Zimmermann M.R.,University of Washington |
Vodicka E.,University of Washington |
Babigumira J.B.,University of Washington |
Okech T.,Africa International University |
And 4 more authors.
Cost Effectiveness and Resource Allocation | Year: 2017
Objective: This study evaluated the potential cost-effectiveness of cervical cancer screening in HIV treatment clinics in Nairobi, Kenya. Methods: A Markov model was used to project health outcomes and costs of cervical cancer screening and cryotherapy at an HIV clinic in Kenya using cryotherapy without screening, visual inspection with acetic acid (VIA), Papanicolaou smear (Pap), and testing for human papillomavirus (HPV). Direct and indirect medical and non-medical costs were examined from societal and clinic perspectives. Results: Costs of cryotherapy, VIA, Pap, and HPV for women with CD4 200-500 cells/mL were $99, $196, $219, and $223 from a societal perspective and $19, $94, $124, and $113 from a clinic perspective, with 17.3, 17.1, 17.1, and 17.1 years of life expectancy, respectively. Women at higher CD4 counts (>500 cells/mL) given cryotherapy VIA, Pap, and HPV resulted in better life expectancies (19.9+ years) and lower cost (societal: $49, $99, $115, and $102; clinic: $13, $51, $71, and $56). VIA was less expensive than HPV unless HPV screening could be reduced to a single visit. Conclusions: Preventative cryotherapy was the least expensive strategy and resulted in highest projected life expectancy, while VIA was most cost-effective unless HPV could be reduced to a single visit. © 2017 The Author(s).
Abubakar A.,University of Tilburg |
Abubakar A.,University Utrecht |
Alonso-Arbiol I.,University of the Basque Country |
Van de Vijver F.J.R.,University of Tilburg |
And 3 more authors.
Journal of Adolescence | Year: 2013
The current study is aimed at evaluating the relationship between attachment and identity development, and their influence on psychological well-being in adolescents with and without disabilities in Kenya. The sample was composed of 296 adolescents (151 with disabilities and 145 without any disability). The mean age in our sample was 16.84 years (SD=1.75). Adolescents with disabilities had significantly lower scores in identity formation, paternal attachment, and life satisfaction. A path model indicated that identity formation partially mediated the relationship between secure attachment and psychological well-being. Our findings indicate that both parent and peer attachment play an important role in the identity formation and psychological well-being of adolescents in Kenya, irrespective of a disabling condition. A multigroup analysis indicated that while the structure of the relationship between variables held for groups, the pattern and strength of the relationships differed. Implications for practice, especially the guidance and counseling services in schools, are discussed. © 2013 The Foundation for Professionals in Services for Adolescents.
Speelman S.,Ghent University |
Farolfi S.,Africa International University |
Frija A.,Ghent University |
Van Huylenbroeck G.,Ghent University
Journal of the American Water Resources Association | Year: 2010
In the context of increasing water scarcity, understanding is growing that irrigation water rights are important and that a lack of an effective water rights system constitutes a major reason for inefficient water management. This study carried out a contingent ranking experiment to study how smallholder irrigators in South Africa would value potential changes in water rights. Three specific dimensions of water rights, relevant for the South African case, are considered: duration, quality of title, and transferability. Results indicate that smallholder irrigators are prepared to pay considerably higher water prices if improvements are made in the water rights system. This implies that the proposed interventions in the water rights system would improve the efficiency and productivity of the small-scale irrigation sector. The increased willingness to pay could furthermore also assist the South African government to reach the objective of increased cost recovery. © 2010 American Water Resources Association.
PubMed | Catholic University of Health and Allied Sciences, Africa International University, University of Khartoum, Kenya Agricultural Research Institute and University of Gezira
Type: | Journal: Frontiers in public health | Year: 2014
Rift Valley fever (RVF) is an important neglected, emerging, mosquito-borne disease with severe negative impact on human and animal health. Mosquitoes in the Aedes genus have been considered as the reservoir, as well as vectors, since their transovarially infected eggs withstand desiccation and larvae hatch when in contact with water. However, different mosquito species serve as epizootic/epidemic vectors of RVF, creating a complex epidemiologic pattern in East Africa. The recent RVF outbreaks in Somalia (2006-2007), Kenya (2006-2007), Tanzania (2007), and Sudan (2007-2008) showed extension to districts, which were not involved before. These outbreaks also demonstrated the changing epidemiology of the disease from being originally associated with livestock, to a seemingly highly virulent form infecting humans and causing considerably high-fatality rates. The amount of rainfall is considered to be the main factor initiating RVF outbreaks. The interaction between rainfall and local environment, i.e., type of soil, livestock, and human determine the space-time clustering of RVF outbreaks. Contact with animals or their products was the most dominant risk factor to transfer the infection to humans. Uncontrolled movement of livestock during an outbreak is responsible for introducing RVF to new areas. For example, the virus that caused the Saudi Arabia outbreak in 2000 was found to be the same strain that caused the 1997-98 outbreaks in East Africa. A strategy that involves active surveillance with effective case management and diagnosis for humans and identifying target areas for animal vaccination, restriction on animal movements outside the affected areas, identifying breeding sites, and targeted intensive mosquito control programs has been shown to succeed in limiting the effect of RVF outbreak and curb the spread of the disease from the onset.
Tchuenche J.M.,University of Dar es Salaam |
Khamis S.A.,Africa International University |
Agusto F.B.,Federal University of Technology Akurre |
Mpeshe S.C.,P.A. College
Acta Biotheoretica | Year: 2011
We formulate and analyze the dynamics of an influenza pandemic model with vaccination and treatment using two preventive scenarios: increase and decrease in vaccine uptake. Due to the seasonality of the influenza pandemic, the dynamics is studied in a finite time interval. We focus primarily on controlling the disease with a possible minimal cost and side effects using control theory which is therefore applied via the Pontryagin's maximum principle, and it is observed that full treatment effort should be given while increasing vaccination at the onset of the outbreak. Next, sensitivity analysis and simulations (using the fourth order Runge-Kutta scheme) are carried out in order to determine the relative importance of different factors responsible for disease transmission and prevalence. The most sensitive parameter of the various reproductive numbers apart from the death rate is the inflow rate, while the proportion of new recruits and the vaccine efficacy are the most sensitive parameters for the endemic equilibrium point. © 2010 Springer Science+Business Media B.V.
Khamis S.A.,Africa International University |
Tchuenche J.M.,University of Dar es Salaam |
Lukka M.,Lappeenranta University of Technology |
Heilio M.,Lappeenranta University of Technology
International Journal of Computer Mathematics | Year: 2011
A model for two fish species and one predator in a patchy environment is formulated using a deterministic model to study the dynamics of fishery in two homogeneous patches, a free fishing zone and a refuge for prey reserve in which fishing is prohibited. The system is analysed around steady states; the criteria for local and global stabilities are established. The existence of bionomic equilibrium of the system is determined and the conditions for their existence are derived. The optimal harvesting policy is studied by using Pontryagin's maximal principle. Sensitivity analysis is carried out and it is observed that the populations are more sensitive to growth, dispersal and predation rates, least sensitive to the catchability coefficient. Statistical analysis is employed to estimate the parameters and to assess both the uncertainty in the model parameters and in the model-based predictions. Graphical representations of the model are provided. © 2011 Taylor & Francis.
Lubega N.,Africa International University |
Harrison W.J.,Africa International University
Orthopaedics and Trauma | Year: 2010
Infection with HIV leads to a gradual depletion of CD4 cells. HIV patients may present with a multitude of musculoskeletal conditions caused either by HIV infection itself or its treatment with highly active anti retroviral therapy (HAART). However, some musculoskeletal conditions like avascular necrosis of the femoral head are caused by a combination of both HIV infection and its treatment with HAART.HIV patients who need elective orthopaedic operations such as arthroplasty should have these procedures delayed until their general condition is optimized. This includes improving their albumin levels and CD4 counts before surgery.HIV also affects the presentation, management and prognosis of trauma patients. Seropositive patients with closed fractures achieve good outcomes after internal fixation, even if they suffer from significant immune depletion. HIV positive patients with open fractures have a worse outcome compared to HIV negative patients. HIV disease negatively affects wound, and probably fracture, healing. © 2010 Elsevier Ltd.
Wamuyu P.K.,Africa International University
Information Technology for Development | Year: 2015
ICT-based enterprises (ICT-BEs) are businesses that produce ICT products, provide ICT processing technologies, or offer ICT support services. Most ICT-BEs grow in particular niche fields of ICT use by offering services that are well tailored to meet the needs of a specific target market. This however is usually short lived, as alternative technologies are developed each day and availed globally within a few months, while the rate of adoption and diffusion of technology is dependent on other factors other than the ICT itself. In most cases technology diffusion is rather slow and uneven at first, but accelerates rapidly once a critical mass of individuals has adopted the technology. This raises the question of how ICT-BEs can cushion themselves against sudden and unpredictable ICT trends, which may lead to existing customers abandoning a technology for any new alternative technology. The study examines the impact of rapid ICT trends on ICT entrepreneurship in the liberalized and globalized Kenyan ICT market. The study is based on qualitative data, collected through four descriptive case studies selected from micro and small enterprises offering ICT solutions. Findings reveal that rapid changes in ICT trends and early adopters' switching behavior negatively affect the survival of an ICT-BE, while customer satisfaction and entrepreneurial creativity positively influence the survival and success of an ICT-BE. The study provides practitioners, budding ICT entrepreneurs, and policy-makers with essential lessons on how ICT trends affect the growth and survival of ICT-BEs and how to mitigate these negative effects and therefore remain in business. © 2014, © 2014 Commonwealth Secretariat.
Wamuyu P.K.,Africa International University
2016 IST-Africa Conference, IST-Africa 2016 | Year: 2016
With most households in rural Kenya dependent on meagre wages from manual labor, the task of balancing immediate family needs with long-Term financial goals is usually a difficult task, which in most cases leave families with minimal or no savings. This paper articulates a study to investigate the potential of using mobile money accounts as a money management platform that can help promote a savings culture as well as establish and nurture financial discipline among poor households in Kenya. Based on the premises that 41% of Kenyans do not save regularly because they do not have enough money to live on let alone save for a rainy day, the study examined innovative ways in which poor households could use mobile money accounts as a tool for financial inclusion, achieving household financial security, and enhancing family role performance. The study took place in Nairobi's Mathare slum. It aimed to understand, in depth, mobile money savings accounts usage among poor households. Key informants were low income traders, who earns a daily income of less than two dollars (about 200 Kenya Shillings). Data was collected using a questionnaire, informal conversations and contextual interviews and supplemented by in-depth interviews with managers from a leading mobile money service provider and the mobile money provider commercial banks. The study results indicates that lack of awareness on the available and affordable mobile money savings products, low interest rates on mobile money fixed deposit savings accounts and high transaction costs when making mobile money payments impacts negatively on mobile money fixed deposit savings accounts usage while availability of microcredit on mobile money savings accounts has a positive effect on the usage. The study provides policy and technology design recommendations that could aid in mobile money lock savings accounts acceptance. © 2016 IIMC.
Catley A.,Africa International University |
Admassu B.,Africa International University |
Abebe D.,Africa International University
Disasters | Year: 2014
Participatory epidemiology methods were employed retrospectively in three pastoralist regions of Ethiopia to estimate the specific causes of excess livestock mortality during drought. The results showed that starvation/dehydration accounted for between 61.5 and 100 per cent of excess livestock mortality during drought, whereas disease-related mortality accounted for between 0 and 28.1 per cent of excess mortality. Field observations indicate that, in livestock, disease risks and mortality increase in the immediate post-drought period, during rain. The design of livelihoods-based drought response programmes should include protection of core livestock assets, and it should take account of the specific causes of excess livestock mortality during drought and immediately afterwards. This study shows that, when comparing livestock feed supplementation and veterinary support, relatively more aid should be directed at the former if the objective is to protect core livestock during drought. Veterinary support should consider disease-related mortality in the immediate post-drought period, and tailor inputs accordingly. © 2014 The Author(s).