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Survival Analysis Methods To Estimate Incidence, Survivorship And Risk Factors For Brucellosis In Livestock In Kajiado East Subcounty, Kajiado County, Kenya
No full textBrucellosis is a common bacterial zoonotic disease that is caused by various Brucella species and mostly affects cattle, goats, sheep, pigs and dogs. It results in significant economic losses and human sufferings. Manifestation in livestock is mainly through abortions, retained placentas, premature births, infertility and reduced milk production. Despite the disease being successfully controlled in many developed regions, it is still of major public health importance in sub-Saharan Africa. In Kenya, there is limited data on incidence of brucellosis in livestock. The main objective of this study was to estimate the incidence rates, disease risk probabilities and the risk factors associated with time to brucellosis infection in different livestock species in Kajiado County. Multistage sampling technique was used whereby in the first stage 4 out of 17 locations were selected randomly, followed by proportionate simple random sampling of herds in the selected locations. Stratified random sampling was used in selected herds to identify animals that were enrolled into the study. A cohort of 1369 sheep, 1711 goats and 709 cattle from 500 compounds were enrolled into the study and followed up for 9 months. At the animal herd level, risk factors that were assessed included production system, mixing with other herds, contact with wildlife and breeding system. At individual animal level, data was collected on breed, age, sex, species, breeding status and breeding system. Blood samples were collected from enrolled animals at enrolment and on each of the two follow-up visits. Sera was tested for antibodies against Brucella using competitive Enzyme-Linked Immunosorbent Assays (ELISA). Semiparametric and nonparametric survival analysis techniques were used to explore risk factors associated with time to brucellosis infection in different livestock species. Disease incidence rates were calculated and
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survival probabilities compared using the log rank method. Cumulative incidence was 1.7%, 0.7% and 0.3% in cattle, sheep and goats respectively. Incidence rates for infection with brucellosis were highest in cattle with a rate 7 times that of goats, experiencing worse survival that sheep and goats. On bivariate analysis, the hazard was 1.5 times higher in cattle that were more than 2 years old compared to the under 2 years old though the finding was not statistically significant. Similarly, for sheep the hazard was about 2 times for sheep more than 6 months old. On multivariable Cox proportional hazard regression, there was marginal statistically significant association between natural breeding system and brucellosis infection (p=0.05) in cattle, while sheep that were raised under semi-zero grazing system had an increased hazard for brucellosis infection (p =0.0001).
More brucellosis incidence studies for Brucella infection are required to aid in the understanding of transmission dynamics and therefore inform prevention and control programs in pastoralist settingsa
Department of Psychiatry, University of Nairobi, ; bDepartment of Mental Health, School of Medicine,
Moi University, Eldoret, Keny
Perceptions of empowerment among Women involved in Coffee farming in Kirinyaga East Sub-county, Kirinyaga County
No full textWomen empowerment play a key role in helping women improve the wellbeing of their households. However, gender systems have remained complex and dynamic. Regions, communities, and countries have different social constructions that make women levels of empowerment to differ. Women in most African communities for a long time remained stewards to their house hold properties but have no access to ownership. Even though the status of women participating in agriculture has received much attention from different studies over the recent years, there still exists research gap concerning the level of empowerment for women in farming activities. This study sought to understand the level of empowerment among women involved in coffee farming, the types of resources and income accessible to and controlled by women as well as the levels of satisfaction of women involved in coffee farming. The study adopted a descriptive survey research design and the findings were used for generalisation of the state of current empowerment of women in farming. The target population was all women participating in coffee farming Kirinyaga East sub-county, Kirinyaga County. Quantitative data was obtained from a sample of 394 participants obtained through simple random sampling from a potential universe of 26,000 small scale women farmers. Qualitative data was obtained from 8 key informants that were purposively sampled. According to findings, 37.2% of the women interviewed were aged between 18-39 years while 53.5% were aged between 40-59 years. Only 19.3 % of the women involved in coffee farming aged 60 years and above. Out of the total sample, only 8.1% had accessed post-secondary education, therefore their main source of income was farming. The findings revealed that 63.5% of the respondents have their farms registered in the names of husbands or their father-in-law. Only 16.8% of the women who have managed to gain land ownership and its registration under their names. Albeit, they are either widowed or single. For the married women, only 19.8% owned land jointly with their husbands. The findings show that the level of education acquired by the women did not have much effect of their ability to be fully registered as land owners as opposed to those who had accessed minimal or no education at all since only 1.6% of the women who had acquired tertiary education had land registered under themselves. The data illustrates that only 27.9% could access payments and dividends from coffee proceeds as opposed to the rest whose husbands and other family members’ access. Patriarchy in assets and land ownership as well as access to income is still highly dominant. Most women take care of the coffee in all stages but have none or limited access to its proceeds. There is however to some extent, elements of joint participation where a proportion 54.4% the women are involved by their husbands in decision making concerning income from coffee farming, assets purchase, sale, and transfer of assets. Women also set aside sufficient time to participate in other leisure activities. From this study, it is noted that women have a key role to play in coffee farming yet they have minimal access to and control of resources as opposed to men. Moreover, there exists a high level of ignorance over empowerment as depicted by respondents’ levels of satisfaction with decision making over income, access to and control of asset despite the fact is that the power over those variables’ rest with their husbands
Assessing Sensory Characteristics and Consumer Preference of Legume-Cereal-Root Based Porridges in Nandi County
No full textPreviously, porridge has been cereal based, consumed as a beverage or weaning food. Malnutrition among children has necessitated inclusion of legumes and roots in an effort to boost nutrient density. Therefore, the current study aimed at identifying the most acceptable porridge based on different food ingredient combination. Composite porridge flour included legumes (soybean, groundnut, and lablab), cereals (finger millet, sorghum, maize, and wheat), pseudocereals (pumpkin seed, buckwheat, and amaranth seed), and roots (cassava and arrowroot). New composite porridge flours were formulated using Nutrisurvey linear programming software. Different composite flours formulated to target either school-going children or a family setup were subjected to sensory analysis and the consumer preference test. Eight new formulations were developed. Buckwheat, wheat, and arrowroot were eliminated, maize and lablab content (%) were reduced, and cassava and finger were increased in the new formulations. A total of 149 participants composed of men (30.9%) and women (69.1%) aged between 11 and >60 yrs were interviewed. Newly formulated porridges were more preferred to the previous porridge formulations on color (40–54.2%), smell (40–52.4%), taste (41.5–47.5%), texture (58.3%), viscosity (35.4–45.8%), and overall acceptability (35–54.2%). The most cited reason for liking or disliking a particular porridge was taste (38.9%) and texture (32.2%), respectively. However, all the sensory attributes positively correlated with overall acceptability. Increased finger millet and cassava proportions in the newly formulated composite porridge flour highly influenced their high acceptability. Thus, consumer acceptability of new products is key for their adoption
Assessment of Isocitrate Dehydrogenase Markers, Clinical Presentation and Imaging Characteristics in Patients Under Management of Glial Neoplasms at Kenyatta National Hospital
No full textTumors of the central nervous system are caused by mutations in genes that regulate cell growth. Improved molecular techniques have enabled scientist to investigate this mutation in detail and even correlate them with prognosis. Isocitrate dehydrogenase mutations are the most important prognosticating factors in patients with glial tumors. This has led to changes in the classification of glial tumors in the new 2016 World Health Organization classification of Tumors of the central Nervous system.
Study Broad Objective
To characterize the IDH-1 status and clinical characteristics of glial tumors managed surgically at the Kenyatta National Hospital
Study Design and Site
This was a cross sectional observational study involving all patients with glial tumors managed at the Kenyatta National Hospital. The study was conducted in the Kenyatta National Hospital, outpatient department, trauma and main theatres, neurosurgical ward(4c) and intensive care unit. The lab work was done in the university of Nairobi histopathology labs.
Participants/Materials and Methods
The cases were accrued over a period of 18 months and included six months of retrospective data review and 1year prospective accrual of patients. Patients who had surgery within the last 6 months, had their records traced in the surgical operations book and files in the records department. Patients were contacted using the contacts given in the files and seen in the clinic. New patients were recruited during routine neurosurgical clinics.
Participants included all patients with new onset glial tumors as determined by histology, those on follow-up for confirmed glial tumors managed within 6 months of the start of the study, and patients with recurrent tumors. All patients received routine standard of care and clinical data collected. Tumors were examined after extirpation by the pathology department and glial tumors identified. Immunohistochemistry was done for oligodendrogliomas, Astrocytomas and Glioblastomas. Grade I tumors and ependymomas were excluded from IDH-1 characterization as it is not prognostic in these tumors. Once sample size was achieved the tumor blocks were processed and tested for isocitrate dehydrogenase mutation. The IDH-1 staining was done
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using Anti-IDH1 R132H antibody clone H09 (Heidelberg 2009) Patients were followed up for 3 months to detect any early postoperative morbidity or mortalities.
Results
A total of 33 glioma patients were operated and managed within an 18-month period. Twenty- three cases were prospective and 10 retrospectives. Twenty two cases were eligible for IDH-1 characterization (Astrocytomas, Oligodendrogliomas and Glioblastomas). Five (24%) of tumors had IDH-1 mutation compared to 16(76%) of tumors with the wild type genotype. The Male to female ratio 1:1.6 with mean age of patients 43.5 years(SD±20.62) with a range of 18-70 years. Most patients came from counties that bordered Nairobi county where the hospital is based. Fourteen patients (63%) of the patients presented with headache as the primary symptom followed by 4 patients(18%) who presented with seizures. Thirteen patients (59%) of the patients presented within 2 weeks and 3 months of onset of the symptoms. Of patients who thought a delay had occurred, physician delay at 22.73% was the commonest cause.
Fifteen patients (68%) of the patients had a karnofsky performance score of 70 and above. Twenty-one patients (95 %) had CT scan as an initial evaluation with sixteen patients (72%) having MRI for surgical planning. Nine patients (45%) had tumors in the frontal lobe followed by 5 patients (23%) with tumours in the parietal lobe. Sixteen patients (76%) of the tumours had well defined margins. Seventeen patients (85%) of the tumours had surrounding oedema.
In 3-month, post-operative follow-up, ten patients (45%) of the patients were alive compared to 8 (38.1%) of patients who had died. Three patients(14.2%) of patients were lost to follow-up. Tumour grade was a predictor of early postoperative mortality with a diagnosis of low-grade glioma having a 6 times protective effect on odds ratio. Whilst Absence of oedema and IDH-1 mutation were also significantly protective from early post-operative mortality.a
Department of Psychiatry, University of Nairobi, ; bDepartment of Mental Health, School of Medicine,
Moi University, Eldoret, Keny
Profiles of patients on warfarin anticoagulation therapy in a leading tertiary referral hospital in Kenya; findings and implications for Kenya.
No full textBackground: Patients' profiles affect the outcome with warfarin; however, this data, and its implications, is scarce in resource-poor countries such as Kenya without access to pharmacogenetics or regular INR testing.Objectives: To characterize the profiles of patients on long-term warfarin therapy and subsequently use the findings to guide future anticoagulation management.Methods: Cross-sectional study undertaken among 180 adult patients receiving warfarin therapy in anticoagulation clinics at a leading referral hospital in Kenya. Sociodemographic characteristics were obtained through face-to-face interviews. Details of warfarin therapy, concomitant medication and comorbidities were retrieved from medical records. Associations between patients' profiles and the clinical indications of anticoagulation were computed p≤0.05.Results: Warfarin maintenance dose was 6.17 (±2.75) mg per day. Over 70% of patients received warfarin maintenance doses of ≥6mg per day. Venous thromboembolism (56.6%) amongst obese patients (p=0.0019) and cardioembolic events (48.3%) among males (p=0.0316) aged ≤50 years (p=0.0436) whose body mass indices were ≤ 25 (p<0.0001) were the most common indications. Two-fifths and 45.0% of the patients had at least one other disease and concomitant medications.Conclusions: Long term warfarin therapy among Kenyans is mainly for overweight or lean middle-aged individuals suffering from venous or cardioembolic diseases and requires high daily doses. Studies should correlate patients' profiles with warfarin response to guide future management
Influence of Monitoring and Evaluation Practices on the Implementation of County Governments’ Infrastructural Development Projects in Marsabit County, Kenya
No full textMonitoring and evaluation (M&E) of projects improves overall efficiency of project planning, management and implementation and therefore various projects are started with the sole goal of changing positively the sociopolitical and economic status of the residents of a given region. Quality execution of infrastructural projects, programmes and initiatives is lacking in the county, leading to projects that have minimal impacts to the livelihood of the residents. The County Government of Marsabit has many development projects that failed to reach targeted impacts due to weak design and implementation and limited data for proper planning. Infrastructural development project supervision especially on roads and other infrastructures are weak, leading to poor workmanship. Little has been done or no research in deeper details that has been done to investigate the influence of the M&E on the implementation of county government infrastructural development projects success in Marsabit County. The purpose of this study was to establish the influence of monitoring and evaluation on the implementation of county governments’ infrastructural development projects in Marsabit County. Four research objectives guided the study. The objectives sought to establish the influence of M&E baseline surveys, M&E planning, management participation in M&E and technical expertise in M&E on the implementation of county governments’ infrastructural development projects in Marsabit County. The study was carried out using descriptive research survey design. The sample was 165 personnel. Data was collected using questionnaires and was analysed using descriptive and inferential statistics. Findings revealed no correlation between M&E baseline surveys, M&E planning, management participation and technical expertise in M&E on the implementation of development projects. Based on the findings it was concluded that infrastructural project implementation was not influenced by M&E baseline surveys. The study also concluded that M&E planning did not influence infrastructural projects implementation. The study also concluded that management participation in M&E did not positively influence infrastructural projects implementation. The study lastly concluded that technical expertise in M&E did not have an influence on the implementation of development projects. The study recommended that the county government should enhance M&E baseline surveys so as to scale up infrastructural project implementation. The study also recommended that there should be M&E planning done by the county government. The study also recommended that there should be proper management participation in all levels of project implementation. The study also recommended that the county government should be technical expertise in M&E and infrastructural projects implementation. The study suggested that a study on influence of stakeholder participation on the implementation of development projects in other counties should be conducted. It was also suggested that a study on influence of personnel characteristics on the implementation of development projects and a study on influence of national government infrastructural policies on the implementation of development projects should be conducted
Influence of Water Resource Use Patterns on the Lorian Swamp Ecosystem
No full textRiver ecosystems are under intense pressure from water user‟s resultant from human or economic activities. Population pressure are over-stretching most of Kenya‟s water towers including the Ewaso Nyiro water catchment areas which was the study area. Developing countries including Kenya have identified water as a vital ingredient in meeting the socio-economic developments as envisioned in Vision 2030. Among the proposed projects was the construction of Isiolo mega dam to support the development of Resort City against the backdrop of depleted water resources in the Ewaso Nyiro River due to water abstractions, large scale irrigation farms and used ranches in the upstream. The study investigated the influence of water resource use patterns on the Lorian swamp ecosystem, which narrowed down on the trend of water levels and pasture in time and space and the overall effects of the proposed Isiolo dam on the ecosystem services namely water and pasture. The data was collected from four sub-location namely, Merti, Mulandanur, Matarba and Saleti in Isiolo County. The respondents were randomly selected using a sampling formula from the targeted sub locations. 100 respondents were administered with questionnaires to obtain the data needed. Additionally, focus group discussion was conducted to gather in-depth information as a triangulation measure. Observations added valuable information to the overall data collection. The field data was uploaded on statistical package for social sciences (SPSS) and the data was analyzed using descriptive statistics. River flow data from CETRAD were calculated and tabulated to triangulate primary data for comparison and validation. The results were presented in bar charts, percentages and mean. The data analysis indicated significant water reduction in Ewaso Nyiro over the years affecting the Lorian Swamp ecosystem. The research finding indicates that from 1960-1969, the cummulative water discharge was 964 million cubic meters and from 2001-2010 it was 572
million cubic meters showing a major decline in water discharge with a difference of 392 million cubic meters translating to 40% reduction over four decades. Further analysis showed that pasture and water are currently adequate but under threat due to loss of traditional governance system, invasive species (Prosopis Juliflora), climate change, water abstraction upstream for farming and other uses, deforestation, encroachment of the catchment arears and ever-increasing population. It was therefore concluded that the further development of proposed dam will have serious effects on water discharge of the Ewaso Nyiro River. The Dam will be anticipated to take 214millions cubic meter against the backdrop of the available annual average water of 583 million cubic meters translating to annual reduction of water in the river by 37%. The future impacts will shrink the Lorian swamp ecosystem from the current 2918-kilometer square to 1809-kilometer square affecting forage production, water reduction including the underground water, Loss of indigenous trees and increased conflict over limited resources. The research further concluded that to balance human developments and sustainability of the Lorian swamp ecosystem the water uptake in the dam be spread over three years at a rate of 71.4 million cubic meter, about 12.3% of annual water discharge. It means that the dam will be filled in three years. The research study further recommends that the National government should explore sustainable timeline to fill the dam in meeting the water demand without compromising the critical Lorian Swamp Ecosystem. Additionally, the County government should constitute an Independent Institution to conduct potential Environmental and Social Impact for the proposed dam. Also, the traditional governance system of the resource management should be formalized and strengthened so as to manage the Lorian Swamp Ecosystem. Finally, the need to curb the serious threat from the invasive species (Prosopis Juliflora) and the concerned Authority should consider innovative ways of taming it
State’s Response To Refugee Crisis: The Case Of Kenya’S Refugee Law, 1991 – 2016
No full textThe focus of this dissertation was the articulation, implementation and impact of Kenya refugee law in the period between 1991 and 2016. Kenya has hosted refugees since independence mainly from neighbouring countries. It was due to this reason that the study set out to find how Kenya‘s legal system was crafted to deal with the refugees issues in the country and the impact of these law. The project relied on broad and definite objectives and adopted a conceptual framework that brought in a number of theories. Written secondary and primary written materials provided most of the study data. Gaps identified in the written literature were filled through oral interviews with people who were knowledgeable on refugee law in Kenya.
The study found out that Kenya refugee law has gone through three major trajectories. First period between 1963 and 1991 encompassed the government being in charge of refugee management in the country and adopting a Laissez-faire attitude towards the refugees. Second phase was in the period, 1991 to 2006 where refugee camps were set up following the influx of refugees fleeing violence from various countries in Africa. Consequently, the Government of Kenya abandoned direct involvement with refugees and shifted the management of refugees to UNHCR. The third trajectory was in the period, 2007 to 2016 where the refugee law was enacted in 2006. The act came with a framework on the handling and management of refugees in the country. Significantly there was a rise of insecurity that was blamed on refugees. This prompted the Kenya Government to come up with a raft of measures, pronouncements and amendments to tame rising insecurity though most of them were challenged in court and found to be unconstitutional. There was also a significant negative shift in Kenyans attitudes towards refugees. They began to see them as competitors rather than people who needed assistance.
The study has shown that the implementation of the Kenya refugee law to some extent was an affront to the constitution of Kenya and the International laws that Kenya is a signatory. The security inspired pronouncement and amendments culminated in the violation of refugee rights in Kenya. Kenyans similarly developed hatred and xenophobia towards refugees leading to what has been termed as securitization of the Kenyan asylum space
Effect of Corporate Governance on Tax Planning of Commercial and Service Firms Listed at the Nairobi Securities Exchange
No full textIn the recent past, research studies have been conducted that give a picture of why some companies avoid taxes more than others. The earliest studies point to characteristics of the firm as proxies for opportunities, incentives and resources for tax planning to explain why some companies more than others do avoid or minimizes tax liability. Recently studies conducted have expounded on this research area by investigating the role played by agency conflicts on corporate tax planning behavior. This research set to determine the how corporate governance influences corporate tax planning of commercial and service firms at the NSE. All 11 commercial and service organizations listed formed population of this work. Independent variants in this research were corporate governance operationalized as the size of the board members, independence of the team and the number of meetings. Control variables were profitability represented by return on equity per year, managerial ownership represented by the percentage of shares held by management and debt financing given by the ratio of total debt to total assets in an year. The response variable was corporate tax planning given by effective tax rate. A five year period, January 2014 and December 2018, was studied through gathering of secondary data. Descriptive research design method was employed while multiple linear regressions model was applied in analysis of the association between the variables. The data was analyzed by use of SPSS version 22. An R-Square value of 0.605 was produced from the study results which meant that a large percentage, 60.5%, of corporate tax planning of commercial and service organizations at the stock exchange can be explained by the six predictor variables as 39.5 of disparity of corporate tax planning rate was related to variables that were not part of this study. Findings of ANOVA highlight how F was important at the 5% level, showing p=0.000. Henceforth, this case showed that the model was appropriate in explaining the correlations between the differing variants. In addition, it was revealed that profitability had a significant effect on tax planning while board size, board independence, board meetings and managerial ownership produced negative but insignificant findings for this research work. Finally, debt financing produced positive and not statistically influence on corporate tax planning among commercial and service organizations listed at the NSE. This research recommends that strategies should be set to increase profitability of firms, because it has a statistically substantial influence on corporate tax planning among commercial and service firms at the NSE
Change Management Strategy And Asset Control: A Case Study Of The United Nations Department Of Safety And Security In Somalia
No full textGlobalization has led to an increase need to improve the management of the assets in order to create value. Asset management has been increasingly been becoming digitized in order to improve their management. The study mainly purposed to investigate the impact of strategy, change management and asset management on asset control using the United Nations Department of Safety and Security Somalia. The objectives of the study were to assess the effect of strategy change management and asset management on asset control in an organization. A case study design was utilized with interviews conducted among managers of UNDSS. The interview guide was comprised of several open-ended questions. Data analysis for the study was carried out using deductive content analysis. The organization utilized strategy and change management practices in order to improve the performance of the organization and to deal with the issues in the organization. However, implementing this was associated with a number of challenges which required the involvement of the employees and the organization leaders. The study also recommended the organization to provide proper training to the employees to ensure ease in change and leadership should ensure that they had basic knowledge on information technology