Water use efficiency of six rangeland grasses under varied soil moisture content levels in the arid Tana River County, Kenya

This study evaluated water use efficiency (WUE) of six range grasses, namely; Chloris roxburghiana, Eragrostis superba, Enteropogon macrostachyus, Cenchrus ciliaris, Chloris gayana, and Sorghum sudanense grown at 80, 50, 30% field capacity (FC) soil moisture contents and rainfed treatment which represented water deficit conditions. The changes in soil moisture content were measured by Gypsum Block which aided in determining the irrigation schedules. The grasses demonstrated varied levels of WUE which was evaluated by amount of biomass productivity in relation to evapotranspired water during the growing period. The three soil moisture content treatments had higher water use efficiency than rainfed conditions. There was a declining trend in WUE with grass species maturity where S. sudanense had higher WUE at 8, 10 and 12th weeks (> 15 kg DM ha-1 mm-) in all the treatments followed by C. gayana and E. macrostachyus and were significantly (p<0.05) different from E. superba, C. ciliaris and C. roxburghiana which had WUE less than 10 among the six grass species. The 30% FC soil moisture content had higher WUE at all the phenological stages for S. sudanense, C. gayana and E. macrostachyus compared to 80, 50% FC and rainfed with all having WUE greater than 20 kg DM ha-1 mm-1. These three species are recommended for irrigated pasture establishment in semi-arid lands where water supply uncertainties exist, owing to their high water use efficiency under lower soil moisture levels.Key words: Water use efficiency (WUE), water stress tolerance, range grasses, pasture irrigation, water deficit, Kenya

Do clinicians adhere to practice guidelines? A descriptive study at a referral hospital in Kenya

Background: Clinical guidelines when implemented correctly have shown to improve disease outcomes. This study describes utilization of Kenya National guidelines in managing ante partum haemorrhage (APH) in 3rd trimester.Objective: To describe adherence to clinical guideline in management of antepartum haemorrhage at Garissa Provincial General Hospital Design: Crossectional mixed methods studySetting: Garissa Provincial General HospitalSubjects: Medical records of patients managed for APH between 2002 and 2012 and Key Informant Interviews (KIIs) of Health workers.Results: 36.1% of the cases assessed were managed with strict adherence to guidelines. 90% of health care workers had high levels of awareness of the existence of guidelines and sited utilization challenges attributed to resource inadequacies.Conclusion: Clinicians are skilled on APH guidelines, but adherence levels are still low. Therefore, continuous appraisal of clinical practices, availing equipment, facilities and supplies to reinforce adherence is recommended

Alcohol and illicit drug use among young people living with HIV compared to their uninfected peers from the Kenyan coast: prevalence and risk indicators

Background: In sub-Saharan Africa, there is paucity of research on substance use patterns among young people living with HIV (YLWH). To address the gap, we sought to: i) determine the prevalence of substance use, specifically alcohol and illicit drug use, among YLWH compared to their HIV-uninfected peers; ii) investigate the independent association between young people’s HIV infection status and substance use; iii) investigate the risk indicators for substance use among these young people. Methods: Between November 2018 and September 2019, a cross-sectional study was conducted at the Kenyan coast recruiting 819 young people aged 18–24 years (407 HIV-positive). Alcohol and drug use disorders identification tests (AUDIT and DUDIT) were administered via audio computer-assisted self-interview alongside other measures. Logistic regression was used to determine substance use risk indicators. Results: The point prevalence of current substance use was significantly lower among YLWH than HIV-uninfected youths: current alcohol use, 13% vs. 24%, p \u3c 0.01; current illicit drug use, 7% vs. 15%, p \u3c 0.01; current alcohol and illicit drug use comorbidity, 4 vs. 11%, p \u3c 0.01. Past-year prevalence estimates for hazardous substance use were generally low among young people in this setting (\u3c 10%) with no significant group differences observed. Being HIV-positive independently predicted lower odds of current substance use, but not hazardous substance use. There was overlap of some risk indicators for current substance use between young people with and without HIV including male sex, khat use and an experience of multiple negative life events, but risk indicators unique to either group were also identified. Among YLWH, none of the HIV-related factors was significantly associated with current substance use. Conclusions: At the Kenyan coast, substance use is a reality among young people. The frequency of use generally appears to be low among YLWH compared to the HIV-uninfected peers. Substance use prevention initiatives targeting young people, regardless of HIV infection status, are warranted in this setting to avert their potential risk for developing substance use disorders, including dependence. The multifaceted intrapersonal and interpersonal factors that place young people at risk of substance use need to be addressed as part of the substance use awareness and prevention initiatives

The Gender Context of HIV Risk and Pregnancy Goals in Western Kenya

Background: Intentional childbearing may place heterosexual couples at risk of HIV infection in resource-limited settings with high HIV prevalence areas where society places great value on having children.Objective: To explore cognitive, cultural, and spatial mapping of sexual and reproductive health domains and services in western Kenya among men and women.Design: Community-based formative qualitative study design.Setting: Five administrative/geographical divisions of Nyando District, western Kenya.Subjects: Adult male 18 years and older and female who were of reproductive-potential ages (15 to 49 years for females)(n=90).Results:Men and women have disparate goals for number of children and engage in gendered patterns of protective method use (contraceptives used by women often in secret, condoms by men but rarely).Conclusion: HIV infection was still seen as stigmatising. These study results are relevant to design of effective integrated delivery for reproductive and HIV services in high-burden sub-Saharan African countries

Opportunities and Challenges to Emergency Department-Based HIV Testing Services and Self-Testing Programs: A Qualitative Study of Healthcare Providers and Patients in Kenya

BACKGROUND: Young people in Sub-Saharan Africa, especially males, have been insufficiently engaged through HIV Testing Services (HTS). In Kenya, younger persons are often treated in emergency departments (EDs) for injuries, an interaction where HTS and HIV self-testing (HIVST) can be leveraged. Data from stakeholders on ED-HTS and HIVST is lacking and needed to understand opportunities and barriers for HIV testing and care, and inform program implementation. METHODS: Between December 2021 and March 2022, 32 in-depth interviews (IDIs) were conducted with 16 male and 16 female patients who had been treated in the Kenyatta National Hospital (KNH) ED, half of whom had been HIV-tested. Six focus-group discussions (FGDs) were also conducted with 50 nurses, doctors, HIV testing counselors, and administrators working in the ED. All transcripts were double-coded and thematically analyzed using Dedoose software and a parallel inductive and deductive coding approach which allowed for capture of both a priori and emergent themes. RESULTS: Patients and providers agreed that ED-HTS are facilitated by friendly staff, patient education, high perceived HIV risk, and confidentiality. However, ED-HTS is limited by burdens on staff, resources, time, and space, as well as severity of patient injuries limiting ability to consent to or prioritize HIV testing. These limitations provide opportunities for ED-HIVST: particularly the ability to test at a comfortable time and place, especially when provided alongside sufficient HIV and testing education, contact with healthcare providers, and psychosocial support. Barriers for ED-HIVST where identified and as patients’ concerns about HIVST accuracy and mental health impacts of a positive test, as well providers’ identified barriers on their concerns for loss to follow up and inability to complete confirmatory testing. COM-B Model [Figure: see text] Application of the COM-B Model of Behavior Change to ED-HIVST Acceptability in Kenya CONCLUSION: ED stakeholders are receptive to HTS and HIVST, and patients desire the opportunity to use HIVST. Potential challenges—such as psychological effects of testing positive, worries about access to follow-up care, and confusion about how to self-administer testing, may be addressed through programming designed to promote education, access and ensure follow-up mechanisms. DISCLOSURES: All Authors: No reported disclosures

Quantifying Non-Photosynthetic Vegetation in a Mixed Grassland Using Hyperspectral Data: A Case Study in Kenya

This study is a first attempt to quantify the non-photosynthetic vegetation (NPV) fraction at a semiarid grassland site located in Kenya. We have first applied a model already developed and calibrated for crop analysis to predict grassland NPV from field spectral reflectance data. The second step will be to refine the model and apply it to the PRISMA image to obtain a quantitative map