88 Records out of 22207 Records

Sharing findings on sickle cell disorder in international collaborative biomedical research : an empirical ethics study in coastal Kenya

Author: Marsh, Victoria Mary Chuck

Awarding University: University of Oxford, England

Level : DPhil

Year: 2012

Holding Libraries: Institute of Commonwealth Studies Library ;

Subject Terms: Sickle cell anemia ; Kilifi District ; Ethics ; Genomics ; Counseling ;

Abstract:

Against the background of a dilemma experienced by researchers during a genomics study at an established biomedical research centre in Kenya, the broad aims of this thesis are to develop appropriate responses to important ethical questions on sharing information on a common and serious genetic condition, sickle cell disorder, and assess the responsibilities of researchers in this regard. Using an empirical approach to normative reflection across two phases of qualitative research, I explore the nature of important moral concerns related to sharing sickle cell disease information from researchers? and community members? points of view; and develop a bottom-up normative analysis around the questions generated. This analysis interweaves community experiences, processes of community reasoning and ex situ normative reflection; placing community views and values centrally while referencing these to wider ethical debates, commentaries and guidelines in the literature. Two main outputs of this thesis are to provide recommendations for information sharing on SCD findings in the genomics study in Kilifi; and to propose a set of key issues to consider for this type of information in other studies and geographic settings. I conclude that researchers have a strong responsibility to share SCD information on affected children with families as a form of ancillary service (validating tests, counselling and care); but less responsibility to actively share carrier information. Concurrent responsibilities are working collaboratively with the Ministry of Health/District General Hospital to plan and implement services for SCD; ensuring counselling services support family stability as far as reasonably possible; and to build forms of community engagement and informed consent that counter risks of diagnostic interpretations of research.

Who cares for orphans? Challenges to kinship and morality in a Luo village in western Kenya.

Author: Cooper, E

Awarding University: University of Oxford, England

Level : DPhil

Year: 2011

Holding Libraries: Institute of Commonwealth Studies Library ;

Subject Terms: Orphans ; Luo (African people) ; Kinship ; Morality ; Western Kenya ; HIV (infection) ; AIDS (disease) ;

Abstract:

This dissertation analyses an ethnographic study of how people in a peri-urban, agricultural village in western Kenya have responded to the questions of who will care for children, and how, when those children?s parents, or other primary caregivers, have died. It examines the practical and ideological implications of wide-scale orphaning among a population that has experienced increased numbers and proportions of orphaned children mainly due to HIV/AIDS, as well as the gradual depletion of resources in terms of both the availability of middle-aged adults and the security of economic livelihoods. The research explores how specific caring relationships, as well as general sociality, have been challenged, adapted, and affirmed or rejected normatively and practically in this context. The research revealed a high degree of questioning in people?s efforts to forge responses to children?s orphaned situations. Rarely was there unambiguous consensus in the study context concerning what should be done in response to children?s orphanhood in light of families? diminished livelihood capacities. More broadly, there was a distinctive concern with how such situations might be appraised in moral terms. The analysis therefore focuses on three main concerns, including: how to understand uncertainty as a condition of life, and the implications of this; how a shared perspective of uncertainty has spurred a concern with morality in the study context, and specifically galvanised a moral economy of kinship; and how the concern with morality affected what was deemed at stake in people?s lives.

Ethical challenges in collecting, using and sharing ethnicity-related data in genomics research in Africa : the case of the MalariaGEN Consortium

Author: de Vries, J

Awarding University: University of Oxford, England

Level : DPhil

Year: 2011

Holding Libraries: Institute of Commonwealth Studies Library ;

Subject Terms: Ethics ; Ethnicity ; Genomics ; Malaria ;

Abstract:

The objective of this thesis is to critically examine ethical challenges in the use of ethnic data in genomics research in Africa, with a particular focus on ethnic stigmatisation. This thesis aims to develop a more informed understanding of the nature and implications of ethnic stigmatisation for genomics research in Africa, through the lens of a current genomics research project in Africa, the MalariaGEN Consortium. I conducted a qualitative empirical study investigating the perspectives of a variety of stakeholders in MalariaGEN. Interviews were conducted in The Gambia, Kenya, and the UK with members of research ethics committees, primarily investigators, fieldworkers and members of funding bodies. An analysis of MalariaGEN project documents was conducted to investigate the emergence of ethical concerns about the use of ethnicity in that project. I analysed data qualitatively using specialist software. Drawing on the data, I propose that ?harm? rather than ?stigma? may be a more accurate way of describing the challenge. Second, I propose that concerns about ethnic stigmatisation may at least in part be a response to the problematic history of using population categories in research. Third, I discuss the importance of clarifying how ethnicity is defined and why it is used in genomics research. Fourth, I argue that the potential for harm is accommodated in MalariaGEN in multiple implicit and explicit mechanisms that are not recognised when sharing project data. Fifth I argue that the potential for stigmatisation in genomics research may not be the result of intentional stigmatisation by malevolent actors, but rather the consequence of unintentional processes.

Examining the relationship between genetic variation at G6PD and severe malaria.

Author: Shah, S S

Awarding University: University of Oxford, England

Level : DPhil

Year: 2011

Holding Libraries: ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; Institute of Commonwealth Studies Library ;

Subject Terms: Malaria/Genetics/Biochemistry/ ;

Abstract:

Glucose-6-phosphate dehydrogenase (G6PD) deficiency, a common heritable trait whose prevalence mirrors geographic patterns of historic malaria endemicity, is thought to confer a selective advantage owing to partial protection conferred against malaria. This thesis examines genetic diversity at the G6PD locus, and the considers how such variation impacts both immediate molecular phenotypes and multifactorial clinical phenotypes. First, Chapter 3 presents a survey of variation at G6PD in several malaria-endemic areas, while Chapter 4 describes a novel technique for polymorphism discovery using pooled massively parallel sequencing. Next, in Chapters 5 and 6, I evaluate the link between genetic variation at the locus and G6PD enzyme activity, identifying major and minor determinants of G6PD deficiency state in an association study conducted in Kenya, and demonstrating a new technique for assaying G6PD deficiency at the level of an individual erythrocyte in a pilot project in Mali. Finally, Chapter 7 addresses the malaria protection hypothesis directly by conducting a fine-mapping case-control association study of severe malaria in the Gambia, where I found that G6PD deficiency alleles exhibited differential direction of association with respect to two important clinical syndromes trending towards risk conferred to severe malarial anemia, and protection with respect to cerebral malaria. Overall, these findings suggest that future clinical association studies should consider heterogeneity at the genetic level, as well as the level of molecular and clinical phenotypes in order to achieve a better mechanistic understanding of the relationship between G6PD deficiency and severe malaria.

The activities of various antimalarial drugs on Plasmodium falciparum isolates from Kilifi, Kenya and studies on mechanisms of resistance.

Author: Mwai, L W

Awarding University: University of Oxford, England

Level : DPhil

Year: 2011

Holding Libraries: Institute of Commonwealth Studies Library ;

Subject Terms: Malaria ; Plasmodium falciparum ; Kilifi, Kenya ; Genetics ; Artemether ; Lumefantrine ; Amodiaquine ; Artesunate ; Piperaquine ; Dihyrdoarteminisin ; Chloroquin ;

Abstract:

Reduced efficacy has been reported against artemether (ATM)/Lumefantrine (LM) (LM-ATM), amodiaquine (AQ)/artesunate (AS) (AQ-AS), two important combination treatment regimens in Africa, and against piperaquine (PQ), a drug which has been evaluated as a potential alternative in Africa, in combination with dihydroarteminisin (DHA). Chloroquine (CQ) resistance in P. falciparum is associated with two main transporters PfCRT and PfMDR1. I investigated the mechanisms of resistance to PQ, LM and AQ, with the overall goal of identifying molecular markers that can be used to track resistance. The key antimalarial drugs were highly active against clinical isolates from Kilifi, Kenya with median inhibitory concentrations (IC50s) of <5nM for DHA and <55 nM for CQ, AQ, PQ, LM and DEAQ (desethylamodiaquine, the active metabolite of AQ). pfcrt-76 and pfmdr-1-86 mutations were associated with AQ, DEAQ and LM but not DHA or PQ activity. Interestingly, > 20% of analysed isolates had decreased susceptibility to LM (IC50 >100nM); these isolates were the most susceptible to CQ and carried wild type genotypes at pfcrt76 and pfmdr1-86. I observed that CQ resistance had been declining in Kilifi since 1993 (prior to CQ withdrawal) to 2006 (7 years after its withdrawal), similar to observations in Malawi. My results support the hypothesis that susceptibility to antimalarial drugs returns when drug pressure is removed, and suggest that the use of LM-ATM may hasten the return of CQ susceptibility. Continued monitoring of drug susceptibility is crucial. pfcrt-76 and pfmdr1-86 may be useful molecular markers of LM-ATM efficacy in Kilifi and other African sites. Using a microarray approach, I identified additional genes (including various transporters) that may contribute to LM resistance.

The interaction between the African elephant (Loxodonta africana africana) and the African honey bee (Apis mellifera scutellata) and its potential application as an elephant deterrent.

Author: King, L E

Awarding University: University of Oxford, England

Level : DPhil

Year: 2010

Holding Libraries: Institute of Commonwealth Studies Library ;

Subject Terms: Elephant/Loxodonta africana/Apis mellifera scutellata/Samburu District/Buffalo Springs National Reserve, Kenya/Beekeeping/Wildlife/ ;

Abstract:

Two key research questions are asked in this thesis (i) what happens when elephants and honey bees interact and (ii) how can we adapt this behaviour into a potential deterrent system for crop-raiding elephants. The first three data chapters explore in detail the behavioural response of elephant families to digital playbacks of bee sounds. This technique has been used successfully by other established elephant research teams. Here, I work with an unfenced savannah elephant population studied by Save the Elephants in Samburu and Buffalo Springs National Reserves, northern Kenya. I show that not only do elephants run from the sound of bees but that they emit a unique low frequency alarm call when doing so, which in turn alarms (or warns) others in the area to retreat. Although these multi-layered behavioural discoveries were groundbreaking, I go on to reveal that bee sounds alone will not be enough to deter elephants for long as they do start to habituate to the playback sounds when no negative conditioning from live bees occurs. Turning to the application of this knowledge, I spend three chapters describing in detail the development and evolution of a unique beehive fence designed specifically for use by poor rural farmers who suffer from frequent crop depredations and damage by elephants. I rely on several rapid rural appraisal techniques to evaluate the impact of the beehive fence on efficiency and effectiveness as well as the perception of the farmers and the potential income and livelihood prospects. The adoption success of the beehive fence system in three rural communities leads to a discussion about the wider application of beehive fences on both a regional and global scale. I end with a list of recommendations for the conditions within which I predict the beehive fences will be effective.

The concept and practice of benefit sharing in health related research in Kenya.

Author: Lairumbi, G M

Awarding University: University of Oxford, England

Level : DPhil

Year: 2010

Holding Libraries: Institute of Commonwealth Studies Library ;

Subject Terms: Health ; Research ; Ethics ;

Abstract:

Benefit sharing has recently become a key ethical paradigm in the governance of international collaborative health research involving human participants. It remains unclear however, to what extent solutions to avoid potential for exploitation are emerging from its implementation especially in resource poor settings. This thesis focuses on this gap, principally by exploring the range of stakeholders? own views of the ethics of benefit sharing in health related research in Kenya. This thesis is based on qualitative data collected among stakeholders involved with health related research in Kenya. Following a detailed review of international and regional research ethics guidelines, empirical data were collected through in-depth interviews with key informants drawn from research institutes, universities, civil society organisations, community representative groups, policy makers and research sponsors. Analysis focused on the framing and operationalisation of the concept of benefit sharing by stakeholders, to understand how it is undertake in practice. Stakeholders have a constrained, narrow view of the concept of benefit sharing although they recognise important moral concerns arising from the conduct of health related research in resource poor settings. Implementation of benefit sharing is complicated by a range of moral and organisational factors. Factors of the moral nature include; conflicting principles, the challenge of defining scope of benefits, the beneficiaries, and the responsibilities, as well as a lack of concern with the longer term value of research, while those that are organisational in nature include incompatible stakeholder interests, lack of mechanisms for coordinating research and power asymmetry among stakeholders.

The rise and fall of civil-authoritarianism in Africa : patronage, participation, and political parties in Kenya and Zambia.

Author: Cheeseman, N

Awarding University: University of Oxford, England

Level : PhD

Year: 2007

Holding Libraries: ;

Subject Terms: Political science ; Authoritarianism ; Political parties ; Political power ;

Abstract:

ABSTRACT NOT AVAILABLE

Continuity and change in Kenyan secondary education since independence, 1969-2004 : a study of gender and social inequalities on educational attainment.

Author: Zani, A P

Awarding University: University of Oxford, England

Level : PhD

Year: 2007

Holding Libraries: Index To Theses ;

Subject Terms: Education/Secondary education/Gender/Inequality/Social conditions and trends/ ;

Abstract:

The aim of this thesis is to establish the trend of social background inequalities on educational attainment, using Kenyan consensus data and two surveys, one conducted in 1969 (Rado et al., 1969) and another in 2004 conducted by this researcher. The educational expansion that has taken place in Kenya is presented in this thesis. There has been an increase in proportions in the population attaining some education and secondary schooling. Gender inequalities have reduced but persisted. Inequalities based on social background have reduced but persisted as evidenced by the over representation of students whose fathers had secondary education and under respresentation of students whose fathers had no education. The odds of reaching form four rather that not for students whose fathers had some education, rather than no education have reduced, but the odds of access to form four for students whose fathers were secondary and above educated have somewhat increased, indicating the advantage experienced by these privileged groups has been maintained. There has been change in distribution patterns and widened access to form four education for students from all backgrounds but continuity of inequality evidenced by the relative advantage that students from privileged background has persisted. Social background influences which types of school students attend and this in turn improves their life chances since further advancement to university and better entry to the labour market is determined by achievement, which is linked to school type. Students from privileged backgrounds attend provincial and national school. The relative advantage of social background on school type selection has remained the same over time. Students in national schools achieved better than those in provincial and district schools. Controlling for school type, the direct association of family background and achievement was not as strong as that between school type and achievement. Over time, the association between school type and attainment has remained the same. Modernization theory is supported as far as distribution of education is concerned, but in the process relative inequalities as a result of privileged background have persisted in educational access, attainment and achievement among form four students in Kenyan secondary schools. Continuity has thrived, despite change and modernisation.

Manufacturing consensus from within : civil society?s role in the liberalization of Kenya?s political economy (1990-2002).

Author: Rogers, K

Awarding University: University of Oxford, England

Level : PhD

Year: 2006

Holding Libraries: Index To Theses ;

Subject Terms: Political science/Liberalization/Political economy ;

Abstract:

Throughout the early 1990s, international donors increased funding for NGOs in Kenya, and elsewhere, with the expectation that a strong civil society would nurture a social consensus in support of democratisation. That donors encouraged the growth of NGOs mandated to promote democratic reform is undeniable. Less certain is the depth of popular support for the vision of democratic reform promoted by donors and NGOs. This study investigates the disparity between the theoretical assumptions that inform the donor community?s engagement with civil society and the reality of social and political processes in Kenya. Drawing on archival research and interviews conducted with Kenyan NGO leaders and donors, the thesis assesses the extent to which donor funding enabled advocacy NGOs to mobilize constituencies in support of the constitutional review process in particular and political liberalization in general in the 1990s. The analysis maps the political battles over constitutional reform in order to illuminate issues of political representation among political parties, civic interest groups, churches, international donors, and foreign governments. By looking at how NGOs networked with other segments of society to influence political change, the research moves among the various layers of the political process and illustrates the forces that shape political agendas within the NGO community. Focusing on a particular section of Kenya?s NGO sector over a twelve year time period, the thesis demonstrates the extraordinary degree of variation that exists within NGO sectors and illustrates the importance of understanding them within their political context. Conclusions drawn from the case study of Kenya suggest broad applications for understanding how, and to what extent, external assistance for NGOs influences the pace and quality of democratisation in Sub-Saharan Africa and beyond.