Prioritization of invasive alien species with the potential to threaten agriculture and biodiversity in Kenya through horizon scanning

Invasive alien species (IAS) rank among the most significant drivers of species extinction and ecosystem degradation resulting in significant impacts on socio-economic development. The recent exponential spread of IAS in most of Africa is attributed to poor border biosecurity due to porous borders that have failed to prevent initial introductions. In addition, countries lack adequate information about potential invasions and have limited capacity to reduce the risk of invasions. Horizon scanning is an approach that prioritises the risks of potential IAS through rapid assessments. A group of 28 subject matter experts used an adapted methodology to assess 1700 potential IAS on a 5-point scale for the likelihood of entry and establishment, potential socio-economic impact, and impact on biodiversity. The individual scores were combined to rank the species according to their overall potential risk for the country. Confidence in individual and overall scores was recorded on a 3-point scale. This resulted in a priority list of 120 potential IAS (70 arthropods, 9 nematodes, 15 bacteria, 19 fungi/chromist, 1 viroid, and 6 viruses). Options for risk mitigation such as full pest risk analysis and detection surveys were suggested for prioritised species while species for which no immediate action was suggested, were added to the plant health risk register and a recommendation was made to regularly monitor the change in risk. By prioritising risks, horizon scanning guides resource allocation to interventions that are most likely to reduce risk and is very useful to National Plant Protection Organisations and other relevant stakeholders

Burden and risk factors of mental and substance use disorders among adolescents and young adults in Kenya: results from the Global Burden of Disease Study 2019Research in context

Summary: Background: Mental and substance use disorders are a major public health concern globally, with high rates of disability, morbidity, and mortality associated with these. In low- and middle-income countries, such as Kenya, mental health is often given low priority, and resources for the prevention and treatment of mental and substance use disorders are limited. Adolescence and young adulthood are critical periods for the development of mental and substance use disorders, with many disorders emerging during this time. In Kenya, the burden and risk factors of mental and substance use disorders among adolescents and young adults is not well understood. Methods: The data used in this study were obtained from the Global Burden of Disease (GBD) Study 2019. We selected the data on the number of mental and substance use disorders among adolescents and young adults in Kenya from the GBD results tool. The data were extracted by mental health (MH) condition, by age group and by sex. We used descriptive statistical methods to summarise and present the data. Specifically, we calculated the disability-adjusted life-years (DALYs) rates, risk factors of mental and substance use disorders by age group and sex. Findings: In 2019, among 10–24-year-olds in Kenya, mental disorders ranked as the second leading cause of disability, following unintentional injuries, and accounted for 248,936 [95% uncertainty interval 175,033; 341,680] DALYs or 9.4% of 2,656,546 total DALYs. Substance use disorders accounted 15,022 [9948; 20,710] DALYs. Depressive, anxiety, and conduct disorders accounted for the most DALYs of mental disorders accounting for 3.1%, 2.3% and 1.7% of the total DALYs, respectively. The main risk factors for incident DALYs in 10–24-year-olds were bullying and victimization (66.5%). Childhood sexual abuse accounted for 13.7% of the DALYs, lead exposure accounted for 8.5% of the DALYs, intimate partner violence accounted for 11.3% of the DALYs (2%) with all victims being females, and illicit drug use accounted for (52.7%) of DALYs. Interpretation: Improved surveillance of mental health and substance use burden at national and county levels is needed. Focus on timely screening and intervention for idiopathic developmental intellectual disability, conduct disorder, and substance use disorder in young boys and depression, anxiety, and eating disorders in young girls and women is critically needed. Funding: MK is funded by FIC/NIMH K43 TW 010716 and R33MH124149-03. The publication was made possible by funding from the Gates Foundation

Guidance on dossier evaluation for the registration of pest control products in Kenya

This document describes guidance on dossier evaluation for the registration of pest control products in Kenya. The document provides guidance for the assessment of a limited number of aspects that are part of evaluation of a pest control product registration dossier. It should therefore not be considered as a complete pesticide evaluation manual, though it is intended to contribute to a future complete pest control product evaluation manual for Kenya. The guidance should be read together with an im plementation report which contains stepping stones for further development.The guidance was developed within the Pesticide management initiative East African Region: Kenya (PEAR -Kenya) project. The project ran in the period 2016 – 2019 and was sponsored and supported by the Dutch Ministry of Agriculture, Nature and Food Quality and the Embassy of the Netherlands in Nairobi.The guidance addresses various aspects of a pest control product evaluation covering low risk pest control products, microbial pest control product, chemical pest control products and equivalence determination. The evaluation procedures developed covers a fast-track pathway for low risk products. For microbial products the procedure focusses on identification, human pathology and infectiveness and hazard and risk assessments for metabolites of potential concern. For chemical products the procedure includes methods for human health and pollinator risk assessments. The evaluation process of new pest control products can be speeded up if the active ingredient or active agent of a new product proves to be equivalent to an already registered product

Implementation of guidance on dossier evaluation for the registration of pest control products in Kenya

This document describes suggestions for further steps that can be taken with regard to the evaluation of pest control products in Kenya. The document should be read together with the document describing proposed guidance on dossier evaluation for the registration of pest control products in Kenya and as such both contribute to a future complete pesticide evaluation manual for Kenya.Both documents were developed within the Pesticide management initiative East African Region: Kenya (PEAR -Kenya) project. The project ran in the period 2016 – 2019 and was sponsored and supported by the Dutch Ministry of Agriculture, Nature and Food Quality and the Embassy of the Netherlands in Nairobi.This document is intended to feed into discussions on further development of a complete pesticide evaluation manual for Kenya using the guidance mentioned as a starting point. Reflections on some of the methods proposed and also information on what is needed to implement the guidance developed in the project are provided. Additionally, suggestions for developing a framework for the risk assessment of aquatic organisms are given

Guidance on dossier evaluation for the registration of pest control products in Kenya

This document describes guidance on dossier evaluation for the registration of pest control products in Kenya. The document provides guidance for the assessment of a limited number of aspects that are part of evaluation of a pest control product registration dossier. It should therefore not be considered as a complete pesticide evaluation manual, though it is intended to contribute to a future complete pest control product evaluation manual for Kenya. The guidance should be read together with an im plementation report which contains stepping stones for further development.The guidance was developed within the Pesticide management initiative East African Region: Kenya (PEAR -Kenya) project. The project ran in the period 2016 – 2019 and was sponsored and supported by the Dutch Ministry of Agriculture, Nature and Food Quality and the Embassy of the Netherlands in Nairobi.The guidance addresses various aspects of a pest control product evaluation covering low risk pest control products, microbial pest control product, chemical pest control products and equivalence determination. The evaluation procedures developed covers a fast-track pathway for low risk products. For microbial products the procedure focusses on identification, human pathology and infectiveness and hazard and risk assessments for metabolites of potential concern. For chemical products the procedure includes methods for human health and pollinator risk assessments. The evaluation process of new pest control products can be speeded up if the active ingredient or active agent of a new product proves to be equivalent to an already registered product

Implementation of guidance on dossier evaluation for the registration of pest control products in Kenya

This document describes suggestions for further steps that can be taken with regard to the evaluation of pest control products in Kenya. The document should be read together with the document describing proposed guidance on dossier evaluation for the registration of pest control products in Kenya and as such both contribute to a future complete pesticide evaluation manual for Kenya.Both documents were developed within the Pesticide management initiative East African Region: Kenya (PEAR -Kenya) project. The project ran in the period 2016 – 2019 and was sponsored and supported by the Dutch Ministry of Agriculture, Nature and Food Quality and the Embassy of the Netherlands in Nairobi.This document is intended to feed into discussions on further development of a complete pesticide evaluation manual for Kenya using the guidance mentioned as a starting point. Reflections on some of the methods proposed and also information on what is needed to implement the guidance developed in the project are provided. Additionally, suggestions for developing a framework for the risk assessment of aquatic organisms are given

The ASOS Surgical Risk Calculator: development and validation of a tool for identifying African surgical patients at risk of severe postoperative complications

Background: The African Surgical Outcomes Study (ASOS) showed that surgical patients in Africa have a mortality twice the global average. Existing risk assessment tools are not valid for use in this population because the pattern of risk for poor outcomes differs from high-income countries. The objective of this study was to derive and validate a simple, preoperative risk stratification tool to identify African surgical patients at risk for in-hospital postoperative mortality and severe complications. Methods: ASOS was a 7-day prospective cohort study of adult patients undergoing surgery in Africa. The ASOS Surgical Risk Calculator was constructed with a multivariable logistic regression model for the outcome of in-hospital mortality and severe postoperative complications. The following preoperative risk factors were entered into the model; age, sex, smoking status, ASA physical status, preoperative chronic comorbid conditions, indication for surgery, urgency, severity, and type of surgery. Results: The model was derived from 8799 patients from 168 African hospitals. The composite outcome of severe postoperative complications and death occurred in 423/8799 (4.8%) patients. The ASOS Surgical Risk Calculator includes the following risk factors: age, ASA physical status, indication for surgery, urgency, severity, and type of surgery. The model showed good discrimination with an area under the receiver operating characteristic curve of 0.805 and good calibration with c-statistic corrected for optimism of 0.784. Conclusions: This simple preoperative risk calculator could be used to identify high-risk surgical patients in African hospitals and facilitate increased postoperative surveillance. © 2018 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.Medical Research Council of South Africa gran

Maternal and neonatal outcomes after caesarean delivery in the African Surgical Outcomes Study: a 7-day prospective observational cohort study.

BACKGROUND: Maternal and neonatal mortality is high in Africa, but few large, prospective studies have been done to investigate the risk factors associated with these poor maternal and neonatal outcomes. METHODS: A 7-day, international, prospective, observational cohort study was done in patients having caesarean delivery in 183 hospitals across 22 countries in Africa. The inclusion criteria were all consecutive patients (aged ≥18 years) admitted to participating centres having elective and non-elective caesarean delivery during the 7-day study cohort period. To ensure a representative sample, each hospital had to provide data for 90% of the eligible patients during the recruitment week. The primary outcome was in-hospital maternal mortality and complications, which were assessed by local investigators. The study was registered on the South African National Health Research Database, number KZ_2015RP7_22, and on ClinicalTrials.gov, number NCT03044899. FINDINGS: Between February, 2016, and May, 2016, 3792 patients were recruited from hospitals across Africa. 3685 were included in the postoperative complications analysis (107 missing data) and 3684 were included in the maternal mortality analysis (108 missing data). These hospitals had a combined number of specialist surgeons, obstetricians, and anaesthetists totalling 0·7 per 100 000 population (IQR 0·2-2·0). Maternal mortality was 20 (0·5%) of 3684 patients (95% CI 0·3-0·8). Complications occurred in 633 (17·4%) of 3636 mothers (16·2-18·6), which were predominantly severe intraoperative and postoperative bleeding (136 [3·8%] of 3612 mothers). Maternal mortality was independently associated with a preoperative presentation of placenta praevia, placental abruption, ruptured uterus, antepartum haemorrhage (odds ratio 4·47 [95% CI 1·46-13·65]), and perioperative severe obstetric haemorrhage (5·87 [1·99-17·34]) or anaesthesia complications (11·47 (1·20-109·20]). Neonatal mortality was 153 (4·4%) of 3506 infants (95% CI 3·7-5·0). INTERPRETATION: Maternal mortality after caesarean delivery in Africa is 50 times higher than that of high-income countries and is driven by peripartum haemorrhage and anaesthesia complications. Neonatal mortality is double the global average. Early identification and appropriate management of mothers at risk of peripartum haemorrhage might improve maternal and neonatal outcomes in Africa. FUNDING: Medical Research Council of South Africa.Medical Research Council of South Africa