Organochlorine pesticide residue levels in soil from the Nyando River Catchment, Kenya

Soil samples were collected from six locations representative of the Nyando River catchment area of the Lake Victoria over a period of two years. Sampling was done four times in the year in February, May, September and December 2005 and 2006 in farms where maize, tea, sugar cane, coffee, rice and vegetables have been grown over the years. This coincided with the effects of different seasons and farming activities on residue levels of the pesticides in use. The objective was to investigate levels and distribution of organochlorine pesticides that have either been banned or are restricted for use in Kenya. Organochlorine pesticides investigated were DDT, lindane, aldrin, dieldrin, heptachlor, endrin, endosulfan (both α- and β- isomers and endosulfan sulphate), the sum is called “total” or Σendosulfan and methoxychlor. Prior to the ban or restriction in use, these pesticides had found wide applications in public health for control of disease vectors and in agriculture for control of crop pests. The analysis revealed presence of all the targeted pesticides with the highest mean concentrations for methoxychlor 138.97±1.517 μg/kg, Σendosulfan (30.267±2.098μg/kg), aldrin (18.317±0.276 μg/kg), respectively. The results show the presence of these pesticides in soils in the basin and this could be impacting negatively on the ecosystem health of the area

Prevalence of Escherichia coli O157:H7 in water and meat and meat products and vegetables sold in the Eastern Cape Province of South Africa and its impact on the diarrhoeic conditions of HIV/AIDS patients

Water and food borne Escherichia coli O157:H7 could be one of the pathogens posing high health risk to patients suffering from Acquired Immunodeficiency Syndrome (AIDS) because of its incrimination in diarrhoea cases in AIDS patients. The present study, which was conducted between March 2005 and August 2006, investigated the prevalence of E. coli O157:H7 in water, meat and meat products and vegetables and its impact on diarrhoeic conditions of confirmed and non-confirmed HIV/AIDS patients in the Amathole District in the Eastern Cape Province of South Africa. The water samples used in the study were obtained from stand pipes supplying treated drinking water to communities residing in Fort Beaufort, Alice, Dimbaza and Mdantsane whereas borehole waters were sampled from Ngwenya and Kwasaki. The meat and meat products and vegetable samples were purchased from shops, butcheries, supermarkets and open air markets in Fort Beaufort, Alice and Mdantsane. The stool swabs used in the study were obtained from HIV/AIDS and outpatient clinics at Frere Hospital in East London. A total of 180 each of water, meat and meat products and vegetable samples and another 360 stool samples were analyzed for E. coli O157:H7. Presumptive E. coli O157 was isolated from the samples by culture-based methods and confirmed using Polymerase Chain Reaction techniques. Anti-biogram as well as risk assessment were also carried out using standard methods. The viable counts of presumptive E. coli O157 for water samples ranged between 3.3 × 104 and 1.71 × 105 CFU/ml, and between 1.8 × 104 and 5.04 × 106 CFU/g for meat and meat products, whereas those for vegetables ranged between 1.3 × 103 and 1.6 × 106 CFU/g. The counts of presumptive E. coli O157 for the water and vegetable samples were not significantly different whereas those for meat and meat products were found to be significantly different (P ≤ 0.05). The prevalence rates of presumptive E coli O157 in meat and meat products was 35.55 percent (64/180), and 25.55 percent (46/180) and 21.66 percent (39/180) for water and vegetables respectively. Prevalence of presumptive E. coli O157 in the stool samples of HIV/AIDS patients was 36.39 percent (131/360), of which 56.5 percent (74/131) and 43.5 percent (57/131) were from stools of confirmed and non-confirmed HIV/AIDS patients, respectively. Molecular analysis of representative presumptive E. coli O157 indicated that 10.29 percent (4/39) of vegetables; 14.81 percent (4/27) of water and 38.46 percent (5/13) of meat and meat products carried E. coli O157:H7. Also 36 percent (9/25) and 17.24 percent (5/29) of the stool samples were positive for E. coli O157:H7. Antimicrobial susceptibility profile revealed that all of the E. coli O157:H7 isolated from water, meat and meat products and vegetables as well as those isolated from stools of confirmed and non-confirmed HIV/AIDS patients were resistant (R) to gentamycin and erythromycin. However, 75 percent (20/27) of these isolates were resistant (R) to ampicillin and tetracycline whereas approximately 25 percent (6/27) were resistant (R) to nalidixic acid, ceftriaxone, and chloramphenicol. All the isolates (27/27) were susceptible (S) to amikacin. Probability of risk of E. coli O157:H7 infection was high for confirmed HIV/AIDS patients than for the non-confirmed HIV/AIDS patients. Estimated probability of risk of E. coli O157:H7 due to ingestion of water was 1.00 for 100 confirmed and non-confirmed HIV/AIDS patients. Risk due to meat and meat products was estimated at 0.27 and 0.20 and for vegetables at 0.21 and 0.15 per 100 confirmed and non-confirmed HIV/AIDS patients. The findings of this study predicted a possible link between E. coli O157:H7 isolated from drinking water, meat and meat products and vegetables and diarrhoeic conditions in both confirmed and non-confirmed HIV/AIDS patients, and concludes that confirmed HIV/AIDS patients can be at higher risk of contracting water and food borne E. coli O157:H7 than nonconfirmed HIV/AIDS patients. It is thus recommended that proper water treatment and food handling, maximum food and water safety and sanitation as well as personal body hygiene should be maintained, in order to prevent E. coli O157:H7 infections. Education initiatives and active surveillance of E. coli O157:H7 should be taken by all the stake-holders working directly or indirectly towards ensuring enduring sound public health

Factors determining anti-malarial drug use in a peri-urban population from malaria holoendemic region of western kenya

<p>Abstract</p> <p>Background</p> <p>Interventions to reverse trends in malaria-related morbidity and mortality in Kenya focus on preventive strategies and drug efficacy. However, the pattern of use of anti-malarials in malaria-endemic populations, such as in western Kenya, is still poorly understood. It is critical to understand the patterns of anti-malarial drug use to ascertain that the currently applied new combination therapy to malaria treatment, will achieve sustained cure rates and protection against parasite resistance. Therefore, this cross-sectional study was designed to determine the patterns of use of anti-malarial drugs in households (n = 397) in peri-urban location of Manyatta-B sub-location in Kisumu in western Kenya.</p> <p>Methods</p> <p>Household factors, associated with the pattern of anti-malarials use, were evaluated. Using clusters, questionnaire was administered to a particular household member who had the most recent malaria episode (within <2 weeks) and used an anti-malarial for cure. Mothers/caretakers provided information for children aged <13 years.</p> <p>Results</p> <p>Stratification of the type of anti-malarial drugs taken revealed that 37.0% used sulphadoxine/pyrimethamine (SP), 32.0% artemisinin-based combined therapy (ACT), 11.1% anti-pyretics, 7.3% chloroquine (CQ), 7.1% quinine, 2.5% amodiaquine (AQ), while 3.0% used others which were perceived as anti-malarials (cough syrups and antibiotics). In a regression model, it was demonstrated that age (<it>P </it>= 0.050), household size (<it>P </it>= 0.047), household head (<it>P </it>= 0.049), household source of income (<it>P </it>= 0.015), monthly income (<it>P </it>= 0.020), duration of use (<it>P </it>= 0.029), dosage of drugs taken (<it>P </it>= 0.036), and source of drugs (<it>P </it>= 0.005) significantly influenced anti-malarial drug use. Overall, 38.8% of respondents used drugs as recommended by the Ministry of Health.</p> <p>Conclusion</p> <p>This study demonstrates that consumers require access to correct and comprehensible information associated with use of drugs, including self-prescription. There is potential need by the Kenyan government to improve malaria care and decrease malaria-related morbidity and mortality by increasing drug affordability, ensuring that the recommended anti-malarial drugs are easily available in all government approved drug outlets and educates the local shopkeepers on the symptoms and appropriate treatment of malaria. Following a switch to ACT in national drug policy, education on awareness and behaviour change is recommended, since the efficacy of ACT alone is not sufficient to reduce morbidity and mortality due to malaria.</p

Human Direct Skin Feeding Versus Membrane Feeding to Assess the Mosquitocidal Efficacy of High-Dose Ivermectin (IVERMAL Trial)

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Detection of Anopheles stephensi mosquitoes by molecular surveillance, Kenya

The Anopheles stephensi mosquito is an invasive malaria vector recently reported in Djibouti, Ethiopia, Sudan, Somalia, Nigeria, and Ghana. The World Health Organization has called on countries in Africa to increase surveillance efforts to detect and report this vector and institute appropriate and effective control mechanisms. In Kenya, the Division of National Malaria Program conducted entomological surveillance in counties at risk for An. stephensi mosquito invasion. In addition, the Kenya Medical Research Institute conducted molecular surveillance of all sampled Anopheles mosquitoes from other studies to identify An. stephensi mosquitoes. We report the detection and confirmation of An. stephensi mosquitoes in Marsabit and Turkana Counties by using endpoint PCR and morphological and sequence identification. We demonstrate the urgent need for intensified entomological surveillance in all areas at risk for An. stephensi mosquito invasion, to clarify its occurrence and distribution and develop tailored approaches to prevent further spread

A comparative analysis of french and luo connecteors of agrument : nature, distribution and derived meaning

La présente est une analyse des connecteurs du français et de la langue luo. Beaucoup d’études de ce genre ont été réalisées et se sont intéressées à la comparaison des connecteurs d’une langue européenne à une autre. Des études portant sur les comparaisons des connecteurs d’une langue européenne à une langue soit bantoue soit nilotique ou couchitique sont rares. Dans une situation de communication, les problèmes liés au vouloir-dire du locuteur retiennent particulièrement notre attention. La présente étude poursuit les objectifs suivants : faire connaître l’origine possible des connecteurs de la langue luo et analyser les similarités et les différences entre les connecteurs de la langue luo et du français quant à leur nature, leur distribution et leur effet de sens. L’étude est basée sur la théorie de l’argumentation d’Anscombre et Ducrot (1987). Une argumentation a lieu lorsque le locuteur présente un énoncé E1 ou un ensemble d’énoncés dans le but de faire admettre à son interlocuteur un autre énoncé E2 (ou une classe d'énoncés). En rapport avec les techniques de collecte de données, notre étude a eu recours à la recherche documentaire, suivie de l’ analyse approfondie des textes littéraires, une pièce de théâtre, des discours politiques et des textes argumentatifs rédigés par les étudiants de Maseno University et Moi University. La recherche prend en considération les correspondances des connecteurs d’addition, d’opposition, de concession, de cause, de conséquence et de temps, luo et français. Les données sont analysées qualitativement car une telle analyse met en relief une description détaillée de données. Nous espérons que les résultats de cette étude intéresseront à la fois les enseignants des langues et ceux de la traduction, ainsi que leurs étudiants, les chercheurs en général et ceux qui travaillent sur les langues africaines en particulier.This is an analysis of French and Luo sentence connectors. Comparative studies are commonly found between one European language and another. Research carried out on connectors of European and Bantu, Nilotic or Cushitic languages are rare. This thesis thus seeks to fill this knowledge gap. As revealed by literature review, European languages have a wide array of connecters that express different semantic values. If identifying and pegging particular semantic values to connectors of European language poses a challenge, it could be asserted that identifying those of African languages is even a more difficult task since African languages have a smaller number of connectors which could convey a bigger array of semantic value. The objectives of the study are: to determine the possible origin of Luo connectors and to analyze the similarities and differences of Luo and French connectors in terms of nature, distribution and semantic value of the connectors. The study is guided by the argumentative theory of Anscombre and Ducrot (1987). According to the theory, in a situation of argument, the locutor presents E1 in order to orient his interlocutor towards E2. The data collection techniques are grounded on library research as well as reading and analyzing of selected literary texts, a short play, political discourse and argumentative texts written by students from Maseno and Moi Universities. The research is limited to connectors of addition, opposition, concession, cause, consequence and of time, Data is analyzed qualitatively since qualitative analysis lays greater emphasis on holistic description of data. The research adopts a descriptive analysis design because it entails analyzing existing data sets. It is hoped that the results of this study will be vital to teachers of language, teachers of translation, students and to researchers who take interest in the Africans languages

Impacts of pesticides on human health and environment in the River Nyando catchment, Kenya

The population of the River Nyando catchment largely relies on rain fed agriculture for their subsistence. Important crops grown include cereals, cash crops fruits and vegetables. Farming is one of the contributors of pollution to Lake Victoria. Organophosphates and other banned organochlorine pesticides such as lindane, aldrin and dieldrin were used by farmers. The pesticides transport was by storm water run-off and air drift into the lake. Environmental risk assessment background information was collected through questionnaire and interviews of farmers to determine knowledge and safe use of pesticides. Fourteen pesticides were identified as commonly used of which four are toxic to bees and five to birds. The farmers identified declines in the number of pollinating insects, the disappearance of Red-billed Oxpecker (Buphagus erythrorthynchus) and wild bird’s fatalities. The general knowledge among farmers about chemicals risks, safety, and chronic illnesses was low. Activities that increases environmental awareness and safety of pesticides should be initiated by the agrochemical firms and government

Pharmacokinetics-Pharmacodynamics of High-Dose Ivermectin with Dihydroartemisinin-Piperaquine on Mosquitocidal Activity and QT-Prolongation (IVERMAL)

Contains fulltext : 201346.pdf (publisher's version ) (Open Access

Patient-level cost of home- and facility-based child pneumonia treatment in Suba Sub County, Kenya.

BACKGROUND:Globally, pneumonia accounted for 16% of deaths among children under 5 years of age and was one of the major causes of death overall in 2018. Kenya is ranked among the top 15 countries with regard to pneumonia prevalence and contributed approximately 74% of the world's annual pneumonia cases in 2018. Unfortunately, less than 50% of children with pneumonia receive appropriate antibiotics for treatment. Homa-Bay County implemented pneumonia community case management utilizing community health workers, as recommended by the World Health Organization (WHO), in 2014. However, since implementation of the program, the relative patient-level cost of home-based and facility-based treatment of pneumonia, as well as the main drivers of these costs in Suba Subcounty, remain uncertain. Therefore, the main objective of this study was to compare the patient-level costs of home based treatment of pneumonia by a community health worker with those of health facility-based treatment. METHODS AND FINDINGS:Using a cross-sectional study design, a structured questionnaire was used to collect quantitative data from 208 caregivers on the direct costs (consultation, medicine, transportation) and indirect costs (opportunity cost) of pneumonia treatment. The average household cost for the community managed patients was KSH 122.65 ($1.29) compared with KSh 447.46 ($4.71), a 4-fold difference, for those treated at the health facility. The largest cost drivers for home treatment and health facility treatment were opportunity costs (KSH 88.25 ($0.93)) and medicine costs (KSH 126.16 ($ 1.33)), respectively. CONCLUSION:This study demonstrates that the costs incurred for home-based pneumonia management are considerably lower compared to those incurred for facility-based management. Opportunity costs (caregiver time and forgone wages) and the cost of medication were the key cost-drivers in the management of pneumonia at the health facility and at home, respectively. These findings emphasize the need to strengthen and scale community case management to overcome barriers and delays in accessing the correct treatment for pneumonia for sick children under 5 years of age

Knowledge and behaviour as determinants of anti-malarial drug use in a peri-urban population from malaria holoendemic region of western Kenya

Abstract Background The appropriate use of anti-malarial drugs determines therapeutic efficacy and the emergence and spread of drug-resistant malaria. Strategies for improving drug compliance require accurate information about current practices at the consumer level. This is to ascertain that the currently applied new combination therapy to malaria treatment will achieve sustained cure rates and protection against parasite resistance. Therefore, this cross-sectional study was designed to determine knowledge and behaviour of the consumers in households (n = 397) in peri-urban location in a malaria holoendemic region of western Kenya. Methods The knowledge and behaviour associated with anti-malarial use were evaluated. Using clusters, a questionnaire was administered to a particular household member who had the most recent malaria episode (within Results Consumers' knowledge on dosage and duration/frequency demonstrated that only 29.4% used the correct artemisinin-based combination therapy (ACT) dosage. Most respondents who used quinine identified the correct duration of use (96.4%) since its administration was entirely at health facilities. To assess behaviours during use of anti-malarial drugs, respondents were stratified into those who took drugs with prescription (39.4%) and without prescription (61.6%). For those without prescription, the reasons given were; procedure of acquisition less costly (39.0%), took same drug for similar symptoms (23.0%), not satisfied with health services (15.5%), neighbour/friend/relative previously taken the same drug (12.5%) and health institution was far from their location (10%). Conclusion Majority of consumers in the study area were knowledgeable on the symptoms of malaria. In addition, majority acquired ineffective anti-malarial drugs for treatment and reported sub-optimal treatment regimens with the currently recommended drugs. Furthermore, behaviours which constrain the successful up-scaling of ACT were common, creating a challenge in the desire to turn efficacy to effectiveness of the combination therapy programme. It will be important to direct and focus interventions in creating awareness on the importance of using recommended drugs to lessen the use of less efficacious anti-malarials. In addition, the consumers need to be educated on the importance of drug adherence in such areas to reduce the emergence and spread of drug-resistant malaria.</p