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This thesis is a study on the Dorfman-Sterrett group-screening designs assuming equal a-prior probabilities of items being defective. Based on a clear theoretical framework, we have studied both restricted and unrestricted Dorfman-Sterrett procedure without and without errors in decision, deriving expressions for expected number of tests (and cost functions), which are used to compare the performance of this procedures with the Dorfman procedure. \lVehave give an alternative approach to determining the expected number of tests in an unrestricted Dorfman-Sterrett design. The restricted Dorfman-Sterrett procedure without errors in decision has also be examined, giving conditions under which the restricted procedure converges to the unrestricted procedure. vVe have shown that for most prevalence rates, the two-stage Dorfman-Sterrett procedure performs just as well as the unrestricted procedure. We have in this thesis also examined the Restricted Dorfman-Sterrett procedure with error in decision. Expressions for the expected number of runs and cost functions have been derived. The results, based on the expected proportional red uct.ion in testing over individual testing, indicate that the single-step Dorfman-Sterrett procedure performs better than the Dorfman procedure for all the prevalence rates less than 30%. The result.s also indicate the t.here is little. if any, difference in performance between the single-step and the two-step Dorfman-Sterrett procedures. For the multi-step Modified Dorfman-Sterrett procedures without errors in decision we have derived the expected number. of runs and compared this results with the expected number of runs for the Dorfman procedure and the multi-step DorfmanSterrett procedure. In. addition, cost functions and expected number of tests for the multi-step Modified Dorfman-Sterrett procedures with errors in decision have also been derived. The results indicate that the modified procedure perform slightly better than Dorfman procedure fer most prevalence rates but is less efficient than the Dorfman-Sterrett procedure. The expressions for expected number of runs and the expected number of incorrect decisions in screening with errors are derived using vVatsons testing of hypothesis approach. Under the testing of hypothesis approach group factors are tested using orthogonal fractional factorial designs of the type giveil in Plackett and Burman (1946). We have also derived expressions for expected number of runs for both the restricted and the unrestricted Modified Dorfman-Sterrett procedures. The results indicate that the Modified Dorfman-Sterrett procedure performs better than the Dorfman procedure for prevalence rates less than 30%. There is also a greater saving for larger prevalence rates. There is a saving of 3~2%in using the Modified procedure instead of the Dorfman procedure when p = 0.29 compared with a s~,ving of 0.18% for p = 0.001. The results however indicate that Sterrett's procedure is more efficient than t.he Modified procedures for prevalence rates less than 30%. These figures seem to disprove the a.ssertion by Huang et al (1089) that a modified Dorfman-Sterrett procedure is more efficient than Sterrett's procedure when the a-priori probability of an item being defective, P. is somewha.t higher (though still quite low) .

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

Presents the results of a monitoring programme of three smallholder irrigation schemes for field crops in Marigat division of Baringo district in Kenya. This was to ascertain the performance of the schemes from both technical and socio-economic criteria and also to identify and document the role of irrigated agriculture in contributing to the farmers household food needs and in improving the overall welfare of the rural farm households. Discusses the results from each irrigation scheme and gives some recommendations

Objectives: To investigate the level of contamination with C. jejuni of raw chicken and beef meats sold in Nairobi and to assess their potential as sources of campylobacter infections to man. Design: Dressed chicken and beef meat samples were randomly sourced from butcheries, markets and supermarkets in various parts of Nairobi over a period of two months. One hundred chicken and 50 beef samples were bacteriologically examined by selective enrichment and culture under microaerophilic environment. Thermophilic campylobacters were identified and characterised using standard physical and biochemical tests. Setting: Veterinary Public Health Laboratories, Kabete, University of Nairobi. Results: Thermophilic campylobacters were isolated from 77 (77%) poultry samples and one (2 %) beef sample. Isolation rate (85.3 %) was higher from chickens <24 hours old since slaughter than those >24 hours old. The beef isolate was 2% C. jejuni. Poultry samples yielded C. jejuni (59%), C. coli (39% and C. laridis (2%). Conclusion: These findings show that poultry meat sold at the counter is a major source of C. jejuni and C. coli, and that it is an important potential source of campylobacter infection. Proper cooking and hygienic handling before consumption is therefore essential.

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We surveyed the phytoseid mites in four different geographical zones of Kenya: Zone I, upper highland and tropical alpine (2400-4400m): Zone II, lower highland (1800-2400m); zone III, midland (800-1800m); Zone IV, tropical, hot and humid( 0-800m ). A total of 107 species was found. In the sub family, amblyseeinae there were 14 species in the genus Neoseilus , one in Aspereroseius Chant, one in Paraphytoseius Swirski &Schechter, five in typhlodromips De Leon, five in Transeius Chant & McMurty, one in Graminaseius Chant &McMurty, 11 in Amblyseius Berlese, one in Arrenoseius Wanstein, two in Typhlodromalus muma, seven in Ueckemannseius Chant &McMurty, one in Ambylodromalus Chant &Mcmurty,, 20 in Euseius Wanstein, one in Iphiseius Berlese, one in Phytoseilus Evans and one in Gynaseius Ehara & Imano. In the subfamily Phytoseiinae Berlese there were four species in the genus Phytoseiius Ribaga. In the subfamily Typhlodrominae Wanstein, there were four species in the genus Kuzinellus Wainstein and 27 in Typhlodromus Scheuten

domain of the putative celB gene from alkalophilic Bacillus

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This book provides an incisive discussion and analysis of the major issues and dynamics in diplomatic practice. It analyses documents and the process of diplomacy, the process and documents of diplomatic negotiations and mediation, and in the third part discusses some of the issues in diplomatic practice, such as reporting, manageemnt of the foreign service and legal and social problems of diplomatic missions.

All-trans-retinal and its condensation-products can cause retinal degeneration in a light-dependent manner and contribute to the pathogenesis of human macular diseases such as Stargardt's disease and age-related macular degeneration. Although these toxic retinoid by-products originate from rod and cone photoreceptor cells, the contribution of each cell type to light-induced retinal degeneration is unknown. In this study, the primary objective was to learn whether rods or cones are more susceptible to light-induced, all-trans-retinal-mediated damage. Previously, we reported that mice lacking enzymes that clear all-trans-retinal from the retina, ATP-binding cassette transporter 4 and retinol dehydrogenase 8, manifested light-induced retinal dystrophy. We first examined early-stage age-related macular degeneration patients and found retinal degenerative changes in rod-rich rather than cone-rich regions of the macula. We then evaluated transgenic mice with rod-only and cone-like-only retinas in addition to progenies of such mice inbred with Rdh8(-/-) Abca4(-/-) mice. Of all these strains, Rdh8(-/-) Abca4(-/-) mice with a mixed rod-cone population showed the most severe retinal degeneration under regular cyclic light conditions. Intense light exposure induced acute retinal damage in Rdh8(-/-) Abca4(-/-) and rod-only mice but not cone-like-only mice. These findings suggest that progression of retinal degeneration in Rdh8(-/-) Abca4(-/-) mice is affected by differential vulnerability of rods and cones to light.

Horseradish peroxidase was deposited in the optic nerve to retrogradely label and reveal the dendritic form of all classes of ganglion cell, or it was injected into the dorsal lateral geniculate nucleus to reveal only those classes projecting to the thalamus. The results were compared with those of the accompanying paper in which the ganglion cells projecting to the midbrain are selectively revealed. Two major classes of ganglion cells are described, the Pα and Pβ cells. For both classes dendritic field size increases with eccentricity from the fovea and there is no overlap in the two classes at any given eccentricity. Cell body size shows a similar mean difference but with a slight overlap. Both cell bodies and dendritic fields are larger along the temporal horizontal meridian than the nasal horizontal meridian, for Pα and for Pβ cells, but these differences are reduced when naso-temporal differences in ganglion cell density are taken into account, that is, size correlates closely with density. Injections restricted to the parvocellular layers of the lateral geniculate nucleus labelled almost exclusively Pβ cells, whereas injections confined to the magnocellular layers labelled almost exclusively Pα cells. As midbrain injections label no Pβ cells and few Pα cells it can be shown that about 80% of ganglion cells are Pβ cells projecting to parvocellular lateral geniculate nucleus, and that about 10% are Pα cells projecting to magnocellular layers. The coverage factor, that is the number of cells covering each point on the retina, varied from 1.9–2.3 for Pβ cells, and from 2–7 for Pα cells. Comparing the results with those of comparable investigations on cats and rabbits shows a much clearer segregation of the terminal targets of different classes of ganglion cell in monkeys, the greatest difference being the absence in the monkey of a projection to the geniculate from gamma- and epsilon-like cells. Further, axons which branch and innervate both thalamus and midbrain are rare in monkeys but common in other mammals. Comparing the results with those from physiological investigations suggests that the Pβ cells correspond to colour-opponent cells, whereas Pα cells correspond to the achromatic broad-band magnocellular cells.

Three cats were raised with monocular deprivation for 5.2-7.2 years, and ganglion-cell densities and soma sizes were measured in their flat-mounted retinae. The retinae were Nissl-stained so that ganglion cells could be measured whether or not they maintained normal central projections. Measurements were made in the area centralis, peripheral binocular segment, and monocular segment of the retinae. There were no significant differences between the deprived and non-deprived retinae in the densities or soma-sizes of alpha cells or other (non-alpha) ganglion cells at any of these retinal locations. These results support the view that the most distal effects of monocular deprivation occur at the retino-geniculate contact, and they suggest that even after long-term monocular deprivation, effects in the lateral geniculate nucleus do not produce secondary, retrograde changes in the retina.

Three cats were raised with monocular deprivation for 5.2-7.2 years, and ganglion-cell densities and soma sizes were measured in their flat-mounted retinae. The retinae were Nissl-stained so that ganglion cells could be measured whether or not they maintained normal central projections. Measurements were made in the area centralis, peripheral binocular segment, and monocular segment of the retinae. There were no significant differences between the deprived and non-deprived retinae in the densities or soma-sizes of alpha cells or other (non-alpha) ganglion cells at any of these retinal locations. These results support the view that the most distal effects of monocular deprivation occur at the retino-geniculate contact, and they suggest that even after long-term monocular deprivation, effects in the lateral geniculate nucleus do not produce secondary, retrograde changes in the retina.

Three cats were raised with monocular deprivation for 5.2-7.2 years, and ganglion-cell densities and soma sizes were measured in their flat-mounted retinae. The retinae were Nissl-stained so that ganglion cells could be measured whether or not they maintained normal central projections. Measurements were made in the area centralis, peripheral binocular segment, and monocular segment of the retinae. There were no significant differences between the deprived and non-deprived retinae in the densities or soma-sizes of alpha cells or other (non-alpha) ganglion cells at any of these retinal locations. These results support the view that the most distal effects of monocular deprivation occur at the retino-geniculate contact, and they suggest that even after long-term monocular deprivation, effects in the lateral geniculate nucleus do not produce secondary, retrograde changes in the retina.

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Retinal pigment epithelial cells (RPE) constitute a simple layer of cuboidal cells that are strategically situated behind the photoreceptor (PR) cells. The inconspicuousness of this monolayer contrasts sharply with its importance [1]. The relationship between the RPE and PR cells is crucial to sight; this is evident from basic and clinical studies demonstrating that primary dysfunctioning of the RPE can result in visual cell death and blindness. RPE cells carry out many functions including the conversion and storage of retinoid, the phagocytosis of shed PR outer segment membrane, the absorption of scattered light, ion and fluid transport and RPE-PR apposition. The magnitude of the demands imposed on this single layer of cells in order to execute these tasks, will become apparent to the reader of this review as will the number of clinical disorders that take origin from these cells.

Retinal pigment epithelial cells (RPE) constitute a simple layer of cuboidal cells that are strategically situated behind the photoreceptor (PR) cells. The inconspicuousness of this monolayer contrasts sharply with its importance [1]. The relationship between the RPE and PR cells is crucial to sight; this is evident from basic and clinical studies demonstrating that primary dysfunctioning of the RPE can result in visual cell death and blindness. RPE cells carry out many functions including the conversion and storage of retinoid, the phagocytosis of shed PR outer segment membrane, the absorption of scattered light, ion and fluid transport and RPE-PR apposition. The magnitude of the demands imposed on this single layer of cells in order to execute these tasks, will become apparent to the reader of this review as will the number of clinical disorders that take origin from these cells.

Located between vessels of the choriocapillaris and light-sensitive outer segments of the photoreceptors, the retinal pigment epithelium (RPE) closely interacts with photoreceptors in the maintenance of visual function. Increasing knowledge of the multiple functions performed by the RPE improved the understanding of many diseases leading to blindness. This review summarizes the current knowledge of RPE functions and describes how failure of these functions causes loss of visual function. Mutations in genes that are expressed in the RPE can lead to photoreceptor degeneration. On the other hand, mutations in genes expressed in photoreceptors can lead to degenerations of the RPE. Thus both tissues can be regarded as a functional unit where both interacting partners depend on each other.

The retinal pigment epithelium (RPE) is a monolayer of cuboidal cells that lies in close association with the rod and cone photoreceptors. This epithelium has diverse features, three of which are discussed in some detail in this review, namely the daily phagocytosis of rod and cone outer segment fragments that are shed from their distal ends; the uptake, processing, transport and release of vitamin A (retinol) and some of its visual cycle intermediates (retinoids); and some of the aspects of its apical and basolateral membrane polarity that are the reverse of most other epithelia. Phagocytosis takes place at the apical surface via membrane receptor-mediated processes that are not yet well defined. Retinol uptake occurs at both the basolateral and apical surfaces by what appear to be separate receptor-mediated processes. The release of a crucial retinoid, 11-cis retinaldehyde (11-cis retinal), occurs solely across the apical membrane. Delivery of retinol across the basolateral membrane is mediated by a retinol binding protein (RBP) that is secreted by the liver as a complex with retinol (vitamin A). Within the cell, retinol and its derivatives are solubilized by intracellular retinoid binding proteins that are selective for retinol (cellular retinol binding protein, CRBP) and 11-cis retinoids (cellular retinal binding protein, CRALBP). Release of 11-cis retinal across the apical membrane and re-uptake of retinol from the photoreceptors during the visual cycle is promoted by an intercellular retinoid binding protein (IRBP). Na,K-ATPase, the membrane-integrated enzyme required to set up the ion gradients that drive other ion transporters, is largely localized to the apical membrane.(ABSTRACT TRUNCATED AT 250 WORDS)

The retinal pigment epithelium (RPE) is a monolayer of cuboidal cells that lies in close association with the rod and cone photoreceptors. This epithelium has diverse features, three of which are discussed in some detail in this review, namely the daily phagocytosis of rod and cone outer segment fragments that are shed from their distal ends; the uptake, processing, transport and release of vitamin A (retinol) and some of its visual cycle intermediates (retinoids); and some of the aspects of its apical and basolateral membrane polarity that are the reverse of most other epithelia. Phagocytosis takes place at the apical surface via membrane receptor-mediated processes that are not yet well defined. Retinol uptake occurs at both the basolateral and apical surfaces by what appear to be separate receptor-mediated processes. The release of a crucial retinoid, 11-cis retinaldehyde (11-cis retinal), occurs solely across the apical membrane. Delivery of retinol across the basolateral membrane is mediated by a retinol binding protein (RBP) that is secreted by the liver as a complex with retinol (vitamin A). Within the cell, retinol and its derivatives are solubilized by intracellular retinoid binding proteins that are selective for retinol (cellular retinol binding protein, CRBP) and 11-cis retinoids (cellular retinal binding protein, CRALBP). Release of 11-cis retinal across the apical membrane and re-uptake of retinol from the photoreceptors during the visual cycle is promoted by an intercellular retinoid binding protein (IRBP). Na,K-ATPase, the membrane-integrated enzyme required to set up the ion gradients that drive other ion transporters, is largely localized to the apical membrane.(ABSTRACT TRUNCATED AT 250 WORDS)

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This study determined retinal thinning in a mammalian model of high myopia using optical coherence tomography (OCT) and histological sections from the same retinal tissue. High myopia was induced in three tree shrews (Tupaia belangeri) by deprivation of form vision via lid suture of one eye, with the other eye a control. Ocular biometry data was obtained by Ascan ultrasonography, keratometry and retinoscopy. The Zeiss StratusOCT was used to obtain Bscans in vivo across the retina. Subsequently, eyes were enucleated and retinas fixed, dehydrated, embedded and sectioned. Treated eyes developed a high degree of axial myopia (−15.9 ± 2.3 D; n = 3). The OCT analysis showed that in myopic eyes the nasal retina thinned more than the temporal retina relative to the disc (p = 0.005). Histology showed that the retinas in the myopic eyes comprise all layers but were thinner than the retinas in normal and control eyes. Detailed thickness measurements in corresponding locations of myopic and control eyes in superior nasal retina using longitudinal reflectivity profiles from OCT and semithin vertical histological sections showed the percentage of retinal thinning in the myopic eyes was similar between methods (OCT 15.34 ± 5.69%; histology 17.61 ± 3.02%; p = 0.10). Analysis of retinal layers revealed that the inner plexiform, inner nuclear and outer plexiform layers thin the most. Cell density measurements showed all neuronal cell types are involved in retinal thinning. The results indicate that in vivo OCT measurements can accurately detect retinal thinning in high myopia.

This study determined retinal thinning in a mammalian model of high myopia using optical coherence tomography (OCT) and histological sections from the same retinal tissue. High myopia was induced in three tree shrews (Tupaia belangeri) by deprivation of form vision via lid suture of one eye, with the other eye a control. Ocular biometry data was obtained by Ascan ultrasonography, keratometry and retinoscopy. The Zeiss StratusOCT was used to obtain Bscans in vivo across the retina. Subsequently, eyes were enucleated and retinas fixed, dehydrated, embedded and sectioned. Treated eyes developed a high degree of axial myopia (−15.9 ± 2.3 D; n = 3). The OCT analysis showed that in myopic eyes the nasal retina thinned more than the temporal retina relative to the disc (p = 0.005). Histology showed that the retinas in the myopic eyes comprise all layers but were thinner than the retinas in normal and control eyes. Detailed thickness measurements in corresponding locations of myopic and control eyes in superior nasal retina using longitudinal reflectivity profiles from OCT and semithin vertical histological sections showed the percentage of retinal thinning in the myopic eyes was similar between methods (OCT 15.34 ± 5.69%; histology 17.61 ± 3.02%; p = 0.10). Analysis of retinal layers revealed that the inner plexiform, inner nuclear and outer plexiform layers thin the most. Cell density measurements showed all neuronal cell types are involved in retinal thinning. The results indicate that in vivo OCT measurements can accurately detect retinal thinning in high myopia.

Ganglion cells are the only retinal neurons communicating directly with the brain. It is well known that mammalian ganglion cells comprise more than a dozen types, clearly distinguishable from one another in structure and function. Each type also appears to send axons to a distinctive subset of the many central visual nuclei receiving direct retinal input. The implication is that each ganglion cell type forms a specialized channel sculpted by evolutionary pressures to fulfill specific visual functions. Though the outlines of this perspective have been clear for decades, many essential details are lacking. The goal of this chapter is to summarize the state of knowledge about where retinal axons are distributed in the brain and which types of ganglion cells contribute to these pathways. The primary focus is on ganglion cell types that appear to be conserved across mammalian phylogeny.

By its action on rhodopsin, light triggers the well-known visual transduction cascade, but can also induce cell damage and death through phototoxic mechanisms – a comprehensive understanding of which is still elusive despite more than 40 years of research. Herein, we integrate recent experimental findings to address several hypotheses of retinal light damage, premised in part on the close anatomical and metabolic relationships between the photoreceptors and the retinal pigment epithelium. We begin by reviewing the salient features of light damage, recently joined by evidence for retinal remodeling which has implications for the prognosis of recovery of function in retinal degenerations. We then consider select factors that influence the progression of the damage process and the extent of visual cell loss. Traditional, genetically-modified, and emerging animal models are discussed, with particular emphasis on cone visual cells. Exogenous and endogenous retinal protective factors are explored, with implications for light damage mechanisms and some suggested avenues for future research. Synergies are known to exist between our long term light environment and photoreceptor cell death in retinal disease. Understanding the molecular mechanisms of light damage in a variety of animal models can provide valuable insights into the effects of light in clinical disorders and may form the basis of future therapies to prevent or delay visual cell loss.

Retinoblastoma is an aggressive eye cancer of infancy and childhood. Survival and the chance of saving vision depend on severity of disease at presentation. Retinoblastoma was the first tumour to draw attention to the genetic aetiology of cancer. Despite good understanding of its aetiology, mortality from retinoblastoma is about 70% in countries of low and middle income, where most affected children live. Poor public and medical awareness, and an absence of rigorous clinical trials to assess innovative treatments impede progress. Worldwide, most of the estimated 9000 newly diagnosed patients every year will die. However, global digital communications present opportunities to optimise standards of care for children and families affected by this rare and often devastating cancer. Parents are now leading the effort for widespread awareness of the danger of leucocoria. Genome-level technologies could make genetic testing a reality for every family affected by retinoblastoma. Best-practice guidelines, online sharing of pathological images, point-of-care data entry, multidisciplinary research, and clinical trials can reduce mortality. Most importantly, active participation of survivors and families will ensure that the whole wellbeing of the child is prioritised in any treatment plan.

Retinoblastoma is an aggressive eye cancer of infancy and childhood. Survival and the chance of saving vision depend on severity of disease at presentation. Retinoblastoma was the first tumour to draw attention to the genetic aetiology of cancer. Despite good understanding of its aetiology, mortality from retinoblastoma is about 70% in countries of low and middle income, where most affected children live. Poor public and medical awareness, and an absence of rigorous clinical trials to assess innovative treatments impede progress. Worldwide, most of the estimated 9000 newly diagnosed patients every year will die. However, global digital communications present opportunities to optimise standards of care for children and families affected by this rare and often devastating cancer. Parents are now leading the effort for widespread awareness of the danger of leucocoria. Genome-level technologies could make genetic testing a reality for every family affected by retinoblastoma. Best-practice guidelines, online sharing of pathological images, point-of-care data entry, multidisciplinary research, and clinical trials can reduce mortality. Most importantly, active participation of survivors and families will ensure that the whole wellbeing of the child is prioritised in any treatment plan.

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Haemophilia is a group of coagulation factor disorders that are mostly inherited. It presents with numerous and varied systemic manifestations depending on the severity of coagulation factor deficiency. There are also ocular manifestations ranging from simple subconjunctival haemorrhage to more debilitating complications like retinal, vitreous and retrobulbar haemorrhage which are potentially blinding.
We report a patient who initially presented with what appeared to be simple post-traumatic retrobulbar haemorrhage. The diagnosis of a bleeding disorder was considered when difficulties in achieving haemostasis were encountered intra-operatively.
Key words: Retrobulbar haemorrhage, haemophilia, trauma, proptosis

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This was a study to evaluate the characteristics and outcome of patients operated on with bilateral cleft lip through surgical outreach programs in Kenya between January 2006 and December 2011. Files for fifty-nine patients operated on during the study period were evaluated. The mean age for surgery was ten months with about forty-five percent of the patients more than one year of age. No presurgical orthopaedic devices were utilized on any of the patients. Mulliken surgical technique and the Manchester technique were the commonest surgical techniques in equal proportions. An overall complication rate of about 7.5 percent was noted. In conclusion we noted a delay in the surgical management of the majority of our patients. This resulted in a backlog of cases. There is thus a need to intensify more surgical outreach camps as well as training more surgeons to assist in the management of clefts. Cleft surgery is a relatively safe surgery that could be carried out in relatively remote centers through surgical outreach programs. This was evidenced by the low complication rates in our series.

J Infect Dis. 1987 Jun;155(6):1108-12.
Retrospective seroepidemiology of AIDS virus infection in Nairobi populations.
Piot P, Plummer FA, Rey MA, Ngugi EN, Rouzioux C, Ndinya-Achola JO, Veracauteren G, D'Costa LJ, Laga M, Nsanze H, et al.
Abstract
Among 446 sera from prostitutes in Nairobi, the prevalence of antibody to human immunodeficiency virus (HIV) rose from 4% in 1981 to 61% in 1985. None of 118 men with chancroid seen in 1980 had antibody to HIV compared with 15% of 107 such men in 1985. Among pregnant women, 2.0% were seropositive in 1985 versus none of 111 in 1981. Seropositive prostitutes and women with sexually transmitted diseases (STDs) tended to have more sex partners and had a higher prevalence of gonorrhoea, and in women with STDs, significantly more seropositive women practiced prostitution. Pregnant women and men with STDs who were born in the most-western region of Kenya were more likely to have antibody to HIV than were such groups from other geographic areas. Our results indicate that the AIDS virus was recently introduced into Kenya, that HIV can rapidly disseminate in a high-risk group of heterosexuals, and that prostitutes may have significantly contributed to the spread of the virus.
PMID:
3471817
[PubMed - indexed for MEDLINE]

J Infect Dis. 1987 Jun;155(6):1108-12.
Retrospective seroepidemiology of AIDS virus infection in Nairobi populations.
Piot P, Plummer FA, Rey MA, Ngugi EN, Rouzioux C, Ndinya-Achola JO, Veracauteren G, D'Costa LJ, Laga M, Nsanze H, et al.
Abstract
Among 446 sera from prostitutes in Nairobi, the prevalence of antibody to human immunodeficiency virus (HIV) rose from 4% in 1981 to 61% in 1985. None of 118 men with chancroid seen in 1980 had antibody to HIV compared with 15% of 107 such men in 1985. Among pregnant women, 2.0% were seropositive in 1985 versus none of 111 in 1981. Seropositive prostitutes and women with sexually transmitted diseases (STDs) tended to have more sex partners and had a higher prevalence of gonorrhoea, and in women with STDs, significantly more seropositive women practiced prostitution. Pregnant women and men with STDs who were born in the most-western region of Kenya were more likely to have antibody to HIV than were such groups from other geographic areas. Our results indicate that the AIDS virus was recently introduced into Kenya, that HIV can rapidly disseminate in a high-risk group of heterosexuals, and that prostitutes may have significantly contributed to the spread of the virus.
PMID:
3471817
[PubMed - indexed for MEDLINE]

A retrospective audit of all the rape cases reported at the Aga Khan Hospital, Nairobi over a two year period was carried out. Out of 37 victims, 86.6% were less than 30 years old and 73.4% did not know who the assailant was. 80% of the victims reported to the hospital within 24 hours of the incident taking place and in 4 (10.8%) of the victims-vaginal swabs grew N. gonorrhoea. None of the victims opted for prosecution and none were referred for further counselling. We recommended that alleged rape victims be seen by a qualified gynaecologist or police surgeon and that they should be examined, investigated and managed by a standard protocol. PIP: This retrospective study was undertaken to identify the management problems of sexual assault cases as seen at the Aga Khan Hospital, Nairobi where an ongoing quality assurance program attempts to maintain high standards of medical care. The study reviewed all records of sexual assault victims over a 2-year period. The results showed that all 37 victims were females and majority (89.1%) were aged between 19 and 30 years old. About 73.4% did not know their assailants, 80% reported to the hospital within 24 hours of the incident and 10.8% of the victims manifested Neisseria gonorrhea in their vaginal swabs. None of the victims made attempts to bring the assailants to justice. Although rape victims usually suffer from posttraumatic stress, none of the victims in this study were referred for further counseling. Lastly, this study recommended that sexual assault victims should be examined, investigated, and managed by a standard protocol

Retrospective Sturdy of Cancer of the Esophagus in Kenya - Cancer Research, 38: 303 - 305, February 1978. (Second of five authors - D.G. Gatei, A.E.O. Wasunna, D.A. Orinda and J. Muruka).

Retrospective Sturdy of Cancer of the Esophagus in Kenya - Cancer Research, 38: 303 - 305, February 1978. (Second of five authors - D.G. Gatei, A.E.O. Wasunna, D.A. Orinda and J. Muruka).

Retrospective Sturdy of Cancer of the Esophagus in Kenya - Cancer Research, 38: 303 - 305, February 1978. (Second of five authors - D.G. Gatei, A.E.O. Wasunna, D.A. Orinda and J. Muruka).

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A clinical, radiological, histological, and geographical study of carcinoma of the esophagus in Kenya is reported. It was found that this cancer is diagnosed more often in males than in females, with a ration of 8:1 (Kenya Cancer Registry). The most common age in males and females is 50 to 59 years. The regions of the esophagus most commonly involved are the middle and lower thirds, in almost equal proportions. An unexplained tendency for the tumor to be poorly differentiated towards the lower third is noted. In addition a review on the possible etiological factors is presented.

A literature survey revealed lack of adequate information on poisoning in Kenya, thus providing the impetus for the present work. In this, study, a 3 year retrospective survey of human poisoning in 19 Kenyan District, Provincial hospitals and Kenyatta National Hospital (KNH), representing approximately 40% of such public hospitals in the country, was carried out. Cases of poisoning were identified by diagnosis codes entered on hospital records at the time of discharge. A total of 1904 cases of poisoning were recorded and the information analyzed with particular focus on childhood poisoning. Distribution pattern with respect to poisoning agents, age and sex is presented. Children aged 0-5 years account for 29.78% while those aged 6-14 years account for 10.24% of cases of poisoning recorded. In the age group 0-5 years, Kerosine, drugs and organophosphates account for 41.09, 23.81 and 15.17% of poisoning cases respectively. It is concluded that any preventive measures targeted at children must focus on the 3 classes of poisons which together account for approximately 80% of all classes of poisoning in children.

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Bull. Anim. Hlth. Prod. Afr., (2010), 58, 22-33.

A RETROSPECTIVE STUDY OF FACTORS ASSOCIATED WITH NEWCASTLE
DISEASE OUTBREAKS IN VILLAGE INDIGENOUS CHICKENS

L.W. Njagi1*, P.N. Nyaga1, P.G. Mbuthia1, L.C. Bebora1, J.N. Michieka1, and U.M. Minga2

1University of Nairobi,
Department of Veterinary Pathology, Microbiology and Parasitology,
Faculty of Veterinary Medicine,
P.O. Box 29053 – 00625, Kangemi, Kenya.
2Open, University of Tanzania, P.O. Box 23409, Dar es salaam, Tanzania
ÉTUDE RÉTROSPECTIVE DES FACTEURS ASSOCIÉS À LA DÉCLARATION DE
LA MALADIE DE NEWCASTLE CHEZ LA POULE DE RACE LOCALE
Résumé
Bien que l'épidémiologie de la maladie de Newcastle soit bien documentée dans les systèmes
aviaires commerciaux, les informations relatives à l’écologie de la maladie chez la poule de race locale, en particulier sous les tropiques, sont par contre peu disponible. L'objectif de cette étude était de déterminer les facteurs de risque associés à la maladie de Newcastle chez la poule de race locale. L'étude a été menée dans cinq zones agro-écologiques et a concernées
soixante quinze ménages élevant des poules de race locale. Les éleveurs ont été sélectionnés de manière aléatoire et évalués sur leurs connaissances de la maladie, et les signes cliniques
manifestés par les oiseaux infectés. Les données sur les pratiques de gestion, l’incidence des
maladies et les facteurs de risque associés à la déclaration de la maladie de Newcastle ont été
recueillies à l'aide d'un questionnaire et analysées à l'aide d’un logiciel de statistiques. Le taux de fréquence de la maladie de Newcastle était élevé (93,8%) dans la zone sèche et faible (50%) dans la zone fraîche et humide (dans les régions basses de montagnes). Les déclaration de la maladie de Newcastle étaient significativement associées aux différents facteurs suivant cloisonnement des oiseaux dans toutes les zones écologiques, sauf celle située dans le Bas-
Midland où pour la plus part des cas signalés, les oiseaux n’étaient pas enfermés; le mode
d’évacuation des oiseaux infectés ; les carcasses des volailles et les matières fécales; les saisons sèches dans les zones sèches juste avant les pluies ; les conditions de ventilation ; les changements irréguliers de température et l’approvisionnement en volaille sur les marchés (P <0,05). Par contre, la poussière n'était pas significative (P> 0,05) associée aux déclarations de la maladie de Newcastle. Les réponses variaient selon les saisons et entre les zones agro - écologiques. En guise de conclusion, l'étude a montré que plusieurs facteurs à savoir: cloisonner les oiseaux, les températures froides ou très chaudes, la ventilation, l'achat d’oiseaux sur les marchés, l'élimination de la matière fécale et les oiseaux infectés sont des facteurs majeurs de risque pour la survenue de la maladie de Newcastle chez les poules de race locale. Il est recommandé que les éleveurs de volaille soient informés sur la transmission de la maladie de Newcastle et sa prévention.

Mots clés: facteurs de risque, zones agro-écologiques, cloisonnement, saisons chaudes et
fraîches.

Summary
Although the epidemiology of Newcastle disease in commercial poultry systems is well
documented, its ecology in indigenous birds, especially in tropics, is not adequately reported.
The objective of this study, therefore, was to determine the risk factors associated with occurrence of Newcastle disease in village indigenous chickens. The study was carried out in
five agro –ecological zones and seventy five households keeping indigenous chickens. Farmers were randomly selected and assessed on whether they understood Newcastle disease including knowing its local name and clinical signs manifested by the affected birds. Those who did not fit into the above category were excluded from further interviews. Data on management practices, incidence of diseases and risk factors associated with Newcastle disease outbreaks were collected using a questionnaire and analysed using statistical package. The prevalence rate of Newcastle disease was highest (93.8%) in the dry zone (Low midland 5) and lowest (50%) in cool wet zone (Lower Highland 1). Newcastle disease outbreaks were significantly associated with the following factors namely: confinement of birds in all ecological zones except in lower midland 5 where most cases were reported without confinement; mode of disposal of infected birds, carcasses and poultry faecal matter; dry seasons in the dry zones just before the rains; wind conditions; short intermittent temperature changes and the restocking of farms with chickens from the markets (P<0.05). Dust storm was not significantly (P>0.05) associated with Newcastle disease outbreaks. The responses varied across the seasons and between the agro – ecological zones.
In conclusion, the study has shown that several factors namely: confinement; cold or very hot
temperatures; winds; introduction of market birds and disposal of manure and sick birds are
major risk factors to occurrence of Newcastle disease in indigenous chickens. It is recommended that flock owners be educated on Newcastle disease transmission and prevention.

Key – words: risk factors, agro–ecological zones, confinement, hot and cold seasons.

A retrospective study was carried out to determine categories, patterns and outcomes of foot conditions in dairy cows from smallholder units in and around Nairobi, Kenya. Analysis was done on 625 hospital case records of dairy cows admitted and treated for foot conditions from 1981 to 2006 at the Large Animal Hospital, Faculty of Veterinary Medicine, University of Nairobi. The records were from cows that had been through one or more parities. Data included type of foot lesion, the affected limb and the claw, and the outcome of treatment. Relative percentages of the foot lesions were computed. Foot lesions with the highest percentages of occurrence were interdigital necrobacillosis (36%), interdigital fibroma (12%) and sole abscess (11%). Others with lower percentages included trauma (8%), claw overgrowth (7%), sole necrosis (severely eroded and necrotized horn of the sole) (6%), septic fetlock arthritis (6%) and septic pedal arthritis (5%). Laminitis and related claw lesions, such as double soles and heel erosion had less than 1% occurrence. The hind feet were affected in 75% of the cases, from which 83% of the lesions involved outer claws. The fore feet were involved in 16% of the cases, of which 57% of the lesions affected inner claws. Simultaneous involvement of both fore and hind feet occurred in only 2% of the cases and 6% of the cows had more than one foot lesion. A total of 90% of the cows were healed after treatment, 6% were slaughtered and 4% died. The results of this study indicated that a high percentage of cases of foot conditions referred to the Animal Hospital from smallholder dairy units in and around Nairobi were infective and a lower percentage was laminitic. We recommend that a farm-level prospective study be conducted in the same area to verify this status.

A retrospective study was carried out to determine categories, patterns and outcomes of foot conditions in dairy cows from smallholder units in and around Nairobi, Kenya. Analysis was done on 625 hospital case records of dairy cows admitted and treated for foot conditions from 1981 to 2006 at the Large Animal Hospital, Faculty of Veterinary Medicine, University of Nairobi. The records were from cows that had been through one or more parities. Data included type of foot lesion, the affected limb and the claw, and the outcome of treatment. Relative percentages of the foot lesions were computed. Foot lesions with the highest percentages of occurrence were interdigital necrobacillosis (36%), interdigital fibroma (12%) and sole abscess (11%). Others with lower percentages included trauma (8%), claw overgrowth (7%), sole necrosis (severely eroded and necrotized horn of the sole) (6%), septic fetlock arthritis (6%) and septic pedal arthritis (5%). Laminitis and related claw lesions, such as double soles and heel erosion had less than 1% occurrence. The hind feet were affected in 75% of the cases, from which 83% of the lesions involved outer claws. The fore feet were involved in 16% of the cases, of which 57% of the lesions affected inner claws. Simultaneous involvement of both fore and hind feet occurred in only 2% of the cases and 6% of the cows had more than one foot lesion. A total of 90% of the cows were healed after treatment, 6% were slaughtered and 4% died. The results of this study indicated that a high percentage of cases of foot conditions referred to the Animal Hospital from smallholder dairy units in and around Nairobi were infective and a lower percentage was laminitic. We recommend that a farm-level prospective study be conducted in the same area to verify this status.

A twenty year retrospective study was carried out in the Small Animal Clinic, University of Nairobi, Kenya and in a private Small Animal Clinic in Nairobi between the years 1988 to 2008. A total of 6548 bitches had been presented with reproductive problems. The cases were categorically grouped according to the type of infertility diagnosed. Non-infectious infertilities were sixty nine percent and infectious types were thirty one percent. Only two percent of the latter were confirmed in one clinic. 23.20 % of non-infectious infertility were managerial, 29.1% anatomical and 7.80% physiological types while 39.80 % were unclassified miscellaneous cases. The cases classified under infectious infertility consisted of; vaginitis/endometritis/metritis (36.3%), pyometra (25.3%), abortions (21.5%), vaginal discharges (11.7%) and miscarriages (5.1%). The incidence of infertilities was highly common in breeds of German shepherd (39%), Doberman (6%), Rottweiler (12%) and their crosses (43%). The percentage of the reproductive cases presented in both clinics had no statistical difference at (p<0.05). It was evident from the results of this study that infectious infertility exists among the bitches in Kenya and it would be beneficial to do further studies to establish the causative agents to avert any possible outbreaks of zoonotic diseases.

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

Description: This book describes four types of indigenous water retention structures used in East Africa. These structures are the Berkad tank, the Charco dam, sand wiers and hillside water retention ditches.

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Description: This book describes four types of indigenous water retention structures used in East Africa. These structures are the Berkad tank, the Charco dam, sand wiers and hillside water retention ditches.

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African Media Review, Vol. II, No. 3.

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 Journal of Civil Engineering, Jomo Kenyatta University of Agriculture and Technology Vol.7 PP

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This paper develops an improved real and reactive power control technique using linear programming (LP) for an integrated power system. The problem is decomposed into two subproblems comprising real (P) and reactive power (Q) modules, and, using a unified approach, the real power generation, voltage magnitude, and transformer tap settings are optimized. The objective function is the fuel cost which is minimized in both the P and Q modules, subject to the operating constraints. The P-Q decomposition combined with the LP formulation improve the computation speed. The paper has another advantage of using the same cost objective function for both modules, unlike other conventional methods which use the power loss function for the Q module. The LP formulation is used for both the P and Q optimization modules, utilizing the revised simplex method which is normally available in a mainframe computer.

Stimulation with phytohemagglutinin of the leukocytes from six of the seven known individuals with UDP-galactose 4-epimerase (= UDP-glucose 4-epimerase; EC 5.1.3.2) deficiency consistently resulted in the appearance of epimerase activity in the cultured cells. A long-term lymphoblast culture derived from one proband also contained an active epimerase enzyme. A comparison of the properties of this enzyme with those of epimerase produced by control lymphoblast lines revealed comparable Km values for UDP-galactose and NAD and identical behavior on polyacrylamide electrophoresis. However, a difference in the NAD requirement for heat stability at 40 degree provided some evidence for a structural defect in this enzyme. Possible explanations for the appearance of UDP-galactose 4-epimerase activity in stimulated lymphocytes include an increased rate of synthesis of a mutant enzyme and a derepression of an epimerase locus during lymphocyte transformation.

The distally based sural island flap was first described by Masquelet, et al., in 1992. It is a skin island flap supplied by the vascular axis of the sural nerve. The aim of this paper is to demonstrate that it can be applied in coverage of difficult wound in the lower third of the leg. We treated nine patients with nine distally based sural island flaps. All the flaps survived, most of the flaps had venous congestion. The largest flap was 10 x 8 cm and Doppler was used in only one flap. This technique is easy and quick to execute without sacrificing major arteries.

The reduction of metmyoglobin by the iron(II) complex of trans-1,2-diaminocyclohexane-N,N,N'N'-tetraacetate (FeCDTA2-) has been investigated. The equilibrium constant, measured spectrophotometrically, is 0.21 with a resulting reduction potential of 0.050 V for Mb0. The rate constant for the reduction is 28 M-1 sec-1 with a deltaH ++ of 13 kcal M-1 and deltaS ++ of -11 eu. Both CN- and OH- inhibit the reduction because of the relatively low reactivity of cyanometmyoglobin (Mb+CN-) and ionized metmyglobin (Mb+OH-). The rate constant for the reduction of Mb+CN- by FeCDTA2- is 4.0 X 10(-2) M-1 sec-1 and that for reduction of Mb+OH- is 4.8 M-1 sec-1. The nitric oxide complex of metmyoglobin is reduced with a rate constant of 10 M-1 sec-1. The kinetics of oxidation of oxymyoglobin by FeCDTA- were studied. The data are consistent with a mechanism where oxidation takes place entirely through the deoxy form. A rate constant of 1.45 X 10(2) M-1 sec-1 was calculated for the oxidation of deoxymyoglobin by FeCDTA-, in equilibrium constant and rate constant for reduction. The above data are discussed in terms of a simple outer-sphere reduction reaction.

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{ OBJECTIVES To compare sociodemographic profiles, child care, child feeding practices and growth indices of children born to HIV-1 seropositive and seronegative mothers. METHODS: A cohort study of 234 children (seropositive and seronegative) born to HIV-1 seropositive mothers and 139 children born to seronegative mothers in Pumwani Maternity Hospital which serves a low-income population in Nairobi, Kenya from December 1991 and January 1994. RESULTS: With few exceptions, at the time of their birth children in all three cohorts had parents with similar characteristics, lived in similar housing in similar geographical areas, had their mothers as their primary care givers, had similar feeding practices and similar growth status and patterns. However, the HIV-1 seropositive mothers were slightly younger (23.8 years vs. 25.0 years, P < 0.01), if married they were less likely to be their husband's first wife (79% vs. 91%

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No ABSTRACT.

This a report of thirty patients who presented at Kenyatta National Hospital( KNH),Uinversity Of Nairobi (UON) during the three year period January 1974-December 1976 with a diagnosis of thyroid carcinoma.Fourteen had follicular, eight papiilary,four anaplastic,and four medullary types.
Eight patients had metastatic deposits in lymph nodes,lung,or bone and majority of these were anaplastic.Twenty patients received surgical treatment.Five total thyroidectomy, 12 had subtotal thyroidectomy,3 had hemithyroidectomy and 2 had radioactive iodine treatment without surgery.
Most patients received subtotal thyroidectomy with or without radiotherapy. The anaplastic cancers had the poorest prognosis, all dying within six months of diagnosis.Early diagnosis with frozen section the papillary/follicular possess good prognosis if appropriate surgical treatment of subtotal or hemithyroidectomy is done.
abstract yet

The objective of the study was to identify the challenges to camel production in The major causes of camel loss in the district were identified as predation (50.9%), drought (28.7%) and camel diseases (20.4%). Severe drought was reported to have occurred in the years; 1984 (12.4%), 1995 (9%), 2005 (42.1%), and 2006 (37.6%), and the livestock species most affected by the drought were cattle (98.1%), sheep (63.9%), donkeys (57.5%), goats (50.8%) and camels (31.2%). Water was reported to be inadequate in the district by 54.6% and 62.1% of the respondents respectively for livestock and human use. Herdsmen reported watering their camels from; rivers (24.6%), dry river beds (40%) and spring (7.7%). The livestock grazing area was reported to be getting smaller (45.7%), overgrazed (21.7%), and destroyed (13%), while only 13% believed that the grazing area had increased. Amongst the pastoralist who responded to the question on their source of income, 78.8% had no alternative source of income apart from livestock keeping. Conclusion; More resources should be allocated by the governments for improvement of camel production and the carrying capacity in pastoral production systems needs to be re-evaluated to ensure  optimal productivity.   Keywords; Camel, predation, drought, diseases, production

The world is today faced with the global pandemic of HIV/AIDS that has evolved rapidly since it was first described. The pandemic has been termed the greatest development challenge for sub Saharan Africa and is rapidly evolving in the Asian continent. The pandemic ha had a significantly negative impact on individual families through loss of loved ones, communities by increasing the burden of caring for the ill, and countries through reduced productivity.     As we look forward to the 21st century, the human population is reminded that even in an age where drugs to treat most ailments are available, human behaviour and individual aspirations are critical in the control of disease. Factors that affect human and social behaviour, such as poverty, discrimination and disenfranchisement have to be addressed on a global basis if the HIV/AIDS epidemic is to be controlled. The HIV/AIDS epidemic presents special challenges and new frontiers for public health interventions and research. HIV/AIDS has revealed the gaps in the understanding of how human behaviour is motivated and how it can be changed.     In this publication we present a review of some of the programs that are specifically targeting the youth with HIV/AIDS prevention activities in the countries of   This publication records the stories of men and women in Eastern Africa, who have tremendous commitment to the work they do even with minimal resources, because they have a vision for the youth of the African continent. It is a story of innovation, creativity, determination and partnership between adults and youth, communities and governments, countries, aid agencies and NGOSs.

Over the last six years there has been a tremendous development of infrastructure projects in virtually all corners of Kenya. This has taken the form of Road Improvement Project, Water and sewerage improvement project and the Electricity Transmission Improvement Project as envisioned in the Kenya Vision 2030. The purpose of this paper is to investigate the principles of compulsory land acquisition and way leaves in the three sectors in Kenya by looking at the current legislative framework governing the entire process of acquisition. In considering the process, the paper explores the various provisions of the relevant act which governs the particular utility envisaged for improvement project component in the Kenya Vision 2030. A critical evaluation of the procedures adopted is outlined in each case and the general public apprehensions towards such acquisitions. The second part of the paper focuses on suggestions on the choice of valuation methodology in making claims for compensation for land for various infrastructure projects in Kenya. This is borne out of the fact that there appear to be very little standardization in the methods adopted by the various bodies. The paper cites several cases under the Electricity Transmission Improvement Project where a large proportion of way leaves are dealt with at local level, with little consistency. Coupled to this is the public concern that electricity lines have potentially serious health effects that continue to attract research and media interest. The paper concludes with a description of the various cases on how to improve compensation paid to those affected by compulsory acquisition in cases of land and way leaves.

A review of drug treatment for Down's syndrome individuals was presented. Drugs used to modify behavior, as well as drugs used with the goal of affecting cognitive processes, were discussed. Some observations were offered as to the effectiveness of past and current drugs on Down's syndrome and some methodological problems relating to drug studies presented. There have not been any drugs that have demonstrated remarkable improvement in the status of Down's syndrome individuals that have been widely accepted as effective.

A review of drug treatment for Down's syndrome individuals was presented. Drugs used to modify behavior, as well as drugs used with the goal of affecting cognitive processes, were discussed. Some observations were offered as to the effectiveness of past and current drugs on Down's syndrome and some methodological problems relating to drug studies presented. There have not been any drugs that have demonstrated remarkable improvement in the status of Down's syndrome individuals that have been widely accepted as effective.

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

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As the AIDS epidemic reaches a dramatic stage of development, the time for African countries to establish effective control programs has come. The history of AIDS in Africa is different from that other regions of the world. The disease developed among heterosexual communities. By 1987, over 8,000 cases of AIDS had been reported from 37 of the 47 nations of Africa. Over 2,000 of these cases were found in Uganda. However, under-reporting and under-representation of the number of actual cases is still a problem. In many cases, there has been a failure to recognize the disease. The demographic and geographic distribution of seroprevalence is discussed. Because of the inaccuracies in AIDS reporting in Africa, epidemic forecasting is difficult. If 5 million are currently infected, a potential 50 million Africans may be infected by 1993. A further discussion of the risk factors for HIV-1 holds that promiscuity is the major problem. Cures and inexpensive treatments for the infection are years away. Energy, resources, and national committees in Africa and the world must be coordinated to combat the ultimate crisis of this century.

Bull N Y Acad Med. 1988 Jul-Aug;64(6):480-90.
A review of HIV-1 in Africa.
Ronald AR, Ndinya-Achola JO, Plummer FA, Simonsen JN, Cameron DW, Ngugi EN, Pamba H.
Abstract
PIP:
As the AIDS epidemic reaches a dramatic stage of development, the time for African countries to establish effective control programs has come. The history of AIDS in Africa is different from that other regions of the world. The disease developed among heterosexual communities. By 1987, over 8,000 cases of AIDS had been reported from 37 of the 47 nations of Africa. Over 2,000 of these cases were found in Uganda. However, under-reporting and under-representation of the number of actual cases is still a problem. In many cases, there has been a failure to recognize the disease. The demographic and geographic distribution of seroprevalence is discussed. Because of the inaccuracies in AIDS reporting in Africa, epidemic forecasting is difficult. If 5 million are currently infected, a potential 50 million Africans may be infected by 1993. A further discussion of the risk factors for HIV-1 holds that promiscuity is the major problem. Cures and inexpensive treatments for the infection are years away. Energy, resources, and national committees in Africa and the world must be coordinated to combat the ultimate crisis of this century.
PMID:
3069166
[PubMed - indexed for MEDLINE]
PMCID:
PMC1630576
Free PMC Article

JASPA Working Paper, ILO, Addis Ababa

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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.

Maize is the key food crop in Kenya, with estimated production (1998) of 3 million tons of which about 40% are marketed. The Government strictly controlled all aspects of maize marketing until 1986 when gradual liberalisation started and this was completed in 1995. The objective of this study is to assess the degree of policy implementation and the impact of liberalisation of maize marketing on stakeholders between 1989 and 1999. The method of the study included review of available literature, conduct of interviews with stakeholders and the authors’ personal observations of maize marketing activities. Results indicate that liberalisation was implemented without the formation of alternative marketing institutions. Also, maize prices fluctuated substantially according to competitive market forces with limited moderating effects from the Government through open market interventions and import tariffs. But soon the rules of regional and worldwide trading organisations will render this impossible. Private sector participation at all levels in the marketing system increased substantially. There is easy maize flow and supplies to all parts of Kenya. One recommended intervention is to form maize farmer-based institutions for the marketing of maize, provision of maize market information and credit. Further studies should assess the impact of liberalisation and continued regulation of maize imports on producers and consumers.

ABSTRACT : Solid waste management (SWM) is a major public health and environmental concern in urban areas of many developing countries. Nairobi’s solid waste situation, which could be taken to generally represent Kenya’s status, is largely characterized by low coverage of solid waste collection, pollution from uncontrolled dumping of waste, inefficient public services, unregulated and uncoordinated private sector and lack of key solid waste management infrastructure. Solid waste generated on daily basis is 4,016 tonnes as predicted by Allison (2010). The collection rate is as low as 33% (JICA, 2010) which leaves about 2,690 tonnes uncollected (almost equal to the total daily waste generation as predicted by JICA (1998)). Apart from Nairobi City Council (NCC), the body that has the primary responsibility for the provision and regulation of SWM services in the city, other actors have come into play such as private companies and community based organizations among others. The models of operation of these actors are not well understood. Effective coordination among these actors is also absent and regulation of the private companies by the city council is only beginning to emerge. According to Mwangi, 2007, analysis of total costs incurred by various actors and amount of waste collected per month showed that CBOs had the least fixed cost of operation as compared to private companies. Further, the CBOs had the lowest cost per tonne of waste collected as compared to other operators who showed almost twice this amount. These suggest that solid waste management is very expensive and CBOs are the cheapest operators of solid waste. Therefore, CBOs should be left as the waste operators in the low income areas where the residents are unable to pay a lot of money for waste management due to their low operating costs. Due to their relatively high operation costs, the private companies are more suited to operate in the high income areas and CBD where the residents or the owners of building are able to afford for the services. However, private enterprises are primarily interested in earning a return on their investment and may not be efficient due to the complexity of their operations outlay especially when proper coordination and SWM models are lacking.

KEY WORDS: Actors, Efficiency, Models and Solid Waste Management

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.

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Abstract

Objective: To establish the epidemiologic characteristics, referral pattern, interventions, visual outcomes and complications resulting in visual impairment/blindness among ocular trauma patients in Tamale Teaching Hospital (TTH) Eye Clinic, Tamale, Ghana.
Materials and Methods: This was a retrospective hospital-based case series in which all new patients of all ages with various eye conditions from 1st January to 31st December 2010 were reviewed from the outpatient/inpatient record books and the sex and age recorded. The files/ folders of patients with ocular trauma were selected and retrieved. The epidemiological characteristics, referral pattern, interventions, visual outcomes and complications resulting in visual impairment/blindness among ocular trauma patients were analysed.
Results: A total of 2,027 records of new patients with various eye conditions were retrieved. Three hundred and sixty one (377 eyes) new ocular trauma patients’ files/ folders were analyzed. The Male: Female ratio was 1:1.1 (p=0.09) for all new patients with various eye conditions whilst it was 1.8:1 (p<0.01) for new ocular trauma patients. Ocular trauma patients were younger than general patients with 20 – 29 years age group having most new patients (27.4%) compared with the over 49 years age group for other new cases (23.4%). Approximately 68.4% of the ocular trauma patients were seen at TTH without a referral. Conjunctival lesions were the commonest finding affecting 124(32.9%) of the ocular trauma patients. The majority of patients 88.1% sustained closed globe trauma, 8.3% had adnexal trauma whilst 3.6% had open globe trauma. The commonest intervention rendered was medical treatment alone to 64.4% of the patients. By the WHO classification, majority 67.4% of traumatized eyes had normal vision, 13.9% were visually impaired and 18.7% were blind. Thus, 110 (32.6%) were visually impaired/ blind in the traumatized eye. The commonest complications resulting in visual impairment/ blindness were corneal opacities/ scars in 33(30.0%) cases.
Conclusion: Majority of ocular trauma patients presented with minor injuries which healed without complications. However, ocular trauma was a major cause of monocular blindness and visual impairment. Ocular trauma also tended to affect a younger age group and especially males compared to other eye diseases.
Key words: Ocular trauma, Epidemiology, Referral pattern, Intervention, Visual outcome, Complication

A retrospective study of the omphlocele has been done. The study was carried out at Kenyatta National Hospital which is the referral hospital for the Republic of Kenya and the teaching hospital for the Faculty of Medicine of the University of Nairobi.

This study covers a ten year period from 1976 ~ 194.

A total of 34 cases have been studied. The yearly incidence has 'heen static notwithstanding our high populati~n growth.

Among the 34 cases there were 18 males and 16

females. Of the 34 cases there were 19 survivals arid15 deaths.

12 deaths (80%) among the 15 followed early surgery.

Only 3 patients ha.dsurgery among 19 survivals. Tne 'major cause of death (6 out of 12) among the surgical cases was respiratory complications. Surgery had been performed within
1-3 days of birth.

Surgical management consisted of excision and repair of the o,mphalocele. Non-surgical regime entailed painting
i'
the omphalocele with mercurochrome (1 patient) or simply

daily clensing with antiseptics followed by sofratule
",
dressing (18 patients).

5

Complication of the ~mphaloceles occured in ~ cases only (Table 4). Malformations co-existing with omphalocele occured in 12 cases of which 7 died. In our series non-surgical regime produced more survival (84.2%) 16 out of 19

Oyieke H.A. and Misra A.K:

{ 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

Constitutional Law and Politics in Africa: A Case Study of Kenya (Nairobi: Faculty of Law, Unviersity of Nairobi.

The infection and treatment (ITM) live vaccination method for control of Theileria parva infection in cattle is increasingly being adopted, particularly in Maasai pastoralist systems. Several studies indicate positive impacts on human livelihoods. Importantly, the first detailed protocol for live vaccine production at scale has recently been published. However, quality control and delivery issues constrain vaccination sustainability and deployment. There is evidence that the distribution of T. parva is spreading from endemic areas in East Africa, North into Southern Sudan and West into Cameroon, probably as a result of anthropogenic movement of cattle. It has also recently been demonstrated that in Kenya, T. parva derived from cape buffalo can 'breakthrough' the immunity induced by ITM. However, in Tanzania, breakthrough has not been reported in areas where cattle co-graze with buffalo. It has been confirmed that buffalo in northern Uganda national parks are not infected with T. parva and R. appendiculatus appears to be absent, raising issues regarding vector distribution. Recently, there have been multiple field population genetic studies using variable number tandem repeat (VNTR) sequences and sequencing of antigen genes encoding targets of CD8+ T-cell responses. The VNTR markers generally reveal high levels of diversity. The antigen gene sequences present within the trivalent Muguga cocktail are relatively conserved among cattle transmissible T. parva populations. By contrast, greater genetic diversity is present in antigen genes from T. parva of buffalo origin. There is also evidence from several studies for transmission of components of stocks present within the Muguga cocktail, into field ticks and cattle following induction of a carrier state by immunization. In the short term, this may increase live vaccine effectiveness, through a more homogeneous challenge, but the long-term consequences are unknown.

Droughts are serious extreme events that have adverse effects on the physical environment and water resource
systems in both developed and developing countries. Consequently, there is need for adequate measures for
responding to and mitigating various impacts arising from drought occurrence. The design and implementation
of drought mitigation and response strategies requires an understanding of the various indices that are used to
examine drought both at single site and in an area. In the case of water resources management during critical
drought periods for instance, a means of objectively identifying drought events in terms time and duration of
occurrence, magnitude and severity is required. This is possible only using various indices to characterize
drought. In this paper, some of the key drought indices are reviewed and their strengths and weaknesses
identified.

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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.