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With the aim of studying the optical, electrochemical, and electronic properties of a new porphyrin-based material, we have synthesized a new porphyrinic complex, namely the (4,4$^{\prime}$-bipyridine)(meso-tetratrifluoromethylphenylporphyrinato)zinc(II) 4,4$^{\prime}$-bipyridine disolvate dihydrate complex with the formula [Zn(TFMPP)(4,4$^{\prime}$-bipy)]${\cdot }$2(4,4$^{\prime}$-bipy)${\cdot }$2H2O (I). This species is characterized by single-crystal X-ray molecular structure. The optical study is performed by UV–visible absorption and fluorescence spectroscopy. The fluorescence intensity presents an emission in the UV–visible range, indicating that this compound can be used as an optoelectronic material. The optical energy gap is 1.95 eV, and the current–voltage characteristics and impedance spectroscopy measurements have been studied to define the electronic properties of the zinc (II) porphyrin complex. The barrier height ${\phi }_{\mathrm{b}}$ is calculated, and the space-charge limited current mechanism is found to control the conductance. The results from the electronic study confirm that our porphyrin derivative can be used for various optoelectronic applications.

H3Africa is developing capacity for health-related genomics research in Africa

ObjectivesTo describe differences in modern contraceptive use among adolescent women aged 15–19 years according to their marital status and to determine factors associated with modern contraceptive use among sexually active women in this population.DesignCross-sectional analysis of Adolescent 360 evaluation baseline survey.SettingThe 15 urban and semiurban wards of Ilemela district, Mwanza region, North-Western Tanzania.ParticipantsAdolescent women aged 15–19 years who were living in the study site from August 2017 to February 2018 and who provided informed consent. Women were classified as married if they had a husband or were living as married. Unmarried women were classified as sexually active if they reported having sexual intercourse in the last 12 months.Outcome measurePrevalence of modern contraceptive among adolescent women aged 15–19 years.ResultsData were available for 3511 women aged 15–19 years, of which 201 (5.7%) were married and 744 (22.5%) were unmarried-sexually active. We found strong evidence of differences in use of modern contraceptive methods according to marital status of adolescent women. Determinants of modern contraception use among unmarried-sexually active women were increasing age, increasing level of education, being in education, hearing of modern contraception from interpersonal sources or in the media in the last 12 months, perceiving partner and/or friends support for contraceptive use, as well as higher knowledge and self efficacy for contraception.ConclusionsSexual and reproductive health programmes aiming to increase uptake of modern contraceptives in this population of adolescent women should consider the importance of girl’s education and social support for contraceptive use particularly among unmarried-sexually active women.

Esophageal squamous cell carcinoma (ESCC) is common in some parts of Kenya. Both the regional factors associated with ESCC in Kenya and geographic distribution has not been completely described. Methods: We analyzed the association of ESCC with smoking, khat chewing, alcohol, diet, socioeconomic status, caustic ingestion and first degree family history of ESCC in a multi-center based matched case-control study. We also determined the geographic origin, age, gender and ethnicity of patients visiting the participating centers between August 2008 and April 2009. Results: Eighty three cases and 166 controls matched for age and gender were studied. The male to female ratio of cases was 2.1:1, majority were from Central and Eastern provinces of Kenya, about one fifth (19%) were younger than 45 years of age. On multivariate analysis, caustic ingestion (OR 11.3 CI 3.0 – 42.5), first degree family history of ESCC (OR 3.5 CI 1.3 – 9.5) and poor housing (OR 2.0 CI 1.1 – 3.5) were independent predictors. Conclusions: Majority hailed from the Central and Eastern provinces probably due to proximity to the study centres. A large proportion of cases were young compared to studies in other high incidence regions in the world. Low socio-economic status, family history of ESCC and a history of caustic ingestion were significant risk factors.

BACKGROUND: The onset of colorectal cancer appears to be two to three decades earlier in developing countries. Data on whether colorectal cancer in the young has worse prognosis than in older patients is conflicting. METHOD: Clinical charts of 70 patients ≤40 years old were reviewed to determine clinical and pathological patterns and treatment outcomes. Their data were compared with a larger group of older patients treated between 1993-2005 at Kenyatta National Hospital in Nairobi, Kenya. RESULTS: The data retrieval was highest for sub-site distribution and lowest for pathology information. Patients ≤ 40 years of age comprised 27.3% of all colorectal cancer cases treated over the study period. There were 41 males (58.6%) and 29 (41.4%) females patients. The most common symptoms were abdominal pain (76.9%), change in bowel habit (71.4%) and rectal bleeding (54.3%). The mean duration of symptoms was 24.6 ± 30 months. The rate of advanced colorectal disease (Duke C and D) was 73.5%. Mean follow-up time was 5.8 months with median survival of only 6.9 months. The Duke staging, histology, symptom duration, locations of tumours, follow-up and the complication rates were similar for young and older patients. ​CONCLUSION: Younger patients form a significant proportion of colorectal cancer burden. Both the clinico-pathological characteristics and treatment outcome correspond to older individuals. It is suggested that the concluded colorectal symptoms in younger patients should also be aggressively evaluated including early endoscopy. A prospective follow-up study of patients with the disease will unravel the true survival picture.

The incidence of colorectal cancer in Africa is increasing. True data on clinical outcomes of the disease is hampered by follow up challenges.Method: Follow up data of 233 patients treated for colorectal cancer between 2005 and 2010 at various Nairobi hospitals were evaluated. The primary outcome was mortality while secondary outcomes included recurrence rates, time to recurrence and the patient, disease and treatment factors associated with mortality and recurrence. Kaplan Meir charts were charted for survival trends. Results: Half of the lesions were located in the rectum. There was no relation-ship between the sub-site location and recurrence and mortality. The mean follow-up period was 15.9 months. Overall recurrence and mortality rates were 37.5% and 29.4% respectively. Most recurrences occurred within one year of surgery. Recurrence was not influenced by age, gender, sub-site, chemotherapy receipt or presence of co-morbidity. Factors significantly associated with mortality included the male gender ( p 0.04), presence of co-morbidity (p 0.029), recurrence (p 0.001), curative intent (p 0.01), disease stage (p 0.036) and receipt of chemotherapy ( p< 0.01). Conclusion: Follow up of colorectal cancer patients is still challenging. The mortality and recurrence rates are high for the short follow up periods. Further studies are needed to explore the determinants of both survival and recurrences, especially with longer follow ups.

Background: Trauma remains a significant cause of morbidity and mortality globally. Trauma registries are a key component of trauma systems in developed countries which have promoted improvement of patient care and outcomes. The experience with trauma registries in low income countries is limited. The current study shares preliminary data from the Kenyatta National Hospital Trauma Registry whilst documenting the process of design to implementation. Methods: A de novo registry dataset was designed based on previous studies and programmed as a custom application for deployment to the site. Scope of data collected was demographic, details of injury, pre-hospital events, hospital care and outcomes. Data were summarized as percentages and means for analysis. Results: The development of the registry from concept to operational software took 12 months. Preliminary data revealed an average completion rate of 88.6%. Majority of patients were young males who were referred to the hospital. Accidental injury at home or on the roads was the most common cause of admission with majority of patients not receiving any pre-hospital care. Sixteen percent of patients died while admitted. Conclusion: The data obtained from this de novo registry largely aligns to previous institutional reports while revealing data points for increased focus during training for registry abstraction. This experience may form the platform for trauma quality improvement initiatives at the institution as well as scaling to other institutions to allow for collation of regional trauma data.

Background: Environmental conditions have been shown to influence incidence of rugby injuries. Harsh weather conditions and detrimental effect on poor Kenyan rugby pitches create a unique environment for injury exposure. We conducted a whole population prospective cohort study to determine the association of pitch conditions with injury incidence and severity. Methods: The study was conducted on 364 registered Kenya Rugby Union (KRU) players throughout the 2010 15-aside season. The injury incidence was calculated as injuries per 1000 match player hours (mph). Pitches were categorized into good and suboptimal based on quality indicators of ground characteristics. Injuries were defined and recorded according to the Rugby International Consensus Group (RICG) protocol and compared between the pitches. Results: One hundred and two injuries were recorded in 60 league games (2400 mph). Twenty nine of the 60 league games were played in the category B (suboptimal condition) pitches. The overall incidence of injuries was 42.50/1000mph. Good pitches had an injury of 29.0 injuries/1000mph (95% CI 0.81- 1.61) compared to 56.9 injuries/1000mph (95% CI 1.76- 2.90) for suboptimal pitches. Conclusion: Although the overall Kenyan injury rate is comparable to the amateur level incidence from other studies, the higher rate associated with suboptimal pitches suggests interventions that can target pitch optimization.

The analysis of non-symmetric functionally graded sandwich plates under thermo-mechanical loading is developed using a novel hyperbolic shear deformation theory and considering thickness stretching effects. This theory accounts for adequate distribution of the transverse shear strains in the thickness of the plate and satisfies the traction free boundary conditions on the top and bottom surface of the plates, thus a shear correction factor is not required. The governing equations of equilibrium of non-symmetric functionally graded sandwich plates can be obtained using virtual work principle and the closed form solutions are obtained by using Navier technique. The accuracy of the present results is established by comparing those with well known trigonometric shear deformation theories. The results are presented for deflections and stresses of non-symmetric simply supported square plates.