At the beginning of the century, splenectomy was used in the treatment of kala-azar, but now is rarely needed, the major indication being for drug resistant kala-azar. Inadvertent splenectomy prior to the diagnosis of kala-azar continues to occur, probably because of a reluctance to perform splenic aspiration in the investigation of splenomegaly. Five Kenyan children underwent splenectomy for drug resistant kala-azar. All were immediately improved, but one died of overwhelming post splenectomy infection (OPSI) two months later and another of a malignant lymphoma seven months after surgery. The other three patients appear to be cured. Splenectomy was considered in a sixth child with kala-azar because of a Salmonella abscess in the spleen, but the abscess ruptured catastrophically before surgery could be arranged.

Rat bite fever has not been reported from Kenya previously. A case of 17 year old Kenyan male who was diagnosed to have rat bite fever after a bite of domestic rat is described. The history, clinical features and demonstration of spirillum like organisms from a thick blood film suggest infection due to spirillum minus. The patient recovered completely after a course of penicillin and gentamicin.

Rat bite fever has not been reported from Kenya previously. A case of 17 year old Kenyan male who was diagnosed to have rat bite fever after a bite of domestic rat is described. The history, clinical features and demonstration of spirillum like organisms from a thick blood film suggest infection due to spirillum minus. The patient recovered completely after a course of penicillin and gentamicin.

Department of Dental Surgery, University of Nairobi, Kenya. The present longitudinal study was conducted on ten children from age 5-6 years to determine the post-eruptive enamel changes of fluorosed permanent incisors. The children were born and reared in an area of Kenya with a water fluoride level of 14-45 parts per million. The incisors were examined and photographed periodically from the time of eruption over a period of 2 1/2 years. It was noted that the fluorosed incisor was intact as it erupted and then it underwent a variety of changes. In some there was mechanical breakdown (pitting) of the chalky white enamel which occurred rapidly initially and then the breakdown slowed down by 2 years. In others, there was smoothening of the pitted enamel resulting in a translucent appearance. Alternatively there was some degree of patchy staining of the enamel without surface breakdown. Much of the cervical 1/3 of the enamel remained intact even in teeth with severe breakdown. In most cases, these changes were bilaterally symmetrical. The possible reasons for these changes are discussed.

The purpose of this study was to record the caries status in children attending public primary schools in Nairobi. The sample comprised 513 children, 262 aged 6-8 years and 251 aged 13-15 years. The children were drawn from six randomly selected schools in the city. Clinical examination was carried out in a room with natural daylight, using the WHO (1977) criteria. Fifty-four per cent of the 6- to 8-year-olds and 50% of the 13- to 15-year-olds were caries-free. The mean dmft in the 6- to 8-year-olds was 1.7, and the mean dmfs was 3.5. The mean DMFT in the 13- to 15-year-olds was 1.8, and the mean DMFS was 2.9. The d- and D-components dominated and were mainly located in the occlusal surfaces. The f-component of the dmft and the F-component of the DMFT comprised 1% and 10%, respectively. There was no statistically significant difference (p > 0.05) in the prevalence of caries between males and females in the younger age group. In the older age group, however, females had a higher (p < 0.05) prevalence than males. In general, the study showed a low caries prevalence in Nairobi children.

Department of Paediatric Dentistry and Orthodontics, Dental School, University of Nairobi, Kenya. The purpose of this study was to record the caries status in children attending public primary schools in Nairobi. The sample comprised 513 children, 262 aged 6-8 years and 251 aged 13-15 years. The children were drawn from six randomly selected schools in the city. Clinical examination was carried out in a room with natural daylight, using the WHO (1977) criteria. Fifty-four per cent of the 6- to 8-year-olds and 50% of the 13- to 15-year-olds were caries-free. The mean dmft in the 6- to 8-year-olds was 1.7, and the mean dmfs was 3.5. The mean DMFT in the 13- to 15-year-olds was 1.8, and the mean DMFS was 2.9. The d- and D-components dominated and were mainly located in the occlusal surfaces. The f-component of the dmft and the F-component of the DMFT comprised 1% and 10%, respectively. There was no statistically significant difference (p > 0.05) in the prevalence of caries between males and females in the younger age group. In the older age group, however, females had a higher (p < 0.05) prevalence than males. In general, the study showed a low caries prevalence in Nairobi children.

Department of Pediatric Dentistry and Orthodontics, Dental School, University of Nairobi, Kenya. The purpose of this study was to assess the prevalence and severity of dental fluorosis in 513 primary school children in Nairobi. The clinical examination was performed in a room with natural daylight using Thylstrup & Fejerskov's index (TFI). Overall, 18% of 6-8-yr-olds had dental fluorosis in the primary dentition and 76% of 13-15-yr-olds in the permanent dentition. There was no significant sex difference (P > 0.05) in either the prevalence or the severity of fluorosis. In children with mixed dentition, the prevalence and severity of fluorosis was higher in the permanent teeth. In the permanent dentition, no clear difference was demonstrable in the severity between the anterior and the posterior teeth. The degree of fluorosis in most of the children in the area served with river water (0.2-0.4 ppm F-) was of a very mild form. However, in the area served with borehole waters, 48% of the children and 40% of the teeth were found to have TFI scores > or = 5. Measures to reduce dental fluorosis are necessary in the latter area.

Department of Paediatric Dentistry and Orthodontics, Dental School, University of Nairobi, Kenya. The purpose of this study was to record the caries status in children attending public primary schools in Nairobi. The sample comprised 513 children, 262 aged 6-8 years and 251 aged 13-15 years. The children were drawn from six randomly selected schools in the city. Clinical examination was carried out in a room with natural daylight, using the WHO (1977) criteria. Fifty-four per cent of the 6- to 8-year-olds and 50% of the 13- to 15-year-olds were caries-free. The mean dmft in the 6- to 8-year-olds was 1.7, and the mean dmfs was 3.5. The mean DMFT in the 13- to 15-year-olds was 1.8, and the mean DMFS was 2.9. The d- and D-components dominated and were mainly located in the occlusal surfaces. The f-component of the dmft and the F-component of the DMFT comprised 1% and 10%, respectively. There was no statistically significant difference (p > 0.05) in the prevalence of caries between males and females in the younger age group. In the older age group, however, females had a higher (p < 0.05) prevalence than males. In general, the study showed a low caries prevalence in Nairobi children.

Department of Preventive Dentistry, Faculty of Dentistry, State University of Rio de Janeiro, Brazil. The uptake of alkali soluble and alkali insoluble fluoride on and in fluorotic enamel was investigated in vitro. Teeth from Kenya, assigned score 3 in accordance with Thylstrup-Fejerskov's fluorosis index, were used. The enamel was treated with either a neutral 2% NaF solution, a 0.2% NaF solution (pH 5.5), or the supernatant from a 0.1% NaF-containing toothpaste (pH 7). The treatment time was 1 h. The reaction product formed on the enamel was analyzed by KOH extraction and acid etching. Significantly higher amounts of alkali soluble fluoride were formed on the enamel from the 2% and 0.2% NaF solutions, as compared with the control. There was also a significant increase in the firmly bound fluoride after treatment with the neutral 2% NaF solution.

Department of Preventive Dentistry, Faculty of Dentistry, State University of Rio de Janeiro, Brazil. The uptake of alkali soluble and alkali insoluble fluoride on and in fluorotic enamel was investigated in vitro. Teeth from Kenya, assigned score 3 in accordance with Thylstrup-Fejerskov's fluorosis index, were used. The enamel was treated with either a neutral 2% NaF solution, a 0.2% NaF solution (pH 5.5), or the supernatant from a 0.1% NaF-containing toothpaste (pH 7). The treatment time was 1 h. The reaction product formed on the enamel was analyzed by KOH extraction and acid etching. Significantly higher amounts of alkali soluble fluoride were formed on the enamel from the 2% and 0.2% NaF solutions, as compared with the control. There was also a significant increase in the firmly bound fluoride after treatment with the neutral 2% NaF solution.

Department of Dental Surgery, College of Health Sciences, University of Nairobi, Kenya. The prevalence of dental caries, malocclusion and fractured incisors was investigated in 245 children from a pastoral community in Kenya. Forty-eight per cent of them were found to be caries-free. The overall mean DMFT was 1.9 (s.d. 2.7). Among those with caries, the mean DMFT was 3.0 (s.d. 2.0). Fifty-eight per cent of the children had malocclusion. Overall, 84% of the sample had Angle's Class I, 11% Class II and 5% Class III molar relation. The prevalence of fractured incisors was 15%. Most of the fractures were in the maxilla and involved enamel only. Minimal treatment had been carried out on the children.

Department of Preventive Dentistry, Faculty of Dentistry, State University of Rio de Janeiro, Brazil. The uptake of alkali soluble and alkali insoluble fluoride on and in fluorotic enamel was investigated in vitro. Teeth from Kenya, assigned score 3 in accordance with Thylstrup-Fejerskov's fluorosis index, were used. The enamel was treated with either a neutral 2% NaF solution, a 0.2% NaF solution (pH 5.5), or the supernatant from a 0.1% NaF-containing toothpaste (pH 7). The treatment time was 1 h. The reaction product formed on the enamel was analyzed by KOH extraction and acid etching. Significantly higher amounts of alkali soluble fluoride were formed on the enamel from the 2% and 0.2% NaF solutions, as compared with the control. There was also a significant increase in the firmly bound fluoride after treatment with the neutral 2% NaF solution.

Meningococcal meningitis has been recognised as serious problem for almost 200 years. In Africa the disease occurs in epidemics periodically during the hot and dry weather in the "meningitis belt" and in east Africa, which is outside this belt the epidemics tend to occur during the cold and dry months. The infection is mainly transmitted from person to person by nasopharyngeal carriers in crowded places like refugee camps and army barracks. The rural/urban migration, the basic structural conditions of housing in squatter settlements and slums together with an overcrowded transport system have also contributed to the transmission of meningococcal meningitis. The earlier treatment of meningococcal meningitis was by the way of repeated CSF drainage. The first important advance in the treatment was intrathecal injection of antimeningococcal serum. A major break through in the treatment was the introduction of sulphonamides which was the preferred treatment until emergence of resistance to sulphonamides in mid 1960's. Penicillin remains the drug of choice currently. Mass immunisation of selected communities using polyvalent A and C polysaccharide vaccine is a useful control measure. Chemoprophylaxis is generally not recommended during epidemics. Given the current population densities and rural/urban migration together with financial constraints, future epidemic in Kenya may be more explosive unless strict surveillance programmes are maintained.

Meningococcal meningitis has been recognised as serious problem for almost 200 years. In Africa the disease occurs in epidemics periodically during the hot and dry weather in the "meningitis belt" and in east Africa, which is outside this belt the epidemics tend to occur during the cold and dry months. The infection is mainly transmitted from person to person by nasopharyngeal carriers in crowded places like refugee camps and army barracks. The rural/urban migration, the basic structural conditions of housing in squatter settlements and slums together with an overcrowded transport system have also contributed to the transmission of meningococcal meningitis. The earlier treatment of meningococcal meningitis was by the way of repeated CSF drainage. The first important advance in the treatment was intrathecal injection of antimeningococcal serum. A major break through in the treatment was the introduction of sulphonamides which was the preferred treatment until emergence of resistance to sulphonamides in mid 1960's. Penicillin remains the drug of choice currently. Mass immunisation of selected communities using polyvalent A and C polysaccharide vaccine is a useful control measure. Chemoprophylaxis is generally not recommended during epidemics. Given the current population densities and rural/urban migration together with financial constraints, future epidemic in Kenya may be more explosive unless strict surveillance programmes are maintained.

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.

Department of Pediatric Dentistry and Orthodontics, University of Nairobi Dental School, Kenya. Data on occlusal features and the need for orthodontic treatment in Kenya is scanty. This study was carried out to determine the prevalence of malocclusion in children in Nairobi, Kenya. Nine hundred and nineteen children aged 13-15 years (468 male, 451 female) were examined. The registration method used was that described by Bjork et al. The prevalence of malocclusion was 72%. The predominant anteroposterior relationship of the dental arches was neutral occlusion (93%). Specific malocclusion traits were highest for crowding (19%), rotations (19%), posterior crossbite (10%), maxillary overjet (10%), and frontal open bite (8%). There was no statistically significant difference in the overall prevalence of malocclusion between males and females, but some occlusal traits were significantly higher in males. Although the findings indicate that the present population is not characterized by a substantial difference in the overall prevalence of malocclusion compared with other communities, some traits differed in prevalence from those reported elsewhere.

Department of Pediatric Dentistry and Orthodontics, University of Nairobi Dental School, Kenya. The need for orthodontic treatment in Kenya was previously not been investigated. This study was undertaken to assess the need for orthodontic treatment in 13- to 15-year-old children in Nairobi. The objective need was assessed in 919 children by using the Norwegian treatment need index, and the subjective need was assessed in 739 children by using a structured questionnaire. Objective treatment need was recorded in 29% and subjective need in 33% of the children. Less than 1% were allocated the 'very great need' category. Relatively more girls than boys were dissatisfied with the appearance of their teeth, and a significantly higher number of girls (P < 0.001) said they would like to have their teeth straightened. The children's perceived need for treatment correlated significantly with the treatment need index. Fixed appliances were found necessary for correcting malocclusion in 23% of the children and removable appliances in 6%. Future studies in Kenya should be directed at determining the societal perception of malocclusion, upon which treatment standards may be based.

Kiambu District Hospital, Kenya. OBJECTIVE: To assess the occurrence of hypodontia (except 3rd molars) in a population of orthodontic patients. DESIGN: A retrospective case study. SETTING: Private orthodontic practice in Nairobi PATIENTS: Six hundred and fifteen orthodontic patients aged eight to fifteen years. RESULTS: Hypodontia occurred in 39 children (6.3%). The missing teeth were observed in 24 males (7.2%) and 15 females (5.3%). Of the children with hypodontia, about 80% lacked one or two teeth, 54% had hypodontia involving anterior teeth, 18% lacked single posterior teeth and 8% had two or more teeth missing in the same quadrant. The highest recorded number of missing teeth in any one individual was seven. The most frequently missing teeth were mandibular 2nd premolars (30%), maxillary 2nd premolars (24%) and maxillary lateral incisors (22%) in that order. CONCLUSIONS: Our data for hypodontia were within the wide range reported in the literature. The finding of patients with hypodontia involving the anterior teeth and others missing more than two teeth in the same quadrant was an indication of a great need for orthodontic treatment. The present findings reiterate the neeed for a thorough radiographic evaluation of patients prior to removal of permanent teeth for orthodontic reasons.

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Normal 0 false false false EN-US 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-qformat: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:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;} Olfactory acuity differs among animal species depending on age and dependence on smell. However, the attendant functional anatomy has not been elucidated. We sought to determine the functional structure of the olfactory mucosa in suckling and adult dog and sheep. Mucosal samples harvested from ethmoturbinates were analyzed qualitatively and quantitatively. In both species, the olfactory mucosa comprised olfactory, supporting and basal cells, and a lamina propria containing bundles of olfactory cell axons, Bowman’s glands and vascular elements. The olfactory cells terminated apically with an expanded knob, from which cilia projected in a radial fashion from its base and in form of a tuft from its apex in the dog and the sheep respectively. Olfactory cilia per knob weremorenumerous in the dog (19±3) compared to the sheep (7±2) (p < 0.05). In the dog, axonal bundles exhibited one to two centrally located capillaries and the bundles were of greater diameters (73.3±10.3_m) than those of the sheep (50.6±6.8_m), which had no capillaries. From suckling to adulthood in the dog, the packing density of the olfactory and supporting cells increased by 22.5% and 12.6% respectively. Surprisingly in the sheep, the density of the olfactory cells decreased by 26.2% while that of the supportive cells showed no change. Overall epithelial thickness reached 72.5±2.9_m in the dog and 56.8±3.1_m in the sheep. These observations suggest that the mucosa is better structurally refined during maturation in the dog than in the sheep.

BACKGROUND: Anthrax is an ancient disease affecting animals and humans. Sporadic cases of anthrax and small epidemics have been seen from time to time in different parts of the world and in Africa. However many clinicians are not very familiar with the various presentations and management of anthrax. It is relevant for the health care workers to re-familiarise themselves with all aspects of anthrax, with the impending threat of bioterrorism. OBJECTIVE: To familiarise healthcare workers on all aspects of anthrax. STUDY SELECTION: To describe epidemiology pathogenesis, clinical features, management and prevention of anthrax including measures to take when weapons grade anthrax is suspected. DATA SYNTHESIS: Three forms of the disease are recognised, cutaneous, inhalational and intestinal. Cutaneous anthrax is the most common form. Inhalation anthrax is the most severe form of anthrax. The treatment of anthrax in most cases is penicillin, however with the threat of bioterrorism, intentional releases of anthrax spores in the environment has caused much concern. Weapons grade anthrax of more virulent strain and resistant to commonly used antibiotics is possible. CONCLUSION: In view of the different clinical presentations and outcomes it is important that health care workers re-familiarise themselves with the disease and in the event of bioterrorism are able to take appropriate measures.

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

Kiambu District Hospital, Kenya. OBJECTIVE: To assess the occurrence of hypodontia (except 3rd molars) in a population of orthodontic patients. DESIGN: A retrospective case study. SETTING: Private orthodontic practice in Nairobi PATIENTS: Six hundred and fifteen orthodontic patients aged eight to fifteen years. RESULTS: Hypodontia occurred in 39 children (6.3%). The missing teeth were observed in 24 males (7.2%) and 15 females (5.3%). Of the children with hypodontia, about 80% lacked one or two teeth, 54% had hypodontia involving anterior teeth, 18% lacked single posterior teeth and 8% had two or more teeth missing in the same quadrant. The highest recorded number of missing teeth in any one individual was seven. The most frequently missing teeth were mandibular 2nd premolars (30%), maxillary 2nd premolars (24%) and maxillary lateral incisors (22%) in that order. CONCLUSIONS: Our data for hypodontia were within the wide range reported in the literature. The finding of patients with hypodontia involving the anterior teeth and others missing more than two teeth in the same quadrant was an indication of a great need for orthodontic treatment. The present findings reiterate the neeed for a thorough radiographic evaluation of patients prior to removal of permanent teeth for orthodontic reasons.

Kiambu District Hospital, Kenya. OBJECTIVE: To assess the occurrence of hypodontia (except 3rd molars) in a population of orthodontic patients. DESIGN: A retrospective case study. SETTING: Private orthodontic practice in Nairobi PATIENTS: Six hundred and fifteen orthodontic patients aged eight to fifteen years. RESULTS: Hypodontia occurred in 39 children (6.3%). The missing teeth were observed in 24 males (7.2%) and 15 females (5.3%). Of the children with hypodontia, about 80% lacked one or two teeth, 54% had hypodontia involving anterior teeth, 18% lacked single posterior teeth and 8% had two or more teeth missing in the same quadrant. The highest recorded number of missing teeth in any one individual was seven. The most frequently missing teeth were mandibular 2nd premolars (30%), maxillary 2nd premolars (24%) and maxillary lateral incisors (22%) in that order. CONCLUSIONS: Our data for hypodontia were within the wide range reported in the literature. The finding of patients with hypodontia involving the anterior teeth and others missing more than two teeth in the same quadrant was an indication of a great need for orthodontic treatment. The present findings reiterate the neeed for a thorough radiographic evaluation of patients prior to removal of permanent teeth for orthodontic reasons.

Department of Paediatric Dentistry and Orthodontics, Faculty of Dental Sciences, University of Nairobi, P.O. Box 19676, Nairobi, Kenya. Although multiple supernumerary teeth without any associated syndromes are rare, their occurrence can create a variety of clinical problems such as derangement of the occlusion, prevention of eruption of permanent teeth, damage to adjacent teeth, cystic degeneration and root resorption. Hence, clinical and radiographic evaluation of patients should always be thorough in order to detect their presence. Furthermore, because the clinical management of multiple supernumerary teeth poses a great challenge to clinicians, timely, appropriate consultation and interdisciplinary approach to treatment is extremely important. We report two cases, a 14 year-old boy with eight and a 13-year-old girl with seven supernumerary teeth not associated with syndromes. In the boy, the teeth were bilaterally distributed in all quadrants in the premolar regions, and in the girl they were distributed bilaterally in the premolar regions in the mandible and bilaterally distal to the upper third molars. The clinical implications and management are discussed.

Department of Paediatric Dentistry and Orthodontics, Faculty of Dental Sciences, University of Nairobi, P.O. Box 19676, Nairobi, Kenya. Although multiple supernumerary teeth without any associated syndromes are rare, their occurrence can create a variety of clinical problems such as derangement of the occlusion, prevention of eruption of permanent teeth, damage to adjacent teeth, cystic degeneration and root resorption. Hence, clinical and radiographic evaluation of patients should always be thorough in order to detect their presence. Furthermore, because the clinical management of multiple supernumerary teeth poses a great challenge to clinicians, timely, appropriate consultation and interdisciplinary approach to treatment is extremely important. We report two cases, a 14 year-old boy with eight and a 13-year-old girl with seven supernumerary teeth not associated with syndromes. In the boy, the teeth were bilaterally distributed in all quadrants in the premolar regions, and in the girl they were distributed bilaterally in the premolar regions in the mandible and bilaterally distal to the upper third molars. The clinical implications and management are discussed.

Department of Paediatric Dentistry and Orthodontics, Faculty of Dental Sciences, University of Nairobi, P.O. Box 19676, Nairobi, Kenya. Although multiple supernumerary teeth without any associated syndromes are rare, their occurrence can create a variety of clinical problems such as derangement of the occlusion, prevention of eruption of permanent teeth, damage to adjacent teeth, cystic degeneration and root resorption. Hence, clinical and radiographic evaluation of patients should always be thorough in order to detect their presence. Furthermore, because the clinical management of multiple supernumerary teeth poses a great challenge to clinicians, timely, appropriate consultation and interdisciplinary approach to treatment is extremely important. We report two cases, a 14 year-old boy with eight and a 13-year-old girl with seven supernumerary teeth not associated with syndromes. In the boy, the teeth were bilaterally distributed in all quadrants in the premolar regions, and in the girl they were distributed bilaterally in the premolar regions in the mandible and bilaterally distal to the upper third molars. The clinical implications and management are discussed.

Department of Paediatric Dentistry and Orthodontics, Faculty of Dental Sciences, University of Nairobi, P.O. Box 19676, Nairobi, Kenya. Although multiple supernumerary teeth without any associated syndromes are rare, their occurrence can create a variety of clinical problems such as derangement of the occlusion, prevention of eruption of permanent teeth, damage to adjacent teeth, cystic degeneration and root resorption. Hence, clinical and radiographic evaluation of patients should always be thorough in order to detect their presence. Furthermore, because the clinical management of multiple supernumerary teeth poses a great challenge to clinicians, timely, appropriate consultation and interdisciplinary approach to treatment is extremely important. We report two cases, a 14 year-old boy with eight and a 13-year-old girl with seven supernumerary teeth not associated with syndromes. In the boy, the teeth were bilaterally distributed in all quadrants in the premolar regions, and in the girl they were distributed bilaterally in the premolar regions in the mandible and bilaterally distal to the upper third molars. The clinical implications and management are discussed.

Department of Paediatric Dentistry and Orthodontics, Faculty of Dental Sciences, University of Nairobi, P.O. Box 19676, Nairobi, Kenya. Although multiple supernumerary teeth without any associated syndromes are rare, their occurrence can create a variety of clinical problems such as derangement of the occlusion, prevention of eruption of permanent teeth, damage to adjacent teeth, cystic degeneration and root resorption. Hence, clinical and radiographic evaluation of patients should always be thorough in order to detect their presence. Furthermore, because the clinical management of multiple supernumerary teeth poses a great challenge to clinicians, timely, appropriate consultation and interdisciplinary approach to treatment is extremely important. We report two cases, a 14 year-old boy with eight and a 13-year-old girl with seven supernumerary teeth not associated with syndromes. In the boy, the teeth were bilaterally distributed in all quadrants in the premolar regions, and in the girl they were distributed bilaterally in the premolar regions in the mandible and bilaterally distal to the upper third molars. The clinical implications and management are discussed.

The objective of this study is to inveigate the real inequality perspective of land ownership and use in Kenya. The study demonstrated that there are varying degrees of inequality in land ownership, access and use in Kenya in terms of land tenure, land size and land potential.The study recommends a review of the constitution,legal and administrative frameworks so as to provide for equitable,transparent and accountable land management and administration.

The objective of this study is to inveigate the real inequality perspective of land ownership and use in Kenya. The study demonstrated that there are varying degrees of inequality in land ownership, access and use in Kenya in terms of land tenure, land size and land potential.The study recommends a review of the constitution,legal and administrative frameworks so as to provide for equitable,transparent and accountable land management and administration.

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.

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.

The objective of this study is to inveigate the real inequality perspective of land ownership and use in Kenya. The study demonstrated that there are varying degrees of inequality in land ownership, access and use in Kenya in terms of land tenure, land size and land potential.The study recommends a review of the constitution,legal and administrative frameworks so as to provide for equitable,transparent and accountable land management and administration.

The objective of this study is to inveigate the real inequality perspective of land ownership and use in Kenya. The study demonstrated that there are varying degrees of inequality in land ownership, access and use in Kenya in terms of land tenure, land size and land potential.The study recommends a review of the constitution,legal and administrative frameworks so as to provide for equitable,transparent and accountable land management and administration.

The objective of this study is to inveigate the real inequality perspective of land ownership and use in Kenya. The study demonstrated that there are varying degrees of inequality in land ownership, access and use in Kenya in terms of land tenure, land size and land potential.The study recommends a review of the constitution,legal and administrative frameworks so as to provide for equitable,transparent and accountable land management and administration.

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The gene Q13L coding for the Capripoxvirus group specific structural protein P32 was expressed in Escherichia coli using plasmid pGEX-2T as a fusion protein with glutathione-s-transferase and purified on glutathione sepharose affinity chromatography column. The protein was then employed for diagnosis of sheeppox, goatpox and lumpyskin disease, by a latex agglutination test (LAT) using the purified P32 antigen and guinea pig detector antiserum raised against the P32 antigen. The LAT and virus neutralization test (VNT) were used to screen one hundred livestock field sera for antibodies to Capripoxvirus, in comparison the LAT was simpler, rapid and 23% more sensitive than the VNT. In addition the LAT was found to be specific for Carpripoxvirus because it did not pick antibodies to Orthopoxvirus and Parapoxvirus. The LA test can be taken for a simple and quick diagnostic tool for primary screening of Carpripoxvirus infection and will reduce the reliance of diagnostic laboratories on tissue culture facilities. Keywords: Carpripox, latex agglutination test, attachment gene J. Trop. Microbiol. Biotechnol. Vol. 3 (2) 2007: pp. 36-43

Bovine foscioliosis coused by F. giganticais widespread in   There is a large collection of reports of fasciolosis in Kenya based on  abattoir data records from veterinary investigation laboratories (VILS) as well as reports on a few farm study was carried out to improve on the reports.  Diagnosis of fasciola infection has traditionally been based on detection of typical eggs in the faeces.  A variety of other techniques are now available eg enzyme-linked immunosorbent assay (ELISA), which has shown to be sensitive and useful. Three agro-ecological zoned were defined depending on the reported prevalence; high risk, medium risk and low risk zones.  Two study districts were picked at random from each zone.  The study farms were selected using the two stage cluster sampling. Faecal and blood samples were collected on the farm.  Serum was later harvested.  ELISA and faecal sedimatation tests (FST) were carried out. A total of 2434 faecal and blood samples were screened.  ELISA achieved the highest (66%) positive rate of the samples from Kwale district and the lowest (23%) rate in Nakuru.  An overall positive prevalence of (43%) for fasciolosis was achieved.  The faecal sedimentation test showed prevalence of 19%.  In both tests high prevalence were observed in Kwale and Kilifi districts.  ELSA was always positive when FST was positive but not the converse. The on-famr survey utilizing two reliable diagnostic tests was meant to improve on existing abattoir reports.  Both tests showed fair to good agreements.  The higher detection by ELISA might be due to deworming and other reasons.  It was concluded that on-farm surveys are better than retrogressive studies; thought the latter are cheaper and faster.,  the current prevalence of fasciolosis are different from past reports with coastal showing higher than expected prevalences.

ABSTRACT: One of the sources of feacal contamination of rainwater harvested from roofs is wind-blown dust containing particulate matter from animal faeces, or through direct defecation. Since the primary habitat for Escherichia coli (E.coli) is the gastro-intestinal tract of mammals and birds (Atlas 1984), it's a good indicator of feacal contamination (Hazen, 1988). This study aimed to investigate the presence of E.coli. In rainwater samples collected from roofs in some areas around Nairobi, which have different levels of livestock density. Forty four of the 89 samples collected tested positive for the presence of E.coli from Ngong Division, which had a cattle density of 1446 per square Kilometre was, 55%, but it was not significantly different from both Kikuyu Division: cattle density of 166; both of which had 34% of the samples testing positive to E. coli (p=0.3094). It was concluded that rain water harvested from roofs for human consumption in the study area should be treated before use.<?xml:namespace prefix = o ns = "urn:schemas-microsoft-com:office:office" />

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ABSTRACT: The efficacies of pyrethrum marc and of albendazole against experimental sheep gastrointestinal nematode infection were compared. Sheep were infected orally with 10000 larvae (Haemonchus spp. (60.1%), Oesophagostomum spp. (13.9%), Trichostrongylus spp. (13.2%), Cooperia spp. (8.3%), Nematodirus spp. (3.5%), Strongyloides spp. (0.8%) and Ostertagia spp. (0.2%)). Faecal egg count reduction in albendazole-treated sheep was 100% by day 4 following treatment, compared to 37.03%, 31.3%, 38.9% and 51.8% on days 4, 6, 8 and 10 in pyrethrum marc-treated sheep. These reductions were statistically significant on days 8 and 10 post-treatment (p<0.05). The potential for using pyrethrins for helminth treatment is discussed.

ABSTRACT: One of the sources of feacal contamination of rainwater harvested from roofs is wind-blown dust containing particulate matter from animal faeces, or through direct defecation. Since the primary habitat for Escherichia coli (E.coli) is the gastro-intestinal tract of mammals and birds (Atlas 1984), it's a good indicator of feacal contamination (Hazen, 1988). This study aimed to investigate the presence of E.coli. In rainwater samples collected from roofs in some areas around Nairobi, which have different levels of livestock density. Forty four of the 89 samples collected tested positive for the presence of E.coli from Ngong Division, which had a cattle density of 1446 per square Kilometre was, 55%, but it was not significantly different from both Kikuyu Division: cattle density of 166; both of which had 34% of the samples testing positive to E. coli (p=0.3094). It was concluded that rain water harvested from roofs for human consumption in the study area should be treated before use.<?xml:namespace prefix = o ns = "urn:schemas-microsoft-com:office:office" />

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The CH2Cl2/MeOH (1:1) extract of the roots of Tephrosia villosa showed good antiplasmodial activity against the chloroquine-sensitive (D6) and chloroquine-resistant (W2) strains of Plasmodium falciparum with IC50 values of 3.1 ± 0.4 and 1.3 ± 0.3 μg/mL, respectively. Chromatographic separation of the extract yielded a new rotenoid, 6α-hydroxy-α-toxicarol, along with five known rotenoids, (rotenone, deguelin, sumatrol, 12a-hydroxy-α-toxicarol and villosinol). Similar treatment of the extract of the stem of Tephrosia purpurea (IC50 = 4.1 ± 0.4 and 1.9 ± 0.2 μg/mL against D6 and W2 strains of P. falciparum, respectively) yielded a new flavone having a unique substituent at C-7/C-8 [trivial name (+)-tephrodin], along with the known flavonoids tachrosin, obovatin methyl ether and derrone. The relative configuration and the most stable conformation in (+)-tephrodin was determined by NMR and theoretical energy calculations. The rotenoids and flavones tested showed good to moderate antiplasmodial activities (IC50 = 9 − 23 μМ). Whereas the cytotoxicity of rotenoids is known, the flavones (+)-tephrodin and tachrosin did not show significant cytotoxicity (IC50 > 100 μМ) against mammalian African monkey kidney (vero) and human larynx carcinoma (HEp2) cell lines.

Phytochemical investigation of the dichloromethane/methanol (1:1) extract of the roots of Bulbine frutescens led to the isolation of a new xanthone, 8-hydroxy-6-methylxanthone-1-carboxylic acid (1) and a new phenylanthraquinone, 6′,8-O-dimethylknipholone (2) along with six known compounds. The structures were elucidated on the basis of NMR and MS spectral data analyses. The structure of compound 1 was confirmed through X-ray crystallography which was then used as a reference to propose the revision of the structures of six seco-anthraquinones into xanthones. The isolated compounds were evaluated for cytotoxicity against human cervix carcinoma KB-3-1 cells with the phenylanthraquinone knipholone being the most active (IC50 = 0.43 μM). Two semi-synthetic knipholone derivatives, knipholone Mannich base and knipholone-1,3-oxazine, were prepared and tested for cytotoxic activity; both showed moderate activities (IC50 value of 1.89 and 2.50 μM, respectively).

A new pterocarpan (named 8-methoxyneorautenol) was isolated from the acetone extract of the
root bark of Erythrina abyssinica. In addition, the known isoflavonoid derivatives eryvarin L, erycristagallin and
shinpterocarpin were identified for the first time from the roots of this plant. The structures were determined on
the basis of spectroscopic evidence. The new compound showed selective antimicrobial activity against
Trichophyton mentagrophytes. The acetone extract of the root bark of E. abyssinica showed radical scavenging
activity towards 2,2-diphenyl-1-picrylhydrazyl radical (DPPH). The pterocarpenes, 3-hydroxy-9-methoxy-10-(3,3-
dimethylallyl)pterocarpene and erycristagallin, were the most active constituents of the roots of this plant and showing dose-dependent activities similar to that of the standard quercetin.

Abstract
BACKGROUND:
The aim of this study was to develop an economical 'in-house' single round polymerase chain reaction (PCR) assay using filter paper-dried blood spots (FP-DBS) for early infant HIV-1 diagnosis and to evaluate its performance in an African setting.
METHODS:
An 'in-house' single round PCR assay that targets conserved regions in the HIV-1 polymerase (pol) gene was validated for use with FP-DBS; first we validated this assay using FP-DBS spiked with cell standards of known HIV-1 copy numbers. Next, we validated the assay by testing the archived FP-DBS (N=115) from infants of known HIV-1 infection status. Subsequently this 'in-house' HIV-1 pol PCR FP-DBS assay was then established in Nairobi, Kenya for further evaluation on freshly collected FP-DBS (N=186) from infants, and compared with findings from a reference laboratory using the Roche Amplicor® HIV-1 DNA Test, version 1.5 assay.
RESULTS:
The HIV-1 pol PCR FP-DBS assay could detect one HIV-1 proviral copy in 38.7% of tests, 2 copies in 46.9% of tests, 5 copies in 72.5% of tests and 10 copies in 98.1% of tests performed with spiked samples. Using the archived FP-DBS samples from infants of known infection status, this assay was 92.8% sensitive and 98.3% specific for HIV-1 infant diagnosis. Using 186 FP-DBS collected from infants recently defined as HIV-1 positive using the commercially available Roche Amplicor v1.5 assay, 178 FP-DBS tested positive by this 'in-house' single-round HIV-1 pol PCR FP-DBS PCR assay. Upon subsequent retesting, the 8 infant FP-DBS samples that were discordant were confirmed as HIV-1 negative by both assays using a second blood sample.
CONCLUSIONS:
HIV-1 was detected with high sensitivity and specificity using both archived and more recently collected samples. This suggests that this 'in-house' HIV-1 pol FP-DBS PCR assay can provide an alternative cost-effective, reliable and rapid method for early detection of HIV-1 infection in infants.

Bacillus cereus strains were tested for production of diarrheal enterotoxin by the reverse passive latex agglutination test and for presence of B. cereus enterotoxin gene (bceT) by polymerase chain reaction. About 50% of 56 B. cereus strains reacted positive in broth culture in the reverse passive latex agglutination test, while the bceT gene was detected in 41.1 % of the strains. A 741 bp probe prepared from the polymerase chain reaction product detected bceT gene in all strains that were positive with the polymerase chain reaction. This study indicated a likelihood of two or more enterotoxins being produced by B. cereus which may be involved in causing diarrheal type food poisoning.

No abstract available.

THE ABSTRACT
The primary task of this study was to investigate perceptions of the quality of the available facilities for the teaching of O – Level chemistry in some selected secondary schools by Chemistry teachers in Mbiri constituency of Murang’a district. The study was limited by among others: Firstly, it was carried out only in one area, Mbiri constituency. This will therefore not allow generalization the district, let alone to all secondary schools in Kenya. Secondly, the amount of money and time for this project, limited this project since it was too little to allow the researcher use a large sample. The project was therefore limited to 10 secondary schools randomly selected in the constituency. The 16 chemistry teachers from the selected schools served as the subjects for this project.
The major tool used in this study was a questionnaire which was personally administered by the researcher to the 16 chemistry teachers. The data collected was analysed using descriptive statistics. Percentages were used to determine the chemistry teachers’ perceptions of the quality of the available chemistry facilities. After analyzing the data it was apparent that:
(i) O – level chemistry teaching facilities are inadequate in these schools.
(ii) The shortage of these facilities is quickly becoming more acute owing partly to the increase of school enrolment and partly due to the increasing percentage of pupils taking up chemistry.
(iii) It was found out that even though these facilities were limited, the few that there are, are normally not used optimally.
(iv) Other major revelations from the study are constraints associated with the teaching of O – Level chemistry.
On the basis of the findings the researcher recommends the following among many others.
(i) The Ministry of Education, Science and Technology should step in and help to reduce the disparity of facilities between the government aided and harambee schools.
(ii) There should be regular seminars for all chemistry teachers at district level.
(iii) There is a real need to construct new science blocks in the near future at the established and upcoming schools.

The role of pastoralist women in conflict resolution and management (study funded by SIDA though IMPACT)

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The role of pastoralist women in conflict resolution and management (study funded by SIDA though IMPACT)

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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.

Normal 0 false false false EN-US 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-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin-top:0in; mso-para-margin-right:0in; mso-para-margin-bottom:10.0pt; mso-para-margin-left:0in; line-height:115%; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:Calibri; mso-fareast-theme-font:minor-latin; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;} This study was conducted in two seasons of2002 at Tigoni, Central Kenya to determine effectiveness of insecticides; neern  extract and mineral oil in managing potato aphids and their associated virus diseases. The treatments were arranged in  randomized complete block design (RCBD) with four replications. In each season, the number of aphids in five randomly  selected plants per treatment was recordced in situ. Virus symptoms (i.ncidence) were scored and expressed as a percentage  to the total plant population per plot. Forty-five days after emergence, 10 plants each from guard rows and inner rows were  randomly selected and serologically assayed for Potato Virus Y (PVY) and Potato Leaf Roll Virus (PLRV) using DAS ELISA test. Results showd that three aphid species Aphis gossypii (Glover), Macrosiphum euphorbiae (Thomas) and Myzus persicae (Sulzer) colonized on the variety with A. gossypii being the most dominant while M. persicae was least.  Higher aphid population coincided with the short rains experienced in one of the seasons. Synthetic insecticides (Bifethrin  and dimethoate) were the most effective among the treatments in reducing aphid infestation while the neem extract and mineral oil (DC- Tron) had no significant (P<0.05) difference. However, mineral-oil treated plots recorded the lowest PVY  incidence while bifenthrin-Ireated plots had the lowest PLRV incidence. It is suggested that a combination of synthetic  insecticides and mineral oil could playa major role in reduction of the aphids and their associated vectors. Normal 0 false false false EN-US X-NONE X-NONE MicrosoftInternetExplorer4

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Normal 0 false false false EN-US 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-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin-top:0in; mso-para-margin-right:0in; mso-para-margin-bottom:10.0pt; mso-para-margin-left:0in; line-height:115%; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:Calibri; mso-fareast-theme-font:minor-latin; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;} This study was conducted in two seasons of2002 at Tigoni, Central Kenya to determine effectiveness of insecticides; neern  extract and mineral oil in managing potato aphids and their associated virus diseases. The treatments were arranged in  randomized complete block design (RCBD) with four replications. In each season, the number of aphids in five randomly  selected plants per treatment was recordced in situ. Virus symptoms (i.ncidence) were scored and expressed as a percentage  to the total plant population per plot. Forty-five days after emergence, 10 plants each from guard rows and inner rows were  randomly selected and serologically assayed for Potato Virus Y (PVY) and Potato Leaf Roll Virus (PLRV) using DAS ELISA test. Results showd that three aphid species Aphis gossypii (Glover), Macrosiphum euphorbiae (Thomas) and Myzus persicae (Sulzer) colonized on the variety with A. gossypii being the most dominant while M. persicae was least.  Higher aphid population coincided with the short rains experienced in one of the seasons. Synthetic insecticides (Bifethrin  and dimethoate) were the most effective among the treatments in reducing aphid infestation while the neem extract and mineral oil (DC- Tron) had no significant (P<0.05) difference. However, mineral-oil treated plots recorded the lowest PVY  incidence while bifenthrin-Ireated plots had the lowest PLRV incidence. It is suggested that a combination of synthetic  insecticides and mineral oil could playa major role in reduction of the aphids and their associated vectors. Normal 0 false false false EN-US X-NONE X-NONE MicrosoftInternetExplorer4

Objective: To determine the prevalence of Molar Incisor Hypomineralization (MIH) and any associated causes of MIH in children from two rural divisions in Kenya. Design: Prospective cross-section study. Setting: Seventeen primary schools in Matungulu and Kangundo divisions of Machakos district in Kenya. Participants: All 6 to 8 year-olds in the seventeen primary schools. Results: A total of 3,591 children (55.6% males and 44.4% females) were examined for MIH. All the children were from a low socioeconomic community with little access to proper medical/dental health care. The prevalence of MIH was 13.73%, with a female to male ratio of 3:1. Conclusion: The prevalence of MIH is high in the study population and is probably associated with the poor health conditions that the children went through at the most venerable period of between birth and age 3 years.

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.

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.

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Department of Orthodontics, Faculty of Dentistry, University of Nairobi, Kenya. A light-curing, fluoride-releasing adhesive (VP 862, Vivadent, Liechtenstein) for bonding of brackets has been produced for inhibition of white spot lesions during orthodontic treatment. The tensile bond strength after 24 hours and 6 months was investigated and compared with two other light-curing adhesives (Transbond, 3M Corp., Monrovia, Calif., and Heliosit-Orthodontic, Vivadent, Liechtenstein) and two chemical-curing adhesives (Concise, 3M, Monrovia Calif., and Saga Bond, Saga Orthodontics, Kongsvinger, Norway). All adhesives produced adequate strength to be recommended for clinical use. The light-curing adhesives produced slightly lower bond strengths after 24 hours and 6 months, except Transbond, which showed an increase in bond strength in this period approaching the two chemical adhesives.

Titanium dioxide has been intensively studied as a wide band gap transition metal oxide due to its n-type semi-conducting property which makes it to have many applications in industry. Some of the observed conductivity arises from its intrinsic point defects. The structural properties and electronic band structures of TiO2 (rutile and anatase) phases, have been investigated using ab-initio methods. The structural properties were obtained using generalized gradient approximation (GGA) employing pseudopotentials and plane wave basis sets. For the two phases of TiO2, the calculated equilibrium lattice constants, bulk moduli and bond lengths were found to be in good agreement with other recent theoretical calculations and also with experimental data. After introduction of various defects to the perfect super cell, the Ti-O bond lengths were altered greatly. The apical bond lengths changed from a constant 1.959 Å to a range of values (1.718 - 1.861) Å, and the equatorial bond lengths changed from a constant 2.006 Å to a range of values (2.072 - 2.231 ) Å for rutile TiO2. The apical bond lengths changed from a constant 1.956 Å to a range of values (1.782 - 1.830) Å, and the equatorial bond lengths changed from a constant 2.050 Å to a range of values (2.112 - 2.214) Å, for anatase TiO2. Also altered were Ti-O-Ti angles, from the two constants (99.93, 131.04)° to a range of values (88.86 - 95.69 and 132.01 - 143.49)° for rutile TiO2. For anatase TiO2, Ti- O-Ti angles changed from the two constants (103.81, 152.39)° to a range of values (93.59 - 149.91 and 156.74 - 176.05)°. Electronic properties were investigated too. Perfect rutile and anatase super cells gave band gaps of 2.24 eV and 2.44 eV, respectively, underground-state conditions. Valence bandwidths (VB) and conduction bandwidths (CB) were also obtained for both phases. VB of 5.6 eV and CB of 1.654 eV were observed for rutile TiO2, while VB of 4.76 eV and CB of 2.35 eV were observed for anatase TiO2; all in good agreement with experimental values. This study also investigated the defect formation enthalpies of Frenkel and Schottky defects in both rutile and anatase phases of TiO2. This study also considered point defect stability in rutile and anatase phases of TiO2. The formation energies for oxygen and titanium atoms, defects were found to be in agreement with the experimental values, especially the case of rutile oxygen atom vacancy. Both Frenkel and Schottky defects were found to induce new energy states in titanium dioxide. Normally band gaps are reduced in defective TiO2 crystals, and in this study, reduced energy band gaps were reported for all the defective super cells. In rutile, the metal oxide gaps were found to almost vanish due to the presence of oxygen atom vacancy, oxygen atom Frenkel and titanium Frenkel defects. These gave direct energy band gaps: 0.35 eV, 0.207 eV and 0.327 eV, respectively. Defects in anatase phase showed a similar trend, with the least energy band gap being reported for the case titanium interstitial (0.041 eV, which is indirect). With such infinitesimal gaps, these otherwise insulating oxides can with ease become conducting metal oxides, by either increasing the temperatures or pressure since these calculations were done at 0 K and 0 pressure. It can thus be said that intrinsic point defects in titanium dioxide do contribute to the improvement of the electrical conductivity of this oxide.

Background: Management of patients with cancer is complex, multi-disciplinary, longitudinal and costly. Abandonment of treatment by patients and loss to follow up is a common scenario, especially in resource poor countries and severely compromises health outcomes.

Objective: To assess the commitment to drug treatment protocol of patients with Acquired Immunodeficiency Syndrome (AIDS)-Related Kaposi’s Sarcoma at Kenyatta National Hospital, Kenya, over a 10 week period .

Methods: The study design was prospective, observational, cross-sectional period prevalence study on patients infected with human immunodeficiency virus (HIV) with Kaposi’s sarcoma. Patients with histological diagnosis of Kaposi’s sarcoma were sequentially enrolled into the study as they attended either the Haematology or Radiotherapy clinic or during their admission in the wards. The choice of the treatment protocol was left at the discretion of the attending physician. A pretested data collection form was used to collect demographic and clinical information about the patients, including treatments prescribed and completion of follow up.

Results: A total of 74 patients were enrolled into the study, 42 (56.8%) males and 32 (43.2%) females. The age ranged between 13 years to 55 years. Their treatment protocols included: Vincristine only, Vincristine plus Bleomycin, Vincristine plus Bleomycin plus Doxorubicin, Radiotherapy plus Vincristine and Radiotherapy only. Few of the patients were not assigned any antitumor treatment. Antiemetic and other conventional medicines were also prescribed when necessary. Fifty four (73%) of the patients abandoned treatment, five (6.8%) died, 15(20.3%) continued to attend clinic over the 10 week period. There was no significant association between sex and outcome (p=0.661).

Discussion: The results of this study demonstrate that abandonment of treatment is a major problem among patients on treatment for cancer in Kenyatta National Hospital in Kenya. Abandonment of treatment heavily contributes to poor clinical outcome hence complicating the burden of cancer in the country. It is therefore important to develop and establish follow-up systems to improve adherence to treatment for the cancer patients at Kenyatta National Hospital.

Key words: Abandonment of treatment, Loss to follow up, AIDS-Related Kaposi’s Sarcoma

The gastrointestinal tracts of 672 crossbred cattle were obtained from various abattoirs in Kiambu District, Kenya from August 1992 to July 1993, and examined for the presence of gastrointestinal nematodes. Eight nematode species were found in 583 (86.8%) of the animals. The nematodes were, in order of prevalence: Haemonchus placei (67.0%), Cooperia pectinata (53.0%), Cooperia punctata (41.7%), Oesophagostomum radiatum (38.4%), Trichostrongylus axei (24.3%), Nematodirus helvetianus (19.6%), Trichuris globulosa (9.7%) and Strongyloides papillosus (3.6%). The intensity of the nematode infection was moderate; the mean burden being less than 7000 worms. H. placei accounted, on average, for 52.3% of the total burden. The total burden was least during the dry seasons and increased gradually during the rainy seasons. Adult H. placei persisted in the host throughout the year and there was no indication of hypobiosis. The heaviest gastrointestinal worm burdens were detected in 1.5- to 3-year-old animals. These findings are discussed with regard to their relevance for strategic control of gastrointestinal nematodes in cattle.

Department of Infectious Disease Epidemiology, Imperial College School of Medicine, London, UK. Previous attempts to determine the interactions between filariasis transmission intensity, infection and chronic disease have been limited by a lack of a theoretical framework that allows the explicit examination of mechanisms that may link these variables at the community level. Here, we show how deterministic mathematical models, in conjunction with analyses of standardized field data from communities with varying parasite transmission intensities, can provide a particularly powerful framework for investigating this topic. These models were based on adult worm population dynamics, worm initiated chronic disease and two major forms of acquired immunity (larval- versus adult-worm generated) explicitly linked to community transmission intensity as measured by the Annual Transmission Potential (ATP). They were then fitted to data from low, moderate and moderately high transmission communities from East Africa to determine the mechanistic relationships between transmission, infection and observed filarial morbidity. The results indicate a profound effect of transmission intensity on patent infection and chronic disease, and on the generation and impact of immunity on these variables. For infection, the analysis indicates that in areas of higher parasite transmission, community-specific microfilarial rates may increase proportionately with transmission intensity until moderated by the generation of herd immunity. This supports recent suggestions that acquired immunity in filariasis is transmission driven and may be significant only in areas of high transmission. In East Africa, this transmission threshold is likely to be higher than an ATP of at least 100. A new finding from the analysis of the disease data is that per capita worm pathogenicity could increase with transmission intensity such that the prevalences of both hydrocele and lymphoedema, even without immunopathological involvement, may increase disproportionately with transmission intensity. For lymphoedema, this rise may be further accelerated with the onset of immunopathology. An intriguing finding is that there may be at least two types of immunity operating in filariasis: one implicated in anti-infection immunity and generated by past experience of adult worms, the other involved in immune-mediated pathology and based on cumulative experience of infective larvae. If confirmed, these findings have important implications for the new global initiative to achieve control of this disease.

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Mice infected with Trypanosoma congolense developed a severe anaemia 1 week after infection, which persisted till treatment with diminazine aceturate when the packed cell volume (PCV) recovered to pre-infection levels. This was accompanied by a marked increase in the plasma levels of the acute phase proteins (APP), serum amyloid P-component (SAP) and haptoglobin (Hp). The initial peak levels of Hp and SAP were attained 7 and 12 days post-infection (DPI), respectively. Thereafter SAP levels decreased significantly to near pre-infection levels, but later increased even after treatment to give a second peak 34 DPI after which there was a decline till the study was terminated. The Hp levels on the other hand decreased to an intermediate level after the initial peak increasing to a second peak 22 DPI. Thereafter Hp decreased significantly following diminazine aceturate treatment to reach pre-infection levels within 5 days post-treatment. This indicates that T. congolense-infected mice develop severe anaemia accompanied by an acute phase response leading to an increase in SAP and Hp but that following treatment divergent responses occurred indicating differences in the pathways for stimulation of the APP. Haptoglobin was shown to be an earlier indicator of infection and a better marker in monitoring the response to treatment.

The vision of the Government of Kenya is to facilitate ICT as a universal tool for education and training. In order to achieve this vision every educational institution, teacher, learner and the respective community should be equipped with appropriate ICT infrastructure, competencies and policies for usage and progress. It calls for recognition of the fact that ICT provides capabilities and skills needed for a knowledge-based economy. It also calls for transforming teaching and learning to incorporate new pedagogies that are appropriate for the 21st  century. The Ministry of Education�s (MOE) mission is to facilitate effective use of ICT to improve access, learning and administration in delivery education programmes and services. The principal objective will be to integrate ICT in the delivery of education and training curricula. XML:NAMESPACE PREFIX = O />  Although not exhaustive, the range of ICT that have been used in the delivery of education to improve access, teaching, learning, and administration includes: Electric Board, Audio Cassette, Radio for Interactive Radio Instructions (IRI), Video/TV-Learning, Computer, Integrated ICT infrastructure and Support Application Systems (SAS).These systems are in use, at various degrees, in most parts of Africa (Charp, 1998). This plan envisages use ofthese digital components to improve access and quality in the delivery of education in Kenya.  The major challenge in respect to this component is limited digital equipment at virtually all levels of education. While the average access rate is one computer to 15 students in most of the developed countries, the access rate in Kenya is approximately one computer to 150 students (EMIS, 2005). Whereas most secondary schools in Kenya have some computer equipment, only a small fraction is equipped with basic ICT infrastructure. In most cases equipment of schools with ICT infrastructure has been through initiatives supported by the parents, government, development agencies and the private sector, including the NEPAD E-Schools programme. Attempts to set up basic ICT infrastructure in primary schools are almost negligible.  According to ICTs in Education Options Paper, one of the main problems is limited penetration of the physical telecommunication infrastructure into rural and low-income areas. Specifically, the main challenge is limited access to dedicated phone lines and high-speed systems or connectivity to access e-mail and Internet resources. The EMIS Survey (2003/2004) indicated that over 70% of secondary schools and a much larger proportion of primary schools require functional telephones. Indeed, many parts of Kenya cannot easily get Internet services because of the poor telephone networks. About 90% of secondary schools need to establish standard Local Area Networks (LANs) in order to improve sharing of learning resources.  Alternative and appropriate technologies for access to Internet resources, including wireless systems remain quite expensive. Indeed, a small proportion of schools have direct access, through Internet Service Providers (ISPs), to high-speed data and communication systems. Furthermore, very few schools in the rural areas use wireless technology such as VSAT to access e-mail and Internet resources. Nearly all of the 6 NEPAD e-Schools are in rural areas and are expected to enjoy internet connectivity through VSAT technology.  While other countries have reported up to 41% of integration of ICT to teaching and learning, the proportion remains substantially low in Africa, Kenya included. Integration aims at the use ICT to support teaching and learning in the delivery of the various curricula to achieve improved education outcomes. Because ICT is interactive media, it facilitates students to develop diversified skills needed for industrialization and a knowledge-based economy. It also allows teachers and learners to proceed at different paces depending on the prevailing circumstances. As a first step, the Ministry of Education has initiated a major ICT project in Secondary schools meant to equip over 200 secondary schools with ICT infrastructure for integration of ICT in teaching/learning process ( KESSP, 2004). Three schools have been chosen in every district of Kenya.

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In Kenya the reported high rates of unwanted pregnancies (more than 90%), among adolescents have subsequently resulted in unsafely induced abortions with the associated high morbidity and mortality rates.
To evaluate the adolescents' behaviour regarding induced abortion.
A cross-sectional, prospective study done from July 1995 to June 1996.
Schools and health facilities in Kiambu and Nairobi districts in Kenya.
Interviews were conducted among adolescents aged 10-19 years in schools at the two districts and selected using a multi-stage random sampling procedure, as well as adolescent girls at two hospitals and two clinics in the immediate post-abortion period.
The number of adolescents health programmes, aimed at reducing the dangers of unsafely induced abortion, which are designed and subsequently implemented.
Demographic and health data, as well as data on behaviour regarding induced abortion were collected using a self-administered questionnaire.
The study sample comprised 1820 adolescents. These were 1048 school girls (SG), 580 school boys (SB) and 192 post-abortion (PA). Many adolescents were aware of abortion dangers, with the awareness being significantly lower among the SB whose girlfriends (GF) had aborted than those whose GF had not (p < 0.01). The practice of abortion was reported among 3.4% SG, 9.3% SBs' GF and 100% PA. Direct and indirect costs of abortion were heavy on the girls. Knowledge of the abortion dangers had no influence on the choice of the abortionist. Abortion encounter positively influenced approval by the adolescents, of abortion for pregnant school girls (p < 0.01).
Despite the costs and awareness of abortion dangers by adolescents, they will take risks

Pregnancy among adolescents is unplanned in many instances. Although some pregnant adolescents carry the pregnancy to term, abortion, in many instances unsafely induced, is a commonly sought solution in Kenya.
OBJECTIVE:
To determine adolescents' perceptions of induced abortion.
DESIGN:
A cross-sectional descriptive study carried out between July 1995 and June 1996.
SETTING:
An urban and a rural district in Kenya.
PARTICIPANTS:
Adolescents aged 10-19 years in schools in Nairobi and Kiambu districts, and a group of immediate post-abortion adolescent girls in some health facilities in Nairobi.
MAIN OUTCOME MEASURES:
The number of health programmes formulated and put into use, which are adolescent-friendly and providing information, education and communication on abortion issues.
DATA COLLECTION:
One thousand eight hundred and twenty adolescents were subjected to a self-administered questionnaire that collected demographic and health data as well as perceptions of induced abortion. Focus group discussions on perceptions of abortion were held with 12 groups of adolescents in schools and the information obtained recorded on paper and in a tape-recorder.
RESULTS:
One thousand nine hundred and fifty two adolescents, comprising of 1048 school girls (SG), 580 boys (SB), 192 post-abortion girls (PA) and 132 adolescents in the focus group discussions, formed the study sample. More than 90% were aware of induced abortion (IA). Knowledge of IA correlated positively with level of education (P < 0.01). Seventy one per cent of SG, 84% of PA and 40% of SB were aware of abortion-related complications, the most common being infections, death and infertility. Eighty three per cent of PA felt that complications were preventable by seeking care from a qualified doctor compared to one quarter each for the SB and SG. 56% PA, 69% SB and 72% SG felt that abortions were preventable. However, less than 40% proposed abstinence as a primary strategy. The most important source of information on abortion was the media followed by friends and teachers.
CONCLUSION:
Adolescents are aware of abortion and the related complications, but there is more variability in their knowledge and preventive measures.

The controversy that has surrounded herbivory studi es in the last few decades prompted our investigati on to establish the extent to which herbivore optimisatio n hypothesis or compensatory growth evidence is rea l. We used the traditional movable cage method to collect primary productivity data on herbage, functional g roups and key individual grass species in various controlled large herbivore treatments in an east African savan na. The herbivore treatments in triplicate blocks included cattle, wild herbivores with and without mega herbi vores and combinations of cattle and wild herbivores also wit h and without mega herbivores. The findings reveale d that at herbage level, most grazed treatments (four out of five) had higher productivity than the ungrazed con trol and three showed grazing optimisation curve at sixth po lynomial degree between monthly productivity and gr azing intensity (1-g/ng). At functional group level forbs productivity was higher in the ungrazed control th an in any of the grazed treatments while at individual grass spe cies level Themeda triandra productivity was higher in all grazed treatments than in ungrazed control. We conc lude against presence of herbivore optimisation hyp othesis at herbage, functional group and species level beca use of lack of attributable grazing effect in graze d treatments that matches complex ecological effects in the ungr azed treatment.

The controversy that has surrounded herbivory studies in the last few decades prompted our investigation to establish the extent to which herbivore optimisation hypothesis or compensatory growth evidence is real. We used the traditional movable cage method to collect primary productivity data on herbage, functional groups and key individual grass species in various controlled large herbivore treatments in an east African savanna. The herbivore treatments in triplicate blocks included cattle, wild herbivores with and without mega herbivores and combinations of cattle and wild herbivores also with and without mega herbivores. The findings revealed that at herbage level, most grazed treatments (four out of five) had higher productivity than the ungrazed control and three showed grazing optimisation curve at sixth polynomial degree between monthly productivity and grazing intensity (1-g/ng). At functional group level forbs productivity was higher in the ungrazed control than in any of the grazed treatments while at individual grass species level Themeda triandra productivity was higher in all grazed treatments than in ungrazed control. We conclude against presence of herbivore optimisation hypothesis at herbage, functional group and species level because of lack of attributable grazing effect in grazed treatments that matches complex ecological effects in the ungrazed treatment.

OBJECTIVE: To find out whether frequent blood transfusions increase the risk of transfusion-related HIV infection in children with Sickle cell anaemia. METHODS: One hundred and ninety-eight children with Sickle cell anaemia were transfused 1-13 times (mean 2,4) between 1982 and 1987. In Kenya routine screening of blood banks for HIV infection began in 1987. The HIV status of these children was compared with 231 non-transfused children: 106 with Sickle cell anaemia and 125 children with haemoglobin AA. In both transfused and non-transfused children age ranges were similar and were 1-12 years. All children were tested with Wellcozyme Elisa test in duplicate. All tests were performed at least 6 months after the last transfusion. Sixty five transfused sicklers were rechecked one year later. RESULTS: All 429 children were HIV negative. CONCLUSIONS: Out findings suggest that HIV seropositivity is low in Kenyan children. Furthermore, even though blood was unscreened in 1982 - 1987 transfusion did not increase the risk of HIV infection in our study children

The absolute configurations of two acyclic triterpenoids 1 and 2, previously isolated from the bark of Ekebergia capensis (Meliaceae) have been determined by the modified Mosher's method.

The role of pastoralist women in conflict resolution and management (study funded by SIDA though IMPACT)

A study was conducted to determine the factors influencing plant-parasitic nematode occurrence, abundance and distribution in the sugarcane fields. Four sugarcane growing zones; Nzoia, Mumias, West Kenya and Busia of Kenya were selected from which 81 fields randomly selected and sampled. Soil samples were taken from sugarcane rhizospheres and nematodes extracted from 200 cm3 soil using the modified Baermann funnel technique. Nematodes were then fixed and mounted on slides and identified to genera level using identification keys. Nematodes of the genera Pratylenchus, Scutellonema and Meloidogyne were predominant in the sugarcane belt of western Kenya with mean densities of 61, 54 and 39, respectively. Nzoia, which falls in a marginal sugarcane zone harboured the highest proportion of these plant parasitic nematodes (55%), while West Kenya zone had the least proportion (4%). Soil texture influenced nematodes with more than 50% occurring in sandy soils compared to other soil types. Build-up of plant parasitic nematodes occurred with subsequent ratoon crops up to the second ratoon before declining in the third ratoon. Anthropogenic effects were significant with 70% higher numbers of plant parasitic nematodes in the out-grower farms compared to the factory-managed farms. This study has revealed the influence of soil texture, crop cycle and anthropogenic factors on abundance and distribution of plant parasitic nematodes in western Kenya sugarcane zones. It has also set the justification of further work to determine the economic importance of the nematodes

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This paper reports on a prospective study conducted between June 1990 and June 1992 to determine method acceptability, user satisfaction and continuation rates for three highly effective and reversible contraceptive methods currently available in Kenya: the CuT 380A (IUCD), the injectable, Depo-Provera and the low-dose oral contraceptive pill, Microgynon. A non-randomised sample of volunteer participants was used. One thousand and seventy-six users were followed up for a period of one year or up to the time of discontinuation of the method, whichever came earlier. Analysis revealed method specific differences in users' characteristics. The OC users were younger and had fewer children than the IUCD or Depo-Provera users. The Depo-Provera users were older, and had the largest family sizes. Many OC users (almost 40%) were single, while almost three-quarters of IUCD and Depo-Provera users were married. IUCD users were also more educated compared to OC and Depo-Provera users. Survival analysis was used to calculate cumulative life table discontinuation rates by method for the 12 month period. Discontinuation rates were highest for OC users (80%) and lowest for IUCD users (20%) and intermediate for Depo-Provera users (39%). Ninety percent of OC and Depo-Provera users and 86% of IUCD users said they were satisfied with their respective methods. While OCs are among the most popular family planning methods in Kenya, they are also one of the most problematic, while IUCD has the fewest compliance problems. Service providers need to address the issue of high discontinuation rates among the young OC users.
PIP:
This paper reports on a prospective study conducted between June 1990 and June 1992 to determine method acceptability, user satisfaction, and continuation rates for three highly effective and reversible contraceptive methods currently available in Kenya: the CuT 380A IUD; the injectable Depo-Provera; and the low-dose oral contraceptive Microgynon. A nonrandomized sample of volunteer participants was used. 1076 users were followed up for a period of 1 year or up to the time of discontinuation of the method, whichever came earlier. Analysis revealed method-specific differences in users' characteristics. The OC users were younger and had fewer children than the IUD or Depo-Provera users. The Depo-Provera users were older and had the largest family sizes. Many OC users (almost 40%) were single, while almost three-quarters of the IUD and Depo-Provera users were married. IUD users were also more educated compared to OC and Depo-Provera users. Survival analysis was used to calculate cumulative life table discontinuation rates by method for the 12-month period. Discontinuation rates were highest for OC users (80%), lowest for IUD users (20%), and intermediate for Depo-Provera users (39%). 90% of OC and Depo-Provera users and 86% of IUD users said they were satisfied with their respective methods. While OCs are among the most popular family planning methods in Kenya, they are also one of the most problematic, while IUDs have shown the fewest compliance problems. Service providers need to address the issue of high discontinuation rates among young OC users

Mucosal specimens are essential to evaluate compartmentalized immune responses to HIV vaccine candidates and other mucosally targeted investigational products. We studied the acceptability and feasibility of repeated mucosal sampling in East African clinical trial participants at low risk of HIV and other sexually transmitted infections.

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

A new impetus is emerging with regard to the potential role that agricultural producer associations might play in improving rural economies. For this study, the use of cereal banking to improve accessibility to premium markets was assessed and the factors influencing farmers' decisions to join them were evaluated. The methodology involved a baseline survey of 213 smallholder maize producers in Bungoma district, western Kenya, plus a logit model analysis to predict the probabilities of farmers joining a cereal bank. Membership of other local community-based organizations and the actual harvests achieved strongly influence farmers' decisions to join a cereal bank.

Oyieke H.A. and Misra A.K:

The prevalence of sexually transmitted infections (STIs) among female sex workers (FSWs) in sub-Saharan Africa remains high. Providing treatment to the affected FSWs is a challenge, and more so to their stable sexual partners. There is scanty research information on acceptance of STI treatment for stable sexual partners by FSWs. We conducted a study to assess acceptance of STI treatment for stable sexual partners by FSWs, and to identify factors associated with acceptance.

The increasing land scarcity and the worsening trend of poverty in Kenya in recent years have raised concerns about the focus on land-based agriculture as the basis of growth in the rural areas. This paper combines two complementary data sets obtained from two locations in Kenya, drawn against distinctively different land availability patterns, to examine the diverse rural asset base and key sources of livelihood in the rural areas. The analysis reveals that while access to productive land is still an important determinant of livelihoods in the rural areas, even where land holdings are very small, growth in farm productivity alone may not guarantee households sufficient incomes to escape poverty. We find evidence to suggest that growth of non-farm sector is necessary and may be much more important in reducing risks and vulnerability to poverty and should be equally emphasized if households in such regions are to escape poverty. Off-farm earnings accounted for at least 50 percent of total household incomes in the two research locations. The study further revealed existence of significant barriers to entry to remunerative livelihoods both at farm and off-farm level. The study advocates for expansion of educational services, infrastructure and strengthening of rural institutions to spur broad-based development in the rural areas.

The increasing land scarcity and the worsening trend of poverty in Kenya in recent years have raised concerns about the focus on land-based agriculture as the basis of growth in the rural areas. This paper combines two complementary data sets obtained from two locations in Kenya, drawn against distinctively different land availability patterns, to examine the diverse rural asset base and key sources of livelihood in the rural areas. The analysis reveals that while access to productive land is still an important determinant of livelihoods in the rural areas, even where land holdings are very small, growth in farm productivity alone may not guarantee households sufficient incomes to escape poverty. We find evidence to suggest that growth of non-farm sector is necessary and may be much more important in reducing risks and vulnerability to poverty and should be equally emphasized if households in such regions are to escape poverty. Off-farm earnings accounted for at least 50 percent of total household incomes in the two research locations. The study further revealed existence of significant barriers to entry to remunerative livelihoods both at farm and off-farm level. The study advocates for expansion of educational services, infrastructure and strengthening of rural institutions to spur broad-based development in the rural areas.

The increasing land scarcity and the worsening trend of poverty in Kenya in recent years have raised concerns about the focus on land-based agriculture as the basis of growth in the rural areas. This paper combines two complementary data sets obtained from two locations in Kenya, drawn against distinctively different land availability patterns, to examine the diverse rural asset base and key sources of livelihood in the rural areas. The analysis reveals that while access to productive land is still an important determinant of livelihoods in the rural areas, even where land holdings are very small, growth in farm productivity alone may not guarantee households sufficient incomes to escape poverty. We find evidence to suggest that growth of non-farm sector is necessary and may be much more important in reducing risks and vulnerability to poverty and should be equally emphasized if households in such regions are to escape poverty. Off-farm earnings accounted for at least 50 percent of total household incomes in the two research locations. The study further revealed existence of significant barriers to entry to remunerative livelihoods both at farm and off-farm level. The study advocates for expansion of educational services, infrastructure and strengthening of rural institutions to spur broad-based development in the rural areas.

Access, sources and value of new medical information: views of final year medical students at the University of Nairobi.
Gituma A, Masika M, Muchangi E, Nyagah L, Otieno V, Irimu G, Wasunna A, Ndiritu M, English M
OBJECTIVE: To evaluate final year medical students' access to new medical information.
METHOD: Cross-sectional survey of final year medical students at the University of Nairobi using anonymous, self-administered questionnaires.
RESULTS: Questionnaires were distributed to 85% of a possible 343 students and returned by 44% (152). Half reported having accessed some form of new medical information within the previous 12 months, most commonly from books and the internet. Few students reported regular access; and specific, new journal articles were rarely accessed. Absence of internet facilities, slow internet speed and cost impeded access to literature; and current training seems rarely to encourage students to seek new information.
CONCLUSION: Almost half the students had not accessed any new medical information in their final year in medical school. This means they are ill prepared for a career that may increasingly demand life-long, self-learning.

Trop Med Int Health. 2009 Jan;14(1):118-22. doi: 10.1111/j.1365-3156.2008.02209.x.

To evaluate final year medical students' access to new medical information.

Abstract:
We tested the practical application of an anaemia scoring chart (the FAMACHA© chart) as a method for controlling Haemonchus contortus in goats kept under smallholder conditions in a sub-humid area of Central Kenya. The objectives were: (1) to test the accuracy of the FAMACHA© chart in identifying anaemic goats (PCV ≤ 18); (2) to quantify the proportion of goats left untreated at farm level when using the chart. On each of two farms, Small East African goats of various ages were allocated to two treatment groups; a FAMACHA© group (F1 (n = 34) and F2 (n = 31) on farms 1 and 2, respectively) and a control group (C1 (n = 34) and C2 (n = 30)). In F1 and F2 goats with a FAMACHA© score of 3, 4 or 5 were treated with anthelmintic after scoring. In C1 and C2 goats were treated every 4 weeks from 15 February to 20 July. Every 2 weeks all goats were scored with the FAMACHA© chart and weighed. Furthermore, faecal samples were collected for faecal egg counts (FEC) and blood samples were collected for packed cell volume (PCV) determination. H. contortus was found to be the predominant nematode on both farms. The mean FECs were higher on farm 1 compared to farm 2, while in contrast the mean PCV levels were lowest on farm 2. The latter was most likely due to the presence of Fasciola spp., flea and tick infections on farm 2. The accuracy of the chart was evaluated by using PCV as the gold standard for anaemia (PCV ≤ 18%). The mean percentage of false-negative scorings per sampling was 0.7% on farm 1 and 1.6% on farm 2, while the mean percentage of false-positive scorings was 9.7% and 21.4%, respectively. It is most likely that the accuracy of the chart was negatively affected by the concurrent parasite infections on farm 2. The mean proportion of untreated goats per sampling was 89% and 77% on farm 1 and farm 2. It was concluded that the FAMACHA© chart can be a valuable tool for decision-making in control of H. contortus in goats kept under smallholder conditions, without morbidity or mortality unacceptable to the farmer. The application may further reduce the risk of development of anthelmintic resistance by increasing refugia. However, caution should be taken under conditions where other anaemia-causing parasites are present (e.g. Fasciola spp. and ecto-parasites), since this possibly decreases the accuracy of the FAMACHA© chart.

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It has been established that H+ secretion can be maintained in frog stomach in the absence of exogenous CO2 by using a nutrient bathing fluid containing 25 mM H2PO4 (pH approximately equal to 4.5) or by lowering the pH of a nonbuffered nutrient solution to about 3.0-3.6. Exogenous CO2 in the presence of these nutrient solutions uniformly caused a marked decrease in H+ secretion, PD, adn short-circuit current (Isc) and an increase in transmucosal resistance (R). Elevation of nutrient [k+] to 83 mM reduced R significantly but transiently without change in H+ when nutrient pH less than 5.0, whereas R returned to base line and H+ increased when nutrient pH greater than 5.0. Acidification of the nutrient medium in the presence of exogenous CO2 results in inhibition of the secretory pump, probably by decreasing intracellular pH, and also interferes with conductance at the nutrient membrane. Removal of exogenous CO2 from standard bicarbonate nutrient solution reduced by 50% the H+, PD, and Isc without change in R; K+-free nutrient solutions reverse these changes in Isc and PD but not in H+. The dropping PD and rising R induced by K+-free nutrient solutions in 5% CO2 - 95% O2 are returned toward normal by 100% O2. Our findings support an important role for exogenous CO2 in maintaining normal acid-base balance in frog mucosa by acting as an acidifying agent.

OBJECTIVE: To review the normal human acid-base physiology and the pathophysiology and management of acid-base disturbances in a two-part presentation. DATA SOURCES: Articles and published peer-review abstracts and a review of studies reported from 1990 to 2000 and identified through a MEDLINE search of the English language literature on acid-base balance. SUMMARY OF REVIEW: Acid-base disorders are usually classified as metabolic (non-respiratory) or respiratory, depending on whether the primary change occurs in the plasma bicarbonate or the carbonic acid (i.e. carbon dioxide) concentrations, respectively. Respiratory or renal compensatory changes usually occur to minimise the effect of the primary disturbance. A metabolic acidosis arises from an abnormal process that generates non-carbonic acid or an abnormal loss of HCO3- and may be identified by an increase or normal anion gap, respectively. The arterial blood gas usually reveals a pH {\textless} 7.36, PCO2 {\textless} 35 mmHg and 'calculated' HCO3- {\textless} 18 mmol/L. In general, a high anion gap acidosis is managed by treating the disorder generating the acid (thereby ceasing the acid production) and enhancing the clearance of the acid anion (e.g. by metabolism or excretion) thereby regenerating the HCO3- reduced by buffering. A metabolic alkalosis arises from an abnormal process generating excess HCO3-. The arterial blood gas usually reveals a pH {\textgreater} 7.44, PCO2 {\textgreater} 45 mmHg and 'calculated' HCO3- {\textgreater} 32 mmol/L. As the kidney has a large capacity to excrete HCO3-, management usually requires treatment of the processes that are generating as well maintaining the alkalosis. Respiratory acidosis and alkalosis are usually caused by a primary disorder of carbon-dioxide excretion, and correction of the pH disorder only occurs with correction of the primary disease process. CONCLUSIONS: In man, acid-base disturbances are usually classified as either metabolic or respiratory. Correction of the underlying disorder is often all that is required to allow the body to metabolise or excrete the acid or alkali and return the buffer pair (HCO3- and PCO2) to normal.

OBJECTIVE: To review the normal human acid-base physiology and the pathophysiology and management of acid-base disturbances in a two-part presentation. DATA SOURCES: Articles and published peer-review abstracts and a review of studies reported from 1990 to 2000 and identified through a MEDLINE search of the English language literature on acid-base balance. SUMMARY OF REVIEW: Acid-base disorders are usually classified as metabolic (non-respiratory) or respiratory, depending on whether the primary change occurs in the plasma bicarbonate or the carbonic acid (i.e. carbon dioxide) concentrations, respectively. Respiratory or renal compensatory changes usually occur to minimise the effect of the primary disturbance. A metabolic acidosis arises from an abnormal process that generates non-carbonic acid or an abnormal loss of HCO3- and may be identified by an increase or normal anion gap, respectively. The arterial blood gas usually reveals a pH {\textless} 7.36, PCO2 {\textless} 35 mmHg and 'calculated' HCO3- {\textless} 18 mmol/L. In general, a high anion gap acidosis is managed by treating the disorder generating the acid (thereby ceasing the acid production) and enhancing the clearance of the acid anion (e.g. by metabolism or excretion) thereby regenerating the HCO3- reduced by buffering. A metabolic alkalosis arises from an abnormal process generating excess HCO3-. The arterial blood gas usually reveals a pH {\textgreater} 7.44, PCO2 {\textgreater} 45 mmHg and 'calculated' HCO3- {\textgreater} 32 mmol/L. As the kidney has a large capacity to excrete HCO3-, management usually requires treatment of the processes that are generating as well maintaining the alkalosis. Respiratory acidosis and alkalosis are usually caused by a primary disorder of carbon-dioxide excretion, and correction of the pH disorder only occurs with correction of the primary disease process. CONCLUSIONS: In man, acid-base disturbances are usually classified as either metabolic or respiratory. Correction of the underlying disorder is often all that is required to allow the body to metabolise or excrete the acid or alkali and return the buffer pair (HCO3- and PCO2) to normal.

Tetracyclines have been among the most widely used antibiotics worldwide. Plasmid-mediated tetracycline resistance among hospital strains of bacteria has continued to rise and of major concern has been the transfer of resistance to pathogenic organisms. Bacteraemia due to hospital acquired S. typhimurium has been a major cause of morbidity at Kenyatta National Hospital (KNH), hence the need to study drug susceptibility pattern of this organism. This study also characterized the tetracycline resistance genes using oligonucleotide probes. Ninety seven S. typhimurium strains isolated from patients at KNH were used. Agar dilution method was used to determine minimum inhibitory concentration (MIC). Plasmids were isolated from each strain and the different plasmid profiles were grouped by their molecular weights into 6 patterns. Out of 97, 87 (88%) strains were resistant. MIC ranged from 1 microgram/ml to 128 micrograms/ml. Genes encoding for tetracycline resistance were located on plasmids of molecular weights 65 MDa, 5.2 or both. Plasmid-encoded antimicrobial resistance is likely to spread to other pathogenic organisms, reduce our ability to treat the infection and increase the cost and duration of treatment.

Tetracyclines have been among the most widely used antibiotics worldwide. Plasmid-mediated tetracycline resistance among hospital strains of bacteria has continued to rise and of major concern has been the transfer of resistance to pathogenic organisms. Bacteraemia due to hospital acquired S. typhimurium has been a major cause of morbidity at Kenyatta National Hospital (KNH), hence the need to study drug susceptibility pattern of this organism. This study also characterized the tetracycline resistance genes using oligonucleotide probes. Ninety seven S. typhimurium strains isolated from patients at KNH were used. Agar dilution method was used to determine minimum inhibitory concentration (MIC). Plasmids were isolated from each strain and the different plasmid profiles were grouped by their molecular weights into 6 patterns. Out of 97, 87 (88%) strains were resistant. MIC ranged from 1 microgram/ml to 128 micrograms/ml. Genes encoding for tetracycline resistance were located on plasmids of molecular weights 65 MDa, 5.2 or both. Plasmid-encoded antimicrobial resistance is likely to spread to other pathogenic organisms, reduce our ability to treat the infection and increase the cost and duration of treatment.