Results No significant difference in creatinine clearance over time was observed between patients with CYP3A5*1 allele and patients without CYP3A5*1 allele, suggesting that the degrees of recovery in ...renal function after living kidney transplantation are similar in the two groups.
There is a growing interest in protein supplementation of dairy-cow diets using leguminous shrubs. The study objective was to ascertain the association between diet supplementation with Calliandra ...calothyrsus and Sesbania sesban and milk production in dairy cattle on commercial smallholder farms. This trial involved 235 cows from 80 smallholder dairy farms in Kenya randomly allocated to 4 intervention groups: (1) receiving Calliandra and Sesbania and nutritional advice; (2) receiving reproductive medicines and advice; (3) receiving both group 1 and 2 interventions; and (4) receiving neither intervention. Farm nutritional practices and management data were collected in a questionnaire, and subsequent physical examinations, mastitis tests, and milk production of cows on the farm were monitored approximately monthly for 16 months. Descriptive and univariable statistical analyses were conducted, and multivariable mixed-model regression was used for identification of factors associated (P<0.05) with daily milk production. The mean milk production was 6.39 liters/cow/day (SD = 3.5). Feeding Calliandra/Sesbania to cows was associated (P<0.0005) with an increase in milk produced by at least 1 liter/cow/day with each kg fed. Other variables positively associated with ln daily milk production in the final model included feeding of Napier grass, amount of silage and dairy meal fed, body condition score, and appetite of the cow. Other variables negatively associated with ln daily milk production in the final model included amount of maize germ fed, days in milk, sudden feed changes, pregnancy, and subclinical mastitis. In conclusion, our field trial data suggest that use of Calliandra/Sesbania through agroforestry can improve milk production in commercial smallholder dairy farms in Kenya. Agroforestry land use systems can be adopted as a way for dairy farmers to cope with feed shortages and low crude protein in farm-available feeds for their cows.
Tomato (Solanum lycopersicon) is among the most consumed vegetables across the globe. In most parts of Kenya, tomato production is characterized by low quality and huge losses due to pests and ...diseases. The most prevelance tomato diseases are caused by bacteria and fungi, most common being bacterial wilt. This study determined the prevalence of Ralstonia solanacearum in tomato farms in Meru South sub-county. The Prevalence of bacterial wilt was carried out by conducting a survey across agroecological zones in Meru South. Study farms were randomly selected. Data on the frequency of occurrence, severity, and impacts of the disease were collected by observation and administration of questionnaires to the farmers. The study broadens the understanding of R. solancaerum prevalence in Meru South sub-county.
Child mortality rates during hospitalisation for acute illness and after discharge are unacceptably high in many under-resourced settings. Childhood vulnerability to recurrent illness, and death, is ...linked to their families' situations and ability to make choices and act (their agency). We examined vulnerability and agency across treatment-seeking journeys for acutely ill children and considered the implications for policy and practice.
A qualitative sub-study was embedded within the prospective CHAIN Network cohort study, which is investigating mechanisms of inpatient and post-hospital discharge mortality among acutely ill young children across a spectrum of nutritional status. Primary data were collected from household members of 20 purposively selected cohort children over 18 months through formal interviews (total n = 74), complemented by informal discussions and observations. Data were analysed using narrative and thematic approaches.
Treatment-seeking pathways were often long and complex, particularly for children diagnosed as severely malnourished. Family members' stories reveal that children's carers, usually mothers, navigate diverse challenges related to intersecting vulnerabilities at individual, household and facility levels. Specific challenges include the costs of treatment-seeking, confusing and conflicting messaging on appropriate care and nutrition, and poor continuity of care. Strong power inequities were observed between family members and health staff, with many mothers feeling blamed for their child's condition. Caregivers' agency, as demonstrated in decision-making and actions, often drew on the social support of others but was significantly constrained by their situation and broader structural drivers.
To support children's care and recovery, health systems must be more responsive to the needs of families facing multiple and interacting vulnerabilities. Reducing incurred treatment costs, improving interpersonal quality of care, and strengthening continuity of care across facilities is essential. Promising interventions need to be co-designed with community representatives and health providers and carefully tested for unintended negative consequences and potential for sustainable scale-up.
The growth rate of female calves on dairy farms is one of the crucial factors which influence age at first calving, affecting lifetime lactation productivity of a dairy cow. Diets with adequate crude ...protein are necessary to support calf growth. The study objective was to determine the effects of nutritional advice and diet supplementation with Calliandra calothyrsus and Sesbania sesban on average daily weight gain in dairy calves on semi-commercial smallholder dairy farms in Kenya. This trial involved 155 calves from 73 smallholder dairy farms, in Kenya, randomly selected and allocated to either intervention or control groups. The intervention group received nutritional advice and seedlings of Calliandra calothyrsus and Sesbania sesban, while the control group did not receive these interventions. Every 1–2 months for 16 months, data on farm nutritional practices and management were collected in a questionnaire, and physical examinations were done to monitor weight and health status. Descriptive and univariable statistical analyses were conducted, and multivariable mixed linear regression models were used for identification of factors associated (P < 0.05) with the natural log transformation of weight gain of calves on a given farm, controlling for clustering of visits within calves. Feeding at least 0.2 kg/day (wet weight) of Calliandra or Sesbania to calves <6 months old resulted in 33.2% increase in daily weight gain, while controlling for confounding by breed and sex of the calf. For calves ≥6 months, there was a significant interaction between amount of hay fed and if calves were also fed on Calliandra or Sesbania. When no Calliandra or Sesbania supplementation was provided, the mean weight gain was low and relatively constant even with increasing amounts of hay. When Calliandra or Sesbania supplement was added to the diet, the mean weight gain increased from 0.17 kg to 0.48 kg when hay was fed at 1 and 5 kg, respectively, while controlling for confounding by amount of maize silage fed and the prevailing season. In conclusion, supplementation of calf diets with at least 0.2 kg/calf/day of Calliandra or Sesbania is beneficial for faster weight gains.
A study was conducted to determine soil organic carbon stocks (SOCs), total nitrogen (TN) and available phosphorous (AP) changes in agricultural land use practices with a focus on maize and coffee ...based agricultural systems along Kapingazi river catchment in Embu County. Demarcation was done into four agro-ecological zones (AEZ) following the river downstream; Lower Highland Zone 1 LH1; Upper Midland Zone 1, UM1; Upper Midland Zone 2, UM2; Upper Midland Zone 3, UM3. Soil samples were obtained from two depths of 0-25 cm and 25-50 cm across slope positions. The soil organic carbon stocks were high in LH1 at 58.38 kg/m2 whereas UM3 had least amount at 29.48 kg/m2. The total nitrogen was higher in LH1 at 0.27% while least at UM3 with 0.07%. The LH1 had higher mean amount of available phosphorous at 19.44 ppm and least at UM3. The coffee agricultural system had more available phosphorous in LH1 at 23.75 ppm whereas maize had more in UM1, UM2 and UM3. The soil organic carbon stocks, available phosphorous and total nitrogen decreased across the AEZ. The Farm Foot Slope sampling point had high soil organic carbon stocks with the lowest amounts in the Farm Summit sampling point at both depths. The concentration of total nitrogen in coffee was high in all slope positions, whereas, available phosphorous was higher in maize. Therefore, it is concluded that topography and agriculture land use and management practices influence soil nutrient status.
Calf growth is an important determinant of dairy herd productivity, particularly in countries where the dairy industry is expanding, such as Kenya. Our objective was to determine factors associated ...with weight gain in randomly selected dairy calves and heifers in smallholder dairy farms (SDF) in Kenya.
A cross-sectional study on a census of 321 calves and heifers (dairy calves and heifers up to 36 months of age), sampled from 200 randomly selected SDF in Naari, Kenya, formed the study population. Youngstock management was recorded using a questionnaire. Biodata were obtained through subsequent physical examination and heart girth measurement. Descriptive statistical analyses were conducted, and mixed model regression was used for identification of factors associated (p < 0.05) with the natural log transformation of estimated average daily weight gain (ADG).
Median and mean ADG of the youngstock were 360 and 443 (s.d. = 375) g day−1, respectively. In the final model, ADG was highest in pre-weaned calves and declined with age. Supplementing with quality hay during the dry season at least weekly was associated with increased ADG. There was an interaction between breed and historical disease on ADG such that disease was associated with decreased ADG in Bos taurus breeds, while ADG in Bos indicus breeds was not affected by disease. There was a significant interaction between education levels of the husband and wife caretakers; when the man’s education was low (having less than or equal to primary school), ADG was highest when the woman had not completed primary school, but was lower when the woman had completed primary, secondary or tertiary education, possibly because such women worked off-farm more often.
General growth performance of animals on these farms was lower than benchmarked standards recommended for optimum dairy production but within previously reported ranges for the East African region. Supplementation of diets (with hay and/or concentrates) is recommended for optimum growth in calves and heifers, especially in the dry season. If nutritional management of Bos taurus youngstock is not improved, crosses of Bos indicus could be better suited for the current nutritional management systems in SDF in Meru having calf disease problems. Interventions to support educating women (the primary caretakers of the cattle) and men in the community on calf management should be initiated, preferably with shared on-farm responsibilities. Training in better management, even for learned farmers, would be critical to better calf growth.
Breast cancer remains the most commonly diagnosed cancer among women, affecting 34 women per every 100,000. This has led to high number of fatalities annually, which need to be mitigated. ...Establishing alternative conventional therapies such as working on mindfulness-based stress (MBS) may be a good alternative to improve prognosis and survival rate of breast cancer patients. However, there is little information on the effects of MBS factors on breast cancer survival. The objective of this study is to predict the effect of MBS factors on breast cancer survival rate among women in Meru and Nyeri Counties using Cox Proportional Hazard Model. Both primary data and secondary data were used. Primary data was obtained using a structured questionnaire from the breast cancer survivors and the medical practioners, while secondary data was obtained from records at Meru teaching and referral hospital and Nyeri level five hospital for the period 2012 to 2017. The MBS variables included cost burden of treatment, stress on diagnosis, prolonged time taken to access treatment, poor diet, alcohol use, physical activity and lack of awareness. . This study used mixed method research design. Data obtained were analysed using R software. Kaplain-Meier estimators were used to estimate the varying effects of MBS factors on survival rate. Log-rank test was used to perform comparisons of survival curves on the patients’ survival rate considering age. The likelihood ratio test showed that MBS factors are significant in predicting hazard rates ( X2= 66.7, p = 0.0000119). Treatment period, lack of awareness, ease of coping with stress and observing the right diet were also found to significantly (p < 0.05) affect breast cancer survival rate. Access of treatment immediately after diagnosis, availing the right information to the patients, helping patients to cope easily with stress and observing the right diet were found to be the best estimators in increasing breast cancer survival rate. The study showed the importance of using model in predicting breast cancer survival rates, which can greatly improve breast cancer prognosis.
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