Nature, through balancing mechanisms, provides ecosystem services, comprising provisioning, regulating, cultural and supporting services for the survival of mankind (MEA, Ecosystems and human well-being: biodiversity synthesis. World Resources Institute, Washington, DC, 2005). The balance and stability is usually upset by interventions or development activities, thereby threatening survival. Maintaining the balance guarantees sustainable development. Pests and disease regulation provides one component of managing the ecosystem. This chapter highlights why pest and disease regulation is important in contributing to sustainable agricultural production and development. Continued multidisciplinary research efforts are needed to enable understanding of the biological interactions between pests, beneficial and host communities on one hand and the interactions between and among cost-effective pest management methods, soil health, climate change, food security and human well-being on the other hand. The holistic approach in developing the understanding of the role of pest and disease regulation in the ecosystem will ultimately contribute to the development of appropriate strategies for the achievement of human well-being

45 Kenyan traditional healers were interviewed with respect to the diagnosis and treatment of eye diseases. Traditional management of eye diseases is based on the healers' concept of the disease causation as well as their knowledge of the herbal, animal and chemical substances that possess (or are reported to possess) remedial effect on the disease. While many of the healers interviewed failed to give a clear distinction between the various eye conditions, diseases such as cataract, foreign bodies and injuries were recognized easily. In almost all cases the medicinal substances were first diluted in water before they were applied to the eyes. Human milk, blood and the white of the egg were the animal substances listed as medicinal to various eye conditions. A solution of sugar was one of the chemical substances used in the treatment of specific eye conditions. Given correct information, some of these healers could f

Resistance to the antifolate sulfadoxine–pyrimethamine (SP), the current mass-treatment antimalarial drug, is associated with selection of point mutations in dihydrofolate reductase and dihydropteroate synthase. Among these mutations, the leucine 164 dihydrofolate reductase mutation (Leu-164) is associated with higher levels of SP resistance; this mutation is also associated with a decrease in the efficacy of chlorproguanil/dapsone, a newly developed antifolate antimalarial drug. Leu-164 has been detected in Southeast Asia and South America, regions where SP is no longer effective. Surprisingly, this mutation has not yet been detected in Africa, using the standard protocol based on PCR–RFLP, despite high SP resistance. In this paper, we discuss briefly the reasons why Leu-164 has not yet been selected in Africa and we propose a means that may slow down the selection of this mutation.

Why do many smallholder farmers fail to adopt improved land management practices which can improve yields and incomes? The reason is not always because these practices are uneconomical but sometimes it is because resource poverty prevents farmers from taking advantage of yield and income enhancing agricultural practices. In this study we examine the relative merits of using a carbon payment scheme compared to a subsidy policy to help reduce the cost of specific land management practices with productivity and ecosystem benefits such as carbon sequestration. Using a 30-year crop simulation model, we examine the impacts of different soil fertility management treatments (SFTs) on yields and soil carbon and proceed to compute discounted incremental revenue streams over the same period. We find that the SFTs simulated are on average profitable given the conditions assumed in our DSSAT simulations. When carbon was priced at $8 or $12/t CO2e, the increase in incremental incomes generated from a carbon payment were invariably higher than those imputed from a 50% fertilizer subsidy. When carbon was priced at $4/Co2e, the increase was almost similar and sometimes higher than that from the imputed income transfer from a 50% subsidy. If these indications hold in further research, it could imply that using fertilizer subsidies as the sole mechanism for stimulating adoption of improved soil fertility management practices may unnecessarily forgo other complementary and possibly superior alternatives. Depending on the specific economic equity considerations, we conclude that either of these instruments can be used to help farmers break through resource barriers that prevent them from adopting productivity-enhancing and environmentally beneficial agricultural practices. However, given the fiscal burden on public finances and possible opportunity costs of any substantial subsidy program, it is possible that a carbon payment system can be a reasonable alternative assuming the range of carbon prices used in this study and especially if accompanied by measures to ameliorate the costs of fertilizer to farmers.

Despite the focus on the importance of trees in Africa and the many projects that try to improve their management, there is very little research and few development projects which address tree related problems in a holistic manner. With respect to forest management arrangements, focus tends to be either exclusively on community forestry, or on private tree planting. Such a divided focus makes it difficult to understand the complementarities and possible synergetic effects of these two approaches in solving common problems and improving local livelihoods. The present article argues that interdisciplinary projects are needed to develop a holistic approach to tree management and to improve the use of trees. This argument builds on the results from the PETREA (People, Trees and Agriculture) research programme in Majawanga (Gairo, Tanzania). In this village, private and collective tree management is characterized by very different uses, opportunities and problems. Common woodlands play an important role in providing villagers with Non-Timber Forest Products (NTFP) from indigenous species that are important for local livelihoods as they provide food, medicine, and grazing areas. The constraints linked to the management of common woodlands pertain to group dynamics and resemble, at first glance, a “tragedy of the commons” as described by Hardin (1968). Private tree planting, on the other hand, provides both local services (including providing fruits, firewood or securing boundaries between fields) and cash from the selling of poles. The constraints characterizing private tree management are linked to land-tenure, tree seedling cost and season for planting. Land tenure is of paramount importance as trees cannot be planted on borrowed or rented land, or at the expense of cropland needed to sustain the household. The season for planting seedlings is a constraint because of a conflict with labour demands for crops needed to survive. Despite being characterized by very different uses and constraints, the management of private and common trees also share common constraints as both require that grazing is under control and that there exist clear rules and efficient institutions able to solve management conflicts. Both types of management should therefore be analyzed together as improving one can help relieve the pressure on the other.

The bacteriophage population is large, dynamic, ancient, and genetically diverse. Limited genomic information shows that phage genomes are mosaic, and the genetic architecture of phage populations remains ill-defined. To understand the population structure of phages infecting a single host strain, we isolated, sequenced, and compared 627 phages of Mycobacterium smegmatis. Their genetic diversity is considerable, and there are 28 distinct genomic types (clusters) with related nucleotide sequences. However, amino acid sequence comparisons show pervasive genomic mosaicism, and quantification of inter-cluster and intra-cluster relatedness reveals a continuum of genetic diversity, albeit with uneven representation of different phages. Furthermore, rarefaction analysis shows that the mycobacteriophage population is not closed, and there is a constant influx of genes from other sources. Phage isolation and analysis was performed by a large consortium of academic institutions, illustrating the substantial benefits of a disseminated, structured program involving large numbers of freshman undergraduates in scientific discovery.

Abstract An influenza pandemic caused by a novel influenza virus A(H1N1)pdm09 spread worldwide in 2009 and is estimated to have caused between 151,700 and 575,400 deaths globally. While whole genome data on new virus enables a deeper insight in the pathogenesis, epidemiology, and drug sensitivities of the circulating viruses, there are relatively limited complete genetic sequences available for this virus from African countries. We describe herein the full genome analysis of influenza A(H1N1)pdm09 viruses isolated in Kenya between June 2009 and August 2010. A total of 40 influenza A(H1N1)pdm09 viruses isolated during the pandemic were selected. The segments from each isolate were amplified and directly sequenced. The resulting sequences of individual gene segments were concatenated and used for subsequent analysis. These were used to infer phylogenetic relationships and also to reconstruct the time of most recent ancestor, time of introduction into the country, rates of substitution and to estimate a time-resolved phylogeny. The Kenyan complete genome sequences clustered with globally distributed clade 2 and clade 7 sequences but local clade 2 viruses did not circulate beyond the introductory foci while clade 7 viruses disseminated country wide. The time of the most recent common ancestor was estimated between April and June 2009, and distinct clusters circulated during the pandemic. The complete genome had an estimated rate of nucleotide substitution of 4.9 × 10− 3 substitutions/site/year and greater diversity in surface expressed proteins was observed. We show that two clades of influenza A(H1N1)pdm09 virus were introduced into Kenya from the \{UK\} and the pandemic was sustained as a result of importations. Several closely related but distinct clusters co-circulated locally during the peak pandemic phase but only one cluster dominated in the late phase of the pandemic suggesting that it possessed greater adaptability.

In Sub Saharan Africa, surgical conditions account for a significant disease burden. Surgical workforce is however inadequate, and thus strategies such as attracting medical students to surgical specialties could avert the situation. This study determined the proportion of students interested in pursuing surgical career and factors that influence choice of this specialty. Although surgery is the most preferred specialty among medical students at the University of Nairobi, there appears to be a declining interest among the clinical students. In order to attract and maintain student interest in the specialty, there is need for early and active mentoring.

Kenya, like many developing nations, continues to experience high childhood mortality in spite of the many efforts put in place by governments and international bodies to curb it. This study sought to investigate the barriers to accessing healthcare services for children aged less than five years in Butere District, a rural district experiencing high rates of mortality and morbidity despite having relatively better conditions for child survival. Methods: Exit interviews were conducted among caregivers seeking healthcare for their children in mid 2007 in all the 6 public health facilities. Additionally, views from caregivers in the community, health workers and district health managers were sought through focus group discussions (FGDs) and key informant interviews (KIs). Results: Three hundred and ninety-seven respondents were surveyed in exit interviews while 45 respondents participated in FGDs and KIs. Some practices by caregivers including early onset of child bearing, early supplementation, and utilization of traditional healers were thought to increase the risk of mortality and morbidity, although reported rates of mosquito net utilization and immunization coverage were high. The healthcare system posed barriers to access of healthcare for the under fives, through long waiting time, lack of drugs and poor services, incompetence and perceived poor attitudes of the health workers. FGDs also revealed wide-spread concerns and misconceptions about health care among the caregivers. Conclusion: Caregivers’ actions were thought to influence children’s progression to illness or health while the healthcare delivery system posed recurrent barriers to the accessing of healthcare for the under-fives. Actions on both fronts are necessary to reduce childhood mortality

Kenya, like many developing nations, continues to experience high childhood mortality in spite of the many efforts put in place by governments and international bodies to curb it. This study sought to investigate the barriers to accessing healthcare services for children aged less than five years in Butere District, a rural district experiencing high rates of mortality and morbidity despite having relatively better conditions for child survival. Methods: Exit interviews were conducted among caregivers seeking healthcare for their children in mid 2007 in all the 6 public health facilities. Additionally, views from caregivers in the community, health workers and district health managers were sought through focus group discussions (FGDs) and key informant interviews (KIs). Results: Three hundred and ninety-seven respondents were surveyed in exit interviews while 45 respondents participated in FGDs and KIs. Some practices by caregivers including early onset of child bearing, early supplementation, and utilization of traditional healers were thought to increase the risk of mortality and morbidity, although reported rates of mosquito net utilization and immunization coverage were high. The healthcare system posed barriers to access of healthcare for the under fives, through long waiting time, lack of drugs and poor services, incompetence and perceived poor attitudes of the health workers. FGDs also revealed wide-spread concerns and misconceptions about health care among the caregivers. Conclusion: Caregivers’ actions were thought to influence children’s progression to illness or health while the healthcare delivery system posed recurrent barriers to the accessing of healthcare for the under-fives. Actions on both fronts are necessary to reduce childhood mortality

In recent years, Internet connectivity has greatly improved across the African continent. This article examines the consequences that this shift has had for East African firms that are part of global value chains (GVCs). Prior work yielded contradictory expectations: firms might benefit from connectivity through increased efficiencies and improved access to markets, although they might also be further marginalized through increasing control of lead firms. Drawing on extensive qualitative research in Kenya and Rwanda,including 264 interviews, we examine 3 sectors (tea, tourism, and business process outsourcing) exploring overarching, cross-cutting themes. The findings support more pessimistic expectations: small African producers are only thinly digitally integrated in GVCs. Moreover, shifting modes of value chain governance, supported by lead firms and facilitated by digital information platforms and data standards are leading to new challenges for firms looking to digitally integrate. Nevertheless, we also find examples in these sectors of opportunities where small firms are able to cater to emerging niche customers, and local or regional markets. Overall, the study shows that improving connectivity does not inherently benefit African firms in GVCs without support for complementary capacity and competitive advantages.

In Kenya, trade policy reforms in the cereals sector were initiated as a key component of the economy-wide structural adjustment programmes (SAPs) during the mid 1980s. The SAPs were later strengthened and made irreversible by Kenya’s commitments at the multilateral trade negotiations. However, the welfare effects of these trade policy reforms remain controversial. This paper to quantifies the market and welfare impacts of trade liberalization in Kenya’s maize sector using a partial equilibrium model with market interrelationships at the farm, wholesale and retail levels. The model is calibrated to simulate a 24 percent reduction in maize import tariffs and a complete abolition of tariffs. The simulations results suggest that tariff reductions yield price decreases across the three market levels. The declining prices increase maize consumption but reduce domestic production. Consequently, consumer surplus increases while producer surplus decreases. However, the gain in consumer surplus is not sufficient to compensate the loss in producer surplus. Thus, the implementation of the multilateral agricultural trade agreement is likely to leave Kenya’s maize sector worse off and cannot be considered as a viable policy based on the compensation principle.

No abstract available.

This article demonstrates that whistleblowing often receives little attention in public administration due to ambivalence regarding administrative roles held by public administrators, the fluid scalar chain and horizontal linkages, and competitive and intricate public, organisational and private interests. Drawing on comparative analysis to elucidate the broader scope of anti-corruption reforms and whistleblowing in public administration, the article explores the influence of the administrative culture on the relationship between whistleblowing behaviours and implementation of anti-corruption reforms in public administration in Kenya. It illustrates how bureaucratic oversight mechanisms such as internal auditing procedures and ethical guidelines tend to underperform where administrative environments largely feature autocratic bureaucratic authority, parochial management styles and centralised decision-making processes. Despite the functional specialty of public institutions, these cultural composites potentially elicit administrative behaviours that generally make whistleblowing anti-organisational, anti-social and an outright illegality in public administration. The absence of whistleblowing legislation or weak whistleblowing laws exacerbate these conditions. Whistleblowing becomes even more complex at the local-state level as social networks and working groups tend to be strengthened by the collectivist associational culture in public administration. Consequently, non-performance of anti-corruption reforms were found to stem from the collective chastisement of whistleblowing practices in public organisations in Kenya. Furthermore, institutional deficits typical in local-state administration seemingly made it riskier for potential whistleblowers to come forth, mainly attendant to loose and inconsistent legislation on corruption. Therefore, to enhance whistleblowing, there is a need to insulate potential whistleblowers from legal retaliation, including cultural retaliations that come in forms of emotional and professional ‘attacks’.

The purpose of the study was to develop an in-depth  understanding of reactions of 40 urban and rural HIV-infected Kenyan women to HIV diagnosis. We employed narrative inquiry principles to guide this qualitative cross-sectional study. We conducted individual in-depth interviews using open- ended questions in April and May 2006. In this article we focus on women

This article deals with participatory forest management (PFM) in Tanzania, Mozambique, and Laos, focusing on the degree to which the legislation supports local communities' security of rights to the forest resources and access to resource benefits, as well as the degree to which the legislation is implemented. The findings are that local communities' security of rights and access to benefits differ markedly among the three countries, whereas there is a striking similarity in the absence of efforts to implement PFM, in particular in areas with valuable timber resources. The underlying reasons for the differences are poor institutional setups and conflicting economic interests at various levels. We argue that the approach to support PFM should acknowledge differences between countries and areas, and that, under all conditions, assistance to communities in building advocacy organizations that can assert their legal rights and demand commitment of national governments is a fundamental prerequisite for success.

BACKGROUND: Diffuse infiltrative lymphocytosis syndrome (DILS) is characterised by a persistent CD8+ lymphocytosis and lymphocytic infiltration of various organs. The exact prevalence isn’t known but some studies have reported between 0.85 – 3%, and appears to be more common in African population. Patients with DILS tend to have higher CD4cell counts and survive longer than those patients without DILS. Most patients present with bilateral parotid gland enlargement and features of the Sicca syndrome. Common sites of extra glandular involvement are the lungs being the most common site, followed by peripheral neuropathy and liver. With the high incidence of HIV in our population it is likely that DILS is under diagnosed probably due to our ignorance of this disease. Awareness of its various presentations may bring to light undiscovered patients with DILS.
OBJECTIVE: To review pathogenesis, diagnostic approach and current trends in the management of Diffuse interstitial lymphocytic syndrome
DATA SOURCE: Literature review of relevant published literature from both Africa and the rest of the world.
DATA SYNTHESIS:Pathologically, under light microscopy, DILS resembles the focal sialadenitis seen with Sjogren’s syndrome, although it tends to be less destructive of the glandular architecture than in Sjogren’s syndrome. Most of the inflammatory infiltrate is composed of CD8+ lymphocytes unlike Sjogren’s which are CD4+. Lymphoepithelial cysts are frequently observed in the parotid glands of patients with DILS. The variation in CD8 count in the course of HIV disease is less understood. The variation in CD8 lymphocytes is implicated in the pathogenesis of a number of clinical manifestations in HIV diseases including diffuse infiltrative lymphocytic syndrome (DILS) and HIV associated CD8+ lymphocytosis syndrome.Parotid gland enlargement in a patient with HIV infection should prompt clinicians to suspect DILS. In addition, clinicians should be aware that the pulmonary process associated with DILS may mimic clinically and radiographically the pneumonic process caused by Pneumocystis carinii. Other manifestations of DILS to consider include a severe form of peripheral neuropathy; lymphocytic infiltration of the liver, evident as hepatitis; myositis; and lymphocytic interstitial nephritis.Management of DILS is determined by the severity of glandular and extra glandularfeatures.Data on therapeutic trials are lacking although there are isolated reports of good response to antiretroviral and steroid therapy.

CONCLUSION: DILS, a subset of HIV disease manifestation, may present as parotid gland swellings. In general, an HIV patient presenting with DILS has a better prognosis than a patient with HIV alone.With the high incidence of HIV in our population it is likely that DILS is under diagnosed probably due to our ignorance of this disease. Awareness of its various presentations may bring to light undiscovered patients with DILS. Clinicians should watch for the possible transformation into B-cell lymphoma. There is still paucity of data about this disease from pathophysiology to treatment to studies correlating the plasma viral load with CD8 lymphocyte count in patients with HIV disease.

BACKGROUND: Diffuse infiltrative lymphocytosis syndrome (DILS) is characterised by a persistent CD8+ lymphocytosis and lymphocytic infiltration of various organs. The exact prevalence isn’t known but some studies have reported between 0.85 – 3%, and appears to be more common in African population. Patients with DILS tend to have higher CD4cell counts and survive longer than those patients without DILS. Most patients present with bilateral parotid gland enlargement and features of the Sicca syndrome. Common sites of extra glandular involvement are the lungs being the most common site, followed by peripheral neuropathy and liver. With the high incidence of HIV in our population it is likely that DILS is under diagnosed probably due to our ignorance of this disease. Awareness of its various presentations may bring to light undiscovered patients with DILS.
OBJECTIVE: To review pathogenesis, diagnostic approach and current trends in the management of Diffuse interstitial lymphocytic syndrome
DATA SOURCE: Literature review of relevant published literature from both Africa and the rest of the world.
DATA SYNTHESIS:Pathologically, under light microscopy, DILS resembles the focal sialadenitis seen with Sjogren’s syndrome, although it tends to be less destructive of the glandular architecture than in Sjogren’s syndrome. Most of the inflammatory infiltrate is composed of CD8+ lymphocytes unlike Sjogren’s which are CD4+. Lymphoepithelial cysts are frequently observed in the parotid glands of patients with DILS. The variation in CD8 count in the course of HIV disease is less understood. The variation in CD8 lymphocytes is implicated in the pathogenesis of a number of clinical manifestations in HIV diseases including diffuse infiltrative lymphocytic syndrome (DILS) and HIV associated CD8+ lymphocytosis syndrome.Parotid gland enlargement in a patient with HIV infection should prompt clinicians to suspect DILS. In addition, clinicians should be aware that the pulmonary process associated with DILS may mimic clinically and radiographically the pneumonic process caused by Pneumocystis carinii. Other manifestations of DILS to consider include a severe form of peripheral neuropathy; lymphocytic infiltration of the liver, evident as hepatitis; myositis; and lymphocytic interstitial nephritis.Management of DILS is determined by the severity of glandular and extra glandularfeatures.Data on therapeutic trials are lacking although there are isolated reports of good response to antiretroviral and steroid therapy.

CONCLUSION: DILS, a subset of HIV disease manifestation, may present as parotid gland swellings. In general, an HIV patient presenting with DILS has a better prognosis than a patient with HIV alone.With the high incidence of HIV in our population it is likely that DILS is under diagnosed probably due to our ignorance of this disease. Awareness of its various presentations may bring to light undiscovered patients with DILS. Clinicians should watch for the possible transformation into B-cell lymphoma. There is still paucity of data about this disease from pathophysiology to treatment to studies correlating the plasma viral load with CD8 lymphocyte count in patients with HIV disease.

BACKGROUND: Diffuse infiltrative lymphocytosis syndrome (DILS) is characterised by a persistent CD8+ lymphocytosis and lymphocytic infiltration of various organs. The exact prevalence isn’t known but some studies have reported between 0.85 – 3%, and appears to be more common in African population. Patients with DILS tend to have higher CD4cell counts and survive longer than those patients without DILS. Most patients present with bilateral parotid gland enlargement and features of the Sicca syndrome. Common sites of extra glandular involvement are the lungs being the most common site, followed by peripheral neuropathy and liver. With the high incidence of HIV in our population it is likely that DILS is under diagnosed probably due to our ignorance of this disease. Awareness of its various presentations may bring to light undiscovered patients with DILS.
OBJECTIVE: To review pathogenesis, diagnostic approach and current trends in the management of Diffuse interstitial lymphocytic syndrome
DATA SOURCE: Literature review of relevant published literature from both Africa and the rest of the world.
DATA SYNTHESIS:Pathologically, under light microscopy, DILS resembles the focal sialadenitis seen with Sjogren’s syndrome, although it tends to be less destructive of the glandular architecture than in Sjogren’s syndrome. Most of the inflammatory infiltrate is composed of CD8+ lymphocytes unlike Sjogren’s which are CD4+. Lymphoepithelial cysts are frequently observed in the parotid glands of patients with DILS. The variation in CD8 count in the course of HIV disease is less understood. The variation in CD8 lymphocytes is implicated in the pathogenesis of a number of clinical manifestations in HIV diseases including diffuse infiltrative lymphocytic syndrome (DILS) and HIV associated CD8+ lymphocytosis syndrome.Parotid gland enlargement in a patient with HIV infection should prompt clinicians to suspect DILS. In addition, clinicians should be aware that the pulmonary process associated with DILS may mimic clinically and radiographically the pneumonic process caused by Pneumocystis carinii. Other manifestations of DILS to consider include a severe form of peripheral neuropathy; lymphocytic infiltration of the liver, evident as hepatitis; myositis; and lymphocytic interstitial nephritis.Management of DILS is determined by the severity of glandular and extra glandularfeatures.Data on therapeutic trials are lacking although there are isolated reports of good response to antiretroviral and steroid therapy.

CONCLUSION: DILS, a subset of HIV disease manifestation, may present as parotid gland swellings. In general, an HIV patient presenting with DILS has a better prognosis than a patient with HIV alone.With the high incidence of HIV in our population it is likely that DILS is under diagnosed probably due to our ignorance of this disease. Awareness of its various presentations may bring to light undiscovered patients with DILS. Clinicians should watch for the possible transformation into B-cell lymphoma. There is still paucity of data about this disease from pathophysiology to treatment to studies correlating the plasma viral load with CD8 lymphocyte count in patients with HIV disease.

Background: Di use In ltrative
Lymphocytosis Syndrome (DILS) is
characterised by a persistent CD8+
lymphocytosis and lymphocytic
in ltration of various organs. The exact
prevalence isn’t known but some studies
have reported between 0.85 – 3%, and
appears to be more common in African
population. Patients with DILS tend to have higher CD4 cell counts and survive
longer than those patients without DILS.
Most patients present with bilateral
parotid gland enlargement and features
of the Sicca syndrome. Common sites
of extra glandular involvement are the
lungs being the most common site,
followed by peripheral neuropathy and
liver. With the high incidence of HIV in
our population it is likely that DILS is
under diagnosed probably due to our
ignorance of this disease. Awareness of
its various presentations may bring to
light undiscovered patients with DILS.
Objective: To review pathogenesis,
diagnostic approach and current trends
in the management of di use interstitial
lymphocytic syndrome.
Data source:  Literature review of
relevant published literature from both
Africa and the rest of the world.
Data synthesis: Pathologically, under
light microscopy, DILS resembles the
focal sialadenitis seen with Sjogren’s
syndrome, although it tends to be less
destructive of the glandular architecture
than in Sjogren’s syndrome. Most of the
in ammatory in ltrate is composed
of CD8+ lymphocytes unlike Sjogren’s
which are CD4+. Lymphoepithelial
cysts are frequently observed in the
parotid glands of patients with DILS.
The variation in CD8+ count in the
course of HIV disease is less understood.
The variation in CD8+ lymphocytes is
implicated in the pathogenesis of a
number of clinical manifestations in HIV
diseases including Di use In ltrative
Lymphocytic Syndrome (DILS) and
HIV associated CD8+ lymphocytosis
syndrome. Parotid gland enlargement
in a patient with HIV infection should prompt clinicians to suspect DILS. In addition, clinicians should be aware
that the pulmonary process associated
with DILS may mimic clinically and
radiographically the pneumonic process
caused by pneumocystis carinii. Other
manifestations of DILS to consider
include a severe form of peripheral
neuropathy; lymphocytic in ltration of
the liver, evident as hepatitis; myositis;
and lymphocytic interstitial nephritis.
Management of DILS is determined
by the severity of glandular and extra
glandular features. Data on therapeutic
trials are lacking although there are
isolated reports of good response to
antiretroviral and steroid therapy.
Conclusion: DILS, a subset of HIV
disease manifestation, may present as
parotid gland swellings. In general, an
HIV patient presenting with DILS has a
better prognosis than a patient with HIV
alone. With the high incidence of HIV
in our population it is likely that DILS is
under diagnosed probably due to our
ignorance of this disease. Awareness of
its various presentations may bring to
light undiscovered patients with DILS.
Clinicians should watch for the possible
transformation into B-cell lymphoma.
There is still paucity of data about
this disease from pathophysiology to
treatment to studies correlating the
plasma viral load with CD8+ lymphocyte
count in patients with HIV disease.

We evaluate the boundary of the Anthropocene geological time interval as an epoch, since it is useful to have a consistent temporal definition for this increasingly used unit, whether the presently informal term is eventually formalized or not. Of the three main levels suggested – an ‘early Anthropocene’ level some thousands of years ago; the beginning of the Industrial Revolution at ∼1800 CE (Common Era); and the ‘Great Acceleration’ of the mid-twentieth century – current evidence suggests that the last of these has the most pronounced and globally synchronous signal. A boundary at this time need not have a Global Boundary Stratotype Section and Point (GSSP or ‘golden spike’) but can be defined by a Global Standard Stratigraphic Age (GSSA), i.e. a point in time of the human calendar. We propose an appropriate boundary level here to be the time of the world's first nuclear bomb explosion, on July 16th 1945 at Alamogordo, New Mexico; additional bombs were detonated at the average rate of one every 9.6 days until 1988 with attendant worldwide fallout easily identifiable in the chemostratigraphic record. Hence, Anthropocene deposits would be those that may include the globally distributed primary artificial radionuclide signal, while also being recognized using a wide range of other stratigraphic criteria. This suggestion for the Holocene–Anthropocene boundary may ultimately be superseded, as the Anthropocene is only in its early phases, but it should remain practical and effective for use by at least the current generation of scientists.

Wheeze is an important sign indicating a potentially severe adverse event in vaccine and drug trials, particularly in children. However, there are currently no consensus definitions of wheeze or associated respiratory compromise in randomized controlled trials (RCTs).

Land is a critical resource in Kenya, having economic, social, political, environmental and cultural significance. Kenya’s population continues to rely on land for both subsistence and economic activities. In fact, the increase of the population from about 20 million people in the 1960s to about 40 million currently, has put enormous pressure on land. Only a third of Kenya’s land is arable while the rest is arid and semi-arid. With most Kenyans still living off the land, contestations over access to, control over and ownership of land are prevalent. In the broader Kenya context, the land question has emerged as a major political issue that can erupt anytime and threaten the existence of the state, as was witnessed in the post-election violence in December 2007 (Kameri-Mbote and Kindiki, 2009). Within this context, women’s rights to land have remained at the core of the quest for gender equality in Kenya. Among various Kenyan communities, women do not traditionally own land or other immovable property. They have use rights which are anchored in their relationships with men as husbands, fathers, brothers or uncles. Such access is tenuous and can be denied by the male benefactors. This situation affects the survival and livelihoods of women and also stifles their effective role in, and contribution to, national development. This is despite the fact that women provide the bulk of agricultural labour.

HIV testing and counseling services in Africa began in the early 1990s, with limited availability and coverage. Fears of stigma and discrimination, complex laboratory systems, and lack of available care and treatment services hampered expansion. Use of rapid point-of-care tests, introduction of services to prevent mother-to-child transmission, and increasing provision of antiretroviral drugs were key events in the late 1990s and early 2000s that facilitated the expansion of HIV testing and counseling services. Innovations in service delivery included providing HIV testing in both clinical and community sites, including mobile and home testing. Promotional campaigns were conducted in many countries, and evolutions in policies and guidance facilitated expansion and uptake. Support from President's Emergency Plan for AIDS Relief and national governments, other donors, and the Global Fund for AIDS, Tuberculosis, and Malaria contributed to significant increases in the numbers of persons tested in many countries. Quality of both testing and counseling, limited number of health care workers, uptake by couples, and effectiveness of linkages and referral systems remain challenges. Expansion of antiretroviral treatment, especially in light of the evidence that treatment contributes to prevention of transmission, will require greater yet strategic coverage of testing services, especially in clinical settings and in combination with other high-impact HIV prevention strategies. Continued support from President's Emergency Plan for AIDS Relief, governments, and other donors is required for the expansion of testing needed to achieve international targets for the scale-up of treatment and universal access to knowledge of HIV status.

Origin of labyrinthine artery is important because it influences the presentation of occlusion of anterior inferior
cerebellar and basilar arteries. It shows ethnic and geographical variation, but there is no data from black African
populations. This study, therefore examined the pattern of origin of labyrinthine artery in adult black Kenyans.
Three hundred and fourty six arteries from one hundred and seventy-three formalin fixed brains were examined
by dissection at the Department of Human Anatomy University of Nairobi, Kenya. Labyrinthine artery arose from
basilar artery in 260 (75.1%); as common trunk with anterior inferior cerebellar artery in 48 (13.9%) and from
the latter in 38 (11.0%) of cases. There was no side and gender difference in the pattern of origin. This implies
that majority of labyrinthine arteries arise from basilar artery, different from that in oriental, Indo-Asian and
Caucasian populations, in which it arises from the anterior inferior cerebellar artery. Preoperative evaluation of
basilar artery branching is recommended.

The problem of school non-attendance is an increasing one in our setting and yet its cause has not been established. This paper presents data of work done through interviews with parents and observations of the home environments of the sample cases in attempt to establish factors associated with school non-attendance. After the initial interviews, the children were seen periodically for follow-ups, usually at two to three monthly intervals for at least one year, by the team which consisted of a consultant psychiatrist, a clinical psychologist, a paediatric registrar and a psychiatric social worker. Out of the ten cases sampled for the study, nine were of school phobia and one of conduct disorder (truancy). Generally, family characteristics significantly associated with school non-attendance in this study were neuroticism in parents, unstable family relationships occasioned by marital discord, parental expectations of high academic performance by the child and, to some extent, poverty. The common management approaches used were family therapy, counselling and anti-depressant pharmacotherapy.

Abstract
This paper assesses the impact of access to credit from rural and community banks (RCBs) on the technical efficiency of smallholder cassava farmers in Ghana. The study employed the stochastic frontier, and endogenous switching regression models to estimate the technical efficiency, and the impact of RCB credit access, respectively, on a randomly selected sample of 300 smallholder cassava farmers in the Fanteakwa District of Ghana. Results suggest that cassava farmers in the District are 70.5 percent technically efficient implying that cassava yield levels could be increased further by 29.5 percent without changing the current levels of inputs. The results further reveal that the gender of the household head, access to extension services, membership in farmer organizations, and proximity to the bank are the major factors that positively influence farmers to access credit from RCBs. On average, farmers who accessed credit from RCBs have significantly higher technical efficiencies than farmers who did not access, suggesting that access to credit from RCBs positively impacts the technical efficiency of smallholder cassava farmers.

Keywords: Credit access; Endogenous switching regression; Rural and community banks; Stochastic frontier model; Technical efficiency.

Introduction A survey to determine the prevalence of trachomatous trichiasis (Tl] requires a large sample size and the recommended participant age is 2': 15 years. This study sought to establish the appropriate age range of individuals to be included in Tl surveys. Methods Data from six previous surveys of adults 2': 15 years old were reanalysed. Results Reanalysis indicated that 69.6-93.3% (average 87.0%) of untreated n occurred in those aged 40+ years and 52.2-86.7% (average 73.1%) in those aged 50 + years (age 2':50 years is used in rapid assessment of avoidable blindness). Age 2':40 years was adopted in a Tl survey conducted in Turkana district because it allowed a smaller sample size than age 2':15 years. Conclusions The estimated backlog of untreated Tl in people aged 2':40 years old in Turkana was 5932 and the overall n backlog was likely to be 6358-8523. These findings cannot be generalised because all surveys were carried out in the same country.

Introduction A survey to determine the prevalence of trachomatous trichiasis (Tl] requires a large sample size and the recommended participant age is 2': 15 years. This study sought to establish the appropriate age range of individuals to be included in Tl surveys. Methods Data from six previous surveys of adults 2': 15 years old were reanalysed. Results Reanalysis indicated that 69.6-93.3% (average 87.0%) of untreated n occurred in those aged 40+ years and 52.2-86.7% (average 73.1%) in those aged 50 + years (age 2':50 years is used in rapid assessment of avoidable blindness). Age 2':40 years was adopted in a Tl survey conducted in Turkana district because it allowed a smaller sample size than age 2':15 years. Conclusions The estimated backlog of untreated Tl in people aged 2':40 years old in Turkana was 5932 and the overall n backlog was likely to be 6358-8523. These findings cannot be generalised because all surveys were carried out in the same country.

Introduction: A survey to determine the prevalence of trachomatous trichiasis (TT) requires a large sample size and the recommended participant age is >15 years. This study sought to establish the appropriate age range of individuals to be included in TT surveys.
Methods: Data from six previous surveys of adults >15 years old were reanalysed.
Results: Reanalysis indicated that 69.6-93.3% (average
87.0%) of untreated TT occurred in those aged 40+ years and 52.2e86.7% (average 73.1%) in those aged 50+ years (age >50 years is used in rapid assessment of avoidable blindness). Age >40 years was adopted in a TT survey conducted in Turkana district because it allowed a smaller sample size than age >15 years.
Conclusions: The estimated backlog of untreated TT in people aged >40 years old in Turkana was 5932 and the overall TT backlog was likely to be 6358-8523. These findings cannot be generalised because all surveys were carried out in the same country.

To estimate the potential impact of an HIV/AIDS Vaccine in Kenya. Design: The Kenyan HIV/AIDS epidemic was modeled using the most current data from national sources including epidemiology and behavioral surveillance. The model’s baseline projection was validated against adult HIV prevalence at antenatal clinics and ge- neral population surveys. The model was used to analyze the effects of scaling up current pre- vention programs and adding potential HIV vac- cines with varying levels of effectiveness and coverage. Results: Even with full scale-up of currently available prevention, care and treat- ment programs, new infections will continue to burden Kenya. The introduction of a partially ef- fective AIDS vaccine could significantly alter the trajectory of the epidemic. Conclusion: The game changing impact that an AIDS vaccine could have on the AIDS epidemic in Kenya under- scores the importance of sustaining political support and financial investment to accelerate HIV/AIDS vaccine research and development.

To estimate the potential impact of an HIV/AIDS Vaccine in Kenya. Design: The Kenyan HIV/AIDS epidemic was modeled using the most current data from national sources including epidemiology and behavioral surveillance. The model’s baseline projection was validated against adult HIV prevalence at antenatal clinics and ge- neral population surveys. The model was used to analyze the effects of scaling up current pre- vention programs and adding potential HIV vac- cines with varying levels of effectiveness and coverage. Results: Even with full scale-up of currently available prevention, care and treat- ment programs, new infections will continue to burden Kenya. The introduction of a partially ef- fective AIDS vaccine could significantly alter the trajectory of the epidemic. Conclusion: The game changing impact that an AIDS vaccine could have on the AIDS epidemic in Kenya under- scores the importance of sustaining political support and financial investment to accelerate HIV/AIDS vaccine research and development.

To estimate the potential impact of an HIV/AIDS Vaccine in Kenya. Design: The Kenyan HIV/AIDS epidemic was modeled using the most current data from national sources including epidemiology and behavioral surveillance. The model’s baseline projection was validated against adult HIV prevalence at antenatal clinics and ge- neral population surveys. The model was used to analyze the effects of scaling up current pre- vention programs and adding potential HIV vac- cines with varying levels of effectiveness and coverage. Results: Even with full scale-up of currently available prevention, care and treat- ment programs, new infections will continue to burden Kenya. The introduction of a partially ef- fective AIDS vaccine could significantly alter the trajectory of the epidemic. Conclusion: The game changing impact that an AIDS vaccine could have on the AIDS epidemic in Kenya under- scores the importance of sustaining political support and financial investment to accelerate HIV/AIDS vaccine research and development.

Obstetric fistula, a devastating maternal health complication associated with social stigma and isolation, is often found in resource-poor settings where access to specialized care is constrained. In this study, the authors examine the perspectives of the healthcare providers on the factors that contribute to obstetric fistulae formation in West Pokot, Kenya. Key informant interviews with healthcare providers, social workers and traditional birth attendants were held to generate information on factors contributing to formation of obstetric fistulae. Thematic analysis based on grounded theory approach was used. Factors that contribute to the occurrence of obstetric fistulae include: female genital mutilation and early forced marriage; unskilled birth attendants and associated birth rituals; infrastructural constraints; and lack of women's empowerment. There is interplay between sociocultural, structural and economic forces in the region that culminate in maternal morbidity and possible mortality. Healthcare providers' perspectives are vital in understanding maternal health problems in rural Kenya. Community level initiatives aimed at improving the health of women in rural resource-poor areas should be encouraged.

Background

The creation of a clinical network was proposed as a means to promote implementation of a set of recommended clinical practices targeting inpatient paediatric care in Kenya. The rationale for selecting a network as a strategy has been previously described. Here, we aim to describe network activities actually conducted over its first 2.5 years, deconstruct its implementation into specific components and provide our ‘insider’ interpretation of how the network is functioning as an intervention.
Methods

We articulate key activities that together have constituted network processes over 2.5 years and then utilise a recently published typology of implementation components to give greater granularity to this description from the perspective of those delivering the intervention. Using the Behaviour Change Wheel we then suggest how the network may operate to achieve change and offer examples of change before making an effort to synthesise our understanding in the form of a realist context–mechanism–outcome configuration.
Results

We suggest our network is likely to comprise 22 from a total of 73 identifiable intervention components, of which 12 and 10 we consider major and minor components, respectively. At the policy level, we employed clinical guidelines, marketing and communication strategies with intervention characteristics operating through incentivisation, persuasion, education, enablement, modelling and environmental restructuring. These might influence behaviours by enhancing psychological capability, creating social opportunity and increasing motivation largely through a reflective pathway.
Conclusions

We previously proposed a clinical network as a solution to challenges implementing recommended practices in Kenyan hospitals based on our understanding of theory and context. Here, we report how we have enacted what was proposed and use a recent typology to deconstruct the intervention into its elements and articulate how we think the network may produce change. We offer a more generalised statement of our theory of change in a context–mechanism–outcome configuration. We hope this will complement a planned independent evaluation of ‘how things work’, will help others interpret results of change reported more formally in the future and encourage others to consider further examination of networks as means to scale up improvement practices in health in lower income countries.

The development of the urban fringes is an inevitable consequence of urbanization given that as cities continue to grow, urban activities spread outwards in waves towards the rural areas. The rural-urban fringes of cities thus, are the exit points for residents relocating from major urban built areas, and entry points for rural migrants into the towns. Firstly, rural-urban fringes are determined by two major factors; that is, administrative boundaries and the differences in the intensity of built up areas and the farmland. Secondly, policy and legal guidelines exhibit inadequacies in handling the dynamism of the fringes and thus the failure by planning agencies in managing the impending growth. Thirdly, prospective land developers, businesses and communities fail to anticipate the results of development because they lack information on potential or approved development plans. This research paper applies urban development theories to explain the drivers of growth at the rural-urban fringes. In this regard, the study draws heavily from a paper by Alonso and Wingo’s explanations on the spatial structure in terms of how the market allocates space to users according to supply and demand; von Thunen’s agricultural land use model whose building blocks are economic rent, distance from the centre and individual decision making explains how the urban structure is influenced by the locational behavior of households in the city. A sample of 134 respondents, drawn from the five (5) neighborhoods located within the Nairobi-Kiambu development corridor informed the research. This was further informed by the rather heterogeneous nature of the neighborhoods in terms of physical characteristics, livelihoods and historical evolution. Observation, questionnaires, focus group discussions and interviews were the main methods applied in the collection of primary data. A synopsis of the findings reveals that, contrary to conclusions in studies carried out elsewhere in Africa that periphery development accommodates low income residents, the Nairobi-Kiambu corridor presents an area interspersed with low and high income households; households locate at the fringes so as to take advantage of relaxed regulations and therefore engage in land use practices that are allowable.

The purpose of the research paper is to inform readers and other researchers on the dynamics of fringe development of a city in an African country. The paper provides insights into causes and effects of rural land conversion into urban land uses. The research is based on a most vibrant development corridor of the city of Nairobi.

Key words: rural-urban fringe, drivers of growth, development corridor, land,
planning.

Department of Paediatrics and Child Health, College of Health Sciences, University of Nairobi, P.O. Box 20956-00202, Nairobi, Kenya. BACKGROUND: Early growth in very low birth weight (VLBW) infants has been found predictive of their later outcomes. This has led to increased interest in establishing measures to optimise such growth. In facilities without the resources required to undertake long-term audits for all the high risk infants they graduate, these growth parameters may also be used as selection criteria for those meriting such follow up reducing costs. OBJECTIVES: To describe early growth patterns among a cohort of VLBW infants and determine some of the factors associated with poor growth among them. DESIGN: Cross section survey. SETTING: Kenyatta National Hospital, Nairobi, Kenya. SUBJECTS: One hundred and seventy five neonatal survivors. RESULTS: Of the 175 infants recruited, the male/female ratio was 4:6, sixty four (36.6%) were intrauterine growth retarded while significant illnesses during the neonatal period were reported in 109 (62.3%). Forty seven percent of the infants had been fed on exclusive breast milk, 33% on mixed feeds while 20% received exclusive preterm formula. The mean neonatal weight gain for the whole cohort was 13.5 (3.9) g/kg/day, length of 0.34 (0.11) cm/week and head circumference of 0.32 (0.71) cm/week. By term only 33 (18.9%), 37 (21.1%) and 48 (28%) had reached the expected (the 3rd percentile) weight, length and head circumference respectively. Sixty percent of the infants gained weight at <15 g/kg/day while 70% and 78% grew in head circumference and length at < 0.5 cm/week respectively. At term weight, head and linear growth faultering were recorded in 81%, 72% and 79% respectively. The factors that were associated with better growth at this stage included feeding on preterm formula (P < 0.001) and absence of neonatal morbidity (P < 0.001). Infants who were appropriate for gestational age at birth also had better catch up growth at term compared to those born small for gestation (P < 0.001) but their neonatal growth itself was not significantly better. CONCLUSION: The mean neonatal growth in all anthropometric measures was less than expected and by the time of their expected delivery, less than 30% of these infants had reached the 3rd percentile of the expected measurement in all the three growth parameters. Choice of milk and neonatal morbidity influenced these growth patterns. RECOMMENDATIONS: Routine fortification of mother's milk or addition of preterm formula and reorganised care of sick newborns is recommended to improve early growth. PMID: 16771104 [PubMed - indexed for MEDLINE]

The study of operators having some special spectral properties like Weyl's theorem, Browder's theorem
and the SVEP has been of important interest for some time now. The SVEP is very useful in the study of
the local spectral theory. In this paper, we explore the single-valued extension property (SVEP) for some
operators on Hilbert spaces. We characterize operators with or without SVEP at zero and those where
Weyl's and Browder's theorems hold. It is shown that if a Fredholm operator has no SVEP at zero, then
zero is an accumulation point of the spectrum of the operator. It is also shown that quasi similar Fredholm
operators have equal Weyl spectrum.

This study was carried out in one of the agriculturally high potential and densily populated areas of Kenya The data presented in this paper was collected during soil survey carried out to asses the suitability of some of these waterlogged areas for drainage and their capability to sustain agricultural production.The wetland soils of central Kenya have histic, gleyic, stagnic, plinthic and/or vertic properties. They occur on mountain areas, structural plains and valleys and generally imperfectly to poorly, drained, shallow to very deep, dark reddish brown to black, friable to firm, in places mottled clay. The Wetland soils are used for irrigated rice production in the plains, cultivation of subsistence crops and horticultural crops in the seasonally flooded Valleys. Reeds and papyrus dominate the Mountains, which are used for forestry, mountains, mountaineering, game reserve and is important water shed zone

Extreme wet spells affect the East Africa Coast (EAC) during March to June (long rains) and October to December (short rains). While these spells are less frequent during the short rains, some of the most extreme wet spells occur at this time of the year. The present study examined the general characteristics of the wet spells during the short rains. A detailed study of the anomalous wet spell event of October 1997, with record rainfall around Mombasa (4.0°S, 39.6°E), was also carried out.
Daily rainfall for 1962-1997 and NCEP2 reanalysis data for 1979-1997 were used to study the characteristics of the wet events. A high spatial coherence is found in the rainfall over the EAC. The circulation features that were common during most of the wet events were: weakening or reversal of the east-west (Walker type) circulation over the Indian Ocean, enhanced convergence between the northern and southern hemisphere trade winds and westward-moving disturbances in the low-level equatorial wind field. During the 1997 wet event, it is shown that prior to the heavy rainfall event a ridge of high pressure, on the eastern coast of southern Africa, intensified and propagated eastwards leading to the strengthening of moist easterlies reaching the EAC. The zonal wind component along longitude 40°E showed shears in the flows that were associated with the development of the Mozambique Channel low/trough in the lower troposphere round which southerlies surged northwards. These southerlies converged with the easterlies near the EAC. Thus, the warm and wet air from the east interacted with the relatively cold and mainly continental air from the south generating instability at the EAC.

Background: The knowledge of evolutionary patterns of the HA gene of the influenza virus is important in vaccinestrain selection.Objective: Genetic analysis of HA1 of influenza viruses isolated in Kenya during the 2010-2011 season with referenceto WHO vaccine strains.Methods: A total of twenty seven (27) influenza A (H1N1) pdm09, Nineteen (19) influenza A (H3N2) and Sixteen (16)influenza B virus isolates were analyzed. A partial HA1 gene was amplified by RT-PCR and sequenced.Results: Phylogenetic analyses revealed that influenza B viruses were closely related to B/Brisbane/60/2008 vaccinestrain while A (H1N1) pdm09 viruses were genetic variants of A/California/07/2009. The Kenyan A (H1N1) pdm09isolates had P83S, D97N, S185T, I321V and E374K amino acid substitutions. Influenza A/H3N2 isolates showed K62E,T212A and S214I simultaneous amino acid substitutions when compared to A/Perth/10/2009. The K62E changeoccurred at antigenic site E. Majority of the Kenyan H3N2 isolates further had S45N and K144N amino acidsubstitutions at sites C and A respectively, which introduced N-glycosylation motifs absent in the vaccine strain.Conclusion: The study showed that although the WHO 2010 vaccine strains recommendations for the southernhemisphere matched with influenza viruses which circulated in Kenya during the 2010-2011 season, the viruses hadevolved genetically from the vaccine strains.

PIP: In November and December, 1993, a self-administered questionnaire was distributed to men in the town of Machakos and to nonmedical hospital workers of Machakos General Hospital. The purpose of the study was to assess their knowledge about and attitude towards vasectomy. The majority of men were in the age group of 30-44 years and were married; the hospital group was more educated. The town men perceived the pill to be the best contraceptive method for women in contrast to the hospital group who gave more importance to bilateral tubal ligation. The hospital group also perceived vasectomy as the best method for men. Overall, 53.2% men were aware of the correct procedure of vasectomy, but only 24% had correct knowledge of how the procedure affects masculinity. The knowledge of the procedure among hospital workers was not very different from that of the town group. Recommendations were made to increase information and education to all groups of people through various media. author's modified

Animal welfare is defined as the ability of an animal to interact comfortably with its environment through its physiological, psychological and behavioural systems. About 70% of dairy production in Kenya is from the smallholder production systems. These production systems are negatively impacted by a number of factors including poor nutrition, substandard husbandry and management practices, lack of appropriate farm inputs, diseases and low incomes. These factors influence the welfare of dairy cattle, hence their importance for its evaluation. This study was therefore designed with the following objectives: 1. to determine the welfare of dairy cattle in the smallholder production units in Nairobi and its environs, 2. to determine the risk factors contributing to poor welfare of dairy cattle in the smallholder production units, 3. to determine the indicators of poor welfare of dairy cattle in the smallholder production units, 4. to determine the farmers’ and stockmen’s perspectives of animal welfare. These objectives were achieved through a cross-sectional study carried out in 80 smallholder dairy units purposively selected in Nairobi and its environs, in which 306 dairy cows were examined. The welfare of cattle in these dairy units was evaluated through several methods which included: visual observations for animal- and farm-level factors that indicate poor welfare of cattle; taking measurements of dairy housing unit dimensions such as cubicle, walk-alley, kerb and feeding bunk; and using a structured questionnaire to interview farmers and stockmen on nutritional regimes and other management practices such as removal of slurry, milking techniques, record keeping and disease control. These factors were recorded and later analyzed. Analyses included descriptive statistics, and simple associations using chi-square at p< 0.05 significance level. Over 80% of these smallholder units had factors that contributed to poor welfare of dairy cattle. These factors included under-size cubicles, small walk-alleys, too high feeding bunks with traumatic edges, too low positioning of neck rails at the feed bunks, sharp objects and edges within the housing units and dilapidated housing structures. The main evidence of poor welfare was injuries on the animals. The body condition score (BCS) of the cows was the main indicator of welfare relating to feeding. Presence of injuries or scars on the skin at various parts of the body was considered a positive indicator of poor welfare either associated with housing structures, management practices or animal interactions. Other causes of poor welfare of the cows were hind-limb tying during milking, teat pulling during hand-milking, more than 24-hour delay before sick cows were treated, and mixing of cattle of different age-groups in the same compartment. Cow-human interaction was poor as evidenced by fearful response and long avoidance distance. This study concludes that poor welfare of dairy cattle exists in all the smallholder units evaluated, which is mainly caused by improper housing and management. Training of farmers and stockmen on animal welfare issues would therefore be a prerequisite to the improvement of dairy cattle welfare. Research on the physiological response to poor welfare of dairy cows in the smallholder units needs to be carried out to enhance the understanding of the impact of these risk factors on smallholder dairy animals.

Animal welfare is defined as the ability of an animal to interact comfortably with its environment through its physiological, psychological and behavioural systems. About 70% of dairy production in Kenya is from the smallholder production systems. These production systems are negatively impacted by a number of factors including poor nutrition, substandard husbandry and management practices, lack of appropriate farm inputs, diseases and low incomes. These factors influence the welfare of dairy cattle, hence their importance for its evaluation. This study was therefore designed with the following objectives: 1. to determine the welfare of dairy cattle in the smallholder production units in Nairobi and its environs, 2. to determine the risk factors contributing to poor welfare of dairy cattle in the smallholder production units, 3. to determine the indicators of poor welfare of dairy cattle in the smallholder production units, 4. to determine the farmers’ and stockmen’s perspectives of animal welfare. These objectives were achieved through a cross-sectional study carried out in 80 smallholder dairy units purposively selected in Nairobi and its environs, in which 306 dairy cows were examined. The welfare of cattle in these dairy units was evaluated through several methods which included: visual observations for animal- and farm-level factors that indicate poor welfare of cattle; taking measurements of dairy housing unit dimensions such as cubicle, walk-alley, kerb and feeding bunk; and using a structured questionnaire to interview farmers and stockmen on nutritional regimes and other management practices such as removal of slurry, milking techniques, record keeping and disease control. These factors were recorded and later analyzed. Analyses included descriptive statistics, and simple associations using chi-square at p< 0.05 significance level. Over 80% of these smallholder units had factors that contributed to poor welfare of dairy cattle. These factors included under-size cubicles, small walk-alleys, too high feeding bunks with traumatic edges, too low positioning of neck rails at the feed bunks, sharp objects and edges within the housing units and dilapidated housing structures. The main evidence of poor welfare was injuries on the animals. The body condition score (BCS) of the cows was the main indicator of welfare relating to feeding. Presence of injuries or scars on the skin at various parts of the body was considered a positive indicator of poor welfare either associated with housing structures, management practices or animal interactions. Other causes of poor welfare of the cows were hind-limb tying during milking, teat pulling during hand-milking, more than 24-hour delay before sick cows were treated, and mixing of cattle of different age-groups in the same compartment. Cow-human interaction was poor as evidenced by fearful response and long avoidance distance. This study concludes that poor welfare of dairy cattle exists in all the smallholder units evaluated, which is mainly caused by improper housing and management. Training of farmers and stockmen on animal welfare issues would therefore be a prerequisite to the improvement of dairy cattle welfare. Research on the physiological response to poor welfare of dairy cows in the smallholder units needs to be carried out to enhance the understanding of the impact of these risk factors on smallholder dairy animals.

Animal welfare is defined as the ability of an animal to interact comfortably with its environment through its physiological, psychological and behavioural systems. About 70% of dairy production in Kenya is from the smallholder production systems. These production systems are negatively impacted by a number of factors including poor nutrition, substandard husbandry and management practices, lack of appropriate farm inputs, diseases and low incomes. These factors influence the welfare of dairy cattle, hence their importance for its evaluation. This study was therefore designed with the following objectives: 1. to determine the welfare of dairy cattle in the smallholder production units in Nairobi and its environs, 2. to determine the risk factors contributing to poor welfare of dairy cattle in the smallholder production units, 3. to determine the indicators of poor welfare of dairy cattle in the smallholder production units, 4. to determine the farmers’ and stockmen’s perspectives of animal welfare. These objectives were achieved through a cross-sectional study carried out in 80 smallholder dairy units purposively selected in Nairobi and its environs, in which 306 dairy cows were examined. The welfare of cattle in these dairy units was evaluated through several methods which included: visual observations for animal- and farm-level factors that indicate poor welfare of cattle; taking measurements of dairy housing unit dimensions such as cubicle, walk-alley, kerb and feeding bunk; and using a structured questionnaire to interview farmers and stockmen on nutritional regimes and other management practices such as removal of slurry, milking techniques, record keeping and disease control. These factors were recorded and later analyzed. Analyses included descriptive statistics, and simple associations using chi-square at p< 0.05 significance level. Over 80% of these smallholder units had factors that contributed to poor welfare of dairy cattle. These factors included under-size cubicles, small walk-alleys, too high feeding bunks with traumatic edges, too low positioning of neck rails at the feed bunks, sharp objects and edges within the housing units and dilapidated housing structures. The main evidence of poor welfare was injuries on the animals. The body condition score (BCS) of the cows was the main indicator of welfare relating to feeding. Presence of injuries or scars on the skin at various parts of the body was considered a positive indicator of poor welfare either associated with housing structures, management practices or animal interactions. Other causes of poor welfare of the cows were hind-limb tying during milking, teat pulling during hand-milking, more than 24-hour delay before sick cows were treated, and mixing of cattle of different age-groups in the same compartment. Cow-human interaction was poor as evidenced by fearful response and long avoidance distance. This study concludes that poor welfare of dairy cattle exists in all the smallholder units evaluated, which is mainly caused by improper housing and management. Training of farmers and stockmen on animal welfare issues would therefore be a prerequisite to the improvement of dairy cattle welfare. Research on the physiological response to poor welfare of dairy cows in the smallholder units needs to be carried out to enhance the understanding of the impact of these risk factors on smallholder dairy animals.

Animal welfare is defined as the ability of an animal to interact comfortably with its environment through its physiological, psychological and behavioural systems. About 70% of dairy production in Kenya is from the smallholder production systems. These production systems are negatively impacted by a number of factors including poor nutrition, substandard husbandry and management practices, lack of appropriate farm inputs, diseases and low incomes. These factors influence the welfare of dairy cattle, hence their importance for its evaluation. This study was therefore designed with the following objectives: 1. to determine the welfare of dairy cattle in the smallholder production units in Nairobi and its environs, 2. to determine the risk factors contributing to poor welfare of dairy cattle in the smallholder production units, 3. to determine the indicators of poor welfare of dairy cattle in the smallholder production units, 4. to determine the farmers’ and stockmen’s perspectives of animal welfare. These objectives were achieved through a cross-sectional study carried out in 80 smallholder dairy units purposively selected in Nairobi and its environs, in which 306 dairy cows were examined. The welfare of cattle in these dairy units was evaluated through several methods which included: visual observations for animal- and farm-level factors that indicate poor welfare of cattle; taking measurements of dairy housing unit dimensions such as cubicle, walk-alley, kerb and feeding bunk; and using a structured questionnaire to interview farmers and stockmen on nutritional regimes and other management practices such as removal of slurry, milking techniques, record keeping and disease control. These factors were recorded and later analyzed. Analyses included descriptive statistics, and simple associations using chi-square at p< 0.05 significance level. Over 80% of these smallholder units had factors that contributed to poor welfare of dairy cattle. These factors included under-size cubicles, small walk-alleys, too high feeding bunks with traumatic edges, too low positioning of neck rails at the feed bunks, sharp objects and edges within the housing units and dilapidated housing structures. The main evidence of poor welfare was injuries on the animals. The body condition score (BCS) of the cows was the main indicator of welfare relating to feeding. Presence of injuries or scars on the skin at various parts of the body was considered a positive indicator of poor welfare either associated with housing structures, management practices or animal interactions. Other causes of poor welfare of the cows were hind-limb tying during milking, teat pulling during hand-milking, more than 24-hour delay before sick cows were treated, and mixing of cattle of different age-groups in the same compartment. Cow-human interaction was poor as evidenced by fearful response and long avoidance distance. This study concludes that poor welfare of dairy cattle exists in all the smallholder units evaluated, which is mainly caused by improper housing and management. Training of farmers and stockmen on animal welfare issues would therefore be a prerequisite to the improvement of dairy cattle welfare. Research on the physiological response to poor welfare of dairy cows in the smallholder units needs to be carried out to enhance the understanding of the impact of these risk factors on smallholder dairy animals.

This paper presents comparative qualitative and quantitative evidence from rural Kenya and Madagascar in an attempt to untangle the causality behind persistent poverty. We find striking differences in welfare dynamics depending on whether one uses total income, including stochastic terms and inevitable measurement error, or the predictable, structural component of income based on a household's asset holdings. Our results suggest the existence of multiple dynamic asset and structural income equilibria, consistent with the poverty traps hypothesis. Furthermore, we find supporting evidence of locally increasing returns to assets and of risk management behaviour consistent with poor households' defence of a critical asset threshold through asset smoothing.

In Kenya, welding services are extensively employed in both the formal and informal sectors. The needs continue to increase with increasing population, infrastructure and vehicle fleet, and economic development. Welding need is even currently very important in support of …