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Samples of burnt clay from kilns in various parts of the country were tested for their cementatious qualities and found to have high silica contents.Results showed that additing upto 40% of the cly to portland cement produced good binders for mass concre and plaster work,particularly for low cost housing.

PIP: Malaria is the most prevalent and devastating public health problem in Africa despite much research and control effort over the last two decades. In most parts of Africa, individuals should take 200 mg of Proguanil daily together with chloroquine 5 mg/kg per week as prophylaxis. Pregnant women and individuals with underlying disease such as sickle cell making them susceptible to severe or complicated malaria, however, should take just 200 mg Proguanil daily. In hard-core multi-drug resistance areas, mefloquine 250 mg once weekly together with chloroquine 300 mg weekly is recommended as prophylaxis. Since no anti-malarial drug confers absolute protection against infection, however, using mosquito nets impregnated with permethrin, insecticides, and mosquito repellents is also advocated for those at high risk of severe malaria. The need also exists to treat cases of malaria when prevention is unsuccessful. Chloroquine in total dose 25 mg/Kg over three days is the first choice treatment of uncomplicated malaria in 4-aminoquinoline sensitive areas. Amodiaquine 25 mg/Kg over three days is the second line treatment, while pyrimethamine/sulphonamide combinations are useful in areas where there is resistance to 4-aminoquinalines. Finally, quinine 10 mg/kg every eight hours for seven days is the treatment of choice for severe and complicated malaria.

Normal 0 false false false MicrosoftInternetExplorer4 st1:*{behavior:url(#ieooui) } /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman"; mso-ansi-language:#0400; mso-fareast-language:#0400; mso-bidi-language:#0400;} Integrated vector management (IVM) for malaria control requires ecological skills that are very scarce and rarely applied in Africa today. Partnerships between communities and academic ecologists can address this capacity deficit, modernize the evidence base for such approaches and enable future scale up. Community-based IVM programmes were initiated in two contrasting settings. On Rusinga Island, Western Kenya, community outreach to a marginalized rural community was achieved by University of Nairobi through a community-based organization. In Dar es Salaam, Tanzania, Ilala Municipality established an IVM programme at grassroots level, which was subsequently upgraded and expanded into a pilot scale Urban Malaria Control Programme with support from national academic institutes. Both programmes now access relevant expertise, funding and policy makers while the academic partners benefit from direct experience of community-based implementation and operational research opportunities. The communities now access up-to-date malaria-related knowledge and skills for translation into local action. Similarly, the academic partners have acquired better understanding of community needs and how to address them. Until sufficient evidence is provided, community-based IVM remains an operational research activity. Researchers can never directly support every community in Africa so community based IVM strategies and tactics will need to be incorporated into undergraduate teaching programmes to generate sufficient numbers of practitioners for national scale programmes. Academic ecologists at African institutions are uniquely positioned to enable the application of practical environmental and entomological skills for malaria control by communities at grassroots level and should be supported to fulfil this neglected role.

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

A case of an HIV positive man with multiple sexually acquired disease occurring concurrently is described. Risk behaviours that could have predisposed him to HIV infection are discussed. The factors which might have interacted to make the sexually acquired infections severe and difficult to treat are postulated. PIP: The case of an HIV-seropositive man with gonorrhea, syphilis, genital warts, and chancroid is described. Multiple sexual partners, genital ulcer diseases, and lack of circumcision may have predisposed him to HIV infection. As indicated by his CD4/CD8 ratio of 0.5, his immunological status was not very compromised. Other factors were therefore probably behind these multiple sexually transmitted diseases (STD). This 30-year old man was inadequately treated for a long time for urethral discharge and genital ulcer disease, and ultimately collapsed on the job with a comprised central nervous system. Bacterial infection related to the multiple STDs could certainly have caused this collapse. The time demands of this man's work, the lack of medical facilities to diagnose and treat such conditions, his unprotected sexual behavior with multiple partners, and broader socioeconomic conditions which separate wage- earning males from their families in Africa conspire to produce multiply-afflicted cases such as these.

Sixty-four patients atteending the Kenyatta National Hospital psychiatric clinic with minor p.yychiatric disorders were assessed using the Enugu Somatization Scale with a view of eliciting the nature and types of somatic complaints they had. A control group of 66, 5th year medical student, was used. The average scores for the head and body symptoms were 10.9 and 22.1 for the neurotics and 0.9 and 1.5 for the controls respectively. Overall the commonest complaints among the patients were vague, the highest positive scores in order a/frequency being. 'What worries me is not steady." . 3.7%), "parts of my body are out of order" (87.3%), "my whole body is not all right" (87.3%), ':feeling various parts of the body shiver" (85. 7%) and ':feeling dizzy" (84. 1 %). The complaints were not related to age, sex, education, occupation or p,\ychiatric diagno,yis. The average scores for the Kenyan neurotic, were higher than that obtained from the Nigerian (head: 8.14; body: 15.2) and Indian neurotics (head: 8.75: body: 11.78) in previous .ytudies. On the other hand the Kenyan controls had lower scores compared to the other 2 groups. The implication of these findings is discussed.

As kenya progressively gets a strong footing in the exploitation of STI,research opportunity in the  built environment industry is large.The industry will be increasingly called upon to be proactive and innovative in improving service provision through active research in innovation in facility design and construction process,development of construction industry facility and environmentally friendly manufacturing technologies for construction materials and components.This calls for strengthening research capabilities of research institutions and forging a close collaboration with the industry and international community as a jointn effort for the good of national development.

Normal 0 false false false MicrosoftInternetExplorer4 st1:*{behavior:url(#ieooui) } /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman"; mso-ansi-language:#0400; mso-fareast-language:#0400; mso-bidi-language:#0400;} Integrated vector management (IVM) for malaria control requires ecological skills that are very scarce and rarely applied in Africa today. Partnerships between communities and academic ecologists can address this capacity deficit, modernize the evidence base for such approaches and enable future scale up. Community-based IVM programmes were initiated in two contrasting settings. On Rusinga Island, Western Kenya, community outreach to a marginalized rural community was achieved by University of Nairobi through a community-based organization. In Dar es Salaam, Tanzania, Ilala Municipality established an IVM programme at grassroots level, which was subsequently upgraded and expanded into a pilot scale Urban Malaria Control Programme with support from national academic institutes. Both programmes now access relevant expertise, funding and policy makers while the academic partners benefit from direct experience of community-based implementation and operational research opportunities. The communities now access up-to-date malaria-related knowledge and skills for translation into local action. Similarly, the academic partners have acquired better understanding of community needs and how to address them. Until sufficient evidence is provided, community-based IVM remains an operational research activity. Researchers can never directly support every community in Africa so community based IVM strategies and tactics will need to be incorporated into undergraduate teaching programmes to generate sufficient numbers of practitioners for national scale programmes. Academic ecologists at African institutions are uniquely positioned to enable the application of practical environmental and entomological skills for malaria control by communities at grassroots level and should be supported to fulfil this neglected role.

Fourteen patients received oral premedication of temazepam in soft gelatin capsules before minor surgery. The plasma concentrations of temazepam and its sedative, anxiolytic and amnesic effects were measured for 24 hours. Absorption was rapid and peak concentrations occurred 49 minutes after administration. Clinical effects were evident at 30 minutes and persisted for about 4 hours. The decline in plasma concentration was biexponential with a distribution half-life of 1.24 hours. The end of the distribution phase coincided approximately with the termination of its clinical effects. A relationship between plasma concentration and effect was observed; concentrations above 300 ng/ml produced measurable changes in tests of mental function. Patients had recovered fully from the effects of temazepam after 24 hours. This dose of temazepam is reliable and effective as premedication before surgery

The effect of acqueous extract of the tuber of Adenia globosa on the isolated preparation of the rat uterus was determined. The crude drug caused a dose-dependent contraction of the tissue preparation. This action was enhanced by a small dose of oxytocin. The results are discussed in relation to the traditional uses of this plant.

This report concerns an outbreak that occurred during July/August 1997. Ten pigs from a herd of 181 pigs in a medium-scale, semi-closed piggery in Kiambu District, Kenya, contracted the clinical disease. The main clinical findings in affected pigs included: fever (40.5-41.8 degrees C), prostration, inappetence, dog-sitting posture, abortion, erythema and raised, firm to the touch and easily palpated light pink to dark purple diamond-shaped to square/rectangular spots on the skin around the belly and the back. Based on the pathognomonic skin lesions, a clinical diagnosis of swine erysipelas was made. The diagnosis was confirmed by the isolation of Erysipelothrix rhusiopathiae organisms from the blood and skin biopsies taken from the affected pigs. Response to treatment with a combination of procaine penicillin and dihydrostreptomycin at the dosage rate of 20,000 IU/kg body weight (based on procaine penicillin) for 3 days was good and all the affected pigs recovered fully. The farm was placed under quarantine to prevent spread of the disease

Samples of burnt clay from kilns in various parts of the country were tested for their cementatious qualities and found to have high silica contents.Results showed that additing upto 40% of the cly to portland cement produced good binders for mass concre and plaster work,particularly for low cost housing.

Normal 0 false false false MicrosoftInternetExplorer4 st1:*{behavior:url(#ieooui) } /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman"; mso-ansi-language:#0400; mso-fareast-language:#0400; mso-bidi-language:#0400;} Integrated vector management (IVM) for malaria control requires ecological skills that are very scarce and rarely applied in Africa today. Partnerships between communities and academic ecologists can address this capacity deficit, modernize the evidence base for such approaches and enable future scale up. Community-based IVM programmes were initiated in two contrasting settings. On Rusinga Island, Western Kenya, community outreach to a marginalized rural community was achieved by University of Nairobi through a community-based organization. In Dar es Salaam, Tanzania, Ilala Municipality established an IVM programme at grassroots level, which was subsequently upgraded and expanded into a pilot scale Urban Malaria Control Programme with support from national academic institutes. Both programmes now access relevant expertise, funding and policy makers while the academic partners benefit from direct experience of community-based implementation and operational research opportunities. The communities now access up-to-date malaria-related knowledge and skills for translation into local action. Similarly, the academic partners have acquired better understanding of community needs and how to address them. Until sufficient evidence is provided, community-based IVM remains an operational research activity. Researchers can never directly support every community in Africa so community based IVM strategies and tactics will need to be incorporated into undergraduate teaching programmes to generate sufficient numbers of practitioners for national scale programmes. Academic ecologists at African institutions are uniquely positioned to enable the application of practical environmental and entomological skills for malaria control by communities at grassroots level and should be supported to fulfil this neglected role.

.

domain of the putative celB gene from alkalophilic Bacillus

BACKGROUND: Patients with discoloured teeth frequently present to the dentist requesting restorations designed to improve their appearance. For teeth that are sound, this might include the use of a veneer restoration. The veneer acts as a thin layer of a material covering the labial surface of a tooth and can be applied directly to the tooth, or by using indirect methods. OBJECTIVES: To examine the effectiveness of direct versus indirect laminate veneer restorations. SEARCH STRATEGY: The following electronic databases were searched: The Cochrane Oral Health Group's Trials Register, The Cochrane Central Register of Controlled Trials (CENTRAL), (The Cochrane Library Issue 3, 2002), MEDLINE (1980 to 19/11/2002) and EMBASE (1980 to 19/11/2002). There was no restriction on language. SELECTION CRITERIA: All randomised controlled trials (RCTs) of participants with permanent anterior teeth suitable for restorations using laminate veneers, comparing direct (different composite materials) and indirect techniques for making dental veneers. The indirect restorations may be either composite or porcelain. The primary outcome was restoration failure. DATA COLLECTION AND ANALYSIS: Assessment of relevance and validity and data extraction were conducted in triplicate. Authors of the primary studies were contacted to provide additional information as necessary. MAIN RESULTS: Six full publications were screened as being potentially relevant to the review, only one trial was found to meet the review's inclusion criteria. Although the trial met the review's inclusion criteria with regard to participant characteristics, interventions and outcomes assessed, problems with the reporting of the data prevented any statistical analysis of the results. REVIEWER'S CONCLUSIONS: There is no reliable evidence to show a benefit of one type of veneer restoration (direct or indirect) over the other with regard to the longevity of the restoration.

J. M. Khalagai,

This report concerns an outbreak that occurred during July/August 1997. Ten pigs from a herd of 181 pigs in a medium-scale, semi-closed piggery in Kiambu District, Kenya, contracted the clinical disease. The main clinical findings in affected pigs included: fever (40.5-41.8 degrees C), prostration, inappetence, dog-sitting posture, abortion, erythema and raised, firm to the touch and easily palpated light pink to dark purple diamond-shaped to square/rectangular spots on the skin around the belly and the back. Based on the pathognomonic skin lesions, a clinical diagnosis of swine erysipelas was made. The diagnosis was confirmed by the isolation of Erysipelothrix rhusiopathiae organisms from the blood and skin biopsies taken from the affected pigs. Response to treatment with a combination of procaine penicillin and dihydrostreptomycin at the dosage rate of 20,000 IU/kg body weight (based on procaine penicillin) for 3 days was good and all the affected pigs recovered fully. The farm was placed under quarantine to prevent spread of the disease

Samples of burnt clay from kilns in various parts of the country were tested for their cementatious qualities and found to have high silica contents.Results showed that additing upto 40% of the cly to portland cement produced good binders for mass concre and plaster work,particularly for low cost housing.

Normal 0 false false false MicrosoftInternetExplorer4 st1:*{behavior:url(#ieooui) } /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman"; mso-ansi-language:#0400; mso-fareast-language:#0400; mso-bidi-language:#0400;} Integrated vector management (IVM) for malaria control requires ecological skills that are very scarce and rarely applied in Africa today. Partnerships between communities and academic ecologists can address this capacity deficit, modernize the evidence base for such approaches and enable future scale up. Community-based IVM programmes were initiated in two contrasting settings. On Rusinga Island, Western Kenya, community outreach to a marginalized rural community was achieved by University of Nairobi through a community-based organization. In Dar es Salaam, Tanzania, Ilala Municipality established an IVM programme at grassroots level, which was subsequently upgraded and expanded into a pilot scale Urban Malaria Control Programme with support from national academic institutes. Both programmes now access relevant expertise, funding and policy makers while the academic partners benefit from direct experience of community-based implementation and operational research opportunities. The communities now access up-to-date malaria-related knowledge and skills for translation into local action. Similarly, the academic partners have acquired better understanding of community needs and how to address them. Until sufficient evidence is provided, community-based IVM remains an operational research activity. Researchers can never directly support every community in Africa so community based IVM strategies and tactics will need to be incorporated into undergraduate teaching programmes to generate sufficient numbers of practitioners for national scale programmes. Academic ecologists at African institutions are uniquely positioned to enable the application of practical environmental and entomological skills for malaria control by communities at grassroots level and should be supported to fulfil this neglected role.

The microbiological quality of ground water (boreholes) and domestic tanks in five locations of Kikuyu Division, Kiambu District, was determined. Two boreholes and twelve domestic tanks were sampled from each location. Seven (70%) out of 10 boreholes were contaminated with faecal coliforms. Total bacterial counts ranged from 1 to 6280 per ml of water while the coliform counts ranged from 0 to 161. Out of 70 water samples screened for faecal coliforms, 63 (90%) were positive. Faecal Streptococci were isolated in 71% of the samples.

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

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

Samples of burnt clay from kilns in various parts of the country were tested for their cementatious qualities and found to have high silica contents.Results showed that additing upto 40% of the cly to portland cement produced good binders for mass concre and plaster work,particularly for low cost housing.

Normal 0 false false false MicrosoftInternetExplorer4 st1:*{behavior:url(#ieooui) } /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman"; mso-ansi-language:#0400; mso-fareast-language:#0400; mso-bidi-language:#0400;} Integrated vector management (IVM) for malaria control requires ecological skills that are very scarce and rarely applied in Africa today. Partnerships between communities and academic ecologists can address this capacity deficit, modernize the evidence base for such approaches and enable future scale up. Community-based IVM programmes were initiated in two contrasting settings. On Rusinga Island, Western Kenya, community outreach to a marginalized rural community was achieved by University of Nairobi through a community-based organization. In Dar es Salaam, Tanzania, Ilala Municipality established an IVM programme at grassroots level, which was subsequently upgraded and expanded into a pilot scale Urban Malaria Control Programme with support from national academic institutes. Both programmes now access relevant expertise, funding and policy makers while the academic partners benefit from direct experience of community-based implementation and operational research opportunities. The communities now access up-to-date malaria-related knowledge and skills for translation into local action. Similarly, the academic partners have acquired better understanding of community needs and how to address them. Until sufficient evidence is provided, community-based IVM remains an operational research activity. Researchers can never directly support every community in Africa so community based IVM strategies and tactics will need to be incorporated into undergraduate teaching programmes to generate sufficient numbers of practitioners for national scale programmes. Academic ecologists at African institutions are uniquely positioned to enable the application of practical environmental and entomological skills for malaria control by communities at grassroots level and should be supported to fulfil this neglected role.

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

test

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Samples of burnt clay from kilns in various parts of the country were tested for their cementatious qualities and found to have high silica contents.Results showed that additing upto 40% of the cly to portland cement produced good binders for mass concre and plaster work,particularly for low cost housing.

Normal 0 false false false MicrosoftInternetExplorer4 st1:*{behavior:url(#ieooui) } /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman"; mso-ansi-language:#0400; mso-fareast-language:#0400; mso-bidi-language:#0400;} Integrated vector management (IVM) for malaria control requires ecological skills that are very scarce and rarely applied in Africa today. Partnerships between communities and academic ecologists can address this capacity deficit, modernize the evidence base for such approaches and enable future scale up. Community-based IVM programmes were initiated in two contrasting settings. On Rusinga Island, Western Kenya, community outreach to a marginalized rural community was achieved by University of Nairobi through a community-based organization. In Dar es Salaam, Tanzania, Ilala Municipality established an IVM programme at grassroots level, which was subsequently upgraded and expanded into a pilot scale Urban Malaria Control Programme with support from national academic institutes. Both programmes now access relevant expertise, funding and policy makers while the academic partners benefit from direct experience of community-based implementation and operational research opportunities. The communities now access up-to-date malaria-related knowledge and skills for translation into local action. Similarly, the academic partners have acquired better understanding of community needs and how to address them. Until sufficient evidence is provided, community-based IVM remains an operational research activity. Researchers can never directly support every community in Africa so community based IVM strategies and tactics will need to be incorporated into undergraduate teaching programmes to generate sufficient numbers of practitioners for national scale programmes. Academic ecologists at African institutions are uniquely positioned to enable the application of practical environmental and entomological skills for malaria control by communities at grassroots level and should be supported to fulfil this neglected role.

A double antibody enzyme linked immunosorbent assay for identification of thermostable muscle antigens of autoclaved meat samples is described. The assay differentiates heterologous thermostable muscle antigens from homologous at P 0.001. In model meat mixtures, the assay detects adulterants at the level of 1% at p0.001 even in phylogenetically related species such as buffalo and cattle.

Antibody responses to a conventional rabies preexposure regimen of a new purified Vero cell rabies vaccine (PVRV) and a human diploid cell vaccine (HDCV) were compared in 80 healthy Kenyan veterinary students. Forty-three of the students received the PVRV and 37 received the HDCV on days 0, 7, and 28. Antibody responses were monitored using the rapid fluorescent-focus inhibition test (RFFIT) and an inhibition enzyme immunoassay (INH EIA) on days 0, 7, 28, and 49. Both vaccines elicited a rapid antibody response. A good correlation between the RFFIT titers and the INH EIA titers was obtained (r = 0.90). Our results also showed that the INH EIA was more reproducible and might therefore be a suitable substitute for the more expensive and less reproducible RFFIT. The geometric mean titers determined by both tests in the two groups of students were statistically similar during the test period. The RFFIT and the INH EIA gave comparable geometric mean titers, which differed significantly only on day 28 in the PVRV group. The effect of the new PVRV is comparable to that of the more expensive HDCV, as determined by the present test systems. The PVRV could therefore be the vaccine of choice, especially in tropical rabies-endemic areas, where the high cost of the HDCV has confined its use to a privileged few.

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

Department of Cariology Endodontology Pedodontology, Academic Centre for Dentistry Amsterdam (ACTA), Louwesweg 1, 1066 EA Amsterdam, The Netherlands. The use of Chewing sticks (Miswaki) in the third world for control of dental plaque is very popular. Some of the studies that have been conducted on this subject have reported marked decrease in the incidences of dental caries and periodontal diseases in the users of Miswaki, when compared to the users of the conventional toothbrush living under similar conditions. Various mechanisms by which the Miswaki contributes to this phenomenon have been suggested. The purpose of the present study was to investigate in vitro, the anti-microbial action, the potential acid buffer capacity and fluoride content of crude aqueous extracts of eight commonly used chewing sticks from three regions in Kenya. The results obtained in the study, showed that one of the Miswaki had remarkable antibiotic activity against three stains of oral bacteria. Three of the Miswaki had significant acid buffer capacity. None of the eight Miswaki showed any significant fluoride release.

Air transportation plays an important role in the social and economic development of the global system and the countries that seek to participate in it. As Africa seeks to takes its place in the global economy, it is increasingly looking to aviation as the primary means of connecting its people and goods with the world. It has been suggested that Africa as a continent needs to move toward a system of hubs to optimize its scarce resources. Jomo Kenyatta International Airport in Nairobi, Kenya is one of the airports in the Eastern region of Africa that is seeking to fill this role. This paper discusses the prospects for success and the challenges that it will need to overcome, including projections through 2020 for the growth in passenger and cargo traffic. Key Words: African aviation, hub-and-spoke, traffic forecasts

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Samples of burnt clay from kilns in various parts of the country were tested for their cementatious qualities and found to have high silica contents.Results showed that additing upto 40% of the cly to portland cement produced good binders for mass concre and plaster work,particularly for low cost housing.

A 33-year old female patient presented with recurrent polyneuropathy during two consecutive pregnancies and recovered completely after spontaneous abortion the first time and after a normal delivery the second time. The patient has had a tubal ligation since then and has remained well up to date.

Normal 0 false false false MicrosoftInternetExplorer4 st1:*{behavior:url(#ieooui) } /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman"; mso-ansi-language:#0400; mso-fareast-language:#0400; mso-bidi-language:#0400;} Integrated vector management (IVM) for malaria control requires ecological skills that are very scarce and rarely applied in Africa today. Partnerships between communities and academic ecologists can address this capacity deficit, modernize the evidence base for such approaches and enable future scale up. Community-based IVM programmes were initiated in two contrasting settings. On Rusinga Island, Western Kenya, community outreach to a marginalized rural community was achieved by University of Nairobi through a community-based organization. In Dar es Salaam, Tanzania, Ilala Municipality established an IVM programme at grassroots level, which was subsequently upgraded and expanded into a pilot scale Urban Malaria Control Programme with support from national academic institutes. Both programmes now access relevant expertise, funding and policy makers while the academic partners benefit from direct experience of community-based implementation and operational research opportunities. The communities now access up-to-date malaria-related knowledge and skills for translation into local action. Similarly, the academic partners have acquired better understanding of community needs and how to address them. Until sufficient evidence is provided, community-based IVM remains an operational research activity. Researchers can never directly support every community in Africa so community based IVM strategies and tactics will need to be incorporated into undergraduate teaching programmes to generate sufficient numbers of practitioners for national scale programmes. Academic ecologists at African institutions are uniquely positioned to enable the application of practical environmental and entomological skills for malaria control by communities at grassroots level and should be supported to fulfil this neglected role.

This study was conducted to evaluate the control of trypanosomosis in camels in Turkana district of Kenya using participatory approaches. Lapur division of the district was conveniently selected as the study area considering logistics and security concerns. Four main animal camps (adakars) formed the study units. Key informants from each adakar were selected for participatory research processes. Participatory mapping, semi-structured interviews, pair-wise comparisons and matrix scoring were the participatory methods employed. Five camel diseases in order of their importance, were identified, namely, camel trypanososmosis, tick infestation, non-specific diarrhoea, mange and harmorrhagic septicaemia. Twelve groups of the lay key informants agreed well on the presenting signs of theses diseases. Although trypanocides were considered by the informants to be reasonably available, the most preferred method for the control of camel trypanosomosis was the use of indigenous remedies. These indigenous remedies included the oral administration to sick camels with variety of herbs mixed with soups from goat, wildcat, bird or donkey meat. The results from this study revealed that camel trypanosomosis is an important disease in Turkana district. The prices of the available modern trypanocides in the management of camel trypanosomosis appeared to hamper the effective control of the disease. However, the efficacy of the widely used indigenous remedies remains undetermined.

Forty-two pigs in a herd of 117 displayed various clinical signs of progressive atrophic rhinitis. The main signs included sneezing, coughing, lachrymation, serous to mucopurulent nasal discharge, and nasal bleeding in 1 pig. Three pigs had lateral deviation of the snout, while 4 had brachygnathia superior with obvious deformation of the face. Four acutely affected weaner pigs appeared weak, while the 7 chronically-affected pigs appeared smaller than their apparently unaffected penmates of the same age. Treatment of the acutely affected pigs with long-acting oxytetracycline at 20 mg/kg body weight intramuscularly, repeated once after 7 days, reduced the severity but did not clear the sneezing from all the pigs. Fifteen pigs were slaughtered 2 months after the clinical diagnosis was made. The carcasses of the chronically affected pigs were about 15% lighter than those of the apparently normal pigs of the same age and from the same pen, which translated to a loss of 921.00 Kenya shillings per pig (US$13.7). Diagnosis of progressive atrophic rhinitis was confirmed by sectioning the snouts of randomly selected slaughtered pigs with obvious deformation of the snout. Sections were made at the level of the 1st/2nd upper premolar tooth. Varying degrees of turbinate atrophy, from mild to complete, were noted. Histopathology of the turbinates revealed metaplasia of nasal epithelium and fibrosis in the lamina propria.

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

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

{ University of Nairobi, Kenya. OBJECTIVES: To profile and quantify the psychometric properties of the NOK (Ndetei-Othieno-Kathuku) scale against internationally used Gold-standards and benchmarks for mild psychiatric disorders and post-traumatic stress disorders and to provide a potential easy to administer culture sensitive instrument for screening and assessing those with possible psychiatric disorders for the Kenyan and similar social-cultural situations. DESIGN: Cross-Sectional quantitative study. SETTING: A psychiatric clinical consultation setting and Kyanguli Secondary School psychotrauma counselling clinical set-up. SUBJECTS: Survivors of the Nairobi USA Embassy bombing who were referred for psychiatric treatment and survivors of a fire disaster from a rural Kenyan school (Kyanguli School fire disaster) including students, parents of the diseased children and staff members. RESULTS: Positive correlation was found between the NOK and all the instruments. The highest correlations were between the NOK and the BDI and SCL-90 (r = 0.557 to 0.786). The differences between the NOK scores among the different groups were statistically significant (F ratio = 13.54 to 160.34, p < 0.01). The reliability coefficient (internal consistency) of the scale

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Samples of burnt clay from kilns in various parts of the country were tested for their cementatious qualities and found to have high silica contents.Results showed that additing upto 40% of the cly to portland cement produced good binders for mass concre and plaster work,particularly for low cost housing.

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

Normal 0 false false false MicrosoftInternetExplorer4 st1:*{behavior:url(#ieooui) } /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman"; mso-ansi-language:#0400; mso-fareast-language:#0400; mso-bidi-language:#0400;} Integrated vector management (IVM) for malaria control requires ecological skills that are very scarce and rarely applied in Africa today. Partnerships between communities and academic ecologists can address this capacity deficit, modernize the evidence base for such approaches and enable future scale up. Community-based IVM programmes were initiated in two contrasting settings. On Rusinga Island, Western Kenya, community outreach to a marginalized rural community was achieved by University of Nairobi through a community-based organization. In Dar es Salaam, Tanzania, Ilala Municipality established an IVM programme at grassroots level, which was subsequently upgraded and expanded into a pilot scale Urban Malaria Control Programme with support from national academic institutes. Both programmes now access relevant expertise, funding and policy makers while the academic partners benefit from direct experience of community-based implementation and operational research opportunities. The communities now access up-to-date malaria-related knowledge and skills for translation into local action. Similarly, the academic partners have acquired better understanding of community needs and how to address them. Until sufficient evidence is provided, community-based IVM remains an operational research activity. Researchers can never directly support every community in Africa so community based IVM strategies and tactics will need to be incorporated into undergraduate teaching programmes to generate sufficient numbers of practitioners for national scale programmes. Academic ecologists at African institutions are uniquely positioned to enable the application of practical environmental and entomological skills for malaria control by communities at grassroots level and should be supported to fulfil this neglected role.

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

Blackwater fever was an important cause of morbidity and mortality in the beginning of this century particularly in West and Central Africa. There has been a marked reduction in the incidence of blackwater fever since 1950 and only sporadic cases occur nowadays. At the Kenyatta National Hospital, three cases of blackwater fever have been seen in the past four years whereas not a single case had been reported between 1975 and 1988. Two of the patients fit into the classical description of blackwater fever and one was possibly due to drug induced haemolysis in a G6PD deficiency patient.

BACKGROUND: Malaria control in Africa relies primarily on early effective treatment for clinical disease, but most early treatments for fever occur through self-medication with shop-bought drugs. Lack of information to community members on over-the-counter drug use has led to widespread ineffective treatment of fevers, increased risks of drug toxicity and accelerating drug resistance. We examined the feasibility and measured the likely impact of training shop keepers in rural Africa on community drug use. METHODS: In a rural area of coastal Kenya, we implemented a shop keeper training programme in 23 shops serving a population of approximately 3500, based on formative research within the community. We evaluated the training by measuring changes in the proportions of drug sales where an adequate amount of chloroquine was purchased and in the percentage of home-treated childhood fevers given an adequate amount of chloroquine. The programme was assessed qualitatively in the community following the shop keeper training. RESULTS: The percentage of drug sales for children with fever which included an antimalarial drug rose from 34.3% (95% CI 28.9%-40.1%) before the training to a minimum of 79.3% (95% CI 71.8%-85.3%) after the training. The percentage of antimalarial drug sales where an adequate amount of drug was purchased rose from 31.8% (95% CI 26.6%-37.6%) to a minimum of 82.9% (95% CI 76.3%-87.3%). The percentage of childhood fevers where an adequate dose of chloroquine was given to the child rose from 3.7% (95% CI 1.2%-9.7%) before the training to a minimum of 65.2% (95% CI 57.7%-72.0%) afterwards, which represents an increase in the appropriate use of over-the-counter chloroquine by at least 62% (95% CI 53.7%-69.3%). Shop keepers and community members were strongly supportive of the aims and outcome of the programme. CONCLUSIONS: The large shifts in behaviour observed indicate that the approach of training shop keepers as a channel for information to the community is both feasible and likely to have a significant impact. Whilst some of the impact seen may be attributable to research effects in a relatively small scale pilot study, the magnitude of the changes support further investigation into this approach as a potentially important new strategy in malaria control.

Normal 0 false false false MicrosoftInternetExplorer4 st1:*{behavior:url(#ieooui) } /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman"; mso-ansi-language:#0400; mso-fareast-language:#0400; mso-bidi-language:#0400;} Integrated vector management (IVM) for malaria control requires ecological skills that are very scarce and rarely applied in Africa today. Partnerships between communities and academic ecologists can address this capacity deficit, modernize the evidence base for such approaches and enable future scale up. Community-based IVM programmes were initiated in two contrasting settings. On Rusinga Island, Western Kenya, community outreach to a marginalized rural community was achieved by University of Nairobi through a community-based organization. In Dar es Salaam, Tanzania, Ilala Municipality established an IVM programme at grassroots level, which was subsequently upgraded and expanded into a pilot scale Urban Malaria Control Programme with support from national academic institutes. Both programmes now access relevant expertise, funding and policy makers while the academic partners benefit from direct experience of community-based implementation and operational research opportunities. The communities now access up-to-date malaria-related knowledge and skills for translation into local action. Similarly, the academic partners have acquired better understanding of community needs and how to address them. Until sufficient evidence is provided, community-based IVM remains an operational research activity. Researchers can never directly support every community in Africa so community based IVM strategies and tactics will need to be incorporated into undergraduate teaching programmes to generate sufficient numbers of practitioners for national scale programmes. Academic ecologists at African institutions are uniquely positioned to enable the application of practical environmental and entomological skills for malaria control by communities at grassroots level and should be supported to fulfil this neglected role.

Fourteen patients received oral premedication of temazepam in soft gelatin capsules before minor surgery. The plasma concentrations of temazepam and its sedative, anxiolytic and amnesic effects were measured for 24 hours. Absorption was rapid and peak concentrations occurred 49 minutes after administration. Clinical effects were evident at 30 minutes and persisted for about 4 hours. The decline in plasma concentration was biexponential with a distribution half-life of 1.24 hours. The end of the distribution phase coincided approximately with the termination of its clinical effects. A relationship between plasma concentration and effect was observed; concentrations above 300 ng/ml produced measurable changes in tests of mental function. Patients had recovered fully from the effects of temazepam after 24 hours. This dose of temazepam is reliable and effective as premedication before surgery

A patient with a primary splenic pregnancy is described

Forty-two pigs in a herd of 117 displayed various clinical signs of progressive atrophic rhinitis. The main signs included sneezing, coughing, lachrymation, serous to mucopurulent nasal discharge, and nasal bleeding in 1 pig. Three pigs had lateral deviation of the snout, while 4 had brachygnathia superior with obvious deformation of the face. Four acutely affected weaner pigs appeared weak, while the 7 chronically-affected pigs appeared smaller than their apparently unaffected penmates of the same age. Treatment of the acutely affected pigs with long-acting oxytetracycline at 20 mg/kg body weight intramuscularly, repeated once after 7 days, reduced the severity but did not clear the sneezing from all the pigs. Fifteen pigs were slaughtered 2 months after the clinical diagnosis was made. The carcasses of the chronically affected pigs were about 15% lighter than those of the apparently normal pigs of the same age and from the same pen, which translated to a loss of 921.00 Kenya shillings per pig (US$13.7). Diagnosis of progressive atrophic rhinitis was confirmed by sectioning the snouts of randomly selected slaughtered pigs with obvious deformation of the snout. Sections were made at the level of the 1st/2nd upper premolar tooth. Varying degrees of turbinate atrophy, from mild to complete, were noted. Histopathology of the turbinates revealed metaplasia of nasal epithelium and fibrosis in the lamina propria

Samples of burnt clay from kilns in various parts of the country were tested for their cementatious qualities and found to have high silica contents.Results showed that additing upto 40% of the cly to portland cement produced good binders for mass concre and plaster work,particularly for low cost housing.

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Five plasters and one fiberglass casting bandages available on the Kenyan market were evaluated for breaking strength and resistance to abrasion. Under the test conditions, scotch cast was found to be 2.6 times stronger than the strongest plaster of Paris preparation when the load per unit thickness was compared and was significantly different from the plaster casts in terms of maximum load (p=0.0001). Among the plaster products, there were significant statistical differences (p=0.029) in maximum strength with Helm and Plasrum-gyps withstanding the greatest load. Scotchcast was the most resistant to abrasion while among the plaster product, Salvaplast and POP-Nairobi Enterprises showed satisfactory resistance Heal, Plasrun-gyps and Veronese proved least resistant under the testing conditions.

OBJECTIVES: Marginal integrity is a major clinical problem in restorative dentistry. The aim of this study was to evaluate the applicability of an edge strength measurement device in an in vitro test to determine the force required to fracture flakes of material by a Vickers indentation at progressively increasing distances from an interface edge of bulk material. METHODS: Five representative resin-composites were investigated. Fourteen disks of specimens (12mm diameter x 2.5mm thick) were prepared for each material. These were divided into seven sub-groups corresponding to different edge-distances (0.4, 0.5, 0.6, 0.7, 0.8, 0.9 and 1.0mm). An edge strength measurement device (CK10) (Engineering Systems, Nottingham, UK) was used. The mode of the failure of each specimen was examined under the integral microscope of the CK10. RESULTS: The force (N)-to-fracture at a distance of 0.5mm from the edge was defined as the edge strength. The highest failure force (edge strength) was observed for Tetric Ceram (174.2N) and the lowest for Filtek Supreme (enamel) (87.0N). Correlations between the failure-forces to fracture materials with edge-distance were regression analyzed giving coefficients (r) ranging from 0.94 (p=0.02) to 0.99 (p=0.01). Two modes of failure were observed: chipping and–generally at greater distances–cracking. SIGNIFICANCE: Edge strength is a definable and potentially useful parameter to characterize this aspect of clinically related behavior. A standardized distance of 0.5mm from the specimen's edge, when chipping failure prevails, is suitable and convenient as a reference point.

J. M. Khalagai,

This report concerns an outbreak that occurred during July/August 1997. Ten pigs from a herd of 181 pigs in a medium-scale, semi-closed piggery in Kiambu District, Kenya, contracted the clinical disease. The main clinical findings in affected pigs included: fever (40.5-41.8 degrees C), prostration, inappetence, dog-sitting posture, abortion, erythema and raised, firm to the touch and easily palpated light pink to dark purple diamond-shaped to square/rectangular spots on the skin around the belly and the back. Based on the pathognomonic skin lesions, a clinical diagnosis of swine erysipelas was made. The diagnosis was confirmed by the isolation of Erysipelothrix rhusiopathiae organisms from the blood and skin biopsies taken from the affected pigs. Response to treatment with a combination of procaine penicillin and dihydrostreptomycin at the dosage rate of 20,000 IU/kg body weight (based on procaine penicillin) for 3 days was good and all the affected pigs recovered fully. The farm was placed under quarantine to prevent spread of the disease

Samples of burnt clay from kilns in various parts of the country were tested for their cementatious qualities and found to have high silica contents.Results showed that additing upto 40% of the cly to portland cement produced good binders for mass concre and plaster work,particularly for low cost housing.

Normal 0 false false false MicrosoftInternetExplorer4 st1:*{behavior:url(#ieooui) } /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman"; mso-ansi-language:#0400; mso-fareast-language:#0400; mso-bidi-language:#0400;} Integrated vector management (IVM) for malaria control requires ecological skills that are very scarce and rarely applied in Africa today. Partnerships between communities and academic ecologists can address this capacity deficit, modernize the evidence base for such approaches and enable future scale up. Community-based IVM programmes were initiated in two contrasting settings. On Rusinga Island, Western Kenya, community outreach to a marginalized rural community was achieved by University of Nairobi through a community-based organization. In Dar es Salaam, Tanzania, Ilala Municipality established an IVM programme at grassroots level, which was subsequently upgraded and expanded into a pilot scale Urban Malaria Control Programme with support from national academic institutes. Both programmes now access relevant expertise, funding and policy makers while the academic partners benefit from direct experience of community-based implementation and operational research opportunities. The communities now access up-to-date malaria-related knowledge and skills for translation into local action. Similarly, the academic partners have acquired better understanding of community needs and how to address them. Until sufficient evidence is provided, community-based IVM remains an operational research activity. Researchers can never directly support every community in Africa so community based IVM strategies and tactics will need to be incorporated into undergraduate teaching programmes to generate sufficient numbers of practitioners for national scale programmes. Academic ecologists at African institutions are uniquely positioned to enable the application of practical environmental and entomological skills for malaria control by communities at grassroots level and should be supported to fulfil this neglected role.

This paper presents the results of a study conducted in a pastoral community in Kenya using participatory appraisal approaches. The objective of the study was to assess the socio-economic impact of camel trypanosomosis (surra) according to the perceptions of the pastoralists. Four livestock grazing units were conveniently selected and in each of them, three groups of key informants comprising five to eight persons were selected for the  participatory exercises. Five camel diseases were listed in order of importance according to their severity and frequency of occurrence including trypanosomosis, mange, non-specific diarrhoea, tick infestations and haemorrhagic septicaemia. The losses listed as incurred due to the five diseases were: losses in milk, meat, blood, fats and hides, dowry payments, and depreciation in sale of animals, losses due to infertility and abortions and losses due to the cost of treatment. There was good agreement (p<0.05) between the informant groups on the losses incurred as a result of the diseases for all the selected loss indicators. Surra and mange were given high median scores on all the indicators while non-specific diarrhoea, tick infestations, and haemorrhagic septicaemia received moderate median scores. Based on the study findings it is concluded that the camel plays a central role in the lives of Turkana pastoralists and that surra has a devastating social and economic impact. There is a need for veterinary and policy decision-makers to focus more attention on the control of surra in this arid and semi-arid area of Kenya.   Keywords:      Camel trypanosomosis, participatory approach, surra, Turkana pastoralists

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

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Western Kenya, which comprise the highlands west of the Rift Valley and the Lake Victoria basin, receive substantial amount of rainfall almost throughout the year. This region has therefore a high agricultural potential. The characteristics of rainfall in this part of the country are influenced by several factors, which range from meso-scale to global. One of the global teleconnection systems that influence the rainfall over this region is the Southern Oscillation (SO). The SO is an irregular, interannual and global scale see saw fluctuation in surface pressure between Indonesia and Southwest Pacific, and occurs at interval of 2 to 7 years. Both the rainfall and Southern Oscillation Index (SOI) data were obtained from the Drought Monitoring Centre (DMC) in Kenya. The Data consisted of monthly rainfall from 24 stations distributed over the region and the monthly-normalized SOI. The period of study was between 1957 to 1993. The seasonal data was derived from the data. The monthly and seasonal rainfall and SOI were subjected to correlation analysis. The t-test was used to determine the statistical significance of the computed correlation values. The spatial and temporal patterns of the correlation values were used to determine the nature of the relationship between the SO and rainfall over western Kenya during various months and seasons. Significant positive correlation values were observed during the months of July- September, while significant negative correlation values were observed during October-December. Low correlation values were however observed during January- May. The significant correlation values observed during July-September and October-December suggest that the SOI can be used as a predictor for the rainfall during these seasons

Samples of burnt clay from kilns in various parts of the country were tested for their cementatious qualities and found to have high silica contents.Results showed that additing upto 40% of the cly to portland cement produced good binders for mass concre and plaster work,particularly for low cost housing.

Normal 0 false false false MicrosoftInternetExplorer4 st1:*{behavior:url(#ieooui) } /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman"; mso-ansi-language:#0400; mso-fareast-language:#0400; mso-bidi-language:#0400;} Integrated vector management (IVM) for malaria control requires ecological skills that are very scarce and rarely applied in Africa today. Partnerships between communities and academic ecologists can address this capacity deficit, modernize the evidence base for such approaches and enable future scale up. Community-based IVM programmes were initiated in two contrasting settings. On Rusinga Island, Western Kenya, community outreach to a marginalized rural community was achieved by University of Nairobi through a community-based organization. In Dar es Salaam, Tanzania, Ilala Municipality established an IVM programme at grassroots level, which was subsequently upgraded and expanded into a pilot scale Urban Malaria Control Programme with support from national academic institutes. Both programmes now access relevant expertise, funding and policy makers while the academic partners benefit from direct experience of community-based implementation and operational research opportunities. The communities now access up-to-date malaria-related knowledge and skills for translation into local action. Similarly, the academic partners have acquired better understanding of community needs and how to address them. Until sufficient evidence is provided, community-based IVM remains an operational research activity. Researchers can never directly support every community in Africa so community based IVM strategies and tactics will need to be incorporated into undergraduate teaching programmes to generate sufficient numbers of practitioners for national scale programmes. Academic ecologists at African institutions are uniquely positioned to enable the application of practical environmental and entomological skills for malaria control by communities at grassroots level and should be supported to fulfil this neglected role.

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

test

n/a

Samples of burnt clay from kilns in various parts of the country were tested for their cementatious qualities and found to have high silica contents.Results showed that additing upto 40% of the cly to portland cement produced good binders for mass concre and plaster work,particularly for low cost housing.

Normal 0 false false false MicrosoftInternetExplorer4 st1:*{behavior:url(#ieooui) } /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman"; mso-ansi-language:#0400; mso-fareast-language:#0400; mso-bidi-language:#0400;} Integrated vector management (IVM) for malaria control requires ecological skills that are very scarce and rarely applied in Africa today. Partnerships between communities and academic ecologists can address this capacity deficit, modernize the evidence base for such approaches and enable future scale up. Community-based IVM programmes were initiated in two contrasting settings. On Rusinga Island, Western Kenya, community outreach to a marginalized rural community was achieved by University of Nairobi through a community-based organization. In Dar es Salaam, Tanzania, Ilala Municipality established an IVM programme at grassroots level, which was subsequently upgraded and expanded into a pilot scale Urban Malaria Control Programme with support from national academic institutes. Both programmes now access relevant expertise, funding and policy makers while the academic partners benefit from direct experience of community-based implementation and operational research opportunities. The communities now access up-to-date malaria-related knowledge and skills for translation into local action. Similarly, the academic partners have acquired better understanding of community needs and how to address them. Until sufficient evidence is provided, community-based IVM remains an operational research activity. Researchers can never directly support every community in Africa so community based IVM strategies and tactics will need to be incorporated into undergraduate teaching programmes to generate sufficient numbers of practitioners for national scale programmes. Academic ecologists at African institutions are uniquely positioned to enable the application of practical environmental and entomological skills for malaria control by communities at grassroots level and should be supported to fulfil this neglected role.

A double antibody enzyme linked immunosorbent assay for identification of thermostable muscle antigens of autoclaved meat samples is described. The assay differentiates heterologous thermostable muscle antigens from homologous at P 0.001. In model meat mixtures, the assay detects adulterants at the level of 1% at p0.001 even in phylogenetically related species such as buffalo and cattle.

The rabies problem in Kenya has been greatest in Machakos District where the disease has persisted endemically for over 40 years. this paper presents the results of a one-year community-based active surveillance for rabies in six randomly selected sublocations in the district for the period 1992 - 1993. Approximately 860 rabid dogs per 100 000 dogs were confirmed in this study, compared to approximately 12 per 100 000 confirmed rabid dogs reported by the existing passive-surveillance system. This active surveillance underestimated the true rabies incidence, because only 41% (130/317) of the potential specimens could be diagnosed. Dogs accounted for 92% (179/194) of primary animal-rabies suspects, 80% (66/83) of secondary suspects, 81% of the confirmed rabies cases. The annual incidence of animal-bites of humans was 234 per 100 000 people and the point estimate human-rabies incidence per year was 25 per million people. Almost all (97%) animal-bites of humans were due to dogs.   The traditional passive-surveillance system grossly underestimated the importance of rabies as a public-health problem in Machakos District. Community-based active surveillance provides a potential cost-effective strategy for greatly improving estimates of rabies incidence and epidemiology to inform veterinary and policy decision-making.

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

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Samples of burnt clay from kilns in various parts of the country were tested for their cementatious qualities and found to have high silica contents.Results showed that additing upto 40% of the cly to portland cement produced good binders for mass concre and plaster work,particularly for low cost housing.

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

Normal 0 false false false MicrosoftInternetExplorer4 st1:*{behavior:url(#ieooui) } /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman"; mso-ansi-language:#0400; mso-fareast-language:#0400; mso-bidi-language:#0400;} Integrated vector management (IVM) for malaria control requires ecological skills that are very scarce and rarely applied in Africa today. Partnerships between communities and academic ecologists can address this capacity deficit, modernize the evidence base for such approaches and enable future scale up. Community-based IVM programmes were initiated in two contrasting settings. On Rusinga Island, Western Kenya, community outreach to a marginalized rural community was achieved by University of Nairobi through a community-based organization. In Dar es Salaam, Tanzania, Ilala Municipality established an IVM programme at grassroots level, which was subsequently upgraded and expanded into a pilot scale Urban Malaria Control Programme with support from national academic institutes. Both programmes now access relevant expertise, funding and policy makers while the academic partners benefit from direct experience of community-based implementation and operational research opportunities. The communities now access up-to-date malaria-related knowledge and skills for translation into local action. Similarly, the academic partners have acquired better understanding of community needs and how to address them. Until sufficient evidence is provided, community-based IVM remains an operational research activity. Researchers can never directly support every community in Africa so community based IVM strategies and tactics will need to be incorporated into undergraduate teaching programmes to generate sufficient numbers of practitioners for national scale programmes. Academic ecologists at African institutions are uniquely positioned to enable the application of practical environmental and entomological skills for malaria control by communities at grassroots level and should be supported to fulfil this neglected role.

A study was done to determine the prevalence of hydatid cysts in goats using ultrasonography. A total of 1,390 goats were examined, 43,6 % (606/1,390) of them from north-western Turkana, Kenya, and 56,4% (784/1,390) from Toposaland, southern Sudan. Hydatid cysts were visualized in 1,82 % (11/ 606) of the goats from north-western Turkana and 4,34% (34/784) of those from Toposaland. Unlike abattoir surveys, the prevalence data obtained in this study were unbiased because entire flocks were examined. The lower prevalence rate of the disease in goats from Turkana was attributed to the hydatid disease control programme in that area, which is absent in Toposaland.

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

OBJECTIVE: To record the costs of hospital care for HIV-positive and -negative patients in Nairobi, and identify costs paid by patients per admission. DESIGN: Cost data were collected on inpatients enrolled in a linked clinical study using standardized costing methods. SETTING: Kenyatta National Hospital, Nairobi's main district hospital. PATIENTS: Consecutive adult medical admissions to one ward over 14 weeks who consented to enrollment; tertiary referrals were excluded. MAIN OUTCOME MEASURE: Average length of stay and cost per patient admission. RESULTS: The hospital costs of 398 patients (163 HIV positive; 33 with clinical AIDS) were analysed. The mean length of stay was 9.3 days and the mean cost per patient admission was US$163. There was no significant difference in costs or mean lengths of stay between HIV-positive and -negative groups, nor were the costs and lengths of stay for clinical AIDS patients significantly different to those for HIV-positive patients without AIDS. The patient charges paid to the hospital per admission, recorded for 344 patients, were on average US$61; and did not differ by HIV status. CONCLUSION: The similar cost patterns for inpatient care irrespective of HIV status or clinical AIDS probably reflects the limited provision of care beyond basic clinical services. Length of stay rather than differing treatment regimes thus appears to be the main cost driver. Private costs of medical care were high and were likely to pressurize households. When resources are limited, the introduction of new, more costly therapies needs careful planning. The study provides cost information for planning care services in resource-poor settings.

A random sample survey using personal interviews was conducted in Machakos and Makueni Districts of Kenya in 1992 to estimate the level of rabies vaccination of the dog population. To substantiate the results of the interviews, a sample of the surveyed dogs 3 months old and above were bled for serum rabies antibody determination using an inhibition enzyme immunoassay (INH EIA). Of the 266 surveyed 3 months old and above, only 29% (77/266) were reportedly vaccinated against rabies. Out of the 197 dog sera titrated for rabies antibody, only 29% (57/197) had detectable antibodies and only 16% (32/197) had antibody tires equal to or greater than the threshold considered protective of 0.5 I.U/ml. There was a strong positive association between a history of previous vaccination and the detection of rabies antibodies. Of 133 dogs with no history of previous vaccination, 20% (26/133) had detectable antibodies. With the rabies incidence in Machakos and Makueni Districts still unacceptably high, the level of vaccination estimated in this survey is clearly inadequate for rabies control and measures designed to increase it are discussed.

Background: The prevalence and frequency of bullying in Nairobi public secondary schools in particular and in Kenyan schools in general is not known. Knowledge of the extent of the problem is essential in developing effective interventions. Aim: To study the prevalence and frequency of bullying in Nairobi public secondary schools, Kenya. Methods: A self-report sociodemographic questionnaire and the Olweus Bullying Questionnaire of 1991 were administered to 1 012 students from a stratified sample of public secondary schools in Nairobi. Results: Between 63.2% (640) and 81.8% (828) of students reported various types of bullying, both direct and indirect, with significant variations found for sex, age, class and year of study, whether in day or boarding school, and the place where bullied. Being bullied was significantly associated with becoming a bully, in turn. Discussion: Bullying is highly prevalent in Kenyan schools. Further studies are needed to characterise bullies and victims in terms of personality and environmental factors that may be associated with or conducive to bullying, as well as to determine the long-term prognosis for both bullies and victims. Further research is also required to determine the most appropriate intervention.

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Samples of burnt clay from kilns in various parts of the country were tested for their cementatious qualities and found to have high silica contents.Results showed that additing upto 40% of the cly to portland cement produced good binders for mass concre and plaster work,particularly for low cost housing.

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

The pathology of calves that died from experimental water intoxication was investigated. Oedema of the brain and urinary bladder, and renal damage were significant pathological findings in these calves. The findings were attributed to positive water balance in calves suffering from water intoxication

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

Between June and December 1992 forty AIDS patients as defined by the CDC criteria, admitted to the medical wards of the Kenyatta National Hospital, were studied to determine the prevalence and pattern of peripheral neuropathy. Their mean age was 33 +/- 3 years with a range of 16 to 55 years. Clinical and laboratory assessment were carried out both to confirm peripheral neuropathy and exclude other causes of peripheral neuropathy apart from AIDS. All the patients had nerve conduction and electromyographic studies done. Eighteen patients were asymptomatic while fourteen had both signs and symptoms. The commonest symptom was painful paresthesiae of the limbs (35%) while the commonest sign was loss of vibration sense (60%). When symptoms, signs, and electrophysiological studies were combined, all the patients fitted the definition of peripheral neuropathy. The commonest type of peripheral neuropathy was distal symmetrical peripheral neuropathy (DSPN) (37.5%). PIP: In Kenya, physicians evaluated 40 AIDS patients admitted to Kenyatta National Hospital during June-December 1992 to determine the prevalence and types of peripheral neuropathy in AIDS patients. 75% were 21-40 years old. 18 (45%) of the 40 AIDS patients had symptoms of peripheral neuropathy. Symptoms included increased sensitivity to stimulation (43%), hyperpathia (15%), and muscle or limb weakness (13%). 26 AIDS patients had signs of peripheral neuropathy, especially impaired sense of vibration (60%). 14 of these patients had both signs and symptoms. Electromyographic and nerve conduction velocity revealed peripheral neuropathy in 16 (40%) AIDS patients. The types of peripheral neuropathy included distal symmetrical peripheral neuropathy (37.5%), polyneuropathy, and mononeuritis multiplex. When the symptoms, signs, and electroneurophysiological test findings were considered, all 40 AIDS patients had evidence of peripheral neuropathy.

BACKGROUND: Malaria control in Africa relies primarily on early effective treatment for clinical disease, but most early treatments for fever occur through self-medication with shop-bought drugs. Lack of information to community members on over-the-counter drug use has led to widespread ineffective treatment of fevers, increased risks of drug toxicity and accelerating drug resistance. We examined the feasibility and measured the likely impact of training shop keepers in rural Africa on community drug use. METHODS: In a rural area of coastal Kenya, we implemented a shop keeper training programme in 23 shops serving a population of approximately 3500, based on formative research within the community. We evaluated the training by measuring changes in the proportions of drug sales where an adequate amount of chloroquine was purchased and in the percentage of home-treated childhood fevers given an adequate amount of chloroquine. The programme was assessed qualitatively in the community following the shop keeper training. RESULTS: The percentage of drug sales for children with fever which included an antimalarial drug rose from 34.3% (95% CI 28.9%-40.1%) before the training to a minimum of 79.3% (95% CI 71.8%-85.3%) after the training. The percentage of antimalarial drug sales where an adequate amount of drug was purchased rose from 31.8% (95% CI 26.6%-37.6%) to a minimum of 82.9% (95% CI 76.3%-87.3%). The percentage of childhood fevers where an adequate dose of chloroquine was given to the child rose from 3.7% (95% CI 1.2%-9.7%) before the training to a minimum of 65.2% (95% CI 57.7%-72.0%) afterwards, which represents an increase in the appropriate use of over-the-counter chloroquine by at least 62% (95% CI 53.7%-69.3%). Shop keepers and community members were strongly supportive of the aims and outcome of the programme. CONCLUSIONS: The large shifts in behaviour observed indicate that the approach of training shop keepers as a channel for information to the community is both feasible and likely to have a significant impact. Whilst some of the impact seen may be attributable to research effects in a relatively small scale pilot study, the magnitude of the changes support further investigation into this approach as a potentially important new strategy in malaria control.

Following the death of 67 boys in a fire tragedy at Kyanguli School in rural Kenya, the level of traumatic grief was assessed in a sample of 164 parents and guardians whose sons died in the fire. The study was cross-sectional. Counseling services were offered to all the bereaved parents soon after the tragedy. The subjects were interviewed using the Traumatic Grief Scale. A group of 92 parents/guardians was interviewed 2 months after the event, while the other group of 72 was assessed 7 days later. The second group of bereaved parents also completed the Self Rating Questionnaire (SRQ) and the Ndetei-Othieno-Kathuku scale (NOK). Over 90% of parents from both groups had a yearning for the departed and found themselves searching for him quite often. There was no much difference in terms of symptoms profile or intensity between the two groups. It appears that the counseling offered had minimal impact on the levels of distress.

Samples of burnt clay from kilns in various parts of the country were tested for their cementatious qualities and found to have high silica contents.Results showed that additing upto 40% of the cly to portland cement produced good binders for mass concre and plaster work,particularly for low cost housing.

Fourteen patients received oral premedication of temazepam in soft gelatin capsules before minor surgery. The plasma concentrations of temazepam and its sedative, anxiolytic and amnesic effects were measured for 24 hours. Absorption was rapid and peak concentrations occurred 49 minutes after administration. Clinical effects were evident at 30 minutes and persisted for about 4 hours. The decline in plasma concentration was biexponential with a distribution half-life of 1.24 hours. The end of the distribution phase coincided approximately with the termination of its clinical effects. A relationship between plasma concentration and effect was observed; concentrations above 300 ng/ml produced measurable changes in tests of mental function. Patients had recovered fully from the effects of temazepam after 24 hours. This dose of temazepam is reliable and effective as premedication before surgery

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

We describe the technique of splenic aspiration in 113 patients presenting with splenomegaly. It was used initially to establish a diagnosis, and in those patients with kala azar, to follow the response of the parasites to therapy until 'parasitological cure'. In all 671 aspirations were performed. No complications occurred in the 69 patients with active kala azar, who collectively had more than 600 aspirations. One patient in a moribund condition had a fatal haemorrhage. The aspirate suggested a lymphoma, confirmed at autopsy. In 68 of the 69 patients with active kala azar, the diagnosis was established at the first aspiration. The essentials of the technique are the use of a small calibre needle (21 G), and speed, the needle being in the spleen for less than a second, with the consequent procurement of a few drops of material only.

Forty-two pigs in a herd of 117 displayed various clinical signs of progressive atrophic rhinitis. The main signs included sneezing, coughing, lachrymation, serous to mucopurulent nasal discharge, and nasal bleeding in 1 pig. Three pigs had lateral deviation of the snout, while 4 had brachygnathia superior with obvious deformation of the face. Four acutely affected weaner pigs appeared weak, while the 7 chronically-affected pigs appeared smaller than their apparently unaffected penmates of the same age. Treatment of the acutely affected pigs with long-acting oxytetracycline at 20 mg/kg body weight intramuscularly, repeated once after 7 days, reduced the severity but did not clear the sneezing from all the pigs. Fifteen pigs were slaughtered 2 months after the clinical diagnosis was made. The carcasses of the chronically affected pigs were about 15% lighter than those of the apparently normal pigs of the same age and from the same pen, which translated to a loss of 921.00 Kenya shillings per pig (US$13.7). Diagnosis of progressive atrophic rhinitis was confirmed by sectioning the snouts of randomly selected slaughtered pigs with obvious deformation of the snout. Sections were made at the level of the 1st/2nd upper premolar tooth. Varying degrees of turbinate atrophy, from mild to complete, were noted. Histopathology of the turbinates revealed metaplasia of nasal epithelium and fibrosis in the lamina propria

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

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This report concerns an outbreak that occurred during July/August 1997. Ten pigs from a herd of 181 pigs in a medium-scale, semi-closed piggery in Kiambu District, Kenya, contracted the clinical disease. The main clinical findings in affected pigs included: fever (40.5-41.8 degrees C), prostration, inappetence, dog-sitting posture, abortion, erythema and raised, firm to the touch and easily palpated light pink to dark purple diamond-shaped to square/rectangular spots on the skin around the belly and the back. Based on the pathognomonic skin lesions, a clinical diagnosis of swine erysipelas was made. The diagnosis was confirmed by the isolation of Erysipelothrix rhusiopathiae organisms from the blood and skin biopsies taken from the affected pigs. Response to treatment with a combination of procaine penicillin and dihydrostreptomycin at the dosage rate of 20,000 IU/kg body weight (based on procaine penicillin) for 3 days was good and all the affected pigs recovered fully. The farm was placed under quarantine to prevent spread of the disease

Samples of burnt clay from kilns in various parts of the country were tested for their cementatious qualities and found to have high silica contents.Results showed that additing upto 40% of the cly to portland cement produced good binders for mass concre and plaster work,particularly for low cost housing.

Normal 0 false false false MicrosoftInternetExplorer4 st1:*{behavior:url(#ieooui) } /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman"; mso-ansi-language:#0400; mso-fareast-language:#0400; mso-bidi-language:#0400;} Integrated vector management (IVM) for malaria control requires ecological skills that are very scarce and rarely applied in Africa today. Partnerships between communities and academic ecologists can address this capacity deficit, modernize the evidence base for such approaches and enable future scale up. Community-based IVM programmes were initiated in two contrasting settings. On Rusinga Island, Western Kenya, community outreach to a marginalized rural community was achieved by University of Nairobi through a community-based organization. In Dar es Salaam, Tanzania, Ilala Municipality established an IVM programme at grassroots level, which was subsequently upgraded and expanded into a pilot scale Urban Malaria Control Programme with support from national academic institutes. Both programmes now access relevant expertise, funding and policy makers while the academic partners benefit from direct experience of community-based implementation and operational research opportunities. The communities now access up-to-date malaria-related knowledge and skills for translation into local action. Similarly, the academic partners have acquired better understanding of community needs and how to address them. Until sufficient evidence is provided, community-based IVM remains an operational research activity. Researchers can never directly support every community in Africa so community based IVM strategies and tactics will need to be incorporated into undergraduate teaching programmes to generate sufficient numbers of practitioners for national scale programmes. Academic ecologists at African institutions are uniquely positioned to enable the application of practical environmental and entomological skills for malaria control by communities at grassroots level and should be supported to fulfil this neglected role.

Critically examined in this paper are the current sources of water for human consumption in Z Kenya. The various treatment methods and their effectiveness are highlighted. The quality control methods and the statutory regulatory bodies in place are mentioned. Water standards in use are compared with those World Health Organization (WHO). The question whether water supply and quality control should continue to be the domain of the civic/municipal authorities and whether they treat their water properly is discussed.

OBJECTIVE: To establish the magnitude of psychiatric disorders among leprosy patients in western Kenya. DESIGN: A cross-sectional descriptive study. SETTING: Busia and Teso districts in western Kenya. SUBJECTS: A sample of 152 male and female, adult leprosy patients. RESULTS: The prevalence of psychiatric morbidity (PM) was 53.29%. The PM was positively correlated with physical disability and marital status but not with age, sex, education, type of leprosy, or duration of the illness. The prevalence of psychiatric morbidity was lower among Kenyan leprosy patients compared to studies carried out in India (56% to 78%). It was high compared to the rate of psychiatric morbidity in those seeking medical help in primary health care centres in Kenya, which was recently estimated to be 10%. CONCLUSION: The prevalence of PM in leprosy patients in western Kenya was lower than that in studies carried out in India. This could be attributed to de-institutionalisation and re-integration of leprosy sufferers back into their local communities. Since the rate was more than double that in the general Kenyan population and seemed to be related to presence of physical disability, an appraisal of psychiatric services offered to these patients is needed.

PMID: 614126 [PubMed - indexed for MEDLINE]

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

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Western Kenya, which comprise the highlands west of the Rift Valley and the Lake Victoria basin, receive substantial amount of rainfall almost throughout the year. This region has therefore a high agricultural potential. The characteristics of rainfall in this part of the country are influenced by several factors, which range from meso-scale to global. One of the global teleconnection systems that influence the rainfall over this region is the Southern Oscillation (SO). The SO is an irregular, interannual and global scale see saw fluctuation in surface pressure between Indonesia and Southwest Pacific, and occurs at interval of 2 to 7 years. Both the rainfall and Southern Oscillation Index (SOI) data were obtained from the Drought Monitoring Centre (DMC) in Kenya. The Data consisted of monthly rainfall from 24 stations distributed over the region and the monthly-normalized SOI. The period of study was between 1957 to 1993. The seasonal data was derived from the data. The monthly and seasonal rainfall and SOI were subjected to correlation analysis. The t-test was used to determine the statistical significance of the computed correlation values. The spatial and temporal patterns of the correlation values were used to determine the nature of the relationship between the SO and rainfall over western Kenya during various months and seasons. Significant positive correlation values were observed during the months of July- September, while significant negative correlation values were observed during October-December. Low correlation values were however observed during January- May. The significant correlation values observed during July-September and October-December suggest that the SOI can be used as a predictor for the rainfall during these seasons

Normal 0 false false false MicrosoftInternetExplorer4 st1:*{behavior:url(#ieooui) } /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman"; mso-ansi-language:#0400; mso-fareast-language:#0400; mso-bidi-language:#0400;} Integrated vector management (IVM) for malaria control requires ecological skills that are very scarce and rarely applied in Africa today. Partnerships between communities and academic ecologists can address this capacity deficit, modernize the evidence base for such approaches and enable future scale up. Community-based IVM programmes were initiated in two contrasting settings. On Rusinga Island, Western Kenya, community outreach to a marginalized rural community was achieved by University of Nairobi through a community-based organization. In Dar es Salaam, Tanzania, Ilala Municipality established an IVM programme at grassroots level, which was subsequently upgraded and expanded into a pilot scale Urban Malaria Control Programme with support from national academic institutes. Both programmes now access relevant expertise, funding and policy makers while the academic partners benefit from direct experience of community-based implementation and operational research opportunities. The communities now access up-to-date malaria-related knowledge and skills for translation into local action. Similarly, the academic partners have acquired better understanding of community needs and how to address them. Until sufficient evidence is provided, community-based IVM remains an operational research activity. Researchers can never directly support every community in Africa so community based IVM strategies and tactics will need to be incorporated into undergraduate teaching programmes to generate sufficient numbers of practitioners for national scale programmes. Academic ecologists at African institutions are uniquely positioned to enable the application of practical environmental and entomological skills for malaria control by communities at grassroots level and should be supported to fulfil this neglected role.

Samples of burnt clay from kilns in various parts of the country were tested for their cementatious qualities and found to have high silica contents.Results showed that additing upto 40% of the cly to portland cement produced good binders for mass concre and plaster work,particularly for low cost housing.

Normal 0 false false false MicrosoftInternetExplorer4 st1:*{behavior:url(#ieooui) } /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman"; mso-ansi-language:#0400; mso-fareast-language:#0400; mso-bidi-language:#0400;} Integrated vector management (IVM) for malaria control requires ecological skills that are very scarce and rarely applied in Africa today. Partnerships between communities and academic ecologists can address this capacity deficit, modernize the evidence base for such approaches and enable future scale up. Community-based IVM programmes were initiated in two contrasting settings. On Rusinga Island, Western Kenya, community outreach to a marginalized rural community was achieved by University of Nairobi through a community-based organization. In Dar es Salaam, Tanzania, Ilala Municipality established an IVM programme at grassroots level, which was subsequently upgraded and expanded into a pilot scale Urban Malaria Control Programme with support from national academic institutes. Both programmes now access relevant expertise, funding and policy makers while the academic partners benefit from direct experience of community-based implementation and operational research opportunities. The communities now access up-to-date malaria-related knowledge and skills for translation into local action. Similarly, the academic partners have acquired better understanding of community needs and how to address them. Until sufficient evidence is provided, community-based IVM remains an operational research activity. Researchers can never directly support every community in Africa so community based IVM strategies and tactics will need to be incorporated into undergraduate teaching programmes to generate sufficient numbers of practitioners for national scale programmes. Academic ecologists at African institutions are uniquely positioned to enable the application of practical environmental and entomological skills for malaria control by communities at grassroots level and should be supported to fulfil this neglected role.

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

test

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Samples of burnt clay from kilns in various parts of the country were tested for their cementatious qualities and found to have high silica contents.Results showed that additing upto 40% of the cly to portland cement produced good binders for mass concre and plaster work,particularly for low cost housing.

Normal 0 false false false MicrosoftInternetExplorer4 st1:*{behavior:url(#ieooui) } /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman"; mso-ansi-language:#0400; mso-fareast-language:#0400; mso-bidi-language:#0400;} Integrated vector management (IVM) for malaria control requires ecological skills that are very scarce and rarely applied in Africa today. Partnerships between communities and academic ecologists can address this capacity deficit, modernize the evidence base for such approaches and enable future scale up. Community-based IVM programmes were initiated in two contrasting settings. On Rusinga Island, Western Kenya, community outreach to a marginalized rural community was achieved by University of Nairobi through a community-based organization. In Dar es Salaam, Tanzania, Ilala Municipality established an IVM programme at grassroots level, which was subsequently upgraded and expanded into a pilot scale Urban Malaria Control Programme with support from national academic institutes. Both programmes now access relevant expertise, funding and policy makers while the academic partners benefit from direct experience of community-based implementation and operational research opportunities. The communities now access up-to-date malaria-related knowledge and skills for translation into local action. Similarly, the academic partners have acquired better understanding of community needs and how to address them. Until sufficient evidence is provided, community-based IVM remains an operational research activity. Researchers can never directly support every community in Africa so community based IVM strategies and tactics will need to be incorporated into undergraduate teaching programmes to generate sufficient numbers of practitioners for national scale programmes. Academic ecologists at African institutions are uniquely positioned to enable the application of practical environmental and entomological skills for malaria control by communities at grassroots level and should be supported to fulfil this neglected role.

A double antibody enzyme linked immunosorbent assay for identification of thermostable muscle antigens of autoclaved meat samples is described. The assay differentiates heterologous thermostable muscle antigens from homologous at P 0.001. In model meat mixtures, the assay detects adulterants at the level of 1% at p0.001 even in phylogenetically related species such as buffalo and cattle.

The microbiological quality of ground water (boreholes) and domestic tanks in five locations of Kikuyu Division, Kiambu District, was determined. Two boreholes and twelve domestic tanks were sampled from each location. Seven (70%) out of 10 boreholes were contaminated with faecal coliforms. Total bacterial counts ranged from 1 to 6280 per ml of water while the coliform counts ranged from 0 to 161. Out of 70 water samples screened for faecal coliforms, 63 (90%) were positive. Faecal Streptococci were isolated in 71% of the samples.

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

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Samples of burnt clay from kilns in various parts of the country were tested for their cementatious qualities and found to have high silica contents.Results showed that additing upto 40% of the cly to portland cement produced good binders for mass concre and plaster work,particularly for low cost housing.

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

Normal 0 false false false MicrosoftInternetExplorer4 st1:*{behavior:url(#ieooui) } /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman"; mso-ansi-language:#0400; mso-fareast-language:#0400; mso-bidi-language:#0400;} Integrated vector management (IVM) for malaria control requires ecological skills that are very scarce and rarely applied in Africa today. Partnerships between communities and academic ecologists can address this capacity deficit, modernize the evidence base for such approaches and enable future scale up. Community-based IVM programmes were initiated in two contrasting settings. On Rusinga Island, Western Kenya, community outreach to a marginalized rural community was achieved by University of Nairobi through a community-based organization. In Dar es Salaam, Tanzania, Ilala Municipality established an IVM programme at grassroots level, which was subsequently upgraded and expanded into a pilot scale Urban Malaria Control Programme with support from national academic institutes. Both programmes now access relevant expertise, funding and policy makers while the academic partners benefit from direct experience of community-based implementation and operational research opportunities. The communities now access up-to-date malaria-related knowledge and skills for translation into local action. Similarly, the academic partners have acquired better understanding of community needs and how to address them. Until sufficient evidence is provided, community-based IVM remains an operational research activity. Researchers can never directly support every community in Africa so community based IVM strategies and tactics will need to be incorporated into undergraduate teaching programmes to generate sufficient numbers of practitioners for national scale programmes. Academic ecologists at African institutions are uniquely positioned to enable the application of practical environmental and entomological skills for malaria control by communities at grassroots level and should be supported to fulfil this neglected role.

A study was undertaken in the semiarid northern Turkana district of Kenya to estimate the prevalence of gastrointestinal nematodes in small ruminants. The study involved 1106 sheep and goats of various ages. The study was conducted between January and August 2001 and covered both the dry and wet seasons. All the animals were shedding nematode eggs throughout the study period. Faecal shedding was higher in young animals compared to adults and the infection was heavier in sheep. The faecal egg counts were significantly higher during the wet season for both sheep and goats. Haemonchus contortus was the main nematode encountered in coprocultures (goats 73%, sheep 62.8%) and postmortem total worm counts. Other nematodes encountered included Trichostrongylus axei, Trichostrongylus colubriformis, Bunostomum trigonocephalum, Oesophagostomum columbianum and Trichuris ovis. This is the first report of B. trigonocephalum in small ruminants in the semiarid areas of Kenya. In conclusion, gastrointestinal helminths may be a potential constraint to the health and production of small ruminants in the Turkana district. H. contortus is the main nematode species affecting the small ruminants in this area.

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

BACKGROUND: Although artesunate and mefloquine have been used as monotherapies in the treatment of malaria in Kenya for a long time, there is insufficient data on the clinical outcome when used as combination therapy in this population. OBJECTIVE: To derive data on the efficacy and safety profile of artesunate-mefloquine combination in the treatment of uncomplicated Plasmodium falciparum malaria in Kenya. DESIGN: An open label single arm clinical trial. SETTING: Bungoma district Hospital. Study area was Bungoma District of Kenya, an endemic area of malaria. The study was conducted between January 2004 and April 2004. SUBJECTS: A total of 200 males and females with uncomplicated plasmodium falciparum malaria weighing 35kg and above were recruited in the study. RESULTS: In the evaluable patient population the day 28 cure rate was 98.4% while day 14 and 7 cure rates were 98.4% and 99.2% respectively. There was rapid relief of symptoms the median time of fever clearance was one day and the most common drug related adverse events were headache dizziness and asthenia. There was no significant derangement in the haematological, biochemical and ECG parameters in the patients on treatment. CONCLUSION: Artesunate-mefloquine combination given simultaneously was found to be highly effective and safe in the treatment of uncomplicated malaria.

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

OBJECTIVES: To determine the histology of the prostate in prostatectomy done for benign prostatic hypertrology (BPH), and prostate needle biopsy done for raised prostatic specific antigen (PSA). DESIGN: A retrospective study. SETTINGS: Nairobi Hospital, Kenyatta National Hospital and Upper Hill Medical Centre. SUBJECTS: The records of all the patients who had prostatectomy for BPH or trans-rectal needle biopsy of the prostate for raised prostatic specific antigen by the author and whose histology was determined at the Nairobi Hospital between May 2004 and December 2006. RESULTS: A total of 108 specimens from 108 patients were sent to the laboratory. The ages of the patients ranged from 48 years to 83 years with a mean of 71.3 years. Of the 108 specimens submitted 82 were benign prostatic hypertrophy and 26 were carcinoma of the prostate. Out of 78 prostatectomy specimens ten (12.8%) had prostate cancer. In the needle biopsy group 16 out of 30 (53%) had prostate cancer. In total there were 82 (76%) patients with histology of benign prostate enlargement and 26 (24%) with histology of prostate cancer. CONCLUSION: Prostate cancer is a common disease in Kenya and a lot of it is important cancer as it will progress and cause death. In this poor resource setting it is possible to make diagnosis of prostate cancer even in the absence of transrectal ultrasound (TRUS) to help biopsy the prostate. The higher the prostatic specific antigen in asymptomatic patients the higher the yield of prostate cancer on biopsy of the prostate.

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Few chemotherapeutic agents are available for the medical management of hydatid disease caused by the parasite Echinococcus granulosus. In order to test the potential of oxfendazole for the treatment of infection with this parasite, nine infected goats and four sheep were given oxfendazole twice weekly at a dose of 30 mg/kg of body weight for 4 weeks and monitored by ultrasound for an additional 4 weeks. Efficacy was finally evaluated by postmortem examination, including determination of protoscolex viability and cyst wall histology. In treated animals, protoscolices were dead or absent in 97% of cysts from oxfendazole-treated animals compared to 28% of cysts from untreated control animals. On postmortem examination, 53% of cysts from treated animals were found to be grossly degenerate. A sample of those cysts that appeared potentially viable all demonstrated evidence of severe damage to the cyst wall. By light microscopy, cysts showed severe disorganization of the adventitial layer with invasion of inflammatory cells and in some cases frank necrosis with no apparent adventitial layer. The follow-up period for assessment of the drug's ability to cause complete degeneration and resorption of cysts was relatively short. This study, however, indicates that oxfendazole is at least as effective as and is easier to administer than albendazole for the treatment of hydatid disease.

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

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

BACKGROUND: Malaria control in Africa relies primarily on early effective treatment for clinical disease, but most early treatments for fever occur through self-medication with shop-bought drugs. Lack of information to community members on over-the-counter drug use has led to widespread ineffective treatment of fevers, increased risks of drug toxicity and accelerating drug resistance. We examined the feasibility and measured the likely impact of training shop keepers in rural Africa on community drug use. METHODS: In a rural area of coastal Kenya, we implemented a shop keeper training programme in 23 shops serving a population of approximately 3500, based on formative research within the community. We evaluated the training by measuring changes in the proportions of drug sales where an adequate amount of chloroquine was purchased and in the percentage of home-treated childhood fevers given an adequate amount of chloroquine. The programme was assessed qualitatively in the community following the shop keeper training. RESULTS: The percentage of drug sales for children with fever which included an antimalarial drug rose from 34.3% (95% CI 28.9%-40.1%) before the training to a minimum of 79.3% (95% CI 71.8%-85.3%) after the training. The percentage of antimalarial drug sales where an adequate amount of drug was purchased rose from 31.8% (95% CI 26.6%-37.6%) to a minimum of 82.9% (95% CI 76.3%-87.3%). The percentage of childhood fevers where an adequate dose of chloroquine was given to the child rose from 3.7% (95% CI 1.2%-9.7%) before the training to a minimum of 65.2% (95% CI 57.7%-72.0%) afterwards, which represents an increase in the appropriate use of over-the-counter chloroquine by at least 62% (95% CI 53.7%-69.3%). Shop keepers and community members were strongly supportive of the aims and outcome of the programme. CONCLUSIONS: The large shifts in behaviour observed indicate that the approach of training shop keepers as a channel for information to the community is both feasible and likely to have a significant impact. Whilst some of the impact seen may be attributable to research effects in a relatively small scale pilot study, the magnitude of the changes support further investigation into this approach as a potentially important new strategy in malaria control.

Department of Psychiatry, University of Nairobi/Africa Mental Health Foundation, Ralph Bunche Road, P.O. Box 48423-00100, Nairobi, Kenya; A descriptive study was carried out in pregnant women who were affected by the 1998 bomb blast in Nairobi, Kenya, and their babies who were in utero at the time of the blast. The psychological effects of the event on the exposed women were severe. After three years, the average score on the Impact of Event Scale - Revised was still higher than 29 for the three subscales combined, suggesting that most of the study group was still suffering from clinical post-traumatic stress disorder (PTSD). The scores on all Childhood Personality Scale (CPS) subscales were significantly higher in children of the study group than in controls. The mothers' PTSD symptom levels at one month after the blast correlated with the children's CPS profiles.

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Samples of burnt clay from kilns in various parts of the country were tested for their cementatious qualities and found to have high silica contents.Results showed that additing upto 40% of the cly to portland cement produced good binders for mass concre and plaster work,particularly for low cost housing.

We describe the technique of splenic aspiration in 113 patients presenting with splenomegaly. It was used initially to establish a diagnosis, and in those patients with kala azar, to follow the response of the parasites to therapy until 'parasitological cure'. In all 671 aspirations were performed. No complications occurred in the 69 patients with active kala azar, who collectively had more than 600 aspirations. One patient in a moribund condition had a fatal haemorrhage. The aspirate suggested a lymphoma, confirmed at autopsy. In 68 of the 69 patients with active kala azar, the diagnosis was established at the first aspiration. The essentials of the technique are the use of a small calibre needle (21 G), and speed, the needle being in the spleen for less than a second, with the consequent procurement of a few drops of material only.

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

PIP: Malaria is the most prevalent and devastating public health problem in Africa despite much research and control effort over the last two decades. In most parts of Africa, individuals should take 200 mg of Proguanil daily together with chloroquine 5 mg/kg per week as prophylaxis. Pregnant women and individuals with underlying disease such as sickle cell making them susceptible to severe or complicated malaria, however, should take just 200 mg Proguanil daily. In hard-core multi-drug resistance areas, mefloquine 250 mg once weekly together with chloroquine 300 mg weekly is recommended as prophylaxis. Since no anti-malarial drug confers absolute protection against infection, however, using mosquito nets impregnated with permethrin, insecticides, and mosquito repellents is also advocated for those at high risk of severe malaria. The need also exists to treat cases of malaria when prevention is unsuccessful. Chloroquine in total dose 25 mg/Kg over three days is the first choice treatment of uncomplicated malaria in 4-aminoquinoline sensitive areas. Amodiaquine 25 mg/Kg over three days is the second line treatment, while pyrimethamine/sulphonamide combinations are useful in areas where there is resistance to 4-aminoquinalines. Finally, quinine 10 mg/kg every eight hours for seven days is the treatment of choice for severe and complicated malaria.

A study was conducted in sixty-two randomly selected herds in Kikuyu division, Kiambu District in Central Kenyan Highlands to obtain prevalence, spectrum and intensity of gastrointestinal helminths in pigs kept by smallholder farmers. Faecal samples from a total of 598 pigs of various age-group categories (piglets, weaners, growers and adults) were taken during a period of a 4 months in 1999 ad examined for helminthes eggs (EPG) using modified McMaster technique. Gastrintestinal helminth eggs wewre observed in 57 (91.9%) of the herds. The Helminths observed were Strongles (35.1%). Ascarids (10%), Trichuris (4), Strongloids (3.2%) and Tapeworms (0.3%). The overall prevalence of the helminaths was 43.5%. the prevalence among the various age groups differed significantly (p<0.01) with the highest prevalence in the weaners (55.6%) and the lowest in the piglets (22.9%). The prevalence of Strongles and Strongloids differed significantly (p<0.01) among the age groups. The highest prevalence for Strongyles was in the growers (41.7%) and the lowest in the piglets (22.9%) while the highest prevalence for lowest in the adults (0.8%). The prevalence of Ascarids differed significantly (p<0.01) among the age groups with the highest prevalence in weaners (27.8%) and the lowest in the piglets (3.6%). The prevalence of Trichuris worms was significantly (p<0.5) higher in the weaners than in the piglets. The high prevalence of the Gatrointestinal helmnths observed indicates the need to control these parasites due to their detrimental effects on productivity and also due to their public health significance.

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

Normal 0 false false false MicrosoftInternetExplorer4 st1:*{behavior:url(#ieooui) } /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman"; mso-ansi-language:#0400; mso-fareast-language:#0400; mso-bidi-language:#0400;} Integrated vector management (IVM) for malaria control requires ecological skills that are very scarce and rarely applied in Africa today. Partnerships between communities and academic ecologists can address this capacity deficit, modernize the evidence base for such approaches and enable future scale up. Community-based IVM programmes were initiated in two contrasting settings. On Rusinga Island, Western Kenya, community outreach to a marginalized rural community was achieved by University of Nairobi through a community-based organization. In Dar es Salaam, Tanzania, Ilala Municipality established an IVM programme at grassroots level, which was subsequently upgraded and expanded into a pilot scale Urban Malaria Control Programme with support from national academic institutes. Both programmes now access relevant expertise, funding and policy makers while the academic partners benefit from direct experience of community-based implementation and operational research opportunities. The communities now access up-to-date malaria-related knowledge and skills for translation into local action. Similarly, the academic partners have acquired better understanding of community needs and how to address them. Until sufficient evidence is provided, community-based IVM remains an operational research activity. Researchers can never directly support every community in Africa so community based IVM strategies and tactics will need to be incorporated into undergraduate teaching programmes to generate sufficient numbers of practitioners for national scale programmes. Academic ecologists at African institutions are uniquely positioned to enable the application of practical environmental and entomological skills for malaria control by communities at grassroots level and should be supported to fulfil this neglected role.

This report concerns an outbreak that occurred during July/August 1997. Ten pigs from a herd of 181 pigs in a medium-scale, semi-closed piggery in Kiambu District, Kenya, contracted the clinical disease. The main clinical findings in affected pigs included: fever (40.5-41.8 degrees C), prostration, inappetence, dog-sitting posture, abortion, erythema and raised, firm to the touch and easily palpated light pink to dark purple diamond-shaped to square/rectangular spots on the skin around the belly and the back. Based on the pathognomonic skin lesions, a clinical diagnosis of swine erysipelas was made. The diagnosis was confirmed by the isolation of Erysipelothrix rhusiopathiae organisms from the blood and skin biopsies taken from the affected pigs. Response to treatment with a combination of procaine penicillin and dihydrostreptomycin at the dosage rate of 20,000 IU/kg body weight (based on procaine penicillin) for 3 days was good and all the affected pigs recovered fully. The farm was placed under quarantine to prevent spread of the disease

Samples of burnt clay from kilns in various parts of the country were tested for their cementatious qualities and found to have high silica contents.Results showed that additing upto 40% of the cly to portland cement produced good binders for mass concre and plaster work,particularly for low cost housing.

Normal 0 false false false MicrosoftInternetExplorer4 st1:*{behavior:url(#ieooui) } /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman"; mso-ansi-language:#0400; mso-fareast-language:#0400; mso-bidi-language:#0400;} Integrated vector management (IVM) for malaria control requires ecological skills that are very scarce and rarely applied in Africa today. Partnerships between communities and academic ecologists can address this capacity deficit, modernize the evidence base for such approaches and enable future scale up. Community-based IVM programmes were initiated in two contrasting settings. On Rusinga Island, Western Kenya, community outreach to a marginalized rural community was achieved by University of Nairobi through a community-based organization. In Dar es Salaam, Tanzania, Ilala Municipality established an IVM programme at grassroots level, which was subsequently upgraded and expanded into a pilot scale Urban Malaria Control Programme with support from national academic institutes. Both programmes now access relevant expertise, funding and policy makers while the academic partners benefit from direct experience of community-based implementation and operational research opportunities. The communities now access up-to-date malaria-related knowledge and skills for translation into local action. Similarly, the academic partners have acquired better understanding of community needs and how to address them. Until sufficient evidence is provided, community-based IVM remains an operational research activity. Researchers can never directly support every community in Africa so community based IVM strategies and tactics will need to be incorporated into undergraduate teaching programmes to generate sufficient numbers of practitioners for national scale programmes. Academic ecologists at African institutions are uniquely positioned to enable the application of practical environmental and entomological skills for malaria control by communities at grassroots level and should be supported to fulfil this neglected role.

PMID: 614126 [PubMed - indexed for MEDLINE]

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

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This paper presents the age, sex and site distribution of oral tumours and tumour like conditions in Kenya. It confirms some important points. First, there is an overall lower mean age for oral tumours in African series compared to non African series. Secondly, sex bias in the distribution of oral tumours is less marked for most tumours in Africans. Thirdly, there is difference in site distribution and oral tumours between Africans and non-African populations.

J. M. Khalagai,  held in Nairobi, Kenya in

This report concerns an outbreak that occurred during July/August 1997. Ten pigs from a herd of 181 pigs in a medium-scale, semi-closed piggery in Kiambu District, Kenya, contracted the clinical disease. The main clinical findings in affected pigs included: fever (40.5-41.8 degrees C), prostration, inappetence, dog-sitting posture, abortion, erythema and raised, firm to the touch and easily palpated light pink to dark purple diamond-shaped to square/rectangular spots on the skin around the belly and the back. Based on the pathognomonic skin lesions, a clinical diagnosis of swine erysipelas was made. The diagnosis was confirmed by the isolation of Erysipelothrix rhusiopathiae organisms from the blood and skin biopsies taken from the affected pigs. Response to treatment with a combination of procaine penicillin and dihydrostreptomycin at the dosage rate of 20,000 IU/kg body weight (based on procaine penicillin) for 3 days was good and all the affected pigs recovered fully. The farm was placed under quarantine to prevent spread of the disease

Normal 0 false false false MicrosoftInternetExplorer4 st1:*{behavior:url(#ieooui) } /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman"; mso-ansi-language:#0400; mso-fareast-language:#0400; mso-bidi-language:#0400;} Integrated vector management (IVM) for malaria control requires ecological skills that are very scarce and rarely applied in Africa today. Partnerships between communities and academic ecologists can address this capacity deficit, modernize the evidence base for such approaches and enable future scale up. Community-based IVM programmes were initiated in two contrasting settings. On Rusinga Island, Western Kenya, community outreach to a marginalized rural community was achieved by University of Nairobi through a community-based organization. In Dar es Salaam, Tanzania, Ilala Municipality established an IVM programme at grassroots level, which was subsequently upgraded and expanded into a pilot scale Urban Malaria Control Programme with support from national academic institutes. Both programmes now access relevant expertise, funding and policy makers while the academic partners benefit from direct experience of community-based implementation and operational research opportunities. The communities now access up-to-date malaria-related knowledge and skills for translation into local action. Similarly, the academic partners have acquired better understanding of community needs and how to address them. Until sufficient evidence is provided, community-based IVM remains an operational research activity. Researchers can never directly support every community in Africa so community based IVM strategies and tactics will need to be incorporated into undergraduate teaching programmes to generate sufficient numbers of practitioners for national scale programmes. Academic ecologists at African institutions are uniquely positioned to enable the application of practical environmental and entomological skills for malaria control by communities at grassroots level and should be supported to fulfil this neglected role.

Samples of burnt clay from kilns in various parts of the country were tested for their cementatious qualities and found to have high silica contents.Results showed that additing upto 40% of the cly to portland cement produced good binders for mass concre and plaster work,particularly for low cost housing.

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

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Department of Medical Physiology, University of Nairobi, Kenya. Finding a simple and easily reproducible formula for assessing fitness and growth for human body has been one constant search over the ages. It was the aim of this project to try and add to this search. Most formulae in this field have complex calculations. Most of them have been derived using single system measurements. To delineate our factor, multisystem measurements were used; metric and imperial. This yielded a factor for describing the relationship between weight and height over the ages. The height is in inches and weight in kilograms. This produced factors (D) and (G) which have childhood, adolescent, adult and old age values. A total of 368 black Kenyans were studied. The age range was 3-85 years.

PIP: 17 regularly mentruating young black Kenyan women were studied during a mentrual cylcle for their reproductive hormonal patterns. The serum concentrations of Follicle Stimulating Hormone (FSH), Luteinizing Hormone (LH) and Prolactin (PRL) were determined by World Health Organization Matched Reagent Programme Radioimmunoassay (WHO-MR-RIA). A biphasic basal body temperature (BBT) record was also noted. The hormonal patterns showed a mid-cycle LH surge and rise in plasma progesterone beginning with the LH peak and lasting a maximum of 6-8 days after the LH peak. Cycle lengths ranged from 25-32 days with a mean of 28 plus or minus 2 days. The follicular phase ranged from 10-17 days, and the luteal phase lasted from 13-15 days. When the mean LH and FSH concentrations and the mean BBT curve were synchronized on the day of the mid-cycle LH peak, the temperature elevation occured about 48 days after the LH peak. Along with the LH, the FSH showed a mid-cycle peak. The results of this study are consistent with those already documented for Caucasian, Asian and African females

Ethiopia is one of the countries on the eastern side of Africa which has high spatial and temporal variability of rainfall. The trade winds are the major source of moisture in this region. The chatacteristics of the trade winds are controlled by the location, intensity and orientation of the majorbquasi-permanent anticyclones of Africa together with other general circulation parameters such as sea surface temperatures, jet streams, easterly waves and extratropical weather systems. The study showed that years of strong El-Nino are characterized by severe droughts over Ethiopia.

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