OBJECTIVE: To evaluate the use of medical therapy in the management of patients with mild, moderate and severe symptoms of benign prostatic hyperplasia. DESIGN: Prospective study. SETTING: Private urology clinic in Mater Hospital, Nairobi between 1995 and 2005. PATIENTS: Six hundred and eighty patients with benign prostatic hypertrophy aged 50-80 years. RESULTS: Two hundred and eighty (43.8%) patients benefited from the drug treatment alone and were released from the clinic follow up after five years. Two hundred and seventy (42.2%) cases could not complete the five years follow up on drugs alone due to symptoms recurrence or severity or unavailability of drugs. They were removed from the drugs alone treatment and put on other interventions. Ninety (15.9%) cases were operated on based on their decision and insistence or severity of their symptoms or no drugs response. CONCLUSIONS: This observational study confirms that medical treatment is beneficial in the management of benign prostatic hyperplasia (BPH) and is cheap and gives better first line option of treatment choice to many patients. It also gives hopes to the surgical risk patients. The quality of life (QOL) of patients and their family disturbance is also improved.

Prior to the introduction of the International Network for Cancer Treatment and Research (INCTR) protocol INCTR 03-06, survival of patients with Burkitt lymphoma at four tertiary care centres in equatorial Africa was probably no more than 10-20%. The results reported here for 356 patients have demonstrated marked improvement in survival through the use of a uniform treatment protocol consisting of cyclophosphamide, methotrexate, vincristine, and intrathecal therapy, and the introduction of non-cross resistant second-line (salvage) therapy, consisting of ifosfamide, mesna, etoposide and cytarabine, when patients failed to achieve a complete response to first-line therapy or relapsed early. Overall survival rates of 67% and 62% were observed at 1 and 2 years (relapse is rare after 1 year of remission). Of interest was the small impact of cerebrospinal fluid (CSF) and bone marrow involvement on outcome. However, the presence or absence of abdominal involvement clearly defined two prognostic groups. An additional finding was the association between CSF pleocytosis and orbital tumours, suggesting that spread of tumour cells to the central nervous system may sometimes occur via direct involvement of cranial nerves in the orbit. Survival rates may be increased in patients with abdominal involvement by combining first- and second-line therapy, but verification will require a further clinical study.

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

Thirty-eight patients in diabetic coma from four different centres were treated with a continuous low-dose intravenous infusion of insulin at an average dose of 7.2 IU/hr. All patients recovered rapidly except for one profoundly shocked patient who died. The mean fall in plasma glucose was 58% four hours after the start of insulin. Blood ketone bodies and plasma free fatty acids showed a similar response. There was no significant difference in plasma glucose response according to severity of acidosis or previous treatment with insulin. Hypokalaemia was uncommon. In the treatment of diabetic coma this technique has proved simple, safe, and effective.

{OBJECTIVE: In this prospective, randomized, open trial, we compared the efficacy and safety of aspart insulin given subcutaneously at different time intervals to a standard low-dose intravenous (IV) infusion protocol of regular insulin in patients with uncomplicated diabetic ketoacidosis (DKA). RESEARCH DESIGN AND METHODS: A total of 45 consecutive patients admitted with DKA were randomly assigned to receive subcutaneous (SC) aspart insulin every hour (SC-1h

The efficacy of a single 2.5-g dose of thiamphenicol against infection with penicillinase-producing strains of Neisseria gonorrhoeae (PPNG) or non-penicillinase-producing strains (non-PPNG) was studied in a two-phase clinical trial in Nairobi. The first phase included men who had had a urethral discharge for less than seven days, were infected with either PPNG or non-PPNG, and had not received previous treatment. The second phase included men with PPNG infections that had not responded to treatment with penicillin. The overall cure rate (determined by follow-up examinations and cultures three and ten days after treatment) was 90.6% in the first phase of the study and 92.1% in the second phase. A second 2.5-g dose of thiamphenicol was administered to four of the six patients in the second phase whose cultures yielded gonococci after the initial dose; the infections of all four patients were cured. The results of disk diffusion tests of gonococcal isolates did not correlate well with the outcome of treatment.

Treatment of HIV infections has involved the use of antiviral drugs as well as those drugs that act against opportunistic infections. Immune modulators have also been used. A review of these drugs is reported emphasizing on those which have great promise in the clinical management of HIV infections in the light of our present knowledge on immunopathology of the disease.

Successful treatment of infections with Trichomonas vaginalis (TV) is difficult because of many confounding factors such as poor abstinence from sex during chemotherapy, lack of standardised chemotherapy, difficulties in understanding transmission patterns and low detection rates among infected individuals. The purpose of this study was to establish the present efficacy of the available drugs at their recommended single or double dosages for Kenya. Adult symptomatic females (age 17-39 years) with positive High Vaginal Swabs but without pregnancy were recruited into the study; and asked to swallow one of the following medicine: nimorazole 2G (Naxogin Farmitalia Carlo Erba, Italy), nimorazole 4G in two equally divided doses 24 hours apart (2GBD), nimorazole 3G, tinidazole 2G (Fasigyn, Pfizer Ltd) and ornidazole 1.5G (Tiberal, Roche, Switzerland). All patients were reviewed 48 hours after the drugs administration and 24 hours after the last dose for the group which received nimorazole 2GBD. 153 patients were recruited into the study. 121 came for follow up out of which 49 were dropped from the study for involvement in sexual intercourse leaving only 72 for the final analysis. Clinical cure was 100% for the group receiving nimorazole 2GBD and nimorazole 3G. Parasitological cure was highest for the group on nimorazole 2GBD (100%) and lowest for the group on tinidazole (50%). Instruction to avoid sex during treatment were withheld from patients. This made it easier during the follow up to pick out and drop from the study those who had had sexual contact

One hundred repeat breeder dairy cows have been studied in detail. Although clinically 60 per cent of them were normal bacteria were isolated from the uteri of the majority (90 per cent). Thirty per cent of these isolates were mixed. Intra-uterine infusion of the uteri with diluted Lugol's Iodine solution, supplemented in a few cases by antibiotic therapy, resulted in a 62 per cent conception rate compared with 26 per cent in the control group. It is concluded that dilute Lugol's Iodine is a useful treatment for repeat breeder cows under conditions similar to those described.

The management of differentiated thyroid cancer remains controversial. A consecutive series of 234 thyroidectomies done by one surgeon in various Nairobi Hospitals from July 1990 to June 1993 were studied. 18 patients were operated on for thyroid cancer. The procedures ranged from lobectomy to total thyroidectomy. Young adults from 20-40 years of age were mainly affected, with a male/female sex ratio of 8:1. The immediate and subsequent morbidity of the operation of total thyroidectomy, in our opinion, overweighs its advantages of improved disease control. This is particularly so when low socio-economic standards lead to lack of compliance with replacement therapy.

Like systemic lupus erythematosus (SLE) itself, manifestations of lupus nephritis are highly varied in their clinical presentation, ranging from mild proteinuria to rapidly progressive glomerulonephritis causing renal insufficiency within weeks. The clinical variability is in keeping with the broad spectrum of histological abnormalities present in renal biopsy specimens from these patients. The therapeutic modalities currently being used in lupus nephritis include oral steroids, pulse methylprednisolone and cytotoxic drugs such as cyclophosphamide and azathioprine either singly or in combinations, depending on the World Health Organisation morphologic classification of the disease. The use of plasmapheresis for proliferative lupus nephritis (WHO class III and IV) and cyclosporin for membranous lupus nephritis (WHO class V) is based on open trials, but not supported by randomised controlled trials. This review assesses the therapeutic modalities available for the treatment of lupus nephritis, giving the available evidence from the literature and acknowledging that none of them might be perfect.

Although early diagnosis and treatment are key factors in the effective control of human African trypanosomiasis (HAT), many cases of the disease delay taking appropriate action, leading to untold suffering. As a better understanding of treatment-seeking behaviour should help in identifying the obstacles to early diagnosis and effective treatment, the treatment pathways followed by 203 former HAT cases in western Kenya and eastern Uganda have recently been explored. About 86% of the HAT cases had utilized more than two different healthcare options before being correctly diagnosed for HAT, with about 70% each using more than three different health facilities. Only about 8% of the cases reported that they had been correctly diagnosed the first time they sought treatment. Just over half (51%) of the HAT cases had been symptomatic for >2 months before being correctly diagnosed for HAT, and such time lags in diagnosis contributed to 72% of the cases receiving their first appropriate treatment only in the late stage of the disease. The likelihood of a correct diagnosis increased with the time the case had been symptomatic. These observations indicate an urgent need to build the diagnostic capacity of the primary healthcare facilities in the study area, so that all HAT cases can be identified and treated in the early stage of the disease.

Although early diagnosis and treatment are key factors in the effective control of human African trypanosomiasis (HAT), many cases of the disease delay taking appropriate action, leading to untold suffering. As a better understanding of treatment-seeking behaviour should help in identifying the obstacles to early diagnosis and effective treatment, the treatment pathways followed by 203 former HAT cases in western Kenya and eastern Uganda have recently been explored. About 86% of the HAT cases had utilized more than two different healthcare options before being correctly diagnosed for HAT, with about 70% each using more than three different health facilities. Only about 8% of the cases reported that they had been correctly diagnosed the first time they sought treatment. Just over half (51%) of the HAT cases had been symptomatic for >2 months before being correctly diagnosed for HAT, and such time lags in diagnosis contributed to 72% of the cases receiving their first appropriate treatment only in the late stage of the disease. The likelihood of a correct diagnosis increased with the time the case had been symptomatic. These observations indicate an urgent need to build the diagnostic capacity of the primary healthcare facilities in the study area, so that all HAT cases can be identified and treated in the early stage of the disease.

Although early diagnosis and treatment are key factors in the effective control of human African trypanosomiasis (HAT), many cases of the disease delay taking appropriate action, leading to untold suffering. As a better understanding of treatment-seeking behaviour should help in identifying the obstacles to early diagnosis and effective treatment, the treatment pathways followed by 203 former HAT cases in western Kenya and eastern Uganda have recently been explored. About 86% of the HAT cases had utilized more than two different healthcare options before being correctly diagnosed for HAT, with about 70% each using more than three different health facilities. Only about 8% of the cases reported that they had been correctly diagnosed the first time they sought treatment. Just over half (51%) of the HAT cases had been symptomatic for >2 months before being correctly diagnosed for HAT, and such time lags in diagnosis contributed to 72% of the cases receiving their first appropriate treatment only in the late stage of the disease. The likelihood of a correct diagnosis increased with the time the case had been symptomatic. These observations indicate an urgent need to build the diagnostic capacity of the primary healthcare facilities in the study area, so that all HAT cases can be identified and treated in the early stage of the disease.

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The objective of this study was to test the hypothesis that sexual risk behaviour would increase following initiation of antiretroviral therapy (ART) in Kenyan female sex workers (FSWs). Design—Prospective cohort study. Setting—FSW cohort in Mombasa, Kenya, 1993-2008. Subjects—898 women contributed HIV-1-seropositive follow-up visits, of whom 129 initiated ART. Intervention—Beginning in March 2004, ART was provided to women qualifying for treatment according to Kenyan National Guidelines. Participants received sexual risk reduction education and free condoms at every visit. Main Outcome Measures—Main outcome measures included unprotected intercourse, abstinence, 100% condom use, number of sexual partners, and frequency of sex. Outcomes were evaluated at monthly follow-up visits using a one week recall interval. Results—Compared to non-ART-exposed follow-up, visits following ART initiation were not associated with an increase in unprotected sex (adjusted odds ratio [AOR] 0.86, 95% confidence interval [CI] 0.62-1.19, P=0.4). There was a non-significant decrease in abstinence (AOR 0.81, 95% CI 0.65-1.01, P=0.07), which was offset by a substantial increase in 100% condom use (AOR 1.54, 95% CI 1.07-2.20, P=0.02). Numbers of sex partners and frequency of sex were similar before versus after starting ART. A trend for decreased sexually transmitted infections following ART initiation provides additional support for the validity of the self-reported behavioural outcomes (AOR 0.67, 95% CI 0.44-1.02, P=0.06). Conclusions—In the setting of ongoing risk reduction education and provision of free condoms, initiation of ART was not associated with increased sexual risk behaviour in this cohort of Kenyan FSWs.

Families in Kenya. In Handbook of World Families, edited by B.N. Adams and J. Trest. Sage Publication, 2005.

In agroforestry systems, farmers plant or retain different tree species because of their different roles. In selection of tree species, farmers seek fast growing trees, which can generate income from sale of timber and woodfuel. Other attributes to such tree crop competition and soil enrichment are borne in mind during tree species screening and selection by farmers. An investigation of tree species composition and spacing in any agroforestry system is a prerequisite to determination of growth and yield of wood resources in agroforestry system. The main objective of this study was to determine relative frequency of the common tree species and their spatial distribution in agroforestry areas of Embu District, Kenya.

In agroforestry systems, farmers plant or retain different tree species because of their different roles. In selection of tree species, farmers seek fast growing trees, which can generate income from sale of timber and woodfuel. Other attributes to such tree crop competition and soil enrichment are borne in mind during tree species screening and selection by farmers. An investigation of tree species composition and spacing in any agroforestry system is a prerequisite to determination of growth and yield of wood resources in agroforestry system. The main objective of this study was to determine relative frequency of the common tree species and their spatial distribution in agroforestry areas of Embu District, Kenya.

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Families in Kenya. In Handbook of World Families, edited by B.N. Adams and J. Trest. Sage Publication, 2005.

Studies show a gap in addressing the reproductive health goals of younger women whose inconsistent use of contraception is high in spite of their great need for it. The women aged 15-24 present high potential for unintended pregnancy and increase the challenge for retention of users which is key in maintaining and pushing up the current gains in contraceptive prevalence rate (CPR)

Oral infection with Herpes Simplex Virus (HSV) is a frequent and well documented complication in immunosuppressed individuals including patients on immunosuppressive medication. We report the development of severe oral infection with HSV type 1 in a 34 year old woman with type 1 diabetes mellitus and end stage renal disease (ESRD) following cadaveric renal transplantation at the Western General Hospital, Edinburgh. The role of acyclovir in therapy and chemoprophylaxis is discussed.

Bloodstream infections are a frequent complication in human immunodeficiency virus (HIV)-infected adults in Africa and usually associated with a poor prognosis. We evaluated bloodstream infections across a decade in 3 prospective cross-sectional surveys of consecutive medical admissions to the Kenyatta National Hospital, Nairobi, Kenya. Participants received standard clinical care throughout. In 1988-1989, 29.5% (28 of 95) of HIV-positive patients had bloodstream infections, compared with 31.9% (46 of 144) in 1992 and 21.3% (43 of 197) in 1997. Bacteremia and mycobacteremia were significantly associated with HIV infection. Infections with Mycobacterium tuberculosis, non-typhi species of Salmonella (NTS), and Streptococcus pneumoniae predominated. Fungemia exclusively due to Cryptococcus neoformans was uncommon. Clinical features at presentation remained similar. Significant improvements in the survival rate were recorded among patients with NTS bacteremia (20%-83%; P<.01) and mycobacteremia (0%-73%; P<.01). Standard clinical management can improve outcomes in resource-poor settings.

The success of antiretroviral therapy in resource-scarce settings is an illustration that complex healthcare interventions can be successfully delivered even in fragile health systems. Documenting the success factors in the scale-up of HIV care and treatment in resource constrained settings will enable health systems to prepare for changing population health needs. This study describes changing demographic and clinical characteristics of adult pre-ART cohorts, and identifies predictors of pre-ART attrition at a large urban HIV clinic in Nairobi, Kenya.

According to the millennium assessment report, during the last century, global drylands have experienced anthropogenic induced climate changes that are predicted to continue and even to accelerate during the present century. The traditional pastoralist spatial domains are facing unprecedented changes due to population growth, urban sprawl and an appetite for land not anticipated by the planners who designated such lands as trust lands. A case in point is Kajiado district which has seen most community owned land blocks subdivided and tenure changed to private especially in areas surrounding It is therefore not only the pastoralists that are finding their roaming area constricted but also the wild animals. A recent court case to protect the migratory corridors of wild animals is a good example. In fact there are more wild animals among these communities than are confined in parks in Kenya. With the inevitable land use changes, and their impacts on livelihoods and environment, this paper explores the literature on the interaction of environmental conservation amid global warming and the potential role of biogas in mitigating the livelihood and vulnerability associated with it. Further, the technology helps manage green house gases and has potential for using the clean development mechanism to raise carbon credits which could be ploughed back in propping the livelihoods of rural communities. The paper highlights the preconditions of successful biogas interventions which include partial or complete confinement of animals in zero grazing units alongside improvement/change of animal breeds to more economically viable ones. However, this raises the greater question whether the radical change of livelihood approaches is at all viable? Key words: Global warming, livelihoods, conservation, biogas, carbon markets

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Sulphadoxine-pyrimethamine (SP), an antifolate, was replaced by artemether-lumefantrine as the first-line malaria drug treatment in Kenya in 2004 due to the wide spread of resistance. However, SP still remains the recommended drug for intermittent preventive treatment in pregnant women and infants (IPTP/I) owing to its safety profile. This study assessed the prevalence of mutations in dihydrofolate reductase (Pfdhfr) and dihydropteroate synthase (Pfdhps) genes associated with SP resistance in samples collected in Kenya between 2008 and 2012.

There has been continuous debate among scholars regarding fertility transition in Africa. Two conclusions emerge: slow pace of decline because of weak facilitating social programs and high demand for large families amidst weak family planning programs. Accelerated fertility decline is expected to occur if there is both substantial decline in desired fertility and increased level of preference implementation. Despite these conclusions, there are also emergent exceptions in Africa, even among the Eastern African countries. Our motivation for the study of this region therefore lies in this context. First, the East African countries share some similarities in policy framework. Secondly, Rwanda and Kenya appear as exceptional in the drive towards accelerating further fertility decline. Fertility change therefore in any one country may have implications in the neighbouring country due to the commonalities especially in language, cultural traits, diffusion and spread new models of behaviour.

J Acquir Immune Defic Syndr. 2000 Aug 15;24(5):458-64.
Trends in HIV-1 incidence in a cohort of prostitutes in Kenya: implications for HIV-1 vaccine efficacy trials.
Baeten JM, Richardson BA, Martin HL Jr, Nyange PM, Lavreys L, Ngugi EN, Mandaliya K, Ndinya-Achola JO, Bwayo JJ, Kreiss JK.
Source
Departments of Epidemiology, Biostatistics, and Medicine, University of Washington, Seattle, Washington, USA. jbaeten@u.washington.edu
Abstract
BACKGROUND:
Accurate predictions of HIV-1 incidence in potential study populations are essential for designing HIV-1 vaccine efficacy trials. Little information is available on the estimated incidence of HIV-1 in such populations, especially information on incidence over time and incidence while participating in risk-reduction programs.
OBJECTIVES:
To examine time trends in HIV-1 incidence in a vaccine preparedness cohort.
DESIGN:
Prospective cohort study of female prostitutes in Mombasa, Kenya.
METHODS:
HIV-1 incidence was determined using open and closed cohort designs. Generalized estimating equations were used to model HIV-1 and sexually transmitted disease (STD) incidence and sexual risk behaviors over time.
RESULTS:
When analyzed as a closed cohort, HIV-1 incidence declined 10-fold during 3 years of follow-up (from 17.4 to 1.7 cases/100 person-years; p <.001). More than 50% of the cases of HIV-1 occurred during the first 6 months after enrollment, and 73% during the first 12 months. When analyzed as an open cohort, HIV-1 incidence density fell during the first 4 calendar years, influenced by accumulation of lower risk participants and variations in study recruitment. Significant declines occurred in both STD incidence and high-risk sexual behaviors during follow-up.
CONCLUSIONS:
This study documents a dramatic decline in the risk of HIV-1 infection while participating in a prospective cohort, with most seroconversions occurring within 1 year of enrollment. Variations in HIV-1 incidence within high-risk populations should be anticipated during the design of vaccine trials.
PMID:
11035617
[PubMed - indexed for MEDLINE]

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A retrospective study of poisoned patients admitted at Kenyatta National Hospital (KNH) over the period January 2002 to June 2003 was carried out. KNH is a national referral and university teaching hospital and patients are admitted from all parts of Kenya. The results of the study are therefore expected to mirror closely the situation in the rest of the country. Data analysis showed that 58.9% of poisoned patients were males. Pesticides and household/industrial chemicals, the two most important poisoning agents, accounted for 43% and 24% of poisoning, respectively. Organophosphates and rodenticides were the two most common pesticides accounting for 57.4% and 31% of poisoning, respectively. Kerosene accounted for 66% of poisoning with household agents. Self-poisoning was prevalent in the age bracket 21-30 years (70.7%)while accidental poisoning, mostly with kerosene,was prevalent in the age group 0-5 years (83.9%). The overall mortality rate from poisoning was 7.0%.

A retrospective study of poisoned patients admitted at Kenyatta National Hospital (KNH) over the period January 2002 to June 2003 was carried out. KNH is a national referral and university teaching hospital and patients are admitted from all parts of Kenya. The results of the study are therefore expected to mirror closely the situation in the rest of the country. Data analysis showed that 58.9% of poisoned patients were males. Pesticides and household/industrial chemicals, the two most important poisoning agents, accounted for 43% and 24% of poisoning, respectively. Organophosphates and rodenticides were the two most common pesticides accounting for 57.4% and 31% of poisoning, respectively. Kerosene accounted for 66% of poisoning with household agents. Self-poisoning was prevalent in the age bracket 21-30 years (70.7%)while accidental poisoning, mostly with kerosene,was prevalent in the age group 0-5 years (83.9%). The overall mortality rate from poisoning was 7.0%.

Many African countries whose economies are largely based on weather/climate sensitive sectors are vulnerable to long‐term changes in weather and climate. This study is aimed at assessing whether the recent decades have observed any significant trend in the intraseasonal descriptors (ISDs) of wet and dry spells at local and sub‐regional levels at seasonal and monthly timescales over equatorial eastern Africa (EEA). Daily rainfall observations over 36 stations and spanning a period of 51 years (1962–2012) were used.

The study has expanded on previous results that showed contrasting trends on seasonal totals between the two rainfall seasons by demonstrating that this also affects the ISDs. At the local level, it was observed that during the long rainfall season, a given ISD would have a significant trend over several neighbouring locations, which was not the case during the short rainfall season. Secondly, for the short rainfall season, a given location would have significant trend in several ISDs. Finally, when a given ISD had a significant trend at seasonal timescale during the long rainfall season, the same ISD would have significant trends in the second and third months of the season and rarely in the first month. Such a feature was not observed for the short rainfall season. Binomial probability distribution assessment confirmed that the significant trends in the various ISDs during the long rainfall season did not occur by mere chance.

The main focus in training evaluation is not only to determine whether training objectives were achieved but also how to improve evaluation so as to enhance both employability of graduates and performance in the job. This is in response to challe nges facing not only graduates in choosing industry jobs that befit their skills, but also employers in selecting graduates whose skills match to their needs. Problem solving is one of the skills acquired during training by graduates and strongly sought fo r by employers during evaluation to promote performance in the job. This paper presents a model for evaluating graduates’ by mapping their problem solving skills to industry jobs ’ competence requirements and the potential of using machine learning techniqu es to train the model in predicting suitable industry jobs for new graduates from college . The paper outlines challenges facing both graduates and industry in selecting industry jobs and skilled graduates respectively, highlight s trends , methods , and gaps in skill evaluation and prediction. A brief discussion is made of key strategies in skill evaluation and prediction that need to be undertaken and evaluation theories behind the key variables of the proposed model.

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Five blue and black cloth traps designed for tsetse were tested for their ability to catch Stomoxys spp. in Kenya. Significantly greatest catches were obtained with Vavoua traps, which then were used to compare odor baits at Nairobi Park. Acetone, lactic acid and animal urine (cow, buffalo, waterbuck, camel) or dung (rhinoceros, elephant and hippopotamus) didn’t increase catches. However, 1-oceten-3-ol dispensed at 0.2-2.0 mg/h increased catches up to 3.7-fold. Vavoua traps were highly specific for Stomoxyinae, with 80% of the catch consisting of 11 different taxa of Stomoxys as well as genera such as Prostomoxys, Haematobosca, Stygeromyia and Rhinomusca. During periods of peak seasonal abundance, up to 3,000 Stomoxys per day were collected in an octenol-baited Vavoua trap. These high catches suggest that Vavoua traps may be of practical use for fly control in isolated settings at a relatively low cost.

The Educational Mission of the Church: An African Perspective

Staphylococcus aureus strains were isolated from 183 of 300 raw milk samples collected at the Kenya Cooperative Creamery (Dandora). Ninety seven percent of the 183 strains isolated  were assayed for the production of enterotoxin A, B, C and D. Seventy two (74.2 %) of these were found to produce either a single or a combination of enterotoxins. Raw milk is a potential source of enterotoxigenic S. aureus in milk and milk products especially if there is defective pasteurization.

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The innate immune component TRIM5α has the ability to restrict retrovirus infection in a species-specific manner. TRIM5α of some primate species restricts infection by HIV-1, while huTRIM5α lacks this specificity. Previous studies have suggested that certain polymorphisms in huTRIM5 may enhance or impair the proteins affinity for HIV-1. This study investigates the role of TRIM5 polymorphisms in resistance/susceptibility to HIV-1 within the Pumwani sex worker cohort in Nairobi, Kenya. A group of women within this cohort remain HIV-1 seronegative and PCR negative despite repeated exposure to HIV-1 through active sex work. Design A 1 kb fragment of Trim5alpha gene, including exon 2, from 1032 women enrolled in the Pumwani sex worker cohort was amplified and sequenced. SNPs and haplotypes were compared between HIV-1 positive and resistant women. Methods The TRIM5 exon 2 genomic fragment was amplified, sequenced and genotyped. Pypop32-0.6.0 was used to determine SNP and haplotype frequencies and statistical analysis was carried out using SPSS-13.0 for windows. Results A TRIM5 SNP (rs10838525) resulting in the amino acid change from Arginine to Glutamine at codon 136, was enriched in HIV-1 resistant individuals (p=1.104E-05; OR:2.991; CI95%:1.806–4.953) and women with 136Q were less likely to seroconvert (p=0.002; Log Rank: 12.799). Wild type TRIM5α exon 2 was associated with susceptibility to HIV-1 (p=0.006; OR:0.279; 95%CI:0.105–0.740) and rapid seroconversion (p=0.001; Log Rank: 14.475). Conclusions Our findings suggest that a shift from arginine to glutamine at codon 136 in the coiled-coil region of TRIM5α confers protection against HIV-1 in the Pumwani sex worker cohort. Keywords: TRIM5α, Single nucleotide polymorphism, HIV-1, Sex Workers, Taxonomy-based Sequence Analysis, Disease Association, Disease Resistance

The antiviral role of TRIM E3 ligases in vivo is not fully understood. To test the hypothesis that TRIM5α and TRIM22 have differential transcriptional regulation and distinct anti-HIV roles according to infection phase and compartment, we measured TRIM5α, TRIM22 and type 1 interferon (IFN-1)-inducible MxA levels in peripheral blood mononuclear cells (PBMCs) during primary and chronic HIV-1 infection, and in matched PBMCs and central nervous system (CNS)-derived cells. Associations with biomarkers of disease progression were explored. The impact of IFN-1, select pro-inflammatory cytokines and HIV on TRIM E3 ligase-specific expression was investigated. PBMCs from individuals with primary and chronic HIV-1 infection had significantly higher levels of MxA and TRIM22 compared to HIV-1 negative PBMCs (P < 0.05, all comparisons). PBMCs from chronic infection had lower levels of TRIM5α compared to primary infection or HIV-1 uninfected (both P = 0.0001). In matched CNS-derived samples and PBMCs, higher levels of MxA (P = 0.001) and TRIM5α (P = 0.0001) were noted in the CNS. There was negative correlation between TRIM22 levels in PBMC and plasma viral load (r = -0.40, P = 0.04). In vitro, IFN-1 and rarely pro-inflammatory cytokines induced TRIM5α and TRIM22 in cell type-dependent manner and knockdown of either protein in CD4+ lymphocytes resulted in increased HIV-1 infection. These data suggest that there are infection-phase specific and anatomically compartmentalized differences in TRIM5α and TRIM22 regulation involving primarily IFN-1 and specific cell types, and indicate subtle differences in the antiviral role and transcriptional regulation of TRIM E3 ligases in vivo.Importance Interferon type I-inducible TRIM E3 ligases are a family of intracellular proteins with potent antiviral activities mediated through diverse mechanisms. However, little is known about the contribution of these proteins to antiviral immunity in vivo and how their expression is regulated. We show here that TRIM5α and TRIM22, two prominent members of the family, have different expression patterns in vivo and that expression pattern depends on HIV-1 infection status and phase. Furthermore, expression differs in peripheral blood versus central nervous system anatomical sites of infection. Only TRIM22 expression correlates negatively with HIV-1 viral load but gene silencing of both proteins enhances HIV-1 infection of target cells. We report on subtle differences in TRIM5α and TRIM22 gene induction by IFN-1 and pro-inflammatory cytokines in CD4+ lymphocytes, monocytes and neuronal cells. This study enhances our understanding of antiviral immunity by intrinsic antiviral factors and how their expression is determined.

Breastfeeding is essential for child health and development in low-resource settings but carries a significant risk of transmission of HIV-1, especially in late stages of maternal disease. We aimed to assess the efficacy and safety of triple antiretroviral compared with zidovudine and single-dose nevirapine prophylaxis in pregnant women infected with HIV.

Smallholder farmers’ access to markets has traditionally been constrained by lack of market information. The need to facilitate farmers’ access to markets has seen the emergence of many projects that employ electronic tools in the provision of market information services (MIS). This study used a triple hurdle analysis to examine the factors influencing farmer awareness of electronic based (e-based) MIS projects, the decision by smallholder farmers in Kenya to participate in such projects and the use of services they provide. It finds that the drivers of awareness, decision to participate in e-based projects and use of the use of e-based MIS various farmer, farm and location-specific characteristics as well as endowments with physical, financial, human, and social capital. It specifically finds that education, distance to market, membership to farmer organizations, household income and cell phone ownership affect both the decision to participate in e-based projects and the use of MIS services such projects offer. The study concludes that transaction costs and social, financial and human capital endowments play an important role in smallholder farmer participation in e-based projects and the use of e-based MIS. The study discusses the implications of these findings for policy and practice.

This study aimed at demonstrating the stabilizing effect of up to 0.4%(wt/wt flour) of rosemary spice (Rosemarinum Officinalis L.) in a flour-based protein-rich product intended for young children. The flour was made of full-fat soya flour, meat (beef) powder, and carrot flour as β ...

Effective strategies are needed for the prevention of mother-to-child HIV transmission (PMTCT) in resource-limited settings. The Kisumu Breastfeeding Study was a single-arm open label trial conducted between July 2003 and February 2009. The overall aim was to investigate whether a maternal triple-antiretroviral regimen that was designed to maximally suppress viral load in late pregnancy and the first 6 mo of lactation was a safe, well-tolerated, and effective PMTCT intervention. METHODS AND FINDINGS: HIV-infected pregnant women took zidovudine, lamivudine, and either nevirapine or nelfinavir from 34-36 weeks' gestation to 6 mo post partum. Infants received single-dose nevirapine at birth. Women were advised to breastfeed exclusively and wean rapidly just before 6 mo. Using Kaplan-Meier methods we estimated HIV-transmission and death rates from delivery to 24 mo. We compared HIV-transmission rates among subgroups defined by maternal risk factors, including baseline CD4 cell count and viral load. Among 487 live-born, singleton, or first-born infants, cumulative HIV-transmission rates at birth, 6 weeks, and 6, 12, and 24 mo were 2.5%, 4.2%, 5.0%, 5.7%, and 7.0%, respectively. The 24-mo HIV-transmission rates stratified by baseline maternal CD4 cell count <500 and ≥500 cells/mm(3) were 8.4% (95% confidence interval [CI] 5.8%-12.0%) and 4.1% (1.8%-8.8%), respectively (p = 0.06); the corresponding rates stratified by baseline maternal viral load <10,000 and ≥10,000 copies/ml were 3.0% (1.1%-7.8%) and 8.7% (6.1%-12.3%), respectively (p = 0.01). None of the 12 maternal and 51 infant deaths (including two second-born infants) were attributed to antiretrovirals. The cumulative HIV-transmission or death rate at 24 mo was 15.7% (95% CI 12.7%-19.4%). CONCLUSIONS: This trial shows that a maternal triple-antiretroviral regimen from late pregnancy through 6 months of breastfeeding for PMTCT is safe and feasible in a resource-limited setting. These findings are consistent with those from other trials using maternal triple-antiretroviral regimens during breastfeeding in comparable settings.

Effective strategies are needed for the prevention of mother-to-child HIV transmission (PMTCT) in resource-limited settings. The Kisumu Breastfeeding Study was a single-arm open label trial conducted between July 2003 and February 2009. The overall aim was to investigate whether a maternal triple-antiretroviral regimen that was designed to maximally suppress viral load in late pregnancy and the first 6 mo of lactation was a safe, well-tolerated, and effective PMTCT intervention.

J. O. Midiwo, A. Yenesew, B. F. Juma, S. Dereses, J. A. Ayoo, A. Aluoch and S. Guchu There are several described medicinal plants in Kenya from a flora of approximately 10,000 members. Strong cross-medical information from the 42 ethnic groups points to the high potential of some of these species. The Myrsinaceae are well established ethno-anthelmintics and anti-bacterials. They are harbingers of long alkyl side chain benzoquinones which clearly have a protective function from their histochemical disposition. The main benzoquinone in the sub-family Myrsinodae is embelin while for the Maesodae it is maesaquinone together with its 5-acetyl derivative; the distribution of these benzoquinones by their alkyl side chain length or the presence/absence of a 6-methyl group is in accord with morphological sub-family de-limitation. The benzoquinones showed anti-feedant, anti-microbial, phytotoxic, acaricidal, insecticidal and nematicidal activity. Many other benzoquinones of medium and minor concentration were also isolated and characterised. Some plants belonging to the Polygonaceae which are widely used as ethno-anthelmintics have been studied. The common anthelmintic anthraquinones were obtained from all five Rumex species while the naphthalenic acetogenin derivative, nepodin was more selectively distributed. The leaf of Polygonum senegalense is up to 17% surface exudate; about thirteen non polar flavonoid derivatives (chalcones, dihydrochalcones, flavanones and a flavone) have been isolated from it. From the internal aerial tissues of this plant, the major flavonoids were common flavonoids, quercetin, kaempferol, luteolin and their glycosides. The only unique compound isolated from this plant was 2prime-glucosyl-6prime-hydroxy-4prime-methoxydihydrochalcone whose aglycone, uvangolatin is part of the exudate mixture. Other leaf exudate plants studied include the stomach-ache medicine, Psiadia punctulata (Compositae) from which novel methylated flavonoids, kaurene and trachyloban diterpenes have been found

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.

Two pentacyclic triterpenoids were isolated, for the first time, from the stem bark of Blighia unijugata Bak. The structures of the two compounds were elucidated on the basis of their spectral data as friedelin and epifriedelinol.

Two pentacyclic triterpenoids were isolated, for the first time, from the stem bark of Blighia unijugata Bak. The structures of the two compounds were elucidated on the basis of their spectral data as friedelin and epifriedelinol.

Two pentacyclic triterpenoids were isolated, for the first time, from the stem bark of Blighia unijugata Bak. The structures of the two compounds were elucidated on the basis of their spectral data as friedelin and epifriedelinol.

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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.

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

The gradient of air temperature with elevation (the temperature lapse rate) in the tropics is predicted to become less steep during the coming century as surface temperature rises, enhancing the threat of warming in high-mountain environments. However, the sensitivity of the lapse rate to climate change is uncertain because of poor constraints on high-elevation temperature during past climate states. We present a 25,000-year temperature reconstruction from Mount Kenya, East Africa, which demonstrates that cooling during the Last Glacial Maximum was amplified with elevation and hence that the lapse rate was significantly steeper than today. Comparison of our data with paleoclimate simulations indicates that state-of-the-art models underestimate this lapse-rate change. Consequently, future high-elevation tropical warming may be even greater than predicted.

Families in Kenya. In Handbook of World Families, edited by B.N. Adams and J. Trest. Sage Publication, 2005.

Colonial policy makers argued that they were  bringing civilization and better standards of living to Africans.  One perceived problem they had to contend with  was the “ignorance” of their subject peoples.  In health delivery, in particular, colonial administrators believed that ignorance accounted for the poor levels of health among Africans, and that knowledge and that knowledge and other preventive measures would greatly enhance standards of living, for instance, among urban Africans. In this paper we test this philosophy against colonial urban health policy’s and show that racism in the delivery of services  greatly undermined African and Asian health in order to afford  high quality services for Europeans in Nairobi.

Agents’ reputation ratings in a social network form a real valued matrix which is discounted with singular value decomposition (SVD) to estimate the trust and distrust levels of agents. SVD eliminates noise as future expected trust and distrust are based on current reputation ratings. A discounting of 20 percent is optimal, further discounting does not improve error reduction. Reputation and trust are closely related. Distrust is different from trust and reputation. Distrust is similar to trust negation; and trust is similar to distrust negation.

Agents’ reputation ratings in a social network form a real-valued matrix which is discounted with singular
value decomposition (SVD) to estimate the trust and distrust levels of agents. SVD eliminates noise as future expected
trust and distrust are based on current reputation ratings. A discounting of 20 percent is optimal, further discounting
does not improve error reduction. Reputation and trust are closely related. Distrust is different from trust and
reputation. Distrust is similar to trust negation, and trust is similar to distrust negation

For effective interactions to take place in a social network, trust is important. We model trust of agents using the peer to peer reputation ratings in the network that forms a real valued matrix.
Singular value decomposition discounts the reputation ratings to estimate the trust levels as trust is the subjective probability of future expectations based on current reputation ratings.
Reputation and trust are closely related and singular value decomposition can estimate trust using the real valued matrix of the reputation ratings of the agents in the network.
Singular value decomposition is an ideal technique in error elimination when estimating trust from reputation ratings. Reputation estimation of trust is optimal at the discounting of 20 %.

The production of pyruvate, glycerol and glycerol-3-phosphate by intact and digitonin-permeabilized Trypanosoma brucei brucei has been studied with glucose or the glycolytic intermediates as substrates. 2. Under aerobic conditions hexosephosphates gave maximal glycolysis in the presence of 40-60 micrograms digitonin/10(8) trypanosomes while the triosephosphates gave it at 20-30 micrograms digitonin/10(8) trypanosomes. 3. In the presence of salicylhydroxamic acid, and the glycolytic intermediates, permeabilized trypanosomes produced equimolar amounts of pyruvate and glycerol-3-phosphate and no glycerol. Under the same conditions, glucose catabolism produced glycerol in addition to pyruvated and glycerol-3-phosphate. 4. In the presence of salicylhydroxamic acid and ATP or ADP intact trypanosomes produced equimolar amounts of pyruvate and (glycerol plus glycerol-3-phosphate) with glucose as substrate. 5. A carrier for ATP and ADP at the glycosomal membrane is implicated. 6. It is apparent that glycerol formation is regulated by the ATP/ADP ratio and that it needs intact glycosomal membrane and the presence of glucose.

The degree of rat erythrocyte lysis and immobilization of Trypanosoma brucei in infected blood by buffered hypotonic solutions of sodium chloride and sources was studied. 2. At 0.3% sodium chloride solution 98% hemolysis of erythrocytes was achieved while 95% of the original bloodstream trypomastigotes survived and were found to be motile and viable for biochemical study. 3. Further increase in the concentration of sodium chloride above 0.3% revealed an increase in the immobilization of trypanosomes and a decrease in the erythrocyte hemolysis. 4. Bloodstream trypomastigotes have been prepared by differential osmotic lysis of infected blood in 0.3% sodium chloride solution and used for studying their metabolism.

African Animal Trypanosomiasis (AAT) transmitted cyclically by tsetse fly (Glossina spp.) is a major obstacle to livestock production in the tropical parts of Africa. The objective of this study was to determine the infection rates of trypanosomes in Glossina species in Mtito Andei Division, Makueni County, Kenya. Tsetse fly species, G. longipennis and G. pallidipes, were trapped and DNA was isolated from their dissected internal organs (proboscis, salivary glands, and midguts). The DNA was then subjected to a nested PCR assay using internal transcribed spacer primers and individual trypanosome species were identified following agarose gel electrophoresis. Out of the 117 flies trapped in the area 39 (33.3%) were teneral while 78 (67%) were nonteneral. G. pallidipes constituted the largest percentage of 58% while G. longipennis were 42%. The overall trypanosomes infection rate in all nonteneral Glossina spp. was 11.53% with G. longipennis recording the highest infection rate of 23.08% while G. pallidipes had an infection rate of 5.77%. T. vivax was the most infectious (10.26%) compared to T. congolense (1.28%). Mean apparent densities were strongly positively correlated with infection rates (r = 0.95) confirming the importance of this parameter as an indicator of AAT transmission risk.

The migration of trypanosomes into the brain parenchyma is still not well understood, considering the presence of a blood brain barrier. We examined the second stage of trypanosomiasis that occurs in the brain using a mice model. Swiss white mice were infected intraperitonealy with 1x104 T. brucei brucei and parasitaemia monitored from the third day up to 28 days post infection. Diminazine aceturate was given intraperitonealy 21 days post infection. One animal was sacrificed at day 21 post infection to establish whether the parasites had reached the brain.

We established the presence of trypanosomes in the brain from day 21 onwards. Scanning electron microscopy showed trypanosomes in the ventricles and some crossing the choroid plexus, while transmission electron microscopy demonstrated the parasites in brain parenchyma. The results indicate a possible route of invasion of trypanosomes into brain parenchyma, shedding some light on the mechanism of this migration.

Tsetse polupations and trypanosome infections were monitored at the Ngulia Rhino Sanctuary to assess the impact of trypanosomiasis on rhinoceros. High densities of Glossina pallidipes were found near a permanent spring by the Ngulia escarpment; G. longipennis and G. brevipalpis were also present in lower numbers. Infection rates in G. pallidipes averaged 3.6%, with three times as many T. vivax as T. congolense infections. T. simiae and T. brucei were present at low frequency. DNA probes revealed that all mature T. congolense infections belonged to the savanna subgroup. G. pallidipes fed on many hosts, with most meals taken from bovides and elephants. Rhino account for one of the blood meals in a small sample taken from G. longipennis. During a time of low tsetse densities (dry season), we estimated that the wild host population was acquiring seven infections per km2 per day. At lower levels of challenge, an experimental rhino became infected with T. congolense. These results are discussed in terms of future plans for the repopulation of rhino in tsetse-infested areas in Kenya.   Keywords; epidemiology, disease, Glossina, parasitology, Trypanosoma

Tsetse polupations and trypanosome infections were monitored at the Ngulia Rhino Sanctuary to assess the impact of trypanosomiasis on rhinoceros. High densities of Glossina pallidipes were found near a permanent spring by the Ngulia escarpment; G. longipennis and G. brevipalpis were also present in lower numbers. Infection rates in G. pallidipes averaged 3.6%, with three times as many T. vivax as T. congolense infections. T. simiae and T. brucei were present at low frequency. DNA probes revealed that all mature T. congolense infections belonged to the savanna subgroup. G. pallidipes fed on many hosts, with most meals taken from bovides and elephants. Rhino account for one of the blood meals in a small sample taken from G. longipennis. During a time of low tsetse densities (dry season), we estimated that the wild host population was acquiring seven infections per km2 per day. At lower levels of challenge, an experimental rhino became infected with T. congolense. These results are discussed in terms of future plans for the repopulation of rhino in tsetse-infested areas in Kenya.   Keywords; epidemiology, disease, Glossina, parasitology, Trypanosoma

African tsetse-fly transmitted trypanosomosis affects a wide range of wild and domesticated animal species. Trypanotolerance, the ability of some breeds to withstand the infection has been recognized and provides a sustainable option in animal production. While a genetic contribution, several behavioural traits are not in doubt, an attempt to find the responsible genes has proven to be complicated. One advance towards generating trypanotolerant animals has been the demonstration of an effective genetic im printing phenomenon in crossbred mice, similar to that observed following challenge. We report a novel reciprocal crossing strategy that exploits epistasis and heterosis in inbred mouse strains to identify imprinting effect controlling trypanosomosis using an F2 (129/ J x CS7BL/6) resource populations. The results indicate that genetic control for trypanotolerance is complicated and the identification of imprinting effect may provide new insights of introgressing trypanotolerance in livestock

African tsetse-fly transmitted trypanosomosis affects a wide range of wild and domesticated animal species. Trypanotolerance, the ability of some breeds to withstand the infection has been recognized and provides a sustainable option in animal production. While a genetic contribution, several behavioural traits are not in doubt, an attempt to find the responsible genes has proven to be complicated. One advance towards generating trypanotolerant animals has been the demonstration of an effective genetic im printing phenomenon in crossbred mice, similar to that observed following challenge. We report a novel reciprocal crossing strategy that exploits epistasis and heterosis in inbred mouse strains to identify imprinting effect controlling trypanosomosis using an F2 (129/ J x CS7BL/6) resource populations. The results indicate that genetic control for trypanotolerance is complicated and the identification of imprinting effect may provide new insights of introgressing trypanotolerance in livestock

Fluorescent natural organic matter at tryptophan-like (TLF) and humic-like fluorescence (HLF) peaks is associated with the presence and enumeration of faecal indicator bacteria in groundwater. We hypothesise, however, that it is predominantly extracellular material that fluoresces at these wavelengths, not bacterial cells. We quantified total (unfiltered) and extracellular (filtered at < 0.22 µm) TLF and HLF in 140 groundwater sources across a range of urban population densities in Kenya, Malawi, Senegal, and Uganda. Where changes in fluorescence occurred following filtration they were correlated with potential controlling variables. A significant reduction in TLF following filtration (ΔTLF) was observed across the entire dataset, although the majority of the signal remained and thus considered extracellular (median 96.9%). ΔTLF was only significant in more urbanised study areas where TLF was greatest. Beneath Dakar, Senegal, ΔTLF was significantly correlated to total bacterial cells (ρs 0.51). No significant change in HLF following filtration across all data indicates these fluorophores are extracellular. Our results suggest that TLF and HLF are more mobile than faecal indicator bacteria and larger pathogens in groundwater, as the predominantly extracellular fluorophores are less prone to straining. Consequently, TLF/HLF are more precautionary indicators of microbial risks than faecal indicator bacteria in groundwater-derived drinking water.

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.

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.

   

Hydro-distilled volatile oils from the leaves of Ocimum gratissimum L. (Lamiaceae) from Meru district in Eastern Kenya were analysed by gas chromatography-mass spectrometry (GC-MS) and also evaluated for antimicrobial activity. The oil was dominated by monoterpens which accounted for 92.48%. This monoterpene fraction was characterized by a high percentage of eugenol (68.8%). The other major monoterpenes were methyl eugenol (13.21%), cis-ocimene (7.47%), trans-ocimene (0.94%), β-pinene (1.10%) and camphor (0.95%). The sesquiterpenes present in fairly good amounts were germacrene D (4.25%) and trans-caryophyllene (1.69%). The minor sesquiterpenes were α-farnesene (0.85%) and β-bisabolene (0.74%). The antimicrobial activities of the essential oils were evaluated against both Gram positive (Staphylococcus aureus, Bacillus spp.) and Gram negative (Escherichia coli, Pseudomonas aeruginosae, Salmonella typhi, Klebisiella pneumoniae, Proteus mirabilis) bacteria and a pathogenic fungus Candida albicans. The oil had pronounced antibacterial and antifungal activities on all the microbes.

Hydro-distilled volatile oils from the leaves of Ocimum gratissimum L. (Lamiaceae) from Meru district in Eastern Kenya were analysed by gas chromatography-mass spectrometry (GC-MS) and also evaluated for antimicrobial activity. The oil was dominated by monoterpens which accounted for 92.48%. This monoterpene fraction was characterized by a high percentage of eugenol (68.8%). The other major monoterpenes were methyl eugenol (13.21%), cis-ocimene (7.47%), trans-ocimene (0.94%), β-pinene (1.10%) and camphor (0.95%). The sesquiterpenes present in fairly good amounts were germacrene D (4.25%) and trans-caryophyllene (1.69%). The minor sesquiterpenes were α-farnesene (0.85%) and β-bisabolene (0.74%). The antimicrobial activities of the essential oils were evaluated against both Gram positive (Staphylococcus aureus, Bacillus spp.) and Gram negative (Escherichia coli, Pseudomonas aeruginosae, Salmonella typhi, Klebisiella pneumoniae, Proteus mirabilis) bacteria and a pathogenic fungus Candida albicans. The oil had pronounced antibacterial and antifungal activities on all the microbes.

Data relating to reproductive parameters of German shepherd bitches were collected from registered German shepherd dog (GSD) breeders with information kept over a 15-year period (1982-1997). The information obtained was verified using the East African Kennel Club records. A total of 594 bitches from 280 breeders were recorded. From these, 798 heats were observed, 594 of which were used for breeding, resulting in 3592 puppies. The mean age at puberty was 519.0 +/- 41 days. Heats occurred throughout the year, although significantly (P < 0.05) higher and lower incidences were observed in October and April respectively Pregnancy significantly (P < 0.01) increased interoestrous interval, which was 247.8 +/- 99.6 and 183 +/- 52 days among bred/pregnant and non-bred bitches respectively. Most bitches in oestrus (73.7%) were bred, and breeding was carried out throughout the year, with a distribution closely related to that of heat incidence. Subsequently, whelping occurred throughout the year, and 95.5% of the bitches that were mated whelped. A mean gestation period of 60.6 +/- 5.1 days was observed. The mean litter size was 6.4 +/- 0.4 puppies, and did not differ significantly between months. The preweaning losses were low, with 2.3% stillbirths, 0.9% culls and 11.4% mortalities.

Data relating to reproductive parameters of German shepherd bitches were collected from registered German shepherd dog (GSD) breeders with information kept over a 15-year period (1982-1997). The information obtained was verified using the East African Kennel Club records. A total of 594 bitches from 280 breeders were recorded. From these, 798 heats were observed, 594 of which were used for breeding, resulting in 3592 puppies. The mean age at puberty was 519.0 +/- 41 days. Heats occurred throughout the year, although significantly (P < 0.05) higher and lower incidences were observed in October and April respectively Pregnancy significantly (P < 0.01) increased interoestrous interval, which was 247.8 +/- 99.6 and 183 +/- 52 days among bred/pregnant and non-bred bitches respectively. Most bitches in oestrus (73.7%) were bred, and breeding was carried out throughout the year, with a distribution closely related to that of heat incidence. Subsequently, whelping occurred throughout the year, and 95.5% of the bitches that were mated whelped. A mean gestation period of 60.6 +/- 5.1 days was observed. The mean litter size was 6.4 +/- 0.4 puppies, and did not differ significantly between months. The preweaning losses were low, with 2.3% stillbirths, 0.9% culls and 11.4% mortalities.

Data relating to reproductive parameters of German shepherd bitches were collected from registered German shepherd dog (GSD) breeders with information kept over a 15-year period (1982-1997). The information obtained was verified using the East African Kennel Club records. A total of 594 bitches from 280 breeders were recorded. From these, 798 heats were observed, 594 of which were used for breeding, resulting in 3592 puppies. The mean age at puberty was 519.0 +/- 41 days. Heats occurred throughout the year, although significantly (P < 0.05) higher and lower incidences were observed in October and April respectively Pregnancy significantly (P < 0.01) increased interoestrous interval, which was 247.8 +/- 99.6 and 183 +/- 52 days among bred/pregnant and non-bred bitches respectively. Most bitches in oestrus (73.7%) were bred, and breeding was carried out throughout the year, with a distribution closely related to that of heat incidence. Subsequently, whelping occurred throughout the year, and 95.5% of the bitches that were mated whelped. A mean gestation period of 60.6 +/- 5.1 days was observed. The mean litter size was 6.4 +/- 0.4 puppies, and did not differ significantly between months. The preweaning losses were low, with 2.3% stillbirths, 0.9% culls and 11.4% mortalities.

Data relating to reproductive parameters of German shepherd bitches were collected from registered German shepherd dog (GSD) breeders with information kept over a 15-year period (1982-1997). The information obtained was verified using the East African Kennel Club records. A total of 594 bitches from 280 breeders were recorded. From these, 798 heats were observed, 594 of which were used for breeding, resulting in 3592 puppies. The mean age at puberty was 519.0 +/- 41 days. Heats occurred throughout the year, although significantly (P < 0.05) higher and lower incidences were observed in October and April respectively Pregnancy significantly (P < 0.01) increased interoestrous interval, which was 247.8 +/- 99.6 and 183 +/- 52 days among bred/pregnant and non-bred bitches respectively. Most bitches in oestrus (73.7%) were bred, and breeding was carried out throughout the year, with a distribution closely related to that of heat incidence. Subsequently, whelping occurred throughout the year, and 95.5% of the bitches that were mated whelped. A mean gestation period of 60.6 +/- 5.1 days was observed. The mean litter size was 6.4 +/- 0.4 puppies, and did not differ significantly between months. The preweaning losses were low, with 2.3% stillbirths, 0.9% culls and 11.4% mortalities.

Data relating to reproductive parameters of German shepherd bitches were collected from registered German shepherd dog (GSD) breeders with information kept over a 15-year period (1982-1997). The information obtained was verified using the East African Kennel Club records. A total of 594 bitches from 280 breeders were recorded. From these, 798 heats were observed, 594 of which were used for breeding, resulting in 3592 puppies. The mean age at puberty was 519.0 +/- 41 days. Heats occurred throughout the year, although significantly (P < 0.05) higher and lower incidences were observed in October and April respectively Pregnancy significantly (P < 0.01) increased interoestrous interval, which was 247.8 +/- 99.6 and 183 +/- 52 days among bred/pregnant and non-bred bitches respectively. Most bitches in oestrus (73.7%) were bred, and breeding was carried out throughout the year, with a distribution closely related to that of heat incidence. Subsequently, whelping occurred throughout the year, and 95.5% of the bitches that were mated whelped. A mean gestation period of 60.6 +/- 5.1 days was observed. The mean litter size was 6.4 +/- 0.4 puppies, and did not differ significantly between months. The preweaning losses were low, with 2.3% stillbirths, 0.9% culls and 11.4% mortalities.

Data relating to reproductive parameters of German shepherd bitches were collected from registered German shepherd dog (GSD) breeders with information kept over a 15-year period (1982-1997). The information obtained was verified using the East African Kennel Club records. A total of 594 bitches from 280 breeders were recorded. From these, 798 heats were observed, 594 of which were used for breeding, resulting in 3592 puppies. The mean age at puberty was 519.0 +/- 41 days. Heats occurred throughout the year, although significantly (P < 0.05) higher and lower incidences were observed in October and April respectively Pregnancy significantly (P < 0.01) increased interoestrous interval, which was 247.8 +/- 99.6 and 183 +/- 52 days among bred/pregnant and non-bred bitches respectively. Most bitches in oestrus (73.7%) were bred, and breeding was carried out throughout the year, with a distribution closely related to that of heat incidence. Subsequently, whelping occurred throughout the year, and 95.5% of the bitches that were mated whelped. A mean gestation period of 60.6 +/- 5.1 days was observed. The mean litter size was 6.4 +/- 0.4 puppies, and did not differ significantly between months. The preweaning losses were low, with 2.3% stillbirths, 0.9% culls and 11.4% mortalities.

Data relating to reproductive parameters of German shepherd bitches were collected from registered German shepherd dog (GSD) breeders with information kept over a 15-year period (1982-1997). The information obtained was verified using the East African Kennel Club records. A total of 594 bitches from 280 breeders were recorded. From these, 798 heats were observed, 594 of which were used for breeding, resulting in 3592 puppies. The mean age at puberty was 519.0 +/- 41 days. Heats occurred throughout the year, although significantly (P < 0.05) higher and lower incidences were observed in October and April respectively Pregnancy significantly (P < 0.01) increased interoestrous interval, which was 247.8 +/- 99.6 and 183 +/- 52 days among bred/pregnant and non-bred bitches respectively. Most bitches in oestrus (73.7%) were bred, and breeding was carried out throughout the year, with a distribution closely related to that of heat incidence. Subsequently, whelping occurred throughout the year, and 95.5% of the bitches that were mated whelped. A mean gestation period of 60.6 +/- 5.1 days was observed. The mean litter size was 6.4 +/- 0.4 puppies, and did not differ significantly between months. The preweaning losses were low, with 2.3% stillbirths, 0.9% culls and 11.4% mortalities.

Data relating to reproductive parameters of German shepherd bitches were collected from registered German shepherd dog (GSD) breeders with information kept over a 15-year period (1982-1997). The information obtained was verified using the East African Kennel Club records. A total of 594 bitches from 280 breeders were recorded. From these, 798 heats were observed, 594 of which were used for breeding, resulting in 3592 puppies. The mean age at puberty was 519.0 +/- 41 days. Heats occurred throughout the year, although significantly (P < 0.05) higher and lower incidences were observed in October and April respectively Pregnancy significantly (P < 0.01) increased interoestrous interval, which was 247.8 +/- 99.6 and 183 +/- 52 days among bred/pregnant and non-bred bitches respectively. Most bitches in oestrus (73.7%) were bred, and breeding was carried out throughout the year, with a distribution closely related to that of heat incidence. Subsequently, whelping occurred throughout the year, and 95.5% of the bitches that were mated whelped. A mean gestation period of 60.6 +/- 5.1 days was observed. The mean litter size was 6.4 +/- 0.4 puppies, and did not differ significantly between months. The preweaning losses were low, with 2.3% stillbirths, 0.9% culls and 11.4% mortalities.

Data relating to reproductive parameters of German shepherd bitches were collected from registered German shepherd dog (GSD) breeders with information kept over a 15-year period (1982-1997). The information obtained was verified using the East African Kennel Club records. A total of 594 bitches from 280 breeders were recorded. From these, 798 heats were observed, 594 of which were used for breeding, resulting in 3592 puppies. The mean age at puberty was 519.0 +/- 41 days. Heats occurred throughout the year, although significantly (P < 0.05) higher and lower incidences were observed in October and April respectively Pregnancy significantly (P < 0.01) increased interoestrous interval, which was 247.8 +/- 99.6 and 183 +/- 52 days among bred/pregnant and non-bred bitches respectively. Most bitches in oestrus (73.7%) were bred, and breeding was carried out throughout the year, with a distribution closely related to that of heat incidence. Subsequently, whelping occurred throughout the year, and 95.5% of the bitches that were mated whelped. A mean gestation period of 60.6 +/- 5.1 days was observed. The mean litter size was 6.4 +/- 0.4 puppies, and did not differ significantly between months. The preweaning losses were low, with 2.3% stillbirths, 0.9% culls and 11.4% mortalities.

Data relating to reproductive parameters of German shepherd bitches were collected from registered German shepherd dog (GSD) breeders with information kept over a 15-year period (1982-1997). The information obtained was verified using the East African Kennel Club records. A total of 594 bitches from 280 breeders were recorded. From these, 798 heats were observed, 594 of which were used for breeding, resulting in 3592 puppies. The mean age at puberty was 519.0 +/- 41 days. Heats occurred throughout the year, although significantly (P < 0.05) higher and lower incidences were observed in October and April respectively Pregnancy significantly (P < 0.01) increased interoestrous interval, which was 247.8 +/- 99.6 and 183 +/- 52 days among bred/pregnant and non-bred bitches respectively. Most bitches in oestrus (73.7%) were bred, and breeding was carried out throughout the year, with a distribution closely related to that of heat incidence. Subsequently, whelping occurred throughout the year, and 95.5% of the bitches that were mated whelped. A mean gestation period of 60.6 +/- 5.1 days was observed. The mean litter size was 6.4 +/- 0.4 puppies, and did not differ significantly between months. The preweaning losses were low, with 2.3% stillbirths, 0.9% culls and 11.4% mortalities.

Data relating to reproductive parameters of German shepherd bitches were collected from registered German shepherd dog (GSD) breeders with information kept over a 15-year period (1982-1997). The information obtained was verified using the East African Kennel Club records. A total of 594 bitches from 280 breeders were recorded. From these, 798 heats were observed, 594 of which were used for breeding, resulting in 3592 puppies. The mean age at puberty was 519.0 +/- 41 days. Heats occurred throughout the year, although significantly (P < 0.05) higher and lower incidences were observed in October and April respectively Pregnancy significantly (P < 0.01) increased interoestrous interval, which was 247.8 +/- 99.6 and 183 +/- 52 days among bred/pregnant and non-bred bitches respectively. Most bitches in oestrus (73.7%) were bred, and breeding was carried out throughout the year, with a distribution closely related to that of heat incidence. Subsequently, whelping occurred throughout the year, and 95.5% of the bitches that were mated whelped. A mean gestation period of 60.6 +/- 5.1 days was observed. The mean litter size was 6.4 +/- 0.4 puppies, and did not differ significantly between months. The preweaning losses were low, with 2.3% stillbirths, 0.9% culls and 11.4% mortalities.

Mwaura F, K M Mavuti and W N Wamicha. . :

Pneumonia is a major cause of morbidity and mortality in infants and children worldwide, with most cases occurring in tuberculosis-endemic settings. Studies have emphasised the potential importance of Mycobacterium tuberculosis in acute severe pneumonia in children as a primary cause or underlying comorbidity, further emphasised by the changing aetiological range with rollout of bacterial conjugate vaccines in high mortality settings. We systematically reviewed clinical and autopsy studies done in tuberculosis-endemic settings that enrolled at least 100 children aged younger than 5 years with severe pneumonia, and that prospectively included a diagnostic approach to tuberculosis in all study participants. We noted substantial heterogeneity between studies in terms of study population and diagnostic methods. Of the 3644 patients who had culture of respiratory specimens for M tuberculosis undertaken, 275 (7·5%) were culture positive, and an acute presentation was common. Inpatient case-fatality rate for pneumonia associated with tuberculosis ranged from 4% to 21% in the four clinical studies that reported pathogen-related outcomes. Prospective studies are needed in high tuberculosis-burden settings to address whether tuberculosis is a cause or comorbidity of childhood acute severe pneumonia.

No abstract available.

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

No abstract available

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

BACKGROUND: In normal pregnancy, the pregnant mother paradoxically tolerates the semi-allogeneic foetus until term. Experimental and clinical data to explain such tolerance in man reflects the involvement of multiple mechanisms. OBJECTIVE: To review the data pertaining to the experimental and clinical efforts to explain why the mother immunologically tolerates a semi-allogeneic pregnancy to term. DESIGN, SETTING AND METHODS: A review of the literature on state of the art thinking among researchers and clinicians on recurrent spontaneous abortions is summarised. RESULTS: A large body of recently published data strongly suggest that a breakdown in immunological maternal-foetal interactions may lead to occasional or recurrent foetal loss. Immunoregulatory activities involving blocking antibodies, regulatory factors, immunological cells, hormones, structural proteins and cytokines constitute the pregnancy-sustaining network. CONCLUSION: The majority of the evidence reviewed points to the involvement of immunological factors in successful pregnancies. However, the underlying mechanisms are inadequately explained, are largely speculative and require more focused investigation. A complete understanding of the mechanisms involved would enhance our capacity to develop rational ways of addressing recurrent pregnancy losses.

OBJECTIVE: To review the cellular and molecular interactions between HIV and the host immune system that lead to full-blown AIDS. DATA SOURCES: Published reports on HIV/host interaction during a fifteen year period beginning from 1987. STUDY SELECTION: Only those studies involving humans and non-human primates were selected. The studies included original articles and state-of-the-art reviews covering in vivo and in vitro findings. DATA EXTRACTION AND SYNTHESIS: This article presents a critical review of the cellular and molecular mechanisms of HIV infection and their relationship to the onset of AIDS. CONCLUSION: HIV has elaborated diverse and somewhat complicated mechanisms for the subversion and evasion of the host immune defence strategies. These include escape through mutation, prolonged latency of the infection, masking of the viral envelope proteins, down-regulation of MHC-I and up-regulation of the Fas-ligand on infected cell surfaces. This review enhances our understanding of HIV/AIDS disease and presents a basis on which management strategies could be developed.