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: Cataract is a leading cause of blindness and vision impairment globally. Cataract surgery is one of the most frequently performed operations worldwide, but good quality services are not universally available. This scoping review aims to summarise the nature and extent of published literature on interventions to improve the quality of services for age-related cataract globally.

Methods: We used the dimensions of quality adopted by WHO-effectiveness, safety, people-centredness, timeliness, equity, integration and efficiency-to which we added planetary health. On 17 November 2019, we searched MEDLINE, Embase and Global Health for manuscripts published since 1990, without language or geographic restrictions. We included studies that reported quality-relevant interventions and excluded studies focused on technical aspects of surgery or that only involved children (younger than 18 years). Screening of titles/abstracts, full-text review and data extraction were performed by two reviewers independently. Studies were grouped thematically and results synthesised narratively.

Results: Most of the 143 included studies were undertaken in high-income countries (n = 93, 65%); 29 intervention groups were identified, most commonly preoperative education (n = 17, 12%) and pain/anxiety management (n = 16, 11%). Efficiency was the quality element most often assessed (n = 58, 41%) followed by people-centredness (n = 40, 28%), while integration (n = 4) and timeliness (n = 3) were infrequently reported, and no study reported outcomes related to planetary health.

Conclusion: Evidence on interventions to improve quality of cataract services shows unequal regional distribution. There is an urgent need for more evidence relevant to low- and middle-income countries as well as across all quality elements, including planetary health.

This analysis attempted to capture the key economic and financial trends in the budget in the 1995/6 year and to provide the rationale for them. These trends were linked to fundamental requisites for development and sustainable growth.

The hydrogeology of rift lakes is complex due to the potential influence of faults and porous volcanic and volcanoclastic media on groundwater flow. We conducted a comprehensive study that integrated geological and hydrogeological data as well as the application of a linear decay model to estimate the groundwater flow between the two of the best-studied lake systems in East Africa, the adjacent Lakes Naivasha and Nakuru- Elmenteita in the Central Kenya Rift. Whereas both lake basins host relatively shallow lakes today, paleo-shorelines and sediments suggest >100 m deep lakes during a wetter climate during the Early Holocene during the so-called African Humid Period. Stable isotope data show variations form highly depleted to more enriched d18O waters. The linear-reservoir depletion model simulates the decline of the Early Holocene lakes in both basins to the modern levels. The altitude difference of ca. 100 m of both paleo-lake levels enables us to estimate the duration of the groundwater decline and the connectivity of the two basins via the Eburru/Gilgil barrier. The results suggest a decline of the groundwater levels during ca. 5 kyrs if there is no recharge, and between 2-2.7 kyrs based on the modern recharge of 0.52 m/yr as the end members of the delay time introduced by subsurface water flow to the hydrology of the lake system. The latter value suggests that ca. 40.95 cubic kilometres of water flowed from Lake Naivasha to Nakuru- Elmenteita at maximum lake level in the Early Holocene following the hydraulic gradient concurrent to the topographic slope. The unexpectedly large volume, more than half of the volume of the paleo-Lake Naivasha during the Early Holocene, emphasizes the importance of groundwater in hydrological modelling of paleo-lakes in rifts. Moreover, the subsurface connectivity of rift lakes also causes a significant lag time to the system introducing a nonlinear component to the system that has to be considered while interpreting paleo-lake records.

This study's objective is to analyze training methods clinicians reported as most and least helpful during the DSM-5 Cultural Formulation Interview field trial, reasons why, and associations between demographic characteristics and method preferences.

Abstract

The industrialization process taking place in Africa has led to an overall increase in groundwater abstraction in most countries in the continent. However, the lack of hydrogeological data, as in many developing countries, makes it difficult to properly manage groundwater systems. This study presents a real case study in which a combination of different hydrogeological tools together with different sources of information allow the assessment of how increased competition for water may be affecting groundwater systems by analysing the sustainability of new abstraction regimes under different real climatic condition (before, during and after La Niña 2016). The area where this approach has been applied is Kwale County (in Coastal Kenya) in a hydrogeological context representative of an important part of the east coast of the continent, where new mining and agriculture activities co-exist with tourism and local communities. The results show that the lack of aquifer systems data can be overcome, at least partly, by integrating different sources of information. Most of the time, water-reliant users collect specific hydrogeological information that can contribute to defining the overall hydrogeological system, since their own main purpose is to exploit the aquifer with the maximum productivity. Therefore, local community water usage, together with different stakeholder's knowledge and good corporate water management act as a catalyst for providing critical data, and allows the generation of credible models for future groundwater management and resource allocation. Furthermore, complementary but simple information sources such as in situ interviews, Google Earth, Trip Advisor and easy-to use analytical methods that can be applied in the African context as in many developing countries, and enables groundwater abstraction to be estimated and the sustainability of the aquifer system to be defined, allowing potential future risks to be assessed.

Collecting self-reported data on adherence to highly active antiretroviral therapy (HAART) can be complicated by patients' reluctance to report poor adherence. The timeliness with which patients attend visits might be a useful alternative to estimate medication adherence. Among Kenyan and Zambian women receiving twice daily HAART, we examined the relationship between self-reported pill taking and timeliness attending scheduled visits. We analyzed data from 566 Kenyan and Zambian women enrolled in a prospective 48-week HAART-response study. At each scheduled clinic visit, women reported doses missed over the preceding week. Self-reported adherence was calculated by summing the total number of doses reported taken and dividing by the total number of doses asked about at the visit attended. A participant's adherence to scheduled study visits was defined as "on time" if she arrived early or within three days, "moderately late" if she was four-seven days late, and "extremely late/missed" if she was more than eight days late or missed the visit altogether. Self-reported adherence was <95% for 29 (10%) of 288 women who were late for at least one study visit vs. 3 (1%) of 278 who were never late for a study visit (odds ratios [OR] 10.3; 95% confidence intervals [95% CI] 2.9, 42.8). Fifty-one (18%) of 285 women who were ever late for a study visit experienced virologic failure vs. 32 (12%) of 278 women who were never late for a study visit (OR 1.7; 95% CI 1.01, 2.8). A multivariate logistic regression model controlling for self-reported adherence found that being extremely late for a visit was associated with virologic failure (OR 2.0; 95% CI 1.2, 3.4). Timeliness to scheduled visits was associated with self-reported adherence to HAART and with risk for virologic failure. Timeliness to scheduled clinic visits can be used as an objective proxy for self-reported adherence and ultimately for risk of virologic failure.

Collecting self-reported data on adherence to highly active antiretroviral therapy (HAART) can be complicated by patients' reluctance to report poor adherence. The timeliness with which patients attend visits might be a useful alternative to estimate medication adherence. Among Kenyan and Zambian women receiving twice daily HAART, we examined the relationship between self-reported pill taking and timeliness attending scheduled visits. We analyzed data from 566 Kenyan and Zambian women enrolled in a prospective 48-week HAART-response study. At each scheduled clinic visit, women reported doses missed over the preceding week. Self-reported adherence was calculated by summing the total number of doses reported taken and dividing by the total number of doses asked about at the visit attended. A participant's adherence to scheduled study visits was defined as "on time" if she arrived early or within three days, "moderately late" if she was four-seven days late, and "extremely late/missed" if she was more than eight days late or missed the visit altogether. Self-reported adherence was <95% for 29 (10%) of 288 women who were late for at least one study visit vs. 3 (1%) of 278 who were never late for a study visit (odds ratios [OR] 10.3; 95% confidence intervals [95% CI] 2.9, 42.8). Fifty-one (18%) of 285 women who were ever late for a study visit experienced virologic failure vs. 32 (12%) of 278 women who were never late for a study visit (OR 1.7; 95% CI 1.01, 2.8). A multivariate logistic regression model controlling for self-reported adherence found that being extremely late for a visit was associated with virologic failure (OR 2.0; 95% CI 1.2, 3.4). Timeliness to scheduled visits was associated with self-reported adherence to HAART and with risk for virologic failure. Timeliness to scheduled clinic visits can be used as an objective proxy for self-reported adherence and ultimately for risk of virologic failure.

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.

This article reveals that the concept of education as a process of growth is a difficult one. Philosophers are, therefore, justified in being weary when pondering over its meaning, both in theory and practice. By way of conclusion, the article appreciates the complexities inherent in the growth theory of education, summarizing its major strength and weaknesses. Then it cautions educational planners and practitioners to be weary when, and if, they translate the theory into practice, so that they utilize the strengths inherent in the theory whilst paying attention to the dangers of its inherent weaknesses.

n/a

The book is written for graduates and undergraduates. It contains advices on how to improve grades in Universities and Colleges.It advises on how to prepare, effectively learn and retain im memory all required materials, and how to gain examination skills.

n/a

It has been stated that the future of trees is on-farm (Simons, 1997). This statement is likely to hold true because trends indicate that tree-planting on-farm is increasing, and because of the growing awareness of the need to grow trees on-farm in the future. Although uncertain it has been estimated that small farmers actually constitute a majority of tree planters, that the number of trees on-farm exceeds the number of trees in plantations, and that this gap tends to increase (Simons, 1997; FAO, 1997). Worldwide deforestation has been estimated at 12.6 mill ha or 0.7 % of the total forested area annually (FAO, 1997). Deforestation and forest degradation result in a dramatic loss of present and, as biodiversity is lost, future options for use of trees (Kjær & Nathan, 2000). This represents a serious problem at the global level but in particular to the millions of rural poor in tropical countries who are dependent on trees. Trees provide important products such as fuel wood, building material, food and fodder. Moreover, trees provide important services such as shade, shelter, erosion control, watershed protection, soil enrichment, etc. As alternative sources disappear, rural people will increasingly have to plant trees on their own land to cover their needs for these products and services in the future. Adoption of agroforestry innovations can increase agricultural production on a sustainable basis and hence improve food security for rural people. (ICRAF, 2000). In that perspective alone, rural people would benefit from planting more trees. Lack of seed and seedlings constitute a serious constraint for smallholders to fully utilise the benefits of trees (ICRAF, 2000; Johansson & Westman, 1992; Aalbæk, 2001). Even when planting material is available, it is often insufficient with regard to choice of species or provenance as well as genetic and physiological quality. It is important to use quality tree planting material for several reasons. First, the physiological quality of seeds and seedlings affects the success of establishment and the subsequent growth rate of the plant. Second, genetic quality is of great economic consequence (Foster, Jones & Kjær, 1995). The chosen material should be selected to suit local conditions and should be of sufficient genetically broad origin to ensure the stability, e.g. resistance against pests and diseases of the planted trees. Using quality plant material is one important avenue to ensure that farmers and other tree planters will gain from planting trees. Improvements, even very small improvements, in the productivity of trees will often be of great importance, especially to subsistence farmers who have invested some of their scarce resources in planting trees (Kjaer & Nathan, 2000).

A retrospective study of 42 patients with perforations of the oesophagus during the period 1981-1987 indicated that 57.1% of the perforations were iatrogenic. Diseases of the oesophagus and in contiguous structures and foreign bodies in the oesophagus caused perforations in 31% of the cases. Perforations in 35.7% of the patients were located in the middle third of the oesophagus. The lower and upper thirds were affected in 31% of the patients in each site. The presenting physical signs included tachycardia (78.6%), fever (76.2%) and dyspnoea (59.5%). The main accompanying symptoms were chest pain and coughs in 100% and in 50% of the patients respectively. Radiographic findings showed hydropneumothorax in 40.5% of the cases and consolidation in 38.1% of the patients. Oesophagoscopy was positive in 78% of cases tested while thoracocentesis was positive in all cases that were tested.

n/a

n/a

Gives guidelines on how to prepare and conduct research and write MBA project in time for graduation. It gives sugestions on how to sucessfuly present oral defense and how to answer question during such sessions.

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.

n/a

Valepotriates, mainly isovaltrate and valtrate, have been separated and quantitatively estimated by reversed-phase HPLC in the leaves, flowers, stems and rhizomes of Valeriana kilimandascharica. The isovaltrate/valtrate concentration reaches a maximum of 5.89% in the leaves, 3.84% in the flowers, 3.17% in the stems and 5.15% in the rhizomes.

.

Effective strategies are needed for the prevention of mother-to-child HIV transmission (PMTCT) in resource-limited settings. The Kisumu Breastfeeding Study was a single-arm open label trial conducted between July 2003 and February 2009. The overall aim was to investigate whether a maternal triple-antiretroviral regimen that was designed to maximally suppress viral load in late pregnancy and the first 6 mo of lactation was a safe, well-tolerated, and effective PMTCT intervention. METHODS AND FINDINGS: HIV-infected pregnant women took zidovudine, lamivudine, and either nevirapine or nelfinavir from 34-36 weeks' gestation to 6 mo post partum. Infants received single-dose nevirapine at birth. Women were advised to breastfeed exclusively and wean rapidly just before 6 mo. Using Kaplan-Meier methods we estimated HIV-transmission and death rates from delivery to 24 mo. We compared HIV-transmission rates among subgroups defined by maternal risk factors, including baseline CD4 cell count and viral load. Among 487 live-born, singleton, or first-born infants, cumulative HIV-transmission rates at birth, 6 weeks, and 6, 12, and 24 mo were 2.5%, 4.2%, 5.0%, 5.7%, and 7.0%, respectively. The 24-mo HIV-transmission rates stratified by baseline maternal CD4 cell count <500 and ≥500 cells/mm(3) were 8.4% (95% confidence interval [CI] 5.8%-12.0%) and 4.1% (1.8%-8.8%), respectively (p = 0.06); the corresponding rates stratified by baseline maternal viral load <10,000 and ≥10,000 copies/ml were 3.0% (1.1%-7.8%) and 8.7% (6.1%-12.3%), respectively (p = 0.01). None of the 12 maternal and 51 infant deaths (including two second-born infants) were attributed to antiretrovirals. The cumulative HIV-transmission or death rate at 24 mo was 15.7% (95% CI 12.7%-19.4%). CONCLUSIONS: This trial shows that a maternal triple-antiretroviral regimen from late pregnancy through 6 months of breastfeeding for PMTCT is safe and feasible in a resource-limited setting. These findings are consistent with those from other trials using maternal triple-antiretroviral regimens during breastfeeding in comparable settings.

The Education Act and the Secondary School Heads’ Manual recognize school heads as
the financial controllers and accounting officers, responsible for all school revenue and
expenditure management. Prior to reforms, procurement and tendering activities in
public institutions, including secondary schools, was carried out under unclear legal
frameworks, which failed to check irregularities arising from the process. Studies
commissioned by the government and the World Bank in 1986 and 1997 revealed
serious shortcomings in the procurement system, leading to loss of public funds.
Procurement reforms were initiated to enhance efficiency and minimize loss of public
resources. Even though the reforms process was initiated about a decade earlier, little
had been documented about the extent to which the regulations had been implemented
in public secondary schools and its effect on expenditure management. To achieve the
objective of this study, a cross-sectional survey design, with quantitative and qualitative
approaches was applied to guide data sourcing, processing and analysis. Primary data
was sourced from 117, which were sampled from a national population of 3,868 schools
that have been in existence for at least ten years as at the time of this study. The sample
included 6 national, 42 provincial and 69 district schools. In terms of gender, 23 were
pure girls’ schools, 19 were boys’ schools, while 75 were mixed schools. The schools
were selected through a stratified random procedure, based on the category of schools;
viz. national, provincial or district. Both quantitative and qualitative approaches were
applied to process and analyze the data. The study found that advertising tenders,
number of committee members trained in procurement had strong positive effects on
expenditure efficiency. Besides, the frequency of tender-splitting had the strongest
negative effect on expenditure efficiency. The adjusted regression models explained 45.1
percent of variance in expenditure management. The study recommends the need for:
procurement regulations to be reviewed for tender committees to include BoG, PTA
and ministry representatives; regular supervision of tender committees by the ministry
officials; training of tender committee members; technical and financial evaluation
committees to be created to enhance efficiency.

The C868T single nucleotide polymorphism (SNP) in the CD4 receptor encodes an amino acid change that could alter its structure and influence human immunodeficiency virus (HIV-1) infection risk. HIV-1-infected pregnant women in Nairobi were followed with their infants for 1 year postpartum. Among 131 infants, those with the 868T allele were more likely than wild-type infants to acquire HIV-1 overall [hazard ratio (HR) = 1.92, 95% confidence interval (CI) 1.05, 3.50, P = 0.03; adjusted HR = 2.03, 95% CI 1.03, 3.98, P = 0.04], after adjusting for maternal viral load. This SNP (an allele frequency of approximately 15% in our cohort) was associated with increased susceptibility to mother-to-child HIV-1 transmission, consistent with a previous study on this polymorphism among Nairobi sex workers.

n/a

This study set out to examine the policy position in Kenyan health care financing, with regard to implementation of the proposed social health scheme (NSHIF) and its performance potential. The specific objectives were to: examine the existing social scheme (NHIF), its role and challenges in health care financing; establish whether or not Kenya has the key pre-requisites for introduction and sustainability of a social health scheme and to provide recommendations on the way forward. This was largely a desk study, supplemented with limited primary data from key informants. The analysis indicates that: i) For a universal social health plan to be sustainable, favorable economic indicators and availability of essential infrastructures are critical prerequisites. Resources must be available, government must be in a position to afford high subsidies, the population must be ready to pay high premiums and the supply of health services must be adequate to cater for the expected increase in demand; ii) Countries that have successfully embraced social health plans introduced their schemes carefully and gradually (overtime) in terms of coverage; iii) Kenya compares unfavorably with these countries in terms of prerequisites for sustainability of a social health scheme, due largely to a poor economy, high poverty levels and shortfalls in facilities and services. The study concludes that Kenya lacks the key prerequisites for introducing and sustaining a universal social health scheme. The scheme can hardly be supported by the current status of the economy and healthcare infrastructures. The study recommends: i) Expansion and development of health care infrastructural capacities through subsidies and tax concessions for those investing in health care and providing subsidized services, particularly to the poor and rehabilitation of the GoK facilities; ii) Increasing the health budget from 7 per cent of government expenditure to above 10 per cent and directing more resources and efforts towards preventive/promotive and primary health care (P&PH); and iii) Other recommendations include subjecting the proposed scheme to an actuarial evaluation and comprehensive policy plan in order to determine the attendant and corresponding premium and benefit levels and pursuing a phased approach in the implementation of the scheme.

n/a

The identification of five novel compounds, pseudo-erythromycin A-6,9-hemiketal, 8,9-anhydro-pseudo-erythromycin A-6,9-hemiketal, 8,9-anhydro-pseudo-N-demethylerythromycin A-6,9-hemiketal, 5-O-beta-D-desosaminylerythronolide A and 15-nor-erythromycin C, in mother liquor concentrates of Streptomyces erythraeus is described. The pseudo-erythromycin derivatives are characterized by a 12-membered macrocyclic ring as a result of C13––C11 trans-lactonization. The five compounds have very little antimicrobial activity.

Choline acetyltransferase (EC 2.3.1.6) catalyzes the biosynthesis of acetylcholine according to the following chemical equation: acetyl-CoA + choline in equilibrium to acetylcholine + CoA. In addition to nervous tissue, primate placenta is the only other animal source which contains appreciable acetylcholine and its biosynthetic enzyme. Human brain caudate nucleus and human placental choline acetyltransferase were purified to electrophoretic homogeneity using ion-exchange and blue dextran-Sepharose affinity chromatography. The molecular weights determined by Sephadex G-150 gel filtration and sodium dodecyl sulfate gel electrophoresis are 67000 plus or minus 3000. N-Ethylmaleimide, p-chloromercuribenzoate, and dithiobis(2-nitrobenzoic acid) inhibit the enzyme. Dithiothreitol reverses the inhibition produced by the latter two reagents. The pKa of the group associated with N-ethylmaleimide inhibition is 8.6 plus or minus 0.3. A chemically competent acetyl-thioenzyme is isolable by Sephadex gel filtration. The enzymes from the brain and placenta are thus far physically and biochemically indistinguishable.

Major national and international critiques of the medical curriculum in the 1980s noted the following significant flaws: (1) over-reliance on learning by rote memory, (2) insufficient exercise in analysis and synthesis/conceptualization, and (3) failure to connect the basic and clinical aspects of training. It was argued that the invention of computers and related imaging techniques called to question the traditional instruction based on the faculty-centered didactic lecture. In the ensuing reform, which adopted case-based, small group, problem-based learning, time allotted to anatomical instruction was severely truncated. Many programs replaced dissection with prosections and computer-based learning. We argue that cadaver dissection is still necessary for (1) establishing the primacy of the patient, (2) apprehension of the multidimensional body, (3) touch-mediated perception of the cadaver/patient, (4) anatomical variability, (5) learning the basic language of medicine, (6) competence in diagnostic imaging, (7) cadaver/patient-centered computer-assisted learning, (8) peer group learning, (9) training for the medical specialties. Cadaver-based anatomical education is a prerequisite of optimal training for the use of biomedical informatics. When connected to dissection, medical informatics can expedite and enhance preparation for a patient-based medical profession. Actual dissection is equally necessary for acquisition of scientific skills and for a communicative, moral, ethical, and humanistic approach to patient care. Anat Rec (New Anat) 269:20-32, 2002.

INTRODUCTION: Nourishment for the brain, a highly vascular organ, is derived from a unique structure called the 'circle of Willis', which is formed by the terminal branches of the internal carotid arteries (ICAs) and basilar arteries (BAs). The circle of Willis forms an anastomotic link between the carotid and vertebrobasilar systems in the arterial supply of the brain, while the BA forms an important component of the brain's posterior circulation and supplies its many vital parts. METHODS: A study was performed on 20 brain specimens used for routine dissections at the Anatomy Department, Kasturba Medical College, in order to examine the morphology of BAs in the brain. RESULTS: In most specimens, the position of the termination of BA was normal, although variations were present in the mode of termination. In one specimen, the BA terminated by dividing into two superior cerebellar arteries. The posterior cerebral arteries (PCAs) arose from ICAs on both sides in this specimen, and a communicating branch was present between the terminal point of the BA and PCA on the left. In another specimen, unilateral variation was seen, with the PCA arising from the ICA on the right and a posterior communicating artery arising from the PCA, connecting it with the BA. The anatomy on the left side was normal. CONCLUSION: We highlight the morphological aspects of the BA, the knowledge of which would help neurosurgeons safely diagnose, as well as plan and execute vascular bypass and shunting procedures for the treatment of stenosis, aneurysms and arteriovenous malformations in the posterior cranial fossa.

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

The objective of the study was to determine the extent to which the Kenyan National Social Security Fund (NSSF) had adopted the Human Capital Management (HCM) practices. The HCM practices that were explored include: resourcing, retention and flexibility strategies, talent management, learning and development, management succession planning, performance and reward management strategies.
The study used the case study design that was based on a target population of 98 management
staff in the human resource and administration department. A sample of forty eight (48) officers
was selected. The sample included eight senior officers who were selected on the basis of their
status and position in the said department, while the rest were selected through the stratified
sampling technique. Data collection instruments used by the study were an interview guide and a
questionnaire. However, a substantial amount of data was collected through documentary
analysis. A response rate of 82.5% was achieved by the questionnaire technique, while six of the
eight senior officers sampled were interviewed. Both content and quantitative analysis were used
to analyze data which was then presented in frequency tables, bar graphs, percentages, rank
ordering, and mean scores and standard deviation.
Overall, the findings of the study indicate that the organization has implemented HCM practices,
but to a negligible extent. Some of the HCM practices adopted by the organization include:
enhancing the organization’s capacity through staff training and development; setting of clear
performance standards; explaining its mission, vision, and values to employees; outsourcing of
non- core activities; and flexibility of staff mortgage and car loan schemes. However, the rest of
the practices have either not been adopted or are adopted to a negligible extent.
The study suggests that there is need for further research particularly in the area of human capital
measurement owing to the fact that, there is hardly any literature available on it.
Key Words- Human capital management, competitive advantage, digital technology, digital
economy, human capital advantage, intangible assets and human capital planning.

The objective of the study was to determine the relationship between human capital management (HCM) practices and performance of commercial banks in Kenya. It was carried out using a cross sectional survey design as well as a correlation research. The study population and sample was 45 commercial banks. A total of 23 banks took part in the final survey. The primary data was generated through questionnaires whose respondents were head of human resource departments in banks while secondary data was sought from the financial statements of banks by means of content analysis. In order to test for the relationship between HCM practices and firm performance, the ordinary least squares (OLS) method was used to perform a regression analysis.
The investigation established that the most used human capital management practices were in
recruitment excellence, collegial and flexible work place and rewards and accountability. The least used practice was communications integrity. The study also noted that with the exception of communication, other human capital management practices had a positive influence on turnover growth. It is concluded that most commercial banks adopt human capital management practices to an average degree. The study further concludes that human capital management practices generally have a positive influence on performance as measured by both turnover growth and return on assets. The study recommends that there is need for commercial banks in Kenya to enhance the human capital management practices.
Key Words- Human capital management, competitive advantage, technological change, human
capital advantage, intangible assets, organizational performance and human capital

JASPA Working Paper, ILO, Addis Ababa

Abstract

The development of the Cenozoic East African Rift System (EARS) profoundly re-shaped the landscape and significantly increased the amplitude of short-term environmental response to climate variation. In particular, the development of amplifier lakes in rift basins after three million years ago significantly contributed to the exceptional sensitivity of East Africa to climate change compared to elsewhere on the African continent. Amplifier lakes are characterized by tectonically-formed graben morphologies in combination with an extreme contrast between high precipitation in the elevated parts of the catchment and high evaporation in the lake area. Such amplifier lakes respond rapidly to moderate, precessional-forced climate shifts, and as they do so apply dramatic environmental pressure to the biosphere. Rift basins, when either extremely dry or lake-filled, form important barriers for migration, mixing and competition of different populations of animals and hominins. Amplifier lakes link long-term, high-amplitude tectonic processes and short-term environmental fluctuations. East Africa may have become the place where early humans evolved as a consequence of this strong link between different time scales.

{ OBJECTIVES: To study the effect of acute stress, caused by intrauterine needling at the intrahepatic vein (IHV), on fetal plasma concentrations of corticotrophin releasing hormone (CRH), and to compare paired fetal and maternal samples for CRH concentration to determine the extent of their joint control. DESIGN: Venous blood samples were obtained from fetuses (gestational age 17-38 weeks) undergoing fetal blood sampling (n = 29) or intrauterine transfusion (n = 17) through either the IHV or the placental cord insertion (PCI). SETTING: The Centre for Fetal Care, Queen Charlotte's and Chelsea Hospital, London, UK. PATIENTS: Pregnant women undergoing clinically indicated fetal blood sampling or intrauterine blood/platelet transfusion. RESULTS: Fetal plasma cortisol increased with intrahepatic vein transfusion (mean (SD) cortisol response Delta64.7 (54.5) nmol/l; p < 0.0001

Background. The host immune response against mucosally-acquired pathogens may be influenced by the mucosal immune milieu during acquisition. Since Neisseria gonorrhoeae can impair dendritic cell and T cell immune function, we hypothesized that co-infection during HIV acquisition would impair subsequent systemic T-cell responses.   Methods. Monthly screening for sexually transmitted infections (STIs) was performed in high risk, HIV seronegative Kenyan female sex workers as part of an HIV prevention trial. Early HIV-specific CD8+ T cell responses and subsequent HIV viral load set point were assayed in participants acquiring HIV, and were correlated with the presence of prior genital infections during HIV acquisition.   Results. Thirty-five participants acquired HIV during follow up, and 16/35 (46%) had a classical STI at the time of acquisition. N. gonorrhoeae co-infection was present during HIV acquisition in 6/35 (17%), and was associated with an increased breadth and magnitude of systemic HIV-specific CD8+ T-cell responses, using both interferon- (IFNg) and MIP-1 beta (MIP1b) as an output. No other genital infections were associated with differences in HIV-specific CD8+ T cell response, and neither N. gonorrhoeae nor other genital infections were associated with differences in HIV plasma viral load at set point.   Conclusion. Unexpectedly, genital N. gonorrhoeae infection during heterosexual HIV acquisition was associated with substantially enhanced HIV-specific CD8+ T-cell responses, although not with differences in HIV viral load set point. This may have implications for the development of mucosal HIV vaccines and adjuvants.

Highly active antiretroviral therapy (HAART) is widely accessible to human immunodeficiency virus (HIV)-infected individuals in Kenya. Their long term use is associated with chronic complications such as lipodystrophy which may lead to stigmatization, reduced self esteem and poor adherence to HAART. This cross-sectional study described the prevalence of lipodystrophy, the phenotypes and severity among adult HIV infected patients on chronic HAART at a HIV clinic in Kenya. Data were collected using an investigator administered questionnaire and anthropometric measurements done using a protocol based on the Third National Health and Nutrition Examination Survey. The prevalence of lipodystrophy was 51.3% (confidence interval (CI) 45.6 to 57.6). Lipoatrophy occurred in 44%, lipohypertrophy in 15% and mixed syndrome in 41% of patients with lipodystrophy. Facial atrophy occurred in 75.7% of patients with lipodystrophy, upper limb atrophy in 48.5%, and lower limb atrophy in 36.8%. Abdominal obesity occurred in 40.4% of patients with lipodystrophy, breast enlargement in 30.9% and dorsocervical fat accumulation in 5.1%. Most patients had severe lipoatrophy, whereas lipohypertrophy was described as mild to moderate using the HIV out-patient study (HOPS) scale. HIV associated lipodystrophy was common in HIV-infected patients on chronic HAART. The main phenotype was lipoatrophy which majority of the patients described as severe.

Highly active antiretroviral therapy (HAART) is widely accessible to human immunodeficiency virus (HIV)-infected individuals in Kenya. Their long term use is associated with chronic complications such as lipodystrophy which may lead to stigmatization, reduced self esteem and poor adherence to HAART. This cross-sectional study described the prevalence of lipodystrophy, the phenotypes and severity among adult HIV infected patients on chronic HAART at a HIV clinic in Kenya. Data were collected using an investigator administered questionnaire and anthropometric measurements done using a protocol based on the Third National Health and Nutrition Examination Survey. The prevalence of lipodystrophy was 51.3% (confidence interval (CI) 45.6 to 57.6). Lipoatrophy occurred in 44%, lipohypertrophy in 15% and mixed syndrome in 41% of patients with lipodystrophy. Facial atrophy occurred in 75.7% of patients with lipodystrophy, upper limb atrophy in 48.5%, and lower limb atrophy in 36.8%. Abdominal obesity occurred in 40.4% of patients with lipodystrophy, breast enlargement in 30.9% and dorsocervical fat accumulation in 5.1%. Most patients had severe lipoatrophy, whereas lipohypertrophy was described as mild to moderate using the HIV out-patient study (HOPS) scale. HIV associated lipodystrophy was common in HIV-infected patients on chronic HAART. The main phenotype was lipoatrophy which majority of the patients described as severe.

Highly active antiretroviral therapy (HAART) is widely accessible to human immunodeficiency virus (HIV)-infected individuals in Kenya. Their long term use is associated with chronic complications such as lipodystrophy which may lead to stigmatization, reduced self esteem and poor adherence to HAART. This cross-sectional study described the prevalence of lipodystrophy, the phenotypes and severity among adult HIV infected patients on chronic HAART at a HIV clinic in Kenya. Data were collected using an investigator administered questionnaire and anthropometric measurements done using a protocol based on the Third National Health and Nutrition Examination Survey. The prevalence of lipodystrophy was 51.3% (confidence interval (CI) 45.6 to 57.6). Lipoatrophy occurred in 44%, lipohypertrophy in 15% and mixed syndrome in 41% of patients with lipodystrophy. Facial atrophy occurred in 75.7% of patients with lipodystrophy, upper limb atrophy in 48.5%, and lower limb atrophy in 36.8%. Abdominal obesity occurred in 40.4% of patients with lipodystrophy, breast enlargement in 30.9% and dorsocervical fat accumulation in 5.1%. Most patients had severe lipoatrophy, whereas lipohypertrophy was described as mild to moderate using the HIV out-patient study (HOPS) scale. HIV associated lipodystrophy was common in HIV-infected patients on chronic HAART. The main phenotype was lipoatrophy which majority of the patients described as severe.

Background. The host immune response against mucosally-acquired pathogens may be influenced by the mucosal immune milieu during acquisition. Since Neisseria gonorrhoeae can impair dendritic cell and T cell immune function, we hypothesized that co-infection during HIV acquisition would impair subsequent systemic T-cell responses.   Methods. Monthly screening for sexually transmitted infections (STIs) was performed in high risk, HIV seronegative Kenyan female sex workers as part of an HIV prevention trial. Early HIV-specific CD8+ T cell responses and subsequent HIV viral load set point were assayed in participants acquiring HIV, and were correlated with the presence of prior genital infections during HIV acquisition.   Results. Thirty-five participants acquired HIV during follow up, and 16/35 (46%) had a classical STI at the time of acquisition. N. gonorrhoeae co-infection was present during HIV acquisition in 6/35 (17%), and was associated with an increased breadth and magnitude of systemic HIV-specific CD8+ T-cell responses, using both interferon- (IFNg) and MIP-1 beta (MIP1b) as an output. No other genital infections were associated with differences in HIV-specific CD8+ T cell response, and neither N. gonorrhoeae nor other genital infections were associated with differences in HIV plasma viral load at set point.   Conclusion. Unexpectedly, genital N. gonorrhoeae infection during heterosexual HIV acquisition was associated with substantially enhanced HIV-specific CD8+ T-cell responses, although not with differences in HIV viral load set point. This may have implications for the development of mucosal HIV vaccines and adjuvants.

The factors responsible for the explosive spread of human immunodeficiency virus type 1 (HIV-1) in sub-Saharan Africa continue to be identified and debated. One of the most controversial factors has been male circumcision. This cross-sectional study was conducted to measure the association between circumcision status and infection with HIV-1 among men with genital ulcer disease. Eight hundred and ten men participated in the study, of whom 190 (23%) were HIV-1-positive. A logistic regression model adjusted for behavioral and historical showed that HIV-1 positivity was independently associated with being uncircumcised (adjusted odds ratio [OR], 4.8; 95% confidence interval [CI], 3.3-7.2) and with a history of urethral discharge (adjusted OR, 2.0; 95% CI, 1.4-2.8). This association could not be explained by measures of sexual exposure to HIV-1 among this population. Male circumcision should be considered as an intervention strategy for AIDS control.

Three cases of HIV infection with choriocarcinoma are presented. One case had prolonged chemotherapy without remission, the second had remission only after combining hysterectomy with chemotherapy and the third who had extensively metastatic disease in the presence of other low risk factors are reported. HIV infection may predispose patients to extensive metastatic choriocarcinoma and influence the course of treatment. We propose that HIV infection be considered a poor prognostic risk for gestation trophoblastic neoplasias

Three cases of HIV infection with choriocarcinoma are presented. One case had prolonged chemotherapy without remission, the second had remission only after combining hysterectomy with chemotherapy and the third who had extensively metastatic disease in the presence of other low risk factors are reported. HIV infection may predispose patients to extensive metastatic choriocarcinoma and influence the course of treatment. We propose that HIV infection be considered a poor prognostic risk for gestation trophoblastic neoplasias

The factors responsible for the explosive spread of human immunodeficiency virus type 1 (HIV-1) in sub-Saharan Africa continue to be identified and debated. One of the most controversial factors has been male circumcision. This cross-sectional study was conducted to measure the association between circumcision status and infection with HIV-1 among men with genital ulcer disease. Eight hundred and ten men participated in the study, of whom 190 (23%) were HIV-1-positive. A logistic regression model adjusted for behavioral and historical showed that HIV-1 positivity was independently associated with being uncircumcised (adjusted odds ratio [OR], 4.8; 95% confidence interval [CI], 3.3-7.2) and with a history of urethral discharge (adjusted OR, 2.0; 95% CI, 1.4-2.8). This association could not be explained by measures of sexual exposure to HIV-1 among this population. Male circumcision should be considered as an intervention strategy for AIDS control.

J Infect Dis. 1993 Jun;167(6):1414-7.
Human immunodeficiency virus infection among high-risk seronegative prostitutes in Nairobi.
Willerford DM, Bwayo JJ, Hensel M, Emonyi W, Plummer FA, Ngugi EN, Nagelkerke N, Gallatin WM, Kreiss J.
Source
Division of Basic Sciences, Fred Hutchinson Cancer Research Center, Seattle.
Abstract
To determine the frequency and duration of antibody-negative human immunodeficiency virus (HIV) infection among heterosexually exposed African women, 56 HIV-seronegative female prostitutes in Nairobi were studied. Polymerase chain reaction (PCR) was used to detect HIV DNA in peripheral blood at enrollment, and women were followed prospectively with serologic testing to determine HIV seroincidence. Six women (11%) were infected with HIV by PCR criteria at enrollment. Seroconversion occurred in 5 of these subjects within 1-12 months, while the sixth remained seronegative when last evaluated at 5 months. The cumulative annual seroconversion rate in the entire cohort was 38%. Using maximum likelihood analysis, the mean interval between HIV infection and seroconversion was estimated to be between 3 and 4 months, similar to that described for homosexual men and blood product recipients in the United States. Prolonged HIV infection in the absence of antibodies appears to be uncommon in this setting.
PMID:
8501333
[PubMed - indexed for MEDLINE]

The factors responsible for the explosive spread of human immunodeficiency virus type 1 (HIV-1) in sub-Saharan Africa continue to be identified and debated. One of the most controversial factors has been male circumcision. This cross-sectional study was conducted to measure the association between circumcision status and infection with HIV-1 among men with genital ulcer disease. Eight hundred and ten men participated in the study, of whom 190 (23%) were HIV-1-positive. A logistic regression model adjusted for behavioral and historical showed that HIV-1 positivity was independently associated with being uncircumcised (adjusted odds ratio [OR], 4.8; 95% confidence interval [CI], 3.3-7.2) and with a history of urethral discharge (adjusted OR, 2.0; 95% CI, 1.4-2.8). This association could not be explained by measures of sexual exposure to HIV-1 among this population. Male circumcision should be considered as an intervention strategy for AIDS control.

The factors responsible for the explosive spread of human immunodeficiency virus type 1 (HIV-1) in sub-Saharan Africa continue to be identified and debated. One of the most controversial factors has been male circumcision. This cross-sectional study was conducted to measure the association between circumcision status and infection with HIV-1 among men with genital ulcer disease. Eight hundred and ten men participated in the study, of whom 190 (23%) were HIV-1-positive. A logistic regression model adjusted for behavioral and historical showed that HIV-1 positivity was independently associated with being uncircumcised (adjusted odds ratio [OR], 4.8; 95% confidence interval [CI], 3.3-7.2) and with a history of urethral discharge (adjusted OR, 2.0; 95% CI, 1.4-2.8). This association could not be explained by measures of sexual exposure to HIV-1 among this population. Male circumcision should be considered as an intervention strategy for AIDS control.

The factors responsible for the explosive spread of human immunodeficiency virus type 1 (HIV-1) in sub-Saharan Africa continue to be identified and debated. One of the most controversial factors has been male circumcision. This cross-sectional study was conducted to measure the association between circumcision status and infection with HIV-1 among men with genital ulcer disease. Eight hundred and ten men participated in the study, of whom 190 (23%) were HIV-1-positive. A logistic regression model adjusted for behavioral and historical showed that HIV-1 positivity was independently associated with being uncircumcised (adjusted odds ratio [OR], 4.8; 95% confidence interval [CI], 3.3-7.2) and with a history of urethral discharge (adjusted OR, 2.0; 95% CI, 1.4-2.8). This association could not be explained by measures of sexual exposure to HIV-1 among this population. Male circumcision should be considered as an intervention strategy for AIDS control.

Human immunodeficiency virus seroconversion in late pregnancy: Effects on pregnancy and childbirth in Kenya

Background: In Kenya, there is limited empirical data on effects of seroconversion in pregnancy and child birth due to low uptake of HIV retesting despite there being a policy directive to do so.
Objectives: To determine the effect of seroconversion in late pregnancy regarding pregnancy and childbirth among women seeking delivery services in Kakamega County Hospital and Pumwani Maternity Hospital.
Methodology: A ten month quasi experimental longitudinal study design was employed whereby 1,156 respondents consecutively sampled.
Results: HIV seroconverters had a higher chance of developing premature rupture of membranes, hemorrhage and puerperal sepsis than HIV negative women. The incidence of Mother to Child Transmission of HIV among exposed newborns was 0.09%. There was a statistically significant relationship between PEP administration, infant morbidity and mortality.
Conclusion: HIV seroconversion was associated with complications during delivery. Recommendations: There’s need to intensify retesting in late pregnancy as well as skilled birth attendance among the women seroconverting in late pregnancy.

Human immunodeficiency Virus seroconversion: Rate and Retesting uptake. A case of Kakamega and Nairobi Counties, Kenya
Background: There is limited empirical data on the prevalence of Human Immunodeficiency Virus (HIV) seroconversion in late pregnancy due to the fact that majority of the women start seeking antenatal care late in pregnancy therefore rarely retest. This leaves a gap in the Elimination of Mother to Child Transmission (eMTCT) strategy thus contributing to high maternal and neonatal morbidity and mortality rates in Kenya.
Objectives: To establish the rate of HIV retesting uptake in late pregnancy and HIV seroconversion rate among women attending Antenatal Clinics in Pumwani Maternity Hospital and Kakamega County Hospital.
Methodology: A longitudinal study design was employed; 1,117 women confirmed as HIV negative in early pregnancy were followed up for three months and retested to ascertain their serostatus. Sample size was obtained through Census and consecutive sampling to recruit individual respondents. Clearance to conduct the study was sought from Ethics Review Committee, Pumwani and Kakamega County Hospitals and the respondents. Researcher administered questionnaires and HIV testing was done for data collection. Descriptive data involved calculation of measures of central tendency. Findings were presented in tables, graphs and narrative.
Results: HIV retesting uptake was 1,073 (96%) and the rate of HIV serocopositivity among initially HIV negative pregnant women that retested was 8 (0.75%).
Conclusion: HIV retesting uptake is very impressive and the rate of HIV seroconversion is very low. Kenya has made good progress towards eMTCT of HIV.

OBJECTIVE: To determine the pattern of growth and development of institutionalised infants and to compare the outcome with that of infants living with their biological mothers. DESIGN: A cross-sectional survey. SETTING: Seven children's homes; Kenyatta National Hospital's New Born Unit and Well Baby Clinics in Nairobi, Kenya. PARTICIPANTS: Eighty-two abandoned babies who fulfilled the selection criteria were recruited and for each abandoned baby two mothered babies matched for age and sex were selected from the well baby clinics. MAIN OUTCOME MEASURES: Anthropometric measures of weight, length, head circumference and left mid arm circumference (LUMAC) were taken and the mean values and Z scores determined to demonstrate growth pattern and nutritional status of the babies. The Revised Denver Development Screening Test (RDDST) was used to assess the development pattern of infants. RESULTS: Seventy per cent of infants were below six months old and 73% were abandoned within the first week of life. Abandoned babies were significantly thinner with the mean LUMAC of 10.8 cm versus 12.3 cm (p = 0.02) Institutionalised babies were significantly wasted (p = 0.00001) and stunted (p = 0.00001). Abandoned babies were significantly delayed in development (p < 0.0001). In all the four sectors tested for, institutionalised babies showed significant delay, p < 0.0001 in each sector. CONCLUSION: This study demonstrates that infants under institutional care have poorer growth and development compared to mothered infants. PIP: This cross-sectional study examined the pattern of growth and development of infants in some of the baby institutions in Nairobi and compared the outcome with that of infants living with their biological mothers. The participating institutions included the Kenyatta National Hospital and 7 children's homes within the city. The study recruited 82 abandoned babies aged 1-18 months who had been abandoned for at least 2 weeks. Each abandoned baby was paired with 2 mothered babies matched for age and sex. Anthropometric measures of weight, length, head circumference, and left mid arm circumference (LUMAC) were taken. The mean values and Z scores were determined to assess growth pattern and nutritional status of the babies. The results showed that abandoned babies were significantly thinner, with a mean LUMAC of 10.8 cm vs. 12.3 cm. Moreover, abandoned babies were significantly wasted (p = 0.00001), stunted (p = 0.00001), and delayed in development (p 0.0001). These findings indicate that institutionalized infants have poorer growth and development compared to mothered infants.

The factors responsible for the explosive spread of human immunodeficiency virus type 1 (HIV-1) in sub-Saharan Africa continue to be identified and debated. One of the most controversial factors has been male circumcision. This cross-sectional study was conducted to measure the association between circumcision status and infection with HIV-1 among men with genital ulcer disease. Eight hundred and ten men participated in the study, of whom 190 (23%) were HIV-1-positive. A logistic regression model adjusted for behavioral and historical showed that HIV-1 positivity was independently associated with being uncircumcised (adjusted odds ratio [OR], 4.8; 95% confidence interval [CI], 3.3-7.2) and with a history of urethral discharge (adjusted OR, 2.0; 95% CI, 1.4-2.8). This association could not be explained by measures of sexual exposure to HIV-1 among this population. Male circumcision should be considered as an intervention strategy for AIDS control.

n/a

n/a

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

Background. The host immune response against mucosally-acquired pathogens may be influenced by the mucosal immune milieu during acquisition. Since Neisseria gonorrhoeae can impair dendritic cell and T cell immune function, we hypothesized that co-infection during HIV acquisition would impair subsequent systemic T-cell responses.   Methods. Monthly screening for sexually transmitted infections (STIs) was performed in high risk, HIV seronegative Kenyan female sex workers as part of an HIV prevention trial. Early HIV-specific CD8+ T cell responses and subsequent HIV viral load set point were assayed in participants acquiring HIV, and were correlated with the presence of prior genital infections during HIV acquisition.   Results. Thirty-five participants acquired HIV during follow up, and 16/35 (46%) had a classical STI at the time of acquisition. N. gonorrhoeae co-infection was present during HIV acquisition in 6/35 (17%), and was associated with an increased breadth and magnitude of systemic HIV-specific CD8+ T-cell responses, using both interferon- (IFNg) and MIP-1 beta (MIP1b) as an output. No other genital infections were associated with differences in HIV-specific CD8+ T cell response, and neither N. gonorrhoeae nor other genital infections were associated with differences in HIV plasma viral load at set point.   Conclusion. Unexpectedly, genital N. gonorrhoeae infection during heterosexual HIV acquisition was associated with substantially enhanced HIV-specific CD8+ T-cell responses, although not with differences in HIV viral load set point. This may have implications for the development of mucosal HIV vaccines and adjuvants.

Abstract
T cell responses against HIV-1 have been identified in a number of exposed uninfected populations. We hypothesized that the ability to mount an effective T cell response is partly determined by the human leucocyte antigens (HLA) phenotype of the individual. We examined whether certain HLA supertypes were associated with differential HIV-1 susceptibility in sexually exposed adults and in the setting of mother to child HIV-1 transmission. By multivariate analysis, decreased HIV-1 infection risk was strongly associated with possession of a cluster of closely related class I HLA alleles (A2/6802 supertype) in sexually exposed adults (Hazard ratio=0.42, 95% confidence intervals (CI): 0.22-0.81, P=0.009) and perinatally exposed infants (Odds ratio=0.12, 95% CI: 0.03-0.54, P=0.006). The alleles in this HLA supertype are known in some cases, to present the same peptide epitopes (termed 'supertopes'), for T cell recognition. The identification of HIV-1 supertopes, which are associated with protection from HIV-1 infection, has important implications for the application of epitope-based HIV-l vaccines in a variety of racial groups.

{ T cell responses against HIV-1 have been identified in a number of exposed uninfected populations. We hypothesized that the ability to mount an effective T cell response is partly determined by the human leucocyte antigens (HLA) phenotype of the individual. We examined whether certain HLA supertypes were associated with differential HIV-1 susceptibility in sexually exposed adults and in the setting of mother to child HIV-1 transmission. By multivariate analysis, decreased HIV-1 infection risk was strongly associated with possession of a cluster of closely related class I HLA alleles (A2/6802 supertype) in sexually exposed adults (Hazard ratio=0.42, 95% confidence intervals (CI): 0.22-0.81

This was a descriptive study which utilized the medical record
s for the kidney donors and recipients who had
been followed up
in
the kidney transplantation programme in Kenyatta National Hospital, Nairobi, Kenya.
Tissue typing is rarely performed routinely among our patients partially due to cost. It is with this in
mind that
we engaged in extraction of more information from the tissue typing data which have been used in kidney
transplantation programme in Kenyatta National Hospital, Nairobi Kenya. The data were extracted from the
medical records of patients who had undergone tissue typing for renal transplantation and were on follow up at
Kenyatta National Hospital. The study had been cleared by the Kenyatta National Hospital/University of
Nairobi Ethics Research Committee, number, P485/9/2013.
The medical records had tissue typing done from 2008 and 2013.
A total of 269 individuals’ human leucocyte
antigen typing were
utilized
. They comprised 134 kidney graft recipients
and 135 donors records
. T
he typing
had been performed using
serology
for class I and polymerase chain reaction for Class II respectively. The data
were analysed using Statistical Program for Social Sciences, calculating the frequencies of each individual for
HLA specificity and expressing it as a percentage of the total popu
lation of 269 individuals. For s
ome genes and
alleles associated
with
type 1 diabetes (
DRB1
*03, DRB1*04 and DQB1*02)
, there were 184/269 (68.4%) of
individual
s who carried genes and al
leles.
Eighty four (84) individuals had HLA
-DRB1*03 allele, 22 had
DRB1*04 while 78 had DQB1*02. Among 135 kidney graft donors, 39 (28.90%) carried HLA
-DRB1*03 and
14 (10.40%) carried DRB1*04. Among 134 kidney graft recipients, 45 (33.57%) had HLA
-DRB1*03
and 13
(9.70%) had HLA
-DRB1*04. Thirt
y-six (26.87%) had HLA
-DQB1*02.
There is increase in the prevalence of diabetes mellitus among other non
-communicable condition
s world over.
Diabetes has both nature and nurture as players for its causation. Genetics w
hich include human leucocyte
antigens have been liked with diabetes. Among our study population, HLA
-DRB1
*03, HLA
-DRB1*04 and
HLA-
DQB1*02 were prevalent and this may guide surveillance and care for both donors and recipients, as well
as inform the
care of our wider population.

This was a descriptive study which utilized the medical records for the kidney donors and recipients who had been followed up in the kidney transplantation programme in Kenyatta National Hospital, Nairobi, Kenya. Tissue typing is rarely performed routinely among our patients partially due to cost. It is with this in mind that we engaged in extraction of more information from the tissue typing data which have been used in kidney transplantation programme in Kenyatta National Hospital, Nairobi Kenya.

Abstract
Human leukocyte antigen (HLA) molecules regulate the cellular immune system and may be determinants of infant susceptibility to human immunodeficiency virus type 1 (HIV-1) infection. Molecular HLA typing for class I alleles was performed on infants followed in a Kenyan perinatal cohort. Early HIV-1 infection status was defined as infection occurring at birth or month 1, while late infection via breast milk was defined as first detection of HIV-1 after 1 month of age. Likelihood ratio tests based on a proportional hazards model adjusting for maternal CD4 T cell count and HIV-1 viral load at 32 weeks of gestation were used to test associations between infant allelic variation and incident HIV-1 infection. Among 433 infants, 76 (18%) were HIV-1 infected during 12 months of follow-up. HLA B*18 was associated with a significantly lower risk of early HIV-1 transmission [relative risk (RR) = 0.26; 95% confidence interval (CI) 0.04–0.82], and none of the 24 breastfeeding infants expressing HLA B*18 who were uninfected at month 1 acquired HIV-1 late via breast milk. We observed a trend toward increased early HIV-1 acquisition for infants presenting HLA A*29 (RR = 2.0; 95% CI 1.0–3.8) and increased late HIV-1 acquisition via breast milk for both Cw*07 and Cw*08 (RR = 4.0; 95% CI 1.0–17.8 and RR = 7.2; 95% CI 1.2–37.3, respectively). HLA B*18 may protect breast-feeding infants against both early and late HIV-1 acquisition, a finding that could have implications for the design and monitoring of HIV-1 vaccines targeting cellular immune responses against HIV-1.

Department of Medicine, University of Washington, Seattle, Washington 98104, USA. cfarq@u.washington.edu Human leukocyte antigen (HLA) molecules regulate the cellular immune system and may be determinants of infant susceptibility to human immunodeficiency virus type 1 (HIV-1) infection. Molecular HLA typing for class I alleles was performed on infants followed in a Kenyan perinatal cohort. Early HIV-1 infection status was defined as infection occurring at birth or month 1, while late infection via breast milk was defined as first detection of HIV-1 after 1 month of age. Likelihood ratio tests based on a proportional hazards model adjusting for maternal CD4 T cell count and HIV-1 viral load at 32 weeks of gestation were used to test associations between infant allelic variation and incident HIV-1 infection. Among 433 infants, 76 (18%) were HIV-1 infected during 12 months of follow-up. HLA B*18 was associated with a significantly lower risk of early HIV-1 transmission [relative risk (RR) = 0.26; 95% confidence interval (CI) 0.04-0.82], and none of the 24 breastfeeding infants expressing HLA B*18 who were uninfected at month 1 acquired HIV-1 late via breast milk. We observed a trend toward increased early HIV-1 acquisition for infants presenting HLA A*29 (RR = 2.0; 95% CI 1.0-3.8) and increased late HIV-1 acquisition via breast milk for both Cw*07 and Cw*08 (RR = 4.0; 95% CI 1.0-17.8 and RR = 7.2; 95% CI 1.2-37.3, respectively). HLA B*18 may protect breast-feeding infants against both early and late HIV-1 acquisition, a finding that could have implications for the design and monitoring of HIV-1 vaccines targeting cellular immune responses against HIV-1. PMID: 15307911 [PubMed - indexed for MEDLINE]

Department of Medicine, University of Washington, Seattle, Washington 98104, USA. cfarq@u.washington.edu Human leukocyte antigen (HLA) molecules regulate the cellular immune system and may be determinants of infant susceptibility to human immunodeficiency virus type 1 (HIV-1) infection. Molecular HLA typing for class I alleles was performed on infants followed in a Kenyan perinatal cohort. Early HIV-1 infection status was defined as infection occurring at birth or month 1, while late infection via breast milk was defined as first detection of HIV-1 after 1 month of age. Likelihood ratio tests based on a proportional hazards model adjusting for maternal CD4 T cell count and HIV-1 viral load at 32 weeks of gestation were used to test associations between infant allelic variation and incident HIV-1 infection. Among 433 infants, 76 (18%) were HIV-1 infected during 12 months of follow-up. HLA B*18 was associated with a significantly lower risk of early HIV-1 transmission [relative risk (RR) = 0.26; 95% confidence interval (CI) 0.04-0.82], and none of the 24 breastfeeding infants expressing HLA B*18 who were uninfected at month 1 acquired HIV-1 late via breast milk. We observed a trend toward increased early HIV-1 acquisition for infants presenting HLA A*29 (RR = 2.0; 95% CI 1.0-3.8) and increased late HIV-1 acquisition via breast milk for both Cw*07 and Cw*08 (RR = 4.0; 95% CI 1.0-17.8 and RR = 7.2; 95% CI 1.2-37.3, respectively). HLA B*18 may protect breast-feeding infants against both early and late HIV-1 acquisition, a finding that could have implications for the design and monitoring of HIV-1 vaccines targeting cellular immune responses against HIV-1. PMID: 15307911 [PubMed - indexed for MEDLINE]

Cohen CR, Sinei SS, Bukusi EA, Bwayo JJ, Holmes KK, Brunham RC. Department of Obstetrics and Gynecology, University of Washington, Seattle 98104-6460, USA. crcohen@u.washington.edu OBJECTIVE: To investigate epidemiologic tubal infertility risk factors and the relationship between HLA class II alleles and Chlamydia trachomatis tubal infertility. METHODS: Forty-seven women with tubal infertility and 46 fertile controls were studied in Nairobi, Kenya. A questionnaire was administered and serum collected for measurement of C trachomatis antibodies. HLA class II molecular typing was done with DNA extracted from peripheral blood lymphocytes. The prevalence of C trachomatis microimmunofluorescence antibody, chlamydia heat shock protein 60 antibody, and HLA class II alleles was compared among cases of tubal infertility and fertile controls. RESULTS: Women with tubal infertility more often had histories of pelvic inflammatory disease (15% versus 0%; odds ratio [OR] 16; 95% confidence interval [CI] 5.5, 47) histories of spontaneous abortion (34% versus 7%; OR 6.7; 95% CI 2.8, 16), and antibodies to C trachomatis (53% versus 26%; OR 3.2; 95% CI 1.3, 7.7) than controls. Among infertile women, DQA*0101 and DQB*0501 alleles were positively associated with C trachomatis tubal infertility (OR 4.9; 95% CI 1.3, 18.6, and OR 6.8; 95% CI 1.6, 29.2, respectively). DQA*0102 was negatively associated with C trachomatis tubal infertility (OR 0.2; 95% CI 0.005, 0.6). CONCLUSION: Chlamydia trachomatis infection is an important cause of tubal infertility in Nairobi. The association of specific HLA class II alleles with C trachomatis microimmunofluorescence seropositivity among women with tubal infertility suggests that the DQ locus might modify susceptibility to and pathogenicity of C trachomatis infection. PMID: 10636506 [PubMed - indexed for MEDLINE]

AIDS. 2008 Apr 23;22(7):807-16. doi: 10.1097/QAD.0b013e3282f51b71.
Human leukocyte antigen-DQ alleles and haplotypes and their associations with resistance and susceptibility to HIV-1 infection.
Hardie RA, Luo M, Bruneau B, Knight E, Nagelkerke NJ, Kimani J, Wachihi C, Ngugi EN, Plummer FA.
Source
Department of Medical Microbiology, University of Manitoba, Winnipeg, Manitoba, Canada.
Abstract
OBJECTIVES:
To determine the association of DQ antigens with resistance and susceptibility to HIV-1.
DESIGN:
Despite repeated exposure to HIV-1, a subset of women in the Pumwani Sex Worker cohort established in Nairobi, Kenya in 1985 have remained HIV-1 negative for at least 3 years and are classified as resistant. Differential susceptibility to HIV-1 infection is associated with HIV-1 specific CD4 and CD8 T cell responses. As human leukocyte antigen-DQ antigens present viral peptides to CD4 cells, we genotyped human leukocyte antigen -DQ alleles for 978 women enrolled in the cohort and performed cross-sectional and longitudinal analyses to identify associations of human leukocyte antigen -DQ with resistance/susceptibility to HIV-1.
METHODS:
DQA1 and DQB1 were genotyped using taxonomy-based sequence analysis. SPSS 13.0 was used to determine associations of DQ alleles/haplotypes with HIV-1 resistance, susceptibility, and seroconversion rates.
RESULTS:
Several DQB1 alleles and DQ haplotypes were associated with resistance to HIV-1 infection. These included DQB1*050301 (P = 0.055, Odds Ratio = 12.77, 95% Confidence Interval = 1.44-112), DQB1*0603 and DQB1*0609 (P = 0.037, Odds Ratio = 3.25, 95% Confidence Interval = 1.12-9.47), and DQA1*010201-DQB1*0603 (P = 0.044, Odds Ratio = 17.33, 95% Confidence Interval = 1.79-168). Conversely, DQB1*0602 (P = 0.048, Odds Ratio = 0.68, 95% Confidence Interval = 0.44-1.05) and DQA1*010201-DQB1*0602 (P = 0.039, Odds Ratio = 0.64, 95% Confidence Interval = 0.41-1.03) were overrepresented in the HIV-1 infected population. DQA1*0504-DQB1*0201, DQA1*010201-DQB1*0201, DQA1*0402-DQB1*0402 and DQA1*0402-DQB1*030101 genotypes were only found in HIV-1 positive subjects (Odds Ratio = 0.30-0.31, 95% Confidence Interval = 0.03-3.70), and these women seroconverted rapidly. The
associations of these DQ alleles and haplotypes with resistance and susceptibility to HIV-1 were independent of the previously reported human leukocyte antigen-DRB*01, human leukocyte antigen A2/6802, and human leukocyte antigen-A*2301.
CONCLUSION:
The associations of DQ alleles and haplotypes with resistance and susceptibility to HIV-1 emphasize the importance of human leukocyte antigen-DQ and CD4 in anti-HIV-1 immunity

Naturally occurring genetic variants of human papillomavirus type 16 (HPV16) are common and have previously been classified into 4 major lineages; European-Asian (EAS), including the sublineages European (EUR) and Asian (As), African 1 (AFR1), African 2 (AFR2), and North-American/Asian-American (NA/AA). We aimed to improve the classification of HPV16 variant lineages by using a large resource of HPV16-positive cervical samples collected from geographically diverse populations in studies on HPV and/or cervical cancer undertaken by the International Agency for Research on Cancer. In total, we sequenced the entire E6 genes and long control regions (LCRs) of 953 HPV16 isolates from 27 different countries worldwide. Phylogenetic analyses confirmed previously described variant lineages and subclassifications. We characterized two new sublineages within each of the lineages AFR1 and AFR2 that are robustly classified using E6 and/or the LCR. We could differentiate previously identified AA1, AA2, and NA sublineages, although they could not be distinguished by E6 alone, requiring the LCR for correct phylogenetic classification. We thus provide a classification system for HPV16 genomes based on 13 and 32 phylogenetically distinguishing positions in E6 and the LCR, respectively, that distinguish nine HPV16 variant sublineages (EUR, As, AFR1a, AFR1b, AFR2a, AFR2b, NA, AA1, and AA2). Ninety-seven percent of all 953 samples fitted this classification perfectly. Other positions were frequently polymorphic within one or more lineages but did not define phylogenetic subgroups. Such a standardized classification of HPV16 variants is important for future epidemiological and biological studies of the carcinogenic potential of HPV16 variant lineages.

To evaluate the fraction of invasive cervical carcinoma (ICC) that could be prevented in HIV-infected women by vaccines currently available against human papillomavirus (HPV)16 and 18, we conducted a cross-sectional study in women with ICC in Nairobi, Kenya. Fifty-one HIV-positive women were frequency-matched by age to 153 HIV-negative women. Cervical cells were tested for HPV DNA using polymerase chain reaction-based assays (SPF10-INNO-LiPA). Comparisons were adjusted for multiplicity of HPV types. As expected, multiple-type infections were much more frequent in HIV-positive (37.2%) than in HIV-negative (13.7%) women, but the distribution of HPV types was similar. HPV16 was detected in 41.2% versus 43.8% and HPV16 and/or 18 in 64.7% versus 60.1% of HIV-positive versus HIV-negative women, respectively. The only differences of borderline statistical significance were an excess of HPV52 (19.6% versus 5.2%) and a lack of HPV45 (7.8% versus 17.0%) in HIV-positive women compared to HIV-negative women, respectively. We have been able to assess an unprecedented number of ICCs in HIV-positive women, but as we did not know the age of HIV acquisition, we cannot exclude that it had occurred too late in life to affect the type of HPV involved in cervical carcinogenesis. However, if our findings were confirmed, they would suggest that the efficacy of current vaccines against HPV16 and 18 to prevent ICC is similar in HIV-positive and HIV-negative women, provided vaccination is administered before sexual debut, as recommended.

n/a

Human poisoning with plants is uncommon as often people only eat material known to be non-toxic. In times of food shortage, people are willing to experiment with new plant material such as roots, fruits and mushrooms and this often leads to poisoning. Cooking, a common practice' among humans, often destroys plant poisons. Poisonous plants which cause acute and sub-acute poisoning are well known to the local community where they grow, as the cause-effect relationship is easy to establish, unlike those that cause chronic toxicity. Herbal medicine may cause poisoning, but this is rare particularly among experienced practitioners of herbal medicine. In this article several known poisonous plants in Kenya are briefly discussed.

n/a

The study leans towards the human capital development nature of universities and applies the philosophy of human resource development to explain the phenomenon of University-Industry Collaboration (U-C-I) in Kenya. The study reports the findings of an empirical research investigating the patterns of U-I-C and the human resource develpment (HRD) driving factors for the identified patterns of collaboration in Kenya using data gathered from 16 universities both public and private. The findings of the study reveal a significant correlation between the Motivation to pursue Collaboration and the Level of U-I-C among key decision makers in universities in Kenya (n=16; r=492; p<0.05). While the findings provide an empirical explanation on the Motivation, Level and Types of collaboration prevailing in Kenya together with the managerial issues universities need to address in order to strengthen links with the productive sector, they strengthen the call for future research to focus on strategic HRD issues offering a viable pillar for supporting U-I-C.

Introduction The Centre for Open and Distance Learning has been established to facilitate the Internal Faculties in launching and managing their programmes using distance mode with a view to increasing access to university education and provide equity in higher education to the learners all over the country. Operational Strategies The operational strategies that have been set up involve collaborative arrangements between the CODL and the Internal Faculties in the development of Study Materials and Learner support Services for off-campus students. The professional in open and distance learning are availed by the Centre to serve the Faculties as trainers while the Faculties provide academic expertise who are facilitated through participatory methods involving application of knowledge, skills and strategies to develop study materials in their respective subjects. Focus The Centre is currently working with Faculties of Science, Commerce and Arts. The Material development process involves training, writing, reviewing and editing followed by conversion to e-content and audio modes. Conclusion These collaborative arrangements will increase access to higher education make significant contribution in the realization of educational Millennium Goals in Kenya where only 20% of all those who qualify obtain admission in the public universities.

Normal 0 false false false EN-US X-NONE X-NONE MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin-top:0in; mso-para-margin-right:0in; mso-para-margin-bottom:10.0pt; mso-para-margin-left:0in; line-height:115%; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:Calibri; mso-fareast-theme-font:minor-latin; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;}
This study was conducted in two seasons of2002 at Tigoni, Central Kenya to determine effectiveness of insecticides; neern  extract and mineral oil in managing potato aphids and their associated virus diseases. The treatments were arranged in  randomized complete block design (RCBD) with four replications. In each season, the number of aphids in five randomly  selected plants per treatment was recordced in situ. Virus symptoms (i.ncidence) were scored and expressed as a percentage  to the total plant population per plot. Forty-five days after emergence, 10 plants each from guard rows and inner rows were  randomly selected and serologically assayed for Potato Virus Y (PVY) and Potato Leaf Roll Virus (PLRV) using DAS ELISA test. Results showd that three aphid species Aphis gossypii (Glover), Macrosiphum euphorbiae (Thomas) and Myzus persicae (Sulzer) colonized on the variety with A. gossypii being the most dominant while M. persicae was least.  Higher aphid population coincided with the short rains experienced in one of the seasons. Synthetic insecticides (Bifethrin  and dimethoate) were the most effective among the treatments in reducing aphid infestation while the neem extract and mineral oil (DC- Tron) had no significant (P<0.05) difference. However, mineral-oil treated plots recorded the lowest PVY  incidence while bifenthrin-Ireated plots had the lowest PLRV incidence. It is suggested that a combination of synthetic  insecticides and mineral oil could playa major role in reduction of the aphids and their associated vectors. Normal 0 false false false EN-US X-NONE X-NONE MicrosoftInternetExplorer4

Most research demonstrating the link between (HRMP) and firm performance has focused on the private sector, yet understanding this relationship in publicly listed firms, in the Developing World setting is equally important. The role of HRMP on firm performance of the NSE listed firms has not been established using the selected set of variables, yet theory has demonstrates that these HRMP can have an effect on firm performance. This study was motivated by the desire to fill this gap in knowledge. The study objective was to establish the relationship between HRMP and firm performance. The research design was cross sectional descriptive survey. Data was collected using a self-administered questionnaire, from a population of 60 NSE listed firms. The response rate was 60%. Simple linear regression was used to analyze the data. The results of the study show a statistically significant relationship between HRMP and performance of firms listed on the Nairobi Securities Exchange. This study contributes to understanding of the link between HRMP and firm performance, while at the same time confirms the findings of previous studies that have found a significant link between HRMP and firm performance. It was recommended that firms have to ensure that the HRMP that they adopt assist them to attain and sustain a superior competitive advantage in their operations.

n/a