Abstract

Background: Endometriosis is enigmatic clinical entity which is described as the location of the endometrial tissue external of the uterine cavity. Endometriosis constitutes a serious health issue due to its high affliction of 10% of reproductive women. With limited resources in Africa, it is essential to assess whether diagnosis of endometriosis by laparoscopic visualization can be used as a substitute for histology. Objective: To correlate the diagnosis of endometriosis by laparoscopic visualization and the histological confirmation of the biopsy taken. Methods: A prospective cross sectional study with a sample size of 443 was undertaken in the diagnosis of endometriosis among Africans in Nairobi, Kenya from March 2019 to March 2021. Women undergoing laparoscopy were screened for endometriosis by visualization and a biopsy was taken for histopathology. Diagnosis of endometriosis by visualization was correlated with histological confirmed endometriosis. Results: Women with a diagnosis of endometriosis through laparoscopic visualization were found to be 77 (17.4%) and 30 (6.8%) had positive histology for endometriosis. Laparoscopic visualization diagnosis had a low positive predictive value of 39%. Conclusion: Laparoscopic visualization diagnosis had a low positive predictive value of 39% and this did not correlate with histopathologic diagnosis. It is essential to perform biopsy with histopathology for the confirmation of endometriosis.

Abstract: A case of acute respiratory distress syndrome due to babesiosis is reported in a 5 years old male Japanese sptiz. The patient was noticed to have developed sudden dyspnoea. The main presenting clinical signs included laboured breathing, broad-base stance but preferred recumbency, pallour and seizures. Blood smears from the ear tips revealed presence of multiple Babesia parasites in the erythrocytes. Hematology results showed slight leucocytosis, severe anemia and thrombocytopenia. Additionally, urinalysis revealed renal pathology and presence of leucocytes in urine. Despite aggressive measures to stabilize the patient, it died within an hour. Autopsy results also confirmed Babesiosis with generalized icterus.

Abstract
Background: Endometriosis is enigmatic clinical entity which is described as the existence of the endometrial tissue external of the uterine cavity. Endometriosis constitutes a serious health issue due to its high affliction of 10% in reproductive age women and its clinical manifestation of infertility and chronic pelvic pain. Despite of years of research, the causative factor and understanding of ambidextrous endometriosis pathology remains elusive, perplex and disconnected. Worldwide, there is clear documentation of prevalence of endometriosis in the development countries, however, the prevalence of endometriosis in most of black Africa is unknown. The current perspective is that indigenous African are rarely affected by endometriosis. Objective: To determine the prevalence, pattern and clinical presentation of endometriosis in indigenous African women with the primary outcome measure being the prevalence of laparoscopic visually diagnosed, histologically confirmed endometriosis and clinical presentation. Methodology: This was a prospective analytical cross-selection study in 2 hospitals in Nairobi city, Kenya. The sample size was 443 women and the duration of the study was from March 2018 to March 2021. The inclusion criteria was women aged at least 18 years up to 49 years undergoing laparoscopic surgery and willing to take part in the study. The patient’s history, clinical and laparoscopic findings and histological diagnosis were recorded and analysed using Social SPSS version 22.0. Results: The mean age of the 443 patients recruited was 33 years. The prevalence of histological confirmed endometriosis in indigenous Africans was 6.8%. Laparoscopic visualization diagnosis had a positive predictive value of 39%. Dysmenorrhoea, chronic pelvic pain scale 8-10 and dyspareunia were significant symptoms of endometriosis P<0.001. Nulliparous patients significantly had a risk of having endometriosis p<0.001. The patients with menarche at 13 years and below had a significant risk of having endometriosis p=0.001. Physical findings on clinical examination of adnexal tenderness and findings of nodules in the pouch of Douglas were significant in relation to endometriosis p<0.001. The most common site of the histological endometriosis implants were on the Pouch of Douglas (30%) and the most common form of endometriosis was superficial (43%). Conclusion: The prevalence of endometriosis in Indigenous Africa is 6.8%. Laparoscopic visualization diagnosis had low a positive predictive value of 39%. Nulliparity, menarche at the age of 13 and below, dysmenorrhoea, chronic pelvic pain scale 8-10 and dyspareunia were significantly associated with endometriosis. The most common site for endometriosis is the of Pouch of Douglas whilst the most common form of endometriosis was superficial.

LAG-3 is a potent negative regulator of the immune response but its impact in HIV infection in poorly understood. Unlike exhaustion markers such as PD-1, Tim-3, 2B4 and CD160, LAG-3 is poorly expressed on bulk and antigen-specific T cells during chronic HIV infection and its expression on innate lymphocyte subsets is not well understood. The aim of this study was to assess LAG-3 expression and association with cellular dysfunction on T cells, NK cells and iNKT cells among a cohort of healthy and HIV-infected female sex workers in Nairobi, Kenya.

The GNB3 C825T polymorphism is associated with increased G protein-mediated signal transduction, SDF-1α-mediated lymphocyte chemotaxis, accelerated HIV-1 progression, and altered responses to antiretroviral therapy among Caucasian subjects. The GNB3 825T allele is highly prevalent in African populations, and as such any impact on HIV-1 acquisition or progression rates could have a dramatic impact. This study examines the association of the 825T polymorphism with HIV-1 acquisition, disease progression and immune activation in two African cohorts. GNB3 825 genotyping was performed for enrolees in both a commercial sex worker cohort and a perinatal HIV transmission (PHT) cohort in Nairobi, Kenya. Ex vivo immune activation was quantified by flow cytometry, and plasma chemokine levels were assessed by cytokine bead array. Results GNB3 genotype was not associated with sexual or vertical HIV-1 acquisition within these cohorts. Within the Pumwani cohort, GNB3 genotype did not affect HIV-1 disease progression among seroconverters or among HIV-1-positive individuals after adjustment for baseline CD4 count. Maternal CD4 decline and viral load increase in the PHT cohort did not differ between genotypes. Multi-parametric flow cytometry assessment of T cell activation (CD69, HLA-DR, CD38) and Treg frequency (CD25+FOXP3+) found no differences between genotype groups. Plasma SDF-1α, MIP-1β and TRAIL levels quantified by cytokine bead array were also similar between groups. Conclusions In contrast to previous reports, we were unable to provide evidence to suggest that the GNB3 C825T polymorphism affects HIV-1 acquisition or disease progression within African populations. Ex vivo immune activation and plasma chemokine levels were similarly unaffected by GNB3 genotype in both HIV-1-negative and HIV-1-positive individuals. The paucity of studies investigating the impact of GNB3 polymorphism among African populations and the lack of mechanistic studies make it difficult to assess the true biological significance of this polymorphism in HIV-1 infection.

The expression of inhibitory markers such as LAG-3 and PD-1 on T lymphocytes regulates immune function. Their expression at the genital mucosa is poorly understood, but regulation of immune activation at the female genital tract likely controls susceptibility to sexually transmitted infections.

We studied the most recent dry-wet-dry cycle in the presently arid Suguta Valley in the Northern Kenya Rift where a 300-m-deep lake has formed during the so-called African Humid Period (AHP, 14.8-5.5 ka BP). Hydromodeling suggests that a relatively moderate 25% increase in precipitation was responsible for this dramatic lake level rise, which demonstrates the character of the Suguta Valley as an amplifier lake system. To detect the response of this lake system to climate fluctuations and their possible driving mechanisms with a focus on abrupt vs. gradual changes, we reconstructed a palaeo-lake level record for the time between 14 and 5 ka BP from up to 40 m thick lake-sediment sequences at three locations in the ~2,500 km2 palaeo-lake Suguta area. The sediments have been investigated for sediment characteristics such as grain size distributions, detrital and authigenic mineral phases, geochemical properties and microfossil assemblages. The stratigraphy for the sequences is based on 38 AMS 14C ages of biogenic carbonate and charcoal samples. Parallel dating of charcoal and snail-shell samples show age differences between 1,570-2,240 years suggesting a remarkably high, but well-defined reservoir age for palaeo-Lake Suguta most likely due to aged groundwater or 14C depleted CO2 degassing from active volcanoes. The observed reservoir effect highlights the potential problems while correlating East African lake level records with chronologies based on 14C datings of aquatic materials. The new chronology of water level fluctuations in the amplifier-lake Suguta indicates a general dry-wet-dry cycle synchronous with other lake chronologies during the AHP and multiple short-term fluctuations with abrupt lake level drops between 100 to 300 m within 100 to 200 years at 12.8-11.6 (during Younger Dryas time), 11.1-10.9; 10.4-10.2; 9.5-9.1; 9.0-8.8; 8.5-8.1 (during the 8.2 ka event) cal ka BP that seem to be linked with changes in the coupling between atmosphere and ocean systems. In contrast, the termination of the overall lake episode during the AHP shows a relatively gradual (linear) response to the reduction of solar heating due to insolation changes. The results of the analysis provides new insights into the sensitivity of Rift Valley lakes to climate change on different time scales. Abrupt climate shifts most likely caused dramatic environmental pressure on the biosphere, including humans that were already able to adopt relatively quickly to environmnetal change by new technologies during this time.

OBJECTIVE: To determine the accuracy and sensitivity of diagnostic peritoneal lavage in the assessment of intra-abdominal injury using the dipstick method. DESIGN: Prospective study, involving the performance of diagnostic peritoneal lavage in the out patient department and surgical wards prior to surgical intervention. SETTING: Kenyatta National Hospital-General Surgical and Orthopaedic wards and outpatient department. The study was conducted over a duration of six months, starting from January 1995 to July 1995. RESULTS: Ninety six patients with penetrating (68) and blunt (28) abdominal trauma underwent diagnostic peritoneal lavage as evaluation of the severity of abdominal trauma. Dipstick (combur 9 strips) was used to evaluate lavage effluent for red blood cells, white blood cells, protein and bilirubin. Forty three patients had positive diagnostic peritoneal lavage (DPL) results, of which 40 (93%) had positive findings at laparatomy and three (7%) had negative findings at laparatomy. The remaining 53 patients had negative DPL results and were managed conservatively. One patient with a negative DPL result became symptomatic and had a positive laparatomy. Conservatively managed patients were discharged after 24 hours observations without any complications. DPL had an accuracy and sensitivity of 93% and specificity of 98%. CONCLUSION: Diagnostic peritoneal lavage is a cheap, safe and reliable method for assessment of abdominal trauma. The method is easy to perform by trained junior doctors in the OPD, or as a bedside procedure. Use of this method reduced negative laparotomy rate from 50% to 6.9% and average duration of stay from 6.5 days to 1.9 days. This method is recommended as a basic tool in the assessment of abdominal trauma patients.

In this study, we sought describe the incidence and outcomes of severe metabolic or mixed acidemia in critically ill patients as well as the use of sodium bicarbonate therapy to treat these illnesses. PMID: 21995879

Abstract. A study was conducted in which samples ol soil. forage, as well as serum, bone, kidney, and liver of waterbuck were collected from Lake Nakuru National Park. The objective was to determine the ecosystem health status in older to establish the causes of animal health problems previously re¬corded in some sections of the Paik. Trace element analysis in serum indicated occurrence ol copper (Cu) deficiency in the north and eastern sections of the Park where mean values were marginal (range: 0.36-0.81. mean: 0.62 mg/1) compared to concentrations recorded in the western part of the Park (range: 0.69 1.48. mean: 1.22 mg/l). Bone analysis on dry matter basis (DM) indicated higher (p < 0.01) levels of cadmium (Cd. 0.437 nig/kg), fhioride (F, 3178 mg/kg). and lead (Pb. 20.62 mg/kg) in animals from the east compared to those from the west (0.002. 1492, 4.87 mg/kg. respectively), suggesting heavy exposure. In addition, samples from the east had much lower than normal calcium (Ca)-to-phosphorus (P) ratios (mean: 1.9:1) compared to those recorded in the west (2.2:1). suggesting poor bone minerali/ation There was a higher concentration of Cd in the kidney (16.24 mg/kg. p < 0.05) and Pb in the liver (58.3 mg/kg. /; < 0.01) in animals from the east compared to those in the west (12.92 and 36.2 mg/kg, respectively), but the converse was true of Cu The liver Cu status was better in animals from the west with, concentrations (mean: 21.7 mg/kg) being about twice those recorded in the east (11.9 mg/kg DM). Forage analysis revealed prospects of Ca, P, and Cu deficiencies in the entire Park. However, in the northeastern section of the Park (measuring 50 ha) where waterbuck residence times are high, forage concentrations of Cd (0.31 mg/kg DM), molybdenum (Mo. 7.20 mg/kg DM). Pb (2.88 mg/kg DM), and /inc (7.n. 126 mg/kg DM) were an order of magnitude greater (p < 0.01) than the levels recorded in the rest of the Park (ranges: 0.133 0.165, 3.69 5.61. 0.485 0.621. 11.6 17.4 mg/kg DM, respectively). These disparities were attributed to a higher soil concentration of CM (2.77 mu/ku DM). Pb (85.1 msi/k DM) and 7,n (1414mg/kg DM i n this section compared lo the rest of the Park (ranges; 0 Id o 15. 5.02 6.26. 1,49 5.44 mg/kg DM. respec¬tively), and su»ngly suggest heavy metal contamination as the source ol annual health problems in the Park.

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This study provides a means for the evaluation of cleaner manufacturing and the provision of cost-effective worker health improvements in developing nations. Individual worker exposure to volatile organic compounds was measured in the paint manufacturing plants of Nairobi, Kenya. A variety of different paint production jobs were monitored, including laboratory researchers, mixers, tinters, fillers, cleaners, raw materials deliverers, and resins producers.
Exposure levels were calculated based on a time-weighted average over an entire 8-10 hour workday. The paint solvents used can cause both acute and chronic health problems for the workers exposed. For example, over half of the or-ganics monitored, i.e. benzene, styrene, and xylene, exhibit carcinogenic properties. The lifetime cancer risk from exposure to these paint solvents was estimated utilizing published cancer potencies, and the risks range from 1.90 x 10-4for raw materials deliverers to 2.60 x 10-2for cleaners.
The highest exposure tasks included cleaning the mixing vats and mixing the paint product, ranging from risks of 8.5 x 10-4 to 2.6 x 10-2, providing evidence that solvent exposure occurs due to point sources. Because of this, simple and inexpensive technologies should significantly reduce the excess exposure of workers in these manufacturing facilities. The cost of minor innovations in the plants themselves, such as fans, drum and mixing vat covers, and respirators, could amount to as much as five times less than the estimated cost of treating workers who develop cancer due to paint solvent exposure.
Keywords Benzene Exposure, Developing Countries, Kenya, Occupational Exposure, Paint Manufacturing, Risk As-assessment, Volatile Organic Compounds

The distribution of Salmonella typhi, S. paratyphi A. and S. paratyphi C. agglutinins among 364 sera from a randomly selected group of healthy individuals in Nairobi and Naivasha (Kenya) were analysed in relation to bacteriologically confirmed cases of typhoid fever at the Kenyatta National Hospital (KNH). Out of these, 30% of the healthy individuals had no detectable Widal titres. Overall agglutinin titres obtained for the healthy population showed that 96% of the individuals had low level reactivity with titres < 1:80 for both H and O antigens of S. typhi, while 4% had titres of 1:160 or above. Agglutinins for S. paratyphi A and C were rarely present in the sera tested. Age and sex were found to have no effect on antibody titre distribution in the two populations but differences in the water source may have affected the percentage of positive tests recorded. In this typhoid endemic region titres upto 1:80 are not uncommon but both H and O titres of 1:160 and above found in conjunction with the clinical picture may be taken to be suggestive of typhoid fever.

The concentrations of organochlorine residues of lindane, aldrin, <*- endosulfan, dieldrin, endrin, p,p'-DDE, p,p'-DDD and p,p'-DDT in samples of seawater, sediment, fish and seaweed from different locations along the coast of Kenya are discussed in relation to the geographical location of the sampling sites and potential sources of residue over a period of two years. All sediment samples were found to contain very low levels of organic carbon except those sampled from Sabaki River that had high (4.7%) organic carbon due to greater primary activity. Most of the pesticides residues (112 samples analysed in 1997 and 258 analysed in 1998/99) were detected in fish, water, sediments and seaweed. The concentration of some residues was higher during the wet season than the dry season in 1997, but no marked seasonal variation was observed in 1998/99. Lindane, aldrin, p,p'-DOT and p,p'-DDE were the most frequently observed residues in all samples while «-endosulfan, dieldrin, p,p'-DDD and endrin were either present in low concentrations or absent in most samples. Water samples had the lowest concentrations of residues (range 0.503 - 9.025 ng g'1). Sediments had the second highest levels of pesticides residues with a range of 0.584 - 59.00 ng g'1 while fish lipid content had the highest levels of residues in 1989/99 with p,p'-DDT concentration of 1011 ng g'1 and 418 ng g"1 p,p'-DDD 'mSiganus rivulatus.

Introduction: Oseltamivir and zanamivir are neuraminidase inhibitors (NAIs) with important roles as drugs for prophylaxis and treatment of influenza. Whereas there have been reports of in vivo resistance of influenza B viruses to NAIs, currently there is lack of information regarding sensitivity or resistance to these drugs in influenza B viruses circulating in Kenya. Here, we report the isolation of influenza B viruses, phenotypic assessment to NAI activities and molecular characterization of NAI-relevant mutations in viruses that circulated in Kenya in the period 2011-2012. Materials and Methods: Influenza B viruses were isolated from patient nasopharyngeal specimens by inoculation onto MDCK monolayers. For phenotypic determination, enzyme inhibition assay using fluorescent MUNANA substrate was used. Known NA inhibitor-resistant and inhibitor-sensitive viruses were included in the assays as controls. IC50 values were determined using curve fitting implemented in Grafit version 7.0 software which is based on 50% of fitted upper asymptote. For molecular characterization of the mutations relevant in NAI resistance, RNA was extracted from the isolates followed by PCR amplification of NA gene segments using gene-specific primers. Nucleotide sequencing of the amplicons were performed using the Sanger dideoxy termination chemistry implemented using the BigDye technology prior to analyses using a suite of bioinformatics tools. Results and Discussion: Twenty four influenza B viruses were isolated and assed in this study. The mean IC50s of the isolates ranged from 17.1nM - 70.1nM for Oseltamivir and 0.0nM - 12.6nM for Zanamivir which were all within the 2011 WHO sensitive limits of 8-128nM for oseltamivir carboxylate and 0.5-12nM for Zanamivir. None of the isolates analyzed depicted oseltamivir or Zanamivir resistance at the eight amino acid positions E119, R152, D198, I222, S250, H274, R371, and G402 in the neuraminidase protein previously found to be associated with resistance or reduced susceptibility to oseltamivir and/or zanamivir. In conclusion, NAIs drugs were effective in treating influenza cause type B viruses during the 2011-2012 Kenyan seasons.

A number of diseases and production problems have been observed in grazing ruminants in many countries around the I world Some of these problems and health effects have been attributed to dietary imbalances in mineral supply and appear \ to be geographically distributed. Grazing cattle require different levels of minerals in their diet depending on the stage of class of development; young and growing, lactating or pregnancy. Common findings indicate that the lactating and young} and growing animals are the most vulnerable to mineral problems, thus providing a sufficient ground for their choice in\ experimental studies. In this preliminary review of the project, the nutritional status of cattle grazing on a range of farms in \ Irons Nzoia District are assessedfrom the mineral content of blood from young and growing as well as lactating animals] sampled during the dry and wet seasons of the study period. Data -will be evaluated in terms of established criteria normality.

Abstract
A questionnaire survey was conducted in rural and urban Kenya to establish biofuel consumption rates and patterns. The survey targeted households, commercial catering enterprises and public institutions such as schools and colleges. Firewood was the main biofuel used, mostly by rural households, who consumed the commodity at average consumption rates in the range 0.8-2.7 kg cap"1 day~'. Charcoal was mostly consumed by the urban households at weighted average rates in the range 0.18-0.69kgcap~' day"1. The consumption rates and patterns for these fuels by restaurants and academic institutions, and those for crop residues are also reported. The rates largely depended on the fuel availability but differed significantly among the three consumer groups and between rural and urban households. Other factors which may have influenced consumption rates are discussed. Although good fuelwood sufficiency was reported in the country in 1997, there were increasing difficulties in accessing these resources by most households, a situation having both short- and long-term implications for biofuel consumption rates and patterns. © 2001 Elsevier Science Ltd. All rights reserved.

Keywords: Biofuels; Per capita consumption; Kenya

Emission ratios (ER) of CO and NO relative to CO2 are reported from real time emission measurements on biofuel fires in Kenya. The experiments were based on available fuels burning in local popular traditional and improved stoves. The mean dCO/dCO2 ratios were 71, 79 and 74 mmol molt-1for firewood, charcoal and agricultural residues, respectively, while the corresponding mean d/NO/d/CO2 ratios for these fuels, in the same order, were 1.8, 2 and 2.2 mmol molt-1, respectively. Whereas stove design characteristics largely influenced the dCO/dCO2 ratios, the fuel nitrogen content was the major factor determining the dCO/dCO2 ratios. The dCO/dCO2 ratio for fuel derived NO is not affected by fire temperature but linearly depend on the fuel nitrogen content. Other important fuel parameters that influenced the observed emission ratio patterns include fuel moisture content, size and volatile matter content in the case of charcoal. In comparison to savanna and forest fires, biofuel fires tend to favour formation of reduced or partially oxidised compounds. It is clear that a change in energy preference up the "energy ladder" leads to a reduction in the CO ER, an important result for emission mitigation policy design.
© 2001 Published by Elsevier Science Etd.
Keywords: Trace gases: Emission ratios; Biofuels; Stoves; Biomass burning

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

OBJECTIVES

Background: Diarrhea caused by Enterobacteriaceae such as Shigella species and Escherichia coli (E. coli) is endemic throughout the world, and is one of the most important causes of global childhood mortality and morbidity. There is a range of antibiotics that can be used for treatment among them quinolones. However, there is emerging increase in microbial resistance to quinolones use, with E. coli and Shigellae among the species of bacteria commonly associated with quinolone resistance. Objective: To investigate the prevalence of quinolone resistance genes in Shigellae and E. coli from patients presenting with diarrhea in Machakos District Hospital. Methods: Bacteria isolates were identified to species level by biochemical methods and serology and thereafter tested for 12 different antibiotics including quinolones, cephalosporins and aminoglycosides. Those resistant to quinolones with a zone diameter of ≤20 mm were tested for the presence of quinolone resistance genes using PCR. The gyrA resistance genes were further analyzed by sequencing to determine mutations within the quinolone resistance regions. Results: There were different E. coli pathotypes and Shigellae spp. They resisted more than four antibiotics: Ciprofloxacin (4%), (Chloramphenical (28%), Cotrimoxazole (78%), Co-amoxilav (70%) Erythromycin (98%) Cefotoxime (18%) and Tetracycline (56%). Mutations responsible for fluoroquinolone resistance in the gyrA, gyrB, parC, and parE genes of E. coli and Shigella spp were: gyrA (17/30, 36%) gyrB (7/30, 23.3%) topoisomerase (parC 3/30, 10%) parE (3/30, 10%). Discussion: There is an increase in fluoroquinolone resistance in Shigellae and E.coli which points to a major challenge in current treatment strategies. In addition, detection of high resistance found to commonly used antibiotics should serve as a warning call for close surveillance and understanding of the epidemiology of the resistance. Key words:

Background: Africa has one of the highest incidences of gonorrhea. Neisseria gonorrhoeae is gaining resistance to most of the available antibiotics, compromising treatment across the world. Whole-genome sequencing (WGS) is an efficient way of predicting AMR determinants and their spread in the population. Recent advances in next-generation sequencing technologies like Oxford Nanopore Technology (ONT) have helped in the generation of longer reads of DNA in a shorter duration with lower cost. Increasing accuracy of base-calling algorithms, high throughput, error-correction strategies, and ease of using the mobile sequencer MinION in remote areas lead to its adoption for routine microbial genome sequencing. To investigate whether MinION-only sequencing is sufficient for WGS and downstream analysis in resource-limited settings, we sequenced the genomes of 14 suspected N. gonorrhoeae isolates from Nairobi, Kenya.

Methods: Using WGS, the isolates were confirmed to be cases of N. gonorrhoeae (n = 9), and there were three co-occurrences of N. gonorrhoeae with Moraxella osloensis and N. meningitidis (n = 2). N. meningitidis has been implicated in sexually transmitted infections in recent years. The near-complete N. gonorrhoeae genomes (n = 10) were analyzed further for mutations/factors causing AMR using an in-house database of mutations curated from the literature.

Results: We observe that ciprofloxacin resistance is associated with multiple mutations in both gyrA and parC. Mutations conferring tetracycline (rpsJ) and sulfonamide (folP) resistance and plasmids encoding beta-lactamase were seen in all the strains, and tet(M)-containing plasmids were identified in nine strains. Phylogenetic analysis clustered the 10 isolates into clades containing previously sequenced genomes from Kenya and countries across the world. Based on homology modeling of AMR targets, we see that the mutations in GyrA and ParC disrupt the hydrogen bonding with quinolone drugs and mutations in FolP may affect interaction with the antibiotic.

Conclusion: Here, we demonstrate the utility of mobile DNA sequencing technology in producing a consensus genome for sequence typing and detection of genetic determinants of AMR. The workflow followed in the study, including AMR mutation dataset creation and the genome identification, assembly, and analysis, can be used for any clinical isolate. Further studies are required to determine the utility of real-time sequencing in outbreak investigations, diagnosis, and management of infections, especially in resource-limited settings.

Sulphadoxine-pyrimethamine (SP), an antifolate, was replaced by artemether-lumefantrine as the first-line malaria drug treatment in Kenya in 2004 due to the wide spread of resistance. However, SP still remains the recommended drug for intermittent preventive treatment in pregnant women and infants (IPTP/I) owing to its safety profile. This study assessed the prevalence of mutations in dihydrofolate reductase (Pfdhfr) and dihydropteroate synthase (Pfdhps) genes associated with SP resistance in samples collected in Kenya between 2008 and 2012.

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The absolute configurations of two acyclic triterpenoids 1 and 2, previously isolated from the bark of Ekebergia capensis (Meliaceae) have been determined by the modified Mosher's method.

From the dried bark of Ekebergia capensis, two novel acyclic triterpenoids, 2,3,22,23-tetrahydroxy-2,6,10,15,19,23-hexamethyl-6,10,14,18-tetracosatetraene and 2-hydroxymethyl-2,3,22,23-tetrahydroxy-6,10,15,19,23-pentamethyl-6,10,14,18-tetracosatetraene were isolated, along with known cyclic triterpenoids. The structures of these two new triterpenoids were determined by spectroscopic and chemical methods.

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

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

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Description
The stem extract of Tephrosia purpurea showed antiplasmodial activity against the D6 (chloroquine-sensitive) and W2 (chloroquine-resistant) strains of Plasmodium falciparum with IC50 values of 10.47 ± 2.22 μg/ml and 12.06 ± 2.54 μg/ml, respectively. A new prenylated flavone, named terpurinflavone, along with the known compounds lanceolatin A, (−)-semiglabrin and lanceolatin B have been isolated from this extract. The new compound, terpurinflavone, showed the highest antiplasmodial activity with IC50 values of 3.12 ± 0.28 μM (D6) and 6.26 ± 2.66 μM (W2). The structures were determined on the basis of spectroscopic evidence.

The pharmacokinetics of cyclophosphamide was studied in 10 Kenyan Africans with Hodgkins lymphoma. The mean +/- s.d. elimination half-life (t1/2) was 7.5 +/- 1.38 h. The mean +/- s.d. volume of the central compartment (V1) was 0.35 +/- 0.12 l/kg and the apparent volume of distribution (V) was 0.64 +/- 0.06 l/kg. The microconstants k21, k12 and k10 were 1.81 +/- 0.84 h-1, 1.90 +/- 1.080 h-1 and 2.05 +/- 0.86 h-1 respectively (mean +/- s.d.).

African medicinal plants Uvaria acuminata and Uvaria lucida were examined for their alkaloidal constituents. Three alkaloids, (-)-anolobine, (-)-anonaine, and (+)-reticuline were isolated from U. acuminata, and four alkaloids, (-)-anolobine, (+)-reticuline, (-)-asimilobine, and (-)-discretamine from U. lucida. Furthermore, HPLC profiles of the alkaloidal fractions of both plants were studied.

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

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

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The pharmacokinetics of cyclophisphamide have been extensively discussed in adult man.A few studies have been done to compare the pharmacokinetics of this important anticancer agent in children and adults of a comparable population

This study investigated the effectiveness of three physical-chemical methods namely; pH adjustment, precipitation with alum and the use of polyelectrolytes. In the treatment of diary wastewater from Brookeside milk processing plant. It also investigated the drainability of the sludge produced by each of the three methods. Laboratory tests were carried out in three different batches, one for each of the three methods. In the alum method enough alum was added to the wastewater samples to cause precipitation by sweep floc. In the pH adjustment method, the pH of samples were lowered to the iso-electric point of the casein proteins of approximately pH 4.5 leading to their precipitation as a result of solubility changes. The polyelectrolytes method involved the use of two polyelectrolytes, Sudfloc 3820 and Sudfloc 3860 each of which was used to coagulate the dirty wastewater. For each of the three methods, the samples were taken in one-litre beakers and subjected to Jar tests to determine the optimum dosages. After one hour of settling the supernatants were decanted and subjected to standard Chemical Oxygen Demand (COD) tests, turbidity and pH measurements. The settled sludge was subjected to drainability studies. Results showed the treatment of dairy wastewater by the three physical-chemical methods to be effective. There were COD removals of between 60% and 90% and turbidity reduction of over 90%. The use of the sudfloc polyelectrolytes was found to be the least demanding in terms of effluent quality control as no pH adjustments of either the wastewater or the effluent was required. The use of polyelectolytes produced the least volumes of sludge and also the better drainability and solids concentration. Sudfloc 3820 was found to achieve better results than Sudfloc 3860 in terms of COD reduction and the drainability of sludge produced although both achieved the same drainability studies. This study showed that each of the three physical-chemical methods can be used effectively to remove the white colour of dairy wastewater as well as the bulk of the proteins and fats, hence, enabling the discharge of the effluents into natural waters to be of good assimilative capacity.

The need to provide agricultural information to farmers has led to emergence of numerous ICT-based MIS projects in developing country. These projects aim at promoting commercialization of smallholder agriculture and subsequently their welfare. This study examines the welfare effects of one such project in western Kenya. It uses household food security and access to medical health services as proxies of welfare. The study finds that farmers that use ICT-based market information are more food secure and have better access to medical health services than their counterpart. It highlights policy implications of these findings.

Bovine foscioliosis coused by F. giganticais widespread in   There is a large collection of reports of fasciolosis in Kenya based on  abattoir data records from veterinary investigation laboratories (VILS) as well as reports on a few farm study was carried out to improve on the reports.  Diagnosis of fasciola infection has traditionally been based on detection of typical eggs in the faeces.  A variety of other techniques are now available eg enzyme-linked immunosorbent assay (ELISA), which has shown to be sensitive and useful. Three agro-ecological zoned were defined depending on the reported prevalence; high risk, medium risk and low risk zones.  Two study districts were picked at random from each zone.  The study farms were selected using the two stage cluster sampling. Faecal and blood samples were collected on the farm.  Serum was later harvested.  ELISA and faecal sedimatation tests (FST) were carried out. A total of 2434 faecal and blood samples were screened.  ELISA achieved the highest (66%) positive rate of the samples from Kwale district and the lowest (23%) rate in Nakuru.  An overall positive prevalence of (43%) for fasciolosis was achieved.  The faecal sedimentation test showed prevalence of 19%.  In both tests high prevalence were observed in Kwale and Kilifi districts.  ELSA was always positive when FST was positive but not the converse. The on-famr survey utilizing two reliable diagnostic tests was meant to improve on existing abattoir reports.  Both tests showed fair to good agreements.  The higher detection by ELISA might be due to deworming and other reasons.  It was concluded that on-farm surveys are better than retrogressive studies; thought the latter are cheaper and faster.,  the current prevalence of fasciolosis are different from past reports with coastal showing higher than expected prevalences.

Reduction of system losses and improvement of voltage profile is one of the key aspects in power system operation. Though many methods are used to achieve this aspect, Distributed Generation (DG) has found increased usage nowadays due to its many advantages. Majority of algorithms proposed in this area have emphasized on real power losses only in their formulations. In modern practical power systems reactive power injection plays a critical role in voltage stability control, thus the reactive power losses need to be incorporated in optimizing DG allocation for voltage profile improvement. This paper aims at solving this problem by proposing a hybrid of GA and IPSO to optimize DG location and size while considering both real and reactive power losses. The hybrid technique aims at inheriting the good traits from the two techniques while avoiding the undesirable ones. Arithmetic crossover and mutation has being employed in the proposed algorithm.

Bovine foscioliosis coused by F. giganticais widespread in   There is a large collection of reports of fasciolosis in Kenya based on  abattoir data records from veterinary investigation laboratories (VILS) as well as reports on a few farm study was carried out to improve on the reports.  Diagnosis of fasciola infection has traditionally been based on detection of typical eggs in the faeces.  A variety of other techniques are now available eg enzyme-linked immunosorbent assay (ELISA), which has shown to be sensitive and useful. Three agro-ecological zoned were defined depending on the reported prevalence; high risk, medium risk and low risk zones.  Two study districts were picked at random from each zone.  The study farms were selected using the two stage cluster sampling. Faecal and blood samples were collected on the farm.  Serum was later harvested.  ELISA and faecal sedimatation tests (FST) were carried out. A total of 2434 faecal and blood samples were screened.  ELISA achieved the highest (66%) positive rate of the samples from Kwale district and the lowest (23%) rate in Nakuru.  An overall positive prevalence of (43%) for fasciolosis was achieved.  The faecal sedimentation test showed prevalence of 19%.  In both tests high prevalence were observed in Kwale and Kilifi districts.  ELSA was always positive when FST was positive but not the converse. The on-famr survey utilizing two reliable diagnostic tests was meant to improve on existing abattoir reports.  Both tests showed fair to good agreements.  The higher detection by ELISA might be due to deworming and other reasons.  It was concluded that on-farm surveys are better than retrogressive studies; thought the latter are cheaper and faster.,  the current prevalence of fasciolosis are different from past reports with coastal showing higher than expected prevalences.

This research was carried out to analyze the effect of long term use of inorganic fertilizers on the Cd, Cr, Cu, Pb, Zn, soil pH and TOC in maize farm soils in Kenya. Samples of soil were collected from 12 experimental sites from Kerita farm that has experienced more than 20 years of inorganic fertilizer application and 2 samples from the control site (Kiptuimet primary school), Trans Nzoia in Kenya while fertilizer samples were purchased from the nearby Kolongolo Market. Results obtained showed that the mean concentration for Cu, Pb, Cr and Zn in maize farm soils was 8.52±1.56mg/kg, 37.72±3.44 mg/kg, 42.11±3.25 mg/kg and 29.36±2.74 mg/kg, respectively while the mean concentration for Cu, Pb, Cr and Zn in the control soils was 5.12±0.71 mg/kg, 18.98±0.88 mg/kg, 19.15±1.56 mg/kg and 14.71±0.63 mg/kg respectively. The mean concentration for Cu in both the control site and maize farm soils was below the detectable limits of the instrument. Soil Ph in maize farm soils and control site was 5.034±0.25 and 6.35±0.21 respectively while soil TOC was 1.11±0.87% and 0.915±0.01% in maize farm soils and control site respectively. The results revealed that maize farm soils had higher levels of heavy metals than the control site suggesting that inorganic fertilizers had had an impact. However the concentration of these toxic elements after long term use of inorganic fertilizers did not exceed the maximum allowable levels set by the USEPA and WHO. Also the levels of these metals in the inorganic fertilizers used in the maize farms were within acceptable levels set by the USEPA and Kenyan standards. Soil pH levels showed a difference between the maize farms and the control site with control having higher pH values than the maize farm soils indicating long term application of inorganic fertilizers effect on soil pH. However both the two sites had generally a low pH of less than 7.0 which was attributed to the composition of the parent rock from which the soils were formed and inherent factors affecting soil pH
which cannot be changed. There was a difference in total organic carbon values between the maize farms and the control site with higher values of TOC in maize farm soils compared to the control site indicating that long-term chemical fertilizer application alone can increase soil total organic carbon.
Keywords: Heavy Metals, Soil pH, TOC, Fertilizers, Maize Farms, Kenya

Land use and land cover changes are important processes that influence the dynamics of human-wildlife conflicts. Effective management of human-wildlife conflicts requires the participation of local communities and other stakeholders. However, local communities need to identify and understand resource use change and their role in the process, so as to facilitate uptake of appropriate land resource management strategies aimed at counteracting human-wildlife conflicts. Approaches aimed at changing local community behavior towards natural resource use require appropriate technologies that bridge the technology and knowledge gaps between policy makers and local communities. PGIS was used to assess and educate local communities on land use and land cover changes as well as visualize the problems associated with resource changes. Local communities were found to be significantly knowledgeable about resource changes and their causes. PGIS compared well to conventional GIS analysis and therefore an appropriate technology for analysing and monitoring landuse and land cover changes.

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

Between February and July 1987, some 40 consecutive patients with established chronic renal failure, on either maintenance dialysis or conservative management, were studied to determine the nature and incidence of upper gastrointestinal tract mucosal disease. Serum assays for gastrin, bombesin and gastric inhibitory polypeptide were also done.

Endoscopic gastritis was evident in 27.5%, duodenitis in 20%, bile reflux in 17.5%, distorted duodenal bulb in 17.5% oesophangitis in 5% and duodenal ulcer in 5%. In 32.5% of the patients there was no endoscopic abnormality noted. No patient had active gastrointestinal bleeding. Gastrin and gastric inhibitory polypeptide were significantly elevated in all study cases when compared to the controls. None of the cases had conditions, other than chronic renal failure to account for fasting hypergastrinemia. Fasting serum gastrin levels did not correlate significantly with endoscopic diagnosis, serum creatinine or creatinine clearance. A statistically significant correlation was found between serum gastrin and bombesin levels.

The results indicate a high prevalance of inflammatory and hypertrophic mucosal changes in chronic renal failure but not peptic ulcer disease, and suggest that these changes may be a consequence of hypergastrinemia.

It is r~ded that all chronic renal failure patients with significantupper gastrointestinal symptomatology and all pre­ renal transplant patients undergo upper gastrointestinal endoscopicassessement.

Background

Urbanisation has been described as a key driver of the evolving non-communicable disease (NCD) epidemic. In Africa, hypertension is the commonest cardiovascular problem. We determined the prevalence and risk factor correlates of hypertension in the largest Nairobi slum.
Methods

In 2010 we conducted a population-based household survey in Kibera, a large informal settlement in Nairobi City; utilising cluster sampling with probability proportional to size. Households were selected using a random walk method. The WHO instrument for stepwise surveillance (STEPS) of chronic disease risk factors was administered by trained medical assistants, who also recorded blood pressure (BP) and anthropometric measures. BP was recorded using a mercury sphygmomanometer utilising the American Heart Association guidelines. Hypertension was defined as per the 7th Report of the Joint National Committee or use of prescribed antihypertensive medication. Those with hypertension or with random capillary blood sugar (RCBS) >11.1 mmol/l had an 8 hours fasting venous blood sugar sample drawn. Age standardised prevalence was computed and multivariate analysis to assess associations.
Results

We screened 2200 and enrolled 2061 adults; 50.9% were males; mean age was 33.4 years and 87% had primary level education. The age-standardised prevalence of hypertension (95% CI) was 22.8% (20.7, 24.9). 20% (53/258) were aware of their hypertensive status; 59.3% had pre-hypertension; 80% reported high levels of physical activity and 52% were classified as harmful alcohol drinkers; 10% were current smokers and 5% had diabetes. Majority of males had normal BMI and waist circumference, whereas a third of females were obese or overweight and 40% had central obesity. Older age, higher general and central obesity were independently associated with hypertension and higher SBP and DBP readings.
Conclusions

Our findings of high prevalence of hypertension, in association with excess body weight in this poor urban slum community, point to the need for greater awareness and implementation of primary preventive strategies.
Keywords
Hypertension prevalence Urban health Poverty areas Africa South of the Sahara Non-communicable diseases

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One common feature of most neurodegenerative diseases, including Alzheimer's disease (AD) and stroke, is the death of neuronal cells. Neuronal cell death is associated with apoptosis, generation of reactive oxygen species and oxidative stress. Neuronal cell death pathways can be reversed by endothelin B receptor agonist, IRL-1620, which was found to enhance neuroprotection by promoting vascular and neuronal growth in a rodent stroke model. Previous studies conducted at our institution indicated that the treatment with IRL-1620 significantly improved neurological and motor function while reducing oxidative stress and overall infarct area. IRL-1620 is a hydrophilic, 15 amino acid peptide and has a molecular weight of 1820Da. In this study, we have encapsulated IRL-1620 in PEGylated liposomes in order to enhance its efficacy. Each batch of liposomes encapsulating IRL-1620 was evaluated for particle size, polydispersity index, and charge (zeta potential) over a period of time to determine their stability. A dose-response bar graph was plotted based on the effect of neuroprotection by free IRL-1620 on differentiated neuronal PC-12 cells. The 1nM concentration was found to have the highest cell viability. The liposomes loaded with IRL-1620 were tested on differentiated neuronal PC-12 cells for their neuroprotective ability against apoptosis caused by removal of nerve growth factor (NGF) against free (non-encapsulated) IRL-1620. The liposomal IRL-1620 was found to proliferate the growth of serum-deprived differentiated PC-12 cells significantly (p<0.0001). In the western blot analysis, the expression of the anti-apoptotic marker, BCL-2 was found to be increased, and that of pro-apoptotic marker, BAX was found to be decreased with liposomal IRL-1620. The effects were found to be independent of the NGF levels. Finally the free IRL-1620 was found to cause neuronal outgrowth equivalent to the 75ng/ml NGF treatment.

Kenya’s agricultural sector accounts for 20–30% of the gross domestic product (GDP). Of this, the livestock sector alone makes a contribution of about 50%. Thus, livestock contributes heavily to the GDP and food security of its population. It also provides the necessary thrust for other forms of development in the country. Recent statistics indicate that currently over 50% of the country’s livestock population is based in the arid and semi-arid lands (ASALs), which form about 80% of the country’s land area. However, comparative international statistics show that livestock contributes 88% of the total agricultural output in Botswana even though the country has half Kenya’s livestock population and is of less agricultural potential. Thus, there is a huge potential contribution that livestock can make to the Kenyan national economy. Unfortunately, this sector receives only 10% of the government’s agricultural expenditure and less than one per cent of total spending, yet it is estimated that Kenya’s potential to export livestock products if adequately exploited would earn more than the earnings from tea and coffee combined. This then calls for new thinking about livestock development strategies to harness the arid landsThe livestock sector accounts for 90% of employment and more than 95% of household incomes in the ASALs. Most of the livestock slaughtered in major urban centres originates in these areas, with an annual slaughter of about 1.6 million Tropical Livestock Units. Kenya’s livestock from the ASALs is worth Kshs 60 billion (US$800 million). The internal livestock trade in trade in thepastoral areas alone nets in about 6 billion shillings (US$80 million )a yearIn the arid areas of the ASALs, arable crop production is not possible without some form of irrigation; while in semi-arid areas rainfall may be sufficient for certain types of crops, requiring special management techniques. Therefore, except for the areaunder cropping, the rest of the arid areas is used for livestock.......

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

Sixty-four patients atteending the Kenyatta National Hospital psychiatric clinic with minor p.yychiatric disorders were assessed using the Enugu Somatization Scale with a view of eliciting the nature and types of somatic complaints they had. A control group of 66, 5th year medical student, was used. The average scores for the head and body symptoms were 10.9 and 22.1 for the neurotics and 0.9 and 1.5 for the controls respectively. Overall the commonest complaints among the patients were vague, the highest positive scores in order a/frequency being. 'What worries me is not steady." . 3.7%), "parts of my body are out of order" (87.3%), "my whole body is not all right" (87.3%), ':feeling various parts of the body shiver" (85. 7%) and ':feeling dizzy" (84. 1 %). The complaints were not related to age, sex, education, occupation or p,\ychiatric diagno,yis. The average scores for the Kenyan neurotic, were higher than that obtained from the Nigerian (head: 8.14; body: 15.2) and Indian neurotics (head: 8.75: body: 11.78) in previous .ytudies. On the other hand the Kenyan controls had lower scores compared to the other 2 groups. The implication of these findings is discussed.

The objective of our study is to assess the influence of organizational culture and market orientation on
performance. The population of the study comprise microfinance institutions that are members of the Association of Microfinance Institutions (AMFI) in Kenya. We used descriptive cross-sectional survey design. We collected primary data using structured questionnaire. We test our hypotheses through regression analysis. Our results demonstrate that organizational culture significantly and positively influence variations in performance. The partial mediation effect of market orientation on the relationship between organizational culture and performance was confirmed. The complimentary effect of organizational culture on market orientation implies that organizations need to spend more resources in nurturing market orientation to create sustainable competitive advantage through delivery of superior customer experience. We conclude that the influence of organizational culture and market orientation on performance is more plausible for mature industries regarded as diverse in terms of customer needs.
Keywords: organizational culture, market orientation, performance, microfinance

Objective: To remove or modify fluorotic enamel stains using a combined chemical micro-abrasion and bleaching technique. Design: An in-vivo study was carried out. A sample of 21 participants was randomly selected from patients presenting with brown staining due to flourosis as the chief complaint. Eighty nine teeth were selected based on the Thylstrup-Fejerskov Index [TFI] with a score of 4 as the acceptable maximum. Only upper anterior teeth were included in the study. Setting: The study was undertaken at the University Of Nairobi Dental Hospital, Kenya. Subjects: Patients with an expressed need for treatment of their discoloured teeth who consented to a clearly demonstrated treatment procedure constituted the sample. Results: Enamel discolouration was removed or modified yielding a uniform colour and lustre depending on the initial depth of the stain. All patients appreciated the colour change. Conclusion: A combined chemical micro-abrasion and bleaching technique is a feasible treatment modality in selected cases of enamel fluorosis.

Objective: To remove or modify fluorotic enamel stains using a combined chemical micro-abrasion and bleaching technique. Design: An in-vivo study was carried out. A sample of 21 participants was randomly selected from patients presenting with brown staining due to flourosis as the chief complaint. Eighty nine teeth were selected based on the Thylstrup-Fejerskov Index [TFI] with a score of 4 as the acceptable maximum. Only upper anterior teeth were included in the study. Setting: The study was undertaken at the University Of Nairobi Dental Hospital, Kenya. Subjects: Patients with an expressed need for treatment of their discoloured teeth who consented to a clearly demonstrated treatment procedure constituted the sample. Results: Enamel discolouration was removed or modified yielding a uniform colour and lustre depending on the initial depth of the stain. All patients appreciated the colour change. Conclusion: A combined chemical micro-abrasion and bleaching technique is a feasible treatment modality in selected cases of enamel fluorosis.

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

This chapter captures the origins and current status of mental health research in Africa and emphasizes the challenges, current and past, pointing out ways in which they might be overcome. It also gives brief hints to think further on the potential of mental health research in Africa. Of course, the chapter is not intended to be a comprehensive overview or a complete guide to research.

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

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

To explore structure and process factors which influence patients' perception of quality inpatient psychiatric nursing care at Mathari hospital. This was a cross-sectional study of 236 inpatients selected by stratified random sampling. Competence to give consent was determined by a minimum score of 24 on Mini Mental State Examination. Patients were interviewed using a semi-structured questionnaire. Differences in proportions of variables were determined by calculating confidence interval and summary chi-squared statistics. P-values of < or =0.05 were considered significant. Majority of patients (87%) were aged 20-49 years with 43% having stayed in the ward for over a month. Structure factors related to patients' perception of care included physical environment, being happy with the way the ward looked was significantly related to satisfaction with care (chi(2) = 5.506, P = 0002). Process factors significantly related to patients' satisfaction with care included nurses providing patients with information on prescribed medicines (chi(2) = 10.50, P = 00012). Satisfaction with care was positively related to ability to recommend someone for admission in the same ward (chi(2) = 20.2, P = 00001). Structure and process factors identified as influencing patients' perception of care were physical environment and nurses' qualities that fit within the characteristics of Peplau's Interpersonal Relations Theory.

Construction industry has been identified as key to the sustainability agenda. Efforts towards improved sustainability compliance in the construction industry involve a socio-technical transformation. Such transitions are said to be purposive, of a wider perspective, multi-dimensional in nature and are influenced by numerous factors. This paper focused on establishing sustainable construction (SC) uptake levels, including identification of key SC drivers and barriers with specific reference to the interior design market segment of the Kenyan construction industry. The study employed a quantitative research approach. For quantitative attributes, the study employed structured questionnaires to collect data from actively practicing architects/interior designers, electrical engineers, mechanical engineers, quantity surveyors and contractors drawn from the interior design market segment of Kenyan construction industry in Nairobi City County. Data analysis employed the descriptive statistics of distribution (frequencies), proportions (percentages), central tendency (mean) and dispersion (standard deviation). Generally, the respondents ranked the overall uptake of the three dimensions of sustainability (economic, environmental and social) as average- ranking as social, environment and economic in a decreasing order of uptake levels. The study findings ranked sustainability driver categories as organization related drivers, stakeholder related drivers, economic related drivers and management related drivers; in order of decreasing influence. Lastly, barrier categories were ranked as economic related barriers, professional/capacity related barriers, technology related barriers and societal/cultural related barriers, in order of decreasing influence. With the average sustainable construction practices uptake in the Kenyan construction industry, there is an implied call to action to leverage known sustainability drivers, while at the same time suppressing the known barriers. This implies significant room for improvement and an appropriate starting point for key construction project stakeholders as above identified.

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

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

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

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

This study investigated sustainability compliance in the Kenyan construction industry focusing on the interior design market segment. This focus was informed by the need to have all market segments involved in sustainable construction endeavours. From past literature, independent variables were identified as sustainability literacy, uptake and assessment with the moderating and dependent variables as market segment peculiarities and sustainable construction compliance respectively. The study had hypothesized, in the alternative, the impact of independent variables individually and jointly on dependent variable in the Kenyan construction industry was above average. The phrase above average was based on threshold which for this study was set at a mean of three [Average]. Additionally, the study sought to assess the extent of independent variables, individually and jointly, as key contributors to sustainable construction compliance in Nairobi City County. The targeted population were key practitioners in the Kenyan construction industry. These were identified as architects/interior designers, electrical engineers, mechanical engineers, quantity surveyors and contractors being the typical core team required for a professionally executed interior design project in Kenya. They have the potential to influence project lifecycle towards improved sustainable construction compliance. Sampling frame was defined as actively practicing key professionals as above identified in Nairobi City County. The Yamane (1967) formula was used to compute sample size which was adjusted for non-response resulting in 60 respondents. For the research instruments, structured questionnaires, appropriate measures were taken to ensure their validity and reliability. Lastly, appropriate research ethics considerations were observed. The unit of analysis and observation was the individual key professional. For data analysis, descriptive statistics were mainly through computation of means and standard deviations and inferential statistics through t-statistic p-value score calculations. Resulting data was presented in form of charts, tables and graphs. Out of the 60 targeted respondents, valid responses were 46 representing a 77% response rate. On hypotheses testing, individually and jointly, sustainable construction literacy, transition/uptake and assessment/evaluation had an above average impact on sustainable construction compliance in the Kenyan construction industry. The findings also established the impact of independent variables on dependent variable in the Kenyan construction industry individually and jointly as above average in Nairobi City County. Additionally, the study highlighted improvement measures for the three independent variables as a means of achieving improved sustainability compliance in the Kenyan construction industry both at policy and practice levels. Recommendations for future research based on the findings of this study were also outlined.

Sixty-four patients atteending the Kenyatta National Hospital psychiatric clinic with minor p.yychiatric disorders were assessed using the Enugu Somatization Scale with a view of eliciting the nature and types of somatic complaints they had. A control group of 66, 5th year medical student, was used. The average scores for the head and body symptoms were 10.9 and 22.1 for the neurotics and 0.9 and 1.5 for the controls respectively. Overall the commonest complaints among the patients were vague, the highest positive scores in order a/frequency being. 'What worries me is not steady." . 3.7%), "parts of my body are out of order" (87.3%), "my whole body is not all right" (87.3%), ':feeling various parts of the body shiver" (85. 7%) and ':feeling dizzy" (84. 1 %). The complaints were not related to age, sex, education, occupation or p,\ychiatric diagno,yis. The average scores for the Kenyan neurotic, were higher than that obtained from the Nigerian (head: 8.14; body: 15.2) and Indian neurotics (head: 8.75: body: 11.78) in previous .ytudies. On the other hand the Kenyan controls had lower scores compared to the other 2 groups. The implication of these findings is discussed.

Objective: To remove or modify fluorotic enamel stains using a combined chemical micro-abrasion and bleaching technique. Design: An in-vivo study was carried out. A sample of 21 participants was randomly selected from patients presenting with brown staining due to flourosis as the chief complaint. Eighty nine teeth were selected based on the Thylstrup-Fejerskov Index [TFI] with a score of 4 as the acceptable maximum. Only upper anterior teeth were included in the study. Setting: The study was undertaken at the University Of Nairobi Dental Hospital, Kenya. Subjects: Patients with an expressed need for treatment of their discoloured teeth who consented to a clearly demonstrated treatment procedure constituted the sample. Results: Enamel discolouration was removed or modified yielding a uniform colour and lustre depending on the initial depth of the stain. All patients appreciated the colour change. Conclusion: A combined chemical micro-abrasion and bleaching technique is a feasible treatment modality in selected cases of enamel fluorosis.

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

Following the death of 67 boys in a fire tragedy at Kyanguli School in rural Kenya, the level of traumatic grief was assessed in a sample of 164 parents and guardians whose sons died in the fire. The study was cross-sectional. Counseling services were offered to all the bereaved parents soon after the tragedy. The subjects were interviewed using the Traumatic Grief Scale. A group of 92 parents/guardians was interviewed 2 months after the event, while the other group of 72 was assessed 7 days later. The second group of bereaved parents also completed the Self Rating Questionnaire (SRQ) and the Ndetei-Othieno-Kathuku scale (NOK). Over 90% of parents from both groups had a yearning for the departed and found themselves searching for him quite often. There was no much difference in terms of symptoms profile or intensity between the two groups. It appears that the counseling offered had minimal impact on the levels of distress.

Objective: To remove or modify fluorotic enamel stains using a combined chemical micro-abrasion and bleaching technique. Design: An in-vivo study was carried out. A sample of 21 participants was randomly selected from patients presenting with brown staining due to flourosis as the chief complaint. Eighty nine teeth were selected based on the Thylstrup-Fejerskov Index [TFI] with a score of 4 as the acceptable maximum. Only upper anterior teeth were included in the study. Setting: The study was undertaken at the University Of Nairobi Dental Hospital, Kenya. Subjects: Patients with an expressed need for treatment of their discoloured teeth who consented to a clearly demonstrated treatment procedure constituted the sample. Results: Enamel discolouration was removed or modified yielding a uniform colour and lustre depending on the initial depth of the stain. All patients appreciated the colour change. Conclusion: A combined chemical micro-abrasion and bleaching technique is a feasible treatment modality in selected cases of enamel fluorosis.

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

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

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

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

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

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

Transcultural psychiatry, whose scientific founder Emil Kraepelin is considered as, in its 100 years of tradition has not only developed a varied range of methods but has also brought about a change in the respective scientific questions as well as in related research and clinical applications. Whereas transcultural research on the psychopathology of depression contributed to the further development of psychiatric nosology, transcultural psychiatry has recently been increasingly faced with issues concerning phenomena of social change and globalization. One region, where such conditions can be observed in particular is Africa, where the dissolving of traditional standards and support systems and growing economic insecurity causes a considerable burden especially on women. As an example, results from a cross-sectional study on East African women using a two step design as well as qualitative and quantitative, standardized psychiatric methods are discussed concerning the association of social change, psycho-social risk factors and the development of depressive disorders. Efficient clinical methods towards diagnosis and treatment of new risk groups will have to be developed, of which an important aspect will be crisis intervention.

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

Objectives: To determine the psychological problems the non-psychiatric doctors commonly encounter, the treatment offered and/or referrals made and to determine any obstacles met in providing psychiatric treatment or making referrals. Design: Cross- sectional survey. Setting: Kenyatta National Hospital, Nairobi, Kenya. Subjects: Doctors working at Kenyatta National Hospital. Results: One hundred and thirty (94 males and 36 females) doctors subm .t .J usable questionnaires. Seventy eight per cent of the respondents were below 35 years and 57 had less than five years experience. The commonest psychiatric disorders seen by doctors were anxiety, depression, psychosomatic disorders and organic psychoses similar to findings in previous prevalence studies. Drugs therapy with anxiolytics antidepressants and antipsychotics were commonly utilised. Brief counselling was the verbal form of treatment most commonly used. Referral to mental health workers was less often done. Obstacles cited by the doctors were the patients' resistance to referral, lack of coordination and insufficient knowledge to treat the disorders. Conclusion: The doctors recognise that psychiatric disorders are common among their patients but they have major obstacles in managing them. These findings are discussed and remedial measures suggested.

The objective of our study is to assess the influence of organizational culture and market orientation on
performance. The population of the study comprise microfinance institutions that are members of the Association of Microfinance Institutions (AMFI) in Kenya. We used descriptive cross-sectional survey design. We collected primary data using structured questionnaire. We test our hypotheses through regression analysis. Our results demonstrate that organizational culture significantly and positively influence variations in performance. The partial mediation effect of market orientation on the relationship between organizational culture and performance was confirmed. The complimentary effect of organizational culture on market orientation implies that organizations need to spend more resources in nurturing market orientation to create sustainable competitive advantage through delivery of superior customer experience. We conclude that the influence of organizational culture and market orientation on performance is more plausible for mature industries regarded as diverse in terms of customer needs.
Keywords: organizational culture, market orientation, performance, microfinance

Objective: To remove or modify fluorotic enamel stains using a combined chemical micro-abrasion and bleaching technique. Design: An in-vivo study was carried out. A sample of 21 participants was randomly selected from patients presenting with brown staining due to flourosis as the chief complaint. Eighty nine teeth were selected based on the Thylstrup-Fejerskov Index [TFI] with a score of 4 as the acceptable maximum. Only upper anterior teeth were included in the study. Setting: The study was undertaken at the University Of Nairobi Dental Hospital, Kenya. Subjects: Patients with an expressed need for treatment of their discoloured teeth who consented to a clearly demonstrated treatment procedure constituted the sample. Results: Enamel discolouration was removed or modified yielding a uniform colour and lustre depending on the initial depth of the stain. All patients appreciated the colour change. Conclusion: A combined chemical micro-abrasion and bleaching technique is a feasible treatment modality in selected cases of enamel fluorosis.

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

Objectives: To describe the psychiatric services offered at Kenyatta National Hospital and the types
of patients and cases seen at Kenyatta National Hospital.
Design: A retrospective study based on case notes and other hospital records.
Settings: Kenyatta National Hospital, Nairobi, Kenya.
Subjects : All patients seen in the various psychiatric clinics and those who attended the Patient
Support Centre Unit in the hospital in the year 2002.
Results : In the year 2002, 598,119 patients were treated at KNH out of which 6,878 (1.15%) were
seen in the psychiatric clinics: 1,709 adults and 1,412 children were referred to the various psychiatric
clinics. At the hospital's Patient Support Centre (PSC) 3,454 patients were seen, mostly for pre and
post-HIV test counselling. Consultations from the wards accounted for 332 (9.6%) of the cases referred
to PSC. The main diagnoses among the latter in order of frequency were alcohol related psychiatric
disorders, acute and transient psychoses, depressive disorders, dissociative and conversion disorders
and dementia.
Conclusion : In view of the high load of acute and transient psychotic states, as well as substance
related disorders, it is recommended that the hospital should establish acute wards for the
comprehensive management of such patients. An alcohol and drug detoxification and rehabilitation
centre should also be developed at the hospital. Services to those with HIV related disorders should also
be improved.

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

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

Normal 0 false false false EN-GB X-NONE X-NONE /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin-top:0cm; mso-para-margin-right:0cm; mso-para-margin-bottom:10.0pt; mso-para-margin-left:0cm; line-height:115%; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;} This study aimed to explore the understanding of and factors in adherence to ARV treatment in people living with HIV and AIDS (PLWHA) who are engaged in harmful alcohol use and to intervene on prioritised factors to improve adherence, using participatory research and action (PRA) methods. We sought to determine the perceptions of and understanding of alcohol abuse and ARV treatment among PLWHA, their peers, family members and health workers. We aimed to increase collaboration between the mental health workers from clinic and hospital level and the community to respond to identified barriers to improve adherence to ARV treatment in PLWHA who use alcohol in a socio-economically deprived urban area in Nairobi (Kariobangi). The work was implemented within an EQUINET programme that aimed to build capacities in participatory action research to explore dimensions of (and impediments to delivery of) Primary Health Care responses to HIV and AIDS. The majority of the PLWHA included in the study were socially disadvantaged, unemployed, and with low education. Social support was equally poor since a large number were widowed, separated or divorced. Most of the PLWHA who participated were single or divorced women, some of them admitted that they sometimes engaged in commercial sex to cater for their basic needs. These factors, together with poor health, limited their economic opportunities and security. In this context, alcohol use, noted by PLWHA, community members and health workers to be prevalent in the community, is not only encouraged by poor living and social conditions, but also by cost (it is relatively cheap) and by the social pressure to use alcohol to escape the mental stress caused by poverty. This is exacerbated by social attitudes that do not discourage alcohol use, and misconceptions that in fact encourage alcohol use, such as that alcohol can kill the HIV virus. This study suggests that the problem of alcohol abuse is poorly recognised for both communities and health workers: It was generally under reported to services, with low numbers of people on ARVs reported to have alcohol related problems, so that health workers see only a small share of the problem. A survey of the local health centres providing ARVs showed that screening for alcohol use was not routinely done and protocols for managing alcohol related disorders were not available. For PLWHA on ARVs, there are already challenges in dealing with the timing, frequency of medication and appointments and the availability and cost of food to support treatment. For PLWHA who use alcohol these difficulties are compounded. There are a range of services in the community that could potentially address these barriers that are involved in nutrition, psychosocial, medical care, PHC, HIV prevention and treatment services, counselling, social, legal, information and referral support for PLWHA. However these do not explicitly deal with the treatment of alcohol and drug related problems in the community or the needs of PLWHA on ARVs who use alcohol, and their adherence to treatment. Reflecting on these problems, the participants implemented a programme of counselling and education. The health workers were taught how to use the AUDIT in identifying problem drinkers and how to recognise and manage alcohol related disorders such as withdrawal fits. The PLWHA and their family members were encouraged to support one another and to identify symptoms of harmful alcohol use among themselves. The process was perceived by those involved to have reduced the harmful use of alcohol in those involved; to have made some improvements in community and health service support; in management of mental health and communication with families and in reducing stigma around alcohol use and HIV. The scores of the PLWHA on the repeat AUDIT questionnaire were however significantly lower than the baseline level.

Due to the widespread calls for the construction industry to adopt sustainable approaches, the various stakeholders are now engaging in the sustainability agenda more than before. This study investigated how the Kenyan construction industry is engaging the sustainability agenda. Specifically, this study sought to establish sustainable construction (SC) literacy levels, key sustainability considerations and SC literacy avenues in the interior design market segment of the Kenyan construction industry. Key project stakeholders in the interior design market segment of the Kenyan construction industry were the target population. A total of 60 (12 architects/interior designers, 12 electrical engineers, 12 mechanical engineers,12 quantity surveyors and 12 contractors) structured questionnaires were distributed, out of which 46 (10 architects/interior designers, 9 electrical engineers, 9 mechanical engineers, 8 quantity surveyors and 10 contractors) were received back. Collected data was analysed using frequencies, percentages, mean item scores (MIS) and standard deviations (SD). The study revealed an average level of sustainability literacy with a composite mean score of 3.7102 and mismatch between SC literacy levels and key sustainability considerations in interior design projects. Additionally, the respondents rated standard SC approaches, legislation, policies and construction trade associations as the least effective contributors to their current SC literacy levels. On the other hand, informal learning, construction professional associations influence, collaboration amongst firms, and formal learning were largely attributed to the respondent’s SC literacy levels. The implication of the findings was that there is need to fine-tune SC literacy drives to the peculiarities of the various industry market segments to ensure their effectiveness in informing practice. Additionally, there is the need to leverage standard SC approaches, legislation, policies and construction trade associations as avenues to improve the overall sustainability literacy levels.

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

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

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

Transcultural psychiatry, whose scientific founder Emil Kraepelin is considered as, in its 100 years of tradition has not only developed a varied range of methods but has also brought about a change in the respective scientific questions as well as in related research and clinical applications. Whereas transcultural research on the psychopathology of depression contributed to the further development of psychiatric nosology, transcultural psychiatry has recently been increasingly faced with issues concerning phenomena of social change and globalization. One region, where such conditions can be observed in particular is Africa, where the dissolving of traditional standards and support systems and growing economic insecurity causes a considerable burden especially on women. As an example, results from a cross-sectional study on East African women using a two step design as well as qualitative and quantitative, standardized psychiatric methods are discussed concerning the association of social change, psycho-social risk factors and the development of depressive disorders. Efficient clinical methods towards diagnosis and treatment of new risk groups will have to be developed, of which an important aspect will be crisis intervention.

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Ampicillin products, 20 capsules, 2 tablets and 23 dry suspensions were evaluated for quality by liquid chromatography at theDrug Analysis Unit University of Nairobi. Four capsule formulations failed limits on content. The Ampicillin content in 5 suspensions dropped below 80% on storage, but had no correlation to decrease in chemical content
 
Ampicillin is semi-synthetic penicillin used in the management of infections caused by sensitive microorganisms. Microbial resistance against ampicillin is well documented and cross-resistance is a common problem among the penicillins. Development of resistance is always associated with exposure of microorganisms to sub-lethal levels of drugs. The quality administered and especially low content of ampicillin in dosage form could therefore contribute to the development of resistance.
 
Work on the quality of drugs in the period 1982 to 1992 has shown presence of poor quality penicillin products in the market [1-4]. This observation was recently reinforced by the findings on quality of phenoxymethylpenicillin syrups [5]. The extensive use of ampicillin in kenya as one of the drugs on the essential drugs list of Ministry of Health [6] led to observed increase in resistance. It was recently replaced by amoxicillin.
 
The communication presents findings on the quality of ampicillian capsules and tablets and dry syrups found on the Kenyan market using liquid chromatography (LC). The preparations were from private and public sources including those submitted to the ministry of Health drug regulatory authority. The latter are intended for marketing in Kenya after registration, and for the purpose of this paper are treated as being on the market.

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Ampicillin products, 20 capsules, 2 tablets and 23 dry suspensions were evaluated for quality by liquid chromatography at theDrug Analysis Unit University of Nairobi. Four capsule formulations failed limits on content. The Ampicillin content in 5 suspensions dropped below 80% on storage, but had no correlation to decrease in chemical content
 
Ampicillin is semi-synthetic penicillin used in the management of infections caused by sensitive microorganisms. Microbial resistance against ampicillin is well documented and cross-resistance is a common problem among the penicillins. Development of resistance is always associated with exposure of microorganisms to sub-lethal levels of drugs. The quality administered and especially low content of ampicillin in dosage form could therefore contribute to the development of resistance.
 
Work on the quality of drugs in the period 1982 to 1992 has shown presence of poor quality penicillin products in the market [1-4]. This observation was recently reinforced by the findings on quality of phenoxymethylpenicillin syrups [5]. The extensive use of ampicillin in kenya as one of the drugs on the essential drugs list of Ministry of Health [6] led to observed increase in resistance. It was recently replaced by amoxicillin.
 
The communication presents findings on the quality of ampicillian capsules and tablets and dry syrups found on the Kenyan market using liquid chromatography (LC). The preparations were from private and public sources including those submitted to the ministry of Health drug regulatory authority. The latter are intended for marketing in Kenya after registration, and for the purpose of this paper are treated as being on the market.

Ampicillin products, 20 capsules, 2 tablets and 23 dry suspensions were evaluated for quality by liquid chromatography at theDrug Analysis Unit University of Nairobi. Four capsule formulations failed limits on content. The Ampicillin content in 5 suspensions dropped below 80% on storage, but had no correlation to decrease in chemical content
 
Ampicillin is semi-synthetic penicillin used in the management of infections caused by sensitive microorganisms. Microbial resistance against ampicillin is well documented and cross-resistance is a common problem among the penicillins. Development of resistance is always associated with exposure of microorganisms to sub-lethal levels of drugs. The quality administered and especially low content of ampicillin in dosage form could therefore contribute to the development of resistance.
 
Work on the quality of drugs in the period 1982 to 1992 has shown presence of poor quality penicillin products in the market [1-4]. This observation was recently reinforced by the findings on quality of phenoxymethylpenicillin syrups [5]. The extensive use of ampicillin in kenya as one of the drugs on the essential drugs list of Ministry of Health [6] led to observed increase in resistance. It was recently replaced by amoxicillin.
 
The communication presents findings on the quality of ampicillian capsules and tablets and dry syrups found on the Kenyan market using liquid chromatography (LC). The preparations were from private and public sources including those submitted to the ministry of Health drug regulatory authority. The latter are intended for marketing in Kenya after registration, and for the purpose of this paper are treated as being on the market.

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Ampicillin products, 20 capsules, 2 tablets and 23 dry suspensions were evaluated for quality by liquid chromatography at theDrug Analysis Unit University of Nairobi. Four capsule formulations failed limits on content. The Ampicillin content in 5 suspensions dropped below 80% on storage, but had no correlation to decrease in chemical content
 
Ampicillin is semi-synthetic penicillin used in the management of infections caused by sensitive microorganisms. Microbial resistance against ampicillin is well documented and cross-resistance is a common problem among the penicillins. Development of resistance is always associated with exposure of microorganisms to sub-lethal levels of drugs. The quality administered and especially low content of ampicillin in dosage form could therefore contribute to the development of resistance.
 
Work on the quality of drugs in the period 1982 to 1992 has shown presence of poor quality penicillin products in the market [1-4]. This observation was recently reinforced by the findings on quality of phenoxymethylpenicillin syrups [5]. The extensive use of ampicillin in kenya as one of the drugs on the essential drugs list of Ministry of Health [6] led to observed increase in resistance. It was recently replaced by amoxicillin.
 
The communication presents findings on the quality of ampicillian capsules and tablets and dry syrups found on the Kenyan market using liquid chromatography (LC). The preparations were from private and public sources including those submitted to the ministry of Health drug regulatory authority. The latter are intended for marketing in Kenya after registration, and for the purpose of this paper are treated as being on the market.

n/a

Ampicillin products, 20 capsules, 2 tablets and 23 dry suspensions were evaluated for quality by liquid chromatography at theDrug Analysis Unit University of Nairobi. Four capsule formulations failed limits on content. The Ampicillin content in 5 suspensions dropped below 80% on storage, but had no correlation to decrease in chemical content
 
Ampicillin is semi-synthetic penicillin used in the management of infections caused by sensitive microorganisms. Microbial resistance against ampicillin is well documented and cross-resistance is a common problem among the penicillins. Development of resistance is always associated with exposure of microorganisms to sub-lethal levels of drugs. The quality administered and especially low content of ampicillin in dosage form could therefore contribute to the development of resistance.
 
Work on the quality of drugs in the period 1982 to 1992 has shown presence of poor quality penicillin products in the market [1-4]. This observation was recently reinforced by the findings on quality of phenoxymethylpenicillin syrups [5]. The extensive use of ampicillin in kenya as one of the drugs on the essential drugs list of Ministry of Health [6] led to observed increase in resistance. It was recently replaced by amoxicillin.
 
The communication presents findings on the quality of ampicillian capsules and tablets and dry syrups found on the Kenyan market using liquid chromatography (LC). The preparations were from private and public sources including those submitted to the ministry of Health drug regulatory authority. The latter are intended for marketing in Kenya after registration, and for the purpose of this paper are treated as being on the market.

We consider a rift valley fever model with treatment in human and livestock populations and trapping in the vector (mosquito) population. The basic reproduction number R 0 is established and used to determine whether the disease dies out or is established in the three populations. When R 0 ≤ 1, the disease-free equilibrium is shown to be globally asymptotically stable and the disease does not spread and when R 0 > 1, a unique endemic equilibrium exists which is globally stable and the disease will spread. The mathematical model is analyzed analytically and numerically to obtain insight of the impact of intervention in reducing the burden of rift valley fever disease’s spread or epidemic and also to determine factors influencing the outcome of the epidemic. Sensitivity analysis for key parameters is also done.