University of Nairobi
  • Nairobi, Nairobi City County, Kenya
Recent publications
Understanding the nature and scope of existing social capital is essential to building the resilience of people living in vulnerable urban settings. This paper explores the question of how aid organisations can better utilise social capital to build the resilience of communities in slums. It specifically examines the relationship between social capital and urban vulnerability. The study used a mixed-methods approach to understand the diverse perspectives of social capital and uncover relationships that exist between social capital, absorptive and adaptive coping strategies in Kibera and Kawangware slums in Nairobi, Kenya. The findings show that coping is not a community or a societal issue; people living in slums resort to either absorptive or adaptive coping strategies or a combination of both due to the precariousness of livelihoods in such contexts. Measures of bonding, bridging, and linking social capital in slums are significantly associated with adaptive coping strategies. Families that had more dependents, were taking care of ill members or that had no regular source of income were more likely to resort to withdrawing children from school, begging, selling assets, amongst others. Livelihood studies overlook critical aspects of social capital such as bridges and linkages, which are essential for building the transformative capacities of slum dwellers. Therefore, aid actors should focus on social capital if they are to build the capacities of people living in slums. More attention should be given to the role of local organisations and initiatives in establishing bridges and linkages so as not to undermine communities’ existing capacities and resource base.
Objective To disseminate the portable sequencer MinION in developing countries for the main purpose of battling infectious diseases, we found a consortium called Global Research Alliance in Infectious Diseases (GRAID). By holding and inviting researchers both from developed and developing countries, we aim to train the participants with MinION’s operations and foster a collaboration in infectious diseases researches. As a real-life example in which resources are limited, we describe here a result from a training course, a metagenomics analysis from two blood samples collected from a routine cattle surveillance in Kulan Progo District, Yogyakarta Province, Indonesia in 2019. Results One of the samples was successfully sequenced with enough sequencing yield for further analysis. After depleting the reads mapped to host DNA, the remaining reads were shown to map to Theileria orientalis using BLAST and OneCodex. Although the reads were also mapped to Clostridium botulinum, those were found to be artifacts derived from the cow genome. An effort to construct a consensus sequence was successful using a reference-based approach with Pomoxis. Hence, we concluded that the asymptomatic cow might be infected with T. orientalis and showed the usefulness of sequencing technology, specifically the MinION platform, in a developing country.
Background Elastography is an addition to grey-scale ultrasonic examination that has gained substantial traction within the last decade. Strain ratio (SR) has been incorporated as a semiquantitative measure within strain elastography, thus a potential imaging biomarker. The World Federation for Ultrasound in Medicine and Biology (WFUMB) published guidelines in 2015 for breast elastography. These guidelines acknowledge the marked variance in SR cut-off values used in differentiating benign from malignant lesions. The objective of this review was to include more recent evidence and seek to determine the optimal strain ratio cut off value for differentiating between benign and malignant breast lesions. Methods Comprehensive search of MEDLINE and Web of Science electronic databases with additional searches via Google Scholar and handsearching set from January 2000 to May 2020 was carried out. For retrieved studies, screening for eligibility, data extraction and analysis was done as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Diagnostic Test Accuracy (PRISMA-DTA) Statement guidelines of 2018. Quality and risk of bias assessment of the studies were performed using the revised Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool. Results A total of 424 articles, 412 from electronic database and 12 additional searches were retrieved and 65 studies were included in the narrative synthesis and subgroup analysis. The overall threshold effect indicated significant heterogeneity among the studies with Spearman correlation coefficient of Logit (TPR) vs Logit (FPR) at − 0.301, p -value = 0.015. A subgroup under machine model consisting seven studies with 783 patients and 844 lesions showed a favourable threshold, Spearman’s correlation coefficient,0.786 ( p = 0.036). Conclusion From our review, currently the optimal breast SR cut-off point or value remains unresolved despite the WFUMB guidelines of 2015. Machine model as a possible contributor to cut-off value determination was suggested from this review which can be subjected to more industry and multi-center research determination.
Background Rheumatic heart disease (RHD) remains a major source of morbidity and mortality in developing countries. A deeper insight into the pathogenetic mechanisms underlying RHD could provide opportunities for drug repurposing, guide recommendations for secondary penicillin prophylaxis, and/or inform development of near-patient diagnostics. Methods We performed quantitative proteomics using Sequential Windowed Acquisition of All Theoretical Fragment Ion Mass Spectrometry (SWATH-MS) to screen protein expression in 215 African patients with severe RHD, and 230 controls. We applied a machine learning (ML) approach to feature selection among the 366 proteins quantifiable in at least 40% of samples, using the Boruta wrapper algorithm. The case–control differences and contribution to Area Under the Receiver Operating Curve (AUC) for each of the 56 proteins identified by the Boruta algorithm were calculated by Logistic Regression adjusted for age, sex and BMI. Biological pathways and functions enriched for proteins were identified using ClueGo pathway analyses. Results Adiponectin, complement component C7 and fibulin-1, a component of heart valve matrix, were significantly higher in cases when compared with controls. Ficolin-3, a protein with calcium-independent lectin activity that activates the complement pathway, was lower in cases than controls. The top six biomarkers from the Boruta analyses conferred an AUC of 0.90 indicating excellent discriminatory capacity between RHD cases and controls. Conclusions These results support the presence of an ongoing inflammatory response in RHD, at a time when severe valve disease has developed, and distant from previous episodes of acute rheumatic fever. This biomarker signature could have potential utility in recognizing different degrees of ongoing inflammation in RHD patients, which may, in turn, be related to prognostic severity.
Orthogonal frequency division multiplexing (OFDM) continues to be the most preferred signal-multiplexing scheme for high-speed data communication. However, OFDM signals are known to have the problem of high peak-to-average power ratio (PAPR), especially when the number of subcarriers is large, which leads to nonlinear amplification in the high power amplifier and consequently to bit-error rate degradation and out-of-band radiation. In this paper, we propose a new optimal tone reservation method for reducing high PAPR in OFDM signals in order to avoid nonlinear amplification effects. The method employs Chebyshev-norm minimization to determine peak-reduction coefficients for OFDM signal. Simulation results show that the proposed method can achieve high PAPR reduction at the expense of a small loss in data rate and a slight increase in average transmit power. For example, with 4 out of 64 subcarriers reserved for peak-reduction coefficients, which represents 6.25% data-rate loss, the method can achieve 4.06 dB of PAPR reduction with only a 0.46 dB increase in average transmit power. Similarly, when 8 subcarriers or 12.5% of the total number of subcarriers are reserved, a PAPR reduction of 5.75 dB is achieved with a paltry 0.19 dB rise in transmit power.
Rift Valley fever (RVF) is a zoonotic disease which leads to livestock losses and human fatalities, thus impoverishing pastoralists who largely depend on livestock for their livelihood. These losses lead to both short- and long-term effects that perpetuate poverty and disrupt family order and structure. We used qualitative methods to understand the lived experiences of pastoralists with RVF after a major outbreak in Kenya. Using narratives, we identified the social, economic and psychological effects of this disease, while focus group discussions helped us to understand the experiences of the pastoralists during and after an outbreak. The major impacts were deprivation and impoverishment, abrupt disruption to their way of life and family dynamics and mistrust of the formal healthcare system. The latter was related to the isolation of patients and the presence of foreign medical personnel in the area that fueled mistrust. Efforts need to be made by public health practitioners and policy-makers to enhance dialogue between clinicians and pastoralists and to come up with practical ways of improving local people’s livelihoods during and after an RVF epidemic.
Introduction Trauma is a leading cause of morbidity and mortality in Kenya. In many countries, substance use is common among patients presenting with injuries to an emergency center (EC). Objective To describe the epidemiology of self-reported substance use among adult injured patients seeking ED care in Nairobi, Kenya. Methods This prospective cross-sectional study, assessed patients presenting with injuries to the Kenyatta National Hospital ED in Nairobi, Kenya from March through June of 2021. Data on substance use, injury characteristics and ED disposition were collected. Substances of interest were alcohol, stimulants, marijuana, and opiates. The Alcohol Use Disorders Identification Test-Concise (AUDIT-C) tool was used to characterize hazardous alcohol use. Results A total of 1,282 patients were screened for participation, of which 646 were enrolled. Among participants, 322 (49.8%) reported substance use in the past month (AUDIT-C positive, stimulants, opiates, and/or marijuana). Hazardous alcohol use was reported by 271 (42.0%) patients who screened positive with AUDIT-C. Polysubstance use, (≥2 substances) was reported by 87 participants in the past month. Median time from injury to ED arrival was 13.1 h for all enrolees, and this number was significantly higher among substance users (median 15.4 h, IQR 5.5 - 25.5; p = 0.029). Conclusions In the population studied, reported substance use was common with a substantial proportion of injured persons screening positive for hazardous alcohol use. Those with substance use had later presentations for injury care. These data suggest that ED programming for substance use disorder screening and care linkage could be impactful in the study setting.
Study region This study focuses on urban flood modeling in developing cities with a special focus on informal settlements giving a specific case study of Mukuru slums in Nairobi city of Kenya. Informal settlements refer to unplanned settlements and areas where the housing doesn’t comply with the current housing codes and regulations and is thus characterized by a lack of legal settlement and housing plan approvals resulting in poor physical infrastructures and social services. Urban flood risks have been given less attention compared to rural riverine flooding in developing cities yet they cause more havoc. Using the appropriate set of models, flood modeling in urban settings is critical in integrated flood risk management. Study focus This study uses a desk review format to promote urban flood modeling knowledge and practice in integrated flood risk management in developing cities. In this regard, the study presents the review of various flood models highlighting their strengths and weaknesses and the significant role of model calibrations in addressing uncertainties while capturing the local scenarios. The paper further presents the role of model stacking where different models are used to understand the same hazard evolution at various scales. New hydrological insights for the region As developing cities grow, so do the flood risks, especially in the informal settlement. This study reveals the importance of comprehensively understanding the flood dynamics at various scales. The study points out the important role of model stacking and calibrations which allows the understanding of flood risks at various city scales for an integrated city flood risk management.
Efficient materials with good optoelectronic properties are required for the good performance of photovoltaic devices. In this work, we present findings of a theoretical investigation of the structural, electronic, elastic, mechanical, and optical properties of K2CuX (X = As, Sb) ternary compounds. The computations were carried out by using the density functional theory (DFT) formalism as implemented in the quantum espresso (QE) software package. The calculated lattice constants of 19.1414 a.u (K2CuAs) and 20.0041 a.u (K2CuSb) are in agreement with the experimental results from the literature. The materials under study were found to have bandgaps of 1.050 eV (K2CuAs) and 1.129 eV (K2CuSb). The valence band was majorly formed by Cu-3d, As-2p, and Cu-4s states while the conduction band was majorly dominated by Cu-5p in K2CuAs, whereas in K2CuSb, the valence band was mainly formed by Cu-3d, Cu-4s, and Sb-3p states while the conduction band was majorly formed by Sb-3p and Cu-5p states. The investigated materials were found to be mechanically stable at zero pressure, ductile, and ionic. The optical absorption coefficient curves were found to cover the ultraviolet to visible (UV-Vis) regions, thus making K2CuAs and K2CuSb good UV-Vis absorbers hence their suitability for photovoltaic applications.
Poster session 3, September 23, 2022, 12:30 PM - 1:30 PM Introduction: Water is a very vital natural resource for all life on earth as it is used widely. Water plays an important role in the world economy, the uses can be categorized into; commercial use where it is used in hostels, restaurants, offices, and other commercial activities. Fungi are ubiquitous in nature; they produce spores that are small-sized, able to stay airborne for a long duration, and transported over long distances during air dispersal. These are major sources of allergens and airway irritants that are detrimental to health. Biofilms in water distribution systems and storage containers provide favorable habitat for microorganisms as they accumulate better in solid-liquid interfaces that enable them to be embedded in the gelatinous matrix of extracellular polymers excreted by the microorganisms leading to resistance of microbes from environmental stresses. Fungi hydrophobicity and adaptability have enabled them to assemble and colonize different surfaces in domestic settings. The potential health effects caused by fungi in treated water are still not well highlighted and thus the need to carry out this study to investigate the mycoflora isolated from stored water. Methods This was a cross-sectional study conducted from 2019-2021, whereby 120 water samples were collected from stored containers in households in Nairobi county Kenya. The fungal strains were plated onto Sabouraud's dextrose agar (SDA), Potato Dextrose Agar, and Czapecks Agar media with chloramphenicol (0.05 mg/mL) (Oxoid, U.K.). The plates were incubated for 7 days at 25°C. Fungal identification was done by direct microscopy and morphological features. Results A total of 101 fungal species were isolated from water samples. Yeasts 48 (47.5%), Rhodotorula 34 (33.6%) accounted for the unicellular fungi. Among Filamentous mycoflora, the most common isolated fungi were Aspergillus species 13(12.8%), followed by Fusarium spp 4 (3.9%) with Mucor and |Rhizopus species accounting for 1 (0.9%) respectively. Yeasts species were the most common species isolated from water species and Aspergillus species were more frequently isolated from filamentous fungi. Conclusion Yeasts species were the most common species isolated from water species and the roles they play in biofilm needs to be further investigated.
Taking holistic actions to improve urban air quality is central to reducing the health risks associated with urbanisation, yet local evidence-based and institutional frameworks to achieve this are still challenging especially in many low-and middle-income countries (LMICs). This paper develops and applies an integrated systemic approach to explore the state of air quality management in Nairobi, Kenya; as an LMIC exemplar city. The urban diagnostics approach developed assesses current particulate matter air pollution in Nairobi; quantifies anthropogenic emissions for the years 2015 and 2020 and projects scenarios of impacts of actions and inactions to 2030. This was combined with a review of grey literature on air quality policies, urban development and interviews with key stakeholders. The analysis suggests that commendable progress has been made to improve air quality in Nairobi but continuing hazardous levels of air pollution still require concerted policy efforts. Data available for numerical simulations have low spatial resolution and are generated from global emission inventories that can miss or misrepresent local emission sources. The current air quality data gap that needs to be addressed are highlighted. Strong political support is required to ensure that current air quality improvement approaches are evidence based to achieve long-term sustainability goals.
Zinc deficiency is common among children with Moderate Acute Malnutrition (MAM) and contributes to growth failure, increased morbidity and mortality. Diarrhoea and poor dietary practices are the main causes of zinc deficiency. Corn-soy Blend (CSB), the standard product in management of children with MAM has a limitation of poor micronutrient bioavailability. Micronutrient powders (MNPs) which are added at the point of consumption have a potential in improving micronutrient status however, scientific evidence on efficacy on improving the zinc status is scarce. A cluster-randomized clinical trial was designed to establish bioequivalence of MNPs to CSB on serum zinc status among children (6–36 months) with MAM in Thika informal settlements, Kenya. Sample size was calculated to show bioequivalence within ±20% limit. Twelve villages were randomized to four study groups. Three experimental groups received different formulations of MNPs added to unfortified CSB porridge as; multiple micronutrients containing zinc (CSB-MNP-A n = 84), multiple micronutrients without zinc (CSB-MNP-B n = 88) and zinc only (CSB-MNP-C n = 94). Control group (n = 80) received standard CSB fortified with multiple micronutrients. Standard amount of CSB was consumed in feeding centres for six months. Serum zinc concentration was assessed pre- and post-intervention. Data was analyzed based on treatment assignment regardless of adherence and drop-out status. Mixed effects linear regression was used to model pre-post change in serum zinc concentration, adjusting for clustering effect and baseline differences. Bioequivalence was assessed using two one-sided t-tests. At baseline, 84.4% were zinc deficient (serum zinc
The media is an important source of public information with mass media particularly playing a key role in times of crises and disasters. The role played by the media becomes even more crucial when there is a global pandemic such as COVID-19. In the wake of an outbreak, the media has the critical role of passing information, reporting, and raising awareness. In Kenya, vernacular radio stations have an important responsibility of disseminating information to a wide section of the citizenry in vernacular languages. COVID-19 being a new pandemic, brings with it new concepts and terminology which may not be readily available in vernacular languages, but which vernacular radio stations must report and create awareness about in local languages. On one hand, this makes information available to everyone, especially those who do not understand English, which is the language that the Government of Kenya and many non-governmental bodies use to communicate about the disease. On the other hand, an attempt by these vernacular radio stations to explain this new disease in vernacular languages by translating concepts related to it often results in reportage that carries misconceptions about the disease that may lead to either downplaying the gravity of the pandemic or unnecessary panic escalation. Based on the results of content analysis of the various radio programmes, interviews and focus group discussions with radio presenters, this chapter discusses how community vernacular radio stations reported on the Corona Virus Disease, by examining the techniques the presenters used in translating novel, specialised, and technical vocabulary related to COVID-19, the losses of meaning brought about by these techniques and how this encouraged or discouraged behaviour change among listeners. It recommends a more pragmatic and communicative approach to medical translation in general, and to the pandemic in particular, as a means of ensuring that not much is lost during the translation process.KeywordsCOVID-19Translation strategiesMeaning lossBehaviour change
Background Foot-and-Mouth Disease Virus (FMDV) is a positive-sense RNA virus of the family of the picornaviridæ that is responsible for one of the livestock diseases with the highest economic impact, the Foot-and-Mouth Disease (FMD). FMD is endemic in Rwanda but there are gaps in knowing its seroprevalence and molecular epidemiology. This study reports the FMD seroprevalence and molecular characterization of FMDV in Eastern Rwanda. Results The overall seroprevalence of FMD in the study area is at 9.36% in cattle and 2.65% in goats. We detected FMDV using molecular diagnostic tools such as RT-PCR and RT-LAMP and the phylogenetic analysis of the obtained sequences revealed the presence of FMDV serotype SAT 2, lineage II. Sequencing of the oropharyngeal fluid samples collected from African buffaloes revealed the presence of Prevotela ruminicola, Spathidium amphoriforme, Moraxella bovoculi Onchocerca flexuosa, Eudiplodinium moggii, Metadinium medium and Verrucomicrobia bacterium among other pathogens but no FMDV was detected in African buffaloes. Conclusions We recommend further studies to focus on sampling more African buffaloes since the number sampled was statistically insignificant to conclusively exclude the presence or absence of FMDV in Eastern Rwanda buffaloes. The use of RT-PCR alongside RT-LAMP demonstrates that the latter can be adopted in endemic areas such as Rwanda to fill in the gaps in terms of molecular diagnostics. The identification of lineage II of SAT 2 in Rwanda for the first time shows that the categorised FMDV pools as previously established are not static over time.
The advent of minimal pain tumescent local anesthesia injection has improved patient safety by eliminating the need for sedation for many wide awake operations, especially in patients with significant medical comorbidities. Modified radical mastectomy (MRM) for breast cancer is commonly performed under general anesthesia as it requires the dissection of the entire breast and an ipsilateral axillary lymph node dissection (ALND). General anesthesia has been shown to have a high risk in patients with severe medical comorbidities. We present a case of a 78-year-old male patient who was diagnosed with invasive ductal breast carcinoma, cardiac failure, and other metabolic abnormalities. Taking his comorbidities into account, we performed a wide awake MRM and ALND after tumescent minimal pain local anesthesia injection. The patient experienced the successful procedure safely with minimal discomfort.
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