Open access: academic publishing and its implications for knowledge equity in Kenya.

Traditional, subscription-based scientific publishing has its limitations: often, articles are inaccessible to the majority of researchers in low- and middle-income countries (LMICs), where journal subscriptions or one-time access fees are cost-prohibitive. Open access (OA) publishing, in which journals provide online access to articles free of charge, breaks this barrier and allows unrestricted access to scientific and scholarly information to researchers all over the globe. At the same time, one major limitation to OA is a high publishing cost that is placed on authors. Following recent developments to OA publishing policies in the UK and even LMICs, this article highlights the current status and future challenges of OA in Africa. We place particular emphasis on Kenya, where multidisciplinary efforts to improve access have been established. We note that these efforts in Kenya can be further strengthened and potentially replicated in other African countries, with the goal of elevating the visibility of African research and improving access for African researchers to global research, and, ultimately, bring social and economic benefits to the region. We (1) offer recommendations for overcoming the challenges of implementing OA in Africa and (2) call for urgent action by African governments to follow the suit of high-income countries like the UK and Australia, mandating OA for publicly-funded research in their region and supporting future research into how OA might bring social and economic benefits to Africa.

Preclinical efficacy testing of three antivenoms against Naja ashei venom-induced lethality.

This study aimed to determine the efficacy of Inoserp, Vins bioproducts, and South African Institute of Medical Research (SAIMR) polyvalent antivenoms in neutralizing Naja ashei venom-induced lethality in mice. The neutralization efficacy of the antivenoms were expressed as effective dose, median effective ratio, potency, normalized potency, volume, and the number of vials of antivenom required to neutralize 100 mg of Naja ashei venom (NAV).

Clinical analysis of aqueductal stenosis in patients with hydrocephalus in a Kenyan setting.

INTRODUCTION: Aqueductal stenosis is the commonest cause of congenital hydrocephalus. The scope of this paper is to highlight the disease burden of hydrocephalus attributed to aqueductal stenosis which still remains unknown in our setting. METHODS: In a descriptive cross-sectional study, 258 records of patients diagnosed with hydrocephalus were analyzed after ethical approval from Kenyatta National Hospital- University of Nairobi (KNH-UON) ethics and research committee from January 2010 to May 2016. Patients with a diagnosis of hydrocephalus due to aqueductal stenosis were included in this study. Patients age, sex, mode of delivery, associated comorbidities, presenting complaints, neurosurgical intervention performed, Kafarnosky score were recorded. Data were divided into 2 sets based on the patient's age i.e. whether < 1 year or > 12 years. Data were recorded on google data collection form and analyzed using Google spreadsheets. RESULTS: Out of 258 cases of hydrocephalus, 52 had aqueductal stenosis. Male to female sex ratio for this condition was 3:2. There were 25 cases < 1year and 27 cases > 12 years old who were diagnosed with hydrocephalus due to aqueductal stenosis. Associated conditions were bilateral congenital talipes equinovarus, spina bifida, Arnold Chairi malformations, meningitis and HIV. The presenting complaints differed according to the age groups. Neurosurgical interventions included Endoscopic Third Ventriculostomy (ETV) in 21 cases, insertion of Ventriculoperitoneal (VP) shunt and ETV were done in 3 cases while the rest had only insertion of VP shunt. The Kafanosky score improve from < 50 pre-op to 19 cases achieving a score of 100, six months post-op. CONCLUSION: Aqueductal stenosis contributes a significant burden of morbidity in patients with hydrocephalus. Clinical presentation differs according to patients age. Accurate diagnosis and treatment remain a cardinal to improving patient outcome.

Variant Anatomy of the Nasal and Labial Branches of the Infraorbital Nerve.

Comprehensive understanding of the variations in the branches of the infraorbital nerve (ION) is vital to the prevention of iatrogenic nerve injury and successful ION blockade during orbitozygomatic facial procedures. Only a few studies exist on the variant anatomy of the branching patterns of this nerve. This article provides a detailed description of the variations of the nasal and superior labial branches of the ION. This study was performed on 84 IONs by dissecting 42 formalin-fixed cadavers from the Laboratory of Topographic Anatomy, Department of Human Anatomy, University of Nairobi. The branches were exposed at their origin and followed to their termination. The findings included variant emergence patterns, anomalous course, and absence as well as extra branches. It was noted that the external nasal nerve was absent in 34.53% cases. There were common trunks between the internal and external nasal nerves and cases of communication between branches of these nerves were also noted. Accessory superior labial nerves were present in 9.52% of the nerves. This detailed study reveals additional variations in the emergence and branching pattern of the ION. Caution is imperative during orbitozygomatic facial surgery to prevent injury to these branches. These variations also underlie the lack of response to surgical treatment for trigeminal neuralgia and also the need for a filtration to achieve full anesthesia after ION block. In addition, the extra branches identified raise the prospects of using these nerves for grafting purposes if their precise patterns are determined.

Variations in emergence and course of the inferior palpebral nerve.

Comprehensive understanding of the anatomy of the inferior palpebral (IP) nerve is crucial to preservation of sensation in the inferior eyelid and conjunctiva. Iatrogenic injuries may occur during blepharoplasty, repair of orbitozygomatic fracture and other maxillofacial surgeries involving this region. Although several studies depict the anatomical variations of the main infraorbital nerve (ION), little information exclusive to the IP nerve exists. This study provides information on the additional variations of the ION with reference to the IP nerve. The study was performed on 84 IP nerves by dissection of 42 formalin-fixed cadavers from the laboratory of topographic anatomy, Department of Human Anatomy, University of Nairobi, Kenya. Each of the nerves were exposed at the emergence and followed to their termination. Variations encountered involved emergence, course, and even absence. Variant emergence was through an accessory infraorbital foramen, an infraorbital notch, and as a common trunk with the external nasal nerve. This nerve shows high anatomical variability that may account for the difficulties and complications encountered in clinical interventions. It is believed that this information will improve clinical management of conditions affecting the region of distribution of the IP nerve.

Young professionals for health development: the Kenyan experience in combating non-communicable diseases.

Young individuals (below 35 years) comprise an estimated 60% of the global population. Not only are these individuals currently experiencing chronic, non-communicable diseases (NCDs), either living with or at risk for these conditions, but will also experience the long-term repercussions of the current NCD policy implementations. It is thus imperative that they meaningfully contribute to the global discourse and responses for NCDs at the local level. Here, we profile one example of meaningful engagement: the Young Professionals Chronic Disease Network (YPCDN). The YPCDN is a global online network that provides a platform for young professionals to deliberate new and innovative methods of approaching the NCD challenges facing our societies. We provide a case study of the 2-year experiences of a country chapter (Kenya) of the YPCDN to demonstrate the significance and impact of emerging leaders in addressing the new global health agenda of the 21st century.