Parts Of Kenya Research Articles

Abstract PO-249: Implementing community cervical mass screenings in low-middle-income countries: A project implemented by the Blueprint for Success Program, International Cancer Institute in Kenya

Abstract Background: Cervical cancer ranks the second most common cancer in women living in less developed regions with over 500, 000 new cases in 2018 translating to 84% of the new cases worldwide. In 2018, over 300,000 women died from cervical cancer with more than 85% of these deaths occurring in low- and middle-income countries. This was about 1.0% of the reported new cases and about 1.1% of deaths reported in Kenya. The global health community has for the past decade been progressively emphasizing on the importance of addressing cancer prevention and screening where the disease burden is greatest. In low resource settings, especially most parts of Kenya where cervical screening services are offered, visual inspection of the cervix is widely used since there is limited access to Pap-Smear and HPV-DNA testing due to cost implications. However, Cervical cancer screening has faced tremendous challenges due to cultural beliefs in the communities hence giving an opportunity to fewer women to access this service. This project aimed to emphasize the importance of community cervical screening to increase cancer awareness, early screenings, diagnosis and linkage into care clinics in Meru county, Kenya. Methods: 2608 women between the ages of 13 and 92 years from January to December 2019, from a cervical cancer screening programme supported by Blueprint for success program in Meru county, were evaluated. Women who had a suspicion for abnormalities had biopsies taken and sent to Lancet Kenya Pathological Laboratory for histopathological testing and findings communicated to the International Cancer Institute Care and Research Clinics for follow-up and linkage to care and management. Biopsies were the only form of confirmatory testing for suspected cervical intraepithelial neoplasia grade 2 or higher CIN 2+. Results: The participants who underwent Visual Inspection with Acetic acid had a mean age of 44.87±14.4 years. 7.02% of the women screened were below 25 years, 57.09% between 25 to 49 years and 35.89% above the age of 49 years. All the women screened were educated on the importance of continual screening based on their HIV status. 2.11% HIV+ women were asked to undergo screening yearly, 83.28% HIV- women were encouraged to access screening at least once every three years whereas the 14.61% women who did not know their HIV status were advised to get tested and get screened based on their HIV status outcome. VIA results from 2552(97.85%) women were found to be normal, 43(1.65%) were abnormal or aceto-white while 13(0.05%) had ulcerations and excessive bleeding. Biopsies were taken from 42(1.61%), Loop Electrosurgical Excision Procedure (LEEP) was done for 1(0.04%), and polypectomy was done for 2(0.08%). Conclusion: Community-based mass screenings have improved early screening and encouraged the uptake of screenings in Meru county. Pap smear cytology and HPV-DNA testing confirmatory tests are recommendations for increasing the uptake due to its provision for privacy and handling the cultural beliefs’ challenge. Citation Format: Andrew Koech, Emma Achieng, Edwin Odoyo, Dennis Munene, Fredrick Chite Asirwa. Implementing community cervical mass screenings in low-middle-income countries: A project implemented by the Blueprint for Success Program, International Cancer Institute in Kenya [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-249.

Institutions and Civil Society Relations in Migori County (Kenya): A Social Network Analysis of Weak and Strong Ties

The goal of this paper is to investigate policy networks in Migori, a small county in the Western part of Kenya, near the border with Tanzania and Victoria Lake. In this study we build a unique network database and we use Social Network Analysis techniques to detect the structural relations among different stakeholders (e.g. institutions and civil society actors) within this county and we focus on different topics (i.e. overall interactions, training and cooperation, and for specific decision making on health and nutrition, and agricultural issues). The main results show the importance to distinguish, in policy networks, the rationale of interactions and their intensity, i.e. weak or strong ties. Institutions and civil society organizations are differently connected according to the functions and intensity of networks in which they operate. For example, for health and nutrition the Ministry is the core actor; the opposite occurs in agriculture, where local communities are the core players; and finally in training and coordination we have an intermediate layout, if compared to the two previous ones.

Bribe and Bribery Labeling in Kenyan Anti-Corruption Discourse: A Conceptual Metaphor Perspective

Corruption in Kenya has been a particularly large problem since its independence from British rule in 1963. This paper explores the motivation behind a cultural specific metaphor of bribe and bribery labeling in Kenya as seen from the conceptual metaphor viewpoint. The study identifies and explains the different terms relating to a bribe and bribery, describes social-cultural values in Kenya, and accounts for the cognitive processes involved in their interpretation. The data includes a list of terms collected from traffic police officers, public transport workers and commuters from different parts of Kenya. These metaphors were identified by the Metaphor Identification Procedure (MIP) created by Pragglejaz Group (2007) and analyzed using the Cognitive Metaphor Theory from Lakoff and Johnson (1987). The results reveal that language spoken by a society is an essential part of its culture, and the lexical distinctions drawn by each language reflect culturally important features of objects, foods, institutions, games, air we breathe and other activities in the society in which the language operates. We argue that conceptual metaphors are conduits of communication, and it is prudent to apply the cognitive linguistic approach for their better contextual appreciation. This paper concludes by suggesting further avenues for research into socio-cultural metaphors, and by calling for the government to innovate new ways of fighting corruption because the players have invented ingenious ways of communicating about it metaphorically beyond comprehension for a lay person.

Foodservice clientele tipping behavior and its impetus on restaurant service reliability in Kenya

ABSTRACT Tipping is an interesting pecuniary behavior involving service providers and hospitality’s restaurant clients. The tipping act goes beyond the hospitality industry and therefore is a common practice across the entire service industry. However, tipping is thought to have adverse negative effects on food service reliability. This is because of the general belief that tipping could be the origin of selective and discriminatory service, with an inclination toward clients who are believed to tip thus compromising service quality hence reliability. This study therefore sought to investigate the relationship between foodservice clientele tipping behavior and its impetus on restaurant service reliability in Kenya. A census of all the two- and three-star hotels was taken, and simple random sampling applied in the selection of study respondents. The study employed descriptive research survey design which is concerned with describing situations on the basis of respondents’ responses and examining their relationships. The area of study under investigation was Kisumu County, the former administrative districts of Nyanza province in Western parts of Kenya, with a sample size of 384 respondents. Questionnaires were self-administered to restaurant clients at the exit point after meals and the study achieved a response rate of 72.1%. The study gave results showing 62.8% gave tips. Further, the study found that respondents tipping behavior was not significantly related to nationality as well as gender (P ˃ 0.05). However, the independent variable – tipping was found to explain 30.5% of the variability of the dependent variable – food service reliability in the two and three-star hotels. Therefore, the study established a significant relationship between tipping and foodservice reliability in the two and there star hotels within Kisumu County, Kenya (P ˂ 0.05).

English

Groundnuts are among the principle economic oilseed largely cultivated in warm regions of Kenya and contribute to domestic food security and cash revenue. The study aimed at evaluating genetic diversity and phenotypic characterization of groundnut varieties grown in some parts of Kenya. Six varieties (ICG83708, ICGV99568, CG7, ICGV12991, RV and Chalimbana) obtained from KALRO (Kakamega) based on quality traits. Seeds were planted in cylindrical cans with 0.2 m3 of soil and allowed to germinate for 3 weeks. Leaf trait measurement was done using 15 cm ruler and the data was recorded in excel spreadsheet and exported to MINITAB v17 software. Extracted DNA was amplified using 11 SSR primers with manual scoring of bands. A dendrogram of cluster analysis was constructed based on simple matching coefficient of 11 microsatellite markers. Principle components showed Eigen values with 67.2% variability of all the traits studied. A total of 35 alleles were detected across the loci of 11 primers used. Major allele frequency ranged from 0.9333 in IPAHM 165 to the least frequency of 0.6333 in IPAHM 176 with an average of 0.7610 across all the markers. The expected heterozygosity had a mean of 0.3178 with highest value of 0.4511 in IPAHM 176. Phylogenetic tree had three major clusters and with high bootstrap values in genotype icgv99568 replicates. Primer IPAHM176 was the most informative marker and should be utilized in selection of parent plants with good quality traits. Breeding programs on groundnuts should utilize grain and seed traits since they are informative and discriminatory.   Key words: Groundnut varieties, phenotypic and genetic characterization, gene diversity.

LC-MS-Based Metabolomics for the Chemosystematics of Kenyan Dodonaea viscosa Jacq (Sapindaceae) Populations.

Dodonaea viscosa Jacq (Sapindaceae) is a medicinal plant with a worldwide distribution. The species has undergone enormous taxonomic changes which caused confusion amongst plant users. In Kenya, for example, two varieties are known to exist based on morphology, i.e., D. viscosa var. viscosa along the coast, and D. viscosa var. angustifolia in the Kenyan inland. These two taxa are recognized as distinct species in some reports. This prompted us to apply metabolomics to understand the relationship among naturally occurring populations of D. viscosa in Kenya, and to identify compounds that can assist in taxonomic delineation of the different varieties of D. viscosa from different parts of Kenya. The phytochemical variability of Kenyan D. viscosa var. angustifolia populations collected from four different geographical regions (Nanyuki, Machakos, Nairobi, and Narok) and one coastal D. viscosa var. viscosa (the Gazi) were analyzed by LC-MS using a metabolomics-driven approach. Four known compounds, two diterpenoids (dodonic acid (1), hautriwaic acid lactone (3), and two flavonoids (5,7,4′,5′-tetrahydroxy-3,6,2′-trimethoxyflavone (2) and catechin (4)) were isolated and purified from the Gazi coastal collection. The presence of these compounds and their relative abundance in other populations was determined by LC-MS analyses. Multivariate statistical analyses of LC-MS data was used for the visualization of the patterns of variation and identification of additional compounds. Eleven discriminant compounds responsible for separating chemometric clusters were tentatively identified. In an antimicrobial assay, hautriwaic acid lactone (3) and catechin (4) were the most active compounds followed by the extract from the coastal (Gazi) population. The clustering pattern of the five populations of D. viscosa suggested that the metabolite profiles were influenced by geo-environmental conditions and did not support the current classification of D. viscosa based on morphology. This study disputes the current classification of D. viscosa in Kenya and recommends revision using tools such as molecular phylogenetics.

Feasible E-Health Strategies to Reduce Maternal Mortality in Kenya

Maternal mortality remains a persistent cause of death in Sub-Saharan Africa. Although e-health technologies are rapidly advancing, many technologies are infeasible given the infrastructure constraints and context of Sub-Saharan Africa. This paper proposes and implement a feasible e-health strategy, which involves the use of simple mobile phone technology and was designed to reduce maternal mortality and neonatal rates through information dissemination, among the nomadic people within a select part of Kenya. This strategy was developed, through an interactive pilot study, to determine the most feasible technique, which was found to be SMS messages, and most appropriate customized information depending on the patient's condition and period in pregnancy. A cross-sectional randomized e-health intervention was implemented in order to determine the effectiveness of the intervention. Due to exceptional circumstances, such as a prolonged health strike, this intervention had mixed results but shows promise of both feasibility and effectiveness.

Risk reduction of diarrhea and respiratory infections following a community health education program - a facility-based case-control study in rural parts of Kenya

BackgroundDiarrheal and acute respiratory infections remain a major cause of death in developing countries especially among children below 5 years of age. About 80% of all hospital attendances in Kenya can be attributed to preventable diseases and at least 50% of these preventable diseases are linked to poor sanitation. The purpose of this study was to assess the impact of a community-based health education program, called Familia Nawiri, in reducing the risk of diarrhea and respiratory infections among people living in three rural Kenyan communities.MethodsCases were defined as patients attending the health facility due to diarrhea or a respiratory infection while controls were patients attending the same health facility for a non-communicable disease defined as an event other than diarrhea, respiratory infection. Adjusted odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using a logistic regression model to assess the risk of diarrheal or respiratory infection in association with exposure to the health education program.ResultsThere were 324 cases and 308 controls recruited for the study with 57% of the cases and 59% of the controls being male. Overall, 13% of cases vs. 20% of control patients were exposed to the education program. Participants exposed to the program had 38% lower odds of diarrhea and respiratory infections compared to those not exposed to the program (adjusted OR 0.62, 95% CI 0.41–0.96). A similar risk reduction was observed for participants in the study who resided in areas with water improvement initiatives (adjusted OR 0.65, 95% CI 0.47–0.90). Variables in the adjusted model included water improvement projects in the area and toilet facilities.ConclusionFindings from this study suggest participants exposed to the education program and those residing in areas with water improvement initiatives have a reduced risk of having diarrhea or respiratory infection.

Soil greenhouse gas emissions under different land-use types in savanna ecosystems of Kenya

Abstract. Field measurement data on greenhouse gas (GHG) emissions are still scarce for many land-use types in Africa, causing a high level of uncertainty in GHG budgets. To address this gap, we present in situ measurements of carbon dioxide (CO2), nitrous oxide (N2O), and methane (CH4) emissions from the lowlands of southern Kenya. We conducted eight chamber measurement campaigns on gas exchange from four dominant land-use types (LUTs) comprising (1) cropland, (2) bushland, (3) grazing land, and (4) conservation land between 29 November 2017 and 3 November 2018, accounting for regional seasonality (wet and dry seasons and transitions periods). Mean CO2 emissions for the whole observation period were the highest by a significant margin (p value < 0.05) in the conservation land (75±6 mg CO2-C m−2 h−1) compared to the three other sites, which ranged from 45±4 mg CO2-C m−2 h−1 (bushland) to 50±5 mg CO2-C m−2 h−1 (grazing land). Furthermore, CO2 emissions varied between seasons, with significantly higher emissions in the wet season than the dry season. Mean N2O emissions were highest in cropland (2.7±0.6 µg N2O-N m−2 h−1) and lowest in bushland (1.2±0.4 µg N2O-N m−2 h−1) but did not vary with season. In fact, N2O emissions were very low both in the wet and dry seasons, with slightly elevated values during the early days of the wet seasons in all LUTs. On the other hand, CH4 emissions did not show any significant differences across LUTs and seasons. Most CH4 fluxes were below the limit of detection (LOD, ±0.03 mg CH4-C m−2 h−1). We attributed the difference in soil CO2 emissions between the four sites to soil C content, which differed between the sites and was highest in the conservation land. In addition, CO2 and N2O emissions positively correlated with soil moisture, thus an increase in soil moisture led to an increase in emissions. Furthermore, vegetation cover explained the seasonal variation in soil CO2 emissions as depicted by a strong positive correlation between the normalized difference vegetation index (NDVI) and CO2 emissions, most likely because, with more green (active) vegetation cover, higher CO2 emissions occur due to enhanced root respiration compared to drier periods. Soil temperature did not show a clear correlation with either CO2 or N2O emissions, which is likely due to the low variability in soil temperature between seasons and sites. Based on our results, soil C, active vegetation cover, and soil moisture are key drivers of soil GHG emissions in all the tested LUTs in southern Kenya. Our results are within the range of previous GHG flux measurements from soils from various LUTs in other parts of Kenya and contribute to more accurate baseline GHG emission estimates from Africa, which are key to reducing uncertainties in global GHG budgets as well as for informing policymakers when discussing low-emission development strategies.

A Conceptual Analysis of Metaphors Engendering HIV and AIDS-Related Stigma and Discrimination in Kisii County, Kenya

Metaphors are mapped across two conceptual domains where A is B. Metaphorical expressionsare defined by dimensions including novelty, conventionality, abstractness and concreteness. The AbaGusii of Western Kenya is a highly conservative community of Bantu speakers of Western part of Kenya. They view HIV and Aids as taboo that cannot be the subject of discussion in public. Hence, People Living with HIV (hereafter PLHIV) are stigmatized and discriminated. The purpose of this paper is to analyse the metaphorical words and concepts that engender HIV and Aids-related stigma and discrimination in Kisii County. Descriptive narratives were elicited from HIV support providers using focus group discussions and follow-up interviews. The narratives were analysed in terms of five attributes of stigma and discrimination within the conceptual metaphor theory. Results revealed some culturally ingrained metaphors that evoke stigma and discrimination. The paper advocates for language management efforts using success stories in HIV and Aids management to construct positive messages to counter the negative metaphors.

Toponymy, Pioneership, and the Politics of Ethnic Hierarchies in the Spatial Organization of British Colonial Nairobi

Toponyms, along with other urban symbols, were used as a tool of control over space in many African countries during the colonial period. This strategy was epitomized by the British, who applied it in Nairobi and other parts of Kenya from the late 1800s. This paper shows that toponymy in colonial Nairobi was an imposition of British political references, urban nomenclature, as well as the replication of a British spatial idyll on the urban landscape of Nairobi. In early colonial Nairobi, the population was mainly composed of three main groups: British, Asians, and Africans. Although the Africans formed the bulk of the population, they were the least represented, socially, economically and politically. Ironically, he British, who were the least in population held the political and economic power, and they applied it vigorously in shaping the identity of the city. The Asians were neither as powerful as the British, nor were they considered to be at the low level of the native Africans. This was the deliberate hierarchical structure that was instituted by the colonial government, where the level of urban citizenship depended on ethnic affiliation. Consequently, this structure was reflected in the toponymy and spatial organization of the newly founded city with little consideration to its pre-colonial status. Streets, buildings and other spaces such as parks were predominantly named after the British monarchy, colonial administrators, settler farmers, and businessmen, as well as prominent Asian personalities. In this paper, historical references such as maps, letter correspondences, monographs, and newspaper archives have been used as evidence to prove that toponyms in colonial Nairobi were the spatial signifiers that reflected the political, ideological and ethnic hierarchies and inequalities of the time.

Prevalence and genotyping of Echinococcus granulosus sensu lato from livestock in north-eastern Kenya.

Cystic echinococcosis (CE) is a zoonotic disease of cosmopolitan distribution and caused by the larval stage of the dog tapeworm, Echinococcus granulosus sensu lato (s.l.). CE occurs in the wider African continent and in Kenya, notably in the Maasailand and Turkana regions; however, recent studies demonstrate its presence in other parts of Kenya. This study determined the occurrence of CE in livestock (camels, goats, sheep and cattle) in Isiolo, Garissa and Wajir counties, and characterized the species of E. granulosus s.l. present. An abattoir survey was used to determine the presence of CE in various organs in livestock. Polymerase chain reaction-restriction fragment length polymorphism and sequencing of the mitochondrial NADH dehydrogenase subunit 1 gene was used for genotyping. A total of 1368 carcasses from 687 goats, 234 camels, 329 sheep and 118 cattle were inspected for the presence of hydatid cysts. The overall proportion of infections was 29.1% in camels, 14.4% in cattle, 9.9% in goats and 8.2% in sheep. The liver was the most infected organ, while only the lung of camels harboured fertile cysts. Of the 139 cysts genotyped, 111 (79.9%) belonged to Echinococcus canadensis (G6/7) and 20 (14.4%) to E. granulosus sensu stricto. One and two cysts were identified as Taenia saginata and unknown Taenia species, respectively. There was a significant association between county of origin and species of the animal with occurrence of CE. This study reports, for the first time, the characterization of Echinococcus species in livestock from Garissa and Wajir counties, and the current situation in Isiolo county. The fertility of cysts in camels and frequency of E. canadensis (G6/7) in all livestock species indicate that camels play an important role in the maintenance of CE in the north-eastern counties of Kenya.

Study of Spatial Distribution of Potentially Toxic Elements in a Nature Reserve in Langata Ecosystem

Introduction: Study of Spatial distribution trends of potentially toxic trace (PTE) element pollution in Nature Reserves in Kenya soil has not been fully done. Pollution from potentially toxic trace elements (PTEs) suspected to be widespread in many parts of Kenya including Nature reserves. This is concidered a threat to wild animals and human health. This therefore necessitates a study to understand the extent of spatial distribution of PTE of much economic and health importance. Methods: About forty soil samples were taken in AFEW nature reserve in Langata Ecosystem at, 25 centimeters deep using soil augur. The samples in Ziplocs were transported to the chemistry labs. at Kabete and analyzed to determine levels of Pb Hg, Co Cr Cu, Zn by Coupled Plasma (ICP) Atomic Emission Spectrophotometry (AES) Optima 8000, Perkin Elmer to determine various ions, the results are presented in mg/gm. Health Quotient (HQ), Health Index (HI) and Pollution Index was calculated from the results. Results: In the study, traces of Potential Toxic Elements (Pb, Hg, Cd, Cr, Cu) were found in soil samples taken in varying quantities. Generally, there was higher levels near a stream in the reserve, Pb ranging from 0.9080mg/gm to 3.6927mg/gm; Hg varying from 1.8355mg/gm to 3.4781mg/gm. All others showed variation with higher levels in batches (B2) near the stream. No Zinc and Aluminum was detected in the samples. Health Index due to five PTEs was 0.859. Conclusion: It can be concluded that there are significant level Pb Hg, and Cobalt in various transects, but more near the stream traversing the reserve. HI is 1 for Pb, Hg, and Co suggesting pollution by lead and Mercury in the Reserve.

Environmental Audit and Policy Compliance of Tobacco Farming Practices in Migori County, Western Kenya.

There is growing evidence that tobacco farming and use, among other critical livelihood factors, has an impact not only on health but also on the environment. The tobacco industry in Kenya has been on the rise with new production areas emerging. However, the nature of the environmental friendliness of the production, processing and consumption technologies have yet to be evaluated in many parts of Kenya. This study undertook an environmental auditing of tobacco farming activities in the South Nyanza region of Kenya for purposes of evaluating their compliance levels and policy formulation. Data collection was achieved through a detailed environmental audit checklist, focused group discussions, interviews, and field observations. Generally, the environmental compliance level with the National Environment Management Authority, World Health Organization standards and world best farming practices was dismal, at 13.6%. Tobacco companies' compliance rating with standards in application of pesticides and agrochemicals, use and management of energy resources, tobacco leaf storage and disposal of uncollected leaves, occupational health and safety, and best established practices in corporate social responsibility stood at 19.8, 15.7, 27.7, 2.1 and 11.8%, respectively. The low compliance level implies unsustainable farming practices; thus the need for enhanced enforcement of good environmental practices in the sector. Development of policies and legislation on economically viable and environmentally sustainable alternative crops is therefore recommended.

Factors influencing economic efficiency of milk production among small-scale dairy farms in Mukurweini, Nyeri County, Kenya.

This paper highlights the factors likely to influence the economic efficiency of small-scale dairy farms in Mukurweini, Nyeri County, Kenya. A total of 91 small-scale dairy farms previously involved in a nutritional training in 2013 were administered with semi-structured questionnaires. Data collected were entered into SPSS and FRONTIER 4.1 was used to compute the technical, allocative and economic efficiency scores for each farm. The scores were then regressed against a set of variables using the Tobit model in STATA to determine the factors associated with the scores. The average age of the household members involved in dairy farming, household size, labour, cost of concentrates and size of land owned had a negative significant influence on economic efficiency. It was concluded that lowering costs, proper utilization of hired labour and intensive use of the available land for dairy farming would lead to an increase in economic efficiency. The study recommends subsidized prices for concentrates, intensive dairy farming, minimization of hired labour and organization of dairy training and workshops in order to increase the efficiency of milk production in small-scale farms in the study area and other parts of Kenya with similar agro-ecological and cultural conditions.

Prevalence and Genotyping of Echinococcus Species from Livestock in Kajiado County, Kenya.

Cystic Echinococcosis (CE) is a widespread neglected zoonotic disease and is caused by the larval stage of the dog tapeworm Echinococcus granulosus sensu lato. CE is more frequent in livestock-rearing areas and where people live a nomadic or seminomadic lifestyle such as in Kajiado County, Kenya. There is limited data on CE disease situation in the county of Maasailand; the present study, therefore, reports on the prevalence of CE in cattle, sheep, and goats and their relative importance in CE transmission in Kajiado County. In total, 1,486 livestock (388 cattle, 625 sheep, and 473 goats) slaughtered in two abattoirs were examined for the presence of hydatid cysts in various organs. Cyst isolates were genotyped by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) of the NADH dehydrogenase subunit 1 gene (nad1). The overall prevalence of CE was 14.8% (220/1486), while prevalence per livestock species was 15.2% (72/473) in goats, 14.9% (93/625) in sheep, and 14.2% (55/388) in cattle. Out of the 421 cysts isolated, 389 cysts were successfully characterized to be either E. granulosus sensu stricto (s. s.), 356/389 (91.5%), E. canadensis (G6/7), 26/389 (6.7%), or E. ortleppi, 7/389 (1.8%). This record confirms predominance of E. granulosus s. s. in Maasailand and other parts of Kenya, while the importance of E. ortleppi and E. canadensis (G6/7) to the general CE burden in Maasailand might be higher than previously thought. More so, a higher infection pressure for humans by E. granulosus s. s. based on its abundance could be speculated. The study sheds significant light on CE situation in livestock in the nomadic/seminomadic society of the Maasai in Kajiado County and provides good bases to investigate human CE in the area.

Health Services Related Factors Influencing Utilization of Antenatal Care (ANC) Services among Expectant Women in Turkana County, Kenya

Antenatal Care (ANC) is a strategic intervention for promoting safe motherhood and reducing maternal mortality and morbidity. A woman dies every minute due to pregnancy-related complications whereas developing countries account for 99% of the global maternal deaths. Low utilization of antenatal care services remains a key indicator of maternal mortality and morbidity in some parts of Kenya like Turkana County where the geographical terrain is complex as well other social and cultural implications that pose significant risks to pregnant women. The purpose of the study was to assess health service-related factors influencing the utilization antenatal care (ANC) services among expectant women in Turkana County, Kenya. The study was carried out in Lodwar County Referral Hospital (LCRH) among pregnant women attending ANC clinic at LCRH and nurses working in the Maternal and Child Health department. Structured questionnaires were used to collect quantitative data involving 297 women and selected using simple random sampling while qualitative data involving 3 nurses working in maternal and child health department was selected purposively and collected using in-depth interviews. Majority of the respondents (48%) were aged 25-35 years, were married (73%), Christians (83%), and had primary education (51%). Quality of services was significantly associated with the utilization of antenatal care services (χ2=12.950; df=6; p=0.044*). There was no significant association between ANC utilization and the means of transport to seek ANC services (χ2=3.411; df=4; p=0.179) and where ANC services are accessed (χ2=1.590; df=4; p=0.452).Women’s attitude towards the ANC services and good communication between the health staff and clients also influence women to seek antenatal services. The study recommends the need to train health workers providing antenatal care services not only on clinical skills but also on client-provider interaction in order to ensure quality and professional delivery of ANC services.

Expanding Access to Depression Treatment in Kenya Through Automated Psychological Support: Protocol for a Single-Case Experimental Design Pilot Study.

BackgroundDepression during pregnancy and in the postpartum period is associated with a number of poor outcomes for women and their children. Although effective interventions exist for common mental disorders that occur during pregnancy and the postpartum period, most cases in low- and middle-income countries go untreated because of a lack of trained professionals. Task-sharing models such as the Thinking Healthy Program have shown great potential in feasibility and efficacy trials as a strategy for expanding access to treatment in low-resource settings, but there are significant barriers to scale-up. We are addressing this gap by adapting Thinking Healthy for automated delivery via a mobile phone. This new intervention, Healthy Moms, uses an existing artificial intelligence system called Tess (Zuri in Kenya) to drive conversations with users.ObjectiveThe objective of this pilot study is to test the Healthy Moms perinatal depression intervention using a single-case experimental design with pregnant women and new mothers recruited from public hospitals outside of Nairobi, Kenya.MethodsWe will invite patients to complete a brief, automated screening delivered via text messages to determine their eligibility. Enrolled participants will be randomized to a 1- or 2-week baseline period and then invited to begin using Zuri. Participants will be prompted to rate their mood via short message service every 3 days during the baseline and intervention periods. We will review system logs and conduct in-depth interviews with participants to study engagement with the intervention, feasibility, and acceptability. We will use visual inspection, in-depth interviews, and Bayesian estimation to generate preliminary data about the potential response to treatment.ResultsOur team adapted the intervention content in April and May 2018 and completed an initial prepilot round of formative testing with 10 women from a private maternity hospital in May and June. In preparation for this pilot study, we used feedback from these users to revise the structure and content of the intervention. Recruitment for this protocol began in early 2019. Results are expected toward the end of 2019.ConclusionsThe main limitation of this pilot study is that we will recruit women who live in urban and periurban centers in one part of Kenya. The results of this study may not generalize to the broader population of Kenyan women, but that is not an objective of this phase of work. Our primary objective is to gather preliminary data to know how to build and test a more robust service. We are working toward a larger study with a more diverse population.International Registered Report Identifier (IRRID)DERR1-10.2196/11800

Influence of NPK Blended Fertilizer Application on Chlorophyll Content and Tissue Mineral Contents of Two Finger Millet Varieties Grown in Acid Soils of Kakamega, Western Kenya

Acidic soils with high exchangeable aluminium ions occur in most parts of Kenya, western Kenya inclusive. Aluminium toxicity is a serious environmental problem that affects crop productivity in Western Kenya region. The county governments of Kakamega, Bungoma, Vihiga, Busia and Trans-Nzoia are promoting the application of NPK blended fertilizer to ameliorate the soil acidity to increase maize production. Finger millet (Eleusine coracana L) is one of the important cereal crops in Kenya and has the ability to grow under unfavorable environmental conditions much better than other cereal crops. It is for this reason that it is currently being popularized in efforts to address food security in the region, however, the effects of NPK blended fertilizer application on the selected physiological parameters of the crop is little known, hence prompting the study. The objective of this study was to investigate the effect of NPK blended fertilizer application on chlorophyll content index and plant tissue mineral analysis. Randomized Complete Block Design with 0,25,50,75,100 kg application rates per acre of NPK blended fertilizer as the treatments were applied in two equal split applications. The measured parameters were chlorophyll content index using CCM-200 spectrophotometer, (Opti- Sciences Inc., Hudson, USA) from the plant leaves at 50% plot maturity. Motsara and Roy Procedures were used to determine plant tissue analysis for nitrogen, phosphorus, potassium, calcium, and magnesium at physiological maturity from the leaves. Data were subjected to analysis of variance (ANOVA) using GenStat statistical package version 15.1. Means were separated by Least Significant Difference (LSD) test at 0.05 probability level. Regression analysis was used to estimate the relationship between variables. At the 75 kg/acre rate, the leaves showed the significant P<0.05 chlorophyll content, calcium, and potassium in both varieties for the two seasons, short rain, and long rain respectively. Control had the lowest physiological activities for both seasons regarding chlorophyll content, tissue calcium, magnesium, nitrogen, phosphorus, and potassium. Significant nitrogen content was observed on Gulu-E variety for both seasons on the highest rate whereas the same trend was observed on P-224 variety and during the short rainy season, a linear increase was observed with increasing NPK blended fertilizer rates. No conclusive pattern was observed during the short rainy season but with the control exhibiting the lowest phosphorus content for both varieties. A significant response to physiology (chlorophyll and plant leaf tissue mineral) might have been due to increased uptake of mineral nutrients present in the NPK blended fertilizer and increased soil pH caused by the liming action of the NPK blended fertilizer.

Forest cover dynamics and underlying driving forces affecting ecosystem services in western Kenya

Deforestation poses a threat to sustainability of forest ecosystem services and socio-economic development in many parts of Kenya. Understanding the trend and extent of forest cover changes and the underlying driving forces over time is pertinent for sustainable management of ecosystems. However, in many parts of the country, such information is still somewhat unknown due to limited data availability for multi-temporal analysis. This paper focuses on western Kenya, a major agricultural region of biodiversity and water catchments that are under threat from forest cover dynamics. The study analyses the status of the forests in the region with the aim of determining the areal extent of coverage, trends in forest cover, drivers of change and associated impacts of deforestation. To achieve these objectives, remote sensing techniques were used to undertake supervised classification on Landsat images of 1995, 2001, 2010 and 2017 with classification scheme of forest and non-forest land cover classes. The results of the study showed that the changes in forest cover varied over time and space. There was considerable net gain in forest areas by about 43% between the period 1995–2001, and thereafter, a continuous decrease ending in a 12.5% loss by 2017. Deforestation in the region is caused by a combination of complex factors that include population pressure, politics and failures in implementation of policy. This study determined the forest cover dynamics and driving forces across diversified sub-basins, an approach that had not been used by previous studies in the region. Thus, the findings will provide valuable information for decision making pertaining to integrated land use and catchment management in order to realize the enormous benefits of sustainable forest ecosystems. The information will not only be important to the study area, but equally applicable to similar tropical regions.