Willingness to pay for extension services in Uganda among farmers involved in crop and animal husbandry

Although the Ugandan government is determined to aid farmers increase agricultural productivity as an intervention on increasing food security and reducing poverty through extension services, resources constraints are dampening its efforts. Private extension services providers are being invited to take up information dissemination roles with queries on the availability and demand of the services among farmers to attract private sector and factors influencing the demand for extension services. Data collected by the Uganda Bureau of Statistics (UBOS) on national service delivery throughout the country in 2008 among 5363 and 3318 farmers involved in crops’ and animals’ husbandry was used to predict willingness to pay, amount farmers were willing to pay for extension services and factors that were to influence willingness to pay. It was established that about 35% and 40% of the farmers were willing to pay on average Ugandan shillings 3,400 (US$1.8) and 3,700 (US$ 2) per trip for extension services in crop and animal husbandry respectively. Key farmer’s attributes that influenced willingness to pay included sex, age, education level, regions of residence and preferred means to receive the services. The demand for extension and preferred price are low for private sectors engagement and the government should first educate the public on the importance of the services.Teaching/Communication/Extension/Profession,

Predator-Proof Bomas as a Tool in Mitigating Human-Predator Conflict in Loitokitok Sub-County, Amboseli Region of Kenya.

Abstract Human-wildlife conflict (HWC) arises when wildlife shares the same physical space with humans. HWC, particularly livestock predation results in great negative impacts both to pastoralist and carnivores. Various approaches including compensation, livestock guarding, translocation of the problematic predator, and predator-proof bomas (PPB) have been used to mitigate such conflicts. We assessed PPB in mitigating human-predator conflict in Loitokitok sub-county by focusing on its effectiveness, most problematic predator, community's perceptions, and comparing the PPB and traditional bomas characteristics. Data were obtained from 90 homesteads in Olgulului, Mbirikani and Kimana/Tikondo group ranches. Correlation and paired t-tests were used to analyze the data. Our findings suggest that the boma sizes correlated with the total number of livestock in the boma (r = 0.386, n = 90, p = 0.000) but not the number of people. Hyena and lion accounted for the highest loss of shoats and cattle, with hyena mostly killing shoats (37%) and lions preying largely on cattle (34%). The most problematic predator was as hyena (68%). We found positive relationships between the most problematic predator and total number of livestock (r = 0.319, n = 90, p = 0.002), and boma circumference (r = 0.295, n = 90, p = 0.005). Livestock predation was high in boma during the wet seasons (April, September, October and December). The erection of PPB reduced livestock predation by 91.11% (n = 45) and time spend guarding livestock at night. We recommend a continuous maintenance of the PPB as a long term solution to livestock loss at night and a close guarding of livestock during the day by adults to reduce day time predations

Combating antibiotic resistance using guidelines and enhanced stewardship in Kenya: a protocol for an implementation science approach

Introduction: Antimicrobial resistance (AMR) is a growing problem globally especially in Sub-Saharan Africa including Kenya. Without any intervention, lower/middle-income countries (LMICs) will be most affected due to already higher AMR levels compared with higher income countries and due to the far higher burden of diseases in the LMICs. Studies have consistently shown that inappropriate use of antimicrobials is the major driver of AMR. To address this challenge, hospitals are now implementing antibiotic stewardship programmes (ASPs), which have been shown to achieve reduced antibiotic usage, to decrease the prevalence of resistance and lead to significant economic benefits. However, the implementation of the guideline is highly dependent on the settings in which they are rolled out. This study, employing an implementation science approach, aims to address the knowledge gap in this area and provide critical data as well as practical experiences when using antibiotic guidelines and stewardship programmes in the public health sector. This will provide evidence of ASP performance and potentially contribute to the county, national and regional policies on antibiotics use. Methods and analysis: The study will be conducted in three geographically diverse regions, each represented by two hospitals. A baseline study on antibiotic usage, resistance and de-escalation, duration of hospital stay, rates of readmission and costs will be carried out in the preimplementation phase. The intervention, that is, the use of antibiotic guidelines and ASPs will be instituted for 18 months using a stepwise implementation strategy that will facilitate learning and continuous improvement of stewardship activities and updating of guidelines to reflect the evolving antibiotic needs. Ethics and dissemination: Approvals to carry out the study have been obtained from the National Commission for Science, Technology and Innovation and the Mount Kenya University Ethics Review Committee. The approvals from the two institutions were used to obtain permission to conduct the study at each of the participating hospitals. Study findings will be presented to policy stakeholders and published in peer-reviewed scientific journals. It is anticipated that the findings will inform the appropriate antibiotic use guidelines within our local context

Voltammetric Determination of Penicillin G in Sodium Dodecyl Sulfate/acetate Buffer Media on Glassy Carbon Electrode

The presence of residues of penicillin in food products like milk and meat of animal origin exerts negative impact on public health such as drug resistance diseases and severe allergic responses. This work reports development of a simple voltammetric method for detection of penicillin using sodium dodecyl sulfate (SDS) in acetate buffer solution (ABS) on glassy carbon electrode. Addition of SDS to the penicillin G containing acetate buffer solution (ABS) was found to enhance the voltammetric oxidation current signal by about 5 times with insignificant shift of the oxidation potentials. Using cyclic voltammetry, the oxidation potentials for penicillin G were found to be 1.65V vs. Ag/AgCl in SDS/ABS, pH 4.5 and 1.60V vs. Ag/AgCl in ABS, pH 4.5. The diffusion coefficients for penicillin G were found to be 6.01x10-7 cm2/sec and 1.39x10-6 cm2/sec in ABS, pH 4.5 and SDS/ABS, pH 4.5 respectively. Linear concentration range were also investigated using square wave voltammetry and found to lie in the range of 1.25 – 15µM penicillin G in SDS/ABS, pH 4.5 and 2.5 – 10µM penicillin G in ABS, pH 4.5.Limits of detection were also found to be 1.25µM and 2.5µM penicillin G in SDS/ABS, pH 4.5 and ABS, pH 4.5 respectively while limits of quantitation were 3.75µM penicillin G in SDS/ABS, pH 4.5 and 7.5µM penicillin G in ABS, pH 4.5. Possible interferants like Na+, K+, Zn2+, Ca2+, Fe3+, Cl-, NO3-, PO43- and SO42- did not have any significant effect on the anodic currents and oxidation potentials of the penicillin G. These results show that the developed method is sensitive enough for use in the analysis of penicillin G in diverse real samples

Square Wave Voltammetric Determination of Penicillin V in Sodium Dodecyl Sulfate Containing Media on Glassy Carbon Electrode

The effect of adding sodium dodecyl sulfate (SDS), a surface-active agent to acetate buffer solution containing penicillin V was investigated. The voltammetric responses of penicillin V on glassy carbon electrode was a function of the concentration of penicillin V, surfactant and pH. Addition of SDS to the penicillin V containing acetate buffer solution (ABS) was found to enhance the voltammetric oxidation current signal by about 10 times with insignificant shift of the oxidation potentials. With this electrochemical method, the optimal pH and SDS concentration were found to be pH 4.5 and 0.347M respectively. Using cyclic voltammetry, the oxidation potential for penicillin V were found to be 1.61V vs. Ag/AgCl in SDS/ABS, pH 4.5 and 1.55V vs. Ag/AgCl in ABS, pH 4.5. Linear concentration range were also investigated using square wave voltammetry and found to lie in the range of 0.04 – 34.6µM penicillin V in SDS/ABS, pH 4.5 and 3.5 – 14.0µM penicillin V in ABS, pH 4.5. Limits of detection were also found to be 0.04µM penicillin V in SDS/ABS, pH 4.5 and 3.5µM penicillin V in ABS, pH 4.5 and limits of quantitation were 0.12µM penicillin V in SDS/ABS, pH 4.5 and 14µM penicillin V in ABS, pH 4.5.Foreign substances like Na+, K+, Mg2+, Zn2+, Ca2+, Fe3+, Cu2+, Cl-, NO3-, PO43- and SO42- did not have any significant effect on the voltammetric currents of penicillin V. These results confirm that this electrochemical method is sensitive enough to be used in the determination of penicillin V in diverse environmental and clinical samples

Gender perspectives on coastal and marine ecosystems services flow in Kwale County, Kenya

IntroductionThe continuous flow of ecosystem services (ESs) within coastal and marine ecosystems supports communities' well-being and security by harnessing required resources such as seafood that address food security. The overexploitation of these coastal resources places communities at risk of losing ES. This study assesses how preference for the ES flow from these ecosystem types (i.e., mangrove forests, coastal lagoons, seagrass beds, coral reefs, and the deep sea) vary by gender in Diani Chale and Kisite-Mpunguti Marine Protected Areas in Kwale County, Kenya. Specifically, the objective of this article was to assess the pattern and variation in mean scores of ES flow across coastal and marine ecosystem types by gender.MethodsA total of 148 respondents (87 men and 61 women) aged 20-72 years participated in describing ES through focus group discussions and the Delphi technique. Respondents were engaged in a participatory activity that involved filling of perceived ES flow scores using a 6-point Likert-type scale in the lookup tables (also known as matrix). Data were analyzed using descriptive statistics for mean scores of ES flow across coastal and marine ecosystem types as perceived by men and women. One-way MANOVA was used to test for the significant differences between mean scores of men and women in ES flow across ecosystem types.ResultsThe aggregate scores for non-use values, regulating services, and cultural services, were scored higher than provisioning services by ecosystem service flow. The overall ES flow scores were higher in the mangrove forests 52/90 and least in the coastal lagoon 39/90. There was a significant variation (p < 0.05) of ES flow by gender: the mean score of men was significantly higher than women for most ES flow in cultural, regulating, and provisioning services across some coastal and marine ecosystem types. However, there was no significant variation (p > 0.05) in the flow of non-use values by gender across ET.ConclusionThe findings of this study highlight the importance of understanding gender views in ES access and use at local levels to support food security. Including gender perspectives in coastal and marine ecosystem governance is critical, especially toward achieving sustainable development goals

Participatory Community Nutrition Education: training manual for community health workers

This manual has been developed based on participatory workshops and subsequent agri-nutrition training courses in Vihiga County, Western Kenya by the Alliance of Bioversity International and CIAT. This manual was further evaluated in Turkana and Busia Counties in Kenya, with the intention to develop agricultural interventions to improve nutrition. The learning objectives for the training are focused on: (1) basic principles of nutrition; (2) a life-cycle approach to nutrition; (3) home gardening; (4) use of underutilized crops to diversify diets; and (5) a practical cooking demonstration session

Correlates of the molecular vaginal microbiota composition of African women.

BACKGROUND: Sociodemographic, behavioral and clinical correlates of the vaginal microbiome (VMB) as characterized by molecular methods have not been adequately studied. VMB dominated by bacteria other than lactobacilli may cause inflammation, which may facilitate HIV acquisition and other adverse reproductive health outcomes. METHODS: We characterized the VMB of women in Kenya, Rwanda, South Africa and Tanzania (KRST) using a 16S rDNA phylogenetic microarray. Cytokines were quantified in cervicovaginal lavages. Potential sociodemographic, behavioral, and clinical correlates were also evaluated. RESULTS: Three hundred thirteen samples from 230 women were available for analysis. Five VMB clusters were identified: one cluster each dominated by Lactobacillus crispatus (KRST-I) and L. iners (KRST-II), and three clusters not dominated by a single species but containing multiple (facultative) anaerobes (KRST-III/IV/V). Women in clusters KRST-I and II had lower mean concentrations of interleukin (IL)-1α (p < 0.001) and Granulocyte Colony Stimulating Factor (G-CSF) (p = 0.01), but higher concentrations of interferon-γ-induced protein (IP-10) (p < 0.01) than women in clusters KRST-III/IV/V. A lower proportion of women in cluster KRST-I tested positive for bacterial sexually transmitted infections (STIs; ptrend = 0.07) and urinary tract infection (UTI; p = 0.06), and a higher proportion of women in clusters KRST-I and II had vaginal candidiasis (ptrend = 0.09), but these associations did not reach statistical significance. Women who reported unusual vaginal discharge were more likely to belong to clusters KRST-III/IV/V (p = 0.05). CONCLUSION: Vaginal dysbiosis in African women was significantly associated with vaginal inflammation; the associations with increased prevalence of STIs and UTI, and decreased prevalence of vaginal candidiasis, should be confirmed in larger studies

Effect of Hydrocortisone on Mortality and Organ Support in Patients With Severe COVID-19: The REMAP-CAP COVID-19 Corticosteroid Domain Randomized Clinical Trial.

Importance: Evidence regarding corticosteroid use for severe coronavirus disease 2019 (COVID-19) is limited. Objective: To determine whether hydrocortisone improves outcome for patients with severe COVID-19. Design, Setting, and Participants: An ongoing adaptive platform trial testing multiple interventions within multiple therapeutic domains, for example, antiviral agents, corticosteroids, or immunoglobulin. Between March 9 and June 17, 2020, 614 adult patients with suspected or confirmed COVID-19 were enrolled and randomized within at least 1 domain following admission to an intensive care unit (ICU) for respiratory or cardiovascular organ support at 121 sites in 8 countries. Of these, 403 were randomized to open-label interventions within the corticosteroid domain. The domain was halted after results from another trial were released. Follow-up ended August 12, 2020. Interventions: The corticosteroid domain randomized participants to a fixed 7-day course of intravenous hydrocortisone (50 mg or 100 mg every 6 hours) (n = 143), a shock-dependent course (50 mg every 6 hours when shock was clinically evident) (n = 152), or no hydrocortisone (n = 108). Main Outcomes and Measures: The primary end point was organ support-free days (days alive and free of ICU-based respiratory or cardiovascular support) within 21 days, where patients who died were assigned -1 day. The primary analysis was a bayesian cumulative logistic model that included all patients enrolled with severe COVID-19, adjusting for age, sex, site, region, time, assignment to interventions within other domains, and domain and intervention eligibility. Superiority was defined as the posterior probability of an odds ratio greater than 1 (threshold for trial conclusion of superiority >99%). Results: After excluding 19 participants who withdrew consent, there were 384 patients (mean age, 60 years; 29% female) randomized to the fixed-dose (n = 137), shock-dependent (n = 146), and no (n = 101) hydrocortisone groups; 379 (99%) completed the study and were included in the analysis. The mean age for the 3 groups ranged between 59.5 and 60.4 years; most patients were male (range, 70.6%-71.5%); mean body mass index ranged between 29.7 and 30.9; and patients receiving mechanical ventilation ranged between 50.0% and 63.5%. For the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively, the median organ support-free days were 0 (IQR, -1 to 15), 0 (IQR, -1 to 13), and 0 (-1 to 11) days (composed of 30%, 26%, and 33% mortality rates and 11.5, 9.5, and 6 median organ support-free days among survivors). The median adjusted odds ratio and bayesian probability of superiority were 1.43 (95% credible interval, 0.91-2.27) and 93% for fixed-dose hydrocortisone, respectively, and were 1.22 (95% credible interval, 0.76-1.94) and 80% for shock-dependent hydrocortisone compared with no hydrocortisone. Serious adverse events were reported in 4 (3%), 5 (3%), and 1 (1%) patients in the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively. Conclusions and Relevance: Among patients with severe COVID-19, treatment with a 7-day fixed-dose course of hydrocortisone or shock-dependent dosing of hydrocortisone, compared with no hydrocortisone, resulted in 93% and 80% probabilities of superiority with regard to the odds of improvement in organ support-free days within 21 days. However, the trial was stopped early and no treatment strategy met prespecified criteria for statistical superiority, precluding definitive conclusions. Trial Registration: ClinicalTrials.gov Identifier: NCT02735707