Milk handling practices and utilization at dairy farms and collection centers under rural and peri-urban milk value chain systems in Nakuru County, Kenya

There are increasing expectations on the compliance of food products to safety and quality standards due to consumer demand for high-quality food. The aim of this study was to determine the quality tests that are carried out on raw milk and its utilization at three milk collection centers in Olenguruone and Dundori regions of Nakuru as well as some selected dairy farms. Using a semi-structured questionnaire, data were collected from milk collection centers’ staff and farmers. Milk sampling for quality control testing was done at both the cooperative delivery points and farm level. The quality of milk handled and stored in different containers was assessed. Descriptive statistics, Chi-square and logistic regression analysis were carried out on the data. Results indicated that the average quantity of milk received at all milk collection centers was about 3687 liters per day. It was noted that most of the milk collection centers’ staff (operators) had certificates or diplomas in dairy science. Their average job experience period in the milk sector was 7 years. Majority of the farmers (90%) and transporters (94%) used plastic containers for milk handling and storage. Farmers who used plastic containers for milking were approximately three times more likely to have their milk rejected compared to those who used mazzi cans, aluminium or stainless-steel containers (p<0.05; Odds ratio =3.20). The alcohol and lactometer tests were carried out on milk received at all collection centers studied. Resazurin test was only carried out in one collection center at Olenguruone that had the required laboratory equipment. Milk quality assessment was not done at the farm level. Traditional fermented milk was the common dairy product produced from evening milk in most dairy farmers’ households. Regular education programs and seminars on milk safety and quality should be provided to both collection centers’ operators and farmers.&nbsp

Factors influencing time to diagnosis and treatment among pediatric oncology patients in Kenya

Early diagnosis and start of treatment are fundamental goals in cancer care. This study determines the time lag and the factors that influence the time to diagnosis and start of treatment. Study participants were parents of childhood cancer patients diagnosed between August 2013 and July 2014 in a hospital in Kenya. Patient, physician, diagnosis, treatment, health care system, and total delay were explored using a questionnaire. Demographic and medical data were collected from the patients' medical records. Parents of 99 childhood cancer patients were interviewed (response rate: 80%). Median total delay was 102 (9–1021) days. Median patient delay (4 days) was significantly shorter than health care system delay (median 87 days; P < .001). Diagnosis delay (median 94 days) was significantly longer than treatment delay (median 6 days; P < .001). days. Lack of health insurance at diagnosis and use of alternative medicine before attending conventional health services were associated with a significantly longer patient delay (P = .041 and P = .017, respectively). The type of cancer had a significant effect on treatment delay (P = .020). The type of health facility attended affected only patient delay (P = .03). Gender, age at diagnosis, stage of disease, parents' education level or income, and distance from hospital did not have a significant effect on the length of any type of delay. Training on childhood cancer should be included in the curricula for medical training institutes. In-service workshops should be held for the health workers already working. Families must be obligated to get health insurance. Families should be encourage to attend conventional health facilities and informed on symptoms of cancer through mass media

Epidemiological profile and clinico-pathological features of pediatric gynecological cancers at Moi Teaching & Referral Hospital, Kenya

Background: The main pediatric (0–18 years) gynecologic cancers include stromal carcinomas (juvenile granulosa cell tumors and Sertoli-Leydig cell tumors), genital rhabdomyosarcomas and ovarian germ cell. Outcomes depend on time of diagnosis, stage, tumor type and treatment which can have long-term effects on the reproductive career of these patients. This study seeks to analyze the trends in clinical-pathologic presentation, treatment and outcomes in the cases seen at our facility. This is the first paper identifying these cancers published from sub-Saharan Africa. Method: Retrospective review of clinico-pathologic profiles and treatment outcomes of pediatric gynecologic oncology patients managed at MTRH between 2010 and 2020. Data was abstracted from gynecologic oncology database and medical charts. Results: Records of 40 patients were analyzed. Most, (92.5%, 37/40) of the patients were between 10 and 18 years. Ovarian germ cell tumors were the leading histological diagnosis in 72.5% (29/40) of the patients; with dysgerminomas being the commonest subtype seen in 12 of the 37 patients (32.4%). The patients received platinum-based chemotherapy in 70% of cases (28/40). There were 14 deaths among the 40 patients (35%) Conclusion: Surgery remains the main stay of treatment and fertility-sparing surgery with or without adjuvant platinum-based chemotherapy are the standard of care with excellent prognosis following early detection and treatment initiation. LMICs face several challenges in access to quality care and that affects survival of these patients. Due to its commonality, ovarian germ cell cancers warrant a high index of suspicion amongst primary care providers attending to adnexal masses in this age group

Effects of Coffee Processing Technologies on Aroma Profiles and Sensory Quality of Ruiru 11 and SL 28 Kenyan Coffee Varieties

The study aimed at comparing the effects of three coffee processing methods on aroma profiles and sensory quality of Ruiru 11 and SL 28 coffee varieties. The processing methods varied onstages of processing and method of mucilage removal. The green coffee beans obtained from the three processing methods were graded and roasted, ground and analyzed for the aroma profilesand sensory quality. Headspace Solid phase Microextraction fibre (SPME) technique were used for the extraction of aroma compounds from coffee samples and characterization of the compounds with use of gas chromatography mass spectrometry (GC-MS).Sensory quality were analyzed by an expert panelist. Various volatile aroma compounds were identified in roasted coffee and classified into their chemical classes involving furans, ketones, pyrazines ketones pyridines, pyrroles and acids. The intensity of aroma compounds were compared in terms of their peak areas and variations were noted between the processing methods with the ecopulper showing higher levels of pyrazines such as 2-methylpyrazine, 2-ethyl-6-methylpyrazine, and wet pulper showing higher levels of furans such asfurfuryl formate andfurfuryl alcohol, acetate. The hand pulper washigh in the level of acids and esters such as acetic acid and propanoic acid, ethyl ester.Similar aroma compounds were identified in headspace of Ruiru 11 and SL 28and there were variations in the intensities of aroma groups such as pyrroles and pyridines.It was concluded that the eco-pulper and hand pulper methods gives better aroma quality than the wet pulper while SL 28 variety gives higher sensory quality than Ruiru 11

Cisplatin for The palliative treatment of cervical cancer at Moi Teaching and Referral Hospital, Eldoret, Kenya: A two-year experience

Objective: In Sub Saharan Africa access to radiation therapy for women with advanced cervical cancer is poor due to the scarcity of radiation machines. In Kenya there is one public functional cobalt machine for a population of 40 million. The cost both direct and indirect are mostly too high for women. We adapted the use of Cisplatin 50 mg/m2 with a 3-4 week interval as an alternative. The effect of this treatment for symptom control is evaluated. Methods: Women with advanced stage cervix cancer who were not able to go for radiotherapy were planned for palliative chemotherapy with cisplatin 50 mg/m2 iv in combination with iv fluids and antiemetics. We continued chemotherapy until symptoms had subsided or to a maximum of 6 cycles. All women that were offered palliative chemotherapy were included for this study. Data were collected systematically at every visit and captured in an electronic database. Results are evaluated using a descriptive analysis. Results: In 2011 and 2012 88 women were planned for palliative chemotherapy. 61 went on to have at least one course of chemo. The women not getting chemo progressed quickly, were unfit due to kidney failure, sought treatment elsewhere or were lost to follow up. Stage was distributed as follows: FIGO Stage 1 1.1%, 2A 1.1% (both women delayed treatment and came back with advanced stage), 2B 9.1%, 3A 24%, 3B 55%, 4A 9.1%. The median number of three courses were given (range 1-6) On presentation 88% of women had bleeding, 69% had discharge and 67% complained of pain. For the women that got at least one course of chemo and who could be evaluated during a follow up visit, bleeding improved for 37/43(86%) women, discharge improved for 28/36(78%) women and pain improved for 24/35(69%) women. Conclusion: Prior to initiating this program advanced cervical cancer patients who presented to hospital were transfused and sent home to die. We have demonstrated that palliative chemotherapy with Cisplatin is feasible and effective in a low resource setting. Bleeding, discharge and pain all improved for the majority of patients who presented to hospital with advanced cervix cancer