Particulate matter pollution in an informal settlement in Nairobi : using citizen science to make the invisible visible

We used a citizen science approach to explore personal exposure to air pollution of selected informal settlement dwellers in Nairobi, Kenya. This paper presents the methods used, with the aim of informing others who wish to conduct similar work in the future, and some results, including policy impact. We used three interlinked methods: 1) a personal mobile exposure monitoring campaign in which individual workers used Dylos monitors to measure variations in their exposure to fine particulate matter (PM2.5) within the settlement over the course of a day, 2) a questionnaire conducted before and after the monitoring campaign to assess any changes in knowledge or attitude in the wider community, and 3) two workshops, which facilitated the citizen science approach and brought together members of the community, local policy makers and researchers. The three elements of the study provided the local community, policymakers and scientists with new insights into the challenges air pollution poses for human health in such settlements, and opportunities for exploring how to monitor, mitigate and avoid these pollutants using a citizen science approach. We found significant differences in PM2.5 exposure between individual workers that could be partially explained by spatial differences in concentration that we identified within the settlement. Residents of the informal settlement identified a number of sources that might explain these differences in concentration, although many residents perceived air quality to be good both indoors and outdoors. The workshops raised awareness of the issue of air pollution and brought together affected community members and local and national policy makers to discuss air pollution issues in Nairobi's informal settlements. As a result, a new knowledge exchange network, the Kenya Air Quality Network, of policy-makers, researchers and community members was formed with the aim to facilitate the improvement of air quality across Kenya

Influence of Teacher Preparation for Instruction and Educational Resource Provision on Students’ Academic Achievement in Public Day Secondary Schools in Chesumei Sub-County Nandi County Kenya

Curriculum leadership in its entirety plays a vital role in academic achievement in educational institutions. However, majority of studies show that administrators have insignificant impact on learners’ academic achievement. This is not the case since school principals are curriculum leaders and are responsible for learners’ performance in many ways. This study investigated the influence of curriculum leadership on learners' academic achievement in public day secondary schools in Chesumei Sub-County, Kenya. The research focused on two specific objectives: (1) examining the influence of teacher preparation for instruction on students' academic achievements and (2) exploring the influence of educational resources’ provision on students' academic achievement The study drew theoretical inspiration from Fielder's contingency theory, which posits that a leader's efficacy is determined by the alignment between their dominant traits and the situational context. To accomplish these objectives, the researcher employed a descriptive survey research design, offering a comprehensive understanding of the current state of curriculum leadership and its impact on academic achievement. The target population was from 19day schools in Chesumei. Pilot study was conducted in two schools. The study utilized purposive sampling, whereby 17 principals, 17 deputies, 17 director of studies and 85 heads of departments were sampled.  Random sampling technique was used to select a representative sample from the 10 % of form four students in each day school in Chesumei Sub-County. There were no adequate textbooks for all subjects in the school which had negatively affected learners’ academic achievement. The study concluded that teacher preparation and educational resource provision enhances students’ academic achievement. Schools should have adequate textbooks for all subjects, enough laboratories, enough teachers and adequate number of classrooms. The findings from this research Endeavour may provide valuable insights into the dynamics of curriculum leadership in the context of Kenyan public day secondary schools. It is expected that the results may aid educational policymakers, school administrators, and teachers in refining strategies and practices to enhance students' academic achievement, consequently contributing to the overall improvement of the education system in Chesumei Sub-County and Kenya at large

Relationship Between Quality of Teacher-pupil Interaction and Primary School Readiness in Preschool Pupils in Nairobi County, Kenya

A lot of attention and emphasis has lately been placed on the development and education of young children. One of the specific areas of concern is on the quality of experiences that young children are exposed to at the early learning centres. This research paper sought to examine the relationship between the quality of teacher-pupil interaction and primary school readiness in preschool pupils in Nairobi County. The sample comprised 156 preschool pupils and 39 teachers in 39 preschools. The Pearson product-moment correlation statistics was used to examine this relationship. The findings indicate that there is a significant and positive relationship between the quality of positive-relationship dimension of teacher-pupil interaction and primary school readiness. A significant but negative relationship was found between the quality of harshness and detachment dimensions of teacher-pupil interaction and primary school readiness. A weak correlation that is not significant was found between the quality of permissiveness dimension of teacher-pupil interaction and primary school readiness. The researchers recommend that only trained and qualified teachers who are more likely to be aware of the desirable styles of teacher-pupil interaction should be deployed in early learning centres. Those already working should be given in-service training to enable them keep abreast of the best pedagogic practices. Keywords: Teacher-pupil interaction, Primary school readines

Nairobi Special Housing Fund

Over the next 15 years, over Kshs. 89.09 billion will be paid by slum-dwellers to informal service-providers for low-quality and high-cost services. This situation is replicated in almost all informal settlements within the city of Nairobi. Developing affordable shelter for the urban poor, and thereby realizing the Constitutional right to housing, will require new forms of pro-poor shelter finance and supportive policies at the urban level. But most of Nairobi’s residential construction has targeted wealthy households, leaving insufficient supply of low-income housing where the needs are most urgent. This paper argues for a County-level affordable housing fund

“It’s like these CHCs don’t exist, are they featured anywhere?”: Social network analysis of community health committees in a rural and urban setting in Kenya

Background In Kenya, Community Health Committees (CHC) were established to enhance community participation in health services. Their role is to provide leadership, oversight in delivery of community health services, promote social accountability and mobilize resources for community health. CHCs form social networks with other actors, with whom they exchange health information for decision-making and accountability. This case study aimed to explore the structure of a rural and an urban CHC network and to analyze how health-related information flowed in these networks. Understanding the pathways of information in community settings may provide recommendations for strategies to improve the role and functioning of CHCs. Methods In 2017, we conducted 4 focus group discussions with 27 community discussants and 10 semi-structured interviews with health professionals in a rural area and an urban slum. Using social network analysis, we determined the structure of their social networks and how health related information flowed in these networks. Results Both CHCs were composed of respected persons nominated by their communities. Each social network had 12 actors that represented both community and government institutions. CHCs were not central actors in the exchange of health-related information. Health workers, community health volunteers and local Chiefs in the urban slum often passed information between the different groups of actors, while CHCs hardly did this. Therefore, CHCs had little control over the flow of health-related information. Although CHC members were respected persons who served in multiple roles within their communities, this did not enhance their centrality. It emerged that CHCs were often left out in the flow of health-related information and decision-making, which led to demotivation. Community health volunteers were more involved by other actors such as health managers and non-governmental organizations as a conduit for health-related information. Conclusion Social network analysis demonstrated how CHCs played a peripheral role in the flow of health-related information. Their perception of being left out of the information flow led to demotivation, which hampered their ability to facilitate community participation in community health services; hence challenging effective participation through CHCs

Synthesis and biological evaluation of N-cyanoalkyl-, Naminoalkyl-, and N-guanidinoalkyl-substituted 4-aminoquinoline derivatives as potent, selective, brain permeable antitrypanosomal agents

YesCurrent drugs against human African trypanosomiasis (HAT) suffer from several serious drawbacks. The search for novel, effective, brain permeable, safe, and inexpensive antitrypanosomal compounds is therefore an urgent need. We have recently reported that the 4-aminoquinoline derivative huprine Y, developed in our group as an anticholinesterasic agent, exhibits a submicromolar potency against Trypanosoma brucei and that its homo- and hetero-dimerization can result in to up to three-fold increased potency and selectivity. As an alternative strategy towards more potent smaller molecule anti-HAT agents, we have explored the introduction of ω-cyanoalkyl, ω-aminoalkyl, or ω-guanidinoalkyl chains at the primary amino group of huprine or the simplified 4-aminoquinoline analogue tacrine. Here, we describe the evaluation of a small in-house library and a second generation of newly synthesized derivatives, which has led to the identification of 13 side chain modified 4-aminoquinoline derivatives with submicromolar potencies against T. brucei. Among these compounds, the guanidinononyltacrine analogue 15e exhibits a 5-fold increased antitrypanosomal potency, 10-fold increased selectivity, and 100-fold decreased anticholinesterasic activity relative to the parent huprine Y. Its biological profile, lower molecular weight relative to dimeric compounds, reduced lipophilicity, and ease of synthesis, make it an interesting anti-HAT lead, amenable to further optimization to eliminate its remaining anticholinesterasic activity.Wellcome Trus

Changing lung function and associated health-related quality-of-life: A five-year cohort study of Malawian adults

Background In Sub-Saharan Africa cross-sectional studies report a high prevalence of abnormal lung function indicative of chronic respiratory disease. The natural history and health impact of this abnormal lung function in low-and middle-income countries is largely unknown. Methods A cohort of 1481 adults representative of rural Chikwawa in Malawi were recruited in 2014 and followed-up in 2019. Respiratory symptoms and health-related quality of life (HRQoL) were quantified. Lung function was measured by spirometry. Findings 1232 (83%) adults participated; spirometry was available for 1082 (73%). Mean (SD) age 49.5 (17.0) years, 278(23%) had ever smoked, and 724 (59%) were women. Forced expiratory volume in one second (FEV1) declined by 53.4 ml/year (95% CI: 49.0, 57.8) and forced vital capacity (FVC) by 45.2 ml/year (95% CI: 39.2, 50.5) . Chronic airflow obstruction increased from 9.5% (7.6, 11.6%) in 2014 to 17.5% (15.3, 19.9%) in 2019. There was no change in diagnosed asthma or in spirometry consistent with asthma or restriction. Rate of FEV1 decline was not associated with diagnosed Chronic obstructive pulmonary disease (COPD), asthma, or spirometry consistent with asthma, COPD, or restriction. HRQoL was adversely associated with respiratory symptoms (dyspnoea, wheeze, cough), previous tuberculosis, declining FEV1 and spirometry consistent with asthma or restriction. These differences exceeded the minimally important difference. Interpretation In this cohort, the increasing prevalence of COPD is associated with the high rate of FEV1 decline and lung function deficits present before recruitment. Respiratory symptoms and sub-optimal lung function are independently associated with reduced HRQoL

Genomic epidemiology of Escherichia coli:Antimicrobial resistance through a One Health lens in sympatric humans, livestock and peri-domestic wildlife in Nairobi, Kenya

BackgroundLivestock systems have been proposed as a reservoir for antimicrobial-resistant (AMR) bacteria and AMR genetic determinants that may infect or colonise humans, yet quantitative evidence regarding their epidemiological role remains lacking. Here, we used a combination of genomics, epidemiology and ecology to investigate patterns of AMR gene carriage in Escherichia coli, regarded as a sentinel organism.MethodsWe conducted a structured epidemiological survey of 99 households across Nairobi, Kenya, and whole genome sequenced E. coli isolates from 311 human, 606 livestock and 399 wildlife faecal samples. We used statistical models to investigate the prevalence of AMR carriage and characterise AMR gene diversity and structure of AMR genes in different host populations across the city. We also investigated household-level risk factors for the exchange of AMR genes between sympatric humans and livestock.ResultsWe detected 56 unique acquired genes along with 13 point mutations present in variable proportions in human and animal isolates, known to confer resistance to nine antibiotic classes. We find that AMR gene community composition is not associated with host species, but AMR genes were frequently co-located, potentially enabling the acquisition and dispersal of multi-drug resistance in a single step. We find that whilst keeping livestock had no influence on human AMR gene carriage, the potential for AMR transmission across human-livestock interfaces is greatest when manure is poorly disposed of and in larger households.ConclusionsFindings of widespread carriage of AMR bacteria in human and animal populations, including in long-distance wildlife species, in community settings highlight the value of evidence-based surveillance to address antimicrobial resistance on a global scale. Our genomic analysis provided an in-depth understanding of AMR determinants at the interfaces of One Health sectors that will inform AMR prevention and control

Population genomics of <i>Escherichia coli</i> in livestock-keeping households across a rapidly developing urban landscape

Quantitative evidence for the risk of zoonoses and the spread of antimicrobial resistance remains lacking. Here, as part of the UrbanZoo project, we sampled Escherichia coli from humans, livestock and peri-domestic wildlife in 99 households across Nairobi, Kenya, to investigate its distribution among host species in this rapidly developing urban landscape. We performed whole-genome sequencing of 1,338 E. coli isolates and found that the diversity and sharing patterns of E. coli were heavily structured by household and strongly shaped by host type. We also found evidence for inter-household and inter-host sharing and, importantly, between humans and animals, although this occurs much less frequently. Resistome similarity was differently distributed across host and household, consistent with being driven by shared exposure to antimicrobials. Our results indicate that a large, epidemiologically structured sampling framework combined with WGS is needed to uncover strain-sharing events among different host populations in complex environments and the major contributing pathways that could ultimately drive the emergence of zoonoses and the spread of antimicrobial resistance

Sodium Stibogluconate (SSG) & Paromomycin Combination Compared to SSG for Visceral Leishmaniasis in East Africa: A Randomised Controlled Trial

Visceral leishmaniasis (VL) is a parasitic disease with about 500,000 new cases each year and is fatal if untreated. The current standard therapy involves long courses, has toxicity and there is evidence of increasing resistance. New and better treatment options are urgently needed. Recently, the antibiotic paromomycin (PM) was tested and registered in India to treat this disease, but the same dose of PM monotherapy evaluated and registered in India was not efficacious in Sudan. This article reports the results of a clinical trial to test the effectiveness of injectable PM either alone (in a higher dose) or in combination with sodium stibogluconate (SSG) against the standard SSG monotherapy treatment in four East African countries—Sudan, Kenya, Ethiopia and Uganda. The study showed that the combination of SSG &PM was as efficacious and safe as the standard SSG treatment, with the advantages of being cheaper and requiring only 17 days rather than 30 days of treatment. In March 2010, a WHO Expert Committee recommended the use of the SSG & PM combination as a first line treatment for VL in East Africa