G.P. Pokhariyal

An exploration of opportunities and challenges facing cervical cancer managers in Kenya

BackgroundKenya like other developing countries is low in resource setting and is facing a number of challenges in the management of cervical cancer. This study documents opportunities and challenges encountered in managing cervical cancer from the health care workers’ perspectives. A qualitative study was conducted among cervical cancer managers who were defined as nurses and doctors involved in operational level management of cervical cancer. The respondents were drawn from four provincial hospitals and the only two main National public referral hospitals in Kenya. Twenty one [21] nurse managers and twelve [12] medical doctors were interviewed using a standardized interview guide. The responses were audio recorded, transcribed verbatim and the content analyzed in emerging themes.FindingsFour themes were identified. Patient related challenges included a large number of patients, presenting in the late stage of disease, low levels of knowledge on cancer of the cervix, low levels of screening and a poor attitude towards screening procedure. Individual health care providers identified a lack of specialised training, difficulty in disclosure of diagnosis to patients, a poor attitude towards cervical cancer screening procedure and a poor attitude towards cervical cancer patients. Health facilities were lacking in infrastructure and medical supplies. Some managers felt ill-equipped in technological skills while the majority lacked access to the internet. Mobile phones were identified as having great potential for improving the management of cervical cancer in Kenya.ConclusionKenya faces a myriad of challenges in the management of cervical cancer. The peculiar negative attitude towards screening procedure and the negative attitude of some managers towards cervical cancer patients need urgent attention. The potential use of mobile phones in cervical cancer management should be explored.

A dynamical model for stage-specific HIV incidences with application to sub-Saharan Africa

In this paper a deterministic model for HIV epidemic with three stages of disease progression among infected patients is discussed. It is assumed that the patient once infected experiences disease progression up to full-blown AIDS. Using two systems of ordinary differential equations that are coupled through a delay in one of the systems, a compartmental model for the dynamics of the HIV/AIDS epidemic is constructed. The transmission of the disease is considered to be only through heterosexual contact and vertically from an infected mother to her unborn child. Numerical integration of the equations is used for simulating the stage-specific epidemic curves, given the demographic and epidemiological parameters of the model. The simulation results with respect to Ugandas HIV/AIDS epidemic scenario obtained are found to be consistent with the published findings namely that the corresponding prevalence is a non-decreasing function of time for at least 30 years of the epidemic. Furthermore, through simulation it is noted that all the three stage-specific prevalence rate curves also satisfy this condition.

Evaluating the utility of mid-infrared spectral subspaces for predicting soil properties

We propose four methods for finding local subspaces in large spectral libraries. The proposed four methods include (a) cosine angle spectral matching; (b) hit quality index spectral matching; (c) self-organizing maps and (d) archetypal analysis methods. Then evaluate prediction accuracies for global and subspaces calibration models. These methods were tested on a mid-infrared spectral library containing 1907 soil samples collected from 19 different countries under the Africa Soil Information Service project. Calibration models for pH, Mehlich-3 Ca, Mehlich-3 Al, total carbon and clay soil properties were developed for the whole library and for the subspace. Root mean square error of prediction was used to evaluate predictive performance of subspace and global models. The root mean square error of prediction was computed using a one-third-holdout validation set. Effect of pretreating spectra with different methods was tested for 1st and 2nd derivative Savitzky–Golay algorithm, multiplicative scatter correction, standard normal variate and standard normal variate followed by detrending methods. In summary, the results show that global models outperformed the subspace models. We, therefore, conclude that global models are more accurate than the local models except in few cases. For instance, sand and clay root mean square error values from local models from archetypal analysis method were 50% poorer than the global models except for subspace models obtained using multiplicative scatter corrected spectra with which were 12% better. However, the subspace approach provides novel methods for discovering data pattern that may exist in large spectral libraries.

Self-reported use of internet by cervical cancer clients in two National Referral Hospitals in Kenya

BackgroundCervical cancer remains a devastating disease in Kenya accounting for more than 2000 deaths each year. Lack of information on cervical cancer prevention and management has been attributed to the apathy among women in seeking health interventions. Use of internet-based and mobile e-health tools could increase information access among cervical cancer patients. The objective of the study was; to establish the extent of use of mobile phones and internet by cervical cancer patients in accessing information related to cancer treatment and management.; find out the characteristics of patients associated with internet use and identify barriers faced by the patients in internet use. A cross sectional descriptive survey of 199 cervical patients visiting the two main referral hospitals in Kenya was done. A structured questionnaire was used to collect data.FindingsThe average length of illness was 2.43 years (SD ± 3.0). Only 7.5 %( n=15) reported to having used the internet as a source of information. 92.5 %( n=184) did not use internet. With Multiple options, 70.9% did not know how to use a computer, 29.2% did not have access to a computer, 14.6% lacked the money to use computers at the local cyber cafe while other barriers identified accounted for 11.1%. Patients reported that the internet had an important role in the management of cancer of the cervix in health education (17.6%), online consultation (14.6%), booking of patients (13.6%), referrals (8.5%) and collecting data (7%). The 96.5% of the respondents who had access to a mobile phone, recommended mobile phones for health education messages (31.7%), reminder alerts for medication (29.7%) and booking appointments (21.6%). There was a statistically significant association between income of the patients and internet use (p = 0.026) in this study.ConclusionsThere is low level use of the internet by cervical cancer clients attended in Public referral facilities in Kenya. This was attributed to; lack of knowledge on how to use computers and lack of access to a computer. High level of access to mobile phones was reported. This is an indicator of great potential for use of mobile phones in the management of cervical cancer through short messaging services (sms), without internet connectivity. There is even greater potential to internet use through web access via mobile phones.

Analysis of Treatment Methods for Victims of Torture in Kenya and East Africa Region

In this article, a comparative study of multisensory trauma processing (MTP) and conventional treatment (CT) on victims of torture/trauma (VOTs) for Kenyan citizens and refugees from East African Region has been undertaken. Kenyan VOTs were selected from the rosters of People Against Torture (PAT) and Release Political Prisoners (RPP). Refugee VOTs were selected from the United Nations High Commission for Refugees (UNHCR) and Urban Refugee Program implemented by GOAL, Kenya. Participants were randomly assigned to the two (MTP and CT) conditions, and the Stress State Inventory (SSI) scores were used to measure changes in posttraumatic stress disorder (PTSD) symptoms. Data values for 34 Kenyan and 35 refugee VOTs were recorded and analyzed. The study confirms the occurrence of PTSD in both samples. The results revealed that PTSD prevalence was 56% among Kenyan and 77% among refugee VOTs. Both treatments reduced SSI scores and PTSD symptoms in the participants. The study provides preliminary evidence that MT...

A model for the growth of infection

The phenomenon of growth is a widely applicable and investigative topic in various disciplines. An economist would study it in the light of demand and supply. A manager would like to study it as an organisational objective and adhere to it. A statistician is interested in it for the demographic studies. Biologists are interested in the study of the growth of infection in plants, animals and human beings so that suitable preventive measures be taken and adequate treatment be done. In this paper a model for the growth of infection is constructed. The model, however, could be used (or constructed on similar lines) for the general phenomenon of growth. In the first section we introduce the phenomenon of growth of infection. In section two we construct a model for the growth of infection such that it levels off (reaches the steady state or becomes asymptotic) at 1 and mention various measures that could be obtained for the undertaken projects. In section three we study a general case of the growth of infection. Although the studies of section two are particular cases of section three we study them first because of the certainty of some events, especially with the living organism.

Anterior tooth relations in Kenyan Africans

Dental plaster casts of 235 Maasai, 116 Kikuyu and 61 Kalenjin children aged 3-16 yr were studied to determine the incidence and magnitude of diastemas, overbite, overjet and anterior open bite. The highest prevalence of diastema was amongst the Maasai (61.3%), of overbite (84%) and overjet (99%) amongst the Kikuyu, and of anterior open bite amongst Kalenjin (24%), with values greater than 0.4 mm up to 11.5 mm. Comparison of the mean values showed that diastema (1.77 mm) and overjet (4.4 mm) were greatest in Maasai, overbite (3.53 mm) in Kalenjin, and anterior open bite (3.50 mm) in Kikuyu. In the total sample, the prevalence and mean of diastema were 49%, 1.68 mm; of overbite 77.4%, 2.96 mm; of overjet 88.6%, 3.83 mm; and of anterior open bite 16.5%, 2.69 mm (with values between 0.4-11.5 mm), while 5.5% had an edge-to-edge bite (-0.5-0.5 mm). The prevalence of diastema decreased whilst its magnitude increased with age. The mean values of overbite and overjet increased, while those for anterior open bite decreased with age. The mean values of diastema, overbite and overjet were greater amongst the females, but the difference was significant only for overjet. The high prevalence and greater values of measurements of anterior tooth relations may be related to variable growth of the bimaxillary dentoalveolar complex and soft tissue influences. This may be important in orthodontic treatment planning, dental prostheses and other clinical dental treatments in Kenyan populations.

An accurate epidemiological model

In this paper, we present the mathematical basis for generating and assessing simulated disease profiles (S-curves) in plant-pathogen (or other) epidemics with the emphasis on accuracy. After introducing in Section 1 the various modeling factors for disease development, in Section 2, we construct a theoretical epidemiological model based on these factors and also discuss a control strategy. In Section 3, we develop a computational model and compare it with earlier models in epidemiology. Finally, in Section 4, we discuss the simulation results of models and draw a conclusion about the superior accuracy of CME, which is an integrated epidemiological model capable of absorbing the interactions between pathogen, host and environment.

Regression and Simulation Models for Human and Baboon Brain Parameters

Las variaciones en los parametros morfometricos del cerebro de los mamiferos pueden estar influenciadas por el proceso de complejidad funcional de la evolucion y adaptacion. Analisis comparativo de las mediciones lineales del cerebro en el humano y babuino han puesto de manifiesto las diferencias morfometricas. En este estudio las mediciones lineales del cerebro humano y babuinos (n = 10 cada uno) fueron utilizados para predecir los valores distintivos para el cerebro de humanos y monos babuinos y los parametros del cuerpo a traves de modelos de regresion multiple. El peso medio del cerebro resulto ser 2,08% y 0,84% del peso corporal de los seres humanos y los babuinos, respectivamente. La elasticidad de los modelos de regresion revelo que el aumento de una unidad porcentual en la distancia occipital-frontal (DE) aumentaria el peso del cerebro humano en 66,19%, mientras que el peso del cerebro babuino se incrementaria en 7,63%. El porcentaje de aumento en la altura de lobulo temporal (HTL) aumentaria el peso del cerebro humano en 16,28%, mientras que el peso del cerebro babuino aumentaria en solo el 0,28%. Si aumenta la distancia frontal-temporal (FT) se reduciria el peso del cerebro humano y babuinos en 14,04% y 0,46%, respectivamente. Tambien se preveen valores entre las especies a traves de tecnicas de simulacion, mediante el uso de proporciones de los parametros del modelo con la aplicacion del lenguaje de programacion Python. Los valores humanos de DE, FT y HTL resultaron ser 2,01, 1,55 y 1,91 veces, respectivamente con respecto a la de los babuinos.

Perfect fluid distribution in class one space-time

Space-times of class one for which the elementary divisors of the second fundamental tensor are real but not simple, do not admit perfect fluid distributions.