Comparison of tithonia (Tithonia diversifolia) green manure, poultry manure and inorganic sources of nitrogen in the growth of kales (Brassicae oleraceae) in Nyeri county, Kenya

Production of vegetables in Nyeri County (Central Kenya) is greatly hampered by failure of farmers to use fertilizers. This is partly because of the relative high cost of the fertilizers. Tithonia green manure may provide a suitable alternative to the conventional inorganic sources of nitrogen. However, there is little information on its potential benefit especially in the growing of kales, (Brasicae oleraceace). Kales were grown on two  experimental sites to compare tithonia green manure, poultry manure and other inorganic sources of nitrogen, namely calcium ammonium nitrate (CAN), urea and ammonium sulphate nitrate (ASN). The fertilizer  treatments were applied in three levels of; 30 kg of N/ha, 60 kg of N/ha and unfertilized control, from inorganic and equivalent of organic sources. Except for tithonia green manure, all the other treatments were  administered at the time of transplanting. The experiment was a Completely Randomized Block Design, with five treatments in three levels, replicated three times on each site, and each site being a replica. Individual plots measured 4 m x 3 m at inter-plant and inter-row spacing of 60 cm x 60 cm, respectively. The inter-plot spacing was 50 cm and inter-block spacing was 100 cm. The fresh weight of kales was compared for all the treatments as well as the control. The data collected were subjected to F-test using SPSS proprietary computer software (Version 12.00). Treatment means found to be significantly different from each other were separated by Duncan Multiple Range Test at 5% confidence level. The results indicated that tithonia green manure applied at 60 kg of N/ha or 9t/ha equivalent of dry matter, produced the highest fresh weight of kales followed by calcium ammonium nitrate applied at the same rates. The difference was significant and higher by an average of 7.65 % from the two experimental sites. Nevertheless, tithonia green manure was not easily available during the traditional planting season in the region. Further research is required to explore the possibility of applying it in mixture with poultry manure because as observed, many smallholder mixed farmers also keep poultry which could be a source of poultry manure. Undoubtly, organic fertilizers complement inorganic fertilizers.Key words: Nitrogen, yields, Tithonia, plant nutrient

Assessment of pollution in Ndarugu river due to runoff and agro-industrial wastewater disposal

River Ndarugu is a tributary of Athi River in Kenya and is one of the main sources of fresh water for domestic use to the villages along the river bank and Nairobi City. It traverses Juja Township in Kiambu County, Central Kenya. During its course through the different agricultural and industrial areas of Gatundu, Gachororo and Juja farms, it receives untreated agro‐industrial waste discharges, effluent from coffee and tea factories, and other agricultural activities in the catchment area. This paper aims at assessing the level of pollution due to these activities. Water samples were collected from seven sampling points during the dry season in July and short wet season in November and December and analysed in situ and at Jomo Kenyatta University Environmental laboratory for eight parameters. These include pH, temperature, electrical conductivity (EC), Turbidity, Nitrogen, Phosphorous, Biochemical oxygen demand (BOD5) and dissolved oxygen (DO).The samples were collected at 15cm depth (to avoid floating materials) and geographical positioning system (GPS) device was used to spatially locate the sampling sites. Samples were taken from upstream and downstream of point and non‐ point sources of pollution. Results indicated that most physical parameters were within the WHO limits for drinking purpose. BOD5 and EC levels increased from 12mg/l to 22mg/l and 55μS/cm to 85μS/cm respectively but DO level decreased from 6.3mg/l to 3.4mg/l moving downstream in dry season. Turbidity was above the allowable limit in both seasons. Nutrient levels were within the limits and no phosphorus was detected. There is need for proper control of wastewater by various techniques, and preliminary treatment of waste discharges prior to effluent disposal. Care should be taken in application of inorganic fertilizers. Management of the watershed is also necessary so as to protect the river from the adverse impacts of agricultural activities and save it from further deterioration.Key words: biochemical oxygen demand, dissolved oxygen, electrical conductivity, pollutio

Cashew nut shell liquid: an agricultural by-product with great potential for commercial exploitation in Kenya

Cashew nut shell liquid (CNSL) is the main by‐product from cashew nuts processing and is obtained during roasting of the nuts by the oil‐bath method. It may also be obtained through expression of residual shells or solvent extraction of the pulverized shells. Kenya has the potential to produce 200,000 Tonnes of cashew nuts and  5,000 Tonnes of CNSL if all the nuts were to be processed locally and with recovery of the liquid. Currently, the country realizes only about 5‐10% of its nuts production potential. Processing of the nuts has been left to small scale processors who in many cases, burn residue shells as fuel or as waste. This practice pollutes the environment profoundly through emission of thick dark smoke with particulate matter. No CNSL is recovered in Kenya currently. The aim of this review paper is to highlight a number of products which can be manufactured in Kenya based on research initially done at Kenya Industrial Research and Development Institute and more recently at Jomo Kenyatta University of Agriculture and Technology Recovery of CNSL and its exploitation in Kenya will not only enhance the economic returns to the cashew industry but also contribute significantly to conservation of the environment. It is recommended that further work be done to scale‐up production of CNSL based products and demonstrate feasibility of the same. Production and local processing of the cashew nuts accompanied by recovery of CNSL should be enhanced.Key words: Cashew nuts, CNSL utilization, cashew nut production, Keny

The incidence and risk factors for intra-operative hypothermia among paediatric patients undergoing general anaesthesia at the Kenyatta National Hospital

Objective: To determine the incidence and risk factors for intra-operative hypothermia in paediatric patients undergoing general anaesthesia at the Kenyatta National Hospital. Design: A prospective observational study.Setting: The Kenyatta National Hospital main operating theatres and affiliated satellite operating theatres.Subjects: A total of 100 paediatric patients (range; three days to 12 years, mean; 4.1 ± 3.3 years) were enrolled in the study.Results: Thirty out of 100 patients developed hypothermia defined as a core temperature <36ºC recorded at least once during provision of general anaesthesia. Ninety percent of those developing hypothermia were male compared to 63% who remained normothermic (p = 0.006). Proportionally, more than twice as many hypothermic patients had a caudal block (43% versus 20%, p = 0.016) and received 121ml more of fluid (p = 0.002) compared to the normothermic group. The patients who became hypothermic tended to be colder at induction of anaesthesia (36.6 ± 0.5ºC versus 37.0 ± 0.5ºC, p = <0.0001) but there was no significant difference in the waiting time, time of  induction, environmental temperatures or theatre temperatures compared to those not developing hypothermia. There was no significant difference in the BMI between the two groups (14.0 ± 2.9 kg/ m2 versus 15.2 ± 3.5 kg/m2, p = 0.101).Conclusion: The incidence of intra-operative core hypothermia in paediatric patients undergoing general anaesthesia at the Kenyatta National Hospital is 30%. Gender (male), lower body temperature at induction, use of caudal block and the volume of intravenous fluids infused were significant independent predictors of core hypothermia. The most significant predictor was body temperature at the time of induction of general anaesthesia

Characteristics of HIV-infected children seen in Western Kenya

Objectives: To describe the characteristics and outcomes of children registered for care in a large HIV care programme in Western Kenya.Design: A retrospective descriptive study.Setting: USAID-AMPATH HIV clinics in health centres; district and sub-district hospitals; Moi Teaching and Referral Hospital in Western Kenya.Subjects: HIV-infected children below age of 15 years seen in a network of 18 clinics in Western Kenya.Interventions: Paediatric HIV diagnosis and care including treatment and prevention of opportunistic infections and provision of combination antiretroviral therapy (CART).Main outcome measures: Diagnosis, clinical stage and immune status at enrollment and follow-up; hospitalisation and death. Descriptive statistical analyses and chi square tests were performedResults: Four thousand and seventeen HIV-infected children seen between June 2002 and April 2008. Median age at enrollment was four years (0-14.2 years), 51% girls, 25% paternal orphans, 10% total orphans and 13% maternal orphans. At enrollment, 25% had weight-for-Age Z scores (WAZ)> -1 and 21% had WAZ scores < 3. Orphaned children had worse WAZ scores (p=0.0001). Twenty five per cent of children were classified as WHO clinical stage 3 and 4, 56% were WHO clinical stages 1 and 2 with 19% missing clinical staging at enrollment. Cough (25%), gastroenteritis (21%), fever (15%), pneumonia (10%) were the commonest presenting features. Twenty six per cent had been diagnosed with tuberculosis and only 25% started on cotrimoxazole preventive therapy (CPT). Median CD4% at enrollment was 16% (0-64%); latest recorded values were 22% (0-64). Sixty four per cent were on cART (cART+), median age at start was 5.4 (014.4 years).The median initial CD4% among cART+ was 13 (0-62) compared to 24 (0-64) for those not on ART (cART-). Median CD4% for cART+ improved to 22% (0-59); whereas cART- was 23% (0-64) at last appointment. During the period of follow-up, one fifth (19%) of children on cART were lost to follow-up compared to slightly over one third (37%) for those not on cART. Thirty four percent were hospitalised; 41% diagnosed with pneumonia. Six per cent of 4017 were confirmed dead.Conclusions: HIV -infected children were enrolled in care early in childhood. Orphan-hood was prevalent in these children as were gastroenteritis, fever, pneumonia and advanced immuno-suppression. Orphans were more likely to be severely malnourished. Only a quarter of children were put on cotrimoxazole preventive therapy. Children commenced on cART late but responded well to treatment. Loss to follow-up was less prevalent among those on cART

Phytochemical and Antimicrobial Investigation of Girardinia diversifolia (Link) Friis (Urticaceae)

Root and stem extracts of Girardinia diversifolia exhibited varying degrees of activity against Bacillus pumilus, Staphylococcus aureus, Escherichia coli, Aspergillus niger, Candida albicans and Saccharomyces cerevisiae. Three compounds namely β-sitosterol, 7-hydroxysitosterol and 3-hydroxystigmast-5-en-7-one, were isolated from the petroleum ether root extract. The present study gives scientific credence to the traditional use of Girardinia diversifolia in the management of microbial infections.Keywords: Girardinia diversifolia, phytochemical, antimicrobialEast and Central African Journal of Pharmaceutical Sciences Vol. 14 (2011) 89-9

Effect of Daily Antenatal Iron Supplementation on Plasmodium Infection in Kenyan Women: A Randomized Clinical Trial.

IMPORTANCE: Anemia affects most pregnant African women and is predominantly due to iron deficiency, but antenatal iron supplementation has uncertain health benefits and can increase the malaria burden. OBJECTIVE: To measure the effect of antenatal iron supplementation on maternal Plasmodium infection risk, maternal iron status, and neonatal outcomes. DESIGN, SETTING, AND PARTICIPANTS: Randomized placebo-controlled trial conducted October 2011 through April 2013 in a malaria endemic area among 470 rural Kenyan women aged 15 to 45 years with singleton pregnancies, gestational age of 13 to 23 weeks, and hemoglobin concentration of 9 g/dL or greater. All women received 5.7 mg iron/day through flour fortification during intervention, and usual intermittent preventive treatment against malaria was given. INTERVENTIONS: Supervised daily supplementation with 60 mg of elemental iron (as ferrous fumarate, n = 237 women) or placebo (n = 233) from randomization until 1 month postpartum. MAIN OUTCOMES AND MEASURES: Primary outcome was maternal Plasmodium infection at birth. Predefined secondary outcomes were birth weight and gestational age at delivery, intrauterine growth, and maternal and infant iron status at 1 month after birth. RESULTS: Among the 470 participating women, 40 women (22 iron, 18 placebo) were lost to follow-up or excluded at birth; 12 mothers were lost to follow-up postpartum (5 iron, 7 placebo). At baseline, 190 of 318 women (59.7%) were iron-deficient. In intention-to-treat analysis, comparison of women who received iron vs placebo, respectively, yielded the following results at birth: Plasmodium infection risk: 50.9% vs 52.1% (crude difference, -1.2%, 95% CI, -11.8% to 9.5%; P = .83); birth weight: 3202 g vs 3053 g (crude difference, 150 g, 95% CI, 56 to 244; P = .002); birth-weight-for-gestational-age z score: 0.52 vs 0.31 (crude difference, 0.21, 95% CI, -0.11 to 0.52; P = .20); and at 1 month after birth: maternal hemoglobin concentration: 12.89 g/dL vs 11.99 g/dL (crude difference, 0.90 g/dL, 95% CI, 0.61 to 1.19; P < .001); geometric mean maternal plasma ferritin concentration: 32.1 µg/L vs 14.4 µg/L (crude difference, 123.4%, 95% CI, 85.5% to 169.1%; P < .001); geometric mean neonatal plasma ferritin concentration: 163.0 µg/L vs 138.7 µg/L (crude difference, 17.5%, 95% CI, 2.4% to 34.8%; P = .02). Serious adverse events were reported for 9 and 12 women who received iron and placebo, respectively. There was no evidence that intervention effects on Plasmodium infection risk were modified by intermittent preventive treatment use. CONCLUSIONS AND RELEVANCE: Among rural Kenyan women with singleton pregnancies, administration of daily iron supplementation, compared with administration of placebo, resulted in no significant differences in overall maternal Plasmodium infection risk. Iron supplementation led to increased birth weight. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT01308112

Presumptive treatment of fever cases as malaria: help or hindrance for malaria control?

BACKGROUND: Malaria incidence has been reported to be falling in several countries in sub-Saharan Africa in recent years. This fall appears to have started before the widespread introduction of insecticide-treated nets. In the new era of calls to eliminate and eradicate malaria in sub-Saharan Africa, exploring possible causes for this fall seem pertinent. PRESENTATION OF THE HYPOTHESIS: The authors explore an argument that presumptive treatment of fever cases as malaria may have played a role in reducing transmission of malaria by the prophylactic effect of antimalarials and their widespread use. This strategy, which is already in practise is termed Opportunistic Presumptive Treatment (OPT). TESTING THE HYPOTHESIS: Further comparison of epidemiological indicators between areas with OPT and more targeted treatment is required. If data suggest a benefit of OPT, combining long acting antimalarials that have an anti-gametocyticidal activity component plus using high levels of vector control measures may reduce transmission, prevent resistant strains spreading and be easily implemented. IMPLICATIONS OF THE HYPOTHESIS: OPT is practised widely by presumptive treatment of fever in health facilities and home management of fever. Improving diagnosis using rapid diagnostic tests and thus reducing the number of doses of antimalarials given may have counter intuitive effects on transmission in the context of elimination of malaria in high to moderate transmission settings

Genetic Pathway in Acquisition and Loss of Vancomycin Resistance in a Methicillin Resistant Staphylococcus aureus (MRSA) Strain of Clonal Type USA300

An isolate of the methicillin-resistant Staphylococcus aureus (MRSA) clone USA300 with reduced susceptibility to vancomycin (SG-R) (i.e, vancomycin-intermediate S. aureus, VISA) and its susceptible “parental” strain (SG-S) were recovered from a patient at the end and at the beginning of an unsuccessful vancomycin therapy. The VISA phenotype was unstable in vitro generating a susceptible revertant strain (SG-rev). The availability of these 3 isogenic strains allowed us to explore genetic correlates of antibiotic resistance as it emerged in vivo. Compared to the susceptible isolate, both the VISA and revertant strains carried the same point mutations in yycH, vraG, yvqF and lspA genes and a substantial deletion within an intergenic region. The revertant strain carried a single additional frameshift mutation in vraS which is part of two component regulatory system VraSR. VISA isolate SG-R showed complex alterations in phenotype: decreased susceptibility to other antibiotics, slow autolysis, abnormal cell division and increased thickness of cell wall. There was also altered expression of 239 genes including down-regulation of major virulence determinants. All phenotypic properties and gene expression profile returned to parental levels in the revertant strain. Introduction of wild type yvqF on a multicopy plasmid into the VISA strain caused loss of resistance along with loss of all the associated phenotypic changes. Introduction of the wild type vraSR into the revertant strain caused recovery of VISA type resistance. The yvqF/vraSR operon seems to function as an on/off switch: mutation in yvqF in strain SG-R turns on the vraSR system, which leads to increase in vancomycin resistance and down-regulation of virulence determinants. Mutation in vraS in the revertant strain turns off this regulatory system accompanied by loss of resistance and normal expression of virulence genes. Down-regulation of virulence genes may provide VISA strains with a “stealth” strategy to evade detection by the host immune system

Randomized controlled field trial to assess the immunogenicity and safety of rift valley fever clone 13 vaccine in livestock

BACKGROUND:Although livestock vaccination is effective in preventing Rift Valley fever (RVF) epidemics, there are concerns about safety and effectiveness of the only commercially available RVF Smithburn vaccine. We conducted a randomized controlled field trial to evaluate the immunogenicity and safety of the new RVF Clone 13 vaccine, recently registered in South Africa. METHODS:In a blinded randomized controlled field trial, 404 animals (85 cattle, 168 sheep, and 151 goats) in three farms in Kenya were divided into three groups. Group A included males and non-pregnant females that were randomized and assigned to two groups; one vaccinated with RVF Clone 13 and the other given placebo. Groups B included animals in 1st half of pregnancy, and group C animals in 2nd half of pregnancy, which were also randomized and either vaccinated and given placebo. Animals were monitored for one year and virus antibodies titers assessed on days 14, 28, 56, 183 and 365. RESULTS:In vaccinated goats (N = 72), 72% developed anti-RVF virus IgM antibodies and 97% neutralizing IgG antibodies. In vaccinated sheep (N = 77), 84% developed IgM and 91% neutralizing IgG antibodies. Vaccinated cattle (N = 42) did not develop IgM antibodies but 67% developed neutralizing IgG antibodies. At day 14 post-vaccination, the odds of being seropositive for IgG in the vaccine group was 3.6 (95% CI, 1.5 - 9.2) in cattle, 90.0 (95% CI, 25.1 - 579.2) in goats, and 40.0 (95% CI, 16.5 - 110.5) in sheep. Abortion was observed in one vaccinated goat but histopathologic analysis did not indicate RVF virus infection. There was no evidence of teratogenicity in vaccinated or placebo animals. CONCLUSIONS:The results suggest RVF Clone 13 vaccine is safe to use and has high (>90%) immunogenicity in sheep and goats but moderate (> 65%) immunogenicity in cattle