Cost Sharing in Public Universities: A Kenyan Case Study.

ERIC Educational Resources Information Center

Rodrigues, Anthony J.; Wandiga, Shem O.

1997-01-01

Presents an analysis of government policy on higher education finance in Kenya, outlines parameters of an appropriate tuition policy (cost recovery, equity, equal access, affordability, student loan program objectives), and provides a model for simulating loan program outcomes. Suggests several proposed policy and administrative reforms concerning…

The rise of injecting drug use in east Africa: a case study from Kenya

PubMed Central

Beckerleg, Susan; Telfer, Maggie; Hundt, Gillian Lewando

2005-01-01

Studies on injecting drug use in East Africa are reviewed. The existingstudies document the spread of heroin injection in Kenya and Tanzania, both countries where HIV rates are high. No data from Uganda on injecting drug use was found by the authors. A case study of the growth of heroin injection in a Kenyan coastal town is presented. The need for needle-exchange programmes and other prevention services is discussed. PMID:16122382

Democracy, Ethics and Social Justice: Implications for Secondary School Leadership in Kenya

ERIC Educational Resources Information Center

Jwan, Julius O.; Kisaka, Sella T.

2017-01-01

Principals in Kenyan schools are required to adopt democratic school leadership practises as part of the government policy. Adopting an interpretive case study, this paper set out to explore the application of democracy, ethics and social justice in secondary schools in Kenya. The study was in two phases. Phase one: twelve school principals were…

Sternal foramina and variant xiphoid morphology in a Kenyan population.

PubMed

El-Busaid, H; Kaisha, W; Hassanali, J; Hassan, S; Ogeng'o, J; Mandela, P

2012-02-01

Sternal foramina may pose a great hazard during sternal puncture, due to inadvertent cardiac or great vessel injury. They can also be misinterpreted as osteolytic lesions in cross-sectional imaging of the sternum. On the other hand, variant xiphoid morphology such as bifid, duplicated, or trifurcated may be mistaken for fractures during imaging. The distribution of these anomalies differs between populations, but data from Africans is scarcely reported. This study therefore aimed to investigate the distribution and frequency of sternal foramina and variant xiphoid morphology in a Kenyan population. Eighty formalin-fixed adult sterna (42 males [M], 38 females [F]) of age range 18-45 years were studied during dissection at the Department of Human Anatomy, University of Nairobi. Soft tissues were removed from the macerated sterna by blunt dissection and foramina recorded in the manubrium, body, and xiphoid process. The xiphisternal ending was classified as single, bifurcated (2 xiphoid processes with a common stem), or duplicated (2 xiphoid processes with separate stems). Results were analysed using SPSS version 17.0. Foramina were present in 11 specimens (13.8%): 7 M, 4 F. The highest frequency was in the sternal body (n = 9), where they predominantly occurred at the 5th intercostal segment. Xiphoid foramina were present in 2 specimens (both males) (2.5%), while manubrial foramen was not encountered. The xiphisternum ended as a single process in 64 cases (34 M, 30 F) (80%). It bifurcated in 10 cases (5 M, 5 F) (12.5%), and duplicated in 6 cases (4 M, 2 F) (7.5%). There were no cases of trifurcation. Sternal foramina in Kenyans vary in distribution and show higher frequency than in other populations. These variations may complicate sternal puncture, and due caution is recommended. The variant xiphisternal morphology may raise alarm for xiphoid fractures and may therefore be considered a differential.

Does Water Hyacinth on East African Lakes Promote Cholera Outbreaks?

PubMed Central

Feikin, Daniel R.; Tabu, Collins W.; Gichuki, John

2010-01-01

Cholera outbreaks continue to occur regularly in Africa. Cholera has been associated with proximity to lakes in East Africa, and Vibrio cholerae has been found experimentally to concentrate on the floating aquatic plant, water hyacinth, which is periodically widespread in East African lakes since the late 1980s. From 1994 to 2008, Nyanza Province, which is the Kenyan province bordering Lake Victoria, accounted for a larger proportion of cholera cases than expected by its population size (38.7% of cholera cases versus 15.3% of national population). Yearly water-hyacinth coverage on the Kenyan section of Lake Victoria was positively associated with the number of cholera cases reported in Nyanza Province (r = 0.83; P = 0.0010). Water hyacinth on freshwater lakes might play a role in initiating cholera outbreaks and causing sporadic disease in East Africa. PMID:20682884

The Self, Political Socializatioon, and Education: Kenya as a Case Study

ERIC Educational Resources Information Center

Hopkins, Richard L.

1973-01-01

The political socialization of various African Kenyan leaders is used to illustrate the author's belief in H. G. Barnett's theory that the individual exerts an influence on the process of cultural change which is in opposition to Gabriel Almond's view that the individual is only a passive participant in society. (JH)

Multilingual Literacies: Invisible Representation of Literacy in a Rural Classroom

ERIC Educational Resources Information Center

Kiramba, Lydiah Kananu

2017-01-01

In many countries, educational policies typically mandate school activities that promote a homogeneous and narrow range of academic literacies for all learners despite the diverse nature of human learning. This ethnographic case study examines how a 12-year-old Kenyan fourth-grade student performing below average on all standardized tests used…

The Challenges of Student Affairs at Kenyan Public Universities

ERIC Educational Resources Information Center

Yakaboski, Tamara; Birnbaum, Matthew

2013-01-01

Kenya is increasingly turning to the promise of mass higher education to help solve a range of economic and social issues. These efforts have had profound effects on university students, faculty and professionals who provide the vital student support services necessary for academic success. This case study explores the challenges that face Kenyan…

The ILRI Graduate Fellows Programme: A Case Study of Impact (1978-1997).

ERIC Educational Resources Information Center

Eley, R.; Ibrahim, H.; Hambly, H.; Demeke, Mulat; Smalley, M.

2003-01-01

Data from 30 Kenyan and 30 Ethiopian fellows of the International Livestock Research Institute indicated that the institute provided high-quality training for graduate students and contributed to capacity building in national agricultural research systems. Such fellowship programs can help reverse the brain drain in African nations. (Contains 16…

Information Systems Education in Kenya: Students' Specialization Choice Trends (A Case Study of Kenya Polytechnic University College)

ERIC Educational Resources Information Center

Ndede-Amadi, Atieno A.

2013-01-01

The objective of this study was to determine the time and level of Information Systems (IS) awareness among Kenyan university students and the choice of IS as a field of specialization. The study posited that the choice of a field of specialization is dependent upon a student's awareness of its existence, its utilization in the real world, its…

A Study on the Sources of Resources and Capacity Building in Resource Mobilization: Case of Private Chartered Universities in Nakuru Town, Kenya

ERIC Educational Resources Information Center

Kipchumba, Simon Kibet; Zhimin, Liu; Chelagat, Robert

2013-01-01

The purpose of this study was to review and analyze the resources needs and sources of resources and level of training and capacity building in resource mobilization in Kenyan private chartered universities. The study employed a descriptive survey research design. Purposeful sampling technique was used to select 63 respondents (staff) from three…

An Evaluation of Factors that Affect Performance of Primary Schools in Kenya: A Case Study of Gatanga District

ERIC Educational Resources Information Center

Gakure, Roselyn W.; Mukuria, Patrick; Kithae, Peter Paul

2013-01-01

Recently, the Kenyan government reaffirmed its commitment to enabling majority of its citizen's access to education through establishment of free primary education program and subsidizing secondary education. However, despite all these efforts, the education sector continues to face myriads of problems, major one being skewed performance in Kenya…

A Case Study of Private Schools in Kibera: An Update

ERIC Educational Resources Information Center

Dixon, Pauline; Tooley, James

2012-01-01

This article provides an update on our earlier paper on the introduction by the Kenyan government in 2003 of free primary education (FPE), and its impact on low-fee private schools. First, published papers that have used our contribution as a springboard for discussion are critically reviewed. The argument and supporting evidence that the poor are…

Linguistic Effects of Globalization: A Case Study of French for Specific Purposes (FSP) in Kenyan Vocational Schools

ERIC Educational Resources Information Center

Mulenda, Mubalama

2013-01-01

The study of French for Specific Purposes (FSP) is a topical subject in this era of globalization. Kenya requires people who can communicate in French in the various specialized areas. It has become crucial in Kenya to respond to the French language needs of students learning tourism and hospitality among other domains which have already shown an…

Comment on Dissociation between running economy and running performance in elite Kenyan distance runners.

PubMed

Santos-Concejero, Jordan; Tucker, Ross

2016-01-01

Mooses and colleagues suggest that running economy alone does not explain superior distance running performance in elite Kenyan runners. Whilst we agree with the multi-factorial hypothesis for Kenyan running success, we do not believe that running economy can be overlooked to the extent that it was based on this particular study. Based on the methods used and the range of athletes tested, in this response letter we question whether this study provides any basis for downplaying the influence of running economy or suggesting that other factors compensate for it to enable superior performance.

RICKETS IN RURAL KENYAN PRESCHOOL CHILDREN: CASE REPORT.

PubMed

Bwibo, N O; Nyawade, S; Neumann, C G

2013-03-01

Clinical rickets has not been reported previously in Embu district, Kenya. Baseline clinical assessments performed for a nutrition intervention study in preschool children (n=324) identified 28 cases of rickets (8.6% of study sample). Clinical characteristics included: delays of sitting, walking, and teething; bone and chest deformities; widened wrists and ankles; and bowed lower extremities. Risk factors identified were short duration of breastfeeding with feeding of cereal-based supplements with little or no milk, low calcium intake, limited sunlight exposure. Vitamin D and calcium deficiencies likely contributed to these cases. Treatment with Vitamin D3 and milk resulted in clinical improvement.

Impact of Free Primary Education in Kenya: A Case Study of Private Schools in Kibera

ERIC Educational Resources Information Center

Tooley, James; Dixon, Pauline; Stanfield, James

2008-01-01

Free primary education (FPE) is widely assumed to be required to ensure that the poor gain enrolment. After the introduction of FPE (from January 2003) in Kenyan schools, huge increases in enrolment were officially reported. However, our research, conducted 10 months after the introduction of FPE in and around the informal settlement of Kibera,…

Developing a Peace and Conflict Resolution Curriculum for Quaker Secondary Schools in Kenya

ERIC Educational Resources Information Center

Hockett, Eloise

2012-01-01

In 2008-2009, a team of educators from George Fox University, in collaboration with a committee of teachers and administrators from selected Quaker secondary schools in western Kenya, developed the first draft of a peace and conflict resolution curriculum for Kenyan form one (ninth grade) students. This case study offers a model for developing a…

A Quantitative Study of Teacher Readiness to Teach School-Based HIV/AIDS Education in Kenyan Primary Schools

ERIC Educational Resources Information Center

Lang'at, Edwin K.

2014-01-01

Purpose and Method of Study: The purpose of this study was to investigate teachers' self-perceived readiness to teach school-based HIV/AIDS Awareness and Prevention education in Kenyan primary schools based on their knowledge, attitudes and instructional confidence. This research utilized a non-experimental quantitative approach with a…

Malaria morbidity and temperature variation in a low risk Kenyan district: a case of overdiagnosis?

NASA Astrophysics Data System (ADS)

Njuguna, John; Muita, James; Mundia, George

2009-05-01

Diagnosis of malaria using only clinical means leads to overdiagnosis. This has implications due to safety concerns and the recent introduction of more expensive drugs. Temperature is a major climatic factor influencing the transmission dynamics of malaria. This study looked at trends in malaria morbidity in the low risk Kenyan district of Nyandarua, coupled with data on temperature and precipitation for the years 2003-2006. July had the highest number of cases (12.2% of all cases) followed by August (10.2% of all cases). July and August also had the lowest mean maximum temperatures, 20.1 and 20.2 °C respectively. April, July and August had the highest rainfall, with daily means of 4.0, 4.3 and 4.9 mm, respectively. Observation showed that the coldest months experienced the highest number of cases of malaria. Despite the high rainfall, transmission of malaria tends to be limited by low temperatures due to the long duration required for sporogony, with fewer vectors surviving. These cold months also tend to have the highest number of cases of respiratory infections. There is a possibility that some of these were misdiagnosed as malaria based on the fact that only a small proportion of malaria cases were diagnosed using microscopy or rapid diagnostic tests. We conclude that overdiagnosis may be prevalent in this district and there may be a need to design an intervention to minimise it.

Preparation of Teacher-Trainees in Pedagogy in Kenyan Universities

ERIC Educational Resources Information Center

Genvieve, Nasimiyu

2017-01-01

There has been a concern about the quality of school teachers being prepared at the university especially in pedagogy. The main objective of the study was to investigate the preparation of teacher-trainees in pedagogy in Kenyan universities.The theoretical framework of the study was based on Shulman's concept of pedagogical content knowledge. The…

Challenges of Administering Teacher Education Programme in Kenyan Universities

ERIC Educational Resources Information Center

Genvieve, Nasimiyu

2017-01-01

Proper management of logistical issues in Teacher education programme tends to promote the quality of preparation of school teachers. The main objective of the study was to investigate challenges of administering teacher education programmes in Kenyan universities. The theoretical framework of the study was adopted as used by Koehler and Mishra's…

Transformations in Kenyan Science Teachers' Locus of Control: The Influence of Contextualized Science and Emancipated Student Learning

ERIC Educational Resources Information Center

Anderson, D.; Nashon, S.; Namazzi, E.; Okemwa, P.; Ombogo, P.; Ooko, S.; Beru, F.

2015-01-01

This study investigated Kenyan science teachers' pedagogical transformations, which manifested as they enacted and experienced a reformed contextualized science curriculum in which students' learning experiences were critical catalysts of teacher change. Twelve high school teachers voluntarily participated in the study and were interviewed about…

The attitudes of Kenyan in-school adolescents toward sexual autonomy.

PubMed

Adaji, Sunday E; Warenius, Linnea U; Ong'any, Antony A; Faxelid, Elisabeth A

2010-03-01

This was a cross-sectional study to examine the attitudes of Kenyan in-school adolescents towards premarital sex, unwanted pregnancies/abortions and contraception. Data collection was undertaken using a structured questionnaire. Kenyan in-school adolescents have conservative attitudes toward premarital sex, disagreeing that adolescent boy and girls should be left alone to satisfy their sexual needs. The girls had the view that boys have uncontrollable sexual appetites. With regards to unwanted pregnancies, the majority of the respondents disagreed with allowing abortions for pregnant school girls while they agreed that a pregnant school girl should be allowed to return to school. However, the majority of the girls held the view that a school boy who had impregnated a school girl should be expelled from school. The attitudes of the respondents to contraception were also largely conservative. The conservative attitudes of the respondents conflicts with the findings of high levels of unsafe sex and reproductive ill-health among Kenyan adolescents. There is need to help Kenyan in-school adolescents to develop more realistic attitudes toward sexuality in order to improve their reproductive health.

Classroom Interaction in Kenyan Primary Schools.

ERIC Educational Resources Information Center

Ackers, Jim; Hardman, Frank

2001-01-01

Reports on a study of classroom interaction in Kenyan primary schools. Analyzes video recordings of 102 lessons in English, mathematics, and science using systematic observation, discourse analysis, and a time-line analysis. Reveals the preponderance of teacher dominated lessons with little opportunity for student interaction. Considers…

A comparative analysis of media reporting of perceived risks and benefits of genetically modified crops and foods in Kenyan and international newspapers.

PubMed

DeRosier, Christopher; Sulemana, Iddisah; James, Harvey S; Valdivia, Corinne; Folk, William; Smith, Randall D

2015-07-01

We empirically examine the reporting on biotechnology in Kenyan and international newspapers between 2010 and early 2014. We identify news articles that reported on biotechnology and analyze their use of words to determine whether there is a balance in the reporting of perceived risks and benefits. We also consider how the sources used in news articles and how the publication of the Séralini study of rats fed genetically modified maize affect the balance of reporting of perceived risks and benefits. We find that in Kenyan news reporting, more articles mention perceived benefits than risks, but when risks are mentioned, new articles contain more references to risks than to benefits. We also find that sources affect the reporting of perceived risks and benefits and that the Séralini study increased the likelihood that perceived risks are reported in Kenyan news reporting, but not in international newspapers. © The Author(s) 2015.

Changing Pedagogical Practice in Kenyan Primary Schools: The Impact of School-Based Training

ERIC Educational Resources Information Center

Hardman, Frank; Abd-Kadir, Jan; Agg, Catherine; Migwi, James; Ndambuku, Jacinta; Smith, Fay

2009-01-01

This study reports on an investigation into the impact of a national, school-based teacher development programme on learning and teaching in Kenyan primary schools. Building on a national baseline study (n=102), 144 video-recorded lessons, covering the teaching of English, maths and science at Standards 3 and 6, were analysed to investigate…

Turkana Children's Sociocultural Practices of Pastoralist Lifestyles and Science Curriculum and Instruction in Kenyan Early Childhood Education

ERIC Educational Resources Information Center

Ng'asike, John Teria

2010-01-01

This dissertation discusses the findings of an ethnographic exploratory study of Turkana nomadic pastoralist children's sociocultural practices of their everyday lifestyles and science curriculum and instruction in Kenyan early childhood curriculum. The study uses the findings from Turkana elders to challenge the dominant society in Kenya that…

Beneath the Surface: A Narrative Inquiry into Educational and Cultural Experiences of Kenyan Adult Women Learners in U.S.A. Universities

ERIC Educational Resources Information Center

Gatua, Mary Wairimu

2011-01-01

This qualitative study examines educational and socio-cultural experiences of seven Kenyan women pursuing higher education in the United States. The study uses in depth interviews to explore the participants' socio-cultural experiences, how they negotiate their multiple identities, and their transformative learning experiences. Three theoretical…

The Discourse of Classroom Interaction in Kenyan Primary Schools

ERIC Educational Resources Information Center

Pontefract, Caroline; Hardman, Frank

2005-01-01

This paper addresses the role of classroom discourse in supporting children's learning in Kenyan primary schools. The discourse strategies of 27 teachers teaching English, mathematics and science across the primary phase were intensively studied using discourse analysis and semi-structured interviews. A survey questionnaire (n = 359) was also used…

Towards Improvement of Student Learning Outcomes: An Assessment of the Professional Development Needs of Lecturers at Kenyan Universities

ERIC Educational Resources Information Center

NaliakaMukhale, Phoebe; Hong, Zhu

2017-01-01

The aim of this study was to explore the professional development needs of lecturers at Kenyan universities. Specifically, the study investigated the challenges that lecturers and their learners face while in class. It also explored the professional development needs of the lecturers, preferred modes of delivery of the professional development…

Dimensions of Kenyan University Academic Staff's Job Satisfaction in View of Various Managerial Leadership Practices

ERIC Educational Resources Information Center

Kiplangat, Henry Kiptiony; Momanyi, Marcella; Kangethe, Ngigi Simon

2017-01-01

Attaining high levels of academic staff job satisfaction has proved to be challenging for university management. This paper is an excerpt of a study that investigated the magnitude of Kenyan University academic staff's job satisfaction based on various managerial leadership practices. The study focused on the Rift Valley Region (RVR) of Kenya. The…

Frontrunners in ICTL: Kenyan Runners' Improvement in Training, Informal Learning and Economic Opportunities Using Smartphones

ERIC Educational Resources Information Center

Hansson, Per Olof; Jobe, William

2014-01-01

The primary aim of this research was to study how mobile technology shapes, changes, and develops informal learning outside the classroom and school environment. In this study we provided each of the 30 Kenyan elite runners with a simple Android smartphone and free Internet for one year. This research project was a developmental intervention with…

Estimating the proportion of pneumonia attributable to pneumococcus in Kenyan adults: latent class analysis.

PubMed

Jokinen, Jukka; Scott, J Anthony G

2010-09-01

Community-acquired pneumonia is a common cause of hospitalization among African adults, and Streptococcus pneumoniae is assumed to be a frequent cause. Pneumococcal conjugate vaccine is currently being introduced into childhood immunization programs in Africa. The case for adult vaccination is dependent on the contribution of the pneumococcus to the hospital pneumonia burden. Pneumococcal diagnosis is complex because there is no gold standard, and culture methods are invalidated by antibiotic use. We used latent class analysis to estimate the proportion of pneumonia episodes caused by pneumococcus. Furthermore, we extended this methodology to evaluate the effect of antimicrobial treatment on test accuracies and the prevalence of the disease. The study combined data from 5 validation studies of pneumococcal diagnostic tests performed on 281 Kenyan adults with pneumonia. The proportion of pneumonia episodes attributable to pneumococcus was 0.46 (95% confidence interval = 0.36-0.57). Failure to account for the effect of antimicrobial exposure underestimates this proportion as 0.32. A history of antibiotic exposure was a poor predictor of antimicrobial activity in patients' urine. Blood culture sensitivity for pneumococcus was estimated at 0.24 among patients with antibiotic exposure, and 0.75 among those without. The large contribution of pneumococcus to adult pneumonia provides a strong case for the investigation of pneumococcal vaccines in African adults.

The Relationship between Kenyan Sign Language and English Literacy

ERIC Educational Resources Information Center

Aura, Lillie Josephine; Venville, Grady; Marais, Ida

2016-01-01

This paper presents results of an investigation into the relationship between Kenyan Sign Language (KSL) and English literacy skills. It is derived from research undertaken towards an MEd degree awarded by The University of Western Australia in 2011. The study employed a correlational survey strategy. Sixty upper primary deaf students from four…

Kenyan School and Culture.

ERIC Educational Resources Information Center

D'Souza, Henry

1980-01-01

The author defines African culture in a Kenyan context and proposes a tri-polar cultural paradigm to chart the metamorphosis of Kenyan culture from a traditional through a national to an international focus. He makes suggestions for the role of the school in promoting an international cultural standard. (Author/SJL)

An Anthropocentric Approach to Saving Biodiversity: Kenyan Pupils' Attitudes towards Parks and Wildlife

ERIC Educational Resources Information Center

Ali, Ibrahim M.

2006-01-01

This study used an unobtrusive attitude survey and questionnaires to investigate Kenyan pupils' attitudes towards parks and wildlife. The positive attitudes found result from their understanding of the link between these resources and their own wellbeing. The sentiments about parks and wildlife expressed by the pupils are an extraction of the…

Physiological and molecular analysis of selected Kenyan maize lines for aluminum tolerance

USDA-ARS?s Scientific Manuscript database

Aluminum (Al) toxicity is an important limitation to maize production in many tropical and sub-tropical acid soil areas. The aim of this study was to survey the variation in Al tolerance in a panel of maize lines adapted for Kenya and look for novel sources of Al tolerance. 112 Kenyan maize accessio...

Background and Classroom Correlates of Child Achievement, Cognitive, and Behavioural Outcomes in Rural Kenyan Schoolchildren

ERIC Educational Resources Information Center

Daley, Tamara C.; Whaley, Shannon E.; Sigman, Marian D.; Guthrie, Donald; Neumann, Charlotte G.; Bwibo, Nimrod

2005-01-01

In the current study, background data (sex, age, and SES) and classroom factors were examined as predictors of scholastic achievement and child cognitive and behavioural outcomes in a group of rural Kenyan schoolchildren during their first year of formal schooling. Previous research in this area has provided mixed results regarding the…

Conducting Action Research in Kenyan Primary Schools: A Narrative of Lived Experiences

ERIC Educational Resources Information Center

Otienoh, Ruth

2015-01-01

This paper is a narrative of my personal experiences of conducting action research in Kenyan primary schools. It highlights the opportunities, successes, challenges and dilemmas I encountered during the process: from the school hunting period, to the carrying out of the actual research in two schools, with four teachers. This study reveals that…

From Attitudes to Practice: Utilising Inclusive Teaching Strategies in Kenyan Primary Schools

ERIC Educational Resources Information Center

Elder, Brent C.; Damiani, Michelle L.; Oswago, Benson O.

2016-01-01

The purpose of this paper is to provide evidence of Kenyan primary school teachers using inclusive teaching strategies in a rural setting with many known barriers to the development of a sustainable inclusive education system. This qualitative study examines teachers' uses of inclusive teaching strategies in primary schools following a series of…

The impact of HIV / AIDS on Kenya's commercial sector.

PubMed

Forsythe, S; Roberts, M

1995-02-01

AIDSCAP is undertaking a project designed to encourage Kenya's private sector to participate in HIV/AIDS prevention efforts. Part of that project involves estimating the impact of HIV/AIDS on Kenya's commercial sector. AIDSCAP and Kenyan researcher estimates are based upon financial data from a sugar estate, a transportation company, a wood processing plant, a textile factory, and a light manufacturing company, a small sample representing the diversity of industries in the country. Most are medium-sized companies with 1200-2200 employees. Preliminary results suggest that absenteeism, training costs, and HIV-related health care will cause the greatest losses to Kenyan businesses. Projections show that the HIV/AIDS epidemic could increase labor costs for some Kenyan businesses by 17% by the year 2005. Despite increasing labor costs, however, the epidemic may not cause a significant drop in profits for larger, capital-intensive Kenyan businesses. Some companies could still find their profits cut by 15-25% within the next 10 years. Study findings and implications for workplace prevention programs are discussed.

A Second Chance to Dream: Initiating ODeL in Secondary School Re-Entry Programs for Young Adult Secondary School Dropouts the Case of Mumias District, Western Kenya

ERIC Educational Resources Information Center

Musita, Richard; Ogange, Betty O.; Lugendo, Dorine

2018-01-01

The Kenyan education system has very limited re-entry options for learners who drop out before attaining secondary school certificate. It is very difficult to access training and or secure a job that requires at least secondary school education. This study examined the prospects of initiating Open and Distance e-Learning(ODeL) in re-entry…

Fatherhood in Kenyan Ethnic Communities: Implication for Child Development

ERIC Educational Resources Information Center

Lasser, Jon; Fite, Kathleen; Wadende, Akinyi P.

2011-01-01

This article reviews the traditional and evolving constructions of fatherhood in Kenyan society, with an emphasis on fatherhood's impact on child development outcomes. Western influence and increased access to technology have changed the role of the Kenyan father, and in turn affected his role in the family. Special attention is given to…

Teachers' Changing Roles in Computer Assisted Roles in Kenyan Secondary Schools

ERIC Educational Resources Information Center

Tanui, Edward K.; Kiboss, Joel K.; Walaba, Aggrey A.; Nassiuma, Dankit

2008-01-01

The use of computer technology in Kenyan schools is a relatively new approach that is currently being included in the school curriculum. The introduction of computer technology for use in teaching does not always seem to be accepted outright by most teachers. The purpose of the study reported in this paper was to investigate the teachers' changing…

An Exploratory Factor Analysis of the Brief COPE with a Sample of Kenyan Caregivers

ERIC Educational Resources Information Center

Kimemia, Muthoni; Asner-Self, Kimberly K.; Daire, Andrew P.

2011-01-01

Given the high prevalence of HIV/AIDS in Kenya, more Kenyans now find themselves in the role of informal caregiver for a family member or multiple family members living with HIV/AIDS. However, there exists little research on how these individuals cope. The present study explores coping responses among caregivers for family members living with…

Male and female Ethiopian and Kenyan runners are the fastest and the youngest in both half and full marathon.

PubMed

Knechtle, Beat; Nikolaidis, Pantelis T; Onywera, Vincent O; Zingg, Matthias A; Rosemann, Thomas; Rüst, Christoph A

2016-01-01

In major marathon races such as the 'World Marathon Majors', female and male East African runners particularly from Ethiopia and Kenya are the fastest. However, whether this trend appears for female and male Ethiopians and Kenyans at recreational level runners (i.e. races at national level) and in shorter road races (e.g. in half-marathon races) has not been studied yet. Thus, the aim of the present study was to examine differences in the performance and the age of female and male runners from East Africa (i.e. Ethiopians and Kenyans) between half- and full marathons. Data from 508,108 athletes (125,894 female and 328,430 male half-marathoners and 10,205 female and 43,489 male marathoners) originating from 126 countries and competing between 1999 and 2014 in all road-based half-marathons and marathons held in one country (Switzerland) were analysed using Chi square (χ(2)) tests, mixed-effects regression analyses and one-way analyses of variance. In half-marathons, 48 women (0.038 %) and 63 men (0.019 %) were from Ethiopia and 80 women (0.063 %) and 134 men (0.040 %) from Kenya. In marathons, three women (0.029 %) and 15 men (0.034 %) were from Ethiopia and two women (0.019 %) and 33 men (0.075 %) from Kenya. There was no statistically significant association between the nationality of East Africans and the format of a race. In both women and men, the fastest race times in half-marathons and marathons were achieved by East African runners (p < 0.001). Ethiopian and Kenyan runners were the youngest in both sexes and formats of race (p < 0.001). In summary, women and men from Ethiopia and Kenya, despite they accounted for <0.1 % in half-marathons and marathons, achieved the fastest race times and were the youngest in both half-marathons and marathons. These findings confirmed in the case of half-marathon the trend previously observed in marathon races for a better performance and a younger age in East African runners from Ethiopia and Kenya.

Urbanisation and the nutrition transition: a comparison of diet and weight status of South African and Kenyan women.

PubMed

Steyn, Nelia P; Nel, Johanna H; Parker, W; Ayah, Rosemary; Mbithe, Dorcus

2012-05-01

To determine and compare the extent of the nutrition transition between Kenyan and South African women. A nationally representative sample of women aged ≥15 years (n=1008) was assessed in Kenya. Weight, height, and waist and hip circumferences were measured. A 24-hour dietary recall was conducted with each participant. This data was compared with data of the Demographic and Health Survey (DHS) of women in South Africa (n=4481). Dietary intake of South African women was based on secondary data analysis of dietary studies using the 24-hour recall method (n=1726). In South Africa, 27.4% women had a BMI ≥30 kg/m(2) compared with 14.2% of Kenyan women. In both countries there were large urban-rural differences in BMI, with the highest prevalence in women in urban areas. BMI increased with age, as did abdominal obesity which was equally prolific in both countries with more than 45% of women in the older groups having a waist/hip ratio ≥0.85. The nutrient mean adequacy ratio (MAR) of the South African rural diet was lower than those of the Kenyans diet (55.9; 57.3%, respectively). Dietary diversity score (DDS) and food variety score (FVS) were significantly lower in South African rural women (3.3; 4.9) compared with Kenyans (4.5; 6.8). Urban-rural differences in diet and weight status indicates that the nutrition transition was similar in both countries despite large sociodemographic differences; however, rural Kenyan women had a better MAR, DDS, and FVS than South African women, most probably due to 60% having access to land.

Clinical Pharmacy Consultations Provided by American and Kenyan Pharmacy Students During an Acute Care Advanced Pharmacy Practice Experience

PubMed Central

Pastakia, Sonak D.; Manji, Imran; Kamau, Evelyn; Schellhase, Ellen M.

2011-01-01

Objective To compare the clinical consultations provided by American and Kenyan pharmacy students in an acute care setting in a developing country. Methods The documented pharmacy consultation recommendations made by American and Kenyan pharmacy students during patient care rounds on an advanced pharmacy practice experience at a referral hospital in Kenya were reviewed and classified according to type of intervention and therapeutic area. Results The Kenyan students documented more interventions than American students (16.7 vs. 12.0 interventions/day) and provided significantly more consultations regarding human immunodeficiency virus (HIV) and antibiotics. The top area of consultations provided by American students was cardiovascular diseases. Conclusions American and Kenyan pharmacy students successfully providing clinical pharmacy consultations in a resource-constrained, acute-care practice setting suggests an important role for pharmacy students in the reconciliation of prescriber orders with medication administration records and in providing drug information. PMID:21655396

`No One Should Destroy the Forest': Using photo-based vignette interviews to understand Kenyan teachers' views of the environment

NASA Astrophysics Data System (ADS)

Quigley, Cassie F.; Miller, Zachary D.; Dogbey, James; Che, S. Megan; Hallo, Jeffrey

2014-11-01

In the midst of the current environmental crisis, scientists, academics, authors, and politicians worldwide are urging citizens to create sustainable communities. However, there is little capability to build a sustainable society without an informed, active, and engaged populous. This requires more than just environmentally knowledgeable citizens. It requires a society that understands the principles of the environment and can also exemplify them in daily life. In order to create a more environmentally literate world, there has been a push for environmental education integrated into schools. This qualitative study sought to examine Kenyan teachers' perspectives on the human-nature interaction by conducting vignette focus-group interviews. It is a subject not widely explored but vital for conservation not only in this area, but also other areas that seek to have an ecological informed populous. The vignettes were created using photographs and explanations of the photographs that the participants collected and emailed to the authors. For the focus-group vignette interviews, there were a total of 55 participants (30 females and 25 males). After InVivo analysis, we had 6 codes (resentment, pride, perils, blame, pragmatism, and self-interested) within 3 major themes. This study has implications for informing science education to combat these traditions of subjecting students to a science curriculum that demotes Kenyan cultural heritage and lifestyle. By incorporating local knowledge such as the ideas discussed in this paper into Kenyan science education, Kenyans can reach one of most challenging objectives of education, which is to produce children who are fundamentally aware of their environment.

Food biotechnology and nutrition in Africa: a case for Kenya.

PubMed

Ngichabe, Christopher K

2002-12-01

Household food consumption surveys indicate that the diet in Kenya is ill balanced and that many families cannot afford nutrient-rich foods such as meat and fruits. In this regard, rural populations-the majority of the Kenyan population-are much worse off than urban populations. Agriculture, the most important sector in the Kenyan economy, contributes 27% of the gross domestic product and generates 65% of the country's export earnings. Food-enhancing biotechnologies thus could increase national food yields and fill nutrition gaps by contributing to household and national food security and poverty reduction in Kenya. To overcome barriers to adopting biotechnology to improve food crops in Kenya and elsewhere in Africa, policy makers must create a receptive environment for, increase public understanding of, and stimulate investment in the new technology.

The Discourse of Whole Class Teaching: A Comparative Study of Kenyan and Nigerian Primary English Lessons

ERIC Educational Resources Information Center

Abd-Kadir, Jan; Hardman, Frank

2007-01-01

This paper explores the discourse of whole class teaching in Kenyan and Nigerian primary school English lessons. Twenty lessons were analysed using a system of discourse analysis focusing on the teacher-led three-part exchange sequence of Initiation-Response-Feedback (IRF). The focus of the analysis was on the first and third part of the IRF…

Informal, Moralistic Health Education in Kenyan Teacher Education and How It Influences the Professional Identity of Student-Teachers

ERIC Educational Resources Information Center

Dahl, Kari K. B.

2015-01-01

This study explores informal health education with a moralistic content in three Kenyan teacher training colleges and what it means for the development of a professional identity in health education student-teachers on a continent affected by far the largest number of health problems. Informal health education with a moralistic content is a kind…

Writings of Lions: Narrative Inquiry of a Kenyan Couple Living in the U.S.

ERIC Educational Resources Information Center

Gilmore, Miranda; Miller, Marianne McInnes

2013-01-01

In this study, we told the story of a Kenyan couple, B. and F., who has left Kenya and moved to Southern California. We followed a narrative inquiry framework, using Clandinin and Connelly's (2000) guidelines. We delineated core components of narrative inquiry research, as well as related the journey of B. and F., who have created dual lives in…

A Review of the Participation of Disabled Persons in the Labour Force: The Kenyan Context

ERIC Educational Resources Information Center

Opini, Bathseba M.

2010-01-01

This paper presents a review of the challenges that disabled people experience in participating in the Kenyan labour market. It draws on existing literature and on a narrative of the experiences of one disabled academic in a Kenyan university to highlight some of the forms of discrimination that disabled people have to cope with in their…

School Based Factors Affecting Learning of Kenyan Sign Language in Primary Schools for Hearing Impaired in Embu and Isiolo Counties, Kenya

ERIC Educational Resources Information Center

Rwaimba, Samuel Muthomi

2016-01-01

This was a descriptive survey study design which sought to establish the school based factors that affect the learning of Kenyan Sign Language in primary schools for learners with hearing impairment in Embu and Isiolo counties in Kenya. The target population was all teachers teaching in primary schools for learners with hearing impairment in the…

Social scripts and stark realities: Kenyan adolescents' abortion discourse.

PubMed

Mitchell, Ellen M H; Halpern, Carolyn Tucker; Kamathi, Eva Muthuuri; Owino, Shirley

2006-01-01

This study explores students' narratives and discourses about adolescent pregnancy and abortion elicited via internet-based open-ended questions posed in response to a cartoon vignette. We report on content analysis of recommendations and strategies for how to manage the unplanned pregnancy of a fictional young couple and in their own personal lives. The responses of 614 young people were analysed. Strategies vary widely. They include giving birth, adoption, running away, abortion, denial, and postponement until discovery. Young people were also queried about unplanned pregnancy resolution among their peers. Discourse analysis reveals competing social scripts on abortion. Florid condemnation of abortion acts in the hypothetical cases contrasts with more frank and sober description of peers' real life abortion behaviour. Students' language is compared with that found in official curricula. The rhetorical devices, moralizing social scripts and dubious health claims about abortion in students' online narratives mirror the tenor and content of their academic curricula as well as Kenyan media presentation of the issue. The need for factual information, dispassionate dialogue and improved contraceptive access is considerable.

An observational study of monitoring of vital signs in children admitted to Kenyan hospitals: an insight into the quality of nursing care?

PubMed

Ogero, Morris; Ayieko, Philip; Makone, Boniface; Julius, Thomas; Malla, Lucas; Oliwa, Jacquie; Irimu, Grace; English, Mike

2018-06-01

Measurement and correct interpretation of vital signs is part of routine clinical care. Repeated measurement enhances early recognition of deterioration, may help prevent morbidity and mortality and is a standard of care in most countries. To examine documentation of vital signs by clinicians for admissions to paediatric wards in Kenyan hospitals, to describe monitoring frequency by nurses and explore factors influencing frequency. Vital signs information (temperature, respiratory and pulse rate) for the first 48 hours of admission was collected from case records of children admitted with non-surgical conditions to 13 Kenyan county hospitals between September 2013 and April 2016. A mixed effect negative binomial regression model was used to explore whether the severity of illness (indicated by danger signs or severe diagnostic episodes) is associated with increased vital signs observation frequency. We examined 54 800 admission episodes with an overall mortality 6.1%. Nurse to bed ratios were very low (1:10 to 1:41 across hospitals). Admitting clinicians documented all or no vital signs in 57.0% and 8.4% cases respectively. For respiratory and pulse rates there was pronounced even end-digit preference (an indicator of incorrect information) and high frequency recording of specific values ( P  < 0.001) suggesting approximation. Monitoring frequency was explored in 41 738 children. Those with inpatient stays ≥48 hours were expected to have a vital signs count of 18, hospitals varied but most did not achieve this benchmark (median 9, range 2-30). There were clinically small but significant associations between vital signs count and presence of multiple severe illnesses or presence of severe pallor (adjusted relative risk ratio = 1.04, P  < 0.01, 95% confidence interval CI = 1.02-1.06 and 1.05, P  = 0.02, 95% CI = 1.01-1.09, respectively). Data suggest accurate admission measures are sometimes missing especially for pulse and respiratory rates, possibly linked to manual measurement. Monitoring frequency is often low in the high risk population studied probably indicating how quality of nursing care is undermined by considerable human resource shortages.

An observational study of monitoring of vital signs in children admitted to Kenyan hospitals: an insight into the quality of nursing care?

PubMed Central

Ogero, Morris; Ayieko, Philip; Makone, Boniface; Julius, Thomas; Malla, Lucas; Oliwa, Jacquie; Irimu, Grace; English, Mike

2018-01-01

Background Measurement and correct interpretation of vital signs is part of routine clinical care. Repeated measurement enhances early recognition of deterioration, may help prevent morbidity and mortality and is a standard of care in most countries. Objective To examine documentation of vital signs by clinicians for admissions to paediatric wards in Kenyan hospitals, to describe monitoring frequency by nurses and explore factors influencing frequency. Methods Vital signs information (temperature, respiratory and pulse rate) for the first 48 hours of admission was collected from case records of children admitted with non-surgical conditions to 13 Kenyan county hospitals between September 2013 and April 2016. A mixed effect negative binomial regression model was used to explore whether the severity of illness (indicated by danger signs or severe diagnostic episodes) is associated with increased vital signs observation frequency. Results We examined 54 800 admission episodes with an overall mortality 6.1%. Nurse to bed ratios were very low (1:10 to 1:41 across hospitals). Admitting clinicians documented all or no vital signs in 57.0% and 8.4% cases respectively. For respiratory and pulse rates there was pronounced even end-digit preference (an indicator of incorrect information) and high frequency recording of specific values (P < 0.001) suggesting approximation. Monitoring frequency was explored in 41 738 children. Those with inpatient stays ≥48 hours were expected to have a vital signs count of 18, hospitals varied but most did not achieve this benchmark (median 9, range 2-30). There were clinically small but significant associations between vital signs count and presence of multiple severe illnesses or presence of severe pallor (adjusted relative risk ratio = 1.04, P < 0.01, 95% confidence interval CI = 1.02-1.06 and 1.05, P = 0.02, 95% CI = 1.01-1.09, respectively). Conclusions Data suggest accurate admission measures are sometimes missing especially for pulse and respiratory rates, possibly linked to manual measurement. Monitoring frequency is often low in the high risk population studied probably indicating how quality of nursing care is undermined by considerable human resource shortages. PMID:29497504

The impact of onset controllability on stigmatization and supportive communication goals toward persons with HIV versus lung cancer: a comparison between Kenyan and U.S. participants.

PubMed

Miller, Ann Neville; Fellows, Kelli L; Kizito, Mary N

2007-01-01

This study examined the impact of controllability of onset (i.e., means of transmission), disease type (HIV and lung cancer), and culture (Kenya and U.S.) on stigmatizing attitudes and goals for supportive communication. Four hundred sixty-four Kenyan students and 526 American students, and 441 Kenyan nonstudents and 591 American nonstudents were randomly assigned to 1 of 12 hypothetical scenario conditions and asked to respond to questions regarding 3 different types of stigmatizing attitudes and 6 types of supportive communication goals with respect to the character in the scenario. Means of transmission had a strong effect on the blame component of stigma, but none on cognitive attitudes and social interaction components. Similarly, although an effect for means of transmission emerged on intention to provide "recognize own responsibility" and "see others' blame" types of support, no effect was evident for most other supportive interaction goals. Although effects for culture were small, Kenyan participants, student and nonstudent alike, were not as quick as American participants to adopt goals of communicating blame in any direction. Implications for measurement of stigma in future research are discussed.

Genotyping of enteroviruses isolated in Kenya from pediatric patients using partial VP1 region.

PubMed

Opanda, Silvanos M; Wamunyokoli, Fred; Khamadi, Samoel; Coldren, Rodney; Bulimo, Wallace D

2016-01-01

Enteroviruses (EV) are responsible for a wide range of clinical diseases in humans. Though studied broadly in several regions of the world, the genetic diversity of human enteroviruses (HEV) circulating in the sub-Saharan Africa remains under-documented. In the current study, we molecularly typed 61 HEV strains isolated in Kenya between 2008 and 2011 targeting the 3'-end of the VP1 gene. Viral RNA was extracted from the archived isolates and part of the VP1 gene amplified by RT-PCR, followed by sequence analysis. Twenty-two different EV types were detected. Majority (72.0 %) of these belonged to Enterovirus B species followed by Enterovirus D (21.3 %) and Enterovirus A (6.5 %). The most frequently detected types were Enterovirus-D68 (EV-D68), followed by Coxsackievirus B2 (CV-B2), CV-B1, CV-B4 and CV-B3. Phylogenetic analyses of these viruses revealed that Kenyan CV-B1 isolates were segregated among sequences of global CV-B1 strains. Conversely, the Kenyan CV-B2, CV-B3, CV-B4 and EV-D68 strains generally grouped together with those detected from other countries. Notably, the Kenyan EV-D68 strains largely clustered with sequences of global strains obtained between 2008 and 2010 than those circulating in recent years. Overall, our results indicate that HEV strains belonging to Enterovirus D and Enterovirus B species pre-dominantly circulated and played a significant role in pediatric respiratory infection in Kenya, during the study period. The Kenyan CV-B1 strains were genetically divergent from those circulating in other countries. Phylogenetic clustering of Kenyan EV-D68 strains with sequences of global strains circulating between 2008 and 2010 than those obtained in recent years suggests a high genomic variability associated with the surface protein encoding VP1 gene in these enteroviruses.

``I Have Been Given the Power to Teach. The Children Understand Me Very Well.'' The Social and Academic Impact of Deaf Teacher Training in Kenya

NASA Astrophysics Data System (ADS)

Johnstone, Christopher; Corce, Heidi

2010-02-01

Kenya has 41 Deaf schools that serve children from Class 1 through secondary school. These schools are all characterised by the fact that they have very few teachers who are fluent in Kenyan sign language. In order to meet the needs of schools and to provide employment opportunities for Deaf Kenyan adults, a small non-governmental organisation identified Deaf secondary school students for training. They received two years of teacher training free of charge. Most have since been awarded teaching contracts by the Kenyan Teacher Service Commission or local school boards. This article reports on results from a preliminary study of the social and academic impacts of this innovation. Results indicate that Deaf teachers are inspirational in the classroom, represent a significant resource for their school communities and are preferred by Deaf students. A follow-up study on the relative learning gains of Deaf students when taught by Deaf teachers is planned once relevant data are available.

The Nature, Challenges and Consequences of Urban Youth Unemployment: A Case of Nairobi City, Kenya

ERIC Educational Resources Information Center

Muiya, Bernard Munyao

2014-01-01

Globally, decline in employment has affected the youth more compared to other cohorts with youth in developing countries being particularly hard hit. There have been various interventions by the Kenyan government to address the challenge of youth employment through human capital development like the Youth Enterprise Development Fund (YEFD).…

Elusive Search for Quality Education: The Case of Quality Assurance and Teacher Accountability

ERIC Educational Resources Information Center

Odhiambo, George

2008-01-01

Purpose: The purpose of this paper is to examine issues of quality and quality assurance in Kenyan schools, identify reasons why Kenya government has difficulties in achieving its well documented search for quality education and to trace the process for ensuring the accountability of teachers in Kenya. This focus is done under conditions of…

Dissociation between running economy and running performance in elite Kenyan distance runners.

PubMed

Mooses, Martin; Mooses, Kerli; Haile, Diresibachew Wondimu; Durussel, Jérôme; Kaasik, Priit; Pitsiladis, Yannis Paul

2015-01-01

The purpose of this study was to investigate the relationship between running economy (RE) and performance in a homogenous group of competitive Kenyan distance runners. Maximal aerobic capacity (VO2max) (68.8 ± 3.8 ml∙kg(-1)∙min(-1)) was determined on a motorised treadmill in 32 Kenyan (25.3 ± 5.0 years; IAAF performance score: 993 ± 77 p) distance runners. Leg anthropometry was assessed and moment arm of the Achilles tendon determined. While Achilles moment arm was associated with better RE (r(2) = 0.30, P = 0.003) and upper leg length, total leg length and total leg length to body height ratio were correlated with running performance (r = 0.42, P = 0.025; r = 0.40, P = 0.030 and r = 0.38, P = 0.043, respectively), RE and maximal time on treadmill (t(max)) were not associated with running performance (r = -0.01, P = 0.965; r = 0.27; P = 0.189, respectively) in competitive Kenyan distance runners. The dissociation between RE and running performance in this homogenous group of runners would suggest that RE can be compensated by other factors to maintain high performance levels and is in line with the idea that RE is only one of many factors explaining elite running performance.

Impact of biogas digesters on wood utilisation and self-reported back pain for women living on rural Kenyan smallholder dairy farms.

PubMed

Dohoo, Carolyn; VanLeeuwen, John; Read Guernsey, Judith; Critchley, Kim; Gibson, Mark

2013-01-01

Women living on rural Kenyan dairy farms spend significant amounts of time collecting wood for cooking. Biogas digesters, which generate biogas for cooking from the anaerobic decomposition of livestock manure, are an alternative fuel source. The objective of this study was to quantify the quality of life and health benefits of installing biogas digesters on rural Kenyan dairy farms with respect to wood utilisation. Women from 62 farms (31 biogas farms and 31 referent farms) participated in interviews to determine reliance on wood and the impact of biogas digesters on this reliance. Self-reported back pain, time spent collecting wood and money spent on wood were significantly lower (p < 0.01) for the biogas group, compared to referent farms. Multivariable linear regression showed that wood consumption increased by 2 lbs/day for each additional family member living on a farm. For an average family of three people, the addition of one cow was associated with increased wood consumption by 1.0 lb/day on biogas farms but by 4.4 lbs/day on referent farms (significant interaction variable - likely due to additional hot water for cleaning milk collection equipment). Biogas digesters represent a potentially important technology that can reduce reliance on wood fuel and improve health for Kenyan dairy farmers.

Emotional and Behavioral Problems among Impoverished Kenyan Youth: Factor Structure and Sex-Differences

PubMed Central

Harder, Valerie S.; Mutiso, Victoria N.; Khasakhala, Lincoln I.; Burke, Heather M.; Rettew, David C.; Ivanova, Masha Y.; Ndetei, David M.

2014-01-01

Data on youth emotional and behavioral problems from societies in Sub-Saharan Africa are lacking. This may be due to the fact that few youth mental health assessments have been tested for construct validity of syndrome structure across multicultural societies that include developing countries, and almost none have been tested in Sub-Saharan Africa. The Youth Self-Report (YSR), for example, has shown great consistency of its syndrome structure across many cultures, yet data from only one developing country in Sub-Saharan Africa have been included. In this study, we test the factor structure of YSR syndromes among Kenyan youth ages 11–18 years from an informal settlement in Nairobi, Kenya and examine sex-differences in levels of emotional and behavioral problems. We find the eight syndrome structure of the YSR to fit these data well (Root Mean Square Error of Approximation=.049). While Kenyan girls have significantly higher internalizing (Anxious/Depressed, Withdrawn/Depressed, Somatic) problem scores than boys, these differences are of similar magnitude to published multicultural findings. The results support the generalizability of the YSR syndrome structure to Kenyan youth and are in line with multicultural findings supporting the YSR as an assessment of emotional and behavioral problems in diverse societies. PMID:25419046

Volcanic unrest in Kenya: geological history from a satellite perspective

NASA Astrophysics Data System (ADS)

Robertson, E.; Biggs, J.; Edmonds, M.; Vye-Brown, C.

2013-12-01

The East African Rift (EAR) system is a 5,000 km long series of fault bounded depressions that run from Djibouti to Mozambique. In the Kenyan Rift, fourteen Quaternary volcanoes lie along the central rift axis. These volcanoes are principally composed of trachyte pyroclastics and trachyte and basaltic lavas forming low-angle multi-vent edifices. Between 1997 and 2008, geodetic activity has been observed at five Kenyan volcanoes, all of which have undergone periods of caldera collapse and explosive activity. We present a remote-sensing study to investigate the temporal and spatial development of volcanic activity at Longonot volcano. High-resolution mapping using ArcGIS and an immersive 3D visualisation suite (GeovisionaryTM) has been used with imagery derived from ASTER, SPOT5 and GDEM data to identify boundaries of eruptive units and establish relative age in order to add further detail to Longonot's recent eruptive history. Mapping of the deposits at Longonot is key to understand the recent geological history and forms the basis for future volcanic hazard research to inform risk assessments and mitigation programs in Kenya. Calderas at Kenyan volcanoes are elliptical in plan view and we use high-resolution imagery to investigate the regional stresses and structural control leading to the formation of these elliptical calderas. We find that volcanoes in the central and northern segments of the Kenyan rift are elongated nearly parallel to the direction of least horizontal compressive stress, likely as a reflection of the direction of the plate motion vector at the time of caldera collapse. The southern volcanoes however are elongated at an acute angle to the plate motion vector, most likely as a result of oblique opening of the Kenyan rift in this region.

Financing Information Communication Technology Projects in Secondary Schools E-Learning: A Case of Mombasa County, Kenya

ERIC Educational Resources Information Center

Wangila, Violet Muyoka

2015-01-01

Information communication and technology (ICTs) has become common place entities in all aspects of life. Within the education sector, ICT has begun to have a special attention although not extensively as in other fields both globally and locally. Limited funds still presents a challenge in rolling out the e-school projects in Kenyan secondary…

Investment in Human Capital through Institutions of Higher Education for the Revival of Kenya's Economy

ERIC Educational Resources Information Center

Wawire, Nelson W.; Nafukho, Fredrick M.

2006-01-01

Despite economic theory postulating that increases in investment in human capital and physical capital leads to increase in economic growth, in the Kenyan case, this has not been true. This paper empirically examines the contribution of human capital and physical capital to economic growth in Kenya. Measures to be undertaken by higher education…

Kenyan Nurses Involvement in National Policy Development Processes

PubMed Central

Juma, Pamela Atieno

2014-01-01

The aim of this study was to critically examine how nurses have been involved in national policy processes in the Kenyan health sector. The paper reports qualitative results from a larger mixed method study. National nonnursing decision-makers and nurse leaders, and provincial managers as well as frontline nurse managers from two Kenyan districts were purposefully selected for interviews. Interviews dealt with nurses' involvement in national policy processes, factors hindering nurses' engagement in policy processes, and ways to enhance nurses' involvement in policy processes. Critical theory and feminist perspectives guided the study process. Content analysis of data was conducted. Findings revealed that nurses' involvement in policy processes in Kenya was limited. Only a few nurse leaders were involved in national policy committees as a result of their positions in the sector. Critical analysis of the findings revealed that hierarchies and structural factors as well as nursing professional issues were the primary barriers constraining nurses' involvement in policy processes. Thus, there is need to address these factors both by nurses themselves and by nonnursing decision makers, in order to enhance nurses engagement in policy making and further the contribution to quality of services to the communities. PMID:25349731

Adverse Childhood Experiences Predict Alcohol Consumption Patterns Among Kenyan Mothers.

PubMed

Goodman, Michael L; Grouls, Astrid; Chen, Catherine X; Keiser, Philip H; Gitari, Stanley

2017-04-16

We analyze whether adverse childhood experiences predict weekly alcohol consumption patterns of Kenyan mothers and their partners. Randomly selected respondents (n = 1,976) were asked about adverse childhood experiences and alcohol consumption patterns for themselves and their partners. Fixed effect models were used to determine odds of reporting weekly alcohol consumption and the number of beverages typically consumed, controlling for wealth, age, education, and partner alcohol consumption. Cumulative adverse childhood experiences predicted higher odds of weekly alcohol consumption of the respondent and her partner. Childhood exposure to physical abuse, emotional neglect, and mental illness in the household significantly increased odds of weekly alcohol consumption by the respondent. More drinks consumed per typical session were higher among respondents with more cumulative adversities. Physical and emotional abuse significantly predicted number of drinks typically consumed by the respondent. To our knowledge, this is the first study to explore and find associations between adverse childhood experiences and alcohol consumption in Kenya. Consistent with high-income settings, exposure to childhood adversities predicted greater alcohol consumption among Kenyan women.

Language Policy and Science Instruction in Kenyan Primary Schools.

ERIC Educational Resources Information Center

Cleghorn, Ailie; And Others

1989-01-01

Describes the difficulties encountered in Kenyan eighth grade science instruction when language policy restricts the use of local vernacular terms. Provides examples from three schools with differing policies on the use of English, Swahili, and tribal languages. Contains 21 references. (SV)

Shorter Ground Contact Time and Better Running Economy: Evidence From Female Kenyan Runners.

PubMed

Mooses, Martin; Haile, Diresibachew W; Ojiambo, Robert; Sang, Meshack; Mooses, Kerli; Lane, Amy R; Hackney, Anthony C

2018-06-25

Mooses, M, Haile, DW, Ojiambo, R, Sang, M, Mooses, K, Lane, AR, and Hackney, AC. Shorter ground contact time and better running economy: evidence from female Kenyan runners. J Strength Cond Res XX(X): 000-000, 2018-Previously, it has been concluded that the improvement in running economy (RE) might be considered as a key to the continued improvement in performance when no further increase in V[Combining Dot Above]O2max is observed. To date, RE has been extensively studied among male East African distance runners. By contrast, there is a paucity of data on the RE of female East African runners. A total of 10 female Kenyan runners performed 3 × 1,600-m steady-state run trials on a flat outdoor clay track (400-m lap) at the intensities that corresponded to their everyday training intensities for easy, moderate, and fast running. Running economy together with gait characteristics was determined. Participants showed moderate to very good RE at the first (202 ± 26 ml·kg·km) and second (188 ± 12 ml·kg·km) run trials, respectively. Correlation analysis revealed significant relationship between ground contact time (GCT) and RE at the second run (r = 0.782; p = 0.022), which represented the intensity of anaerobic threshold. This study is the first to report the RE and gait characteristics of East African female athletes measured under everyday training settings. We provided the evidence that GCT is associated with the superior RE of the female Kenyan runners.

Supporting early career health investigators in Kenya: A qualitative study of HIV/AIDS research capacity building.

PubMed

Daniels, Joseph; Nduati, Ruth; Kiarie, James; Farquhar, Carey

2015-01-01

Strategies to transfer international health research training programs to sub-Saharan African institutions focus on developing cadres of local investigators who will lead such programs. Using a critical leadership theory framework, we conducted a qualitative study of one program to understand how collaborative training and research can support early career investigators in Kenya toward the program transfer goal. We used purposive sampling methods and a semi-structured protocol to conduct in-depth interviews with US (N = 5) and Kenyan (N = 5) independent investigators. Transcripts were coded using a two-step process, and then compared with each other to identify major themes. A limited local research environment, funding needs and research career mentorship were identified as major influences on early career researchers. Institutional demands on Kenyan faculty to teach rather than complete research restricted investigators' ability to develop research careers. This was coupled with lack of local funding to support research. Sustainable collaborations between Kenyan, US and other international investigators were perceived to mitigate these challenges and support early career investigators who would help build a robust local research environment for training. Mutually beneficial collaborations between Kenyan and US investigators developed during training mitigate these challenges and build a supportive research environment for training. In these collaborations, early career investigators learn how to navigate the complex international research environment to build local HIV research capacity. Shared and mutually beneficial resources within international research collaborations are required to support early career investigators and plans to transfer health research training to African institutions.

Challenges in the Decentralization of Recruitment and Selection of Teachers in Kenyan Secondary Schools: A Case of Gucha District

ERIC Educational Resources Information Center

Moraa, Samba Serah; Chepkoech, Koske Luciana; Simiyu, Mulongo Leonard

2017-01-01

Decentralization of teacher recruitment and selection in Kenya was as a result of World Bank/IMF policies, which support projects that guarantee direct net economic returns by productivity and indirect returns on externalities. The approach has been used as a way of improving service delivery. This strategy that has been successful elsewhere may…

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kenda, W.; Shrivastava, V.K.

A Definitional Mission team evaluated the prospects of the US Trade and Development Program (TDP) funding a feasibility study that would assist the Government of Kenya in developing power cogeneration plants in three Kenyan sugar factories and possibly two more that are now in the planning stage or construction. The major Kenyan sugar producing region around Kisumu, on Lake Victoria has climatic conditions that permit cane growing operations ideally suitable for cogeneration of power in sugar factories. The total potentially available capacity from the proposed rehabilitation of the three mills will be approximately 25.15 MW, or 5.7 percent of totalmore » electricity production.« less

Valuing Recreational Benefits of Coral Reefs: The Case of Mombasa Marine National Park and Reserve, Kenya

NASA Astrophysics Data System (ADS)

Ransom, Kevin P.; Mangi, Stephen C.

2010-01-01

A contingent valuation study was conducted with adult Kenyan citizens and foreign tourists to estimate the value of recreational benefits arising from coral reefs at Mombasa Marine National Park and Reserve (MMNPR), and to assess the implications for local reef management. Citizen and foreign visitors to MMNPR were willing to pay an extra 2.2 (median = 1.6) and 8 (median = 6.7) per visit respectively, in addition to current park entrance fees, to support reef quality improvements. By aggregating visitors’ willingness to pay bids over the number of visitors to MMNPR in 2006-2007 the value of benefits was estimated at 346,733, which was more than twice the total annual operational expenditure of 152,383 for MMNPR. The findings indicate that annual revenues from citizen and foreign visitors may be increased by 60% to 261,932 through the implementation of proposed higher park fees of 3.10 for citizens and 15 for foreign visitors. However, any fee increase would serve to intensify concerns among citizens that only relatively affluent Kenyans can afford to visit MMNPR. Park managers need to demonstrate that the extra revenue would be used to fund the proposed conservation activities. This valuation study demonstrates that visitors are prepared to pay higher user fees for access to the marine protected area revealing considerable untapped resource to finance reef quality improvements.

Valuing recreational benefits of coral reefs: the case of Mombasa Marine National Park and Reserve, Kenya.

PubMed

Ransom, Kevin P; Mangi, Stephen C

2010-01-01

A contingent valuation study was conducted with adult Kenyan citizens and foreign tourists to estimate the value of recreational benefits arising from coral reefs at Mombasa Marine National Park and Reserve (MMNPR), and to assess the implications for local reef management. Citizen and foreign visitors to MMNPR were willing to pay an extra $2.2 (median = $1.6) and $8 (median = $6.7) per visit respectively, in addition to current park entrance fees, to support reef quality improvements. By aggregating visitors' willingness to pay bids over the number of visitors to MMNPR in 2006-2007 the value of benefits was estimated at $346,733, which was more than twice the total annual operational expenditure of $152,383 for MMNPR. The findings indicate that annual revenues from citizen and foreign visitors may be increased by 60% to $261,932 through the implementation of proposed higher park fees of $3.10 for citizens and $15 for foreign visitors. However, any fee increase would serve to intensify concerns among citizens that only relatively affluent Kenyans can afford to visit MMNPR. Park managers need to demonstrate that the extra revenue would be used to fund the proposed conservation activities. This valuation study demonstrates that visitors are prepared to pay higher user fees for access to the marine protected area revealing considerable untapped resource to finance reef quality improvements.

Career Experiences of Women Academicians in Kenyan Institutions of Higher Learning

ERIC Educational Resources Information Center

Nanyama, Evalyne

2012-01-01

Currently, women academicians in Kenya are underrepresented at all levels in Kenyan IHL, leading to less participation and integration into the administration and governance of higher institutions. As a result women academicians have little chance of making meaningful contributions to important policies and decisions that affect the institutions…

Pedometer-determined physical activity of Western Kenyan children.

PubMed

Croteau, Karen; Schofield, Grant; Towle, George; Suresh, Vijiayarani

2011-08-01

It is speculated that rural Kenyan children are more physically active than those in developed countries. The purpose of this study was to examine pedometer-measured physical activity levels of western Kenyan youth. Participants in this study were children in Levels 3 and 5 who attended a private primary school. The sample (n = 72) consisted of 43 girls and 29 boys (average age = 9.8 ± 1.1, range = 8-12 years). Age, gender, tribe, and height and weight measures were collected. Weight status category was determined according to CDC guidelines. Participants wore a sealed Yamax pedometer for 4 weekdays during the measurement period. Data analysis included descriptive statistics and 2-way ANOVA (age × gender). The total sample averaged 14558 ± 3993 daily steps. There was no significant effect for age [F(4,68) = 1.682, P = .102] nor significant age × gender interaction [F(4,68)=1.956, P = .117]. There was a significant effect for gender [F(1,68) = 4.791, P = .033], with boys (16262 ± 4698) significantly more active than girls (13463 ± 3051). The observed daily steps are higher than those observed in the U.S., similar to samples in other developed countries, but lower than Amish youth.

Public Disorder, Private Boons? Inter-Sectoral Dynamics Illustrated by the Kenyan Case. PROPHE Working Paper Series. WP No. 9

ERIC Educational Resources Information Center

Otieno, Wycliffe; Levy, Daniel

2007-01-01

Within and beyond Africa, it is the public sector much more than the private sector that is the scene of strikes and other forms of disorder, conflict and difficulty. Yet the private sector can be much affected by the public problems. Effects may be simultaneously positive for the private sector and deleterious for the public sector. Although a…

Open and Distance Learning and Information and Communication Technologies--Implications for Formal and Non-Formal Education: A Kenyan Case

ERIC Educational Resources Information Center

Situma, David Barasa

2015-01-01

The female population in Kenya was reported at 50.05% in 2011, according to a World Bank report published in 2012. Despite this slightly higher percentage over males, women in Kenya are not well represented in education and training compared to their male counterparts (Kenya National Bureau of Statistics, 2012). The need to empower girls and women…

Use of standardised patients to assess quality of healthcare in Nairobi, Kenya: a pilot, cross-sectional study with international comparisons.

PubMed

Daniels, Benjamin; Dolinger, Amy; Bedoya, Guadalupe; Rogo, Khama; Goicoechea, Ana; Coarasa, Jorge; Wafula, Francis; Mwaura, Njeri; Kimeu, Redemptar; Das, Jishnu

2017-01-01

The quality of clinical care can be reliably measured in multiple settings using standardised patients (SPs), but this methodology has not been extensively used in Sub-Saharan Africa. This study validates the use of SPs for a variety of tracer conditions in Nairobi, Kenya, and provides new results on the quality of care in sampled primary care clinics. We deployed 14 SPs in private and public clinics presenting either asthma, child diarrhoea, tuberculosis or unstable angina. Case management guidelines and checklists were jointly developed with the Ministry of Health. We validated the SP method based on the ability of SPs to avoid detection or dangerous situations, without imposing a substantial time burden on providers. We also evaluated the sensitivity of quality measures to SP characteristics. We assessed quality of practice through adherence to guidelines and checklists for the entire sample, stratified by case and stratified by sector, and in comparison with previously published results from urban India, rural India and rural China. Across 166 interactions in 42 facilities, detection rates and exposure to unsafe conditions were both zero. There were no detected outcome correlations with SP characteristics that would bias the results. Across all four conditions, 53% of SPs were correctly managed with wide variation across tracer conditions. SPs paid 76% less in public clinics, but proportions of correct management were similar to private clinics for three conditions and higher for the fourth. Kenyan outcomes compared favourably with India and China in all but the angina case. The SP method is safe and effective in the urban Kenyan setting for the assessment of clinical practice. The pilot results suggest that public providers in this setting provide similar rates of correct management to private providers at significantly lower out-of-pocket costs for patients. However, comparisons across countries are sensitive to the tracer condition considered.

Use of standardised patients to assess quality of healthcare in Nairobi, Kenya: a pilot, cross-sectional study with international comparisons

PubMed Central

Daniels, Benjamin; Dolinger, Amy; Bedoya, Guadalupe; Rogo, Khama; Goicoechea, Ana; Coarasa, Jorge; Wafula, Francis; Mwaura, Njeri; Kimeu, Redemptar

2017-01-01

Introduction The quality of clinical care can be reliably measured in multiple settings using standardised patients (SPs), but this methodology has not been extensively used in Sub-Saharan Africa. This study validates the use of SPs for a variety of tracer conditions in Nairobi, Kenya, and provides new results on the quality of care in sampled primary care clinics. Methods We deployed 14 SPs in private and public clinics presenting either asthma, child diarrhoea, tuberculosis or unstable angina. Case management guidelines and checklists were jointly developed with the Ministry of Health. We validated the SP method based on the ability of SPs to avoid detection or dangerous situations, without imposing a substantial time burden on providers. We also evaluated the sensitivity of quality measures to SP characteristics. We assessed quality of practice through adherence to guidelines and checklists for the entire sample, stratified by case and stratified by sector, and in comparison with previously published results from urban India, rural India and rural China. Results Across 166 interactions in 42 facilities, detection rates and exposure to unsafe conditions were both zero. There were no detected outcome correlations with SP characteristics that would bias the results. Across all four conditions, 53% of SPs were correctly managed with wide variation across tracer conditions. SPs paid 76% less in public clinics, but proportions of correct management were similar to private clinics for three conditions and higher for the fourth. Kenyan outcomes compared favourably with India and China in all but the angina case. Conclusions The SP method is safe and effective in the urban Kenyan setting for the assessment of clinical practice. The pilot results suggest that public providers in this setting provide similar rates of correct management to private providers at significantly lower out-of-pocket costs for patients. However, comparisons across countries are sensitive to the tracer condition considered. PMID:29225937

Viewing the Kenyan health system through an equity lens: implications for universal coverage

PubMed Central

2011-01-01

Introduction Equity and universal coverage currently dominate policy debates worldwide. Health financing approaches are central to universal coverage. The way funds are collected, pooled, and used to purchase or provide services should be carefully considered to ensure that population needs are addressed under a universal health system. The aim of this paper is to assess the extent to which the Kenyan health financing system meets the key requirements for universal coverage, including income and risk cross-subsidisation. Recommendations on how to address existing equity challenges and progress towards universal coverage are made. Methods An extensive review of published and gray literature was conducted to identify the sources of health care funds in Kenya. Documents were mainly sourced from the Ministry of Medical Services and the Ministry of Public Health and Sanitation. Country level documents were the main sources of data. In cases where data were not available at the country level, they were sought from the World Health Organisation website. Each financing mechanism was analysed in respect to key functions namely, revenue generation, pooling and purchasing. Results The Kenyan health sector relies heavily on out-of-pocket payments. Government funds are mainly allocated through historical incremental approach. The sector is largely underfunded and health care contributions are regressive (i.e. the poor contribute a larger proportion of their income to health care than the rich). Health financing in Kenya is fragmented and there is very limited risk and income cross-subsidisation. The country has made little progress towards achieving international benchmarks including the Abuja target of allocating 15% of government's budget to the health sector. Conclusions The Kenyan health system is highly inequitable and policies aimed at promoting equity and addressing the needs of the poor and vulnerable have not been successful. Some progress has been made towards addressing equity challenges, but universal coverage will not be achieved unless the country adopts a systemic approach to health financing reforms. Such an approach should be informed by the wider health system goals of equity and efficiency. PMID:21612669

Capillary refill: prognostic value in Kenyan children

PubMed Central

Pamba, A; Maitland, K

2004-01-01

Aims: To determine whether delayed capillary refill time (>3 seconds) is a useful prognostic indicator in Kenyan children admitted to hospital. Methods: A total of 4160 children admitted to Kilifi District Hospital with malaria, malarial anaemia, acute respiratory tract infection (ARI), severe anaemia (haemoglobin <50 g/l), gastroenteritis, malnutrition, meningitis, or septicaemia were studied. Results: Overall, delayed capillary refill time (dCRT), present in 346/4160 (8%) of the children, was significantly more common in fatal cases (44/189, 23%) than survivors (7.5%), and had useful prognostic value. In children admitted with malaria, gastroenteritis, or malnutrition, likelihood ratio tests suggested that dCRT was useful in identifying high risk groups for mortality, but its prognostic value in anaemia, ARI, and sepsis was unclear due to low case fatality or limited numbers. The severity features of impaired consciousness and deep breathing were significantly associated both with the presence of dCRT and fatal outcome. In children, with either of these severity features, a less stringent value of dCRT(>2 s) identified 50% of children with hypotension (systolic BP <2SD) and 40% of those requiring volume resuscitation (for metabolic acidosis). Conclusions: Although CRT is a simple bedside test, which may be used in resource poor settings as a guide to the circulatory status, dCRT should not be relied on in the absence of other features of severity. In non-severe disease, the additional presence of hypoxia, a moderately raised creatinine (>80 µmol/l), or a raised white cell count should prompt the need for fluid expansion. PMID:15383440

Variations in Mortality in Children Admitted with Pneumonia to Kenyan Hospitals

PubMed Central

Ayieko, Philip; Okiro, Emelda A.; Edwards, Tansy; Nyamai, Rachel; English, Mike

2012-01-01

Background The existing case fatality estimates of inpatient childhood pneumonia in developing countries are largely from periods preceding routine use of conjugate vaccines for infant immunization and such primary studies rarely explore hospital variations in mortality. We analysed case fatality rates of children admitted to nine Kenyan hospitals with pneumonia during the era of routine infant immunization with Hib conjugate vaccine to determine if significant variations exist between hospitals. Methods Pneumonia admissions and outcomes in paediatric wards are described using data collected over two time periods: a one-year period (2007–2008) in nine hospitals, and data from a 9.25-year period (1999-March 2008) in one of the participating hospitals. Hospital case fatality rates for inpatient pneumonia during 2007 to 2008 were modeled using a fixed effect binomial regression model with a logit link. Using an interrupted time series design, data from one hospital were analysed for trends in pneumonia mortality during the period between 1997 and March 2008. Results Overall, 195 (5.9%) children admitted to all 9 hospitals with pneumonia from March 2007 to March 2008 died in hospital. After adjusting for child’s sex, comorbidity, and hospital effect, mortality was significantly associated with child’s age (p<0.001) and pneumonia severity (p<0.001). There was evidence of significant variations in mortality between hospitals (LR χ2 = 52.19; p<0.001). Pneumonia mortality remained stable in the periods before (trend −0.03, 95% CI −0.1 to 0.02) and after Hib introduction (trend 0.04, 95% CI −0.04 to 0.11). Conclusions There are important variations in hospital-pneumonia case fatality in Kenya and these variations are not attributed to temporal changes. Such variations in mortality are not addressed by existing epidemiological models and need to be considered in allocating resources to improve child health. PMID:23139752

Interpreting Kenyan Science Teachers' Views about the Effect of Student Learning Experiences on Their Teaching

ERIC Educational Resources Information Center

Nashon, Samson Madera

2013-01-01

Analysis of views from a select group of Kenyan science teachers regarding the effect of student learning experiences on their teaching after implementing a contextualized science unit revealed that the teachers' (a) literal interpretation and adherence to the official curriculum conflicted with the students' desires to understand scientific…

Translingualism, Kenyan Hip-Hop and Emergent Ethnicities: Implications for Language Theory and Pedagogy

ERIC Educational Resources Information Center

Milu, Esther

2018-01-01

This article reports on preliminary findings of three prominent Kenyan hip-hop artists, Jua Cali, Abbas Kubaff, and Nazizi Hirji, as they theorize and construct emergent ethnicities vis-à-vis their translingual practices. Using in-depth phenomenological interviews, observations of their everyday language use, and analysis of their language choices…

On Farm and Packhouse: Employment at the Bottom of a Global Value Chain

ERIC Educational Resources Information Center

Dolan, Catherine S.

2004-01-01

The fresh vegetables commodity chain linking Kenyan producers with United Kingdom (UK) consumers employs significant numbers of workers in production and processing. This chain is dominated by UK retailers that determine the production imperatives of Kenyan firms upstream in the chain and, indirectly the employment strategies they adopt. This…

Industrialization Stresses, Alcohol Abuse & Substance Dependence: Differential Gender Effects in a Kenyan Rural Farming Community

ERIC Educational Resources Information Center

Walt, Lisa C.; Kinoti, Elias; Jason, Leonard A.

2013-01-01

Developing countries' industrialization and urbanization attempts have been linked to psychological distress and alcohol abuse. We used Hobfoll's COR theory to examine the relationship between gender, perceived resource loss (an indicator of industrialization stress), and alcohol abuse and dependence in a sample of Kenyan rural village men and…

Reflections from a Computer Simulations Program on Cell Division in Selected Kenyan Secondary Schools

ERIC Educational Resources Information Center

Ndirangu, Mwangi; Kiboss, Joel K.; Wekesa, Eric W.

2005-01-01

The application of computer technology in education is a relatively new approach that is trying to justify inclusion in the Kenyan school curriculum. Being abstract, with a dynamic nature that does not manifest itself visibly, the process of cell division has posed difficulties for teachers. Consequently, a computer simulation program, using…

Children's Emotion Regulation across and within Nations: A Comparison of Ghanaian, Kenyan, and American Youth

ERIC Educational Resources Information Center

Morelen, Diana; Zeman, Janice; Perry-Parrish, Carisa; Anderson, Ellen

2012-01-01

This research examined national, regional, developmental, and gender differences in children's reported management of anger and sadness. Participants (8-15 years) were 103 Ghanaian children from a village setting, 142 Ghanaian children from a middle-class urban context, 106 Kenyan children from an impoverished urban context, and 170 children from…

"Paradoxical Health Education": Learning about Health in Kenyan Teacher Training Colleges

ERIC Educational Resources Information Center

Dahl, Kari Kragh Blume

2014-01-01

This paper suggests the term "paradoxical" to understand how health education (HE) is carried out and experienced as contradictory and inconsistent by student-teachers who learn about health in Kenyan teacher training colleges (TTC). The claim is that students, apart from formal HE lessons, also learn about health in non-curricular HE,…

Are gait characteristics and ground reaction forces related to energy cost of running in elite Kenyan runners?

PubMed

Santos-Concejero, J; Tam, N; Coetzee, D R; Oliván, J; Noakes, T D; Tucker, R

2017-03-01

The aim of this study was to determine whether gait cycle characteristics are associated with running economy in elite Kenyan runners. Fifteen elite Kenyan male runners completed two constant-speed running sets on a treadmill (12 km ·h -1 and 20 km ·h -1 ). VO 2 and respiratory exchange ratio values were measured to calculate steady-state oxygen and energy cost of running. Gait cycle characteristics and ground contact forces were measured at each speed. Oxygen cost of running at different velocities was 192.2 ± 14.7 ml· kg -1 · km -1 at 12 km· h -1 and 184.8 ± 9.9 ml· kg -1 · km -1 at 20 km· h -1 , which corresponded to a caloric cost of running of 0.94 ± 0.07 kcal ·kg -1 ·km -1 and 0.93 ± 0.07 kcal· kg -1 · km -1 . We found no significant correlations between oxygen and energy cost of running and biomechanical variables and ground reaction forces at either 12 or 20 km· h -1 . However, ground contact times were ~10.0% shorter (very large effect) than in previously published literature in elite runners at similar speeds, alongside an 8.9% lower oxygen cost (very large effect). These results provide evidence to hypothesise that the short ground contact times may contribute to the exceptional running economy of Kenyan runners.

Maternal health services utilisation by Kenyan adolescent mothers: Analysis of the Demographic Health Survey 2014.

PubMed

Banke-Thomas, Aduragbemi; Banke-Thomas, Oluwasola; Kivuvani, Mwikali; Ameh, Charles Anawo

2017-06-01

Kenya has one of the highest adolescent fertility rates in East-Africa, estimated at 106 births per 1000 females aged 15-19years. In addition to promoting safe sexual behaviour, utilisation of maternal health services (MHS) is essential to prevent poor outcomes of pregnancy and childbirth. To ensure optimum planning, particularly in the context of the Sustainable Development Goals, this study assesses the current service utilisation patterns of Kenyan adolescent mothers and the factors that affect this utilisation. Using data from the recently published 2014 Kenya Demographic Health Survey, we collected demographic and utilisation data of all three MHSs (antenatal care (ANC), skilled birth attendance (SBA) and postnatal care (PNC)) of adolescent mothers aged 15-19years. We then conducted bivariate and multivariate analyses to test associations between selected demographic and service utilisation variables. Our findings showed that half of Kenyan adolescent mothers have had their first birth by the age of 16. MHS utilisation rates amongst Kenyan adolescent mothers were 93%, 65%, 92% for ANC, SBA and PNC respectively. Mother's education, religion, ethnicity, place of residence, wealth quintile, mass media exposure, and geographical region were significant predictors for both ANC and SBA utilisation. Education level of partner was significant for ANC utilisation while parity was significant for both SBA and PNC. Adolescent MHS utilisation is not optimum in Kenya. More work that includes affordable care provision, cultural re-orientation, targeted mass-media campaigns and male involvement in care need to be done with emphasis on the most disadvantaged areas. Copyright © 2017 Elsevier B.V. All rights reserved.

Anti-bacterial efficacy of alcoholic hand rubs in the Kenyan market, 2015.

PubMed

Ochwoto, Missiani; Muita, Lucy; Talaam, Keith; Wanjala, Cecilia; Ogeto, Frank; Wachira, Faith; Osman, Saida; Kimotho, James; Ndegwa, Linus

2017-01-01

Hand hygiene is known to be effective in preventing hospital and community-acquired infections. The increasing number of hand sanitizer brands in Kenyan hospitals and consumer outlets is of concern. Thus the main aim of this study was to evaluate the anti-bacterial efficacy and organoleptic properties of these hand sanitizers in Kenya. This was an experimental, laboratory-based study of 14 different brands of hand sanitizers (coded HS1-14) available in various retail outlets and hospitals in Kenya. Efficacy was evaluated using standard non-pathogenic Escherichia coli (ATCC 25922), Staphylococcus aureus (ATCC 25923) and Pseudomonas aeruginosa (ATCC 27853) as per the European Standard (EN). The logarithmic reduction factors (RF) were assessed at baseline and after treatment, and log reduction then calculated. Ten and 25 healthy volunteers participated in the efficacy and organoleptic studies respectively. Four (28.6%) hand sanitizers (HS12, HS9, HS13 and HS14) showed a 5.9 reduction factor on all the three bacteria strains. Seven (50%) hand sanitizers had efficacies of <3 against all the three bacteria strains used. Efficacy on E. Coli was higher compared to the other pathogens. Three hand sanitizers were efficacious on one of the pathogens and not the other. In terms of organoleptic properties, gel-based formulations were rated far higher than the liquid based formulations brands. Fifty percent (50%) of the selected hand sanitizers in the Kenyan market have efficacy that falls below the World Health Organization (WHO) and DIN EN 1500:2013. Of the 14 hand sanitizers found in the Kenyan market, only four showed efficacies that were comparable to the WHO-formulation. There is a need to evaluate how many of these products with <3 efficacy that have been incorporated into the health system for hand hygiene and the country's policy on regulations on their usage.

Six-Year Incidence of Blindness and Visual Impairment in Kenya: The Nakuru Eye Disease Cohort Study

PubMed Central

Bastawrous, Andrew; Mathenge, Wanjiku; Wing, Kevin; Rono, Hillary; Gichangi, Michael; Weiss, Helen A.; Macleod, David; Foster, Allen; Burton, Matthew J.; Kuper, Hannah

2016-01-01

Purpose To describe the cumulative 6-year incidence of visual impairment (VI) and blindness in an adult Kenyan population. The Nakuru Posterior Segment Eye Disease Study is a population-based sample of 4414 participants aged ≥50 years, enrolled in 2007–2008. Of these, 2170 (50%) were reexamined in 2013–2014. Methods The World Health Organization (WHO) and US definitions were used to calculate presenting visual acuity classifications based on logMAR visual acuity tests at baseline and follow-up. Detailed ophthalmic and anthropometric examinations as well as a questionnaire, which included past medical and ophthalmic history, were used to assess risk factors for study participation and vision loss. Cumulative incidence of VI and blindness, and factors associated with these outcomes, were estimated. Inverse probability weighting was used to adjust for nonparticipation. Results Visual acuity measurements were available for 2164 (99.7%) participants. Using WHO definitions, the 6-year cumulative incidence of VI was 11.9% (95%CI [confidence interval]: 10.3–13.8%) and blindness was 1.51% (95%CI: 1.0–2.2%); using the US classification, the cumulative incidence of blindness was 2.70% (95%CI: 1.8–3.2%). Incidence of VI increased strongly with older age, and independently with being diabetic. There are an estimated 21 new cases of VI per year in people aged ≥50 years per 1000 people, of whom 3 are blind. Therefore in Kenya we estimate that there are 92,000 new cases of VI in people aged ≥50 years per year, of whom 11,600 are blind, out of a total population of approximately 4.3 million people aged 50 and above. Conclusions The incidence of VI and blindness in this older Kenyan population was considerably higher than in comparable studies worldwide. A continued effort to strengthen the eye health system is necessary to support the growing unmet need in an aging and growing population. PMID:27820953

Six-Year Incidence of Blindness and Visual Impairment in Kenya: The Nakuru Eye Disease Cohort Study.

PubMed

Bastawrous, Andrew; Mathenge, Wanjiku; Wing, Kevin; Rono, Hillary; Gichangi, Michael; Weiss, Helen A; Macleod, David; Foster, Allen; Burton, Matthew J; Kuper, Hannah

2016-11-01

To describe the cumulative 6-year incidence of visual impairment (VI) and blindness in an adult Kenyan population. The Nakuru Posterior Segment Eye Disease Study is a population-based sample of 4414 participants aged ≥50 years, enrolled in 2007-2008. Of these, 2170 (50%) were reexamined in 2013-2014. The World Health Organization (WHO) and US definitions were used to calculate presenting visual acuity classifications based on logMAR visual acuity tests at baseline and follow-up. Detailed ophthalmic and anthropometric examinations as well as a questionnaire, which included past medical and ophthalmic history, were used to assess risk factors for study participation and vision loss. Cumulative incidence of VI and blindness, and factors associated with these outcomes, were estimated. Inverse probability weighting was used to adjust for nonparticipation. Visual acuity measurements were available for 2164 (99.7%) participants. Using WHO definitions, the 6-year cumulative incidence of VI was 11.9% (95%CI [confidence interval]: 10.3-13.8%) and blindness was 1.51% (95%CI: 1.0-2.2%); using the US classification, the cumulative incidence of blindness was 2.70% (95%CI: 1.8-3.2%). Incidence of VI increased strongly with older age, and independently with being diabetic. There are an estimated 21 new cases of VI per year in people aged ≥50 years per 1000 people, of whom 3 are blind. Therefore in Kenya we estimate that there are 92,000 new cases of VI in people aged ≥50 years per year, of whom 11,600 are blind, out of a total population of approximately 4.3 million people aged 50 and above. The incidence of VI and blindness in this older Kenyan population was considerably higher than in comparable studies worldwide. A continued effort to strengthen the eye health system is necessary to support the growing unmet need in an aging and growing population.

Education Quality and the Kenyan 8-4-4 Curriculum: Secondary School Learners' Experiences

ERIC Educational Resources Information Center

Milligan, Lizzi O.

2017-01-01

This article explores the implementation of Kenyan secondary education in rural Western Kenya, focusing on learners' experiences. One of the key challenges to educational quality is shown to be the size and breadth of the secondary education curriculum. Learners are in school 12 hours a day with those approaching their final exams working three to…

The Award of the PhD Degree in Kenyan Universities: A Quality Assurance Perspective

ERIC Educational Resources Information Center

Ayiro, Laban P.; Sang, James K.

2011-01-01

This article attempts to bring to the fore the need for enhanced quality assurance processes in the award of PhDs by Kenyan universities. The findings reveal that quality challenges exist in the institutional processes established for the award of this advanced degree across the universities in the country. It is hoped that the findings will stir…

A Kenyan Cloud School. Massive Open Online & Ongoing Courses for Blended and Lifelong Learning

ERIC Educational Resources Information Center

Jobe, William

2013-01-01

This research describes the predicted outcomes of a Kenyan Cloud School (KCS), which is a MOOC that contains all courses taught at the secondary school level in Kenya. This MOOC will consist of online, ongoing subjects in both English and Kiswahili. The KCS subjects offer self-testing and peer assessment to maximize scalability, and digital badges…

Analysis of Influence of Sponsorship Career Function of Mentorship on Women's Leadership Advancement in Kenyan Universities

ERIC Educational Resources Information Center

Severina, Wambeti Njagi; Edabu, Paul; Kimani, Cecilia

2016-01-01

Women working in Kenyan universities should be provided with the many benefits of sponsorship, a mentorship function. Mentors should for example give their mentees challenging assignments which prepare them for top leadership positions. But it is possible that women may not be getting this support from their mentors. Therefore, the researcher did…

The Experience of Patriarchy by Kenyan Women in the Pursuit of Higher Education

ERIC Educational Resources Information Center

Machira, Mary Achieng

2013-01-01

Low enrollment of women in higher education is a problem in Africa, particularly in Kenya, where despite the government's introduction of affirmative action, female enrollment averages only 36.7% at public universities. This gender gap may be due to the patriarchal influence in Kenyan society, where the role of women is seen as child-bearing,…

Childhood overweight and obesity among Kenyan pre-school children: association with maternal and early child nutritional factors.

PubMed

Gewa, Constance A

2010-04-01

To report on the prevalence of overweight and obesity among pre-school children in Kenya and examine the associations between childhood overweight and selected maternal and child-related factors. Demographic Health Survey data, multistage stratified cluster sampling methodology. Rural and urban areas of Kenya. A total of 1495 children between the ages of 3 and 5 years in Kenya. Over 30 % of the children were stunted, approximately 16 % were underweight, 4 % were wasted, approximately 18 % were overweight and 4 % were obese; 8 % were both overweight/obese and stunted. Maternal overweight and obesity, higher levels of maternal education, being a large or very large child at birth, and being stunted were each associated with higher odds of overweight and obesity among Kenyan children. Older children and large household size were each associated with lower odds of overweight and obesity among Kenyan children. The analysis demonstrates the presence of under- and overnutrition among Kenyan pre-school children and the importance of focusing on expanding efforts to prevent and treat malnutrition within this population. It also identifies some of the modifiable factors that can be targeted in these efforts.

Intra-household relations and treatment decision-making for childhood illness: a Kenyan case study.

PubMed

Molyneux, C S; Murira, G; Masha, J; Snow, R W

2002-01-01

This study, conducted on the Kenyan coast, assesses the effect of intra-household relations on maternal treatment-seeking. Rural and urban Mijikenda mothers' responses to childhood fevers in the last 2 weeks (n=317), and to childhood convulsions in the previous year (n=43), were documented through survey work. The intra-household relations and decision-making dynamics surrounding maternal responses were explored through in-depth individual and group interviews, primarily with women (n=223). Responses to convulsions were more likely than responses to fevers to include a healer consultation (p<0.0001), and less likely to include the purchase of over-the-counter medications (p<0.0001). Mothers received financial or advisory assistance from others in 71% (n=236) of actions taken outside the household in response to fevers. In-depth interviews suggested that general agreement on appropriate therapy results in relatively few intra-household conflicts over the treatment of fevers. Disputes over perceived cause and appropriate therapy of convulsions, however, highlighted the importance of age, gender and relationship to household head in intra-household relations and treatment decision-making. Although mothers' treatment-seeking preferences are often circumscribed by these relations, a number of strategies can be drawn upon to circumvent 'inappropriate' decisions, sometimes with implications for future household responses to similar syndromes. The findings highlight the complexity of intra-household relations and treatment decision-making dynamics. Tentative implications for interventions aimed at improving the home management of malaria, and for further research, are presented.

Modifiable factors associated with active pulmonary tuberculosis in a Kenyan prison.

PubMed

Amwayi, A S; Kikuvi, G M; Muchiri, E M

2010-02-01

To establish modifiable factors associated with active pulmonary tuberculosis (PTB) among prisoners. Retrospective matched case-control study. Nakuru GK prison in Kenya. A total of 144 subjects (48 cases and 96 controls) were recruited into the study. Cases were adult prisoners who had at least two initial sputum specimens being Acid Fast Bacilli-positive (AFB+) on direct smear microscopy and hence recruited to PTB WHO DOTS Programme. Controls were adults with no chronic cough and not on PTB treatment six months prior to the study. Independent factors significantly associated with active PTB disease were: self reported HIV+ status (OR=11; 95% CI = 2.42-47.77), evidence of BCG vaccination (OR = 0.20; 95% CI = 0.05-0.60), contact with PTB case (OR = 7.0; 95% CI = 1.17-38.23), unemployment (OR = 9.0; 95% CI = 1.84-43.97) and sharing linen (OR = 4.32; 95%CI = 1.08-17.29). Modifiable factors associated with active PTB in Nakuru G.K prison are: HIV status, BCG vaccination, PTB case contact, poverty and poor personal hygiene. We recommend HIV counselling and testing of all PTB patients, screening for TB upon prison entry and TB contact investigation and improving personal hygiene of prisoners.

Street children turn to sex-work to survive.

PubMed

1995-08-01

The Kenyan government currently deports tourists who are caught with child prostitutes and charges the children with prostitution. A harder treatment of foreigners caught with child prostitutes may soon emerge. The Undugu Society in Kenya, an organization working with street children, welcomes such changes. It teaches children practical skills, e.g., tailoring and carpentry. The Society has four schools and sponsors 1000 children to attend school or workshops. It sends social workers into the slums to counsel and gain the trust of street children as well as to encourage them to attend workshops. The Society has workshops on HIV transmission and emphasizes behavior change rather than condom use. Kenyan law prohibits adults from having sex with a child less than 18 years old. Juvenile courts deal with children caught engaging in solicitation of customers and/or prostitution. Children found guilty go to children's homes for rehabilitation into mainstream society. More and more countries of sex-tourists are punishing tourists who engage in sexual intercourse with minors in Kenya. Fear that high-profile cases will harm the multi-million-dollar tourist industry as well as lack of state resources makes Kenya reluctant to prosecute tourists. In 1994, most of Nairobi's 40,000 street children were engaged in prostitution. The leading centers of child prostitution are all tourist areas: Nairobi, Mombasa, Malindi, Lamu, and Diani. 80% of pornographic material in Kenya features children. Kenyan taxi drivers, tour guides, and hotel workers serve as middlemen in child prostitution. Urban poverty forces many children on to the streets. Rural children sent to urban areas to work as maids or servants in a rich house are often sexually abused. They then escape to the streets. Many child prostitutes come from poor families and have low literacy and no practical skills. AIDS orphans also become prostitutes to survive.

Transformations in Kenyan Science Teachers' Locus of Control: The Influence of Contextualized Science and Emancipated Student Learning

NASA Astrophysics Data System (ADS)

Anderson, D.; Nashon, S.; Namazzi, E.; Okemwa, P.; Ombogo, P.; Ooko, S.; Beru, F.

2015-11-01

This study investigated Kenyan science teachers' pedagogical transformations, which manifested as they enacted and experienced a reformed contextualized science curriculum in which students' learning experiences were critical catalysts of teacher change. Twelve high school teachers voluntarily participated in the study and were interviewed about their pedagogical transformations following their enactment of a reformed contextualized science curriculum. The outcomes demonstrated that students' emancipated behaviours, learning and performance, qualitatively influenced teacher change and pedagogical reform. Specifically, changes in students, as a result of the ways the science curriculum was implemented, resulted in epiphanies and dilemmas for teachers who subsequently resolved to surrender their tightly held pedagogical control (locus of control) for the betterment of the learning environment and their sense of professional satisfaction.

Speech and Language Disorders in Kenyan Children: Adapting Tools For Regions With Few Assessment Resources

PubMed Central

Carter, Julie Anne; Murira, Grace; Gona, Joseph; Tumaini, Judy; Lees, Janet; Neville, Brian George; Newton, Charles Richard

2013-01-01

This study sought to adapt a battery of Western speech and language assessment tools to a rural Kenyan setting. The tool was developed for children whose first language was KiGiryama, a Bantu language. A total of 539 Kenyan children (males=271, females=268, ethnicity=100% Kigiryama. Data were collected from 303 children admitted to hospital with severe malaria and 206 age-matched children recruited from the village communities. The language assessments were based upon the Content, Form and Use (C/F/U) model. The assessment was based upon the adapted versions of the Peabody Picture Vocabulary Test, Test for the Reception of Grammar, Renfrew Action Picture Test, Pragmatics Profile of Everyday Communication Skills in Children, Test of Word Finding and language specific tests of lexical semantics, higher level language. Preliminary measures of construct validity suggested that the theoretical assumptions behind the construction of the assessments were appropriate and re-test and inter-rater reliability scores were acceptable. These findings illustrate the potential to adapt Western speech and language assessments in other languages and settings, particularly those in which there is a paucity of standardised tools. PMID:24294109

Parents’ and Professionals’ Perceptions on Causes and Treatment Options for Autism Spectrum Disorders (ASD) in a Multicultural Context on the Kenyan Coast

PubMed Central

Gona, Joseph K.; Rimba, Kenneth; Mapenzi, Rachel; Kihara, Michael

2015-01-01

Objective To explore parents’ and professionals’ perceived causes and treatment of Autism Spectrum Disorders (ASD) on the Kenyan Coast. Methods In-depth interviews and focus group discussions using guiding questions were utilized in data collection. One hundred and three participants, who included parents of children with ASD, special needs teachers, clinicians, and social workers from diverse cultural background, participated in this study. The interviews and focus groups were recorded, transcribed verbatim and then translated to English. Themes were generated using content analysis. Results Preternatural causes were mentioned and included evil spirits, witchcraft, and curses. Biomedical causes comprised infections, drug abuse, birth complications, malnutrition, and genetic related problems. Treatment varied from traditional and spiritual healing to modern treatment in health facilities, and included consultations with traditional healers, offering prayers to God, and visits to hospitals. Conclusions The results suggest that regardless of cultural backgrounds, people on the Kenyan Coast have similar views on perceived causes and treatment of ASD. These findings provide valuable conceptual understanding for professionals when planning and implementing community based rehabilitation interventions targeting children with ASD within a local context. PMID:26267668

Congratulating the people of Kenya on their commitment to peaceful elections, as demonstrated on March 4, 2013, and calling on Kenyans to come together to continue to implement political, institutional, and accountability reforms envisioned in the Kenyan constitution.

THOMAS, 113th Congress

Rep. Bass, Karen [D-CA-37

2013-04-26

House - 05/06/2013 Referred to the Subcommittee on Africa, Global Health, Global Human Rights and International Organizations. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

Disaster Risk Management - The Kenyan Challenge

NASA Astrophysics Data System (ADS)

Nabutola, W.; Scheer, S.

2009-04-01

Keywords: natural disasters; man-made disasters; terrorist attacks; land slides; disaster policies and legislations; fire; earthquakes; hurricanes; soil erosion; disaster research policy; Preamble: "Risk does not begin and end on the floor of the New York Stock Exchange. The vastness of the subject matter is daunting. Risk touches on the most profound aspects of psychology, mathematics, statistics and history. The literature is monumental; each day's headlines bring many new items of interest. But I know we are not unique, everywhere in the world risks abound." "AGAINST THE GODS the remarkable story of risk" by Peter L. Bernstein, 1998 The real challenge is what can we, as a nation do to avert, prevent them, or in the unfortunate event that they occur, how can we mitigate their impact on the economy? Introductory remarks: Disaster in Kenya, as indeed anywhere else, is not one of those happenings we can wish away. It can strike anywhere any time. Some of it is man-made but most of it is natural. The natural are sometimes induced by man in one way or another. For example, when we harvest trees without replacing them, this diminishes the forest cover and can lead to soil erosion, whose advanced form is land slides. Either way disasters in their different forms and sizes present challenges to the way we live our lives or not, perhaps, even how we die. Disasters in our country have reached crisis stage. ‘In Chinese language, crisis means danger, but it also means opportunity' Les Brown, motivational speaker in "the power of a larger vision" Why I am interested Whereas Kenya experiences man made and natural disasters, there are more sinister challenges of the man-made variety. These loom on the horizon and, from time to time raise their ugly heads, taking many Kenyan lives in their wake, and property destroyed. These are post election violence and terrorist attacks, both related to politics, internal and external. In January 2008, soon after presidential and national assembly elections Kenya plunged into bloodshed. One Kenyan went for another, people who had been living together as neighbours suddenly turned on one another. Some of the more glaring outcomes were: • About 1,300 Kenyans died. • Property worth billions of shillings was destroyed. • Thousands of Kenyans fled their homes/farms/houses. • To date Kenya has Internally Displaced Persons (IDP). It has become a buzzword, almost fashionable if it were not so sad and grave, and a disgrace to democracy. During the short rains in September and October we experienced floods, land slides, crop failures. Ironically, in the previous months, we had just gone through drought, crops had failed, livestock died, sadly some people died, some through vagaries of weather while others as a result of inter-community friction. The net results were: • Kenya is primarily an agricultural economy sector employs over 80%. Only 20% of the land is arable, the rest is arid and semi arid land, occupied by the nomadic Kenyans. So when there is drought or floods, we get challenges that spark inter-community conflicts. Food shortages lead to higher food prices, a kilogramme bag of maize meal rose from barely affordable Kes. 52.00 to 120.00 in less than two months. In any case the food is not necessarily always available. • The global financial crisis affected our economy very adversely. Fuel prices rose from Kenya Shillings 60.00 per litre to 112.00. • Ironically Kenya's parliament voted against a law that would have compelled them to pay taxes. • As if in anticipation of citizen reactions the MP's passed the media law that would gag freedom of the press. METHODOLOGY 1. Review literature available on disasters in Kenya over the last decades. 2. I will ask Kenyans what they understand by the terms disasters and risks. 3. I will ask the Kenyan authorities - central government and local governments, what plans they have. 4. I will ask Kenya Red Cross what their plans are, their challenges and opportunities they see for Kenyans. EXPECTED OUTCOMES OF MY STUDY • Petition for and inform the need for the establishment and development of an Integrated Disaster Risk Management Centre in Kenya • Enhance a national contingency management bill to cater for the increased frequency and variety of disasters in Kenya • Set up a national awareness campaign of potential risks in Kenyans' daily endeavours, including Early Warning Systems, perhaps with support from those who have had to deal with similar, like the European Union, and devise ways and means to mitigate them when they occur. Better still work on well tested methods of preventing their happening in the first place. • Decentralize the whole issue of management of disasters considering that they can occur anywhere in the country and a response from Nairobi is not useful if it takes hours to reach the point of reference LESSONS LEARNT I am curious to establish what lessons we have learnt to inform the way we manage disasters in general and natural disasters in particular. Disasters are getting more frightening and intense. The advancement in technology should be useful in dealing with disasters. Given the recent events in 2008 alone, we need to commit much more resources to research and development to deal with disasters however they are caused. We should work towards being able to continue with our lives regardless of the risks and disasters that come our way as individuals and as a nation, by designing a strategy and policies that have worked elsewhere.

Disaster Risk Management - The Kenyan Challenges

NASA Astrophysics Data System (ADS)

Nabutola, W.

2009-04-01

Keywords: natural disasters; man-made disasters; terrorist attacks; land slides; disaster policies and legislations; fire; earthquakes; hurricanes; soil erosion; disaster research policy; Preamble: "Risk does not begin and end on the floor of the New York Stock Exchange. The vastness of the subject matter is daunting. Risk touches on the most profound aspects of psychology, mathematics, statistics and history. The literature is monumental; each day's headlines bring many new items of interest. But I know we are not unique, everywhere in the world risks abound." "AGAINST THE GODS the remarkable story of risk" by Peter L. Bernstein, 1998 The real challenge is what can we, as a nation do to avert, prevent them, or in the unfortunate event that they occur, how can we mitigate their impact on the economy? Introductory remarks: Disaster in Kenya, as indeed anywhere else, is not one of those happenings we can wish away. It can strike anywhere any time. Some of it is man-made but most of it is natural. The natural are sometimes induced by man in one way or another. For example, when we harvest trees without replacing them, this diminishes the forest cover and can lead to soil erosion, whose advanced form is land slides. Either way disasters in their different forms and sizes present challenges to the way we live our lives or not, perhaps, even how we die. Disasters in our country have reached crisis stage. ‘In Chinese language, crisis means danger, but it also means opportunity' Les Brown, motivational speaker in "the power of a larger vision" Why I am interested Whereas Kenya experiences man made and natural disasters, there are more sinister challenges of the man-made variety. These loom on the horizon and, from time to time raise their ugly heads, taking many Kenyan lives in their wake, and property destroyed. These are post election violence and terrorist attacks, both related to politics, internal and external. In January 2008, soon after presidential and national assembly elections Kenya plunged into bloodshed. One Kenyan went for another, people who had been living together as neighbours suddenly turned on one another. Some of the more glaring outcomes were: • About 1,300 Kenyans died. • Property worth billions of shillings was destroyed. • Thousands of Kenyans fled their homes/farms/houses. • To date Kenya has Internally Displaced Persons (IDP). It has become a buzzword, almost fashionable if it were not so sad and grave, and a disgrace to democracy. During the short rains in September and October we experienced floods, land slides, crop failures. Ironically, in the previous months, we had just gone through drought, crops had failed, livestock died, sadly some people died, some through vagaries of weather while others as a result of inter-community friction. The net results were: • Kenya is primarily an agricultural economy sector employs over 80%. Only 20% of the land is arable, the rest is arid and semi arid land, occupied by the nomadic Kenyans. So when there is drought or floods, we get challenges that spark inter-community conflicts. Food shortages lead to higher food prices, a kilogramme bag of maize meal rose from barely affordable Kes. 52.00 to 120.00 in less than two months. In any case the food is not necessarily always available. • The global financial crisis affected our economy very adversely. Fuel prices rose from Kenya Shillings 60.00 per litre to 112.00. • Ironically Kenya's parliament voted against a law that would have compelled them to pay taxes. • As if in anticipation of citizen reactions the MP's passed the media law that would gag freedom of the press. METHODOLOGY 1. Review literature available on disasters in Kenya over the last decades. 2. I will ask Kenyans what they understand by the terms disasters and risks. 3. I will ask the Kenyan authorities - central government and local governments, what plans they have. 4. I will ask Kenya Red Cross what their plans are, their challenges and opportunities they see for Kenyans. EXPECTED OUTCOMES OF MY STUDY • Petition for and inform the need for the establishment and development of an Integrated Disaster Risk Management Centre in Kenya • Enhance a national contingency management bill to cater for the increased frequency and variety of disasters in Kenya • Set up a national awareness campaign of potential risks in Kenyans' daily endeavours, including Early Warning Systems, perhaps with support from those who have had to deal with similar, like the European Union, and devise ways and means to mitigate them when they occur. Better still work on well tested methods of preventing their happening in the first place. • Decentralize the whole issue of management of disasters considering that they can occur anywhere in the country and a response from Nairobi is not useful if it takes hours to reach the point of reference LESSONS LEARNT I am curious to establish what lessons we have learnt to inform the way we manage disasters in general and natural disasters in particular. Disasters are getting more frightening and intense. The advancement in technology should be useful in dealing with disasters. Given the recent events in 2008 alone, we need to commit much more resources to research and development to deal with disasters however they are caused. We should work towards being able to continue with our lives regardless of the risks and disasters that come our way as individuals and as a nation, by designing a strategy and policies that have worked elsewhere.

A Cause for Concern The Spread of Militant Islam in East Africa

DTIC Science & Technology

2017-01-11

support militant Islamist groups .110 Qatar has likewise been supporting Salafists financially since the late 1970s and, according to Hussein Solomon ...a Tanzanian national, and Abdirahim Mohamed Abdullahi, a Kenyan national, along with four other attackers assessed to be of Kenyan origin, departed...doubt that extremist groups are intimately familiarly with these socioeconomic, cultural, and ethnic levers and understand how to manipulate them. But

Diversity in Education: Kenyan Sign Language as a Medium of Instruction in Schools for the Deaf in Kenya

ERIC Educational Resources Information Center

Mweri, Jefwa G.

2014-01-01

In Kenya, the only official document that deals with the use of mother tongue (MT) in Schools is the 1967 Gachathi report. The report has clear-cut guidance and policy regarding MT use by the hearing children. However, for deaf children, no such policy exists; therefore, the use of the deaf child's MT (Kenyan Sign Language (KSL)) in schools for…

Perceptions of emergency care in Kenyan communities lacking access to formalised emergency medical systems: a qualitative study

PubMed Central

Broccoli, Morgan C; Calvello, Emilie J B; Skog, Alexander P; Wachira, Benjamin; Wallis, Lee A

2015-01-01

Objectives We undertook this study in Kenya to understand the community's emergency care needs and barriers they face when trying to access care, and to seek community members’ thoughts regarding high impact solutions to expand access to essential emergency services. Design 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. Setting 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. Results 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: system structure, resources, transportation, trained healthcare providers and initial care at the scene. Conclusions Access to emergency care in Kenya 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 a national level. These community-generated solutions likely have a wider applicability in the region. PMID:26586324

Sociocultural and Victimization Factors That Impact Attitudes Toward Intimate Partner Violence Among Kenyan Women.

PubMed

Mugoya, George C T; Witte, Tricia H; Ernst, Kacey C

2015-10-01

This study investigates the association between acceptance of intimate partner violence (IPV) and reported IPV victimization among Kenyan women, taking into consideration select sociocultural factors that may also influence acceptance of IPV. Data from a nationally representative, cross-sectional, household survey conducted between November 2008 and February 2009 in Kenya were analyzed. Hierarchical multiple regression was conducted to estimate the effect of select sociodemographic characteristics and reported IPV victimization on acceptance of IPV. The results showed that while both sociodemographic characteristics and reported IPV victimization were significantly associated with IPV acceptance, sociocultural factors had a greater impact. Programs aimed at empowering women and culturally competent IPV prevention strategies may be the key elements to reducing IPV. © The Author(s) 2014.

Attributions and Attitudes of Mothers and Fathers in Kenya.

PubMed

Oburu, Paul Odhiambo

2011-07-01

OBJECTIVE: The present study examined differences and similarities between Kenyan mothers and fathers in attributions regarding successes and failures in caregiving situations and progressive versus authoritarian attitudes. DESIGN: Interviews were conducted with both mothers and fathers in 100 two-parent families in Kenya. RESULTS: Mothers were more likely to make attributions regarding adult-controlled failure in caregiving situations than were fathers, but mothers and fathers did not differ on attributions regarding uncontrollable success, child-controlled failure, or authoritarian or progressive attitudes. Moderate to large correlations were found between mothers and fathers in terms of attributions regarding uncontrollable success, authoritarian attitudes, and modernity of attitudes. CONCLUSIONS: Kenyan mothers and fathers hold very similar attributions for success and failures in caregiving situations as well as parenting attitudes.

Attitudes and awareness of female genital mutilation: a questionnaire-based study in a Kenyan hospital.

PubMed

Livermore, L; Monteiro, R; Rymer, J

2007-11-01

There are considerable efforts in Kenya to increase awareness of the issues and health risks associated with female genital mutilation (FGM) through educational programmes. The Kenyan government formally outlawed FGM in 2001. This questionnaire-based study aimed to explore attitudes and awareness of FGM in Kenya with particular reference to the law, health complications and educational programmes. A significant decline in the prevalence of FGM was demonstrated and awareness of health complications of FGM shown to be the main factor causing this trend. The need for further efforts to eradicate the practice and the importance of religion and culture in shaping social attitudes was evident. The outlawing of FGM was considered a positive advance but may have the detrimental effect of deterring women from seeking medical assistance for complications relating to FGM.

Plume-induced continental break-up from Red Sea to Lake Malawi: 3D numerical models of the East African Rift System

NASA Astrophysics Data System (ADS)

Koptev, Alexander; Burov, Evgueni; Calais, Eric; Leroy, Sylvie; Gerya, Taras; Cloetingh, Sierd; Guillou-Frottier, Laurent

2017-04-01

We use numerical thermo-mechanical experiments in order to analyze the role of active mantle plume, far-field tectonic stresses and pre-existing lithospheric heterogeneities in structural development of the East African Rift system (EARS). It is commonly assumed that the Cenozoic rifts have avoided the cratons and follow the mobile belts which serve as the weakest pathways within the non-uniform material structured during pre-rift stages. Structural control of the pre-existing heterogeneities within the Proterozoic belts at the scale of individual faults or rifts has been demonstrated as well. However, the results of our numerical experiments show that the formation of two rift zones on opposite sides of a thick lithosphere segment can be explained without appealing to pre-imposed heterogeneities at the crustal level. These models have provided a unified physical framework to understand the development of the Eastern branch, the Western branch and its southern prolongation by the Malawi rift around thicker lithosphere of the Tanzanian and Bangweulu cratons as a result of the interaction between pre-stressed continental lithosphere and single mantle plume anomaly corresponding to the Kenyan plume. The second series of experiments has been designed in order to investigate northern segment of the EARS where Afro-Arabian plate separation is supposed to be related with the impact of Afar mantle plume. We demonstrate that whereas relatively simple linear rift structures are preferred in case of uni-directional extension, more complex rifting patterns combining one or several ridge-ridge-ridge triple junctions can form in response to bi-directional extensional far-field stresses. In particular, our models suggest that Afar triple junction represents an end-member mode of plume-induced bi-directional rifting combining asymmetrical northward traction and symmetrical EW extension of similar magnitudes. The presence of pre-existing linear weak zones appears to be not mandatory for deformation localization ultimately leading to present configuration of the Afar triple junction. Finally, for laterally extended experiments we have used parameters of the best-fit models for the southern and northern segments of the EARS in order to define the position of Kenyan plume and the velocity boundary conditions. These models cover all rifting and spreading structures associated with both Afar and Kenyan plumes: Red Sea Rift and the Aden Ridge to the north of the Afar Triple Junction; Main Ethiopian Rift running to the south that continues as the Kenyan Rift; Western Rift and its southern prolongation corresponding to Malawi rift. We argue that all these basic features associated with Cenozoic rifting in the EARS can be reproduced in a relatively simple context of the interaction between two mantle anomalies corresponding to Afar and Kenyan plumes and pre-stressed rheologically stratified continental lithosphere containing only first-order structural heterogeneities (such as Tanzanian and Bangweulu cratons).

The long-run poverty and gender impacts of mobile money.

PubMed

Suri, Tavneet; Jack, William

2016-12-09

Mobile money, a service that allows monetary value to be stored on a mobile phone and sent to other users via text messages, has been adopted by the vast majority of Kenyan households. We estimate that access to the Kenyan mobile money system M-PESA increased per capita consumption levels and lifted 194,000 households, or 2% of Kenyan households, out of poverty. The impacts, which are more pronounced for female-headed households, appear to be driven by changes in financial behavior-in particular, increased financial resilience and saving-and labor market outcomes, such as occupational choice, especially for women, who moved out of agriculture and into business. Mobile money has therefore increased the efficiency of the allocation of consumption over time while allowing a more efficient allocation of labor, resulting in a meaningful reduction of poverty in Kenya. Copyright © 2016, American Association for the Advancement of Science.

Material girls and Material love: Consuming femininity and the contradictions of post-girl power among Kenyan schoolgirls

PubMed Central

Mojola, Sanyu A.

2016-01-01

In this paper, I use qualitative data to explore the practices engaged in by Kenyan schoolgirls to participate in modern consuming womanhood, as well as the contradictory implications of these practices for thinking about globalized mediated femininities and their enactment in resource-poor settings. The paper examines the centrality of consumption to valued modern femininity among young women around the world, as well as the structural reality of gendered access to income. I show how the cooptation of the materiality of romantic love and normative expectations of male provision in romantic relationships bridge the gap between consumption desires and economic realities among Kenyan schoolgirls in both powerful and problematic ways. The paper ends with a reflection of the implications of these findings for post-girl power, the post-feminist age and the re-inscription of patriarchy. PMID:28344428

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hyman, E.L.

Efforts at promoting more fuel-efficient charcoal stoves to replace traditional charcoal stoves in Kenya offer some lessons for the dissemination of appropriate technologies. This paper looks at the market-based approach which has made the Kenyan charcoal stoves project a success. Trends in woodfuels (wood and charcoal) consumption in Kenya are identified; the traditional technology for charcoal combustion and the upgraded traditional technologies are described; production achievement and the dissemination and promotion strategy used are examined; and a financial and economic analysis is performed with social, health and environmental effects assessed. Other ways to achieve a more favourable balance between woodfuelsmore » consumption and supply are then discussed looking at more efficient charcoal kilns and household woodstoves, improved institutional stoves and increased wood production. The replication potential of the Kenya experiment in other countries is also explored. The lessons learnt from the the Kenya experience concern the relationship between technology, choice and delivery systems as they interact with, economic, institutional, and policy factors. In this case, the design work accepted the traditional technology as a starting point which helped ensure widespread acceptance by households. The potential desirability of relying on local artisans to manufacture consumer durables using existing private sector channels to market these goods is also shown. It also highlights the importance of going beyond a laissez-faire approach and supporting training, demonstration, and publicity to faciliate the workings of the private sector. In the Kenyan case, technology choice was relatively unsubsidized and left ot the preferences of consumers.« less

The Law of War: Can 20th-Century Standards Apply to the Global War on Terrorism?

DTIC Science & Technology

2005-01-01

perpetrated by Kenyans against Kenyans, were accompanied by reports of greater instances of oathing and intimidation, maiming of cattle on European...or mutilated (some so severely they were permanently maimed), 200 huts destroyed by fire, and 1,000 cattle maimed (usually by having the tendons of...examples where security forces castrated detainees, forced them to engage in acts of sodomy, and, to use her words, “Perpetrated similar horrifying acts

A resolution congratulating the people of Kenya on their commitment to peaceful elections, as demonstrated on March 4, 2013, and calling on Kenyans to come together to continue to implement political, institutional, and accountability reforms envisioned in the Kenyan constitution.

THOMAS, 113th Congress

Sen. Coons, Christopher A. [D-DE

2013-03-22

Senate - 04/22/2013 Resolution agreed to in Senate with an amendment and an amendment to the Title and an amended preamble by Unanimous Consent. (All Actions) Tracker: This bill has the status Agreed to in SenateHere are the steps for Status of Legislation:

Perceptions and uptake of health insurance for maternal care in rural Kenya: a cross sectional study.

PubMed

Maina, Jackson Michuki; Kithuka, Peter; Tororei, Samuel

2016-01-01

In Kenya, maternal and child health accounts for a large proportion of the expenditures made towards healthcare. It is estimated that one in every five Kenyans has some form of health insurance. Availability of health insurance may protect families from catastrophic spending on health. The study intended to determine the factors affecting the uptake of health insurance among pregnant women in a rural Kenyan district. This was cross-sectional study that sampled 139 pregnant women attending the antenatal clinic at a level 5 hospital in a Kenyan district. The information was collected through a pretested interview schedule. The median age of the study participants was 28 years. Out of the 139 respondents, 86(62%) planned to pay for their deliveries through insurance. There was a significant relationship between insurance uptake and marital status Adjusted odds ratio (AOR) 6.4(1.4-28.8). Those with tertiary education were more likely to take up insurance AOR 5.1 (1.3-19.2). Knowing the benefits of insurance and the limits the insurance would settle in claims was associated with an increase in the uptake of insurance AOR 7.6(2.3-25.1), AOR 6.4(1.5-28.3) respectively. Monthly income and number of children did not affect insurance uptake. Being married, tertiary education and having some knowledge on how insurance premiums are paid are associated with uptake of medical insurance. Information generated from this study if utilized will bring a better understanding as to why insurance coverage may be low and may provide a basis for policy changes among the insurance companies to increase the uptake.

Perceptions and uptake of health insurance for maternal care in rural Kenya: a cross sectional study

PubMed Central

Maina, Jackson Michuki; Kithuka, Peter; Tororei, Samuel

2016-01-01

Introduction In Kenya, maternal and child health accounts for a large proportion of the expenditures made towards healthcare. It is estimated that one in every five Kenyans has some form of health insurance. Availability of health insurance may protect families from catastrophic spending on health. The study intended to determine the factors affecting the uptake of health insurance among pregnant women in a rural Kenyan district. Methods This was cross-sectional study that sampled 139 pregnant women attending the antenatal clinic at a level 5 hospital in a Kenyan district. The information was collected through a pretested interview schedule. Results The median age of the study participants was 28 years. Out of the 139 respondents, 86(62%) planned to pay for their deliveries through insurance. There was a significant relationship between insurance uptake and marital status Adjusted odds ratio (AOR) 6.4(1.4-28.8). Those with tertiary education were more likely to take up insurance AOR 5.1 (1.3-19.2). Knowing the benefits of insurance and the limits the insurance would settle in claims was associated with an increase in the uptake of insurance AOR 7.6(2.3-25.1), AOR 6.4(1.5-28.3) respectively. Monthly income and number of children did not affect insurance uptake. Results Being married, tertiary education and having some knowledge on how insurance premiums are paid are associated with uptake of medical insurance. Information generated from this study if utilized will bring a better understanding as to why insurance coverage may be low and may provide a basis for policy changes among the insurance companies to increase the uptake. PMID:27279952

Worldwide distribution of Waardenburg syndrome.

PubMed

Nayak, Chetan S; Isaacson, Glenn

2003-09-01

To clarify the multiracial occurrence of Waardenburg syndrome, we present a case series and literature review. A computerized review of the English-language literature was conducted to assess the distribution of reported occurrences of Waardenburg syndrome in populations around the world. We detail the clinical features of 2 family cohorts: one of Western European origin and the other from South Asia. A computerized literature review found sporadic cases of the syndrome in many ethnic groups, including Japanese, Taiwanese, and Middle Eastern families. The highest reported incidence is among Kenyan Africans. Waardenburg syndrome accounts for between 2% and 5% of cases of congenital deafness. It was first described in Northern European cohorts and is widely identified in fair-skinned populations. We hope to raise awareness of the worldwide distribution of this important cause of hearing loss.

Corruption in the Kenya Police Force and Impacts on Kenyan Security: Investigating the Need for Police Reforms

DTIC Science & Technology

2017-03-21

against the citizens. Kenya Police have always been linked with abuse of power with impunity when tackling crime or executing their duties. For example...Therefore, ethical police code of conducts in American 14 policing were established in the efforts to control excessive use of power while...occurs when the police encounter with the citizens during their routine enforcement of the law. The high -level of negative attitudes among Kenyans to the

Transnational Terrorism in East Africa: A Qualitative and Quantitative Analysis of the Recent Rise in Kenyan Violence

DTIC Science & Technology

2014-06-01

vibrant coastal beach tourism industry that is at odds with the locally dominant Islamic religion and culture; the perception that the country’s...other large scale cross-border attack by Al- Shabaab was the July 2010 twin bombing of a popular sports bar and restaurant in the Ugandan capital...Kenyan nationals from neighboring countries, as the majority of them frequently travel by road to and from Kenya for business, leisure, and tourism , 35

Evaluation of a training DVD on pneumococcal conjugate vaccine for Kenyan EPI healthcare workers.

PubMed

Stokx, Jocelijn; Dochez, Carine; Ochieng, Pamela; Bahl, Jhilmil; Were, Fred

2016-01-01

The Kenyan Ministry of Public Health and Sanitation was the first in Africa to introduce the new 10-valent Pneumococcal Conjugate Vaccine, PCV-10, in 2011. For successful implementation and to avoid adverse events following immunisation, specific training on handling and storage of the PCV-10 vaccine was required. Therefore, a training DVD was recorded in English and partly in Kiswahili to be used in combination with in-classroom training. Since the Kenyan Immunisation Programme was the first to use a DVD for training healthcare workers, an evaluation was done to obtain feedback on content, format and use, and propose suggestions to improve quality and uptake of the DVD. Feedback was obtained from nurses and vaccinology course participants through the completion of a questionnaire. Nurses also participated in focus group discussions and trainers in key informant interviews. Twelve trainers, 72 nurses and 26 international vaccinology course participants provided feedback, with some notable differences between the three study groups. The survey results confirmed the acceptability of the content and format, and the feasibility of using the DVD in combination with in-classroom teaching. To improve the quality and adoption of the DVD, key suggestions were: Inclusion of all EPI vaccines and other important health issues; broad geographic distribution of the DVD; and bilingual English/Kiswahili use of languages or subtitles. The Kenyan DVD is appreciated by a heterogeneous and international audience rendering the DVD suitable for other Anglophone African countries. Differences between feedback from nurses and vaccinology course participants can be explained by the practical approach of the DVD and the higher education and service level of the latter. A drawback is the use of DVD players and televisions due to lack of electricity, but it is a matter of time before all rural health facilities in Africa will have access to electricity and modern technology.

Service delivery in Kenyan district hospitals – what can we learn from literature on mid-level managers?

PubMed Central

2013-01-01

Background There is a growing emphasis on the need to tackle inadequate human resources for health (HRH) as an essential part of strengthening health systems; but the focus is mostly on macro-level issues, such as training, recruitment, skill mix and distribution. Few attempts have been made to understand the capability of health workers, their motivation and other structural and organizational aspects of systems that influence workforce performance. We have examined literature on the roles of mid-level managers to help us understand how they might influence service delivery quality in Kenyan hospitals. In the Kenyan hospital settings, these are roles that head of departments who are also clinical or nursing service providers might play. Methods A computerized search strategy was run in Pub Med, Cochrane Library, Directory of Open Access Journals Social Science Research Network, Eldis, Google Scholar and Human Resources for Health web site databases using both free-text and MeSH terms from 1980 to 2011. In addition, citation searching from excluded and included articles was used and relevant unpublished literature systematically identified. Results and discussion A total of 23 articles were finally included in the review from over 7000 titles and abstracts initially identified. The most widely documented roles of mid-level managers were decision-making or problem-solving, strategist or negotiator and communicator. Others included being a therapist or motivator, goal setting or articulation and mentoring or coaching. In addition to these roles, we identified important personal attributes of a good manager, which included interpersonal skills, delegation and accountability, and honesty. The majority of studies included in the review concerned the roles that mid-level managers are expected to play in times of organizational change. Conclusion This review highlights the possible significance of mid-level managers in achieving delivery of high-quality services in Kenyan public hospitals and strongly suggests that approaches to strengthen this level of management will be valuable. The findings from this review should also help inform empirical studies of the roles of mid-level managers in these settings. PMID:23442524

Evolution, distribution, and characteristics of rifting in southern Ethiopia

NASA Astrophysics Data System (ADS)

Philippon, Melody; Corti, Giacomo; Sani, Federico; Bonini, Marco; Balestrieri, Maria-Laura; Molin, Paola; Willingshofer, Ernst; Sokoutis, Dimitrios; Cloetingh, Sierd

2014-04-01

Southern Ethiopia is a key region to understand the evolution of the East African rift system, since it is the area of interaction between the main Ethiopian rift (MER) and the Kenyan rift. However, geological data constraining rift evolution in this remote area are still relatively sparse. In this study the timing, distribution, and style of rifting in southern Ethiopia are constrained by new structural, geochronological, and geomorphological data. The border faults in the area are roughly parallel to preexisting basement fabrics and are progressively more oblique with respect to the regional Nubia-Somalia motion proceeding southward. Kinematic indicators along these faults are mainly dip slip, pointing to a progressive rotation of the computed direction of extension toward the south. Radiocarbon data indicate post 30 ka faulting at both western and eastern margins of the MER with limited axial deformation. Similarly, geomorphological data suggest recent fault activity along the western margins of the basins composing the Gofa Province and in the Chew Bahir basin. This supports that interaction between the MER and the Kenyan rift in southern Ethiopia occurs in a 200 km wide zone of ongoing deformation. Fault-related exhumation at ~10-12 Ma in the Gofa Province, as constrained by new apatite fission track data, occurred later than the ~20 Ma basement exhumation of the Chew Bahir basin, thus pointing to a northward propagation of the Kenyan rift-related extension in the area.

Africa: Myth and Reality.

ERIC Educational Resources Information Center

Brown, Barbara B.

1994-01-01

Reports on the Third International Social Studies Conference held in Nairobi, Kenya, in 1994. Discusses democracy, educational reform efforts, and the importance of tourism to the Kenyan economy. Asserts that U.S. teachers must use accurate and nonstereotypical instructional materials in teaching about Africa. (CFR)

Undernutrition among Kenyan children: contribution of child, maternal and household factors.

PubMed

Gewa, Constance A; Yandell, Nanette

2012-06-01

To examine the contribution of selected child-, maternal- and household-related factors to child undernutrition across two different age groups of Kenyan under-5s. Demographic and Health Survey data, multistage stratified cluster sampling methodology. Rural and urban areas of Kenya. A total of 1851 children between the ages of 0 and 24 months and 1942 children between the ages of 25 and 59 months in Kenya. Thirty per cent of the younger children were stunted, 13 % were underweight and 8 % were wasted. Forty per cent of the older children were stunted, 17 % were underweight and 4 % were wasted. Longer breast-feeding duration, small birth size, childhood diarrhoea and/or cough, poor maternal nutritional status and urban residence were associated with higher odds of at least one form of undernutrition, while female gender, large birth size, up-to-date immunization, higher maternal age at first birth, BMI and education level at the time of the survey and higher household wealth were each associated with lower odds of at least one form of undernutrition among Kenyan children. The more proximal child factors had the strongest impact on the younger group of children while the intermediate and more distal maternal and household factors had the strongest impact on child undernutrition among the older group of children. The present analysis identifies determinants of undernutrition among two age groups of Kenyan pre-school children and demonstrates that the contribution of child, maternal and household factors on children's nutritional status varies with children's age.

Technical Secondary Schools and the Labour Market: Some Results from a Tracer Study in Kenya.

ERIC Educational Resources Information Center

Narman, Anders

1988-01-01

Reports tracer studies of Kenyan youths leaving technical school to determine their success at obtaining gainful employment. Almost 43% were neither in formal schooling nor training, nor employed a year after leaving, although technical skills were seen as useful, particularly in private life. (DP)

Privatising the Public: Marketisation as a Strategy in Public University Transformation

ERIC Educational Resources Information Center

Munene, Ishmael I.

2008-01-01

In this study, the transformation of a Kenyan public university through marketisation and privatisation was investigated qualitatively. By focusing on senior university administrators, deans, department heads, union leaders, student leaders and senior scholars at Kenyatta University the study identified the reasons for, and strategies used to…

An Improvement in Instructional Quality: Can Evaluation of Teaching Effectiveness Make a Difference?

ERIC Educational Resources Information Center

Ngware, Moses Waithanji; Ndirangu, Mwangi

2005-01-01

Purpose: To report study findings on teaching effectiveness and feedback mechanisms in Kenyan universities, which can guide management in developing a comprehensive quality control policy. Design/methodology/approach: The study adopted an exploratory descriptive design. Three public and two private universities were randomly selected to…

Who Goes to University in Kenya? A Study of Social Background of Kenyan Undergraduate Students.

ERIC Educational Resources Information Center

Eshiwani, George S.

The social and educational background and the educational and occupational aspirations of undergraduate students in Kenya were studied. The study sample consisted of 232 male and 210 female undergraduate students at Kenyatta University College. A questionnaire was administered to determine: students' characteristics, including sex, age, marital…

Impacts of population growth and economic development on water quality of a lake: case study of Lake Victoria Kenya water.

PubMed

Juma, Dauglas Wafula; Wang, Hongtao; Li, Fengting

2014-04-01

Anthropogenic-induced water quality pollution is a major environmental problem in freshwater ecosystems today. As a result of this, eutrophication of lakes occurs. Population and economic development are key drivers of water resource pollution. To evaluate how growth in the riparian population and in the gross domestic product (GDP) with unplanned development affects the water quality of the lake, this paper evaluates Lake Victoria Kenyan waters basin. Waters quality data between 1990 and 2012 were analyzed along with reviews of published literature, papers, and reports. The nitrate-nitrogen (NO3-N), soluble phosphorus (PO4-P), chlorophyll a, and Secchi transparencies were evaluated as they are key water quality indicators. The NO3-N increased from 10 μg l(-1) in 1990 to 98 μg 1(-1) in 2008, while PO4-P increased from 4 μg l(-1) in 1990 to 57 μg l(-1) in 2008. The population and economic growth of Kenya are increasing with both having minimums in 1990 of 24.143 million people and 12.18 billion US dollars, to maximums in 2010 of 39.742 million people and 32.163 billion US dollars, respectively. A Secchi transparency is reducing with time, indicating an increasing pollution. This was confirmed by an increase in aquatic vegetation using an analysis of moderate resolution imaging spectroradiometer (MODIS) images of 2000 and 2012 of Kenyan waters. This study found that increasing population and GDP increases pollution discharge thus polluting lakes. One of major factors causing lake water pollution is the unplanned or poor waste management policy and service.

Malaria and Chikungunya Detected Using Molecular Diagnostics Among Febrile Kenyan Children.

PubMed

Waggoner, Jesse; Brichard, Julie; Mutuku, Francis; Ndenga, Bryson; Heath, Claire Jane; Mohamed-Hadley, Alisha; Sahoo, Malaya K; Vulule, John; Lefterova, Martina; Banaei, Niaz; Mukoko, Dunstan; Pinsky, Benjamin A; LaBeaud, A Desiree

2017-01-01

In sub-Saharan Africa, malaria is frequently overdiagnosed as the cause of an undifferentiated febrile illness, whereas arboviral illnesses are presumed to be underdiagnosed. Sera from 385 febrile Kenyan children, who presented to 1 of 4 clinical sites, were tested using microscopy and real-time molecular assays for dengue virus (DENV), chikungunya virus (CHIKV), malaria, and Leptospira . Malaria was the primary clinical diagnosis for 254 patients, and an arboviral infection (DENV or CHIKV) was the primary diagnosis for 93 patients. In total, 158 patients (41.0%) had malaria and 32 patients (8.3%) had CHIKV infections. Compared with real-time polymerase chain reaction, microscopy demonstrated a percent positive agreement of 49.7%. The percentage of malaria cases detected by microscopy varied significantly between clinical sites. Arboviral infections were the clinical diagnosis for patients on the Indian Ocean coast (91 of 238, 38.2%) significantly more often than patients in the Lake Victoria region (2 of 145, 1.4%; P < .001). However, detection of CHIKV infections was significantly higher in the Lake Victoria region (19 of 145 [13.1%] vs 13 of 239 [5.4%]; P = .012). The clinical diagnosis of patients with an acute febrile illness, even when aided by microscopy, remains inaccurate in malaria-endemic areas, contributing to inappropriate management decisions.

Isolation and molecular characterization of Fikirini rhabdovirus, a novel virus from a Kenyan bat.

PubMed

Kading, Rebekah C; Gilbert, Amy T; Mossel, Eric C; Crabtree, Mary B; Kuzmin, Ivan V; Niezgoda, Michael; Agwanda, Bernard; Markotter, Wanda; Weil, M Ryan; Montgomery, Joel M; Rupprecht, Charles E; Miller, Barry R

2013-11-01

Zoonotic and vector-borne pathogens have comprised a significant component of emerging human infections in recent decades, and bats are increasingly recognized as reservoirs for many of these disease agents. To identify novel pathogens associated with bats, we screened tissues of bats collected in Kenya. Virus isolates were identified by next generation sequencing of viral nucleic acid preparations from the infected cell culture supernatant and characterized. Here we report the identification of Fikirini rhabdovirus, a novel rhabdovirus isolated from a bat, Hipposideros vittatus, captured along the Kenyan coast.

Refugees Flexing Social Power as Agents of Stability: Creating Modes of Economic Livelihoods in Kenya’s Camps

DTIC Science & Technology

2017-11-21

incubator for terrorism Official Kenyan policy was that refugees remain within the camps, but it was not until al-Qaeda bombed the U.S. embassy in Kenya...during 1998, and another terrorist bombing occurred at a hotel in the Kenyan city of Mombasa in 2002 that the government actively pursued this policy...evidence for most, if not all, of the bombings and attacks. The nature of bombings , and what makes them so appealing to terrorists, is the difficulty

Discovery and Validation of Biomarkers to Guide Clinical Management of Pneumonia in African Children

PubMed Central

Huang, Honglei; Ideh, Readon C.; Gitau, Evelyn; Thézénas, Marie L.; Jallow, Muminatou; Ebruke, Bernard; Chimah, Osaretin; Oluwalana, Claire; Karanja, Henri; Mackenzie, Grant; Adegbola, Richard A.; Kwiatkowski, Dominic; Kessler, Benedikt M.; Berkley, James A.; Howie, Stephen R. C.; Casals-Pascual, Climent

2014-01-01

Background. Pneumonia is the leading cause of death in children globally. Clinical algorithms remain suboptimal for distinguishing severe pneumonia from other causes of respiratory distress such as malaria or distinguishing bacterial pneumonia and pneumonia from others causes, such as viruses. Molecular tools could improve diagnosis and management. Methods. We conducted a mass spectrometry–based proteomic study to identify and validate markers of severity in 390 Gambian children with pneumonia (n = 204) and age-, sex-, and neighborhood-matched controls (n = 186). Independent validation was conducted in 293 Kenyan children with respiratory distress (238 with pneumonia, 41 with Plasmodium falciparum malaria, and 14 with both). Predictive value was estimated by the area under the receiver operating characteristic curve (AUC). Results. Lipocalin 2 (Lpc-2) was the best protein biomarker of severe pneumonia (AUC, 0.71 [95% confidence interval, .64–.79]) and highly predictive of bacteremia (78% [64%–92%]), pneumococcal bacteremia (84% [71%–98%]), and “probable bacterial etiology” (91% [84%–98%]). These results were validated in Kenyan children with severe malaria and respiratory distress who also met the World Health Organization definition of pneumonia. The combination of Lpc-2 and haptoglobin distinguished bacterial versus malaria origin of respiratory distress with high sensitivity and specificity in Gambian children (AUC, 99% [95% confidence interval, 99%–100%]) and Kenyan children (82% [74%–91%]). Conclusions. Lpc-2 and haptoglobin can help discriminate the etiology of clinically defined pneumonia and could be used to improve clinical management. These biomarkers should be further evaluated in prospective clinical studies. PMID:24696240

Changing patterns of clinical malaria since 1965 among a tea estate population located in the Kenyan highlands*

PubMed Central

Shanks, G. D.; Biomndo, K.; Hay, S. I.; Snow, R. W.

2012-01-01

The changing epidemiology of clinical malaria since 1965 among hospitalized patients was studied at a group of tea estates in the western highlands of Kenya. These data indicate recent dramatic increases in the numbers of malaria admissions (6·5 to 32·5% of all admissions), case fatality (1·3 to 6%) and patients originating from low-risk, highland areas (34 to 59%). Climate change, environmental management, population migration, and breakdown in health service provision seem unlikely explanations for this changing disease pattern. The coincident arrival of chloroquine resistance during the late 1980s in the sub-region suggests that drug resistance is a key factor in the current pattern and burden of malaria among this highland population. PMID:10974991

Challenges and coping strategies of parents of children with autism on the Kenyan coast.

PubMed

Gona, Joseph K; Newton, Charles R; Rimba, Kenneth K; Mapenzi, Rachel; Kihara, Michael; Vijver, Fonns V; Abubakar, Amina

2016-01-01

Research on the challenges of raising a child with autism is mostly conducted in Europe, North America and Australia, and has revealed that parents have to come to terms with living with a lifelong developmental disability. In addition, parents are faced with numerous concerns, such as caring burdens, poor prognosis, and negative public attitudes. Virtually no research has been conducted in Africa on this subject. Thirty-seven interviews and eight focus group discussions were conducted with parents of children with autism and professionals in regular contact with these parents from rural and urban counties of the Kenyan coast. The study investigated challenges faced by parents and how they cope with those challenges. A purposive-convenience sampling procedure was used in selecting the study participants. A digital recorder was used to record all the interviews and focus group discussions. Transcriptions were done in Swahili, translated into English, and then imported to the NVivo software program for content analysis. The results indicate that parents of children with autism on the Kenyan coast experience common challenges including stigma, lack of appropriate treatment, financial and caring burdens regardless of their religious and cultural backgrounds. Coping strategies applied by parents comprised problem-focused aspects that involve diet management and respite care, and emotion-focused aspects that consist of beliefs in supernatural powers, prayers and spiritual healing. This qualitative study reveals a range of challenges that could have significant impact when caring for a child with autism. Coping strategies applied by parents target the physical health of the child and the psychological wellbeing of the parent. Consideration of these outcomes is vital as they could impact the initiation of a community-based rehabilitation service delivery in rural settings where parents play an active role.

Otitis Media and Its Sequelae in Kenyan Schoolchildren.

PubMed

Simões, Eric A F; Kiio, Francis; Carosone-Link, Phyllis J; Ndegwa, Serah N; Ayugi, John; Macharia, Isaac M

2016-12-01

The goal of this study was to obtain representative Kenyan data on the point prevalence of acute otitis media (AOM) and its sequelae (otitis media with effusion [OME] and chronic suppurative otitis media [CSOM]), a major cause of preventable hearing loss in children in developing countries. In Africa, there are limited studies on the prevalence of AOM and its sequelae in children. Study subjects were children aged 2 to 15 years and were enrolled from randomly selected preprimary and primary schools. After parental or guardian consent, subjects had a questionnaire administered, otoscopy and tympanometry were done, and audiometry was performed on those with ear problems detected on these examinations. A total of 9825 (75%) children was from rural schools. The prevalence of CSOM was 15 of 1000, OME was 15 of 1000, and AOM was 7 of 1000 children. Rural Rift Valley schoolchildren had the highest prevalence of CSOM (24 of 1000) compared with other regions (12 of 1000; P < .0001). Ear discharge occurred before 3.5 years in 50% of 901 children with ear discharge. A history of ear discharge was associated with abnormal tympanograms (odds ratio [OR], 11.9-19.2) and mild-to-severe hearing loss (OR, 21.6-38.6), even in children without ear disease (OR, 10.7-24.4). The burden of AOM sequelae in Kenyan preschool and schoolchildren is significant, and it occurs mostly in the first 4 years of life. By preventing early recurrent AOM, pneumococcal vaccination might partly avert nonreversible sequelae. © The Author 2015. Published by Oxford University Press on behalf of the Pediatric Infectious Diseases Society. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Challenges and coping strategies of parents of children with autism on the Kenyan coast

PubMed Central

Gona, JK; Newton, CR; Rimba, KK; Mapenzi, R; Kihara, M; Vijver, FV; Abubakar, A

2017-01-01

Introduction Research on the challenges of raising a child with autism is mostly conducted in Europe, North America and Australia, and has revealed that parents have to come to terms with living with a lifelong developmental disability. In addition, parents are faced with numerous concerns, such as caring burdens, poor prognosis, and negative public attitudes. Virtually no research has been conducted in Africa on this subject. Methods Thirty-seven interviews and eight focus group discussions were conducted with parents of children with autism and professionals in regular contact with these parents from rural and urban counties of the Kenyan coast. The study investigated challenges faced by parents and how they cope with those challenges. A purposive–convenience sampling procedure was used in selecting the study participants. A digital recorder was used to record all the interviews and focus group discussions. Transcriptions were done in Swahili, translated into English, and then imported to the NVivo software program for content analysis. Results The results indicate that parents of children with autism on the Kenyan coast experience common challenges including stigma, lack of appropriate treatment, financial and caring burdens regardless of their religious and cultural backgrounds. Coping strategies applied by parents comprised problem-focused aspects that involve diet management and respite care, and emotion-focused aspects that consist of beliefs in supernatural powers, prayers and spiritual healing. Conclusions This qualitative study reveals a range of challenges that could have significant impact when caring for a child with autism. Coping strategies applied by parents target the physical health of the child and the psychological wellbeing of the parent. Consideration of these outcomes is vital as they could impact the initiation of a community-based rehabilitation service delivery in rural settings where parents play an active role. PMID:27098766

Estimated burden of fungal infections in Kenya.

PubMed

Guto, John Abuga; Bii, Christine C; Denning, David W

2016-08-31

Kenya is a developing country with a high rate of tuberculosis (TB) and a moderate HIV infection burden. No estimate of the burden of fungal diseases in Kenya is published. We used specific populations at risk and fungal infection frequencies from the literature to estimate national incidence or prevalence of serious fungal infections. Used sources were: 2010 WHO TB statistics, Kenya Acquired Immunodeficiency Syndrome (AIDS) Epidemic Update 2012, Kenya Facts and figures 2012, Kenya Demographic and Health Survey 2008-2009. Of Kenya's population of ~40 million, 43% are under 15 years old and approximately 594,660 Kenyan women get >4 episodes Candida vulvovaginitis annually (2,988/100,000). The HIV/AIDS population at risk of opportunistic infections (OI) is 480,000 and the OI estimates include 306,000 patients with oral thrush (768/100,000), 114,000 with oesophageal candidiasis (286/100,000), 11,900 with cryptococcal meningitis (29/100,000) and 17,000 patients with Pneumocystis pneumonia (42/100,000). Chronic pulmonary aspergillosis following TB has a prevalence of 10,848 cases (32/100,000). The adult asthma prevalence is 3.1% and assuming 2.5% have allergic bronchopulmonary aspergillosis then 17,696 (44/100,000) are affected.  Invasive aspergillosis, candidaemia and Candida peritonitis are probably uncommon. Tinea capitis infects 9.6% of children in Kenya, while fungal keratitis and otomycoses are difficult to estimate. At any one time, about 7% of the Kenyan population suffers from a significant fungal infection, with recurrent vaginitis and tinea capitis accounting for 82% of the infections. These estimates require further epidemiological studies for validation.

Development and pilot testing of an intervention to promote care engagement and adherence among HIV-positive Kenyan MSM.

PubMed

Graham, Susan M; Micheni, Murugi; Kombo, Bernadette; Van Der Elst, Elisabeth M; Mugo, Peter M; Kivaya, Esther; Aunon, Frances; Kutner, Bryan; Sanders, Eduard J; Simoni, Jane M

2015-12-01

In many African settings, MSM are a stigmatized group whose access to and engagement in HIV care may be challenging. Our aim was to design a targeted, culturally appropriate intervention to promote care engagement and antiretroviral therapy (ART) adherence for MSM in coastal Kenya, and describe intervention safety, feasibility, and acceptability based upon a small pilot study. Based on qualitative work including in-depth interviews with HIV-positive MSM and focus groups with providers, we developed a tailored intervention and conducted a pilot test to refine intervention materials and procedures. The Shikamana intervention combines modified Next-Step Counseling by trained providers, support from a trained peer navigator, and tailored use of SMS messaging, phone calls, and discrete pill carriers. Providers, including counselors and clinicians, work together with peer navigators as a case management team. Forty HIV-positive MSM aged 19-51 participated in intervention development and testing. Six counselors, three clinical officers, and four MSM peers were trained in intervention procedures. Of 10 ART-naïve participants who enrolled in the pilot, eight completed follow-up with no adverse events reported. One participant was lost to follow-up after 2 months and another failed to initiate ART despite ongoing counseling. No adverse events were reported. Staff feedback and exit interviews rated the intervention as feasible and acceptable. This adherence support intervention tailored for Kenyan MSM was well tolerated, feasible, and acceptable in the pilot phase. A randomized controlled trial of a scaled-up programme to estimate intervention efficacy is ongoing.

Exploring Cultural Influences of Self-Management of Diabetes in Coastal Kenya

PubMed Central

Abdulrehman, Munib Said; Woith, Wendy; Jenkins, Sheryl; Kossman, Susan; Hunter, Gina Louise

2016-01-01

In spite of increasing prevalence of diabetes among Kenyans and evidence suggesting Kenyans with diabetes maintain poor glycemic control, no one has examined the role of cultural attitudes, beliefs, and practices in their self-management of diabetes. The purpose of this ethnographic study was to describe diabetes self-management among the Swahili of coastal Kenya, and explore factors that affect diabetes self-management within the context of Swahili culture. Thirty men and women with type 2 diabetes from Lamu town, Kenya, participated in this study. Diabetes self-management was insufficiently practiced, and participants had limited understanding of diabetes. Economic factors such as poverty and the high cost of biomedical care appear to have more influence in self-management behavior than socio-cultural and educational factors do. Economic and socio-cultural influences on diabetes self-management should not be underestimated, especially in a limited resource environment like coastal Kenya, where biomedical care is not accessible or affordable to all. PMID:28462335

Around the Table: Food Insecurity, Socioeconomic Status, and Instrumental Social Support among Women Living in a Rural Kenyan Island Community.

PubMed

Nagata, Jason M; Fiorella, Kathryn J; Salmen, Charles R; Hickey, Matthew D; Mattah, Brian; Magerenge, Richard; Milner, Erin M; Weiser, Sheri D; Bukusi, Elizabeth A; Cohen, Craig R

2015-01-01

The objective of this study was to investigate the relationship among socioeconomic status, social support, and food insecurity in a rural Kenyan island community. A cross-sectional random sample of 111 female heads of households representing 583 household members were surveyed in Mfangano Island, Kenya from August to October 2010 using adaptations of the Household Food Insecurity Access Scale and the Medical Outcomes Study Social Support Survey. In multiple linear regression models, less instrumental social support, defined as concrete direct ways people help others (B = -0.81; 95% confidence interval [CI] -1.45 to -0.17), and decreased ownership scale based on owning material assets (B = -2.93; 95% CI -4.99 to -0.86) were significantly associated with increased food insecurity, controlling for age, education, marital status, and household size. Social support interventions geared at group capacity and resilience may be crucial adjuncts to improve and maintain the long term food security and health of persons living in low-resource regions.

A Cross-National Study of Implicit Theories of a Creative Person

ERIC Educational Resources Information Center

Hopp, Manuel; Händel, Marion; Stoeger, Heidrun; Vialle, Wilma; Ziegler, Albert

2016-01-01

Implicit theories can influence learning behavior, the approaches individuals take to learning and performance situations, and the learning goals individuals set, as well as, indirectly, their accomplishments, intelligence, and creativity. For this cross-cultural study, Kenyan and German students were asked to draw a creative person and rate it on…

Necessity and benefits of physician assistants' participation in international clinical experiences.

PubMed

Kibe, Lucy Wachera

2012-01-01

Several consultation stations have been set up in an unfinished stone building. My team is made up of a Kenyan physician assistant (called clinical officer), a Kenyan medical student, and me, a US physician assistant student. We are huddled around a small worn-out square table. A middle-aged woman and her two children, ages 2 and 6, approach the table. They have traveled 2 miles to the medical camp. The children, covered in dust, are emaciated with protruding abdomens, dry skin, and congested noses. The clinical officer (CO) conducts a brief interview in Swahili, the Kenyan national language. The mother explains that they have been coughing up thick yellow sputum for a week and have no appetite. They've also had diarrhea for a couple of weeks. I examine the children, who are obviously scared. Hot, moist skin. They are both running a fever. I listen to the lungs: reduced lung sounds. The protruding abdomens are rock hard. I report the findings to the team. The CO turns to the Kenyan medical student and me and quizzes us on differential diagnoses with rationale for each. We come up with malaria, pneumonia, TB, and worm infestation. Due to limited resources, medical diagnosis in Kenya relies heavily on history and physical exam. The CO explains that comorbid conditions are probable. Luckily, we have malaria-testing kits at the camp. They test negative for malaria. We decide to treat them for pneumonia. We also offer them a free hot meal, toothbrushes, T-shirts, coloring paper, and crayons. The children manage to smile. The mother is so grateful, she cries.

Assessment and Evaluation Modeling. Symposium 38. [AHRD Conference, 2001].

ERIC Educational Resources Information Center

2001

This symposium on assessment and evaluation modeling consists of three presentations. "Training Assessment Among Kenyan Smallholder Entrepreneurs" (George G. Shibanda, Jemymah Ingado, Bernard Nassiuma) reports a study that assessed the extent to which the need for knowledge, information, and skills among small scale farmers can promote…

Trainers Attitudes towards the Teaching of AIDS Education in a Kenyan Teachers' College

ERIC Educational Resources Information Center

Nzau, K. A.; Ondimu, K. A.; Gikuhi, C. W.

2012-01-01

The purpose of this study was to examine the teaching of AIDS education. The study was mainly concerned with the implementation of the AIDS education curriculum. In particular the study sought to investigate the attitudes held by trainers and trainees towards the subject and make suggestions to improve its teaching. The study was conducted in a…

Diet and hygiene practices influence morbidity in schoolchildren living in Schistosomiasis endemic areas along Lake Victoria in Kenya and Tanzania-A cross-sectional study.

PubMed

Mohamed, Iman; Kinung'hi, Safari; Mwinzi, Pauline N M; Onkanga, Isaac O; Andiego, Kennedy; Muchiri, Geoffrey; Odiere, Maurice R; Vennervald, Birgitte Jyding; Olsen, Annette

2018-03-01

Since 2011, cohorts of schoolchildren in regions bordering Lake Victoria in Kenya and Tanzania have been investigated for morbidity caused by Schistosoma mansoni infection. Despite being neighbouring countries with similar lifestyles and ecological environments, Tanzanian schoolchildren had lower S. mansoni prevalence and intensity and they were taller and heavier, fewer were wasted and anaemic, and more were physical fit compared to their Kenyan peers. The aim of the present study was to evaluate whether diet and school-related markers of socioeconomic status (SES) could explain differences in morbidity beyond the effect of infection levels. Parasitological and morbidity data from surveys in 2013-2014 were compared with information on diet and school-related markers of SES collected in 2015 using questionnaires. A total of 490 schoolchildren (163 Kenyans and 327 Tanzanians) aged 9-11 years provided data. A higher proportion of Tanzanian pupils (69.4%, 95% CI: 64.3-74.5) knew where to wash hands after toilet visits compared to Kenyan pupils (48.5%, 95% CI: 40.9-56.1; P<0.0005). Similar proportions of children in the two countries ate breakfast, lunch and dinner, but the content of the meals differed. At all three meals, a higher proportion (95% CI) of Tanzanian pupils consumed animal proteins (mostly fish proteins) compared to their Kenyan peers (35.0% (28.3-41.7) vs. 0%; P<0.0005 at breakfast; 69.0% (63.9-74.1) vs. 43.6% (35.8-51.4); P<0.0005 at lunch; and 67.2% (62.1-72.3) vs. 53.4% (45.8-61.0); P = 0.003 at dinner). Multivariable analyses investigating risk factors for important morbidity markers among individuals revealed that after controlling for schistosome and malaria infections, eating animal proteins (fish) and knowing where to wash hands after toilet visits were significant predictors for both haemoglobin levels and physical fitness (measured as VO2 max). These results suggest that the differences in morbidity may be affected by factors other than S. mansoni infection alone. Diet and hygiene practice differences were associated with health status of schoolchildren along Lake Victoria in Kenya and Tanzania. Trials Registration numbers: ISRCT 16755535 (Kenya), ISRCT 95819193 (Tanzania).

Influence of Parenting Styles on the Adolescent Students' Academic Achievement in Kenyan Day Secondary Schools

ERIC Educational Resources Information Center

Odongo, Alice Atieno; Aloka, Peter J. O.; Raburu, Pamela

2016-01-01

The present study sought to establish the influence of parenting styles on adolescent academic achievement in day secondary schools in North Rachuonyo Sub-County, Kenya. Baumrind's theory of parenting style informed the study. The Concurrent Triangulation Design was used. The target population comprised 2409 day secondary students registered for…

Transformational Leadership, Organizational Commitment, and Job Satisfaction: A Comparative Study of Kenyan and U.S. Financial Firms

ERIC Educational Resources Information Center

Walumbwa, Fred O.; Orwa, Bani; Wang, Peng; Lawler, John J.

2005-01-01

This study explores the nature of the relationship between transformational leadership and two work-related attitudes, organizational commitment and job satisfaction, by comparing Kenya and the United States. The results show that transformational leadership has a strong and positive effect on organizational commitment and job satisfaction in both…

Supervision Challenges Encountered during Kenyan University Students' Practicum Attachment

ERIC Educational Resources Information Center

Kathuri-Ogola, Lucy; VanLeeuwen, Charlene; Kabaria-Muriithi, Joan; Weeks, Lori E.; Kieru, Jane; Ndayala, Phoebe

2015-01-01

There is little published research that examines the supervision experience of field attachment supervisors in Kenya. In this study, we identify the challenges encountered by field supervisors during student field attachments with community organizations. Fifteen organizations that had hosted third year students from the Department of Community…

A Study of the Relationship between Academic Achievement Motivation and Home Environment among Standard Eight Pupils

ERIC Educational Resources Information Center

Muola, J. M.

2010-01-01

The objective of this study was to investigate the relationship between academic achievement motivation and home environment among standard eight pupils. The study was carried out on 235 standard eight Kenyan pupils from six urban and rural primary schools randomly selected from Machakos district. Their age ranged between 13 and 17 years. Two…

Implementing an Open Source Electronic Health Record System in Kenyan Health Care Facilities: Case Study

PubMed Central

Magare, Steve; Monda, Jonathan; Kamau, Onesmus; Houston, Stuart; Fraser, Hamish; Powell, John; English, Mike; Paton, Chris

2018-01-01

Background The Kenyan government, working with international partners and local organizations, has developed an eHealth strategy, specified standards, and guidelines for electronic health record adoption in public hospitals and implemented two major health information technology projects: District Health Information Software Version 2, for collating national health care indicators and a rollout of the KenyaEMR and International Quality Care Health Management Information Systems, for managing 600 HIV clinics across the country. Following these projects, a modified version of the Open Medical Record System electronic health record was specified and developed to fulfill the clinical and administrative requirements of health care facilities operated by devolved counties in Kenya and to automate the process of collating health care indicators and entering them into the District Health Information Software Version 2 system. Objective We aimed to present a descriptive case study of the implementation of an open source electronic health record system in public health care facilities in Kenya. Methods We conducted a landscape review of existing literature concerning eHealth policies and electronic health record development in Kenya. Following initial discussions with the Ministry of Health, the World Health Organization, and implementing partners, we conducted a series of visits to implementing sites to conduct semistructured individual interviews and group discussions with stakeholders to produce a historical case study of the implementation. Results This case study describes how consultants based in Kenya, working with developers in India and project stakeholders, implemented the new system into several public hospitals in a county in rural Kenya. The implementation process included upgrading the hospital information technology infrastructure, training users, and attempting to garner administrative and clinical buy-in for adoption of the system. The initial deployment was ultimately scaled back due to a complex mix of sociotechnical and administrative issues. Learning from these early challenges, the system is now being redesigned and prepared for deployment in 6 new counties across Kenya. Conclusions Implementing electronic health record systems is a challenging process in high-income settings. In low-income settings, such as Kenya, open source software may offer some respite from the high costs of software licensing, but the familiar challenges of clinical and administration buy-in, the need to adequately train users, and the need for the provision of ongoing technical support are common across the North-South divide. Strategies such as creating local support teams, using local development resources, ensuring end user buy-in, and rolling out in smaller facilities before larger hospitals are being incorporated into the project. These are positive developments to help maintain momentum as the project continues. Further integration with existing open source communities could help ongoing development and implementations of the project. We hope this case study will provide some lessons and guidance for other challenging implementations of electronic health record systems as they continue across Africa. PMID:29669709

Sickle cell disease and HIV: a case highlighting management challenges for children in a resource-limited setting.

PubMed

Odera, Esther Brenda; Kwobah, Charles; Stone, Geren; Some, Faraj; Vreeman, Rachel Christine

2014-01-01

Sickle cell disease (SCD) is a genetic disorder resulting from a mutation in the hemoglobin (Hb) gene. Sickle cell disease results in chronic anemia and a variety of acute and chronic complications that can lead to early mortality. A child with both SCD and HIV presents a management challenge, particularly in a resource-limited setting. In this case report, we describe the case of an 18-month-old Kenyan girl with SCD and HIV who developed a severe hypersensitivity reaction to first-line antiretroviral therapy (ART). Selecting an appropriate drug substitute for a child with SCD and HIV presents a management dilemma when the available options have problematic side effect profiles or are inaccessible or inappropriate according to national guidelines. The challenges in choosing an appropriate ART regimen for a child with SCD and HIV highlight the lack of data and scarcity of treatment options for pediatric patients.

Successful increase in contraceptive uptake among Kenyan HIV-1-serodiscordant couples enrolled in an HIV-1 prevention trial.

PubMed

Ngure, Kenneth; Heffron, Renee; Mugo, Nelly; Irungu, Elizabeth; Celum, Connie; Baeten, Jared M

2009-11-01

To evaluate a multipronged approach to promote dual contraceptive use by women within heterosexual HIV-1-serodiscordant partnerships. For 213 HIV-1-serodiscordant couples in Thika, Kenya, participating in an HIV-1 prevention clinical trial, contraceptive promotion was initiated through a multipronged intervention that included staff training, couples family planning sessions, and free provision of hormonal contraception on-site. Contraceptive use and pregnancy incidence were compared between two time periods (before versus after June 2007, when the intervention was initiated) and between Thika and other Kenyan trial sites (Eldoret, Kisumu, and Nairobi). Generalized estimating equations and Andersen-Gill proportional hazards modeling were used. Nonbarrier contraceptive use increased after implementation of the intervention: from 31.5 to 64.7% of visits among HIV-1-seropositive women [odds ratio 4.0, 95% confidence interval (CI) 3.0-5.3] and from 28.6 to 46.7% of visits among HIV-1-seronegative women (odds ratio 2.2, 95% CI 1.4-3.5). In comparison, at the other Kenyan sites, where the intervention was not implemented, contraceptive use changed minimally, from 15.6 to 22.3% of visits for HIV-1-seropositive women and from 13.6 to 12.7% among HIV-1-seronegative women. Self-reported condom use remained high during follow-up. Pregnancy incidence at the Thika was significantly lower after compared with before June 2007 (hazard ratio 0.2, 95% CI 0.1-0.6) and was approximately half that at other Kenyan sites during the intervention period (hazard ratio 0.5, 95% CI 0.3-0.8). A multipronged family planning intervention can lead to high nonbarrier contraceptive uptake and reduced pregnancy incidence among women in HIV-1-serodiscordant partnerships.

Civil unrest and birthweight: an exploratory analysis of the 2007/2008 Kenyan Crisis.

PubMed

Bell, Suzanne; Prata, Ndola; Lahiff, Maureen; Eskenazi, Brenda

2012-05-01

For decades, Africa has been plagued by political and ethnic conflict, the health ramifications of which are often not investigated. A crisis occurred recently in Kenya following the 2007 presidential election. Ethnic violence ensued, targeting the incumbent President Kibaki's Kikuyu people. The violence occurred primarily in Nairobi and the Rift Valley of Kenya. We sought to examine the association between exposure to the 2007/2008 Kenyan Crisis and birthweight. Using the 2008/2009 Kenyan Demographic and Health Survey (KDHS), we compared birthweights of infants in utero or not yet conceived during the 15 months after the political turmoil following the 2007 presidential election (exposed) to those who were born before the crisis (unexposed). There were 663 "exposed" and 687 "unexposed" infants. Multivariate regression was used. We examined the possibility of two-way and three-way interactions between exposure status, ethnicity (Kikuyu versus non-Kikuyu), and region (violent region versus not). Overall, exposure to the Kenyan Crisis was associated with lower birthweight. Kikuyu women living in a violent region who were exposed during their 2nd trimester had the greatest difference in birthweight in comparison to all unexposed infants: 564.4g lower (95% CI 285.1, 843.6). Infants of Kikuyu exposed during the 2nd trimester and living in a violent region weighed 603.6g less (95% CI 333.6, 873.6) than Kikuyu infants born during the unexposed period. Political unrest may have implications for the birthweight of infants, particularly among targeted populations. Given the adverse sequelae associated with lowered birthweight, these results suggest that particular attention should be paid to pregnant women and targeted ethnic groups following such events. Copyright © 2012 Elsevier Ltd. All rights reserved.

Girls' Attitudes Towards Science in Kenya

NASA Astrophysics Data System (ADS)

Chetcuti, Deborah A.; Kioko, Beriter

2012-07-01

This study investigated girls' attitudes towards science in Kenya. It was carried out with 120 girls from four secondary schools in the Eastern province of Kenya. These were an urban single-sex (SS) and co-educational (Co-Ed) school and a rural SS and Co-Ed school. Different schools were chosen in order to explore whether there are any differences in attitudes in SS and Co-Ed schools and in schools in rural and urban areas. The methodology included the use of both questionnaires and focus group interviews. The main aim was to gain insight into the extent and depth of students' attitudes towards science. The findings of the study showed that the majority of Kenyan girls who participated in the study have a favourable attitude towards science. Girls in SS schools were found to have a more favourable attitude than those in Co-Ed schools, while girls in rural area schools were found to find science more relevant than those in urban schools. It emerged from this study that the attitudes of Kenyan girls are influenced by their perceptions of the relevance of science, enjoyment of studying science, perceptions of the suitability of science for a career, and their perceptions of subject difficulty.

Where is information quality lost at clinical level? A mixed-method study on information systems and data quality in three urban Kenyan ANC clinics

PubMed Central

Hahn, Daniel; Wanjala, Pepela; Marx, Michael

2013-01-01

Background Well-working health information systems are considered vital with the quality of health data ranked of highest importance for decision making at patient care and policy levels. In particular, health facilities play an important role, since they are not only the entry point for the national health information system but also use health data (and primarily) for patient care. Design A multiple case study was carried out between March and August 2012 at the antenatal care (ANC) clinics of two private and one public Kenyan hospital to describe clinical information systems and assess the quality of information. The following methods were developed and employed in an iterative process: workplace walkthroughs, structured and in-depth interviews with staff members, and a quantitative assessment of data quality (completeness and accurate transmission of clinical information and reports in ANC). Views of staff and management on the quality of employed information systems, data quality, and influencing factors were captured qualitatively. Results Staff rated the quality of information higher in the private hospitals employing computers than in the public hospital which relies on paper forms. Several potential threats to data quality were reported. Limitations in data quality were common at all study sites including wrong test results, missing registers, and inconsistencies in reports. Feedback was seldom on content or quality of reports and usage of data beyond individual patient care was low. Conclusions We argue that the limited data quality has to be seen in the broader perspective of the information systems in which it is produced and used. The combination of different methods has proven to be useful for this. To improve the effectiveness and capabilities of these systems, combined measures are needed which include technical and organizational aspects (e.g. regular feedback to health workers) and individual skills and motivation. PMID:23993022

Where is information quality lost at clinical level? A mixed-method study on information systems and data quality in three urban Kenyan ANC clinics.

PubMed

Hahn, Daniel; Wanjala, Pepela; Marx, Michael

2013-08-29

Well-working health information systems are considered vital with the quality of health data ranked of highest importance for decision making at patient care and policy levels. In particular, health facilities play an important role, since they are not only the entry point for the national health information system but also use health data (and primarily) for patient care. A multiple case study was carried out between March and August 2012 at the antenatal care (ANC) clinics of two private and one public Kenyan hospital to describe clinical information systems and assess the quality of information. The following methods were developed and employed in an iterative process: workplace walkthroughs, structured and in-depth interviews with staff members, and a quantitative assessment of data quality (completeness and accurate transmission of clinical information and reports in ANC). Views of staff and management on the quality of employed information systems, data quality, and influencing factors were captured qualitatively. Staff rated the quality of information higher in the private hospitals employing computers than in the public hospital which relies on paper forms. Several potential threats to data quality were reported. Limitations in data quality were common at all study sites including wrong test results, missing registers, and inconsistencies in reports. Feedback was seldom on content or quality of reports and usage of data beyond individual patient care was low. We argue that the limited data quality has to be seen in the broader perspective of the information systems in which it is produced and used. The combination of different methods has proven to be useful for this. To improve the effectiveness and capabilities of these systems, combined measures are needed which include technical and organizational aspects (e.g. regular feedback to health workers) and individual skills and motivation.

The impact of a national poverty reduction program on the characteristics of sex partners among Kenyan adolescents.

PubMed

Rosenberg, Molly; Pettifor, Audrey; Thirumurthy, Harsha; Halpern, Carolyn Tucker; Handa, Sudhanshu

2014-02-01

Cash transfer programs have the potential to prevent the spread of HIV, particularly among adolescents. One mechanism through which these programs may work is by influencing the characteristics of the people adolescents choose as sex partners. We examined the four-year impact of a Kenyan cash transfer program on partner age, partner enrollment in school, and transactional sex-based relationships among 684 adolescents. We found no significant impact of the program on partner characteristics overall, though estimates varied widely by gender, age, schooling, and economic status. Results highlight the importance of context in exploring the potential HIV preventive effects of cash transfers.

Results from Kenya's 2014 Report Card on the Physical Activity and Body Weight of Children and Youth.

PubMed

Wachira L, Joy M; Muthuri, Stella K; Tremblay, Mark S; Onywera, Vincent O

2014-05-01

The report card presents available evidence on the physical activity (PA) and body weight status of Kenyan children and youth. It highlights areas where Kenya is succeeding and those in which more action is needed. Comprehensive review and analysis of available data on core indicators for Kenyan children and youth 5-17 years were conducted. The grading system used was based on a set of specific criteria and existing grading schemes from similar report cards in other countries. Of the 10 core indicators discussed, body composition was favorable (grade B) while overall PA levels, organized sport participation, and active play were assigned grades of C. Active transportation and sedentary behaviors were also favorable (grade B). Family/peers, school, governmental and nongovernmental strategies were graded C. The majority of Kenyan children and youth have healthy body composition levels and acceptable sedentary time, but are not doing as well in attaining the World Health Organization (WHO) recommendation on PA. Although Kenya seems to be doing well in most indicators compared with some developed countries, there is a need for action to address existing trends toward unhealthy lifestyles. More robust and representative data for all indicators are required.

Kenya Quaker Secondary School Peace Curriculum Pilot Project: Examining the Role of the Principal in the Successes and Challenges of the Implementation

ERIC Educational Resources Information Center

Hockett, Eloise

2015-01-01

This qualitative study examined the implementation of a peace curriculum for Kenyan Quaker secondary schools. Fourteen schools were selected for this study 1 year after school leaders attended specific training sessions. On site visits were made to 12 of the 14 schools selected for this study, and interviews conducted with the remaining…

Indigenous and Western Knowledges in Science Education: An Ethnographic Study of Rural and Urban Secondary Schools and Classrooms in Kenya

ERIC Educational Resources Information Center

O'Hern, Darren M.

2010-01-01

In Kenya, indigenous knowledges related to the natural sciences are not considered in the formal science education of secondary students. Despite the prevalence of studies that examine indigenous knowledges in Kenyan school and community contexts, the perspectives of students and teachers concerning indigenous natural science knowledges and their…

Cultural Protective and Risk Factors: Professional Perspectives about Child Sexual Abuse in Kenya

ERIC Educational Resources Information Center

Plummer, Carol A.; Njuguna, Wambui

2009-01-01

Objective: The aim of this study was to explore perspectives on cultural risks and protective factors among professionals in Kenya. Method: An exploratory/descriptive survey of Kenyan professionals working to prevent or intervene with child sexual abuse was undertaken to determine their perspectives on how tribal culture impacts vulnerability to…

Barriers to Participation of Women Students with Disabilities in University Education in Kenya

ERIC Educational Resources Information Center

Opini, Bathseba

2012-01-01

This paper discusses barriers to the participation of women with disabilities in Kenyan university education. While studies have shown that students with disabilities are increasingly enrolling in and completing university education, the number of women with disabilities in higher education remains low. This paper highlights the factors that…

Teacher Improvement through Peer Teacher Evaluation in Kenyan Schools

ERIC Educational Resources Information Center

Arnodah, Itolondo Wilfrida

2013-01-01

Purpose: This article aims to assess the awareness among educators of strategies put in place for peer teacher evaluation (PTE), and training opportunities availed to them in relation to PTE. Design/methodology/approach: The study was conducted in secondary schools in three selected districts of Western Province of Kenya using a descriptive survey…

DOE Office of Scientific and Technical Information (OSTI.GOV)

Tracy, Jennifer; Alstone, Peter; Jacobson, Arne

In this study, we performed a market trial of off-grid LED lighting products in Maai Mahiu, arural Kenyan town. Our goals were to assess consumer demand and consumer preferences with respect to off-grid lighting systems and to gain feedback from off-grid lighting users at the point of purchase and after they have used to products for some time.

Posttraumatic stress and functional impairment in Kenyan children following the 1998 American Embassy bombing.

PubMed

Pfefferbaum, Betty; North, Carol S; Doughty, Debby E; Gurwitch, Robin H; Fullerton, Carol S; Kyula, Jane

2003-04-01

This study examined a convenience sample of 562 Nairobi school children exposed to the 1998 bombing of the American Embassy in Nairobi, Kenya. Posttraumatic stress reactions to the bombing were related to posttraumatic stress reactions to other trauma and to peritraumatic reaction. Self-reported functional impairment was minimal.

Circling "the Scourge"

ERIC Educational Resources Information Center

Keller, Bess

2005-01-01

In Kenya alone, where the infection rate is estimated to have reached 13 percent of the population, 27,000 teachers will die and more than 2 million children will lose one or both parents to AIDS in the next five years. The Kenyan project uses "study circles," in which teachers learn together about HIV, script new sexual behaviors for…

Embracing Connectedness and Change: A Complex Dynamic Systems Perspective for Applied Linguistic Research

ERIC Educational Resources Information Center

Cameron, Lynne

2015-01-01

Complex dynamic systems (CDS) theory offers a powerful metaphorical model of applied linguistic processes, allowing holistic descriptions of situated phenomena, and addressing the connectedness and change that often characterise issues in our field. A recent study of Kenyan conflict transformation illustrates application of a CDS perspective. Key…

Gendered Constructions of Citizenship: Young Kenyans' Negotiations of Rights Discourses

ERIC Educational Resources Information Center

Arnot, Madeleine; Chege, Fatuma N.; Wawire, Violet

2012-01-01

This paper contributes to the study of citizenship by interrogating how young people in Nairobi (Chege and Arnot 2012) perceive their rights of citizenship. It builds on previous analyses of the connections between gender, education and poverty's poor urban settlements by focusing on the political dimensions of the young people's lives. The…

Stress Related Factors among Primary and Part-Time Caregiving Grandmothers of Kenyan Grandchildren

ERIC Educational Resources Information Center

Oburu, Paul Odhiambo; Palmerus, Kerstin

2005-01-01

The present study examined whether the total stress experienced by 241 caregiving grandmothers was linked to levels of care provided, child behavioral difficulty, and perceived availability of emotional and instrumental support. One hundred and twenty eight of these participants adopted their orphaned grandchildren on full-time basis. The rest (n…

ICTs as Placed Resources in a Rural Kenyan Secondary School Journalism Club

ERIC Educational Resources Information Center

Kendrick, Maureen; Chemjor, Walter; Early, Margaret

2012-01-01

In this study, we draw on three interrelated concepts, i.e. placed resources, multiliteracies and the carnivalesque, to understand how information and communication technology (ICT) resources are taken up within the context of a print-based journalism club. Our research participants attend an under-resourced girls' residential secondary school in…

A comparative study to screen dementia and APOE genotypes in an ageing East African population

PubMed Central

Chen, Chien-Hsiun; Mizuno, Toshiki; Elston, Robert; Kariuki, Monica M.; Hall, Kathleen; Unverzagt, Fred; Hendrie, Hugh; Gatere, Samuel; Kioy, Paul; Patel, Nilesh B.; Friedland, Robert P.; Kalaria, Raj N.

2010-01-01

Previous studies have established cross-cultural methods to screen for ageing- related dementia and susceptibility genes, in particular Alzheimer’s disease (AD) among the Canadian Cree, African Americans and Yoruba in Nigeria. We determined whether the Community Screening Interview for Dementia (CSID), translated into Kikuyu, a major language of Kenya, could be used to evaluate dementia of the Alzheimer type. Using two sets of coefficients of cognitive and informant scores, two discriminant function (DF) scores were calculated for each of 100 elderly (>65 years) Nyeri Kenyans. When the cut-off points were selected for 100% sensitivities, the specificities of the DF scores were remarkably similar (93.75%) in the Kenyan sample. We propose the adapted CSID can be utilised to detect dementia among East Africans. We also show that apolipoprotein E ε4 allele frequencies were high (∼30%) and not different between normal subjects and those with probable AD. There was no evidence to suggest years of education or vascular factors were associated with dementia status. PMID:18703255

Parental mediation of adolescent media use and demographic factors as predictors of Kenyan high school students' exposure to sexual content in television.

PubMed

Ngula, Kyalo wa; Mberia, Hellen K; Miller, Ann Neville

2016-01-01

Research in Western nations suggests that parents' involvement in their children's media use can make a difference in how adolescents select, process and respond to sexual television messages. Little or no published research has investigated this issue in sub-Saharan Africa, even though adolescents and young adults remain among the groups at highest risk for HIV transmission. This study investigated the relationship between Kenyan adolescents' level of exposure to sexual television content and their parents' mediation of their television use. A cluster sample of 427 Nairobi public high school students was surveyed regarding parental mediation of their media use and their intake of sexual television content. Co-viewing with opposite sex friends was associated with higher intake of sexual TV content. This relationship was stronger among boarding school students than among day school students. Parental mediation and co-viewing variables predicted three times as much variance among boarding than among day school students.

4th Stage Transvaginal omental herniation during VBAC complicated by shoulder dystocia: a unique presentation of uterine rupture

PubMed Central

2013-01-01

Background Uterine rupture is a common complication in women attempting their first virginal birth after caesarean section (VBAC) but the risk diminishes with subsequent VBACs. It occurs in rates of 0.5-9% and is influenced by various factors. Case presentation A unique case of uterine rupture in a Kenyan woman of African descent during a repeat VBAC complicated by shoulder dystocia was discovered during the 4th stage of labour when omentum was noted protruding through the vagina. She had delivered 4 years earlier by caesarean section. Conclusion It is not common to experience uterine rupture among women attempting repeat VBAC. When it occurs, it may not always follow the known pattern intra-partum and is often associated with poor foetal outcome. PMID:23521920

DOE Office of Scientific and Technical Information (OSTI.GOV)

Walker, Heidi, E-mail: heidi.mwalker@yahoo.ca; Sinclair, A. John, E-mail: john.sinclair@ad.umanitoba.ca; Spaling, Harry, E-mail: harry.spaling@kingsu.ca

Meaningful public engagement is a challenging, but promising, feature of strategic environmental assessment (SEA) due to its potential for integrating sustainability principles into policies, plans and programs in developing countries such as Kenya. This research examined two selected SEA case studies to identify the extent of participation, learning outcomes attributable to participation, and if any learning outcomes led to social action for sustainability at the community level. Strengths across the two cases were the inclusion of marginalized populations and consideration of socio-economic concerns. Consistent weaknesses included inadequate notice, document inaccessibility, lack of feedback and communication, and late analysis of alternatives.more » Despite some learning conditions being unfulfilled, examples of instrumental, communicative, and transformative learning were identified through a focus group and semi-structured interviews with community participants and public officials. Some of these learning outcomes led to individual and social actions that contribute to sustainability. -- Highlights: • The strengths and weaknesses of Kenyan SEA public participation processes were identified. • Multiple deficiencies in the SEA process likely frustrate meaningful public engagement. • Participant learning was observed despite process weaknesses. • Participant learning can lead to action for sustainability at the community level.« less

Integrated community case management for childhood illnesses: explaining policy resistance in Kenya.

PubMed

Juma, Pamela A; Owuor, Karen; Bennett, Sara

2015-12-01

There has been a re-emphasis recently on community health workers to provide child health care services including integrated community case management for childhood illness (iCCM). This research analysed iCCM policy development in Kenya and in particular the types of decision-making criteria used by Kenyan policy-makers in considering whether to advance iCCM policy. Data were collected through document reviews (n = 41) and semi-structured interviews (n = 19) with key stakeholders in iCCM policy including government officials, development partners, bilateral donors, and civil society organizations. Initial analysis was guided by the policy triangle with further analysis of factors affecting policy decision-making drawing upon a simple framework developed by Grindle and Thomas (Policy makers, policy choices and policy outcomes: the political economy of reform in developing countries. 1989; Policy Sci 22: :213-48.). Policy development for iCCM has been slow in Kenya, compared with other Sub-Saharan African countries. At the time of the study, the Government had just completed the Community Health Training Manual which incorporated iCCM as a module, but this was the only formal expression of iCCM in Kenya. We found technical considerations, notably concerns about community health workers dispensing antibiotics to be a key factor slowing iCCM policy development, but this also overlapped with bureaucratic considerations, such as how the development of community health worker cadres may affect clinicians, as well as initial concerns about how an integrated approach might affect vertically oriented programs. International actors through agreements such as the Millennium Development Goals helped to get child survival onto the national policy agenda and such actors were active promoters of iCCM policy change. However international funders had not committed funding to scale-up iCCM policy, and this probably constrained their influence over iCCM policy debate. Kenyan actors' concerns about iCCM underline the importance of adapting global policies to local conditions, and also generating local evidence to inform decision-making. © The Author 2015. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Perceptions of Parents on the Practice of Private Tuition in Public Learning Institutions in Kenya

ERIC Educational Resources Information Center

Mwebi, Robert B.; Maithya, Redempta

2016-01-01

The practice of private tuition outside normal class hours is a phenomenon which has prevailed in Kenyan basic learning institutions despite the repeated ban by the government. The purpose of the study was to establish parental perceptions on extra tuition in public schools in Kenya. Descriptive survey design was used for the study. A total of 40…

Risk of nontyphoidal Salmonella bacteraemia in African children is modified by STAT4.

PubMed

Gilchrist, James J; Rautanen, Anna; Fairfax, Benjamin P; Mills, Tara C; Naranbhai, Vivek; Trochet, Holly; Pirinen, Matti; Muthumbi, Esther; Mwarumba, Salim; Njuguna, Patricia; Mturi, Neema; Msefula, Chisomo L; Gondwe, Esther N; MacLennan, Jenny M; Chapman, Stephen J; Molyneux, Malcolm E; Knight, Julian C; Spencer, Chris C A; Williams, Thomas N; MacLennan, Calman A; Scott, J Anthony G; Hill, Adrian V S

2018-03-09

Nontyphoidal Salmonella (NTS) is a major cause of bacteraemia in Africa. The disease typically affects HIV-infected individuals and young children, causing substantial morbidity and mortality. Here we present a genome-wide association study (180 cases, 2677 controls) and replication analysis of NTS bacteraemia in Kenyan and Malawian children. We identify a locus in STAT4, rs13390936, associated with NTS bacteraemia. rs13390936 is a context-specific expression quantitative trait locus for STAT4 RNA expression, and individuals carrying the NTS-risk genotype demonstrate decreased interferon-γ (IFNγ) production in stimulated natural killer cells, and decreased circulating IFNγ concentrations during acute NTS bacteraemia. The NTS-risk allele at rs13390936 is associated with protection against a range of autoimmune diseases. These data implicate interleukin-12-dependent IFNγ-mediated immunity as a determinant of invasive NTS disease in African children, and highlight the shared genetic architecture of infectious and autoimmune disease.

Household water insecurity is associated with a range of negative consequences among pregnant Kenyan women of mixed HIV status.

PubMed

Krumdieck, Natalie R; Collins, Shalean M; Wekesa, Pauline; Mbullo, Patrick; Boateng, Godfred O; Onono, Maricianah; Young, Sera L

2016-12-01

Water insecurity (WI) is a serious and worsening problem worldwide, but its role in health outcomes among people living with HIV or pregnant women is unknown. We assessed experiences of WI in a cohort of 323 pregnant Kenyan women of mixed HIV status. The majority (77.7%) had at least one experience of WI in the previous month; it was associated with negative economic, nutrition, disease, and psychosocial outcomes. A standardized cross-culturally valid household WI scale would facilitate assessment of the prevalence and consequences of WI, and increased attention to WI could reveal an overlooked, but modifiable, cause of adverse HIV outcomes.

Antiretroviral treatment interruptions induced by the Kenyan postelection crisis are associated with virological failure.

PubMed

Mann, Marita; Diero, Lameck; Kemboi, Emmanuel; Mambo, Fidelis; Rono, Mary; Injera, Wilfred; Delong, Allison; Schreier, Leeann; Kaloustian, Kara W; Sidle, John; Buziba, Nathan; Kantor, Rami

2013-10-01

Antiretroviral treatment interruptions (TIs) cause suboptimal clinical outcomes. Data on TIs during social disruption are limited. We determined effects of unplanned TIs after the 2007-2008 Kenyan postelection violence on virological failure, comparing viral load (VL) outcomes in HIV-infected adults with and without conflict-induced TI. Two hundred and one patients were enrolled, median 2.2 years after conflict and 4.3 years on treatment. Eighty-eight patients experienced conflict-related TIs and 113 received continuous treatment. After adjusting for preconflict CD4, patients with TIs were more likely to have detectable VL, VL >5,000 and VL >10,000. Unplanned conflict-related TIs are associated with increased likelihood of virological failure.

Physics Practical Work and Its Influence on Students' Academic Achievement

ERIC Educational Resources Information Center

Musasia, Amadalo Maurice; Ocholla, Alphayo Abacha; Sakwa, Thomas Welikhe

2016-01-01

In Kenyan secondary schools, form two is an important class for all students. The students choose relevant subjects to study in form three and four. Physics is compulsory at form one and two but optional thereafter. Performance in the subject at the end of the secondary school is usually dismal. Majority of students lack motivation for most…

Classes of Psychotic Experiences in Kenyan Children and Adolescents

ERIC Educational Resources Information Center

Mamah, Daniel; Owoso, Akinkunle; Mbwayo, Anne W.; Mutiso, Victoria N.; Muriungi, Susan K.; Khasakhala, Lincoln I.; Barch, Deanna M.; Ndetei, David M.

2013-01-01

Psychotic-like experiences (PLEs) have been observed worldwide in both adults and children outside the context of a clinical disorder. In the current study, we investigate the prevalence and patterns of PLEs among children and adolescents in Kenya. Among 1,971 students from primary and secondary schools around Nairobi (aged 8-19), 22.1 % reported…

The Relationship between Moral Reasoning and Pedagogical Preferences in Kenyan and American College Students.

ERIC Educational Resources Information Center

Plueddemann, James E.

1989-01-01

Investigates the relationship between moral reasoning and instructional preference in a cross-cultural setting. Questions whether the kind of schooling as well as the amount of schooling correlate with levels of moral reasoning. Finds significant correlations. Contends that the importance of this study lies in its use to facilitate the adaptation…

"Youth in a Void": Sexuality, HIV/AIDS and Communication in Kenyan Public Schools

ERIC Educational Resources Information Center

Njue, Carolyne; Voeten, Helene; Ahlberg, Beth Maina

2011-01-01

The disappearance of traditional sex education during rites of passage in African societies has left many youth uncertain of where to look for information. Against this backcloth, the objectives of this study were to identify knowledge gaps amongst adolescents in Kenya regarding sexuality, HIV/AIDS and reproductive health. A thematic analysis was…

Technical Secondary Students in Kenya: Origins, Achievement and Destinations.

ERIC Educational Resources Information Center

Lauglo, Jon

1989-01-01

Reports a study in which 1,000 high school seniors at 8 Kenyan schools participated. Data were gathered regarding their social and geographical regions, and the results on the Kenya Certificate of Education (KCE) examination were used. Findings show there is no rule that school-based vocational training is inferior to academic secondary education.…

Private Supplementary Tutoring: Motivations and Effects: A Review Study

ERIC Educational Resources Information Center

Chui, Mary Mugwe

2016-01-01

For long, mixed reaction on the importance of supplementary tutorials in Kenyan schools, both primary and secondary, have been expressed by the various stakeholders. While some have argued for them, others have been fully opposed to it and viewed it as an attempt by teachers to exploit parents with the argument that the government pays them to do…

Instructional Constraints in Teaching of Reading in Early Childhood Classes in Nairobi County, Kenya

ERIC Educational Resources Information Center

Marima, Esther Wairimu; Kamau-Kang'ethe, Rachael W.; Runo, Mary N.

2016-01-01

Reading has been identified as one of the most reliable indicators of whether a learner will attain the competence needed to achieve academic success and contribute actively to society. Research findings in Kenyan primary and secondary schools reveal inadequate reading skills among the students. The purpose of this study was to identify approaches…

Through Their Lens: The Potential of Photovoice for Documentation of Environmental Perspectives among Kenyan Teachers

ERIC Educational Resources Information Center

Quigley, Cassie F.; Dogbey, James; Che, S. Megan; Hallo, Jeffrey; Womac, Patrick

2014-01-01

This study explores the potential of photovoice for understanding environmental perspectives of teachers in the Narok District of Kenya. The objective of this paper is to share this photo-methodology with environmental educators so they may use it as an innovative methodological tool to understand the construction of environmental perspectives.…

"Women and the Environmental Are Together": Using Participatory Rural Appraisal to Examine Gendered Tensions about the Environment

ERIC Educational Resources Information Center

Quigley, Cassie F.; Che, S. Megan; Achieng, Stella; Liaram, Sarah

2017-01-01

Environmental education research (EER) rarely includes women's perspectives. This means that in environmental education research, an entire knowledge source is largely ignored. This study employed a methodology called Participatory Rural Appraisal, a methodology new to the field of EER, of Kenyan teachers from the Maasai Mara region to understand…

Quality of Learning Facilities and Learning Environment: Challenges for Teaching and Learning in Kenya's Public Universities

ERIC Educational Resources Information Center

Ndirangu, Mwangi; Udoto, Maurice O.

2011-01-01

Purpose: The purpose of this article is to report findings on the perceptions of quality of educational facilities in Kenyan public universities, and the implications for teaching/learning, and the learning environment. Design/methodology/approach: The study adopted an exploratory descriptive design. A total of 332 and 107 undergraduate students…

The Construct Validity of the Self Description Questionnaire on High School Students in Kenya

ERIC Educational Resources Information Center

Mucherah, Winnie; Finch, Holmes

2010-01-01

This study investigated the structural equivalence of the Self Description Questionnaire (SDQ) in relation to Kenyan high school students. A total of 1,990 students from two same-sex boarding schools participated. Confirmatory factor analysis revealed the overall model fit the data well. However, an examination of the individual factors revealed…

Shifts in malaria vector species composition and transmission dynamics along the Kenyan coast over the past 20 years.

PubMed

Mwangangi, Joseph M; Mbogo, Charles M; Orindi, Benedict O; Muturi, Ephantus J; Midega, Janet T; Nzovu, Joseph; Gatakaa, Hellen; Githure, John; Borgemeister, Christian; Keating, Joseph; Beier, John C

2013-01-08

Over the past 20 years, numerous studies have investigated the ecology and behaviour of malaria vectors and Plasmodium falciparum malaria transmission on the coast of Kenya. Substantial progress has been made to control vector populations and reduce high malaria prevalence and severe disease. The goal of this paper was to examine trends over the past 20 years in Anopheles species composition, density, blood-feeding behaviour, and P. falciparum sporozoite transmission along the coast of Kenya. Using data collected from 1990 to 2010, vector density, species composition, blood-feeding patterns, and malaria transmission intensity was examined along the Kenyan coast. Mosquitoes were identified to species, based on morphological characteristics and DNA extracted from Anopheles gambiae for amplification. Using negative binomial generalized estimating equations, mosquito abundance over the period were modelled while adjusting for season. A multiple logistic regression model was used to analyse the sporozoite rates. Results show that in some areas along the Kenyan coast, Anopheles arabiensis and Anopheles merus have replaced An. gambiae sensu stricto (s.s.) and Anopheles funestus as the major mosquito species. Further, there has been a shift from human to animal feeding for both An. gambiae sensu lato (s.l.) (99% to 16%) and An. funestus (100% to 3%), and P. falciparum sporozoite rates have significantly declined over the last 20 years, with the lowest sporozoite rates being observed in 2007 (0.19%) and 2008 (0.34%). There has been, on average, a significant reduction in the abundance of An. gambiae s.l. over the years (IRR = 0.94, 95% CI 0.90-0.98), with the density standing at low levels of an average 0.006 mosquitoes/house in the year 2010. Reductions in the densities of the major malaria vectors and a shift from human to animal feeding have contributed to the decreased burden of malaria along the Kenyan coast. Vector species composition remains heterogeneous but in many areas An. arabiensis has replaced An. gambiae as the major malaria vector. This has important implications for malaria epidemiology and control given that this vector predominately rests and feeds on humans outdoors. Strategies for vector control need to continue focusing on tools for protecting residents inside houses but additionally employ outdoor control tools because these are essential for further reducing the levels of malaria transmission.

Implementing an Open Source Electronic Health Record System in Kenyan Health Care Facilities: Case Study.

PubMed

Muinga, Naomi; Magare, Steve; Monda, Jonathan; Kamau, Onesmus; Houston, Stuart; Fraser, Hamish; Powell, John; English, Mike; Paton, Chris

2018-04-18

The Kenyan government, working with international partners and local organizations, has developed an eHealth strategy, specified standards, and guidelines for electronic health record adoption in public hospitals and implemented two major health information technology projects: District Health Information Software Version 2, for collating national health care indicators and a rollout of the KenyaEMR and International Quality Care Health Management Information Systems, for managing 600 HIV clinics across the country. Following these projects, a modified version of the Open Medical Record System electronic health record was specified and developed to fulfill the clinical and administrative requirements of health care facilities operated by devolved counties in Kenya and to automate the process of collating health care indicators and entering them into the District Health Information Software Version 2 system. We aimed to present a descriptive case study of the implementation of an open source electronic health record system in public health care facilities in Kenya. We conducted a landscape review of existing literature concerning eHealth policies and electronic health record development in Kenya. Following initial discussions with the Ministry of Health, the World Health Organization, and implementing partners, we conducted a series of visits to implementing sites to conduct semistructured individual interviews and group discussions with stakeholders to produce a historical case study of the implementation. This case study describes how consultants based in Kenya, working with developers in India and project stakeholders, implemented the new system into several public hospitals in a county in rural Kenya. The implementation process included upgrading the hospital information technology infrastructure, training users, and attempting to garner administrative and clinical buy-in for adoption of the system. The initial deployment was ultimately scaled back due to a complex mix of sociotechnical and administrative issues. Learning from these early challenges, the system is now being redesigned and prepared for deployment in 6 new counties across Kenya. Implementing electronic health record systems is a challenging process in high-income settings. In low-income settings, such as Kenya, open source software may offer some respite from the high costs of software licensing, but the familiar challenges of clinical and administration buy-in, the need to adequately train users, and the need for the provision of ongoing technical support are common across the North-South divide. Strategies such as creating local support teams, using local development resources, ensuring end user buy-in, and rolling out in smaller facilities before larger hospitals are being incorporated into the project. These are positive developments to help maintain momentum as the project continues. Further integration with existing open source communities could help ongoing development and implementations of the project. We hope this case study will provide some lessons and guidance for other challenging implementations of electronic health record systems as they continue across Africa. ©Naomi Muinga, Steve Magare, Jonathan Monda, Onesmus Kamau, Stuart Houston, Hamish Fraser, John Powell, Mike English, Chris Paton. Originally published in JMIR Medical Informatics (http://medinform.jmir.org), 18.04.2018.

Successful increase in contraceptive uptake among Kenyan HIV-1 serodiscordant couples enrolled in an HIV-1 prevention trial

PubMed Central

Ngure, Kenneth; Heffron, Renee; Mugo, Nelly; Irungu, Elizabeth; Celum, Connie; Baeten, Jared

2016-01-01

Objective To evaluate a multi-pronged approach to promote dual contraceptive use by women within heterosexual HIV-1 serodiscordant partnerships. Methods For 213 HIV-1 serodiscordant couples in Thika, Kenya participating in an HIV-1 prevention clinical trial, contraceptive promotion was initiated through a multi-pronged intervention that included staff training, couples family planning sessions, and free provision of hormonal contraception on-site. Contraceptive use and pregnancy incidence were compared between two time periods (before versus after June 2007, when the intervention was initiated) and between Thika and other Kenyan trial sites (Eldoret, Kisumu, and Nairobi). Generalized estimating equations and Andersen-Gill proportional hazards modeling were used. Results Non-barrier contraceptive use increased after implementation of the intervention: from 31.5% to 64.7% of visits among HIV-1 seropositive women (odds ratio [OR] 4.0, 95% confidence interval [CI] 3.0–5.3) and from 28.6% to 46.7% of visits among HIV-1 seronegative women (OR 2.2, 95% CI 1.4–3.5). In comparison, at the other Kenyan sites, where the intervention was not implemented, contraceptive use changed minimally, from 15.6% to 22.3% of visits for HIV-1 seropositive women and from 13.6% to 12.7% among HIV-1 seronegative women. Self-reported condom use remained high during follow-up. Pregnancy incidence at the Thika was significantly lower after compared with before June 2007 (hazard ratio [HR] 0.2, 95% CI 0.1–0.6), and was approximately half that at other Kenyan sites during the intervention period (HR 0.5, 95% CI 0.3–0.8). Conclusions A multi-pronged family planning intervention can lead to high non-barrier contraceptive uptake and reduced pregnancy incidence among women in HIV-1 serodiscordant partnerships. PMID:20081393

Integrated Numerical Model for the East African Rift System: Plume-induced Rifting and Continental Break-up from Lake Malawi to Red Sea

NASA Astrophysics Data System (ADS)

Koptev, A.; Leroy, S. D.; Calais, E.; Gerya, T.

2016-12-01

We present numerical experiments that target to reveal the role of active mantle plume, far-field tectonic forces and pre-existing lithospheric heterogeneities in structural development of the East African Rift system (EARS). Starting with models capturing the essential geophysical features of the central and southern parts of the EARS (two «cratonic» bodies (Tanzanian craton and Bangweulu block) embedded into a «normal» surrounding lithosphere) we show that development of the magmatic Eastern branch, the amagmatic Western branch and its southern prolongation (Malawi rift) can be the result of non-uniform splitting of some hot plume material that has been initially seeded underneath the southern part of Tanzanian craton. The second series of experiments has been designed in order to investigate northern segment of the EARS where Afro-Arabian plate separation is supposed to be related with the impact of Afar mantle plume. These models permit us to reproduce observed orientation and relative position of two spreading axes (Red Sea, Gulf of Aden) and rifting (Main Ethiopian rift) one. All are joining at Afar triple junction. Finally, for laterally extended experiment we have used parameters of the best-fit models for the southern and northern segments of the EARS in order to define the position of Kenyan plume and the velocity boundary conditions. This model cover all rifting and spreading structure associated with both Afar and Kenyan plumes: Red Sea Rift and the Aden Ridge to the north of the Afar Triple Junction; Main Ethiopian Rift running to the south that continues as the Kenyan Rift; Western Rift and its southern prolongation corresponding to Malawi rift.We argue that main features of the EARS can be reproduced in a relatively simple context of the interaction between two mantle anomalies corresponding to Afar and Kenyan plumes and pre-stressed rheologically stratified continental lithosphere containing only first-order structural heterogeneities (such as Tanzanian and Bangweulu cratons).

Cumulative Psychosocial Risk is a Salient Predictor of Depressive Symptoms among Vertically HIV-Infected and HIV-Affected Adolescents at the Kenyan Coast.

PubMed

Abubakar, Amina; Van de Vijver, Fons J R; Hassan, Amin S; Fischer, Ronald; Nyongesa, Moses K; Kabunda, Beatrice; Berkley, James A; Stein, Alan; Newton, Charles R

Little is known of mental health outcomes among vertically HIV-infected or HIV-affected adolescents in Africa. The current study set out to describe depressive symptoms and their correlates among vertically HIV-infected and HIV-affected adolescents at the Kenyan Coast. 130 adolescents (vertically HIV-infected [n = 44], HIV-affected [n = 53], and unexposed [n = 33]) and their caregivers participated in this cross-sectional study. An adapted version of the Beck Depression Inventory-11 (BDI) was administered to examine depressive symptoms in both adolescents and caregivers, together with measures of sociodemographic, medical, and anthropometric characteristics. Our analysis indicated a main effect of HIV status on mean BDI scores in HIV-infected (18.4 [SD = 8.3) and HIV-affected (16.8 [SD = 7.3]) adolescents compared to the community controls (12.0 [SD = 7.9]), F (2, 127) = 6.704, P = .002, η 2  = .095. Post hoc analysis showed that BDI scores of HIV-infected adolescents were higher than those of community controls (P < .001). Similarly, HIV-affected adolescents had BDI scores that were higher than those of community controls (P = .007). However, there was no difference in BDI scores between HIV-infected and HIV-affected adolescents (P = .304). A path analytic model indicated that cumulative psychosocial risk (orphanhood, family poverty, and caregiver depressive symptoms) were positive predictors of BDI scores among adolescents, while nutritional status had a limited role. Both HIV-infected and HIV-affected adolescents are at a high risk of experiencing depressive symptoms, largely due to the multiple psychosocial risk factors in their environment. The provision of adequate psychosocial support and counseling needs to become an integral part of the care program for adolescents from families living with HIV/AIDS at the Kenyan coast and other similar settings. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Spatial distribution and habitat characterisation of Anopheles larvae along the Kenyan coast

PubMed Central

Mwangangi, Joseph M.; Mbogo, Charles M.; Muturi, Ephantus J.; Nzovu, Joseph G.; Githure, John I.; Yan, Guiyun; Minakawa, Noboru; Novak, Robert; Beier, John C.

2009-01-01

Background & objectives A study was conducted to characterise larval habitats and to determine spatial heterogeneity of the Anopheles mosquito larvae. The study was conducted from May to June 1999 in nine villages along the Kenyan coast. Methods Aquatic habitats were sampled by use of standard dipping technique. The habitats were characterised based on size, pH, distance to the nearest house, coverage of canopy, surface debris, algae and emergent plants, turbidity, substrate, and habitat type. Results A total of 110 aquatic habitats like stream pools (n = 10); puddles (n = 65); tire tracks (n = 5); ponds (n = 5) and swamps (n = 25) were sampled in nine villages located in three districts of the Kenyan coast. A total of 7,263 Anopheles mosquito larvae were collected, 63.9% were early instars and 36.1% were late instars. Morphological identification of the III and IV instar larvae by use of microscopy yielded 90.66% (n = 2,377) Anopheles gambiae Complex, 0.88% (n = 23) An. funestus, An. coustani 7.63% (n = 200), An. rivulorum 0.42% (n = 11), An. pharoensis 0.19% (n = 5), An. swahilicus 0.08% (n = 2), An. wilsoni 0.04% (n = 1) and 0.11% (n = 3) were unidentified. A subset of the An. gambiae Complex larvae identified morphologically, was further analysed using rDNA-PCR technique resulting in 68.22% (n = 1,290) An. gambiae s.s., 7.93% (n = 150) An. arabiensis and 23.85% (n = 451) An. merus. Multiple logistic regression model showed that emergent plants (p = 0.019), and floating debris (p = 0.038) were the best predictors of An. gambiae larval abundance in these habitats. Interpretation & conclusion Habitat type, floating debris and emergent plants were found to be the key factors determining the presence of Anopheles larvae in the habitats. For effective larval control, the type of habitat should be considered and most productive habitat type be given a priority in the mosquito abatement programme. PMID:17378216

Spatial distribution and habitat characterisation of Anopheles larvae along the Kenyan coast.

PubMed

Mwangangi, Joseph M; Mbogo, Charles M; Muturi, Ephantus J; Nzovu, Joseph G; Githure, John I; Yan, Guiyun; Minakawa, Noboru; Novak, Robert; Beier, John C

2007-03-01

A study was conducted to characterise larval habitats and to determine spatial heterogeneity of the Anopheles mosquito larvae. The study was conducted from May to June 1999 in nine villages along the Kenyan coast. Aquatic habitats were sampled by use of standard dipping technique. The habitats were characterised based on size, pH, distance to the nearest house, coverage of canopy, surface debris, algae and emergent plants, turbidity, substrate, and habitat type. A total of 110 aquatic habitats like stream pools (n=10); puddles (n=65); tire tracks (n=5); ponds (n=5) and swamps (n=25) were sampled in nine villages located in three districts of the Kenyan coast. A total of 7,263 Anopheles mosquito larvae were collected, 63.9% were early instars and 36.1% were late instars. Morphological identification of the III and IV instar larvae by use of microscopy yielded 90.66% (n=2377) Anopheles gambiae Complex, 0.88% (n=23) An. funestus, An. coustani 7.63% (n=200), An. rivulorum 0.42% (n=11), An. pharoensis 0.19% (n=5), An. swahilicus 0.08% (n=2), An. wilsoni 0.04% (n=1) and 0.11% (n=3) were unidentified. A subset of the An. gambiae Complex larvae identified morphologically, was further analysed using rDNA-PCR technique resulting in 68.22% (n=1290) An. gambiae s.s., 7.93% (n=150) An. arabiensis and 23.85% (n=451) An. merus. Multiple logistic regression model showed that emergent plants (p = 0.019), and floating debris (p = 0.038) were the best predictors of An. gambiae larval abundance in these habitats. Habitat type, floating debris and emergent plants were found to be the key factors determining the presence of Anopheles larvae in the habitats. For effective larval control, the type of habitat should be considered and most productive habitat type be given a priority in the mosquito abatement programme.

A Phenomenological Study of Sexual Harassment and Violence among Girls Attending High Schools in Urban Slums, Nairobi, Kenya

ERIC Educational Resources Information Center

Abuya, Benta A.; Onsomu, Elijah O.; Moore, DaKysha; Sagwe, Jackline

2012-01-01

In 2003, 31% of young Kenyan women ages 15-24 reported sexual harassment and violence (SHV), with a majority experiencing sexual debut due to coercion (Central Bureau of Statistics, 2004). Data were obtained from a sample of 20 girls attending school in Kamu and Lafamu (pseudonyms used for the study sites), 10 girls who had dropped out of school,…

Examining the Attitudes and Concerns of the Kenyan Teachers toward the Inclusion of Children with Disabilities in the General Education Classroom: A Mixed Methods Study

ERIC Educational Resources Information Center

Odongo, George; Davidson, Roseanna

2016-01-01

The philosophy of inclusive education aims at enabling all children to learn in the regular education classrooms. It is widely believed that the successful implementation of any inclusive policy is largely influenced by teachers being positive about the expectations. Grounded in Positioning Theory, this study was conducted to examine the attitude,…

Effect of Programmed Instruction on Students' Attitude towards Structure of the Atom and the Periodic Table among Kenyan Secondary Schools

ERIC Educational Resources Information Center

Wangila, M. J.; Martin, W.; Ronald, M.

2015-01-01

This study examined the effect of Programmed Instruction on students' attitude towards Structure of the Atom and the Periodic Table (SAPT) among mixed (co-educational) secondary schools of Butere district, Kakamega county, Kenya. The quasi-experimental research design was adopted, using the nonrandomized Solomon four-group as a model. The sample…

Uhuru (SAS-1/Explorer 42)

NASA Astrophysics Data System (ADS)

Murdin, P.

2000-11-01

NASA satellite, launched from the San Marco platform off the Kenyan coast in 1970. The first satellite dedicated to x-ray astronomy. Completed an all-sky x-ray survey and studied individual sources. Discovered x-ray binaries, including Hercules X-1 and Centaurus X-1, and confirmed the variability of Cygnus X-1. Uhuru means `freedom' in Swahili. (See also SMALL ASTRONOMY SATELLITE, EXPLORER.)...

From Transmission to Transformation: An Exploration of Education for Holistic Transformation in Selected Christian and Public Universities in Kenya

ERIC Educational Resources Information Center

Ntamushobora, Faustin

2012-01-01

This exploratory study investigated the impact of learning experiences on the intellectual, spiritual and community lives of Kenyan alumni who have graduated from master's programs in Christian and public universities in Kenya between June 2006 and 2010. A purposive sample of twenty-three graduates from four universities was used to collect data…

The Teaching of English Idioms in Kenyan Secondary Schools: Difficulties and Effective Strategies

ERIC Educational Resources Information Center

Gathigia, Moses Gatambuki; Njoroge, Martin C.

2016-01-01

The acquisition of idiomatic expressions is one of the primary challenges to learners of English as a Second Language (ESL) in multilingual contexts such as Kenya; yet, the learners are expected to use these expressions in their writing. The study on which this paper is based sought to assess the teaching of English idiomatic expressions in Kenyan…

Predictors of Attitudes toward Intimate Partner Violence: A Comparative Study of Men in Zambia and Kenya

ERIC Educational Resources Information Center

Lawoko, Stephen

2008-01-01

Attitudes toward intimate partner violence (IPV) were compared between Zambian and Kenyan men on sociodemographic, attitudinal, and structural predictors of such attitudes. Data were retrieved from the latest Demographic and Health Surveys in each country. The results showed that many men in Zambia (71%) and Kenya (68%) justified IPV to punish a…

Kenyan Student-Teacher Counsellors' Creativity and Its Relationship with Their Gender, Age, and Teaching Experience

ERIC Educational Resources Information Center

Kinai, Theresia Kavuli

2013-01-01

The purpose of the study was: (1) assess creativity of postgraduate student-teacher counselors whose age range was 25-54 years old, and teaching experience of 4-25 years; and (2) to find out whether age, gender, and teaching experience influence creativity. Seventy-two participants (43 females and 29 males) responded to the ICAS (Ibadan Creativity…

Key Factors that Influence the Diffusion and Infusion of Information and Communication Technologies in Kenyan Higher Education

ERIC Educational Resources Information Center

Macharia, Jimmy K. N.; Pelser, Theunis G.

2014-01-01

Previous studies have shown that in the higher education sector, information and communication technology (ICT) provides the impetus for change from the traditional concepts of teaching and learning, as well as prime motivation behind the change in scholarly and professional activities. This underscores the importance of ICT in higher education in…

Explaining the effects of a multifaceted intervention to improve inpatient care in rural Kenyan hospitals -- interpretation based on retrospective examination of data from participant observation, quantitative and qualitative studies

PubMed Central

2011-01-01

Background We have reported the results of a cluster randomized trial of rural Kenyan hospitals evaluating the effects of an intervention to introduce care based on best-practice guidelines. In parallel work we described the context of the study, explored the process and perceptions of the intervention, and undertook a discrete study on health worker motivation because this was felt likely to be an important contributor to poor performance in Kenyan public sector hospitals. Here, we use data from these multiple studies and insights gained from being participants in and observers of the intervention process to provide our explanation of how intervention effects were achieved as part of an effort to better understand implementation in low-income hospital settings. Methods Initial hypotheses were generated to explain the variation in intervention effects across place, time, and effect measure (indicator) based on our understanding of theory and informed by our implementation experience and participant observations. All data sources available for hospitals considered as cases for study were then examined to determine if hypotheses were supported, rejected, or required modification. Data included transcriptions of interviews and group discussions, field notes and that from the detailed longitudinal quantitative investigation. Potentially useful explanatory themes were identified, discussed by the implementing and research team, revised, and merged as part of an iterative process aimed at building more generic explanatory theory. At the end of this process, findings were mapped against a recently reported comprehensive framework for implementation research. Results A normative re-educative intervention approach evolved that sought to reset norms and values concerning good practice and promote 'grass-roots' participation to improve delivery of correct care. Maximal effects were achieved when this strategy and external support supervision helped create a soft-contract with senior managers clarifying roles and expectations around desired performance. This, combined with the support of facilitators acting as an expert resource and 'shop-floor' change agent, led to improvements in leadership, accountability, and resource allocation that enhanced workers' commitment and capacity and improved clinical microsystems. Provision of correct care was then particularly likely if tasks were simple and a good fit to existing professional routines. Our findings were in broad agreement with those defined as part of recent work articulating a comprehensive framework for implementation research. Conclusions Using data from multiple studies can provide valuable insight into how an intervention is working and what factors may explain variability in effects. Findings clearly suggest that major intervention strategies aimed at improving child and newborn survival in low-income settings should go well beyond the fixed inputs (training, guidelines, and job aides) that are typical of many major programmes. Strategies required to deliver good care in low-income settings should recognize that this will need to be co-produced through engagement often over prolonged periods and as part of a directive but adaptive, participatory, information-rich, and reflective process. PMID:22132875

Explaining the effects of a multifaceted intervention to improve inpatient care in rural Kenyan hospitals--interpretation based on retrospective examination of data from participant observation, quantitative and qualitative studies.

PubMed

English, Mike; Nzinga, Jacinta; Mbindyo, Patrick; Ayieko, Philip; Irimu, Grace; Mbaabu, Lairumbi

2011-12-02

We have reported the results of a cluster randomized trial of rural Kenyan hospitals evaluating the effects of an intervention to introduce care based on best-practice guidelines. In parallel work we described the context of the study, explored the process and perceptions of the intervention, and undertook a discrete study on health worker motivation because this was felt likely to be an important contributor to poor performance in Kenyan public sector hospitals. Here, we use data from these multiple studies and insights gained from being participants in and observers of the intervention process to provide our explanation of how intervention effects were achieved as part of an effort to better understand implementation in low-income hospital settings. Initial hypotheses were generated to explain the variation in intervention effects across place, time, and effect measure (indicator) based on our understanding of theory and informed by our implementation experience and participant observations. All data sources available for hospitals considered as cases for study were then examined to determine if hypotheses were supported, rejected, or required modification. Data included transcriptions of interviews and group discussions, field notes and that from the detailed longitudinal quantitative investigation. Potentially useful explanatory themes were identified, discussed by the implementing and research team, revised, and merged as part of an iterative process aimed at building more generic explanatory theory. At the end of this process, findings were mapped against a recently reported comprehensive framework for implementation research. A normative re-educative intervention approach evolved that sought to reset norms and values concerning good practice and promote 'grass-roots' participation to improve delivery of correct care. Maximal effects were achieved when this strategy and external support supervision helped create a soft-contract with senior managers clarifying roles and expectations around desired performance. This, combined with the support of facilitators acting as an expert resource and 'shop-floor' change agent, led to improvements in leadership, accountability, and resource allocation that enhanced workers' commitment and capacity and improved clinical microsystems. Provision of correct care was then particularly likely if tasks were simple and a good fit to existing professional routines. Our findings were in broad agreement with those defined as part of recent work articulating a comprehensive framework for implementation research. Using data from multiple studies can provide valuable insight into how an intervention is working and what factors may explain variability in effects. Findings clearly suggest that major intervention strategies aimed at improving child and newborn survival in low-income settings should go well beyond the fixed inputs (training, guidelines, and job aides) that are typical of many major programmes. Strategies required to deliver good care in low-income settings should recognize that this will need to be co-produced through engagement often over prolonged periods and as part of a directive but adaptive, participatory, information-rich, and reflective process. © 2011 English et al; licensee BioMed Central Ltd.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Schipper, L.; Hollander, J.M.; Milukas, M.

A study was carried out of the flows of commercial energy in the economy of Kenya. Indications were sought of the extent to which energy conservation, (i.e., increase in efficiency of energy use) has reduced the ratio of energy inputs to economic outputs, in the post-1973 years. An assessment was made of the potential for energy conservation to reduce the growth of Kenyan energy use in the future and of significant barriers to increasing energy efficiency. Consideration was given to the role of government policy and of international assistance in fostering energy conservation in Kenya and other developing countries. Themore » study was performed by analyzing available energy data and statistics from the largest oil companies, the Kenyan electric utility, and the government. These sources were supplemented by conducting personal interviews with personnel of nearly 50 commercial firms in Kenya. Direct consumption of fuel accounts for 94% of the commercial energy use in Kenya, while electricity accounts for 6%. The sectoral division of fuel use is: transportation 53%, industry 21%, energy production 11%, agriculture 9%, buildings and residences 5%, and construction 1%. For electricity the division is: buildings and residences 48%, industry 45%, energy production 4%, agriculture 2%, and construction 1%. Recent progress in conservation is reported.« less

Antiretroviral Treatment Interruptions Induced by the Kenyan Postelection Crisis Are Associated With Virological Failure

PubMed Central

Kemboi, Emmanuel; Mambo, Fidelis; Rono, Mary; Injera, Wilfred; Delong, Allison; Schreier, Leeann; Kaloustian, Kara W.; Sidle, John; Buziba, Nathan; Kantor, Rami

2014-01-01

Background Antiretroviral treatment interruptions (TIs) cause suboptimal clinical outcomes. Data on TIs during social disruption are limited. Methods We determined effects of unplanned TIs after the 2007–2008 Kenyan postelection violence on virological failure, comparing viral load (VL) outcomes in HIV-infected adults with and without conflict-induced TI. Results Two hundred and one patients were enrolled, median 2.2 years after conflict and 4.3 years on treatment. Eighty-eight patients experienced conflict-related TIs and 113 received continuous treatment. After adjusting for preconflict CD4, patients with TIs were more likely to have detectable VL, VL >5,000 and VL >10,000. Conclusions Unplanned conflict-related TIs are associated with increased likelihood of virological failure. PMID:24047971

New cure or same old story? International (Africa).

PubMed

1996-03-25

In Kenya, Professor Arthur Obel claimed that he has discovered a wonder drug, Pearl Omega, which can reverse HIV-positive status in some patients. In response to criticism, Obel modified his claim to assert that his drug alleviates the suffering of AIDS patients and prolongs their lives. Obel refused to provide proof that 7 of 32 HIV-positive patients who received Pearl Omega had become seronegative. While the Kenyan government supports local initiatives in the world-wide search for a cure for AIDS, it insists that all drugs being used to treat the disease undergo rigorous testing. With 5% of the Kenyan population believed to be HIV positive, medical authorities expect that the Pearl Omega debate is far from over.

The plasma virome of febrile adult Kenyans shows frequent parvovirus B19 infections and a novel arbovirus (Kadipiro virus)

PubMed Central

Ngoi, Carolyne N.; Siqueira, Juliana; Li, Linlin; Deng, Xutao; Mugo, Peter; Graham, Susan M.; Price, Matt A.; Sanders, Eduard J.

2016-01-01

Viral nucleic acids present in the plasma of 498 Kenyan adults with unexplained fever were characterized by metagenomics analysis of 51 sample pools. The highest to lowest fraction of plasma pools was positive for parvovirus B19 (75 %), pegivirus C (GBV-C) (67 %), alpha anellovirus (59 %), gamma anellovirus (55 %), beta anellovirus (41 %), dengue virus genotype 2 (DENV-2) (16 %), human immunodeficiency virus type 1 (6 %), human herpesvirus 6 (6 %), HBV (4 %), rotavirus (4 %), hepatitis B virus (4 %), rhinovirus C (2 %), Merkel cell polyomavirus (MCPyV; 2 %) and Kadipiro virus (2 %). Ranking by overall percentage of viral reads yielded similar results. Characterization of viral nucleic acids in the plasma of a febrile East African population showed a high frequency of parvovirus B19 and DENV infections and detected a reovirus (Kadipiro virus) previously reported only in Asian Culex mosquitoes, providing a baseline to compare with future virome studies to detect emerging viruses in this region. PMID:27902331

Solar disinfection of drinking water contained in transparent plastic bottles: characterizing the bacterial inactivation process.

PubMed

McGuigan, K G; Joyce, T M; Conroy, R M; Gillespie, J B; Elmore-Meegan, M

1998-06-01

A series of experiments is reported to identify and characterize the inactivation process in operation when drinking water, heavily contaminated with a Kenyan isolate of Escherichia coli, is stored in transparent plastic bottles that are then exposed to sunlight. The roles of optical and thermal inactivation mechanisms are studied in detail by simulating conditions of optical irradiance, water turbidity and temperature, which were recorded during a series of solar disinfection measurements carried out in the Kenyan Rift Valley. Optical inactivation effects are observed even in highly turbid water (200 ntu) and at low irradiances of only 10 mW cm-2. Thermal inactivation is found to be important only at water temperatures above 45 degrees C, at which point strong synergy between optical and thermal inactivation processes is observed. The results confirm that, where strong sunshine is available, solar disinfection of drinking water is an effective, low cost method for improving water quality and may be of particular use to refugee camps in disaster areas. Strategies for improving bacterial inactivation are discussed.

The plasma virome of febrile adult Kenyans shows frequent parvovirus B19 infections and a novel arbovirus (Kadipiro virus).

PubMed

Ngoi, Carolyne N; Siqueira, Juliana; Li, Linlin; Deng, Xutao; Mugo, Peter; Graham, Susan M; Price, Matt A; Sanders, Eduard J; Delwart, Eric

2016-12-01

Viral nucleic acids present in the plasma of 498 Kenyan adults with unexplained fever were characterized by metagenomics analysis of 51 sample pools. The highest to lowest fraction of plasma pools was positive for parvovirus B19 (75 %), pegivirus C (GBV-C) (67 %), alpha anellovirus (59 %), gamma anellovirus (55 %), beta anellovirus (41 %), dengue virus genotype 2 (DENV-2) (16 %), human immunodeficiency virus type 1 (6 %), human herpesvirus 6 (6 %), HBV (4 %), rotavirus (4 %), hepatitis B virus (4 %), rhinovirus C (2 %), Merkel cell polyomavirus (MCPyV; 2 %) and Kadipiro virus (2 %). Ranking by overall percentage of viral reads yielded similar results. Characterization of viral nucleic acids in the plasma of a febrile East African population showed a high frequency of parvovirus B19 and DENV infections and detected a reovirus (Kadipiro virus) previously reported only in Asian Culex mosquitoes, providing a baseline to compare with future virome studies to detect emerging viruses in this region.

Neutropenia in HIV-Infected Kenyan Women Receiving Triple Antiretroviral Prophylaxis to Prevent Mother-to-Child HIV Transmission Is Not Associated with Serious Clinical Sequelae.

PubMed

Iuliano, A Danielle; Weidle, Paul J; Brooks, John T; Masaba, Rose; Girde, Sonali; Ndivo, Richard; Ogindo, Paul; Omolo, Paul; Zeh, Clement; Thomas, Timothy K

2015-01-01

Absolute neutrophil counts (ANCs) are lower in East African adults. To assess the impact of lower ANCs, we reviewed data from HIV-infected Kenyan women receiving antiretroviral therapy antepartum and postpartum. The Kisumu Breastfeeding Study (KiBS) participants received an antiretroviral regimen from 34 weeks' gestation through 6 months postpartum. Measured ANCs and subsequent illnesses were reviewed. Adverse events (AEs) potentially attributable to neutropenia were identified, and ANCs were graded using the 2004 Division of AIDS table for Grading the Severity of AEs. Among 478 women with ≥1 postpartum ANC measured, 298 (62.1%) women met criteria for an AE (<1.3 × 10(9) cells/L). Of those, 38 (12.5%) women experienced a nonlife-threatening illness potentially attributable to neutropenia. More than half of KiBS women met criteria for neutropenia. The mild clinical experience of most participants with low ANCs supports that these values might be typical for this population and may not result in adverse clinical sequelae. © The Author(s) 2013.

Differentiation in Access to, and the Use and Sharing of (Open) Educational Resources among Students and Lecturers at Kenyan Universities

ERIC Educational Resources Information Center

Pete, Judith; Mulder, Fred; Neto, Jose Dutra Oliveira

2017-01-01

In order to obtain a fair "OER picture" for the Global South a large-scale study has been carried out for a series of countries, including Kenya. In this paper we report on the Kenya study, run at four universities that have been selected with randomly sampled students and lecturers. Empirical data have been generated by the use of a…

Testing and testing positive: childhood adversities and later life HIV status among Kenyan women and their partners.

PubMed

Goodman, Michael L; Raimer-Goodman, Lauren; Chen, Catherine X; Grouls, Astrid; Gitari, Stanley; Keiser, Philip H

2017-12-01

Adverse childhood experiences are a critical feature of lifelong health. No research assesses whether childhood adversities predict HIV-testing behaviors, and little research analyzes childhood adversities and later life HIV status in sub-Saharan Africa. We use regression models with cross-sectional data from a representative sample (n = 1974) to analyze whether adverse childhood experiences, separately or as cumulative exposures, predict reports of later life HIV testing and testing HIV+ among semi-rural Kenyan women and their partners. No significant correlation was observed between thirteen cumulative childhood adversities and reporting prior HIV testing for respondent or partner. Separately, childhood sexual abuse and emotional neglect predicted lower odds of reporting having previously been tested for HIV. Witnessing household violence during one's childhood predicted significantly higher odds of reporting HIV+. Sexual abuse predicted higher odds of reporting a partner tested HIV+. Preventing sexual abuse and household violence may improve HIV testing and test outcomes among Kenyan women. More research is required to understand pathways between adverse childhood experiences and partner selection within Kenya and sub-Saharan Africa, and data presented here suggest understanding pathways may help improve HIV outcomes. © The Author 2016. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Many Districts Left Behind: An Individual Change Analysis of Inequity in the Kenyan Primary Educational Opportunities (2001-2007)

ERIC Educational Resources Information Center

Bagaka's, Joshua Gisemba

2010-01-01

The study examined variations in district performance in KCPE national examination in Kenya between 2001 and 2007. The individual change model revealed that district poverty rate was not a significant predictor of either the initial district performance (2001) or the rate of change over the seven-year period. The regional context of North Eastern…

Implementation of Early Childhood Development Education Service Standard Guidelines on Physical Facilities in Public and Private Early Childhood Education Centres Kakamega County, Kenya

ERIC Educational Resources Information Center

Sitati, Emmily M.; Ndirangu, Mwangi; Kennedy, Bota; Rapongo, George S.

2016-01-01

In 2006, the Kenyan Ministry of Education (MoE) developed an early childhood development education (ECDE) service standard guidelines to guide the ECDE stakeholders in provision of early childhood education (ECE) programmes. The study sought to investigate the implementation of the ECDE service standard guidelines on provision of physical…

Strategies for Prevention and Intervention of Drug Abuse among Students in Secondary Schools in Kenya

ERIC Educational Resources Information Center

Marais, Petro; Maithya, Redempta

2015-01-01

Drug abuse is becoming an increasing problem among students in Kenya. The major cause for concern is that a high proportion of the Kenyan youth in secondary schools are involved in drugs (NACADA 2012). As a result, these young people eventually become addicted, posing a threat to their own health and safety. This study sought to establish the…

Parental Choice and Learner Achievement in Primary Education in Rachuonyo Sub County, Kenya: Focusing on Quality of Education

ERIC Educational Resources Information Center

Oyier, Charles Richard; Odundo, Paul Amollo; Obat, Rispa Atieno; Lilian, Ganira Khavugwi; Akondo, Joseph Ochieng

2015-01-01

Kenyan government launched Free Primary Education (FPE) in 2003 to make schooling affordable to all parents, but less attention has been paid to the quality assurance and equity of the education system. Studies have indicated that the FPE policy sacrificed the quality of education and this led to parents avoiding FPE offered in primary schools and…

Two complement receptor one alleles have opposing associations with cerebral malaria and interact with α+thalassaemia.

PubMed

Opi, D Herbert; Swann, Olivia; Macharia, Alexander; Uyoga, Sophie; Band, Gavin; Ndila, Carolyne M; Harrison, Ewen M; Thera, Mahamadou A; Kone, Abdoulaye K; Diallo, Dapa A; Doumbo, Ogobara K; Lyke, Kirsten E; Plowe, Christopher V; Moulds, Joann M; Shebbe, Mohammed; Mturi, Neema; Peshu, Norbert; Maitland, Kathryn; Raza, Ahmed; Kwiatkowski, Dominic P; Rockett, Kirk A; Williams, Thomas N; Rowe, J Alexandra

2018-04-25

Malaria has been a major driving force in the evolution of the human genome. In sub-Saharan African populations, two neighbouring polymorphisms in the Complement Receptor One ( CR1 ) gene, named Sl2 and McC b , occur at high frequencies, consistent with selection by malaria. Previous studies have been inconclusive. Using a large case-control study of severe malaria in Kenyan children and statistical models adjusted for confounders, we estimate the relationship between Sl2 and McC b and malaria phenotypes, and find they have opposing associations. The Sl2 polymorphism is associated with markedly reduced odds of cerebral malaria and death, while the McC b polymorphism is associated with increased odds of cerebral malaria. We also identify an apparent interaction between Sl2 and α + thalassaemia, with the protective association of Sl2 greatest in children with normal α-globin. The complex relationship between these three mutations may explain previous conflicting findings, highlighting the importance of considering genetic interactions in disease-association studies. © 2018, Opi et al.

Learning from the nurses and the paramedics: the experience of a Kenyan medical officer intern-a call for research

PubMed Central

Mwenda, Aruyaru Stanley

2012-01-01

In the Kenyan medical educations system, one has to go through one year of internship after graduating from medical school in order to be licensed to practise medicine. This internship period is laden with work to the extent of overwhelming and stressing the medical officer interns. Irrespective of what competence interns come with into the field there is still a lot they have to learn from the nurses and the paramedics. Most of the learning takes place during the acute care settings when the intern is on call and is from the nurses. The paramedics most helpful to the intern are the theater assistants who teach interns how to use the various surgical instruments and sometimes direct during minor operations. PMID:22891094

Bounded agency in humanitarian settings: a qualitative study of adherence to antiretroviral therapy among refugees situated in Kenya and Malaysia.

PubMed

Mendelsohn, Joshua B; Rhodes, Tim; Spiegel, Paul; Schilperoord, Marian; Burton, John Wagacha; Balasundaram, Susheela; Wong, Chunting; Ross, David A

2014-11-01

HIV-positive refugees confront a variety of challenges in accessing and adhering to antiretroviral therapy (ART) and attaining durable viral suppression; however, there is little understanding of what these challenges are, how they are navigated, or how they may differ across humanitarian settings. We sought to document and examine accounts of the threats, barriers and facilitators experienced in relation to HIV treatment and care and to conduct comparisons across settings. We conducted semi-structured interviews among a purposive sample of 14 refugees attending a public, urban HIV clinic in Kuala Lumpur, Malaysia (July-September 2010), and 12 refugees attending a camp-based HIV clinic in Kakuma, Kenya (February-March 2011). We used framework methods and between-case comparison to analyze and interpret the data, identifying social and environmental factors that influenced adherence. The multiple issues that threatened adherence to antiretroviral therapy or precipitated actual adherence lapses clustered into three themes: "migration", "insecurity", and "resilience". The migration theme included issues related to crossing borders and integrating into treatment systems upon arrival in a host country. Challenges related to crossing borders were reported in both settings, but threats pertaining to integration into, and navigation of, a new health system were exclusive to the Malaysian setting. The insecurity theme included food insecurity, which was most commonly reported in the Kenyan setting; health systems insecurity, reported in both settings; and emotional insecurity, which was most common in the Kenyan setting. Resilient processes were reported in both settings. We drew on the concept of "bounded agency" to argue that, despite evidence of personal and community resilience, these processes were sometimes insufficient for overcoming social and environmental barriers to adherence. In general, interventions might aim to bolster individuals' range of action with targeted support that bolsters resilient processes. Specific interventions are needed to address locally-based food and health system insecurities. Copyright © 2014 Elsevier Ltd. All rights reserved.

Investigating the Relevance of Some Suggested Textbooks for the Teaching of the New Chemistry Syllabus in Kenyan Secondary Schools. African Studies in Curriculum Development & Evaluation No. 88.

ERIC Educational Resources Information Center

Ochola, Joel Aduma

This study was designed to find out how far suggested textbooks have been adopted in teaching a new chemistry syllabus in Kenya and if the chemistry books now being used in schools to teach the new syllabus involve activity and encourage the process of scientific inquiry. The new syllabus is a merger between the traditional separate chemistry…

Visualising Pareto-optimal trade-offs helps move beyond monetary-only criteria for water management decisions

NASA Astrophysics Data System (ADS)

Hurford, Anthony; Harou, Julien

2014-05-01

Water related eco-system services are important to the livelihoods of the poorest sectors of society in developing countries. Degradation or loss of these services can increase the vulnerability of people decreasing their capacity to support themselves. New approaches to help guide water resources management decisions are needed which account for the non-market value of ecosystem goods and services. In case studies from Brazil and Kenya we demonstrate the capability of many objective Pareto-optimal trade-off analysis to help decision makers balance economic and non-market benefits from the management of existing multi-reservoir systems. A multi-criteria search algorithm is coupled to a water resources management simulator of each basin to generate a set of Pareto-approximate trade-offs representing the best case management decisions. In both cases, volume dependent reservoir release rules are the management decisions being optimised. In the Kenyan case we further assess the impacts of proposed irrigation investments, and how the possibility of new investments impacts the system's trade-offs. During the multi-criteria search (optimisation), performance of different sets of management decisions (policies) is assessed against case-specific objective functions representing provision of water supply and irrigation, hydropower generation and maintenance of ecosystem services. Results are visualised as trade-off surfaces to help decision makers understand the impacts of different policies on a broad range of stakeholders and to assist in decision-making. These case studies show how the approach can reveal unexpected opportunities for win-win solutions, and quantify the trade-offs between investing to increase agricultural revenue and negative impacts on protected ecosystems which support rural livelihoods.

Clinical analysis of aqueductal stenosis in patients with hydrocephalus in a Kenyan setting.

PubMed

Kaur, Loyal Poonamjeet; Munyiri, Nderitu Joseph; Dismus, Wekesa Vincent

2017-01-01

Aqueductal stenosis is the commonest cause of congenital hydrocephalus. The scope of this paper is to highlight the disease burden of hydrocephalus attributed to aqueductal stenosis which still remains unknown in our setting. In a descriptive cross-sectional study, 258 records of patients diagnosed with hydrocephalus were analyzed after ethical approval from Kenyatta National Hospital- University of Nairobi (KNH-UON) ethics and research committee from January 2010 to May 2016. Patients with a diagnosis of hydrocephalus due to aqueductal stenosis were included in this study. Patients age, sex, mode of delivery, associated comorbidities, presenting complaints, neurosurgical intervention performed, Kafarnosky score were recorded. Data were divided into 2 sets based on the patient's age i.e. whether < 1 year or > 12 years. Data were recorded on google data collection form and analyzed using Google spreadsheets. Out of 258 cases of hydrocephalus, 52 had aqueductal stenosis. Male to female sex ratio for this condition was 3:2. There were 25 cases < 1year and 27 cases > 12 years old who were diagnosed with hydrocephalus due to aqueductal stenosis. Associated conditions were bilateral congenital talipes equinovarus, spina bifida, Arnold Chairi malformations, meningitis and HIV. The presenting complaints differed according to the age groups. Neurosurgical interventions included Endoscopic Third Ventriculostomy (ETV) in 21 cases, insertion of Ventriculoperitoneal (VP) shunt and ETV were done in 3 cases while the rest had only insertion of VP shunt. The Kafanosky score improve from < 50 pre-op to 19 cases achieving a score of 100, six months post-op. Aqueductal stenosis contributes a significant burden of morbidity in patients with hydrocephalus. Clinical presentation differs according to patients age. Accurate diagnosis and treatment remain a cardinal to improving patient outcome.

Merced County Streams Project, Haystack Reservoir, California Intensive Cultural Resources Survey.

DTIC Science & Technology

1982-03-25

evaluation of sampling strategies: simulated " 1excavations of a Kenyan pastoralist site. In Simulation studies in archaeology , edited by Ian Hodder, pp. 123...Publications ift American Archaeology and Ethnology 6(2):333-368. Berkeley. Barrett, Samuel A., and Edward W. Gifford _ -1933 Miwok material culture...University of Oregon Books, Eugene. !r Bennyhoff, James A. 1956 An appraisal of the archaeological resources of Yosemite National Park. University of

An Investigation on the Relationship between the School Level of Funding and Performance at K.C.S.E. in Mumias District, Western Province, Kenya

ERIC Educational Resources Information Center

Sisungo, Z.; Kaberia, L.; Buhere, P.

2014-01-01

The Kenyan government has been spending between 20% to 40% of its revenue on education with the aim to improving access and quality. Much of these resources have been devoted towards establishment and procurement of school inputs such as classrooms, teachers and textbooks. This study investigated the effects of funding on performance in Mumias…

An Assessment of the Attitudes of Students towards History and Government in Selected Secondary Schools in Bomet County in Kenya

ERIC Educational Resources Information Center

David, Rono; Cheruiyot, Rono Obadiah

2016-01-01

History and Government is a subject that is an integral part of the Kenyan secondary school curriculum. Over the years, many students have been developing little or no interest in the subject because it is perceived as being marginal as compared to sciences. Several studies in Kenya have discovered that performance in secondary schools is hugely…

Social and Spill-Over Benefits as Motivating Factors to Investment in Formal Education in Africa: A Reflection around Ghanaian, Kenyan and Rwandan Contexts

ERIC Educational Resources Information Center

Ampofo, S. Y.; Bizimana, B.; Ndayambaje, I.; Karongo, V.; Lawrence, K. Lyn; Orodho, J. A.

2015-01-01

This study examined the social and spill-over benefits as motivating factors to investment in formal education in selected countries in Africa. The paper had three objectives, namely) to profile the key statistics of formal schooling; ii) examine the formal education and iii) link national goals of education with expectations in Ghana, Kenya and…

Pilot Study on the Impact of Biogas as a Fuel Source on Respiratory Health of Women on Rural Kenyan Smallholder Dairy Farms

PubMed Central

Dohoo, Carolyn; Guernsey, Judith Read; Critchley, Kimberley; VanLeeuwen, John

2012-01-01

Biomass burning in indoor environments has been highlighted as a major cause of respiratory morbidity for women and children in low-income countries. Inexpensive technological innovations which reduce such exposures are needed. This study evaluated the impact of low tech compost digesters, which generate biogas for cooking, versus traditional fuel sources on the respiratory health of nonsmoking Kenyan farmwomen. Women from 31 farms with biogas digesters were compared to age-matched women from 31 biomass-reliant farms, in June 2010. Only 43% of the biogas group reported any breathing problems, compared to 71% in the referent group (P = 0.03). Referent women self-reported higher rates of shortness of breath (52% versus 30%), difficulty breathing (42% versus 23%), and chest pain while breathing (35% versus 17%) during the last 6 months (P = 0.09 to 0.12) compared to biogas women. Biogas women demonstrated slightly better spirometry results but differences were not statistically significant, likely due to limited latency between biogas digester installation and spirometry testing. Most biogas women reported improved personal respiratory health (87%) and improved children's health (72%) since biogas digester installation. These findings suggest that using biogas in cookhouses improves respiratory symptoms but long-term impacts on lung function are unclear. PMID:22969815

The Akhonya Dental Project: a new charity aiming to provide oral health education and preventative care in Kenya.

PubMed

Barber, S

2010-01-09

Kenya is a country plagued by HIV and lacking in adequate healthcare resources, and despite dental caries remaining the most common disease in the world, there is estimated to be only one dentist per 100,000 population in Kenya. Evidence suggests that many Kenyans are unaware of the causes of dental disease and half of the population are unaware of measures that can be taken to prevent dental disease. Oral health education is a clearly vital for improving the health of the Kenyan population. The Akhonya Dental Project is a new charity which aims to provide oral health education, prevention and treatment for AIDS orphans in rural Kenya. This article describes the ethos of the charity and long-term aim to increase oral health awareness in the region.

Kenyan female sex workers' use of female-controlled nonbarrier modern contraception: do they use condoms less consistently?

PubMed

Yam, Eileen A; Okal, Jerry; Musyoki, Helgar; Muraguri, Nicholas; Tun, Waimar; Sheehy, Meredith; Geibel, Scott

2016-03-01

To examine whether nonbarrier modern contraceptive use is associated with less consistent condom use among Kenyan female sex workers (FSWs). Researchers recruited 579 FSWs using respondent-driven sampling. We conducted multivariate logistic regression to examine the association between consistent condom use and female-controlled nonbarrier modern contraceptive use. A total of 98.8% reported using male condoms in the past month, and 64.6% reported using female-controlled nonbarrier modern contraception. In multivariate analysis, female-controlled nonbarrier modern contraceptive use was not associated with decreased condom use with clients or nonpaying partners. Consistency of condom use is not compromised when FSWs use available female-controlled nonbarrier modern contraception. FSWs should be encouraged to use condoms consistently, whether or not other methods are used simultaneously. Copyright © 2016 Elsevier Inc. All rights reserved.

Antiplasmodial activity of four Kenyan medicinal plants.

PubMed

Omulokoli, E; Khan, B; Chhabra, S C

1997-04-01

A preliminary antiplasmodial and phytochemical screening of four Kenyan medicinal plants was carried out. The medicinal plants were extracted and tested for in vitro antiplasmodial activity against chloroquine-sensitive (K67) and chloroquine-resistant (ENT36) strains of Plasmodium falciparum. Out of 16 extracts, 12 were active against ENT36 strain while seven were active against K67 strain, that is, IC50 < or = 50 micrograms/ml. The most active extracts on both strains were those of leaves of Phyllanthus reticulatus Poir, and Suregada zanzibariensis Baill. (Euphorbiaceae) with IC50 < or = 10 micrograms/ml. The stembark of Terminalia spinosa Engl. (Combretaceae) and the stems of Dissotis brazzae Cogn. (Melastomataceae) had IC50 < or = 10 micrograms/ml for strains K67 and ENT36, respectively. A preliminary phytochemical analysis of these plants revealed the presence of different classes of primary and secondary metabolites.

Epidemiology of Theileria bicornis among black and white rhinoceros metapopulation in Kenya.

PubMed

Otiende, Moses Y; Kivata, Mary W; Makumi, Joseph N; Mutinda, Mathew N; Okun, Daniel; Kariuki, Linus; Obanda, Vincent; Gakuya, Francis; Mijele, Dominic; Soriguer, Ramón C; Alasaad, Samer

2015-01-17

A huge effort in rhinoceros conservation has focused on poaching and habitat loss as factors leading to the dramatic declines in the endangered eastern black rhinoceros (Diceros bicornis michaeli) and the southern white rhinoceros (Ceratotherium simum simum). Nevertheless, the role disease and parasite infections play in the mortality of protected populations has largely received limited attention. Infections with piroplasmosis caused by Babesia bicornis and Theileria bicornis has been shown to be fatal especially in small and isolated populations in Tanzania and South Africa. However, the occurrence and epidemiology of these parasites in Kenyan rhinoceros is not known. Utilizing 18S rRNA gene as genetic marker to detect rhinoceros infection with Babesia and Theileria, we examined blood samples collected from seven rhinoceros populations consisting of 114 individuals of black and white rhinoceros. The goal was to determine the prevalence in Kenyan populations, and to assess the association of Babesia and Theileria infection with host species, age, sex, location, season and population mix (only black rhinoceros comparing to black and white rhinoceros populations). We did not detect any infection with Babesia in the sequenced samples, while the prevalence of T. bicornis in the Kenyan rhinoceros population was 49.12% (56/114). White rhinoceros had significantly higher prevalence of infection (66%) compared to black rhinoceros (43%). The infection of rhinoceros with Theileria was not associated with animal age, sex or location. The risk of infection with Theileria was not higher in mixed species populations compared to populations of pure black rhinoceros. In the rhinoceros studied, we did not detect the presence of Babesia bicornis, while Theileria bicornis was found to have a 49.12% prevalence with white rhinoceros showing a higher prevalence (66%) comparing with black rhinoceros (43%). Other factors such as age, sex, location, and population mix were not found to play a significant role.

Male infertility in a private Kenyan hospital.

PubMed

Muthuuri, J M

2005-07-01

To study the incidence and aetiology of male infertility in Mombasa, Kenya. Retrospective study. The Mombasa Hospital Private Clinics, from January 1996 to 2001. Forty three men, aged between 21 and 55 years, referred to me with the chief complaint of infertility of unknown cause. Patients were managed conservatively and operatively. Histological and laboratory evaluations. Of the 43 patients observed, ten (23%) presented with signs of hypogonadism, fifteen (35%) with signs of acute and sub-acute inflammatory process (pain and swelling), four (9%) and prolactinaemia, two (5%) had signs of gonadotropin insufficiency and another two (5%) patients had varicocoeles. We did not establish the cause in ten (23%) patients. Male infertility in Mombasa appears to be primarily due to hypogonadism (23%), although in an equal proportion the cause is not obvious (idiopathic). A significant number of the infertility cases can be attributed to easily treatable conditions such as infections and infestations (16%). The sample available is however not big enough to warrant any major conclusions as to the overall male infertility status in establishing possible avenues for future research.

The Kenyan national response to internationally agreed sexual and reproductive health and rights goals: a case study of three policies.

PubMed

Oronje, Rose N

2013-11-01

While priorities for, and decision-making processes on, sexual and reproductive health and rights have been determined and led mainly at the international level, conflicting power dynamics and responses at the national level in some countries have continued to pose challenges for operationalising international agreements. This paper demonstrates how these conflicts have played out in Kenya through an analysis of three policy-making processes, which led to the Adolescent Reproductive Health and Development Policy (2003), the Sexual Offences Act (2006), and the National Reproductive Health Policy (2007). The paper is based on data from a broader study on the drivers and inhibitors of sexual and reproductive health policy reform in Kenya, using a qualitative, case study design. Information was gathered through 54 semi-structured, in-depth interviews with governmental and civil society policy actors and an extensive review of policy documents and media reports. The paper shows that the transformative human rights framing of access to sexual and reproductive health, supported by both a strong global women's rights movement and progressive governmental and inter-governmental actors to defeat opposition to sexual and reproductive health and rights at the international level, has not been as influential or successful at the national level in Kenya, and has made comprehensive national reforms difficult to achieve. Copyright © 2013 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

The economic costs of malaria in four Kenyan districts: do household costs differ by disease endemicity?

PubMed

Chuma, Jane; Okungu, Vincent; Molyneux, Catherine

2010-06-02

Malaria inflicts significant costs on households and on the economy of malaria endemic countries. There is also evidence that the economic burden is higher among the poorest in a population, and that cost burdens differ significantly between wet and dry seasons. What is not clear is whether, and how, the economic burden of malaria differs by disease endemicity. The need to account for geographical and epidemiological differences in the estimation of the social and economic burden of malaria is well recognized, but there is limited data, if any, to support this argument. This study sought to contribute towards filling this gap by comparing malaria cost burdens in four Kenyan districts of different endemicity. A cross-sectional household survey was conducted during the peak malaria transmission season in the poorest areas in four Kenyan districts with differing malaria transmission patterns (n = 179 households in Bondo; 205 Gucha; 184 Kwale; 141 Makueni). There were significant differences in duration of fever, perception of fever severity and cost burdens. Fever episodes among adults and children over five years in Gucha and Makueni districts (highland endemic and low acute transmission districts respectively) lasted significantly longer than episodes reported in Bondo and Kwale districts (high perennial transmission and seasonal, intense transmission, respectively). Perceptions of illness severity also differed between districts: fevers reported among older children and adults in Gucha and Makueni districts were reported as severe compared to those reported in the other districts. Indirect and total costs differed significantly between districts but differences in direct costs were not significant. Total household costs were highest in Makueni (US$ 19.6 per month) and lowest in Bondo (US$ 9.2 per month). Cost burdens are the product of complex relationships between social, economic and epidemiological factors. The cost data presented in this study reflect transmission patterns in the four districts, suggesting that a relationship between costs burdens and the nature of transmission might exist, and that the same warrants more attention from researchers and policy makers.

Nocturnal haemoglobin oxygen desaturation in urban and rural East African paediatric cohorts with and without sickle cell anaemia: a cross-sectional study.

PubMed

L'Esperance, V S; Ekong, T; Cox, S E; Makani, J; Newton, C R; Soka, D; Komba, A; Kirkham, F J; Hill, C M

2016-04-01

Low haemoglobin oxygen saturation (SpO2) predicts complications in children with sickle cell anaemia (SCA) in the North but there are few data from Africa, where the majority of the patients reside. We measured daytime and overnight SpO2 in children with SCA in routine follow-up clinic, and controls without symptoms of SCA, comparing rural (Kilifi, Kenya) and urban (Dar-es-Salaam, Tanzania) cohorts. Daytime SpO2 was lower in 65 Tanzanian children with SCA (TS; median 97 (IQR 94-100)%); p<0.0001) than in 113 Kenyan children with SCA (KS; 99 (98-100)%) and 20 Tanzanian controls (TC; 100 (98-100)%). Compared with 95 Kenyan children with SCA, in 54 Tanzanian children with SCA and 19 TC who returned for overnight oximetry, mean (KS 99.0 (96.7-99.8)%; TS 97.9 (95.4-99.3)%; TC 98.4 (97.5-99.1)%; p=0.01) and minimum nocturnal SpO2 (92 (86-95)%; 87 (78.5-91)%; 90 (83.5-93)% p=0.0001) were lower. The difference between children with SCA persisted after adjustment for haemoglobin (p=0.004). Urban Tanzanian children, with and without SCA, experience greater exposure to low daytime and night-time SpO2 compared with rural Kenyan children with SCA. Possible explanations include differences in the prevalence of obstructive sleep apnoea or asthma, alterations in the oxyhaemoglobin desaturation curve or cardiovascular compromise, for example, to shunting at atrial or pulmonary level secondary to increased pulmonary artery pressure. The fact that non-SCA siblings in the urban area are also affected suggests that environmental exposures, for example, air pollution, nutrition or physical exercise, may play a role. Further studies should determine aetiology and clinical relevance for the SCA phenotype in children resident in Africa. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Multiple traumas, postelection violence, and posttraumatic stress among impoverished Kenyan youth.

PubMed

Harder, Valerie S; Mutiso, Victoria N; Khasakhala, Lincoln I; Burke, Heather M; Ndetei, David M

2012-02-01

Research on posttraumatic stress disorder (PTSD) among youth has focused on specific subgroups from developed countries. Most of the world's youth and war-like violence, however, is concentrated in developing countries, yet there is limited mental health data within affected countries. This study focused on a random community-based sample of 552 impoverished youth ages 6-18 within an informal settlement in Nairobi, Kenya, which experienced war-like violence for a month following the contested presidential election of 2007. Six months after the violence ended, 99 (18%) had PTSD according to the UCLA PTSD Reaction Index (Steinberg, Brymer, Decker, & Pynoos, 2004), and an additional 18 (3%) were found to have partial PTSD due to high overall scores. Kenyan psychologists conducted diagnostic interviews and found the positive predictive value of the assessment tool to be 72% in this sample; the confirmed prevalence was 12%. Similar to other studies worldwide, Criterion C (avoidance) was the limiting factor for diagnosing PTSD according to the DSM-IV-TR, and parent-child agreement was at best fair. The number of traumatic experiences was strongly associated with PTSD outcomes. Differences due to age or sex were not found. The findings indicate the need for universal mental health services for trauma-exposed youth and their families in the impoverished informal settlements of Nairobi, Kenya. Copyright © 2012 International Society for Traumatic Stress Studies.

The Life-Cycle Costs of School Water, Sanitation and Hygiene Access in Kenyan Primary Schools

PubMed Central

Alexander, Kelly T.; Mwaki, Alex; Adhiambo, Dorothy; Cheney-Coker, Malaika; Muga, Richard; Freeman, Matthew C.

2016-01-01

Water, Sanitation and Hygiene (WASH) programs in schools can increase the health, dignity and comfort of students and teachers. Understanding the costs of WASH facilities and services in schools is one essential piece for policy makers to utilize when budgeting for schools and helping to make WASH programs more sustainable. In this study we collected data from NGO and government offices, local hardware shops and 89 rural primary schools across three Kenyan counties. Current expenditures on WASH, from school and external (NGO, government, parent) sources, averaged 1.83 USD per student per year. After reviewing current expenditures, estimated costs of operations and maintenance for bringing schools up to basic WASH standards, were calculated to be 3.03 USD per student per year. This includes recurrent costs, but not the cost of installing or setting up WASH infrastructure, which was 18,916 USD per school, for a school of 400 students (4.92 USD per student, per year). These findings demonstrate the need for increases in allocations to schools in Kenya, and stricter guidance on how money should be spent on WASH inputs to enable all schools to provide basic WASH for all students. PMID:27355962

Everyday objects of learning about health and healing and implications for science education

NASA Astrophysics Data System (ADS)

Gitari, Wanja

2006-02-01

The role of science education in rural development is of great interest to science educators. In this study I investigated how residents of rural Kirumi, Kenya, approach health and healing, through discussions and semistructured and in-depth interviews with 150 residents, 3 local herbalists, and 2 medical researchers over a period of 6 months. I constructed objects of learning by looking for similarities and differences within interpretive themes. Objects of learning found comprise four types of personal learning tools, three types of relational learning tools, three genres of moral obligation, and five genres of knowledge guarding. Findings show that rural people use (among other learning tools) inner sensing to engage thought processes that lead to health and healing knowledge. The sociocultural context is also an important component in learning. Inner sensing and residents' sociocultural context are not presently emphasized in Kenyan science teaching. I discuss the potential use of rural objects of learning in school science, with specific reference to a health topic in the Kenyan science curriculum. In addition, the findings add to the literature in the Science, Technology, Society, and Environment (STSE) approach to science education, and cross-cultural and global science education.

Kenyan Religious Leaders’ Views on Same-Sex Sexuality and Gender Nonconformity: Religious Freedom versus Constitutional Rights

PubMed Central

Mbote, David Kuria; Sandfort, Theo G. M.; Waweru, Esther; Zapfel, Andrew

2016-01-01

Religion plays an important role in framing the public discourse on sexuality, especially in countries where religion fully permeates social life. We explored the perspectives of Kenyan religious leaders on sexual and gender diversity in their country’s specific context. Two hundred and twelve Catholic, Islam and Protestant leaders from urban centers and rural townships completed a self-administered questionnaire, specifically developed for this study. The leaders’ perspectives were predominantly negative. Limited acceptance was conditional on sexual minorities not engaging in same-sex practices or seeing such practices as sinful. A substantial minority (37%) endorsed the use of violence for maintaining social values, especially regarding homosexuality and gender nonconformity. The majority of religious leaders agreed on the difference between civil law and religious doctrine. Human rights principles enshrined in the Kenya Constitution were seen as also applicable to sexual and gender minorities. Decriminalization of same-sex sexuality was seen as against one’s religion. Perspectives were less negative if leaders were familiar with lesbian, gay, bisexual, and transgender (LGBT) persons. Interventions that promote intergroup contact could be effective in changing religious leaders’ mindsets and advancing human rights and health for sexual and gender minorities. PMID:27982708

The Life-Cycle Costs of School Water, Sanitation and Hygiene Access in Kenyan Primary Schools.

PubMed

Alexander, Kelly T; Mwaki, Alex; Adhiambo, Dorothy; Cheney-Coker, Malaika; Muga, Richard; Freeman, Matthew C

2016-06-27

Water, Sanitation and Hygiene (WASH) programs in schools can increase the health, dignity and comfort of students and teachers. Understanding the costs of WASH facilities and services in schools is one essential piece for policy makers to utilize when budgeting for schools and helping to make WASH programs more sustainable. In this study we collected data from NGO and government offices, local hardware shops and 89 rural primary schools across three Kenyan counties. Current expenditures on WASH, from school and external (NGO, government, parent) sources, averaged 1.83 USD per student per year. After reviewing current expenditures, estimated costs of operations and maintenance for bringing schools up to basic WASH standards, were calculated to be 3.03 USD per student per year. This includes recurrent costs, but not the cost of installing or setting up WASH infrastructure, which was 18,916 USD per school, for a school of 400 students (4.92 USD per student, per year). These findings demonstrate the need for increases in allocations to schools in Kenya, and stricter guidance on how money should be spent on WASH inputs to enable all schools to provide basic WASH for all students.

Kenyan Religious Leaders' Views on Same-Sex Sexuality and Gender Nonconformity: Religious Freedom versus Constitutional Rights.

PubMed

Mbote, David Kuria; Sandfort, Theo G M; Waweru, Esther; Zapfel, Andrew

Religion plays an important role in framing the public discourse on sexuality, especially in countries where religion fully permeates social life. We explored the perspectives of Kenyan religious leaders on sexual and gender diversity in their country's specific context. A total of 212 Catholic, Islamic, and Protestant leaders from urban centers and rural townships completed a self-administered questionnaire specifically developed for this study. The leaders' perspectives were predominantly negative. Limited acceptance was conditional on sexual minorities not engaging in same-sex practices or seeing such practices as sinful. A substantial minority (37%) endorsed the use of violence for maintaining social values, especially regarding homosexuality and gender nonconformity. The majority of religious leaders agreed on the difference between civil law and religious doctrine. Human rights principles enshrined in Kenya's Constitution were considered to be applicable to sexual and gender minorities. Decriminalization of same-sex sexuality was seen as against one's religion. Perspectives were less negative if leaders were familiar with lesbian, gay, bisexual, and transgender (LGBT) persons. Interventions that promote intergroup contact could be effective in changing religious leaders' mind-sets and advancing human rights and health for sexual and gender minorities.

Children consuming cassava as a staple food are at risk for inadequate zinc, iron, and vitamin A intake.

PubMed

Gegios, Alison; Amthor, Rachel; Maziya-Dixon, Busie; Egesi, Chedozie; Mallowa, Sally; Nungo, Rhoda; Gichuki, Simon; Mbanaso, Ada; Manary, Mark J

2010-03-01

Cassava contains little zinc, iron, and beta-carotene, yet it is the primary staple crop of over 250 million Africans. This study used a 24-hour dietary recall to test the hypothesis that among healthy children aged 2-5 years in Nigeria and Kenya, cassava's contribution to the childrens' daily diets is inversely related to intakes of zinc, iron, and vitamin A. Dietary and demographic data and anthropometric measurements were collected from 449 Kenyan and 793 Nigerian children. Among Kenyan children 89% derived at least 25% of their dietary energy from cassava, while among the Nigerian children 31% derived at least 25% of energy from cassava. Spearman's correlation coefficient between the fraction of dietary energy obtained from cassava and vitamin A intake was r = -0.15, P < 0.0001, zinc intake was r = -0.11, P < 0.0001 and iron intake was r = -0.36, P < 0.0001. In Kenya, 59% of children consumed adequate vitamin A, 22% iron, and 31% zinc. In Nigeria, 17% of children had adequate intake of vitamin A, 57% iron, and 41% zinc. Consumption of cassava is a risk factor for inadequate vitamin A, zinc and/or iron intake.

INTERNAL ROOT MORPHOLOGY IN MANDIBULAR FIRST PERMANENT MOLARS IN A KENYAN POPULATION.

PubMed

Muriithi, N J; Maina, S W; Okoth, J; Gathece, L W

2012-05-01

To determine the internal root morphology and gender variations in mandibular first permanent molars in a Kenyan population. In vitro descriptive cross sectional study. School of Dental Sciences, University of Nairobi The mesial root of mandibular first molars had two canals in 96.3% of the teeth in both males and females and-type IV canal configuration was most prevalent in the mesial root. The distal root of the mandibular first molar had one canal in 57.7% of the teeth in males and females. There were significant gender variations in the number of canals and canal configurations in the distal root. Two canals were more prevalent in females (53.6%) compared to males (30.4%) and a single canal was more frequent in males (69.6%) compared to females (46.4%) (P=0.001). Canal types 1, 11 and IV were the most frequent in the mandibular distal root. The gender variation in the frequency of canal types I, II and IV in the distal root was statistically significant (P=0.001). Most of the mandibular first molars have three canals (56%). Two canals in the distal root are more frequent among females (53.6%) compared to males (30.4%).

Time Series Analysis of Sexual Assault Case Characteristics and the 2007–2008 Period of Post-Election Violence in Kenya

PubMed Central

Anastario, Michael P.; Adhiambo Onyango, Monica; Nyanyuki, Joan; Naimer, Karen; Muthoga, Rachel; Sirkin, Susannah; Barrick, Kelle; van Hasselt, Martijn; Aruasa, Wilson; Kibet, Cynthia; Omollo, Grace

2014-01-01

Background Following the declaration that President Mwai Kibaki was the winner of the Kenyan presidential election held on December 27, 2007, a period of post-election violence (PEV) took place. In this study, we aimed to identify whether the period of PEV in Kenya was associated with systematic changes in sexual assault case characteristics. Methods and Findings Medical records of 1,615 patients diagnosed with sexual assault between 2007 and 2011 at healthcare facilities in Eldoret (n = 569), Naivasha (n = 534), and Nakuru (n = 512) were retrospectively reviewed to examine characteristics of sexual assault cases over time. Time series and linear regression were used to examine temporal variation in case characteristics relative to the period of post-election violence in Kenya. Key informant interviews with healthcare workers at the sites were employed to triangulate findings. The time series of sexual assault case characteristics at these facilities were examined, with a specific focus on the December 2007–February 2008 period of post-election violence. Prais-Winsten estimates indicated that the three-month period of post-election violence was associated with a 22 percentage-point increase in cases where survivors did not know the perpetrator, a 20 percentage-point increase in cases with more than one perpetrator, and a 4 percentage-point increase in cases that had evidence of abdominal injury. The post-election violence period was also associated with an 18 percentage-point increase in survivors waiting >1 month to report to a healthcare facility. Sensitivity analyses confirmed that these characteristics were specific to the post-election violence time period. Conclusion These results demonstrate systematic patterns in sexual assault characteristics during the PEV period in Kenya. PMID:25170917

Lipoma of the cheek presenting with recurrent sialadenitis of the right parotid gland: a case report.

PubMed

Tom, Osundwa; Tom, Ochola

2016-11-03

Lipomas are benign neoplasms arising from adipose tissue. Oral lipomas have been reported in the buccal mucosa, tongue, floor of the mouth and lips; however, the case of a lipoma occurring as an antecedent lesion to recurrent sialadenitis is hitherto unreported in the English literature. We report the case of an intraoral lipoma occurring with signs and symptoms of recurrent sialadenitis in a 15-year-old Kenyan girl of Kikuyu descent. The lipoma was antecedent leading to partial obstruction and stasis related to the right Stensen's duct culminating in recurrent sialadenitis of the ipsilateral parotid gland. Due to the slow growth, softness, diffuse nature and lack of pain, lipomas may exist below the diagnostic radar, hence, the need to have a high index of suspicion and utilize diagnostic aids as necessary. In this case magnetic resonance imaging was key in establishing the existence of the lipoma. The lipoma was excised with resolution of the recurrent sialadenitis. The purpose of this report is to present the diagnostic challenge emanating from the pressure effects of an intraoral soft tissue lipoma masquerading as recurrent sialadenitis with a view to improving on patient care through sensitization.

An Investigation into the Relationship Between Theory and Practical Biology at 'A' Level in Kenyan Secondary Schools. African Studies in Curriculum Development & Evaluation No. 100.

ERIC Educational Resources Information Center

Mutsune, Myra Kanaidza

Until 1982, achievement in A-level biology in Kenya was measured by an examination which consisted of four papers, three measuring theory work and one measuring practical skills. In 1982, a three paper examination was developed, the first two papers measuring theory and the third paper measuring practical skills. Based on the change in the test…

Localizing HIV/AIDS discourse in a rural Kenyan community.

PubMed

Banda, Felix; Oketch, Omondi

2011-01-01

This paper examines the effectiveness of multimodal texts used in HIV/AIDS campaigns in rural western Kenya using multimodal discourse analysis (Kress and Van Leeuwen, 2006; Martin and Rose, 2004). Twenty HIV/AIDS documents (posters, billboards and brochures) are analysed together with interview data (20 unstructured one-on-one interviews and six focus groups) from the target group to explore the effectiveness of the multimodal texts in engaging the target rural audience in meaningful interaction towards behavioural change. It is concluded that in some cases the HIV/AIDS messages are misinterpreted or lost as the multimodal texts used are unfamiliar and contradictory to the everyday life experiences of the rural folk. The paper suggests localization of HIV/AIDS discourse through use of local modes of communication and resources.

The cost of uncomplicated childhood fevers to Kenyan households: implications for reaching international access targets

PubMed Central

Larson, Bruce A; Amin, Abdinasir A; Noor, Abdisalan M; Zurovac, Dejan; Snow, Robert W

2006-01-01

Background Fever is the clinical hallmark of malaria disease. The Roll Back Malaria (RBM) movement promotes prompt, effective treatment of childhood fevers as a key component to achieving its optimistic mortality reduction goals by 2010. A neglected concern is how communities will access these new medicines promptly and the costs to poor households when they are located in rural areas distant to health services. Methods We assemble data developed between 2001 and 2002 in Kenya to describe treatment choices made by rural households to treat a child's fever and the related costs to households. Using a cost-of-illness approach, we estimate the expected cost of a childhood fever to Kenyan households in 2002. We develop two scenarios to explore how expected costs to households would change if more children were treated at a health care facility with an effective antimalarial within 48 hours of fever onset. Results 30% of uncomplicated fevers were managed at home with modern medicines, 38% were taken to a health care facility (HCF), and 32% were managed at home without the use of modern medicines. Direct household cash expenditures were estimated at $0.44 per fever, while the total expected cost to households (cash and time) of an uncomplicated childhood fever is estimated to be $1.91. An estimated mean of 1.42 days of caretaker time devoted to each fever accounts for the majority of household costs of managing fevers. The aggregate cost to Kenyan households of managing uncomplicated childhood fevers was at least $96 million in 2002, equivalent to 1.00% of the Kenyan GDP. Fewer than 8% of all fevers were treated with an antimalarial drug within 24 hours of fever onset, while 17.5% were treated within 48 hours at a HCF. To achieve an increase from 17.5% to 33% of fevers treated with an antimalarial drug within 48 hours at a HCF (Scenario 1), children already being taken to a HCF would need to be taken earlier. Under this scenario, direct cash expenditures would not change, and total household costs would fall slightly to $1.86 because caretakers also save time with prompt treatment if the child has malaria. Conclusion The management of uncomplicated childhood fevers imposes substantial costs on Kenyan households. Achieving substantial improvements in the numbers of fevers treated within 48 hours at a HCF with an effective antimalarial drug (Scenario 1) will not impose additional costs on households. Achieving additional improvements in fevers treated promptly at a HCF (Scenario 2) will impose additional costs on some households roughly equal to average cash expenses for transportation to a HCF. Additional financing mechanisms that further reduce the costs of accessing care at a HCF and/or that make artemisinin-based combination therapies (ACTs) accessible for home management need to be developed and evaluated as a top priority. PMID:17196105

The cost of uncomplicated childhood fevers to Kenyan households: implications for reaching international access targets.

PubMed

Larson, Bruce A; Amin, Abdinasir A; Noor, Abdisalan M; Zurovac, Dejan; Snow, Robert W

2006-12-29

Fever is the clinical hallmark of malaria disease. The Roll Back Malaria (RBM) movement promotes prompt, effective treatment of childhood fevers as a key component to achieving its optimistic mortality reduction goals by 2010. A neglected concern is how communities will access these new medicines promptly and the costs to poor households when they are located in rural areas distant to health services. We assemble data developed between 2001 and 2002 in Kenya to describe treatment choices made by rural households to treat a child's fever and the related costs to households. Using a cost-of-illness approach, we estimate the expected cost of a childhood fever to Kenyan households in 2002. We develop two scenarios to explore how expected costs to households would change if more children were treated at a health care facility with an effective antimalarial within 48 hours of fever onset. 30% of uncomplicated fevers were managed at home with modern medicines, 38% were taken to a health care facility (HCF), and 32% were managed at home without the use of modern medicines. Direct household cash expenditures were estimated at $0.44 per fever, while the total expected cost to households (cash and time) of an uncomplicated childhood fever is estimated to be $1.91. An estimated mean of 1.42 days of caretaker time devoted to each fever accounts for the majority of household costs of managing fevers. The aggregate cost to Kenyan households of managing uncomplicated childhood fevers was at least $96 million in 2002, equivalent to 1.00% of the Kenyan GDP. Fewer than 8% of all fevers were treated with an antimalarial drug within 24 hours of fever onset, while 17.5% were treated within 48 hours at a HCF. To achieve an increase from 17.5% to 33% of fevers treated with an antimalarial drug within 48 hours at a HCF (Scenario 1), children already being taken to a HCF would need to be taken earlier. Under this scenario, direct cash expenditures would not change, and total household costs would fall slightly to $1.86 because caretakers also save time with prompt treatment if the child has malaria. The management of uncomplicated childhood fevers imposes substantial costs on Kenyan households. Achieving substantial improvements in the numbers of fevers treated within 48 hours at a HCF with an effective antimalarial drug (Scenario 1) will not impose additional costs on households. Achieving additional improvements in fevers treated promptly at a HCF (Scenario 2) will impose additional costs on some households roughly equal to average cash expenses for transportation to a HCF. Additional financing mechanisms that further reduce the costs of accessing care at a HCF and/or that make artemisinin-based combination therapies (ACTs) accessible for home management need to be developed and evaluated as a top priority.

The Unrecognized Burden of Influenza in Young Kenyan Children, 2008-2012.

PubMed

McMorrow, Meredith L; Emukule, Gideon O; Njuguna, Henry N; Bigogo, Godfrey; Montgomery, Joel M; Nyawanda, Bryan; Audi, Allan; Breiman, Robert F; Katz, Mark A; Cosmas, Leonard; Waiboci, Lilian W; Duque, Jazmin; Widdowson, Marc-Alain; Mott, Joshua A

2015-01-01

Influenza-associated disease burden among children in tropical sub-Saharan Africa is not well established, particularly outside of the 2009 pandemic period. We estimated the burden of influenza in children aged 0-4 years through population-based surveillance for influenza-like illness (ILI) and acute lower respiratory tract illness (ALRI). Household members meeting ILI or ALRI case definitions were referred to health facilities for evaluation and collection of nasopharyngeal and oropharyngeal swabs for influenza testing by real-time reverse transcription polymerase chain reaction. Estimates were adjusted for health-seeking behavior and those with ILI and ALRI who were not tested. During 2008-2012, there were 9,652 person-years of surveillance among children aged 0-4 years. The average adjusted rate of influenza-associated hospitalization was 4.3 (95% CI 3.0-6.0) per 1,000 person-years in children aged 0-4 years. Hospitalization rates were highest in the 0-5 month and 6-23 month age groups, at 7.6 (95% CI 3.2-18.2) and 8.4 (95% CI 5.4-13.0) per 1,000 person-years, respectively. The average adjusted rate of influenza-associated medically attended (inpatient or outpatient) ALRI in children aged 0-4 years was 17.4 (95% CI 14.2-19.7) per 1,000 person-years. Few children who had severe laboratory-confirmed influenza were clinically diagnosed with influenza by the treating clinician in the inpatient (0/33, 0%) or outpatient (1/109, 0.9%) settings. Influenza-associated hospitalization rates from 2008-2012 were 5-10 times higher than contemporaneous U.S. estimates. Many children with danger signs were not hospitalized; thus, influenza-associated severe disease rates in Kenyan children are likely higher than hospital-based estimates suggest.

A policy analysis of the implementation of a Reproductive Health Vouchers Program in Kenya.

PubMed

Abuya, Timothy; Njuki, Rebecca; Warren, Charlotte E; Okal, Jerry; Obare, Francis; Kanya, Lucy; Askew, Ian; Bellows, Ben

2012-07-23

Innovative financing strategies such as those that integrate supply and demand elements like the output-based approach (OBA) have been implemented to reduce financial barriers to maternal health services. The Kenyan government with support from the German Development Bank (KfW) implemented an OBA voucher program to subsidize priority reproductive health services. Little evidence exists on the experience of implementing such programs in different settings. We describe the implementation process of the Kenyan OBA program and draw implications for scale up. Policy analysis using document review and qualitative data from 10 in-depth interviews with facility in-charges and 18 with service providers from the contracted facilities, local administration, health and field managers in Kitui, Kiambu and Kisumu districts as well as Korogocho and Viwandani slums in Nairobi. The OBA implementation process was designed in phases providing an opportunity for learning and adapting the lessons to local settings; the design consisted of five components: a defined benefit package, contracting and quality assurance; marketing and distribution of vouchers and claims processing and reimbursement. Key implementation challenges included limited feedback to providers on the outcomes of quality assurance and accreditation and budgetary constraints that limited effective marketing leading to inadequate information to clients on the benefit package. Claims processing and reimbursement was sophisticated but required adherence to time consuming procedures and in some cases private providers complained of low reimbursement rates for services provided. OBA voucher schemes can be implemented successfully in similar settings. For effective scale up, strong partnership will be required between the public and private entities. The government's role is key and should include provision of adequate funding, stewardship and looking for opportunities to utilize existing platforms to scale up such strategies.

Sustainable Low-Carbon Expansion for the Power Sector of an Emerging Economy: The Case of Kenya.

PubMed

Carvallo, Juan-Pablo; Shaw, Brittany J; Avila, Nkiruka I; Kammen, Daniel M

2017-09-05

Fast growing and emerging economies face the dual challenge of sustainably expanding and improving their energy supply and reliability while at the same time reducing poverty. Critical to such transformation is to provide affordable and sustainable access to electricity. We use the capacity expansion model SWITCH to explore low carbon development pathways for the Kenyan power sector under a set of plausible scenarios for fast growing economies that include uncertainty in load projections, capital costs, operational performance, and technology and environmental policies. In addition to an aggressive and needed expansion of overall supply, the Kenyan power system presents a unique transition from one basal renewable resource-hydropower-to another based on geothermal and wind power for ∼90% of total capacity. We find geothermal resource adoption is more sensitive to operational degradation than high capital costs, which suggests an emphasis on ongoing maintenance subsidies rather than upfront capital cost subsidies. We also find that a cost-effective and viable suite of solutions includes availability of storage, diesel engines, and transmission expansion to provide flexibility to enable up to 50% of wind power penetration. In an already low-carbon system, typical externality pricing for CO 2 has little to no effect on technology choice. Consequently, a "zero carbon emissions" by 2030 scenario is possible with only moderate levelized cost increases of between $3 and $7/MWh with a number of social and reliability benefits. Our results suggest that fast growing and emerging economies could benefit by incentivizing anticipated strategic transmission expansion. Existing and new diesel and natural gas capacity can play an important role to provide flexibility and meet peak demand in specific hours without a significant increase in carbon emissions, although more research is required for other pollutant's impacts.

A Policy Analysis of the implementation of a Reproductive Health Vouchers Program in Kenya

PubMed Central

2012-01-01

Background Innovative financing strategies such as those that integrate supply and demand elements like the output-based approach (OBA) have been implemented to reduce financial barriers to maternal health services. The Kenyan government with support from the German Development Bank (KfW) implemented an OBA voucher program to subsidize priority reproductive health services. Little evidence exists on the experience of implementing such programs in different settings. We describe the implementation process of the Kenyan OBA program and draw implications for scale up. Methods Policy analysis using document review and qualitative data from 10 in-depth interviews with facility in-charges and 18 with service providers from the contracted facilities, local administration, health and field managers in Kitui, Kiambu and Kisumu districts as well as Korogocho and Viwandani slums in Nairobi. Results The OBA implementation process was designed in phases providing an opportunity for learning and adapting the lessons to local settings; the design consisted of five components: a defined benefit package, contracting and quality assurance; marketing and distribution of vouchers and claims processing and reimbursement. Key implementation challenges included limited feedback to providers on the outcomes of quality assurance and accreditation and budgetary constraints that limited effective marketing leading to inadequate information to clients on the benefit package. Claims processing and reimbursement was sophisticated but required adherence to time consuming procedures and in some cases private providers complained of low reimbursement rates for services provided. Conclusions OBA voucher schemes can be implemented successfully in similar settings. For effective scale up, strong partnership will be required between the public and private entities. The government’s role is key and should include provision of adequate funding, stewardship and looking for opportunities to utilize existing platforms to scale up such strategies. PMID:22823923

Deforestation and Vectorial Capacity of Anopheles gambiae Giles Mosquitoes in Malaria Transmission, Kenya

PubMed Central

Afrane, Yaw A.; Little, Tom J.; Lawson, Bernard W.; Githeko, Andrew K.

2008-01-01

We investigated the effects of deforestation on microclimates and sporogonic development of Plasmodium falciparum parasites in Anopheles gambiae mosquitoes in an area of the western Kenyan highland prone to malaria epidemics. An. gambiae mosquitoes were fed with P. falciparum–infected blood through membrane feeders. Fed mosquitoes were placed in houses in forested and deforested areas in a highland area (1,500 m above sea level) and monitored for parasite development. Deforested sites had higher temperatures and relative humidities, and the overall infection rate of mosquitoes was increased compared with that in forested sites. Sporozoites appeared on average 1.1 days earlier in deforested areas. Vectorial capacity was estimated to be 77.7% higher in the deforested site than in the forested site. We showed that deforestation changes microclimates, leading to more rapid sporogonic development of P. falciparum and to a marked increase of malaria risk in the western Kenyan highland. PMID:18826815

Phylogeography of the wild and cultivated stimulant plant qat (Catha edulis, Celastraceae) in areas of historical cultivation.

PubMed

Tembrock, Luke R; Simmons, Mark P; Richards, Christopher M; Reeves, Patrick A; Reilley, Ann; Curto, Manuel A; Meimberg, Harald; Ngugi, Grace; Demissew, Sebsebe; Al Khulaidi, Abdul Wali; Al-Thobhani, Mansoor; Simpson, Sheron; Varisco, Daniel M

2017-04-01

Qat ( Catha edulis , Celastraceae) is a woody plant species cultivated for its stimulant alkaloids. Qat is important to the economy and culture in large regions of Ethiopia, Kenya, and Yemen. Despite the importance of this species, the wild origins and dispersal of cultivars have only been described in often contradictory historical documents. We examined the wild origins, human-mediated dispersal, and genetic divergence of cultivated qat compared to wild qat. We sampled 17 SSR markers and 1561 wild and cultivated individuals across the historical areas of qat cultivation. On the basis of genetic structure inferred using Bayesian and nonparametric methods, two centers of origin in Kenya and one in Ethiopia were found for cultivated qat. The centers of origin in Ethiopia and northeast of Mt. Kenya are the primary sources of cultivated qat genotypes. Qat cultivated in Yemen is derived from Ethiopian genotypes rather than Yemeni wild populations. Cultivated qat with a wild Kenyan origin has not spread to Ethiopia or Yemen, whereas a small minority of qat cultivated in Kenya originated in Ethiopia. Hybrid genotypes with both Ethiopian and Kenyan parentage are present in northern Kenya. Ethiopian cultivars have diverged from their wild relatives, whereas Kenyan qat has diverged less. This pattern of divergence could be caused by the extinction of the wild-source qat populations in Ethiopia due to deforestation, undersampling, and/or artificial selection for agronomically important traits. © 2017 Tembrock et al. Published by the Botanical Society of America. This work is licensed under a Creative Commons public domain license (CC0 1.0).

Engaging religious leaders to support HIV prevention and care for gays, bisexual men, and other men who have sex with men in coastal Kenya

PubMed Central

Gichuru, Evans; Kombo, Bernadette; Mumba, Noni; Sariola, Salla; Sanders, Eduard J.; van der Elst, Elise M.

2018-01-01

Abstract In Kenyan communities, religious leaders are important gatekeepers in matters of health and public morality. In a context that is generally homophobic, religious leaders may aggravate or reduce stigmatization of sexual minorities such as gay and bisexual men, and other men who have sex with men (GBMSM). Literature indicates mixed results in efforts to encourage religious leaders to work effectively and sensitively with issues regarding HIV and sexuality. This paper describes the implementation of an engagement intervention with religious leaders from different denominations, which took place following a homophobic hate attack that was led by local religious leaders, at an HIV research clinic for GBMSM on the Kenyan coast. After the homophobic attack, tailored engagement activities, including a comprehensive four-day online sensitivity training course took place between June 2015 and October 2016 in the Kenyan coast. HIV researchers, together with trained GBMSM activists, organized the series of engagement activities for religious leaders which unfolded iteratively, with each subsequent activity informed by the results of the previous one. Facilitated conversations were used to explore differences and disagreements in relation to questions of scripture, mission, HIV, and human sexuality. As a result, researchers noted that many religious leaders, who initially expressed exceedingly negative attitudes towards GBMSM, started to express far more accepting and supportive views of sexuality, sexual identities, and same-sex relations. This paper describes the changes in religious leaders’ discourses relating to GBMSM, and highlights the possibility of using engagement interventions to build trust between research institutes, religious leaders, and GBMSM. PMID:29770367

Changing Malaria Prevalence on the Kenyan Coast since 1974: Climate, Drugs and Vector Control

PubMed Central

Snow, Robert W.; Kibuchi, Eliud; Karuri, Stella W.; Sang, Gilbert; Gitonga, Caroline W.; Mwandawiro, Charles; Bejon, Philip; Noor, Abdisalan M.

2015-01-01

Background Progress toward reducing the malaria burden in Africa has been measured, or modeled, using datasets with relatively short time-windows. These restricted temporal analyses may miss the wider context of longer-term cycles of malaria risk and hence may lead to incorrect inferences regarding the impact of intervention. Methods 1147 age-corrected Plasmodium falciparum parasite prevalence (PfPR2-10) surveys among rural communities along the Kenyan coast were assembled from 1974 to 2014. A Bayesian conditional autoregressive generalized linear mixed model was used to interpolate to 279 small areas for each of the 41 years since 1974. Best-fit polynomial splined curves of changing PfPR2-10 were compared to a sequence of plausible explanatory variables related to rainfall, drug resistance and insecticide-treated bed net (ITN) use. Results P. falciparum parasite prevalence initially rose from 1974 to 1987, dipped in 1991–92 but remained high until 1998. From 1998 onwards prevalence began to decline until 2011, then began to rise through to 2014. This major decline occurred before ITNs were widely distributed and variation in rainfall coincided with some, but not all, short-term transmission cycles. Emerging resistance to chloroquine and introduction of sulfadoxine/pyrimethamine provided plausible explanations for the rise and fall of malaria transmission along the Kenyan coast. Conclusions Progress towards elimination might not be as predictable as we would like, where natural and extrinsic cycles of transmission confound evaluations of the effect of interventions. Deciding where a country lies on an elimination pathway requires careful empiric observation of the long-term epidemiology of malaria transmission. PMID:26107772

Engaging religious leaders to support HIV prevention and care for gays, bisexual men, and other men who have sex with men in coastal Kenya.

PubMed

Gichuru, Evans; Kombo, Bernadette; Mumba, Noni; Sariola, Salla; Sanders, Eduard J; van der Elst, Elise M

2018-01-01

In Kenyan communities, religious leaders are important gatekeepers in matters of health and public morality. In a context that is generally homophobic, religious leaders may aggravate or reduce stigmatization of sexual minorities such as gay and bisexual men, and other men who have sex with men (GBMSM). Literature indicates mixed results in efforts to encourage religious leaders to work effectively and sensitively with issues regarding HIV and sexuality. This paper describes the implementation of an engagement intervention with religious leaders from different denominations, which took place following a homophobic hate attack that was led by local religious leaders, at an HIV research clinic for GBMSM on the Kenyan coast. After the homophobic attack, tailored engagement activities, including a comprehensive four-day online sensitivity training course took place between June 2015 and October 2016 in the Kenyan coast. HIV researchers, together with trained GBMSM activists, organized the series of engagement activities for religious leaders which unfolded iteratively, with each subsequent activity informed by the results of the previous one. Facilitated conversations were used to explore differences and disagreements in relation to questions of scripture, mission, HIV, and human sexuality. As a result, researchers noted that many religious leaders, who initially expressed exceedingly negative attitudes towards GBMSM, started to express far more accepting and supportive views of sexuality, sexual identities, and same-sex relations. This paper describes the changes in religious leaders' discourses relating to GBMSM, and highlights the possibility of using engagement interventions to build trust between research institutes, religious leaders, and GBMSM.

Kenyan women adult literacy learners: why their motivation is difficult to sustain.

PubMed

Mwiria, K

1993-05-01

Kenya, like other Third World countries, has illiteracy rates for women which are twice those of men (in 1978, 35% of males and 70% of females aged 15 and above were illiterate). Since the beginning of the country's literacy campaign in 1979, women have comprised more than 70% of attendees. While this situation remains the case, the overall enrolment figures for the program have shown a gradual decline from 1979 to 1990 due to a lack of emphasis on individual motivation. Women dominate the literacy programs for several reasons: 1) women historically had less access to formal education than men; 2) the changing economy has forced women to assume extra responsibilities outside the home which make the women want to acquire formal skills; 3) women's schedules are often flexible enough to allow them to attend classes; 4) literacy classes provide women with needed socialization opportunities; and 5) in some communities cultural norms prevent men from attending classes with women. Women also have many obstacles which make their desire to become adult learners difficult to sustain. They have responsibilities which range from child-bearing to management of their family farms which leave them little time for study or class attendance. There is also little encouragement offered the women either at home or in their classes. At home they are confronted with a myriad of demands on their time. Their classes take place in conditions which are not very conducive to learning (classrooms designed for children or open air centers). The literacy teachers are, for the most part, unqualified. They must meet only minimal requirements and receive no training. The women also have less opportunities to practice their new skills outside of the classroom. Women have less time then men to read, and they are less fluent then men in English and Kiswahili, the 2 official languages of Kenya. Because Kenyan society is male-dominated, there is little encouragement given to women who attempt to acquire literacy. Also, men tend to dominate the position of authority in the literary programs and also make up 66% of the cadre of full-time teachers, giving the women few role models and fewer opportunities to work with an instructor who would be particularly sensitive to their needs. Since there is a demonstrated positive correlation between formal education and better health practices and agricultural productivity, there is a real need to attract more women to the literacy program and to motivate them to remain in the program. The best way to accomplish this would be to improve the status of women in Kenyan society. Until this occurs, however, measures can be taken to increase the number of women in administrative and teaching positions and to improve the quality of teachers through training and proper remuneration. The literacy program itself can be used to improve the status of women in society.

Learning from Others.

ERIC Educational Resources Information Center

Daisey, Peggy; Dabney, Jocelyn

1997-01-01

Discusses the use of biographies to increase student interest in plant science. Presents the biography of Wangari Maathai, a Kenyan woman who empowered women and children to plant and care for millions of trees in Kenya, as an example of teaching with biographies. (JRH)

Municipal solid waste management challenges in developing countries--Kenyan case study.

PubMed

Henry, Rotich K; Yongsheng, Zhao; Jun, Dong

2006-01-01

This paper provides an overview of the state of municipal solid waste management (MSWM) by local authorities in Kenya as a case study of a low-income developing country. Approaches of possible solutions that can be undertaken to improve municipal solid waste (MSW) services are discussed. Poor economic growth (1.1% in 1993) has resulted in an increase in the poverty level which presently stands at 56%. Migration from the rural areas to the urban areas has resulted in unplanned settlements in suburban areas accommodating about 60% of the urban population on only 5% urban land area. Political interference also hampers smooth running of local authorities. Vulnerability of pollution of surface and groundwater is high because local authorities rarely considered environmental impact in siting MSW disposal sites. Illegal dumping of MSW on the river banks or on the roadside poses environmental and economic threats on nearby properties. Poor servicing of MSW collection vehicles, poor state of infrastructure and the lack of adequate funding militate against optimization of MSW disposal service. The rural economy needs to be improved if rural-urban migration is to be managed. Involvement of stakeholders is important to achieve any meaningful and sustainable MSWM. The role of the informal sector through community-based organizations (CBOs), Non-Governmental Organizations (NGOs) and the private sector in offering solutions towards improvement of MSWM also is explored.

'She's my sister-in-law, my visitor, my friend' -- challenges of staff identity in home follow-up in an HIV trial in Western Kenya.

PubMed

Madiega, Philister Adhiambo; Jones, Gemma; Prince, Ruth Jane; Geissler, Paul Wenzel

2013-04-01

Identities ascribed to research staff in face-to-face encounters with participants have been raised as key ethical challenge in transnational health research. 'Misattributed' identities that do not just deviate from researchers' self-image, but obscure unequivocal aspects of researcher identity - e.g. that they are researchers - are a case of such ethical problem. Yet, the reasonable expectation of unconcealed identity can conflict with another ethical premise: confidentiality; this poses challenges to staff visiting participants at home. We explore these around a case study of 'follow-up' staff, observed during an ethnographic study of a Kenyan HIV 'trial community', which included participant observation, conversations, and interviews with staff (n = 79) and participants (n = 89). We found that because of the need to maintain confidentiality and because of some suspicions towards researchers, research staff drew upon alternative identities - presenting themselves to non-participants as relatives or friends, rather than as researchers. Several staff experienced this as necessary but uncomfortable. Simultaneously, staff and participants forged close relations in line with their fictional identities, which however also posed challenges because they entailed personal responsibilities that were difficult to live up to, due to limited resources, and the trial's limited duration. Similar challenges may arise in transnational HIV treatment programmes and should be explored further in that context. © 2013 Blackwell Publishing Ltd.

'Everyone has a secret they keep close to their hearts': challenges faced by adolescents living with HIV infection at the Kenyan coast.

PubMed

Abubakar, Amina; Van de Vijver, Fons J R; Fischer, Ronald; Hassan, Amin S; K Gona, Joseph; Dzombo, Judith Tumaini; Bomu, Grace; Katana, Khamis; Newton, Charles R

2016-02-29

The upsurge in the uptake of antiretroviral therapy (ART) has led to a significant increase in the survival of vertically acquired HIV infected children, many of whom are currently living into adolescence and early adulthood. However little if anything is known of the lived experiences and the challenges faced by HIV positive adolescents in the African context. We set out to investigate psychosocial challenges faced by HIV infected adolescents on the Kenyan coast. A total of 44 participants (12 HIV-infected adolescents, 7 HIV uninfected adolescents, and 25 key informants) took part in this qualitative study, using individually administered in-depth interviews. A framework approach was used to analyze the data using NVIVO software. We observed that the challenges faced by adolescents in rural Kenya could be placed into six major themes: poverty, poor mental and physical health, the lack of a school system that is responsive to their needs, challenges in how to disclose to peers and family members, high levels of stigma in its various forms, and challenges of medical adherence leading to the need for close monitoring. In this African community, vertically acquired HIV-infected adolescents face a complex set of social, economic and medical challenges. Our study points to the urgent need to develop multisectorial intervention support programmes to fully address these challenges.

Evaluation of the Parasight Platform for Malaria Diagnosis

PubMed Central

Eshel, Yochay; Houri-Yafin, Arnon; Benkuzari, Hagai; Lezmy, Natalie; Soni, Mamta; Charles, Malini; Swaminathan, Jayanthi; Solomon, Hilda; Sampathkumar, Pavithra; Premji, Zul; Mbithi, Caroline; Nneka, Zaitun; Onsongo, Simon; Maina, Daniel; Levy-Schreier, Sarah; Cohen, Caitlin Lee; Gluck, Dan; Pollak, Joseph Joel

2016-01-01

ABSTRACT The World Health Organization estimates that nearly 500 million malaria tests are performed annually. While microscopy and rapid diagnostic tests (RDTs) are the main diagnostic approaches, no single method is inexpensive, rapid, and highly accurate. Two recent studies from our group have demonstrated a prototype computer vision platform that meets those needs. Here we present the results from two clinical studies on the commercially available version of this technology, the Sight Diagnostics Parasight platform, which provides malaria diagnosis, species identification, and parasite quantification. We conducted a multisite trial in Chennai, India (Apollo Hospital [n = 205]), and Nairobi, Kenya (Aga Khan University Hospital [n = 263]), in which we compared the device to microscopy, RDTs, and PCR. For identification of malaria, the device performed similarly well in both contexts (sensitivity of 99% and specificity of 100% at the Indian site and sensitivity of 99.3% and specificity of 98.9% at the Kenyan site, compared to PCR). For species identification, the device correctly identified 100% of samples with Plasmodium vivax and 100% of samples with Plasmodium falciparum in India and 100% of samples with P. vivax and 96.1% of samples with P. falciparum in Kenya, compared to PCR. Lastly, comparisons of the device parasite counts with those of trained microscopists produced average Pearson correlation coefficients of 0.84 at the Indian site and 0.85 at the Kenyan site. PMID:27974542

Infant feeding counselling of HIV-infected women in two areas in Kenya in 2008.

PubMed

Israel-Ballard, Kiersten; Waithaka, Margaret; Greiner, Ted

2014-11-01

While WHO no longer recommends individual infant feeding counselling to HIV-positive women, it may still be practised in some settings and for specific cases. In any case, lessons can be learned by examining how well front line health workers are able to take on counselling tasks. This qualitative study was designed to assess how counsellors deal with challenges they face in two Kenyan provinces. It consisted of brief post-counselling exit interviews with 80 mothers, observations of 21 counselling sessions and 11 key informant interviews. Much infant feeding counselling was of reasonable quality, better than often reported elsewhere. However, nutrition and infant feeding were given low priority, counsellors' training was inadequate, individual postnatal counselling as well as growth monitoring and promotion were rarely done and complementary feeding was inadequately covered. Acceptable, feasible, affordable, sustainable and safe (AFASS) assessments were not of satisfactory quality. Breast milk expression was mentioned only to a minority and the possibility of heat treatment during the transition to cessation was not mentioned. Counsellors were often biased in discussing risks of breastfeeding and replacement feeding. Implementing the new WHO guidance will reduce the need for AFASS assessments, greatly simplifying both the government's and counsellors' tasks. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Human papillomavirus genotypes in penile cancers from Japanese patients and HPV-induced NF-κB activation.

PubMed

Senba, Masachika; Mori, Naoki; Wada, Akihiro; Fujita, Shuichi; Yasunami, Michio; Irie, Sumiko; Hayashi, Tomayoshi; Igawa, Tsukasa; Kanetake, Hiroshi; Takahara, Osamu; Toriyama, Kan

2010-03-01

The causal relationship between chronic inflammation and cancer is widely accepted. Numerous investigations have identified nuclear factor-κB (NF-κB) as an important modulator in driving chronic inflammation to cancer. This study aimed to determine the prevalence of human papillomavirus (HPV) in penile cancer in Japanese patients and whether NF-κB is subsequently overexpressed in penile cancer. Thirty-four specimens of penile tissue (16 malignant and 18 benign cases) were examined to determine the association of HPV infection. An in situ hybridization (ISH) method was used to detect and localize HPV-DNA. A sensitive HPV polymerase chain reaction (PCR) procedure was used for the detection of HPV-DNA, and DNA sequencing was used to identify the HPV genotype. HPV-DNA was detected in 37.5 and 75% of cases of penile cancer, using ISH and PCR, respectively. Our efforts to detect HPV genotypes were unsuccessful as HPV-DNA could not be extracted from these materials. Using ISH, a prevalence of 68.2% of HPV infection was found in penile cancer in Kenyan patients in east Africa. In the present study, all 9 HPV-positive cases, (100%) were NF-κB-positive in the nucleus and/or cytoplasm. In contrast, of the 25 HPV-negative cases, 15 (60%) were NF-κB-positive in the nucleus and/or cytoplasm. Therefore, ISH is a method which is able to prove infection of a large quantity of HPV more effectively when compared with PCR. Thus, a large quantity of HPV infection leads to the activity of NF-κB. The most prevalent genotype was the HPV-22 found in 83.3% of the penile cancer cases. In addition, HPV-11 was found in 81.8% of the non-cancer cases. For cases with a high level of infection, the activity of NF-κB increased compared with those with a low level of HPV infection.

Malaria hotspots defined by clinical malaria, asymptomatic carriage, PCR and vector numbers in a low transmission area on the Kenyan Coast.

PubMed

Kangoye, David Tiga; Noor, Abdisalan; Midega, Janet; Mwongeli, Joyce; Mkabili, Dora; Mogeni, Polycarp; Kerubo, Christine; Akoo, Pauline; Mwangangi, Joseph; Drakeley, Chris; Marsh, Kevin; Bejon, Philip; Njuguna, Patricia

2016-04-14

Targeted malaria control interventions are expected to be cost-effective. Clinical, parasitological and serological markers of malaria transmission have been used to detect malaria transmission hotspots, but few studies have examined the relationship between the different potential markers in low transmission areas. The present study reports on the relationships between clinical, parasitological, serological and entomological markers of malaria transmission in an area of low transmission intensity in Coastal Kenya. Longitudinal data collected from 831 children aged 5-17 months, cross-sectional survey data from 800 older children and adults, and entomological survey data collected in Ganze on the Kenyan Coast were used in the present study. The spatial scan statistic test used to detect malaria transmission hotspots was based on incidence of clinical malaria episodes, prevalence of asymptomatic asexual parasites carriage detected by microscopy and polymerase chain reaction (PCR), seroprevalence of antibodies to two Plasmodium falciparum merozoite antigens (AMA1 and MSP1-19) and densities of Anopheles mosquitoes in CDC light-trap catches. There was considerable overlapping of hotspots by these different markers, but only weak to moderate correlation between parasitological and serological markers. PCR prevalence and seroprevalence of antibodies to AMA1 or MSP1-19 appeared to be more sensitive markers of hotspots at very low transmission intensity. These findings may support the choice of either serology or PCR as markers in the detection of malaria transmission hotspots for targeted interventions.

The relationship of weekend admission and mortality on the public medical wards at a Kenyan referral hospital.

PubMed

Stone, Geren S; Aruasa, Wilson; Tarus, Titus; Shikanga, Mainard; Biwott, Benson; Ngetich, Thomas; Andale, Thomas; Cheriro, Betsy

2015-11-01

Research has demonstrated disparities in the outcomes of patients admitted to hospital on weekends in high-income countries. No published research has evaluated if any similar discrepancy exists in low-resource settings. To determine if any difference in mortality exists between weekend and weekday admissions on the public medical wards at a Kenyan referral hospital, we performed a retrospective observational study of inpatients over a 3-month study period. During the study period, 261 (27.3%) of the 956 patients were admitted over the weekend. The mortality rates for patients admitted on weekends and weekdays did not differ with 156 (22.4%) of the 695 patients admitted on weekdays dying compared to 55 (21.1%) of the 261 patients admitted on weekends. After adjusting for age, insurance status, co-morbid illness, HIV status, employment, referral status and gender, still no association existed between weekend admission and mortality. Among adult patients on the medical wards, patients admitted on weekends had similar mortality rates to those admitted on weekdays. This similarity may reflect a stable level of care or a generalized shortage of resources and staffing that subsumes any impact of weekly variations. Future research examining optimal staffing and resource levels is needed in such settings. © The Author 2015. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Barnes, C.; Ensminger, J.; O'Keefe, P.

This book presents papers on the use of wood fuels in Kenya. Topics considered include domestic energy consumption, historical aspects, the Kenyan economy, ecology, supply and demand, forests, aspects of energy consumption in a pastoral ecosystem, estimation of present and future demand for wood fuels, and energy source development.

76 FR 47647 - Additional Designation of Person Whose Property and Interests in Property Are Blocked Pursuant to...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-05

... 10 Apr 1979; POB Garissa, Kenya; nationality Kenya; Kenyan ID No. 23446085 (Kenya); Passport A1180173 (Kenya) expires 20 Aug 2017; (INDIVIDUAL) [SOMALIA] Dated: July 29, 2011. Barbara C. Hammerle, Acting...

Sauti Za Wananchi "voice of the people": patient satisfaction on the medical wards at a Kenyan Referral Hospital.

PubMed

Stone, Geren Starr; Jerotich, Tecla Sum; Cheriro, Betsy Rono; Kiptoo, Robert Sitienei; Crowe, Susie Joanne; Koros, Elijah Kipkorir; Muthoni, Doreen Mutegi; Onalo, Paul Theodore

2014-01-01

Patient satisfaction is one indicator of healthcare quality. Few studies have examined the inpatient experiences in resource-scarce environments in sub-Saharan Africa. To examine patient satisfaction on the public medical wards at a Kenyan referral hospital, we performed a cross-sectional survey focused on patients' satisfaction with medical information and their relationship with staffing and hospital routine. Ratings of communication with providers, efforts to protect privacy, information about costs, food, and hospital environment were also elicited. Overall, the average patient satisfaction rating was 64.7, nearly midway between "average" and "good" Higher rated satisfaction was associated with higher self-rated general health scores and self-rated health gains during the hospitalization (p=0.023 and p=0.001). Women who shared a hospital bed found privacy to be "below average" to "poor" Most men (72.7%) felt information about costs was insufficient. Patients rated food and environmental quality favorably while also frequently suggesting these areas could be improved. Overall, patients expressed satisfaction with the care provided. These ratings may reflect modest patients' expectations as well as acceptable circumstances and performance. Women expressed concern about privacy while men expressed a desire for more information on costs. Inconsistencies were noted between patient ratings and free response answers.

Muscle co-activation and its influence on running performance and risk of injury in elite Kenyan runners.

PubMed

Tam, Nicholas; Santos-Concejero, Jordan; Coetzee, Devon R; Noakes, Timothy D; Tucker, Ross

2017-01-01

The relationship between muscle co-activation and energy cost of transport and risk of injury (initial loading rate and joint stiffness) has not been jointly studied. Fourteen elite Kenyan male runners were tested at two speeds (12 and 20 km · h -1 ), where oxygen consumption, kinematic, kinetic and electromyography were recorded. Electromyography of seven lower limb muscles was recorded. Pre-activation and ground contact of agonist:antagonist co-activation was determined. All muscles displayed higher activity during pre-activation except rectus femoris (RF). Conversely, no differences were found during ground contact except for higher biceps femoris (BF) at 20 km · h -1 . Knee stiffness was correlated to RF-BF co-activation during both pre-activation and ground contact at both running speeds. However, energy cost of transport was only positively correlated to the above-mentioned muscle pairs at 20 km · h -1 (r = 0620, P = 0.032; r = 0.682, P = 0.015, respectively). These findings emphasise the influence of neuromuscular control and performance and its support to musculoskeletal system to optimise function and modulate risk of injury. Further, neuromuscular activity during terminal swing is also important and necessary to execute and maintain performance.

Using Patient-Pathway Analysis to Inform a Differentiated Program Response to Tuberculosis: The Case of Kenya

PubMed Central

Masini, Enos; Hanson, Christy; Ogoro, Jeremiah; Brown, Jessie; Ngari, Faith; Mingkwan, Pia; Makayova, Julia; Osberg, Mike

2017-01-01

Abstract Background A recent tuberculosis prevalence survey in Kenya found that the country is home to nearly twice as many patients with tuberculosis as previously estimated. Kenya has prioritized identifying and treating the unnotified or missing cases of tuberculosis. This requires a better understanding of patient care seeking and system weaknesses. Methods A patient-pathway analysis (PPA) was completed to assess the alignment between patient care seeking and the availability of tuberculosis diagnostic and treatment services at the national level and for all 47 counties at the subnational level in Kenya. Results It was estimated that more than half of patients initiate care in the public sector. Nationally, just under half of patients encountered tuberculosis diagnostic and treatment capacity where they initiated care. Overall, there was distinct variation in diagnostic and treatment availability across counties and facility levels. Discussion The PPA results emphasized the need for a differentiated approach to tuberculosis care, by county, and the distinct need for better referral systems. The majority of Kenyans actively sought care; improving diagnostic and treatment capacity in the formal and informal private sector, as well as in the public sector, could help identify the majority of missing cases. PMID:29117349

Anatomy and prevalence of atlas vertebrae bridges in a Kenyan population: An osteological study.

PubMed

Karau, Paul Bundi; Ogengo, Julius A; Hassanali, Jameela; Odula, Paul

2010-09-01

Atlas bridges are bony outgrowths over the third segment of the vertebral artery. They may exist as incipient, incomplete, or complete bridges, converting the groove into a deep sulcus, incomplete, or complete foramen respectively. These bridges and their associated foramina display bilateral and sex differences in their prevalence and type. Occurrence of these bridges may predispose to vertebrobasilar insufficiency and Barre-Lieou syndrome. The coexistence of lateral and posterior bridges as well as side predilection is not clear in either sex. Their relative occurrence may also point to some evolutionary patterns. We studied the prevalence, side predilection, coexistence, and anatomical features of atlas bridges using 102 dry atlases (49 males and 53 females) obtained from the osteology department of the National Museums of Kenya. Complete posterior bridges occurred in 14.7% and 13.7% on the right and left sides, respectively. A lateral bridge was found in 3.9% of cases on the right side only. There was positive correlation in the coexistence of the bridges. A retrotransverse foramen was found in 13% of cases. This study has found that posterior and lateral atlas bridges occur in association especially on the right side. Complete bridges were more prevalent in females and were more often present on the right side. This pattern seems to mirror the sexual predilection of vertebral artery compression syndromes. Gender roles may have an influence on the occurrence of these bridges and therefore the syndromes as well.

Socialising Multilingualism: Determinants of Codeswitching in Kenyan Primary Classrooms.

ERIC Educational Resources Information Center

Merritt, Marilyn; And Others

1992-01-01

Using ethnographic observations of classroom interaction in three primary schools, determinants of teachers' language choice and codeswitching among English, Swahili, and mother-tongue were explored: official school policy, cognitive concerns, classroom management concerns, values and attitudes about societal multilingualism. (36 references)…

Child health and education in Kenyan schools programmes.

PubMed

Fleming, J

1991-03-01

Jane Fleming describes the health education in schools programme launched by the Aga Khan Health Services in Kisumu, Kenya. The project has brought major improvements in child health and mortality rates as well as better health awareness to the community as a whole.

'Haven of safety' and 'secure base': a qualitative inquiry into factors affecting child attachment security in Nairobi, Kenya.

PubMed

Polkovnikova-Wamoto, Anastasia; Mathai, Muthoni; Stoep, Ann Vander; Kumar, Manasi

2016-01-01

Secure attachment in childhood and adolescence protects children from engagement in high risk behaviors and development of mental health problems over the life span. Poverty has been shown to create impoverishment in certain aspects of caregiving and correspondingly to compromise development of secure attachment in children. Nineteen children 8 to 14 years old from two schools in a middle income area and an urban informal settlement area of Nairobi were interviewed using an adapted Child Attachment Interview (CAI) protocol. CAI was developed to provide a glimpse into the 'meta-theories' children have about themselves, parents, parenting and their attachment ties with parents and extended family members. Narratives obtained with the CAI were analyzed using thematic analysis. Both Bowlby's idea of 'secure base' as well as Bronfrenbrenner's 'ecological niche' are used as reference points to situate child attachment and parenting practices in the larger Kenyan context. We found that with slight linguistic alterations CAI can be used to assess attachment security of Kenyan children in this particular age range. We also found that the narration ability in both groups of children was generally good such that formal coding was possible, despite cultural differences. Our analysis suggested differences in narrative quality across the children from middle class and lower socio-economic class schools on specific themes such as: sensitivity of parenting (main aspects of sensitivity were associated with disciplinary methods and child's access to education), birth order , parental emotional availability , and severity of inter-parental conflicts and child's level of exposure. The paper puts in context a few cultural practices such as greater household responsibility accorded to the eldest child and stern to harsh disciplinary methods adopted by parents in the Kenyan setting.

Stable isotope analyses of tooth enamel carbonate of large herbivores from the Tugen Hills deposits: Palaeoenvironmental context of the earliest Kenyan hominids

NASA Astrophysics Data System (ADS)

Roche, Damien; Ségalen, Loïc; Senut, Brigitte; Pickford, Martin

2013-11-01

Understanding shifts in past climatic and environmental conditions are crucial for throwing light on human evolution. Available reconstructions of the palaeoecology of faunal and floral assemblages indicate that the earliest Kenyan hominids, including Orrorin tugenensis, are associated with forest landscapes. In this study, we present stable isotope data of tooth enamel carbonate of large herbivores associated with these hominids in order further to evaluate their environmental context. Fossil teeth were sampled in the Lukeino Formation (6.1-5.7 Ma, Late Miocene) and the Mabaget Formation (5.3-4.5 Ma, Early Pliocene) at the foot of the Tugen Hills (Great Rift Valley). Despite chemical changes in fossil enamel, preservation of the palaeoenvironmental signals is supported by the difference in δ18O between hippos and terrestrial fauna. Moreover, the giraffid specimen from the Mabaget Formation exhibits one of the highest δ18O values, as expected for a drought-tolerant animal. The δ13C of large herbivores indicates that the earliest Kenyan hominids inhabited a mixed C3-C4 environment as did Ardipithecus (Ethiopia) and Sahelanthropus (Chad), two early putative hominids. The Tugen Hills might have been a wooded grassland with patches of woodland. There is no record of closed-canopy forest at the time of deposition. We emphasize differences in food habits among herbivore groups. Deinotheres, nearly all elephantids and the giraffid individual had a C3 diet which reflected browsing behaviour. The intake of C4 plants prevailed for equids and gomphotheres and was consistent with grazing habits. Most hippos and suids were mixed C3-C4 feeders and consequently were generalist herbivores. Bovids and rhinos had a diet ranging from C3 to C4 plants. Variations in δ13C and δ18O among faunal assemblages suggest changes in local climate and vegetation. Moister conditions likely occurred in the Early Pliocene and the latest Miocene (ca. 5.7 Ma) than before. The C3 plant biomass would have increased in the latest Miocene. There were probably denser stands of trees within the depositional environment during the Early Pliocene than in the Late Miocene, which is consistent with palaeontological studies.

Injured bodies, damaged lives: experiences and narratives of Kenyan women with obstetric fistula and Female Genital Mutilation/Cutting.

PubMed

Mwanri, Lillian; Gatwiri, Glory Joy

2017-03-14

It is well acknowledged that Female Genital Mutilation/Cutting (FGM/C/C) leads to medical, psychological and sociocultural sequels. Over 200 million cases of FGM/C exist globally, and in Kenya alone, a total of 12,418,000 (28%) of women have undergone FGM/C, making the practice not only a significant national, but also a global health catastrophe. FGM/C is rooted in patriarchal and traditional cultures as a communal experience signifying a transition from girlhood to womanhood. The conversations surrounding FGM/C have been complicated by the involvement of women themselves in perpetuating the practice. A qualitative inquiry employing face-to-face, one-on-one, in-depth semi-structured interviews was used in a study that included 30 women living with obstetric fistulas in Kenya. Using the Social Network Framework and a feminist analysis we present stories of Kenyan women who had developed obstetric fistulas following prolonged and obstructed childbirth. Of the 30 participants, three women reported that health care workers informed them that FGM/C was one of the contributing factors to their prolonged and obstructed childbirth. They reported serious obstetric complications including: the development of obstetric fistulas, lowered libido, poor quality of life and maternal and child health outcomes, including death. Fistula and subsequent loss of bodily functionalities such as uncontrollable leakage of body wastes, was reported by the women to result in rejection by spouses, families, friends and communities. Rejection further led to depression, loss of work, increased sense of apathy, lowered self-esteem and image, as well as loss of identity and communal sociocultural cohesion. FGM/C is practised in traditional, patriarchal communities across Africa. Although the practice aims to bind community members and to celebrate a rite of passage; it may lead to harmful health and social consequences. Some women with fistula report their fistula was caused by FGM/C. Concerted efforts which embrace feminist understandings of society, as well as multi-sectoral, multidisciplinary and community development approaches need to be employed to address FGM/C, and to possibly reduce cases of obstetric fistulas in Kenya and beyond. Both government and non-government organisations need to be involved in making legislative, gender sensitive policies that protect women from FGM/C. In addition, the policy makers need to be in the front line to improve the lives of women who endured the consequences of FGM/C.

Designing for Scale: Reflections on Rolling Out Reading Improvement in Kenya and Liberia.

PubMed

Gove, Amber; Korda Poole, Medina; Piper, Benjamin

2017-03-01

Since 2008, the Ministries of Education in Liberia and Kenya have undertaken transitions from small-scale pilot programs to improve reading outcomes among primary learners to the large-scale implementation of reading interventions. The effects of the pilots on learning outcomes were significant, but questions remained regarding whether such large gains could be sustained at scale. In this article, the authors dissect the Liberian and Kenyan experiences with implementing large-scale reading programs, documenting the critical components and conditions of the program designs that affected the likelihood of successfully transitioning from pilot to scale. They also review the design, deployment, and effectiveness of each pilot program and the scale, design, duration, enabling conditions, and initial effectiveness results of the scaled programs in each country. The implications of these results for the design of both pilot and large-scale reading programs are discussed in light of the experiences of both the Liberian and Kenyan programs. © 2017 Wiley Periodicals, Inc.

An Elective Pharmaceutical Care Course to Prepare Students for an Advanced Pharmacy Practice Experience in Kenya

PubMed Central

Miller, Monica L.; Ogallo, William; Pastakia, Sonak D.

2013-01-01

Objective. To develop a prerequisite elective course to prepare students for an advanced pharmacy practice experience (APPE) in Kenya. Design. The course addressed Kenyan culture, travel preparation, patient care, and disease-state management. Instructional formats used were small-group discussions and lectures, including some Web-based presentations by Kenyan pharmacists on disease states commonly treated in Kenya. Cultural activities include instruction in conversational and medical Kiswahili and reading of a novel related to global health programs. Assessment. Student performance was assessed using written care plans, quizzes, reflection papers, a formulary management exercise, and pre- and post-course assessments. Student feedback on course evaluations indicated that the course was well received and students felt prepared for the APPE. Conclusion. This course offered a unique opportunity for students to learn about pharmacy practice in global health and to apply previously acquired skills in a resource-constrained international setting. It prepares students to actively participate in clinical care activities during an international APPE. PMID:23610478

Antibodies among men and children to placental-binding Plasmodium falciparum-infected erythrocytes that express var2csa.

PubMed

Beeson, James G; Ndungu, Francis; Persson, Kristina E M; Chesson, Joanne M; Kelly, Greg L; Uyoga, Sophie; Hallamore, Sandra L; Williams, Thomas N; Reeder, John C; Brown, Graham V; Marsh, Kevin

2007-07-01

During pregnancy, specific variants of Plasmodium falciparum-infected erythrocytes (IEs) can accumulate in the placenta through adhesion to chondroitin sulfate A (CSA) mediated by expression of PfEMP1 encoded by var2csa-type genes. Antibodies against these variants are associated with protection from maternal malaria. We evaluated antibodies among Kenyan, Papua New Guinean, and Malawian men and Kenyan children against two different CSA-binding P. falciparum isolates expressing var2csa variants. Specific IgG was present at significant levels among some men and children from each population, suggesting exposure to these variants is not exclusive to pregnancy. However, the level and prevalence of antibodies was substantially lower overall than exposed multigravidas. IgG-binding was specific and did not represent antibodies to subpopulations of non-CSA-binding IEs, and some sera inhibited IE adhesion to CSA. These findings have significant implications for understanding malaria pathogenesis and immunity and may be significant for understanding the acquisition of immunity to maternal malaria.

Developing a Nursing Database System in Kenya

PubMed Central

Riley, Patricia L; Vindigni, Stephen M; Arudo, John; Waudo, Agnes N; Kamenju, Andrew; Ngoya, Japheth; Oywer, Elizabeth O; Rakuom, Chris P; Salmon, Marla E; Kelley, Maureen; Rogers, Martha; St Louis, Michael E; Marum, Lawrence H

2007-01-01

Objective To describe the development, initial findings, and implications of a national nursing workforce database system in Kenya. Principal Findings Creating a national electronic nursing workforce database provides more reliable information on nurse demographics, migration patterns, and workforce capacity. Data analyses are most useful for human resources for health (HRH) planning when workforce capacity data can be linked to worksite staffing requirements. As a result of establishing this database, the Kenya Ministry of Health has improved capability to assess its nursing workforce and document important workforce trends, such as out-migration. Current data identify the United States as the leading recipient country of Kenyan nurses. The overwhelming majority of Kenyan nurses who elect to out-migrate are among Kenya's most qualified. Conclusions The Kenya nursing database is a first step toward facilitating evidence-based decision making in HRH. This database is unique to developing countries in sub-Saharan Africa. Establishing an electronic workforce database requires long-term investment and sustained support by national and global stakeholders. PMID:17489921

Installing and implementing a computer-based patient record system in sub-Saharan Africa: the Mosoriot Medical Record System.

PubMed

Rotich, Joseph K; Hannan, Terry J; Smith, Faye E; Bii, John; Odero, Wilson W; Vu, Nguyen; Mamlin, Burke W; Mamlin, Joseph J; Einterz, Robert M; Tierney, William M

2003-01-01

The authors implemented an electronic medical record system in a rural Kenyan health center. Visit data are recorded on a paper encounter form, eliminating duplicate documentation in multiple clinic logbooks. Data are entered into an MS-Access database supported by redundant power systems. The system was initiated in February 2001, and 10,000 visit records were entered for 6,190 patients in six months. The authors present a summary of the clinics visited, diagnoses made, drugs prescribed, and tests performed. After system implementation, patient visits were 22% shorter. They spent 58% less time with providers (p < 0.001) and 38% less time waiting (p = 0.06). Clinic personnel spent 50% less time interacting with patients, two thirds less time interacting with each other, and more time in personal activities. This simple electronic medical record system has bridged the "digital divide." Financial and technical sustainability by Kenyans will be key to its future use and development.

Antibiotic Residues in Milk from Three Popular Kenyan Milk Vending Machines.

PubMed

Kosgey, Amos; Shitandi, Anakalo; Marion, Jason W

2018-05-01

Milk vending machines (MVMs) are growing in popularity in Kenya and worldwide. Milk vending machines dispense varying quantities of locally sourced, pasteurized milk. The Kenya Dairy Board has a regulatory framework, but surveillance is weak because of several factors. Milk vending machines' milk is not routinely screened for antibiotics, thereby increasing potential for antibiotic misuse. To investigate, a total of 80 milk samples from four commercial providers ( N = 25), street vendors ( N = 21), and three MVMs ( N = 34) were collected and screened in Eldoret, Kenya. Antibiotic residue surveillance occurred during December 2016 and January 2017 using Idexx SNAP ® tests for tetracyclines, sulfamethazine, beta-lactams, and gentamicin. Overall, 24% of MVM samples and 24% of street vendor samples were presumably positive for at least one antibiotic. No commercial samples were positive. Research into cost-effective screening methods and increased monitoring by food safety agencies are needed to uphold hazard analysis and critical control point for improving antibiotic stewardship throughout the Kenyan private dairy industry.

Kenyan university students' views on AIDS.

PubMed

Sindiga, I; Lukhando, M

1993-11-01

In view of the rapidly increasing number of AIDS cases reported in Kenya since 1984, a survey was conducted among Kenyatta University undergraduate students during October and November 1988 to gauge their knowledge, attitudes and practices with regard to the disease. A random sample of 344 individuals both men and women was interviewed. The results showed that almost everyone had heard about AIDS and the knowledge was spread evenly across gender. Although the students were able to identify the symptoms of a full blown AIDS victim, their knowledge on HIV was vague. Other findings were: that condoms were lowly rated as a strategy for minimizing the risk of contracting AIDS and the majority of the students attempted to reduce the chance of contracting the disease by having one sex partner. However, the students were apathetic about contracting the disease. In the event of becoming victims of AIDS, most of them indicated that they would not merely wait to die; instead they would commit suicide. In view of these findings, there is a case for educating this group on how to respond to the AIDS infection.

Post Rape Care Provision to Minors in Kenya: An Assessment of Health Providers' Knowledge, Attitudes, and Practices.

PubMed

Wangamati, Cynthia Khamala; Gele, Abdi Ali; Sundby, Johanne

2017-03-01

Child sexual abuse (CSA) is a major global health challenge. Extant literature in Kenya indicates an alarming rate of sexually abused minors presenting to poorly equipped health facilities with untrained health providers for post rape care. National guidelines on management of sexual violence have been in existence since 2004; however, little is known on the impact of these guidelines on post rape care provision to minors. Therefore, the study aims to assess the knowledge, attitudes, and practices of health providers with regard to post rape care provision in a Kenyan District health facility. The study used a triangulation of different qualitative methods: review of 42 health records of minors seeking post rape care, 15 in-depth interviews, and informal conversations with health providers. Findings indicate that the Kenyan national guidelines on management of sexual violence were nonexistent in the health facility. Consequently, health providers possessed limited knowledge on post rape care administration. The limited knowledge translated to poor collection and preservation of evidence, inadequate psychosocial support, and clinical care. In addition, rape myth attitudes and religious beliefs contributed to survivor blaming and provider hesitance in provision of legal abortion care, respectively. To facilitate provision of quality post rape care, policy makers and health institutions' managers need to avail protocols in line with evidence-based best practices to guide health providers in post rape care administration. In addition, there is need for rigorous training and supervision of health professionals to ensure better service provision.

Decomposing Kenyan socio-economic inequalities in skilled birth attendance and measles immunization

PubMed Central

2013-01-01

Introduction Skilled birth attendance (SBA) and measles immunization reflect two aspects of a health system. In Kenya, their national coverage gaps are substantial but could be largely improved if the total population had the same coverage as the wealthiest quintile. A decomposition analysis allows identifying the factors that influence these wealth-related inequalities in order to develop appropriate policy responses. The main objective of the study was to decompose wealth-related inequalities in SBA and measles immunization into their contributing factors. Methods Data from the Kenyan Demographic and Health Survey 2008/09 were used. The study investigated the effects of socio-economic determinants on [1] coverage and [2] wealth-related inequalities of SBA utilization and measles immunization. Techniques used were multivariate logistic regression and decomposition of the concentration index (C). Results SBA utilization and measles immunization coverage differed according to household wealth, parent’s education, skilled antenatal care visits, birth order and father’s occupation. SBA utilization further differed across provinces and ethnic groups. The overall C for SBA was 0.14 and was mostly explained by wealth (40%), parent’s education (28%), antenatal care (9%), and province (6%). The overall C for measles immunization was 0.08 and was mostly explained by wealth (60%), birth order (33%), and parent’s education (28%). Rural residence (−19%) reduced this inequality. Conclusion Both health care indicators require a broad strengthening of health systems with a special focus on disadvantaged sub-groups. PMID:23294938

A comparison of three infant skinfold reference standards: Tanner-Whitehouse, Cambridge Infant Growth Study, and WHO Child Growth Standards.

PubMed

Miller, Elizabeth M

2015-10-01

As researchers increasingly focus on early infancy as a critical period of development, there is a greater need for methodological tools that can address all aspects of infant growth. Infant skinfold measures, in particular, are measurements in need of reliable reference standards that encompass all ages of infants and provide an accurate assessment of the relative fatness of a population. This report evaluates three published reference standards for infant skinfold measurements: Tanner-Whitehouse, Cambridge Infant Growth Study, and the World Health Organization (WHO) Child Growth Standards. To assess these standards, triceps skinfolds from a population of rural Kenyan infants (n = 250) and triceps skinfolds and subscapular skinfolds from infants in the National Health and Nutrition Examination Survey 1999-2002 (NHANES; n = 1197) were calculated as z-scores from the lambda-mu-sigma curves provided by each reference population. The Tanner-Whitehouse standards represented both the Kenyan and US populations as lean, while the Cambridge standards represented both populations as overfat. The distribution of z-scores based on the WHO standards fell in the middle, but excluded infants from both populations who were below the age of 3 months. Based on these results, the WHO reference standard is the best skinfold reference standard for infants over the age of 3 months. For populations with infants of all ages, the Tanner-Whitehouse standards are recommended, despite representing both study populations as underfat. Ideally, the WHO will extend their reference standard to include infants between the ages of 0 and 3 months. © 2014 John Wiley & Sons Ltd.

Serotype and genetic diversity of human rhinovirus strains that circulated in Kenya in 2008.

PubMed

Milanoi, Sylvia; Ongus, Juliette R; Gachara, George; Coldren, Rodney; Bulimo, Wallace

2016-05-01

Human rhinoviruses (HRVs) are a well-established cause of the common cold and recent studies indicated that they may be associated with severe acute respiratory illnesses (SARIs) like pneumonia, asthma, and bronchiolitis. Despite global studies on the genetic diversity of the virus, the serotype diversity of these viruses across diverse geographic regions in Kenya has not been characterized. This study sought to characterize the serotype diversity of HRV strains that circulated in Kenya in 2008. A total of 517 archived nasopharyngeal samples collected in a previous respiratory virus surveillance program across Kenya in 2008 were selected. Participants enrolled were outpatients who presented with influenza-like (ILI) symptoms. Real-time RT-PCR was employed for preliminary HRV detection. HRV-positive samples were amplified using RT-PCR and thereafter the nucleotide sequences of the amplicons were determined followed by phylogenetic analysis. Twenty-five percent of the samples tested positive for HRV. Phylogenetic analysis revealed that the Kenyan HRVs clustered into three main species comprising HRV-A (54%), HRV-B (12%), and HRV-C (35%). Overall, 20 different serotypes were identified. Intrastrain sequence homology among the Kenyan strains ranged from 58% to 100% at the nucleotide level and 55% to 100% at the amino acid level. These results show that a wide range of HRV serotypes with different levels of nucleotide variation were present in Kenya. Furthermore, our data show that HRVs contributed substantially to influenza-like illness in Kenya in 2008. © 2016 The Authors. Influenza and Other Respiratory Viruses Published by John Wiley & Sons Ltd.

Examining the safety of menstrual cups among rural primary school girls in western Kenya: observational studies nested in a randomised controlled feasibility study

PubMed Central

Juma, Jane; Nyothach, Elizabeth; Laserson, Kayla F; Oduor, Clifford; Arita, Lilian; Ouma, Caroline; Oruko, Kelvin; Omoto, Jackton; Mason, Linda; Alexander, Kelly T; Fields, Barry; Onyango, Clayton; Phillips-Howard, Penelope A

2017-01-01

Objective Examine the safety of menstrual cups against sanitary pads and usual practice in Kenyan schoolgirls. Design Observational studies nested in a cluster randomised controlled feasibility study. Setting 30 primary schools in a health and demographic surveillance system in rural western Kenya. Participants Menstruating primary schoolgirls aged 14–16 years participating in a menstrual feasibility study. Interventions Insertable menstrual cup, monthly sanitary pads or ‘usual practice’ (controls). Outcome measures Staphylococcus aureus vaginal colonization, Escherichia coli growth on sampled used cups, toxic shock syndrome or other adverse health outcomes. Results Among 604 eligible girls tested, no adverse event or TSS was detected over a median 10.9 months follow-up. S. aureusprevalence was 10.8%, with no significant difference over intervention time or between groups. Of 65 S.aureus positives at first test, 49 girls were retested and 10 (20.4%) remained positive. Of these, two (20%) sample isolates tested positive for toxic shock syndrome toxin-1; both girls were provided pads and were clinically healthy. Seven per cent of cups required replacements for loss, damage, dropping in a latrine or a poor fit. Of 30 used cups processed for E. coli growth, 13 (37.1%, 95% CI 21.1% to 53.1%) had growth. E. coli growth was greatest in newer compared with established users (53%vs22.2%, p=0.12). Conclusions Among this feasibility sample, no evidence emerged to indicate menstrual cups are hazardous or cause health harms among rural Kenyan schoolgirls, but large-scale trials and post-marketing surveillance should continue to evaluate cup safety. PMID:28473520

Examining the safety of menstrual cups among rural primary school girls in western Kenya: observational studies nested in a randomised controlled feasibility study.

PubMed

Juma, Jane; Nyothach, Elizabeth; Laserson, Kayla F; Oduor, Clifford; Arita, Lilian; Ouma, Caroline; Oruko, Kelvin; Omoto, Jackton; Mason, Linda; Alexander, Kelly T; Fields, Barry; Onyango, Clayton; Phillips-Howard, Penelope A

2017-05-04

Examine the safety of menstrual cups against sanitary pads and usual practice in Kenyan schoolgirls. Observational studies nested in a cluster randomised controlled feasibility study. 30 primary schools in a health and demographic surveillance system in rural western Kenya. Menstruating primary schoolgirls aged 14-16 years participating in a menstrual feasibility study. Insertable menstrual cup, monthly sanitary pads or 'usual practice' (controls). Staphylococcus aureus vaginal colonization, Escherichia coli growth on sampled used cups, toxic shock syndrome or other adverse health outcomes. Among 604 eligible girls tested, no adverse event or TSS was detected over a median 10.9 months follow-up. S. aureus prevalence was 10.8%, with no significant difference over intervention time or between groups. Of 65  S.aureus positives at first test, 49 girls were retested and 10 (20.4%) remained positive. Of these, two (20%) sample isolates tested positive for toxic shock syndrome toxin-1; both girls were provided pads and were clinically healthy. Seven per cent of cups required replacements for loss, damage, dropping in a latrine or a poor fit. Of 30 used cups processed for E. coli growth, 13 (37.1%, 95% CI 21.1% to 53.1%) had growth. E. coli growth was greatest in newer compared with established users (53%vs22.2%, p=0.12). Among this feasibility sample, no evidence emerged to indicate menstrual cups are hazardous or cause health harms among rural Kenyan schoolgirls, but large-scale trials and post-marketing surveillance should continue to evaluate cup safety. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

‘SHE'S MY SISTER-IN-LAW, MY VISITOR, MY FRIEND’ – CHALLENGES OF STAFF IDENTITY IN HOME FOLLOW-UP IN AN HIV TRIAL IN WESTERN KENYA

PubMed Central

Madiega, Philister Adhiambo; Jones, Gemma; Prince, Ruth Jane; Geissler, Paul Wenzel

2013-01-01

Identities ascribed to research staff in face-to-face encounters with participants have been raised as key ethical challenge in transnational health research. ‘Misattributed’ identities that do not just deviate from researchers' self-image, but obscure unequivocal aspects of researcher identity – e.g. that they are researchers – are a case of such ethical problem. Yet, the reasonable expectation of unconcealed identity can conflict with another ethical premise: confidentiality; this poses challenges to staff visiting participants at home. We explore these around a case study of ‘follow-up’ staff, observed during an ethnographic study of a Kenyan HIV ‘trial community’, which included participant observation, conversations, and interviews with staff (n = 79) and participants (n = 89). We found that because of the need to maintain confidentiality and because of some suspicions towards researchers, research staff drew upon alternative identities – presenting themselves to non-participants as relatives or friends, rather than as researchers. Several staff experienced this as necessary but uncomfortable. Simultaneously, staff and participants forged close relations in line with their fictional identities, which however also posed challenges because they entailed personal responsibilities that were difficult to live up to, due to limited resources, and the trial's limited duration. Similar challenges may arise in transnational HIV treatment programmes and should be explored further in that context. PMID:23521821

Recentralization within decentralization: County hospital autonomy under devolution in Kenya

PubMed Central

Manyara, Anthony M.; Molyneux, Sassy; Tsofa, Benjamin

2017-01-01

Background In 2013, Kenya transitioned into a devolved system of government with a central government and 47 semi-autonomous county governments. In this paper, we report early experiences of devolution in the Kenyan health sector, with a focus on public county hospitals. Specifically, we examine changes in hospital autonomy as a result of devolution, and how these have affected hospital functioning. Methods We used a qualitative case study approach to examine the level of autonomy that hospitals had over key management functions and how this had affected hospital functioning in three county hospitals in coastal Kenya. We collected data by in-depth interviews of county health managers and hospital managers in the case study hospitals (n = 21). We adopted the framework proposed by Chawla et al (1995) to examine the autonomy that hospitals had over five management domains (strategic management, finance, procurement, human resource, and administration), and how these influenced hospital functioning. Findings Devolution had resulted in a substantial reduction in the autonomy of county hospitals over the five key functions examined. This resulted in weakened hospital management and leadership, reduced community participation in hospital affairs, compromised quality of services, reduced motivation among hospital staff, non-alignment of county and hospital priorities, staff insubordination, and compromised quality of care. Conclusion Increasing the autonomy of county hospitals in Kenya will improve their functioning. County governments should develop legislation that give hospitals greater control over resources and key management functions. PMID:28771558

Lessons in Spiritual Leadership from Kenyan Women

ERIC Educational Resources Information Center

Ngunjiri, Faith Wambura

2010-01-01

Purpose: The purpose of this paper is to explicate spiritual leadership lessons of beneficence, courage, hope and ubuntu/humanness that are derived from the experiences of women leaders in Kenya. The paper seeks to connect African data with existing literature on spiritual leadership, to demonstrate where African spiritual leadership is similar…

School Guidance and Counseling in Kenya: Historical Development, Current Status, and Future Prospects

ERIC Educational Resources Information Center

Wambu, Grace W.; Fisher, Teresa A.

2015-01-01

Despite the government's emphasis on guidance and counseling program implementation in Kenyan schools and a rapid increase in the number of trained school counselors, lack of standardized training curriculums, ethical standards, counseling models, and role ambiguity persist. This article reviews the historical development of guidance and…

Into Africa: Telemedicine Links Canada with Nairobi and Kampala.

ERIC Educational Resources Information Center

House, M.; MacLeod, S.

During the past decade teleconferencing systems have gained a substantial role in continuing medical education in Canada through maintenance of contact between physicians in remote and urban areas, medical education, group consultation, and administration. A group of Canadian physicians at Memorial University of Newfoundland and their Kenyan and…

Shared Understandings: Environmental Perspectives of Kenyan Community Members and Teachers

ERIC Educational Resources Information Center

Quigely, Cassie F.; Dogbey, James; Che, S. Megan; Hallo, Jeffrey

2015-01-01

Environmental issues are a shared human concern as communities in all nations and geographic regions are grappling with environmental degradation. Despite this concern, there are multiple different viewpoints on the current state of environmental issues and how to understand these problems. Understanding how different communities conceive of the…

USSR Report, International Affairs

DTIC Science & Technology

1986-09-09

and planted in the black Djibouti soil the cutting of a jojoba —a tree capable of enduring all the adversities of the desert and symbolizing in local... jojoba , Africa will be able to breathe a sigh of relief," the Kenyan DAILY NATION wrote. "We would all like this most protracted and explosive

Coping with Quality Assurance Challenges Faced by Secondary Schools' Headteachers in Gucha District, Kenya

ERIC Educational Resources Information Center

Mobegi, Florence Osiri; Ondigi, Benjamin A.

2011-01-01

Since independence, the Kenyan government has demonstrated its commitment to the provision of quality secondary school education through allocation of financial resources, provision of trained teachers and establishment of quality assurance department. However, despite the substantial allocation of resources, secondary schools still face major…

Globalization of Chikungunya Virus: Threat to the U.S.

USDA-ARS?s Scientific Manuscript database

In August, 2004, Kenyan health authorities and partners identified chikungunya virus as the cause of the febrile epidemic in a coastal island city. The virus is transmitted by Aedes mosquitoes in tropical Africa and Asia; the fever is rarely fatal but can incapacitate for weeks. Control was delayed,...

Tracking Environmental Sustainability Performance of Public Universities in Kenya

ERIC Educational Resources Information Center

Mungai, David N.

2017-01-01

Environmental Sustainability Performance Contract (PC) targets were introduced in the 2012/13 financial year as part of the broader public sector reforms and a strategy for performance improvement in the public service that includes Kenyan public universities. However, no evaluation has been conducted to assess performance improvement and impact.…

How Secondary School Principals Build Trust in Kenyan Secondary Schools

ERIC Educational Resources Information Center

Abaya, Joel Ondieki

2011-01-01

The most successful school leaders are those who have been able to transform their schools into centers of deep and ongoing learning by managing relationships (Kaser & Halbert, 2009). Consequently, strong levels of trust are preconditions for successful school improvement initiative. Research confirms that no cooperation strategy works in high…

Teaching Africa's Cities through Meja Mwangi's Novels

ERIC Educational Resources Information Center

Smiley, Sarah L.

2009-01-01

This article presents a lesson plan used to teach about African urbanization using Kenyan novels. Specifically, three urban novels written by Meja Mwangi are used. Based on a qualitative survey of student preference and learning, this lesson plan uses these novels alongside more traditional academic texts to achieve effective student learning.…

Examining the Cultural Adjustment Experiences of African International College Students: A Qualitative Analysis

ERIC Educational Resources Information Center

Constantine, Madonna G.; Anderson, Gregory M.; Berkel, LaVerne A.; Caldwell, Leon D.; Utsey, Shawn O.

2005-01-01

The authors examined the cultural adjustment experiences of 12 Kenyan, Nigerian, and Ghanaian international college students through semistructured interviews. Using consensual qualitative research methodology (C. E. Hill, B. J. Thompson, & E. N. Williams, 1997), 7 primary domains or themes related to these students' cultural adjustment…

Do Kenyan Set Book Novel Kidagaa Kimemwozea Advance Environmental Education?

ERIC Educational Resources Information Center

Magothe, Stephen Njangiru

2016-01-01

Environmental protection is a sensitive issue in the world today. Erratic weather changes have been witnessed in many parts world including Kenya. Indeed, scholars and critics have argued that human beings are a major contributing factor to destruction of nature through industrialization, farming activities, transport, deforestation, wildlife…

The Dilemmas of Explaining Africa

ERIC Educational Resources Information Center

Ochonu, Moses

2008-01-01

African professors are often asked by Americans at academic gatherings, campus events, and informal social gatherings what they think of the never-ending civil war in the Democratic Republic of the Congo, the genocide in Sudan, anarchy in Somalia, last year's disastrous elections in Nigeria, the Kenyan political crisis, and other problems. Whether…

You cannot prevent a disease; you only treat diseases when they occur: knowledge, attitudes and practices to water-health in a rural Kenyan community.

PubMed

Levison, M M; Elliott, S J; Karanja, D M S; Schuster-Wallace, C J; Harrington, D W

2011-06-01

Almost 1 billion individuals lack access to improved water supplies, with 2.6 billion lacking adequate sanitation. This leads to the propagation of multiple waterborne diseases. The objective of this study was to explore local knowledge, attitudes and practices to understand the mechanisms and pre-conditions for sustainable uptake and use of these facilities. Data collection took place in a rural Kenyan community in September 2009. A qualitative approach was taken, with 4 focus groups and 25 in-depth interviews conducted. Participant characteristics varied by age, gender, education, marital status, employment and community standing. Few participants reported current access to improved water and sanitation facilities. Though they expressed desire for latrines and water sources, barriers including lack of funds and social capital, decrease the ability for installation. Participants understood that there was a link between the quality of water and their health, however, perceived benefits of current contaminated sources outweigh the potential health impacts and proliferate their continued use. While water-health links are understood to varying degrees within the community, contextual (physical environment), compositional (individual) and collective (community) factors interact to influence health. Community challenges, such as lack of unity, lack of education and lack control were identified as the main barriers to initiating change, despite a desire for increased access to safe water and sanitation.

Africanizing Science in Post-colonial Kenya: Long-Term Field Research in the Amboseli Ecosystem, 1963-1989.

PubMed

Lewis, Amanda E

2017-11-08

Following Kenya's independence in 1963, scientists converged on an ecologically sensitive area in southern Kenya on the northern slope of Mt. Kilimanjaro called Amboseli. This region is the homeland of the Ilkisongo Maasai who grazed this ecosystem along with the wildlife of interest to the scientists. Biologists saw opportunities to study this complex community, an environment rich in biological diversity. The Amboseli landscape proved to be fertile ground for testing new methods and lines of inquiry in the biological sciences that were generalizable and important for shaping natural resource management policies in Kenya. However, the local community was in the midst of its own transformation from a primarily transhumant lifestyle to a largely sedentary one, a complex political situation between local and national authorities, and the introduction of a newly educated generation. This article examines the intersection of African history and field science through the post-colonial Africanization of Kenyan politics, the broadening of scientific practices in Amboseli in previously Western-occupied spaces to include Kenyan participants, and an increasing awareness of the role of local African contexts in the results, methods, and implications of biological research. "Africanization" as an idea in the history of science is multifaceted encompassing not just Africans in the scientific process, but it needs an examination of the larger political and social context on both a local and national level.

Developing clinical strength-of-evidence approach to define HIV-associated malignancies for cancer registration in Kenya.

PubMed

Korir, Anne; Mauti, Nathan; Moats, Pamela; Gurka, Matthew J; Mutuma, Geoffrey; Metheny, Christine; Mwamba, Peter M; Oyiro, Peter O; Fisher, Melanie; Ayers, Leona W; Rochford, Rosemary; Mwanda, Walter O; Remick, Scot C

2014-01-01

Sub-Saharan Africa cancer registries are beset by an increasing cancer burden further exacerbated by the AIDS epidemic where there are limited capabilities for cancer-AIDS match co-registration. We undertook a pilot study based on a "strength-of-evidence" approach using clinical data that is abstracted at the time of cancer registration for purposes of linking cancer diagnosis to AIDS diagnosis. The standard Nairobi Cancer Registry form was modified for registrars to abstract the following clinical data from medical records regarding HIV infection/AIDS in a hierarchal approach at time of cancer registration from highest-to-lowest strength-of-evidence: 1) documentation of positive HIV serology; 2) antiretroviral drug prescription; 3) CD4+ lymphocyte count; and 4) WHO HIV clinical stage or immune suppression syndrome (ISS), which is Kenyan terminology for AIDS. Between August 1 and October 31, 2011 a total of 1,200 cancer cases were registered. Of these, 171 cases (14.3%) met clinical strength-of-evidence criteria for association with HIV infection/AIDS; 69% (118 cases were tumor types with known HIV association - Kaposi's sarcoma, cervical cancer, non-Hodgkin's and Hodgkin's lymphoma, and conjunctiva carcinoma) and 31% (53) were consistent with non-AIDS defining cancers. Verifiable positive HIV serology was identified in 47 (27%) cases for an absolute seroprevalence rate of 4% among the cancer registered cases with an upper boundary of 14% among those meeting at least one of strength-of-evidence criteria. This pilot demonstration of a hierarchal, clinical strength-of-evidence approach for cancer-AIDS registration in Kenya establishes feasibility, is readily adaptable, pragmatic, and does not require additional resources for critically under staffed cancer registries. Cancer is an emerging public health challenge, and African nations need to develop well designed population-based studies in order to better define the impact and spectrum of malignant disease in the backdrop of HIV infection.

Provision of bednets and water filters to delay HIV-1 progression: cost-effectiveness analysis of a Kenyan multisite study.

PubMed

Kern, Eli; Verguet, Stéphane; Yuhas, Krista; Odhiambo, Frederick H; Kahn, James G; Walson, Judd

2013-08-01

To estimate the effectiveness, costs and cost-effectiveness of providing long-lasting insecticide-treated nets (LLINs) and point-of-use water filters to antiretroviral therapy (ART)-naïve HIV-infected adults and their family members, in the context of a multisite study in Kenya of 589 HIV-positive adults followed on average for 1.7 years. The effectiveness, costs and cost-effectiveness of the intervention were estimated using an epidemiologic-cost model. Model epidemiologic inputs were derived from the Kenya multisite study data, local epidemiological data and from the published literature. Model cost inputs were derived from published literature specific to Kenya. Uncertainty in the model estimates was assessed through univariate and multivariate sensitivity analyses. We estimated net cost savings of about US$ 26 000 for the intervention, over 1.7 years. Even when ignoring net cost savings, the intervention was found to be very cost-effective at a cost of US$ 3100 per death averted or US$ 99 per disability-adjusted life year (DALY) averted. The findings were robust to the sensitivity analysis and remained most sensitive to both the duration of ART use and the cost of ART per person-year. The provision of LLINs and water filters to ART-naïve HIV-infected adults in the Kenyan study resulted in substantial net cost savings, due to the delay in the initiation of ART. The addition of an LLIN and a point-of-use water filter to the existing package of care provided to ART-naïve HIV-infected adults could bring substantial cost savings to resource-constrained health systems in low- and middle-income countries. © 2013 Blackwell Publishing Ltd.

The Effect of Human Immunodeficiency Virus Prevention and Reproductive Health Text Messages on Human Immunodeficiency Virus Testing Among Young Women in Rural Kenya: A Pilot Study.

PubMed

Njuguna, Njambi; Ngure, Kenneth; Mugo, Nelly; Sambu, Carrole; Sianyo, Christopher; Gakuo, Stephen; Irungu, Elizabeth; Baeten, Jared; Heffron, Renee

2016-06-01

More than half of human immunodeficiency virus (HIV)-infected individuals in Kenya are unaware of their status, and young women carry a disproportionate burden of incident HIV infections. We sought to determine the effect of an SMS intervention on uptake of HIV testing among female Kenyan college students. We conducted a quasi-experimental study to increase HIV testing among women 18 to 24 years old. Four midlevel training colleges in Central Kenya were allocated to have their study participants receive either weekly SMS on HIV and reproductive health topics or no SMS. Monthly 9-question SMS surveys were sent to all participants for 6 months to collect data on HIV testing, sexual behavior, and HIV risk perception. We used multivariate Cox proportional hazards regression to detect differences in the time to the first HIV test reported by women during the study period. We enrolled 600 women between September 2013 and March 2014 of whom 300 received weekly SMS and monthly surveys and 300 received only monthly surveys. On average, women were 21 years of age (interquartile range, 20-22), 71.50% had ever had sex and 72.62% had never tested for HIV. A total of 356 women reported testing for HIV within the 6 months of follow-up: 67% from the intervention arm and 51% from the control arm (hazard ratio, 1.57; 95% confidence interval, 1.28-1.92). Use of weekly text messages about HIV prevention and reproductive health significantly increased rates of HIV testing among young Kenyan women and would be feasible to implement widely among school populations.

The Unrecognized Burden of Influenza in Young Kenyan Children, 2008-2012

PubMed Central

McMorrow, Meredith L.; Emukule, Gideon O.; Njuguna, Henry N.; Bigogo, Godfrey; Montgomery, Joel M.; Nyawanda, Bryan; Audi, Allan; Breiman, Robert F.; Katz, Mark A.; Cosmas, Leonard; Waiboci, Lilian W.; Duque, Jazmin; Widdowson, Marc-Alain; Mott, Joshua A.

2015-01-01

Influenza-associated disease burden among children in tropical sub-Saharan Africa is not well established, particularly outside of the 2009 pandemic period. We estimated the burden of influenza in children aged 0–4 years through population-based surveillance for influenza-like illness (ILI) and acute lower respiratory tract illness (ALRI). Household members meeting ILI or ALRI case definitions were referred to health facilities for evaluation and collection of nasopharyngeal and oropharyngeal swabs for influenza testing by real-time reverse transcription polymerase chain reaction. Estimates were adjusted for health-seeking behavior and those with ILI and ALRI who were not tested. During 2008–2012, there were 9,652 person-years of surveillance among children aged 0–4 years. The average adjusted rate of influenza-associated hospitalization was 4.3 (95% CI 3.0–6.0) per 1,000 person-years in children aged 0–4 years. Hospitalization rates were highest in the 0–5 month and 6–23 month age groups, at 7.6 (95% CI 3.2–18.2) and 8.4 (95% CI 5.4–13.0) per 1,000 person-years, respectively. The average adjusted rate of influenza-associated medically attended (inpatient or outpatient) ALRI in children aged 0–4 years was 17.4 (95% CI 14.2–19.7) per 1,000 person-years. Few children who had severe laboratory-confirmed influenza were clinically diagnosed with influenza by the treating clinician in the inpatient (0/33, 0%) or outpatient (1/109, 0.9%) settings. Influenza-associated hospitalization rates from 2008–2012 were 5–10 times higher than contemporaneous U.S. estimates. Many children with danger signs were not hospitalized; thus, influenza-associated severe disease rates in Kenyan children are likely higher than hospital-based estimates suggest. PMID:26379030

Dengue Outbreak in Mombasa City, Kenya, 2013-2014: Entomologic Investigations.

PubMed

Lutomiah, Joel; Barrera, Roberto; Makio, Albina; Mutisya, James; Koka, Hellen; Owaka, Samuel; Koskei, Edith; Nyunja, Albert; Eyase, Fredrick; Coldren, Rodney; Sang, Rosemary

2016-10-01

Dengue outbreaks were first reported in East Africa in the late 1970s to early 1980s including the 1982 outbreak on the Kenyan coast. In 2011, dengue outbreaks occurred in Mandera in northern Kenya and subsequently in Mombasa city along the Kenyan coast in 2013-2014. Following laboratory confirmation of dengue fever cases, an entomologic investigation was conducted to establish the mosquito species, and densities, causing the outbreak. Affected parts of the city were identified with the help of public health officials. Adult Ae. aegypti mosquitoes were collected using various tools, processed and screened for dengue virus (DENV) by cell culture and RT-PCR. All containers in every accessible house and compound within affected suburbs were inspected for immatures. A total of 2,065 Ae. aegypti adults were collected and 192 houses and 1,676 containers inspected. An overall house index of 22%, container index, 31.0% (indoor = 19; outdoor = 43) and Breteau index, 270.1, were observed, suggesting that the risk of dengue transmission was high. Overall, jerry cans were the most productive containers (18%), followed by drums (17%), buckets (16%), tires (14%) and tanks (10%). However, each site had specific most-productive container-types such as tanks (17%) in Kizingo; Drums in Nyali (30%) and Changamwe (33%), plastic basins (35%) in Nyali-B and plastic buckets (81%) in Ganjoni. We recommend that for effective control of the dengue vector in Mombasa city, all container types would be targeted. Measures would include proper covering of water storage containers and eliminating discarded containers outdoors through a public participatory environmental clean-up exercise. Providing reliable piped water to all households would minimize the need for water storage and reduce aquatic habitats. Isolation of DENV from male Ae. aegypti mosquitoes is a first observation in Kenya and provides further evidence that transovarial transmission may have a role in DENV circulation and/or maintenance in the environment.

Dengue Outbreak in Mombasa City, Kenya, 2013–2014: Entomologic Investigations

PubMed Central

Barrera, Roberto; Makio, Albina; Mutisya, James; Koka, Hellen; Owaka, Samuel; Koskei, Edith; Nyunja, Albert; Eyase, Fredrick; Coldren, Rodney; Sang, Rosemary

2016-01-01

Dengue outbreaks were first reported in East Africa in the late 1970s to early 1980s including the 1982 outbreak on the Kenyan coast. In 2011, dengue outbreaks occurred in Mandera in northern Kenya and subsequently in Mombasa city along the Kenyan coast in 2013–2014. Following laboratory confirmation of dengue fever cases, an entomologic investigation was conducted to establish the mosquito species, and densities, causing the outbreak. Affected parts of the city were identified with the help of public health officials. Adult Ae. aegypti mosquitoes were collected using various tools, processed and screened for dengue virus (DENV) by cell culture and RT-PCR. All containers in every accessible house and compound within affected suburbs were inspected for immatures. A total of 2,065 Ae. aegypti adults were collected and 192 houses and 1,676 containers inspected. An overall house index of 22%, container index, 31.0% (indoor = 19; outdoor = 43) and Breteau index, 270.1, were observed, suggesting that the risk of dengue transmission was high. Overall, jerry cans were the most productive containers (18%), followed by drums (17%), buckets (16%), tires (14%) and tanks (10%). However, each site had specific most-productive container-types such as tanks (17%) in Kizingo; Drums in Nyali (30%) and Changamwe (33%), plastic basins (35%) in Nyali-B and plastic buckets (81%) in Ganjoni. We recommend that for effective control of the dengue vector in Mombasa city, all container types would be targeted. Measures would include proper covering of water storage containers and eliminating discarded containers outdoors through a public participatory environmental clean-up exercise. Providing reliable piped water to all households would minimize the need for water storage and reduce aquatic habitats. Isolation of DENV from male Ae. aegypti mosquitoes is a first observation in Kenya and provides further evidence that transovarial transmission may have a role in DENV circulation and/or maintenance in the environment. PMID:27783626

Use of population-based surveillance to determine the incidence of rotavirus gastroenteritis in an urban slum and a rural setting in Kenya.

PubMed

Breiman, Robert F; Cosmas, Leonard; Audi, Allan; Mwiti, William; Njuguna, Henry; Bigogo, Godfrey M; Olack, Beatrice; Ochieng, John B; Wamola, Newton; Montgomery, Joel M; Williamson, John; Parashar, Umesh D; Burton, Deron C; Tate, Jacqueline E; Feikin, Daniel R

2014-01-01

Rotavirus gastroenteritis is a major cause of mortality among children <2 years of age. Disease burden data are important for introducing and sustaining new rotavirus vaccines in immunization programs. We analyzed population-based infectious disease surveillance data from 2007 to 2010 from Kenyan sites in rural and urban slum areas. Stool specimens were collected from patients of all ages presenting to study clinics with diarrheal disease and tested for rotavirus by enzyme immunoassay. Incidence rates were adjusted using data on healthcare utilization (from biweekly home visits) and proportion of stools collected at study clinics from patients meeting case definitions. Rotavirus was detected in 285 (9.0%) of 3174 stools tested, including 122 (11.9%) from children <5 years of age and 162 (7.6%) from participants ≥5 years of age. Adjusted incidence rates for infants were 13,419 and 12,135 per 100,000 person-years of observation in rural and urban areas, respectively. Adjusted incidence rates were high in adults across age ranges. The rates suggest that annually, among children <5 years of age, there are >54,500 cases of rotavirus-associated gastroenteritis in rural Nyanza Province and >16,750 cases in Nairobi urban slums. Community-based surveillance in urban and rural Kenya suggests that rotavirus plays an important role as a cause of acute gastroenteritis in adults, as well as in children. In addition to substantially preventing illness and complications from diarrheal disease in children, rotavirus infant immunization has the potential of indirectly preventing diarrheal disease in older children and adults, assuming children are the predominant sources of transmission.

Using Patient-Pathway Analysis to Inform a Differentiated Program Response to Tuberculosis: The Case of Kenya.

PubMed

Masini, Enos; Hanson, Christy; Ogoro, Jeremiah; Brown, Jessie; Ngari, Faith; Mingkwan, Pia; Makayova, Julia; Osberg, Mike

2017-11-06

A recent tuberculosis prevalence survey in Kenya found that the country is home to nearly twice as many patients with tuberculosis as previously estimated. Kenya has prioritized identifying and treating the unnotified or missing cases of tuberculosis. This requires a better understanding of patient care seeking and system weaknesses. A patient-pathway analysis (PPA) was completed to assess the alignment between patient care seeking and the availability of tuberculosis diagnostic and treatment services at the national level and for all 47 counties at the subnational level in Kenya. It was estimated that more than half of patients initiate care in the public sector. Nationally, just under half of patients encountered tuberculosis diagnostic and treatment capacity where they initiated care. Overall, there was distinct variation in diagnostic and treatment availability across counties and facility levels. The PPA results emphasized the need for a differentiated approach to tuberculosis care, by county, and the distinct need for better referral systems. The majority of Kenyans actively sought care; improving diagnostic and treatment capacity in the formal and informal private sector, as well as in the public sector, could help identify the majority of missing cases. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

Gender and Poverty Reduction: A Kenyan Context

ERIC Educational Resources Information Center

Kimani, Elishiba Njambi; Kombo, Donald Kisilu

2010-01-01

Poverty is a dehumanising condition for every one. It erodes human rights of the affected whether women or men. Poverty subjects an individual to a state of powerlessness, hopelessness, and lack of self-esteem, confidence, and integrity, leading to a situation of multidimensional vulnerability. Poverty has a gender dimension since women and men…

Learning English Language by Radio in Primary Schools in Kenya

ERIC Educational Resources Information Center

Odera, Florence Y.

2011-01-01

Radio is one of the most affordable educational technologies available for the use in education and development in developing countries. This article explores the use of school radio broadcast to assist teachers and pupils to learn and improve English language both written and spoken in Kenyan primary schools. English language occupies a central…

An Ambassador on and off the Field

ERIC Educational Resources Information Center

Elfman, Lois

2009-01-01

This article features Oklahoma State University (OSU) soccer midfielder Yolanda Odenyo. Odenyo grew up in Sweden the daughter of a Swedish mother and Kenyan father. Each year, she would spend her summer months in either Kenya or Zaire. She believes her extensive travels gave her a global perspective and a strong appreciation for human rights and…

Impact of a Temporary Food Shortage on Children and Their Mothers.

ERIC Educational Resources Information Center

McDonald, Mary Alice; And Others

1994-01-01

Evaluated the effects of a drought and temporary food shortage on 248 Kenyan mother-child dyads' energy intake, weight, and behaviors. Found that school-age children were affected more negatively than toddlers, showing significant declines in energy intake, age-corrected weight, activity on the playground, and classroom attention. Behavior…

University Agency in Peacebuilding: Perspectives on Conflict and Development in Kenya

ERIC Educational Resources Information Center

Johnson, Ane Turner

2013-01-01

In 2007, Kenya erupted into violence as a result of heavily contested elections. Because identity divisions lay at the heart of the conflict, the nation's public universities were deeply impacted, at times pitting students, faculty, and staff against one another, and disrupting the ability of Kenyan higher education to contribute to the…

A Triumph of Hope over Reason? Aid Accords and Education Policy in Kenya

ERIC Educational Resources Information Center

Colclough, Christopher; Webb, Andrew

2012-01-01

Despite a long history of post-independence aid to education, Kenya's relationships with overseas donors have, until recently, been markedly fractious. Donors' concerns about transparency and corruption, in the context of a political regime which became increasingly authoritarian, led to sharp reductions in aid to Kenyan education during the…

The role of academia and industry in nurturing women in physics in Kenya

NASA Astrophysics Data System (ADS)

Nyamwandha, Cecilia A.; Kasina, Angeline; Muthui, Zipporah W.; Awuor, Emily; Baki, Paul

2015-12-01

The authors look at some of the primary initiatives taken by the government, academia, and industry to nurture the goals and dreams of Kenyan women physicists. They discuss key transformative lines of progress as evidenced by statistics, and the enabling environments and platforms upon which these were made possible.

Life Support

ERIC Educational Resources Information Center

Keller, Bess

2005-01-01

In this article, the author introduces Peter Kinoti Inoti, the headmaster of a Kenyan primary school, who finds himself at the forefront of bringing AIDS education to a country that's remained silent about the disease for decades. Inoti, who had been a teacher at the primary level--grades 1-8--for more than two decades, juggles his duties as an…

Multicampus University Systems: Africa and the Kenyan Experience. Routledge Research in International and Comparative Education

ERIC Educational Resources Information Center

Munene, Ishmael I.

2014-01-01

In the face of increasing social demand and cutbacks in state budgetary support, universities in African countries are now turning towards a multicampus system strategy. As African governments have adopted neoliberal education policies that place premium on entrepreneurialism, profit making, privatization, and markets as drivers of university…

Reaching youth through franchise clinics: assessment of Kenyan private sector involvement in youth services.

PubMed

Decker, Martha; Montagu, Dominic

2007-03-01

This paper evaluates the ability of social franchise programs, which use private providers to offer reproductive health services, to provide services to youth in western Kenya. Although franchise clinics have rarely targeted youth, they appear to offer a viable alternative for providing reproductive health services to this age group.

Synchronising Pedagogy and Musical Experiences in Early Childhood: Addressing Challenges in Preschool Music Education in Kenya

ERIC Educational Resources Information Center

Andang'o, Elizabeth A.

2009-01-01

This paper examines pedagogy in early childhood music education and the resultant learning experiences in music for children in Kenyan preschools. Two important principles proposed for the synchronisation of teaching and learning in early childhood music education are cultural relevance and developmental appropriateness. These terms are…

Integrating Cultural Values into the Curriculum for Kenyan Schools.

ERIC Educational Resources Information Center

Maina, Faith

A strong cultural identity enables individuals to become independent and self-reliant people who function in their own environment. People who have little sense of their cultural identity or have been alienated from their culture can become dependent and lack skills for meaningful survival in their own environment. This predicament is particularly…

Revisiting the Fortunate Few: University Graduates in the Kenyan Labor Market.

ERIC Educational Resources Information Center

Hughes, Rees

1987-01-01

A survey of 294 University of Nairobi (Kenya) graduates in 4 graduating classes, 1970-83, examined trends in first employment of college graduates, the growing surplus of college graduates in the labor market, inflation of job qualifications, and the influence of family socioeconomic background on postgraduation employment when jobs are scarce.…

Public Funding of Primary Education in Kenya: Recent Tends, Challenges, and Implications for the Future.

ERIC Educational Resources Information Center

Mukudi, Edith

1999-01-01

Kenyan primary education is plagued by problems of high attrition and gender and regional disparities in access and achievement. Poverty, institutionalized corruption, and declining public funding are primary factors. More funding is needed for teacher salaries, infrastructure development, and improved educational access. (Contains 23 references.)…

The Challenges and Future of Public Higher Education Leadership in Kenya

ERIC Educational Resources Information Center

Odhiambo, George

2014-01-01

This article discusses some of the key challenges and points of tension pertaining to leadership in higher education in Kenya. Effective leadership approaches are discussed including an exploration of why effective leadership is more important in Kenyan public higher education now than ever. Given the complex context within which public higher…

"Making It": Understanding Adolescent Resilience in Two Informal Settlements (Slums) in Nairobi, Kenya

ERIC Educational Resources Information Center

Kabiru, Caroline W.; Beguy, Donatien; Ndugwa, Robert P.; Zulu, Eliya M.; Jessor, Richard

2012-01-01

Many adolescents living in contexts characterized by adversity achieve positive outcomes. We adopt a protection-risk conceptual framework to examine resilience (academic achievement, civic participation, and avoidance of risk behaviors) among 1,722 never-married 12-19 year olds living in two Kenyan urban slums. We find stronger associations…

Geography Students' Assessment of Internship Experience at a Kenyan University

ERIC Educational Resources Information Center

Simiyu, Robert Romborah; Okaka, Fredrick Okoth; Omondi, Paul

2015-01-01

This paper reports findings of Moi University's geography students' assessment of their internship, which underscore the importance of internship in bridging the gap between theoretical knowledge and its application in the real world of work. Not only were the majority of the students able to apply geographical knowledge and skills in their work…

Philosophy for Children Kenyan Style

ERIC Educational Resources Information Center

Odierna, Rebecca

2012-01-01

It was the last day of Philosophy 492, the author's college course dedicated to teaching the principles and strategies of philosophy for children (p4c) Hawai'i. Months before she joined the Philosophy 492 class, she was asked to join Emerging Humanity as a volunteer in a project that focused on enhancing the classroom environments at the…

Creating windows of opportunity for policy change: Incorporating evidence into decentralized planning in Kenya.

PubMed Central

Ashford, Lori S.; Smith, Rhonda R.; De Souza, Roger-Mark; Fikree, Fariyal F.; Yinger, Nancy V.

2006-01-01

PROBLEM: Because researchers and policy-makers work in different spheres, policy decisions in the health arena are often not based on available scientific evidence. APPROACH: We describe a model that illustrates the policy process and how to work strategically to translate knowledge into policy actions. Several types of activity--agenda-setting, coalition building and policy learning--together can create a window of opportunity for policy change. LOCAL SETTING: Activities were undertaken as part of the Kenyan Ministry of Health's new decentralized planning-process. The objective was to ensure that the results of a national assessment of health services were used in the preparation of district-level health plans. RELEVANT CHANGES: Following the intervention, 70 district-level, evidence-based work plans were developed and approved by the Kenyan Ministry of Health. LESSONS LEARNED: Substantial investment and effort are needed to bring stakeholders together to work towards policy change. More in-depth evaluation of these efforts can aid understanding of how systematic approaches to policy change can be replicated elsewhere. PMID:16917657

Gender scripts and unwanted pregnancy among urban Kenyan women.

PubMed

Izugbara, Chimaraoke O; Ochako, Rhoune; Izugbara, Chibuogwu

2011-10-01

Women's lived experiences and lay accounts of unwanted pregnancy remain poorly interrogated. We investigated portrayals of unwanted pregnancy using narrative data gathered from 80 women in Nairobi, Kenya. Unwanted pregnancy had a diversity of significance for the women. Pregnancies were not simply unwanted because they occurred when women became pregnant without wanting to. Rather, pregnancies were considered unwanted largely because they had occurred in contexts that did not reinforce socially-sanctioned notions of motherhood and 'proper' procreation and/or revealed women's use of their sexuality in ways deemed culturally-inappropriate. Kenyan women's invocation of femininity scripts to explain unwanted pregnancy; the centrality of gender in everyday life in contemporary Kenya; women's and girls' poor access to effective family planning services; growing female poverty; and Kenya's restrictive abortion policy imply that unwanted pregnancy and its consequences will persist in the country. Addressing unwanted pregnancy and its consequences requires making accessible quality contraceptive and abortion services as well as sexuality information. It also calls for providers who understand the socio-cultural norms that circumscribe fertility and reproductive behaviours.

Kenyan who "discovered the cure for AIDS" taken to court.

PubMed

1996-06-01

In Nairobi, Kenya, Professor Obel, the Kenyan scientist who produced two drugs that he claimed would cure acquired immunodeficiency syndrome (AIDS), is being taken to court, and Pearl Omega, one of the drugs, has been banned by the Ministry of Health. Initially, Obel may have gained support in the ministry because of his friendship with Phillip Mbithi, former Chief Secretary in the office of the president, and others. Obel claimed in March to have found a cure for AIDS; he was lambasted by scientists. On April 24, Assistant Health Minister Basil Criticos told parliament that the government was to carry out clinical trials of the drug and that Obel was to be encouraged. On May 2, Health Minister Joshua Angatia stated that Pearl Omega was a herbal concoction whose efficacy had never scientifically been proven. The Society of People with AIDS in Kenya has taken Obel to court; some patients who had taken part in trials of Kemron, Obel's other miracle drug, had been told by the professor that they had become HIV-negative.

Lessons learnt from the first controlled human malaria infection study conducted in Nairobi, Kenya.

PubMed

Hodgson, Susanne H; Juma, Elizabeth; Salim, Amina; Magiri, Charles; Njenga, Daniel; Molyneux, Sassy; Njuguna, Patricia; Awuondo, Ken; Lowe, Brett; Billingsley, Peter F; Cole, Andrew O; Ogwang, Caroline; Osier, Faith; Chilengi, Roma; Hoffman, Stephen L; Draper, Simon J; Ogutu, Bernhards; Marsh, Kevin

2015-04-28

Controlled human malaria infection (CHMI) studies, in which healthy volunteers are infected with Plasmodium falciparum to assess the efficacy of novel malaria vaccines and drugs, have become a vital tool to accelerate vaccine and drug development. CHMI studies provide a cost-effective and expeditious way to circumvent the use of large-scale field efficacy studies to deselect intervention candidates. However, to date few modern CHMI studies have been performed in malaria-endemic countries. An open-label, randomized pilot CHMI study was conducted using aseptic, purified, cryopreserved, infectious P. falciparum sporozoites (SPZ) (Sanaria® PfSPZ Challenge) administered intramuscularly (IM) to healthy Kenyan adults (n = 28) with varying degrees of prior exposure to P. falciparum. The purpose of the study was to establish the PfSPZ Challenge CHMI model in a Kenyan setting with the aim of increasing the international capacity for efficacy testing of malaria vaccines and drugs, and allowing earlier assessment of efficacy in a population for which interventions are being developed. This was part of the EDCTP-funded capacity development of the CHMI platform in Africa. This paper discusses in detail lessons learnt from conducting the first CHMI study in Kenya. Issues pertinent to the African setting, including community sensitization, consent and recruitment are considered. Detailed reasoning regarding the study design (for example, dose and route of administration of PfSPZ Challenge, criteria for grouping volunteers according to prior exposure to malaria and duration of follow-up post CHMI) are given and changes other centres may want to consider for future studies are suggested. Performing CHMI studies in an African setting presents unique but surmountable challenges and offers great opportunity for acceleration of malaria vaccine and drug development. The reflections in this paper aim to aid other centres and partners intending to use the CHMI model in Africa.

Prevalence of antibodies against Rift Valley fever virus in Kenyan wildlife

PubMed Central

EVANS, A.; GAKUYA, F.; PAWESKA, J. T.; ROSTAL, M.; AKOOLO, L.; VAN VUREN, P. J.; MANYIBE, T.; MACHARIA, J. M.; KSIAZEK, T. G.; FEIKIN, D. R.; BREIMAN, R. F.; KARIUKI NJENGA, M.

2008-01-01

SUMMARY Rift Valley fever virus (RVFV) is an arbovirus associated with periodic outbreaks, mostly on the African continent, of febrile disease accompanied by abortion in livestock, and a severe, fatal haemorrhagic syndrome in humans. However, the maintenance of the virus during the inter-epidemic period (IEP) when there is low or no disease activity detected in livestock or humans has not been determined. This study report prevalence of RVFV-neutralizing antibodies in sera (n=896) collected from 16 Kenyan wildlife species including at least 35% that were born during the 1999–2006 IEP. Specimens from seven species had detectable neutralizing antibodies against RVFV, including African buffalo, black rhino, lesser kudu, impala, African elephant, kongoni, and waterbuck. High RVFV antibody prevalence (>15%) was observed in black rhinos and ruminants (kudu, impala, buffalo, and waterbuck) with the highest titres (up to 1:1280) observed mostly in buffalo, including animals born during the IEP. All lions, giraffes, plains zebras, and warthogs tested were either negative or less than two animals in each species had low (⩽1:16) titres of RVFV antibodies. Of 249 sera collected from five wildlife species during the 2006–2007 outbreak, 16 out of 19 (84%) of the ruminant (gerenuk, waterbuck, and eland) specimens had RVFV-neutralizing titres ⩾1:80. These data provide evidence that wild ruminants are infected by RVFV but further studies are required to determine whether these animals play a role in the virus maintenance between outbreaks and virus amplification prior to a noticeable outbreak. PMID:17988425

Sequence-Based Genotyping of Expressed Swine Leukocyte Antigen Class I Alleles by Next-Generation Sequencing Reveal Novel Swine Leukocyte Antigen Class I Haplotypes and Alleles in Belgian, Danish, and Kenyan Fattening Pigs and Göttingen Minipigs.

PubMed

Sørensen, Maria Rathmann; Ilsøe, Mette; Strube, Mikael Lenz; Bishop, Richard; Erbs, Gitte; Hartmann, Sofie Bruun; Jungersen, Gregers

2017-01-01

The need for typing of the swine leukocyte antigen (SLA) is increasing with the expanded use of pigs as models for human diseases and organ-transplantation experiments, their use in infection studies, and for design of veterinary vaccines. Knowledge of SLA sequences is furthermore a prerequisite for the prediction of epitope binding in pigs. The low number of known SLA class I alleles and the limited knowledge of their prevalence in different pig breeds emphasizes the need for efficient SLA typing methods. This study utilizes an SLA class I-typing method based on next-generation sequencing of barcoded PCR amplicons. The amplicons were generated with universal primers and predicted to resolve 68-88% of all known SLA class I alleles dependent on amplicon size. We analyzed the SLA profiles of 72 pigs from four different pig populations; Göttingen minipigs and Belgian, Kenyan, and Danish fattening pigs. We identified 67 alleles, nine previously described haplotypes and 15 novel haplotypes. The highest variation in SLA class I profiles was observed in the Danish pigs and the lowest among the Göttingen minipig population, which also have the highest percentage of homozygote individuals. Highlighting the fact that there are still numerous unknown SLA class I alleles to be discovered, a total of 12 novel SLA class I alleles were identified. Overall, we present new information about known and novel alleles and haplotypes and their prevalence in the tested pig populations.

Relationship between oviposition, virulence gene expression and parasitism success in Cotesia typhae nov. sp. parasitoid strains.

PubMed

Benoist, R; Chantre, C; Capdevielle-Dulac, C; Bodet, M; Mougel, F; Calatayud, P A; Dupas, S; Huguet, E; Jeannette, R; Obonyo, J; Odorico, C; Silvain, J F; Le Ru, B; Kaiser, L

2017-12-01

Studying mechanisms that drive host adaptation in parasitoids is crucial for the efficient use of parasitoids in biocontrol programs. Cotesia typhae nov. sp. (Fernández-Triana) (Hymenoptera: Braconidae) is a newly described parasitoid of the Mediterranean corn borer Sesamia nonagrioides (Lefebvre) (Lepidoptera: Noctuidae). Braconidae are known for their domesticated bracovirus, which is injected with eggs in the host larva to overcome its resistance. In this context, we compared reproductive success traits of four Kenyan strains of C. typhae on a French and a Kenyan populations of its host. Differences were found between the four strains and the two most contrasted ones were studied more thoroughly on the French host population. Parasitoid offspring size was correlated with parasitism success and the expression of bracovirus virulence genes (CrV1 and Cystatin) in the host larva after parasitism. Hybrids between these two parasitoid strains showed phenotype and gene expression profiles similar to the most successful parental strain, suggesting the involvement of dominant alleles in the reproductive traits. Ovary dissections revealed that the most successful strain injected more eggs in a single host larva than the less successful one, despite an equal initial ovocyte number in ovaries. It can be expected that the amount of viral particles increase with the number of eggs injected. The ability to bypass the resistance of the allopatric host may in consequence be related to the oviposition behaviour (eggs allocation). The influence of the number of injected eggs on parasitism success and on virulence gene expression was evaluated by oviposition interruption experiments.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Jones, B.; Renault, R.W.

Platy calcite crystals, which have their c axis parallel to their shortest length axis, are common components of travertine deposits found around some hot springs in the Kenya Rift Valley. They are composite crystals formed of numerous paper-thin subcrystals. Individual plates allowed to grow without obstruction develop a hexagonal motif. The Kenyan crystals typically form in hot (>75 C) waters that have a low Ca content (<10 mg/l), a high CO{sub 2} content, and a high rate of CO{sub 2} degassing. At Chemurkeu, aggregates of numerous small platy crystals collectively form lattice crystals that superficially resemble ray crystals. The wallsmore » of the lattice crystals are formed of large platy crystals that have their long and intermediate length axes aligned parallel to the plane of the long axis of the lattice crystal. Internally, the lattice crystals are formed of small platy calcite crystals arranged in a boxlike pattern that creates the appearance of a lattice when viewed in thin section. Lattice crystals are highly porous, with each pore being enclosed by platy crystals. At Lorusio, travertines are mainly formed of pseudodentrites that are constructed by numerous small platy crystals attached to a main stem which is a large platy crystal that commonly curves along its long axis. The pseudodentrites are the main construction blocks in ledges and lilypads that form in the vent pool and spring outflow channels, where the water is too hot for microbes other than hyperthermophiles. The platy calcite crystals in the Kenyan travertines are morphologically similar to platy calcite crystals that form as scale in pipes in the geothermal fields of New Zealand and hydrothermal angel wing calcite from the La Fe mine in Mexico. Comparison of the Kenyan and New Zealand crystals indicates that platy calcite crystals form from waters with a low Ca{sup 2+} content and a high CO{sub 3}/Ca ratio due to rapid rates of CO{sub 2} degassing.« less

Factors associated with high heterogeneity of malaria at fine spatial scale in the Western Kenyan highlands.

PubMed

Baidjoe, Amrish Y; Stevenson, Jennifer; Knight, Philip; Stone, William; Stresman, Gillian; Osoti, Victor; Makori, Euniah; Owaga, Chrispin; Odongo, Wycliffe; China, Pauline; Shagari, Shehu; Kariuki, Simon; Drakeley, Chris; Cox, Jonathan; Bousema, Teun

2016-06-04

The East African highlands are fringe regions between stable and unstable malaria transmission. What factors contribute to the heterogeneity of malaria exposure on different spatial scales within larger foci has not been extensively studied. In a comprehensive, community-based cross-sectional survey an attempt was made to identify factors that drive the macro- and micro epidemiology of malaria in a fringe region using parasitological and serological outcomes. A large cross-sectional survey including 17,503 individuals was conducted across all age groups in a 100 km(2) area in the Western Kenyan highlands of Rachuonyo South district. Households were geo-located and prevalence of malaria parasites and malaria-specific antibodies were determined by PCR and ELISA. Household and individual risk-factors were recorded. Geographical characteristics of the study area were digitally derived using high-resolution satellite images. Malaria antibody prevalence strongly related to altitude (1350-1600 m, p < 0.001). A strong negative association with increasing altitude and PCR parasite prevalence was found. Parasite carriage was detected at all altitudes and in all age groups; 93.2 % (2481/2663) of malaria infections were apparently asymptomatic. Malaria parasite prevalence was associated with age, bed net use, house construction features, altitude and topographical wetness index. Antibody prevalence was associated with all these factors and distance to the nearest water body. Altitude was a major driver of malaria transmission in this study area, even across narrow altitude bands. The large proportion of asymptomatic parasite carriers at all altitudes and the age-dependent acquisition of malaria antibodies indicate stable malaria transmission; the strong correlation between current parasite carriage and serological markers of malaria exposure indicate temporal stability of spatially heterogeneous transmission.

HIV/AIDS-related social anxieties in adolescents in three African countries.

PubMed

Venier, J L; Ross, M W; Akande, A

1998-02-01

This study examines the social anxieties associated with HIV prevention in adolescents in three African countries (Nigeria, Kenya, and Zimbabwe). The subjects used in this study were black Africans in form 2 or grade 10 in public high schools (Nigeria, n = 387; Kenya, n = 274; Zimbabwe n = 313). Subjects responded to the 33 item AIDS Social Assertiveness Scale (ASAS). Data indicated similar factor structures for each of the three countries and included five factors. The combined sample factor intercorrelations were modestly but significantly correlated. The mean scores for each factor were compared, and ANOVA of the factors by country, by gender, and by interaction between country and gender were performed. The factor structures were very similar between countries, each including five factors that had similar themes: condom interactions, refusal of risk, confiding in significant others, contact with people with HIV/AIDS, and general assertiveness. These factor structures were also very similar to one found in previous studies of Australian adolescents on the ASAS. The Kenyan means for four of the five factors were significantly lower than those for Nigeria, and were also significantly lower than the Zimbabwean means for two of the five factors, suggesting that Kenyan students are less anxious about social situations related to HIV/AIDS than others. Significant variance was found for several factors due to gender, country, and the interaction between gender and country. These results have important implications for designing education programs. The similarities of anxieties regarding HIV/AIDS social situations suggest that these clusters of social barriers to reduction of HIV infection risk might form the basis of educational interventions, and that dimensions of HIV social anxieties are similar across countries.

Theatre Safari in East Africa: An Exploration of Theatre in Kenya.

ERIC Educational Resources Information Center

Hutchinson, P. William

Six months of observation--at two universities, at a drama festival, and with several independent theatre companies--form the basis for this evaluation of theatre in Kenya, Africa. While Kenyan dramas deal with a variety of themes, the majority are topical rather than universal in their treatment of issues. In many, the emphasis is on the…

Investigating Local Sustainable Environmental Perspectives of Kenyan Community Members and Teachers

ERIC Educational Resources Information Center

Quigley, Cassie F.; Dogbey, James; Che, S. Megan; Hallo, Jeffrey

2015-01-01

Efforts to conserve and preserve the environment in developing or marginalized locales frequently involve a one-way transfer of knowledge and materials from a source in a more developed location. This situation often degenerates into a short-term donor project which risks little to no long-term impacts on local or indigenous relationships with the…

What Happened and Why? Considering the Role of Truth and Memory in Peace Education Curricula

ERIC Educational Resources Information Center

Lauritzen, Solvor Mjøberg; Nodeland, Tuva Skjelbred

2017-01-01

This paper is an exploration of challenges arising in the interplay between a standardised peace education curriculum and a localised post-conflict setting. Drawing on interview data from two Kenyan schools, the paper explores the reception of peace education initiatives implemented in Kenya following the post-election violence of 2007/2008…

African Journal: Schooling and Politics in Rural Kenya

ERIC Educational Resources Information Center

Axelrod, Paul

2008-01-01

In 2003, York University awarded an honorary doctorate to Phoebe Asiyo, a former Kenyan member of Parliament, in recognition of her impressive human rights work. The author learned at the time that Ms. Asiyo's family provided major support to Wikondiek School (located near their home in western Kenya), many of whose students were AIDS orphans.…

Feminist Articulations, Social Literacies, and Ubiquitous Mobile Technology Use in Kenya

ERIC Educational Resources Information Center

Sanya, Brenda N.; Odero, Phantus W.

2017-01-01

This article examines the changes occurring in learning and literacy in the age of ubiquitous mobile phone use. Focusing on rural Kenyan women's use of mobile phone technologies in civic education programs, mobile banking, and to contact family members, the article explores how these women's use of mobile phones, based on their everyday needs, has…

Interpreting Student Views of Learning Experiences in a Contextualized Science Discourse in Kenya

ERIC Educational Resources Information Center

Nashon, Samson Madera; Anderson, David

2013-01-01

Despite the centrality of the informal manufacturing sector ("Jua Kali") to the Kenyan society and its richness in scientific phenomena, there is no strong link between activities in the Jua Kali and school science. And, although there has been an ongoing public discourse in Kenya to industrialize, this hope is unlikely without…

The Hermeneutics of Education Management Information Systems for Kitinga Primary School in Mwingi Central - Kenya

ERIC Educational Resources Information Center

Akaranga, Stephen Ifedha; Makau, Bretta Kavutha

2016-01-01

The data or information records are very important in any organization. With the increase in generation of data in the Kenyan education sector, there is need to devise appropriate means and strategies of storing and retrieving the available data which was hitherto written manually. The Modern Information Communication Technology has necessitated…

They Bring Their Memories with Them: Somali Bantu Resettlement in a Globalized World

ERIC Educational Resources Information Center

Smith, Yda Jean

2010-01-01

The Somali Bantu, arriving in the United States after many years in Kenyan refugee camps, face significant barriers to successful integration into American society. Those responsible for managing initial resettlement at the local level were not prepared to provide appropriate assistance to this group. The arrival of the Somali Bantu highlighted…

"If You Don't Abstain, You Will Die of AIDS": AIDS Education in Kenyan Public Schools

ERIC Educational Resources Information Center

Njue, Carolyne; Nzioka, Charles; Ahlberg, Beth-Maina; Pertet, Anne M.; Voeten, Helene A. C. M.

2009-01-01

We explored constraints of implementing AIDS education in public schools in Kenya. Sixty interviews with teachers and 60 focus group discussions with students were conducted in 21 primary and nine secondary schools. System/school-level constraints included lack of time in the curriculum, limited reach of secondary-school students (because AIDS…

Developmental Inventories Using Illiterate Parents as Informants: Communicative Development Inventory (CDI) Adaptation for Two Kenyan Languages

ERIC Educational Resources Information Center

Alcock, K. J.; Rimba, K.; Holding, P.; Kitsao-Wekulo, P.; Abubakar, A.; Newton, C. R. J. C.

2015-01-01

Communicative Development Inventories (CDIs, parent-completed language development checklists) are a helpful tool to assess language in children who are unused to interaction with unfamiliar adults. Generally, CDIs are completed in written form, but in developing country settings parents may have insufficient literacy to complete them alone. We…

The Writing Skill in the Contemporary Society: The Kenyan Perspective

ERIC Educational Resources Information Center

Okari, Florence Mokeira

2016-01-01

This paper is an overview of the writing skill in the lower levels of learning in the contemporary society. The following areas of writing are highlighted: the writing programme and its goals, the basic methodology for writing tasks, broad groups of writing skills, the teaching of the writing skills in pre-primary and primary schools where…

"No One Should Destroy the Forest": Using Photo-Based Vignette Interviews to Understand Kenyan Teachers' Views of the Environment

ERIC Educational Resources Information Center

Quigley, Cassie F.; Miller, Zachary D.; Dogbey, James; Che, S. Megan; Hallo, Jeffrey

2014-01-01

In the midst of the current environmental crisis, scientists, academics, authors, and politicians worldwide are urging citizens to create sustainable communities. However, there is little capability to build a sustainable society without an informed, active, and engaged populous. This requires more than just environmentally knowledgeable citizens.…

Many Children Left Behind? Textbooks and Test Scores in Kenya. NBER Working Paper No. 13300

ERIC Educational Resources Information Center

Glewwe, Paul; Kremer, Michael; Moulin, Sylvie

2007-01-01

A randomized evaluation suggests that a program which provided official textbooks to randomly selected rural Kenyan primary schools did not increase test scores for the average student. In contrast, the previous literature suggests that textbook provision has a large impact on test scores. Disaggregating the results by students' initial academic…

Kenyan Girls as Agents of Peace: Enhancing the Capacity of Future Women Peacebuilders

ERIC Educational Resources Information Center

Zanoni, Katie

2017-01-01

The role of women in peacebuilding efforts has been recognized through various international instruments that have advanced the ability of women to access the peace table. In order for women to act as leaders, they must possess the capacity to disrupt structural, cultural, and direct forms of violence, engage in peacemaking activities, and employ…

Optical model for the water characterization of the highly turbid water of the Winam Gulf (Victoria Lake)

NASA Astrophysics Data System (ADS)

Santini, F.; Cavalli, R. M.; Palombo, A.; Pignatti, S.

2007-10-01

The study, proposed within the framework of the cooperation with Kenyan Authorities, has been carried out on the Kenyan part of the Lake Victoria. This lake is one of the largest freshwater bodies of the world where, over the last few years, environmental challenges and human impact have perturbed the ecological balance. Pollution and sediments loads from the tributaries rivers and antrophic sources caused a worrying increase of the turbidity level of the lake water. Secchi transparency index has declined from 5 meters in the 1930s to less than one meter in the 1990s. With the aim of providing an inexpensive way to gather information linked to the water clarity and quality, a method for remotely sensed data interpretation, devoted to produce chl (chlorophyll), CDOM (coloured dissolved organic matter) and TSS (total suspended solids) maps, has been assessed. At this purpose a bio-optical model, based on radiative transfer theory in water bodies, has been refined. The method has been applied on an image acquired on January 2004 by ENVISAT/MERIS sensor just a week after an in situ campaign took place. During the in situ campaign a data set for model refinement and products validation has been collected. This data comprise surface radiometric quantity and samples for laboratory analyses. The comparison between the obtained maps and the data provided by the laboratory analysis showed a good correspondence, demonstrating the potentiality of remote observation in supporting the management of the water resources.

Stigmatizing attitudes toward mental illness among primary school children in Kenya.

PubMed

Ndetei, David M; Mutiso, Victoria; Maraj, Anika; Anderson, Kelly K; Musyimi, Christine; McKenzie, Kwame

2016-01-01

Literature describing stigmatizing attitudes towards people with mental illness by children in the developing world is lacking. Children's mental health issues in the Kenyan context are especially pertinent due to the increased likelihood of exposure to risk factors and the high prevalence of mental disorders. The objective of the current study was to examine socio-demographic factors associated with the endorsement of stigmatizing attitudes towards people with mental illness among Kenyan school children. We analyzed cross-sectional survey data from 4585 primary school-aged children in standards one through seven in the Eastern Province of Kenya. We examined relationships between the endorsement of stigmatizing attitudes and age, gender, district, religion, being in the standard appropriate for one's age, and parental employment status. Stigma scores decreased with increasing age (β = -0.83; 95 % CI = -0.99 to -0.67). Boys had higher stigma scores compared to girls (β = 1.55; 95 % CI = 0.86-2.24). Students from the rural district had higher average stigma scores as compared to those from the peri-urban district (β = 1.14; 95 % CI = 0.44-1.84). Students who were not in the standard appropriate for their age had lower stigma scores than those who were in the standard typical for their age (β = -1.60; 95 % CI = -2.43 to -0.77). Stigmatizing attitudes toward the mentally ill exist among primary school children in Kenya; thus, anti-stigma interventions are needed, and our findings highlight particular subgroups that could be targeted.

Using time series structural characteristics to analyze grain prices in food insecure countries

USGS Publications Warehouse

Davenport, Frank; Funk, Chris

2015-01-01

Two components of food security monitoring are accurate forecasts of local grain prices and the ability to identify unusual price behavior. We evaluated a method that can both facilitate forecasts of cross-country grain price data and identify dissimilarities in price behavior across multiple markets. This method, characteristic based clustering (CBC), identifies similarities in multiple time series based on structural characteristics in the data. Here, we conducted a simulation experiment to determine if CBC can be used to improve the accuracy of maize price forecasts. We then compared forecast accuracies among clustered and non-clustered price series over a rolling time horizon. We found that the accuracy of forecasts on clusters of time series were equal to or worse than forecasts based on individual time series. However, in the following experiment we found that CBC was still useful for price analysis. We used the clusters to explore the similarity of price behavior among Kenyan maize markets. We found that price behavior in the isolated markets of Mandera and Marsabit has become increasingly dissimilar from markets in other Kenyan cities, and that these dissimilarities could not be explained solely by geographic distance. The structural isolation of Mandera and Marsabit that we find in this paper is supported by field studies on food security and market integration in Kenya. Our results suggest that a market with a unique price series (as measured by structural characteristics that differ from neighboring markets) may lack market integration and food security.

Multiple transitions and HIV risk among orphaned Kenyan schoolgirls.

PubMed

Mojola, Sanyu A

2011-03-01

Why are orphaned girls at particular risk of acquiring HIV infection? Using a transition-to-adulthood framework, this study employs qualitative data from Nyanza Province, Kenya, to explore pathways to HIV risk among orphaned and nonorphaned high-school girls. It shows how simultaneous processes such as leaving their parental home, negotiating financial access, and relationship transitions interact to produce disproportionate risk for orphaned girls. The role of financial provision and parental love in modifying girls' trajectories to risk are also explored. A testable theoretical model is proposed based on the qualitative findings, and policy implications are suggested.

Modeling malaria and typhoid fever co-infection dynamics.

PubMed

Mutua, Jones M; Wang, Feng-Bin; Vaidya, Naveen K

2015-06-01

Malaria and typhoid are among the most endemic diseases, and thus, of major public health concerns in tropical developing countries. In addition to true co-infection of malaria and typhoid, false diagnoses due to similar signs and symptoms and false positive results in testing methods, leading to improper controls, are the major challenges on managing these diseases. In this study, we develop novel mathematical models describing the co-infection dynamics of malaria and typhoid. Through mathematical analyses of our models, we identify distinct features of typhoid and malaria infection dynamics as well as relationships associated to their co-infection. The global dynamics of typhoid can be determined by a single threshold (the typhoid basic reproduction number, R0(T)) while two thresholds (the malaria basic reproduction number, R0(M), and the extinction index, R0(MM)) are needed to determine the global dynamics of malaria. We demonstrate that by using efficient simultaneous prevention programs, the co-infection basic reproduction number, R0, can be brought down to below one, thereby eradicating the diseases. Using our model, we present illustrative numerical results with a case study in the Eastern Province of Kenya to quantify the possible false diagnosis resulting from this co-infection. In Kenya, despite having higher prevalence of typhoid, malaria is more problematic in terms of new infections and disease deaths. We find that false diagnosis-with higher possible cases for typhoid than malaria-cause significant devastating impacts on Kenyan societies. Our results demonstrate that both diseases need to be simultaneously managed for successful control of co-epidemics. Copyright © 2015 Elsevier Inc. All rights reserved.

"Even if you know everything you can forget": health worker perceptions of mobile phone text-messaging to improve malaria case-management in Kenya.

PubMed

Jones, Caroline O H; Wasunna, Beatrice; Sudoi, Raymond; Githinji, Sophie; Snow, Robert W; Zurovac, Dejan

2012-01-01

This paper presents the results of a qualitative study to investigate the perceptions and experiences of health workers involved in a a cluster-randomized controlled trial of a novel intervention to improve health worker malaria case-management in 107 government health facilities in Kenya. The intervention involved sending text-messages about paediatric outpatient malaria case-management accompanied by "motivating" quotes to health workers' mobile phones. Ten malaria messages were developed reflecting recommendations from the Kenyan national guidelines. Two messages were delivered per day for 5 working days and the process was repeated for 26 weeks (May to October 2009). The accompanying quotes were unique to each message. The intervention was delivered to 119 health workers and there were significant improvements in correct artemether-lumefantrine (AL) management both immediately after the intervention (November 2009) and 6 months later (May 2010). In-depth interviews with 24 health workers were undertaken to investigate the possible drivers of this change. The results suggest high acceptance of all components of the intervention, with the active delivery of information in an on the job setting, the ready availability of new and stored text messages and the perception of being kept 'up to date' as important factors influencing practice. Applying the construct of stages of change we infer that in this intervention the SMS messages were operating primarily at the action and maintenance stages of behaviour change achieving their effect by creating an enabling environment and providing a prompt to action for the implementation of case management practices that had already been accepted as the clinical norm by the health workers. Future trials testing the effectiveness of SMS reminders in creating an enabling environment for the establishment of new norms in clinical practice as well as in providing a prompt to action for the implementation of the new case-management guidelines are justified.

“Even if You Know Everything You Can Forget”: Health Worker Perceptions of Mobile Phone Text-Messaging to Improve Malaria Case-Management in Kenya

PubMed Central

Jones, Caroline O. H.; Wasunna, Beatrice; Sudoi, Raymond; Githinji, Sophie; Snow, Robert W.; Zurovac, Dejan

2012-01-01

This paper presents the results of a qualitative study to investigate the perceptions and experiences of health workers involved in a a cluster-randomized controlled trial of a novel intervention to improve health worker malaria case-management in 107 government health facilities in Kenya. The intervention involved sending text-messages about paediatric outpatient malaria case-management accompanied by “motivating” quotes to health workers’ mobile phones. Ten malaria messages were developed reflecting recommendations from the Kenyan national guidelines. Two messages were delivered per day for 5 working days and the process was repeated for 26 weeks (May to October 2009). The accompanying quotes were unique to each message. The intervention was delivered to 119 health workers and there were significant improvements in correct artemether-lumefantrine (AL) management both immediately after the intervention (November 2009) and 6 months later (May 2010). In-depth interviews with 24 health workers were undertaken to investigate the possible drivers of this change. The results suggest high acceptance of all components of the intervention, with the active delivery of information in an on the job setting, the ready availability of new and stored text messages and the perception of being kept ‘up to date’ as important factors influencing practice. Applying the construct of stages of change we infer that in this intervention the SMS messages were operating primarily at the action and maintenance stages of behaviour change achieving their effect by creating an enabling environment and providing a prompt to action for the implementation of case management practices that had already been accepted as the clinical norm by the health workers. Future trials testing the effectiveness of SMS reminders in creating an enabling environment for the establishment of new norms in clinical practice as well as in providing a prompt to action for the implementation of the new case-management guidelines are justified. PMID:22719911

Science-based health innovation in sub-Saharan Africa

PubMed Central

2010-01-01

In recent years emerging markets such as India, China, and Brazil have developed appropriate business models and lower-cost technological innovations to address health challenges locally and internationally. But it is not well understood what capabilities African countries, with their high disease burden, have in science-based health innovation. This gap in knowledge is addressed by this series in BMC International Health and Human Rights. The series presents the results of extensive on-the-ground research in the form of four country case studies of health and biotechnology innovation, six studies of institutions within Africa involved in health product development, and one study of health venture funds in Africa. To the best of our knowledge it is the first extensive collection of empirical work on African science-based health innovation. The four country cases are Ghana, Rwanda, Tanzania and Uganda. The six case studies of institutions are A to Z Textiles (Tanzania), Acorn Technologies (South Africa), Bioventures venture capital fund (South Africa), the Malagasy Institute of Applied Research (IMRA; Madagascar), the Kenyan Medical Research Institute (KEMRI; Kenya), and Niprisan’s development by Nigeria’s National Institute for Pharmaceutical Research and Development and Xechem (Nigeria). All of the examples highlight pioneering attempts to build technological capacity, create economic opportunities, and retain talent on a continent significantly affected by brain drain. They point to the practical challenges for innovators on the ground, and suggest potentially helpful policies, funding streams, and other support systems. For African nations, health innovation represents an opportunity to increase domestic capacity to solve health challenges; for international funders, it is an opportunity to move beyond foreign aid and dependency. The shared goal is creating self-sustaining innovation that has both health and development impacts. While this is a long-term strategy, this series shows the potential of African-led innovation, and indicates how it might balance realism against opportunity. There is ample scope to learn lessons more systematically from cases like those we discuss; to link entrepreneurs, scientists, funders, and policy-makers into a network to share opportunities and challenges; and ultimately to better support and stimulate African-led health innovation. PMID:21144069

Science-based health innovation in sub-Saharan Africa.

PubMed

Al-Bader, Sara; Masum, Hassan; Simiyu, Ken; Daar, Abdallah S; Singer, Peter A

2010-12-13

In recent years emerging markets such as India, China, and Brazil have developed appropriate business models and lower-cost technological innovations to address health challenges locally and internationally. But it is not well understood what capabilities African countries, with their high disease burden, have in science-based health innovation.This gap in knowledge is addressed by this series in BMC International Health and Human Rights. The series presents the results of extensive on-the-ground research in the form of four country case studies of health and biotechnology innovation, six studies of institutions within Africa involved in health product development, and one study of health venture funds in Africa. To the best of our knowledge it is the first extensive collection of empirical work on African science-based health innovation.The four country cases are Ghana, Rwanda, Tanzania and Uganda. The six case studies of institutions are A to Z Textiles (Tanzania), Acorn Technologies (South Africa), Bioventures venture capital fund (South Africa), the Malagasy Institute of Applied Research (IMRA; Madagascar), the Kenyan Medical Research Institute (KEMRI; Kenya), and Niprisan's development by Nigeria's National Institute for Pharmaceutical Research and Development and Xechem (Nigeria).All of the examples highlight pioneering attempts to build technological capacity, create economic opportunities, and retain talent on a continent significantly affected by brain drain. They point to the practical challenges for innovators on the ground, and suggest potentially helpful policies, funding streams, and other support systems.For African nations, health innovation represents an opportunity to increase domestic capacity to solve health challenges; for international funders, it is an opportunity to move beyond foreign aid and dependency. The shared goal is creating self-sustaining innovation that has both health and development impacts. While this is a long-term strategy, this series shows the potential of African-led innovation, and indicates how it might balance realism against opportunity. There is ample scope to learn lessons more systematically from cases like those we discuss; to link entrepreneurs, scientists, funders, and policy-makers into a network to share opportunities and challenges; and ultimately to better support and stimulate African-led health innovation.

Changes in Vaginal Microbiota and Immune Mediators in HIV-1-Seronegative Kenyan Women Initiating Depot Medroxyprogesterone Acetate.

PubMed

Roxby, Alison C; Fredricks, David N; Odem-Davis, Katherine; Ásbjörnsdóttir, Kristjana; Masese, Linnet; Fiedler, Tina L; De Rosa, Stephen; Jaoko, Walter; Kiarie, James N; Overbaugh, Julie; McClelland, R Scott

2016-04-01

Depot medroxyprogesterone acetate (DMPA) is associated with HIV acquisition. We studied changes in vaginal microbiota and inflammatory milieu after DMPA initiation. In a cohort of HIV-negative Kenyan women, we collected monthly vaginal swabs over 1 year before and after DMPA. Using quantitative polymerase chain reaction, we compared quantities of Lactobacillus crispatus, Lactobacillus jensenii, Lactobacillus iners, Gardnerella vaginalis, and total bacterial load (16S ribosomal RNA gene levels). Six vaginal immune mediators were measured with enzyme-linked immunosorbent assay. Trends in the detection and quantity of bacteria were estimated by logistic and linear mixed-effects regression. From 2010 to 2012, 15 HIV-seronegative women initiated DMPA, contributing 85 visits (median, 6 visits/woman; range, 3-8 visits/woman). The median time of DMPA-exposed follow-up was 8.4 months (range, 1.5-11.6 months). Seven women (46%) had bacterial vaginosis within 70 days before DMPA start. L. iners was detected in 13 women (87%) before DMPA start, but other lactobacilli were rarely detected. Gardnerella vaginalis decreased by 0.21 log10 copies per swab per month after DMPA exposure (P = 0.01). Total bacterial load decreased by 0.08 log10 copies per swab per month of DMPA (P = 0.02). Sustained decreases in interleukin (IL)-6 (P = 0.03), IL-8 (P = 0.04), and IL-1 receptor antagonist (P < 0.001) were also noted. Nine women (60%) had L. crispatus detected post-DMPA, which significantly correlated with reduced IL-6 (P < 0.01) and IL-8 (P = 0.02). Initiation of DMPA led to sustained shifts in vaginal bacterial concentrations and levels of inflammatory mediators. Further studies are warranted to outline components of the vaginal microbiota influenced by DMPA use and impact on HIV susceptibility.

Declining responsiveness of Plasmodium falciparum infections to artemisinin-based combination treatments on the Kenyan coast.

PubMed

Borrmann, Steffen; Sasi, Philip; Mwai, Leah; Bashraheil, Mahfudh; Abdallah, Ahmed; Muriithi, Steven; Frühauf, Henrike; Schaub, Barbara; Pfeil, Johannes; Peshu, Judy; Hanpithakpong, Warunee; Rippert, Anja; Juma, Elizabeth; Tsofa, Benjamin; Mosobo, Moses; Lowe, Brett; Osier, Faith; Fegan, Greg; Lindegårdh, Niklas; Nzila, Alexis; Peshu, Norbert; Mackinnon, Margaret; Marsh, Kevin

2011-01-01

The emergence of artemisinin-resistant P. falciparum malaria in South-East Asia highlights the need for continued global surveillance of the efficacy of artemisinin-based combination therapies. On the Kenyan coast we studied the treatment responses in 474 children 6-59 months old with uncomplicated P. falciparum malaria in a randomized controlled trial of dihydroartemisinin-piperaquine vs. artemether-lumefantrine from 2005 to 2008. (ISRCTN88705995). The proportion of patients with residual parasitemia on day 1 rose from 55% in 2005-2006 to 87% in 2007-2008 (odds ratio, 5.4, 95%CI, 2.7-11.1; P<0.001) and from 81% to 95% (OR, 4.1, 95%CI, 1.7-9.9; P = 0.002) in the DHA-PPQ and AM-LM groups, respectively. In parallel, Kaplan-Meier estimated risks of apparent recrudescent infection by day 84 increased from 7% to 14% (P = 0.1) and from 6% to 15% (P = 0.05) with DHA-PPQ and AM-LM, respectively. Coinciding with decreasing transmission in the study area, clinical tolerance to parasitemia (defined as absence of fever) declined between 2005-2006 and 2007-2008 (OR body temperature >37.5°C, 2.8, 1.9-4.1; P<0.001). Neither in vitro sensitivity of parasites to DHA nor levels of antibodies against parasite extract accounted for parasite clearance rates or changes thereof. The significant, albeit small, decline through time of parasitological response rates to treatment with ACTs may be due to the emergence of parasites with reduced drug sensitivity, to the coincident reduction in population-level clinical immunity, or both. Maintaining the efficacy of artemisinin-based therapy in Africa would benefit from a better understanding of the mechanisms underlying reduced parasite clearance rates. Controlled-Trials.com ISRCTN88705995.

Traditional and scientific conceptions of snakes in Kenya: Alternative perspectives for teaching

NASA Astrophysics Data System (ADS)

Wojnowski, David

A 3-month qualitative study was conducted mid-September through mid-December 2005 to investigate rural southeast Kenyan teachers' conceptions of snakes. Teachers from five villages near Mt. Kasigau were interviewed to obtain an overall sense of what they thought about snakes (n = 60). Of those 60 teachers, 28 attended a 6-hour seminar on reptiles and amphibians. From these 28 teachers, 8 teachers from three villages were afforded additional educational opportunities about snakes, and 2 teachers from this group of 8 were teamed with 2 herpetologists as mentors during the last 2 months of the study. In turn, seven of these eight teachers presented lessons about snakes using live specimens to their fellow teachers and students. Observations of teacher participants during workshops and field outings were documented as well as teacher classroom pedagogy involving snakes before, during, and after the institute. Semi-structured and open-ended interviews were conducted with the eight core teacher participants and field notes were used to document participant observations during serendipitous live snake encounters, of which, there were many. In addition, village elders, including medicine men, one education administrator and one minister were interviewed to obtain a historical cultural backdrop, which teachers expressed as being an important influence while formulating their own conceptions about snakes. Findings suggest that teachers' conceptions of snakes, within a culture where all snakes are feared and killed onsite, can change toward a more favorable orientation when given the opportunity to learn about snakes, witness positive modeling of snake handling through mentoring by herpetologists, and experience direct contact with live harmless nonaggressive snakes (e.g., the Brown House Snake [Lamprohis fuliginosus] and Kenyan Sand Boa [ Eryx colubrinus]).

Access to and value of information to support good practice for staff in Kenyan hospitals

PubMed Central

Muinga, Naomi; Sen, Barbara; Ayieko, Philip; Todd, Jim; English, Mike

2015-01-01

Background Studies have sought to define information needs of health workers within very specific settings or projects. Lacking in the literature is how hospitals in low-income settings are able to meet the information needs of their staff and the use of information communication technologies (ICT) in day-to-day information searching. Objective The study aimed to explore where professionals in Kenyan hospitals turn to for work-related information in their day-to-day work. Additionally, it examined what existing solutions are provided by hospitals with regard to provision of best practice care. Lastly, the study explored the use of ICT in information searching. Design Data for this study were collected in July 2012. Self-administered questionnaires (SAQs) were distributed across 22 study hospitals with an aim to get a response from 34 health workers per hospital. Results SAQs were collected from 657 health workers. The most popular sources of information to guide work were fellow health workers and printed guidelines while the least popular were scientific journals. Of value to health workers were: national treatment policies, new research findings, regular reports from surveillance data, information on costs of services and information on their performance of routine clinical tasks; however, hospitals only partially met these needs. Barriers to accessing information sources included: ‘not available/difficult to get’ and ‘difficult to understand’. ICT use for information seeking was reported and with demographic specific differences noted from the multivariate logistic regression model; nurses compared to medical doctors and older workers were less likely to use ICT for health information searching. Barriers to accessing Internet were identified as: high costs and the lack of the service at home or at work. Conclusions Hospitals need to provide appropriate information by improving information dissemination efforts and providing an enabling environment that allows health workers find the information they need for best practice. PMID:25979113

Access to and value of information to support good practice for staff in Kenyan hospitals.

PubMed

Muinga, Naomi; Sen, Barbara; Ayieko, Philip; Todd, Jim; English, Mike

2015-01-01

Studies have sought to define information needs of health workers within very specific settings or projects. Lacking in the literature is how hospitals in low-income settings are able to meet the information needs of their staff and the use of information communication technologies (ICT) in day-to-day information searching. The study aimed to explore where professionals in Kenyan hospitals turn to for work-related information in their day-to-day work. Additionally, it examined what existing solutions are provided by hospitals with regard to provision of best practice care. Lastly, the study explored the use of ICT in information searching. Data for this study were collected in July 2012. Self-administered questionnaires (SAQs) were distributed across 22 study hospitals with an aim to get a response from 34 health workers per hospital. SAQs were collected from 657 health workers. The most popular sources of information to guide work were fellow health workers and printed guidelines while the least popular were scientific journals. Of value to health workers were: national treatment policies, new research findings, regular reports from surveillance data, information on costs of services and information on their performance of routine clinical tasks; however, hospitals only partially met these needs. Barriers to accessing information sources included: 'not available/difficult to get' and 'difficult to understand'. ICT use for information seeking was reported and with demographic specific differences noted from the multivariate logistic regression model; nurses compared to medical doctors and older workers were less likely to use ICT for health information searching. Barriers to accessing Internet were identified as: high costs and the lack of the service at home or at work. Hospitals need to provide appropriate information by improving information dissemination efforts and providing an enabling environment that allows health workers find the information they need for best practice.

Adenovirus type 35-vectored tuberculosis vaccine has an acceptable safety and tolerability profile in healthy, BCG-vaccinated, QuantiFERON(®)-TB Gold (+) Kenyan adults without evidence of tuberculosis.

PubMed

Walsh, Douglas S; Owira, Victorine; Polhemus, Mark; Otieno, Lucas; Andagalu, Ben; Ogutu, Bernhards; Waitumbi, John; Hawkridge, Anthony; Shepherd, Barbara; Pau, Maria Grazia; Sadoff, Jerald; Douoguih, Macaya; McClain, J Bruce

2016-05-05

In a Phase 1 trial, we evaluated the safety of AERAS-402, an adenovirus 35-vectored TB vaccine candidate expressing 3 Mycobacterium tuberculosis (Mtb) immunodominant antigens, in subjects with and without latent Mtb infection. HIV-negative, BCG-vaccinated Kenyan adults without evidence of tuberculosis, 10 QuantiFERON(®)-TB Gold In-Tube test (QFT-G)(-) and 10 QFT-G(+), were randomized 4:1 to receive AERAS-402 or placebo as two doses, on Days 0 and 56, with follow up to Day 182. There were no deaths, serious adverse events or withdrawals. For 1 AERAS-402 QFT-G(-) and 1 AERAS-402 QFT-G(+) subject, there were 3 self-limiting severe AEs of injection site pain: 1 after the first vaccination and 1 after each vaccination, respectively. Two additional severe AEs considered vaccine-related were reported after the first vaccination in AERAS-402 QFT-G(+) subjects: elevated blood creatine phosphokinase and neutropenia, the latter slowly improving but remaining abnormal until study end. AERAS-402 was not detected in urine or throat cultures for any subject. In intracellular cytokine staining studies, curtailed by technical issues, we saw modest CD4+ and CD8+ T cell responses to Mtb Ag85A/b peptide pools among both QFT-G(-) and (+) subjects, with trends in the CD4+ T cells suggestive of boosting after the second vaccine dose, slightly more so in QFT-G(+) subjects. CD4+ and CD8+ responses to Mtb antigen TB10.4 were minimal. Increases in Adenovirus 35 neutralizing antibodies from screening to end of study, seen in 50% of AERAS-402 recipients, were mostly minimal. This small study confirms acceptable safety and tolerability profiles for AERAS-402, in line with other Phase 1 studies of AERAS-402, now to include QFT-G(+) subjects. Published by Elsevier Ltd.

Children's Reading Ability in Early Primary Schooling: Challenges for a Kenyan Rural Community

ERIC Educational Resources Information Center

Mwoma, Teresa

2017-01-01

School outcomes and good performance in different subjects depends on children's ability to read. Thus teaching children on how to read during early grades is critical in promoting learning to read. More advanced skills acquired in later grades depend on early grade learning, so children who do not acquire these reading skills in their early…

Predictors of Attitudes toward Disability and Employment Policy Issues among Undergraduate Students at the University of Nairobi

ERIC Educational Resources Information Center

Mamboleo, George Isaboke

2009-01-01

Disability rights issues are an emerging area of discourse in Kenya. Persons with disabilities in Kenya face many barriers to integration into the larger Kenyan society possibly due to barriers such as societal negative attitudes. Research has indicated that the greatest barrier to rehabilitation of persons with disabilities is negative attitudes…

History Teaching in Kenyan Secondary School, for Peace, Reconciliation and National Integration

ERIC Educational Resources Information Center

Chang'ach, John Koskey

2011-01-01

The main objectives of teaching history and government are: First, to demonstrate an understanding of how people and events of the past has influenced the ways in which people live and behave; Second, to appreciate the need for an importance of mutual responsibility; and Third, to develop a sense of patriotism and national pride. The paper seeks…

Vitamin B-12 in breast milk and diet, and riboflavin in breastmilk, are very low in Kenyan lactating women, although vitamin B-6 is sufficient.

USDA-ARS?s Scientific Manuscript database

Background: Breastmilk B-vitamin concentrations can fluctuate with maternal intake. Low maternal intake of B-vitamins may result in low B-vitamin breastmilk concentrations and consequently B-vitamin deficiency in their infants because infants 0–6 months are recommended to be exclusively breastfed. T...

The Gender-Education-Poverty Nexus: Kenyan Youth's Perspective on Being Young, Gendered and Poor

ERIC Educational Resources Information Center

Chege, Fatuma N.; Arnot, Madeleine

2012-01-01

This article argues that the role of education within the gender-poverty debate needs to be reconceptualised. It stresses the importance of conceptualising the gender-education-poverty nexus as a cluster of complex interactive combinations and bonds in which education outcomes are shaped by, and shape, both poverty and gender. The aim of the paper…

Problem Based Learning Technique and Its Effect on Acquisition of Linear Programming Skills by Secondary School Students in Kenya

ERIC Educational Resources Information Center

Nakhanu, Shikuku Beatrice; Musasia, Amadalo Maurice

2015-01-01

The topic Linear Programming is included in the compulsory Kenyan secondary school mathematics curriculum at form four. The topic provides skills for determining best outcomes in a given mathematical model involving some linear relationship. This technique has found application in business, economics as well as various engineering fields. Yet many…

Music and Physical Play: What Can We Learn from Early Childhood Teachers in Kenya?

ERIC Educational Resources Information Center

Freshwater, Amy; Sherwood, Elizabeth; Mbugua, Esther

2008-01-01

Sharing classroom practices across international borders can add new dimensions to teaching methods, no matter where one calls home. With this idea in mind, the authors (two U.S. early childhood teacher educators and a Kenyan-born U.S. early childhood teacher) have corresponded for several years through e-mail with a small group of early childhood…

Students Selection for University Course Admission at the Joint Admissions Board (Kenya) Using Trained Neural Networks

ERIC Educational Resources Information Center

Wabwoba, Franklin; Mwakondo, Fullgence M.

2011-01-01

Every year, the Joint Admission Board (JAB) is tasked to determine those students who are expected to join various Kenyan public universities under the government sponsorship scheme. This exercise is usually extensive because of the large number of qualified students compared to the very limited number of slots at various institutions and the…

Growing Up at the "Margins": Concerns, Aspirations, and Expectations of Young People Living in Nairobi's Slums

ERIC Educational Resources Information Center

Kabiru, Caroline W.; Mojola, Sanyu A.; Beguy, Donatien; Okigbo, Chinelo

2013-01-01

We explore the concerns, challenges, aspirations, and expectations of sub-Saharan African youth, and investigate how these youth cope with neighborhood constraints to aspiration achievement. We draw on cross-sectional survey data from 4,033 12-22-year-olds (50.3% males) from two Kenyan urban slums and subsequent in-depth interviews conducted with…

Benefits and Challenges of Introducing a Blended Project-Based Approach in Higher Education: Experiences from a Kenyan University

ERIC Educational Resources Information Center

Munezero, Myriam D.; Bekuta, Balozi K.

2016-01-01

This article investigates a blended project-based approach that was introduced to forestry and ICT undergraduates as an extracurricular activity at the University of Eldoret, Kenya. The approach blends problem-based learning and participatory design to solve real-life forestry problems. Even though the use of the approach itself is not novel, in…

A Survey of Approaches Used in Teaching Reading in Early Childhood Classes in Dagoretti and Westlands Divisions, Nairobi County, Kenya

ERIC Educational Resources Information Center

Marima, Esther Wairimu

2016-01-01

Reading proficiency has been identified as one of the most reliable indicators of whether a learner will attain the competence needed to achieve academic success and contribute actively to society. Research findings in Kenyan primary and secondary schools reveal inadequate reading skills among the students. There are different approaches in…

Self-Regulation of Facebook Usage and Academic Performance of Students in Kenyan Universities

ERIC Educational Resources Information Center

Wanjohi, Racheal N.; Mwebi, Robert B.; Nyang'ara, Naftal M.

2015-01-01

The increasing connectivity of places to the internet platform has led to widespread use of the social media platforms in homes, workplaces and schools wherein it is preferred by mostly the young people christened as dot.com generation. The use of social media platforms has a potential effect on the productivity of the users either in their places…

Teaching Conflict Management Skills in Schools: Prerequisite for Peace and Achievement of Millennium Development Goals in Kenya

ERIC Educational Resources Information Center

Dawo, Jane Irene A.; Wagah, Mical Ongachi

2011-01-01

The Kenyan society is experiencing a lot of conflicts, some with devastating effects such as deaths, starvation, disease and destruction. These normally arise out of difference between people. Secondary schools being part of the society have not been left out of this challenge as evidenced by mass media reports on strikes, demonstrations and…

Quality control of Kato slide counts for Schistosoma mansoni: a review of 12 years' experience in Kenya.

PubMed Central

Sturrock, R. F.; Ouma, J. H.; Kariuki, H. C.; Thiongo, F. W.; Koech, D. K.; Butterworth, A. E.

1997-01-01

A total of 19 annual or biannual audits were performed over a 12-year period by an independent microscopist on randomized subsamples of Kato slides examined for Schistosoma mansoni eggs by Kenyan microscopists from the Division of Vector-borne Diseases (DVBD). The recounts were invariably lower than the originals owing to some deterioration of the preparations between counts, but the two were strongly correlated: significant regressions of recounts on counts taking up 80-90% of the observed variance. Observer bias differed significantly between microscopists but remained stable over time, whereas repeatability of recounts on counts dropped slightly in periods of maximum work load but did not vary systematically with time. Approximately 7% of the counts and recounts disagreed on the presence or absence of eggs, but less than a third of these were negatives that were found positive on recount. False negatives dropped to 1.3% if duplicate counts were considered. The performance of the Kenyan microscopists was remarkably high and consistent throughout the 12-year period. This form of quality control is suitable for projects where limited funds preclude full-time supervisors using more sophisticated systems. PMID:9447781

Genetic homogeneity of goat malaria parasites in Asia and Africa suggests their expansion with domestic goat host.

PubMed

Kaewthamasorn, Morakot; Takeda, Mika; Saiwichai, Tawee; Gitaka, Jesse N; Tiawsirisup, Sonthaya; Imasato, Yuhei; Mossaad, Ehab; Sarani, Ali; Kaewlamun, Winai; Channumsin, Manun; Chaiworakul, Suchart; Katepongpun, Wichit; Teeveerapunya, Surapong; Panthong, Jarus; Mureithi, Dominic K; Bawm, Saw; Htun, Lat Lat; Win, Mar Mar; Ismail, Ahmed Ali; Ibrahim, Abdalla Mohamed; Suganuma, Keisuke; Hakimi, Hassan; Nakao, Ryo; Katakura, Ken; Asada, Masahito; Kaneko, Osamu

2018-04-11

Plasmodium was first identified in a goat in Angola in 1923, and only recently characterized by DNA isolation from a goat blood sample in Zambia. Goats were first domesticated in the Fertile Crescent approximately 10,000 years ago, and are now globally distributed. It is not known if the Plasmodium identified in African goats originated from parasites circulating in the local ungulates, or if it co-evolved in the goat before its domestication. To address this question, we performed PCR-based surveillance using a total of 1,299 goat blood samples collected from Sudan and Kenya in Africa, Iran in west Asia, and Myanmar and Thailand in southeast Asia. Plasmodium DNA was detected from all locations, suggesting that the parasite is not limited to Africa, but widely distributed. Whole mitochondrial DNA sequences revealed that there was only one nucleotide substitution between Zambian/Kenyan samples and others, supporting the existence of a goat-specific Plasmodium species, presumably Plasmodium caprae, rather than infection of goats by local ungulate malaria parasites. We also present the first photographic images of P. caprae, from one Kenyan goat sample.

High Levels of Asymptomatic and Subpatent Plasmodium falciparum Parasite Carriage at Health Facilities in an Area of Heterogeneous Malaria Transmission Intensity in the Kenyan Highlands

PubMed Central

Stresman, Gillian H.; Stevenson, Jennifer C.; Ngwu, Nnenna; Marube, Elizabeth; Owaga, Chrispin; Drakeley, Chris; Bousema, Teun; Cox, Jonathan

2014-01-01

In endemic settings, health facility surveys provide a convenient approach to estimating malaria transmission intensity. Typically, testing for malaria at facilities is performed on symptomatic attendees, but asymptomatic infections comprise a considerable proportion of the parasite reservoir. We sampled individuals attending five health facilities in the western Kenyan highlands. Malaria prevalence by rapid diagnostic test (RDT) was 8.6–32.9% in the health facilities. Of all polymerase chain reaction-positive participants, 46.4% (95% confidence interval [95% CI] = 42.6–50.2%) of participants had infections that were RDT-negative and asymptomatic, and 55.9% of those infections consisted of multiple parasite clones as assessed by merozoite surface protein-2 genotyping. Subpatent infections were more common in individuals reporting the use of non-artemisinin–based antimalarials in the 2 weeks preceding the survey (odds ratio = 2.49, 95% CI = 1.04–5.92) compared with individuals not reporting previous use of antimalarials. We observed a large and genetically complex pool of subpatent parasitemia in the Kenya highlands that must be considered in malaria interventions. PMID:25331807

Cultural factors associated with the intent to be screened for prostate cancer among adult men in a rural Kenyan community.

PubMed

Mutua, Kinyao; Pertet, Anne M; Otieno, Careena

2017-11-23

The aim of this study was to determine cultural factors associated with prostate cancer screening intent among adult Kenyan African men. A cross-sectional quantitative study with an analytic design was carried out in a randomly selected sample of 155 adult men aged 25-98 years living in a rural community in Kenya. Constructs from the Theory of Planned Behaviour were used to guide this study. A 5 -point Likert scale was used to assess fatalistic beliefs, fear, perceived benefits, and family influence. A structured questionnaire was used to collect quantitative data at the household level. Only 2.4% of the study participants had been screened for prostate cancer. About 2/3rd (64%) of the participants felt that they were at risk of getting prostate cancer; 44% intended to be screened within the following 6 months. Mean scores on a 5-point Likert scale indicated: strong beliefs in the benefits of prostate screening (4.2 (±SD .8), men aged over 40 were not perceived to be at risk of getting prostate cancer (1.3 ± .6), relatively high fatalistic beliefs of prostate cancer screening (3.6 (±SD .8), high degree of fear or apprehension of prostate cancer screening (3.2 (±SD 1.2), and a high level of influence of family members in prostate cancer screening (3.9 (±SD 1.0). The Wald criterion demonstrated that only family influence made a significant contribution to the intent to screen for prostate cancer (p = 0.031). Age, education, marital status, fatalism, fear, and benefit of screening were not associated with the intent to screen for prostate cancer. Strong beliefs of the benefits of prostate screening tended to be surpassed by relatively high fatalistic beliefs and fear or apprehension in prostate cancer screening. The family plays an important role in influencing decision making related to prostate cancer screening in Africans.

Identifying interventions to help rural Kenyan mothers cope with food insecurity: results of a focused ethnographic study.

PubMed

Pelto, Gretel H; Armar-Klemesu, Margaret

2015-12-01

An ethnographic study was conducted in two areas in southern and western Kenya to identify potential interventions to improve the quality, availability and affordability of foods consumed by infants and young children. A cultural-ecological model of determinants of nutrition identified the sectors of information for data collection related to infant and young child (IYC) diet and feeding-related behaviours, and the focused ethnographic study manual was used to guide the research. The results provide qualitative evidence about facilitators and constraints to IYC nutrition in the two geographical areas and document their inter-connections. We conclude with suggestions to consider 13 potential nutrition-sensitive interventions. The studies provide empirical ethnographic support for arguments concerning the importance of combining nutrition-specific and nutrition-sensitive interventions through a multi-sectoral, integrated approach to improve the nutrition of infants and young children in low-income, resource-constrained populations. They also document the value of ethnography as a component of landscape analysis in nutrition programme and policy planning. Key messages In addition to constraints on infant and young child diet that originate in environmental and technological conditions in both agro-ecological zones, other factors that affect feeding practices include features of social organisation, household access to social support, caregivers income-earning activities and their own health. The results of the ethnographies, which highlight the importance of obtaining the knowledge and perspectives of caregivers of infants and young children, reveal the interactions of the multiple factors that affect child nutrition and the need for simultaneous nutrition-sensitive interventions to complement nutrition-specific intervention actions. Most caregivers in both areas not only understood the importance of diet and food quality for child survival, they also regarded it as essential for child growth and development. This indicates that caregivers in these rural Kenyan communities have adopted the basic biomedical interpretation of the importance of child nutrition as an integral part of their 'knowledge frameworks'. © 2015 John Wiley & Sons Ltd.

Dengue and yellow fever virus vectors: seasonal abundance, diversity and resting preferences in three Kenyan cities.

PubMed

Agha, Sheila B; Tchouassi, David P; Bastos, Armanda D S; Sang, Rosemary

2017-12-29

The transmission patterns of dengue (DENV) and yellow fever (YFV) viruses, especially in urban settings, are influenced by Aedes (Stegomyia) mosquito abundance and behavior. Despite recurrent dengue outbreaks on the Kenyan coast, these parameters remain poorly defined in this and other areas of contrasting dengue endemicity in Kenya. In assessing the transmission risk of DENV/YFV in three Kenyan cities, we determined adult abundance and resting habits of potential Aedes (Stegomyia) vectors in Kilifi (dengue-outbreak prone), and Nairobi and Kisumu (no dengue outbreaks reported). In addition, mosquito diversity, an important consideration for changing mosquito-borne disease dynamics, was compared. Between October 2014 and June 2016, host-seeking adult mosquitoes were sampled using CO 2 -baited BG-Sentinel traps (12 traps daily) placed in vegetation around homesteads, across study sites in the three major cities. Also, indoor and outdoor resting mosquitoes were sampled using Prokopack aspirators. Three samplings, each of five consecutive days, were conducted during the long-rains, short-rains and dry season for each city. Inter-city and seasonal variation in mosquito abundance and diversity was evaluated using general linear models while mosquito-resting preference (indoors vs outdoors) was compared using Chi-square test. Aedes aegypti, which comprised 60% (n = 7772) of the total 12,937 host-seeking mosquitoes collected, had comparable numbers in Kisumu (45.2%, n = 3513) and Kilifi (37.7%, n = 2932), both being significantly higher than Nairobi (17.1%, n = 1327). Aedes aegypti abundance was significantly lower in the short-rains and dry season relative to the long-rains (P < 0.0001). Aedes bromeliae, which occurred in low numbers, did not differ significantly between seasons or cities. Mosquito diversity was highest during the long-rains and in Nairobi. Only 10% (n = 43) of the 450 houses aspirated were found positive for resting Ae. aegypti, with overall low captures in all areas. Aedes aegypti densities were comparable indoors/outdoors in Kilifi; but with higher densities outdoors than indoors in Kisumu and Nairobi. The presence and abundance of Ae. aegypti near human habitations and dwellings, especially in Kilifi/Kisumu, is suggestive of increased DENV transmission risk due to higher prospects of human vector contact. Despite low abundance of Ae. bromeliae suggestive of low YFV transmission risk, its proximity to human habitation as well as the observed diversity of potential YFV vectors should be of public health concern and monitored closely for targeted control. The largely outdoor resting behavior for Ae. aegypti provides insights for targeted adult vector control especially during emergency outbreak situations.

The prevalence of mental disorders among upper primary school children in Kenya.

PubMed

Ndetei, David Musyimi; Mutiso, Victoria; Musyimi, Christine; Mokaya, Aggrey G; Anderson, Kelly K; McKenzie, Kwame; Musau, Abednego

2016-01-01

The aim of this study was to estimate the prevalence and correlates of mental disorders among upper primary school children in grades five through seven in Kenya. The Youth Self Report (YSR) instrument was adapted for use in Kenyan schools and administered to 2267 school children in grades five through seven from 23 randomly selected schools. We estimated the prevalence of DSM-IV mental disorders, and used logistic regression analyses to examine the socio-demographic factors associated with each disorder. The prevalence of any mental disorder among Kenyan school children was 37.7 % (95 % CI = 35.7-39.7 %). Somatic complaints were the most prevalent (29.6 %, 95 % CI = 27.8-31.5 %), followed by affective disorders (14.1 %, 95 % CI = 12.7-15.6 %) and conduct disorder (12.5 %, 95 % CI = 11.2-13.9). The presence of one or more comorbid mental disorder was seen among 18.2 % (95 % CI = 16.6-19.8 %) of children. Male sex, living in a peri-urban vs. rural area, being held back in school, having divorced or separated parents, and having an employed mother were associated with an increased likelihood of having most of the mental disorders examined, whereas increasing age was associated with a reduced likelihood. We observed a high prevalence of mental disorders among school children in Kenya. If not detected early, these disorders may interfere with children's psychological, social, and educational development. Our findings highlight the importance of implementing screening measures in schools that can detect single and multiple disorders in order to improve the mental health and well-being of the next generation.

Correlates of disclosure of sexual violence among Kenyan youth.

PubMed

Boudreau, Courtney L; Kress, Howard; Rochat, Roger W; Yount, Kathryn M

2018-05-01

Sexual violence (SV) against children is a global health and human rights issue that can have short and long-term consequences for health and wellbeing. Disclosing SV increases the likelihood that children can access health and protective services and receive psychosocial support. Research in high-income countries has found that child SV survivors are more likely to disclose when they are girls/women, experience fewer SV events, and experience SV perpetrated by a stranger. No studies have examined correlates of SV disclosure in Kenya. The objective of this research was to assess the correlates of disclosing SV among Kenyan youth ages 13-24 who reported an SV experience before age 18. In 2010, the Kenya Ministry of Gender, Children and Social Development, the U.S. Centers for Disease Control and Prevention's (CDC) Division of Violence Prevention, the UNICEF Kenya Country Office, and the Kenya National Bureau of Statistics (KNBS) conducted a national survey of violence against children. These data were used to conduct weighted logistic regression analyses to determine which factors were correlated with reporting SV disclosure. Among the 27.8% of girls/women and 14.5% of boys/men who reported SV before age 18, 44.6% of girls/women and 28.2% of boys/men reported to have disclosed the experience. In weighted logistic regression analysis, the odds of disclosure were lower among survivors who were boys/men and among survivors who reported more SV events, and higher when any perpetrator was a family member. More context-specific research on SV disclosure among young people is needed globally. Copyright © 2018 Elsevier Ltd. All rights reserved.

Cost, cost-efficiency and cost-effectiveness of integrated family planning and HIV services.

PubMed

Shade, Starley B; Kevany, Sebastian; Onono, Maricianah; Ochieng, George; Steinfeld, Rachel L; Grossman, Daniel; Newmann, Sara J; Blat, Cinthia; Bukusi, Elizabeth A; Cohen, Craig R

2013-10-01

To evaluate costs, cost-efficiency and cost-effectiveness of integration of family planning into HIV services. Integration of family planning services into HIV care and treatment clinics. A cluster-randomized trial. Twelve health facilities in Nyanza, Kenya were randomized to integrate family planning into HIV care and treatment; six health facilities were randomized to (nonintegrated) standard-of-care with separately delivered family planning and HIV services. We assessed costs, cost-efficiency (cost per additional use of more effective family planning), and cost-effectiveness (cost per pregnancy averted) associated with the first year of integration of family planning into HIV care. More effective family planning methods included oral and injectable contraceptives, subdermal implants, intrauterine device, and female and male sterilization. We collected cost data through interviews with study staff and review of financial records to determine costs of service integration. Integration of services was associated with an average marginal cost of $841 per site and $48 per female patient. Average overall and marginal costs of integration were associated with personnel costs [initial ($1003 vs. $872) and refresher ($498 vs. $330) training, mentoring ($1175 vs. $902) and supervision ($1694 vs. $1636)], with fewer resources required for other fixed ($18 vs. $0) and recurring expenses ($471 vs. $287). Integration was associated with a marginal cost of $65 for each additional use of more effective family planning and $1368 for each pregnancy averted. Integration of family planning and HIV services is feasible, inexpensive to implement, and cost-efficient in the Kenyan setting, and thus supports current Kenyan integration policy.

Improving Literacy Instruction in Kenya through Teacher Professional Development and Text Messages Support: A Cluster Randomized Trial

ERIC Educational Resources Information Center

Jukes, Matthew C. H.; Turner, Elizabeth L.; Dubeck, Margaret M.; Halliday, Katherine E.; Inyega, Hellen N.; Wolf, Sharon; Zuilkowski, Stephanie Simmons; Brooker, Simon J.

2017-01-01

We evaluated a program to improve literacy instruction on the Kenyan coast using training workshops, semiscripted lesson plans, and weekly text-message support for teachers to understand its impact on students' literacy outcomes and on the classroom practices leading to those outcomes. The evaluation ran from the beginning of Grade 1 to the end of…

School Governance, Teacher Incentives, and Pupil-Teacher Ratios: Experimental Evidence from Kenyan Primary Schools. NBER Working Paper No. 17939

ERIC Educational Resources Information Center

Duflo, Esther; Dupas, Pascaline; Kremer, Michael

2012-01-01

We examine a program that enabled Parent-Teacher Associations (PTAs) in Kenya to hire novice teachers on short-term contracts, reducing class sizes in grade one from 82 to 44 on average. PTA teachers earned approximately one-quarter as much as teachers operating under central government civil-service institutions but were absent one day per week…

The "Ideal" vs. the "Reality": Medium of Instruction Policy and Implementation in Different Class Levels in a Western Kenyan School

ERIC Educational Resources Information Center

Jones, Jennifer M.

2014-01-01

This paper investigates the perceptions of teachers from one Sabaot dominated primary school in western Kenya regarding the medium of instruction (MoI) policy in different class levels. While their "ideal" MoI policy bears some resemblance to the official policy which advocates mother tongue (MT) as medium in lower primary and English in…

Differential Bundle Functioning Analysis of the Self-Description Questionnaire Self-Concept Scale for Kenyan Female and Male Students Using the MIMIC Model

ERIC Educational Resources Information Center

Mucherah, Winnie; Finch, W. Holmes; Keaikitse, Setlhomo

2012-01-01

Understanding adolescent self-concept is of great concern for educators, mental health professionals, and parents, as research consistently demonstrates that low self-concept is related to a number of problem behaviors and poor outcomes. Thus, accurate measurements of self-concept are key, and the validity of such measurements, including the…

Multilingual Literacy Skill Development in Kenya: Results from Medium Scale Randomized Controlled Trials

ERIC Educational Resources Information Center

Piper, Benjamin

2016-01-01

If children do not learn how to read in the first few years of primary school, they at greater risk of dropping out. It is therefore crucial to identify and test interventions that have the potential of making a large impact, can be implemented quickly, and are affordable to be taken to scale by the Kenyan government. This paper presents the…

The Relationship between Subsidized Free Day Secondary Education and Retention in Secondary Schools in Kenya

ERIC Educational Resources Information Center

James, Asena Muganda; Simiyu, Aggrey Mukasa; Riechi, Andrew

2016-01-01

A workforce that can adapt to the fast changing global dynamics is critical for sustainable growth and development. Secondary level segment in the education cycle of a Kenyan plays a key role in the development of this workforce and is important since it de-links one from elementary (primary) learning, provides a chance for one to complete the…

The Perceptions of the Preparedness of Medical Graduates to Take on Internship Responsibilities in Low Resource Hospitals in Kenya

ERIC Educational Resources Information Center

Muthaura, Patricia N.; Khamis, Tashmin K.

2013-01-01

The Aga Khan University is developing an Undergraduate Medical Education (UGME) curriculum for implementation in East Africa in 2016, which aims to serve the health needs of the populations there. Pilot focus group discussions of recent interns were conducted at the Aga Khan University Hospital, Nairobi to find out: (1) If Kenyan medical students…

The Effect of Free Primary Education Policy on Late School Entry in Urban Primary Schools in Kenya

ERIC Educational Resources Information Center

Ngware, Moses W.; Oketch, Moses; Ezeh, Alex C.; Mutisya, Maurice

2013-01-01

Late school entry is driven by several factors, one of the key ones being the cost barrier to schooling. Policies such as free primary education (FPE) that advocate for universal coverage are therefore partly aimed at removing the cost barrier. The Kenyan Government, like many in sub-Saharan Africa (SSA), introduced FPE in 2003 with the aim of…

Low plasma vitamin B-12 in Kenyan school children is highly prevalent and improved by supplemental animal source foods

USDA-ARS?s Scientific Manuscript database

The high prevalence of vitamin B-12 deficiency in many regions of the world is becoming recognized as a widespread public health problem, but it is not known to what extent this deficiency results from a low intake of the vitamin or from its malabsorption from food. In rural Kenya, where a previous ...

Iron in Micronutrient Powder Promotes an Unfavorable Gut Microbiota in Kenyan Infants

PubMed Central

Tang, Minghua; Frank, Daniel N.; Hendricks, Audrey E.; Ir, Diana; Esamai, Fabian; Liechty, Edward; Hambidge, K. Michael; Krebs, Nancy F.

2017-01-01

Iron supplementation may have adverse health effects in infants, probably through manipulation of the gut microbiome. Previous research in low-resource settings have focused primarily on anemic infants. This was a double blind, randomized, controlled trial of home fortification comparing multiple micronutrient powder (MNP) with and without iron. Six-month-old, non- or mildly anemic, predominantly-breastfed Kenyan infants in a rural malaria-endemic area were randomized to consume: (1) MNP containing 12.5 mg iron (MNP+Fe, n = 13); (2) MNP containing no iron (MNP−Fe, n = 13); or (3) Placebo (CONTROL, n = 7), from 6–9 months of age. Fecal microbiota were profiled by high-throughput bacterial 16S rRNA gene sequencing. Markers of inflammation in serum and stool samples were also measured. At baseline, the most abundant phylum was Proteobacteria (37.6% of rRNA sequences). The proteobacterial genus Escherichia was the most abundant genus across all phyla (30.1% of sequences). At the end of the intervention, the relative abundance of Escherichia significantly decreased in MNP−Fe (−16.05 ± 6.9%, p = 0.05) and CONTROL (−19.75 ± 4.5%, p = 0.01), but not in the MNP+Fe group (−6.23 ± 9%, p = 0.41). The second most abundant genus at baseline was Bifidobacterium (17.3%), the relative abundance of which significantly decreased in MNP+Fe (−6.38 ± 2.5%, p = 0.02) and CONTROL (−8.05 ± 1.46%, p = 0.01), but not in MNP-Fe (−4.27 ± 5%, p = 0.4445). Clostridium increased in MNP-Fe only (1.9 ± 0.5%, p = 0.02). No significant differences were observed in inflammation markers, except for IL-8, which decreased in CONTROL. MNP fortification over three months in non- or mildly anemic Kenyan infants can potentially alter the gut microbiome. Consistent with previous research, addition of iron to the MNP may adversely affect the colonization of potential beneficial microbes and attenuate the decrease of potential pathogens. PMID:28753958

Research on AIDS: knowledge, attitudes and practices among street youth.

PubMed

Barker, G

1993-01-01

CHILDHOPE (with funding from the United Nations Children's Fund and the aid of nongovernmental organizations in the Philippines, Thailand, Colombia, and Kenya) conducted surveys of street youth in order to ascertain their knowledge, attitudes, and practices in regard to sex and the prevention of human immunodeficiency virus (HIV) infections and other sexually transmitted diseases (STDs). The youth also participated in acquired immunodeficiency syndrome (AIDS) prevention and sex education activities. Youth from all 4 sites reported early sexual activity and multiple partners. Sex was used in all 4 sites to obtain pleasure (recreation), income (prostitution), food or shelter (survival sex), and power (gang rape). Philippine youth reported prostitution and survival sex, including homosexual sex, with foreigners and locals. Kenyan girls reported both prostitution (their main occupation) and survival sex. Kenyan males reported prostitution with foreigners and locals, and rapes of girls. In Bogota, males reported rapes of girls, and gang rapes of females for punishment or initiation. They also reported using sex workers and exchanging sex with men or women for food and shelter. Females from Bogota reported that their "friends" sometimes used survival sex to support their children; nearly all had been previously involved in survival sex on the street. Sexual abuse was common in Kenya and the Philippines; some youth in Manila were abused at shelters. In all 4 sites, there was a high awareness of AIDS and STDs, but information was often incorrect, especially in regard to transmission and treatment of STDs. Although nearly all of the youth knew about modes of transmission of HIV, those from the Philippines and Colombia did not have a personal realization or fear that they could contract it, while those from Kenya and Thailand believed they were at high risk and wanted assistance. 20/21 Kenyan girls were tested by the Undugu Society for HIV after detection of current STD infections in 7 of them; 4 were HIV positive. 2 of these have returned home, and 2 are being provided shelter, counseling and support by the Society. Without changing the problems that create a need for survival sex among youth, little can be done about promoting safe sex and healthy lifestyles.

Peer mentors, mobile phone and pills: collective monitoring and adherence in Kenyatta National Hospital's HIV treatment programme

PubMed Central

Moyer, Eileen

2014-01-01

In 2006, the Kenyan state joined the international commitment to make antiretroviral treatment free in public health institutions to people infected with HIV. Less than a decade later, treatment has reached over 60% of those who need it in Kenya. This paper, which is based on an in-depth ethnographic case study of the HIV treatment programme at Kenyatta National Hospital, conducted intermittently between 2008 and 2014, examines how HIV-positive peer mentors encourage and track adherence to treatment regimens within and beyond the clinic walls using mobile phones and computer technology. This research into the everyday practices of patient monitoring demonstrates that both surveillance and adherence are collective activities. Peer mentors provide counselling services, follow up people who stray from treatment regimens, and perform a range of other tasks related to patient management and treatment adherence. Despite peer mentors’ involvement in many tasks key to encouraging optimal adherence, their role is rarely acknowledged by co-workers, hospital administrators, or public health officials. Following a biomedical paradigm, adherence at Kenyatta and in Kenya is framed by programme administrators as something individual clients must do and for which they must be held accountable. This framing simultaneously conceals the sociality of adherence and undervalues the work of peer mentors in treatment programmes. PMID:25175291

Effect of eliminating open defecation on diarrhoeal morbidity: an ecological study of Nyando and Nambale sub-counties, Kenya.

PubMed

Njuguna, John

2016-08-04

Defecating in the open predisposes people to soil transmitted helminthes and diarrhoeal diseases. An estimated 5.6 million Kenyans defecate in the open. Kenya launched a program to eradicate open defecation by 2013 in the rural areas. By end of 2013, only two sub-counties had eliminated open defecation. These are Nambale and Nyando. The study looked at the impact of eradicating open defecation on diarrhea prevalence among children in these two sub-counties. Data on diarrhoea morbidity among children under 5 years was extracted from the Kenya Health Information System for all the sub-counties in Busia and Kisumu counties for 2012, 2013 and 2014 respectively. Prevalence was calculated for each sub-county in Kisumu for comparison with Nyando's. Prevalence was also calculated for each sub-county in Busia County and compared to that of Nambale sub-county. A Mann-Whitney U Test was done to test the null hypothesis that diarrhoea prevalence was similar in both open defecation and open defecation free sub-counties. A Mann-Whitney U Test revealed significant difference in diarrhoeal prevalence of open defecation sub-counties (Md = 18.4, n = 34) and open defecation free sub-counties (Md = 9.8, n = 5), U = 9, z = -3.2, p = .001. Among the two Counties, Nambale had the lowest prevalence. It recorded a decline from 9.8 to 5.7 % across the three years. Prevalence for diarrhoea cases in Nyando declined from 19.1 to 15.2 % across the three years. Nyando initially had the second highest prevalence in Kisumu County and by 2014 it had the lowest prevalence. The two sub-counties with open defecation free status had lower prevalence of diarrhoea cases compared to sub-counties which were yet to attain open defecation free status. This suggests that elimination of open defecation may reduce the number of diarrhoea cases.

Characterisation of recent foot-and-mouth disease viruses from African buffalo (Syncerus caffer) and cattle in Kenya is consistent with independent virus populations.

PubMed

Wekesa, Sabenzia Nabalayo; Sangula, Abraham Kiprotich; Belsham, Graham J; Tjornehoj, Kirsten; Muwanika, Vincent B; Gakuya, Francis; Mijele, Dominic; Siegismund, Hans Redlef

2015-02-03

Understanding the epidemiology of foot-and-mouth disease (FMD), including roles played by different hosts, is essential for improving disease control. The African buffalo (Syncerus caffer) is a reservoir for the SAT serotypes of FMD virus (FMDV). Large buffalo populations commonly intermingle with livestock in Kenya, yet earlier studies have focused on FMD in the domestic livestock, hence the contribution of buffalo to disease in livestock is largely unknown. This study analysed 47 epithelia collected from FMD outbreaks in Kenyan cattle between 2008 and 2012, and 102 probang and serum samples collected from buffalo in three different Kenyan ecosystems; Maasai-Mara (MME) (n = 40), Tsavo (TSE) (n = 33), and Meru (ME) (n = 29). Antibodies against FMDV non-structural proteins were found in 65 of 102 (64%) sera from buffalo with 44/102 and 53/102 also having neutralising antibodies directed against FMDV SAT 1 and SAT 2, respectively. FMDV RNA was detected in 42% of the buffalo probang samples by RT-qPCR (Cycle Threshold (Ct) ≤32). Two buffalo probang samples were positive by VI and were identified as FMDV SAT 1 and SAT 2 by Ag-ELISA, while the latter assay detected serotypes O (1), A (20), SAT 1 (7) and SAT 2 (19) in the 47 cattle epithelia. VP1 coding sequences were generated for two buffalo and 21 cattle samples. Phylogenetic analyses revealed SAT 1 and SAT 2 virus lineages within buffalo that were distinct from those detected in cattle. We found that FMDV serotypes O, A, SAT 1 and SAT 2 were circulating among cattle in Kenya and cause disease, but only SAT 1 and SAT 2 viruses were successfully isolated from clinically normal buffalo. The buffalo isolates were genetically distinct from isolates obtained from cattle. Control efforts should focus primarily on reducing FMDV circulation among livestock and limiting interaction with buffalo. Comprehensive studies incorporating additional buffalo viruses are recommended.

Kenyan isolates of Puccinia graminis f. sp. tritici from 2008 to 2014: Virulence to SrTmp in the Ug99 race group and implications for breeding programs

USDA-ARS?s Scientific Manuscript database

Frequent emergence of new variants in the Puccinia graminis f. sp. tritici (Pgt) Ug99 race group in Kenya has made pathogen survey a priority. We analyzed 140 isolates from 78 Pgt samples collected in Kenya between 2008 and 2014 and identified six races, including three not detected prior to 2013. G...

Kenya Women in Physics: Societal, Cultural, and Professional Challenges

NASA Astrophysics Data System (ADS)

Baki, Paul; Wabwile, Ruth L.; Nyamwandha, Cecilia A.; Odongo, Diana A.

2009-04-01

In this paper we give an overview of the challenges Kenyan women physicists face in their educational and career engagements as a result of social-cultural stigma, cultural prejudices, and balancing family and work demands. We also discuss steps being taken in Kenya to address gender inequality in almost all spheres of public and private workplaces and the benefits to a prosperous developing nation of educating the girl child.

The Use of Presupposition in the Creation of Socio-Political Dominance in Kenyan Parliamentary Debates between 1992 and 2010

ERIC Educational Resources Information Center

Peter, Christine Atieno; Mukuthuria, Mwenda; Muriung, Peter

2016-01-01

Presupposition, a linguistic element can be employed in utterances. When this is done it enhances the comprehension of what is being communicated. This aspect of language that is implicit assumption of an utterance is a strategy that may be used to express a speaker's socio-political dominance. The truth of what is said is taken for granted and…

Childhood exposure to emotional abuse and later life stress among Kenyan women: a mediation analysis of cross-sectional data.

PubMed

Goodman, Michael L; Gutarra, Claudia; Billingsley, Katherine M; Keiser, Philip H; Gitari, Stanley

2017-07-01

We explore whether perceived stress among Kenyan mothers is predicted by childhood exposure to emotional abuse - both witnessed among parents and experienced directly. Further, we explore whether this association is mediated by social support, family functioning and polygynous marriage. We used cross-sectional data from a systematic random sample (n = 1974) of mothers in semi-rural Kenya. Data were collected using validated scales and trained interviewers. Analyses were conducted using bootstrapped structural equation models and fixed-effects linear regression models, controlling for age and household wealth. Reported experience of emotional abuse - both directly experienced and observed among household adults - was high in the present population (72.5% and 69%, respectively). Perceived stress among women was significantly higher if they were exposed to more emotional abuse during childhood (p < .001). Lower social support, worse family functioning and higher rates of polygynous marriage mediated pathways between emotional abuse exposure during childhood and adult perceived stress. Future research should investigate whether social integration, identity formation and self-esteem underlie observed dynamics in sub-Saharan Africa. Efforts to promote social integration and support should target children currently experiencing emotional abuse, and may include child-targeted high quality television programing and adult-targeted media and celebrity campaigns.

A cryptic mitochondrial DNA link between North European and West African dogs.

PubMed

Adeola, Adeniyi C; Ommeh, Sheila C; Song, Jiao-Jiao; Olaogun, S Charles; Sanke, Oscar J; Yin, Ting-Ting; Wang, Guo-Dong; Wu, Shi-Fang; Zhou, Zhong-Yin; Lichoti, Jacqueline K; Agwanda, Bernard R; Dawuda, Philip M; Murphy, Robert W; Peng, Min-Sheng; Zhang, Ya-Ping

2017-03-20

Domestic dogs have an ancient origin and a long history in Africa. Nevertheless, the timing and sources of their introduction into Africa remain enigmatic. Herein, we analyse variation in mitochondrial DNA (mtDNA) D-loop sequences from 345 Nigerian and 37 Kenyan village dogs plus 1530 published sequences of dogs from other parts of Africa, Europe and West Asia. All Kenyan dogs can be assigned to one of three haplogroups (matrilines; clades): A, B, and C, while Nigerian dogs can be assigned to one of four haplogroups A, B, C, and D. None of the African dogs exhibits a matrilineal contribution from the African wolf (Canis lupus lupaster). The genetic signal of a recent demographic expansion is detected in Nigerian dogs from West Africa. The analyses of mitochondrial genomes reveal a maternal genetic link between modern West African and North European dogs indicated by sub-haplogroup D1 (but not the entire haplogroup D) coalescing around 12,000 years ago. Incorporating molecular anthropological evidence, we propose that sub-haplogroup D1 in West African dogs could be traced back to the late-glacial dispersals, potentially associated with human hunter-gatherer migration from southwestern Europe. Copyright © 2016 Institute of Genetics and Developmental Biology, Chinese Academy of Sciences, and Genetics Society of China. Published by Elsevier Ltd. All rights reserved.

Rates and Covariates of Recent Sexual and Physical Violence Against HIV-Infected Outpatient Drinkers in Western Kenya.

PubMed

Papas, Rebecca K; Gakinya, Benson N; Mwaniki, Michael M; Lee, Hana; Kiarie, Stella W; Martino, Steve; Loxley, Michelle P; Keter, Alfred K; Klein, Debra A; Sidle, John E; Baliddawa, Joyce B; Maisto, Stephen A

2017-08-01

Victimization from physical and sexual violence presents global health challenges. Partner violence is higher in Kenya than Africa. Violence against drinkers and HIV-infected individuals is typically elevated, so dual vulnerabilities may further augment risk. Understanding violence risks can improve interventions. Participants were 614 HIV-infected outpatient drinkers in western Kenya enrolled in a randomized trial to reduce alcohol use. At baseline, past 90-day partner physical and sexual violence were examined descriptively and in gender-stratified regression models. We hypothesized higher reported violence against women than men, and positive violence association with HIV stigma and alcohol use across gender. Women reported significantly more current sexual (26.3 vs. 5.7%) and physical (38.9 vs. 24.8%) victimization than men. Rates were generally higher than Kenyan lifetime national averages. In both regression models, HIV stigma and alcohol-related sexual expectations were significantly associated with violence while alcohol use was not. For women, higher violence risk was also conferred by childhood violence, past-year transactional sex, and younger age. HIV-infected Kenyan drinkers, particularly women, endorse high current violence due to multiple risk factors. Findings have implications for HIV interventions. Longitudinal research is needed to understand development of risk.

Suicide clusters among young Kenyan men.

PubMed

Goodman, Michael L; Puffer, Eve S; Keiser, Philip H; Gitari, Stanley

2017-11-01

Suicide is a leading cause of global mortality. Suicide clusters have recently been identified among peer networks in high-income countries. This study investigates dynamics of suicide clustering within social networks of young Kenya men ( n = 532; 18-34 years). We found a strong, statistically significant association between reported number of friends who previously attempted suicide and present suicide ideation (odds ratio = 1.9; 95% confidence interval (1.42, 2.54); p < 0.001). This association was mediated by lower collective self-esteem (23% of total effect). Meaning in life further mediated the association between collective self-esteem and suicide ideation. Survivors of peer suicide should be evaluated for suicide risk.

Mother-to-child transmission of HIV in Kenya: results from a nationally representative study.

PubMed

Sirengo, Martin; Muthoni, Lilly; Kellogg, Timothy A; Kim, Andrea A; Katana, Abraham; Mwanyumba, Sophie; Kimanga, Davies O; Maina, William K; Muraguri, Nicolas; Elly, Benjamin; Rutherford, George W

2014-05-01

Kenya has an estimated 13,000 new infant HIV infections that occur annually. We measured the burden of HIV infection among women of childbearing age and assessed access to and coverage of key prevention of mother-to-child transmission interventions. The second Kenya AIDS Indicator Survey was a nationally representative 2-stage cluster sample of households. We analyzed data from women aged 15-54 years who had delivered a newborn within the preceding 5 years and from whom we obtained samples for HIV testing. Of 3310 women who had ≥1 live birth in the preceding 5 years, 2862 (86.5%) consented to HIV testing in the survey, and 171 (6.1%) were found to be infected. Ninety-five percent received prenatal care, 93.1% were screened for HIV during prenatal care, and of those screened, 97.8% received their test results. Seventy-six women were known to be infected in their last pregnancy. Of these, 54 (72.3%) received antepartum antiretroviral prophylaxis, and 51 (69.1%) received intrapartum prophylaxis; 56 (75.3%) reported their newborns received postpartum prophylaxis. Of the 76 children born to these mothers, 63 (82.5%) were tested for HIV at the first immunization visit or thereafter, and 8 (15.1%) were HIV infected. We found a substantial burden of HIV in Kenyan women of childbearing age and a cumulative 5-year mother-to-child transmission rate of 15%. Although screening has improved over the past 5 years, fewer than three-quarters of infected pregnant women are receiving antiretroviral prophylaxis. Universal antiretroviral therapy for HIV-infected pregnant women will be essential in achieving Kenyan's target to eliminate mother-to-child transmission to <5% by 2015.

Brands, costs and registration status of antimalarial drugs in the Kenyan retail sector

PubMed Central

Amin, Abdinasir A; Snow, Robert W

2005-01-01

Background Although an important source of treatment for fevers, little is known about the structure of the retail sector in Africa with regard to antimalarial drugs. This study aimed to assess the range, costs, sources and registration of antimalarial drugs in the Kenyan retail sector. Methods In 2002, antimalarial drug registration and trade prices were established by triangulating national registration lists, government gazettes and trade price indices. Data on registration status and trade prices were compared with similar data generated through a retail audit undertaken among 880 randomly sampled retailers in four districts of Kenya. Results Two hundred and eighteen antimalarial drugs were in circulation in Kenya in 2002. These included 65 "sulfur"-pyrimethamine (sulfadoxine-pyrimethamine and sulfalene-pyrimethamine (SP), the first-line recommended drug in 2002) and 33 amodiaquine (AQ, the second-line recommended drug) preparations. Only half of SP and AQ products were registered with the Pharmacy and Poisons Board. Of SP and AQ brands at district level, 40% and 44% were officially within legal registration requirements. 29% of retailers at district level stocked SP and 95% stocked AQ. The retail price of adult doses of SP and AQ were on average 0.38 and 0.76 US dollars, 100% and 347% higher than trade prices from manufacturers and importers. Artemether-lumefantrine, the newly announced first-line recommended antimalarial drug in 2004, was found in less than 1% of all retail outlets at a median cost of 7.6 US dollars. Conclusion There is a need to ensure that all antimalarial drugs are registered with the Pharmacy and Poisons Board to facilitate a more stringent post-marketing surveillance system to ensure drugs are safe and of good quality post-registration. PMID:16042815

Associations of diet quality with dairy group membership, membership duration and non-membership for Kenyan farm women and children: a comparative study.

PubMed

Walton, Colleen; Taylor, Jennifer; VanLeeuwen, John; Yeudall, Fiona; Mbugua, Samwel

2014-02-01

To examine associations among diet quality and dairy group membership, membership duration and non-member status for women and school-aged children in rural Kenya. A cross-sectional survey, using chain referral sampling, was conducted and diet quality indices and prevalence of inadequate intake (PII) were estimated using the 'estimated average requirement' cut-off point method from single 24 h recalls, using a Kenyan nutrient database. PII was compared among members and non-members and among membership-duration groups. Women and children of dairy group members (n 88), across membership-duration groups (1-3, 4-6, 7-9 and 10+ years), and non-members (n 23) living among members. Small farms in central Kenya. Members had higher energy, percentage of energy from animal-source foods and dietary diversity. Member women and children had lower PII for respectively seven and three of eleven micronutrients. Reduced PII for milk-source micronutrients was associated with membership duration for women. Many member women (38%) had inadequate vitamin A intake and 39% of member children had inadequate Zn intake. Members' PII was also high (>45%) for Fe, Ca and vitamin B12. A higher prevalence of being overweight among member women compared with non-member women suggested nutrition transition effects of higher farm productivity. Dairy group membership was positively associated with adequate quantity and quality of diets for women and children. Long-term membership was insufficient to address micronutrient deficiencies. Understanding and addressing barriers to better diet quality and strategies to mitigate negative nutrition transition effects are needed to optimize nutritional outcomes of dairy group membership.

Semen Bacterial Concentrations and HIV-1 RNA Shedding Among HIV-1-Seropositive Kenyan Men.

PubMed

Korhonen, Christine J; Srinivasan, Sujatha; Huang, Dandi; Ko, Daisy L; Sanders, Eduard J; Peshu, Norbert M; Krieger, John N; Muller, Charles H; Coombs, Robert W; Fredricks, David N; Graham, Susan M

2017-03-01

HIV-1 is transmitted through semen from men to their sexual partners. Genital infections can increase HIV-1 RNA shedding in semen, but shedding also occurs in the absence of typical pathogens. We hypothesized that higher bacterial concentrations in semen would be associated with higher HIV-1 RNA levels. We analyzed semen samples from 42 HIV-1-seropositive Kenyan men using quantitative polymerase chain reaction (PCR) to assess bacterial concentrations and real-time PCR to measure HIV-1 RNA levels. Generalized estimation equations were used to evaluate associations between these 2 measures. Broad-range 16S rRNA gene PCR with pyrosequencing was performed on a subset of 13 samples to assess bacterial community composition. Bacteria were detected in 96.6% of 88 samples by quantitative PCR. Semen bacterial concentration and HIV-1 RNA levels were correlated 0.30 (P = 0.01). The association between bacterial concentration and HIV-1 RNA detection was not significant after adjustment for antiretroviral therapy (ART) (adjusted odds ratio: 1.27, 95% CI: 0.84 to 1.91). Factors associated with semen bacterial concentration included insertive anal sex (adjusted beta 0.92, 95% CI: 0.12 to 1.73) and ART use (adjusted beta: -0.77, 95% CI: -1.50 to 0.04). Among 13 samples with pyrosequencing data, Corynebacterium spp., Staphylococcus spp., and Streptococcus spp. were most frequently detected. Most of these HIV-1-infected men had bacteria in their semen. ART use was associated with undetectable semen HIV-1 RNA and lower semen bacterial concentrations, whereas insertive anal sex was associated with higher bacterial concentrations. Additional studies evaluating the relationship between semen bacteria, inflammation, mucosal immunity, and HIV-1 shedding are needed to understand implications for HIV-1 transmission.

Semen Bacterial Concentrations and HIV-1 RNA Shedding Among HIV-1–Seropositive Kenyan Men

PubMed Central

Srinivasan, Sujatha; Huang, Dandi; Ko, Daisy L.; Sanders, Eduard J.; Peshu, Norbert M.; Krieger, John N.; Muller, Charles H.; Coombs, Robert W.; Fredricks, David N.; Graham, Susan M.

2017-01-01

Introduction: HIV-1 is transmitted through semen from men to their sexual partners. Genital infections can increase HIV-1 RNA shedding in semen, but shedding also occurs in the absence of typical pathogens. We hypothesized that higher bacterial concentrations in semen would be associated with higher HIV-1 RNA levels. Methods: We analyzed semen samples from 42 HIV-1–seropositive Kenyan men using quantitative polymerase chain reaction (PCR) to assess bacterial concentrations and real-time PCR to measure HIV-1 RNA levels. Generalized estimation equations were used to evaluate associations between these 2 measures. Broad-range 16S rRNA gene PCR with pyrosequencing was performed on a subset of 13 samples to assess bacterial community composition. Results: Bacteria were detected in 96.6% of 88 samples by quantitative PCR. Semen bacterial concentration and HIV-1 RNA levels were correlated 0.30 (P = 0.01). The association between bacterial concentration and HIV-1 RNA detection was not significant after adjustment for antiretroviral therapy (ART) (adjusted odds ratio: 1.27, 95% CI: 0.84 to 1.91). Factors associated with semen bacterial concentration included insertive anal sex (adjusted beta 0.92, 95% CI: 0.12 to 1.73) and ART use (adjusted beta: −0.77, 95% CI: −1.50 to 0.04). Among 13 samples with pyrosequencing data, Corynebacterium spp., Staphylococcus spp., and Streptococcus spp. were most frequently detected. Conclusion: Most of these HIV-1–infected men had bacteria in their semen. ART use was associated with undetectable semen HIV-1 RNA and lower semen bacterial concentrations, whereas insertive anal sex was associated with higher bacterial concentrations. Additional studies evaluating the relationship between semen bacteria, inflammation, mucosal immunity, and HIV-1 shedding are needed to understand implications for HIV-1 transmission. PMID:27861240

The Africa Yoga Project: A Participant-Driven Concept Map of Kenyan Teachers' Reported Experiences.

PubMed

Klein, Jessalyn E; Cook-Cottone, Catherine; Giambrone, Carla

2015-01-01

The Africa Yoga Project (AYP) trains and funds Kenyans to teach community yoga classes. Preliminary research with a small sample of AYP teachers suggested the program had a positive impact. This study used concept mapping to explore the experiences of a larger sample. Participants brainstormed statements about how practicing and/or teaching yoga changed them. They sorted statements into self-defined piles and rated them in terms of perceived importance. Multidimensional scaling (MDS) of sort data calculated statement coordinates wherein each statement is placed in proximity to other statements as a function of how frequently statements are sorted together by participants. These results are then and mapped in a two-dimensional space. Hierarchical cluster analysis (HCA) of these data identified clusters (i.e., concepts) among statements. Cluster average importance ratings gave the concept map depth and indicated concept importance. Bridging analysis and researchers' conceptual understanding of yoga literature facilitated HCA interpretive decisions. Of 72 AYP teachers, 52 and 48 teachers participated in brainstorming and sorting/rating activities, respectively. Teachers brainstormed 93 statements about how they had changed. The resultant MDS statement map had adequate validity (stress value = .29). HCA created a 12-cluster solution with the following concepts of perceived change: Identity as a Yoga Teacher; Prosocial Development; Existential Possibility; Genuine Positive Regard; Value and Respect for Others (highest importance); Presence, Acceptance, and Competence; Service and Trust; Non-judgment and Emotion Regulation (lowest importance); Engagement and Connection; Interpersonal Effectiveness; Psychosocial Functioning; and Physical Competence and Security. Teachers perceived the AYP as facilitating change across physical, mental, and spiritual domains. Additional research is needed to quantify and compare this change to other health promotion program outcomes.

"I Did Not Want to Give Birth to a Child Who has HIV": Experiences Using PrEP During Pregnancy Among HIV-Uninfected Kenyan Women in HIV-Serodiscordant Couples.

PubMed

Pintye, Jillian; Beima-Sofie, Kristin M; Kimemia, Grace; Ngure, Kenneth; Trinidad, Susan Brown; Heffron, Renee A; Baeten, Jared M; Odoyo, Josephine; Mugo, Nelly; Bukusi, Elizabeth A; Kelley, Maureen C; John-Stewart, Grace C

2017-11-01

The perceptions, motivations, and beliefs of HIV-uninfected women about pre-exposure prophylaxis (PrEP) use during pregnancy can influence its uptake and adherence. This study elicited the views of HIV-uninfected women with personal experience taking PrEP during pregnancy. Qualitative interviews were conducted with HIV-uninfected women who had personal experience taking PrEP while pregnant. Semistructured interviews were conducted with 21 HIV-uninfected Kenyan women in HIV-serodiscordant couples enrolled in an open-label PrEP demonstration project who became pregnant while using PrEP and continued PrEP through their pregnancy. Interviews were audio-recorded and transcribed into English. A qualitative descriptive analysis was performed, using a constant comparison approach to identify key themes related to PrEP use in pregnancy. Desire to remain HIV uninfected and have an HIV-free infant were strong motivators influencing continued use of PrEP during pregnancy. Supporting HIV-infected partners and childbearing within an HIV-serodiscordant relationship were also motivators. Women had challenges distinguishing normal pregnancy symptoms from PrEP side effects and were concerned that observed side effects could be signs of danger for the infant related to PrEP exposure. Health care providers were important conduits of knowledge about PrEP, and continuity of PrEP providers throughout pregnancy facilitated adherence. HIV-uninfected women in HIV-serodiscordant couples were motivated to use PrEP during pregnancy to remain HIV uninfected and to have an HIV-free child but had concerns about side effects. Health care providers will be important for PrEP messaging and adherence support in this unique population.

CTC Sentinel. Volume 6, Issue 10

DTIC Science & Technology

2013-10-01

and the office of Kenyan President Uhuru Kenyatta.11 Fighting continued into the evening of Tuesday , 6 Daniel Howden, “Terror in Nairobi: The Full...provided Iraq with $1 billion per month starting in 1982. See John Bulloch and Harvey Morris , The Gulf War: Its Origins, History and Consequences (London...Expected,” UN High Commissioner for Refu- gees, September 5, 2013. 25 Biro. 26 Loveday Morris , Joby Warrick and Souad Mekhen- net, “Rival al-Qaeda

The Effectiveness of SMASSE Teacher Training Programme on KCSE Performance in Mathematics and Chemistry Subjects in Kikuyu District, Kenya

ERIC Educational Resources Information Center

Kiige, Mwangi James; Atina, James Onywoki

2016-01-01

The changeover of the Kenyan system of education from the 7-4-2-3 to the current 8-4-4 in 1984 made science subjects (Biology, Chemistry and Physics) compulsory to all students up to form two at the secondary school level. This meant increased numbers of students in one class at a time attending the science subjects, which may compromise quality.…

Narrating sexual identities in Kenya: "Choice," value, and visibility.

PubMed

Zingsheim, Jason; Goltz, Dustin Bradley; Murphy, Alexandra G; Mastin, Teresa

2017-04-03

This article examines the discursive construction of female same-sex sexual identities in Nairobi. We identify the discursive forces of "choice," devaluation, and invisibility as influential within Kenyan media representations of lesbian, gay, bisexual, transgender, and intersex citizens. Using creative focus groups and participant observation, we demonstrate how same-sex attracted women in Nairobi resist and rearticulate these discursive forces to assert their identity and agency as individuals and as a queer community.

Complex Subtype Diversity of HIV-1 Among Drug Users in Major Kenyan Cities.

PubMed

Gounder, Kamini; Oyaro, Micah; Padayachi, Nagavelli; Zulu, Thando Mbali; de Oliveira, Tulio; Wylie, John; Ndung'u, Thumbi

2017-05-01

Drug users are increasingly recognized as a key population driving human immunodeficiency virus (HIV) spread in sub-Saharan Africa. To determine HIV-1 subtypes circulating in this population group and explore possible geographic differences, we analyzed HIV-1 sequences among drug users from Nairobi, Mombasa, and Kisumu in Kenya. We sequenced gag and env from 55 drug users. Subtype analysis from 220 gag clonal sequences from 54 of 55 participants (median = 4/participant) showed that 44.4% were A, 16.7% were C, 3.7% were D, and 35.2% were intersubtype recombinants. Of 156 env clonal sequences from 48 of 55 subjects (median = 3/participant), 45.8% were subtype A, 14.6% were C, 6.3% were D, and 33.3% were recombinants. Comparative analysis of both genes showed that 30 (63.8%) participants had concordant subtypes, while 17 (36.2%) were discordant. We identified one genetically linked transmission pair and two cases of dual infection. These data are indicative of extensive HIV-1 intersubtype recombination in Kenya and suggest decline in subtype D prevalence.

Complex Subtype Diversity of HIV-1 Among Drug Users in Major Kenyan Cities

PubMed Central

Gounder, Kamini; Oyaro, Micah; Padayachi, Nagavelli; Zulu, Thando Mbali; de Oliveira, Tulio; Wylie, John

2017-01-01

Abstract Drug users are increasingly recognized as a key population driving human immunodeficiency virus (HIV) spread in sub-Saharan Africa. To determine HIV-1 subtypes circulating in this population group and explore possible geographic differences, we analyzed HIV-1 sequences among drug users from Nairobi, Mombasa, and Kisumu in Kenya. We sequenced gag and env from 55 drug users. Subtype analysis from 220 gag clonal sequences from 54 of 55 participants (median = 4/participant) showed that 44.4% were A, 16.7% were C, 3.7% were D, and 35.2% were intersubtype recombinants. Of 156 env clonal sequences from 48 of 55 subjects (median = 3/participant), 45.8% were subtype A, 14.6% were C, 6.3% were D, and 33.3% were recombinants. Comparative analysis of both genes showed that 30 (63.8%) participants had concordant subtypes, while 17 (36.2%) were discordant. We identified one genetically linked transmission pair and two cases of dual infection. These data are indicative of extensive HIV-1 intersubtype recombination in Kenya and suggest decline in subtype D prevalence. PMID:28068781

Contending with Psychological Distress in Contexts with Limited Mental Health Resources: HIV-Positive Kenyan Women's Experiences.

PubMed

Kako, Peninnah M; Wendorf, Angela R; Stevens, Patricia E; Ngui, Emmanuel; Otto-Salaj, Laura L

2016-01-01

This study describes the psychosocial distress experiences of HIV-positive women in Kenya. In-depth narrative interviews were conducted three times over six months between 2009 and 2010 with 54 HIV-positive women living in Kenya to explore how the women perceived psychological distress and the steps they took to find support to cope with their HIV-positive diagnosis. Thematic analysis revealed that the women described psychological distress as: physical and emotional shock, worry, and hopelessness and suicidality. The women reported receiving support to cope through spiritual connections, family and friends, others coping with HIV/AIDS, and health care agencies. This study heightens awareness of the critical value of understanding culturally relevant mental health evaluations in a limited mental health access context.

Prevalence and comparison of Streptococcus infantarius subsp. infantarius and Streptococcus gallolyticus subsp. macedonicus in raw and fermented dairy products from East and West Africa.

PubMed

Jans, Christoph; Kaindi, Dasel Wambua Mulwa; Böck, Désirée; Njage, Patrick Murigu Kamau; Kouamé-Sina, Sylvie Mireille; Bonfoh, Bassirou; Lacroix, Christophe; Meile, Leo

2013-10-15

Streptococcus infantarius subsp. infantarius (Sii) and Streptococcus gallolyticus subsp. macedonicus are members of the Streptococcus bovis/Streptococcus equinus complex (SBSEC) associated with human infections. SBSEC-related endocarditis was furthermore associated with rural residency in Southern Europe. SBSEC members are increasingly isolated as predominant species from fermented dairy products in Europe, Asia and Africa. African variants of Sii displayed dairy adaptations to lactose metabolism paralleling those of Streptococcus thermophilus including genome decay. In this study, the aim was to assess the prevalence of Sii and possibly other SBSEC members in dairy products of East and West Africa in order to identify their habitat, estimate their importance in dairy fermentation processes and determine geographic areas affected by this potential health risk. Presumptive SBSEC members were isolated on semi-selective M17 and SM agar media. Subsequent genotypic identification of isolates was based on rep-PCR fingerprinting and SBSEC-specific16S rRNA gene PCR assay. Detailed identification was achieved through application of novel primers enhancing the binding stringency in partial groES/groEL gene amplification and subsequent DNA sequencing. The presence of S. thermophilus-like lacS and lacZ genes in the SBSEC isolates was determined to elucidate the prevalence of this dairy adaptation. Isolates (n = 754) were obtained from 72 raw and 95 fermented milk samples from Côte d'Ivoire and Kenya on semi-selective agar media. Colonies of Sii were not detected from raw milk despite high microbial titers of approximately 10(6)CFU/mL on M17 agar medium. However, after spontaneous milk fermentation Sii was genotypically identified in 94.1% of Kenyan samples and 60.8% of Kenyan isolates. Sii prevalence in Côte d'Ivoire displayed seasonal variations in samples from 32.3% (June) to 40.0% (Dec/Jan) and isolates from 20.5% (June) to 27.7% (Dec/Jan) present at titers of 10(6)-10(8)CFU/mL. lacS and lacZ genes were detected in all Kenyan and 25.8% (June) to 65.4% (Dec/Jan) of Ivorian Sii isolates. Regional differences in prevalence of Sii and dairy adaptations were observed, but no clear effect of dairy animal, fermentation procedure and climate was revealed. Conclusively, the high prevalence of Sii in Kenya, Côte d'Ivoire in addition to Somalia, Sudan and Mali strongly indicates a pivotal role of Sii in traditional African dairy fermentations potentially paralleling that of typical western dairy species S. thermophilus. Putative health risks associated with the consumption of high amounts of live Sii and potential different degrees of evolutionary adaptation or ecological colonization require further epidemiologic and genomic investigations, particularly in Africa. © 2013.

Prevalence and comparison of Streptococcus infantarius subsp. infantarius and Streptococcus gallolyticus subsp. macedonicus in raw and fermented dairy products from East and West Africa

PubMed Central

Jans, Christoph; Kaindi, Dasel Wambua Mulwa; Böck, Désirée; Njage, Patrick Murigu Kamau; Kouamé-Sina, Sylvie Mireille; Bonfoh, Bassirou; Lacroix, Christophe; Meile, Leo

2016-01-01

Streptococcus infantarius subsp. infantarius (Sii) and Streptococcus gallolyticus subsp. macedonicus are members of the Streptococcus bovis/Streptococcus equinus complex (SBSEC) associated with human infections. SBSEC-related endocarditis was furthermore associated with rural residency in Southern Europe. SBSEC members are increasingly isolated as predominant species from fermented dairy products in Europe, Asia and Africa. African variants of Sii displayed dairy adaptations to lactose metabolism paralleling those of Streptococcus thermophilus including genome decay. In this study, the aim was to assess the prevalence of Sii and possibly other SBSEC members in dairy products of East and West Africa in order to identify their habitat, estimate their importance in dairy fermentation processes and determine geographic areas affected by this potential health risk. Presumptive SBSEC members were isolated on semi-selective M17 and SM agar media. Subsequent genotypic identification of isolates was based on rep-PCR fingerprinting and SBSEC-specific16S rRNA gene PCR assay. Detailed identification was achieved through application of novel primers enhancing the binding stringency in partial groES/groEL gene amplification and subsequent DNA sequencing. The presence of S. thermophilus-like lacS and lacZ genes in the SBSEC isolates was determined to elucidate the prevalence of this dairy adaptation. Isolates (n = 754) were obtained from 72 raw and 95 fermented milk samples from Côte d'Ivoire and Kenya on semi-selective agar media. Colonies of Sii were not detected from raw milk despite high microbial titers of approximately 106 CFU/mL on M17 agar medium. However, after spontaneous milk fermentation Sii was genotypically identified in 94.1% of Kenyan samples and 60.8% of Kenyan isolates. Sii prevalence in Côte d'Ivoire displayed seasonal variations in samples from 32.3% (June) to 40.0% (Dec/Jan) and isolates from 20.5% (June) to 27.7% (Dec/Jan) present at titers of 106–108 CFU/mL. lacS and lacZ genes were detected in all Kenyan and 25.8% (June) to 65.4% (Dec/Jan) of Ivorian Sii isolates. Regional differences in prevalence of Sii and dairy adaptations were observed, but no clear effect of dairy animal, fermentation procedure and climate was revealed. Conclusively, the high prevalence of Sii in Kenya, Côte d'Ivoire in addition to Somalia, Sudan and Mali strongly indicates a pivotal role of Sii in traditional African dairy fermentations potentially paralleling that of typical western dairy species S. thermophilus. Putative health risks associated with the consumption of high amounts of live Sii and potential different degrees of evolutionary adaptation or ecological colonization require further epidemiologic and genomic investigations, particularly in Africa. PMID:24131584

Toll-like receptor polymorphisms in malaria-endemic populations

PubMed Central

Greene, Jennifer A; Moormann, Ann M; Vulule, John; Bockarie, Moses J; Zimmerman, Peter A; Kazura, James W

2009-01-01

Background Toll-like receptors (TLR) and related downstream signaling pathways of innate immunity have been implicated in the pathogenesis of Plasmodium falciparum malaria. Because of their potential role in malaria pathogenesis, polymorphisms in these genes may be under selective pressure in populations where this infectious disease is endemic. Methods A post-PCR Ligation Detection Reaction-Fluorescent Microsphere Assay (LDR-FMA) was developed to determine the frequencies of TLR2, TLR4, TLR9, MyD88-Adaptor Like Protein (MAL) single nucleotide polymorphisms (SNPs), and TLR2 length polymorphisms in 170 residents of two regions of Kenya where malaria transmission is stable and high (holoendemic) or episodic and low, 346 residents of a malaria holoendemic region of Papua New Guinea, and 261 residents of North America of self-identified ethnicity. Results The difference in historical malaria exposure between the two Kenyan sites has significantly increased the frequency of malaria protective alleles glucose-6-phoshpate dehydrogenase (G6PD) and Hemoglobin S (HbS) in the holoendemic site compared to the episodic transmission site. However, this study detected no such difference in the TLR2, TLR4, TLR9, and MAL allele frequencies between the two study sites. All polymorphisms were in Hardy Weinberg Equilibrium in the Kenyan and Papua New Guinean populations. TLR9 SNPs and length polymorphisms within the TLR2 5' untranslated region were the only mutant alleles present at a frequency greater than 10% in all populations. Conclusion Similar frequencies of TLR2, TLR4, TLR9, and MAL genetic polymorphisms in populations with different histories of malaria exposure suggest that these innate immune pathways have not been under strong selective pressure by malaria. Genotype frequencies are consistent with Hardy-Weinberg Equilibrium and the Neutral Theory, suggesting that genetic drift has influenced allele frequencies to a greater extent than selective pressure from malaria or any other infectious agents in these populations. PMID:19317913

Biofortified yellow cassava and vitamin A status of Kenyan children: a randomized controlled trial.

PubMed

Talsma, Elise F; Brouwer, Inge D; Verhoef, Hans; Mbera, Gloria N K; Mwangi, Alice M; Demir, Ayşe Y; Maziya-Dixon, Busie; Boy, Erick; Zimmermann, Michael B; Melse-Boonstra, Alida

2016-01-01

Whereas conventional white cassava roots are devoid of provitamin A, biofortified yellow varieties are naturally rich in β-carotene, the primary provitamin A carotenoid. We assessed the effect of consuming yellow cassava on serum retinol concentration in Kenyan schoolchildren with marginal vitamin A status. We randomly allocated 342 children aged 5-13 y to receive daily, 6 d/wk, for 18.5 wk 1) white cassava and placebo supplement (control group), 2) provitamin A-rich cassava (mean content: 1460 μg β-carotene/d) and placebo supplement (yellow cassava group), and 3) white cassava and β-carotene supplement (1053 μg/d; β-carotene supplement group). The primary outcome was serum retinol concentration; prespecified secondary outcomes were hemoglobin concentration and serum concentrations of β-carotene, retinol-binding protein, and prealbumin. Groups were compared by using ANCOVA, adjusting for inflammation, baseline serum concentrations of retinol and β-carotene, and stratified design. The baseline prevalence of serum retinol concentration <0.7 μmol/L and inflammation was 27% and 24%, respectively. For children in the control, yellow cassava, and β-carotene supplement groups, the mean daily intake of cassava was 378, 371, and 378 g, respectively, and the total daily supply of provitamin A and vitamin A from diet and supplements was equivalent to 22, 220, and 175 μg retinol, respectively. Both yellow cassava and β-carotene supplementation increased serum retinol concentration by 0.04 μmol/L (95% CI: 0.00, 0.07 μmol/L); correspondingly, serum β-carotene concentration increased by 524% (448%, 608%) and 166% (134%, 202%). We found no effect on hemoglobin concentration or serum concentrations of retinol-binding protein and prealbumin. In our study population, consumption of yellow cassava led to modest gains in serum retinol concentration and a large increase in β-carotene concentration. It can be an efficacious, new approach to improve vitamin A status. This study was registered with clinicaltrials.gov as NCT01614483. © 2016 American Society for Nutrition.

Azithromycin to prevent post-discharge morbidity and mortality in Kenyan children: a protocol for a randomised, double-blind, placebo-controlled trial (the Toto Bora trial)

PubMed Central

Singa, Benson O; John-Stewart, Grace C; Richardson, Barbra A; Brander, Rebecca L; McGrath, Christine J; Tickell, Kirkby D; Amondi, Mary; Rwigi, Doreen; Babigumira, Joseph B; Kariuki, Sam; Nduati, Ruth; Walson, Judd L

2017-01-01

Introduction Child mortality due to infectious diseases remains unacceptably high in much of sub-Saharan Africa. Children who are hospitalised represent an accessible population at particularly high risk of death, both during and following hospitalisation. Hospital discharge may be a critical time point at which targeted use of antibiotics could reduce morbidity and mortality in high-risk children. Methods and analysis In this randomised, double-blind, placebo-controlled trial (Toto Bora Trial), 1400 children aged 1–59 months discharged from hospitals in Western Kenya, in Kisii and Homa Bay, will be randomised to either a 5-day course of azithromycin or placebo to determine whether a short course of azithromycin reduces rates of rehospitalisation and/or death in the subsequent 6-month period. The primary analysis will be modified intention-to-treat and will compare the rates of rehospitalisation or death in children treated with azithromycin or placebo using Cox proportional hazard regression. The trial will also evaluate the effect of a short course of azithromycin on enteric and nasopharyngeal infections and cause-specific morbidities. We will also identify risk factors for postdischarge morbidity and mortality and subpopulations most likely to benefit from postdischarge antibiotic use. Antibiotic resistance in Escherichia coli and Streptococcus pneumoniae among enrolled children and their primary caregivers will also be assessed, and cost-effectiveness analyses will be performed to inform policy decisions. Ethics and dissemination Study procedures were reviewed and approved by the institutional review boards of the Kenya Medical Research Institute, the University of Washington and the Kenyan Pharmacy and Poisons Board. The study is being externally monitored, and a data safety and monitoring committee has been assembled to monitor patient safety and to evaluate the efficacy of the intervention. The results of this trial will be published in peer-reviewed scientific journals and presented at relevant academic conferences and to key stakeholders. Trial registration number NCT02414399. PMID:29289941

Impact of single annual treatment and four-monthly treatment for hookworm and Ascaris lumbricoides, and factors associated with residual infection among Kenyan school children.

PubMed

Kepha, Stella; Mwandawiro, Charles S; Anderson, Roy M; Pullan, Rachel L; Nuwaha, Fred; Cano, Jorge; Njenga, Sammy M; Odiere, Maurice R; Allen, Elizabeth; Brooker, Simon J; Nikolay, Birgit

2017-02-09

School-based deworming is widely implemented in various countries to reduce the burden of soil-transmitted helminths (STHs), however, the frequency of drug administration varies in different settings. In this study, we compared the impact of a single annual treatment and 4-monthly treatment over a follow-up among Kenyan school children, and investigated the factors associated with residual infection. We performed a secondary analysis of data from a randomized trial investigating whether deworming for STHs alters risk of acquiring malaria. Children received either a single treatment or 4-monthly albendazole treatments were followed longitudinally from February 2014 to October 2014. The relative impact of treatment and factors associated with residual infections were investigated using mixed-effects regression models. Predisposition to infection was assessed based on Spearman's rank and Kendall's Tau correlation coefficients. In the 4-monthly treatment group, the proportion of children infected with hookworm decreased from 59.9 to 5.7%, while Ascaris lumbricoides infections dropped from 55.7 to 6.2%. In the single treatment group, hookworm infections decreased over the same time period from 58.7 to 18.3% (12.6% absolute difference in reduction, 95% CI: 8.9-16.3%), and A. lumbricoides from 56.7 to 23.3% (17.1% absolute difference in reduction, 95% CI: 13.1-21.1%). There was strong evidence for predisposition to both STH types. Residual hookworm infection among children on 4-monthly treatment were associated with male sex and baseline nutritional status, whereas A. lumbricoides infection was associated with individual and school-level infection at baseline, latrine cleanliness at schools. This study found that 4-monthly treatment w more effective than single annual treatment. Repeated treatments led to dramatic reductions in the intensities of STHs, but did not completely clear infections among school children in Kenya, a presumed reflection of reinfection in a setting where there is ongoing transmission.

A strategy to increase adoption of locally-produced, ceramic cookstoves in rural Kenyan households.

PubMed

Silk, Benjamin J; Sadumah, Ibrahim; Patel, Minal K; Were, Vincent; Person, Bobbie; Harris, Julie; Otieno, Ronald; Nygren, Benjamin; Loo, Jennifer; Eleveld, Alie; Quick, Robert E; Cohen, Adam L

2012-05-16

Exposure to household air pollutants released during cooking has been linked to numerous adverse health outcomes among residents of rural areas in low-income countries. Improved cookstoves are one of few available interventions, but achieving equity in cookstove access has been challenging. Therefore, innovative approaches are needed. To evaluate a project designed to motivate adoption of locally-produced, ceramic cookstoves (upesi jiko) in an impoverished, rural African population, we assessed the perceived benefits of the cookstoves (in monetary and time-savings terms), the rate of cookstove adoption, and the equity of adoption. The project was conducted in 60 rural Kenyan villages in 2008 and 2009. Baseline (n = 1250) and follow-up (n = 293) surveys and a stove-tracking database were analyzed. At baseline, nearly all respondents used wood (95%) and firepits (99%) for cooking; 98% desired smoke reductions. Households with upesi jiko subsequently spent <100 Kenyan Shillings/week on firewood more often (40%) than households without upesi jiko (20%) (p = 0.0002). There were no significant differences in the presence of children <2 years of age in households using upesi jiko (48%) or three-stone stoves (49%) (p = 0.88); children 2-5 years of age were less common in households using upesi jiko versus three-stone stoves (46% and 69%, respectively) (p = 0.0001). Vendors installed 1,124 upesi jiko in 757 multi-family households in 18 months; 68% of these transactions involved incentives for vendors and purchasers. Relatively few (<10%) upesi jiko were installed in households of women in the youngest age quartile (<22 years) or among households in the poorest quintile. Our strategy of training of local vendors, appropriate incentives, and product integration effectively accelerated cookstove adoption into a large number of households. The strategy also created opportunities to reinforce health messages and promote cookstoves sales and installation. However, the project's overall success was diminished by inequitable and incomplete adoption by households with the lowest socioeconomic status and young children present. Additional evaluations of similar strategies will be needed to determine whether our strategy can be applied equitably elsewhere, and whether reductions in fuel use, household air pollution, and the incidence of respiratory diseases will follow adoption of improved cookstoves.

A strategy to increase adoption of locally-produced, ceramic cookstoves in rural Kenyan households

PubMed Central

2012-01-01

Background Exposure to household air pollutants released during cooking has been linked to numerous adverse health outcomes among residents of rural areas in low-income countries. Improved cookstoves are one of few available interventions, but achieving equity in cookstove access has been challenging. Therefore, innovative approaches are needed. To evaluate a project designed to motivate adoption of locally-produced, ceramic cookstoves (upesi jiko) in an impoverished, rural African population, we assessed the perceived benefits of the cookstoves (in monetary and time-savings terms), the rate of cookstove adoption, and the equity of adoption. Methods The project was conducted in 60 rural Kenyan villages in 2008 and 2009. Baseline (n = 1250) and follow-up (n = 293) surveys and a stove-tracking database were analyzed. Results At baseline, nearly all respondents used wood (95%) and firepits (99%) for cooking; 98% desired smoke reductions. Households with upesi jiko subsequently spent <100 Kenyan Shillings/week on firewood more often (40%) than households without upesi jiko (20%) (p = 0.0002). There were no significant differences in the presence of children <2 years of age in households using upesi jiko (48%) or three-stone stoves (49%) (p = 0.88); children 2–5 years of age were less common in households using upesi jiko versus three-stone stoves (46% and 69%, respectively) (p = 0.0001). Vendors installed 1,124 upesi jiko in 757 multi-family households in 18 months; 68% of these transactions involved incentives for vendors and purchasers. Relatively few (<10%) upesi jiko were installed in households of women in the youngest age quartile (<22 years) or among households in the poorest quintile. Conclusions Our strategy of training of local vendors, appropriate incentives, and product integration effectively accelerated cookstove adoption into a large number of households. The strategy also created opportunities to reinforce health messages and promote cookstoves sales and installation. However, the project’s overall success was diminished by inequitable and incomplete adoption by households with the lowest socioeconomic status and young children present. Additional evaluations of similar strategies will be needed to determine whether our strategy can be applied equitably elsewhere, and whether reductions in fuel use, household air pollution, and the incidence of respiratory diseases will follow adoption of improved cookstoves. PMID:22591643

Risk factors for pneumonia in urban-dwelling HIV-infected women: a case-control study in Nairobi, Kenya.

PubMed

Penner, Jeremy; Meier, Amalia S; Mwachari, Christina; Ayuka, Francis; Muchina, Belinda; Odhiambo, Joseph; Cohen, Craig R

2003-02-01

In sub-Saharan Africa, respiratory tract infections (RTI) are the leading cause of serious morbidity and mortality in HIV-infected persons. This study sought to investigate demographic, socioeconomic, and environmental risk factors for pneumonia in a cohort of HIV-infected women. The authors performed a nested case-control study in a cohort of HIV-1-infected adults followed in Nairobi, Kenya. Thirty-nine women who developed pneumonia during the follow-up period were selected as cases, and 66 women who did not develop pneumonia were randomly chosen to serve as control subjects. A questionnaire was administered in subjects' homes that assessed demographics, home environment, and socioeconomic status. Women were followed in the cohort for a median of 36.8 months (range, 27.3-39.3). Adjusting for length of follow-up period, factors associated with lower socioeconomic status (lower monthly spending [OR = 3.2; 95% CI, 1.2-8.4 per 10,000 Kenyan shilling decrease], having no savings [OR = 4.1; 95% CI, 1.4-11.9], less sturdy home construction material such as mud or cement walls [OR = 2.6; 95% CI, 1.1-5.9] or dirt floors [OR = 2.8; 95% CI, 1.0-7.6], and lack of a window in the home [OR = 5.5; 95% CI, 0.9-32.2]) and being widowed (OR = 4.3; 95% CI, 1.2-15.1) or single (OR = 3.3; 95% CI, 1.0-11.2) were associated with an increased risk of pneumonia. In multivariate analysis, widowed (AOR = 5.9; 95% CI, 1.3-26.3), single (AOR = 7.7; 95% CI, 1.6-36.4), and divorced (AOR = 4.5; 95% CI, 1.0-20.1) women, those without savings (AOR = 3.7; 95% CI, 1.2-11.7), and those living in more crowded and contagious conditions (AOR = 1.5; 95% CI, 1.1-2.1) remained at increased risk of pneumonia. If confirmed by prospective investigation, these findings could help identify persons and subpopulations of HIV-infected women with the greatest risk of pneumonia.

A Critical Analysis of Purchasing Arrangements in Kenya: The Case of the National Hospital Insurance Fund

PubMed Central

Munge, Kenneth; Mulupi, Stephen; Barasa, Edwine W.; Chuma, Jane

2018-01-01

Background: Purchasing refers to the process by which pooled funds are paid to providers in order to deliver a set of health care interventions. Very little is known about purchasing arrangements in low- and middle-income countries (LMICs), and certainly not in Kenya. This study aimed to critically analyse purchasing arrangements in Kenya, using the National Hospital Insurance Fund (NHIF) as a case study. Methods: We applied a principal-agent relationship framework, which identifies three pairs of principal-agent relationships (government-purchaser, purchaser-provider, and citizen-purchaser) and specific actions required within them to achieve strategic purchasing. A qualitative case study approach was applied. Data were collected through document reviews (statutes, policy and regulatory documents) and in-depth interviews (n=62) with key informants including NHIF officials, Ministry of Health (MoH) officials, insurance industry actors, and health service providers. Documents were summarised using standardised forms. Interviews were recorded, transcribed verbatim, and analysed using a thematic framework approach. Results: The regulatory and policy framework for strategic purchasing in Kenya was weak and there was no clear accountability mechanism between the NHIF and the MoH. Accountability mechanisms within the NHIF have developed over time, but these emphasized financial performance over other aspects of purchasing. The processes for contracting, monitoring, and paying providers do not promote equity, quality, and efficiency. This was partly due to geographical distribution of providers, but also due to limited capacity within the NHIF. There are some mechanisms for assessing needs, preferences, and values to inform design of the benefit package, and while channels to engage beneficiaries exist, they do not always function appropriately and awareness of these channels to the beneficiaries is limited. Conclusion: Addressing the gaps in the NHIF’s purchasing performance requires a number of approaches. Critically, there is a need for the government through the MoH to embrace its stewardship role in health, while recognizing the multiplicity of actors given Kenya’s devolved context. Relatively recent decentralisation reforms present an opportunity that should be grasped to rewrite the contract between the government, the NHIF and Kenyans in the pursuit of universal health coverage (UHC). PMID:29524953

Challenges experienced by service providers in the delivery of medico-legal services to survivors of sexual violence in Kenya.

PubMed

Ajema, C; Mukoma, W; Kilonzo, N; Bwire, B; Otwombe, K

2011-05-01

While much discussion has been devoted to defining the standards of care required when offering services to survivors of sexual violence, much less attention has been given to procedures for evidence collection to allow the successful prosecution of perpetrators. In Kenya there are no comprehensive guidelines that outline the roles of the survivor, the community, health care workers, and the police with regard to the handling of forensic evidence, a deficit that contributes to delays in prosecuting, or even a failure to prosecute sex offenders. This study examines some of the obstacles in Kenya to the adequate handling of forensic evidence in sexual violence cases. It was based on in-depth interviews with respondents drawn from health facilities, police stations, civil society organizations and with the Government Chemist in three Kenyan provinces. The study's objective was to examine the existing policy requirements regarding the maintenance of an evidence chain by the health and criminal justice systems, and how effectively they are being implemented. The findings indicate that the quality of the evidence obtained by the health care workers was often deficient, depending on the time elapsed before the rape survivor reports to the health facility; the equipment available at the health facility; the age of the survivor; and the level of knowledge of the service provider regarding the types of evidence to be collected from survivors of sexual violence. Copyright © 2011 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

Integrating participatory engagement and scientific research to inform causes and solutions to water problems in the River Njoro Watershed Kenya.

NASA Astrophysics Data System (ADS)

Jenkins, M.

2012-12-01

Over the course of 9 years, an international multidisciplinary team of US and Kenyan scientists under the Sustainable Management of Rural Watersheds (SUMAWA) Project, based at Egerton University in Kenya, worked with Kenyan public agencies to apply a variety of participatory methods and outreach activities combined with land use mapping, hydrologic and water system modeling, and other scientific tools and evaluations to investigate and identify solutions to declining water quantity and quality problems affecting communities and environmental and productive sectors in the River Njoro Watershed in Kenya. Traditional participatory rural appraisal techniques were modified to engage low income, informal, and tribal communities in identification of local services, benefits, and groups linked to water and riparian resources and collect their perceptions of water-related problems, priorities, and solution options throughout the watershed. Building on this foundation of insights, information, and engagement on water issues with local communities and other stakeholders, the project designed a research agenda aimed at creating shared scientific understanding of the causes of identified problems and developing and testing promising interventions to address community and stakeholder priority concerns. This presentation will share lessons from the SUMAWA experience of using a problem-driven, solution-oriented, community-based watershed approach to address water resource problems at local scale in a semi-arid African developing country setting.

[Integrated Quality Management System (IQMS): a model for improving the quality of reproductive health care in rural Kenya].

PubMed

Herrler, Claudia; Bramesfeld, Anke; Brodowski, Marc; Prytherch, Helen; Marx, Irmgard; Nafula, Maureen; Richter-Aairijoki, Heide; Musyoka, Lucy; Marx, Michael; Szecsenyi, Joachim

2015-01-01

To develop a model aiming to improve the quality of services for reproductive health care in rural Kenya and designed to measure the quality of reproductive health services in such a way that allows these services to identify measures for improving their performance. The Integrated Quality Management System (IQMS) was developed on the basis of a pre-existing and validated model for quality promotion, namely the European Practice Assessment (EPA). The methodology for quality assessment and feedback of assessment results to the service teams was adopted from the EPA model. Quality assessment methodology included data assessment through staff, patient surveys and service visitation. Quality is assessed by indicators, and so indicators had to be developed that were appropriate for assessing reproductive health care in rural Kenya. A search of the Kenyan and international literature was conducted to identify potential indicators. These were then rated for their relevance and clarity by a panel of Kenyan experts. 260 indicators were rated as relevant and assigned to 29 quality dimensions and 5 domains. The implementation of IQMS in ten facilities showed that IQMS is a feasible model for assessing the quality of reproductive health services in rural Kenya. IQMS enables these services to identify quality improvement targets and necessary improvement measures. Both strengths and limitations of IQMS will be discussed. Copyright © 2015. Published by Elsevier GmbH.

Opportunities and challenges for implementing cost accounting systems in the Kenyan health system

PubMed Central

Kihuba, Elesban; Gheorghe, Adrian; Bozzani, Fiammetta; English, Mike; Griffiths, Ulla K.

2016-01-01

Background Low- and middle-income countries need to sustain efficiency and equity in health financing on their way to universal health care coverage. However, systems meant to generate quality economic information are often deficient in such settings. We assessed the feasibility of streamlining cost accounting systems within the Kenyan health sector to illustrate the pragmatic challenges and opportunities. Design We reviewed policy documents, and conducted field observations and semi-structured interviews with key informants in the health sector. We used an adapted Human, Organization and Technology fit (HOT-fit) framework to analyze the components and standards of a cost accounting system. Results Among the opportunities for a viable cost accounting system, we identified a supportive broad policy environment, political will, presence of a national data reporting architecture, good implementation experience with electronic medical records systems, and the availability of patient clinical and resource use data. However, several practical issues need to be considered in the design of the system, including the lack of a framework to guide the costing process, the lack of long-term investment, the lack of appropriate incentives for ground-level staff, and a risk of overburdening the current health management information system. Conclusion To facilitate the implementation of cost accounting into the health sector, the design of any proposed system needs to remain simple and attuned to the local context. PMID:27357072

A computer-based medical record system and personal digital assistants to assess and follow patients with respiratory tract infections visiting a rural Kenyan health centre.

PubMed

Diero, Lameck; Rotich, Joseph K; Bii, John; Mamlin, Burke W; Einterz, Robert M; Kalamai, Irene Z; Tierney, William M

2006-04-10

Clinical research can be facilitated by the use of informatics tools. We used an existing electronic medical record (EMR) system and personal data assistants (PDAs) to assess the characteristics and outcomes of patients with acute respiratory illnesses (ARIs) visiting a Kenyan rural health center. We modified the existing EMR to include details on patients with ARIs. The EMR database was then used to identify patients with ARIs who were prospectively followed up by a research assistant who rode a bicycle to patients' homes and entered data into a PDA. A total of 2986 clinic visits for 2009 adult patients with respiratory infections were registered in the database between August 2002 and January 2005; 433 patients were selected for outcome assessments. These patients were followed up in the villages and assessed at 7 and 30 days later. Complete follow-up data were obtained on 381 patients (88%) and merged with data from the enrollment visit's electronic medical records and subsequent health center visits to assess duration of illness and complications. Symptoms improved at 7 and 30 days, but a substantial minority of patients had persistent symptoms. Eleven percent of patients sought additional care for their respiratory infection. EMRs and PDA are useful tools for performing prospective clinical research in resource constrained developing countries.

An Effective Intervention to Reduce Intravaginal Practices Among HIV-1 Uninfected Kenyan Women

PubMed Central

McClelland, R. Scott; Ravel, Jacques; Ahmed, Aabid; Cleland, Charles M.; Gajer, Pawel; Mwamzaka, Musa; Marshed, Fatma; Shafi, Juma; Masese, Linnet; Fajans, Mark; Anderson, Molly E.; Jaoko, Walter; Kurth, Ann E.

2014-01-01

Abstract Intravaginal practices (IVP) are common among African women and are associated with HIV acquisition. A behavioral intervention to reduce IVP is a potential new HIV risk-reduction strategy. Fifty-eight HIV-1-uninfected Kenyan women reporting IVP and 42 women who denied IVP were followed for 3 months. Women using IVP attended a skill-building, theory-based group intervention occurring weekly for 3 weeks to encourage IVP cessation. Vaginal swabs at each visit were used to detect yeast, to detect bacterial vaginosis, and to characterize the vaginal microbiota. Intravaginal insertion of soapy water (59%) and lemon juice (45%) was most common among 58 IVP women. The group-counseling intervention led to a decrease in IVP from 95% (54/58) at baseline to 0% (0/39) at month 3 (p=0.001). After 3 months of cessation, there was a reduction in yeast on vaginal wet preparation (22% to 7%, p=0.011). Women in the IVP group were more likely to have a Lactobacillus iners-dominated vaginal microbiota at baseline compared to controls [odds ratio (OR), 6.4, p=0.006] without significant change in the microbiota after IVP cessation. The group counseling intervention was effective in reducing IVP for 3 months. Reducing IVP may be important in itself, as well as to support effective use of vaginal microbicides, to prevent HIV acquisition. PMID:25265254

Opportunities and challenges for implementing cost accounting systems in the Kenyan health system.

PubMed

Kihuba, Elesban; Gheorghe, Adrian; Bozzani, Fiammetta; English, Mike; Griffiths, Ulla K

2016-01-01

Low- and middle-income countries need to sustain efficiency and equity in health financing on their way to universal health care coverage. However, systems meant to generate quality economic information are often deficient in such settings. We assessed the feasibility of streamlining cost accounting systems within the Kenyan health sector to illustrate the pragmatic challenges and opportunities. We reviewed policy documents, and conducted field observations and semi-structured interviews with key informants in the health sector. We used an adapted Human, Organization and Technology fit (HOT-fit) framework to analyze the components and standards of a cost accounting system. Among the opportunities for a viable cost accounting system, we identified a supportive broad policy environment, political will, presence of a national data reporting architecture, good implementation experience with electronic medical records systems, and the availability of patient clinical and resource use data. However, several practical issues need to be considered in the design of the system, including the lack of a framework to guide the costing process, the lack of long-term investment, the lack of appropriate incentives for ground-level staff, and a risk of overburdening the current health management information system. To facilitate the implementation of cost accounting into the health sector, the design of any proposed system needs to remain simple and attuned to the local context.

Reliability of School Surveys in Estimating Geographic Variation in Malaria Transmission in the Western Kenyan Highlands

PubMed Central

Gitonga, Caroline W.; Gillig, Jonathan; Owaga, Chrispin; Marube, Elizabeth; Odongo, Wycliffe; Okoth, Albert; China, Pauline; Oriango, Robin; Brooker, Simon J.; Bousema, Teun; Drakeley, Chris; Cox, Jonathan

2013-01-01

Background School surveys provide an operational approach to assess malaria transmission through parasite prevalence. There is limited evidence on the comparability of prevalence estimates obtained from school and community surveys carried out at the same locality. Methods Concurrent school and community cross-sectional surveys were conducted in 46 school/community clusters in the western Kenyan highlands and households of school children were geolocated. Malaria was assessed by rapid diagnostic test (RDT) and combined seroprevalence of antibodies to bloodstage Plasmodium falciparum antigens. Results RDT prevalence in school and community populations was 25.7% (95% CI: 24.4-26.8) and 15.5% (95% CI: 14.4-16.7), respectively. Seroprevalence in the school and community populations was 51.9% (95% CI: 50.5-53.3) and 51.5% (95% CI: 49.5-52.9), respectively. RDT prevalence in schools could differentiate between low (<7%, 95% CI: 0-19%) and high (>39%, 95% CI: 25-49%) transmission areas in the community and, after a simple adjustment, were concordant with the community estimates. Conclusions Estimates of malaria prevalence from school surveys were consistently higher than those from community surveys and were strongly correlated. School-based estimates can be used as a reliable indicator of malaria transmission intensity in the wider community and may provide a basis for identifying priority areas for malaria control. PMID:24143250

Impact of foot-and-mouth disease on milk production on a large-scale dairy farm in Kenya.

PubMed

Lyons, Nicholas A; Alexander, Neal; Stärk, Katharina D C; Dulu, Thomas D; Sumption, Keith J; James, Andrew D; Rushton, Jonathan; Fine, Paul E M

2015-06-15

The economic impact of foot-and-mouth disease (FMD) has been poorly characterised particularly in endemic settings where such knowledge is important for decision-making on disease control with limited resources. In order to address this, a study was designed using individual animal data from a large-scale dairy farm in Kenya to estimate the impact of an FMD outbreak due to serotype SAT2 virus on milk yield. Daily milk yields from 218 mainly European-breed cattle that were lactating during the 29-day outbreak period were considered in the analysis. At the herd level, the average daily yields decreased from around 20 to 13kg per cow, recovering approximately 2 months after the commencement of the outbreak. Generalised estimating equations (GEE) and an autoregressive correlation matrix were used to compare yields of reported clinical FMD cases and non-cases. No difference was found between reported clinical and non-clinical cases suggesting inaccurate case recording, poor sensitivity of the case definition and subclinical infections being present. To further investigate the impact of FMD, yields were predicted for each individual animal based on historic data from the same herd using a similar GEE approach. For cattle lactating during the outbreak, comparisons were made between actual and predicted yields from the commencement of the outbreak to 305 days lactation using a linear regression model. Animals produced significantly less than predicted if in parity 2 or greater and between 0 and 50 days in milk (DIM) at the start of the outbreak period. The maximum effect was seen among animals in parity ≥4 and between 0 and 50 DIM at the start of the outbreak, producing on average 688.7kg (95%CI 395.5, 981.8) less milk than predicted for their remaining lactation, representing an average 15% reduction in the 305 day production for these animals. Generalisation of the results requires caution as the majority of Kenyan milk is produced in smallholder farms. However, such farms use similar genetics and feeding practices to the study farm, and such systems are increasingly important in the supply of milk globally. These results make an important and unique contribution to the evidence base on FMD impact among dairy cattle in an endemic setting. Copyright © 2015 Elsevier B.V. All rights reserved.

Cancer genetics education in a low- to middle-income country: evaluation of an interactive workshop for clinicians in Kenya.

PubMed

Hill, Jessica A; Lee, Su Yeon; Njambi, Lucy; Corson, Timothy W; Dimaras, Helen

2015-01-01

Clinical genetic testing is becoming an integral part of medical care for inherited disorders. While genetic testing and counseling are readily available in high-income countries, in low- and middle-income countries like Kenya genetic testing is limited and genetic counseling is virtually non-existent. Genetic testing is likely to become widespread in Kenya within the next decade, yet there has not been a concomitant increase in genetic counseling resources. To address this gap, we designed an interactive workshop for clinicians in Kenya focused on the genetics of the childhood eye cancer retinoblastoma. The objectives were to increase retinoblastoma genetics knowledge, build genetic counseling skills and increase confidence in those skills. The workshop was conducted at the 2013 Kenyan National Retinoblastoma Strategy meeting. It included a retinoblastoma genetics presentation, small group discussion of case studies and genetic counseling role-play. Knowledge was assessed by standardized test, and genetic counseling skills and confidence by questionnaire. Knowledge increased significantly post-workshop, driven by increased knowledge of retinoblastoma causative genetics. One-year post-workshop, participant knowledge had returned to baseline, indicating that knowledge retention requires more frequent reinforcement. Participants reported feeling more confident discussing genetics with patients, and had integrated more genetic counseling into patient interactions. A comprehensive retinoblastoma genetics workshop can increase the knowledge and skills necessary for effective retinoblastoma genetic counseling.

Hypothetical performance of syndrome-based management of acute paediatric admissions of children aged more than 60 days in a Kenyan district hospital.

PubMed Central

English, Mike; Berkley, James; Mwangi, Isiah; Mohammed, Shebbe; Ahmed, Maimuna; Osier, Faith; Muturi, Neema; Ogutu, Bernhards; Marsh, Kevin; Newton, Charles R. J. C.

2003-01-01

OBJECTIVE: To investigate whether the outpatient, syndrome-based approach of the Integrated Management of Childhood Illness (IMCI) protocol could be extended to the inpatient arena to give clear and simple minimum standards of care for poorly resourced facilities. METHODS: A prospective, one-year admission cohort retrospectively compared hypothetical performance of syndrome-based management with paediatrician-defined final diagnosis. Admission syndrome definitions were based on local adaptations to the IMCI protocol that encompassed 20 clinical features, measurement of oxygen saturation, and malaria microscopy. FINDINGS: After 315 children with clinically obvious diagnoses (e.g. sickle cell disease and burns) were excluded, 3705 admission episodes were studied. Of these, 2334 (63%) met criteria for at least one severe syndrome (mortality 8% vs <1% for "non-severe" cases), and half of these had features of two or more severe syndromes. No cases of measles were seen. Syndrome-based treatment would have been appropriate (sensitivity >95%) for severe pneumonia, severe malaria, and diarrhoea with severe dehydration, and probably for severe malnutrition (sensitivity 71%). Syndrome-directed treatment suggested the use of broad-spectrum antibiotics in 75/133 (56% sensitivity) children with bacteraemic and 63/71 (89% sensitivity) children with meningitis. CONCLUSIONS: Twenty clinical features, oxygen saturation measurements, and results of malaria blood slides could be used for inpatient, syndrome-based management of acute paediatric admissions. The addition of microscopy of the cerebrospinal fluid and haemoglobin measurements would improve syndrome-directed treatment considerably. This approach might rationalize admission policy and standardize inpatient paediatric care in resource-poor countries, although the clinical detection of bacteraemia remains a problem. PMID:12764512

Malaria, Leishmaniasis and Shistosomiasis Vector Ecology, Transmission, Immunology and Prophylaxis in Kenya

DTIC Science & Technology

1994-01-27

medium supplemented with 20% fetal bovine serum, 250 ug/ml streptomycin, 250 U/ml penicillin , and 500 KEMRI Final Report DAMD17-87-G-7016 & DAMD17-89-Z...Leishmania major in a Kenyan Patient: Clinical Description and Parasite Characterization Larry Hendricks , Y.B. Mebrahtu, P.G. Lawyer, R. Muigai, C. Oster, P...Adungo, F.K. Owaga, P.V. Perkins, L.D. Hendricks , and R.E. Whitmire. Attack Rates of Malaria in School Children in The Siaya and Kisumu Districts, Nyanza

Department of the Navy Fiscal Year 2014 Annual Financial Report. The Nation’s Total Force: At the Right Place, At the Right Time, All the Time

DTIC Science & Technology

2014-11-01

for ship movement planning ● Improves collaboration with the University of Melbourne, Kenyan and Indian scientific organizations Self - Healing ...broken capsules forms a waxy, water-repellant coating across the exposed steel that protects against corrosion While many self - healing paints are...The DON also participated in the first Guam Exercise (GUAMEX) with the Japanese Maritime Self -Defense Force to enhance the interoperability of the

Evaluating, predicting and mapping belowground carbon stores in Kenyan mangroves.

PubMed

Gress, Selena K; Huxham, Mark; Kairo, James G; Mugi, Lilian M; Briers, Robert A

2017-01-01

Despite covering only approximately 138 000 km 2 , mangroves are globally important carbon sinks with carbon density values three to four times that of terrestrial forests. A key challenge in evaluating the carbon benefits from mangrove forest conservation is the lack of rigorous spatially resolved estimates of mangrove sediment carbon stocks; most mangrove carbon is stored belowground. Previous work has focused on detailed estimations of carbon stores over relatively small areas, which has obvious limitations in terms of generality and scope of application. Most studies have focused only on quantifying the top 1 m of belowground carbon (BGC). Carbon stored at depths beyond 1 m, and the effects of mangrove species, location and environmental context on these stores, are poorly studied. This study investigated these variables at two sites (Gazi and Vanga in the south of Kenya) and used the data to produce a country-specific BGC predictive model for Kenya and map BGC store estimates throughout Kenya at spatial scales relevant for climate change research, forest management and REDD+ (reduced emissions from deforestation and degradation). The results revealed that mangrove species was the most reliable predictor of BGC; Rhizophora muronata had the highest mean BGC with 1485.5 t C ha -1 . Applying the species-based predictive model to a base map of species distribution in Kenya for the year 2010 with a 2.5 m 2 resolution produced an estimate of 69.41 Mt C [±9.15 95% confidence interval (C.I.)] for BGC in Kenyan mangroves. When applied to a 1992 mangrove distribution map, the BGC estimate was 75.65 Mt C (±12.21 95% C.I.), an 8.3% loss in BGC stores between 1992 and 2010 in Kenya. The country-level mangrove map provides a valuable tool for assessing carbon stocks and visualizing the distribution of BGC. Estimates at the 2.5 m 2 resolution provide sufficient details for highlighting and prioritizing areas for mangrove conservation and restoration. © 2016 John Wiley & Sons Ltd.

Prevalence and correlates of treatment failure among Kenyan children hospitalised with severe community-acquired pneumonia: a prospective study of the clinical effectiveness of WHO pneumonia case management guidelines.

PubMed

Agweyu, Ambrose; Kibore, Minnie; Digolo, Lina; Kosgei, Caroline; Maina, Virginia; Mugane, Samson; Muma, Sarah; Wachira, John; Waiyego, Mary; Maleche-Obimbo, Elizabeth

2014-11-01

To determine the extent and pattern of treatment failure (TF) among children hospitalised with community-acquired pneumonia at a large tertiary hospital in Kenya. We followed up children aged 2-59 months with WHO-defined severe pneumonia (SP) and very severe pneumonia (VSP) for up to 5 days for TF using two definitions: (i) documentation of pre-defined clinical signs resulting in change of treatment (ii) primary clinician's decision to change treatment with or without documentation of the same pre-defined clinical signs. We enrolled 385 children. The risk of TF varied between 1.8% (95% CI 0.4-5.1) and 12.4% (95% CI 7.9-18.4) for SP and 21.4% (95% CI 15.9-27) and 39.3% (95% CI 32.5-46.4) for VSP depending on the definition applied. Higher rates were associated with early changes in therapy by clinician in the absence of an obvious clinical rationale. Non-adherence to treatment guidelines was observed for 70/169 (41.4%) and 67/201 (33.3%) of children with SP and VSP, respectively. Among children with SP, adherence to treatment guidelines was associated with the presence of wheeze on initial assessment (P = 0.02), while clinician non-adherence to guideline-recommended treatments for VSP tended to occur in children with altered consciousness (P < 0.001). Using propensity score matching to account for imbalance in the distribution of baseline clinical characteristics among children with VSP revealed no difference in TF between those treated with the guideline-recommended regimen vs. more costly broad-spectrum alternatives [risk difference 0.37 (95% CI -0.84 to 0.51)]. Before revising current pneumonia case management guidelines, standardised definitions of TF and appropriate studies of treatment effectiveness of alternative regimens are required. © 2014 The Authors. Tropical Medicine & International Health published by John Wiley & Sons Ltd.

Long-term changes in Serengeti-Mara wildebeest and land cover: Pastoralism, population, or policies?

PubMed Central

Homewood, K.; Lambin, E. F.; Coast, E.; Kariuki, A.; Kikula, I.; Kivelia, J.; Said, M.; Serneels, S.; Thompson, M.

2001-01-01

Declines in habitat and wildlife in semiarid African savannas are widely reported and commonly attributed to agropastoral population growth, livestock impacts, and subsistence cultivation. However, extreme annual and shorter-term variability of rainfall, primary production, vegetation, and populations of grazers make directional trends and causal chains hard to establish in these ecosystems. Here two decades of changes in land cover and wildebeest in the Serengeti-Mara region of East Africa are analyzed in terms of potential drivers (rainfall, human and livestock population growth, socio-economic trends, land tenure, agricultural policies, and markets). The natural experiment research design controls for confounding variables, and our conceptual model and statistical approach integrate natural and social sciences data. The Kenyan part of the ecosystem shows rapid land-cover change and drastic decline for a wide range of wildlife species, but these changes are absent on the Tanzanian side. Temporal climate trends, human population density and growth rates, uptake of small-holder agriculture, and livestock population trends do not differ between the Kenyan and Tanzanian parts of the ecosystem and cannot account for observed changes. Differences in private versus state/communal land tenure, agricultural policy, and market conditions suggest, and spatial correlations confirm, that the major changes in land cover and dominant grazer species numbers are driven primarily by private landowners responding to market opportunities for mechanized agriculture, less by agropastoral population growth, cattle numbers, or small-holder land use. PMID:11675492

Variation of facial features among three African populations: Body height match analyses.

PubMed

Taura, M G; Adamu, L H; Gudaji, A

2017-01-01

Body height is one of the variables that show a correlation with facial craniometry. Here we seek to discriminate the three populations (Nigerians, Ugandans and Kenyans) using facial craniometry based on different categories of body height of adult males. A total of 513 individuals comprising 234 Nigerians, 169 Ugandans and 110 Kenyans with mean age of 25.27, s=5.13 (18-40 years) participated. Paired and unpaired facial features were measured using direct craniometry. Multivariate and stepwise discriminate function analyses were used for differentiation of the three populations. The result showed significant overall facial differences among the three populations in all the body height categories. Skull height, total facial height, outer canthal distance, exophthalmometry, right ear width and nasal length were significantly different among the three different populations irrespective of body height categories. Other variables were sensitive to body height. Stepwise discriminant function analyses included maximum of six variables for better discrimination between the three populations. The single best discriminator of the groups was total facial height, however, for body height >1.70m the single best discriminator was nasal length. Most of the variables were better used with function 1, hence, better discrimination than function 2. In conclusion, adult body height in addition to other factors such as age, sex, and ethnicity should be considered in making decision on facial craniometry. However, not all the facial linear dimensions were sensitive to body height. Copyright © 2016 Elsevier GmbH. All rights reserved.

A Biosecurity Survey in Kenya, November 2014 to February 2015.

PubMed

Ndhine, Edwardina Otieno; Slotved, Hans-Christian; Osoro, Eric Mogaka; Olsen, Katja N; Rugutt, Moses; Wanjohi, Cathryn W; Mwanda, Walter; Kinyagia, Benson Mburu; Steenhard, Nina R; Hansen, John-Erik Stig

2016-01-01

A biosecurity survey was performed to gather information on the biosecurity level and laboratory capacity in Kenya for the purpose of providing information outlining relevant components for biosecurity legislation, biosecurity implementation, and enforcement of biosecurity measures in Kenya. This survey is, to the authors' knowledge, the first to be published from an African country. A total of 86 facilities with laboratories covering relevant categories, such as training laboratories, human diagnostic laboratories, veterinary diagnostic laboratories, and research laboratories, were selected to participate in the survey. Each facility was visited by a survey team and staff were asked to answer 29 groups of questions from a questionnaire. The survey showed that Kenyan laboratory facilities contain biological agents of biosecurity concern. The restrictions for these agents were found to be limited for several of the facilities, in that many laboratory facilities and storage units were open for access by either students or staff who had no need of access to the laboratory. The survey showed a great deal of confusion in the terms biosecurity and biosafety and a generally limited biosecurity awareness among laboratory personnel. The survey showed that the security of biological agents of biosecurity concern in many facilities does not meet the international requirements. The authors recommend developing a legal framework in Kenya for effective controls, including national biosecurity regulations, guidelines, and procedures, thereby reducing the risk that a Kenyan laboratory would be the source of a future biological attack.

Sediments from the Boxing Day tsunami on the coasts of southeastern India and Kenya

NASA Astrophysics Data System (ADS)

Weiss, R.; Bahlburg, H.

2006-12-01

On the Boxing Day 2004, the world community experienced a catastrophic tsunami in the Indian Ocean and could also saw how unprepared and unaware countries along the Indian ocean were. Beyond the tragedy of the tremendous loss of lives, the result of this event is an opportunity to study a global tsunami (mega-tsunami) in many regards. Here, we report on tsunami sediments left behind on beaches at the coast of Tamil Nadu (India) and on beaches between Malindi and Lamu (Kenya). Characteristic debris accumulations on the beach surface at Tamil Nadu (India) showed the impact of three tsunami waves. In this area, the tsunami climbed ~5 m up the beach; the last traces of a tsunami wave were found ~580 m away from the shoreline. Palm trees indicated an overland flow depth of 3.5 m, ~50 m from the shoreline. The tsunami deposits were up to 30 cm thick. They had an erosional base to the underlying soil and pre-tsunami beach deposits and were made up of moderately well- to well-sorted coarse and medium sand. The sand sheet thins inland, but without a decrease in grain size. Three distinct layers could be identified within the tsunami deposit. The lower one occasionally displayed cross-bedding with foresets dipping landward indicating deposition during run-up. The two upper layers were graded or parallel-laminated without indicators of flow directions. The boundaries between the different layers were marked by dark laminae, rich in heavy minerals. Also, the presence of benthic foraminifera indicates entrainment of sediment into the water column by the incoming tsunami wave in water depths less than 30 m. On beaches between Malindi and Lamu, Kenya, the traces of only one tsunami wave could be found, which attained a run-up height of about 3 m and traveled ~35 m inland with respect to the tidal stage at tsunami impact. The tsunami sediments consist of one layer of fine sand and are predominantly composed of heavy minerals supplied to the sea by nearby rivers. A slight fining-inland trend could be identified in the thinning- inland sand layer. Benthic foraminifera also indicate an entrainment of sediment by the incoming tsunami wave in a water depth less than 30 m, however there are indications that sediment might be entrained in a water depth of 80 m. The fact that only one sand layer occurs in Kenya as opposed to three at Tamil Nadu might lead to the conclusion that only one wave approached the Kenyan coast. This interpretation is misleading because the Kenyan coast is several thousand kilometers away from source area of the tsunami; the non-linear behavior of the incoming tsunami waves, especially the interaction with the nearby reef, may have resulted in the discovered sedimentologic evidence of the tsunami impact on the Kenyan coast.

Age-Related Buildup of Humoral Immunity against Epitopes for Rosette Formation and Agglutination in African Areas of Malaria Endemicity

PubMed Central

Barragan, Antonio; Kremsner, Peter G.; Weiss, Walter; Wahlgren, Mats; Carlson, Johan

1998-01-01

In this report, we show an age-related buildup of agglutinating activity as well as serum activity against rosette formation in children living in areas of Kenya and Gabon where malaria is endemic. Sera from Kenyans in general exhibited a stronger and wider immune response toward the epitopes, probably reflecting a difference in transmission patterns between the two areas. Thus, our results indicate that repeated malaria attacks in areas of endemicity, and consequently exposure to different isolate-specific antigens, will elicit an antibody-mediated response eventually enabling recognition of the majority of rosetting and agglutinating antigens. The correlation between antirosetting and agglutinating capacity was poor in individual cases, indicating that the rosetting epitopes are only a minor part of the highly diverse surface-exposed antigens (mainly PfEMP1) on the surface of parasitized erythrocytes toward which antibodies may react. These data together with our previous findings that the protection against cerebral malaria correlates with presence of antirosetting antibodies shed new light on our understanding of the gradual acquisition of immunity toward severe complications of malarial infection which children reared in areas of endemicity attain. PMID:9746579

Communicating about sex: adolescents and parents in Kenya.

PubMed

Kiragu, K; Obwaka, E; Odallo, D; Van Hulzen, C

1996-01-01

To guide the development of adolescent reproductive health programs in Kenya, a national IEC survey was conducted with 1476 adolescents 15-19 years of age and 2894 of their parents. The survey was conducted in 1994 by the Johns Hopkins University Population Communication Services, in collaboration with the Kenyan National Council for Population Development and the Central Bureau of Statistics. Both parents and children were most likely to report having discussed school, future careers, and alcohol/drug use during the year preceding the survey; topics least likely to be discussed included boy-girl relationships, acquired immunodeficiency syndrome (AIDS), sexual relations, abortion, contraception, and puberty. Mothers were more likely to discuss reproductive health issues with their children than fathers. Both male and female adolescents indicated they would be most comfortable discussing sexual matters with their same-sex siblings, friends, and health care workers. Over 75% of children and adults were supportive of school-based family life education programs. In many cases, parents lacked correct information about reproductive health issues. Interventions designed to facilitate parent-child communication include a weekly call-in radio program, a comic book that encourages teens to talk to their parents, and a booklet for parents suggesting ways of initiating discussions on sexual issues.