Anti-inflammatory activity of selected plants used by the Ilkisonko Maasai, Kenya

Background: The Ilkisonko Maasai are a Kenyan pastoralist community that uses indigenous plants for the management of pain and inflammatory conditions such as arthritis. Objectives: The purpose of this study was to validate the use of plants for medicinal purposes by the Ilkisonko Maasai through testing for anti-inflammatory activity using the carrageenan-induced rat paw oedema assay. Methodology: The methanol extracts (400 mg/kg body weight) of Rhus natalensis (bark), Acacia drepanolobium (bark), Acacia nilotica (bark), Acacia reficiens (bark), Acacia robusta (bark), Grewia villosa (bark), Ximenia americana (bark and leaves) and Rhus vulgaris (leaves) were evaluated for in vivo anti-inflammatory efficacy using the carrageenan-induced rat paw oedema assay. Diclofenac (20 mg/kg body weight) was used as the positive control and paw volume was measured by a plethysmometer. Results: The maximum percentage inhibition (PI) of the extracts was observed as Grewia villosa (58.6% at 24 h), Rhus vulgaris (57.8% at 24 h), Acacia nilotica (55.5% at 1 h), Ximenia americana (54.5% at 1 h), Acacia drepanolobium (50.9% at 24 h), Acacia reficiens (47.6% at 1 h), Rhus natalensis (43.8% at 24 h) and Acacia robusta (37.4% at 24 h) (p < 0.05 for all PI). Diclofenac (20 mg/kg) showed a steady increase in PI from 1 h to 4 h with a maximum PI of 66.2% (p < 0.05) at 4 h and the lowest PI of 14.3% at 24 h. Conclusion: All extracts of the plants assessed exhibited anti-inflammatory activity at early phase of inflammation. Additionally, extracts of five plants, namely Rhus natalensis, Acacia drepanolobium, Acacia robusta, Grewia villosa and Rhus vulgaris showed anti-inflammatory activity at both early and late phases of inflammation. There is need for further studies to identify phytochemicals with active anti-inflammatory activity. Key words- Ilkisonko Maasai, carrageenan, inflammation, Rhus, Acacia, Grewia and Ximeni

Factors Associated with Uptake of Cervical Cancer Screening among Women Aged 18-49 Years in Njiru Sub-County, Nairobi Kenya

Cervical cancer remains a major public health concern in developing countries including Kenya, where it is currently ranked the highest cause of cancer deaths. Early detection of cervical cancer using Pap smear provides an appropriate way of prevention which, would in turn lead to a decrease in incidence and mortality. This study aimed at assessing the awareness, perceptions, reproductive and sexual practices influencing uptake of cervical cancer screening among women aged 18-49 years in Njiru Sub County, Nairobi County. Two hundred and forty seven women participated in this cross-sectional study. Data were collected using semi-structured questionnaires and focused group discussion (FGD). Data was analyzed using SPSS version 19.0. Descriptive statistics were used to give proportions and frequencies. Pearson’s chi square (χ2) was used to test for associations among variables and differences were considered statistically significant at p≤0.05. The mean age of the respondents was 30.7±1.18 years. Most (32%), of the respondents were aged 25-29 years. Majority (96.4%) of the respondents in this study were Christians and most (68%) of them were married. Approximately fifty percent of the study respondents had primary level education followed by secondary (38.9%), tertiary (8.9%) and no formal education 2.4%. About 46% of the respondents were self-employed. Approximately eighty five percent (211/247) of the study respondents were aware of cervical cancer and had commonly (36.4%) obtained their information from media followed by health talks (34.8 %). Of those who were aware 25.6% (54/211) reported cervical cancer to be caused by Human Papilloma Virus (HPV). Most 43.6% (41/94) of the respondents who had ever been screened perceived the cervical screening procedures as uncomfortable followed by 24.5% (23/94) who perceived it as embarrassing. Majority 52.1% (49/94) of those who had been screened reported to have not received any support from their partners. More than ninety percent 94.7% reported that cervical cancer screening was very useful in the prevention of cervical cancer. The factors associated with uptake of cervical cancer screening were awareness (p≤0.035), opinion about cervical screening (p≤0.000), cervical screening usefulness (p≤0.006), frequency of having cervical screening done (p≤0.000) and partner support (p≤0.000). There is need to improve public awareness by educating women on the risk factors associated with cervical cancer and benefits of cervical screening through health talks and promotions, mass media awareness. Health professionals and healthcare workers should take the opportunity to educate and encourage women attending health facilities for other health problems to undergo cervical cancer screening. There is need to include men in education on cervical cancer especially sexual partners/ spouses so that they can encourage their spouses/partners in terms of moral and material support to increase the uptake of cervical cancer screening. Keywords: cervical cancer, screening, uptake, awarenes

Uterine fibroid embolization for symptomatic fibroids: study at a teaching hospital in Kenya

Objective: Characterization of magnetic (MRI) features in women undergoing uterine fibroid embolization (UFE) and identification of clinical correlates in an African population. Materials and Methods: Patients with symptomatic fibroids who are selected to undergo UFE at the hospital formed the study population. The baseline MRI features, baseline symptom score, short-term imaging outcome, and mid-term symptom scores were analyzed for interval changes. Assessment of potential associations between short-term imaging features and mid-term symptom scores was also done. Results: UFE resulted in statistically significant reduction (P \u3c 0.001) of dominant fibroid, uterine volumes, and reduction of symptom severity scores, which were 43.7%, 40.1%, and 37.8%, respectively. Also, 59% of respondents had more than 10 fibroids. The predominant location of the dominant fibroid was intramural. No statistically significant association was found between clinical and radiological outcome. Conclusion: The response of uterine fibroids to embolization in the African population is not different from the findings reported in other studies from the west. The presence of multiple and large fibroids in this study is consistent with the case mix described in other studies of African-American populations. Patient counseling should emphasize the independence of volume reduction and symptom improvement. Though volume changes are of relevance for the radiologist in understanding the evolution of the condition and identifying potential technical treatment failures, it should not be the main basis of evaluation of treatment success

In vitro and in vivo antiplasmodial activity of extracts of selected Kenyan medicinal plants

Background: Malaria is one of the most important parasitic diseases in the world. It remains a major public health problem in Africa and is responsible for the annual death of over one million children below the age of five years. The Plasmodium falciparum is the most widespread etiological agent for human malaria and has become increasingly resistant to standard antimalarial drugs. Therefore, this necessitates a continuous effort to search for new drugs, particularly with novel modes of action. The medicinal plants have invariably been a rich source for new drugs and some antimalarial drugs in use today (quinine and artemisinin) were either obtained from plants or developed using their chemical structures as templates. Objective: The aim of the study was to screen seven selected medicinal plants from Kenya for antimalarial activity. Materials and methods: Twenty one (21) extracts from seven plants: C. myricoides, C. abyssinica, A. racemosus, A. remota, C. edulis, S. princeae and L. calostachys were selected for in vitro antimalarial screening out of which 10 extracts with good activity in vitro were tested further in a mouse model. In vitro antiplasmodial testing was done by measuring ability of the test sample to inhibit the incorporation of radio-labelled hypoxanthine into the malaria parasite. In vivo bioassay was done in mice using Peter’s 4-days suppressive test. Results: From the results achieved, 10 out of the 21 extracts tested, exhibited antiplasmodial activity, with IC50 values ranging from 6.93μg/ml to 88.4μg/ml. when tested in vivo one of the extracts had high activity with chemosuppression of 82.17%, while the rest ranged between 39.93% and 61.86%. Conclusions: The activities observed especially with the methanol extracts indicate that these plants deserve to be investigated further as potential antimalarial agents. Keywords: Medicinal plants, Extracts,  Antiplasmodial activit

Awareness of Cervical Cancer among Women in Uasin Gishu County, Kenya

Globally, cancer is a public health problem and is ranks as the fourth most frequent cancer among women. About half a million women develop invasive cancer of the uterine cervix each year, with more than 85% occurring in low-income countries. This study assessed cervical cancer awareness on among women in Uasin Gishu County, Kenya. A house hold survey was conducted among women of reproductive age (18-49 years) in Uasin Gishu County. The data was collected using a semi-structured questionnaire, interview schedules and focus group discussions. Statistical package for social sciences (SPSS) was used to generate statistical parameters like mean, standard deviation, etc. The X2 test was used as a test of significance and multiple logistic regression analysis with odds ratio at 95% confidence interval was utilized. Majority of the participants, 91.4% (n=363) had heard about cervical cancer with the main source of information being from the media 38.2% (n=136). Although majority 73% (n=229) were able to identify how cervical cancer is transmitted, only 24% (n=86) correctly identified HPV as the causative agent of cervical cancer. Vaginal bleeding was identified 40.5% (n=162) as the common sign and symptom of cervical cancer. 83.3% (n=280) reported that anyone who had ever had sexual contact qualified to be screened. Though majority 83.7% (n=304) indicated willingness to go for cervical cancer screening, actual practice was low at 35.5%. Though there was adequate knowledge and awareness about cervical cancer, the same did not translate into practice. This was attributed to the general negative attitude towards cervical cancer control interventions

Contributing Factors to Late Age Pregnancy and its Outcome Among Elderly Primigravidas in Kakamega County,Kenya

Delayed childbearing is becoming apparent in developing countries especially among the upper and middle class women as they become increasingly empowered. The objective of this study was to determine the pre-disposing factors to late age pregnancy among childbearing women. A cross sectional survey of childbearing women aged between 18 and 40 years and hospital personnel, in 3 selected hospitals and tertiary institutions in Kakamega County, Kenya was carried out. Purposive and stratified sampling strategies were employed. The findings revealed that although the majority age of primigravidas lies between 26 to 30 years, an increasing number of women at the age of 31 to 40 years were still having their first borns. Primigravidas at such ages were found to be more vulnerable to birth complications. It emerged that prolonged education, financial stability, career development, lifestyle, drug and substance abuse and lack of awareness were the leading contributing factors to delayed pregnancy among child bearing women.

IN VIVO SCREENING OF ANTIMALARIAL ACTIVITY OF ACACIA MELLIFERA (BENTH) (LEGUMINOSAE) ON PLASMODIUM BERGHEI IN MICE

The activities of total extracts and lupane triterpenes, isolated from the stem bark of Acacia mellifera, were evaluated against Plasmodium berghei strain ANKA in a female Swiss mouse model. Five isolated compounds and the crude extracts were evaluated for antimalarial activity and Quinine hydrochloride was used as a positive control. Only betulin and the methanolic extract produced considerable antimalarial activity in mice infected with P. berghei parasites. This study demonstrated the presence of bioactive agents in Acacia mellifera

Khat use and psychotic symptoms in a rural Khat growing population in Kenya: a household survey

Background:Khat is an amphetamine like psychostimulant chewed by over 10 million people globally. Khat use is thought to increase the risk of psychosis among its chewers. The evidence around this however remains inconclusive stemming from the scanty number of studies in this area and small study sample sizes. We undertook a large household survey to determine the association between psychotic symptoms and khat chewing in a rural khat growing and chewing population in Kenya. Methods:For this cross-sectional household survey, we randomly selected 831 participants aged 10 years and above residing in the Eastern region of Kenya. We used the psychosis screening questionnaire (PSQ) to collect information on psychotic symptoms and a researcher designed sociodemographic and clinical questionnaire to collect information on its risk factors. We used descriptive analysis to describe the burden of khat chewing and other substance use as well as rates and types of psychotic symptoms. Using a univariate and multivariate analyses with 95% confidence interval, we estimated the association between khat chewing and specific psychotic symptoms. Results:The prevalence of current khat chewing in the region was at 36.8% (n = 306) with a male gender predominance (54.8%). At least one psychotic symptom was reported by 16.8% (n = 168) of the study population. Interestingly, psychotic symptoms in general were significantly prevalent in women (19.5%) compared to men (13.6%) (p = 0.023). Khat chewing was significantly associated with reported strange experiences (p = 0.024) and hallucinations (p = 0.0017), the two predominantly reported psychotic symptoms. In multivariate analysis controlling for age, gender, alcohol use and cigarette smoking, there was a positive association of strange experiences (OR, 2.45; 95%CI, 1.13–5.34) and hallucination (OR, 2.08; 95% C.I, 1.06–4.08) with khat chewing. Of note was the high concurrent polysubstance use among khat chewers specifically alcohol use (78.4%) and cigarette smoking (64.5%). Conclusions:Psychotic symptoms were significantly elevated in khat users in this population. Future prospective studies examining dose effect and age of first use may establish causality

Risk of Fungi Associated with Aflatoxin and Fumonisin in Medicinal Herbal Products in the Kenyan Market

Utilization of herbal products is a major concern due to the possibility of contamination by toxigenic fungi that are mycotoxin producers such as Aspergillus species during processing and packaging. Research was carried out to determine the presence of aflatoxins and fumonisins in herbal medicinal products sold in Eldoret and Mombasa towns in Kenya. The study employed both exploratory and laboratory experimental design. The herbal products were purchased from the market and transported to Kenya Medical Research Institute for processing and analysis. Fungal contaminants were determined according to Pharmacopoeia specifications. The toxins were quantified using ELISA based technique. The genus Aspergillus was the most dominant followed by Penicillium. Fungal counts ranged between 1 CFU/g and >1000 cfu/g. Analysis of variance showed that the rate of fungal contaminants for Eldoret and Mombasa samples had significant association (p≤0.001). Aflatoxin levels ranged from 1 to 24 ppb, while fumonisin levels ranged from 1 to >20 ppb. Only 31% of samples met the standards for microbial limits as specified in Pharmacopoeia. There is need for product microbial quality improvement through proper harvesting, processing, storage, and marketing. It is recommended that a policy be enacted to enable regulation of herbal products in Kenya

Larvicidal effect of Mundulea sericea (Leguminosaea) plant extract against Aedes aegypti (L.) (Diptera: Culicidae)

IntroductionThe medical importance of mosquitoes as vectors forthe transmission of serious diseases that causemorbidity, mortality, economic loss, and socialdisruption such as malaria, lymphatic filariasis, andviral diseases is well recorded (Becker et al, 2003).Aedes aegypti, the main carrier for viruses that causedengue and dengue hemorrhagic and yellow fevers, isfound majorly in the tropics and subtropics. There is noeffective vaccine against dengue, and thus the only wayof significantly lowering the incidence of this disease isthrough mosquito control (Malavige et al, 2004).Chemical measures were first tried, but they failed sincetheir overuse led to disruption of natural biologicalcontrol systems and outbreak of new insect species. Inaddition, use of insecticides led to the development ofmosquito resistance, environmental pollution, andundesirable effect on non-target organisms (Brown,1986). In a bid to resolve these problems, interest ininsecticides of natural origin, specifically plant-derivedproducts has recently received close attention.Several studies have emphasized the importance ofresearch and development of herbal substances forcontrolling mosquitoes (Shaala et al, 2005). Theirresults may vary, but natural plant products may be apossible alternative to synthetic substances, as they areeffective and compatible with human and animal lifeand the environment (Chaithong et al, 2006).The genus Mundulea consists of about 15 species,widespread throughout Africa, Madagascar, Mauritius,India, Sri Lanka and Papua New Guinea. Only a singlespecies, Mundulea sericea, is found in Southern Africa.This species occurs in South Africa, Botswana, Namibiaand Angola, north to tropical Africa, and east toMadagascar, India, Sri Lanka and Papua New Guinea(Watt and Breyer-Brandwick, 1962).Mundulea sericea is one of the commonest fish poisonswhere both bark and seeds are used (Neuwinger, 2004).In addition, the Chinese used M. sericea to controltobacco budworm Heliothis virescens (Lepidopteriae:Noctuidae) (Yoshida and Toscano, 1994).The toxic principal of the plant is rotenone, anisoflavonoid (Vedcourt and Trump, 1969). Therotenoids deguelin and tephrosin are the potent activeprinciples which have been isolated from extracts of M.sericea (Luyengi et al, 1994). Deguelin is a natural plantderivedrotenoid, most commonly used as an insecticidein Africa and South America (Udeani et al, 1997).Rotenoids from the bark of M. sericea have beencommercially used as insecticide. These chemicalcompounds in the bark, leaves and seed are the activecompounds responsible for the fish poison. It isreported that the strength varies geographically (Wattand Breyer-Brandwick, 1962).The current study involved extraction and evaluation ofroot bark and seedpod of M. sericea for larvicidalactivities on Aedes aegypt