The Malady of Boys' Performance: What are the Effects of Institutional Variables on students’ performance at Kenya Certificate of Secondary Education in Subukia Sub-District, Nakuru County, Kenya?

This study examined institutional variables affecting the performance boys at Kenya Certificate of Secondary Education (KSCE) examinations in Subukia District, Nakuru County. The study adopted a descriptive survey research design.  The target population   was 7,943 consisting of 7,886 boy students and 57 principals.  The study drew a sample of 429 consisting of 366 students and 6 principals. Questionnaires were used to collect data from the students while the interview schedules were   used to collect qualitative data from the principals. The main findings were that truancy and coupling especially in mixed schools as well as inability to pay school levies on time were the main institutional variables that negatively affected students’ academic performance in national examinations. The study concluded that as boys progress within the school system their performance declined due to the interference of the intertwined institutional and home based variables.   It was   recommended  that secondary schools should consider having a fully operational guidance and counseling departments to mitigate on the effects of institutional factors affecting the  performance of boys  in KCSE  in Subukia District, Nakuru County, Kenya. Key Words: Malady,   Boys' Performance, Kenya Certificate of Secondary Education, Institutional Variables,   Subukia Sub-District, Nakuru County, Kenya.

Athari za Masuala ya Kijamii kwenye Mfumo wa Ikolojia Jamii: Uchanganuzi wa Diwani za Bara Jingine na Rangi ya Anga

Makala haya yanalenga kuchunguza athari za masuala ya kijamii kwenye mfumo wa ikolojia jamii. Madhumuni ya uchunguzi huo ni kubainisha athari za masuala ya kijamii kwenye mfumo wa ikolojia kwenye diwani za Bara Jingine (Mberia, 2001) na Rangi ya Anga (Mberia, 2014). Aidha, ili kufanikisha azma hiyo, tumetumia mbinu ya usampulishaji lengwa katika kuchagua kazi ambazo zitatoa data mwafaka na kuzichanganua kwa njia ya maelezo huku tukitoa ufafanuzi na uthibitisho kutoka katika diwani ya Bara Jingine na Rangi ya Anga. Kadhalika, tumeongozwa na Nadharia ya Mfumo Ikolojia ambayo inaangazia uhusiano, upatano na mwingiliano kati ya binadamu na binadamu mwenzake au baina yake na viumbe wengine (Bronfenbrenner, 1989). Matokeo yaliyopatikana baada ya kufanyika kwa uchunguzi yamedhihirisha kuwa masuala ya kijamii kama vile matumizi ya mihadarati, ubaguzi wa kijinsia, ndoa za mapema na teknolojia ya kisasa yanaathiri mfumo wa ikolojia. Hii ni kwa sababu maisha ya binadamu na viumbe wengine hayawezi kukamilika bila kutegemeana. Isitoshe, kuingiliana na kutagusana baina ya binadamu mmoja na mwingine kunaibua migogoro na mikinzano ambayo huathiri si ustawi wa binadamu pekee, bali pia ustawi viumbe wengine. Hii ni kwa kuwa wote wanaishi kwenye mazingira yaleyale. Tafiti za baadaye zinaweza zikashughulikia jinsi masuala ya kisiasa yanavyoathiri mfumo wa ikolojia

Socio-Demographic, Nutritional and Adherence as Determinants of Nevirapine Plasma Concentration among HIV-1 Patients from Two Geographically Defined Regions of Kenya

Background: Data are skewed on the role of Socio-demographic, nutritional and adherence related factors on the influence of nevirapine plasma concentrations among Kenyan population. This study rigorously determined these three factors on nevirapine plasma concentrations among HIV patients receiving HIV treatment in two regions known for high prevalence of HIV and long duration of ART uptake.Methods: Blood samples were collected from 377 consenting HIV adult patients receiving an NVP-based first-line ART regimen. A detailed sociodemographic questionnaire was administered. NVP plasma concentration was measured by liquid chromatography - tandem mass spectrometry (LC-MS/MS). Results: The majority (59.2%) of the patients were female, 72.2% were from western Kenya (predominantly Nilotic speaking community). The patients’ mean age was 41.6 (SD ± 11.5) years and the mean duration of ART was 5.1 (SD ± 4.8) years. The median BMI of the patients was 25 kg/m2 (IQR = 22.2 - 28.7 kg/m2). The majority 81.2% were receiving 3TC/NVP/TDF ART regimen, 30% had changed their initial ART regimen with 54.4% reporting missing taking current ARVs. Overall NVP plasma levels ranged from 4-44207 ng/mL (median 6213 ng/mL, IQR 3097–8606.5 ng/mL). There were 105 (25.5%) participants with NVP levels of <3100 ng/mL, associated with poor viral suppression. Multivariate linear regression analysis showed region of origin (adjusted β 976, 95% CI, 183.2 to 1768.82; p = 0.016), gender (adjusted β 670, 95% CI, 293.6 to 1634.2; p = 0.047), education level (adjusted β -39.0779, 95% CI, -39.07 to 1085.7; p = 0.068), initial ART regimen type (adjusted β = -548.1, 95% C = -904.2 to -192; p =0.003) and ARV uptake in the past 30 days (adjusted β = -1109, 95% C = -2135 to -83; p =0.034) remained independently associated with NVP plasma levels.Conclusion: NVP plasma concentration is highly heterogenous among Kenyan population with a significant proportion of patients reporting levels of <3100 ng/ml, correlated with poor viral suppression. The host pharmacoecologic factors, such as gender, age, weight, education level, region of origin (ethnicity), ART regimen type and adherence, are key in influencing NVP plasma concentration. Taking these factors into consideration, HIV treatment may be personalized to achieve optimal treatment success. Keywords: Nevirapine plasma concentration, host pharmacoecologic factors, HIV-1 patients in Kenya DOI: 10.7176/JHMN/81-05 Publication date:October 31st 202

Pathogenicity of Selected Kenyan Entomopathogenic Nematodes of Genus Steinernema against Banana Weevil (Cosmopolites Sordidus)

Banana weevil is a pest with a great impact on banana production in the world. The objective of this study was to evaluate the pathogenicity of the Kenyan entomopathogenic nematodes (EPNs) of genus Steinernema against the weevil Cosmopolites sordidus (Germar) under laboratory conditions. Adult weevils were trapped from banana fields in Maragua, Central Kenya and larvae extracted from the infested banana rhizomes. The adults were treated with three Kenyan EPNs Steinernema weiseri, Steinernema yirgalemense and the new Steinernema spp and with Steinernema carpocapsae ALL strain as a standard and plain distilled water as a control in five replicates. The treatments were 500ijs, 750ijs and 1000ijs per adult on petri dishes and 1000ijs, 3000ijs and 5000ijs per adult on pseudo-stems. The treatments for larvae in petri dishes were 300ijs, 400ijs and 500ijs. The adults were not susceptible to all the nematodes at all doses and preparations while larvae were highly susceptible to the four test EPNs at all concentrations. There was a significant difference at P<0.05 in the mortality of larvae between nematode Steinernema carpocapsae and Steinernema weiseri. A significant difference was observed between nematode Steinernema carpocapsae and Steinernema yirgalemense. There was also a significant difference between the new Steinernema spp and Steinernema weiseri and finally in the two nematodes the new Steinernema spp and Steinernema yirgalemense. All the test nematodes caused over 90 % larval mortality within 48 hours. The mean percent mortality of larva increased with nematode concentration for all the test nematodes. The results indicated that the four test EPNs significantly (P<0.05) caused high mortality within 24-48 hrs. The findings indicate that the banana weevil larvae are susceptible to the local entomopathogenic nematodes and potentially useful in the management of the banana weevil. It is however recommended that more research be conducted on the formulation and application technology to enhance their effectiveness in the field

Planning, temporary urbanism and citizen-led alternative-substitute place-making in the Global South

This paper argues that planning in the Global South needs to be embedded within a more complex and systemic framework based on understanding cities' functions and transformations, at both local and regional levels, whilst advocating for and incorporating informal and temporary dynamics. This is to differentiate between two competing processes: formal planning and citizen-led place-making, here considered as a form of reactive alternative-substitute place-making that occurs when there is no available alternative. The paper calls for a better integration of such impermanent, adaptable, temporary and alternative forms of place-making into the planning process for regional futures

Evaluation of the diagnostic performance of the urine dipstick test for the detection of urinary tract infections in patients treated in Kenyan hospitals

This work is a subset of the large HATUA (Holistic approach to unravel antibacterial resistance) consortium funded by the UK Medical Research Council (MR/S004785/1).Introduction. Culture is the gold-standard diagnosis for urinary tract infections (UTIs). However, most hospitals in low-resource countries lack adequately equipped laboratories and relevant expertise to perform culture and, therefore, rely heavily on dipstick tests for UTI diagnosis. Research gap. In many Kenyan hospitals, routine evaluations are rarely done to assess the accuracy of popular screening tests such as the dipstick test. As such, there is a substantial risk of misdiagnosis emanating from inaccuracy in proxy screening tests. This may result in misuse, under-use or over-use of antimicrobials. Aim. The present study aimed to assess the accuracy of the urine dipstick test as a proxy for the diagnosis of UTIs in selected Kenyan hospitals. Methods. A hospital-based cross-sectional method was used. The utility of dipstick in the diagnosis of UTIs was assessed using midstream urine against culture as the gold standard. Results. The dipstick test predicted 1416 positive UTIs, but only 1027 were confirmed positive by culture, translating to a prevalence of 54.1 %. The sensitivity of the dipstick test was better when leucocytes and nitrite tests were combined (63.1 %) than when the two tests were separate (62.6 and 50.7 %, respectively). Similarly, the two tests combined had a better positive predictive value (87.0 %) than either test alone. The nitrite test had the best specificity (89.8 %) and negative predictive value (97.4 %) than leucocytes esterase (L.E) or both tests combined. In addition, sensitivity in samples from inpatients (69.2 %) was higher than from outpatients (62.7 %). Furthermore, the dipstick test had a better sensitivity and positive predictive value among female (66.0 and 88.6 %) than male patients (44.3 and 73.9 %). Among the various patient age groups, the dipstick test’s sensitivity and positive predictive value were exceptionally high in patients ≥75 years old (87.5 and 93.3 %). Conclusion. Discrepancies in prevalence from the urine dipstick test and culture, the gold standard, indicate dipstick test inadequacy for accurate UTI diagnosis. The finding also demonstrates the need for urine culture for accurate UTI diagnosis. However, considering it is not always possible to perform a culture, especially in low-resource settings, future studies are needed to combine specific UTI symptoms and dipstick results to assess possible increases in the test’s sensitivity. There is also a need to develop readily available and affordable algorithms that can detect UTIs where culture is not available.Publisher PDFPeer reviewe

Hypothermia amongst neonatal admissions in Kenya: a retrospective cohort study assessing prevalence, trends, associated factors, and its relationship with all-cause neonatal mortality

Background: Reports on hypothermia from high-burden countries like Kenya amongst sick newborns often include few centers or relatively small sample sizes. Objectives: This study endeavored to describe: (i) the burden of hypothermia on admission across 21 newborn units in Kenya, (ii) any trend in prevalence of hypothermia over time, (iii) factors associated with hypothermia at admission, and (iv) hypothermia's association with inpatient neonatal mortality. Methods: A retrospective cohort study was conducted from January 2020 to March 2023, focusing on small and sick newborns admitted in 21 NBUs. The primary and secondary outcome measures were the prevalence of hypothermia at admission and mortality during the index admission, respectively. An ordinal logistic regression model was used to estimate the relationship between selected factors and the outcomes cold stress (36.0°C–36.4°C) and hypothermia (<36.0°C). Factors associated with neonatal mortality, including hypothermia defined as body temperature below 36.0°C, were also explored using logistic regression. Results: A total of 58,804 newborns from newborn units in 21 study hospitals were included in the analysis. Out of these, 47,999 (82%) had their admission temperature recorded and 8,391 (17.5%) had hypothermia. Hypothermia prevalence decreased over the study period while admission temperature documentation increased. Significant associations were found between low birthweight and very low (0–3) APGAR scores with hypothermia at admission. Odds of hypothermia reduced as ambient temperature and month of participation in the Clinical Information Network (a collaborative learning health platform for healthcare improvement) increased. Hypothermia at admission was associated with 35% (OR 1.35, 95% CI 1.22, 1.50) increase in odds of neonatal inpatient death. Conclusions: A substantial proportion of newborns are admitted with hypothermia, indicating a breakdown in warm chain protocols after birth and intra-hospital transport that increases odds of mortality. Urgent implementation of rigorous warm chain protocols, particularly for low-birth-weight babies, is crucial to protect these vulnerable newborns from the detrimental effects of hypothermia

Use of antenatal services and delivery care among women in rural western Kenya: a community based survey

BACKGROUND: Improving maternal health is one of the UN Millennium Development Goals. We assessed provision and use of antenatal services and delivery care among women in rural Kenya to determine whether women were receiving appropriate care. METHODS: Population-based cross-sectional survey among women who had recently delivered. RESULTS: Of 635 participants, 90% visited the antenatal clinic (ANC) at least once during their last pregnancy (median number of visits 4). Most women (64%) first visited the ANC in the third trimester; a perceived lack of quality in the ANC was associated with a late first ANC visit (Odds ratio [OR] 1.5, 95% confidence interval [CI] 1.0–2.4). Women who did not visit an ANC were more likely to have < 8 years of education (adjusted OR [AOR] 3.0, 95% CI 1.5–6.0), and a low socio-economic status (SES) (AOR 2.8, 95% CI 1.5–5.3). The ANC provision of abdominal palpation, tetanus vaccination and weight measurement were high (>90%), but provision of other services was low, e.g. malaria prevention (21%), iron (53%) and folate (44%) supplementation, syphilis testing (19.4%) and health talks (14.4%). Eighty percent of women delivered outside a health facility; among these, traditional birth attendants assisted 42%, laypersons assisted 36%, while 22% received no assistance. Factors significantly associated with giving birth outside a health facility included: age ≥ 30 years, parity ≥ 5, low SES, < 8 years of education, and > 1 hour walking distance from the health facility. Women who delivered unassisted were more likely to be of parity ≥ 5 (AOR 5.7, 95% CI 2.8–11.6). CONCLUSION: In this rural area, usage of the ANC was high, but this opportunity to deliver important health services was not fully utilized. Use of professional delivery services was low, and almost 1 out of 5 women delivered unassisted. There is an urgent need to improve this dangerous situation

Agricultural Nematology in East and Southern Africa : Problems, Management Strategies and Stakeholder Linkages

This is the peer reviewed version of the following article: Herbert Talwana, et al, ‘Agricultural nematology in East and Southern Africa: problems, management strategies and stakeholder linkages’, Pest Management Science Vol. 72 (2): 226-245, February 2016, which has been published in final form at http://dx.doi.org/10.1002/ps.4104. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving. © 2015 Society of Chemical Industry.By 2050, Africa’s population is projected to exceed two billion. Africa will have to increase food production more than 50% in the coming 50 years to meet the nutritional requirements of its growing population. Nowhere is the need to increase agricultural productivity more pertinent than in much of sub-Saharan Africa where it is currently static or declining. Optimal pest management will be essential, because intensification of any system creates heightened selection pressures for pests. Plant-parasitic nematodes and their damage potential are intertwined with intensified systems and can be an indicator of unsustainable practices. As soil pests, nematodes are commonly overlooked or misdiagnosed, particularly where appropriate expertise and knowledge transfer systems are meager or inadequately funded. Nematode damage to roots results in less efficient root systems that are less able to access nutrients and water, which can produce symptoms typical of water or nutrient deficiency, leading to misdiagnosis of the underlying cause. Damage in subsistence agriculture is exacerbated by growing crops on degraded soils and in areas of low water retention where strong root growth is vital. This review focuses on the current knowledge of economically important nematode pests affecting key crops, nematode control methods, and the research and development needs for sustainable management, stakeholder involvement and capacity building in the context of crop security in East and Southern Africa, especially Kenya, Tanzania, Uganda and Zimbabwe.Peer reviewe

Incident type 2 diabetes attributable to suboptimal diet in 184 countries

The global burden of diet-attributable type 2 diabetes (T2D) is not well established. This risk assessment model estimated T2D incidence among adults attributable to direct and body weight-mediated effects of 11 dietary factors in 184 countries in 1990 and 2018. In 2018, suboptimal intake of these dietary factors was estimated to be attributable to 14.1 million (95% uncertainty interval (UI), 13.8–14.4 million) incident T2D cases, representing 70.3% (68.8–71.8%) of new cases globally. Largest T2D burdens were attributable to insufficient whole-grain intake (26.1% (25.0–27.1%)), excess refined rice and wheat intake (24.6% (22.3–27.2%)) and excess processed meat intake (20.3% (18.3–23.5%)). Across regions, highest proportional burdens were in central and eastern Europe and central Asia (85.6% (83.4–87.7%)) and Latin America and the Caribbean (81.8% (80.1–83.4%)); and lowest proportional burdens were in South Asia (55.4% (52.1–60.7%)). Proportions of diet-attributable T2D were generally larger in men than in women and were inversely correlated with age. Diet-attributable T2D was generally larger among urban versus rural residents and higher versus lower educated individuals, except in high-income countries, central and eastern Europe and central Asia, where burdens were larger in rural residents and in lower educated individuals. Compared with 1990, global diet-attributable T2D increased by 2.6 absolute percentage points (8.6 million more cases) in 2018, with variation in these trends by world region and dietary factor. These findings inform nutritional priorities and clinical and public health planning to improve dietary quality and reduce T2D globally.publishedVersio