Health care seeking behaviors and perspective on indigenous palliative care among cancer patients in Kenya.

INTRODUCTION: Holistic integrated community palliative care services remain a mirage to cancer patients. Nonetheless, a number of cancer patients are jamming traditional medicinal places seeking therapy. The results of these visits are undocumented. This study explored healthcare seeking behaviors and perspectives on cancer indigenous palliative care among patients visiting traditional health practitioners in Kenya. METHODS: A cross-sectional study was undertaken through client exit survey. Face to face interviews were conducted using semi-structured questionnaires with all consenting cancer patients exiting mapped outlets. Data was analyzed using Statistical Package for Social Science Version 22.0. RESULTS: A total of 433 respondents were interviewed and the majority were female 59.6%, Christians 97.2%, married 89.8% and educated 85.7%. Their mean age was 48.25 ± 15. 58. Education, sex and religion were significantly associated with perceived improvement. The predominant cancer types were breast cancer (22.4%); throat (14.8%), prostate (12.9%), bone (12.5%), cervical (9.9%), stomach (6.0%) and skin cancer (5.1%). The most frequently used traditional medicine was herbal medicine that was driven by unresponsive conditions (42.2%), inaccessible biomedical services (18.8%) and yearning for second opinion (18%) over a condition. Seventy six percent of the respondents reported improved and prolonged quality of life. 78.2% reported improved eating, drinking, standing, walking and doing light duties alone. Patients felt healthier, hopeful, happier, confident and bonded to their families. CONCLUSIONS: Use of indigenous palliative care is predominant to all major cancer conditions and driven by the quest for cure, successful stories, trustworthiness and beliefs, previous experience and avoiding medical procedures such as surgery.

Experimental prosopis management practices and grassland restoration in three Eastern African countries.

Woody species have been introduced in many parts of the world to provide economic benefits, but some of those species are now among the worst invaders, causing widespread economic and environmental damage. Management of woody species to restore original ecosystem services, such as biodiverse grassland that can provide fodder and sequester carbon, are needed to limit the impacts of alien species. However, the best management methods, i.e., the most economically efficient and effective way to remove trees and the most effective way to restore or rehabilitate the cleared land, are not developed for many species. In Eastern Africa, prosopis (Prosopis julifora) has invaded large areas of savanna and grassland, thereby affecting, among other things, fodder and water for livestock, access to dry season grazing lands and ultimately pastoral livelihoods. We tested three prosopis treatments (manual uprooting and cut stump and basal bark herbicide application) in combination with three incremental restoration interventions (divots, divots + mulching, divots + mulching + grass seed sowing). The three-year study was replicated in Ethiopia (Afar National Regional State), Kenya (Baringo county) and Tanzania (Moshi district). Prosopis survival and vegetation development, both diversity and biomass, were recorded. The prosopis treatments were all highly effective (between 85 and 100% tree mortality in almost all cases), but the two treatments that involved the complete removal of the aboveground biomass (manual and cut stump) yielded a more productive and more diverse vegetation than the treatment that killed the trees standing (basal bark). Compared to the effect of prosopis removal, the effect of restoration interventions on vegetation composition was small, indicating that most species re-established from the soil seed bank. The results show that it is possible to restore land previously invaded by prosopis. Despite the different rates of vegetation establishment and variation in species composition, the restoration interventions resulted in vegetation that in some cases contained a substantial fraction of perennial grasses. The method chosen to control prosopis depends on the availability of resources, including herbicides, and the need to remove rootstocks if the intention is to plant crops. Supplementary Information: The online version contains supplementary material available at 10.1186/s43170-023-00163-5.

Large herbivores maintain a two-phase herbaceous vegetation mosaic in a semi-arid savanna.

Many arid and semi-arid rangelands exhibit distinct spatial patterning of vegetated and bare soil-dominated patches. The latter potentially represent a grazing-induced, degraded ecosystem state, but could also arise via mechanisms related to feedbacks between vegetation cover and soil moisture availability that are unrelated to grazing. The degree to which grazing contributes to the formation or maintenance of degraded patches has been widely discussed and modeled, but empirical studies of the role of grazing in their formation, persistence, and reversibility are limited.We report on a long-term (17 years) grazing removal experiment in a semi-arid savanna where vegetated patches composed of perennial grasses were interspersed within large (>10 m2) patches of bare soil.Short-term (3 years) grazing removal did not allow bare patches to become revegetated, whereas following long-term (17 years) grazing removal, bare soil patches were revegetated by a combination of stoloniferous grasses and tufted bunchgrasses. In the presence of grazers, stoloniferous grasses partially recolonized bare patches, but this did not lead to full recovery or to the establishment of tufted bunchgrasses.These results show that grazers alter both the balance between bare and vegetated patches, as well as the types of grasses dominating both patch types in this semiarid savanna.Synthesis: Large herbivores fundamentally shaped the composition and spatial pattern of the herbaceous layer by maintaining a two-phase herbaceous mosaic. However, bare patches within this mosaic can recover given herbivore removal over sufficiently long time scales, and hence do not represent a permanently degraded ecosystem state.

Polygyny does not explain the superior competitive ability of dominant ant associates in the African ant-plant, Acacia (Vachellia) drepanolobium.

The Acacia drepanolobium (also known as Vachellia drepanolobium) ant-plant symbiosis is considered a classic case of species coexistence, in which four species of tree-defending ants compete for nesting space in a single host tree species. Coexistence in this system has been explained by trade-offs in the ability of the ant associates to compete with each other for occupied trees versus the ability to colonize unoccupied trees. We seek to understand the proximal reasons for how and why the ant species vary in competitive or colonizing abilities, which are largely unknown. In this study, we use RADseq-derived SNPs to identify relatedness of workers in colonies to test the hypothesis that competitively dominant ants reach large colony sizes due to polygyny, that is, the presence of multiple egg-laying queens in a single colony. We find that variation in polygyny is not associated with competitive ability; in fact, the most dominant species, unexpectedly, showed little evidence of polygyny. We also use these markers to investigate variation in mating behavior among the ant species and find that different species vary in the number of males fathering the offspring of each colony. Finally, we show that the nature of polygyny varies between the two commonly polygynous species, Crematogaster mimosae and Tetraponera penzigi: in C. mimosae, queens in the same colony are often related, while this is not the case for T. penzigi. These results shed light on factors influencing the evolution of species coexistence in an ant-plant mutualism, as well as demonstrating the effectiveness of RADseq-derived SNPs for parentage analysis.