Switch from 200 to 350 CD4 baseline count: what it means to HIV care and treatment programs in Kenya

Introduction: With the increasing population of infected individuals in Africa and constrained resources for care and treatment, antiretroviralmanagement continues to be an important public health challenge. Since the announcement of World Health Organization recommendation andguidelines for initiation of antiretroviral Treatment at CD4 count below 350, many developing countries are adopting this strategy in their countryspecific guidelines to care and treatment of HIV and AIDS. Despite the benefits to these recommendations, what does this switch from 200 to 350CD4 count mean in antiretroviral treatment demand? Methods: A Multi-centre study involving 1376 patients in health care settings in Kenya. CD4count was carried out by flow cytometry among the HIV infected individuals in Kenya and results analyzed in view of the In-country and the newCD4 recommendation for initiation of antiretroviral treatment. Results: Across sites, 32% of the individual required antiretroviral at <200 CD4Baseline, 40% at <250 baseline count and 58% based on the new criteria of <350 CD4 Count. There were more female (68%) than Male(32%).Different from <200 and <250 CD4 baseline criteria, over 50% of all age groups required antiretroviral at 350 CD4 baseline. Age groupsbetween 41-62 led in demand for ART. Conclusion: With the new guidelines, demand for ARVs has more than doubled with variations notedwithin regions and age groups. As A result, HIV Care and Treatment Programs should prepare for this expansion for the benefits to be realized.Key words: CD4, New criteria, HIV, AIDS, care and treatment, ARV initiatio

Ethnobotanical study of medicinal plants used by the people of Mosop, Nandi County in Kenya

Background: Throughout the history, nature has provided mankind with most of their basic needs, which include food, shelter, medicine, clothes, flavours, scents as well as raw materials. Given that they are an integral part of cultural heritage, medicinal plants have played a significant role in human healthcare systems around the world. Investigating various biological resources for use as medicines requires ethnomedicinal studies.Methods: Data on utilization of ethnomedicinal plants from local healers in Kenya’s Mosop Sub-County in Nandi County was documented through open-ended, semi-structured questionnaires. A number of quantitative indices, such as the Use Citation (UC), Informant Consensus Factor (ICF), Use Value (UV), Frequency of Citation (FoC) and Relative Frequency of Citation (RFC) were used to convey the potential medical benefits, vitality and variety of the ethnomedicine.Results: 102 informants provided information on 253 ethnomedicinal plant species, classified into 74 families. There were 249 native plant species identified, along with few exotic species: Senegalia senegal (L.) Britton, Persea americana Mill, Carica papaya L. and Solanum betaceum Cav. Of all recorded species, 32% and 27% were herbs and trees, respectively. Among plant parts, leaves were most frequently utilized (27%) and roots (26%), while decoctions (21%) were the most widely used formulations. The dominant family was Asteraceae, with 28 species, followed by Lamiaceae, with 19 species. The highest ICF value was 0.778 for a number of parasitic and infectious illnesses, including ringworms, athlete’s foot rot, tetanus, typhoid, intestinal parasites, abscesses, malaria, and amoebiasis. The study’s data validates the region’s widespread use of traditional medicinal plant remedies.Conclusion: The current study will lay a foundation of knowledge for future research investigations. The abundance of knowledge regarding ethnomedicinal species and their medicinal applications will stimulate further phytochemical and pharmacological research, which could lead to the discovery of potentially significant pharmaceuticals

Working on legitimacy in land governance; Training manual.

Contains fulltext : 212652pub.pdf (publisher's version ) (Open Access

Strengthening local land registration in conflict-affected northern Uganda; Main findings and policy recommendations.

Contains fulltext : 212647pub.pdf (publisher's version ) (Open Access

Density dependence and the spread of invasive big-headed ants (Pheidole megacephala) in an East African savanna

Supercolonial ants are among the largest cooperative units in nature, attaining extremely high densities. How these densities feed back into their population growth rates and how abundance and extrinsic factors interact to affect their population dynamics remain open questions. We studied how local worker abundance and extrinsic factors (rain, tree density) affect population growth rate and spread in the invasive big-headed ant, which is disrupting a keystone mutualism between acacia trees and native ants in parts of East Africa. We measured temporal changes in big-headed ant (BHA) abundance and rates of spread over 20 months along eight transects, extending from areas behind the front with high BHA abundances to areas at the invasion front with low BHA abundances. We used models that account for negative density dependence and incorporated extrinsic factors to determine what variables best explain variation in local population growth rates. Population growth rates declined with abundance, however, the strength of density dependence decreased with abundance. We suggest that weaker density dependence at higher ant abundances may be due to the beneficial effect of cooperative behavior that partially counteracts resource limitation. Rainfall and tree density had minor effects on ant population dynamics. BHA spread near 50 m/year, more than previous studies reported and comparable to rates of spread of other supercolonial ants. Although we did not detect declines in abundance in areas invaded a long time ago (> 10 years), continued monitoring of abundance at invaded sites may help to better understand the widespread collapse of many invasive ants.Fil: Pietrek, Alejandro Gerardo. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Salta. Instituto de Bio y Geociencias del NOA. Universidad Nacional de Salta. Facultad de Ciencias Naturales. Museo de Ciencias Naturales. Instituto de Bio y Geociencias del NOA; Argentina. University of Florida; Estados Unidos. Mpala Research Centre; KeniaFil: Goheen, Jacob R.. Mpala Research Centre; Kenia. University of Wyoming; Estados UnidosFil: Riginos, Corinna. Mpala Research Centre; Kenia. University of Wyoming; Estados Unidos. Nature Conservancy; Estados UnidosFil: Maiyo, Nelly J.. Ol Pejeta Conservancy; KeniaFil: Palmer, Todd M.. Mpala Research Centre; Kenia. University of Florida; Estados Unido

Fortification of Carica papaya fruit seeds to school meal snacks may aid Africa mass deworming programs: a preliminary survey

Abstract Background Soil transmitted helminths (STHs) are among the world’s neglected tropical diseases. Morbidity due to STHs is greatest in school-age children who typically have the highest burden of infection. In 2001, WHO passed a resolution for the use of large-scale mass drug administration (MDA) to deworm vulnerable children through school based programs. Though effective, there is concern that MDA might not be sustainable over extended periods. Additionally the current MDA strategy does not consider child malnutrition, a very common malady in resource limited countries. We report a pilot evaluation of an innovation that bundles school feeding and deworming. Methods We designed a maize (corn) flour fortified with grounded dried papaya (Carica papaya) seeds and used it to prepare porridge as per the usual school meal recipe Children from three primary schools from Nandi County in Kenya were randomized into three arms: One school received 300 ml papaya fortified porridge daily (papaya group), the second school received similar serving of plain porridge without the pawpaw ingredient (control group) and the third school received plain porridge and the conventional MDA approach of one time 400 mg dosage of albendazole (albendazole arm). Prior to the randomization, an initial baseline stool microscopy analysis was done to determine presence and intensity of intestinal worms. Core indicators of nutrition-height, weight and hemoglobin counts were also assessed. The children were monitored daily for two months and final stool sample analysis and clinical monitoring done at the end of the study. Baseline and follow-up data were analyzed and compared through SAS version 9.1 statistical package. Results A total of 326 children participated in the trial. The overall prevalence of Ascaris lumbricoides was 29.4% (96), Trichuris Trichura 5.2% (17) and hookworm 1 (0.3%). Papaya seed fortified porridge reduced the Ascaris lumbricoides egg count by 63.9% after the two month period (mean 209.7epg to 75.7 p < 0.002) as compared to the albendazole arm 78.8% (129.5 epg to 27.5, p value 0.006). The control group showed an increase in egg count (42.epg to 56.3) though it was not statistically significant. Hemoglobin counts in the papaya group increased from a mean of 2 g/dL (11.5 g/dL to 13.5 g/dL, p < 0.001), as compared to the albendazole arm that increased by 1 g/dL (12.8–13.9, p < 0.001). No significant change was observed in the placebo arm (13.2 to 13.1). Interestingly the papaya group showed a significant reduction of children with Tinea capitis (ringworms) (54.4 to 34%, p < 0.002) as compared to the albendazole arm that showed an increase in ringworm infestation though not statistically significant (39.7 to 64.7% p = 0.608). Conclusion Papaya seed fortified porridge had a significant effect on reduction of Ascaris lumbricoides burden. It had a better nutritional outcome and effect on child fungal infections than albendazole. Its application as a routine school meal may aid current national school based nutrition and deworming programs in Africa. Trial registration This study was retrospectively registered at Clinicaltrials.gov Ref. NCT02725255 on 31st March 2016

The Influence of Food Environments on Food Security Resilience during the COVID-19 Pandemic: An Examination of Urban and Rural Difference in Kenya

Hunger and food insecurity has worsened due to the COVID-19 pandemic. The types of food environments (e.g., natural/built) that people can access may improve household resilience to food-system shocks. This paper examines (1) urban and rural differences in the perceived influence of the COVID-19 pandemic on agricultural, livelihoods, food environment attributes, diets; and (2) whether access to different food environments was associated with food security. A two-part telephonic survey (COVID-19 Surveillance Community Action Network Food Systems Tool and Household Food Insecurity Access Scale) was conducted in Western Kenya (n = 173) and an informal settlement in Nairobi (n = 144) in January/February 2021. Limitations on the acquisition of farm inputs and movement restrictions had an adverse impact on agriculture and food sales. Urban residents reported a more significant impact on livelihoods (97% vs. 87%, p &lt; 0.001), with day laborers being the most impacted. Rural respondents reported access to significantly more food environments and lower food insecurity. Multiple linear regression analysis revealed that younger respondents, &le;1 income source, had more difficulty acquiring food, decreased access to cultivated environments, and increased access to informal markets were predictors for higher food insecurity. These data indicate that access to specific types of food environments may improve household resilience

Frenemy at the gate: Invasion by Pheidole megacephala facilitates a competitively subordinate plant ant in Kenya

Biological invasions can lead to the reassembly of communities and understanding and predicting the impacts of exotic species on community structure and functioning are a key challenge in ecology. We investigated the impact of a predatory species of invasive ant, Pheidole megacephala, on the structure and function of a foundational mutualism between Acacia drepanolobium and its associated acacia-ant community in an East African savanna. Invasion by P. megacephala was associated with the extirpation of three extrafloral nectar-dependent Crematogaster acacia ant species and strong increases in the abundance of a competitively subordinate and locally rare acacia ant species, Tetraponera penzigi, which does not depend on host plant nectar. Using a combination of long-term monitoring of invasion dynamics, observations and experiments, we demonstrate that P. megacephala directly and indirectly facilitates T. penzigi by reducing the abundance of T. penzigi’s competitors (Crematogaster spp.), imposing recruitment limitation on these competitors, and generating a landscape of low-reward host plants that favor colonization and establishment by the strongly dispersing T. penzigi. Seasonal variation in use of host plants by P. megacephala may further increase the persistence of T. penzigi colonies in invaded habitat. The persistence of the T. penzigi–A. drepanolobium symbiosis in invaded areas afforded host plants some protection against herbivory by elephants (Loxodonta africana), a key browser that reduces tree cover. However, elephant damage on T. penzigi-occupied trees was higher in invaded than in uninvaded areas, likely owing to reduced T. penzigi colony size in invaded habitats. Our results reveal the mechanisms underlying the disruption of this mutualism and suggest that P. megacephala invasion may drive long-term declines in tree cover, despite the partial persistence of the ant–acacia symbiosis in invaded areas.Fil: Palmer, Todd M.. Mpala Research Centre; Kenia. University of Florida; Estados UnidosFil: Riginos, Corinna. The Nature Conservancy; Estados Unidos. University of Wyoming; Estados UnidosFil: Milligan, Patrick D.. University of Florida; Estados Unidos. Mpala Research Centre; KeniaFil: Hays, Brandon R.. Mpala Research Centre; Kenia. University of Wyoming; Estados UnidosFil: Pietrek, Alejandro Gerardo. Mpala Research Centre; Kenia. University of Florida; Estados Unidos. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Salta. Instituto de Bio y Geociencias del NOA. Universidad Nacional de Salta. Facultad de Ciencias Naturales. Museo de Ciencias Naturales. Instituto de Bio y Geociencias del NOA; ArgentinaFil: Maiyo, Nelly J.. Ol Pejeta Conservancy; KeniaFil: Mutisya, Samuel. Ol Pejeta Conservancy; KeniaFil: Gituku, Benard. Ol Pejeta Conservancy; KeniaFil: Musila, Simon. National Museums of Kenya; KeniaFil: Carpenter, Scott. University of Yale; Estados UnidosFil: Goheen, Jacob R.. Mpala Research Centre; Kenia. University of Wyoming; Estados Unido