Impact of traffic, poverty and facility ownership on travel time to emergency care in Nairobi, Kenya

Background: In many low and middle-income countries (LMICs), timely access to emergency healthcare services is limited. In urban settings, traffic can have a significant impact on travel time, leading to life-threatening delays for time-sensitive injuries and medical emergencies. In this study, we examined travel times to hospitals in Nairobi, Kenya, one of the largest and most congested cities in the developing world. Methods: We used a network approach to estimate average minimum travel times to different types of hospitals (e.g. ownership and level of care) in Nairobi under both congested and uncongested traffic conditions. We also examined the correlation between travel time and socioeconomic status. Results: We estimate the average minimum travel time during uncongested traffic conditions to any level 4 health facility (primary hospitals) or above in Nairobi to be 4.5 min (IQR 2.5­6.1). Traffic added an average of 9.0 min (a 200% increase). In uncongested conditions, we estimate an average travel time of 7.9 min (IQR 5.1­10.4) to level 5 facilities (secondary hospitals) and 11.6 min (IQR 8.5­14.2) to Kenyatta National Hospital, the only level 6 facility (tertiary hospital) in the country. Traffic congestion added an average of 13.1 and 16.0 min (166% and 138% increase) to travel times to level 5 and level 6 facilities, respectively. For individuals living below the poverty line, we estimate that preferential use of public or faith-based facilities could increase travel time by as much as 65%. Conclusion: Average travel times to health facilities capable of providing emergency care in Nairobi are quite low, but traffic congestion double or triple estimated travel times. Furthermore, we estimate significant disparities in timely access to care for those individuals living under the poverty line who preferentially seek care in public or faith-based facilities

AutoBT: A new Paradigm in Periodontal regeneration

Background: Autogenous bone is an ideal material for the reconstruction of hard tissue defects, because it promotes osteogenesis, osteo-induction and osteo-conduction. The use of AutoBT, a novel bone grafting material produced from autogenous teeth, resulted in excellent bone healing based on an analysis of its inorganic components, surface structure and histologic evidence of the healing process.Materials & Methods: Ten sites were included using the following inclusion criteria. Inclusion criteria: One or more sites showing intra-bony defect with probing pocket depth (PPD) ≥ 5mm, clinical attachment loss of ≥ 3mm, 2 or 3 wall intra-bony defects with radiographic defect of size ≥ 3 mm & in same patient mobile teeth indicated for extraction. In test group, among 5 sites, regenerative treatment was performed using tooth as autograft along with chorion membrane & in control group, 5 sites were treated with demineralized freeze-dried bone allograft (DFDBA) with chorion membrane. Clinical parameters such PPD, CAL were evaluated at baseline, 3 & 6 months & radiographic parameters at baseline & after 6 months of treatment.Results: The patients treated by tooth as autoBT material with chorion membrane showed non- significant results to DFDBA with chorion membrane in intra-bony defects in all the clinical parameters. So AutoBT can be used as a useful alternative to DFDBA in periodontal regenerative therapy for intra-bony defects.

Development and evaluation of a low-cost amaranth (Amaranthus cruentus) containing food for preschool children

Se elaboró una mezcla en polvo para la alimentación de niños preescolares, partiendo de semilla integral de amaranto (Amaranthus cruentus), avena perlada, frijol de soya, sacarosa y aceite vegetal. Se encontró que la mezcla era semejante en análisis químico proximal y contenido calórico total, e idéntica en patrón de distribución de calorías y contenido de vitaminas y minerales, a una fórmula infantil de soya y avena previamente desarrollada. La mezcla de amaranto igualó al patrón FAO/OMS 1973 para niños en su contenido de triptofano, y excedió a este patrón y a la fórmula de soya y avena en todos los otros aminoácidos esenciales; la misma mezcla reflejó un PER corregido mayor que los de la caseína, y la fórmula de soya y avena. En pruebas de alimentación con niños de 1 - 3 años de edad, no se detectó diferencia significativa en aumento de peso, obtenido por los dos productos. El costo anticipado de la mezcla de amaranto es 6% menor que el de la fórmula de soya y avena