http://ir.mu.ac.ke:8080/jspui/handle/123456789/60 Mon, 20 Apr 2026 09:31:34 GMT 2026-04-20T09:31:34Z http://ir.mu.ac.ke:8080/jspui/handle/123456789/9998 Title: Environmental Conflict Management in Kenya: Understanding the Resolution of Season-Driven Ranch Conflicts in West Pokot Authors: Matui, Bramwel N.; Kwonyike, Joshua Abstract: This paper examines the presence of intra-Pokot environmental conflict and factors associated with it, with the aim of understanding and recommending its resolution. For the sake of the paper, conflict can be defined as disputes between two or more people, groups or communities. It is a disagreement over the use of a natural resource such as water, pasture and grazing land or a dispute of ownership of livestock and land (ITDG-EA, 2004). On the other hand, Conflict resolution refers to measures aimed at minimising, reducing or outrightly removing the conditions that are proximate factors associated with the conflict. The main question asked here is: What are the factors associated with the presence of the conflict, and how can this conflict be managed? Mon, 01 Jan 2007 00:00:00 GMT http://ir.mu.ac.ke:8080/jspui/handle/123456789/9998 2007-01-01T00:00:00Z http://ir.mu.ac.ke:8080/jspui/handle/123456789/9960 Title: Cultural and behavioral drivers of zoonotic disease transmission and persistence among diverse pastoralist communities in East Africa Authors: Oketch, Dismas C.O.; Njoroge, Ruth; Ngage, Tonny O.; Omar, Asha Abdikadir; Magarre, Abdulai; Pasha, Raphael; Gachohi, John; Muriuki, Samuel Waiguru; Khamadi, Samoel Ashimosi; Boru, Ali Duba; Bodha, Boku; Kilowua, Lydia; Nyaga, Nazaria Wanja; Njaanake, Humphrey Kariuki; Kamaara, Eunice Abstract: Background Zoonotic diseases such as brucellosis, Rift Valley fever, anthrax, rabies and bovine tuberculosis are highly prevalent among pastoralist communities in low-and middle-income countries. Methods This study adopts a One Health approach, employing a range of participatory methods including informal observations, “go-along interviews,” narrative-, and key informant- interviews, to explore the cultural, behavioral, and structural drivers of zoonotic disease transmission among pastoralist communities in East Africa. We unpack how the physical environment, socio-economic systems, health systems, community influence and cultural competence as well as individual pastoralists' unique characteristics, behaviors and lifestyles can be leveraged for effective public health interventions that reduce zoonotic risks and improve health outcomes for both humans and livestock. Results We present data from 214 purposively selected participants, including 19 key informants, 68 in-depth interviews, 20 focus group discussions, and 22 direct ethnographic observations. Traditional knowledge and beliefs, risky cultural dietary practices such as consumption of raw milk, meat and blood, unprotected parturition assistance, unsafe disposal of carcasses and aborted fetuses were common and carried increased risk of zoonotic transmission. Women and children handled and milked small ruminants while adult men and morans (young warriors) were mostly involved with cattle, camels and slaughtering; hence exposing them to zoonotic pathogens disproportionately. There were piles of manure made up of animal excreta and secretions that were potentially highly contaminated with saprophytes and soil-borne zoonotic pathogens. Discussion While livestock play a significant and indispensable role in the daily livelihoods of pastoralist communities, close association of pastoralists with livestock coupled with their unique cultural and behavioral practices increases their risk of exposure to deadly zoonotic diseases. Although, most of these practices are environmentally and culturally adaptive, their risk for transmission is often overlooked. The study also highlights inadequate sanitary practices, poor disposal of animal carcasses and placentae and the absence of veterinary oversight in the production, distribution and consumption of livestock products. Conclusions Our study provides a holistic understanding of the subjective perspectives and nuanced insights underlying the emergence and persistence of zoonotic diseases within pastoralist communities. It also underscores the need for culturally sensitive One Health interventions that address these practices and enhance community awareness of zoonotic disease risks and prevention strategies which are often overlooked by conventional epidemiological studies. Wed, 01 Jan 2025 00:00:00 GMT http://ir.mu.ac.ke:8080/jspui/handle/123456789/9960 2025-01-01T00:00:00Z http://ir.mu.ac.ke:8080/jspui/handle/123456789/9955 Title: Institutional Factors Influencing Acquisition of Clinical Competencies Among Nursing Undergraduates in Government and Private Universities in Uganda Authors: Joan, Kempango; Franklin, Boibanda; Joyce, Lugulu; Justice, Kintu Mugenyi Abstract: Clinical competencies acquisition is one of the core components of nursing education that equips students with the practical knowledge and competencies for effective patient care. In Uganda, both government and private universities offer courses in nursing with the aim of producing skilled professionals to meet the healthcare needs of the population. However, despite the efforts made by educational institutions, students' ability to acquire clinical skills is often influenced by a variety of institutional factors. Therefore, this study explored the institutional factors influencing acquisition of clinical competencies among nursing undergraduates in both government and private universities in Uganda. The research adopted a mixed-method approach, involving 108 final-year students, 8 Heads of Departments (HODs), and 48 clinical supervisors across eight universities in Uganda. Data were collected using a pre coded self-administered questionnaire and focus group discussions (FGDs). Quantitative data were analyzed using descriptive statistics and chi-square tests, while qualitative data were transcribed and analyzed using thematically. The study Original Article 14 3(1), 2024 Kempango et al. found that institutional factors, such as support from heads of departments, regular feedback from supervisors, and meaningful performance progress reports, were critical in enhancing students' clinical competencies. A strong positive correlation (r = 0.668, p=0.00) was found between institutional arrangements and the acquisition of clinical skills. Additionally, students expressed a preference for university supervisors due to their approachability and support in clinical settings. The study recommends that in order to strengthen competency acquisition, institutions should be advised to build up faculty leadership, develop the mentorship structures and ensure that there are proper support mechanisms for students in the clinical placements. Tue, 21 Jan 2025 00:00:00 GMT http://ir.mu.ac.ke:8080/jspui/handle/123456789/9955 2025-01-21T00:00:00Z http://ir.mu.ac.ke:8080/jspui/handle/123456789/9954 Title: HIVdrug resistance, early treatment outcomes and impact of guidelines compliance after protease inhibitor-based second-line failure in a dedicated resistance clinic in western Kenya: a retrospective cohort study Authors: Humphre, John M.; Ali, ShamimM; DeLong, Allison; Novitsky, Vlad; Sang, Edwin; Jawed, Bilal; Kemboi, Emmanuel; Ngetich, Celia; Goodrich, Suzanne; Gardner, Adrian; Hogan, Joseph W.; Kantor, Rami Abstract: Introduction: Data on drug resistance, viral outcomes and guidelines compliance following protease inhibitor (PI)-based second-line failure in low- and middle-income countries are limited, particularly in the era of dolutegravir-containing antiretro viral therapy (ART). Methods: We conducted a retrospective cohort study of people living with HIV (PLWH) ≥3 years old with second-line viral failure (VF, ≥1000 copies/ml) at the Academic Model Providing Access to Healthcare from 2011 to 2021. We assessed resis tance prevalence and patterns at second-line VF, stratified by PI (atazanavir/ritonavir or lopinavir/ritonavir), and examined correlations of resistance and treatment strategies with VF at 6–18 months post-genotype. Analyses employed inverse prob ability weighting, adjusting for calendar year, age, gender, ART duration, PI at genotyping and class-specific resistance, and considered guidelines-supported versus unsupported strategies. Results: Of 187 participants (median age 41 years, 54% female, 41% on atazanavir/ritonavir, 59% on lopinavir/ritonavir-based ART), 91% had any resistance (NRTI 79%, NNRTI 80%, major PI 37%, dual-class 36%, triple-class 37%). Predicted resistance to third-line options was 67% for etravirine or rilpivirine and 10% for darunavir/ritonavir. Despite higher resistance detected on atazanavir/ritonavir versus lopinavir/ritonavir, predicted darunavir/ritonavir resistance was similar. At median 9 months post-genotype, 95% of 173 participants with available data were on a guidelines-supported regimen (55% second-line; 45% third-line, 86% dolutegravir-based), of whom 28% had post-genotype VF. Of the 5% not on guidelines-supported regimens, 71% had post-genotype VF. Adjusted odds of VF were higher for guidelines-unsupported versus supported regimens (OR = 4.52; 95% CI 1.02−26.24), and odds of VF were 97% lower for those on third-line versus second-line (OR = 0.07; 95% CI 0.02−0.20). Conclusions: We found high levels of drug resistance and early VF following PI-based second-line failure in Kenya. Treatment guidelines compliance and switches to third-line, even within guidelines recommendations, improved early viral outcomes. Findings highlight the vulnerability of PLWH with advanced ART experience and resistance profiles, and the importance of following guidelines and improving access to third-line and drug resistance testing, particularly in the new ART era Mon, 26 May 2025 00:00:00 GMT http://ir.mu.ac.ke:8080/jspui/handle/123456789/9954 2025-05-26T00:00:00Z