The Impacts of Water Abstraction in Tropical Rivers: A Case of South West Upper Tana Basin, Kenya.

The study to determine the impacts of water abstraction in South West Upper Tana Basin which is part of the larger Upper Tana basin was undertaken in four major rivers, Thika, Kimakia, Kiama and Chania. Data for this study was obtained from the Kenya Meteorological department (KMD), Water Resources Management (WRA) and questionnaire surveys. The questionnaires were administered in the period between January 2018 and December 2018 to determine the impacts of water abstraction in both dry and wet seasons. Regression and correlation analysis was used to determine the nature and strength of relationships between different variables. The results of the study indicate that the main impacts of water abstraction are hydrological, environmental and socio-economic. The hydrological impacts include reduced water levels, changes in stream morphology, decreased turbidity and reduced siltation. Socio-economic impacts include increased income from crop production and conflicts while environmental impacts were mainly changes in riparian vegetation. The study established that the best combination of impacts of water abstraction in the South West Upper Tana Basin were changes in water turbidity, decline in water levels, improved crop yields, changes in channel morphology and siltation with a coefficient correlation r of 0.57 and coefficient of determination R2 of 0.52. To mitigate these impacts, there is a need for better enforcement of legislations on water abstraction and the monitoring of the river basins to curb water over-abstraction. Public awareness campaigns and involvement of stakeholders could also minimize these impacts. Keywords: Water abstraction, hydrological impacts, socio-economic impacts, environmental impacts, South West Upper Tana Basin (SWUT). DOI: 10.7176/JEES/9-5-08 Publication date:May 31st 201

Immunogenicity and safety of fractional doses of 17D-213 yellow fever vaccine in HIV-infected people in Kenya (YEFE): a randomised, double-blind, non-inferiority substudy of a phase 4 trial

Background Evidence indicates that fractional doses of yellow fever vaccine are safe and sufficiently immunogenic for use during yellow fever outbreaks. However, there are no data on the generalisability of this observation to populations living with HIV. Therefore, we aimed to evaluate the immunogenicity of fractional and standard doses of yellow fever vaccine in HIV-positive adults. Methods We conducted a randomised, double-blind, non-inferiority substudy in Kilifi, coastal Kenya to compare the immunogenicity and safety of a fractional dose (one-fifth of the standard dose) versus the standard dose of 17D-213 yellow fever vaccine among HIV-positive volunteers. HIV-positive participants aged 18–59 years, with baseline CD4+ T-cell count of at least 200 cells per mL, and who were not pregnant, had no previous history of yellow fever vaccination or infection, and had no contraindication for yellow fever vaccination were recruited from the community. Participants were randomly assigned 1:1 in blocks (variable block sizes) to either a fractional dose or a standard dose of the 17D-213 yellow fever vaccine. Vaccines were administered subcutaneously by an unblinded nurse and pharmacist; all other study personnel were blinded to the vaccine allocation. The primary outcome of the study was the proportion of participants who seroconverted by the plaque reduction neutralisation test (PRNT50) 28 days after vaccination for the fractional dose versus the standard dose in the per-protocol population. Secondary outcomes were assessment of adverse events and immunogenicity during the 1-year follow-up period. Participants were considered to have seroconverted if the post-vaccination antibody titre was at least 4 times greater than the pre-vaccination titre. We set a non-inferiority margin of not less than a 17% decrease in seroconversion in the fractional dose compared with the standard dose. This study is registered with ClinicalTrials.gov, NCT02991495. Findings Between Jan 29, 2019, and May 17, 2019, 303 participants were screened, and 250 participants were included and vaccinated; 126 participants were assigned to the fractional dose and 124 to the standard dose. 28 days after vaccination, 112 (96%, 95% CI 90–99) of 117 participants in the fractional dose group and 115 (98%, 94–100) of 117 in the standard dose group seroconverted by PRNT50. The difference in seroconversion between the fractional dose and the standard dose was –3% (95% CI –7 to 2). Fractional dosing therefore met the non-inferiority criterion, and non-inferiority was maintained for 1 year. The most common adverse events were headache (n=31 [12%]), fatigue (n=23 [9%]), myalgia (n=23 [9%]), and cough (n=14 [6%]). Reported adverse events were either mild (182 [97%] of 187 adverse events) or moderate (5 [3%]) and were self-limiting. Interpretation Fractional doses of the 17D-213 yellow fever vaccine were sufficiently immunogenic and safe demonstrating non-inferiority to the standard vaccine dose in HIV-infected individuals with CD4+ T cell counts of at least 200 cells per mL. These results provide confidence that fractional dose recommendations are applicable to populations with high HIV prevalence. Funding Wellcome Trust, Médecins Sans Frontières Foundation, and the UK Department for International Development

Performance of Non-State Actors in Provision of Water Services in Arid and Semi-Arid Areas: A case of Kyuso Sub-County, Kenya

The study on performance of Non-State actors in provision of water services in arid and semi-arid areas was undertaken in Kyuso Sub-county, Kenya. Data on the performance of Non-State actors including their contribution to water service provision, challenges and measures to improve their performance was collected between January 2020 and December 2020. Questionnaire survey and interview schedules were used to collect data from households, managers of the Community Based Organizations (CBOs) and Non-Governmental Organizations (NGOs) and County government officials. Data collected was analysed using SPSS and Excel software to reveal the trends in water service provision by Non-State actors. The results indicated that Non-State actors have greatly reduced the distance that residents have to travel to access water in the study area to about a kilometre. The study also established that Non-State actors were facing several challenges including poor management structures, poor water infrastructure, low rainfall, inadequate water storage facilities, high water connection fee and vandalism of infrastructure. To mitigate these challenges, the study recommended that the Non-State actors should improve structures of public participation, invest in training the managers of the projects and improve their water storage facilities. The County government should also ensure that there is adequate and frequent supply of water through the Kiambere-Mwingi water pipeline that some of the Non-State actors rely on to supply water to the residents. Keywords: Non-State actors, water service provision, Kyuso Sub-County, Water Access DOI: 10.7176/JEES/11-11-05 Publication date: November 30th 202