Terminalia brownii is an African medicinal plant used to treat parasitic and microbial infections [1]. Chromatographic separations on the stem bark extract aimed at identifying the active components led to isolation of a new oleanane-type triterpenoid, along with seven known oleanane-type triterpenoids and seven ellagic acid derivatives. The new compound was identified using spectroscopic methods as 3β,24-O-ethylidenyl-2α,19α-dihydroxyolean-12-en-28-oic acid (1). The compounds were evaluated for their antiplasmodial, antileishmanial and antimicrobial activities giving the most potent antiplasmodial activity with IC50 values of 2.76 µg/mL for 23-galloylarjunolic acid (2) against P. falciparum W2 strain and the most potent antimicrobial activity with IC50 values of 0.32 µg/mL for diellagic lactone (3) against C. glabrata.

Food spoilage and poisoning pathogens lead to pre- and post-harvest losses of crop produce and poisoning
of food and feed stuff; posing a great threat to food security and safety worldwide. This project aimed to
investigate the pesticidal activity and presence of chemical compounds in Vernonia glabra; as an alternative
control approach, to food crop protection. Organic extracts of leaves and flowers showed the highest
activity against S. aureus (mean inhibition zones of 1.85 and 1.78 respectively), than the standard antibiotic
(Streptomycin 1.30). Flavonoids were greatly present in all extracts screened. The results of this study
justify the use of V. glabra in traditional herbal medicine, and suggest that the plant has ideal
characteristics in the application as bio-pesticide control to crops and food stuff.

Description
Background. This study examines an intervention strategy to reduce the risk of chromium (Cr) exposure. It follows a previous Cr exposure investigation, which revealed that large volumes of Cr-contaminated waste were burnt on site. The study site had a long history of land-based waste disposal since 1994.
Objective. The potential for phytoremediation using bamboo species to restore Cr-contaminated soil was evaluated.
Methods. Chromium levels and physico-chemical properties of the tannery and control soils were analyzed before transplanting six different bamboo species. Translocation, bio-concentration and bioaccumulation factors of the species were assessed for phytoremediation capabilities.
Results. Chromium levels in the tannery soils ranged from 1337.0 to 3398.0 mg/kg dw. The chromium levels were significantly higher (P < 0.05) than those of the control soils (0.20 to 2.34 mg/kg dw) and …

Two sterols, b-sitosterol and stigmasterol, were isolated from the stem bark of combetrum fragrans~ The, identity.of'.these.compounds was established by spectral analysis.

Two sterols, b-sitosterol and stigmasterol, were isolated from the stem bark of combetrum fragrans~ The, identity.of'.these.compounds was established by spectral analysis.

Aim: To establish the prevalence of pica behaviour during pregnancy; to identify the substances commonly ingested and their prevalence; and to determine the characteristics of women who reported practicing pica.

Method: Was descriptive, cross sectional study involving use of questionnaire administered in interview format. Study was conducted at Pumwani Maternity Hospital, Nairobi, Kenya. Participants included a convenience sample of 1071 ante natal women with a mean age of 28.1 (+_ 7.3) years. Subjects were selected based on availability, accessibility, and willingness to participate in the study.

Results: Seven hundred and ninety three (74.0%) participants reported practicing pica regularly on a daily basis. Pica prevalence categorised by substances ingested was as follows: soft stones (odowa), 89.8%; soil, 61.2%; and others, 9.6% and no pica, 26.0%. Majority of women who reported practicing pica (62.5%) ingested more than one substance. Most women who practiced pica reported having experienced strong cravings prior to ingestion of pica items, childhood pica, pica before pregnancy, pica in previous pregnancy and a history of pica in family members and significant others in the community.

Conclusions: Pica prevalence was significantly high among the subjects indicating that pica in pregnancy might be more common and widespread in Kenya than health care providers assume or observe. There is no need to routinely screen pregnant women for pica during antenatal visits as this will provide a more systematic and a less expensive way of establishing its epidemiologic status. A nationwide investigation of pica prevalence is also recommended in order to establish possible health consequences of pica on mother and child.

A case of a female neonate with Pierre Robin Syndrome with frequent cyanotic episodes and feeding difficulties which could not be adequately managed by positioning and oral airway placement is presented. Tongue-anterior mandible fusion procedure was performed with satisfactory results

A study was carried out to establish the presence of Cryptococcus neoformans and Candida species in two pigeon-frequented areas; garbage piles from two separate sites in Nairobi, and dog faeces from Small animal clinic, University of Nairobi, Kabete. The sampling included both solid materials and air. Potato Dextrose agar, CHROMagar and urea media were used for isolation and characterization of these yeasts. Various species of Candidaand Cryptococcus neoformans were isolated in numbers ranging from 104 to 105 colony forming units per gramme or per 2-minute exposure to air; from both pigeon-frequented areas and garbage sites. Cryptococcus was isolated more than Candida species in pigeon-frequented areas, while the reverse was the case for garbage sites, both for solid and aerial samples. The dog faeces yielded Candida organisms mainly. The presence of these yeasts in both solid samples and air highlights the possibility of these areas, which are frequently traversed by humans and animals (including chickens and other birds), as being possible sources of infection for humans and animals. Aerial contamination means the organisms can be disseminated far and wide easily.

In field trials with (a) determinate and (b) indeterminate pigeon pea cv., pod damage by Heliothis armigera, Pardasena virgulana and Melanagromyza obtusa and seed yield losses ranged from 37% and 23% in an early-flowering cv. of (b) to 64% and 52% in a late-flowering cv. of (b), resp

the partograph is a tool used globally to record labour progress. Although it has the potential to improve maternal and neonatal outcomes, some midwives struggle with using it in practice. Training in partograph use is limited, and the theory is often divorced from practice. Innovative ways of improving training are urgently required. We therefore aimed to determine whether the use of an e-learning tool is beneficial for learning partograph skills. an uncontrolled before-and-after study was conducted, informed by Kirkpatrick's four-stage model of evaluation; we report on the first two stages. We included a cohort of third and fourth year midwifery students who were studying at one university in Nairobi. The same hypothetical case scenario was used, pre- and post-implementation of the World Health Organization partograph e-learning tool, to assess students' partograph completion ability. Views on the tool were also sought, using semi-structured questionnaires. Data were analysed using standard statistical techniques and framework analysis. 92 (88%) students participated. Students expressed positive views about the e-learning tool. However, the mean post-intervention score (27.21) was less than half of the maximum obtainable score. There was some improvement in test scores; year three mean score pre-intervention was 21.39 (SD 5.72), which increased to 25.10 (5.41) post-intervention (paired-t=3.47, p=0.001); year four mean score pre-intervention was 24.39 (5.98) which increased to 29.30 (6.77) post-intervention (paired t=3.85, df=91, p<0.001). In the post-test, year four students scored higher than year three students (unpaired t=3.28, df=90, p=0.001). Students were unable to plot cervical dilatation correctly, once established labour had been confirmed. e-Learning training is acceptable to student midwives and has the potential to be an effective means of teaching the practical application of the partograph. However, in this study, their inability to correctly plot transference from the latent to active phase of labour suggests that the partograph itself may be too complicated. Modifications and further evaluation of the e-learning tool would be required before any widespread implementation. Furthermore, students need the clinical support to operationalise their learning; educating qualified midwives and obstetricians to be positive role models when completing the partograph would be one potential solution. Further research is required, taking on board the recommendations from our pilot study, to investigate the impact of partograph e-learning on practice and clinical outcomes.

Midwifery. 2013 Mar 4. pii: S0266-6138(12)00183-0. doi: 10.1016/j.midw.2012.10.003. [Epub ahead of print]
A pilot quasi-experimental study to determine the feasibility of implementing a partograph e-learning tool for student midwife training in Nairobi.
Tina Lavender D, Omoni G, Lee K, Wakasiaki S, Campbell M, Watiti J, Mathai M.
Source

Jean McFarlane Building, University of Manchester, Manchester M13 9PL, UK. Electronic address: tina.lavender@manchester.ac.uk.
Abstract
OBJECTIVE:

the partograph is a tool used globally to record labour progress. Although it has the potential to improve maternal and neonatal outcomes, some midwives struggle with using it in practice. Training in partograph use is limited, and the theory is often divorced from practice. Innovative ways of improving training are urgently required. We therefore aimed to determine whether the use of an e-learning tool is beneficial for learning partograph skills.
DESIGN:

an uncontrolled before-and-after study was conducted, informed by Kirkpatrick's four-stage model of evaluation; we report on the first two stages. We included a cohort of third and fourth year midwifery students who were studying at one university in Nairobi. The same hypothetical case scenario was used, pre- and post-implementation of the World Health Organization partograph e-learning tool, to assess students' partograph completion ability. Views on the tool were also sought, using semi-structured questionnaires. Data were analysed using standard statistical techniques and framework analysis.
FINDINGS:

92 (88%) students participated. Students expressed positive views about the e-learning tool. However, the mean post-intervention score (27.21) was less than half of the maximum obtainable score. There was some improvement in test scores; year three mean score pre-intervention was 21.39 (SD 5.72), which increased to 25.10 (5.41) post-intervention (paired-t=3.47, p=0.001); year four mean score pre-intervention was 24.39 (5.98) which increased to 29.30 (6.77) post-intervention (paired t=3.85, df=91, p<0.001). In the post-test, year four students scored higher than year three students (unpaired t=3.28, df=90, p=0.001). Students were unable to plot cervical dilatation correctly, once established labour had been confirmed.
KEY CONCLUSION:

e-Learning training is acceptable to student midwives and has the potential to be an effective means of teaching the practical application of the partograph. However, in this study, their inability to correctly plot transference from the latent to active phase of labour suggests that the partograph itself may be too complicated. Modifications and further evaluation of the e-learning tool would be required before any widespread implementation. Furthermore, students need the clinical support to operationalise their learning; educating qualified midwives and obstetricians to be positive role models when completing the partograph would be one potential solution. Further research is required, taking on board the recommendations from our pilot study, to investigate the impact of partograph e-learning on practice and clinical outcomes.

Copyright © 2012 Elsevier Ltd. All rights reserved.

the partograph is a tool used globally to record labour progress. Although it has the potential to improve maternal and neonatal outcomes, some midwives struggle with using it in practice. Training in partograph use is limited, and the theory is often divorced from practice. Innovative ways of improving training are urgently required. We therefore aimed to determine whether the use of an e-learning tool is beneficial for learning partograph skills.

Division of Bacterial and Mycotic Diseases, Centers for Disease Control, Atlanta, GA 30333. An epidemic of meningococcal disease occurred in Nairobi, Kenya, during 1989, outside the "meningitis belt" of sub-Saharan Africa. About 3800 cases occurred between April and November (250/100,000 population). The case-fatality rate was 9.4% among hospitalized patients. Areas that included Nairobi's largest slums had particularly high attack rates. The epidemic displayed an unusual age distribution, with high attack rates among those 20-29 years old. A vaccination campaign was conducted. By early January, the weekly case count had fallen to 25 from a high of 272 (in September). A case-control study estimated the vaccine efficacy to be 87% (95% confidence interval, 67%-95%). A model estimated that the vaccination campaign reduced the number of cases by at least 20%. Multilocus enzyme electrophoretic typing demonstrated that the strain responsible for this large epidemic is closely related to strains that caused other recent epidemics, documenting further spread of what may be a particularly virulent clonal complex of group A Neisseria meningitidis.

To study the Knowledge, Attitude, and Use of Pit and Fissure Sealants by Dentists in Nairobi. Materials and methods: This was a descriptive cross-sectional study which was done between May and June 1999. Questionnaires were distributed to 115 dentists who were sampled through convenience sampling. Setting: Nairobi Subjects: Dentists in public and private practice. Results: Sixty nine dentists (60%) responded. (50.7%) of the dentists had average knowledge on PFS. Majority of the respondents (92.7%) agreed that Pit and fissure sealants should be part of preventive measures for dental caries. (65%) claimed to use Pit and fissure sealants with only a third using them regularly. The Pediatric dentists used sealants frequently. Conclusion: Application of PFS was not practiced much in Nairobi and sealant usage was associated with dentist's knowledge about them. There is need to disseminate knowledge on PFS to the dentists and sensitize the public about prevention of dental decay using sealants.

To study the Knowledge, Attitude, and Use of Pit and Fissure Sealants by Dentists in Nairobi. Materials and methods: This was a descriptive cross-sectional study which was done between May and June 1999. Questionnaires were distributed to 115 dentists who were sampled through convenience sampling. Setting: Nairobi Subjects: Dentists in public and private practice. Results: Sixty nine dentists (60%) responded. (50.7%) of the dentists had average knowledge on PFS. Majority of the respondents (92.7%) agreed that Pit and fissure sealants should be part of preventive measures for dental caries. (65%) claimed to use Pit and fissure sealants with only a third using them regularly. The Pediatric dentists used sealants frequently. Conclusion: Application of PFS was not practiced much in Nairobi and sealant usage was associated with dentist's knowledge about them. There is need to disseminate knowledge on PFS to the dentists and sensitize the public about prevention of dental decay using sealants.

To study the Knowledge, Attitude, and Use of Pit and Fissure Sealants by Dentists in Nairobi. Materials and methods: This was a descriptive cross-sectional study which was done between May and June 1999. Questionnaires were distributed to 115 dentists who were sampled through convenience sampling. Setting: Nairobi Subjects: Dentists in public and private practice. Results: Sixty nine dentists (60%) responded. (50.7%) of the dentists had average knowledge on PFS. Majority of the respondents (92.7%) agreed that Pit and fissure sealants should be part of preventive measures for dental caries. (65%) claimed to use Pit and fissure sealants with only a third using them regularly. The Pediatric dentists used sealants frequently. Conclusion: Application of PFS was not practiced much in Nairobi and sealant usage was associated with dentist's knowledge about them. There is need to disseminate knowledge on PFS to the dentists and sensitize the public about prevention of dental decay using sealants.

Introduction: Surgical extirpation of pituitary lesions and can be performed by craniotomy or trans-sphenoidal approaches. This could be for pituitary ablation, excision of pituitary adenomas, craniopharyngiomas, suprasellar meningiomas and other types of tumors of the sellar region. Despite this being a common neurosurgical procedure there is a paucity of data on the local Kenyan experience and outcomes following pituitary surgery. Study Design and Site: A retrospective study at the Kenyatta National Teaching and Referral Hospital, Nairobi. Objectives: To evaluate the clinical presentation, management and outcome of patients undergoing surgery for pituitary lesions at the Kenyatta National Hospital. Patients and Methods: Following ethical approval, patients’ records were retrieved and assessed for clinical and radiologic features of pituitary lesions, surgical treatment and post operative outcome. All the data was coded and analysed using Statistical Package for Social Sciences (SPSS) version 16.0. Frequencies and means were computed for description of the various variables and the association between categorical variables calculated using Chi-square test while comparison of mean values was performed using the one-way analysis of variance test (ANOVA). Results: A total of 65 patients were included with 39 (60%) female and 26 (40%) male patients. The mean age was 36.88 years (+ 14.689) and majority of the patients (55%) were aged between 26 and 45 years. The most common presentation were visual disturbances reported by 57 (87.7%) of the patients having reduction in visual acuity, while 37 (56.9%) had bitemporal hemianopia. Amenorrhea and primary infertility were reported by 11 (16.9%) patients while 14 (21.5%) and 8 (12.3%) had galactorrhea and gynecomastia respectively. Ten patients (15.4%) had acromegalic features of hypergnathia and acral enlargement of hands and feet. Sixty two (95.4%) patients were operated during the study period and of these 28 (45.2%) by the transphenoidal approach as opposed to 34 (54.85%) by craniotomy. The pterional trans-sylvian approach was the most common of the transcranial hypohysectomies accounting for 17 (50%) patients, while 15 patients (44.1%) were operated by the subfrontal approach and two patients were operated via midline inter-hemispheric approach.2nd Bi-ennual International Scientific Conference 2013, Nairobi Kenya 29 Majority (96.4%) of trans-sphenoidal hypophysectomies were by sub-labial incision. Fifty (76.9%) of the patients had good functional outcome while 11 (16.9%) and 4 (6.2%) suffered moderate and severe disability respectively. Patients’ age (p=0.0029), duration of symptoms prior to surgery (p=0.0018) and surgical management versus conservative (p=0.001) significantly affected patient outcome. There was no statistically significant difference in outcome between patients of different sex (p=0.058) or the type of operation performed (p=0.191). Conclusion: Transsphenoidal and trans-cranial approaches are effective and safe treatment strategies for pituitary lesions with low morbidity, mortality and recurrence rates. With the paradigm shift towards more trans-sphenoidal and particularly endonasal approaches, additional prospective studies are required to assess clinical and endocrinological outcomes.

Introduction to Philosophy of Religion, University of Nairobi, 1988

Background: Preterm birth (PTB) is a major cause of infant
morbidity and mortality in developing countries. Recent data suggest
that in addition to Human Immunodeficiency Virus (HIV) infection,
use of antiretroviral therapy (ART) increases the risk of PTB. As the
mechanisms remain unexplored, we conducted this study to
determine whether HIV and ART were associated with placental
changes that could contribute to PTB.
Setting: We collected and evaluated placentas from 38 HIVpositive
women on ART and 43 HIV-negative women who had
preterm deliveries in Nairobi, Kenya.
Methods: Anatomical features of the placentas were examined at
gross and microscopic levels. Cases were matched for gestational
age and compared by the investigators who were blinded to maternal
HIV serostatus.
Results: Among preterm placentas, HIV infection was significantly
associated with thrombosis (P = 0.001), infarction (P = 0.032),
anomalies in cord insertion (P = 0.02), gross evidence of membrane
infection (P = 0.043), and reduced placental thickness (P = 0.010).
Overall, preterm placentas in both groups were associated with
immature villi, syncytial knotting, villitis, and deciduitis. Features of
HIV-positive versus HIV-negative placentas included significant
fibrinoid deposition with villus degeneration, syncytiotrophoblast
delamination, red blood cell adhesion, hypervascularity, and reduction
in both surface area and perimeter of the terminal villi.
Conclusions: These results imply that HIV infection and/or ART
are associated with morphological changes in preterm placentas that
contribute to delivery before 37 weeks. Hypervascularity suggests
that the observed pathologies may be attributable, in part, to hypoxia.
Further research to explore potential mechanisms will help elucidate
the pathways that are involved perhaps pointing to interventions for
decreasing the risk of prematurity among HIV-positive women.
Key Words: preterm birth, term birth, placenta, HIV, ART

Background: Preterm birth (PTB) is a major cause of infant morbidity and mortality in developing countries. Recent data suggest that in addition to Human Immunodeficiency Virus (HIV) infection, use of antiretroviral therapy (ART) increases the risk of PTB. As the mechanisms remain unexplored, we conducted this study to determine whether HIV and ART were associated with placental changes that could contribute to PTB.

Setting: We collected and evaluated placentas from 38 HIV-positive women on ART and 43 HIV-negative women who had preterm deliveries in Nairobi, Kenya.

Methods: Anatomical features of the placentas were examined at gross and microscopic levels. Cases were matched for gestational age and compared by the investigators who were blinded to maternal HIV serostatus.

Results: Among preterm placentas, HIV infection was significantly associated with thrombosis (P = 0.001), infarction (P = 0.032), anomalies in cord insertion (P = 0.02), gross evidence of membrane infection (P = 0.043), and reduced placental thickness (P = 0.010). Overall, preterm placentas in both groups were associated with immature villi, syncytial knotting, villitis, and deciduitis. Features of HIV-positive versus HIV-negative placentas included significant fibrinoid deposition with villus degeneration, syncytiotrophoblast delamination, red blood cell adhesion, hypervascularity, and reduction in both surface area and perimeter of the terminal villi.

Conclusions: These results imply that HIV infection and/or ART are associated with morphological changes in preterm placentas that contribute to delivery before 37 weeks. Hypervascularity suggests that the observed pathologies may be attributable, in part, to hypoxia. Further research to explore potential mechanisms will help elucidate the pathways that are involved perhaps pointing to interventions for decreasing the risk of prematurity among HIV-positive women.

This paper presents a case for the need to build a virtual bibliography of Kenyan literature on the World Wide Web; this catalogue without cards will present to the wide audience with access to the internet basic and correct information on this literature. In the course of discussing the place of modern information technology in the world, the paper discusses the Kenyan literary heritage as a form of higher culture reflecting social experiences, capturing the souls of the nation and encapsulating the high ideals of humanism and progress. Further, the paper calls for honesty and sensitivity in the preservation of information on the literary texts, lest this information is laid open to possible distortion, even manipulation, by those who post it on the World Wide Web. Implicitly, the paper makes a case for the need of the developing world

n/a

Journal of the Institute of Certified Public Accountants of Kenya. (pages 13-15)

Farmers of the Sagana irrigation project, Kenya, have identified fluctuating and low prices for their agricultural produce as their main constraint. This paper reports results from a study carried out to identify an alternative cropping system that could be used to optimize their returns by harvesting their crops when the market price is highest. The study shows that there is a complex interaction of factors affecting the selection of a cropping system: climatic, water requirements, marketing and farmer preferences. It also illustrates how proper planning of the cropping calendar can reduce irrigation water requirements and maximize project benefits.

Malaria remains a serious parasitic disease killing over one million people annually. One of the strategies to manage the malaria problem is to control the population of mosquito at larval or adult stages of their life cycle. However with. the appearance of insect resistance to conventional insecticides together with the growing environmental concern on the use of many synthetic insecticides, in particular halogenated compounds such as DDT, the search for effective and environmentally friendly insecticidal agents is intensifying. In this effort some East African plant extracts and pure compounds have been tested for larvicidal activities (Muwangi and Mukiama, 1988; Mwangi and Rembold, 1988; Gikonyo et aI., 1998).

Kenya has consistently reported new and serious disease and pest problems on key crops over the
years, often associated with substantial crop yield losses. In just the last six years, for example, maize
lethal necrosis – a disease responsible for crop losses valued at about US$ 4.1 million in 2014 alone –
and tomato leaf miner entered and got established in the country. For small-scale farmers, who make
up 80% of the farming community and contribute 25% of the GDP, an attack by such diseases could
spell doom for their income and food supply. Decisive action is needed to prevent new pests and
diseases from spreading and becoming established. Also, other well-established crop pests and
diseases regularly cause major crop losses. Farmers need help to take preventative measures and
avoid costly and often less effective treatments after the problem has entered the crop. Extension
campaigns can play a critical role in controlling crops pests and diseases by acting as a source of
timely information. One such approach, plant health rallies, has been embraced in Kenya, though so
far on a limited scale. In 2015 the University of Nairobi and Plantwise undertook a study in parts of
Kenya among 150 farmers and 27 extension staff in five counties to get a picture of extension
campaigns in crop health and to understand how the role of plant health rallies could be enhanced in
delivering a comprehensive service to farmers. The study focused on maize lethal necrosis, mango
fruit fly, Napier grass stunt, tomato leaf miner and wheat stem rust, all which have the potential for high
economic impact.

Sweet potato is one of the most important staple food crops consumed in Kenya and throughout Africa but yields are greatly reduced by plant parasitic nematodes (PPN). The aim of this study was to determine the prevalence of PPN in Kenyan sweet potato fields and their relationship with soil and climatic variables. Soil samples were collected from sweet potato fields in Busia, Teso, Kisii, Embu and Makueni counties. Thirteen nematode genera were identified across the five counties with Meloidogyne, Pratylenchus and Rotylenchus being the most prevalent. There was a significant (P <0.05) relationship between PPN abundance and sodium, calcium and iron. Canonical correspondence analysis of climatic variables revealed that the relationship between rainfall and nematode genera was significant (P <0.05) while maximum and minimum temperatures were not significant. This description of PPN assemblages associated with sweet potato in Kenya and their relationship with environmental variables provides a starting point from which appropriate nematode management strategies can be implemented.

Sweet potato is one of the most important staple food crops consumed in Kenya and throughout Africa but yields are greatly reduced by plant parasitic nematodes (PPN). The aim of this study was to determine the prevalence of PPN in Kenyan sweet potato fields and their relationship with soil and climatic variables. Soil samples were collected from sweet potato fields in Busia, Teso, Kisii, Embu and Makueni counties. Thirteen nematode genera were identified across the five counties with Meloidogyne, Pratylenchus and Rotylenchus being the most prevalent. There was a significant (P <0.05) relationship between PPN abundance and sodium, calcium and iron. Canonical correspondence analysis of climatic variables revealed that the relationship between rainfall and nematode genera was significant (P <0.05) while maximum and minimum temperatures were not significant. This description of PPN assemblages associated with sweet potato in Kenya and their relationship with environmental variables provides a starting point from which appropriate nematode management strategies can be implemented.

Two wetlands (Hyena and Nalogomon) in the Nairobi National Park were investigated by comparing plant composition in and around their immediate vicinity. The most common aquatic plant species in the Hyena wetland was Cyperus dives while in the Nalogomon wetland was Typha domingensis. The terrestrial vegetation surrounding Hyena wetland dominated by while that of surrounding Nalogomon wetland was the grass Hyparrhemia rufa. It was also noted that Hyena Dam waters were colonized by aquatic weeds, namely Gunnera perpensa, Enhydra fluctuans and Ludwigia abyssinica, that were absent in Nalogomon wetland waters. This could have been due to eutrophication of the waters of Hyena Dam as it originated from human settlements (city estates) outside the park boundary.

This article reports a preliminary examination of plant remains and the tentative implications that have so far been deduced from them. The plant samples were acquired by archaeological excavations at one of the Hyrax Sirikwa sites within Nakuru Municipality, Kenya. Hyrax Hill has numerous prehistoric sites that represent occupations dating as far back as the Neolithic period. Several of the Neolithic sites have been studied (see Leakey 1945, Onyango-Abuje 1977, Merrick 1983). However, of specific relevance to this report are the Sirikwa culture sites that are found in a group throughout the lower northwestern portion of the hill. There are at least 13 of these Sirikwa occurrences comprising about 13 hollows and 13 mounds.

Recent data suggest that infection with human immunodeficiency virus type 1 (HIV-1) subtype C results in prolonged high-level viremia (>5 log10 copies/mL) during early infection. We examined the relationship between HIV-1 subtype and plasma viremia among 153 African seroconverters. Mean setpoint viral loads were similar for C and non-C subtypes: 4.36 vs 4.42 log10 copies/mL (P = .61). The proportion of subtype C-infected participants with viral loads >5 log10 copies/mL was not greater than the proportion for those with non-C infection. Our data do not support the hypothesis that higher early viral load accounts for the rapid spread of HIV-1 subtype C in southern Africa.

Eighty six Klebsiella isolates from Kenyatta National Hospital and the Centre for Microbiology, Kenya Medical Research Institute, Nairobi were screened for resistance to commonly prescribed antimicrobial agents and for their plasmid content. Plasmids were transferred into Esherichia coli K-12 and resulting transconjugants screened for resistance to the antimicrobial agents used on Klebsiella donors and for their plasmid content. Plasmids from the Klebsiella isolates were also transformed into Eschericia coli and transformants analyzed for resistance and plasmid content. Endonuclease restriction mapping was done to characterize the plasmids from Klebsiella isolates and their Eschericia coli transformants. Resistance was found to be plasmid borne and transmissible.

Eighty six Klebsiella isolates from Kenyatta National Hospital and the Centre for Microbiology, Kenya Medical Research Institute, Nairobi were screened for resistance to commonly prescribed antimicrobial agents and for their plasmid content. Plasmids were transferred into Esherichia coli K-12 and resulting transconjugants screened for resistance to the antimicrobial agents used on Klebsiella donors and for their plasmid content. Plasmids from the Klebsiella isolates were also transformed into Eschericia coli and transformants analyzed for resistance and plasmid content. Endonuclease restriction mapping was done to characterize the plasmids from Klebsiella isolates and their Eschericia coli transformants. Resistance was found to be plasmid borne and transmissible.

Eighty six Klebsiella isolates from Kenyatta National Hospital and the Centre for Microbiology, Kenya Medical Research Institute, Nairobi were screened for resistance to commonly prescribed antimicrobial agents and for their plasmid content. Plasmids were transferred into Esherichia coli K-12 and resulting transconjugants screened for resistance to the antimicrobial agents used on Klebsiella donors and for their plasmid content. Plasmids from the Klebsiella isolates were also transformed into Eschericia coli and transformants analyzed for resistance and plasmid content. Endonuclease restriction mapping was done to characterize the plasmids from Klebsiella isolates and their Eschericia coli transformants. Resistance was found to be plasmid borne and transmissible.

Treatment of gonorrhea is complicated by the development of antimicrobial resistance in Neisseria gonorrhoeae (GC) to the antibiotics recommended for treatment. Knowledge on types of plasmids and the antibiotic resistance genes they harbor is useful in monitoring the emergence and spread of bacterial antibiotic resistance. In Kenya, studies on gonococcal antimicrobial resistance are few and data on plasmid mediated drug resistance is limited. The present study characterizes plasmid mediated resistance in N. gonorrhoeae isolates recovered from Kenya between 2013 and 2018.

Malaria remains the biggest threat to public health, especially among pregnant women and young children in sub-Saharan Africa. Prompt and accurate diagnosis is critical for effective case management and detection of drug resistance. Conventionally, microscopy and rapid diagnostic tests (RDTs) are the tools of choice for malaria diagnosis. RDTs are simple to use and have been extensively used in the diagnosis of malaria among travelers to malaria-endemic regions, routine case management, and surveillance studies. Most RDTs target the histidine-rich protein (PfHRP) which is exclusively found in Plasmodium falciparum and a metabolic enzyme Plasmodium lactate dehydrogenase (pLDH) which is common among all Plasmodium species. Other RDTs incorporate the enzyme aldolase that is produced by all Plasmodium species. Recently, studies have reported false-negative RDTs primarily due to the deletion of the histidine-rich protein (pfhrp2 and pfhrp3) genes in field isolates of P. falciparum. Herein, we review published literature to establish pfhrp2/pfhrp3 deletions, the extent of these deletions in different geographical regions, and the implication in malaria control. We searched for publications on pfhrp2/pfhrp3 deletions and retrieved all publications that reported on this subject. Overall, 20 publications reported on pfhrp2/pfhrp3 deletions, and most of these studies were done in Central and South America, with very few in Asia and Africa. The few studies in Africa that reported on the occurrence of pfhrp2/pfhrp3 deletions rarely evaluated deletions on the flanking genes. More studies are required to evaluate the existence and extent of these gene deletions, whose presence may lead to delayed or missed treatment. This information will guide appropriate diagnostic approaches in the respective areas.

A quantitative nucleic acid sequence-based amplification (QT-NASBA) assay was employed to predict retrospectively the outcome of sulfadoxine-pyrimethamine (SP) treatment of uncomplicated malaria in children aged <6 years in an endemic region. Blood samples were collected at initial diagnosis and during follow-up. Mutation-specific nested PCR methods to analyse DHFR (Arg-59) and DHPS (Glu-540) mutations that are associated with SP drug resistance were applied. Parasite genotyping was performed to distinguish between re-infection and recrudescence. Eighty-six patients were recruited of which 66 were available for follow-up. Nine children were classified as early treatment failure, 13 cases were classified as late clinical failure, 32 as late parasitological failure, and only 12 children had an adequate clinical and parasitological response. DHFR and DHPS mutations conferring SP resistance were abundant in the Plasmodium population. Blood samples obtained 7 days after treatment were used to predict retrospectively the outcome of SP treatment. QT-NASBA was able to give a correct prediction of treatment outcome in 85.7% of the cases. Positive predictive value (PPV) of QT-NASBA case was 95% (95% confidence interval = 88.3-100) and negative predictive value (NPV) was 63% (95% CI = 39.5-86.5). In contrast, microscopy correctly predicted outcome in only 37.5% of the cases. PPV of microscopy was 100% (95% CI = 73.9-100) and the NPV was 25.5% (95% CI = 13.0-38.0). The analysis of a day 7 blood sample with QT-NASBA allows for the prediction of late clinical or parasitological treatment failure in the majority of the cases analysed in the present study.

We have determined the relationship between point mutations in the gene that encodes the sulfa target, dihydropteroate synthase (DHPS) and the chemosensitivity profile to sulfadoxine and dapsone in 67 isolates from Kilifi, Kenya. We assessed the presence of mutations at codons 436, 437, 540, 581, and 613 of dhps. The results showed that the dhps genotype had a strong influence on the sensitivity to sulfadoxine and dapsone, but that the correlation was far from perfect. Eleven isolates carried a wild-type dhps allele, but were resistant to sulfadoxine (IC(50) values >10 microg/ml), and 4/28 isolates were classed as sensitive to sulfadoxine (IC(50) values <10 microg/ml), but carried a triple mutant (436/437/613) allele of dhps. These data show that in low folate medium in vitro, the dhps genotype alone did not account completely for sulfadoxine or dapsone resistance; other factors such as the utilisation of exogenous folate must also be considered