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

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.

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A total of 54 patients were diagnosed and treated for plastic anaemia between July, 1973 to December 1978 at the Kenyatta National Hospital. The sex distribution was equal. Most of the age groups were affected with the majority of Cases occurring in the young age groups.
Most tribes in Kenya were found not to be free from a plastic anaemia and there was a predominance of the disease amongst the Kikuyu tribe who lived in and around Nairobi.
Very few factors associated with actiology could. Be elicited and this was partially due to adequate histoties taken at the time of admission by the various physicians. Even though great difficulties are encountered in establishing an aetiologic role for a given agent, so that in large proportion of patients remains unexplained.
The presenting clinical features were those of anaemic haemorrhages due to thrombocytopenia and infections resulting from leucopenia, all of which were observed in all the patients reviewed except for the 4 patients with pure red cell aplasia.
The other 50 patients had hypoplastic marrows. Confirmation of diagnosis was delayed due to initial blood transfusion given before peripheral blood film examination in most patients.
Massive blood transfusion was given to patients on remission. Although platelet concentrates are available and obviate the massive blood transactions, only very few patients received platelet infusions.
Corticosteroid and androgenic asteroids were administered but there was no laid down policy as to the protocol to be followed. Hence administration of these drugs was done in a haphazard manner with a big proportion of patients going without any steroid therapy. This may have accounted to a great extent, for the very poor remission rate noted.
Since it has been observed that pure red cell aplacia remits spontaneously, prolonged therapy of these patients should be pursued vigorously.
Most of the deaths encountered occurred during the first 4 months of admission and they were mainly due to complications of the disease process mainly infections, congestive cardiac failure and excessive haemorrhage.

Using the method of retrograde labeling of ganglion cells with HRP, we studied in adult rats the plastic changes in the retinogeniculate projections due to monocular enucleations shortly after birth. Four normal and 6 neonatally enucleated rats were used. In two of the normal and 4 of the enucleated rats a small amount of HRP was injected into the dorsal lateral geniculate nucleus (LGd) and in 4 other rats massive injections were made into the optic tract near the LGd. Neonatally unilaterally eye-enucleated rats were characterized by an expanded distribution of ipsilaterally projecting ganglion cells all over the retina of the remaining eye and by a densely packed distribution of these cells in the lower temporal retina in which area these cells have only a moderate density in normal rats. On the contrary, in the lower temporal retina of monocularly enucleated rats the incidence of contralaterally projecting ganglion cells was decreased. Soma areas of ipsi- and contralaterally projecting ganglion cells were measured for the peripheral crescent in lower temporal and lower nasal retinas. As compared with normal rats, neonatally enucleated rats had a larger mean soma area of ipsilaterally projecting cells and a smaller mean soma area of contralaterally projecting cells. This result was interpreted as suggesting that after neonatal monocular enucleation medium to large cells had changed their side of axonal projection from the contralateral to ipsilateral LGd.

Using the method of retrograde labeling of ganglion cells with HRP, we studied in adult rats the plastic changes in the retinogeniculate projections due to monocular enucleations shortly after birth. Four normal and 6 neonatally enucleated rats were used. In two of the normal and 4 of the enucleated rats a small amount of HRP was injected into the dorsal lateral geniculate nucleus (LGd) and in 4 other rats massive injections were made into the optic tract near the LGd. Neonatally unilaterally eye-enucleated rats were characterized by an expanded distribution of ipsilaterally projecting ganglion cells all over the retina of the remaining eye and by a densely packed distribution of these cells in the lower temporal retina in which area these cells have only a moderate density in normal rats. On the contrary, in the lower temporal retina of monocularly enucleated rats the incidence of contralaterally projecting ganglion cells was decreased. Soma areas of ipsi- and contralaterally projecting ganglion cells were measured for the peripheral crescent in lower temporal and lower nasal retinas. As compared with normal rats, neonatally enucleated rats had a larger mean soma area of ipsilaterally projecting cells and a smaller mean soma area of contralaterally projecting cells. This result was interpreted as suggesting that after neonatal monocular enucleation medium to large cells had changed their side of axonal projection from the contralateral to ipsilateral LGd.

Traditionally the auditory system was considered a hard-wired sensory system; this view has been challenged in recent years in light of the plasticity of other sensory systems, particularly the visual and somatosensory systems. Practical experience in clinical audiology together with the use of prosthetic devices, such as cochlear implants, contributed significantly to the present view on the plasticity of the central auditory system, which was originally based on data obtained in animal experiments. The loss of auditory receptors, the hair cells, results in profound changes in the structure and function of the central auditory system, typically demonstrated by a reorganization of the projection maps in the auditory cortex. These plastic changes occur not only as a consequence of mechanical lesions of the cochlea or biochemical lesions of the hair cells by ototoxic drugs, but also as a consequence of the loss of hair cells in connection with aging or noise exposure. In light of the aging world population and the increasing amount of noise in the modern world, understanding the plasticity of the central auditory system has its practical consequences and urgency. In most of these situations, a common denominator of central plastic changes is a deterioration of inhibition in the subcortical auditory nuclei and the auditory cortex. In addition to the processes that are elicited by decreased or lost receptor function, the function of nerve cells in the adult central auditory system may dynamically change in the process of learning. A better understanding of the plastic changes in the central auditory system after sensory deafferentation, sensory stimulation, and learning may contribute significantly to improvement in the rehabilitation of damaged or lost auditory function and consequently to improved speech processing and production.

In the last years, an increasing interest has been paid to the olfactory system, particularly to its abilities of plasticity and its potential continuous neurogenesis throughout adult life. Although mechanisms underlying adult neurogenesis have been largely investigated in animals, to some degree they remain unclear in humans. Based on human research findings, the present review will focus on the olfactory bulb as an evidence of the astonishing plasticity of the human olfactory system.

In the last years, an increasing interest has been paid to the olfactory system, particularly to its abilities of plasticity and its potential continuous neurogenesis throughout adult life. Although mechanisms underlying adult neurogenesis have been largely investigated in animals, to some degree they remain unclear in humans. Based on human research findings, the present review will focus on the olfactory bulb as an evidence of the astonishing plasticity of the human olfactory system.

From July 1990 to January 1991 we studied platelet functions in 55 indigenous Kenyan patients (23 males and 32 females) with sickle cell anaemia (SCA) in steady state (SCASS) and in 20 (11 males and 9 females) SCA patients in vaso-occlusive sickle cell crisis (VSCC). A control group of 50 healthy (23 males and 27 females) individuals matched for age and sex was also studied. Platelet aggregation time to ADP in SCASS (57.2 +/- 39.1) and in VSCC (31 +/- 11.1) were more prolonged (p < 0.05) compared to controls (12.7 +/- 5.2). It was also significantly more prolonged (p < 0.05) in VSCC than in SCASS. Platelet adhesiveness time was 31.1 +/- 13.7 seconds in SCASS, 30.9 +/- 11.1 in VSCC, and 37.7 +/- 13.0 in controls and was significantly lower in both SCA groups (p < 0.05) but there was no significant difference between the two SCA groups themselves. Clot retraction was 52.8 +/- 6.9 in SCASS, 53.6 +/- 10.7 in VSCC, and 45.9 +/- 8 in controls and was significantly higher in both SCA groups than in controls (p < 0.05). There was no significant difference between the two SCA groups themselves. We conclude that platelet function is deranged in indigenous Kenyan patients with SCA.

OBJECTIVE: To determine platelet abnormalities in patients with menigococcal meningitis. DESIGN: Case control study. SUBJECTS: Fifty seven cases of mennigococcal meningitis based on a cerebrospinal fluid gram stain for gram negative diplococcus or positive culture were recruited. Fifty-seven controls matched for age and sex were also recruited. The following platelet functions tests were performed; platelet counts, platelet adhesiveness, platelet aggregation and clot retraction. RESULTS: Fifty seven patients (41 males and 16 females) with meningococcal meningitis were studied. Their mean age was 25.5 +/- 8.32 years with a range of 15 to 45 years. Five patients had purpura, four peripheral gangrene, eight conjunctival haemorrhages and one was in shock. There was a statistical significant difference in the platelet aggregation and clot retraction between the patients and controls at p-values of 0.0001 and 0.0002 respectively. There was no significant difference in the platelet count and adhesiveness between the patients and the controls at a p-value of 0.203 and 0.22 respectively. No association was found between the platelet functions and the clinical presentations. CONCLUSION: Patients with meningococcal meningitis have abnormalities in the platelet functions mainly in aggregation and adhesiveness.

In a nine months period,from March 1987 to November

1987, inc1usiv€, studies on p1ac21et functions, pla$ma fibrinolytic activity and coagulation screen were carried out in 40 patients (30 males and 10 females) with the nephrotic syndrome and 40 matches controls at the Kenyatta
National Hospital. The age range was S-Sl years, mean + SD

20.5+11.6.

patients had unchanged platelet counts and clot retraction compared to controls (p>O.OS), whereas platelet adhesiveness and platelet agg~egation to adenosine diphosphate U",DP) were significantly reduced among patients (P0.05) as well as between plasma fibrinogen concentration and total cholesterol (r=0.25, P>0.05).
It is concluded that our patients have a degree of hype-rcoagulability. Whether the factors for and against hypercoagulabiJ .ity compensate f cr each other in the causation of complications need to be verified. A larger populatibn and more detailed haemostatic study will in future be needed to cover more nephrotic patients in different areas of the country. It is also necessary to folIo w up ou r pat ient s f or complicat ions resul ting from
this hypercoagulable state, like thromboembolic events and

is.c!haemic heart diseas.e to find ou.t.. their pre...lence .

and

contr.ibutionto morbidity and mortality among Africans with

nephrotic syndrome.

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.

Plectranthus is a large and widespread genus with a diversity of ethnobotanical uses. The genus is plagued with numerous nomenclatural disharmonies that make it difficult to collate accurate data on the uses. The aim of this review is to gather together all ethnobotanical information on
Plectranthus and to map the data onto the most up-to-date phylogenetic classification in order to see if there are similar uses among related species and hence provide a framework for the prediction and exploration of new uses of species. The uses of 62 species of Plectranthus were mapped onto a current phylogeny based on DNA sequence data. The phylogeny reveals two major Clades, 1 and 2. The members of Clade 1 (corresponding to the formally recognized genus Coleus ) were richer in number and diversity of uses than members of Clade 2 (comprising the remaining species of Plectranthus
). The high incidence of synonymy can lead to problems in uncovering a species’ ethnobotanical profile. About 30% of all citations of Plectranthus use a synonym and most of the synonyms are attributed to 10 of the most used species, 9 of which are in Clade 1. Members of the ‘Coleus’ Clade are the most studied group both taxonomically and economically. The higher incidence of study may be as a result of the higher diversity of uses and the fact that species in Clade 1, such as Plectranthus barbatus, Plectranthus amboinicus andPlectranthus mollis, are geographically more widespread than those in Clade 2. Plectranthus species in Clade 1 are frequently used as medicines and are used to treat a range of ailments, particularly digestive, skin, infective and respiratory problems. Plectranthus
used as foods, flavours, fodder and materials are also mostly found in Clade 1. Monoterpenoids, sesquiterpenoids, diterpenoids and phenolics have been reported in species of Plectranthus. The abietane diterpenoids are the most diverse of the diterpenoids isolated from species of Plectranthus. The labdane diterpenoid, forskolin, occurs in Plectranthus barbatus and could explain some of the traditional uses of this species. This review highlights the fact that not enough is known about the chemistry of other species of Plectranthus to explain their traditional uses.

Keywords: Plectranthus; Ethnobotanical uses; Coleus

Department of Periodontology/ Community and Preventive Dentistry, School of Dental Sciences, University of Nairobi, P.O. Box 19676 - 00202, Nairobi, Kenya. OBJECTIVE: To determine the influence of oral hygiene habits and practices on the risk of developing oral leukoplakia. DESIGN: Case control study. SETTING: Githongo sublocation in Meru District. SUBJECTS: Eighty five cases and 141 controls identified in a house-to-house screening. RESULTS: The relative risk (RR) of oral leukoplakia increased gradually across the various brushing frequencies from the reference RR of 1.0 in those who brushed three times a day, to 7.6 in the "don't brush" group. The trend of increase was statistically significant (X2 for Trend : p = 0.001). The use of chewing stick as compared to conventional tooth brush had no significant influence on RR of oral leukoplakia. Non-users of toothpastes had a significantly higher risk of oral leukoplakia than users (RR = 1.8; 95% confidence levels (CI) = 1.4-2.5). Among tobacco smokers, the RR increased from 4.6 in those who brushed to 7.3 in those who did not brush. Among non-smokers, the RR of oral leukoplakia in those who did not brush (1.8) compared to those who brushed was also statistically significant (95% CL = 1.6-3.8). CONCLUSION: Failure to brush teeth and none use of toothpastes are significantly associated with the development of oral leukoplakia, while the choice of brushing tools between conventional toothbrush and chewing stick is not. In addition, failure to brush teeth appeared to potentiate the effect of smoking tobacco in the development of oral leukoplakia. Recommendations: Oral health education, instruction and motivation for the improvement of oral hygiene habits and practices; and therefore oral hygiene status, should be among the strategies used in oral leukoplakia preventive and control programmes.

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Survey in southwest Kenya above the western margin of the Gregory Rift Valley since 1994 has led to the discovery of LSA, MSA, Acheulean and possible Oldowan occurrences, as well as fossil-bearing sites representative of the early Pliocene. A long sedimentary sequence of airfall and waterlain tuVs, fluvial and lacustrine sediments and paleosols is exposed in the region of the confluence of the Ewaso Ngiro, Narok, Seyabei, Ntuka and Olonganaiyo rivers. At Lemudongo, a total of 278 well-preserved fossil bones and teeth of a variety of species including carnivores, primates, suids, bovids, hippopotamids, crocodilians, hyracoids and rodents, were collected in one day along a 70 m area of sediment outcrop. Three potentially datable tuVs are stratified within this 6 m-thick fossil-bearing paleosol. The presence of Nyanzochoerus kanamensis suggests this locality is older than 2•5 m.y.a. Four Acheulean sites have low densities of handaxes and cleavers, mainly made on phonolite, basalt and quartz. None are clearly in primary context. Excavations at Ntuka River 3 have yielded a long sequence of new Early LSA microblade industries in discrete horizons that have high densities of well-preserved bones and teeth of equids, bovids, micromammals and humans. Paleosol stable carbon and oxygen isotope analysis at this site demonstrate substantial environmental changes through time in the 7•5 m sedimentary section. In the Ntuka area, Late Quaternary sediments contain numerous in-situ early and late MSA and early LSA sites with well-preserved faunas, a penecontemporary fossil carnivore den site and other fossil-bearing sites with minimally fragmented faunas associated with low artefact densities. This provides a rare opportunity to compare faunal and lithic resource exploitation patterns through time during the Middle and Early Later Stone Age, and to compare faunal exploitation patterns of humans and carnivores on the same landscape.

{ Sexually transmitted diseases (STDs) are highly prevalent in pregnant women in many developing countries and have been associated with poor obstetric outcomes. Case detection and treatment of STDs in women is problematic and expensive, underscoring the need for other strategies. To explore the potential benefits of routine antimicrobial therapy on pregnancy outcome, we carried out a randomized, double-blind, clinical trial in one of the antenatal clinics in Nairobi, Kenya. Four hundred pregnant women between 28 and 32 weeks' gestation were given a single dose of 250 mg ceftriaxone intramuscularly or a placebo. There was a significant difference between ceftriaxone and placebo-treated women in infant birth weight (3,209 versus 3,056 g

   

Geochemical data are presented for primitive alkaline lavas from the Chyulu Hills Volcanic Province of southern Kenya, situated some 100 km east of the Kenya Rift Valley. In addition to their primitive compositions, a striking and ubiquitous feature is a strong but variable depletion in K relative to other highly incompatible elements when normalized to primitive mantle values. Semi-quantitative models are developed that best explain the petrogenesis of these lavas in terms of partial melting of a source that contained residual amphibole (but not phlogopite). The presence of amphibole implies a source in the subcontinental lithosphere rather than the asthenosphere. It is suggested that the amphibole is of metasomatic origin and was precipitated in the lithospheric mantle by infiltrating fluids and/or melts derived from rising mantle plume material. A raised geotherm as a consequence of the continued ascent of the plume material led to dehydration melting of the metasomatized mantle and generation of the Chyulu Hills lavas. It is proposed that the Chyulu Hills Volcanic Province represents an analogue for the earliest stages of continental rift initiation, during which interaction between a plume and initially refractory lithosphere may lead to the generation of lithospheric melts.

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.

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.

Cardiovascular diseases (CVD) are rapidly increasing in Africa due to epidemiologic transition. Many risk factors are acquired in chidhood and early adulthood. University students are exposed to multiple lifestyle influences. Understanding the dynamics of risk factors in this population provides a platform for early intervention.

Cardiovascular diseases (CVD) are rapidly increasing in Africa due to epidemiologic transition. Many risk factors are acquired in chidhood and early adulthood. University students are exposed to multiple lifestyle influences. Understanding the dynamics of risk factors in this population provides a platform for early intervention.

The alkaline serine protease VCP1 of the fungus Pochonia chlamydosporia belongs to a family of subtilisin-like enzymes that are involved in infection of nematode and insect hosts. It is involved early in the infection process, removing the outer proteinaceous vitelline membrane of nematode eggs. Little is known about the regulation of this gene, even though an understanding of how nutrients and other factors affect its expression is critical for ensuring its efficacy as a biocontrol agent. This paper provides new information on the regulation of vcp1 expression. Sequence analysis of the upstream regulatory region of this gene in 30 isolates revealed that it was highly conserved and contained sequence motifs characteristic of genes that are subject to carbon, nitrogen and pH-regulation. Expression studies, monitoring enzyme activity and mRNA, confirmed that these factors affect VCP1 production. As expected, glucose reduced VCP1 expression and for a few hours so did ammonium chloride. Surprisingly, however, by 24 h VCP1 levels were increased in the presence of ammonium chloride for most isolates. Ambient pH also regulated VCP1 expression, with most isolates producing more VCP1 under alkaline conditions. There were some differences in the response of one isolate with a distinctive upstream sequence including a variant regulatory-motif profile. Cryo-scanning electron microscopy studies indicated that the presence of nematode eggs stimulates VCP1 production by P. chlamydosporia, but only where the two are in close contact. Overall, the results indicate that readily-metabolisable carbon sources and unfavourable pH in the rhizosphere/egg-mass environment may compromise nematode parasitism by P. chlamydosporia. However, contrary to previous indications using other nematophagous and entomopathogenic fungi, ammonium nitrate (e.g. from fertilizers) may enhance biocontrol potential in some circumstances.

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Pneumatocele, a special form of lung injury, is characterized by intrathoracic images of cavities detected on X-ray films. These cavities develop immediately after a trauma of the thorax, disappear rapidly and have a relatively favourable outcome.

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.

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.

Burchell's Zebra ( Equus Burchelli Antiquorum) were sampled for gastrointestinal parasites at the Lewa Downs Game Ranch in Isiolo District between 4/7/95 and 11/7/95. The stomach, small intestines and abdominal cavity were searched for parasites. The parasites were identified to genus level but in some cases to species level. Feacal egg counts, hematology and serum biochemistry screening were also performed. All animals were infested with at least three genera of gastrointestinal parasites including at least one nematode genus. A total of nine genera were recovered representing eight families. These included six nematode families, Strongylidae, Strongylinae, Atractidae, Oxyuridae, Spiruridae, and Setaridae one cestode family, Anoplocephalidae and one family of the larvae of Gasterophilus bot flies, Gastrophilidae. The most prevalent families were Atracidae (100%) and Strongylinae (80%). The mean total worm burden was 78,764. The average of individual genera varied from 0-77,890worms. The average worm burdens were higher in females than in males. In comparing the mean total egg counts, there were generally higher egg counts in animals with higher worm burdens. Hematology results were within baseline values for Burchell's zebra. Blood biochemistry showed high levels of Alkaline Phosphatase, Creatine Kinase, Lactase dehydrogenase and Aspartate transaminase was partly attributed to exertion before death

Fifteen yearling goats with similar weight were used to evaluate the potential of Zizyphus spina-christi leaves as a supplement to goats fed on Cynodon dactylon grass. Animals were randomly assigned to five feeding regimes and individually stall-fed for a preliminary period of 14 days, followed by 14 days of feeding to determine dry matter intake and digestibility, and a 3-month  feeding period to determine body weight changes. The treatments were formulated based on leaf: grass ratios of 0%, 25%, 50%, 75%, and 100%. Z. spina-christi leaves had higher crude protein and lower fibre content than C. dactylon grass (P<0.05). Dry matter intake, digestibility and body weight changes increased significantly (P < 0.05) as the level of supplementation increased. Thus, Z. spina-christi foliage is a potential feed supplement in the dry season, as the dry season grasses are deficient in the required nutrients and cannot meet goat requirements

Rainfall modeling is significant for prediction and forecasting purposes in agriculture, weather derivatives, hydrology, and risk and disaster preparedness. Normally two models are used to model the rainfall process as a chain dependent process representing the occurrence and intensity of rainfall. Such two models help in understanding the physical features and dynamics of rainfall process. However rainfall data is zero inflated and exhibits overdispersion which is always underestimated by such models. In this study we have modeled the two processes simultaneously as a compound Poisson process. The rainfall events are modeled as a Poisson process while the intensity of each rainfall event is Gamma distributed. We minimize overdispersion by introducing the dispersion parameter in the model implemented through Tweedie distributions. Simulated rainfall data from the model shows a resemblance of the actual rainfall data in terms of seasonal variation, means, variance, and magnitude. The model also provides mechanisms for small but important properties of the rainfall process. The model developed can be used in forecasting and predicting rainfall amounts and occurrences which is important in weather derivatives, agriculture, hydrology, and prediction of drought and flood occurrences.

OBJECTIVE: To develop a simulation model for dental arch shapes. DESIGN: Analysis of measurements of dental casts to determine a general second degree equation for the dental arches. SETTING: Department of Human Anatomy and School of Computing and Informatics, University of Nairobi. SUBJECTS: The measurement of dental casts, 30 (15M and 15F) each from three Kenyan ethnic groups (Maasai, Kalenjin, Kikuyu), aged 12 years. RESULTS: The arches change their shapes from a parabola to an ellipse, governed by the boundary conditions at the position of the canine tooth, based on the general second degree equation for the conic sections. CONCLUSION: The simulation model graphically confirms the change from parabolic to elliptic shapes of dental arches with boundary conditions at the canine. This could be used to show the changes in dental arches for other ethnic groups.

The decision to pay out earnings or retain dividends has been a subject of debate for many scholars. The effect of dividend on the firm value and cost of capital have been covered in attempt to resolve the dividend puzzle. This research paper tests the applicability of constant dividend model by companies listed at the Nairobi stock exchange. Data was collected from annual reports and share price schedules obtained from Nairobi stock exchange and Capital market Authority for a population of 20 companies that paid dividends consistently from 2002 to 2008. The data was then analyzed by re-computing the dividends that should have been paid if the dividend constant model was applied. This recomputed figure was later compared to the dividend as paid out by the companies thought the years of study. Paired sample t-test statistic was also performed to determine whether there is a significant difference between the two dividend figures. The findings of the research established that the dividend model was not employed by the companies listed at the Nairobi stock exchange. Most firms instead adopted stable and predictable policy where a specific amount of dividend per share each year was paid periodically. In some years there was a slight adjustment of the dividend paid after an increase in earnings, but only by a sustainable amount. The study shows that the relationship between the stock market prices and the dividend paid from the constant dividend model is uneven from one year to another and where there was a relationship it was insignificant. Though a share would be highly priced, a high dividend per share was not always declared.

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The health sector reforms that have hitherto taken place (including introduction of National Health Insurance Fund, free health services, cost-sharing, exemptions and waivers, etc) have all aimed largely at addressing affordability and access to health care services. Spending to promote access to health care is crucial, given also that Kenya is a signatory to the WHO Abuja Declaration. The latter requires member countries to spend at least 15 per cent of their national incomes (GDP) on health (Kenya spends 9 per cent). Many Kenyans therefore continue to have no access to or cannot afford to pay for their health care needs. It is due to the failures of the past programs, that the National Social Health Insurance Fund (NSHIF) was conceptualized for implementation, with a view to enabling more effective provision of health cover to all Kenyans, at both in- and out-patient service levels. In contrast to the private/commercial health insurance plans where premiums are actuary based (higher risk individuals pay more for their medical cover), a social health plan s contributions are based on members ability to pay but access to services depends on individuals health care needs, hence a socialized concept, with emphasis on community spirit of solidarity.

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.

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.

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.

The Abuja Declaration, adopted at the Africa Union special summit on AIDS in 2001, called upon African governments to allocate 15% of their national budgets to health spending, with more emphasis on HIV/AIDS programmes. This commitment echoes the United Nations General Assembly Special Session on HIV/AIDS
(UNGASS), which calls for an increase in spending on HIV/AIDS programmes to US$ 7-10 billion by 2005. The declaration of commitment by the Africa Union calls for minimum spending that provides coverage of essential prevention, care, and mitigation services in an effort to reduce the spread of the epidemic. In Kenya,
despite the government's commitment to fight the pandemic, very little information is available on the actual expenditures on HIV/IDS activities. The objective of this study was to track HIV/AIDS expenditure and analyse the budget from an HIV/AIDS perspective. Understanding how the financial and other national resources
are used towards realization of the national objectives as outlined in the HIV/AIDS related strategic goals in each country, will help the planners to choose pertinent, useful and attainable interventions.

This paper discusses the issue of private tuition mainly at primary educational
level within various contexts, including governance. The paper notes that even
though the practice ofprivate tuition has been in existence for quite some time,
very little, if any, research has been undertaken to explain its nature, extent and
implications for the education system. Besides, nothing is known about its overall
socio-economic setups at the international as well as the national levels.
Technically, private tuition is not allowed in Kenya. However, there is ample
evidence to show that the practice is taking place on a very large scale. The
most affected is the mainstream system, with some of its teachers engaging in
the practice. The emphasis on examination as a basis for staff recruitment and
promotion has further aggravated this problem. Indeed, even some Ministry of
Education, Science and Technology (MoES&T) officials - who are supposed to
articulate Government Policy on Education - take their children to private tuition
classes. This is because they too, have to equally compete for the limited places
at higher levels oflearning and this can only be achieved through good performance
in National Examinations. This paper focuses on the genesis of private
tuition and schooling in comparison to public education, as well as the factors
that sustain the behind-the-scenes private tuition system, leading to consumers
of education (pupils and parents) demanding for private tuition services, and
those that lead to producers (tutors, including teachers and other entrepreneurs)
producing and supplying the commodity - private tuition.
This study was limited to a desk review ofpertinent literature and selected key
informant interviews. The study's key findings indicate that socio-economic inequalities
continue to be pervasively manifest in the practice ofprivate tuition;
quality service is not guaranteed as long as private tuition continues to get no
official recognition; and while private tuition constitutes a serious financial burden
to the low income households, strong support for it comes from both parents
and students.
The study recommends urgent recognition ofthe integral role played by private
tuition in the management and delivery ofeducation services, hence strong evidence
that banning private tuition is unlikely to achieve the intended levels of
compliance, especially on the part ofthe producers and consumers. Such recognition
should therefore pave way for stakeholder dialogue between parents and
education managers, while incorporating the expertise and views of education
scholars, to improve equity in education financing without compromising quality.
It is further recommended that a study of a larger primary data-based scale be
carried out to facilitate an authoritative authentication of the findings, and, in
effect, be used to guide the way forward in terms of formulating an effective
policy on private tuition and related planning and implementation issues.

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.

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.

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.

JASPA Working Paper, ILO, Addis Ababa

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Malaria is a major public health problem that is presently complicated by the development of resistance by Plasmodium falciparum to the mainstay drugs. Thus, new drugs with unique structures and mechanism of action are required to treat drug-resistant strains of malaria. Historically, compounds containing a novel structure from natural origin represent a major source for the discovery and development of new drugs for several diseases. This paper presents ethnophytotherapeutic remedies, ethnodiagnostic skills, and related traditional knowledge utilized by the Digo community of the Kenyan Coast to diagnose malaria as a lead to traditional bioprospecting. The current study was carried out in three Digo villages of Diani sub-location between May 2009 and December 2009. Data was collected using semi-structured interviews, and open and close-ended questionnaires. A total of 60 respondents (34 men and 26 women) provided the targeted information. The results show that the indigenous knowledge of Digo community on malaria encompasses not only the symptoms of malaria but also the factors that are responsible for causing malaria, attributes favoring the breeding of mosquitoes and practices employed to guard against mosquito bites or to protect households against malaria. This knowledge is closely in harmony with scientific approaches to the treatment and control of the disease. The Digo community uses 60 medicinal plants distributed in 52 genera and 27 families to treat malaria. The most frequently mentioned symptoms were fever, joint pains, and vomiting while the most frequently mentioned practices employed to guard against mosquito bites and/or to protect households against malaria was burning of herbal plants such as Ocimum suave and ingestion of herbal decoctions and concoctions. The Digo community has abundant ethnodiagnostic skills for malaria which forms the basis of their traditional bioprospecting techniques. Keywords: malaria, antimalarials, ethnopharmacology, ethnodiagnostic skills, Digo community, bioprospecting

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Journal of Eastern African Literary and Cultural Studies

Potatoes (Solanum tuberosum L.) are second in importance after maize in Kenya as food crop. It is grown mainly by small scale farmers in more than 100,000 ha country wide producing more than 1 million tonnes annually. The marketing value chain has been described as ineffective, with farmers getting far much lesser compared with other players. Recognizing this, the Government of Kenya developed laws in 2005 to streamline the chain and ensure farmers gain from the potato production. It also established some specific laws in 2008 to interpret the 2005 laws in target chain levels. This study was carried out between December 2009 and February 2010 to monitor implementation, enforcement and economic impact of legal notice no. 113 of 2008 of the Government of Kenya using formal questionnaires administered to traders and farmers in selected seven markets and regions. Information was also obtained from focused group discussions as well as stakeholder participation in a workshop. The findings show that traders and farmers are aware of the regulations but are not implementing them. Farmers had higher (97%) knowledge of regulations compared with traders (92%). The major reasons cited by farmers for not being able to implement the regulations included cartels, lack of storage facilities and information about the potato production costs and prevailing market prices at any given time. Calculations show that the contribution of potatoes to the Kenyan economy is 300% higher than what is in government records. This study provides more evidence of the effect of the legal notice on the potato marketing value chain in Kenya and policy recommendations to ensure enforcement of the regulations and streamline the potato value chain.

The important role that women play in the management of water resources has been recognized in
various parts of the world. This is because they play a significant role in accessing water for
various uses such as washing, cooking, watering of crops and livestock rearing. Their effective
participation in water management is however influenced by existing policy, institutional and
legal frameworks. In this study, the various policies that enhance women’s participation in water
resources management in Kajiado County of Kenya were evaluated from the perspective of
relevance, value and limitations. This was done with a view to suggesting practical measures to
ensure the women’s important and critical roles are properly captured in the proposed policies on
water resources management in the County and elsewhere in the country. The findings show that
although the existing policies, legal and institutional frameworks are fairly comprehensive in
addressing women’s roles in the management of water resources, the policies do not, however,
directly and adequately address women’s issues and concerns in water resources management in
the County.

The ability of policies on biodiversity prospecting to contribute over the long term to economic development, conservation and the equitable sharing of genetic resources is examined. Consideration is given to: national innovation policy and biodiversity, the linkage of biotechnology to biodiversity, biotechnology transfer, technology assessment, and blind alleys and windows of opportunity. The discussion underlines that biodiversity prospecting will not contribute much to developing countries unless it helps them accumulate technological capacity through training programmes and technology development through scientific innovation. In order that national biotechnology policies enhance biodiversity prospecting much attention needs to be paid to human resource development, technological innovation, legal and institutional reforms, biotechnology regulation and intellectual property management. The experiences of INBio (Costa Rica's National Biodiversity Institute), a pilot technology transfer project, are discussed

Oyieke H.A. and Misra A.K:

Oyieke H.A. and Misra A.K:

The critical challenge facing Kenya is to raise the rate of economic growth to levels
incorporating broad-based improvement in the standards of living and well-being of Kenyans
in order to reduce poverty which has increased rapidly in the recent past (PRSP, 2000).
Kenya's economic growth rate declined dramatically from an average of 6.6% in 1970s to
4.2% in 1980s to an average 2.1% in the 1990s. The living conditions of the vast majority
of Kenyans are deteriorating rapidly. There is a marked increase in the number of people
unable to access clean water, clothing, shelter, health services and education. Unemployment
is a problem in Kenya. Average unemployment is at 23%, and is even higher for youth that
drop out of school and for women, averaging 25% in both cases (Chune, 2003). Government
services in many cases are no longer available. Growing disparities in access to services have
further undercut the living conditions of low-income households. School enrolments, infant
mortality and life expectancy have deteriorated (UNDp, 2002).
Kenya's economic objectives of growth, poverty reduction and improved resource utilization
and access have remained essentially the same since independence. The quest for sustainable
socio-economic development has however been a challenging endeavor, influencing some
policy shifts. The strident call has basically centred on poverty reduction, inclusion of those
excluded from the enjoyment of the benefits of economic growth and the redistribution of
productive resources. What have consequently changed are the strategies to achieve the
objectives of sustainable human development focusing on improving the quality of life of the
majority poor.
Poverty reduction broadly defined requires processes that help people to improve their
capabilities and functioning, that enable them to take charge of their affairs (Gondi, 2005).
Kenya has come up with many poverty reduction policies since independence, most of which
have had little success. The previous pre-1990s povertyreduction policies erroneouslyassumed
that the benefits of rapid growth of key sectors such as industry, service and agriculture would
automatically trickle down to all sectors of society. So more effort was injected into improving
economic performance (export incentive, agricultural food processing, etc.), at the expense
of promoting societal welfare enhancing projects. For example, some policies like the rural
and informal sector development did not receive the much-needed political will and required
resource allocation, to be effective.
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JASPA Working Paper, ILO, Addis Ababa

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{ The Blantyre coma scale (BCS) is used to assess children with severe falciparum malaria, particularly as a criterion for cerebral malaria, but it has not been formally validated. We compared the BCS to the Adelaide coma scale (ACS), for Kenyan children with severe malaria. We examined the inter-observer agreement between 3 observers in the assessment of coma scales on 17 children by measuring the proportion of agreement (PA), disagreement rate (DR) and fixed sample size kappa (kappa n). We assessed the sensitivity and specificity of the scales in detecting events (seizures and hypoglycaemia) in 240 children during admission and the usefulness of the scales in predicting outcome. There was considerable disagreement between observers in the assessment of both scales (BCS: PA = 0.55

Although military conflicts are common on the African continent, there is a paucity of data regarding bomb-blast injuries in this region and in Kenya in particular. This paper describes the pattern of maxillofacial injuries sustained after the August 1998 bomb blast that occurred in Nairobi, Kenya. A retrospective cross-sectional study was carried out using hospital-based records of 290 bomb-blast survivors admitted at the Kenyatta National Referral and Teaching Hospital in Nairobi. Using a self-designed form to record information about variables such as the sex and age of the survivors and type of location of soft- and hard-tissue injuries, it was found that of the 290 bomb-blast survivors, 78% had sustained one or more maxillofacial injuries. Soft-tissue injuries (cuts, lacerations or bruises) were the most common, constituting 61.3% of all injuries in the maxillofacial region; 27.6% had severe eye injuries, while 1.4% had fractures in the cranio-facial region. This paper concludes that the effective management of bomb-blast injuries as well as those caused by other types of disaster requires a multidisciplinary approach. The high percentage of maxillofacial injuries confirm that maxillofacial surgeons should form an integral part of this multidisciplinary team.

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As a result of socio-economic and political challenges facing Kenya: 46% of the country‟s 38 million people are living below the poverty line; there are a rapidly growing number of orphans and vulnerable children - half of which have resulted from a HIV/AIDs pandemic which has hit the country in the last two decades; frequent droughts, and the recently unprecedented post-election violence following the disputed 2007 general elections, social protection programmes for the country‟s poor and vulnerable population have become increasingly important both economically and politically.
This study, using data and information obtained from government and donor representatives closely involved with Kenya‟s CT programmes and secondary data, examines Kenya‟s Social Protection Programmes with special focus on CT programmes.
Starting with a brief review of the prevailing poverty and economic conditions and challenges facing the country, the paper examines government attitude and attention towards Cash Transfer (CT) and non-cash social protection programmes; the evolution, coverage and other features of the existing CT programmes in the country; the roles of the government and development partners in the programmes; domestic and external influences in the establishment of the various social protection programmes; estimated costs of the required CT programmes and the affordability and sustainability of the programme in view of the prevailing economic conditions and capacities; and the political economy and the overall ownership of the implementation of CT programme in the country.
While Kenya has had a long history of implementation of non-cash transfer programmes, such as: food relief in the drought stricken areas; emergency and special programmes; school bursaries for needy children, and a wide range of other interventions, CTs are new, mainly in their pilot or early stages and have been in existence only in the last 5 years.
The existing CT programmes have a limited coverage of the targeted members in three programmes, viz the Orphans and Vulnerable Children (OVC), the Elderly and the Hunger Safety Net programme. With the on-going discussions to finalise the country‟s Policy on Social Protection and the Social Protection Strategy (2009-2012) and a large increase in government‟s financing of the CT programmes through national budget, the national coverage of these programmes is expected to rise substantially by 2012.
There are high prospects of enhancing and institutionalising CT and non-CT social protection programmes in the country‟s budgetary system in view of the broad political support the programmes have received from a wide spectrum of political actors in the country. The liberalisation of the country‟s political system in 1992 which ushered in a highly vibrant and competitive multi-party political environment, has favoured introduction and expansion of social protection initiatives, both cash and non-cash.
A number of donors, notably UNICEF, DFID, World Bank and SIDA played key technical and financial roles in the establishment of CT programmes in the country creating the perception that the programmes were donor driven and that the government was more in favour of non-cash interventions. With increasing government and public appreciation of CT programmes as an appropriate tool for reaching more effectively a special group of the population the extremely poor or hard-core poor, who cannot participate in productive economic activities, the government participation in financing the programmes has risen dramatically, in the last two years. The government is expected to shoulder the bulk of the required resources for these programmes in the coming years but with supplementary resources from willing development partners.
There is considerable consensus among the stakeholders that the CT programmes are affordable and sustainable even without external donors, so long as the programmes are expanded gradually, taking into account the capacity of the national economy to support the programmes at various levels. The successful implementation of much larger non-cash social protection programmes such as the Free Primary Education for 8 million pupils and Free Day Secondary Education and the Constituency Development Fund are generally taken as good indicators of the ability of the country to sustain CT programmes as long as political will is there.
Most of the stakeholders were of the view the CT programmes are too socially and politically sensitive to be heavily dependent on external support which was often determined by exogenous factors beyond the government‟s control.
Kenya‟s draft National Social Protection Strategy, estimates that the country could escalate the Cash Transfer Programme nationally to cover all the extremely poor consisting of the People with Disabilities (PWD), Orphans and Vulnerable Children (OVC), and Households with Older Persons above 65 years, at a total cost of approximately Ksh 12 billion annually (about 3.3% of the national budget), at a monthly cash “transfer” of Ksh 1,000 per household.

{ The Blantyre coma scale (BCS) is used to assess children with severe falciparum malaria, particularly as a criterion for cerebral malaria, but it has not been formally validated. We compared the BCS to the Adelaide coma scale (ACS), for Kenyan children with severe malaria. We examined the inter-observer agreement between 3 observers in the assessment of coma scales on 17 children by measuring the proportion of agreement (PA), disagreement rate (DR) and fixed sample size kappa (kappa n). We assessed the sensitivity and specificity of the scales in detecting events (seizures and hypoglycaemia) in 240 children during admission and the usefulness of the scales in predicting outcome. There was considerable disagreement between observers in the assessment of both scales (BCS: PA = 0.55

This paper evaluates Kenyas food price crisis over 2002.11 using a political economy approach. Kenya.s food prices have been high and volatile relative to world food prices. Moreover, domestic food markets are highly integrated while about 30 per cent of...........

JASPA Working Paper, ILO, Addis Ababa

This article explores the package of “Agenda item 4” reforms
undertaken by the Kenyan government in the mediation process following
the 2007–8 postelection violence, including those relating to long-standing
issues over constitutional revision. It situates the previous lack of reforms
within Kenya’s political economy and demonstrates how political and economic
interests thwarted progress and produced the postelection crisis.
It also examines the more recent attempts to address reforms following
the signing of the National Accord and the creation of a power-sharing
government, and finds strong public support for constitutional revision.
It concludes that these pressures from below, along with a realignment of political interests and institutional change from power-sharing, helped support
reform.

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Many aspects of African traditional family patterns and child-rearing practices are increasingly being challenged by new pressures, re-evaluated against emerging values and replaced by new arrangements as part of a continuing transition in the social and cultural ecology of African family life. All the interlocking forces of change discussed in this paper have put added stress on the family's capacity to secure sustainable well-being. Although the changes affect everyone, women and children from the poorest families who already suffer different kinds of deprivation in many aspects of their lives are usually the worst affected. At the crossroads of family tradition and transition is the issue of sustainable child welfare. New and innovative strategies are required to strengthen the capabilities of individuals, families and communities to share care-giving responsibilities within the framework of reciprocity and partnerships to facilitate sustainable social relationships in and outside the family. This may require building alliances beyond the family and community to open a wider range of opportunities for men, women and children and a change in the overall perception of parenting to make the unique role of women in childcare meaningful, viable and sustainable

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.

Journal of Eastern African Literary and Cultural Studies

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In 27 December 2007, Kenyans went to the polls to e
lect their presidential, parliamentary, and
civic leaders. This general election was described
as replete with serious anomalies—a situation
that continues to raise serious doubts about the va
lidity of the electoral process. On 30 December
2007, after three days of uncertainty, the Electora
l Commission of Kenya (ECK) Chairman,
Samuel Kivuitu, announced Mwai Kibaki's re-election
amidst chaos. According to ECK, Kibaki
(Party of National Unity – PNU) won the presidentia
l election with 4,584,721 votes (46 percent),
against 4,352,903 (44 percent) garnered by Odinga (
Orange Democratic Party –ODM).
The whole process was less than transparent, castin
g doubt on the credibility of the electoral
outcome, especially the presidential election. The
majority of those involved—whether media,
civil society organizations, politicians, religious
institutions, leaders, even ordinary citizens—
were perceived as politically tainted, partisan, or
compromised. Many felt that the churches,
which prior to the referendum on the draft constitu
tion of 2005 were regarded as voices of reason
and moral authority, had failed in the 2007 electio
ns to provide visionary and unbiased
leadership. This essay discusses the background to
the violence and critically analyzes varied
church responses as well as the implications of the
se responses for political stability in Kenya

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

Although military conflicts are common on the African continent, there is a paucity of data regarding bomb-blast injuries in this region and in Kenya in particular. This paper describes the pattern of maxillofacial injuries sustained after the August 1998 bomb blast that occurred in Nairobi, Kenya. A retrospective cross-sectional study was carried out using hospital-based records of 290 bomb-blast survivors admitted at the Kenyatta National Referral and Teaching Hospital in Nairobi. Using a self-designed form to record information about variables such as the sex and age of the survivors and type of location of soft- and hard-tissue injuries, it was found that of the 290 bomb-blast survivors, 78% had sustained one or more maxillofacial injuries. Soft-tissue injuries (cuts, lacerations or bruises) were the most common, constituting 61.3% of all injuries in the maxillofacial region; 27.6% had severe eye injuries, while 1.4% had fractures in the cranio-facial region. This paper concludes that the effective management of bomb-blast injuries as well as those caused by other types of disaster requires a multidisciplinary approach. The high percentage of maxillofacial injuries confirm that maxillofacial surgeons should form an integral part of this multidisciplinary team.

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Journal of Eastern African Literary and Cultural Studies

Normal 0 false false false EN-US 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:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman","serif";} Products of gene modification have vast implications. Creating public awareness and disseminating information on the subject seeks to demystify some of the widely held falsehoods regarding genetically modified products. This is an informative, thorough and easy to understand guidebook that aims to enlighten and debunk some of the commonly held misconceptions on products of gene modification and to give the reader a better understanding of the role genetic modification will play. The review sheds light on the safety, and application of these products in medicine, the food industry and other areas, especially those where genetic modification may represent a cheap, faster, credible, viable alternative in achieving sustainable development among resource-poor communities.

Normal 0 false false false EN-US 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:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman","serif";} Products of gene modification have vast implications. Creating public awareness and disseminating information on the subject seeks to demystify some of the widely held falsehoods regarding genetically modified products. This is an informative, thorough and easy to understand guidebook that aims to enlighten and debunk some of the commonly held misconceptions on products of gene modification and to give the reader a better understanding of the role genetic modification will play. The review sheds light on the safety, and application of these products in medicine, the food industry and other areas, especially those where genetic modification may represent a cheap, faster, credible, viable alternative in achieving sustainable development among resource-poor communities.

In Kenya and sub‐Saharan Africa generally, there has been little systematic discussion of post‐colonial struggles for land rights. Studies have ignored the fact that the ‘land question ‘ is not about production alone and have, thus, failed to assess its wider consequences for society. This raises questions about the current socio‐political dimension of the land question and the consequences of the interplay between the ‘land question ‘ and other changes under way in the country. This study addresses these questions by discussing popular struggles of access to land in the coastal region of Kenya where the land question has a distinct political history. The analysis is based on a survey conducted in Kilifi district, Coast provinces, between September 1995 and November 1996.

BACKGROUND: Peptic ulcer disease (PUD) occurs in up to one fourth of patients with chronic renal failure (CRF). Some of the factors implicated in its causation include hypergastrinaemia, secondary hyperparathyroidism, drugs and, recently, Helicobacter pylori infection. Studies on the latter have been few, with none having been carried out in Kenya. OBJECTIVE: To evaluate the upper gastrointestinal tract endoscopic findings and to determine the prevalence of H. pylori in CRF patients with dyspepsia. STUDY DESIGN AND POPULATION: A prospective study of seventy seven consecutive patients with CRF and dyspepsia compared with consecutive age, sex and socio-economically matched seventy seven controls (no CRF) with dyspepsia. SETTING: Kenyatta National Hospital (KNH), the major referral and teaching hospital, Nairobi, Kenya. METHODS: In both the study population and the controls, upper gastrointestinal endoscopy was carried out. H. pylori was tested for using the biopsy urease test and histology. Patients were considered to have H. pylori if they tested positive on both tests. OUTCOME MEASURES: Findings at endoscopy and presence of H. pylori. RESULTS: Inflammatory lesions (gastritis, duodenitis) (42%) and duodenal ulcers (18.4%) were the commonest findings in the two groups combined. The prevalence of H. pylori in the 154 subjects studied was 54.5%. There was no statistically significant difference between the prevalence of H. pylori in CRF patients (53.2%) and the controls (55.8%) (p = 0.746). Patients with endoscopically proven PUD had a very high prevalence of H. pylori (87.3%) regardless of their renal function status. CONCLUSION: Dyspepsia in patients with or without CRF was due to multiple causes and over 50% were attributable to H. pylori. The prevalence of H. pylon in dyspeptic CRF patients was similar to that in dyspeptic patients with normal renal function.