Regeneration of the East African greenheart, Warburgia ugandensis (Sprague) through tissue culture

Warburgia ugandensis is a medicinal plant in the family Canellaceae. There has been a very high demand for Warburgia products for medicinal purposes leading to overexploitation. Warburgia also produces recalcitrant seeds, a fact that has hindered the natural regeneration of this species. In this study, clonal propagation was postulated to be an alternative to propagation through seeds. Shoot tip explant materials were obtained from glasshouse maintained seedlings and these were surface sterilized using both ethanol and sodium hypochlorite. Shoot proliferation and elongation was achieved on shoot tips cultured on full strength Murashige and Skoog (MS) medium containing 3% sucrose, 1.13 mg L-1 benzylamine purine (BAP) and 0.11 mg L-1 of kinetin (KIN). A combination of BAP and kinetin resulted in a significant (p< 0.01) shoot elongation (3.0 cm) and the number of shoots (4 shoots per explants) after 44 days. The best in vitro rooting (50%) was induced through 1 mg L-1 naphthalene acetic acid (NAA) on a half strength Gamborg’s woody plant medium (WPM) containing 3% sucrose. These results indicate that W. ugandensis can be regenerated via in vitro culture using a combined BAP and kinetin to induce multiple shoots and subsequently rooting them under 1 mg/L NAA. The study has therefore developed a protocol for mass clonal propagation of this important medicinal tree.Key words: In vitro, organogenesis, plant shoots, Warburgia ugandensi

Substance abuse and psychiatric co-morbidities: a case study of patients at Mathari Psychiatric Hospital, Nairobi, Kenya

Substance abuse co-morbidity with psychiatric disorders is common and has been widely reported, except in Kenya. This study aimed to determine the prevalence, pattern and socio-economic burden of a dual diagnosis of substance abuse disorder and other psychiatric conditions. This was a cross-sectional descriptive study of 691 patients admitted at Mathari hospital. Only 42 patients had a first working diagnosis of substance abuse but nearly thirty-five percent of the patients scored for a Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) diagnosis of alcohol dependance/abuse. There was high co-morbidity of alcohol abuse/dependence with opiate, sedative and 'khat' use, as well as with mood and other psychotic disorders. Substance abuse disorders correlated significantly with other psychiatric disorders. Only 12 patients were in a drug rehabilitation unit, all of whom had a dual psychiatric diagnosis of affective disorder. There were high co-morbidity rates of substance abuse in both general psychiatric wards and drug rehabilitation units. KEY WORDS: substance abuse, co-morbidity, psychiatric disorders, Keny

Systematic review and meta-analysis: prevalence of alcohol use among young people in eastern Africa.

OBJECTIVE: Systematic review and meta-analysis of published studies of alcohol use among young people (age 15-24 years) in eastern Africa to estimate prevalence of alcohol use and determine the extent of use of standardised screening questionnaires in alcohol studies. METHODS: Five databases (MEDLINE, EMBASE, Global Health, Africa-wide, and PsycINFO) were searched for publications until 30th June 2013. Results were summarised using the guidelines on preferred reporting items for systematic reviews and meta-analyses (PRISMA) and on quality assessment using the modified quality assessment tool for systematic reviews of observational studies (QATSO). Heterogeneity was assessed using the I(2) statistic (DerSimonian-Laird). RESULTS: We identified 2785 potentially relevant studies, of which 56 were eligible for inclusion. Only two studies (4%) used the standardised Alcohol Use Disorder Identification Test (AUDIT) questionnaire, and six studies (13%) used the Cut down, Annoyed, Guilt, Eye opener (CAGE) questionnaire. The reported median prevalence of alcohol use was ever-use 52% [interquartile range (IQR): 20-58%], use in the last month 28% (IQR: 17-37%), use in the last year 26% (IQR: 22-32%), and problem drinking as defined by CAGE or AUDIT 15% (IQR: 3-36%). We observed high heterogeneity between studies, with the highest prevalence of ever use of alcohol among university students (82%; 95%CI: 79-85%) and female sex workers (66%; 95%CI: 58-74%). Current use was most prevalent among male sex workers (69%; 95%CI: 63-75%). CONCLUSIONS: Reported alcohol use and problem drinking were common among diverse groups of young people in eastern Africa, indicating the urgent need for alcohol-focused interventions in this population. Few studies have used standardised alcohol screening questionnaires. Epidemiological research to investigate alcohol-focused interventions in young people should aim to apply such questionnaires that should be validated for use in this population

Improving the effectiveness of psychotherapy in two public hospitals in Nairobi

This paper is the first in a planned series of papers studying the effectiveness of psychotherapy and counselling in Nairobi. It describes a method for checking the effectiveness of psychotherapy and improving service quality in a Kenyan context. Rather than prematurely imposing psychotherapy protocols developed in Western countries in another cultural context, we believe that first studying psychological interventions as they are practised may generate understanding of which psychological problems are common, what interventions therapists use, and what seems to be effective in reducing psychiatric problems. The initial step is to assess outcome of psychological treatments as they are conducted. This is followed by statistical analyses aimed at identifying patient groups who are not improving at acceptable rates. Therapists will then be trained in a 'best practice' approach, and controlled trials are used in a final step, testing new interventions specifically targeted at patient groups with sub-optimal outcomes

Improving the effectiveness of psychotherapy in two public hospitals in Nairobi

This paper is the first in a planned series of papers studying the effectiveness of psychotherapy and counselling in Nairobi. It describes a method for checking the effectiveness of psychotherapy and improving service quality in a Kenyan context. Rather than prematurely imposing psychotherapy protocols developed in Western countries in another cultural context, we believe that first studying psychological interventions as they are practised may generate understanding of which psychological problems are common, what interventions therapists use, and what seems to be effective in reducing psychiatric problems. The initial step is to assess outcome of psychological treatments as they are conducted. This is followed by statistical analyses aimed at identifying patient groups who are not improving at acceptable rates. Therapists will then be trained in a 'best practice' approach, and controlled trials are used in a final step, testing new interventions specifically targeted at patient groups with sub-optimal outcomes