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There is presently an intentional shift in research from synthetic dyes, which are considered as harmful to the environment to more environmentally friendly dyes such as natural dyes that are derived from plant and animal sources. Apart from being friendly to the environment, some natural dyes have the unique advantage of being able to impart antimicrobial and antifungal finish properties to fabric hence introducing therapeutic potentials in them. For proper dyeing of fabric, dyeing parameters need to be optimized to achieve the best fastness results. In this paper, we investigate and report the optimum dyeing conditions for the dyeing of extracts from Aloe succotrina, a unique royal purple dye, onto cotton fabric. Dyeing was done on pure, scoured and mercerized fabric sourced from Rivatex East Africa in Eldoret. Four conditions namely, temperature, pH, dye concentration and time were optimized by measuring the highest colour strength (K/S) value. To further evaluate the colour of the dyed fabric, CIELAB values were recorded for each of the optimized parameters using a spectrometer. The optimum dyeing conditioned were as follows, the optimum pH was 7.1, temperature 100 ℃, dyeing concentration undiluted and time 60 Minutes.

BackgroundYoung people aged 15 to 24 years account for one-third of new adult HIV infections. Controlling the HIV epidemic requires effective interventions targeted toward young people and their needs. Smartphone games offer a promising avenue for reaching this population with evidence-based HIV prevention interventions. It is crucial to the effectiveness of these interventions that they be acceptable and intrinsically motivating to adolescents as well as acceptable to their parents. ObjectiveTumaini is a narrative-based smartphone game designed to help prevent HIV among young Africans aged 11 to 14 years by delaying first sex and increasing condom use at first sex. Following a 16-day feasibility study of Tumaini, we assessed the acceptability (1) of the intervention, where acceptability was operationalized as appeal, relevance, value, usability, and understandability, and (2) of this study and a planned future randomized controlled efficacy trial. MethodsDuring the randomized feasibility study (n=60) of Tumaini in western Kenya in spring 2017, 30 participants used the intervention on a study-provided smartphone. The app automatically logged participant interaction with the game in time-stamped log files. All 30 participants completed an Audio Computer-Assisted Self-Interview–based game experience survey, and 27 took part in 4 focus group discussions (FGDs) about the game’s appeal, relevance, value, usability, and understandability. Their parents (n=22) also participated in 4 FGDs about the acceptability of the intervention, of this study, and of a planned efficacy trial. Survey data were analyzed using SAS software (SAS Institute Inc); FGD transcripts were coded and analyzed in MAXQDA 12 (Verbi GmbH); and gameplay log files were analyzed using Microsoft Excel. ResultsAdolescent participants’ survey responses indicated that Tumaini scored well with players on all indicators of acceptability (appeal, relevance, value, usability, and understandability). Focus group analyses aligned with these findings and emphasized a high degree of player engagement with the game, which was supported by log file analysis. Adolescent participants were eager for additional content, and parents were receptive to a longer study involving biomarkers, based on their positive experiences with this study. There is scope to improve communication with parents about their role in the intervention. As the game was tested in beta version, there is also scope to fine-tune some of the game mechanics to increase usability. ConclusionsThis study shows the strong acceptability of an interactive smartphone-based game both to adolescents and their parents in western Kenya and that of the study methods used to pilot-test the intervention. It also suggests that longitudinal efficacy studies of this type of intervention, including those using biomarkers, have the potential to be acceptable among parents. Trial RegistrationClinicalTrials.gov NCT03054051; https://clinicaltrials.gov/ct2/show/NCT03054051 (Archived by WebCite at http://www.webcitation.org/70U2gCNtW)

Cystic Echinococcosis (CE/Hydatidosis) is a parasitic zoonosis of public health importance that causes considerable economic loss worldwide. The aim of this study was to assess prevalence and monetary loss of CE in livestock slaughtered in Migori County, Kenya. The study was conducted by retrieving and analyzing secondary data over a ten year period (2007–2016) from annual meat inspection reports from sub-county veterinary offices within Migori County. The data included species/number of slaughtered animals and number of organs condemned due to presence of hydatid cyst(s) recorded. The results showed CE prevalence was highest in cattle (5.3%) followed by goats (2.0%), least affected were sheep (0.1%). The overall direct monetary loss was $152,003/year. The study results confirm occurrence of CE in Migori County and demonstrate an emerging new CE focus in Kenya with a significant direct monetary loss, a phenomenon that require serious attention to control the spread of CE in Kenya. Keywords: Cystic Echinococcosis, Prevalence, Monetary loss, Migori County-Kenya, Zoonosis

Abstract Background Existing evidence suggests that organisation-level policies are important in enabling gender equality and equity in the workplace. However, there is little research exploring the knowledge of health sector employees on whether policies and practices to advance women’s career progression exist in their organisations. In this qualitative study, we explored the knowledge and perspectives of health managers on which of their organisations' workplace policies and practices contribute to the career advancement of women and their knowledge of how such policies and practices are implemented and monitored. Methods We employed a purposive sampling method to select the study participants. The study adopted qualitative approaches to gain nuanced insights from the 21 in-depth interviews and key informant interviews that we conducted with health managers working in public and private health sector organisations. We conducted a thematic analysis to extract emerging themes relevant to advancing women’s career progression in Kenya’s health sector. Results During the interviews, only a few managers cited the policies and practices that contribute to women’s career advancement. Policies and practices relating to promotion and flexible work schedules were mentioned most often by these managers as key to advancing women's career progression. For instance, flexible work schedules were thought to enable women to pursue further education which led to promotion. Some female managers felt that women were promoted to leadership positions only when running women-focused programs. There was little mention of capacity-building policies like training and mentorship. The health managers reported how policies and practices are implemented and monitored in general, however, they did not state how this is done for specific policies and practices. For the private sector, the health managers stated that implementation and monitoring of these policies and practices is conducted at the institutional level while for the public sector, this is done at the national or county level. Conclusions We call upon health-sector organisations in Kenya to offer continuous policy sensitisation sessions to their staff and be deliberate in having supportive policies and other pragmatic interventions beyond policies such as training and mentorship that can enable women’s career progression.

Abstract Background Malaria transmission in Tanzania is driven by mosquitoes of the Anopheles gambiae complex and Anopheles funestus group. The latter includes An. funestus s.s., an anthropophilic vector, which is now strongly resistant to public health insecticides, and several sibling species, which remain largely understudied despite their potential as secondary vectors. This paper provides the initial results of a cross-country study of the species composition, distribution and malaria transmission potential of members of the Anopheles funestus group in Tanzania. Methods Mosquitoes were collected inside homes in 12 regions across Tanzania between 2018 and 2022 using Centres for Disease Control and Prevention (CDC) light traps and Prokopack aspirators. Polymerase chain reaction (PCR) assays targeting the noncoding internal transcribed spacer 2 (ITS2) and 18S ribosomal DNA (18S rDNA) were used to identify sibling species in the An. funestus group and presence of Plasmodium infections, respectively. Where DNA fragments failed to amplify during PCR, we sequenced the ITS2 region to identify any polymorphisms. Results The following sibling species of the An. funestus group were found across Tanzania: An. funestus s.s. (50.3%), An. parensis (11.4%), An. rivulorum (1.1%), An. leesoni (0.3%). Sequencing of the ITS2 region in the nonamplified samples showed that polymorphisms at the priming sites of standard species-specific primers obstructed PCR amplification, although the ITS2 sequences closely matched those of An. funestus s.s., barring these polymorphisms. Of the 914 samples tested for Plasmodium infections, 11 An. funestus s.s. (1.2%), and 2 An. parensis (0.2%) individuals were confirmed positive for P. falciparum. The highest malaria transmission intensities [entomological inoculation rate (EIR)] contributed by the Funestus group were in the north-western region [108.3 infectious bites/person/year (ib/p/y)] and the south-eastern region (72.2 ib/p/y). Conclusions Whereas An. funestus s.s. is the dominant malaria vector in the Funestus group in Tanzania, this survey confirms the occurrence of Plasmodium-infected An. parensis, an observation previously made in at least two other occasions in the country. The findings indicate the need to better understand the ecology and vectorial capacity of this and other secondary malaria vectors in the region to improve malaria control. Graphical Abstract

The availability of quality and timely data for routine monitoring of mental, neurological and substance use (MNS) disorders is a challenge, particularly in Africa. We assessed the feasibility of using an open-source data science technology (R Shiny) to improve health data reporting in Nairobi City County, Kenya. Based on a previously used manual tool, in June 2022, we developed a digital online data capture and reporting tool using the open-source Kobo toolbox. Primary mental health care providers (nurses and physicians) working in primary healthcare facilities in Nairobi were trained to use the tool to report cases of MNS disorders diagnosed in their facilities in real-time. The digital tool covered MNS disorders listed in the World Health Organization's (WHO) Mental Health Gap Action Program Intervention Guide (mhGAP-IG). In the digital system, data were disaggregated as new or repeat visits. We linked the data to a live dynamic reproducible dashboard created using R Shiny, summarising the data in tables and figures. Between January and August 2023, 9064 cases of MNS disorders (4454 newly diagnosed, 4591 revisits and 19 referrals) were reported using the digital system compared to 5321 using the manual system in a similar period in 2022. Reporting in the digital system was real-time compared to the manual system, where reports were aggregated and submitted monthly. The system improved data quality by providing timely and complete reports. Open-source applications to report health data is feasible and acceptable to primary health care providers. The technology improved real-time data capture, reporting, and monitoring, providing invaluable information on the burden of MNS disorders and which services can be planned and used for advocacy. The fast and efficient system can be scaled up and integrated with national and sub-national health information systems to reduce manual data reporting and decrease the likelihood of errors and inconsistencies.

BackgroundCOVID-19 pandemic had devastating socio-economic and health effects, including mental health. This study examines the intersectionality between gender and mental health outcomes among Kenyan adults in informal settlements of Nairobi, Kisumu, and Kilifi Counties during the COVID-19 crisis. This is necessary to inform mental health response in case of another pandemic.MethodsWe analyzed data collected in a longitudinal survey between July 2020 (fourth round) and February 2021 (fifth round). The data covered COVID-19-related effects on job loss, food insecurity, access to health services, and mental health. Participants were randomly sampled from existing cohorts at the Population Council. The outcomes of interest were depressive and anxiety disorders, combined into a binary composite outcome variable. Descriptive statistics included means for continuous variables and frequencies and proportions for categorical variables. Chi-square tests were used to examine the differences between groups. The relationship between the gendered COVID-19 socio-economic effects and participants’ mental health was examined using modified Poisson regression.ResultsA total of 4,050 participants were interviewed, 66% female and median age 38 [interquartile range (IQR): 29–46]. Complete income loss was strongly associated with negative mental health outcomes in multiple intersections with varied magnitudes. The association was larger among older females (≥50 years) (PR = 1.33, 95% CI = 1.17–1.51, p

Purpose: The study focused on Employee Welfare Management Practices as a determinant of Organizational Commitment among medical doctors in Developing Countries; Evidence from County Referral hospitals in Kenya. Design/Methodology: The study utilized descriptive and correlational research designs targeting 116 medical doctors. Simple random sampling technique was used. Structured questionnaires aided data collection from Medical Doctors in County Referral Hospital within Western region, Kenya. Validity and reliability of the instrument was tested. Data was analyzed using both descriptive and inferential statistics. Findings: The study found out that Employee Welfare Management Practices had a positive and significant effect on Organization Commitment. Implications/Originality/Value: The study seeks to guide policy makers in hospitals to develop a more explicit and proactive employee welfare agenda like spacious houses or generous house allowance, transport facilitation in cases of emergency recalls, flexible work schedules with shift allowances paid. This will boost medical doctors’ commitment and enhance a harmonious and effective workforce and workplaces.

Abstract Background Anopheles funestus is a leading vector of malaria in most parts of East and Southern Africa, yet its ecology and responses to vector control remain poorly understood compared with other vectors such as Anopheles gambiae and Anopheles arabiensis. This study presents the first large-scale survey of the genetic and phenotypic expression of insecticide resistance in An. funestus populations in Tanzania. Methods We performed insecticide susceptibility bioassays on An. funestus mosquitoes in nine regions with moderate-to-high malaria prevalence in Tanzania, followed by genotyping for resistance-associated mutations (CYP6P9a, CYP6P9b, L119F-GSTe2) and structural variants (SV4.3 kb, SV6.5 kb). Generalized linear models were used to assess relationships between genetic markers and phenotypic resistance. An interactive R Shiny tool was created to visualize the data and support evidence-based interventions. Results Pyrethroid resistance was universal but reversible by piperonyl-butoxide (PBO). However, carbamate resistance was observed in only five of the nine districts, and dichloro-diphenyl-trichloroethane (DDT) resistance was found only in the Kilombero valley, south-eastern Tanzania. Conversely, there was universal susceptibility to the organophosphate pirimiphos-methyl in all sites. Genetic markers of resistance had distinct geographical patterns, with CYP6P9a-R and CYP6P9b-R alleles, and the SV6.5 kb structural variant absent or undetectable in the north-west but prevalent in all other sites, while SV4.3 kb was prevalent in the north-western and western regions but absent elsewhere. Emergent L119F-GSTe2, associated with deltamethrin resistance, was detected in heterozygous form in districts bordering Mozambique, Malawi and the Democratic Republic of Congo. The resistance landscape was most complex in western Tanzania, in Tanganyika district, where all five genetic markers were detected. There was a notable south-to-north spread of resistance genes, especially CYP6P9a-R, though this appears to be interrupted, possibly by the Rift Valley. Conclusions This study underscores the need to expand resistance monitoring to include An. funestus alongside other vector species, and to screen for both the genetic and phenotypic signatures of resistance. The findings can be visualized online via an interactive user interface and could inform data-driven decision-making for resistance management and vector control. Since this was the first large-scale survey of resistance in Tanzania’s An. funestus, we recommend regular updates with greater geographical and temporal coverage. Graphical Abstract

The study sought to examine the influence of competitor orientation on innovation in Kenya’s Deposit Taking SACCO’s. The study adopted descriptive survey research design and targeted 49 respondents drawn from all the 7 Kenyan deposit taking SACCO’s in western region. A census study was considered. Structured questionnaires and an interview schedule were used to collect data. Data was analyzed using descriptive and inferential statistics. The data was presented in a tabular form. Simple linear regression results indicated that competitor orientation accounted for 51.4% of variance in innovation (R2 = .514) and was statistically significant (F=40.207 β=.554, t=6.341, p

Abstract Background Insecticide-treated nets (ITNs) contributed significantly to the decline in malaria since 2000. Their protective efficacy depends not only on access, use, and net integrity, but also location of people within the home environment and mosquito biting profiles. Anopheline mosquito biting and human location data were integrated to identify potential gaps in protection and better understand malaria transmission dynamics in Busia County, western Kenya. Methods Direct observation of human activities and human landing catches (HLC) were performed hourly between 1700 to 0700 h. Household members were recorded as home or away; and, if at home, as indoors/outdoors, awake/asleep, and under a net or not. Aggregated data was analysed by weighting hourly anopheline biting activity with human location. Standard indicators of human-vector interaction were calculated using a Microsoft Excel template. Results There was no significant difference between indoor and outdoor biting for Anopheles gambiae sensu lato (s.l.) (RR = 0.82; 95% CI 0.65–1.03); significantly fewer Anopheles funestus were captured outdoors than indoors (RR = 0.41; 95% CI 0.25–0.66). Biting peaked before dawn and extended into early morning hours when people began to awake and perform routine activities, between 0400–0700 h for An. gambiae and 0300–0700 h for An. funestus. The study population away from home peaked at 1700–1800 h (58%), gradually decreased and remained constant at 10% throughout the night, before rising again to 40% by 0600–0700 h. When accounting for resident location, nearly all bites within the peri-domestic space (defined as inside household structures and surrounding outdoor spaces) occurred indoors for unprotected people (98%). Using an ITN while sleeping was estimated to prevent 79% and 82% of bites for An. gambiae and An. funestus, respectively. For an ITN user, most remaining exposure to bites occurred indoors in the hours before bed and early morning. Conclusion While use of an ITN was estimated to prevent most vector bites in this context, results suggest gaps in protection, particularly in the early hours of the morning when biting peaks and many people are awake and active. Assessment of additional human exposure points, including outside of the peri-domestic setting, are needed to guide supplementary interventions for transmission reduction.

In this article we discuss cross-cultural similarities and variations in parents' engagement in the everyday activities in which their preschool-age children engage, focusing on mothers' and fathers' presence in the same setting as their children, the impact of their presence on the types of activities in which the children engaged, and the extent of mothers' and fathers' involvement with their children in those activities. The data were gathered from different societies - the United States, Korea, Russia, Estonia, and Kenya. They reveal that the children were involved primarily in play (more than in lessons, work, or conversation), and this was unaffected by the presence of either parent. However, parents were relatively less likely to be involved in their children's play than in the other activities. Mothers, not surprisingly, were more likely to be found in the same setting as their children and, even when taking account of their greater presence, were more likely to be involved with their children than were fathers.

Objectives We aimed to capture evidence on enablers and barriers to improving equal opportunity and effective organisational interventions that can advance women’s leadership in India and Kenya’s health sectors.Methods We systematically searched JSTOR, PubMed, SCOPUS and Web of Science databases, reference lists of selected articles and Google Scholar using string searches. We included studies that were published in English from 2000 to 2022 in peer-reviewed journals or grey literature, focused on paid, formal health professionals in India or Kenya, described factors relating to women’s representation/leadership.Results We identified 26 studies, 15 from India and 11 from Kenya. From each country, seven studies focused on nursing. Participants included women and men health sector workers. Seven studies used mixed methods, 11 were qualitative, 5 were quantitative and 3 were commentaries. Factors influencing women’s career progression at individual/interpersonal levels included family support, personal attributes (knowledge/skills) and material resources. Factors at the organisational level included capacity strengthening, networking, organisational policies, gender quotas, work culture and relationships, flexibility, and work burden. Nursing studies identified verbal/sexual harassment and professional hierarchies as barriers to career progression. Structural barriers included a lack of infrastructure (training institutes and acceptable working environments). Normative themes included occupational segregation by gender (particularly in nursing), unpaid care work burden for women and gender norms.Studies of interventions to improve women’s career progression and sex-disaggregated workforce data in India or Kenya were limited, especially on leadership within career pathways. The evidence focuses on enablers and barriers at work, rather than on organisations/systems to support women’s leadership or address gender norms.Conclusions Women in India and Kenya’s health sectors face multiple impediments in their careers, which impact their advancement to leadership. This calls for gender-transformative interventions to tackle discrimination/harassment, provide targeted training/mentorship, better parental leave/benefits, flexible/remote working, family/coworker support and equal-opportunity policies/legislation.

Objectives This paper examines the availability of legal provisions, or the lack thereof, that support women to progress equitably into leadership positions within the health workforce in India and Kenya.Methods We adapted the World Bank’s Women, Business and Law framework of legal domains relevant to gender equality in the workplace and applied a ‘law cube’ to analyse the comprehensiveness, accountability and equity and human rights considerations of 27 relevant statutes in India and 11 in Kenya that apply to people in formal employment within the health sector. We assessed those laws against 30 research-validated good practice measures across five legal domains: (1) pay; (2) workplace protections; (3) pensions; (4) care, family life and work–life balance; and (5) reproductive rights. In India, the pension domain and related measures were not assessed because the pension laws do not apply to the public and private sector equally.Results Several legal domains are addressed inadequately or not at all, including pay in India, reproductive rights in Kenya and the care, family life and the work–life balance domain in both countries. Additionally, we found that among the Kenyan laws reviewed, few specify accountability mechanisms, and equity and human rights measures are mainly absent from the laws assessed in both countries. Our findings highlight inadequacies in the legal environments in India and Kenya may contribute to women’s under-representation in leadership in the health sector. The absence of specified accountability mechanisms may impact the effective implementation of legislation, undermining their potential to promote equal opportunities.Conclusions Government action is needed in both countries to ensure that legislation addresses best practice provisions, equity and human rights considerations, and provides for independent review mechanisms to ensure accountability for implementation of existing and future laws. This would contribute to ensuring that legal environments uphold the equality of opportunity necessary for realising gender justice in the workplace for the health workforce.Primary source of funding Bill & Melinda Gates Foundation (INV-031372).

Purpose: The study established the effect of resource orientation on service delivery of Level Four Public Hospitals in Kakamega County, Kenya Methodology/Approach: Mixed research design comprising of a descriptive and causal were applied. Targeted 304 comprising of 162 nurses, 135 Hospitals office staff and 7 Hospital Administrators. The study sample size was 173 using Yamane formulae. The study applied stratified and simple random sampling technique. Structured questionnaires aided in data collection. Pilot study was done at Sabatia District hospital in Vihiga County. Reliability was tested using Cronbach Alpha while validity was tested using content validity. SPPs versio 23 was used for effective descriptive as well as inferential statistics. Findings: The study found out that customer orientation had a significant influence on service delivery (t-statistic=7.489. Implications: Important to medical practitioners, government Authorities, and management of hospitals in managing strategic orientation plans for service delivery. The study recommends that customers orientation should be prioritized since it enhances service delivery.

ObjectivesPrecise HDV-RNA detection and quantification are pivotal for diagnosis and monitoring of response to newly approved treatment. We evaluate the performance of three HDV RNA detection and quantification assays.MethodsHepatitis Delta RT-PCR system kit, EurobioPlex HDV assay, and RoboGene HDV RNA Quantification kit 2.0 were used for testing 151 HBsAg-positive samples, 90 HDV-RNA negative and 61 HDV-RNA positive. We also evaluated serial dilutions of the WHO international standard for HDV, PEI 7657/12. All HDV-RNA positive samples were genotyped using a next-generation sequencing strategy.ResultsQualitative results indicated a 100% concordance between tests. Quantitative results correlated well, r2 = 0.703 (Vircell-vs-Eurobio), r2 = 0.833 (Vircell-vs-RoboGene), r2 = 0.835 (Robogene-vs-Eurobio). Bias index was 2.083 (Vircell-vs-Eurobio), -1.283 (Vircell-vs-RoboGene), and -3.36 (Robogene-vs-Eurobio). Using the WHO IS, Vircell overestimated the viral load by 0.98 log IU/mL, Eurobio by 1.46 log IU/mL, and RoboGene underestimated it by 0.98 log IU/mL. Fifty-nine samples were successfully genotyped (Genotype 1, n=52; Genotype 5, n=7; Genotype 6, n=1), with similar results for correlation and bias.ConclusionThis study underscores the necessity of using reliable HDV-RNA detection and quantification assays, as evidenced by the high concordance rates in qualitative detection and the observed variability in quantitative results. These findings highlight the importance of consistent assay use in clinical practice to ensure accurate diagnosis and effective treatment monitoring of HDV infection.

Many organizations have realized the significant role suppliers play in determining organizational performance. This study sought to examine the influence of supplier development practices on supply chain performance of County Governments in Kenya. This study employed a descriptive survey research design targeting 112 procurement staff. The study utilized both stratified and simple random techniques. For data collection close ended questionnaires was used. For data analysis descriptive and inferential statistics were used. Descriptive statistics used were mean and standard deviation and Inferential statistics used Pearson correlations and simple linear regression. The study found that supplier development practices had a positive and significant effect on supply chain performance of County Governments in Kenya. The findings extends our knowledge on supplier development practices that can enhance performance. The study recommends for County Governments to develop suppliers through training, supplier financing and innovation so as to enhance performance of supply chain.

Mental illness has grown to become a prevalent and global health concern that affects individuals across various demographics. Timely detection and accurate diagnosis of mental disorders are crucial for effective treatment and support as late diagnosis could result in suicidal, harmful behaviors and ultimately death. To this end, the present study introduces a novel pipeline for the analysis of facial expressions, leveraging both the AffectNet and 2013 Facial Emotion Recognition (FER) datasets. Consequently, this research goes beyond traditional diagnostic methods by contributing a system capable of generating a comprehensive mental disorder dataset and concurrently predicting mental disorders based on facial emotional cues. Particularly, we introduce a hybrid architecture for mental disorder detection leveraging the state-of-the-art object detection algorithm, YOLOv8 to detect and classify visual cues associated with specific mental disorders. To achieve accurate predictions, an integrated learning architecture based on the fusion of Convolution Neural Networks (CNNs) and Visual Transformer (ViT) models is developed to form an ensemble classifier that predicts the presence of mental illness (e.g., depression, anxiety, and other mental disorder). The overall accuracy is improved to about 81% using the proposed ensemble technique. To ensure transparency and interpretability, we integrate techniques such as Gradient-weighted Class Activation Mapping (Grad-CAM) and saliency maps to highlight the regions in the input image that significantly contribute to the model’s predictions thus providing healthcare professionals with a clear understanding of the features influencing the system’s decisions thereby enhancing trust and more informed diagnostic process.

Abstract Background Anopheles funestus is a major malaria vector in Eastern and Southern Africa and is currently the dominant malaria-transmitting vector in many parts of Tanzania. Previous research has identified its preference for specific aquatic habitats, especially those that persist in dry months. This observation suggests the potential for targeted control through precise habitat mapping and characterization. In this study, we investigated the influence of habitat characteristics, land cover and human population densities on An. funestus distribution during dry seasons. Based on the results, we developed a habitat suitability model for this vector species in south-eastern Tanzania. Methods Eighteen villages in south-eastern Tanzania were surveyed during the dry season from September-December 2021. Water bodies were systematically inspected for mosquito larvae and characterized by their physico-chemical characteristics and surrounding environmental features. A generalized linear model was used to assess the presence of An. funestus larvae as a function of the physico-chemical characteristics, land use and human population densities. The results obtained from this model were used to generate spatially explicit predictions of habitat suitability in the study districts. Results Of the 1466 aquatic habitats surveyed, 440 were positive for An. funestus, with river streams having the highest positivity (74%; n = 322) followed by ground pools (15%; n = 67). The final model had an 83% accuracy in predicting positive An. funestus habitats, with the most important characteristics being permanent waters, clear waters with or without vegetation or movement and shading over the habitats. There was also a positive association of An. funestus presence with forested areas and a negative association with built-up areas. Human population densities had no influence on An. funestus distribution. Conclusions The results of this study underscore the crucial role of both the specific habitat characteristics and key environmental factors, notably land cover, in the distribution of An. funestus. In this study area, An. funestus predominantly inhabits river streams and ground pools, with a preference for clear, perennial waters with shading. The strong positive association with more pristine environments with tree covers and the negative association with built-up areas underscore the importance of ecological transitions in vector distribution and malaria transmission risk. Such spatially explicit predictions could enable more precise interventions, particularly larval source management, to accelerate malaria control. Graphical Abstract

The use of muscadine grape extracts (MGSE). in cancer treatment has gained attention due to its distinctive composition of polyphenols and antioxidants. This review analyses the reported anti-cancer properties of MGSE. The study commences by reviewing the phytochemical composition of MGSE, highlighting the presence of resveratrol and ellagic acid. Furthermore, the review underscores the mechanism of action of these active compounds in MGSE in combating cancer cells. The anti-cancer potential of MGSE compared to other plant extracts is also discussed. In addition, it highlights MGSE's superiority and distinct phytochemical composition in preventing cancer growth by comparing its anti-cancer compounds with those of other anti-cancer medicinal plants. Lastly, the combinatory approaches of MGSE with traditional cancer therapies, its safety, and its possible side effects were highlighted. This work provides an understanding of the anti-cancer properties of MGSE, positioning it as a valuable and unique challenge within the field of cancer therapy.

The study examined the effect of supplier selection practices on supply chain performance of county referral hospitals in Kenya. Descriptive survey design was utilized. Both stratified random and simple random techniques were used in the selection of 81 respondents. For data collection close ended questionnaires and an interview schedule was used. Data was analyzed using descriptive statistics which entailed frequency and percentage and also using inferential statistics whereby simple linear regression was utilized. Findings revealed that supplier selection practices positively and significantly impacted on the supply chain performance. The study concludes that supplier selection practices can be a strategic organizational weapon which may be used to achieve supply chain performance. The study recommends for supply chain managers in county referral hospitals to take into consideration supplier evaluation and supplier certification as aspects of supplier selection as this may enhance supply chain performance.

Vaccination is crucial in reducing child mortality and the prevalence of Vaccine-Preventable-Diseases (VPD), especially in low-and-middle-income countries like Kenya. However, non-vaccination, under-vaccination, and missed opportunities for vaccination (MOV) pose significant challenges to these efforts. This study aimed to analyze the impact of demographic and socio-economic factors on non-vaccination, under-vaccination, and MOV among children aged 0-23 months in Kenya from 2003 to 2014. A secondary data analysis of data from the Kenya Demographic Health Surveys (KDHS) conducted during this period was conducted, with a total of 11,997 participants, using a two-stage, multi-stage, and stratified sampling technique. The study examined factors such as child's sex, residence, mother's age, marital status, religion, birth order, maternal education, wealth quintile, province, child's birth order, parity, number of children in the household, place of delivery, and mother's occupation. Binary logistic regression was employed to identify the determinants of non-vaccination, under-vaccination, and MOV, and multivariable logistic regression analysis to report odds ratios (OR) and their corresponding 95% confidence intervals (CI). In 2003, the likelihood of non-vaccination decreased with higher maternal education levels: mothers who did not complete primary education (AOR = 0.55, 95% CI = 0.37-0.81), completed primary education (AOR = 0.34, 95% CI = 0.21-0.56), and had secondary education or higher (AOR = 0.26, 95% CI = 0.14-0.50) exhibited decreasing probabilities. In 2008/09, divorced/separated/widowed mothers (AOR = 0.22, 95% CI = 0.07-0.65) and those with no religion (AOR = 0.37, 95% CI = 0.17-0.81) showed lower odds of non-vaccination, while lower wealth quintiles were associated with higher odds. In 2014, non-vaccination was higher among younger mothers aged 15-19 years (AOR = 12.53, 95% CI = 1.59-98.73), in North Eastern Province (AOR = 7.15, 95% CI = 2.02-25.30), in families with more than 5 children (AOR = 4.19, 95% CI = 1.09-16.18), and in children born at home (AOR = 4.47, 95% CI = 1.32-15.17). Similar patterns were observed for under-vaccination and MOV. This information can inform strategies for bridging the gaps in immunization coverage and promoting equitable vaccination practices in Kenya.

Vaccines are effective and cost-effective. Non-vaccination, under-vaccination, and missed opportunities for vaccination (MOV), have contributed to incomplete vaccination coverage in Kenya. Analyzing their trends is essential for targeting interventions and improvement strategies. This study aimed to assess trends of non-vaccination, under-vaccination, and MOV among children aged 0-23 months in Kenya using data obtained from the Kenya Demographic and Health Surveys (KDHS) conducted in 2003, 2008/09, and 2014. A two-stage, multi-stage, and stratified sampling technique was used. Weighted analysis was conducted to ensure generalizability to the full population. Using the KDHS sample size estimation process, the sample size was estimated for each indicator, with varying standard error estimates, level of coverage and estimated response rates. Final sample size was 2380 (2003), 2237 (2008/09) and 7380 (2014). To determine the level of non-vaccination, under-vaccination and MOV among children aged 0-23 months, a weighted descriptive analysis was used to estimate their prevalence, with 95% confidence intervals (CI) for each year. MOV was defined using an algorithm as a binary variable. Data coding and recoding were done using Stata (version 14; College Station, TX: StataCorp LP). Trends in proportions of non-vaccination, under-vaccination and MOV were compared between 2003, 2008/09, and 2014 using the Cochrane-Armitage trend test. All results with P≤0.05 were considered statistically significant. Trends in proportion of non-vaccination among children aged 0-23 months in Kenya was 13.2%, 6.1% and 3.2% in 2003, 2008/09 and 2014, respectively (P = 0.0001). Trends in proportion of under-vaccination among children aged 0-23 months in Kenya was 54.3%, 50% and 51.3% in 2003, 2008/09 and 2014, respectively (P = 0.0109). The trends in proportion of children who experienced MOV was 22.7% in 2003, 31.9% in 2008/09 and 37.6% in 2014 (P = 0.0001). In the study duration, non-vaccination decreased by 10%, under-vaccination remained relatively stable, and MOV increased by ~15%. There is need for the Government and partners to implement initiatives that improve vaccine access and coverage, particularly in regions with low coverage rates, and to address missed opportunities for vaccination.

IntroductionAdolescent girls and young women (AGYW) face a high burden of gender-based violence (GBV) worldwide. The COVID-19 pandemic and associated policies led to global increases in GBV, decreased access to resources, and disruptions of pathways to care. We aimed to understand the effects of COVID-19 on AGYW affected by GBV in Kisumu, Kenya, as well as to identify possible interventions to mitigate those effects.MethodsFocus group discussions (FGDs) were conducted with AGYW aged 15–25 with a history of exposure to GBV. AGYW were split into age-matched groups; aged 15–19 for younger groups and 19–25 for older groups. Discussions focused on how COVID-19 affected experiences of GBV, access to care services, economic and social outcomes, and opportunities for interventions to mitigate negative impacts of COVID-19 and violence.ResultsFive FGDs with 46 AGYW were completed in June-September 2021. AGYW described increases in all types of GBV, particularly sexual abuse and intimate partner violence. Early marriage and subsistence transactional sex also increased. AGYW described violence as both a cause and effect of poor economic, social and health consequences related to the pandemic. Notably, AGYW emphasized stress, lack of mental health support and increased substance use as risk factors for violence, and discussed the deleterious mental health effects of violence—particularly in the wake of disruption of mental health services. COVID-19 disrupted referrals to violence-related services, and reduced access to both medical services and psychosocial services. AGYW believed that interventions focused on improving mental health as well as economic empowerment would be the most feasible and acceptable in mitigating the negative effects of COVID-19 and related exacerbations in violence.DiscussionAGYW reported increases in almost all forms of GBV during the pandemic, with related exacerbation in mental health. Concurrently, AGYW endorsed decreased access to care services. As there is no evidence that violence and mental health challenges will quickly resolve, there is an urgent need to identify and implement interventions to mitigate these negative effects.

Abstract Background Maspin, a putative tumor suppressor that is down-regulated in breast and prostate cancer, has been associated with decreased cell motility. Snail transcription factor is a zinc finger protein that is increased in breast cancer and is associated with increased tumor motility and invasion by induction of epithelial-mesenchymal transition (EMT). We investigated the molecular mechanisms by which Snail increases tumor motility and invasion utilizing prostate cancer cells. Methods Expression levels were analyzed by RT-PCR and western blot analyses. Cell motility and invasion assays were performed, while Snail regulation and binding to maspin promoter was analyzed by luciferase reporter and chromatin immunoprecipitation (ChIP) assays. Results Snail protein expression was higher in different prostate cancer cells lines as compared to normal prostate epithelial cells, which correlated inversely with maspin expression. Snail overexpression in 22Rv1 prostate cancer cells inhibited maspin expression and led to increased migration and invasion. Knockdown of Snail in DU145 and C4-2 cancer cells resulted in up-regulation of maspin expression, concomitant with decreased migration. Transfection of Snail into 22Rv1 or LNCaP cells inhibited maspin promoter activity, while stable knockdown of Snail in C4-2 cells increased promoter activity. ChIP analysis showed that Snail is recruited to the maspin promoter in 22Rv1 cells. Conclusions Overall, this is the first report showing that Snail can negatively regulate maspin expression by directly repressing maspin promoter activity, leading to increased cell migration and invasion. Therefore, therapeutic targeting of Snail may be useful to re-induce expression of maspin tumor suppressor and prevent prostate cancer tumor progression.

Abstract Background Nuclear factor kappa B (NF-κB) is a transcription factor typically expressed with two specific subunits (p50, p65). Investigators have reported that NF-κB is activated during the induction of in vitro long term potentiation (LTP), a paradigm of synaptic plasticity and correlate of memory, suggesting that NF-κB may be necessary for some aspects of memory encoding. Furthermore, NF-κB has been implicated as a potential requirement in behavioral tests of memory. Unfortunately, very little work has been done to explore the effects of deleting specific NF-κB subunits on memory. Studies have shown that NF-κB p50 subunit deletion (p50−/−) leads to memory deficits, however some recent studies suggest the contrary where p50−/− mice show enhanced memory in the Morris water maze (MWM). To more critically explore the role of the NF-κB p50 subunit in synaptic plasticity and memory, we assessed long term spatial memory in vivo using the MWM, and synaptic plasticity in vitro utilizing high frequency stimuli capable of eliciting LTP in slices from the hippocampus of NF-κB p50−/− versus their controls (p50+/+). Results We found that the lack of the NF-κB p50 subunit led to significant decreases in late LTP and in selective but significant alterations in MWM tests (i.e., some improvements during acquisition, but deficits during retention). Conclusions These results support the hypothesis that the NF-κ p50 subunit is required in long term spatial memory in the hippocampus.

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.