A review of the biology of tilapia species in Lake Victoria with special reference to its feeding and breeding habits

The study, manipulation and design of materials and devices at level approaching atomic sizes has given rise to nanoscience and nanotechnology, with the former being concerned more with the new properties whereas the latter - nanotechnology focuses on new devices. The nanoscale science and technology involves and cuts across different disciplines. It is now recognized that science founded on the unified concepts on matter at the nanoscale is the new basis for knowledge creation, innovation, and technology integration, and therefore receiving heightened attention world over.

Arising from the current and potential impacts of nanoscience and nanotechnology in all facets of humanity – way of life, health and the environment, it is imperative that any country takes stock of the status of the two intertwined disciplines. For example, it is known that nanotechnology can improve efficiency in manufacturing, energy resources and utilization, reduce environmental impacts of industry and transportation, enhance healthcare, produce better pharmaceuticals, improve agriculture and food production, and expand the capabilities of information technologies. The level of preparedness of a country to create new knowledge, exploit it or absorb such, it will be seen depends on the synergistic relationships amongst all the stakeholders right from the beginning of the research, product development processes, and policy and legislative frameworks that protect the workers producing and consumers of such products.

A study of the Kenya’s situation reveals that so far there minimal understanding or appreciation of what nanoscience and nanotechnology are amongst the key stakeholders, and what their potential benefits are or would be. The teaching of and research in these areas and the accompanying infrastructure are weak and uncoordinated. The regulatory frameworks and policies governing, particularly the manufacturing processes of or nanoscale products are either nonexistent or very weak/inadequate.

PIP: In 1990, the annual population growth rate in Kenya was 3.8%, among the highest rates world wide. The ever growing adolescent fertility rate (111-152/1000 from 1969-1989) contributed to this rapid growth. Further repeat pregnancies among adolescents remained high in the 1980's and ranged from 20%-28.6%, depending on the survey. Even though overall prevalence of pregnancy fell 15.4% between 1978-1984, it remained the same for the 15-19 year old group. Teenage births have made up at least 35% of total deliveries. 1985 data revealed that even though adolescents represent 11-35% of the total obstetric population, problems ranked high among them: 38% of all eclampsia cases and high maternal mortality (102/100,000 vs. 57/100,000 older mothers). Studies showed that adolescents are sexually active, are ignorant about contraception, and do not use contraception. Yet contraceptive and family planning services are free in Kenya. Nevertheless the teenagers are at high risk of an unwanted pregnancy, sexually transmitted diseases (STDs), and AIDS. In the early 1980s, Kenyatta National Hospital reported 53% of 74.1% of septic abortion cases being single women were between 14-20 years old. Similar results emerged from other studies. Health professionals believed these results to be underestimated, however. In the 1980s, 33% of all adolescents between 13-15 years old in a rural area had gonorrhea. In Kenyatta, 36% of pregnant 15-24 year olds had at least 1 STD while,e only 16% of those 24 years old did. Further, teenagers are especially vulnerable to psychological problems when they 1st learn of their pregnancy. Health services should be geared to meet the specific needs of adolescents, such as contraception education and antenatal services. PMID: 12316815 [PubMed - indexed for MEDLINE]

PIP: In 1990, the annual population growth rate in Kenya was 3.8%, among the highest rates world wide. The ever growing adolescent fertility rate (111-152/1000 from 1969-1989) contributed to this rapid growth. Further repeat pregnancies among adolescents remained high in the 1980's and ranged from 20%-28.6%, depending on the survey. Even though overall prevalence of pregnancy fell 15.4% between 1978-1984, it remained the same for the 15-19 year old group. Teenage births have made up at least 35% of total deliveries. 1985 data revealed that even though adolescents represent 11-35% of the total obstetric population, problems ranked high among them: 38% of all eclampsia cases and high maternal mortality (102/100,000 vs. 57/100,000 older mothers). Studies showed that adolescents are sexually active, are ignorant about contraception, and do not use contraception. Yet contraceptive and family planning services are free in Kenya. Nevertheless the teenagers are at high risk of an unwanted pregnancy, sexually transmitted diseases (STDs), and AIDS. In the early 1980s, Kenyatta National Hospital reported 53% of 74.1% of septic abortion cases being single women were between 14-20 years old. Similar results emerged from other studies. Health professionals believed these results to be underestimated, however. In the 1980s, 33% of all adolescents between 13-15 years old in a rural area had gonorrhea. In Kenyatta, 36% of pregnant 15-24 year olds had at least 1 STD while,e only 16% of those 24 years old did. Further, teenagers are especially vulnerable to psychological problems when they 1st learn of their pregnancy. Health services should be geared to meet the specific needs of adolescents, such as contraception education and antenatal services. PMID: 12316815 [PubMed - indexed for MEDLINE]

There is need to fill the gap between two entities which use different languages to communicate which can be done either via human translation or machine translation means. The world has over 7000 living natural languages, thus making it costly if human translation route is taken hence need for machine translation. There is need to know the available machine translation approaches and their requirement in order to decide which one suits for particular languages or not, hence the motivation for this survey. The survey provide overview and architectures of the three major techniques available namely: rule based translation, corpus based translation and hybrid based translation plus their subcategories available in each approach.

In an endeavour to comprehend the mechanisms of vertebrate embryonic development including how the embryo attains its form and structures, biologist have over the years devised a number of methods. In all the techniques employed, the choice of the method is largely determined by the question to be answered amongst other factors. This review looks at the various methods that have been developed, ranging from the use of simple lenses through histological sectioning and direct manipulation to the use of biochemical probes and extracts

Invasive cancer of the cervix is considered a preventable disease because cancers develop slowly through per-cancerous changes to invasive cancer in about 10 - 15 years. Pap smear screening for the early detection of cancer of the cervix contributes to early successful treatment

Invasive cancer of the cervix is considered a preventable disease because cancers develop slowly through per-cancerous changes to invasive cancer in about 10 - 15 years. Pap smear screening for the early detection of cancer of the cervix contributes to early successful treatment

Invasive cancer of the cervix is considered a preventable disease because cancers develop slowly through per-cancerous changes to invasive cancer in about 10 - 15 years. Pap smear screening for the early detection of cancer of the cervix contributes to early successful treatment

This article investigates the forces leading to migration of husbands from rural Kenya, the economic situation and activities of wives with migrant husbands, receipt of remittances by wives and the possible influences on capital formation in rural Kenya, using the Nyeri district as a case study. Although the residual sample of rural wives whose husbands have migrated to urban areas in Kenya is small, the analysis of this sample highlights several important points worthy of investigation. It seems that rural husbands who migrate from rural Kenya have limited education and skills and are mostly pushed out of rural areas rather than pulled. The wives seem not to be empowered in relation to economic and family decisions-making. The husband and his relatives retain control of important economic and household decisions and this has negative impacts on agricultural productivity. The wives are hampered by their relative lack of access to agricultural extension officers, finance for farm investment and capital resources for use on their farm. Probit analysis suggests that the probability of a wife obtaining remittances from a migrant husband declines with the number of years of his absence and the age of the wife but increases with the number of her dependent children and whether or not she employs hired labour. Duration of migration is important in explaning the amount of remittances but not in explaining the likelihood of wives receiving remittances. Overall indications are that remittances are mostly motivated by altruism or social obligation of the migrant to his family. This study was limited by lack of resources but nonetheless provides useful pointers to further research.  

New Directions in water legislation in Kenya?. A Paper presented as the National Workshop on environmental Governance in kenya, held at the UNEP Headquarters Gigiri, Nairobi, March 29-30. 2000

OBJECTIVE: To determine the barriers to uptake of eye care services and to establish the pattern of utilization of eye care services in the Nairobi Comprehensive Eye Care Services (NCES) Project; the catchment area of the Mbagathi District Eye Unit of Nairobi. DESIGN: Community based survey conducted from 15th to 31st October 2007. Setting: Kibera and Dagoreti divisions of Nairobi City. SUBJECTS: Of the 4,200 people of all ages who were randomly selected; 4,056 were examined giving a response rate of 96.6%. Of those not examined, 126 (3.0%) were not available and 15 (0.4%) refused to be examined. Mean age of the study population was 22 years. RESULTS: A total of 294 subjects (7.2%) despite having some ocular disorder, had not visited any health facility to seek treatment. The majority, 144 (49%) gave the reason as no perceived need to seek treatment as the problem did not bother them; especially those with refractive error. A third, 97 (33%), gave the reason as lack of money, 22 (7.5%) said that they did not know where to seek eye care and 20 (6.8%) said they had no time to seek eye care. Only 3 said that the health facility where to go for eye care was too far. The population in the survey area has vast number of nearby secondary and tertiary eye care facilities to choose from. The majority of subjects indicated Mbagathi District Hospital (20.9%), Kikuyu Eye Unit (18.5%), Kenyatta National Hospital (12.1%) and private clinics (10.9%) as their health facilities of choice for eye care. The rest preferred Lions Sight First Eye Hospital, St Mary's Hospital, City Council Health Centers and optical shops. 7.7% of the subjects would visit a health centre or dispensary if they had an eye problem. A signifi cant proportion of respondents (7.5%) had no idea where they could seek treatment for eye disorders; most of them knew Mbagathi District Hospital and Kenyatta National Hospital but were not aware that eye care services were available at these facilities. CONCLUSION: Despite the large number of eye care facilities surrounding the NCES, community members are not able to access their services mainly because of lack of felt need (ignorance) and lack of money (poverty). RECOMMENDATIONS: There is need for eye health education and review of cost of services to the very poor communities within the NCES. It is important to strengthen the community eye care structures and referral network now that the project area has excess secondary and tertiary health facilities offering eye care services.

OBJECTIVE: To determine the barriers to uptake of eye care services and to establish the pattern of utilization of eye care services in the Nairobi Comprehensive Eye Care Services (NCES) Project; the catchment area of the Mbagathi District Eye Unit of Nairobi. DESIGN: Community based survey conducted from 15th to 31st October 2007. Setting: Kibera and Dagoreti divisions of Nairobi City. SUBJECTS: Of the 4,200 people of all ages who were randomly selected; 4,056 were examined giving a response rate of 96.6%. Of those not examined, 126 (3.0%) were not available and 15 (0.4%) refused to be examined. Mean age of the study population was 22 years. RESULTS: A total of 294 subjects (7.2%) despite having some ocular disorder, had not visited any health facility to seek treatment. The majority, 144 (49%) gave the reason as no perceived need to seek treatment as the problem did not bother them; especially those with refractive error. A third, 97 (33%), gave the reason as lack of money, 22 (7.5%) said that they did not know where to seek eye care and 20 (6.8%) said they had no time to seek eye care. Only 3 said that the health facility where to go for eye care was too far. The population in the survey area has vast number of nearby secondary and tertiary eye care facilities to choose from. The majority of subjects indicated Mbagathi District Hospital (20.9%), Kikuyu Eye Unit (18.5%), Kenyatta National Hospital (12.1%) and private clinics (10.9%) as their health facilities of choice for eye care. The rest preferred Lions Sight First Eye Hospital, St Mary's Hospital, City Council Health Centers and optical shops. 7.7% of the subjects would visit a health centre or dispensary if they had an eye problem. A signifi cant proportion of respondents (7.5%) had no idea where they could seek treatment for eye disorders; most of them knew Mbagathi District Hospital and Kenyatta National Hospital but were not aware that eye care services were available at these facilities. CONCLUSION: Despite the large number of eye care facilities surrounding the NCES, community members are not able to access their services mainly because of lack of felt need (ignorance) and lack of money (poverty). RECOMMENDATIONS: There is need for eye health education and review of cost of services to the very poor communities within the NCES. It is important to strengthen the community eye care structures and referral network now that the project area has excess secondary and tertiary health facilities offering eye care services.

The small cichlid fish Alcolapia grahami lives in Lake Magadi, Kenya, one of the most extreme aquatic environments on Earth (pH ~10, carbonate alkalinity ~300 mequiv l−1). The Magadi tilapia is the only 100% ureotelic teleost; it normally excretes no ammonia. This is interpreted as an evolutionary adaptation to overcome the near impossibility of sustaining an NH3 diffusion gradient across the gills against the high external pH. In standard ammoniotelic teleosts, branchial ammonia excretion is facilitated by Rh glycoproteins, and cortisol plays a role in upregulating these carriers, together with other components of a transport metabolon, so as to actively excrete ammonia during high environmental ammonia (HEA) exposure. In Magadi tilapia, we show that at least three Rh proteins (Rhag, Rhbg and Rhcg2) are expressed at the mRNA level in various tissues, and are recognized in the gills by specific antibodies. During HEA exposure, plasma ammonia levels and urea excretion rates increase markedly, and mRNA expression for the branchial urea transporter mtUT is elevated. Plasma cortisol increases and branchial mRNAs for Rhbg, Rhcg2 and Na+,K+-ATPase are all upregulated. Enzymatic activity of the latter is activated preferentially by NH4+ (versus K+), suggesting it can function as an NH4+-transporter. Model calculations suggest that active ammonia excretion against the gradient may become possible through a combination of Rh protein and NH4+-activated Na+-ATPase function.

Rhabdomyolysis is a potentially lethal disorder, characterized by elevated serum concentrations of creatine kinase (CK) due to skeletal muscle injury. In this paper a patient with diabetic ketoacidosis (DKA) is reported who developed rhabdomyolysis (maximum CK level, 37,700 U/L; normal, {\textless} 170 U/L), anemia (6.2 g/dL) and thrombocytopenia (16,000/microL). This combination of rhabdomyolysis with anemia and thrombocytopenia has not yet been reported in DKA. The pathogenic mechanism leading to rhabdomyolysis in DKA remains unsettled. From the literature it seems that those patients who develop rhabdomyolysis have very high glucose levels and a high osmolality on admission. Low phosphate levels can play a role as well. The etiology of anemia and thrombocytopenia in our patient remains obscure. Intravascular hemolysis could not be demonstrated but intramedullar hemolysis, due to osmolar shift or hypophosphatemia, cannot be excluded. A review of the literature data revealed that rhabdomyolysis is not so uncommon in DKA. However, to obtain incidence data in children, prospective studies are necessary.

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Abstract | Historically, rheumatic diseases have not received much attention in Africa, particularly
in sub- Saharan Africa, possibly owing to a focus on the overwhelming incidence of infectious
diseases and the decreased life span of the general population in this region. Global attention
and support, together with better health policies and planning, have improved outcomes for
many infectious diseases; thus, increasing attention is being turned to chronic non- communicable
diseases. Rheumatic diseases were previously considered to be rare among Africans but there is
now a growing interest in these conditions, particularly as the number of rheumatologists on the
continent increases. This interest has resulted in a growing number of publications from Africa
on the more commonly encountered rheumatic diseases, as well as case reports of rare diseases.
Despite the limited amount of available data, some aspects of the epidemiology, genetics and
clinical and laboratory features of rheumatic diseases in African populations are known, as is some
detail on the use of therapeutics. Similarities and differences in these conditions can be seen
across the multi- ethnic and genetically diverse African continent, and it is hoped that increased
awareness of rheumatic diseases in Africa will lead to earlier diagnosis and better outcomes
for patients.

Abstract
|
Historically, rheumatic diseases have not received much attention in Africa, particularly
in sub- Saharan Africa, possibly owing to a focus on the overwhelming incidence of infectious
diseases and the decreased life span of the general population in this region. Global attention
and support, together with better health policies and planning, have improved outcomes for
many infectious diseases; thus, increasing attention is being turned to chronic non- communicable
diseases. Rheumatic diseases were previously considered to be rare among Africans but there is
now a growing interest in these conditions, particularly as the number of rheumatologists on the
continent increases. This interest has resulted in a growing number of publications from Africa
on the more commonly encountered rheumatic diseases, as well as case reports of rare diseases.
Despite the limited amount of available data, some aspects of the epidemiology, genetics and
clinical and laboratory features of rheumatic diseases in African populations are known, as is some
detail on the use of therapeutics. Similarities and differences in these conditions can be seen
across the multi- ethnic and genetically diverse African continent, and it is hoped that increased
awareness of rheumatic diseases in Africa will lead to earlier diagnosis and better outcomes
for patients.

Although multiple supernumerary teeth without any associated syndromes are rare, their occurrence can create a variety of clinical problems such as derangement of the occlusion, prevention of eruption of permanent teeth, damage to adjacent teeth, cystic degeneration and root resorption. Hence, clinical and radiographic evaluation of patients should always be thorough in order to detect their presence. Furthermore, because the clinical management of multiple supernumerary teeth pauses a great challenge to clinicians, timely, appropriate consultation and interdisciplinary approach to treatment is extremely important. We report two cases, a 14 year-old boy with eight and a 13-year-old girl with seven supernumerary teeth not associated with syndromes. In the boy, the teeth were bilaterally distributed in all quadrants in the premolar regions, and in the girl they were distributed bilaterally in the premolar regions in the mandible and bilaterally distal to the upper third molars. The clinical implications and management are discussed.

Rhipicephalus appendiculatus is the major tick vector of Theileria parva, an apicomplexan protozoan parasite that causes the most economically important and lethal disease of cattle in East and central Africa. The African cape buffalo (Syncerus caffer) is the major wildlife host of T. parva from southern Uganda and Kenya to southern Africa. We show herein that R. appendiculatus appears to be absent from the two largest national parks in northern Uganda. Syncerus caffer is common in both of these national parks, specifically Murchison falls (MFNP) and Kidepo Valley (KVNP). We re-confirmed the previously reported absence of T. parva in buffalo sampled in the two northern parks based on RLB data using a nested PCR based on the T. parva p104 gene. By contrast, T. parva-infected R. appendiculatus ticks and parasite-infected buffalo were present in Lake Mburo (LMNP) in South central Uganda. This suggests that the distribution of R. appendiculatus, which is predicted to include the higher rainfall regions of northern Uganda, may be limited by additional, as yet unknown factors.

OBJECTIVES: To study the burden of disease of reproductive tract infections (RTIs) and cervical dysplasia in women attending a family planning clinic in Nairobi, Kenya, and to assess the acceptability of integrating reproductive healthcare services into existing family planning facilities. METHODS: In a family planning clinic in Nairobi, Kenya, 520 women were enrolled in a study on RTI and cervical dysplasia. RESULTS: RTI pathogens were detected in over 20% of women, the majority being asymptomatic. HIV-1 testing was positive in 10.2%. The diagnosis of cervical dysplasia was made on 12% of the cytology smears (mild in 5.8%, moderate in 3.5%, severe in 1.2%), and 1.5% had invasive cervical cancer. The intervention of case detection of RTI and Papanicolaou smear taking was well received by clients and considered feasible by the staff. CONCLUSIONS: Early detection and treatment of potentially curable cervical lesions and RTI provide a unique opportunity to improve women's health. In Kenya, where the current contraceptive prevalence rate is 33%, family planning clinics are excellent sites to introduce health interventions.

Ricinus communis and Euclea divinorum of the family Euphorbiaceae and Ebenaceae, respectively, are traditionally used by Traditional Birth Attendants (TBAs) in Machakos district of Kenya to induce or augment labor, manage protracted labor, post-partum hemorrhage and retained after birth. Ethnopharmacological relevance of the study will be the provision of scientific evidence and justification for the ethnic use of both plants as oxytocic agents in the initiation of labor, treatment of prolonged labor, post-partum hemorrhage and retained placenta. Materials and methods: The plants were harvested in the wild, identified and voucher specimens preserved. The root bark was processed to powder form, from which aqueous and ethanol extracts were obtained. Each of the extracts was separately tested on isolated uterine muscle tissue from nonpregnant and pregnant rabbits. The effect on contraction frequency (number of contractions per second) in the absence or presence of oxytocin was evaluated statistically using ANOVA. P values o0.05 were considered significant. Results and conclusions: All uteri exhibited a strong initial contraction following exposure to the aqueous and ethanol root bark extracts of both plants. After recovery, the resumed contraction frequencies varied with the plant extract and exogenous hormone. The results show that the extracts of both plants were able to stimulate uterine tissue contractility directly and to augment the tissue’s response to oxytocin. The increase in uterine contractions as a percentage relative to negative controls was particularly significant in pregnant rabbit tissues in the presence of oxytocin, where increments of up to 245% were observed. Further pharmacological studies are however required to determine the active principles, possible mechanisms of action, efficacy and safety margins of the plant extracts.

Defining research career paths that enable Africans to address local and global health issues is essential for population health. This study was conducted to better understand how international health training programs contribute to human resource capacity building in health research. Research career motivations, decision-making and experiences were explored among a small group of Kenyan HIV/AIDS researchers who had completed an international training program. We found that intersecting social dynamics within specific geographic spaces influenced individual training decision-making and motivated research career decisions over time. The concept that 'geo-social motivation' is an important determinant of success for an African considering a research career developed from this study, and may be used to tailor future health research human resource capacity-building programs.

Lameness in cattle is one of the major causes of economic losses in dairy production systems (Hernandez et al., 2005; Kossaibati & Esslemont, 1997). These losses occur through various negative impact directly on cattle and indirectly on the dairy production system. These include reduced milk yield (Hernandez et al., 2005), discarding of milk due to withdrawal period of drugs used to treat some of the lameness conditions, cost of veterinary drugs and professional services in managing the conditions (Enting et al., 1997), lowered conception rate and increased calving interval (Melendez et al., 2003; Sogstad et al.,2006), reduced ovarian activity during early postpartum period (Garbarino et al., 2004), as well as premature culling and occasional mortalities (Enting et al., 1997). Lameness has also been identified as a major welfare determinant in cattle because of discomfort and pain that it causes (Offer et al., 2000). Claw lesions account for between 60% and 90% of all lameness incidences in cattle in various countries of the world (Bergsten et al., 1994; Manske et al., 2002; Weaver, 2000). More than 60% of lameness in cattle is caused by lesions and disorders affecting the horn of the claw such as sole ulcers, heel erosion, sole bruising, white line separation and underrun (double) soles. All these claw disorders and lesions have a direct or indirect effect on the dermis (corium) of the claw and are associated with laminitis ( Belge & Bakir, 2005; Manske et al., 2002; Nocek, 1997). They are common in cattle raised under intense systems and feedlots (Smilie et al., 1991). Claw horn disorders in cattle are discernible at clinical level by lameness symptoms or at subclinical level by hoof trimming to reveal non-painful lesions within or under the horn (Clarkson et al., 1996; Nocek, 1997). However, adoption of confined housing in dairy cattle husbandry as is the practice in smallholder dairy production systems particularly in developing countries has led to higher incidences of claw disorders. This is mainly due to cattle spending long hours standing on confined hard floors that exposes claws to higher pressures which predispose them to circumscribed excessive local loading, thus stimulating more horn production and enlarging of the claws.

In the year 2009, a study was carried out in abattoirs supplying meat in Nairobi, Kenya and its environs. Three slaughterhouses with different level of hygiene control, classified as export, improved and typical local, were selected. Three hundred cattle were tracked along the slaughtering process to sample faeces and carcass swabs. Faecal samples from the rectum were taken from each animal after stunning. Two carcass sites, flank and brisket were swabbed after flaying, evisceration and after cleaning. In total seven samples were taken from each carcass. METHODS: E.coli O157 was isolated by culture and serotyped using card agglutination test. The isolates were further tested for verotoxin production and Monte Carlo simulation was run to determine the risk of carcass contamination. A HACCP model was also developed for one of the abattoirs. E.coli O157:H7 was detected from the faecal and carcasses samples at different stages. RESULTS: Two hundred and eighty out of 2,100 samples (13.3%) were IMVIC positive for E. coli. (++---) and Sorbitol MacConkey negative and were therefore tentative E. coli O157 colonies. After serotyping for O157, 92 out of 280 (4.3%) isolates, were positive for E. coli O157:H7. Forty two isolates were tested for verotoxin production, eight were positive for VT1 only while two were positive for both VT1 and VT2. The probability of a carcass being contaminated with E.coli O157 in the abattoir was 2.9% (90% CI: 0.8%-6.1%), 4.8% (90%CI: 2.0%-8.6%) and 3.8% (90%CI: 1.3%-7.3%) in the export, the local improved and the typical local abattoir respectively. Based on E. coli detection as an indicator of hygiene, the risk of contamination is low in the export slaughter house followed by the typical local slaughter house and highest in the local improved; however the confidence intervals overlapped and the level of hygiene was not significantly different. This trend was observed also for the probability of a carcasses being contaminated with vero-toxin producing E. coli: 0.7% (90% CI: 0.2%-1.7%), 1.2% (90% CI: 0.4%-2.4%) and 1.0% (90% CI: 0.3%-2.0%) in the export, the local improved and the typical local abattoir, respectively. SUMMARY: This study shows that there is a risk of carcass contamination with E.coli O157 in all the different categories of slaughterhouses in Nairobi.

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Cervical cancer is the second most common cause of cancer mortality among women worldwide (Franco et al, 2003). Epidemiological studies have shown a strong link between human papilloma virus (HPV) infection and the development of cervical cancer (Franco et al, carcinogenic process (Chan et al, 2005). Most HPV infections are transient and regress spontaneously and only a minority of women develops persistent infection that with time may evolve into cervical intraepithelial neoplasia and/or progress to invasive cervical cancer(Villa, 1997; Franco et al, 1999). Given that host immune response to HPV is thought to be an important determinant of HPV acquisition and progression to high-grade cervical lesions and cancer, it is plausible that human leucocyte antigen (HLA) variations may affect pathogenesis of cervical neoplasia (Beskow et al, 2005; Clerici et al, 1997; Hildesheim et al, 1997). The major histocompatibility complex is a highly polymorphic gene cluster on the short arm of chromosome six. The genes in this cluster are divided into three classes with different roles in immune responses. HLA gene polymorphisms result in variations in peptide-binding cleft, therefore influencing the antigens bound and presented to T cells (Beskow et al, 2005; Wang e al, 2005). The HLA class I genes (HLAA, -B, and –C) present foreign antigens to CD8+ Cytotoxic T lymphocytes, while class II genes (HLA-DR, - DQ and –DP) present antigenic peptides to CD4+ T helper cells and are important in host immune responses to viruses and other pathogens (Wang et al, 2001).

Background:
Stress ulcers develop due to extreme physiological stress among critically ill patients. Data on it management is scant in resource limited settings.

Objectives:
To determine the incidence, risk factors and management of stress ulcers among adult patients admitted to the Critical Care Unit of a Kenyan referral hospital, Kenyatta National Hospital. The outcome of the prophylaxis was also evaluated.

Methodology:
This was a retrospective cohort study among 186 critically ill adult patients admitted between January and December, 2012. The data was extracted from patient files. Logistic regression was performed to determine the risk factors for development of stress ulcers by manual forward stepwise model building.

Results:
Ninety percent of the patients received prophylaxis and this was done within 72 hours of admission. Twenty patients did not qualify for prophylaxis but received it. Most (76.4%) patients received prophylaxis with histamine 2 receptor blockers. The incidence of stress ulcers was 36.6% which was mainly treated with ranitidine (57.4% of cases) and omeprazole (38.8% of cases). The only diagnostic criteria were presence of the following clinical signs: epigastric tenderness (60 patients, 36.6%) and melena (3, 4.4%) and hematemesis (5, 7.4%). Mechanical ventilation of patients was the most important risk factor for stress ulcer development (adjusted OR: 43.76, 95% CI [5.067, 377.9]; followed by hospital stay for more than 7 days (adjusted OR: 11.88, 95% CI [3.923, 36.9]). Antibiotics (adjusted OR: 0.044, 95% CI [0.002, 0.936]) and benzodiazepines (adjusted OR: 0.074, 95% CI [0.013, 0.419] appeared to confer protection. Prophylaxis with histamine receptor antagonists did not seem to confer protection.

Conclusion:
The incidence of stress ulcers was high and methods for prophylaxis of stress ulcer need to be improved.

Key words: Stress ulcers, Critical care, antibiotics, benzodiazepines, antibiotics, CNS depressants

Diabetic foot ulcers contribute significantly to the morbidity and mortality of patients with diabetes mellitus. The diabetic patients with foot ulcers require long hospitalisation and carry risk of limb amputation. The risk factors for developing diabetic foot ulcers are manageable. In Kenya there is paucity of data on such risk factors. Objective: To determine the prevalence of diabetic foot ulcers and the risk factors in a clinic-based setting . Design: Cross-sectional study. Setting: Kenyatta National Hospital, Kenya. Subjects: Patients with both type 1 and 2 diabetes mellitus who had active foot ulcers in both outpatient and inpatient units. Main outcome measures: Diabetic foot ulcers glycated haemoglobin, neuropathy, peripheral vascular disease and fasting lipid profile. Results: One thousand seven hundred and eighty eight patients with diabetes mellitus were screened and 82(4.6%) were found to have foot ulcers. The males and females with diabetic foot ulcers were compared in age, duration of foot ulcers, blood pressure, glycaemic control, neurological disability score and their proportion. Diabetic foot ulcers occurred mostly in patients who had had diabetes for a long duration. The types of (occurence) ulcers were neuropathic (47.5%), neuroischaemic (30.5%) and ischaemic (18%). The neuropathic ulcers had significantly poorer glycaemic control compared to other types and the longest duration (23.3 weeks). Ischaemic ulcers had significantly higher total cholesterol and diastolic blood pressure compared to other ulcer types. Wagner stage 2 ulcers were the commonest (49.4%) but stage 4 ulcers had their highest neuropathic score (7.8/10) and longest duration (23.6weeks). Aerobic infective pathogens were isolated from 73.2% of the ulcers. Conclusion: The prevalence of diabetic foot ulcers was 4.6% in this tertiary clinic. The risk factors of diabetic foot ulcers in the study were poor glycaemic control, diastolic hypertension, dyslipidaemia, infection and poor self-care. These findings are similar to studies done in other environments and they are modifiable to achieve prevention, delay in formation or improved healing of foot ulcers in patients with diabetes. Therefore, specific attention should be paid to the management of these risk factors in patients with or without diabetes foot ulcers in this clinic.

BACKGROUND: Diabetic foot ulcers contribute significantly to the morbidity and mortality of patients with diabetes mellitus. The diabetic patients with foot ulcers require long hospitalisation and carry risk of limb amputation. The risk factors for developing diabetic foot ulcers are manageable. In Kenya there is paucity of data on such risk factors. OBJECTIVE: To determine the prevalence of diabetic foot ulcers and the risk factors in a clinic-based setting. DESIGN: Cross-sectional study. SETTING: Kenyatta National Hospital, Kenya. SUBJECTS: Patients with both type 1 and 2 diabetes mellitus who had active foot ulcers in both outpatient and inpatient units. MAIN OUTCOME MEASURES: Diabetic foot ulcers glycated haemoglobin, neuropathy, peripheral vascular disease and fasting lipid profile. RESULTS: One thousand seven hundred and eighty eight patients with diabetes mellitus were screened and 82 (4.6%) were found to have foot ulcers. The males and females with diabetic foot ulcers were compared in age, duration of foot ulcers, blood pressure, glycaemic control, neurological disability score and their proportion. Diabetic foot ulcers occurred mostly in patients who had had diabetes for a long duration. The types of (occurence) ulcers were neuropathic (47.5%), neuroischaemic (30.5%) and ischaemic (18%). The neuropathic ulcers had significantly poorer glycaemic control compared to other types and the longest duration (23.3 weeks). Ischaemic ulcers had significantly higher total cholesterol and diastolic blood pressure compared to other ulcer types. Wagner stage 2 ulcers were the commonest (49.4%) but stage 4 ulcers had their highest neuropathic score (7.8/10) and longest duration (23.6 weeks). Aerobic infective pathogens were isolated from 73.2% of the ulcers. CONCLUSION: The prevalence of diabetic foot ulcers was 4.6% in this tertiary clinic. The risk factors of diabetic foot ulcers in the study were poor glycaemic control, diastolic hypertension, dyslipidaemia, infection and poor self-care. These findings are similar to studies done in other environments and they are modifiable to achieve prevention, delay in formation or improved healing of foot ulcers in patients with diabetes. Therefore, specific attention should be paid to the management of these risk factors in patients with or without diabetes foot ulcers in this clinic.

This study was undertaken to determine the household, calf management, and calf factors associated with the occurrence of Eimeria, Cryptosporidia, and diarrhea in pre-weaned calves reared in smallholder dairy farms in Mukurwe-ini Sub-County of Nyeri County, Kenya. In addition, the study also evaluated factors associated with average daily weight gain in the same pre-weaned calves.

A study was carried out in Nakuru and Mukurweini districts of Kenya to identify the risk factors associated with gastrointestinal nematode (GIN) infection in cattle on 128 dairy farms between June 16th 2010 and August 30th 2010. Faecal samples were collected from the rectum of 419 heads of cattle that were above three months of age on the selected farms, refrigerated and delivered to the Department of Veterinary Pathology, Microbiology and Parasitology, Faculty of Veterinary Medicine, University of Nairobi, for GIN analyses (McMaster method) within 7 days. Questionnaires were administered on every farm to collect individual animal and farm management data. Logistic regression analysis was carried out (univariable and multivariable), and a model developed using a backward elimination method. The univariable analysis revealed that animal age, district, time to last deworming, frequency of manure removal, source of forages, and the type of dewormer used last as the factors associated with GIN infections in cattle. The final regression model indicated that animal age, farm district, time to last deworming, and the type of dewormer used last as the factors associated with nematode infections in cattle. The study concluded that grazing management and the deworming management, particularly among young animals, were the main factors associated with cattle GIN infections.

Abstract
Nematode infections are a serious constraint to pig production, especially where free range pig keeping is practiced. This study investigated the epidemiology of nematodes in free range pigs in Busia District, Kenya. Three hundred and six pigs from 135 farms were sampled for faeces that were analysed for nematode eggs per gram (EPG) of faeces using the McMaster technique. The nematode eggs were also identified to genus and species based on morphology. A questionnaire on risk factors was also administered to the pig owners. The overall prevalence and mean nematode EPG were 84.2% and 2,355, respectively. The nematode eggs were identified as those belonging to Oesophagostomum spp. (75%), Strongyloides ransomi (37%), Ascaris suum (18%), Metastrongylus spp. (11%), Trichuris suis (7%) and Physocephalus sexalatus (3%). The prevalence of nematodes was positively correlated (p < 0.05) with the amount of rainfall in the division of the pigs' origin (all nematodes except S. ransomi). The prevalence of nematodes was also associated with the age of the pigs. A lower burden of nematodes was associated (p < 0.05) with a history of deworming (A. suum) and the provision of night housing (S. ransomi and Metastrongylus spp.). In conclusion, this study has provided information on nematode infections and the associated risk factors for free range pigs in Busia District, which can be used when

Many of the nongenetic causal risk factors of intellectual disability (ID) can be prevented if they are identified early.
There is paucity on information regarding potential risk factors associated with this condition in Kenya.This study aimed to establish
risk factors associated with severity of nongenetic intellectual disability (ID) among children presenting with this condition at
Kenyatta National Hospital (KNH). Methods. A hospital-based cross-sectional study was conducted over the period between March
and June 2017 in pediatric and child/youth mental health departments of Kenyatta National Hospital (KNH), Kenya. It included
children aged 2–18 years diagnosed with ID without underlying known genetic cause. Results. Of 97 patients with nongenetic
ID, 24% had mild ID, 40% moderate, 23% severe-profound, and 10% unspecified ID. The mean age of children was 5.6 (±3.6)
years. Male children were predominant (62%). Three independent factors including “labor complications” [AOR = 9.45, 95% CI =
1.23–113.29,