Investigation of Over the Counter Diagnosis and Drug Dispensation in Chemists A Case Study in Thika District, Kenya (An Observational Study)

Over-the-counter (OTC) drugs are medicines that may be obtained directly by a consumer without a prescription from a healthcare professional, as compared to drugs sold to consumers possessing a valid prescription. In many countries, Kenya included, these drugs are often located on the shelves of stores like any other packaged product. Some drugs may be legally classified as OTC but may only be dispensed by a pharmacist after an assessment of the patient's needs and/or the provision of patient education. OTC drugs are capable of being misused, abused especially where inappropriate drugs and incorrect dosages are given which may lead to short and long-term negative effects. The major concern surrounds the correct diagnosis and the appropriateness of the dispensed drugs and information provided to the consumers. This study focused on the OTC drugs in chemists. It was important to know why people opt for OTC drugs instead of the prescribed drugs. To meet this objective, an observational study was carried out in Thika District of Kenya to determine why patients prefer the OTC drugs to prescribed drugs. The results showed that the cost of prescription, source of diagnosis information, source of prescription information, amount of income of the respondent and previous experience on the same similar symptoms were determinants of buying OTC drugs. Education levels, age, place of residence, occupation and hospital type near the respondent were the covariates.  The results of this study have enabled the researcher to come up with recommendations to the Ministries of Medical Services and that of Public Health on the best policies to use in dispensing OTC drugs

Genetic determinants of Nef-mediated CD4 and HLA class I down-regulation differences between HIV-1 subtypes B and C

BACKGROUND: HIV-1 subtype C Nef sequences have a significantly lower ability overall to down-regulate CD4 and HLA-I than subtype B Nef sequences. Here we investigated whether Nef amino acids differing in frequency between HIV-1 subtypes B and C explain lower CD4 and HLA-I down-regulation ability of subtype C. FINDINGS: Subtype-specific mutations were introduced into representative subtype B and C Nef sequences and the CD4 and HLA-I down-regulation ability of these mutants was measured by flow cytometry in a CD4+ T cell line. Subtype C consensus 20I and subtype B consensus 20M reduced and increased HLA-I down-regulation respectively, and the S88G immune escape mutation (which is significantly more frequent in subtype C than subtype B) reduced CD4 and HLA-I down-regulation. CONCLUSIONS: Our data suggest that these subtype-specific differences may partly contribute to inter-subtype functional differences, and identification of an immune escape mutation – S88G – that impairs Nef function is of relevance to vaccine design

Calculation of new enteric methane emission factors for small ruminants in western Kenya highlights the heterogeneity of smallholder production systems

Context: African livestock play a critical role in food security and the wider economy, while accounting for >70% of African agricultural greenhouse gas emissions. Accurate estimates of greenhouse gas emissions from livestock are required for inventory purposes and to assess the efficacy of mitigation measures. While there is an increasing number of studies assessing methane (CH$_{4}$) emissions of cattle, little attention has been paid to small ruminants (SR). Aims: Enteric CH$_{4}$ emissions were assessed from 1345 SR in three counties of western Kenya to develop more accurate emission factors (EF) for enteric CH$_{4}$ from sheep and goats. Methods: Using on-farm animal activity data, feed samples were also analysed to produce estimates of feed digestibility by season and region. The combined data were also used to estimate daily CH$_{4}$ production by season, location and class of animal to produce new EF for annual enteric CH$_{4}$ production of SR. Key results: Mean dry-matter digestibility of the feed basket was in the range of 58–64%, depending on region and season (~10% greater than Tier I estimates). EF were similar for sheep (4.4 vs 5 kg CH$_{4}$/year), but lower for goats (3.7 vs 5 kg CH$_{4}$/year) than those given for SR in developing countries in Intergovernmental Panel on Climate Change (Tier I) estimates. Conclusions: Published estimates of EF for SR range widely across Africa. In smallholder systems in western Kenya, SR appear to be managed differently from cattle, and EF appear to be driven by different management considerations. Implications: The findings highlighted the heterogenous nature of SR enteric emissions in East Africa, but also suggested that emissions from SR are quantitatively less important than other estimates suggest compared with cattle

Growth and Yield Evaluation of \u3ci\u3eUrochloa\u3c/i\u3e Grass Cultivars in Sub-Humid Region of Kenya

Livestock production in sub humid region of Kenya is constrained by inadequate and low quality pasture. A study was conducted to evaluate growth and productivity of eight improved Urochloa grass cultivars in lower midlands, upper midlands and lower highlands agro-ecological zones (AEZ) in Eldoret, Kitale and Alupe respectively, western Kenya. The grass cultivars were; Urochloa brizantha cvs. Marandu, Xaraes, Piata, and MG-4, U. decumbens, cv. Basilisk, U. humidicola cvs. Humidicola and Llanero and Urochloa hybrid cv. Mulato II. Rhodes grass (Chloris gayana) and Napier grass (Pennisetum purpureum cv. Kakamega 1) were included as controls. At establishment stage, growth parameters (height, cover and spread) and dry matter yield (DMY) were monitored at 14 weeks after seedling emergence (WAE) and standardization cut conducted to stimulate uniform plant growth. Thereafter (production stage), the plants were repeatedly harvested for DMY determination at 6, 8 and 12 weeks intervals. The growth parameters and DMY varied significantly (p \u3c 0.05) among the cultivars in all the AEZ in all the measurement dates. Napier grass recorded the highest mean height (60 to 120 cm) at the end of establishment period while among Urochloa cultivars, MG-4, Basilisk and Xaraes recorded the highest mean height and plot cover across all AEZs. All Urochloa cultivars gave significantly (p \u3c 0.05) lower DMY than Napier grass in Kitale and Alupe while Basilisk and Xaraes recorded similar DMY to Napier grass in Eldoret. In Eldoret, Xaraes recorded the highest DMY (2.54 t ha-1) while in Kitale and Alupe the highest DMY was recorded in MG-4 (3.7 t ha-1) and Basilisk (4.72 t ha-1), respectively. Increasing cutting interval increased DMY but reduced nutritive value of Urochloa cultivars in Kitale. Basilisk, MG-4, Xaraes and Piata showed potential to establish and grow well across AEZs and to maximize production and nutritive value cutting at 8 weeks interval is recommended

Genetic diversity study of Kenyan cassava germplasm using simple sequence repeats

Cassava (Manihot esculenta Cranzt) is an important food security crop for resource poor rural communities particularly in Africa. Little is however known about molecular diversity of Kenyan cassava germplasm. This led to a study whose objective was to identify genetic constitution of cassava accessions from different regions of Kenya using molecular tools. Seven pairs of micro satellite (SSR) primers previously developed from cassava were used to detect polymorphic 21 alleles in a sample of 69 accessions. The cluster analysis of similarity matrix obtained at 68% with SSR data showed that the 69 accessions were grouped into five marker based groups. This study proved that SSRs could be used to identify cassava accessions as well as in the assessment of level of genetic relatedness among accessions.Keywords: Cassava, simple sequence repeat (SSR) markers, genetic diversity

Soil Microbial Carbon, Nitrate and Ammonium Nitrogen Dynamics in \u3ci\u3eUrochloa\u3c/i\u3e Grass Cultivated in Sub-Humid Kenya

A study was conducted to monitor the dynamics of available soil phosphorus (P), soil microbial biomass carbon (SMBC), nitrogen (SMBN), ammonium and nitrate nitrogen under seven Urochloa grass cultivars at Kitale, Kenya. The Urochloa cultivars: Urochloa brizantha cvs. Marandu, MG-4, Piata, Xaraes, U. decumbens cv. Basilisk, U. hybrid cv. Mulato II and U. humidicola cv. Llanero was compared with two popularly grown forages, Rhodes grass (Chloris gayana cv. KAT R3), Napier grass (Pennisetum purpureum cv. KK1) and annual weeds. The treatments were tested in a randomized complete block design arranged in a split plot treatment structure with two rates of fertilizer N (0 and 100 kg N ha-1yr-1) and P (0 and 40 kg P ha-1) assigned to the main plots and the grass cultivars assigned to the subplots. After 80 weeks, moist rhizosphere soil was sampled at 0 – 10 cm depth to determine microbial biomass. Application of fertilizer N and P did not significantly (P \u3e 0.05) influence SMBC, SMBN, ammonium N (NH4+N) and nitrate N (NO3-N). However, significant (P = 0.001) changes in soil properties, including NH4+N and NO3-N due to grass cultivars, were observed. After 80 weeks, the bare plot, annual weeds and Napier grass accumulated higher pools of ammonium and nitrate N, but the microbial biomass (SMBC and SMBN) in these treatments were lower than in Urochloa grasses. Soil pH was also low, while NO3-N was high indicating increased nitrification in the bare and Napier grass plots. Ammonium N was the most dominant form of inorganic N in Llanero and Piata due to increased plant uptake or reduced nitrification rates. The results suggested that the change in the SMBC and SMBN in the Urochloa grasses was regulated by the nitrate and ammonium N and soil pH

A simplified approach for producing Tier 2 enteric-methane emission factors based on East African smallholder farm data

Context: Accurate reporting of livestock greenhouse-gas (GHG) emissions is important in developing effective mitigation strategies, but the cost and labour requirements associated with on-farm data collection often prevent this effort in low- and middle-income countries. Aim: The aim of this study was to investigate the precision and accuracy of simplified activity data collection protocols in African smallholder livestock farms for country-specific enteric-methane emission factors. Method: Activity data such as live weight (LW), feed quality, milk yield, and milk composition were collected from 257 smallholder farms, with a total herd of 1035 heads of cattle in Nandi and Bomet counties in western Kenya. The data collection protocol was then altered by substituting the actual LW measurements with algorithm LW (ALG), feed quality (FQ) data being sourced from the Feedipedia database, reducing the need for daily milk yield records to a single seasonal milk measurement (MiY), and by using a default energy content of milk (MiE). Daily methane production (DMP) was calculated using these simplified protocols and the estimates under individual and combined protocols were compared with values derived from the published (PUBL) estimation protocol. Key results: Employing the algorithm LW showed good agreement in DMP, with only a small negative bias (7%) and almost no change in variance. Calculating DMP on the basis of Feedipedia FQ, by contrast, resulted in a 27% increase in variation and a 27% positive bias for DMP compared with PUBL. The substitutions of milk (MiY and MiE) showed a modest change in variance and almost no bias in DMP. Conclusion: It is feasible to use a simplified data collection protocol by using algorithm LW, default energy content of milk value, seasonal single milk yield data, but full sampling and analysis of feed resources is required to produce reliable Tier 2 enteric-methane emission factors. Implications: Reducing enteric methane emissions from the livestock is a promising pathway to reduce the effects of climate change, and, hence, the need to produce accurate emission estimates as a benchmark to measure the effectiveness of mitigation options. However, it is expensive to produce accurate emission estimates, especially in developing countries; hence, it is important and feasible to simplify on-farm data collection

HIV/AIDS-related non-Hodgkin’s lymphomas and confounders: preliminary report of the Sub-Saharan Africa Lymphoma Consortium (SSALC)

CITATION: Ayers, L.W. et al. 2012. HIV/AIDS-related non-Hodgkin’s lymphomas and confounders : preliminary report of the Sub-Saharan Africa Lymphoma Consortium (SSALC). Infectious Agents and Cancer, 7(Suppl 1):P11, doi:10.1186/1750-9378-7-S1-P11.The original publication is available at http://infectagentscancer.biomedcentral.comSSALC was established to characterize HIV/AIDS-related lymphoma and the indigenous background of malignant lymphomas (ML) in sub-Saharan Africa. Because WHO classified lymphoma subgroups can vary in prevalence African, Asian or European ancestry, we surveyed lymphoma heterogeneity in geographically diverse East, South and West sub-Saharan populations, particularly for HIV/AIDS associated immunophenotypes.http://infectagentscancer.biomedcentral.com/articles/10.1186/1750-9378-7-S1-P11Publisher's versio

A simplified approach for producing Tier 2 enteric methane emission factors based on East African smallholder farm data

Context: Accurate livestock greenhouse gas (GHG) emissions reporting is important in developing effective mitigation strategies, but the cost and labor requirements associated with on-farm data collection often prevent this effort in low-and-middle-income countries. Aim: The aim of this study was to investigate the precision and accuracy of simplified activity data collection protocols in African smallholder livestock farms for country-specific enteric methane emission factors. Method: Activity data such as live weight (LW), feed quality, milk yield, and milk composition were collected from 257 smallholder farms with a total herd of 1,035 heads of cattle in Nandi and Bomet counties in Western Kenya. The data collection protocol was then altered by substituting actual LW measurements with algorithm LW (ALG), feed quality (FQ) data sourced from the Feedipedia database, reducing the need for daily milk yield records to a single seasonal milk measurement (MiY), and using a default energy content of milk (MiE). Daily methane production (DMP) was calculated using these simplified protocols and the estimates under individual and combined protocols were compared with values derived from the published (PUBL) estimation protocol. Key results: Employing the algorithm LW showed good agreement in DMP with only a small negative bias (7%) and almost no change in variance. Calculating DMP based on Feedipedia FQ, by contrast, resulted in a 27% increase in variation and a 27% positive bias for DMP compared to PUBL. The substitutions of milk (MiY and MiE) showed a modest change in variance and almost no bias in DMP. Conclusion: It is feasible to use a simplified data collection protocol by using algorithm LW, default energy content of milk value, seasonal single milk yield data, but full sampling and analysis of feed resources is required to produce reliable Tier 2 enteric methane emission factors. Implications: Reducing enteric methane emissions from the livestock is a promising pathway to reduce the effects of climate change hence the need to produce accurate emissions estimates as benchmark to measure the effectiveness of mitigation options. However, it is expensive to produce accurate emission estimates especially in developing countries, hence important and feasible to simplify on-farm data collection

Farm-level emission intensities of smallholder cattle (Bos indicus; B. indicus–B. taurus crosses) production systems in highlands and semi-arid regions

Ruminants are central to the economic and nutritional life of much of sub-Saharan Africa, but cattle are now blamed for having a disproportionately large negative environmental impact through emissions of greenhouse gas (GHG). However, the mechanism underlying excessive emissions occurring only on some farms is imperfectly understood. Reliable estimates of emissions themselves are frequently lacking due to a paucity of reliable data. Employing individual animal records obtained at regular farm visits, this study quantified farm-level emission intensities (EIs) of greenhouse gases of smallholder farms in three counties in Western Kenya. CP was chosen as the functional unit to capture the outputs of both milk and meat. The results showed that milk is responsible for 80–85% of total CP output. Farm EI ranged widely from 20 to >1 000 kg CO$_{2}$-eq/kg CP. Median EIs were 60 (Nandi), 71 (Bomet), and 90 (Nyando) kg CO$_{2}$-eq/kg. Although median EIs referenced to milk alone (2.3 kg CO$_{2}$-eq/kg milk) were almost twice that reported for Europe, up to 50% of farms had EIs comparable to the mean Pan-European EIs. Enteric methane (CH$_{4}$) contributed >95% of emissions and manure ∼4%, with negligible emissions attributed to inputs to the production system. Collecting data from individual animals on smallholder farms enabled the demonstration of extremely heterogeneous EI status among similar geographical spaces and provides clear indicators on how low EI status may be achieved in these environments. Contrary to common belief, our data show that industrial-style intensification is not required to achieve low EI. Enteric CH$_{4}$ production overwhelmingly drives farm emissions in these systems and as this is strongly collinear with nutrition and intake, an effort will be required to achieve an “efficient frontier” between feed intake, productivity, and GHG emissions