Task Sharing and Shifting to Provide Pathology Diagnostic Services: The Kenya Fine-Needle Aspiration Biopsy Cytology and Bone Marrow Aspiration and Trephine Biopsy Training Program

Purpose: Fine-needle aspiration biopsy (FNAB) cytology is a simple, inexpensive, and accurate diagnostic test for benign, infectious, and malignant lesions of the breast, thyroid, lymph nodes, and other organs. Similarly, bone marrow aspiration and trephine (BMAT) biopsy procedures are relatively simple and inexpensive techniques that are important for diagnosing and monitoring many hematologic diseases including leukemias and lymphomas. However, the scarcity of pathologists in Kenya limits patient access to these simple diagnostic tests. We describe a task sharing and shifting program that sought to improve the provision of FNABs and BMAT biopsies in tertiary public hospitals in Kenya. Methods: Between January 2016 and February 2017, we trained pathologists, pathology residents, and technologists from the University of Nairobi and Aga Khan University Hospital, Nairobi, in FNAB and BMAT biopsies, who in turn trained pathologists, medical officers (MO), clinical officers (CO), and technologists at five tertiary public hospitals. The program involved curriculum development, training workshops, the establishment of new and strengthening existing FNAB and BMAT biopsy clinics, interim site visits, audits, and stakeholder workshops. Results: Fifty-one medical personnel at the tertiary hospitals were trained. The FNAB numbers increased by 41% to 1,681, with 139 malignant diagnoses (7.1%). BMAT biopsy numbers increased by 268% to 140, with 34 malignant cases. Between 60% and 100% of the FNAB and BMAT biopsy procedures were performed by MO and CO over the project period. One new FNAB and two new BMAT biopsy clinics were established. Conclusion: This project demonstrates a successful model of task sharing and shifting from specialist pathologists to MO and CO that improved access to important FNAB and BMAT biopsy services in a low-resource setting

Delivery of Integral Calculus at Maseno University: Is STACK Really Playing an Integral Part?

Abstract—Integral Calculus II is a second-year undergraduate course offered by the Department of Pure and Applied Mathematics at Maseno University. It is one of the 20 foundational courses with a high enrolment of about 800 students drawn from the school of Mathematics, Education, Science, and Business. Because of the large number of enrollments in these foundational courses, and the small number of teaching staff, instructors face challenges in providing immediate personalized feedback that can guide learning. Systems for Teaching and Assessment which use Computer Algebra Kernerl, STACK, a computer-aided assessment plug-in that provides a sophisticated assessment in mathematics-related disciplines, was used to deploy Continuous Assessment Tests (CAT) in the course for 370 students. This paper reports on the findings of the course based on a comparison between student test scores in STACK and in the final course exam

Using technology acceptance model to understand fish farmers’ intention to use black soldier fly larvae meal in Nile tilapia production in Kenya

The purpose of this study was to identify the underlying socio-psychological factors that influence pond and cage farmers’ intentions to adopt Black Soldier Fly Larvae (BSFL) in Kenya. Based on the Technology Acceptance Model (TAM), this study empirically investigated the relationship between TAM constructs, namely Perceived Ease of Use (PEOU), Perceived Usefulness (PU), Attitude towards Use (ATT), and Behavioral Intention (BI) to use BSFL. The study used a cross-sectional survey design to collect primary data from 211 randomly selected cage operators (98) and pond farmers (113) in Kenya’s Siaya, Kisumu, and Homabay Counties. A structural equation model was employed to examine hypothesized paths in the uptake of BSFL meal with the aid of SmartPLS 3. The inner model path coefficients suggested that ATT had the strongest effect on farmers’ intentions to adopt BSFL (0.411). Further, PU had a greater relative influence on intention to adopt BSFL than PEOU based on the model path coefficients of 0.319 and 0.178 respectively. This indicates that the more respondents believe BSFL is useful in their fish farm's production conditions, the more likely they are to adopt BSFL. Consequently, these findings have direct implications for policy development and the potential use of BSFL in aquaculture

Comprehensive analysis of multiple mycotoxins and Aspergillus flavus metabolites in maize from Kenyan households

This study assessed the levels of mycotoxins in maize from Kenyan households. Further, local open pollinated maize varieties were compared with commercial hybrids to evaluate which variety is less susceptible to myco-toxin contamination. Four hundred and eighty (n = 480) maize samples were collected in the years 2018-2020 from households in Eastern, Western, Coastal and Lake Victoria regions of Kenya. Liquid chromatography coupled to tandem mass spectrometry was used to detect and quantify 22 mycotoxins, along with 31 Aspergillus flavus metabolites in the samples. Eastern Kenya had the highest aflatoxin (AF) contamination with 75% of samples having AF levels above the Kenyan regulatory limits (10 mu g/kg), the highest concentration was 558.1 mu g/kg. In Western Kenya, only 18% of samples had concentration levels above the Kenyan regulatory limits for AF with highest sample having 73.3 mu g/kg. The Lake Victoria region had the most fumonisins (F) contamination, with 53% of the samples having fumonisin B1 (FB1) < 1000 mu g/kg. However, only 20% of the samples surpassed the Kenyan regulatory limit for total fumonisins (2000 mu g/kg) with the highest concentration being 13,022 mu g/ kg. In addition, 21.6% of samples from the Lake Victoria region had zearalenone (ZEN) and deoxynivalenol (DON) above regulatory limits for European countries (1000 mu g/kg). Western region had the least A. flavus metabolites contamination (18%) while the Eastern region had the highest incidence of A. flavus metabolites (81%). Among the A. flavus metabolites, cyclopiazonic acid (CPA), beta-cyclopiazonic acid (13 CPA), flavacol (FLV) and methylcitreo-isocoumarin (MIC) positively correlated with each other but negatively correlated with the other metabolites. Significant positive co-occurrence was also noted among Fusarium mycotoxins: nivalenol (NIV) positively correlated with DON (r = 0.81), fusarenon-X (FX) (r = 0.81) and ZEN (r = 0.70). Negative correlations were observed between Aspergillus and Fusarium mycotoxins: aflatoxin B1 (AFB1) negatively corre-lated with FB1 (r =-0.11), FX (r =-0.17) and ZEN (r =-0.20). Local open-pollinated maize varieties (L-opv) were less susceptible to mycotoxin contamination compared to the commercial hybrids (C-hy). This study reveals that Kenyan maize is contaminated with multiple mycotoxins most of which are not regulated in Kenya despite being regulated in other parts of the world. A comprehensive legislation should therefore be put in place to protect the Kenyan public against chronic exposure to these mycotoxins. In addition to high yield, there is a need for commercial hybrid maize breeders to incorporate mycotoxin resistance as an important trait in germplasm improvement in seeds production

Stakeholders’ perspectives on the use of black soldier fly larvae as an alternative sustainable feed ingredient in aquaculture, Kenya

The use of novel feed ingredients from aquaculture is growing globally. However, their contributions to scalable and sustainable aquafeed solutions are unclear. New ingredients for feeds are desired in the framework of sustainability and a circular economy; thus, initiatives for implementing such novel ingredients are of interest to agricultural practitioners. As research continues on the potential contribution of insect-based feeds in aquaculture in Kenya, understanding stakeholders’ perspectives about the use of black soldier fly larvae (BSFL) meal is critically important. Given that no such studies have been conducted in Kenya, the overarching goal was to quantify stakeholder perspectives on the use of BSFL meal in aquaculture. Specifically, the objectives of the study were to 1) determine stakeholders’ perceived benefits and perceived risks regarding the use of BSFL meal in aquaculture; 2) identify the important considerations when legalising BSFL meal in Kenya; and 3) determine the driving factors to promote the adoption of BSFL in fish production. Purposive sampling was used to select forty (40) experts for a Delphi study, 24 of whom responded. The Kendall’s coefficient of concordance was used to assess the experts’ consensus. The results study results suggest that there is agreement among stakeholders regarding the need to use BSFL as alternative protein ingredient in aquaculture. There was a significantly higher perception of benefits of BSFL in aquafeed than of risks, signifying a high degree of acceptance. Sanitary policy and inspection, feed safety, environmental influences and fish quality were given as the top-ranked important considerations when legalising BSFL in aquaculture. Creating and enhancing fish farmers’ awareness of the benefits of BSFL in fish production (100%) was ranked as the most important driving factor, followed by identifying pioneer farmers of safe BSFL production and their introduction as the leading farmers. Consequently, the study recommends the need for academia, government and industries to collaborate closely to develop technology on the use of BSFL in aquaculture. If further recommends that the fish farmers and insect farmers should be engaged in the process, as this might increase the acceptance of BSFL in aquaculture upon its legalisation

Determinants of fish farmers’ awareness of insect-based aquafeeds in Kenya; the case of black soldier fly larvae meal

AbstractIt is evident from scientific studies that black soldier fly larvae can replace the widely used fishmeal, which is costly and unsustainable for smallholder farmers, in aquafeeds. The purpose of this study was to evaluate the factors t influencing fish farmers’ awareness of use of black soldier fly larvae meal as an ingredient in fish feeds. The effect of farmers’ socioeconomic status and aquaculture practices on their awarenessabout black soldier fly larvae based aquafeeds was examined using a binary logit regression model. The regression analysis results revealed that fish farming experience (β = 0.327; p = 0.001), distance to feed sources (β = 0.009; p = 0.034), farmers’ income (β = −0.505; p = 0.008) and knowledge about the components of existing feed (β = 2.667; p = 0.004) significantly influenced the farmers’ awareness about black soldier fly larvae meal. The results suggest that communication and farmer education are key in improving the farmers’ awareness about novel fish feed ingredients. Therefore, there is need for both public and private institutions to improve awareness creation through local print and electronic media to enhance fish farmers’ awareness of insect-based aquafeeds

The role of indigenous knowledge in fisheries resource management for aquaculture development: A case study of the Kenyan Lake Victoria region

Abstract Indigenous knowledge is critical in the conservation of wild fish genetic resources and consequent development of fish seed for improved aquaculture production. Local fisher communities rely on aquatic resources mainly for livelihood and subsistence and have therefore come up with systems to manage these resources for sustainable use. This study aimed at identifying the role of indigenous people's knowledge in fish conservation as a way of improving aquaculture, with a specific focus on the conservation of aquaculture fish species in Kenya. Data was collected from individual fisherfolk through semi‐structured questionnaires and field observations. Pearson's chi‐square test was performed on variables that were predicted to influence indigenous knowledge. The chi‐square tests revealed a significant relationship between age and indigenous knowledge (χ2 = 15.153, p = 0.004). Results also revealed a significant relationship between an individual's years of residence in the area and indigenous knowledge (χ2 = 17.767, p = 0.003). It was found that the indigenous people use various concepts and strategies for fish conservation and fish production. From the findings of the study, it is recommended that scientists and policy actors should adopt the indigenous people's knowledge as a source of baseline information for fisheries and aquaculture research, and as additional or alternative strategies for the management of fish genetic resources

Socio‐economic impacts of climate change and adaptation actions among smallholder fish farmers in Sub‐Saharan Africa

Abstract Aquaculture is the world's fastest‐growing food‐producing sector, making it a significant contributor to food and nutrition security for the globally growing human population. Nevertheless, its long‐term growth is limited by the effects of climate change. Aquaculture in Sub‐Saharan Africa (SSA), which is dominated by small‐scale fish farming, is increasingly threatened by climate change, which has a substantial influence on its productivity and scalability. In this context, the present research looks at the socio‐economic consequences of climate change on small‐scale fish producers in SSA, as well as potential adaptation techniques to the effects of climate change. A clear understanding of these socio‐economic repercussions of climate change is critical for developing effective strategies to reduce future impacts and safeguard aquaculture‐based livelihoods. Furthermore, understanding the socio‐economic consequences of climate change on communities dependent on aquaculture is important for advising policymakers and decision‐makers on formulating and implementing policies that sustain aquaculture production amidst the climate change crisis. This article suggests various adaptation strategies to increase resilience to climate change, including diversification of livelihoods and species, use and incorporation of local and indigenous knowledge, shifting to aquaculture species less vulnerable to changing climatic conditions, capacity building through aquaculture insurance schemes, continued fish supply from capture fisheries, and consolidation of equity and human rights concerns. These adaptive methods, when combined, have the potential to enhance outcomes for populations who are more susceptible owing to their unstable socio‐economic conditions

A review of production, post-harvest handling and marketing of sweetpotatoes in Kenya and Uganda

Sweetpotato (Ipomea batatas) is a versatile crop that serves the roles of food and nutrition security, cash crop in both raw and processed forms. It is a source of livestock feed and has great potential as a raw material for industrial processing. The potential of sweetpotato has been greatly underexploited by the fact that it has been regarded as a poor man’s food and is mainly grown under marginal conditions for subsistence by most producers, who are rural small-scale farmers in developing countries, such as Kenya and Uganda. Losses in the highly perishable root crop and its leaves are exacerbated by lack of appropriate postharvest knowledge, technologies and facilities. Inadequate information on available cultivars also limits the maximum utilization of the crop and leaves. The current review examines production potential, postharvest handling practices, marketing, and physicochemical and nutritional properties of sweetpotatoes