Search

The electrical distribution system is crucial for the utility grid to transmit power from generators to consumers. Considering the intricate structure of distribution systems and their significant role in power networks, establishing a robust fault classification and location scheme is vital. Due to ageing, distribution systems are often prone to faults from factors like poor operational conditions and wear and tear. The line faulting rate and the pertinent restoration epochs influence the frequency and duration of power disruptions. Thus, precisely locating the fault section is essential to minimize power restoration timeframes. This paper presents a hybrid fault classification and location technique in a combined continuous overhead and underground distribution line. A simulation of the hybrid model was designed in Simulink for an 11 kV combined continuous overhead and underground electrical distribution line, considering short circuit faults as they are the most predominant and cause massive damage in distributed systems. The proposed technique first classifies the fault using Discrete Wavelet Transforms (DWT) and Multi-layer Perceptron-Artificial Neural Networks (MLP-ANN). Next, the impedance and Adaptive Neuro-Fuzzy System (ANFIS) based technique is employed for fault location. At a sample rate of 50 kHz, the DWT was applied to current signals and the coefficients used for ANN training, while phase impedance values were used as input to the ANFIS for training. The simulation results showed accuracy of 96.6% for fault classification and 99.17% for fault location. The developed models can significantly enhance fault location for speedier outage resolution by promptly repairing the affected distribution lines.

The COVID-19 epidemic has forced education managers and teachers to begin or enhance e-learning mode of education across the world. Kenya has not been left behind. This article is geared towards identification of challenges that face technologically based/supported education in schools.

Background. Taro (Colocasia esculenta) is one of the underutilized crops in Kenya, grown under a wide range of environmental and edaphic conditions. This crop has exceptional dietary value and numerous culinary applications due to its edible leaves and corms. However, the mineral nutrient composition of taro in Kenya is still not well known due to a lack of scientific information concerning production. Objective. To determine the proximate composition and mineral profile of taro under different watering regimes and planting densities in Embu, Kenya. Methodology. A study was conducted at the Kenya Agricultural and Livestock Research Organization (KALRO) – Embu Research Centre, during the long rains (LR) 2021, and short rains (SR) 2021/2022. A factorial experiment with a split-plot layout arranged in a completely randomized block design was adopted. The watering regimes (100 %, 60 %, and 30 % based on the field capacity (FC)) were the main factor while the sub-factor was the planting density, with three replications. The planting densities used were 0.5 m × 0.5 m (40,000 plants ha-1), 1 m × 0.5 m (20,000 plants ha-1), and 1 m × 1 m (10,000 plants ha-1), representative of high, medium, and low planting densities respectively. Proximate analysis and mineral content were determined. Results. Significant differences (P < 0.05) in seasons were noted for protein, fibre, potassium, calcium, sodium, and zinc in the taro corms. The high carbohydrate content observed in this study (35 – 39 %) indicates that taro tubers are a good source of nutritional energy. Potassium (> 5000 mg kg -1) and magnesium (> 1000 mg kg -1) were the most prevalent mineral elements in taro corms and leaves, with copper (< 25 mg kg -1) being the least prevalent. Implications. Consumption of nutrient-rich foods such as taro helps the body to utilize the necessary nutrients to combat malnutrition and promote food security in rural communities. Conclusion. Taro leaves can be recommended as leafy vegetables as they are good sources of potassium, magnesium, calcium, manganese, iron, copper, and zinc; and the corms have low fat and protein content, high calorific energy, and high carbohydrate content. Taro represents one of the main sources of energy in many parts of the tropics and its production can be recommended in sub-humid areas in Kenya.

Transformer performance and efficiency can be enhanced by effectively address the properties of its insulation system. The power transformer insulation system weakens as a result of operational thermal stresses brought on by dynamic loading and shifting environmental patterns. Winding hot spot temperature is a crucial metric that must be maintained below the prescribed limit while power transformers are operating so as to maintained power system reliability. This is due to the fact that, among other variables, the time-dependent aging effect of insulation depends on transitions in hot spot temperatures. Due to the non‐linear nature of the conventional mathematical models used to determine these temperatures, and complexity of thermal phenomena, investigations still need to be exercised to fully understand the variables that associate with hot spot temperature computation with minimum error. This paper explores the possibilities of enhancing top oil and hot spot temperature estimation accuracy through the use of an adaptive neuro-fuzzy inference (ANFIS) technique. The paper presents an adaptive neuro fuzzy model to approximate the hot spot temperature of a mineral oil-filled power transformer based on loading, and established top oil temperature. Initially, a sub-ANFIS top oil temperature estimation model based on loading and ambient temperature as inputs is established. Using a hybrid optimization technique, the ANFIS membership functions were fine-tuned throughout the training process to reduce the difference between the actual and anticipated outcomes. The correctness and reliability of the created adaptive neural fuzzy model have been verified using real-world field data from a 60/90MVA, 132 kV power transformers under dynamic operating regimes. The ANFIS model results were validated against field measured values and literature-based electrical-thermal analogous models, establishing a precise input-output correlation. The developed ANFIS model achieves the highest coefficient of determination for both TOT and HST (0.98 and 0.96) and the lowest mean square error (7.8 and 10.3) among the compared thermal models. Correct determination of HST can help asset managers in thermal analysis trending of the in-service transformers, helping them to make proper loading recommendations for safeguarding the asset.

BackgroundThe use of digital tools and applications in health professions education is increasing exponentially, however this has the potential to increase the digital inequities with the resulting effect of vulnerable groups facing an increased risk of digital exclusion. It is therefore important to approach digitalization with contextual determinants of the intended and unintended impact in mind. We present a perspective paper on digital equity, informed by lessons learnt at the Kenya Medical Training College (KMTC).MethodsUsing a case description methodology, we examined routine educational data collected from faculty at KMTC in November 2022. This included quantitative and qualitative data on access, ownership, utilization, confidence and skills to create, share, and exchange knowledge on the institution’s learning management system. We used these factors as the conceptual framework for understanding how faculty adopt digitalization in health professions education.Results306 faculty responded to the survey (response rate 27.8%) of whom 90.8 and 75.2% had personal laptops at home and at work and 75.9% had internet at work. 53.4% (n = 163) knew they had accounts created on the institution’s learning management system (LMS) majority of whom had basic skills and were able to perform skills such as logging in and accessing learning resources. However, a minority had advanced skills needed for teaching and learning in the LMS.ConclusionMedical education institutions in LMICs need to adopt programs to enhance digital literacy and monitoring of access, utilization and self-efficacy across all learner and faculty groups, to ensure that digital technologies reduce rather than exacerbate existing inequities.

Background. Taro (Colocasia esculenta) can be grown in a variety of environmental and edaphic conditions, but it is most typically grown in wetlands. The optimal conditions for its growth are two water regimes i.e., waterlogged or flooded conditions to dryland or unflooded conditions. An important criterion in crop yield is water use efficiency (WUE), and it has been suggested that crop production per unit of water used can be increased. Objectives. To determine the WUE of taro in Kenya’s sub-humid environment under different watering regimes and planting densities. Methodology. A study was conducted at the Kenya Agricultural and Livestock Research Organization (KALRO) – Embu Research Centre, during the long rains (LR) 2021, short rains (SR) 2021/2022, and long rains (LR) 2022. A factorial experiment with a split-plot layout arranged in a completely randomized block design was used. The main factor was the irrigation levels while the sub-factor was the planting density, with three replications. The three irrigation levels were at 100 %, 60 %, and 30 % based on the field capacity (FC). The planting densities used were 0.5m × 0.5m (40,000 plants ha-1), 1m × 0.5m (20,000 plants ha-1), and 1m × 1m (10,000 plants ha-1), representative of high, medium, and low planting densities respectively. Results. The WUE was influenced by season and watering regime (P < 0.05). The 30% FC had the highest WUE with the 100 % FC having the lowest. The high WUE under 30 % FC (19.40 kg ha-1mm-1) was associated with the high biomass (1.97 kg) and low water use (2269.41 mm) recorded under limited water conditions. The medium (1m × 0.5m) planting density attained the highest WUE (12.16 kg ha-1mm-1) with the high planting density (0.5m × 0.5m) having the lowest (10.65 kg ha-1mm-1), though no significant differences were recorded. Implications. The varying watering regimes and planting densities in this study have different capacities to utilize the supplied water. The total taro biomass increased with decrease in water supplied and in turn maximized the water use efficiency. Conclusion. To achieve the highest yield per unit of water consumed, a watering regime of 30 % FC and a planting density of 1 m × 0.5 m (20,000 plants ha-1) is recommended.

BackgroundIn patients with sepsis, elevated lactate has been shown to be a strong predictor of in-hospital mortality. However, the optimal cutoff for rapidly stratifying patients presenting to the emergency department at risk for increased in-hospital mortality has not been well defined. This study aimed to establish the optimal point-of-care (POC) lactate cutoff that best predicted in-hospital mortality in adult patients presenting to the emergency department.MethodsThis was a retrospective study. All adult patients who presented to the emergency department at the Aga Khan University Hospital, Nairobi, between 1 January 2018 and 31 August 2020 with suspected sepsis or septic shock and were admitted to the hospital were included in the study. Initial POC lactate results (GEM 3500® blood gas analyzer) and demographic and outcome data were collected. A receiver operating characteristic (ROC) curve for initial POC lactate values was plotted to determine the area under the curve (AUC). An optimal initial lactate cutoff was then determined using the Youden Index. Kaplan–Meier curves were used to determine the hazard ratio (HR) for the identified lactate cutoff.ResultsA total of 123 patients were included in the study. They had a median age of 61 years [interquartile range (IQR) 41.0–77.0]. Initial lactate independently predicted in-hospital mortality [adjusted odds ratio (OR) 1.41 95% confidence interval (CI 1.06, 1.87) p = 0.018]. Initial lactate was found to have an area under the curve (AUC) of 0.752 (95% CI, 0.643 to 0.86). Additionally, a cutoff of 3.5 mmol/L was found to best predict in-hospital mortality (sensitivity 66.7%, specificity 71.4%, PPV 70%, NPV 68.2%). Mortality was 42.1% (16/38) in patients with an initial lactate of ≥ 3.5 mmol/L and 12.7% (8/63) in patients with an initial lactate of

Abstract Background E-learning has been widely adopted as a teaching and learning approach in medical education internationally. However, its adoption in low- and middle-income countries is still at an infantile stage. The use of e-learning may help to overcome some of the barriers to access to quality education and provide flexible, low-cost, user-centred, and easily updated learning. To address the need for research education during the COVID-19 pandemic, we developed and implemented an e-learning course for students enrolled in higher diploma courses at the Kenya Medical Training College (KMTC). In this paper, we report our experience teaching the online research course in resource-constrained settings to enable other medical educators, students and institutions in similar settings to understand the most appropriate approaches to incorporating e-learning interventions. Methods This was a cross-sectional study that reviewed the experiences of learners and lecturers on a research course at Kenya Medical Training College. All higher diploma students admitted to the college in the 2020/21 academic year were invited to take part in the study. We also included all lecturers that were involved in the coordination and facilitation of the course. We analysed qualitative and quantitative data that were collected from the e-learning platform, an online course-evaluation form and reports from course lecturers. Results We enrolled 933 students on the online research course. These students had joined 44 higher diploma courses in 11 campuses of the college. The students struggled to complete synchronous e-learning activities on the e-learning platform. Only 53 and 45% of the students were able to complete the pretest and the posttest, respectively. Four themes were identified through a thematic analysis of qualitative data (1) Students gained research competencies (2) Students appreciated the use of diverse e-learning technologies (3) Students felt overwhelmed by the research course (4) Technological challenges reduce the effectiveness of online learning. Conclusion Our results suggest that e-learning can be used to teach complex courses, such as research in resource-constrained settings. However, faculty should include more asynchronous e-learning activities to enhance teaching and learning and improve student experiences.

Background: Visceral Leishmaniasis caused by Leishmania donovani is a major health problem in the tropics and sub-tropic regions where it is endemic. We aimed in testing the leishmanicidal activity and toxicity of Prosopis juliflora leaf extract in BALB/c mice and in vitro test systems respectively. Methods: In the year 2017 until 2019, BALB/c mice of mixed sexes aged between 6 and 8 weeks in groups of 8 were used. Group I treated with 100 mg/kg of P. juliflora extract, Group II -1 mg/kg of Sodium stibogluconate (SSG) and Group III treated with normal saline. All mice were anaesthized and sacrificed to obtain blood, spleen samples for antibody measurements, and determination of parasite loads. Results: There was significant inhibitory effect (P

Taro (Colocasia esculenta (L.) Schott) is one of the most underutilized crops in sub-Saharan Africa and an important staple food in the tropics. Understanding its growth response under selected watering regimes and planting densities underpins this research. A study was conducted at the Kenya Agricultural and Livestock Research Organization (KALRO), Embu Research Centre, during the long rains (LR) in 2021 and the short rains (SR) in 2021–2022. A factorial experiment with a split-plot layout arranged in a completely randomized block design was used. The main factor was the irrigation levels, while the subfactor was the planting density, with three replications. The three irrigation levels were at 100%, 60%, and 30% based on the field capacity (FC). The planting densities used were 0.5 m × 0.5 m (40,000 plants ha−1), 1 m × 0.5 m (20,000 plants ha−1), and 1 m × 1 m (10,000 plants ha−1), representative of high, medium, and low planting densities, respectively. Time and season (P

Abstract Zoonotic pathogens are among the most important causes of ill health all over the world. The presence of these pathogens in free ranging baboons may have significant implications for humans. In Kenya, the encroachment of wildlife habitats has led to increased interaction between humans and wildlife especially non‐human primates. The current study therefore aimed at investigating any possible zoonotic gastrointestinal helminths of olive baboons (Papio anubis) at the human–wildlife interface in two park borders and a ranch in Kenya, namely, Tsavo West National Park, Tana River Primate Reserve and Mutara Ranch, Laikipia, Kenya. One hundred and forty‐seven baboons were used in the study. They were trapped in the wild, sampled for stool marked and then released back to the wild. Gastrointestinal (GIT) helminths identified were Strongyloides, Oesophagostomum, Enterobius spp and Trichuris Trichiura from all the three sites while Schistosoma mansoni was only detected from Tsavo baboons and with very low incidence (2.1%). The prevalence of these parasites varied among the sites but significant difference in prevalence was only noted in Strongyloides and Oesophagostomum (p

Glycinergic synapses play a central role in motor control and pain processing in the central nervous system. Here, authors present cryo-EM structures of the full-length glycine receptors (GlyRs) reconstituted into lipid nanodiscs in the unliganded, glycine-bound and allosteric modulator-bound conformations and reveal global conformational changes underlying GlyR channel gating and modulation.

Abstract Background Kenya introduced the monovalent G1P [8] Rotarix® vaccine into the infant immunization schedule in July 2014. We examined trends in rotavirus group A (RVA) genotype distribution pre- (January 2010–June 2014) and post- (July 2014–December 2018) RVA vaccine introduction. Methods Stool samples were collected from children aged

Background: The COVID-19 pandemic relies on real-time polymerase chain reaction (qRT-PCR) for the detection of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), to facilitate roll-out of patient care and infection control measures. There are several qRT-PCR assays with little evidence on their comparability. We report alterations to the developers’ recommendations to sustain the testing capability in a resource-limited setting. Methods: We used a SARS-CoV-2 positive control RNA sample to generate several 10-fold dilution series that were used for optimization and comparison of the performance of the four qRT-PCR assays: i) Charité Berlin primer-probe set, ii) European Virus Archive – GLOBAL (EVAg) primer-probe set, iii) DAAN premixed commercial kit and iv) Beijing Genomics Institute (BGI) premixed commercial kit. We adjusted the manufacturer- and protocol-recommended reaction component volumes for these assays and assessed the impact on cycle threshold (Ct) values. Results: The Berlin and EVAg E gene and RdRp assays reported mean Ct values within range of each other across the different titrations and with less than 5% difference. The DAAN premixed kit produced comparable Ct values across the titrations, while the BGI kit improved in performance following a reduction of the reaction components. Conclusion: We achieved a 2.6-fold and 4-fold increase in the number of tests per kit for the commercial kits and the primer-probe sets, respectively. All the assays had optimal performance when the primers and probes were used at 0.375X, except for the Berlin N gene assay. The DAAN kit was a reliable assay for primary screening of SARS-CoV-2 whereas the BGI kit’s performance was dependent on the volumes and concentrations of both the reaction buffer and enzyme mix. Our recommendation for SARS-CoV-2 diagnostic testing in resource-limited settings is to optimize the assays available to establish the lowest volume and suitable concentration of reagents required to produce valid results.

Laboratory diagnosis plays a critical role in the containment of a pandemic. Strong laboratory quality management systems (QMS) are essential for laboratory diagnostic services. However, low laboratory capacities in resource-limited countries has made the maintenance of laboratory quality assurance, especially during a pandemic, a daunting task. In this paper, we describe our experience of how we went about providing diagnostic testing services for SARS-CoV-2 through laboratory reorganization, redefining of the laboratory workflow, and training and development of COVID-19 documented procedures, all while maintaining the quality assurance processes during the COVID-19 pandemic at the Kenya Medical Research Institute (KEMRI) Wellcome Trust Research Programme (KWTRP) laboratory. The KWTRP laboratory managed to respond to the COVID-19 outbreak in Kenya by providing diagnostic testing for the coastal region of the country, while maintaining its research standard quality assurance processes. A COVID-19 team comprising of seven sub-teams with assigned specific responsibilities and an organizational chart with established reporting lines were developed. Additionally, a total of four training sessions were conducted for county Rapid Response Teams (RRTs) and laboratory personnel. A total of 11 documented procedures were developed to support the COVID-19 testing processes, with three for the pre-analytical phases, seven for the analytical phase, and one for the post-analytical phase. With the workflow re-organization, the development of appropriate standard operating procedures, and training, research laboratories can effectively respond to pandemic outbreaks while maintaining research standard QMS procedures.

Kala-azar is a parasitic disease caused by Leishmania species transmitted by sand fly. In Kenya, kala-azar is endemic in thirty subcounties spread over in eleven counties in the arid zones. Climate change-influenced seasonal weather variability and environmental alterations remain important determinants of many vector-borne diseases. The present study focused on climate change and environmental influence on kala-azar in West Pokot. A descriptive cross-sectional and retrospective research design was adapted. Study area was purposively selected. Locations were randomly selected, and households were systematically selected. Three hundred sixty-three household questionnaires, eleven key informant interviews, and five focus group discussions were undertaken. Secondary data were obtained from Kacheliba subcounty hospital records. Statistical Package for the Social Sciences version 24 was used to analyze quantitative data while qualitative data were analyzed to establish connection for interpretation. Kala-azar cases have been on the rise on aggregate and surge towards the end of dry season and just after the rains. Significant environmental factors included the presence of seasonal rain water pathways and rock piles around houses (AOR = 4.7; 95% CI = (2.3-9.6), p

Abstract Background Contagious bovine pleuropneumonia (CBPP) caused by Mycoplasma mycoides subspecies mycoides (Mmm) is an important disease of cattle that causes serious economic losses. With the known effectiveness of new generation macrolides, tulathromycin and gamithromycin were assessed in comparison with oxytetracycline as a positive control and saline as a negative control for effectiveness in inhibiting lung lesion development, promoting resolution, preventing spread and bacteriological clearance in susceptible local cattle breeds in two separate studies in Kenya and Zambia. Animals were monitored for clinical signs, sero-conversion as well as detailed post-mortem examination for CBPP lesions. Results Using the Hudson and Turner score for lesion type and size, tulathromycin protected 90%, gamithromycin 80%, and oxytetracycline 88% of treated animals in Kenya. In Zambia, all animals (100%) treated with macrolides were free of lung lesions, while oxytetracycline protected 77.5%. Using the mean adapted Hudson and Turner score, which includes clinical signs, post-mortem findings and serology, tulathromycin protected 82%, gamithromycin 56% and oxytetracycline 80% of the animals in Kenya whereas in Zambia, tulathromycin protected 98%, gamithromycin 94% and oxytetracycline 80%. The saline-treated groups had 93 and 92% lesions in Kenya and Zambia respectively, with Mmm recovered from 5/14 in Kenya and 10/13 animals in Zambia. Whereas the groups treated with macrolides were free from lesions in Zambia, in Kenya 5/15 tulathromycin-treated animals and 6/15 gamithromycin-treated animals showed lesions. Oxytetracycline-treated animals showed similarities with 3/14 and 4/15 showing lesions in Zambia and Kenya respectively and Mmm recovery from one animal in Kenya and six in Zambia. In both studies, lesion scores of saline-treated groups were significantly higher than those of the antibiotic treated groups (p

Serotonin receptors (5-HT3R) belong to the pentameric ligand-gated ion channel superfamily and mediate excitatory postsynaptic signaling. Here the authors present the high-resolution cryo-EM structure of 5-HT3AR bound with the competitive antagonist granisetron and further validate the granisetron-binding mode with electrophysiology measurements and MD simulations.

Respiratory syncytial virus (RSV) can trigger secondary airway bacterial infections. Here, by proteomics and metagenomics analyses of samples from Kenyan children, the authors report that RSV associates with Streptococcus burden and a local upper airway response with direct antibacterial properties.

Background: Nasopharyngeal samples contain higher quantities of bacterial and host nucleic acids relative to viruses; presenting challenges during virus metagenomics sequencing, which underpins agnostic sequencing protocols. We aimed to develop a viral enrichment protocol for unbiased whole-genome sequencing of respiratory syncytial virus (RSV) from nasopharyngeal samples using the Oxford Nanopore Technology (ONT) MinION platform. Methods: We assessed two protocols using RSV positive samples. Protocol 1 involved physical pre-treatment of samples by centrifugal processing before RNA extraction, while Protocol 2 entailed direct RNA extraction without prior enrichment. Concentrates from Protocol 1 and RNA extracts from Protocol 2 were each divided into two fractions; one was DNase treated while the other was not. RNA was then extracted from both concentrate fractions per sample and RNA from both protocols converted to cDNA, which was then amplified using the tagged Endoh primers through Sequence-Independent Single-Primer Amplification (SISPA) approach, a library prepared, and sequencing done. Statistical significance during analysis was tested using the Wilcoxon signed-rank test. Results: DNase-treated fractions from both protocols recorded significantly reduced host and bacterial contamination unlike the untreated fractions (in each protocol p

Background. Pedology is the study of soil genesis in its natural state. One way to assess the strength and productivity of a scientific field is to measure the number of publications over time. The number of soil papers published worldwide has almost doubled in the last ten years. However, that has not been the case in Eastern Africa, where this review is conducted. The scarcity of research in pedology motivates this study. Objectives. To review and analyze trends of publications in pedology/soil survey for the last ten years in (2010 - 2019) in Eastern Africa. Methodology. A search of scientific literature using Google and Google Scholar was conducted from 2010 - 2019. The search terms used were - soil survey, soil characterization, pedological characterization, and each of the Eastern African countries (Ethiopia, Kenya, Uganda, Tanzania, Rwanda, and Sudan). We then scrutinized the abstracts to find quantitative data on geographical locations. Additional articles were reviewed by checking through the reference lists of relevant studies in the peer-reviewed articles. Results. 56 scientific articles, 3 MSc/PhD theses reports, and 4 project reports/ proceedings were included for the full review. Out of this, 39 journal papers were identified and reviewed based on the years they were published, and the countries where they were published. Most articles were published in 2018. The data was then split into two segments, from the years 2010 - 2014 and 2015 - 2019. Between the years 2015 to 2019, a total of 36 articles were published compared to the years 2010 to 2014 where a total of 15 articles were published. This shows a slight increase in publications for the years under study. From the 56 articles, Ethiopia records the highest number of published articles from various journals having a total of 25 papers constituting 45% closely followed by Tanzania, having 27% equivalent to 15 papers. Kenya comes third in the overall ranking at 13% with 7 papers. The last three countries are Sudan, Rwanda, and Uganda with 10%, 3%, and 2% respectively. Implications. The results suggest that pedology seems to be a disappearing skill in the Eastern Africa region. Though there has been a spike in publications from 2015-2018, the current situation must be improved as there are limited publications from 2010 - 2019. Conclusion. The study shows that there have been a low number of publications in Eastern African countries. Ethiopia which has the highest number of publications shows the most promise in soil pedology publications. There is a need for an increase in pedology research which is important for agricultural production and land use planning.

Background. International recommendations for the control of the coronavirus disease 2019 (COVID-19) pandemic emphasize the central role of laboratory testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the etiological agent, at scale. The availability of testing reagents, laboratory equipment and qualified staff are important bottlenecks to achieving this. Elsewhere, pooled testing (i.e. combining multiple samples in the same reaction) has been suggested to increase testing capacities in the pandemic period. Methods. We discuss our experience with SARS-CoV-2 pooled testing using real-time reverse transcription polymerase chain reaction (RT-PCR) on the Kenyan Coast. Results. In mid-May, 2020, our RT-PCR testing capacity for SARS-CoV-2 was improved by ~100% as a result of adoption of a six-sample pooled testing strategy. This was accompanied with a concomitant saving of ~50% of SARS-CoV-2 laboratory test kits at both the RNA extraction and RT-PCR stages. However, pooled testing came with a slight decline of test sensitivity. The RT-PCR cycle threshold value (ΔCt) was ~1.59 higher for samples tested in pools compared to samples tested singly. Conclusions. Pooled testing is a useful strategy to increase SARS-CoV-2 laboratory testing capacity especially in low-income settings.

Covid-19 epidemic has forced education managers and teachers to begin or enhance e-learning mode of education across the world. Kenya have not been left behind. This article is geared towards identification of challenges that face technologically based / supported education. First is the accessibility question. The availability and actual use of ICT tools/ system for learning is a mirage to many. Availability of ICT system and devices is limited to most learners, teachers, and parents due to their socioeconomic status. Even for the cases where gadgets and platforms are availability, the drive and preference of the owners of devices / system towards the education material is not guaranteed. There is also a question of digital divide, most of Kenya parents and schools do not have internet or smart phones for the same. Secondly, is the issue of pedagogy –this implies practice and methodology that best fit the teaching of youthful students. Use of technologies in teaching should be done in a professional way by adhering to how instructional materials are prepared, dissemination of the same materials and then fusing it to technology for effective teaching and learning. There are few programs that are professional done towards this aspect in Africa. The screenshot below is an indication of factors that may hinder the eLearning education. It was taken from online training of Machakos University tutors. A survey was done where the participants indicated challenges that they may face in their teaching. Clearly, pedagogy and access was their main concern as shown from the percentages of each challenges.

Background: The objective of this study was to determine the prevalence of thermophilic Campylobacter spp. in asymptomatic school-going children and establish the antibiotic resistance patterns of the isolates towards the drugs used to treat campylobacteriosis, including macrolides, quinolones and tetracycline. Campylobacter spp. are a leading cause of enteric illness and have only recently shown resistance to antibiotics. Methods: This study isolated Campylobacter spp., including Campylobacter coli, Campylobacter jejuni and Campylobacter lari, in stool samples from asymptomatic school-going children in one of the biggest urban slums in Kenya. The disc diffusion method using EUCAST breakpoints was used to identify antibiotic-resistant isolates, which were further tested for genes encoding for tetracycline resistance using primer-specific polymerase chain reaction. Results: In total, 580 stool samples were collected from 11 primary schools considering both gender and age. Subjecting 294 biochemically characterized Campylobacter spp. isolates to genus-specific PCR, 106 (18.27% of stool samples) isolates were confirmed Campylobacter spp. Out of the 106 isolates, 28 (4.83%) were Campylobacter coli, 44 (7.58%) were Campylobacter jejuni while 11 (1.89%) were Campylobacter lari. Campylobacter jejuni had the highest number of isolates that were multi-drug resistant, with 26 out of the 28 tested isolates being resistant to ciprofloxacin (5 mg), nalidixic acid (30 mg), tetracycline (30 mg) and erythromycin (15 mg). Conclusions: In conclusion, asymptomatic school going children in the study area were found to be carriers of multidrug resistant Campylobacter coli, Campylobacter jejuni and Campylobacter lari at 84%. A one-health approach, which considers overlaps in environment, animals and human ecosystems, is recommended in addressing multidrug resistane in Campylobacter, since animals are the main reservoirs and environmental contamination is evident.

Background. International recommendations for the control of the coronavirus disease 2019 (COVID-19) pandemic emphasize the central role of laboratory testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the etiological agent, at scale. The availability of testing reagents, laboratory equipment and qualified staff are important bottlenecks to achieving this. Elsewhere, pooled testing (i.e. combining multiple samples in the same reaction) has been suggested to increase testing capacities in the pandemic period. Methods. We discuss our experience with SARS-CoV-2 pooled testing using real-time reverse transcription polymerase chain reaction (RT-PCR) on the Kenyan Coast. Results. In mid-May, 2020, our RT-PCR testing capacity for SARS-CoV-2 was improved by ~100% as a result of adoption of a six-sample pooled testing strategy. This was accompanied with a concomitant saving of ~50% of SARS-CoV-2 laboratory test kits at both the RNA extraction and RT-PCR stages. However, pooled testing came with a slight decline of test sensitivity. The RT-PCR cycle threshold value (ΔCt) was ~1.59 higher for samples tested in pools compared to samples tested singly. Conclusions. Pooled testing is a useful strategy to increase SARS-CoV-2 laboratory testing capacity especially in low-income settings.

Summary: Background: The Lancet Commission on Global Surgery established the Three Delays framework, categorising delays in accessing timely surgical care into delays in seeking care (First Delay), reaching care (Second Delay), and receiving care (Third Delay). Globally, knowledge gaps regarding delays for fracture care, and the lack of large prospective studies informed the rationale for our international observational study. We investigated delays in hospital admission as a surrogate for accessing timely fracture care and explored factors associated with delayed hospital admission. Methods: In this prospective observational substudy of the ongoing International Orthopaedic Multicenter Study in Fracture Care (INORMUS), we enrolled patients with fracture across 49 hospitals in 18 low-income and middle-income countries, categorised into the regions of China, Africa, India, south and east Asia, and Latin America. Eligible patients were aged 18 years or older and had been admitted to a hospital within 3 months of sustaining an orthopaedic trauma. We collected demographic injury data and time to hospital admission. Our primary outcome was the number of patients with open and closed fractures who were delayed in their admission to a treating hospital. Delays for patients with open fractures were defined as being more than 2 h from the time of injury (in accordance with the Lancet Commission on Global Surgery) and for those with closed fractures as being a delay of more than 24 h. Secondary outcomes were reasons for delay for all patients with either open or closed fractures who were delayed for more than 24 h. We did logistic regression analyses to identify risk factors of delays of more than 2 h in patients with open fractures and delays of more than 24 h in patients with closed fractures. Logistic regressions were adjusted for region, age, employment, urban living, health insurance, interfacility referral, method of transportation, number of fractures, mechanism of injury, and fracture location. We further calculated adjusted relative risk (RR) from adjusted odds ratios, adjusted for the same variables. This study was registered with ClinicalTrials.gov, NCT02150980, and is ongoing. Findings: Between April 3, 2014, and May 10, 2019, we enrolled 31 255 patients with fractures, with a median age of 45 years (IQR 31–62), of whom 19 937 (63·8%) were men, and 14 524 (46·5%) had lower limb fractures, making them the most common fractures. Of 5256 patients with open fractures, 3778 (71·9%) were not admitted to hospital within 2 h. Of 25 999 patients with closed fractures, 7141 (27·5%) were delayed by more than 24 h. Of all regions, Latin America had the greatest proportions of patients with delays (173 [88·7%] of 195 patients with open fractures; 426 [44·7%] of 952 with closed fractures). Among patients delayed by more than 24 h, the most common reason for delays were interfacility referrals (3755 [47·7%] of 7875) and Third Delays (cumulatively interfacility referral and delay in emergency department: 3974 [50·5%]), while Second Delays (delays in reaching care) were the least common (423 [5·4%]). Compared with other methods of transportation (eg, walking, rickshaw), ambulances led to delay in transporting patients with open fractures to a treating hospital (adjusted RR 0·66, 99% CI 0·46–0·93). Compared with patients with closed lower limb fractures, patients with closed spine (adjusted RR 2·47, 99% CI 2·17–2·81) and pelvic (1·35, 1·10–1·66) fractures were most likely to have delays of more than 24 h before admission to hospital. Interpretation: In low-income and middle-income countries, timely hospital admission remains largely inaccessible, especially among patients with open fractures. Reducing hospital-based delays in receiving care, and, in particular, improving interfacility referral systems are the most substantial tools for reducing delays in admissions to hospital. Funding: National Health and Medical Research Council of Australia, Canadian Institutes of Health Research, McMaster Surgical Associates, and Hamilton Health Sciences.

Serotonin receptor (5-HT3AR), a pentameric ligand-gated ion channel, regulates numerous gastrointestinal functions. Here the authors provide a cryo-electron microscopic structure from the full-length 5-HT3AR in the apo-state which corresponds to a resting conformation of the channel.

Copyright of African Journal of Reproductive Health is the property of Women's Health & Action Research Centre and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract Yield-phenology relation is a critical issue affecting rainfed maize field productivity in semiarid east African Plateau (EAP). We first introduced Chinese ridge-furrow mulching (RFM) system to EAP, using three maize cultivars with early-, mid- and late-maturing traits as test materials. A two-year field experiment was conducted in a semiarid farm of Kenya from 2012 to 2013. Three treatments were designed: alternative ridge and furrow with transparent plastic mulching (FT), with black plastic mulching (FB) and without mulching (CK). We found that FT and FB significantly increased soil moisture and accelerated crop maturity across two growing seasons. Leaf area and shoot biomass were increased by 30.2% and 67.5% in FT, 35.2% and 73.5% in FB, respectively, compared with CK. Grain yield, water use efficiency and economic output were increased by 55.6%, 57.5% and 26.7% in FT, and 50.8%, 53.3% and 19.8% in FB, respectively. Optimal yield and economic benefit were observed in late-maturing cultivar due to increased topsoil temperature in FT in 2012 (cool), and in early-maturing cultivar owing to cooling effect in FB in 2013 (warm). Our study suggested RFM system, combined with crop phenology selection, be a promising strategy to boost maize productivity and profitability in semiarid EAP.

Background: Human rhinovirus (HRV) is the predominant cause of upper respiratory tract infections, resulting in a significant public health burden. The virus circulates as many different types (168), each generating strong homologous, but weak heterotypic, immunity. The influence of these features on transmission patterns of HRV in the community is understudied. Methods: Nasopharyngeal swabs were collected from patients with symptoms of acute respiratory infection (ARI) at nine out-patient facilities across a Health and Demographic Surveillance System between December 2015 and November 2016. HRV was diagnosed by real-time RT-PCR, and the VP4/VP2 genomic region of the positive samples sequenced. Phylogenetic analysis was used to determine the HRV types. Classification models and G-test statistic were used to investigate HRV type spatial distribution. Demographic characteristics and clinical features of ARI were also compared. Results: Of 5,744 NPS samples collected, HRV was detected in 1057 (18.4%), of which 817 (77.3%) were successfully sequenced. HRV species A, B and C were identified in 360 (44.1%), 67 (8.2%) and 390 (47.7%) samples, respectively. In total, 87 types were determined: 39, 10 and 38 occurred within species A, B and C, respectively. HRV types presented heterogeneous temporal patterns of persistence. Spatially, identical types occurred over a wide distance at similar times, but there was statistically significant evidence for clustering of types between health facilities in close proximity or linked by major road networks. Conclusion: This study records a high prevalence of HRV in out-patient presentations exhibiting high type diversity. Patterns of occurrence suggest frequent and independent community invasion of different types. Temporal differences of persistence between types may reflect variation in type-specific population immunity. Spatial patterns suggest either rapid spread or multiple invasions of the same type, but evidence of similar types amongst close health facilities, or along road systems, indicate type partitioning structured by local spread.

Globally, rotavirus group A (RVA) remains a major cause of severe childhood diarrhea, despite the use of vaccines in more than 100 countries. RVA sequencing for local outbreaks facilitates investigation into strain composition, origins, spread, and vaccine failure. In 2018, we collected 248 stool samples from children aged less than 13 years admitted with diarrheal illness to Kilifi County Hospital, coastal Kenya. Antigen screening detected RVA in 55 samples (22.2%). Of these, VP7 (G) and VP4 (P) segments were successfully sequenced in 48 (87.3%) and phylogenetic analysis based on the VP7 sequences identified seven genetic clusters with six different GP combinations: G3P[8], G1P[8], G2P[4], G2P[8], G9P[8] and G12P[8]. The G3P[8] strains predominated the season (n = 37, 67.2%) and comprised three distinct G3 genetic clusters that fell within Lineage I and IX (the latter also known as equine-like G3 Lineage). Both the two G3 lineages have been recently detected in several countries. Our study is the first to document African children infected with G3 Lineage IX. These data highlight the global nature of RVA transmission and the importance of increasing global rotavirus vaccine coverage.

Background: Human rhinovirus (HRV) is the predominant cause of upper respiratory tract infections, resulting in a significant public health burden. The virus circulates as many different types (~160), each generating strong homologous, but weak heterotypic, immunity. The influence of these features on transmission patterns of HRV in the community is understudied. Methods: Nasopharyngeal swabs were collected from patients with symptoms of acute respiratory infection (ARI) at nine out-patient facilities across a Health and Demographic Surveillance System between December 2015 and November 2016. HRV was diagnosed by real-time RT-PCR, and the VP4/VP2 genomic region of the positive samples sequenced. Phylogenetic analysis was used to determine the HRV types. Classification models and G-test statistic were used to investigate HRV type spatial distribution. Demographic characteristics and clinical features of ARI were also compared. Results: Of 5,744 NPS samples collected, HRV was detected in 1057 (18.4%), of which 817 (77.3%) were successfully sequenced. HRV species A, B and C were identified in 360 (44.1%), 67 (8.2%) and 390 (47.7%) samples, respectively. In total, 87 types were determined: 39, 10 and 38 occurred within species A, B and C, respectively. HRV types presented heterogeneous temporal patterns of persistence. Spatially, identical types occurred over a wide distance at similar times, but there was statistically significant evidence for clustering of types between health facilities in close proximity or linked by major road networks. Conclusion: This study records a high prevalence of HRV in out-patient presentations exhibiting high type diversity. Patterns of occurrence suggest frequent and independent community invasion of different types. Temporal differences of persistence between types may reflect variation in type-specific population immunity. Spatial patterns suggest either rapid spread or multiple invasions of the same type, but evidence of similar types amongst close health facilities, or along road systems, indicate type partitioning structured by local spread.

Objective(s):Solanum acueastrum Dunal.has been shown to have some chemotherapeutic value. Leaf and berry water and methanol compounds of S. acueastrum were evaluated for possible antileishmanial activity In vivo on BALB/c mice and in vitro against Leishmania major promastigotes, amastigotes and vero cells. Materials and Methods: Dry S. aculeastrum berry and leaf material were extracted in methanol and water. L. major parasites were exposed to different concentrations of S. aculeastrum fruit and leaf compounds and the IC50 on the promastigotes, percentage of infection rate of macrophages by amastigotes and the toxicological effect on vero cells were determined. BALB/c mice were infected subcutaneously with 1×106 promastigotes and kept for four weeks to allow for disease establishment. Infected mice were treated with fruit and leaf methanolic and water compounds, amphotericin B (AmB), and sterile phosphate buffered saline (PBS). Results: Fruit methanol compound was most effective in inhibiting the growth of promastigotes with IC5078.62 μg/ml. Fruit water compound showed the best activity in inhibiting infection of macrophages by amastigotes. Fruit methanol compound was more toxic at Ld50=8.06 mg/ml to vero cells than amphotericin B. Analysis of variance computation indicated statistically significant difference in lesion sizes between experimental and control mice groups (P=0.0001). Splenic impression smears ANOVA indicated a highly significant difference in parasitic numbers between the experimental and the control groups (P=0.0001). Conclusion: The results demonstrate that compounds from S. aculeastrum have potential anti-leishmanial activities and the medicinal use of the plant poses considerable toxicity against dividing vero cells.

The principle objective of terracing is to reduce runoff and soil loss but it also contributes to increasing the soil moisture content through improved infiltration. A field experiment was conducted in Suswa, Narok County during the short and long rain seasons of 2013-2015 to assess the effect of terracing on crop yields. A randomized complete block design was used with maize and beans as the test crops. The study examined maize plant height, leaf area index (LAI), above ground biomass yields, number of bean pods and grain yields in the upper (U), upper middle (UM), middle (M), lower middle (LM) and lower (L) terrace, slope positions with farmers’ fields where terraces were not maintained were used as the control. The results showed that yields were significantly (PLM>UM>M>U, with values ranging from 7.2 t ha-1 to 3.0 t ha-1 for maize and 1374 kg ha-1 to 306 kg ha-1 for beans. Significant differences (P

Desensitization in pentameric ligand-gated ion channels plays an important role in regulating neuronal excitability. Here, we show that docosahexaenoic acid (DHA), a key ω−3 polyunsaturated fatty acid in synaptic membranes, enhances the agonist-induced transition to the desensitized state in the prokaryotic channel GLIC. We determined a 3.25 Å crystal structure of the GLIC-DHA complex in a potentially desensitized conformation. The DHA molecule is bound at the channel-periphery near the M4 helix and exerts a long-range allosteric effect on the pore across domain-interfaces. In this previously unobserved conformation, the extracellular-half of the pore-lining M2 is splayed open, reminiscent of the open conformation, while the intracellular-half is constricted, leading to a loss of both water and permeant ions. These findings, in combination with spin-labeling/EPR spectroscopic measurements in reconstituted-membranes, provide novel mechanistic details of desensitization in pentameric channels.