Important co-morbidity in patients with diabetes mellitus in three clinics in Western Kenya

SETTING: Diabetes clinics in three hospitals in Western Kenya: Moi Teaching and Referral Hospital and two associated district hospitals. OBJECTIVE: To determine the proportion of diabetes patients with a history of tuberculosis (  TB), human immunodeficiency virus (HIV  ) infection and tobacco smoking. DESIGN: A descriptive study using routinely collected data from patient records in the three diabetes clinics. RESULTS: Of 1376 patients analyzed, 750 (55%) were female. The mean age of the patients in the clinics was 53.5 years (95%CI 52.2–54.8), with an average duration of diabetes of 8.1 years (95%CI 7.6–8.7). Of all patients, 5.6% reported a history of TB, similar to the frequency about 20 years earlier (1990) in Tanzania. Only 30% of the patients reported knowing their HIV status; 6% were HIV-positive. A history of tobacco smoking was reported by 3.8% of the patients. CONCLUSION: The HIV epidemic does not seem to have significantly changed the relationship between TB and diabetes mellitus (DM) in this cohort of diabetes patients. The frequency of HIV and TB in this special population was comparable to that in the general population, and only a small proportion of patients reported a history of tobacco smoking

Entrepreneurial Factors Influencing the Performance of Government Funded Youth Group Enterprises in Turbo Sub-County Uasin Gishu County - Kenya

Kenyan’s young people experience unemployment and scarcity of job opportunities due to increased influx of new graduates from Universities and other learning institutions. One of government’s initiatives to boost youths economically was by funding youth group enterprises through the program called Youth Enterprise Development Funds (YEDF) and Uwezo fund. In Uasin Gishu it is reported that youth unemployment remains to be high with more than 600,000 youths unemployed compared to other counties. The study was guided by four objectives; establish the influence of group leadership on the performance of government funded youth group enterprises; determine the contribution of Entrepreneurship skills on the performance of government funded youth group enterprises; find out the role of entrepreneurial resources on the performance of government funded youth group enterprises and find out the role of entrepreneurial vision on the performance of government funded youth group enterprises Turbo Sub-County Uasin Gishu County. The study adopted a descriptive survey research design; used stratified random and random sampling to get respondents for the study. Simple and multiple linear regressions was used to show how independent variables related to dependent (performance of group enterprises). From the study it was found out that though majority of youth group enterprises 77.7% are not doing well in terms of performance. It was found out that most of government fund beneficiaries do not have some of important skills such as entrepreneurial skills and entrepreneurial vision necessary for good business performance

Nutrient flows and balances in intensive crop-dairy production systems in the Kenya highlands

Sustainability of their agricultural systems is essential for many tropical countries where the majority of the people depend upon agriculture for their livelihoods. In the short term economic sustainability is the main factor influencing viability of an agricultural system and of the farms which form its production units. In the long-term, however, economic viability will depend upon the nutrient status of a system. In common with much of the eastern African highlands, Kiambu district in central Kenya has high and increasing pressure on its land and farmers are responding by steadily intensifying their farming systems. This paper addresses the hypothesis that where ruminant livestock are present in intensifying smallholder cropping systems, they make a positive contribution to the nutrient status of the smallholder system. For 21 crop-dairy farms representative of the major smallholder-farming systems in the central highlands of Kenya, annual nutrient balances were determined in a longitudinal study. The farms were visited twice a week; data on all farm inputs and outputs were collected, based on farmer recall. Measures of livestock feed inputs were collected fortnightly. Estimates of nutrient gains and losses in the soil resulting from erosion, leaching, denitrification, volatilisation and N fixation were taken from the literature. Using these data, annual nutrient balances per hectare were estimated for N, P and K. The majority of the sample farms had balanced nutrient flows or were in positive balance for N, P and K overall because of positive flows to the dairy sub-unit, which counterbalanced the outflows from the crop sub-unit. The dairy unit contributed significantly, principally through feed purchases, particularly concentrates for lactating cows. Napier grass and crop residues were also purchased, and large quantities of roadside grass were collected from outside the farms. On the majority of the farms the nutrients returned to the cropping land as manure (which consisted of faeces, bedding material and feed refusals) contributed more nutrients than inorganic fertilisers. It is concluded that the dairy cattle played a major role in contributing nutrient in-flows into these intensive smallholder farms, as well as providing the household’s regular source of income through milk sales

Technology development and field testing: access to credit to allow smallholder dairy farmers in central Kenya to reallocate concentrates during lactation

A field trial with smallholder dairy farmers in central Kenya was carried out to study the feasibility of reallocating concentrates as a means of increasing the profitability of milk production. Researchers designed the trial with extension officers, dairy co-operative and feed company staff to ensure that all stakeholders and key players were involved. Central to the design was the provision of feed on credit from the dairy co-operative to its members, the volunteer farmers involved in the study. The role of the research team was to present the technology to the farmers and monitor the implementation and impact. Farmers were not constrained in the way they chose to implement the recommendations, but the research team monitored any modifications as well as recording production parameters and characteristics of the farm and feed management systems likely to explain underlying variation. The recommendation was to feed 8 kg/day in early lactation, withdrawing concentrates completely after twelve weeks so that during the course of lactation the amount fed would be equivalent to the most frequent farmer practice, a flat rate of 2 kg/day. Actual quantities offered by most farmers were reported to be higher than in previous lactations, but varied from 2-10 kg/day. Although some decreased the amount offered between 8-12 weeks post lactation most continued with the higher levels until a drop in milk yield was observed. Milk production increased as a result of the intervention with a large part of the variation in milk yield (r2 = 0.55) reflecting the amount of concentrate offered. Month of calving and sampling also influenced the production response For many smallholder dairy farmers one of the key constraints to making technological changes expected to improve production is the lack of credit to allow them to make investments. The results so far available from our study showed that farmers were able to increase their milk yield as a result of the intervention, and that, as expected, the response depended on the level of concentrate offered

Complementary feeding practices and nutritional status of children 6-23 months in Kitui County, Kenya

Objectives: Inappropriate complementary feeding practices among  children aged 6-23 months is major cause of under nutrition. There is scarce information on the relationship between complementary feeding practices and nutritional status. This study aimed to determine the factors contributing to the complementary feeding practices and the nutritional status of children aged 6 -23 months.Methodology and Results: A randomly selected sample of 201 children aged 6-23 months was investigated using a cross sectional analytical design in four randomly selected sub-counties in Kitui County. Data wereanalyzed using ENA for SMART for nutrition status, Nutri-survey for dietary intake and SPSS. Results showed that most caregivers (70.6%) had attained primary level education. Majority of respondents (69.2%) had lowlevels of income. The average number of meals consumed per day was 4.1 ± 0.01. The main foods consumed were carbohydrates with little  consumption of fruits and vegetables. The levels of wasting, stunting andunderweight were 7.0%, 22.9% and 10.9%, respectively.Conclusions and application of findings: The complementary feeding practices were inadequate to meet the macronutrient and micronutrients needs of the children. The foods lacked variety, children took fewer meals per day and key foods were consumed less frequently than expected. The low food production in the semi- arid area coupled with low income could be associated with the food insecurity and consequently to the quality, quantity and diversity of the foods consumed by the children. The levels of malnutrition were relatively high for these children aged 6-23 months and this could be attributed to food insecurity indicated by low dietary diversity. The study noted a significant relationship between complementary feeding practices and nutritional status. The study recommends use of locally available, affordable and variety of foods to improve nutrient content of complementary foods. The study recommends agricultural interventions to enhance the nutritional content of complementary foods. Nutrition education on appropriate Infant and Young Child Feeding among mothers is essential.Key words: Complementary feeding practices, Nutritional status, children under 6-23 month

Impact of Agricultural Diversification on Food Security among Smallholder Farming Community in Kilifi South Sub-County, Kenya

Food security is critical to the economic, social, religious, political and cultural development in Kenya. It is crucial to the attainment of economic growth, poverty reduction and sustainable development. Kilifi Sub-County is food insecure and this is a major hindrance to its rural development strategy. Rainfall unreliability, poor distribution and its erratic nature is major challenge to food security in this Sub-County. Despite past efforts put to increase food agricultural production in the Sub-County, food insecurity continues to be felt. Factors causing food insecurity are not clearly understood. The objective of this study is to: determine the influence of agricultural diversification as a livelihood strategy on food security status in Kilifi Sub-County. The research methodology involved a survey using a standard questionnaire which was administered to a sample size of 384 households selected using systematic random sampling procedure. The main data to be collected are indicators which include food availability and food access. Quantitative research method was used to capture data on agricultural diversification as a livelihood strategy among the smallholder farmers in Kilifi south Sub-County. To further enhance food security and improve food security status in Kilifi South Sub-county, engagement in agricultural diversification activities should be encouraged. The findings of this study would be beneficial to leaders, stakeholders and policy makers in decision making process pertaining suitable interventions in attainment of food security in Kilifi South Sub-county. The data was analyzed using multiple regression to measure the combined contribution of livelihood strategies. The analysis of the influence of agricultural diversification on food security revealed that 19% of the households kept cows, 13% kept sheep, 33% kept goats and 35% kept poultry. Additionally, 62% relied on maize, 9% on cassava, 2% on sorghum, 18% on cowpeas and 9% relied on coconut. The study revealed that the households which kept poultry were 35% food secure and those who planted maize and cowpeas were 62% and 18% food secure respectively. It was recommended that these variables were to be addressed by all stakeholders in order to improve the food security status