Lipidemia status among HIV positive adult male on HAART attending the HIV clinic at Kericho district hospital, Kericho

Background: It is unfortunate that while Highly Active Anti-retroviral Therapy (HAART) has become the standard of care among HIV positive patients, the medications have been associated with metabolic abnormalities recognised to cause lipidemia.Objective: To establish lipidemia status among HIV positive adult male patients attending HIV clinic at Kericho District Hospital.Design: A cross sectional analytical study.Setting: HIV clinic at Kericho District Hospital, Kenya.Subjects: HIV positive adult male patientsResults: The results indicated that the mean age was 43.52 ± 9.17 years and out of which 82.27% were married. Primary Education level attained 40.97% .The mean lipid profile level was LDL 2.5 ± 1.05mmol/l, cholesterol 4.49 mmol/L ± 1.28 mmol/l, HDL 1.47 ± 0.58 mmol/l and triglycerides 1.96 ± 1.32 mmol/l, against the expected level of LDL (1.1. - 2.4 mmol/L), HDL (0.9 - 1.68 mmol/L) triglyceride (0.41 - 2.61 mmol/L) and total cholesterol (2.55 - 5.7 mmol/L).The prevalence lipidemia was 48.17%.Conclusion: The findings showed that the mean LDL was elevated with proportion of lipidemia at a significant higher level among HIV positive adult patients on HAART with considerable improvement in the nutritional status. Future work should investigate the biological mechanisms and pathways through which micronutrients affects high density lipoprotein (HDL) and low density lipoproteins (LDL)

Nutritional status of adult male on art at Kericho District Hospital, Kericho County, Kenya

Background: Nutrition and HIV are strongly related and any immune impairment as a result of HIV leads to malnutrition while malnutrition leads to immune impairment and thus worsens the effect of HIV. Individuals living with HIV have special nutritional needs irrespective of whether they are on anti-retroviral treatment or receiving care services.Objective: To establish nutritional status of adult male on ART at Kericho District Hospital, Kenya.Design: Cross sectional analytical study.Setting: HIV clinic at Kericho District Hospital, Kenya.Subjects: HIV positive adult male patientsResults: Body Mass Index ≥18.5 and ≤ 24.5 (70.92), >16 & < 18.5 (11.94), >25.5 and < 30 (11.94), ≤ 16 (2.58) and ≥30.Conclusion: There is a high burden of malnutrition among PLHIV on ART (29.1%). Nutritional assessment, Counseling and support (NACS) should be the key intervention during the course of chronic HIV care and follow up

Patient Associated Factors that Affect Adherence to Warfarin Therapy in a Tertiary Referral Hospital in Kenya

Warfarin is the most widely used oral anticoagulant but non-adherence to its therapy contributes significantly to sub-optimal anticoagulation control. A crosssectional study was carried out among 147 adult outpatients at Kenyatta National Hospital to determine the level of adherence and explore the associated factors. Adherence was associated with age, gender heart valve surgery, alcohol consumption, and cost of treatment. On multivariate analysis, the independent variables associated with adequate adherence were age (OR = 0.429, 95% CI = 0.228-0.808; p = 0.009), gender (OR = 0.299, 95% CI = 0.123-0.728; p = 0.008) and the type of thromboembolic disease (OR = 0.385, 95% CI = 0.214-0.690; p = 0.001). Adherence was better among females, older age groups and patients who had undergone heart valve surgery. Adherence was poorer among males, younger participants and patients with venous thromboembolism. We suggest that medication adherence counseling to warfarin therapy should be emphasized in poor-adherent patient populations.Key words: Warfarin, adherence, patient factors, Keny

Analysis of woodfuel supply and demand balance in Kiambu, Thika and Maragwa districts in central Kenya

This study was undertaken in Kiambu, Thika and Maragwa districts of Central Kenya and it aimed at developing micro-level wood energy plan that would act as a case study for future decentralized wood energy plans in Kenya. Primary data was collected from households, service/production institutions comprising of factories/industries, schools, restaurants, hospitals and prisons using structured questionnaires. The study established a deficit between supply and demand balance of -41.7, -45.6 and -50.1% of woodfuel in 2006 for Kiambu, Thika and Maragwa districts respectively. The strategies suggested in micro-level wood energy plans to curb these deficits include allocation of gazetted plantation forest to fuel wood production, increase of improved stove technology, increase of on-farm tree land area and use of alternative energy sources. The combination of all these strategies gave a surplus of 22,903, 46,947 and 32,409 tons of woodfuel in Kiambu, Thika and Maragwa districts, respectively by 2018. The study recommended implementation of the identified strategies aimed at reducing the huge deficit between supply and demand, enhancing inter-institutional collaboration in all sectors related to wood energy development, developing clear policies to guide charcoal and firewood production and marketing and having regular wood energy surveys

A review on the contribution of crop diversification to Sustainable Development Goal 1 “No poverty” in different world regions

I am grateful to Professor Maggie Gill and Dr Leslie Lipper for initial discussions, to Dr Leslie Lipper for arranging the meetings with the experts at the Food and Agriculture Organization (FAO) and to the experts at FAO for the valuable discussions on the topic. I would also like to thank Kirsten MacSween for revising the English. This research has been funded by the UK Natural Environment Research Council (NERC), NE/N005619/1.Peer reviewedPublisher PD

Managing soil organic carbon in tropical agroecosystems: evidence from four long-term experiments in Kenya

In sub-Saharan Africa, maize is one of the most important staple crops, but long-term maize cropping with low external inputs has been associated with the loss of soil fertility. While adding high-quality organic resources combined with mineral fertilizer has been proposed to counteract this fertility loss, the long-term effectiveness and interactions with site properties still require more understanding. This study used repeated measurements over time to assess the effect of different quantities and qualities of organic resource addition combined with mineral nitrogen (N) on the change of soil organic carbon (SOC) contents over time (and SOC stocks in the year 2021) in four ongoing long-term experiments in Kenya. These experiments were established with identical treatments in moist to dry climates, on coarse to clayey soil textures, and have been conducted for at least 16 years. They received organic resources in quantities equivalent to 1.2 and 4 t C ha−1 yr−1 in the form of Tithonia diversifolia (high quality, fast turnover), Calliandra calothyrsus (high quality, intermediate turnover), Zea mays stover (low quality, fast turnover), sawdust (low quality, slow turnover) and local farmyard manure (variable quality, intermediate turnover). Furthermore, the addition of 240 kg N ha−1 yr−1 as mineral N fertilizer or no fertilizer was the split-plot treatment. At all four sites, a loss of SOC was predominantly observed, likely because the sites had been converted to cropland only a few decades before the start of the experiments. Across sites, the average decline of SOC content over 19 years in the 0 to 15 cm topsoil layer ranged from 42 % to 13 % of the initial SOC content for the control and the farmyard manure treatments at 4 t C ha−1 yr−1, respectively. Adding Calliandra or Tithonia at 4 t C ha−1 yr−1 limited the loss of SOC contents to about 24 % of initial SOC, while the addition of sawdust, maize stover (in three of the four sites) and sole mineral N addition showed no significant reduction of SOC loss over the control. Site-specific analyses, however, did show that at the site with the lowest initial SOC content (about 6 g kg−1), the addition of 4 t C ha−1 yr−1 farmyard manure or Calliandra with mineral N led to a gain in SOC contents. The other sites lost SOC in all treatments, albeit at site-specific rates. While subsoil SOC stocks in 2021 were little affected by organic resource additions (no difference in three of the four sites), the topsoil SOC stocks corroborated the results obtained from the SOC content measurements (0–15 cm) over time. The relative annual change of SOC contents showed a higher site specificity in farmyard manure, Calliandra and Tithonia treatments than in the control treatment, suggesting that the drivers of site specificity in SOC buildup (soil mineralogy, soil texture, climate) need to be better understood for effective targeting management of organic resources. Farmyard manure showed the highest potential for reducing SOC losses, but the necessary quantities to build SOC are often not realistic for smallholder farmers in Africa. Therefore, additional agronomic interventions such as intercropping, crop rotations or the cultivation of crops with extended root systems are necessary to maintain or increase SOC.</p

Biophysical interactions in tropical agroforestry systems

sequential systems, simultaneous systems Abstract. The rate and extent to which biophysical resources are captured and utilized by the components of an agroforestry system are determined by the nature and intensity of interac-tions between the components. The net effect of these interactions is often determined by the influence of the tree component on the other component(s) and/or on the overall system, and is expressed in terms of such quantifiable responses as soil fertility changes, microclimate modification, resource (water, nutrients, and light) availability and utilization, pest and disease incidence, and allelopathy. The paper reviews such manifestations of biophysical interactions in major simultaneous (e.g., hedgerow intercropping and trees on croplands) and sequential (e.g., planted tree fallows) agroforestry systems. In hedgerow intercropping (HI), the hedge/crop interactions are dominated by soil fertility improvement and competition for growth resources. Higher crop yields in HI than in sole cropping are noted mostly in inherently fertile soils in humid and subhumid tropics, and are caused by large fertility improvement relative to the effects of competition. But, yield increases are rare in semiarid tropics and infertile acid soils because fertility improvement does not offse