In vitro fertilization : the status of the frozen embryo

9TH Annual ethics conference. Theme : Bioethics medical, legal, environmental and cultural aspects in healthcare ethics at STRATHMORE UNIVERSITY, 25-26 OCTOBER 2012.The first Kenyan IVF babies were born on 8th May 2006. The event was celebrated as a breakthrough. It was to offer hope for perhaps thousands of Kenyan couples who were childless. Since then a number of IVF clinics have sprang up around the country. Childless couples are routinely offered IVF as a solution to their childless state. Little is said about the state of the frozen embryo. Or the ethics and morality of the IVF treatment. The number of frozen embryos in Kenya is unknown. There are between 400,000 and 500,000 frozen embryos in the USA alone. With an estimated 20,000 being added annually

Trends of HIV infection among infants born to HIV infected mothers on PMCT antiretroviral treatment in western Kenya.

Background : More than 365,000 of unborn children are at risk of getting HIV infection in the developing world through "vertical" transmission. Although, ARVs are being used to reduce maternal HIV transmission, limited information exists indicating their impact on the trend of HIV prevalence among infants born to HIV infected mothers. Objective : To determine the trend of HIV infection among infants born to HIV infected mothers in relation to specific ARVs administered to pregnant women and lactating mothers of 18 months and below infants. Methodology : Dried blood spot samples in the following quantities per year thus, in 2010, n = 4,210, in 2011, n=4,093, in 2012, n=4,686, in 2013, n=3,080 were collected from infants aged ≤18 months whose mothers were HIV positive. The samples were analyzed using Cobas Polymerase Chain Reaction Assay in early infant diagnosis laboratory at the Center for Infectious and Parasitic Diseases Control Research, Kenya Medical Research Institute (KEMRI). Results: Out of the total number of samples tested 2010, 409(9.7%) tested HIV positive. In 2011, 350(8.5%), in 2012, 368(7.9%) and in 2013, 221(7.2%) were HIV positive respectively. The trend of HIV in infants whose mothers had been put on various ARVs was as follows: AZT+3TC +EFV, in 2010, the number was 10.4%. In 2011, it moved to 9.1%, in 2012, to 6.3% and 2013, dropped to 6.0%. AZT+3TC+NVP, in 2010, the number was 7.1%, in 2011, moved to 6.1%, in 2012, falling to 4.7% and 2013 to3.9%. SdNVP, in 2010, the number was 10.3%. In 2011, moved to 7.4%, in 2012, dropping to 6.2% and in 2013, at 6.0%. Those mothers who had not been given any ARVs, their infants had HIV prevalence as follows: in 2010, the number was 11.2%. In 2011, it climbed to 12.6%, moving to 12.7% in 2012, and 12.9% in 2013. Conclusion: There was direct relationship between specific ARV administration and HIV infection among those infants. That was evident by the fact that, HIV appeared to decrease with sub-sequent years of provision of specific drugs. However, HAART (AZT+3TC+ EFV) seemed to provide greater impact in HIV prevention compared to other HAART (AZT+3TC+NVP) and SdNVP. The worst groups are those not on any ARVs. Single-dose Nevirapine commonly is used for prevention event-hough prior studies have shown exposure to it develop drug resistance, which can compromise the effective not only of itself, but also other non-nucleoside reverse transcriptase inhibitors (NNRTIs) Recommendation : There is need for all HIV positive pregnant women to be put on ARVs and monitored for ARVs uptake to reduce the transmission of HIV from mother to child. Key words: HIV, ARVs, Infants, &nbsp

Sustainable small ruminant breeding program for climate-smart villages in Kenya

Improving productivity of sheep and goats (i.e. small ruminants- SR) under smallholder farming systems faced with challenges of unfavourable climatic events has been identified as one means of enhancing livelihoods of communities living in these areas. Interventions are targeted through clusters of farmers grouped into “climate smart villages” (CSV) under a collaborative action by CCAFS, ViAgroforestry, World Neighbours and the Kenya Agricultural and Livestock Research Organization. This baseline study was implemented to understand the socio-economic aspects, population structure, management practices and production constraints of SR in the CSV of the Lower Nyando basin of Kenya. The results indicate that the community is mainly comprised of young people (mainly students) and men and women above 50 years of age who manage the various households. Land sizes owned are small, with 58% of the households owning less than one hectare of land on which they grow crops and rear on average eight SR in addition to some cattle and poultry. The SR reared are mainly indigenous breeds, with some crossbreds resulting from the few introduced Red Maasai sheep and the Galla goats for improved productivity. Breeding of SR is not controlled, and since larger animals fetch better prices on the market, over time negative selection has affected the SR population. SR are generally left to graze on stovers from crops, and take a long time to grow to maturity (up to 4 years). Farmers in the CSV know what traits they desire in their SR, and are willing to learn and change their practices in order to improve their livelihoods. It is evident that the organization of the households into CSVs provides a great opportunity for capacity development which should have a strong component of engaging the youth, and the development of a selection and breed improvement program for SR in the Lower Nyando area

Genetic diversity in pigeonpea [Cajanus cajan (L.) Millsp.] Landraces as revealed by simple sequence repeat markers

Open Access JournalGenetic relationships among 88 pigeonpea accessions from a presumed centre of origin and diversity, India and a presumed secondary centre of diversity in East Africa were evaluated using six microsatellite markers. Forty-seven (47) alleles were detected in the populations studied, with a mean of eight alleles per locus. Populations were defined by region (India and East Africa) and sub-populations by country in the case of East Africa and State in the case of India. Substantial differentiation among regions was evident from Roger’s modified distance and Wright’s F statistic. Greatest genetic diversity in terms of number of alleles, number of rare alleles and Nei’s unbiased estimate of gene diversity (H) was found in India as opposed to East Africa. This supports the hypothesis that India is the centre of diversity and East Africa is a secondary centre of diversity. Within East Africa, germplasm from Tanzania had the highest diversity according to Nei’s unbiased estimate of gene diversity, followed by Kenya and Uganda. Germplasm from Kenya and Tanzania were more closely related than that of Uganda according to Roger’s modified distance. Within India, results did not indicate a clear centre of diversity. Values of genetic distance indicated that genetic relationships followed geographical proximity

System characteristics and management practices for small ruminant production in “Climate Smart Villages” of Kenya

The CGIAR research programme on Climate Change Agriculture and Food Security, in collaboration with several partners is testing a portfolio of interventions to address the threat of changing climatic conditions for smallholder farming communities living beside river flood plains, grouped into “Climate Smart Villages” (CSVs). We present characteristics of farms in CSV in relation to small ruminant (SR) production and the scenario for a breeding and improvement programme. Information was collated using participatory systems research methods from 140 households in seven CSVs in Nyando basin, Kenya. Although most households were headed by men, there were a higher proportion of adult women within the communities, and literacy levels were moderate. A total of 58 percent of the population owned <1 ha of land for growing crops and rearing on average 6.96 ± 3.35 Tropical Livestock Units comprising different species of animals. Women headed households owned more sheep which were mainly crosses of unspecified local breeds, than Goats which were mainly the Small East African breed-type. Mating among the SR was random, with no control of inbreeding as flocks mixed in grazing fields and at water points. Farmers desired large and resilient animals for better market prices; however, growth rates were slow. The SR flocks were dynamic with 31 percent of the animals moving in and out of flocks in a year. A community breeding programme optimally using available resources and incorporating gender integrated innovative technologies could be implemented for the CSV, alongside strong capacity development on animal husbandry, health and marketing of products

Can a community health worker administered postnatal checklist increase health-seeking behaviors and knowledge?: evidence from a randomized trial with a private maternity facility in Kiambu County, Kenya

Background: Since the 2009 WHO and UNICEF recommendation that women receive home-based postnatal care within the first three days after birth, a growing number of low-income countries have explored integrating postnatal home visit interventions into their maternal and newborn health strategies. This randomized trial evaluates a pilot program in which community health workers (CHWs) visit or call new mothers three days after delivery in peri-urban Kiambu County, Kenya. Methods: Participants were individually randomized to one of three groups: 1) early postnatal care three days after delivery provided in-person with a CHW using a simple checklist, 2) care provided by phone with a CHW using the same checklist, or 3) a standard of care group. Surveys were conducted ten days and nine weeks postnatal to measure outcomes related to compliance with referrals, self-reported health problems for mother and baby, care-seeking behaviors, and postnatal knowledge and practices around the recognition of danger signs, feeding, nutrition, infant care and family planning. Results: The home visit administration of the checklist increased the likelihood that women recognized postnatal problems for themselves and their babies and increased the likelihood that they sought care to address those problems identified for the child. In both the home visit and mobile phone implementation of the checklist, actions taken for postnatal problems happened earlier, particularly for infants. Knowledge was found to be high across all groups, with limited evidence that the checklist impacted knowledge and postnatal practices around the recognition of danger signs, feeding, nutrition, infant care and family planning. Conclusion: We find evidence that CHW-administered postnatal checklists can lead to better recognition of postnatal problems and more timely care-seeking. Furthermore, our results suggest that CHWs can affordably deliver many of the benefits of postnatal checklists. Trial Registration: ClinicalTrials.gov NCT02104635; registered April 2, 2014

p16INK4a/Ki-67 dual stain cytology for cervical cancer screening in Thika district, Kenya

Background: The identification of suited early detection tests is one among the multiple requirements to reduce cervical cancer incidence in developing countries. Methods: We evaluated p16INK4a/Ki-67 dual-stain cytology in a screening population in Thika district, Kenya and compared it to high-risk human papillomavirus (HR-HPV) DNA testing and visual inspection by acetic acid (VIA) and Lugol’s iodine (VILI). Results: Valid results for all tests could be obtained in 477 women. 20.9 % (100/477) were tested positive for HR-HPV DNA, 3.1 % (15/477) had positive VIA/VILI and 8.2 % (39/477) positive p16INK4a/Ki-67 cytology. Of 22 women that showed up for colposcopy and biopsy, 6 women were diagnosed with CIN3 and two with CIN2. All women with CIN2/3 were negative in VIA/VILI screening and positive by HR-HPV DNA testing. But HPV was also positive in 91.7 % (11/12) of women with normal histology. p16INK4a/Ki-67 cytology was positive in all 6 women with CIN3, in one of the two CIN2 and in only 8.3 % (1/12) of women with normal histology. Conclusions: p16INK4a/Ki-67 cytology is an interesting test for further studies in developing countries, since our findings point to a lower fraction of false positive test results using p16INK4a/Ki-67 cytology compared to HPV DNA testing in a Kenyan screening population. VIA/VILI missed all histology-proven CIN2/3

Innovative use of sheep and goats by women in climate smart villages in Kenya

The Nyando Basin in Kenya, a rich agricultural flood plain around Lake Victoria with a population density exceeding 400 persons per square kilometre, has been adversely affected by extreme weather events that include droughts and floods. Literacy levels are low. Land sizes are small, generally less than one hectare, and poverty rates are high. Through a partnership around collective action, seven villages have been selected to pilot climate smart integrated crop and livestock production. The approach focusses on improving local knowledge of climate risks, variability in seasonal rainfall, and targeted introduction of technologies to increase productivity of crops and livestock in order to enhance livelihoods. Given the household composition and differential access and control over resources by men and women in the communities a gendered approach was adapted for sheep and goat improvement. Men generally control practices around goats, while women have a greater say on sheep. Past uncontrolled breeding of sheep and goats, closed to introduction of animals from elsewhere has resulted in smaller sized animals that take long to mature, and do not fetch good market prices. The CGIAR led project thus introduced improved strains of resilient but more productive indigenous breeds of Gala goats and Red Maasai sheep for crossbreeding with the local breeds and has resulted in women taking a lead in community led breeding programmes resulting in crosses with better performance and desirable traits