Shone’s complex

Shone’s complex is a rare cardiac anomaly consisting of four obstructive lesions of the left heart: supramitral membrane/ring; parachute mitral valve; subaortic stenosis; and coarctation of the aorta. We report on an 18 year-old woman with a variant of Shone’s complex, associated with a large patent ductus arteriosus (PDA ) and pulmonary hypertension. She underwent a successful percutaneous therapeutic catheterisation for the treatment of the coarctation of the aorta and the large PDA using a 45mm covered stent. To our knowledge, this is the first reported case where a covered stent was deployed to treat a native coarctation of the aorta and a PDA in a patient who also had a parachute mitral valve and a bicuspid aortic valve

Milk Yield of Dairy Cattle Fed Common \u3ci\u3eUrochloa\u3c/i\u3e Grass in Kenya

Urochloa grass mainly grown in South America, East Asia and Australia has its origin in East and Central Africa. Its success in South America for animal production triggered interest in Kenya where the main forage species Napier grass was threatened by head smut and stunt diseases. Therefore, a study was carried out at Mtwapa research station in the coastal lowlands of Kenya under controlled condition to compare the lactation performance of dairy cattle fed on Urochloa hybrid cv. Mulato II, U. decumbens cv. Basilisk, U. brizantha cvs. Piata, MG-4 and Xaraes with Napier grass. An on-farm participatory study was conducted in eastern midlands of Kenya where farmers compared their local feeds (varied mixtures of Napier grass, maize stover and natural pastures) with either Piata, Xaraes, MG-4 or Basilisk). Results from the on-station experiment showed no significant differences (P \u3c 0.05) in daily milk yield between dairy cows fed Piata (4.7 kg) and those fed on Napier grass (4.6 kg) while cows fed on either Mulato II or Xaraes produced less (P \u3c 0.05) milk; 4.4 and 3.6 kg respectively. In the farmers’ trial, milk yield increased by 15 - 40% when they fed their cows on Urochloa grasses. The studies concluded that Urochloa grasses had potential to replace or compliment Napier grass in dairy feeding in Kenya towards increased milk production

Complete Genome Sequence of Mycobacterium avium subsp. paratuberculosis, Isolated from Human Breast Milk

Mycobacterium avium subsp. paratuberculosis causes Johne’s disease (JD) in cattle, sheep, goats, and other ruminant animals. JD presents as a chronic granulomatous intestinal infection with a worldwide distribution and imposes a significant economic toll on livestock industries (1). M. avium subsp. paratuberculosis has a complex cell wall structure containing mycolic acids and several lipids similar to those of other members of this genus, yet it is the most slowly growing member. This bacterium often requires 8 to 16 weeks before colonies are visible in culture, which is a major hurdle in diagnostics and therefore in the implementation of optimal JD control measures. Although a well-established domestic and wild animal pathogen, it has also been implicated as a causative agent in human Crohn’s disease (2), and even though this link is controversial (3), M. avium subsp. paratuberculosis isolates have been obtained from humans. For instance, M. avium subsp. paratuberculosis 4, the isolate whose sequence we report here, was originally isolated from the breast milk of a Crohn’s disease patient in 2000 (4)

Complete Genome Sequence of Mycobacterium avium subsp. paratuberculosis, Isolated from Human Breast Milk

Mycobacterium avium subsp. paratuberculosis causes Johne’s disease (JD) in cattle, sheep, goats, and other ruminant animals. JD presents as a chronic granulomatous intestinal infection with a worldwide distribution and imposes a significant economic toll on livestock industries (1). M. avium subsp. paratuberculosis has a complex cell wall structure containing mycolic acids and several lipids similar to those of other members of this genus, yet it is the most slowly growing member. This bacterium often requires 8 to 16 weeks before colonies are visible in culture, which is a major hurdle in diagnostics and therefore in the implementation of optimal JD control measures. Although a well-established domestic and wild animal pathogen, it has also been implicated as a causative agent in human Crohn’s disease (2), and even though this link is controversial (3), M. avium subsp. paratuberculosis isolates have been obtained from humans. For instance, M. avium subsp. paratuberculosis 4, the isolate whose sequence we report here, was originally isolated from the breast milk of a Crohn’s disease patient in 2000 (4)

Relationship between self-evaluative components and moderating contextual factors among university student gymnasium exercisers

Regular physical activity (PA) is known to improve psychological traits such as self-esteem (SE), body image (BI) and body satisfaction (BS). However, there are apparent mixed reports about the role of PA in promoting psychosocial wellbeing and moderating factors. This study investigated the relationship between SE, BI and BS of gym exercisers at a university and contextual factors of exercise principles; frequency, duration and types of activity, and participants’ demographics variables. Rosenberg self-esteem scale, Body image questionnaire and Body satisfaction Scale were administered among randomly selected gym exercisers (n = 92); 60(65.2%) males and 32(34.8 %.) females, aged between 15 and 30 years. Self-esteem showed significant correlations with BS (r = 0.237, p = .023) and with BI (r = 0.287, p = .006). Body satisfaction mean scores were significantly different across duration of exercise sessions (F=3.672, p=.008) in favour of 1.5-hour gym sessions compared to longer or shorter ones. Substantial differences were also observed in BI across favourite physical activities (F = 3.224, p = .026) with post hoc showing Zumba scoring highest. Regression analyses showed significant influence of exercise type (Adjusted R Squared = .040, Beta = .239, p = .023) and gender (Adjusted R Squared = .054, Beta = .239, p = .023) on BI scores. Type and duration of exercise and gender have moderating effects on self-evaluative components. Gym instructors and stakeholders should consider duration for each type of exercise in fitness programmes to optimise participants’ wellbeing. Exercise counselling regarding participants’ self-evaluative components and how these could affect their mental health and overall quality of life in different social-cultural settings need to be explored in future studies

Characteristics of HIV-infected adolescents enrolled in a disclosure intervention trial in western Kenya

Knowledge of one's own HIV status is essential for long-term disease management, but there are few data on how disclosure of HIV status to infected children and adolescents in sub-Saharan Africa is associated with clinical and psychosocial health outcomes. We conducted a detailed baseline assessment of the disclosure status, medication adherence, HIV stigma, depression, emotional and behavioral difficulties, and quality of life among a cohort of Kenyan children enrolled in an intervention study to promote disclosure of HIV status. Among 285 caregiver-child dyads enrolled in the study, children's mean age was 12.3 years. Caregivers were more likely to report that the child knew his/her diagnosis (41%) compared to self-reported disclosure by children (31%). Caregivers of disclosed children reported significantly more positive views about disclosure compared to caregivers of non-disclosed children, who expressed fears of disclosure related to the child being too young to understand (75%), potential psychological trauma for the child (64%), and stigma and discrimination if the child told others (56%). Overall, the vast majority of children scored within normal ranges on screenings for behavioral and emotional difficulties, depression, and quality of life, and did not differ by whether or not the child knew his/her HIV status. A number of factors were associated with a child's knowledge of his/her HIV diagnosis in multivariate regression, including older age (OR 1.8, 95% CI 1.5-2.1), better WHO disease stage (OR 2.5, 95% CI 1.4-4.4), and fewer reported caregiver-level adherence barriers (OR 1.9, 95% CI 1.1-3.4). While a minority of children in this cohort knew their HIV status and caregivers reported significant barriers to disclosure including fears about negative emotional impacts, we found that disclosure was not associated with worse psychosocial outcomes

Identification of Niches for Integration of Brachiaria Grasses in Smallholder Mixed Crop-Livestock Farming Systems in Kenya

Inadequate quantity and quality of feed is the major constraint to livestock productivity in Kenya. Low rainfall, lack of adapted forages and poor management of sown forages are major factors that affect feed resources production. In most of the farming systems, forages are relegated to the less fertile and degraded soils resulting into poor growth. As a result the growth is poor resulting in deficient in minerals content, low crude protein (CP) and energy. The situation in exacerbated by climate variability and frequent drought. On the other hand, feed resources derived from crop residues, particularly cereals are of poor quality and not sufficient to meet animal production (Njarui and Mureithi, 2006). A research programme was initiated in 2012 to explore superior feed resources and increase availability of high quality forages to increase livestock productivity in East Africa. The program focuses on evaluation of drought and marginal soil adapted improved Brachiaria cultivars from South America. The genus Brachiaria is predominantly an African grass with about 100 species. The Brachiaria grasses are the most widely grown forages in South America (Miles et al., 2004). These grasses produce high biomass, enhance soil fertility and reduce greenhouse gas emission (Peters et al., 2012), are highly nutritious and are known to increase milk (Njarui, pers. comm.) thus suitable for different farming systems of Kenya. However, before integration of these grasses into farming systems, it was imperative to identify suitable niches suitable for growing these grasses. The knowledge gained from the study will facilitate development of suitable approaches for promoting these grasses across diverse production systems of Kenya

Iron for Africa-Report of an Expert Workshop.

Scientific experts from nine countries gathered to share their views and experience around iron interventions in Africa. Inappropriate eating habits, infections and parasitism are responsible for significant prevalence of iron deficiency, but reliable and country-comparable prevalence estimates are lacking: improvements in biomarkers and cut-offs values adapted to context of use are needed. Benefits of iron interventions on growth and development are indisputable and outweigh risks, which exist in populations with a high infectious burden. Indeed, pathogen growth may increase with enhanced available iron, calling for caution and preventive measures where malaria or other infections are prevalent. Most African countries programmatically fortify flour and supplement pregnant women, while iron deficiency in young children is rather addressed at individual level. Coverage and efficacy could improve through increased access for target populations, raised awareness and lower cost. More bioavailable iron forms, helping to decrease iron dose, or prebiotics, which both may lower risk of infections are attractive opportunities for Africa. Fortifying specific food products could be a relevant route, adapted to local context and needs of population groups while providing education and training. More globally, partnerships involving various stakeholders are encouraged, that could tackle all aspects of the issue

Alcohol and illicit drug use among young people living with HIV compared to their uninfected peers from the Kenyan coast: prevalence and risk indicators

Background: In sub-Saharan Africa, there is paucity of research on substance use patterns among young people living with HIV (YLWH). To address the gap, we sought to: i) determine the prevalence of substance use, specifically alcohol and illicit drug use, among YLWH compared to their HIV-uninfected peers; ii) investigate the independent association between young people’s HIV infection status and substance use; iii) investigate the risk indicators for substance use among these young people. Methods: Between November 2018 and September 2019, a cross-sectional study was conducted at the Kenyan coast recruiting 819 young people aged 18–24 years (407 HIV-positive). Alcohol and drug use disorders identification tests (AUDIT and DUDIT) were administered via audio computer-assisted self-interview alongside other measures. Logistic regression was used to determine substance use risk indicators. Results: The point prevalence of current substance use was significantly lower among YLWH than HIV-uninfected youths: current alcohol use, 13% vs. 24%, p \u3c 0.01; current illicit drug use, 7% vs. 15%, p \u3c 0.01; current alcohol and illicit drug use comorbidity, 4 vs. 11%, p \u3c 0.01. Past-year prevalence estimates for hazardous substance use were generally low among young people in this setting (\u3c 10%) with no significant group differences observed. Being HIV-positive independently predicted lower odds of current substance use, but not hazardous substance use. There was overlap of some risk indicators for current substance use between young people with and without HIV including male sex, khat use and an experience of multiple negative life events, but risk indicators unique to either group were also identified. Among YLWH, none of the HIV-related factors was significantly associated with current substance use. Conclusions: At the Kenyan coast, substance use is a reality among young people. The frequency of use generally appears to be low among YLWH compared to the HIV-uninfected peers. Substance use prevention initiatives targeting young people, regardless of HIV infection status, are warranted in this setting to avert their potential risk for developing substance use disorders, including dependence. The multifaceted intrapersonal and interpersonal factors that place young people at risk of substance use need to be addressed as part of the substance use awareness and prevention initiatives

A randomized control trial of phototherapy and 20% albumin versus phototherapy and saline in Kilifi, Kenya

Objective: The study evaluated the efficacy of phototherapy and 20% albumin infusion to reduce total serum bilirubin (TSB) in neonates with severe hyperbilirubinemia. The primary outcome was a reduction of TSB at the end of treatment. The secondary outcomes were the need for exchange transfusion, inpatient mortality, neurological outcomes at discharge, and development outcomes at 12-months follow-up. Results: One hundred and eighteen neonates were randomly assigned to phototherapy and 20% albumin (n = 59) and phototherapy and saline (n = 69). The median age at admission was 5 (interquartile range (IQR) 3–6) days, and the median gestation was 36 (IQR 36–38) weeks. No significant differences were found in the change in TSB (Mann–Whitney U =609, p = 0.98) and rate of change in TSB per hour after treatment (Mann–Whitney U = 540, p = 0.39) between the two groups. There were no significant differences between the two groups in the proportion of participants who required exchange transfusion (χ2 (2) = 0.36, p = 0.546); repeat phototherapy (χ2 (2) = 2.37, p = 0.123); and those who died (χ2 (2) = 0.92, p = 0.337). Trial registration The trial was registered in the International Standardized Randomized Controlled Trial Number (ISRCTN); trial registration number ISRCTN89732754