The study aimed to develop a customized Data Governance Maturity Model (DGMM) for the Ministry of Defence (MoD) in Kenya to address data governance challenges in military settings. Current frameworks lack specific req...The study aimed to develop a customized Data Governance Maturity Model (DGMM) for the Ministry of Defence (MoD) in Kenya to address data governance challenges in military settings. Current frameworks lack specific requirements for the defence industry. The model uses Key Performance Indicators (KPIs) to enhance data governance procedures. Design Science Research guided the study, using qualitative and quantitative methods to gather data from MoD personnel. Major deficiencies were found in data integration, quality control, and adherence to data security regulations. The DGMM helps the MOD improve personnel, procedures, technology, and organizational elements related to data management. The model was tested against ISO/IEC 38500 and recommended for use in other government sectors with similar data governance issues. The DGMM has the potential to enhance data management efficiency, security, and compliance in the MOD and guide further research in military data governance.展开更多
Diabetes is a major public health concern worldwide. Low and middle-income countries are the most affected. Diabetes self-management can significantly reduce the burden of diabetes complications and mortality. This cr...Diabetes is a major public health concern worldwide. Low and middle-income countries are the most affected. Diabetes self-management can significantly reduce the burden of diabetes complications and mortality. This cross-sectional study was conducted at the outpatient department of a county referral hospital in Kenya, from 1st August 2022 to 30th October 2022. Patients with known type II diabetes of age ≥ 20 years visiting the hospital for routine follow-up visits were included. A 7-tem Summary of Diabetes Self-care Activities (SDSAC) Questionnaire was used to assess Diabetes self-care activities. For data entry and statistical analysis, SPSS for Windows version 27.0 was used. There were 96 (39.2%) males and 149 (60.8%) females. Most of the participants were more than 61 years, 148 (60.4%). Significant association was found between the sum scale scores of dietary activities, blood glucose testing, physical activity, foot care, and neuropathy at 95% CI and (p Conclusions: Diabetes self-management activities have an impact on microvascular complications in patients with diabetes.展开更多
Background: Blood transfusion (BT) is crucial to the provision of modern health care. However, blood is scarce and costly, and its use is associated with risks. Therefore, the medical professionals who handle it shoul...Background: Blood transfusion (BT) is crucial to the provision of modern health care. However, blood is scarce and costly, and its use is associated with risks. Therefore, the medical professionals who handle it should have adequate knowledge to ensure rational and safe utilization. The objective of the study was to determine the level of BT knowledge among junior medical doctors in Kenya. Methodology: A cross-sectional study was conducted among junior medical doctors working in Western Kenya. Data was collected using questionnaires from August 2021 to March 2022, and analysis was done by way of descriptive and inferential statistics. A p Results: A total of 150 medical doctors participated in the study. Males comprised 60% (n = 90), and the mean age of the participants was 29.9 (SD 3.6) with a range of 25 - 45 years. The mean knowledge score was 54.1% ± 16.4% and was associated with orientation (AOR = 3.157, 95% CI = 1.194 - 8.337). Conclusion: Blood transfusion knowledge among the doctors was suboptimal and was associated with pre-internship induction. There is a need for additional education in BT during all phases of medical training and practice, including orientation for medical interns.展开更多
Kenya, a lower-middle-income country in East Africa, faces a rising burden of chronic kidney disease (CKD), with an estimated 12,500 individuals suffering from end-stage renal disease (ESRD). Renal transplantation—th...Kenya, a lower-middle-income country in East Africa, faces a rising burden of chronic kidney disease (CKD), with an estimated 12,500 individuals suffering from end-stage renal disease (ESRD). Renal transplantation—the preferred treatment option for ESRD, remains underutilized. Since the first transplant in 1978, seven centers have been established, with 829 transplants performed by 2022. Living-related renal transplants (LRRT) dominate, while deceased donor renal transplantation (DDRT) is yet to be implemented. Recent data show improved outcomes, with one-year graft survival rates up to 96%, but challenges such as acute rejection rates (32.8%) and limited donor outcome data persist. Barriers include high costs, limited insurance coverage, inadequate laboratory infrastructure, and a transplant workforce shortage. Efforts to establish DDRT programs are underway but are hampered by the absence of organ procurement systems and insufficient laboratory capabilities. Future priorities include reducing costs and expanded insurance coverage for transplant care. Investments in laboratory infrastructure, local tissue typing, and surgical training are essential. Strengthening international collaborations and public education campaigns can improve donor pools and transplantation access. Strategic policy reforms and resource allocation are vital to scaling up Kenya’s kidney transplant program and addressing the unmet needs of its ESRD population.展开更多
The study determined the carbon stocks and litter nutrient concentration in tropical forests along the ecological gradient in Kenya.This could help understand the potential of mitigating climate change using tropical ...The study determined the carbon stocks and litter nutrient concentration in tropical forests along the ecological gradient in Kenya.This could help understand the potential of mitigating climate change using tropical forest ecosystems in different ecological zones,which are being affected by climate change to a level that they are becoming carbon sources instead of sinks.Stratified sampling technique was used to categorize tropical forests into rain,moist deciduous and dry zone forests depending on the average annual rainfall received.Simple random sampling technique was used to select three tropical forests in each category.Modified consistent sampling technique was used to develop 10 main 20 m×100 m plots in each forest,with 202 m×50 m sub-plots in each plot.Systematic random sampling technique was used in selecting 10 sub-plots from each main plot for inventory study.Non-destructive approach based on allometric equations using trees’diameter at breast height(DBH),total height and species’wood specific gravity were used in estimating tree carbon stock in each forest.Soil organic carbon(SOC)and litter nutrient concentration(total phosphorus and nitrogen)were determined in each forest based on standard laboratory procedures.The results indicated that,whilst trees in rain forests recorded a significantly higher(p<0.001)DBH(20.36 cm)and total tree height(12.1 m),trees in dry zone forests recorded a significantly higher(p<0.001)specific gravity(0.67 kg m^(−3)).Dry zone tropical forests stored a significantly lower amount of total tree carbon of 73 Mg ha^(−1),compared to tropical rain forests(439.5 Mg ha^(−1))and moist deciduous tropical forests(449 Mg ha^(−1)).The SOC content was significantly higher in tropical rainforests(3.9%),compared to soils from moist deciduous(2.9%)and dry zone forests(1.8%).While litter from tropical rain forests recorded a significantly higher amount of total nitrogen(3.4%),litter from dry zone forests recorded a significantly higher concentration of total phosphorus(0.27%).In conclusion,ecological gradient that is dictated by the prevailing temperatures and precipitation affects the tropical forests carbon stock potential and litter nutrient concentration.This implies that,the changing climate is having a serious implication on the ecosystem services such as carbon stock and nutrients cycling in tropical forests.展开更多
Online learning has taken root and with the advancement in technology more and more educators are embracing online learning.During the COVID-19 pandemic,with total shut down of face-to-face learning,the Kenyan governm...Online learning has taken root and with the advancement in technology more and more educators are embracing online learning.During the COVID-19 pandemic,with total shut down of face-to-face learning,the Kenyan government had moved learning online and remotely.To find out on how learners in remote areas were experiencing learning during the COVID-19 pandemic,a study was carried out using rapid ethnography design.Five final year secondary students were sampled.Data was collected through interviews,observations,and document analysis.This paper reports on the findings of online and remote learning platforms,which were available,accessed,and preferred by the learners in remote areas of Kenya during the pandemic.It also highlights the importance of e-learning platforms in addressing learning experiences and success.展开更多
Surface water provides crucial support to the aquatic ecosystem and humans in numerous ways.However,its quality is paramount in determining its impact on the health of the aquatic ecosystem and humans.Currently,the ma...Surface water provides crucial support to the aquatic ecosystem and humans in numerous ways.However,its quality is paramount in determining its impact on the health of the aquatic ecosystem and humans.Currently,the malady of pollution arising from anthropogenic activities poses a significant threat to the quality of most rivers.The quality of water in the Kapingazi river in Embu County has received limited attention which is a concern that needs to be addressed.This study therefore,sought to investigate the status of water quality in river Kapingazi.The study analyzed 96 samples from four locations in a span of eight months which combined the dry and wet seasons of the year.Parameters measured in-situ included turbidity,pH,total dissolved solids(TDS),temperature,dissolved oxygen(DO)and electrical conductivity(EC)while ex-situ parameters were phosphates,nitrates and concentrations of heavy metals:iron and manganese.Results showed that Water Quality Index(WQI)during the drought period was74.05,suggesting that the water quality is only recommended for agricultural and industrial applications.During wet season,the water quality index was 89.67,reflecting a poor status,as more contaminants were likely introduced through surface runoff.Overall,the WQI averaged to 88.02.This study concludes that water in River Kapingazi is not suitable for human consumption;therefore,appropriate treatment is essential prior to its use.Similarly,the findings indicate that both rainy and drought periods significantly affect water quality,presenting challenges for its use for various purposes.It is recommended that the allocation of resources towards water treatment facilities and regulation of pollution sources should be enforced to ensure the safety of river water for diverse applications.展开更多
A multi-faceted Case Area Targeted Intervention (CATI) approach emphasizing the integration of Water, Sanitation and Hygiene (WASH) interventions and Oral Cholera Vaccine (OCV) campaign was employed to respond to the ...A multi-faceted Case Area Targeted Intervention (CATI) approach emphasizing the integration of Water, Sanitation and Hygiene (WASH) interventions and Oral Cholera Vaccine (OCV) campaign was employed to respond to the outbreak of cholera in Garissa County. Drinking water sources in areas heavily impacted by cholera were systematically mapped and tested for microbiological quality. The quality assessment was carried out in April 2023 during an ongoing cholera outbreak in the county. A total of 109 samples were collected and tested for thermotolerant coliforms and other in situ parameters. The finding revealed that more than 87% of the samples did not meet the World Health Organization (WHO) standard for thermotolerant coliforms;and 30% had turbidity values above the recommended threshold values. None of the 109 samples had any traceable residual chlorine. Following these findings, the county government implemented the targeted interventions which resulted in a positive impact in the fight against cholera. The WHO supported key interventions which included capacity building in water quality monitoring and prepositioning of critical WASH commodities to the cholera affected areas.展开更多
Introduction: Bacterial skin and soft tissue infections (SSTIs) are a cause of frequent inpatient and outpatient care visits whose causative agents are associated with a high antimicrobial resistance burden. For insig...Introduction: Bacterial skin and soft tissue infections (SSTIs) are a cause of frequent inpatient and outpatient care visits whose causative agents are associated with a high antimicrobial resistance burden. For insights on antimicrobial susceptibilities in a rural setting, we examined specimens from suspected SSTIs from two public health facilities in Kenya. We additionally assessed antibiotic use, appropriateness of empiric therapy and risk factors for SSTI. Methodology: Between 2021 and 2023, 265 patients at Kisii and Nyamira County Referral hospitals were enrolled. Wound swabs/aspirates were collected and processed following standard microbiological procedures. Identification and antimicrobial susceptibility were performed using the VITEK 2 Compact platform. Demographic, clinical, and microbiological data were analyzed with R Statistical software. Results: S. aureus was isolated in 16.2% (43/265) of patients with a methicillin resistance (MRSA) proportion of 14% (6/43). While 13/15 drugs elicited susceptibilities ranging from 84% - 100%, penicillin (16%) and trimethoprim-sulfamethoxazole [TMP-SXT] (23%) yielded the lowest susceptibilities. Escherichia coli (n = 33), Klebsiella pneumoniae (n = 8), Pseudomonas aeruginosa (n = 8), and Citrobacter species (n = 4) were the most commonly isolated gram-negative species. Gram-negative strains showed high susceptibilities to most of the tested drugs (71% - 100%) with the exception of ampicillin (18%), TMP-SXT (33%), and first and second generation cephalosporins. Conclusions: The low MRSA prevalence and generally high antibiotic susceptibilities for S. aureus and gram-negative bacteria present opportunities for antibiotic stewardship in the study setting. Diminished susceptibilities against penicillin/ampicillin and TMP-SXT accord with prevailing local data and add a layer of evidence for their cautious empiric use.展开更多
This paper presents an analysis of spatial and temporal variation of rainfall and thunderstorm occurrence over Ken-ya from January 1987 to December 2017.The meteorological data used were obtained from the Kenya Meteor...This paper presents an analysis of spatial and temporal variation of rainfall and thunderstorm occurrence over Ken-ya from January 1987 to December 2017.The meteorological data used were obtained from the Kenya Meteorological Department(KMD)for the same period.This included the monthly thunderstorm occurrences and rainfall amounts of 26 synoptic stations across the country.The characteristics of monthly,seasonal and annual frequency results were presented on spatial maps while Time series graphs were used to display the pattern for annual cycle,seasonal varia-tions and the inter-annual variability of rainfall amounts and thunderstorm occurrences.A well-known non-parametric statistical method Mann Kendall(MK)trend test was used to determine and compare the statistical significance of the trends.Thunderstorm frequencies over the Eastern,Central and Coast regions of the country showed a bimodal pattern with high frequencies coinciding with March-April-May(MAM)and October-November-December(OND)rainy sea-sons.Very few thunderstorm days were detected over June-July-August(JJA)season.The areas to the western part of the country,near Lake Victoria,had the highest thunderstorm frequencies in the country over the three seasons:MAM,JJAS and OND.The annual frequency showed a quasi-unimodal pattern.These places near Lake Victoria showed sig-nificantly increasing thunderstorm trends during the MAM and OND seasons irrespective of the rainfall trends.This shows the effects of Lake Victoria over these areas,and it acts as a continuous source of moisture for thunderstorm for-mation.However,most stations across the country showed a reducing trend of thunderstorm frequency during MAM and JJA seasons.The importance of these findings is that they could support various policy makers,and users of cli-mate information,especially in the agriculture and aviation industries.展开更多
Understanding the location of the subsurface heat sources is crucial for efficient geothermal resource exploration and exploitation. This study aimed to investigate the faults and the depth to heat sources for a geoth...Understanding the location of the subsurface heat sources is crucial for efficient geothermal resource exploration and exploitation. This study aimed to investigate the faults and the depth to heat sources for a geothermal system in Magadi, southern Rift Valley, through the integration of gravity mapping, 3D Euler deconvolution, and spectral analysis. Gravity mapping is a powerful geophysical method widely used to infer subsurface density variations, which are indicative of geological structures and volcanic intrusions that can be potential heat sources. The Volcano-Tectonic and Fluvial-Deltaic Sedimentation process of the Kenyan rift which encompasses the Magadi basin are responsible for geomorphic and geologic processes in the area. Alkali lava sheets of Magadi plateau trachytes covered with lacustrine sediments characterize 80% of the area. Deeper is the Tanzanian craton basement, overlain by Pliocene to Miocene volcanic and sedimentary rocks. A gravity survey with a data density of 2.375 stations/km<sup>2</sup> produced high-resolution anomaly and total horizontal derivative maps showing gravity highs between −180 mGals to −174 mGals along the eastern zone of the study area. A buried major fault trending N-S was delineated in the mid-upper region of the area by Euler solutions at an average depth of 350 meters. Deeper features associated with possible volcanic dykes and sills gave Euler depth ranges of 0.7 km to 2.2 km. Radial average spectral analysis showed depth to the top of shallow and deep features at 2.4694 km and 5.827 km respectively. The correlation between gravity anomalies, geological structures, and present hot springs supports the hypothesis that volcanic processes have played a significant role in the development of the geothermal system in the study area.展开更多
AIM:To investigate the prevalence of visual impairment(VI)and provide an estimation of uncorrected refractive errors in school-aged children,conducted by optometry students as a community service.METHODS:The study was...AIM:To investigate the prevalence of visual impairment(VI)and provide an estimation of uncorrected refractive errors in school-aged children,conducted by optometry students as a community service.METHODS:The study was cross-sectional.Totally 3343 participants were included in the study.The initial examination involved assessing the uncorrected distance visual acuity(UDVA)and visual acuity(VA)while using a+2.00 D lens.The inclusion criteria for a subsequent comprehensive cycloplegic eye examination,performed by an optometrist,were as follows:a UDVA<0.6 decimal(0.20 logMAR)and/or a VA with+2.00 D≥0.8 decimal(0.96 logMAR).RESULTS:The sample had a mean age of 10.92±2.13y(range 4 to 17y),and 51.3%of the children were female(n=1715).The majority of the children(89.7%)fell within the age range of 8 to 14y.Among the ethnic groups,the highest representation was from the Luhya group(60.6%)followed by Luo(20.4%).Mean logMAR UDVA choosing the best eye for each student was 0.29±0.17(range 1.70 to 0.22).Out of the total,246 participants(7.4%)had a full eye examination.The estimated prevalence of myopia(defined as spherical equivalent≤-0.5 D)was found to be 1.45%of the total sample.While around 0.18%of the total sample had hyperopia value exceeding+1.75 D.Refractive astigmatism(cil<-0.75 D)was found in 0.21%(7/3343)of the children.The VI prevalence was 1.26%of the total sample.Among our cases of VI,76.2%could be attributed to uncorrected refractive error.Amblyopia was detected in 0.66%(22/3343)of the screened children.There was no statistically significant correlation observed between age or gender and refractive values.CONCLUSION:The primary cause of VI is determined to be uncorrected refractive errors,with myopia being the most prevalent refractive error observed.These findings underscore the significance of early identification and correction of refractive errors in school-aged children as a means to alleviate the impact of VI.展开更多
Introduction: Enterobacteriaceae causing urinary tract infections (UTI) have developed resistance to the commonly used antibiotics due to emergence of Extended Spectrum Beta-Lactamases (ESBLs) and Carbapenamase produc...Introduction: Enterobacteriaceae causing urinary tract infections (UTI) have developed resistance to the commonly used antibiotics due to emergence of Extended Spectrum Beta-Lactamases (ESBLs) and Carbapenamase producing Enterobactericeae which are a public health problem worldwide. This study aims to determine the prevalence and characterize ESBLs and carbapenamase producing Enterobactericeae. Method: A cross-sectional study was carried out in Gertrude’s Children’s Hospital, Nairobi. 238 urine samples were collected from patients with urinary symptoms attending the outpatient department within the period 2020-2021. The urine were examined macroscopically and microscopically. Identification and antimicrobial susceptibility testing were done using VITEK® 2 Compact system (BioMérieux). Double disc synergy test and modified hodge tests were done as confirmatory tests for ESBLs and Carbapenamase phenotypes respectively. Polymerase Chain Reaction was used for the detection of blaCTX-M, blaTEM, blaSHV, blaKPC and blaOXA-48 genes. Results: From the 238 children sampled the prevalence of UTI caused by Enterobactericeae was 22.3%. The Enterobacteriaceae species isolated were Escherichia coli (84.9%), Klebsiella pneumoniae (5.66%), Proteus mirabillis (5.66%), Enterobacter aerogenes (1.89%) and Morganella morganii (1.89%). The isolated species were resistant to ampicillin. Meropenem had the highest susceptibility. Only E. coli species had the ESBLs (26.4%) and carbapenamase (1.9%) phenotypes. 100% had BlaCTX-M while 50% had blaTEM resistant gene. There was a significant association (p Conclusion: Ampicillin resistance resulted to use of alternative drugs and Meropenem was the drug of choice where increased resistance to the recommended drugs was noted. Further research on resistant genes is recommended.展开更多
The discovery of Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2) in Wuhan, Hubei province, China, in December 2019 raised global health warnings. Quickly, in 2020, the virus crossed borders and infected i...The discovery of Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2) in Wuhan, Hubei province, China, in December 2019 raised global health warnings. Quickly, in 2020, the virus crossed borders and infected individuals across the world, evolving into the COVID-19 pandemic. Notably, early signs of the virus’s existence were observed in various countries before the initial outbreak in Wuhan. As of 12<sup>th</sup> of April, the respiratory disease had infected over 762 million people worldwide, with over 6.8 million deaths recorded. This has led scientists to focus their efforts on understanding the virus to develop effective means to diagnose, treat, prevent, and control this pandemic. One of the areas of focus is the isolation of this virus, which plays a crucial role in understanding the viral dynamics in the laboratory. In this study, we report the isolation and detection of locally circulating SARS-CoV-2 in Kenya. The isolates were cultured on Vero Cercopithecus cell line (CCL-81) cells, RNA extraction was conducted from the supernatants, and reverse transcriptase-polymerase chain reaction (RT-PCR). Genome sequencing was done to profile the strains phylogenetically and identify novel and previously reported mutations. Vero CCL-81 cells were able to support the growth of SARS-CoV-2 in vitro, and mutations were detected from the two isolates sequenced (001 and 002). Genome sequencing revealed the circulation of two isolates that share a close relationship with the Benin isolate with the D614G common mutation identified along the S protein. These virus isolates will be expanded and made available to the Kenya Ministry of Health and other research institutions to advance SARS-CoV-2 research in Kenya and the region.展开更多
Pigeon peas, a type of pulse, have immense nutritional potential to improve health in arid and semi-arid regions. However, unlocking this potential relies heavily on understanding their technological properties, such ...Pigeon peas, a type of pulse, have immense nutritional potential to improve health in arid and semi-arid regions. However, unlocking this potential relies heavily on understanding their technological properties, such as hydration rate, volumetric expansion, and cooking time. These properties directly influence processing, accessibility, and acceptability as a food source. However, there is limited information on technological properties of improved varieties. The study aimed to determine technological properties of improved pigeon pea varieties grown in Machakos County. Seven improved pigeon peas varieties namely: KARI Mbaazi 1, KARI Mbaazi 2, ICEAP 00850, KAT 60/8, Mituki, Egerton Mbaazi 1, Egerton Mbaazi 2 and ICEAP 00554 (control variety) were used in this study. These varieties were tested for water absorption capacity (WAC), volumetric expansion, density, cooking time (CT) and total soluble solids (TSS) in the broth. The experiment was arranged in a Completely Randomized Design (CRD) replicated three times. Data analysis was conducted using SAS software version 9.1.3 (SAS, 2006). Means separation was done using Tukey’s honestly significant difference (HSD) at 95% Confidence Level. There were significant differences in water absorption capacity (WAC), volumetric expansion, density, TSS, and CT among the improved varieties (p p < 0.05). KARI Mbaazi 2 exhibited the greatest volumetric expansion after cooking (VEAC) at 11%. Additionally, control variety recorded the highest water absorption capacity (125.48%), which was significantly greater compared to the improved pigeon pea varieties. Cooking time in minutes was shortest for Mituki (46.0) and KAT 60/8 (55.7) and longest for both KARI Mbaazi 1 and ICEAP00850 at 160 minutes. All the varieties showed high TSS ranging from 10.5 to 26.7% indicating the potential to select varieties with desired flavour profiles. Improved pigeon pea varieties (Mituki and KAT60/8) displayed desired technological properties alongside the control variety. These findings inform the specific culinary applications and nutritional needs which enhance utilisation of pigeon peas as food. Further research is needed to determine the impact of the technological properties on the digestibility and glycaemic index of pigeon peas.展开更多
Non-communicable diseases (NCDs) are a significant global health challenge, contributing to 50% of worldwide morbidity and 63% of mortality. The burden is particularly substantial in low—and middle-income countries (...Non-communicable diseases (NCDs) are a significant global health challenge, contributing to 50% of worldwide morbidity and 63% of mortality. The burden is particularly substantial in low—and middle-income countries (LMICs), where 80% of NCD-related deaths occur. A quasi-experimental study addressed this challenge from May 2022 to March 2023. This study utilized a non-equivalent pre-and post-test design, with 300 participants in the quantitative and 70 in the qualitative. The study employed multistage cluster and random sampling to select ten community units, resulting in 150 community health volunteers (CHVs) in the control unit and 150 in the intervention group. Data collection was facilitated through the KOBO app. Qualitative data analysis involved six homogeneous focus group discussions (FGDs) and ten key informant interviews (KIIs), audio-recorded, transcribed, and analyzed using N-Vivo 12. Despite efforts to implement screening programs and improve linkages to care, significant barriers persist. This article reviews these barriers, drawing on current literature and empirical evidence. Key obstacles identified include limited awareness, inadequate healthcare infrastructure, cultural beliefs, financial constraints, fragmented healthcare systems, and challenges linking individuals to appropriate care services. The article explores strategies to overcome these barriers, emphasizing the importance of collaborative approaches involving stakeholders at various levels. Addressing these challenges aims to strengthen NCD screening and linkages to care, ultimately improving health outcomes for populations globally. Several recommendations emerge from the study’s findings and literature review. Raising awareness about NCDs and preventive measures is crucial and can be achieved through targeted health education campaigns and community outreach programs. Addressing healthcare infrastructure deficiencies, such as inadequate facilities and workforce shortages, is essential to ensure access to quality care. Cultural beliefs and practices also play a significant role in shaping health-seeking behavior. Engaging with local communities and incorporating cultural sensitivity into healthcare delivery can help bridge the gap between traditional beliefs and modern healthcare practices. Financial constraints pose a significant barrier to healthcare services, particularly in LMICs. Innovative financing mechanisms, such as health insurance schemes or subsidies, can help alleviate this burden and improve access to care. Furthermore, the fragmented nature of healthcare systems can hinder effective NCD management. Enhancing coordination and integration between primary care providers, specialists, and community health workers is essential to ensure seamless care delivery and patient follow-up. Finally, strengthening linkages between screening programs and care services is critical for the timely diagnosis and management of NCDs. This requires establishing robust referral systems and ensuring continuity of care for patients throughout their healthcare journey. In conclusion, addressing the multifaceted barriers to NCD screening and care linkage is essential for improving health outcomes globally. By implementing targeted interventions and fostering collaboration among stakeholders, progress can be made towards reducing the burden of NCDs and promoting population health.展开更多
Small-scale farming accounts for 78% of total agricultural production in Kenya and contributes to 23.5% of the country’s GDP. Their crop production activities are mostly rainfed subsistence with any surplus being sol...Small-scale farming accounts for 78% of total agricultural production in Kenya and contributes to 23.5% of the country’s GDP. Their crop production activities are mostly rainfed subsistence with any surplus being sold to bring in some income. Timely decisions on farm practices such as farm preparation and planting are critical determinants of the seasonal outcomes. In Kenya, most small-scale farmers have no reliable source of information that would help them make timely and accurate decisions. County governments have extension officers who are mandated with giving farmers advisory services to farmers but they are not able to reach most farmers due to facilitation constraints. The mode and format of sharing information is also critical since it’s important to ensure that it’s timely, well-understood and usable. This study sought to assess access to geospatial derived and other crop production information by farmers in four selected counties of Kenya. Specific objectives were to determine the profile of small-scale farmers in terms of age, education and farm size;to determine the type of information that is made available to them by County and Sub-County extension officers including the format and mode of provision;and to determine if the information provided was useful in terms of accuracy, timeliness and adequacy. The results indicated that over 80% of the farmers were over 35 years of age and over 56% were male. Majority had attained primary education (34%) or secondary education (29%) and most farmers in all the counties grew maize (71%). Notably, fellow farmers were a source of information (71%) with the frequency of sharing information being mostly seasonal (37%) and when information was available (43%). Over 66% of interviewed farmers indicating that they faced challenges while using provided information. The results from the study are insightful and helpful in determining effective ways of providing farmers with useful information to ensure maximum benefits.展开更多
Microvascular complications are one of the major causes of morbidity and mortality worldwide among patients with diabetes mellitus (DM). More than 50% of Nyeri County Referral Hospital (NCRH) admissions result from no...Microvascular complications are one of the major causes of morbidity and mortality worldwide among patients with diabetes mellitus (DM). More than 50% of Nyeri County Referral Hospital (NCRH) admissions result from non-communicable diseases (NCDs) and over 55% of hospital deaths are attributable to NCDs. In Kenya, Nyeri County has the highest prevalence of diabetes mellitus compared to other counties. This study therefore sought to assess the prevalence of microvascular complications and the associated risk factors among patients attending Nyeri County Referral Hospital in Kenya. A hospital-based cross-sectional study was conducted on 314 DM patients on follow-up at NCRH from August 2022 to October 2022. Data were analyzed using STATA version 17. Univariate and multivariate logistic regression analyses are used to determine the risk factors associated with Microvascular complications of DM. Among the 314 participants with DM, 58% were females. The overall prevalence of Microvascular complications (MVCs) is 36.62%. Diabetic peripheral neuropathy was the most frequent complication (27.4%). Inadequate physical exercise was a risk factor for all MVCs. Age, marital status, and level of education were risk factors for neuropathy while smoking and alcohol intake were risk factors for nephropathy. Non-smokers were 98% less likely to have nephropathy (OR = 0.024;95% CI 0.003 - 0.145). The odds of those who exercise once weekly getting retinopathic complications reduced by 83% (OR = 0.18, 95% CI 0.049 - 0.398) compared to those who exercise daily. The findings highlight the implication of lifestyle factors in the development of MVCs among DM patients. Therefore, benefits of microvascular complications prevention should thus be factored into the management of patients with diabetes mellitus.展开更多
Introduction: Cancer is a chronic debilitating disease that unnerves patients, communities, and nations. At some point in cancer patient’s disease experience, chemotherapy is used, and the patient is expected to adhe...Introduction: Cancer is a chronic debilitating disease that unnerves patients, communities, and nations. At some point in cancer patient’s disease experience, chemotherapy is used, and the patient is expected to adhere to treatment to improve survival and quality of life. Methods: This multisite Cluster Randomized Trial (CRT) evaluated the effectiveness of mobile phone Short Message Service (SMS) support on the adherence to treatment schedules among adult cancer patients in Kenya. Data was collected using questionnaires. Ethical approvals were obtained from relevant Ethical Review Boards (ERBs). Results: The mean adherence was 83%. There was a significant difference between treatment arms in relation to the adherence. The intervention arm had a higher mean adherence difference, M = 3.913, 95% CI 2.632-5.193, t (402) = 6.006, p ≤ 0.001), with Cohen’s d = 0.60. Although not significant, (χ<sup>2</sup>dd = 0.151, df = 1, p = 2.064), more women were perfect adheres than males. Perfect adherers were satisfied with SMS support (χ<sup>2</sup>dd = 7.620, df = 1, p = 0.06), were in the intervention arm (χ<sup>2</sup>dd = 22.942, df = 1, p ≤ 0.001), and had trust in the care provider (χ<sup>2</sup>dd = 10.591 p ≤ 0.001). SMS support was not significant in the multivariate analysis but had an estimated effect size of 0.958 (z = 1.424, p = 0.154, CI = 0.242-3.781), indicating that mean adherence was slightly better in the presence of the intervention. Conclusions: SMS-support intervention has demonstrated superiority in influencing adherence. Further, health system-related factors have a significant influence on the adherence to chemotherapy treatment. Interventions to re-design health systems that are responsive to unmet care needs of cancer patients must be explored. .展开更多
文摘The study aimed to develop a customized Data Governance Maturity Model (DGMM) for the Ministry of Defence (MoD) in Kenya to address data governance challenges in military settings. Current frameworks lack specific requirements for the defence industry. The model uses Key Performance Indicators (KPIs) to enhance data governance procedures. Design Science Research guided the study, using qualitative and quantitative methods to gather data from MoD personnel. Major deficiencies were found in data integration, quality control, and adherence to data security regulations. The DGMM helps the MOD improve personnel, procedures, technology, and organizational elements related to data management. The model was tested against ISO/IEC 38500 and recommended for use in other government sectors with similar data governance issues. The DGMM has the potential to enhance data management efficiency, security, and compliance in the MOD and guide further research in military data governance.
文摘Diabetes is a major public health concern worldwide. Low and middle-income countries are the most affected. Diabetes self-management can significantly reduce the burden of diabetes complications and mortality. This cross-sectional study was conducted at the outpatient department of a county referral hospital in Kenya, from 1st August 2022 to 30th October 2022. Patients with known type II diabetes of age ≥ 20 years visiting the hospital for routine follow-up visits were included. A 7-tem Summary of Diabetes Self-care Activities (SDSAC) Questionnaire was used to assess Diabetes self-care activities. For data entry and statistical analysis, SPSS for Windows version 27.0 was used. There were 96 (39.2%) males and 149 (60.8%) females. Most of the participants were more than 61 years, 148 (60.4%). Significant association was found between the sum scale scores of dietary activities, blood glucose testing, physical activity, foot care, and neuropathy at 95% CI and (p Conclusions: Diabetes self-management activities have an impact on microvascular complications in patients with diabetes.
文摘Background: Blood transfusion (BT) is crucial to the provision of modern health care. However, blood is scarce and costly, and its use is associated with risks. Therefore, the medical professionals who handle it should have adequate knowledge to ensure rational and safe utilization. The objective of the study was to determine the level of BT knowledge among junior medical doctors in Kenya. Methodology: A cross-sectional study was conducted among junior medical doctors working in Western Kenya. Data was collected using questionnaires from August 2021 to March 2022, and analysis was done by way of descriptive and inferential statistics. A p Results: A total of 150 medical doctors participated in the study. Males comprised 60% (n = 90), and the mean age of the participants was 29.9 (SD 3.6) with a range of 25 - 45 years. The mean knowledge score was 54.1% ± 16.4% and was associated with orientation (AOR = 3.157, 95% CI = 1.194 - 8.337). Conclusion: Blood transfusion knowledge among the doctors was suboptimal and was associated with pre-internship induction. There is a need for additional education in BT during all phases of medical training and practice, including orientation for medical interns.
文摘Kenya, a lower-middle-income country in East Africa, faces a rising burden of chronic kidney disease (CKD), with an estimated 12,500 individuals suffering from end-stage renal disease (ESRD). Renal transplantation—the preferred treatment option for ESRD, remains underutilized. Since the first transplant in 1978, seven centers have been established, with 829 transplants performed by 2022. Living-related renal transplants (LRRT) dominate, while deceased donor renal transplantation (DDRT) is yet to be implemented. Recent data show improved outcomes, with one-year graft survival rates up to 96%, but challenges such as acute rejection rates (32.8%) and limited donor outcome data persist. Barriers include high costs, limited insurance coverage, inadequate laboratory infrastructure, and a transplant workforce shortage. Efforts to establish DDRT programs are underway but are hampered by the absence of organ procurement systems and insufficient laboratory capabilities. Future priorities include reducing costs and expanded insurance coverage for transplant care. Investments in laboratory infrastructure, local tissue typing, and surgical training are essential. Strengthening international collaborations and public education campaigns can improve donor pools and transplantation access. Strategic policy reforms and resource allocation are vital to scaling up Kenya’s kidney transplant program and addressing the unmet needs of its ESRD population.
基金funded by the Kenya National Research Fund(NRF-Kenya,2018).
文摘The study determined the carbon stocks and litter nutrient concentration in tropical forests along the ecological gradient in Kenya.This could help understand the potential of mitigating climate change using tropical forest ecosystems in different ecological zones,which are being affected by climate change to a level that they are becoming carbon sources instead of sinks.Stratified sampling technique was used to categorize tropical forests into rain,moist deciduous and dry zone forests depending on the average annual rainfall received.Simple random sampling technique was used to select three tropical forests in each category.Modified consistent sampling technique was used to develop 10 main 20 m×100 m plots in each forest,with 202 m×50 m sub-plots in each plot.Systematic random sampling technique was used in selecting 10 sub-plots from each main plot for inventory study.Non-destructive approach based on allometric equations using trees’diameter at breast height(DBH),total height and species’wood specific gravity were used in estimating tree carbon stock in each forest.Soil organic carbon(SOC)and litter nutrient concentration(total phosphorus and nitrogen)were determined in each forest based on standard laboratory procedures.The results indicated that,whilst trees in rain forests recorded a significantly higher(p<0.001)DBH(20.36 cm)and total tree height(12.1 m),trees in dry zone forests recorded a significantly higher(p<0.001)specific gravity(0.67 kg m^(−3)).Dry zone tropical forests stored a significantly lower amount of total tree carbon of 73 Mg ha^(−1),compared to tropical rain forests(439.5 Mg ha^(−1))and moist deciduous tropical forests(449 Mg ha^(−1)).The SOC content was significantly higher in tropical rainforests(3.9%),compared to soils from moist deciduous(2.9%)and dry zone forests(1.8%).While litter from tropical rain forests recorded a significantly higher amount of total nitrogen(3.4%),litter from dry zone forests recorded a significantly higher concentration of total phosphorus(0.27%).In conclusion,ecological gradient that is dictated by the prevailing temperatures and precipitation affects the tropical forests carbon stock potential and litter nutrient concentration.This implies that,the changing climate is having a serious implication on the ecosystem services such as carbon stock and nutrients cycling in tropical forests.
文摘Online learning has taken root and with the advancement in technology more and more educators are embracing online learning.During the COVID-19 pandemic,with total shut down of face-to-face learning,the Kenyan government had moved learning online and remotely.To find out on how learners in remote areas were experiencing learning during the COVID-19 pandemic,a study was carried out using rapid ethnography design.Five final year secondary students were sampled.Data was collected through interviews,observations,and document analysis.This paper reports on the findings of online and remote learning platforms,which were available,accessed,and preferred by the learners in remote areas of Kenya during the pandemic.It also highlights the importance of e-learning platforms in addressing learning experiences and success.
文摘Surface water provides crucial support to the aquatic ecosystem and humans in numerous ways.However,its quality is paramount in determining its impact on the health of the aquatic ecosystem and humans.Currently,the malady of pollution arising from anthropogenic activities poses a significant threat to the quality of most rivers.The quality of water in the Kapingazi river in Embu County has received limited attention which is a concern that needs to be addressed.This study therefore,sought to investigate the status of water quality in river Kapingazi.The study analyzed 96 samples from four locations in a span of eight months which combined the dry and wet seasons of the year.Parameters measured in-situ included turbidity,pH,total dissolved solids(TDS),temperature,dissolved oxygen(DO)and electrical conductivity(EC)while ex-situ parameters were phosphates,nitrates and concentrations of heavy metals:iron and manganese.Results showed that Water Quality Index(WQI)during the drought period was74.05,suggesting that the water quality is only recommended for agricultural and industrial applications.During wet season,the water quality index was 89.67,reflecting a poor status,as more contaminants were likely introduced through surface runoff.Overall,the WQI averaged to 88.02.This study concludes that water in River Kapingazi is not suitable for human consumption;therefore,appropriate treatment is essential prior to its use.Similarly,the findings indicate that both rainy and drought periods significantly affect water quality,presenting challenges for its use for various purposes.It is recommended that the allocation of resources towards water treatment facilities and regulation of pollution sources should be enforced to ensure the safety of river water for diverse applications.
文摘A multi-faceted Case Area Targeted Intervention (CATI) approach emphasizing the integration of Water, Sanitation and Hygiene (WASH) interventions and Oral Cholera Vaccine (OCV) campaign was employed to respond to the outbreak of cholera in Garissa County. Drinking water sources in areas heavily impacted by cholera were systematically mapped and tested for microbiological quality. The quality assessment was carried out in April 2023 during an ongoing cholera outbreak in the county. A total of 109 samples were collected and tested for thermotolerant coliforms and other in situ parameters. The finding revealed that more than 87% of the samples did not meet the World Health Organization (WHO) standard for thermotolerant coliforms;and 30% had turbidity values above the recommended threshold values. None of the 109 samples had any traceable residual chlorine. Following these findings, the county government implemented the targeted interventions which resulted in a positive impact in the fight against cholera. The WHO supported key interventions which included capacity building in water quality monitoring and prepositioning of critical WASH commodities to the cholera affected areas.
文摘Introduction: Bacterial skin and soft tissue infections (SSTIs) are a cause of frequent inpatient and outpatient care visits whose causative agents are associated with a high antimicrobial resistance burden. For insights on antimicrobial susceptibilities in a rural setting, we examined specimens from suspected SSTIs from two public health facilities in Kenya. We additionally assessed antibiotic use, appropriateness of empiric therapy and risk factors for SSTI. Methodology: Between 2021 and 2023, 265 patients at Kisii and Nyamira County Referral hospitals were enrolled. Wound swabs/aspirates were collected and processed following standard microbiological procedures. Identification and antimicrobial susceptibility were performed using the VITEK 2 Compact platform. Demographic, clinical, and microbiological data were analyzed with R Statistical software. Results: S. aureus was isolated in 16.2% (43/265) of patients with a methicillin resistance (MRSA) proportion of 14% (6/43). While 13/15 drugs elicited susceptibilities ranging from 84% - 100%, penicillin (16%) and trimethoprim-sulfamethoxazole [TMP-SXT] (23%) yielded the lowest susceptibilities. Escherichia coli (n = 33), Klebsiella pneumoniae (n = 8), Pseudomonas aeruginosa (n = 8), and Citrobacter species (n = 4) were the most commonly isolated gram-negative species. Gram-negative strains showed high susceptibilities to most of the tested drugs (71% - 100%) with the exception of ampicillin (18%), TMP-SXT (33%), and first and second generation cephalosporins. Conclusions: The low MRSA prevalence and generally high antibiotic susceptibilities for S. aureus and gram-negative bacteria present opportunities for antibiotic stewardship in the study setting. Diminished susceptibilities against penicillin/ampicillin and TMP-SXT accord with prevailing local data and add a layer of evidence for their cautious empiric use.
文摘This paper presents an analysis of spatial and temporal variation of rainfall and thunderstorm occurrence over Ken-ya from January 1987 to December 2017.The meteorological data used were obtained from the Kenya Meteorological Department(KMD)for the same period.This included the monthly thunderstorm occurrences and rainfall amounts of 26 synoptic stations across the country.The characteristics of monthly,seasonal and annual frequency results were presented on spatial maps while Time series graphs were used to display the pattern for annual cycle,seasonal varia-tions and the inter-annual variability of rainfall amounts and thunderstorm occurrences.A well-known non-parametric statistical method Mann Kendall(MK)trend test was used to determine and compare the statistical significance of the trends.Thunderstorm frequencies over the Eastern,Central and Coast regions of the country showed a bimodal pattern with high frequencies coinciding with March-April-May(MAM)and October-November-December(OND)rainy sea-sons.Very few thunderstorm days were detected over June-July-August(JJA)season.The areas to the western part of the country,near Lake Victoria,had the highest thunderstorm frequencies in the country over the three seasons:MAM,JJAS and OND.The annual frequency showed a quasi-unimodal pattern.These places near Lake Victoria showed sig-nificantly increasing thunderstorm trends during the MAM and OND seasons irrespective of the rainfall trends.This shows the effects of Lake Victoria over these areas,and it acts as a continuous source of moisture for thunderstorm for-mation.However,most stations across the country showed a reducing trend of thunderstorm frequency during MAM and JJA seasons.The importance of these findings is that they could support various policy makers,and users of cli-mate information,especially in the agriculture and aviation industries.
文摘Understanding the location of the subsurface heat sources is crucial for efficient geothermal resource exploration and exploitation. This study aimed to investigate the faults and the depth to heat sources for a geothermal system in Magadi, southern Rift Valley, through the integration of gravity mapping, 3D Euler deconvolution, and spectral analysis. Gravity mapping is a powerful geophysical method widely used to infer subsurface density variations, which are indicative of geological structures and volcanic intrusions that can be potential heat sources. The Volcano-Tectonic and Fluvial-Deltaic Sedimentation process of the Kenyan rift which encompasses the Magadi basin are responsible for geomorphic and geologic processes in the area. Alkali lava sheets of Magadi plateau trachytes covered with lacustrine sediments characterize 80% of the area. Deeper is the Tanzanian craton basement, overlain by Pliocene to Miocene volcanic and sedimentary rocks. A gravity survey with a data density of 2.375 stations/km<sup>2</sup> produced high-resolution anomaly and total horizontal derivative maps showing gravity highs between −180 mGals to −174 mGals along the eastern zone of the study area. A buried major fault trending N-S was delineated in the mid-upper region of the area by Euler solutions at an average depth of 350 meters. Deeper features associated with possible volcanic dykes and sills gave Euler depth ranges of 0.7 km to 2.2 km. Radial average spectral analysis showed depth to the top of shallow and deep features at 2.4694 km and 5.827 km respectively. The correlation between gravity anomalies, geological structures, and present hot springs supports the hypothesis that volcanic processes have played a significant role in the development of the geothermal system in the study area.
文摘AIM:To investigate the prevalence of visual impairment(VI)and provide an estimation of uncorrected refractive errors in school-aged children,conducted by optometry students as a community service.METHODS:The study was cross-sectional.Totally 3343 participants were included in the study.The initial examination involved assessing the uncorrected distance visual acuity(UDVA)and visual acuity(VA)while using a+2.00 D lens.The inclusion criteria for a subsequent comprehensive cycloplegic eye examination,performed by an optometrist,were as follows:a UDVA<0.6 decimal(0.20 logMAR)and/or a VA with+2.00 D≥0.8 decimal(0.96 logMAR).RESULTS:The sample had a mean age of 10.92±2.13y(range 4 to 17y),and 51.3%of the children were female(n=1715).The majority of the children(89.7%)fell within the age range of 8 to 14y.Among the ethnic groups,the highest representation was from the Luhya group(60.6%)followed by Luo(20.4%).Mean logMAR UDVA choosing the best eye for each student was 0.29±0.17(range 1.70 to 0.22).Out of the total,246 participants(7.4%)had a full eye examination.The estimated prevalence of myopia(defined as spherical equivalent≤-0.5 D)was found to be 1.45%of the total sample.While around 0.18%of the total sample had hyperopia value exceeding+1.75 D.Refractive astigmatism(cil<-0.75 D)was found in 0.21%(7/3343)of the children.The VI prevalence was 1.26%of the total sample.Among our cases of VI,76.2%could be attributed to uncorrected refractive error.Amblyopia was detected in 0.66%(22/3343)of the screened children.There was no statistically significant correlation observed between age or gender and refractive values.CONCLUSION:The primary cause of VI is determined to be uncorrected refractive errors,with myopia being the most prevalent refractive error observed.These findings underscore the significance of early identification and correction of refractive errors in school-aged children as a means to alleviate the impact of VI.
文摘Introduction: Enterobacteriaceae causing urinary tract infections (UTI) have developed resistance to the commonly used antibiotics due to emergence of Extended Spectrum Beta-Lactamases (ESBLs) and Carbapenamase producing Enterobactericeae which are a public health problem worldwide. This study aims to determine the prevalence and characterize ESBLs and carbapenamase producing Enterobactericeae. Method: A cross-sectional study was carried out in Gertrude’s Children’s Hospital, Nairobi. 238 urine samples were collected from patients with urinary symptoms attending the outpatient department within the period 2020-2021. The urine were examined macroscopically and microscopically. Identification and antimicrobial susceptibility testing were done using VITEK® 2 Compact system (BioMérieux). Double disc synergy test and modified hodge tests were done as confirmatory tests for ESBLs and Carbapenamase phenotypes respectively. Polymerase Chain Reaction was used for the detection of blaCTX-M, blaTEM, blaSHV, blaKPC and blaOXA-48 genes. Results: From the 238 children sampled the prevalence of UTI caused by Enterobactericeae was 22.3%. The Enterobacteriaceae species isolated were Escherichia coli (84.9%), Klebsiella pneumoniae (5.66%), Proteus mirabillis (5.66%), Enterobacter aerogenes (1.89%) and Morganella morganii (1.89%). The isolated species were resistant to ampicillin. Meropenem had the highest susceptibility. Only E. coli species had the ESBLs (26.4%) and carbapenamase (1.9%) phenotypes. 100% had BlaCTX-M while 50% had blaTEM resistant gene. There was a significant association (p Conclusion: Ampicillin resistance resulted to use of alternative drugs and Meropenem was the drug of choice where increased resistance to the recommended drugs was noted. Further research on resistant genes is recommended.
文摘The discovery of Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2) in Wuhan, Hubei province, China, in December 2019 raised global health warnings. Quickly, in 2020, the virus crossed borders and infected individuals across the world, evolving into the COVID-19 pandemic. Notably, early signs of the virus’s existence were observed in various countries before the initial outbreak in Wuhan. As of 12<sup>th</sup> of April, the respiratory disease had infected over 762 million people worldwide, with over 6.8 million deaths recorded. This has led scientists to focus their efforts on understanding the virus to develop effective means to diagnose, treat, prevent, and control this pandemic. One of the areas of focus is the isolation of this virus, which plays a crucial role in understanding the viral dynamics in the laboratory. In this study, we report the isolation and detection of locally circulating SARS-CoV-2 in Kenya. The isolates were cultured on Vero Cercopithecus cell line (CCL-81) cells, RNA extraction was conducted from the supernatants, and reverse transcriptase-polymerase chain reaction (RT-PCR). Genome sequencing was done to profile the strains phylogenetically and identify novel and previously reported mutations. Vero CCL-81 cells were able to support the growth of SARS-CoV-2 in vitro, and mutations were detected from the two isolates sequenced (001 and 002). Genome sequencing revealed the circulation of two isolates that share a close relationship with the Benin isolate with the D614G common mutation identified along the S protein. These virus isolates will be expanded and made available to the Kenya Ministry of Health and other research institutions to advance SARS-CoV-2 research in Kenya and the region.
文摘Pigeon peas, a type of pulse, have immense nutritional potential to improve health in arid and semi-arid regions. However, unlocking this potential relies heavily on understanding their technological properties, such as hydration rate, volumetric expansion, and cooking time. These properties directly influence processing, accessibility, and acceptability as a food source. However, there is limited information on technological properties of improved varieties. The study aimed to determine technological properties of improved pigeon pea varieties grown in Machakos County. Seven improved pigeon peas varieties namely: KARI Mbaazi 1, KARI Mbaazi 2, ICEAP 00850, KAT 60/8, Mituki, Egerton Mbaazi 1, Egerton Mbaazi 2 and ICEAP 00554 (control variety) were used in this study. These varieties were tested for water absorption capacity (WAC), volumetric expansion, density, cooking time (CT) and total soluble solids (TSS) in the broth. The experiment was arranged in a Completely Randomized Design (CRD) replicated three times. Data analysis was conducted using SAS software version 9.1.3 (SAS, 2006). Means separation was done using Tukey’s honestly significant difference (HSD) at 95% Confidence Level. There were significant differences in water absorption capacity (WAC), volumetric expansion, density, TSS, and CT among the improved varieties (p p < 0.05). KARI Mbaazi 2 exhibited the greatest volumetric expansion after cooking (VEAC) at 11%. Additionally, control variety recorded the highest water absorption capacity (125.48%), which was significantly greater compared to the improved pigeon pea varieties. Cooking time in minutes was shortest for Mituki (46.0) and KAT 60/8 (55.7) and longest for both KARI Mbaazi 1 and ICEAP00850 at 160 minutes. All the varieties showed high TSS ranging from 10.5 to 26.7% indicating the potential to select varieties with desired flavour profiles. Improved pigeon pea varieties (Mituki and KAT60/8) displayed desired technological properties alongside the control variety. These findings inform the specific culinary applications and nutritional needs which enhance utilisation of pigeon peas as food. Further research is needed to determine the impact of the technological properties on the digestibility and glycaemic index of pigeon peas.
文摘Non-communicable diseases (NCDs) are a significant global health challenge, contributing to 50% of worldwide morbidity and 63% of mortality. The burden is particularly substantial in low—and middle-income countries (LMICs), where 80% of NCD-related deaths occur. A quasi-experimental study addressed this challenge from May 2022 to March 2023. This study utilized a non-equivalent pre-and post-test design, with 300 participants in the quantitative and 70 in the qualitative. The study employed multistage cluster and random sampling to select ten community units, resulting in 150 community health volunteers (CHVs) in the control unit and 150 in the intervention group. Data collection was facilitated through the KOBO app. Qualitative data analysis involved six homogeneous focus group discussions (FGDs) and ten key informant interviews (KIIs), audio-recorded, transcribed, and analyzed using N-Vivo 12. Despite efforts to implement screening programs and improve linkages to care, significant barriers persist. This article reviews these barriers, drawing on current literature and empirical evidence. Key obstacles identified include limited awareness, inadequate healthcare infrastructure, cultural beliefs, financial constraints, fragmented healthcare systems, and challenges linking individuals to appropriate care services. The article explores strategies to overcome these barriers, emphasizing the importance of collaborative approaches involving stakeholders at various levels. Addressing these challenges aims to strengthen NCD screening and linkages to care, ultimately improving health outcomes for populations globally. Several recommendations emerge from the study’s findings and literature review. Raising awareness about NCDs and preventive measures is crucial and can be achieved through targeted health education campaigns and community outreach programs. Addressing healthcare infrastructure deficiencies, such as inadequate facilities and workforce shortages, is essential to ensure access to quality care. Cultural beliefs and practices also play a significant role in shaping health-seeking behavior. Engaging with local communities and incorporating cultural sensitivity into healthcare delivery can help bridge the gap between traditional beliefs and modern healthcare practices. Financial constraints pose a significant barrier to healthcare services, particularly in LMICs. Innovative financing mechanisms, such as health insurance schemes or subsidies, can help alleviate this burden and improve access to care. Furthermore, the fragmented nature of healthcare systems can hinder effective NCD management. Enhancing coordination and integration between primary care providers, specialists, and community health workers is essential to ensure seamless care delivery and patient follow-up. Finally, strengthening linkages between screening programs and care services is critical for the timely diagnosis and management of NCDs. This requires establishing robust referral systems and ensuring continuity of care for patients throughout their healthcare journey. In conclusion, addressing the multifaceted barriers to NCD screening and care linkage is essential for improving health outcomes globally. By implementing targeted interventions and fostering collaboration among stakeholders, progress can be made towards reducing the burden of NCDs and promoting population health.
文摘Small-scale farming accounts for 78% of total agricultural production in Kenya and contributes to 23.5% of the country’s GDP. Their crop production activities are mostly rainfed subsistence with any surplus being sold to bring in some income. Timely decisions on farm practices such as farm preparation and planting are critical determinants of the seasonal outcomes. In Kenya, most small-scale farmers have no reliable source of information that would help them make timely and accurate decisions. County governments have extension officers who are mandated with giving farmers advisory services to farmers but they are not able to reach most farmers due to facilitation constraints. The mode and format of sharing information is also critical since it’s important to ensure that it’s timely, well-understood and usable. This study sought to assess access to geospatial derived and other crop production information by farmers in four selected counties of Kenya. Specific objectives were to determine the profile of small-scale farmers in terms of age, education and farm size;to determine the type of information that is made available to them by County and Sub-County extension officers including the format and mode of provision;and to determine if the information provided was useful in terms of accuracy, timeliness and adequacy. The results indicated that over 80% of the farmers were over 35 years of age and over 56% were male. Majority had attained primary education (34%) or secondary education (29%) and most farmers in all the counties grew maize (71%). Notably, fellow farmers were a source of information (71%) with the frequency of sharing information being mostly seasonal (37%) and when information was available (43%). Over 66% of interviewed farmers indicating that they faced challenges while using provided information. The results from the study are insightful and helpful in determining effective ways of providing farmers with useful information to ensure maximum benefits.
文摘Microvascular complications are one of the major causes of morbidity and mortality worldwide among patients with diabetes mellitus (DM). More than 50% of Nyeri County Referral Hospital (NCRH) admissions result from non-communicable diseases (NCDs) and over 55% of hospital deaths are attributable to NCDs. In Kenya, Nyeri County has the highest prevalence of diabetes mellitus compared to other counties. This study therefore sought to assess the prevalence of microvascular complications and the associated risk factors among patients attending Nyeri County Referral Hospital in Kenya. A hospital-based cross-sectional study was conducted on 314 DM patients on follow-up at NCRH from August 2022 to October 2022. Data were analyzed using STATA version 17. Univariate and multivariate logistic regression analyses are used to determine the risk factors associated with Microvascular complications of DM. Among the 314 participants with DM, 58% were females. The overall prevalence of Microvascular complications (MVCs) is 36.62%. Diabetic peripheral neuropathy was the most frequent complication (27.4%). Inadequate physical exercise was a risk factor for all MVCs. Age, marital status, and level of education were risk factors for neuropathy while smoking and alcohol intake were risk factors for nephropathy. Non-smokers were 98% less likely to have nephropathy (OR = 0.024;95% CI 0.003 - 0.145). The odds of those who exercise once weekly getting retinopathic complications reduced by 83% (OR = 0.18, 95% CI 0.049 - 0.398) compared to those who exercise daily. The findings highlight the implication of lifestyle factors in the development of MVCs among DM patients. Therefore, benefits of microvascular complications prevention should thus be factored into the management of patients with diabetes mellitus.
文摘Introduction: Cancer is a chronic debilitating disease that unnerves patients, communities, and nations. At some point in cancer patient’s disease experience, chemotherapy is used, and the patient is expected to adhere to treatment to improve survival and quality of life. Methods: This multisite Cluster Randomized Trial (CRT) evaluated the effectiveness of mobile phone Short Message Service (SMS) support on the adherence to treatment schedules among adult cancer patients in Kenya. Data was collected using questionnaires. Ethical approvals were obtained from relevant Ethical Review Boards (ERBs). Results: The mean adherence was 83%. There was a significant difference between treatment arms in relation to the adherence. The intervention arm had a higher mean adherence difference, M = 3.913, 95% CI 2.632-5.193, t (402) = 6.006, p ≤ 0.001), with Cohen’s d = 0.60. Although not significant, (χ<sup>2</sup>dd = 0.151, df = 1, p = 2.064), more women were perfect adheres than males. Perfect adherers were satisfied with SMS support (χ<sup>2</sup>dd = 7.620, df = 1, p = 0.06), were in the intervention arm (χ<sup>2</sup>dd = 22.942, df = 1, p ≤ 0.001), and had trust in the care provider (χ<sup>2</sup>dd = 10.591 p ≤ 0.001). SMS support was not significant in the multivariate analysis but had an estimated effect size of 0.958 (z = 1.424, p = 0.154, CI = 0.242-3.781), indicating that mean adherence was slightly better in the presence of the intervention. Conclusions: SMS-support intervention has demonstrated superiority in influencing adherence. Further, health system-related factors have a significant influence on the adherence to chemotherapy treatment. Interventions to re-design health systems that are responsive to unmet care needs of cancer patients must be explored. .
