An investigation of the structure beneath Magadi area in southern Kenya rift using gravimetric data

Magadi area is located in the southern part of the Kenyan rift, an activecontinental rift that is part of the East African Rift system. Local seismic activity monitored previously around Lake Magadi revealed an earthquake cluster caused by swarm activity in the rift centre at shallow depths, which was probably triggered by magma movements. There was need for a follow-up to locate any body at depth with sufficient density contrast that may represent magmatic intrusions. Gravity measurements were carried out in 58 established stations and data from 52 other stations merged from existing coverage of previous measurements. Necessary corrections were applied to the gravity data and a Bouguer contour map prepared. Euler deconvolution technique was used to image depth to the causative bodies along selected profiles on the Bouguer anomaly map. Two  dimensional gravity forward models of the subsurface structure were generated by using Euler depth solutions in the start models. Among others, a unique body of density of 3.20 gcm-3 was modelled on the northern region near little Magadi at a depth of approximately 0.4 km. The location of the body coincides with the area where earthquake swarm occurs. Such a body of high density contrasts may be caused by mafic intrusions into the crust. Discontinuities in Euler solution cluster along the profiles indicated buried faults in the volcanic rift infill. The high seismicity may hence be associated to magma intrusions.Key words: Gravity, Bouguer anomaly, Euler Deconvolution, Keny

Effectiveness and Safety of 2-Hourly 20 MCG Oral Misoprostol Solution Compared to Standard Intravenous Oxytocin in Labour Induction Due to Pre-Labour Rupture of Membranes at Term: A Randomised Clinical Trial at Kenyatta National Hospital

Background: Pre-labour rupture of membranes (PROM) at term is a common event whose management varies from centre to centre. The practice at the Kenyatta National Hospital (KNH) for patients with PROM at term is to initiate delivery of the patient soon on admission with intravenous oxytocin, if there are no contraindications to vaginal delivery. However, in PROM at term, if the cervix is not ripe,vaginal administration of prostaglandin pessaries for cervical ripening is not possible when there is active draining of liquor, thus use of intravenous oxytocin may take a very long time or fail all together. Oral misoprostol at low doses has been found to be a safe and effective agent for labour induction in numerous studies carried out in the developed world, where there are better resources for monitoring of labour. None of the studies has been carried out in Kenya,a limited resource country. Therefore, there is a need to determine the effectiveness and safety of oral misoprostol solution at the KNH, a limited resource set up.Objective: To determine the effectiveness and safety of 2-hourly 20 mcg oral misoprostol solution compared to the standard intravenous oxytocinin labour induction in mothers with pre-labour rupture of membranes at term at the Kenyatta National Hospital.Design: An unblinded randomised clinical trial.Setting: Kenyatta National Hospital Labour Ward Unit.Participants: Eighty three pregnant women with pre-labour rupture of membranes at term without an indication for Caeserian section were consented and randomised for labour induction with either oral misoprostol at a dose of 20mcg 2-hourly up to a maximum of 4-doses, or with  intravenous oxytocin according to the WHO protocol.Main outcome measures: Induction to delivery interval; maternal  complications and early neonatal outcomes.Results: The overall induction success rates in the misoprostol arm was 81% versus 83% in the oxytocin arm (P=0.447). The mean induction to vaginal delivery interval in the misoprostol arm was 8.4 hours as compared to 9.45 hours in the oxytocin arm (P=0.116). The induction to active labour interval was similar in the two study arms. The mean induction to active labour in the misoprostol arm was 4.02 hours as versus 4.51 hours in the oxytocin arm (P=0.223 ). Two women who had failed induction with misoprostol were augmented with oxytocin and delivered vaginally. The Caesarean section rates were 19% in the misoprostol arm and 17% in the oxytocin arm (P=0.447), which was not statistically significant. The maternal outcomes were similar in the two study arms. Four women had tachysystole in the misoprostol arm, compared to three  in the oxytocin arm (P=0.253). In the misoprostol arm two women had hypertonus compared to three in the oxytocin arm (P=0.322).There was one case of hyperstimulation in the misoprostol arm and two in in the oxytocin arm. There were no differences in the foetal/ neonatal outcomes. No baby had an Apgar score of less than seven at one or five minutes. No baby was admitted to the New Born Unit in either of the two arms. There was no case of a still birth in either of the study arms. There was no significant difference in the passage of meconium between the two arms, 39% in the misoprostol arm and 35.7% in the oxytocin arm (P=0.755). The passage of meconium did not impact on the neonatal outcomes.Conclusion: Oral misoprostol solution 20mcg 2-hourly is as safe and effective as the standard intravenous oxytocin for labour induction in women presenting with prelabour rupture of membranes at term at the Kenyatta National Hospital

Spectral analysis of ground magnetic data in Magadi area, Southern Kenya rift

The area surrounding Lake Magadi in the southern Kenya rift is characterized by hot springs that issue from fractures distributed along the shores of the lake. Presence of earthquake swarms that cluster in northern margin of Lake Magadi strongly indicate magmatic activity in the area. This study was done as a follow-up to investigate depth to the heat source possibly causing high seismic activity and high heat flow in the area. A ground magnetic survey was conducted to investigate geothermal potential of the area and a magnetic anomaly contour map prepared. Spectral analysis involving determining power spectrum was applied to magnetic data along selected profiles cutting through discerned anomalies. Spectral analysis results suggest that the Curie-point isotherm depth under Magadi ranges from 5.20 km to 8.30 km. Estimated vertical temperature gradients along the profiles ranges from 111.53°C/km to 69.92°C/km. The hightemperature gradients and relatively shallow Curie point depths indicates high heat flow which suggests presence of a hot magmatic intrusion

The dominant Anopheles vectors of human malaria in Africa, Europe and the Middle East: occurrence data, distribution maps and bionomic précis

<p>Abstract</p> <p>Background</p> <p>This is the second in a series of three articles documenting the geographical distribution of 41 dominant vector species (DVS) of human malaria. The first paper addressed the DVS of the Americas and the third will consider those of the Asian Pacific Region. Here, the DVS of Africa, Europe and the Middle East are discussed. The continent of Africa experiences the bulk of the global malaria burden due in part to the presence of the <it>An. gambiae </it>complex. <it>Anopheles gambiae </it>is one of four DVS within the <it>An. gambiae </it>complex, the others being <it>An. arabiensis </it>and the coastal <it>An. merus </it>and <it>An. melas</it>. There are a further three, highly anthropophilic DVS in Africa, <it>An. funestus</it>, <it>An. moucheti </it>and <it>An. nili</it>. Conversely, across Europe and the Middle East, malaria transmission is low and frequently absent, despite the presence of six DVS. To help control malaria in Africa and the Middle East, or to identify the risk of its re-emergence in Europe, the contemporary distribution and bionomics of the relevant DVS are needed.</p> <p>Results</p> <p>A contemporary database of occurrence data, compiled from the formal literature and other relevant resources, resulted in the collation of information for seven DVS from 44 countries in Africa containing 4234 geo-referenced, independent sites. In Europe and the Middle East, six DVS were identified from 2784 geo-referenced sites across 49 countries. These occurrence data were combined with expert opinion ranges and a suite of environmental and climatic variables of relevance to anopheline ecology to produce predictive distribution maps using the Boosted Regression Tree (BRT) method.</p> <p>Conclusions</p> <p>The predicted geographic extent for the following DVS (or species/suspected species complex*) is provided for Africa: <it>Anopheles </it>(<it>Cellia</it>) <it>arabiensis</it>, <it>An. </it>(<it>Cel.</it>) <it>funestus*</it>, <it>An. </it>(<it>Cel.</it>) <it>gambiae</it>, <it>An. </it>(<it>Cel.</it>) <it>melas</it>, <it>An. </it>(<it>Cel.</it>) <it>merus</it>, <it>An. </it>(<it>Cel.</it>) <it>moucheti </it>and <it>An. </it>(<it>Cel.</it>) <it>nili*</it>, and in the European and Middle Eastern Region: <it>An. </it>(<it>Anopheles</it>) <it>atroparvus</it>, <it>An. </it>(<it>Ano.</it>) <it>labranchiae</it>, <it>An. </it>(<it>Ano.</it>) <it>messeae</it>, <it>An. </it>(<it>Ano.</it>) <it>sacharovi</it>, <it>An. </it>(<it>Cel.</it>) <it>sergentii </it>and <it>An. </it>(<it>Cel.</it>) <it>superpictus*</it>. These maps are presented alongside a bionomics summary for each species relevant to its control.</p

Knowledge, attitudes, and practices regarding emergency contraception among nurses and nursing students in two hospitals in Nairobi, Kenya.

A cross-sectional descriptive study on knowledge, attitudes, and practice about emergency contraception (EC) was conducted among nurses and nursing students using a self-administered questionnaire. One-hundred-sixty-seven qualified nurses and 63 nursing students completed the questionnaire. Over 95% listed at least one regular contraceptive method but only 2.6% spontaneously listed EC as a contraceptive method, whereas 48% of the respondents had heard of EC. Significantly more nursing students than qualified nurses were familiar with EC. Knowledge about the types of EC, applications, and side effects was poor and 49% of the respondents considered EC as an abortifacient. Of those familiar with EC, 77% approved its use for rape victims and 21% for adolescents and schoolgirls. Only 3.5% of all respondents had personally used EC in the past, 23% of those familiar with EC intend to use it in the future, whereas 53% intend to provide or promote it. The view that EC was abortifacient negatively influenced the decision to use or provide EC in the future. The present findings suggest that the level of knowledge of EC is poor and more information is needed. These findings indicate the potential to popularize emergency contraception in Kenya among nurses and nursing students

Farmers' evaluation of legume cover crops for erosion control in Gathwariga catchment, Kenya

Studies were conducted in Gathwariga catchment, Kenya with the aim of evaluating farmers' perception about the impact of legume cover crops (LCC) on soil erosion control. A sensitization workshop involving the farmers was held to discuss the benefits of using LCC for erosion control after which the farmers opted for the following treatments: pure stand of maize (Zea mays) (T1), maize intercropped with Mucuna pruriens (T2), maize plus Vicia benghalensis (T3) and maize plus Lablab purpureus (T4). All the farmers indicated that plots previously planted with LCC provided post-harvest cover to the soil almost 7 months after planting which was crucial in controlling erosion during the on-set of subsequent rains when the ground is bare. The post-harvest percent cover taken at the beginning of the subsequent season was 0, 43.2, 9.0, and 11.4% for T1, T2, T3 and T4 respectively. T1 had 9, 2 and 2.5 times more soil loss than T2, T3 and T4 respectively. The eroded sediments had higher concentrations of plant nutrient elements than the 'field soil'. A follow up visit showed that 84% of the farmers planted mucuna as a sole crop to control erosion in degraded areas, one used mucuna as an intercrop with cassava, two decided to plant mucuna on relatively flat areas for seed multiplication while one farmer had grown mucuna to reclaim a gully.International Journal of Agriculture and Rural Development Vol. 5 2004: 176-18

The sting of death: a case report of breaking bad news with maternal death

Maternal death stings core deep for the relatives and the service providers in an obstetric unit where they had anticipated a joyful experience from childbirth. We describe a case of death disclosure and breaking bad news in our unit. This was a case of a 34 year old, Para 1+0, who underwent elective caesarean section at term, secondary to one previous scar. The operation was successfully conducted and was discharged to the postnatal ward two hours after the surgery in stable condition. Four hours later, the patient was wheeled back to the labor ward gasping. Despite emergency resuscitative measures the patient succumbed. Death was disclosed to the immediate relative in privacy, after a summary of chronology of events, assembling a disclosure team and taking cognizance of emotional reactions. This case is presented to suggest guidelines for breaking bad news upon maternal death to minimize families’ suffering from long-term emotionalconsequences, pathologic grief reactions and cases of medical litigationKeywords: Maternal death disclosure, Breaking bad news, Guideline