Asset-Based Adaptation Project Promotes Tree and Shrub Diversity and Above-Ground Carbon Stocks in Smallholder Agroforestry Systems in Western Kenya

Agroforestry has potential to address the adverse effects of climate change through carbon sequestration, increasing biodiversity and improving adaptive capacity and resilience among smallholder farmers. However, this potential is context specific and insufficiently quantified in smallholder faming systems, partly because of inherent variability of smallholder farms. Our study aimed to determine the tree/shrub diversity and carbon stocks in different agroforestry systems within smallholder farms in two 100 km2 sites, the so-called lower and middle Nyando sites, in western Kenya. In both, context-specific agroforestry adoption had been promoted among households of four community associations through an asset-based community development (ABCD) approach. Their farms were assessed and compared with those of relevant comparison samples. Trees and shrubs were inventoried on a total of 106 farms, and their formations classified in five major agroforestry practices: hedgerows, multipurpose trees on farm (MPT), riparian buffers, woodlots, and boundary planting. To assess above-ground biomass (AGB) of individual trees/shrubs, diameter at breast height measurements were taken. Strong regional differences were considered in data analysis and presentation. Altogether, 3,353 and 6,346 trees/shrubs were inventoried in the lower and middle Nyando sites, respectively. AGB was significantly higher in middle than in lower Nyando. Woodlots had the highest amount of AGB carbon stock, while MPT had the highest diversity of tree/shrub species in all the groups. Conversely, boundary planting had the highest number of trees/shrubs inventoried and hence was the most common agroforestry practice across all the samples in both regions. Dominant AGB contributor species were Grevillea robusta (37.8%) in middle, and Eurphobia tirucalli (16.5%) in lower Nyando. This study provides empirical evidence that asset-based and community-driven selection and implementation of both tree/shrub species and agroforestry practices can contribute positively to species and practice diversity, which are associated with AGB carbon stock levels and wider agro-ecosystem diversity. This study hence provides benchmark information that is relevant for SDG goal 15 on “life on land,” and various specific targets, and can inform sustainable establishment of carbon sink facilities by supporting smallholders to uptake contextually suitable and economically sensible agroforestry practices in an overall effort to foster and support sustainable development.

Asymptomatic and Submicroscopic Plasmodium Infections in an Area Before and During Integrated Vector Control in Homa Bay, Western Kenya

Background Long lasting insecticidal bednets (LLINs) have been the primary vector control strategy until indoor residual spraying (IRS) was added in Homa Bay and Migori Counties in western Kenya. The objective of this study was to evaluate the impact of LLINs integrated with organophosphate-based (Actellic 300 CS) IRS on the prevalence of asymptomatic and submicroscopic Plasmodium species infections in Homa Bay County. Methods Four consecutive community cross-sectional surveys for Plasmodium species infection were conducted in residents of Homa Bay County, Kenya commencing immediately before and 2 years after introduction of annual IRS. Finger-prick blood samples were obtained to prepare thick and thin smears for microscopic determination and qPCR diagnosis of Plasmodium genus, P. falciparum, P. malariae and P. ovale infection. Results Plasmodium spp. infection prevalence by microscopy was 18.5% before IRS and 14.2%, 3.3% and 1.3% after two annual rounds of IRS (χ²= 186.9, df = 3, p < 0.0001). Submicroscopic (blood smear negative, qPCR positive) parasitemia was 50.4% before IRS and 43.2%, 68.0% and 80.7% after IRS (χ²= 31.98, df = 3, p < 0.0001). Geometric mean density of P. falciparum parasitemia decreased over the 2-year study period (ANOVA, F = 28.95, df = 3, 243, p < 0.0001). The proportion of blood smear positive asymptomatic infections that included P. falciparum did not significantly change over the study period. In contrast, the proportion of asymptomatic submicroscopic P. falciparum infections trended upward following introduction of IRS (pre-IRS 48.2% versus post-IRS 41.6%, 61.3% and 75.4%; (χ²= 24.00, df = 3, p = 0.0002). Conclusions These data suggest that two annual rounds of IRS integrated with LLIN significantly reduced the prevalence of Plasmodium parasitemia, whereas the proportion of submicroscopic infections that included P. falciparum parasite increases. Strategies that aim at reducing the number of asymptomatic submicroscopic infections should be considered to diminish cryptic P. falciparum transmission and enhance malaria control.

Comparison of household socioeconomic status classification methods and effects on risk estimation: Lessons from a natural experimental study, Kisumu, Western Kenya

IntroductionLow household socioeconomic status is associated with unhealthy behaviours including poor diet and adverse health outcomes. Different methods leading to variations in SES classification has the potential to generate spurious research findings or misinform policy. In low and middle-income countries, there are additional complexities in defining household SES, a need for fieldwork to be conducted efficiently, and a dearth of information on how [1]classification could impact estimation of disease risk. MethodsUsing cross-sectional data from 200 households in Kisumu County, Western Kenya, we compared three approaches of classifying households into low, middle, or high SES: fieldworkers (FWs), Community Health Volunteers (CHVs), and a Multiple Correspondence Analysis econometric model (MCA). We estimated the sensitivity, specificity, and inter-rater reliability and misclassification of the three methods using MCA as a comparator. We applied an unadjusted generalized linear model to determine prevalence ratios to assess the association of household SES status with a self-reported diagnosis of diabetes or hypertension for one household member. Results Compared with MCA, FWs successfully classified 21.7% (95%CI=14.4%-31.4%) of low SES households, 32.8% (95%CI=23.2-44.3) of middle SES households, and no high SES households. CHVs successfully classified 22.5% (95%CI=14.5%-33.1%) of low SES households, 32.8% (95%CI=23.2%-44.3%) of middle SES households, and no high SES households. The level of agreement in SES classification was similar between FWs and CHVs but poor compared to MCA, particularly for high SES. None of the three methods differed in estimating the risk of hypertension or diabetes. ConclusionsFW and CHV assessments are community-driven methods for SES classification. Compared to MCA, these approaches appeared biased towards low or middle household SES and not sensitive to high household SES. The three methods did not differ in risk estimation for diabetes and hypertension. A mix of approaches and further evaluation to refine SES classification methodology is recommended.

A Qualitative Examination of Perceived Stigma and its Sources Among Adolescents Living With HIV in Western Kenya

Introduction. Adolescents (10-19 years) living with HIV (ALWH) face unique challenges in controlling HIV long-term, including stigma and perception of stigma within their communities. Methods. We conducted a qualitative investigation of the sources of perceived HIV-related stigma with ALWH in western Kenya. Forty-six ALWH on ART, aware of their status, and engaged in care were enrolled. Interviews explored perceived stigma by probing the individuals and experiences that adolescents identify as causing or perpetuating their ongoing fears. Results. Participants (54% male, mean age 17.4) reported ongoing fears of stigmatization related to friends and peers not living with HIV. They described previous enacted and first-hand observations of stigma, most often occurring in pre-adolescence, by age mates or peers at school as the most common cause for their ongoing fears. Conclusions. Perceived stigma is prevalent among ALWH and develops from experiences in pre-adolescence. Anti-HIV stigma interventions addressing educators and children in school settings to combat perceived stigma at its source should be investigated.

Molecular Characterization and Genotype Distribution of Thioester-containing Protein 1 Gene, A Key Regulator of Malaria Transmission in An. Gambiae Mosquitoes in Western Kenya

BackgroundEvolutionary pressures lead to the selection of efficient malaria vectors either resistant or susceptible to Plasmodiumparasites.These forcesmay elevate the introduction of new species genotypes that adapt to new breeding habitats which could have serious implications on malaria transmission.Thioester-containing protein 1 (TEP1) of Anopheles gambiaeplays an important role in innate immune defenses against parasites. This study aims to characterize the distribution pattern of TEP1 polymorphisms determining vector competence and subsequently malaria transmission in western Kenya. MethodsAnopheles gambiaeadult and larvae were collected using pyrethrum spray catches (PSC) and plastic dippers respectivelyfrom Homa Bay, Kakamega, Bungoma, and Kisumu countiesbetween 2017 and 2020.Collected adults and larvae reared to the adult stage were morphologically identified and then identified to sibling species by PCR.TEP1 alleles were determined using restriction fragment length polymorphisms-polymerase chain reaction (RFLP-PCR) and to validate the TEP1 genotyping results, a representative sample of alleles was sequenced.ResultsTwo TEP1 alleles (TEP1*S1 and TEP1*R2)and three corresponding genotypes (*S1/S1, *R2/S1, and *R2/R2)were identified. TEP1*S1 and TEP1*R2 with their corresponding genotypes, homozygous *S1/S1 and heterozygous *R2/S1 were widely distributed across all sites with allele frequencies of approximately 80% and 20%, respectively bothin An. gambiaeand An. arabiensis. There was no significant difference detected among the population and between the two mosquito species in TEP1 allele frequency and genotype frequency. The overall low levels in population structure (FST= 0.019) across all sites corresponded to an effective migration index (Nm= 12.571) and lowNei’s genetic distance values (<0.500) among the subpopulation.The comparative fixation index values revealed minimal genetic differentiation between speciesand high levels of gene flow among populations.ConclusionThere is a low genetic diversity and population structure in western Kenya. TEP1* R2 and TEP1*S1 were the most common alleles in both species which may have been maintained through generations in time, However, the TEP1*R2 allele was in low frequencies and may be used to estimatemalaria prevalence. Continued surveillance of the distribution of TEP1 is essential for monitoring the population dynamics of local vectors and their implications on malaria transmission and hence designing targeted vector interventions.

Cross-Sectional Association of Food Source with Food Insecurity, Dietary Diversity and Body Mass Index in Western Kenya

The triple burden of malnutrition in many low- and middle-income countries (LMICs) is partly a result of changing food environments and a shift from traditional diets to high-calorie Western-style diets. Exploring the relationship between food sources and food- and nutrition-related outcomes is important to understanding how changes in food environments may affect nutrition in LMICs. This study examined associations of household food source with household food insecurity, individual dietary diversity and individual body mass index in Western Kenya. Interview-administered questionnaire and anthropometric data from 493 adults living in 376 randomly-selected households were collected in 2019. Adjusted regression analyses were used to assess the association of food source with measures of food insecurity, dietary diversity and body mass index. Notably, participants that reported rearing domesticated animals for consumption (‘own livestock’) had lower odds of moderate or severe household food insecurity (odds ratio (OR) = 0.29 (95% CI: 0.09, 0.96)) and those that reported buying food from supermarkets had lower odds of moderate or severe household food insecurity (borderline significant, OR = 0.37 (95% CI: 0.14, 1.00)), increased dietary diversity scores (Poisson coefficient = 0.17 (95% CI: 0.10, 0.24)) and higher odds of achieving minimum dietary diversity (OR = 2.84 (95% CI: 1.79, 4.49)). Our findings provide insight into the relationship between food environments, dietary patterns and nutrition in Kenya, and suggest that interventions that influence household food source may impact the malnutrition burden in this context.

Immunohistochemical Analysis of Prostein Expression in Archived Prostatic Core Biopsies from Prostate Cancer Patients in Western Kenya

Background Prostate cancer is the leading cause of cancer-associated mortality in men. Most of the current biomarkers for detection of the disease have low sensitivity and specificity. Prostein is a newly reported prostate cancer biomarkers whose diagnostic utility can help in early detection of the disease. Nonetheless, previous studies have utilized limited number of samples to evaluate its immunohistochemistry (IHC) and reports on the African population are not available. The current study aimed to determine the prostein expression in archived prostatic core biopsies from prostate cancer patients in Western Kenya. Materials and Methods This was a retrospective study conducted on malignant and benign prostatic tissue core biopsies of 106 patients who underwent prostate core biopsy at Jaramogi Oginga Odinga Teaching and Referral Hospital and division of urology at Synergy Clinics, Kisumu between January 2018 to May 2021. Immunohistochemical technique was performed on each of the 106 samples and on the following non-prostatic male control biopsies; Testis, Penis, Liver and Esophagus. Cellular location of prostein staining was evaluated at X40, X100 and X400 magnification using a light microscope and was classified as cytoplasmic or nucleocytoplasmic. Intensity of prostein expression was assessed for each core biopsy at similar magnification and graded according the immunohistochemistry composite score. Results The biopsies had been obtained from men whose mean (SE) age was 72.00±0.93 years. 95.3% (101) of the biopsies were malignant and 4.7% (5) were benign. Four non-prostatic male tissues were included. 97% of malignant and all the benign prostate tissue stained positive for prostein whereas the four non-prostatic male tissues were negative. Staining intensities were weak (24.5%), Moderate (17.0%), strong (55.7%) and non-stained (2.8%). The staining was highly immunolocalized within the cytoplasm (95.1% cases) as compared to nucleocytoplasmic (2.0% cases). The mean immunoreactivity composite score was 1.91±0.96 (0.0-3.14). Strongly stained sections had a punctate plasma membrane staining pattern clustered within the cytoplasm in a perinuclear location whereas the weakly stained sections had faint and punctate coarse brown cytoplasmic granular appearing. Conclusion Prostein is exclusively expressed in benign and malignant prostate tissue with a higher cytoplasmic granular staining pattern in the present population. These findings suggest that prostein diagnostic utility is applicable in the current study population and routine IHC diagnosis of prostate cancer may be recommended.

Performance of Urochloa and Megathyrsus Forage Grasses in Smallholder Farms in Western Kenya

Livestock productivity has remained low in sub-Saharan African countries compared to other places on the globe. The feeding component is the major limitation, in both quantity and quality. Among other inputs, feeding takes 55–70% of the costs involved. Livestock play a major role especially in smallholder mixed farms through provision of household nutrition and income through milk and meat. Equally, fertilization of cropland benefits from livestock manure, and livestock often act as insurance and savings by providing liquidity for unforeseen and urgent financial needs. Increasing livestock productivity would enhance the fore-mentioned benefits contributing to well-being and livelihoods. Toward this endeavor and with smallholder dairy farmers' participation, we undertook an evaluation of 10 selected forages from Urochloa Syn. Brachiaria and Megathyrsus syn. Panicum genus and compared them with Napier grass, i.e., Cenchrus purpureus Syn. Pennisetum purpureum commonly grown by farmers. For detailed and robust evaluation, we established the species in eight trial sites spread in four administrative counties in Western Kenya (Bungoma, Busia, Kakamega, and Siaya). In each site, the forages were established in plots in a randomized complete block design, replicated three times. Each site was linked to a group of farmers interested in dairy. For 2 years, dry matter production, plant height, and leaf-to-stem ratio was determined across all sites. Further, we guided farmers to generate participatory forage evaluation criteria, which they later administered across their respective forage demonstration sites individually on plot-by-plot basis to generate preference rating compared to what they normally grow—Napier grass. The results showed significant differences across the forage types within and between the sites. Cumulative dry matter yields ranged 13.7–49.9 t/ha over 10 harvestings across forage types and the counties, while values for crude protein were 1.85–6.23 t/ha and 110,222–375,988 MJ/ha for metabolizable energy. Farmer preferences emerged that highlighted forages with likely better chances of adoption with weighed scores ranging 5.5–7.6 against a scale of 1–9, across the counties. The observations provide additional and well-performing forage options for the farmers and possibly in similar production systems and ecologies. Awareness creation targeting livestock and dairy producers would be key, reaching, and informing them on alternative forage options, with potential to increase livestock productivity.