Pathogenic E.coli and other pathogenic gram negative enteric strains from foecal samples of children without diarrhoea living in Mukuru slums, Nairobi

Background: Diarrhoea remains a major public health problem among children and adults in developing nations such as Kenya. The risk of infection is higher in children due to their developing immunity, relatively poor hygiene and habits especially those living in informal settlements where water supply and sanitation are inadequate.Objectives: To determine the prevalence of selected enteric pathogens from children without diarrhoea attending two clinics in Mukuru as well as the anti-microbial resistance patterns, and pathogenicity of E. coli isolated.Design: A cross sectional study.Setting: Mukuru slum, Nairobi County.Subjects: Three hundred and twenty two children of ages five and below.Results: Mukuru Kwa Njenga; E. coli 34.6%, Salmonella spp. 1.3%, Shigella 0.7%, Citrobacter spp. 2.3%, Klebsiella spp. 5.3%, Proteus spp. 7.0%, No growth 2.3%. Mukuru Kwa Reuben; E. coli 63.4%, Salmonella 0.6%, Shigella 0.6%, Citrobacter spp. 1.2%,Klebsiella spp. 14.3%, Proteus spp. 16.1%, No growth 3.7%. No significant difference among the organisms isolated in both clinics (p = 0.982). Ampicillin, Amoxycillin/ Clavulanic, cefoxitin had high resistance, while gentamicin was 100% susceptible. 46.6% E. coli isolates were positive for at least one of the eight virulence genes tested.Conclusion: Salmonella, Shigella and pathogenic E.coli associated with diarrhoea and presence of resistance genes were identified in foecal samples of children without diarrhoea living in Mukuru informal settlements in Nairobi. The major concern from the findings of this study was the emerging high resistance of E.coli that was observed to cephamycin (Cefoxitin)

The Cerebro-placental Ratio as a Prognostic Factor of Foetal Outcome in Patients with Third Trimester Hypertension

Background: Hypertensive disorders of pregnancy can cause complications in both the maternal and fetal circulations resulting in poor fetal outcome. These circulations can be safely and non-invasively assessed using arterial Doppler indices of the umbilical and middle cerebral arteries to obtain the cerebro-placental ratio. The study objective was to determine the role of the cerebro-placental ratio as a prognostic factor of fetal outcome in patients with hypertensive states of pregnancy delivered at least 32 weeks of gestation by dates.Methods: This was a prospective cohort study undertaken at Kenyatta National Hospital, a tertiary referral hospital in Nairobi. A total of 160 gravid patients of median age 28 years and at least 32 weeks gestations were recruited from labor ward over a 9 month study period by consecutive sampling method. Doppler ultrasound analyses of the foetal umbilical and cerebral arteries were done and the cerebro-placental ratio calculated.Results: At sonography, the average ultrasound age was 31 weeks. The median gestation at admission was 34 weeks. Twenty nine percent had an abnormal Cerebro-placental ratio (<1.0).125/160 (78%) delivered via caesarean section and 35/160(22%) delivered vaginally.51/160(32%)  severe pre-eclamptic toxaemia out of which 39% had cerebroplacental ratio<1.0 109/160(68%) had mild pre-eclamptic toxaemia out of which 24% had cerebroplacental ratio <1.0 Still births were 12.5 times more likely in mothers with cerebroplacental ratio <1.0 than those with CPR 1.0 (p value 0.05). A foetal birth score < 7 was 66 times more often in  mothers with cerebro-placental ratio< 1.0 than mothers with CPR 1.0. (P 0.05). Low birth weight was 4.7 times more likely among mothers with cerebroplacental ratio < 1.0.as compared to those with mothers with CPR1.0 (95% CI 2, 11.1; p0.001). A foetal birth score < 7 was 66 times more likely among neonates delivered vaginally as compared to those born via caesarean section(95% CI 1.3, 23; p=0.02). Still births were 14.5 times more often than among neonates born vaginally as compared to those born via caesarean section (95% CI 3, 84; p0.001). The prognostic Odds Ratio for cerebro-placental ratio was 12.5 for live births (95% CI 2, 74; p=0.005), 66 for fetal birth score <7 (95% Confidence interval 13, 340; p< 0.001) and 4.7 for low birth weight (95% CI 2, 11.1; p< 0.001) and 1.1 (95% CI 0.9, 1.4; p=0.327).Conclusion: Cerebro-placental ratio is significantly predictive of adverse perinatal outcome when used to monitor mothers with hypertensive states of pregnancy. Cerebroplacental ratio.Key words: Cerebro-placental Ratio, Prognostic Factor, Foetal Outcome, Third Trimester, Hypertensio

Technology development and field testing: access to credit to allow smallholder dairy farmers in central Kenya to reallocate concentrates during lactation

A field trial with smallholder dairy farmers in central Kenya was carried out to study the feasibility of reallocating concentrates as a means of increasing the profitability of milk production. Researchers designed the trial with extension officers, dairy co-operative and feed company staff to ensure that all stakeholders and key players were involved. Central to the design was the provision of feed on credit from the dairy co-operative to its members, the volunteer farmers involved in the study. The role of the research team was to present the technology to the farmers and monitor the implementation and impact. Farmers were not constrained in the way they chose to implement the recommendations, but the research team monitored any modifications as well as recording production parameters and characteristics of the farm and feed management systems likely to explain underlying variation. The recommendation was to feed 8 kg/day in early lactation, withdrawing concentrates completely after twelve weeks so that during the course of lactation the amount fed would be equivalent to the most frequent farmer practice, a flat rate of 2 kg/day. Actual quantities offered by most farmers were reported to be higher than in previous lactations, but varied from 2-10 kg/day. Although some decreased the amount offered between 8-12 weeks post lactation most continued with the higher levels until a drop in milk yield was observed. Milk production increased as a result of the intervention with a large part of the variation in milk yield (r2 = 0.55) reflecting the amount of concentrate offered. Month of calving and sampling also influenced the production response For many smallholder dairy farmers one of the key constraints to making technological changes expected to improve production is the lack of credit to allow them to make investments. The results so far available from our study showed that farmers were able to increase their milk yield as a result of the intervention, and that, as expected, the response depended on the level of concentrate offered

Assessment of Genetic Variation and Population Structure of Diverse Rice Genotypes Adapted to Lowland and Upland Ecologies in Africa Using SNPs

Using interspecific crosses involving Oryza glaberrima Steud. as donor and O. sativa L. as recurrent parents, rice breeders at the Africa Rice Center developed several 'New Rice for Africa (NERICA)' improved varieties. A smaller number of interspecific and intraspecific varieties have also been released as ‘Advanced Rice for Africa (ARICA)’. The objective of the present study was to investigate the genetic variation, relatedness, and population structure of 330 widely used rice genotypes in Africa using DArTseq-based single nucleotide polymorphisms (SNPs). A sample of 11 ARICAs, 85 NERICAs, 62 O. sativa spp. japonica, and 172 O. sativa spp. indica genotypes were genotyped with 27,560 SNPs using diversity array technology (DArT)-based sequencing (DArTseq) platform. Nearly 66% of the SNPs were polymorphic, of which 15,020 SNPs were mapped to the 12 rice chromosomes. Genetic distance between pairs of genotypes that belong to indica, japonica, ARICA, and NERICA varied from 0.016 to 0.623, from 0.020 to 0.692, from 0.075 to 0.763, and from 0.014 to 0.644, respectively. The proportion of pairs of genotypes with genetic distance > 0.400 was the largest within NERICAs (35.1% of the pairs) followed by ARICAs (18.2%), japonica (17.4%), and indica (5.6%). We found one pair of japonica, 11 pairs of indica, and 35 pairs of NERICA genotypes differing by <2% of the total scored alleles, which was due to 26 pairs of genotypes with identical pedigrees. Cluster analysis, principal component analysis, and the model-based population structure analysis all revealed two distinct groups corresponding to the lowland (primarily indica and lowland NERICAs) and upland (japonica and upland NERICAs) growing ecologies. Most of the interspecific lowland NERICAs formed a sub-group, likely caused by differences in the O. glaberrima genome as compared with the indica genotypes. Analysis of molecular variance revealed very great genetic differentiation (FST = 0.688) between the lowland and upland ecologies, and 31.2% of variation attributable to differences within cluster groups. About 8% (1,197 of 15,020) of the 15,020 SNPs were significantly (P < 0.05) different between the lowland and upland ecologies and formed contrasting haplotypes that could clearly discriminate lowland from upland genotypes. This is the first study using high density markers that characterized NERICA and ARICA varieties in comparison with indica and japonica varieties widely used in Africa, which could aid rice breeders on parent selection for developing new improved rice germplasm

Using a model-based geostatistical approach to design and analyse the prevalence of schistosomiasis in Kenya

BackgroundInfections caused by both Schistosoma mansoni and Schistosoma haematobium are endemic in Kenya, with over six million children at risk. A national school-based deworming programme was launched in 2012 with the goal of eliminating parasitic worms as a public health problem. This study used a model-based geostatistical (MBG) approach to design and analyse the impact of the programme and inform treatment strategy changes for schistosomiasis (SCH).MethodsA cross-sectional survey of 200 schools across 27 counties of Kenya was utilised. The study design, selection of the schools, and analysis followed the MBG approach, which incorporated historical data on treatment, morbidity, and environmental covariates.ResultsThe overall SCH prevalence was 5.0% (95% CI 4.9%–5.2%) and was estimated, with a high predictive probability of 0.999, to be between 1% and&lt; 10%. The predictive probabilities at county level revealed county heterogeneity, with that of four counties estimated to be between 0% and&lt; 1%, that of 20 counties estimated to be between 1% and&lt; 10%, that of two counties estimated to be between 10% and&lt; 20%, and that of one county estimated to be between 20% and&lt; 50%.ConclusionSCH treatment requirements can now be confidently refined based on the World Health Organization’s guidelines. The four counties with prevalences of between 0% and&lt; 1% may consider suspending treatment only in areas (i.e., sub-counties and wards) where the prevalence is&lt; 1%

A Case of Ministry of Finance

Submitted in Partial Fulfillment of the Requirements for the Degree of Master of Science (Computer- Based Information Systems,( MCBIS)The purpose of this study was to assess the benefits of adoption of an asset management system in the public sector in Kenya. The study was guided by the following specific objectives; to determine the present state of asset management, determine the role an asset management system; analyze the present model for implementing an asset management system and to determine how the present model can be improved for successful implementation of an asset management system in the Government of Kenya. The research design for this study was a case study design. The population of interest for this study was employees from the Ministry of Finance. Stratified random sampling was used to select 70 respondents across the strata. Both quantitative and qualitative data was used in this study. Quantitative data was collected using a semi structured questionnaire. Qualitative data was collected by the use of interview guides. Secondary data were used; sources included text books, journals, newsletters, asset management implementation model manuals. Statistical Package for Social Science Software (SPSS) was used to help in analysis of quantitative data. The study found out that asset management in the government was not integrated across departments and therefore procurement department was most entrusted with the role of asset management. Study observed that previous AMS implementation process attempt did not observe the set timelines due to lack of policy, inclusion in implementation process and 'buy in' by the employees. Poor integration of activities within departments, lack of standardization in categorization/cataloging of assets, lack of AMS flexibility in its operation and poor design of the asset management model were challenges mentioned to hamper AMS implementation process. Study concludes that AM information system in the government is faced by various design, operation and implementation challenges leading to it being stalled. AM in the government remains exclusively a decision making process. The system also fails to integrate various departments either for regular information flow, monetary or occasional information