Maintaining Africa's water infrastructure: findings from a Water Audit in Kitui County, Kenya (REACH Policy brief)

A lack of information about previous investments and current status of infrastructure creates a challenge for those responsible for water service provision. REACH’s work in Kitui County, Kenya, aims to address this information deficit by providing a detailed inventory of rural and small town piped water schemes. The first step is piloting a Water Audit methodology that can be used county-wide. This policy brief presents results of an audit of infrastructure in one sub-county of Kitui County and outlines the implications for attaining universal service delivery

TO ESTABLISH PEER SUPPORT STRATEGIES FOR DECREASING OUT-OF-SEAT BEHAVIOUR FOR LEARNERS WITH AUTISM SPECTRUM DISORDERS IN SPECIAL SCHOOLS, EMBU COUNTY, KENYA

The study sought to establish peer-support strategies used in decreasing out-of-seat behaviour for learners with Autism Spectrum Disorders in special schools, in Embu County, Kenya. The study used Abraham Maslow's hierarchy of needs. This theory states that the motivation of human needs is acquired at different levels. The study adopted a survey research design. The study target population were 25 headteachers, 48 teachers, 65 parents and 5 EARCS from 2 special schools and 23 special units in Embu County. Purposive sampling was employed. The sample size constituted 20% of 25 schools, 5 head teachers, 32 teachers, 10 parents, and 5 EARCs translating to 62 respondents. Questionnaires were used to collect data from the headteachers and teachers, an interview schedule was conducted on parents/guardians and an observation checklist was used to observe learners with Autism Spectrum Disorders in class. Piloting was done at St. Monica School for Intellectual Disabled to enhance the validity and reliability of the research instruments. Data were analysed using Statistical Package for Social Sciences (SPSS) computer presented program and findings were presented in form of frequency distribution tables, bar graphs and pie charts. Findings of the study revealed that most teachers have existing self-management techniques aimed at reducing out-of-seat behavior. The pupils were generally happy with the techniques the teachers had set together. Similarly, the teachers were happy to carry out the existing peer support techniques to reduce out-of-seat behavior. Most teachers strongly agreed that by observing what peers do, children develop self-efficiency. The study concluded that the use of peer support strategies play a significant role in behaviour change among children with ASD because the strategy enables them to come together, share experience and decide on solutions to a common challenge. The study recommended that the Ministry of Education should put in place measures to compel schools through monitoring and capacity building such as training to ensure that SNE learners’ are appropriately placed. The government should allocate extra funds to public primary special schools to help them procure materials for SNE learners to prepare the schools for the implementation of SNE curriculum. Further research should be carried out in all counties in Kenya on peer-support strategies for decreasing out-of-seat behaviour in learners with Autism Spectrum Disorders. Similarly, other areas regarding learners with Autism Spectrum Disorders should be explored.  Article visualizations

Uncontrolled hypertension among patients with comorbidities in sub-Saharan Africa : protocol for a systematic review and meta-analysis

Background Uncontrolled hypertension is the most important risk factor and leading cause of cardiovascular diseases. It is predicted that the number of people with hypertension will increase, and a large proportion of this increase will occur in developing countries. The highest prevalence of uncontrolled hypertension is reported in sub-Saharan Africa, and treatment for hypertension is unacceptably low. Hypertension commonly co-exists with comorbidities and this is associated with poorer health outcomes for patients. This review aims to estimate the prevalence of uncontrolled hypertension among patients with comorbidities in sub-Saharan Africa. Methods and analysis All published and unpublished studies on the prevalence of uncontrolled hypertension among patients with comorbidities in sub-Saharan Africa will be included. MEDLINE via OVID, Embase, and Web of Science will be searched to identify all relevant articles published from January 2000 to June 2019. Experts in the field will be contacted for unpublished literature, and Open SIGLE will be reviewed for relevant information. No language restriction will be imposed. Two reviewers will select, screen, extract data, and assess the risk of bias while a third reviewer will arbitrate the disagreements. A meta-analysis will be performed on variables that are similar across the included studies. Proportions will be stabilized before estimates are pooled using a random effects model. The presence of publication bias will be assessed using Egger’s test and visual inspection of the funnel plots. This systematic and meta-analysis review protocol will be reported in accordance with the PRISMA-P protocol guidelines. Results will be stratified by country, comorbidity, and geographic region

Using Intermittent Sand Filters of Various Depths to Remove NH3-N, NO3N and NO2N from the Wastewater of Sugar Milling Factory

Intermittent sand filter systems have been used in wastewater treatment according to Selecky (2012) especially their application for on-site wastewater management. Intermittent sand filters have not been used to treat effluent from sugar factories in Kenya. There is very limited information on how to optimize their application in treating effluent from sugar factory in Kenya. This study focused on optimization of intermittent sand filter used in treatment of wastewater from sugar factory. Samples of wastewater were randomly taken from Kibos Sugar and Allied factories. These samples were loaded into sand filters with different sand depths of 0.30, 0.45 and 0.60m. Different loading rates, volumes and frequencies were applied for each depth. Samples from the filtrate were collected and analyzed in the laboratory for NH3-N, NO3-N and NO2-N values. The data was subjected to analysis of variance for fractional factorial (ANOVA) using the GenStat Version 13.2 computer programme. Wastewater generated from the sugar factories had NH3-N, NO3-N and NO2-N were within the WHO acceptable limits. The sugar factory managers targeting to remove NO3-N should use a sand filter with a depth of 0.45m by loading it at a rate of 2L/min, volume of 30L and frequency of 12hrs. To remove NO2N using a sand filter of 0.45 m deep, they should use a loading rate of 4L/min, loading volume of 10L and loading frequency of 12hrs. Keywords: Effluent, factory, filter, intermittent, sand, sugar, wastewater

Effects of vitamin D deficiency on neurobehavioural outcomes in children: a systematic review [version 1; peer review: 2 approved]

Introduction: Vitamin D plays an important role in brain development in experimental studies; however, the effect of vitamin D deficiency on child development remains inadequately characterized. We aimed to estimate the effects of vitamin D deficiency on neurobehavioural outcomes in children up to 18 years of age. Methods: We searched PubMed, EMBASE, PsycINFO, Scopus, Cochrane Library, Web of Science and Open Grey for published studies up to 10th January 2020. We included all studies that assessed the effects of maternal or child vitamin D status or vitamin D supplementation on neurobehavioural outcomes in children. Study findings were synthesized qualitatively as the high level of heterogeneity in study populations and methodologies precluded a quantitative meta-analysis. Results: Our search identified 5,633 studies, of which 32 studies with 31,445 participants from 18 countries were included in the systematic review. Of the studies identified, two were randomized controlled trials (RCTs) of vitamin D supplementation in children, while 30 were observational. One RCT (n=55) reported a beneficial effect of supplementation with lower doses compared to higher doses of vitamin D on motor development while the other RCT (n=70) found no beneficial effect of vitamin D supplementation on cognition in extremely preterm infants. Twelve mother-child studies (n=17,136) and five studies in children (n=1,091) reported an association between low maternal or child 25-hydroxyvitamin D levels and impaired neurobehavioural outcomes in children, while 15 mother-child studies (n=20,778) and eight studies in children (n=7,496) reported no association. Conclusions: Although animal studies point to an effect of vitamin D deficiency on brain development, there are few studies on the effects of vitamin D deficiency on neurobehavioural outcomes in children and their findings are inconsistent. There is a need for well-conducted, adequately powered studies to further determine these effects in children. Registration: PROSPERO ID CRD42018087619 ; registered on 15 February 2018

Factors influencing smallholder farmers’ inputs use in major bean production corridors in Kenya

This study analysed socio-economic determinants for inputs use in major bean corridors in Kenya. It comprised 417 respondents sampled from four major bean corridors. A structured questionnaire was used in data collection. Probit model was used to assess determinants of input use among the bean-farming households. From the results, 74% of respondents were male with a mean age of 48.6 years. The probability of using agricultural inputs increased with education level and income from crop sales. Fertilizer was mainly used in Bomet (73%) and Narok (74%) counties. Eighty-five percent planted recycled seeds. Education level and Income from crops positively influenced inputs use. It was concluded that education level, incomes from sale of crops, livestock and livestock products, and farm income influenced use of inputs. As a recommendation, Capacity building on merits of input use and promotion of public-private partnerships to strengthen input supply system would enhance increased input use by smallholder farmers.Keywords: Bean, inputs, determinants, Keny

Optimizing the Emitter Layer for Higher Efficiency Solar Cell Based SiGe Using AMPS1D

The thin-film SiGe is considered as promising candidate to meet the outstanding need for photovoltaic applications with enhanced adsorption characteristics and improved conversion efficiency [1-6]. In this paper, we simulated a solar cell type SiGe using AMPS1D (Analysis of Microelectronic and photonic structure) developed at Pennsylvania State University, to analyze emitter layer (thickness, doping) and we studied their influence on the photovoltaic solar cell. The simulation result shows that the maximum efficiency of 16.181 % has been achieved, with short circuit current density of 32.657 mA/cm2, open circuit voltage of 0.61 V and fill factor of 0.809. The obtained results show that the proposed design can be considered as a potential candidate for high performance photovoltaic applications

Sensitivity And Specificity Of Hiv Rapid Tests Used For Research And Voluntary Counselling And Testing

Background: HIV rapid tests (RT) are a quick and non-technically demanding means to perform HIV voluntary counselling and testing (VCT) but understanding their limitations is vital to delivering quality VCT. Objective: To determine the sensitivity and specificity of HIV rapid tests used for research and voluntary counselling and testing at four sites in East Africa. Design: Cross-sectional study. Setting: Masaka District, Uganda; a sugar plantation in Kakira, Uganda; Coastal Villages in the Kilifi District of Kenya; and the Urban slum of Kangemi located West of Nairobi, Kenya. Subjects: Six thousands two hundred and fifty five consenting volunteers were enrolled into the study, and 675 prevalent HIV infections were identified. Results: The RT sensitivity tended to be high for all assays at all sites (97.63-100%) with the exception of the Uni-Gold assay (90.24% in Kangemi, 96.58% in Kilifi). Twenty four RT results were recorded as ‘weak positives\', 22 (92%) of which were negative by ELISA. There was a high rate of RT false positives in Uganda (positive predictive values ranging from 45.70% to 86.62%). Conclusions: The sensitivity and specificity of the RT varied significantly across sites. The rate of RT misclassification in Uganda suggests that a multiple test algorithm may be preferable to a single test as screener for HIV VCT. East African Medical Journal Vol. 85 (10) 2008: pp. 500-50

The relationship between facility delivery and infant immunization in Ethiopia

ObjectiveTo determine whether facility delivery is related to compliance with recommended infant immunizations, particularly those that occur weeks or months after delivery.MethodsIn a retrospective analysis, multivariate logistic regression was used to assess data from the 2011 Ethiopia Demographic and Health Survey (EDHS) to determine the strongest correlates of facility delivery. These correlates were then used, along with facility delivery itself, to determine the relationship between facility delivery and infant immunization.ResultsIn total, 3334 women delivered a newborn 12–24 months before the 2011 EDHS: 90.2% (3007) delivered at home, and 9.8% (327) delivered in a facility. Education, wealth status, urban residence, and number of children under 5 years living in the household were the factors most strongly associated with facility delivery. When facility delivery and its strongest correlates were entered into multivariate logistic regression models with infant immunizations as the outcome, facility delivery was significantly associated with increased likelihood of DPT‐HepB‐Hib, polio, and measles vaccination, and increased likelihood of being fully immunized (all P < 0.01). Facility delivery was the strongest single factor associated with infants being immunized, doubling the odds of full immunization.ConclusionThe impact of facility delivery on health outcomes transcends the immediate delivery and postpartum period.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/135167/1/ijgo217.pd

Recommendations for dealing with waste contaminated with Ebola virus: a Hazard Analysis of Critical Control Points approach

Objective To assess, within communities experiencing Ebola virus outbreaks, the risks associated with the disposal of human waste and to generate recommendations for mitigating such risks. Methods A team with expertise in the Hazard Analysis of Critical Control Points framework identified waste products from the care of individuals with Ebola virus disease and constructed, tested and confirmed flow diagrams showing the creation of such products. After listing potential hazards associated with each step in each flow diagram, the team conducted a hazard analysis, determined critical control points and made recommendations to mitigate the transmission risks at each control point. Findings The collection, transportation, cleaning and shared use of blood-soiled fomites and the shared use of latrines contaminated with blood or bloodied faeces appeared to be associated with particularly high levels of risk of Ebola virus transmission. More moderate levels of risk were associated with the collection and transportation of material contaminated with bodily fluids other than blood, shared use of latrines soiled with such fluids, the cleaning and shared use of fomites soiled with such fluids, and the contamination of the environment during the collection and transportation of blood-contaminated waste. Conclusion The risk of the waste-related transmission of Ebola virus could be reduced by the use of full personal protective equipment, appropriate hand hygiene and an appropriate disinfectant after careful cleaning. Use of the Hazard Analysis of Critical Control Points framework could facilitate rapid responses to outbreaks of emerging infectious disease