The Congruence between Teachers and Learners Perceptions! Exploration of Relationship between Teachers and Learners Perceptions and Mathematics Performance in Lower Primary Schools in Kenya

The difficulties and problems hindering good performance in mathematics by Lower Primary school children seem to emanate from teachers and learners perceptions towards mathematics learning and performance. This may be due to the fact that the methods used at lower primary don’t agree with the ones initially applied by the children’s teachers at preschool level. The effect of that could result in creating a negative perception towards math learning and performance hence denying children a precious start to their future mathematics performance. There is a persistent indication that a discontinuity exists between pre-school learning methods and those in the lower primary schools. Teaching methods of the lower primary should be amended to make allowance for the stages of children’s development and provide opportunities to encourage children to improve in their ability to understand and apply mathematical concepts. The purpose of this study was to explore the relationship between teachers and learners perceptions and mathematics performance in Lower Primary Schools of the Makuyu Zone, Murang’a South District in Kenya. The objectives of this study were: - to evaluate the teachers’ perception on the value of pre-school mathematics; and to evaluate the children’s perception with regard to mathematics learning. This study used a descriptive survey design to achieve the set objectives. Purposive (deliberately) sampling was used to select a sample population of 60 pupils; a lottery (random choice) method of sampling was applied to get 30 teachers, whereas 10 head teachers were chosen through appointment (deliberate) sampling.  Open-ended questionnaires to collect data from the selected teachers and head teachers were applied; and for the children's responses, an interview schedule was employed. Observational checklists were also used where archival records were to apply. To test the construct validity and reliability of the research instruments, the researchers used 'split-half'.  The researchers pilot-tested the research instruments with a small representative group from the population. The data collected was analysed, using frequency counts and percentages.  It was presented in tables, bar graphs, pie charts and histograms as necessary to present a better picture of the findings. This study recommends frequent mathematics methodology seminars, workshops/in-service training for lower primary mathematics’ teachers. Paid study leave/time and promotions to enhance teacher motivation and creation of positive perceptions towards teaching of mathematic which will go along way in improving mathematics performance. Keywords: Preschool; Mathematics Performance; Instructional Method

The Congruence between Teaching and Learning! Exploration of the Relationship between Preschool Teaching or Instructional Methods and Mathematics Performance in Lower Primary Schools in Kenya

The obstacles and difficulties hindering good performance in mathematics by Lower Primary school children seem to originate from inconsistence of instructional methods applied by teachers at the level. These methods don’t agree with the ones initially applied by the children’s teachers at preschool level. The effect of that could result in denying children a precious start to their future mathematics performance. There is a persistent indication that a discontinuity exists between pre-school learning methods and those in the lower primary schools. Teaching methods of the lower primary should be amended to make allowance for the stages of children’s development and provide opportunities to encourage children to improve in their ability to understand and apply mathematical concepts. The purpose of this study was to explore the impact of the pre-school mathematics programme on mathematics performance in the Lower Primary Schools of the Makuyu Zone, Murang’a South District. The objectives of this study were: - to investigate continuity of teaching methods from pre-school to lower primary school; and to compare the relationship between performance in mathematics of children who had had pre-school education with those who had not. This study used a descriptive survey design to achieve the set objectives. Purposive (deliberately) sampling was used to select a sample population of 60 pupils; a lottery (random choice) method of sampling was applied to get 30 teachers, whereas 10 head teachers were chosen through appointment (deliberate) sampling.  Open-ended questionnaires to collect data from the selected teachers and head teachers were applied; and for the children's responses, an interview schedule was employed. Observational checklists were also used where archival records were to apply. To test the construct validity and reliability of the research instruments, the researchers used 'split-half'.  The researchers pilot-tested the research instruments with a small representative group from the population. The data collected was analysed, using frequency counts and percentages and presentations were done in tables, bar graphs, pie charts and histograms as necessary to present a better picture of the findings. This study recommends frequent mathematics methodology seminars, workshops/in-service training for lower primary mathematics’ teachers which will guarantee effective methodological knowledge for teachers to teach mathematics effectively. Children’s learning at play should be very much emphasized. To avoid discontinuity this study recommends that in the lower primary male and female teachers should alternate to make the learners get used to male teachers. More male teachers should also get to teach in the preschool level. Keywords: Preschool; Mathematics Performance; Instructional Method

Regulation of medical diagnostics and medical devices in the East African community partner states.

BACKGROUND: Medical devices and in vitro diagnostic tests (IVD) are vital components of health delivery systems but access to these important tools is often limited in Africa. The regulation of health commodities by National Regulatory Authorities is intended to ensure their safety and quality whilst ensuring timely access to beneficial new products. Streamlining and harmonizing regulatory processes may reduce delays and unnecessary expense and improve access to new products. Whereas pharmaceutical products are widely regulated less attention has been placed on the regulation of other health products. A study was undertaken to assess regulation of medical diagnostics and medical devices across Partner States of the East African Community (EAC). METHODS: Data was collected during October 2012 through desk based review of documents and field research, including face to face interviews with the assistance of a structured questionnaire with closed and open ended questions. Key areas addressed were (i) existence and role of National Regulatory Authorities; (ii) policy and legal framework for regulation; (iii) premarket control; (iv) marketing controls; (v) post-marketing control and vigilance; (vi) country capacity for regulation; (vii) country capacity for evaluation studies for IVD and (viii) priorities and capacity building for harmonization in EAC Partner States. RESULTS: Control of medical devices and IVDs in EAC Partner States is largely confined to national disease programmes such as tuberculosis, HIV and malaria. National Regulatory Authorities for pharmaceutical products do not have the capacity to regulate medical devices and in some countries laboratory based organisations are mandated to ensure quality of products used. Some activities to evaluate IVDs are performed in research laboratories but post market surveillance is rare. Training in key areas is considered essential to strengthening regulatory capacity for IVDs and other medical devices. CONCLUSIONS: Regulation of medical devices and in vitro diagnostics has been neglected in EAC Partner States. Regulation is weak across the region, and although the majority of States have a legal mandate to regulate medical devices there is limited capacity to do so. Streamlining regulation in the EAC is seen as a positive aspiration with diagnostic tests considered a priority area for harmonisation

Synergistic Antiplasmodial Activity of Artemisia annua fractions against in vitro cultures of Plasmodium falciparum

Background: Artemisia annua has a very rich phytochemistry comprising several classes of compounds, mainly monoterpenes, sesquiterpenes, and flavonoids.  It has been used in China for about 2000 years in the treatment of fever. Objective: The aim was to determine if there is any synergistic effect on the Artemisia annua phytochemicals. Materials and methods: Artemisia annua used in this study was obtained from a hybrid of the plant grown in the Tanzania highlands (2000-2200 m altitude) in Arusha by Natural Uwemba System for Health (N.U.S.Ag). The dried leaves were ground, and sequentially extracted with hexane, dichloromethane (DCM), methanol and water and the extracts were then combined. The extract was then fractionated using high performance liquid chromatography (HPLC). The effect of the combined crude extract was tested at different doses on in-vitro cultures (a CQ sensitive isolate D6 and CQ resistant isolate W2) of Plasmodium falciparum. The fractions and different blends of these were tested at different doses to determine their role, if any, on the activity of the full blend of the plant. Results: Of nine fractions thus tested against D6 and W2, four had activities of less than 3.9µg /ml, three fractions had activities of between 4.77-14.76 µg/ml and the remaining two had activities above 250g/µml. The seven more active fractions were re-evaluated in a subtractive bioassay procedure, in which one of each fraction was excluded at a time from the full 7-component blend. The activity of the combined seven active compounds was 10.40+0.50 µg/ml against W2.  Of these, one showed IC50 of less than 3.9 µg/ml and all blends showed IC50 at below 27µg/ml. Conclusion: The results show that different components of A. annua contribute to the synergistic anti-Plasmodium activity. The results constitute a useful basis for identifying the components of the plant other than artemisinin that contribute to the activity of herb. Key words- Artemisia annua, malaria, Plasmodium falciparum, artemisinin, synergy

Risk of Injection-Site Abscess among Infants Receiving a Preservative-Free, Two-Dose Vial Formulation of Pneumococcal Conjugate Vaccine in Kenya.

There is a theoretical risk of adverse events following immunization with a preservative-free, 2-dose vial formulation of 10-valent-pneumococcal conjugate vaccine (PCV10). We set out to measure this risk. Four population-based surveillance sites in Kenya (total annual birth cohort of 11,500 infants) were used to conduct a 2-year post-introduction vaccine safety study of PCV10. Injection-site abscesses occurring within 7 days following vaccine administration were clinically diagnosed in all study sites (passive facility-based surveillance) and, also, detected by caregiver-reported symptoms of swelling plus discharge in two sites (active household-based surveillance). Abscess risk was expressed as the number of abscesses per 100,000 injections and was compared for the second vs first vial dose of PCV10 and for PCV10 vs pentavalent vaccine (comparator). A total of 58,288 PCV10 injections were recorded, including 24,054 and 19,702 identified as first and second vial doses, respectively (14,532 unknown vial dose). The risk ratio for abscess following injection with the second (41 per 100,000) vs first (33 per 100,000) vial dose of PCV10 was 1.22 (95% confidence interval [CI] 0.37-4.06). The comparator vaccine was changed from a 2-dose to 10-dose presentation midway through the study. The matched odds ratios for abscess following PCV10 were 1.00 (95% CI 0.12-8.56) and 0.27 (95% CI 0.14-0.54) when compared to the 2-dose and 10-dose pentavalent vaccine presentations, respectively. In Kenya immunization with PCV10 was not associated with an increased risk of injection site abscess, providing confidence that the vaccine may be safely used in Africa. The relatively higher risk of abscess following the 10-dose presentation of pentavalent vaccine merits further study

Design of a study to determine the impact of insecticide resistance on malaria vector control: a multi-country investigation.

BACKGROUND: Progress in reducing the malaria disease burden through the substantial scale up of insecticide-based vector control in recent years could be reversed by the widespread emergence of insecticide resistance. The impact of insecticide resistance on the protective effectiveness of insecticide-treated nets (ITN) and indoor residual spraying (IRS) is not known. A multi-country study was undertaken in Sudan, Kenya, India, Cameroon and Benin to quantify the potential loss of epidemiological effectiveness of ITNs and IRS due to decreased susceptibility of malaria vectors to insecticides. The design of the study is described in this paper. METHODS: Malaria disease incidence rates by active case detection in cohorts of children, and indicators of insecticide resistance in local vectors were monitored in each of approximately 300 separate locations (clusters) with high coverage of malaria vector control over multiple malaria seasons. Phenotypic and genotypic resistance was assessed annually. In two countries, Sudan and India, clusters were randomly assigned to receive universal coverage of ITNs only, or universal coverage of ITNs combined with high coverage of IRS. Association between malaria incidence and insecticide resistance, and protective effectiveness of vector control methods and insecticide resistance were estimated, respectively. RESULTS: Cohorts have been set up in all five countries, and phenotypic resistance data have been collected in all clusters. In Sudan, Kenya, Cameroon and Benin data collection is due to be completed in 2015. In India data collection will be completed in 2016. DISCUSSION: The paper discusses challenges faced in the design and execution of the study, the analysis plan, the strengths and weaknesses, and the possible alternatives to the chosen study design

Emergence of new types of Theileria orientalis in Australian cattle and possible cause of theileriosis outbreaks

Theileria parasites cause a benign infection of cattle in parts of Australia where they are endemic, but have, in recent years, been suspected of being responsible for a number of outbreaks of disease in cattle near the coast of New South Wales. The objective of this study was to identify and characterize the species of Theileria in cattle on six farms in New South Wales where disease outbreaks have occurred, and compare with Theileria from three disease-free farms in Queensland that is endemic for Theileria. Special reference was made to sub-typing of T. orientalis by type-specific PCR and sequencing of the small subunit (SSU) rRNA gene, and sequence analysis of the gene encoding a polymorphic merozoite/piroplasm surface protein (MPSP) that may be under immune selection. Nucleotide sequencing of SSU rRNA and MPSP genes revealed the presence of four Theileria genotypes: T. orientalis (buffeli), T. orientalis (ikeda), T. orientalis (chitose) and T. orientalis type 4 (MPSP) or type C (SSU rRNA). The majority of animals showed mixed infections while a few showed single infection. When MPSP nucleotide sequences were translated into amino acids, base transition did not change amino acid composition of the protein product, suggesting possible silent polymorphism. The occurrence of ikeda and type 4 (type C) previously not reported to occur and silent mutation is thought to have enhanced parasite evasion of the host immune response causing the outbreak

Rhinovirus dynamics across different social structures

Rhinoviruses (RV), common human respiratory viruses, exhibit significant antigenic diversity, yet their dynamics across distinct social structures remain poorly understood. Our study delves into RV dynamics within Kenya by analysing VP4/2 sequences across four different social structures: households, a public primary school, outpatient clinics in the Kilifi Health and Demographics Surveillance System (HDSS), and countrywide hospital admissions and outpatients. The study revealed the greatest diversity of RV infections at the countrywide level (114 types), followed by the Kilifi HDSS (78 types), the school (47 types), and households (40 types), cumulatively representing >90% of all known RV types. Notably, RV diversity correlated directly with the size of the population under observation, and several RV type variants occasionally fuelled RV infection waves. Our findings highlight the critical role of social structures in shaping RV dynamics, information that can be leveraged to enhance public health strategies. Future research should incorporate whole-genome analysis to understand fine-scale evolution across various social structures

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Changing Patterns of Malaria Epidemiology between 2002 and 2010 in Western Kenya: The Fall and Rise of Malaria

The impact of insecticide treated nets (ITNs) on reducing malaria incidence is shown mainly through data collection from health facilities. Routine evaluation of long-term epidemiological and entomological dynamics is currently unavailable. In Kenya, new policies supporting the provision of free ITNs were implemented nationwide in June 2006. To evaluate the impacts of ITNs on malaria transmission, we conducted monthly surveys in three sentinel sites with different transmission intensities in western Kenya from 2002 to 2010.Longitudinal samplings of malaria parasite prevalence in asymptomatic school children and vector abundance in randomly selected houses were undertaken monthly from February 2002. ITN ownership and usage surveys were conducted annually from 2004 to 2010. Asymptomatic malaria parasite prevalence and vector abundances gradually decreased in all three sites from 2002 to 2006, and parasite prevalence reached its lowest level from late 2006 to early 2007. The abundance of the major malaria vectors, Anopheles funestus and An. gambiae, increased about 5-10 folds in all study sites after 2007. However, the resurgence of vectors was highly variable between sites and species. By 2010, asymptomatic parasite prevalence in Kombewa had resurged to levels recorded in 2004/2005, but the resurgence was smaller in magnitude in the other sites. Household ITN ownership was at 50-70% in 2009, but the functional and effective bed net coverage in the population was estimated at 40.3%, 49.4% and 28.2% in 2010 in Iguhu, Kombewa, and Marani, respectively.The resurgence in parasite prevalence and malaria vectors has been observed in two out of three sentinel sites in western Kenya despite a high ownership of ITNs. The likely factors contributing to malaria resurgence include reduced efficacy of ITNs, insecticide resistance in mosquitoes and lack of proper use of ITNs. These factors should be targeted to avoid further resurgence of malaria transmission