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Determinants of household catastrophic costs for drug sensitive tuberculosis patients in Kenya

Infectious Diseases of Poverty 2021年第4期10卷 18-32页

作者： Beatrice Kirubi Jane Ong'angto Peter Nguhiu Knut Lonnroth aiban rono Kristi Sidney-Annerstedt Department of Global Public Health Karolinska InstitutetStockholmSweden WHO Collaborating Centre for Tuberculosis and Social Medicine StockholmSweden The Health and Social Protection Action Research&Knowledge Sharing Network(SPARKS) StockholmSweden Centre for Respiratory Disease Research Kenya Medical Research InstituteNairobiKenya Health Economics Research Unit KEMRI-WellcomeTrust Research ProgramNairobiKenya Monitoring Evaluation&ResearchNational TuberculosisLeprosy and Lung Disease ProgramMinistry of HealthNairobiKenya

Background::Despite free diagnosis and treatment for tuberculosis(TB),the costs during treatment impose a significant financial burden on patients and their *** study sought to identify the determinants for cata-strophic costs among patients with drug-sensitive TB(DSTB)and their households in ***::The data was collected during the 2017 Kenya national patient cost survey from a nationally representative sample(n=1071).Treatment related costs and productivity losses were *** costs exceeding 20%of household income were defined as catastrophic and used as the *** Poisson regression analysis was performed to measure the association between selected individual,household and disease characteristics and occurrence of catastrophic costs.A deterministic sensitivity analysis was carried using different thresholds and the significant predictors were ***::The proportion of catastrophic costs among DSTB patients was 27%(n=294).Patients with catastrophic costs had higher median productivity losses,39 h[interquartile range(IQR):20-104],and total median costs of USD 567(IQR:299-1144).The incidence of catastrophic costs had a dose response with household *** poorest quintile was 6.2 times[95%confidence intervals(CI):4.0-9.7]more likely to incur catastrophic costs compared to the *** prevalence of catastrophic costs decreased with increasing household expenditure quintiles(proportion of catastrophic costs:59.7%,32.9%,23.6%,15.9%,and 9.5%)from the lowest quintile(Q1)to the highest quintile(Q5).Other determinants included hospitalization:prevalence ratio(PR)=2.8(95%CI:1.8-4.5)and delayed treatment:PR=1.5(95%CI:1.3-1.7).Protective factors included receiving care at a public health facility:PR=0.8(95%CI:0.6-1.0),and a higher body mass index(BMI):PR=0.97(95%CI:0.96-0.98).Pre TB expenditure,hospitalization and BMI were significant predictors in all sensitivity analysis ***::There are signif

关键词： Tuberculosis Health expenditure Income loss Social protection Kenya

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Fault Diagnosis of Roller Bearing Using Deep Learning

Fault Diagnosis of Roller Bearing Using Deep Learning

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作者： rono NOAH KIPYEGO 湖南大学

学位级别：硕士

滚动轴承故障诊断在机械操作中起着关键作用。比如,滚动轴承故障诊断在确保工作环境的安全性、防止机械故障、消除与滚动轴承部件故障相关的其他风险是非常重要的,最重要的是帮助工程师和其他部门做出决策以及时预防性维护。因此,为了... 详细信息

滚动轴承故障诊断在机械操作中起着关键作用。比如,滚动轴承故障诊断在确保工作环境的安全性、防止机械故障、消除与滚动轴承部件故障相关的其他风险是非常重要的,最重要的是帮助工程师和其他部门做出决策以及时预防性维护。因此,为了提高滚动轴承故障诊断技术的可靠性,迫切需要在滚动轴承故障诊断领域进行更多的研究。故障诊断过程可归纳为四个阶段:振动信号采集阶段,从信号中提取重要特征的特征提取阶段,降维阶段将高维特征降到低维,最后分类阶段来诊断部件的状况。滚动轴承故障诊断的分特征提取可以分为两类:统计特征和深度学习特征。深度学习方法即堆叠自动编码器和堆叠去噪自动编码器有很多优点,例如自动特征提取和高性能,因此使它们在选择合适的滚动轴承故障诊断方法时更为优选。在本论文工作中,集合经验模式分解(EEMD)被用于提取统计模型中的特征,浅层学习,然后被馈送到奇异值分解(SVD)以进行特征的降维,最后支持向量机分类器(SVM)用于轴承的状态识别。在深度学习的情况下,客观地使用简单自编码(AE),堆叠自编码(SAE)和堆叠去噪自编码(SDAE)来诊断故障。这些深度学习方法纯粹是无监督的。重要的是,这些方法不需要预处理输入数据,而是将原始数据直接馈入模型,然后进行数据训练,在堆叠去噪自动编码器的情况下添加噪声,然后训练每层自动编码器,最后引入支持向量机进行分类处理。然后在性能,稳定性等方面比较统计模型和深度学习模型的结果。

关键词：故障诊断滚动轴承 AE SAE SDAE 深度学习降维 EEMD SVD

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Assessment of hydrocarbon generation potential and thermal maturity of the deep offshore Lamu Basin, Kenya

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Energy Geoscience 2023年第3期4卷 48-62页

作者： G.A.Osukuku O.O.Osinowo W.A.Sonibare E.W.Makhanu S.rono A.Omar Pan African University for Life and Earth Sciences Institute(Including Health and Agriculture) PAULESIUniversity of IbadanNigeria Schlumberger Offshore Service Limited the Netherlands National Oil Corporation of Kenya Kenya

In this study, the secondary well data for Cretaceous to Miocene cutting samples in four deep offshore exploration wells, i.e., Pomboo-1 in the north, Kubwa-1 in the central, Simba-1 and Kiboko-1 in the south of the deep offshore Lamu Basin were assessed for identifying source rock presence and examining thermal maturity of the source rocks. The 2D basin modelling was used to analyse the bulk gas transformation in the basin. Total organic carbon (TOC) content values for the wells range from 0.09 wt % to 2.23 wt % with an average of 0.78 wt %. The average organic richness is higher in the Upper Cretaceous (0.83 wt %) than in the Palaeogene (0.65 wt %), Lower Cretaceous (0.28 wt %) and Upper Jurassic (0.30 wt %). The S_(1) averages for the Upper Cretaceous are 3.76 mg HC/g rock in Pomboo-1 and 0.31mg HC/g rock in Kubwa-1. The S_(2) averages for the Upper Cretaceous are 5.00 mg HC/g rock in Pomboo-1 and 0.72 mg HC/g rock in Kubwa-1. Hydrogen index (HI) values vary between 4 and 512 mg HC/g TOC with an average of 157.09 mg HC/g TOC. Organic matters were identified as mixed types of Ⅱ-Ⅲ (oil and gas prone) and Ⅲ-Ⅳ (gas prone) kerogen in the potential source rocks. The HI and S_(2) yield values are exceptionally high for the observed TOC values in Pomboo-1. The vitrinite reflectance and Tmax values of deep offshore Lamu Basin are in the ranges of 0.38%–0.72% and 360–441 ℃, respectively. It suggests the existence of both immature and mature source rocks. Vitrinite reflectance maturity favours near coastal region in the Upper Cretaceous. These results explain why Pomboo-1, Kubwa-1, Simba-1 and Kiboko-1 wells were dry. The temperatures are still cool for hydrocarbon generation in deep offshore. The critical risk for deep offshore Lamu Basin is charge, primarily source presence, and a lack of definitive evidence of a deep-water marine source rock being present. The four wells penetrate good quality reservoir and seal rocks, but source rock presence and maturity remain the cri

关键词： Rock-eval pyrolysis Vitrinite reflectance Kerogen type Thermal alteration index Petroleum geochenisty 2D basin modelling

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Traditional knowledge, use and conservation of plants by the communities of Tharaka-Nithi County, Kenya

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Plant Diversity 2020年第6期42卷 479-487页

作者： Vivian Kathambi Fredrick Munyao Mutie Peninah Cheptoo rono Neng Wei Jacinta Ndunge Munyao Peris Kamau Robert Wahiti Gituru Guang-Wan Hu Qing-Feng Wang CAS Key Laboratory of Plant Germplasm Enhancement and Specialty Agriculture Wuhan Botanical GardenChinese Academy of SciencesWuhan430074China Sino-Africa Joint Research Center Chinese Academy of SciencesWuhan430074China University of Chinese Academy of Sciences Beijing100049China East African Herbarium National Museums of KenyaP.O.Box 451660-0100NairobiKenya Jomo Kenyatta University of Agriculture and Technology NairobiKenya

Rural communities in Kenya largely depend on plant resources for their *** utilization of these resources depends on the availability of plant resources and the level of knowledge of the *** conducted an ethnobotanical study in Tharaka-Nithi County in Kenya to determine the knowledge and utilization of various plant species by the local *** study was conducted in four major administrative regions from June 2018 to February 2019,involving interview schedules using semi-structured open-ended questionnaires and guided field collections with 48 informants.A total of 214 plant species distributed in 73 families and 169 genera with 616 Use Reports(URs)were *** was the highest family cited by the informants(31 species)followed by Lamiaceae and Euphorbiaceae(each with 11 species).Trees(49%)and shrubs(32%)were the top life forms of the plants frequently utilized by the local *** general plant uses reported were medicinal,food,fodder,construction,fuel,pesticidal,religious,live fencing,and making *** gilletii,Prunus africana,and Solanum incanum were found to be highly valued by the local *** utilization as food and medicinal uses against snake-bite related problems had the highest Informant Consensus Factor(ICF).Only 29(13.6%)of the species reported had their status assessed by the International Union for Conservation of Nature(IUCN).Conservation measures,alongside awareness creation in this region,are highly recommended for the species endemic to the region,highly depended on by the community,and those threatened according to IUCN standards.

关键词： Conservation Indigenous knowledge Medicinal plants Nutrition Tharaka-Nithi

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Prevalence and Individual-Level Determinants of Uptake of Three or More Doses of Sulphadoxine-Pyrimethamine for Intermittent Preventive Treatment of Malaria in Pregnancy in Busia County, Kenya

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Open Journal of Epidemiology 2024年第3期14卷 405-418页

作者： Anne Nduta Miatu Betsy rono Cheriro Kamija Samuel Phiri School of Public Health Department of Environmental Health and Disease Control Jomo Kenyatta University of Agriculture and Technology Nairobi Kenya School of Global and Public Health Kamuzu University of Health Sciences Blantyre Malawi

Background: Malaria in pregnancy causes maternal anemia, low birth weight, intrauterine growth retardation, and preterm deliveries. In malaria-endemic regions in Kenya, percentage of pregnant women hospitalized with malaria reach up to 60%. WHO recommends at least three doses of sulphadoxine pyrimethamine for Intermittent Preventive Treatment of Malaria in Pregnancy (IPTp) antenatally. This study sought to ascertain the prevalence and individual-level factors influencing the uptake of IPTp-SP3+. Methods: A facility-based cross-sectional study at Busia County Referral Hospital. 384 mothers were consecutively sampled at the maternity unit during delivery. Semi-structured questionnaires were used to collect data. Odds ratio (OR) and adjusted OR were used to determine statistical significance of individual factors influencing uptake of three or more IPTp-SP. Results: 43.0% of participants took IPTp-SP3+. Individual factors that affected the uptake of IPTp-SP3+ included starting ANC visits in the first trimester (adjusted odds ratio (aOR) = 2.1, 95% CI: 1.23 – 3.67, p = 0.046), having more than four ANC visits (aOR = 3.1, 95% CI: 1.49 – 6.50, p = 0.002), having a higher monthly income (aOR = 2.6, 95% CI: 1.24 – 5.36, p = 0.012), being aware of the advantages of IPTp-SP medications (aOR = 3.7, 95% CI: 1.40 – 9.74, p = 0.008), and having a positive attitude toward ANC services (aOR = 3.2, 95% CI: 1.61 – 6.31, p = 0.001). Conclusion: Less than half of the pregnant mothers are complyingIPTp-SP3+. There should be aggressive efforts by the County and National Ministries of Health promoting initiation of ANC attendance early and attendance of all the recommended eight visits together with ensuring availability of the drugs.

关键词： Malaria in Pregnancy Antenatal Clinic Intermittent Prevention of Malaria in Pregnancy Dosage Uptake Sulphadoxine-Pyrimethamine and Individual Level Factors

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The Emerging Trade in Donkey Hide: An Opportunity or a Threat for Communities in Kenya?

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Agricultural Sciences 2019年第9期10卷 1152-1177页

作者： Gemma Carder Oscar Ingasia Evans Ngenoh Samuel Theuri Desmond rono Philemon Langat Brooke London UK Brooklyn Economic Consulting Ltd. Nairobi Kenya Brooke (East Africa) Nairobi Kenya

Donkey hides are used in a form of Traditional Chinese medicine called ejiao, the demand for ejiao is currently so high the global donkey population is currently in decline. Africa’s donkey population is considered a key source for the trade, with Kenya being highlighted as being particularly affected. In Kenya donkeys play a vital contribution to people’s livelihoods;this study aimed to explore the potential impact of the donkey hide trade on small holder farmer’s livelihoods. The study was conducted in five counties in Kenya;data was collected using household survey questionnaires, focus group discussions and key informant interviews. When household survey participants (n = 421) were asked if the number of donkeys in their herd had decreased within the last two years 34.2% (n = 144) reported a decrease, of those 43.8% (n = 63) reported the selling of donkeys as the primary cause of reduction in herd size. Increased money spent on the transportation of farm produce, water and firewood was the most frequently reported effect of the loss of donkeys (62.5%, n = 263). Some focus group discussion participants said that they had previously sold their donkeys to raise money for school fees, likewise 43% (n = 97) of focus group discussion participants said that they would sell their donkeys to pay medical bills. Results from the study suggest that small holder farmers are choosing to sell their donkeys for an instant boost in income, but long-term this is unlikely to be a sustainable livelihood option.

关键词： Donkey Hide Trade Kenya Livelihoods Traditional Chinese Medicine Ejiao Working Equids

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Prevalence of Microvascular Complications and Associated Risk Factors among Diabetes Mellitus Patients Attending Nyeri County Referral Hospital, Kenya: A Cross-Sectional Study

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Open Journal of Epidemiology 2024年第3期14卷 444-458页

作者： Rachael Ireri Gideon Kikuvi Susan Mambo Betsy C. rono Cheriro Jomo Kenyatta University of Agriculture and Technology Juja Kenya Department of Clinical Medicine Kenya Medical Training College Nairobi Kenya

Microvascular complications are one of the major causes of morbidity and mortality worldwide among patients with diabetes mellitus (DM). More than 50% of Nyeri County Referral Hospital (NCRH) admissions result from non-communicable diseases (NCDs) and over 55% of hospital deaths are attributable to NCDs. In Kenya, Nyeri County has the highest prevalence of diabetes mellitus compared to other counties. This study therefore sought to assess the prevalence of microvascular complications and the associated risk factors among patients attending Nyeri County Referral Hospital in Kenya. A hospital-based cross-sectional study was conducted on 314 DM patients on follow-up at NCRH from August 2022 to October 2022. Data were analyzed using STATA version 17. Univariate and multivariate logistic regression analyses are used to determine the risk factors associated with Microvascular complications of DM. Among the 314 participants with DM, 58% were females. The overall prevalence of Microvascular complications (MVCs) is 36.62%. Diabetic peripheral neuropathy was the most frequent complication (27.4%). Inadequate physical exercise was a risk factor for all MVCs. Age, marital status, and level of education were risk factors for neuropathy while smoking and alcohol intake were risk factors for nephropathy. Non-smokers were 98% less likely to have nephropathy (OR = 0.024;95% CI 0.003 - 0.145). The odds of those who exercise once weekly getting retinopathic complications reduced by 83% (OR = 0.18, 95% CI 0.049 - 0.398) compared to those who exercise daily. The findings highlight the implication of lifestyle factors in the development of MVCs among DM patients. Therefore, benefits of microvascular complications prevention should thus be factored into the management of patients with diabetes mellitus.

关键词： Diabetes Mellitus Microvascular Complications Risk Factors Retinopathy Neuropathy Nephropathy

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Increased Orexin Expression Promotes Sleep/Wake Disturbances in the SOD1-G93A Mouse Model of Amyotrophic Lateral Sclerosis

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Chinese Medical Journal 2015年第2期128卷 239-244页

作者： rono Liu Zhao-Fu Sheng Bing Cai Yong-He Zhang Dono-Sheng Fan Department of Neurology Peking University Third Hospital Beijing 100191 China Department of Pharmacology School of Basic Medical Science Peking University Beijing 100191 China

Background：Sleep/wake disturbances in patients with amyotrophic lateral sclerosis （ALS） are well-documented,however,no animal or mechanistic studies on these disturbances *** is a crucial neurotransmitter in promoting wakefulness in sleep/wake regulation,and may play an important role in sleep disturbances in *** this study,we used SOD1-G93A transgenic mice as an ALS mouse model to investigate the sleep/wake disturbances and their possible mechanisms in ***：Electroencephalogram/electromyogram recordings were performed in SOD1-G93A transgenic mice and their littermate control mice at the ages of 90 and 120 days,and the samples obtained from these groups were subjected to quantitative reverse transcriptase-polymerase chain reaction,western blotting,and enzyme-linked immunosorbent ***：For the first time in SOD1-G93A transgenic mice,we observed significantly increased wakefulness,reduced sleep time,and up-regulated orexins （prepro-orexin,orexin A and B） at both 90 and 120 *** analysis confirmed moderate to high correlations between sleep/wake time （total sleep time,wakefulness time,rapid eye movement [REM] sleep time,non-REM sleep time,and deep sleep time） and increase in orexins （prepro-orexin,orexin A and B）.Conclusion：Sleep/wake disturbances occur before disease onset in this ALS mouse *** orexins may promote wakefulness and result in these disturbances before and after disease onset,thus making them potential therapeutic targets for amelioration of sleep disturbances in *** studies are required to elucidate the underlying mechanisms in the future.

关键词： Amyotrophic Lateral Sclerosis Orexin Sleep/Wake Disturbance

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