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Web Article
Dr. Kamenju J.; 2019.
Mulwa M. Is Kenya Ready for an MVNO.; 2015.
Waweru JN. Library orientation.; 2014.
Kabugu A, Gikunju M. Open access and the role of the librarian.; 2014.
CT O. HydroMe: R codes for estimating water retention and infiltration model parameters using experimental data.; 2013. Abstract

This package is version 2 of HydroMe v.1 package. It estimates the parameters in infiltration and water retention models by curve-fitting method. The models considered are those that are commonly used in soil science. It has new models for water retention characteristic curve and debugging of errors in HydroMe v.1

Sebastian W, Justus S, Robinson M, Alex O. Promoting photovoltaic energy in Kenya through training.; 2013.
 Kathumo VM, Gachene CKK, Okello JJ, Ngigi M, Miruka M. Using PGIS Reverse Lower Tana River Forest Destruction: Comprehending the Magnitude of Problem, Kenya.; 2012.
Dr. Kamenju J.; 2011.
Ojienda T, Aloo LO. Researching Kenyan Law.; 2011.
O. MAGOMERET, D. OBUKOSIAS, W. PROFMUTITUEUNICE, F O, C. NGICHABE, I. SHIBAIROS. Molecular Characterization of ‘Candidatus’ liberibacter species/strains causing huanglongbing disease of citrus in Kenya..; 2009.
Othieno CJ, Kitazi N, Mburu J, Obondo A, Mathai MA, Loewenson R. Community participation in the management of Mental disorders in Kariobangi, Kenya .; 2008.
OMARI HASSAN. Environmental Ethics in Islam.; 2008.
E. GICHURE, O. AGWANDAC, C. COMBESM, W. PROFMUTITUEUNICE, K. NGUGIEC, B. BERCRAND, P. LASHERMES. Identification of Molecular Markers linked to a gene conferring resistance to coffee berry disease (Colletotrichum Kahawae in Coffee arabica..; 2008.
Kevin Pietersen, Hans BeekmanAllali Abdelkader HGAOEOTADLLS. Africa Environment Outlook2 (AEO2).; 2006.
Bailasha NK, Nteere JS, Rintaugu EG, Wanderi PM. Motivation orientation in sports - A study of athletes in Kenya .; Forthcoming.
Seth D. Goldstein, MD1; Dominic Papandria MD2; ALMDMPH3;, ani Georges Azzies, MD4; Eric Borgstein FRCS5; CMD6; SFMDMPH7; PJMBCB;RG, Mary Klingensmith, MD9; Mohamed Labib10 FLMD; MMMD11; EO’F12; RRMDMPH7;A, Fizan Abdullah, MD PD1. “Innovative approaches to educating the global surgical worldforce: A pilot camparison of online curricula for use in low and middle income countries”.; Submitted.
Matula PD, Sikalie D. Cross- Cultural Management..; 2018.
Hutchinson DM, Andika DD, Kioko DE, Mulwa DR, Isutsa PD, Musieba MF. Role of AIVs in Climate Smart Agriculture. 2016; 2016.role_of_aivs_in_climate_smart_agriculture.pdf
Masinde M. Open Access4D: Battle not won.; 2015. Abstract

The trend is still: “transferring of Northern designs to Southern realities” While 41% of the world’s household have access to the Internet, Africa is lagging far behind at 9%. Africa has abysmal penetration rate for landline telephone, the number of fixed-broadband subscriptions Internet has increased the digital divide.... Africa is slow to take up technological innovation as most have to be imported from elsewhere..” Liam (2009)

Evans W, Nderitu, J., Cheminingwa. management bean pests. Nairobi; 2015.mgt_of_snap_beans_pests.pdf
Gikunju M. Open Access Resources .; 2015.
Gikunju M. Open Access Initiatives .; 2014.
Mutiga J. VALUE ADDITION AND ATTITUDE CHANGE IN LANGUAGE REVITALIZATION: THE CASE OF KITHARAKA. Nairobi; 2014. Abstractvalue_addition_and_attitude_change.pdf

Many studies, including Anchimbe (2007), Whiteley (1974) and UNESCO (1953) have sought to establish that language loyalty or the lack of it does relate to the presence or death of linguistic identity. Further, it has been claimed that it is within the context of language contact that people become aware of the status of their language against another’s language. People may also observe a greater degree of loyalty to the language of an ethnic group to which they do not belong, because of value they may attach to it compared to their own language and the benefits they may deem to accrue by this allegiance. If this state of affairs is left unchecked, the resultant language shift may lead to the death of the less prestigious of the languages in question. A purposeful value addition and attitude change according to Paulston (1994:16-17) will regenerate and reverse the loss and “give new life to a dead language” especially if there is increased use of the language, as a result of change of attitude and increased functions for general communication, literacy and education.
In this chapter I will highlight factors that led to the marginalization of Kitharaka. Further, I will give examples of other currently or formally marginalized languages of Kenya. I will then narrow down to specifically examine and illustrate the role played by literacy and on-going mother tongue education programme in the revitalization of Kitharaka.

Makworo" "NK, O.Ogoy" "D, Mukabana" "RW, Ochieng" "VO. A comparative efficacy study of commercially available insecticides against Anopheles gambiae.; 2013. Abstract

Efficacy of commercially available insecticides from Kenya, Nigeria and South Africa were tested against Anopheles gambiae mosquitoes. Non-blood-fed, 2-5 day old female mosquitoes were liberated into Peet-Grady chambers sprayed with 0.3±0.1g of insecticides. KT50, KT95 and mortality rates of the mosquitoes were noted 24hrs post-spraying. Field efficacy studies were carried out by spraying insecticides in houses with near uniform resting densities of An. gambiae complex mosquitoes. Mosquitoes entering the houses were collected using hand held aspirators, counted and the means calculated. An. gambiae complex mosquitoes were identified using species diagnostic primers. Laboratory results showed Ridsect and Mortein doom ultrafast to be fast acting with KT50 of 0.412 and 0.1983 minutes and KT95 of 4.339 and 5.947 minutes, respectively, among the Kenyan products. Baygon and Mobil had a fast knock down effect with KT50 of 0.415 and 0.551 and KT95 of 3.022 and 3.877 minutes, respectively, among the Nigerian samples. Mortein odorless had a faster knockdown effect with a KT50 of 0.632 and KT95 of 2.576 while Mortein ultrafast had aKT50 of 0.780 and KT95 of 2.654 minutes among the South African Samples. On mortality rates, Mortein doom ultrafast and Ridsect from Kenya achieved 100% mortality, Mortein PowerGard and Raid from Nigeria resulted to 99% mortality and Mortein odorless and Mortein ultrafast from S. Africa had 100% and 99% mortality. The field efficacy tests showed that the most effective products from Kenya, Nigeria and South Africa were Ridsect, Mobil and Mortein Ultrafast, respectively. Molecular identification assays revealed that the wild mosquitoes consisted of 66.34% (71/107) An. arabiensis and 33.66% (36/107) failed to amplify hence could not be identified. Reconstitution of the insecticides with different active ingredients, substitution and optimization of others is recommended. More research on the biology of the malaria vector will help in improving the reconstitution of the insecticides
Key Words: Anopheles gambiae complex, House resting density, KT50 and KT95

Isutsa PDK, Hutchinson DMJ, Otiato DDA, Kioko DE, Muthoka DPN, Mulwa PRMS, Matofari DJ, Musieba MF, Joseph W. KAPAP Vegetables VC proposal 2ND PHASE- 30-10-2013. Nairobi; 2013.kapap_vegetables_vc_proposal_2nd_phase-_30-10-2013.pdf
Nderitu, J., Evans W, Cheminingwa. Management of thrips. Nairobi; 2013.mgt_of_thrips119.pdf
Wasamba P. Storm. Nairobi; 2013.storm.pdf
Wasamba P. Tender Touch. Nairobi; 2013.tender_touch.pdf
Kianji G. SGL 407: Engineering Geology.; 2012.
Kianji G. SGL 412: Seismology.; 2012.
JOAB OOKO. VALUE PREMIUM AND INDUSTRY TYPE: EVIDENCE FROM THE NAIROBI STOCK EXCHANGE. Nairobi: University of Nairobi; 2011. Abstractvalue_premium_and_industry_type_2.pdf

Investors will always want to invest in projects than can guarantee higher returns than others, holding risk constant. They therefore tend to employ strategies that will contribute to the realization of higher returns. One of the most frequently used strategies is value investing where investors purchase value stocks rather than growth stocks in order to be benefit from potential long term performance of value stocks in the form of superior average returns. In finance, the word value premium refers to the excess return expected as a result of investing in value stocks as opposed to growth stocks. This study sought to find out whether there exists a value premium at the NSE when stocks are sorted on the basis of book to market value, and whether
industry type plays a role in value premium. It’s indicative from the study that value stocks outperformed growth stocks for the period under study. This is consistent with other studies done in Kenya. Muhoro (2004) tested a value premium of 0.64 for the period 1999-2002 at the NSE and Ngigi (2006) also tested the existence of value premium at the NSE. The result of the test in this study , conducted at 0.05 confidence level is that there exist value premium at the NSE. When stocks are grouped according to industries, there still exists value premium. Industrial and allied sector have the highest value premium of 4.125 while agricultural sector have the lowest value premium of -1.162. Therefore for a value strategist at the NSE, industrial and allied sector stocks are the best to invest in while agricultural sector stocks are the worst to invest in. The findings are also consistent with findings from similar studies in other markets in the world. Previous studies show that for 60 plus years value has outperformed growth. The conclusion of this study is that there exists a value premium at the N.S.E when stocks are sorted on the basis of B/M ratio . However there exists no significant difference in value premium across industries. This implies industry type is not a significant determinant of value premium.

WAITA SEBASTIAN. Workshop on Research Grant and Project Grant Training on proposal writing. NAIROBI: Elsevier; 2011. Abstract

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Wasamba P. Morning Star. Nairobi; 2010.morning_star.pdf
Wasamba P. Pilgrim. Nairobi; 2010.a_pilgrim.pdf
Wasamba P. Down Me. Nairobi; 2009.down_me-1.pdf
Wasamba P. Immortal.; 2009.immortal.pdf
Omangi HG. Types of Communication.; 2009.
Omangi HG. Types of Communication.; 2009.
Omangi HG. Culture and Conflict.; 2008.
Omangi HG. Culture and Conflict.; 2008.
Owiti L. Kenya's Achievements and Challenges in Implementing the Beijing Platform for Action. Nairobi: Kenya Avancement for the Rights of the Child; 2005.
Iraki XN. Prospects of A Futures Market in Kenya . Nairobi; 1996.
PHOEBE DRODHIAMBOACHIENG. F. A. Odhiambo. UN-HABITAT; 1988. Abstractabstract_1.doc

Inflammation may play an important role in the pathophysiology of sickle cell disease (SCD), and recent studies have identified the 70-kDa heat shock protein (Hsp70) as an important mediator of inflammatory responses. Here we demonstrate a significant increase in circulating serum Hsp70 level in SCD during vaso-occlusive crisis (VOC) as compared with baseline steady-state levels (P <0.05) and a significant increase in Hsp70 levels in SCD at baseline compared with normal controls (P <0.05). Taken together, these results indicate that circulating serum Hsp70 might be a marker for VOC in SCD.

Mungania G. Maudhui Mbalimbali Katika Ushairi wa Mathias E. Mnyampala (Penda-Chako). Nairobi: University of Nairobi.; Forthcoming.
Kiplagat D. STRATEGY FOR THE IMPLEMENTATION AND ADOPTION OF E-PROCUREMENT IN KENYA PUBLIC SECTOR. Wausi D, ed. Nairobi: University of Nairobi; Forthcoming. Abstract

There is strong consensus among researchers and practitioners regarding the strategic importance of developing efficient purchasing techniques to increase transparency and fairness, reduce corruption, ensure competitiveness and reduce costs. An increasing number of government authorities are adopting e-procurement solutions to reap the above stated benefits (Panayiotou et al., 2004). E-procurement is the process of purchasing goods and services electronically , and can be defined as “the use of integrated (commonly web-based) communication systems for the conduct of part or all of the purchasing process; a process that may incorporate stages from the initial need identification by users, through search, sourcing, negotiation, ordering, receipt, payment and post-purchase review” (Presutti,2003).

In this research proposal I propose to comprehensively study through explorative case study five successful cases of e-procurement in the public sector in Korea, Australia, Italy, Ireland, Philippine's and use their experiences, challenges and strategies employed to come up with a multi-disciplinary framework for the successful implementation and adoption of e-procurement in the public sector in Kenya. In this research critical successes factors (CSFs) and diffusion of innovation theory will be used in the study. Explorative case study and qualitative research design methodology will be used in this research study although aspects on the attitude of the intended users will be analyzed quantitatively.

Mungania G. Ufundishaji wa Kiswahili katika shule za upili chini ya mfumo wa 8-4-4 (Kidato cha Kwanza). Anonymous, ed. Nairobi: University of Nairobi.; Forthcoming.
Odhiambo MA. Antimicrobial and phytochemical properties of some medicinal plants used by the Luo community of Kenya.; Submitted. Abstract

The Luo community of Kenya have traditionally used plants for treatment of various disease conditions,
some of which we now know to be caused by microbial infections. Some of these plants, namely Lannea
stuhlmanii, Carissa edulis, Combretum fragrans, Conyza sumatrensis, Ormocarpum trichocarpum, Sida
cuneifolia, Plumbago zeylanica, and Rhoicissus revoilii, were studied. Their ethanol extracts were
screened for their antimicrobial activity against Candida albicans, Escherichia coli, Staphylococcus aureus
and Bacillus pumulus.
Ethanolic root extract of C sumatrensis had good antibacterial activity against E. coli, while extracts of
C fragrans root bark, C edulis root, S. cuneifolia whole plant, R. revoilii tubers and leaf extract of C
sumatrensis in the same solvent had good activity against it. Activity against B. pumulus was observed in
all extracts except those of L. stuhlmanii bark and R. revoilii tubers. Good activity against S. aureus was
observed for C fragrans, S. cuneifolia and L. stuhlmanii.
R. revoihi, L. stuhlmanii, C fragrans and C edulis exhibited good antifungal activity against Candida
Combretum fragrans bark extract had the highest overall antimicrobial activity of all the different plant
extracts examined and was subsequently chosen for further studies. All its ethanol, methanol, ethyl
acetate and chloroform extracts were found to have significant antimicrobial activity.
Combretum fragrans bark powder was found to contain saponins, cardiac glycosides, free anthraquinones
(anthracene glycosides), tannins and flavonoids. However, it had no starch nor alkaloids.
The chloroform extract of C fragrans was subjected to column chromatographic separation and
sitosterol (with stigmasterol as a minor compound) was isolated and identified. Sitosterol was shown to
have antifungal activity against C albicans and antibacterial activity against Escherichia coli.
The results of this work would therefore appear to lend support to the traditional use of Lannea
stuhlmanii, Combretum fragrans, Conyza sumatrensis (tineasis), Plumbago zeylanica, and Rhoicissus
revoilii in disease conditions where microbial infections may be a factor. Use of growth enhancers like
Carissa edulis in combination therapy may be justified on the basis of their immune boosting activity.

Omolo MJ. Assessment Of Knowledge And Attitude On Antiretroviral Therapy Among Nursing Students.; Submitted. Abstract

Title: Assessment of knowledge and attitude on antiretroviral therapy among nursing students. Objective: To assess the knowledge and attitude of final year nursing students at Kenyatta National Hospital. Specific Objectives were to establish the knowledge of nursing students on Anti-retroviral therapy and to determine the attitude of students towards patients who are on Anti-retroviral therapy Method: The study done at Kenyatta National hospital administered questionnaires to 150 students and 138 were found eligible. Data collected was analyzed using STATA. Results: The findings of the study showed that 39.8% of the nursing students had knowledge about Anti-Retroviral drugs; 42% of the students had some ideas while 18% of the students did not have adequate knowledge. Married and older students seemed to have better knowledge on ART compared to young and single Nurses significant at a P-value of 0.033. Attitude towards ART was positive from 34.8% of the students while 65.2% of the nursing students had not expressed their feeling. There was significant association between attitude and sex. Conclusion: This study confirmed lack of adequate knowledge on Antiretroviral therapy among newly qualified nursing students. The study recommended inclusion of HIV/AIDS based units in the basic training of nurses

Njoroge PK. Assessment of parental sex education to own adolescents among parents in a Peri urban community.; Submitted. Abstract

This was a Survey of Parents' Knowledge, Attitude and Practice of sex education to their own adolescents. The study was conducted between January and March in three divisions of Kiambaa Division of Kiambu District, Central Province of Kenya. This study area is located about 20 km from the city of Nairobi. The study population were parents with at least one child in adolescence. Depending on availability either one or both parents were included in the study. The study instrument was structured, mainly pre-coded questionnaire. The data was obtained through personal interviews conducted from house La ho u sc . The sample population was made up of 729 parents, 70.4% of whom were females. The survey found that 46.3% of parents gave sex education to their own adolescents, majority of them giving it to those of their sex only. Parents gave their adolescents sex education from a mean age (of the adolescent) of 10.33 years (SD=3.51) and the practice was associated with Parents Social, Economic and Demographic factors. 'Of these factors, knowledge that own adolescents received sex education from sources other than the parent had highest odds ratio 10R=4.l8). Age of the parent was the only other factor with odds for the practice (OR=.l.03 ). The level of sex education given to adolescents was higher for girls than for boys. The level of practice to boys was associated with age and socio-economic status (SES) inde~ of the parent. Knowledge of sex education among parents was high and associated with a parents' sex and SES index. Males scored signi ficantly higher than females and parents of Jow SES scored significantly higher than those of high SES index. The attitude to sex education was positive, with nearly all parents feeling that sex education for adolescents was appropriate and that it should be given by own parents, starting from a mean age of 10.61 years (SD=2. 84) and that it should include contraceptive education. The study recommended further studies on parents to understand why the level of practice is unmatched with the high levels of knowledge and attitude and to determine why those parents who know that their adolescents receive sex education from other sources are more likely to give sex education to their adolescents than those who did not. 'Other recommendations were: a study to assess the feasibility of using PTA' s to impart sex education to adolescents in schools, beginning Family Life education in primary schools at standard four (corresponding to age .10-11 years),and establishing of community based centres for sex education counselling for parents with adolescents and adolescents out of school.

Qureshi ZP. Case Records and Commentaries.; Submitted.
Akama MK. Current pattern of road traffic accidents, maxillofacial and associated injuries in Nairobi.; Submitted. Abstract

Objective: To describe the characteristics and pattern of maxillofacial and concomitant injuries sustained in Road Traffic Accidents (RTAs).
Study Area: Kenyatta National Hospital (KNH).
Study Design: A descriptive cross sectional study including all patients involved in RTAs
brought to casualty and dental departments of KNH as well as accident victims admitted to the
KNH mortuary over a four- month period from September 2004 to December 2004.
Results: A total of 482 people involved in RTAs were included in the study. Four hundred and
thirteen (85.7%) had non-fatal injuries whereas 69 (14.3%) had sustained fatal injuries.
Nonfatal injuries. The 21-30-year-old age group was the most affected. The male to female ratio
was 4:1. Day time injuries were recorded among 60.3% of the participants. The incidence of
RTAs was highest on Fridays. There were 245 (59.5%) pedestrians and 139 (33.7%) passengers
involved. Most accidents were caused by passenger service vehicles (matatu) which were
responsible for 256 (62%) casualties whereas private saloon cars were involved in 150 (36.3%)
cases. Non- use of safety belts was reported in 90 (56.6%) cases whereas over-speeding was
reported by 120 (29.1 %) casualties. Alcohol use by drivers was reported in 26 (6.3%) cases
whereas vehicle defects accounted for 62 (15%) cases.Three hundred and seventy (89.6%)
casualties had soft tissue injuries (STls) involving the craniofacial region with facial cuts being the
majority (69.2%). Two hundred and seventy three (66.1 %) incidents of other STls than those of
the head region were noted, the lower limbs accounting for 45.4% of these. Only 5.1% of the
casualties had fractures involving the maxillofacial skeleton. Skeletal injuries other than those
involving the maxillofacial region were found in 142 (34.1%) incidents. The lower limbs were
more affected with 61 (43%) incidents followed by the upper limbs (24.6%). Pedestrians were
most involved in sustaining skeletal injuries than other categories of road users.
Fatal RTAs: Sixty nine (14.3%) of the 482 participants were fatally injured. The 21-30- year-old
age group was the most affected (20%). The male to female ratio was 3.3:1. Matatus and minibuses
were the leading cause of fatal accidents together having been responsible for 28 (40.6%) of
the accidents. Pedestrians (71.4%) were by far more involved than other categories of road users.
Most participants had multiple injuries with chest injuries having been the most common (50
cases). Fourty six (66.7%) victims had injuries to the head region with subdural haemorrhage
having been the commonest injury found at autopsy (47.8%). Injuries to the chest were found in
fifty (72.2%) victims whereas abdominal and limb injuries were recorded in 42 (60.9%) and 34
(49.3%) victims respectively. Head injury alone was the leading cause of death (37.7%) followed
by head and chest injuries combined (13.0%)
Conclusion: The majority of people involved in RTAs were in their third decade of life with
males having been the predominant group affected. Pedestrians were the leading casualties
amongst road users. Most of the accidents were caused by passenger service vehicles. The lower
limbs sustained most soft tissue and skeletal injuries compared to other anatomic sites other than
the craniofacial area. The leading cause of death was head injury.

Olang' POR. Effects of Spinal Anesthesia during Elective Caesarean Section on Neonatal outcome at the Kenyatta National Hospital.; Submitted. Abstract

Utero-placental circulation and hence fetal well-being depends on maternal blood pressure.
Spinal anesthesia for cesarean section causes sudden and severe drops in blood pressure thus
threatening fetal and neonatal acid-base balance. Several protocols have been formulated to
prevent maternal hypotension but none has been shown to totally eliminate this risk.

This was a prospective non-randomized descriptive study that adopted a consecutive sampling
method. All eligible ASA (American Society of Anesthesiologists) I and ASA II mothers slated
for elective cesarean section at the Labour Ward of The Kenyatta National Hospital in Nairobi
were visited in the ante-natal ward the day or night before surgery and an informed consent
obtained for inclusion in the study. Any pre-selected mother who ended up needing emergency
surgery or changed her mind about inclusion in the study was excluded. Similarly, any willing
mother who did not qualify for spinal anesthesia was excluded from the study.
A sample size of 172 cases was taken and this required approximately 15 weeks of data
collection. Maternal blood pressures were recorded every minute until delivery. Immediately
after delivery, a section of the umbilical cord was clumped with 2 clumps. Umbilical arterial and
venous blood samples were collected in heparinized syringes and taken to the laboratory within
one hour of collection and analyzed for blood gases and pH as a measure of foetal! neonatal
compromise. Apgar scores were also noted at birth and after 5 minutes and later correlated with
the cord blood gas analyses and maternal blood pressures.
The anesthesia provider was requested to complete a data sheet which was then collected by the
principal investigator on the same day the surgery was performed.
Data analysis was done using SPSS software version 16.0 and presented in the form of tables,
graphs and charts.

A total of 172 patients were successfully recruited into the study and the total number of
umbilical cord blood samples analyzed (both arterial and venous) was 316. 28 blood samples
clotted and were not available for analysis.
43 babies (27.2%) were born with neonatal acidemia defined as umbilical arterial blood pHS 7.2.
There was, however, no significant relationship between neonatal acidemia and low Apgar
scores; neither was there a significant relationship between low Apgar scores and maternal
hypotension. 104 patients (65.8%) had a wedge inserted under the right hip as recommended for
prevention of aorto-caval compression. There was, however, no significant difference in the
incidence of maternal hypotension among those with a wedge and those without. Vasopressors
were used in 84 patients (53.2%). These included the use of ephedrine alone or epinephrine
alone or a combination of the two in the process of treating or preventing maternal hypotension.
The use of Va sopressors resulted in significantly fewer incidences of hypotension (p=0.018). The
use of preload with crystalloids before induction of spinal anaesthesia was noted to be
significantly related to the use of Vasopressors whenever the volume of preload was less than
500mls (p=0.027). Similarly, maximum levels of spinal block above T6 resulted in significant
incidences of maternal hypotension (p=O.OO1). Maternal height < 155cm did not have any
significant effect on the incidence of maternal hypotension.

Maternal hypotension can lead to poor neonatal outcome due to its effects on placental perfusion
and hence foetal oxygenation. This study has shown that vasopressor use during spinal
anaesthesia effectively minimizes the incidence of maternal hypotension. Crystalloid preload of
over 500mls is effective in preventing or moderating maternal hypotension.
A well conducted spinal anaesthetic for caesarean section with meticulous control/management
of adverse effects results in healthy neonates and mothers

Githaiga JW. Evaluation of diagnostic peritoneal lavage and needle paracentesis in the management of penetrating and blunt abdominal trauma, at Kenyatta National Hospital.; Submitted. Abstract

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

Indalo DM. Factors Affecting Patients Retention And Defaulter Rates In An Anti-retroviral Therapy Program.; Submitted. Abstract

The purpose of this research was to determine patients' retention and associated factors in the Antiretroviral Therapy (ART) program. Specifically, it establishes factors that contribute to patients' retention and recommends the appropriate strategies that enhance sustainable retention of patients in the ART program. The case studies were carried out at Kibera Community Based Health Care project/clinic - AMREF intervention area in Kibera slum
A descriptive cross-sectional method was employed aimed at collecting information from the patients in the program through random sampling, while stratified sampling was used to pick on defaulters, who were traced by Community Health Workers as well as key informants. A representative sample constituted 357 patients in the ART program, 27 defaulters and 8 Health Care Providers of the total population of patients in the program. Quantitative data was collected using a standardized questionnaire administered to the study participants in the program and defaulters. Qualitative data
was obtained through; focus Group Discussion and Key informants interviews. Ethical consideration and risk to human subjects was put into consideration, through provision of willing consent and confidentiality upheld at all times.
The study reveals that AMREF in Kenya, Kibera project continues to playa leading role in the fight against HIV/AIDS. A majority of the respondents (69%) confirmed to have disclosed their HIV status to someone while 31% were categorical that they have not disclosed their status to anyone. It is imperative to point out that disclosure levels were high (88%) amongst respondents in the 51-55 years age group and closely followed by those in the 41-45 years age group (77%). The study also found out that 49.5% of the respondents were on the affirmative that indeed they find it easy discussing their challenges with their clinicians, while 50.5% noted that they do not find it easy. It is
interesting to observe that the challenges of side effects related to ARV are more pronounced amongst those who skip appointments at the clinic compared to stigma and lack of food. A considerable number (15%) of the respondents noted that they like the clinic as it provides free ARVs while 4% lauded the good counseling services offered at the clinic. Some 3% liked the facility as it was near to their areas of residence. Asked to state the reasons why they would prefer other ART clinics, most of the respondents (63%) pointed to the distance from their areas of residence, 14% made reference to the quality of services while 8% explained that they would prefer other clinics if they offer food supplements as part of the program.
In conclusion psycho-social counseling appeared the most preferred service in the facility, it enforces adherence to medication and also reduces stigma related condition among the patients and those around them. MSF Belgium clinics were most preferred clinic in Kibera slum; AMREF Kibera project management should consider exchange visits to their sites and learn from each other. The study detects that there is a cross cutting call from the study approach that an ideal ART programme should provide comprehensive care and support (37%) and offer free medical care (15%) to enhance
accessibility besides integrating PTC (7%) among others as captured from the interviews with defaulters. Service delivery it was suggested should also be done professionally without unethical and coercive practices such sexual harassment among other malpractices that accentuate default.
AMREF Kibera project should consider to networking and collaborating with other organizations that are working in informal settlement to learn and share best practice to enhance adherence to ART care. Address the attitude of health care providers in the facility through trainings, supervision and assessment of care. The project should also review its approach to ART care and through operation research to boost ART care in marginalized communities in the informal settlements.

Mbunya NN. Factors hindering paediatric ward nurses from using nursing care plans at Kenyatta National Hospital.; Submitted. Abstract

Factors Hindering Paediatric Ward Nurses from Using Nursing Care Plans at Kenyata
National Hospital (KNH)
BACKGROUND: Documentation is an essential and integral part of quality nursing care.
A nursing care plan best suits this purpose because it combines holistic and scientific
approach to patient care. Further, it communicates and supports continuity of care though
minimally used by nurses.
OBJECTIVE: The aim was to identify factors hindering paediatric nurses from using
nursing care plans.
METHOD: This cross-sectional descriptive study was conducted from June to August 2007
at KNH. It used a random sample of 7 in-charge and 100 non in-charge nurses who filled a
self-administered close-ended questionnaire. Pearson product-moment correlation was used
to assess the association between variables with a P value set at 0.05.
RESULTS: Only 2% nurses were utilizing care plans. The characteristics of the nurse (i.e.
age: r = .026, p= .796 ; qualification: r = .007 , p= .941 and years of service: r = .135 , p=
.181 ), nursing work (i.e. workload: r = .099 ,p = .328 and stress: r = -.027 ,p = .786) and
nursing administration (i.e. staffing: r = .192 ,p = .680 and care plan policy: r = .277 ,p =
.547) had a non significant linear relationship with utilizing care plans. The linear
relationship between familiarity with the care plan content (r=.198, p= .049)) and its use
was statistically significant whereas ease to update a care plantr = .013, p = .897) was not.
CONCLUSION: Further research is indicated to determine hospital-specific factors
predicting non-use of care plans in order to address them with aim of popularizing their
use. This will go a long way to enrich the four main areas of nursing: Research, Education,
Administration and Teaching.

Dulo, Simeon, Otieno;, Odira P(S)PM. Impact of poor solid waste management in Kenya on groundwater .; Submitted. Abstract

One of the most obvious impacts of rapid urbanization and economic development can be witnessed in the form of uncollected municipal solid waste. The study reports on solid waste management in selected towns in Kenya. It reviews the collection, handling, policy support, institutional development, private sector involment, user participation, technical development and waste management. The study revealed that the urban councils were grappling with challenges of preventing environmental degradation due to non-systematic solid waste management and the impetus in pollution control was rather slow and seems to be mostly crisis driven.

Nyamu DG. Knowledge on diabetes mellitus among diabetic patients attending Kenyatta national hospital outpatient clinic.; Submitted. Abstract

Background: Diabetes mellitus (DM) is a disease that has significant morbidity and mortality worldwide resulting from complications arising from poor control. 1,3
There is no local data to show the level of diabetic patients' knowledge on this disease at KNH, an important aspect in DM management. In the present cross-sectional study, determination of the diabetic patient's knowledge of his/her disease was undertaken for the first time at KNH.
Study Objectives: To determine the proportion of KNH DM outpatients with adequate knowledge on the disease and to determine the level of provision of diabetic education to the DM outpatients.
Study design: This was a descriptive cross-sectional study from September 2007 to January 2008.105 DM patients (above 18 years) who had given informed consent were interviewed to determine the level of their knowledge on OM and hence the proportion of respondents with adequate knowledge. Codes were manually assigned to all questions and the respective answers. Five randomly selected KNH OM OPO healthcare providers were also interviewed to determine the level of KNH preparedness in the provision of diabetic education to the OM outpatients. A sequential sampling procedure was used to interview the diabetic patients. Every Wednesday during the course of the study one different OM healthcare provider was picked and interviewed.
Data Analysis: The data obtained were captured using Epi-data computer software which was then exported to SPSS version 15.0 for analysis. Statistical significance was determined using the Pearson Chi Square at p<0.05, at 95% confidence limit. Results: 105 diabetic patients aged 18 years and above were interviewed; 53(50.5%) were males and 52 (49.5%) females. The age categories 18-30, 31-40,41-50, 51-60, 61-70 and above 70 years accounted forl2 (11.4%), 24 (22.9%), 21 (20.0%),21 (20.0%),22 (21.0°) and 5(4.8%) OM patients respectively. The highest education levels; College/University, Secondary, Primary and Non-formal accounted for 27(25.7%), 42(40.0%), 25(23.8%) and 11(10.5%) DM patients respectively. 52 (49.5%)patients had sufficient knowledge on the diabetes mellitus disease itself, 64(61%) on DM complications, 35 (33.3%) on DM medications, 84 (80%), on the importance of dietary control, 73 (70%) on the importance of doing exercises and 11 (10.5%) on the importance of DM Affiliate Associations.
Patients with highest academic level had the highest proportion of patients with adequate knowledge on the disease (p=O.OOO 1), dietary control (p=O.O 1) and exercise (p=0.03). Patients' age influenced the proportion of patients with adequate knowledge on OM complications (p=0.03). The study also showed that diabetic patients' education was conducted mainly verbally at OPO clinic once a week for two hours and only one healthcare provider conducted the training at each education session though the number of staff was ten. Conclusion: Patients were mainly taught verbally. Two-thirds to three-quarter of the patients had sufficient knowledge on the OM disease, importance of dietary requirements and exercise programs.90% of patients had insufficient knowledge on diabetes organizations and two-thirds on rational use of DM medications. Recommendation: Hospital's training and education on rational use of DM medications should be improved. The hospital should make the healthcare providers and the DM patients aware of the DM' associations for patients' benefit. More research involving larger samples over longer periods should be carried out in order to reflect what happens over a longer period of time.

Omonge E;, Kyateesa; J, Otieno FCF;, Kayima, Lule G;, McLigeyo AA. Metabolic factors associated with the development of lipodystrophy in patients on long-term highly active anti-retroviral therapy (HAART).; Submitted. Abstract

Dyslipidemia, insulin resistance and diabetes are frequent in patients on highly active anti-retroviral
therapy (HAART) and especially in patients with lipodystrophy, and may lead to atherosclerosis. This
study described the metabolic alterations associated with lipodystrophy in adults on chronic HAART in
Kenya. The prevalence of dyslipidaemia amongst the study participants was (211) 79.6%. Elevated total
cholesterol was found in 129, high low-density-lipoprotein cholesterol (LDL-C) in 107, low High-density
lipoprotein cholesterol (HDL-C) in 110 and high triglycerides in 131 participants. Lipodystrophic
patients were more likely to have dyslipidemia than normal lipids (55.4 versus 35.1%, p = 0.007 OR 2.2
CI 1.3 to 4.6) with 57, 45.9, 65.9 and 45.2% having elevated total cholesterol, elevated LDL-C, elevated
triglycerides and low HDL-C, respectively. Hypertriglyceridemia and hypercholesterolemia were
significantly associated with lipodystrophy (OR 3.8 CI 2.3 to 6.4; p = 0.000) and (OR 1.94 CI 1.2 to 3.2; p
= 0.008), respectively. The odds of lipodystrophy was 2.913 times higher for patients with elevated
triglycerides than for those with normal triglycerides (p < 0.001). Sixty-four (24.3%) participants had
dysglycemia, with 3.5% having diabetes and 20.8% having impaired fasting glucose (IFG). Among
patient with lipodystrophy, 69.8% had normal fasting glucose, 25.1% had IFG and 5.1% were diabetic.
Lipodystrophic patients were not more likely to have abnormal blood sugars than normal blood sugars
(p value 0.125).

Kayima, Joshua Kyateesa; McLigeyo AA, Omonge E;, Omonge E;, Otieno FCF;, Lule G;, McLigeyo AA. Metabolic factors associated with the development of lipodystrophy in patients on long-term highly active anti-retroviral therapy (HAART).; Submitted. Abstract

Dyslipidemia, insulin resistance and diabetes are frequent in patients on highly active anti-retroviral
therapy (HAART) and especially in patients with lipodystrophy, and may lead to atherosclerosis. This
study described the metabolic alterations associated with lipodystrophy in adults on chronic HAART in
Kenya. The prevalence of dyslipidaemia amongst the study participants was (211) 79.6%. Elevated total
cholesterol was found in 129, high low-density-lipoprotein cholesterol (LDL-C) in 107, low High-density
lipoprotein cholesterol (HDL-C) in 110 and high triglycerides in 131 participants. Lipodystrophic
patients were more likely to have dyslipidemia than normal lipids (55.4 versus 35.1%, p = 0.007 OR 2.2
CI 1.3 to 4.6) with 57, 45.9, 65.9 and 45.2% having elevated total cholesterol, elevated LDL-C, elevated
triglycerides and low HDL-C, respectively. Hypertriglyceridemia and hypercholesterolemia were
significantly associated with lipodystrophy (OR 3.8 CI 2.3 to 6.4; p = 0.000) and (OR 1.94 CI 1.2 to 3.2; p
= 0.008), respectively. The odds of lipodystrophy was 2.913 times higher for patients with elevated
triglycerides than for those with normal triglycerides (p < 0.001). Sixty-four (24.3%) participants had
dysglycemia, with 3.5% having diabetes and 20.8% having impaired fasting glucose (IFG). Among
patient with lipodystrophy, 69.8% had normal fasting glucose, 25.1% had IFG and 5.1% were diabetic.
Lipodystrophic patients were not more likely to have abnormal blood sugars than normal blood sugars
(p value 0.125).

Onyambu CK. The pattern of chest radiographic findings in immunocompromised patients at the Kenyatta national hospital.; Submitted. Abstract

The pattern of chest radiograph findings were studied in 280 HIV positive individuals.
These were compared to 40 HIV negative patients who acted as controls. The
commonest disease seen was pneumonia 94 (33.9%), followed by pulmonary
tuberculosis 89 (3l.7%). Mixed infections were seen in 34 (12.2%) cases while PCP
occurred in 16(5.6%) cases. The pneumonia seen was more of bronchopneumonia than
lobar pneumonia in-patients with HIV (33.9) than HIV negative patients (23%).
The cases of pulmonary tuberculosis seen showed less upper lobe distribution than in
HIV negative patients. Most of the cases showed mid and lower zone distribution.
There are less cavitations than HIV negative patients. Also more cases with hilar and
mediastinal nodes were seen. There were 34 (12.2%) cases of mixed infection, which
constituted of 3 (1.1 %) cases of non-Hodgkin's lymphoma. These mainly presented
with hilar and mediastinal nodes. The clinical differentiating features were KS skin
nodules in-patients with pulmonary K.S.

Kilonzo BM. A Plastic Anaemia At The Kenyatta National Hospital During The Period 1973-1978.; Submitted. Abstract

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

Chepchirchir A. Primary school children in Kibera, Nairobi, Kenya.; Submitted. Abstract

Study objective was to determine the prevalence and etiology of dermatophyte
infections and establish the relationship between type of infection and age and gender
of the primary school children in Kibera during the period between September 2006
and January 2007.
Study design, was a cross- sectional descriptive study that focused on the prevalence,
distribution and species differentiation of the causative agents of dermatophytosis in
city council sponsored primary schools in Kibera, Nairobi.
The setting. The study was conducted in Kibera, the largest of the informal
settlements within the capital city, Nairobi which is home to between 700-1,000,000
Subjects. The study targeted primary school children from the ages of 5 years to 15
years from four government sponsored primary schools namely Olympic, Kibera,
Ayany and Mbagathi Way. A sample of 424 pupils was selected from a population of
8904 pupils in the four schools.
Materials and Methods. The pupils responded to questions from a structured
questionnaire that was prepared to elicit socio economic and demographic data from
the participants. Physical examination was carried out on every participant to
determine presence of skin infection. Photography was done for those with skin
lesions and specimens collected from the infected sites. The specimens were
processed in the mycology laboratory to determine the etiological agents of the skin
Results. From the participants, 11.2% had ringworm infection with tinea capitis
being the commonest type while the grey patch type was the dominant clinical
The distribution of ringworm among schools was statistically significant with
Olympic primary school registering the highest ratio of those infected to those not
Both male and female pupils within the age bracket of 6-8 years were significantly
infectedthan other age categories. Infection rate decreased with increase in age.
(p= 0.002)
Gender related prevalence was statistically significant with girls registering more
infectionsthan boys in their categories. (P=O.033)
All the three genera of fungi associated with dermatophytes were isolated with a number
of species namely T violecium (35), T mentagrophytes(3), T terestre(3), T
schoenleinii(2), and T interdigitale( 1), M canis(2), M. equinum( 1), E. jlocossum(1).
T. violecium was the predominant species isolated, at (35)71% followed by T.
mentagrophytes and T terrestre at (3)6% each.
Conclusion: The study shows a high prevalence of 11.2% dermatophyte infection among
the school children in this locality. Contributing factors to the high frequency and chronic
occurrences of ring worm in this area include poor living environment, children
interaction patterns and poor health seeking behaviour. There is need for health education
to create awareness among the communities in urban informal settlements to seek
treatment and improve on hygiene to reduce the prevalence of these infections.

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