Impacts of Water and Sanitation Activities on the Environment in the Upper Mara Basin

The provision of reliable and safe water supplies is an essential element in improving the quality of life for mankind. However, over time the natural resource base has become severely stressed due to unsustainable use of the resources. This study was undertaken to evaluate the impacts of water, sanitation and hygiene (WASH) activities on the environment in the upper Mara River basin. Sampled water and sanitation projects were identified by observation and Geographic Information System (GIS) was used to map and report on these projects. Impacts of the projects on land and environmental quality were assessed using Land Quality Indicators (LQI); fresh water quality, solid and liquid waste generation and management and soil erosion. Water samples were analyzed for physical, chemical and bacteriological parameters and only 23.4% of sampled water sources were found suitable as domestic water sources. Most open water sources were contaminated with E. Coli caused by open defecation in the basin which on average was 38%. The study showed that, 21.3% of the sampled water supply projects had evidence of soil erosion around them which was mainly caused by livestock overcrowding at water points. Among the wastewater generating and management activities in upper Mara basin, Bomet municipal stabilization pond posed the greatest pollution threat to the environment since it lacked capacity to treat waste water to standards before it overflowed into the environment. This study recommended that WASH project implementers, users and managers should plan for and implement environmentally sustainable projects. In addition, WASH stakeholders in the basin should make comprehensive efforts to provide improved water sources and sanitation to all the residents. Keywords: Water, Sanitation, Environment, Impact

The Global Financial Crisis, Inflation Rate And Stock Market Returns In Kenya

The moderating effect of events such as the 2008 Global Financial Crisis (GFC) on the relation between stock market returns and macroeconomic variables has attracted very little attention. This study investigates the extent to which the 2008 GFC moderated the relationship between inflation rate and stock market returns. The study uses month-onmonth inflation rate and year-on-year inflation rate from 1st January 1993 to 31st December 2015 and divides the sample data into pre-crisis period (from 1st January 1993 to 31st December 2007); crisis period (from 1st January 2008 to 30th June 2009); and post-crisis period (from 1st July 2009 to 31st December 2015). It uses a product-term regression model instead of the most widely applied additive regression model. Results indicate that a unit increase in the both measures of inflation rate had significant depressing effects on stock market returns after the crisis compared to before the crisis. Likewise, the results reveal that average stock market returns were significantly higher after the crisis compared to before the crisis at low rather than medium or high values of the two measures of inflation rate. These results suggest that the Kenyan stock market is highly sensitive to variations in inflation rate, especially as it emerges from a financial or political turmoil. This study is empirically innovative in the sense that it is the first to examine the moderating effect of the 2008 GFC on the relation between inflation rate and stock market returns in Kenya using a product-term model

Prevalence of Human Papillomavirus infection by age and cervical cytology in Thika, Kenya

Human papillomavirus (HPV) infections cause cervical cancer and premalignant dysplasia. Data on HPV and cervical cancer in Kenya are scarce. Type-specific HPV prevalence data provides a basis for assessing the impact of HPV vaccination programs on cervical cytology and how HPV based screening will influence cervical cancer prevention. To investigate HPV infections in a population in Kenya, we obtained cervical cells specimen from 498 women in a population in Thika district. We report HPV type specific prevalence and distribution data for 498 women (age range 18-74 years; mean age 36 years) recruited into the study in relation to age and cervical cytology. The study was conducted between January to May 2010. Pap smears were performed, HR HPV DNA were detected by Digene Hybrid capture 2® (hc2) test and HPV genotyping was performed with Multiplex Luminex HPV genotyping kit (Multimetrix, Progen, Germany). Samples from 106 women (21.3%) tested positive for HPV. Multiple HPV types were detected in 40 (37.7% of HC2-positive samples) and the rest had infection with single HPV type. The most common HR HPV type at all ages was HPV16, 52, 56, 66, and 18. There was a marked decline in the prevalence of HR-HPV with age. The pattern of HR HPV distribution in this population was slightly different from existing literature, which has important consequences for HPV vaccination and prevention programs

Comparison of the prevalence and characteristics of inpatient adverse events using medical records review and incident reporting

Background. Information on adverse events (AEs) in hospitalised patients in developing countries is scanty.Objective. To compare the magnitude and characteristics of inpatient AEs in a tertiary, not-for-profit healthcare facility in Kenya, using medical records review and incident reporting.Methods. Estimation of prevalence was done using incidents reported in 2010 from a random sample of medical records for hospital admissions. Nurse reviewers used 18 screening criteria, followed by physician reviewers to confirm occurrence. An AE was defined as an unexpected clinical event (UE) associated with death, disability or prolonged hospitalisation not explained by the disease condition. The kappa statistic was used to estimate inter-rater agreement, and analysis was done using logistic regression.Results. The study identified 53 UEs from 2 000 randomly selected medical records and 33 reported UEs from 23 026 admissions in the index year. The prevalences of AEs from medical records review and incident reports were 1.4% (95% confidence interval (CI) 0.9 - 2.0) and 0.03% (95% CI 0.012 - 0.063), respectively. Compared with incident reporting, review of medical records identified more disability (13.2% v. 0%; p=0.03) and prolonged hospital stays (43.4% v. 18.2%; p=0.02).Conclusions. Review of medical records is preferable to incident reporting in determining the prevalence of AEs in health facilities with limited inpatient quality improvement experience. Further research is needed to determine whether staff education and a positive culture change through promotion of non-punitive UE reporting or a combination of approaches would improve the comprehensiveness of AE reporting

Epidemiology of sorghum anthracnose (Colletotrichum sublineolum) and leaf blight (Exserohilum turcicum) in Kenya

A 3-year study on the epidemiology of sorghum anthracnose (Colletotrichum sublineolum) and leaf blight (Exserohilum turcicum [Setosphaeria turcica]) was conducted at Alupe in western Kenya from 1994 to 1996. A nonlinear logistic model was used to summarize 72 anthracnose and 108 leaf blight disease progress curves from different planting dates and cultivars. Effects of planting date and cultivar on disease development were compared based on estimates of the rate (β), the absolute rate (θ), inflection point (μ) and upper asymptote (γ), disease severity at milk stage (v95), and time taken to reach a disease severity of 2% (t2, an estimate of time when disease is first observed). Leaf blight epidemics always started earlier than those of anthracnose, but exhibited lower disease severity at crop maturity. Effects of planting date and cultivar on β varied between years. Delaying planting reduced time to disease onset (i.e. µ and t2) and increased absolute rate of progress θ, resulting in maximum severity at crop 'milk stage' and maturity (v95 and γ, respectively). Resistant cultivars had highest µ and t2 but lowest θ, v95 and γ values for both diseases. Delaying planting affected anthracnose progress more on the resistant cultivars, in contrast with leaf blight for which progress on susceptible cultivars was more affected. The implications of these findings for disease management are discussed, and recommendations made to improve disease screening methodologie

Exposure to parasitic infections determines features and phenotypes of active convulsive epilepsy in Africa

Background: Epilepsy affects 70 million people worldwide, 80% of whom are in low-and-middle income countries (LMICs). Infections of the central nervous system (CNS) contribute considerably to the burden of epilepsy in LMICs, but the nature and presentation of epilepsy following these infections is not fully understood. We examined if epilepsy foutcomes are associated with the exposure to parasitic infections. Methods: This was a case-comparison study nested in a cross-sectional survey of people with active convulsive epilepsy, with cases as those exposed to parasitic infections, and comparison as those unexposed. Associations of exposure to parasites with clinical and electroencephalographic features of epilepsy were done using a modified mixed effects Poisson regression model across five sites in Africa. Multiplicative and additive scale (RERI) interactions were explored to determine the effect of co-infections on epilepsy features. Population attributable fractions (PAF) were calculated to determine the proportion of severe clinical and electroencephalographic features of epilepsy attributable to CNS infections. Results: A total of 997 participants with active convulsive epilepsy from the five African sites were analyzed, 51% of whom were males. Exposure to parasitic infections was associated with more frequent seizures in adult epilepsy (relative risk (RR)=2.58, 95% confidence interval (95%CI):1.71-3.89). In children, exposure to any parasite was associated with convulsive status epilepticus (RR=4.68, (95%CI: 3.79-5.78), intellectual disabilities (RR=2.13, 95%CI: 1.35-3.34) and neurological deficits (RR=1.92, 95%CI: 1.42-2.61). Toxoplasma gondii and Onchocerca volvulus interacted synergistically to increase the risk of status epilepticus (RERI=0.91, 95%CI=0.48-1.35) in the data pooled across the sites. Exposure to parasitic infections contributed to 30% of severe features of epilepsy as shown by PAF. Conclusions: Parasitic infections may determine features and phenotypes of epilepsy through synergistic or antagonistic interactions, which can be different in children and adults. Interventions to control or manage infections may reduce complications and improve prognosis in epilepsy

Prevalence and factors associated with aflatoxin contamination of peanuts from Western Kenya

Aflatoxin contamination of peanuts poses a risk to human health and has been identified as a major constraint to trade in eastern Africa. A survey was carried out to obtain baseline data on levels of aflatoxin in peanuts from major production regions in western Kenya. A total of 384 and 385 samples from Busia and Homabay districts, respectively, were obtained and analyzed for aflatoxin content with an indirect competitive ELISA protocol. Levels of aflatoxin ranged from 0 to 2688 and 7525 μg/kg in samples from Busia and Homa Bay, respectively. Of 769 samples, 87.01% contained b4 μg/kg of aflatoxin, 5.45% were in the range ≥4 and 20 μg/kg, while 7.54% exceeded the Kenya's regulatory limit of 20 μg/kg. There was a highly significant (χ2=14.17; Pb0.0002) association between district of origin and sample aflatoxin levels. This observation was supported by a significant (χ2=11.98; P=0.0005) association between levels of aflatoxin and agro ecological zones. Only 3.26% of the samples from the dryer LM3 zone had N20 μg/kg compared with 10.28% of the samples from the wetter and humid LM1 zone. There was also a highly significant (χ2=9.73; P=0.0018) association between cultivar improvement status and aflatoxin levels. Logistic regression analysis revealed that the odds for peanuts from Busia being contaminated were 2.6 times greater than those for peanuts from Homabay. Planting improved cultivars would lower the odds of contamination to a half (odds ratio=0.552) those for local landraces. These results are discussed in relation to the risk of human exposure to aflatoxins and the need for proper sampling procedures for regulatory purposes

Prevalence, incidence, and severity of sorghum diseases in Western Kenya

To assess the prevalence and severity of sorghum diseases in western Kenya, a 2-year survey was conducted (July 1995 and 1996), in 91 and 109 farmers’ fields, respectively. Fields were generally <0.5 ha and production environment ranged from warm-humid to warm-semi-arid. Fourteen foliar and six panicle diseases were observed, with limited variation in disease prevalence and severity between the 2 years. The most common foliar diseases observed were (in decreasing order of prevalence) oval leaf spot (Ramulispora sorghicola), rust (Puccinia purpurea), ladder leaf spot (Cercospora fusimaculans), zonate leaf spot (Gloeocercospora sorghi), gray leaf spot (Cercospora sorghi), leaf blight (Exserohilum turcicum), and anthracnose (Colletotrichum sublineolum); with prevalence ranging from 95 to 97% of fields for oval leaf spot, and 44 to 65% of fields for anthracnose. Head smut (Sporisorium reilianum), was observed in 73 to 75% of fields, covered kernel smut (S. sorghi) 42 to 43% of fields, and loose smut (S. cruenta) 14 to 24% of fields. Head smut incidence was >25% in 3% of fields surveyed. Grain yield reduction from smut diseases alone was estimated to be 5%. Out of eight probability distribution functions compared, the double Gaussian model best described the frequency of disease severity levels for most diseases. Based on the best-fitting model, the proportion of fields with disease severity level thought to cause yield loss (severity rating >5 on a 1 to 9 scale, where 1 = no disease) was calculated as 26.6% for oval leaf spot, 15.3% for rust, 14.8% for anthracnose, 4.8% for ladder leaf spot, and 1.5% for leaf blight. The production environment influenced the prevalence of disease severity. Severe anthracnose, leaf blight, and ladder leaf spot were confined to fields in the humid LM1 and LM2 agro-ecological zones, rust was ubiquitous, and severe gray leaf spot was more prevalent in the dryer LM4 zone