Mapping Air Quality Using Remote Sensing Technology: A Case Study of Nairobi County

Nairobi County experiences rapid industrialization and urbanization that contributes to the deteriorating state of air quality, posing a potential health risk to its growing population. Currently, in Nairobi County, most air quality monitoring stations use low-cost, inaccurate monitors prone to defects. The study’s objective was to map Nairobi County’s air quality using freely available remotely sensed imagery. The Air Pollution Index (API) formula was used to characterize the air quality from cloud-free Landsat satellite images i.e., Landsat 5 TM, Landsat 7 ETM+, and Landsat 8 OLI from Google Earth Engine. The API values were computed based on vegetation indices namely NDVI, TVI, DVI, and the SWIR1 and NIR bands on the QGIS platform. Qualitative accuracy assessment was done using sample points drawn from residential, industrial, green spaces, and traffic hotspot categories, based on a passive-random sampling technique. In this study, Landsat 5 API imagery for 2010 provided a reliable representation of local conditions but indicated significant pollution in green spaces, with recorded values ranging from -143 to 334. The study found that Landsat 7 API imagery in 2002 showed expected results with the range of values being -55 to 287, while Landsat 8 indicated high pollution levels in Nairobi. The results emphasized the importance of air quality factors in API calibration and the unmatched spatial coverage of satellite observations over ground-based monitoring techniques. The study recommends the recalibration of the API formula for characteristic regions, exploring newer satellite sensors like those onboard Landsat 9 and Sentinel 2, and involving key stakeholders in a discourse to develop a suitable Kenyan air quality index.

The level of patients’ satisfaction and perception on quality of nursing services in the Renal unit, Kenyatta National Hospital Nairobi, Kenya

Introduction: Renal failure is on the increase and patients have to identify with renal services and centres where services for renal replacement therapies are rendered. This calls for health care workers to offer services that are perceived as quality and satisfying in order to meet the biophysical and psychological needs of the patients. Study design: This was a descriptive cross-sectional study undertaken at the Renal unit of Kenyatta National Hospital (KNH). Purpose: The study aimed at determining the level of satisfaction and perception of the quality of nursing services in the Renal unit. Methodology: The study population included all patients who were seeking dialysis services during one month period of data collection. The sample size was 151 following data collection. Data collection tools consisted of semi-structured questionnaires which were administered with the aid of research assistants as well as checklists which were self administered. Data analysis and results: Analysis of data was performed using the statistical package of social sciences (SPSS) version 16. Results of data analysis were presented in form of descriptive statistics which included mean, standard deviation and percentages. Regression analysis, t-test and ANOVA were conducted to determine demographic predictors of patient satisfaction with the nursing services. The results of the study revealed that patients in the Renal unit were generally satisfied with the nursing services. The aggregate mean score for all patients on Likert scale was 71.2 out of 105, with a standard deviation of 16.8. Level of satisfaction was 67.8%. The findings also showed that there was no association between demographic characteristics with the levels of satisfaction with the nursing services. Recommendation: The hospital should keep the patients’ level of satisfaction high and maintain it through the provision of more dialysis machines and hiring more nurses.

Chimeric ALT Perforator-Free Flap with Vastus Lateralis Muscle for the Obliteration of the Intrathoracic Dead Space Post-Pneumonectomy: A Case Report

Chest wall reconstruction is a surgical procedure aimed at restoring the integrity and function of the chest wall, which may be damaged due to trauma, cancer, infection, or congenital defects. The chest wall plays a vital role in protecting the thoracic organs, supporting the respiratory system, and maintaining the shape of the chest. Therefore, any defect or deformity of the chest wall can have significant functional and aesthetic consequences for the patient. The authors present a case report at Kenyatta National Hospital (KNH) of a dyspneic 47-year-old male patient with a right anterolateral chest wall defect post-pneumonectomy previously complicated by bronchopleural fistula. Past attempts at the chest wall reconstruction had utilized the ipsilateral latissimus dorsi muscle, pectoralis major muscle, and the omental pedicled flaps with limited success. A chimeric anterolateral thigh (ALT) perforator-free flap with vastus lateralis (VL) muscle was used to obliterate the post-pneumonectomy intrathoracic dead space and to provide a cutaneous paddle. This case report aims to show the versatility of the ALT flap for chest wall reconstruction to prevent the post-pneumonectomy syndrome associated with tracheal deviation, inspiratory stridor, and exertional dyspnea. In conclusion, chest wall reconstruction with obliteration of intrathoracic dead space post-pneumonectomy is challenging and needs careful planning and execution.

Optimization and Characterization of Cellulose Extraction from Grevillea robusta (Silky Oak) Leaves by Soda-Anthraquinone Pulping Using Response Surface Methodology

Response surface methodology (RSM) using the central composite design (CCD) was applied to examine the impact of soda-anthraquinone pulping conditions on Grevillea robusta fall leaves. The pulping factors studied were: NaOH charge 5% to 20% w/v, pulping time 30 to 180 minutes, and the anthraquinone charge 0.1 to 0.5% w/w based on the oven-dried leaves. The responses evaluated were the pulp yield, cellulose content, and the degree of delignification. Various regression models were used to evaluate the effects of varying the pulping conditions. The optimum conditions attained were;NaOH charge of 14.63%, 0.1% anthraquinone, and a pulping period of 154 minutes, corresponding to 20.68% pulp yield, 80.56% cellulose content, and 70.34% lignin removal. Analysis of variance (ANOVA), was used to determine the most important variables that improve the extraction process of cellulose. The experiment outcomes matched those predicted by the model (Predicted R2 = 0.9980, Adjusted R2 = 0.9994), demonstrating the adequacy of the model used. FTIR analysis confirmed the elimination of the non-cellulosic fiber constituents. The lignin and hemicellulose-related bands (around 1514 cm−1, 1604 cm−1, 1239 cm−1, and 1734 cm−1) decreased with chemical treatment, indicating effective cellulose extraction by the soda-anthraquinone method. Similar results were obtained by XRD, SEM and thermogravimetric analysis of the extracted cellulose. Therefore, Grevillea robusta fall leaves are suitable renewable, cost-effective, and environmentally friendly non-wood biomass for cellulose extraction.

Nurse’s knowledge, attitude and practice on the initial management of acute poisoning among adult casualties: Study at Kenyatta National Hospital, Kenya

The purpose of this study was to determine nurse’s knowledge, attitude and practice on the initial management of acute poisoning among adult casualties seen at Accident and Emergency Department (AED), Kenyatta National Hospital (KNH). The study was cross sectional. Both qualitative and quantitative methods of data collection were employed. The target population were all nurses working at AED, KNH. Purposive sampling was used to select study subjects. Sample size included all Accident and Emergency (A&E) nurses who met subject’s inclusion criteria. Structured questionnaires, observation checklist and interview were used to collect the data. Sixty eight (82%) of A&E nurses participated in this study. The study found out that with higher nursing qualification and training on courses related to emergency care, knowledge and skills of A&E nurses on the initial management of acute poisoning is enhanced. A&E nurses with lower education level had a higher mean score of positive attitude compared with nurses with higher nursing qualification. Majority 60 (88.2%) of the A&E nurses indicated that, they required more training on the initial management of acute poisoning. Study recommends that A&E nurses should be trained on various types of poisoning including;assessment, clinical presentations and management to include gut decontaminations. In addition, refresher courses should be organised for those already trained. Flowcharts that will enhance easy identification and management of poisoned casualties should be put in place and utilized accordingly.

Association between the Length of Interpregnancy Interval and Pregnancy Outcomes in Women with One Previous Caeserian Section Undergoing a Repeat Caeserian Delivery at Term at Pumwani Maternity Hospital between 2014 and 2018 a Cross-Sectional Study

Caesarean sections constitute major surgery, and are associated with immediate maternal and perinatal risks with implications on future pregnancies. After a caesarean delivery, the World Health Organization (WHO) recommends an Inter-pregnancy Interval (IPI) of at least 24 months to lower the risk of adverse maternal and perinatal outcomes in the subsequent pregnancy. However, whether the recommendation confers obstetric benefits is unclear as there’s paucity of data in low- and medium-income countries (LMIC). The objective was to determine the association between IPI length and maternal and neonatal outcomes in women with one previous caesarian section undergoing a repeat caesarian delivery at term in Pumwani Maternity Hospital between 1st January 2014 and 31st December 2018. A cross-sectional study was done where patients who had delivered via repeat caesarean section at term between 1st January 2014 and 31st December 2018 were evaluated. The files of 625 patients were retrieved and IPI was determined from the time interval between a previous caesarean section delivery and the beginning of the subsequent pregnancy, established from the date of the last normal menstrual period as recorded or extrapolated from an early trimester obstetric scan. The files were allotted to study groups as follows: <24 months/short IPI (n = 170), 24 - 29 months/intermediate IPI (n = 384), and 60+ months/long IPI (n = 121) and data on sociodemographic/reproductive characteristics and maternal and neonatal outcomes abstracted and uploaded to SPSS (version 21) worksheet. Descriptive, bivariate, and multivariate logistic regression analyses were done and a p-value of 0.05 was considered statistically significant. The demographic and reproductive characteristics were comparable across the three IPI groups. Maternal outcomes such as uterine rupture, post-partum haemorrhage (PPH), blood transfusions, preeclampsia, and maternal mortality were comparable across short, intermediate, and long IPI. Some neonatal outcomes, however, showed evidence of an association with IPI. These were prematurity (p = 0.03) and developing congenital malformations (p = 0.01). Other neonatal outcomes (birth outcomes, birth weight, Apgar at 5, and NBU admission) were similar. In conclusion, maternal outcomes are comparable when the IPI after a repeat caesarean section at term is short, intermediate, and long. Congenital anomalies and premature births should be anticipated when the IPI is long (more than 59 months).

Comparison and Prediction of the above Ground Carbon Storage in Croplands on the Inhabited Slopes on Mount Kilimanjaro (Tanzania) and the Taita Hills (Kenya)

Mount Kilimanjaro and the Taita Hills are adjacent montane areas that experience similar climate and agricultural activity, but which differ in their geologic history, nature of elevation gradients and cultures. We assessed differences in cropland above ground carbon (AGC) between the two sites and against environmental variables. One hectare sampling plots were randomly distributed along elevational gradients stratified by cropland type;AGC was derived from all trees with diameter ≥ 10 cm at breast height in each plot. Predictor variables were physical and edaphic variables and human population. A generalized linear model was used for predicting AGC with AIC used for ranking models. AGC was spatially upscaled in 2 km buffer and visually compared. Kilimanjaro has higher AGC in cropped and agroforestry areas than the Taita Hills, but only significant difference in AGC variation in agroforestry areas (F = 9.36, p = 0.03). AGC in cropped land and agroforestry in Kilimanjaro has significant difference on mean (t = 4.62, p = 0.001) and variation (F = 17.41, p = 0.007). In the Taita Hills, significant difference is observed only on the mean AGC (t = 4.86, p = 0.001). Common tree species that contribute the most to AGC in Kilimanjaro are Albizia gummifera and Persea americana, and in the Taita Hills Grevillea robusta and Mangifera indica. Significant and univariate predictors of AGC in Mount Kilimanjaro are pH (R2 = 0.80, p = 0.00) and EVI (R2 = 0.68, p = 0.00). On Mount Kilimanjaro, the top multivariate model contained SOC, CEC, pH and BLD (R2 = 0.90, p = 0.00), whereas in the Taita Hills, the top multivariate model contained elevation, slope and population (R2 = 0.89, p = 0.00). Despite of the difference in land management history of Mount Kilimanjaro and the Taita Hills, mean of AGC in croplands does not differ significantly. Difference occurs on variation of AGC, type of trees contributing AGC, and environmental variables that explain AGC distribution. The research results provide reference for management of carbon sequestration on inhabited montane areas.

Stability Analysis of a Multi Area System with Renewable Energy and Multi-Terminal DC Tie Lines

Security constrained multi area multi objective dynamic economic dispatch (SCMAMODED) with renewable energy (RE) and all the possible MTDC stability constraints is formulated for the first time. The stability merits of multi terminal DC (MTDC) tie lines as compared to the traditional HVAC forms the main objective of this paper. Probabilistic load flow (PLF) is applied to determine the system parameters while the uncertainties are modelled using Scenario Based Method (SBM). The simulation results reveal that with the use of MTDC tie lines, the frequency and voltage stability in the MAMODED with renewable energy sources (RES) are enhanced while keeping the MTDC power exchange interface nodes at secure levels.

Security and Stability Aspects of Multi Objective Dynamic Economic Dispatch with Renewable Energy and HVDC Transmission Lines

Renewable sources of energy are being integrated into the power grids due to their economic and environmental merits as compared with the traditional fossil-fuel-fired power generation. However, their significant penetration demands a thorough research in terms of system reliability, that is, security and stability. In this paper, Security Constrained Multi Objective Dynamic Economic Dispatch (SCMODED) problem considering cubic thermal cubic cost function, wind, solar penetration, cubic transmission power losses and cubic emissions cost function as objectives is first formulated. Both HVDC and HVAC lines are included in their formulation. Various approaches like probabilistic load flow (PLF), scenario based method, participation factors and Harmony Search algorithm etc. are employed in the solution process. Security and stability effects of renewable energy (RE) penetration are investigated and analyzed. The simulated results reveal that RE penetration leads to reduced cost and emissions and increased security concerns. Further, there is increased power system instability and hence increased load shedding so as to help the power system attain steady state stability. Inclusion of HVDC lines facilitates rapid and fast control to increase the transient stability limit by the action of the converter ignition angle (CIA) and converter extinction angle (CEA).

Impact of Climate Change on Species Distribution and Carbon Storage of Agroforestry Trees on Isolated East African Mountains

Changes in climate will affect conditions for species growth and distribution, particularly along elevation gradients, where environmental conditions change abruptly. Agroforestry tree (AGT) species on the densely inhabited slopes of Mount Kilimanjaro and Taita Hills will change their elevation distribution, and associated carbon storage. This study assesses the potential impacts of climate change by modelling species distribution using maximum entropy. We focus on important agroforestry tree species (Albiziagummifera, Mangiferaindica and Perseaamericana) and projected climate variables under IPCC-AR5 RCP 4.5 and 8.5 for the mid-century (2055) and late century (2085). Results show differential response: downward migration for M. indica on the slopes of Mount Kilimanjaro is contrasted with Avocado that will shift upslope on the Taita Hills under RCP 8.5. Perseaamericana will lose suitable habitat on Kilimanjaro whereas M. indica will expand habitat suitability. Potential increase in suitable areas for agroforestry species in Taita Hills will occur except for Albizia and Mango which will potentially decrease in suitable areas under RCP 4.5 for period 2055. Shift in minimum elevation range will affect species suitable areas ultimately influencing AGC on the slopes of Mount Kilimanjaro and Taita Hills. The AGC for agroforestry species will decrease on the slopes of Mount Kilimanjaro but AGC for Mango will increase under RCP 8.5 for period 2055 and 2085. In Taita Hills, AGC will remain relatively stable for A. gummifera and P. americana under RCP 8.5 for period 2055 and 2085 but decrease in AGC will occur for M. indica under projected climate change. Climate change will affect AGT species and the amount of carbon stored differently between the sites. Such insight can inform AGT species choice, and conservation and support development by improving carbon sequestration on sites and reliable food production.

Effectiveness of Drought Risk Reduction Policies: Case Study of Hay Production in Kajiado County, Kenya

Kenya has integrated several international, continental, and regional strategies and policies into its national and county programs to address climate-related disasters in livestock systems in pastoralism. This study reviews how these policy instruments have been integrated into local laws and the viability of hay production, a drought risk reduction strategy. The methodology used was a desktop review of policies, a KAP survey using a quantitative and qualitative questionnaire on 354 pastoralists and key informants selected using stratified random sampling, and a cost-benefit analysis of 23 hay farms in Kajiado-Central sub-county. The findings established that Kenya had adopted adequate legal instruments to support disasters in general and droughts specifically. However, the strategies are not elaborated into practical guidance resulting in poor implementation. For instance, the flagship hay production project in Kajiado focuses on building infrastructure on the government farms, with little support going to the actual hay farmers. In addition, staffing levels of technical officers are too low to adequately translate the strategies into activities that address the hay farmer’s pain points, namely the lack of a stable hay market, expensive capital assets and machinery, lack of quality forage seeds, and extension education. This paper recommends reviewing the implementation of the ongoing hay flagship projects to address the hay enterprise’s profitability and elaborating the strategies down to guidance that can be easily rolled out cognizant of the low staffing levels. Public-private partnerships can also address some challenges by stabilizing the hay markets, providing storage, and maintaining good-quality hay. In addition, the strategic feed reserve should include hay for pastoral livestock systems under drought risk reduction programs. Thus, targeted, relevant projects are critical if private hay enterprises are a sustainable drought risk reduction strategy.

Analysis of Hay Demand from Pastoralism Systems on Viability of Hay Production as a Climate Adaptation Strategy in Kajiado County, Kenya

Hay production is a flagship project under drought risk reduction and climate change adaptation programs in pastoralism livestock systems in Kenya. For decision-makers to plan and evaluate their projects, they need localized data on hay production and supply and to understand what attitudes influence demand for hay by pastoralists. A cost-benefit analysis on 23 hay farms and a questionnaire knowledge, attitude and practice survey on 340 pastoralists in Kajiado Central were undertaken. This study provides the hay production versus hay deficit figures in Kajiado Central County. The study also measures the financial losses livestock keepers incur during drought migration and correlates these losses against livestock keeper’s decision to buy hay for their animals. The study established that the drought in 2017, Kajiado Central County had a 48% hay deficit (2,580,000 hay bales) worth about KES 902 million needed to cover three months of the severest period of the drought. At the same time, hay production and supply were 49,138 grown hay and 3292 purchased hay bales and 6177 bags of commercial feeds and forage. The study also found that 86% of livestock keepers buy hay only when their animals started dying at the severest period of the drought. Hay buying mainly occurs in drought years, and averagely for three months only. From 2005 to 2020, there have been five years of severe drought. Because hay production is a critical climate change adaptation and mitigation strategy for droughts, Kajiado needs to reduce the hay deficit by 67% (average of 2015 & 2017), disaster management planners need to align the hay supply to hay purchasing practices. In addition, decision-makers need to address the low hay supply by tackling the challenges of hay production. Furthermore, disaster management planners could use the study to determine the trigger points to start disaster response for livestock feed.

Why Kenya should worry about Anopheles stephensi

On the 18th of February, the Kenya Medical Research Institute(KEMRI) raised an alarm that it had detected Anopheles(An.) stephensi in Laisamis and Saku sub counties of Marsabit county during a routine mosquito surveillance[1,2]. Up until this announcement, the invasive mosquito had been reported in other horn of African countries: Djibouti(2012), Ethiopia(2016).

Enhanced surveillance and cohesive policies needed to tackle Rift Valley fever

Dear editor,There has been an upsurge in Rift Valley fever (RVF) outbreaks in Kenya in the recent past.Even as I write this letter,the country is experiencing an outbreak which was confirmed by the Ministry of Health on 8 June 2018[1].The current outbreak was first reported in Wajir County on 2nd June but has currently spread to other

World’s first malaria vaccine and its significance to malaria control in Africa

In October 2021,the World Health Organization(WHO)endorsed the first malaria vaccine,as a complementary tool for widespread use among children in at-risk areas;sub-Saharan Africa and in other regions with moderate to high Plasmodium falciparum malaria transmission,including our country,Kenya[1].The breakthrough followed three decades of clinical trials in seven African countries including Ghana,Kenya and Malawi,where a large-scale pilot programme coordinated by the WHO since 2019,administered 2.3 million doses of Mosquirix,the malaria vaccine,to infants[1].