Prevalence of HepatitisB virus infections among HIV infected individuals in Nairobi, Kenya

Objectives: To determine the prevalence and characteristics of HBV infections among HIV infected individuals in Nairobi, KenyaDesign: A cross-sectional study.Setting: Kenya Medical Research Institute HBV Laboratory, Nairobi, KenyaSubjects: A total of four hundred HIV infected patients randomised from a Nairobi HIV comprehensive care centre between June and October 2015.Results: Of the 400 subjects screened; (27.75%) had HBV immunisation, (3%) had acute disease, (4.75%) were on recovery, (2.5%) were in chronic stage, (1.75%) were asymptomatic and (2.25%) had occult HBV. Statistical analysis showed that age andgender were not significantly associated with the risk of HBV or occult HBV infections.Conclusion: HIV/HBV co-infections is still >5.5% but the rates could be higher than reported here. Utility of HBV sero-markers especially in infection staging is therefore very important in disease diagnosis and surveillance

Transitional Enrolment Trends within the Different Educational Levels in Kenya: An Analysis of Promoting Facets

Countries in Sub-Saharan Africa have for decades grappled with bridging the gap in enrolment numbers between male and female students. Education for All (EFA) goals have provided guidance to these countries on attainment of gender equality in education. EFA goal number 5 articulates the international commitments aimed at achieving global gender equality in education by 2015. This is to be arrived at by increasing the enrolment of female learners at different levels of education. The Ministry of Education in Kenya developed policies and strategies to enable an increase in female students enrolling in school. With these policies and strategies, Kenya has realised tremendous successes in terms of enrolment numbers. However the country still faces challenges in some geographic areas. In as much as there is an increase in the number of girls participating in primary and secondary school levels, Kenya is yet to attain gender equality in education. The number of boys in these levels of education still surpass that of girls by a concerning proportion. Interestingly these trends change in post secondary education levels. Universities have recorded an amplified enrolment of female. This paper documents trends in enrolment numbers by gender in primary, secondary and post-secondary levels of education in Kenya. Further, the paper interrogates the facets that promote the shifts in the enrolment trends. Keywords: Enrolment trends; Gender inequality in education; Education in Kenya; Gender and Education; Gender differences in Education

Activity Budget and Foraging Patterns of Nubian Giraffes (\u3cem\u3eGiraffa camelopardalis camelopardalis\u3c/em\u3e) in Lake Nakuru National Park, Kenya

How animals decide to spend their time has a key impact on their survival and reproduction. These behavioral decisions are shaped by ecological and environmental factors, such as seasonal changes. Foraging patterns show how an animal chooses to forage in its environment as influenced by resource availability, competition, and predation risk. Giraffe activity budget has been investigated in populations across Africa and found to be influenced by body size, diet composition, and sex. The activity budget and foraging patterns of Nubian giraffes vary considerably between ecosystems. The Nubian giraffe, a subspecies of the Northern giraffe species (Giraffa Camelopardalis) is a critically endangered population and occurs only within Kenya, Uganda, Ethiopia, and Southern Sudan. We performed 3 months of behavioral observation on a population of Nubian giraffes in Lake Nakuru National Park, Kenya, to assess seasonal activity budgets and foraging patterns. We found that in the wet and dry seasons giraffe spent approximately the same amount of time (53% and 57%, respectively) foraging. Movement and resting duration decreased slightly from dry to wet seasons 22% to 20% and 25% to 22% respectively. Across both seasons, Vachellia xanthophloea (67%), Maytenus senegalensis (19%), and Solanum incanum (9%) made up the bulk of giraffe\u27s diet. In the dry season, giraffes additionally foraged on Maerua triphylla (2%), Vachellia gerrardi (2%), and Grewia similis (1%); in the wet season, they added Vachellia abyssinica (2%) and Rhus natalensis (2%) to their diet. The most utilized browsing height was 3.5 meters (level 5), below their average height. Giraffes browse at lower heights after they consume the young shoots from the top of the bushes. Overall, seasonality did not appear to influence the Nubian giraffe\u27s activity budget or foraging patterns in LNNP. Planting perennial plants encourage uniform park resource use, boosts forage diversity, and minimizes Vachellia browsing pressure

Interaction design for rural agricultural sensor networks

We describe the ongoing design of a sensor network for small family farms in rural Kenya. The sensor network is just one part of an ‘ecology of resources’ in which handheld devices are used to bridge the sensor network and a computer-based access point. We describe the two villages where the system is deployed and the user requirements collected. We then describe the architecture of the sensor network and detail how it fits in with the larger integrated system. We then detail our approach to interface and interaction design, and conclude by describing the next steps in the project

Opportunities for Coping with Climate Change and Variability Through Adoption of Soil and Water Conservation Technologies in Semi-arid Eastern Kenya

Scenario analysis using data generated from APSIM model was conducted to investigate the effect of soil and water conservation practices (tied ridges and mulching) on grain yield of improved maize varieties (Katumani and Makueni) generated with and without N fertilizers under below normal (<250 mm), normal (≥250 < 350 mm) and above normal seasons (≥350 mm) in two sites, Katumani and Makindu in Machakos and Makueni counties Eastern Kenya. Results indicate that the yields were significant (<0.01) under the different seasons and treatments with the magnitude of the yields response varied. Highest yields in Katumani (3,370 kg/ha) were obtained during below normal seasons and when both fertilizer and tied ridges were used. In Makindu, however, under all treatments, highest yields were obtained during above normal seasons with 3,708 kg/ha yield when 40 kg N/ha fertilizer was applied. Lowest yields on the other hand, were obtained during normal seasons in both sites with 507 kg/ha in Katumani and 552 kg/ha under tied ridges and mulching + fertilizers in Makindu. Compared with farmers practice (control), the yield increment obtained was 4 kg/ha (0.6 %) and 5 kg/ha (0.7 %) in Katumani; 32 kg/ha (4.6 %) and 33 kg/ha (4.7 %) in Makindu under mulching and tied ridges respectively during below normal seasons otherwise the yield decreased during normal and above normal seasons with up to 19 % in Makindu when tied ridges was practised. Fertilization increased the yields of maize by as high as 2,552 kg/ha (433 %) and 2,319 kg/ha (166 %) in Katumani and Makindu respectively during above normal seasons. However, during normal seasons, there was yield decrease in Makindu by 42 %. When both fertilization and soil and water conservation practices was done, yield increase was 2,335 kg/ha (456 %) and 2,382 kg/ha (465 %) in Katumani during normal seasons under mulching +40 kg N/ha and tied ridges +40 kg N/ha respectively. In Makindu, yields declined during normal seasons, however, increase was by 2,229 kg/ha (160 %) and 2,108 kg/ha (152 %) during above normal seasons under mulching +40 kg N/ha and tied ridges +40 kg N/ha respectively. The results indicate that the use of fertilizers and soil and water conservation are indispensable for ensuring food security in semi-arids where rainfall is very variable

Comparison of the prevalence and characteristics of inpatient adverse events using medical records review and incident reporting

Background. Information on adverse events (AEs) in hospitalised patients in developing countries is scanty.Objective. To compare the magnitude and characteristics of inpatient AEs in a tertiary, not-for-profit healthcare facility in Kenya, using medical records review and incident reporting.Methods. Estimation of prevalence was done using incidents reported in 2010 from a random sample of medical records for hospital admissions. Nurse reviewers used 18 screening criteria, followed by physician reviewers to confirm occurrence. An AE was defined as an unexpected clinical event (UE) associated with death, disability or prolonged hospitalisation not explained by the disease condition. The kappa statistic was used to estimate inter-rater agreement, and analysis was done using logistic regression.Results. The study identified 53 UEs from 2 000 randomly selected medical records and 33 reported UEs from 23 026 admissions in the index year. The prevalences of AEs from medical records review and incident reports were 1.4% (95% confidence interval (CI) 0.9 - 2.0) and 0.03% (95% CI 0.012 - 0.063), respectively. Compared with incident reporting, review of medical records identified more disability (13.2% v. 0%; p=0.03) and prolonged hospital stays (43.4% v. 18.2%; p=0.02).Conclusions. Review of medical records is preferable to incident reporting in determining the prevalence of AEs in health facilities with limited inpatient quality improvement experience. Further research is needed to determine whether staff education and a positive culture change through promotion of non-punitive UE reporting or a combination of approaches would improve the comprehensiveness of AE reporting

Evaluation of Kilifi epilepsy education programme: a randomized controlled trial

Objectives: The epilepsy treatment gap is largest in resource-poor countries.Weevaluated the efficacy of a 1-day health education program in a rural area of Kenya. The primary outcome was adherence to antiepileptic drugs (AEDs) as measured by drug levels in the blood, and the secondary outcomes were seizure frequency and Kilifi Epilepsy Beliefs and Attitudes Scores (KEBAS). Methods: Seven hundred thirty-eight people with epilepsy (PWE) and their designated supporter were randomized to either the intervention (education) or nonintervention group. Data were collected at baseline and 1 year after the education intervention was administered to the intervention group. There were 581 PWE assessed at both time points. At the end of the study, 105 PWE from the intervention group and 86 from the nonintervention group gave blood samples, which were assayed for the most commonly used AEDs (phenobarbital, phenytoin, and carbamazepine). The proportions of PWE with detectable AED levels were determined using a standard blood assay method. The laboratory technicians conducting the assays were blinded to the randomization. Secondary outcomes were evaluated using questionnaires administered by trained field staff. Modified Poisson regression was used to investigate the factors associated with improved adherence (transition from nonoptimal AED level in blood at baseline to optimal levels at follow-up), reduced seizures, and improved KEBAS, which was done as a post hoc analysis. This trial is registered in ISRCTN register under ISRCTN35680481. Results: There was no significant difference in adherence to AEDs based on detectable drug levels (odds ratio [OR] 1.46, 95% confidence interval [95% CI] 0.74–2.90, p = 0.28) or by self-reports (OR 1.00, 95% CI 0.71–1.40, p = 1.00) between the intervention and nonintervention group. The intervention group had significantly fewer beliefs about traditional causes of epilepsy, cultural treatment, and negative stereotypes than the nonintervention group. There was no difference in seizure frequency. A comparison of the baseline and follow-up data showed a significant increase in adherence—intervention group (36–81% [p \u3c 0.001]) and nonintervention group (38–74% [p \u3c 0.001])—using detectable blood levels. The number of patients with less frequent seizures (≤3 seizures in the last 3 months) increased in the intervention group (62–80% [p = 0.002]) and in the nonintervention group (67–75% [p = 0.04]). Improved therapeutic adherence (observed in both groups combined) was positively associated with positive change in beliefs about risks of epilepsy (relative risk [RR] 2.00, 95% CI 1.03–3.95) and having nontraditional religious beliefs (RR 2.01, 95% CI 1.01–3.99). Reduced seizure frequency was associated with improved adherence (RR 1.72, 95% CI 1.19–2.47). Positive changes in KEBAS were associated with having tertiary education as compared to none (RR 1.09, 95% CI 1.05–1.14). Significance: Health education improves knowledge about epilepsy, but once only contact does not improve adherence. However, sustained education may improve adherence in future studies

Potential value of GCM-based seasonal rainfall forecasts for maize management in semi-arid Kenya

We estimate the potential value of general circulation model (GCM)-based seasonal precipitation forecasts for maize planting and fertilizer management decisions at two semi-arid locations (Katumani and Makindu) in Southern Kenya. Analyses combine downscaled rainfall forecasts, crop yield simulation, stochastic enterprise budgeting and identification of profit-maximizing fertilizer N rates and stand densities. October–February rainfall predictions were downscaled from a GCM, run with both observed and forecast sea surface temperature boundary conditions – representing upper and lower bounds of predictability – and stochastically disaggregated into daily crop model inputs. Simulated interactive effects of rainfall, N supply and stand density on yield and profit are consistent with literature. Perfect foreknowledge of daily weather for the growing season would be worth an estimated 15–30% of the average gross value of production and 24–69% of average gross margin, depending on location and on whether household labor is included in cost calculations. GCM predictions based on observed sea surface temperatures increased average gross margins 24% at Katumani and 9% at Makindu when labor cost was included. At the lead time used, forecasts using forecast sea surface temperatures are not skillful and showed nearzero value. Forecast value was much more sensitive to grain price than to input costs. Stochastic dominance analysis shows that farmers at any level of risk aversion would prefer the forecast-based management strategy over management optimized for climatology under the study’s assumptions, despite high probability (25% at Katumani, 34% at Makindu) of lower returns in individual years. Results contribute to knowledge of seasonal forecast value in a relatively high-risk, high-predictability context; utility and value of forecasts derived from a GCM; and risk implications of smallholder farmers responding to forecasts

Exposure to parasitic infections determines features and phenotypes of active convulsive epilepsy in Africa

Background: Epilepsy affects 70 million people worldwide, 80% of whom are in low-and-middle income countries (LMICs). Infections of the central nervous system (CNS) contribute considerably to the burden of epilepsy in LMICs, but the nature and presentation of epilepsy following these infections is not fully understood. We examined if epilepsy foutcomes are associated with the exposure to parasitic infections. Methods: This was a case-comparison study nested in a cross-sectional survey of people with active convulsive epilepsy, with cases as those exposed to parasitic infections, and comparison as those unexposed. Associations of exposure to parasites with clinical and electroencephalographic features of epilepsy were done using a modified mixed effects Poisson regression model across five sites in Africa. Multiplicative and additive scale (RERI) interactions were explored to determine the effect of co-infections on epilepsy features. Population attributable fractions (PAF) were calculated to determine the proportion of severe clinical and electroencephalographic features of epilepsy attributable to CNS infections. Results: A total of 997 participants with active convulsive epilepsy from the five African sites were analyzed, 51% of whom were males. Exposure to parasitic infections was associated with more frequent seizures in adult epilepsy (relative risk (RR)=2.58, 95% confidence interval (95%CI):1.71-3.89). In children, exposure to any parasite was associated with convulsive status epilepticus (RR=4.68, (95%CI: 3.79-5.78), intellectual disabilities (RR=2.13, 95%CI: 1.35-3.34) and neurological deficits (RR=1.92, 95%CI: 1.42-2.61). Toxoplasma gondii and Onchocerca volvulus interacted synergistically to increase the risk of status epilepticus (RERI=0.91, 95%CI=0.48-1.35) in the data pooled across the sites. Exposure to parasitic infections contributed to 30% of severe features of epilepsy as shown by PAF. Conclusions: Parasitic infections may determine features and phenotypes of epilepsy through synergistic or antagonistic interactions, which can be different in children and adults. Interventions to control or manage infections may reduce complications and improve prognosis in epilepsy

Epidemiology of sorghum anthracnose (Colletotrichum sublineolum) and leaf blight (Exserohilum turcicum) in Kenya

A 3-year study on the epidemiology of sorghum anthracnose (Colletotrichum sublineolum) and leaf blight (Exserohilum turcicum [Setosphaeria turcica]) was conducted at Alupe in western Kenya from 1994 to 1996. A nonlinear logistic model was used to summarize 72 anthracnose and 108 leaf blight disease progress curves from different planting dates and cultivars. Effects of planting date and cultivar on disease development were compared based on estimates of the rate (β), the absolute rate (θ), inflection point (μ) and upper asymptote (γ), disease severity at milk stage (v95), and time taken to reach a disease severity of 2% (t2, an estimate of time when disease is first observed). Leaf blight epidemics always started earlier than those of anthracnose, but exhibited lower disease severity at crop maturity. Effects of planting date and cultivar on β varied between years. Delaying planting reduced time to disease onset (i.e. µ and t2) and increased absolute rate of progress θ, resulting in maximum severity at crop 'milk stage' and maturity (v95 and γ, respectively). Resistant cultivars had highest µ and t2 but lowest θ, v95 and γ values for both diseases. Delaying planting affected anthracnose progress more on the resistant cultivars, in contrast with leaf blight for which progress on susceptible cultivars was more affected. The implications of these findings for disease management are discussed, and recommendations made to improve disease screening methodologie