Adoption of Computerised Health Information System Focusing on Kenya’s Health Facilities

Although the benefits of information technology are clear adapting new information systems to health care has proven difficult globally and rates of use have been limited. With the challenge of inadequate health workers and low quality of service delivery, Information Communication Technology is essential to ensure availability of Information to multiple users and multiple settings. It is also important for Integration of variable types of data media, data legibility, reduced medical errors, complete and quality data. It also enable structured data entry, accurate calculation of processes, provision of tools for decision support and data based analysis. Although Kenya as a developing country has invested in Information Communication Technology with the aim of improving patient care, all indications have shown slow adoption of technology in healthcare industry. Therefore it is important to focus on means of hastening adoption of HIS in order to enhance service delivery in the health sector and hence effective service delivery for Kenyan people. Keywords: Adoption, Health Information Systems, ICT Infrastructure

The Influence of Infrastructural Investment on Adoption of ICT in Health Information System: A Case of Sub County Referral Hospitals in Nakuru County, Kenya

The use of Information Communication Technology is essential in overcoming the challenges of inadequate health workers and low quality of service delivery. This study was an effort to strengthen the Health Management Information Systems pillar by seeking to assess the adoption of ICT in Health Systems in Nakuru County. The overall objective for this study was to assess the adoption of ICT in health information systems. For the purpose of this paper the researcher has focused on establishing the influence of infrastructural investment on adoption of ICT in HIS. The study employed cross-sectional design with a deductive approach. The target population was 534 made of medical personnel drawn from the sub-county Hospitals within Nakuru County out of which a sample of 98 respondents was used in the study. Data was collected using self-administered questionnaires with questions based on five points Likert Scale which required the respondents to indicate their level of agreement with the statements. The data was analyzed and descriptive statistics used to summarize the responses into frequencies and percentages. The findings were presented in bar graphs with descriptive narratives. The results showed that Lack of adequate ICT infrastructure has hampered ICT adoption in public hospitals in Nakuru County. The study recommends improvement of ICT infrastructure. The County Health Ministry should also support ICT adoption in the public hospitals by allocating adequate funds for this purpose. Keywords: Adoption of ICT, Health Information Systems, ICT Infrastructur

Analysis of woodfuel supply and demand balance in Kiambu, Thika and Maragwa districts in central Kenya

This study was undertaken in Kiambu, Thika and Maragwa districts of Central Kenya and it aimed at developing micro-level wood energy plan that would act as a case study for future decentralized wood energy plans in Kenya. Primary data was collected from households, service/production institutions comprising of factories/industries, schools, restaurants, hospitals and prisons using structured questionnaires. The study established a deficit between supply and demand balance of -41.7, -45.6 and -50.1% of woodfuel in 2006 for Kiambu, Thika and Maragwa districts respectively. The strategies suggested in micro-level wood energy plans to curb these deficits include allocation of gazetted plantation forest to fuel wood production, increase of improved stove technology, increase of on-farm tree land area and use of alternative energy sources. The combination of all these strategies gave a surplus of 22,903, 46,947 and 32,409 tons of woodfuel in Kiambu, Thika and Maragwa districts, respectively by 2018. The study recommended implementation of the identified strategies aimed at reducing the huge deficit between supply and demand, enhancing inter-institutional collaboration in all sectors related to wood energy development, developing clear policies to guide charcoal and firewood production and marketing and having regular wood energy surveys

Analysis of Heartwood -Sapwood Demarcation Methods and Variation of Sapwood and Heartwood within and Between 15 Year Old Plantation Grown Eucalyptus Regnans

Abstract This study was carried out using 15-yea

Wood characteristics and properties of plantation mountain ash (E. regnans) and their variation

Six 15-year old Eucalyptus regnans F.Muell trees from three seedlots in a progeny trial in Narbethong, Victoria were examined in this study. Wood discs were removed from the base, breast height, 20 %, 40 %, 60 % and 80 % of the total tree height. Three methods used to demarcate the boundary between the sapwood and heartwood on the disc cross sectional surface were examined. The first method was based on the difference between sapwood and heartwood. The second method which was based on the difference in pH between sapwood and heartwood used 0.1 % methyl orange stain. The third method which was based on the presence or absence of tyloses in the vessels used a light table. Measurements were also made on the cross sectional surfaces of the discs to determine the sapwood width, heartwood percent, and the number, length and year of formation of each kino vein. The presence of decay and discolouration was also noted. Sapwood and heartwood wood blocks were cut from discs along the four cardinal directions. The basic density and moisture content of all wood blocks from the four axes and the remaining pie shaped pieces from each disc were determined. Mean basic density and moisture content based on the wood blocks from only the four axes were also computed. No difference was found in the demarcation of the sapwood-heartwood boundary between the methods based on natural colour and stain. Demarcation of the boundary using the light table method gave significantly different results to those found for the colour and stain methods. Based on the light table results, the presence of the tyloses appears to vary greatly between the base and breast height while at the 20 %, 40 and 60 heights they are more uniformly distributed. The mean sapwood width varied significantly between trees with values ranging from 24.2 mm to 28.7 mm with on average about four to five growth rings present in the sapwood zone. The mean sapwood also varied significantly with height. The lowest mean sapwood width of 21.0 mm was found at breast height and the mean sapwood width increased to 33.9 mm at the 80 height and increased from breast height to 29.9 mm at the base of the tree. The mean heartwood percent varied significantly between trees and with height. Two trees from seedlot number 13 had a mean heartwood percent of about 42 which was about 6 % lower than the mean heartwood percent of about 48 for the two trees from from seedlot number 23. The largest heartwood percent of 69.51 was found at the breast height and decreased to 0 (zero) at the 80 height and also decreased from the value at breast height to 65.75 at the base of the trees. A correlation of 0.967 was found between heartwood diameter and disc diameter. Kino veins were found in all six trees with the earliest formed vein at the tree age of 4 years. For the six trees, the total number and average length of kino veins decreased with height. The average length varied greatly between trees while the total number of kino veins was relatively uniform in five out of six trees. The presence of decay and discolouration was noted in five out of six trees. Basic density varied significantly between trees and with height but not between the sapwood and heartwood which had mean basic density values of 0.430 g/cm3 and 0.435 g/cm3 respectively. The mean basic density of 0.408 g/cm3 was lowest at breast height and highest at 80 height where the mean basic density was 0.468 g/cm3. Tree number 2 from seedlot number 13 had the highest mean density of 0.486 gm/cm3 and this was significantly greater than the lowest value of 0.422 g/cm3 found for tree number 4 from seedlot number 23. The interactions between trees and heights and between heights and axes were also found to be significant. Moisture content varied significantly between trees and with height but not between the north, south, east and west cardinal directions which had mean values of 146.98 148.47 %, 148.91 and 151.15 respectively. The mean moisture content at breast height was the highest with a value of 161.14 and the lowest value of 134.33 was found at the 80 height. Tree number 2 had the lowest mean moisture content of 127.65 and tree number 5 had the highest value of 161.05%. The interactions between heights and locations (sapwood or heartwood) and between axes and locations were significant. A correlation of -0.923 was found between moisture content and basic density. The mean basic density values and the mean moisture content values determined from blocks removed along only the four axes were strongly correlated to the weighted disc values based on virtually all the wood from each disc

Prevalence of weak RhD phenotype in the blood donor population of Nairobi Regional Blood Transfusion Centre - Kenya

Background: The weak RhD phenotype is a form of RhD antigen that, in routine RhD typing, does not react by agglutination with potent monoclonal anti-D serum, but requires addition of antiglobulin serum to demonstrate the presence of the antigen. However, the weak D antigen can cause immunization or sensitization when a truly D-negative recipient is exposed to it. It is therefore crucial to correctly determine the RhD status of units in the blood donor pool of a transfusion service.Statement of the problem: The prevalence of the weak RhD phenotype is known to vary between races and countries, and the documented prevalence in one race or country is not applicable to others. The prevalence of the weak Rh-D phenotype has not been well documented in the Kenya population.Objectives: The objective of the study was to determine the prevalence of the weak RhD antigen in blood donors at the RBTC in Nairobi. The study was also to explore the weak RhD antigen in relation to the gender and age of the donors in the population.Methods: Donor blood samples were typed by mixing monoclonal anti D with red cell saline suspensions in microtitre plates which were then spun at 2000 rpm for 1 minute. RhD negative samples were further tested by a tube agglutination method. Samples confirmed negative by the two methods were then tested by the indirect antiglobulin technique (IAT) in a Du test.Results: Of the 384 donor samples tested, 26 (6.8%) reacted negatively with an D in the microtitre and tube tests. Eight (30.8% of negatives, and 2.1 % of total) of the 26 “negative” samples reacted positively by the IAT or Du test. There was no relationship between gender or age and weak RhD positivity.Conclusion and recommendation: The prevalence of weak RhD was found to be 2.1 % in the donor population of the RBTC Nairobi Kenya. The Du test should be applied to all blood donor samples found to be RhD negative in routine blood typing.Keywords: Weak RhD antigen, Du Test, Microtitre, Anti Human Globulin (AHG), Monoclonal anti -

The Heterogeneity and Prevalence of ABO and RH D Antigens in the Voluntary Blood Donors of Kenya

Blood groups (antigens) are proteins, glycoproteins or glycolipids inherited surface markers on the red blood cell membranes, which determine the blood phenotypes of human beings. There are 36 blood group systems with over 300 antigens. Among them, ABO and Rh are of clinical significance. For a safe transfusion, a blood donor and recipient should be ABO and Rh D compatible. The heterogeneity of ABO and RhD blood groups systems shows variations in different parts of the world. In Kenya, there is limited study done on ABO and Rh D blood groups heterogeneity among blood donors. The aim of this study was to determine the heterogeneity and prevalence of ABO and Rh D blood groups among voluntary blood donors in Kenya, which is fundamental for compelling management of blood bank stocks. The study sites were, Nairobi, Mombasa, Kisumu, Nakuru, Eldoret, Embu, Meru, Garrisa, Nyeri, Machakos, Thika, Voi, Malindi, Kericho, Kisii, Narok, Bungoma, Kitale, Lodwar and Busia. The presence of blood groups was determined by serological techniques both microtitre and tube methods. Commercial monoclonal antisera (anti-A, anti-B, anti-D and Antihuman globulin) were used. Descriptive statistics and Chi-square were applied in data analysis and results were presented in tables. The results showed that there was a statistical significance difference p< 0.01 between the positive and negative blood types in both the ABO and Rh D systems. Blood group O (51.75%); positive (46.75%), negative (3.5%), weak D (1 .5%), followed by A (24.25%), positive (23.25%), negative (0.5%), weak D (0.25%). B (18.75%); positive (17.25%), negative (1%), weak D (0.25%) and the least is AB at 5.5%; positive (5.5%), negative (0%), weak D (0%). Among the RhD system, D positive was the most common (93%), followed by D negative (5%) and weak D was the least common (2%). This study recommends an extended study with a large sample size and to include heterogeneity of other blood groups of clinical significance

Short CommunicationsStrength Properties and Groups of Major Commercial Timbers Grown in Kenya

The strength properties (based on two physical and four mechanical parameters) were assessed for 49 timber species grown in Kenya based on small clear specimens. Data on mean values were computed from which other statistical information on minimum, mean and maximum strength values were generated. The relationships between physical and selected mechanical properties were also analysed using regression analysis. The species were further classified into four strength groups based on a method developed in Australia but modified to fit the major uses of timber in Kenya. The results confirmed the influence of moisture content and specific gravity on strength properties. There was an observed increase in specific gravity and mechanical strength properties on drying, a fact which favours the use of dry timber. The results also confirmed that both specific gravity and stiffness are useful in predicting strength properties of timber. However, the moderate values of R2 obtained for several relationships reflect clear variation between species due to various factors and the need for applying allowances (Safety factors) when applying the regression models generated. The strength groups developed revealed that most species in Kenya are suitable for heavy engineering works and building construction. The system of grouping developed is suitable where machine grading is not yet in use on a meaningful scale. Discovery and Innovation Vol. 13 no. 3/4 December (2001) pp. 144-149 KEY WORDS: strength properties, commercial timber, physical and mechanical properties Résumé Les propriétés de résistance, basées sur deux paramètres physiques et quatre mécaniques ont été évaluées pour 49 espèces de bois cultivées au Kenya sur des petits spécimens. Les données sur des valeurs moyennes ont été saisies et elles ont servi à générer d'autres informations statistiques comme la résistance minimale, moyenne, maximale. Des rapports entre propriétés physiques et mécaniques retenues pour l'étude ont été également calculés par analyse de régression. Les espèces ont été ensuite classées dans quatre groupes de résistance basée sur une méthode développée en Australie mais modifiée pour l'adapter aux utilisations principales du bois au Kenya. Les résultats ont confirmé l'influence de l'humidité et de la densité spécifique sur des propriétés de résistance. On a observé une augmentation de densité spécifique et de propriétés mécaniques de résistance résultant du séchage, un fait qui plaide en faveur de l'utilisation du bois sec. Les résultats ont également confirmé que la densité et la rigidité étaient des paramètres utiles pour la prédiction des propriétés de résistance du bois. Cependant les valeurs modérées de R2 obtenues pour plusieurs rapports reflètent une nette variation entre les espèces, résultant de divers facteurs, d'où besoin est d'appliquer des marges de sécurité lors de l'application des modèles de régression générés. Les groupes de résistance mis sur pied ont révélé que la plupart des espèces au Kenya sont bien indiquées pour les travaux d'ingénierie lourde et la construction de bâtiments. Le système de groupements développés convient dans les lieux où les appareils d'étalonnage sont peu utilisés ou ne le sont pas du tout. Mots-clés: propriétés de résistance, bois commercial, propriétés physiques et propriétés mécaniques sélectionnée

In Vitro Antimicrobial and Antiproliferative Activities of the Root Bark Extract and Isolated Chemical Constituents of Zanthoxylum paracanthum Kokwaro (Rutaceae)

Zanthoxylum paracanthum Kokwaro (Rutaceae) is an endemic Kenyan and Tanzanian plant used in folk medicine by local populations. Although other Zanthoxylum species have been studied, only Z. paracantum stem extracts have been profiled, even though the roots are also used as herbal remedies. As root extracts may be another source of pharmaceutical compounds, the CH2Cl2/MeOH (1:1) root bark extract was studied in this report. Eight root bark compounds were isolated and their structural identities were confirmed by mass spectrometry (MS) and nuclear magnetic resonance (NMR) (using COSY, HSQC, NOESY and HMBC) analyses. The structural identities were determined as follows: the fatty acid&mdash;myristic acid (1); the sterol&mdash;stigmasterol (2); the lignan&mdash;sesamin (3); two &beta;-carboline alkaloids&mdash;10-methoxycanthin-6-one (6) and canthin-6-one (7); and three phenanthridine alkaloids&mdash;8-acetonyldihydrochelerythrine (4), arnottianamide (5) and 8-oxochelerythrine (8). Some of these compounds were identified in the species for the first time. These compounds and the extract were then tested in vitro against methicillin-resistant Staphylococcus aureus (MRSA), Escherichia coli (ATCC 25922), Staphylococcus aureus (ATCC 29213) and Candida albicans (ATCC 10231) before tests for antiproliferative activity against the human breast cancer (HCC 1395), human prostate cancer (DU 145) and normal (Vero E6) cell lines were conducted. Minimum inhibition concentration values of 3.91, 1.95, 0.98 and 7.81 &micro;g/mL against MRSA, S. aureus, E. coli and C. albicans, respectively, were recorded. Among the isolates, canthin-6-one was the most active, followed by 10-methoxycanthin-6-one. The root extract and some of the compounds also had antiproliferative activity against the HCC 1395 cell line. Stigmasterol and canthin-6-one had IC50 values of 7.2 and 0.42. The root bark extract also showed activity, at 8.12 &micro;g/mL, against the HCC 1395 cells. Out of the chemical isolates, 10-methoxycanthin-6-one and canthin-6-one showed the strongest inhibition of the DU 145 cells. The root extract had significant antimicrobial and antiproliferative activities, supporting the traditional use of this plant in treating microbial infections and cancer-related ailments