Rotavirus infection is the single most common cause of acute gastroenteritis in children under five years of age. Rotavirus gastroenteritis has a high morbidity and mortality in children in Kenya. To determine the short term clinical outcome for children admitted to Kenyatta National Hospital with rotavirus gastroenteritis and the correlates of poor outcome. Short longitudinal survey. Kenyatta National Hospital from February to May 2008. Five hundred children were screened using a rapid antigen detection kit and ELISA. Of the 191 children who tested positive for rotavirus in stool; 172 children were recruited into the study. Eighty eight per cent of the patients were discharged within one week, 8.1% stayed for more than seven days while 4.1% died. Children who had co-morbidities such as malnutrition, rickets and pneumonia had worse outcomes. Rotavirus gastroenteritis has a long hospital stay and a high mortality. Children in shock on admission and those with co-morbid conditions should get priority for they have a poor outcome

Rotavirus infection is the single most common cause of acute gastroenteritis in children under five years of age. Rotavirus gastroenteritis has a high morbidity and mortality in children in Kenya. To determine the short term clinical outcome for children admitted to Kenyatta National Hospital with rotavirus gastroenteritis and the correlates of poor outcome. Short longitudinal survey. Kenyatta National Hospital from February to May 2008. Five hundred children were screened using a rapid antigen detection kit and ELISA. Of the 191 children who tested positive for rotavirus in stool; 172 children were recruited into the study. Eighty eight per cent of the patients were discharged within one week, 8.1% stayed for more than seven days while 4.1% died. Children who had co-morbidities such as malnutrition, rickets and pneumonia had worse outcomes. Rotavirus gastroenteritis has a long hospital stay and a high mortality. Children in shock on admission and those with co-morbid conditions should get priority for they have a poor outcome

Load forecasting refers to the prediction of future load conditions based on present or historical data. This is important especially for transmission planning and economic dispatch. In this paper, an Artificial Neural Network (ANN) is trained using historical data for a sub-station at Ruiru, Kenya and the corresponding loading conditions for the sub-station are used to test its accuracy in forecasting the electrical load when given other parameters.

Background
Rotavirus infection is the single most common cause of acute gastroenteritis in children
under five years of age. Rotavirus gastroenteritis (RVG) has a high morbidity and mortality in
children in Kenya. The costs of care and treatment for rotavirus gastroenteritis are high.
Comprehensive data on the outcomes and cost of care of RVG in Kenya are lacking.
Objective
To determine the short term clinical outcomes and compute average cost of care for children
admitted to Kenyatta National Hospital (KNH) with rotavirus gastroenteritis.
Methodology
A short longitudinal survey at Kenyatta National Hospital, Nairobi, Kenya from February to
May 2008. A minimum sample size of 165 was sufficient for both primary and secondary
objectives of this study. This samples size was calculated using mortality as the worst
outcome with a mortality rate of 11.6%. Children less than 3 years of age admitted to the
paediatric wards with a diagnosis of acute gastroenteritis were tested for rotavirus in stool
samples using a rapid antigen detection kit and ELISA. Those found positive for rotavirus
and gave consent were recruited into the study. A full clinical evaluation was done and a predesigned
questionnaire administered. The recruited patients were followed up till discharge
or death. Their outcomes, costs incurred and the bills they paid were entered into the
questionnaire. The average costs were then calculated.
Results
Five hundred of the children admitted to KNH with acute gastroenteritis were screened for
rotavirus. One hundred and ninety one (38.2%) of them tested positive for rotavirus in stool
and 172 children were recruited into the study. Of the 172 children, 87.8% were discharged
within one week, 8.1% stayed for more than 7 days while 4.1% died. The average cost of
care per child admitted with rotavirus gastroenteritis was Kshs 6,505.79 to the patient, Kshs.
14,178.21 and Kshs. 16,556.08 to the hospital and economy/society respectively using the
National Hospital Insurance Fund bed charge rates. Children who had co-morbidities had
worse outcomes in comparison to those who did not have any co-morbidity.
Conclusion
Rotavirus gastroenteritis has a significant impact on young children and their families in
terms of long hospital stay, high morbidity and mortality. It incurs considerable resource
utilization in health care settings, substantial costs for national health care and lost work
days to the economy.
Recommendation
A cost benefit analysis for the whole country should be done to guide in policy making for
routine rotavirus vaccination

The effect of zidovudine on plasma and genital human immunodeficiency virus type 1 (HIV-1) was determined in 42 antiretroviral-naive HIV-1-seropositive women in Nairobi. After 7 days of zidovudine treatment, HIV-1 RNA levels decreased by 0.5 to 1.1 log(10) in plasma and genital secretions. HIV-1 RNA half-life following zidovudine treatment was 4.7, 1.3, and 0.9 days in plasma, cervix, and vagina, respectively, and significantly shorter in genital secretions than in plasma (P < 0.001). Defining the short-term effect of zidovudine on plasma and genital HIV-1 is important for improving perinatal HIV-1 interventions

The effect of zidovudine on plasma and genital human immunodeficiency virus type 1 (HIV-1) was determined in 42 antiretroviral-naive HIV-1-seropositive women in Nairobi. After 7 days of zidovudine treatment, HIV-1 RNA levels decreased by 0.5 to 1.1 log(10) in plasma and genital secretions. HIV-1 RNA half-life following zidovudine treatment was 4.7, 1.3, and 0.9 days in plasma, cervix, and vagina, respectively, and significantly shorter in genital secretions than in plasma (P < 0.001). Defining the short-term effect of zidovudine on plasma and genital HIV-1 is important for improving perinatal HIV-1 interventions.

Background and aims Degradation of physical, chemical and biological properties of soils in sub-Saharan Africa mainly results from little or no organic resource application coupled with sub-optimal fertilizer application. A study was conducted over three seasons, from March 2010 toAugust 2011,toevaluatepotentialofsix organic materials (bagasse, cow manure, filtermud, maize stover, sugarcane straw and Tithonia diversifolia) for compost production and their influence on maize yield and soil fauna diversity. Methods Treatments comprised of the six composts, commercial fertilizer and no-input control, laid out in randomized complete block design in four replicates. Soil macrofauna were collected using soil monolith method. Data obtained were subjected to analysis of variance (ANOVA) using GENSTAT whereas differences were evaluated using Fisher’s least significant
difference (LSD). Correlation between macrofauna and soil chemical properties was done using CANOCO 3.1. Results The ANOVA showed significantly higher N and P on filtermud (10.0 g N kg−1 and 979 mg P kg−1) and T. diversifolia (9.6 g N kg−1 and 614 mg P kg−1) composts. Generally, amending soils with composts increased C, N and P of the soil by 90 %, 29 % and 20%,respectively,while fertilizer treated plots recorded 42 %, 4 % and 110 % increase in C, N and P, respectively. Control plots recorded 25 % increase in C, but 15 % and 50 % decline in N and P, respectively. Maize yields were highest in fertilizer (4.4 Mg ha−1), followed by composts (2.8 Mg ha−1) and lowest in control plots (1.4 Mg ha−1). Soil macrofauna responded positively to addition of composts. Isopterans, Oligochaeta and Hymenopterans dominated the sites constituting 44 %, 26 % and 17 %, respectively of all the macrofauna. Relationships between macrofauna and soil chemical properties were positively significant.
Conclusions Results of this study demonstrate the potential of composts in improving soil biodiversity and crop productivity.

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

Data from two closely related questions in a survey on rabbits is analyzed in order to determine whether results from these two groups of questions would yield similar results about numbers of rabbits kept by a household. One question seeks a straightforward answer about numbers of rabbits kept while the other group of questions breaks the question into several questions seeking numbers of rabbits disaggregated by sex and age. This is prompted by the fact that record keeping is not a very common undertaking in a small holder agricultural setting in Kenya and that in their absence, farmers may not recall precisely how many rabbits they own unless a headcount is performed. A paired sample t test is implemented to detect any significant under-reporting of rabbit numbers based on numbers from the straightforward question which we hypothesize would yield numbers far less than what is on the farm. The results show that such under-reporting is not serious enough. The conclusion is that between the two question modes implemented in the survey, the straightforward question is suitable as it is time saving when the survey data required does not include numbers disaggregated by sex or age of rabbits.

Data from two closely related questions in a survey on rabbits is analyzed in order to determine
whether results from these two groups of questions would yield similar results about numbers of
rabbits kept by a household. One question seeks a straightforward answer about numbers of
rabbits kept while the other group of questions breaks the question into several questions seeking
numbers of rabbits disaggregated by sex and age. This is prompted by the fact that record
keeping is not a very common undertaking in a small holder agricultural setting in Kenya and
that in their absence, farmers may not recall precisely how many rabbits they own unless a
headcount is performed. A paired sample t test is implemented to detect any significant
underreporting of rabbit numbers based on numbers from the straightforward question which we
hypothesize would yield numbers far less than what is on the farm. The results show that such
underreporting is not serious enough. The conclusion is that between the two question modes
implemented in the survey, the straightforward question is suitable as it is time saving when the
survey data required does not include numbers disaggregated by sex or age of rabbits.

Breastfeeding is the ideal infant food—it provides both optimal nutrition and numerous factors that contribute to infant immunity, growth, cognition, and health. It also enhances maternal–infant bonding and child-spacing and may provide long-term benefits to mothers. An estimated 7.7 million children under 5 years of age die annually, with >30% dying of infectious diseases [1, 2]. Breastfeeding has been identified as the most effective intervention to prevent under-5 mortality [3]. It was therefore a huge public health and policy challenge to discern the best infant feeding strategy when it was discovered that HIV-1 could be transmitted through breastfeeding. While nonbreastfeeding could entirely prevent transmission of a rapidly fatal infection, implementation of artificial feeding could be associated with increased infant mortality and morbidity. Over the past two decades, mothers, clinicians, and policy makers have wrestled with balancing infant risk of HIV-1 acquisition against risk of infant mortality in the context of concurrently changing interventions that decrease transmission of HIV-1.

The Maasai pastoralists have in the last decade experienced disruptions in their economies and livelihoods following climate shifts. For instance, they have been losing up to 30 % of their herd annually to drought related disasters, yet information on the various land uses is still fragmented. This has been worsened by the shortening famine cycles which has impacted pastoral livelihood system as they highly depend on natural resource. Yet, these key resources have been dwindling over the past 30 years compromising their ability to meet basic need such as food. To address this gap, the study focused on long term evaluation of land use. The study’s objective was to determine land use transformations and their impacts particularly on the pastoral livelihood system.

Two groups of 6 rats each received subcutaneous injections of 2.3 mg/kg or 5.0 mg/kg of quinuronium, respectively, on two consecutive days, while 5 rats injected with physiological saline served as controls. Clinical signs of muscular tremors, jumps, enlarged and hyperemic eyeballs, lacrimation, depression and anorexia were observed following administration of quinuronium. One rat receiving 5 mg/kg died before termination of the study. When killed 48 h after the first injection, the quinuronium-treated rats had a higher liver weight/body weight ratio compared to the controls. Quinuronium resulted in hepatic centrilobular fatty degeneration, but no depletion of hepatic glutathione (GSH). The present findings suggest that glutathione depletion does not seem to be involved in quinuronium hepatotoxicity

The  study found out that Masinga Dam has adversely affected the public health in the communities around the dam. malaria was the most prevalent ailment followed by typhoid fever. Bilharzia has also increased since the dam was constructed.

The  study found out that Masinga Dam has adversely affected the public health in the communities around the dam. malaria was the most prevalent ailment followed by typhoid fever. Bilharzia has also increased since the dam was constructed.

The  study found out that Masinga Dam has adversely affected the public health in the communities around the dam. malaria was the most prevalent ailment followed by typhoid fever. Bilharzia has also increased since the dam was constructed.

Seventeen cows of various breeds with varying degrees of severity of advanced ocular squamous cell carcinoma were treated by radical surgery, which included enucleation and extirpation of the surrounding ocular muscles and tissues. The degree of severity and the extent of the carcinoma lesion was correlated with the outcome of treatment for each case. It was observed that: 1. eyeball involvement, 2. ulceration and subsequent infection of carcinoma lesion involving the eyelids and 3. involvement of the regional lymphnodes especially the parotid , are some of the main factors that could be used to draw prognosis of such cases. Although the initial surgery may not be costly, the overall cost of managing postoperative complications is prohibitive and results to vast economic losses that should not be ignored.

SUMMARY LIII)' lIIorpllOlogiClI changcs ill the goat ,csris after:. sillgle illlraperilOlieal injec,ioll of ethalle ,lillie' I.:lIIeslll"llOnarc (EI )S) werc investigatcd mint; (1Orh liglH alld deCll'On microscopy. The (olllpolind was ;almillistered at two dose Icvels: 75 mgll

Erythrocyte complement regulatory proteins, complement receptor 1 (CR1) and decay accelerating factor (CD55) protect red blood cells (RBCs) from complement mediated damage by controlling complement activation cascade and potentially protect RBCs from complement mediated damage that may occur when immune complexes are formed following malaria infection. Given the important role of RBCs in regulation of complement activation, we considered the competence of sickle cell trait RBCs in these functions. Methods: Children (age 0-192 months; n=116) were enrolled in a nested case controlled study conducted in Kombewa Division, Kisumu west District between October and December 2004. Based on hemoglobin (Hb) type, children were stratified into those with HbAS (n=47) and HbAA (n=69). The 47 HbAS individuals were matched to the 69 HbAA individuals of similar age (± 2 months or ± 24 months for those below or more than 192 months, respectively) at a ratio of 1:1 or 1:2. Circulating CR1 levels and CD levels were quantified using a FACScan cytometer under normal and reduced oxygen saturation. Results: The mean CR1 copy numbers per RBC was comparable in the two groups. However, between the ages of 49-192 months, the mean CR1 copy numbers per erythrocyte was significantly higher in children who had HbAS compared to those with HbAA (P=0.0332). The mean CD55 levels were comparable between the two groups but after deoxygenation, the mean CD levels in RBCs of individuals with HbAS was significantly higher than in the HbAA (P=0.011). Conclusion: The mean CR1 and CD55 copy numbers per RBC were comparable between the two groups under normal and reduced oxygen saturation. Beyond the age of 49 months, the CR1 copy numbers was higher in the HbAS compared to HbAA and this was also true for CD55 levels under deoxygenated conditions. Taken together, these results demonstrate that in the younger age groups, the protection afforded by HbAS against severe manifestations of malaria may be due to other factors other than complement regulatory proteins but beyond the age of 49 months, this protection may be partly due to the high CR1 copy numbers in the HbAS individuals.

Department of Paediatrics and Child Health, College of Health Sciences, University of Nairobi, P.O. Box 20956-00202, Nairobi, Kenya. BACKGROUND: Early growth in very low birth weight (VLBW) infants has been found predictive of their later outcomes. This has led to increased interest in establishing measures to optimise such growth. In facilities without the resources required to undertake long-term audits for all the high risk infants they graduate, these growth parameters may also be used as selection criteria for those meriting such follow up reducing costs. OBJECTIVES: To describe early growth patterns among a cohort of VLBW infants and determine some of the factors associated with poor growth among them. DESIGN: Cross section survey. SETTING: Kenyatta National Hospital, Nairobi, Kenya. SUBJECTS: One hundred and seventy five neonatal survivors. RESULTS: Of the 175 infants recruited, the male/female ratio was 4:6, sixty four (36.6%) were intrauterine growth retarded while significant illnesses during the neonatal period were reported in 109 (62.3%). Forty seven percent of the infants had been fed on exclusive breast milk, 33% on mixed feeds while 20% received exclusive preterm formula. The mean neonatal weight gain for the whole cohort was 13.5 (3.9) g/kg/day, length of 0.34 (0.11) cm/week and head circumference of 0.32 (0.71) cm/week. By term only 33 (18.9%), 37 (21.1%) and 48 (28%) had reached the expected (the 3rd percentile) weight, length and head circumference respectively. Sixty percent of the infants gained weight at <15 g/kg/day while 70% and 78% grew in head circumference and length at < 0.5 cm/week respectively. At term weight, head and linear growth faultering were recorded in 81%, 72% and 79% respectively. The factors that were associated with better growth at this stage included feeding on preterm formula (P < 0.001) and absence of neonatal morbidity (P < 0.001). Infants who were appropriate for gestational age at birth also had better catch up growth at term compared to those born small for gestation (P < 0.001) but their neonatal growth itself was not significantly better. CONCLUSION: The mean neonatal growth in all anthropometric measures was less than expected and by the time of their expected delivery, less than 30% of these infants had reached the 3rd percentile of the expected measurement in all the three growth parameters. Choice of milk and neonatal morbidity influenced these growth patterns. RECOMMENDATIONS: Routine fortification of mother's milk or addition of preterm formula and reorganised care of sick newborns is recommended to improve early growth. PMID: 16771104 [PubMed - indexed for MEDLINE]

Sigmoid volvulus in pregnancy is a rare condition that poses a myriad of challenges in diagnosis and management of the patient. It demands on the clinician a high index of suspicion, expeditious treatment involving resuscitation and good judgment in handling of the bowel in face of added potential morbidity and mortality to the mother and fetus. We report a case of gangrenous sigmoid volvulus with a viable third trimester pregnancy and discuss potential pitfalls in diagnosis and management.

Sigmoid volvulus in pregnancy is a rare condition that poses a myriad of challenges in diagnosis and management of the patient. It demands on the clinician a high index of suspicion, expeditious treatment involving resuscitation and good judgment in handling of the bowel in face of added potential morbidity and mortality to the mother and fetus. We report a case of gangrenous sigmoid volvulus with a viable third trimester pregnancy and discuss potential pitfalls in diagnosis and management.

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Cultivated Plasmodium falciparum gametocytes reach maturity in vitro in approximately 14-16 days, during which they pass through five morphologically distinct developmental stages. Purification of the earlier developmental stages has not been previously reported. We have modified the standard discontinuous Percoll gradient method for the separation of stage IV and V gametocytes to obtain enriched preparations of those and the earlier P. falciparum gametocyte stages. In contrast to the stages II, III, and IV, the mature stage V gametocytes from our gradient readily transformed into gametes. Such preparations may be useful in research studies on the mechanisms that underlie gametocytogenesis.

This study investigates the signaling hypothesis by testing the displacement property of dividends. The study uses Ohlson (1995; 2001) model and follows Hand and Landsman (2005) approach. The study however varies the methodology by using pooled Time Series Cross Section data and Panel Corrected Standard Error estimation and also control for size to take care of scale effects. The study’s findings provide further empirical evidence that dividends are used as signals about future earnings prospects of the firm. After following Thakor (2003) approach in testing for the free cashflow hypothesis, the study’s results do not provide evidence in favour of the cashflow hypothesis it is therefore ruled out. The study’s results shed further insights on the controversy regarding the information content of dividend changes about future profitability.

Objectives: To determine the prevalence and pattern of significant refractive errors in standard 8 pupils attending public school.
Design: Cross sectional community based study
Setting: Langata Location of Kibera Division, Nairobi Province
Subjects: All (1,253) year 2003 standard 8 pupils in school during the study
Results: The prevalence of significant refractive errors 10.2%, myopia 9.4%, hypermetropia 0.3% and astigmatism 0.5%. Of these, only 11.7 % (15/128) students had spectacles with the correct power.
Conclusions: About 10.2% of class 8 pupils attending public primary schools in Langata need spectacles but only a few have them.
Recommendation: There is need for a school screening programme offering low cost spectacles so that children who may be having learning difficulties due to lack of spectacles can be identified and assisted promptly.

In humans, traumatic experiences are sometimes followed by psychiatric disorders. In chimpanzees, studies have demonstrated an association between traumatic events and the emergence of behavioral disturbances resembling posttraumatic stress disorder (PTSD) and depression. We addressed the following central question: Do chimpanzees develop posttraumatic symptoms, in the form of abnormal behaviors, which cluster into syndromes similar to those described in human mood and anxiety disorders?

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

OBJECTIVE: To evaluate the effectiveness of sildenafil (Viagra) in the treatment of male erectile dysfunction in Nairobi.
DESIGN: Prospective open label extension study. SETTING: Urology clinics at the Nairobi Hospital, Kenyatta National Hospital and the author's private clinic in Hurlingham, Nairobi.
PARTICIPANTS: Two hundred and nineteen adult male patients with erectile dysfunction.
RESULTS: The age range was 33-80 years with a mean of 62.5 years and a peak incidence in the 60-69 year age group. One hundred and nineteen patients (54.34%) had organic causes, 85 patients (38.81%) had psychogenic causes and 15 patients had mixed causes. Two hundred patients (91.32%) had improved sexual function after treatment with viagra. This improvement was sustained during the study period of sixteen weeks and included improved erectile and orgasmic functions and overall sexual satisfaction. One hundred and fifty seven of these patients responded to therapy with 50 mg of viagra; 40 patients with 25 mg and three patients with 100 mg of therapy. Nineteen patients (8.68%) had no improvement in sexual function after viagra administration. Seven patients (3.2%) had adverse effects which were mild and transient. They included mild headaches in three patients, mild dyspepsia in two patients and facial flushing and nausea and vomiting in one patient, respectively.
CONCLUSION: Oral sildenafil (Viagra) is an effective well tolerated and simple treatment for male erectile dysfunction in the majority of cases. The cost of treatment at about ten United States dollars for the 50 mg tablet is prohibitive and may limit its wide use by many deserving patients in this locality.
PIP: This prospective open-label extension study was carried out to evaluate the effectiveness of sildenafil (Viagra) in the treatment of male erectile dysfunction in Nairobi, Kenya. A total of 219 adult male patients with erectile dysfunction were instructed to take 50 mg, 25 mg, or 100 mg of sildenafil orally 1 hour prior to planned sexual activity, but not more than once every 24 hours. Patients were reviewed at 4-week intervals for 16 weeks to assess the efficacy and adverse effects of the drug. The age range was 33-80 years with a mean of 62.5 years and a peak incidence in the 60-69 year age group. The causes of erectile dysfunction were organic (n = 119, 54.34%), psychogenic (n = 85, 38.81%), and mixed (n = 15). 200 patients (91.32%) had improved sexual function after treatment with Viagra. This improvement included improved erectile and orgasmic functions and overall sexual satisfaction. 157 patients responded to the 50-mg treatment regimen; 40, to the 25-mg regimen; and 3, to the 100-mg regimen. No improvement in sexual function was reported in 19 patients (8.68%) after Viagra administration. In addition, 7 patients reported mild and transient adverse effects of the drug, including mild headache, dyspepsia, facial flushing, nausea, and vomiting. In conclusion, oral sildenafil (Viagra) is an effective well-tolerated and simple treatment for male erectile dysfunction in the majority of cases. However, the cost of treatment may prohibit and limit its wide use by many deserving patients in this area.

OBJECTIVE: To evaluate the effectiveness of sildenafil (Viagra) in the treatment of male erectile dysfunction in Nairobi. DESIGN: Prospective open label extension study. SETTING: Urology clinics at the Nairobi Hospital, Kenyatta National Hospital and the author's private clinic in Hurlingham, Nairobi. PARTICIPANTS: Two hundred and nineteen adult male patients with erectile dysfunction. RESULTS: The age range was 33-80 years with a mean of 62.5 years and a peak incidence in the 60-69 year age group. One hundred and nineteen patients (54.34%) had organic causes, 85 patients (38.81%) had psychogenic causes and 15 patients had mixed causes. Two hundred patients (91.32%) had improved sexual function after treatment with viagra. This improvement was sustained during the study period of sixteen weeks and included improved erectile and orgasmic functions and overall sexual satisfaction. One hundred and fifty seven of these patients responded to therapy with 50 mg of viagra; 40 patients with 25 mg and three patients with 100 mg of therapy. Nineteen patients (8.68%) had no improvement in sexual function after viagra administration. Seven patients (3.2%) had adverse effects which were mild and transient. They included mild headaches in three patients, mild dyspepsia in two patients and facial flushing and nausea and vomiting in one patient, respectively. CONCLUSION: Oral sildenafil (Viagra) is an effective well tolerated and simple treatment for male erectile dysfunction in the majority of cases. The cost of treatment at about ten United States dollars for the 50 mg tablet is prohibitive and may limit its wide use by many deserving patients in this locality.
PIP: This prospective open-label extension study was carried out to evaluate the effectiveness of sildenafil (Viagra) in the treatment of male erectile dysfunction in Nairobi, Kenya. A total of 219 adult male patients with erectile dysfunction were instructed to take 50 mg, 25 mg, or 100 mg of sildenafil orally 1 hour prior to planned sexual activity, but not more than once every 24 hours. Patients were reviewed at 4-week intervals for 16 weeks to assess the efficacy and adverse effects of the drug. The age range was 33-80 years with a mean of 62.5 years and a peak incidence in the 60-69 year age group. The causes of erectile dysfunction were organic (n = 119, 54.34%), psychogenic (n = 85, 38.81%), and mixed (n = 15). 200 patients (91.32%) had improved sexual function after treatment with Viagra. This improvement included improved erectile and orgasmic functions and overall sexual satisfaction. 157 patients responded to the 50-mg treatment regimen; 40, to the 25-mg regimen; and 3, to the 100-mg regimen. No improvement in sexual function was reported in 19 patients (8.68%) after Viagra administration. In addition, 7 patients reported mild and transient adverse effects of the drug, including mild headache, dyspepsia, facial flushing, nausea, and vomiting. In conclusion, oral sildenafil (Viagra) is an effective well-tolerated and simple treatment for male erectile dysfunction in the majority of cases. However, the cost of treatment may prohibit and limit its wide use by many deserving patients in this area.

Silver nanoparticles (Ag-NPs), zinc oxide (ZnO-NPs) and zinc oxide–silver (ZnO–Ag-NPs) were biosynthesized based on
the rich matrix of alkaloids, flavones, tannins capping/stabilizing agents present in Bidens pilosa extract. Different plant
parts-root, leaf and seed ware used to prepare the plant extract for synthesis. Also, zinc and silver nitrate salts were
used as precursor materials. The surface plasmon peaks (SPR) based on the UV–Vis results for the Ag-NPs, ZnO-NPs were
located between 408–411 and 365–450 nm respectively. The SPR peaks for the Ag–ZnO-NPs occurred at 300–450 nm
indicating both blue and red shifts. The Ag–ZnO-NPs SPR shifts were associated with possible nanoparticle size reduction
and change in dielectric constant of the synthesis medium. Raman measurement peaks at 356, 484, 1350, 1578,
2435 cm−1 associated with OH, –C==C–, –C–O, S=O, =C–H moieties indicated successful capping. Nanoparticle yield was
temperature dependent and optimal yield could not be tied to a particular plant part as source of extract. Tunneling
electron microscope results showed Ag-NPs and ZnO-NPs were globular/spherical with a diameter range of 2–20 nm.
Interestingly, ZnO-NPs TEM displayed isolated miniaturized globular nanoparticles (< 2 nm) which then joined up to form
a large donut shaped structure indicating different formation mechanisms for the nanoparticles. XRD results showed the
Ag-NPs, ZnO-NPs and the Ag–ZnO-NPs particles were crystalline in nature. The high signal/noise in XRD originated from
possible crystalline biomaterials in the extracts. Energy dispersive spectroscopy (EDS) elemental composition results
confirmed successful formation of the nanoparticles. Anti-Microbial activity of the synthesized Ag-NPs, ZnO-NPs and
ZnO–Ag-NPs were studied against gram negative bacteria Escherichia coli (E. coli), gram positive bacteria Staphylococcus
aureus and fungus Candida albicans. Different ZnO: Ag-NPs nanocomposite ratios were used to test for antimicrobial
activity. Optimal antimicrobial activity was attained at Ag-NPs:ZnO-NPs ratio of 4:1 which also displayed the least minimum
inhibition concentration (MIC) and therefore was used as the active ingredient in formulating a hand sanitizing
antiseptic. The formulated antiseptic exhibited good antimicrobial activity.
Keywords

Seventeen cows of various breeds with varying degrees of severity of advanced ocular squamous cell carcinoma were treated by radical surgery, which included enucleation and extirpation of the surrounding ocular muscles and tissues. The degree of severity and the extent of the carcinoma lesion was correlated with the outcome of treatment for each case. It was observed that: 1. eyeball involvement, 2. ulceration and subsequent infection of carcinoma lesion involving the eyelids and 3. involvement of the regional lymphnodes especially the parotid , are some of the main factors that could be used to draw prognosis of such cases. Although the initial surgery may not be costly, the overall cost of managing postoperative complications is prohibitive and results to vast economic losses that should not be ignored.

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Ninety seven patients were examined for dental caries using two standard methods: (a) clinical examination based on WHO Basic Methods Oral Health surveys and (b) radiographic examination. Clinical examination method under records caries by upto 40%. Such under recording may give an impression of a decreasing caries prevalence in epidemiological studies.

Magadi soda and bean debris-ash have been used as condiments for a long time by various ethnic groups in East and Central Africa in cooking traditional dishes. The aim of the study was to investigate whether magadi soda and bean debris-ash had similar effects and functional attributes when added to traditional dishes during cooking. Reason for the addition of the two condiments has not been revealed by researchers. Mineral content, in-vitro bioavailability studies and pH of non-ashed and ashed magadi soda and bean debris were evaluated. The results indicated that high concentrations of sodium ions (30.2%) and potassium ions (64.2%) were observed in magadi soda and bean debris-ash, respectively. In-vitro iron and zinc bioavailability decreased significantly with the addition of magadi soda and bean debris-ash in maize, beans and sorghum. Equally, the cooking time was significantly reduced. The mean pH for both magadi soda (9.66) and bean debris-ash (9.75) were not significantly different indicating that both aqueous solutions had alkaline properties. The similarity in properties especially in mineral profile,alkalinity, decreased cooking time and lowered mineral uptake by magadi soda and bean debris-ash explain similar functionality in foods they are added to during cooking. Despite the similarities observed, communities should be informed of the negative nutritional effects of these condiments so as to diversify their meal patterns accordingly

Using the fast Fourier transform (FFT) method, we determined the spectral characteristics of some meteorological variables over Kenya and identified the prominent periodicities associated with the variables. The meteorological variables studied are the maximum temperature, mini-mum temperature, average temperature, wind speed, precipitation, relative humidity, solar radia-tion intensity, evaporation and sunshine duration. Data from five terrestrial stations, represent-ing the regional climatic zones in Kenya, were employed in the study. The result reveals periods that are associated with solar activity. It is established that solar forcing is very significant over the Kenyan climate. The Sun-Climate relations were influenced at some locations by local ef-fects such as orography and vegetation.

Keywords: periodicity, solar activity, Sun-climate relations

OBJECTIVE–To determine the efficacy of the nonoxynol 9 contraceptive sponge in preventing sexual acquisition of the human immunodeficiency virus (HIV). DESIGN–Prospective, randomized placebo-controlled trial. SETTING–Research clinic for prostitutes in Nairobi, Kenya. PATIENTS AND INTERVENTIONS–One hundred thirty-eight HIV-seronegative women were enrolled, of whom 74 were assigned to nonoxynol 9 sponge use and 64 to placebo use. These two groups did not significantly differ with respect to demographic characteristics, sexual practices, or prevalence of genital infections at enrollment, except for a lower number of sex partners per week and a higher initial prevalence of genital ulcers among women assigned to nonoxynol 9 sponge use. Among the 116 women who returned for follow-up, the mean durations of follow-up were 14 and 17 months for the two groups, respectively. MAIN OUTCOME MEASURE–HIV seroconversion. RESULTS–Nonoxynol 9 sponge use was associated with an increased frequency of genital ulcers (relative risk [RR], 3.3; P less than .0001) and vulvitis (RR, 3.3; P less than .0001) and a reduced risk of gonococcal cervicitis (RR, 0.4; P less than .0001). Twenty-seven (45%) of 60 women in the nonoxynol 9 sponge group and 20 (36%) of 56 women in the placebo group developed HIV antibodies. The hazard ratio for the association between nonoxynol 9 sponge use and HIV seroconversion was 1.7 (95% confidence interval [CI], 0.9 to 3.0). Using multivariate analysis to control for the presence of genital ulcers at enrollment, the adjusted hazard ratio for the association between nonoxynol 9 sponge use and seroconversion was 1.6 (95% CI, 0.8 to 2.8). CONCLUSIONS–Genital ulcers and vulvitis occurred with increased frequency in nonoxynol 9 sponge users. We were unable to demonstrate that nonoxynol 9 sponge use was effective in reducing the risk of HIV infection among highly exposed women.

OBJECTIVE–To determine the efficacy of the nonoxynol 9 contraceptive sponge in preventing sexual acquisition of the human immunodeficiency virus (HIV). DESIGN–Prospective, randomized placebo-controlled trial. SETTING–Research clinic for prostitutes in Nairobi, Kenya. PATIENTS AND INTERVENTIONS–One hundred thirty-eight HIV-seronegative women were enrolled, of whom 74 were assigned to nonoxynol 9 sponge use and 64 to placebo use. These two groups did not significantly differ with respect to demographic characteristics, sexual practices, or prevalence of genital infections at enrollment, except for a lower number of sex partners per week and a higher initial prevalence of genital ulcers among women assigned to nonoxynol 9 sponge use. Among the 116 women who returned for follow-up, the mean durations of follow-up were 14 and 17 months for the two groups, respectively. MAIN OUTCOME MEASURE–HIV seroconversion. RESULTS–Nonoxynol 9 sponge use was associated with an increased frequency of genital ulcers (relative risk [RR], 3.3; P less than .0001) and vulvitis (RR, 3.3; P less than .0001) and a reduced risk of gonococcal cervicitis (RR, 0.4; P less than .0001). Twenty-seven (45%) of 60 women in the nonoxynol 9 sponge group and 20 (36%) of 56 women in the placebo group developed HIV antibodies. The hazard ratio for the association between nonoxynol 9 sponge use and HIV seroconversion was 1.7 (95% confidence interval [CI], 0.9 to 3.0). Using multivariate analysis to control for the presence of genital ulcers at enrollment, the adjusted hazard ratio for the association between nonoxynol 9 sponge use and seroconversion was 1.6 (95% CI, 0.8 to 2.8). CONCLUSIONS–Genital ulcers and vulvitis occurred with increased frequency in nonoxynol 9 sponge users. We were unable to demonstrate that nonoxynol 9 sponge use was effective in reducing the risk of HIV infection among highly exposed women.

MRC Human Immunology Unit, University of Oxford, Oxford, UK. The IFN-y enzyme-linked immunospot (ELI-Spot) assay is often used to map HIV-specific CD8 T-cell responses. We compared overlapping 15-mer pools with optimized CD8 epitopes to screen ELISpot responses in HIV-infected individuals. The 15-mer pools detected responses to previously undefined epitopes, but often missed low-level responses to predefined epitopes, particularly when the epitope was central in the 15-mer, rather than at the N-terminus or C-terminus. These factors should be considered in the monitoring of HIV vaccine trials.

The effect of eight half-yearly treatment rounds with diethylcarbamazine (DEC; 6mg/kg bodyweight) on Wuchereria bancrofti-specific circulating filarial antigen (CFA), a marker of adult worm infection, was followed in 79 individuals who were CFA-positive before start of treatment. Half of these were also microfilariae (mf)-positive. Microfilaraemia decreased rapidly after onset of treatment and became undetectable after four treatments. Circulating antigenaemia also decreased progressively, but at a much slower rate. After two, four and eight treatment rounds, the mean CFA intensity was reduced by 81, 94 and 98%, and the prevalence of CFA positivity was 85, 66 and 57%, compared with pre-treatment, respectively. CFA clearance rates were negatively related to pre-treatment CFA intensities, and were higher among pre-treatment mf-negative individuals than among pre-treatment mf-positive individuals. Even among patients who had pre-treatment CFA intensities above the upper measuring level (32000antigen units), and who continued to have intensities above this level after treatment, a decrease in post-treatment CFA intensities was obvious from a continuous decrease in ELISA optical density values. Repeated DEC therapy thus appears to have a slow but profound and persistent macrofilaricidal effect, which in the long run may be beneficial to populations undergoing DEC-based control interventions by reducing the probability of future morbidity development.

The response pattern of specific antibodies to the microfilarial sheath (sheath-Ab) of the mosquito-borne filarial parasite Wuchereria bancrofti was investigated in individuals from two East African communities with different levels of endemicity. Individuals from both communities presented a strong inverse relationship between positivity for sheath-Ab and being positive for microfilariae (mf) and circulating filarial antigens (CFA). The prevalence of sheath-Ab positivity was highest in young individuals, but peaked at a younger age in the high (1-14 years) than the low (15-19 years) endemicity community. IgG1, IgG2, IgG3 and IgE intensities to a crude adult filarial worm antigen were higher, and IgG4 intensities were lower, in sheath-Ab positive than in sheath-Ab negative individuals, probably reflecting the infection status of individuals. From the study it appears that individuals become sheath-Ab positive before mf and/or CFA can be detected in the peripheral blood, and only after later disappearance of sheath-Ab from the circulation can CFA and mf be diagnosed. In light of the findings, possible roles of the distinct sheath-Ab in the host-parasite relationship are discussed, and a hypothesis is proposed which suggests that sheath-Ab play an important role in the regulation of host microfilaraemia.

Bancroftian filariasis infection, disease and specific antibody response patterns in a high and a low endemicity community in East Africa were analyzed and compared to assess the relationship between these parameters and community transmission intensity. Overall prevalences of microfilaremia and circulating filarial antigenemia were 24.9% and 52.2% in the high and 2.7% and 16.5% in the low endemicity community, respectively. A positive history of acute attacks of adenolymphangitis was given by 12.2% and 7.1% of the populations, 4.0% and 0.9% of the adult (> or = 20 years old) individuals presented with limb lymphedema, and 25.3% and 5.3% of the adult males had hydrocele, in the high and the low endemicity community, respectively. Both infection and disease appeared earlier and reached much higher levels in the high than in the low endemicity community. The observed overall and age-specific infection and disease patterns in the two communities were in agreement with the view that these are primarily shaped by transmission intensity. No statistically significant relationships between infection status of fathers and mothers and that of their children were observed in any of the communities for either microfilaremia or for circulating filarial antigenemia. The overall levels (prevalence and geometric mean intensity) of filarial-specific IgG1, IgG2, IgG4, and IgE were significantly higher in the high endemicity community than in the low endemicity dommunity. Surprisingly, the opposite pattern was found for IgG3. Community transmission intensity thus appears to be an important determinant of observed inter-community variation in infection, disease, and host response patterns in Bancroftian filariasis.

DBL-Institute for Health Research and Development, Jaegersborg Alle 1D, 2920 Charlottenlund, Denmark. pesimonsen@dblnet.dk The effect of eight half-yearly treatment rounds with diethylcarbamazine (DEC; 6mg/kg bodyweight) on Wuchereria bancrofti-specific circulating filarial antigen (CFA), a marker of adult worm infection, was followed in 79 individuals who were CFA-positive before start of treatment. Half of these were also microfilariae (mf)-positive. Microfilaraemia decreased rapidly after onset of treatment and became undetectable after four treatments. Circulating antigenaemia also decreased progressively, but at a much slower rate. After two, four and eight treatment rounds, the mean CFA intensity was reduced by 81, 94 and 98%, and the prevalence of CFA positivity was 85, 66 and 57%, compared with pre-treatment, respectively. CFA clearance rates were negatively related to pre-treatment CFA intensities, and were higher among pre-treatment mf-negative individuals than among pre-treatment mf-positive individuals. Even among patients who had pre-treatment CFA intensities above the upper measuring level (32000antigen units), and who continued to have intensities above this level after treatment, a decrease in post-treatment CFA intensities was obvious from a continuous decrease in ELISA optical density values. Repeated DEC therapy thus appears to have a slow but profound and persistent macrofilaricidal effect, which in the long run may be beneficial to populations undergoing DEC-based control interventions by reducing the probability of future morbidity development.

The  study found out that Masinga Dam has adversely affected the public health in the communities around the dam. malaria was the most prevalent ailment followed by typhoid fever. Bilharzia has also increased since the dam was constructed.

Magnesium oxide and bone meal were used as chemical defluoridating agents to reduce excessive amounts of fluoride from artificial water samples which had been prepared to simulate Kenyan water samples with a fluoride concentration ranging from 1 to 9.3 ppm. The water filtrate from bone meal was clear and palatable. The filtrate from magnesium oxide was slightly slimy and cloudy, but palatable. Either of these chemical agents may be used in simple defluoridation procedures in rural and suburban areas using borehole water to reduce the excess fluoride in the water to beneficial non-toxic levels. Both magnesium oxide and bone meal are inexpensive chemicals and readily available in Kenya.

A simple low cost solar cell characterization experiment has been developed for senior undergraduate students in the Department of Physics, University of Nairobi. Experiments were conducted with 20 W and 40 W power solar modules on different sunny days and times at the open roof top of Physics Department, University of Nairobi. It was observed that the current- voltage (I-V) curves obtained for all the measurements were very similar for each module despite the day or time of measurement. The fill factor (FF), short circuit current (Isc), open circuit voltage (Voc), maximum current (Im) and maximum voltage (Vm) were very similar to those supplied by the manufacturer, an indication of reliability and accuracy of the method. The technique eliminates the need for expensive characterization equipment like solar simulators.

The paper evaluates simple meat preservation techniques with the potential for application at household or small scale butchers level in rural areas of Kenya. These techniques involve the lowering of water activity of meat and microbial inhibition chemically or physically. The experimental details for preservation by pressing and solar drying, chemical inhibition, quality factors, organoleptic assessment and costs are also discussed

The paper evaluates simple meat preservation techniques with the potential for application at household or small scale butchers level in rural areas of Kenya. These techniques involve the lowering of water activity of meat and microbial inhibition chemically or physically. The experimental details for preservation by pressing and solar drying, chemical inhibition, quality factors, organoleptic assessment and costs are also discussed

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A simple method for storing mosquito bloodmeal samples, which permits extraction and detection of human DNA after polymerase chain reaction (PCR) amplification of target DNA sequences, was tested. Abdomens of bloodfed field-collected Anopheles gambiae s.l. and An. funestus mosquitoes (Diptera: Culicidae) were directly expressed onto filter paper, air-dried and stored at room temperature. DNA was extracted and amplified at human hypervariable loci TC11, VWA and D1S80. The amplified products were separated using polyacrylamide gel electrophoresis, visualised by silver staining, and results compared with those from mosquitoes that had been preserved in liquid nitrogen. DNA from blooded abdomens stored on dried filter papers could be amplified with greater than 95 % success for any locus, storage temperature, mosquito species or storage duration. Collection and drying of mosquito bloodmeals directly onto filter paper appears to be a more convenient method for sample transportation and storage than the conventional method involving cryopreservation.

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environs. Ground based and Satellite-derived meteorological data were utilized in this study and included thunder events, total rainfall, number of rainy days, maximum rainfall in 24 hours, relative humidity, minimum and maximum temperature, wind speed and direction and Cold Cloud Duration (CCD). In the context of disaster management, the synergistic approach to risk management involves four closely related phases, one of which is the scientific analysis of specific hazard. This is the phase addressed in this study. A risk indicator based on physical and statistical characteristics of thunderstorms at the two locations was developed by examining the patterns of deviations from the mean thunderstorm events and their frequencies. Various aspects of the lightning risks at the two areas are described and discussed. Model results indicate that higher risks of lightning stroke occurred during the long rains season (March to May) as compared to the short rains (September to November) season. This was attributed to higher frequency of thunderclouds during the long rains season. The rain generating mechanisms during the long rains were observed to have higher frequencies of thunder events. The dry season (December to February and June to August) exhibits lowest lightning stroke risks. It is hoped that the results from this study may be of use to the various sectors of economy that need to take into account the dangers/risks of lightning strokes into their day to day operations so as to minimise or avert disasters from lightning strokes. Some of the sectors that may benefit from the results of this study include the Kenya Oil Refinery Depots, Kenya Power and Lighting Company, the Chemical and construction industries among others

Aims: Sequel to the resurgence of TB co-infection in HIV/AIDS patients in sub-Saharan Africa, efavirenz has become an important component of the highly active antiretroviral treatment (HAART). The objective of this study therefore is to provide a simple reversedphase high performance liquid chromatographic (HPLC) method for the determination of efavirenz in human plasma.

Study Design: Method development and experimental study.
Place and Duration of Study: School of Pharmacy, University of Nairobi, Nairobi, Kenya, between October 2009 and September 2010.

Methodology: A 500μl drug-free plasma sample was each placed in six different centrifuge tubes (2ml) and varying aliquots of the stock solution (100μg/ml) of efavirenz were spiked and vortexed for 60sec to give concentrations of 0.5, 1.0, 2.0, 4.0, 8.0 and 16μg/ml for calibration standards and 2.0, 4.0, 8.0 and 16.0μg/ml for quality control samples. The off-column sample pretreatment was carried out by protein precipitation
using ice-cold acetonitrile. The samples were chromatographed in a phenomenex (C18) 5μm particle size column with 250x4.6mm I.D and UV detection at 254nm using a mobile phase, which was made up of a mixture of solutions A and B. Both consisted of acetonitrile, 25mM ammonium acetate buffer and glacial acetic acid in proportions of 90:10:0.1 and 10:90:0.1(v/v), respectively. The analytical technique was validated for precision, accuracy and analyte recovery.

Results: The calibration plot for efavirenz was found to be linear over the concentration range of 0.5 to 16.0μg/ml with the regression line equation obtained as y=26842x–409.4 and the regression coefficient (R2=0.999), which allows for accurate reading of the concentrations of the test samples. The RSD (%) in intraday and interday assays ranged from 0.44 to 0.78%. Accuracy ranged from 92 to 110% and the recovery was >97%.

Conclusion: This new HPLC method is simple, reproducible and cost-effective and can be used for therapeutic drug monitoring of efavirenz in HIV/AIDS patients on HAART as demonstrated in this study.

   

Motivation: Advances in techniques to sparsely label neurons unlock the potential to reconstruct connectivity from 3D image stacks acquired by light microscopy. We present an application for semi-automated tracing of neurons to quickly annotate noisy datasets and construct complex neuronal topologies, which we call the Simple Neurite Tracer. Availability: Simple Neurite Tracer is open source software, licensed under the GNU General Public Licence (GPL) and based on the public domain image processing software ImageJ. The software and further documentation are available via http://fiji.sc/Simple\_Neurite\_Tracer as part of the package Fiji, and can be used on Windows, Mac OS and Linux. Documentation and introductory screencasts are available at the same URL. Contact: longair@ini.phys.ethz.ch; longair@ini.phys.ethz.ch

Differentiation of bloodstream-form trypanosomes into procyclic (midgut) forms is an important first step in the establishment of an infection within the tsetse fly. This complex process is mediated by a wide variety of factors, including those associated with the vector itself, the trypanosomes and the bloodmeal. As part of an on-going project in our laboratory, we recently isolated and characterized a bloodmeal-induced molecule with both lectin and trypsin activities from midguts of the tsetse fly, Glossina longipennis [Osir, E.O., Abubakar, L., Imbuga, M.O., 1995. Purification and characterization of a midgut lectin-trypsin complex from the tsetse fly, Glossina longipennis. Parasitol. Res. 81, 276-281]. The protein (lectin-trypsin complex) was found to be capable of stimulating differentiation of bloodstream trypanosomes in vitro. Using polyclonal antibodies to the complex, we screened a G. fuscipes fuscipes cDNA midgut expression library and identified a putative proteolytic lectin gene. The cDNA encodes a putative mature polypeptide with 274 amino acids (designated Glossina proteolytic lectin, Gpl). The deduced amino acid sequence includes a hydrophobic signal peptide and a highly conserved N-terminal sequence motif. The typical features of serine protease trypsin family of proteins found in the sequence include the His/Asp/Ser active site triad with the conserved residues surrounding it, three pairs of cysteine residues for disulfide bridges and an aspartate residue at the specificity pocket. Expression of the gene in a bacterial expression system yielded a protein (M(r) approximately 32,500). The recombinant protein (Gpl) bound d(+) glucosamine and agglutinated bloodstream-form trypanosomes and rabbit red blood cells. In addition, the protein was found to be capable of inducing transformation of bloodstream-form trypanosomes into procyclic forms in vitro. Antibodies raised against the recombinant protein showed cross-reactivity with the alpha subunit of the lectin-trypsin complex. These results support our earlier hypothesis that this molecule is involved in the establishment of trypanosome infections in tsetse flies.

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OBJECTIVE: To determine the prevalence of Xerophthalmia among Kenyan children aged four to seven years in high risk using Conjuctival Impression Cytology and transfer. DESIGN: A cross sectional community based study. SETTING: Mathare slum in Nairobi and Tiva/Ithiani area of Kitui. SUBJECTS: Children aged four to seven years residing in the above areas were assessed for both clinical and cytological features of vitamin A deficiency. RESULTS: Of the 342 children included in this study, 316 (92.0%) were normal, five (1.5%) had XN, 19 (5.9% had XIA and two (0.6%) had XIB. No signs of corneal Xerophthalmia were seen in this study. Conjuctival impression cytology and transfer (CICT) was used to asses for squamous metaplastic changes associated with Vitamin A deficiency (VAD). Seventy five (23.1%) of the children were normal by CICT while 249 (76.9%) were abnormal. In comparing the two areas of study, only 13.2% of the children in Mathare had normal CICT compared to 50% in Kitui. For each of the age groups studied there was significant difference between the two areas with children from Mathare being more deficient than those from Kitui. CONCLUSION: VAD is a significant health problem in the high risk areas assessed by CICT in this study.

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

Recent research efforts in Multi-disciplinary Design Optimization (MDO) have concentrated
on the development of optimization methods that incorporate uncertainty present in design
variables and/or from noise variables to perform robust or reliability-based design. This work
presents a simulated annealing (SA) approach within the framework of highfidelity 'black-
box'analysis codes for aerodynamic shape design. The analysis codes are restricted to
inexpensive (seconds per analysis iteration) or moderately expensive (minutes per analysis …

Potential impacts of climate change on surface water yields over the Sondu River basin in the western region of Kenya were analysed using the Soil and Water Assessment Tool (SWAT) model with climate input data obtained from the fourth generation coupled Ocean-Atmosphere European Community Hamburg Model (ECHAM4) using the Providing Regional Climates for Impacts Studies (PRECIS) model. Daily time step regional climate scenarios at a spatial grid resolution of 0.44 Ëš over the Eastern Africa region were matched to the Sondu river basin and used to calibrate and validate the SWAT model. Analysis of historical and projected rainfall over the basin strongly indicated that the climate of the area will significantly change with wetter climates being experienced by 2030 and beyond. Projected monthly rainfall distribution shows increasing trends in the relatively dry DJF and SON seasons while showing decreasing trends in the relatively wet MAM and JJA seasons. Potential changes in water yields resulting from climate change were computed by comparing simulated yields under climate change scenarios with those simulated under baseline conditions.

Abstract
Potential impacts of climate change on surface water yields over the Sondu River basin in the western region of Kenya were analysed using the Soil and Water Assessment Tool (SWAT) model with climate input data obtained from the fourth generation coupled Ocean-Atmosphere European Community Hamburg Model (ECHAM4) using the Providing Regional Climates for Impacts Studies (PRECIS) model. Daily time step regional climate scenarios at a spatial grid resolution of 0.44˚ over the Eastern Africa region were matched to the Sondu river basin and used to calibrate and validate the SWAT model.
Analysis of historical and projected rainfall over the basin strongly indicated that the climate of the area will significantly change with wetter climates being experienced by 2030 and beyond. Projected monthly rainfall distribution shows increasing trends in the relatively dry DJF and SON seasons while showing decreasing trends in the relatively wet MAM and JJA seasons. Potential changes in water yields resulting from climate change were computed by comparing simulated yields under climate change scenarios with those simulated under baseline conditions.
There was evidence of substantial increases in water yields ranging between 88% and 110% of the baseline yields by 2030 and 2050 respectively. Although simulated water yields are subject to further verification from observed values, this study has provided useful information about potential changes in water yields as a result of climate change over the Sondu River basin and in similar basins in this region
Keywords: Simulated Impacts, Climate Change, Water Yields, Sondu Basin, Kenya

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.

The study simulated streamflow response under changing climate for Ewaso Ngiro river in Upper Ewaso
Ngiro Catchment (UENC), using Soil and Water Assessment Tool (SWAT). Data from National Centre
for Meteorological research (CNRM) model of Co-Ordinated Regional Downscaling Experiment
(CORDEX) was used to generate climate change scenarios (temperature and rainfall) for representative
concentration pathway (RCP) 4.5 and 8.5 from 2021-2080 relative to the baseline 1976-2005. SWAT
model was set up using historical daily rainfall and temperature data, soils, Digital Elevation Model and
land cover map, and calibrated against observed streamflow. Decreasing trend in historical rainfall and
streamflow was observed while increasing trend was observed for temperature. Projections indicated
increasing trend in temperature in both RCPs, with RCP 8.5 having higher increase (1.1-2.60 C) than
RCP 4.5 (1.0-1.70 C). Rainfall was found to increase from March-November, and decreased in
December-February in all scenarios. Change in total annual rainfall ranged from 0.1-18.5% in 20212050
and 1.2-18.7% in 2051-2080, which corresponded to increase in streamflow of 20.9-23.6% and
21.2-28.2% respectively. Streamflow in March-May decreased (-26 to -10%) in all scenarios and
increased in June-February (9-114%). This was found contrary to streamflow patterns simulated in
neighboring catchments where studies indicate increasing streamflow trend in March-May. Streamflow
response was found to be sensitive to changes in rainfall, thus emphasis should be put on water
conservation and catchment management including protection of headwater forests through agroforestry,
afforestation and reforestation.
Key words: Climate change, Streamflow, Simulation, Upper Ewaso Ngiro Catchment

Differentiation of bloodstream-form trypanosomes into procyclic (midgut) forms is an important first step in the establishment of an infection within the tsetse fly. This complex process is mediated by a wide variety of factors, including those associated with the vector itself, the trypanosomes and the bloodmeal. As part of an on-going project in our laboratory, we recently isolated and characterized a bloodmeal-induced molecule with both lectin and trypsin activities from midguts of the tsetse fly, Glossina longipennis [Osir, E.O., Abubakar, L., Imbuga, M.O., 1995. Purification and characterization of a midgut lectin-trypsin complex from the tsetse fly, Glossina longipennis. Parasitol. Res. 81, 276-281]. The protein (lectin-trypsin complex) was found to be capable of stimulating differentiation of bloodstream trypanosomes in vitro. Using polyclonal antibodies to the complex, we screened a G. fuscipes fuscipes cDNA midgut expression library and identified a putative proteolytic lectin gene. The cDNA encodes a putative mature polypeptide with 274 amino acids (designated Glossina proteolytic lectin, Gpl). The deduced amino acid sequence includes a hydrophobic signal peptide and a highly conserved N-terminal sequence motif. The typical features of serine protease trypsin family of proteins found in the sequence include the His/Asp/Ser active site triad with the conserved residues surrounding it, three pairs of cysteine residues for disulfide bridges and an aspartate residue at the specificity pocket. Expression of the gene in a bacterial expression system yielded a protein (M(r) approximately 32,500). The recombinant protein (Gpl) bound d(+) glucosamine and agglutinated bloodstream-form trypanosomes and rabbit red blood cells. In addition, the protein was found to be capable of inducing transformation of bloodstream-form trypanosomes into procyclic forms in vitro. Antibodies raised against the recombinant protein showed cross-reactivity with the alpha subunit of the lectin-trypsin complex. These results support our earlier hypothesis that this molecule is involved in the establishment of trypanosome infections in tsetse flies.

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.

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A mathematical model was developed to simulate the deep-bed convective drying of Algerian wheat and barley using the characteristics of the selected local varieties. The nonequilibrium model, composed of a system of partial differential equations (PDEs), was solved using temporal and spatial discretization with some simplifying assumptions. The simulated results were compared with experimental data obtained during drying of wheat in deep beds (1-, 5-, and 10-cm depths) in a laboratory dryer under the experimental conditions of 60°C temperature, 10% RH, 0.7 m/s air velocity, and initial grain moisture content of 25.0% (db). The simulation results obtained by the mathematical model were in good agreement with those obtained by experiments carried out on the Algerian wheat.

In investigating Kenya rainfall variability and its relationship to other climatic elements it has become imperative to analyze the irregularly distributed rainfall events in time. To meet this requirement, this study used a stepwise regression technique. The study seeks to improve existing rainfall monitoring and prediction in Nairobi. Monthly rainfall data was fitted to several mathematical functions. The best mathematical model which best simulated the March-May (MAM) and October -December (OND) seasonal rainfall over the three stations of analysis was chosen using a stepwise regression technique. The value of R-squared for the best fit was computed to show the percentage of rainfall information that is explained by the variation in the independent (time) variable. From the results obtained, the stepwise regression technique selected the fourth degree polynomial as the best fit for analyzing the March-May (MAM) and October -December (OND) seasonal rainfall data set. Solar cycle period of ten (10) years was employed to get the fourth degree polynomial variables. Hence from the study, it can be deducted that the 4th degree polynomial function can be used to predict the peak and the general pattern of seasonal rainfall over Nairobi, with acceptable error values. This information can be used in the planning and management of water resources over Nairobi. The same information can be extended to other areas.

: In investigating Kenya rainfall variability and its relationship to other climatic
elements it has become imperative to analyze the irregularly distributed rainfall events in time.
To meet this requirement, this study used a stepwise regression technique. The study seeks to
improve existing rainfall monitoring and prediction in Nairobi. Monthly rainfall data was fitted
to several mathematical functions. The best mathematical model which best simulated the
March-May (MAM) and October -December (OND) seasonal rainfall over the three stations of
analysis was chosen using a stepwise regression technique. The value of R-squared for the best
fit was computed to show the percentage of rainfall information that is explained by the
variation in the independent (time) variable. From the results obtained, the stepwise regression
technique selected the fourth degree polynomial as the best fit for analyzing the March-May
(MAM) and October -December (OND) seasonal rainfall data set. Solar cycle period of ten (10)
years was employed to get the fourth degree polynomial variables. Hence from the study, it can
be deducted that the 4th degree polynomial function can be used to predict the peak and the
general pattern of seasonal rainfall over Nairobi, with acceptable error values. This information

The potential for air pollutants transport, dispersion patterns and impacts within and around the Mui basin, Kitui County is simulated. The spatial-temporal distribution of air pollutants from the proposed coal mines was investigated using Hybrid Single Particle Lagrangian Integrated Trajectories (HYSPLIT) and dispersion analyses. The spatial distribution of wind patterns was investigated using wind rose to explain the observed air pollution
distribution. The analysis was carried out for the dry and wet seasons of the study area namely: December, January, February (DJF), March, April, May (MAM), June, July, August (JJA) and September, October, November (SON) seasons. From the analysis, the season during which the exposure levels would pose much health threat was established based on frequency of winds blowing in certain direction and speed. By spatial analysis of the
proximity of proposed mines and direction of dominant winds, areas most prone to pollution were delineated. The results showed that winds over the area were generally low and southerly. The residents to the northern and northwestern sectors would be at most at risk should the mining commence. Due to low wind speeds during January and the onset of JJA season, residents and workers at the mine would be affected adversely. The results may contribute to the design of effective control strategies to reduce impact of emitted pollutants.

Keywords:
Pollution, Wind rose, HYSPLIT, Trajectory, Dispersion, Exposure

Meteorological elements are observed to display diurnal and/ or semi diurnal variability. Therefore the ability of the UK 11-level GCM to correctly simulate these diurnal variations of weather elements may be used as a measure of how realistic the model is compared to the real atmosphere. The model is forced by the diurnal variation of insolation. In order to study the diurnal cycle of the GCM, the simulated April 1986 sub-daily fields were kept, sampled at every 6 hours. All the data were instantaneous values, apart from rainfall, snowfall, evaporation and sensible heat fluxes which were each accumulated over each time step (10 minutes) for the 6 hours period. The variables were then averaged over the model month (30 days). The mean daily fields were computed separately for 0600 GMT, 1200 GMT, 1800GMT and 0000 GMT. The diurnal variation of three variables, namely; surface temperature, rainfall and wind were examined. The simulated surface temperature indicated similar diurnal characteristic as the observed. Thus there was an increase in temperature from morning to afternoon, followed by a general decrease at night. The simulated diurnal variation of the precipitation, particularly the afternoon maximum, was consistent with the general observed diurnal variation of precipitation over many areas in East Africa. The simulated wind anomaly vector was observed to rotate clockwise in the northern hemisphere and anticlockwise in the southern hemisphere. Such a diurnal behaviour of the wind has been observed in the real atmosphere. This characteristic is associated with the zonal movement of the region of maximum insolation (low pressure) from east to west.

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Differentiation of bloodstream-form trypanosomes into procyclic (midgut) forms is an important first step in the establishment of an infection within the tsetse fly. This complex process is mediated by a wide variety of factors, including those associated with the vector itself, the trypanosomes and the bloodmeal. As part of an on-going project in our laboratory, we recently isolated and characterized a bloodmeal-induced molecule with both lectin and trypsin activities from midguts of the tsetse fly, Glossina longipennis [Osir, E.O., Abubakar, L., Imbuga, M.O., 1995. Purification and characterization of a midgut lectin-trypsin complex from the tsetse fly, Glossina longipennis. Parasitol. Res. 81, 276-281]. The protein (lectin-trypsin complex) was found to be capable of stimulating differentiation of bloodstream trypanosomes in vitro. Using polyclonal antibodies to the complex, we screened a G. fuscipes fuscipes cDNA midgut expression library and identified a putative proteolytic lectin gene. The cDNA encodes a putative mature polypeptide with 274 amino acids (designated Glossina proteolytic lectin, Gpl). The deduced amino acid sequence includes a hydrophobic signal peptide and a highly conserved N-terminal sequence motif. The typical features of serine protease trypsin family of proteins found in the sequence include the His/Asp/Ser active site triad with the conserved residues surrounding it, three pairs of cysteine residues for disulfide bridges and an aspartate residue at the specificity pocket. Expression of the gene in a bacterial expression system yielded a protein (M(r) approximately 32,500). The recombinant protein (Gpl) bound d(+) glucosamine and agglutinated bloodstream-form trypanosomes and rabbit red blood cells. In addition, the protein was found to be capable of inducing transformation of bloodstream-form trypanosomes into procyclic forms in vitro. Antibodies raised against the recombinant protein showed cross-reactivity with the alpha subunit of the lectin-trypsin complex. These results support our earlier hypothesis that this molecule is involved in the establishment of trypanosome infections in tsetse flies.

Over the past four decades, Lake Victoria basin has experienced drastic environmental changes on account of both natural and anthropogenic factors. The natural factors include prolonged droughts and the recent emergence of water hyacinth in the Lake, while anthropogenic factors include the deforestation rates, poor agricultural practices, and destruction of critical wetlands. This study examines the potential impact of deforestation on the rainfall over the lake Victoria basin. To assess the potential impact of deforestation on rainfall over the region, the General Circulation Model (GCM) ECHAM5 was applied. ECHAM5 was used to predict the possible impact of land cover and land use changes on rainfall using land cover and land use scenarios based on the Integrated Model to Assess Global Environment (IMAGE). The projected vegetation cover for 2050 was used to model the impact of deforestation, which indicated a general decrease in the canopy. The results from the model indicate a decrease in rainfall over many parts, although some areas showed increased rainfall. From the study we conclude that while deforestation has an impact on climate, there seem to be a complex interaction between forest and the rainfall generation mechanism.

In semi arid Kenya, the occurrence of flush floods and soil erosion on agricultural watersheds is attributed to intense rainstorm events of short duration. Thus when agricultural watersheds have no erosion control structures in place, the generation of direct runoff would increase with cultivation. Of the two components of runoff namely, runoff volume and peak runoff discharge, the consideration of peak runoff discharge rate is critical to the design of effective hydraulic structures for controlling floods and soil erosion. In order to accurately predict a watershed's peak runoff discharge, it is important to select a model that is deterministic and yet simple to use. The model should be able to consider the time distribution of runoff response as influenced by Watershed characteristics. The time to peak runoff discharge is largely influenced by the time of concentration. The time of concentration depends on the shape, size and relief of the watershed. In Iiuni Watershed, the Nash model, a parsimonious deterministic model, was selected to predict peak runoff discharges. This model uses the instantaneous unit hydrograph principle to simulate the direct runoff hydrographs and estimate peak runoff discharge. The Nash model was applied using input parameters derived from the watershed's rainfall-runoff characteristics. The results obtained showed that the Nash model was good in predicting peak runoff discharges. This statistic of comparison, R2 (coefficient of efficiency) for the model was above 70% for the model which is indicative of good model prediction of peak runoff discharge (Nash and Sutcliffe, 1970). From this analysis, the Nash model is recommended for the estimation of peak runoff discharge from un-gauged agricultural watersheds in Kenya.

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Background/aim: Glaucoma accounts for 8% of global blindness and surgery remains an important treatment. We aimed to determine the impact of adding simulation-based surgical education for glaucoma.

Methods: We designed a randomised controlled, parallel-group trial. Those assessing outcomes were masked to group assignment. Fifty-one trainee ophthalmologists from six university training institutions in sub-Saharan Africa were enrolled by inclusion criteria of having performed no surgical trabeculectomies and were randomised. Those randomised to the control group received no placebo intervention, but received the training intervention after the initial 12-month follow-up period. The intervention was an intense simulation-based surgical training course over 1 week. The primary outcome measure was overall simulation surgical competency at 3 months.

Results: Twenty-five were assigned to the intervention group and 26 to the control group, with 2 dropouts from the intervention group. Forty-nine were included in the final intention-to-treat analysis. Surgical competence at baseline was comparable between the arms. This increased to 30.4 (76.1%) and 9.8 (24.4%) for the intervention and the control group, respectively, 3 months after the training intervention for the intervention group, a difference of 20.6 points (95% CI 18.3 to 22.9, p<0.001). At 1 year, the mean surgical competency score of the intervention arm participants was 28.6 (71.5%), compared with 11.6 (29.0%) for the control (difference 17.0, 95% CI 14.8 to 19.4, p<0.001).

Conclusion: These results support the pursuit of financial, advocacy and research investments to establish simulation surgery training units and courses including instruction, feedback, deliberate practice and reflection with outcome measurement to enable trainee glaucoma surgeons to engage in intense simulation training for glaucoma surgery.

Trial registration number: PACTR201803002159198.

N-Phenylcinnarnohydroxamic acid (PCHA) reacts with iron(III) and vanadium(V) in the presence of thiocyanate to form water-insoluble orange and green complexes, respectively. The iron(III)-PCHA and vanadium(V)-PCHA-thiocyanate complexes can be quantitatively extracted into toluene and other common organic solvents at pH 1.5–2.0. The absorption spectra and composition of both complexes are described. The effects of foreign ions and of experimental variables on the extraction and determination of the two metal ions are studied. A simple, selective method is described for the simultaneous determination of iron(III) and vanadium(V) by extraction-spectrophotometry; absorbances are measured at 440 and 580 nm. Mixtures can be determined over the range 10−4–10−5 M in each metal. The method was applied successfully to the analysis of standard steels for iron and vanadium.

To highlight the presence of this uncommon developmental disorder in our set up and show that simultaneous open reduction and salter innominate osteotomy can restore normal hip development Design: Prospective study. Setting: Kenyatta National Hospital between 2002 and 2004. Subjects: Children with typical developmental dysplasia of the hip (DDH) who were 18 months and above were operated on. Methods: Clinical and radiological assessment of the hips was done and skin traction was applied for between two to four weeks until femoral head came down to the level of the acetabulum. Open reduction, iliopsoas and adductor releases, capsulorraphy and salter innominate osteotomy was then done. The graft was held by two smooth Kirschner (k) wires. Unlike Salter, the femoral head was held in the socket by a smooth Kwire. A hip spica was applied for 12 weeks and thereafter the children were allowed to mobilize freely at their own pace. Follow up clinical and radiological assessment was done. Results: Two female children with three congenital dislocations of the hips were operated. They were 18 months and three and a half years old at the time of the initial surgery. At follow up of between nine and 27 months, there was good initial clinical and radiological outcome. The average acetabular index dropped from an average of 41 degrees pre-operatively to an average of 18 degrees post-operatively. Conclusion: This operation redirects the acetabulum without deepening it, achieving good femoral head coverage. Long term follow is intended. Pooling of patients with this uncommon disorder in our environment is advocated to further develop surgical competency. Early competent screening of new born babies could enable early conservative management with good outcome.

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This integrative review on the teaching of reading in Kenyan primary schools provides a foundation for the growing movement there to improve reading education. In gathering sources for this review, we took an inclusive historical stance. Thus, we did not dismiss research reports that lacked traditional indicators of quality such as being published in peer-reviewed journals. We used multiple methods to find relevant research and associated documents, including two trips to Kenya. The review is organized by six topics: (a) language of instruction, (b) reading instruction, (c) reading materials, (d) reading culture, (e) assessment, and (f) teacher development. The review concludes with six proposals for policymakers, educational researchers, and teacher educators for the development of reading instruction based on what we learned in reviewing the literature. The first proposals are intended specifically to address the teaching of reading in Kenya, but they may be relevant to other sub-Saharan nations. The final proposal encourages others to conduct similar reviews to make possible a handbook of reading in Africa.

Four hundred and three teenage secondary school students (50.6% males) from two girls' and two boys' Nairobi City Schools, selected by stratified sampling, were screened to determine the prevalence of proteinuria, haematuria, nitrituria and hypertension. Nine students (2.2%) had significant proteinuria while 14 (3.5%) had microscopic haematuria. Two students had combined proteinuria and haematuria. There was no statistically significant difference in the prevalence of proteinuria and/or haematuria between the sexes. Other urinary abnormalities detected were leucocyturia in 14(3.5%) and nitrites in four (1%). Leucocyturia was commonner in females (p = 0.001). Cloudy urinary appearance was significantly associated with the presence of leucocyturia (p = 0.0028) and proteinuria (p = 0.0276). Neither personal history of recurrent sore throat and skin infections nor family history of hypertension, diabetes mellitus or kidney disease was significantly associated with proteinuria or haematuria. Blood pressure tended to increase with age. Mean systolic and diastolic blood pressures were significantly higher in boys than girls in the age group 15-18 years (P < 0.001). Of the 397 students whose blood pressures were measured, four (1%) were found to be hypertensive. Weight and body mass index were strong positive correlates of blood pressure. The prevalence of proteinuria, haematuria, other urinary abnormalities and hypertension ranges between 1% and 3.5% among teenage secondary school children. The majority are asymptomatic and have no significant associations. It is recommended that routine urinalysis and blood pressure measurements should be part of the school health service so as to identify asymptomatic students who require close monitoring and/or intervention.

A 30 year old female with an unexpected right adrenal phaechromacytoma invading the renal vein, the inferior vena cava and extending into the right atrium is presented. She also had BuddChiari syndrome due to invasion of the hepatic veins by the tumour. Additionally, the tumour had metastasised to the liver and the lungs. Despite elevated 24 hour urinary vanillylmandelic acid (VMA) the patient was normotensive pre-operatively. The patient underwent right adrenalectomy and extended nephrectomy with milking of the tumaur from the inferior vena cava. Unfortunately, the patient developed multiple hypotensive episodes and adult respiratory distress syndrome post-operatively and died three weeks after surgery.

A preliminary report of 50 cases of acute pelvic inflammatory disease (PID) studied at the Kenyatta National Hospital to find out the role of chlamydia trachomatis in its aetiology is presented. Endocervical swab cultures were done. There were 2/50 (4.0%) cases positive for chlamydia trachomatis. The role of this pathogen in the aetiology of acute PID is discussed.

Department of Obstetrics and Gynaecology, University of Nairobi, Kenya. This pilot study aimed to determine the feasibility of a larger study of contraception and risk of HIV infection in women. We also measured risk factors for and occurrence of HIV infection in the participants. A cohort of 1537 seronegative women attending a family planning clinic in Nairobi, Kenya was enrolled and followed for up to 12 months per woman. HIV testing was done quarterly. A nested case-control analysis was done with seroconverting women (cases) and 3 matched controls per case, who had detailed interviews and received physical examinations and STD tests. The prevalence of HIV at enrollment was 6.1%; seropositive women were excluded from further analysis. The 12-month life-table cumulative incidence of HIV was 2.1 per 100 women (95% confidence interval [CI] 1.1-3.2). In the nested case-control analysis (17 cases and 51 controls), the crude odds ratio of HIV infection comparing oral contraceptive (OC) users with other women was 3.5 (95%) CI 0.8-21.5), which persisted after control for single confounders at a time. The putative association between OC use sand HIV infection is critical to public health policy, yet no study has been conducted specifically to measure it, yielding weak and conflicting evidence. We intend to conduct a larger study with a similar design as the current pilot study, which confirmed the feasibility of a more definitive project.

Department of Obstetrics and Gynaecology, University of Nairobi, Kenya. This pilot study aimed to determine the feasibility of a larger study of contraception and risk of HIV infection in women. We also measured risk factors for and occurrence of HIV infection in the participants. A cohort of 1537 seronegative women attending a family planning clinic in Nairobi, Kenya was enrolled and followed for up to 12 months per woman. HIV testing was done quarterly. A nested case-control analysis was done with seroconverting women (cases) and 3 matched controls per case, who had detailed interviews and received physical examinations and STD tests. The prevalence of HIV at enrollment was 6.1%; seropositive women were excluded from further analysis. The 12-month life-table cumulative incidence of HIV was 2.1 per 100 women (95% confidence interval [CI] 1.1-3.2). In the nested case-control analysis (17 cases and 51 controls), the crude odds ratio of HIV infection comparing oral contraceptive (OC) users with other women was 3.5 (95%) CI 0.8-21.5), which persisted after control for single confounders at a time. The putative association between OC use sand HIV infection is critical to public health policy, yet no study has been conducted specifically to measure it, yielding weak and conflicting evidence. We intend to conduct a larger study with a similar design as the current pilot study, which confirmed the feasibility of a more definitive project.

PIP: The 1725 women presenting at Kenyatta National Hospital in 1984-86 for IUD insertion were screened for cervical Chlamydia trachomatis and Neisseria gonorrhoea before the IUD insertion. 207 (12%) cases of chlamydia trachomatis and 61 (3.5%) cases of Neisseria gonorrhoea were detected. There was no association between the ages of the women and the prevalence of these 2 sexually transmitted pathogens; however, there was a significant relationship between the prevalence of N gonorrhoea and marital status. N gonorrhoea was detected in 6.2% of never-married and 5.2% of formerly married women compared with 2.3% of currently married subjects (p0.001). Although there was no significant relationship between parity and the rate of isolation of the 2 pathogens, infection tended to be lower in women with 5 or more children. Educational attainment was significantly associated with N gonorrhoea infection: 5.1% in women who had 0-7 years of schooling compared with 3.0% in those with 8 or more years of education (p0.05). 12 women with C trachomatis infection were also positive for N gonorrhoea. There was no significant relationship between C trachomatis infection and any of the demographic variables examined. Given the finding that the greatest risk of pelvic inflammatory disease occurs in the 1st month of IUD use, it can be speculated that pathogens are inserted into the uterine cavity at the time of IUD insertion. It is therefore recommended that clients–especially the unmarried, the formerly unmarried, and those with low levels of education–be screened and treated for N gonorrhoea and C trachomatis before an IUD is inserted.

Department of Obstetrics and Gynaecology, University of Nairobi, Kenya. BACKGROUND: A WHO expert group and the International Planned Parenthood Federation recommend against use of intrauterine devices (IUDs) in HIV-1-infected women based on theoretical concerns about pelvic infection and increased blood loss. We investigated whether the risk of complications after IUD insertion is higher in HIV-1-infected women than in non-infected women. METHODS: 649 (156 HIV-1 infected 493 non-infected) women in Nairobi, Kenya, who requested and met local eligibility criteria for insertion of an IUD were enrolled. We gathered information on IUD-related complications, including pelvic inflammatory disease, removals due to infection, pain, or bleeding, expulsions, and pregnancies at 1 and 4 months after insertion. Patients' HIV-1 status was masked from physicians. FINDINGS: Complications were identified in 48 of 615 women (11 [7.6%] HIV-1-infected women, 37 [7.9%] non-infected). Incident pelvic inflammatory disease (two [1.4%] HIV-1 infected, one [0.2%] non-infected) and infection-related complications (any tenderness, removal of IUD for infection or pain; ten [6.9%] HIV-1 infected, 27 [5.7%] non-infected) were also rare and similar in the two groups. Complication rates were similar by CD4 (immune) status. Multivariate analyses suggested no association between HIV-1 infection and increased risks for overall complications (odds ratio 0.8 [95% CI 0.4-1.7]) or infection-related complications (1.0 [0.5-2.3]), adjusted for marital status, study site, previous IUD use, ethnic origin, and frequency of sexual intercourse, but a slight increase cannot be ruled out. INTERPRETATION: Our data suggest that IUDs may be a safe contraceptive method for appropriately selected HIV-1-infected women with continuing access to medical services. PIP: Both the International Planned Parenthood Federation and the World Health Organization have warned against use of IUDs in HIV-infected women due to theoretical concerns about pelvic infection and increased blood loss. No published studies have investigated this concern, however. The validity of this recommendation was investigated in a comparative study of 156 HIV-1-infected and 493 non-infected women from two public family planning clinics (Kenyatta National Hospital and Riruta City Clinic) in Nairobi, Kenya, who requested and met local eligibility criteria for IUD insertion. At 1 and 4 months after insertion, information was collected from physicians–blinded as to the patient's HIV status–on IUD-related complications such as pelvic inflammatory disease (PID), removals, expulsions, and pregnancies. Complications were identified in 11 (7.6%) HIV-positive and 37 (7.9%) HIV-negative women. There were only 3 incident cases of PID, 2 of which occurred in HIV-infected women. IUD removal due to pain or infection occurred in 10 (6.9%) HIV-infected and 27 (5.7%) noninfected women. There were no differences in overall IUD complications in HIV-1-infected women by CD4 status (severely, moderately, or mildly immunocompromised). After adjustment for marital status, study site, previous IUD use, ethnic origin, and frequency of sexual intercourse, multivariate analysis suggested no association between HIV-1 infection and increased risks for overall IUD-related complications (odds ratio (OR), 0.8; 95% confidence interval (CI), 0.4-1.7) or infection-related complications (OR, 1.0; 95% CI, 0.5-2.3). These findings suggest that the IUD may be a safe contraceptive method for appropriately selected HIV-infected women with continuing access to medical services.

Department of Obstetrics and Gynaecology, University of Nairobi Medical School, Kenya. Most of the small increased risk in pelvic inflammatory disease (PID) associated with the intrauterine contraceptive device (IUCD) appears to be caused by bacterial contamination of the endometrial cavity at the time of insertion. This randomized clinical trial of 1813 women in Nairobi, Kenya, assessed the effectiveness of 200 mg of doxycycline given orally at the time of insertion in reducing the occurrence of PID. The rate of this infection in the doxycycline-treated group was 31% lower than that in the placebo-treated group (1.3 and 1.9%, respectively; RR 0.69; 95% CI 0.32 to 1.5). The rate of an unplanned IUCD-related visit to the clinic was also 31% lower in the doxycycline-treated group (RR 0.69; 95% CI 0.52 to 0.91). Although the significance level (P = 0.17) for the reduction is PID does not meet the conventional standard of 0.05, the results may be suggestive of an effect. Moreover, the reduction in IUCD-related visits (P = 0.004) not only represents an important decrease in morbidity but also substantiates the reduction found for PID. Further studies are needed to corroborate these results. Consideration should be given to the prophylactic use of doxycycline at the time of IUCD insertion as an approach to preventing PID and other IUCD-related morbidity. PIP: This double-blind, randomized clinical trial was conducted to investigate whether the use of prophylactic doxycycline at intrauterine contraceptive device (IUCD) insertion can reduce the incidence of pelvic inflammatory disease (PID) in women. 1813 women in Nairobi, Kenya, were given 200 mg of doxycycline, taken orally at the time of IUCD insertion. Analysis of the data collected show that the rate of PID infection in the doxycycline-treated group was 31% lower than that in the placebo-treated group. The rate of an unplanned IUCD-related visit to the clinic was also 31% lower in the doxycycline-treated group. Although the significance level (P = 0.17) for the reduction in PID does not meet the conventional standard of 0.05, the results may be suggestive of an effect. In addition, the reduction in IUCD-related visits (P = 0.004) not only represents an important decrease in morbidity, but also substantiates the reduction found for PID. To conclude, the prophylactic use of doxycycline at the time of IUCD insertion appears effective, well tolerated, and cost-effective. Further studies are needed to corroborate these results and consideration should be given to the prophylactic use of doxycycline at the time of IUCD insertion as an approach in preventing PID and other IUCD-related morbidity.

PIP: This research report studies several biochemical and histochemical aspects of cervical carcinoma and explores their use in follow-up of patients undergoing radiotherapy. Material came from 19 patients with invasive cervical carcinoma admitted to Kenyatta National Hospital. A control group consisted of 20 women matched for age who attended clinics at the hospital but were not suffering from any malignant disease; control tissue for histological examination was obtained from 3 women who had undergone hysterectomy for uterine fibroids. Biochemical assays for alkaline and acid phosphatases in patients with cervical carcinoma show an increase in alkaline phosphatase in carcinomatous tissue (35.7 umoles/hr/mg) as opposed to normal tissue (7.2). Acid phosphatase values were only moderately raised. Assays of the same enzymes in blood showed a less marked difference between patients and controls (ranges of 7.5-20.8 and 3-14, respectively). When examined histochemically, increased alkaline phosphatase activity was observed in connective tissue, epithelium of the glands and blood capillaries of tumor tissue. 1 section containing normal tissue bordering carcinomatous tissue demonstrated normal alkaline phosphatase activity in the normal tissue and increased activity in the tumor tissue. In summary, there is increased enzyme activity around the tumor areas, but values for serum levels show an overlap of normal and abnormal cases and are therefore not predictive. Results demonstrate a clear difference in activities of these enzymes in carcinomatous tissue and normal tissue, which may be of value in follow-up care.

This pilot study aimed to determine the feasibility of a larger study of contraception and risk of HIV infection in women. We also measured risk factors for and occurrence of HIV infection in the participants. A cohort of 1537 seronegative women attending a family planning clinic in Nairobi, Kenya was enrolled and followed for up to 12 months per woman. HIV testing was done quarterly. A nested case-control analysis was done with seroconverting women (cases) and 3 matched controls per case, who had detailed interviews and received physical examinations and STD tests. The prevalence of HIV at enrollment was 6.1%; seropositive women were excluded from further analysis. The 12-month life-table cumulative incidence of HIV was 2.1 per 100 women (95% confidence interval [CI] 1.1-3.2). In the nested case-control analysis (17 cases and 51 controls), the crude odds ratio of HIV infection comparing oral contraceptive (OC) users with other women was 3.5 (95%) CI 0.8-21.5), which persisted after control for single confounders at a time. The putative association between OC use sand HIV infection is critical to public health policy, yet no study has been conducted specifically to measure it, yielding weak and conflicting evidence. We intend to conduct a larger study with a similar design as the current pilot study, which confirmed the feasibility of a more definitive project.

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.

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Sexually transmitted diseases (STDs) have a significant adverse effect on reproductive and child health worldwide. The control of STDs such as gonorrhea is therefore an absolute priority. Cefixime, an oral third-generation cephalosporin with in vitro activity similar to that of ceftriaxone, may be an effective candidate for the treatment of gonorrhea. The efficacy of a single oral 400-mg dose of cefixime was compared with that of a single intramuscular 250-mg dose of ceftriaxone for the treatment of Neisseria gonorrhoeae urethritis in 190 men and cervicitis in 46 women in Nairobi, Kenya. A bacteriologic cure was recorded in 100% of 63 evaluatable patients treated with ceftriaxone and 118 (98%) of 121 evaluatable patients treated with cefixime. Cefixime, as a single oral dose, is an effective alternative for the treatment of uncomplicated gonococcal urethritis in men and cervicitis in women

INTRODUCTION: Plasmodium falciparum relies on gametocytogenesis to transmit from humans to mosquitoes. Gametocyte development 1 (Pfgdv1) is an upstream activator and epigenetic controller of gametocytogenesis. The emergence of drug resistance is a major public health concern and this requires the development of new strategies that target the transmission of malaria. As a putative drug target, Pfgdv1 has not been characterized to identify its polymorphisms and alleles under selection and how such polymorphisms influence protein structure. METHODS: This study characterized single-nucleotide polymorphisms (SNPs) in primary sequences (n = 30) of Pfgdv1 gene generated from thirty blood samples collected from patients infected with P. falciparum and secondary sequences (n = 216) retrieved from PlasmoDB. ChromasPro, MUSCLE, Tajima's D statistic, SLAC, and STRUM were used in editing raw sequences, performing multiple sequence alignment (MSA), identifying signatures of selection, detecting codon sites under selection pressure, and determining the effect of SNPs, respectively. RESULTS: MSA of primary and secondary sequences established the existence of five SNPs, consisting of four non-synonymous substitutions (nsSNPs) (p.P217H, p.R398Q, p.H417N, and p.D497E), and a synonymous substitution (p.S514S). The analysis of amino acid changes reveals that p.P217H, p.R398Q, and p.H417N comprise non-conservative changes. Tajima's D statistic showed that these SNPs were under balancing selection, while SLAC analysis identified p.P217H to be under the strongest positive selection. . Further analysis based on thermodynamics indicated that p.P217H has a destabilizing effect, while p.R398Q and p.D497E have stabilizing effects on the protein structure. CONCLUSIONS: The existence of four nsSNPs implies that Pfgdv1 has a minimal diversity in the encoded protein. Selection analysis demonstrates that these nsSNPs are under balancing selection in both local and global populations. However, p.P217H exhibits positive directional selection consistent with previous reports where it showed differentiatial selection of P. falciparum in low and high transmission regions. Therefore, in-silico prediction and experimental determination of protein structure are necessary to evaluate Pfgdv1 as a target candidate for drug design and development.

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Abstract
BACKGROUND:
Relatively little is known concerning the immunohistochemical marking of sinonasal
adenocarcinoma (SNA). The most clinically problematic tumors are those that seem
histologically identical to colonic adenocarcinoma, a neoplasm that may metastasize to the
sinonasal region. To determine whether differentiated immunohistochemical expression of
keratins could differentiate primary from metastatic tumors and to understand the biology of
these tumors, differentiated keratin and oncoprotein expression was investigated.
METHODS:
Eleven patients with sinonasal adenocarcinoma were investigated for expression of cytokeratins
7 and 20 (CK7, CK20), AE 1/3, CAM 5.2, smooth muscle-specific actin, muscle-specific actin,
desmin, S-100, carcinoembryonic antigen (CEA), p53, and HER-2/neu.
RESULTS:
All sinonasal adenocarcinomas of intestinal type were cytokeratin 7 positive. None of the tumors
showed myoepithelial differentiation. Strong HER-2/neu staining was seen in some tumors.
CONCLUSIONS:
Strong HER-2/neu staining in some cases suggests this oncogene may be involved in the genesis
of SNA. Immunohistochemical staining with cytokeratin 7 may be potentially useful in
differentiating primary from metastatic disease in sinonasal adenocarcinomas of the intestinal
subtype.
Copyright 2003 Wiley Periodicals, Inc. Head Neck 25: 763-771, 2003

The first case of COVID-19 was reported in Kenya in March 2020 and soon after non-pharmaceutical interventions (NPIs) were established to control the spread of the disease. The NPIs consisted, and continue to consist, of mitigation measures followed by a period of relaxation of some of the measures. In this paper, we use a deterministic mathematical model to analyze the dynamics of the disease, during the first wave, and relate it to the intervention measures. In the process, we develop a new method for estimating the disease parameters. Our solutions yield a basic reproduction number, R0 = 2.76, which is consistent with other solutions. The results further show that the initial mitigation reduced disease transmission by 40% while the subsequent relaxation increased transmission by 25%. We also propose a mathematical model on how interventions of known magnitudes collectively affect disease transmission rates. The modelled positivity rate curve compares well with observations. If interventions of unknown magnitudes have occurred, and data is available on the positivity rate, we use the method of planar envelopes around a curve to deduce the modelled positivity rate and the magnitudes of the interventions. Our solutions deduce mitigation and relaxation effects of 42.5% and 26%, respectively; these percentages are close to values obtained by the solution of the SIRD system. Our methods so far apply to a single wave; there is a need to investigate the possibility of extending them to handle multiple waves.Competing Interest StatementThe authors have declared no competing interest.Clinical TrialNot a clinical trialFunding StatementNo funding supportAuthor DeclarationsI confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.YesThe details of the IRB/oversight body that provided approval or exemption for the research described are given below:KNH-UoN Ethics and Research Committee https://erc.uonbi.ac.keAll necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived.YesI understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).YesI have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable.YesData sources: All the data used is in the public domain [1, 44, 56, 57]