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Monitoring and Evaluation Work Plan on Provision of Curative and Preventive Tuberculosis Healthcare Services in Institutions of Public Health in Kisumu County, Kenya
No full textThis research was focused on assessing how monitoring and evaluation work plan influence provision of curative and preventive tuberculosis healthcare practices in institutions of public health in Kisumu County, Kenya. The study unit of analysis was public health institutions that practice M&E system on provision of health care services. The target population consisting of doctors, M&E officers, clinical officers, nurses and patients in four public health institutions in Kisumu county, Kenya. The study was guided by pragmatism paradigm. A descriptive survey research design was employed to collect both quantitative and qualitative data and correlational design was used to test the hypothesis. A sample of 221 respondents was selected from a population of 517 using stratified random sampling. A structured questionnaire with both open and close ended with Likert type on 1-5 five point scale and interview schedule was used to collect data. A descriptive survey research design was employed to collect both quantitative and qualitative data and correlational design was used to test the hypothesis. Quantitative data was analyzed using descriptive and inferential statistics and data presented in frequency tables using means and standard deviations while qualitative data was presented in in narrative statements. Hypothesis was tested using linear regression at 0.05 level of significance to determine the degree and direction of relationships among variables. The study attained reliability of instruments using Cronbach Alpha coefficient of 0.735 for all items implying that the instrument was reliable. The results indicated that showed that M&E work plan regression was (r2=0.028, p<0.05). The study results indicated that present results for quantitative data based on composite mean score of 3.90 and 0.447 standard deviation for this variable. M&E system therefore, contributes significantly to the effective provision of curative and preventive tuberculosis health care services in public health institutions
Effects of Supplemental Irrigation on Crop Yields: Case Study Kales (Brassica Oleracea) Crop
No full textThe aim of this study was to investigate the effects that supplemental irrigation (SI) has on Kale (Brassica Oleracea) crop yields as compared to wholly rain-fed crop. The experiments were conducted in Kieni, Central Kenya where the rainfall pattern was bimodal. The planting for rain-fed crops was done in three blocks each measuring 10m x1m with a spacing of 30cm between plants and 45cm between rows of plants and the procedure repeated for the crops receiving SI. The average weekly yields were computed for both crops for each season comprised of 14 weeks. The average weekly yields were subjected to Analysis of Variance (ANOVA) to determine whether the average yields from rain-fed and supplemental irrigated crops were statistically different. This was done by MS Excel 2016 spread sheets by setting a statistical level of significance of 5%. F value was 17.94 higher than the critical value of 4.01 while the P-value of 9x10-5 was lower than the 5% level of confidence meaning that there was a significant difference in the yield means of rain-fed and SI crops. The total rain-fed crop yields for the period was 147.0 Kgs and that of the one under SI was 238Kgs, an increase of about 62%. Therefore, supplemental irrigation can be adopted in areas where rainfall trends are declining to increase crop yields when all other factors remain constant for farmers to increase resilience
Newly diagnosed HIV positive children: a unique index case to improve HIV diagnosis and linkage to care of parents.
No full textNewly diagnosed HIV positive children may be unique index cases to identify undiagnosed parents. Data was used from the Pediatric Urgent Start of HAART (NCT02063880) trial, which enrolled hospitalized, ART-naïve, HIV positive children ages 0-12 years in Kenya. Exact McNemar's tests were used to compare proportions of mothers and fathers tested for HIV, linked to care, and on ART at baseline and 6 months. This analysis included 87 newly diagnosed children with HIV who completed 6 months of follow-up. Among 83 children with living mothers, there were improvements in maternal linkage to care and treatment comparing baseline to 6 months (36% vs. 78%; p < 0.0001 and 22% vs. 52%; p < 0.0001). Among 80 children with living fathers, there were increases from baseline to 6 months in the number of fathers who knew the child's HIV status (34% vs. 78%; p < 0.0001), fathers ever tested for HIV (43% vs. 65%; p < 0.0001), fathers ever tested HIV positive (21% vs. 43%; p < 0.0001), fathers ever linked to care (15% vs. 35%; p < 0.0001), and fathers ever initiated on ART (11% vs. 23%; p = 0.0039). Newly diagnosed HIV positive children can be important index cases to identify parents with undiagnosed HIV or poor engagement in care.
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Impact of Double-Intake Programmes on the Teacher Co-Efficient Determinant of Quality Education at the University of Nairobi, Kenya
No full textThis research was carried out in order to determine the impact of double-intake programmes on the quality of education in the University of Nairobi in Kenya using the teacher coefficient measure. It had one objective and one research question. Using descriptive survey research design the target population consisted of 61,000 regular students enrolled in 43schools/faculties, 5,900 students in their fourth year of study and 2,000 teaching staff. Calmorin and Calmorin (2007) formula for scientifically determining sample size yielded a total of 489 respondents. Simple random sampling was used to select 251 fourth year students while stratified random sampling was used to select 238 teaching staff as actual respondents. Data were collected using questionnaires, document analysis, observation and interview. Quantitative and qualitative data analysis methods were used with the aid of statistical package for social sciences (SPSS) version 26.The findings show that the number of students admitted overwhelmed both the academic and non-academic staff members who served them because the university accepted to engage in double intake programmes without considering an increase in the number of the staff members and this skewed student to faculty ratio led to degenerated service provision. Consequently, the research recommends that the university plans adequately for the number of staff required versus the anticipated students to be enrolled in future since a compromise in the student to faculty ratio will definitely have a negative impact on the quality of education
Dynamics of HIV DNA reservoir seeding in a cohort of superinfected Kenyan women.
No full textA reservoir of HIV-infected cells that persists despite suppressive antiretroviral therapy (ART) is the source of viral rebound upon ART cessation and the major barrier to a cure. Understanding reservoir seeding dynamics will help identify the best timing for HIV cure strategies. Here we characterize reservoir seeding using longitudinal samples from before and after ART initiation in individuals who sequentially became infected with genetically distinct HIV variants (superinfected). We previously identified cases of superinfection in a cohort of Kenyan women, and the dates of both initial infection and superinfection were determined. Six women, superinfected 0.2-5.2 years after initial infection, were subsequently treated with ART 5.4-18.0 years after initial infection. We performed next-generation sequencing of HIV gag and env RNA from plasma collected during acute infection as well as every ~2 years thereafter until ART initiation, and of HIV DNA from PBMCs collected 0.9-4.8 years after viral suppression on ART. We assessed phylogenetic relationships between HIV DNA reservoir sequences and longitudinal plasma RNA sequences prior to ART, to determine proportions of initial and superinfecting variants in the reservoir. The proportions of initial and superinfection lineage variants present in the HIV DNA reservoir were most similar to the proportions present in HIV RNA immediately prior to ART initiation. Phylogenetic analysis confirmed that the majority of HIV DNA reservoir sequences had the smallest pairwise distance to RNA sequences from timepoints closest to ART initiation. Our data suggest that while reservoir cells are created throughout pre-ART infection, the majority of HIV-infected cells that persist during ART entered the reservoir near the time of ART initiation. We estimate the half-life of pre-ART DNA reservoir sequences to be ~25 months, which is shorter than estimated reservoir decay rates during suppressive ART, implying continual decay and reseeding of the reservoir up to the point of ART initiation
Factors influencing livestock export in Somaliland’s terminal markets
No full textLivestock export from Somaliland to the Arabian Peninsula countries is an important economic activity and the mainsource of Somaliland’s foreign exchange earnings. We have employed multiple regression time series analysis of secondary data to understand factors that influence the monthly volumes of small ruminants (sheep and goats) and cattle traded for export in three terminal markets in Somaliland. Results show that the Hajj season, number of livestock exporters active in the markets, market location and livestock ban imposed by the import countries are the main factors that influence the monthly volume of livestock transacted for export. Further, the results indicate that though drought does not influence the volume of small ruminants, it has an influence on the volume of cattle, while the implementation
of quarantine stations has a significant influence on the volumes of livestock exports. Finally, border restrictions imposed by Ethiopia do not influence the volume of livestock transacted for export in the study markets. Most of the factors analysed to have influence on monthly volume livestock transacted for export are institutional and policy-related hence can be corrected though requisite regulatory, institutional and policy reforms in consultations with stakeholder
Levels of Total Mercury in Farmed and Wild-caught Oreochromis Niloticus Niloticus (Nile Tilapia), Pond Sediments and Water in the Migori Gold Mining Belt, Kenya
No full textMercury is a well-known toxicant with a myriad of ill effects on human health. It occurs naturally in the environment at basal levels. Human activities, such as mercury use in artisanal and small scale gold mining is one of the major sources of environmental mercury pollution. Migori is renowned for artisanal gold mining. Inland fish farming is also practised in this area with Nile tilapia (Oreochromis niloticus niloticus) is the main fish reared. Studies have shown that up to 90% of the mercury used during gold panning in Migori is lost to the environment. Consequently, the mine tailings, soils and waters in these areas are heavily contaminated with mercury. Mercury is washed off to the nearby streams and rivers by run-water, thus extending the pollution farther to the water system. Inland fish farms and Lake Victoria draw their waters from these polluted streams and rivers with mercury being deposited in soil sediments, water and eventually taken up by planktons, insects and other lower organisms which form a major part of the diet for the tilapia fish. Mercury gets absorbed into the fish through feeds, skin and gills. In fish, the mercury is partitioned differently across various tissues depending on the partition coefficients of the tissues to the different mercury forms. Tilapia brain, liver and muscle tissues were selected for this study. Tilapia brain and liver have high-fat content hence are likely to concentrate high amounts of methyl- and other organic forms of mercury which are lipophilic. The liver is also the main organ for metabolism and elimination of the mercury from the fish. Tilapia fish muscle is the major part of consumed by man. Thus it is a tissue of interest in this study since its contamination poses a risk to human health. This study assessed the levels of total mercury (T-Hg) in fish pond sediments, water and tissues of farmed and wild-caught Nile tilapia (Oreochromis niloticus niloticus) in the Migori gold mining belt. The correlation between the mean T-Hg levels in the tilapia fish tissues and the mean T-Hg in pond water and sediments was evaluated. The potential risk to human health from the consumption of the fish was also
determined. Ten locations in Rongo and Nyatike sub-counties in Migori with known artisanal gold mining and inland fish farming activities were conveniently selected for the study. Five tilapia fish (irrespective of sex) were sampled from each site except Minyenya (where four fish were sampled). Two replicate samples of pond water and sediment were collected from each site except for the lake (soil and sediment not sampled). Each fish sample yielded one sample of brain, liver and muscle tissues. A 0.3 - 0.5g portions of the samples were homogenised and acid-digested to reduce all the mercury forms to mercury metal (this yield is referred to as total mercury (T-Hg) which was analysed using cold vapour atomic absorption spectroscopy and the mean T-Hg levels recorded in μg/g wet weight. All the data generated were organised, aggregated and mean measures established. Microsoft Excel (2016) and Statistical Package for the Social Sciences (SPSS, version 20.0) were used for statistical analysis. Data for mercury analysis was expressed as the mean± standard deviation. One-Way Analysis of Variance (ANOVA) was used to analyse the levels of T-Hg in fish tissues across the sites. Tukey's HSD test was used as a post-hoc test. Pearson's rank correlation and the t-test were used to determine whether there were any relationships between the various parameters in the study. Values of p≤0.05 were considered significant in all cases. Sediment quality was evaluated using a geo-accumulation index (IGEO) while the estimated daily intake of fish per meal (EDIm), target hazard quotient (THQ), and the maximum allowable fish consumption rate (CRmw) were used as human health risk indices. Concentrations of mean T-Hg in sediments ranged from 0.208±0.000 to 1.113±0.008 μg/g wet weight (n=8, 95% CI); with six of the eight sites sampled being moderately polluted (1≤IGeo˂2), whereas two sites (Minyenya and Kokaka) being strongly polluted (3≤IGeo˂4). Mean T-Hg in the water samples ranged from 0.002±0.000 to 0.004±0.001 μg/ml wet weight (n=8, 95% CI) with all the sites having higher values (up to 40 times higher)
for T-Hg than the maximum contaminant level of 0.0001 μg/ml allowable for mean T-Hg in unpolluted surface water set by the Food and Agriculture Organization (FAO). The concentrations of mean T-Hg were highest in the tilapia brain tissues, ranging from 0.128±0.021 to 3.798±1.421 μg/g wet weight (n= 49, 95% CI); with the highest proportion (78%, 38/49 samples) having mean T-Hg levels above (up to eight times higher) the limits of 0.5 μg/g wet weight recommended as safe by WHO for consumption by the general human population. The mean T-Hg in tilapia muscle tissues ranged from 0.179±0.020 to 0.595±0.065 μg/g wet weight (n= 49, 95% CI) with 31% (15/49) of fish muscle tissues tested having the levels above 0.5 μg/g wet weight. Mean T-Hg levels were lowest in tilapia liver tissues, ranging from 0.103±0.118 to 0.588±0.374 μg/g wet weight (n= 49, 95% CI) with only 27% (13/49) of fish liver tissues tested having the levels above 0.5 μg/g wet weight. However, most of the tilapia fish samples (87.8% (43/49) of brain, 69.4% (34/49) of liver and (68.7% 34/49) of muscle tissues respectively had mean T-Hg above the 0.2 μg/g (wet weight) level recommended by WHO for at-risk populations (frequent fish eaters, people with renal and liver diseases, pregnant mothers and developing children). There were positive correlations between mean T-Hg levels in tilapia brain and muscle tissues and the mean T-Hg levels in fish pond sediments (r=0.528, p<0.05 and r=0.524, p<0.05 respectively). However, there was no significant correlation between the mean T-Hg content in soil sediments and the mean T-Hg level in fish liver tissues. There was a positive correlation between mean T-Hg levels in tilapia brain tissues and mean T-Hg levels in pond water (r=0.402, p<0.05) as well as between mean T-Hg levels in tilapia muscle tissues and mean T-Hg levels in pond water (r=0.616, p<0.05). However, there was no significant correlation between the mean T-Hg content in pond water and the mean T-Hg level in fish liver tissues. The estimated daily intake of fish per meal (EDIm) and target hazard quotient (THQ) for human consumption ranged
from 2.43-15.84 μg/g and 24.3-158.4 μg/g respectively while the maximum allowable fish consumption rate for humans in meals/week (CRmw) ranged from 1-4 whole fish. These findings show that the levels of mean T-Hg in tissues of Nile Tilapia in the Migori gold mining belt are above-recommended limits. Consumption of Nile tilapia, therefore, bears a significant risk of mercury exposure in frequent fish-eaters, pregnant women and children of developmental age in the Migori gold mining belt, but is safe for the general human population