Fertility Differentials in Kenya: The Effect of Female Migration

This study uses the Kenya Demographic and Health Survey (KDHS) data conducted in 1988/89.The hypothesis of the paper is that women who migrate tend to maximise their other lifetime aspirations at the expense of their reproductive roles and performance. That is, female migrants are involved in behaviours and practices that negatively influence fertility relative to non-migrants. The analysis shows that through the influence of migration on fertility, reproductive behaviour and performance is modified; migration is a mechanism through which the changes observed in fertility behaviour and levels can be explained. The influence of migration on fertility levels is estimated using two procedures: the comparison of the mean CEB and multivariate analysis. The study demonstrated that there is an inverse relationship between migration and the number of children ever born

Evaluation of Near Infrared Spectroscopy for Sugarcane Quality Determination in Western Kenya

In Kenya, sugar is produced exclusively from sugarcane cultivated in Nyanza, parts of Rift Valley counties, Western Kenya and coastal region. Since the industry inception in early 1900s, farmer payments for delivered milling sugarcane has been based on tonnage delivered, with no consideration for quality of cane. However, in early 2000s, Kenya, attempted to put in place structures for paying farmers based on quality as measured by sucrose content amongst other factors. An effective, fast and accurate method of determining such quality has been missing, thus delaying implementation. Near Infrared (NIR) spectroscopy has been suggested as an accurate, non destructive and high-speed method for estimating the quality of milling cane. This research evaluated performance of a Matrix-F FT NIR spectrophotometer for estimation of cane quality in Nzoia Sugar Company, western Kenya. A total of 688 milling cane samples were obtained from randomly selected trucks delivering cane to the factory using a core sampler. The samples were finely shredded and analyzed by a method combining wet disintegration and core press as the primary measurements and NIR. The NIR spectrometer was calibrated using OPUS Lab Chemometrics software for pol, brix, fibre, moisture in cane . Results from wet chemistry were linearly regressed against the NIR results. The R2 values were 0.9787, 0.9503, 0.8432 and 0.8725 for brix, pol, moisture and fibre, respectively. The results demonstrate that NIR spectroscopic analysis is an acceptable method for use in Kenya for quality based cane payment system. Keywords: NIR spectroscopy, sugarcane quality, Kenya

Contraceptive Use Dynamics Among Migrant Women in Kenya

This paper investigates the relationships between migration and the determinants of contraceptive use in Kenya based on the 1988/1989 Kenya Demographic and Health Survey (KDHS). The KDHS collected detailed information on pregnancies, contraceptive use, marriage, employment, places of residences and how long one has lived in these places of residences. The paper examines whether the contraceptive use dynamics of women who migrate characteristically differ from that of non-migrants in Kenya. The principal hypothesis of the paper is that women who migrate comprise a group who acts rationally to maximise their other lifetime aspirations at the expense of their reproductive roles. The study further assumes that through the influence of fertility process by migration characteristics, contraceptive use is also influenced. The association between the process of migration and contraceptive use dynamics is analysed using cross-tabulation with percentages and logistic regression analysis. The findings show that, in Kenya, migration influences contraceptive use among migrant women. That is, the probability of using contraception is higher among the migrant women than the non-migrants. The issue is important to researchers and policy-makers. Because fertility behaviour is influenced by change and characteristics of place of origin and destination, public policy interventions is necessary in order to account for the residential experience of women served by family planning and maternal child health programmes in different places.En utilisant les donn\ue9es de #233;es de l1'Enqu\ueate d\ue9mographique et de Sant\ue9 (EDS) du Kenya de 1988/1989, l'auteur de cet article examine les rapports qui existent entre la migration et les d\ue9terminants de l'utilisation des contraceptifs au Kenya. Avec l'EDS, des donn\ue9es importantes sur les grossesses, l'utilisation de la contraception, le mariage, l'emploi, le lieu de r\ue9sidence et la dur\ue9e sur le lieu de r\ue9sidence ont pu \ueatre collect\ue9es. Par cet article, l'auteur cherche \ue0 savoir si au Kenya la dynamique d'utilisation des contraceptifs par les migrantes diff\ue8re de mani\ue8re significative de celle des non-migrantes. Cet article se fonde sur le principe que les femmes qui migrent sont un groupe qui agit de mani\ue8re rationnelle pour profiter au maximum de la vie au d\ue9pend de leur r\uf4le reproductif. L'\ue9tude a \ue9galement comme hypoth\ue8se qu'en influen\ue7ant le processus de f\ue9condit\ue9, les caract\ue9ristiques de la migration influencent aussi l'utilisation de la contraception. L'association entre le processus de migration et la dynamique d'utilisation de la contraception est \ue9tudi\ue9e \ue0 travers des tableaux crois\ue9s entre les pourcentages et l'analyse de r\ue9gression logistique. Les r\ue9sultats obtenus ont montr\ue9 que, au Kenya, la migration influence l'utilisation de la contraception parmi les migrantes. Cela veut dire que la probabilit\ue9 d'utilisation de la contraception est plus grande chez les migrantes que chez les non-migrantes. Ces r\ue9sultats sont utiles aux chercheurs et aux d\ue9cideurs politiques. Puisque le comportement en mati\ue8re de f\ue9condit\ue9 est influenc\ue9 par les changements et les sp\ue9cificit\ue9s du lieu de d\ue9part et celui de destination, des mesures de politique publique sont n\ue9cessaires pour prendre en compte l'exp\ue9rience des femmes assist\ue9es par les programmes de planification familiale et de sant\ue9 maternelle et infantile \ue0 divers endroits

A Novel Treatment for Acid Mine Drainage Utilizing Reclaimed Limestone Residual

The viability of utilizing Reclaimed Limestone Residual (RLR) to remediate Acid Mine Drainage (AMD) was investigated. Physical and chemical characterization of RLR showed that it is composed of various minerals that contain significant quantities of limestone or calcium bearing compounds that can be exploited for acid neutralization. Acid Neutralization Potential (ANP) test results showed that RLR has a neutralization potential of approximately 83% as calcium carbonate (CaCO{sub 3}). Neutralization tests with most of the heavy metals associated with AMD showed removal efficiencies of over 99%. An unexpected benefit of utilizing RLR was the removal of hexavalent chromium Cr (VI) from the aqueous phase. Due to an elevation in pH by RLR most AMD heavy metals are removed from solution by precipitation as their metal hydroxides. Cr (VI) however is not removed by pH elevation and therefore subsequent ongoing tests to elucidate the mechanism responsible for this reaction were conducted

Migration and Fertility Relationship: A Case Study of Kenya

Migration patterns in Kenya in general differentially affect fertility levels, patterns and behaviour. For economically dynamic areas, out-migration and the associated spousal separation and differential sex ratios seem to be associated with falling fertility, though migration is not the only or even the principal factor involved. In lagging and/or peripheral areas, by contrast, the demographic effect of migration seems to promote high fertility by undermining some critical factors of fertility determinants and behaviour. Examples from Africa in general and Kenya in particular are invoked to examine and explain this important association between migration and fertility. Furthermore, the paper incorporates the geography of economic and social development to help understand the relationship between migration and fertility.Au Kenya, les formes de migration affectent g\ue9n\ue9ralement les comportements, types et niveaux de f\ue9condit\ue9 de mani\ue8re diff\ue9rente. Dans les r\ue9gions dynamiques \ue9conomiquement, l'\ue9migration ainsi que la s\ue9paration d'avec les \ue9pouses et les taux de diff\ue9rentiels de sexe qui l'accompagnent semblent \ueatre associ\ue9s \ue0 la baisse de la f\ue9condit\ue9, bien que la migration ne soit pas l'unique voire le principal facteur. Par contre, dans les r\ue9gions attard\ue9es ou p\ue9riph\ue9riques, l'impact d\ue9mographique de la migration semble \ueatre la promotion du taux \ue9lev\ue9 de f\ue9condit\ue9 au d\ue9triment de quelques facteurs importants du comportement et des d\ue9terminants de la f\ue9condit\ue9. Des exemples tir\ue9s de l'Afrique en g\ue9n\ue9ral et du Kenya en particulier sont utilis\ue9s pour \ue9tudier et expliquer cette association importante entre la migration et la f\ue9condit\ue9. En outre, cet article contient aussi la g\ue9ographie du d\ue9veloppement \ue9conomique et social pour aider \ue0 la compr\ue9hension des rapports entre la migration et la f\ue9condit\ue9

Association between thrombocytes count and Plasmodium falcipurum infection among children under five years attending Kombewa Sub-County Hospital

Malaria is a leading cause of morbidity and mortality especially among children, expectant women and continues to be a global health burden. Haematological changes mark some of the most common complications in malaria as they play a major role in malaria pathology. Thrombocytes in particular, have been shown to bind infected erythrocytes and kill intracellular malaria parasites thereby indicating a protective function of platelets in the early stages. However, the mechanism that leads to low thrombocytes count in malaria infected individuals is not clear. Understanding the mechanism of platelet reduction during pathogenesis of malaria infection will be fundamental in malaria severity classification, monitoring of platelet count during infection and prompt initiation of anti-malarial therapy. In trying to understand these facts, this study sort to establish the association between platelet count and P. falciparum infection amongst children less than five years. This was a retrospective case-control study, n=549. Children below the age of five years that attending Kombewa Sub -County Hospital were recruited. Study participants were identified using the inclusion criteria and followed horizontally to retrieve platelet count from complete blood count results. The respective malaria blood film reads were then recorded, stratified to give case and control from which random sampling was done. Chi-square test and Tukey’s multiple comparison tests from Graph pad prism 5 were used in the analysis. The odds of exposure to low platelet count were then established with a confidence level of 95%. We found significant difference between the cases and controls in regard to parasite density (Chi square=157.5, p value <0.05), mean parasite density in controls =2042.1/?l compared to cases= 142880/?l. The odds of cases being exposed to malaria was 12 times more than controls (OR=12.382, 95%). We also found no variation in thrombocytes counts in relation to gender, children with thrombocytopenia were having higher parasite density, parasite density as a result of P.falciparum infection is not dependent on gender and children that suffered malarial infection were twelve times likely to develop thrombocytopenia. Further studies are then recommended to establish the effects of incorporation of platelet aggregation inhibitors such as aspirin in malaria treatment.Key Words: Plasmodium falciparum, thrombocytopenia, infectio

Hepatitis B assessment without hepatitis B virus DNA quantification: a prospective cohort study in Uganda

BACKGROUND: Chronic hepatitis B infection affects 240 million people, with the highest prevalence in Africa and Asia, and results in 700 000 deaths annually. Access to diagnostics, particularly for hepatitis B virus viral load quantification (HBV DNA), is a major barrier to treatment. We aimed to test World Health Organization guidelines for hepatitis B management in resource-limited settings. METHODS: We compared treatment allocation with and without the use of HBV DNA in a cohort in Uganda. Hepatitis B surface antigen test-positive, human immunodeficiency virus-negative, treatment-naïve adults were recruited prospectively. Following liver ultrasound and routine haematological and biochemical tests, preliminary allocations into treatment and observation groups were made. HBV DNA was performed for each participant and final treatment decisions were made and compared with preliminary allocations. RESULTS: Full assessment was completed for 100 participants; treatment was indicated in 20. Assessment without HBV DNA identified patients for treatment with a positive predictive value of 88.2% and a negative predictive value of 94% compared with assessment using HBV DNA. CONCLSUIONS: Where HBV DNA is unavailable, patients with hepatitis B can be assessed by liver ultrasound and routine laboratory tests. These findings will enable physicians in resource-limited settings to initiate treatment more readily and inform policy with regards to viral hepatitis elimination

Community-based rehabilitation program for cerebral PALSY (CP) children in North Uganda

Background: CP is a common neurologic disease in children, with a worldwide estimated prevalence of 93 million. Data on the African context are limited. Purpose: This study was aimed at evaluating the efficacy of a mixed outpatient/home physiotherapy program in children with CP admitted to St. Mary's Lacor Hospital (Gulu), the reference center of north Uganda. Methods: This is an observational, uncontrolled, prospective study. All children with CP (aged from 0.5 to 12 years) admitted in the Physiotherapy Unit from January to December 2017 were enrolled. A written consent form (English or Acholi language) was obtained from the mother/ caregiver. Each patient was evaluated at baseline and every two weeks for three months. CP sub-types were defined according to Surveillance of Cerebral Palsy in Europe classification. The child\ub4s abilities were staged through the Gross Motor Function Classification System Expanded and Revised (GMFCS-E&R; scale from I to V, the higher the worse). Changes in motor function were measured through the 66-item version (GMFM-66; scores ranging from 0 to 100, the higher the better). At baseline and subsequent visits, Bobath treatment was applied for 30 minutes by an experienced physiotherapist, who trained the caregiver on customized home exercises following a diary prescription. The functional status reported by the caregiver and the overall compliance were assessed. Changes in GMFCS-E&R and GMFM-66 at 6 and 12 weeks were recorded. The normality of score distributions was tested (Shapiro-Wilks). If confirmed, repeated ANOVA modeling was applied to scores across time points. Results: Fifty-two consecutive children were enrolled (mean age 2.2 years, range 0.5-9.9). Spastic bilateral (19 patients, 36%) and dystonic (16, 31%) were the most common CP sub-types. The main cause of CP were asphyxia during the delivery (26 cases, 50%) and cerebral malaria (10, 19%). Thirty-three/52 cases (67%) presented level V GMFCS-E&R. GMFM-66 mean score at baseline was 19.86 range: 0-52.9. Seventeen/52 (33%) children were assessed at 6 and/or 12 weeks, while 35 (67%) missed at least three study visits (reasons: 28 transportation cost, 2 remote home, 4 other). In 16/17 (94%) patients home exercises were performed correctly. The GMFM-66 mean score increased from 14.8 at baseline to 20.4 and to 24.9 at 6 weeks (p=0.02) and 12 weeks (p=0.00), respectively. The improvement was observed irrespectively from CP sub-type or cause of disability. Conclusion(s): Although on a small number of patients, this study suggests that a mixed outpatient/home physiotherapy program can improve CP disability in compliant children treated in a developing country, like north Uganda. The high drop-out rate and its causes point towards the need for implementing local community programs and/or transport facilities. Implications: These results suggest that a mixed outpatient/home physiotherapy program can benefit children with CP living in developing countries and strengthen the need of a policy aimed at improving the access to the physiotherapy service. In addition, they confirm that neurological damage during the assisted delivery is the major cause of CP in this conte

Targeted Next Generation Sequencing for malaria research in Africa:Current status and outlook

Targeted Next Generation Sequencing (TNGS) is an efficient and economical Next Generation Sequencing (NGS) platform and the preferred choice when specific genomic regions are of interest. So far, only institutions located in middle and high-income countries have developed and implemented the technology, however, the efficiency and cost savings, as opposed to more traditional sequencing methodologies (e.g. Sanger sequencing) make the approach potentially well suited for resource-constrained regions as well. In April 2018, scientists from the Plasmodium Diversity Network Africa (PDNA) and collaborators met during the 7th Pan African Multilateral Initiative of Malaria (MIM) conference held in Dakar, Senegal to explore the feasibility of applying TNGS to genetic studies and malaria surveillance in Africa. The group of scientists reviewed the current experience with TNGS platforms in sub-Saharan Africa (SSA) and identified potential roles the technology might play to accelerate malaria research, scientific discoveries and improved public health in SSA. Research funding, infrastructure and human resources were highlighted as challenges that will have to be mitigated to enable African scientists to drive the implementation of TNGS in SSA. Current roles of important stakeholders and strategies to strengthen existing networks to effectively harness this powerful technology for malaria research of public health importance were discussed