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Declining soil fertility and limited quantity and quality of livestock feeds are major constraints to agricultural production in northwestern Kenya. Legumes used as green manures may aid in overcoming soil nutrient depletion and lack of fodder. Relay-cropped mucuna (Mucuna pruriens (L.) DC. var. Utilis (Wright) Bruck) and lablab (Lab- lab purpureus (L.) Sweet cv. Rongai) were evaluated as alternatives to dry season, natural fallow for sustaining soil productivity in a maize (Zea mays L.)-common bean (Phaseolus vulgaris L.) intercrop on farmers' fields in northwestern Kenya. Four treatments were the factorial combinations of the two legumes and two levels of legume defoliation (none, or herbage above 10 cm removed prior to incorporation of remainder). Three controls were cattle manure (5 Mg ha I), inorganic N (30 kg ha-1), and natural fallow. Undefoliated mucuna (UD-M) yielded more biomass (2.3 Mg ha-1, mean of two seasons) than undefoliated lab-lab (UD-L; 0.8 Mg ha-1) under the relay intercrop, contributing more nutrients to succeeding maize than lablab. Defoliation of the legume green manures removed on average 0.9 Mg ha-1 yr-1 of high quality top-canopy herbage. Nitrogen contribution ranged from 6 kg ha1 for defoliated lablab (D-L) to 65 kg ha-1 for UD-M. Maize grain yield was greater (P = 0.003) following incorporation of mucuna vs. lablab in both seasons. Defoliation of legume residues prior to incorporation decreased subsequent maize grain yield (3.19 vs. 2.49 Mg ha-1 following mucuna; 2.28 vs. 1.92 Mg ha-1 following lablab). Relative to the natural fallow control, UD-M, defoliated mucuna (D-M), and UD-L resulted in 52, 34, and 14% increases in subsequent maize grain yield. In conclusion, relay cropping green manure legumes, particularly mucuna, has potential to increase subsequent maize grain yield even when some of the fodder is used as livestock feed. [ABSTRACT FROM AUTHOR]

To evaluate the impact of clinician-targeted mHealth-generated care suggestions on compliance with hypertension care guidelines in a resource-limited setting. This study was conducted in 10 rural health clinics in Western Kenya that offered hypertension care through nurses and clinical officers. Sites were grouped into intervention and control groups. Intervention group clinicians had patient-specific care suggestions triggered and displayed on a mobile application, mUzima, for their action. Care suggestions were also triggered in the mHealth application for control arm clinicians but were not displayed. Differences in compliance with hypertension care guidelines were evaluated. The study involved 378 patients with hypertension who had care suggestions generated during visits (217 in intervention group and 161 in control group). There was a higher proportion of adherence to hypertension care guidelines in the intervention group compared to the control group (91.1% vs. 85.7%, p=0.014). The random effects model showed significant variability in compliance rates among study clinicians (variance of 0.44, 95% CI: 0.12 -1.62). When displayed care suggestions were rejected by intervention providers, the most common reason given was 'Previously ordered' (58.8%). Clinicians felt that care suggestions improved awareness of hypertension care guidelines. The successful scaled implementation of mUzima with patient specific care suggestions led to higher adherence to hypertension care guidelines and improved quality of hypertension care. Tailormade m-Health applications in resource constrained settings for hypertension care and other chronic non-communicable diseases has the potential to lead to better adherence to care guidelines and quality of care.

Background: SARS-CoV-2 has extensively spread in cities and rural communities, and studies are needed to quantify exposure in the population. We report seroprevalence of SARS-CoV-2 in two well-characterized populations in Kenya at two time points. These data inform the design and delivery of public health mitigation measures., Methods: Leveraging on existing population based infectious disease surveillance (PBIDS) in two demographically diverse settings, a rural site in western Kenya in Asembo, Siaya County, and an urban informal settlement in Kibera, Nairobi County, we set up a longitudinal cohort of randomly selected households with serial sampling of all consenting household members in March and June/July 2021. Both sites included 1,794 and 1,638 participants in the March and June/July 2021, respectively. Individual seroprevalence of SARS-CoV-2 antibodies was expressed as a percentage of the seropositive among the individuals tested, accounting for household clustering and weighted by the PBIDS age and sex distribution., Results: Overall weighted individual seroprevalence increased from 56.2% (95%CI: 52.1, 60.2%) in March 2021 to 63.9% (95%CI: 59.5, 68.0%) in June 2021 in Kibera. For Asembo, the seroprevalence almost doubled from 26.0% (95%CI: 22.4, 30.0%) in March 2021 to 48.7% (95%CI: 44.3, 53.2%) in July 2021. Seroprevalence was highly heterogeneous by age and geography in these populations-higher seroprevalence was observed in the urban informal settlement (compared to the rural setting), and children aged <10 years had the lowest seroprevalence in both sites. Only 1.2% and 1.6% of the study participants reported receipt of at least one dose of the COVID-19 vaccine by the second round of serosurvey-none by the first round., Conclusions: In these two populations, SARS-CoV-2 seroprevalence increased in the first 16 months of the COVID-19 pandemic in Kenya. It is important to prioritize additional mitigation measures, such as vaccine distribution, in crowded and low socioeconomic settings., Competing Interests: No competing interests were disclosed., (Copyright: © 2023 Munywoki PK et al.)