Participatory Evaluation of \u3ci\u3eUrochloa\u3c/i\u3e and \u3ci\u3eMegathyrsus\u3c/i\u3e Forage Species in Western Kenya: Farmers Perspective

Despite western Kenya potential in dairy production, it has lagged behind compared to other regions in the country. This comes against growing per capita milk consumption in Kenya currently estimated at 120 litres per person per year. As a result, western Kenya is largely net importer of milk from neighbouring counties albeit the possibility improving productivity within. Among the most prevalent constraint to increased productivity is limited forage quality and quantity throughout the year. Napier stunting disease, which suppresses forage production from Napier grass, the most prevalent cultivated forage in western Kenya, exacerbates this. To contribute to addressing the problem, we selected several hybrids/cultivars of Urochloa and Megathyrsus and grown by several farmer groups in Kakamega, Busia, Bungoma and Siaya counties in western Kenya. To rate the forages, we guided farmers in generating criteria, by each group, on parameters/attributes they consider ideal for a forage to possess. On a scale of 1–9, farmers scored on the way they perceive each criterion, with the higher the score the more relevance it carries. In their respective groups, individual farmers scored on forage demonstrations replicated 3 times, on by plot-by-plot basis. We pooled groups’ criteria scores with individual farmer forage scores to generate weighted scores leading to forage rankings. We observed that criteria regarded highly relate to biomass production, fast growth rate, capability of regrowth, palatability and acceptability by animals among others. Test forages ranked differently by counties indicating provenances that stand good chance of adoption in relation to the farmers’ perspectives, and possibly in other similar areas

Estado nutricional y factores de riesgo de desnutrición en preescolares que acuden a consulta en el Centro de Salud San Francisco, Tulcán. 2022

Evaluar el estado nutricional y los factores de riesgo de desnutrición en los preescolares que acuden a consulta en el Centro de Salud San Francisco de la ciudad de Tulcán.El estado nutricional es de vital importancia en la salud de los niños menores de 5 años. Esta investigación tuvo como objetivo determinar el estado nutricional y los factores de riesgo de desnutrición en preescolares que acuden a la Consulta en el Centro de Salud San Francisco, Tulcán 2022. Fue un estudio descriptivo no experimental, de corte transversal, cuantitativo; se trabajó con una población de 53 niños que acudieron a la consulta. Se aplicó un cuestionario para identificar datos sociodemográficos, y factores de riesgo de desnutrición a las madres de los niños menores de 5 años, dentro de los cuales se aplicó un recordatorio de 24 horas; se evaluó el estado nutricional de los niños con todos los indicadores antropométricos. Como resultados principales: mayoría de niños varones, la mayoría de las madres son adultas jóvenes, y quienes se encarga del cuidado es la madre; al evaluar el estado nutricional se halló desnutrición crónica en el 24,64% de los niños bajo peso en el 7,55%, 7,55% posible riesgo de sobrepeso; en total 30% de los niños tiene algún problema de malnutrición por exceso o déficit. Se hallaron como factores de riesgo a la presencia de IRA (47,17%), subalimentación energética (13%), subalimentación proteica (34%), subalimentación lipídica (18,87%), subalimentación glucídica (26,42%). Se hallan factores protectores como: 100% de niños recibieron lactancia materna y se encuentran con esquema completo de vacunación, tienen horario de comida regular, y consumen alimentos en casa.Licenciatur

First Africa non-communicable disease research conference 2017: sharing evidence and identifying research priorities

Non-communicable diseases (NCDs) prevalence is rising fastest in lower income settings, and with more devastating outcomes compared to High Income Countries (HICs). While evidence is consistent on the growing health and economic consequences of NCDs in sub-Saharan Africa (SSA), specific efforts aimed at addressing NCD prevention and control remain less than optimum and country level progress of implementing evidence backed cost-effective NCD prevention approaches such as tobacco taxation and restrictions on marketing of unhealthy food and drinks is slow. Similarly, increasing interest to employ multi-sectoral approaches (MSA) in NCD prevention and policy is impeded by scarce knowledge on the mechanisms of MSA application in NCD prevention, their coordination, and potential successes in SSA. In recognition of the above gaps in NCD programming and interventions in Africa, the East Africa NCD alliance (EANCDA) in partnership with the African Population and Health Research Center (APHRC) organized a three-day NCDs conference in Nairobi. The conference entitled “First Africa Non-Communicable Disease Research Conference 2017: Sharing Evidence and Identifying Research Priorities” drew more than one hundred fifty participants and researchers from several institutions in Kenya, South Africa, Nigeria, Cameroon, Uganda, Tanzania, Rwanda, Burundi, Malawi, Belgium, USA and Canada. The sections that follow provide detailed overview of the conference, its objectives, a summary of the proceedings and recommendations on the African NCD research agenda to address NCD prevention efforts in Africa

Acute Renal Failure in a Caucasian Traveler with Severe\ud Malaria: A Case Report

Acute renal failure (ARF) secondary to severe malaria is uncommon. We report a case of a patient visiting Africa for the first time presenting with malaria and ARF. There was complete recovery after hemodialysis. Early initiation of hemodialysis proves to be useful in restoration of renal function

Teachers' Professional Development in Oman: Challenges, Efforts and Solutions

Teachers’ in-service training as such is not a new thing in Oman, but due to the national effort put in re-organising and systematising in-service training programmes in the past few years, a whole new phase has emerged in teacher professional development (TPD). The article describes how TPD is responding to the challenges of improving the quality of teaching and learning in Oman. The article also describes the tools used to examine the impact of the provided in-service training. Change in skills of teachers is necessary but not sufficient to make practices and pedagogies change. Results from interviews reveal that teachers encounter a variety of obstacles in schools when trying to make use of what they have learned in TPD programmes. Applying new skills and pedagogies often implies a radical change in established practices and ways of thinking in school culture with unquestionable elements due to long traditions.</p

Building focused cardiac ultrasound capacity in a lower middle-income country: A single centre study to assess training impact

Background: In low- and middle-income countries (LMICs) where echocardiography experts are in short supply, training non-cardiologists to perform Focused Cardiac Ultrasound (FoCUS) could minimise diagnostic delays in time-critical emergencies. Despite advocacy for FoCUS training however, opportunities in LMICs are limited, and the impact of existing curricula uncertain. The aim of this study was to assess the impact of FoCUS training based on the Focus Assessed Transthoracic Echocardiography (FATE) curriculum. Our primary objective was to assess knowledge gain. Secondary objectives were to evaluate novice FoCUS image quality, assess inter-rater agreement between expert and novice FoCUS and identify barriers to the establishment of a FoCUS training programme locally. Methods: This was a pre-post quasi-experimental study at a tertiary hospital in Nairobi, Kenya. Twelve novices without prior echocardiography training underwent FATE training, and their knowledge and skills were assessed. Pre- and post-test scores were compared using the Wilcoxon signed-rank test to establish whether the median of the difference was different than zero. Inter-rater agreement between expert and novice scans was assessed, with a Cohen\u27s kappa \u3e0.6 indicative of good inter-rater agreement. Results: Knowledge gain was 37.7%, with a statistically significant difference between pre-and post-test scores (z = 2.934, p = 0.001). Specificity of novice FoCUS was higher than sensitivity, with substantial agreement between novice and expert scans for most FoCUS target conditions. Overall, 65.4% of novice images were of poor quality. Post-workshop supervised practice was limited due to scheduling difficulties. Conclusions: Although knowledge gain is high following a brief training in FoCUS, image quality is poor and sensitivity low without adequate supervised practice. Substantial agreement between novice and expert scans occurs even with insufficient practice when the prevalence of pathology is low. Supervised FoCUS practice is challenging to achieve in a real-world setting in LMICs, undermining the effectiveness of training initiatives

Perceptions of malaria and acceptance of rapid diagnostic tests and related treatment practises among community members and health care providers in Greater Garissa, North Eastern Province, Kenya.

BACKGROUND: Conventional diagnosis of malaria has relied upon either clinical diagnosis or microscopic examination of peripheral blood smears. These methods, if not carried out exactly, easily result in the over- or under-diagnosis of malaria. The reliability and accuracy of malaria RDTs, even in extremely challenging health care settings, have made them a staple in malaria control programmes. Using the setting of a pilot introduction of malaria RDTs in Greater Garissa, North Eastern Province, Kenya, this study aims to identify and understand perceptions regarding malaria diagnosis, with a particular focus on RDTs, and treatment among community members and health care workers (HCWs). METHODS: The study was conducted in five districts of Garissa County. Focus group discussions (FGD) were performed with community members that were recruited from health facilities (HFs) supported by the MENTOR Initiative. In-depth interviews (IDIs) and FGDs with HCWs were also carried out. Interview transcripts were then coded and analysed for major themes. Two researchers reviewed all codes, first separately and then together, discussed the specific categories, and finally characterized, described, and agreed upon major important themes. RESULTS: Thirty-four FGDs were carried out with a range of two to eight participants (median of four). Of 157 community members, 103 (65.6%) were women. The majority of participants were illiterate and the highest level of education was secondary school. Some 76% of participants were of Somali ethnicity. Whilst community members and HCWs demonstrated knowledge of aspects of malaria transmission, prevention, diagnosis, and treatment, gaps and misconceptions were identified. Poor adherence to negative RDT results, unfamiliarity and distrust of RDTs, and an inconsistent RDT supply were the main challenges to become apparent in FGDs and IDIs. CONCLUSION: Gaps in knowledge or incorrect beliefs exist in Greater Garissa and have the potential to act as barriers to complete and correct malaria case management. Addressing these knowledge gaps requires comprehensive education campaigns and a reliable and constant RDT supply. The results of this study highlight education and supply chain as key factors to be addressed in order to make large scale roll out of RDTs as successful and effective as possible