Department of Agricultural Economics

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It has been the view of the Association of Surgeons of East Africa (ASEA) that, like primary health care, there is primary surgery. The unit of provision of primary surgery is the district hospital. The training of surgeons for district hospitals starts at the undergraduate level, leading to the attainment of Bachelor of Medicine and Bachelor of Surgery (M.B. Ch.B.) degree. After internship the doctor works in a district or provincial hospital for 2-3 years, then trains for the degree of Master of Medicine (M. Med. (Surg.)) for a period of 3 years. The training involves rotation through all branches of surgery, so that the surgeon should be able to handle all aspects of routine surgery in a district hospital. To equip the surgeon further, a period in an outside setting is considered advisable. There are arrangements for regional surgical colleges to standardise the form of surgical training in the ASEA region. To keep surgeons in touch with the outside world, specialist training is done outside the region, but arrangements are being made for localised specialised units to offer this training.

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{ OBJECTIVES To compare sociodemographic profiles, child care, child feeding practices and growth indices of children born to HIV-1 seropositive and seronegative mothers. METHODS: A cohort study of 234 children (seropositive and seronegative) born to HIV-1 seropositive mothers and 139 children born to seronegative mothers in Pumwani Maternity Hospital which serves a low-income population in Nairobi, Kenya from December 1991 and January 1994. RESULTS: With few exceptions, at the time of their birth children in all three cohorts had parents with similar characteristics, lived in similar housing in similar geographical areas, had their mothers as their primary care givers, had similar feeding practices and similar growth status and patterns. However, the HIV-1 seropositive mothers were slightly younger (23.8 years vs. 25.0 years, P < 0.01), if married they were less likely to be their husband's first wife (79% vs. 91%

{ OBJECTIVES To compare sociodemographic profiles, child care, child feeding practices and growth indices of children born to HIV-1 seropositive and seronegative mothers. METHODS: A cohort study of 234 children (seropositive and seronegative) born to HIV-1 seropositive mothers and 139 children born to seronegative mothers in Pumwani Maternity Hospital which serves a low-income population in Nairobi, Kenya from December 1991 and January 1994. RESULTS: With few exceptions, at the time of their birth children in all three cohorts had parents with similar characteristics, lived in similar housing in similar geographical areas, had their mothers as their primary care givers, had similar feeding practices and similar growth status and patterns. However, the HIV-1 seropositive mothers were slightly younger (23.8 years vs. 25.0 years, P < 0.01), if married they were less likely to be their husband's first wife (79% vs. 91%

Records were available for 197 patients with malignant lymphomas (MLs) aged 13 years and above seen at Kenyatta National Hospital (KNH) between the years 1973 and 1986. There were 110 cases of Hodgkin's disease (HD) and 87 cases of non-Hodgkin's lymphomas (NHLs). The distribution of the two groups according to sex and histologic sub-types was not significantly different. HD patients were on average significantly younger than NHL patients (28.8 years versus 41.1 years). Over 70% of both HD and NHL cases presented in stages III and IV and the distribution of the groups according to stage of disease was not statistically significant. There was no significant correlation between stage of disease at diagnosis and histologic subtypes for either group. Losses to follow-up were high in both groups. Female sex was associated with longer periods of follow-up in both groups, being statistically significant for HD and not so for NHLs. Age was not correlated with duration of follow-up for NHLS whereas for HD cases, older age (above 53 years) was associated with shortened follow-up periods. The mortality rate was higher in NHLs than in HD cases.

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This paper investigates the possibilities of applying emerging management theories and techniques to constitutionally created offices in Kenya and East African region. The benefits from application of these theories, particularly in the judicial services are highlighted.

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Although pyogenic thyroiditis is rare,the four cases have been seen and treated at Kenyatta National Hospital (KNH) over the last 10 years.This is a report of one of these cases detailing the clinical presentation and operative findings.
A middle aged female with a large painful shining anterior neck swelling of 4days duration.She had difficulty of swallowing,but no dyspnoea.She was febrile,with moderate anaemia, polymorph-leucocytosis (52%)and lymphocytosis(36%).Thyroid immunoglobulins were unavailable.131 iodine uptake studies was reduced,plain x-ray of the trachea/neck was unremarkable.
A thick suppurative pus from the left lobe grew on organisms.The discusses various forms of thyroid abcesses ,their causes and treatment.

Participatory research on bovine trypanosomiasis was conducted with Orma pastoralists in Tana River District, Kenya. The use of participatory methods to understand local perceptions of disease signs, disease causes, disease incidence by cattle age group, seasonal patterns of disease and preferences for indigenous and modern control methods are described. Results indicated that local characterization of diseases called gandi and buku by Orma pastoralists was similar to modern veterinary knowledge on chronic trypanosomiasis and haemorrhagic trypanosomiasis (due to Trypanosoma vivax), respectively. The mean incidence of gandi varied from 10.2% in calves to 28.6% in adult cattle. The mean incidence of buku varied from 3.1% in calves to 9.6% in adults. Pearson correlation coefficients for disease incidence by age group were 0.498 (P < 0.01) and 0.396 (P < 0.05) for gandi and buku, respectively. Informants observed cases of trypanosomiasis in 24.1% of cattle (all age groups); these cases accounted for 41.8% of all sick cattle during the preceding 12-month period. Eight indigenous and three modern trypanosomiasis control methods were identified. Results indicated that an integrated approach to trypanosomiasis control based on private, individual action was well established in the assessment area. When presented with four different trypanosomiasis control methods, community representatives selected 'better use of trypanocides' as the most preferred intervention and 'community-based tsetse control' as the least preferred intervention. This finding prompted researchers to modify the original project activities. Constraints facing the sustainability of community-based tsetse control are discussed.

This paper describes the methodology and presents preliminary results of an economic appraisal of a community based health care project in Kenya. Community health workers, trained for 12 weeks and deployed in two locations in Kenya's Western Province, act as first contact providers of basic health care and promoters of selected health, sanitation and nutrition practices. A Cost Benefit Analysis has been undertaken using the Willingness to Pay approach to compare the costs of the project and its benefits. The benefits are in the form of more easily accessible basic health care and are measured as consumer surplus accruing to the community. Gain in consumer surplus is consequent on the fall of average user costs and rise in utilisation of the project established points of first contact with primary health care. The argument for the economic viability of the project is validated by the large Net Present Value and Benefit Cost Ratio obtained for the whole of the project area and for the two locations separately. Although the evaluation technique used faces the problem of valuation of community time, aggregation of health care services at all points of first contact and the partial nature of cost benefit analysis evaluations, the results are strongly in favour of decentralisation of primary health care on similar lines in the rest of the country.

According to the statements made by a number of scholars, in the 80's East African Anglophone novel, which once received a nickname of "social documentary", began to lose gradually its social commitment. Many of the writers known previously as the most active supporters of the social trend, moved their attempts to other literan areas - criminal novel ("Weapon of hunger" by Meja Mцangi, 1989), love story (Yussuf Dawood's "Off my chest", 1988), even children's literature (books for children in Gikuyu, written by Ngugi wa Thiong'o). However, in the late 80's and early 90's East African Anglophone novel stepped onto a new level of social trend, moving from "social documentary" to "social epic". The authors now are trying to sum up the historical experience of East African countries over a large time span, and to that effect appeal mostly to elaborate and spacious literary forms, such as epic novel. These authors, although chosen one and the same literary form, are showing clearly their inclinations towards different styles of writing. For example, Tanzanian author Moyez Vassanji in his novel "The gunny sack" (1989) makes a rather convincing attempt to replant on East African soil the method of "mythological writing", previously used by such author as Gabriel Garcia Marquez. The novel definitely appeals not only to local reader, but to a wider international audience; on its pages the author manages to restore not only the fate of several generations of Indian family, but even the slightest details of their mentality, using myth as one of the basic means for changing the dimensions of time and space, according to the logic of the narration. The development of Kenyan novel in the early 90's confirms also one of the main tendencies in modem literature - bridging between "elite" and popular fiction. The first attempt of an epic novel in Kenyan Anglophone literature was, oddly enough, made by the veteran of Kenyan popular fiction David Maillu in his "Broken drum" H991). The novel hardly aims the widest reading public - nevertheless, stylistically it bears distinct features of popular fiction, such as crime story, romance, etc. Popular novel in East Africa also shows certain inclination towards urgent social themes, but the authors inevitably uses the artistic means they feel most happy with - that is, the style of popular fiction. For example, the "clash of cultures" - the experience of young Africans studying abroad - is presented in the form of a picaresque ("Times beyond" by Omondi Makoloo, 1992) or love story ("The girl from Uganda" by Tengio Urrio, 1993); feministic problems are spiced with sentimentalism ("Judy the nun" by P .Waweru, 1990); the thoughts on the hardships of younger generation are guised in Bildungs roman ("The plight of succession" by a Tanzanian Prosper Rwegoshora, 1990). At the same time, some authors, who have been ploughing successfully the field of pop fiction for a few decades, show their interest in more elaborate literary forms ("Dedan Kimathi: the real story" by Samuel Kaluga, 1990). All the mentioned facts do not allow us to state that the division into popular and elite novel will disappear within the foreseeable future. However, the most interesting developments seem to take place precisely in the field of bridging between these two branches of East African fiction.

According to the statements made by a number of scholars, in the 80's East African Anglophone novel, which once received a nickname of "social documentary", began to lose gradually its social commitment. Many of the writers known previously as the most active supporters of the social trend, moved their attempts to other literan areas - criminal novel ("Weapon of hunger" by Meja Mцangi, 1989), love story (Yussuf Dawood's "Off my chest", 1988), even children's literature (books for children in Gikuyu, written by Ngugi wa Thiong'o). However, in the late 80's and early 90's East African Anglophone novel stepped onto a new level of social trend, moving from "social documentary" to "social epic". The authors now are trying to sum up the historical experience of East African countries over a large time span, and to that effect appeal mostly to elaborate and spacious literary forms, such as epic novel. These authors, although chosen one and the same literary form, are showing clearly their inclinations towards different styles of writing. For example, Tanzanian author Moyez Vassanji in his novel "The gunny sack" (1989) makes a rather convincing attempt to replant on East African soil the method of "mythological writing", previously used by such author as Gabriel Garcia Marquez. The novel definitely appeals not only to local reader, but to a wider international audience; on its pages the author manages to restore not only the fate of several generations of Indian family, but even the slightest details of their mentality, using myth as one of the basic means for changing the dimensions of time and space, according to the logic of the narration. The development of Kenyan novel in the early 90's confirms also one of the main tendencies in modem literature - bridging between "elite" and popular fiction. The first attempt of an epic novel in Kenyan Anglophone literature was, oddly enough, made by the veteran of Kenyan popular fiction David Maillu in his "Broken drum" H991). The novel hardly aims the widest reading public - nevertheless, stylistically it bears distinct features of popular fiction, such as crime story, romance, etc. Popular novel in East Africa also shows certain inclination towards urgent social themes, but the authors inevitably uses the artistic means they feel most happy with - that is, the style of popular fiction. For example, the "clash of cultures" - the experience of young Africans studying abroad - is presented in the form of a picaresque ("Times beyond" by Omondi Makoloo, 1992) or love story ("The girl from Uganda" by Tengio Urrio, 1993); feministic problems are spiced with sentimentalism ("Judy the nun" by P .Waweru, 1990); the thoughts on the hardships of younger generation are guised in Bildungs roman ("The plight of succession" by a Tanzanian Prosper Rwegoshora, 1990). At the same time, some authors, who have been ploughing successfully the field of pop fiction for a few decades, show their interest in more elaborate literary forms ("Dedan Kimathi: the real story" by Samuel Kaluga, 1990). All the mentioned facts do not allow us to state that the division into popular and elite novel will disappear within the foreseeable future. However, the most interesting developments seem to take place precisely in the field of bridging between these two branches of East African fiction.

According to the statements made by a number of scholars, in the 80's East African Anglophone novel, which once received a nickname of "social documentary", began to lose gradually its social commitment. Many of the writers known previously as the most active supporters of the social trend, moved their attempts to other literan areas - criminal novel ("Weapon of hunger" by Meja Mцangi, 1989), love story (Yussuf Dawood's "Off my chest", 1988), even children's literature (books for children in Gikuyu, written by Ngugi wa Thiong'o). However, in the late 80's and early 90's East African Anglophone novel stepped onto a new level of social trend, moving from "social documentary" to "social epic". The authors now are trying to sum up the historical experience of East African countries over a large time span, and to that effect appeal mostly to elaborate and spacious literary forms, such as epic novel. These authors, although chosen one and the same literary form, are showing clearly their inclinations towards different styles of writing. For example, Tanzanian author Moyez Vassanji in his novel "The gunny sack" (1989) makes a rather convincing attempt to replant on East African soil the method of "mythological writing", previously used by such author as Gabriel Garcia Marquez. The novel definitely appeals not only to local reader, but to a wider international audience; on its pages the author manages to restore not only the fate of several generations of Indian family, but even the slightest details of their mentality, using myth as one of the basic means for changing the dimensions of time and space, according to the logic of the narration. The development of Kenyan novel in the early 90's confirms also one of the main tendencies in modem literature - bridging between "elite" and popular fiction. The first attempt of an epic novel in Kenyan Anglophone literature was, oddly enough, made by the veteran of Kenyan popular fiction David Maillu in his "Broken drum" H991). The novel hardly aims the widest reading public - nevertheless, stylistically it bears distinct features of popular fiction, such as crime story, romance, etc. Popular novel in East Africa also shows certain inclination towards urgent social themes, but the authors inevitably uses the artistic means they feel most happy with - that is, the style of popular fiction. For example, the "clash of cultures" - the experience of young Africans studying abroad - is presented in the form of a picaresque ("Times beyond" by Omondi Makoloo, 1992) or love story ("The girl from Uganda" by Tengio Urrio, 1993); feministic problems are spiced with sentimentalism ("Judy the nun" by P .Waweru, 1990); the thoughts on the hardships of younger generation are guised in Bildungs roman ("The plight of succession" by a Tanzanian Prosper Rwegoshora, 1990). At the same time, some authors, who have been ploughing successfully the field of pop fiction for a few decades, show their interest in more elaborate literary forms ("Dedan Kimathi: the real story" by Samuel Kaluga, 1990). All the mentioned facts do not allow us to state that the division into popular and elite novel will disappear within the foreseeable future. However, the most interesting developments seem to take place precisely in the field of bridging between these two branches of East African fiction.

According to the statements made by a number of scholars, in the 80's East African Anglophone novel, which once received a nickname of "social documentary", began to lose gradually its social commitment. Many of the writers known previously as the most active supporters of the social trend, moved their attempts to other literan areas - criminal novel ("Weapon of hunger" by Meja Mцangi, 1989), love story (Yussuf Dawood's "Off my chest", 1988), even children's literature (books for children in Gikuyu, written by Ngugi wa Thiong'o). However, in the late 80's and early 90's East African Anglophone novel stepped onto a new level of social trend, moving from "social documentary" to "social epic". The authors now are trying to sum up the historical experience of East African countries over a large time span, and to that effect appeal mostly to elaborate and spacious literary forms, such as epic novel. These authors, although chosen one and the same literary form, are showing clearly their inclinations towards different styles of writing. For example, Tanzanian author Moyez Vassanji in his novel "The gunny sack" (1989) makes a rather convincing attempt to replant on East African soil the method of "mythological writing", previously used by such author as Gabriel Garcia Marquez. The novel definitely appeals not only to local reader, but to a wider international audience; on its pages the author manages to restore not only the fate of several generations of Indian family, but even the slightest details of their mentality, using myth as one of the basic means for changing the dimensions of time and space, according to the logic of the narration. The development of Kenyan novel in the early 90's confirms also one of the main tendencies in modem literature - bridging between "elite" and popular fiction. The first attempt of an epic novel in Kenyan Anglophone literature was, oddly enough, made by the veteran of Kenyan popular fiction David Maillu in his "Broken drum" H991). The novel hardly aims the widest reading public - nevertheless, stylistically it bears distinct features of popular fiction, such as crime story, romance, etc. Popular novel in East Africa also shows certain inclination towards urgent social themes, but the authors inevitably uses the artistic means they feel most happy with - that is, the style of popular fiction. For example, the "clash of cultures" - the experience of young Africans studying abroad - is presented in the form of a picaresque ("Times beyond" by Omondi Makoloo, 1992) or love story ("The girl from Uganda" by Tengio Urrio, 1993); feministic problems are spiced with sentimentalism ("Judy the nun" by P .Waweru, 1990); the thoughts on the hardships of younger generation are guised in Bildungs roman ("The plight of succession" by a Tanzanian Prosper Rwegoshora, 1990). At the same time, some authors, who have been ploughing successfully the field of pop fiction for a few decades, show their interest in more elaborate literary forms ("Dedan Kimathi: the real story" by Samuel Kaluga, 1990). All the mentioned facts do not allow us to state that the division into popular and elite novel will disappear within the foreseeable future. However, the most interesting developments seem to take place precisely in the field of bridging between these two branches of East African fiction.

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The response to anti-allotype (anti-Ab4), Nocardia Water Soluble Mitogen (NWSM), pneumococcal polysaccharide type III (SSS III), and human Fc fragments of various purified and unfractionated rabbit spleen cell populations was determined in terms of 3H-thymidine up-take. B cells were isolated either from untreated suspensions of spleen cells or from suspensions from which adherent and phagocytic cells were removed. The purification factor was greater than the enhancement of 3H-thymidine uptake by anti-Ab4, NWSM, and SSS III as compared with the response of unfractionated spleen cells. It thus appears that a helper cell was involved: the mitogen response of purified B cells was enhanced by the addition of T cells. B subpopulations were separated by sedimentation or by rosetting, which allowed us to separate Fcgamma receptor-bearing cells from cells that did not possess this receptor. There were differences between cells responding to B mitogens not only in sedimentation velocity but also in the absolute number of cells. B cells bearing the Fcgamma receptor were less responsive to anti-Ab4 and more responsive to SSS III, NWSM, and human Fc than were B cells lacking the Fcgamma receptor.

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Colonial policy makers argued that they were  bringing civilization and better standards of living to Africans.  One perceived problem they had to contend with  was the “ignorance” of their subject peoples.  In health delivery, in particular, colonial administrators believed that ignorance accounted for the poor levels of health among Africans, and that knowledge and that knowledge and other preventive measures would greatly enhance standards of living, for instance, among urban Africans. In this paper we test this philosophy against colonial urban health policy’s and show that racism in the delivery of services  greatly undermined African and Asian health in order to afford  high quality services for Europeans in Nairobi.

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Fatigue crack growth tests were performed on compact tension specimens (CTS) made in two thicknesses 12 and 24 mm. Tests were conducted at two frequencies of 0·25 and 30 Hz, applying a stress ratio R varying from – 0·7 to 0·7. The results were analysed using the linear elastic fracture mechanics approach. They showed that the increase in both positive and negative R caused increased fatigue crack growth rates. Also an empirical effective stress intensity factor range, ΔKeff, was found more appropriate to correlate the fatigue crack growth data than the ΔK factor frequently used in crack growth studies. The loading frequency had only a little influence on crack growth rates at low R. However, at high R, growth rates were significantly higher at lower frequencies. It is suggested that this frequency influence may be associated with environmental effects, due to the embrittlement caused by hydrogen from the moist air, while the crack was fully open.

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This paper reports a palaeomagnetic study of the lower Proterozoic granites, exposed in the western part of Kenya and dated at 2530 ± 50 Ma (λRb= 1.39 × 10−11 yr−1). Ten sites out of 13 have yielded stable palaeomagnetic directions which are believed to be primary. Polished section and thermomagnetic analyses indicate titanomagnetite grains as the main carrier of the primary component of the natural remanence. The mean palaeomagnetic north pole is calculated at 210.7° E, 60.9° N with A95= 13.5°.

Results of a paleomagnetic study carried out on the exposed volcanic rocks on the western side of the South Kenya Rift Valley are presented. Nine stratigraphic groups ranging in age from Miocene to Pleistocene were sampled. The rocks consist of basalts, trachytes, nephelinites, melanephelinites, olivine melanephelinites and ignimbrites. Paleomagnetic poles obtained for different age ranges are as follows: Period I (0.64–0.72 Ma), 116°E, 85°N (A95 = 6°); Period II (1.6–6.9 Ma), 297°E, 84°N (A95 = 4°); Period III (12.0–15.0 Ma), 34°E, 80°N (A95 = 9°). The results for Period II show large secular variations which are in disagreement with the model predictions for near-equatorial sites.

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Baseline information on densities, distributions and population trends of the African elephant was obtained during KREMU's 1977 and 1978 aerial surveys of all pastoral rangelands in Kenya. It was estimated in 1978 that there were between 44,000 and 67,000 elephants in Kenya 73% of the estimated 1977 population. The ratio of live to dead elephants in 1978 has further decreased to 44:56 compared to 51:49 in 1977. Of the 5,000 to 10,000 located in the general agricultural zone, most were in the national parks and forest reserves.

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Compares wild herbivore and livestock poulation data collected during the aerial suveys throughout the rangelands areas during 1977 and 1978. rangelands which were flown in straight line belt transects the first year at l0km spacing and the second at 5km apart. Elephant population estimates according to the ecoregions were: Northern Rift Valley 1,600 in 1977 but not included in 1978; Northern volcanics 1,600 in 1977 and 110 in 1978; Northern Central 4,170 in 1977 and 1,930 in 1978; North East 9,500 in 1977 and 3,060 in 1978; South Central 2,800 in 1977 and 4,130 in 1978, East Central-Coastal 13,900 in 1977 and 8,450 in 1978; South East 25,500 in 1977 and 21,900 in 1978; South West 1,800 in 1977 and 3,180 in 1978 providing a total estimate for 1977 of 59,800 and for 1978 of 42,800.

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The arterial blood supply, position, and length of the appendix were studied 103 Zambian cadavers. In 39.8%, more than one appendicular artery was found. In position, 43.6% were pelvic, and 20.3% retro-cecal. The average length of the appendix was 12.0 cm in males, and 11.4 cm in females. The prevalence of the dual blood supply and pelvic position, may partly explain the recorded rarity of appendicitis among Africans.

The effects of intravenous administration of potassium phosphate in the treatment of diabetic ketoacidosis were studied in nine children, ages 9 9/12 to 17 10/12 yr. During phosphate infusion (20–40 meq/L of fluid), all children maintained normal serum concentrations of phosphorus. Transient hypocalcemia occurred in six and transient hypomagnesemia in five patients. One child developed carpopedal spasms refractory to intravenous infusion of calcium gluconate but responsive to intramuscular injection of magnesium sulfate. In three patients, serum levels of intact parathyroid hormone were low at the time of hypocalcemia, an observation that suggests transient hypoparathyroidism. This study indicates that the use of potassium phosphate as the sole source of potassium replacement might potentiate ketoacidosis-induced hypocalcemia through multiple mechanisms.

In the central area of the retina of mouse the rate of synaptogenesis in the inner plexiform layer (IPL) drops precipitously at about the time the eyes open. To determine if the visual input at eye opening provides a signal for the neurons to stop adding synapses, mice were raised in darkness during the period of maximal synaptogenesis and through eye opening. Retinal synaptic arrays of dark-reared and normally reared animals were compared quantitatively. The rate of synaptogenesis after eye opening in dark-reared mice indicated that the onset of visual stimulation was not the cue to stop synaptogenesis. However, the synaptic arrays of the IPL of dark-reared mice consistently had more conventional synapses than those of normally reared mice. It is concluded that the number of conventional synapses in the central retina was increased by dark-rearing.

In whole-mounts of Golgi stained rat retinae four cell types are described in the ganglion cell layer. Three of these cell types are considered to be analogous to the alpha, delta and gamma cells described in the cat retina by Boycott & Wässle (1974). The fourth cell type is thoughtt to be a displaced amacrine cell. All the cell types described are present in all parts of the retina. There is no evidence for an increase in dendritic field size with increasing distance from the optic disk.