Ethnomedicine of the Kagera Region, north western Tanzania. Part 3: plants used in traditional medicine in Kikuku village, Muleba District.

BACKGROUND\ud \ud The Kagera region of north western Tanzania has a rich culture of traditional medicine use and practice. Traditional medicines are the mainstay of healthcare in this region and are known to support the management of many illnesses such as malaria, bacterial infections, epilepsy, gynecological problems and others. However, most of the plants being used have either not been documented or evaluated for safety and efficacy or both. This study, the sixth of an ongoing series, reports on the medicinal plants that are used at Kikuku village, Muleba District.\ud \ud METHODOLOGY\ud \ud A semi-structured questionnaire was used to collect information on the common/local names of the plants, parts of the plants used, diseases treated, methods of preparing the herbal remedies, dosage of the remedies administered, frequency and duration of treatment and toxicity of the medicines. A literature review was carried out for information on the ethnomedical uses of the reported plants.\ud \ud RESULTS\ud \ud A total of 49 plant species belonging to 47 genera and 24 plant families were documented. The family Euphorbiaceae and Asteraceae had the highest representation. The plants are used for the treatment of skin conditions (10 plants; 20%), bacterial infections and wounds (14 plants; 28.6%), malaria (14 plants; 28.6%), gastrointestinal disorders (11 plants; 22.4%), gynecological problems including infertility (8 plants; 16.3%), hypertension (5 plants; 10.2%), viral infections (7 plants; 14.3%), chest problems (5 plants; 10.2%), diabetes (3 plants; 6.1%), cancer (2 plants; 4.1%), inflammatory conditions (arthritis, rheumatism), HIV and AIDS, and hernia each treated by 1 plant (3 plants in total; 6.1%). Information obtained from the literature indicate that 25 (51.0%) of the therapeutic claims are supported by laboratory results or have similar claims of ethnomedical use from other countries.\ud \ud CONCLUSION\ud \ud Herbal remedies comprise an important and effective component of the healthcare system in Kikuku village with plants in the families Euphorbiaceae and Asteraceae comprising an important part of plants used in the indigenous healthcare management in the village. Malaria and bacterial infections dominate the list of diseases that are managed using traditional medicines

Occupational noise-induced hearing loss among workers at Jomo Kenyatta International Airport, Nairobi

Background: Occupational noise induced hearing loss (NIHL) occurs among workers exposed to excessive amounts of noise for long durations. The average level of noise in some locations at Jomo Kenyatta International Airport (JKIA) was above the safe limit of 85dB hence workers were thought to be at risk.Objective: To determine the occurrence and socio demographic attributes for NIHL at JKIA.Design: Cross sectional descriptive study.Setting: Jomo Kenyatta International Airport, Nairobi, Kenya.Results: Mean age of respondents was 37 years with range 22 to 62, SD 8.98. Mean duration of exposure to noise was 10.7 years with range 1 to 40, SD 8.15. Prevalence of NIHL was 15.3%, with ground crew at 14.8% and air crew 16.1%. Ground crew had significantly poorer mean hearing threshold level at 3, 4 and 6 kHz than air crew (p=0.015). Male workers were affected more than female counterparts with a male to female ratio of 4:3. 97% of those affected were non-managers, 3% managers while 68% of those affected resided in Embakasi Division close to the airport. Hearing threshold level at 4 kHz deteriorated with increasing age whereby those aged 50 years and above had a 13.7 times higher relative risk than those aged 20 to 29 years. Duration of exposure more than 10 years also had significantly higher risk (

Functionalised natural zeolite and its potential for treating drinking water containing excess amount of nitrate

An excess level of nitrate in drinking water is responsible for methemoglobinemia, or ‘blue baby’ disease. Consequently, management of nitrate in drinking water is universally of public health interest. In this study, clinoptilolite functionalised with cationic surfactant hexadecyltrimethyl ammonium (HDTMA) was used for the removal of nitrate from drinking water. The effects of surfactant loading, adsorbent dosage, pH, coexisting ions, temperature and environmental water quality on the adsorption of nitrate were investigated. It was found that adsorption was optimum when the initial concentration of the functionalising surfactant was 3 000 mg∙ℓ-1. An increase in adsorbent dosage raised the percentage removal of nitrate. The valency of the coexisting anion had a major effect on nitrate removal, with the presence of phosphate (a trivalent anion) leading to the lowest removal ability. Temperature and pH had negligible effects on adsorbent performance. Environmental water samples (natural groundwater samples from Limpopo Province, South Africa) were tested and it was found that the World Health Organisation (WHO) regulatory compliance can be achieved even when the initial concentration of nitrate exceeds 300 mg∙ℓ-1. Equilibrium data was modelled using the Freundlich and Langmuir isotherms and the data conformed well to the Freundlich isotherm, indicating the heterogeneous nature of the active sites. Kinetically, nitrate adsorption was best described by the pseudo-second rate equation.Keywords: adsorption, zeolite, nitrate, kinetics, equilibriu

Slowing Disease Progression in Type 2 Diabetes: Latest Advances

Background: Largest head-to-head, double-blind study of metformin, glyburide and rosiglitazone (N = 4,360). Primary objective: To compare the durability of glycemic control using rosiglitazone versus metformin or glyburide as initial monotherapy in patients with recently diagnosed type 2 diabetes. Design: Double-blind, randomized, controlled trial. Inclusion criteria: Type 2 diabetes ≤ 3 years, drug-naive, male and female, aged 30–75 years, FPG 126–180 mg/dl (7–10 mmol/l). Exclusion criteria: Previous use of glucose-lowering therapy, women of child-bearing potential, significant hepatic disease, renal impairment, unstable or severe angina, known CHF (NYHA Class I–IV), uncontrolled hypertension. Treatment duration: Treatment period: 4 to 6 years. Median duration of treatment: 4 years (rosiglitazone and metformin); 3.3 years (glyburide). Interventions: Rosiglitazone, metformin, glyburide

Success rate of crowns and fixed partial dentures provided to patients at the School of Dental Sciences, University of Nairobi

Objective: To evaluate the success rate of crowns and conventional fixed partial dentures provided to patients at the School of Dental Sciences, University of Nairobi.Design: Descriptive cross-sectional study.Setting: School of Dental Sciences, University of Nairobi.Subjects: 97 patients (35 male, 62 female) who had been provided with a total of 150 prostheses at the School of Dental Sciences between 2009 and 2015.Materials and Methods: An interviewer administered questionnaire was used to collect information on socio-demographic data, oral hygiene practices, pain/sensitivity associated with prosthesis, level of satisfaction with the prosthesis and frequency of dental visits. A clinical and radiographic evaluation was conducted for the crowns and fixed partial dentures.Results: The success rate for Fixed Partial Dentures (FPDs) was 75.4% (95% CI: 54.88-95.85%). A statistically significant association was demonstrated between FPD design and success (Fisher’s Exact Test = 8.194, p=0.018) and between the position of the fixed partial denture in the mouth and success (X2= 6.596, p = 0.017). The success rate of crowns was 66.7% (95% CI: 48.89-84.45%). A significant association was demonstrated between the level of training of the clinician and the success of crowns (X2 = 7.772, p= 0.009) and between length of service and the success of crowns (Fisher’s exact test = 8.846, p=0.011).Conclusion: The success rate for crowns and FPDs in our study was lower than the success rate reported in similar studies. Whereas the design and location of prosthesis in the mouth had a significant influence on the success of FPDs, the level of training of clinician and length of service had a significant influence on the success of crowns

Vegetation community structure and diversity in swamps undergoing anthropogenic impacts in Uasin Gishu County, Kenya

Wetlands in Kenya face continuous threat of destruction by agricultural activies, urbanization and pollution. However, their floristic compositions remain unkown since research remains restricted to wetlands of national importance because of their touristic values. A study was conducted in 2006 to determine the species composition and diversity of the vegetation in four swamps within Uasin Gishu County.Data on species composition and diversity were collected using belt transects method and analyzed using cluster analysis and analysis of variance (ANOVA). Two hundred and eighty six plant species belonging to 70 families were enumerated in the four wetlands, with Leseru swamp having the highest species number (176) and diversity (4.02). Families Poacea and Asteracea were represented by the highest number of species (41 each). The four swamps exhibited significantly different levels of human activity and impact; where Chepkongony was the most and Marula the least affected. It is recommended that the wetlands should be declared conservation areas and protected from further drainage or uncontrolled explotation.Keywords: Swamps, species composition, species diversity, Uasin Gishu, anthropogenic factors

Ethnomedicine of the Kagera Region, north western Tanzania. Part 2: The medicinal plants used in Katoro Ward, Bukoba District

\ud The Kagera region of north western Tanzania has a rich culture of traditional medicine use and practices. The dynamic inter-ethnic interactions of different people from the surrounding countries constitute a rich reservoir of herbal based healing practices. This study, the second in an ongoing series, reports on the medicinal plant species used in Katoro ward, Bukoba District, and tries to use the literature to establish proof of the therapeutic claims. Ethnomedical information was collected using semi-structured interviews in Kyamlaile and Kashaba villages of Katoro, and in roadside bushes on the way from Katoro to Bukoba through Kyaka. Data collected included the common/local names of the plants, parts used, the diseases treated, methods of preparation, dosage, frequency and duration of treatments. Information on toxicity and antidote were also collected. Literature was consulted to get corroborative information on similar ethnomedical claims and proven biological activities of the plants. Thirty three (33) plant species for treatment of 13 different disease categories were documented. The most frequently treated diseases were those categorized as specific diseases/conditions (23.8% of all remedies) while eye diseases were the least treated using medicinal plants (1.5% of all remedies). Literature reports support 47% of the claims including proven anti-malarial, anti-microbial and anti-inflammatory activity or similar ethnomedical uses. Leaves were the most frequently used plant part (20 species) followed by roots (13 species) while making of decoctions, pounding, squeezing, making infusions, burning and grinding to powder were the most common methods used to prepare a majority of the therapies. Therapeutic claims made on plants used in traditional medicine in Katoro ward of Bukoba district are well supported by literature, with 47% of the claims having already been reported. This study further enhances the validity of plants used in traditional medicine in this region as resources that can be relied on to provide effective, accessible and affordable basic healthcare to the local communities. The plants documented also have the potential of being used in drug development and on farm domestication initiatives.\u

Risk mapping of Rinderpest sero-prevalence in Central and Southern Somalia based on spatial and network risk factors

The Somali livestock production system is oriented towards domestic trade and export with seasonal movement patterns of herds/flocks in search of water and pasture and towards export points. The objective of the study is to develop a predictive spatial model of presence of rinderpest.Habka loo diyaariyo xoola soomaliyeed ee loogu talagalay in lagu iibiyo dalka gudihiisa ama dibaddiisa, iyagoo xoolahaas loo kaxaynaayo hadba meeshi biyo iyo baad leh iyo goobtii laga dhoofinayaba. Qasdiga daraasaadkaani wuxuu yahay sidii loo hormarin lahaa habka looga hortegi lahaa cudurrada faafa ee lo'da.Il sistema di produzione di bestiame somalo è orientato verso il commercio interno e l'esportazione con movimenti stagionali delle mandrie/greggi in cerca di acqua e pascoli e verso i luoghi di esportazione. L'obiettivo dello studio è quello di sviluppare un modello spaziale predittivo della presenza di peste bovina

Refining a questionnaire to assess breast cancer knowledge and barriers to screening in Kenya: Psychometric assessment of the BCAM

Background Our study objective was to determine the validity and reliability of the breast module of a cancer awareness measure (BCAM) among adult women in western Kenya. Methods The study was conducted between October and November 2012, following three breast cancer screening events. Purposive and systematic random sampling methods were used to identity 48 women for cognitive focus group discussions, and 1061 (594 who attended vs. 467 who did not attend screening events) for surveys, respectively. Face and psychometric validity of the BCAM survey was assessed using cognitive testing, factor analysis of survey data, and correlations. Internal reliability was assessed using Cronbach’s alpha. Results Among survey participants, the overall median age was 34 (IQR: 26–44) years. Compared to those women who did not attend the screening events, women attendees were older (median: 35 vs. 32 years, p = 0.001) more often married (79% vs. 72%, p = 0.006), more educated (52% vs. 46% with more than an elementary level of education, p = 0.001), more unemployed (59% vs. 11%, p = 0.001), more likely to report doing breast self-examination (56% vs. 40%, p = 0.001) and more likely to report having felt a breast lump (16% vs. 7%, p = 0.001). For domain 1 on knowledge of breast cancer symptoms, one factor (three items) with Eigen value of 1.76 emerged for the group that did not attend screening, and 1.50 for the group that attended screening. For both groups two factors (factor 1 “internal influences” and factor 2 “external influences”) emerged among domain 4 on barriers to screening, with varied item loadings and Eigen values. There were no statistically significant differences in the factor scores between attendees and non-attendees. There were significant associations between factor scores and other attributes of the surveyed population, including associations with occupation, transportation type, and training for and practice of breast self-examination. Cronbach’s alpha showed an acceptable internal consistency. Conclusion Certain subpopulations are less likely than others to attend breast screening in Kenya. A survey measure of breast cancer knowledge and perceived barriers to screening shows promise for use in Kenya for characterizing clinical and community population beliefs, but needs adaptation for setting, language and culture

Nephropathy in patients with recently diagnosed type 2 diabetes mellitus black Africans

Background: Albuminuria is long recognised as a sign of renal disease in diabetes. In type 1 diabetes, renal disease occurs after a longer duration of diabetic state. In type 2 diabetes, it is more variable. Objective: To determine the prevalence and any risk factors of albuminuria in short­ term (≤2 yrs) type 2 diabetes. Design: Cross sectional, descriptive study. Microalbuminuria was assessed using micro II strips. Setting: Outpatient diabetic clinic at Kenyatta National Hospital, Nairobi. Subjects: Patients who were newly diagnosed or had had type 2 diabetes for two years or less. Main outcome measures: Microalbuminuria, lipids, glycated haemoglobin, fasting blood glucose and blood pressure. Results: One hundred and thirty nine patients who had type 2 diabetes mellitus for ≤2 yrs were seen, but only 100 patients were included in the study over a six month period. Their mean (SD) age was 53.7 (9.3) years. Mean (SD) duration of diabetes was 10.3 (7.5) months. Fifty per cent of the study patients were hypertensive. Only 48% had HbAic \u3c8% while 36% had HbAic \u3e9%. The lipid profile of total, LDL - HDL­ cholesterol and triglycerides were predominantly within normal limits. Twenty six per cent were established to have albuminuria of which one patient had macroalbuminuria. Blood pressure, glycated haemoglobin and lipid parameters were not significantly different from patients without albuminuria Conclusion: Albuminuria occurred in a significant proportion of patients with short term type 2 diabetes. Comparable to studies done elsewhere on short-term type 2 diabetes, albuminuria is both a sign of nephropathy and a cardiovascular risk factor. It should be looked for in all patients with type 2 diabetes attending this clinic, even at diagnosis