Atmospheric aerosols from seven rural sites in northern Vietnam, east of Hanoi, were sampled and analyzed. The aim of the study was to evaluate trace elemental and black carbon (BC) concentrations in fine particles (PM 2.5) and to investigate the influence of the …

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This paper reports measurements of black carbon (BC) and total carbon (TC)(TC= BC+ organic carbon) in the lower troposphere in Nairobi and the towns of Nanyuki and Meru in Kenya. The rural sites of Nanyuki and Meru are both located on the equator on the …

Contribution of scientific research to local and international journals from Africa and indeed Kenya is weak in comparison to other regions. One of the main problems is the non-availability of reliable and affordable analytical instrumentation. Energy-Dispersive X-ray …

There have been very few studies in Kenya on aerosols despite the global demand on aerosol ground studies in the perspective of climate and the human well being. Therefore, atmospheric aerosol studies became the basis of the work covered in this thesis which …

Tropospheric aerosols have adverse implications on human health, climate, and visibility. Particles in combustion source emissions have complex physical and chemical characteristics. They regularly contain Polycyclic Aromatic Hydrocarbons (PAH) molecules …

Aerosol samples were collected at an altitude of 3678 m on Mt Kenya in August 2001. A virtual impactor was used to collect particles in fine (aerodynamic diameter, da< 2.5 µm) and coarse (2.5 µm< da< 10 µm) size fractions. The samples were analyzed for particulate mass …

Air pollutants from industrial and urban sources contain harmful elements and chemical compounds. This work presents a study on background industrial and urban aerosol particles in the city of Nairobi. Its main focus was the understanding of elemental, black …

Background Developing countries have limited air quality management systems due to inadequate legislation and lack of political will, among other challenges. Maintaining a balance between economic development and sustainable environment is a challenge …

Air pollution problems in major cities within the developing countries need to be studied. There are scanty measurements from the developing countries on airborne particles despite their adverse implications to human health, visibility and climate. One of the major sources of …

Air quality is a serious and worsening problem in the rapidly growing cities of sub-Saharan Africa (SSA), due to rapid urbanization, growing vehicle fleets, changing life styles, limited road infrastructure and land use planning, and high per-vehicle emissions. However, the …

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Airborne black carbon (BC) particles have serious implications for human health and climate change and thus represent a prime target for mitigation policies. The sources of BC include vehicles burning diesel fuel, which are common in urban areas in low-income countries. The …

An air pollution campaign was carried out in the town of Nanyuki at four different sites during July and August 1999. Nanyuki is situated on the equator on the northwestern slope of Mount Kenya at about 1930 m above sea level. The intention of the project was to …

The subject conference (documented in www. who. int) was organized by WHO in collaboration with WMO, CCAC, UNFCC, UNECE, The World Bank, UN-DESA and EU-DEVCO in Geneva, Switzerland from 30 October to 01 November 2018. The conference …

There have been very few studies in Kenya on aerosols despite the global demand on aerosol ground studies in the perspective of climate and the human well being. Therefore, atmospheric aerosol studies became the basis of the work covered in this thesis which …

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Energy dispersive X-ray fluorescence (EDXRF) analysis of aerosol samples in Nairobi is presented. Results show that elemental concentrations are of the order of 10− 4 to 10− 6 μg/m 3 for most elements analyzed. The total suspended particulate (TSP) matter was …

A clinical, radiological, histological, and geographical study of carcinoma of the esophagus in Kenya is reported. It was found that this cancer is diagnosed more often in males than in females, with a ration of 8:1 (Kenya Cancer Registry). The most common age in males and females is 50 to 59 years. The regions of the esophagus most commonly involved are the middle and lower thirds, in almost equal proportions. An unexplained tendency for the tumor to be poorly differentiated towards the lower third is noted. In addition a review on the possible etiological factors is presented.

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This study assessed probable water that could be harvested during rainy seasons over Embu County of Kenya. Monthly rainfall data was obtained from Kenya Meteorological Department while percentage distribution of household by household size, main roofing material, number of rooms in the main dwelling and per capita volume of water required was sourced from Kenya Integrated Household Budget of Survey (KIHBS). Minimum water demand per household was computed based on KIHBS. Kenya National Bureau of Statistics (KNBS) 2009 population census was used to determine population and number of occupants in the main dwelling. Embu County receives bimodal rainfall during March-April-May (MAM) and October-November-December (OND). Rainfall is highly variable with 8190 and 7490 litres of harvested water during MAM and OND season respectively expected to last for approximately 43 days (MAM) while 39 days (OND) and thus not sufficient to satisfy minimum water demand levels for Embu population. The total potential harvestable water during MAM and OND accounted for 45.4 % and would go a long way in meeting water demands in the region. Notably, harvestable water was being used to supplement natural sources of water. Therefore, enhanced water harvesting during rainy season could provide an alternate source of domestic water.

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Gender mainstreaming is crucial in soil and water conservation initiatives. The existing technologies though, as designed, are expected to be gender neutral, lead to gender differences at the adoption stage. This was confirmed during a study conducte d in Kathekakai settlement scheme, Machakos district where despite both men and women participating in soil and water conservation initiatives, women’s efforts to adopt the recommended technologies were hampered by their limited access to authoritative infor ma- tion and lack of control over land. Women though playing major roles as farmers (64.6%), could not make key decisions on land u se. Previous reports indicate that the women in Machakos district contributed significantly to soil and water conservation efforts in the mid 1980’s leading to terracing of over 70% of the district. Gender mainstreaming efforts need to be enhanced for achievement o f sustainable and effective soil and water conservation for improved agricultural production and livelihoods

The important role that women play in the management of water resources has been recognized in
various parts of the world. This is because they play a significant role in accessing water for
various uses such as washing, cooking, watering of crops and livestock rearing. Their effective
participation in water management is however influenced by existing policy, institutional and
legal frameworks. In this study, the various policies that enhance women’s participation in water
resources management in Kajiado County of Kenya were evaluated from the perspective of
relevance, value and limitations. This was done with a view to suggesting practical measures to
ensure the women’s important and critical roles are properly captured in the proposed policies on
water resources management in the County and elsewhere in the country. The findings show that
although the existing policies, legal and institutional frameworks are fairly comprehensive in
addressing women’s roles in the management of water resources, the policies do not, however,
directly and adequately address women’s issues and concerns in water resources management in
the County.

Given the high mortality associated with neonatal illnesses and severe malnutrition and the development of packages of interventions that provide similar challenges for service delivery mechanisms we set out to explore how well such services are provided in Kenya.

BACKGROUND Hospital mortality data can inform planning for health interventions and may help optimize resource allocation if they are reliable and appropriately interpreted. However such data are often not available in low income countries including Kenya. METHODS Data from the Clinical Information Network covering 12 county hospitals' paediatric admissions aged 2-59 months for the periods September 2013 to March 2015 were used to describe mortality across differing contexts and to explore whether simple clinical characteristics used to classify severity of illness in common treatment guidelines are consistently associated with inpatient mortality. Regression models accounting for hospital identity and malaria prevalence (low or high) were used. Multiple imputation for missing data was based on a missing at random assumption with sensitivity analyses based on pattern mixture missing not at random assumptions. RESULTS The overall cluster adjusted crude mortality rate across hospitals was 6 · 2% with an almost 5 fold variation across sites (95% CI 4 · 9 to 7 · 8; range 2 · 1% - 11 · 0%). Hospital identity was significantly associated with mortality. Clinical features included in guidelines for common diseases to assess severity of illness were consistently associated with mortality in multivariable analyses (AROC =0 · 86). CONCLUSION All-cause mortality is highly variable across hospitals and associated with clinical risk factors identified in disease specific guidelines. A panel of these clinical features may provide a basic common data framework as part of improved health information systems to support evaluations of quality and outcomes of care at scale and inform health system strengthening efforts.

Background: Regular assessment of quality of care allows monitoring of progress towards system goals and identifies gaps that need to be addressed to promote better outcomes.We report efforts to initiate routine assessments in a low-income country in partnership with government.
Methods: A cross-sectional survey undertaken in 22 ‘internship training’ hospitals across Kenya that examined availability of essential resources and process of care based on review of 60 case-records per site focusing on the common childhood illnesses (pneumonia, malaria, diarrhea/ dehydration, malnutrition and meningitis).
Results: Availability of essential resources was 75% (45/61 items) or more in 8/22 hospitals. A total of 1298 (range 54–61) case records were reviewed. HIV testing remained suboptimal at 12% (95% CI 7–19). A routinely introduced structured pediatric admission record form improved documentation of core admission symptoms and signs (median score for signs 22/ 22 and 8/22 when form used and not used respectively). Correctness of penicillin and gentamicin dosing was above 85% but correctness of prescribed intravenous fluid or oral feed volumes for severe dehydration and malnutrition were 54% and 25% respectively. Introduction of Zinc for diarrhea has been relatively successful (66% cases) but use of artesunate for malaria remained rare. Exploratory analysis suggests considerable variability of the quality of care across hospitals.

Background: Quality of patient care in hospitals has been shown to be inconsistent during weekends and night- time hours, and is often associated with reduced patient monitoring, poor antibiotic prescription practices and poor patient outcomes. Poorer care and outcomes are commonly attributed to decreased levels of staffing, supervision and expertise and poorer access to diagnostics. However, there are few studies examining this issue in low resource settings where mortality from common childhood illnesses is high and health care systems are weak. Methods: This study uses data from a retrospective cross-sectional study aimed at “ evaluating the uptake of best practice clinical guidelines in a tertiary hospital ” with a pre and post intervention approach that spanned the period 2005 to 2009. We evaluated a primary hypothesis that mortality for children with pneumonia and/or dehydration aged 2 – 59 months admitted on weekends differed from those admitted on weekdays. A secondary hypothesis that poor quality of care could be a mechanism for higher mortality was also explored. Logistic regression was used to examine the association between mortality and the independent predictors of mortality. Results: Our analysis indicates that there is no difference in mortality on weekends compared to weekdays even after adjusting for the significant predictors of mortality (OR = 1.15; 95% CI 0.90 -1.45; p = 0.27). There were similarly no significant differences between weekends and weekdays for the quality of care indicators, however, there was an overall improvement in mortality and quality of care through the period of study. Conclusion: Mortality and the quality of care does not differ by the day of admission in a Kenyan tertiary hospital, however mortality remains high suggesting that continued efforts to improve care are warranted

According to UN demographic projections, the world population aged 60 years and above is increasing rapidly. It is estimated that by the year 2025, there will be about 1.2 billion people above the age of 60 years worldwide. The older population in Africa currently estimated to be slightly over 42 million is projected to reach 205 million by 2050. Many of the elderly enter old age after a life of deprivation with limited access to resources. Objectives: The purpose of this study was to determine the nutritional and oral health status of elderly persons as a part of a wider study carried out in Nairobi, Kenya. Methods: Data were collected from 289 persons aged 45 years and above using a semi-structured questionnaire. Oral health status was assessed by dental examination, while nutritional status was assessed using Body Mass Index (BMI) and Mid Upper Arm Circumference (MUAC). Results: The study established that many of the elderly persons suffered from dental problems, especially periodontitis, dental caries, tooth mobility and missing teeth. The level of malnutrition using the MUAC was 18.8% while by BMI it was 11.4%. 46.4% had normal nutritional status while some of them (40.9%) were overweight, with more females (48.0%) than males (25.9%) being overweight. Conclusions: Undernutrition, obesity and dental problems are issues of concern among the elderly in Nairobi.

A case study was conducted in two reaches in the Naro Moru river basin, which extends from the humid western slopes of Mount Kenya to the semi-arid Laikipia plateau. The study involved measuring the amount of water abstracted from all abstraction points, as well as river discharge, for a period of eight months starting from November 1990. Results showed that the amount of water abstracted from each reach as a percentage of the available river inflow rose from 10% at the end of the wet season to over 60% at the end of the dry season. A survey of water permits revealed that legal abstractions constituted 30% of the amount abstracted during the wet season, but only 8% of the dry season abstractions. Communal water supply systems taking water for domestic use, for watering livestock and for irrigation accounted for over 90% of the water that was abstracted from the river during the period of study.

This study was carried out over a period of ten weeks between June and August 2011 at the KNH theatres. A total of 370 patients scheduled for elective surgery whose blood had been crossmatched prior to being taken to theatre were recruited into the study. Majority of requests in the study period were requests for whole blood while requests for other blood products were rarely made. Most surgical teams made requests for two units of blood for the adults for most surgical procedures. Cross-matching of one unit of blood per patient however predominated followed by cross-matching of two units per patient. Single unit transfusions for adult patients were the most common despite requests for two units being the majority. However in the category of children the average blood volume transfused was 18.9mllKg. The overall Cross-match to Transfusion ratio during the study period was 1.42. Most of the blood that was cross-matched (64.8%) was transfused of the patients was transfused to them. The mean estimated duration blood products were kept out of the cold chain was 17 minutes. The methods mainly used to reduce the need for pre-operative blood transfusions included use of diathermy, pre-operative hemodilution and use of hypotensive anesthesia. The main transfusion triggers were estimated blood loss, conjuctival pallour and change in haemodynamic status. In the study subjects above 14 years, the mean estimated blood loss triggering transfusion was 750 mls. The study established that all patients received peri-operative fluids with crystalloid infusions predominating. There was a highly significant relationship( P

Extracts of seven medicinal plant species used for treatment of malaria in traditional/cultural health systems of the Ameru people in Kenya were tested in vitro and in vivo against Plasmodium falciparum (D6 and W2 strains) and P. berghei, respectively. Of the plants tested, 28.57% were highly active (IC50 <10 μg/ml) and 42.86% moderately active (IC50 10–50 μg/ml), while 28.57% had weak activity of 50–125 μg/ml in vitro. The water and methanol extracts of Boscia salicifolia Oliv. and Artemisia afra Jacq. (ex-Willd.) were the most active against both the chloroquine (CQ)-sensitive (D6) and the CQ-resistant (W2) P. falciparum strains. Artemisia afra and Rhus natalensis Bernh. (ex-Krauss) exhibited the highest parasite clearance and chemo-suppression (>70%) in vivo (in mice). The plants with high in vitro anti-plasmodial (low IC50 values) and high anti-malarial activity (high chemo-suppression) in vivo are potential sources of novel anti-malarial drugs.

A study to determine the presence and prevalence of bovine tuberculosis in slaughter cattle in Kenya was carried out in two abattoirs from July to November 2009. Routine postmortem meat inspection was performed on a subpopulation of 929 cattle selected randomly from among 4,984. Carcases were inspected for gross tuberculous lesions which were then examined for acid-fast bacilli, (AFB), cultured for isolation of mycobacteria and the isolates characterised by DNA molecular analysis. Of the carcases examined, 176 (18.95 %, 95 % CI) had lesions suggestive of tuberculosis. AFB were observed in 63/176 of the lesioned cattle and mycobacteria were isolated from 64 of them. The isolates were identified as Mycobacterium bovis (19/64), Mycobacterium tuberculosis, (2/64) and mycobacteria other than tuberculosis (43/64). The prevalence of M. bovis by molecular analysis was 2.05 % (95 % CI). This study documents for the first time the presence of bovine tuberculosis among slaughter cattle in Kenya. There is therefore a need to formulate and implement control programmes in order to minimise transmission among animals and to humans. Isolation of M. tuberculosis from cattle underscores the risk tuberculous humans pose to animals

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

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

Patients in whom acid-fast bacilli smear-positive pulmonary tuberculosis was newly diagnosed were randomized to receive 400 mg moxifloxacin, 300 mg isonaizid, or 600 mg rifampin daily for 5 days. Sixteen-hour overnight sputa collections were made for the 2 days before and for 5 days of monotherapy. Bactericidal activity was estimated by the time taken to kill 50% of viable bacilli (vt50) and the fall in sputum viable count during the first 2 days designated as the early bactericidal activity (EBA). The mean vt50 of moxifloxacin was 0.88 days (95% confidence interval [CI], 0.43-1.33 days) and the mean EBA was 0.53 (95% CI 0.28-0.79). For the isoniazid group, the mean vt50 was 0.46 days (95% CI, 0.31-0.61 days) and the mean EBA was 0.77 (95% CI, 0.54-1.00). For rifampin, the mean vt50 was 0.71 days (95% CI, 0.48-0.95 days) and the mean EBA was 0.28 (95% CI, 0.15-0.41). Using the EBA method, isoniazid was significantly more active than rifampin (p < 0.01) but not moxifloxacin. Using the vt50 method, isoniazid was more active than both rifampin and moxifloxacin (p = 0.03). Moxifloxacin has an activity similar to rifampin in human subjects with pulmonary tuberculosis, suggesting that it should undergo further assessment as part of a short course regimen for the treatment of drug-susceptible tuberculosis.

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

The suitability for use in the canning industry of eight new dry bean varieties, selected from 150 new advanced drought tolerant dry bean lines was studied. Physical attributes including seed size, dimensions, hundred seed mass, bulk density, water uptake, volume increase and leaching characteristics on soaking were evaluated. There were significant differences (p<0.05) in seed dimensions, hundred seed mass and bulk density. DSS 11-04 (14.67 mm), DRM 11-14 (13.32 mm) and DPC 11-05 (12.84 mm) were highest in seed length. There were significant differences (p<0.05) in maximum soaking rate (Vmax), time at which Vmax occurred, water uptake at which Vmax occurred, final water uptake (UF) and time taken to reach UF. However, there were no significant differences (p>0.05) in volume change. The rate of water uptake was highest in DNB 11-10 (24.00%/h) followed by Kenya Early (19.33%/h) and DSR 11-01 (18.33%/h). The extent of final water uptake was highest in DSS 11-04 (122.0%), DRM 11-14 (118.0%) and DRK 11-12 (113.3%). No significant differences (p>0.05) among varieties were observed in maximum leaching rate (Vlmax) and the time taken to reach final electrical conductivity (tECF) the measure of leaching characteristics. Significant differences (p = 0.05) were observed in time at which Vlmax occurred, electrical conductivity at which Vlmax occurred and final electrical conductivity (ECF). The extent of leaching was highest in DNB 11-10, Mex 142 and DMC 11-13 at 1.00, 0.97 and 0.93 deciSiemen/metre, respectively. All the genotypes DNB 11-10, DSS 11-04, DRK 11-12, DRM 11-14, DPC 11-05, DMC 11-13, DSR 11-01 and Kenya Early are comparable to the control Mexican 142 and are suitable for further use in the canning process according to the results of these physical tests.

Fusarium head blight is a devastating disease of wheat and other small-grain cereals, causing grain yield reduction, reduced quality and mycotoxin contamination. This study was conducted in two districts of Kenya to determine the incidence of Fusarium species and mycotoxin contamination in freshly harvested wheat. A survey was carried out during the 2004 growing season in different agro-climatic zones to determine the presence of Fusarium head blight and weather conditions during the critical stages of wheat growth. Fungal contamination was determined by isolation on agar media while mycotoxin analysis was by direct competitive ELISA. Fusarium head blight was reported by 81% of the farmers and wet conditions were prevalent during anthesis. The wheat grain samples were highly contaminated with fungi, especially Epicoccum, Alternaria and Fusarium species. The mean Fusarium infection rate varied from 13 to 18%, with the major head blight – causing species being F. poae, F. graminearum, F. equiseti, and F. avenaceum. Fusarium poae, F. chlamydosporum and F. oxysporum were the most prevalent in all the agro-ecological zones while F. graminearum was isolated in 6 out of the 9 agro-ecological zones. Most grain samples were contaminated with mycotoxins deoxynivalenol, T-2 toxin, zearalenone and aflatoxin B1. The most prevalent mycotoxin was T-2 (86% of the samples) followed by deoxynivalenol (59%), zearalenone (53%), and aflatoxin B1 (52%). The maximum mycotoxin concentration was 302mg/kg, 95.8mg/kg, 65.7mg/kg and 6.9mg/kg for deoxynivalenol, zearalenone, T-2 toxin and aflatoxin B1, respectively. The incidence and levels of the mycotoxins varied depending on the agro-ecological zone. Samples with high proportion of total Fusarium infection contained higher deoxynivalenol and T-2 toxin levels. Co-occurrence of deoxynivalenol, T-2 toxin and zearalenone was fund in up to 35% of the samples. The results suggested the presence of Fusarium head blight in Kenya and associated mycotoxin contamination, though at low but significant levels. The presence of the different mycotoxins, though at low levels, could pose chronic adverse health effects to human and livestock fed on the contaminated wheat products.

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Aims: To produce speciÆc antibodies against the haptenic fungal toxin aØatoxin B1 (AFB1) and apply these antibodies in immunochemical assays for aØatoxins. Methods and Results: Rabbits were immunized using an AFB1 -bovine serum albumin conjugate and serum titres determined by double-antibody enzyme immunoassay. High titres of antibodies with very high afÆnity for AFB 1 were obtained 15 and 4 weeks after the initial immunization and the Ærst booster immunization respectively. The antibodies were employed in enzyme immunoassay (EIA) and immunoafÆnity chromatography (IAC) methods for aflatoxins. With a detection limit of 15 · 8pgml)1 for AFB1 , the EIA employing these antibodies is the most sensitive test for AFB1 described so far. In IAC columns, these antibodies provided high binding capacity for all major aØatoxins, including AFB1 , AFB2 , AFG1 and AFG2 Conclusions: The antibodies described here are useful for the analysis of trace levels of aflatoxins. SigniÆcance and Impact of the Study: Polyclonal antibody-based EIA and IAC methods for aflatoxin analysis offer a suitable alternative to the more expensive monoclonal antibody- based methodS.

A survey was carried out during the 2004 wheat-cropping season in 6 agro-ecclogical zones to determine fusarium contamination of freshly harvested wheat grain. This was done by plating in culture media. Contaminations with mycotoxins t!cnxynivalcnol, zenralenonc and aflatoxin B I were determined by competitive EUSA. Farmers indicated presence ol'hcnd blight 111 wheat fields and occurrence of wet weather during flowering. Wheat residue was mainly directly grazed to animals in the field or ploughed in. Most popular rotation was wheal-maize followed by continuous wheat cropping. Fusarium contaminated 85 % of the wheat samples, but kernel infection rate was 15%. Fusarium species most isolated were F.poae. F. chlumvdospnrum and F. grammC:Ul1lfll. Other fungi isolated were Alternaria. Epicoccum. Aspergigiilus anti Penicillium. Mycotoxins deoxynivalenol, zearalenone and aflatoxin B1. There is need for regular screening for Fusarium mycotoxins in wheat grain.

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Data from two closely related questions in a survey on rabbits is analyzed in order to determine
whether results from these two groups of questions would yield similar results about numbers of
rabbits kept by a household. One question seeks a straightforward answer about numbers of
rabbits kept while the other group of questions breaks the question into several questions seeking
numbers of rabbits disaggregated by sex and age. This is prompted by the fact that record
keeping is not a very common undertaking in a small holder agricultural setting in Kenya and
that in their absence, farmers may not recall precisely how many rabbits they own unless a
headcount is performed. A paired sample t test is implemented to detect any significant
underreporting of rabbit numbers based on numbers from the straightforward question which we
hypothesize would yield numbers far less than what is on the farm. The results show that such
underreporting is not serious enough. The conclusion is that between the two question modes
implemented in the survey, the straightforward question is suitable as it is time saving when the
survey data required does not include numbers disaggregated by sex or age of rabbits.

In this study, electrophoretic deposition (EPD) technique was used to deposit TiO2 thin film on a conducting glass substrate for use in water purification from organic contaminants. The optimum deposition parameters of a good quality film in terms of adherence to the substrate, homogeneity of the film and the extent of microcracking upon drying were: ethanol for obtaining a stable suspension, a pH of 3 for best stability of the suspension and the speed of coating, TiO2 loading concentration of 4 wt %; 0.3wt% iodine dispersant with respect to TiO2 concentration, an applied voltage of 25 volts, and films’ sintering temperature of 573 K for highest photocatalytic activity. The quantitative analysis of phenol by bromination method was used to determine photocatalytic decomposition of phenol in water.

The study sought to establish the relationship between monitoring and evaluation practices and performance of County Maternal Health programmes in Kenya. The combined monitoring and evaluation practices included planning for M&E, stakeholder engagement, capacity building for M&E, and M&E data use. The study adopted a descriptive survey research design. To obtain 282 respondents, stratified random sampling was used. A self-administered structured questionnaire was the study's research instrument. Using descriptive narratives, qualitative data was analyzed within specific themes. Quantitative data was analyzed descriptively using measures of central tendencies and measures of dispersion. Regression was conducted for testing the study hypotheses. Data was presented using frequency tables. The study found that stakeholders’ engagement in M&E and capacity building for M&E influenced the performance of County Maternal Health Programmes in Kenya. The study also found that the respondents agreed that planning for M&E and the data management for M&E. This implied that the combined monitoring and evaluation practices influence performance of County Maternal Health Programmes in Kenya.The study found a strong correlation between the performance of county maternal health programmes and combined monitoring and evaluation practices. The study concluded that combined planning for M&E monitoring and evaluation practices influenced the performance of county maternal health programmes. The study suggests that management develop an effective methodology as well as raise awareness of M&E activities for the success of the project. The study also suggests that human resources issues such as workers charged with monitoring and evaluation ought to have technical capabilities, and roles and duties of monitoring and evaluation personnel should be outlined at the start of projects. To ensure M&E sustainability health sector reforms, investments in strong and vibrant technical harmonization platforms that can sustain the change agenda at all times and every required level.

Effective monitoring and evaluation practices is widely known to help improve performance, the quality and effectiveness of planning and decision making and achievement of results. This is because monitoring focuses on the implementation process and progress towards the achievement of project objectives. Despite the Kenya Government’s effort to promote County Maternal Health programmes through legal frameworks such as the county integrated monitoring and evaluation practices tool, and while there is empirical evidence that monitoring and evaluation practices contributes to enhanced performance, actual performance of county health sector across Kenya remains poor. The purpose of the study was to establish moderating influence of contextual determinants on the relationship between monitoring and evaluation practices and performance of County Maternal Health programmes in Kenya. The paradigm that is suitable for this study is pragmatism. The study adopted a descriptive survey research design. The study targeted 8 regional blocks in Kenya (Central,, Western Coast, Eastern, Rift Valley, North Eastern, Nyanza, Nairobi) where one county from each block was selected. From these counties the target population was 1165 respondents including Medical officers, Clinical Officers, Trained Community health workers, Nurses, County Health Management Team and County Delivery Unit officers from level 4 and 5 hospitals. Sampling procedure for this study was guided by the research design which is descriptive survey design. Stratified random sampling was used to obtain 282 respondents from which information was obtained for this study. The research instruments that were used for data collection are: a self-administered structured questionnaire and interview guides. Descriptive and inferential data analysis techniques were used in this study. Regression was conducted for testing the study hypothesis. The research established that there was a strong correlation between the performance of county maternal health programmes and contextual determinants (r=0.638, p=0.000<0.05). The study found that after introduction of contextual determinants into the relationship, and the interaction term in model 2 increased the R square by 0.08. This implies that the interaction between contextual determinants and monitoring and evaluation practices explains 8.0% variations in performance of county maternal health programmes. The study concluded that contextual determinants significantly moderate the relationship between monitoring and evaluation practices and performance of County Maternal Health Programmes in Kenya. The study recommends investing in robust and dynamic technical coordination platforms that can sustain the agenda for change. and at all levels is necessary to ensure the sustainability of M&E reforms in the health sector.

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The level of cord termination and level of vertebral intersection of intercristal line and transumbilical plane (TUP), frequently used landmarks, show ethnic variation. The relationship of the spinal cord termination to these lines is vital in spinal surgery and anesthesia, but data on these parameters are scarce in the African population. The purpose of this work is to determine the level of cord termination and establish its relationship with intercristal line and TUP. One hundred and twelve specimens obtained from the department of Human Anatomy at the University of Nairobi were used in this study. The conus medullaris was exposed by laminectomy and its vertebral level together with those of intercristal line and TUP recorded. The distance of conus medullaris from intercristal plane was measured in millimeters. Data obtained were coded and analyzed using Statistical Package for Social Sciences (SPSS) for windows version 16.0 Chicago, Illinois, 2002. Student's t-test was used in the statistical assessment of gender differences. A P value of less than 0.05 was considered significant. The median level of termination of the cord was the upper third of L2, 51.9% of cases terminating below this. There was no statistically significant gender difference in the level of termination of the cord. The intercristal plane passed through L4/L5 disc (70.9%) and below (29.1%). The TUP corresponded with intercristal line in 78.2% of subjects. The mean distance of the spinal cord termination from intercristal line was 99 +/- 24 mm. The spinal cord terminates at or below the upper third of L2. Care should be exercised during lumbar punctures and spinal epidural anesthesia among Africans. Intecristal line and TUP are safe landmarks to use in location of conus medullaris.

The level of cord termination and level of vertebral intersection of intercristal line and transumbilical plane (TUP), frequently used landmarks, show ethnic variation. The relationship of the spinal cord termination to these lines is vital in spinal surgery and anesthesia, but data on these parameters are scarce in the African population. The purpose of this work is to determine the level of cord termination and establish its relationship with intercristal line and TUP. One hundred and twelve specimens obtained from the department of Human Anatomy at the University of Nairobi were used in this study. The conus medullaris was exposed by laminectomy and its vertebral level together with those of intercristal line and TUP recorded. The distance of conus medullaris from intercristal plane was measured in millimeters. Data obtained were coded and analyzed using Statistical Package for Social Sciences (SPSS) for windows version 16.0 Chicago, Illinois, 2002. Student's t-test was used in the statistical assessment of gender differences. A P value of less than 0.05 was considered significant. The median level of termination of the cord was the upper third of L2, 51.9% of cases terminating below this. There was no statistically significant gender difference in the level of termination of the cord. The intercristal plane passed through L4/L5 disc (70.9%) and below (29.1%). The TUP corresponded with intercristal line in 78.2% of subjects. The mean distance of the spinal cord termination from intercristal line was 99 +/- 24 mm. The spinal cord terminates at or below the upper third of L2. Care should be exercised during lumbar punctures and spinal epidural anesthesia among Africans. Intecristal line and TUP are safe landmarks to use in location of conus medullaris.

Susceptibility to IVM (IVM) of “strain A” Haemonchus contortus which had been exposed to IVM four times over a 2-year period was compared to IVM susceptibility of “strain C” H. contortus which had no prior field exposure to IVM, by in vivo and in vitro methods. In vivo, the percentage reduction in faecal egg counts (FEC) and the total worm counts (TWC) were compared between control animals (lambs and kids) and animals treated with low dose IVM (20 μg/kg). In vitro susceptibility to IVM was evaluated by larval migration inhibition (LMI) after the two strains of H. contortus were exposed to different concentrations of IVM. The dose response, measured as the proportion of larvae inhibited from migrating, was used to estimate LD50. Although differences in response to IVM in the in vivo determinations were not significant, “strain A” H. contortus had a significantly higher LD50 than “strain C” in the LMI assay. Coincident with the conduct of the in vivo experiment, it was observed that “strain A” H. contortus established and survived better than “strain C” in the control lambs.

A study was undertaken in a semi-arid area of Kenya between August 1991 and June 1993 to evaluate the effects of anthelmintic treatment using ivermectin before or during the rains, on performance of mixed sheep and goat flocks, in comparison with an untreated flock. Performance parameters measured included age and weight of dams at first parturition, parturition intervals, body weights of dams and offspring, and birth weights, growth rates, and mortality rates of offspring. Among these parameters, birth weights and growth rates of offspring were found to be significantly improved by the treatment administered before the rains compared with the other two treatments. Mortality was lower in lambs and kids with high birth weights. Treatment, either before or during the rains, significantly reduced the faecal egg output and improved body weight, packed cell volume and flock fertility. Liveweight was confirmed to be a better measure of sexual maturity than age. It was further shown that lambs and kids, born of dams at their first lambing or kidding, experienced higher mortality rates than lambs and kids born of dams in their second and subsequent parturitions. Overall, treatment with ivermectin before the onset of rains was equal to or better, in terms of the performance parameters measured, than treatment during the rains, whilst treatment compared with no treatment increased performance in almost all of the parameters measured.

Susceptibility to IVM (IVM) of “strain A” Haemonchus contortus which had been exposed to IVM four times over a 2-year period was compared to IVM susceptibility of “strain C” H. contortus which had no prior field exposure to IVM, by in vivo and in vitro methods. In vivo, the percentage reduction in faecal egg counts (FEC) and the total worm counts (TWC) were compared between control animals (lambs and kids) and animals treated with low dose IVM (20 μg/kg). In vitro susceptibility to IVM was evaluated by larval migration inhibition (LMI) after the two strains of H. contortus were exposed to different concentrations of IVM. The dose response, measured as the proportion of larvae inhibited from migrating, was used to estimate LD50. Although differences in response to IVM in the in vivo determinations were not significant, “strain A” H. contortus had a significantly higher LD50 than “strain C” in the LMI assay. Coincident with the conduct of the in vivo experiment, it was observed that “strain A” H. contortus established and survived better than “strain C” in the control lambs.

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.

A pharmacognostical investigation of Elaeodendron buchananii
(Loes.) Loes. has been undertaken. Phytochemical and pharmacological
properties of the active (poisonous) principles of the plant
have also been studied.
The pharmacognostical investigation of the plant involved identifying
features of the different parts of the plant using photographic
and macroscopic methods .
Results of the screening tests of the different parts of the
plant for the active constituents indicated the presence of chemical
compounds with a, b-unsaturated 6- lactone ring, possibly cardiac
glycosides. Investigation of a suitable solvent system for the extraction
of these compounds was undertaken. Of the different parts
of the plant examined for active principles , the leaves were found
to contain the highest percentage of the chemical compounds with <,
(3- unsaturated 0-- lactone ring. Isolation and purification of the
active principle(s) from the original crude plant extracts involving
the removal of pigments, tannins! resins and excess lead has been
described. Crystellisat ion of the isolated gycoside from a suitable
solvent system and the subsequent study of some of the physical l and
chemical properties of the isolated compound has been described.
From the elemental analysis and the molecular weight of the
isolated compound the molecular formula of t he compound has been
determined as C32H47011. Using the infra-red, ultraviolet, nuclear
magnetic resonance and mass spectra$ a partial molecular structure
has been suggested.
The isolated compound has been reacted with Kedde reagent and
the resulting coloured complex has been examined to see whether it
obeys Beer - Lambert law. The calibration curve obtained has been
used to determine the percentage recovery of the isolated compound
in the leaves of the plant.
The pharmacological study of the isolated compound has also
been undertaken. This study involved the investigation of the
effects of the isolated compound on the blood pressure of anaesthetised
rat and the effect of the compound on the isolated perfused
rabbi t heart.
Suggestions for further work as regards pharmacognostical investigation
of the plant together with ascertaining the exact structural
formula of the compound has been proposed.

The research discussed in this book sought to penetrate the functional role fo teachers and students’ attitudes towards Christian Religious Education in Kenya. A mixed methods (qualitative and quantitative) approach was employed with the investigations being ‘ex post facto’ in design. A random stratified procedure was employed to select the constituents of the sample. The sample consisted of 49 teachers and 909 students. The methodology, findings, discussion, conclusions and recommendations of the research are presented in the book.

Decline in quality education has become one of the major challenges facing the education sector as the Government tries to widen access to basic education. To address these challenges, the major thrust has been to develop feasible policies, objectives, strategies, programs and activities to guide the development of the sector. For instance, the strategies proposed by MPET for primary education included increasing access and participation as well as raising relevance and quality. However, the quality of education can not be improved without improving the teacher. Consequently, many primary school teachers went back to school and enrolled in degree courses at universities. This paper discusses the attempt to assess the extent to which the teacher who enrolled in the B.Ed. program of the University of Nairobi have been able to expand their knowledge and pedagogical skills in different subjects. Can these teachers contribute to improved efficiency and effectiveness with respect to the provision and delivery of education? In what ways have they contributed to increased in education at the primary level?

What entails the training of young children making them ready for primary school and in essence for the future? Are there specific items, procedures, factors, etc. that need to be considered for the successful achievements of this goal? Can anybody who loves children undertake teaching preschoolers? These are some of the question that Teaching children seeks to address. This book navigates the waters of preschool teaching – the process of learning, teaching methods, motivation, differences in children all thorough to evaluation as preschool children lay blocks for their future. The journey along this road of preschool education and training begins here.