Prevalence and risk factors for gender based violence during pregnancy in Kisumu county Kenya

Background: Gender Based Violence (GBV) is a pervasive and systemic public health problem affecting pregnant women but there is paucity of data on the magnitude of GBV during pregnancy and the factors associated with it in Kenya, particularly in areas where the prevalence of GBV in the general population is unacceptably high.Objectives: To determine the prevalence and factors associated with GBV during pregnancy in Kisumu County.Design: A cross sectional survey conducted between May and October 2016. Multivariate Logistic Regression was performed and the Odds Ratio (OR) at 95% Confidence Interval (CI) calculated to identify the factors associated with GBV.Setting: Two public primary health care facilities in each of the six sub counties in Kisumu County.Subjects: 691 eligible pregnant women attending antenatal care in the selected facilities responded to a questionnaire and were screened for GBV.Results: The mean and median age was 24.5 and 24 years respectively, and the age at sexual debut was 16.7 2.2 years. Thirty nine (39.2%) had experienced physical violence during the current pregnancy, perpetrated by an intimate partner (97%).Increased risk of violence was associated with having secondary level of education or more in the women OR=2.088,95% CI[1.147-3.802],occasional alcohol consumption by the intimate partner(IP) OR=2.843, 95%CI[1.519-4.059], witnessing violence as a child OR=3.380, 95%CI[2.427-6.046] and prior experience of physical OR=13.116,95%CI[7.976-21.569] or sexual violence OR=4.208,95% CI[2.603-6.803]. Male partner dominance in decision making, OR=5.930, 95%CI [3.998-8.797] and infidelity by the woman OR=3.442, 95% CI [1.696-9.686] or her IP, OR=9.906, 95% CI [6.088-16.119] were associated with increased violence. The belief in the social superiority of a man OR=3.949, 95%CI [2.044-7.631], man’s right to assert over a woman OR=3.163, 95%CI [1.930-5.185] and the belief that women should tolerate violence to save a relationship/marriage OR=9.493, 95% CI [5.746-5.681] were predictors of increased violence.Conclusion: A substantial proportion of pregnant women experience GBV in Kisumu County. The findings indicate the need for routine screening for GBV at ANC and the potential for initiation of interventions to mitigate the negative effects of violence for the affected women. Approaches targeting beliefs and strengthening of legal structures may be viable primary prevention options.

Impact of Clinical Officer Anaesthetist Training Programme at the Kenya Medical Training College, Nakuru, on Trainee Satisfaction, Quality of practice, and cadre Shortfall Alleviation

Objective: To determine the impact of Clinical Officer (C.O) Anaesthetist Training programme at Kenya Medical Training College (KMTC) Nakuru, on Trainee satisfaction, quality of practice and cadre shortfall alleviation.Design: Cross-sectional descriptive studySetting: Kenya Medical Training College, Nakuru.Subjects: All thirty one Clinical Officer Anaesthetist graduates from KMTC Nakuru, since the training programme started 8 years ago.Results: Twenty nine of the 31 C.O Anaesthetist graduates responded. Twenty six of the 29 respondents (89.7%) passed in the final qualifying examination in the first sitting. Twenty one (72.4%) are working in Public health facilities. All graduates are distributed in 16 out of the 47 counties in Kenya. Twenty six (89.7%) are satisfied with the training. Their average working week is 54 hours, with a median of 45 working hours a week. They recommend an improvement in peripheral nerve blocks and epidural training in the 2005 curriculum.Conclusion: C.O Anaesthetist training in KMTC Nakuru over the last eight years has produced self reported satisfied, adequately trained graduates and has had an impact in alleviating shortage of this cadre in Kenya. Improvement in peripheral nerve blocks and epidural training is needed

INTEGRATING CASSAVA VARIETIES AND Typhlodramulus aripo TO SUSTAIN BIOLOGICAL CONTROL OF CASSAVA GREEN MITE

The cassava green mite (CGM), Mononychellus tanajoa , is a pest that reduces root yield of cassava ( Manihot esculenta Crantz) by 30-80% in the cassava belts of Africa. The objective of this study was to identify cassava varieties that enhance abundance and persistence of Typhlodramulus aripo on cassava and increase its efficiency in controlling CGM. Nine cassava (Manihot esculenta Crantz) varieties were evaluated in Kenya based on CGM abundance and HCN of leaves for their ability to sustain low CGM populations to enhance biocontrol of T. aripo. Cassava fields were surveyed in five agro-ecological zones in Uganda and samples of cassava apices were analysed for cassava varieties to sustain high population of T. aripo. In the screening study of CGM abundance and HCN content of leaves and the lowest cumulative CGM population densities (<1200 mites/leaf) were recorded on MM97/3567, Tajirika and MM96/9308, with the lowest cyanide content of leaves, 8.5 \ub1 4.9, 12.5 \ub1 3.2 and 12.3 \ub1 2.5 mg kg-1, respectively. Cassava varieties with hairy and non-hairy tips sustained T. aripo with highest densities (0.96 actives per tip) on hairy TME14. High T. aripo population densities corresponded to high densities of hairs on cassava tips. There were significant inverse linear relationships between CGM densities and T. aripo on TME14 at moderate CGM population densities (CGM damage level 2).Le tantinet vert de la cassave (CGM), Mononychellus tanajoa , est un insecte nuisible qui r\ue9duit la production de racine de cassave ( Manihot esculenta Crantz) de 30-80 % dans les ceintures de cassave de l\u2019Afrique. L\u2019objectif de cette \ue9tude \ue9tait d\u2019identifier des vari\ue9t\ue9s de cassave qui am\ue9liorent l\u2019abondance et la persistance de Typhlodramulus aripo sur la cassave et augmentent son efficacit\ue9 dans le contr\uf4le de CGM. Neuf cassave (Manihot esculenta Crantz) les vari\ue9t\ue9s ont \ue9t\ue9 \ue9valu\ue9es au Kenya bas\ue9 sur l\u2019abondance CGM et HCN de part pour leur capacit\ue9 de soutenir bas des populations de CGM pour am\ue9liorer biocontrol de T. aripo. Les champs de cassave ont \ue9t\ue9 \ue9tudi\ue9s dans cinq zones agro-\ue9cologiques en Ouganda et les \ue9chantillons de sommets de cassave ont \ue9t\ue9 analys\ue9s pour les vari\ue9t\ue9s de cassave pour soutenir la haute population de T. aripo. Dans l\u2019\ue9tude de projection d\u2019abondance CGM et de contenu de HCN de cong\ue9s et des densit\ue9s d\ue9mographiques CGM cumulatives les plus basses (<1200 tantinets/feuille) ont \ue9t\ue9 enregistr\ue9s sur MM97/3567, Tajirika et MM96/9308, avec le contenu de cyanure le plus bas de cong\ue9s, 8.5 \ub1 4.9, 12.5 \ub1 3.2 et 12.3 kg de 2.5 mgs \ub1 1, respectivement. Les vari\ue9t\ue9s de cassave avec les bouts poilus et non-poilus ont soutenu T. aripo avec les plus hautes densit\ue9s (0.96 actives par bout) sur TME14 poilu. Haut T. aripo les densit\ue9s d\ue9mographiques a correspondu \ue0 de hautes densit\ue9s de hairs sur les bouts de cassave. Il y avait des rapports lin\ue9aires inverses significatifs entre les densit\ue9s CGM et T. aripo sur TME14 aux densit\ue9s d\ue9mographiques CGM mod\ue9r\ue9es (le niveau de dommage de CGM 2)

Malnutrition and cachexia among cancer out-patients in Nairobi, Kenya

Cancer is the third leading cause of death in Kenya. However, there is scarce information on the nutritional status of cancer patients to guide in decision making. The present study sought to assess the risk of malnutrition, and factors associated with malnutrition and cachexia, among cancer out-patients, with the aim of informing nutrition programmes for cancer management in Kenya and beyond. This was a facility-based cross-sectional study performed at Kenyatta National Hospital and Texas Cancer Centre in Nairobi, Kenya. The risk of malnutrition was assessed using the Malnutrition Universal Screening Tool (MUST). Diagnoses of malnutrition and cachexia were done using the European Society of Clinical Nutrition and Metabolism (ESPEN) and Fearon criteria, respectively. A total of 512 participants were assessed. Those at risk of malnutrition were 33·1 % (12·5 % at medium risk, 20·6 % at high risk). Prevalence of malnutrition was 13·4 %. The overall weight loss >5 % over 3 months was 18·2 % and low fat-free mass index was 43·1 %. Prevalence of cachexia was 14·1 % compared with 8·5 % obtained using the local criteria. Only 18·6 % participants had received any form of nutrition services. Age was a predictor of malnutrition and cachexia in addition to site of cancer for malnutrition and cigarette smoking for cachexia. The use of the MUST as a screening tool at the first point of care should be explored. The predictive value of current nutrition assessment tools, and the local diagnostic criteria for malnutrition and cachexia should be reassessed to inform the development of appropriate clinical guidelines and future capacity-building initiatives that will ensure the correct identification of patients at risk for timely care

Phylogenetic diversity of cassava green mite, Mononychellus progresivus from different geographical sites in East Africa

Cassava green mite (CGM) of the Mononychellus genus is an invasive species in Africa, introduced from South America. Its phylogenetic diversity over geographical localities has never been assessed in East Africa, where mite density dynamics oscillate from few individuals to a peak of hundreds. The objective of this study was to determine CGM species comparative phylogenetic diversity from seven distinct geographical sites in East Africa. Six sites were sampled for CGM races, two samples from each country. DNA was extracted on internal transcribed spacer 2 (ITS2) and cytochrome oxidase subunit I (COI), and compared for phylogenetic variations of CGM from different locations of East African region. A comparative search from the NCBI Gene bank resulted into identical species nucleotides from Congo and Benin. Sequences from the two sites in Kenya were 99-100% similar to CGM nucleotide from the Congo-Benin accessions (X79902.1) on ITS2 gene region. On COI, a 98-99% site sequences similarity was observed on M. progresivus accession X79901.1. A closely related divergence of specimens collected from Tanzania and Uganda was determined. Both Uganda and Tanzania had 99% match to X79901.1 on COI region. Similarly, the Uganda and Tanzania samples had 99% match to emb/X79902.1 on the 18Sr RNA region. The CGM sequence from coastal Kenya had the highest phylogenetic divergence from the Congo-Benin sequences. A small biogeographic phylogenetic divergence (0-1%) was evident from the analyses among the six collection sites. The results confirm M. progresivus identity in East Africa it also indicates intra-species phylogenetic variations on the COI gene region of interest.L\u2019acarien vert du manioc (CGM) du genre Mononychellus est espece invasive Introduite de l\u2019Amerique du Sud en Afrique. Sa diversite phyllogenetique au sein et entre les localites n\u2019a jamais ete evaluee en Afrique de l\u2019Est, ou la densite d\u2019acarien varie de quelques individus a plusieurs centaines. L\u2019objectif de cette etude etait de determiner la diversite phyllogenetiques des especes CGM et de comparer sept sites geographiquement differents en Afrique de l\u2019Est. six sites ont ete echantillonnes pour des races de CGM, a raison de deux echantillons par pays. De l\u2019AND a ete extrait sur l\u2019espaceur interne transcrit 2 (ITS2) et sous-unite I de cytochrome oxidase (COI), ces echantillons ont ete compares pour les variations phyllogenetiques de CGM provenant de localites differentes de la region Est Africaine. Une etude comparee a la banque de gene de NCBI a revele des especes identiques en provenance de Congo et du Benin, de point de vue de leur nucleotides. Des sequences provenant des deux sites au Kenya ont exhibe 99-100% de similarite avec les nucleotides de CGM provenant des accessions Congo-Benin (X79902.1) sur la region genetique ITS2. Sur COI, une similarite de 98-99% a ete observee sur l\u2019accession M. progresivus X79901.1. Une divergence de sujets genetiquement proches a ete observe chez des specimens collectes en Tanzannie et en Ouganda. Ouganda et Tanzanie ont exhibe 99% de similitude a X79901.1 sur la region COI. De meme, les echantillons provenant de Ouganda et de Tanzannie presentaient 99% de similitude avec emb/X79902.1 sur la region 18Sr RNA. La sequence de CGM provenant de cote kenyane avait la divergence phyllogenique la plus elevee d\u2019avec les sequences Congo-Benin. Une legere divergence phyllogenetique geographiaque (0-1%) a ete note des analyses dans les sites de collection. Les resultats conferment l\u2019identite de M. progresivus identity en Afrique de l\u2019Est. l\u2019etude a aussi revele des variations phyllogenetiques sur la region de gene d\u2019interet COI

Linking diet switching to reproductive performance across populations of two critically endangered mammalian herbivores.

Optimal foraging theory predicts that animals maximise energy intake by consuming the most valuable foods available. When resources are limited, they may include lower-quality fallback foods in their diets. As seasonal herbivore diet switching is understudied, we evaluate its extent and effects across three Kenyan reserves each for Critically Endangered eastern black rhino (Diceros bicornis michaeli) and Grevy's zebra (Equus grevyi), and its associations with habitat quality, microbiome variation, and reproductive performance. Black rhino diet breadth increases with vegetation productivity (NDVI), whereas zebra diet breadth peaks at intermediate NDVI. Black rhino diets associated with higher vegetation productivity have less acacia (Fabaceae: Vachellia and Senegalia spp.) and more grass suggesting that acacia are fallback foods, upending conventional assumptions. Larger dietary shifts are associated with longer calving intervals. Grevy's zebra diets in high rainfall areas are consistently grass-dominated, whereas in arid areas they primarily consume legumes during low vegetation productivity periods. Whilst microbiome composition between individuals is affected by the environment, and diet composition in black rhino, seasonal dietary shifts do not drive commensurate microbiome shifts. Documenting diet shifts across ecological gradients can increase the effectiveness of conservation by informing habitat suitability models and improving understanding of responses to resource limitatio

Conservation research in times of COVID-19 - the rescue of the northern white rhino

COVID-19 has changed the world at unprecedented pace. The measures imposed by governments across the globe for containing the pandemic have severely affected all facets of economy and society, including scientific progress. Сonservation research has not been exempt from these negative effects, which we here summarize for the BioRescue project, aiming at saving the northern white rhinoceros (Ceratotherium simum cottoni), an important Central African keystone species, of which only two female individuals are left. The development of advanced assisted reproduction and stem-cell technologies to achieve this goal involves experts across five continents. Maintaining international collaborations under conditions of national shut-down and travel restrictions poses major challenges. The associated ethical implications and consequences are particularly troublesome when it comes to research directed at protecting biological diversity – all the more in the light of increasing evidence that biodiversity and intact ecological habitats might limit the spread of novel pathogens

Amyloid precursor protein drives down-regulation of mitochondrial oxidative phosphorylation independent of amyloid beta

Amyloid precursor protein (APP) and its extracellular domain, soluble APP alpha (sAPPα) play important physiological and neuroprotective roles. However, rare forms of familial Alzheimer’s disease are associated with mutations in APP that increase toxic amyloidogenic cleavage of APP and produce amyloid beta (Aβ) at the expense of sAPPα and other non-amyloidogenic fragments. Although mitochondrial dysfunction has become an established hallmark of neurotoxicity, the link between Aβ and mitochondrial function is unclear. In this study we investigated the effects of increased levels of neuronal APP or Aβ on mitochondrial metabolism and gene expression, in human SH-SY5Y neuroblastoma cells. Increased non-amyloidogenic processing of APP, but not Aβ, profoundly decreased respiration and enhanced glycolysis, while mitochondrial DNA (mtDNA) transcripts were decreased, without detrimental effects to cell growth. These effects cannot be ascribed to Aβ toxicity, since higher levels of endogenous Aβ in our models do not cause oxidative phosphorylation (OXPHOS) perturbations. Similarly, chemical inhibition of β-secretase decreased mitochondrial respiration, suggesting that non-amyloidogenic processing of APP may be responsible for mitochondrial changes. Our results have two important implications, the need for caution in the interpretation of mitochondrial perturbations in models where APP is overexpressed, and a potential role of sAPPα or other non-amyloid APP fragments as acute modulators of mitochondrial metabolism