The use and profitability of hermetic technologies for grain storage among smallholder farmers in eastern Kenya.

Hermetic storage technologies (HSTs) have been disseminated in Sub-Saharan Africa (including Kenya) to reduce grain storage losses among farmers. We carried out a study in three counties in eastern Kenya to assess the use and profitability of HSTs among farmers. Data were collected from 613 farmers using a semi-structured questionnaire and Kobo Toolbox via android tablets. Results showed an increase in use of HSTs among farmers from 53.7% in 2015 to 91.2% in 2017. PICS was the most used hermetic bags by farmers (84%) in 2017. Majority of farmers (73.5%) received training in the use of HSTs from extension agents and agro-dealers. About 40% of respondents purchased additional (one to five) bags after their first experience using them. The quantity of grain produced made up about half of the farmer's decision to store. The primary reason (87%) farmers used hermetic bags was the need to manage insect pests. Maize and beans were the most produced and most stored crops; but maize was the most stored in HST. Grain price seasonality showed a near doubling effect between the lean and harvest seasons. Estimates of the return on investments (ROI) ranged between 13 and 80% for all crops and maize stored in hermetic bags had the highest ROI. Awareness and trainings are key in increasing adoption and proper use of HSTs.

Effects of Hermetic Storage on Adult Sitophilus oryzae L. (Coleoptera: Curculionidae) Acoustic Activity Patterns and Mortality.

Hermetic storage is of interest to farmers and warehouse managers as a method to control insect pests in small storage facilities. To develop improved understanding of effects of hermetic storage on insect pest activity and mortality over time, oxygen levels, acoustic signals, and observations of visual movement were recorded from replicates of 25, 50, and 100 adult Sitophilus oryzae (L.) (Coleoptera: Curculionidae) hermetically sealed in 500- and 1,000-ml glass jars. Recordings were done for 28 d; twice daily for the first 6 d and twice weekly thereafter. Insect sounds were analyzed as short bursts (trains) of impulses with spectra that matched average spectra (profiles) of previously verified insect sound impulses. Oxygen consumption was highest in treatments of 100 insects/500-ml jar and lowest in 25/1000-ml jars. The rates of bursts per insect, number of impulses per burst, and rates of burst impulses per insect decreased as the residual oxygen levels decreased in each treatment. Activity rates <0.02 bursts s-1, the acoustic detection threshold, typically occurred as oxygen fell below 5%. Mortality was observed at 2% levels. The time to obtain these levels of insect activity and oxygen depletion ranged from 3-14 d depending on initial infestation levels. Acoustic detection made it possible to estimate the duration required for reduction of insect activity to levels resulting in negligible damage to the stored product under hermetic conditions. Such information is of value to farmers and warehouse managers attempting to reduce pest damage in stored crops.

Scaling up Non-Communicable Disease Control: Lessons to be learnt from the Infectious Disease Paradigm in Kenya

Non-communicable diseases (NCD) are emerging as the leading cause of morbidity and mortality globally; with the greatest rise in incidence of cardiovascular disease cases observed in Sub-Saharan Africa. This is in addition to the heavy burden of infectious diseases already present in this setting.Describing the cross-cutting epidemiology of NCDs and infectious diseases with focus on the interaction between tuberculosis and diabetes mellitus; HIV and cardiovascular disease; HIV and cervical cancer as well as assessing the disparities in funding and service delivery systems between NCDs and infectious diseases; we review this rising double burden of infectious and non-infectious diseases and propose four lessons that can be learnt from the HIV response and adapted to inform the scale up of NCD control in Kenya which are also applicable in other African countries

Triple-Layer Plastic Bags Protect Dry Common Beans (Phaseolus vulgaris) Against Damage by Acanthoscelides obtectus (Coleoptera: Chrysomelidae) During Storage.

Fumigated dry common beans (Phaseolus vulgaris L.) that were artificially infested with Acanthoscelides obtectus Say, and others that were not artificially infested, were stored in hermetic triple-layer PICS (Lela Agro, Kano, Nigeria) or woven polypropylene (PP) bags for 6 mo at ambient laboratory temperature conditions of 22.6 ± 1.9°C and 60.1 ± 4.3% relative humidity. In an additional trial, beans contained in PP bags were treated with Actellic Super dust before introducing A. obtectus. Moisture content, number of live adult A. obtectus, seed damage, weight loss, and seed germination were determined at monthly intervals. At 6 mo, beans stored in PICS bags retained higher moisture than those stored in PP bags, but in all treatments the moisture level remained below that recommended for safe storage of beans. In the PICS bags, proliferation of A. obtectus did not proceed and at 6 mo, beans stored in these bags did not have insect-inflicted seed damage or weight loss. In contrast, seed damage and weight loss in PP bags exceeded economic threshold after 1 mo in the absence of Actellic Super dust (Syngenta Crop protection AG, Basle, Switzerland), and after 2 mo in the presence of it. Germination of beans stored in PP bags decreased greatly whereas the beans stored in PICS bags did not show reduced germination. Chemical free storage of common beans in PICS bags protects them against damage by A. obtectus.

T cell anergy and activation are associated with suboptimal humoral responses to measles revaccination in HIV-infected children on anti-retroviral therapy in Nairobi, Kenya.

HIV-infected children are less capable of mounting and maintaining protective humoral responses to vaccination against measles compared to HIV-uninfected children. This poses a public health challenge in countries with high HIV burdens. Administration of anti-retroviral therapy (ART) and revaccinating children against measles is one approach to increase measles immunity in HIV-infected children, yet it is not effective in all cases. Immune anergy and activation during HIV infection are factors that could influence responses to measles revaccination. We utilized a flow cytometry-based approach to examine whether T cell anergy and activation were associated with the maintenance of measles-specific immunoglobulin (Ig)G antibodies generated in response to measles revaccination in a cohort of HIV-infected children on ART in Nairobi, Kenya. Children who sustained measles-specific IgG for at least 1 year after revaccination displayed significantly lower programmed cell death 1 (PD-1) surface expression on CD8(+) T cells on a per-cell basis and exhibited less activated CD4(+) T cells compared to those unable to maintain detectable measles-specific antibodies. Children in both groups were similar in age and sex, CD4(+) T cell frequency, duration of ART treatment and HIV viral load at enrolment. These data suggest that aberrant T cell anergy and activation are associated with the impaired ability to sustain an antibody response to measles revaccination in HIV-infected children on ART.

SCALING UP NON-COMMUNICABLE DISEASE CONTROL: LESSONS TO BE LEARNT FROM THE INFECTIOUS DISEASE PARADIGM IN KENYA.

Non-communicable diseases (NCD) are emerging as the leading cause of morbidity & mortality globally, with the greatest rise in incidence of cardiovascular disease cases observed in Sub-Saharan Africa. This is in addition to the heavy burden of infectious diseases already present in this setting. Describing the cross-cutting epidemiology of NCDs and infectious diseases with focus on the interaction between tuberculosis and diabetes mellitus, HIV and cardiovascular disease, HIV and cervical cancer as well as assessing the disparities in funding and service delivery systems between NCDs and infectious diseases; we review this rising double burden of infectious and non-infectious diseases and propose four lessons that can be learnt from the HIV response and adapted to inform the scale up of NCD control in Kenya which are also applicable in other African countries.

Provider-initiated HIV testing and counselling for TB patients and suspects in Nairobi, Kenya.

SETTING: Integrated tuberculosis (TB) and human immunodeficiency virus (HIV) services in a resource-constrained setting. OBJECTIVE: Pilot provider-initiated HIV testing and counselling (PITC) for TB patients and suspects. DESIGN: Through partnerships, resources were mobilised to establish and support services. After community sensitisation and staff training, PITC was introduced to TB patients and then to TB suspects from December 2003 to December 2005. RESULTS: Of 5457 TB suspects who received PITC, 89% underwent HIV testing. Although not statistically significant, TB suspects with TB disease had an HIV prevalence of 61% compared to 63% for those without. Of the 614 suspects who declined HIV testing, 402 (65%) had TB disease. Of 2283 patients referred for cotrimoxazole prophylaxis, 1951 (86%) were enrolled, and of 1727 patients assessed for antiretroviral treatment (ART), 1618 (94%) were eligible and 1441 (83%) started treatment. CONCLUSIONS: PITC represents a paradigm shift and is feasible and acceptable to TB patients and TB suspects. Clear directives are nevertheless required to change practice. When offered to TB suspects, PITC identifies large numbers of persons requiring HIV care. Community sensitisation, staff training, multitasking and access to HIV care contributed to a high acceptance of HIV testing. Kenya is using this experience to inform national response and advocate wide PITC implementation in settings faced with the TB-HIV epidemic.

Control of skin infection in HIV positive individuals and AIDS patients

HIV prevalence is still increasing in many parts of the world. Poverty and inequity still prevail; and drugs are inaccessible to the majority of people living with HIV. Opportunistc infections constitute the major problem which makes their lives uncomfortable. At a Catholic Community Health Care giving health services to about 500;000 people living in the slums of Nairobi city; it has been observed that the main health problems facing HIV/ADS patients are: recurrent skin infection due to exfoliative staphylococcus aureus which presents as itchy rashes and pseudomycosis; development of cellulities or black pigmentation of skin; recurrent herpes zoster infection; chest infection and diarrhoea. This staph aureus is resistant to affordable topical antibiotics. Applying 2 percent chlorohexidine/cetrimide (savlon) once daily is useful when itching and rashes start; before they become septic. When the rashes are gone; savlon is applied once or twice in a week to keep the load of Staph aureus within normal range. If the patient develops superficial or deep cellulitis he is treated with neomycin/cetrimide ointment (oral erythromycin is added if the patient is having boils). Once the skin is back to normal the patient is also maintained as above. This management has proved quite effective in reducing recurrent skin infection. There is less use of topical antibiotics; antifungal drugs and hydrocortisone due to pseudomycosis compared with the previous period before the above managment was started