Diversity and utilization of antimalarial ethnophytotherapeutic remedies among the Kikuyus (Central Kenya)

Plants in Kenya are becoming increasingly important as sources of traditional medicines. The World Health Organization (WHO) has estimated that malaria kills about 2.7 million people every year, 90% of who are from Africa. Malaria continues to be a national concern in Kenya as it plays a major role in the high mortality rates being experienced currently. The use and miss-use of chloroquine to prevent and treat falciparium malaria has led to widespread appearance of chloroquine resistant parasites in Kenya and other tropical countries. These factors and the rising costs of non-chloroquine drugs have made the local people to turn to traditional remedies for management of this menace. This paper examines the current utilization of traditional plant medicines in managing malaria menace in Central Kenya. The results show both indigenous and introduced species are in use indicating traditional medicinal practices in this region are dynamic. In total 58 species in 54 genera and 33 families were identified. The family Rubiaceae was found to have the highest number of reported species. Use of the various taxa is compared between five districts within Central Province of Kenya. The commonest species in this pharmacopoeia are: Caesalpinia volkensii Harms, Strychnos henningsii Gilg, Ajuga remota Benth., Warbugia ugandensis Sprague and Olea europaea L. The first three species are used in all the five districts while the others are restricted in some of the districts. In 74% of the anti-malarial plant species reported in this study, the remedies are obtained in destructive manner and may need conservation measures to ensure sustainable utilization. The results of this study become a basis for selecting plants for further pharmacological and phytochemical studies in developing new and locally relevant anti-malarial agents

Utilisation of priority traditional medicinal plants and local people's knowledge on their conservation status in arid lands of Kenya (Mwingi District)

Mwingi District lies within the Kenyan Arid and Semiarid lands (ASALs) in Eastern Province. Although some ethnobotanical surveys have been undertaken in some arid and semiarid areas of Kenya, limited studies have documented priority medicinal plants as well as local people's awareness of conservation needs of these plants. This study sought to establish the priority traditional medicinal plants used for human, livestock healthcare, and those used for protecting stored grains against pest infestation in Mwingi district. Further, the status of knowledge among the local people on the threat and conservation status of important medicinal species was documented. This study identified 18 species which were regarded as priority traditional medicinal plants for human health. In terms of priority, 8 were classified as moderate, 6 high, while 4 were ranked highest priority species. These four species are Albizia amara (Roxb.) Boiv. (Mimosacaeae), Aloe secundiflora (Engl. (Aloaceae), Acalypha fruticosa Forssk. (Euphorbiaceae) and Salvadora persica L. (Salvadoraceae)

Traditional management of ear, nose and throat (ENT) diseases in Central Kenya

Diseases of ear, nose and throat (ENT) often have serious consequences including hearing impairment, and emotional strain that lower the quality of life of patients. In Kenya, upper respiratory infections are among the most common infections encountered in outpatient facilities. Some of these infections are becoming difficult to control because some of the causing microorganisms have acquired antibiotic resistance and hence the need to develop new drugs with higher efficacy. Ethnobotanical studies have now been found to be instrumental in improving chances of discovering plants with antimicrobial activity in new drug development. In Kenya the majority of local people are turning to herbal remedies for primary health care needs. In most cases the sources of these remedies are undocumented and the knowledge about them passed orally form generation to generation, hence under threat of disappearing with current rates of modernisation. This study explored the traditional remedies used in managing various ENT diseases in seven districts of the Central Province of Kenya. The most common ENT conditions managed using traditional therapies include: common cold, cough, tonsillitis, otitis-media, chest pains and asthma. The results indicate that 67 species belonging to 36 plant families were utilized in this region. These plants were of varying habits; herbs (37.3%), shrubs (34.4%), trees (25.4%) as well as some grasses and sedges (3%). The traditional preparations were found to be made mainly from leaves (49%), roots (20.5%) and barks (12.5%). For each of the ENT conditions multiple species are utilized mainly as individual preparations but occasionally as polyherbal concoctions. In the case of common cold for example, 30 different species are used. Plants reported in this survey are important candidates for antimicrobial tests against ENT disease causing micro-organisms, especially those with antibiotic resistance

Comprehensive transcriptome of the maize stalk borer, Busseola fusca, from multiple tissue types, developmental stages, and parasitoid wasp exposures

International audienc

Public preferences and priorities for end-of-life care in Kenya:a population-based street survey

BACKGROUND: End-of-life care needs are great in Africa due to the burden of disease. This study aimed to explore public preferences and priorities for end-of-life care in Nairobi, Kenya. METHODS: Population-based street survey of Kenyans aged ≥18; researchers approached every 10th person, alternating men and women. Structured interviews investigated quality vs. quantity of life, care priorities, preferences for information, decision-making, place of death (most and least favourite) and focus of care in a hypothetical scenario of serious illness with <1 year to live. Descriptive analysis examined variations. RESULTS: 201 individuals were interviewed (100 women) representing 17 tribes (n = 90 44.8%, Kikuyu). 56.7% (n = 114) said they would always like to be told if they had limited time left. The majority (n = 121, 61.4%) preferred quality of life over quantity i.e. extending life (n = 47, 23.9%). Keeping a positive attitude and ensuring relatives/friends were not worried were prioritised above having pain/discomfort relieved. The three most concerning problems were pain (45.8%), family burden (34.8%) and personal psychological distress (29.8%). Home was both the most (51.1% n = 98) and least (23.7% n = 44) preferred place of death. CONCLUSION: This first population-based survey on preferences and priorities for end-of-life care in Africa revealed that psycho-social domains were of greatest importance to the public, but also identified variations that require further exploration. If citizens’ preferences and priorities are to be met, the development of end-of-life care services to deliver preferences in Kenya should ensure an holistic model of palliative care responsive to individual preferences across care settings including at home

Ethnotherapeutic management of Sexually Transmitted Diseases (STDs) and reproductive health conditions in Central Province of Kenya

255-261Sexually transmitted diseases (STDs) are among the most common infectious diseases that pose major public health concerns in the world today. Although plants used in management of reproductive health in traditional communities play a major role in primary healthcare, they are often over looked in most ethnobotanical surveys. The study investigates various STDs and reproductive health conditions managed through ethnotherapeutic agents as well as the important herbal remedies utilized in Central Province of Kenya. Of 49 plant species belonging to 30 families used in managing various STDs and reproductive health conditions in the study area, 16 species were mentioned three or more times during the survey. Herbal agents used for the treatment of these conditions, especially the ones with high agreement on their use among respondents, form an important resource for antimicrobial screening against microorganisms associated with STDs especially those which have already developed resistant strains. Several species were used in managing pain associated with reproductive issues and may warrant investigations to authenticate their analgesic properties

Mortality Across Two ART Trials Enrolling at ≤200 vs ≤350 CD4 cells/uL in Kenya

Background: In 2011, Kenyan HIV treatment guidelines changed from initiating ART at a CD4 of ≤200 to ≤350 cells/uL. We compared 6-month mortality in 2 research cohorts, one enrolled before and one after the 2011 ART initiation guidelines changed. We hypothesized that following the new guidelines, 6-month post-ART mortality would be lower. Methods: HIV seropositive adults were enrolled in 2 clinical trials at the Coptic Hope Center, Kenya, in 2006 (drug adherence intervention) and 2013 (drug resistance testing intervention, ongoing). In both trials, participants were enrolled prior to ART initiation and started ART following enrollment. Missed visits were investigated to determine if the participant had died using standardized procedures. Linear regression was used to compare mean baseline CD4 count and Cox proportional hazards regression was used to compare 6-month mortality between the two studies. Subjects who enrolled after January 31 2014 were omitted from the analysis. Results: There were 362 and 379 participants in 2006 and 2013 cohorts with at least 6 months of follow-up time. 25 participants in 2013 and none from 2006 were missing a baseline CD4 count. The proportion of female participants in each cohort was 66% and 37%, in 2006 and 2013 respectively. The distribution of subjects and deaths by study and CD4 count is shown in Table 1. The mean baseline CD4 count was 73 cells/uL higher (95% CI: 56, 89; p Conclusions: With implementation of guidelines to initiate ART at a CD4 ≤350 cells/uL, the mean CD4 count increased among those accessing care to initiate ART, though 6-month mortality remained approximately the same. Despite new guidelines, many participants initiated ART with dangerously low CD4 counts. Earlier HIV diagnosis and rapid linkage to care is necessary to achieve survival gains from new ART guidelines