Survey of Nematode-Destroying Fungi from Selected Vegetable-Growing Areas in Kenya

Plant-parasitic nematodes cause severe damage to a wide range of economic crops, causing upto 5% yield losses globally. In Kenya, vegetables are affected, among other pests, by parasitic nematodes, causing upto 80% loss in yield. Nematode control is very difficult and relies heavily on use of chemical nematicides. Use of these chemical nematicides leads to biological magnification, and elimination of natural enemies of other pathogens, thus creating a need for greater application of pesticides, increased production costs, and development of insecticide-resistance. These factors have led to a growing interest in search for alternate management strategies. The objective of this study was, therefore, to document nematode-destroying fungi in selected, major vegetable-growing areas in Kenya as a step towards developing a self-sustaining system for management of plant-parasitic nematodes. Soil samples were collected from five vegetable-production zones, viz., Kinare, Kabete, Athi-river, Machakos and Kibwezi, and transported to the laboratory for extraction of nematode-destroying fungi. The soil-sprinkle technique described by Jaffee et al (1996) was used for isolating the nematode-destroying fungi from soil, while, their identification was done using identification keys described by Soto Barrientos et al (2001). From this study, a total of 171 fungal isolates were identified as nematodedestroying. The highest population was recorded in Kabete, at 33.9% of the total, followed by Machakos, Kibwezi, Athi-river, with the least in Kinare, at 24.6, 22.2, 11.7 and 7.6% of the total population, in that order. Arthrobotrys was the most frequent genus, with mean occurrence of 7.3, followed by Monacrosporium with 6 and Stylophage with 5.2. A. dactyloides was significantly (P=0.002) affected by the agro-ecological zone, with the highest occurrence recorded in Kabete, and the least in Athi-river. Kibwezi recorded highest diversity index, with a mean of 1.017, while, Athi-river recorded the least, with a mean of 0.333. Kibwezi had the highest species richness, recording a mean of 3.4, while, the least mean of 1.6 was recorded in Athi-river. Mean species richness of 2.2 was recorded for both Kabete and Machakos, and 1.8 for Kinare. From the three genera recorded, Arthrobotrys was more effective at trapping nematodes compared to Monocrosporium and Stylopage. The genus Arthrobotrys had the highest number of trapped nematodes, with a total population of 57, followed by Monacrosporium, the least being Stylopage, with 45 and 36, respectively, in a period of 104 hours. From the study, it is evident that agricultural practices affect occurrence and diversity of nematodedestroying fungi, and, Arthrobotrys can be used as a bio-control agent for managing plant-parasitic nematodes

Refining a questionnaire to assess breast cancer knowledge and barriers to screening in Kenya: Psychometric assessment of the BCAM

Background Our study objective was to determine the validity and reliability of the breast module of a cancer awareness measure (BCAM) among adult women in western Kenya. Methods The study was conducted between October and November 2012, following three breast cancer screening events. Purposive and systematic random sampling methods were used to identity 48 women for cognitive focus group discussions, and 1061 (594 who attended vs. 467 who did not attend screening events) for surveys, respectively. Face and psychometric validity of the BCAM survey was assessed using cognitive testing, factor analysis of survey data, and correlations. Internal reliability was assessed using Cronbach’s alpha. Results Among survey participants, the overall median age was 34 (IQR: 26–44) years. Compared to those women who did not attend the screening events, women attendees were older (median: 35 vs. 32 years, p = 0.001) more often married (79% vs. 72%, p = 0.006), more educated (52% vs. 46% with more than an elementary level of education, p = 0.001), more unemployed (59% vs. 11%, p = 0.001), more likely to report doing breast self-examination (56% vs. 40%, p = 0.001) and more likely to report having felt a breast lump (16% vs. 7%, p = 0.001). For domain 1 on knowledge of breast cancer symptoms, one factor (three items) with Eigen value of 1.76 emerged for the group that did not attend screening, and 1.50 for the group that attended screening. For both groups two factors (factor 1 “internal influences” and factor 2 “external influences”) emerged among domain 4 on barriers to screening, with varied item loadings and Eigen values. There were no statistically significant differences in the factor scores between attendees and non-attendees. There were significant associations between factor scores and other attributes of the surveyed population, including associations with occupation, transportation type, and training for and practice of breast self-examination. Cronbach’s alpha showed an acceptable internal consistency. Conclusion Certain subpopulations are less likely than others to attend breast screening in Kenya. A survey measure of breast cancer knowledge and perceived barriers to screening shows promise for use in Kenya for characterizing clinical and community population beliefs, but needs adaptation for setting, language and culture

Community-based perceptions of emergency care in Kenya

Access to quality emergency services is an essential component of the human right to health, but barriers to emergency care are found throughout Africa and the wider world. Data to support the development of emergency care are essential to improve access to care and further infrastructure development. We undertook this study to understand the community\u27s emergency care needs and the barriers they face when trying to access care and to engage community members with developing high impact solutions to expand access to essential emergency services. To accomplish this, we used a qualitative research methodology to conduct 59 focus groups with 528 total Kenyan community member participants. Data were coded, aggregated, and analysed using the content analysis approach. Participants were uniformly selected from all eight of the historical Kenyan provinces (Central. Coast, Eastern, Nairobi, North Eastern, Nyanza, Rift Valley, and Western), with equal rural and urban community representation. We found that socioeconomic and cultural factors play a major role both in seeking and reaching emergency care. Community members in Kenya experience a wide range of medical emergencies and seem to understand their time-critical nature. They rely on one another for assistance in the face of substantial barriers to care: a lack of a structured system, resources, transportation, trained healthcare providers, and initial care on scene. The results of this study indicate the need for specific interventions to reduce barriers to access essential emergency services in Kenya. Access to emergency care can be improved by encouraging recognition and initial treatment of emergent illness in the community, strengthening the pre­-hospital care system, improving emergency care delivery at health facilities, and creating new policies at both county and national levels

Adapting ethical guidelines for adolescent health research to street-connected children and youth in low- and middle-income countries: a case study from western Kenya

BACKGROUND: Street-connected children and youth (SCCY) in low- and middle-income countries (LMIC) have multiple vulnerabilities in relation to participation in research. These require additional considerations that are responsive to their needs and the social, cultural, and economic context, while upholding core ethical principles of respect for persons, beneficence, and justice. The objective of this paper is to describe processes and outcomes of adapting ethical guidelines for SCCY's specific vulnerabilities in LMIC. METHODS: As part of three interrelated research projects in western Kenya, we created procedures to address SCCY's vulnerabilities related to research participation within the local context. These consisted of identifying ethical considerations and solutions in relation to community engagement, equitable recruitment, informed consent, vulnerability to coercion, and responsibility to report. RESULTS: Substantial community engagement provided input on SCCY's participation in research, recruitment, and consent processes. We designed an assent process to support SCCY to make an informed decision regarding their participation in the research that respected their autonomy and their right to dissent, while safeguarding them in situations where their capacity to make an informed decision was diminished. To address issues related to coercion and access to care, we worked to reduce the unequal power dynamic through street outreach, and provided access to care regardless of research participation. CONCLUSIONS: Although a vulnerable population, the specific vulnerabilities of SCCY can to some extent be managed using innovative procedures. Engaging SCCY in ethical research is a matter of justice and will assist in reducing inequities and advancing their health and human dignity

Barriers to uptake of breast cancer screening in Kenya

Objectives: To conduct clinical breast cancer screening in three sites in Western Kenya and explore community barriers to screening uptake.Design: Cross-sectional study.Setting: Western Kenya specifically, Mosoriot, Turbo, and Kapsokwony.Subjects: Community members (18 years and older) who did not attend the screening events.Outcome Measure: The outcome measure was having heard about the breast cancer screening events. Both structured and open-ended questions were used for datacollection. Item frequency, correlations, and content analyses were performed.Results: A total of 733 community members were surveyed (63% women, median age 33 years, IQR=26-43). More than half (55%) of respondents had heard about the screening but did not attend. The majority of those who had heard about this particular screening had knowledge of screening availability in general (45% vs. 25%, p<0.001). Only 8.0% of those who heard and 6.0% of those who had not heard of the screening event hadpreviously undergone clinical breast exam (p=0.20). Reasons for not attending the screening event were personal factors, including busy schedule (41.0%), perceived low personal risk (12.7%), lack of transport (4.2%), as well as health facility factors such as poor publicity (14.4%) and long queues (8.7%).Conclusion: Barriers to breast cancer screening uptake were associated with inadequate publicity, perceived long waits at event and busy lives among community women

Impact of an Educational Intervention on Breast Cancer Knowledge in Western Kenya

Our objective was to assess the effectiveness of educational sessions that accompanied breast cancer screening events in three communities in western Kenya between October and November 2013. Five hundred and thirty-two women were recruited to complete a test of breast cancer-relevant knowledge and randomly allocated to ‘pre-test’ or ‘post-test’ groups that immediately preceded or followed participation in the educational sessions. The education was organized as a presentation by health professionals and focused mainly on causes of breast cancer, early and late cancer presentation signs, high-risk groups, screening methods to find early-stage breast cancer, self-breast exam procedures and treatment options for this disease. Participants were invited to ask questions and practice finding nodules in silicone breast models. The median age was 35 years (interquartile range: 28–45), and 86% had not undergone breast cancer screening previously. Many individual items in our test of knowledge showed statistically significant shifts to better-informed responses. When all items in the assessment questionnaire were scored as a ‘test’, on average there was a 2.80 point (95% CI: 2.38, 3.22) significant improvement in knowledge about breast cancer after the educational session. Our study provides evidence for the effectiveness of an educational strategy carefully tailored for women in these communities in Kenya

Effects of Medicinal Plant Extracts and Photosensitization on Aflatoxin Producing Aspergillus flavus

This study was undertaken with an aim of exploring the effectiveness of medicinal plant extracts in the control of aflatoxin production. Antifungal properties, photosensitization, and phytochemical composition of aqueous and organic extracts of fruits from Solanum aculeastrum, bark from Syzygium cordatum, and leaves from Prunus africana, Ocimum lamiifolium, Lippia kituiensis, and Spinacia oleracea were tested. Spores from four-day-old cultures of previously identified toxigenic fungi, UONV017 and UONV003, were used. Disc diffusion and broth dilution methods were used to test the antifungal activity. The spores were suspended in 2 ml of each extract separately and treated with visible light (420 nm) for varying periods. Organic extracts displayed species and concentration dependent antifungal activity. Solanum aculeastrum had the highest zones of inhibition diameters in both strains: UONV017 (mean = 18.50±0.71 mm) and UONV003 (mean = 11.92±0.94 mm) at 600 mg/ml. Aqueous extracts had no antifungal activity because all diameters were below 8 mm. Solanum aculeastrum had the lowest minimum inhibitory concentration at 25 mg/ml against A. flavus UONV017. All the plant extracts in combination with light reduced the viability of fungal conidia compared with the controls without light, without extracts, and without both extracts and light. Six bioactive compounds were analyzed in the plant extracts. Medicinal plant extracts in this study can control conidia viability and hence with further development can control toxigenic fungal spread

Gender differences in HIV knowledge among adolescents and young people in low-and middle-income countries: a systematic review

ObjectivesThis review seeks to critically analyze studies assessing gender differences in HIV-related knowledge among adolescents and young people in low- and middle-income countries.MethodsUsing PRISMA guidelines and searching Pubmed and Scopus online databases, the search strategy combined search keywords with Boolean operators: (HIV OR AIDS) AND (knowledge) AND (gender) AND (adolescents). AC and EG conducted the search and independently reviewed all articles in Covidence software; conflicts were resolved by GC. Articles were included if they evaluated differences in HIV knowledge in at least two groups ages 10–24 and were implemented in a low or middle-income country.ResultsThe search resulted in 4,901 articles, of which fifteen studies, implemented in 15 countries, met selection criteria. Twelve evaluated differences in HIV knowledge in school settings; three evaluated participants in clinic settings. Adolescent males consistently scored higher in composite knowledge scores, as well as knowledge of HIV transmission, prevention, attitudes and sexual decision-making.ConclusionWe found gender-based discrepancies between knowledge, perception of risk and HIV prevalence among youth globally, with boys consistently scoring higher in HIV knowledge. However, there is significant evidence that social and cultural contexts render girls at high risk of HIV infection, and the gaps in girls' knowledge and boys' roles in HIV risk must be addressed urgently. Future research should consider interventions that facilitate discussion and HIV knowledge building across genders