Maintaining Africa's water infrastructure: findings from a Water Audit in Kitui County, Kenya (REACH Policy brief)

A lack of information about previous investments and current status of infrastructure creates a challenge for those responsible for water service provision. REACH’s work in Kitui County, Kenya, aims to address this information deficit by providing a detailed inventory of rural and small town piped water schemes. The first step is piloting a Water Audit methodology that can be used county-wide. This policy brief presents results of an audit of infrastructure in one sub-county of Kitui County and outlines the implications for attaining universal service delivery

Antimicrobial Susceptibility Patterns of Urinary Bacteria Amongst Paediatric Patients at The Nairobi Hospital, Kenya

Objective: To determine the antimicrobial susceptibility patterns of urinary tract infections in the paediatric age group at The Nairobi Hospital.Design: A retrospective cross-sectional descriptive study.Setting: The Nairobi Hospital records department.Results: A total of 31 organisms were isolated consisting of Escherichia coli (n=132; 44.3%), Klebsiella species (n=59; 17.8%), Proteus species (n=28; 9.4%), Staphylococcus aureus (n=14; 5.7%), Pseudomonas species (n=14; 4.7%) and Enterococcus species (n=12; 4%). Others were less frequently isolated making up a total of 14.1%. Girls were more affected than boys with a ratio 6:4. Amongst the E.coli and Klebsilla isolates which were the most commonly isolated, resistance was high to commonly used antimicrobials such as trimethoprim/sulfamethoxazole (75%-80%) and amoxicillin clavulanate (50%). There was no statistical significance in the difference in the organisms isolated (p= 0.775) or their susceptibilities to tested  antimicrobials, between inpatients and outpatients.Conclusion: The change in the susceptibility patterns of the isolated organisms to the most commonly used antimicrobials points to a need for revision of the current guidelines, prudent use of antibiotics and regular surveillance of uropathogens and antimicrobial susceptibility patterns on a larger scale

Evaluation of the Nature of Drought Experienced in Makueni County, Kenya

Drought events remain a major threat to lives and livelihoods in sub-Saharan Africa (SSA) due to the high exposure and vulnerability of populations. In the last three decades, Kenya experienced high frequency of drought events. The frequency of drought is projected to increase in the future more so due to anthropogenic climate change  whose impacts include erratic  seasonal rainfall and increased frequency of extreme rainfall events such as drought. Droughts present extreme conditions of water scarcity which have adverse effects on the physical environment and water resource systems particularly for arid and semi arid regions. The design and implementation of drought mitigation and response strategies requires an understanding of the nature and impacts of drought. Previous mitigation measures have been done randomly without establishing the nature of drought , reason as to why drought in Makueni County whether major or minor has severe impacts on this community.Makueni County of, Kenya has suffered many severe and extreme drought conditions the nature and impacts of which have however remained unknown and undocumented.  The objective of this study was to examine the nature of drought in Makueni over the last three decades. Secondary data comprising of rainfall records from Makindu, Mavindini and Kibwezi areas was used to compute a drought index. The standardised precipitation index SPI was used to identify the nature of drought occurring in the study area. The results revealed that Makueni County experienced three episodes of extreme meteorological droughts in the last three decades. In the same period, Hydrological drought persisted for over 8 years while over five extreme and severe Agricultural droughts were analysed in the study area. Though the drought conditions in the study area are pathetic, the residents of Makueni County seemingly did not fathom the nature of drought that they experienced. The findings of this study are anticipated to inform decision makers and development actors in Kenya, whose interest is to mitigate, and respond to drought on Kenyans lives, economy and development as a whole

Utilization of community-based outpatient addiction treatment programmes in Kenya

This paper examines a number of outpatient addictions treatment programmes developed in various regions of Kenya. The uptake of outpatient services at four sites between 2007 and 2010 has been examined. A field-based follow-up survey was administered to determine abstinence rates among clients who participated in treatment. Factors involved in recovery outcomes are discussed. Utilization of outpatient addictions treatment and retention in services increased over the three-year period, and field-based follow up with clients showed 42% abstinence rates. Key Words: Outpatient treatment, Alcohol, Drug, Addiction recovery, HIV, Keny

Food safety and public health implications of growing urban food markets

Currently, Africa suffers from the highest per capita rate of foodborne illnesses in the world. The riskiest foods from a health perspective are animal-source foods, fruits, and fresh vegetables. Consumption of all these is growing rapidly in African cities. Food products sold in formal markets and retail outlets are not necessarily safer than those sold in informal markets. Improvements in urban food safety will require intentioned investments in domestic market infrastructure and improved awareness of the shared responsibility to provide safe food by regulators and value chain actors

Factors influencing smallholder farmers’ inputs use in major bean production corridors in Kenya

This study analysed socio-economic determinants for inputs use in major bean corridors in Kenya. It comprised 417 respondents sampled from four major bean corridors. A structured questionnaire was used in data collection. Probit model was used to assess determinants of input use among the bean-farming households. From the results, 74% of respondents were male with a mean age of 48.6 years. The probability of using agricultural inputs increased with education level and income from crop sales. Fertilizer was mainly used in Bomet (73%) and Narok (74%) counties. Eighty-five percent planted recycled seeds. Education level and Income from crops positively influenced inputs use. It was concluded that education level, incomes from sale of crops, livestock and livestock products, and farm income influenced use of inputs. As a recommendation, Capacity building on merits of input use and promotion of public-private partnerships to strengthen input supply system would enhance increased input use by smallholder farmers.Keywords: Bean, inputs, determinants, Keny

HIV mortality in urban slums of Nairobi, Kenya 2003-2010: a period effect analysis.

RIGHTS : This article is licensed under the BioMed Central licence at http://www.biomedcentral.com/about/license which is similar to the 'Creative Commons Attribution Licence'. In brief you may : copy, distribute, and display the work; make derivative works; or make commercial use of the work - under the following conditions: the original author must be given credit; for any reuse or distribution, it must be made clear to others what the license terms of this work are.BACKGROUND: It has been almost a decade since HIV was declared a national disaster in Kenya. Antiretroviral therapy (ART) provision has been a mainstay of HIV treatment efforts globally. In Kenya, the government started ART provision in 2003 with significantly scale-up after 2006. This study aims to demonstrate changes in population-level HIV mortality in two high HIV prevalence slums in Nairobi with respect to the initiation and subsequent scale-up of the national ART program. METHODS: We used data from 2070 deaths of people aged 15-54 years that occurred between 2003 and 2010 in a population of about 72,000 individuals living in two slums covered by the Nairobi Urban Health and Demographic Surveillance System. Only deaths for which verbal autopsy was conducted were included in the study. We divided the analysis into two time periods: the "early" period (2003-2006) which coincides with the initiation of ART program in Kenya, and the "late" period (2007-2010) which coincides with the scale up of the program nationally. We calculated the mortality rate per 1000 person years by gender and age for both periods. Poisson regression was used to predict the risk of HIV mortality in the two periods while controlling for age and gender. RESULTS: Overall, HIV mortality declined significantly from 2.5 per 1,000 person years in the early period to 1.7 per 1,000 person years in the late period. The risk of dying from HIV was 53 percent less in the late period compared to the period before, controlling for age and gender. Women experienced a decline in HIV mortality between the two periods that was more than double that of men. At the same time, the risk of non-HIV mortality did not change significantly between the two time periods. CONCLUSIONS: Population-level HIV mortality in Nairobi's slums was significantly lower in the approximate period coinciding with the scale-up of ART provision in Kenya. However, further studies that incorporate ART coverage data in mortality estimates are needed. Such information will enhance our understanding of the full impact of ART scale-up in reducing adult mortality among marginalized slum populations in Kenya

Effects of vitamin D deficiency on neurobehavioural outcomes in children: a systematic review [version 1; peer review: 2 approved]

Introduction: Vitamin D plays an important role in brain development in experimental studies; however, the effect of vitamin D deficiency on child development remains inadequately characterized. We aimed to estimate the effects of vitamin D deficiency on neurobehavioural outcomes in children up to 18 years of age. Methods: We searched PubMed, EMBASE, PsycINFO, Scopus, Cochrane Library, Web of Science and Open Grey for published studies up to 10th January 2020. We included all studies that assessed the effects of maternal or child vitamin D status or vitamin D supplementation on neurobehavioural outcomes in children. Study findings were synthesized qualitatively as the high level of heterogeneity in study populations and methodologies precluded a quantitative meta-analysis. Results: Our search identified 5,633 studies, of which 32 studies with 31,445 participants from 18 countries were included in the systematic review. Of the studies identified, two were randomized controlled trials (RCTs) of vitamin D supplementation in children, while 30 were observational. One RCT (n=55) reported a beneficial effect of supplementation with lower doses compared to higher doses of vitamin D on motor development while the other RCT (n=70) found no beneficial effect of vitamin D supplementation on cognition in extremely preterm infants. Twelve mother-child studies (n=17,136) and five studies in children (n=1,091) reported an association between low maternal or child 25-hydroxyvitamin D levels and impaired neurobehavioural outcomes in children, while 15 mother-child studies (n=20,778) and eight studies in children (n=7,496) reported no association. Conclusions: Although animal studies point to an effect of vitamin D deficiency on brain development, there are few studies on the effects of vitamin D deficiency on neurobehavioural outcomes in children and their findings are inconsistent. There is a need for well-conducted, adequately powered studies to further determine these effects in children. Registration: PROSPERO ID CRD42018087619 ; registered on 15 February 2018

The Dynamics of Implementing Software Engineering Projects

The study set out to establish whether project dynamics is perceived as a factor that affects the implementation of software engineering projects in Nairobi, Kenya and used the findings to model the dynamics of the implementation process. According to literature, the software industry in Kenya is relatively young and therefore necessary to look into other more established industries to identify key factors and challenges. Kenya's software projects experience a myriad of dynamism during implementation; the budgets are volatile, human resources required for project implementation come on board with many differing skills that add to the complexity of executing and implementing the projects, and there are also many internal and external variables to the implementation process that keep on changing. Since many projects suffer from the 90% syndrome in which a project is thought to be 90% complete for half of the total time required, software projects are not excluded. Tasks which are completed as part of a software project may be flawed and may need rework. For software projects, implementation is double phased and there are numerous changing variables in both phases that contribute to the dynamics of implementing software projects. The study used the Kenya ICT sector as a case study and utilized the findings to model the dynamics of implementing software projects. The model depicted that there is a lot of dynamism in implementing software projects. The dynamism revolves around the changing project variables that influence the success or failure of the said projects. The study recommends that modeling the dynamics of implementing any software project is critical to enable detection of any hindrances to successful implementation and avoid wastage of resources. The models can aid in detecting the effects of any unforeseen uncertainties within the implementation process early enough so that appropriate action can be taken to mitigate any uncertainties.