: East African Medical Journal. East African Medical Journal; 2002. Abstract
BACKGROUND: Malaria control in Africa relies primarily on early effective treatment for clinical disease, but most early treatments for fever occur through self-medication with shop-bought drugs. Lack of information to community members on over-the-counter drug use has led to widespread ineffective treatment of fevers, increased risks of drug toxicity and accelerating drug resistance. We examined the feasibility and measured the likely impact of training shop keepers in rural Africa on community drug use. METHODS: In a rural area of coastal Kenya, we implemented a shop keeper training programme in 23 shops serving a population of approximately 3500, based on formative research within the community. We evaluated the training by measuring changes in the proportions of drug sales where an adequate amount of chloroquine was purchased and in the percentage of home-treated childhood fevers given an adequate amount of chloroquine. The programme was assessed qualitatively in the community following the shop keeper training. RESULTS: The percentage of drug sales for children with fever which included an antimalarial drug rose from 34.3% (95% CI 28.9%-40.1%) before the training to a minimum of 79.3% (95% CI 71.8%-85.3%) after the training. The percentage of antimalarial drug sales where an adequate amount of drug was purchased rose from 31.8% (95% CI 26.6%-37.6%) to a minimum of 82.9% (95% CI 76.3%-87.3%). The percentage of childhood fevers where an adequate dose of chloroquine was given to the child rose from 3.7% (95% CI 1.2%-9.7%) before the training to a minimum of 65.2% (95% CI 57.7%-72.0%) afterwards, which represents an increase in the appropriate use of over-the-counter chloroquine by at least 62% (95% CI 53.7%-69.3%). Shop keepers and community members were strongly supportive of the aims and outcome of the programme. CONCLUSIONS: The large shifts in behaviour observed indicate that the approach of training shop keepers as a channel for information to the community is both feasible and likely to have a significant impact. Whilst some of the impact seen may be attributable to research effects in a relatively small scale pilot study, the magnitude of the changes support further investigation into this approach as a potentially important new strategy in malaria control.
OSODO MRSOGONDAGRACE. "Adegnibagbe, S., Perusuh, M. & Ogonda, G. (1997). A Comparative Review of Special Education in Kenya, Nigeria and Zimbabwe with reference to provision and Research.". In: International Journal of Special Education. Rao, W. O., Ogonji, J. A.. and Aywa, S.; 1997. Abstract
Summing multipliers is an important class of operators in the geometric theory of general Banach spaces. They are particularly useful in the study of the structure of the classical spaces. The work done by Grothendieck and Pietsch provides a good basis for the study of this class of operators. The topic of this study is Aspects on (p,q)-summing multipliers. (p,q)-summing multipliers are sequences of bounded linear operators mapping weakly p-summable sequences into strongly q-summable sequences. This study is concerned with using the concepts of absolute and p-summing multipliers to characterize the space of all (p,q)-summing multipliers. In particular we show that the space of all (p, q)-summing multipliers is complete. This is accomplished through a detailed study of the concepts of the summing operators and absolute and p-summing multipliers
FREDRICK DRONYANGOJOHN. "Adeline V L, Dimba E, Wakoli A K, Njiru A K, Awange D O, Onyango J F, Chindia M L: Clinicopathological features of Ameloblastoma in Kenya: a 10-year audit. J Craniofac Surg 2008; 19: 1589 .". In: J Craniofac Surg 2008; 19: 1589 . University of Nairobi Press; 2008. Abstract
Mefloquine pharmacokinetics were studied in Kenyan African normal volunteers and in patients with severe acute attack of Plasmodium falciparum malaria. Peak concentrations were achieved in both groups at 20-24 hours. The mean half-life of elimination was 385 +/- 150 hours (mean +/- SD) in normal subjects while in severe malaria it was 493 +/- 215 hours which was significantly longer (P less than or equal to 0.001). The volume of distribution was significantly smaller in severe malaria where it was 30.76 +/- 10.50 l/kg (mean +/- SD) while in the normal subjects it was 40.90 +/- 20.70 l/kg (mean +/- SD) (P less than or equal to 0.001). The total body clearance in severe malaria was 3.75 +/- 1.51 l/h (mean +/- SD). This was significantly lower than in the normal subjects where it was 5.15 +/- 1.50 l/h (mean +/- SD) (P less than or equal to 0.001).
MUNGAI DRMBUGUAPAUL. "Adem A Asblom A Johansson G Mbugua P M and Karlsson E (1988): Toxins from the venom of the green mamba Dendroaspis angusticeps that inhibit the binding of quinuclidinyl benzilate to muscarinic acetylcholine receptors (BBA 12211). Biochim Biophys Acta 968 .". In: Federation of Analytical Chemistry and Spectroscopy Society (FACSS) XV, Boston, November 1988. AWC and FES; 1988. Abstract

Department of Pharmacology and Toxicology, College of Pharmacy, University of Texas, Austin 78712.

Primary cultures of spontaneously beating myocardial cells isolated from neonatal rat hearts were used to screen the cardiotoxic effects of Jamesoni's mamba (Dendroaspis jamesoni) venom and components isolated from the venom by gel filtration and ion exchange chromatography. Cardiotoxicity was evaluated on the basis of leakage of lactate dehydrogenase (LDH), changes in morphology, cell membrane lysis, cellular viability, and alterations in spontaneous beating activity. The whole venom caused dose- and time-dependent leakage of LDH, disruption of the cell monolayer, decreases in viability, and inhibition of beating activity. Gel filtration of the venom yielded eight fractions (DjI to DjVIII). DjI (30 micrograms/ml), DjII (20 micrograms/ml), and DjV (20 micrograms/ml) caused significant (P less than 0.001) leakage of LDH, extensive morphologic damage, and decreases in viability. At lower concentrations DjI to DjVIII caused progressive inhibition of spontaneous beating activity. The main fraction (DjV), which was the most toxic, was further separated into 14 polypeptides (Dj1 to Dj14) by ion-exchange chromatography using Bio-Rex 70. Based on the ability to induce LDH leakage, produce morphologic damage, lyse cell membranes, and arrest beating activity, four categories of polypeptides were identified: cardiotoxins, Dj1 and Dj2; cardiotoxinlike polypeptides, Dj3 to Dj8; less active membrane lytic polypeptides, Dj9 to Dj13; and membrane lytic polypeptide, Dj14.

PMID: 3410805 [PubMed - indexed for MEDLINE]

Hazlett, DT; Bowmer MI; NFD'costa RAR; AGRH; L; L;. "ademba.". 1984. Abstract

PIP: Of 110 males selected for review with possible chancroid, 96 were clinically diagnosed as having chancroid, 7 as having herpetic lesions, and 7 as having syphilis. Of the 96 patients diagnosed clinically as chancroid, 76 (79.2%) were culture positive for H. ducreyi. 9 (9.4%) of these 96 patients yielded Herpes Simplex Virus (HSV). Both HSV and H. ducreyi were isolated from 5 of the patients, and from 4 of the patients HSV alone was isolated. 7 patients (6.4%) were clinically diagnosed as having herpetic ulcers. 5 of these grew HSV. Overall, 14 of the 110 patients (12.7%) yielded HSV. 1 patient, who presented with small vesicular lesions characteristic of HSV, yielded the virus on culture. The vesicles were initially negative for H. ducreyi, but 6 days later he had developed deep purulent ulcers in the same sites as the vesicular lesions and became culture positive for H. ducreyi snd HSV-negative. The possible association between HSV and chancroid is discussed in the light of these findings and comparisons made between the results of the present study and earlier findings made in Kenya and elsewhere, with suggestions being given as to the reasons for the apparent differences. The HSV isolation techniques used in this study may be less sensitive than those used in other studies, but it is highly unlikely that this possibility alone accounts for all of the observed differences. Patients with hepetic ulcers may be less likely to present early in the course of the disease, if at all, believing the infection to be minor and one that will heal on its own. It is also possible that HSV infection is less common in Kenya, either alone or as an initiator of chancroid, than in the US or Europe, becuase of a higher rate of childhood HSV infections in Kenya, which may confer a degree of immunity against genital HSV infection in this population. The lower prevalence of HSV in association with H. ducreyi reported may be at least partly the result of a much higher incidence in Kenya of chancroid which is not initiated by HSV. A higher incidence of HSV genital infection in Europe and America would also make it more likely that HSV would fortuitously be isolated more frequently from H. ducreyi positive lesions.

J PROFCHINDIAMARK, ELIZABETH DRDIMBA. "Aden A, Dimba EA, Ndolo UM, Chindia ML.Socio-economic effects of khat chewing in north eastern Kenya.East Afr Med J. 2006 Mar;83(3):69-73.". In: East Afr Med J. 2006 Mar;83(3):69-73. Hekima III (1) 27-42; 2006. Abstract
BACKGROUND: The khat habit is a widespread phenomenon which has in the past two decades spread to parts of Western Europe and North America from Eastern Africa and the Arabian Peninsula. Although khat has been identified as one of the most commonly abused substances in Kenya, restrictions on cultivation, trade and usage have been non-existent since its legalisation in 1977. OBJECTIVE: To describe the socio-economic effects of khat chewing in Ijara District in the North Eastern Province of Kenya. DESIGN: Cross sectional study. SETTING: Ijara District, North Eastern Kenya. SUBJECTS: Fifty respondents were interviewed. RESULTS: Eighty eight percent of the respondents were khat chewers, and the majority (80%) had family members who engaged in the khat habit. There was a general lack of education on the negative effects of khat chewing. Due to reported mood changes and withdrawal symptoms when not chewing khat, many respondents used more than half of their domestic budgets on khat, but few (28%) perceived this as a waste of resources. Fifty four percent of khat chewers typically started the habit during the day, implying a waste of time for productive work. However, only 40% of the persons interviewed admitted that the drug affected work performance negatively. The khat habit was associated with strain on family relationships, anti-social behaviour and health effects such as insomnia. CONCLUSION: In spite of the negative socio-economic impact of khat in Ijara District, khat consumption remains a widespread habit.
Tung CS, Chu KM, Tseng CJ, Yin TH. "Adenosine in hemorrhagic shock: possible role in attenuating sympathetic activation." Life Sci.. 1987;41(11):1375-82. Abstract

Changes in plasma purine nucleoside level, autonomic activity and hemodynamic reactions were studied in pentobarbital anesthetized rabbits during hemorrhagic shock. Shock was elicited by bleeding the animals to a mean blood pressure of 40 mmHg and maintained until 60% of the maximum bleeding volume in the reservoir had been taken up spontaneously. The remaining shed blood was reinfused thereafter. Norepinephrine (NE), epinephrine (E), adenosine (AD) and uric acid were measured by HPLC with electrochemical detection, fluorometry or UV absorbance. The results showed hemorrhagic shock caused a significant rise in plasma NE, E, AD, and uric acid levels, but the magnitudes and time profiles were different among them. Plasma NE and E increased during the shock compensatory period then declined in the decompensation period whereas adenosine and its metabolite uric acid were elevated persistently during both periods. It is concluded that a balance between autonomic activity and tissue metabolism is important in the maintenance of hemodynamics during shock.

A. S. Azi, Riechi A. R., Khatete I. W. "Adequacy Assessment of Government’s Budgetary Allocations for the Provision of Lecture Halls in Nigeria’s Federal Universities." International Journal of Social Sciences and Information Technology. 2017;II(XI):1455-1467.abstract_5.doc
ACHIENG’ L, M. D. JOSHI, OGOLA EN, KARARI E. "Adequacy of Blood Pressure Control, and Level of Adherence to Antihypertensive therapy at Kenyatta N Hospital." East Afri Med Journal. 2009;86(11):499-506.Website
Kairithia Fredrick, Karanja, N.K, Eunice Cheserem, Kinuthia John, Mwangi C, Dalton W. "Adequacy of vital signs monitoring in post delivery mothers at the Naivasha District Hospital of Nakuru County, Kenya. ." International Journal of Medical and Clinical Sciences. 2015; 2(1): 030-035.
WAMBUI PROFKOGIMAKAU-. "Adere, J.W., Kogi-Makau, W and Karuri, E.G. The Right to Adequate Food and Nutrition as Actualized by Christian and Muslim Mothers in Kibera. A Case Study of Kibera Slums in Nairobi, Kenya.". In: Paper presented at the Inaugural National Nutrition Congress. 21st-23rd February 2005. AIDS 24(6):891-7; 2005. Abstract
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.
Ong’ayo MN, Osanjo GO, Oluka MO. "Adherence to Anti-Tuberculosis Treatment among Paediatric Patients at Kenyatta National Hospital.". In: 1st International Scientific Conference, College Of Health Sciences, University Of Nairobi.; 2011.
Ong’ayo MN, Osanjo GO, Oluka MO. "Adherence to Anti-Tuberculosis Treatment among Paediatric Patients at Kenyatta National Hospital.". In: 1st International Scientific Conference, College Of Health Sciences, University Of Nairobi.; 2011.
Gatuguta AW, Muchunga EK. "Adherence to Antiretroviral treatment among adolescents at Kenyatta National Hospital.". 2012. AbstractWebsite

All over the world and specifically sub-Saharan Africa, there is massive scaling up of availability and accessibility to highly active antiretroviral therapy. (HAART) which resulted in improved survival and reduced incidence of opportunistic infections among people living with HIV & AIDS. Nonetheless, whereas efforts to increase access to HIV & AIDS treatment have achieved the desired effects with respect to improvement in the quality of life, other issues such as adherence, sustainability and effectiveness of treatment have emerged.
The goal to sustain a near optimal adherence for successful antiretroviral treatment is undoubtedly a major concern in the management of HIV & AIDS. Among adolescents, the challenge assumes greater proportions given the unique circumstances the group is exposed to. For instance, emotional, neurocognitive and physical development changes are some of the challenges. The transition from paediatric to adult state coupled with the knowledge about their HIV status that prompts them to initiate treatment on their own is to say the least, monumental challenges for adolescents. Moreover, adolescents are generally in school where they are subjected to stigma, discrimination and unfavourable school schedules that do not permit them time to access treatment and medication. Several studies have concluded that a high level of adherence to HAART at 95% or higher is necessary in order to avoid treatment failure and emergence of resistant strains.
Consequently, patients with 95% or higher adherence are known to have a superior virological outcome, an increase in CD4 lymphocyte count, and a lower rate of hospitalization compared with patients with lower levels of adherence.
As cited earlier, a near optimal adherence is a challenge for all patients, and non-adherent behavior is a big problem during adolescent period.
The aim of the study was therefore to determine adherence levels to antiretroviral drugs among adolescents and also establish levels of appointment keeping to clinic visits and pharmacy drug refi 11.

Musalia AW, Mutungi A, Gachuno O, Kiarie J. "Adherence to national guidelines in prevention of mother to child transmission of HIV.". 2010. AbstractWebsite

Mother-to-child transmission (MTCT) of Human Immunodeficiency Virus (HIV) contributes to over 90% of the paediatric HIV infections. The national PMTCT guidelines make recommendations for specific interventions to reduce perinatal transmission. Data on adherence to the guidelines by caregivers and quality of PMTCT care is however limited.
OBJECTIVE:

To evaluate the extent to which PMTCT care offered to HIV positive women admitted for delivery at Kenyatta National Hospital (KNH) and Pumwani Maternity Hospital (PMH) adheres to National Guidelines in order to reduce vertical transmission of HIV during labour and delivery.
DESIGN:

A cross-sectional study.
SETTING:

Kenyatta National Hospital and Pumwani Maternity Hospital from January to April 2009.
SUBJECTS:

All consenting HIV positive women admitted to the labour wards at the two facilities and planned for delivery.
RESULTS:

A total of 370 women were enrolled, 266 at Pumwani Maternity Hospital and 104 at Kenyatta National Hospital. Among the enrolled women 357 (96.4%) had been counselled on vertical transmission and 205 (55.4%) had HIV disease staging by CD4 cell count. There were no significant differences between the two study sites in the proportion of women counselled on MTCT (p = 0.398) and receiving HIV disease staging by CD4 testing (p = 0.28). Three hundred and forty nine (94.3%) women were offered varied ARV regimens for PMTCT. 101(27.3%) received HAART, 94 (26.9%) were given single dose nevirapine and 130 (37%) received AZT+NVP combination prophylaxis. Twenty one women received no ARV prophylaxis. Overall, 268 women (72.5%) had spontaneous vertex delivery. An episiotomy rate of 7% was observed and no vacuum delivery was recorded. A Caesarean section rate of 27.5% was recorded with PMTCT as an indication in almost half of the cases. Women delivered at KNH were more likely to receive HAART (p < 0.001) and to be delivered by elective caesarean (p < 0.001).
CONCLUSION:

A great majority of HIV positive women admitted for delivery received counseling on vertical transmission and were offered ARVs for PMTCT. Many women did not get CD4 measurement and clinical staging as recommended in the National guidelines.

Musalia AW, Mutungi A, Gachuno O, Kiarie J. "Adherence to national guidelines in prevention of mother to child transmission of HIV." East Afr Med J. 2010;87(12):488-94. Abstract

Mother-to-child transmission (MTCT) of Human Immunodeficiency Virus (HIV) contributes to over 90% of the paediatric HIV infections. The national PMTCT guidelines make recommendations for specific interventions to reduce perinatal transmission. Data on adherence to the guidelines by caregivers and quality of PMTCT care is however limited.

Migowa AN, Gatinu B, RW. N. "Adherence to oral rehydration therapy among in-patient children aged 1-59 months with some or no dehydration. ." J Trop Pediatr. 2010 Apr;56(2):103-7. doi: 10.1093/tropej/fmp059. Epub 2009 Jul 14.. 2010. Abstract

Abstract
OBJECTIVE:

To determine adherence to oral rehydration solution (ORS) among in-patients aged 1-59 months suffering from gastroenteritis and having some dehydration (SD) or no dehydration (ND) in two rural hospitals in Kenya.
METHODS:

Children aged 1-59 months suffering from acute gastroenteritis with (SD) or (ND) were enrolled into the study, examined and medical records reviewed. On the second and third day of follow up, children were re-examined to ascertain hydration status and care-takers interviewed.
RESULTS:

Ninety-nine children were enrolled. Forty-five (75%) of the 60 children with SD received a correct prescription for ORS but only 12 (20%) received the correct amount. Among the 39 children with ND, 23 (59%) received a correct prescription for ORS, however only 16 (41%) received the correct amount. On the 3rd day, 9 (15%) of the 60 children with SD at baseline and 2 (5%) of the 39 with ND were classified as having SD.
CONCLUSION:

Four in five children with SD and 6 in 10 children with ND fail to receive the correct amounts of ORS.

Mutinda CM, Onyango FE, Maleche-Obimbo E, Kumar R, Wamalwa D, Were F, Osano B, Mburugu P. "ADHERENCE TO PNEUMONIA GUIDELINES FOR CHILDREN 2 - 59 MONTHS AT GARRISA PROVINCIAL GENERAL HOSPITAL." East Afr Med J. 2014;91(1):13-20. Abstract

Clinical Practice Guidelines for childhood illnesses including pneumonia in Kenya are contained in the Ministry of Health Basic Paediatric Protocols. In the presence of a cough and/ or difficulty in breathing and increased respiratory rate for age, pneumonia is diagnosed. In addition to these the presence of lower chest wall indrawing denotes severe pneumonia; The presence of cyanosis, inability to drink/ breastfeed, grunting, level of consciousness using the AVPU scale less than A in addition to the aforementioned is classified as very severe pneumonia. Recommended management is intravascular Crystalline penicillin, gentamycin and oxygen for severe pneumonia, intravascular crystalline penicillin for severe pneumonia and oral amoxyl or cotrimaxole for pneumonia. These guidelines have been disseminated through the Emergency Triage And Treatment Plus (ETAT +) coursesheld since 2007. Implementation of guidelines into care has been shown to reduce case fatality from pneumonia by 36%.

Mutinda CM, Onyango FE, Maleche –Obimbo E, Kumar R, Wamalwa D, Were F, Osano BO, Mburugu P. "Adherence to Pneumonia guidelines for children 2 – 59 months at Garrisa Provincial General Hospital." East Africa Medical Journal. 2014;91:13-20.
ONYANGO MRMBUGEDUNCAN. "Adhiambo, B., A. Oduor and D. Mbuge, 2003. Rainwater Harvesting for Improved Livelihoods, Exposition Catalogue 2003, Global Water Partnership (GWP) Associated Project of the the Regional Land Management Unit (RELMA) and Kenya Rainwater Association.". In: Makerere University, Kampala, Elsevier Publishers pp 142-147. CIGR Electocic Journal; 2003. Abstract
isolated from preterm neonates during the outbreak of gastroenteritis in hospital in Nairobi, Kenya, were resistance to trimethoprin-sulfathoxaxole, Chloramphenicol, oxytetracycline and ampicilin, but only a few strains were resistant to cefazolin, cefamandole, cefataximine, amikacin and nalidixic acid. Fourteen different antimicrobial resistance patterns were observed in the 229 strains of E.coli analyzed. Eighty-two percent of the EPEC strains belonged to two resistance patterns. There was no consistent relationship between palsmid profile group and antimicrobial resistance pattern, although one resistance pattern was more frequently observed in EAF-positive strins belonging to the dominant plasmid profile group. Nine percent of the EPEC strins were resistant to gentamicin compared to 37% in the non-EPEC group. No correlation was observed between administration of gentamicin and percentage of resistant strains isolated. None of the nine neonates receiving gentamicin died during the outbreak. Gentamicin resistance was observed in E.coli strains from six out of these nine neonates. Five out of fourteen neonates who received other antimicrobials, or no antibiotic at all, died. Key words: Enteropathogenic Escherichia Coli; antimicrobial resistance;
Kuria MW. "Adjustment Disorders Chapter 14.". In: Aid to Undergraduate Psychiatry. Nairobi: Kenyatta University Press; 2014.
IKIARA MRGERRISHONK. "Adjustment, Technological capabilities and Enterprise Dynamics in Kenya, jointly with Ganeshan Wignaraja.". In: Sanjah hall (ed), Import Liberalization, Industrialization and Technological Capability in Sub-Saharan Africa, United Nations University, Intech Maastricht. Asian Economic and Social Society; 1997. Abstract
The Road to Democarcy, ESAURP, Dar es Salaam
DR DAVIDNYIKA. "Adjustments of the Wild A8. .". In: Department of Surveying; University of Nairobi. Nairobi.; 1972.
M. PROFMACHARIAW, N PROFWEREFREDRICK. "Admani B, Macharia W and Were F: Prevalence of Varicella Zoster in Immune-compromised children at Kenyatta National Hospital .". In: E Afr Med. J. F.N. kamau, G. N Thothi and I.O Kibwage; 2008. Abstract
Two male patients with diabetes mellitus and alcohol dependence syndrome are presented. Both were married and in middle age. MI stayed alone in the city while his spouse and two children lived in the rural home. He showed no obvious underlying psychiatric morbidity. FWK was living with his family in the city. He was an alcoholic receiving psychiatric care for alcoholism. They both presented separately at different hospitals with decompensated diabetes following heavy alcohol consumption. The history and clinico-laboratory picture of both patients are presented and brief management programme and outcome are also given. Review of literature on alcoholism and its potential impact on the course and management of diabetes is presented.
Mwangi JK. "Administration and Supervision in early Childhood Education.". In: Teaching Module for Bachelor of Education degree in Early Childhood Education Year 1. Nairobi; 2013.
ODERA PROFALILAPATRICK. "'Administration of Cooperatives for Rural Development in Kenya' in Fassil G. Kiros, ed., Challenging Rural Poverty, (Treton, N. J.: Africa World Press, 1985).". In: 'Firm Linkages in Kenya's Tourism Sector', IDS Discussion Paper No.297. International Union of Crystallography; 1995. Abstract
Presented here is a 16-year-old girl who was referred on 30th January 1996 with diagnosis of cord compression with spastic paraplegia with sensory level at T7/T8. CT scan myelogam confirmed soft tissue density mass displacing cord to the left with no dye being seen beyond T3. Thoracic spine decompressive laminectomy was performed on 1st January 1996 at Nairobi West Hospital extending from T3 to T6 level, which revealed a fibrous haemorrhagic tumour. Histology showed meningioma (mixed fibrous type and meningoepitheliomatous type) with many psammoma bodies. She had a stormy post-operative period, with infection and wound dehiscence. This was treated with appropriate antibiotics and wound care. She was eventually rehabilitated and was able to walk with the aid of a walking frame because of persistent spasticity of right leg. She was seen once as an outpatient by author on 6th July 1996, she was able to use the walking frame, but the right leg was still held in flexion deformity at the knee. She was thus referred to an orthopaedic surgeon for possible tenotomy. She was able to resume her studies at the University ambulating using a wheel chair and walking frame. She presented with worsening of symptoms in 2001 (five years after her first surgery). MRI scan thoracic spine revealed a left anterolateral intradural lesion extending from T3 to T5 vertebral body level compressing and displacing the spinal cord. She had a repeat surgery on 6th March 2001 at Kenyatta National Hospital; spastic paraparesis and urinary incontinenece persisted. She also developed bed sores and recurrent urinary tract infections. She was followed up by the author and other medical personnel in Mwea Mission Hospital where she eventually succumbed in 2005, nine years after her first surgery. This case is presented as a case of incompletely excised spinal meningioma to highlight some of the problems of managing spinal meningiomas when operating microscope and embolisation of tumours are not readily available. Also the family experienced financial constraint in bringing the patient for regular follow-up, and getting access to appropriate antibiotics, catheters and urine bags.
Chepkonga S. "Administrative Strategies for Using Social Media in Higher Education Institutions in Kenya.". In: International Conference on Research and Innovation in Education University of Nairobi.; 2019.
Wanjala, G., Akumu Maurice O. "Adminstrative Strategies Towards Disaster Awareness and Preparedness in Secondary Schools in Homa-Bay County, Kenya." International Journal of Development Research . 2017;7(10):16420-16423 .abstract3.pdf
WAMBUI PROFKOGIMAKAU-. "Adolescent Health: Programmatic Evaluation of the AoW Child and Adolescent Health in Tanzania. World Health Organization, Geneva.". In: A paper presented at the 2nd International Food and Nutrition Conference (IFNC), Tuskegee, Alabama, USA: 8-10th October 2006. AIDS 24(6):891-7; 2005. Abstract
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.
Ojwang PJ, Gitau W, Shah MV. "Adolescent hypophosphataemic rickets.". 1982.Website
K'Oyugi BO. Adolescents Sexual and Reproductive Health and Future Challenges. Morocco: Partners in Population and Development; 2007.
P G, J M, Steyn P, Njau I, Cordero J. "Adolescents’ knowledge, attitudes and practices towards family planning and contraceptive use: a qualitative study from Kilifi County, Kenya." The European Journal of Contraception and Reproductive Health Care. 2016;21(Supplement 1):83.
Maina SM, Olima W, Anyamba T. "Adopting a new Eco-Ethical Philosophy of Living:."; 2013.
C PROFANYAMBATOMTEBESI, Maina S, Olima W. "Adopting a new eco-ethical philosophy of living; the diminishing options for Nairobi and humanity." Africa Habitat . 2010;Review 4 . Abstract

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

Mwabu G, Tura M, Aredo D, Tsegaye W, TG, Mwangi W. "Adoption and Continued Use of Improved Maize Seeds: Case Study of Ethiopia ." African Journal of Agricultural Research. 2010;5(17):2350-2358.
Ondiek CO, Omulo EOT, William Okelo-Odongo. "Adoption framework of software as a service for the development of small and medium enterprises.". In: IBM/Unesco-Hp Workshop on Trends in Distributed Computing Applications. Nairobi; 2013.
Njoroge, R.W. NGRO & CM. "Adoption of Biogas Technology Projects among Rural Household of Lanet Location- Nakuru County." African Journal of Project Planning and Management - UON (In press). 2013.
Ondiek CO, Omulo EOT, Okello-Odongo W. "Adoption of cloud computing architecture: software as a service for the development of small and medium enterprises.". In: Adoption of cloud computing architecture: software as a service for the development of small and medium enterprises. Nairobi; 2013.
Kamau A, Ngeranwa J, Ombaka D, Mutiso M. "Adoption of Eco-Friendly Dry-Land Agriculture and Water Technologies in Kitui County, Kenya.". In: Technology and Management at the Interface of Cultures: Harnessing culture and technology for sustainable development, good governance and innovative technology transfer. Jaramogi Oginga Odinga University of Science and Technology (JOUST), Bondo; 2015.abstract_joust_final.pdf
of in case study of and in Kenya AMPKB: SME(SME)A. "Adoption of Mobile Payments in Kenyan Businesses: A case study of Small and Medium Enterprises (SME) in Kenya." International Journal of Computer Applications. 2014;107(7):0975-8887.
Gichira CM, Kahonge MA, Miriti EK. "Adoption of Open Source Software by Organizations – A Framework for Kenya." International Journal of Computer Applications (0975 – 8887). 2012;59(7):25-32.
KINYANJUI DRMURIITHIMOSES. "Adoption of Radio-based agricultural innovation among small scale farmers in The revenue impact and elements of tax reforms in Kenya.". In: A study of Nyeri. I.E.K Internatioanl Conference l; 1998. Abstract
This paper develops an improved real and reactive power control technique using linear programming (LP) for an integrated power system. The problem is decomposed into two subproblems comprising real (P) and reactive power (Q) modules, and, using a unified approach, the real power generation, voltage magnitude, and transformer tap settings are optimized. The objective function is the fuel cost which is minimized in both the P and Q modules, subject to the operating constraints. The P-Q decomposition combined with the LP formulation improve the computation speed. The paper has another advantage of using the same cost objective function for both modules, unlike other conventional methods which use the power loss function for the Q module. The LP formulation is used for both the P and Q optimization modules, utilizing the revised simplex method which is normally available in a mainframe computer.
English M, Gathara D, Mwinga S, Ayieko P, Opondo C, Aluvaala J, Kihuba E, Mwaniki P, Were F, Grace Irimu, R W Nduati, Wasunna A, Mogoa W, Nyamai R. "Adoption of recommended practices and basic technologies in a low-income setting.". 2014;10(2013-305561):452-456. Abstractadoption_of_recommended_practices_and_basic_technologies_in_a_low-income_setting.pdf

Objective In global health considerable attention is focused on the search for innovations; however, reports tracking their adoption in routine hospital settings from low-income countries are absent. Design and setting We used data collected on a consistent panel of indicators during four separate cross sectional, hospital surveys in Kenya to track changes over a period of 11 years (2002–2012). Main outcome measures Basic resource availability,use of diagnostics and uptake of recommended practices. Results There appeared little change in availability of a panel of 28 basic resources (median 71% in 2002 to 82% in 2012) although availability of specific feeds for severe malnutrition and vitamin K improved. Use of blood glucose and HIV testing increased but remained inappropriately low throughout. Commonly (malaria) and uncommonly (lumbar puncture) performed diagnostic tests frequently failed to inform practice while pulse oximetry, a simple and cheap technology, was rarely available even in 2012. However, increasing adherence to prescribing guidance occurred during a period from 2006 to 2012 in which efforts were made to disseminate guidelines. Conclusions Findings suggest changes in clinical practices possibly linked to dissemination of guidelines at reasonable scale. However, full availability of basic resources was not attained and major gaps likely exist between the potential and actual impacts of simple diagnostics and technologies representing problems with availability, adoption and successful utilisation. These findings are relevant to debates on scaling up in low income settings and to those developing novel therapeutic or diagnostic interventions.

English M, Gathara D, Mwinga S, Ayieko P, Opondo C, Aluvaala J, Kihuba E, Mwaniki P, Were F, Grace Irimu, R W Nduati. "Adoption of recommended practices and basic technologies in a low-income setting.". 2013;(99):452-456. Abstract

Objective In global health considerable attention is focused on the search for innovations; however, reports tracking their adoption in routine hospital settings from low-income countries are absent.
Design and setting We used data collected on a consistent panel of indicators during four separate cross-sectional, hospital surveys in Kenya to track changes over a period of 11 years (2002–2012).
Main outcome measures Basic resource availability, use of diagnostics and uptake of recommended practices. Results There appeared little change in availability of a panel of 28 basic resources (median 71% in 2002 to 82% in 2012) although availability of specific feeds for severe malnutrition and vitamin K improved. Use of blood glucose and HIV testing increased but remained inappropriately low throughout. Commonly (malaria) and uncommonly (lumbar puncture) performed diagnostic tests frequently failed to inform practice while pulse oximetry, a simple and cheap technology, was rarely available even in 2012. However, increasing adherence to prescribing guidance occurred during a period from 2006 to 2012 in which efforts were made to disseminate guidelines.
Conclusions Findings suggest changes in clinical practices possibly linked to dissemination of guidelines at reasonable scale. However, full availability of basic resources was not attained and major gaps likely exist between the potential and actual impacts of simple diagnostics and technologies representing problems with availability, adoption and successful utilisation. These findings are relevant to debates on scaling up in low-income settings and to those developing novel therapeutic or diagnostic interventions.

English M, Gathara D, Mwinga S, Ayieko P, Opondo C, Aluvaala J, Kihuba E, Mwaniki P, Were F, Grace Irimu, R W Nduati, Wasunna A, Mogoa W, Nyamai R. "Adoption of recommended practices and basic technologies in a low-income setting." Arch Dis Child. 2014;(99):452-456.adoption_of_recommended_practices_and_basic_technologies_in_a_low-income_setting.pdf
Muli E, Opiyo ETO, Okello-Odongo W. "Adoption of Self-Study for University Education in Kenya.". In: Operations Research Society of Eastern Africa (ORSEA). Nairobi; 2014.
Magutu PO, Omondi GO. "The Adoption of Strategic Human Resource Management Practices In Commercial Banks: The Process And Challanges In Kenya.". In: Journal of Human Resources Management Research. IBIMA Publishing; 2011. Abstract

Developing an effective human resource system that is compatible with organizational strategy is critical for the functioning and success of an organization in the competitive business arena. The main objectives of the study were to establish the extent of adoption of strategic human resource management practices among commercial banks in Kenya; and to determine the factors that influence adoption of strategic human resource management practices by commercial banks in Kenya. The research questions were systematically generated from the objectives. In the data analysis, descriptive statistics and factor analysis were used to help draw comparisons and conclusions based on the results. It was assumed in the data analysis that the results obtained were quite representative for the general population considering the sampled size.
The conclusions of the study are based on the research questions leading to the main purpose of the study. First, a number of human resource practices can be used as strategic weapons for organization to remain competitive. The key strategic resources management practices can be broken into two components. The first component is post-entry/ on-the-job strategic human resources management practices, which include the implementation of chosen human resources management strategy. The second component is pre-entry strategic human resources management practices, which include the recognition of the individual roles of employees before they are employed, keen selection and development. Secondly, the factors that have discouraged the adoption of strategic human resource management practices by commercial banks in Kenya can be broken into three components. The first component is poor communication and decision making process, which include failure of union representatives and managers to meet often to discuss concerns and cooperate in finding solutions to human resources issues. The second component is poor planning on HR issues, which include the failure to cover employees by a "non-traditional" incentive pay plan which applies across shifts of workers. The third component is on poor job orientations which includes lack of extensive efforts to set clear expectations about required work behaviors of the new workers.
Keywords: Strategic Human Resource Management Practice, Commercial Banks and Kenyas.

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