Ogutu EO. A 10-year (1976-1986) retrospective study was done on 30 cases with histological diagnosis of pancreatic carcinoma. The male to female ratio was 1.3:1 and the peak incidence was in the 6th and 7th decades. The head of the pancreas was involved in 96% of cases while solid adenocarcinoma of duct cell origin accounted for 73.3% of cases, followed by anaplastic carcinoma (23.3%). The commonest complications were distinct metastasis (86.6%), obstructive jaundice (73.3%) and upper gastrointestinal bleed (13.6%).

Only 2% of patients with Meckel's diverticulae (MD) will manifest clinical problems. Diverticulitis occurs in approximately 10-20% of patients with symptomatic MD and more often in the elderly population. We report a case of Meckels diverticulitis presenting with perforation and mesenteric abscess in a young African man. The authors present information on diagnostic pitfalls and advise a lower threshold for consideration of MD as a differential diagnosis of acute right iliac fossa pain especially when the CT scan denotes a normal appendix in a male patient.

OBJECTIVE: To determine the causes and pattern of lower limb amputations at the Kenyatta National Hospital. DESIGN: Descriptive prospective study. SETTING: The Kenyatta National Hospital between July 2003 and June 2004. RESULTS: A total of 77 lower limb amputations (LLA) were performed on 74 patients. The age ranged from seven months to 96 years (mean 44.8 +/- 22.5). Forty six patients (62.1%) were male. Majority of the patients (89.1%) had primary or no formal education, forty one (55.4%) were unemployed, with 39% self employed in the informal sector. Peripheral vascular diseases were the main indication for LLA (55.3%), 13 patients (17.5%) due to diabetes-related gangrene. Eighteen patients (24.3%) had tumours, mainly osteogenic sarcoma (16.2%), while trauma accounted for 18.9%. Forty two (55%) of the amputations were above-the-knee, 24 (31%) below-the-knee, four (5%) hip disarticulations and seven (9%) were foot amputations. CONCLUSION: This study found peripheral vascular diseases unrelated to diabetes to be the main indication for lower limb amputations at Kenyatta National Hospital contrary to previous institutional and loco-regional studies which report trauma as the leading cause. Further investigation into vascular causes is therefore recommended.

OBJECTIVE: To determine the local aetiological spectrum of surgically relevant causes of abdominal pain. DESIGN: A prospective descriptive study was carried out. SETTING: Kenyatta National Hospital, Nairobi, Kenya during the month of October 2002. SUBJECTS: Patients aged 13 years and older presenting to the casualty department with abdominal pain were followed through the hospital system to determine whether they would undergo laparotomy and, in those cases who underwent laparotomy, to determine the nature of the pathology found at laparatomy. RESULTS: Abdominal pain was a presenting complaint in 1557 (16.7%) of patients presenting to the casualty department during the study period. Abdominal pain accounted for 17.9% (398 out of 2225 patients) of all admissions via the casualty department. Laparotomy was performed on 68 (4.4%) of patients who presented with abdominal pain to the casualty department. In female patients presenting with abdominal pain, the incidence of ectopic pregnancy and acute appendicitis was 65.3% and 16.3% respectively. The incidence of neoplasia found at laparatomy, for abdominal pain, on patients admitted to the general surgical ward was 3.0%. The incidence of neoplasia, as a cause of abdominal pain resulting in laparatomy was 3.3%. CONCLUSION: The results highlight the fact, with respects to abdominal pain, that there are significant differences between the disease patterns in different geographical locations. Assuming the converse could adversely affect the management of patients with abdominal pain locally.

BACKGROUND: Congenital heart disease (CHD) is a significant cause of death amongst infants. The timing of treatment in relation to the natural history of the disease correlates with the treatment outcome. OBJECTIVES: To determine the age at first suspicion of CHD, the age at confirmation of the diagnosis of CHD and the percentage follow-up at the first post diagnosis out patient clinic and to determine the influence of patient's sex, parental income and parental education have on the MP. DESIGN: A five year retrospective study. SETTING: Kenyatta National Hospital between January 1st 2000 and December 31st 2004. SUBJECTS: Two hundred and fourteen patients were studied. RESULTS: The overall mean age at referral to a paediatric cardiologist was 16.9 +/- 24.4 months [n = 102]. The mean age at which CHD was confirmed by echocardiography was 18.6 +/- 25.6 months [n = 202]. The mean age at which CHD was first suspected in patients from the province with the highest parental income was 9.5 +/- 5.1 months [n = 6]. The mean age at which CHD was first suspected in patients from a province with a significantly lower parent income was 19.1 +/- 23.2 months [n = 22], (p = 0. 046). The mean age at which CHD was confirmed in referred male patients was 16.0 +/- 17.6 months [n=48] and the mean age at which CHD was confirmed in referred female patients was 18.8 +/- 21.7 months [n = 52] (p = 0.25). CONCLUSION: The mean age at referral to a paediatric cardiologist was 16.9 months. This suggests that a significant number of patients may miss the opportunity to have optimal surgical intervention. Parental income appears to influence the MP, however, the level of parental education and patient sex did not.

BACKGROUND: Congenital heart disease (CHD) is a significant cause of death amongst infants. The timing of treatment in relation to the natural history of the disease correlates with the treatment outcome. OBJECTIVES: To determine the age at first suspicion of CHD, the age at confirmation of the diagnosis of CHD and the percentage follow-up at the first post diagnosis out patient clinic and to determine the influence of patient's sex, parental income and parental education have on the MP. DESIGN: A five year retrospective study. SETTING: Kenyatta National Hospital between January 1st 2000 and December 31st 2004. SUBJECTS: Two hundred and fourteen patients were studied. RESULTS: The overall mean age at referral to a paediatric cardiologist was 16.9 +/- 24.4 months [n = 102]. The mean age at which CHD was confirmed by echocardiography was 18.6 +/- 25.6 months [n = 202]. The mean age at which CHD was first suspected in patients from the province with the highest parental income was 9.5 +/- 5.1 months [n = 6]. The mean age at which CHD was first suspected in patients from a province with a significantly lower parent income was 19.1 +/- 23.2 months [n = 22], (p = 0. 046). The mean age at which CHD was confirmed in referred male patients was 16.0 +/- 17.6 months [n=48] and the mean age at which CHD was confirmed in referred female patients was 18.8 +/- 21.7 months [n = 52] (p = 0.25). CONCLUSION: The mean age at referral to a paediatric cardiologist was 16.9 months. This suggests that a significant number of patients may miss the opportunity to have optimal surgical intervention. Parental income appears to influence the MP, however, the level of parental education and patient sex did not.

BACKGROUND: The Risk Adjustment in Congenital Heart Surgery (RACHS-1) system has been used as a benchmark to compare surgical results in developed countries. Its ability to stratify postoperative mortality risk has been validated in several developed countries, however, this has not been examined in a developing country. OBJECTIVES: To assess the ability of the RACHS-1 system to stratify postoperative mortality risk in a developing country. DESIGN: Retrospective study over a five year period between 1st January 2002 and 31st December 2006. SETTING: Kenyatta National Hospital, a teaching and referral hospital in Nairobi, Kenya. SUBJECTS: Three hundred and seventeen consecutive operations were performed on 313 patients aged between 0.25 and 204 months. RESULTS: Operations were performed in RACHS-1 categories 1, 2, 3 and 4 with hospital mortalities of 2.5%, 16.9%, 29.4% and 50% respectively. The difference in mortality between categories 1 and 2 was significant (p-value of 0.0003), however, the difference in mortality between categories 2 and 3 and categories 3 and 4 was not significant (p-values 0.193 and 0.67 respectively). CONCLUSIONS: The RACHS-1 system did not adequately stratify risk in a low case load setting. The use of the RACHS-1 method as a benchmark to compare surgical results of paediatric cardiac surgery services in developing countries may be limited.

BACKGROUND: Congenital heart disease (CHD) is a significant cause of death amongst infants. The timing of treatment in relation to the natural history of the disease correlates with the treatment outcome. OBJECTIVES: To determine the age at first suspicion of CHD, the age at confirmation of the diagnosis of CHD and the percentage follow-up at the first post diagnosis out patient clinic and to determine the influence of patient's sex, parental income and parental education have on the MP. DESIGN: A five year retrospective study. SETTING: Kenyatta National Hospital between January 1st 2000 and December 31st 2004. SUBJECTS: Two hundred and fourteen patients were studied. RESULTS: The overall mean age at referral to a paediatric cardiologist was 16.9 +/- 24.4 months [n = 102]. The mean age at which CHD was confirmed by echocardiography was 18.6 +/- 25.6 months [n = 202]. The mean age at which CHD was first suspected in patients from the province with the highest parental income was 9.5 +/- 5.1 months [n = 6]. The mean age at which CHD was first suspected in patients from a province with a significantly lower parent income was 19.1 +/- 23.2 months [n = 22], (p = 0. 046). The mean age at which CHD was confirmed in referred male patients was 16.0 +/- 17.6 months [n=48] and the mean age at which CHD was confirmed in referred female patients was 18.8 +/- 21.7 months [n = 52] (p = 0.25). CONCLUSION: The mean age at referral to a paediatric cardiologist was 16.9 months. This suggests that a significant number of patients may miss the opportunity to have optimal surgical intervention. Parental income appears to influence the MP, however, the level of parental education and patient sex did not.

PMID: 614126 [PubMed - indexed for MEDLINE]

This paper investigates the relationships between knowledge of common sexually transmitted diseases and or HIV/AIDS and sexual behaviour change among adolescents in school and out of school in Nairobi City. Despite the existence of a well-structured health education system supported by informal health educators, it is apparent that health education knowledge acquired is not commensurate with desired changes in attitudes and behaviour. This study sampled 250 adolescents in Nairobi City aged between 14 to 24 years. Furthermore, focus group discussions were conducted to supplement views of individual respondents. The respondents socio-economic and cultural backgrounds represented well the major societal groups and classes. It was found that 93.2 percent of adolescents were knowledgeable of sexually transmitted diseases and over 90 per cent accurately identified symptoms of common sexually transmitted diseases and HIV/AIDS. However, it also emerged that peer pressure and peer networks have a very strong impact on attitude and behaviour of adolescent. The study recommends that more research is needed to understand how effects of peer networks could be made more effective in reducing adolescents pre-marital sex.

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This paper investigates the relationships between knowledge of common sexually transmitted diseases and or HIV/AIDS and sexual behaviour change among adolescents in school and out of school in Nairobi City. Despite the existence of a well-structured health education system supported by informal health educators, it is apparent that health education knowledge acquired is not commensurate with desired changes in attitudes and behaviour. This study sampled 250 adolescents in Nairobi City aged between 14 to 24 years. Furthermore, focus group discussions were conducted to supplement views of individual respondents. The respondents socio-economic and cultural backgrounds represented well the major societal groups and classes. It was found that 93.2 percent of adolescents were knowledgeable of sexually transmitted diseases and over 90 per cent accurately identified symptoms of common sexually transmitted diseases and HIV/AIDS. However, it also emerged that peer pressure and peer networks have a very strong impact on attitude and behaviour of adolescent. The study recommends that more research is needed to understand how effects of peer networks could be made more effective in reducing adolescents pre-marital sex.

This paper investigates the relationships between knowledge of common sexually transmitted diseases and or HIV/AIDS and sexual behaviour change among adolescents in school and out of school in Nairobi City. Despite the existence of a well-structured health education system supported by informal health educators, it is apparent that health education knowledge acquired is not commensurate with desired changes in attitudes and behaviour. This study sampled 250 adolescents in Nairobi City aged between 14 to 24 years. Furthermore, focus group discussions were conducted to supplement views of individual respondents. The respondents socio-economic and cultural backgrounds represented well the major societal groups and classes. It was found that 93.2 percent of adolescents were knowledgeable of sexually transmitted diseases and over 90 per cent accurately identified symptoms of common sexually transmitted diseases and HIV/AIDS. However, it also emerged that peer pressure and peer networks have a very strong impact on attitude and behaviour of adolescent. The study recommends that more research is needed to understand how effects of peer networks could be made more effective in reducing adolescents pre-marital sex.

This paper investigates the relationships between knowledge of common sexually transmitted diseases and or HIV/AIDS and sexual behaviour change among adolescents in school and out of school in Nairobi City. Despite the existence of a well-structured health education system supported by informal health educators, it is apparent that health education knowledge acquired is not commensurate with desired changes in attitudes and behaviour. This study sampled 250 adolescents in Nairobi City aged between 14 to 24 years. Furthermore, focus group discussions were conducted to supplement views of individual respondents. The respondents socio-economic and cultural backgrounds represented well the major societal groups and classes. It was found that 93.2 percent of adolescents were knowledgeable of sexually transmitted diseases and over 90 per cent accurately identified symptoms of common sexually transmitted diseases and HIV/AIDS. However, it also emerged that peer pressure and peer networks have a very strong impact on attitude and behaviour of adolescent. The study recommends that more research is needed to understand how effects of peer networks could be made more effective in reducing adolescents pre-marital sex.

This paper investigates the relationships between knowledge of common sexually transmitted diseases and or HIV/AIDS and sexual behaviour change among adolescents in school and out of school in Nairobi City. Despite the existence of a well-structured health education system supported by informal health educators, it is apparent that health education knowledge acquired is not commensurate with desired changes in attitudes and behaviour. This study sampled 250 adolescents in Nairobi City aged between 14 to 24 years. Furthermore, focus group discussions were conducted to supplement views of individual respondents. The respondents socio-economic and cultural backgrounds represented well the major societal groups and classes. It was found that 93.2 percent of adolescents were knowledgeable of sexually transmitted diseases and over 90 per cent accurately identified symptoms of common sexually transmitted diseases and HIV/AIDS. However, it also emerged that peer pressure and peer networks have a very strong impact on attitude and behaviour of adolescent. The study recommends that more research is needed to understand how effects of peer networks could be made more effective in reducing adolescents pre-marital sex.

This paper investigates the relationships between knowledge of common sexually transmitted diseases and or HIV/AIDS and sexual behaviour change among adolescents in school and out of school in Nairobi City. Despite the existence of a well-structured health education system supported by informal health educators, it is apparent that health education knowledge acquired is not commensurate with desired changes in attitudes and behaviour. This study sampled 250 adolescents in Nairobi City aged between 14 to 24 years. Furthermore, focus group discussions were conducted to supplement views of individual respondents. The respondents socio-economic and cultural backgrounds represented well the major societal groups and classes. It was found that 93.2 percent of adolescents were knowledgeable of sexually transmitted diseases and over 90 per cent accurately identified symptoms of common sexually transmitted diseases and HIV/AIDS. However, it also emerged that peer pressure and peer networks have a very strong impact on attitude and behaviour of adolescent. The study recommends that more research is needed to understand how effects of peer networks could be made more effective in reducing adolescents pre-marital sex.

This paper investigates the relationships between knowledge of common sexually transmitted diseases and or HIV/AIDS and sexual behaviour change among adolescents in school and out of school in Nairobi City. Despite the existence of a well-structured health education system supported by informal health educators, it is apparent that health education knowledge acquired is not commensurate with desired changes in attitudes and behaviour. This study sampled 250 adolescents in Nairobi City aged between 14 to 24 years. Furthermore, focus group discussions were conducted to supplement views of individual respondents. The respondents socio-economic and cultural backgrounds represented well the major societal groups and classes. It was found that 93.2 percent of adolescents were knowledgeable of sexually transmitted diseases and over 90 per cent accurately identified symptoms of common sexually transmitted diseases and HIV/AIDS. However, it also emerged that peer pressure and peer networks have a very strong impact on attitude and behaviour of adolescent. The study recommends that more research is needed to understand how effects of peer networks could be made more effective in reducing adolescents pre-marital sex.

This paper investigates the relationships between knowledge of common sexually transmitted diseases and or HIV/AIDS and sexual behaviour change among adolescents in school and out of school in Nairobi City. Despite the existence of a well-structured health education system supported by informal health educators, it is apparent that health education knowledge acquired is not commensurate with desired changes in attitudes and behaviour. This study sampled 250 adolescents in Nairobi City aged between 14 to 24 years. Furthermore, focus group discussions were conducted to supplement views of individual respondents. The respondents socio-economic and cultural backgrounds represented well the major societal groups and classes. It was found that 93.2 percent of adolescents were knowledgeable of sexually transmitted diseases and over 90 per cent accurately identified symptoms of common sexually transmitted diseases and HIV/AIDS. However, it also emerged that peer pressure and peer networks have a very strong impact on attitude and behaviour of adolescent. The study recommends that more research is needed to understand how effects of peer networks could be made more effective in reducing adolescents pre-marital sex.

This paper investigates the relationships between knowledge of common sexually transmitted diseases and or HIV/AIDS and sexual behaviour change among adolescents in school and out of school in Nairobi City. Despite the existence of a well-structured health education system supported by informal health educators, it is apparent that health education knowledge acquired is not commensurate with desired changes in attitudes and behaviour. This study sampled 250 adolescents in Nairobi City aged between 14 to 24 years. Furthermore, focus group discussions were conducted to supplement views of individual respondents. The respondents socio-economic and cultural backgrounds represented well the major societal groups and classes. It was found that 93.2 percent of adolescents were knowledgeable of sexually transmitted diseases and over 90 per cent accurately identified symptoms of common sexually transmitted diseases and HIV/AIDS. However, it also emerged that peer pressure and peer networks have a very strong impact on attitude and behaviour of adolescent. The study recommends that more research is needed to understand how effects of peer networks could be made more effective in reducing adolescents pre-marital sex.

This paper investigates the relationships between knowledge of common sexually transmitted diseases and or HIV/AIDS and sexual behaviour change among adolescents in school and out of school in Nairobi City. Despite the existence of a well-structured health education system supported by informal health educators, it is apparent that health education knowledge acquired is not commensurate with desired changes in attitudes and behaviour. This study sampled 250 adolescents in Nairobi City aged between 14 to 24 years. Furthermore, focus group discussions were conducted to supplement views of individual respondents. The respondents socio-economic and cultural backgrounds represented well the major societal groups and classes. It was found that 93.2 percent of adolescents were knowledgeable of sexually transmitted diseases and over 90 per cent accurately identified symptoms of common sexually transmitted diseases and HIV/AIDS. However, it also emerged that peer pressure and peer networks have a very strong impact on attitude and behaviour of adolescent. The study recommends that more research is needed to understand how effects of peer networks could be made more effective in reducing adolescents pre-marital sex.

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This paper investigates the relationships between knowledge of common sexually transmitted diseases and or HIV/AIDS and sexual behaviour change among adolescents in school and out of school in Nairobi City. Despite the existence of a well-structured health education system supported by informal health educators, it is apparent that health education knowledge acquired is not commensurate with desired changes in attitudes and behaviour. This study sampled 250 adolescents in Nairobi City aged between 14 to 24 years. Furthermore, focus group discussions were conducted to supplement views of individual respondents. The respondents socio-economic and cultural backgrounds represented well the major societal groups and classes. It was found that 93.2 percent of adolescents were knowledgeable of sexually transmitted diseases and over 90 per cent accurately identified symptoms of common sexually transmitted diseases and HIV/AIDS. However, it also emerged that peer pressure and peer networks have a very strong impact on attitude and behaviour of adolescent. The study recommends that more research is needed to understand how effects of peer networks could be made more effective in reducing adolescents pre-marital sex.

This paper investigates the relationships between knowledge of common sexually transmitted diseases and or HIV/AIDS and sexual behaviour change among adolescents in school and out of school in Nairobi City. Despite the existence of a well-structured health education system supported by informal health educators, it is apparent that health education knowledge acquired is not commensurate with desired changes in attitudes and behaviour. This study sampled 250 adolescents in Nairobi City aged between 14 to 24 years. Furthermore, focus group discussions were conducted to supplement views of individual respondents. The respondents socio-economic and cultural backgrounds represented well the major societal groups and classes. It was found that 93.2 percent of adolescents were knowledgeable of sexually transmitted diseases and over 90 per cent accurately identified symptoms of common sexually transmitted diseases and HIV/AIDS. However, it also emerged that peer pressure and peer networks have a very strong impact on attitude and behaviour of adolescent. The study recommends that more research is needed to understand how effects of peer networks could be made more effective in reducing adolescents pre-marital sex.

This paper investigates the relationships between knowledge of common sexually transmitted diseases and or HIV/AIDS and sexual behaviour change among adolescents in school and out of school in Nairobi City. Despite the existence of a well-structured health education system supported by informal health educators, it is apparent that health education knowledge acquired is not commensurate with desired changes in attitudes and behaviour. This study sampled 250 adolescents in Nairobi City aged between 14 to 24 years. Furthermore, focus group discussions were conducted to supplement views of individual respondents. The respondents socio-economic and cultural backgrounds represented well the major societal groups and classes. It was found that 93.2 percent of adolescents were knowledgeable of sexually transmitted diseases and over 90 per cent accurately identified symptoms of common sexually transmitted diseases and HIV/AIDS. However, it also emerged that peer pressure and peer networks have a very strong impact on attitude and behaviour of adolescent. The study recommends that more research is needed to understand how effects of peer networks could be made more effective in reducing adolescents pre-marital sex.

Vertex epidural haematomas (VEDH) are rare and difficulties are encountered in diagnosis and management. This is a case report of a patient with a vertex epidural haematoma who presented with signs of severe head injury with upper limb decerebrate posture. We discuss the challenges of radiological investigation and neurosurgical management of VEDH.

Vertex epidural haematomas (VEDH) are rare and difficulties are encountered in diagnosis and management. This is a case report of a patient with a vertex epidural haematoma who presented with signs of severe head injury with upper limb decerebrate posture. We discuss the challenges of radiological investigation and neurosurgical management of VEDH.

This paper investigates the relationships between knowledge of common sexually transmitted diseases and or HIV/AIDS and sexual behaviour change among adolescents in school and out of school in Nairobi City. Despite the existence of a well-structured health education system supported by informal health educators, it is apparent that health education knowledge acquired is not commensurate with desired changes in attitudes and behaviour. This study sampled 250 adolescents in Nairobi City aged between 14 to 24 years. Furthermore, focus group discussions were conducted to supplement views of individual respondents. The respondents socio-economic and cultural backgrounds represented well the major societal groups and classes. It was found that 93.2 percent of adolescents were knowledgeable of sexually transmitted diseases and over 90 per cent accurately identified symptoms of common sexually transmitted diseases and HIV/AIDS. However, it also emerged that peer pressure and peer networks have a very strong impact on attitude and behaviour of adolescent. The study recommends that more research is needed to understand how effects of peer networks could be made more effective in reducing adolescents pre-marital sex.

This paper investigates the relationships between knowledge of common sexually transmitted diseases and or HIV/AIDS and sexual behaviour change among adolescents in school and out of school in Nairobi City. Despite the existence of a well-structured health education system supported by informal health educators, it is apparent that health education knowledge acquired is not commensurate with desired changes in attitudes and behaviour. This study sampled 250 adolescents in Nairobi City aged between 14 to 24 years. Furthermore, focus group discussions were conducted to supplement views of individual respondents. The respondents socio-economic and cultural backgrounds represented well the major societal groups and classes. It was found that 93.2 percent of adolescents were knowledgeable of sexually transmitted diseases and over 90 per cent accurately identified symptoms of common sexually transmitted diseases and HIV/AIDS. However, it also emerged that peer pressure and peer networks have a very strong impact on attitude and behaviour of adolescent. The study recommends that more research is needed to understand how effects of peer networks could be made more effective in reducing adolescents pre-marital sex.

This paper investigates the relationships between knowledge of common sexually transmitted diseases and or HIV/AIDS and sexual behaviour change among adolescents in school and out of school in Nairobi City. Despite the existence of a well-structured health education system supported by informal health educators, it is apparent that health education knowledge acquired is not commensurate with desired changes in attitudes and behaviour. This study sampled 250 adolescents in Nairobi City aged between 14 to 24 years. Furthermore, focus group discussions were conducted to supplement views of individual respondents. The respondents socio-economic and cultural backgrounds represented well the major societal groups and classes. It was found that 93.2 percent of adolescents were knowledgeable of sexually transmitted diseases and over 90 per cent accurately identified symptoms of common sexually transmitted diseases and HIV/AIDS. However, it also emerged that peer pressure and peer networks have a very strong impact on attitude and behaviour of adolescent. The study recommends that more research is needed to understand how effects of peer networks could be made more effective in reducing adolescents pre-marital sex.

This paper investigates the relationships between knowledge of common sexually transmitted diseases and or HIV/AIDS and sexual behaviour change among adolescents in school and out of school in Nairobi City. Despite the existence of a well-structured health education system supported by informal health educators, it is apparent that health education knowledge acquired is not commensurate with desired changes in attitudes and behaviour. This study sampled 250 adolescents in Nairobi City aged between 14 to 24 years. Furthermore, focus group discussions were conducted to supplement views of individual respondents. The respondents socio-economic and cultural backgrounds represented well the major societal groups and classes. It was found that 93.2 percent of adolescents were knowledgeable of sexually transmitted diseases and over 90 per cent accurately identified symptoms of common sexually transmitted diseases and HIV/AIDS. However, it also emerged that peer pressure and peer networks have a very strong impact on attitude and behaviour of adolescent. The study recommends that more research is needed to understand how effects of peer networks could be made more effective in reducing adolescents pre-marital sex.

This paper investigates the relationships between knowledge of common sexually transmitted diseases and or HIV/AIDS and sexual behaviour change among adolescents in school and out of school in Nairobi City. Despite the existence of a well-structured health education system supported by informal health educators, it is apparent that health education knowledge acquired is not commensurate with desired changes in attitudes and behaviour. This study sampled 250 adolescents in Nairobi City aged between 14 to 24 years. Furthermore, focus group discussions were conducted to supplement views of individual respondents. The respondents socio-economic and cultural backgrounds represented well the major societal groups and classes. It was found that 93.2 percent of adolescents were knowledgeable of sexually transmitted diseases and over 90 per cent accurately identified symptoms of common sexually transmitted diseases and HIV/AIDS. However, it also emerged that peer pressure and peer networks have a very strong impact on attitude and behaviour of adolescent. The study recommends that more research is needed to understand how effects of peer networks could be made more effective in reducing adolescents pre-marital sex.

This paper investigates the relationships between knowledge of common sexually transmitted diseases and or HIV/AIDS and sexual behaviour change among adolescents in school and out of school in Nairobi City. Despite the existence of a well-structured health education system supported by informal health educators, it is apparent that health education knowledge acquired is not commensurate with desired changes in attitudes and behaviour. This study sampled 250 adolescents in Nairobi City aged between 14 to 24 years. Furthermore, focus group discussions were conducted to supplement views of individual respondents. The respondents socio-economic and cultural backgrounds represented well the major societal groups and classes. It was found that 93.2 percent of adolescents were knowledgeable of sexually transmitted diseases and over 90 per cent accurately identified symptoms of common sexually transmitted diseases and HIV/AIDS. However, it also emerged that peer pressure and peer networks have a very strong impact on attitude and behaviour of adolescent. The study recommends that more research is needed to understand how effects of peer networks could be made more effective in reducing adolescents pre-marital sex.

This paper investigates the relationships between knowledge of common sexually transmitted diseases and or HIV/AIDS and sexual behaviour change among adolescents in school and out of school in Nairobi City. Despite the existence of a well-structured health education system supported by informal health educators, it is apparent that health education knowledge acquired is not commensurate with desired changes in attitudes and behaviour. This study sampled 250 adolescents in Nairobi City aged between 14 to 24 years. Furthermore, focus group discussions were conducted to supplement views of individual respondents. The respondents socio-economic and cultural backgrounds represented well the major societal groups and classes. It was found that 93.2 percent of adolescents were knowledgeable of sexually transmitted diseases and over 90 per cent accurately identified symptoms of common sexually transmitted diseases and HIV/AIDS. However, it also emerged that peer pressure and peer networks have a very strong impact on attitude and behaviour of adolescent. The study recommends that more research is needed to understand how effects of peer networks could be made more effective in reducing adolescents pre-marital sex.

This paper investigates the relationships between knowledge of common sexually transmitted diseases and or HIV/AIDS and sexual behaviour change among adolescents in school and out of school in Nairobi City. Despite the existence of a well-structured health education system supported by informal health educators, it is apparent that health education knowledge acquired is not commensurate with desired changes in attitudes and behaviour. This study sampled 250 adolescents in Nairobi City aged between 14 to 24 years. Furthermore, focus group discussions were conducted to supplement views of individual respondents. The respondents socio-economic and cultural backgrounds represented well the major societal groups and classes. It was found that 93.2 percent of adolescents were knowledgeable of sexually transmitted diseases and over 90 per cent accurately identified symptoms of common sexually transmitted diseases and HIV/AIDS. However, it also emerged that peer pressure and peer networks have a very strong impact on attitude and behaviour of adolescent. The study recommends that more research is needed to understand how effects of peer networks could be made more effective in reducing adolescents pre-marital sex.

This paper investigates the relationships between knowledge of common sexually transmitted diseases and or HIV/AIDS and sexual behaviour change among adolescents in school and out of school in Nairobi City. Despite the existence of a well-structured health education system supported by informal health educators, it is apparent that health education knowledge acquired is not commensurate with desired changes in attitudes and behaviour. This study sampled 250 adolescents in Nairobi City aged between 14 to 24 years. Furthermore, focus group discussions were conducted to supplement views of individual respondents. The respondents socio-economic and cultural backgrounds represented well the major societal groups and classes. It was found that 93.2 percent of adolescents were knowledgeable of sexually transmitted diseases and over 90 per cent accurately identified symptoms of common sexually transmitted diseases and HIV/AIDS. However, it also emerged that peer pressure and peer networks have a very strong impact on attitude and behaviour of adolescent. The study recommends that more research is needed to understand how effects of peer networks could be made more effective in reducing adolescents pre-marital sex.

This paper investigates the relationships between knowledge of common sexually transmitted diseases and or HIV/AIDS and sexual behaviour change among adolescents in school and out of school in Nairobi City. Despite the existence of a well-structured health education system supported by informal health educators, it is apparent that health education knowledge acquired is not commensurate with desired changes in attitudes and behaviour. This study sampled 250 adolescents in Nairobi City aged between 14 to 24 years. Furthermore, focus group discussions were conducted to supplement views of individual respondents. The respondents socio-economic and cultural backgrounds represented well the major societal groups and classes. It was found that 93.2 percent of adolescents were knowledgeable of sexually transmitted diseases and over 90 per cent accurately identified symptoms of common sexually transmitted diseases and HIV/AIDS. However, it also emerged that peer pressure and peer networks have a very strong impact on attitude and behaviour of adolescent. The study recommends that more research is needed to understand how effects of peer networks could be made more effective in reducing adolescents pre-marital sex.

This paper investigates the relationships between knowledge of common sexually transmitted diseases and or HIV/AIDS and sexual behaviour change among adolescents in school and out of school in Nairobi City. Despite the existence of a well-structured health education system supported by informal health educators, it is apparent that health education knowledge acquired is not commensurate with desired changes in attitudes and behaviour. This study sampled 250 adolescents in Nairobi City aged between 14 to 24 years. Furthermore, focus group discussions were conducted to supplement views of individual respondents. The respondents socio-economic and cultural backgrounds represented well the major societal groups and classes. It was found that 93.2 percent of adolescents were knowledgeable of sexually transmitted diseases and over 90 per cent accurately identified symptoms of common sexually transmitted diseases and HIV/AIDS. However, it also emerged that peer pressure and peer networks have a very strong impact on attitude and behaviour of adolescent. The study recommends that more research is needed to understand how effects of peer networks could be made more effective in reducing adolescents pre-marital sex.

A study that devised a modified method of reporting antibiotic sensitivity results was undertaken. Enterobacteriaceae and Gram positive cocci were tested for drug sensitivity by a disc diffusion method. Zones of bacterial growth inhibition were measured, dividing the isolates into four groups: the highly sensitive, the moderately sensitive, the slightly sensitive and the resistant ones. The slightly sensitive isolates were taken as indicators of antibiotic resistance acquisition. By that system, when more than 50% of the isolates fell into the slightly and resistant groups, that meant that the antibiotic concerned would be discontinued for some time until the bacteria reverted to being moderately sensitive. The study also provided a method of making antibiotic discs from local blotting papers, and a sample of a form on which antibiotic sensitivity results could be recorded was presented. The method is considered to be easy and very appropriate for developing countries in detecting gradual and abrupt acquisition of antibiotic resistance by bacteria.

A study that devised a modified method of reporting antibiotic sensitivity results was undertaken. Enterobacteriaceae and Gram positive cocci were tested for drug sensitivity by a disc diffusion method. Zones of bacterial growth inhibition were measured, dividing the isolates into four groups: the highly sensitive, the moderately sensitive, the slightly sensitive and the resistant ones. The slightly sensitive isolates were taken as indicators of antibiotic resistance acquisition. By that system, when more than 50% of the isolates fell into the slightly and resistant groups, that meant that the antibiotic concerned would be discontinued for some time until the bacteria reverted to being moderately sensitive. The study also provided a method of making antibiotic discs from local blotting papers, and a sample of a form on which antibiotic sensitivity results could be recorded was presented. The method is considered to be easy and very appropriate for developing countries in detecting gradual and abrupt acquisition of antibiotic resistance by bacteria.

Department of Paediatrics, College of Health Sciences, University of Nairobi, Kenya. Sodium supplementation was done on 41 very low birth weight (VLBW) preterm infants with 25 other infants of similar weight status as controls. All the infants were fed on their own mothers milk whose sodium and potassium content was determined. Serum and urinary sodium, potassium and creatinine levels were determined in both groups during the study period of six weeks. Determination of weight gain, length gain and head circumference gain showed that these anthropometric parameters are significantly increased by sodium supplementation while sodium and potassium concentrations were not significantly affected. There were no cases of either hypernatraemia or hyponatraemia though renal excretion of sodium was very high in the supplemented group. Conclusions drawn from the study are that very little weight gain could have been due to fluid retention and that though sodium supplementation does not affect sodium profiles in these infants it has significant effect on their growth rate which may be due to its indirect/direct association with bone and protein metabolism.

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

Normal 0 false false false EN-US X-NONE X-NONE /* 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:10.0pt; font-family:"Times New Roman","serif";} Products of gene modification have vast implications. Creating public awareness and disseminating information on the subject seeks to demystify some of the widely held falsehoods regarding genetically modified products. This is an informative, thorough and easy to understand guidebook that aims to enlighten and debunk some of the commonly held misconceptions on products of gene modification and to give the reader a better understanding of the role genetic modification will play. The review sheds light on the safety, and application of these products in medicine, the food industry and other areas, especially those where genetic modification may represent a cheap, faster, credible, viable alternative in achieving sustainable development among resource-poor communities.

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Maintenance of soil organic matter through integrated soil fertility management is important for soil
quality and agricultural productivity, and for the persistence of soil faunal diversity and biomass. Little
is known about the interactive effects of soil fertility management and soil macrofauna diversity on
soil aggregation and SOM dynamics in tropical arable cropping systems. A study was conducted in a
long-term trial at Kabete, Central Kenya, to investigate the effects of organic inputs (maize stover or
manure) and inorganic fertilizers on soil macrofauna abundance, biomass and taxonomic diversity, water
stable aggregation, whole soil and aggregate-associated organic C and N, as well as the relations between
these variables. Differently managed arable systems were compared to a long-term green fallow system
representing a relatively undisturbed reference.
Fallowing, and application of farm yard manure (FYM) in combination with fertilizer, significantly
enhanced earthworm diversity and biomass as well as aggregate stability and C and N pools in the top
15cm of the soil. Earthworm abundance significantly negatively correlated with the percentage of total
macroaggregates and microaggregates within macroaggregates, but all earthworm parameters positively
correlated with whole soil and aggregate associated C and N, unlike termite parameters. Factor analysis
showed that 35.3% of the total sample variation in aggregation and C and N in total soil and aggregate
fractions was explained by earthworm parameters, and 25.5% by termite parameters. Multiple regression
analysis confirmed this outcome.
The negative correlation between earthworm abundance and total macroaggregates and microaggregates
within macroaggregate could be linked to the presence of high numbers of Nematogenia lacuum
in the arable treatments without organic amendments, an endogeic species that feeds on excrements of
other larger epigeic worms and produces small excrements. Under the conditions studied, differences
in earthworm abundance, biomass and diversity were more important drivers of management-induced
changes in aggregate stability and soil C and N pools than differences in termite populations.
Keywords: Earthworm, Termite, Taxonomic richness, Soil organic matter, Carbon, Nitrogen, Soil aggregate fraction

PURPOSE: To build capacity in the resource-poor setting to support the clinical investigation and treatment of AIDS-related malignancies in a region of the world hardest hit by the AIDS pandemic. METHODS: An initial MEDLINE database search for international collaborative partnerships dedicated to AIDS malignancies in developing countries failed to identify any leads. This search prompted us to report progress on our collaboration in this aspect of the epidemic. Building on the formal Uganda-Case Western Reserve University (Case) Research Collaboration dating back to 1987, established NIH-supported centers of research excellence at Case, and expanding activities in Kenya, scientific and training initiatives, research capital amongst our institutions are emerging to sustain a international research enterprise focused on AIDS and other viral-related malignancies. RESULTS: A platform of clinical research trials with pragmatic design has been developed to further enhance clinical care and sustain training initiatives with partners in East Africa and the United States. An oral chemotherapy feasibility trial in AIDS lymphoma is near completion; a second lymphoma trial of byrostatin and vincristine is anticipated and a feasibility trial of indinavir for endemic Kaposi's sarcoma is planned. CONCLUSIONS: In the absence of published reports of evolving international partnerships dedicated to AIDS malignancy in resource constrained settings, we feel it important for such progress on similar or related international collaborative pursuits to be published. The success of this effort is realized by the long-term international commitment of the collaborating investigators and institutions to sustain this effort in keeping with ethical and NIH standards for the conduct of research; the provision of formal training of investigators and research personnel on clinical problems our East African partners are faced with in practice and the development of pragmatic clinical trials and therapeutic intervention to facilitate technology transfer and enhance clinical practice.

PMID: 15829373 [PubMed - indexed for MEDLINE]

PURPOSE: To build capacity in the resource-poor setting to support the clinical investigation and treatment of AIDS-related malignancies in a region of the world hardest hit by the AIDS pandemic. METHODS: An initial MEDLINE database search for international collaborative partnerships dedicated to AIDS malignancies in developing countries failed to identify any leads. This search prompted us to report progress on our collaboration in this aspect of the epidemic. Building on the formal Uganda-Case Western Reserve University (Case) Research Collaboration dating back to 1987, established NIH-supported centers of research excellence at Case, and expanding activities in Kenya, scientific and training initiatives, research capital amongst our institutions are emerging to sustain a international research enterprise focused on AIDS and other viral-related malignancies. RESULTS: A platform of clinical research trials with pragmatic design has been developed to further enhance clinical care and sustain training initiatives with partners in East Africa and the United States. An oral chemotherapy feasibility trial in AIDS lymphoma is near completion; a second lymphoma trial of byrostatin and vincristine is anticipated and a feasibility trial of indinavir for endemic Kaposi's sarcoma is planned. CONCLUSIONS: In the absence of published reports of evolving international partnerships dedicated to AIDS malignancy in resource constrained settings, we feel it important for such progress on similar or related international collaborative pursuits to be published. The success of this effort is realized by the long-term international commitment of the collaborating investigators and institutions to sustain this effort in keeping with ethical and NIH standards for the conduct of research; the provision of formal training of investigators and research personnel on clinical problems our East African partners are faced with in practice and the development of pragmatic clinical trials and therapeutic intervention to facilitate technology transfer and enhance clinical practice.

PMID: 15829373 [PubMed - indexed for MEDLINE]

OBJECTIVE: To compare the findings of venous sonography with contrast venography in the detection of deep venous thrombosis (DVT) of the lower limbs. DESIGN: Prospective study. SETTING: The Kenyatta National Hospital, a teaching and referral hospital in Nairobi. SUBJECTS: Fifty five limbs in 44 patients with clinical suspicion of DVT were evaluated during the seven months study period (October 2002-April 2003). The ethics committee in the institution granted approval for the study and participants gave written informed consent. INTERVENTION: Venous sonography in which a three step protocol involving B-mode gray scale compression sonography, colour and colour Doppler sonography was obtained after contrast venography in patients with clinical suspicion of DVT. The ultrasound examination was done within 24 hours of the contrast venogram. RESULTS: The overall sensitivity of venous sonography was 88.9%, specificity 91.8% and accuracy 90.9%. Considering only DVT above the calf, the sensitivity improved to 100%. An alternative diagnosis was found by ultrasound in 48.6% of the negative for DVT cases. CONCLUSION: The accuracy of venous sonography as done locally is high and comparable to that in developed countries. We recommend that for patients with clinical suspicion of DVT, venous sonography be done as the initial imaging investigation and venography be reserved for those patients with equivocal or inadequate sonography results. PMID: 17886423 [PubMed - indexed for MEDLINE

BACKGROUND: Diagnostic radiology investigations play important roles in the management of Burkitt's Lymphoma. OBJECTIVES: To document the various radiological manifestations of Burkitt's lymphoma as seen in patients at the Kenyatta National Hospital. DESIGN: Prospective study of Burkitt's Lymphoma cases admitted to the paediatric and Ear, Nose and Throat Wards. SETTING: Kenyatta National Hospital. MAIN OUTCOME MEASURES: All histological proven cases of BL had the following documented; Age sex, tribe, geographical (province) of origin, full medical evaluation results, presenting site of tumour, radiological findings and results of chest X-ray, abdominal ultrasound occipital frontal view of the skull X-ray. computerised tomography, myelography and orthopantomograms. RESULTS: In the period between April 1991 and March 1992 this study registered 49 patients age range 2 to 14 years. These were males 34 (69%) and females 15 (31%). The commonest radiological findings was associate with intra abdominal lymphoma seen in 65.2% of the cases, the least findings associated with cervical adenopathy and pleural effusion each 3.3% of cases. Twenty (41%) of the disease was clinically confined to the facial area while radiologically 25% of these were demonstrated to extend to the abdomen as well. CONCLUSION: Disease extent on radiological examination was found to be more extensive compared to clinical evaluation alone. The observation emphasised the role of radiological investigation in the management of lymphomas in this setting.East Afr Med J. 2004 Aug;(8 Suppl):S104-10. PMID: 15617420 [PubMed - indexed for MEDLINE