University of Nairobi

About: University of Nairobi is a education organization based out in Nairobi, Nairobi, Kenya. It is known for research contribution in the topics: Population & Health care. The organization has 6702 authors who have published 10777 publications receiving 231294 citations. The organization is also known as: UoN & IAU-020319.

Cardiac surgery capacity in sub-saharan Africa: quo vadis?

Abstract: Background Current data on cardiac surgery capacity on which to base effective concepts for developing sustainable cardiac surgical programs in Africa are lacking or of low quality. Methods A questionnaire concerning cardiac surgery in Africa was sent to 29 colleagues—26 cardiac surgeons and 3 cardiologists in 16 countries. Further, data on numbers of surgeons practicing in Africa were retrieved from the Cardiothoracic Surgery Network (CTSNet). Results There were 25 respondents, yielding a response rate of 86.2%. Three models emerged: the Ghanaian/German model with a senior local consultant surgeon (Model 1); surgeons visiting for a short period to perform humanitarian surgery (Model 2); and expatriate surgeons on contract to develop cardiac programs (Model 3). The 933 cardiothoracic surgeons listed by CTSNet translated into one surgeon per 1.3 million people. In North Africa, the figure was three surgeons per 1 million and in sub-Saharan Africa (SSA), one surgeon per 3.3 million people. The identified 156 cardiac surgeons represented a surgeon to population ratio of 1:5.9 million people. In SSA, the ratio was one surgeon per 14.3 million. In North Africa, it was one surgeon per 1.1 million people. Open heart operations were approximately 12 per million in Africa, 2 per million in SSA, and 92 per million people in North Africa. Conclusion Cardiothoracic health care delivery would worsen in SSA without the support of humanitarian surgery. Although all three models have potential for success, the Ghanaian/German model has proved to be successful in the long term and could inspire health care policy makers and senior colleagues planning to establish cardiac programs in Africa.

Evolution of upper crustal faulting assisted by magmatic volatile release during early-stage continental rift development in the East African Rift

Abstract: During the development of continental rifts, strain accommodation shifts from border faults to intra-rift faults. This transition represents a critical process in the evolution of rift basins in the East African Rift, resulting in the focusing of strain and, ultimately, continental breakup. An analysis of fault and fluid systems in the younger than 7 Ma Natron and Magadi basins (Kenya-Tanzania border) reveals the transition as a complex interaction between plate flexure, magma emplacement, and magmatic volatile release. Rift basin development was investigated by analyzing fault systems, lava chronology, and geochemistry of spring systems. Results show that extensional strain in the 3 Ma Natron basin is primarily accommodated along the border fault, whereas results from the 7 Ma Magadi basin reveal a transition to intra-rift fault–dominated strain accommodation. The focusing of strain into a system of intra-rift faults in Magadi also occurred without oblique-style rifting, as is observed in Ethiopia, and border fault hanging-wall flexure can account for only a minor portion of faulting along the central rift axis (∼12% or less). Instead, areas of high upper crustal strain coincide with the presence of hydrothermal springs that exhibit carbon isotopes and N2-He-Ar abundances indicating mixing between mantle-derived (magmatic) fluids and air saturated water. By comparing the distribution of fault-related strain and zones of magmatic fluid release in the 3 Ma Natron and 7 Ma Magadi basins, we present a conceptual model for the evolution of early-stage rifting. In the first 3 m.y., border faults accommodate the majority of regional extension (1.24–1.78 mm yr–1 in Natron at a slip rate ranging 1.93–3.56 mm yr–1), with a significant portion of intra-rift faulting (38%–96%) driven by flexure of the border fault hanging wall. Fluids released from magma bodies ascend along the border fault and then outward into nearby faults forming in the flexing hanging wall. By 7 m.y., there is a reduction in the amount of extension accommodated along the border fault (0.40–0.66 mm yr–1 in Magadi at a slip rate ranging from 0.62 to 1.32 mm yr–1), and regional extension is primarily accommodated in the intra-rift fault population (1.34–1.60 mm yr–1), with an accompanying transition of magmatic volatile release into the rift center. The focusing of magma toward the rift center and concomitant release of magmatic fluids into the flexing hanging wall provides a previously unrecognized mechanism that may help to weaken crust and assist the transition to intra-rift dominated strain accommodation. We conclude that the flow of magmatic fluids within fault systems plays an important role in weakening lithosphere and focusing upper crustal strain in early-stage continental rift basins prior to the establishment of magmatic segments.

Primary human immunodeficiency virus type 1 infection: clinical manifestations among women in Mombasa, Kenya.

Abstract: The occurrence of clinical manifestations associated with primary human immunodeficiency virus type 1 (HIV-1) infection was evaluated in a prospective cohort study of female sex workers in Mombasa, Kenya. Among 103 women who seroconverted to HIV-1, fever, vomiting, diarrhea, headache, arthralgia, myalgia, skin rash, swollen lymph nodes, extrainguinal lymphadenopathy, inguinal lymphadenopathy, and vaginal candidiasis were noted significantly more frequently at visits in which seroconversion first became evident. Eighty-one percent of seroconverting women had >/=1 of these 11 symptoms or signs. Among 44% of the women, the acute illness was severe enough to prevent them from working. Having >/=2 of 6 selected symptoms and signs yielded a sensitivity of 51%, specificity of 83%, positive likelihood ratio of 3.2, and negative likelihood ratio of 0.5 for acute HIV-1 infection. The recognition of primary HIV-1-infection illness in high-risk populations and subsequent risk-reduction counseling could potentially reduce secondary HIV-1 transmission during this highly infectious period.