This paper investigates the possibilities of applying emerging management theories and techniques to constitutionally created offices in Kenya and East African region. The benefits from application of these theories, particularly in the judicial services are highlighted.

This paper investigates the possibilities of applying emerging management theories and techniques to constitutionally created offices in Kenya and East African region. The benefits from application of these theories, particularly in the judicial services are highlighted.

This paper investigates the possibilities of applying emerging management theories and techniques to constitutionally created offices in Kenya and East African region. The benefits from application of these theories, particularly in the judicial services are highlighted.

This paper investigates the possibilities of applying emerging management theories and techniques to constitutionally created offices in Kenya and East African region. The benefits from application of these theories, particularly in the judicial services are highlighted.

This paper investigates the possibilities of applying emerging management theories and techniques to constitutionally created offices in Kenya and East African region. The benefits from application of these theories, particularly in the judicial services are highlighted.

An in vitro study of the antinematodal action of two groups of compounds which act on the receptor complex of the inhibitory neurotransmitter, Gamma-aminobutyric acid (GABA) in mammalian systems is described. The compounds, Ivermectin and two benzodiazepines, Diazepam and a water soluble Midazolam were tested singly or in combination against two microfilarial parasites Onchocerca lienalis (closely related to Onchocerca volvulus) and Brugia pahangi. The combination of ivermectin and diazepam at a concentration of 0.1 microgram/ml and 33 micrograms/ml respectively achieved the same effect on microfilarial motility as when ivermectin was given at 1 microgram/ml alone or diazepam at 66 micrograms/ml alone. Similarly when the combination of ivermectin at 0.1 microgram/ml and midazolam at 10 micrograms/ml was used it achieved the same effect as ivermectin at 1 microgram/ml alone or midazolam at 33 micrograms/ml alone. This showed that both benzodiazepines had a synergistic effect on the activity of ivermectin. The microfilariae of B. pahangi were insensitive to both groups of compounds at all concentrations used.

Tala Quarrry in African Geoscience Review Vol. 9 Number 4 pp. 385-396.  

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An enzyme immunoassay (EIA) was developed in-house for the detection of anti-hepatitis C virus (HCV) antibody against the prevailing genotypes in India. The specific reactivity of the test was compared with commercial second and third-generation EIAs and reverse transcription nested polymerase chain reaction (RT-nested PCR). Fifteen thousand nine hundred twenty-two healthy blood donors at the All India Institute of Medical Sciences (AIIMS), New Delhi, India, were screened for anti-HCV antibody. Two hundred ninety-five (1.85%) of these donors were positive. The screening was also used to determine how many patients with acute hepatitis and chronic liver diseases were positive for anti-HCV antibody. Five hundred sixty-four chronic liver disease patients were screened for anti-HCV antibody and 78 (13.83%) were found positive. Two hundred forty-seven sporadic acute viral hepatitis patients were screened for viral infection markers. Hepatitis B and E viruses (HBV and HEV) were the major etiologic agents. HCV was associated with 9% of the acute cases. Anti-HCV core IgM with HCV RNA detection were found to be helpful for the diagnosis of acute HCV infection.

Mini- and microsatellite sequences show high levels of variation and therefore provide excellent tools for both the genotyping and population genetic analysis of parasites. Herein we describe the identification of a panel of 11 polymorphic microsatellites and 49 polymorphic minisatellites of the protozoan haemoparasite Theileria parva. The PCR products were run on high resolution Spreadex gels on which the alleles were identified and sized. The sequences of the mini- and microsatellites were distributed across the four chromosomes with 16 on chromosome 1, 12 on chromosome 2, 14 on chromosome 3 and 18 on chromosome 4. The primers from the 60 sequences were tested against all the Theileria species that co-infect cattle in East and Southern Africa and were found to be specific for T. parva. In order to demonstrate the utility of these markers, we characterised eight tissue culture isolates of T. parva isolated from cattle in widely separated regions of Eastern and Southern Africa (one from Zambia, one from Uganda, two from Zimbabwe, four from Kenya) and one Kenyan tissue culture isolate from Cape buffalo (Syncerus caffer). The numbers of alleles per locus range from three to eight indicating a high level of diversity between these geographically distinct isolates. We also analysed five isolates from cattle on a single farm at Kakuzi in the central highlands of Kenya and identified a range of one to four alleles per locus. Four of the Kakuzi isolates represented distinct multilocus genotypes while two exhibited identical multilocus genotypes. This indicates a high level of diversity in a single population of T. parva. Cluster analysis of multilocus genotypes from the 14 isolates (using a neighbour joining algorithm) revealed that genetic similarity between isolates was not obviously related to their geographical origin.

The relative value of an anti-hepatitis C virus (HCV) serological assay and reverse transcriptase-nested polymerase chain reaction assays (RT-PCR) were investigated for the constant 5' putative noncoding region of HCV for the diagnosis of HCV-associated chronic liver diseases in India. One hundred fifteen patients with biopsy proven chronic active hepatitis and 140 cases of cirrhosis of the liver were investigated for anti-HCV antibody using a second generation commercial enzyme-linked immunosorbent assay (ELISA). A proportion of these patients: 42 with chronic hepatitis and 27 with cirrhosis of the liver were analysed further for HCV RNA in the serum using RT-nested PCR assay. Thirty-three (12.9%) of the 255 patients were positive for anti-HCV antibody and 23 of 69 (33.3%) patients were positive for HCV RNA in serum. Fifteen of the 33 (45.5%) anti-HCV positive patients had HCV RNA in the serum. Eight of 36 (22.2%) HCV seronegative patients tested were found with HCV RNA. This indicates that the diagnosis of HCV infection is not possible if it is based solely on the available serodiagnostic tests. Inclusion of both assays improved the diagnostic efficiency, 18.8% (13/69) were negative for all virological markers associated with HBV and HCV infection. Since a majority of the chronic liver disease patients (143/255 [56%]) were seronegative for either HBV or HCV infection, it is significant that HCV RNA was detected in 38% (8/21) of a randomly selected group from these patients. The antibody assay and PCR were compared using interclass correlation (kappa statistics).(ABSTRACT TRUNCATED AT 250 WORDS)

Hepatitis C virus (HCV) shows substantial nucleotide sequence diversity distributed throughout the viral genome, with many variants showing only 68-79% overall sequence homology. This has led to problems in diagnosis of HCV using commercial immunoassays. Based on clustering of homologous sequences, various genotypes and subtypes of HCV have been described from different geographical regions. In the present study, 11 isolates from India were genotyped using sequence comparison for part of the non-structural (NS5) and structural (core) regions. Parts of the genome covering 451 bp (nt 9-459) of the core gene and a 249 bp fragment (nt 7959-8207) of the NS5 gene were reverse transcribed and amplified using nested polymerase chain reaction (RT-PCR). The amplified fragments were cloned and sequenced. The classification into genotypes was done on the basis of phylogenetic analysis. Four isolates showed sequence homology to type 1b. Two of the isolates were classified as type 3a. One isolate was classified as type 3b and the remaining four isolates were found to be variants of type 3 but did not belong to any designated subtype. On the basis of phylogenetic analysis two of the unclassified isolates were put into a new subtype of 3 named as 3g. In one of these variants, parts of a 5'-noncoding (5' NCR; 204 bp), envelope-E1 (435 bp), and NS3 (502 bp) regions were also amplified, cloned, and sequenced. This study demonstrates the type 3 variants including a new subtype (3g) to be the major cause of HCV infection in India.

Background: The challenge of cost in establishing cytology and/or Human Papillomavirus (HPV) mass screening for cervical cancer in resource limited countries prompted adoption of visual inspection techniques as alternative tests despite them having low specificity.
Objectives: To determine the pattern of cervical intraepitheliallesions and infections in women with abnormal visual inspection test results referred to Kenyatta National Hospital (KNH).
Methodology: A descriptive cross-sectional study was conducted at KNH where women who were referred to this facility after having abnormal visual inspection test results were recruited.
Results: Of the 232 participants recruited, 57(24.6%) had a report of atypical squamous cells of undetermined significance (ASUCS) or worse as follows; 5(2.2%) were ASCUS, 13(5.6%) were low grade squamous intraepithelial lesions (LSIL), 4(1.7%) were atypical glandular cells (AGC), 1(0.4%) was atypical squamous cells cannot exclude high grade (ASC-H), 20(8.6%) were high grade squamous intraepithelial lesions (HSIL) and 18(7.8%) were reported as having carcinoma on cytology. Of these abnormal results 3(1.3%) were from 33 women (14.2%) more than 50 years of age who were also recruited in this study. Infections were detected in 1 (4.7%) of the study participants.
Conclusions and recommendations: Pap smear was useful as follow-up test as it reduced number of referrals for definitive diagnosis to 16.8% while sparing the rest (83.2%) from unnecessary treatment. Pap smear is therefore recommended as follow-up test in women with abnormal visual inspection test results. Increase awareness to service providers and the general public about the Government Policy on the use of visual inspection tests in women more than 50 years of age since 14.2% were inappropriately screened by the visual inspection test.

v:* {behavior:url(#default#VML);} o:* {behavior:url(#default#VML);} w:* {behavior:url(#default#VML);} .shape {behavior:url(#default#VML);} 12.00 Normal 0 false false false EN-GB X-NONE X-NONE /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman","serif";} Common nearly best linear estimates of location and scale parameters of normal and logistic distributions, which are based on complete samples, are considered. Here the population from which the samples are drawn is either normal or logistic population or a fusion of both distributions and the estimates are computed when it is not yet known which of the two populations (between the normal and logistic) is true. The problem discussed in this paper involves two possible population types in a given sample. Samples of sizes  and  are used to validate these estimates and a comparison of their variances is made with those of the best linear unbiased estimators (BLUEs) for normal and logistic distributions.

v:* {behavior:url(#default#VML);} o:* {behavior:url(#default#VML);} w:* {behavior:url(#default#VML);} .shape {behavior:url(#default#VML);} 12.00 Normal 0 false false false EN-GB X-NONE X-NONE /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman","serif";} Common nearly best linear estimates of location and scale parameters of normal and logistic distributions, which are based on complete samples, are considered. Here the population from which the samples are drawn is either normal or logistic population or a fusion of both distributions and the estimates are computed when it is not yet known which of the two populations (between the normal and logistic) is true. The problem discussed in this paper involves two possible population types in a given sample. Samples of sizes  and  are used to validate these estimates and a comparison of their variances is made with those of the best linear unbiased estimators (BLUEs) for normal and logistic distributions.

Naisho JN, Ongaya L, Musandu JO. PIP: In highlighting the role of traditional birth attendants (TBAs) in the implementation of primary health care (PHC) in Kenya, the following topics are discussed: characteristics of TBAs as reported in studies, the training program, program objectives, content, the training process, resources for training, the role of TBAs in PHC, and evaluation. The definition of midwife is given as midwives trained in a community setting to assist in delivery within the confines of accepted cultural beliefs. A study of 28 midwives from different regions in Kenya in 1980 found that most were illiterate women between 24 and 68 years olds received no monetary gain, had a variety of occupational backgrounds, and provided varying amounts of advice but little pre- or postnatal care. Almost all advised mothers to breast feed for at least 2 years. 80% of mother use TBAs for delivery. In order to minimize maternal (5-20/1000 live births on the average) and infant mortality, many countries have or are developing training programs for TBAs. Inadequacies in TBA care may be little prenatal care, too little postnatal care, and deficits in promoting child spacing; other unsafe practices may be improper washing of hands and severing the umbilical cord with unsterile objects. Other advantages of training TBAs involve less cost, less need for transportation, personalized setting in the home, source of health education in the community, and rapport with her clients. The training program goal is to reduce mortality by eliminating bad practices. The objectives are to reduce maternal deaths or illness from hemorrhage, infection, and toxemia; to encourage better nutrition; to reduce perineal or vaginal tears which may lead to longterm disability from urinary or rectal fistula; to reduce the number of pregnancies or exposure to risk; and to reduce neonatal tetanus asphyxia, infection, diarrhea, and malnutrition. Activities entail educating adolescent girls and pregnant women on menstruation and sexuality within cultural norms, prenatal care and delivery and postnatal care, maternal care, and educating mothers about personal hygiene, nutrition, child spacing, and immunization, and acknowledgement of the valuable service TBAs contribute to the community. Programs have operated for 10 years and evaluation is underway. PMID: 2630785 [PubMed - indexed for MEDLINE]

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As part of a study to assess zoonotic milk-borne health risks, seasonal survey data and unpasteurized milk samples were collected between January 1999 and February 2000 from randomly selected informal milk market agents (220 and 236 samples in the dry and wet seasons, respectively) and from households purchasing raw milk (213 and 219 samples in the dry and wet seasons, respectively) in rural and urban locations in Central Kenya and screened for antibiotics, Brucella abortus (B. abortus) and presence of Escherichia coli (E. coli 0157:H7).The latter was assessed based on samples from consumer households only. Antibodies to B. abortus were screened using the indirect antibody Enzyme Linked Immunosorbent Assay (ELISA) and the Milk Ring Test (MRT). The presence of E. coli 0157:H7 was assessed by culture, biochemical characterization, serological testing for production of verocytotoxin one (VTI) and two (VT2) and polymerase chain reaction (PCR) analysis for the presence of genes encoding for the toxins.                                                                                                         The prevalence of antibodies to B.abortus varied considerably ranging from none in milk sold in small units and originating from intensive production systems to over 10% in samples that were bulked or originating from extensive production systems. E. coli 0157:H7 was isolated from two samples (0.8%), one of which produced VTI. All urban consumers (100%) and nearly all rural consumers (96%) of marketed milk boiled the milk before consumption, mainly in tea, thus reducing chances of exposure to live pathogens and potential health risks.

As part of a study to assess zoonotic milk-borne health risks, seasonal survey data and unpasteurized milk samples were collected between January 1999 and February 2000 from randomly selected informal milk market agents (220 and 236 samples in the dry and wet seasons, respectively) and from households purchasing raw milk (213 and 219 samples in the dry and wet seasons, respectively) in rural and urban locations in Central Kenya and screened for antibiotics, Brucella abortus (B. abortus) and presence of Escherichia coli (E. coli 0157:H7).The latter was assessed based on samples from consumer households only. Antibodies to B. abortus were screened using the indirect antibody Enzyme Linked Immunosorbent Assay (ELISA) and the Milk Ring Test (MRT). The presence of E. coli 0157:H7 was assessed by culture, biochemical characterization, serological testing for production of verocytotoxin one (VTI) and two (VT2) and polymerase chain reaction (PCR) analysis for the presence of genes encoding for the toxins.                                                                                                         The prevalence of antibodies to B.abortus varied considerably ranging from none in milk sold in small units and originating from intensive production systems to over 10% in samples that were bulked or originating from extensive production systems. E. coli 0157:H7 was isolated from two samples (0.8%), one of which produced VTI. All urban consumers (100%) and nearly all rural consumers (96%) of marketed milk boiled the milk before consumption, mainly in tea, thus reducing chances of exposure to live pathogens and potential health risks.

PIP: Masturbatory semen specimen from 49 fertile Black African males in Kenya whose wives were pregnant was obtained after at least 3 days of abstinence for the analysis of parameters which included volume motility, vitality, sperm concentration, pH, fructose and acid phosphatase levels. About 1/2 the spermatozoa was actively progressive in motility, while 40% was nonmotile. Vitality in the 1st hour revealed that 81.4% of the sperm was alive. About 90% of the semen specimens had more than 40% idea forms of spermatozoa. Spermatozoal abnormalities were a frequent feature. There was no correlation between age and the testicular volume, but seminal fluid volume and sperm density tended to decrease with age. Serum levels of Follicle Stimulating Hormone, Luteinizing Hormone, Prolactin and Testosterone were determined in the subjects' sera, enabling the establishment of reference values for these parameters in African Kenyan males.

The safety and immunogenicity of plasmid pTHr DNA, modified vaccinia virus Ankara (MVA) human immunodeficiency virus type 1 (HIV-1) vaccine candidates were evaluated in four Phase I clinical trials in Kenya and Uganda. Both vaccines, expressing HIV-1 subtype A gag p24/p17 and a string of CD8 T-cell epitopes (HIVA), were generally safe and well-tolerated. At the dosage levels and intervals tested, the percentage of vaccine recipients with HIV-1-specific cell-mediated immune responses, assessed by a validated ex vivo interferon gamma (IFN-gamma) ELISPOT assay and Cytokine Flow Cytometry (CFC), did not significantly differ from placebo recipients. These trials demonstrated the feasibility of conducting high-quality Phase 1 trials in Africa.

The avian lung has a highly sophisticated morphology with a complex vascular system. Extant data regarding avian pulmonary angioarchitecture are few and contradictory. We used corrosion casting techniques, light microscopy, as well as scanning and transmission electron microscopy to study the development, topography, and distribution of the parabronchial vasculature in the chicken lung. The arterial system was divisible into three hierarchical generations, all formed external to the parabronchial capillary meshwork. These included the interparabronchial arteries (A1) that ran parallel to the long axes of parabronchi and gave rise to orthogonal parabronchial arteries (A2) that formed arterioles (A3). The arterioles formed capillaries that participated in the formation of the parabronchial mantle. The venous system comprised six hierarchical generations originating from the luminal aspect of the parabronchi, where capillaries converged to form occasional tiny infundibular venules (V6) around infundibulae, or septal venules (V5) between conterminous atria. The confluence of the latter venules formed atrial veins (V4), which gave rise to intraparabronchial veins (V3) that traversed the capillary meshwork to join the interparabronchial veins (V1) directly or via parabronchial veins (V2). The primitive networks inaugurated through sprouting, migration, and fusion of vessels and the basic vascular pattern was already established by the 20th embryonic day, with the arterial system preceding the venous system. Segregation and remodeling of the fine vascular entities occurred through intussusceptive angiogenesis, a process that probably progressed well into the posthatch period. Apposition of endothelial cells to the attenuating epithelial cells of the air capillaries resulted in establishment of the thin blood-gas barrier. Fusion of blood capillaries proceeded through apposition of the anastomosing sprouts, with subsequent thinning of the abutting boundaries and ultimate communication of the lumens. Orthogonal reorientation of the blood capillaries at the air capillary level resulted in a cross-current system at the gas exchange interface.

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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.

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Our eyes send different 'images' of the outside world to the brain — an image of contours (line drawing), a colour image (watercolour painting) or an image of moving objects (movie). This is commonly referred to as parallel processing, and starts as early as the first synapse of the retina, the cone pedicle. Here, the molecular composition of the transmitter receptors of the postsynaptic neurons defines which images are transferred to the inner retina. Within the second synaptic layer — the inner plexiform layer — circuits that involve complex inhibitory and excitatory interactions represent filters that select 'what the eye tells the brain'.

Our eyes send different 'images' of the outside world to the brain — an image of contours (line drawing), a colour image (watercolour painting) or an image of moving objects (movie). This is commonly referred to as parallel processing, and starts as early as the first synapse of the retina, the cone pedicle. Here, the molecular composition of the transmitter receptors of the postsynaptic neurons defines which images are transferred to the inner retina. Within the second synaptic layer — the inner plexiform layer — circuits that involve complex inhibitory and excitatory interactions represent filters that select 'what the eye tells the brain'.

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Modern wireless systems are placing greater
emphasis on antenna designs for future development in
communication technology because the antenna is a key
element in the overall communication system. A
Microstrip Antenna is well suited for wireless
communication due to its light weight, low volume and
low profile planar configuration which can be easily
conformed to the host surface. In this paper, an
optimization method based on adaptive neuro-fuzzy
inference system (ANFIS) for determining the parameters
used in the design of a rectangular microstrip patch
antenna is presented. The ANFIS has the advantages of
expert knowledge of fuzzy inference system (FIS) and the
learning capability of artificial neural network (ANN). By
calculating and optimizing the patch dimensions and the
feed point of a rectangular microstrip antenna, this paper
shows that ANFIS produces good results that are in
agreement with Ansoft HFSS 13.0 simulation results.

Antimalarial therapy is a major contributor to declining malaria morbidity and mortality. However, the high toxicity and low bioavailability of current antimalarials and emerging drug resistance necessitates drug-delivery research. We have previously developed glyceryl-dilaurate nanolipid carriers (GDL-NLCs) for antimalarial drug delivery. Here, we show evidence that GDL-NLCs themselves selectively target Plasmodium-infected red blood cells (iRBCs), and cause severe parasite impairment. The glyceryl-dilaurate lipid-moiety was important in the targeting. GDL-NLCs localized to the parasite mitochondrion and uptake led to mitochondrial-membrane polarization and Ca(2+) ion accumulation, ROS release, and stage-specific iRBC lysis. GDL-NLC treatment also resulted in externalization of iRBC-membrane phosphatidylserine and enhanced iRBC clearance by macrophages. GDL-NLC uptake disrupted the parasite-induced tubulovesicular network, which is vital for nutrient import by the parasite. Laser optical trap studies revealed that GDL-NLCs also restored iRBC flexibility. Such restoration of iRBC flexibility may help mitigate the vasculature clogging that can lead to cerebral malaria. We demonstrate the suitability of GDL-NLCs for intravenous delivery of antimalarial combinations artemether-clindamycin and artemether-lumefantrine in the murine model. Complete parasite clearance was achieved at 5-20% of the therapeutic dose of these combinations. Thus, this nanostructured lipid formulation can solubilize lipophilic drugs, selectively target and impair the parasite-infected red cell, and therefore constitutes a potent delivery vehicle for antimalarials.

Unfed Amblyomma variegatum F. nymphs were experimentally infected in the laboratory with a hymenopteran parasitoid, Ixodiphagus hookeri (Howard). The parasitoid was originally obtained from ticks collected from cattle in the Trans-Mara area of Kenya where it naturally infects 50% of A. variegatum nymphs. In the field, nymphs collected from cattle were found to be infected, but not those collected from grass. The optimum temperature for emergence of parasitoids from the nymphs in the laboratory was 28°C, but emerged parasitoids were more active and survived longer at 22°C. There was a higher proportion of parasitoid nonemergence from laboratory-infected than from the field-infected nymphs. This study is the first record of infection of A. variegatum in the laboratory with a parasitoid. Possibilities of mass rearing and use of the parasitoid as a biocontrol agent for ticks are discussed.

Although early diagnosis and treatment are key factors in the effective control of human African trypanosomiasis (HAT), many cases of the disease delay taking appropriate action, leading to untold suffering. As a better understanding of treatment-seeking behaviour should help in identifying the obstacles to early diagnosis and effective treatment, the treatment pathways followed by 203 former HAT cases in western Kenya and eastern Uganda have recently been explored. About 86% of the HAT cases had utilized more than two different healthcare options before being correctly diagnosed for HAT, with about 70% each using more than three different health facilities. Only about 8% of the cases reported that they had been correctly diagnosed the first time they sought treatment. Just over half (51%) of the HAT cases had been symptomatic for >2 months before being correctly diagnosed for HAT, and such time lags in diagnosis contributed to 72% of the cases receiving their first appropriate treatment only in the late stage of the disease. The likelihood of a correct diagnosis increased with the time the case had been symptomatic. These observations indicate an urgent need to build the diagnostic capacity of the primary healthcare facilities in the study area, so that all HAT cases can be identified and treated in the early stage of the disease.

JASPA Working Paper, ILO, Addis Ababa

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Throughout history, visitation of the hospitalised child has always been restricted. The subject of whether hospitalised children should be visited by other children has been accorded minimal attention.

Throughout history, visitation of the hospitalised child has always been restricted. The subject of whether hospitalised children should be visited by other children has been accorded minimal attention.

Prematurity is the leading cause of global neonatal and infant mortality. Many babies could survive by the provision of essential newborn care. This qualitative study was conducted in order to understand, from a family and professional perspective, the barriers and facilitators to essential newborn care. The study will inform the development of an early warning score for preterm and low birthweight infants in low and middle income countries (LMICs).

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Normal 0 false false false EN-US X-NONE X-NONE MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;} Soil occurs in nature in groups with unique response characteristics to its forming factors. These characteristics should ideally be represented as a family of curves in the models for producing soil maps. However, the current approaches for producing soil maps use a single model which either blocks/controls the grouping effects or do not statistically recognize the natural landscape groupings. This study tested mixed-effects modelling technique for ingenious recognition of soil groupings and consequent improvement of the accuracy of the resultant soil maps. Mixed-effects modelling is a form of regression analysis for simultaneous modelling of the average landscape characteristics and individual groups within the landscape. It can model a family of curves and potentially remove inadequacies inherent in the current models for soil mapping. Its potential in regression kriging of continuous and categorical soil attributes has been shown in this paper, where it produced about 60% accuracy with holdout validation. Compared to the current application of a single model in regression kriging, mixed-effects modelling produced about five times improvement of the mapping accuracy. It is anticipated that its adoption will contribute to improved soil mapping

Human interference with the climate system is occurring. [WGI AR5 2.2, 6.3, 10.3-6, 10.9] Climate change poses risks for human and natural systems (Figure TS.1). The assessment of impacts, adaptation, and vulnerability in the Working Group II contribution to the IPCC’s Fifth Assessment Report (WGII AR5) evaluates how patterns of risks and potential benefits are shifting due to climate change and how risks can be reduced through mitigation and adaptation. It recognizes that risks of climate change will vary across regions and populations, through space and time, dependent on myriad factors including the extent of mitigation and adaptation. [INSERT FIGURE TS.1 HERE Figure TS.1: Climate-related hazards, exposure, and vulnerability interact to produce risk. Changes in both the climate system (left) and development processes including adaptation and mitigation (right) are drivers of hazards, exposure, and vulnerability. [19.2, Figure 19-1]] Section A of this summary characterizes observed impacts, vulnerability and exposure, and responses to date. Section B examines the range of future risks and potential benefits across sectors and regions, highlighting where choices matter for reducing risks through mitigation and adaptation. Section C considers principles for effective adaptation and the broader interactions among adaptation, mitigation, and sustainable development. Box TS.1 introduces the context of the WGII AR5, and Box TS.2 defines central concepts. To accurately convey the degree of certainty in key findings, the report relies on the consistent use of calibrated uncertainty language, introduced in Box TS.3. Chapter references in square brackets indicate support for findings, paragraphs of findings, figures, and tables in this summary.

Journal of Eastern African Literary and Cultural Studies

A leucine aminopeptidase was found in the midgut of the human body louse, Pediculus humanus humanus L. (Anoplura: Pediculidae). The enzyme is activated by the bloodmeal with a pH optimum at 8. The enzyme is soluble in both aqueous and detergent-containing solutions. The two forms of the enzyme had the same Km but exhibited different catalytic activities with regard to Vmax values in these solutions. The enzyme is inhibited competitively by a substrate analogue 1,10-phenanthroline and by Mn2+ ions in the presence and absence of detergent.

The purpose of many studies in the field of Information Systems (IS) research is to analyse causal relationship between variables. Structural Equation Modelling (SEM) is a statistical technique for testing and estimating those causal relationship based on statistical data and qualitative causal assumption. Partial Least Square Structural Equation Modelling (PLS-SEM) is the technique that is mostly used in IS research. It has been subject to many reviews either in confirmatory or exploratory settings. However, it has recently emerged that PLS occupies the middle ground of exploratory and confirmatory settings. Thus, this paper intends to propose an updated guideline for the use of PLS-SEM in Information Systems Research in exploratory settings maintaining interpretability. A systematic literature review of 40 empirical and methodological studies published between 2012 and 2016 in the leading journal of the field guide future empirical work.

The purpose of many studies in the field of Information Systems (IS) research is to analyse causal relationship between variables. Structural Equation Modelling (SEM) is a statistical technique for testing and estimating those causal relationship based on statistical data and qualitative causal assumption. Partial Least Square Structural Equation Modelling (PLS-SEM) is the technique that is mostly used in IS research. It has been subject to many reviews either in confirmatory or exploratory settings. However, it has recently emerged that PLS occupies the middle ground of exploratory and confirmatory settings. Thus, this paper intends to propose an updated guideline for the use of PLS-SEM in Information Systems Research in exploratory settings maintaining interpretability. A systematic literature review of 40 empirical and methodological studies published between 2012 and 2016 in the leading journal of the field guide future empirical work.

The purpose of many studies in the field of Information Systems (IS) research is to analyse causal relationship between variables. Structural Equation Modelling (SEM) is a statistical technique for testing and estimating those causal relationship based on statistical data and qualitative causal assumption. Partial Least Square Structural Equation Modelling (PLS-SEM) is the technique that is mostly used in IS research. It has been subject to many reviews either in confirmatory or exploratory settings. However, it has recently emerged that PLS occupies the middle ground of exploratory and confirmatory settings. Thus, this paper intends to propose an updated guideline for the use of PLS-SEM in Information Systems Research in exploratory settings maintaining interpretability. A systematic literature review of 40 empirical and methodological studies published between 2012 and 2016 in the leading journal of the field guide future empirical work.

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Sweet potato leaf curl virus has been reported in different sweet potato growing regions of Kenya. Partial nucleotide sequences of Kenyan Sweet potato leaf curl virus isolates were compared with other isolates from different parts of the world. Sequences from ORFs AV1 (in the virion sense) and ORFs AC1, AC2, and AC4 (in the complementary sense) were analyzed using OMEGA 5 software. Samples from Central, and Coast Kenya were closely related to isolates from Spain and India with nucleotide sequence identities that varied from 61 to 96%. AV1 sequences of four samples from central were related with over 92% nucleotide sequence identity. AC2 fragments of Isolates from Western and Coast had 95% and 96% nucleotide sequence identity and amino acid sequence identity respectively indicating that the AC2 protein may have had common ancestry. The study reports the first partial sequences of begomovirus infecting sweet potato inform different parts of Kenya and their phylogenetic relationship with other begomoviruses from other parts of the world.

The midgut of the human body louse Pediculus humanus humanus contains a thermally stable leucine aminopeptidase, which was detected by agarose gel electrophoresis using l-amino oxidase. Midgut extracts were homogenized in saline or in 1% Triton X-100 and the aminopeptidase was purified by Superose 6 gel filtration chromatography. A peak with enzyme activity that was extracted with or without Triton X-100 was eluted at a molecular weight 67–69 kDa. Non-denaturing polyacrylamide gel electrophoresis resolved one band of molecular weight of 69 kDa for samples that were extracted in a saline buffer. Two closely linked bands of molecular weight 67 kDa and 69 kDa were observed in samples that were extracted in 1% Triton X-100.

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This research examines the relationship between commercial banks (CBs) and the small enterprise sector (SES) and identifies constraints' which impede the flow of financial assistance from the commercial banks to the latter in Kenya. The variables that were examined included; requirements for successful loan application, lending levels, degree of risk attached to small enterprise lending, levels of economic impact and stages in business development at which banks become willing to support. For the small enterprises, the study sought to profile the business and its owner and, to examine its financing. The sampling units were drawn from CBs and SES within Nairobi. In data collection, questionnaires, interview and document review was employed. The study found that high interest rates and long processing procedures kept small businesses away from banks. The study established that, on the part of the banks, the entrepreneurs lacked business management skills and did not keep proper records. Moreover, the banks experienced general reproach from the small business owners, based upon conventional beliefs.

Wetlands are lands that are transitional between terrestrial and aquatic systems where the water is usually at or near the surface of the land or land that is covered with shallow water (Cowardin et al. 1979, Roggeri 1995). In the context of dry lands, wetlands are areas that are permanently, seasonally or occasionally water logged with fresh or saline water that supports characteristic animals and plants. In the dry lands of eastern Africa, wetlands cover about 3 percent of the total land area and include shallow lakes and margin s of deep lakes, swamps and marshes found on upper flood plains of major rivers, coastal river flood plains and high mountain peat bogs and tarns (Omoding 1995). These ecosystems support valuable biodiversity, including large numbers of mammals, reptiles, fishes and birds as well as diverse plant communities (Denny 1993). They also provide valuable resources and environmental benefits, such as biomass cropping for livestock pasture, water supply, agriculture, fisheries and subsistence hunting of wildlife that sustain local economies and communities (Shumway 1999).

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There is an increasing need to incorporate into agricultural research an element of community participation. Community involvement in the identification of problems and solutions is seen as the key to adoption ands adaptation of new technologies. These two processes have been identified as crucial for sustainable agriculture and hence sustainable rural communities.

A wide gap exists between researchers in the various institutions and the farmer. Yet the latter is the end user of the products thereof. This is an approach to the top-down approach to agricultural extension where extension agents tell farmer's what ought to be done with little regard to the farmers experience and circumstances. Participatory action research (PAR) techniques bridge the gap between the farmer's experiences and the research/extension services. It enables analysis of problem situations and opportunities by farmers and researchers in a participatory and inclusive process. Within the agro-ecosystem health framework PAR is the process that generates a farmer driven demand for research and technology development. This paper describes how PAR is being used in an integrated assessment of agricultural communities in Kiambu agro-ecosystem.

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

There are distinct breeds suitable for diverse purposes in the different production environments or ecological zones. Farmers in different production systems have different trait preferences and the strategies followed by them are also as diverse as the agro-environments within which they operate. In order to design a viable breeding plan, farmers’ preferences for the different traits need to be investigated. In this paper available tools and methods for defining livestock breeding objective traits are described, discussed and comparisons among them are made. The reviewed tools were: participatory rural appraisal (PRA), choice experiments, ranking of animals from own flock/herd and ranking of others animals. Each methodology may be appropriate to specific situation; however, it is recommended that a combination of approaches be used to precisely capture the breeding objective traits of livestock producers. Elucidation of objective traits using the tools with active involvement of producers can result in appropriate livestock genetic improvement that is well grounded in practical reality and truly reflects owners’ preferences.

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

As agroforestry technologies are developed and promoted, there is a need to integrate indigenous knowledge about pest identification and management techniques into the scaling-up process in order to improve farmers’ pest management practices. This paper documents farmers’ knowledge, perceptions and management practices against termites in agroforestry in Tororo District, Uganda. The applicability and implications of such information in the development and promotion of sustainable termite management in agroforestry are discussed.

This study was conducted in the northern part of Kenya, in Kakuma division, Turkana district. Kakuma is a semi-arid area under nomadic pastoralism as the main activity. The presence of a refugee camp has attracted many people from within the Turkana community and also the outside community. The study aimed at documenting the effects of emergent land use changes on vegetation resources and the socio-economic environment in Kakuma. Data on vegetation density and cover was collected. Socio-economic data was collected from the local Turkana population and the settlement camp. The data was analysed using SPSS computer package and descriptive statistics. There was a significant difference (P<0.05) in vegetation cover and density with increasing distance away from the settlement camp. The mean tree crown cover was low near the settlement camp (6.2%) but high away from the settlement camp (57.7%). Mean tree density was high near the settlement camp (13 individuals/ 100m2). Shrub crown cover was low (0.9%) in the areas that had settlements. The need for fencing and building materials was the main cause of low shrub cover. The density of the shrub species generally increased as one moved away from the settlement camp (17 individuals/ 16m2). Herb species cover and density was high near the settlement camp(68% and 202 individuals/ 1m2 respectively) but this comprised mostly of species unpalatable to livestock like Tribulus terrestris and Portulaca oleraceae. The study revealed that droughts and livestock raids in the previous years had set in motion social and ecological changes. The loss of livestock through raids and droughts encouraged sedenterization. This affected the cultural patterns and has had an effect on the rangeland condition. Lack of mobility concentrated livestock in specific areas, thus depleting the forage resources and creating conditions for soil erosion. Trading activities between the refugees and the Turkana had both positive and negative impact on the economic, social and cultural setup of the local community. The increase in population around Kakuma and the settlement camp has set in motion changes that have affected vegetation and social structures. The immediate social and economic returns from the exploitation of resources have overridden the long-term benefits. In regard to this there is a need for education on the impacts, both short-term and long-term, of the various activities on the vegetation, livestock resources and also the pastoral lifestyle. Key words: Pastoralism, Settlement, Land use, Environmental impact.

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Effective surveillance for infectious diseases is an essential and resource-consuming activity for mitigating unwanted consequences for animal and public health. Allocation of scarce resources for surveillance must be considered against alternative prevention and control measures and regularly reviewed. Few studies estimate cost-effectiveness and benefits of different animal disease surveillance approaches and systems. In this study, we considered the benefits and resource costs of participatory epidemiology (PE) surveys and participatory disease surveillance (PDS) compared with routine passive surveillance. Focusing on a 6-month interval in a primarily pastoralist district in Kenya, basic performance indicators for surveillance measured were (1) number of outbreaks; (2) number of samples generated from suspected outbreaks; (3) number of positive laboratory confirmations. Costs of passive surveillance and interventions mounted were determined for the 6-month interval. In the same district, PE surveys were conducted in randomly selected communities to determine the number of outbreaks of notifiable cattle diseases in the same 6-month interval. Additional information was collected on the scale of morbidity and mortality for historical outbreaks (numbers and duration), the value of individual animals and the number of active outbreaks. Costs associated with mounting PE visits were ascertained and extrapolated to district level. One month after completion of PE visits, district level stakeholders were interviewed to determine the response, if any, to outbreaks detected during the visits. The study provides cost effectiveness estimates at a district level for the 6-month interval, including losses which occurred from outbreaks missed by passive surveillance and costs if PE were applied at regular intervals. In addition, the findings consider available prevention and control responses and provide decision-makers with evidence to inform future application of participatory approaches in animal disease surveillance.

A model for the establishment of a four-dimensional regional geodetic reference datum is presented. Starting from the three-dimensional integrated geodetic network model, formulations for the establishment of a four-dimensional regional datum are developed. Astronomic latitudes, astronomic longitudes, gravity values, gravity potential differences, gravity differences, and GPS-vectors are considered as observables. The estimated parameters defining the datura are point coordinates, deflections of the vertical and geoidai undulations, and velocities and accelerations on the positional coordinates. The network datum is considered observed over several epochs with parameters estimated from previous epochs being introduced into later epochs as stochastic prior information parameters.

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

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

It is postulated that a participatory orientation to the strategic planning process could influence the realization of the expected strategic planning outcomes. Past studies investigating the relationship between strategic planning and performance mainly focuses on the direct relationship between these two variables. This study examines the influence of employee participation on the expected relationship between strategic planning and strategic planning outcomes. The study was carried out in Kenya, within the insurance sector. A structured questionnaire was used to gather the required data from 31 firms. Study findings reveal that
employee participation does influence the strength of the relationship between strategic planning and strategic planning outcomes and this influence is statistically significant.
Key words: Strategic planning process, participation, insurance, Kenya

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In contrast with mammalian cells, little is known about the control of Ca2+ entry into primitive protozoans. Here we report that Ca2+ influx in pathogenic Trypanosoma brucei can be regulated by phospholipase A2 (PLA2) and the subsequent release of arachidonic acid (AA). Several PLA2 inhibitors blocked Ca2+ entry; 3-(4-octadecyl)-benzoylacrylic acid (OBAA; IC50 0.4+/-0.1 microM) was the most potent. We identified in live trypanosomes PLA2 activity that was sensitive to OBAA and could be stimulated by Ca2+, suggesting the presence of positive feedback control. The cell-associated PLA2 activity was able to release [14C]AA from labelled phospholipid substrates. Exogenous AA (5-50 microM) also initiated Ca2+ entry in a manner that was inhibited by the Ca2+ antagonist La3+ (100 microM). Ca2+ entry did not depend on AA metabolism or protein kinase activation. The cell response was specific for AA, and fatty acids with greater saturation than tetraeicosanoic acid (AA) or with chain lengths less than C20 exhibited greatly diminished ability to initiate Ca2+ influx. Myristate and palmitate inhibited PLA2 activity and also inhibited Ca2+ influx. Overall, these results demonstrate that Ca2+ entry into T. brucei can result from phospholipid hydrolysis and the release of eicosanoic acids.

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

The Marsabit Forest Reserve (MFR), a green island in an arid environmental setting, generates multiple ecosystem goods and services (ES) to the local community critical for their livelihoods. The forest has been experiencing substantial land conversion for town expansion, agriculture production and settlements threatening long-term ES provision. Sustaining the forest ES under increasing anthropogenic pressures is one of the great challenges of the Marsabit forest community. We used focus group discussions in the thirteen locations around the forest and individual key informant's interviews in the identification of drivers of change and their potential impacts on ES in MFR. We used the scenario development process (SDP) in coming up with four divergent but plausible exploratory scenarios. The study established that the main ES provided by the forest was, water, fuelwood, forage (dry season grazing resource), medicinal plants and timber for construction. Stakeholders identified population pressure, unsustainable utilisation of forest resources, institutional barriers to effective resource management, land use and climate change as the main drivers impacting ES provision in the forest. Land use change and climate change were considered the most significant drivers yet the most uncertain in the future impacting ES provision in the MFR. The SDP identified four alternative future scenarios for the MFR by the year 2043 with the Marsabit we want scenario identified as the most desirable future for the sustainable supply of ES with adequate adaptation to observed changes. Stakeholders came up with a joint action plan implementation matrix for the identified scenario while mitigating the negative aspects of the alternative scenarios. The results support the need for participatory land use planning that takes into to account the growing threat of climate change to natural forest systems.

Abstract

The Marsabit Forest Reserve (MFR), a green island in an arid environmental setting, generates multiple ecosystem goods and services (ES) to the local community critical for their livelihoods. The forest has been experiencing substantial land conversion for town expansion, agriculture production and settlements threatening long-term ES provision. Sustaining the forest ES under increasing anthropogenic pressures is one of the great challenges of the Marsabit forest community. We used focus group discussions in the thirteen locations around the forest and individual key informant's interviews in the identification of drivers of change and their potential impacts on ES in MFR. We used the scenario development process (SDP) in coming up with four divergent but plausible exploratory scenarios. The study established that the main ES provided by the forest was, water, fuelwood, forage (dry season grazing resource), medicinal plants and timber for construction. Stakeholders identified population pressure, unsustainable utilisation of forest resources, institutional barriers to effective resource management, land use and climate change as the main drivers impacting ES provision in the forest. Land use change and climate change were considered the most significant drivers yet the most uncertain in the future impacting ES provision in the MFR. The SDP identified four alternative future scenarios for the MFR by the year 2044 with the Marsabit we want scenario identified as the most desirable future for the sustainable supply of ES with adequate adaptation to observed changes. Stakeholders came up with a joint action plan implementation matrix for the identified scenario while mitigating the negative aspects of the alternative scenarios. The results support the need for participatory land use planning that takes into to account the growing threat of climate change to natural forest systems.

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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.

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

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

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

Motor air pollution has become a problematic issue both within as it contributes to environmental degradation. It is evident that air crises in cities continue to rise partly because of the increasing levels of motor vehicle emissions. With the expansion of the …

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Plasma HIV-1 RNA set point is an important predictor of HIV-1 disease progression. We hypothesized that inoculum size and HIV-1 exposure prior to HIV-1 transmission may modulate set point. We evaluated predictors of set point among 141 African HIV-1 seroconverters and their HIV-1-infected study partners. We compared characteristics of seroconverters and their HIV-1-infected partners and HIV-1 set point. Data were from a clinical trial of genital HSV-2 suppression with acyclovir to reduce HIV-1 transmission in HIV-1 serodiscordant couples with HIV-1 transmission linkage assigned through virus sequencing. Our analysis includes data from all transmissions including those with transmission linkage to the HIV-1-infected "source partner" and those that were not linked to their HIV-1-infected study partner. In multivariable analysis, higher plasma HIV-1 in source partners was associated with higher seroconverter set point ( + 0.44 log10 copies/ml per log(10) source partner plasma HIV-1, p < 0.001). In addition, bacterial vaginosis (BV) among female source partners near the time of infection was associated with higher set point in their male seroconverters ( + 0.49 log(10), p = 0.04). Source partner characteristics associated with lower set point included male circumcision ( - 0.63 log(10), p = 0.03) and assignment to acyclovir ( - 0.44 log10, p = 0.02). The proportion of variation in set point explained by plasma HIV-1 RNA of the source partner, after controlling for other factors, was 0.06. Source partner plasma HIV-1 level is the most significant predictor of seroconverter set point, possibly reflecting characteristics of the transmitted virus. Acyclovir use, BV among women source partners, and circumcision among male source partners may alter the set point by affecting transmitted virus inoculum in the source partners' genital compartment.

No abstract available.

No abstract available.

We examined partner notification among syphilitic pregnant women in Nairobi. At delivery, 377 women were found to be rapid plasma reagin (RPR) reactive. Data were available for 94% of the partners of women who were tested during pregnancy; over 67% of the partners had received syphilis treatment while 23% had not sought treatment mainly because they felt healthy. Six per cent of the women had not informed their partners as they feared blame and/or violence. Adverse pregnancy outcome was related to lack of partner treatment during pregnancy (7% versus 19%, odds ratio (OR) 3.0, 95% confidence interval (CI) 0.9-10.0). Our data suggest that messages focusing on the health of the unborn child have a positive effect on partner notification and innovative and locally adapted strategies for partner notification need more attention.

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

Cult Health Sex. 2012;14(1):17-30. doi: 10.1080/13691058.2011.608436. Epub 2011 Sep 21.
Partners and clients of female sex workers in an informal urban settlement in Nairobi, Kenya.
Ngugi E, Benoit C, Hallgrimsdottir H, Jansson M, Roth EA.
Source
Centre for HIV Prevention and Research, University of Nairobi, Nairobi, Kenya.
Abstract
This paper compares and contrasts number of partners and condom use behaviour for female sex workers and a sample of women working in other economic activities, with both samples drawn from the large informal settlement of Kibera, Nairobi. As expected, univariate analysis revealed much higher numbers of overall sexual partners and higher levels of condom use among female sex workers compared to Kibera women in other occupations. An unexpected finding, however, was that female sex workers with a romantic partner had significantly fewer sexual partners per unit time than female sex workers without such a partner. This finding held for multivariate analysis, with negative binomial regression analyses showing that having a romantic partner was significantly associated with reductions in total number of both sexual partners overall and with sexual partners who did not use condoms. In contrast, HIV status, education, number of immediate family members and levels of alcohol consumption were non-significant factors for both regression analyses. Results suggest that female sex workers' romantic partners act as more than sources of possible HIV infection; rather, romantic partners appear to have an important positive impact on health. We discuss this finding in light of possible harm-reduction programmes focusing on female sex workers and their romantic partners.
PMID:
21936649

BACKGROUND: Most persons who are infected with human immunodeficiency virus type 1 (HIV-1) are also infected with herpes simplex virus type 2 (HSV-2), which is frequently reactivated and is associated with increased plasma and genital levels of HIV-1. Therapy to suppress HSV-2 reduces the frequency of reactivation of HSV-2 as well as HIV-1 levels, suggesting that suppression of HSV-2 may reduce the risk of transmission of HIV-1. METHODS: We conducted a randomized, placebo-controlled trial of suppressive therapy for HSV-2 (acyclovir at a dose of 400 mg orally twice daily) in couples in which only one of the partners was seropositive for HIV-1 (CD4 count, > or = 250 cells per cubic millimeter) and that partner was also infected with HSV-2 and was not taking antiretroviral therapy at the time of enrollment. The primary end point was transmission of HIV-1 to the partner who was not initially infected with HIV-1; linkage of transmissions was assessed by means of genetic sequencing of viruses. RESULTS: A total of 3408 couples were enrolled at 14 sites in Africa. Of the partners who were infected with HIV-1, 68% were women, and the baseline median CD4 count was 462 cells per cubic millimeter. Of 132 HIV-1 seroconversions that occurred after randomization (an incidence of 2.7 per 100 person-years), 84 were linked within couples by viral sequencing: 41 in the acyclovir group and 43 in the placebo group (hazard ratio with acyclovir, 0.92, 95% confidence interval [CI], 0.60 to 1.41; P=0.69). Suppression with acyclovir reduced the mean plasma concentration of HIV-1 by 0.25 log(10) copies per milliliter (95% CI, 0.22 to 0.29; P<0.001) and the occurrence of HSV-2-positive genital ulcers by 73% (risk ratio, 0.27; 95% CI, 0.20 to 0.36; P<0.001). A total of 92% of the partners infected with HIV-1 and 84% of the partners not infected with HIV-1 remained in the study for 24 months. The level of adherence to the dispensed study drug was 96%. No serious adverse events related to acyclovir were observed. CONCLUSIONS: Daily acyclovir therapy did not reduce the risk of transmission of HIV-1, despite a reduction in plasma HIV-1 RNA of 0.25 log(10) copies per milliliter and a 73% reduction in the occurrence of genital ulcers due to HSV-2. (ClinicalTrials.gov number, NCT00194519.) 2010 Massachusetts Medical Society

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.

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.

PMID: 614126 [PubMed - indexed for MEDLINE]