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Web-based learning systems give students the freedom to determine what to study based on each individual learner’s learning goals. These systems support learners in constructing their own knowledge for solving problems at hand. However, in the absence of instructors, learners often need to be supported as they learn in ways that are tailored to suit a specific learner. Adaptive web-based learning systems fit in such situations. In order for an adaptive learning system to be able to provide learning support, it needs to build a model of each individual learner and then to use the attribute values for each learner as stored in the model to determining the kind of learning support that is suitable for each learner. Examples of such attributes are learner knowledge level, learning styles and learner errors committed by learners during learning. There are two important issues about the use of learner models. Firstly, how to initialize the attributes in the learner models and secondly, how to update the attribute values of the learner model as learners interact with the learning system. With regard to initialization of learner models, one of the approaches used is to input into a machine learning algorithm attribute values of learners who are already using the system and who are similar (hence called neighbors) to the learner whose model is being initialized. The algorithm will use these values to predict initial values for the attributes of a new learner. Similarity among learners is often expressed as the distance from one learner to another. This distance is often determined using a heterogeneous function of Euclidean and Overlap measures (HOEM). This paper reports the results of an investigation on how HOEM compares to two different variations of Value Difference Metric (VDM) combined with the Euclidean measure (HVDM) using different numbers of neighbors. An adaptive web-based learning system teaching object oriented programming was used. HOEM was found to be more accurate than the two variations of HVDM

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Background:
Marine invertebrates rely solely on innate immune mechanisms, the cellular component of which is characterized by hemocytes that phagocytize microbes and secrete soluble antimicrobial and cytotoxic substances. In this regard, marine invertebrates are a potential source of promising antimicrobial compounds with novel mechanisms of action.
Objective:
The objective of this study was to evaluate extracts of the gut, gonad, spines and mouth parts of the sea urchin Tripneustes gratilla for antimicrobial and haemolytic activities in vitro.
Methods:
Potentially bioactive metabolites were extracted using methanol and chloroform and tested for activity against Salmonella typhi, Escherichia coli, Shigella sonnei, Pseudomonas aeruginosa and Penicillium spp. using the agar disc diffusion method. Toxicity was determined by assaying for hemolysis against human red blood cells.
Results:
Bioactivity against the tested bacteria was observed mainly with the methanol and chloroform extracts of the gonads and gut. Higher antibacterial activity was present in the methanol extracts compared to chloroform extracts. Activity against the Penicillium spp was detected only in the methanol extracts, while the chloroform extracts showed no activity. The various extracts of the sea urchin lacked any detectable hemolytic activity against human erythrocytes.
Discussion:
These research findings suggest that marine echinoderms are a potential source of novel antimicrobial compounds.
Key words:
Tripneustes gratilla, antimicrobial activity, marine invertebrates

14.00 800x600 Normal 0 false false false EN-GB X-NONE X-NONE MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Calibri","sans-serif"; mso-bidi-font-family:"Times New Roman";} Variant anatomy of the superior thyroid artery is important during surgical procedures, interpretation of angiograms, and interventional radiography in the neck. Pattern of the variations shows population differences but there is no data from the Kenyan population. This study therefore investigated the variations in origin of the superior thyroid artery in a Kenyan population. Forty six necks (36 males and 10 females) from 46 cadavers of black Kenyans in Department of Human Anatomy University of Nairobi, Kenya were bilaterally dissected to expose the origin of the superior thyroid artery. Pattern of origin of the vessel was determined on both sides in males and females. It originated from the external carotid artery common carotid artery and linguo-facial trunk in 80%, 13% and 6.5% of the cadavers respectively on the right side. All but one of the superior thyroid arteries were ventral branches. There was asymmetric origin in 6.5% of cases. Origin from the common carotid artery was associated with high carotid bifurcation. Nearly 20% of superior thyroid arteries showed variant origin. Of these, 6.5% arose from the linguo-facial trunk, much higher than in the Caucasian and Oriental populations. Origin from common carotid artery is substantially lower than prevailing figures from other populations. These findings support ethnic variations. Preoperative angiographic evaluation is recommended.

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

14.00 800x600 Normal 0 false false false EN-GB X-NONE X-NONE MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Calibri","sans-serif"; mso-bidi-font-family:"Times New Roman";} Variant anatomy of the superior thyroid artery is important during surgical procedures, interpretation of angiograms, and interventional radiography in the neck. Pattern of the variations shows population differences but there is no data from the Kenyan population. This study therefore investigated the variations in origin of the superior thyroid artery in a Kenyan population. Forty six necks (36 males and 10 females) from 46 cadavers of black Kenyans in Department of Human Anatomy University of Nairobi, Kenya were bilaterally dissected to expose the origin of the superior thyroid artery. Pattern of origin of the vessel was determined on both sides in males and females. It originated from the external carotid artery common carotid artery and linguo-facial trunk in 80%, 13% and 6.5% of the cadavers respectively on the right side. All but one of the superior thyroid arteries were ventral branches. There was asymmetric origin in 6.5% of cases. Origin from the common carotid artery was associated with high carotid bifurcation. Nearly 20% of superior thyroid arteries showed variant origin. Of these, 6.5% arose from the linguo-facial trunk, much higher than in the Caucasian and Oriental populations. Origin from common carotid artery is substantially lower than prevailing figures from other populations. These findings support ethnic variations. Preoperative angiographic evaluation is recommended.

14.00 800x600 Normal 0 false false false EN-GB X-NONE X-NONE MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Calibri","sans-serif"; mso-bidi-font-family:"Times New Roman";} Variant anatomy of the superior thyroid artery is important during surgical procedures, interpretation of angiograms, and interventional radiography in the neck. Pattern of the variations shows population differences but there is no data from the Kenyan population. This study therefore investigated the variations in origin of the superior thyroid artery in a Kenyan population. Forty six necks (36 males and 10 females) from 46 cadavers of black Kenyans in Department of Human Anatomy University of Nairobi, Kenya were bilaterally dissected to expose the origin of the superior thyroid artery. Pattern of origin of the vessel was determined on both sides in males and females. It originated from the external carotid artery common carotid artery and linguo-facial trunk in 80%, 13% and 6.5% of the cadavers respectively on the right side. All but one of the superior thyroid arteries were ventral branches. There was asymmetric origin in 6.5% of cases. Origin from the common carotid artery was associated with high carotid bifurcation. Nearly 20% of superior thyroid arteries showed variant origin. Of these, 6.5% arose from the linguo-facial trunk, much higher than in the Caucasian and Oriental populations. Origin from common carotid artery is substantially lower than prevailing figures from other populations. These findings support ethnic variations. Preoperative angiographic evaluation is recommended.

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Separation of midgut membrane proteins from the tick, Ambylomma variegatum, using a nonionic detergent (Triton X-114), resulted in two protein fractions, namely DET (detergent) and AQ (aqueous). In immunoblotting analysis with polyclonal antibodies against these fractions, 4 proteins (Mr approximately 27,000, 67,000, 86,000 and 95,000,) and 2 proteins (M, approximately 54,000 and 67,000) were detected in the DET and AQ fractions, respectively. Three of the DET fraction proteins Mr approximately 27,000, 67,000 and 95,000 were glycosylated since they bound to the lectin, concanavalin A. In 2-dimensional gel electrophoresis, the AQ and DET fraction proteins were found to be acidic in nature. In a series of bioassay experiments, rabbits were first immunised with both DET and AQ fractions and then infested with ticks. The egg batch weights of these ticks were reduced by 50% compared to control ticks. Furthermore, there was a significant reduction in the hatchability of eggs laid by ticks fed on rabbits previously immunised with both DET (14%) and AQ (33%) fractions. Based on the egg hatchability, the reproductive capacity of ticks was reduced by 77 and 48% by DET and AQ fractions, respectively.

The pattern of formation of the rectus sheath from the aponeuroses of external oblique, internal oblique, and transversus abdominis muscles shows regional variations. These variations may influence the microscopic organisation of the rectus sheath. Specimens were collected during autopsies from thirty one subjects (16 male, 15 female) aged 18-70 years old. The rectus sheath was exposed through gentle dissection of the superficial fascia of the anterior abdominal wall. Five millimeter thick sections were harvested and processed for light microscopy. Both walls of the rectus sheath were made up of three distinct zones: superficial, intermediate, and deep. The superficial and deep zones were fibroelastic while the intermediate zones comprised compact bundles of collagen fibres. In the anterior wall of the rectus sheath, these bundles above and below the arcuate line, respectively, were obliquely and transversely disposed. The bundles of the posterior wall of the rectus sheath were, however, transversely aligned. In conclusion, the microscopic organisation of the rectus sheath is determined by its pattern of formation. This sheath is mainly formed by the aponeuroses of the internal oblique and transversus abdominis.

 The pattern of formation of the human rectus sheath exhibits variations, it is not clear if these variations are population specific. This study aimed at describing the pattern of formation of the rectus sheath in a select Kenyan population. Formation of the rectus sheath was analyzed in eighty subjects (47 male, 33 female) during autopsies and cadaveric dissection. The anterior wall of the rectus sheath in all cases was aponeurotic and firmly attached to rectus abdominis muscle. The posterior wall of the rectus sheath was aponeurotic in 71 (88.5%) cases, the rest were musculoaponeurotic and only seen in males. In all cases the aponeurosis of internal obliqueabdominis split into two lamina; a deep lamina that fused with the aponeurosis of transverses abdominis at the lateral border of rectus abdominis and a superficial lamina that fused with aponeurosis of external oblique abdominis mid-way between the medial and lateral borders of rectus abdominis muscle. The pattern of formation of the rectus sheath among Kenyans shows some variations which have not been reported by previous workers. Knowledge of these variations is important in surgery as this sheath is always incised when making most aabdominal incisions.

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Like any other diseases of poultry, tumours are important to poultry keepers. This is because farmers keep poultry mainly for commercial purposes and are affected by any condition that would cau se death of the chickens or reduce their productivity. There are various tumours that affect chickens, mostly the older ones. This is a report of two manifestations of ovarian carcinoma and two extraordinary manifestations of Marek’s disease/Leucosis compl ex observed in Kenya. Possible impacts on poultry production are discussed.

Soil physical degradation is a gradual process of many steps beginning from structural deterioration and ending in differential loss of finer particles through erosion. Control of the degradation remains a challenge to many scientists due to lack of proper assessment protocols. This study developed a sequential protocol with emphasis on definition of physical degradation and successive soil testing to determine the stages of degradation development. The protocol was tested in Cambisols, Arenosols, and Ferralsols in Eastern Kenya. Soil physical degradation due to 10 years land use change was defined as more than 25% drop in infiltration and water retention characteristics and aggregate stability and more than 30% increase in bulk density and silt content. Then a soil testing model was sequentially applied to identify physical degradation phases. Visual assessment of degradation symptoms, RUSLE model, and diffuse infrared spectral reflectance were used in the soil testing model as predictors of physical degradation. Visual assessment was found to be cheap and fast method for identifying final stages of physical degradation with 60% accuracy. Visual assessment combined with RUSLE model improved the assessment accuracy to 80%. Infrared spectral reflectance, which is sensitive to subtle changes in soil physical conditions, was also found as a potential surrogate predictor of early-warning signs of soil physical degradation. Inclusion of spectra into the assessment model improved the accuracy to 95%. This protocol is effective in identifying phases of soil physical degradation, which are useful for planning degradation control and monitoring schemes. Its further testing and worldwide application is recommended.

Soil physical degradation is a gradual process of many steps beginning from structural deterioration and ending in differential loss of finer particles through erosion. Control of the degradation remains a challenge to many scientists due to lack of proper assessment protocols. This study developed a sequential protocol with emphasis on definition of physical degradation and successive soil testing to determine the stages of degradation development. The protocol was tested in Cambisols, Arenosols, and Ferralsols in Eastern Kenya. Soil physical degradation due to 10 years land use change was defined as more than 25% drop in infiltration and water retention characteristics and aggregate stability and more than 30% increase in bulk density and silt content. Then a soil testing model was sequentially applied to identify physical degradation phases. Visual assessment of degradation symptoms, RUSLE model, and diffuse infrared spectral reflectance were used in the soil testing model as predictors of physical degradation. Visual assessment was found to be cheap and fast method for identifying final stages of physical degradation with 60% accuracy. Visual assessment combined with RUSLE model improved the assessment accuracy to 80%. Infrared spectral reflectance, which is sensitive to subtle changes in soil physical conditions, was also found as a potential surrogate predictor of early-warning signs of soil physical degradation. Inclusion of spectra into the assessment model improved the accuracy to 95%. This protocol is effective in identifying phases of soil physical degradation, which are useful for planning degradation control and monitoring schemes. Its further testing and worldwide application is recommended.

Background Aneurysms of the anterior cerebral and anterior communicating arteries are common and their microvascular surgical management requires sound knowledge of the normal and variant vascular anatomy. Objective The purpose of this study was to evaluate variations of the anterior cerebral and anterior communicating arteries. Methods: Thirty six cadaveric brains (72 hemispheres) were studied by gross dissection for the pattern of arterial blood supply. Results The anterior cerebral artery (ACA) was observed to originate from the ipsilateral internal carotid artery (ICA) in all the cases studied. The most common type of termination of the ACA was bifurcation into pericallosal (PerA) and callosomarginal (CMA) arteries with the PerA-CMA junction being supracallosal (60%), infracallosal (27%) or precallosal (5%). Unique variations observed include an accessory ACA from the ACoA, 'bihemispheric pericallosal arteries', intertwining course of the A2 segments of the ACAs and crossing branches from 1 hemisphere to another. Variations of the ACoA were also observed including fenestration (26%) and duplication (13%). Conclusions The majority of ACA bifurcations, in the current study, were supracallosal suggesting the need for exploration of the interhemispheric fissure during surgical corrections of distal ACA aneurysms. Further, the incidence of the callosomarginal artery in this series appears to be at variance with other studies highlighting the need to standardize the definition of the artery. Anterior communicating artery fenestration was the most common variation raising concern as this has been shown to compromise collateral flow and predispose to aneurysm formation. Key Words: Anterior Cerebral artery, Anterior Communicating Artery, Kenya, Variations

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Description: This book describes four types of indigenous water retention structures used in East Africa. These structures are the Berkad tank, the Charco dam, sand wiers and hillside water retention ditches.

Rural households greatly depend on non-timber forest products (NTFPs) to sustain livelihoods, more so in meeting household basic daily needs. Specifically in Kakamega forest households depend on NTFPs such as firewood to meet household energy needs, herbal medicines for ailment treatment, pastures to feed household stock, thatch grass to maintain shelters, and fruits and vegetables for food. Since these direct products are obtained from the forest free of charge and have no efficient market, their economic contribution to rural household economy remains unknown yet their role is factually immense. Establishing the economic value of NTFPs consumed by households therefore becomes very necessary in understanding the actual contribution NTFPs make in the sustenance of rural livelihoods. This study estimated and compared economic value of NTFPs consumed by rural households living around Kakamega forest using three valuation approaches namely: substitutes’ prices method direct prices method and opportunity cost of time method. Socioeconomic, institutional and geophysical data that included household characteristics such as age, gender, household sizes, occupations, land and liverstock ownership, NTFPs consumption quantities (and that of coresponding substitutes), time expended on extraction, time values, prices of NTFPs (and the substitutes)on local retail markets, distances to the forests and forest management regimes were collected in the areas surrounding Kakamega forest using a semi-structured questionnaire. Results show that the substitute value is highest followed by directly priced value and lastly by the value generated through the opportunity cost of time, with an annual average consumption of US $120, US$92 and US$78, respectively, per household. The paper concludes with important policy recommendations for conservation of Kakamega forest.

Separation of midgut membrane proteins from the tick, Ambylomma variegatum, using a nonionic detergent (Triton X-114), resulted in two protein fractions, namely DET (detergent) and AQ (aqueous). In immunoblotting analysis with polyclonal antibodies against these fractions, 4 proteins (Mr approximately 27,000, 67,000, 86,000 and 95,000,) and 2 proteins (M, approximately 54,000 and 67,000) were detected in the DET and AQ fractions, respectively. Three of the DET fraction proteins Mr approximately 27,000, 67,000 and 95,000 were glycosylated since they bound to the lectin, concanavalin A. In 2-dimensional gel electrophoresis, the AQ and DET fraction proteins were found to be acidic in nature. In a series of bioassay experiments, rabbits were first immunised with both DET and AQ fractions and then infested with ticks. The egg batch weights of these ticks were reduced by 50% compared to control ticks. Furthermore, there was a significant reduction in the hatchability of eggs laid by ticks fed on rabbits previously immunised with both DET (14%) and AQ (33%) fractions. Based on the egg hatchability, the reproductive capacity of ticks was reduced by 77 and 48% by DET and AQ fractions, respectively.

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Viral hepatitis is a major public health problem in India, which is hyperendemic for HAV and HEV. Seroprevalence studies reveal that 90%-100% of the population acquires anti-HAV antibody and becomes immune by adolescence. Many epidemics of HEV have been reported from India. HAV related liver disease is uncommon in India and occurs mainly in children. HEV is also the major cause of sporadic adult acute viral hepatitis and ALF. Pregnant women and patients with CLD constitute the high risk groups to contract HEV infection, and HEV-induced mortality among them is substantial, which underlines the need for preventive measures for such groups. Children with HAV and HEV coinfection are prone to develop ALF. India has intermediate HBV endemicity, with a carrier frequency of 2%-4%. HBV is the major cause of CLD and HCC. Chronic HBV infection in India is acquired in childhood, presumably before 5 years of age, through horizontal transmission. Vertical transmission of HBV in India is considered to be infrequent. Inclusion of HBV vaccination in the expanded programme of immunization is essential to reduce the HBV carrier frequency and disease burden. HBV genotypes A and D are prevalent in India, which are similar to the HBV genotypes in the West. HCV infection in India has a population prevalence of around 1%, and occurs predominantly through transfusion and the use of unsterile glass syringes. HCV genotypes 3 and 2 are prevalent in 60%-80% of the population and they respond well to a combination of interferon and ribavirin. About 10%-15% of CLD and HCC are associated with HCV infection in India. HCV infection is also a major cause of post-transfusion hepatitis. HDV infection is infrequent in India and is present about 5%-10% of patients with HBV-related liver disease. HCC appears to be less common in India than would be expected from the prevalence rates of HBV and HCV. The high disease burden of viral hepatitis and related CLD in India, calls for the setting up of a hepatitis registry and formulation of government-supported prevention and control strategies.

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.

The  study found out that Masinga Dam has adversely affected the public health in the communities around the dam. malaria was the most prevalent ailment followed by typhoid fever. Bilharzia has also increased since the dam was constructed.

Rangeland condition and trend in Mashuru s. .DivIsion of Kajiado District in Kenya has been deteriorating in terms of grazing capacity due to degradation of vegetation resources. Therefore a research study was conducted in 2001/2 with the objective of analyzing the types of vegetation degradation, their causes and their influence on rangeland condition and trend. The results ofthe qualitative study showed that excessive use of the woody species by humans for woodfuel, building and fencing materials, medicine and ornamentals had led ,I I to vegetation degradation due to loss of cover, change in plant composition and biodiversity. On the other hand, overgrazing and ecological succession of the grazing ]ands had led to bush encroachment and thickening. These types of vegetation degradation have had an overall effect of loss of grass cover and hence loss of grazing capacity for livestock, especially cattle. The causes of vegetation decrease or increase over the last 30 years have been due to deforestation (trees and shrubs), bush encroachment and thickening, change in plant species composition and natural calamities such as droughts, wild fires and armyworm invasions at various times. The overall results indicated that there has been a downward trend in range condition over the last 30 years which had affected livestock productivity. There is need therefore, for concerted efforts to be made to reverse or halt further vegetation degradation in the area through the participation of the local people, governmental and non-governmental organizations presently involved in rehabilitation and conservation of vegetation resources in the area.

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

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

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Red Cross Children's Hospital, Rondebosch, 7701, Cape Town, South Africa.

OBJECTIVE: To draw attention to the sub-optimal care that HIV-infected children are receiving in Africa. DATA SOURCES: Relevant published literature. DATA SYNTHESIS: Sub-optimal response to paediatric HIV infection has aggravated the negative impact that the epidemic has had on child health in Africa. Recently the African Network for the Care of Children Affected by HIV/AIDS (ANNECA) released an advocacy statement that called for the optimisation of prevention, diagnosis, treatment and care for children affected by the AIDS pandemic. Effective prevention strategies if comprehensively implemented, could prevent more than 500 000 paediatric infections per annum at current antenatal HIV prevalence rates. Improved care that includes universal utilisation of early diagnostic testing systems, cotrimoxazole prophylaxis, nutritional support and the timely introduction of antiretroviral therapy could improve the quality of life and lifespan of most infected children. CONCLUSION: Political leaders, public health officials and fellow child health professionals are urged to redouble their efforts to reverse the magnitude of the paediatric epidemic in Africa.

PMID: 17685215 [PubMed - indexed for MEDLINE]

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

OBJECTIVE: To describe vasculitis in HIV patients, their CD4 levels, anatomical sites affected and clinical patterns. DESIGN: Prospective, descriptive study. SETTING: Kisumu District Hospital and Nairobi Rheumatology Clinic between January 2002 and May 2005. SUBJECTS: Eight patients with HIV and vasculitis. RESULTS: Eight patients (four males and four females) were recruited with an age range of 24-61 years, mean 33.13 years. Five had central nervous system vasculitis and three had peripheral vasculitis. The CD4 counts were low, range 2-200 cells/mm3 (mean of 79.25 cells/mm3), normal levels of CD4 are 355-1298 cells/mm3, indicating severe immunosuppression. Two patients tested positive for HBV (hepatitis B virus). CONCLUSION: HIV associated vasculitis is recognised and may be complicated by coinfection with hepatitis viruses. It occurs at low CD4 counts. Central nervous system involvement is a common site. Management is multidisciplinary.

In the past decades, anaerobic digestion (AD) has steadily gained importance. However, the technology is not regarded as a top priority in science policy and in industrial development at present. In order for AD to further develop, it is crucial that AD profits from the current fuel issues emerging in the international arena. AD can provide low-cost treatment of sewage and solid domestic wastes, which represents a vast application potential that should be promoted in the developing world. Furthermore, the developments in the last decades in the domain of anaerobic microbiology and technology have generated some interesting niches for the application of AD, such as anaerobic nitrogen removal and the treatment of chlorinated organics. Recently, AD has also generated some serendipities, such as the use of AD in processes for sulphur and calcium removal and the coupling of AD with microbial fuel cells. The international developments in terms of bio-refineries and CO2-emission abatement are of crucial importance with respect to the impetus that AD will receive in the coming decade. There should be little doubt that by placing the focus of AD on the production of green energy and clean nutrients, the future of AD will be assured. PMID: 16180409 [PubMed - indexed for MEDLINE

BACKGROUND: The 'Ten Questions' Questionnaire (TQQ) is used to detect severe neurological impairment in children living in resource-poor countries. Its usefulness has been established in Asia and the Caribbean, but there are a few published studies from Africa. We evaluated the TQQ as part of a larger study of neurological impairment in a rural community, on the coast of Kenya. METHODS: The study was conducted in two phases from June 2001 to May 2002; in phase one, a community household screening of 10,218 children aged 6-9 years using the TQQ was performed. Phase two involved a comprehensive clinical and psychological assessment of all children testing positive on the TQQ (n = 810) and an equivalent number of those testing negative (n = 766). Data were interpreted using the impairment-specific approach. RESULTS: Overall, the sensitivity rates for screening the different impairments were: cognitive (70.0%), motor (71.4%), epilepsy (100%), hearing (87.4%) and visual (77.8%). All the specificity rates were greater than 96%. However, the positive predictive values were low, and ranged from 11 to 33%. CONCLUSIONS: These results are similar to those from other continents and provide evidence that the TQQ can be used to compare the epidemiology of moderate/severe impairment in different parts of the world. Furthermore, the TQQ can be used to screen for moderately/severely impaired children in resource-poor countries; however, the low positive predictive values mean that other assessments are required for confirmation. Copyright 2004 S. Karger AG, Basel

Background. The host immune response against mucosally-acquired pathogens may be influenced by the mucosal immune milieu during acquisition. Since Neisseria gonorrhoeae can impair dendritic cell and T cell immune function, we hypothesized that co-infection during HIV acquisition would impair subsequent systemic T-cell responses.   Methods. Monthly screening for sexually transmitted infections (STIs) was performed in high risk, HIV seronegative Kenyan female sex workers as part of an HIV prevention trial. Early HIV-specific CD8+ T cell responses and subsequent HIV viral load set point were assayed in participants acquiring HIV, and were correlated with the presence of prior genital infections during HIV acquisition.   Results. Thirty-five participants acquired HIV during follow up, and 16/35 (46%) had a classical STI at the time of acquisition. N. gonorrhoeae co-infection was present during HIV acquisition in 6/35 (17%), and was associated with an increased breadth and magnitude of systemic HIV-specific CD8+ T-cell responses, using both interferon- (IFNg) and MIP-1 beta (MIP1b) as an output. No other genital infections were associated with differences in HIV-specific CD8+ T cell response, and neither N. gonorrhoeae nor other genital infections were associated with differences in HIV plasma viral load at set point.   Conclusion. Unexpectedly, genital N. gonorrhoeae infection during heterosexual HIV acquisition was associated with substantially enhanced HIV-specific CD8+ T-cell responses, although not with differences in HIV viral load set point. This may have implications for the development of mucosal HIV vaccines and adjuvants.

BACKGROUND: Health care-seeking behavior for sexually transmitted diseases (STDs) is important in STD/HIV control. GOAL: The goal of this study was to describe the proportion seeking care, patient delay, and choice of provider among men and women with STD-related complaints in Nairobi, Kenya. STUDY DESIGN: A population-based questionnaire was administered in 7 randomly selected clusters (small geographic areas covering approximately 150 households each). RESULTS: Of the 291 respondents reporting complaints, 20% of men versus 35% of women did not seek care, mainly because symptoms were not considered severe, symptoms had disappeared, or as a result of lack of money. Of those who sought care, women waited longer than men (41 vs. 16 days). Most men and women went to the private sector (72% and 57%, respectively), whereas the informal sector was rarely visited (13% and 16%, respectively). Relatively more women visited the government sector (28% vs. 15%). Because women were mostly monogamous, they did not relate their complaints to sexual intercourse, which hampered prompt care-seeking. CONCLUSION: Women should be convinced to seek care promptly, eg, through health education in communities.

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This paper deals with the derivation of logistic model for cattle, sheep and goats in a commercial ranching system in Machakos District, Kenya, a savannah ecosystem with average annual rainfall of 589.3  159.3mm and an area of 10,117ha. It involves modeling livestock population dynamics as discrete-time logistic equations wiyh fixed carrying capacities. The fixed carrying capacities are generated endogenously using time-series ranch data, covering a period of 15 years, from 1987 to 2001, in a commercial ranching enterprise. The model incorporates interaction parameters, generated endogenously. The estimation of the logistic models involves estimation of econometric models for each livestock species, followed by the recovery of the logistic model mathematically. Optimisation procedures are employed to determine the optimal stocking levels and the optimal off-take levels. The model-generated carrying capacities are 2,985, 791 and 201 animal units (AU) for cattle, sheep and goats, respectively. Optimal stocking levels are 1,369, 154 and 69 Aus for cattle, sheep and goats, respectively, while the optimal off-take levels are 857, 88 and 63 for cattle, sheep and goats, respectively. This shows that the logistic model-based system analysis is applicable to the management of mixed-species commercial ranching enterprises.

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Oyieke H.A. and Misra A.K:

Background. The host immune response against mucosally-acquired pathogens may be influenced by the mucosal immune milieu during acquisition. Since Neisseria gonorrhoeae can impair dendritic cell and T cell immune function, we hypothesized that co-infection during HIV acquisition would impair subsequent systemic T-cell responses.   Methods. Monthly screening for sexually transmitted infections (STIs) was performed in high risk, HIV seronegative Kenyan female sex workers as part of an HIV prevention trial. Early HIV-specific CD8+ T cell responses and subsequent HIV viral load set point were assayed in participants acquiring HIV, and were correlated with the presence of prior genital infections during HIV acquisition.   Results. Thirty-five participants acquired HIV during follow up, and 16/35 (46%) had a classical STI at the time of acquisition. N. gonorrhoeae co-infection was present during HIV acquisition in 6/35 (17%), and was associated with an increased breadth and magnitude of systemic HIV-specific CD8+ T-cell responses, using both interferon- (IFNg) and MIP-1 beta (MIP1b) as an output. No other genital infections were associated with differences in HIV-specific CD8+ T cell response, and neither N. gonorrhoeae nor other genital infections were associated with differences in HIV plasma viral load at set point.   Conclusion. Unexpectedly, genital N. gonorrhoeae infection during heterosexual HIV acquisition was associated with substantially enhanced HIV-specific CD8+ T-cell responses, although not with differences in HIV viral load set point. This may have implications for the development of mucosal HIV vaccines and adjuvants.

Background. The host immune response against mucosally-acquired pathogens may be influenced by the mucosal immune milieu during acquisition. Since Neisseria gonorrhoeae can impair dendritic cell and T cell immune function, we hypothesized that co-infection during HIV acquisition would impair subsequent systemic T-cell responses.   Methods. Monthly screening for sexually transmitted infections (STIs) was performed in high risk, HIV seronegative Kenyan female sex workers as part of an HIV prevention trial. Early HIV-specific CD8+ T cell responses and subsequent HIV viral load set point were assayed in participants acquiring HIV, and were correlated with the presence of prior genital infections during HIV acquisition.   Results. Thirty-five participants acquired HIV during follow up, and 16/35 (46%) had a classical STI at the time of acquisition. N. gonorrhoeae co-infection was present during HIV acquisition in 6/35 (17%), and was associated with an increased breadth and magnitude of systemic HIV-specific CD8+ T-cell responses, using both interferon- (IFNg) and MIP-1 beta (MIP1b) as an output. No other genital infections were associated with differences in HIV-specific CD8+ T cell response, and neither N. gonorrhoeae nor other genital infections were associated with differences in HIV plasma viral load at set point.   Conclusion. Unexpectedly, genital N. gonorrhoeae infection during heterosexual HIV acquisition was associated with substantially enhanced HIV-specific CD8+ T-cell responses, although not with differences in HIV viral load set point. This may have implications for the development of mucosal HIV vaccines and adjuvants.

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Background. The host immune response against mucosally-acquired pathogens may be influenced by the mucosal immune milieu during acquisition. Since Neisseria gonorrhoeae can impair dendritic cell and T cell immune function, we hypothesized that co-infection during HIV acquisition would impair subsequent systemic T-cell responses.   Methods. Monthly screening for sexually transmitted infections (STIs) was performed in high risk, HIV seronegative Kenyan female sex workers as part of an HIV prevention trial. Early HIV-specific CD8+ T cell responses and subsequent HIV viral load set point were assayed in participants acquiring HIV, and were correlated with the presence of prior genital infections during HIV acquisition.   Results. Thirty-five participants acquired HIV during follow up, and 16/35 (46%) had a classical STI at the time of acquisition. N. gonorrhoeae co-infection was present during HIV acquisition in 6/35 (17%), and was associated with an increased breadth and magnitude of systemic HIV-specific CD8+ T-cell responses, using both interferon- (IFNg) and MIP-1 beta (MIP1b) as an output. No other genital infections were associated with differences in HIV-specific CD8+ T cell response, and neither N. gonorrhoeae nor other genital infections were associated with differences in HIV plasma viral load at set point.   Conclusion. Unexpectedly, genital N. gonorrhoeae infection during heterosexual HIV acquisition was associated with substantially enhanced HIV-specific CD8+ T-cell responses, although not with differences in HIV viral load set point. This may have implications for the development of mucosal HIV vaccines and adjuvants.

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Traditional medicine has utilized plants to palliate, cure and/or prevent diseases in both humans and
animals. The acquisition of knowledge has been through trial and error, and observation. Today, the enhanced search for botanical drugs throughout the world has increased the need for accurate means of identifying plants with possible pharmacological and biological activity. A number of methodologies have been used in selecting plants likely to possess pharmacological properties, but many have recorded low success rates. Data reported in this paper reveal that the accuracy of identification of these herbal drugs for pertinent ailments using ethnobotanical data is almost as accurate as techniques applied in modern medical practice. This paper discusses the value of ethno - botanical data in the preliminary search for potential drug plants.

Background. The host immune response against mucosally-acquired pathogens may be influenced by the mucosal immune milieu during acquisition. Since Neisseria gonorrhoeae can impair dendritic cell and T cell immune function, we hypothesized that co-infection during HIV acquisition would impair subsequent systemic T-cell responses.   Methods. Monthly screening for sexually transmitted infections (STIs) was performed in high risk, HIV seronegative Kenyan female sex workers as part of an HIV prevention trial. Early HIV-specific CD8+ T cell responses and subsequent HIV viral load set point were assayed in participants acquiring HIV, and were correlated with the presence of prior genital infections during HIV acquisition.   Results. Thirty-five participants acquired HIV during follow up, and 16/35 (46%) had a classical STI at the time of acquisition. N. gonorrhoeae co-infection was present during HIV acquisition in 6/35 (17%), and was associated with an increased breadth and magnitude of systemic HIV-specific CD8+ T-cell responses, using both interferon- (IFNg) and MIP-1 beta (MIP1b) as an output. No other genital infections were associated with differences in HIV-specific CD8+ T cell response, and neither N. gonorrhoeae nor other genital infections were associated with differences in HIV plasma viral load at set point.   Conclusion. Unexpectedly, genital N. gonorrhoeae infection during heterosexual HIV acquisition was associated with substantially enhanced HIV-specific CD8+ T-cell responses, although not with differences in HIV viral load set point. This may have implications for the development of mucosal HIV vaccines and adjuvants.

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Background. The host immune response against mucosally-acquired pathogens may be influenced by the mucosal immune milieu during acquisition. Since Neisseria gonorrhoeae can impair dendritic cell and T cell immune function, we hypothesized that co-infection during HIV acquisition would impair subsequent systemic T-cell responses.   Methods. Monthly screening for sexually transmitted infections (STIs) was performed in high risk, HIV seronegative Kenyan female sex workers as part of an HIV prevention trial. Early HIV-specific CD8+ T cell responses and subsequent HIV viral load set point were assayed in participants acquiring HIV, and were correlated with the presence of prior genital infections during HIV acquisition.   Results. Thirty-five participants acquired HIV during follow up, and 16/35 (46%) had a classical STI at the time of acquisition. N. gonorrhoeae co-infection was present during HIV acquisition in 6/35 (17%), and was associated with an increased breadth and magnitude of systemic HIV-specific CD8+ T-cell responses, using both interferon- (IFNg) and MIP-1 beta (MIP1b) as an output. No other genital infections were associated with differences in HIV-specific CD8+ T cell response, and neither N. gonorrhoeae nor other genital infections were associated with differences in HIV plasma viral load at set point.   Conclusion. Unexpectedly, genital N. gonorrhoeae infection during heterosexual HIV acquisition was associated with substantially enhanced HIV-specific CD8+ T-cell responses, although not with differences in HIV viral load set point. This may have implications for the development of mucosal HIV vaccines and adjuvants.

Background. The host immune response against mucosally-acquired pathogens may be influenced by the mucosal immune milieu during acquisition. Since Neisseria gonorrhoeae can impair dendritic cell and T cell immune function, we hypothesized that co-infection during HIV acquisition would impair subsequent systemic T-cell responses.   Methods. Monthly screening for sexually transmitted infections (STIs) was performed in high risk, HIV seronegative Kenyan female sex workers as part of an HIV prevention trial. Early HIV-specific CD8+ T cell responses and subsequent HIV viral load set point were assayed in participants acquiring HIV, and were correlated with the presence of prior genital infections during HIV acquisition.   Results. Thirty-five participants acquired HIV during follow up, and 16/35 (46%) had a classical STI at the time of acquisition. N. gonorrhoeae co-infection was present during HIV acquisition in 6/35 (17%), and was associated with an increased breadth and magnitude of systemic HIV-specific CD8+ T-cell responses, using both interferon- (IFNg) and MIP-1 beta (MIP1b) as an output. No other genital infections were associated with differences in HIV-specific CD8+ T cell response, and neither N. gonorrhoeae nor other genital infections were associated with differences in HIV plasma viral load at set point.   Conclusion. Unexpectedly, genital N. gonorrhoeae infection during heterosexual HIV acquisition was associated with substantially enhanced HIV-specific CD8+ T-cell responses, although not with differences in HIV viral load set point. This may have implications for the development of mucosal HIV vaccines and adjuvants.

OBJECTIVE: To study infections complicating ventriculoperitoneal (VP) shunt surgery in children with non-tumour hydrocephalus at the Kenyatta National Hospital, Nairobi. DESIGN: A retrospective survey. SETTING: Kenyatta National Hospital, Nairobi between January 1982 and December 1991. SUBJECTS: Three hundred and forty five patients who underwent V-P shunt placement for non-tumour hydrocephalus. RESULTS: Three hundred and forty five patients underwent V-P shunt placement for non-tumour hydrocephalus. There were 107 infection episodes involving 85 patients. The ages of these patients ranged from three months to 12 years. Most of the patients had congenital hydrocephalus. The infection rate was high (24.6%) although comparable to infection rates reported for clean surgery in the hospital. Fever, septic wounds and features of shunt malfunction were the main presenting features. Bacteriological studies confirmed Staphylococcus aureus and coagulase negative staphylococci as the two most commonly isolated micro-organisms. CONCLUSION: This study emphasises need to reduce infection rate in ventriculoperitoneal shunt surgery at the Kenyatta National Hospital. Definitive surgical treatment for hydrocephalus was in most cases delayed and this problem was also observed during revision of infected shunts. Late presentation was often due to ignorance and the fact that many patients went for traditional forms of treatment first before going to hospital.

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

Background. The host immune response against mucosally-acquired pathogens may be influenced by the mucosal immune milieu during acquisition. Since Neisseria gonorrhoeae can impair dendritic cell and T cell immune function, we hypothesized that co-infection during HIV acquisition would impair subsequent systemic T-cell responses.   Methods. Monthly screening for sexually transmitted infections (STIs) was performed in high risk, HIV seronegative Kenyan female sex workers as part of an HIV prevention trial. Early HIV-specific CD8+ T cell responses and subsequent HIV viral load set point were assayed in participants acquiring HIV, and were correlated with the presence of prior genital infections during HIV acquisition.   Results. Thirty-five participants acquired HIV during follow up, and 16/35 (46%) had a classical STI at the time of acquisition. N. gonorrhoeae co-infection was present during HIV acquisition in 6/35 (17%), and was associated with an increased breadth and magnitude of systemic HIV-specific CD8+ T-cell responses, using both interferon- (IFNg) and MIP-1 beta (MIP1b) as an output. No other genital infections were associated with differences in HIV-specific CD8+ T cell response, and neither N. gonorrhoeae nor other genital infections were associated with differences in HIV plasma viral load at set point.   Conclusion. Unexpectedly, genital N. gonorrhoeae infection during heterosexual HIV acquisition was associated with substantially enhanced HIV-specific CD8+ T-cell responses, although not with differences in HIV viral load set point. This may have implications for the development of mucosal HIV vaccines and adjuvants.

Ground Flowers of Matricaria Recutita (German Chamomile) Banat Variety grown in Kenya, were subjected to Clevenger distillation under varying temperature, distillation, pressure conditions and the yields assessed. An inert solvent being present in the collecting column of the Clevenger apparatus increases the yield of the oil by reducing dispersion of the blue oil; its presence however, in the distillation flask inhibits the production of the essential oil. Distillation under reduced pressure leads to a decrease in the yield of the oil produced. A break in distillation time especially during the first three hours of distillation also leads to a decrease in the yield of the oil produced.

The world is today faced with the global pandemic of HIV/AIDS that has evolved rapidly since it was first described. The pandemic has been termed the greatest development challenge for sub Saharan Africa and is rapidly evolving in the Asian continent. The pandemic ha had a significantly negative impact on individual families through loss of loved ones, communities by increasing the burden of caring for the ill, and countries through reduced productivity.     As we look forward to the 21st century, the human population is reminded that even in an age where drugs to treat most ailments are available, human behaviour and individual aspirations are critical in the control of disease. Factors that affect human and social behaviour, such as poverty, discrimination and disenfranchisement have to be addressed on a global basis if the HIV/AIDS epidemic is to be controlled. The HIV/AIDS epidemic presents special challenges and new frontiers for public health interventions and research. HIV/AIDS has revealed the gaps in the understanding of how human behaviour is motivated and how it can be changed.     In this publication we present a review of some of the programs that are specifically targeting the youth with HIV/AIDS prevention activities in the countries of   This publication records the stories of men and women in Eastern Africa, who have tremendous commitment to the work they do even with minimal resources, because they have a vision for the youth of the African continent. It is a story of innovation, creativity, determination and partnership between adults and youth, communities and governments, countries, aid agencies and NGOSs.

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BACKGROUND: The viral safety of blood depends on donor selection and screening of the blood for viruses. OBJECTIVE: To determine the frequency of human immunodeficiency viruses 1 and 2, hepatitis B virus and hepatitis C virus in a population of donors. DESIGN: Retrospective study including all blood donations at a hospital-based transfusion unit between January 1995 and August 1998. RESULTS: A significant declining trend in the frequency of the human immunodeficiency virus from 4.5% in 1995 to 3.0% in 1998 was noted. Hepatitis B virus (HBV) decreased from 4.2% in 1995 to 3.9% in 1998, while hepatitis C (HCV) increased from 1.5% in 1996 to 1.8% in 1998. The changes for both HBV and HCV were not statistically significant. CONCLUSION: The safety of blood and blood products with respect to HIV, HBV and HCV is very high. It is important to educate donors regarding transfusion transmitted infections. It is recommended that HCV screening be implemented as a standard test for all donations.

Differentiation of bloodstream-form trypanosomes into procyclic (midgut) forms is an important first step in the establishment of an infection within the tsetse fly. This complex process is mediated by a wide variety of factors, including those associated with the vector itself, the trypanosomes and the bloodmeal. As part of an on-going project in our laboratory, we recently isolated and characterized a bloodmeal-induced molecule with both lectin and trypsin activities from midguts of the tsetse fly, Glossina longipennis [Osir, E.O., Abubakar, L., Imbuga, M.O., 1995. Purification and characterization of a midgut lectin-trypsin complex from the tsetse fly, Glossina longipennis. Parasitol. Res. 81, 276-281]. The protein (lectin-trypsin complex) was found to be capable of stimulating differentiation of bloodstream trypanosomes in vitro. Using polyclonal antibodies to the complex, we screened a G. fuscipes fuscipes cDNA midgut expression library and identified a putative proteolytic lectin gene. The cDNA encodes a putative mature polypeptide with 274 amino acids (designated Glossina proteolytic lectin, Gpl). The deduced amino acid sequence includes a hydrophobic signal peptide and a highly conserved N-terminal sequence motif. The typical features of serine protease trypsin family of proteins found in the sequence include the His/Asp/Ser active site triad with the conserved residues surrounding it, three pairs of cysteine residues for disulfide bridges and an aspartate residue at the specificity pocket. Expression of the gene in a bacterial expression system yielded a protein (M(r) approximately 32,500). The recombinant protein (Gpl) bound d(+) glucosamine and agglutinated bloodstream-form trypanosomes and rabbit red blood cells. In addition, the protein was found to be capable of inducing transformation of bloodstream-form trypanosomes into procyclic forms in vitro. Antibodies raised against the recombinant protein showed cross-reactivity with the alpha subunit of the lectin-trypsin complex. These results support our earlier hypothesis that this molecule is involved in the establishment of trypanosome infections in tsetse flies.

Ethnopharmacological relevance: Traditional medicines play an important role in the management of chronically painful and debilitating joint conditions, particularly in the rural Africa. However, their potential use as sources of medicines has not been fully exploited. The present study was carried to find the medicinal plants traditionally used to manage chronic joint pains in Machakos and Makueni counties in Kenya. Materials and methods: To obtain this ethnobotanical information, 30 consenting traditional herbal med-ical practitioners were interviewed exclusively on medicinal plant use in the management of chronic joint pains, in a pre-planned workshop. Results and discussion: In this survey, a total of 37 plants belonging to 32 genera and 23 families were cited as being important for treatment of chronic joint pains. The most commonly cited plant species were Pavetta crassipes K. Schum, Strychnos henningsii Gilg., Carissa spinarum L., Fagaropsis hildebrandtii (Engl.) Milve-Redh. and Zanthoxylum chalybeum Engl. Acacia mellifera (Vahl) Benth., Amaranthus albus L., Balanites glabra Mildbr. & Schltr., Grewia fallax K. Schum., Lactuca capensis, Launaea cornuta (Oliv. & Hiern) O. Jeffrey, Lippia kituiensis Vatke, Pappea capensis Eckl. & Zeyh. and Pennisetum glaucum (L.) R. Br. are documented for the first time as being important in the management of chronic joint pains. Conclusions: The findings of this study show that a variety of medicinal plants are used in the management of chronic joint pains and the main mode of administration is oral. Keywords: Ethnobotanical survey; Medicinal plants; Chronic joint pains; Rheumatoid arthritis; Akamba; Machakos-Kenya

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

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Participatory research on bovine trypanosomiasis was conducted with Orma pastoralists in Tana River District, Kenya. The use of participatory methods to understand local perceptions of disease signs, disease causes, disease incidence by cattle age group, seasonal patterns of disease and preferences for indigenous and modern control methods are described. Results indicated that local characterization of diseases called gandi and buku by Orma pastoralists was similar to modern veterinary knowledge on chronic trypanosomiasis and haemorrhagic trypanosomiasis (due to Trypanosoma vivax), respectively. The mean incidence of gandi varied from 10.2% in calves to 28.6% in adult cattle. The mean incidence of buku varied from 3.1% in calves to 9.6% in adults. Pearson correlation coefficients for disease incidence by age group were 0.498 (P < 0.01) and 0.396 (P < 0.05) for gandi and buku, respectively. Informants observed cases of trypanosomiasis in 24.1% of cattle (all age groups); these cases accounted for 41.8% of all sick cattle during the preceding 12-month period. Eight indigenous and three modern trypanosomiasis control methods were identified. Results indicated that an integrated approach to trypanosomiasis control based on private, individual action was well established in the assessment area. When presented with four different trypanosomiasis control methods, community representatives selected 'better use of trypanocides' as the most preferred intervention and 'community-based tsetse control' as the least preferred intervention. This finding prompted researchers to modify the original project activities. Constraints facing the sustainability of community-based tsetse control are discussed.

We demonstrate that a mutation in the homeobox gene, MSX1, causes a common developmental anomaly, familial tooth agenesis. Genetic linkage analyses in a family with autosomal dominant agenesis of second premolars and third molars identified a locus on chromosome 4p, where the MSX1 gene resides. Sequence analyses demonstrated an Arg31Pro missense mutation in the homeodomain of MSX1 in all affected family members. Arg 31 is a highly conserved homeodomain residue that interacts with the ribose phosphate backbone of target DNA. We propose that the Arg31 Pro mutatrion comprises MSX1 interactions, and suggest that MSX1 functions are critical for normal development of specific human teeth.

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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.

Results of four years' studies from a number of hospitals in Kenya have shown that nosocomial infections in burns units are due to Methicillin Resistant Staphylococcus aureus (MRSA). Through chromosomal DNA and plasmid DNA, the stain is highly resistant to sulphonamide ointment and other antibiotics. 90% of patients admitted in burns units get colonized or infected with MRSA. The strain prolongs the duration of patients in hospitals. The burns degenerate to second and third degree burns, thereby necessitating skin grafting. The environment has been found to be contaminated with this strain with some staff members having chronic throat infections. Minocycline was found to be effective in treating the infected staff members. Cleaning this environment with Sodium dichloroisocyanurate (precepts)/Sodium hypochlorite (JIK) reduced drastically the mechanical transmission of bacteria in the units. The duration of stay of the patient was reduced. This shows that MRSA which is spread in government and private hospitals can cheaply be controlled by the proper use of disinfectants, antiseptics, and use of effective antibiotics when necessary.

The culture, values and standard of living of people is reflected in their art and design, and, for centuries art has been used to communicate and reflect the lives and times of people. Somewhere along the line, however, there has developed a belief that art and design parted ways with "people". On one hand, "people" have developed % belief that design is the preserve of a talented few, while, on the other hand, designer* claim that "...people do not understand us". Yet, design can only thrive where the community or people, is more artistic. Because of technological developments, the world around, has become one big homestead, the global village. The development of these high technologies is attributed to and spearheaded by the more developed countries. The rate of development of these technologies has been so high such that many of the less developed countries (LDCs) are left breathless and beaten. The United Nations (UN) in its concern for sustainable global development has in recent years sought to re-examine ways of pulling the LDCs into the mainstream of global development. The World Commission on Culture and Development (WCCD) that was established in 1992 provided 1jie framework to extend the development paradigm beyond economic criteria. Among other things, the WCCD "...explores many dimensions of culture and development -as well as their interactions -in an increasingly complex and interconnected and rapidly changing world". In the case of Africa, this has led to the wider special initiative for Africa. This initiative is deeply rooted in the belief that Africa has something to contribute to global development. The initiative seeks to identify aspects of Africa, be they cultural, environmental, craft or anything else, develop and package or repackage them and avail them to the rest of the world. UNESCO, has set out to intervene, initially, in the areas of Industrial, Textile and Graphic Design, Photography and Music. Textile and Graphic Design workshop was therefore, the first of these high level interaction of African artists in Development.

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

Objective: To determine the prevalence and pattern of eye diseases and visual impairment in the Nairobi Comprehensive Eye Care Services (NCES) Project; the catchment area of the Mbagathi District Eye Unit of Nairobi. Design: Community based survey conducted from October 15th to 31st 2007 Setting: Kibera and Dagoreti divisions of Nairobi City Subjects: 4200 people of all ages were randomly selected; 4056 were examined (96.6% response rate). 122 (2.9%) were not available and 15 (0.4%) declined to be examined. Results: Females: 54.2%, Males: 45.8%. Mean age; 22.4 years, SD; 16.5. Only 241(5.9%) aged >50years old. The leading eye disorders in Kibera and Dagoretti divisions are conjunctival disorders including allergic conjunctivitis and conjunctival growths. This was found to affect 7.6% of the subjects. This was followed by refractive errors found in 5.3% of the subjects. Cataract was found in 30 subjects (0.7%). Disorders of the retina and the optic nerve were found in 1.1% of the subjects and corneal disorders in 0.5%. The prevalence of visual impairment was 0.6%, severe visual impairment was 0.05% and blindness was 0.1%. This indicates that most of the ocular disorders encountered were not visually threatening. The main cause of visual impairment is refractive errors and the causes of severe visual impairment and blindness are cataract, corneal opacity and glaucoma. Conclusion: The population of the NCES is relatively young and the prevalence of blindness and visual impairment is low. The main cause of visual impairment was refractive errors and the causes of severe visual impairment and blindness were cataract, corneal opacity and glaucoma. Recommendations: The level of blindness in NCES is low and the project should focus more on rendering eye care and not treatment of blindness. There is need to address the issue of refractive errors as this was one of the main ocular problems encountered. In this survey, it was not possible to perform detailed refraction and hence it was recommend that a refractive error survey be conducted; especially in school going children.

18) , P.M. Muturi, S. Dirlikov and P.M. Gitu. .

Twenty variceal banding sessions were performed in eight patients between February 1995 and September 1996. A total of 69 rings were used to band the varices and at each session between two to six rings were used. Two of the eight had active bleeding and both underwent variceal banding to successfully arrest their bleeding as inpatients. Sixteen other variceal banding sessions were performed on an outpatient basis to obliterate their varices. Four of the eight patients had had sclerotherapy before and varices were still present. No acute or long term complications were noted. In one patient, variceal banding could not be performed as he developed stridor upon placement of the overtube. All the patients had advanced varices (Grade III or IV) and extended for more than 15 cms in the oesophagus. Endoscopic variceal obliteration remains the treatment of choice for patients with portal hypertension with variceal bleeding. Variceal banding is associated with a superior outcome when compared with sclerotherapy; the variceal kill time is shorter, infective complications less, rebleeding occurs less commonly and transfusion requirements are lower.

Over a six-month-period, from 1st March 1988 to 30th September 1988, 127 patients suspected of having ectopic gestation at the Kenyatta National Hospital (KNH) were referred for sonographic examination, of whom 100 (78.7%) had enough data for a final diagnosis. During sonography, ectopic pregnancy was diagnosed in 31 (31%) patients, out of whom 15 (48.4%) were confirmed to have ectopic gestation at laparotomy. Of the 69 who were thought to have other gynaecological disorders at sonographic examination, 2 (2.9%) were later found to have other ectopic gestation at surgery. Of the 17 patients who had ectopic gestation finally, extrauterine gestational sac with a demonstrable foetal pole were observed in only 6 (35.3%) cases, thus allowing a confident diagnosis of ectopic pregnancy by sonography. An empty, bulky uterus, demonstrable adnexal mass, pseudo-gestational sac and fluid in the culde-sac, together improved the sonographic positive predictive value to 67.0%. This study has shown that sonography can be used in the diagnosis of ectopic pregnancy at the KNH. However, in order to improve its reliability, further studies are recommended involving a combination of pregnancy test and sonography. PIP: Between March and September 1988 at the Kenyatta National Hospital in Nairobi, Kenya, clinicians included all patients (127) referred for ultrasonography due to suspected ectopic pregnancy (age range, 18-45 years) in a study to determine whether ultrasonography can be used to accurately diagnose ectopic pregnancy. The researchers examined only the records of 100 patients who had data adequate enough to make a final diagnosis. Based on sonography, clinicians believed 31 women had an ectopic pregnancy, but laparotomy confirmed that just 15 (48.4%) of these women actually had an ectopic pregnancy. Based on sonography, they did not suspect ectopic pregnancy in the other 69 patients, but laparotomy revealed that 2 patients (2.9%) did indeed have an ectopic pregnancy. Thus, the overall ectopic pregnancy rate among the 100 women was 17%. The remaining 83 women had other gynecological conditions. 52.9% of the women with an actual ectopic pregnancy had a pseudogestational sac, which had a positive predictive value of 53% and a negative predictive value of 90%. A pseudogestational sac had a sensitivity of 53% and specificity of 90%. Just 6 ectopic pregnancy cases (35.3%) had an extrauterine gestational sac with a clear fetal pole and a fetal heart beat. An enlarged uterus was more common in women with an ectopic pregnancy than in those with other conditions (82.4% vs. 51.8%; p .05). Every ectopic pregnancy case had a complex adnexal mass compared to just 48.2% of those with other conditions (p .001). When a woman had all these conditions combined–an empty, enlarged uterus; distinct adnexal mass; a pseudogestational sac; and fluid in the cul-de-sac-sonography's positive predictive value increased to 67%. The researchers recommended additional studies using a combination of the urinary pregnancy test and sonography to improve sonography's reliability. PMID: 8181431 [PubMed - indexed for MEDLINE]

Over a six-month-period, from 1st March 1988 to 30th September 1988, 127 patients suspected of having ectopic gestation at the Kenyatta National Hospital (KNH) were referred for sonographic examination, of whom 100 (78.7%) had enough data for a final diagnosis. During sonography, ectopic pregnancy was diagnosed in 31 (31%) patients, out of whom 15 (48.4%) were confirmed to have ectopic gestation at laparotomy. Of the 69 who were thought to have other gynaecological disorders at sonographic examination, 2 (2.9%) were later found to have other ectopic gestation at surgery. Of the 17 patients who had ectopic gestation finally, extrauterine gestational sac with a demonstrable foetal pole were observed in only 6 (35.3%) cases, thus allowing a confident diagnosis of ectopic pregnancy by sonography. An empty, bulky uterus, demonstrable adnexal mass, pseudo-gestational sac and fluid in the culde-sac, together improved the sonographic positive predictive value to 67.0%. This study has shown that sonography can be used in the diagnosis of ectopic pregnancy at the KNH. However, in order to improve its reliability, further studies are recommended involving a combination of pregnancy test and sonography. PIP: Between March and September 1988 at the Kenyatta National Hospital in Nairobi, Kenya, clinicians included all patients (127) referred for ultrasonography due to suspected ectopic pregnancy (age range, 18-45 years) in a study to determine whether ultrasonography can be used to accurately diagnose ectopic pregnancy. The researchers examined only the records of 100 patients who had data adequate enough to make a final diagnosis. Based on sonography, clinicians believed 31 women had an ectopic pregnancy, but laparotomy confirmed that just 15 (48.4%) of these women actually had an ectopic pregnancy. Based on sonography, they did not suspect ectopic pregnancy in the other 69 patients, but laparotomy revealed that 2 patients (2.9%) did indeed have an ectopic pregnancy. Thus, the overall ectopic pregnancy rate among the 100 women was 17%. The remaining 83 women had other gynecological conditions. 52.9% of the women with an actual ectopic pregnancy had a pseudogestational sac, which had a positive predictive value of 53% and a negative predictive value of 90%. A pseudogestational sac had a sensitivity of 53% and specificity of 90%. Just 6 ectopic pregnancy cases (35.3%) had an extrauterine gestational sac with a clear fetal pole and a fetal heart beat. An enlarged uterus was more common in women with an ectopic pregnancy than in those with other conditions (82.4% vs. 51.8%; p .05). Every ectopic pregnancy case had a complex adnexal mass compared to just 48.2% of those with other conditions (p .001). When a woman had all these conditions combined–an empty, enlarged uterus; distinct adnexal mass; a pseudogestational sac; and fluid in the cul-de-sac-sonography's positive predictive value increased to 67%. The researchers recommended additional studies using a combination of the urinary pregnancy test and sonography to improve sonography's reliability. PMID: 8181431 [PubMed - indexed for MEDLINE]

isolated from preterm neonates during the outbreak of gastroenteritis in hospital in Nairobi, Kenya, were resistance to trimethoprin-sulfathoxaxole, Chloramphenicol, oxytetracycline and ampicilin, but only a few strains were resistant to cefazolin, cefamandole, cefataximine, amikacin and nalidixic acid. Fourteen different antimicrobial resistance patterns were observed in the 229 strains of E.coli analyzed. Eighty-two percent of the EPEC strains belonged to two resistance patterns. There was no consistent relationship between palsmid profile group and antimicrobial resistance pattern, although one resistance pattern was more frequently observed in EAF-positive strins belonging to the dominant plasmid profile group. Nine percent of the EPEC strins were resistant to gentamicin compared to 37% in the non-EPEC group. No correlation was observed between administration of gentamicin and percentage of resistant strains isolated. None of the nine neonates receiving gentamicin died during the outbreak. Gentamicin resistance was observed in E.coli strains from six out of these nine neonates. Five out of fourteen neonates who received other antimicrobials, or no antibiotic at all, died. Key words: Enteropathogenic Escherichia Coli; antimicrobial resistance;

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

Isolated mouse interstitial cells were incubated with different concentrations of khat (Catha edulis) extract (0.06 mg/ml, 0.6 mg/ml. 6 mg/ml. 30 mg/ml and 60 mg/ml) and cell viability as well as testosterone concentration measured at 30 min intervals over a 3 h incubation period. High concentrations of khat extract (30 mg/ml and 60 mg/ml) significantly inhibited testosterone production while low concentrations (0.06 mg/ml. 0.6 mg/ml and 6 mg/ml) significantly stimulated (P < 0.05) testosterone production by mouse interstitial cells. Similarly, at concentrations of 30 mg/ml and 60 mg/ml, there was a significant decrease in interstitial cell viability, whereas at 0.06 mg/ml, 0.6 mg/ml and 6 mg/ml there was no significant decrease. There was only a weak correlation (r= 0.39) between testosterone production and viable interstitial cells. We postulate that khat extract at high concentrations may cause reproductive function impairment in the user but at low concentrations. may enhance testosterone production with accompanying effects on reproductive functions in male mice. @2006 Publishedby Elsevier Ireland Ltd. Kel'lVords: In dtro; Khat; Testosterone; Interstitial cells; Mouse

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OBJECTIVE: To estimate the prevalence and pattern of conjuctival squamous cell carcinoma (CSCC) in patients with HIV infection. DESIGN: A hospital based cross sectional study. SETTING: Kenyatta National Hospital (KNH) and Kikuyu Eye Unit (KEU) during the period November 2003 and May 2004. SUBJECTS: Four hundred and nine HIV positive patients. RESULTS: Four hundred and nine HIV positive patients aged 25 to 53 years were screened. Male to Female ratio was 1:1. One hundred and three had conjunctival growths. Thirty two had histologically proven conjunctiva squamous cell carcinoma (CSCC). Estimated prevalence of CSCC among HIV positive patients was 7.8%. The average duration of growth of the conjunctival masses was 21.8 months. The average size of the lesions at the time of presentation was 6.6 mm. Twenty two (68.8%) patients had primary CSCC, while ten (31.2%) had recurrent lesions. The pattern of the histopathology results was: fifteen (46.9%) patients had poorly differentiated squamous cell carcinoma; nine (28%) had moderately differentiated squamous cell carcinoma; five patients (15.6%) had CIN; two patients (6.3%) had dysplasia and one patient (3.1%) had a well differentiated squamous cell carcinoma. CONCLUSIONS: Prevalence of CSCC in HIV/AIDS patients was 7.8%. Patients present late with advanced lesions. Recurrence rates from previous surgery are high. The often uncharacteristic complaints and findings on presentation complicate the clinical diagnosis. Active search for early manifestations of CSCC in HIV / AIDS patients, complete surgical excision and close follow up is necessary. Alternative treatment methods and techniques like the topical use of antimetabolites should be explored further.

Department of Paediatrics, College of Health Sciences, University of Nairobi, Kenya. Verbal autopsy was used to determine causes of death in 239 children under the age of 5 years. The diagnosis derived from verbal autopsy was corroborated with hospital diagnosis in 39 cases. There was concurrence of diagnosis in 72% of the cases. Using the diagnosis of bronchopneumonia to validate the method, verbal autopsy was found to have a sensitivity of 71%, specificity of 92%, a positive predictive value of 85%. Reliability index of agreement was 0.654. Recall period up to 29 months after death was found to be reliable. PMID: 2282890 [PubMed - indexed for MEDLINE]

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Department of Veterinary Medicine, Faculty of Veterinary Medicine, Makerere University, Kampala, Uganda. Pulmonary oedema is a common sign of East Coast fever (ECF, Theileria parva infection) of cattle. A trial was conducted on farms in Uganda to compare a product containing both the antitheilerial compound parvaquone and the diuretic compound frusemide with one containing only parvaquone, in the treatment of ECF. The trial involved 40 clinical cases of ECF, some of them complicated by other infections, in cattle of all ages and on several farms. Confirmed cases were treated with either parvaquone+frusemide (P+F) or parvaquone alone (P). Survival after treatment with P+F was 77% compared with 71% with P. Five of the 10 fatalities were complicated cases. The cure rate for severe but uncomplicated ECF was 89% with P+F and 40% with P. Pulmonary signs were resolved within 24-48 h after treatment with P+F and clinical recovery was noticeably more rapid than with P. The antiparasitic effect of the two treatments was similar. P+F could be particularly useful when reporting, diagnosis or laboratory confirmation of ECF is delayed, because advanced cases are more likely to be encountered under these circumstances.

Twenty variceal banding sessions were performed in eight patients between February 1995 and September 1996. A total of 69 rings were used to band the varices and at each session between two to six rings were used. Two of the eight had active bleeding and both underwent variceal banding to successfully arrest their bleeding as inpatients. Sixteen other variceal banding sessions were performed on an outpatient basis to obliterate their varices. Four of the eight patients had had sclerotherapy before and varices were still present. No acute or long term complications were noted. In one patient, variceal banding could not be performed as he developed stridor upon placement of the overtube. All the patients had advanced varices (Grade III or IV) and extended for more than 15 cms in the oesophagus. Endoscopic variceal obliteration remains the treatment of choice for patients with portal hypertension with variceal bleeding. Variceal banding is associated with a superior outcome when compared with sclerotherapy; the variceal kill time is shorter, infective complications less, rebleeding occurs less commonly and transfusion requirements are lower.

Seventeen cows of various breeds with varying degrees of severity of advanced ocular squamous cell carcinoma were treated by radical surgery, which included enucleation and extirpation of the surrounding ocular muscles and tissues. The degree of severity and the extent of the carcinoma lesion was correlated with the outcome of treatment for each case. It was observed that: 1. eyeball involvement, 2. ulceration and subsequent infection of carcinoma lesion involving the eyelids and 3. involvement of the regional lymphnodes especially the parotid , are some of the main factors that could be used to draw prognosis of such cases. Although the initial surgery may not be costly, the overall cost of managing postoperative complications is prohibitive and results to vast economic losses that should not be ignored.

Six Topi (Damaliscus korrigum) from the Masai Mara area of Kenya were examined.  All had lungworm nodules. The nodules were generalized in distribution among the lung lobes.  These nodules were essentially hepatized lung tissue with adult worms, larvae and eggs with marked cellular reaction accompanying the infection. The cell types were mostly lymphocytes, plasma cells, macrophages, giant cells and eosinophils. The worms were identified as protostrongylus africanus.

No abstract available.

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Localization of Newcastle disease viral nucleoprotein and pathological lesions was valuated in tissues of 55 indigenous ducks (45 experimentally infected and 10 sentinel ones). In addition, ten Newcastle disease infected chickens were used to ensure that the virus inoculum administered to the ducks produced the disease in chickens, the susceptible hosts. Ducks were killed on day 1, 4, 8 and 14 post-infection. Postmortem examination was done with six tissues (liver, spleen, lung, caecal tonsils, kidneys and brain) being collected from each bird. The tissues were preserved in 10% neutral formalin for 24 h. They were then transferred to 70% ethanol for histology and immunohistochemical staining. Airsacculitis, necrotic splenic foci, congested intestines, lymphoid depleted caecal tonsils and focal infiltrations by mononuclear cells were the main pathological lesions in infected ducks. Over 28.9% of the infected ducks had Newcastle disease viral nucleoprotein in macrophage-like large mononuclear cells in the caecal tonsils and kidney tubular epithelium. The viral antigens were located in the cytoplasm and nucleolus of the cells. The other organs had no detectable viral antigens. This study shows that the kidneys and caecal tonsils are the likely predilection sites for the virus in ducks. They thus need to be considered as diagnostic indicators for the viral carriage in ducks.

Studies that address the deeply rooted uncertainty in identifying planning sectors and profiling required
competencies in preparing plans, especially in the urbanization sector (US), are scanty. This is due in part to
the lack of concerns for the effectiveness of the plans and competencies of the planners. The value chain (VC)
model was appraised to provide a framework for ascertaining relevance and accuracy of planning sectors and
concurrence with required competencies. Data on planning sectors and required competencies was collected at
five stakeholder consultative fora, 23 key informant (KI) institutions and seven working sessions. The framework
of the model facilitated analyzing the data through disaggregation. The urbanization sector (US), which is the
main primary activity (MPA) in the model, was assigned the role of the main planning sector (MPS) and expressed
as “MPS:US” in the urbanization value chain. MPS:US was disaggregated into four planning sectors in the value
chain, and each sector ascertained through disaggregation from level 1 to 3. It was found that the structure of
the model and its function provide appropriate framework for ascertaining relevance and accuracy of planning
sectors, and also concur with competencies that are similarly ascertained. Second, the two expressions for
disaggregation to ascertain planning sectors and required competencies each respectively combine into one
expression for simultaneous disaggregation. The paper concludes that the structure and function of VC model and
the expression for simultaneous disaggregation provides a framework of methodology for systematic ascertaining
of planning sectors and competencies, and allows variation of number of planning sectors any one value chain
represents. The paper recommends adopting the structure and functions of the VC model, and the expression for
simultaneous disaggregation as a framework for ascertaining planning sectors and competencies, starting with
the conduct of planning studios in the training of planners

The outbreak of COVID-19 pandemic saw overwhelming effects on consumers’ buying behavior globally, with economic productive activities shifting from offline to online. As a result, many business leaders were left with no option other than adopt the use of Information Technology to ensure business operations continuity, enhance efficiency as well as sustainability. In Kenya, unlike most commercial banks, Saccos have largely been left behind in embracing new banking technologies such as agency banking, internet banking, or mobile banking. Therefore, the use of paperwork, physical and in-person meetings to conduct business has remained widespread amongst many Saccos in the country, before COVID 19 that forced Saccos to shift to virtual banking as an effective alternative, toward addressing their customers’ needs while ensuring safety. This study examined the adoption of Mobile Banking models and Virtual Banking technologies and innovations to establish the factors influencing their adoption by potential users. The study also explored the adoption of Virtual banking amongst Saccos in Kenya, investigating the electronic delivery channels used, and their suitability. The study objectives were accomplished through an exploratory and descriptive approach based on ways of improving access to credit through relationships between Sacco and their clientele in Kenya through the adoption of Virtual Banking. The data used was collected from SACCO-based respondents who included Sacco ICT officers, managers, and members using questionnaires. Data analysis was done using the Statistical Package for Social Sciences (SPSS). The study established that there was wide adoption of various Mobile Banking models and technologies to realize virtual banking adoption by Saccos. Most Saccos were found to favor the Joint venture model and the non-bank-driven model. The extent of adoption of virtual banking amongst bank clientele was found to be influenced by social, economic, and technological factors. The study recommended that Saccos should consider sharing information and technologies across various networks as this is likely to lead to much more gains in adopting technologies that would improve their sustainability as while fostering better customer experience.

Buffalo-derived Theileria parva can 'break through' the immunity induced by the infection and treatment vaccination method (ITM) in cattle. However, no such 'breakthroughs' have been reported in northern Tanzania where there has been long and widespread ITM use in pastoralist cattle, and the Cape buffalo (Syncerus caffer) is also present. We studied the exposure of vaccinated and unvaccinated cattle in northern Tanzania to buffalo-derived T. parva using p67 gene polymorphisms and compared this to its distribution in vaccinated cattle exposed to buffalo-derived T. parva in central Kenya, where vaccine 'breakthroughs' have been reported. Additionally, we analysed the CD8+ T cell target antigen Tp2 for positive selection. Our results showed that 10% of the p67 sequences from Tanzanian cattle (n = 39) had a buffalo type p67 (allele 4), an allele that is rare among East African isolates studied so far. The percentage of buffalo-derived p67 alleles observed in Kenyan cattle comprised 19% of the parasites (n = 36), with two different p67 alleles (2 and 3) of presumptive buffalo origin. The Tp2 protein was generally conserved with only three Tp2 variants from Tanzania (n = 33) and five from Kenya (n = 40). Two Tanzanian Tp2 variants and two Kenyan Tp2 variants were identical to variants present in the trivalent Muguga vaccine. Tp2 evolutionary analysis did not show evidence for positive selection within previously mapped epitope coding sites. The p67 data indicates that some ITM-vaccinated cattle are protected against disease induced by a buffalo-derived T. parva challenge in northern Tanzania and suggests that the parasite genotype may represent one factor explaining this.

Abstract
Objective

To describe the relationship between number and distribution of valves.
Methods

Sixty-six popliteal vein specimens were used for the study after routine dissection at the Department of Human Anatomy, University of Nairobi. The extents of the popliteal vein were identified at the adductor hiatus and soleal arch, cut at these points and then longitudinally sliced open. The number and distribution of valves were then recorded. Data were presented using photomacrographs and tables.
Results

The median number of valves was 1 (mean 0.8; range 0–2), with the lower part of the popliteal vein as the most consistent valve position. Most striking was the valve absence noted in 27 (41%) of the veins.
Conclusion

These findings suggest that a significant proportion of popliteal veins do not have valves thus providing a credible structural link that may predispose the popliteal vein to deep venous thrombosis in the study population.

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Interest rate derivatives form part of the largest portion of traded financial instruments. Hence, it is important to have models that describe their dynamics accurately. This study aims at pricing Quanto caps and floors using the multi-curve cross-currency LIBOR market model (MCCCLMM) dynamics. A Black Scholes MCCCLMM Quanto caplet and floorlet formula is first derived. The MCCCLMM parameters are then calibrated to exactly match the USD and GBP cap market prices. The estimated model parameters are then used to price the Quanto options in the Black MCCCLMM Quanto caplet and floorlet formula. These prices are then compared to the Quanto cap and floor prices estimated via Monte Carlo simulations so as to ascertain its pricing accuracy

Variant anatomy of the testicular artery is important for safe surgery in the retroperioneal area, and
accurate diagnosis of testicular and renal disease. The pattern of origin, number, course and branching
display ethnic and geographical variations. Data from black African populations and especially Eastern
Africa is scarce. The objective of this study was, therefore, to describe the topography of the intraabdominal
part of testicular artery in a sample of the Kenyan population. This was a descriptive crosssectional
study on one hundred (100) testicular arteries at the Department of Human Anatomy, University
of Nairobi. The samples were obtained from autopsy cases and cadaveric specimens. Standard midline
abdominal incisions were made, flaps of the anterior abdominal wall reflected and the intestines,
mesentery and pariental peritoneum retracted systematically to expose the testicular arteries. Their site
and level of origin, number, course and branching were examined. Macrographs of representative
variations were taken using a high resolution digital camera. The results were analysed using SPSS
version 21, and are presented using macrographs and frequency tables. Thirty three (33%) of the arteries
displayed a variant anatomy, with regard to their site of origin (8%), number (4%), course (14%) and
branching pattern (7%). Among the 14 cases of aberrant course, five (5%) arched over the left renal
vein, eight (8%) were retrocaval and one (1%) had a retroureteric course. Seven (7%) bifurcated within
the abdomen. The level of origin along the aorta varied from 1 centimetre above the renal arteries to 5.5
centimetres below them while the vertebral level of origin ranged from T12 to L4. This shows that the
testicular artery among Kenyans displays a high prevalence of variant anatomy characterized by origin
from the accessory renal artery, high level of aortic origin, duplication, retrocaval course and
intraabdominal; division. Preopertaive evaluation of renal and gonadal vasculature is recommended to
minimize misdiagnosis and inadvertent injury retroperitoneal surgery.