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BackgroundA substantial proportion of the world population is affected by malaria with 241 million malaria cases reported globally. Intermittent Preventive Treatment in pregnancy (IPTp) with Sulfadoxine-Pyrimethamine (SP) is an effective chemotherapy but its utilisation has not been optimised. Few studies focus on young mothers and their experiences regarding the optimal uptake of IPTp-SP.MethodsThe study design was cross-sectional with data derived from six focus group discussions with mothers aged 15–24 years who had a pregnancy and gave birth to a live baby within the last two years in Kisumu and Migori counties, Kenya. Inductive analysis was used to identify themes and patterns.ResultsYoung mothers were motivated to take IPTp-SP during pregnancy if they had prior knowledge about SP and its associated benefits and if they were knowledgeable about the consequences of malaria infection during pregnancy. Perceived side effects of SP, lack of awareness of SP as a malaria prevention therapy, lack of knowledge on the benefits of SP, dosage and frequency of uptake, poor communication by health providers towards young mothers, and inconsistent supply of SP at health facilities inhibited young mothers from attaining the recommended 3+ doses of IPTp-SP.ConclusionsThere is a need for health literacy programmes that focus on increasing knowledge of IPTp-SP dosage, timing and benefits for both the young pregnant mother and her foetus. Community engagement through dialogue with mentor mothers and male partners will be an important complementary approach in establishing a support system for young women for positive health outcomes including attaining the recommended 3+ doses of IPTp-SP.

Land use practices near river ecotones result in numerous inputs of terrestrial materials into the river ecosystem. While macroinvertebrates population metrics is widely used in monitoring water quality changes, including those induced by humans, the use of lipid profiles in these organisms to monitor influence of land use practices is rather ignored. The aim of this study was to determine lipid profile in macroinvertebrates as potential indicator of human influence in Sagana River Basin, a high altitude tropical highland stream in Kenya. Sites were selected based on differences in land use activities delineated: forest with minimal land use activities, while cropland and saw milling areas had varying degrees of land use activities, with urban areas designated as sites with most human impacts. The macroinvertebrate metrics such as occurrence, abundance, diversity, percentage of oligochaetes and chironomids (%OC), as well as the Ephemeroptera, Plecoptera and Trichoptera (%EPT) index differed relative to land use changes. Variation in the Fatty Acids (FAs), alcohols and sterols in benthic macroinvertebrates was related to the land use activities along the stream. Evidently, streams traversing the urban areas had higher concentrations of Phospholipid fatty acids (PLFA), while streams traversing croplands had the highest neutral lipid fatty acids (NLFA). The dominance of monounsaturated FAs (MUFAs) in forest, shortchain FAs (SCFAs) and polyunsaturated FAs (PUFAs) in croplands and longchain FAs (LCFAs) near urban areas clear indicate different sources of these materials, mainly from terrestrial sources. Individual fatty acids, alcohols and sterols profiles discerned difference in land use changes. The concentrations of SCFAs, MUFAs, LCFAs, TeoH, 27Δ5.22, 28Δ5,24, 28Δ5,22, 29Δ5,22 and 29Δ5,22 in the benthic macroinvertebrates samples were positively associated with OC%, EPT, total abundance and eH’. Meanwhile the concentration of phytol, AqOH, 27Δ5 and SCOH were associated with Simpson index. The current findings support the combination of macroinvertebrates species composition, abundance, diversity and lipids profiles to detect land use activities at the riverine scale. While implementing catchment-based river management and conservation activities should incorporate lipid analysis as a management tool. There is need for continuous monitoring of long term trends in land use activities on the changes in lipid content of the macroinvertebrates.

Safeguarding challenges in global health research include sexual abuse and exploitation, physical and psychological abuse, financial exploitation and neglect. Intersecting individual identities (such as gender and age) shape vulnerability to risk. Adolescents, who are widely included in sexual and reproductive health research, may be particularly vulnerable. Sensitive topics like teenage pregnancy may lead to multiple risks. We explored potential safeguarding risks and mitigation strategies when studying teenage pregnancies in informal urban settlements in Nairobi, Kenya. Risk mapping was initiated by the research team that had prolonged engagement with adolescent girls and teen mothers. The team mapped potential safeguarding risks for both research participants and research staff due to, and unrelated to, the research activity. Mitigation measures were agreed for each risk. The draft risk map was validated by community members and coresearchers in a workshop. During implementation, safeguarding risks emerged across the risk map areas and are presented as case studies. Risks to the girls included intimate partner violence because of a phone provided by the study; male participants faced potential disclosure of their perceived criminal activity (impregnating teenage girls); and researchers faced psychological and physical risks due to the nature of the research. These cases shed further light on safeguarding as a key priority area for research ethics and implementation. Our experience illustrates the importance of mapping safeguarding risks and strengthening safeguarding measures throughout the research lifecycle. We recommend co-developing and continuously updating a safeguarding map to enhance safety, equity and trust between the participants, community and researchers.

Abstract Background Nile tilapia has a variety of phenotypes suitable for aquaculture farming, yet its entire gene pool with potential for breeding climate ready strains in resource-limited settings remains scanty and poorly documented. SNP calling has become increasingly popular in molecular genetic studies due to their abundance and precision in estimating and identifying an organism’s genetic makeup. SNPs are versatile in trait-specific breeding, which, in contrast to pedigree breeding, is affordable and speeds up genetic advancement by allowing animals to be used as parents sooner. Results Clustering analysis revealed a strong correlation between the experimental sample, Oreochromis niloticus, Oreochromis aureus and Betta splendens. Three other species indicated evolutionary independence. Comparative genomics identified similarities between fishes with common genetic and evolutionary ancestry, allowing for better adaptation to local environmental conditions. Some of the selected genes exhibiting substantial effect on immunity include: Prxs, MMR1 like, ZMYM4-like partial; stress-reactive genes including: PALLD-like gene, LPLBAG6-like and growth-related genes including: NF1x like, PEDF and CL like. Experimental sample, O. niloticus, O. aureas and Danio rerio, can hybridize in their natural environments bringing about genetic admixture ancestry that hybridizes new genes which confer beneficial phenotypes. Conclusion Breeding for specific traits could be a useful addition to aquaculture to allow expansion of the ecological niche and genetic base for tilapia. Some of the beneficial genes that can be hybridized include Slc25a24 and Slc12member 10, tandem duplicate 1, for salinity tolerance and Abca1, bcl2a and mylk13 for hypoxia tolerance. Breeders should introduce beneficial traits into fish breeds to ensure they are climate ready and able to weather climate shocks. This will allow aquaculture to contribute to food and nutrition security in line with SDG2 and improve the economic status of fish-farming communities in the Global South countries.

Populations in informal settlements grapple with poor living conditions and inability to access quality education. Expenditure behaviour especially on short term basis is one of the major causes of poverty as majority live from hand to mouth and not in position to provide their children with education. This study applied canonical correlation used in a wide range of disciplines to analyse the relationship between short term expenditure and poverty levels. The main objective was to establish the relationship between short term expenditure and poverty levels among residents of informal settlements, assess the impact of this behaviour on education and propose possible mitigation strategies to the problem. Results indicate that people in informal settlements spend as much as they earn or even more on short term basis. Therefore, they cannot save for projects, invest and educate their children. This keeps the families in unending circus of poverty in all generations.

Abstract Background Malaria in pregnancy remains a major public health problem in endemic areas of the sub-Saharan African (SSA) region. However, there is limited understanding of the association between women’s empowerment and the uptake of sulfadoxine–pyrimethamine for intermittent preventive treatment of malaria during pregnancy (IPTp-SP) in Kenya. This study examines the association between women’s empowerment indicators (decision-making power, control of assets, education, and employment status) and the uptake of three or more doses of IPTp-SP in the Lake endemic region of Kenya. Methods The analysis utilized a dataset from a cross-sectional baseline survey of 3129 women aged 15–49 years in Kisumu and Migori Counties who had a live birth within the last 2 years preceding the study. Data were collected between June to August 2021. A descriptive analysis was conducted to show the distribution of respondents by key background characteristics, and bivariate and multivariate logistic regression to examine statistically significant associations between women’s empowerment measures and the uptake of 3+ doses of IPTp-SP. Results Among the 3129 women surveyed, 1978 (65.7%) received 3+ doses of IPTp-SP during their most recent pregnancy. Controlling for individual characteristics and the number of ANC visits, the odds of taking 3+ doses of IPTp-SP increased among women who had high decision-making autonomy (AOR = 2.33; CI = 1.81–3.01; P

Incorporating crop residues into the soil is an effective method for improving soil carbon sequestration, fertility, and crop productivity. Such potential benefits, however, may be offset if residue addition leads to a substantial increase in soil greenhouse gas (GHG) emissions. This study aimed to quantify the effect of different crop residues with varying C/N ratios and different nitrogen (N) fertilizers on GHG emissions, yield, and yield-scaled emissions (GHGI) in winter wheat. The field experiment was conducted during the 2018–2019 winter wheat season, comprising of four residue treatments (no residue, maize residue, soybean residue, and maize-soybean mixed residue) and four fertilizer treatments (control, urea, manure, and manure + urea). The experiment followed a randomized split-plot design, with N treatments as the main plot factor and crop residue treatments as the sub-plot factor. Except for the control, all N treatments received 150 kg N ha−1 season−1. The results showed that soils from all treatments acted as a net source of N2O and CO2 fluxes but as a net sink of CH4 fluxes. Soybean residue significantly increased soil N2O emissions, while mixed residue had the lowest N2O emissions among the three residues. However, all residue amendments significantly increased soil CO2 emissions. Furthermore, soybean and mixed residues significantly increased grain yield by 24% and 21%, respectively, compared to no residue amendment. Both soybean and mixed residues reduced GHGI by 25% compared to maize residue. Additionally, the urea and manure + urea treatments exhibited higher N2O emissions among the N treatments, but they contributed to significantly higher grain yields and resulted in lower GHGI. Moreover, crop residue incorporation significantly altered soil N dynamics. In soybean residue-amended soil, both NH4+ and NO3− concentrations were significantly higher (p < 0.05). Conversely, soil NO3− content was notably lower in the maize-soybean mixed residue amendment. Overall, our findings contribute to a comprehensive understanding of how different residue additions from different cropping systems influence soil N dynamics and GHG emissions, offering valuable insights into effective agroecosystems management for long-term food security and soil sustainability while mitigating GHG emissions.

This paper examines the history of community and indigenous language mass media evolution in Turkana County from 1963-2022. It adopted a qualitative research approach. This is because, it involved collecting and analyzing non-numerical data through; texts, video, or audio. This was done in-order to understand concepts, opinions and also experiences from various respondents. It also used to gather in-depth insights into a problem or generate new ideas for this research. The paper highlighted on the pros and cons that has hit the Turkana community since 1963 on their interaction with the fourth estate in terms of social, political and economic development as compared to other communities in the country. The study was conducted in Turkana county, which is the area occupied by the Turkana people. Its focus was on the farmers, pastoralist, traders, politicians and administrators. The research illuminates on the impact of indigenous mass media empowerment to the community by use of vernacular language. That’s why it discusses on its evolution and the impact it has created to the Turkana Community of Turkana County in Kenya. The research is significant in that, it informs the marginalized communities on the utilization of indigenous mass media to empower themselves in terms of socially, economically and politically by receiving regular and updated information from experts.

Objectives: This study examined the treatment response of mixed vs single-species Plasmodium falciparum infections to artemisinin-based combination therapies (ACTs). Methods: A total of 1211 blood samples collected on days 0, 7, 14, 21, 28, 35, and 42 from 173 individuals enrolled in two randomized ACT efficacy studies were tested for malaria using 18s ribosomal RNA-based real-time polymerase chain reaction. All recurrent parasitemia were characterized for Plasmodium species composition and time to reinfection during 42-day follow-up compared across ACTs. Results: Day 0 samples had 71.1% (116/163) single P. falciparum infections and 28.2% (46/163) coinfections. A total of 54.0% (88/163) of individuals tested positive for Plasmodium at least once between days 7-42. A total of 19.3% (17/88) of individuals with recurrent infections were infected with a different Plasmodium species than observed at day 0, with 76.5% (13/17) of these “hidden” infections appearing after clearing P. falciparum present at day 0. Artesunate-mefloquine (16.4 hours) and dihydroartemisinin-piperaquine (17.6 hours) had increased clearance rates over artemether-lumefantrine (21.0 hours). Dihydroartemisinin-piperaquine exhibited the longest duration of reinfection prophylaxis. Cure rates were comparable across each species composition. Conclusion: No differences in clearance rates were found depending on whether the infection contained species other than P. falciparum. Significantly longer durations of protection were observed for individuals treated with dihydroartemisinin-piperaquine.

Surface water pollution is a challenge due to effluent discharge from land-based factors like agro-based sectors, settlements, and poor sanitation. The research investigated the spatial and seasonal variation of physico-chemical and biological water quality due to land use changes along the Thika River sub-catchment, Upper Tana, Kenya. The study applied purposive sampling technique from the different zones within the catchment during the dry and wet season of 2021. The samples were tested for physico-chemical and microbial contaminants. R-studio was used to calculate the mean values and t-test performed at a 95% confidence interval to determine variation of the parameters in the two seasons and mean levels compared to the Kenya Bureau of Standards (KEBS) 2010 and the World Health Organization (WHO) acceptable quality for drinking water. There was significant variation in sulphate and nitrate concentration, total coliform and fecal coliform and no significant variations in physical parameters throughout the seasons. The total coliform and fecal coliform exceeded KEBS and WHO limits.

Abstract Background Breast cancer is the most common female cancer worldwide. Its diagnosis and prognosis remain scanty, imprecise, and poorly documented. Previous studies have indicated that some genetic mutational signatures are suspected to lead to progression of various breast cancer scenarios. There is paucity of data on the role of AI tools in delineating breast cancer mutational signatures. This study sought to investigate the relationship between breast cancer genetic mutational profiles using artificial intelligence models with a view to developing an accurate prognostic prediction based on breast cancer genetic signatures. Prior research on breast cancer has been based on symptoms, origin, and tumor size. It has not been investigated whether diagnosis of breast cancer can be made utilizing AI platforms like Cytoscape, Phenolyzer, and Geneshot with potential for better prognostic power. This is the first ever attempt for a combinatorial approach to breast cancer diagnosis using different AI platforms. Method Artificial intelligence (AI) are mathematical algorithms that simulate human cognitive abilities and solve difficult healthcare issues such as complicated biological abnormalities like those experienced in breast cancer scenarios. The current models aimed to predict outcomes and prognosis by correlating imaging phenotypes with genetic mutations, tumor profiles, and hormone receptor status and development of imaging biomarkers that combine tumor and patient-specific features. Geneshotsav 2021, Cytoscape 3.9.1, and Phenolyzer Nature Methods, 12:841–843 (2015) tools, were used to mine breast cancer-associated mutational signatures and provided useful alternative computational tools for discerning pathways and enriched networks of genes of similarity with the overall goal of providing a systematic view of the variety of mutational processes that lead to breast cancer development. The development of novel-tailored pharmaceuticals, as well as the distribution of prospective treatment alternatives, would be aided by the collection of massive datasets and the use of such tools as diagnostic markers. Results Specific DNA-maintenance defects, endogenous or environmental exposures, and cancer genomic signatures are connected. The PubMed database (Geneshot) search for the keywords yielded a total of 21,921 genes associated with breast cancer. Then, based on their propensity to result in gene mutations, the genes were screened using the Phenolyzer software. These platforms lend credence to the fact that breast cancer diagnosis using Cytoscape 3.9.1, Phenolyzer, and Geneshot 2021 reveals high profile of the following mutational signatures: BRCA1, BRCA2, TP53, CHEK2, PTEN, CDH1, BRIP1, RAD51C, CASP3, CREBBP, and SMAD3.

Abstract Malaria transmission depends on the presence of Plasmodium gametocytes that are the only parasite life stage that can infect mosquitoes. Gametocyte production varies between infections and over the course of infections. Infection duration is highly important for gametocyte production but poorly quantified. Between 2017 and 2019 an all-age cohort of individuals from Tororo, eastern Uganda was followed by continuous passive and routine assessments. We longitudinally monitored 104 incident infections from 98 individuals who were sampled once every 28 days and on any day of symptoms. Among infections that lasted ≥ 3 months, gametocyte appearance was near-universal with 96% of infections having detectable gametocytes prior to clearance. However, most infections were of much shorter duration; 55.7% of asymptomatic infections were detected only once. When considering all asymptomatic infections, regardless of their duration, only 36.3% had detectable gametocytes on at least one time-point prior to parasite clearance. Infections in individuals with sickle-cell trait (HbAS) were more likely to have gametocytes detected (Hazard Rate (HR) = 2.68, 95% CI 1.12, 6.38; p = 0.0231) and had gametocytes detected at higher densities (Density Ratio (DR) = 9.19, 95% CI 2.79, 30.23; p = 0.0002) compared to infections in wildtype (HbAA) individuals. Our findings suggest that a large proportion of incident infections is too short in duration and of too low density to contribute to onward transmission.

Potato virus Y (PVY) is a highly diverse and genetically variable virus with various strains. Differential evolutionary routes have been reported in the genus Potyvirus, caused by natural selection pressure, mutation, and recombination, with their virulence being dependent on different environmental conditions. Despite its significance and economic impact on Solanaceous species, the understanding of PVY’s phylogeography in Kenya remains limited and inadequately documented. The study centers on the molecular characterization of a Kenyan PVY isolate, GenBank accession number PP069009. In-depth phylogenetic analysis unveiled a strong evolutionary association between the Kenyan isolate and isolate [JQ924287] from the United States of America, supported by a robust 92% probability. Recombinant analyses exposed a mosaic-like genetic architecture within the Kenyan isolate, indicating multiple gene recombination events. Selection pressure scrutiny identified specific sites under selective pressure, with evidence of positive/diversifying and negative/purifying selection. Population genetics analysis revealed a calculated nucleotide diversity (π) of 0.00354881, while analysis of molecular variance (AMOVA) unveiled a structured genetic landscape with an øST value of 0.45224. The extensive haplotype network depicted the possibility of diverse PVY strains occurring across continents. This analysis provides valuable insights into the genetic diversity and distribution of PVY globally, highlighting the importance of understanding evolutionary dynamics for effective management and control strategies of PVY on a global scale.

Single nucleotide polymorphisms (SNPs) in the Plasmodium falciparum multi-drug resistance protein 1 (Pfmrp1) gene have previously been reported to confer resistance to Artemisinin-based Combination Therapies (ACTs) in Southeast Asia. A total of 300 samples collected from six sites between 2008 and 2019 under an ongoing malaria drug sensitivity patterns in Kenya study were evaluated for the presence of SNPs at Pfmrp1 gene codons: H191Y, S437A, I876V, and F1390I using the Agena MassARRAY® platform. Each isolate was further tested against artemisinin (ART), lumefantrine (LU), amodiaquine (AQ), mefloquine (MQ), quinine (QN), and chloroquine (CQ) using malaria the SYBR Green I-based method to determine their in vitro drug sensitivity. Of the samples genotyped, polymorphism at Pfmrp1 codon I876V was the most frequent, with 59.3% (163/275) mutants, followed by F1390I, 7.2% (20/278), H191Y, 4.0% (6/151), and S437A, 3.3% (9/274). A significant decrease in median 50% inhibition concentrations (IC50s) and interquartile range (IQR) was noted; AQ from 2.996 ng/ml [IQR = 2.604-4.747, n = 51] in 2008 to 1.495 ng/ml [IQR = 0.7134-3.318, n = 40] (P

Background. Detecting a group of esophageal cancer (EC) cases in endemic regions is essential in identifying high-risk populations and executing appropriate interventions. The main aim of this study was to determine the epidemiology of EC in Eritrea. Methods. A retrospective (period: 2011 – 2021) study was carried out by abstracting data on EC patients from the logbook kept at the National Health Laboratory (ENHL). Information on socio-demographic, clinical history, and biopsy analysis findings was collected. For the statistical assessment of data, the End Results (SEER) Joinpoint Regression Program (V.4.5.0.1) was used to calculate crude incidence rate (CIR), age-adjusted incidence rate (ASR), and estimated annual percentage change (EAPC) by sex, age, and histotype. Results. A total of 189 patient’s samples (134 (70.9%) females vs. 55 (29.1%) males, ratio 2.43 : 1) were evaluated. Of the 155 patients with EC, 44 (28.4%) and 111 (71.6%) were diagnosed with esophageal adenocarcinoma (EAC) and esophageal squamous cell carcinoma (ESCC), respectively (AC/ESCC ratio, 0.4). The median age (IQR) of patients with EC was 60 years (46.0 – 70 years) – (males 62 (IQR: 49.0 – 77 years) vs. females 60 (IQR: 46 -67 years), p-value =0.43. Within age bands, the F: M ratios in patients with ESCC were as follows: >20 -29 years =2: 1; 30-39 years =8 : 1; 40 – 49 years =10.5 : 1; 50-59 years =6.67 : 1; 60-69 years =3.25.1; 70-79 years =1.5 : 1 and>80 years =2 : 1. The all-age CIR and ASR for EC were 0.468 per 100 000 and 2.281 per 100 000 persons, respectively. Similarly, the all-age ASR for both males and females was 2.88 per 100 000 and 1.61 per 100 000. Over the study period, the EAPC for all cases was -3.0% (95% CI, −11.3 to 6.1, p-value =0.455). Conclusion. In large part, EC is a women’s disease in Eritrea. The unusually high incidence of ESCC and the high female-to-male ratio point at sex-dependent exposures as a major driver of the EAC epidemic in the country. Therefore, research on the risk factors of EC in Eritrea is urgently needed.

Child undernutrition is a persistent challenge in arid and semi-arid areas due to low and erratic rainfall, recurrent droughts and food insecurity. In these settings, caregivers face several challenges in accessing health services for sick and/or malnourished children, including long distances to health facilities, harsh terrain, and lack of money to pay for transportation costs to the health facilities, leading to low service coverage and sub-optimal treatment outcomes. To address these challenges and optimize treatment outcomes, the World Health Organization recommends utilizing community health volunteers (CHVs) to manage acute malnutrition in the community. This study explored the perceptions of community members regarding acute malnutrition treatment by CHVs in Turkana and Isiolo counties in Kenya. The study utilized a cross-sectional study design and included a purposive sample of caregivers of children, CHVs, officers who trained and supervised CHVs and community leaders in the intervention area. Focus group discussions and key informant interviews were used to explore perceptions towards the management of acute malnutrition by CHVs. Generally, caregivers and CHVs perceived the intervention to be beneficial as it readily addressed acute malnutrition treatment needs in the community. The intervention was perceived to be acceptable, effective, and easily accessible. The community health structure provided a platform for commodity supply and management and CHV support supervision. This was a major enabler in implementing the intervention. The intervention faced operational and systemic challenges that should be considered before scale-up.

While many studies have characterized mobility patterns and disease dynamics of settled populations, few have focused on more mobile populations. Highly mobile groups are often at higher disease risk due to their regular movement that may increase the variability of their environments, reduce their access to health care, and limit the number of intervention strategies suitable for their lifestyles. Quantifying the movements and their associated disease risks will be key to developing interventions more suitable for mobile populations. Turkana, Kenya is an ideal setting to characterize these relationships. While the vast, semi-arid county has a large mobile population (>60%) and was recently shown to have endemic malaria, the relationship between mobility and malaria risk in this region has not yet been defined. Here, we worked with 250 semi-nomadic households from four communities in Central Turkana to 1) characterize mobility patterns of travelers and 2) test the hypothesis that semi-nomadic individuals are at greater risk of malaria exposure when migrating with their herds than when staying at their semi-permanent settlements. Participants provided medical and travel histories, demographics, and a dried blood spot for malaria testing before and after the travel period. Further, a subset of travelers was given GPS loggers to document their routes. Four travel patterns emerged from the logger data, Long Term, Transient, Day trip, and Static, with only Long Term and Transient trips being associated with malaria cases detected in individuals who carried GPS devices. After completing their trips, travelers had a higher prevalence of malaria than those who remained at the household (9.2% vs 4.4%), regardless of gender and age. These findings highlight the need to develop intervention strategies amenable to mobile lifestyles that can ultimately help prevent the transmission of malaria.

BackgroundDiabetic retinopathy (DR) is the most frequent complication of type 2 diabetes and remains the leading cause of preventable blindness. Current clinical decisions regarding the administration of antidiabetic drugs do not sufficiently incorporate the risk of DR due to the inconclusive evidence from preceding meta-analyses. This umbrella review aimed to systematically evaluate the effects of antidiabetic drugs on DR in people with type 2 diabetes.MethodsA systematic literature search was undertaken in Medline, Embase, and the Cochrane Library (from inception till 17th May 2022) without language restrictions to identify systematic reviews and meta-analyses of randomized controlled trials or longitudinal studies that examined the association between antidiabetic drugs and DR in people with type 2 diabetes. Two authors independently extracted data and assessed the quality of included studies using the AMSTAR-2 (A MeaSurement Tool to Assess Systematic Reviews) checklist, and evidence assessment was performed using the GRADE (Grading of recommendations, Assessment, Development and Evaluation). Random-effects models were applied to calculate relative risk (RR) or odds ratios (OR) with 95% confidence intervals (CI). This study was registered with PROSPERO (CRD42022332052).ResultsWith trial evidence from 11 systematic reviews and meta-analyses, we found that the use of glucagon-like peptide-1 receptor agonists (GLP-1 RA), sodium-glucose cotransporter-2 inhibitors (SGLT-2i), or dipeptidyl peptidase-4 inhibitors (DPP-4i) was not statistically associated with the risk of DR, compared to either placebo (RR: GLP-1 RA, 0.98, 0.89-1.08; SGLT-2i, 1.00, 95% CI 0.79-1.27; DPP-4i, 1.17, 0.99-1.39) or other antidiabetic drugs. Compared to other antidiabetic drugs, meglitinides (0.34, 0.01-8.25), SGLT-2i (0.73, 0.10-5.16), thiazolidinediones (0.92, 0.67-1.26), metformin (1.15, 0.81-1.63), sulphonylureas (1.24, 0.93-1.65), and acarbose (4.21, 0.44-40.43) were not statistically associated with the risk of DR. With evidence from longitudinal studies only, insulin was found to have a higher risk of DR than other antidiabetic drugs (OR: 2.47, 95% CI: 2.04-2.99).ConclusionOur results indicate that antidiabetic drugs are generally safe to prescribe regarding the risk of DR among people with type 2 diabetes. Further robust and large-scale trials investigating the effects of insulin, meglitinides, and acarbose on DR are warranted.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?RecordID=332052, identifier CRD42022332052.

Premature end-of-life Vehicles (ELVs) are on the rise in Kenya due to an increase in road accidents, as reported by National Transport and Safety Authority. These premature ELVs are poorly managed, frequently found parked in police station yards, garages, and residential estates, posing risks to public health and environment, thus undermining progress toward sustainable development goals. There have been scattered efforts on their management through policies and legislation, such as the Environmental Management and Coordination Act of 1999; the umbrella law on environment,which remains generic and insufficient in effectively addressing premature ELVs. This article presents the findings of a study conducted to assess the existing management mechanisms of premature ELVs in Nairobi City County. The study employed semi-structured questionnaires administered to households (n = 170) and conducted key informant interviews (n = 88) within relevant agencies in the County. The results show that the most common mechanism for handling premature ELVs is their sale to garages for spare parts sourcing (31%), while the least utilized method invloves selling them for recycling (3%). Furthermore, there exists an opportunity to implement circular economy principles in the management of premature ELVs. Consequently, there is a pressing need for government to develop appropriate policies, legal frameworks, and institutional support to effectively manage premature ELVs.

ABSTRACTMalaria is a leading cause of illness and death in children under 5 years of age in Sub-Saharan Africa. Currently, there is no highly efficacious malaria vaccine capable of inducing long-lasting immunity. This has increased interest in exploring different vaccine development strategies, including whole-parasite vaccines, and utilizing more effective adjuvant delivery systems. Here, we evaluate the immunogenicity and protective efficacy of a whole-parasite Plasmodium yoelii 17X blood-stage vaccine formulated with the clinically tested cationic adjuvant formulation, CAF01. The vaccine protected both inbred and outbred mice, and protected mice from homologous and heterologous challenge infections. Tracking of RBC subsets in vaccinated mice demonstrated that vaccine-induced immunity cleared parasitized normocytes as well as reticulocytes. Infection prior to vaccination led to an augmented level of protection and boosted immunity post vaccination. The vaccine induced parasite-specific IgG, mainly of the IgG1 subclass, and cellular responses, with a mixed Th1/Th2/Th17 cytokine profile. Mechanistic studies demonstrated that CD4+ T-cells (but not CD8+ T-cells), and Th1 and Th2 cytokines (interferon gamma and tumor necrosis factor, IL-10) were critical in controlling parasitemia and survival following challenge. Vaccinated µMT mice were not protected, suggesting that B-cells also play a role in protective immunity. Depletion of splenic macrophages with clodronate did not affect vaccine efficacy. These pre-clinical findings will inform the transition of this vaccine candidate into clinical trials.IMPORTANCEMalaria is a devastating disease that has claimed many lives, especially children

AbstractUnderutilized crops play an important role in sustainable food systems, especially in drought-stricken areas occasioned by climate change. These crops, particularly cassava have become a priority in Siaya County, Kenya. This is because of its adaptive nature in the region and its contribution to sustainable food systems. Therefore, both the government and other development bodies have initiated programs to support the development of the cassava value chain while introducing it to mainstream farming systems. Most of these programs have targeted farm-based groups as entry points. However, there is still weak integration between small-scale cassava farmers and development organizations resulting in low performance of the sector. Therefore, this study aims at understanding the framework in which farmer groups are formed and how they are coordinated to link farmers to development organizations. The study adopted a qualitative approach design whereby key informant interviews and focus group discussions were conducted in Siaya County. Data was recorded, transcribed and analysed using ATLAS.ti. software. The results show that most of the farmer groups are just entities sampled together simply because most development organizations use them as entry points. However, there are minimal investments in these groups in terms of capacity development to spearhead cassava value chain development. Notably, most organizations push their agenda through these groups leading to the failure of the programs initiated. Therefore, there is a need to organize the farmer groups into economic entities, sensitize the members on the importance of groups and engage the county agricultural officers when collaborating with development organizations.

Climate-Smart Agriculture (CSA) presents the opportunity to meet the world increasing food demands in the face of climate variability. In Kenya, CSA has been promoted as a means of adapting to climate change among Kenyan farmers under Kenya Climate Smart Agriculture Project (KCSAP) and farmers’ participation is key. This study, therefore, sought to identify the extent of participation in climate-smart agricultural projects (CSAPs) in terms of longevity of farmers’ participation in CSAPs and the number of climate-smart agricultural practices adopted from the projects by the farmers in Kakamega County, Kenya. Multi-stage sampling technique was employed to collect cross-sectional primary data from 240 project participants in Kakamega County, Kenya. Data collected were analyzed using descriptive statistics and Tobit regression model. Results revealed that farmers’ extent of participation in CSAPs in terms of both longevity and number of climate-smart practices adopted from the project was positively and significantly influenced by the type of project funder and number of climate-smart practices offered by the projects. The longevity was significantly and negatively influenced by frequency of extension visits and distance to the market while the number of climate-smart practices adopted was significantly negatively influenced by distance to the market and legal land ownership status. The study recommended the need for expansion and promotion of climate-smart agricultural projects to non-benefiting communities in order to accelerate economic growth and poverty reduction through partnerships between the national and international governments funding agricultural projects and closer collaboration with local leaders, extension agents and more youthful farmers.

AbstractIt is evident from scientific studies that black soldier fly larvae can replace the widely used fishmeal, which is costly and unsustainable for smallholder farmers, in aquafeeds. The purpose of this study was to evaluate the factors t influencing fish farmers’ awareness of use of black soldier fly larvae meal as an ingredient in fish feeds. The effect of farmers’ socioeconomic status and aquaculture practices on their awarenessabout black soldier fly larvae based aquafeeds was examined using a binary logit regression model. The regression analysis results revealed that fish farming experience (β = 0.327; p = 0.001), distance to feed sources (β = 0.009; p = 0.034), farmers’ income (β = −0.505; p = 0.008) and knowledge about the components of existing feed (β = 2.667; p = 0.004) significantly influenced the farmers’ awareness about black soldier fly larvae meal. The results suggest that communication and farmer education are key in improving the farmers’ awareness about novel fish feed ingredients. Therefore, there is need for both public and private institutions to improve awareness creation through local print and electronic media to enhance fish farmers’ awareness of insect-based aquafeeds.

The food price crisis of 2007–2008 and the recent resurgence of food prices have focused increasing attention on the causes and consequences of food price volatility in international food markets and the developing world, particularly in sub-Saharan Africa (SSA). Agricultural Price Index was 34% higher as of 30 June 2022, compared to January 2021. This paper reviews increasing food crisis in Africa in the wake of climate change, COVID-19, and the Russia–Ukraine war and the implications on Africa’s food security stability. Climate change is affecting the fundamental basis of agriculture through changes in temperature, rainfall, and weather, and by intensifying the occurrences of floods, droughts, and heat stress. COVID-19 pandemic disrupted the production and supply chains, while the ongoing Russia–Ukraine war continues to disrupt the global food market and food prices. SSA is susceptible to the effects of this war, and this has already resulted in high demand for food commodities and increased food prices. The study calls for the need for the international community to establish a strategic food reserve to face food crises triggered by armed conflicts or climate-induced disasters and pandemics. This mechanism may facilitate reactive interventions that help to contain the human security implications of food crises, thus fostering peace. Solutions also lie in implementing programs and policies informing the monitoring of weather shocks and advancing supporting to those impacted. Additionally, the governments of SSAs should embrace domestic production of farm inputs such as fertilizer to avoid overdependence on imports which are susceptible to wars and conflict.

Objectives Women with a history of preterm delivery (PTD) are at higher risk of developing cardiovascular diseases (CVD) later in life. However, it is not well established whether PTD is associated with CVD risk factors, hypertension and type 2 diabetes mellitus (T2DM). Therefore, in this study, we examined the associations between PTD compared with term delivery and subsequent risk of hypertension and T2DM.Design Retrospective matched population-based open cohort study.Setting Clinical Practice Research Datalink GOLD data in the UK.Participants A total of 3335 18–49-year-old women with preterm delivery were matched by age and region to 12 634 without a record of preterm delivery.Primary outcome measures Outcomes of interest were newly diagnosed hypertension or T2DM at least 6 months after delivery. During the study period (January 2000–December 2019), hypertension or T2DM events in the medical records of women with (exposed) and without (unexposed) preterm delivery were compared. HR and 95% CI were estimated using Cox proportional hazards models adjusted for potential confounders.Results Over a median follow-up period of 5.11 (IQR 2.15–9.56) years, the HRs for hypertension in women who delivered preterm compared with women who delivered at term were 1.42 (95%CI 1.09 to 1.80) and 1.18 (95%CI 0.90 to 1.56) in the unadjusted and adjusted models, respectively. For T2DM, over a median follow-up period of 5.17 (IQR 2.18–9.67) years, the HRs in women who delivered preterm compared with those who delivered at term were 1.67 (95%CI 1.12 to 2.48) and 1.10 (95%CI 0.72 to 1.68) in the unadjusted and adjusted models, respectively.Conclusion We found no independent effect of preterm delivery on risk of hypertension or type 2 diabetes in this study. While significant associations were observed in unadjusted analyses, associations were lost after adjustment and may be attributable to other reproductive complications. Additional studies are needed to confirm these findings.

Introduction Global morbidity from enteric infections and diarrhoea remains high in children in low-income and middle-income countries, despite significant investment over recent decades in health systems and water and sanitation infrastructure. Other types of societal development may be required to reduce disease burden. Ecological research on the influence of household and neighbourhood societal development on pathogen transmission dynamics between humans, animals and the environment could identify more effective strategies for preventing enteric infections.Methods and analysis The ‘enteric pathome’—that is, the communities of viral, bacterial and parasitic pathogens transmitted from human and animal faeces through the environment is taxonomically complex in high burden settings. This integrated cohort-exposure assessment study leverages natural socioeconomic spectrums of development to study how pathome complexity is influenced by household and neighbourhood infrastructure and hygiene conditions. We are enrolling under 12-month-old children in low-income and middle-income neighbourhoods of two Kenyan cities (Nairobi and Kisumu) into a ‘short-cohort’ study involving repeat testing of child faeces for enteric pathogens. A mid-study exposure assessment documenting infrastructural, behavioural, spatial, climate, environmental and zoonotic factors characterises pathogen exposure pathways in household and neighbourhood settings. These data will be used to inform and validate statistical and agent-based models (ABM) that identify individual or combined intervention strategies for reducing multipathogen transmission between humans, animals and environment in urban Kenya.Ethics and dissemination The protocols for human subjects’ research were approved by Institutional Review Boards at the University of Iowa (ID-202004606) and AMREF Health Africa (ID-ESRC P887/2020), and a national permit was obtained from the Kenya National Commission for Science Technology and Innovation (ID# P/21/8441). The study was registered on Clinicaltrials.gov (Identifier: NCT05322655) and is in pre-results stage. Protocols for research on animals were approved by the University of Iowa Animal Care and Use Committee (ID 0042302).

Urbanization is rapidly increasing across Africa, including in Nairobi, Kenya. Many people, recent migrants and long-term residents, live within dense and dynamic urban informal settlements. These contexts are fluid and heterogeneous, and deepening the understanding of how vulnerabilities and marginalization are experienced is important to inform pointed action, service delivery and policy priorities. The aim of this paper is to explore vulnerabilities and marginalization within Korogocho and Viwandani informal settlements in Nairobi and generate lessons on the value of a spectrum of community based participatory research approaches for understanding health and well-being needs and pinpointing appropriate interventions. In the exploratory stages of our ARISE consortium research, we worked with co-researchers to use the following methods: social mapping, governance diaries, and photo voice. Social mapping (including the use of Focus Group Discussions) identified key vulnerable groups: marginalized and precarious child heads of households (CHHs), Persons with disability who face multiple discrimination and health challenges, and often isolated older adults; and their priority needs, including health, education, water and sanitation. The governance diaries generated an understanding of the perceptions of the particularly vulnerable and marginalized informal settlement residents regarding the various people and institutions with the power to influence health and wellbeing; while photo voice highlighted the lived experiences of vulnerability and marginality. Understanding and responding to fluid and intersecting marginalities and vulnerabilities within growing urban informal settlements is particularly critical to achieving inclusive urbanization, where no one is left behind, a theme central to the Sustainable Development Goals and Kenya’s Vision 2030.

The Universal Declaration of Human Rights has declared that education is fundamental human rights to the well-being of any society. Therefore, the study was motivated by the need to improve students’ academic performance in Kenya Certificate of Secondary Education examination, a case in Laikipia County, Kenya. The study was guided by one objective. To determine the extent to which appraisal of teachers on classroom physical environment influences students’ performance in Kenya Certificate of Secondary Education in Laikipia County. The study targeted 94 public secondary schools which comprises of 94 principals and 1100 teachers in Laikipia County. Purposive sampling was used to select 45 principals while simple random sampling was used to select 300 teachers. Questionnaires were used to collect data from principals and teachers. The findings of the null hypothesis there is no significant relationship between teacher appraisal on classroom physical environment and students’ performance using Chi square test was (df=16, Pearson X2=233.083, p=0.005 at 0.05 significance level). The null hypothesis was rejected hence there is a significant relationship between teacher appraisal on classroom physical environment and students’ performance to both principals and teachers to enhance establishment of effective appraisal process and Teachers Service Commission to have a well-placed sound policy and include all stakeholders, well-defined criterion on how to appraise, promote and appoint competent and experienced principals because a number of them lack competency in appraisal process.

Background: Sexual and gender minority (SGM) people in Kenya face pervasive socio-cultural and structural discrimination. Persistent stress stemming from anti-SGM stigma and prejudice may place SGM individuals at increased risk for negative mental health outcomes. This study explored experiences with violence (intimate partner violence and SGM-based violence), mental health outcomes (psychological distress, PTSD symptoms, and depressive symptoms), alcohol and other substance use, and prioritization of community needs among SGM adults in Western Kenya. Methods: This study was conducted by members of a collaborative research partnership between a U.S. academic institution and a Kenyan LGBTQ civil society organization (CSO). A convenience sample of 527 SGM adults (92.7% ages 18-34) was recruited from community venues to complete a cross-sectional survey either on paper or through an online secure platform. Results: For comparative analytic purposes, three sexual orientation and gender identity (SOGI) groups were created: (1) cisgender sexual minority women (SMW; 24.9%), (2) cisgender sexual minority men (SMM; 63.8%), and (3) gender minority individuals (GMI; 11.4%). Overall, 11.7% of participants reported clinically significant levels of psychological distress, 53.2% reported clinically significant levels of post-traumatic stress disorder (PTSD) symptoms, and 26.1% reported clinically significant levels of depressive symptoms. No statistically significant differences in clinical levels of these mental health concerns were detected across SOGI groups. Overall, 76.2% of participants reported ever using alcohol, 45.6% home brew, 43.5% tobacco, 39.1% marijuana, and 27.7% miraa or khat. Statistically significant SOGI group differences on potentially problematic substance use revealed that GMI participants were less likely to use alcohol and tobacco daily; and SMM participants were more likely to use marijuana daily. Lifetime intimate partner violence (IPV) was reported by 42.5% of participants, and lifetime SGM-based violence (SGMV) was reported by 43.4%. GMI participants were more likely than other SOGI groups to have experienced both IPV and SGMV. Participants who experienced SGMV had significantly higher rates of clinically significant depressive and PTSD symptoms. Conclusions: Despite current resilience demonstrated by SGM adults in Kenya, there is an urgent need to develop and deliver culturally appropriate mental health services for this population. Given the pervasiveness of anti-SGM violence, services should be provided using trauma-informed principles, and be sensitive to the lived experiences of SGM adults in Kenya. Community and policy levels interventions are needed to decrease SGM-based stigma and violence, increase SGM visibility and acceptance, and create safe and affirming venues for mental health care. Political prioritization of SGM mental health is needed for sustainable change.

Abstract Indigenous knowledge is critical in the conservation of wild fish genetic resources and consequent development of fish seed for improved aquaculture production. Local fisher communities rely on aquatic resources mainly for livelihood and subsistence and have therefore come up with systems to manage these resources for sustainable use. This study aimed at identifying the role of indigenous people's knowledge in fish conservation as a way of improving aquaculture, with a specific focus on the conservation of aquaculture fish species in Kenya. Data was collected from individual fisherfolk through semi‐structured questionnaires and field observations. Pearson's chi‐square test was performed on variables that were predicted to influence indigenous knowledge. The chi‐square tests revealed a significant relationship between age and indigenous knowledge (χ2 = 15.153, p = 0.004). Results also revealed a significant relationship between an individual's years of residence in the area and indigenous knowledge (χ2 = 17.767, p = 0.003). It was found that the indigenous people use various concepts and strategies for fish conservation and fish production. From the findings of the study, it is recommended that scientists and policy actors should adopt the indigenous people's knowledge as a source of baseline information for fisheries and aquaculture research, and as additional or alternative strategies for the management of fish genetic resources.

The paper discusses the overlooked political marginalisation of Karamojong pastoralists in Uganda, contrary to a commonly held belief that ecological factors and pastoralism are the leading contributors to poverty and underdevelopment in Karamoja. Anchored within the theoretical strand of marginalisation, this article discusses how the actions of those operating at the centre of power perpetuate persistent poverty in Karamoja. A particular focus is placed on political representation, resource allocation and the engagement of local people in poverty eradication and development. The paper argues that the grants from central government are meagre and misguided, Karamoja is poorly and ineffectively represented at policy levels, and the local people have a limited voice in poverty alleviation and development programmes. The paper concludes that Karamoja’s persistent poverty is to a great extent a product of political marginalisation. Finally, it recommends affirmative action, effective local leadership, sensitisation and involvement of local people in poverty alleviation initiatives and combating corruption in public offices.

Abstract Combined antiretroviral therapy (cART) durability and time to modification are important quality indicators in HIV/AIDs treatment programs. This analysis describes the incidence, patterns, and factors associated with cART modifications in HIV patients enrolled in four treatment centers in Asmara, Eritrea from 2005 to 2021. Retrospective cohort study combining data from 5020 [males, 1943 (38.7%) vs. females, 3077 (61.3%)] patients were utilized. Data on multiple demographic and clinical variables were abstracted from patient’s charts and cART program registry. Independent predictors of modification and time to specified events were evaluated using a multi-variable Cox-proportional hazards model and Kaplan–Meier analysis. The median (±IQR) age, CD4+ T-cell count, and proportion of patients with WHO Clinical stage III/IV were 48 (IQR 41–55) years; 160 (IQR 80–271) cells/µL; and 2667 (53.25%), respectively. The cumulative frequency of all cause cART modification was 3223 (64%): 2956 (58.8%) substitutions; 37 (0.7%) switches; and both, 230 (4.5%). Following 241,194 person-months (PMFU) of follow-up, incidence rate of cART substitution and switch were 12.3 (95% CI 11.9–12.8) per 1000 PMFU and 3.9 (95% CI 3.2–4.8) per 10,000 PMFU, respectively. Prominent reasons for cART substitution included toxicity/intolerance, drug-shortage, new drug availability, treatment failure, tuberculosis and pregnancy. The most common adverse event (AEs) associated with cART modification included lipodystrophy, anemia and peripheral neuropathy, among others. In the adjusted multivariate Cox regression model, Organisation (Hospital B: aHR = 1.293, 95% CI 1.162–1.439, p value

Abstract Background Female reproductive factors are gaining prominence as factors that enhance cardiovascular disease (CVD) risk; nonetheless, menstrual cycle characteristics are under-recognized as a factor associated with CVD. Additionally, there is limited data from the UK pertaining to menstrual cycle characteristics and CVD risk. Methods A UK retrospective cohort study (1995–2021) using data from a nationwide database (The Health Improvement Network). Women aged 18–40 years at index date were included. 252,325 women with history of abnormal menstruation were matched with up to two controls. Two exposures were examined: regularity and frequency of menstrual cycles; participants were assigned accordingly to one of two separate cohorts. The primary outcome was composite cardiovascular disease (CVD). Secondary outcomes were ischemic heart disease (IHD), cerebrovascular disease, heart failure (HF), hypertension, and type 2 diabetes mellitus (T2DM). Cox proportional hazards regression models were used to derive adjusted hazard ratios (aHR) of cardiometabolic outcomes in women in the exposed groups compared matched controls. Results During 26 years of follow-up, 20,605 cardiometabolic events occurred in 704,743 patients. Compared to women with regular menstrual cycles, the aHRs (95% CI) for cardiometabolic outcomes in women with irregular menstrual cycles were as follows: composite CVD 1.08 (95% CI 1.00–1.19), IHD 1.18 (1.01–1.37), cerebrovascular disease 1.04 (0.92–1.17), HF 1.30 (1.02–1.65), hypertension 1.07 (1.03–1.11), T2DM 1.37 (1.29–1.45). The aHR comparing frequent or infrequent menstrual cycles to menstrual cycles of normal frequency were as follows: composite CVD 1.24 (1.02–1.52), IHD 1.13 (0.81–1.57), cerebrovascular disease 1.43 (1.10–1.87), HF 0.99 (0.57–1.75), hypertension 1.31 (1.21–1.43), T2DM 1.74 (1.52–1.98). Conclusions History of either menstrual cycle irregularity or frequent or infrequent cycles were associated with an increased risk of cardiometabolic outcomes in later life. Menstrual history may be a useful tool in identifying women eligible for periodic assessment of their cardiometabolic health.

Abstract Introduction To describe the incidence and prevalence of pelvic inflammatory disease (PID) and to estimate the risk of cardiometabolic outcomes among women with PID compared to women without PID. Methods A UK retrospective matched cohort study using data from The Health Improvement Network. To assess cardiometabolic risk, women (aged ≥ 16 years) with PID were compared to matched controls without PID. Annual prevalence and incidence of PID (1998–2017) were estimated among women aged 16–50 years using annual cross-sectional and cohort analyses, respectively. Adjusted hazard ratios (aHR) and 95% CI for cardiometabolic outcomes were estimated using Cox proportional hazards models. The primary outcome was composite cardiovascular disease (CVD) and its subtypes, including ischaemic heart disease (IHD), heart failure (HF) and cerebrovascular disease. Secondary outcomes were hypertension, and type 2 diabetes mellitus (T2DM). Results Among the 715 recorded composite CVD events, the crude incidence rate per 1000 person-years was 1.5 among women with history of PID compared to 1.3 in matched controls. Compared to women without PID (N = 73,769), the aHRs for cardiometabolic outcomes among women with PID (N = 19,804) were: composite CVD 1.10 (95% CI 0.93–1.30); IHD 1.19 (95% CI 0.93–1.53); cerebrovascular disease 1.13 (95% CI 0.90–1.43); HF 0.92 (95% CI 0.62–1.35) hypertension 1.10 (95% CI 1.01–1.20); and T2DM 1.25 (95% CI 1.09–1.43). The prevalence (per 10,000 population) of PID was 396.5 in 1998 and 237 in 2017. The incidence (per 10,000 person-years) of PID was 32.4 in 1998 and 7.9 in 2017. Conclusion There was no excess risk of composite CVD or its subtypes among women with history of PID compared to matched controls. Findings from our study suggest that history of PID was associated with an increased risk of hypertension and type 2 diabetes mellitus, two major risk factors for CVD. Additional studies are required to support these findings.

Improved fish post-harvest technologies (IFPT) have been promoted as more efficient methods of fish processing, preservation, and value addition than the traditional methods prevalent in developing countries. The adoption rates, however, do not appear to be convincing. The purpose of this study was to determine the socio-demographic and psychological factors that influence intention of Kenyan farmed fish traders to use IFPT. The technology acceptance model (TAM) was used to properly explain the impact of TAM constructs such as perceived usefulness (PU), perceived ease of use (PEOU), and attitude (ATT), as well as socio-demographic factors such as gender, age, education level and fish trading experience on traders’ intention to use the technologies. A cross-sectional survey was conducted to collect data using a semi-structured questionnaire from 146 traders in Busia, Siaya and Kakamega counties. At a significance level of p = 0.05, a linear regression model was used to examine the socio-demographic and psychological determinants of the traders’ behavioral intention to use the improved technologies. The regression analysis revealed that PU (β = 0.443; p = 0.000), PEOU (β = 0.364; p = 0.000) and ATT (β = 0.615; p = 0.000) influence traders’ intention to use IFPT, with ATT having the highest influence on intention. However, the traders’ socio-demographic characteristics have no effect on their intention to use the technologies, as the coefficients for gender (β = 0.148; p = 0.096), age (β = 0.016; p = 0.882), level of education (β = −0.135; p = 0.141) and fish trading experience (β = 0.017; p = 0.869) are all insignificant. These findings show that the traders intend to use IFPT and will use them when it is in their best economic interests.

Abstract Background As part of a larger food security project under Ethiopia’s Agricultural Growth Program (CASCAPE), 928 farms in the Ethiopian Highlands were surveyed between 2012 and 2017. The aim was to determine whether the Net Farm Income (NFI) is a relevant indicator that drives food security at the household and the farm level, and to determine its drivers across six study regions of Ethiopia (i.e., Addis Ababa, Hawassa, Haramaya, Bahir Dar, Jimma, and Mekelle). The effect of different socio-economic and environmental drivers on NFI was determined using descriptive statistics, correlation analysis, k-means clustering and comparison of high and low NFI quartiles per region. Results The average annual NFI in Ethiopia was just below 1000 US$ per farm household, with Addis Ababa region leading. Jimma and Bahir Dar were just above average, and the others were at the lower end. In the correlation analysis, NFI was best explained by farm size, net cash flow and the use of nitrogen fertilizer. Male-headed households earned considerably more than female-headed households. The k-means clustering yielded two major farm types on the basis of significant differences in rainfall, farm size, education level, crop diversity, cash flow and N fertilizer use. An analysis of richest 25% versus poorest 25% per region showed Addis Ababa, Bahir Dar, Jimma and Mekelle regions all had significant differences between the two quartiles in farm size, crop diversity and N fertilizer use, whereas Hawassa and Haramaya regions seem more homogeneous. Conclusions The survey results present new entry points for informed decision making through targeted, area-specific food security policies in the Ethiopian Highlands by virtue of insight in the regional spread of NFI and its driving forces. Important deductions from the results are policy actions that are obtainable from the results. For example, the farm-size variable provides an indicator on the type of policy action that is required to determine the farm sizes that generate sufficient returns on the overall farming investment. Next, cash-flow is a variable that speaks to the idea on the amount of hard-cash needed by a household to enable it get meaningful returns on cash invested on farming, or a guaranteed minimum return on any specific crop(s) or animal production. Nitrogen fertilizer as an analysis variable is predominantly a crop productivity indicator. In order for the farming to be sustainable, there is need for policy articulation on the amount of nitrogen required for specific yields and crops. Finally, location and rainfall parameters require recommendations on location specific crop management policies that correspond to the rainfall amount, soil types, ecological zones and distance from the markets as maybe gleaned from the results.

This study aimed at investigating the genetic lineages of peste des petits ruminants virus (PPRV) currently circulating in Burkina Faso. As part of PPR surveillance in 2021 and 2022, suspected outbreaks in different regions were investigated. A risk map was produced to determine high-risk areas for PPR transmission. Based on alerts, samples were obtained from three regions and all sampled localities were confirmed to fall within PPR high risk areas. We collected swab samples from the eyes, mouth, and nose of sick goats. Some tissue samples were also collected from dead animals suspected to be infected by PPRV. In total, samples from 28 goats were analysed. Virus confirmation was performed with RT-PCR amplification targeting the nucleocapsid (N) gene. Partial N gene sequencing (350 bp) was carried out using the RT-PCR products of positives samples to characterise the circulating lineages. Eleven sequences, including ten new sequences, have been obtained. Our study identified the presence of the PPRV lineage IV in the three studied regions in Burkina Faso with a genetic heterogeneity recorded for the sequences analysed. Previously published data and results of this study suggest that PPRV lineage IV seems to be replacing lineage II in Burkina Faso.

Abstract African swine fever (ASF) is an important viral disease of swine caused by the African swine fever virus (ASFV), which threatens swine production profoundly. To better understand the gene expression changes when pig infected with ASFV, RNA sequencing was performed to characterize differentially expressed genes (DEGs) of six tissues from Kenya domestic pigs and Landrace × Yorkshire (L/Y) pigs infected with ASFV Kenya1033 in vivo. As results, a total of 209, 522, 34, 505, 634 and 138 DEGs (q-value < 0.05 and |Log2foldchange| values >2) were detected in the kidney, liver, mesenteric lymph node, peripheral blood mononuclear cell, submandibular lymph node and spleen, respectively. The expression profiles of DEGs shared in the multiple tissues illustrated variation in regulation function in the different tissues. Functional annotation analysis and interaction of proteins encoded by DEGs revealed that genes including IFIT1, IFITM1, MX1, OASL, ISG15, SAMHD1, IFINA1, S100A12 and S100A8 enriched in the immune and antivirus pathways were significantly changed when the hosts were infected with ASFV. The genes mentioned could play crucial roles in the process of the reaction to non-lethal ASF infection, which may will help to improve the ASF tolerance in the pig population through molecular breeding strategies.

BackgroundDespite the outstanding measles vaccine coverage (MVC) in Eritrea, sporadic outbreaks are not uncommon. Therefore, understanding the incidence of laboratory-confirmed measles virus cases, related factors, and spatial inequalities in testing and surveillance remains crucial. In this analysis, we evaluated the incidence and spatiotemporal distribution of measles in Eritrea. An evaluation of the factors associated with measles vaccination and IgM positive (+) febrile rash was also undertaken.MethodsA retrospective (period: 2002–2020) study was carried out by abstracting data from the integrated disease surveillance and response database (IDSR). Data was analyzed using descriptive statistics and binary logistic regression. Spatial variability and distribution of confirmed cases was evaluated using ArcGIS Pro version 3.0.1.ResultsIn total, 9,111 suspected cases, 2,767 [1,431 (51.7%) females] were serologically tested. The median (IQR) age, minimum-maximum age were 7 years (IQR: 4–14 years) and 1 month-97 years, respectively. Among the 608(21.9%) laboratory-confirmed cases, 534 (87.8%) were unvaccinated and 53 (9.92%) were 30 years presenting with the highest rates (69.9/100,000). Higher odds (OR) of MV test positivity was associated with age at onset – higher in the following age-bands [10–14 years: OR = 1.6 (95%CI, 1.1–2.2, value of p = 0.005); 15–29 years: OR = 7.0 (95%CI, 5.3–9.2, value of p = 0.005); and > =30 years: OR = 16.7 (95%CI, 11.7–24) p 2015: OR = 1.4, 95%CI: 1.1–1.7, value of p

Objective Data on long-term outcomes of preterm (PT) and low birth weight (LBW) infants in countries with high rates of neonatal mortality and childhood stunting are limited, especially from community settings. The current study sought to explore growth and neurodevelopmental outcomes of PT/LBW infants from a rural community-based setting of Kenya up to 18 months adjusted age.Design Cross-sectional study.Setting Migori County, Kenya.Participants Three hundred and eighty-two PT/LBW infants (50.2% of those identified as eligible) from a cluster randomised control trial evaluating a package of facility-based intrapartum quality of care interventions for newborn survival consented for follow-up.Outcome measures Caregiver interviews and infant health, growth and neurodevelopmental assessments were completed at 6, 12 or 18 months±2 weeks. Data included sociodemographic information, medical history, growth measurements and neurodevelopmental assessment using the Ten Questions Questionnaire, Malawi Developmental Assessment Tool and Hammersmith Infant Neurological Examination. Analyses were descriptive and univariate regression models. No alterations were made to planned data collection.Results The final sample included 362 PT/LBW infants, of which 56.6% were moderate to late PT infants and 64.4% were LBW. Fewer than 2% of parents identified their child as currently malnourished, but direct measurement revealed higher proportions of stunting and underweight than in national demographic and health survey reports. Overall, 22.7% of caregivers expressed concern about their child’s neurodevelopmental status. Neurodevelopmental delays were identified in 8.6% of infants based on one or more standardised tools, and 1.9% showed neurological findings indicative of cerebral palsy.Conclusions Malnutrition and neurodevelopmental delays are common among PT/LBW infants in this setting. Close monitoring and access to early intervention programmes are needed to help these vulnerable infants thrive.Trial registration number NCT03112018.

Objectives The under-five mortality (U5M) rate in Kenya (41 per 1000 live births) remains significantly above international goals (25 per 1000 live births). This is further exacerbated by regional inequalities in mortality. We aimed to describe U5M in Migori County, Kenya, and identify associated factors that can serve as programming targets.Design Cross-sectional observational survey.Setting Areas served by the Lwala Community Alliance and control areas in Migori County, Kenya.Participants This study included 15 199 children born to respondents during the 18 years preceding the survey.Primary and secondary outcome measures The primary outcome was mortality in the first 5 years of life. The survey was powered to detect a 10% change in various health metrics over time with 80% power.Results A total of 15 199 children were included in the primary analyses, and 230 (1.5%) were deceased before the fifth birthday. The U5M rate from 2016 to 2021 was 32.2 per 1000 live births. Factors associated with U5M included year of birth (HR 0.926, p

Günümüzde yetişkinler kadar çocuklar da giderek karmaşık hale gelen ekonomik sistemde doğru kararlar verebilmelerini gerektiren bir çağda yaşamaktadırlar. Çocukların doğru finansal kararlar almalarını sağlamak için çocuklara finansal bilgi ve beceri kazandırılmasının kritik ve acil bir ihtiyaç olduğu pek çok araştırmacının ortak görüşüdür. Çocuklar için finansal eğitim programı hazırlanırken cinsiyet, ırk, yaş, eğitim düzeyi vb. birçok faktör dikkate alınmalıdır. Ayrıca eğitim programlarının çocukların yaşam boyu kullanabilecekleri finansal bilgi ve becerileri içerecek şekilde yapılandırılmaları önerilmektedir. Erken yaşlarda kazanılacak/kazandırılacak doğru tüketim alışkanlıkları ve tasarruf bilinci ile ülkemiz kalkınmasına katkı sağlanabilir. Bu çalışmanın amacı, 10 yaş grubu öğrencilerinin finansal okuryazarlık eğitimleri ile tüketim ve tasarruf davranışları arasındaki ilişkinin ortaya konulmasıdır. Araştırmada Eskişehir ili Tepebaşı ve Odunpazarı ilçe merkezinde Mustafa Kemal İlkokulu, Dumlupınar İlkokulu ve Şehit Mustafa Türker İlkokulu’na 4. Sınıfta öğrenim gören (10 yaş grubu) toplam 122 öğrenciden bir çalışma grubu oluşturulmuştur. Araştırma yarı-deneysel bir çalışma olarak yürütülmüştür. Bu doğrulta her üç okulda deney ve kontrol grupları oluşturulmuştur. Deney gruplarına araştırmacılar tarafından hazırlanan finansal okuryazarlık eğitim modüleri doğrultunda toplam 300 dakika (10 modül) eğitim verilmiştir. Araştırma sonunda deney grubunda bulunan öğrencilerin finansal okuryazarlık eğitimleri ile tüketim ve tasarruf konularında bilgi ve becerilerinin arttığı gözlenmiştir.

The sol-gel technique was used to prepare the nanocatalyst from waste egg shells for the production of yellow oleander biodiesel. In this study, the physicochemical and catalytic properties of the nanocatalysts were investigated using: X-ray fluorescence spectrometry (XRF), transmission electron microscopy (TEM), the Barrett-Joyner-Halenda (BJH) model to quantify the pore structure of the samples, and Brunauer-Emmett-Teller (BET) to calculate the exact surface area were the techniques used. The results of the EDX, and XRF analysis showed that the synthesized nanocatalyst was majorly CaO. At 90.46 ± 1.73%, this was higher than the control for incinerated eggshells. From TEM images the particles were spherical in shape with particle sizes ranging from ≈ 7 to 41 nm. BET analysis results indicated that the nanocatalyst was mesoporous with surface area, average pore diameter, and pore volume was; 5.54 ± 0.48 m2/g, 18.57 ± 2.16 nm, and ≈ 0.016 ± 0.0 – 0.017 ± 0.0 cm³/g, respectively. The surface area to volume ratios were 3.27 ± 108 m-1, 2.52 ± 108, and 1.95 ± 108 m-1, respectively. Incinerated eggshells highest followed the synthesized nanocatalyst and CaO, respectively. The synthesized eggshell nanocatalyst was found to be a potential nanocatalyst.

Abstract Background Western Kenya, being a malaria-endemic region, has a high prevalence of hemoglobinopathies mostly sickle cell and thalassemia. The hemoglobin fractions or variants, HbA, HbA2, and HbF, serve as biomarkers for the detection of hemoglobinopathies and are commonly used in laboratory screening and diagnosis of these diseases. Diagnosis of diseases entails accurate and precise representation of a patient’s condition. This is the main aim of International Organization for Standardization (ISO) certified laboratories of offering a reliable diagnostic guide for the various diseases. For this to be realized, valid normal reference ranges are required. Such are reference values that are valid for local population of the setting where they are to be used is critical in quantitative diagnostic tests. Local normal reference ranges are necessary because research has revealed variations in the phenotypic expression of the genes for biological characteristics in humans inhabiting different geographical regions, owing to epigenetic differences imposed by physical environments, and associated sociocultural influences, even in cases of similarity in gene patterns. No local normal reference ranges for hemoglobin fractions are reported for Kenya and Africa as a whole. Laboratories therefore continue to use those found in textbooks and brochures from manufacturers of diagnostic reagents, which are derived from populations of geographical locations faraway and socioculturally different from Kenya. This could be misleading in diagnosis of hemoglobinopathies in western Kenya and indeed all of Kenya. Therefore, the present study aimed at exploring the possibility of developing local normal reference ranges for the concentrations of hemoglobin fractions, HbA, HbA2, and HbF, based on hemoglobinopathy-free, non-anemic subjects attending the Aga Khan Hospital Kisumu in western Kenya and its satellites. The hospital serves the populations inhabiting in and predominantly indigenous to western Kenya. Objectives To derive the 95% confidence intervals for hemoglobin fractions (HbA, HbA2, and HbF), evaluate the potential of these intervals as normal reference values for the local population by use of concentrations for non-anemic hemoglobinopathy-free subjects and compare the performance of the current HPLC normal ranges with those intervals we derived, based on receiver operating characteristic (ROC) curve. Materials and methods This was an analytical retrospective study using routine assay results from laboratory database for 386 non-anemic, HPLC-confirmed hemoglobinopathy-free subjects. Blood samples were obtained at the Kisumu Aga Khan Hospital and its satellite sites in western Kenya, covering January 2015 to November 9, 2021. The data for Hb fractions were nonparametric, and so confidence intervals, together with the age of subjects, were thus expressed as the median and interquartile range (IQR). Data for the gender and other characteristics of study subjects were summarized in frequencies and proportions, Kruskal-Wallis H-test was used to test the significance of differences in Hb concentrations between stations and age groups, while Mann-Whitney U-test is between males and females. The receiver operating characteristic (ROC) curve was used to evaluate the potential of the derived confidence intervals as normal reference values in comparison with the commonly used normal values for hemoglobin fractions. Results The potential normal reference intervals were computed as 95% confidence intervals (CI) for median percentage levels for the concentrations of the Hb fractions HbA, HbA2, and HbF for the hemoglobinopathy-free patients. The overall confidence intervals were derived first for the combined sample of all the hemoglobinopathy-free patients combined together irrespective station where blood specimens were obtained, age or gender, and then followed by those for separate groups, stratified based on station, age, and gender. The overall median values for the hemoglobin fractions were hemoglobin: A (HbA) 87.7, IQR = 5.7, 95% CI = 76.3–99.1; hemoglobin A2 (HbA2), 3.0, IQR = 0.6; 95% CI = 1.8–4.2; and hemoglobin F (HbF), 0.8, IQR = 0.8; 95% CI = 0.00–2.4, with the P window, 4.98, IQR = 0.4; 95% CI = 4.18–5.78. The commonly used normal reference ranges for the hemoglobin fractions were as follows: HbA 95–98%, had an accuracy of 57.5%, HbA2 of 1.5–3.5%, had an accuracy of 95.9% in grading the presumed healthy population as hemoglobinopathy-free, while HbF 0–2.0 was equal to that established by the present study. Conclusion It is important to report that the use of normal range for HbA of 95–98% published by Kratz et al. [1] in western Kenya has a potential threat of misdiagnosis of normal population and thus needs urgent review as it lacked efficacy (p = 0.795) in grading hemoglobinopathy-free subjects as normal with a poor accuracy of 57.5%, a sensitivity of 100%, specificity of 0.3%, positive predictive validity of 15.1%, negative predictive validity of 1%, and 1.03 positive likelihood ratio. However, the traditional normal range for HbA2 of 1.5–3.5% on use in western Kenya may be retained as it was effective (p < 0.0001) in grading majority of study subjects as normal with an accuracy of 95.9%, sensitivity of 98.4%, specificity of 93.3%, positive predictive validity of 99.7%, negative predictive validity of 70.0%, 14.7 positive likelihood ratio, and 0.017 negative likelihood ratio. Similarly, the existing normal range for HbF of 0–2.0 on use was almost the same as the one we derived of 0–2.4 and therefore may be retained for use in western Kenya. It is anticipated that the finding of this study will help improve the management of hemoglobinopathies in Kenya and Africa at large, by contributing to improvement in the validity of the clinical-pathologic interpretation assay results for the percentage values for the Hb fractions.