Bioethics in Kenya: Who is Interested in Certificate Courses

Inadequate training in matters of ethics renders health care providers unprepared for dilemmas faced in public health, research, and clinical practice. Certificate course training offer opportunities to gain more knowledge and skills on all matter ethics. Over the past decade, the increase in research activities in Kenya has not been proportionate to training in ethics. The centre of Biomedical Ethics and Culture (CBEC), Kenya Medical Research Institute (KEMRI) Bioethics training Initiative (CK-BTI) is a Forgaty funded program for building capacity in research ethics for Kenya and Pakistan. This paper evaluates the characteristics of participants that attended the CK-BTI certificate level courses in Kenya between 2017 to 2021. This data was analysed for this paper and utilized information from the training application process. Between November 2017 and July 2021, a total of 1,359 applications were received and 457 (33.6%) trained. The target countries were Kenya and Pakistan but interest was drawn from Tanzania, Uganda, Nigeria, and Zambia. The continued interest in the certificate level ethics courses may imply a need to increase the number of ethics training offered within the East African region.

North and East African mitochondrial genetic variation needs further characterization towards precision medicine

Mitochondria are maternally inherited cell organelles with their own genome, and perform various functions in eukaryotic cells such as energy production and cellular homeostasis. Due to their inheritance and manifold biological roles in health and disease, mitochondrial genetics serves a dual purpose of tracing the history as well as disease susceptibility of human populations across the globe. This requires a comprehensive catalogue of commonly observed genetic variations in the mitochondria for all regions throughout the world. So far, however, certain regions, such as North and East Africa have been understudied. Towards this, we have created the most comprehensive quality-controlled North and East African mitochondrial dataset to date by compiling 11 published cohorts with novel data of mitochondrial genomes from 159 Sudanese individuals. We combined these 641 mitochondrial sequences with sequences from the 1000 Genomes (n=2,504) and the Human Genome Diversity Project (n=828) and used the tool haplocheck for extensive quality control and detection of in-sample contamination. Using a subset of high-coverage mitochondrial sequences we predict 15 potentially novel haplogroups in North and East African subjects and observe likely phylogenetic deviations from the established PhyloTree reference for haplogroups L0a1 and L2a1. This demonstrates common hitherto unexplored variants in mitochondrial genomes of the North and East African region that lead to novel phylogenetic relationships, calling for further in-depth population genetic studies in that region.

Saving the endangered Native Victoria Tilapia, Oreochromis variabilis Boulenger (1906), in Upper Victoria Nile

This study investigated the catch estimates, mortality, growth, food and feeding habits, and water parameters of Oreochromis variabilis in Upper Victoria Nile (UVN) from 2008 to 2019. Catch rates ranged 0.32±0.08 to 3.42±1.13 kg, boat-1, day-1 with the length-weight relationship indicating Isometric growth. Growth parameters obtained were L∞=36.75, K=0.44 yr-1, t0=-0.4540, tmax=6.4years, ØL=2.774, ØW=-0.301. Total mortality (Z) was 1.74yr-1, natural mortality (M) =0.95yr-1 using riverine surface temperature (RST) of 26oC giving a fishing mortality F of 0.79 yr-1 and exploitation ratio (E) of 0.4504 showing that growth parameters concurs with annual estimates and yield (F=6.589; P±=0.05). Catch estimates correlated with water parameters that indicated a significant difference. Mortality parameters showed that the fishery could be experiencing exploitation pressure. Although growth rates revealed that the fish is a long-lived species, if managed properly, its population could recover. Therefore, culturing the species and restocking in rivers and lakes in which this specie was not observed in the East African region are recommended.

Ethical, legal and social issues in the use of mobile technologies and archived cellphone data in the East African region: A Scoping Review (Preprint)

BACKGROUND Mobile phone adoption and the implementation of mobile health (mHealth) interventions to overcome health system challenges is on the rise in Africa and elsewhere in the world. Data derived from mobile phones hold great promise for transforming healthcare delivery and public health research. To date, little is known about the ethical, legal and social concerns related to the use of these data in Africa. OBJECTIVE We conducted a scoping review to explore the existing literature in order to understand the current ethical issues that arise when using mobile technology interventions and call detail records for public health research in the context of East Africa. METHODS We searched PubMed database for published studies describing ethical challenges while using mobile technologies and data in public health research between 2000 and 2020. A predefined search strategy was used as inclusion criteria with search terms such as “East Africa”, “mHealth”, “mobile phone data”, “public health”, “ethics”, or “privacy”. We followed five stages of a published framework for scoping reviews by Arksey and O’Malley. These stages include: (1) identifying the research question; (2) identifying relevant studies; (3) study selection; (4) charting the data; and (5) collating, summarizing, and reporting the results. Studies were screened using pre-specified eligibility criteria through a two-stage process by two independent reviewers. Data extracted included title, publication year, target population, geographic region, setting, and relevance to mHealth and ethics. RESULTS Of the 94 studies identified from PubMed, 33 met the review inclusion criteria for the final scoping review. The included studies were conducted in three out of five countries in the East African Community. Five themes emerged as major concerns for using mHealth interventions and mobile phone data: privacy and confidentiality, data security and protection concerns, sociocultural issues, regulatory and legal and, adequate informed consent process. CONCLUSIONS This scoping review identified major crosscutting concerns related to use of mobile technologies and mobile phone data common to the East African region. A comprehensive framework that accounts for ethical, sociocultural, legal and regulatory concerns and, adequate consent process is needed to guide the safe use of mobile technology data for public health research purposes.

Does banking regulatory regime affect the quality of bank earnings in the East African region?

PurposeIn this paper, the authors examine the association between the banking regulatory regime and the quality of bank earnings. We further investigate whether the banking agency regulatory characteristics moderate the association between banking regulation and earnings quality.Design/methodology/approachUsing panel data spanning 29 years over the period 1991 to 2019, the authors model bank earnings quality as a function of scores for banking regulation for 170 banks in the East African region using both the feasible generalized least squares (FGLS) and generalized method of moments (GMM) estimation methods.FindingsThe results, which are robust for endogeneity among other checks, reveal a positive impact of bank regulatory mechanisms on the quality of bank earnings. The authors further establish differential impact of specific regulatory mechanisms, with some contributing positively toward earnings management while others contributing negatively toward earnings management. The differential impacts of banking regulation on earnings quality are also manifested in the country-level analyses.Research limitations/implicationsFirst, the study utilises a mix of bank-specific, country-specific as well as economy-specific variables in one dataset. Second, the authors utilise survey-based data using the World Bank's Bank Regulation and Supervision Surveys (BRSS) for the periods 1999 to 2019. The authors assume that the bank regulatory mechanisms in place pre-1999 are close to the mechanisms in place as per the 1999 BRSS. Given limitations in data availability, the authors are not able to control for banks engaging in multiple activities such as insurance, underwriting of securities, FinTechs, among others.Practical implicationsThe results are useful in bridging the gap between theory and practice regarding the expected effect of strict banking regulations on the quality of earnings in Eastern African Banks. For the positive impact of banking regulation on bank earnings quality to be felt, the institutional, social and environmental specificities of the five selected countries need to be adequately developed and taken into consideration.Originality/valueThis study is perhaps the first to utilise a large dataset of commercial banks from countries in a developing region characterised by relatively lower enforcement and dynamism in the banking regulation. Further, in-depth studies on the association between banking regulation and earnings quality remain sparse.

Future Changes in Precipitation Extremes over East Africa Based on CMIP6 Models

This paper presents an analysis of projected precipitation extremes over the East African region. The study employs six indices defined by the Expert Team on Climate Change Detection Indices to evaluate extreme precipitation. Observed datasets and Coupled Model Intercomparison Project Phase six (CMIP6) simulations are employed to assess the changes during the two main rainfall seasons: March to May (MAM) and October to December (OND). The results show an increase in consecutive dry days (CDD) and decrease in consecutive wet days (CWD) towards the end of the 21st century (2081–2100) relative to the baseline period (1995–2014) in both seasons. Moreover, simple daily intensity (SDII), very wet days (R95 p), very heavy precipitation >20 mm (R20 mm), and total wet-day precipitation (PRCPTOT) demonstrate significant changes during OND compared to the MAM season. The spatial variation for extreme incidences shows likely intensification over Uganda and most parts of Kenya, while a reduction is observed over the Tanzania region. The increase in projected extremes may pose a serious threat to the sustainability of societal infrastructure and ecosystem wellbeing. The results from these analyses present an opportunity to understand the emergence of extreme events and the capability of model outputs from CMIP6 in estimating the projected changes. More studies are recommended to examine the underlying physical features modulating the occurrence of extreme incidences projected for relevant policies.

Economic growth dynamics of the East African region

The article is devoted to the description of the dynamics of the economic development of the East African states. The paper gives a description of the current economic situation of the East African countries, lists the states included in the East African region, gives the economic and geographical characteristics of the studied region. The author also analyses the evolution of the sectoral composition of gross domestic product (GDP) of the East African countries, considers the economic factors that influence the economic growth of the states of the region. The study analyses the problem of employment and unemployment in the East African countries. The paper considers the ways of improving the economic development of the region, in particular, economic diversification, inclusive growth and structural transformation, as well as structural and institutional measures that would encourage productive investment in the economy.

‘It is stressful, almost every hour…’: Experiences of caring for people living with dementia in Kenya—An interpretive phenomenological approach

Introduction As chronic conditions such as dementia become increasingly prevalent, the role of caregivers will become ever more critical. In the East African region, little is known about the experiences of caring for people living with dementia. This study aims to describe the views of being a caregiver, including day-to-day responsibilities and duties, determine the impact of caregiving and understand participants’ experiences of supports available or required to facilitate caring for a person living with dementia in Kenya. Methods This was a qualitative study that employed an interpretative phenomenological analysis (IPA) approach. We used convenience sampling to identify study participants in three counties in Kenya. Participants were main caregivers for the family and hence included both families and paid caregivers. We recruited 10 caregivers to participate in the study (9 females and 1 male). Data were analysed manually following the IPA approach. Results Three main themes emerged from the analysis: the personal experience of caregiving, supports to assist with caregiving and the perceived unmet care needs. The challenges experienced varied based on the support available to the caregiver, the number of years in the caregiving role and knowledge and skills related to providing care. Conclusion Our study shows that caring for a person living with dementia is an arduous experience, requiring significant mental and physical effort. The study highlights a general lack of knowledge and awareness of dementia among families, healthcare professionals and the general public. Training programmes for caregivers, including dementia care skills, educating healthcare practitioners and organising public awareness programmes to understand and accept dementia are urgently needed.