Aims: The study aimed at determining the antimicrobial activities and cytotoxicity properties of medicinal plants collected from southwestern Kenya. Methods and results: A total of 23 ethanol extracts of selected medicinal plants were bio-assayed against Gramnegative bacterial strains (Escherichia coli NU14, Helicobacter pylori ATCC 700824, and Porphyromonas gingivalis ATCC 33277). Cytotoxicity tests were also carried out on mammalian cell lines (AGS, KB, and TR146). Preliminary type of phytochemical compounds present in the extracts was determined by thin-layer chromatography. Cassia didymobotrya plant extract (1 mg/mL) had strong antimicrobial activity against P. gingivalis (average zone of inhibition of 21.70 ± 0.88 mm, MIC 0.13 ± 0.00 mg/mL and MBC 0.50 ± 0.00 mg/mL). Escherichia coli was resistant to all the extracts bioassayed. Leonotis nepetifolia (15.80 ± 0.20 mm) and Clerodendrum myriacoides (14.20 ± 0.44 mm) showed only moderate activity against H. pylori. Cell cytotoxicity results indicated a dose-dependent response against KB, TR146 and AGS cell lines with C. didymobotrya having IC50 values of 47.64 and 704.00 µg/mL on KB and TR146 cell lines, respectively. L. nepetifolia and C. myriacoides did produce IC50 of 0.1883 mg/mL and 0.1061 mg/mL against the AGS cell line respectively. Conclusion, significance and impact of the study Most of the extracts had no or weak activity against test isolates, but C. didymobotrya leaves extracts showed strong activity against P. gingivalis. C. didymobotrya can offer alternative medicare to P. gingivalis conditions.
Plants, Medicinal--adverse effects ; Kenya (Southwestern)

BACKGROUND: There is no normative craniofacial anthropometric data for the Kenyan-African population. The purpose of this investigation was to determine normative anthropometric craniofacial measurements and proportional relationships for Kenyans of African descent and to compare the data with African Americans (AA), North American Whites (NAW), and neoclassical canons. METHODS: Twenty-five direct facial anthropometric measurements, and 4 angular measurements, were taken on 72 Kenyan-African participants (age range 18–30 years) recruited at the University of Nairobi in Kenya. The data were compared with AA and NAW populations, and neoclassical canons. Descriptive statistics of the variables were computed for the study population. RESULTS: Significant differences between both Kenyan males and females were detected in forehead height (~ 5 mm greater for males, ~ 4.5 mm for females), nasal height (reduced by ~ 4 mm in males, ~ 3 mm in females), nasal width (8–9 mm greater), upper lip height (> 3 mm), and eye width (greater by ~ 3 mm) compared to NAW subjects. All vertical measurements obtained were significantly different compared with NAW. Differences were observed in comparison with AA subjects, but less marked. Mouth width was similar in all groups. Angular measurements were variable. Neoclassical canons did not apply to the Kenyan population. CONCLUSIONS: Anthropometric measurements of NAW showed clear differences when compared with the Kenyan population, and variations exist with comparative AA data. The anthropometric data in terms of linear measurements, angular measurements, and proportional values described may serve as a database for facial analysis in the Kenyan-African population.
African Americans ; Anthropometry ; Female ; Forehead ; Humans ; Kenya ; Lip ; Male ; Mouth

Adolescent ; Adult ; Child ; Decision Trees ; Female ; HIV Infections ; economics ; transmission ; Humans ; Infectious Disease Transmission, Vertical ; economics ; prevention & control ; Kenya ; Middle Aged ; Mothers ; South Africa ; Vietnam ; Young Adult

To assess safety of the no-flip ShangRing male circumcision technique and to determine clinical course and safety of spontaneous detachment (i.e., allowing the device to fall off), we conducted a case series of no-flip ShangRing circumcision combined with a randomized controlled trial of removal 7 days postcircumcision versus spontaneous detachment at two health facilities in Kenya. The primary outcome was the safety of the no-flip technique based on moderate and severe adverse events (AEs) during the procedure and through 42-day follow-up. A main secondary outcome was clinical course and safety of spontaneous detachment. Two hundred and thirty males 10 years and older underwent no-flip circumcision; 114 randomized to 7-day removal and 116 to spontaneous detachment. All circumcisions were successfully completed. Overall 5.3% (6/114) of participants in the 7-day group and 1.7% (2/116) in the spontaneous group had an AE; with no differences when compared to the 3% AE rate in historical data from African studies using the original flip technique (P = 0.07 and P = 0.79, respectively). Overall 72.4% (84/116) of participants in the spontaneous group wore the ShangRing until it detached. Among the remaining (27.6%; 32/116), the ring was removed, primarily at the participants' request, due to pain or discomfort. There was no difference in AE rates (P = 0.169), visit day declared healed (P = 0.324), or satisfaction (P = 0.371) between randomization groups. The median time to detachment was 14.0 (IQR: 7-21, range: 5-35) days. The no-flip technique and spontaneous detachment are safe, effective, and acceptable to boys and men 10 years and older. Phimosis and penile adhesions do not limit successful ShangRing circumcision with the no-flip technique.
Adolescent ; Adult ; Child ; Circumcision, Male/methods* ; Humans ; Kenya ; Male ; Middle Aged ; Patient Satisfaction ; Treatment Outcome ; Wound Healing ; Young Adult

Prompt malaria diagnosis is crucial so antimalarial drugs and supportive care can then be rapidly initiated. A 15-year-old boy who had traveled to Africa (South Africa, Kenya, and Nigeria between January 3 and 25, 2011) presented with fever persisting over 5 days, headache, diarrhea, and dysuria, approximately 17 days after his return from the journey. Urinalysis showed pyuria and hematuria. Blood examination showed hemolytic anemia, thrombocytopenia, disseminated intravascular coagulation, and hyperbilirubinemia. Plasmapheresis and hemodialysis were performed for 19 hospital days. Falciparum malaria was then confirmed by peripheral blood smear, and antimalarial medications were initiated. The patient's condition and laboratory results were quickly normalized. We report a case of severe acute renal failure associated with delayed diagnosis of falciparum malaria, and primary use of supportive treatment rather than antimalarial medicine. The present case suggests that early diagnosis and treatment is important because untreated tropical malaria can be associated with severe acute renal failure and fatality. Physicians must be alert for correct diagnosis and proper management of imported tropical malaria when patients have travel history of endemic areas.
Acute Kidney Injury* ; Adolescent ; Africa ; Anemia, Hemolytic ; Antimalarials ; Delayed Diagnosis* ; Diagnosis ; Diarrhea ; Disseminated Intravascular Coagulation ; Dysuria ; Early Diagnosis ; Fever ; Headache ; Hematuria ; Humans ; Hyperbilirubinemia ; Kenya ; Malaria* ; Male ; Nigeria ; Plasmapheresis ; Plasmodium falciparum ; Pyuria ; Renal Dialysis ; Renal Insufficiency ; Thrombocytopenia ; Urinalysis

BACKGROUND/OBJECTIVES: Although it is crucial to identify those children likely to be treated in an appropriate nutrition rehabilitation programme and discharge them at the appropriate time, there is no golden standard for such identification. The current study examined the appropriateness of using Mid-Upper Arm Circumference for the identification, follow-up and discharge of malnourished children. We also assessed its discrepancy with the Weight-for-Height based diagnosis, the rate of recovery, and the discharge criteria of the children during nutrition rehabilitation. SUBJECTS/METHODS: The study present findings from 156 children (aged 6-59 months) attending a supplementary feeding programme at Makadara and Jericho Health Centres, Eastern District of Nairobi, Kenya. Records of age, weight, height and mid-upper arm circumference were selected at three stages of nutrition rehabilitation: admission, follow-up and discharge. The values obtained were then used to calculate z-scores as defined by WHO Anthro while estimating different diagnostic indices. RESULTS: Mid-upper arm circumference single cut-off (< 12.5 cm) was found to exhibit high values of sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, negative likelihood ratio at both admission and discharge. Besides, children recorded higher rate of recovery at 86 days, an average increment of 0.98 cm at the rate of 0.14mm/day, and a weight gain of 13.49gm/day, albeit higher in female than their male counterparts. Nevertheless, children admitted on basis of low MUAC had a significantly higher MUAC gain than WH at 0.19mm/day and 0.13mm/day respectively. CONCLUSIONS: Mid-upper arm circumference can be an appropriate tool for identifying malnourished children for admission to nutrition rehabilitation programs. Our results confirm the appropriateness of this tool for monitoring recovery trends and discharging the children thereafter. In principle the tool has potential to minimize nutrition rehabilitation costs, particularly in community therapeutic centres in developing countries.
Arm* ; Child* ; Developing Countries ; Diagnosis ; Female ; Follow-Up Studies* ; Humans ; Infant ; Infant Nutritional Physiological Phenomena ; Kenya ; Male ; Malnutrition ; Rehabilitation* ; Sensitivity and Specificity ; Weight Gain

BACKGROUND: The Maasai are the most widely known African ethnic group located in Kenya and northern Tanzania. Most spend their days either barefoot or in their traditional shoes made of car tires. Although they walk long distances of up to sixty kilometers a day, they do not suffer from any foot ailments. Little is known about their foot structure and gait. The goal of this investigation was to characterize various aspects of Maasai foot in standing and walking. METHODS: Foot length, calf circumference, hindfoot alignment, step length, cadence, and walking velocity were obtained from 1,096 adult Maasai people (545 males and 551 females; mean age, 40.28 +/- 14.69 years; age range, 16 to 65 years). All included subjects were from rural areas, where the primary terrain was sandy soil, who spend most of their lifetime barefoot, walking. They all denied any medical history or previous symptoms related to foot problems. A trained clinician scanned all feet for deformities. Static (standing) and dynamic (walking) Harris mat footprints were taken to determine the distribution of forefoot pressure patterns during walking. RESULTS: The average foot length was 250.14 +/- 18.12 mm (range, 210 to 295 mm) and calf circumference was 32.50 +/- 3.22 cm (range, 25 to 41 cm). The mean hindfoot alignment was 6.21degrees +/- 1.55degrees of valgus. Sixty-four subjects (5.84%) had bilateral flat-shaped feet with a low medial longitudinal arch that exactly matched the broad pattern of their static footprints. Step length, cadence, and walking velocity were 426.45 +/- 88.73 cm (range, 200 to 690 cm), 94.35 steps/min (range, 72 to 111 steps/min), and 40.16 +/- 8.36 m/min (range, 18.20 to 63.36 m/min), respectively. A total of 83.39% subjects showed unilateral or bilateral deformities of multiple toes regardless of age. The most frequent deformity was clawing (98.79%) of which the highest incidence occurred with the fifth toe (93.23%). Dynamic footprints showed even pressure patterns throughout the forefoot (64.87%), followed by lateral forefoot pressure concentration patterns (21.81%). CONCLUSIONS: Our study shows the distinct parameters that provide more insight into the Maasai foot.
Adolescent ; Adult ; Aged ; Biomechanical Phenomena ; Ethnic Groups ; Female ; Foot/*anatomy & histology/*physiology ; Foot Deformities, Acquired/*epidemiology/ethnology ; Gait/*physiology ; Humans ; Kenya ; Male ; Middle Aged ; Rural Population ; Tanzania ; Walking/*physiology ; Young Adult

Anatomy has historically been a cornerstone in medical education regardless of nation or specialty. Revolution in the training of anatomy has been based on the lack of adequate instructors, cadavers and the general high cost of anatomy training. This has led to the abandonment of dissection by most countries in favour of other methods of learning. At the University of Nairobi, the need for more instructors has been addressed by training anatomists and by incorporating surgical resident students in the training of undergraduate medical students. The catchment of collecting cadavers has been increased to address the need for cadavers, with increased competition for this resource from other medical schools in Kenya. This article shares our experience at the Department of Human Anatomy, University of Nairobi, and presents arguments for the dissection course as a central tool for teaching macroscopic anatomy.
Anatomy ; education ; Cadaver ; Curriculum ; Dissection ; education ; Education, Medical, Undergraduate ; Humans ; Kenya ; Schools, Medical ; Students, Medical

Paederus dermatitis is a characteristic irritant contact dermatitis caused by paederin which is a chemical substance released by insects of the genus Paederus. Erythematous vesiculobullous eruption with a burning sensation occur within 24 hours after contact with Paederus. This dermatitis is frequently seen in regions with hot, tropical climates such as Africa and the Middle East. There have been a few reports of Paederus dermatitis in Korea. We recently had a patient with Paederus dermatitis who traveled to Kenya. We would like to highlight an awareness of this peculiar dermatitis due to the increasing numbers of travelers visiting tropical countries.
Africa ; Burns ; Dermatitis* ; Dermatitis, Contact ; Humans ; Insects ; Kenya ; Korea ; Middle East ; Sensation ; Tropical Climate

Parasites were collected from 20 Burchell's zebra, Equus burchelli antiquorum, from Isiolo district, Kenya. 10 were ranched animals from the Lewa Downs Ranch and 10 free ranging from the areas adjacent to the ranch to the north. The animals were culled from 4th to 18th June 1995. The gastrointestinal tract was removed from the carcass and separated as stomach, small and large intestines and searched for parasites. The abdominal cavity was scrutinized for Setaria species. The parasites were identified to genus and in some cases species level. All animals were infected with at least three genera of parasites of which at least one genus was a nematode. A total of 10 genera representing eight families were recovered from the two groups. These included six nematode families, Strongylidae, Atractidae, Oxyuridae, Spiruridae, Setariidae, and Ascaridae, one cestode family, Anoplocephalidae and one family of the larvae of Gasterophilus bot flies, Gasterophilidae. The most prevalent families were Atractidae (100%) and Gasterophilidae (100%). The principle nematode genera was Crossocephalus whose total burden, plus or minus the standard deviation, was 3,471,129 +/- 1,352,922. Setaria species were recovered from the abdominal cavity of 45% of all the animals examined. The overall total worm burden was higher in the free ranging zebra 2,743,410 +/- 849,604 than the ranched zebra, 787,669 +/- 246,006. The range of individual genera varied from 0 to 269,225 in the free ranging group, which was higher than 0 to 77,890 in the ranched animals. From statistical analysis, no significant difference could be found between males and females. However, the burdens of genera Strongylus, Triodontophorus, Crossocephalus and Parascaris were significantly higher in free ranging animals.
Animals ; Diptera ; Equidae/*parasitology ; Feces/parasitology ; Female ; Gastrointestinal Diseases/epidemiology/parasitology/*veterinary ; Helminthiasis, Animal/epidemiology/*parasitology ; Helminths/*isolation&purification ; Kenya/epidemiology ; Male ; Parasite Egg Count/veterinary ; Prevalence ; Statistics, Nonparametric