Teaching of Physical Education Course as a Fundamental Right of Students in Secondary Schools in Kenya: A Study of Bomet District

The purpose of this study was to assess the gap in policy between the promise and reality in physical education in secondary schools in Bomet District - Kenya. The objective was to establish the extent to which the teaching of physical education formed a fundamental right for students in secondary schools. Biological Sciences Curriculum Study model guided the study. This study utilized descriptive survey method of research. Sampling designs used were simple random, purposive and stratified random sampling. Questionnaire, interview guide and observation schedules were used to collect data and a total of 281 respondents took part in the study. Data analysis was done using descriptive and inferential statistics. It was found that the students were denied their right to be educated physically in secondary schools in Bomet District. This research recommends that the Directorate of Quality Assurance should deploy specialist physical educators to district levels that are responsible for the periodic supervision and evaluation of physical education in secondary schools. Key word: Physical educatio

Combined Antibacterial and Antifungal Activities of Eucalyptus citriodora and Syzygium aromaticum Essential Oils

Background: The increasing proportion of skin infections encountered in general practice represents a substantial level of morbidity. The emergence of multi-drug resistant strains is a formidable threat to the fight against skin diseases and hence alternative forms of treatment are essential. Syzygium aromaticum and Eucalyptus citriodora oils as single entities have demonstrated potency against some of the concerned micro-organisms and any synergistic activity between the two oils could minimise development of resistance by the microorganisms to the two oils. Objective: The aim of this study was to evaluate for synergism between Eucalyptus citriodora and Syzygium aromaticum essential oils against selected pathogenic microorganisms of the skin. Materials and methods: Eucalyptus citriodora (eucalyptus oil) and Syzygium aromaticum (clove oil) essential oils were used in this study. In-vitro antimicrobial activities of Sysygium aromaticum and Eucalyptus citriodora oils, alone and in combination were tested against Staphylococcus aureus ATCC 25923, Pseudomonas aeruginosa, E. coli ATCC 25922, MRSA, Candida albicans, Trichophyton mentagrophytes, Microsporum gypseum and Cryptococcus neoformans. Results: The combination of the two oils exhibited synergistic activity against Staphylococcus aureus (FICI: 0.240), E. coli (FICI: 0.54), MRSA (FICI: 0.48), and Microsporum gypseum (FICI: 0.36) while the combination exhibited additive activity against Candida albicans (FICI: 2.04). Conclusion: The combination of clove and eucalyptus oils possesses synergistic activity against most of the test pathogens and therefore may be combined for enhanced antimicrobial activity against a wide range of skin disease-causing microorganisms. Keywords: antifungal, antibacterial, synergism, Eucalyptus citriodora, Syzygium aromaticum, essential oil

Combined Antibacterial and Antifungal Activities of Eucalyptus citriodora and Syzygium aromaticum Essential Oils - Supporting Information

Background: The increasing proportion of skin infections encountered in general practice represents a substantial level of morbidity. The emergence of multi-drug resistant strains is a formidable threat to the fight against skin diseases and hence alternative forms of treatment are essential. Syzygium aromaticum and Eucalyptus citriodora oils as single entities have demonstrated potency against some of the concerned micro-organisms and any synergistic activity between the two oils could minimise development of resistance by the microorganisms to the two oils. Objective: The aim of this study was to evaluate for synergism between Eucalyptus citriodora and Syzygium aromaticum essential oils against selected pathogenic microorganisms of the skin. Materials and methods: Eucalyptus citriodora (eucalyptus oil) and Syzygium aromaticum (clove oil) essential oils were used in this study. In-vitro antimicrobial activities of Sysygium aromaticum and Eucalyptus citriodora oils, alone and in combination were tested against Staphylococcus aureus ATCC 25923, Pseudomonas aeruginosa, E. coli ATCC 25922, MRSA, Candida albicans, Trichophyton mentagrophytes, Microsporum gypseum and Cryptococcus neoformans. Results: The combination of the two oils exhibited synergistic activity against Staphylococcus aureus (FICI: 0.240), E. coli (FICI: 0.54), MRSA (FICI: 0.48), and Microsporum gypseum (FICI: 0.36) while the combination exhibited additive activity against Candida albicans (FICI: 2.04). Conclusion: The combination of clove and eucalyptus oils possesses synergistic activity against most of the test pathogens and therefore may be combined for enhanced antimicrobial activity against a wide range of skin disease-causing microorganisms. Keywords: antifungal, antibacterial, synergism, Eucalyptus citriodora, Syzygium aromaticum, essential oil

Enhanced infection prophylaxis reduces mortality in severely immunosuppressed HIV-infected adults and older children initiating antiretroviral therapy in Kenya, Malawi, Uganda and Zimbabwe: the REALITY trial

Meeting abstract FRAB0101LB from 21st International AIDS Conference 18–22 July 2016, Durban, South Africa. Introduction: Mortality from infections is high in the first 6 months of antiretroviral therapy (ART) among HIV‐infected adults and children with advanced disease in sub‐Saharan Africa. Whether an enhanced package of infection prophylaxis at ART initiation would reduce mortality is unknown. Methods: The REALITY 2×2×2 factorial open‐label trial (ISRCTN43622374) randomized ART‐naïve HIV‐infected adults and children >5 years with CD4 <100 cells/mm3. This randomization compared initiating ART with enhanced prophylaxis (continuous cotrimoxazole plus 12 weeks isoniazid/pyridoxine (anti‐tuberculosis) and fluconazole (anti‐cryptococcal/candida), 5 days azithromycin (anti‐bacterial/protozoal) and single‐dose albendazole (anti‐helminth)), versus standard‐of‐care cotrimoxazole. Isoniazid/pyridoxine/cotrimoxazole was formulated as a scored fixed‐dose combination. Two other randomizations investigated 12‐week adjunctive raltegravir or supplementary food. The primary endpoint was 24‐week mortality. Results: 1805 eligible adults (n = 1733; 96.0%) and children/adolescents (n = 72; 4.0%) (median 36 years; 53.2% male) were randomized to enhanced (n = 906) or standard prophylaxis (n = 899) and followed for 48 weeks (3.8% loss‐to‐follow‐up). Median baseline CD4 was 36 cells/mm3 (IQR: 16–62) but 47.3% were WHO Stage 1/2. 80 (8.9%) enhanced versus 108(12.2%) standard prophylaxis died before 24 weeks (adjusted hazard ratio (aHR) = 0.73 (95% CI: 0.54–0.97) p = 0.03; Figure 1) and 98(11.0%) versus 127(14.4%) respectively died before 48 weeks (aHR = 0.75 (0.58–0.98) p = 0.04), with no evidence of interaction with the two other randomizations (p > 0.8). Enhanced prophylaxis significantly reduced incidence of tuberculosis (p = 0.02), cryptococcal disease (p = 0.01), oral/oesophageal candidiasis (p = 0.02), deaths of unknown cause (p = 0.02) and (marginally) hospitalisations (p = 0.06) but not presumed severe bacterial infections (p = 0.38). Serious and grade 4 adverse events were marginally less common with enhanced prophylaxis (p = 0.06). CD4 increases and VL suppression were similar between groups (p > 0.2). Conclusions: Enhanced infection prophylaxis at ART initiation reduces early mortality by 25% among HIV‐infected adults and children with advanced disease. The pill burden did not adversely affect VL suppression. Policy makers should consider adopting and implementing this low‐cost broad infection prevention package which could save 3.3 lives for every 100 individuals treated