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B PROFOJWANGSHADRACK. "Seventy years of the East African Medical Journal towards safe motherhood. East Afr Med J.1993.". In: East Afr Med J.1993. Rao, W. O., Ogonji, J. A.. and Aywa, S.; 1993. Abstract
Obstetrical and gynaecological articles related to safe motherhood published in the East African Medical Journal between 1924 and 1989 were reviewed. A total of 133 topics were published. Out of these, 84 (63.2%) were obstetrical and 49 (36.8%) gynaecological. Out of the obstetrical topics, 66 were pregnancy related, 12 were public health and the rest medical topics. A rapid increase in the number of the relevant topics is seen especially after 1970. This is probably due to the increase in the number of of obstetricians training locally in the African region and the international nature of the Journal during the last two decades. PIP: A review of all published articles in the East African Medical Journal between 1924 and 1989 was presented. All articles pertaining to obstetrical and gynecological topics related to maternal care were reviewed. The aim was to identify the role the journal has played in distributing information about safe motherhood research. This journal is one of the oldest to present information originating in Africa and recently has gained international recognition. Articles that were studies conducted in other parts of the world are now published. The number of topics devoted to obstetrics and safe motherhood has increased during the past 20 years. Publication by researchers in this journal has contributed to specialists advancement within universities and medical areas. The first maternal-related article was published in 1024 and was devoted to performance of a cesarean section on a woman in Mombasa, an article of particular importance for African countries with high maternal mortality and morbidity from child birth. There have been a total of 133 articles on motherhood since 1924, of which 84 were on obstetrics and 49 on gynecology. World War II probably affected the decline in articles during the period 1940-49. There was a rapid increase in motherhood articles between 1950 and 1989, which also corresponded to an increase in trained obstetricians and gynecologists. Prior to 1970, most specialists were trained outside of Africa and did not publish in this journal. By subject area, there were 12 topics on public health related issues, 43 on prenatal care, 19 on delivery, 4 on postpartum care, and 6 on medically related issues such as infections, diabetes mellitus in pregnancy, hypertension, and heart disease.
B PROFOJWANGSHADRACK, OTIENO DRODAWAFRANCISXAVIER. "Rogo KO, Omany J, Onyango JN, Ojwang SBO.Carcinoma of the cervix in the African setting. Int. J. Obstet. Gynaecol. 1990: 33, 249-.". In: Int. J. Obstet. Gynaecol. 1990: 33, 249-. Rao, W. O., Ogonji, J. A.. and Aywa, S.; 1990. Abstract

Carcinoma of the cervix is the commonest female malignancy in sub-Saharan Africa today. A brief description of its prevalence and distribution is given. Kenyan data is then used to illustrate the predominance of advanced disease in mostly premenopausal women (70%) of high parity. Follow up is characteristically poor and treatment results, although difficult to calculate with accuracy, are also poor. These are compared to FIGO statistics. Against this background aspects peculiar to the tumor, patient and treatment facilities in Africa are cited and discussed with reference to current relevant literature.

B PROFPATELNILESH, G. PROFKIOYPAUL. "Effect of Catha edulis (khat) on behaviour and its potential to induce seizures in Sprague Dawley rats.East Afr Med J. 2007 May;84(5):219-25.PMID: 17892196 [PubMed - indexed for MEDLINE].". In: East Afr Med J. 2007 May;84(5):219-25.PMID: 17892196 [PubMed - indexed for MEDLINE]. International Journal of BiochemiPhysics; 2007. Abstract
Department of Medical Physiology, Moi University, P.O. Box 4606, Eldoret, Kenya. BACKGROUND: Khat is a plant whose young shoots and leaves are habitually used in Eastern Africa and the Arabian Peninsula as a drug of recreation. Although it is used without any control in these regions, it contains two controlled substances, cathinone (schedule I) which is present in fresh khat and cathine (schedule VI) which is a degradation product of cathinone abundant in old khat. OBJECTIVE: To determine the effect of khat on locomotor behaviour and seizures in rats. DESIGN: Experimental study. SETTING: University of Nairobi. SUBJECTS: Adult male rats in groups of six were given fresh khat, old khat, methylphenidate and saline at varying doses and observed over three hours. RESULTS: Fresh khat at low doses and old khat at high doses stimulated locomotor activity. High doses of fresh and old khat induced stereotype behaviour and seizures. CONCLUSION: The results show that khat stimulates locomotor and stereotypic behavioural activity and can induce seizures; results similar to those observed with amphetamine analogs. PMID: 17892196 [PubMed - indexed for MEDLINE]
B DRODUOLCHARLES. "Interpretive Procedures in Classroom Discourse: Journal of Applied Discourse. The University of Aston in Birmingham (1994).". In: 12th International Congress on Animal Reproduction, the Hague, 1992.Workshop on sperm preservation in swine. The Cleveland Museum of Natural History; 1994.
B PROFOJWANGSHADRACK, OTIENO DRODAWAFRANCISXAVIER. "Lilian W, Nasah BI Leke RJI, Ojwang SBO Determinants of Perinatal Mortaligy Hour and Day of birth and method of delivery at the central maternity .". In: J. Obstet. Gyna East Afr. 10(2): 65 1992,. EM Ngatia, LW Gathece, FG Macigo, TK Mulli, LN Mutara, EG Wagaiyu.; 1991. Abstract

PIP: In this study, 273 university students (161 men and 112 women) were interviewed by means of a self-administered questionnaire to determine their knowledge, attitude, and practice concerning sexually transmitted diseases (STDs). The mean age of the men was 22.4 +or- 1.6 years and that of the women was 22.1 +or- 1.6 years. 97.4% of the students were sexually experienced. Knowledge of common STDs was high, but knowledge of their signs, symptoms, and consequences was low. 24.5% of the male and 3.7% of the female students had had an STD. The principal sources of information on STDs included books, films, and TV for 39.6% of the students and teachers for 16.8% of the students. Parents played a very minimal role. It is suggested that primary and secondary school students be taught about STDs as part of reproductive health education and that such education be continued at the college level in order to increase the awareness among young people. author's modified

B PROFOJWANGSHADRACK, OTIENO DRODAWAFRANCISXAVIER. "Ojwang SBO, Kamidigo MO.Placenta percreta with spontaneous rupture of the uterus before labour and a uterine carnual ring.E. Afr. Med. J. 1981:58, 886.". In: J.Obstet.Gynae. East Centr. Afr. 1: 140, 1982. EM Ngatia, LW Gathece, FG Macigo, TK Mulli, LN Mutara, EG Wagaiyu.; 1981. Abstract
PIP: This research report studies several biochemical and histochemical aspects of cervical carcinoma and explores their use in follow-up of patients undergoing radiotherapy. Material came from 19 patients with invasive cervical carcinoma admitted to Kenyatta National Hospital. A control group consisted of 20 women matched for age who attended clinics at the hospital but were not suffering from any malignant disease; control tissue for histological examination was obtained from 3 women who had undergone hysterectomy for uterine fibroids. Biochemical assays for alkaline and acid phosphatases in patients with cervical carcinoma show an increase in alkaline phosphatase in carcinomatous tissue (35.7 umoles/hr/mg) as opposed to normal tissue (7.2). Acid phosphatase values were only moderately raised. Assays of the same enzymes in blood showed a less marked difference between patients and controls (ranges of 7.5-20.8 and 3-14, respectively). When examined histochemically, increased alkaline phosphatase activity was observed in connective tissue, epithelium of the glands and blood capillaries of tumor tissue. 1 section containing normal tissue bordering carcinomatous tissue demonstrated normal alkaline phosphatase activity in the normal tissue and increased activity in the tumor tissue. In summary, there is increased enzyme activity around the tumor areas, but values for serum levels show an overlap of normal and abnormal cases and are therefore not predictive. Results demonstrate a clear difference in activities of these enzymes in carcinomatous tissue and normal tissue, which may be of value in follow-up care.
B PROFMBAYAVERTISTINE. "Foy H, Kondi A, Mbaya V.Serum vitamin B12 and folate levels in normal and riboflavin-deficient baboons (Papio anubis). Br J Haematol. 1966 Mar;12(2):239-45.". In: Br J Haematol. 1966 Mar;12(2):239-45. Wangari Veronica Wanjiru; 1966. Abstract
As the number of fatalities from cardiovascular diseases declines in western industrial nations, an opposite trend is observed in the East African region. Inter-regional variations in the prevalence of vascular disorders have been attributed to socioeconomic, psychosocial and heritable physiological parameters. Although faulty mineralocorticoid metabolism and the dysfunctional kidney are prominent features of circulatory problems, many current studies are focused on membrane receptors, transmembrane ion transport mechanisms, ion channels and the possible genetic polymorphisms that determine the characteristics of those molecular structures in the vascular system of normal or hypertensive persons. In this review, a composite of the data available on each of the above parameters and its significance in the pathogenesis of hypertension in the industrial West and transforming economies of East Africa is presented.
B N, Kibui A, Mwanda S. "Teaching as Communication.". In: TRAINING N IN PEDAGOGY VOL 1. NAIROBI: CODL; 2014.
B PROFOJWANGSHADRACK, OTIENO DRODAWAFRANCISXAVIER. "Ndavi PM, Kigondu CS, Nyagero JM, Nichols DJ, Jesencky K. Ojwang SBO,Gachara M Survey of attitude of Kenya Medical doctors on family (FP): Secondary data analysis.J. Obst. Gyn. East. Cent. Afr. 1995:38-44.". In: Int J Gynaecol Obstet.1996 Jun;53(3):235-41. Rao, W. O., Ogonji, J. A.. and Aywa, S.; 1995. Abstract
OBJECTIVES: The objective of the study was to determine the efficacy of chloroquine in pregnant women with Plasmodium falciparum parasitemia at therapeutic doses of 25 mg/kg body weight divided over 3 days. <br>METHODS: Three-hundred pregnant women in Kilifi Hospital at the coast of Kenya were screened for malaria parasitemia using Giemsa stained thick blood smears. In vivo and in vitro parasite sensitivity to chloroquine was determined. <br>RESULTS: P. falciparum infections were present in 65 (22%) of 300 pregnant women. The in vivo tests showed that 46% of all the P. falciparum infections were resistant to chloroquine predominantly at RI and RII levels. The in vitro tests showed a resistance rate of 35%. <br>CONCLUSIONS: A large proportion of pregnant women with malaria do not respond to chloroquine therapy and alternative drugs are required.
B PROFOJWANGSHADRACK, OTIENO DRODAWAFRANCISXAVIER. "Ojwang SBO.The impact of family planning in Kenya during the last 10 years. E. Afr. Med. J. 1991:68, 69.". In: E. Afr. Med. J. 1991:68, 69. Rao, W. O., Ogonji, J. A.. and Aywa, S.; 1991. Abstract

In this study, a total of 519 patients were interviewed. 82.5% had incomplete abortion. The implication of abortion especially when induced is emphasised. Economic implications that are contributed by the youth are stressed. 83.6% of the patients had not used any contraception. The role of contraception in preventing unwanted pregnancy and therefore induced abortion is stressed. The role of the physician in providing contraception and appropriate contraceptive knowledge is discussed. PIP: A study of 519 consecutive women admitted to Kenyatta National Hospital with the diagnosis of abortion revealed that the majority were young and had a history of nonuse of contraception. Abortion was incomplete in 428 (83%) of cases; 60 (12%) cases involved sepsis. Women 20-24 years of age accounted for 221 (43%) of the abortions; the other two most represented age groups were 25-29 years (28%) and 14-19 years (17%). 460 (89%) of the abortion patients had never used a contraceptive method. The most frequently cited reasons for nonuse were desire for pregnancy (48%), no conscious reason (13%), procrastination in getting to a family planning clinic (8%), no knowledge of family planning (6%), and fear of side effects (6%). Of the 64 cases of failed contraception, 27 were using the pill, 25 had an IUD in place, and 8 were relying on the rhythm method. Among contraceptive users, the major sources of information about contraception were nurses (52%), radio and newspapers (19%), and other women (15%). Only 4% indicated that a physician had discussed family planning with them. Given the resource drain that treatment of incomplete abortion can place on Kenya's health care system and the risk of abortion-induced pelvic infection and subsequent infertility, Kenya's health workers should be encouraged to be more aggressive in promoting family planning use among young women.

B PROFOJWANGSHADRACK, OTIENO DRODAWAFRANCISXAVIER. "Ojwang SBO, Sinei SKA Post caesarian section febrile morbidity at the Kenyatta National Hospital.Medicom 1979:55.". In: E.Afr. Med. J. 1985:62, 271. Rao, W. O., Ogonji, J. A.. and Aywa, S.; 1979. Abstract
PIP: This research report studies several biochemical and histochemical aspects of cervical carcinoma and explores their use in follow-up of patients undergoing radiotherapy. Material came from 19 patients with invasive cervical carcinoma admitted to Kenyatta National Hospital. A control group consisted of 20 women matched for age who attended clinics at the hospital but were not suffering from any malignant disease; control tissue for histological examination was obtained from 3 women who had undergone hysterectomy for uterine fibroids. Biochemical assays for alkaline and acid phosphatases in patients with cervical carcinoma show an increase in alkaline phosphatase in carcinomatous tissue (35.7 umoles/hr/mg) as opposed to normal tissue (7.2). Acid phosphatase values were only moderately raised. Assays of the same enzymes in blood showed a less marked difference between patients and controls (ranges of 7.5-20.8 and 3-14, respectively). When examined histochemically, increased alkaline phosphatase activity was observed in connective tissue, epithelium of the glands and blood capillaries of tumor tissue. 1 section containing normal tissue bordering carcinomatous tissue demonstrated normal alkaline phosphatase activity in the normal tissue and increased activity in the tumor tissue. In summary, there is increased enzyme activity around the tumor areas, but values for serum levels show an overlap of normal and abnormal cases and are therefore not predictive. Results demonstrate a clear difference in activities of these enzymes in carcinomatous tissue and normal tissue, which may be of value in follow-up care.
B PROFOJWANGSHADRACK, OTIENO DRODAWAFRANCISXAVIER. "Ndavi PM, Kigondu CS, Nyagero JM, Nichols DJ, Jesencky K. Ojwang SBO,Gachara M Survey of attitude of Kenya Medical doctors on family (FP): Secondary data analysis.J. Obst. Gyn. East. Cent. Afr. 1995:38-44.". In: College of Health Sciences, UON, 1971-1995.II: GYNAECOLOGY AND FAMILY PLANNING. EM Ngatia, LW Gathece, FG Macigo, TK Mulli, LN Mutara, EG Wagaiyu.; 1995. Abstract
OBJECTIVE: In sub-Saharan Africa, many family planning programmes do not encourage advance provision of oral contraceptives to clients who must wait until menses to initiate pill use. Since some resistance to advance provision of pills is due to provider fears that the practice may be harmful, we conducted a study in Kenya in 1997 to compare pill-taking outcomes between 20 "advance provision" clients and 280 "standard" clients. DESIGN: Prospective observational study. SETTING: Six family planning clinics in Central and Western Kenya. SUBJECTS: Women presenting as new clients at MOH family planning clinics. INTERVENTIONS: Researchers used prospective tracking to compare indicators of pill-taking success between non-menstruating clients given pills to carry home for later use and menstruating clients who began pill use immediately. MAIN OUTCOME MEASURES: Pill-taking outcomes such as side effects, compliance, knowledge, satisfaction, and a continuation proxy. RESULTS: Among clients returning for re-supply, those receiving advance provision of pills did no worse than, and often had superior outcomes to, their counterparts who started taking pills immediately after the clinic visit. CONCLUSIONS: Advance provision of pills, already practiced worldwide, is safe and feasible. Explicit mention should be made of advance provision of pills in national family planning guidance documents and training curricula in Kenya and throughout sub-Saharan Africa.
B PROFOJWANGSHADRACK, OTIENO DRODAWAFRANCISXAVIER. "Orinda DAO, Ojwang SBO, Shiramba TL, Kiungu A. A clinical biochemical and histological study of carcinoma of the cervix as seen at the Kenyatta National Hosptial. E.Afr. Med. J. 1985:62, 271.". In: E.Afr. Med. J. 1985:62, 271. EM Ngatia, LW Gathece, FG Macigo, TK Mulli, LN Mutara, EG Wagaiyu.; 1985. Abstract
PIP: This research report studies several biochemical and histochemical aspects of cervical carcinoma and explores their use in follow-up of patients undergoing radiotherapy. Material came from 19 patients with invasive cervical carcinoma admitted to Kenyatta National Hospital. A control group consisted of 20 women matched for age who attended clinics at the hospital but were not suffering from any malignant disease; control tissue for histological examination was obtained from 3 women who had undergone hysterectomy for uterine fibroids. Biochemical assays for alkaline and acid phosphatases in patients with cervical carcinoma show an increase in alkaline phosphatase in carcinomatous tissue (35.7 umoles/hr/mg) as opposed to normal tissue (7.2). Acid phosphatase values were only moderately raised. Assays of the same enzymes in blood showed a less marked difference between patients and controls (ranges of 7.5-20.8 and 3-14, respectively). When examined histochemically, increased alkaline phosphatase activity was observed in connective tissue, epithelium of the glands and blood capillaries of tumor tissue. 1 section containing normal tissue bordering carcinomatous tissue demonstrated normal alkaline phosphatase activity in the normal tissue and increased activity in the tumor tissue. In summary, there is increased enzyme activity around the tumor areas, but values for serum levels show an overlap of normal and abnormal cases and are therefore not predictive. Results demonstrate a clear difference in activities of these enzymes in carcinomatous tissue and normal tissue, which may be of value in follow-up care.
B M, Narla RD, Amata R, Olubayo F, Songa J, Kyamanyua S, Ateka EM. "Efficiency of cassava brown streak virus transmission by two whitefly species in coastal Kenya." General and Molecular Virology . 2009;1(4):040-045 .efficiency_of_cbvs_transmission_by_2_whitefly_species_in_coastal_kenya1.pdf
B PROFMBAYAVERTISTINE. "Mbaya, V. B., Hepatic Changes Induced by Schrebera alata: A Preliminary Report on The Toxicology of Il Kau Kawa, Afr.J. Med. Sci. 5:131 1975.". In: Afr.J. Med. Sci. 5:131. Wangari Veronica Wanjiru; 1975. Abstract
As the number of fatalities from cardiovascular diseases declines in western industrial nations, an opposite trend is observed in the East African region. Inter-regional variations in the prevalence of vascular disorders have been attributed to socioeconomic, psychosocial and heritable physiological parameters. Although faulty mineralocorticoid metabolism and the dysfunctional kidney are prominent features of circulatory problems, many current studies are focused on membrane receptors, transmembrane ion transport mechanisms, ion channels and the possible genetic polymorphisms that determine the characteristics of those molecular structures in the vascular system of normal or hypertensive persons. In this review, a composite of the data available on each of the above parameters and its significance in the pathogenesis of hypertension in the industrial West and transforming economies of East Africa is presented.
B PROFOJWANGSHADRACK. "Mutungi AK, Sinei SK, Ojwang SBO, Kigondu SK, Ndavi PM.Contraceptive Acceptance and Continuation in women managed for incompleteabortion at Kenyatta National Hospital.J. Obst. Gyn. East Cent. Afr. 1999: 14, 84-88.". In: East Afr Med J. 2006 Mar;83(3):110-3. Rao, W. O., Ogonji, J. A.. and Aywa, S.; 1999. Abstract

Presented here is a 16-year-old nulliparous girl who had embryonal rhabdomyosarcoma causing uterine inversion. She had been referred with a one year history of continuous vaginal bleeding and vaginal swelling. Histology had shown sarcoma botyroides and had received five courses of chemotherapy at the referring hospital. At surgery she was found to have uterine inversion and extended hysterectomy was carried out to be followed by radiotherapy.

B PROFOJWANGSHADRACK, OTIENO DRODAWAFRANCISXAVIER. "Ojwang SBO, Maggwa ABN Adolescent sexuality in Kenya.E. Afr. Med. J. 1991: 68, 74.". In: E. Afr. Med. J. 1991: 68, 74. Rao, W. O., Ogonji, J. A.. and Aywa, S.; 1991. Abstract

Adolescent sexuality has become a major problem all over the world. This review paper describes the main problems encountered in Kenya with regards to adolescent sexuality. The role of the Government and some non-governmental organisations is outlined. Factors which contribute to the problem of adolescent sexuality in Kenya are described. The paper stresses the role of research in solving these problems and finally suggests some strategies which may be adopted in order to minimise the undesirable effects of adolescent sexuality in Kenya. PIP: Kenya's population has increased from 5.4 million in 1948 to 15.3 million in 1979 and is expected to rise to 39 million by 2000. The population growth rate has risen from 2.5% in 1948 to 3.8% in 1979. Improvements in health and economic status since independence have caused significant changes from 1948-79: the fertility rate of women has increased from 6.5-7.9, the crude death rate has decreased from 25/1000-14/1000, infant mortality has decreased from 184/1000-104/1000 births, and life expectancy has increased from 35-54 years. Adolescent girls, 15-24, contribute up to 30% of total pregnancies of females, 15-49, and will form 44.2% of the reproductive age group by 2000. Between 1960 and 1979 the fertility rate of girls 15-19 has increased from 141/1000-168/1000. The age of menarche has dropped from 17 to 12-15. In 1 rural community 41.9% of the girls and 76.1% of the boys aged 12-23 had at least one sexual experience. The mean age at first coitus was 13.7 for boys and 14.9 for girls. 42% of the girls and 74.8% of the boys had more than one sexual partner. Because of the gradual change from extended families to nuclear families, education, role models, and any established activities that initiated youth into adulthood have virtually disappeared, leaving adolescents uneducated and unprepared. Only 2-6% use any form of contraception. 58.4% of rural and 64.4% of urban pregnant girls are in primary school at the time of conception. 8340-10,400 girls drop out of school due to pregnancy each year. 46.6% of girls who get pregnant are not married. Abortions among the adolescents account for 28-64% of abortions done in hospitals, but because of strict abortion laws in Kenya, most adolescents resort to criminal abortions frequently performed by inexperienced people in unsanitary conditions. Sexually transmitted diseases (STDs) are not uncommon among adolescents: 36.8% of pregnant adolescent females had at least 1 STD, compared to 16% of those aged 25 and above. Contraceptive services, education, and laws protecting the adolescent must be instituted in response to the problems of adolescent sexuality.

B PROFOJWANGSHADRACK, OTIENO DRODAWAFRANCISXAVIER. "Ojwang SBO, Basu AK Tubo ovarian shistosomiasis presenting as a ruptured ectopic pregnancy. J. Obstet. Gyn. East. Cent. Afr. 1984:3,44.". In: E.Afr. Med. J. 1985:62, 271. Rao, W. O., Ogonji, J. A.. and Aywa, S.; 1984. Abstract
PIP: This research report studies several biochemical and histochemical aspects of cervical carcinoma and explores their use in follow-up of patients undergoing radiotherapy. Material came from 19 patients with invasive cervical carcinoma admitted to Kenyatta National Hospital. A control group consisted of 20 women matched for age who attended clinics at the hospital but were not suffering from any malignant disease; control tissue for histological examination was obtained from 3 women who had undergone hysterectomy for uterine fibroids. Biochemical assays for alkaline and acid phosphatases in patients with cervical carcinoma show an increase in alkaline phosphatase in carcinomatous tissue (35.7 umoles/hr/mg) as opposed to normal tissue (7.2). Acid phosphatase values were only moderately raised. Assays of the same enzymes in blood showed a less marked difference between patients and controls (ranges of 7.5-20.8 and 3-14, respectively). When examined histochemically, increased alkaline phosphatase activity was observed in connective tissue, epithelium of the glands and blood capillaries of tumor tissue. 1 section containing normal tissue bordering carcinomatous tissue demonstrated normal alkaline phosphatase activity in the normal tissue and increased activity in the tumor tissue. In summary, there is increased enzyme activity around the tumor areas, but values for serum levels show an overlap of normal and abnormal cases and are therefore not predictive. Results demonstrate a clear difference in activities of these enzymes in carcinomatous tissue and normal tissue, which may be of value in follow-up care.
B PROFOJWANGSHADRACK. "Role of intracavitary 137caesium in the management of carcinoma of the uterine cervix in Kenya. East Afr Med J. 1977 Sep;54(9):472-5.". In: East Afr Med J. 1977 Sep;54(9):472-5. Rao, W. O., Ogonji, J. A.. and Aywa, S.; 1977. Abstract
PIP: This research report studies several biochemical and histochemical aspects of cervical carcinoma and explores their use in follow-up of patients undergoing radiotherapy. Material came from 19 patients with invasive cervical carcinoma admitted to Kenyatta National Hospital. A control group consisted of 20 women matched for age who attended clinics at the hospital but were not suffering from any malignant disease; control tissue for histological examination was obtained from 3 women who had undergone hysterectomy for uterine fibroids. Biochemical assays for alkaline and acid phosphatases in patients with cervical carcinoma show an increase in alkaline phosphatase in carcinomatous tissue (35.7 umoles/hr/mg) as opposed to normal tissue (7.2). Acid phosphatase values were only moderately raised. Assays of the same enzymes in blood showed a less marked difference between patients and controls (ranges of 7.5-20.8 and 3-14, respectively). When examined histochemically, increased alkaline phosphatase activity was observed in connective tissue, epithelium of the glands and blood capillaries of tumor tissue. 1 section containing normal tissue bordering carcinomatous tissue demonstrated normal alkaline phosphatase activity in the normal tissue and increased activity in the tumor tissue. In summary, there is increased enzyme activity around the tumor areas, but values for serum levels show an overlap of normal and abnormal cases and are therefore not predictive. Results demonstrate a clear difference in activities of these enzymes in carcinomatous tissue and normal tissue, which may be of value in follow-up care.
B PROFOJWANGSHADRACK, OTIENO DRODAWAFRANCISXAVIER. "Mutungi AK, Sinei SK, Ojwang SBO, Kigondu SC, Ndavi PM Reasons for the non-use of contraception by Post-abortion women at Kenyatta National hospital. J. Obst. Gyn East. Central. Afr. 1999: 14, 89-96.". In: Gynaec Eastern & Central Africa. March 1999. EM Ngatia, LW Gathece, FG Macigo, TK Mulli, LN Mutara, EG Wagaiyu.; 1999. Abstract
OBJECTIVE: In sub-Saharan Africa, many family planning programmes do not encourage advance provision of oral contraceptives to clients who must wait until menses to initiate pill use. Since some resistance to advance provision of pills is due to provider fears that the practice may be harmful, we conducted a study in Kenya in 1997 to compare pill-taking outcomes between 20 "advance provision" clients and 280 "standard" clients. DESIGN: Prospective observational study. SETTING: Six family planning clinics in Central and Western Kenya. SUBJECTS: Women presenting as new clients at MOH family planning clinics. INTERVENTIONS: Researchers used prospective tracking to compare indicators of pill-taking success between non-menstruating clients given pills to carry home for later use and menstruating clients who began pill use immediately. MAIN OUTCOME MEASURES: Pill-taking outcomes such as side effects, compliance, knowledge, satisfaction, and a continuation proxy. RESULTS: Among clients returning for re-supply, those receiving advance provision of pills did no worse than, and often had superior outcomes to, their counterparts who started taking pills immediately after the clinic visit. CONCLUSIONS: Advance provision of pills, already practiced worldwide, is safe and feasible. Explicit mention should be made of advance provision of pills in national family planning guidance documents and training curricula in Kenya and throughout sub-Saharan Africa.
B PROFOJWANGSHADRACK, OTIENO DRODAWAFRANCISXAVIER. "Ojwang SBO.Adolescent sexuality in Africa. A working document for the Commonwealth Secretariat/IPPF/WHO Workshop in Mombasa 1987 (Commonwealth secretariat Award as the best document chosen from African region).". In: WHO Workshop in Mombasa. EM Ngatia, LW Gathece, FG Macigo, TK Mulli, LN Mutara, EG Wagaiyu.; 1987. Abstract

Part of a detailed analysis of 864 unmarried teenage mothers delivering in Pumwani Maternity Hospital and Kenyatta National Hospital is presented. Teenage pregnancy amounted for 42.3% of all deliveries of unmarried mothers. Most teenage patients were above 16 years of age, had a religious background of wide coverage, had low quality antenatal care and low education. 94.6% were found to be primigravidas. This dominance has also been found by other workers. PIP: A prospective cross-sectional descriptive study of unmarried mothers delivering in Pumwani Maternity Hospital and Kenyatta National Hospital, Nairobi, Kenya, from December 1986-April 1987, was conducted with a pretested open-ended questionnaire: the 864 teen mothers are described here. They ranged from 13.4-19 years, most were 17-19. 49.4% were Catholic and 45% Protestant. 88.5% attended prenatal clinics once; 51.5% attended 5 times, although only 13% went to hospital clinics for specialized care. For reasons for not going for prenatal care teens stated that they were too shy to undergo a clinical exam, afraid of parents' reaction, unaware of the pregnancy or of the existence of prenatal care, they had not menstruated, or were in school, in prison, or had long work hours. Most girls had primary education, and 97.9% had dropped out of school. 34% dropped out because of pregnancy, and 32% for lack of tuition fees. Reasons for dropping out of school were tabulated, encompassing a broad range of social problems such as war, death, divorce, alcoholism or illness of parents, no tuition or uniform funds, poor grades, and running away from school. In Africa, teen pregnancy is probably increasing because of decreasing age at menarche and relaxing of traditional values.

B PROFOJWANGSHADRACK, K. PROFSINEISAMUEL. "Human immunodeficiency virus in gestational trophoblastic neoplasias–is it a poor prognostic risk factor. East Afr Med J. 1992 Nov;69(11):647-8.". In: East Afr Med J. 1992 Nov;69(11):647-8. Central artificial Insemination Station Magazine; 1992. Abstract
Three cases of HIV infection with choriocarcinoma are presented. One case had prolonged chemotherapy without remission, the second had remission only after combining hysterectomy with chemotherapy and the third who had extensively metastatic disease in the presence of other low risk factors are reported. HIV infection may predispose patients to extensive metastatic choriocarcinoma and influence the course of treatment. We propose that HIV infection be considered a poor prognostic risk for gestation trophoblastic neoplasias
B PROFOJWANGSHADRACK. "Audit of hysterectomies at the Aga Khan Hospital, Nairobi: justification of operative indications. East Afr Med J. 1992 Sep;69(9):483-6.". In: East Afr Med J. 1992 Sep;69(9):483-6. Rao, W. O., Ogonji, J. A.. and Aywa, S.; 1992. Abstract
An audit of 381 hysterectomies performed over a 5 year period (1986-1990) was carried out. In order to assess justification of the indication for hysterectomy pre-operative diagnoses were divided into two groups: those potentially confirmable by pathologic study and those not potentially confirmable by pathologic study. Out of the 273 cases studied in the first group, 246 (90.1%) were justified, while out of the 108 cases studied in the second group, 82 (75.9%) were justified. An overall 86% justification rate was observed. Adenomyosis as a histopathologic finding was seen more commonly in Asian than African patients (P < 0.005). Morbidity rate was 20% and there were no mortalities. The procedure in general was considered safe and justified
B PROFOJWANGSHADRACK, OTIENO DRODAWAFRANCISXAVIER. "Ojwang SBO Some aspects of cervical cancer in young African women in Kenya. E. Afr. Med. J. 1985:62, 889-895.". In: E. Afr. Med. J. 1985:62, 889-895. Rao, W. O., Ogonji, J. A.. and Aywa, S.; 1985. Abstract
Almost 30 years after its introduction into the management of ovarian carcinoma, second-look laparotomy remains controversial. Although its supporters agree on its indications, there is a considerable number of conflicting reports on the actual benefits of the procedure. Diagnostic inaccuracy, invasiveness and expense are some of the reasons raised by opponents against its routine performance and their recommendations range from limited selective application to total avoidance. The role of second-look laparotomy is reviewed, with particular reference to developing countries where scarcity of resources must always be balanced against the need to provide the best care possible to the individual cancer patient. A management schedule for ovarian carcinoma, including second-look laparotomy, appropriate under these circumstances is given.
B PROFOJWANGSHADRACK, OTIENO DRODAWAFRANCISXAVIER. "Ojwang SBO, Mati JKG, Kjellgren O, Wanguyu S Radiotherapy management of carcinoma of the cervix in Kenya, Preliminary results.E. Afr. Med. J. 1978:55, 258.". In: E. Afr. Med. J. 1978.55, 194. Rao, W. O., Ogonji, J. A.. and Aywa, S.; 1978. Abstract
PIP: This research report studies several biochemical and histochemical aspects of cervical carcinoma and explores their use in follow-up of patients undergoing radiotherapy. Material came from 19 patients with invasive cervical carcinoma admitted to Kenyatta National Hospital. A control group consisted of 20 women matched for age who attended clinics at the hospital but were not suffering from any malignant disease; control tissue for histological examination was obtained from 3 women who had undergone hysterectomy for uterine fibroids. Biochemical assays for alkaline and acid phosphatases in patients with cervical carcinoma show an increase in alkaline phosphatase in carcinomatous tissue (35.7 umoles/hr/mg) as opposed to normal tissue (7.2). Acid phosphatase values were only moderately raised. Assays of the same enzymes in blood showed a less marked difference between patients and controls (ranges of 7.5-20.8 and 3-14, respectively). When examined histochemically, increased alkaline phosphatase activity was observed in connective tissue, epithelium of the glands and blood capillaries of tumor tissue. 1 section containing normal tissue bordering carcinomatous tissue demonstrated normal alkaline phosphatase activity in the normal tissue and increased activity in the tumor tissue. In summary, there is increased enzyme activity around the tumor areas, but values for serum levels show an overlap of normal and abnormal cases and are therefore not predictive. Results demonstrate a clear difference in activities of these enzymes in carcinomatous tissue and normal tissue, which may be of value in follow-up care.
B DRESHUNFRANCIS. "Phonemic analysis and Phonological harmony in Akan:Francis Bannerman Eshun. ..1988. NOTIS NO. (AJZ4367) LOCATION Memorial Library AWO Masters Theses Basement North CALL NO. AWO E759F735.". In: Occasional Papers in Language and Linguistics, Volume 2, 2004. UN-HABITAT; 1988. Abstract
A simple gas chromatographic assay utilising alkali flame ionisation detection is described for the estimation of cyclophosphamide as its trifluoroacetate derivative from plasma. Examination of five patients following intravenous cyclophosphamide gave values of 8.9 h (SD 2.7) for the half-life and 0.061 liters/h/kg (SD 0.011) for whole-body clearance of the drug.
B MISSREGOASSUMPTA. "Rego, A.B., 1975 "Chapter 15, The Weather Station", in A Guide to Fieldwork in Kenya, KIE, Jomo Kenyatta Foundation, Nairobi.". In: Royal Botanic Gardens , Kew , England. El-Banhawy, E. M.; 1975. Abstract
We surveyed the phytoseid mites in four different geographical zones of Kenya: Zone I, upper highland and tropical alpine (2400-4400m): Zone II, lower highland (1800-2400m); zone III, midland (800-1800m); Zone IV, tropical, hot and humid( 0-800m ). A total of 107 species was found. In the sub family, amblyseeinae there were 14 species in the genus Neoseilus , one in Aspereroseius Chant, one in Paraphytoseius Swirski &Schechter, five in typhlodromips De Leon, five in Transeius Chant & McMurty, one in Graminaseius Chant &McMurty, 11 in Amblyseius Berlese, one in Arrenoseius Wanstein, two in Typhlodromalus muma, seven in Ueckemannseius Chant &McMurty, one in Ambylodromalus Chant &Mcmurty,, 20 in Euseius Wanstein, one in Iphiseius Berlese, one in Phytoseilus Evans and one in Gynaseius Ehara & Imano. In the subfamily Phytoseiinae Berlese there were four species in the genus Phytoseiius Ribaga. In the subfamily Typhlodrominae Wanstein, there were four species in the genus Kuzinellus Wainstein and 27 in Typhlodromus Scheuten
B PROFOJWANGSHADRACK, OTIENO DRODAWAFRANCISXAVIER. "Rogo KO, Omany J, Onyango JN, Ojwang SBO.Carcinoma of the cervix in African setting. Int. J. Obstet. Gynaecol. 1990: 33, 249-.". In: Int. J. Obstet. Gynaecol. 1990: 33, 249-. EM Ngatia, LW Gathece, FG Macigo, TK Mulli, LN Mutara, EG Wagaiyu.; 1990. Abstract
Carcinoma of the cervix is the commonest female malignancy in sub-Saharan Africa today. A brief description of its prevalence and distribution is given. Kenyan data is then used to illustrate the predominance of advanced disease in mostly premenopausal women (70%) of high parity. Follow up is characteristically poor and treatment results, although difficult to calculate with accuracy, are also poor. These are compared to FIGO statistics. Against this background aspects peculiar to the tumor, patient and treatment facilities in Africa are cited and discussed with reference to current relevant literature.
B PROFOJWANGSHADRACK, OTIENO DRODAWAFRANCISXAVIER. "Einhorn N. Ojwang SBO Carcinoma of the cervix in Kenya Proceeding of the Conference of the working party on Radionuclides and Afterloading techinique in the treatment of cancer of the uterus in developing areas, Balgrade, Yugoslavia 1976.". In: E. Afr. Med. J. 1978.55, 194. EM Ngatia, LW Gathece, FG Macigo, TK Mulli, LN Mutara, EG Wagaiyu.; 1976. Abstract
PIP: This research report studies several biochemical and histochemical aspects of cervical carcinoma and explores their use in follow-up of patients undergoing radiotherapy. Material came from 19 patients with invasive cervical carcinoma admitted to Kenyatta National Hospital. A control group consisted of 20 women matched for age who attended clinics at the hospital but were not suffering from any malignant disease; control tissue for histological examination was obtained from 3 women who had undergone hysterectomy for uterine fibroids. Biochemical assays for alkaline and acid phosphatases in patients with cervical carcinoma show an increase in alkaline phosphatase in carcinomatous tissue (35.7 umoles/hr/mg) as opposed to normal tissue (7.2). Acid phosphatase values were only moderately raised. Assays of the same enzymes in blood showed a less marked difference between patients and controls (ranges of 7.5-20.8 and 3-14, respectively). When examined histochemically, increased alkaline phosphatase activity was observed in connective tissue, epithelium of the glands and blood capillaries of tumor tissue. 1 section containing normal tissue bordering carcinomatous tissue demonstrated normal alkaline phosphatase activity in the normal tissue and increased activity in the tumor tissue. In summary, there is increased enzyme activity around the tumor areas, but values for serum levels show an overlap of normal and abnormal cases and are therefore not predictive. Results demonstrate a clear difference in activities of these enzymes in carcinomatous tissue and normal tissue, which may be of value in follow-up care.
B DRSINGHCHANDRA. "Hydromagnetic Unsteady Flow of Dusty Viscous Liquid Through a Channel with Variable Pressure Gradient.". In: International Journal of BiochemiPhysics, Vol. 13, No. 1. Materials Research Society; 2004. Abstract
1. Singh C. B.  .  August . .
B PROFOJWANGSHADRACK, OTIENO DRODAWAFRANCISXAVIER. "Gichangi P, Estambale B, Mwayo J, Rogo K, Ojwang SBO, Opiyo A,Termmerman M.Knowledge and Practice about cervical cancer and papsmear testing among patients at Kenyatta National Hospital, Nairobi, Kenya.Inst. J. Gynecol. Cancer 2003, 13.827 .". In: East Afr Med J. 2006 Mar;83(3):110-3. Rao, W. O., Ogonji, J. A.. and Aywa, S.; 2003. Abstract
Presented here is a 16-year-old nulliparous girl who had embryonal rhabdomyosarcoma causing uterine inversion. She had been referred with a one year history of continuous vaginal bleeding and vaginal swelling. Histology had shown sarcoma botyroides and had received five courses of chemotherapy at the referring hospital. At surgery she was found to have uterine inversion and extended hysterectomy was carried out to be followed by radiotherapy.
B S, L G, E W. "Knowledge, attitude and use of mouthwash among Dental and Medical students of the University of Nairobi." International Journal of Dentistry and Oral Health. 2016. 2016;2(4):2-6.
B PROFOJWANGSHADRACK. "Management of shoulder dystocia. East Afr Med J. 1992 Jul;69(7):391-3.". In: East Afr Med J. 1992 Jul;69(7):391-3. Rao, W. O., Ogonji, J. A.. and Aywa, S.; 1992. Abstract
Shoulder dystocia is a rare obstetric emergency with which few clinicians have adequate experience. A case which was successfully managed is presented and current management procedures reviewed.
B PROFOJWANGSHADRACK. "Second look laparotomy–its role in the management of ovarian carcinoma. Second look laparotomy–its role in the management of ovarian carcinoma. East Afr Med J. 1989 Dec;66(12):844-50.". In: East Afr Med J. 1989 Dec;66(12):844-50. Rao, W. O., Ogonji, J. A.. and Aywa, S.; 1989. Abstract
Almost 30 years after its introduction into the management of ovarian carcinoma, second-look laparotomy remains controversial. Although its supporters agree on its indications, there is a considerable number of conflicting reports on the actual benefits of the procedure. Diagnostic inaccuracy, invasiveness and expense are some of the reasons raised by opponents against its routine performance and their recommendations range from limited selective application to total avoidance. The role of second-look laparotomy is reviewed, with particular reference to developing countries where scarcity of resources must always be balanced against the need to provide the best care possible to the individual cancer patient. A management schedule for ovarian carcinoma, including second-look laparotomy, appropriate under these circumstances is given.
B R, M C, G.O.Oyoo. "Different techniques to assess microvascular damage in systemic sclerosis." Afr J Rheumatol . 2015;2(3):46-49. Abstractrheumatology_full_flow1.pdf

Blood perfusion
Systemic Sclerosis (SSc) is a connective
tissue disease with multifactorial
aetiology and autoimmune pathogenesis.
SSc is characterized by structural and
functional alterations of microcirculation,
with important clinical implications, such
as Raynaud Phenomenon (RP) and digital
ulcers1,2. For these reason, morphological
and functional assessment of the peripheral
microvasculature is a must for diagnosis,
prognosis and therapy in SSc patients 2.
Nailfold videocapillaroscopy
Nailfold videocapillaroscopy (NVC) is
the best safe and non-invasive method
to detect morphological microvascular
abnormalities. NVC allows to distinguish
secondary RP from both primary RP and
healthy subjects, identify morphological
patterns that are specific to various SSc
stages (‘Early’, ‘Active’ and ‘Late’ patterns
of microvascular damage) and calculate
the Microangiopathy Evolution Score
(MES) to follow disease evolution3,4.
The video-capillaroscope makes
use of a magnification system (from 50x
up to 500x magnification), and it has an
optical/digital probe which can be moved
over the surface of the finger nails from
the 2nd to the 5th finger of both hands2.
The normal NVC image is characterized
by normal skin transparency, morphology
of the capillary to “U” or “hairpin shape”,
morphological/structural homogeneity,
10-12 capillaries / linear millimetre, one
capillary inside dermal papilla, diameters
of capillary branches <20 μm, and lack of
morphological atypia2. Nailfold capillaries
are frequently normal in primary RP,
but it is possible to observe capillaries
with efferent branch enlargement or
tortuous capillaries. Therefore in normal
conditions, or in the presence of primary
RP, the NVC examination is characterized
by a regular array of capillary loops
along the nailfold bed, without abnormal
Different techniques to assess microvascular damage in
systemic sclerosis
Ruaro B1, Sulli A1, Smith V2, Paolino S1, Pizzorni C1, Cutolo M1
enlargements nor capillary loss2.
Conversely, secondary RP is characterized
by the morphological signs that represent
the microvascular damage: these include
giant capillaries, microhaemorrhages,
capillary loss, presence of avascular
areas and angiogenesis. These sequential
capillaroscopic changes are typical of the
microvascular involvement observed in
more than 95% of SSc patients and are
described by the term “SSc pattern”2,3.
NVC technique identifies
morphological patterns specific to
various stages of SSc (‘Early’, ‘Active’
and ‘Late’ patterns)3,4. The ‘Early’
SSc pattern is characterized by few
enlarged/giant capillaries, few capillary
microhaemorrhages, no evident capillary
loss and a relatively well preserved
capillary distribution. The ‘Active’ SSc
pattern, a marker of disease progression, is
characterized by frequent giant capillaries
(more than 66%), frequent capillary
microhaemorrhages, moderate (up to 33%)
capillary loss, absent or mild ramified
capillaries and a mild disorganization of
the capillary architecture. In the ‘Late’
SSc pattern there is irregular enlargement
of the capillaries, severe (>66%) capillary
loss with evident avascular areas,
ramified or bushy capillaries and a severe
disorganization of the normal capillary
array, although giant capillaries and
microhaemorrhages are almost absent3,4
(Figure 1). NVC is also used to make a
quantitative assessment (i.e. quantify
certain characteristics and make semiquantitative
scoring) of the microvascular
damage. The usual capillaroscopic
parameters (diagnostic parameters,
such as irregularly enlarged capillaries,
giant capillaries, microhaemorrhages;
and progression parameters, such as
reduced capillary number, capillary
ramifications and capillary architectural
disorganization) are evaluated by a semiquantitative
scale. Score 0-3 has been
adopted for all these parameters3

B DRESHUNFRANCIS. "Redundancy Rules in Kiswahili.". In: Occasional Papers in Language and Linguistics, Volume 2, 2004. UN-HABITAT; 2004. Abstract
A simple gas chromatographic assay utilising alkali flame ionisation detection is described for the estimation of cyclophosphamide as its trifluoroacetate derivative from plasma. Examination of five patients following intravenous cyclophosphamide gave values of 8.9 h (SD 2.7) for the half-life and 0.061 liters/h/kg (SD 0.011) for whole-body clearance of the drug.
B MISSREGOASSUMPTA. "Muyanda-Mutebi,P., and Rego, A.B (eds), 1988, UNICEF Teaching/Learning Methodology Guide for Environmental Education including Popuation Education in Eastern and Southern Africa, UNICEF, Nairobi.". In: Royal Botanic Gardens , Kew , England. El-Banhawy, E. M.; 1988. Abstract
We surveyed the phytoseid mites in four different geographical zones of Kenya: Zone I, upper highland and tropical alpine (2400-4400m): Zone II, lower highland (1800-2400m); zone III, midland (800-1800m); Zone IV, tropical, hot and humid( 0-800m ). A total of 107 species was found. In the sub family, amblyseeinae there were 14 species in the genus Neoseilus , one in Aspereroseius Chant, one in Paraphytoseius Swirski &Schechter, five in typhlodromips De Leon, five in Transeius Chant & McMurty, one in Graminaseius Chant &McMurty, 11 in Amblyseius Berlese, one in Arrenoseius Wanstein, two in Typhlodromalus muma, seven in Ueckemannseius Chant &McMurty, one in Ambylodromalus Chant &Mcmurty,, 20 in Euseius Wanstein, one in Iphiseius Berlese, one in Phytoseilus Evans and one in Gynaseius Ehara & Imano. In the subfamily Phytoseiinae Berlese there were four species in the genus Phytoseiius Ribaga. In the subfamily Typhlodrominae Wanstein, there were four species in the genus Kuzinellus Wainstein and 27 in Typhlodromus Scheuten
B PROFOJWANGSHADRACK, OTIENO DRODAWAFRANCISXAVIER. "Ojwang SBO, Omuga B.Contraceptive use among women admitted with abortion in Nairobi. E. Afr. Med. J. 1991::68, 197.". In: E. Afr. Med. J. 1991::68, 197. EM Ngatia, LW Gathece, FG Macigo, TK Mulli, LN Mutara, EG Wagaiyu.; 1991. Abstract

In this study, a total of 519 patients were interviewed. 82.5% had incomplete abortion. The implication of abortion especially when induced is emphasised. Economic implications that are contributed by the youth are stressed. 83.6% of the patients had not used any contraception. The role of contraception in preventing unwanted pregnancy and therefore induced abortion is stressed. The role of the physician in providing contraception and appropriate contraceptive knowledge is discussed. PIP: A study of 519 consecutive women admitted to Kenyatta National Hospital with the diagnosis of abortion revealed that the majority were young and had a history of nonuse of contraception. Abortion was incomplete in 428 (83%) of cases; 60 (12%) cases involved sepsis. Women 20-24 years of age accounted for 221 (43%) of the abortions; the other two most represented age groups were 25-29 years (28%) and 14-19 years (17%). 460 (89%) of the abortion patients had never used a contraceptive method. The most frequently cited reasons for nonuse were desire for pregnancy (48%), no conscious reason (13%), procrastination in getting to a family planning clinic (8%), no knowledge of family planning (6%), and fear of side effects (6%). Of the 64 cases of failed contraception, 27 were using the pill, 25 had an IUD in place, and 8 were relying on the rhythm method. Among contraceptive users, the major sources of information about contraception were nurses (52%), radio and newspapers (19%), and other women (15%). Only 4% indicated that a physician had discussed family planning with them. Given the resource drain that treatment of incomplete abortion can place on Kenya's health care system and the risk of abortion-induced pelvic infection and subsequent infertility, Kenya's health workers should be encouraged to be more aggressive in promoting family planning use among young women.

B PROFOJWANGSHADRACK, OTIENO DRODAWAFRANCISXAVIER. "Ojwang SBO, Mati JKG, Kjellgren O, Wanguyu S Radiotherapy management of carcinoma of the cervix in Kenya, Preliminary results.E. Afr. Med. J. 1978:55, 258.". In: E. Afr. Med. J. 1978.55, 194. EM Ngatia, LW Gathece, FG Macigo, TK Mulli, LN Mutara, EG Wagaiyu.; 1978. Abstract
PIP: This research report studies several biochemical and histochemical aspects of cervical carcinoma and explores their use in follow-up of patients undergoing radiotherapy. Material came from 19 patients with invasive cervical carcinoma admitted to Kenyatta National Hospital. A control group consisted of 20 women matched for age who attended clinics at the hospital but were not suffering from any malignant disease; control tissue for histological examination was obtained from 3 women who had undergone hysterectomy for uterine fibroids. Biochemical assays for alkaline and acid phosphatases in patients with cervical carcinoma show an increase in alkaline phosphatase in carcinomatous tissue (35.7 umoles/hr/mg) as opposed to normal tissue (7.2). Acid phosphatase values were only moderately raised. Assays of the same enzymes in blood showed a less marked difference between patients and controls (ranges of 7.5-20.8 and 3-14, respectively). When examined histochemically, increased alkaline phosphatase activity was observed in connective tissue, epithelium of the glands and blood capillaries of tumor tissue. 1 section containing normal tissue bordering carcinomatous tissue demonstrated normal alkaline phosphatase activity in the normal tissue and increased activity in the tumor tissue. In summary, there is increased enzyme activity around the tumor areas, but values for serum levels show an overlap of normal and abnormal cases and are therefore not predictive. Results demonstrate a clear difference in activities of these enzymes in carcinomatous tissue and normal tissue, which may be of value in follow-up care.
B DRSINGHCHANDRA. "Unsteady Magneto-hydrodynamic flow of Dusty fluid through a Channel.". In: International Symposia in Mathematics, B.H.U. (INDIA). Materials Research Society; Submitted.
B PROFMBAYAVERTISTINE. "KONDI A, MACDOUGALL L, FOY H, MEHTA S, MBAYA V.Anaemias of marasmus and kwashiorkor in Kenya.Arch Dis Child. 1963 Jun;38:267-75.". In: Arch Dis Child. 1963 Jun;38:267-75. Wangari Veronica Wanjiru; 1963. Abstract
As the number of fatalities from cardiovascular diseases declines in western industrial nations, an opposite trend is observed in the East African region. Inter-regional variations in the prevalence of vascular disorders have been attributed to socioeconomic, psychosocial and heritable physiological parameters. Although faulty mineralocorticoid metabolism and the dysfunctional kidney are prominent features of circulatory problems, many current studies are focused on membrane receptors, transmembrane ion transport mechanisms, ion channels and the possible genetic polymorphisms that determine the characteristics of those molecular structures in the vascular system of normal or hypertensive persons. In this review, a composite of the data available on each of the above parameters and its significance in the pathogenesis of hypertension in the industrial West and transforming economies of East Africa is presented.
B PROFOJWANGSHADRACK, OTIENO DRODAWAFRANCISXAVIER. "Kigondu SC, Ojutu JO, Nyonyitono RM, Ojwang SBO, Sanghvi HCG, Muthami LM, Nyagero JM.Condom: acceptability and use among patients attending sexually transmitted diseases (STD) clinic. J. Obst. Gyn. East Cent. Afr. 1992: 10, 25-30.". In: East Afr Med J.1993. Rao, W. O., Ogonji, J. A.. and Aywa, S.; 1992. Abstract
Obstetrical and gynaecological articles related to safe motherhood published in the East African Medical Journal between 1924 and 1989 were reviewed. A total of 133 topics were published. Out of these, 84 (63.2%) were obstetrical and 49 (36.8%) gynaecological. Out of the obstetrical topics, 66 were pregnancy related, 12 were public health and the rest medical topics. A rapid increase in the number of the relevant topics is seen especially after 1970. This is probably due to the increase in the number of of obstetricians training locally in the African region and the international nature of the Journal during the last two decades. PIP: A review of all published articles in the East African Medical Journal between 1924 and 1989 was presented. All articles pertaining to obstetrical and gynecological topics related to maternal care were reviewed. The aim was to identify the role the journal has played in distributing information about safe motherhood research. This journal is one of the oldest to present information originating in Africa and recently has gained international recognition. Articles that were studies conducted in other parts of the world are now published. The number of topics devoted to obstetrics and safe motherhood has increased during the past 20 years. Publication by researchers in this journal has contributed to specialists advancement within universities and medical areas. The first maternal-related article was published in 1024 and was devoted to performance of a cesarean section on a woman in Mombasa, an article of particular importance for African countries with high maternal mortality and morbidity from child birth. There have been a total of 133 articles on motherhood since 1924, of which 84 were on obstetrics and 49 on gynecology. World War II probably affected the decline in articles during the period 1940-49. There was a rapid increase in motherhood articles between 1950 and 1989, which also corresponded to an increase in trained obstetricians and gynecologists. Prior to 1970, most specialists were trained outside of Africa and did not publish in this journal. By subject area, there were 12 topics on public health related issues, 43 on prenatal care, 19 on delivery, 4 on postpartum care, and 6 on medically related issues such as infections, diabetes mellitus in pregnancy, hypertension, and heart disease.
B PROFOJWANGSHADRACK, OTIENO DRODAWAFRANCISXAVIER. "Rogo KO, Ojwang SBO, Stendal Second look laparatomy. Its role in management of ovarian carcinoma.E. Afr. Med. J. 1990: 66,844.". In: Int. J. Obstet. Gynaecol. 1990: 33, 249-. Rao, W. O., Ogonji, J. A.. and Aywa, S.; 1990. Abstract
Carcinoma of the cervix is the commonest female malignancy in sub-Saharan Africa today. A brief description of its prevalence and distribution is given. Kenyan data is then used to illustrate the predominance of advanced disease in mostly premenopausal women (70%) of high parity. Follow up is characteristically poor and treatment results, although difficult to calculate with accuracy, are also poor. These are compared to FIGO statistics. Against this background aspects peculiar to the tumor, patient and treatment facilities in Africa are cited and discussed with reference to current relevant literature.
B O, P G, H S, J O’o. "Castration causes progressive reduction of length of the rabbit penis." Anatomy Journal of Africa. 2014;3(3):412-416.
B PROFOJWANGSHADRACK, OTIENO DRODAWAFRANCISXAVIER. "Lema VM, Ojwang SBO, Wanjala SHM Rupture of gravid uterus. E. Afr. Med. J. 1991: 68, 430.". In: E. Afr. Med. J. 1991: 68, 430. EM Ngatia, LW Gathece, FG Macigo, TK Mulli, LN Mutara, EG Wagaiyu.; 1991. Abstract
A total of 105 patients were treated for ruptured gravid uteri at the Kenyatta National Hospital, Nairobi, Kenya, over a five year period, January, 1984 to December, 1988. During the same period, there were 44,156 deliveries, giving an incidence of uterine rupture of 1:425 deliveries. Of these, records for 95 patients were traced and analysed, and the results are presented here. Majority (61.0%) of these patients were aged less than 30 years, and 62.1% were gravida 5 or less. 54 (56.8%) of them had rupture of scarred uteri, 33 (34.7%) had spontaneous rupture, while 8 (8.4%) had traumatic rupture. 56 (59.0%) ruptured while at the Kenyatta National Hospital. Repair of the uterus without tubal ligation was the treatment offered to most of them, while total abdominal hysterectomy was rarely done. The perinatal case fatality rate was 60% and there were two maternal deaths giving a maternal case fatality rate of 2.1%. Factors associated with uterine rupture at the Kenyatta National Hospital are discussed, and possible ways of reducing the incidence suggested. PIP: Physicians treated 105 patients with uterine rupture at Kenyatta National Hospital (KNH) in Nairobi, Kenya between January 1984-December 1988. The ruptured gravid uterus incidence during the study period was 1:425. 56.8% of the mothers were between 20-29 years old. 62.1% were gravida 5. 21.1% had received no prenatal care. 59% ruptured at this hospital. Adequate labor monitoring would have prevented rupturing. 56.8% experienced at least 1 previous cesarean section (C-section). Only 2 women had had a classical C-section. Moreover 21.1% of mothers who had prenatal care at KNH underwent a previous C-section. Perhaps health workers did not evaluate these women properly. 74% of the mothers were at least 38 weeks gestation. 34.7% had a spontaneous rupture due to prolonged labor (12 hours). 8.4% experienced a traumatic rupture. 94.7% happened during labor. Most of the tears (51.6%) occurred along the lower anterior uterine segment primarily on the transverse or on a C-section scar. Surgeons were able to repair the uterus without tubal ligation in 47.4% of the cases. They could repair the uterus of 11.6%, but also had to perform a tubal ligation. They conducted a partial hysterectomy on 38% and total hysterectomy on 3.2%. 38.9% gave birth to their infants vaginally. 55.8% of the mothers gave birth to a stillborn infant. 35.8% of the infants were delivered in good condition and survived. 4.2% were in poor condition and survived and 4.2% were in poor condition and died. All the infants in the peritoneal cavity were already dead, but not all of those in the uterus died. The case fatality rate stood at 60%. 2.1% of the mothers died, all after surgery. 1 mother actually died of injuries from an earlier assault. In conclusion, C-section was the major predisposing factor. Ruptured gravida uteri continued to be a major obstetric problem in Kenya.
B PROFOJWANGSHADRACK, OTIENO DRODAWAFRANCISXAVIER. "Ojwang SBO.Ovarian Cancer in Kenya E. Afr. Med. J. 1980:57, 131.". In: J.Obstet.Gynae. East Centr. Afr. 1: 140, 1982. EM Ngatia, LW Gathece, FG Macigo, TK Mulli, LN Mutara, EG Wagaiyu.; 1980. Abstract
PIP: This research report studies several biochemical and histochemical aspects of cervical carcinoma and explores their use in follow-up of patients undergoing radiotherapy. Material came from 19 patients with invasive cervical carcinoma admitted to Kenyatta National Hospital. A control group consisted of 20 women matched for age who attended clinics at the hospital but were not suffering from any malignant disease; control tissue for histological examination was obtained from 3 women who had undergone hysterectomy for uterine fibroids. Biochemical assays for alkaline and acid phosphatases in patients with cervical carcinoma show an increase in alkaline phosphatase in carcinomatous tissue (35.7 umoles/hr/mg) as opposed to normal tissue (7.2). Acid phosphatase values were only moderately raised. Assays of the same enzymes in blood showed a less marked difference between patients and controls (ranges of 7.5-20.8 and 3-14, respectively). When examined histochemically, increased alkaline phosphatase activity was observed in connective tissue, epithelium of the glands and blood capillaries of tumor tissue. 1 section containing normal tissue bordering carcinomatous tissue demonstrated normal alkaline phosphatase activity in the normal tissue and increased activity in the tumor tissue. In summary, there is increased enzyme activity around the tumor areas, but values for serum levels show an overlap of normal and abnormal cases and are therefore not predictive. Results demonstrate a clear difference in activities of these enzymes in carcinomatous tissue and normal tissue, which may be of value in follow-up care.
B DRSINGHCHANDRA. "Magneto-hydrodynamic Steady Flow of Liquid Between Two Parallel Plates.". In: Proceedings of Kenya Mathematical Society. Materials Research Society; Submitted.
B PROFMBAYAVERTISTINE. "Foy H, Kondi A, Mbaya V.Hematologic and biochemical indices in the East African baboon.Blood. 1965 Nov;26(5):682-6.". In: Blood. 1965 Nov;26(5):682-6. Wangari Veronica Wanjiru; 1965. Abstract

Hematologic values for peripheral blood and marrow, serum proteins, B12 and folic acid levels are given for recently caught and captive baboons (P. anubis and P.sinocephalus) in Nairobi. The hemaglobin levels were higher in captive than in wild animals. There was no change in the serum proteins unless the animals were on a riboflavindeficient diet. Marrow activity as estimated by counting red cell precursors as a percentage of the total nucleated red cell population agreed with that of red cell uptake of Fe59 ferric chloride. Hemosiderin was present in the marrow in all the animals. Protein turnover studies using I131-labeled albumin with ion exchange resins indicated that the protein catabolic rate and turnover was high. This may have been due to the selective destruction of the human albumin in the baboon.

B PROFOJWANGSHADRACK, OTIENO DRODAWAFRANCISXAVIER. "Ojwang SBO Placenta Praevia Gynaecological Tumour at the Kenyatta National Hospital Obstetrical and Gynaecological long commentaries and case records, M.Med Thesis 1995.". In: Int J Gynaecol Obstet.1996 Jun;53(3):235-41. Rao, W. O., Ogonji, J. A.. and Aywa, S.; 1995. Abstract
OBJECTIVES: The objective of the study was to determine the efficacy of chloroquine in pregnant women with Plasmodium falciparum parasitemia at therapeutic doses of 25 mg/kg body weight divided over 3 days. <br>METHODS: Three-hundred pregnant women in Kilifi Hospital at the coast of Kenya were screened for malaria parasitemia using Giemsa stained thick blood smears. In vivo and in vitro parasite sensitivity to chloroquine was determined. <br>RESULTS: P. falciparum infections were present in 65 (22%) of 300 pregnant women. The in vivo tests showed that 46% of all the P. falciparum infections were resistant to chloroquine predominantly at RI and RII levels. The in vitro tests showed a resistance rate of 35%. <br>CONCLUSIONS: A large proportion of pregnant women with malaria do not respond to chloroquine therapy and alternative drugs are required.
B PROFOJWANGSHADRACK. "Pseudo-precocious puberty in a Kenyan African child: a case report. East Afr Med J. 1991 Jul;68(7):585-9.". In: East Afr Med J. 1991 Jul;68(7):585-9. Rao, W. O., Ogonji, J. A.. and Aywa, S.; 1991. Abstract
A female Kenyan child with pseudoprecocious puberty due to juvenile granulosa cell tumour is presented. Clinical features in this patient included a mass in the lower abdomen, a growth spurt and appearance of pubic hairs as well as enlargements of the breasts. No similar case has been reported in a Kenyan child. The management and review of literature are discussed
B PROFPATELNILESH, G. PROFKIOYPAUL. "Oyungu, E., Kioy, P.G., Patel, N.B. (2009) Proconvulsant Effect of Khat (Catha edulis) in Spargue Dawley Rats. J. Ethnopharmacol 30: 121(3): 476-8. Epub 2008 Nov 8.". In: Ethiop. 12(2), 121 - 128. International Journal of BiochemiPhysics; 2009. Abstract
Department of Medical Physiology, Moi University, P.O Box 4606, Eldoret, Kenya. erenoyungu2002@yahoo.co.uk ETHNOPHARMACOLOGICAL RELEVANCE: Catha edulis (khat) is a plant whose fresh young leaves are used by an estimated five million people in eastern Africa and the Arabian Peninsula as a drug of recreation. The fresh leaves and shoots are rich in cathinone, a psychostimulant with effects similar to those of amphetamines. Psychostimulants produce a dose-related excitation of the central nervous system which can lead to seizures and convulsions. However there are no reports on studies of the effect of this herb on brain excitability and seizures. This knowledge is useful for doctors who may prescribe drugs whose side effects include lowering seizure threshold because there could be additive proconvulsant effect among khat users. AIM OF THE STUDY: to determined whether khat lowers pentylenetetrazole (PTZ) seizure threshold. METHODOLOGY: Male Sprague dawley rats were given fresh aqueous khat extract, old aqueous khat extract (3 g/kg bw), methylphenidate or saline and the timed intravenous (PTZ) seizure threshold test was used to study its effect on seizure threshold. RESULTS: Fresh khat (3 g/kg) and methylphenidate (4 mg/kg) lowered PTZ seizure threshold. CONCLUSION: Khat lowers seizure threshold. PMID: 19056477 [PubMed - indexed for MEDLINE]
B PROFOJWANGSHADRACK, OTIENO DRODAWAFRANCISXAVIER. "Ojwang SBO, Bennun M. Musila S.Uterine rupture due to road traffic accidents E. Afr. Med. J. 1978: 55,14.". In: E. Afr. Med. J. 1978: 55,14. Rao, W. O., Ogonji, J. A.. and Aywa, S.; 1978. Abstract
PIP: This research report studies several biochemical and histochemical aspects of cervical carcinoma and explores their use in follow-up of patients undergoing radiotherapy. Material came from 19 patients with invasive cervical carcinoma admitted to Kenyatta National Hospital. A control group consisted of 20 women matched for age who attended clinics at the hospital but were not suffering from any malignant disease; control tissue for histological examination was obtained from 3 women who had undergone hysterectomy for uterine fibroids. Biochemical assays for alkaline and acid phosphatases in patients with cervical carcinoma show an increase in alkaline phosphatase in carcinomatous tissue (35.7 umoles/hr/mg) as opposed to normal tissue (7.2). Acid phosphatase values were only moderately raised. Assays of the same enzymes in blood showed a less marked difference between patients and controls (ranges of 7.5-20.8 and 3-14, respectively). When examined histochemically, increased alkaline phosphatase activity was observed in connective tissue, epithelium of the glands and blood capillaries of tumor tissue. 1 section containing normal tissue bordering carcinomatous tissue demonstrated normal alkaline phosphatase activity in the normal tissue and increased activity in the tumor tissue. In summary, there is increased enzyme activity around the tumor areas, but values for serum levels show an overlap of normal and abnormal cases and are therefore not predictive. Results demonstrate a clear difference in activities of these enzymes in carcinomatous tissue and normal tissue, which may be of value in follow-up care.
B DRODUOLCHARLES. "Needs Assessment for Establishing a Gender Resource Centre. CIDA (GESP) 1999.". In: 12th International Congress on Animal Reproduction, the Hague, 1992.Workshop on sperm preservation in swine. The Cleveland Museum of Natural History; 1999.
B PROFOJWANGSHADRACK, OTIENO DRODAWAFRANCISXAVIER. "Ojwang SBO Placenta Praevia Gynaecological Tumour at the Kenyatta National Hospital Obstetrical and Gynaecological long commentaries and case records, M.Med Thesis 1995.". In: College of Health Sciences, UON, 1971-1995.II: GYNAECOLOGY AND FAMILY PLANNING. EM Ngatia, LW Gathece, FG Macigo, TK Mulli, LN Mutara, EG Wagaiyu.; 1995. Abstract
OBJECTIVE: In sub-Saharan Africa, many family planning programmes do not encourage advance provision of oral contraceptives to clients who must wait until menses to initiate pill use. Since some resistance to advance provision of pills is due to provider fears that the practice may be harmful, we conducted a study in Kenya in 1997 to compare pill-taking outcomes between 20 "advance provision" clients and 280 "standard" clients. DESIGN: Prospective observational study. SETTING: Six family planning clinics in Central and Western Kenya. SUBJECTS: Women presenting as new clients at MOH family planning clinics. INTERVENTIONS: Researchers used prospective tracking to compare indicators of pill-taking success between non-menstruating clients given pills to carry home for later use and menstruating clients who began pill use immediately. MAIN OUTCOME MEASURES: Pill-taking outcomes such as side effects, compliance, knowledge, satisfaction, and a continuation proxy. RESULTS: Among clients returning for re-supply, those receiving advance provision of pills did no worse than, and often had superior outcomes to, their counterparts who started taking pills immediately after the clinic visit. CONCLUSIONS: Advance provision of pills, already practiced worldwide, is safe and feasible. Explicit mention should be made of advance provision of pills in national family planning guidance documents and training curricula in Kenya and throughout sub-Saharan Africa.
B K, Ogutu O, JM M, P G. "Abnormal cervical cytology among women in a rural Kenyan population – Narok district." J. Obstet. Gynaecol. East. Cent. Afr. 2005;88:113-118.abnormal_cytology.docx
B PROFOJWANGSHADRACK, OTIENO DRODAWAFRANCISXAVIER. "Ojwang SBO, Ouko J.Prediction of Foetal weight by fundal height girth measurements. J. Obst. Gyn. East Cent. Afri. 1984:3, 111.". In: J. of Ob. Gy. E & Centr Afric. 3(2); 63, 1984. EM Ngatia, LW Gathece, FG Macigo, TK Mulli, LN Mutara, EG Wagaiyu.; 1984. Abstract
PIP: This research report studies several biochemical and histochemical aspects of cervical carcinoma and explores their use in follow-up of patients undergoing radiotherapy. Material came from 19 patients with invasive cervical carcinoma admitted to Kenyatta National Hospital. A control group consisted of 20 women matched for age who attended clinics at the hospital but were not suffering from any malignant disease; control tissue for histological examination was obtained from 3 women who had undergone hysterectomy for uterine fibroids. Biochemical assays for alkaline and acid phosphatases in patients with cervical carcinoma show an increase in alkaline phosphatase in carcinomatous tissue (35.7 umoles/hr/mg) as opposed to normal tissue (7.2). Acid phosphatase values were only moderately raised. Assays of the same enzymes in blood showed a less marked difference between patients and controls (ranges of 7.5-20.8 and 3-14, respectively). When examined histochemically, increased alkaline phosphatase activity was observed in connective tissue, epithelium of the glands and blood capillaries of tumor tissue. 1 section containing normal tissue bordering carcinomatous tissue demonstrated normal alkaline phosphatase activity in the normal tissue and increased activity in the tumor tissue. In summary, there is increased enzyme activity around the tumor areas, but values for serum levels show an overlap of normal and abnormal cases and are therefore not predictive. Results demonstrate a clear difference in activities of these enzymes in carcinomatous tissue and normal tissue, which may be of value in follow-up care.
B A, C.G. G, M O. "The acceptability of camel milk and milk products from north eastern province in some urban areas of Kenya." African Journal of Food Science. 2012;6(19):465-473. Abstractpub_11_akweya_et_al.pdfWebsite

A total of 138 households were interviewed on various aspects of camel milk and camel milk products using a single-visit multiple-subject diagnostic survey in Garisa, Wajir and Eastleigh the main urban centres with high camel milk consumption. 75% of the respondents generally take camel milk or milk products every day. Raw and sour milk are the most popular products. The most important purchasing criterion for raw camel milk was taste (19 and18%) while packaging was more important for pasteurized milk (18, 18 and 16%) for Wajir, Garisa and Eastleigh respectively. For Yoghurt, the most important purchasing criteria were taste (18%) and aroma (19%). The taste of sour milk is the most important attribute in both Garisa (30%) and Eastleigh (24%). To enhance marketing of camel milk, the appropriate attributes demanded by customers needs to be seriously addressed. Promotion of camel milk and products to non conventional consumers should be done in order to increase their consumption.

B PROFMBAYAVERTISTINE. "Foy, H., A. Kondi and V.B. Mbaya, Erythroid Aplasia in Riboflavin Deficient Baboons And it.". In: Brit. J. Haematology 13:967. Wangari Veronica Wanjiru; 1967. Abstract
As the number of fatalities from cardiovascular diseases declines in western industrial nations, an opposite trend is observed in the East African region. Inter-regional variations in the prevalence of vascular disorders have been attributed to socioeconomic, psychosocial and heritable physiological parameters. Although faulty mineralocorticoid metabolism and the dysfunctional kidney are prominent features of circulatory problems, many current studies are focused on membrane receptors, transmembrane ion transport mechanisms, ion channels and the possible genetic polymorphisms that determine the characteristics of those molecular structures in the vascular system of normal or hypertensive persons. In this review, a composite of the data available on each of the above parameters and its significance in the pathogenesis of hypertension in the industrial West and transforming economies of East Africa is presented.
B R, I B, S D, B S, Gladys M, M R, L L, YC Z, W D. "Radiology Education in Africa: Analysis of results from 13 countries." Journal of the American College of Radiology. 2016.
B PROFOJWANGSHADRACK, OTIENO DRODAWAFRANCISXAVIER. "Mutungi A.K. Sanghvi; Sinei S.K. Ojwang SBO, Kigondu SC The frequency of Antenatal Care and Diagnosis of two Public hospitals in Nairobi, Kenya.J. Obst. Gyn. East Central Africa 1999: 14, 78-83.". In: East Afr Med J. 2006 Mar;83(3):110-3. Rao, W. O., Ogonji, J. A.. and Aywa, S.; 1999. Abstract
Presented here is a 16-year-old nulliparous girl who had embryonal rhabdomyosarcoma causing uterine inversion. She had been referred with a one year history of continuous vaginal bleeding and vaginal swelling. Histology had shown sarcoma botyroides and had received five courses of chemotherapy at the referring hospital. At surgery she was found to have uterine inversion and extended hysterectomy was carried out to be followed by radiotherapy.
B PROFOJWANGSHADRACK, OTIENO DRODAWAFRANCISXAVIER. "Odongo FN, Ojwang SBO E. Afr. Med. J. 1991: 67, 830.". In: E. Afr. Med. J. 1991: 68, 74. Rao, W. O., Ogonji, J. A.. and Aywa, S.; 1991. Abstract

Adolescent sexuality has become a major problem all over the world. This review paper describes the main problems encountered in Kenya with regards to adolescent sexuality. The role of the Government and some non-governmental organisations is outlined. Factors which contribute to the problem of adolescent sexuality in Kenya are described. The paper stresses the role of research in solving these problems and finally suggests some strategies which may be adopted in order to minimise the undesirable effects of adolescent sexuality in Kenya. PIP: Kenya's population has increased from 5.4 million in 1948 to 15.3 million in 1979 and is expected to rise to 39 million by 2000. The population growth rate has risen from 2.5% in 1948 to 3.8% in 1979. Improvements in health and economic status since independence have caused significant changes from 1948-79: the fertility rate of women has increased from 6.5-7.9, the crude death rate has decreased from 25/1000-14/1000, infant mortality has decreased from 184/1000-104/1000 births, and life expectancy has increased from 35-54 years. Adolescent girls, 15-24, contribute up to 30% of total pregnancies of females, 15-49, and will form 44.2% of the reproductive age group by 2000. Between 1960 and 1979 the fertility rate of girls 15-19 has increased from 141/1000-168/1000. The age of menarche has dropped from 17 to 12-15. In 1 rural community 41.9% of the girls and 76.1% of the boys aged 12-23 had at least one sexual experience. The mean age at first coitus was 13.7 for boys and 14.9 for girls. 42% of the girls and 74.8% of the boys had more than one sexual partner. Because of the gradual change from extended families to nuclear families, education, role models, and any established activities that initiated youth into adulthood have virtually disappeared, leaving adolescents uneducated and unprepared. Only 2-6% use any form of contraception. 58.4% of rural and 64.4% of urban pregnant girls are in primary school at the time of conception. 8340-10,400 girls drop out of school due to pregnancy each year. 46.6% of girls who get pregnant are not married. Abortions among the adolescents account for 28-64% of abortions done in hospitals, but because of strict abortion laws in Kenya, most adolescents resort to criminal abortions frequently performed by inexperienced people in unsanitary conditions. Sexually transmitted diseases (STDs) are not uncommon among adolescents: 36.8% of pregnant adolescent females had at least 1 STD, compared to 16% of those aged 25 and above. Contraceptive services, education, and laws protecting the adolescent must be instituted in response to the problems of adolescent sexuality.

B PROFOJWANGSHADRACK, OTIENO DRODAWAFRANCISXAVIER. "Ojwang SBO, Kamidigo MO.Placenta percreta with spontaneous rupture of the uterus before labour and a uterine carnual ring.E. Afr. Med. J. 1981:58, 886.". In: E.Afr. Med. J. 1985:62, 271. Rao, W. O., Ogonji, J. A.. and Aywa, S.; 1981. Abstract
PIP: This research report studies several biochemical and histochemical aspects of cervical carcinoma and explores their use in follow-up of patients undergoing radiotherapy. Material came from 19 patients with invasive cervical carcinoma admitted to Kenyatta National Hospital. A control group consisted of 20 women matched for age who attended clinics at the hospital but were not suffering from any malignant disease; control tissue for histological examination was obtained from 3 women who had undergone hysterectomy for uterine fibroids. Biochemical assays for alkaline and acid phosphatases in patients with cervical carcinoma show an increase in alkaline phosphatase in carcinomatous tissue (35.7 umoles/hr/mg) as opposed to normal tissue (7.2). Acid phosphatase values were only moderately raised. Assays of the same enzymes in blood showed a less marked difference between patients and controls (ranges of 7.5-20.8 and 3-14, respectively). When examined histochemically, increased alkaline phosphatase activity was observed in connective tissue, epithelium of the glands and blood capillaries of tumor tissue. 1 section containing normal tissue bordering carcinomatous tissue demonstrated normal alkaline phosphatase activity in the normal tissue and increased activity in the tumor tissue. In summary, there is increased enzyme activity around the tumor areas, but values for serum levels show an overlap of normal and abnormal cases and are therefore not predictive. Results demonstrate a clear difference in activities of these enzymes in carcinomatous tissue and normal tissue, which may be of value in follow-up care.
B PROFOJWANGSHADRACK, OTIENO DRODAWAFRANCISXAVIER. "Einhorn N. Ojwang SBO Carcinoma of the cervix in Kenya Proceeding of the Conference of the working party on Radionuclides and Afterloading techinique in the treatment of cancer of the uterus in developing areas, Balgrade, Yugoslavia 1976.". In: East Afr Med J. 1977 Sep;54(9):472-5. Rao, W. O., Ogonji, J. A.. and Aywa, S.; 1976. Abstract
PIP: This research report studies several biochemical and histochemical aspects of cervical carcinoma and explores their use in follow-up of patients undergoing radiotherapy. Material came from 19 patients with invasive cervical carcinoma admitted to Kenyatta National Hospital. A control group consisted of 20 women matched for age who attended clinics at the hospital but were not suffering from any malignant disease; control tissue for histological examination was obtained from 3 women who had undergone hysterectomy for uterine fibroids. Biochemical assays for alkaline and acid phosphatases in patients with cervical carcinoma show an increase in alkaline phosphatase in carcinomatous tissue (35.7 umoles/hr/mg) as opposed to normal tissue (7.2). Acid phosphatase values were only moderately raised. Assays of the same enzymes in blood showed a less marked difference between patients and controls (ranges of 7.5-20.8 and 3-14, respectively). When examined histochemically, increased alkaline phosphatase activity was observed in connective tissue, epithelium of the glands and blood capillaries of tumor tissue. 1 section containing normal tissue bordering carcinomatous tissue demonstrated normal alkaline phosphatase activity in the normal tissue and increased activity in the tumor tissue. In summary, there is increased enzyme activity around the tumor areas, but values for serum levels show an overlap of normal and abnormal cases and are therefore not predictive. Results demonstrate a clear difference in activities of these enzymes in carcinomatous tissue and normal tissue, which may be of value in follow-up care.
B PROFOJWANGSHADRACK, OTIENO DRODAWAFRANCISXAVIER. "Mutungi AK, Sinei SK, Ojwang SBO, Kigondu SK, Ndavi PM.Contraceptive Acceptance and Continuation in women managed for incompleteabortion at Kenyatta National Hospital.J. Obst. Gyn. East Cent. Afr. 1999: 14, 84-88.". In: Gynaec Eastern & Central Africa. March 1999. EM Ngatia, LW Gathece, FG Macigo, TK Mulli, LN Mutara, EG Wagaiyu.; 1999. Abstract
OBJECTIVE: In sub-Saharan Africa, many family planning programmes do not encourage advance provision of oral contraceptives to clients who must wait until menses to initiate pill use. Since some resistance to advance provision of pills is due to provider fears that the practice may be harmful, we conducted a study in Kenya in 1997 to compare pill-taking outcomes between 20 "advance provision" clients and 280 "standard" clients. DESIGN: Prospective observational study. SETTING: Six family planning clinics in Central and Western Kenya. SUBJECTS: Women presenting as new clients at MOH family planning clinics. INTERVENTIONS: Researchers used prospective tracking to compare indicators of pill-taking success between non-menstruating clients given pills to carry home for later use and menstruating clients who began pill use immediately. MAIN OUTCOME MEASURES: Pill-taking outcomes such as side effects, compliance, knowledge, satisfaction, and a continuation proxy. RESULTS: Among clients returning for re-supply, those receiving advance provision of pills did no worse than, and often had superior outcomes to, their counterparts who started taking pills immediately after the clinic visit. CONCLUSIONS: Advance provision of pills, already practiced worldwide, is safe and feasible. Explicit mention should be made of advance provision of pills in national family planning guidance documents and training curricula in Kenya and throughout sub-Saharan Africa.
B PROFOJWANGSHADRACK, OTIENO DRODAWAFRANCISXAVIER. "Ojwang SBO Management of pain in patients with advanced gynaecological cancer. E. Afr. Med. J. 1985:62, 817-819.". In: E.Afr. Med. J 62(11) 802.1985. EM Ngatia, LW Gathece, FG Macigo, TK Mulli, LN Mutara, EG Wagaiyu.; 1985. Abstract

Part of a detailed analysis of 864 unmarried teenage mothers delivering in Pumwani Maternity Hospital and Kenyatta National Hospital is presented. Teenage pregnancy amounted for 42.3% of all deliveries of unmarried mothers. Most teenage patients were above 16 years of age, had a religious background of wide coverage, had low quality antenatal care and low education. 94.6% were found to be primigravidas. This dominance has also been found by other workers. PIP: A prospective cross-sectional descriptive study of unmarried mothers delivering in Pumwani Maternity Hospital and Kenyatta National Hospital, Nairobi, Kenya, from December 1986-April 1987, was conducted with a pretested open-ended questionnaire: the 864 teen mothers are described here. They ranged from 13.4-19 years, most were 17-19. 49.4% were Catholic and 45% Protestant. 88.5% attended prenatal clinics once; 51.5% attended 5 times, although only 13% went to hospital clinics for specialized care. For reasons for not going for prenatal care teens stated that they were too shy to undergo a clinical exam, afraid of parents' reaction, unaware of the pregnancy or of the existence of prenatal care, they had not menstruated, or were in school, in prison, or had long work hours. Most girls had primary education, and 97.9% had dropped out of school. 34% dropped out because of pregnancy, and 32% for lack of tuition fees. Reasons for dropping out of school were tabulated, encompassing a broad range of social problems such as war, death, divorce, alcoholism or illness of parents, no tuition or uniform funds, poor grades, and running away from school. In Africa, teen pregnancy is probably increasing because of decreasing age at menarche and relaxing of traditional values.

B N, M.K L, D.A M, H E, M.R J, S.I K, I M, L.K O, J.O M. "New ent-clerodane and abietane diterpenoids from the roots of Kenyan Croton megalocarpoides Friis & M.G. Gilbert." Planta Medica. 2016;doi, http://dx.doi.org/10.1055/s-0042-108857.ndunda_et_al._planta_medica_2.pdf
B PROFOJWANGSHADRACK, OTIENO DRODAWAFRANCISXAVIER. "Gichangi PB, B Wayo, Benson Estambale, De Yust H., Ojwang SBO, RogokAbwao, Termmerman M, Impact on HIV infection on invasive cervical cancer in Kenyan Women AIDS 2003, 17: 1-6.". In: East Afr Med J. 2006 Mar;83(3):110-3. Rao, W. O., Ogonji, J. A.. and Aywa, S.; 2003. Abstract
Presented here is a 16-year-old nulliparous girl who had embryonal rhabdomyosarcoma causing uterine inversion. She had been referred with a one year history of continuous vaginal bleeding and vaginal swelling. Histology had shown sarcoma botyroides and had received five courses of chemotherapy at the referring hospital. At surgery she was found to have uterine inversion and extended hysterectomy was carried out to be followed by radiotherapy.
B AZ, K S. "Management Perception on Performance Contracting Strategy at the City Council of Nairobi, Kenya." International Journal of Managerial Studies and Research (IJMSR). 2014;2(7):148-159.
B PROFOJWANGSHADRACK, OTIENO DRODAWAFRANCISXAVIER. "Lilian W, Nasah BI Leke RJI, Ojwang SBO Determinants of Perinatal Mortaligy Hour and Day of birth and method of delivery at the central maternity .". In: East Afr Med J. 1992 Sep;69(9):483-6. Rao, W. O., Ogonji, J. A.. and Aywa, S.; 1991. Abstract
An audit of 381 hysterectomies performed over a 5 year period (1986-1990) was carried out. In order to assess justification of the indication for hysterectomy pre-operative diagnoses were divided into two groups: those potentially confirmable by pathologic study and those not potentially confirmable by pathologic study. Out of the 273 cases studied in the first group, 246 (90.1%) were justified, while out of the 108 cases studied in the second group, 82 (75.9%) were justified. An overall 86% justification rate was observed. Adenomyosis as a histopathologic finding was seen more commonly in Asian than African patients (P < 0.005). Morbidity rate was 20% and there were no mortalities. The procedure in general was considered safe and justified
B TD, M. C, S. W, A OL. "FACTORS INFLUENCING APPLICATION OF EVIDENCE-BASED PRACTICE AMONG NURSES." African Journal of Midwifery and Women's Health. 2012;Vol. 6(Iss. 2):pp 71-77 .factors_influencing_application_of_evidence-based_practice_among_nurses.docx
B WH, J S, M WS, B.O A, M MJ. "Effect of nitration on pressed TiO2 photoelectrodes for dye-sensitized solar cells." African Journal of Science and Technology. 2007;8(2):63-71.wafula_hb_aduda_bo_et_al.pdf
B PROFOJWANGSHADRACK, OTIENO DRODAWAFRANCISXAVIER. "Orinda DAO, Ojwang SBO, Shiramba TL, Kiungu A. A clinical biochemical and histological study of carcinoma of the cervix as seen at the Kenyatta National Hosptial. E.Afr. Med. J. 1985:62, 271.". In: E.Afr. Med. J. 1985:62, 271. Rao, W. O., Ogonji, J. A.. and Aywa, S.; 1985. Abstract
PIP: This research report studies several biochemical and histochemical aspects of cervical carcinoma and explores their use in follow-up of patients undergoing radiotherapy. Material came from 19 patients with invasive cervical carcinoma admitted to Kenyatta National Hospital. A control group consisted of 20 women matched for age who attended clinics at the hospital but were not suffering from any malignant disease; control tissue for histological examination was obtained from 3 women who had undergone hysterectomy for uterine fibroids. Biochemical assays for alkaline and acid phosphatases in patients with cervical carcinoma show an increase in alkaline phosphatase in carcinomatous tissue (35.7 umoles/hr/mg) as opposed to normal tissue (7.2). Acid phosphatase values were only moderately raised. Assays of the same enzymes in blood showed a less marked difference between patients and controls (ranges of 7.5-20.8 and 3-14, respectively). When examined histochemically, increased alkaline phosphatase activity was observed in connective tissue, epithelium of the glands and blood capillaries of tumor tissue. 1 section containing normal tissue bordering carcinomatous tissue demonstrated normal alkaline phosphatase activity in the normal tissue and increased activity in the tumor tissue. In summary, there is increased enzyme activity around the tumor areas, but values for serum levels show an overlap of normal and abnormal cases and are therefore not predictive. Results demonstrate a clear difference in activities of these enzymes in carcinomatous tissue and normal tissue, which may be of value in follow-up care.
B PROFOJWANGSHADRACK, OTIENO DRODAWAFRANCISXAVIER. "Ojwang SBO, Kjeligren O.The role of Intracavitatary caesium in the management of carcinoma of the cervix in Kenya.E. Afr. Med. J. 1977:55, 472.". In: E. Afr. Med. J. 1978.55, 194. Rao, W. O., Ogonji, J. A.. and Aywa, S.; 1977. Abstract
PIP: This research report studies several biochemical and histochemical aspects of cervical carcinoma and explores their use in follow-up of patients undergoing radiotherapy. Material came from 19 patients with invasive cervical carcinoma admitted to Kenyatta National Hospital. A control group consisted of 20 women matched for age who attended clinics at the hospital but were not suffering from any malignant disease; control tissue for histological examination was obtained from 3 women who had undergone hysterectomy for uterine fibroids. Biochemical assays for alkaline and acid phosphatases in patients with cervical carcinoma show an increase in alkaline phosphatase in carcinomatous tissue (35.7 umoles/hr/mg) as opposed to normal tissue (7.2). Acid phosphatase values were only moderately raised. Assays of the same enzymes in blood showed a less marked difference between patients and controls (ranges of 7.5-20.8 and 3-14, respectively). When examined histochemically, increased alkaline phosphatase activity was observed in connective tissue, epithelium of the glands and blood capillaries of tumor tissue. 1 section containing normal tissue bordering carcinomatous tissue demonstrated normal alkaline phosphatase activity in the normal tissue and increased activity in the tumor tissue. In summary, there is increased enzyme activity around the tumor areas, but values for serum levels show an overlap of normal and abnormal cases and are therefore not predictive. Results demonstrate a clear difference in activities of these enzymes in carcinomatous tissue and normal tissue, which may be of value in follow-up care.
B M, L O. Rapid assessment of milk sheds in 16 Districts in Kenya. Nairobi: Land O Lakes; 2008.
B MISSREGOASSUMPTA. "Rego, A.B., 1972 (Editorial Committee) Australia and New Zealand, Geography for Kenya Schools, KIE, Jomo Kenyatta Foundation, Nairobi.". In: Royal Botanic Gardens , Kew , England. El-Banhawy, E. M.; 1972. Abstract
We surveyed the phytoseid mites in four different geographical zones of Kenya: Zone I, upper highland and tropical alpine (2400-4400m): Zone II, lower highland (1800-2400m); zone III, midland (800-1800m); Zone IV, tropical, hot and humid( 0-800m ). A total of 107 species was found. In the sub family, amblyseeinae there were 14 species in the genus Neoseilus , one in Aspereroseius Chant, one in Paraphytoseius Swirski &Schechter, five in typhlodromips De Leon, five in Transeius Chant & McMurty, one in Graminaseius Chant &McMurty, 11 in Amblyseius Berlese, one in Arrenoseius Wanstein, two in Typhlodromalus muma, seven in Ueckemannseius Chant &McMurty, one in Ambylodromalus Chant &Mcmurty,, 20 in Euseius Wanstein, one in Iphiseius Berlese, one in Phytoseilus Evans and one in Gynaseius Ehara & Imano. In the subfamily Phytoseiinae Berlese there were four species in the genus Phytoseiius Ribaga. In the subfamily Typhlodrominae Wanstein, there were four species in the genus Kuzinellus Wainstein and 27 in Typhlodromus Scheuten
B PROFOJWANGSHADRACK, OTIENO DRODAWAFRANCISXAVIER. "Rogo KO, Ojwang SBO, Stendal Second look laparatomy. Its role in management of ovarian carcinoma.E. Afr. Med. J. 1990: 66,844.". In: Int. J. Obstet. Gynaecol. 1990: 33, 249-. EM Ngatia, LW Gathece, FG Macigo, TK Mulli, LN Mutara, EG Wagaiyu.; 1990. Abstract
Carcinoma of the cervix is the commonest female malignancy in sub-Saharan Africa today. A brief description of its prevalence and distribution is given. Kenyan data is then used to illustrate the predominance of advanced disease in mostly premenopausal women (70%) of high parity. Follow up is characteristically poor and treatment results, although difficult to calculate with accuracy, are also poor. These are compared to FIGO statistics. Against this background aspects peculiar to the tumor, patient and treatment facilities in Africa are cited and discussed with reference to current relevant literature.
B PROFOJWANGSHADRACK, OTIENO DRODAWAFRANCISXAVIER. "Mati JKG, Ojwang SBO, Odipo WS Present attitude towards female sterilization and projected in the next generation of Kenyan women. Proceedings of the second conference of the International Association of Voluntary Sterilization, Geneva 1973.". In: E. Afr. Med. J. 1978.55, 194. EM Ngatia, LW Gathece, FG Macigo, TK Mulli, LN Mutara, EG Wagaiyu.; 1973. Abstract
PIP: This research report studies several biochemical and histochemical aspects of cervical carcinoma and explores their use in follow-up of patients undergoing radiotherapy. Material came from 19 patients with invasive cervical carcinoma admitted to Kenyatta National Hospital. A control group consisted of 20 women matched for age who attended clinics at the hospital but were not suffering from any malignant disease; control tissue for histological examination was obtained from 3 women who had undergone hysterectomy for uterine fibroids. Biochemical assays for alkaline and acid phosphatases in patients with cervical carcinoma show an increase in alkaline phosphatase in carcinomatous tissue (35.7 umoles/hr/mg) as opposed to normal tissue (7.2). Acid phosphatase values were only moderately raised. Assays of the same enzymes in blood showed a less marked difference between patients and controls (ranges of 7.5-20.8 and 3-14, respectively). When examined histochemically, increased alkaline phosphatase activity was observed in connective tissue, epithelium of the glands and blood capillaries of tumor tissue. 1 section containing normal tissue bordering carcinomatous tissue demonstrated normal alkaline phosphatase activity in the normal tissue and increased activity in the tumor tissue. In summary, there is increased enzyme activity around the tumor areas, but values for serum levels show an overlap of normal and abnormal cases and are therefore not predictive. Results demonstrate a clear difference in activities of these enzymes in carcinomatous tissue and normal tissue, which may be of value in follow-up care.
B DRSINGHCHANDRA. "Optimal Use of Departmental facilities.". In: Proceedings of the First In House Seminar pp. 35 - 38. Materials Research Society; 2002. Abstract
1. Singh C. B.  .  August . .
B PROFOJWANGSHADRACK. "In vivo and in vitro response of Plasmodium falciparum to chloroquine in pregnant women in Kilifi district, Kenya. East Afr Med J. 1992 Jun;69(6):306-10.". In: East Afr Med J. 1992 Jun;69(6):306-10. Rao, W. O., Ogonji, J. A.. and Aywa, S.; 1992. Abstract
In a malaria-endemic area of the Coast of Kenya with chloroquine resistant Plasmodium falciparum, we determined the prevalence and density of falciparum infection in gravid women and assessed the in vivo and in vitro parasite response to a regimen of chloroquine 25 mg/kg body weight divided over three days. P. falciparum infections were present in 65 (21.7%) of 300 pregnant women. The proportion of primigravidae who were parasitaemic was 41.8% which was significantly higher than that of the multigravidae (17.1, P less than 0.01). Primigravidae did not show a significantly higher mean parasite density than the multigravidae. The in vivo tests showed that 45.9% of all the P. falciparum infections were resistant to chloroquine predominantly at RI and RII levels with percentages 36.1% and 8.2%, respectively. PIP: At the antenatal clinic of Kilifi District Hospital in the Coast Province of Kenya, researchers enrolled 300 pregnant volunteers 15-32 years olds, living in the district to screen and treat then for Plasmodium falciparum infection and to follow those with parasitemia on days 0, 1, 2, 14, 17, 21, and 28. They also conducted in vitro studies to determine resistance to chloroquine. They combined in vivo and in vitro study took place between November 20, 1988 and January 17, 1989. 65 women (21.7%) had P. falciparum in their peripheral blood smear. Primigravidae were more likely to be parasitemia than were multigravidae (41.8% vs. 17.1%; p .001). Their mean parasite density was also higher but not significantly so. Parasite density fell consistently with rising parity. Malaria infections in 54.1% of the women responded to 25 mg/kg chloroquine. the remaining 45.9% (28) of cases exhibited in vivo resistance, especially at RI an RII levels (36.1% and 8.2%, respectively). Primigravidae were more likely to experience failure to clear parasites by day 7 than multigravidae. Further, among women experiencing a parasitemia on day 7, parasites tended to reappear on day 14 and 21 in primigravidae. Initial parasite density did not affect clearance of parasites. Primigravidae continued to have a higher level of parasitemia throughout treatment than did multigravidae. It took at least 24 hours for the chloroquine to be completely absorbed thus the mean level of parasitemia decreased sharply between 0-2 days. Amodiaquine induced a parasitemia in 89.3% (25 cases) of the chloroquine resistant infections. Even though the 3 remaining cases with parasitemia received amodiaquine treatment, clinicians administered Fansidar, resulting in a clearing of parasitemia in 7 days. 34.8% of in vitro parasite cultures were resistant to chloroquine. The reduced ability of pregnant women to clear parasitemia likely explained the lower level of in vitro resistance.
B PROFOJWANGSHADRACK, OTIENO DRODAWAFRANCISXAVIER. "Ojwang SBO.Adolescent sexuality in Africa. A working document for the Commonwealth Secretariat/IPPF/WHO Workshop in Mombasa 1987 (Commonwealth secretariat Award as the best document chosen from African region).". In: WHO Workshop in Mombasa. Rao, W. O., Ogonji, J. A.. and Aywa, S.; 1987. Abstract
Almost 30 years after its introduction into the management of ovarian carcinoma, second-look laparotomy remains controversial. Although its supporters agree on its indications, there is a considerable number of conflicting reports on the actual benefits of the procedure. Diagnostic inaccuracy, invasiveness and expense are some of the reasons raised by opponents against its routine performance and their recommendations range from limited selective application to total avoidance. The role of second-look laparotomy is reviewed, with particular reference to developing countries where scarcity of resources must always be balanced against the need to provide the best care possible to the individual cancer patient. A management schedule for ovarian carcinoma, including second-look laparotomy, appropriate under these circumstances is given.
B DRESHUNFRANCIS. "Aspects of Akan Phonology. University of Wisconsin Press, 1993.". In: Occasional Papers in Language and Linguistics, Volume 2, 2004. UN-HABITAT; 1993. Abstract
A simple gas chromatographic assay utilising alkali flame ionisation detection is described for the estimation of cyclophosphamide as its trifluoroacetate derivative from plasma. Examination of five patients following intravenous cyclophosphamide gave values of 8.9 h (SD 2.7) for the half-life and 0.061 liters/h/kg (SD 0.011) for whole-body clearance of the drug.
B MISSREGOASSUMPTA. "Peters, F.A and Rego, A.B 19985, Geography Fieldwork 2. A Guide for Upper Forms, Oxford University Press, Nairobi.". In: Royal Botanic Gardens , Kew , England. El-Banhawy, E. M.; 1985. Abstract
We surveyed the phytoseid mites in four different geographical zones of Kenya: Zone I, upper highland and tropical alpine (2400-4400m): Zone II, lower highland (1800-2400m); zone III, midland (800-1800m); Zone IV, tropical, hot and humid( 0-800m ). A total of 107 species was found. In the sub family, amblyseeinae there were 14 species in the genus Neoseilus , one in Aspereroseius Chant, one in Paraphytoseius Swirski &Schechter, five in typhlodromips De Leon, five in Transeius Chant & McMurty, one in Graminaseius Chant &McMurty, 11 in Amblyseius Berlese, one in Arrenoseius Wanstein, two in Typhlodromalus muma, seven in Ueckemannseius Chant &McMurty, one in Ambylodromalus Chant &Mcmurty,, 20 in Euseius Wanstein, one in Iphiseius Berlese, one in Phytoseilus Evans and one in Gynaseius Ehara & Imano. In the subfamily Phytoseiinae Berlese there were four species in the genus Phytoseiius Ribaga. In the subfamily Typhlodrominae Wanstein, there were four species in the genus Kuzinellus Wainstein and 27 in Typhlodromus Scheuten
B PROFOJWANGSHADRACK, OTIENO DRODAWAFRANCISXAVIER. "Ojwang SBO.The impact of family planning in Kenya during the last 10 years. E. Afr. Med. J. 1991:68, 69.". In: E. Afr. Med. J. 1991:68, 69. EM Ngatia, LW Gathece, FG Macigo, TK Mulli, LN Mutara, EG Wagaiyu.; 1991. Abstract

In this study, a total of 519 patients were interviewed. 82.5% had incomplete abortion. The implication of abortion especially when induced is emphasised. Economic implications that are contributed by the youth are stressed. 83.6% of the patients had not used any contraception. The role of contraception in preventing unwanted pregnancy and therefore induced abortion is stressed. The role of the physician in providing contraception and appropriate contraceptive knowledge is discussed. PIP: A study of 519 consecutive women admitted to Kenyatta National Hospital with the diagnosis of abortion revealed that the majority were young and had a history of nonuse of contraception. Abortion was incomplete in 428 (83%) of cases; 60 (12%) cases involved sepsis. Women 20-24 years of age accounted for 221 (43%) of the abortions; the other two most represented age groups were 25-29 years (28%) and 14-19 years (17%). 460 (89%) of the abortion patients had never used a contraceptive method. The most frequently cited reasons for nonuse were desire for pregnancy (48%), no conscious reason (13%), procrastination in getting to a family planning clinic (8%), no knowledge of family planning (6%), and fear of side effects (6%). Of the 64 cases of failed contraception, 27 were using the pill, 25 had an IUD in place, and 8 were relying on the rhythm method. Among contraceptive users, the major sources of information about contraception were nurses (52%), radio and newspapers (19%), and other women (15%). Only 4% indicated that a physician had discussed family planning with them. Given the resource drain that treatment of incomplete abortion can place on Kenya's health care system and the risk of abortion-induced pelvic infection and subsequent infertility, Kenya's health workers should be encouraged to be more aggressive in promoting family planning use among young women.

B PROFOJWANGSHADRACK, OTIENO DRODAWAFRANCISXAVIER. "Ojwang SBO, Kjeligren O.The role of Intracavitatary caesium in the management of carcinoma of the cervix in Kenya.E. Afr. Med. J. 1977:55, 472.". In: E. Afr. Med. J. 1978.55, 194. EM Ngatia, LW Gathece, FG Macigo, TK Mulli, LN Mutara, EG Wagaiyu.; 1977. Abstract
PIP: This research report studies several biochemical and histochemical aspects of cervical carcinoma and explores their use in follow-up of patients undergoing radiotherapy. Material came from 19 patients with invasive cervical carcinoma admitted to Kenyatta National Hospital. A control group consisted of 20 women matched for age who attended clinics at the hospital but were not suffering from any malignant disease; control tissue for histological examination was obtained from 3 women who had undergone hysterectomy for uterine fibroids. Biochemical assays for alkaline and acid phosphatases in patients with cervical carcinoma show an increase in alkaline phosphatase in carcinomatous tissue (35.7 umoles/hr/mg) as opposed to normal tissue (7.2). Acid phosphatase values were only moderately raised. Assays of the same enzymes in blood showed a less marked difference between patients and controls (ranges of 7.5-20.8 and 3-14, respectively). When examined histochemically, increased alkaline phosphatase activity was observed in connective tissue, epithelium of the glands and blood capillaries of tumor tissue. 1 section containing normal tissue bordering carcinomatous tissue demonstrated normal alkaline phosphatase activity in the normal tissue and increased activity in the tumor tissue. In summary, there is increased enzyme activity around the tumor areas, but values for serum levels show an overlap of normal and abnormal cases and are therefore not predictive. Results demonstrate a clear difference in activities of these enzymes in carcinomatous tissue and normal tissue, which may be of value in follow-up care.
B DRSINGHCHANDRA. "Unsteady motion of a conducting fluid through a square Channel under Transverse Magnetic field.". In: International Symposia in Mathematics, Banaras Hindu University (INDIA). Materials Research Society; Submitted.
B PROFMBAYAVERTISTINE. "Kondi, A., H. Foy and V.B. Mbaya, Erythroid Aplasia in Kwashiorkor, Brit. Med. J. 1:725 1962.". In: Med. J. 1:725. Wangari Veronica Wanjiru; 1962. Abstract
As the number of fatalities from cardiovascular diseases declines in western industrial nations, an opposite trend is observed in the East African region. Inter-regional variations in the prevalence of vascular disorders have been attributed to socioeconomic, psychosocial and heritable physiological parameters. Although faulty mineralocorticoid metabolism and the dysfunctional kidney are prominent features of circulatory problems, many current studies are focused on membrane receptors, transmembrane ion transport mechanisms, ion channels and the possible genetic polymorphisms that determine the characteristics of those molecular structures in the vascular system of normal or hypertensive persons. In this review, a composite of the data available on each of the above parameters and its significance in the pathogenesis of hypertension in the industrial West and transforming economies of East Africa is presented.
B PROFOJWANGSHADRACK. "In vivo and in vitro response of Plasmodium falciparum to chloroquine in pregnant women in Kilifi district, Kenya. East Afr Med J. 1992 Jun;69(6):306-10.". In: East Afr Med J. 1992 Jun;69(6):306-10. Rao, W. O., Ogonji, J. A.. and Aywa, S.; 1992. Abstract
In a malaria-endemic area of the Coast of Kenya with chloroquine resistant Plasmodium falciparum, we determined the prevalence and density of falciparum infection in gravid women and assessed the in vivo and in vitro parasite response to a regimen of chloroquine 25 mg/kg body weight divided over three days. P. falciparum infections were present in 65 (21.7%) of 300 pregnant women. The proportion of primigravidae who were parasitaemic was 41.8% which was significantly higher than that of the multigravidae (17.1, P less than 0.01). Primigravidae did not show a significantly higher mean parasite density than the multigravidae. The in vivo tests showed that 45.9% of all the P. falciparum infections were resistant to chloroquine predominantly at RI and RII levels with percentages 36.1% and 8.2%, respectively. PIP: At the antenatal clinic of Kilifi District Hospital in the Coast Province of Kenya, researchers enrolled 300 pregnant volunteers 15-32 years olds, living in the district to screen and treat then for Plasmodium falciparum infection and to follow those with parasitemia on days 0, 1, 2, 14, 17, 21, and 28. They also conducted in vitro studies to determine resistance to chloroquine. They combined in vivo and in vitro study took place between November 20, 1988 and January 17, 1989. 65 women (21.7%) had P. falciparum in their peripheral blood smear. Primigravidae were more likely to be parasitemia than were multigravidae (41.8% vs. 17.1%; p .001). Their mean parasite density was also higher but not significantly so. Parasite density fell consistently with rising parity. Malaria infections in 54.1% of the women responded to 25 mg/kg chloroquine. the remaining 45.9% (28) of cases exhibited in vivo resistance, especially at RI an RII levels (36.1% and 8.2%, respectively). Primigravidae were more likely to experience failure to clear parasites by day 7 than multigravidae. Further, among women experiencing a parasitemia on day 7, parasites tended to reappear on day 14 and 21 in primigravidae. Initial parasite density did not affect clearance of parasites. Primigravidae continued to have a higher level of parasitemia throughout treatment than did multigravidae. It took at least 24 hours for the chloroquine to be completely absorbed thus the mean level of parasitemia decreased sharply between 0-2 days. Amodiaquine induced a parasitemia in 89.3% (25 cases) of the chloroquine resistant infections. Even though the 3 remaining cases with parasitemia received amodiaquine treatment, clinicians administered Fansidar, resulting in a clearing of parasitemia in 7 days. 34.8% of in vitro parasite cultures were resistant to chloroquine. The reduced ability of pregnant women to clear parasitemia likely explained the lower level of in vitro resistance.
B PROFOJWANGSHADRACK, OTIENO DRODAWAFRANCISXAVIER. "Omuga BOO, Ojwang SBO Antenatal care and educational problems of unmarried teenage mothers in Nairobi. E. Afr. Med. J. 1990:67, 690.". In: E. Afr. Med. J. 1990:67, 690. Rao, W. O., Ogonji, J. A.. and Aywa, S.; 1990. Abstract

Part of a detailed analysis of 864 unmarried teenage mothers delivering in Pumwani Maternity Hospital and Kenyatta National Hospital is presented. Teenage pregnancy amounted for 42.3% of all deliveries of unmarried mothers. Most teenage patients were above 16 years of age, had a religious background of wide coverage, had low quality antenatal care and low education. 94.6% were found to be primigravidas. This dominance has also been found by other workers. PIP: A prospective cross-sectional descriptive study of unmarried mothers delivering in Pumwani Maternity Hospital and Kenyatta National Hospital, Nairobi, Kenya, from December 1986-April 1987, was conducted with a pretested open-ended questionnaire: the 864 teen mothers are described here. They ranged from 13.4-19 years, most were 17-19. 49.4% were Catholic and 45% Protestant. 88.5% attended prenatal clinics once; 51.5% attended 5 times, although only 13% went to hospital clinics for specialized care. For reasons for not going for prenatal care teens stated that they were too shy to undergo a clinical exam, afraid of parents' reaction, unaware of the pregnancy or of the existence of prenatal care, they had not menstruated, or were in school, in prison, or had long work hours. Most girls had primary education, and 97.9% had dropped out of school. 34% dropped out because of pregnancy, and 32% for lack of tuition fees. Reasons for dropping out of school were tabulated, encompassing a broad range of social problems such as war, death, divorce, alcoholism or illness of parents, no tuition or uniform funds, poor grades, and running away from school. In Africa, teen pregnancy is probably increasing because of decreasing age at menarche and relaxing of traditional values.

B PROFOJWANGSHADRACK, OTIENO DRODAWAFRANCISXAVIER. "Ojwang SBO, Maggwa ABN Adolescent sexuality in Kenya.E. Afr. Med. J. 1991: 68, 74.". In: E. Afr. Med. J. 1991: 68, 74. EM Ngatia, LW Gathece, FG Macigo, TK Mulli, LN Mutara, EG Wagaiyu.; 1991. Abstract

Adolescent sexuality has become a major problem all over the world. This review paper describes the main problems encountered in Kenya with regards to adolescent sexuality. The role of the Government and some non-governmental organisations is outlined. Factors which contribute to the problem of adolescent sexuality in Kenya are described. The paper stresses the role of research in solving these problems and finally suggests some strategies which may be adopted in order to minimise the undesirable effects of adolescent sexuality in Kenya. PIP: Kenya's population has increased from 5.4 million in 1948 to 15.3 million in 1979 and is expected to rise to 39 million by 2000. The population growth rate has risen from 2.5% in 1948 to 3.8% in 1979. Improvements in health and economic status since independence have caused significant changes from 1948-79: the fertility rate of women has increased from 6.5-7.9, the crude death rate has decreased from 25/1000-14/1000, infant mortality has decreased from 184/1000-104/1000 births, and life expectancy has increased from 35-54 years. Adolescent girls, 15-24, contribute up to 30% of total pregnancies of females, 15-49, and will form 44.2% of the reproductive age group by 2000. Between 1960 and 1979 the fertility rate of girls 15-19 has increased from 141/1000-168/1000. The age of menarche has dropped from 17 to 12-15. In 1 rural community 41.9% of the girls and 76.1% of the boys aged 12-23 had at least one sexual experience. The mean age at first coitus was 13.7 for boys and 14.9 for girls. 42% of the girls and 74.8% of the boys had more than one sexual partner. Because of the gradual change from extended families to nuclear families, education, role models, and any established activities that initiated youth into adulthood have virtually disappeared, leaving adolescents uneducated and unprepared. Only 2-6% use any form of contraception. 58.4% of rural and 64.4% of urban pregnant girls are in primary school at the time of conception. 8340-10,400 girls drop out of school due to pregnancy each year. 46.6% of girls who get pregnant are not married. Abortions among the adolescents account for 28-64% of abortions done in hospitals, but because of strict abortion laws in Kenya, most adolescents resort to criminal abortions frequently performed by inexperienced people in unsanitary conditions. Sexually transmitted diseases (STDs) are not uncommon among adolescents: 36.8% of pregnant adolescent females had at least 1 STD, compared to 16% of those aged 25 and above. Contraceptive services, education, and laws protecting the adolescent must be instituted in response to the problems of adolescent sexuality.

B PROFOJWANGSHADRACK, OTIENO DRODAWAFRANCISXAVIER. "Ojwang SBO, Bennun M. Musila S.Uterine rupture due to road traffic accidents E. Afr. Med. J. 1978: 55,14.". In: E. Afr. Med. J. 1978: 55,14. EM Ngatia, LW Gathece, FG Macigo, TK Mulli, LN Mutara, EG Wagaiyu.; 1978. Abstract
PIP: This research report studies several biochemical and histochemical aspects of cervical carcinoma and explores their use in follow-up of patients undergoing radiotherapy. Material came from 19 patients with invasive cervical carcinoma admitted to Kenyatta National Hospital. A control group consisted of 20 women matched for age who attended clinics at the hospital but were not suffering from any malignant disease; control tissue for histological examination was obtained from 3 women who had undergone hysterectomy for uterine fibroids. Biochemical assays for alkaline and acid phosphatases in patients with cervical carcinoma show an increase in alkaline phosphatase in carcinomatous tissue (35.7 umoles/hr/mg) as opposed to normal tissue (7.2). Acid phosphatase values were only moderately raised. Assays of the same enzymes in blood showed a less marked difference between patients and controls (ranges of 7.5-20.8 and 3-14, respectively). When examined histochemically, increased alkaline phosphatase activity was observed in connective tissue, epithelium of the glands and blood capillaries of tumor tissue. 1 section containing normal tissue bordering carcinomatous tissue demonstrated normal alkaline phosphatase activity in the normal tissue and increased activity in the tumor tissue. In summary, there is increased enzyme activity around the tumor areas, but values for serum levels show an overlap of normal and abnormal cases and are therefore not predictive. Results demonstrate a clear difference in activities of these enzymes in carcinomatous tissue and normal tissue, which may be of value in follow-up care.
B DRSINGHCHANDRA. "Unsteady Magneto-hydrodynamic Channel flow of a Dusty Rivlin Erictiuon fluid.". In: Bulgarian Academy of Sciences, Theoretical and Applied Mechanics, Sofia, ,X, NO.3. Materials Research Society; Submitted.
B PROFMBAYAVERTISTINE. "Foy, H., A. Kondi and V.B. Mbaya, Riboflavin Deficiency and Bone Marrow Function in Baboons, Brit. J. Nutr. 18:307 1964.". In: Brit. J. Nutr. 18:307. Wangari Veronica Wanjiru; 1964. Abstract
As the number of fatalities from cardiovascular diseases declines in western industrial nations, an opposite trend is observed in the East African region. Inter-regional variations in the prevalence of vascular disorders have been attributed to socioeconomic, psychosocial and heritable physiological parameters. Although faulty mineralocorticoid metabolism and the dysfunctional kidney are prominent features of circulatory problems, many current studies are focused on membrane receptors, transmembrane ion transport mechanisms, ion channels and the possible genetic polymorphisms that determine the characteristics of those molecular structures in the vascular system of normal or hypertensive persons. In this review, a composite of the data available on each of the above parameters and its significance in the pathogenesis of hypertension in the industrial West and transforming economies of East Africa is presented.
B PROFOJWANGSHADRACK. "Genital prolapse as a problem in rural community. East Afr Med J. 1995.". In: East Afr Med J. 1995. Rao, W. O., Ogonji, J. A.. and Aywa, S.; 1995. Abstract
OBJECTIVES: The objective of the study was to determine the efficacy of chloroquine in pregnant women with Plasmodium falciparum parasitemia at therapeutic doses of 25 mg/kg body weight divided over 3 days. <br>METHODS: Three-hundred pregnant women in Kilifi Hospital at the coast of Kenya were screened for malaria parasitemia using Giemsa stained thick blood smears. In vivo and in vitro parasite sensitivity to chloroquine was determined. <br>RESULTS: P. falciparum infections were present in 65 (22%) of 300 pregnant women. The in vivo tests showed that 46% of all the P. falciparum infections were resistant to chloroquine predominantly at RI and RII levels. The in vitro tests showed a resistance rate of 35%. <br>CONCLUSIONS: A large proportion of pregnant women with malaria do not respond to chloroquine therapy and alternative drugs are required.
B PROFOJWANGSHADRACK, OTIENO DRODAWAFRANCISXAVIER. "Odongo FNZO, Ojwang SBO Verucose carcinoma of the vulva: Report of two cases and literature review E. Afr. Med. J. 1990:67, 830-831.". In: East Afr Med J. 1991 Jul;68(7):585-9. Rao, W. O., Ogonji, J. A.. and Aywa, S.; 1990. Abstract
A female Kenyan child with pseudoprecocious puberty due to juvenile granulosa cell tumour is presented. Clinical features in this patient included a mass in the lower abdomen, a growth spurt and appearance of pubic hairs as well as enlargements of the breasts. No similar case has been reported in a Kenyan child. The management and review of literature are discussed
B PROFPATELNILESH, G. PROFKIOYPAUL. "Chien-Hsiun Chen, Toshiki Mizuno, Robert Elston, Monica M Kariuki, Kathleen Hall, Fred Unverzagt, Hugh Hendrie, Samuel Gatere, Paul Kioy, Nilesh B Patel, Robert P Friedland, Raj N Kalaria. (2008) A comparative study to screen dementia and APOE genotypes i.". In: Ethiop. 12(2), 121 - 128. International Journal of BiochemiPhysics; 2008. Abstract

Laboratory of Neurogeriatrics, Department of Neurology and Department of Epidemiology and Biostatistics, School of Medicine, Case Western Reserve University, Cleveland, OH, USA.

Previous studies have established cross-cultural methods to screen for ageing- related dementia and susceptibility genes, in particular Alzheimer's disease (AD) among the Canadian Cree, African Americans and Yoruba in Nigeria. We determined whether the Community Screening Interview for Dementia (CSID), translated into Kikuyu, a major language of Kenya, could be used to evaluate dementia of the Alzheimer type. Using two sets of coefficients of cognitive and informant scores, two discriminant function (DF) scores were calculated for each of 100 elderly (>65 years) Nyeri Kenyans. When the cut-off points were selected for 100% sensitivities, the specificities of the DF scores were remarkably similar (93.75%) in the Kenyan sample. We propose the adapted CSID can be utilised to detect dementia among East Africans. We also show that apolipoprotein E varepsilon4 allele frequencies were high ( approximately 30%) and not different between normal subjects and those with probable AD. There was no evidence to suggest years of education or vascular factors were associated with dementia status.

PMID: 18703255 [PubMed - as supplied by publisher]

B DRODUOLCHARLES. "First Year Language Competence. The British Council, 1997.". In: 12th International Congress on Animal Reproduction, the Hague, 1992.Workshop on sperm preservation in swine. The Cleveland Museum of Natural History; 1997.
B PROFOJWANGSHADRACK, OTIENO DRODAWAFRANCISXAVIER. "Kigondu SC, Ojutu JO, Nyonyitono RM, Ojwang SBO, Sanghvi HCG, Muthami LM, Nyagero JM.Condom: acceptability and use among patients attending sexually transmitted diseases (STD) clinic. J. Obst. Gyn. East Cent. Afr. 1992: 10, 25-30.". In: J. Obstet. Gyna East Afr. 10(2): 65 1992,. EM Ngatia, LW Gathece, FG Macigo, TK Mulli, LN Mutara, EG Wagaiyu.; 1992. Abstract

PIP: In this study, 273 university students (161 men and 112 women) were interviewed by means of a self-administered questionnaire to determine their knowledge, attitude, and practice concerning sexually transmitted diseases (STDs). The mean age of the men was 22.4 +or- 1.6 years and that of the women was 22.1 +or- 1.6 years. 97.4% of the students were sexually experienced. Knowledge of common STDs was high, but knowledge of their signs, symptoms, and consequences was low. 24.5% of the male and 3.7% of the female students had had an STD. The principal sources of information on STDs included books, films, and TV for 39.6% of the students and teachers for 16.8% of the students. Parents played a very minimal role. It is suggested that primary and secondary school students be taught about STDs as part of reproductive health education and that such education be continued at the college level in order to increase the awareness among young people. author's modified

B PROFOJWANGSHADRACK, OTIENO DRODAWAFRANCISXAVIER. "Ojwang SBO, Basu AK Tubo ovarian shistosomiasis presenting as a ruptured ectopic pregnancy. J. Obstet. Gyn. East. Cent. Afr. 1984:3,44.". In: J. of Ob. Gy. E & Centr Afric. 3(2); 63, 1984. EM Ngatia, LW Gathece, FG Macigo, TK Mulli, LN Mutara, EG Wagaiyu.; 1984. Abstract
PIP: This research report studies several biochemical and histochemical aspects of cervical carcinoma and explores their use in follow-up of patients undergoing radiotherapy. Material came from 19 patients with invasive cervical carcinoma admitted to Kenyatta National Hospital. A control group consisted of 20 women matched for age who attended clinics at the hospital but were not suffering from any malignant disease; control tissue for histological examination was obtained from 3 women who had undergone hysterectomy for uterine fibroids. Biochemical assays for alkaline and acid phosphatases in patients with cervical carcinoma show an increase in alkaline phosphatase in carcinomatous tissue (35.7 umoles/hr/mg) as opposed to normal tissue (7.2). Acid phosphatase values were only moderately raised. Assays of the same enzymes in blood showed a less marked difference between patients and controls (ranges of 7.5-20.8 and 3-14, respectively). When examined histochemically, increased alkaline phosphatase activity was observed in connective tissue, epithelium of the glands and blood capillaries of tumor tissue. 1 section containing normal tissue bordering carcinomatous tissue demonstrated normal alkaline phosphatase activity in the normal tissue and increased activity in the tumor tissue. In summary, there is increased enzyme activity around the tumor areas, but values for serum levels show an overlap of normal and abnormal cases and are therefore not predictive. Results demonstrate a clear difference in activities of these enzymes in carcinomatous tissue and normal tissue, which may be of value in follow-up care.
B PROFMBAYAVERTISTINE. "Foy, H., A. Kondi and V.B. Mbaya, Serum B-12 and Folate Levels in Normal and Riboflavin Deficient Baboons. Brit. J. Haematology 12:234 1966.". In: Brit. J. Haematology 12:234. Wangari Veronica Wanjiru; 1966. Abstract
As the number of fatalities from cardiovascular diseases declines in western industrial nations, an opposite trend is observed in the East African region. Inter-regional variations in the prevalence of vascular disorders have been attributed to socioeconomic, psychosocial and heritable physiological parameters. Although faulty mineralocorticoid metabolism and the dysfunctional kidney are prominent features of circulatory problems, many current studies are focused on membrane receptors, transmembrane ion transport mechanisms, ion channels and the possible genetic polymorphisms that determine the characteristics of those molecular structures in the vascular system of normal or hypertensive persons. In this review, a composite of the data available on each of the above parameters and its significance in the pathogenesis of hypertension in the industrial West and transforming economies of East Africa is presented.
B PROFOJWANGSHADRACK. "Resistance to chloroquine therapy in pregnant women with malaria parasitemia. Int J Gynaecol Obstet.1996 Jun;53(3):235-41.". In: Int J Gynaecol Obstet.1996 Jun;53(3):235-41. Rao, W. O., Ogonji, J. A.. and Aywa, S.; 1996. Abstract
OBJECTIVES: The objective of the study was to determine the efficacy of chloroquine in pregnant women with Plasmodium falciparum parasitemia at therapeutic doses of 25 mg/kg body weight divided over 3 days. <br>METHODS: Three-hundred pregnant women in Kilifi Hospital at the coast of Kenya were screened for malaria parasitemia using Giemsa stained thick blood smears. In vivo and in vitro parasite sensitivity to chloroquine was determined. <br>RESULTS: P. falciparum infections were present in 65 (22%) of 300 pregnant women. The in vivo tests showed that 46% of all the P. falciparum infections were resistant to chloroquine predominantly at RI and RII levels. The in vitro tests showed a resistance rate of 35%. <br>CONCLUSIONS: A large proportion of pregnant women with malaria do not respond to chloroquine therapy and alternative drugs are required.
B PROFOJWANGSHADRACK, OTIENO DRODAWAFRANCISXAVIER. "Ojwang SBO, Omuga B.Contraceptive use among women admitted with abortion in Nairobi. E. Afr. Med. J. 1991::68, 197.". In: E. Afr. Med. J. 1991::68, 197. Rao, W. O., Ogonji, J. A.. and Aywa, S.; 1991. Abstract

In this study, a total of 519 patients were interviewed. 82.5% had incomplete abortion. The implication of abortion especially when induced is emphasised. Economic implications that are contributed by the youth are stressed. 83.6% of the patients had not used any contraception. The role of contraception in preventing unwanted pregnancy and therefore induced abortion is stressed. The role of the physician in providing contraception and appropriate contraceptive knowledge is discussed. PIP: A study of 519 consecutive women admitted to Kenyatta National Hospital with the diagnosis of abortion revealed that the majority were young and had a history of nonuse of contraception. Abortion was incomplete in 428 (83%) of cases; 60 (12%) cases involved sepsis. Women 20-24 years of age accounted for 221 (43%) of the abortions; the other two most represented age groups were 25-29 years (28%) and 14-19 years (17%). 460 (89%) of the abortion patients had never used a contraceptive method. The most frequently cited reasons for nonuse were desire for pregnancy (48%), no conscious reason (13%), procrastination in getting to a family planning clinic (8%), no knowledge of family planning (6%), and fear of side effects (6%). Of the 64 cases of failed contraception, 27 were using the pill, 25 had an IUD in place, and 8 were relying on the rhythm method. Among contraceptive users, the major sources of information about contraception were nurses (52%), radio and newspapers (19%), and other women (15%). Only 4% indicated that a physician had discussed family planning with them. Given the resource drain that treatment of incomplete abortion can place on Kenya's health care system and the risk of abortion-induced pelvic infection and subsequent infertility, Kenya's health workers should be encouraged to be more aggressive in promoting family planning use among young women.

B PROFOJWANGSHADRACK, OTIENO DRODAWAFRANCISXAVIER. "Ojwang SBO.Ovarian Cancer in Kenya E. Afr. Med. J. 1980:57, 131.". In: E.Afr. Med. J. 1985:62, 271. Rao, W. O., Ogonji, J. A.. and Aywa, S.; 1980. Abstract
PIP: This research report studies several biochemical and histochemical aspects of cervical carcinoma and explores their use in follow-up of patients undergoing radiotherapy. Material came from 19 patients with invasive cervical carcinoma admitted to Kenyatta National Hospital. A control group consisted of 20 women matched for age who attended clinics at the hospital but were not suffering from any malignant disease; control tissue for histological examination was obtained from 3 women who had undergone hysterectomy for uterine fibroids. Biochemical assays for alkaline and acid phosphatases in patients with cervical carcinoma show an increase in alkaline phosphatase in carcinomatous tissue (35.7 umoles/hr/mg) as opposed to normal tissue (7.2). Acid phosphatase values were only moderately raised. Assays of the same enzymes in blood showed a less marked difference between patients and controls (ranges of 7.5-20.8 and 3-14, respectively). When examined histochemically, increased alkaline phosphatase activity was observed in connective tissue, epithelium of the glands and blood capillaries of tumor tissue. 1 section containing normal tissue bordering carcinomatous tissue demonstrated normal alkaline phosphatase activity in the normal tissue and increased activity in the tumor tissue. In summary, there is increased enzyme activity around the tumor areas, but values for serum levels show an overlap of normal and abnormal cases and are therefore not predictive. Results demonstrate a clear difference in activities of these enzymes in carcinomatous tissue and normal tissue, which may be of value in follow-up care.
B PROFOJWANGSHADRACK, OTIENO DRODAWAFRANCISXAVIER. "Mati JKG, Ojwang SBO, Odipo WS Present attitude towards female sterilization and projected in the next generation of Kenyan women. Proceedings of the second conference of the International Association of Voluntary Sterilization, Geneva 1973.". In: East Afr Med J. 1977 Sep;54(9):472-5. Rao, W. O., Ogonji, J. A.. and Aywa, S.; 1973. Abstract
PIP: This research report studies several biochemical and histochemical aspects of cervical carcinoma and explores their use in follow-up of patients undergoing radiotherapy. Material came from 19 patients with invasive cervical carcinoma admitted to Kenyatta National Hospital. A control group consisted of 20 women matched for age who attended clinics at the hospital but were not suffering from any malignant disease; control tissue for histological examination was obtained from 3 women who had undergone hysterectomy for uterine fibroids. Biochemical assays for alkaline and acid phosphatases in patients with cervical carcinoma show an increase in alkaline phosphatase in carcinomatous tissue (35.7 umoles/hr/mg) as opposed to normal tissue (7.2). Acid phosphatase values were only moderately raised. Assays of the same enzymes in blood showed a less marked difference between patients and controls (ranges of 7.5-20.8 and 3-14, respectively). When examined histochemically, increased alkaline phosphatase activity was observed in connective tissue, epithelium of the glands and blood capillaries of tumor tissue. 1 section containing normal tissue bordering carcinomatous tissue demonstrated normal alkaline phosphatase activity in the normal tissue and increased activity in the tumor tissue. In summary, there is increased enzyme activity around the tumor areas, but values for serum levels show an overlap of normal and abnormal cases and are therefore not predictive. Results demonstrate a clear difference in activities of these enzymes in carcinomatous tissue and normal tissue, which may be of value in follow-up care.
B PROFOJWANGSHADRACK, OTIENO DRODAWAFRANCISXAVIER. "Mutungi A.K. Sanghvi; Sinei S.K. Ojwang SBO, Kigondu SC The frequency of Antenatal Care and Diagnosis of two Public hospitals in Nairobi, Kenya.J. Obst. Gyn. East Central Africa 1999: 14, 78-83.". In: Gynaec Eastern & Central Africa. March 1999. EM Ngatia, LW Gathece, FG Macigo, TK Mulli, LN Mutara, EG Wagaiyu.; 1999. Abstract
OBJECTIVE: In sub-Saharan Africa, many family planning programmes do not encourage advance provision of oral contraceptives to clients who must wait until menses to initiate pill use. Since some resistance to advance provision of pills is due to provider fears that the practice may be harmful, we conducted a study in Kenya in 1997 to compare pill-taking outcomes between 20 "advance provision" clients and 280 "standard" clients. DESIGN: Prospective observational study. SETTING: Six family planning clinics in Central and Western Kenya. SUBJECTS: Women presenting as new clients at MOH family planning clinics. INTERVENTIONS: Researchers used prospective tracking to compare indicators of pill-taking success between non-menstruating clients given pills to carry home for later use and menstruating clients who began pill use immediately. MAIN OUTCOME MEASURES: Pill-taking outcomes such as side effects, compliance, knowledge, satisfaction, and a continuation proxy. RESULTS: Among clients returning for re-supply, those receiving advance provision of pills did no worse than, and often had superior outcomes to, their counterparts who started taking pills immediately after the clinic visit. CONCLUSIONS: Advance provision of pills, already practiced worldwide, is safe and feasible. Explicit mention should be made of advance provision of pills in national family planning guidance documents and training curricula in Kenya and throughout sub-Saharan Africa.
B PROFOJWANGSHADRACK, OTIENO DRODAWAFRANCISXAVIER. "Ojwang SBO Some aspects of cervical cancer in young African women in Kenya. E. Afr. Med. J. 1985:62, 889-895.". In: E. Afr. Med. J. 1985:62, 889-895. EM Ngatia, LW Gathece, FG Macigo, TK Mulli, LN Mutara, EG Wagaiyu.; 1985. Abstract

Part of a detailed analysis of 864 unmarried teenage mothers delivering in Pumwani Maternity Hospital and Kenyatta National Hospital is presented. Teenage pregnancy amounted for 42.3% of all deliveries of unmarried mothers. Most teenage patients were above 16 years of age, had a religious background of wide coverage, had low quality antenatal care and low education. 94.6% were found to be primigravidas. This dominance has also been found by other workers. PIP: A prospective cross-sectional descriptive study of unmarried mothers delivering in Pumwani Maternity Hospital and Kenyatta National Hospital, Nairobi, Kenya, from December 1986-April 1987, was conducted with a pretested open-ended questionnaire: the 864 teen mothers are described here. They ranged from 13.4-19 years, most were 17-19. 49.4% were Catholic and 45% Protestant. 88.5% attended prenatal clinics once; 51.5% attended 5 times, although only 13% went to hospital clinics for specialized care. For reasons for not going for prenatal care teens stated that they were too shy to undergo a clinical exam, afraid of parents' reaction, unaware of the pregnancy or of the existence of prenatal care, they had not menstruated, or were in school, in prison, or had long work hours. Most girls had primary education, and 97.9% had dropped out of school. 34% dropped out because of pregnancy, and 32% for lack of tuition fees. Reasons for dropping out of school were tabulated, encompassing a broad range of social problems such as war, death, divorce, alcoholism or illness of parents, no tuition or uniform funds, poor grades, and running away from school. In Africa, teen pregnancy is probably increasing because of decreasing age at menarche and relaxing of traditional values.

B M, Olubayo F, Narla R, Songa J, Amata R, Kyamanywa S, Ateka EM. "First record of spiraling whitefly in coastal Kenya: emergence, host range, distribution and association with cassava brown streak virus disease." Int. J. Agric. Biol. 2010;12:411-415.
b. "Review of ocular trauma in Tamale Teaching Hospital, Tamale, Ghana." Journal of Ophthalmology of Eastern Central and Southern Africa. 2015;19(2):75-82. Abstractvol19_no_2.pdf

Abstract

Objective: To establish the epidemiologic characteristics, referral pattern, interventions, visual outcomes and complications resulting in visual impairment/blindness among ocular trauma patients in Tamale Teaching Hospital (TTH) Eye Clinic, Tamale, Ghana.
Materials and Methods: This was a retrospective hospital-based case series in which all new patients of all ages with various eye conditions from 1st January to 31st December 2010 were reviewed from the outpatient/inpatient record books and the sex and age recorded. The files/ folders of patients with ocular trauma were selected and retrieved. The epidemiological characteristics, referral pattern, interventions, visual outcomes and complications resulting in visual impairment/blindness among ocular trauma patients were analysed.
Results: A total of 2,027 records of new patients with various eye conditions were retrieved. Three hundred and sixty one (377 eyes) new ocular trauma patients’ files/ folders were analyzed. The Male: Female ratio was 1:1.1 (p=0.09) for all new patients with various eye conditions whilst it was 1.8:1 (p<0.01) for new ocular trauma patients. Ocular trauma patients were younger than general patients with 20 – 29 years age group having most new patients (27.4%) compared with the over 49 years age group for other new cases (23.4%). Approximately 68.4% of the ocular trauma patients were seen at TTH without a referral. Conjunctival lesions were the commonest finding affecting 124(32.9%) of the ocular trauma patients. The majority of patients 88.1% sustained closed globe trauma, 8.3% had adnexal trauma whilst 3.6% had open globe trauma. The commonest intervention rendered was medical treatment alone to 64.4% of the patients. By the WHO classification, majority 67.4% of traumatized eyes had normal vision, 13.9% were visually impaired and 18.7% were blind. Thus, 110 (32.6%) were visually impaired/ blind in the traumatized eye. The commonest complications resulting in visual impairment/ blindness were corneal opacities/ scars in 33(30.0%) cases.
Conclusion: Majority of ocular trauma patients presented with minor injuries which healed without complications. However, ocular trauma was a major cause of monocular blindness and visual impairment. Ocular trauma also tended to affect a younger age group and especially males compared to other eye diseases.
Key words: Ocular trauma, Epidemiology, Referral pattern, Intervention, Visual outcome, Complication

B PROFMBAYAVERTISTINE. "Mbaya, V.B., Hypertension in East Africans and Others of African Descent: A Review, E. Afr. Med. J. 75(5): 300 1998.". In: E. Afr. Med. J. 75(5): 300. Wangari Veronica Wanjiru; 1998. Abstract
As the number of fatalities from cardiovascular diseases declines in western industrial nations, an opposite trend is observed in the East African region. Inter-regional variations in the prevalence of vascular disorders have been attributed to socioeconomic, psychosocial and heritable physiological parameters. Although faulty mineralocorticoid metabolism and the dysfunctional kidney are prominent features of circulatory problems, many current studies are focused on membrane receptors, transmembrane ion transport mechanisms, ion channels and the possible genetic polymorphisms that determine the characteristics of those molecular structures in the vascular system of normal or hypertensive persons. In this review, a composite of the data available on each of the above parameters and its significance in the pathogenesis of hypertension in the industrial West and transforming economies of East Africa is presented.
B PROFOJWANGSHADRACK, OTIENO DRODAWAFRANCISXAVIER. "Mutungi AK, Sinei SK, Ojwang SBO, Kigondu SC, Ndavi PM Reasons for the non-use of contraception by Post-abortion women at Kenyatta National hospital. J. Obst. Gyn East. Central. Afr. 1999: 14, 89-96.". In: East Afr Med J. 2006 Mar;83(3):110-3. Rao, W. O., Ogonji, J. A.. and Aywa, S.; 1999. Abstract
Presented here is a 16-year-old nulliparous girl who had embryonal rhabdomyosarcoma causing uterine inversion. She had been referred with a one year history of continuous vaginal bleeding and vaginal swelling. Histology had shown sarcoma botyroides and had received five courses of chemotherapy at the referring hospital. At surgery she was found to have uterine inversion and extended hysterectomy was carried out to be followed by radiotherapy.
B PROFOJWANGSHADRACK, OTIENO DRODAWAFRANCISXAVIER. "Lema VM, Ojwang SBO, Wanjala SHM Rupture of gravid uterus. E. Afr. Med. J. 1991: 68, 430.". In: E. Afr. Med. J. 1991: 68, 430. Rao, W. O., Ogonji, J. A.. and Aywa, S.; 1991. Abstract
A total of 105 patients were treated for ruptured gravid uteri at the Kenyatta National Hospital, Nairobi, Kenya, over a five year period, January, 1984 to December, 1988. During the same period, there were 44,156 deliveries, giving an incidence of uterine rupture of 1:425 deliveries. Of these, records for 95 patients were traced and analysed, and the results are presented here. Majority (61.0%) of these patients were aged less than 30 years, and 62.1% were gravida 5 or less. 54 (56.8%) of them had rupture of scarred uteri, 33 (34.7%) had spontaneous rupture, while 8 (8.4%) had traumatic rupture. 56 (59.0%) ruptured while at the Kenyatta National Hospital. Repair of the uterus without tubal ligation was the treatment offered to most of them, while total abdominal hysterectomy was rarely done. The perinatal case fatality rate was 60% and there were two maternal deaths giving a maternal case fatality rate of 2.1%. Factors associated with uterine rupture at the Kenyatta National Hospital are discussed, and possible ways of reducing the incidence suggested. PIP: Physicians treated 105 patients with uterine rupture at Kenyatta National Hospital (KNH) in Nairobi, Kenya between January 1984-December 1988. The ruptured gravid uterus incidence during the study period was 1:425. 56.8% of the mothers were between 20-29 years old. 62.1% were gravida 5. 21.1% had received no prenatal care. 59% ruptured at this hospital. Adequate labor monitoring would have prevented rupturing. 56.8% experienced at least 1 previous cesarean section (C-section). Only 2 women had had a classical C-section. Moreover 21.1% of mothers who had prenatal care at KNH underwent a previous C-section. Perhaps health workers did not evaluate these women properly. 74% of the mothers were at least 38 weeks gestation. 34.7% had a spontaneous rupture due to prolonged labor (12 hours). 8.4% experienced a traumatic rupture. 94.7% happened during labor. Most of the tears (51.6%) occurred along the lower anterior uterine segment primarily on the transverse or on a C-section scar. Surgeons were able to repair the uterus without tubal ligation in 47.4% of the cases. They could repair the uterus of 11.6%, but also had to perform a tubal ligation. They conducted a partial hysterectomy on 38% and total hysterectomy on 3.2%. 38.9% gave birth to their infants vaginally. 55.8% of the mothers gave birth to a stillborn infant. 35.8% of the infants were delivered in good condition and survived. 4.2% were in poor condition and survived and 4.2% were in poor condition and died. All the infants in the peritoneal cavity were already dead, but not all of those in the uterus died. The case fatality rate stood at 60%. 2.1% of the mothers died, all after surgery. 1 mother actually died of injuries from an earlier assault. In conclusion, C-section was the major predisposing factor. Ruptured gravida uteri continued to be a major obstetric problem in Kenya.
B PROFOJWANGSHADRACK, OTIENO DRODAWAFRANCISXAVIER. "Ojwang SBO, Ouko J.Prediction of Foetal weight by fundal height girth measurements. J. Obst. Gyn. East Cent. Afri. 1984:3, 111.". In: E.Afr. Med. J. 1985:62, 271. Rao, W. O., Ogonji, J. A.. and Aywa, S.; 1984. Abstract
PIP: This research report studies several biochemical and histochemical aspects of cervical carcinoma and explores their use in follow-up of patients undergoing radiotherapy. Material came from 19 patients with invasive cervical carcinoma admitted to Kenyatta National Hospital. A control group consisted of 20 women matched for age who attended clinics at the hospital but were not suffering from any malignant disease; control tissue for histological examination was obtained from 3 women who had undergone hysterectomy for uterine fibroids. Biochemical assays for alkaline and acid phosphatases in patients with cervical carcinoma show an increase in alkaline phosphatase in carcinomatous tissue (35.7 umoles/hr/mg) as opposed to normal tissue (7.2). Acid phosphatase values were only moderately raised. Assays of the same enzymes in blood showed a less marked difference between patients and controls (ranges of 7.5-20.8 and 3-14, respectively). When examined histochemically, increased alkaline phosphatase activity was observed in connective tissue, epithelium of the glands and blood capillaries of tumor tissue. 1 section containing normal tissue bordering carcinomatous tissue demonstrated normal alkaline phosphatase activity in the normal tissue and increased activity in the tumor tissue. In summary, there is increased enzyme activity around the tumor areas, but values for serum levels show an overlap of normal and abnormal cases and are therefore not predictive. Results demonstrate a clear difference in activities of these enzymes in carcinomatous tissue and normal tissue, which may be of value in follow-up care.
B PROFOJWANGSHADRACK, OTIENO DRODAWAFRANCISXAVIER. "Ojwang SBO, Mati JKG and Makokha AE The problem of Gynaecological Cancer in Kenya with reference to some practical problems in Radiotherapy management of carcinoma of the cervix in a developing country.Proceedings of the Conference of the Nigerian Obstetr.". In: E. Afr. Med. J. 1978.55, 194. Rao, W. O., Ogonji, J. A.. and Aywa, S.; 1977. Abstract
PIP: This research report studies several biochemical and histochemical aspects of cervical carcinoma and explores their use in follow-up of patients undergoing radiotherapy. Material came from 19 patients with invasive cervical carcinoma admitted to Kenyatta National Hospital. A control group consisted of 20 women matched for age who attended clinics at the hospital but were not suffering from any malignant disease; control tissue for histological examination was obtained from 3 women who had undergone hysterectomy for uterine fibroids. Biochemical assays for alkaline and acid phosphatases in patients with cervical carcinoma show an increase in alkaline phosphatase in carcinomatous tissue (35.7 umoles/hr/mg) as opposed to normal tissue (7.2). Acid phosphatase values were only moderately raised. Assays of the same enzymes in blood showed a less marked difference between patients and controls (ranges of 7.5-20.8 and 3-14, respectively). When examined histochemically, increased alkaline phosphatase activity was observed in connective tissue, epithelium of the glands and blood capillaries of tumor tissue. 1 section containing normal tissue bordering carcinomatous tissue demonstrated normal alkaline phosphatase activity in the normal tissue and increased activity in the tumor tissue. In summary, there is increased enzyme activity around the tumor areas, but values for serum levels show an overlap of normal and abnormal cases and are therefore not predictive. Results demonstrate a clear difference in activities of these enzymes in carcinomatous tissue and normal tissue, which may be of value in follow-up care.
B O, HO O. "Hearing disorders in HIV positive adult patients not on anti- retroviral drugs at Kenyatta National Hospital. ." East African Medical Journal . 2010;87:570-573. AbstractWebsite

Objectives: To determine the prevalence and type of hearing disorders in HIV positive patients not on anti - retroviral drugs (ARVs) and correlate this with the world health Organization (WHO) stage of HIV disease and CD4 positive cell counts.
Design: Case control study.
Setting: comprehensive care clinic (CCC) and voluntary counseling and testing centre at Kenyatta National Hospital.
Subjects: One hundread and ninety four HIV positive patients attending CCC and 124 HIV negative subjects recruited from voluntary counseling and testing (VCT) centre.
Results: Hearing loss (HL) was present in 33.5% of HIV positive compared to 8.1% in negative subjects. No gender bias in HL Sensorineural hearing loss (SNHL) was the most common and the frequencies most ‘affected were four and eight kHz

Conclusion: Hearing loss is more prevalent in HIV positive individuals not on anti - retroviral drugs than negative normal subjects. Low CD4 cell count and advanced HIV diseases were associated with increased chance of having a hearing loss. Otological care should be part of the comprehensive care of HIV positive patients.

B PROFOJWANGSHADRACK, OTIENO DRODAWAFRANCISXAVIER. "Gichangi PB, B Wayo, Benson Estambale, De Yust H., Ojwang SBO, RogokAbwao, Termmerman M, Impact on HIV infection on invasive cervical cancer in Kenyan Women AIDS 2003, 17: 1-6.". In: Trainer. EM Ngatia, LW Gathece, FG Macigo, TK Mulli, LN Mutara, EG Wagaiyu.; 2003. Abstract
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B PROFOJWANGSHADRACK, OTIENO DRODAWAFRANCISXAVIER. "Omuga BOO, Ojwang SBO Antenatal care and educational problems of unmarried teenage mothers in Nairobi. E. Afr. Med. J. 1990:67, 690.". In: E. Afr. Med. J. 1990:67, 690. EM Ngatia, LW Gathece, FG Macigo, TK Mulli, LN Mutara, EG Wagaiyu.; 1990. Abstract

Part of a detailed analysis of 864 unmarried teenage mothers delivering in Pumwani Maternity Hospital and Kenyatta National Hospital is presented. Teenage pregnancy amounted for 42.3% of all deliveries of unmarried mothers. Most teenage patients were above 16 years of age, had a religious background of wide coverage, had low quality antenatal care and low education. 94.6% were found to be primigravidas. This dominance has also been found by other workers. PIP: A prospective cross-sectional descriptive study of unmarried mothers delivering in Pumwani Maternity Hospital and Kenyatta National Hospital, Nairobi, Kenya, from December 1986-April 1987, was conducted with a pretested open-ended questionnaire: the 864 teen mothers are described here. They ranged from 13.4-19 years, most were 17-19. 49.4% were Catholic and 45% Protestant. 88.5% attended prenatal clinics once; 51.5% attended 5 times, although only 13% went to hospital clinics for specialized care. For reasons for not going for prenatal care teens stated that they were too shy to undergo a clinical exam, afraid of parents' reaction, unaware of the pregnancy or of the existence of prenatal care, they had not menstruated, or were in school, in prison, or had long work hours. Most girls had primary education, and 97.9% had dropped out of school. 34% dropped out because of pregnancy, and 32% for lack of tuition fees. Reasons for dropping out of school were tabulated, encompassing a broad range of social problems such as war, death, divorce, alcoholism or illness of parents, no tuition or uniform funds, poor grades, and running away from school. In Africa, teen pregnancy is probably increasing because of decreasing age at menarche and relaxing of traditional values.

B DRSINGHCHANDRA, B DRSINGHCHANDRA. "Magneto-hydrodynamic Unsteady Flow of a Dusty liquid Through a Channel Under the Influence of Inclined Magnetic Field.". In: International Journal of Biochemiphysics, Vol. 5 (Nos 1& 2). Materials Research Society; 1996. Abstract
1. Singh C. B.  .  August . .
B PROFOJWANGSHADRACK. "Audit of hysterectomies at the Aga Khan Hospital, Nairobi: justification of operative indications. East Afr Med J. 1992 Sep;69(9):483-6.". In: East Afr Med J. 1992 Sep;69(9):483-6. Rao, W. O., Ogonji, J. A.. and Aywa, S.; 1992. Abstract
An audit of 381 hysterectomies performed over a 5 year period (1986-1990) was carried out. In order to assess justification of the indication for hysterectomy pre-operative diagnoses were divided into two groups: those potentially confirmable by pathologic study and those not potentially confirmable by pathologic study. Out of the 273 cases studied in the first group, 246 (90.1%) were justified, while out of the 108 cases studied in the second group, 82 (75.9%) were justified. An overall 86% justification rate was observed. Adenomyosis as a histopathologic finding was seen more commonly in Asian than African patients (P < 0.005). Morbidity rate was 20% and there were no mortalities. The procedure in general was considered safe and justified.
B PROFOJWANGSHADRACK, OTIENO DRODAWAFRANCISXAVIER. "Ojwang SBO Management of pain in patients with advanced gynaecological cancer. E. Afr. Med. J. 1985:62, 817-819.". In: WHO Workshop in Mombasa. Rao, W. O., Ogonji, J. A.. and Aywa, S.; 1985. Abstract
Almost 30 years after its introduction into the management of ovarian carcinoma, second-look laparotomy remains controversial. Although its supporters agree on its indications, there is a considerable number of conflicting reports on the actual benefits of the procedure. Diagnostic inaccuracy, invasiveness and expense are some of the reasons raised by opponents against its routine performance and their recommendations range from limited selective application to total avoidance. The role of second-look laparotomy is reviewed, with particular reference to developing countries where scarcity of resources must always be balanced against the need to provide the best care possible to the individual cancer patient. A management schedule for ovarian carcinoma, including second-look laparotomy, appropriate under these circumstances is given.
B PROFOJWANGSHADRACK, OTIENO DRODAWAFRANCISXAVIER. "Ojwang SBO, Mati JKG Carcinoma of the uterine cervix in Kenya E. Afr. Med. J. 1978.55, 194.". In: E. Afr. Med. J. 1978.55, 194. Rao, W. O., Ogonji, J. A.. and Aywa, S.; 1978. Abstract
PIP: This research report studies several biochemical and histochemical aspects of cervical carcinoma and explores their use in follow-up of patients undergoing radiotherapy. Material came from 19 patients with invasive cervical carcinoma admitted to Kenyatta National Hospital. A control group consisted of 20 women matched for age who attended clinics at the hospital but were not suffering from any malignant disease; control tissue for histological examination was obtained from 3 women who had undergone hysterectomy for uterine fibroids. Biochemical assays for alkaline and acid phosphatases in patients with cervical carcinoma show an increase in alkaline phosphatase in carcinomatous tissue (35.7 umoles/hr/mg) as opposed to normal tissue (7.2). Acid phosphatase values were only moderately raised. Assays of the same enzymes in blood showed a less marked difference between patients and controls (ranges of 7.5-20.8 and 3-14, respectively). When examined histochemically, increased alkaline phosphatase activity was observed in connective tissue, epithelium of the glands and blood capillaries of tumor tissue. 1 section containing normal tissue bordering carcinomatous tissue demonstrated normal alkaline phosphatase activity in the normal tissue and increased activity in the tumor tissue. In summary, there is increased enzyme activity around the tumor areas, but values for serum levels show an overlap of normal and abnormal cases and are therefore not predictive. Results demonstrate a clear difference in activities of these enzymes in carcinomatous tissue and normal tissue, which may be of value in follow-up care.
B DRESHUNFRANCIS. "The Concept of 'Falling' in Akan. University of Wisconsin Department of African Language & Literature Seminars, 1992.". In: Occasional Papers in Language and Linguistics, Volume 2, 2004. UN-HABITAT; 1992. Abstract
A simple gas chromatographic assay utilising alkali flame ionisation detection is described for the estimation of cyclophosphamide as its trifluoroacetate derivative from plasma. Examination of five patients following intravenous cyclophosphamide gave values of 8.9 h (SD 2.7) for the half-life and 0.061 liters/h/kg (SD 0.011) for whole-body clearance of the drug.
B MISSREGOASSUMPTA. "Muthoka, M. and Rego, A.B., 1985, Environmental Education Module for In-Service Training of Social Science Teachers and Supervisors for Secondary Schools, UNESCO-UNEP International Environmental Education Programme, No.10, UNESCO, Paris, Division of Scien.". In: Royal Botanic Gardens , Kew , England. El-Banhawy, E. M.; 1985. Abstract
We surveyed the phytoseid mites in four different geographical zones of Kenya: Zone I, upper highland and tropical alpine (2400-4400m): Zone II, lower highland (1800-2400m); zone III, midland (800-1800m); Zone IV, tropical, hot and humid( 0-800m ). A total of 107 species was found. In the sub family, amblyseeinae there were 14 species in the genus Neoseilus , one in Aspereroseius Chant, one in Paraphytoseius Swirski &Schechter, five in typhlodromips De Leon, five in Transeius Chant & McMurty, one in Graminaseius Chant &McMurty, 11 in Amblyseius Berlese, one in Arrenoseius Wanstein, two in Typhlodromalus muma, seven in Ueckemannseius Chant &McMurty, one in Ambylodromalus Chant &Mcmurty,, 20 in Euseius Wanstein, one in Iphiseius Berlese, one in Phytoseilus Evans and one in Gynaseius Ehara & Imano. In the subfamily Phytoseiinae Berlese there were four species in the genus Phytoseiius Ribaga. In the subfamily Typhlodrominae Wanstein, there were four species in the genus Kuzinellus Wainstein and 27 in Typhlodromus Scheuten
B PROFOJWANGSHADRACK, OTIENO DRODAWAFRANCISXAVIER. "Odongo FNZO, Ojwang SBO Verucose carcinoma of the vulva: Report of two cases and literature review E. Afr. Med. J. 1990:67, 830-831." EM Ngatia, LW Gathece, FG Macigo, TK Mulli, LN Mutara, EG Wagaiyu.; 1990. Abstract

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

B PROFOJWANGSHADRACK, OTIENO DRODAWAFRANCISXAVIER. "Ojwang SBO, Mati JKG and Makokha AE The problem of Gynaecological Cancer in Kenya with reference to some practical problems in Radiotherapy management of carcinoma of the cervix in a developing country.Proceedings of the Conference of the Nigerian Obstetr.". In: E. Afr. Med. J. 1978.55, 194. EM Ngatia, LW Gathece, FG Macigo, TK Mulli, LN Mutara, EG Wagaiyu.; 1977. Abstract
PIP: This research report studies several biochemical and histochemical aspects of cervical carcinoma and explores their use in follow-up of patients undergoing radiotherapy. Material came from 19 patients with invasive cervical carcinoma admitted to Kenyatta National Hospital. A control group consisted of 20 women matched for age who attended clinics at the hospital but were not suffering from any malignant disease; control tissue for histological examination was obtained from 3 women who had undergone hysterectomy for uterine fibroids. Biochemical assays for alkaline and acid phosphatases in patients with cervical carcinoma show an increase in alkaline phosphatase in carcinomatous tissue (35.7 umoles/hr/mg) as opposed to normal tissue (7.2). Acid phosphatase values were only moderately raised. Assays of the same enzymes in blood showed a less marked difference between patients and controls (ranges of 7.5-20.8 and 3-14, respectively). When examined histochemically, increased alkaline phosphatase activity was observed in connective tissue, epithelium of the glands and blood capillaries of tumor tissue. 1 section containing normal tissue bordering carcinomatous tissue demonstrated normal alkaline phosphatase activity in the normal tissue and increased activity in the tumor tissue. In summary, there is increased enzyme activity around the tumor areas, but values for serum levels show an overlap of normal and abnormal cases and are therefore not predictive. Results demonstrate a clear difference in activities of these enzymes in carcinomatous tissue and normal tissue, which may be of value in follow-up care.
B DRSINGHCHANDRA. "A note on the Temperature Distribution of a Viscous Incompressible Fluid in a Channel Bounded by Two Parallel Plates.". In: J. of Scientific Research, B.H.U. (INDIA), Vol. XXIV (1-2). Materials Research Society; Submitted.
B PROFOJWANGSHADRACK. "Embryonal rhabdomyosarcoma with uterine inversion: case report. East Afr Med J. 2006 Mar;83(3):110-3.". In: East Afr Med J. 2006 Mar;83(3):110-3. Rao, W. O., Ogonji, J. A.. and Aywa, S.; 2006. Abstract
Presented here is a 16-year-old nulliparous girl who had embryonal rhabdomyosarcoma causing uterine inversion. She had been referred with a one year history of continuous vaginal bleeding and vaginal swelling. Histology had shown sarcoma botyroides and had received five courses of chemotherapy at the referring hospital. At surgery she was found to have uterine inversion and extended hysterectomy was carried out to be followed by radiotherapy.
B PROFOJWANGSHADRACK, K. PROFSINEISAMUEL. "Human immunodeficiency virus in gestational trophoblastic neoplasias–is it a poor prognostic risk factor. East Afr Med J. 1992 Nov;69(11):647-8.". In: East Afr Med J. 1992 Nov;69(11):647-8. Rao, W. O., Ogonji, J. A.. and Aywa, S.; 1992. Abstract
Three cases of HIV infection with choriocarcinoma are presented. One case had prolonged chemotherapy without remission, the second had remission only after combining hysterectomy with chemotherapy and the third who had extensively metastatic disease in the presence of other low risk factors are reported. HIV infection may predispose patients to extensive metastatic choriocarcinoma and influence the course of treatment. We propose that HIV infection be considered a poor prognostic risk for gestation trophoblastic neoplasias
B PROFOJWANGSHADRACK. "Some aspects of teenage pregnancy in Nairobi: a prospective study on teenage mothers at Kenyatta National Hospital and Pumwani Maternity Hospital. East Afr Med J. 1990 Jun;67(6):432-6.". In: East Afr Med J. 1990 Jun;67(6):432-6. Rao, W. O., Ogonji, J. A.. and Aywa, S.; 1990. Abstract
In order to determine the magnitude of teenage pregnancy and also to determine the demographic and socio-economic problems associated with these pregnancies, a prospective study was conducted in two major delivery centres in Nairobi. The incidence of teenage pregnancy was found to be 10.5%. For Kenyatta National Hospital (KNH), the incidence was 13.1% and Pumwani Maternity Hospital (PMH) recorded an incidence of 8.8%. Most of the teenagers (82.8%) were from large families, and upto 59.4% had been pregnant at least once. They had low education; 66.7% had only primary level education. Both the teenager and their parents were unemployed. Their average age at menarche was 14.2 years. 70% had had intercourse by 16 years. Up to 60% had no knowledge of contraceptives and; most of those who knew, had it from informal sources. Only 1% had used any known contraceptive method. It is concluded that intervention programme like adolescent antenatal clinics, adolescent sexuality education and appropriate use of contraceptives be provided as a matter of priority. All health facilities should open special units for handling adolescent sexuality. This should include both sexes. Teachers, parents and respectable community leaders should effectively be involved in formulation of programmes that would reduce teenage pregnancies. These measures should be started right at the primary school level.
B DRESHUNFRANCIS. "Vowel Systems of Kenyan Languages. Paper ready to be presented at a Symposium on African Languages and Linguistics.". In: Cancer Chemother Pharmacol. 1978;1(4):229-31. UN-HABITAT; 2006. Abstract
A simple gas chromatographic assay utilising alkali flame ionisation detection is described for the estimation of cyclophosphamide as its trifluoroacetate derivative from plasma. Examination of five patients following intravenous cyclophosphamide gave values of 8.9 h (SD 2.7) for the half-life and 0.061 liters/h/kg (SD 0.011) for whole-body clearance of the drug.
B MISSREGOASSUMPTA. "Muthoka, M.C. and Rego, A.B al.at 1990, A Guide on Environmental Education, UNESCO.". In: Royal Botanic Gardens , Kew , England. El-Banhawy, E. M.; 1990. Abstract
We surveyed the phytoseid mites in four different geographical zones of Kenya: Zone I, upper highland and tropical alpine (2400-4400m): Zone II, lower highland (1800-2400m); zone III, midland (800-1800m); Zone IV, tropical, hot and humid( 0-800m ). A total of 107 species was found. In the sub family, amblyseeinae there were 14 species in the genus Neoseilus , one in Aspereroseius Chant, one in Paraphytoseius Swirski &Schechter, five in typhlodromips De Leon, five in Transeius Chant & McMurty, one in Graminaseius Chant &McMurty, 11 in Amblyseius Berlese, one in Arrenoseius Wanstein, two in Typhlodromalus muma, seven in Ueckemannseius Chant &McMurty, one in Ambylodromalus Chant &Mcmurty,, 20 in Euseius Wanstein, one in Iphiseius Berlese, one in Phytoseilus Evans and one in Gynaseius Ehara & Imano. In the subfamily Phytoseiinae Berlese there were four species in the genus Phytoseiius Ribaga. In the subfamily Typhlodrominae Wanstein, there were four species in the genus Kuzinellus Wainstein and 27 in Typhlodromus Scheuten
B PROFOJWANGSHADRACK, OTIENO DRODAWAFRANCISXAVIER. "Odongo FN, Ojwang SBO E. Afr. Med. J. 1991: 67, 830.". In: E. Afr. Med. J. 1991: 68, 74. EM Ngatia, LW Gathece, FG Macigo, TK Mulli, LN Mutara, EG Wagaiyu.; 1991. Abstract

Adolescent sexuality has become a major problem all over the world. This review paper describes the main problems encountered in Kenya with regards to adolescent sexuality. The role of the Government and some non-governmental organisations is outlined. Factors which contribute to the problem of adolescent sexuality in Kenya are described. The paper stresses the role of research in solving these problems and finally suggests some strategies which may be adopted in order to minimise the undesirable effects of adolescent sexuality in Kenya. PIP: Kenya's population has increased from 5.4 million in 1948 to 15.3 million in 1979 and is expected to rise to 39 million by 2000. The population growth rate has risen from 2.5% in 1948 to 3.8% in 1979. Improvements in health and economic status since independence have caused significant changes from 1948-79: the fertility rate of women has increased from 6.5-7.9, the crude death rate has decreased from 25/1000-14/1000, infant mortality has decreased from 184/1000-104/1000 births, and life expectancy has increased from 35-54 years. Adolescent girls, 15-24, contribute up to 30% of total pregnancies of females, 15-49, and will form 44.2% of the reproductive age group by 2000. Between 1960 and 1979 the fertility rate of girls 15-19 has increased from 141/1000-168/1000. The age of menarche has dropped from 17 to 12-15. In 1 rural community 41.9% of the girls and 76.1% of the boys aged 12-23 had at least one sexual experience. The mean age at first coitus was 13.7 for boys and 14.9 for girls. 42% of the girls and 74.8% of the boys had more than one sexual partner. Because of the gradual change from extended families to nuclear families, education, role models, and any established activities that initiated youth into adulthood have virtually disappeared, leaving adolescents uneducated and unprepared. Only 2-6% use any form of contraception. 58.4% of rural and 64.4% of urban pregnant girls are in primary school at the time of conception. 8340-10,400 girls drop out of school due to pregnancy each year. 46.6% of girls who get pregnant are not married. Abortions among the adolescents account for 28-64% of abortions done in hospitals, but because of strict abortion laws in Kenya, most adolescents resort to criminal abortions frequently performed by inexperienced people in unsanitary conditions. Sexually transmitted diseases (STDs) are not uncommon among adolescents: 36.8% of pregnant adolescent females had at least 1 STD, compared to 16% of those aged 25 and above. Contraceptive services, education, and laws protecting the adolescent must be instituted in response to the problems of adolescent sexuality.

B PROFOJWANGSHADRACK, OTIENO DRODAWAFRANCISXAVIER. "Ojwang SBO, Mati JKG Carcinoma of the uterine cervix in Kenya E. Afr. Med. J. 1978.55, 194.". In: E. Afr. Med. J. 1978.55, 194. EM Ngatia, LW Gathece, FG Macigo, TK Mulli, LN Mutara, EG Wagaiyu.; 1978. Abstract
PIP: This research report studies several biochemical and histochemical aspects of cervical carcinoma and explores their use in follow-up of patients undergoing radiotherapy. Material came from 19 patients with invasive cervical carcinoma admitted to Kenyatta National Hospital. A control group consisted of 20 women matched for age who attended clinics at the hospital but were not suffering from any malignant disease; control tissue for histological examination was obtained from 3 women who had undergone hysterectomy for uterine fibroids. Biochemical assays for alkaline and acid phosphatases in patients with cervical carcinoma show an increase in alkaline phosphatase in carcinomatous tissue (35.7 umoles/hr/mg) as opposed to normal tissue (7.2). Acid phosphatase values were only moderately raised. Assays of the same enzymes in blood showed a less marked difference between patients and controls (ranges of 7.5-20.8 and 3-14, respectively). When examined histochemically, increased alkaline phosphatase activity was observed in connective tissue, epithelium of the glands and blood capillaries of tumor tissue. 1 section containing normal tissue bordering carcinomatous tissue demonstrated normal alkaline phosphatase activity in the normal tissue and increased activity in the tumor tissue. In summary, there is increased enzyme activity around the tumor areas, but values for serum levels show an overlap of normal and abnormal cases and are therefore not predictive. Results demonstrate a clear difference in activities of these enzymes in carcinomatous tissue and normal tissue, which may be of value in follow-up care.
B DRSINGHCHANDRA. "Unsteady Magneto-hydrodynamic fluid flow through a Channel.". In: J. of Scientific Research, B.H.U. (INDIA), Vol. XXVIII (2). Materials Research Society; Submitted.
B PROFMBAYAVERTISTINE. "FOY H, KONDI A, MBAYA V.EFFECT OF RIBOFLAVINE DEFICIENCY ON BONE MARROW FUNCTION AND PROTEIN METABOLISM IN BABOONS. PRELIMINARY REPORT.Br J Nutr. 1964;18:307-18.". In: Br J Nutr. 1964;18:307-18. Wangari Veronica Wanjiru; 1964. Abstract
As the number of fatalities from cardiovascular diseases declines in western industrial nations, an opposite trend is observed in the East African region. Inter-regional variations in the prevalence of vascular disorders have been attributed to socioeconomic, psychosocial and heritable physiological parameters. Although faulty mineralocorticoid metabolism and the dysfunctional kidney are prominent features of circulatory problems, many current studies are focused on membrane receptors, transmembrane ion transport mechanisms, ion channels and the possible genetic polymorphisms that determine the characteristics of those molecular structures in the vascular system of normal or hypertensive persons. In this review, a composite of the data available on each of the above parameters and its significance in the pathogenesis of hypertension in the industrial West and transforming economies of East Africa is presented.
B Ganda, GO Oyoo KMJM. "Peripheral arterial disease in rheumatoid arthritis patients at the Kenyatta National Hospital, Kenya." East African Medical Journa. 2011;88(12). AbstractWebsite

Objective: To determine the magnitude of the rosclerotic arterial disease in Rheumatoid Arthritis(RA) patients at Kenyatta National Hospital.
Design: hospital based cross-sectional study.
Setting: Kenyatta National Hospital Rheumatology outpatient clinic.
Subjects: Rheumatoid Arthritis patients.
Results: We obtained ABI measurements in 90 RA patients, among them 23(25.5% 95% CI 17.2-36.1) had obstructed lower limb arteries. Among the 23, 21(91.3%) had mild PAD, two (8.7%) had moderate PAD; none had severe PAD nor incompressible vessels. The obstruction of vessels was independent of diabetes, hypertension, dyslipidemia and cigarette smoking though these factors increased the likelihood of having PAD. Risk age( ≥45 males, ≥55 females), Established RA(> 5 year duration) and severe RA were found to be significantly associated with the likelihood of having PAD. These trends remained significant after multivariable adjustment for potential confounders. twenty five (27.7%) of the study subjects exhibited symptoms of intermittent claudication, 13(52%) of them had PAD on ABI measurements, The Edinburgh claudication questionnaire was found to have 56.5% sensitivity and 82% specificity in detection
of PAD in RA patients. Conclusion: There seems to be an association between PAD in RA with chronicity and severity of the RA. This association may support the pathogenic role of accumulated systemic inflammation in atherosclerosis. Clinicians should be alert to the possibility of impared arterial function and thus subsequent cardiovascular morbidity and mortality in this group of patients.

B Ganda, GO Oyoo KMJM. "Peripheral arterial disease in rheumatoid arthritis patients at the Kenyatta National Hospital, Kenya ." East African Medical Journal. 2011;88(12). Abstract

Objective: To determine the magnitude of the rosclerotic arterial disease in Rheumatoid Arthritis(RA) patients at Kenyatta National Hospital.
Design: hospital based cross-sectional study.
Setting: Kenyatta National Hospital Rheumatology outpatient clinic.
Subjects: Rheumatoid Arthritis patients.
Results: We obtained ABI measurements in 90 RA patients, among them 23(25.5% 95% CI 17.2-36.1) had obstructed lower limb arteries. Among the 23, 21(91.3%) had mild PAD, two (8.7%) had moderate PAD; none had severe PAD nor incompressible vessels. The obstruction of vessels was independent of diabetes, hypertension, dyslipidemia and cigarette smoking though these factors increased the likelihood of having PAD. Risk age( ≥45 males, ≥55 females), Established RA(> 5 year duration) and severe RA were found to be significantly associated with the likelihood of having PAD. These trends remained significant after multivariable adjustment for potential confounders. twenty five (27.7%) of the study subjects exhibited symptoms of intermittent claudication, 13(52%) of them had PAD on ABI measurements, The Edinburgh claudication questionnaire was found to have 56.5% sensitivity and 82% specificity in detection
of PAD in RA patients. Conclusion: There seems to be an association between PAD in RA with chronicity and severity of the RA. This association may support the pathogenic role of accumulated systemic inflammation in atherosclerosis. Clinicians should be alert to the possibility of impared arterial function and thus subsequent cardiovascular morbidity and mortality in this group of patients.

B Nyaoke, C Perciani, Mureithi MW, MacD KS, Jaoko WO. "Feasibility of Mucosal Sampling in Low-risk Women in HIV/AIDS Vaccine Clinical Trials."; 2016.
B" "KA, R" "KJ, Amin" "M, E" "CJ. "Vulval- perineal giant condylomata( Buschke Lowenstein tumor) in HIV infected women: case report.". In: Kenya Obstetrics and Gynecology Society 37th Conference. Sirikwa, Eldoret; 2013.
B. PROFESTAMBALEBENSON. "The potential of schistosomal skin test as a diagnostic method in the detection of schistosomiasis. East Afr Med J. 1989 Jul;66(7):485-8.". In: East Afr Med J. 1989 Jul;66(7):485-8. Taylor & Francis; 1989. Abstract
One hundred and sixty seven volunteer medical students were exposed to intradermal skin tests for schistosomiasis. 35(21%) were positive. On further screening using routine stool and urine examinations, only 11(6.6%) were found to have eggs of Schistosoma mansoni. We conclude that although a useful procedure, schistosomal skin test should not be used alone for the diagnosis of schistosoma infections but should be complimented with the routine stool and urine examinations.
B. PROFESTAMBALEBENSON. "Koukounari A, Estambale BB, Kiambo Njagi J, Cundill B, Ajanga A, Crudder C, Otido J, Jukes MC, Clarke SE, Brooker S.Relationships between anaemia and parasitic infections in Kenyan schoolchildren: A Bayesian hierarchical modelling approach. Int J Parasito.". In: Int J Parasitol. 2008 Jun 12. [Epub ahead of print]. Taylor & Francis; 2008. Abstract
Anaemia is multi-factorial in origin and disentangling its aetiology remains problematic, with surprisingly few studies investigating the relative contribution of different parasitic infections to anaemia amongst schoolchildren. We report cross-sectional data on haemoglobin, malaria parasitaemia, helminth infection and undernutrition among 1523 schoolchildren enrolled in classes 5 and 6 (aged 10-21 years) in 30 primary schools in western Kenya. Bayesian hierarchical modelling was used to investigate putative relationships. Children infected with Plasmodium falciparum or with a heavy Schistosoma mansoni infection, stunted children and girls were found to have lower haemoglobin concentrations. Children heavily infected with S. mansoni were also more likely to be anaemic compared with uninfected children. This study further highlights the importance of malaria and intestinal schistosomiasis as contributors to reduced haemoglobin levels among schoolchildren and helps guide the implementation of integrated school health programmes in areas of differing parasite transmission.
B. PROFESTAMBALEBENSON. "Kiambo N., Magnussen, P., Estambale B., Ouma J.H., Mugo B (2003). Prevention of anaemia in pregnancy using insecticide-treated bednets and sulfadoxine-pyrimethamine in a highly malarious are of Kenya: A randomized controlled trial. Trans. R Soc. Trop. Med.". In: Trans. R Soc. Trop. Med. Hyg. 97: 277 . Taylor & Francis; 2003. Abstract
As part of a larger study on the effects of permethrin-impregnated bednets on the transmission of Wuchereria bancrofti, subjects from 12 villages in the Coastal province of Kenya, south of Mombasa, were investigated. The aims were to update the epidemiological data and elucidate the spatial distribution of W. bancrofti infection. Samples of night blood from all the villagers aged i 1 year were checked for the parasite, and all the adult villagers (aged >/= 15 years) were clinically examined for elephantiasis and, if male, for hydrocele. Overall, 16.0% of the 6531 villagers checked for microfilariae (mff) were found microfilaraemic, although the prevalence of microfilaraemia in each village varied from 8.1%-27.4%. The geometric mean intensity of infection among the microfilaraemic was 322 mff/ml blood. At village level, intensity of the microfilaraemia was positively correlated with prevalence, indicating that transmission has a major influence on the prevalence of microfilaraemia. Clinical examination of 2481 adults revealed that 2.9% had elephantiasis of the leg and that 19.9% of the adult men (10.8%-30.1% of the men investigated in each village) had hydrocele. Although the overall prevalence of microfilaraemia in the study villages had not changed much since earlier studies in the 1970s, both prevalence and intensity varied distinctly between the study villages. Such geographical variation over relatively short distances appears to be a common but seldom demonstrated feature in the epidemiology of bancroftian filariasis, and the focal nature of the geographical distribution should be carefully considered by those mapping the disease.
B. PROFESTAMBALEBENSON. "Antibodies in the serum of golden hamsters experimentally infected with the intestinal trematode Echinostoma caproni. J Helminthol. 1991 Dec;65(4):239-47. Erratum in: J Helminthol 1992 Mar;66(1):78.". In: J Helminthol. 1991 Dec;65(4):239-47. Erratum in: J Helminthol 1992 Mar;66(1):78. Taylor & Francis; Submitted. Abstract
The serum antibody response in golden hamsters (Mesocricetus auratus) infected with the intestinal trematode Echinostoma caproni was examined with ELISA, SDS-PAGE and Western blot, and IFAT techniques. All methods showed that the hamsters responded slowly but developed a clear positive humoral response to the infection. In most hamsters, an antibody response to infection could not be detected earlier than 11-13 weeks after infection with 6 or 25 metacercariae, and responses were weak when compared to previous results from mice infected with the same parasite. IFAT with positive hamster sera on live juvenile E. caproni showed only fluorescence at the posterior tip, which is a different pattern from that seen using from infected mice, indicating a different response to antigens on the juvenile parasites by these two hosts. The results are discussed in relation to the limited selfcure and development of resistance which is observed in golden hamsters infected with E. caproni.
B. PROFESTAMBALEBENSON. "Alusala DN, Estambale BB, Magnussen P, Friis H, Luoba AI, Mwaniki D.Predictors of serum ferritin and haemoglobin during pregnancy, in a malaria-endemic area of western Kenya.Ann Trop Med Parasitol. 2008 Jun;102(4):297-308.". In: Ann Trop Med Parasitol. 2008 Jun;102(4):297-308. Taylor & Francis; 2008. Abstract
Between 2000 and 2004, a cross-sectional survey was conducted, as part of a prospective cohort study, among the women attending antenatal-care clinics in Bondo district, a malaria-endemic area of western Kenya. The aim was to assess the prevalence of iron deficiency and determine the predictors of haemoglobin and serum ferritin concentrations in the women who had a gestational age between 14 and 24 weeks. A standardized questionnaire was used to collect and store the relevant bio-data for the study. Haemoglobin and ferritin concentrations were evaluated, sickle-cell status was determined, and malarial parasitaemias were detected and evaluated, using blood samples collected at enrollment. Multiple regression analysis was then used to test for significant predictors of the haemoglobin and serum ferritin concentrations. Although 842 women were enrolled in the prospective cohort study, haemoglobin concentrations were evaluated for only 828 of them, serum ferritin levels for 621, and levels of parasitaemia for 812. The mean haemoglobin concentration recorded was 10.9 g/dl. Although 37.9% of the subjects had mild-moderate anaemia (7.0-10.5 g haemoglobin/dl), only 0.5% were severely anaemic (<7.0 g haemoglobin/dl). The geometric mean serum ferritin concentration recorded was 18.9 microg/litre, and 32.3% of the subjects evaluated had low serum concentrations of ferritin (<12 microg/litre). Among the parasitaemic primigravidae (but not the parasitaemic multigravidae), those found positive for sickle-cell trait had significantly lower haemoglobin concentrations than those found negative in a sickling test (P=0.01). Among the pregnant women of Bondo district, gravidity, malarial infection and sickle cell appear to be key predictors of haemoglobin concentration.
B. PROFESTAMBALEBENSON. "P.B. Gichangi, J. Bwayo, B. Estambale, H. De Vyust, S. Ojwang, K. Rogo, H. Abwao, M. Temmerman (2003). The Impact of HIV infection on invasive cervical cancer in Kenyan women. AIDS 17: 1963 .". In: AIDS 17: 1963 . Taylor & Francis; 2003. Abstract
As part of a larger study on the effects of permethrin-impregnated bednets on the transmission of Wuchereria bancrofti, subjects from 12 villages in the Coastal province of Kenya, south of Mombasa, were investigated. The aims were to update the epidemiological data and elucidate the spatial distribution of W. bancrofti infection. Samples of night blood from all the villagers aged i 1 year were checked for the parasite, and all the adult villagers (aged >/= 15 years) were clinically examined for elephantiasis and, if male, for hydrocele. Overall, 16.0% of the 6531 villagers checked for microfilariae (mff) were found microfilaraemic, although the prevalence of microfilaraemia in each village varied from 8.1%-27.4%. The geometric mean intensity of infection among the microfilaraemic was 322 mff/ml blood. At village level, intensity of the microfilaraemia was positively correlated with prevalence, indicating that transmission has a major influence on the prevalence of microfilaraemia. Clinical examination of 2481 adults revealed that 2.9% had elephantiasis of the leg and that 19.9% of the adult men (10.8%-30.1% of the men investigated in each village) had hydrocele. Although the overall prevalence of microfilaraemia in the study villages had not changed much since earlier studies in the 1970s, both prevalence and intensity varied distinctly between the study villages. Such geographical variation over relatively short distances appears to be a common but seldom demonstrated feature in the epidemiology of bancroftian filariasis, and the focal nature of the geographical distribution should be carefully considered by those mapping the disease.
B. PROFESTAMBALEBENSON. "Estambale BB, Simonsen PE, Knight R, Bwayo JJ.Bancroftian filariasis in Kwale District of Kenya. I. Clinical and parasitological survey in an endemic community. Ann Trop Med Parasitol. 1994 Apr;88(2):145-51.". In: Ann Trop Med Parasitol. 1994 Apr;88(2):145-51. Taylor & Francis; 1994. Abstract
A cross-sectional parasitological and clinical survey for Wuchereria bancrofti infection was carried out in an endemic community of south-eastern Kenya, to obtain background epidemiological information for detailed serological studies on bancroftian filariasis in the same community. Quantitative examination of night blood samples (100 microliters) from 1129 individuals (76% of the population), using the counting chamber technique, revealed circulating microfilariae in 13.7% of the study group. Prevalence increased with age, and was higher in males (15.9%) than in females (11.6%). The geometric mean intensity among infected individuals was 223 microfilariae/ml blood (336 microfilariae/ml for males and 212 microfilariae/ml for females). Approximately 16.5% of the males aged > or = 15 years had hydrocele and 2.4% of the population had elephantiasis. The prevalence of these conditions increased with age; in those aged > or = 50 years, 23.8% of males had hydrocele and 6.1% of the total population had elephantiasis. Acute cases of epididymo-orchitis, adenolymphangitis and funiculitis were also seen. The microfilarial prevalence in males with hydrocele was not significantly different from that in asymptomatic males, but none of the elephantiasis cases had microfilaraemia. The striking difference in microfilaraemia pattern between hydrocele and elephantiasis patients may reflect different mechanisms underlying the development of these two chronic manifestations. The overall prevalences of microfilaraemia and clinical manifestations in this community were moderate when compared with those found in other studies carried out along the coast of eastern Africa.
B. PROFESTAMBALEBENSON. "Luoba AI, Geissler PW, Estambale B, Ouma JH, Magnussen P, Alusala D, Ayah R, Mwaniki D, Friis H. Geophagy among pregnant and lactating women in Bondo District, western Kenya. Trans R Soc Trop Med Hyg. 2004 Dec;98(12):734-41.". In: Trans R Soc Trop Med Hyg. 2004 Dec;98(12):734-41. Taylor & Francis; 2004. Abstract
Geophagy was studied among 827 pregnant women in western Kenya, during and after pregnancy. The women were recruited at a gestational age of 14-24 weeks and followed-up to 6 months post-partum. The median age (range) of the women was 23 years and median parity 2. At recruitment, 378 were eating earth, of which most (65%) reported earth-eating before pregnancy. The preferred type of earth eaten was soft stone, known locally as odowa (54.2%) and earth from termite mounds (42.8%). The prevalence remained high during pregnancy, and then declined to 34.5% and 29.6% at 3 and 6 months post-partum respectively (P < 0.001). The mean daily earth intake was 44.5 g during pregnancy, which declined to 25.5 g during lactation (P < 0.001). A random sample of 204 stools was collected from the women and analysed for silica content as a tracer for earth-eating. The mean silica content was 2.1% of the dry weight of stool. Geophagous women had a higher mean silica content than the non-geophagous ones (3.1% vs. 1.4%, P < 0.001). Faecal silica and reported geophagy were strongly correlated (P < 0.001).
B. O, A. M, A. W. "Kenya National Bureau of Statistics (KNBS) and ICF Macro. Kenya Demographic and Health Survey 2008-09.". In: Child Health. Calverton, Maryland: KNBS and ICF Macro.; 2010.
B. PROFESTAMBALEBENSON. "Gichangi P, Bwayo J, Estambale B, Rogo K, Njuguna E, Ojwang S, Temmerman M.HIV impact on acute morbidity and pelvic tumor control following radiotherapy for cervical cancer.Gynecol Oncol. 2006 Feb;100(2):405-11. Epub 2005 Nov 4.". In: Gynecol Oncol. 2006 Feb;100(2):405-11. Epub 2005 Nov 4. Taylor & Francis; 2006. Abstract
OBJECTIVE: To determine the impact of HIV infection on acute morbidity and pelvic tumor control following external beam radiotherapy (EBRT) for cervical cancer. METHOD: 218 patients receiving EBRT who also had HIV testing after informed consent was obtained were evaluated. Acute treatment toxicity was documented weekly during treatment and 1 month post-EBRT. Pelvic tumor control was documented at 4 and 7 months post-EBRT. Clinicians were blinded for HIV results. RESULTS: About 20% of the patients were HIV-positive. Overall, 53.4% of the patients had radiation-related acute toxicity (grade 3-4). HIV infection was associated with a 7-fold higher risk of multisystem toxicity: skin, gastrointestinal tract (GIT) and genitourinary tract (GUT) systems. It was also an independent risk factor for treatment interruptions (adjusted relative risk 2.2). About 19% of the patients had residual tumor at 4 and 7 months post-EBRT. HIV infection was independently and significantly associated with 6-fold higher risk of residual tumor post-EBRT. The hazard ratio of having residual tumor after initial EBRT was 3.1-times larger for HIV-positive than for HIV-negative patients (P = 0.014). CONCLUSION: HIV is associated with increased risk of multisystem radiation-related toxicity; treatment interruptions and pelvic failure (residual tumor) following EBRT. HIV infection is an adverse prognostic factor for outcome of cervical cancer treatment.
B. N. "Seafront Archaeology." A cultural impact assessment of the SheillaSanddunes in Lamu Kenya.In International Journal of Humanities. 2010;No6:vol2.
B. PROFESTAMBALEBENSON. "Schistosomiasis control in the community. East Afr Med J. 1996 Aug;73(8):493-4.". In: East Afr Med J. 1996 Aug;73(8):493-4. Taylor & Francis; 1996. Abstract
Four hundred and ninety nine children (aged between one month and five years) admitted with clinical features of meningitis were recruited in cross-sectional survey of bacterial meningitis in hospitals within Nairobi. Lumbar punctures were done on all of them and the cerebrospinal fluid (CSF) analysed bacteriologically and serologically for the common causative organisms. Two hundred and fifty (50.1%) cases were diagnosed clinically as having meningitis. Of these, 132 (52.8%) had turbid CSF specimens, while 118 (47.2%) were clear. When turbid CSF specimens were cultured, 83 (62.8%) yielded three common bacterial micro-organisms namely; Neisseria meningitidis, Streptococcus pneumoniae and Haemophilus influenzae in that order of frequency. The implications of these findings in paediatric meningitis together with the drug sensitivity patterns is presented and discussed.
B. PROFESTAMBALEBENSON. "Pamba HO, Bwibo NO, Chunge CN, Estambale BB.Albendazole (Zentel) in the treatment of helminthiasis in children below two years of age: a preliminary report.East Afr Med J. 1987 Jul;64(7):448-52.". In: East Afr Med J. 1987 Jul;64(7):448-52. Taylor & Francis; 1987. Abstract
An in vitro study of the antinematodal action of two groups of compounds which act on the receptor complex of the inhibitory neurotransmitter, Gamma-aminobutyric acid (GABA) in mammalian systems is described. The compounds, Ivermectin and two benzodiazepines, Diazepam and a water soluble Midazolam were tested singly or in combination against two microfilarial parasites Onchocerca lienalis (closely related to Onchocerca volvulus) and Brugia pahangi. The combination of ivermectin and diazepam at a concentration of 0.1 microgram/ml and 33 micrograms/ml respectively achieved the same effect on microfilarial motility as when ivermectin was given at 1 microgram/ml alone or diazepam at 66 micrograms/ml alone. Similarly when the combination of ivermectin at 0.1 microgram/ml and midazolam at 10 micrograms/ml was used it achieved the same effect as ivermectin at 1 microgram/ml alone or midazolam at 33 micrograms/ml alone. This showed that both benzodiazepines had a synergistic effect on the activity of ivermectin. The microfilariae of B. pahangi were insensitive to both groups of compounds at all concentrations used.
B. PROFESTAMBALEBENSON. "Filarial-specific antibody response in East African bancroftian filariasis: effects of host infection, clinical disease, and filarial endemicity. Am J Trop Med Hyg. 2006 Jul;75(1):97-107.". In: Am J Trop Med Hyg. 2006 Jul;75(1):97-107. Taylor & Francis; 2006. Abstract
The effect of host infection, chronic clinical disease, and transmission intensity on the patterns of specific antibody responses in Bancroftian filariasis was assessed by analyzing specific IgG1, IgG2, IgG3, IgG4, and IgE profiles among adults from two communities with high and low Wuchereria bancrofti endemicity. In the high endemicity community, intensities of the measured antibodies were significantly associated with infection status. IgG1, IgG2, and IgE were negatively associated with microfilaria (MF) status, IgG3 was negatively associated with circulating filarial antigen (CFA) status, and IgG4 was positively associated with CFA status. None of the associations were significantly influenced by chronic lymphatic disease status. In contrast, IgG1, IgG2, and IgG4 responses were less vigorous in the low endemicity community and, except for IgG4, did not show any significant associations with MF or CFA status. The IgG3 responses were considerably more vigorous in the low endemicity community than in the high endemicity one. Only IgG4 responses exhibited a rather similar pattern in the two communities, being significantly positively associated with CFA status in both communities. The IgG4:IgE ratios were higher in infection-positive individuals than in infection-negative ones, and higher in the high endemicity community than in the low endemicity one. Overall, these results indicate that specific antibody responses in Bancroftian filariasis are more related to infection status than to chronic lymphatic disease status. They also suggest that community transmission intensity play a dominant but subtle role in shaping the observed response patterns.
B. PROFESTAMBALEBENSON. "Estambale BBA (2001). Parasitic infestations in children. An Editorial: E. Afr. Med. J. 78. 277-278.". In: E. Afr. Med. J. 78. 277-278. Taylor & Francis; 2001. Abstract
Bancroftian filariasis infection, disease and specific antibody response patterns in a high and a low endemicity community in East Africa were analyzed and compared to assess the relationship between these parameters and community transmission intensity. Overall prevalences of microfilaremia and circulating filarial antigenemia were 24.9% and 52.2% in the high and 2.7% and 16.5% in the low endemicity community, respectively. A positive history of acute attacks of adenolymphangitis was given by 12.2% and 7.1% of the populations, 4.0% and 0.9% of the adult (> or = 20 years old) individuals presented with limb lymphedema, and 25.3% and 5.3% of the adult males had hydrocele, in the high and the low endemicity community, respectively. Both infection and disease appeared earlier and reached much higher levels in the high than in the low endemicity community. The observed overall and age-specific infection and disease patterns in the two communities were in agreement with the view that these are primarily shaped by transmission intensity. No statistically significant relationships between infection status of fathers and mothers and that of their children were observed in any of the communities for either microfilaremia or for circulating filarial antigenemia. The overall levels (prevalence and geometric mean intensity) of filarial-specific IgG1, IgG2, IgG4, and IgE were significantly higher in the high endemicity community than in the low endemicity dommunity. Surprisingly, the opposite pattern was found for IgG3. Community transmission intensity thus appears to be an important determinant of observed inter-community variation in infection, disease, and host response patterns in Bancroftian filariasis.
B. PROFESTAMBALEBENSON. "The occurrence of Cryptosporidium oocysts in faecal samples submitted for routine examination at Kenyatta National Hospital. East Afr Med J. 1989 Dec;66(12):792-5.". In: East Afr Med J. 1989 Dec;66(12):792-5. Taylor & Francis; 1989. Abstract
One hundred and thirty-three loose or diarrhoeic stool specimens from patients admitted at Kenyatta National Hospital were examined for cryptosporidiosis. Oocysts were detected in 5(3.8%) of the total in which Cryptosporidium was the sole pathogenic agent. In addition to Cryptosporidium, other pathogens isolated included bacteria, protozoa and helminths. We therefore report that Cryptosporidium is a cause of diarrhoea and should be looked for in the absence of other pathogenic organisms.
B. PROFESTAMBALEBENSON. "Clarke SE, Jukes MC, Njagi JK, Khasakhala L, Cundill B, Otido J, Crudder C, Estambale BB, Brooker S.Effect of intermittent preventive treatment of malaria on health and education in schoolchildren: a cluster-randomised, double-blind, placebo-controlled tr.". In: Lancet. 2008 Jul 12;372(9633):127-38. Taylor & Francis; 2008. Abstract
BACKGROUND: Malaria is a major cause of morbidity and mortality in early childhood, yet its consequences for health and education during the school-age years remain poorly understood. We examined the effect of intermittent preventive treatment (IPT) in reducing anaemia and improving classroom attention and educational achievement in semi-immune schoolchildren in an area of high perennial transmission. METHODS: A stratified, cluster-randomised, double-blind, placebo-controlled trial of IPT was done in 30 primary schools in western Kenya. Schools were randomly assigned to treatment (sulfadoxine-pyrimethamine in combination with amodiaquine or dual placebo) by use of a computer-generated list. Children aged 5-18 years received three treatments at 4-month intervals (IPT n=3535, placebo n=3223). The primary endpoint was the prevalence of anaemia, defined as a haemoglobin concentration below 110 g/L. This outcome was assessed through cross-sectional surveys 12 months post-intervention. Analysis was by both intention to treat, excluding children with missing data, and per protocol. This study is registered with ClinicalTrials.gov, number NCT00142246. FINDINGS: 2604 children in the IPT group and 2302 in the placebo group were included in the intention-to-treat analysis of the primary outcome; the main reason for exclusion was loss to follow-up. Prevalence of anaemia at 12 months averaged 6.3% in the IPT group and 12.6% in the placebo group (adjusted risk ratio 0.52, 95% CI 0.29-0.93; p=0.028). Significant improvements were also seen in two of the class-based tests of sustained attention, with a mean increase in code transmission test score of 6.05 (95% CI 2.83-9.27; p=0.0007) and counting sounds test score of 1.80 (0.19-3.41; p=0.03), compared with controls. No effect was shown for inattentive or hyperactive-compulsive behaviours or on educational achievement. The per-protocol analysis yielded similar results. 23 serious adverse events were reported within 28 days of any treatment (19 in the IPT group and four in the placebo group); the main side-effects were problems of balance, dizziness, feeling faint, nausea, and/or vomiting shortly after treatment. INTERPRETATION: IPT of malaria improves the health and cognitive ability of semi-immune schoolchildren. Effective malaria interventions could be a valuable addition to school health programmes.
B. PROFESTAMBALEBENSON. "Estambale BB.Microbial infections in the twenty first century: a continuous challenge.East Afr Med J. 2003 Aug;80(8):393-4.". In: East Afr Med J. 2003 Aug;80(8):393-4. Taylor & Francis; 2003. Abstract
As part of a larger study on the effects of permethrin-impregnated bednets on the transmission of Wuchereria bancrofti, subjects from 12 villages in the Coastal province of Kenya, south of Mombasa, were investigated. The aims were to update the epidemiological data and elucidate the spatial distribution of W. bancrofti infection. Samples of night blood from all the villagers aged i 1 year were checked for the parasite, and all the adult villagers (aged >/= 15 years) were clinically examined for elephantiasis and, if male, for hydrocele. Overall, 16.0% of the 6531 villagers checked for microfilariae (mff) were found microfilaraemic, although the prevalence of microfilaraemia in each village varied from 8.1%-27.4%. The geometric mean intensity of infection among the microfilaraemic was 322 mff/ml blood. At village level, intensity of the microfilaraemia was positively correlated with prevalence, indicating that transmission has a major influence on the prevalence of microfilaraemia. Clinical examination of 2481 adults revealed that 2.9% had elephantiasis of the leg and that 19.9% of the adult men (10.8%-30.1% of the men investigated in each village) had hydrocele. Although the overall prevalence of microfilaraemia in the study villages had not changed much since earlier studies in the 1970s, both prevalence and intensity varied distinctly between the study villages. Such geographical variation over relatively short distances appears to be a common but seldom demonstrated feature in the epidemiology of bancroftian filariasis, and the focal nature of the geographical distribution should be carefully considered by those mapping the disease.
B. PROFESTAMBALEBENSON. "Comparative study of aminosidine, etophamide and nimorazole, alone or in combination, in the treatment of intestinal amoebiasis in Kenya. Eur J Clin Pharmacol. 1990;39(4):353-7.". In: Eur J Clin Pharmacol. 1990;39(4):353-7. Taylor & Francis; 1990. Abstract
417 patients suffering from intestinal amoebiasis were randomly allocated to 6 different treatment groups in a controlled study in 3 District Hospitals in Kenya. The patients received either aminosidine (A), etophamide (E), nimorazole (N), or the combinations NA, NE, EA. Treatment in all cases was given twice daily for 5 days. Before and after treatment, rectosigmoidoscopy was done in each patient, and stool examination with characterization of invasive (IF) and non invasive (NIF) forms of amoeba was done daily throughout treatment, and on Days 15, 30 and 60 of follow-up. Clinical cure was good after all the treatments, varying from 90 to 100%; parasitological cure at the end of treatment was 100% in the NA and EA treatments groups, and 98% in A group. The incidence of relapses was nil in the EA group, followed by 3% in NA and 6% in A groups. Anatomical cure (healing of ulcers) was 97.8% in the NA group, 95.5% in the N group and 88.5% in the A group. Drug tolerance was excellent or good after all the treatments, except that the EA combination produced diarrhoea in 76.5% of patients. Overall analysis of the findings, including tolerance of the various treatments, showed that aminosidine either alone or in combination with nimorazole gave the best results. Ulcers seen on rectosigmoidoscopy were more common in patients excreting invasive forms of amoebae in their stools.
B. PROFESTAMBALEBENSON. "De Vuyst H, Gichangi P, Estambale B, Njuguna E, Franceschi S, Temmerman M.Human papillomavirus types in women with invasive cervical carcinoma by HIV status in Kenya. Int J Cancer. 2008 Jan 1;122(1):244-6.". In: Int J Cancer. 2008 Jan 1;122(1):244-6. Taylor & Francis; 2008. Abstract
To evaluate the fraction of invasive cervical carcinoma (ICC) that could be prevented in HIV-infected women by vaccines currently available against human papillomavirus (HPV)16 and 18, we conducted a cross-sectional study in women with ICC in Nairobi, Kenya. Fifty-one HIV-positive women were frequency-matched by age to 153 HIV-negative women. Cervical cells were tested for HPV DNA using polymerase chain reaction-based assays (SPF10-INNO-LiPA). Comparisons were adjusted for multiplicity of HPV types. As expected, multiple-type infections were much more frequent in HIV-positive (37.2%) than in HIV-negative (13.7%) women, but the distribution of HPV types was similar. HPV16 was detected in 41.2% versus 43.8% and HPV16 and/or 18 in 64.7% versus 60.1% of HIV-positive versus HIV-negative women, respectively. The only differences of borderline statistical significance were an excess of HPV52 (19.6% versus 5.2%) and a lack of HPV45 (7.8% versus 17.0%) in HIV-positive women compared to HIV-negative women, respectively. We have been able to assess an unprecedented number of ICCs in HIV-positive women, but as we did not know the age of HIV acquisition, we cannot exclude that it had occurred too late in life to affect the type of HPV involved in cervical carcinogenesis. However, if our findings were confirmed, they would suggest that the efficacy of current vaccines against HPV16 and 18 to prevent ICC is similar in HIV-positive and HIV-negative women, provided vaccination is administered before sexual debut, as recommended. Copyright 2007 Wiley-Liss, Inc.
B. PROFESTAMBALEBENSON. "A. Blackwell, A.E Stuart, B.A. Estambale (2003). The repellent and antifeedant activity of Myrica Gale oil against Aedes aegypti mosquitoes and its enhancement by the addition of salicyluric acid. J.R. Coll. Physicians Edinb. 33: 209 .". In: J.R. Coll. Physicians Edinb. 33: 209 . Taylor & Francis; 2003. Abstract
As part of a larger study on the effects of permethrin-impregnated bednets on the transmission of Wuchereria bancrofti, subjects from 12 villages in the Coastal province of Kenya, south of Mombasa, were investigated. The aims were to update the epidemiological data and elucidate the spatial distribution of W. bancrofti infection. Samples of night blood from all the villagers aged i 1 year were checked for the parasite, and all the adult villagers (aged >/= 15 years) were clinically examined for elephantiasis and, if male, for hydrocele. Overall, 16.0% of the 6531 villagers checked for microfilariae (mff) were found microfilaraemic, although the prevalence of microfilaraemia in each village varied from 8.1%-27.4%. The geometric mean intensity of infection among the microfilaraemic was 322 mff/ml blood. At village level, intensity of the microfilaraemia was positively correlated with prevalence, indicating that transmission has a major influence on the prevalence of microfilaraemia. Clinical examination of 2481 adults revealed that 2.9% had elephantiasis of the leg and that 19.9% of the adult men (10.8%-30.1% of the men investigated in each village) had hydrocele. Although the overall prevalence of microfilaraemia in the study villages had not changed much since earlier studies in the 1970s, both prevalence and intensity varied distinctly between the study villages. Such geographical variation over relatively short distances appears to be a common but seldom demonstrated feature in the epidemiology of bancroftian filariasis, and the focal nature of the geographical distribution should be carefully considered by those mapping the disease.
B. PROFESTAMBALEBENSON. "Protozoan infections and HIV-1 infection: a review. East Afr Med J. 1992 Jul;69(7):373-7.". In: East Afr Med J. 1992 Jul;69(7):373-7. Taylor & Francis; 1992. Abstract
Reactivation of latent infection is the principal mechanism relating Toxoplasma gondii and Pneumocystis carinii to HIV. Less common is reactivation in Leishmania donovani, Trypanosoma cruzi, and microsporidian infections. An impaired primary immune response occurs in all these infections, and also with Cryptosporidium and Isospora belli. Association of HIV infection with gut parasites including Giardia lamblia and Entamoeba histolytica, and also with Trichomonas vaginalis infection is likely to be related to sexual modes of contact that favour both HIV and the parasite. The severity of malaria is not definitely associated with HIV, but Plasmodium falciparum infection may favour more rapid evolution of the HIV infection. Both malaria and trichomoniasis favour HIV transmission; the former by necessitating blood transfusion, and the latter by enhancing viral transmission during sexual contact.
B. PROFESTAMBALEBENSON. "Alusala DN, Estambale BB, Magnussen P, Friis H, Luoba AI, Mwaniki D.Predictors of serum ferritin and haemoglobin during pregnancy, in a malaria-endemic area of western Kenya.Ann Trop Med Parasitol. 2008 Jun;102(4):297-308.". In: Ann Trop Med Parasitol. 2008 Jun;102(4):297-308. Taylor & Francis; 2008. Abstract
Between 2000 and 2004, a cross-sectional survey was conducted, as part of a prospective cohort study, among the women attending antenatal-care clinics in Bondo district, a malaria-endemic area of western Kenya. The aim was to assess the prevalence of iron deficiency and determine the predictors of haemoglobin and serum ferritin concentrations in the women who had a gestational age between 14 and 24 weeks. A standardized questionnaire was used to collect and store the relevant bio-data for the study. Haemoglobin and ferritin concentrations were evaluated, sickle-cell status was determined, and malarial parasitaemias were detected and evaluated, using blood samples collected at enrollment. Multiple regression analysis was then used to test for significant predictors of the haemoglobin and serum ferritin concentrations. Although 842 women were enrolled in the prospective cohort study, haemoglobin concentrations were evaluated for only 828 of them, serum ferritin levels for 621, and levels of parasitaemia for 812. The mean haemoglobin concentration recorded was 10.9 g/dl. Although 37.9% of the subjects had mild-moderate anaemia (7.0-10.5 g haemoglobin/dl), only 0.5% were severely anaemic (<7.0 g haemoglobin/dl). The geometric mean serum ferritin concentration recorded was 18.9 microg/litre, and 32.3% of the subjects evaluated had low serum concentrations of ferritin (<12 microg/litre). Among the parasitaemic primigravidae (but not the parasitaemic multigravidae), those found positive for sickle-cell trait had significantly lower haemoglobin concentrations than those found negative in a sickling test (P=0.01). Among the pregnant women of Bondo district, gravidity, malarial infection and sickle cell appear to be key predictors of haemoglobin concentration.
B. PROFESTAMBALEBENSON. "Clarke SE, Brooker S, Njagi JK, Njau E, Estambale B, Muchiri E, Magnussen P. Malaria morbidity among school children living in two areas of contrasting transmission in western Kenya. Am J Trop Med Hyg. 2004 Dec;71(6):732-8.". In: Am J Trop Med Hyg. 2004 Dec;71(6):732-8. Taylor & Francis; 2004. Abstract
Research in malaria-endemic areas is usually focused on malaria during early childhood. Less is known about malaria among older school age children. The incidence of clinical attacks of malaria was monitored, using active case detection in primary schools, in two areas of western Kenya that differ in the intensity of transmission. Clinical malaria was more common in schools in the Nandi highlands, with a six-fold higher incidence of malaria attacks during the malaria epidemic in 2002, compared with school children living in a holoendemic area with intense perennial transmission during the same period. The high incidence coupled with the high parasite densities among cases is compatible with a low level of protective immunity in the highlands. The malaria incidence among school children exposed to intense year-round transmission (26 per 100 school children per year) was consistent with reports from other holoendemic areas. Taken together with other published studies, the data suggest that malaria morbidity among school age children increases as transmission intensity decreases. The implications for malaria control are discussed.
B. PROFESTAMBALEBENSON. "Luoba AI, Wenzel Geissler P, Estambale B, Ouma JH, Alusala D, Ayah R, Mwaniki D, Magnussen P, Friis H. Earth-eating and reinfection with intestinal helminths among pregnant and lactating women in western Kenya. Trop Med Int Health. 2005 Mar;10(3):220-7.". In: Trop Med Int Health. 2005 Mar;10(3):220-7. Taylor & Francis; 2005. Abstract
We conducted a longitudinal study among 827 pregnant women in Nyanza Province, western Kenya, to determine the effect of earth-eating on geohelminth reinfection after treatment. The women were recruited at a gestational age of 14-24 weeks (median: 17) and followed up to 6 months postpartum. The median age was 23 (range: 14-47) years, the median parity 2 (range: 0-11). After deworming with mebendazole (500 mg, single dose) of those found infected at 32 weeks gestation, 700 women were uninfected with Ascaris lumbricoides, 670 with Trichuris trichiura and 479 with hookworm. At delivery, 11.2%, 4.6% and 3.8% of these women were reinfected with hookworm, T. trichiura and A. lumbricoides respectively. The reinfection rate for hookworm was 14.8%, for T. trichiura 6.65, and for A. lumbricoides 5.2% at 3 months postpartum, and 16.0, 5.9 and 9.4% at 6 months postpartum. There was a significant difference in hookworm intensity at delivery between geophagous and non-geophagous women (P=0.03). Women who ate termite mound earth were more often and more intensely infected with hookworm at delivery than those eating other types of earth (P=0.07 and P=0.02 respectively). There were significant differences in the prevalence of A. lumbricoides between geophagous and non-geophagous women at 3 (P=0.001) and at 6 months postpartum (P=0.001). Women who ate termite mound earth had a higher prevalence of A. lumbricoides, compared with those eating other kinds of earth, at delivery (P=0.02), 3 months postpartum (P=0.001) and at 6 months postpartum (P=0.001). The intensity of infections with T. trichiura at 6 months postpartum was significantly different between geophagous and non-geophagous women (P=0.005). Our study shows that geophagy is associated with A. lumbricoides reinfection among pregnant and lactating women and that intensities built up more rapidly among geophagous women. Geophagy might be associated with reinfection with hookworm and T. trichiura, although these results were less unequivocal. These findings call for increased emphasis, in antenatal care, on the potential risks of earth-eating, and for deworming of women after delivery.
B. PROFESTAMBALEBENSON. "Estambale BB, Simonsen PE, Vennervald BJ, Knight R, Bwayo JJ.Bancroftian filariasis in Kwale District of Kenya. III. Quantification of the IgE response in selected individuals from an endemic community.Ann Trop Med Parasitol. 1995 Jun;89(3):287-95.". In: Ann Trop Med Parasitol. 1995 Jun;89(3):287-95. Taylor & Francis; 1995. Abstract
One hundred and sixty-two individuals from a community in Kwale District, Kenya, endemic for bancroftian filariasis, were selected for a study on the IgE response to filarial antigen (prepared from adult Brugia pahangi). Following clinical and parasitological examination, the individuals were grouped into different categories, based on the presence/absence of microfilaraemia, the presence/absence of acute or chronic (hydrocele or elephantiasis) clinical manifestations, and age. The total and filarial-specific IgE responses were evaluated in all individuals, and the responses in the various categories were compared with each other and with the responses of control groups of individuals from filariasis-free areas. The majority of individuals from the endemic area had highly elevated serum concentrations of total IgE. Overall and within each clinical category, the concentration of total IgE was higher in those individuals from the endemic area who had microfilaraemias than in those that did not. The majority of individuals from the filariasis endemic area also had significantly elevated levels of filarial-specific IgE. In contrast, the concentration of specific IgE was lower in subjects with microfilariae than in those without, irrespective of their clinical status. Only a small proportion of total IgE was filarial-specific, the mean value varying from 0.4% to 9.8%, depending on category. Among the endemic individuals, the mean proportion of total IgE which was filarial-specific was 3.6 times higher in the microfilaria-negative than in the microfilaria-positive, indicating that much of the filarial-induced IgE in microfilaraemic individuals could be non-specific. No clear relationship was observed between the IgE response and the clinical manifestations or age of the endemic individuals.(ABSTRACT TRUNCATED AT 250 WORDS)
B. PROFESTAMBALEBENSON. "Jaoko WG, Simonsen PE, Meyrowitsch DW, Estambale BB, Malecela-Lazaro MN, Michael E.Filarial-specific antibody response in East African bancroftian filariasis: effects of host infection, clinical disease, and filarial endemicity.Am J Trop Med Hyg. 2006 Jul.". In: Am J Trop Med Hyg. 2006 Jul;75(1):97-107. Taylor & Francis; 2006. Abstract
The effect of host infection, chronic clinical disease, and transmission intensity on the patterns of specific antibody responses in Bancroftian filariasis was assessed by analyzing specific IgG1, IgG2, IgG3, IgG4, and IgE profiles among adults from two communities with high and low Wuchereria bancrofti endemicity. In the high endemicity community, intensities of the measured antibodies were significantly associated with infection status. IgG1, IgG2, and IgE were negatively associated with microfilaria (MF) status, IgG3 was negatively associated with circulating filarial antigen (CFA) status, and IgG4 was positively associated with CFA status. None of the associations were significantly influenced by chronic lymphatic disease status. In contrast, IgG1, IgG2, and IgG4 responses were less vigorous in the low endemicity community and, except for IgG4, did not show any significant associations with MF or CFA status. The IgG3 responses were considerably more vigorous in the low endemicity community than in the high endemicity one. Only IgG4 responses exhibited a rather similar pattern in the two communities, being significantly positively associated with CFA status in both communities. The IgG4:IgE ratios were higher in infection-positive individuals than in infection-negative ones, and higher in the high endemicity community than in the low endemicity one. Overall, these results indicate that specific antibody responses in Bancroftian filariasis are more related to infection status than to chronic lymphatic disease status. They also suggest that community transmissi
B. K, S.M. M, Ouko C. "Lessons Learned from Smallholder Agroforestry Project in Semi Arid Regions of Kenya." Agriculture, Ecosystems & Environment. 2013.
B. PROFESTAMBALEBENSON. "K. Fonck, N. Kidula, W. Jaoko, B. Estambale, P. Claeys, J. Ndinya-Achola, P. Kirui, J. Bwayo, M. Termmerman (2000). Validity of vaginal discharge algorithm among pregnant and non-pregnant women in Nairobi, Kenya. Sexually Transmitted Infections 76, 33-38.". In: Sexually Transmitted Infections 76, 33-38. Taylor & Francis; 2000. Abstract
Bancroftian filariasis infection, disease and specific antibody response patterns in a high and a low endemicity community in East Africa were analyzed and compared to assess the relationship between these parameters and community transmission intensity. Overall prevalences of microfilaremia and circulating filarial antigenemia were 24.9% and 52.2% in the high and 2.7% and 16.5% in the low endemicity community, respectively. A positive history of acute attacks of adenolymphangitis was given by 12.2% and 7.1% of the populations, 4.0% and 0.9% of the adult (> or = 20 years old) individuals presented with limb lymphedema, and 25.3% and 5.3% of the adult males had hydrocele, in the high and the low endemicity community, respectively. Both infection and disease appeared earlier and reached much higher levels in the high than in the low endemicity community. The observed overall and age-specific infection and disease patterns in the two communities were in agreement with the view that these are primarily shaped by transmission intensity. No statistically significant relationships between infection status of fathers and mothers and that of their children were observed in any of the communities for either microfilaremia or for circulating filarial antigenemia. The overall levels (prevalence and geometric mean intensity) of filarial-specific IgG1, IgG2, IgG4, and IgE were significantly higher in the high endemicity community than in the low endemicity dommunity. Surprisingly, the opposite pattern was found for IgG3. Community transmission intensity thus appears to be an important determinant of observed inter-community variation in infection, disease, and host response patterns in Bancroftian filariasis.
B. PROFESTAMBALEBENSON. "Estambale BB, Howells RE.The efficacy of 22,23-dihydroavermectin B1 (Ivermectin) acting singly or in combination with a benzodiazepine on microfilariae of Onchocerca species and Brugia pahangi (an in vitro study).Zentralbl Bakteriol. 1989 Jul;271(2):249-5.". In: Zentralbl Bakteriol. 1989 Jul;271(2):249-55. Taylor & Francis; 1989. Abstract
An in vitro study of the antinematodal action of two groups of compounds which act on the receptor complex of the inhibitory neurotransmitter, Gamma-aminobutyric acid (GABA) in mammalian systems is described. The compounds, Ivermectin and two benzodiazepines, Diazepam and a water soluble Midazolam were tested singly or in combination against two microfilarial parasites Onchocerca lienalis (closely related to Onchocerca volvulus) and Brugia pahangi. The combination of ivermectin and diazepam at a concentration of 0.1 microgram/ml and 33 micrograms/ml respectively achieved the same effect on microfilarial motility as when ivermectin was given at 1 microgram/ml alone or diazepam at 66 micrograms/ml alone. Similarly when the combination of ivermectin at 0.1 microgram/ml and midazolam at 10 micrograms/ml was used it achieved the same effect as ivermectin at 1 microgram/ml alone or midazolam at 33 micrograms/ml alone. This showed that both benzodiazepines had a synergistic effect on the activity of ivermectin. The microfilariae of B. pahangi were insensitive to both groups of compounds at all concentrations used.
B. PROFESTAMBALEBENSON. "Jaoko WG, Michael E, Meyrowitsch DW, Estambale BB, Malecela MN, Simonsen PE.Immunoepidemiology of Wuchereria bancrofti infection: parasite transmission intensity, filaria-specific antibodies, and host immunity in two East African communities. Infect Immun.". In: Infect Immun. 2007 Dec;75(12):5651-62. Epub 2007 Oct 1. Taylor & Francis; 2007. Abstract
We compared the age profiles of infection and specific antibody intensities in two communities with different transmission levels in East Africa to examine the contribution of humoral responses to human immunity to the vector-borne helminth Wuchereria bancrofti. The worm intensities were higher and exhibited a nonlinear age pattern in a high-transmission community, Masaika, in contrast to the low but linearly increasing age infection profile observed for a low-transmission community, Kingwede. The mean levels of specific immunoglobulin G1 (IgG1), IgG2, IgG4, and IgE were also higher in Masaika, but intriguingly, the IgG3 response was higher in Kingwede. The age-antibody patterns differed in the two communities but in a manner apparently contrary to a role in acquired immunity when the data were assessed using simple correlation methods. By contrast, multivariate analyses showed that the antibody response to infection may be classified into three types and that two of these types, a IgG3-type response and a response measuring a trade-off in host production of IgG4 and IgG3 versus production of IgG1, IgG2, and IgE, had a negative effect on Wuchereria circulating antigen levels in a manner that supported a role for these responses in the generation of acquired immunity to infection. Mathematical modeling supported the conclusions drawn from empirical data analyses that variations in both transmission and worm intensity can explain community differences in the age profiles and impacts of these antibody response types. This study showed that parasite-specific antibody responses may be associated with the generation of acquired immunity to human filarial infection but in a form which is dependent on worm transmission intensity and interactions between immune components.
B. PROFESTAMBALEBENSON. "P. Gichangi, H. De Vyust, P. Claeys, B. Estambale, J. Bwayo, K. Rogo, M. Temmerman (2002). HIV and cervical cancer in Kenya: A 10 year retrospective study at Kenyatta National Hospital. Int. J Gynaecol Obst. 76 (1), 55-63.". In: Int. J Gynaecol Obst. 76 (1), 55-63. Taylor & Francis; 2002. Abstract
As part of a larger study on the effects of permethrin-impregnated bednets on the transmission of Wuchereria bancrofti, subjects from 12 villages in the Coastal province of Kenya, south of Mombasa, were investigated. The aims were to update the epidemiological data and elucidate the spatial distribution of W. bancrofti infection. Samples of night blood from all the villagers aged i 1 year were checked for the parasite, and all the adult villagers (aged >/= 15 years) were clinically examined for elephantiasis and, if male, for hydrocele. Overall, 16.0% of the 6531 villagers checked for microfilariae (mff) were found microfilaraemic, although the prevalence of microfilaraemia in each village varied from 8.1%-27.4%. The geometric mean intensity of infection among the microfilaraemic was 322 mff/ml blood. At village level, intensity of the microfilaraemia was positively correlated with prevalence, indicating that transmission has a major influence on the prevalence of microfilaraemia. Clinical examination of 2481 adults revealed that 2.9% had elephantiasis of the leg and that 19.9% of the adult men (10.8%-30.1% of the men investigated in each village) had hydrocele. Although the overall prevalence of microfilaraemia in the study villages had not changed much since earlier studies in the 1970s, both prevalence and intensity varied distinctly between the study villages. Such geographical variation over relatively short distances appears to be a common but seldom demonstrated feature in the epidemiology of bancroftian filariasis, and the focal nature of the geographical distribution should be carefully considered by those mapping the disease.
B. PROFESTAMBALEBENSON. "A study of the efficacy and safety of albendazole (Zentel) in the treatment of intestinal helmenthiasis in Kenyan children less than 2 years of age. East Afr Med J. 1989 Mar;66(3):197-202.". In: East Afr Med J. 1989 Mar;66(3):197-202. Taylor & Francis; 1989. Abstract
One hundred children comprising of 57 males and 43 females aged between 8 and 24 months entered the study. 46 children had single and 54 children had multiple helminth infections. All children received albendazole 200 mg (10 ml) suspension as a single dose. Albendazole proved very effective and safe in the treatment of single and multiple helminth infections in children under 2 years of age, achieving cure rates of 100% in both Ascaris lumbricoides and Necator americanus respectively, 83% in Trichuris trichiura and 66% in Hymenolepis nana. Treatment of polyparasitism appears to be of benefit in improving nutritional status using haemoglobin concentrations as an index.
B. PROFESTAMBALEBENSON. "Temperley M, Mueller DH, Njagi JK, Akhwale W, Clarke SE, Jukes MC, Estambale BB, Brooker S.Costs and cost-effectiveness of delivering intermittent preventive treatment through schools in western Kenya.Malar J. 2008 Sep 30;7:196.". In: Malar J. 2008 Sep 30;7:196. Taylor & Francis; 2008. Abstract
BACKGROUND: Awareness of the potential impact of malaria among school-age children has stimulated investigation into malaria interventions that can be delivered through schools. However, little evidence is available on the costs and cost-effectiveness of intervention options. This paper evaluates the costs and cost-effectiveness of intermittent preventive treatment (IPT) as delivered by teachers in schools in western Kenya. METHODS: Information on actual drug and non-drug associated costs were collected from expenditure and salary records, government budgets and interviews with key district and national officials. Effectiveness data were derived from a cluster-randomised-controlled trial of IPT where a single dose of sulphadoxine-pyrimethamine and three daily doses of amodiaquine were provided three times in year (once termly). Both financial and economic costs were estimated from a provider perspective, and effectiveness was estimated in terms of anaemia cases averted. A sensitivity analysis was conducted to assess the impact of key assumptions on estimated cost-effectiveness. RESULTS: The delivery of IPT by teachers was estimated to cost US$ 1.88 per child treated per year, with drug and teacher training costs constituting the largest cost components. Set-up costs accounted for 13.2% of overall costs (equivalent to US$ 0.25 per child) whilst recurrent costs accounted for 86.8% (US$ 1.63 per child per year). The estimated cost per anaemia case averted was US$ 29.84 and the cost per case of Plasmodium falciparum parasitaemia averted was US$ 5.36, respectively. The cost per case of anaemia averted ranged between US$ 24.60 and 40.32 when the prices of antimalarial drugs and delivery costs were varied. Cost-effectiveness was most influenced by effectiveness of IPT and the background prevalence of anaemia. In settings where 30% and 50% of schoolchildren were anaemic, cost-effectiveness ratios were US$ 12.53 and 7.52, respectively. CONCLUSION: This study provides the first evidence that IPT administered by teachers is a cost-effective school-based malaria intervention and merits investigation in other settings.
B. PROFESTAMBALEBENSON. "P.Gichangi, B. Estambale, J. Bwayo, K. Rogo, A. Opiyo, M. Temmerman (2003). Knowledge and practice about cervical cancer and Pap smear testing among patients at Kenyatta National Hospital Nairobi, Kenya. Int. J. Gynecol. Cancer. 13: 1 .". In: Int. J. Gynecol. Cancer. 13: 1 . Taylor & Francis; 2003. Abstract
As part of a larger study on the effects of permethrin-impregnated bednets on the transmission of Wuchereria bancrofti, subjects from 12 villages in the Coastal province of Kenya, south of Mombasa, were investigated. The aims were to update the epidemiological data and elucidate the spatial distribution of W. bancrofti infection. Samples of night blood from all the villagers aged i 1 year were checked for the parasite, and all the adult villagers (aged >/= 15 years) were clinically examined for elephantiasis and, if male, for hydrocele. Overall, 16.0% of the 6531 villagers checked for microfilariae (mff) were found microfilaraemic, although the prevalence of microfilaraemia in each village varied from 8.1%-27.4%. The geometric mean intensity of infection among the microfilaraemic was 322 mff/ml blood. At village level, intensity of the microfilaraemia was positively correlated with prevalence, indicating that transmission has a major influence on the prevalence of microfilaraemia. Clinical examination of 2481 adults revealed that 2.9% had elephantiasis of the leg and that 19.9% of the adult men (10.8%-30.1% of the men investigated in each village) had hydrocele. Although the overall prevalence of microfilaraemia in the study villages had not changed much since earlier studies in the 1970s, both prevalence and intensity varied distinctly between the study villages. Such geographical variation over relatively short distances appears to be a common but seldom demonstrated feature in the epidemiology of bancroftian filariasis, and the focal nature of the geographical distribution should be carefully considered by those mapping the disease.
B. PROFESTAMBALEBENSON. "Estambale BB, Knight R, Chunge R.HaematemTrans R Soc Trop Med Hyg. 1992 Jul-Aug;86(4):458.". In: Trans R Soc Trop Med Hyg. 1992 Jul-Aug;86(4):458. Taylor & Francis; 1992. Abstract
Reactivation of latent infection is the principal mechanism relating Toxoplasma gondii and Pneumocystis carinii to HIV. Less common is reactivation in Leishmania donovani, Trypanosoma cruzi, and microsporidian infections. An impaired primary immune response occurs in all these infections, and also with Cryptosporidium and Isospora belli. Association of HIV infection with gut parasites including Giardia lamblia and Entamoeba histolytica, and also with Trichomonas vaginalis infection is likely to be related to sexual modes of contact that favour both HIV and the parasite. The severity of malaria is not definitely associated with HIV, but Plasmodium falciparum infection may favour more rapid evolution of the HIV infection. Both malaria and trichomoniasis favour HIV transmission; the former by necessitating blood transfusion, and the latter by enhancing viral transmission during sexual contact.
B. PROFESTAMBALEBENSON. "Brooker S, Akhwale W, Pullan R, Estambale B, Clarke SE, Snow RW, Hotez PJ.Epidemiology of plasmodium-helminth co-infection in Africa: populations at risk, potential impact on anemia, and prospects for combining control.Am J Trop Med Hyg. 2007 Dec;77(6 Sup.". In: Am J Trop Med Hyg. 2007 Dec;77(6 Suppl):88-98. Taylor & Francis; 2008. Abstract
Human co-infection with Plasmodium falciparum and helminths is ubiquitous throughout Africa, although its public health significance remains a topic for which there are many unknowns. In this review, we adopted an empirical approach to studying the geography and epidemiology of co-infection and associations between patterns of co-infection and hemoglobin in different age groups. Analysis highlights the extensive geographic overlap between P. falciparum and the major human helminth infections in Africa, with the population at coincident risk of infection greatest for hookworm. Age infection profiles indicate that school-age children are at the highest risk of co-infection, and re-analysis of existing data suggests that co-infection with P. falciparum and hookworm has an additive impact on hemoglobin, exacerbating anemia-related malarial disease burden. We suggest that both school-age children and pregnant women–groups which have the highest risk of anemia–would benefit from an integrated approach to malaria and helminth control.
B. PROFESTAMBALEBENSON. "Mukoko DA, Pedersen EM, Masese NN, Estambale BB, Ouma JH. Bancroftian filariasis in 12 villages in Kwale district, Coast province, Kenya - variation in clinical and parasitological patterns. Ann Trop Med Parasitol. 2004 Dec;98(8):801-15.". In: Ann Trop Med Parasitol. 2004 Dec;98(8):801-15. Taylor & Francis; 2004. Abstract
As part of a larger study on the effects of permethrin-impregnated bednets on the transmission of Wuchereria bancrofti, subjects from 12 villages in the Coastal province of Kenya, south of Mombasa, were investigated. The aims were to update the epidemiological data and elucidate the spatial distribution of W. bancrofti infection. Samples of night blood from all the villagers aged i 1 year were checked for the parasite, and all the adult villagers (aged >/= 15 years) were clinically examined for elephantiasis and, if male, for hydrocele. Overall, 16.0% of the 6531 villagers checked for microfilariae (mff) were found microfilaraemic, although the prevalence of microfilaraemia in each village varied from 8.1%-27.4%. The geometric mean intensity of infection among the microfilaraemic was 322 mff/ml blood. At village level, intensity of the microfilaraemia was positively correlated with prevalence, indicating that transmission has a major influence on the prevalence of microfilaraemia. Clinical examination of 2481 adults revealed that 2.9% had elephantiasis of the leg and that 19.9% of the adult men (10.8%-30.1% of the men investigated in each village) had hydrocele. Although the overall prevalence of microfilaraemia in the study villages had not changed much since earlier studies in the 1970s, both prevalence and intensity varied distinctly between the study villages. Such geographical variation over relatively short distances appears to be a common but seldom demonstrated feature in the epidemiology of bancroftian filariasis, and the focal nature of the geographical distribution should be carefully considered by those mapping the disease.
B. PROFESTAMBALEBENSON. "Estambale BB, Simonsen PE, Vennervald BJ, Knight R, Bwayo JJ.Bancroftian filariasis in Kwale District of Kenya. II. Humoral immune responses to filarial antigens in selected individuals from an endemic community.Ann Trop Med Parasitol. 1994 Apr;88(2):153-.". In: Ann Trop Med Parasitol. 1994 Apr;88(2):153-61. Taylor & Francis; 1994. Abstract
Humoral immune responses to filarial infection were investigated in 162 individuals, covering the full clinical and parasitological spectrum of bancroftian filariasis as seen in an endemic community of Kwale District, Kenya. Sera were tested for specific antifilarial antibodies (total immunoglobulins, IgM, IgGl, IgG4 and IgE) using ELISA. Most individuals showed an immunological response to the filarial antigen (prepared from adult Brugia pahangi). How these responses were related to the clinical manifestations, parasitological status and age was analysed by comparing the mean antibody levels among different categories of endemic individuals, and by comparing these to the levels in control groups from filariasis-free areas. IgM and IgE anti-filarial antibodies were detected with low specificity in unabsorbed sera. A higher specificity, clearly distinguishing the mean antibody levels in the endemic categories from those of control groups, was obtained for total specific immunoglobulins, and for IgE in sera absorbed with protein A. The most specific results were obtained for IgGl and IgG4; clear inter-category differences were observed for these classes. The mean level of specific IgG4 was significantly higher in microfilaraemic groups than in amicrofilaraemic groups, whereas the mean level of specific IgGl was significantly higher in amicrofilaraemic, symptomatic cases than in microfilaraemic, symptomatic cases. In most categories of endemic individuals, and for most antibody isotypes, the mean levels of specific antibodies tended to be higher (although not significantly) in the younger individuals than in the older individuals. Overall, the differences in the filarial antibody responses were more closely related to the presence or absence of microfilariae and to the age of the individuals than to the disease manifestations in this endemic population.
B. PROFESTAMBALEBENSON. "S. Brooker, S. Clarke, JK Njagi, S. Polack, B. Mugo, B. Estambale, E. Muchiri, P. Magnussen, J. Cox (2004). Spatial clustering of malaria and associated risk factors during an epidemic in a highland area of western Kenya. Trop Med & Int. Health 9 (7) 757 .". In: Trop Med & Int. Health 9 (7) 757 . Taylor & Francis; 2004. Abstract
We conducted a longitudinal study among 827 pregnant women in Nyanza Province, western Kenya, to determine the effect of earth-eating on geohelminth reinfection after treatment. The women were recruited at a gestational age of 14-24 weeks (median: 17) and followed up to 6 months postpartum. The median age was 23 (range: 14-47) years, the median parity 2 (range: 0-11). After deworming with mebendazole (500 mg, single dose) of those found infected at 32 weeks gestation, 700 women were uninfected with Ascaris lumbricoides, 670 with Trichuris trichiura and 479 with hookworm. At delivery, 11.2%, 4.6% and 3.8% of these women were reinfected with hookworm, T. trichiura and A. lumbricoides respectively. The reinfection rate for hookworm was 14.8%, for T. trichiura 6.65, and for A. lumbricoides 5.2% at 3 months postpartum, and 16.0, 5.9 and 9.4% at 6 months postpartum. There was a significant difference in hookworm intensity at delivery between geophagous and non-geophagous women (P=0.03). Women who ate termite mound earth were more often and more intensely infected with hookworm at delivery than those eating other types of earth (P=0.07 and P=0.02 respectively). There were significant differences in the prevalence of A. lumbricoides between geophagous and non-geophagous women at 3 (P=0.001) and at 6 months postpartum (P=0.001). Women who ate termite mound earth had a higher prevalence of A. lumbricoides, compared with those eating other kinds of earth, at delivery (P=0.02), 3 months postpartum (P=0.001) and at 6 months postpartum (P=0.001). The intensity of infections with T. trichiura at 6 months postpartum was significantly different between geophagous and non-geophagous women (P=0.005). Our study shows that geophagy is associated with A. lumbricoides reinfection among pregnant and lactating women and that intensities built up more rapidly among geophagous women. Geophagy might be associated with reinfection with hookworm and T. trichiura, although these results were less unequivocal. These findings call for increased emphasis, in antenatal care, on the potential risks of earth-eating, and for deworming of women after delivery.
B. O, A. M, A. W. "Maternal Health; Kenya National Bureau of Statistics (KNBS) and ICF Macro.". In: Maternal Health. Calverton, Maryland: KNBS and ICF Macro.; 2010.
B. PROFESTAMBALEBENSON. "Gichangi P, Estambale B, Bwayo J, Rogo K, Ojwang S, Njuguna E, Temmerman M.Acceptability of human immunodeficiency virus testing in patients with invasive cervical cancer in Kenya.Int J Gynecol Cancer. 2006 Mar-Apr;16(2):681-5.". In: Int J Gynecol Cancer. 2006 Mar-Apr;16(2):681-5. Taylor & Francis; 2006. Abstract
Invasive cervical cancer (ICC) is common in areas where human immunodeficiency virus (HIV) is also prevalent. Currently, HIV seroprevalence as well as acceptability of HIV testing in ICC patients in Kenya is unknown. The objective of this study was to determine the acceptability of HIV testing among patients with ICC. Women with histologically verified ICC at Kenyatta National Hospital participated in the study. A structured questionnaire was administered to patients who gave informed consent. HIV pre- and posttesting counseling was done. Blood was tested for HIV using enzyme-linked immunosorbent assay. Overall, 11% of ICC patients were HIV seropositive. The acceptance rate of HIV testing was 99%; yet, 5% of the patients did not want to know their HIV results. Patients less than 35 years old were two times more likely to refuse the result of the HIV test (odds ratio [OR] 2.2). Patients who did not want to know their HIV results were three times more likely to be HIV seropositive (OR 3.1). Eighty four percent of the patients were unaware of their HIV seropositive status. The HIV-1 seroprevalence in ICC patients was comparable to the overall seroprevalence in Kenya. ICC patients were interested in HIV testing following pretest counseling. Offering routine HIV testing is recommended in ICC patients.
B. N. "Protecting Archaeological Heritage in Kenya." a management challenge International Journal of social sciences. 2010;Vol 2. No 1.
B. PROFESTAMBALEBENSON. "Mirza NB, Estambale BB, Wamola IA, Kariuki N, Onyono E, Kabiru P, Piollet M.Bacterial meningitis in children admitted in hospitals within Nairobi.East Afr Med J. 1998 Feb;75(2):73-6.". In: East Afr Med J. 1998 Feb;75(2):73-6. Taylor & Francis; 1998. Abstract
Four hundred and ninety nine children (aged between one month and five years) admitted with clinical features of meningitis were recruited in cross-sectional survey of bacterial meningitis in hospitals within Nairobi. Lumbar punctures were done on all of them and the cerebrospinal fluid (CSF) analysed bacteriologically and serologically for the common causative organisms. Two hundred and fifty (50.1%) cases were diagnosed clinically as having meningitis. Of these, 132 (52.8%) had turbid CSF specimens, while 118 (47.2%) were clear. When turbid CSF specimens were cultured, 83 (62.8%) yielded three common bacterial micro-organisms namely; Neisseria meningitidis, Streptococcus pneumoniae and Haemophilus influenzae in that order of frequency. The implications of these findings in paediatric meningitis together with the drug sensitivity patterns is presented and discussed.
B. PROFESTAMBALEBENSON. "Pathogenicity of Trichomonas hominis in Kenya. East Afr Med J. 1988 Aug;65(8):532-4.". In: East Afr Med J. 1988 Aug;65(8):532-4. Taylor & Francis; 1988. Abstract
An in vitro study of the antinematodal action of two groups of compounds which act on the receptor complex of the inhibitory neurotransmitter, Gamma-aminobutyric acid (GABA) in mammalian systems is described. The compounds, Ivermectin and two benzodiazepines, Diazepam and a water soluble Midazolam were tested singly or in combination against two microfilarial parasites Onchocerca lienalis (closely related to Onchocerca volvulus) and Brugia pahangi. The combination of ivermectin and diazepam at a concentration of 0.1 microgram/ml and 33 micrograms/ml respectively achieved the same effect on microfilarial motility as when ivermectin was given at 1 microgram/ml alone or diazepam at 66 micrograms/ml alone. Similarly when the combination of ivermectin at 0.1 microgram/ml and midazolam at 10 micrograms/ml was used it achieved the same effect as ivermectin at 1 microgram/ml alone or midazolam at 33 micrograms/ml alone. This showed that both benzodiazepines had a synergistic effect on the activity of ivermectin. The microfilariae of B. pahangi were insensitive to both groups of compounds at all concentrations used.
B. PROFESTAMBALEBENSON. "Orech FO, Christensen DL, Larsen T, Friis H, Aagaard-Hansen J, Estambale BA.Mineral content of traditional leafy vegetables from western Kenya.Int J Food Sci Nutr. 2007 Dec;58(8):595-602.". In: Int J Food Sci Nutr. 2007 Dec;58(8):595-602. Taylor & Francis; 2007. Abstract

Socio-economic changes that have taken place in Africa have influenced people's eating habits in both rural and urban set-ups. Most people prefer introduced foods to traditional foods, including plant foods whose consumption is widely regarded as a primitive culture manifesting poor lifestyles. However, recent studies on traditional plant foods have shown that some are highly nutritious; containing high levels of both vitamins and minerals. They also have potential as a remedy to counter food insecurity since most are well adapted to the local environment, enabling them to resist pests, drought and diseases. This paper describes the mineral (calcium, iron and zinc) contents in some 54 traditional vegetable species collected from Nyang'oma area of Bondo district, western Kenya. Atomic absorption spectroscopy was used to determine the mineral content. We found that most traditional leafy vegetables, domesticated and wild, generally contain higher levels of calcium, iron and zinc compared with the introduced varieties such as spinach (Spanacia oleracea), kale (Brassica oleracea var. acephala) and cabbage (Brassica oleracea var. capitata). The results of this study could contribute towards identification, propagation and subsequent domestication and cultivation promotion of nutrient-rich and safe species within the farming systems of the local communities in Kenya, sub-Saharan Africa or elsewhere.

B. PROFESTAMBALEBENSON. "Simonsen PE, Meyrowitsch DW, Jaoko WG, Malecela MN, Mukoko D, Pedersen EM, Ouma JH, Rwegoshora RT, Masese N, Magnussen P, Estambale BB, Michael E.Bancroftian filariasis infection, disease, and specific antibody response patterns in a high and a low endemi.". In: Am J Trop Med Hyg. 2002 May;66(5):550-9. Taylor & Francis; 2002. Abstract
Bancroftian filariasis infection, disease and specific antibody response patterns in a high and a low endemicity community in East Africa were analyzed and compared to assess the relationship between these parameters and community transmission intensity. Overall prevalences of microfilaremia and circulating filarial antigenemia were 24.9% and 52.2% in the high and 2.7% and 16.5% in the low endemicity community, respectively. A positive history of acute attacks of adenolymphangitis was given by 12.2% and 7.1% of the populations, 4.0% and 0.9% of the adult (> or = 20 years old) individuals presented with limb lymphedema, and 25.3% and 5.3% of the adult males had hydrocele, in the high and the low endemicity community, respectively. Both infection and disease appeared earlier and reached much higher levels in the high than in the low endemicity community. The observed overall and age-specific infection and disease patterns in the two communities were in agreement with the view that these are primarily shaped by transmission intensity. No statistically significant relationships between infection status of fathers and mothers and that of their children were observed in any of the communities for either microfilaremia or for circulating filarial antigenemia. The overall levels (prevalence and geometric mean intensity) of filarial-specific IgG1, IgG2, IgG4, and IgE were significantly higher in the high endemicity community than in the low endemicity dommunity. Surprisingly, the opposite pattern was found for IgG3. Community transmission intensity thus appears to be an important determinant of observed inter-community variation in infection, disease, and host response patterns in Bancroftian filariasis.
B. Adelaide, Ogutu O, Mutungi A. "The prevalence of glucose intolerance among antenatal clients at Kenyatta Nnational hospital at 24-36 weeks of gestation." East African Medical Journal . 2011;Vol. 88 (No.9).
B.A.Kimeto. Pathology and Pathogenesis of Trypanosoma Vivax Infection in Cattle. Nairobi: University Of Nairobi; 1989.thesis..pdf
B.E O, V.N M, Z.B A, G W. "Organizational Resources, Innovation and Performance of Insurance Companies in Kenya." 1st DBA Africa Management Review International conference ( 2015). 2015;1(1).
B.Irungu M, Mwangi CG, Njenga KP, K. M. "Impact of Sociocultural factors on adoption of modern technologies in beekeeping projects among women groups in Kajiado County- Kenya." International Journal for Innovation Education and Research. 2016;4(4):55-64.
B.L. A, Onyango CM, Kathumo VM, Onwonga RN, Karuku GN. "Climate Change Effects on Crop Production in Yatta sub-County: Farmer Perceptions and Adaptation Strategies." African Journal of Food, Agriculture, Nutrition and Development. 2019;19(1):14010-14042.
B.MUTSOTSO, E.M. MUYA. "CHARACTERISTICS OF BELOW -GROUND BIODIVERSITY SITES IN KENYA:THEIR CONSTRANTS ,INTERVENTIONS AND EMERGING ISSUES." Tropical and Subtropical Agroecosystems. 2008:991-1003.

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