Responding to Major Burn Disasters in Resource-Limited Settings: Lessons Learned From an Oil Tanker Explosion in Nakuru, Kenya.

BACKGROUN

Mean water balance dynamics and smallholder management options for improved agro-ecosystem productivity

United States Agency for International Developmen

Two Phase Flow Modeling: Summary of Flow Regimes and Pressure Drop Correlations in Reduced and Partial Gravity

The purpose of this report is to provide a summary of state-of-the-art predictions for two-phase flows relevant to Advanced Life Support. We strive to pick out the most used and accepted models for pressure drop and flow regime predictions. The main focus is to identify gaps in predictive capabilities in partial gravity for Lunar and Martian applications. Following a summary of flow regimes and pressure drop correlations for terrestrial and zero gravity, we analyze the fully developed annular gas-liquid flow in a straight cylindrical tube. This flow is amenable to analytical closed form solutions for the flow field and heat transfer. These solutions, valid for partial gravity as well, may be used as baselines and guides to compare experimental measurements. The flow regimes likely to be encountered in the water recovery equipment currently under consideration for space applications are provided in an appendix

Quantifying Physical and Economic Losses of African Indigenous Vegetable Solanum aethiopicum Along the Commercial Supply Value Chain

This paper is based on research work done by the authors on African Indigenous vegetables with financial support from the European Union and Forum for Agricultural Research in Africa (FARA) through its Promoting African & European Partnerships in Agricultural Research & Development (PAEPARD). This is part of the outputs of the project entitled “Enhancing nutrition security and incomes through adding value to indigenous vegetables in East and Central Uganda”. Abstract This study presents results of a research that was conducted in Uganda to expound the issues of Solanum aethopicum (Nakati) value chain supply, physical and economic quantification of losses in the supply chain. Specifically the study was designed to; (i) identify and map the value chain actors of an indigenous leafy vegetable S. aethiopicum production and marketing and (ii) quantify the physical losses along the S. aethiopicum vegetable supply chain and (iii) estimate the economic losses along the S. aethiopicum vegetable supply chain.A Participatory Rural Appraisal (PRA) was conducted at Namulonge, Kabanyoro, Busukuma and Zirobwe villages on 7th August 2016, 9th August 2016, 10th August 2016 and 12th August 2016, respectively with the farmers to understand the S. aethiopicum actors’ perception of value chain vegetable losses and mitigating solutions. At each supply chain stage namely field, transit, wholesale and retail. The losses were expressed as difference of the weight of vegetables that entered each stage and weighed again  when the value adding  stage is completed which became the quantity that enters the subsequent stage, thus the losses were determined as a percentage of those that never went to market in relation to the total potential from the field.The value chain actor mapping has revealed a short a short value chain with a number of value chain actors namely; 60 input suppliers, 40 farmer groups, 42 wholesalers, 48 retailers, 2 processors and 61 transporters.  With the exception of agro input supply node which handle pesticides, the rest of the actors handle fresh leafy vegetables that are prone to heavy weight losses due to wilting, rotting and transit contamination. The study further indicated that the physical quantities of S. aethopicum harvested varied in different farms, nonetheless, on average 1473.3 kgs per acre of S. aethopicum is harvested and of the harvested vegetables, 69.4kgs and 73.7 kgs get lost in the field and marketing process, respectively. This translates into S. aethopicum vegetable losses of 13.3% and 5.2% in the field and market points, respectively. Most of this loss occurred on-farm with 13.3% of the harvested crop not entering the commercial-supply chain followed by retail level, 3.5% losses and least at wholesale level of 1.7%. In terms of economic losses, sale of S. aethopicum earned farmers on average 567,233 Shs per acre, sizeable revenue of 26,700 Shs and 53,192 Shs get lost in the field and marketing process, respectively. This is equivalent to S. aethopicum revenue losses of 18% and 35.9% in the field and market points, respectively. Overall, 79,892 Shs of S. aethopicum revenues was lost in the commercial supply chain constituting 53.9% of the losses. Break down of revenue losses showed that at farm level, the loss is 18%, at wholesale level the losses are 10.2% and at retail level losses are 25.7%.It therefore can be concluded that there is a high physical and economic losses of leafy S. aethopicum vegetables at different stages in the supply chain. More research efforts could be focussed on technologies that reduce post-harvest losses such as drying and minimal processing technologies at farm level where greatest losses are experienced. Keywords: African indigenous vegetables, supply chain, economic loss, physical losses DOI: 10.7176/JESD/10-2-0

Trends in outpatient malaria cases, following Mass Long Lasting Insecticidal Nets (LLIN) distribution in epidemic prone and endemic areas of Kenya

Background: There were over 6 million case of malaria reported in Kenya in 2015 and it remains a major public health priority despite significant investments in interventions to control and prevent infections in high risk areas.Objectives: To analyse trends from 2011-2015, and report i) outpatient department (OPD) malaria case prevalence, ii) the proportion of confirmed malaria cases of all OPD cases stratified by age category, and iii) the proportion of the population potentially protected by long-lasting insecticidal nets (LLINs), following mass distribution of LLINs in malaria epidemic prone and endemic areas.Design: A retrospective study.Setting: Kenya’s Coast endemic, Lake endemic and Highland epidemic zones.Subjects: All outpatient malaria cases reported in the District Health Information System.Results: The proportion of people who received mass LLINs ranged from 80-95% in epidemic prone and endemic areas of Kenya. The coastal endemic zone had the lowest number of reported malaria cases at almost 840,000 in 2011, compared with the lake endemic zone which reported 4.3 million total cases. Confirmed malaria cases of all the OPD morbidity increased by 1%, 20% and 4% in the Highland epidemic prone, the Lake and Coast endemic region in 2011 to 2015, respectively. There was a trend towards fewer cases across all three high risk regions from 2012-2013, but this reversed with increasing cases being reported in 2014-2015.Conclusion: Despite a high LLIN coverage malaria cases increased over time. There is need for patient-level studies to assess if LLINs are being used appropriately and to look towards other complimentary malaria prevention strategies

Bringing care to the community: expanding access to health care in rural Malawi through mobile health clinics.

SETTING: Malawi has chronic shortages of health workers, high burdens of human immunodeficiency virus (HIV) infection and malaria and a predominately rural population. Mobile health clinics (MHCs) could provide primary health care for adults and children in hard-to-reach areas. OBJECTIVES: To determine the feasibility, volume, and types of services provided by three MHCs from 2011 to 2013 in Mulanje District, Malawi. DESIGN: Cross-sectional retrospective study. RESULTS: The MHCs conducted 309 492 visits for primary health care, and in 2013 services operated on 99% of planned days. Despite an improvement in service provision, overall patient visits declined over the study period. Malaria and respiratory and gastro-intestinal conditions constituted 60% of visits. Females (n = 11 543) significantly outnumbered males (n = 2481) tested for HIV, yet males tested HIV-positive (27%) more often than females (14%). Malaria accounted for 26 421 (35%) visits for children aged <5 years, with a significant increase in the rainy season. Implementation of rapid diagnostic testing was associated with a decline in numbers treated for malaria. Antibiotic stockouts at government clinics were associated with increased MHC visits. CONCLUSION: MHCs can routinely provide primary health care for adults and children living in rural Malawi and complement fixed clinics. Moving from a complementary role to integration within the government health system remains a challenge

Trends of reported outpatient malaria cases to assess the Test, Treat and Track (T3) policy in Kenya

Background: Kenya reports over six million malaria cases annually. In 2012 the country adopted the Test, Treat and Track (T3) policy to ensure that all suspected malaria cases are tested, confirmed cases are treated with quality-assured drugs and timely accurate malaria surveillance are in place to guide policy and practice.Objective: To describe the trends of confirmed outpatient malaria cases and the consumption of artemisinin-based combination therapy (ACT) in the government health facilities in Kenya following the roll out of the T3 initiative.Design: A retrospective review study.Setting: All government health facilities in the 47 counties.Subjects: Secondary data on all outpatient malaria cases and ACT consumed as reported in the District Helth Information Software (DHIS).Results: Total malaria cases decreased from 8.5 to 6.8million cases in 2012 and 2015, respectively. Confirmed malaria cases increased from 1.97 (23%) to 4.9 (72%) million cases. The greatest decrease in total malaria cases and the greatest rise in confirmation of suspected cases occurred in the lower level health facilities. More confirmation of suspected cases occurred in the malaria endemic regions compared to other epidemiological zones. Excess ACT consumption reduced by 46% to reach 27% in 2015.Conclusion: Though there was increased confirmation of suspected malaria, still onethird of the outpatients were treated clinically in 2015. About one-third of ACTs were also used in excess in 2015. There is need for enhanced efforts to adhere to the T3 policy and malaria elimination guidelines