The women's group programme in the S.R.D.P.

This paper is based primarily on research carried out as part of the Second Overall Evaluation of the Special Rural Development Programme conducted by the Institute for Development Studies in 1975. The paper begins with a general description and evaluation of the Women's Group Programme and then presents case studies of the six S.R.D.P. areas: Kapenguria, Kwale, Mbere, Migori/Kuria, Tetu and Vihiga/Hamisi. Eor each area, a brief description is given of the women who attended the leaders training courses offered as part of the Programme. The courses themselves are also described. Membership figures are given for the women's groups in the six areas, as well as brief accounts of group activities and plans. Finally, the role of local government officers is described - the frequency of contacts, the specific offices and ministries involved, and the nature of the assistance given. In general, the Women's Group Programme i s found to be a successful effort in the field of rural development which should be continued and expanded. A number of recommendations are made for improvement, both of the Programme in general and in specific S.R.D.P. areas. The broad participation and increased cooperation of a number of ministries and other agencies is recommended, both at the national level and in the field. It is also suggested that the objectives and curricula of the courses for women's leaders be brought more sharply into focus. Emphasis should also be placed on new approaches to income generation for women's groups, in addition to the traditional focus on family welfare and handicrafts. (I The general section of this paper appeared as Chapter Fifteen of I.D.S. Occasional Paper No. 12, and the case studies first appeared as I.D.S. Working Papers Nos. 231 - 236

Barriers to contraceptive use in humanitarian settings: experiences of South Sudanese refugee women living in Adjumani district, Uganda; an exploratory qualitative study

Introduction: Contraceptive use can be lifesaving, empowering and cost-effective for women and girls. Access to contraception is still challenging to female refugees due to several barriers including language, low educational level, lack of information, influence by family members, limited income, cultural and religious norms. This study explored barriers to contraceptive use among South Sudanese refugee women living in Adjumani district, Uganda. Methods: An exploratory study design using qualitative methods were employed involving women of reproductive age (15–49 years). Purposive sampling was used to select participants for Focus Group Discussions (FGDs) and In-depth Interviews (IDIs) from three settlements in Adjumani district. We conducted four FGDs, each consisting of 8 participants. We also conducted fourteen in-depth interviews (IDIs) with women of reproductive age. The IDI and FGD guides were translated into local languages before they were used to collect data. The interviews were recorded, transcribed verbatim and translated into English. Audio recordings were labeled before being translated back to English. Deductive, team-based coding was implemented, and a codebook developed. Transcripts were entered, and data coded using Atlas ti version 14. Data were analyzed using content analysis to produce the final outputs for the study. Results: The study found several challenges to contraceptive use. These included gender dynamics, socially constructed myths on contraceptive use, cultural norms, limited knowledge about contraceptives, men’s negative attitudes, antagonism of contraceptive use by leaders and reprisal of women who use contraception. Conclusion: The study concluded that there is need for community strategies to break down the barriers to contraception utilization among refugee women. Such strategies should involve men and women alongside gatekeepers to enhance sustainability

COMPOSITION AND VARIATION OF FATTY ACIDS AMONG GROUNDNUT CULTIVARS IN UGANDA

Groundnuts ( Arachis hypogaea L.) contain approximately 44-56% oil made up of fatty acids. Oleic and linoleic acids comprise about 80% of fatty acids in groundnuts. Groundnuts with >80% oleic are beneficial health-wise and also improve groundnut quality, flavour, and extended shelf-life, which is beneficial to traders. In Uganda, however, little is known about the fatty acids content of commercially available cultivars. This study was undertaken to determine the fatty acid composition of the most recently released commercially available groundnut cultivars in Uganda. Eleven groundnut genotypes were profiled for different fatty acids using gas chromatography (GC). Data were recorded in percentages from chromatographs and totaled up to about 100%. Oleic to linoleic ratios (O/L) and iodine values were calculated from fatty acid data. Groundnut genotypes tested differed significantly (P<0.05) in oleic, linoleic, palmitic, behenic, gadoleic, arachidic and palmitoleic acids. Oleic acid was highest in Lot 197 line, and linoleic acid was lowest in the same line. Oleic acid was lowest in Serenut 7 (43.19%) and linoleic acid was highest in the same line (33.45%). The lowest iodine value was observed in 197 (84.14); and the highest in Serenut 9T (96.59). Significant correlations (P<0.001) were observed between most of the fatty acids, except between arachidic versus gadoleic, stearic and gamma linoleic.L\u2019Arachide ( Arachis hypogaea L.) contient approximativement 44-55% d\u2019huile faites d\u2019acides gras. Les acides ol\ue9ique et linol\ue9ique constituent environ 80% des acides gras dans l\u2019arachide. Les arachides avec plus de 80% d\u2019ol\ue9iques sont b\ue9n\ue9fiques pour la sant\ue9 et aussi am\ue9liorent la qualit\ue9 de l\u2019arachide, le go\ufbt, et une longue dur\ue9e de conservation, avantageux pour les commer\ue7ants. En Ouganda, toutefois, tr\ue8s peu d\u2019informations sont disponibles concernant la teneur en acides gras des cultivars commercialement disponibles. Cette \ue9tude a \ue9t\ue9 entreprise pour d\ue9terminer la composition en acide gras de la majorit\ue9 des cultivars d\u2019arachides r\ue9cemment lib\ue9r\ue9s et commercialement disponibles en Ouganda. Onze g\ue9notypes d\u2019arachide ont \ue9t\ue9 profil\ue9s pour les diff\ue9rents acides gras en utilisant le gaz chromatographie (GC). Les donn\ue9es ont\ua0\ue9t\ue9 collect\ue9es des chromatographes en pourcentages et additionn\ue9es jusqu\u2019\ue0 environ 100%. Les rapports d\u2019ol\ue9iques au linol\ue9iques (O/L) et les valeurs d\u2019iode ont \ue9t\ue9 calcul\ue9es \ue0 partir des donn\ue9es des acides gras. Les g\ue9notypes d\u2019arachide test\ue9s ont \ue9t\ue9 significativement (P<0,05) diff\ue9rents en acides ol\ue9ique, linol\ue9ique, palmitique, b\ue9h\ue9nique, gadol\ue9ique, arachidique et palmitoleique. L\u2019acide ol\ue9ique \ue9tait le plus \ue9lev\ue9 dans la lign\ue9e Lot 197, et l\u2019acide linol\ue9ique \ue9tait le plus faible dans la m\ueame lign\ue9e. L\u2019acide ol\ue9ique \ue9tait le plus faible en Serenut 7 (43,19%) et l\u2019acide linol\ue9ique \ue9tait le plus \ue9lev\ue9 dans la m\ueame lign\ue9e (33,45%). La plus faible valeur de l\u2019iode \ue9tait observ\ue9e dans 197 (84,14)\ua0; et la valeur la plus \ue9lev\ue9e dans Serenut 9T (96,59). Des corr\ue9lations significatives (P<0,001) \ue9taient observ\ue9e entre la majorit\ue9 des acides gras, sauf entre l\u2019acide arachidique contre les acides gadol\ue9ique, st\ue9arique et gamma linol\ue9ique

Genome‑wide association studies reveal novel loci for resistance to groundnut rosette disease in the African core groundnut collection

Groundnut is cultivated in several African countries where it is a major source of food, feed and income. One of the major constraints to groundnut production in Africa is groundnut rosette disease (GRD), which is caused by a complex of three agents: groundnut rosette assistor luteovirus, groundnut rosette umbravirus and its satellite RNA. Despite several years of breeding for GRD resistance, the genetics of the disease is not fully understood. The objective of the current study was to use the African core collection to establish the level of genetic variation in their response to GRD, and to map genomic regions responsible for the observed resistance. The African groundnut core genotypes were screened across two GRD hotspot locations in Uganda (Nakabango and Serere) for 3 seasons. The Area Under Disease Progress Curve combined with 7523 high quality SNPs were analyzed to establish marker-trait associations (MTAs). Genome-Wide Association Studies based on Enriched Compressed Mixed Linear Model detected 32 MTAs at Nakabango: 21 on chromosome A04, 10 on B04 and 1 on B08. Two of the significant markers were localised on the exons of a putative TIR-NBS-LRR disease resistance gene on chromosome A04. Our results suggest the likely involvement of major genes in the resistance to GRD but will need to be further validated with more comprehensive phenotypic and genotypic datasets. The markers identified in the current study will be developed into routine assays and validated for future genomics-assisted selection for GRD resistance in groundnut

Evaluation of a proposed clinical case definition of paediatrics acquired immune deficiency Syndrome

Objective: To evaluate the proposed criteria against the laboratory parameters and to identify the clinical features with the highest predictive value in the diagnosis of paediatric AIDS. Design: A cross sectional study. Setting: Kenyatta National Hospital, Nairobi. Results: More than twenty three per cent of the children studied were seropositive and 14%were diagnosed as having AIDS. Almost 70% of the children studied were below 24 months.AIDS was significantly associated with mouth lesions, both ulcers and oral candidiasis, skin lesions especially eczema and generalised pruritic dermatitis, prolonged cough, prolonged fever and generalised lymphadenopathy. The WHO criteria had a sensitivity of 60%, a specificity of 94%, positive predictive value of 60%, and negative predictive value of 94%. The Nairobi diagnostic criteria had a sensitivity of 80%, a specificity of 79%, a positive predictive value of 38% and a negative predictive value of 96%. Conclusion: The Nairobi Diagnostic Criteria are superior to the WHO criteria as a screening test due to their higher sensitivity, 80% against 60% for WHO. (East African Medical Journal: 2002 79(3): 111-114

Mass antimicrobial treatment in pregnancy: A randomized placebo controlled trial in a population with high rates of sexually transmitted diseases

Sexually transmitted diseases (STDs) are highly prevalent in pregnant women in many developing countries and have been associated with poor obstetric outcomes. Case detection and treatment of STDs in women is problematic and expensive, underscoring the need for other strategies. To explore the potential benefits of routine antimicrobial therapy on pregnancy outcome, we carried out a randomized, double-blind, clinical trial in one of the antenatal clinics in Nairobi, Kenya. Four hundred pregnant women between 28 and 32 weeks\u27 gestation were given a single dose of 250 mg ceftriaxone intramuscularly or a placebo. There was a significant difference between ceftriaxone and placebo-treated women in infant birth weight (3,209 versus 3,056 g, P = .01). In addition, there was a trend toward lower rates of birth weight \u3c 2,500 g (4.0% versus 9.2%, P = .08) and postpartum endometritis (3.8% versus 10.4%, P = .05) in the intervention than in the placebo group. Neisseria gonorrhoeae was isolated from the cervixes of postpartum women in 1.8% of the intervention group as compared to 4.2% of the control group. These data suggest a beneficial effect of antimicrobial prophylaxis on pregnancy outcome. Larger studies should be carried out to examine the public health impact of this intervention

HIV-1 and immunological changes during pregnancy: a comparison between HIV-1-seropositive and HIV-1-seronegative women in Nairobi, Kenya.

Objective To assess changes in the proportion of CD4 and CD8 T-lymphocyte profiles during pregnancy, at delivery and postpartum, and to determine whether HIV-1 infection affects the normal profile. Design and methods A total of 416 pregnant HIV-1-infected women and an age and parity-matched HIV-seronegative group of 407 pregnant women were enrolled into a prospective study on the impact of HIV-1 infection on pregnancy. Maternal blood was obtained for lymphocyte subset determination at enrollment, delivery and 6 weeks postpartum. Whole blood sample drawn in EDTA-containing tubes were used to determine T-helper/inducer (CD4) and T-suppressor/cytotoxic (CD8) cells by direct immunofluorescence using monoclonal antibodies. Results No relationship was found between gestational age and any immunological variable. The CD4 percentage was lower postpartum than antenatally, in both HIV-1-seropositive and seronegative women, but this was not true for absolute CD4 counts. CD8 absolute counts and percentages were significantly higher postpartum than antenatally. The differences between HIV-1-seropositive and seronegative women in changes over pregnancy in CD4 and CD8 cells and their ratio, were not statistically significant. Conclusion Our findings do not support a short-term synergistic effect of HIV-1 and pregnancy on the immune function as determined by T-lymphocyte subsets

Mass antimicrobial treatment in pregnancy. A randomized, placebo-controlled trial in a population with high rates of sexually transmitted diseases.

Sexually transmitted diseases (STDs) are highly prevalent in pregnant women in many developing countries and have been associated with poor obstetric outcomes. Case detection and treatment of STDs in women is problematic and expensive, underscoring the need for other strategies. To explore the potential benefits of routine antimicrobial therapy on pregnancy outcome, we carried out a randomized, double-blind, clinical trial in one of the antenatal clinics in Nairobi, Kenya. Four hundred pregnant women between 28 and 32 weeks\u27 gestation were given a single dose of 250 mg ceftriaxone intramuscularly or a placebo. There was a significant difference between ceftriaxone and placebo-treated women in infant birth weight (3,209 versus 3,056 g, P = .01). In addition, there was a trend toward lower rates of birth weight \u3c 2,500 g (4.0% versus 9.2%, P = .08) and postpartum endometritis (3.8% versus 10.4%, P = .05) in the intervention than in the placebo group. Neisseria gonorrhoeae was isolated from the cervixes of postpartum women in 1.8% of the intervention group as compared to 4.2% of the control group. These data suggest a beneficial effect of antimicrobial prophylaxis on pregnancy outcome. Larger studies should be carried out to examine the public health impact of this intervention

Mother-To-Child Transmission Of Human Immunodeficiency Virus Type 1: Report From The Nairobi Study

Mother-to-child transmission of human immunodeficiency virus type 1 (HIV-1) is a significant problem in countries with endemic HIV-1 infection. Between 1986 and 1991, 365 children of HIV-L-infected mothers and 363 control children were studied in Kenya. The overall risk of transmission from mother to child, determined by serologic evidence of infection by age ⩽5? 12 months and excess mortality in the HIV-I-exposed group, was 42.8% (range, 27.6%-62.2%). Marriage was the only maternal characteristic associated with transmission (odds ratio, 2.2; 95% confidence interval, 1.2–4.2; P \u3c .05). Children who experienced growth failure were more likely to be infected. In 44% of children ultimately infected, the pattern of antibody response implied intrapartum or postnatal exposure to HIV-1. Of potential postnatal exposures examined, duration of breast-feeding beyond age 15 months and the mother being married were independently associated with increased risk of infection and seroconversion of children. The percentage of HIV infection attributable to breast-feeding ⩽5? 15 months was 32%. The frequency of mother-to-child transmission of HIV-I was high; a substantial proportion of infection occurred postnatally, possibly through breast-feeding