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  1. Factors influencing union formation in Nairobi, Kenya.

    PubMed

    Bocquier, Philippe; Khasakhala, Anne

    2009-07-01

    Using retrospective data from the Urban Integration Survey conducted in 2001 in Nairobi, Kenya, on a sample of 955 women and men aged 25-54, this paper compares factors influencing entry into union formation for men and women. The analysis uses event history methods, specifically Cox Proportional Hazards regression, stratified by age cohort and run separately by sex. The results indicate that delay in union formation is more pronounced for women than for men. Cohabitation without formal marriage is the prominent form of union, especially among the younger generation, and appears to have increased. For men, the timing of union is more dependent upon human capital acquisition than on cultural factors. These findings show that the marriage search model, which was first applied in Western countries, can also hold in cities of developing countries. Nonetheless, neither the search model nor the integration or the independence models apply to women's union formation, which very few exogenous factors can explain. PMID:19250585

  2. Determinants for participation in a public health insurance program among residents of urban slums in Nairobi, Kenya: results from a cross-sectional survey

    PubMed Central

    2012-01-01

    Background The government of Kenya is making plans to implement a social health insurance program by transforming the National Hospital Insurance Fund (NHIF) into a universal health coverage program. This paper examines the determinants associated with participation in the NHIF among residents of urban slums in Nairobi city. Methods The study used data from the Nairobi Urban Health and Demographic Surveillance System in two slums in Nairobi city, where a total of about 60,000 individuals living in approximately 23,000 households are under surveillance. Descriptive statistics and multivariate logistic regression analysis were used to describe the characteristics of the sample and to identify factors associated with participation in the NHIF program. Results Only 10% of the respondents were participating in the NHIF program, while less than 1% (0.8%) had private insurance coverage. The majority of the respondents (89%) did not have any type of insurance coverage. Females were more likely to participate in the NHIF program (OR = 2.4; p < 0.001), while respondents who were formerly in a union (OR = 0.5; p < 0.05) and who were never in a union (OR = 0.6; p < 0.05) were less likely to have public insurance coverage. Respondents working in the formal employment sector (OR = 4.1; p < 0.001) were more likely to be enrolled in the NHIF program compared to those in the informal sector. Membership in microfinance institutions such as savings and credit cooperative organizations (SACCOs) and community-based savings and credit groups were important determinants of access to health insurance. Conclusions The proportion of slum residents without any type of insurance is high, which underscores the need for a social health insurance program to ensure equitable access to health care among the poor and vulnerable segments of the population. As the Kenyan government moves toward transforming the NHIF into a universal health program, it is important to harness the unique opportunities

  3. Women, poverty and adverse maternal outcomes in Nairobi, Kenya

    PubMed Central

    2010-01-01

    Background The link between poverty and adverse maternal outcomes has been studied largely by means of quantitative data. We explore poor urban Kenyan women's views and lived experiences of the relationship between economic disadvantage and unpleasant maternal outcomes. Method Secondary analysis of focus group discussions and in-depth individual interviews data with women in two slums in Nairobi, Kenya. Results Urban poor women in Nairobi associate poverty with adverse maternal outcomes. However, their accounts and lived experiences of the impact of poverty on maternal outcomes underscore dynamics other than those typically stressed in the extant literature. To them, poverty primarily generates adverse maternal outcomes by exposing women to exceedingly hard and heavy workloads during pregnancy and the period surrounding it; to intimate partner violence; as well as to inhospitable and unpleasant treatment by service providers. Conclusions Poverty has wider and more intricate implications for maternal outcomes than are acknowledged in extant research. To deliver their expected impact, current efforts to promote better maternal outcomes must be guided by a more thorough perspective of the link between women's livelihoods and their health and wellbeing. PMID:21122118

  4. Coping Strategies among Urban Poor: Evidence from Nairobi, Kenya

    PubMed Central

    Amendah, Djesika D.; Buigut, Steven; Mohamed, Shukri

    2014-01-01

    Aims In Kenya, it is estimated that 60 to 80% of urban residents live in slum or slum-like conditions. This study investigates expenditures patterns of slum dwellers in Nairobi, their coping strategies and the determinants of those coping strategies. Method We use a dataset from the Indicator Development for Surveillance of Urban Emergencies (IDSUE) research study conducted in four Nairobi slums from April 2012 to September 2012. The dataset includes information related to household livelihoods, earned incomes of household members, expenditures, shocks, and coping strategies. Results Food spending is the single most important component, accounting for 52% of total households' income and 42% of total expenditures. Households report a variety of coping strategies over the last four weeks preceding the interview. The most frequently used strategy is related to reduction in food consumption, followed by the use of credit, with 69% and 52% of households reporting using these strategies respectively. A substantial proportion of households also report removing children from school to manage spending shortfalls. Formal employment, owning a business, rent-free housing, belonging to the two top tiers of income brackets, and being a member of social safety net reduced the likelihood of using any coping strategy. Exposure to shocks and larger number of children under 15 years increased the probability of using a coping strategy. Policy Implications Policies that contain food price inflation, improve decent-paying job opportunities for the urban poor are likely to reduce the use of negative coping strategies by providing urban slum dwellers with steady and reliable sources of income. In addition, enhancing access to free primary schooling in the slums would help limit the need to use detrimental strategies like “removing” children from school. PMID:24427272

  5. Client retention and health among sex workers in Nairobi, Kenya.

    PubMed

    Izugbara, Chimaraoke O

    2012-12-01

    It is still a small body of research that directly addresses female sex workers' relationships with their regular commercial male partners. I used ethnographic data from Nairobi, Kenya to interrogate motivations and strategies for recruiting and retaining regular male clients among female sex workers (FSWs). Regular commercial male partners, popularly called customer care, wera or wesh by Nairobi's FSWs, played diverse roles in their lives. Client retention enabled sex workers to manage the risk of reduced marriage prospects, guaranteed them steady work, livelihoods, and incomes, and prevented their victimization and harassment. To retain clients, sex workers obliged them a great deal, pretended they had quit prostitution, and sometimes resorted to magical practices. However, these strategies were also accompanied by risks that reinforced the vulnerability of sex workers. Lack of critical attention to sex workers' practices for managing perceived risks in their particular type of work may hamper current programmatic efforts to make their job safer. PMID:22434396

  6. Maxillofacial injuries caused by terrorist bomb attack in Nairobi, Kenya.

    PubMed

    Odhiambo, W A; Guthua, S W; Macigo, F G; Akama, M K

    2002-08-01

    Although military conflicts are common on the African continent, there is a paucity of data regarding bomb-blast injuries in this region and in Kenya in particular. This paper describes the pattern of maxillofacial injuries sustained after the August 1998 bomb blast that occurred in Nairobi, Kenya. A retrospective cross-sectional study was carried out using hospital-based records of 290 bomb-blast survivors admitted at the Kenyatta National Referral and Teaching Hospital in Nairobi. Using a self-designed form to record information about variables such as the sex and age of the survivors and type of location of soft- and hard-tissue injuries, it was found that of the 290 bomb-blast survivors, 78% had sustained one or more maxillofacial injuries. Soft-tissue injuries (cuts, lacerations or bruises) were the most common, constituting 61.3% of all injuries in the maxillofacial region; 27.6% had severe eye injuries, while 1.4% had fractures in the cranio-facial region. This paper concludes that the effective management of bomb-blast injuries as well as those caused by other types of disaster requires a multidisciplinary approach. The high percentage of maxillofacial injuries confirm that maxillofacial surgeons should form an integral part of this multidisciplinary team. PMID:12361069

  7. Prevalence of HIV, Sexually Transmitted Infections, and Risk Behaviours Among Female Sex Workers in Nairobi, Kenya: Results of a Respondent Driven Sampling Study

    PubMed Central

    Kellogg, Timothy A.; Geibel, Scott; Muraguri, Nicholas; Okal, Jerry; Tun, Waimar; Raymond, H. Fisher; Dadabhai, Sufia; Sheehy, Meredith; Kim, Andrea A.

    2016-01-01

    We conducted a respondent driven sampling survey to estimate HIV prevalence and risk behavior among female sex workers (FSWs) in Nairobi, Kenya. Women aged 18 years and older who reported selling sex to a man at least once in the past 3 months were eligible to participate. Consenting FSWs completed a behavioral questionnaire and were tested for HIV and sexually transmitted infections (STIs). Adjusted population-based prevalence and 95 % confidence intervals (CI) were estimated using RDS analysis tool. Factors significantly associated with HIV infection were assessed using log-binomial regression analysis. A total of 596 eligible participants were included in the analysis. Overall HIV prevalence was 29.5 % (95 % CI 24.7–34.9). Median age was 30 years (IQR 25–38 years); median duration of sex work was 12 years (IQR 8–17 years). The most frequent client-seeking venues were bars (76.6 %) and roadsides (29.3 %). The median number of clients per week was seven (IQR 4–18 clients). HIV testing was high with 86.6 % reported ever been tested for HIV and, of these, 63.1 % testing within the past 12 months. Of all women, 59.7 % perceived themselves at ‘great risk’ for HIV infection. Of HIV-positive women, 51.0 % were aware of their infection. In multivariable analysis, increasing age, inconsistent condom use with paying clients, and use of a male condom as a method of contraception were independently associated with unrecognized HIV infection. Prevalence among STIs was low, ranging from 0.9 % for syphilis, 1.1 % for gonorrhea, and 3.1 % for Chlamydia. The data suggest high prevalence of HIV among FSWs in Nairobi. Targeted and routine HIV and STI combination prevention strategies need to be scaled up or established to meet the needs of this population. PMID:25428282

  8. Prevalence of HIV, sexually transmitted infections, and risk behaviours among female sex workers in Nairobi, Kenya: results of a respondent driven sampling study.

    PubMed

    Musyoki, Helgar; Kellogg, Timothy A; Geibel, Scott; Muraguri, Nicholas; Okal, Jerry; Tun, Waimar; Fisher Raymond, H; Dadabhai, Sufia; Sheehy, Meredith; Kim, Andrea A

    2015-02-01

    We conducted a respondent driven sampling survey to estimate HIV prevalence and risk behavior among female sex workers (FSWs) in Nairobi, Kenya. Women aged 18 years and older who reported selling sex to a man at least once in the past 3 months were eligible to participate. Consenting FSWs completed a behavioral questionnaire and were tested for HIV and sexually transmitted infections (STIs). Adjusted population-based prevalence and 95 % confidence intervals (CI) were estimated using RDS analysis tool. Factors significantly associated with HIV infection were assessed using log-binomial regression analysis. A total of 596 eligible participants were included in the analysis. Overall HIV prevalence was 29.5 % (95 % CI 24.7-34.9). Median age was 30 years (IQR 25-38 years); median duration of sex work was 12 years (IQR 8-17 years). The most frequent client-seeking venues were bars (76.6 %) and roadsides (29.3 %). The median number of clients per week was seven (IQR 4-18 clients). HIV testing was high with 86.6 % reported ever been tested for HIV and, of these, 63.1 % testing within the past 12 months. Of all women, 59.7 % perceived themselves at 'great risk' for HIV infection. Of HIV-positive women, 51.0 % were aware of their infection. In multivariable analysis, increasing age, inconsistent condom use with paying clients, and use of a male condom as a method of contraception were independently associated with unrecognized HIV infection. Prevalence among STIs was low, ranging from 0.9 % for syphilis, 1.1 % for gonorrhea, and 3.1 % for Chlamydia. The data suggest high prevalence of HIV among FSWs in Nairobi. Targeted and routine HIV and STI combination prevention strategies need to be scaled up or established to meet the needs of this population. PMID:25428282

  9. Traffic Impacts on PM2.5 Air Quality in Nairobi, Kenya

    PubMed Central

    Kinney, Patrick L.; Gichuru, Michael Gatari; Volavka-Close, Nicole; Ngo, Nicole; Ndiba, Peter K.; Law, Anna; Gachanja, Anthony; Gaita, Samuel Mwaniki; Chillrud, Steven N.; Sclar, Elliott

    2011-01-01

    Motor vehicle traffic is an important source of particulate pollution in cities of the developing world, where rapid growth, coupled with a lack of effective transport and land use planning, may result in harmful levels of fine particles (PM2.5) in the air. However, a lack of air monitoring data hinders health impact assessments and the development of transportation and land use policies that could reduce health burdens due to outdoor air pollution. To address this important need, a study of traffic-related PM2.5 was carried out in the city of Nairobi, Kenya, a model city for sub-Saharan Africa, in July 2009. Sampling was carried out using portable filter-based air samplers carried in backpacks by technicians on weekdays over two weeks at several sites in and around Nairobi ranging from high-traffic roadways to rural background. Mean daytime concentrations of PM2.5 ranged from 10.7 at the rural background site to 98.1 μg/m3 on a sidewalk in the central business district. Horizontal dispersion measurements demonstrated a decrease in PM2.5 concentration from 128.7 to 18.7 μg/m3 over 100 meters downwind of a major intersection in Nairobi. A vertical dispersion experiment revealed a decrease from 119.5 μg/m3 at street level to 42.8 μg/m3 on a third-floor rooftop in the central business district. Though not directly comparable to air quality guidelines, which are based on 24-hour or annual averages, the urban concentrations we observed raise concern with regard to public health and related policy. Taken together with survey data on commuting patterns within Nairobi, these results suggest that many Nairobi residents are exposed on a regular basis to elevated concentrations of fine particle air pollution, with potentially serious long-term implications for health. PMID:21779151

  10. Traffic Impacts on PM(2.5) Air Quality in Nairobi, Kenya.

    PubMed

    Kinney, Patrick L; Gichuru, Michael Gatari; Volavka-Close, Nicole; Ngo, Nicole; Ndiba, Peter K; Law, Anna; Gachanja, Anthony; Gaita, Samuel Mwaniki; Chillrud, Steven N; Sclar, Elliott

    2011-06-01

    Motor vehicle traffic is an important source of particulate pollution in cities of the developing world, where rapid growth, coupled with a lack of effective transport and land use planning, may result in harmful levels of fine particles (PM(2.5)) in the air. However, a lack of air monitoring data hinders health impact assessments and the development of transportation and land use policies that could reduce health burdens due to outdoor air pollution. To address this important need, a study of traffic-related PM(2.5) was carried out in the city of Nairobi, Kenya, a model city for sub-Saharan Africa, in July 2009. Sampling was carried out using portable filter-based air samplers carried in backpacks by technicians on weekdays over two weeks at several sites in and around Nairobi ranging from high-traffic roadways to rural background. Mean daytime concentrations of PM(2.5) ranged from 10.7 at the rural background site to 98.1 μg/m(3) on a sidewalk in the central business district. Horizontal dispersion measurements demonstrated a decrease in PM(2.5) concentration from 128.7 to 18.7 μg/m(3) over 100 meters downwind of a major intersection in Nairobi. A vertical dispersion experiment revealed a decrease from 119.5 μg/m(3) at street level to 42.8 μg/m(3) on a third-floor rooftop in the central business district. Though not directly comparable to air quality guidelines, which are based on 24-hour or annual averages, the urban concentrations we observed raise concern with regard to public health and related policy. Taken together with survey data on commuting patterns within Nairobi, these results suggest that many Nairobi residents are exposed on a regular basis to elevated concentrations of fine particle air pollution, with potentially serious long-term implications for health. PMID:21779151

  11. Speciation of particulate carbonaceous species at an urban-background site in Nairobi, Kenya.

    NASA Astrophysics Data System (ADS)

    Gatari, Michael; Lavrich, Richard; Preston, Bill; Gaita, Samuel; Hays, Michael

    2010-05-01

    Tropospheric aerosols have adverse implications on human health, climate, and visibility. Particles in combustion source emissions have complex physical and chemical characteristics. They regularly contain Polycyclic Aromatic Hydrocarbons (PAH) molecules that can be harmful to human health. Combustion particles in the atmosphere can acts as mutagens or carcinogens and tend to be in the PM2.5 size range (particles with aerodynamic diameters of 2.5 μm or less) and are thus able to access the alveolar region of the respiratory system. Much of the urban carbonaceous aerosol is related to traffic emissions. Generally, particle concentration levels and the abundance of molecular species in atmospheric aerosols are not well studied in developing countries. This study is the first to investigate hydrocarbons (HC) levels in the city of Nairobi, Kenya. The human population in Nairobi is increasing rapidly as is the use of on-road vehicles. Total-suspended particle matter (PM35) in Nairobi air was collected for 24h on quartz fiber filters using a high volume sampler (flow rate = 1130 LPM). The sampling system was used in earlier U.S. air pollution studies but was donated in 1997 by California Air Research Board (CARB) USA to the University of Nairobi's Institute of Nuclear Science & Technology via a World Health Organization (WHO) twinning program. The sampler was placed 20 m above the Earth's surface in a Main Campus building at the University of Nairobi. USEPA analyzed the particle mass for organic markers using direct thermal extraction-gas chromatography mass spectrometry (GC- MS). A thermal optical method was used for determination of the organic (OC) and elemental (EC) carbon in the PM. Ten samples was analyzed for roughly sixty-four HC species. Four filter samples were taken in August and six in October 2006. Of these species, 21 to 26 were PAH. The results show different concentrations between August and October depicting the influence of a regional aerosol. The

  12. Enumeration of Sex Workers in the Central Business District of Nairobi, Kenya

    PubMed Central

    Kimani, Joshua; McKinnon, Lyle R.; Wachihi, Charles; Kusimba, Judith; Gakii, Gloria; Birir, Sarah; Muthui, Mercy; Kariri, Anthony; Muriuki, Festus K.; Muraguri, Nicholas; Musyoki, Helgar; Ball, T. Blake; Kaul, Rupert; Gelmon, Lawrence

    2013-01-01

    Accurate program planning for populations most at risk for HIV/STI acquisition requires knowledge of the size and location where these populations can best be reached. To obtain this information for sex workers operating at 137 hotspots in the central business district (CBD) in Nairobi, Kenya, we utilized a combined mapping and capture-recapture enumeration exercise. The majority of identified hotspots in this study were bars. Based on this exercise, we estimate that 6,904 male and female sex workers (95% confidence intervals, 6690 and 7118) were working nightly in the Nairobi CBD in April 2009. Wide ranges of captures per spot were obtained, suggesting that relatively few hot spots (18%) contain a relatively high proportion of the area's sex workers (65%). We provide geographic data including relatively short distances from hotspots to our dedicated sex worker outreach program in the CBD (mean<1 km), and clustering of hotspots within a relatively small area. Given the size covered and areas where sex work is likely taking place in Nairobi, the estimate is several times lower than what would be obtained if the entire metropolitan area was enumerated. These results have important practical and policy implications for enhancing HIV/STI prevention efforts. PMID:23372713

  13. Attitudes toward Psychiatry: A Survey of Medical Students at the University of Nairobi, Kenya

    ERIC Educational Resources Information Center

    Ndetei, David M.; Khasakhala, Lincoln; Ongecha-Owuor, Francisca; Kuria, Mary; Mutiso, Victoria; Syanda, Judy; Kokonya, Donald

    2008-01-01

    Objectives: The authors aim to determine the attitudes of University of Nairobi, Kenya, medical students toward psychiatry. Methods: The study design was cross-sectional. Self-administered sociodemographic and the Attitudes Toward Psychiatry-30 items (ATP-30) questionnaires were distributed sequentially to every third medical student in his or her…

  14. HIV mortality in urban slums of Nairobi, Kenya 2003–2010: a period effect analysis

    PubMed Central

    2013-01-01

    Background It has been almost a decade since HIV was declared a national disaster in Kenya. Antiretroviral therapy (ART) provision has been a mainstay of HIV treatment efforts globally. In Kenya, the government started ART provision in 2003 with significantly scale-up after 2006. This study aims to demonstrate changes in population-level HIV mortality in two high HIV prevalence slums in Nairobi with respect to the initiation and subsequent scale-up of the national ART program. Methods We used data from 2070 deaths of people aged 15–54 years that occurred between 2003 and 2010 in a population of about 72,000 individuals living in two slums covered by the Nairobi Urban Health and Demographic Surveillance System. Only deaths for which verbal autopsy was conducted were included in the study. We divided the analysis into two time periods: the “early” period (2003–2006) which coincides with the initiation of ART program in Kenya, and the “late” period (2007–2010) which coincides with the scale up of the program nationally. We calculated the mortality rate per 1000 person years by gender and age for both periods. Poisson regression was used to predict the risk of HIV mortality in the two periods while controlling for age and gender. Results Overall, HIV mortality declined significantly from 2.5 per 1,000 person years in the early period to 1.7 per 1,000 person years in the late period. The risk of dying from HIV was 53 percent less in the late period compared to the period before, controlling for age and gender. Women experienced a decline in HIV mortality between the two periods that was more than double that of men. At the same time, the risk of non-HIV mortality did not change significantly between the two time periods. Conclusions Population-level HIV mortality in Nairobi’s slums was significantly lower in the approximate period coinciding with the scale-up of ART provision in Kenya. However, further studies that incorporate ART coverage data in

  15. What do family planning clients and university students in Nairobi, Kenya, know and think about emergency contraception?

    PubMed

    Muia, E; Ellertson, C; Clark, S; Lukhando, M; Elul, B; Olenja, J; Westley, E

    2000-04-01

    Currently, emergency contraception is seldom used in Kenya. As part of a larger study designed to provide insight into the possible roles for the method in Kenya, we assessed the knowledge of and attitudes towards emergency contraception in two groups of potential users, and we focus on these data specifically in this paper. We interviewed clustered samples of clients at ten family planning clinics in Nairobi (n = 282) and conducted four focus group discussions with students at two universities in Kenya (n = 42). Results show that despite relatively low levels of awareness and widespread misinformation, when the method was explained, both clients and students expressed considerable interest, but also expressed some health and other concerns. PMID:11000711

  16. Cryptosporidium species detected in calves and cattle in Dagoretti, Nairobi, Kenya.

    PubMed

    Kang'ethe, Erastus K; Mulinge, Erastus K; Skilton, Robert A; Njahira, Moses; Monda, Joseph G; Nyongesa, Concepta; Mbae, Cecilia K; Kamwati, Stanley K

    2012-09-01

    A total of 1,734 cattle faecal samples from 296 dairy-keeping households were collected from urban settings in Nairobi, Kenya. Modified Ziehl-Neelsen staining method and an immunofluorescence assay were used to identify those samples with Cryptosporidium oocyst infection. Oocysts from positive faecal samples were isolated by Sheather's sucrose flotation method and picked from the concentrate using cover slips. Genomic DNA was extracted from 124 of the faecal samples that were positive for Cryptosporidium and was used as template for nested PCR of the 18S rRNA gene. Twenty-five samples (20 %) were PCR-positive for Cryptosporidium, and 24 of the PCR products were successfully cloned and sequenced. Sequence and phylogenetic analysis identified 17 samples (68 %) as Cryptosporidium parvum-like, four samples (16 %) as Cryptosporidium ryanae, three samples (12 %) as Cryptosporidium andersoni and one sample (4 %) as Cryptosporidium hominis. To the best of our knowledge, this is the first genotyping study to report C. parvum-like, C. andersoni and C. hominis in cattle from Kenya. The results of this study show Cryptosporidium infections in calves and cattle may be potential zoonotic reservoirs of the parasite that infects humans. PMID:22797974

  17. When families fail: shifting expectations of care among people living with HIV in Nairobi, Kenya

    PubMed Central

    Moyer, Eileen; Igonya, Emmy Kageha

    2014-01-01

    The availability of free antiretroviral treatment in public health facilities since 2004 has contributed to the increasing biomedicalization of AIDS care in Kenya. This has been accompanied by a reduction of funding for community-based care and support organizations since the 2008 global economic crisis and a consequent donor divestment from HIV projects in Africa. This paper explores the ways that HIV interventions, including support groups, home-based care and antiretroviral treatments have shaped expectations regarding relations of care in the low-income area of Kibera in Nairobi, Kenya, over the last decade. Findings are based on 20 months of ethnographic research conducted in Nairobi between January 2011 and August 2013. By focusing on three eras of HIV treatment – pre-treatment, treatment scale-up, and post-crisis – the authors illustrate how family and community-based care have changed with shifts in funding. Many support groups that previously provided HIV care in Kibera, where the state is largely absent and family networks are thin, have been forced to cut services. Large-scale HIV treatment programmes may allow the urban poor in Nairobi to survive, but they are unlikely to thrive. Many care needs continue to go unmet in the age of treatment, and many economically marginal people who had found work in care-oriented community-based organizations now find themselves jobless or engaged in work not related to HIV. PMID:25175290

  18. A qualitative exploration of access to urban migrant healthcare in Nairobi, Kenya.

    PubMed

    Arnold, Christine; Theede, Jason; Gagnon, Anita

    2014-06-01

    In recent years, Kenya's capital city Nairobi has experienced an influx of international economic migrants, as well as migrants forced to flee their neighboring countries of origin, or coming from UNHCR-managed refugee camps into the city. Urban migrants regularly face challenges integrating with host communities and consequently face health vulnerabilities. The International Organization for Migration in Kenya was concerned about the potential marginalization of urban migrants from mainstream health programming and a lack of data upon which to base their activities. The purpose of this project was to gain a greater understanding of urban migrants' barriers to accessing healthcare in Nairobi compared with barriers faced by Kenyans living in the same locations. Guiding our work was a conceptual framework for assessing access to healthcare, which defines availability, geographic accessibility, financial accessibility and acceptability as the four dimensions of access. We identified key informants in collaboration with The National Organisation for Peer Educators, and these individuals assisted in identifying communities within Nairobi where large proportions of migrants reside. Four communities were selected for further study. In each, interviews with government officials and service providers were conducted, and focus group discussions were held with both migrants and Kenyans. Verbatim transcripts were content-analyzed using an open coding technique. Common barriers to accessing care that were shared by migrants and Kenyans included waiting times, drug availability, transportation and cost. Barriers unique to migrants were: threat of harassment; cost discrepancies between migrant and Kenyan clients; real or perceived discrimination; documentation requirements and language barriers. Despite articles from the 2010 Constitution of Kenya that assert the right to health for every person in Kenya, migrants continue to experience unique barriers in accessing healthcare

  19. Predictors of overweight and obesity in adult women in Nairobi Province, Kenya

    PubMed Central

    2012-01-01

    Background Since obesity in urban women is prevalent in Kenya the study aimed to determine predictors of overweight and obesity in urban Kenyan women. Methods A cross-sectional study was undertaken in Nairobi Province. The province was purposively selected because it has the highest prevalence of overweight and obesity in Kenya. A total of 365 women aged 25–54 years old were randomly selected to participate in the study. Results Higher age, higher socio-economic (SE) group, increased parity, greater number of rooms in the house, and increased expenditure showed greater mean body mass index (BMI),% body fat and waist circumference (WC) at highly significant levels (p <0.001). Most of the variance in BMI was explained by age, total physical activity, percentage of fat consumed, parity and SE group in that order, together accounting for 18% of the variance in BMI. The results suggest that age was the most significant predictor of all the dependent variables appearing first in all the models, while parity was a significant predictor of BMI and WC. The upper two SE groups had significantly higher mean protein (p <0.05), cholesterol (p <0.05) and alcohol (p <0.001) intakes than the lower SE groups; while the lower SE groups had significantly higher mean fibre (p <0.001) and carbohydrate (p <0.05) intakes. A fat intake greater than 100% of the DRI dietary reference intake (DRI) had a significantly greater mean BMI (p <0.05) than a fat intake less than the DRI. Conclusions The predictors of overweight and obesity showed that urbanization and the nutrition transition were well established in the sample of women studied in the high SE groups. They exhibited a sedentary lifestyle and consumed a diet high in energy, protein, fat, cholesterol, and alcohol and lower in fibre and carbohydrate compared with those in the low SE groups. PMID:23009185

  20. Malaria Parasitemia among Febrile Patients Seeking Clinical Care at an Outpatient Health Facility in an Urban Informal Settlement Area in Nairobi, Kenya

    PubMed Central

    Njuguna, Henry N.; Montgomery, Joel M.; Cosmas, Leonard; Wamola, Newton; Oundo, Joseph O.; Desai, Meghna; Buff, Ann M.; Breiman, Robert F.

    2016-01-01

    Nairobi is considered a low-risk area for malaria transmission, but travel can influence transmission of malaria. We investigated the demographic characteristics and travel history of patients with documented fever and malaria in a study clinic in a population-based surveillance system over a 5-year period, January 1, 2007 to December 31, 2011. During the study period, 11,480 (68%) febrile patients had a microscopy test performed for malaria, of which 2,553 (22%) were positive. Malaria was detected year-round with peaks in January, May, and September. Children aged 5–14 years had the highest proportion (28%) of positive results followed by children aged 1–4 years (23%). Almost two-thirds of patients with malaria reported traveling outside Nairobi; 79% of these traveled to three counties in western Kenya. History of recent travel (i.e., in past month) was associated with malaria parasitemia (odds ratio: 10.0, 95% confidence interval: 9.0–11.0). Malaria parasitemia was frequently observed among febrile patients at a health facility in the urban slum of Kibera, Nairobi. The majority of patients had traveled to western Kenya. However, 34% reported no travel history, which raises the possibility of local malaria transmission in this densely populated, urban setting. These findings have important implications for malaria control in large Nairobi settlements. PMID:26598567

  1. Malaria Parasitemia Among Febrile Patients Seeking Clinical Care at an Outpatient Health Facility in an Urban Informal Settlement Area in Nairobi, Kenya.

    PubMed

    Njuguna, Henry N; Montgomery, Joel M; Cosmas, Leonard; Wamola, Newton; Oundo, Joseph O; Desai, Meghna; Buff, Ann M; Breiman, Robert F

    2016-01-01

    Nairobi is considered a low-risk area for malaria transmission, but travel can influence transmission of malaria. We investigated the demographic characteristics and travel history of patients with documented fever and malaria in a study clinic in a population-based surveillance system over a 5-year period, January 1, 2007 to December 31, 2011. During the study period, 11,480 (68%) febrile patients had a microscopy test performed for malaria, of which 2,553 (22%) were positive. Malaria was detected year-round with peaks in January, May, and September. Children aged 5-14 years had the highest proportion (28%) of positive results followed by children aged 1-4 years (23%). Almost two-thirds of patients with malaria reported traveling outside Nairobi; 79% of these traveled to three counties in western Kenya. History of recent travel (i.e., in past month) was associated with malaria parasitemia (odds ratio: 10.0, 95% confidence interval: 9.0-11.0). Malaria parasitemia was frequently observed among febrile patients at a health facility in the urban slum of Kibera, Nairobi. The majority of patients had traveled to western Kenya. However, 34% reported no travel history, which raises the possibility of local malaria transmission in this densely populated, urban setting. These findings have important implications for malaria control in large Nairobi settlements. PMID:26598567

  2. Risk factors for Chlamydia trachomatis pelvic inflammatory disease among sex workers in Nairobi, Kenya.

    PubMed

    Kimani, J; Maclean, I W; Bwayo, J J; MacDonald, K; Oyugi, J; Maitha, G M; Peeling, R W; Cheang, M; Nagelkerke, N J; Plummer, F A; Brunham, R C

    1996-06-01

    Among 302 female sex workers in Nairobi, Kenya, who were followed for 17.6 +/- 11.1 months, 146 had one or more infections with Chlamydia trachomatis; 102 had uncomplicated cervical infection only, 23 had C. trachomatis pelvic inflammatory disease (PID), and 21 had combined C. trachomatis and Neisseria gonorrhoeae PID. As determined by multivariate logistic regression analysis, risk factors for C. trachomatis PID included repeated C. trachomatis infection (odds ratio [OR], 1.8; 95% confidence interval [CI], 1.3-2.4; P = .0004), antibody to C. trachomatis heat-shock protein 60 (OR, 3.9; CI, 1.04-14.5; P = .04), oral contraceptive use (OR, 0.28; 95% CI, 0.08-0.99; P = .048), and number of episodes of nongonococcal nonchlamydial PID (OR, 1.7; 95% CI, 1.1-2.7; P = .02). Among human immunodeficiency virus (HIV)-seropositive women, a CD4 lymphocyte count of <400/mm3 was an additional independent risk factor for C. trachomatis PID (OR, 21.7; 95% CI, 1.2-383; P = .036); among HLA-typed women, HLA-A31 was independently associated with C. trachomatis PID (OR, 5.6; 95% CI, 1.1-29.4; P = .043). The results suggest an immune-mediated pathogenesis for C. trachomatis PID. PMID:8648217

  3. Slum Sanitation and the Social Determinants of Women's Health in Nairobi, Kenya

    PubMed Central

    Corburn, Jason; Hildebrand, Chantal

    2015-01-01

    Inadequate urban sanitation disproportionately impacts the social determinants of women's health in informal settlements or slums. The impacts on women's health include infectious and chronic illnesses, violence, food contamination and malnutrition, economic and educational attainment, and indignity. We used household survey data to report on self-rated health and sociodemographic, housing, and infrastructure conditions in the Mathare informal settlement in Nairobi, Kenya. We combined quantitative survey and mapping data with qualitative focus group information to better understand the relationships between environmental sanitation and the social determinants of women and girls' health in the Mathare slum. We find that an average of eighty-five households in Mathare share one toilet, only 15% of households have access to a private toilet, and the average distance to a public toilet is over 52 meters. Eighty-three percent of households without a private toilet report poor health. Mathare women report violence (68%), respiratory illness/cough (46%), diabetes (33%), and diarrhea (30%) as the most frequent physical burdens. Inadequate, unsafe, and unhygienic sanitation results in multiple and overlapping health, economic, and social impacts that disproportionately impact women and girls living in urban informal settlements. PMID:26060499

  4. Slum Sanitation and the Social Determinants of Women's Health in Nairobi, Kenya.

    PubMed

    Corburn, Jason; Hildebrand, Chantal

    2015-01-01

    Inadequate urban sanitation disproportionately impacts the social determinants of women's health in informal settlements or slums. The impacts on women's health include infectious and chronic illnesses, violence, food contamination and malnutrition, economic and educational attainment, and indignity. We used household survey data to report on self-rated health and sociodemographic, housing, and infrastructure conditions in the Mathare informal settlement in Nairobi, Kenya. We combined quantitative survey and mapping data with qualitative focus group information to better understand the relationships between environmental sanitation and the social determinants of women and girls' health in the Mathare slum. We find that an average of eighty-five households in Mathare share one toilet, only 15% of households have access to a private toilet, and the average distance to a public toilet is over 52 meters. Eighty-three percent of households without a private toilet report poor health. Mathare women report violence (68%), respiratory illness/cough (46%), diabetes (33%), and diarrhea (30%) as the most frequent physical burdens. Inadequate, unsafe, and unhygienic sanitation results in multiple and overlapping health, economic, and social impacts that disproportionately impact women and girls living in urban informal settlements. PMID:26060499

  5. Informal settlements and a relational view of health in Nairobi, Kenya: sanitation, gender and dignity.

    PubMed

    Corburn, Jason; Karanja, Irene

    2016-06-01

    On an urban planet, slums or informal settlements present an increasing challenge for health promotion. The living conditions in complex informal settlements interact with how people navigate through their daily lives and political institutions to shape health inequities. In this article, we suggest that only a relational place-based characterization of informal settlements can accurately capture the forces contributing to existing urban health inequities and inform appropriate and effective health promotion interventions. We explore our relational framework using household survey, spatial mapping and qualitative focus group data gathered in partnership with residents and non-governmental organizations in the Mathare informal settlement in Nairobi, Kenya. All data interpretation included participation with local residents and organizations. We focus on the inter-relationships between inadequate sanitation and disease, social, economic and human rights for women and girls, who we show are most vulnerable from poor slum infrastructure. We suggest that this collaborative process results in co-produced insights about the meanings and relationships between infrastructure, security, resilience and health. We conclude that complex informal settlements require relational and context-specific data gathering and analyses to understand the multiple determinants of health and to inform appropriate and effective healthy city interventions. PMID:25421267

  6. Family Kinship Patterns and Female Sex Work in the Informal Urban Settlement of Kibera, Nairobi, Kenya.

    PubMed

    Ngugi, Elizabeth N; Benoit, Cecilia; Hallgrimsdottir, Helga; Jansson, Mikael; Roth, Eric A

    2012-06-01

    A basic ecological and epidemiological question is why some women enter into commercial sex work while other women in the same socio-economic environment never do. To address this question respondent driven sampling principles were adopted to recruit and collect data for 161 female sex workers and 159 same aged women who never engaged in commercial sex in Kibera, a large informal settlement in Nairobi, Kenya. Univariate analysis indicated that basic kinship measures, including number of family members seen during adolescence and at present, not having a male guardian while growing up, and earlier times of ending relationships with both male and female guardians were associated with commercial sex work in Kibera. Multivariate analysis via logistic regression modeling showed that not having a male guardian during childhood, low education attainment and a small number of family members seen at adolescence were all significant predictors of entering sex work. By far the most important predictor of entering sex work was not having any male guardian, e.g., father, uncle, older brother, etc. during childhood. Results are interpreted in light of the historic pattern of sub-Saharan African child fostering and their relevance for young women in Kibera today. PMID:26523084

  7. Phosphorus budget in the low-income, peri-urban area of Kibera in Nairobi (Kenya).

    PubMed

    Kelderman, P; Koech, D K; Gumbo, B; O'Keeffe, J

    2009-01-01

    Kibera, located in Nairobi, Kenya is one of the largest (235,000 inhabitants) low-income areas in East Africa. Surface waters in Kibera show high pollution levels with respect to SRP (soluble reactive phosphorus; range: 2-10 mg P/L), coming from the uncontrolled wastewater discharges in the area. The different P production and consumption values in Kibera were estimated using interviews (155 interviewed) as well as detailed P house-keeping for five representative families. The results show that highest P consumption comes from food, in particular cereals. Highest P production came from urine (55% of the total) and faeces (31%), with relatively lower contributions from grey water and solid wastes. The overall P budget in Kibera amounted to around 9 x 10(3) kg P/month. This is equivalent to 0.47 g P/person yr, both for P production and consumption, with a relative error of 20%. Comparing with the estimated P outflows via the Kibera surface waters, around 65% of the P produced in Kibera will leave the area. In future ECOSAN techniques such as urine separation could well be applied for efficient recycling of these waste sources. PMID:19923773

  8. Nutritional Status of Under-five Children Living in an Informal Urban Settlement in Nairobi, Kenya

    PubMed Central

    Burke, Heather; Cosmas, Leonard; Bamrah, Sapna; Dooling, Kathleen; Feikin, Daniel R.; Talley, Leisel E.; Breiman, Robert F.

    2011-01-01

    Malnutrition in sub-Saharan Africa contributes to high rates of childhood morbidity and mortality. However, little information on the nutritional status of children is available from informal settlements. During the period of post-election violence in Kenya during December 2007–March 2008, food shortages were widespread within informal settlements in Nairobi. To investigate whether food insecurity due to post-election violence resulted in high prevalence of acute and chronic malnutrition in children, a nutritional survey was undertaken among children aged 6-59 months within two villages in Kibera, where the Kenya Medical Research Institute/Centers for Disease Control and Prevention conducts population-based surveillance for infectious disease syndromes. During 25 March–4 April 2008, a structured questionnaire was administered to caregivers of 1,310 children identified through surveillance system databases to obtain information on household demographics, food availability, and child-feeding practices. Anthropometric measurements were recorded on all participating children. Indices were reported in z-scores and compared with the World Health Organization (WHO) 2005 reference population to determine the nutritional status of children. Data were analyzed using the Anthro software of WHO and the SAS. Stunting was found in 47.0% of the children; 11.8% were underweight, and 2.6% were wasted. Severe stunting was found in 23.4% of the children; severe underweight in 3.1%, and severe wasting in 0.6%. Children aged 36-47 months had the highest prevalence (58.0%) of stunting while the highest prevalence (4.1%) of wasting was in children aged 6-11 months. Boys were more stunted than girls (p<0.01), and older children were significantly (p<0.0001) stunted compared to younger children. In the third year of life, girls were more likely than boys to be wasted (p<0.01). The high prevalence of chronic malnutrition suggests that stunting is a sustained problem within this urban

  9. Nutritional status of under-five children living in an informal urban settlement in Nairobi, Kenya.

    PubMed

    Olack, Beatrice; Burke, Heather; Cosmas, Leonard; Bamrah, Sapna; Dooling, Kathleen; Feikin, Daniel R; Talley, Leisel E; Breiman, Robert F

    2011-08-01

    Malnutrition in sub-Saharan Africa contributes to high rates of childhood morbidity and mortality. However, little information on the nutritional status of children is available from informal settlements. During the period of post-election violence in Kenya during December 2007-March 2008, food shortages were widespread within informal settlements in Nairobi. To investigate whether food insecurity due to post-election violence resulted in high prevalence of acute and chronic malnutrition in children, a nutritional survey was undertaken among children aged 6-59 months within two villages in Kibera, where the Kenya Medical Research Institute/Centers for Disease Control and Prevention conducts population-based surveillance for infectious disease syndromes. During 25 March-4 April 2008, a structured questionnaire was administered to caregivers of 1,310 children identified through surveillance system databases to obtain information on household demographics, food availability, and child-feeding practices. Anthropometric measurements were recorded on all participating children. Indices were reported in z-scores and compared with the World Health Organization (WHO) 2005 reference population to determine the nutritional status of children. Data were analyzed using the Anthro software of WHO and the SAS. Stunting was found in 47.0% of the children; 11.8% were underweight, and 2.6% were wasted. Severe stunting was found in 23.4% of the children; severe underweight in 3.1%, and severe wasting in 0.6%. Children aged 36-47 months had the highest prevalence (58.0%) of stunting while the highest prevalence (4.1%) of wasting was in children aged 6-11 months. Boys were more stunted than girls (p < 0.01), and older children were significantly (p < 0.0001) stunted compared to younger children. In the third year of life, girls were more likely than boys to be wasted (p < 0.01). The high prevalence of chronic malnutrition suggests that stunting is a sustained problem within this urban

  10. Mother-Daughter Communication about Sexual Maturation, Abstinence and Unintended Pregnancy: Experiences from an Informal Settlement in Nairobi, Kenya

    ERIC Educational Resources Information Center

    Crichton, Joanna; Ibisomi, Latifat; Gyimah, Stephen Obeng

    2012-01-01

    Parental communication and support is associated with improved developmental, health and behavioral outcomes in adolescence. This study explores the quality of mother-daughter communication about sexual maturation, abstinence and unintended pregnancy in Korogocho, an informal settlement in Nairobi, Kenya. We use data from 14 focus group…

  11. Health care seeking practices of caregivers of children under 5 with diarrhea in two informal settlements in Nairobi, Kenya.

    PubMed

    Mukiira, Carol; Ibisomi, Latifat

    2015-06-01

    In Kenya, as in other developing countries, diarrhea is among the leading causes of child mortality. Despite being easy to prevent and treat, care seeking for major child illnesses including diarrhea remains poor in the country. Mortality due to diarrhea is even worse in informal settlements that are characterized by poor sanitary conditions and largely unregulated health care system among other issues. The study aims to examine the health care seeking practices of caregivers of children under 5 with diarrhea in two informal settlements in Nairobi, Kenya. The article used data from a maternal and child health (MCH) prospective study conducted between 2006 and 2010. Results show that more than half (55%) of the caregivers sought inappropriate health care in the treatment of diarrhea of their child. Of the 55%, about 35% sought no care at all. Use of oral rehydration solution and zinc supplements, which are widely recommended for management of diarrhea, was very low. The critical predictors of health care seeking identified in the study are duration of illness, informal settlement of residence, and the child's age. The study showed that appropriate health care seeking practices for childhood diarrhea remain a great challenge among the urban poor in Kenya. PMID:24270995

  12. Inconsistencies in Self-Reporting of Sexual Activity Among Young People in Nairobi, Kenya

    PubMed Central

    Beguy, Donatien; Kabiru, Caroline W.; Nderu, Evangeline N.; Ngware, Moses W.

    2009-01-01

    Purpose Accurate and reliable data on the prevalence of adolescents' sexual behavior are paramount for effective sexual and reproductive health intervention. Adolescents' sexual behavior has been widely studied. However, scholars have raised concerns about the accuracy and reliability of self-reported sexual behavior by adolescents. Previous research shows high levels of adolescent sexual activity in urban informal settlements; yet, the accuracy of self-reported sexual experience in these settings is understudied. Methods The objective of this article is to assess consistency of self-reported sexual activity among 2324 adolescents living in slum and nonslum settlements in Nairobi, Kenya. We examine two forms of inconsistencies, namely, what we term “reborn virgins” and inconsistent timing of sexual debut, during two rounds of survey. Factors influencing inconsistent reporting are explored through logistic regression. Results A total of 469 (20%) adolescents gave inconsistent information on whether they have ever had sex (n = 190) or timing of first intercourse (n = 279). Males, slum residents, and adolescents attending school were more likely to give inconsistent sexual information. Among inconsistent reporters, slum residents, adolescents reporting substance use, and those with secondary (vs. primary) education were more likely to reclaim virginity status than to misreport the timing of first sex. However, older adolescents were less likely to reclaim virginity status. Conclusions We found significant differences between adolescents who provide consistent reports and those who misreport sexual behavior data. We argue that researchers should account for biases stemming from misreporting of sensitive information among young people and, in particular, should be cognizant of how reporting quality may vary across demographic groups. PMID:19931832

  13. Genetic Diversity of Cryptosporidium in Children in an Urban Informal Settlement of Nairobi, Kenya

    PubMed Central

    Mbae, Cecilia; Mulinge, Erastus; Waruru, Anthony; Ngugi, Benjamin; Wainaina, James; Kariuki, Samuel

    2015-01-01

    Introduction Globally Cryptosporidium and Giardia species are the most common non-bacterial causes of diarrhoea in children and HIV infected individuals, yet data on their role in paediatric diarrhoea in Kenya remains scant. This study investigated the occurrence of Cryptosporidium species, genotypes and subtypes in children, both hospitalized and living in an informal settlement in Nairobi. Methods This was a prospective cross-sectional study in which faecal specimen positive for Cryptosporidium spp. by microscopy from HIV infected and uninfected children aged five years and below presenting with diarrhoea at selected outpatient clinics in Mukuru informal settlements, or admitted to the paediatric ward at the Mbagathi District Hospital were characterized. The analysis was done by Polymerase Chain Reaction-Restriction Fragment Length Polymorphism (PCR-RFLP) of the 18srRNA gene for species identification and PCR-sequencing of the 60 kDa glycoprotein (GP60) gene for subtyping. Results C. hominis was the most common species of Cryptosporidium identified in125/151(82.8%) of the children. Other species identified were C. parvum 18/151(11.9%), while C. felis and C. meleagridis were identified in 4 and 2 children, respectively. Wide genetic variation was observed within C. hominis, with identification of 5 subtype families; Ia, Ib, Id, Ie and If and 21 subtypes. Only subtype family IIc was identified within C. parvum. There was no association between species and HIV status or patient type. Conclusion C. hominis is the most common species associated with diarrhoea in the study population. There was high genetic variability in the C. hominis isolates with 22 different subtypes identified, whereas genetic diversity was low within C. parvum with only one subtype family IIc identified. PMID:26691531

  14. Vulnerability to food insecurity in urban slums: experiences from Nairobi, Kenya.

    PubMed

    Kimani-Murage, E W; Schofield, L; Wekesah, F; Mohamed, S; Mberu, B; Ettarh, R; Egondi, T; Kyobutungi, C; Ezeh, A

    2014-12-01

    Food and nutrition security is critical for economic development due to the role of nutrition in healthy growth and human capital development. Slum residents, already grossly affected by chronic poverty, are highly vulnerable to different forms of shocks, including those arising from political instability. This study describes the food security situation among slum residents in Nairobi, with specific focus on vulnerability associated with the 2007/2008 postelection crisis in Kenya. The study from which the data is drawn was nested within the Nairobi Urban Health and Demographic Surveillance System (NUHDSS), which follows about 70,000 individuals from close to 30,000 households in two slums in Nairobi, Kenya. The study triangulates data from qualitative and quantitative sources. It uses qualitative data from 10 focus group discussions with community members and 12 key-informant interviews with community opinion leaders conducted in November 2010, and quantitative data involving about 3,000 households randomly sampled from the NUHDSS database in three rounds of data collection between March 2011 and January 2012. Food security was defined using the Household Food Insecurity Access Scale (HFIAS) criteria. The study found high prevalence of food insecurity; 85% of the households were food insecure, with 50% being severely food insecure. Factors associated with food security include level of income, source of livelihood, household size, dependence ratio; illness, perceived insecurity and slum of residence. The qualitative narratives highlighted household vulnerability to food insecurity as commonplace but critical during times of crisis. Respondents indicated that residents in the slums generally eat for bare survival, with little concern for quality. The narratives described heightened vulnerability during the 2007/2008 postelection violence in Kenya in the perception of slum residents. Prices of staple foods like maize flour doubled and simultaneously household

  15. Co-occurrence of behavioral risk factors of common non-communicable diseases among urban slum dwellers in Nairobi, Kenya

    PubMed Central

    Haregu, Tilahun Nigatu; Oti, Samuel; Egondi, Thaddaeus; Kyobutungi, Catherine

    2015-01-01

    Background The four common non-communicable diseases (NCDs) account for 80% of NCD-related deaths worldwide. The four NCDs share four common risk factors. As most of the existing evidence on the common NCD risk factors is based on analysis of a single factor at a time, there is a need to investigate the co-occurrence of the common NCD risk factors, particularly in an urban slum setting in sub-Saharan Africa. Objective To determine the prevalence of co-occurrence of the four common NCDs risk factors among urban slum dwellers in Nairobi, Kenya. Design This analysis was based on the data collected as part of a cross-sectional survey to assess linkages among socio-economic status, perceived personal risk, and risk factors for cardiovascular and NCDs in a population of slum dwellers in Nairobi, Kenya, in 2008–2009. A total of 5,190 study subjects were included in the analysis. After selecting relevant variables for common NCD risk factors, we computed the prevalence of all possible combinations of the four common NCD risk factors. The analysis was disaggregated by relevant background variables. Results The weighted prevalences of unhealthy diet, insufficient physical activity, harmful use of alcohol, and tobacco use were found to be 57.2, 14.4, 10.1, and 12.4%, respectively. Nearly 72% of the study participants had at least one of the four NCD risk factors. About 52% of the study population had any one of the four NCD risk factors. About one-fifth (19.8%) had co-occurrence of NCD risk factors. Close to one in six individuals (17.6%) had two NCD risk factors, while only 2.2% had three or four NCD risk factors. Conclusions One out of five of people in the urban slum settings of Nairobi had co-occurrence of NCD risk factors. Both comprehensive and differentiated approaches are needed for effective NCD prevention and control in these settings. PMID:26385542

  16. Capacity indicators for disaster preparedness in hospitals within Nairobi County, Kenya

    PubMed Central

    Simiyu, Cynthia Nekesa; Odhiambo-Otieno, George; Okero, Dominic

    2014-01-01

    The goal of this study was to assess hospital capacity for disaster preparedness within Nairobi County. This information would be valuable to institutional strategists to resolve weaknesses and reinforce strengths in hospital capacity hence ensure efficient and effective service delivery during disasters. Analytical cross-sectional research design was used. Indicator variables for capacity were hospital equipment, hospital infrastructure, surrounding hospital environment, training, drills, staff knowledge and staff capabilities. Thirty two hospitals were studied of which nine of them were public hospitals. Data analysis was done using SPSS and presented in the form of frequency tables at p < 0.05. Study results indicated that hospital capacity to disaster preparedness in Nairobi County existed in 22 (68.88%) hospitals, in 6 (64.95%) public hospitals and 16 (69.64%) private hospitals. The difference in capacity between public and private hospitals within the County was less than 5%. This showed that both public and private hospitals were relatively at par, with regard to the capacity to handle disaster cases. Study findings also revealed that the surrounding hospital environment was the most highly rated indicator while inter hospital training and drills were the least rated. Although existent in hospitals within Nairobi County, for maximum hospital capacity and disaster preparedness within Nairobi County to be achieved, the existent gap in inter hospital training and inter hospital drills, both of which fall under the finance health systems pillar, required addressing. PMID:25574325

  17. Quantifying Urban Texture in Nairobi, Kenya and its Implications for Understanding Natural Hazard Impact

    NASA Astrophysics Data System (ADS)

    Taylor, Faith E.; Malamud, Bruce D.; Millington, James D. A.

    2016-04-01

    The configuration of infrastructure networks such as roads, drainage and power lines can both affect and be affected by natural hazards such as earthquakes, intense rain, wildfires and extreme temperatures. In this paper, we present and compare two methods to quantify urban topology on approximate scales of 0.0005 km2 to 10 km2 and create classifications of different 'urban textures' that relate to risk of natural hazard impact in an area. The methods we use focus on applicability in urban developing country settings, where access to high resolution and high quality data may be difficult. We use the city of Nairobi, Kenya to trial these methods. Nairobi has a population >3 million, and is a mix of informal settlements, residential and commercial development. The city and its immediate surroundings are subject to a variety of natural hazards such as floods, landslides, fires, drought, hail, heavy wind and extreme temperatures; all of these hazards can occur singly, but also have the potential for one to trigger another, thus providing a 'cascade' of hazards, or for two of the hazards to occur spatially and temporally near each other and interact. We use two measures of urban texture: (i) Street block textures, (ii) Google Earth land cover textures. Street block textures builds on the methodology of Louf and Barthelemy (2014) and uses Open Street Map data to analyse the shape, size, complexity and pattern of individual blocks of land created by fully enclosed loops of the major and minor road network of Nairobi. We find >4000 of these blocks ranging in size from approximately 0.0005 km2 to 10 km2, with approximately 5 classifications of urban texture. Google Earth land cover texture is a visual classification of homogeneous parcels of land performed in Google Earth using high-resolution airborne imagery and a qualitative criteria for each land cover type. Using the Google Earth land cover texture method, we identify >40 'urban textures' based on visual

  18. Curriculum Reorientation in Rural Development: Implications for Home Economics. Report of the International Seminar (Nairobi, Kenya, February 19-23, 1990).

    ERIC Educational Resources Information Center

    Van der Vynckt, Susan, Ed.; Sachs-Israel, Margarete, Ed.

    This document contains papers presented at a seminar that examined the Home Economics curriculum at Kenyatta University (Nairobi, Kenya) in the context of Kenya's new educational system. The seminar studied themes of nutrition and health, child development and care, and rural development. Working groups prepared reports on each of these themes.…

  19. Evidence of a Double Burden of Malnutrition in Urban Poor Settings in Nairobi, Kenya

    PubMed Central

    Kimani-Murage, Elizabeth W.; Muthuri, Stella K.; Oti, Samuel O.; Mutua, Martin K.; van de Vijver, Steven; Kyobutungi, Catherine

    2015-01-01

    Background Many low- and middle-income countries are undergoing a nutrition transition associated with rapid social and economic transitions. We explore the coexistence of over and under- nutrition at the neighborhood and household level, in an urban poor setting in Nairobi, Kenya. Methods Data were collected in 2010 on a cohort of children aged under five years born between 2006 and 2010. Anthropometric measurements of the children and their mothers were taken. Additionally, dietary intake, physical activity, and anthropometric measurements were collected from a stratified random sample of adults aged 18 years and older through a separate cross-sectional study conducted between 2008 and 2009 in the same setting. Proportions of stunting, underweight, wasting and overweight/obesity were dettermined in children, while proportions of underweight and overweight/obesity were determined in adults. Results Of the 3335 children included in the analyses with a total of 6750 visits, 46% (51% boys, 40% girls) were stunted, 11% (13% boys, 9% girls) were underweight, 2.5% (3% boys, 2% girls) were wasted, while 9% of boys and girls were overweight/obese respectively. Among their mothers, 7.5% were underweight while 32% were overweight/obese. A large proportion (43% and 37%%) of overweight and obese mothers respectively had stunted children. Among the 5190 adults included in the analyses, 9% (6% female, 11% male) were underweight, and 22% (35% female, 13% male) were overweight/obese. Conclusion The findings confirm an existing double burden of malnutrition in this setting, characterized by a high prevalence of undernutrition particularly stunting early in life, with high levels of overweight/obesity in adulthood, particularly among women. In the context of a rapid increase in urban population, particularly in urban poor settings, this calls for urgent action. Multisectoral action may work best given the complex nature of prevailing circumstances in urban poor settings. Further

  20. Factors associated with adequate weekly reporting for disease surveillance data among health facilities in Nairobi County, Kenya, 2013

    PubMed Central

    Mwatondo, Athman Juma; Ng'ang'a, Zipporah; Maina, Caroline; Makayotto, Lyndah; Mwangi, Moses; Njeru, Ian; Arvelo, Wences

    2016-01-01

    Introduction Kenya adopted the Integrated Disease Surveillance and Response (IDSR) strategy in 1998 to strengthen disease surveillance and epidemic response. However, the goal of weekly surveillance reporting among health facilities has not been achieved. We conducted a cross-sectional study to determine the prevalence of adequate reporting and factors associated with IDSR reporting among health facilities in one Kenyan County. Methods Health facilities (public and private) were enrolled using stratified random sampling from 348 facilities prioritized for routine surveillance reporting. Adequately-reporting facilities were defined as those which submitted >10 weekly reports during a twelve-week period and a poor reporting facilities were those which submitted <10 weekly reports. Multivariate logistic regression with backward selection was used to identify risk factors associated with adequate reporting. Results From September 2 through November 30, 2013, we enrolled 175 health facilities; 130(74%) were private and 45(26%) were public. Of the 175 health facilities, 77 (44%) facilities classified as adequate reporting and 98 (56%) were reporting poorly. Multivariate analysis identified three factors to be independently associated with weekly adequate reporting: having weekly reporting forms at visit (AOR19, 95% CI: 6-65], having posters showing IDSR functions (AOR8, 95% CI: 2-12) and having a designated surveillance focal person (AOR7, 95% CI: 2-20). Conclusion The majority of health facilities in Nairobi County were reporting poorly to IDSR and we recommend that the Ministry of Health provide all health facilities in Nairobi County with weekly reporting tools and offer specific trainings on IDSR which will help designate a focal surveillance person. PMID:27303581

  1. Gender differentials and old age survival in the Nairobi slums, Kenya.

    PubMed

    Bennett, Rachel; Chepngeno-Langat, Gloria; Evandrou, Maria; Falkingham, Jane

    2016-08-01

    This paper examines gender differentials in survival amongst older people (50+ years) in the Nairobi slums and to the best of our knowledge is the first study of its kind in an urban African setting. The results provide evidence contrary to the expected paradox of poorer self-rated health yet better survival amongst older women. Older women in the Nairobi slums have poorer self-rated health and poorer circumstances across other factors, including disability and socio-economic status. Further, older women in the slums do not have better survival. The conventional female advantage in mortality only becomes apparent after accounting for the cumulative influence of individual characteristics, social networks, health and socio-economic status, suggesting the female advantage in unadjusted old-age mortality does not apply to contexts where women experience significant disadvantage across multiple life domains. This highlights the urgent need to redress the support, status and opportunities available for women across the life course in contexts such as the Nairobi slums. In addition, a greater number of factors differentiate mortality risk amongst men than amongst women, suggesting inequality amongst slum dwelling older men and highlighting the need for gender sensitive interventions which account for the particular needs of both genders in old age. PMID:27423067

  2. Causes of calf mortality in peri-urban area of Nairobi, Kenya.

    PubMed

    Gitau, George K; Aleri, Joshua W; Mbuthia, Paul G; Mulei, Charles M

    2010-12-01

    The study reported data from 507 post-mortem records in the Department of Pathology, Microbiology and Parasitology, Faculty of Veterinary Medicine, University of Nairobi, Kenya. The records were from carcasses obtained from the peri-urban area of Nairobi during a 20-year period between 1990 and 2009. Approximately 80% (393/507) of the calf carcasses had their diagnosis made through post-mortem examination, while the rest (114/507) were inconclusive. Just less than half (48.3%) of the calf carcasses presented had their age specified by the owners compared to 51.7% whose age was not specified. For calf carcasses whose age was specified by the owners, those indicated as more than 3 months were one-and-a-half times as many as those below 3 months old. The proportion of female carcasses (53.8%, 273/507) presented for post-mortem were slightly higher than the male carcasses (46.2%, 234/507). Diseases or conditions of the respiratory system were the most common 17.7% (97/507) while gastrointestinal tract (GIT) was second and affected 16.1% (88/507) of the cases. Another small number, 3.3% (18/507), died from bloat giving the total cases associated with GIT as 19.4% (106/507). Severe calf malnutrition and septicaemia were the third most reported causes of calf mortality in similar proportions at 14.3% (78/507) and 14.4% (79/507), respectively. Other minor causes of calf mortality were tick-borne diseases 8.6% (47/507), helminthiasis and poisoning, 2.9% (16/507) and 1.8% (10/507), respectively. PMID:20526675

  3. Putting on a brave face: the experiences of women living with HIV and AIDS in informal settlements of Nairobi, Kenya.

    PubMed

    Amuyunzu-Nyamongo, M; Okeng'o, L; Wagura, A; Mwenzwa, E

    2007-01-01

    This paper examines two key dimensions of HIV and AIDS in sub-Saharan Africa, namely poverty and gender, within the particular context of informal settlements. The study, conducted in five informal settlements of Nairobi, Kenya explored the challenges facing women living with HIV and AIDS (WLWA) in informal settlements in Nairobi in terms of the specific risk environments of informal settlements, the support they receive and their perceptions of their future. The data were gathered through an interviewer-based questionnaire administered to 390 WLWA and 20 key informant interviews with Kenya Network of Women with AIDS (KENWA) project personnel. The results show that for WLWA in informal settlements, poverty and poor living conditions combine to increase the risk environment for HIV infection and other opportunistic infections and that the WLWA then face HIV- and AIDS-related problems that are exacerbated by poverty and by the poor living environments. In response, the WLWA had devised coping strategies that were largely centred on survival, including commercial sex work and the sale of illicit liquor, thus increasing their susceptibility to re-infections. Insecurity in informal settlements curtailed their participation in income generating activities (IGAs) and increased their risk of rape and HIV re-infection. Recognising the disadvantaged position of communities in informal settlements, the non-governmental organizations (NGOs), community-based organizations (CBOs) and faith-based organizations (FBOs) provide a range of services including HIV and AIDS information and therapy. Paradoxically, living in urban informal settlements was found to increase WLWA's access to HIV and AIDS prevention and treatment services through NGOs and social networks that are not found in more established residential areas. The sustainability of these services is, however, questioned, given the lack of local resources, weak state support and high donor dependency. We suggest that the

  4. Enteropathogenic Escherichia coli serotype O111:HNT isolated from preterm neonates in Nairobi, Kenya.

    PubMed Central

    Senerwa, D; Olsvik, O; Mutanda, L N; Lindqvist, K J; Gathuma, J M; Fossum, K; Wachsmuth, K

    1989-01-01

    This investigation was initiated as a consequence of several cases of diarrhea in a nursery ward for preterm babies in Nairobi, Kenya. Ten lactose-positive colonies were isolated from the stools of each of 30 neonates, regardless of whether they had diarrhea; 229 strains were identified as Escherichia coli and 65 strains were identified as Klebsiella pneumoniae. Six strains were lost during laboratory handling. No other bacterial, viral, or parasitic enteropathogens were identified. Using synthetic alkaline phosphatase-labeled probes, the bacterial isolates were found to be negative for the presence of genes coding for heat-stable and heat-labile enterotoxins. Seventy-eight E. coli strains isolated from a total of 13 neonates possessed the E. coli enteropathogenic adhesion factor (EAF) gene, as demonstrated by the use of a cloned radiolabeled DNA fragment probe. These strains possessed similar plasmid profiles constituting a core plasmid profile, and while all adhered to HeLa cells, none produced Vero cell cytotoxins. The EAF gene was located on a 65-megadalton plasmid. Serotyping showed the strains to be of serogroup O111 and serotype H nontypable, a well known enteropathogenic type. Five neonates died during the outbreak, and the fatality rate was 30.7% (4 of 13) for neonates infected with EAF-positive E. coli strains compared with 7.7% (1 of 13) for neonates from whom only EAF-negative E. coli strains were isolated. K. pneumoniae only was isolated from five neonates. Images PMID:2568996

  5. Concern about HIV and AIDS among older people in the slums of Nairobi, Kenya.

    PubMed

    Chepngeno-Langat, Gloria; Falkingham, Jane C; Madise, Nyovani J; Evandrou, Maria

    2012-09-01

    The article explores the way that social networks and personal experiences affect perceived HIV-related concerns among people aged 50 years or older living in a low resource neighborhood with high HIV prevalence in Nairobi, Kenya. Multiple logistic regression is used to model the association between the reporting of an HIV-related concern and individual-level characteristics, personal experiences, and social interaction. The main concerns regarding HIV reported by older people in the study included caring for orphaned children (65%), caring for people with AIDS (48%), and losing material and social support from adult children (36%). Interestingly, 38% of respondents voiced concerns about HIV infection among older people. Respondents who had been individually affected by HIV and AIDS, who were part of a wide social network, or who participated in community activities were frequently more likely to report a concern. The findings highlight the significance of the role of social interaction and social networks in the diffusion of information and knowledge. These findings have implications for HIV and AIDS policy and programs, highlighting the potential for social networks and community-level interventions to educate and increase awareness about HIV and AIDS among older people. Community leaders can make good peer educators and communication agents for HIV/AIDS campaigns. Additionally, the recognized high level of personal vulnerability to HIV infection among older people suggests the need for targeted sexual behavior change programs among this often neglected group. PMID:22324649

  6. Real or perceived: the environmental health risks of urban sack gardening in Kibera slums of Nairobi, Kenya.

    PubMed

    Gallaher, Courtney Maloof; Mwaniki, Dennis; Njenga, Mary; Karanja, Nancy K; WinklerPrins, Antoinette M G A

    2013-03-01

    Cities around the world are undergoing rapid urbanization, resulting in the growth of informal settlements or slums. These informal settlements lack basic services, including sanitation, and are associated with joblessness, low-income levels, and insecurity. Families living in such settlements may turn to a variety of strategies to improve their livelihoods and household food security, including urban agriculture. However, given the lack of formal sanitation services in most of these informal settlements, residents are frequently exposed to a number of environmental risks, including biological and chemical contaminants. In the Kibera slums of Nairobi, Kenya, households practice a form of urban agriculture called sack gardening, or vertical gardening, where plants such as kale and Swiss chard are planted into large sacks filled with soil. Given the nature of farming in slum environments, farmers and consumers of this produce in Kibera are potentially exposed to a variety of environmental contaminants due to the lack of formal sanitation systems. Our research demonstrates that perceived and actual environmental risks, in terms of contamination of food crops from sack gardening, are not the same. Farmers perceived exposure to biological contaminants to be the greatest risk to their food crops, but we found that heavy metal contamination was also significant risk. By demonstrating this disconnect between risk perception and actual risk, we wish to inform debates about how to appropriately promote urban agriculture in informal settlements, and more generally about the trade-offs created by farming in urban spaces. PMID:23512752

  7. Do migrant children face greater health hazards in slum settlements? Evidence from Nairobi, Kenya.

    PubMed

    Bocquier, Philippe; Beguy, Donatien; Zulu, Eliya M; Muindi, Kanyiva; Konseiga, Adama; Yé, Yazoumé

    2011-06-01

    Between 60% and 70% of Nairobi City's population live in congested informal settlements, commonly referred to as slums, without proper access to sanitation, clean water, health care and other social services. Children in such areas are exposed to disproportionately high health hazards. This paper examines the impact of mother and child migration on the survival of more than 10,000 children in two of Nairobi's informal settlements--Korogocho and Viwandani--between July 2003 and June 2007, using a two-stage semi-parametric proportional hazards (Cox) model that controls for attrition and various factors that affect child survival. Results show that the slum-born have higher mortality than non-slum-born, an indication that delivery in the slums has long-term health consequences for children. Children born in the slums to women who were pregnant at the time of migration have the highest risk of dying. Given the high degree of circular migration, factors predisposing children born in the slums to recent migrant mothers to higher mortality should be better understood and addressed. PMID:21108011

  8. An Investigation of the Relationship of ICT Training of Principals in ICT Integration in Management Public Secondary Schools: A Case of Nairobi County, Kenya

    ERIC Educational Resources Information Center

    Chepkonga, Susan

    2015-01-01

    The purpose of this study was to find out whether there exists a relationship between ICT training of principals and ICT integration in management of public secondary schools in Kenya. Cross-sectional survey design was used in Nairobi County where quantitative research strategy was applied for the collection of data using questionnaires. The…

  9. Correlates for cardiovascular diseases among diabetic/hypertensive patients attending outreach clinics in two Nairobi slums, Kenya

    PubMed Central

    Mugure, Gladys; Karama, Mohamed; Kyobutungi, Catherine; Karanja, Simon

    2014-01-01

    Introduction Cardiovascular diseases (CVD) are the leading cause of death in the world. Over 80% of CVD related deaths occur in low- and middle-income countries (LMICs). Diabetes and hypertension, whose prevalence in Kenya is on the rise, are major risk factors for CVD. Despite this, studies indicate that awareness on the management of risk factors for CVD among diabetic/hypertensive patients in African populations is generally low. The aim of the study was to determine the risk factors for CVD among diabetic and/or hypertensive patients attending diabetes and hypertension management clinics in Korogocho and Viwandani slums of Nairobi. Methods Data were collected using questionnaires administered to 206 diabetic/hypertensive patients attending the clinics between July 2010 and February 2011. A review of these patients’ medical records was done to determine the history of CVD outcomes such as hypertensive heart diseases, stroke and peripheral arterial diseases. Results Majority (66.5%) of the study participants were females mainly in the 51-65 age category. The study findings revealed that 73 (33.4%) respondents had CVD outcomes. In addition, 41.8% of the respondents were not aware of the causes of diabetes/hypertension. Age category 51-65 years had the highest (43.8%) number of respondents with CVD. Sex of the respondents and awareness of the link between hypertension and CVD were significantly associated with CVD outcomes (p<0.05) among the respondents. Conclusion Measures to improve awareness levels among patients at high risk of CVD outcomes are needed to complement other measures to reduce CVD risk among such patients. PMID:25852804

  10. Emergency contraception in Nairobi, Kenya: knowledge, attitudes and practices among policymakers, family planning providers and clients, and university students.

    PubMed

    Muia, E; Ellertson, C; Lukhando, M; Flul, B; Clark, S; Olenja, J

    1999-10-01

    To gauge knowledge, attitudes, and practices about emergency contraception in Nairobi, Kenya, we conducted a five-part study. We searched government and professional association policy documents, and clinic guidelines and service records for references to emergency contraception. We conducted in-depth interviews with five key policymakers, and with 93 family planning providers randomly selected to represent both the public and private sectors. We also surveyed 282 family planning clients attending 10 clinics, again representing both sectors. Finally, we conducted four focus groups with university students. Although one specially packaged emergency contraceptive (Postinor levonorgestrel tablets) is registered in Kenya, the method is scarcely known or used. No extant policy or service guidelines address the method specifically, although revisions to several documents were planned. Yet policymakers felt that expanding access to emergency contraception would require few overt policy changes, as much of the guidance for oral contraception is already broad enough to cover this alternative use of those same commodities. Participants in all parts of the study generally supported expanded access to emergency contraception in Kenya. They did, however, want additional, detailed information, particularly about health effects. They also differed over exactly who should have access to emergency contraception and how it should be provided. PMID:10640169

  11. Water and sanitation service delivery, pricing, and the poor: An empirical estimate of subsidy incidence in Nairobi, Kenya

    NASA Astrophysics Data System (ADS)

    Fuente, David; Gakii Gatua, Josephine; Ikiara, Moses; Kabubo-Mariara, Jane; Mwaura, Mbutu; Whittington, Dale

    2016-06-01

    The increasing block tariff (IBT) is among the most widely used tariffs by water utilities, particularly in developing countries. This is due in part to the perception that the IBT can effectively target subsidies to low-income households. Combining data on households' socioeconomic status and metered water use, this paper examines the distributional incidence of subsidies delivered through the IBT in Nairobi, Kenya. Contrary to conventional wisdom, we find that high-income residential and nonresidential customers receive a disproportionate share of subsidies and that subsidy targeting is poor even among households with a private metered connection. We also find that stated expenditure on water, a commonly used means of estimating water use, is a poor proxy for metered use and that previous studies on subsidy incidence underestimate the magnitude of the subsidy delivered through water tariffs. These findings have implications for both the design and evaluation of water tariffs in developing countries.

  12. Curriculum Development and Education for Living Together: Conceptual and Managerial Challenges in Africa. Final Report of the Seminar (Nairobi, Kenya, June 25-29, 2001) (Developpement du Curriculum et Education pour Vivre Ensemble: Problemes de Concepts et de Gestion en Afrique. Rapport Final du Seminaire (Nairobi, Kenya, 25-29 Juin 2001).

    ERIC Educational Resources Information Center

    Aglo, John, Ed.; Lethoko, Mankolo, Ed.

    The Nairobi, Kenya, seminar sought to analyze existing official school curricula from the vantage point of their potential contribution to learning and to address the issue of curriculum management with a view to improving the capacity of basic schooling to contribute to enhanced social cohesion. This final report is divided into four parts. Part…

  13. Occurrence of midline diastema and frenum attachments amongst school children in Nairobi, Kenya.

    PubMed

    Kaimenyi, J T

    1998-01-01

    The aim of this study was to determine the prevalence of midline diastema, tongue tie and frenum attachments amongst school children in Nairobi. A total of 1802 children aged between 4 and 16 years were selected randomly using multistage sampling technique. To avoid oversampling in either sex, a proportionate sampling procedure was used. Thereafter, a thorough intra-oral examination was carried out using a mouth mirror under artificial or natural light with the children lying on a supine position. Presence or absence of midline interdental spaces unusually bigger than other interdental spaces were noted and recorded on a prepared dateacollection form. Accurate location of the origin of the frenum was done using Placek et al Morphological-functional classification of the labial frenum attachments. Data was analyzed manually by tally method. Results showed that 35% had upper and lower midline diastema. 55% were females and 45% were males. Their mean age was 7.6 years. 0.2% had a high lingual frenum. The commonest location of frenum attachment amongst children with lower midline diastema was the mucogingival junction (86%) whereas amongst those with upper midline diastema it was attached gingiva (50%). None of the children had frenum attachment on the interdental papilla. It was concluded that the maxilla had a higher prevalence of midline diastema than the mandible and that papillary penetrating frenum attachments amongst these patients were higher in the maxilla than the mandible. PMID:10530193

  14. Partners and clients of female sex workers in an informal urban settlement in Nairobi, Kenya.

    PubMed

    Ngugi, Elizabeth; Benoit, Cecilia; Hallgrimsdottir, Helga; Jansson, Mikael; Roth, Eric Abella

    2012-01-01

    This paper compares and contrasts number of partners and condom use behaviour for female sex workers and a sample of women working in other economic activities, with both samples drawn from the large informal settlement of Kibera, Nairobi. As expected, univariate analysis revealed much higher numbers of overall sexual partners and higher levels of condom use among female sex workers compared to Kibera women in other occupations. An unexpected finding, however, was that female sex workers with a romantic partner had significantly fewer sexual partners per unit time than female sex workers without such a partner. This finding held for multivariate analysis, with negative binomial regression analyses showing that having a romantic partner was significantly associated with reductions in total number of both sexual partners overall and with sexual partners who did not use condoms. In contrast, HIV status, education, number of immediate family members and levels of alcohol consumption were non-significant factors for both regression analyses. Results suggest that female sex workers' romantic partners act as more than sources of possible HIV infection; rather, romantic partners appear to have an important positive impact on health. We discuss this finding in light of possible harm-reduction programmes focusing on female sex workers and their romantic partners. PMID:21936649

  15. A Survey on Conflict Resolution Mechanisms in Public Secondary Schools: A Case of Nairobi Province, Kenya

    ERIC Educational Resources Information Center

    Ramani, Ken; Zhimin, Liu

    2010-01-01

    The broad objective of the study was to determine various mechanisms applied in resolving conflicts within public secondary schools in Nairobi province. This study used descriptive and exploratory research design. A sample comprising of principals, representatives of Boards of Governors (BoG's), class teachers, students and education officers was…

  16. Psychosocial and Health Aspects of Drug Use by Students in Public Secondary Schools in Nairobi, Kenya

    ERIC Educational Resources Information Center

    Ndetei, David M.; Khasakhala, Lincoln I.; Mutiso, Victoria; Ongecha-Owuor, Francisca A.; Kokonya, Donald A.

    2009-01-01

    The objective of this study was to evaluate the influence of family, psychosocial, health, demographic, and behavioral characteristics on regular drug use. All the students of 17 randomly stratified public secondary schools in Nairobi were required to complete self-administered sociodemographic and the Drug Use Screening Inventory-Revised (DUSI-R)…

  17. Street Children and The Work Ethic: New Policy for an Old Moral, Nairobi (Kenya)

    ERIC Educational Resources Information Center

    Droz, Yvan

    2006-01-01

    Kenyan policy-makers use the language of children's rights to legitimize, within the new global political order, an old colonial concern about controlling the urban marginal population. The local business community's worries about the safety of Nairobi's streets stand paramount, while the growing financial and political leverage of NGOs…

  18. Opportunities and Challenges: Integration of ICT in Teaching and Learning Mathematics in Secondary Schools, Nairobi, Kenya

    ERIC Educational Resources Information Center

    Amuko, Sheila; Miheso, Marguerite; Ndeuthi, Sophie

    2015-01-01

    This presentation is based on a larger study whose purpose was to explore the various opportunities and challenges influencing integration of ICT in teaching and learning Mathematics in secondary schools in Nairobi County. The study, adopted a descriptive survey design. Three instruments questionnaires', a structured interview schedule and an…

  19. Unintended pregnancy and subsequent use of modern contraceptive among slum and non-slum women in Nairobi, Kenya

    PubMed Central

    2014-01-01

    Background In spite of major gains in contraceptive prevalence over the last few decades, many women in most parts of the developing world who would like to delay or avoid pregnancy do not use any method of contraception. This paper seeks to: a) examine whether experiencing an unintended pregnancy is associated with future use of contraception controlling for a number factors including poverty at the household and community levels; and b) investigate the mechanisms through which experiencing an unintended pregnancy leads to uptake of contraception. Methods Quantitative and qualitative data from a cross-sectional research project conducted in 2009/10 in two slum settlements and two non-slum settings of Nairobi, Kenya are used. The quantitative component of the project was based on a random sample of 1,259 women aged 15–49 years. Logistic regression models were used to assess the effect of unintended pregnancy on future contraceptive use. The qualitative component of the project successfully interviewed a total of 80 women randomly selected from survey participants who had reported having at least one unintended pregnancy. Results Women whose last pregnancy was unintended were more likely to be using a modern method of contraception, compared to their peers whose last pregnancy was intended, especially among the wealthier group as shown in the interaction model. Among poor women, unintended pregnancy was not associated with subsequent use of contraception. The qualitative investigation with women who had an unplanned pregnancy reveals that experiencing an unintended pregnancy seems to have served as a “wake-up call”, resulting in greater attention to personal risks, including increased interest in pregnancy prevention. For some women, unintended pregnancy was a consequence of strong opposition by their partners to family planning, while others reported they started using contraceptives following their unintended pregnancy, but discontinued after experiencing

  20. Association between family composition and the well-being of vulnerable children in Nairobi, Kenya.

    PubMed

    Radcliff, Elizabeth; Racine, Elizabeth F; Brunner Huber, Larissa R; Whitaker, Beth Elise

    2012-08-01

    The objective of this study is to examine the relationship between a vulnerable child's family composition (family size and primary caregiver) and three child well-being indicators (immunization status, access to food, educational security). Using 2006-2009 intake data from a Kenyan non-governmental aid agency, this cross-sectional study evaluated a population of 1,424 children in two urban slum settlements in Nairobi. Logistic regression was used to obtain adjusted odds ratios and 95% confidence intervals to examine the relationship between family composition measures and child well-being. Multivariate results were also stratified by orphan status. Vulnerable children who live in household sizes of 4-6 members and vulnerable children who live with non-relatives had greater odds of inadequate immunization (OR = 1.51, 95% CI: 1.13-2.01, OR = 9.02, 95% CI: 4.62-17.62). Paradoxically, vulnerable children living with non-relative caregivers were at lower risk for inadequate food (OR = 0.19, 95% CI 0.07-0.33). Single orphans with an HIV positive parent were less likely to be fully immunized than single orphans with an HIV negative parent. The results provide information on specific groups which could benefit from increased attention related to childhood immunization education and intervention programs. The findings also underscore the need for policies which support families as a means of supporting vulnerable children. Finally, findings reinforce the wisdom of programs which target vulnerable children based on needs, rather than orphan status. These findings can be useful for informing future program and policy development designed to meet needs of vulnerable children. PMID:21750894

  1. Health care utilization for acute illnesses in an urban setting with a refugee population in Nairobi, Kenya: a cross-sectional survey

    PubMed Central

    2014-01-01

    Background Estimates place the number of refugees in Nairobi over 100,000. The constant movement of refugees between countries of origin, refugee camps, and Nairobi poses risk of introduction and transmission of communicable diseases into Kenya. We assessed the care-seeking behavior of residents of Eastleigh, a neighborhood in Nairobi with urban refugees. Methods During July and August 2010, we conducted a Health Utilization Survey in Section II of Eastleigh. We used a multistage random cluster sampling design to identify households for interview. A standard questionnaire on the household demographics, water and sanitation was administered to household caretakers. Separate questionnaires were administered to household members who had one or more of the illnesses of interest. Results Of 785 households targeted for interview, data were obtained from 673 (85.7%) households with 3,005 residents. Of the surveyed respondents, 290 (9.7%) individuals reported acute respiratory illness (ARI) in the previous 12 months, 222 (7.4%) reported fever in the preceding 2 weeks, and 54 (1.8%) reported having diarrhea in the 30 days prior to the survey. Children <5 years old had the highest frequency of all the illnesses surveyed: 17.1% (95% CI 12.2-21.9) reported ARI, 10.0% (95% CI 6.2-13.8) reported fever, and 6.9% (3.8-10.0) reported diarrhea during the time periods specified for each syndrome. Twenty-nine [7.5% (95% CI 4.3-10.7)] hospitalizations were reported among all age groups of those who sought care. Among participants who reported ≥1 illness, 330 (77.0%) sought some form of health care; most (174 [59.8%]) sought health care services from private health care providers. Fifty-five (18.9%) participants seeking healthcare services visited a pharmacy. Few residents of Eastleigh (38 [13.1%]) sought care at government-run facilities, and 24 (8.2%) sought care from a relative, a religious leader, or a health volunteer. Of those who did not seek any health care services (99 [23

  2. Increased risk of HIV in women experiencing physical partner violence in Nairobi, Kenya.

    PubMed

    Fonck, Karoline; Leye, Els; Els, Leye; Kidula, Nancy; Ndinya-Achola, Jeconiah; Temmerman, Marleen

    2005-09-01

    As part of a study on etiology of sexually transmitted infections (STI) among 520 women presenting at the STI clinic in Nairobi, data on partner violence and its correlates were analyzed. Prevalence of lifetime physical violence was 26%, mainly by an intimate partner (74%). HIV seropositive women had an almost twofold increase in lifetime partner violence. Women with more risky sexual behavior such as early sexual debut, number of sex partners, history of condom use and of STI, experienced more partner violence. Parity and miscarriage were associated with a history of lifetime violence. We found an inverse association between schooling and level of violence. Six percent of the women had been raped. Gender-based violence screening and services should be integrated into voluntary counseling and testing programs as well as in reproductive health programs. Multi-sector approaches are needed to change prevailing attitudes towards violence against women. PMID:16133903

  3. The Nairobi Birth Survey 1. the study design, the population and outline results.

    PubMed

    Mati, J K; Aggarwal, V P; Lucas, S; Sanghvi, H C; Corkhill, R

    1982-12-01

    The Nairobi Birth Survey was planned with the following objectives: 1) establish the social, obstetric and epidemiological characteristics of the obstetric population of Nairobi, Kenya; 2) examine the pattern and distribution of antenatal and delivery care; and 3) assess the true incidence of stillbirths and 1st 24-hour neonatal deaths, congenital abnormalities and major obstetric complications. The Survey consisted of 1) a study of all stillbirths and 24-hour neonatal deaths over a period of 7 months (March-September 1981), and 2) recording of all births taking place in Nairobi over a 7 week period (June 15-August 4, 1981). During the 7 week period there were 5,293 single births, including 187 perinatal deaths, with a stillbirth rate of 23/1,000 births and a 24-hour neonatal death rate of 12/1,000. The obstetric population was found to be predominantly young, with 57.8% of all mothers being under 25 years of age. Nearly 20% were teenagers. 23% of the mothers were having their 5th or more children at the time of the Survey. In 79.3% of the mothers the antenatal period was uncomplicated. Hypertensive disease in pregnancy was found to be the leading cause of complications, existing in 10.4% of the pregnancies. The majority of the mothers delivered in public institutions. Together with the student midwives, midwives conducted 79.7% of the births. The 3 maternal deaths in this survey give a maternal mortality rate of .56/1,000 deliveries. 701 perinatal deaths occured in the 7 month study, which corresponds to 71.2%. These deaths were mostly associated with complications of labor, including prolonged and difficult labor. In 40.9% of the cases the deaths could have been avoided with appropriate action. In 436 babies that were autopsied, 33 had congenital abnormalities. PMID:12313673

  4. Increasing HIV-1 pretreatment drug resistance among antiretroviral-naïve adults initiating treatment between 2006 and 2014 in Nairobi, Kenya.

    PubMed

    Chung, Michael H; Silverman, Rachel; Beck, Ingrid A; Yatich, Nelly; Dross, Sandra; McKernan-Mullin, Jennifer; Bii, Stephen; Tapia, Kenneth; Stern, Joshua; Chohan, Bhavna; Sakr, Samah R; Kiarie, James N; Frenkel, Lisa M

    2016-06-19

    Antiretroviral-naïve adults initiating antiretroviral therapy in Nairobi, Kenya were tested for HIV-1 drug resistance at codons K103N, Y181C, G190A, M184V, and K65R using an oligonucleotide ligation assay. Prevalence of pretreatment drug resistance increased from 3.89% in 2006 to 10.93% in 2014 (P < 0.001), and 95% of those with resistance had at least one nonnucleoside reverse transcriptase inhibitor mutation. Resistance to tenofovir (K65R) was found in 2014 but not in 2006. PMID:27058353

  5. Occupational exposure to roadway emissions and inside informal settlements in sub-Saharan Africa: A pilot study in Nairobi, Kenya

    NASA Astrophysics Data System (ADS)

    Ngo, Nicole S.; Gatari, Michael; Yan, Beizhan; Chillrud, Steven N.; Bouhamam, Kheira; Kinney, Patrick L.

    2015-06-01

    Few studies examine urban air pollution in sub-Saharan Africa (SSA), yet urbanization rates there are among the highest in the world. In this study, we measured 8-hr average occupational exposure levels of fine particulate matter (PM2.5), black carbon (BC), ultra violet active-particulate matter (UV-PM), and trace elements for individuals who worked along roadways in Nairobi, specifically bus drivers, garage workers, street vendors, and women who worked inside informal settlements. We found BC and re-suspended dust were important contributors to PM2.5 levels for all study populations, particularly among bus drivers, while PM2.5 exposure levels for garage workers, street vendors, and informal settlement residents were not statistically different from each other. We also found a strong signal for biomass emissions and trash burning, which is common in Nairobi's low-income areas and open-air garages. These results suggest that the large portion of urban residents in SSA who walk along roadways would benefit from air quality regulations targeting roadway emissions from diesel vehicles, dust, and trash burning. This is the first study to measure occupational exposure to urban air pollution in SSA and results imply that roadway emissions are a serious public health concern.

  6. Kantis: A new Australopithecus site on the shoulders of the Rift Valley near Nairobi, Kenya.

    PubMed

    Mbua, Emma; Kusaka, Soichiro; Kunimatsu, Yutaka; Geraads, Denis; Sawada, Yoshihiro; Brown, Francis H; Sakai, Tetsuya; Boisserie, Jean-Renaud; Saneyoshi, Mototaka; Omuombo, Christine; Muteti, Samuel; Hirata, Takafumi; Hayashida, Akira; Iwano, Hideki; Danhara, Tohru; Bobe, René; Jicha, Brian; Nakatsukasa, Masato

    2016-05-01

    Most Plio-Pleistocene sites in the Gregory Rift Valley that have yielded abundant fossil hominins lie on the Rift Valley floor. Here we report a new Pliocene site, Kantis, on the shoulder of the Gregory Rift Valley, which extends the geographical range of Australopithecus afarensis to the highlands of Kenya. This species, known from sites in Ethiopia, Tanzania, and possibly Kenya, is believed to be adapted to a wide spectrum of habitats, from open grassland to woodland. The Kantis fauna is generally similar to that reported from other contemporaneous A. afarensis sites on the Rift Valley floor. However, its faunal composition and stable carbon isotopic data from dental enamel suggest a stronger C4 environment than that present at those sites. Although the Gregory Rift Valley has been the focus of paleontologists' attention for many years, surveys of the Rift shoulder may provide new perspective on African Pliocene mammal and hominin evolution. PMID:27178456

  7. Lead contamination in street soils of Nairobi City and Mombasa Island, Kenya

    SciTech Connect

    Onyari, J.M.; Wandiga, S.O.; Njenga, G.K.; Nyatebe, J.O. )

    1991-05-01

    The advent of modern industrialization and, in particular, the motor vehicle has witnessed dramatic increases in lead usage both as a component of lead-acid storage battery and from 1923 as organic lead alkyl anti-knock additive in petroleum. Several workers have established a correlation between increasing lead concentration in roadside soils and vehicular traffic density. Although researchers studied the heavy metal content in Lake Victoria sediments, no urban roadside soils were investigated. Since lead is used as a petrol additive in Kenya, it is necessary to document the extent and magnitude of lead contamination of roadside soils in inland and coastal urban environments and evaluate its environmental implications.

  8. Nutrition Planning and Policy for African Countries. Summary Report of a Seminar Held at the Institute for Development Studies (Nairobi, Kenya, June 2-19, 1976). Cornell International Nutrition Monograph Series, Number 5 (1977).

    ERIC Educational Resources Information Center

    Latham, Michael C., Ed.; Westley, Sidney B., Ed.

    This paper is the summary report of a seminar which was held in Kenya at the Institute for Development Studies of the University of Nairobi from June 2-19, 1976. The seminar was sponsored by USAID through a contract to Cornell University in Ithaca, New York. Ten English-speaking African countries, whose responsibilities are related to nutrition…

  9. Tetracycline residue levels in cattle meat from Nairobi salughter house in Kenya.

    PubMed

    Muriuki, F K; Ogara, W O; Njeruh, F M; Mitema, E S

    2001-08-01

    Two hundred and fifty beef samples were collected from five slaughterhouses in and around the city of Nairobi. The beef animals were sourced from various parts of the country. Samples of 50-100 grams were collected randomly from the liver, kidney and muscle of different beef carcasses. The samples collected were processed using multiresidue analytical methods that included liquid-gas partitioning and set-pat C18 cartridges chromatographic clean up. Chlortetracycline and oxytetracycline detection was done using Knauer Model 128 HPLC with an electron capture detector. Out of the 250 samples that were analyses for tetracycline residues 114 (45.6%) had detectable tetracycline residues. Of the 114 samples with detectable tetracycline residues, 60 (24%) were liver samples, 35 (14%), were kidney samples and 19 (7.6%) were muscle samples. The mean (p>0.05) residue levels of tetracycline for the five slaughterhouses studied were as follows: Athi River 1,046 micro g/kg, Dandora 594 micro g/kg, Ngong 701 micro g/kg, Kiserian 524 micro g/kg and Dagoretti 640 micro g/kg. Of the 250 samples analysed 110 (44%) had oxytetracyclines while 4 (1.6%) had chlortetracyclines. The mean residue levels of the detected tetracyclines were higher than the recommended maximum levels in edible tissues. This study indicates the presence of tetracycline residues in the various edible tissues. Regulatory authorities should ensure proper withdrawal periods before slaughter. This study indicates the presence of tetracycline residues in the various edible tissues. Regulatory authorities should ensure proper withdrawal period before slaughter of the animals. PMID:14614278

  10. Kenya.

    PubMed

    1988-01-01

    Attention in this discussion of Kenya is directed to the following: geography; people; history; government; political conditions; the economy; defense; and relations between Kenya and the US. In 1987, the population was estimated at 21.6 million with an estimated annual growth rate of 4.1%. Traditional herders, Arab Muslims, and cosmopolitan residents of Nairobi all contribute to the culture of Kenya. The standard of living in major cities is among the highest in sub-Saharan Africa. Fossils located in east Africa suggest that protohumans roamed the area more than 20 million years ago. Recent anthropological finds near Kenya's Lake Turkana indicate that the "Homo" genus of humans lived in the area 2.6 million years ago. Kenya's colonial history dates from the Berlin conference of 1885. In 1895, the British government established the East African Protectorate and, soon after, opened the fertile highlands to white settlers. The settlers were allowed a voice in government before it officially was made a British colony in 1920, but Africans were not permitted any direct political participation until 1944. Kenya became independent on December 12, 1963, and in 1964 assumed the status of a republic within the Commonwealth. The president is elected by the National Assembly to serve a 5-year term, but if the president dissolves the assembly, a new presidential election must be held. Since independence, Kenya has maintained remarkable stability during many changes within the democratic system. Kenya's major political challenge is to reinvigorate its economy, which has suffered from a combination of problems such as government deficit spending, a chronic shortage of foreign exchange, and the rising cost of oil imports. Economic growth has declined since 1973, and real gross domestic product (GDP) has grown only by about 2.75% for the 1980-86 period. One of Kenya's basic problems is its population growth rate. With less than 20% of the land classified as potentially arable and

  11. Fatal injuries in the slums of Nairobi and their risk factors: results from a matched case-control study.

    PubMed

    Ziraba, Abdhalah Kasiira; Kyobutungi, Catherine; Zulu, Eliya Msiyaphazi

    2011-06-01

    Injuries contribute significantly to the rising morbidity and mortality attributable to non-communicable diseases in the developing world. Unfortunately, active injury surveillance is lacking in many developing countries, including Kenya. This study aims to describe and identify causes of and risk factors for fatal injuries in two slums in Nairobi city using a demographic surveillance system framework. The causes of death are determined using verbal autopsies. We used a nested case-control study design with all deaths from injuries between 2003 and 2005 as cases. Two controls were randomly selected from the non-injury deaths over the same period and individually matched to each case on age and sex. We used conditional logistic regression modeling to identity individual- and community-level factors associated with fatal injuries. Intentional injuries accounted for about 51% and unintentional injuries accounted for 49% of all injuries. Homicides accounted for 91% of intentional injuries and 47% of all injury-related deaths. Firearms (23%) and road traffic crashes (22%) were the leading single causes of deaths due to injuries. About 15% of injuries were due to substance intoxication, particularly alcohol, which in this community comes from illicit brews and is at times contaminated with methanol. Results suggest that in the pervasively unsafe and insecure environment that characterizes the urban slums, ethnicity, residence, and area level factors contribute significantly to the risk of injury-related mortality. PMID:21630106

  12. HIV and STI Prevalence and Risk Factors Among Male Sex Workers and Other Men Who Have Sex With Men in Nairobi, Kenya

    PubMed Central

    Muraguri, Nicholas; Tun, Waimar; Okal, Jerry; Broz, Dita; Raymond, H. Fisher; Kellogg, Timothy; Dadabhai, Sufia; Musyoki, Helgar; Sheehy, Meredith; Kuria, David; Kaiser, Reinhard; Geibel, Scott

    2016-01-01

    Previous surveys of men who have sex with men (MSM) in Africa have not adequately profiled HIV status and risk factors by sex work status. MSM in Nairobi, Kenya, were recruited using respondent-driven sampling, completed a behavioral interview, and were tested for HIV and sexually transmitted infections. Overlapping recruitment among 273 male sex workers and 290 other MSM was common. Sex workers were more likely to report receptive anal sex with multiple partners (65.7% versus 18.0%, P < 0.001) and unprotected receptive anal intercourse (40.0% versus 22.8%, P = 0.005). Male sex workers were also more likely to be HIV infected (26.3% versus 12.2%, P = 0.007). PMID:25501346

  13. HIV and STI prevalence and risk factors among male sex workers and other men who have sex with men in Nairobi, Kenya.

    PubMed

    Muraguri, Nicholas; Tun, Waimar; Okal, Jerry; Broz, Dita; Raymond, H Fisher; Kellogg, Timothy; Dadabhai, Sufia; Musyoki, Helgar; Sheehy, Meredith; Kuria, David; Kaiser, Reinhard; Geibel, Scott

    2015-01-01

    : Previous surveys of men who have sex with men (MSM) in Africa have not adequately profiled HIV status and risk factors by sex work status. MSM in Nairobi, Kenya, were recruited using respondent-driven sampling, completed a behavioral interview, and were tested for HIV and sexually transmitted infections. Overlapping recruitment among 273 male sex workers and 290 other MSM was common. Sex workers were more likely to report receptive anal sex with multiple partners (65.7% versus 18.0%, P < 0.001) and unprotected receptive anal intercourse (40.0% versus 22.8%, P = 0.005). Male sex workers were also more likely to be HIV infected (26.3% versus 12.2%, P = 0.007). PMID:25501346

  14. Occupational exposure to roadway emissions and inside informal settlements in sub-Saharan Africa: A pilot study in Nairobi, Kenya

    PubMed Central

    Ngo, Nicole S.; Gatari, Michael; Yan, Beizhan; Chillrud, Steven N.; Bouhamam, Kheira; Kinneym, Patrick L.

    2015-01-01

    Few studies examine urban air pollution in sub-Saharan Africa (SSA), yet urbanization rates there are among the highest in the world. In this study, we measured 8-hr average occupational exposure levels of fine particulate matter (PM2.5), black carbon (BC), ultra violet active-particulate matter (UV-PM), and trace elements for individuals who worked along roadways in Nairobi, specifically bus drivers, garage workers, street vendors, and women who worked inside informal settlements. We found BC and re-suspended dust were important contributors to PM2.5 levels for all study populations, particularly among bus drivers, while PM2.5 exposure levels for garage workers, street vendors, and informal settlement residents were not statistically different from each other. We also found a strong signal for biomass emissions and trash burning, which is common in Nairobi’s low-income areas and open-air garages. These results suggest that the large portion of urban residents in SSA who walk along roadways would benefit from air quality regulations targeting roadway emissions from diesel vehicles, dust, and trash burning. This is the first study to measure occupational exposure to urban air pollution in SSA and results imply that roadway emissions are a serious public health concern. PMID:26034383

  15. Prevalence of hepatitis B and C viral co-infections among HIV-1 infected individuals in Nairobi, Kenya

    PubMed Central

    2013-01-01

    Background Hepatitis B virus (HBV) and Hepatitis C virus (HCV) co-infections among HIV-1 infected individuals are growing worldwide health problems characterized by lack of effective vaccines, need for expensive treatment, chronicity of morbidity and associated mortality. Their prevalence and distribution patterns continue to vary across geographical locations with high prevalence being detected among high risk populations. To determine the prevalence of HBV and HCV among HIV-1 infected individuals, blood samples were collected from consenting study subjects visiting comprehensive HIV clinics in Nairobi during the period between October and December 2009. Methods Blood samples from volunteers were screened with ELISA tests for detecting HIV, HBV surface antigen (HBsAg) and anti-HCV antibodies. Results In a total of three (300) hundred infected individuals consisting of 129 (43%) males and 171 (57%) females 15.3% (46/300) were HIV-1 co-infected with either HBV or HCV or both, 10.3% (31/300) with HIV-1 and HCV and 6% (18/300) with HIV-1 and HBV infections. However, only three individuals (1%) were coinfected with the three viruses (HIV/HBV/HCV). Conclusion Though, low levels of co-infection with all three viruses were reported, there could be higher prevalence rates than reported here especially among high risk populations. PMID:24016453

  16. Youth at the Nexus: Ideology in HIV Prevention in Nairobi, Kenya

    ERIC Educational Resources Information Center

    Ahmed, Zohra

    2011-01-01

    In the fight against HIV/AIDS, the Behavior Change Communication (BCC) model stands as international best practice in preventive education. Ideally, a BCC intervention aims to changes behaviors and attitudes by facilitating group negotiation and introspection, with a resultant improvement in health. However, introducing this best practice model to…

  17. Intestinal parasitic infections in children presenting with diarrhoea in outpatient and inpatient settings in an informal settlement of Nairobi, Kenya

    PubMed Central

    2013-01-01

    Background The distribution of and factors associated with intestinal parasitic infections are poorly defined in high risk vulnerable populations such as urban slums in tropical sub-Saharan Africa. Methods In a cross sectional study, children aged 5 years and below who presented with diarrhoea were recruited from selected outpatient clinics in Mukuru informal settlement, and from Mbagathi District hospital, Nairobi, over a period of two years (2010–2011). Stool samples were examined for the presence of parasites using direct, formal-ether concentration method and the Modified Ziehl Neelsen staining technique. Results Overall, 541/2112 (25.6%) were positive for at least one intestinal parasite, with the common parasites being; Entamoeba histolytica, 225 (36.7%),Cryptosporidium spp. 187, (30.5%), Giardia lamblia, 98 (16%).The prevalence of intestinal parasites infection was higher among children from outpatient clinics 432/1577(27.4%) than among those admitted in hospital 109/535 (20.1%) p < 0.001. Infections with E. histolytica, and G. lamblia were higher among outpatients than inpatients (13.8% vs 1.3% p < 0.001 and 5.8% vs 1.3% p < 0.049) respectively, while infection with Cryptosporidium spp. was higher among inpatients than outpatients (15.3% vs 6.7%) respectively p < 0.001. Other parasites isolated among outpatients included Isospora belli, 19 (1.2%), Ascaris lumbricoides, 26 (1.6%), and Hymenolepis nana 12 (0.8%), with the remainder detected in less than ten samples each. HIV-infected participants were more likely to be infected with any parasite than uninfected participants, Adjusted Odds Ratio (AOR), 2.04, 95% CI, 1.55-2.67, p < 0.001), and with Cryptosporidium spp. (AOR, 2.96, 95% CI 2.07-4.21, p < 0.001).The inpatients were less likely to be infected with E. histolytica than outpatients (AOR, 0.11, 95% CI, 0.51- 0.24, p < 0.001), but more likely for inpatients to be infected with Cryptosporidium spp. than outpatients (AOR, 1

  18. Potential effectiveness of Community Health Strategy to promote exclusive breastfeeding in urban poor settings in Nairobi, Kenya: a quasi-experimental study.

    PubMed

    Kimani-Murage, E W; Norris, S A; Mutua, M K; Wekesah, F; Wanjohi, M; Muhia, N; Muriuki, P; Egondi, T; Kyobutungi, C; Ezeh, A C; Musoke, R N; McGarvey, S T; Madise, N J; Griffiths, P L

    2016-04-01

    Early nutrition is critical for later health and sustainable development. We determined potential effectiveness of the Kenyan Community Health Strategy in promoting exclusive breastfeeding (EBF) in urban poor settings in Nairobi, Kenya. We used a quasi-experimental study design, based on three studies [Pre-intervention (2007-2011; n=5824), Intervention (2012-2015; n=1110) and Comparison (2012-2014; n=487)], which followed mother-child pairs longitudinally to establish EBF rates from 0 to 6 months. The Maternal, Infant and Young Child Nutrition (MIYCN) study was a cluster randomized trial; the control arm (MIYCN-Control) received standard care involving community health workers (CHWs) visits for counselling on antenatal and postnatal care. The intervention arm (MIYCN-Intervention) received standard care and regular MIYCN counselling by trained CHWs. Both groups received MIYCN information materials. We tested differences in EBF rates from 0 to 6 months among four study groups (Pre-intervention, MIYCN-Intervention, MIYCN-Control and Comparison) using a χ(2) test and logistic regression. At 6 months, the prevalence of EBF was 2% in the Pre-intervention group compared with 55% in the MIYCN-Intervention group, 55% in the MIYCN-Control group and 3% in the Comparison group (P<0.05). After adjusting for baseline characteristics, the odds ratio for EBF from birth to 6 months was 66.9 (95% CI 45.4-96.4), 84.3 (95% CI 40.7-174.6) and 3.9 (95% CI 1.8-8.4) for the MIYCN-Intervention, MIYCN-Control and Comparison group, respectively, compared with the Pre-intervention group. There is potential effectiveness of the Kenya national Community Health Strategy in promoting EBF in urban poor settings where health care access is limited. PMID:26708714

  19. Educational Challenges and Diminishing Family Safety Net Faced by High-School Girls in a Slum Residence, Nairobi, Kenya

    ERIC Educational Resources Information Center

    Abuya, Benta A.; Onsomu, Elijah O.; Moore, Dakysha

    2012-01-01

    In 2010, there was a slight decrease in the number of out-of school adolescents from 75 million in 2009 (UNESCO, 2009) to 71 million in 2010, of which 55% are girls (UNESCO, 2010). In Kenya, only 17% of girls have secondary education (CBS, 2004). This paper analyzes the role of families in girls' secondary education in two schools within Nairobi…

  20. Evaluation of Teaching Veterinary Medicine at the University of Nairobi.

    ERIC Educational Resources Information Center

    Lindstrom, U. B.

    1976-01-01

    A survey of graduates from the University of Nairobi, Kenya in the field of veterinary medicine is reported. Areas covered include curriculum; teaching techniques; quality of faculty; and examinations. (JMF)

  1. Occurrence patterns of pharmaceutical residues in wastewater, surface water and groundwater of Nairobi and Kisumu city, Kenya.

    PubMed

    K'oreje, K O; Vergeynst, L; Ombaka, D; De Wispelaere, P; Okoth, M; Van Langenhove, H; Demeestere, K

    2016-04-01

    Emerging organic contaminants have not received a lot of attention in developing countries, particularly Africa, although problems regarding water quantity and quality are often even more severe than in more developed regions. This study presents general water quality parameters as well as unique data on concentrations and loads of 24 pharmaceuticals including antibiotic, anti(retro)viral, analgesic, anti-inflammatory and psychiatric drugs in three wastewater treatment plants, three rivers and three groundwater wells in Nairobi and Kisumu. This allowed studying removal efficiencies in wastewater treatment, identifying important sources of pharmaceutical pollution and distinguishing dilution effects from natural attenuation in rivers. In general, antiretrovirals and antibiotics, being important in the treatment of common African diseases such as HIV and malaria, were in all matrices more prevalent as compared to the Western world. Wastewater stabilization ponds removed pharmaceuticals with an efficiency between 11 and 99%. Despite this large range, a different removal is observed for a number of compounds, as compared to more conventional activated sludge systems. Total concentrations in river water (up to 320 μg L(-1)) were similar or exceeded concentrations in untreated wastewater, with domestic discharges from slums, wastewater treatment plant effluent and waste dumpsites identified as important sources. In shallow wells situated next to pit latrines and used for drinking water, the recalcitrant antiretroviral nevirapine was measured at concentrations as high as 1-2 μg L(-1). Overall, distinct pharmaceutical contamination patterns as compared to the Western world can be concluded, which might be a trigger for further research in developing regions. PMID:26859608

  2. A Community-based Oral Health Promotion Model for HIV Patients in Nairobi, East District in Kenya: a Study Protocol

    PubMed Central

    Koyio, Lucina N.; van der Sanden, Wil J.M.; van der Ven, Andre; Mulder, Jan; Creugers, Nico H.J.; Merkx, Matthias A.W.; Frencken, Jo E.

    2013-01-01

    General HIV-related orofacial lesions, most commonly oropharyngeal candidiasis, have a typical clinical appearance and can be recognised by members of the community. Although affected patients often experience pain leading to compromised eating and swallowing, barriers such as social stigma and lack of knowledge regarding available services may prevent them from seeking early care. Educating the community about these lesions through community health workers (CHWs) who are democratically elected community members may encourage individuals affected to seek early oral healthcare in the health facilities. A health facility (HF) is a health centre mainly run by clinical officers (CO), i.e. personnel with a 3-year medical training, and nurses. This study aims to evaluate the effect of a CHW training programme on: i) their knowledge and recognition of HIV-related oral-facial lesions at a community level; and ii) referral of affected patients from the community to the HFs. Design and Methods All 800 CHWs in 2 administrative divisions of Nairobi East District (test group n=400; control group n=400) will be selected. The test group will receive training. CHWs in both groups will be assessed at 4 time points: −3, 0, +3 and +6 months with reference to the training on: i) their knowledge of HIV-related orofacial lesions (using a written questionnaire); and ii) their performance in referring affected patients to the HFs (using clinical data). Expected Impact Early recognition of HIV-related orofacial lesions at a community level will prompt community members to seek early oral care, leading to early HIV testing and counselling regarding failure of antiretroviral therapy, while treatment outcomes are still favourable. PMID:25170476

  3. Using Young Mothers' Clubs to Improve Knowledge of Postpartum Hemorrhage and Family Planning in Informal Settlements in Nairobi, Kenya.

    PubMed

    Ndirangu, Gathari; Gichangi, Anthony; Kanyuuru, Lynn; Otai, Jane; Mulindi, Rose; Lynam, Pamela; Koskei, Nancy; Tappis, Hannah; Archer, Linda

    2015-08-01

    Women living in Nairobi's informal settlements face a higher risk of maternal death than those living elsewhere in the country, and have limited knowledge of actions they can take to improve their chances of survival during pregnancy and childbirth. As one strategy to reach this high risk group, Jhpiego has implemented young mothers' clubs (YMCs). These clubs comprise mothers aged 18-30 who come together on a weekly basis to share experiences and solutions to their challenges while receiving health education from health facility staff and community health workers (CHWs). The aim of this study was to assess whether the YMC strategy could be used to improve participants' knowledge of postpartum hemorrhage (PPH), positive behavior around childbirth, and family planning. Participants in nine YMCs (n = 193) across four informal settlements were interviewed to assess their knowledge of safe motherhood topics before and after a series of eight health education sessions. Data were analyzed with the McNemar test to determine significance of change in knowledge pre- and post-intervention. The largest improvements were observed in knowledge about what to include in a birth plan, with correct responses increasing from 32 to 73% (p < 0.001), 58-93% (p < 0.001), 36-66% (p < 0.001), 58-85% (p < 0.001), and 64-88% (p < 0.001) for identifying a birth companion, budget, skilled birth attendant, emergency supplies, and place of birth, respectively. Less substantial improvements were observed in knowledge of danger signs of PPH (up 10% from 77%, p = 0.003). Although knowledge of actions to take in the event of bleeding after delivery did significantly improve, final knowledge scores remained low--knowledge to urinate increased from 14 to 28% (p < 0.001) and to breastfeed from 12 to 24% (p = 0.005). Even though the vast majority of respondents (84%) knew before the intervention that a woman should space pregnancy by at least 2 years after delivery, there was an increase to 94% after

  4. Kenya's Radio Language Arts Project: evaluation results.

    PubMed

    Oxford, R L

    1985-01-01

    The Kenya Radio Language Arts Project (RLAP), which has just been completed, documents the effectiveness of interactive radio-based educational instruction. Analyses in the areas of listening, reading, speaking, and writing show that children in radio classrooms consistently scored better than children in nonradio classrooms in every test. An evaluation of the project was conducted with the assistance of the Center for Applied Linguistics (CAL). Evaluation results came from a variety of sources, including language tests, observations, interviews, demographic and administrative records, and an attitude survey. A large proportion of the project's students were considerably transient. Only 22% of the total student population of 3908 were "normal progression" students -- that is, they advanced regularly through their education during the life of the project. Students who moved from the area, failed a standard (grade), dropped out, or were otherwise untrackable, comprised the remaining 78% of the total. 7 districts were included in the project. Tests were developed for listening and reading in Standards 1, 2, and 3 and in speaking and writing in Standards 2 and 3. The achievement tests were based on the official Kenya curriculum for those standards, so as to measure achievement against the curriculum. Nearly all the differences were highly significant statistically, with a probability of less than 1 in 1000 that the findings could have occurred by chance. Standard 1 radio students scored nearly 8 points higher than did their counterparts in the control group. Standard 2 and 3 radio students outperformed the control students by 4 points. The radio group consistently outperformed the control group in reading, writing, and speaking. Unstructured interviews and observations were conducted by the RLAP field staff. Overwhelmingly positive attitudes about the project prevailed among project teachers and headmasters. The data demonstrate that RLAP works. In fact, it works so

  5. Knowledge, attitudes, and practices regarding emergency contraception among nurses and nursing students in two hospitals in Nairobi, Kenya.

    PubMed

    Gichangi, P B; Karanja, J G; Kigondu, C S; Fonck, K; Temmerman, M

    1999-04-01

    A cross-sectional descriptive study on knowledge, attitudes, and practice about emergency contraception (EC) was conducted among nurses and nursing students using a self-administered questionnaire. One-hundred-sixty-seven qualified nurses and 63 nursing students completed the questionnaire. Over 95% listed at least one regular contraceptive method but only 2.6% spontaneously listed EC as a contraceptive method, whereas 48% of the respondents had heard of EC. Significantly more nursing students than qualified nurses were familiar with EC. Knowledge about the types of EC, applications, and side effects was poor and 49% of the respondents considered EC as an abortifacient. Of those familiar with EC, 77% approved its use for rape victims and 21% for adolescents and schoolgirls. Only 3.5% of all respondents had personally used EC in the past, 23% of those familiar with EC intend to use it in the future, whereas 53% intend to provide or promote it. The view that EC was abortifacient negatively influenced the decision to use or provide EC in the future. The present findings suggest that the level of knowledge of EC is poor and more information is needed. These findings indicate the potential to popularize emergency contraception in Kenya among nurses and nursing students. PMID:10457870

  6. Medico-social and socio-demographic factors associated with maternal mortality at Kenyatta National Hospital, Nairobi, Kenya.

    PubMed

    Makokha, A E

    1991-01-01

    To identify the most significant determinants of maternal mortality in Kenya, a prospective study involving 49,335 deliveries occurring at Kenyatta National Hospital from January 1978-87 was conducted. There were 156 maternal deaths in this series, for a maternal mortality rate of 3.2/1000 deliveries. The 5 most frequent causes of death were abortion (24%), hypertensive disease of pregnancy (13%), sepsis (13%), anemia (10%), and cardiac disease (7%). 24% of women who died were age 19 years or under, 27% were 20-24 years, 23% were 25-29 years, and 11% were 30-34 years. The largest percentage (24%) of deaths involved nulliparous women; 16% were to women of parity 5 and above. 28% of the women who died were single, and single women contributed the majority of deaths from abortion. 66% of the women who died had received no prenatal care. The proportion of avoidable deaths was 19% among clinic attenders compared to 29% among non-attenders. Overall, age, parity, and marital status--traditionally regarded as the key factors associated with maternal mortality--vary in their impact, given the cause of death and medical services received. The assumption that high parity is associated with maternal mortality was not confirmed in this study due to the significant number of deaths from abortion that involved single, nulliparous women. In addition, many women who died were in the optimum age group for childbearing, but were more prone to suffer from anemia, hypertension, ectopic pregnancy, and cardiac disease than women over 30 years old. Overall, 126 deaths were considered avoidable. Contributory factors were slowness of surgical management of emergencies, prolonged confinement of women with cardiac disease, and a lack of emergency supplies of blood and drugs for complicated deliveries. PMID:12316813

  7. Resilience in the face of post-election violence in Kenya: the mediating role of social networks on wellbeing among older people in the Korogocho informal settlement, Nairobi.

    PubMed

    Bennett, Rachel; Chepngeno-Langat, Gloria; Evandrou, Maria; Falkingham, Jane

    2015-03-01

    Older people in slum settings are a vulnerable sub-group during crises, yet have received minimal attention in the development discourse. This paper examines the protective role of different types of social networks for older slum dwellers' wellbeing during adversity by investigating the relationship between social networks, the Kenyan 2007/08 post-election violence, and dimensions of wellbeing namely self-rated health, life satisfaction and happiness amongst older people in the Korogocho slum, Nairobi. The analyses are based on conditional change logistic regression models using data from a unique longitudinal survey of the health and wellbeing of older people. The results show that maintaining or increasing formal local networks reduced the detrimental effects of the post-election violence for older people's wellbeing, whilst household environment and informal local and non-local networks did not influence the relationship. Consequently, the paper provides evidence that supporting inclusive community organisations which are accessible to older people can be valuable in promoting the resilience of this population group. PMID:25618605

  8. Association between the use of biomass fuels on respiratory health of workers in food catering enterprises in Nairobi Kenya

    PubMed Central

    Keraka, Margaret; Ochieng, Carolyne; Engelbrecht, Jacobus; Hongoro, Charles

    2013-01-01

    Introduction Indoor air pollution from biomass fuel use has been found to be responsible for more than 1.6 million annual deaths and 2.7% of the global burden of disease. This makes it the second biggest environmental contributor to ill health, behind unsafe water and sanitation. Methods The main objective of this study was to investigate if there was any association between use of bio-fuels in food catering enterprises and respiratory health of the workers. A cross-sectional design was employed, and data collected using Qualitative and quantitative techniques. Results The study found significantly higher prevalence of respiratory health outcomes among respondents in enterprises using biomass fuels compared to those using processed fuels. Biomass fuels are thus a major public health threat to workers in this sub-sector, and urgent intervention is required. Conclusion The study recommends a switch from biomass fuels to processed fuels to protect the health of the workers. PMID:23898361

  9. A population-based survey of prevalence of diabetes and correlates in an urban slum community in Nairobi, Kenya

    PubMed Central

    2013-01-01

    Background Urban slum populations in Africa continue to grow faster than national populations. Health strategies that focus on non-communicable diseases (NCD) in this segment of the population are generally lacking. We determined the prevalence of diabetes and associated cardiovascular disease (CVD) risk factors correlates in Kibera, Nairobi’s largest slum. Methods We conducted a population-based household survey utilising cluster sampling with probability proportional to size. Households were selected using a random walk method and consenting residents aged 18 years and above were recruited. The WHO STEPS instrument was administered. A random capillary blood sugar (RCBS) was obtained; known persons with diabetes and subjects with a RCBS >11.1 had an 8 hours fasting blood sugar (FBS) drawn. Diabetes was defined as a RCBS of ≥ 11.1 mmol/l and a FBS of ≥ 7.0 mmol/l, or a prior diagnosis or receiving diabetes drug treatment. Results Out of 2061 enrolled; 50.9% were males, mean age was 33.4 years and 87% had a minimum of primary education. Only 10.6% had ever had a blood sugar measurement. Age adjusted prevalence of diabetes was 5.3% (95% CI 4.2-6.4) and prevalence increased with age peaking at 10.5% (95% CI 6.8-14.3%) in the 45–54 year age category. Diabetes mellitus (DM) correlates were: 13.1% smoking, 74.9% alcohol consumption, 75.7% high level of physical activity; 16.3% obese and 29% overweight with higher rates in women. Among persons with diabetes the odds of obesity, elevated waist circumference and hypertension were three, two and three fold respectively compared to those without diabetes. Cardiovascular risk factors among subjects with diabetes were high and mirrored that of the entire sample; however they had a significantly higher use of tobacco. Conclusions This previously unstudied urban slum has a high prevalence of DM yet low screening rates. Key correlates include cigarette smoking and high alcohol consumption. However high

  10. Kenya.

    PubMed

    Obura, D O

    2001-12-01

    The Kenya coast is bathed by the northward-flowing warm waters of the East Africa Coastal Current, located between latitudes 1 and 5 degrees S. With a narrow continental shelf, the coastal marine environments are dominated by coral reefs, seagrass beds and mangroves, with large expanses of sandy substrates where river inputs from Kenya's two largest rivers, the Tana and Athi rivers, prevent the growth of coral reefs. The northern part of the coast is seasonally influenced by upwelling waters of the Somali Current, resulting in lower water temperatures for part of the year. The coast is made up of raised Pleistocene reefs on coastal plains and hills of sedimentary origin, which support native habitats dominated by scrub bush and remnant pockets of the forests that used to cover East Africa and the Congo basin. The marine environment is characterized by warm tropical conditions varying at the surface between 25 degrees C and 31 degrees C during the year, stable salinity regimes, and moderately high nutrient levels from terrestrial runoff and groundwater. The semi-diurnal tidal regime varies from 1.5 to 4 m amplitude from neap to spring tides, creating extensive intertidal platform and rocky-shore communities exposed twice-daily during low tides. Fringing reef crests dominate the whole southern coast and parts of the northern coast towards Somalia, forming a natural barrier to the wave energy from the ocean. Coral reefs form the dominant ecosystem along the majority of the Kenya coast, creating habitats for seagrasses and mangroves in the lagoons and creeks protected by the reef crests. Kenya's marine environment faces a number of threats from the growing coastal human population estimated at just under three million in 2000. Extraction of fish and other resources from the narrow continental shelf, coral reef and mangrove ecosystems increases each year with inadequate monitoring and management structures to protect the resource bases. Coastal development in urban and

  11. A trans-disciplinary study on the health risks of cryptosporidiosis from dairy systems in Dagoretti, Nairobi, Kenya: study background and farming system characteristics.

    PubMed

    Kang'ethe, Erastus K; Kimani, Violet N; McDermott, Brigid; Grace, Delia; Lang'at, Alfred K; Kiragu, Monica W; Karanja, Nancy; Njehu, Alice N; Randolph, Thomas; Mbugua, Gabriel; Irungu, Tabitha W; Ombutu, Peninnah

    2012-09-01

    This paper characterises the dairy farming system in Dagoretti, Nairobi. Characterisation was part of a broader ecohealth project to estimate the prevalence and risk of cryptosporidiosis and develop risk mitigation strategies. In the project a trans-disciplinary team addressed epidemiological, socioeconomic, environmental and policy aspects of cryptosporidiosis, an emerging zoonosis. This paper also provides background and describes sampling methods for the wider project. Three hundred dairy households were probabilistically sampled from a sampling frame of all dairy households in five of the six locations of Dagoretti, one of the eight districts of Nairobi Province. Randomly selected households identified 100 non-dairy-keeping households who also took part in the study. A household questionnaire was developed, pre-tested and administered in the dry and wet seasons of 2006. An additional study on livelihood and economic benefits of dairying took place with 100 dairy farmers randomly selected from the 300 farms (as well as 40 non-dairy neighbours as a control group), and a risk-targeted survey of environmental contamination with Cryptosporidium was conducted with 20 farmers randomly selected from the 29 farmers in the wider survey who were considered at high risk because of farming system. We found that around 1 in 80 urban households kept dairy cattle with an average of three cattle per household. Cross-breeds of exotic and local cattle predominate. Heads of dairy-keeping households were significantly less educated than the heads of non-dairy neighbours, had lived in Dagoretti for significantly longer and had significantly larger households. There was a high turnover of 10 % of the cattle population in the 3-month period of the study. Cattle were zero grazed, but productivity parameters were sub-optimal as were hygiene and husbandry practices. In conclusion, dairy keeping is a minor activity in urban Nairobi but important to households involved and their community

  12. Time-series analysis of weather and mortality patterns in Nairobi's informal settlements

    PubMed Central

    Egondi, Thaddaeus; Kyobutungi, Catherine; Kovats, Sari; Muindi, Kanyiva; Ettarh, Remare; Rocklöv, Joacim

    2012-01-01

    Background Many studies have established a link between weather (primarily temperature) and daily mortality in developed countries. However, little is known about this relationship in urban populations in sub-Saharan Africa. Objectives The objective of this study was to describe the relationship between daily weather and mortality in Nairobi, Kenya, and to evaluate this relationship with regard to cause of death, age, and sex. Methods We utilized mortality data from the Nairobi Urban Health and Demographic Surveillance System and applied time-series models to study the relationship between daily weather and mortality for a population of approximately 60,000 during the period 2003–2008. We used a distributed lag approach to model the delayed effect of weather on mortality, stratified by cause of death, age, and sex. Results Increasing temperatures (above 75th percentile) were significantly associated with mortality in children and non-communicable disease (NCD) deaths. We found all-cause mortality of shorter lag of same day and previous day to increase by 3.0% for a 1 degree decrease from the 25th percentile of 18°C (not statistically significant). Mortality among people aged 50+ and children aged below 5 years appeared most susceptible to cold compared to other age groups. Rainfall, in the lag period of 0–29 days, increased all-cause mortality in general, but was found strongest related to mortality among females. Low temperatures were associated with deaths due to acute infections, whereas rainfall was associated with all-cause pneumonia and NCD deaths. Conclusions Increases in mortality were associated with both hot and cold weather as well as rainfall in Nairobi, but the relationship differed with regard to age, sex, and cause of death. Our findings indicate that weather-related mortality is a public health concern for the population in the informal settlements of Nairobi, Kenya, especially if current trends in climate change continue. PMID:23195509

  13. Musculoskeletal imaging insight 2015: Kenya.

    PubMed

    Stevens, Kathryn J; Mutiso, Kavulani; Sconfienza, Luca Maria; Monu, Johnny

    2016-07-01

    Over the past 6 years the International Skeletal Society (ISS) outreach programs have become popular amongst the various radiology organizations in sub-Saharan Africa. So much so that that the ISS outreach is now routinely expected to participate in many of the international radiology conferences in that part of the world. The organizational planning for an outreach visit to Kenya took place over a 3-year period. Eventually a double-headed event; the seventh and eighth sub-Saharan outreach efforts were organized in Nairobi and in Mombasa, Kenya. The Nairobi outreach was an educational course on musculoskeletal imaging at the University of Nairobi and the Aga Khan University in Nairobi from 26 to 28 May 2015. The Mombasa outreach was organized in collaboration with the African Society of Radiology (ASR) at their annual meeting in Mombasa from 30 May to 2 June 2015. PMID:27115883

  14. InterVA versus Spectrum: how comparable are they in estimating AIDS mortality patterns in Nairobi's informal settlements?

    PubMed Central

    Oti, Samuel Oji; Wamukoya, Marilyn; Mahy, Mary; Kyobutungi, Catherine

    2013-01-01

    Background The Spectrum computer package is used to generate national AIDS mortality estimates in settings where vital registration systems are lacking. Similarly, InterVA-4 (the latest version of the InterVA programme) is used to estimate cause-of-mortality data in countries where cause-specific mortality data are not available. Objective This study aims to compare trends in adult AIDS-related mortality estimated by Spectrum with trends from the InterVA-4 programme applied to data from a Health and Demographic Surveillance System (HDSS) in Nairobi, Kenya. Design A Spectrum model was generated for the city of Nairobi based on HIV prevalence data for Nairobi and national antiretroviral therapy coverage, underlying mortality, and migration assumptions. We then used data, generated through verbal autopsies, on 1,799 deaths that occurred in the HDSS area from 2003 to 2010 among adults aged 15–59. These data were then entered into InterVA-4 to estimate causes of death using probabilistic modelling. Estimates of AIDS-related mortality rates and all-cause mortality rates from Spectrum and InterVA-4 were compared and presented as annualised trends. Results Spectrum estimated that HIV prevalence in Nairobi was 7%, while the HDSS site measured 12% in 2010. Despite this difference, Spectrum estimated higher levels of AIDS-related mortality. Between 2003 and 2010, the proportion of AIDS-related mortality in Nairobi decreased from 63 to 40% according to Spectrum and from 25 to 16% according to InterVA. The net AIDS-related mortality in Spectrum was closer to the combined mortality rates when AIDS and tuberculosis (TB) deaths were included for InterVA-4. Conclusion Overall trends in AIDS-related deaths from both methods were similar, although the values were closer when TB deaths were included in InterVA. InterVA-4 might not accurately differentiate between TB and AIDS deaths. PMID:24160914

  15. Trauma, Grief and Depression in Nairobi Children After the 1998 Bombing of the American Embassy

    ERIC Educational Resources Information Center

    Pfefferbaum, Betty; North, Carol S.; Doughty, Debby E.; Pfefferbaum, Rose L.; Dumont, Cedric E.; Pynoos, Robert S.; Gurwitch, Robin H.; Ndetei, David

    2006-01-01

    Despite the increasingly dangerous world where trauma and loss are common, relatively few studies have explored traumatic grief in children. The 1998 American Embassy bombing in Nairobi, Kenya, provided an unfortunate opportunity to examine this topic. This report describes findings in 156 children who knew someone killed in the incident, assessed…

  16. Factors Associated with Low Achievement among Students from Nairobi's Urban Informal Neighborhoods

    ERIC Educational Resources Information Center

    Ejakait, Epari; Mutisya, Maurice; Ezeh, Alex; Oketch, Moses; Ngware, Moses

    2011-01-01

    This article contributes new evidence on factors associated with low achievement among pupils in urban informal neighborhoods in Nairobi, Kenya. The authors use three different data sets to examine the effect of residence in particular neighborhoods, pupil gender, primary school type, and household socioeconomic status on pupil achievement in the…

  17. Gender, aging, poverty and health: Survival strategies of older men and women in Nairobi slums

    PubMed Central

    Mudege, Netsayi N.; Ezeh, Alex C.

    2009-01-01

    This paper is based on data from focus group discussions and in-depth individual interviews carried out in two slum areas, Korogocho and Viwandani in Nairobi, Kenya. It discusses how the division between domestic sphere and public sphere impacts on survival during, and adaptation to old age. Although this paper adopts some of the tenets of the life course approach, it posits that women's participation in the domestic sphere may sometimes give them a ‘gender advantage’ over men in terms of health and adaptation to old age. The paper also discusses the impact of gender roles on the cultivation of social networks and how these networks in turn impact on health and social adjustment as people grow older. It investigates how older people are adjusting and coping with the new challenges they face as a result of high morbidity and mortality among adults in the reproductive age groups. PMID:19907648

  18. The Emergence of Private University Education in Kenya: Trends, Prospects, and Challenges

    ERIC Educational Resources Information Center

    Oketch, Moses O.

    2004-01-01

    The first step towards the introduction and development of university education in Kenya was a private initiative. Although the initiative was rejected, it led to the establishment of the Royal Technical College in Nairobi. The Royal College, Nairobi was elevated to university status under a special arrangement with the University of London in…

  19. Tuberculosis and HIV at the National Level in Kenya: Results From the Second Kenya AIDS Indicator Survey

    PubMed Central

    Mbithi, Agneta; Gichangi, Anthony; Kim, Andrea A.; Katana, Abraham; Weyenga, Herman; Williamson, John; Robinson, Katherine; Oluoch, Tom; Maina, William K.; Kellogg, Timothy A.; De Cock, Kevin M.

    2016-01-01

    Background Co-morbidity with tuberculosis and HIV is a common cause of mortality in sub-Saharan Africa. In the second Kenya AIDS Indicator Survey, we collected data on knowledge and experience of HIV and tuberculosis, as well as on access to and coverage of relevant treatment services and antiretroviral therapy (ART) in Kenya. Methods A national, population-based household survey was conducted from October 2012 to February 2013. Information was collected through household questionnaires, and blood samples were taken for HIV, CD4 cell counts, and HIV viral load testing at a central laboratory. Results Overall, 13,720 persons aged 15–64 years participated; 96.7% [95% confidence interval (CI): 96.3 to 97.1] had heard of tuberculosis, of whom 2.0% (95% CI: 1.7 to 2.2) reported having prior tuberculosis. Among those with laboratory-confirmed HIV infection, 11.6% (95% CI: 8.9 to 14.3) reported prior tuberculosis. The prevalence of laboratory-confirmed HIV infection in persons reporting prior tuberculosis was 33.2% (95% CI: 26.2 to 40.2) compared to 5.1% (95% CI: 4.5 to 5.8) in persons without prior tuberculosis. Among those in care, coverage of ART for treatment-eligible persons was 100% for those with prior tuberculosis and 88.6% (95% CI: 81.6 to 95.7) for those without. Among all HIV-infected persons, ART coverage among treatment-eligible persons was 86.9% (95% CI: 74.2 to 99.5) for persons with prior tuberculosis and 58.3% (95% CI: 47.6 to 69.0) for those without. Conclusions Morbidity from tuberculosis and HIV remain major health challenges in Kenya. Tuberculosis is an important entry point for HIV diagnosis and treatment. Lack of knowledge of HIV serostatus is an obstacle to access to HIV services and timely ART for prevention of HIV transmission and HIV-associated disease, including tuberculosis. PMID:24732814

  20. [Migration between rural peripheral areas and urban central areas in Africa: a theoretical and empirical study of migration using the example of Nairobi].

    PubMed

    Vorlaufer, K

    1984-01-01

    Migration between rural peripheral areas and urban central areas is analyzed using the city of Nairobi, Kenya, as an example. The study is based on official Kenyan data for 1969-1979. The role of Nairobi as a focal point for both centripetal and centrifugal migration is discussed, and the volume, intensity, and direction of migration streams are examined. An attempt is also made to evaluate this migration in terms of modernization and dependency theories. PMID:12340512

  1. Assessing the Impact of Free Primary Education Using Retrospective and Prospective Data: Lessons from the Nairobi Case Study

    ERIC Educational Resources Information Center

    Ngware, Moses Waithanji; Oketch, Moses; Ezeh, Alex Chika; Mutisya, Maurice; Ejakait, Charles Epari

    2012-01-01

    This paper describes the design and methodology used to assess the impact of free primary education (FPE) policy in Nairobi, Kenya. The key outcome of the study was to assess the impact of FPE on schooling outcomes among the urban poor. The study assesses the impact of FPE by examining how two non-comparable groups responded to the introduction of…

  2. Internationalization of an African University in the Post-Colonial Era: A Case Study of the University of Nairobi

    ERIC Educational Resources Information Center

    Otieno, Iddah Aoko

    2012-01-01

    This case study uses post-colonial and dependency theoretical lenses to investigate the forces influencing policy, procedures, and participation in international activity in the post-colonial African university environment of Kenya's first national public university-the University of Nairobi (UoN). The research addresses (1) the approaches and…

  3. Introducing a model of cardiovascular prevention in Nairobi's slums by integrating a public health and private-sector approach: the SCALE-UP study

    PubMed Central

    van de Vijver, Steven; Oti, Samuel; Tervaert, Thijs Cohen; Hankins, Catherine; Kyobutungi, Catherine; Gomez, Gabriela B.; Brewster, Lizzy; Agyemang, Charles; Lange, Joep

    2013-01-01

    Introduction Cardiovascular disease (CVD) is a leading cause of death in sub-Saharan Africa (SSA), with annual deaths expected to increase to 2 million by 2030. Currently, most national health systems in SSA are not adequately prepared for this epidemic. This is especially so in slum settlements where access to formal healthcare and resources is limited. Objective To develop and introduce a model of cardiovascular prevention in the slums of Nairobi by integrating public health and private sector approaches. Study design Two non-profit organizations that conduct public health research, Amsterdam Institute for Global Health and Development (AIGHD) and African Population and Health Research Center (APHRC), collaborated with private-sector Boston Consulting Group (BCG) to develop a service delivery package for CVD prevention in slum settings. A theoretic model was designed based on the integration of public and private sector approaches with the focus on costs and feasibility. Results The final model includes components that aim to improve community awareness, a home-based screening service, patient and provider incentives to seek and deliver treatment specifically for hypertension, and adherence support. The expected outcomes projected by this model could prove potentially cost effective and affordable (1 USD/person/year). The model is currently being implemented in a Nairobi slum and is closely followed by key stakeholders in Kenya including the Ministry of Health, the World Health Organization (WHO), and leading non-governmental organizations (NGOs). Conclusion Through the collaboration of public health and private sectors, a theoretically cost-effective model was developed for the prevention of CVD and is currently being implemented in the slums of Nairobi. If results are in line with the theoretical projections and first impressions on the ground, scale-up of the service delivery package could be planned in other poor urban areas in Kenya by relevant policymakers

  4. Orphans and Vulnerable Children in Kenya: Results From a Nationally Representative Population-Based Survey

    PubMed Central

    Lee, Veronica C.; Muriithi, Patrick; Gilbert-Nandra, Ulrike; Kim, Andrea A.; Schmitz, Mary E.; Odek, James; Mokaya, Rose; Galbraith, Jennifer S.

    2016-01-01

    Background In Kenya, it is estimated that there are approximately 3.6 million children aged <18 years who have been orphaned or who are vulnerable. We examined the data from the second Kenya AIDS Indicator Survey (KAIS 2012) to determine the number and profile of orphans and vulnerable children (OVC) in Kenya who were aged <18 years. Methods KAIS 2012 was a nationally representative, population-based household survey. We analyzed the data for all the children from birth to age 17 years who resided in an eligible household so as to determine whether their parents were alive or had been very ill to define their OVC status. Results We estimated that there were 2.6 million OVC in Kenya in 2012, of whom 1.8 million were orphans and 750,000 were vulnerable. Among orphans, 15% were double orphans. Over one-third of all the OVC were aged between 10 and 14 years. Households with ≥1 OVC (12% of all households) were usually in the lowest 2 wealth quintiles, and 22% of OVC households had experienced moderate or severe hunger. Receipt of OVC support services was low for medical (3.7%), psychological (4.1%), social (1.3%), and material support (6.2%); educational support was slightly more common (11.5%). Orphanhood among children aged <15 years increased from 1993 to 2003 (P < 0.01) but declined from 2003 to 2012 (P < 0.01). Conclusions The 2.6 million OVC constitute a significant proportion of Kenya’s population aged <18 years. Special attention should be paid to OVC to prevent further vulnerability and ensure their well-being and development as they transition into adulthood. PMID:24732824

  5. Reporting AIDS in Kenya: a personal report. Guidelines for journalists have been issued in the UK. What about Africa?

    PubMed

    Hanssen, N

    1993-01-01

    A Norwegian journalist reports on his experiences covering the acquired immunodeficiency syndrome (AIDS) epidemic in Kenya. Denial by the government has resulted in reduced figures. President Daniel Arap Moi refuses to admit that the epidemic has become national in scope. The public broadcasting services carry little information about the epidemic. A study indicating that 25/1700 prostitutes in Nairobi were positive for human immunodeficiency virus (HIV) has been met with skepticism by the public, who question the survey (what was the relationship between researchers and prostitutes, were the prostitutes paid to risk their lives, why was the study carried out in Africa). Some believe the 25 positive women are 'immune' because of a similar gene pattern. There are 750,000 HIV positive adults and 30,000 AIDS cases in Kenya, including a large number of cases among street urchins. Most AIDS cases are sent home to die because of the short supply of hospital beds (45,000). One of these was Ruth Kasuki, a 36-year-old mother of three and AIDS educator and counselor in Kenya, who is now deceased. In an interview conducted shortly before her death, she criticizes the government for its denial and predicts disastrous results. Ms. Kasuki also blamed the extramarital affairs of men for the spread of AIDS among Kenyan women. 8% of women receiving antenatal care are estimated to have HIV; in Nyanza Coast and Nairobi the estimate reaches 12%. Ms. Kasuki also cited the negative attitude of the clergy. PMID:12287718

  6. Lake Naivasha, Kenya

    NASA Technical Reports Server (NTRS)

    2008-01-01

    If you live in Europe and buy roses, there is a good chance that they were grown in Kenya specifically, in one of the colossal greenhouses that blot out the once wild shores of Lake Naivasha, 90km north-west of Nairobi. Some 25% of Europe's cut flowers come from Kenya. After a tentative start in the 1980s the industry is now the country's third-largest foreign-currency earner, bringing in $120m a year. But the recent violence in Kenya is having a major impact on the flower growers. A local trade union says 3,000 of the 30,000 workers employed in Naivasha's flower farms have abandoned their jobs. Kenya emerged as a flower power when Israel scaled down its own industry. It has since lost business to neighboring Ethiopia, which offers tax breaks and better security, but Naivasha's perfect intensity of sunlight and days of near-constant length should keep it on top.

    The ASTER image was acquired February 2, 2008, covers an area of 25 x 26.6 km, and is located near 0.8 degrees south latitude, 36.4 degrees east longitude.

    The U.S. science team is located at NASA's Jet Propulsion Laboratory, Pasadena, Calif. The Terra mission is part of NASA's Science Mission Directorate.

  7. Ethnopharmacological survey of Samburu district, Kenya

    PubMed Central

    Nanyingi, Mark O; Mbaria, James M; Lanyasunya, Adamson L; Wagate, Cyrus G; Koros, Kipsengeret B; Kaburia, Humphrey F; Munenge, Rahab W; Ogara, William O

    2008-01-01

    Background Ethnobotanical pharmacopoeia is confidently used in disease intervention and there is need for documentation and preservation of traditional medical knowledge to bolster the discovery of novel drugs. The objective of the present study was to document the indigenous medicinal plant utilization, management and their extinction threats in Samburu District, Kenya. Methods Field research was conducted in six divisions of Samburu District in Kenya. We randomly sampled 100 consented interviewees stratified by age, gender, occupation and level of education. We collected plant use data through semi-structured questionnaires; transect walks, oral interviews and focus groups discussions. Voucher specimens of all cited botanic species were collected and deposited at University of Nairobi's botany herbarium. Results Data on plant use from the informants yielded 990 citations on 56 medicinal plant species, which are used to treat 54 different animal and human diseases including; malaria, digestive disorders, respiratory syndromes and ectoparasites. Conclusion The ethnomedicinal use of plant species was documented in the study area for treatment of both human and veterinary diseases. The local population has high ethnobotanical knowledge and has adopted sound management conservation practices. The major threatening factors reported were anthropogenic and natural. Ethnomedical documentation and sustainable plant utilization can support drug discovery efforts in developing countries. PMID:18498665

  8. Development of the roadmap and guidelines for the prevention and management of high blood pressure in Africa: Proceedings of the PASCAR Hypertension Task Force meeting: Nairobi, Kenya, 27 October 2014.

    PubMed

    Dzudie, A; Ojji, D; Anisiuba, B C; Abdou, B A; Cornick, R; Damasceno, A; Kane, A L; Mocumbi, A O; Mohamed, A; Nel, G; Ogola, E; Onwubere, B; Otieno, H; Rainer, B; Schutte, A; Ali, I T; Twagirumukiza, M; Poulter, N; Mayosi, B

    2015-01-01

    Africa has one of the fastest growing economies in the world. The economic changes are associated with a health transition characterised by a rise in cardiovascular risk factors and complications, which tend to affect the African population at their age of maximum productivity. Recent data from Africa have highlighted the increasing importance of high blood pressure in this region of the world. This condition is largely underdiagnosed and poorly treated, and therefore leads to stroke, renal and heart failure, and death. Henceforth, African countries are taking steps to develop relevant policies and programmes to address the issue of blood pressure and other cardiovascular risk factors in response to a call by the World Health Organisation (WHO) to reduce premature deaths from non-communicable diseases (NCDs) by 25% by the year 2025 (25 × 25). The World Heart Federation (WHF) has developed a roadmap for global implementation of the prevention and management of raised blood pressure using a health system approach to help realise the 25 × 25 goal set by the WHO. As the leading continental organisation of cardiovascular professionals, the Pan-African Society of Cardiology (PASCAR) aims to contextualise the roadmap framework of the WHF to the African continent through the PASCAR Taskforce on Hypertension. The Taskforce held a workshop in Kenya on 27 October 2014 to discuss a process by which effective prevention and control of hypertension in Africa may be achieved. It was agreed that a set of clinical guidelines for the management of hypertension are needed in Africa. The ultimate goal of this work is to develop a roadmap for implementation of the prevention and management of hypertension in Africa under the auspices of the WHF. PMID:25940121

  9. Making non-discrimination and equal opportunity a reality in Kenya's health provider education system: results of a gender analysis.

    PubMed

    Newman, Constance; Kimeu, Anastasiah; Shamblin, Leigh; Penders, Christopher; McQuide, Pamela A; Bwonya, Judith

    2011-01-01

    IntraHealth International's USAID-funded Capacity Kenya project conducted a performance needs assessment of the Kenya health provider education system in 2010. Various stakeholders shared their understandings of the role played by gender and identified opportunities to improve gender equality in health provider education. Findings suggest that occupational segregation, sexual harassment and discrimination based on pregnancy and family responsibilities present problems, especially for female students and faculty. To grow and sustain its workforce over the long term, Kenyan human resource leaders and managers must act to eliminate gender-based obstacles by implementing existing non-discrimination and equal opportunity policies and laws to increase the entry, retention and productivity of students and faculty. Families and communities must support girls' schooling and defer early marriage. All this will result in a fuller pool of students, faculty and matriculated health workers and, ultimately, a more robust health workforce to meet Kenya's health challenges. PMID:22543441

  10. Exploring the barriers to health care and psychosocial challenges in cervical cancer management in Kenya

    PubMed Central

    Ngutu, Mariah; Nyamongo, Isaac K

    2015-01-01

    Cervical cancer is the most frequent cancer among women aged between 15 years and 44 years in Kenya, resulting in an estimated 4,802 women being diagnosed with cervical cancer and 2,451 dying from the disease annually. It is often detected at its advanced invasive stages, resulting in a protracted illness upon diagnosis. This qualitative study looked at the illness trajectories of women living with cervical cancer enrolled for follow-up care at Kenyatta National Hospital cancer treatment center and the Nairobi Hospice, both in Nairobi county, Kenya. Using the qualitative phenomenological approach, data were collected through 18 in-depth interviews with women living with cervical cancer between April and July 2011. In-depth interviews with their caregivers, key informant interviews with health care workers, and participant observation field notes were used to provide additional qualitative data. These data were analyzed based on grounded theory’s inductive approach. Two key themes on which the data analysis was then anchored were identified, namely, psychosocial challenges of cervical cancer and structural barriers to quality health care. Findings indicated a prolonged illness trajectory with psychosocial challenges, fueled by structural barriers that women were faced with after a cervical cancer diagnosis. To address issues relevant to the increasing numbers of women with cervical cancer, research studies need to include larger samples of these women. Also important are studies that allow in-depth understanding of the experiences of women living with cervical cancer. PMID:26346001

  11. Determinants of health insurance ownership among women in Kenya: evidence from the 2008–09 Kenya demographic and health survey

    PubMed Central

    2014-01-01

    Background The Government of Kenya is making plans to implement a social health insurance program by transforming the National Hospital Insurance Fund (NHIF) into a universal health coverage program. The objective of this study was to examine the determinants associated with health insurance ownership among women in Kenya. Methods Data came from the 2008–09 Kenya Demographic and Health Survey, a nationally representative survey. The sample comprised 8,435 women aged 15–49 years. Descriptive statistics and multivariable logistic regression analysis were used to describe the characteristics of the sample and to identify factors associated with health insurance ownership. Results Being employed in the formal sector, being married, exposure to the mass media, having secondary education or higher, residing in households in the middle or rich wealth index categories and residing in a female-headed household were associated with having health insurance. However, region of residence was associated with a lower likelihood of having insurance coverage. Women residing in Central (OR = 0.4; p < 0.01) and North Eastern (OR = 0.1; p < 0.5) provinces were less likely to be insured compared to their counterparts in Nairobi province. Conclusions As the Kenyan government transforms the NHIF into a universal health program, it is important to implement a program that will increase equity and access to health care services among the poor and vulnerable groups. PMID:24678655

  12. Trends in non-communicable disease mortality among adult residents in Nairobi's slums, 2003–2011: applying InterVA-4 to verbal autopsy data

    PubMed Central

    Oti, Samuel O.; van de Vijver, Steven; Kyobutungi, Catherine

    2014-01-01

    Background About 80% of deaths from non-communicable diseases (NCDs) occur in developing countries such as Kenya. However, not much is known about the burden of NCDs in slums, which account for about 60% of the residences of the urban population in Kenya. This study examines trends in NCD mortality from two slum settings in Nairobi. Design We use verbal autopsy data on 1954 deaths among adults aged 35 years and older who were registered in the Nairobi Urban Health and Demographic Surveillance System between 2003 and 2011. InterVA-4, a computer-based program, was used to assign causes of death for each case. Results are presented as annualized cause-specific mortality rates (CSMRs) and cause-specific mortality fractions (CSMFs) by sex. Results The CSMRs for NCDs did not appear to change significantly over time for both males and females. Among males, cardiovascular diseases (CVDs) and neoplasms were the leading NCDs – contributing CSMFs of 8 and 5%, respectively, on average over time. Among females, CVDs contributed a CSMF of 14% on average over time, while neoplasms contributed 8%. Communicable diseases and related conditions remained the leading causes of death, contributing a CSMF of over 50% on average in males and females over time. Conclusions Our findings are consistent with the Global Burden of Disease 2010 study which shows that communicable diseases remain the dominant cause of death in Africa, although NCDs were still significant contributors to mortality. We recommend an integrated approach towards disease prevention that focuses on health systems strengthening in resource-limited settings such as slums. PMID:25377336

  13. Mother-to-Child Transmission of HIV in Kenya: Results From a Nationally Representative Study

    PubMed Central

    Sirengo, Martin; Muthoni, Lilly; Kellogg, Timothy A.; Kim, Andrea A.; Katana, Abraham; Mwanyumba, Sophie; Kimanga, Davies O.; Maina, William K.; Muraguri, Nicolas; Elly, Benjamin; Rutherford, George W.

    2016-01-01

    Background Kenya has an estimated 13,000 new infant HIV infections that occur annually. We measured the burden of HIV infection among women of childbearing age and assessed access to and coverage of key prevention of mother-to-child transmission interventions. Methods The second Kenya AIDS Indicator Survey was a nationally representative 2-stage cluster sample of households. We analyzed data from women aged 15–54 years who had delivered a newborn within the preceding 5 years and from whom we obtained samples for HIV testing. Results Of 3310 women who had ≥1 live birth in the preceding 5 years, 2862 (86.5%) consented to HIV testing in the survey, and 171 (6.1%) were found to be infected. Ninety-five percent received pre-natal care, 93.1% were screened for HIV during prenatal care, and of those screened, 97.8% received their test results. Seventy-six women were known to be infected in their last pregnancy. Of these, 54 (72.3%) received antepartum antiretroviral prophylaxis, and 51 (69.1%) received intrapartum prophylaxis; 56 (75.3%) reported their newborns received postpartum prophylaxis. Of the 76 children born to these mothers, 63 (82.5%) were tested for HIV at the first immunization visit or thereafter, and 8 (15.1%) were HIV infected. Conclusions We found a substantial burden of HIV in Kenyan women of childbearing age and a cumulative 5-year mother-to-child transmission rate of 15%. Although screening has improved over the past 5 years, fewer than three-quarters of infected pregnant women are receiving antiretroviral prophylaxis. Universal antiretroviral therapy for HIV-infected pregnant women will be essential in achieving Kenyan’s target to eliminate mother-to-child transmission to <5% by 2015. PMID:24732822

  14. Does the quality of parent-child connectedness matter for adolescents' sexual behaviors in Nairobi informal settlements?

    PubMed

    Sidze, Estelle M; Elungata'a, Patricia; Maina, Beatrice W; Mutua, Michael M

    2015-04-01

    This study investigated the associations between parent-child connectedness and sexual behaviors among adolescents living in informal settlements in Nairobi, Kenya, a vulnerable group with respect to reproductive health outcomes. The study was based on data from the Transition to Adulthood project, a study designed to follow adolescents aged 12-22 for 3 years in the informal settlements of Korogocho and Viwandani. Direct face-to-face questions were asked to adolescents about parenting variables and sexual behaviors. This study used a subsample of 689 sexually experienced 12-22-years-olds at Wave 2. Bivariate analysis compared gender differences for three outcomes-sexual activity in the 12 months prior to the survey and, among those who had had sex in this period, multiple sexual partners and condom use at last sex. Multivariate logistic regressions were used to identify associations between these outcomes and the quality of parent-child connectedness. About 60% of adolescent females and males were sexually active in the 12 months prior to the survey. The multivariate results showed a strong association between the quality of parent-child connectedness and condom use among adolescent males. Living with related or unrelated guardians (versus living with biological parents) was also associated with higher odds of multiple sexual partners and lower odds of condom use at last sex among adolescent females and with higher odds of sexual activity among adolescent males. Sexual and reproductive health programs targeting adolescents living in Nairobi informal settlements would benefit from attention to assisting parents to improve their ability to play the connectedness role. PMID:25501658

  15. Results of Automated Retinal Image Analysis for Detection of Diabetic Retinopathy from the Nakuru Study, Kenya

    PubMed Central

    2015-01-01

    Objective Digital retinal imaging is an established method of screening for diabetic retinopathy (DR). It has been established that currently about 1% of the world’s blind or visually impaired is due to DR. However, the increasing prevalence of diabetes mellitus and DR is creating an increased workload on those with expertise in grading retinal images. Safe and reliable automated analysis of retinal images may support screening services worldwide. This study aimed to compare the Iowa Detection Program (IDP) ability to detect diabetic eye diseases (DED) to human grading carried out at Moorfields Reading Centre on the population of Nakuru Study from Kenya. Participants Retinal images were taken from participants of the Nakuru Eye Disease Study in Kenya in 2007/08 (n = 4,381 participants [NW6 Topcon Digital Retinal Camera]). Methods First, human grading was performed for the presence or absence of DR, and for those with DR this was sub-divided in to referable or non-referable DR. The automated IDP software was deployed to identify those with DR and also to categorize the severity of DR. Main Outcome Measures The primary outcomes were sensitivity, specificity, and positive and negative predictive value of IDP versus the human grader as reference standard. Results Altogether 3,460 participants were included. 113 had DED, giving a prevalence of 3.3% (95% CI, 2.7–3.9%). Sensitivity of the IDP to detect DED as by the human grading was 91.0% (95% CI, 88.0–93.4%). The IDP ability to detect DED gave an AUC of 0.878 (95% CI 0.850–0.905). It showed a negative predictive value of 98%. The IDP missed no vision threatening retinopathy in any patients and none of the false negative cases met criteria for treatment. Conclusions In this epidemiological sample, the IDP’s grading was comparable to that of human graders’. It therefore might be feasible to consider inclusion into usual epidemiological grading. PMID:26425849

  16. Antiretroviral Treatment Scale-up Among Persons Living With HIV in Kenya: Results From a Nationally Representative Survey

    PubMed Central

    Odhiambo, Jacob O.; Kellogg, Timothy A.; Kim, Andrea A.; Ng’ang’a, Lucy; Mukui, Irene; Umuro, Mamo; Mohammed, Ibrahim; De Cock, Kevin M.; Kimanga, Davies O.; Schwarcz, Sandra

    2016-01-01

    Background In 2007, 29% of HIV-infected Kenyans in need of antiretroviral therapy (ART), based on an immunologic criterion of CD4 ≤350 cells per microliter, were receiving ART. Since then, substantial treatment scale-up has occurred in the country. We analyzed data from the second Kenya AIDS Indicator Survey (KAIS 2012) to assess progress of treatment scale-up in Kenya. Methods KAIS 2012 was a nationally representative survey of persons aged 18 months to 64 years that collected information on HIV status, care, and treatment. ART eligibility was defined based on 2 standards: (1) 2011 Kenya eligibility criteria for ART initiation: CD4 ≤350 cells per microliter or co-infection with active tuberculosis and (2) 2013 World Health Organization (WHO) eligibility criteria for ART initiation: CD4 ≤500 cells per microliter, co-infection with active tuberculosis, currently pregnant or breastfeeding, and infected partners in serodiscordant relationships. Blood specimens were tested for HIV antibodies and HIV-positive specimens tested for CD4 cell counts. Results Among 13,720 adults and adolescents aged 15–64 years, 11,626 provided a blood sample, and 648 were HIV infected. Overall, 58.8% [95% confidence interval (CI): 52.0 to 65.5) were eligible for treatment using the 2011 Kenya eligibility criteria and 77.4% (95% CI: 72.4 to 82.4) using the 2013 WHO eligibility criteria. Coverage of ART was 60.5% (95% CI: 50.8 to 70.2) using the 2011 Kenya eligibility criteria and 45.9% (95% CI: 37.7 to 54.2) using the 2013 WHO eligibility criteria. Conclusions ART coverage has increased from 29% in 2007 to 61% in 2012. If Kenya adopts the 2013 WHO guidelines for ART initiation, need for ART increases by an additional 19 percentage points and current coverage decreases by an additional 15 percentage points, representing an additional 214,000 persons who will need to be reached. PMID:24732815

  17. Medical Injection Use Among Adults and Adolescents Aged 15 to 64 Years in Kenya: Results From a National Survey

    PubMed Central

    Kimani, Daniel; Kamau, Rachel; Ssempijja, Victor; Robinson, Katherine; Oluoch, Tom; Njeru, Mercy; Mwangi, Jane; Njogu, David; Kim, Andrea A.

    2016-01-01

    Background Unsafe medical injections remain a potential route of HIV transmission in Kenya. We used data from a national survey in Kenya to study the magnitude of medical injection use, medication preference, and disposal of medical waste in the community. Methods The Kenya AIDS Indicator Survey 2012 was a nationally representative population-based survey. Among participants aged 15–64 years, data were collected regarding medical injections received in the year preceding the interview; blood samples were collected from participants for HIV testing. Results Of the 13,673 participants who answered questions on medical injections, 35.9% [95% confidence interval (CI): 34.5 to 37.3] reported receiving ≥1 injection in the past 12 months and 51.2% (95% CI: 49.7 to 52.8) preferred receiving an injection over a pill. Among those who received an injection from a health care provider, 95.9% (95% CI: 95.2 to 96.7) observed him/her open a new injection pack, and 7.4% (95% CI: 6.4 to 8.4) had seen a used syringe or needle near their home or community in the past 12 months. Men who had received ≥1 injection in the past 12 months (adjusted odds ratio, 3.2; 95% CI: 1.2 to 8.9) and women who had received an injection in the past 12 months, not for family planning purposes (adjusted odds ratio, 2.6; 95% CI: 1.2 to 5.5), were significantly more likely to be HIV infected compared with those who had not received medical injection in the past 12 months. Conclusions Injection preference may contribute to high rates of injections in Kenya. Exposure to unsafe medical waste in the community poses risks for injury and infection. We recommend that community- and facility-based injection safety strategies be integrated in disease prevention programs. PMID:24413041

  18. Correlates of objectively measured overweight/obesity and physical activity in Kenyan school children: results from ISCOLE-Kenya

    PubMed Central

    2014-01-01

    Background Childhood overweight/obesity and inadequate physical activity burden Western countries, and now, pose a growing threat to the health of children in low and middle income countries. Behavioural transitions toward more sedentary lifestyles coupled with increased consumption of high calorie foods has resulted in rising proportions of overweight/obesity and decreasing levels of physical activity in school-aged children. The objective of this study was to determine the prevalence and to investigate factors associated with overweight/obesity and physical activity in Kenyan children aged 9 to 11 years. Methods Body composition and physical activity measures of participating children were accomplished by anthropometric assessment, accelerometry, and administration of questionnaires related to diet and lifestyle, and the school and neighbourhood environments. Data collection was conducted in the city of Nairobi as part of a larger International Study of Childhood Obesity, Lifestyle and Environment. Results A total of 563 participants (46.5% boys, 53.5% girls) were included in the analyses. Of these, 3.7% were underweight, 14.4% were overweight, and 6.4% were obese based on WHO cut-points. Mean daily sedentary time was 398 minutes, time spent in light physical activity was 463 minutes, and time spent in moderate-to-vigorous physical activity was 36 minutes based on activity cut-points developed by Treuth et al. Only 12.6% of participating children were meeting the recommendation of ≥ 60 minutes of daily moderate-to-vigorous physical activity, and 45.7% of participants used active transportation to/from school. Increasing parental education level, total annual household income, and attending a private rather than public school were associated positively with being overweight/obese and negatively with meeting physical activity guidelines. Conclusions This study provided the evidence for an existing prevalence of childhood overweight/obesity in Nairobi

  19. Policy Scripts and Students' Realities Regarding Sexuality Education in Secondary Schools in Kenya

    ERIC Educational Resources Information Center

    Obare, Francis; Birungi, Harriet

    2013-01-01

    This paper explores the sexual and reproductive health (SRH) policy context and the realities facing in-school young people in Kenya. It is based on a review of the health and education sector policy documents as well as data from self-administered questionnaires with 3624 male and female students from eight secondary schools in Nairobi. Findings…

  20. Women's NutriBusiness Cooperatives in Kenya: An Integrated Strategy for Sustaining Rural Livelihoods

    ERIC Educational Resources Information Center

    Maretzki, Audrey N.

    2007-01-01

    With funding provided by the Center for Higher Education of the United States Agency for International Development, The Pennsylvania State University and Tuskegee University collaborated with the University of Nairobi in establishing women's NutriBusiness Cooperatives in the Rift Valley and Central Provinces of Kenya. Between 1992 and 1999, the…

  1. University medical education in Kenya: The challenges.

    PubMed

    Ndetei, David M; Mathai, Muthoni; Khasakhala, Lincoln I; Mutiso, Victoria; Mbwayo, Anne W

    2010-01-01

    There are two medical schools training doctors in Kenya: the Moi University established in 1984 and the University of Nairobi established in 1967. The University of Nairobi has so far produced the majority of Kenyan doctors. Both are public universities with the Government being the main financier. The increased demand for university education and the inability to meet these demands has led to the introduction of a system of training self-sponsored medical students alongside Government-subsidised students. One other public university has started a medical school. The pressure to increase the number of schools and students in the absence of increased resources poses a particular challenge to the country. PMID:20854156

  2. Same-sex sexual behavior of men in Kenya: Implications for HIV prevention, programs, and policy

    PubMed Central

    Geibel, S.

    2012-01-01

    Unprotected anal sex has long been recognized as a risk factor for HIV transmission among men who have sex with men (MSM). In Africa, however, general denial of MSM existence and associated stigma discouraged research. To address this gap in the literature, partners conducted the first behavioral surveys of MSM in Kenya. The first study was to assess HIV risk among MSM in Nairobi, and the second study a pre-post intervention study of male sex workers in Mombasa. The 2004 behavioral survey of 500 men in Mombasa revealed that MSM were having multiple sexual partners and failed to access appropriate prevention counseling and care at Kenya clinics. A 2006 capture-recapture enumeration in Mombasa estimated that over 700 male sex workers were active, after which a pre-intervention baseline survey of 425 male sex workers was conducted. Awareness of unprotected anal sex as an HIV risk behavior and consistent condom use with clients was low, and use of oil-based lubricants high. Based on this information, peer educators were trained in HIV prevention, basic counseling skills, and distribution of condoms and lubricants. To assess impact of the interventions, a follow-up survey of 442 male sex workers was implemented in 2008. Exposure to peer educators was significantly associated with increased consistent condom use, improved HIV knowledge, and increased use of water-based lubricants. These results have provided needed information to the Government of Kenya and have informed HIV prevention interventions. PMID:24753921

  3. Living with HIV postdiagnosis: a qualitative study of the experiences of Nairobi slum residents

    PubMed Central

    Wekesa, Eliud; Coast, Ernestina

    2013-01-01

    Objectives To characterise the experiences of heterosexual men and women living with HIV postdiagnosis and explain these experiences in relation to their identity and sexuality. Design Qualitative study using in-depth interviews and a theoretically informed biographic disruption theory. Setting Interviews were conducted in two Nairobi slums (Kenya). Participants 41 HIV-infected heterosexual men and women aged 18 years or older. Results People living with HIV have divergent experiences surrounding HIV diagnosis. Postdiagnosis, there are multiple phases of identity transition, including status (non-)disclosure, and attempts at identity repair and normalcy. For some people, this process involves a transition to a new self-identity, incorporating both HIV and antiretroviral treatment (ART) into their lives. For others, it involves a partial transition, with some aspects of their prediagnosis identity persisting, and for others it involves a rejection of HIV identity. Those people who were able to incorporate HIV/AIDS in their identity, without it being disruptive to their biography, were pursuing safer sexual and reproductive lives. By contrast, those people with a more continuous biography continued to reflect their prediagnosis identity and sexual behaviour. Conclusions People living with HIV/AIDS (PLWHA) had to rework their sense of identity following diagnosis in the context of living in a slum setting. Men and women living with HIV in slums are poorly supported by health systems and services as they attempt to cope with a diagnosis of HIV. Given the availability of ART, health services and professionals need to support the rights of PLWHA to be sexually active if they want to and achieve their fertility goals, while minimising HIV transmission risk. PMID:23645922

  4. Malnutrition and Childhood Disability in Turkana, Kenya: Results from a Case-Control Study

    PubMed Central

    Evans, Jennifer; Munyendo, David; Zuurmond, Maria; Frison, Severine; Mwenda, Victoria; Otieno, David; Kisia, James

    2015-01-01

    Background Children with disabilities may be particularly vulnerable to malnutrition, as a result of exclusions and feeding difficulties. However, there is limited evidence currently available on this subject. Methods A population-based case-control study was conducted in Turkana County, Kenya, between July and August 2013. Key informants in the community identified children aged 6 months to 10 years who they believed may have a disability. These children were screened by a questionnaire (UNICEF-Washington Group) and assessed by a paediatrician to confirm whether they had a disability and the type. Two controls without disabilities were selected per case: A sibling control (sibling nearest in age) and a neighbourhood control (nearest neighbour within one year of age). The caregiver completed a questionnaire on behalf of the child (e.g. information on feeding, poverty, illness, education), and anthropometric measures were taken. We undertook multivariable logistic and linear regression analyses to estimate the relationship between disability and malnutrition. Results The study included 311 cases with disabilities, 196 sibling controls and 300 neighbour controls. Children with disabilities were more likely to report a range of feeding difficulties. They were 1.6–2.9 times more likely to have malnutrition in comparison to neighbour controls or family controls, including general malnutrition (low weight for age), stunting (low height for age), low body mass index (BMI) or low mid upper arm circumference (MUAC) for age. Children with disabilities were almost twice as likely to have wasting (low weight for height) in comparison to neighbour controls (OR = 1.9, 95% CI 1.1–3.2), but this difference was not apparent compared with siblings (OR = 1.5, 95% CI 0.8–2.7). Children with disabilities also faced other exclusions. For instance those aged 5+ were much more likely not to attend school than neighbour controls (OR = 8.5, 95% CI 4.3–16.9). Conclusions Children

  5. The seismicity in Kenya (East Africa) for the period 1906-2010: A review

    NASA Astrophysics Data System (ADS)

    Mulwa, J. K.; Kimata, F.; Suzuki, S.; Kuria, Z. N.

    2014-01-01

    Kenya has had a seismic station since 1963 as part of the World Wide Standardized Seismograph Network (WWSSN). In 1990, the University of Nairobi in collaboration with GeoForschungsZentrum (GFZ) started to build up a local seismological network, the Kenya National Seismic Network (KNSN), which operated for about ten years between 1993-2002. This, however, experienced a myriad of problems ranging from equipment breakdown, vandalism and lack of spares. Kenya is seismically active since the Kenya rift valley traverses through the country from north to south bisecting the country into eastern and western regions. In the central part, the Kenya rift branches to form the NW-SE trending Kavirondo (Nyanza) rift. The Kenya rift valley and the Kavirondo (Nyanza) rift are the most seismically active where earthquakes of local magnitude (Ml) in the order of ⩽2.0-5.0 occur. Furthermore, historical records show that earthquakes of magnitudes of the order of Ml ⩾ 6.0 have occurred in Kenya. Such large magnitude earthquakes include the January 6, 1928 Subukia earthquake (Ml 7.1) and an aftershock (Ml 6.2) four days later, as well as the 1913 Turkana region earthquake (Ml 6.2). Since early 1970's, numerous seismic investigations have been undertaken in Kenya in order to understand the formation and structure of the Kenyan part of the East African rift valley. Earthquake data from these studies is, however, rather disorganized and individual datasets, including that acquired during the period 1993-2002, cannot furnish us with comprehensive information on the seismicity of Kenya for the past ∼100 years. The purpose of this paper is, therefore, to review the seismicity in Kenya for the period 1906-2010 by utilizing data and results from different sources. The general seismicity of Kenya has been evaluated using historical data, data recorded by local seismic networks, the United States Geological Survey catalogue as well as earthquake data from the numerous seismic

  6. Status of Voluntary Medical Male Circumcision in Kenya: Findings From 2 Nationally Representative Surveys in Kenya, 2007 and 2012

    PubMed Central

    Galbraith, Jennifer S.; Ochieng, Athanasius; Mwalili, Samuel; Emusu, Donath; Mwandi, Zebedee; Kim, Andrea A.; Rutherford, George; Maina, William K.; Kimanga, Davies O.; Chesang, Kipruto; Cherutich, Peter

    2016-01-01

    Background The Kenyan Ministry of Health initiated a voluntary medical male circumcision (VMMC) program in 2008. We used data from 2 nationally representative surveys to estimate trends in the number, demographic characteristics, and sexual behaviors of recently circumcised and uncircumcised HIV-uninfected men in Kenya. Methods We compared the proportion of circumcised men between the first and second Kenya AIDS Indicator Survey (KAIS 2007 and KAIS 2012) to assess the progress of Kenya’s VMMC program. We calculated the number of uncircumcised HIV-uninfected men. We conducted descriptive analyses and used multivariable methods to identify the variables independently associated with HIV-uninfected uncircumcised men aged 15–64 years in the VMMC priority region of Nyanza. Results The proportion of men who reported being circumcised increased significantly from 85.0% in 2007 to 91.2% in 2012. The proportions of circumcised men increased in all regions, with the highest increases of 18.1 and 9.0 percentage points in the VMMC priority regions of Nyanza and Nairobi, respectively. Half (52.5%) of HIV-uninfected and uncircumcised men had never been married, and 84.6% were not using condoms at all times with their last sexual partner. Conclusions VMMC prevalence has increased across Kenya demonstrating the success of the national program. Despite this accomplishment, the Nyanza region remains below the target to circumcise 80% of all eligible men aged 15–49 years between 2009 and 2013. As new cohorts of young men enter into adolescence, consistent focus is needed. To ensure sustainability of the VMMC program, financial resources and coordinated planning must continue. PMID:24732820

  7. Assessment and recommendations for two sites with active and potential aquaculture production in Rift Valley and Coast Provinces, Kenya

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Kenya has a long history of local fish consumption. The population in the Lake Victoria area (Rift Valley Province) Northwest of Nairobi and coastal communities (Coast Province) have historically included fish in their diet. Migration from villages to urban areas and increasing commerce has created ...

  8. Understanding the poultry trade network in Kenya: Implications for regional disease prevention and control.

    PubMed

    McCarron, Margaret; Munyua, Peninah; Cheng, Po-Yung; Manga, Thomas; Wanjohi, Cathryn; Moen, Ann; Mounts, Anthony; Katz, Mark A

    2015-07-01

    Infectious diseases in poultry can spread quickly and lead to huge economic losses. In the past decade, on multiple continents, the accelerated spread of highly pathogenic avian Influenza A (H5N1) virus, often through informal trade networks, has led to the death and culling of hundreds of millions of poultry. Endemic poultry diseases like Newcastle disease and fowl typhoid can also be devastating in many parts of the world. Understanding trade networks in unregulated systems can inform policy decisions concerning disease prevention and containment. From June to December 2008 we conducted a cross-sectional survey of backyard farmers, market traders, and middlemen in 5/8 provinces in Kenya. We administered a standardized questionnaire to each type of actor using convenience, random, snowball, and systematic sampling. Questionnaires addressed frequency, volume, and geography of trade, as well as biosecurity practices. We created a network diagram identifying the most important locations for trade. Of 380 respondents, 51% were backyard farmers, 24% were middlemen and 25% were market traders. Half (50%) of backyard farmers said they raised poultry both for household consumption and for sale. Compared to market traders, middlemen bought their poultry from a greater number of villages (median 4.2 villages for middlemen vs. 1.9 for market traders). Traders were most likely to purchase poultry from backyard farmers. Of the backyard farmers who sold poultry, 51% [CI 40-63] reported selling poultry to market traders, and 54% [CI 44-63] sold to middlemen. Middlemen moved the largest volume of poultry on a weekly basis (median purchases: 187 birds/week [IQR 206]; median sales: 188 birds/week [IQR 412.5]). The highest numbers of birds were traded in Nairobi - Kenya's capital city. Nairobi was the most prominent trading node in the network (61 degrees of centrality). Many smaller sub-networks existed as a result of clustered local trade. Market traders were also integral to the

  9. Pattern of pedestrian injuries in the city of Nairobi: implications for urban safety planning.

    PubMed

    Ogendi, Japheths; Odero, Wilson; Mitullah, Winnie; Khayesi, Meleckidzedeck

    2013-10-01

    Pedestrians are overrepresented in road traffic injuries and deaths in Nairobi, the capital city of Kenya, yet little research has been done to provide better understanding of the characteristics of pedestrian injuries. This paper presents the data obtained from road traffic injury admissions to Kenyatta National Hospital (KNH) over a 3-month period starting from 1 June to 31 August 2011. A total of 176 persons involved road traffic injuries in Nairobi were admitted to KNH during this period. Pedestrians comprised the highest (59.1 %) proportion of road traffic injury admissions, followed by motor vehicle passengers (24.4 %) and motor cyclists (9.7 %). Bicyclists and drivers accounted for 5.1 and 1.7 %, respectively. Cars (39.4 %) were the leading category of motorized four-wheeler vehicles that were involved in collisions with pedestrians, followed by matatus (35.5 %). Seventy percent of pedestrians were hit while crossing the road, 10.8 % while standing by the road, and 8.1 % while walking along the road. The highest proportion of pedestrian crashes occurred on Saturdays (25.5 %) and Sundays (16.7 %). Most of the pedestrian injuries (67.7 %) affected the limbs. The paper argues that safety of pedestrians should be a priority in road safety efforts in the city of Nairobi. Urban road safety planners should adopt existing cost-effective interventions to improve the safety of pedestrians such as area-wide traffic calming to limit the speeds of motor vehicles to 30 km/h, providing sidewalks for pedestrians, traffic calming in residential neighborhoods, people-and-not-car-oriented urban road designs, traffic education, and enforcement of traffic regulations. PMID:23430375

  10. The effect of enhanced public–private partnerships on Maternal, Newborn and child Health Services and outcomes in Nairobi–Kenya: the PAMANECH quasi-experimental research protocol

    PubMed Central

    Bakibinga, Pauline; Ettarh, Remare; Ziraba, Abdhalah K; Kyobutungi, Catherine; Kamande, Eva; Ngomi, Nicholas; Osindo, Jane

    2014-01-01

    Introduction Rapid urbanisation in Kenya has resulted in growth of slums in urban centres, characterised by poverty, inadequate social services and poor health outcomes. The government's initiatives to improve access to quality healthcare for mothers and children are largely limited to public health facilities, which are few and/or inaccessible in underserved areas such as the slums. The ‘Partnership for Maternal, Newborn and Child Health’ (PAMANECH) project is being implemented in two Nairobi slums, Viwandani and Korogocho, to assess the impact of strengthening public–private partnerships for the delivery of healthcare on the health of mothers, newborns and young children in two informal settlements in Kenya. Methods and analysis This is a quasi-experimental study; our approach is to support private as well as public health providers and the community to enhance access to and demand for quality healthcare services. Key activities include: infrastructural upgrade of selected Private Not-For-Profit health facilities operating in the two slums, building capacity for healthcare providers as well as the Health Management Teams in Nairobi, facilitating provision of supportive supervision by the local health authorities and forming networks of Community Health Volunteers (CHVs) to create demand for health services. To assess the impact of the intervention, the study is utilising multiple data sources using a combination of qualitative and quantitative methods. A baseline survey was conducted in 2013 and an end-line survey will be conducted at least 1 year after full implementation of the intervention. Systematic monitoring and documentation of the intervention is on-going to strengthen the case for causal inference. Ethics and dissemination Ethical approval for the study was obtained from the Kenya Medical Research Institute. Key messages from the results will be packaged and widely disseminated through workshops, conference presentations, reports, factsheets and

  11. Religious involvement, social engagement, and subjective health status of older residents of informal neighborhoods of Nairobi.

    PubMed

    Kodzi, Ivy Abla; Obeng Gyimah, Stephen; Emina, Jacques; Chika Ezeh, Alex

    2011-06-01

    Although past research has extensively documented the effects of religious involvement and social integration on the health outcomes of older people, relatively little research has examined the relationship among older Africans. In this article, we examined the effects of religious affiliation and participation as well as forms of social engagement, including social support, sociability, and community participation on self-reported health. The study used data from a sample of older men and women (50 years and above) from two informal settlements in Nairobi Kenya. Differences in religious groups were statistically significant. Frequency of religious attendance was negatively associated with health, while the number of close friends, social support, and frequency of community participation were positively and independently related to self-reported health. PMID:20589536

  12. Populations at Increased Risk for HIV Infection in Kenya: Results From a National Population-Based Household Survey, 2012

    PubMed Central

    Githuka, George; Hladik, Wolfgang; Mwalili, Samuel; Cherutich, Peter; Muthui, Mercy; Gitonga, Joshua; Maina, William K.; Kim, Andrea A.

    2016-01-01

    Background Populations with higher risks for HIV exposure contribute to the HIV epidemic in Kenya. We present data from the second Kenya AIDS Indicator Survey to estimate the size and HIV prevalence of populations with high-risk characteristics. Methods The Kenya AIDS Indicator Survey 2012 was a national survey of Kenyans aged 18 months to 64 years which linked demographic and behavioral information with HIV results. Data were weighted to account for sampling probability. This analysis was restricted to adults aged 18 years and older. Results Of 5088 men and 6745 women, 0.1% [95% confidence interval (CI): 0.03 to 0.14] were persons who inject drugs (PWID). Among men, 0.6% (CI: 0.3 to 0.8) had ever had sex with other men, and 3.1% (CI: 2.4 to 3.7) were males who had ever engaged in transactional sex work (MTSW). Among women, 1.9% (CI: 1.3 to 2.5) had ever had anal sex, and 4.1% (CI: 3.5 to 4.8) were women who had ever engaged in transactional sex work (FTSW). Among men, 17.6% (CI: 15.7 to 19.6) had been male clients of transactional sex workers (TSW). HIV prevalence was 0% among men who have sex with men, 6.3% (CI: 0 to 18.1) among persons who injected drugs, 7.1% (CI: 4.8 to 9.4) among male clients of TSW, 7.6% (CI: 1.8 to 13.4) among MTSW, 12.1% (CI: 7.1 to 17.1) among FTSW, and 12.1% (CI: 5.0 to 19.2) among females who ever had engaged in anal sex. Conclusions Population-based data on high-risk populations can be used to set realistic targets for HIV prevention, care, and treatment for these groups. These data should inform priorities for high-risk populations in the upcoming Kenyan strategic plan on HIV/AIDS. PMID:24732821

  13. Metal extent in blood of livestock from Dandora dumping site, Kenya: Source identification of Pb exposure by stable isotope analysis.

    PubMed

    Nakata, Hokuto; Nakayama, Shouta M M; Ikenaka, Yoshinori; Mizukawa, Hazuki; Ishii, Chihiro; Yohannes, Yared B; Konnai, Satoru; Darwish, Wageh Sobhy; Ishizuka, Mayumi

    2015-10-01

    Nairobi city in Kenya produces 2000 tons/day of garbage, and most of it is dumped onto the Dandora dumping site, home to a quarter-million residents. This study was conducted (1) to assess the contamination levels of nine metals and a metalloid (arsenic) in the blood of pigs, goats, sheep and cattle from Dandora, and (2) to identify a possible source of lead (Pb) pollution. Cadmium (Cd, 0.17-4.35 μg/kg, dry-wt) and Pb (90-2710 μg/kg) levels in blood were generally high, suggesting human exposure to Cd through livestock consumption and Pb poisoning among pigs (2600 μg/kg) and cattle (354 μg/kg). Results of Pb isotope ratios indicated that the major exposure route might differ among species. Our results also suggested a possibility that the residents in Dandora have been exposed to the metals through livestock consumption. PMID:25997160

  14. Determinants of Primary School Non-Enrollment and Absenteeism: Results from a Retrospective, Convergent Mixed Methods, Cohort Study in Rural Western Kenya

    PubMed Central

    King, Nia; Dewey, Cate; Borish, David

    2015-01-01

    Background Education is a key element in the socioeconomic development required to improve quality of life in Kenya. Despite the introduction of free primary education, primary school enrollment and attendance levels remain low. Drawing on qualitative and quantitative data, this study explores the determinants of non-enrollment and absenteeism in rural western Kenya and potential mitigation strategies to address these issues. Methods The study was conducted in Bwaliro village in rural western Kenya. A random sample of 64 students was obtained by blocking the village primary school’s student population according to grade level, gender, and orphan status. Qualitative and quantitative data were collected through interviews with parents, guardians, and key informants, and focus group discussions with students. Quantitative data were compared using chi-square tests, Student’s T-test, and Poisson regressions. Qualitative data were analyzed using thematic content analysis. Results Malaria, menstruation, and lack of money were among the most notable determinants of primary school dropout and absenteeism, and these factors disproportionately impacted orphans and female students. Potential mitigation strategies suggested by the community included provision of malaria treatment or prevention, reduction in education costs, expansion of the established school-feeding program, and provision of sanitary pads. Conclusion Despite free primary education, numerous factors continue to prevent children in rural western Kenya from attending primary school. The findings suggest that interventions should primarily target orphaned and female students. Prior to implementation, suggested mitigation strategies should be assessed for cost-effectiveness. PMID:26371885

  15. Identifying Risk Factors for Recent HIV Infection in Kenya Using a Recent Infection Testing Algorithm: Results from a Nationally Representative Population-Based Survey

    PubMed Central

    Kim, Andrea A.; Parekh, Bharat S.; Umuro, Mamo; Galgalo, Tura; Bunnell, Rebecca; Makokha, Ernest; Dobbs, Trudy; Murithi, Patrick; Muraguri, Nicholas; De Cock, Kevin M.; Mermin, Jonathan

    2016-01-01

    Introduction A recent infection testing algorithm (RITA) that can distinguish recent from long-standing HIV infection can be applied to nationally representative population-based surveys to characterize and identify risk factors for recent infection in a country. Materials and Methods We applied a RITA using the Limiting Antigen Avidity Enzyme Immunoassay (LAg) on stored HIV-positive samples from the 2007 Kenya AIDS Indicator Survey. The case definition for recent infection included testing recent on LAg and having no evidence of antiretroviral therapy use. Multivariate analysis was conducted to determine factors associated with recent and long-standing infection compared to HIV-uninfected persons. All estimates were weighted to adjust for sampling probability and nonresponse. Results Of 1,025 HIV-antibody-positive specimens, 64 (6.2%) met the case definition for recent infection and 961 (93.8%) met the case definition for long-standing infection. Compared to HIV-uninfected individuals, factors associated with higher adjusted odds of recent infection were living in Nairobi (adjusted odds ratio [AOR] 11.37; confidence interval [CI] 2.64–48.87) and Nyanza (AOR 4.55; CI 1.39–14.89) provinces compared to Western province; being widowed (AOR 8.04; CI 1.42–45.50) or currently married (AOR 6.42; CI 1.55–26.58) compared to being never married; having had ≥ 2 sexual partners in the last year (AOR 2.86; CI 1.51–5.41); not using a condom at last sex in the past year (AOR 1.61; CI 1.34–1.93); reporting a sexually transmitted infection (STI) diagnosis or symptoms of STI in the past year (AOR 1.97; CI 1.05–8.37); and being aged <30 years with: 1) HSV-2 infection (AOR 8.84; CI 2.62–29.85), 2) male genital ulcer disease (AOR 8.70; CI 2.36–32.08), or 3) lack of male circumcision (AOR 17.83; CI 2.19–144.90). Compared to HIV-uninfected persons, factors associated with higher adjusted odds of long-standing infection included living in Coast (AOR 1.55; CI 1.04–2

  16. Kenya and UNESCO-IHP Coordinated research Projects on Water Resources Assessment.

    NASA Astrophysics Data System (ADS)

    Omondi, C. J.; Mbugua, A. W.

    2015-12-01

    The 2011-2012 Horn of Africa drought crisis affected Kenya, resulting in destruction of livelihoods and weakening of traditional drought coping mechanisms and reduced capacities for humanitarian agencies. In response to this catastrophe and in line with the Nairobi Declaration of the Heads of States Summit regarding the crisis, and building on the experience and expertise of its International Hydrological programme, UNESCO launched the Groundwater Resources Investigation for Drought Mitigation in Africa Programme (GRIDMAP). Through GRIDMAP the Turkana groundwater Survey was implemented. The approach comprised of integrating existing ancillary field data, satellite imagery and ground-truthing. High resolution maps identifying groundwater occurrence, soil textures and recharge areas were constructed. Exploratory wells were drilled in some of the identified aquifers.A network of shallow aquifers was identified to spread across the area, only hidden by a few meters of the overburden below the surface. Presently 5 boreholes have been drilled within this aquifer and the average yield per borehole is about 80cu m/hour. The large paleo lake Lotikipi Basin aquifer covers a surface of 4146sq.km and hosts over 248 BCM in its 3-km deep graben structure. These deep aquifer-bearing structures comprise highly permeable Plio-Pleistocene fluvio-deltaic and lacustrine deposits interlayed with volcanic ash layers reworked by nearby rivers. Groundwater in these aquifers is partly static and partly dynamic in the graben-like structures. In view of these findings, the Government of Kenya and UNESCO Nairobi office have signed a cooperative framework agreement in May 2015 to continue with these groundwater assessments in a phased approach but eventually to cover the whole country. In addition and following UNESCO-IHP strategic plan-VIII: Water Security: Responses to Local, Regional, and Global Challenges (2014-2021) under theme 2: Groundwater in a changing environment, Kenya and Tanzania

  17. The Status of HIV Testing and Counseling in Kenya: Results From a Nationally Representative Population-Based Survey

    PubMed Central

    Ng’ang’a, Anne; Waruiru, Wanjiru; Ngare, Carol; Ssempijja, Victor; Gachuki, Thomas; Njoroge, Inviolata; Oluoch, Patricia; Kimanga, Davies O.; Maina, William K.; Mpazanje, Rex; Kim, Andrea A.

    2016-01-01

    Background HIV testing and counseling (HTC) is essential for successful HIV prevention and treatment programs. The national target for HTC is 80% of the adult population in Kenya. Population-based data to measure progress towards this HTC target are needed to assess the country’s changing needs for HIV prevention and treatment. Methods In 2012–2013, we conducted a national HIV survey among Kenyans aged 18 months to 64 years. Respondents aged 15–64 years were administered a questionnaire that collected information on demographics, HIV testing behavior, and self-reported HIV status. Blood samples were collected for HIV testing in a central laboratory. Participants were offered home-based testing and counseling to learn their HIV status in the home and point-of-care CD4 testing if they tested HIV-positive. Results Of 13,720 adults who were interviewed, 71.6% [95% confidence interval (CI): 70.2 to 73.1] had been tested for HIV. Among those, 56.1% (95% CI: 52.8 to 59.4) had been tested in the past year, 69.4% (95% CI: 68.0 to 70.8) had been tested more than once, and 37.2% (95% CI: 35.7 to 38.8) had been tested with a partner. Fifty-three percent (95% CI: 47.6 to 58.7) of HIV-infected persons were unaware of their infection. Overall 9874 (72.0%) of participants accepted home-based HIV testing and counseling; 4.1% (95% CI: 3.3 to 4.9) tested HIV-positive, and of those, 42.5% (95% CI 31.4 to 53.6) were in need of immediate treatment for their HIV infection but not receiving it. Conclusions HIV testing rates have nearly reached the national target for HTC in Kenya. However, knowledge of HIV status among HIV-infected persons remains low. HTC needs to be expanded to reach more men and couples, and strategies are needed to increase repeat testing for persons at risk for HIV infection. PMID:24732818

  18. Factors Associated with HIV Infection in Married or Cohabitating Couples in Kenya: Results from a Nationally Representative Study

    PubMed Central

    Kaiser, Reinhard; Bunnell, Rebecca; Hightower, Allen; Kim, Andrea A.; Cherutich, Peter; Mwangi, Mary; Oluoch, Tom; Dadabhai, Sufia; Mureithi, Patrick; Mugo, Nelly; Mermin, Jonathan

    2011-01-01

    Background In order to inform prevention programming, we analyzed HIV discordance and concordance within couples in the Kenya AIDS Indicator Survey (KAIS) 2007. Methods KAIS was a nationally representative population-based sero-survey that examined demographic and behavioral indicators and serologic testing for HIV, HSV-2, syphilis, and CD4 cell counts in 15,853 consenting adults aged 15–64 years. We analyzed interview and blood testing data at the sexual partnership level from married or cohabitating couples. Multivariable regression models were used to identify factors independently associated with HIV discordant and concordant status. Results Of 3256 couples identified in the survey, 2748 (84.4%) had interview and blood testing data. Overall, 3.8% of couples were concordantly infected with HIV, and in 5.8% one partner was infected, translating to 338,000 discordant couples in Kenya. In 83.6% of HIV-infected Kenyans living in married or cohabitating couples neither partner knew their HIV status. Factors independently associated with HIV-discordance included young age in women (AOR 1.5, 95% CI: 1.2–1.8; p<0.0001), increasing number of lifetime sexual partners in women (AOR 1.5, 95% CI: 1.3–1.8; p<0.0001), HSV-2 infection in either or both partners (AOR 4.1, 95% CI: 2.3–7.2; p<0.0001), and lack of male circumcision (AOR 1.6, 95% CI: 1.0–2.5; p = 0.032). Independent factors for HIV-concordance included HSV-2 infection in both partners (AOR 6.5, 95% CI: 2.3–18.7; p = 0.001) and lack of male circumcision (AOR 1.8, 95% CI: 1.0–3.3; p = 0.043). Conclusions Couple prevention interventions should begin early in relationships and include mutual knowledge of HIV status, reduction of outside sexual partners, and promotion of male circumcision among HIV-uninfected men. Mechanisms for effective prevention or suppression of HSV-2 infection are also needed. PMID:21423615

  19. Results From the First Six Years of National Sentinel Surveillance for Influenza in Kenya, July 2007–June 2013

    PubMed Central

    Katz, Mark A.; Muthoka, Philip; Emukule, Gideon O.; Kalani, Rosalia; Njuguna, Henry; Waiboci, Lilian W.; Ahmed, Jamal A.; Bigogo, Godfrey; Feikin, Daniel R.; Njenga, Moses K.; Breiman, Robert F.; Mott, Joshua A.

    2014-01-01

    Background Recent studies have shown that influenza is associated with significant disease burden in many countries in the tropics, but until recently national surveillance for influenza was not conducted in most countries in Africa. Methods In 2007, the Kenyan Ministry of Health with technical support from the CDC-Kenya established a national sentinel surveillance system for influenza. At 11 hospitals, for every hospitalized patient with severe acute respiratory illness (SARI), and for the first three outpatients with influenza-like illness (ILI) per day, we collected both nasopharyngeal and oropharyngeal swabs. Beginning in 2008, we conducted in-hospital follow-up for SARI patients to determine outcome. Specimens were tested by real time RT-PCR for influenza A and B. Influenza A-positive specimens were subtyped for H1, H3, H5, and (beginning in May 2009) A(H1N1)pdm09. Results From July 1, 2007 through June 30, 2013, we collected specimens from 24,762 SARI and 14,013 ILI patients. For SARI and ILI case-patients, the median ages were 12 months and 16 months, respectively, and 44% and 47% were female. In all, 2,378 (9.6%) SARI cases and 2,041 (14.6%) ILI cases were positive for influenza viruses. Most influenza-associated SARI cases (58.6%) were in children <2 years old. Of all influenza-positive specimens, 78% were influenza A, 21% were influenza B, and 1% were influenza A/B coinfections. Influenza circulated in every month. In four of the six years influenza activity peaked during July–November. Of 9,419 SARI patients, 2.7% died; the median length of hospitalization was 4 days. Conclusions During six years of surveillance in Kenya, influenza was associated with nearly 10 percent of hospitalized SARI cases and one-sixth of outpatient ILI cases. Most influenza-associated SARI and ILI cases were in children <2 years old; interventions to reduce the burden of influenza, such as vaccine, could consider young children as a priority group. PMID:24955962

  20. Equatorial paleomagnetic time-averaged field results from 0-5 Ma lavas from Kenya and the latitudinal variation of angular dispersion

    NASA Astrophysics Data System (ADS)

    Opdyke, Neil D.; Kent, Dennis V.; Huang, Kainian; Foster, David A.; Patel, J. P.

    2010-05-01

    Lavas of Pliocene-Pleistocene age were sampled in two regions in Kenya: Mount Kenya on the equator and the Loiyangalani region, east of Lake Turkana, at about 3°N. We sampled 100 sites distributed around the Mount Kenya Massif and to the northeast along the Nyambini Range. The equator bisects Mount Kenya, and all sites were sampled within 40' of the equator. Thirty-two sites were sampled in the Loiyangalani area, making a total of 132 sites. Many sites from the Mount Kenya study were severely affected by lightning; however, after progressive AF demagnetization 69 sites yielded directions with α95 equal to or less than 10°. Normal polarity sites dominate (N = 58 and a mean of declination (dec) = 1.2°, inclination (inc) = -0.7°, and α95 = 3.6°) with only 11 reverse polarity sites (mean of dec = 182.3°, inc = 0.6°, and α95 = 7.2°); no transitional directions were identified. Inverting the reverse sites yields a combined mean direction of dec = l.4°, inc = -0.7°, and α95 = 3.2°. This result is not significantly different from what is expected from the geocentric axial dipole for the mean locality (dec = 0° and inc = 0°); a quadrupole component was not resolved. The samples from the Loiyangalani region were not seriously affected by lightning, and all 32 sites gave satisfactory data with α95 less than 10° (17 reverse sites, dec = 183.4°, inc = 0.8°, and α95 = 6.7°; 15 normal sites, dec = 358.6°, inc = -1.1°, and α95 = 4.7°); after inverting the reverse sites the combined mean was dec = 1.1°, inc = -1.0°, and α95 = 4.1°. Altogether, we had a total of 101 successful sites. A virtual geomagnetic pole (VGP) was calculated from each site mean; the VGP dispersion is low, with Sb = 10.9° for Mount Kenya and 9.8° for the Loiyangalani region. This dispersion agrees with updated Model G of McElhinny and McFadden (1997) and model TK03 of Tauxe and Kent (2004) that was tuned to the compilation of McElhinny and McFadden (1997) but disagrees with the

  1. Contraceptive Adoption, Discontinuation, and Switching among Postpartum Women in Nairobi's Urban Slums.

    PubMed

    Mumah, Joyce N; Machiyama, Kazuyo; Mutua, Michael; Kabiru, Caroline W; Cleland, John

    2015-12-01

    Unmet need for contraception is highest within 12 months post-delivery, according to research. Using longitudinal data from the Nairobi Urban Health and Demographic Surveillance System, we assess the dynamics of contraceptive use during the postpartum period among women in Nairobi's slums. Results show that by 6 months postpartum, 83 percent of women had resumed sexual activity and 51 percent had resumed menses, yet only 49 percent had adopted a modern contraceptive method. Furthermore, almost half of women discontinued a modern method within 12 months of initiating use, with many likely to switch to another short-term method with high method-related dissatisfaction. Women who adopted a method after resumption of menses had higher discontinuation rates, though the effect was much reduced after adjusting for other variables. To reduce unmet need, effective intervention programs are essential to lower high levels of discontinuation and encourage switching to more effective methods. PMID:26643488

  2. Improving medical education in Kenya: an international collaboration.

    PubMed

    Mayo, Alexa

    2014-04-01

    This paper describes a partnership between the University of Nairobi College of Health Sciences (CHS) Library and the University of Maryland Health Sciences and Human Services Library (HS/HSL). The libraries are collaborating to develop best practices for the CHS Library as it meets the challenge of changing medical education information needs in a digital environment. The collaboration is part of a Medical Education Partnership Initiative. The library project has several components: an assessment of the CHS Library, learning visits in the United States and Kenya, development of recommendations to enhance the CHS Library, and ongoing evaluation of the program's progress. Development of new services and expertise at the CHS Library is critical to the project's success. A productive collaboration between the HS/HSL and CHS Library is ongoing. A successful program to improve the quality of medical education will have a beneficial impact on health outcomes in Kenya. PMID:24860265

  3. Improving medical education in Kenya: an international collaboration*†

    PubMed Central

    Mayo, Alexa

    2014-01-01

    This paper describes a partnership between the University of Nairobi College of Health Sciences (CHS) Library and the University of Maryland Health Sciences and Human Services Library (HS/HSL). The libraries are collaborating to develop best practices for the CHS Library as it meets the challenge of changing medical education information needs in a digital environment. The collaboration is part of a Medical Education Partnership Initiative. The library project has several components: an assessment of the CHS Library, learning visits in the United States and Kenya, development of recommendations to enhance the CHS Library, and ongoing evaluation of the program's progress. Development of new services and expertise at the CHS Library is critical to the project's success. A productive collaboration between the HS/HSL and CHS Library is ongoing. A successful program to improve the quality of medical education will have a beneficial impact on health outcomes in Kenya. PMID:24860265

  4. Expanding clinical medical training opportunities at the University of Nairobi: adapting a regional medical education model from the WWAMI program at the University of Washington.

    PubMed

    Child, Mara J; Kiarie, James N; Allen, Suzanne M; Nduati, Ruth; Wasserheit, Judith N; Kibore, Minnie W; John-Stewart, Grace; Njiri, Francis J; O'Malley, Gabrielle; Kinuthia, Raphael; Norris, Tom E; Farquhar, Carey

    2014-08-01

    A major medical education need in Sub-Saharan Africa includes expanding clinical training opportunities to develop health professionals. Medical education expansion is a complicated process that requires significant investment of financial and human resources, but it can also provide opportunities for innovative approaches and partnerships. In 2010, the U.S. President's Emergency Plan for AIDS Relief launched the Medical Education Partnership Initiative to invest in medical education and health system strengthening in Africa. Building on a 30-year collaborative clinical and research training partnership, the University of Nairobi in Kenya developed a pilot regional medical education program modeled on the WWAMI (Washington, Wyoming, Alaska, Montana, and Idaho) medical education program at the University of Washington in the United States. The University of Nairobi adapted key elements of the WWAMI model to expand clinical training opportunities without requiring major capital construction of new buildings or campuses. The pilot program provides short-term clinical training opportunities for undergraduate students and recruits and trains clinical faculty at 14 decentralized training sites. The adaptation of a model from the Northwestern United States to address medical education needs in Kenya is a successful transfer of knowledge and practices that can be scaled up and replicated across Sub-Saharan Africa. PMID:25072575

  5. Expanding Clinical Medical Training Opportunities at the University of Nairobi: Adapting a Regional Medical Education Model from the WWAMI Program at the University of Washington

    PubMed Central

    Child, Mara J.; Kiarie, James N.; Allen, Suzanne M.; Nduati, Ruth; Wasserheit, Judith N.; Kibore, Minnie W.; John-Stewart, Grace; Njiri, Francis J.; O'Malley, Gabrielle; Kinuthia, Raphael; Norris, Tom E.; Farquhar, Carey

    2014-01-01

    A major medical education need in Sub-Saharan Africa includes expanding clinical training opportunities to develop health professionals. Medical education expansion is a complicated process that requires significant investment of financial and human resources, but it can also provide opportunities for innovative approaches and partnerships. In 2010, the U.S. President's Emergency Plan for AIDS Relief (PEPFAR) launched the Medical Education Partnership Initiative to invest in medical education and health system strengthening in Africa. Building on a 30-year collaborative clinical and research training partnership, the University of Nairobi in Kenya developed a pilot regional medical education program modeled on the WWAMI (Washington, Wyoming, Alaska, Montana, and Idaho) medical education program at the University of Washington in the United States. The University of Nairobi adapted key elements of the WWAMI model to expand clinical training opportunities without requiring major capital construction of new buildings or campuses. The pilot program provides short-term clinical training opportunities for undergraduate students and recruits and trains clinical faculty at 14 decentralized training sites. The adaptation of a model from the Northwestern United States to address medical education needs in Kenya is a successful transfer of knowledge and practices that can be scaled up and replicated across Sub-Saharan Africa. PMID:25072575

  6. HIV Type 1 Transmission Networks Among Men Having Sex with Men and Heterosexuals in Kenya

    PubMed Central

    Faria, Nuno Rodrigues; Hassan, Amin; Hamers, Raph L.; Mutua, Gaudensia; Anzala, Omu; Mandaliya, Kishor; Cane, Patricia; Berkley, James A.; Rinke de Wit, Tobias F.; Wallis, Carole; Graham, Susan M.; Price, Matthew A.; Coutinho, Roel A.; Sanders, Eduard J.

    2014-01-01

    Abstract We performed a molecular phylogenetic study on HIV-1 polymerase sequences of men who have sex with men (MSM) and heterosexual patient samples in Kenya to characterize any observed HIV-1 transmission networks. HIV-1 polymerase sequences were obtained from samples in Nairobi and coastal Kenya from 84 MSM, 226 other men, and 364 women from 2005 to 2010. Using Bayesian phylogenetics, we tested whether sequences clustered by sexual orientation and geographic location. In addition, we used trait diffusion analyses to identify significant epidemiological links and to quantify the number of transmissions between risk groups. Finally, we compared 84 MSM sequences with all HIV-1 sequences available online at GenBank. Significant clustering of sequences from MSM at both coastal Kenya and Nairobi was found, with evidence of HIV-1 transmission between both locations. Although a transmission pair between a coastal MSM and woman was confirmed, no significant HIV-1 transmission was evident between MSM and the comparison population for the predominant subtype A (60%). However, a weak but significant link was evident when studying all subtypes together. GenBank comparison did not reveal other important transmission links. Our data suggest infrequent intermingling of MSM and heterosexual HIV-1 epidemics in Kenya. PMID:23947948

  7. HIV Type 1 transmission networks among men having sex with men and heterosexuals in Kenya.

    PubMed

    Bezemer, Daniela; Faria, Nuno Rodrigues; Hassan, Amin; Hamers, Raph L; Mutua, Gaudensia; Anzala, Omu; Mandaliya, Kishor; Cane, Patricia; Berkley, James A; Rinke de Wit, Tobias F; Wallis, Carole; Graham, Susan M; Price, Matthew A; Coutinho, Roel A; Sanders, Eduard J

    2014-02-01

    We performed a molecular phylogenetic study on HIV-1 polymerase sequences of men who have sex with men (MSM) and heterosexual patient samples in Kenya to characterize any observed HIV-1 transmission networks. HIV-1 polymerase sequences were obtained from samples in Nairobi and coastal Kenya from 84 MSM, 226 other men, and 364 women from 2005 to 2010. Using Bayesian phylogenetics, we tested whether sequences clustered by sexual orientation and geographic location. In addition, we used trait diffusion analyses to identify significant epidemiological links and to quantify the number of transmissions between risk groups. Finally, we compared 84 MSM sequences with all HIV-1 sequences available online at GenBank. Significant clustering of sequences from MSM at both coastal Kenya and Nairobi was found, with evidence of HIV-1 transmission between both locations. Although a transmission pair between a coastal MSM and woman was confirmed, no significant HIV-1 transmission was evident between MSM and the comparison population for the predominant subtype A (60%). However, a weak but significant link was evident when studying all subtypes together. GenBank comparison did not reveal other important transmission links. Our data suggest infrequent intermingling of MSM and heterosexual HIV-1 epidemics in Kenya. PMID:23947948

  8. Community Dialogue to Shift Social Norms and Enable Family Planning: An Evaluation of the Family Planning Results Initiative in Kenya

    PubMed Central

    Creanga, Andreea A.; Galavotti, Christine; Wamalwa, Emmanuel

    2016-01-01

    Introduction Use of family planning (FP) is powerfully shaped by social and gender norms, including the perceived acceptability of FP and gender roles that limit women’s autonomy and restrict communication and decision-making between men and women. This study evaluated an intervention that catalyzed ongoing community dialogues about gender and FP in Siaya county, Nyanza Province, Kenya. Specifically, we explored the changes in perceived acceptability of FP, gender norms and use of FP. Methods We used a mixed-method approach. Information on married men and women’s socio-demographic characteristics, pregnancy intentions, gender-related beliefs, FP knowledge, attitudes, and use were collected during county-representative, cross-sectional household surveys at baseline (2009; n11 = 650 women; n12 = 305 men) and endline (2012; n21 = 617 women; n22 = 317 men); exposure to the intervention was measured at endline. We assessed changes in FP use at endline vs. baseline, and fitted multivariate logistic regression models for FP use to examine its association with intervention exposure and explore other predictors of use at endline. In-depth, qualitative interviews with 10 couples at endline further explored enablers and barriers to FP use. Results At baseline, 34.0% of women and 27.9% of men used a modern FP method compared to 51.2% and 52.2%, respectively, at endline (p<0.05). Exposure to FP dialogues was associated with 1.78 (95% CI: 1.20–2.63) times higher odds of using a modern FP method at endline for women, but this association was not significant for men. Women’s use of modern FP was significantly associated with higher spousal communication, control over own cash earnings, and FP self-efficacy. Men who reported high approval of FP were significantly more likely to use modern FP if reporting high approval of FP and more equitable gender beliefs. FP dialogues addressed persistent myths and misconceptions, normalized FP discussions, and increased its

  9. Determinants of Sexual Activity and Pregnancy among Unmarried Young Women in Urban Kenya: A Cross-Sectional Study

    PubMed Central

    2015-01-01

    Objectives With age of marriage rising in Kenya, the period between onset of puberty and first marriage has increased, resulting in higher rates of premarital sexual activity and pregnancy. We assessed the determinants of sexual activity and pregnancy among young unmarried women in urban Kenya. Methods Baseline data from five urban areas in Kenya (Nairobi, Mombasa, Kisumu, Machakos, and Kakamega) collected in 2010 by the Measurement, Learning & Evaluation project were used. Women aged 15-24 years, who had never been married, and were not living with a male partner at the time of survey (weighted n=2020) were included. Using weighted, multivariate Cox proportional hazard regression and logistic regression analyses, we assessed factors associated with three outcome measures: time to first sex, time to first pregnancy, and teenage pregnancy. Results One-half of our sample had ever had sex; the mean age at first sex among the sexually-experienced was 17.7 (± 2.6) years. About 15% had ever been pregnant; mean age at first pregnancy was 18.3 (±2.2) years. Approximately 11% had a teenage pregnancy. Three-quarters (76%) of those who had ever been pregnant (weighted n=306) reported the pregnancy was unwanted at the time. Having secondary education was associated with a later time to first sex and first pregnancy. In addition, religion, religiosity, and employment status were associated with time to first sex while city of residence, household size, characteristics of household head, family planning knowledge and misconceptions, and early sexual debut were significantly associated with time to first pregnancy. Education, city of residence, household wealth, early sexual debut, and contraceptive use at sexual debut were associated with teenage pregnancy for those 20-24 years. Conclusion Understanding risk and protective factors of youth sexual and reproductive health can inform programs to improve young people’s long-term potential by avoiding early and unintended

  10. Implementing school malaria surveys in Kenya: towards a national surveillance system

    PubMed Central

    2010-01-01

    Objective To design and implement surveys of malaria infection and coverage of malaria control interventions among school children in Kenya in order to contribute towards a nationwide assessment of malaria. Methods The country was stratified into distinct malaria transmission zones based on a malaria risk map and 480 schools were visited between October 2008 and March 2010. Surveys were conducted in two phases: an initial opportunistic phase whereby schools were selected for other research purposes; and a second phase whereby schools were purposively selected to provide adequate spatial representation across the country. Consent for participation was based on passive, opt-out consent rather than written, opt-in consent because of the routine, low-risk nature of the survey. All children were diagnosed for Plasmodium infection using rapid diagnostic tests, assessed for anaemia and were interviewed about mosquito net usage, recent history of illness, and socio-economic and household indicators. Children's responses were entered electronically in the school and data transmitted nightly to Nairobi using a mobile phone modem connection. RDT positive results were corrected by microscopy and all results were adjusted for clustering using random effect regression modelling. Results 49,975 children in 480 schools were sampled, at an estimated cost of US$ 1,116 per school. The overall prevalence of malaria and anaemia was 4.3% and 14.1%, respectively, and 19.0% of children reported using an insecticide-treated net (ITN). The prevalence of infection showed marked variation across the country, with prevalence being highest in Western and Nyanza provinces, and lowest in Central, North Eastern and Eastern provinces. Nationally, 2.3% of schools had reported ITN use >60%, and low reported ITN use was a particular problem in Western and Nyanza provinces. Few schools reported having malaria health education materials or ongoing malaria control activities. Conclusion School malaria

  11. Chemical composition and mosquito repellency of essential oil of Conyza newii propagated in different geographical locations of Kenya.

    PubMed

    Mayeku, W P; Omollo, N I; Odalo, O J; Hassanali, A

    2014-09-01

    Previously, essential oil of Conyza newii (Asterale: Asteracea, Oliv. & Hiern) growing in the northern part of West Pokot (35°E, 1°N) of Kenya was shown to be highly repellent [RD50 = 8.9 × 10(-5) mg/cm(2) , 95% confidence interval (CL)] to Anopheles gambiae s.s. Fumigant toxicity of the oil to the mosquito was also demonstrated. The major constituents of the oil were found to be monoterpenoids, including (S)-(-)-perillyl alcohol, (S)-(-)-perillaldehyde, geraniol, (R)-(+)-limonene, trans-β-ocimene and 1,8-cineol. In this study, the chemical composition and repellency of essential oils of the plant seedlings collected from West Pokot (35°E, 1°N) and propagated in seven different geographical regions of Kenya [West Pokot (35°E, 1°N), Kilome (37°E, 1°S), Naivasha (36°E, 0°), Webuye (34°E, 1°N), Nyakach (34°E, 0°), Kericho (35°E, 0°) and Nairobi (36°E, 1°S)] were compared. There were significant variations (P < 0.01, 95% CL) in the relative proportions of the six constituents and this was reflected in the repellency of the essential oils (P < 0.01, 95% CL). Higher repellency of the oil was associated with greater proportions of (S)-(-) perillyl alcohol, (S)-(-)-perillaldehyde and geraniol, and lower repellency was associated with an increased proportion of (R)-(+)-limonene. The results suggest significant epigenetic (chemotypic) variations in the repellency and composition of C. newii essential oils growing in different regions of Kenya. PMID:24266583

  12. Sexual risk-reduction strategies among HIV-infected men receiving ART in Kibera, Nairobi.

    PubMed

    Ragnarsson, Anders; Thorson, Anna; Dover, Paul; Carter, Jane; Ilako, Festus; Indalo, Dorcas; Ekstrom, Anna Mia

    2011-03-01

    This paper explores motivational factors and barriers to sexual behaviour change among men receiving antiretroviral treatment (ART). Twenty in-depth interviews were undertaken with male patients enrolled at the African Medical and Research Foundation clinic in Africa's largest urban informal settlement, Kibera in Nairobi, Kenya. All participants experienced prolonged and severe illness prior to the initiation of ART. Fear of symptom relapse was the main trigger for sexual behaviour change. Partner reduction was reported as a first option for behaviour change since this decision could be made by the individual. Condom use was perceived as more difficult as it had to be negotiated with female partners. Cultural norms regarding expectations for reproduction and marriage were not supportive of sexual risk-reduction strategies. Thus, local sociocultural contexts of HIV-infected people must be incorporated into the contextual adaptation and design of ART programmes and services as they have an over-riding influence on sexual behaviour and programme effectiveness. Also, HIV-prevention interventions need to address both personal, micro- and macro-level factors of behaviour to encourage individuals to take on sexual risk-reduction strategies. In order to achieve the anticipated preventive effect of ART, these issues are important for the donor community and policy-makers, who are the major providers of ART programme support within weak health systems in sub-Saharan Africa. PMID:21347894

  13. Women Who Have Sex with Women in Kenya and Their Sexual and Reproductive Health

    PubMed Central

    Zaidi, Sidra S.; Ocholla, Akinyi M.; Otieno, Rena A.

    2016-01-01

    Abstract Purpose: To describe sexual and reproductive health characteristics of women who have sex with women (WSW) in Kenya's three most populous cities: Kisumu, Mombasa, and Nairobi. Although the last decade has shown an upsurge of health-related research studies in African sexual minority populations, these studies have generally concentrated on the health status of men who have sex with men to the exclusion of WSW. This study presents the first findings on Kenyan WSW's sexual and reproductive health. Methods: A community-based, cross-sectional survey was conducted among 280 women who were at least 18 years old, had at least one female sexual partner in the past three years, and were Kenyan residents. Results: A significant proportion of participants reported that they had at least one male sexual partner in the past three years (38.9%), ever had an abortion (13.2%), been infected with at least one sexually transmitted infection (STI) in the past three years (33.9%), and been tested for HIV at least once (88.9%). Of the women who reported having been tested for HIV, 9.4% (7.5% of the total sample) received a positive test result. Some women noted that they were open with their doctors about their sexual orientation, and that their doctors had not reacted negatively to this information. Conclusion: WSW in Kenya are at risk for negative sexual and reproductive health outcomes, including HIV, STIs, unplanned pregnancy, and unsafe abortion, positioning these women as a critical population for public health efforts. Some WSW actively exercise their agency in making important health decisions. Therefore, this study indicates a need to incorporate WSW's health concerns within Kenyan national health policy programming. PMID:26684690

  14. High-Resolution Spatial Distribution and Estimation of Access to Improved Sanitation in Kenya

    PubMed Central

    Jia, Peng; Anderson, John D.; Leitner, Michael; Rheingans, Richard

    2016-01-01

    Background Access to sanitation facilities is imperative in reducing the risk of multiple adverse health outcomes. A distinct disparity in sanitation exists among different wealth levels in many low-income countries, which may hinder the progress across each of the Millennium Development Goals. Methods The surveyed households in 397 clusters from 2008–2009 Kenya Demographic and Health Surveys were divided into five wealth quintiles based on their national asset scores. A series of spatial analysis methods including excess risk, local spatial autocorrelation, and spatial interpolation were applied to observe disparities in coverage of improved sanitation among different wealth categories. The total number of the population with improved sanitation was estimated by interpolating, time-adjusting, and multiplying the surveyed coverage rates by high-resolution population grids. A comparison was then made with the annual estimates from United Nations Population Division and World Health Organization /United Nations Children's Fund Joint Monitoring Program for Water Supply and Sanitation. Results The Empirical Bayesian Kriging interpolation produced minimal root mean squared error for all clusters and five quintiles while predicting the raw and spatial coverage rates of improved sanitation. The coverage in southern regions was generally higher than in the north and east, and the coverage in the south decreased from Nairobi in all directions, while Nyanza and North Eastern Province had relatively poor coverage. The general clustering trend of high and low sanitation improvement among surveyed clusters was confirmed after spatial smoothing. Conclusions There exists an apparent disparity in sanitation among different wealth categories across Kenya and spatially smoothed coverage rates resulted in a closer estimation of the available statistics than raw coverage rates. Future intervention activities need to be tailored for both different wealth categories and nationally

  15. Decreased incidence of sexually transmitted diseases among trucking company workers in Kenya: results of a behavioural risk-reduction programme.

    PubMed

    Jackson, D J; Rakwar, J P; Richardson, B A; Mandaliya, K; Chohan, B H; Bwayo, J J; Ndinya-Achola, J O; Martin, H L; Moses, S; Kreiss, J K

    1997-06-01

    556 male HIV-seronegative male employees of trucking companies in Mombasa, Kenya, were exposed to HIV serological testing, individual counseling, condom promotion, and sexually transmitted disease (STD) diagnosis and management, and returned for at least one follow-up visit in a prospective study to measure changes in sexual behavior and STD incidence after the intervention. There was a significant decrease in sex with high-risk partners over the 1-year period of follow-up, but no change in condom use among study participants; 30% of men reported consistent condom use during extramarital sex throughout the study period. The change in heterosexual risk behavior was accompanied by a significant decrease in the incidence of gonorrhea, nongonococcal urethritis, and genital ulcer disease. The percentage of men reporting extramarital sex decreased from 49% to 36%, while contact with female prostitutes declined from 12% to 6%. PMID:9189216

  16. Zinc isotope ratios of bones and teeth as new dietary indicators: results from a modern food web (Koobi Fora, Kenya)

    PubMed Central

    Jaouen, Klervia; Beasley, Melanie; Schoeninger, Margaret; Hublin, Jean-Jacques; Richards, Michael P.

    2016-01-01

    In order to explore the possibilities of using zinc (Zn) stable isotope ratios as dietary indicators, we report here on the measurements of the ratio of stable isotopes of zinc (66Zn/64Zn, expressed here as δ66Zn) in bioapatite (bone and dental enamel) of animals from a modern food web in the Koobi Fora region of the Turkana Basin in Kenya. We demonstrate that δ66Zn values in both bone and enamel allow a clear distinction between carnivores and herbivores from this food web. Differences were also observed between browsers and grazers as well as between carnivores that consumed bone (i.e. hyenas) compared to those that largely consume flesh (i.e. lions). We conclude that Zn isotope ratio measurements of bone and teeth are a new and promising dietary indicator. PMID:27189145

  17. Zinc isotope ratios of bones and teeth as new dietary indicators: results from a modern food web (Koobi Fora, Kenya)

    NASA Astrophysics Data System (ADS)

    Jaouen, Klervia; Beasley, Melanie; Schoeninger, Margaret; Hublin, Jean-Jacques; Richards, Michael P.

    2016-05-01

    In order to explore the possibilities of using zinc (Zn) stable isotope ratios as dietary indicators, we report here on the measurements of the ratio of stable isotopes of zinc (66Zn/64Zn, expressed here as δ66Zn) in bioapatite (bone and dental enamel) of animals from a modern food web in the Koobi Fora region of the Turkana Basin in Kenya. We demonstrate that δ66Zn values in both bone and enamel allow a clear distinction between carnivores and herbivores from this food web. Differences were also observed between browsers and grazers as well as between carnivores that consumed bone (i.e. hyenas) compared to those that largely consume flesh (i.e. lions). We conclude that Zn isotope ratio measurements of bone and teeth are a new and promising dietary indicator.

  18. Zinc isotope ratios of bones and teeth as new dietary indicators: results from a modern food web (Koobi Fora, Kenya).

    PubMed

    Jaouen, Klervia; Beasley, Melanie; Schoeninger, Margaret; Hublin, Jean-Jacques; Richards, Michael P

    2016-01-01

    In order to explore the possibilities of using zinc (Zn) stable isotope ratios as dietary indicators, we report here on the measurements of the ratio of stable isotopes of zinc ((66)Zn/(64)Zn, expressed here as δ(66)Zn) in bioapatite (bone and dental enamel) of animals from a modern food web in the Koobi Fora region of the Turkana Basin in Kenya. We demonstrate that δ(66)Zn values in both bone and enamel allow a clear distinction between carnivores and herbivores from this food web. Differences were also observed between browsers and grazers as well as between carnivores that consumed bone (i.e. hyenas) compared to those that largely consume flesh (i.e. lions). We conclude that Zn isotope ratio measurements of bone and teeth are a new and promising dietary indicator. PMID:27189145

  19. Community experiences and perceptions of reproductive health vouchers in Kenya

    PubMed Central

    2013-01-01

    Background Research on demand-side health care financing approaches such as output-based aid (OBA) programs have focused on evaluating the role of the programs improving such outcomes as utilization of services and quality of services with limited focus on the experiences and perceptions of the target communities. This paper examines community members’ views of the output-based aid voucher program in Kenya. Methods A household survey was conducted in 2010 among 1,336 women aged 15-49 years living in the catchment areas of contracted health facilities in three districts participating in the voucher program (Kisumu, Kiambu and Kitui). Twenty seven focus group discussions were conducted with voucher users, non-users, opinion leaders and voucher distributors in the three districts as well as in Nairobi. Analysis of the quantitative data involved frequency distributions and cross-tabulations. Qualitative data were transcribed and analyzed by adopting framework analysis and further triangulation of themes across respondents. Results Majority (84%) of survey respondents had heard about the safe motherhood voucher compared to 24% and 1% that had heard about the family planning and gender-based violence recovery services (GBVRS) vouchers respectively. Similarly, 20% of the respondents had used the safe motherhood voucher compared to 2% for family planning and none for the GBVRS vouchers. From the community members’ perspectives, the voucher program is associated with improvements in access to health services for poor women, improved quality of care, and empowerment of women to make health care decisions. However, community members cited difficulties in accessing some accredited health facilities, limitations with the system of selling vouchers, lack of male involvement in women’s reproductive health issues, and poor understanding of the benefits associated with purchasing the voucher. Conclusion The findings of this paper showed that the voucher program in Kenya is

  20. Tuberculosis treatment outcomes among hospital workers at a public teaching and national referral hospital in Kenya

    PubMed Central

    Makori, L.; Gikera, M.; Wafula, J.; Chakaya, J.; Edginton, M. E.; Kumar, A. M. V.

    2013-01-01

    Setting: Kenyatta National Hospital (KNH), Nairobi, Ken-ya, a large referral and teaching hospital. Objective: 1) To document tuberculosis (TB) case notification rates and trends; 2) to describe demographic, clinical and workplace characteristics and treatment outcomes; and 3) to examine associations between demographic and clinical characteristics, HIV/AIDS (human immunodeficiency virus/acquired immune-deficiency syndrome) treatment and anti-tuberculosis treatment outcomes among hospital workers with TB at KNH during the period 2006–2011. Design: A retrospective cohort study involving a review of medical records. Results: The TB case notification rate among hospital staff ranged between 413 and 901 per 100 000 staff members per year; 51% of all cases were extra-pulmonary TB; 74% of all cases were among medical, paramedical and support staff. The TB-HIV coinfection rate was 60%. Only 75% had a successful treatment outcome. Patients in the retreatment category, those with unknown HIV status and those who were support staff had a higher risk of poor treatment outcomes. Conclusion: The TB case rate among hospital workers was unacceptably high compared to that of the general population, and treatment outcomes were poor. Infection control in the hospital and management of staff with TB requires urgent attention. PMID:26393055

  1. Pharmacy workers’ knowledge and provision of medication for termination of pregnancy in Kenya

    PubMed Central

    Reiss, Kate; Footman, Katharine; Akora, Vitalis; Liambila, Wilson; Ngo, Thoai D

    2016-01-01

    Objective To assess pharmacy workers’ knowledge and provision of abortion information and methods in Kenya. Methods In 2013 we interviewed 235 pharmacy workers in Nairobi, Mombasa and Kisumu about the medical abortion services they provide. We also used mystery clients, who made 401 visits to pharmacies to collect first-hand information on abortion practices. Results The majority (87.5%) of pharmacy workers had heard of misoprostol but only 39.2% had heard of mifepristone. We found that pharmacy workers had limited knowledge of correct medical abortion regimens, side effects and complications and the legal status of abortion drugs. 49.8% of pharmacy workers reported providing abortion information to clients and 4.3% reported providing abortion methods. 75.2% of pharmacies referred mystery clients to another provider, though 64.2% of pharmacies advised mystery clients to continue with their pregnancy. Pharmacy workers reported that they were experiencing demand for abortion services from clients. Conclusions Pharmacy workers are important providers of information and referrals for women seeking abortion, however their medical abortion knowledge is limited. Training pharmacy workers on medical abortion may improve the quality of information provided and access to safe abortion. PMID:26869694

  2. Notes from the Field: Ongoing Cholera Outbreak - Kenya, 2014-2016.

    PubMed

    George, Githuka; Rotich, Jacob; Kigen, Hudson; Catherine, Kiama; Waweru, Bonface; Boru, Waqo; Galgalo, Tura; Githuku, Jane; Obonyo, Mark; Curran, Kathryn; Narra, Rupa; Crowe, Samuel J; O'Reilly, Ciara E; Macharia, Daniel; Montgomery, Joel; Neatherlin, John; De Cock, Kevin M; Lowther, Sara; Gura, Zeinab; Langat, Daniel; Njeru, Ian; Kioko, Jackson; Muraguri, Nicholas

    2016-01-01

    On January 6, 2015, a man aged 40 years was admitted to Kenyatta National Hospital in Nairobi, Kenya, with acute watery diarrhea. The patient was found to be infected with toxigenic Vibrio cholerae serogroup O1, serotype Inaba. A subsequent review of surveillance reports identified four patients in Nairobi County during the preceding month who met either of the Kenya Ministry of Health suspected cholera case definitions: 1) severe dehydration or death from acute watery diarrhea (more than four episodes in 12 hours) in a patient aged ≥5 years, or 2) acute watery diarrhea in a patient aged ≥2 years in an area where there was an outbreak of cholera. An outbreak investigation was immediately initiated. A confirmed cholera case was defined as isolation of V. cholerae O1 or O139 from the stool of a patient with suspected cholera or a suspected cholera case that was epidemiologically linked to a confirmed case. By January 15, 2016, a total of 11,033 suspected or confirmed cases had been reported from 22 of Kenya's 47 counties (Table). The outbreak is ongoing. PMID:26820494

  3. Progress in Reversing the HIV Epidemic through Intensified Access to Antiretroviral Therapy: Results from a Nationally Representative Population-Based Survey in Kenya, 2012

    PubMed Central

    Kim, Andrea A.; Mukui, Irene; N’gan’ga, Lucy; Katana, Abraham; Koros, Dan; Wamicwe, Joyce; De Cock, Kevin M.

    2016-01-01

    Background In 2014, the Joint United Nations Programme on HIV/AIDS (UNAIDS) called for 90% of persons living with HIV (PLHIV) to know their status, 90% of these to be on antiretroviral therapy (ART), and 90% of these to be virally suppressed by 2020 (90-90-90). It is not clear whether planned ART scale-up in countries whose eligibility criteria for ART initiation are based on recommendations from the 2013 World Health Organization treatment guidelines will be sufficient to meet UNAIDS' new global targets. Materials and Methods Using data from a nationally representative population-based household survey of persons in Kenya we compared coverage and unmet need associated with HIV diagnosis, ART, and viral suppression among PLHIV aged 15–64 years in 2012 based on criteria outlined in the 2014 national ART guidelines and UNAIDS’ 90-90-90 goals. Estimates were weighted to account for sampling probability and nonresponse. Results Eight in ten PLHIV aged 15–64 years needed ART based on treatment eligibility. Need for treatment based on the national treatment policy was 97.4% of treatment need based on UNAIDS’ 90-90-90 goals, requiring an excess of 24,000 PLHIV to access treatment beyond those eligible for ART to achieve UNAIDS’ 90-90-90 treatment target. The gap in treatment coverage was high, ranging from 43.1% nationally to 52.3% in Nyanza among treatment-eligible PLHIV and 44.6% nationally to 52.4% in Nyanza among all PLHIV. Conclusion Maintaining the current pace of ART scale-up in Kenya will result in thousands of PLHIV unreached, many with high viral load and at-risk of transmitting infection to others. Careful strategies for reaching 90-90-90 will be instrumental in determining whether intensified access to treatment can be achieved to reach all who require ART. PMID:26930291

  4. Does Integrating Family Planning into HIV Services Improve Gender Equitable Attitudes? Results from a Cluster Randomized Trial in Nyanza, Kenya.

    PubMed

    Newmann, Sara J; Rocca, Corinne H; Zakaras, Jennifer M; Onono, Maricianah; Bukusi, Elizabeth A; Grossman, Daniel; Cohen, Craig R

    2016-09-01

    This study investigated whether integrating family planning (FP) services into HIV care was associated with gender equitable attitudes among HIV-positive adults in western Kenya. Surveys were conducted with 480 women and 480 men obtaining HIV services from 18 clinics 1 year after the sites were randomized to integrated FP/HIV services (N = 12) or standard referral for FP (N = 6). We used multivariable regression, with generalized estimating equations to account for clustering, to assess whether gender attitudes (range 0-12) were associated with integrated care and with contraceptive use. Men at intervention sites had stronger gender equitable attitudes than those at control sites (adjusted mean difference in scores = 0.89, 95 % CI 0.03-1.74). Among women, attitudes did not differ by study arm. Gender equitable attitudes were not associated with contraceptive use among men (AOR = 1.06, 95 % CI 0.93-1.21) or women (AOR = 1.03, 95 % CI 0.94-1.13). Further work is needed to understand how integrating FP into HIV care affects gender relations, and how improved gender equity among men might be leveraged to improve contraceptive use and other reproductive health outcomes. PMID:26837632

  5. Burden of HIV Infection Among Children Aged 18 Months to 14 Years in Kenya: Results From a Nationally Representative Population-Based Cross-sectional Survey

    PubMed Central

    Ng’eno, Bernadette; Mwangi, Ann; Ng’ang’a, Lucy; Kim, Andrea A.; Waruru, Anthony; Mukui, Irene; Ngugi, Evelyn W.; Rutherford, George W.

    2016-01-01

    Backgrounds In Kenya, mathematical models estimate that there are approximately 220,000 children aged less than 15 years infected with HIV. We analyzed data from the second Kenya AIDS Indicator Survey (KAIS 2012) to estimate the prevalence of HIV infection among children aged 18 months to 14 years. Methods KAIS 2012 was a nationally representative 2-stage cluster sample household survey. We studied children aged 18 months to 14 years whose parents or guardians answered questions pertaining to their children by interview. Blood specimens were collected for HIV serology and viral load measurement. Results We identified 5162 children who were eligible for the study. Blood was obtained for 3681 (71.3%) children. Among child participants, 16.4% had been tested for HIV infection in the past, and among children with parents or guardians who self-reported HIV-positive status, 52.9% had been tested for HIV infection. Twenty-eight (0.9%) children tested HIV-positive in the survey. Of these, 11 had been previously diagnosed with HIV infection before the survey. All 11 children were in HIV care and receiving cotrimoxazole; 8 were on antiretorivral therapy (ART). Among those on ART, 4 were virologically suppressed. Conclusions HIV causes a substantial burden of disease in the Kenyan pediatric population. Although most children who had been diagnosed with HIV before the survey were engaged in care and treatment, they represented less than half of HIV-infected children identified in the survey. Future efforts should focus on identifying infected children and getting them into care and on suppressive ART as early as possible. PMID:24732823

  6. Prevalence and Incidence of HIV Infection, Trends, and Risk Factors Among Persons Aged 15–64 Years in Kenya: Results From a Nationally Representative Study

    PubMed Central

    Kimanga, Davies O.; Ogola, Samuel; Umuro, Mamo; Ng’ang’a, Anne; Kimondo, Lucy; Murithi, Patrick; Muttunga, James; Waruiru, Wanjiru; Mohammed, Ibrahim; Sharrif, Shahnaaz; De Cock, Kevin M.; (UK), FRCP; Kim, Andrea A.

    2016-01-01

    Background Enhanced HIV surveillance using demographic, behavioral, and biologic data from national surveys can provide information to evaluate and respond to HIV epidemics efficiently. Methods From October 2012 to February 2013, we conducted a 2-stage cluster sampling survey of persons aged 18 months to 64 years in 9 geographic regions in Kenya. Participants answered questionnaires and provided blood for HIV testing. We estimated HIV prevalence, HIV incidence, described trends in HIV prevalence over the past 5 years, and identified factors associated with HIV infection. This analysis was restricted to persons aged 15–64 years. Results HIV prevalence was 5.6% [95% confidence interval (CI): 4.9 to 6.3] in 2012, a significant decrease from 2007, when HIV prevalence, excluding the North Eastern region, was 7.2% (95% CI: 6.6 to 7.9). HIV incidence was 0.5% (95% CI: 0.2 to 0.9) in 2012. Among women, factors associated with undiagnosed HIV infection included being aged 35–39 years, divorced or separated, from urban residences and Nyanza region, self-perceiving a moderate risk of HIV infection, condom use with the last partner in the previous 12 months, and reporting 4 or more lifetime number of partners. Among men, widowhood, condom use with the last partner in the previous 12 months, and lack of circumcision were associated with undiagnosed HIV infection. Conclusions HIV prevalence has declined in Kenya since 2007. With improved access to treatment, HIV prevalence has become more challenging to interpret without data on new infections and mortality. Correlates of undiagnosed HIV infection provide important information on where to prioritize prevention interventions to reduce transmission of HIV in the broader population. PMID:24445338

  7. Rheological variations across an active rift system -- results from lithosphere-scale 3D gravity and thermal models of the Kenya Rift

    NASA Astrophysics Data System (ADS)

    Meeßen, Christian; Sippel, Judith; Cacace, Mauro; Scheck-Wenderoth, Magdalena; Fishwick, Stewart; Heine, Christian; Strecker, Manfred R.

    2015-04-01

    Due to its tectono-volcanic activity and economic (geothermal and petroleum) potential, the eastern branch of the East African Rift System (EARS) is one of the best studied extensional systems worldwide and an important natural laboratory for the development of geodynamic concepts on rifting and nascent continental break-up. The Kenya Rift, an integral part of the eastern branch of the EARS, has formed in the area of weak Proterozoic crust of the Mozambique mobile belt adjacent to the rheologically stronger Archean Tanzania craton. To assess the variations in lithospheric strength between different tectonic domains and their influence on the tectonic evolution of the region, we developed a set of structural, density, thermal and rheological 3D models. For these models we integrated multi-disciplinary information, such as published geological field data, sediment thicknesses, well information, existing structural models, seismic refraction and reflection data, seismic tomography, gravity and heat-flow data. Our main approach focused on combined 3D isostatic and gravity modelling. The resulting lithosphere-scale 3D density model provides new insights into the depth distribution of the crust-mantle boundary and thickness variations of different crustal density domains. The latter further facilitate interpretations of variations of lithologies and related physical rock properties. By considering lithology-dependent heat production and thermal conductivity, we calculate the conductive thermal field across the region of the greater Kenya Rift. Finally, the assessed variations in lithology and temperature allow deriving differences in the integrated strength of the lithosphere across the different tectonic domains.

  8. Challenges in providing counselling to MSM in highly stigmatized contexts: results of a qualitative study from Kenya.

    PubMed

    Taegtmeyer, Miriam; Davies, Alun; Mwangome, Mary; van der Elst, Elisabeth M; Graham, Susan M; Price, Matt A; Sanders, Eduard J

    2013-01-01

    The role of men who have sex with men (MSM) in the African HIV epidemic is gaining recognition yet capacity to address the HIV prevention needs of this group is limited. HIV testing and counselling is not only a critical entry point for biomedical HIV prevention interventions, such as pre-exposure prophylaxis, rectal microbicides and early treatment initiation, but is also an opportunity for focused risk reduction counselling that can support individuals living in difficult circumstances. For prevention efforts to succeed, however, MSM need to access services and they will only do so if these are non-judgmental, informative, focused on their needs, and of clear benefit. This study aimed to understand Kenyan providers' attitudes towards and experiences with counselling MSM in a research clinic targeting this group for HIV prevention. We used in-depth interviews to explore values, attitudes and cognitive and social constructs of 13 counsellors and 3 clinicians providing services to MSM at this clinic. Service providers felt that despite their growing experience, more targeted training would have been helpful to improve their effectiveness in MSM-specific risk reduction counselling. They wanted greater familiarity with MSM in Kenya to better understand the root causes of MSM risk-taking (e.g., poverty, sex work, substance abuse, misconceptions about transmission, stigma, and sexual desire) and felt frustrated at the perceived intractability of some of their clients' issues. In addition, they identified training needs on how to question men about specific risk behaviours, improved strategies for negotiating risk reduction with counselling clients, and improved support supervision from senior counsellors. This paper describes the themes arising from these interviews and makes practical recommendations on training and support supervision systems for nascent MSM HIV prevention programmes in Africa. PMID:23762241

  9. Challenges in Providing Counselling to MSM in Highly Stigmatized Contexts: Results of a Qualitative Study from Kenya

    PubMed Central

    Taegtmeyer, Miriam; Davies, Alun; Mwangome, Mary; van der Elst, Elisabeth M.; Graham, Susan M.; Price, Matt A.; Sanders, Eduard J.

    2013-01-01

    The role of men who have sex with men (MSM) in the African HIV epidemic is gaining recognition yet capacity to address the HIV prevention needs of this group is limited. HIV testing and counselling is not only a critical entry point for biomedical HIV prevention interventions, such as pre-exposure prophylaxis, rectal microbicides and early treatment initiation, but is also an opportunity for focused risk reduction counselling that can support individuals living in difficult circumstances. For prevention efforts to succeed, however, MSM need to access services and they will only do so if these are non-judgmental, informative, focused on their needs, and of clear benefit. This study aimed to understand Kenyan providers' attitudes towards and experiences with counselling MSM in a research clinic targeting this group for HIV prevention. We used in-depth interviews to explore values, attitudes and cognitive and social constructs of 13 counsellors and 3 clinicians providing services to MSM at this clinic. Service providers felt that despite their growing experience, more targeted training would have been helpful to improve their effectiveness in MSM-specific risk reduction counselling. They wanted greater familiarity with MSM in Kenya to better understand the root causes of MSM risk-taking (e.g., poverty, sex work, substance abuse, misconceptions about transmission, stigma, and sexual desire) and felt frustrated at the perceived intractability of some of their clients' issues. In addition, they identified training needs on how to question men about specific risk behaviours, improved strategies for negotiating risk reduction with counselling clients, and improved support supervision from senior counsellors. This paper describes the themes arising from these interviews and makes practical recommendations on training and support supervision systems for nascent MSM HIV prevention programmes in Africa. PMID:23762241

  10. Task Shifting the Management of Non-Communicable Diseases to Nurses in Kibera, Kenya: Does It Work?

    PubMed Central

    Some, David; Edwards, Jeffrey K.; Reid, Tony; Van den Bergh, Rafael; Kosgei, Rose J.; Wilkinson, Ewan; Baruani, Bienvenu; Kizito, Walter; Khabala, Kelly; Shah, Safieh; Kibachio, Joseph; Musembi, Phylles

    2016-01-01

    Background In sub-Saharan Africa there is an increasing need to leverage available health care workers to provide care for non-communicable diseases (NCDs). This study was conducted to evaluate adherence to Médecins Sans Frontières clinical protocols when the care of five stable NCDs (hypertension, diabetes mellitus type 2, epilepsy, asthma, and sickle cell) was shifted from clinical officers to nurses. Methods Descriptive, retrospective review of routinely collected clinic data from two integrated primary health care facilities within an urban informal settlement, Kibera, Nairobi, Kenya (May to August 2014). Results There were 3,554 consultations (2025 patients); 733 (21%) were by nurses out of which 725 met the inclusion criteria among 616 patients. Hypertension (64%, 397/616) was the most frequent NCD followed by asthma (17%, 106/616) and diabetes mellitus (15%, 95/616). Adherence to screening questions ranged from 65% to 86%, with an average of 69%. Weight and blood pressure measurements were completed in 89% and 96% of those required. Laboratory results were reviewed in 91% of indicated visits. Laboratory testing per NCD protocols was higher in those with hypertension (88%) than diabetes mellitus (67%) upon review. Only 17 (2%) consultations were referred back to clinical officers. Conclusion Nurses are able to adhere to protocols for managing stable NCD patients based on clear and standardized protocols and guidelines, thus paving the way towards task shifting of NCD care to nurses to help relieve the significant healthcare gap in developing countries. PMID:26812079

  11. “Making it”: Understanding adolescent resilience in two informal settlements (slums) in Nairobi, Kenya

    PubMed Central

    Kabiru, Caroline W.; Beguy, Donatien; Ndugwa, Robert P.; Zulu, Eliya M.; Jessor, Richard

    2013-01-01

    Many adolescents living in contexts characterized by adversity achieve positive outcomes. We adopt a protection-risk conceptual framework to examine resilience (academic achievement, civic participation, and avoidance of risk behaviors) among 1,722 never-married 12-19 year olds living in two Kenyan urban slums. We find stronger associations between explanatory factors and resilience among older (15-19 years) than younger (12-14 years) adolescents. Models for pro-social behavior and models for anti-social behavior emerge as key predictors of resilience. Further accumulation of evidence on risk and protective factors is needed to inform interventions to promote positive outcomes among youth situated in an ecology of adversity. PMID:24382935

  12. "Making It": Understanding Adolescent Resilience in Two Informal Settlements (Slums) in Nairobi, Kenya

    ERIC Educational Resources Information Center

    Kabiru, Caroline W.; Beguy, Donatien; Ndugwa, Robert P.; Zulu, Eliya M.; Jessor, Richard

    2012-01-01

    Many adolescents living in contexts characterized by adversity achieve positive outcomes. We adopt a protection-risk conceptual framework to examine resilience (academic achievement, civic participation, and avoidance of risk behaviors) among 1,722 never-married 12-19 year olds living in two Kenyan urban slums. We find stronger associations…

  13. Transition into First Sex among Adolescents in Slum and Non-Slum Communities in Nairobi, Kenya

    ERIC Educational Resources Information Center

    Kabiru, Caroline W.; Beguy, Donatien; Undie, Chi-Chi; Zulu, Eliya Msiyaphazi; Ezeh, Alex C.

    2010-01-01

    While early sexual experiences are a key marker of the transition from childhood to adulthood, it is widely acknowledged that precocious initiation of sexual activity predisposes adolescents to negative health and psychological outcomes. Extant studies investigating adolescent sexuality in sub-Saharan Africa often rely on cross-sectional data…

  14. The Nature, Challenges and Consequences of Urban Youth Unemployment: A Case of Nairobi City, Kenya

    ERIC Educational Resources Information Center

    Muiya, Bernard Munyao

    2014-01-01

    Globally, decline in employment has affected the youth more compared to other cohorts with youth in developing countries being particularly hard hit. There have been various interventions by the Kenyan government to address the challenge of youth employment through human capital development like the Youth Enterprise Development Fund (YEFD).…

  15. Factors Associated with Sexual Activity among High-School Students in Nairobi, Kenya

    ERIC Educational Resources Information Center

    Kabiru, Caroline W.; Orpinas, Pamela

    2009-01-01

    The high level of HIV infection in sub-Saharan Africa has led to an increased interest in understanding the determinants of sexual activity among young people, who are at high risk of sexually transmitted infections. The present study examined sociodemographic, behavioral, and psychosocial factors associated with heterosexual activity among a…

  16. Evaluation of Library Utilization by Students Enrolled in External Degree Programme in University of Nairobi, Kenya

    ERIC Educational Resources Information Center

    Gor, Peter Ochieng

    2012-01-01

    With the increasing popularity of distance education, focus has turned to the role of libraries in distance learning process. It is widely agreed that like their campus-based counterparts, distance education learners need adequate library services if they are to gain quality education. This study sought to examine library utilization by students…

  17. Correlates of Condom Use among Male High School Students in Nairobi, Kenya

    ERIC Educational Resources Information Center

    Kabiru, Caroline W.; Orpinas, Pamela

    2009-01-01

    Background: Correct and consistent condom use is an effective strategy to reduce the risk of sexually transmitted infections (STIs). This study examines sociodemographic, behavioral, and psychosocial characteristics of 3 groups of adolescent males: consistent, sporadic, and non-condom users. Methods: The sample consisted of 931 sexually…

  18. Public preferences and priorities for end-of-life care in Kenya: a population-based street survey

    PubMed Central

    2014-01-01

    Background End-of-life care needs are great in Africa due to the burden of disease. This study aimed to explore public preferences and priorities for end-of-life care in Nairobi, Kenya. Methods Population-based street survey of Kenyans aged ≥18; researchers approached every 10th person, alternating men and women. Structured interviews investigated quality vs. quantity of life, care priorities, preferences for information, decision-making, place of death (most and least favourite) and focus of care in a hypothetical scenario of serious illness with <1 year to live. Descriptive analysis examined variations. Results 201 individuals were interviewed (100 women) representing 17 tribes (n = 90 44.8%, Kikuyu). 56.7% (n = 114) said they would always like to be told if they had limited time left. The majority (n = 121, 61.4%) preferred quality of life over quantity i.e. extending life (n = 47, 23.9%). Keeping a positive attitude and ensuring relatives/friends were not worried were prioritised above having pain/discomfort relieved. The three most concerning problems were pain (45.8%), family burden (34.8%) and personal psychological distress (29.8%). Home was both the most (51.1% n = 98) and least (23.7% n = 44) preferred place of death. Conclusion This first population-based survey on preferences and priorities for end-of-life care in Africa revealed that psycho-social domains were of greatest importance to the public, but also identified variations that require further exploration. If citizens’ preferences and priorities are to be met, the development of end-of-life care services to deliver preferences in Kenya should ensure an holistic model of palliative care responsive to individual preferences across care settings including at home. PMID:24529217

  19. Lack of Knowledge of HIV Status a Major Barrier to HIV Prevention, Care and Treatment Efforts in Kenya: Results from a Nationally Representative Study

    PubMed Central

    Cherutich, Peter; Kaiser, Reinhard; Galbraith, Jennifer; Williamson, John; Shiraishi, Ray W.; Ngare, Carol; Mermin, Jonathan; Marum, Elizabeth; Bunnell, Rebecca

    2012-01-01

    Background We analyzed HIV testing rates, prevalence of undiagnosed HIV, and predictors of testing in the Kenya AIDS Indicator Survey (KAIS) 2007. Methods KAIS was a nationally representative sero-survey that included demographic and behavioral indicators and testing for HIV, HSV-2, syphilis, and CD4 cell counts in the population aged 15–64 years. We used gender-specific multivariable regression models to identify factors independently associated with HIV testing in sexually active persons. Results Of 19,840 eligible persons, 80% consented to interviews and blood specimen collection. National HIV prevalence was 7.1% (95% CI 6.5–7.7). Among ever sexually active persons, 27.4% (95% CI 25.6–29.2) of men and 44.2% (95% CI 42.5–46.0) of women reported previous HIV testing. Among HIV-infected persons, 83.6% (95% CI 76.2–91.0) were unaware of their HIV infection. Among sexually active women aged 15–49 years, 48.7% (95% CI 46.8–50.6) had their last HIV test during antenatal care (ANC). In multivariable analyses, the adjusted odds ratio (AOR) for ever HIV testing in women ≥35 versus 15–19 years was 0.2 (95% CI: 0.1–0.3; p<0.0001). Other independent associations with ever HIV testing included urban residence (AOR 1.6, 95% CI: 1.2–2.0; p = 0.0005, women only), highest wealth index versus the four lower quintiles combined (AOR 1.8, 95% CI: 1.3–2.5; p = 0.0006, men only), and an increasing testing trend with higher levels of education. Missed opportunities for testing were identified during general or pregnancy-specific contacts with health facilities; 89% of adults said they would participate in home-based HIV testing. Conclusions The vast majority of HIV-infected persons in Kenya are unaware of their HIV status, posing a major barrier to HIV prevention, care and treatment efforts. New approaches to HIV testing provision and education, including home-based testing, may increase coverage. Targeted interventions should involve sexually active men

  20. Facing Kenya's energy predicament

    SciTech Connect

    O'Keefe, P.; Shakow, D.

    1980-06-01

    Kenya's bleak economic future is not helped by its dependence on foreign oil and lack of fossil-fuel reserves. At a conference on Kenya's energy needs, held in May 1979, options for averting a fuel-food crisis were considered. Recognition of Kenya's resource poverty and the immediate need to establish wood-fuel production products, charcoal conversion, conservation projects, and a research agenda were the main themes of that conference and the bases for a Kenyan energy policy.

  1. Barriers to contraceptive use in Kenya.

    PubMed

    Kamau, R K; Karanja, J; Sekadde-Kigondu, C; Ruminjo, J K; Nichols, D; Liku, J

    1996-10-01

    This study was designed to identify and to better understand the barriers to contraceptive use among Kenyan-couples. Data were collected through structured interviews and focus group discussions among couples not planning for pregnancy and not using any effective contraceptive method. The study was conducted in the Baba Dogo urban slum area of Nairobi, and Chwele, a rural sub-location in Bungoma, western Kenya. Some important barriers to contraceptive use were identified in couples wishing to space or limit further births. Those barriers included lack of agreement on contraceptive use and on reproductive intentions; husband's attitude on his role as a decision maker; perceived undesirable side effects, distribution and infant mortality; negative traditional practices and desires such as naming relatives, and preference for sons as security in old age. There were also gaps in knowledge on contraceptive methods, fears, rumours and misconceptions about specific methods and unavailability or poor quality of services in the areas studied. This paper recommends that information and educational programmes should be instituted to increase contraceptive knowledge, to emphasise the value of quality of life over traditional reproductive practices and desires, and to improve availability and quality of services. PMID:8997845

  2. Oral Health Training Programs for Community and Professional Health Care Workers in Nairobi East District Increases Identification of HIV-Infected Patients

    PubMed Central

    Koyio, Lucina N.; van der Sanden, Wil J. M.; Dimba, Elizabeth; Mulder, Jan; Creugers, Nico H. J.; Merkx, Matthias A. W.; van der Ven, Andre; Frencken, Jo E.

    2014-01-01

    Background Better knowledge and skills for diagnosis and management of human immunodeficiency virus (HIV) related oral lesions by primary healthcare workers (PHWs) may increase recognition of HIV-related oral lesions (HROLs) and may improve implementation of HIV testing in Kenya. For this purpose training programs at health facility and community level were evaluated. Design and Methods A pre-post control-test group design in two administrative divisions of Nairobi East District was used. Clinical competencies of PHWs (n = 32 intervention, and n = 27 control) at health facility level were assessed 9 months after training, and after 6 months for community health workers, (CHWs) (n = 411 intervention and n = 404 control) using written questionnaires, clinical data and patient interviews. Effects on referral for HIV testing and actual HIV testing were assessed by comparing laboratory registries pre- and post training. Results PHWs in intervention (n = 27; 84%) and control (n = 15; 60%) divisions, and CHWs in intervention (n = 330; 80%) and control (189; 47%) divisions, completed all questionnaires. Trained PHWs significantly increased their knowledge of HROLs (p<0.02), frequency of oral examinations, diagnosis of HROLs and referral of patients with HROLs for HIV testing. Trained CHWs significantly gained knowledge about HROLs (p<0.02) and referred more patients with HROLs to health facilities. Overall percentage of HIV-positive test results was three-fold for HROLs compared to non-HROLs. Specifically, 70% of patients with oro pharyngeal candidiasis (OPC), the most commonly diagnosed HROL, were confirmed as being HIV-positive. Increase in overall HIV testing rates (1.6% pre-, 1.2% post training) and overall percentage of HIV-positive results (13% pre-, 16% post-intervention) was not significant. Conclusion Training programs significantly increased PHW and CHW knowledge, recognition and management of HROLs but increased neither overall HIV

  3. Poor Infant Feeding Practices and High Prevalence of Malnutrition in Urban Slum Child Care Centres in Nairobi: A Pilot Study.

    PubMed

    Mwase, Ivan; Mutoro, Antonina; Owino, Victor; Garcia, Ada L; Wright, Charlotte M

    2016-02-01

    Little is known about the style and quality of feeding and care provided in child day-care centres in slum areas. This study purposively sampled five day-care centres in Nairobi, Kenya, where anthropometric measurements were collected among 33 children aged 6-24 months. Mealtime interactions were further observed in 11 children from four centres, using a standardized data collection sheet. We recorded the child actions, such as mood, interest in food, distraction level, as well as caregiver actions, such as encouragement to eat, level of distraction and presence of neutral actions. Of the 33 children assessed, with a mean age of 15.9 ± 4.9 months, 14 (42%) were female. Undernutrition was found in 13 (39%) children with at least one Z score <-2 or oedema (2): height for age <-2 (11), weight for age <-2 (11), body mass index for age <-2 (4). Rates of undernutrition were highest (9 of 13; 69%) in children aged 18-24 months. Hand-washing before the meal was lacking in all centres. Caregivers were often distracted and rarely encouraged children to feed, with most children eating less than half of their served meal. Poor hygiene coupled with non-responsive care practices observed in the centres is a threat to child health, growth and development. PMID:26507408

  4. Impact evaluation of a community-based intervention for prevention of cardiovascular diseases in the slums of Nairobi: the SCALE-UP study

    PubMed Central

    van de Vijver, Steven; Oti, Samuel Oji; Gomez, Gabriela B.; Agyemang, Charles; Egondi, Thaddaeus; van Charante, Eric Moll; Brewster, Lizzy M.; Hankins, Catherine; Tanovic, Zlata; Ezeh, Alex; Kyobutungi, Catherine; Stronks, Karien

    2016-01-01

    Background A combination of increasing urbanization, behaviour change, and lack of health services in slums put the urban poor specifically at risk of cardiovascular disease (CVD). This study aimed to evaluate the impact of a community-based CVD prevention intervention on blood pressure (BP) and other CVD risk factors in a slum setting in Nairobi, Kenya. Design Prospective intervention study includes awareness campaigns, household visits for screening, and referral and treatment of people with hypertension. The primary outcome was overall change in mean systolic blood pressure (SBP), while secondary outcomes were changes in awareness of hypertension and other CVD risk factors. We evaluated the intervention's impact through consecutive cross-sectional surveys at baseline and after 18 months, comparing outcomes of intervention and control group, through a difference-in-difference method. Results We screened 1,531 and 1,233 participants in the intervention and control sites. We observed a significant reduction in mean SBP when comparing before and after measurements in both intervention and control groups, −2.75 mmHg (95% CI −4.33 to −1.18, p=0.001) and −1.67 mmHg (95% CI −3.17 to −0.17, p=0.029), respectively. Among people with hypertension at baseline, SBP was reduced by −14.82 mmHg (95% CI −18.04 to −11.61, p<0.001) in the intervention and −14.05 (95% CI −17.71 to −10.38, p<0.001) at the control site. However, comparing these two groups, we found no difference in changes in mean SBP or hypertension prevalence. Conclusions We found significant declines in SBP over time in both intervention and control groups. However, we found no additional effect of a community-based intervention involving awareness campaigns, screening, referral, and treatment. Possible explanations include the beneficial effect of baseline measurements in the control group on behaviour and related BP levels, and the limited success of treatment and suboptimal adherence in

  5. Men's Understanding of and Experiences During the Postcircumcision Abstinence Period: Results From a Field Study of ShangRing Circumcision During Routine Clinical Services in Kenya and Zambia

    PubMed Central

    Li, Philip S.; Zulu, Robert; Awori, Quentin D.; Agot, Kawango; Combes, Stephanie; Simba, Raymond O.; Lee, Richard K.; Hart, Catherine; Lai, Jaim Jou; Zyambo, Zude; Goldstein, Marc; Feldblum, Paul J.; Sokal, David C.

    2016-01-01

    Background: Men's understanding of counseling messages after voluntary medical male circumcision (VMMC) plays an important role in whether they follow them. Data on triggers for early resumption of sex may be useful as scale-up of VMMC for HIV prevention continues in sub-Saharan Africa. Methods: Data on understanding of post-VMMC abstinence recommendations, resumption of sex, condom use, and triggers for resuming sex were collected from participants during a follow-up interview 35–42 days after ShangRing circumcision in Kenya and Zambia. Results: Of 1149 men who had ShangRing circumcision, 1096 (95.4%) completed follow-up. Nearly all (99.2%) reported being counseled to abstain from sex post-VMMC; among those, most (92.2%) recalled the recommended abstinence period was 6 weeks. Most men (94.1%) reported that the counselor gave reasons for post-VMMC abstinence and recalled appropriate reasons. Few (13.4%) men reported resuming sex at 35–42 days' follow-up. Among those, 54.8% reported never using a condom post-VMMC. Younger participants (odds ratio 0.3, 95% confidence interval: 0.2 to 0.5, P < 0.0001) and those reporting at least some condom use at baseline (odds ratio 0.5, 95% confidence interval: 0.3 to 0.7, P = 0.0003) were less likely to report resuming sex. Among men who reported some condom use, most (71.5%) said condoms were much easier or easier to use after circumcision. Men reported various reasons for early resumption of sex, primarily strong sexual desire (76.4%). Conclusions: Most men reported awareness of and adherence to the counseling recommendations for post-VMMC abstinence. A minority reported early resumption of sex, and, among those, condom use was low. Results could be used to improve post-VMMC counseling. PMID:27331585

  6. Estimating the Prevalence and Predictors of Incorrect Condom Use Among Sexually Active Adults in Kenya: Results From a Nationally Representative Survey

    PubMed Central

    Grasso, Michael A.; Schwarcz, Sandra; Galbraith, Jennifer S.; Musyoki, Helgar; Kambona, Caroline; Kellogg, Timothy A.

    2016-01-01

    Background Condom use continues to be an important primary prevention tool to reduce the acquisition and transmission of HIV and other sexually transmitted infections. However, incorrect use of condoms can reduce their effectiveness. Methods Using data from a 2012 nationally representative cross-sectional household survey conducted in Kenya, we analyzed a subpopulation of sexually active adults and estimated the percent that used condoms incorrectly during sex, and the type of condom errors. We used multivariable logistic regression to determine variables to be independently associated with incorrect condom use. Results Among 13,720 adolescents and adults, 8014 were sexually active in the previous 3 months (60.3%; 95% confidence interval [CI], 59.0–61.7). Among those who used a condom with a sex partner, 20% (95% CI, 17.4–22.6) experienced at least one instance of incorrect condom use in the previous 3 months. Of incorrect condom users, condom breakage or leakage was the most common error (52%; 95% CI, 44.5–59.6). Factors found to be associated with incorrect condom use were multiple sexual partnerships in the past 12 months (2 partners: adjusted odds ratio [aOR], 1.5; 95% CI, 1.0–2.0; P = 0.03; ≥3: aOR, 2.3; 95% CI, 1.5–3.5; P < 0.01) and reporting symptoms of a sexually transmitted infection (aOR, 2.8; 95% CI, 1.8–4.3; P < 0.01). Conclusions Incorrect condom use is frequent among sexually active Kenyans and this may translate into substantial HIV transmission. Further understanding of the dynamics of condom use and misuse, in the broader context of other prevention strategies, will aid program planners in the delivery of appropriate interventions aimed at limiting such errors. PMID:26766524

  7. Effects of antenatal care and HIV treatment integration on elements of the PMTCT cascade: Results from the SHAIP cluster-randomized controlled trial in Kenya

    PubMed Central

    Turan, Janet M.; Onono, Maricianah; Steinfeld, Rachel L.; Shade, Starley B.; Owuor, Kevin; Washington, Sierra; Bukusi, Elizabeth A.; Ackers, Marta L.; Kioko, Jackson; Interis, Evelyn C.; Cohen, Craig R.

    2015-01-01

    Background Integrating antenatal care (ANC) and HIV care may improve uptake and retention in services along the prevention of mother-to-child transmission (PMTCT) cascade. The current study aimed to determine if integration of HIV services into ANC settings improves PMTCT service utilization outcomes. Methods ANC clinics in rural Kenya were randomized to integrated (6 clinics, 569 women) or non-integrated (6 clinics, 603 women) services. Intervention clinics provided all HIV services, including highly active antiretroviral therapy (HAART), while control clinics provided PMTCT services but referred women to HIV care clinics within the same facility. PMTCT utilization outcomes among HIV-infected women (maternal HIV care enrollment, HAART initiation, and 3-month infant HIV testing uptake) were compared using generalized estimating equations and Cox regression. Results HIV care enrollment was higher in intervention compared to control clinics (69% versus 36%, Odds Ratio (OR)=3.94, 95% Confidence Interval (CI): 1.14–13.63). Median time to enrollment was significantly shorter among intervention arm women (0 versus 8 days, Hazard Ratio (HR)=2.20, 95% CI: 1.62–3.01). Eligible women in the intervention arm were more likely to initiate HAART (40% versus 17%, OR=3.22, 95% CI: 1.81–5.72). Infant testing was more common in the intervention arm (25% versus 18%), however not statistically different. No significant differences were detected in postnatal service uptake or maternal retention. Conclusions Service integration increased maternal HIV care enrollment and HAART uptake. However, PMTCT utilization outcomes were still suboptimal, and postnatal service utilization remained poor in both study arms. Further improvements in the PMTCT cascade will require additional research and interventions. PMID:25967269

  8. Understanding the Impact of Subsidizing Artemisinin-Based Combination Therapies (ACTs) in the Retail Sector – Results from Focus Group Discussions in Rural Kenya

    PubMed Central

    Kedenge, Sarah V.; Kangwana, Beth P.; Waweru, Evelyn W.; Nyandigisi, Andrew J.; Pandit, Jayesh; Brooker, Simon J.; Snow, Robert W.; Goodman, Catherine A.

    2013-01-01

    Background There is considerable interest in the potential of private sector subsidies to increase availability and affordability of artemisinin-based combination therapies (ACTs) for malaria treatment. A cluster randomized trial of such subsidies was conducted in 3 districts in Kenya, comprising provision of subsidized packs of paediatric ACT to retail outlets, training of retail staff, and community awareness activities. The results demonstrated a substantial increase in ACT availability and coverage, though patient counselling and adherence were suboptimal. We conducted a qualitative study in order to understand why these successes and limitations occurred. Methodology/Principal Findings Eighteen focus group discussions were conducted, 9 with retailers and 9 with caregivers, to document experiences with the intervention. Respondents were positive about intervention components, praising the focused retailer training, affordable pricing, strong promotional activities, dispensing job aids, and consumer friendly packaging, which are likely to have contributed to the positive access and coverage outcomes observed. However, many retailers still did not stock ACT, due to insufficient supplies, lack of capital and staff turnover. Advice to caregivers was poor due to insufficient time, and poor recall of instructions. Adherence by caregivers to dosing guidelines was sub-optimal, because of a wish to save tablets for other episodes, doses being required at night, stopping treatment when the child felt better, and the number and bitter taste of the tablets. Caregivers used a number of strategies to obtain paediatric ACT for older age groups. Conclusions/Significance This study has highlighted that important components of a successful ACT subsidy intervention are regular retailer training, affordable pricing, a reliable supply chain and community mobilization emphasizing patient adherence and when to seek further care. PMID:23342143

  9. Additional results on palaeomagnetic stratigraphy of the Koobi Fora Formation, east of Lake Turkana (Lake Rudolf), Kenya

    USGS Publications Warehouse

    Hillhouse, J.W.; Ndombi, J.W.M.; Cox, A.; Brock, A.

    1977-01-01

    The magnetostratigraphy of the hominid-bearing sediments exposed east of Lake Turkana has been strengthened by new palaeomagnetic results. Ages obtained from several tuffs by the 40Ar/39Ar method suggest an approxmate match between the observed magnetozones and the geomagnetic polarity time scale; however, the palaeomagnetic results are also compatible with a younger chronology suggested by conventional K-Ar dating of the KBS Tuff. ?? 1977 Nature Publishing Group.

  10. Trends in Causes of Adult Deaths among the Urban Poor: Evidence from Nairobi Urban Health and Demographic Surveillance System, 2003-2012.

    PubMed

    Mberu, Blessing; Wamukoya, Marylene; Oti, Samuel; Kyobutungi, Catherine

    2015-06-01

    What kills people around the world and how it varies from place to place and over time is critical in mapping the global burden of disease and therefore, a relevant public health question, especially in developing countries. While more than two thirds of deaths worldwide are in developing countries, little is known about the causes of death in these nations. In many instances, vital registration systems are nonexistent or at best rudimentary, and even when deaths are registered, data on the cause of death in particular local contexts, which is an important step toward improving context-specific public health, are lacking. In this paper, we examine the trends in the causes of death among the urban poor in two informal settlements in Nairobi by applying the InterVA-4 software to verbal autopsy data. We examine cause of death data from 2646 verbal autopsies of deaths that occurred in the Nairobi Urban Health and Demographic Surveillance System (NUHDSS) between 1 January 2003 and 31 December 2012 among residents aged 15 years and above. The data is entered into the InterVA-4 computer program, which assigns cause of death using probabilistic modeling. The results are presented as annualized trends from 2003 to 2012 and disaggregated by gender and age. Over the 10-year period, the three major causes of death are tuberculosis (TB), injuries, and HIV/AIDS, accounting for 26.9, 20.9, and 17.3% of all deaths, respectively. In 2003, HIV/AIDS was the highest cause of death followed by TB and then injuries. However, by 2012, TB and injuries had overtaken HIV/AIDS as the major causes of death. When this is examined by gender, HIV/AIDS was consistently higher for women than men across all the years generally by a ratio of 2 to 1. In terms of TB, it was more evenly distributed across the years for both males and females. We find that there is significant gender variation in deaths linked to injuries, with male deaths being higher than female deaths by a ratio of about 4 to 1. We

  11. Access and Attitudes to HPV Vaccination amongst Hard-To-Reach Populations in Kenya

    PubMed Central

    Watson-Jones, Deborah; Mugo, Nelly; Lees, Shelley; Mathai, Muthoni; Vusha, Sophie; Ndirangu, Gathari; Ross, David A.

    2015-01-01

    Background Sub-Saharan Africa bears the greatest burden of cervical cancer. Human papillomavirus (HPV) vaccination programmes to prevent the disease will need to reach vulnerable girls who may not be able access health and screening services in the future. We conducted formative research on facilitators and barriers to HPV vaccination and potential acceptability of a future HPV vaccination programme amongst girls living in hard-to-reach populations in Kenya. Methods Stakeholder interviews with Ministry of Health staff explored barriers to and support for the uptake of HPV vaccination. A situation assessment was conducted to assess community services in Maasai nomadic pastoralist communities in Kajiado County and in Korogocho informal settlement in Nairobi city, followed by focus group discussions (n=14) and semi-structured interviews (n=28) with health workers, parents, youth, and community and religious leaders. These covered marriage, knowledge of cervical cancer and HPV, factors that might inhibit or support HPV vaccine uptake and intention to accept HPV vaccine if a programme was in place. Results Reported challenges to an HPV vaccination programme included school absenteeism and drop-out, early age of sex and marriage, lack of parental support, population mobility and distance from services. Despite little prior knowledge of cervical cancer and HPV, communities were interested in receiving HPV vaccination. Adequate social mobilisation and school-based vaccination, supplemented by out-reach activities, were considered important facilitating factors to achieve high coverage. There was some support for a campaign approach to vaccine delivery. Conclusions Given the high level of support for a vaccine against cervical cancer and the experience of reaching pastoralist and slum-dwellers for other immunizations, implementing an HPV vaccine programme should be feasible in such hard-to-reach communities. This may require additional delivery strategies in addition to the

  12. Sexual reproductive health service provision to young people in Kenya; health service providers’ experiences

    PubMed Central

    2013-01-01

    Background Addressing the sexual and reproductive health (SRH) needs of young people remains a challenge for most developing countries. This study explored the perceptions and experiences of Health Service Providers (HSP) in providing SRH services to young people in Kenya. Methods Qualitative study conducted in eight health facilities; five from Nairobi and three rural district hospitals in Laikipia, Meru Central, and Kirinyaga. Nineteen in-depth interviews (IDI) and two focus group discussions (FGD) were conducted with HSPs. Interviews were tape recorded and transcribed. Data was coded and analysed using the thematic framework approach. Results The majority of HSPs were aware of the youth friendly service (YFS) concept but not of the supporting national policies and guidelines. HSP felt they lacked competency in providing SRH services to young people especially regarding counselling and interpersonal communication. HSPs were conservative with regards to providing SRH services to young people particularly contraception. HSP reported being torn between personal feelings, cultural and religious values and beliefs and their wish to respect young people’s rights to accessing and obtaining SRH services. Conclusion Supporting youth friendly policies and competency based training of HSP are two common approaches used to improve SRH services for adolescents. However, these may not be sufficient to change HSPs’ attitude to adolescents seeking help. There is need to address the cultural, religious and traditional value systems that prevent HSPs from providing good quality and comprehensive SRH services to young people. Training updates should include sessions that enable HSPs to evaluate how their personal and cultural values and beliefs influence practice. PMID:24229365

  13. The Tupange Project in Kenya: A Multifaceted Approach to Increasing Use of Long-Acting Reversible Contraceptives

    PubMed Central

    Muthamia, Michael; Owino, Kenneth; Nyachae, Paul; Kilonzo, Margaret; Kamau, Mercy; Otai, Jane; Kabue, Mark; Keyonzo, Nelson

    2016-01-01

    ABSTRACT Background: Long-acting reversible contraceptives (LARCs) are safe and highly effective, and they have higher continuation rates than short-acting methods. Because only a small percentage of sexually active women in Kenya use LARCs, the Tupange project implemented a multifaceted approach to increase uptake of LARCs, particularly among the urban poor. The project included on-site mentoring, whole-site orientation, commodity security, quality improvement, and multiple demand-promotion and service-provision strategies, in the context of wide method choice. We report on activities in Nairobi between July 2011 and December 2014, the project implementation period. Methods: We used a household longitudinal survey of women of reproductive age to measure changes in the contraceptive prevalence rate (CPR) and other family planning-related variables. At baseline in July 2010, 2,676 women were interviewed; about 50% were successfully tracked and interviewed at endline in December 2014. A baseline service delivery point (SDP) survey of 112 health facilities and 303 service providers was conducted in July 2011, and an endline SDP survey was conducted in December 2014 to measure facility-based interventions. The SDP baseline survey was conducted after the household survey, as facilities were selected based on where clients said they obtained services. Results: The project led to significant increases in use of implants and intrauterine devices (IUDs). Uptake of implants increased by 6.5 percentage points, from 2.4% at baseline to 8.9% by endline, and uptake of IUDs increased by 2.1 percentage points, from 2.2% to 4.3%. By the endline survey, 37.7% of clients using pills and injectables at baseline had switched to LARCs. Contraceptive use among the poorest and poor wealth quintiles increased by 20.5 and 21.5 percentage points, respectively, from baseline to endline. Various myths and misconceptions reported about family planning methods declined significantly between

  14. Contraceptive Practices and Fertility Desires Among HIV-Infected and Uninfected Women in Kenya: Results From a Nationally Representative Study

    PubMed Central

    Ngugi, Evelyn W.; Kim, Andrea A.; Nyoka, Raymond; Ng’ang’a, Lucy; Mukui, Irene; Ng’eno, Bernadette; Rutherford, George W.

    2016-01-01

    Background Prevention of unplanned pregnancies is a critical element in the prevention of mother-to-child transmission of HIV infection, but its potential has not been fully realized. We assessed the utilization of family planning (FP) and fertility desires among women of reproductive age by HIV status. Methods We selected a nationally representative sample of households using a stratified 2-stage cluster design and surveyed women aged 15–49 years. We administered questionnaires and examined predictors of current use of FP and desire for children among sexually active women with known HIV infection and women who were HIV uninfected. Results Of 3583 respondents, 68.2% were currently using FP, and 57.7% did not desire children in the future. Among women who did not desire children in the future, 70.9% reported that they were using FP, including 68.7% of women with known HIV infection and 71.0% of women who were HIV uninfected. Women with known HIV infection had similar odds of using FP as women with no HIV infection (odds ratio, 1.12; 95% confidence interval: 0.81 to 1.54). Women with no HIV infection had significantly higher adjusted odds of desiring future children (adjusted OR, 2.27; 95% confidence interval: 1.31 to 3.93) than women with known HIV infection. Conclusions There is unmet need for FP for HIV-infected women, underscoring a gap in the national prevention of mother-to-child transmission of HIV strategy. Efforts to empower HIV-infected women to prevent unintended pregnancies should lead to expanded access to contraceptive methods and take into account women’s reproductive intentions. PMID:24413040

  15. Factors affecting motivation and retention of primary health care workers in three disparate regions in Kenya

    PubMed Central

    2014-01-01

    Background The World Health Organization (WHO) and the Government of Kenya alike identify a well-performing health workforce as key to attaining better health. Nevertheless, the motivation and retention of health care workers (HCWs) persist as challenges. This study investigated factors influencing motivation and retention of HCWs at primary health care facilities in three different settings in Kenya - the remote area of Turkana, the relatively accessible region of Machakos, and the disadvantaged informal urban settlement of Kibera in Nairobi. Methods A cross-sectional cluster sample design was used to select 59 health facilities that yielded interviews with 404 health care workers, grouped into 10 different types of service providers. Data were collected in November 2011 using structured questionnaires and a Focus Group Discussion guide. Findings were analyzed using bivariate and multivariate methods of the associations and determinants of health worker motivation and retention. Results The levels of education and gender factors were lowest in Turkana with female HCWs representing only 30% of the workers against a national average of 53%. A smaller proportion of HCWs in Turkana feel that they have adequate training for their jobs. Overall, 13% of the HCWs indicated that they had changed their job in the last 12 months and 20% indicated that they could leave their current job within the next two years. In terms of work environment, inadequate access to electricity, equipment, transport, housing, and the physical state of the health facility were cited as most critical, particularly in Turkana. The working environment is rated as better in private facilities. Adequate training, job security, salary, supervisor support, and manageable workload were identified as critical satisfaction factors. Family health care, salary, and terminal benefits were rated as important compensatory factors. Conclusions There are distinct motivational and retention factors that affect

  16. Determinants for HIV testing and counselling in Nairobi urban informal settlements

    PubMed Central

    2011-01-01

    Background Counselling and testing is important in HIV prevention and care. Majority of people in sub-Saharan Africa do not know their HIV status and are therefore unable to take steps to prevent infection or take up life prolonging anti-retroviral drugs in time if infected. This study aimed at exploring determinants of HIV testing and counselling in two Nairobi informal settlements. Methods Data are derived from a cross-sectional survey nested in an ongoing demographic surveillance system. A total of 3,162 individuals responded to the interview and out of these, 82% provided a blood sample which was tested using rapid test kits. The outcome of interest in this paper was HIV testing status in the past categorised as "never tested"; "client-initiated testing and counselling (CITC)" and provider-initiated testing and counselling (PITC). Multinomial logistic regression was used to identify determinants of HIV testing. Results Approximately 31% of all respondents had ever been tested for HIV through CITC, 22% through PITC and 42% had never been tested but indicated willingness to test. Overall, 62% of females and 38% of males had ever been tested for HIV. Males were less likely to have had CITC (OR = 0.47; p value < 0.001) and also less likely to have had PITC (OR = 0.16; p value < 0.001) compared to females. Individuals aged 20-24 years were more likely to have had either CITC or PITC compared to the other age groups. The divorced/separated/widowed were more likely (OR = 1.65; p value < 0.01) to have had CITC than their married counterparts, while the never married were less likely to have had either CITC or PITC. HIV positive individuals (OR = 1.60; p value < 0.01) and those who refused testing in the survey (OR = 1.39; p value < 0.05) were more likely to have had CITC compared to their HIV negative counterparts. Conclusion Although the proportion of individuals ever tested in the informal settlements is similar to the national average, it remains low compared to

  17. Pregnant Women's Intentions and Subsequent Behaviors Regarding Maternal and Neonatal Service Utilization: Results from a Cohort Study in Nyanza Province, Kenya.

    PubMed

    Creanga, Andreea A; Odhiambo, George Awino; Odera, Benjamin; Odhiambo, Frank O; Desai, Meghna; Goodwin, Mary; Laserson, Kayla; Goldberg, Howard

    2016-01-01

    Higher use of maternal and neonatal health (MNH) services may reduce maternal and neonatal mortality in Kenya. This study aims to: 1) prospectively explore women's intentions to use MNH services (antenatal care, delivery in a facility, postnatal care, neonatal care) at <20 and 30-35 weeks' gestation and their actual use of these services; 2) identify predictors of intention-behavior discordance among women with positive service use intentions; 3) examine associations between place of delivery, women's reasons for choosing it, and birthing experiences. We used data from a 2012-2013 population-based cohort of pregnant women in the Demographic Surveillance Site in Nyanza province, Kenya. Of 1,056 women completing the study (89.1% response rate), 948 had live-births and 22 stillbirths, and they represent our analytic sample. Logistic regression analysis identified predictors of intention-behavior discordance regarding delivery in a facility and use of postnatal and neonatal care. At <20 and 30-35 weeks' gestation, most women intended to seek MNH services (≥93.9% and ≥87.5%, respectively, for all services assessed). Actual service use was high for antenatal (98.1%) and neonatal (88.5%) care, but lower for delivery in a facility (76.9%) and postnatal care (51.8%). Woman's age >35 and high-school education were significant predictors of intention-behavior discordance regarding delivery in a facility; several delivery-related factors were significantly associated with intention-behavior discordance regarding use of postnatal and neonatal care. Delivery facilities were chosen based on proximity to women's residence, affordability, and service quality; among women who delivered outside a health facility, 16.3% could not afford going to a facility. Good/very good birth experiences were reported by 93.6% of women who delivered in a facility and 32.6% of women who did not. We found higher MNH service utilization than previously documented in Nyanza province. Further

  18. Diagnosis of sexually transmitted infections and bacterial vaginosis among HIV-1-infected pregnant women in Nairobi

    PubMed Central

    Marx, G; John-Stewart, G; Bosire, R; Wamalwa, D; Otieno, P; Farquhar, C

    2011-01-01

    Summary HIV-infected women with sexually transmitted infections (STIs) or bacterial vaginosis (BV) during pregnancy are at increased risk for poor obstetric outcomes. In resource-limited settings, diagnostic testing for STIs and BV is often not available and most pregnant women are managed using syndromic algorithms. As part of a Nairobi perinatal cohort, HIV-1-infected pregnant women were interviewed and samples were collected for STIs and BV testing. Diagnostic accuracy of STIs and BV by syndromic algorithms was evaluated with comparison to the reference standard. Among 441 women, prevalence of BV was 37%, trichomoniasis 16%, chlamydia 4%, syphilis 3% and gonorrhoea 2%. Significantly more women with STIs were aged 21-years-old, had not attended secondary school and had a history of STIs. Syndromic diagnosis of STIs and BV demonstrated a sensitivity of 45% and 57%, and positive predictive value of 30% and 42%, respectively. Among these HIV-infected, pregnant women, STIs and vaginal infections were common and syndromic diagnosis was insensitive, resulting in missed opportunities to intervene and improve infant and maternal health. PMID:20975086

  19. Women's Nutribusiness cooperatives in Kenya: an integrated strategy for sustaining rural livelihoods.

    PubMed

    Maretzki, Audrey N

    2007-01-01

    With funding provided by the Center for Higher Education of the United States Agency for International Development, The Pennsylvania State University and Tuskegee University collaborated with the University of Nairobi in establishing women's NutriBusiness Cooperatives in the Rift Valley and Central Provinces of Kenya. Between 1992 and 1999, the cooperatives were established, facilities and equipment were supplied and extensive participatory training was provided by university-affiliated investigators and project staff. This initiative enabled approximately 2500 rural Kenyan women farmers to add value to their crops by processing and locally marketing nutritious, convenient, culturally-appropriate weaning food mixes. Implementation of the NutriBusiness model is described and challenges of cultural engagement are highlighted. PMID:17996628

  20. Delivering Prevention Interventions to People Living with HIV in Clinical Care Settings: Results of a Cluster Randomized Trial in Kenya, Namibia, and Tanzania

    PubMed Central

    Kidder, Daniel; Medley, Amy; Pals, Sherri L.; Carpenter, Deborah; Howard, Andrea; Antelman, Gretchen; DeLuca, Nicolas; Muhenje, Odylia; Sheriff, Muhsin; Somi, Geoffrey; Katuta, Frieda; Cherutich, Peter; Moore, Janet

    2016-01-01

    We conducted a group randomized trial to assess the feasibility and effectiveness of a multi-component, clinic-based HIV prevention intervention for HIV-positive patients attending clinical care in Namibia, Kenya, and Tanzania. Eighteen HIV care and treatment clinics (six per country) were randomly assigned to intervention or control arms. Approximately 200 sexually active clients from each clinic were enrolled and interviewed at baseline and 6- and 12-months post-intervention. Mixed model logistic regression with random effects for clinic and participant was used to assess the effectiveness of the intervention. Of 3522 HIV-positive patients enrolled, 3034 (86 %) completed a 12-month follow-up interview. Intervention participants were significantly more likely to report receiving provider-delivered messages on disclosure, partner testing, family planning, alcohol reduction, and consistent condom use compared to participants in comparison clinics. Participants in intervention clinics were less likely to report unprotected sex in the past 2 weeks (OR = 0.56, 95 % CI 0.32, 0.99) compared to participants in comparison clinics. In Tanzania, a higher percentage of participants in intervention clinics (17 %) reported using a highly effective method of contraception compared to participants in comparison clinics (10 %, OR = 2.25, 95 % CI 1.24, 4.10). This effect was not observed in Kenya or Namibia. HIV prevention services are feasible to implement as part of routine care and are associated with a self-reported decrease in unprotected sex. Further operational research is needed to identify strategies to address common operational challenges including staff turnover and large patient volumes. PMID:26995678

  1. Delivering Prevention Interventions to People Living with HIV in Clinical Care Settings: Results of a Cluster Randomized Trial in Kenya, Namibia, and Tanzania.

    PubMed

    Bachanas, Pamela; Kidder, Daniel; Medley, Amy; Pals, Sherri L; Carpenter, Deborah; Howard, Andrea; Antelman, Gretchen; DeLuca, Nicolas; Muhenje, Odylia; Sheriff, Muhsin; Somi, Geoffrey; Katuta, Frieda; Cherutich, Peter; Moore, Janet

    2016-09-01

    We conducted a group randomized trial to assess the feasibility and effectiveness of a multi-component, clinic-based HIV prevention intervention for HIV-positive patients attending clinical care in Namibia, Kenya, and Tanzania. Eighteen HIV care and treatment clinics (six per country) were randomly assigned to intervention or control arms. Approximately 200 sexually active clients from each clinic were enrolled and interviewed at baseline and 6- and 12-months post-intervention. Mixed model logistic regression with random effects for clinic and participant was used to assess the effectiveness of the intervention. Of 3522 HIV-positive patients enrolled, 3034 (86 %) completed a 12-month follow-up interview. Intervention participants were significantly more likely to report receiving provider-delivered messages on disclosure, partner testing, family planning, alcohol reduction, and consistent condom use compared to participants in comparison clinics. Participants in intervention clinics were less likely to report unprotected sex in the past 2 weeks (OR = 0.56, 95 % CI 0.32, 0.99) compared to participants in comparison clinics. In Tanzania, a higher percentage of participants in intervention clinics (17 %) reported using a highly effective method of contraception compared to participants in comparison clinics (10 %, OR = 2.25, 95 % CI 1.24, 4.10). This effect was not observed in Kenya or Namibia. HIV prevention services are feasible to implement as part of routine care and are associated with a self-reported decrease in unprotected sex. Further operational research is needed to identify strategies to address common operational challenges including staff turnover and large patient volumes. PMID:26995678

  2. Spectrum of Microbial Diseases and Resistance Patterns at a Private Teaching Hospital in Kenya: Implications for Clinical Practice

    PubMed Central

    Maina, Daniel; Omuse, Geoffrey; Revathi, Gunturu; Adam, Rodney D.

    2016-01-01

    Background Accurate local prevalence of microbial diseases and microbial resistance data are vital for optimal treatment of patients. However, there are few reports of these data from developing countries, especially from sub-Saharan Africa. The status of Aga Khan University Hospital Nairobi as an internationally accredited hospital and a laboratory with an electronic medical record system has made it possible to analyze local prevalence and antimicrobial susceptibility data and compare it with other published data. Methods We have analyzed the spectrum of microbial agents and resistance patterns seen at a 300 bed tertiary private teaching hospital in Kenya using microbial identity and susceptibility data captured in hospital and laboratory electronic records between 2010 and 2014. Results For blood isolates, we used culture collection within the first three days of hospitalization as a surrogate for community onset, and within that group, Escherichia coli was the most common, followed by Staphylococcus aureus. In contrast, Candida spp. and Klebsiella pneumoniae were the most common hospital onset causes of bloodstream infection. Antimicrobial resistance rates for the most commonly isolated Gram negative organisms was higher than many recent reports from Europe and North America. In contrast, Gram positive resistance rates were quite low, with 94% of S. aureus being susceptible to oxacillin and only rare isolates of vancomycin-resistant enterococci. Conclusions The current report demonstrates high rates of antimicrobial resistance in Gram negative organisms, even in outpatients with urinary tract infections. On the other hand, rates of resistance in Gram positive organisms, notably S. aureus, are remarkably low. A better understanding of the reasons for these trends may contribute to ongoing efforts to combat antimicrobial resistance globally. PMID:26807811

  3. Mucosal Blood Group Antigen Expression Profiles and HIV Infections: A Study among Female Sex Workers in Kenya

    PubMed Central

    Chanzu, Nadia Musimbi; Mwanda, Walter; Oyugi, Julius; Anzala, Omu

    2015-01-01

    Background The ABO blood group antigens are carbohydrate moieties expressed on human red blood cells however; these antigens can also be expressed on some other cells particularly the surface of epithelial cells and may be found in mucosal secretions. In many human populations 80% secrete ABO antigens (termed ‘secretors’) while 20% do not (termed ‘non-secretors’). Furthermore, there are disease conditions that are associated with secretor status. Objective To investigate correlations between secretor status and HIV infection among female sex workers in Nairobi, Kenya. Methodology This cross-sectional study recruited 280 female sex workers aged 18–65 years from the Pumwani Majengo cohort, Kenya. Blood typing was determined by serological techniques using monoclonal antibodies to the ABO blood group antigens. Secretor phenotyping was determined using anti-H specific lectins specific to salivary, vaginal and cervical blood group H antigen using the agglutination inhibition technique and correlated to individual HIV sero-status. Participants were additionally screened for Bacterial vaginosis, Neisseria gonorrhoea and Trichomonas vaginalis. Results Out of the 280 participants, 212 (75.7%) were secretors and 68 (24.3%) were non-secretors. The incidence of all infections: HIV, Bacterial vaginosis, Neisseria gonorrhoea and Trichomonas vaginalis was higher among secretors compared to non-secretors. However, this difference was only statistically significant for HIV infection incidence rates: HIV infected secretors (83.7%) versus HIV un-infected secretors (71.8%) (p = 0.029) Based on ABO phenotype stratification, the incidence of HIV infection was higher among blood group A secretors (26/52 = 50%), in comparison to B (12/39 = 33.3%: p = 0.066), AB (3/9 = 33.3%: p = 0.355), and O secretors (36/112 = 32.1%: p = 0.028). Conclusion This is the first report to document the variable expression of the ABH blood group antigens profiling secretor and non-secretor phenotypes

  4. University/City Partnerships: Creating Policy Networks for Urban Transformation in Nairobi

    ERIC Educational Resources Information Center

    Klopp, Jacqueline; Ngau, Peter; Sclar, Elliot

    2011-01-01

    This paper describes an innovative collaboration between the Center for Sustainable Urban Development at Columbia University and the Department of Urban and Regional Planning at the University of Nairobi. By bringing universities into urban policy networks, this partnership aims to re-shape pedagogy, policy and research action for sustainable…

  5. Antecedent Factors Affecting Academic Performance of Graduate Students at the Nairobi Evangelical Graduate School of Theology

    ERIC Educational Resources Information Center

    Mbogo, Rosemary Wahu

    2016-01-01

    This paper reports the findings of a Master's level thesis work that was done in 1997 to assess the antecedent factors affecting the academic performance of graduate students at the Nairobi Evangelical School of Theology (N.E.G.S.T.), which is currently Africa International University (AIU). The paper reviews the effect of lack of finance on…

  6. Developing a Nursing Database System in Kenya

    PubMed Central

    Riley, Patricia L; Vindigni, Stephen M; Arudo, John; Waudo, Agnes N; Kamenju, Andrew; Ngoya, Japheth; Oywer, Elizabeth O; Rakuom, Chris P; Salmon, Marla E; Kelley, Maureen; Rogers, Martha; St Louis, Michael E; Marum, Lawrence H

    2007-01-01

    Objective To describe the development, initial findings, and implications of a national nursing workforce database system in Kenya. Principal Findings Creating a national electronic nursing workforce database provides more reliable information on nurse demographics, migration patterns, and workforce capacity. Data analyses are most useful for human resources for health (HRH) planning when workforce capacity data can be linked to worksite staffing requirements. As a result of establishing this database, the Kenya Ministry of Health has improved capability to assess its nursing workforce and document important workforce trends, such as out-migration. Current data identify the United States as the leading recipient country of Kenyan nurses. The overwhelming majority of Kenyan nurses who elect to out-migrate are among Kenya's most qualified. Conclusions The Kenya nursing database is a first step toward facilitating evidence-based decision making in HRH. This database is unique to developing countries in sub-Saharan Africa. Establishing an electronic workforce database requires long-term investment and sustained support by national and global stakeholders. PMID:17489921

  7. Environmental and comfort upgrading through lean technologies in informal settlements: Case study in Nairobi, Kenia and New Delhi, India

    NASA Astrophysics Data System (ADS)

    De Angelis, Enrico; Tagliabue, Lavinia Chiara; Zecchini, Paolo; Milanesi, Mattia

    2016-07-01

    Informal settlements, namely slums (or bidonville or favelas) are one of the stronger challenge for urban context in developing countries. The increase of urban population leads to a widespread poverty and critical life conditions for a large segment of population, in particular in Sub-Saharan Africa, where a high percentage of people lives in informal settlements. The problems in slums are multiple: people suffer malnutrition and poor sanitation, flooding or drought, and live in shelters providing no thermal comfort in many days of the year, furthermore scarce and highly polluting energy sources are available. Climate change and an unavoidable heat island effect make these living conditions nearly catastrophic. This paper focuses on the main characters of these slums and on how to what promote the improvement of living conditions with a lean, low cost, low impact, feasible upgrading of the housing or more properly shelters. The subject of the analysis is the Mathare 4A Upgrading Programme in the city of Nairobi, Kenya, one of the highest slum-dwellers growing rate. The technological solutions applied in this context have been verified in a different climate condition such as the city of New Delhi, India where the phenomenon of the slums is significantly burdensome. The analysis of the comfort conditions inside a type housing has been carried out using hourly weather data and dynamic heat transfer simulation, without any HVAC system and striving only natural ventilation. Data about internal temperature and relative humidity conditions have been applied to evaluate the comfort hours using the Predicted Mean Vote method, the adaptive thermal comfort principles and the bioclimatic charts for the two climates in Nairobi and New Delhi. The percentage of hours within the comfort range and the amount of degree-hours exceeding comfort values showed for different upgrading strategies, how it is possible to deeply influence the living conditions by technological and

  8. Potential Applications of LANDSAT Data in Energy Management Associated with Kenya's Forests

    NASA Technical Reports Server (NTRS)

    Maghenda, M. M.; Bloemer, H. L.; Brumfield, J. O.

    1982-01-01

    LANDSAT can be effectively used to monitor the extent and magnitude of forest cover change in Kenya in order to evaluate the potential for energy supply. Digital processing of LANDSAT data provides a reliable monitoring technique for forest resource management in Kenya. Data analysis was used to illustrate that Kenya's forests are indeed diminishing. A model used to make projections for the availability of fuelwood as an energy source is presented. The resulting figures imply that Kenya's forest will all but disappear around the end of the 20th century. Analysis of LANDSAT data for Mau East substantiates these alarming findings.

  9. A Look at Kenya's Children.

    ERIC Educational Resources Information Center

    Roberson, Glenda F.; Muoki, Isaac Mulatya

    Focusing on the education of young children in Kenya, this brief paper contains excerpts from a question and answer interview between two early childhood educators from the United States and Kenya. Both similarities and differences of the Kenyan and the U.S. system of education are revealed. Interview topics covered include the following: socially…

  10. A retrospective study of characteristics of impacted mandibular wisdom teeth in 110 patients treated in Nairobi, Kenya.

    PubMed

    Guthua, S W; Mwaniki, D L

    1992-01-01

    Analysis of 110 records of patients who presented with impacted mandibular 3rd molars was carried out to determine the frequency of occurrence of unilateral and bilateral impactions and their characteristics. 68.2% of the patients had bilateral impactions. Among the patients with bilateral impactions, 72% had mesioangular impaction occurring either bilaterally or in combination with other types of impaction. Furthermore, 38.7% mesioangular impactions were observed on the right and left sides in the patients with bilateral impactions. Among the patients with unilateral impactions 40.2% presented with mesioangular impaction, while 25.7% presented with distoangular impactions. While these observations support the general consensus regarding aetiology of mandibular 3rd molar impactions as being tooth-tissue discrepancy, the possible influence of other factors is suggested. PMID:1344275

  11. A Phenomenological Study of Sexual Harassment and Violence among Girls Attending High Schools in Urban Slums, Nairobi, Kenya

    ERIC Educational Resources Information Center

    Abuya, Benta A.; Onsomu, Elijah O.; Moore, DaKysha; Sagwe, Jackline

    2012-01-01

    In 2003, 31% of young Kenyan women ages 15-24 reported sexual harassment and violence (SHV), with a majority experiencing sexual debut due to coercion (Central Bureau of Statistics, 2004). Data were obtained from a sample of 20 girls attending school in Kamu and Lafamu (pseudonyms used for the study sites), 10 girls who had dropped out of school,…

  12. Students' Perceived Challenges in an Online Collaborative Learning Environment: A Case of Higher Learning Institutions in Nairobi, Kenya

    ERIC Educational Resources Information Center

    Muuro, Maina Elizaphan; Wagacha, Waiganjo Peter; Oboko, Robert; Kihoro, John

    2014-01-01

    Earlier forms of distance education were characterized by minimal social interaction like correspondence, television, video and radio. However, the World Wide Web (WWW) and online learning introduced the opportunity for much more social interaction, particularly among learners, and this has been further made possible through social media in Web…

  13. Community participation to refine measures of socio-economic status in urban slum settings in Kenya.

    PubMed

    Ngongo, Carrie Jane; Mathingau, Florence Alice; Burke, Heather; Brieger, William; Frick, Kevin; Chapman, Kimberly; Breiman, Robert

    Ownership of household durable assets can be a useful proxy for determining relative socio-economic status in a community, but the assets that should be measured are not always unambiguous. Often the selection of asset variables has been ad hoc or not well explained in the literature. Although the benefits of conducting focus groups to design surveys are widely recognized, the use of focus groups to adapt community-specific asset indices has not previously been reported in Kenya. This article describes how focus group discussions can allow communities to express how residents value assets and distinguish relative wealth. Focus group discussions were conducted within the informal urban settlement of Kibera in Nairobi, Kenya. Participants identified assets that distinguish between the poorest and the least poor in their community. They considered whether they would move away from the slum if they had the opportunity, and many would not, citing reasons ranging from loyalty to the community to greater living expenses on the outside. Local perceptions of relative poverty and mobility provide insight into how quality of life in this setting can be assessed and potentially improved. Moreover, a qualitative approach can lead to the adaptation of a community asset index for use in further research. PMID:18644763

  14. Factors affecting actualisation of the WHO breastfeeding recommendations in urban poor settings in Kenya.

    PubMed

    Kimani-Murage, Elizabeth W; Wekesah, Frederick; Wanjohi, Milka; Kyobutungi, Catherine; Ezeh, Alex C; Musoke, Rachel N; Norris, Shane A; Madise, Nyovani J; Griffiths, Paula

    2015-07-01

    Poor breastfeeding practices are widely documented in Kenya, where only a third of children are exclusively breastfed for 6 months and only 2% in urban poor settings. This study aimed to better understand the factors that contribute to poor breastfeeding practices in two urban slums in Nairobi, Kenya. In-depth interviews (IDIs), focus group discussions (FGDs) and key informant interviews (KIIs) were conducted with women of childbearing age, community health workers, village elders and community leaders and other knowledgeable people in the community. A total of 19 IDIs, 10 FGDs and 11 KIIs were conducted, and were recorded and transcribed verbatim. Data were coded in NVIVO and analysed thematically. We found that there was general awareness regarding optimal breastfeeding practices, but the knowledge was not translated into practice, leading to suboptimal breastfeeding practices. A number of social and structural barriers to optimal breastfeeding were identified: (1) poverty, livelihood and living arrangements; (2) early and single motherhood; (3) poor social and professional support; (4) poor knowledge, myths and misconceptions; (5) HIV; and (6) unintended pregnancies. The most salient of the factors emerged as livelihoods, whereby women have to resume work shortly after delivery and work for long hours, leaving them unable to breastfeed optimally. Women in urban poor settings face an extremely complex situation with regard to breastfeeding due to multiple challenges and risk behaviours often dictated to them by their circumstances. Macro-level policies and interventions that consider the ecological setting are needed. PMID:25521041

  15. Use of Population-based Surveillance to Determine the Incidence of Rotavirus Gastroenteritis in an Urban Slum and a Rural Setting in Kenya

    PubMed Central

    Breiman, Robert F.; Cosmas, Leonard; Audi, Allan; Mwiti, William; Njuguna, Henry; Bigogo, Godfrey M.; Olack, Beatrice; Ochieng, John B.; Wamola, Newton; Montgomery, Joel M.; Williamson, John; Parashar, Umesh D.; Burton, Deron C.; Tate, Jacqueline E.; Feikin, Daniel R.

    2015-01-01

    Background Rotavirus gastroenteritis is a major cause of mortality among children <2 years of age. Disease burden data are important for introducing and sustaining new rotavirus vaccines in immunization programs. Methods We analyzed population-based infectious disease surveillance data from 2007 to 2010 from Kenyan sites in rural and urban slum areas. Stool specimens were collected from patients of all ages presenting to study clinics with diarrheal disease and tested for rotavirus by enzyme immunoassay. Incidence rates were adjusted using data on healthcare utilization (from biweekly home visits) and proportion of stools collected at study clinics from patients meeting case definitions. Results Rotavirus was detected in 285 (9.0%) of 3174 stools tested, including 122 (11.9%) from children <5 years of age and 162 (7.6%) from participants ≥5 years of age. Adjusted incidence rates for infants were 13,419 and 12,135 per 100,000 person-years of observation in rural and urban areas, respectively. Adjusted incidence rates were high in adults across age ranges. The rates suggest that annually, among children <5 years of age, there are >54,500 cases of rotavirus-associated gastroenteritis in rural Nyanza Province and >16,750 cases in Nairobi urban slums. Conclusions Community-based surveillance in urban and rural Kenya suggests that rotavirus plays an important role as a cause of acute gastroenteritis in adults, as well as in children. In addition to substantially preventing illness and complications from diarrheal disease in children, rotavirus infant immunization has the potential of indirectly preventing diarrheal disease in older children and adults, assuming children are the predominant sources of transmission. PMID:24343615

  16. Is Working Risky or Protective for Married Adolescent Girls in Urban Slums in Kenya? Understanding the Association between Working Status, Savings and Intimate-Partner Violence

    PubMed Central

    Muthengi, Eunice; Gitau, Tabither; Austrian, Karen

    2016-01-01

    Introduction Previous studies have shown that women’s empowerment, though beneficial in many aspects, can also increase the risk of intimate-partner violence (IPV). This study seeks to examine the association between work and experience of physical violence among married adolescents, and to understand the impact of access to independent financial resources on this risk. Authors draw on the asset-building framework and the ecological model. Methods The data is from a baseline survey of girls aged 15–19 residing in urban slums in four cities and towns in Kenya (Nairobi, Thika, Nakuru and Kisumu). The analytic sample is 452 married girls. Logistic regression is used to examine associations between working status, savings and experience of IPV in the previous six months, controlling for other factors. This is complemented by content analysis of in-depth interviews with 32 adolescent girls and 16 young men. Results Compared to girls who did not work, working with no regular savings was significantly associated with greater odds (OR = 1.96, p<0.01) of experiencing IPV. There was no difference between girls who did not work and those who worked but had regular savings. Qualitative findings indicate savings decrease girls’ dependency on men and allow them to leave abusive partners. Discussion Findings imply that in these communities with patriarchal gender norms and high levels of poverty, female employment and financial conflicts can be triggers of violence in marriages. On the other hand, girls’ management of and access to independent financial resources through savings can potentially help to reduce this risk. PMID:27232997

  17. Early Age at Time of Primary Epstein–Barr Virus Infection Results in Poorly Controlled Viral Infection in Infants From Western Kenya: Clues to the Etiology of Endemic Burkitt Lymphoma

    PubMed Central

    Piriou, Erwan; Asito, Amolo S.; Sumba, Peter O.; Fiore, Nancy; Middeldorp, Jaap M.; Moormann, Ann M.; Ploutz-Snyder, Robert

    2012-01-01

    (See the editorial commentary by Bagni and Whitby, on pages 873–4.) Background. Infection with Epstein–Barr virus (EBV) early in life and repeated malaria exposure have been proposed as risk factors for endemic Burkitt lymphoma (eBL). Methods. Infants were enrolled from 2 rural sites in Kenya: the Kisumu District, where malaria transmission is holoendemic and risk for eBL is high, and the Nandi District, where malaria transmission is limited and the risk for eBL is low. Blood samples were taken from infants through 2 years of age to measure EBV viral load, EBV antibodies, and malaria parasitemia. Results. We observed a significantly younger age at time of primary EBV infection in children from Kisumu compared with children from Nandi (mean age, 7.28 months [±0.33 SEM] in Kisumu vs 8.39 months [±0.26 SEM] in Nandi), with 35.3% of children in Kisumu infected before 6 months of age. To analyze how different predictors affected EBV viral load over time, we performed multilevel mixed modeling. This modeling revealed that residence in Kisumu and younger age at first EBV infection were significant predictors for having a higher EBV viral load throughout the period of observation. Conclusions. Children from a region at high risk for eBL were infected very early in life with EBV, resulting in higher viral loads throughout infancy. PMID:22301635

  18. Kenya Hospices and Palliative Care Association: integrating palliative care in public hospitals in Kenya

    PubMed Central

    Ali, Zipporah

    2016-01-01

    Background In Kenya, cancers as a disease group rank third as a cause of death after infectious and cardiovascular diseases. It is estimated that the annual incidence of cancer is about 37,000 new cases with an annual mortality of 28,000 cases (Kenya National Cancer Control Strategy 2010). The incidence of non-communicable diseases accounts for more than 50% of total hospital admissions and over 55% of hospital deaths (Kenya National Strategy for the Prevention and Control of Non Communicable Diseases 2015–2020). The prevalence of HIV is 6.8 (KIAS 2014). Most of these patients will benefit from palliative care services, hence the need to integrate palliative care services in the public healthcare system. Method The process of integrating palliative care in public hospitals involved advocacy both at the national level and at the institutional level, training of healthcare professionals, and setting up services within the hospitals that we worked with. Technical support was provided to each individual institution as needed. Results Eleven provincial hospitals across the country have now integrated palliative care services (Palliative Care Units) and are now centres of excellence. Over 220 healthcare providers have been trained, and approximately, over 30,000 patients have benefited from these services. Oral morphine is now available in the hospital palliative care units. Conclusion As a success of the pilot project, Kenya Hospices and Palliative Care Association (KEHPCA) is now working with the Ministry of Health Kenya to integrate palliative care services in 30 other county hospitals across the country, thus ensuring more availability and access to more patients. Other developing countries can learn from Kenya’s successful experience.

  19. EXPLOITING CHEMICAL ECOLOGY FOR LIVELIHOOD IMPROVEMENT OF SMALL HOLDER FARMERS IN KENYA.

    PubMed

    Winter, E; Midega, C; Bruce, T; Hummel, H E; Langner, S S; Leithold, G; Khan, Z; Pickett, J

    2014-01-01

    study is needed. A second approach made use of species-specific insect monitoring traps baited with highly specific female sex pheromones for attracting and monitoring destructive insect pests. The female sex pheromone (8-methyl-decane-2-ol propanoate) of Diabrotica virgifera virgifera (Coleoptera: Chrysomelidae) (Western Corn Rootworm) is readily available as bait in the "Metcalf sticky cup trap" for trapping males, an extraordinarily sensitive technique for monitoring the presence or absence of male beetles in a given area. Li et al. (2006) had argued for the likelihood of easy immigration of this cosmopolitan maize pest into East Africa. Our results, however, so far indicate the absence of a local population in the area of Mbita, while not excluding its presence at Nairobi or Mombasa. Both investigations contribute to different aspects of Kenyan economic development and may be seen as two independent but complementary contributions towards livelihood improvement of small holder farmers in Kenya. PMID:26084106

  20. Risk factors for postpartum depression in women living with HIV attending prevention of mother-to-child transmission clinic at Kenyatta National Hospital, Nairobi.

    PubMed

    Yator, Obadia; Mathai, Muthoni; Vander Stoep, Ann; Rao, Deepa; Kumar, Manasi

    2016-07-01

    Mothers with HIV are at high risk of a range of psychosocial issues that may impact HIV disease progression for themselves and their children. Stigma has also become a substantial barrier to accessing HIV/AIDS care and prevention services. The study objective was to determine the prevalence and severity of postpartum depression (PPD) among women living with HIV and to further understand the impact of stigma and other psychosocial factors in 123 women living with HIV attending prevention of mother-to-child transmission (PMTCT) clinic at Kenyatta National Hospital located in Nairobi, Kenya. We used the Edinburgh Postnatal Depression Scale and HIV/AIDS Stigma Instrument - PLWHA (HASI - P). Forty-eight percent (N = 59) of women screened positive for elevated depressive symptoms. Eleven (9%) of the participants reported high levels of stigma. Multivariate analyses showed that lower education (OR = 0.14, 95% CI [0.04-0.46], p = .001) and lack of family support (OR = 2.49, 95% CI [1.14-5.42], p = .02) were associated with the presence of elevated depressive symptoms. The presence of stigma implied more than ninefold risk of development of PPD (OR = 9.44, 95% CI [1.132-78.79], p = .04). Stigma was positively correlated with an increase in PPD. PMTCT is an ideal context to reach out to women to address mental health problems especially depression screening and offering psychosocial treatments bolstering quality of life of the mother-baby dyad. PMID:27045273

  1. Kenya's Plans for Its Children.

    ERIC Educational Resources Information Center

    Chege, Nancy

    1995-01-01

    This article looks into the reasons behind Kenya's rapidly declining fertility rates over the last decade. Examines such factors as economic conditions, Westernization, contraceptive use, and formal education programs. (LZ)

  2. Growing a miracle in Kenya.

    PubMed

    Farruggia, Michael J

    2013-01-01

    A Kenyan woman, a retired nurse, and a nurse executive in America are miraculously led together to start a library in Kima, Kenya. Small beginnings grow into the Heather May-MashoodAbiola Children's Resource Centre (HEMAMA). Named after two infant children lost by the Kenyan woman and the nurse executive, HEMAMA is making a difference in the lives of children in the Kima, Kenya community. PMID:24282879

  3. Agriculture and development in Africa: the case of Kenya.

    PubMed

    Hyden, G

    1987-01-01

    The Government of Kenya has successfully developed macroeconomic policies that overcome constraints in the domestic and international environments and have a relatively well-functioning public sector. At present, the major challenge facing Kenya concerns the ability of the government to improve agricultural productivity given the weakness of its research services and peasant resistance to development. The response to the 1984 drought indicates that the Government of Kenya has the formal structures in place to deal with emergencies, yet the absence of reliable statistics on grain production, marketing, and on-farm storage led to serious miscalculations of the severity of the drought. Government of Kenya has been reluctant to experiment with institutional forms that reduce the opportunity for direct political control, especially over agricultural marketing. Privatization of the grain trade or the establishment of cooperatively owned local dairies has been proposed but rejected as too risky. New policies and concerted action, at both the government and community levels, tend to be in response to threat or hardship rather than a result of a dynamic strategy. Given this tendency to avoid experimentation with alternative political forms, socioeconomic development in Kenya may be limited in the years ahead. PMID:12341775

  4. Birth spacing and child mortality: an analysis of prospective data from the Nairobi urban health and demographic surveillance system.

    PubMed

    Fotso, Jean Christophe; Cleland, John; Mberu, Blessing; Mutua, Michael; Elungata, Patricia

    2013-11-01

    The majority of studies of the birth spacing-child survival relationship rely on retrospective data, which are vulnerable to errors that might bias results. The relationship is re-assessed using prospective data on 13,502 children born in two Nairobi slums between 2003 and 2009. Nearly 48% were first births. Among the remainder, short preceding intervals are common: 20% of second and higher order births were delivered within 24 months of an elder sibling, including 9% with a very short preceding interval of less than 18 months. After adjustment for potential confounders, the length of the preceding birth interval is a major determinant of infant and early childhood mortality. In infancy, a preceding birth interval of less than 18 months is associated with a two-fold increase in mortality risks (compared with lengthened intervals of 36 months or longer), while an interval of 18-23 months is associated with an increase of 18%. During the early childhood period, children born within 18 months of an elder sibling are more than twice as likely to die as those born after an interval of 36 months or more. Only 592 children experienced the birth of a younger sibling within 20 months; their second-year mortality was about twice as high as that of other children. These results support the findings based on retrospective data. PMID:22958417

  5. Zoonotic surveillance for rickettsiae in domestic animals in Kenya.

    PubMed

    Mutai, Beth K; Wainaina, James M; Magiri, Charles G; Nganga, Joseph K; Ithondeka, Peter M; Njagi, Obadiah N; Jiang, Ju; Richards, Allen L; Waitumbi, John N

    2013-06-01

    Abstract Rickettsiae are obligate intracellular bacteria that cause zoonotic and human diseases. Arthropod vectors, such as fleas, mites, ticks, and lice, transmit rickettsiae to vertebrates during blood meals. In humans, the disease can be life threatening. This study was conducted amidst rising reports of rickettsioses among travelers to Kenya. Ticks and whole blood were collected from domestic animals presented for slaughter at major slaughterhouses in Nairobi and Mombasa that receive animals from nearly all counties in the country. Blood samples and ticks were collected from 1019 cattle, 379 goats, and 299 sheep and were screened for rickettsiae by a quantitative PCR (qPCR) assay (Rick17b) using primers and probe that target the genus-specific 17-kD gene (htrA). The ticks were identified using standard taxonomic keys. All Rick17b-positive tick DNA samples were amplified and sequenced with primers sets that target rickettsial outer membrane protein genes (ompA and ompB) and the citrate-synthase encoding gene (gltA). Using the Rick17b qPCR, rickettsial infections in domestic animals were found in 25/32 counties sampled (78.1% prevalence). Infection rates were comparable in cattle (16.3%) and sheep (15.1%) but were lower in goats (7.1%). Of the 596 ticks collected, 139 had rickettsiae (23.3%), and the detection rates were highest in Amblyomma (62.3%; n=104), then Rhipicephalus (45.5%; n=120), Hyalomma (35.9%; n=28), and Boophilus (34.9%; n=30). Following sequencing, 104 out of the 139 Rick17b-positive tick DNA had good reverse and forward sequences for the 3 target genes. On querying GenBank with the generated consensus sequences, homologies of 92-100% for the following spotted fever group (SFG) rickettsiae were identified: Rickettsia africae (93.%, n=97), Rickettsia aeschlimannii (1.9%, n=2), Rickettsia mongolotimonae (0.96%, n=1), Rickettsia conorii subsp. israelensis (0.96%, n=1), Candidatus Rickettsia kulagini (0.96% n=1), and Rickettsia spp. (1.9% n=2). In

  6. The effect of integration of HIV care and treatment into antenatal care clinics on mother-to-child HIV transmission and maternal outcomes in Nyanza, Kenya: results from the SHAIP cluster randomized controlled trial

    PubMed Central

    Washington, Sierra; Owuor, Kevin; Turan, Janet M.; Steinfeld, Rachel L.; Onono, Maricianah; Shade, Starley B.; Bukusi, Elizabeth A.; Ackers, Marta L.; Cohen, Craig R.

    2015-01-01

    Background Many HIV-infected pregnant women identified during antenatal care do not enroll in long-term HIV care, resulting in deterioration of maternal health and continued risk of HIV transmission to infants. Methods We performed a cluster-randomized trial to evaluate the effect of integrating HIV care into ANC clinics in rural Kenya. Twelve facilities were randomized to provide either integrated services (ANC, PMTCT, and HIV care delivered in the ANC clinic; n=6 intervention facilities), or standard ANC services (including PMTCT and referral to a separate clinic for HIV care; n=6 control facilities). Results There were high patient attrition rates over the course of this study. Among study participants who enrolled in HIV care, there was twelve month follow up data for 256/611 (41.8%) women, and postpartum data for only 325/1172 (28%) women. By 9 months of age, 382/568 (67.3%) infants at intervention sites and 338/594 (57.0%) at control sites had tested for HIV (OR 1.45, 95% CI 0.71-2.82); 7.3% of infants tested HIV-positive at intervention sites compared to 8.0% of infants at control sites (OR 0.89, 95% CI 0.56-1.43). The composite clinical/immunologic progression into AIDS was similar in both arms (4.9% vs. 5.1 %, OR 0.83, 95% CI 0.41 - 1.68). Conclusions Despite the provision of integrated services, patient attrition was substantial in both arms, suggesting barriers beyond lack of service integration. Integration of HIV services into the ANC clinic was not associated with a reduced risk HIV transmission to infants and did not appear to affect short-term maternal health outcomes. PMID:25886930

  7. Na2O and Trace Elements Behavior in Trachytes and Phonolites at Suswa Volcano, Kenya: the Result of Combined Magma Mixing and Volatile-rich Na-Trace Element Fluids

    NASA Astrophysics Data System (ADS)

    Espejel-Garcia, V. V.; Anthony, E. Y.; Ren, M.; MacDonald, R.; Skilling, I. P.; White, J. C.

    2008-12-01

    The evolution of Suswa, a Quaternary volcano in the Kenya Rift, was dominated by the eruption of two rock suites, separated by a caldera event. Suswa is part of the Central Kenya Peralkaline Province (CKPP), which includes the Greater Olkaria Volcanic Complex (GOVC) and inter-center mafic fields, e.g. Tandamara and Elmenteita, whose compositions range from basalt to basaltic trachy-andesite (BTA). Both suites at Suswa range from trachyte to phonolite, but are distinguished by the amount of SiO2: pre- and syn-caldera rocks have 60-62%, and post-caldera rocks 57-59%. Trachyte to phonolite trends within each suite result from increasing Na2O, which is accompanied by increases in a number of trace elements (Be, Hf, Nb, Rb, Th, Y, Zn, Zr, and REE, except Eu). Magmatic processes included magma mixing, in which BTA magma similar to those of Tandamara and Elmenteita intruded the pre-caldera Suswa trachytic chamber, and fluid complexing, which was responsible for the enrichment in Na2O and trace elements. The importance of magma mixing in the CKPP has been recently documented at the GOVC by Macdonald et al. (2008, J Pet 49, 1515-1547), for which mafic-intermediate magmatic inclusions within comendites and disequilibrium phenocryst assemblages are part of the evidence. Evidence for mixing at Suswa includes: 1) mixed feldspar assemblages, e.g. syn-caldera ignimbrite samples contain both alkali feldspar (An2Ab62Or36), and xenocrystic plagioclase (An45Ab52Or3), and 2) heterogeneous matrix glass compositions. Glass in pre-caldera rocks is trachytic, similar to whole-rock compositions. Syn-caldera rocks have glass compositions both trachytic and intermediate between trachyte and BTA, while Tandamara BTA rocks contain trachytic glass. Glass in post-caldera rocks is mostly phonolitic. Glass inclusions in plagioclase xenocrysts are basaltic, similar to flows in the area. X-Y elemental plots do not show linear trends, as would be predicted from a mixing process. We attribute this to

  8. "When we are together I feel at home." Types and sources of social support among youth newly diagnosed with HIV in Kenya: implications for intervention.

    PubMed

    Lypen, Kathryn D; Lockwood, Nicole M; Shalabi, Firas; Harper, Gary W; Ngugi, Elizabeth

    2015-01-01

    Social support helps youth manage psychosocial stress. Though many studies have investigated the role of social support in helping youth in developed countries cope with their HIV status, such research is lacking among youth living in sub-Saharan African countries, including Kenya. The importance of research on youth living with HIV in Kenya is enhanced given young people's unique developmental stages and the HIV prevalence rate of 8.8% among Kenyans aged 25 to 29 years. To gain further insight, qualitative focus group interviews were conducted with 53 youth aged 18 to 27 years who lived in the informal urban settlement of Kibera in Nairobi, Kenya. A phenomenological approach was used to analyse the data from which four major types of social support were identified: 1) emotional; 2) informational; 3) appraisal; and 4) instrumental. Within each of these overarching themes more specific sub-themes were identified. The youth also reported receiving social support from eight main sources: 1) family; 2) friends; 3) clinicians and clinical services; 4) counsellors; 5) support groups; 6) religious sources; 7) partners; and 8) other. These findings suggest that various forms of social support, provided by diverse sources, which may fall outside of those commonly involved in interventions, can help youth living with HIV cope with their diagnosis and promote healthy lifestyles. Future research should investigate the roles and interactions of different types and sources of support, specifically as they relate to interventions aiming to ameliorate the experiences of youth newly diagnosed with HIV. PMID:26439602

  9. Molecular detection and characterization of potentially new Babesia and Theileria species/variants in wild felids from Kenya.

    PubMed

    Githaka, Naftaly; Konnai, Satoru; Kariuki, Edward; Kanduma, Esther; Murata, Shiro; Ohashi, Kazuhiko

    2012-10-01

    Piroplasms frequently infect domestic and wild carnivores. At present, there is limited information on the occurrence and molecular identity of these tick-borne parasites in wild felids in Kenya. In 2009, a pair of captive lions (Panthare leo) was diagnosed with suspected babesiosis and mineral deficiency at an animal orphanage on the outskirts of Nairobi, Kenya. Blood smears indicated presences of haemoparasites in the erythrocytes, however, no further investigations were conducted to identify the infecting agent. The animals recovered completely following diet supplementation and treatment with anti-parasite drug. In this report, we extracted and detected parasite DNA from the two lions and seven other asymptomatic feline samples; two leopards (Panthera pardus) and five cheetahs (Acinonyx jubatus). Reverse line blot with probes specific for Babesia spp. of felines indicated the presence of new Babesia species or genotypes in the lions and leopards, and unknown Theileria sp. in the cheetahs. Phylogenetic analyses using partial sequences of 18S ribosomal RNA (18S rRNA) gene showed that the parasite infecting the lions belong to the Babesia canis complex, and the parasite variant detected in the leopards clusters in a clade bearing other Babesia spp. reported in wild felids from Africa. The cheetah isolates falls in the Theileria sensu stricto group. Our findings indicate the occurrence of potentially new species or genotypes of piroplams in all three feline species. PMID:22796449

  10. University Students and the Employment Market--A Profile of Present Graduates from University College, Nairobi. Staff Paper No. 74.

    ERIC Educational Resources Information Center

    Rastad, Svein-Erik

    There are various assumptions underlying the University Tracer Project at the University College, Nairobi, Africa: (1) that there is a relationship between subjects studied in university and the employment sought and found; (2) that this relationship will increase as competition for jobs increases; (3) that this relationship is sufficiently…

  11. Differences in Counseling Men and Women: Family Planning in Kenya.

    ERIC Educational Resources Information Center

    Kim, Young Mi; Kols, Adrienne; Mwarogo, Peter; Awasum, David

    2000-01-01

    Comparisions of family planning sessions in Kenya found distinct gender differences in reasons for visiting the clinics and communication styles of both the clients and the counselors. These communication patterns may be a result of Kenyan gender roles and men's and women's different reasons for seeking family planning services. Implications of…

  12. Communicaton of Curriculum Content in Universities in Kenya

    ERIC Educational Resources Information Center

    Macharia, Juliet W.

    2008-01-01

    The history of Education in most developing Countries shows that higher education has grown tremendously. In 1960's a Country such as Kenya had only one University but today, she boasts of seven public Universities and very many private ones. With expansion, student's numbers have increased. As a result of the needs and demands of a growing…

  13. Barriers and facilitators to pre-exposure prophylaxis (PrEP) eligibility screening and ongoing HIV testing among target populations in Bondo and Rarieda, Kenya: Results of a consultation with community stakeholders

    PubMed Central

    2014-01-01

    Background As pre-exposure prophylaxis (PrEP) moves closer to availability in developing countries, practical considerations for implementation become important. We conducted a consultation with district-level community stakeholders experienced in HIV-prevention interventions with at-risk populations in Bondo and Rarieda, Kenya to generate locally grounded approaches to the future rollout of oral PrEP to four populations: fishermen, widows, female sex workers, and serodiscordant couples. Methods The 20 consultation participants represented the Ministry of Health, faith- and community-based organizations, health facilities, community groups, and nongovernmental organizations. Participants divided into breakout groups and followed a structured discussion guide asking them to identify barriers to implementing HIV-prevention interventions (including PrEP) with each population. Questions also solicited solutions for addressing these barriers, as well as other facilitators for PrEP implementation. In particular, questions focused on how to encourage people to screen for PrEP eligibility by having HIV and other blood tests and how to encourage compliance with ongoing HIV testing. Results The barriers and facilitators/solutions discussants provided were frequently population-specific, but there were also broad-level similarities across populations. Service delivery barriers to HIV-prevention interventions concerned the need for staff trained to address the needs of particular populations. Service delivery facilitators to provision of ongoing HIV testing consisted of offering testing options besides facility-based testing. Stigma was the main community-level barrier for all groups, whereas barriers at the level of target populations included mobility; lifestyle and life circumstances, especially cultural norms among fishermen and widows; and fears, lack of awareness, and misinformation. Proposed facilitators and strategies for addressing community- and population

  14. Satellite-based drought monitoring in Kenya in an operational setting

    NASA Astrophysics Data System (ADS)

    Klisch, A.; Atzberger, C.; Luminari, L.

    2015-04-01

    The University of Natural Resources and Life Sciences (BOKU) in Vienna (Austria) in cooperation with the National Drought Management Authority (NDMA) in Nairobi (Kenya) has setup an operational processing chain for mapping drought occurrence and strength for the territory of Kenya using the Moderate Resolution Imaging Spectroradiometer (MODIS) NDVI at 250 m ground resolution from 2000 onwards. The processing chain employs a modified Whittaker smoother providing consistent NDVI "Mondayimages" in near real-time (NRT) at a 7-daily updating interval. The approach constrains temporally extrapolated NDVI values based on reasonable temporal NDVI paths. Contrary to other competing approaches, the processing chain provides a modelled uncertainty range for each pixel and time step. The uncertainties are calculated by a hindcast analysis of the NRT products against an "optimum" filtering. To detect droughts, the vegetation condition index (VCI) is calculated at pixel level and is spatially aggregated to administrative units. Starting from weekly temporal resolution, the indicator is also aggregated for 1- and 3-monthly intervals considering available uncertainty information. Analysts at NDMA use the spatially/temporally aggregated VCI and basic image products for their monthly bulletins. Based on the provided bio-physical indicators as well as a number of socio-economic indicators, contingency funds are released by NDMA to sustain counties in drought conditions. The paper shows the successful application of the products within NDMA by providing a retrospective analysis applied to droughts in 2006, 2009 and 2011. Some comparisons with alternative products (e.g. FEWS NET, the Famine Early Warning Systems Network) highlight main differences.

  15. Acceptability and Feasibility of Repeated Mucosal Specimen Collection in Clinical Trial Participants in Kenya

    PubMed Central

    Omosa-Manyonyi, Gloria; Park, Harriet; Mutua, Gaudensia; Farah, Bashir; Bergin, Philip J.; Laufer, Dagna; Lehrman, Jennifer; Chinyenze, Kundai; Barin, Burc; Fast, Pat; Gilmour, Jill; Anzala, Omu

    2014-01-01

    Background Mucosal specimens are essential to evaluate compartmentalized immune responses to HIV vaccine candidates and other mucosally targeted investigational products. We studied the acceptability and feasibility of repeated mucosal sampling in East African clinical trial participants at low risk of HIV and other sexually transmitted infections. Methods and Findings The Kenya AIDS Vaccine Initiative (KAVI) enrolled participants into three Phase 1 trials of preventive HIV candidate vaccines in 2011–2012 at two clinical research centers in Nairobi. After informed consent to a mucosal sub-study, participants were asked to undergo collection of mucosal secretions (saliva, oral fluids, semen, cervico-vaginal and rectal), but could opt out of any collection at any visit. Specimens were collected at baseline and two additional time points. A tolerability questionnaire was administered at the final sub-study visit. Of 105 trial participants, 27 of 34 women (79%) and 62 of 71 men (87%) enrolled in the mucosal sub-study. Nearly all sub-study participants gave saliva and oral fluids at all visits. Semen was collected from about half the participating men (47–48%) at all visits. Cervico-vaginal secretions were collected by Softcup from about two thirds of women (63%) at baseline, increasing to 78% at the following visits, with similar numbers for cervical secretion collection by Merocel sponge; about half of women (52%) gave cervico-vaginal samples at all visits. Rectal secretions were collected with Merocel sponge from about a quarter of both men and women (24%) at all 3 visits, with 16% of men and 19% of women giving rectal samples at all visits. Conclusions Repeated mucosal sampling in clinical trial participants in Kenya is feasible, with a good proportion of participants consenting to most sampling methods with the exception of rectal samples. Experienced staff members of both sexes and trained counselors with standardized messaging may improve acceptance of rectal

  16. The HAART cell phone adherence trial (WelTel Kenya1): a randomized controlled trial protocol

    PubMed Central

    Lester, Richard T; Mills, Edward J; Kariri, Antony; Ritvo, Paul; Chung, Michael; Jack, William; Habyarimana, James; Karanja, Sarah; Barasa, Samson; Nguti, Rosemary; Estambale, Benson; Ngugi, Elizabeth; Ball, T Blake; Thabane, Lehana; Kimani, Joshua; Gelmon, Lawrence; Ackers, Marta; Plummer, Francis A

    2009-01-01

    Background The objectives are to compare the effectiveness of cell phone-supported SMS messaging to standard care on adherence, quality of life, retention, and mortality in a population receiving antiretroviral therapy (ART) in Nairobi, Kenya. Methods and Design A multi-site randomized controlled open-label trial. A central randomization centre provided opaque envelopes to allocate treatments. Patients initiating ART at three comprehensive care clinics in Kenya will be randomized to receive either a structured weekly SMS ('short message system' or text message) slogan (the intervention) or current standard of care support mechanisms alone (the control). Our hypothesis is that using a structured mobile phone protocol to keep in touch with patients will improve adherence to ART and other patient outcomes. Participants are evaluated at baseline, and then at six and twelve months after initiating ART. The care providers keep a weekly study log of all phone based communications with study participants. Primary outcomes are self-reported adherence to ART and suppression of HIV viral load at twelve months scheduled follow-up. Secondary outcomes are improvements in health, quality of life, social and economic factors, and retention on ART. Primary analysis is by 'intention-to-treat'. Sensitivity analysis will be used to assess per-protocol effects. Analysis of covariates will be undertaken to determine factors that contribute or deter from expected and determined outcomes. Discussion This study protocol tests whether a novel structured mobile phone intervention can positively contribute to ART management in a resource-limited setting. Trial Registration Trial Registration Number: NCT00830622 PMID:19772596

  17. Energy flows in a secondary city: a case study of Nakuru, Kenya

    SciTech Connect

    Milukas, M.V.

    1987-01-01

    Secondary cities are currently seen as an important focus for promoting a more spatially-equitable pattern of economic infrastructure in developing countries, but their energy needs have not been considered. To test the thesis of this work - that the present pattern of energy demand in secondary cities differs, in important ways, from that of primary cities - a case study was conducted in the East African city of Nakuru, Kenya. Energy supplies used in Nakuru fall into two categories: industrial sources (electricity and petroleum) and traditional sources (wood, charcoal, and agricultural residues). This analysis of Nakuru's use of industrial sources is introduced by a historical discussion of nationwide patterns of distribution, use, and pricing of electricity and petroleum products, and is followed by data gathered from Nakuru's suppliers of these energy sources. The portrait of energy use in Nakuru is completed with an analysis of the demand for traditional energy sources. Surveys were conducted to estimate the total quantities of charcoal, wood, and agricultural resides used in Nakuru. The cornerstone of this effort was a residential energy survey stratified according to income. Nakuru is shown to rely on biomass fuels (charcoal) to a much greater degree than Nairobi, thereby proving the thesis.

  18. Sex workers in Kenya, numbers of clients and associated risks: an exploratory survey.

    PubMed

    Elmore-Meegan, Michael; Conroy, Ronán M; Agala, C Bernard

    2004-05-01

    In Kenya in 1999, an estimated 6.9% of women nationally said they had exchanged sex for money, gifts or favours in the previous year. In 2000 and 2001, in collaboration with sex workers who had formed a network of self-help groups, we conducted an exploratory survey among 475 sex workers in four rural towns and three Nairobi townships, regarding where they worked, the number of clients they had and the risks they were exposed to. Participants were identified by a network of social contacts in the seven centres. Most of the women (88%) worked from bars, hotels, bus stages and discos; 57% lived with a stable partner and almost 90% had dependent children. In the previous month, 17% had been assaulted and 35% raped by clients. Unwanted pregnancy was common; 86% had had at least one abortion. Compared with women in rural towns, township sex workers were younger (median age 22 vs. 26), saw more clients (median 9 vs. 4 per week) and earned more from sex work (up to 63-90 euros vs. 12 euros per week). Issues of alternative sources of income, safety for sex workers and the conditions which create the necessity for sex work are vital to address. The question of number of clients and the nature of sex work have obvious implications for HIV/STI prevention policy. PMID:15242210

  19. Kenyan medical student and consultant experiences in a pilot decentralised training program at the University of Nairobi

    PubMed Central

    Kibore, Minnie W.; Daniels, Joseph A.; Child, Mara J.; Nduati, Ruth; Njiri, Francis J.; Kinuthia, Raphael; O'Malley, Gabrielle; John-Stewart, Grace; Kiarie, James; Farquhar, Carey

    2015-01-01

    Background Over the past decade, the University of Nairobi (UoN) has increased the number of enrolled medical students three-fold in response to the growing need for more doctors. This has resulted in a congested clinical training environment and limited opportunities for students to practice clinical skills at the tertiary teaching facility. To enhance the clinical experience, the UoN Medical Education Partnership Initiative Program undertook to train medical students in non-tertiary hospitals around the country under the mentorship of consultant preceptors at these hospitals. This study focused on the evaluation of the pilot decentralised training rotation. Methods The decentralised training program was piloted in October 2011 with 29 fourth-year medical students at four public hospitals for a seven-week rotation. We evaluated student and consultant experiences using a series of focus group discussions. A three-person team developed the codes for the focus groups and then individually and anonymously coded the transcripts. The teams’ findings were triangulated to confirm major themes. Results Before the rotation, the students expressed the motivation to gain more clinical experience as they felt they lacked adequate opportunity to exercise clinical skills at the tertiary referral hospital. By the end of the rotation, the students felt they had been actively involved in patient care, had gained clinical skills and had learned to navigate socio-cultural challenges in patient care. They further expressed the wish to return to those hospitals for future practice. The consultants expressed their motivation to teach and mentor students and acknowledged that the academic interaction had positively impacted on patient care. Discussion The decentralised training enhanced students’ learning by providing opportunities for clinical and community experiences and has demonstrated how practicing medical consultants can be engaged as preceptors in students learning. This

  20. Invasive Salmonellosis in Kilifi, Kenya

    PubMed Central

    Muthumbi, Esther; Morpeth, Susan C.; Ooko, Michael; Mwanzu, Alfred; Mwarumba, Salim; Mturi, Neema; Etyang, Anthony O.; Berkley, James A.; Williams, Thomas N.; Kariuki, Samuel; Scott, J. Anthony G.

    2015-01-01

    Background. Invasive salmonelloses are a major cause of morbidity and mortality in Africa, but the incidence and case fatality of each disease vary markedly by region. We aimed to describe the incidence, clinical characteristics, and antimicrobial susceptibility patterns of invasive salmonelloses among children and adults in Kilifi, Kenya. Methods. We analyzed integrated clinical and laboratory records for patients presenting to the Kilifi County Hospital between 1998 and 2014. We calculated incidence, and summarized clinical features and multidrug resistance. Results. Nontyphoidal Salmonella (NTS) accounted for 10.8% and 5.8% of bacteremia cases in children and adults, respectively, while Salmonella Typhi accounted for 0.5% and 2.1%, respectively. Among 351 NTS isolates serotyped, 160 (45.6%) were Salmonella Enteritidis and 152 (43.3%) were Salmonella Typhimurium. The incidence of NTS in children aged <5 years was 36.6 per 100 000 person-years, being highest in infants aged <7 days (174/100 000 person-years). The overall incidence of NTS in children varied markedly by location and declined significantly during the study period; the pattern of dominance of the NTS serotypes also shifted from Salmonella Enteritidis to Salmonella Typhimurium. Risk factors for invasive NTS disease were human immunodeficiency virus infection, malaria, and malnutrition; the case fatality ratio was 22.1% (71/321) in children aged <5 years and 36.7% (11/30) in adults. Multidrug resistance was present in 23.9% (84/351) of NTS isolates and 46.2% (12/26) of Salmonella Typhi isolates. Conclusions. In Kilifi, the incidence of invasive NTS was high, especially among newborn infants, but typhoid fever was uncommon. NTS remains an important cause of bacteremia in children <5 years of age. PMID:26449944

  1. Fort Cobb Reservoir Watershed, Oklahoma and Thika River Watershed, Kenya Twinning Pilot Project

    NASA Astrophysics Data System (ADS)

    Moriasi, D.; Steiner, J.; Arnold, J.; Allen, P.; Dunbar, J.; Shisanya, C.; Gathenya, J.; Nyaoro, J.; Sang, J.

    2007-12-01

    The Fort Cobb Reservoir Watershed (FCRW) (830 km2) is a watershed within the HELP Washita Basin, located in Caddo and Washita Counties, OK. It is also a benchmark watershed under USDA's Conservation Effects Assessment Project, a national project to quantify environmental effects of USDA and other conservation programs. Population in south-western Oklahoma, in which FCRW is located, is sparse and decreasing. Agricultural focuses on commodity production (beef, wheat, and row crops) with high costs and low margins. Surface and groundwater resources supply public, domestic, and irrigation water. Fort Cobb Reservoir and contributing stream segments are listed on the Oklahoma 303(d) list as not meeting water quality standards based on sedimentation, trophic level of the lake associated with phosphorus loads, and nitrogen in some stream segments in some seasons. Preliminary results from a rapid geomorphic assessment results indicated that unstable stream channels dominate the stream networks and make a significant but unknown contribution to suspended-sediment loadings. Impairment of the lake for municipal water supply, recreation, and fish and wildlife are important factors in local economies. The Thika River Watershed (TRW) (867 km2) is located in central Kenya. Population in TRW is high and increasing, which has led to a poor land-population ratio with population densities ranging from 250 people/km2 to over 500 people/km2. The poor land-population ratio has resulted in land sub-division, fragmentation, over- cultivation, overgrazing, and deforestation which have serious implications on soil erosion, which poses a threat to both agricultural production and downstream reservoirs. Agricultural focuses mainly on subsistence and some cash crops (dairy cattle, corn, beans, coffee, floriculture and pineapple) farming. Surface and groundwater resources supply domestic, public, and hydroelectric power generation water. Thika River supplies 80% of the water for the city of

  2. After Nairobi: can the international community help to develop health promotion in Africa?

    PubMed

    Dixey, Rachael

    2014-03-01

    The Nairobi Conference presaged a surge of interest in the development of health promotion in sub-Saharan Africa. A number of Africans have asserted that health promotion is underdeveloped in the continent, with the principles of the Ottawa Charter not widely adopted. This paper does not presume to say how health promotion could be developed in Africa, as that is for Africans to decide for themselves. Rather, it debates some issues which the international epistemic health promotion community could address in order to work in solidarity with African colleagues in taking forward the health promotion agenda in their continent. These issues include the Eurocentric nature of health promotion discourse, the different disease burden of Africa and the lack of training capacity in African universities. PMID:23945088

  3. Circumcising Circumcision: Renegotiating Beliefs and Practices among Somali Women in Johannesburg and Nairobi.

    PubMed

    Jinnah, Zaheera; Lowe, Lucy

    2015-01-01

    Female circumcision among Somalis is a deeply personal and subjective practice, framed within traditional norms and cultural practices, but negotiated within contemporary realities to produce a set of processes and practices that are nuanced, differentiated, and undergoing change. Based on ethnographic research among Somali women in Johannesburg and Nairobi, we argue that the context of forced migration provides women with opportunities to renegotiate and reinvent what female circumcision means to them. The complex, subjective, and diverse perceptions and experiences of circumcision as embedded processes, within the context of migration, we argue has been overlooked in the literature, which has tended to be framed within a normative discourse concerned with the medical effects of the practice, or in anthropological studies, counter to the normative discourse based on personal narratives. PMID:26076054

  4. Fertility Desires among Men and Women Living with HIV/AIDS in Nairobi Slums: A Mixed Methods Study

    PubMed Central

    Wekesa, Eliud; Coast, Ernestina

    2014-01-01

    Objectives Fertility desires require new understanding in a context of expanding access to antiretroviral therapy for people living with HIV/AIDS in Sub-Saharan Africa. This paper studies the fertility desires and their rationales, of slum-dwelling Kenyan men and women living with HIV/AIDS who know their serostatus, but have different antiretroviral therapy treatment statuses. It addresses two research questions: How do people living with HIV/AIDS consider their future fertility? What factors contribute to an explanation of fertility desires among people living with HIV/AIDS. Methods A mixed methods study (survey [n = 513] and in-depth interviews [n = 41]) with adults living with HIV/AIDS living in Nairobi slums was conducted in 2010. Regression analyses assess independent relationships between fertility desires and socio-demographic factors. Analyses of in-depth interviews are used to interpret the statistical analyses of fertility desires. Results Our analyses show that fertility desires are complex and ambivalent, reflecting tensions between familial and societal pressures to have children versus pressures for HIV (re-)infection prevention. More than a third (34%) of men and women living with HIV expressed future fertility desires; however, this is significantly lower than in the general population. Factors independently associated with desiring a child among people living with HIV/AIDS were age, sex, number of surviving children, social support and household wealth of the respondent. Discussion Increasing access to ART is changing the context of future childbearing for people living with HIV/AIDS. Prevailing values mean that, for many people living with HIV/AIDS, having children is seen as necessary for a “normal” and healthy adult life. However, the social rewards of childbearing conflict with moral imperatives of HIV prevention, presenting dilemmas about the “proper” reproductive behaviour of people living with HIV/AIDS. The health policy and

  5. East African Rift Valley, Kenya

    NASA Technical Reports Server (NTRS)

    1990-01-01

    This rare, cloud free view of the East African Rift Valley, Kenya (1.5N, 35.5E) shows a clear view of the Turkwell River Valley, an offshoot of the African REift System. The East African Rift is part of a vast plate fracture which extends from southern Turkey, through the Red Sea, East Africa and into Mozambique. Dark green patches of forests are seen along the rift margin and tea plantations occupy the cooler higher ground.

  6. Girls' Attitudes towards Science in Kenya

    ERIC Educational Resources Information Center

    Chetcuti, Deborah A.; Kioko, Beriter

    2012-01-01

    This study investigated girls' attitudes towards science in Kenya. It was carried out with 120 girls from four secondary schools in the Eastern province of Kenya. These were an urban single-sex (SS) and co-educational (Co-Ed) school and a rural SS and Co-Ed school. Different schools were chosen in order to explore whether there are any differences…

  7. Child Sexual Abuse in Tanzania and Kenya

    ERIC Educational Resources Information Center

    Lalor, Kevin

    2004-01-01

    Objective: Most research on child abuse in Tanzania and Kenya is unpublished in the international literature. The purpose of this paper is to examine the various commentaries and reports extant, toward an overview of the nature and frequency of child sexual abuse in Tanzania and Kenya. Methods: Contacts were made with academics, government…

  8. Fate of Upstream Anthropogenic Nitrogen Inputs in a Tropical Catchment, Athi-Galana-Sabaki River, Kenya.

    NASA Astrophysics Data System (ADS)

    Marwick, Trent R.

    2013-04-01

    As part of a broader study on the riverine biogeochemistry in the Athi-Galana-Sabaki (A-G-S) River basin (Kenya), we present data collected during three climatic seasons to constrain the sources, transformations and transit of multiple N species as they flow through the A-G-S basin (~47,000 km2), stretching from downstream of heavily polluted Nairobi and surrounds to the outlet at the Indian Ocean. Total dissolved inorganic nitrogen (DIN) concentrations entering the study area were highest during the dry season (1195 µmol/L), almost completely in the form of ammonium (99.8%), whilst total DIN was an order of magnitude lower during the short and long rain seasons (212 and 193 µmol/L, respectively). Nitrate was the dominant form of DIN entering the study area during the short and long rain seasons (97.9% and 85.6% of total DIN respectively), with the increased flow conditions resulting in minimal instream N-cycling prior to discharge to the ocean. Conversely, longer water residence time and intense cycling and removal of N in the upper- to mid-catchment during the dry season creates two polarities comparative to wet season conditions, where (1) significantly less DIN is exported to the ocean during the dry season, and (2) dry season particulate N export is significantly enriched in δ15N, strongly reflecting the dominance of organic wastes as the source of riverine nitrogen. The rapid removal of ammonium in the upper study area during the dry season was followed by a quantitatively similar production of nitrate and nitrous oxide downstream, pointing towards strong nitrification over this reach during the dry season. The nitrous oxide was rapidly degassed downstream, while the elevated nitrate concentrations steadily decreased to levels observed elsewhere in African river networks. Low pelagic primary production rates over the same reach suggest benthic denitrification was the dominant process controlling the removal of these nitrates, although large cyanobacterial

  9. Predictors of Attitudes toward Disability and Employment Policy Issues among Undergraduate Students at the University of Nairobi

    ERIC Educational Resources Information Center

    Mamboleo, George Isaboke

    2009-01-01

    Disability rights issues are an emerging area of discourse in Kenya. Persons with disabilities in Kenya face many barriers to integration into the larger Kenyan society possibly due to barriers such as societal negative attitudes. Research has indicated that the greatest barrier to rehabilitation of persons with disabilities is negative attitudes…

  10. HIV/AIDS among youth in urban informal (slum) settlements in Kenya: What are the correlates of and motivations for HIV testing?

    PubMed Central

    2011-01-01

    Background Although HIV counseling and testing (HCT) is widely considered an integral component of HIV prevention and treatment strategies, few studies have examined HCT behavior among youth in sub-Saharan Africa-a group at substantial risk for HIV infection. In this paper we examine: the correlates of HIV testing, including whether associations differ based on the context under which a person gets tested; and the motivations for getting (or not getting) an HIV test. Methods Drawing on data collected in 2007 from 4028 (51% male) youth (12-22 years) living in Korogocho and Viwandani slum settlements in Nairobi (Kenya), we explored the correlates of and motivations for HIV testing using the Health Belief Model (HBM) as a theoretical framework. Multinomial and binary logistic regression analyses were employed to examine correlates of HIV testing. Bivariate analyses were employed to assess reasons for or against testing. Results Nineteen percent of males and 35% of females had been tested. Among tested youth, 74% of males and 43% of females had requested for their most recent HIV test while 7% of males and 32% of females reported that they were required to take their most recent HIV test (i.e., the test was mandatory). About 60% of females who had ever had sex received an HIV test because they were pregnant. We found modest support for the HBM in explaining variation in testing behavior. In particular, we found that perceived risk for HIV infection may drive HIV testing among youth. For example, about half of youth who had ever had sex but had never been tested reported that they had not been tested because they were not at risk. Conclusions Targeted interventions to help young people correctly assess their level of risk and to increase awareness of the potential value of HIV testing may help enhance uptake of testing services. Given the relative success of Prevention of Mother-to-Child Transmission (PMTCT) services in increasing HIV testing rates among females

  11. Kenya Women in Physics: Societal, Cultural, and Professional Challenges

    NASA Astrophysics Data System (ADS)

    Baki, Paul; Wabwile, Ruth L.; Nyamwandha, Cecilia A.; Odongo, Diana A.

    2009-04-01

    In this paper we give an overview of the challenges Kenyan women physicists face in their educational and career engagements as a result of social-cultural stigma, cultural prejudices, and balancing family and work demands. We also discuss steps being taken in Kenya to address gender inequality in almost all spheres of public and private workplaces and the benefits to a prosperous developing nation of educating the girl child.

  12. A community-based intervention for primary prevention of cardiovascular diseases in the slums of Nairobi: the SCALE UP study protocol for a prospective quasi-experimental community-based trial

    PubMed Central

    2013-01-01

    Background The burden of cardiovascular disease is rising in sub-Saharan Africa with hypertension being the main risk factor. However, context-specific evidence on effective interventions for primary prevention of cardiovascular diseases in resource-poor settings is limited. This study aims to evaluate the feasibility and cost-effectiveness of one such intervention—the “Sustainable model for cardiovascular health by adjusting lifestyle and treatment with economic perspective in settings of urban poverty”. Methods/Design Design: A prospective quasi-experimental community-based intervention study. Setting: Two slum settlements (Korogocho and Viwandani) in Nairobi, Kenya. Study population: Adults aged 35 years and above in the two communities. Intervention: The intervention community (Korogocho) will be exposed to an intervention package for primary prevention of cardiovascular disease that comprises awareness campaigns, household screening for cardiovascular diseases risk factors, and referral and treatment of people with high cardiovascular diseases risk at a primary health clinic. The control community (Viwandani) will continue accessing the usual standard of care for primary prevention of cardiovascular diseases in Kenya. Data: Demographic and socioeconomic data; anthropometric and clinical measurements including blood pressure. Population-based data will be collected at the baseline and endline—12 months after implementing the intervention. These data will be collected from a random sample of 1,610 adults aged 35 years and above in the intervention and control sites at both baseline and endline. Additionally, operational (including cost) and clinic-based data will be collected on an ongoing basis. Main outcomes: (1) A positive difference in the change in the proportion of the intervention versus control study populations that are at moderate or high risk of cardiovascular disease; (2) a difference in the change in mean systolic blood pressure in the

  13. Malaria in Kenya's Western Highlands

    PubMed Central

    Hay, Simon I.; Omumbo, Judy A.; Snow, Robert W.

    2005-01-01

    Records from tea estates in the Kericho district in Kenya show that malaria reemerged in the 1980s. Renewed epidemic activity coincided with the emergence of chloroquine-resistant Plasmodium falciparum malaria and may have been triggered by the failure of antimalarial drugs. Meteorologic changes, population movements, degradation of health services, and changes in Anopheles vector populations are possible contributing factors. The highland malaria epidemics of the 1940s were stopped largely by sporontocidal drugs, and combination chemotherapy has recently limited transmission. Antimalarial drugs can limit the pool of gametocytes available to infect mosquitoes during the brief transmission season. PMID:16229773

  14. Prioritization of Zoonotic Diseases in Kenya, 2015

    PubMed Central

    Bitek, Austine; Osoro, Eric; Pieracci, Emily G.; Muema, Josephat; Mwatondo, Athman; Kungu, Mathew; Nanyingi, Mark; Gharpure, Radhika; Njenga, Kariuki; Thumbi, Samuel M.

    2016-01-01

    Introduction Zoonotic diseases have varying public health burden and socio-economic impact across time and geographical settings making their prioritization for prevention and control important at the national level. We conducted systematic prioritization of zoonotic diseases and developed a ranked list of these diseases that would guide allocation of resources to enhance their surveillance, prevention, and control. Methods A group of 36 medical, veterinary, and wildlife experts in zoonoses from government, research institutions and universities in Kenya prioritized 36 diseases using a semi-quantitative One Health Zoonotic Disease Prioritization tool developed by Centers for Disease Control and Prevention with slight adaptations. The tool comprises five steps: listing of zoonotic diseases to be prioritized, development of ranking criteria, weighting criteria by pairwise comparison through analytical hierarchical process, scoring each zoonotic disease based on the criteria, and aggregation of scores. Results In order of importance, the participants identified severity of illness in humans, epidemic/pandemic potential in humans, socio-economic burden, prevalence/incidence and availability of interventions (weighted scores assigned to each criteria were 0.23, 0.22, 0.21, 0.17 and 0.17 respectively), as the criteria to define the relative importance of the diseases. The top five priority diseases in descending order of ranking were anthrax, trypanosomiasis, rabies, brucellosis and Rift Valley fever. Conclusion Although less prominently mentioned, neglected zoonotic diseases ranked highly compared to those with epidemic potential suggesting these endemic diseases cause substantial public health burden. The list of priority zoonotic disease is crucial for the targeted allocation of resources and informing disease prevention and control programs for zoonoses in Kenya. PMID:27557120

  15. Unprogrammed Deworming in the Kibera Slum, Nairobi: Implications for Control of Soil-Transmitted Helminthiases

    PubMed Central

    Harris, Julie R.; Worrell, Caitlin M.; Davis, Stephanie M.; Odero, Kennedy; Mogeni, Ondari D.; Deming, Michael S.; Mohammed, Aden; Montgomery, Joel M.; Njenga, Sammy M.; Fox, LeAnne M.; Addiss, David G.

    2015-01-01

    Background Programs for control of soil-transmitted helminth (STH) infections are increasingly evaluating national mass drug administration (MDA) interventions. However, “unprogrammed deworming” (receipt of deworming drugs outside of nationally-run STH control programs) occurs frequently. Failure to account for these activities may compromise evaluations of MDA effectiveness. Methods We used a cross-sectional study design to evaluate STH infection and unprogrammed deworming among infants (aged 6–11 months), preschool-aged children (PSAC, aged 1–4 years), and school-aged children (SAC, aged 5–14 years) in Kibera, Kenya, an informal settlement not currently receiving nationally-run MDA for STH. STH infection was assessed by triplicate Kato-Katz. We asked heads of households with randomly-selected children about past-year receipt and source(s) of deworming drugs. Local non-governmental organizations (NGOs) and school staff participating in school-based deworming were interviewed to collect information on drug coverage. Results Of 679 children (18 infants, 184 PSAC, and 477 SAC) evaluated, 377 (55%) reported receiving at least one unprogrammed deworming treatment during the past year. PSAC primarily received treatments from chemists (48.3%) or healthcare centers (37.7%); SAC most commonly received treatments at school (55.0%). Four NGOs reported past-year deworming activities at 47 of >150 schools attended by children in our study area. Past-year deworming was negatively associated with any-STH infection (34.8% vs 45.4%, p = 0.005). SAC whose most recent deworming medication was sourced from a chemist were more often infected with Trichuris (38.0%) than those who received their most recent treatment from a health center (17.3%) or school (23.1%) (p = 0.05). Conclusion Unprogrammed deworming was received by more than half of children in our study area, from multiple sources. Both individual-level treatment and unprogrammed preventive chemotherapy may serve an

  16. Community perceptions of air pollution and related health risks in Nairobi slums.

    PubMed

    Egondi, Thaddaeus; Kyobutungi, Catherine; Ng, Nawi; Muindi, Kanyiva; Oti, Samuel; van de Vijver, Steven; Ettarh, Remare; Rocklöv, Joacim

    2013-10-01

    Air pollution is among the leading global risks for mortality and responsible for increasing risk for chronic diseases. Community perceptions on exposure are critical in determining people's response and acceptance of related policies. Therefore, understanding people' perception is critical in informing the design of appropriate intervention measures. The aim of this paper was to establish levels and associations between perceived pollution and health risk perception among slum residents. A cross-sectional study of 5,317 individuals aged 35+ years was conducted in two slums of Nairobi. Association of perceived score and individual characteristics was assessed using linear regression. Spatial variation in the perceived levels was determined through hot spot analysis using ArcGIS. The average perceived air pollution level was higher among residents in Viwandani compared to those in Korogocho. Perceived air pollution level was positively associated with perceived health risks. The majority of respondents were exposed to air pollution in their place of work with 66% exposed to at least two sources of air pollution. Less than 20% of the respondents in both areas mentioned sources related to indoor pollution. The perceived air pollution level and related health risks in the study community were low among the residents indicating the need for promoting awareness on air pollution sources and related health risks. PMID:24157509

  17. In their own words: assessment of satisfaction with residential location among migrants in Nairobi slums.

    PubMed

    Mudege, Netsayi Noris; Zulu, Eliya M

    2011-06-01

    Using qualitative data collected from a sample of rural-urban migrants over the age of 15 in two Nairobi slums interviewed in 2008, this paper discusses the migrants' extent of satisfaction with their residential location and decision to migrate. The study sheds light on why people continue to migrate to, and stay in, the rapidly growing slum settlements despite the high levels of poverty and poor health conditions in these areas. Tenure status is related to satisfaction for all ages. Environmental factors were frequently mentioned as a source of dissatisfaction. Life cycle and 'age-cohort effects' may also affect satisfaction for different age groups in terms of who is satisfied as well as the issues that are considered for satisfaction. High levels of dissatisfaction with slum life may be responsible for high out-migration in slum areas, although it does not mean that those who remain do so because they are satisfied. At the same time, challenges associated with slum life do not automatically signify dissatisfaction. Perceived success, as well as conditions in the area of origin can be used to explain and understand satisfaction/dissatisfaction with slum life. Satisfaction with migration and residential location may be related not only to the destination place, but also to events in the area of origin. PMID:20809178

  18. Rift Valley fever outbreak--Kenya, November 2006-January 2007.

    PubMed

    2007-02-01

    In mid-December 2006, several unexplained fatalities associated with fever and generalized bleeding were reported to the Kenya Ministry of Health (KMOH) from Garissa District in North Eastern Province (NEP). By December 20, a total of 11 deaths had been reported. Of serum samples collected from the first 19 patients, Rift Valley fever (RVF) virus RNA or immunoglobulin M (IgM) antibodies against RVF virus were found in samples from 10 patients; all serum specimens were negative for yellow fever, Ebola, Crimean-Congo hemorrhagic fever, and dengue viruses. The outbreak was confirmed by isolation of RVF virus from six of the specimens. Humans can be infected with RVF virus from bites of mosquitoes or other arthropod vectors that have fed on animals infected with RVF virus, or through contact with viremic animals, particularly livestock. Reports of livestock deaths and unexplained animal abortions in NEP provided further evidence of an RVF outbreak. On December 20, an investigation was launched by KMOH, the Kenya Field Epidemiology and Laboratory Training Program (FELTP), the Kenya Medical Research Institute (KEMRI), the Walter Reed Project of the U.S. Army Medical Research Unit, CDC-Kenya's Global Disease Detection Center, and other partners, including the World Health Organization (WHO) and Médecins Sans Frontières (MSF). This report describes the findings from that initial investigation and the control measures taken in response to the RVF outbreak, which spread to multiple additional provinces and districts, resulting in 404 cases with 118 deaths as of January 25, 2007. PMID:17268404

  19. Geological and geophysical reconnaissance of the Lotikipi plain of northwestern Kenya and its relationship to the northern Kenya Rift

    NASA Astrophysics Data System (ADS)

    Wescott, William A.; Stone, Denise M.; Wigger, Stephen T.

    1995-08-01

    The Lotikipi plain, located in the northwestern corner of Kenya, is a broad saucer-shaped depression surrounded by, and mainly filled by, volcanic rocks. Recently acquired geophysical surveys (gravity, magnetic, and seismic) show for the first time the structural configuration of this area and has resulted in an interpretation of its geological history within the framework of the evolution of the northern Kenya Rift. Two sub-basins have been recognized; the Lotikipi in the west and the Gatome in the east, separated by the Lokwanamoru range. They are dominantly filled by Oligo-Miocene volcanics, which are overlain by Late Tertiary(?) to Recent alluvial sedimentary deposits. The Lotikipi basin is characterized by relatively weak normal faulting and reaches a depth of approximately 4000 m. The Gatome basin is defined by a major down-to-the-east normal fault on its west margin and is approximately 6000 m deep. A thick sub-volcanic stratigraphic section, recognized from seismic data, suggests that the deepest part of the Gatome basin may be related to the Cretaceous Abu Gabra-Anza Graben rift trend. The commencement of volcanism in the Lotikipi plain during the Oligocene marked the earliest phase in the evolution of the northern Kenya Rift. This event preceeded the onset of significant extension of the upper crust and is interpreted as the result of a thermal anomaly in the mantle.

  20. Evolutionary sequences and hydrocarbon potential of Kenya sedimentary basins

    SciTech Connect

    Cregg, A.K. )

    1991-03-01

    Kenya basins have evolved primarily through extension related to episodic continental rifting. In eastern Kenya, thick accumulations of sediments formed within grabens during the prerift phase (Precambrian to Carboniferous) of the Gondwana breakup. Synrift sedimentation (Late Carboniferous to Middle Jurassic) occurred within a north-south rift system, which included the Mandera basin, South Anza basin, and Lamu embayment. During the Early Jurassic, a marine transgression invaded the margins of the eastern Kenya rift basins, resulting in the deposition of platform carbonates and shales. A Callovian-aged salt basin formed in the offshore regions of the Lamu embayment. Intermittent tectonic activity and eustatic sea-level changes controlled sedimentation, which produced marine shales, carbonates or evaporites, and fluvio-deltaic to lacustrine sandstones. From the Early Cretaceous to recent, continental sediments were deposited within the North Anza and Turkana basins. These fluvial-lacustrine sediments are similar to the Lower Cretaceous sequences that have produced oil in the Mesozoic Sudanese Abu Gabra rift. Although exploration activities began in the early 1950s, significant occurrences of potential reservoir, source, and seal lithologies as well as trapping configurations remain in many areas. Favorable structures and sequences of reservoir sandstones and carbonates overlain by potentially sealing lacustrine or marine shales, evaporites, or volcanics have been noted. Potential source beds are believed to be present within shales of the lacustrine or marine depositional environments.

  1. Use of mobile learning technology among final year medical students in Kenya

    PubMed Central

    Masika, Moses Muia; Omondi, Gregory Barnabas; Natembeya, Dennis Simiyu; Mugane, Ephraim Mwatha; Bosire, Kefa Ogonyo; Kibwage, Isaac Ongubo

    2015-01-01

    Introduction Mobile phone penetration has increased exponentially over the last decade as has its application in nearly all spheres of life including health and medical education. This study aimed at assessing the use of mobile learning technology and its challenges among final year undergraduate students in the College of Health sciences, University of Nairobi. Methods This was a cross-sectional descriptive study conducted among final year undergraduate students at the University of Nairobi, College of Health Sciences. Self-administered, anonymous questionnaires were issued to all final year students in their lecture rooms after obtaining informed consent. Data on demographics, mobile device ownership and mobile learning technology use and its challenges was collected. Data entry and analysis was done using SPSS®. Chi-square and t-test were used for bivariate analysis. Results We had 292 respondents; 62% were medical students, 16% were nursing students, 13% were pharmacy students and 9% were dental surgery students. The majority were female (59%) and the average age was 24 years. Eighty eight percent (88%) of the respondents owned a smart device and nearly all of them used it for learning. 64% of the respondents used medical mobile applications. The main challenges were lack of a smart device, lack of technical know-how in accessing or using apps, sub-optimal internet access, cost of acquiring apps and limited device memory. Conclusion Mobile learning is increasingly popular among medical students and should be leveraged in promoting access and quality of medical education. PMID:26327964

  2. Sequence and peptide-binding motif for a variant of HLA-A*0214 (A*02142) in an HIV-1-resistant individual from the Nairobi Sex Worker cohort.

    PubMed

    Luscher, M A; MacDonald, K S; Bwayo, J J; Plummer, F A; Barber, B H

    2001-02-01

    As part of the ongoing study of natural HIV-1 resistance in the women of the Nairobi Sex Workers' study, we have examined a resistance-associated HLA class I allele at the molecular level. Typing by polymerase chain reaction using sequence-specific primers determined that this molecule is closely related to HLA-A*0214, one of a family of HLA-A2 supertype alleles which correlate with HIV-1 resistance in this population. Direct nucleotide sequencing shows that this molecule differs from A*0214, having a silent nucleotide substitution. We therefore propose to designate it HLA-A*02142. We have determined the peptide-binding motif of HLA-A*0214/02142 by peptide elution and bulk Edman degradative sequencing. The resulting motif, X-[Q,V]-X-X-X-K-X-X-[V,L], includes lysine as an anchor at position 6. The data complement available information on the peptide-binding characteristics of this molecule, and will be of use in identifying antigenic peptides from HIV-1 and other pathogens. PMID:11261925

  3. Health-care waste incineration and related dangers to public health: case study of the two teaching and referral hospitals in Kenya.

    PubMed

    Njagi, Nkonge A; Oloo, Mayabi A; Kithinji, J; Kithinji, Magambo J

    2012-12-01

    There are practically no low cost, environmentally friendly options in practice whether incineration, autoclaving, chemical treatment or microwaving (World Health Organisation in Health-care waste management training at national level, [2006] for treatment of health-care waste. In Kenya, incineration is the most popular treatment option for hazardous health-care waste from health-care facilities. It is the choice practiced at both Kenyatta National Hospital, Nairobi and Moi Teaching and Referral Hospital, Eldoret. A study was done on the possible public health risks posed by incineration of the segregated hazardous health-care waste in one of the incinerators in each of the two hospitals. Gaseous emissions were sampled and analyzed for specific gases the equipment was designed and the incinerators Combustion efficiency (CE) established. Combustion temperatures were also recorded. A flue gas analyzer (Model-Testos-350 XL) was used to sample flue gases in an incinerator under study at Kenyatta National Hospital--Nairobi and Moi Teaching and Referral Hospital--Eldoret to assess their incineration efficiency. Flue emissions were sampled when the incinerators were fully operational. However the flue gases sampled in the study, by use of the integrated pump were, oxygen, carbon monoxide, nitrogen dioxide, nitrous oxide, sulphur dioxide and No(x). The incinerator at KNH operated at a mean stack temperature of 746 °C and achieved a CE of 48.1 %. The incinerator at MTRH operated at a mean stack temperature of 811 °C and attained a CE of 60.8 %. The two health-care waste incinerators achieved CE below the specified minimum National limit of 99 %. At the detected stack temperatures, there was a possibility that other than the emissions identified, it was possible that the two incinerators tested released dioxins, furans and antineoplastic (cytotoxic drugs) fumes should the drugs be subjected to incineration in the two units. PMID:22718254

  4. Transactional Distance as a Predictor of Perceived Learner Satisfaction in Distance Learning Courses: A Case Study of Bachelor of Education Arts Program, University of Nairobi, Kenya

    ERIC Educational Resources Information Center

    Mbwesa, Joyce Kanini

    2014-01-01

    There is a long history of study and recognition of the critical role of interaction in supporting and even defining distance education. Interaction has been identified as key to the success of distance learning. It is key in fostering, supporting and engaging in the learning process. Moore (1989) posits that the physical distance that exists in…

  5. Temperature Variation and Heat Wave and Cold Spell Impacts on Years of Life Lost Among the Urban Poor Population of Nairobi, Kenya

    PubMed Central

    Egondi, Thaddaeus; Kyobutungi, Catherine; Rocklöv, Joacim

    2015-01-01

    Weather extremes are associated with adverse health outcomes, including mortality. Studies have investigated the mortality risk of temperature in terms of excess mortality, however, this risk estimate may not be appealing to policy makers assessing the benefits expected for any interventions to be adopted. To provide further evidence of the burden of extreme temperatures, we analyzed the effect of temperature on years of life lost (YLL) due to all-cause mortality among the population in two urban informal settlements. YLL was generated based on the life expectancy of the population during the study period by applying a survival analysis approach. Association between daily maximum temperature and YLL was assessed using a distributed lag nonlinear model. In addition, cold spell and heat wave effects, as defined according to different percentiles, were investigated. The exposure-response curve between temperature and YLL was J-shaped, with the minimum mortality temperature (MMT) of 26 °C. An average temperature of 21 °C compared to the MMT was associated with an increase of 27.4 YLL per day (95% CI, 2.7–52.0 years). However, there was no additional effect for extended periods of cold spells, nor did we find significant associations between YLL to heat or heat waves. Overall, increased YLL from all-causes were associated with cold spells indicating the need for initiating measure for reducing health burdens. PMID:25739007

  6. Students' Mathematics Self-Concept and Motivation to Learn Mathematics: Relationship and Gender Differences among Kenya's Secondary-School Students in Nairobi and Rift Valley Provinces

    ERIC Educational Resources Information Center

    Githua, Bernard Nyingi; Mwangi, John Gowland

    2003-01-01

    Although scientific and technological developments are mathematics-based, many students continue to perform poorly in mathematics. This study investigated how students' mathematics self-concept (MSC) is related to their motivation to learn mathematics (SMOT) and gender differences in the two constructs. Out of 165,900 students in 256 secondary…

  7. International Symposium on Remote Sensing of Environment, 20th, Nairobi, Kenya, Dec. 4-10, 1986, Proceedings. Volumes 1, 2, and 3

    SciTech Connect

    Not Available

    1987-01-01

    Papers concerning remote sensing and the environment are presented, including topics such as information for decision making, global monitoring and research, information systems for resource management, environmental monitoring and desertification, and early warning of environmental causes of African famine. Other aspects covered are geology and mineral resources, hydrology and water resources, agriculture and food resources, forestry and rangeland resources, mapping and charting, ocean and coastal applications, and earth observation systems for resource and environmental assessment. The use of Landsat MSS and TM, SIR, SPOT, MOMS, Meteosat, and NOAA/AVHRR data, computer based geographic information systems, gold exploration, groundwater survey, flood monitoring, crop estimations, rangeland monitoring, wildlife tracking, coral reef studies, coastal change detection, international cooperation in remote sensing, monitoring sand movement, structural analysis, mapping sediments, image processing, rainfall assessment, watershed management, biomass energy mapping, impacts of dam construction, vegetation mapping, extraction of hydrological parameters, remote sensing of urban environments, space maps, topographic mapping, Fourier models for interpreting thermal-IR imagery, and the monitoring of landuse changes.

  8. Use of Computers in Information Handling. Report of the DSE/PADIS Training Workshop (Nairobi, Kenya, April 21-May 2, 1986).

    ERIC Educational Resources Information Center

    Huttemann, Lutz, Ed.; Inganji, Francis K., Ed.

    This workshop attended by 21 participants from 13 countries was designed to promote the use of computerized information and documentation services in the eastern and southern African subregion, and increase the exchange of experiences of the personnel involved in the field. The full text is provided for the following papers presented at the…

  9. Bartonella spp. in bats, Kenya.

    PubMed

    Kosoy, Michael; Bai, Ying; Lynch, Tarah; Kuzmin, Ivan V; Niezgoda, Michael; Franka, Richard; Agwanda, Bernard; Breiman, Robert F; Rupprecht, Charles E

    2010-12-01

    We report the presence and diversity of Bartonella spp. in bats of 13 insectivorous and frugivorous species collected from various locations across Kenya. Bartonella isolates were obtained from 23 Eidolon helvum, 22 Rousettus aegyptiacus, 4 Coleura afra, 7 Triaenops persicus, 1 Hipposideros commersoni, and 49 Miniopterus spp. bats. Sequence analysis of the citrate synthase gene from the obtained isolates showed a wide assortment of Bartonella strains. Phylogenetically, isolates clustered in specific host bat species. All isolates from R. aegyptiacus, C. afra, and T. persicus bats clustered in separate monophyletic groups. In contrast, E. helvum and Miniopterus spp. bats harbored strains that clustered in several groups. Further investigation is needed to determine whether these agents are responsible for human illnesses in the region. PMID:21122216

  10. The cost of health professionals' brain drain in Kenya

    PubMed Central

    Kirigia, Joses Muthuri; Gbary, Akpa Raphael; Muthuri, Lenity Kainyu; Nyoni, Jennifer; Seddoh, Anthony

    2006-01-01

    Background Past attempts to estimate the cost of migration were limited to education costs only and did not include the lost returns from investment. The objectives of this study were: (i) to estimate the financial cost of emigration of Kenyan doctors to the United Kingdom (UK) and the United States of America (USA); (ii) to estimate the financial cost of emigration of nurses to seven OECD countries (Canada, Denmark, Finland, Ireland, Portugal, UK, USA); and (iii) to describe other losses from brain drain. Methods The costs of primary, secondary, medical and nursing schools were estimated in 2005. The cost information used in this study was obtained from one non-profit primary and secondary school and one public university in Kenya. The cost estimates represent unsubsidized cost. The loss incurred by Kenya through emigration was obtained by compounding the cost of educating a medical doctor and a nurse over the period between the average age of emigration (30 years) and the age of retirement (62 years) in recipient countries. Results The total cost of educating a single medical doctor from primary school to university is US$ 65,997; and for every doctor who emigrates, a country loses about US$ 517,931 worth of returns from investment. The total cost of educating one nurse from primary school to college of health sciences is US$ 43,180; and for every nurse that emigrates, a country loses about US$ 338,868 worth of returns from investment. Conclusion Developed countries continue to deprive Kenya of millions of dollars worth of investments embodied in her human resources for health. If the current trend of poaching of scarce human resources for health (and other professionals) from Kenya is not curtailed, the chances of achieving the Millennium Development Goals would remain bleak. Such continued plunder of investments embodied in human resources contributes to further underdevelopment of Kenya and to keeping a majority of her people in the vicious circle of ill

  11. Distribution of the main malaria vectors in Kenya

    PubMed Central

    2010-01-01

    Background A detailed knowledge of the distribution of the main Anopheles malaria vectors in Kenya should guide national vector control strategies. However, contemporary spatial distributions of the locally dominant Anopheles vectors including Anopheles gambiae, Anopheles arabiensis, Anopheles merus, Anopheles funestus, Anopheles pharoensis and Anopheles nili are lacking. The methods and approaches used to assemble contemporary available data on the present distribution of the dominant malaria vectors in Kenya are presented here. Method Primary empirical data from published and unpublished sources were identified for the period 1990 to 2009. Details recorded for each source included the first author, year of publication, report type, survey location name, month and year of survey, the main Anopheles species reported as present and the sampling and identification methods used. Survey locations were geo-positioned using national digital place name archives and on-line geo-referencing resources. The geo-located species-presence data were displayed and described administratively, using first-level administrative units (province), and biologically, based on the predicted spatial margins of Plasmodium falciparum transmission intensity in Kenya for the year 2009. Each geo-located survey site was assigned an urban or rural classification and attributed an altitude value. Results A total of 498 spatially unique descriptions of Anopheles vector species across Kenya sampled between 1990 and 2009 were identified, 53% were obtained from published sources and further communications with authors. More than half (54%) of the sites surveyed were investigated since 2005. A total of 174 sites reported the presence of An. gambiae complex without identification of sibling species. Anopheles arabiensis and An. funestus were the most widely reported at 244 and 265 spatially unique sites respectively with the former showing the most ubiquitous distribution nationally. Anopheles gambiae

  12. Spatial modelling and mapping of female genital mutilation in Kenya

    PubMed Central

    2014-01-01

    Background Female genital mutilation/cutting (FGM/C) is still prevalent in several communities in Kenya and other areas in Africa, as well as being practiced by some migrants from African countries living in other parts of the world. This study aimed at detecting clustering of FGM/C in Kenya, and identifying those areas within the country where women still intend to continue the practice. A broader goal of the study was to identify geographical areas where the practice continues unabated and where broad intervention strategies need to be introduced. Methods The prevalence of FGM/C was investigated using the 2008 Kenya Demographic and Health Survey (KDHS) data. The 2008 KDHS used a multistage stratified random sampling plan to select women of reproductive age (15–49 years) and asked questions concerning their FGM/C status and their support for the continuation of FGM/C. A spatial scan statistical analysis was carried out using SaTScan™ to test for statistically significant clustering of the practice of FGM/C in the country. The risk of FGM/C was also modelled and mapped using a hierarchical spatial model under the Integrated Nested Laplace approximation approach using the INLA library in R. Results The prevalence of FGM/C stood at 28.2% and an estimated 10.3% of the women interviewed indicated that they supported the continuation of FGM. On the basis of the Deviance Information Criterion (DIC), hierarchical spatial models with spatially structured random effects were found to best fit the data for both response variables considered. Age, region, rural–urban classification, education, marital status, religion, socioeconomic status and media exposure were found to be significantly associated with FGM/C. The current FGM/C status of a woman was also a significant predictor of support for the continuation of FGM/C. Spatial scan statistics confirm FGM clusters in the North-Eastern and South-Western regions of Kenya (p < 0.001). Conclusion This suggests that the

  13. Perceived social support and the psychological well-being of AIDS orphans in urban Kenya.

    PubMed

    Okawa, Sumiyo; Yasuoka, Junko; Ishikawa, Naoko; Poudel, Krishna C; Ragi, Allan; Jimba, Masamine

    2011-09-01

    Parental deaths due to AIDS seriously affect the psychological well-being of children. Social support may provide an effective resource in the care of vulnerable children in resource-limited settings. However, few studies have examined the relationships between social support and psychological well-being among AIDS orphans. This cross-sectional study was conducted to explore associations between perceived social support (PSS) and the psychological well-being of AIDS orphans, and to identify socio-demographic factors that are associated with PSS. Data were collected from 398 pairs of AIDS orphans (aged 10-18 years) and their caregivers in Nairobi, Kenya. The participants provided information on their socio-demographic characteristics, the children's PSS, and the children's psychological status (based on measures of depressive symptoms and self-esteem). Of the 398 pairs, 327 were included in the analysis. PSS scores of AIDS orphans showed significant correlations with depressive symptoms (ρ =-0.31, p<0.001) and self-esteem (ρ=0.32, p<0.001). Socio-demographic factors, such as HIV-positive status of children (β=3.714, p=0.014) and cohabitation with siblings (β=3.044, p=0.016), were also associated with higher PSS scores. In particular, HIV-infected children (n=37) had higher scores of PSS from a special person (β=2.208, p=0.004), and children living with biological siblings (n=269) also had higher scores of PSS from both a special person (β=1.411, p=0.029) and friends (β=1.276, p=0.039). In conclusion, this study showed that PSS is positively associated with the psychological well-being of AIDS orphans. Siblings and special persons can be effective sources of social support for AIDS orphans, which help to promote their psychological well-being. PMID:21500024

  14. Healthcare in Kenya: learning from a Third World country.

    PubMed

    Hoy, R

    Kenya's healthcare problems are exacerbated by illiteracy, widespread communities, poor sanitation in some areas, and tribal customs and traditions. This article gives an overview of Kenya's healthcare system that was gained by the author during a study tour to Kenya in March 1991. PMID:1290901

  15. Risk Factors for HIV Acquisition in a Prospective Nairobi-Based Female Sex Worker Cohort.

    PubMed

    McKinnon, Lyle R; Izulla, Preston; Nagelkerke, Nico; Munyao, Julius; Wanjiru, Tabitha; Shaw, Souradet Y; Gichuki, Richard; Kariuki, Cecilia; Muriuki, Festus; Musyoki, Helgar; Gakii, Gloria; Gelmon, Lawrence; Kaul, Rupert; Kimani, Joshua

    2015-12-01

    With two million new HIV infections annually, ongoing investigations of risk factors for HIV acquisition is critical to guide ongoing HIV prevention efforts. We conducted a prospective cohort analysis of HIV uninfected female sex workers enrolled at an HIV prevention clinic in Nairobi (n = 1640). In the initially HIV uninfected cohort (70 %), we observed 34 HIV infections during 1514 person-years of follow-up, i.e. an annual incidence of 2.2 % (95 % CI 1.6-3.1 %). In multivariable Cox Proportional Hazard analysis, HIV acquisition was associated with a shorter baseline duration of sex work (aHR 0.76, 95 % CI 0.63-0.91), minimum charge/sex act (aHR 2.74, 0.82-9.15, for low vs. intermediate; aHR 5.70, 1.96-16.59, for high vs. intermediate), N. gonorrhoeae infection (aAHR 5.89, 95 % CI 2.03-17.08), sex with casual clients during menses (aHR 6.19, 95 % CI 2.58-14.84), Depo Provera use (aHR 5.12, 95 % CI 1.98-13.22), and estimated number of annual unprotected regular partner contacts (aHR 1.004, 95 % CI 1.001-1.006). Risk profiling based on baseline predictors suggested that substantial heterogeneity in HIV risk is evident, even within a key population. These data highlight several risk factors for HIV acquisition that could help to re-focus HIV prevention messages. PMID:26091706

  16. A survey for Echinococcus spp. of carnivores in six wildlife conservation areas in Kenya.

    PubMed

    Kagendo, D; Magambo, J; Agola, E L; Njenga, S M; Zeyhle, E; Mulinge, E; Gitonga, P; Mbae, C; Muchiri, E; Wassermann, M; Kern, P; Romig, T

    2014-08-01

    To investigate the presence of Echinococcus spp. in wild mammals of Kenya, 832 faecal samples from wild carnivores (lions, leopards, spotted hyenas, wild dogs and silver-backed jackals) were collected in six different conservation areas of Kenya (Meru, Nairobi, Tsavo West and Tsavo East National Parks, Samburu and Maasai Mara National Reserves). Taeniid eggs were found in 120 samples (14.4%). In total, 1160 eggs were isolated and further analysed using RFLP-PCR of the nad1 gene and sequencing. 38 of these samples contained eggs of Echinococcus spp., which were identified as either Echinococcus felidis (n=27) or Echinococcus granulosus sensu stricto (n=12); one sample contained eggs from both taxa. E. felidis was found in faeces from lions (n=20) and hyenas (n=5) while E. granulosus in faeces from lions (n=8), leopards (n=1) and hyenas (n=3). The host species for two samples containing E. felidis could not be identified with certainty. As the majority of isolated eggs could not be analysed with the methods used (no amplification), we do not attempt to give estimates of faecal prevalences. Both taxa of Echinococcus were found in all conservation areas except Meru (only E. felidis) and Tsavo West (only E. granulosus). Host species identification for environmental faecal samples, based on field signs, was found to be unreliable. All samples with taeniid eggs were subjected to a confirmatory host species RLFP-PCR of the cytochrome B gene. 60% had been correctly identified in the field. Frequently, hyena faeces were mistaken for lion and vice versa, and none of the samples from jackals and wild dogs could be confirmed in the tested sub-sample. This is the first molecular study on the distribution of Echinococcus spp. in Kenyan wildlife. The presence of E. felidis is confirmed for lions and newly reported for spotted hyenas. Lions and hyenas are newly recognized hosts for E. granulosus s.s., while the role of leopards remains uncertain. These data provide the basis for

  17. A Seasonal Air Transport Climatology for Kenya

    NASA Technical Reports Server (NTRS)

    Gatebe, C. K.; Tyson, P. D.; Annegarn, H.; Piketh, S.; Helas, G.

    1998-01-01

    A climatology of air transport to and from Kenya has been developed using kinematic trajectory modeling. Significant months for trajectory analysis have been determined from a classification of synoptic circulation fields. Five-point back and forward trajectory clusters to and from Kenya reveal that the transport corridors to Kenya are clearly bounded and well defined. Air reaching the country originates mainly from the Saharan region and northwestern Indian Ocean of the Arabian Sea in the northern hemisphere and from the Madagascan region of the Indian Ocean in the southern hemisphere. Transport from each of these source regions show distinctive annual cycles related to the northeasterly Asian monsoon and the southeasterly trade wind maximum over Kenya in May. The Saharan transport in the lower troposphere is at a maximum when the subtropical high over northern Africa is strongly developed in the boreal winter. Air reaching Kenya between 700 and 500 hPa is mainly from Sahara and northwest India Ocean flows in the months of January and March, which gives way to southwest Indian Ocean flow in May and November. In contrast, air reaching Kenya at 400 hPa is mainly from southwest Indian Ocean in January and March, which is replaced by Saharan transport in May and November. Transport of air from Kenya is invariant, both spatially and temporally, in the tropical easterlies to the Congo Basin and Atlantic Ocean in comparison to the transport to the country. Recirculation of air has also been observed, but on a limited and often local scale and not to the extent reported in southern Africa.

  18. Dynamic seasonal nitrogen cycling in response to anthropogenic N loading in a tropical catchment, Athi-Galana-Sabaki River, Kenya

    NASA Astrophysics Data System (ADS)

    Marwick, T. R.; Tamooh, F.; Ogwoka, B.; Teodoru, C.; Borges, A. V.; Darchambeau, F.; Bouillon, S.

    2014-01-01

    As part of a broader study on the riverine biogeochemistry in the Athi-Galana-Sabaki (A-G-S) River catchment (Kenya), we present data constraining the sources, transit and transformation of multiple nitrogen (N) species as they flow through the A-G-S catchment (~47 000 km2). The data set was obtained in August-September 2011, November 2011, and April-May 2012, covering the dry season, short rain season and long rain season respectively. Release of (largely untreated) wastewater from the city of Nairobi had a profound impact on the biogeochemistry of the upper Athi River, leading to low dissolved oxygen (DO) saturation levels (36-67%), high ammonium (NH4+) concentrations (123-1193 μmol L-1), and high dissolved methane (CH4) concentrations (3765-6729 nmol L-1). Riverine dissolved inorganic nitrogen (DIN; sum of NH4+ and nitrate (NO3-); nitrite was not measured) concentration at the most upstream site on the Athi River was highest during the dry season (1195 μmol L-1), while DIN concentration was an order of magnitude lower during the short and long rain seasons (212 and 193 μmol L-1, respectively). During the rain seasons, low water residence time led to relatively minimal in-stream N cycling prior to discharge to the ocean, whereas during the dry season we speculate that prolonged residence time creates two differences comparative to wet season, where (1) intense N cycling and removal of DIN is possible in the upper to mid-catchment and leads to significantly lower concentrations at the outlet during the dry season, and (2) as a result this leads to the progressive enrichment of 15N in the particulate N (PN) pool, highlighting the dominance of untreated wastewater as the prevailing source of riverine DIN. The rapid removal of NH4+ in the upper reaches during the dry season was accompanied by a quantitatively similar production of NO3- and nitrous oxide (N2O) downstream, pointing towards strong nitrification over this reach during the dry season. Nitrous oxide

  19. Healthy Firms: Constraints to Growth among Private Health Sector Facilities in Ghana and Kenya

    PubMed Central

    Burger, Nicholas E.; Kopf, Daniel; Spreng, Connor P.; Yoong, Joanne; Sood, Neeraj

    2012-01-01

    Background Health outcomes in developing countries continue to lag the developed world, and many countries are not on target to meet the Millennium Development Goals. The private health sector provides much of the care in many developing countries (e.g., approximately 50 percent in Sub-Saharan Africa), but private providers are often poorly integrated into the health system. Efforts to improve health systems performance will need to include the private sector and increase its contributions to national health goals. However, the literature on constraints private health care providers face is limited. Methodology/Principal Findings We analyze data from a survey of private health facilities in Kenya and Ghana to evaluate growth constraints facing private providers. A significant portion of facilities (Ghana: 62 percent; Kenya: 40 percent) report limited access to finance as the most significant barrier they face; only a small minority of facilities report using formal credit institutions to finance day to day operations (Ghana: 6 percent; Kenya: 11 percent). Other important barriers include corruption, crime, limited demand for goods and services, and poor public infrastructure. Most facilities have paper-based rather than electronic systems for patient records (Ghana: 30 percent; Kenya: 22 percent), accounting (Ghana: 45 percent; Kenya: 27 percent), and inventory control (Ghana: 41 percent; Kenya: 24 percent). A majority of clinics in both countries report undertaking activities to improve provider skills and to monitor the level and quality of care they provide. However, only a minority of pharmacies report undertaking such activities. Conclusions/Significance The results suggest that improved access to finance and improving business processes especially among pharmacies would support improved contributions by private health facilities. These strategies might be complementary if providers are more able to take advantage of increased access to finance when they have

  20. Spatial determinants of poverty in rural Kenya

    PubMed Central

    Okwi, Paul O.; Ndeng'e, Godfrey; Kristjanson, Patti; Arunga, Mike; Notenbaert, An; Omolo, Abisalom; Henninger, Norbert; Benson, Todd; Kariuki, Patrick; Owuor, John

    2007-01-01

    This article investigates the link between poverty incidence and geographical conditions within rural locations in Kenya. Evidence from poverty maps for Kenya and other developing countries suggests that poverty and income distribution are not homogenous. We use spatial regression techniques to explore the effects of geographic factors on poverty. Slope, soil type, distance/travel time to public resources, elevation, type of land use, and demographic variables prove to be significant in explaining spatial patterns of poverty. However, differential influence of these and other factors at the location level shows that provinces in Kenya are highly heterogeneous; hence different spatial factors are important in explaining welfare levels in different areas within provinces, suggesting that targeted propoor policies are needed. Policy simulations are conducted to explore the impact of various interventions on location-level poverty levels. Investments in roads and improvements in soil fertility are shown to potentially reduce poverty rates, with differential impacts in different regions. PMID:17942704

  1. Low latitude ionospheric scintillation and zonal plasma irregularity drifts climatology around the equatorial anomaly crest over Kenya

    NASA Astrophysics Data System (ADS)

    Olwendo, O. J.; Baki, P.; Cilliers, P. J.; Doherty, P.; Radicella, S.

    2016-02-01

    In this study we have used a VHF and GPS-SCINDA receiver located at Nairobi (36.8°E, 1.3°S, dip -24.1°) in Kenya to investigate the climatology of ionospheric L-band scintillation occurrences for the period 2009 to 2012; and seasonal variation of the zonal plasma drift irregularities derived from a VHF receiver for the period 2011. The annual and diurnal variations of L-band scintillation indicate occurrence at post sunset hours and peaks in the equinoctial months. However VHF scintillation occurs at all seasons around the year and is characterized by longer duration of activity and a slow fading that continues till early morning hours unlike in the L-band where they cease after midnight hours. A directional analysis has shown that the spatial distribution of scintillation events is mainly on the Southern and Western part of the sky over Nairobi station closer to the edges of the crest of the Equatorial Ionization Anomaly. The distribution of zonal drift velocities of the VHF related scintillation structures indicates that they move at velocities in the range of 20-160 m/s and their dimension in the East-West direction is in the range of 100-00 km. The December solstice is associated with the largest plasma bubbles in the range of 600-900 km. The most significant observation from this study is the occurrence of post-midnight scintillation without pre-midnight scintillations during magnetically quiet periods. The mechanism leading to the formation of the plasma density irregularity causing scintillation is believed to be via the Rayleigh Tailor Instability; it is however not clear whether we can also attribute the post-midnight plasma bubbles during magnetic quiet times to the same mechanism. From our observations in this study, we suggest that a more likely cause of the east ward zonal electric fields at post-midnight hours is the coupling of the ionosphere with the lower atmosphere during nighttime. This however needs a further investigation based on relevant

  2. Patterns of Drug Abuse in Public Secondary Schools in Kenya

    ERIC Educational Resources Information Center

    Ndetei, David M.; Khasakhala, Lincoln I.; Mutiso, Victoria; Ongecha-Owuor, Francisca A.; Kokonya, Donald A.

    2009-01-01

    The objective of this study was to establish the association between substance abuse and the sociodemographic characteristics of secondary school students. All the students of 17 randomly stratified public secondary schools in Nairobi were required to complete self-administered sociodemographic and the School Toolkit questionnaires in a…

  3. Parental Involvement in Homework and Primary School Academic Performance in Kenya

    ERIC Educational Resources Information Center

    Echaune, Manasi; Ndiku, Judah M.; Sang, Anthony

    2015-01-01

    The factors associated with students' academic performance may have been addressed but the impact of parental involvement continues to be a significant issue. Some schools in Kenya post poor results amid claims that parents are not supportive. This study examined the effect of parental involvement in homework on academic performance in public…

  4. Motivation for Reading and Upper Primary School Students' Academic Achievement in Reading in Kenya

    ERIC Educational Resources Information Center

    Mucherah, Winnie; Herendeen, Abbey

    2013-01-01

    This study examined primary school students' reading motivation and performance on the standardized exam. Participants included 901 seventh and eighth grade students from Kenya. There were 468 females and 433 males. Contrary to previous studies, results showed reading challenge and aesthetics, but not efficacy, predicted reading achievement,…

  5. Strategies for Prevention and Intervention of Drug Abuse among Students in Secondary Schools in Kenya

    ERIC Educational Resources Information Center

    Marais, Petro; Maithya, Redempta

    2015-01-01

    Drug abuse is becoming an increasing problem among students in Kenya. The major cause for concern is that a high proportion of the Kenyan youth in secondary schools are involved in drugs (NACADA 2012). As a result, these young people eventually become addicted, posing a threat to their own health and safety. This study sought to establish the…

  6. The Distance Learning Mode of Training Teachers in Kenya: Challenges, Prospects, and Suggested Policy Framework

    ERIC Educational Resources Information Center

    Maritim, Ezra K.

    2009-01-01

    Globally, distance learning has gained legitimacy as an effective mode for learning and training. This legitimacy has occurred as a result of, "inter alia", its flexibility with respect to time, pace and entry requirements, affordability, cost-effectiveness, and reputation for high quality. In Kenya, distance learning--although relatively new--is…

  7. Outward Peace, Inward Pieces: A Case of the Effect of the Kenya Post-Election Violence

    ERIC Educational Resources Information Center

    Ochieng', Josephine Atieno

    2010-01-01

    In December 2007, unprecedented violence erupted in Kenya following the announcement of disputed presidential election results. The electorate was divided along ethnic lines and tribal clashes bordering on ethnic cleansing escalated. Those supporting opposing camps found themselves on the wrong side of the political divide leading to killings,…

  8. Predictors of Attitudes toward Intimate Partner Violence: A Comparative Study of Men in Zambia and Kenya

    ERIC Educational Resources Information Center

    Lawoko, Stephen

    2008-01-01

    Attitudes toward intimate partner violence (IPV) were compared between Zambian and Kenyan men on sociodemographic, attitudinal, and structural predictors of such attitudes. Data were retrieved from the latest Demographic and Health Surveys in each country. The results showed that many men in Zambia (71%) and Kenya (68%) justified IPV to punish a…

  9. Teacher Incentives in Developing Countries: Recent Experimental Evidence from Kenya. Working Paper 2008-09

    ERIC Educational Resources Information Center

    Glewwe, Paul; Ilias, Nauman; Kremer, Michael

    2008-01-01

    This paper reviews recent evidence on the impact of a teacher incentives program in Kenya. The results are based on a randomized trial, which removes many sources of bias that can arise in analyses of non-experimental data. One hundred schools in a rural area were randomly divided into 50 that participated in a teacher incentives program and 50…

  10. The Right to Education for Children in Domestic Labour: Empirical Evidence from Kenya

    ERIC Educational Resources Information Center

    Munene, Ishmael I.; Ruto, Sara J.

    2010-01-01

    Since 1948, various UN conventions have recognised basic education as a human right. Yet this right continues to be denied to many child labourers across the world. This articles draws on the results of a study examining how children in domestic labour in Kenya access and participate in education. Three issues were explored: (1) the correlates of…

  11. University Agency in Peacebuilding: Perspectives on Conflict and Development in Kenya

    ERIC Educational Resources Information Center

    Johnson, Ane Turner

    2013-01-01

    In 2007, Kenya erupted into violence as a result of heavily contested elections. Because identity divisions lay at the heart of the conflict, the nation's public universities were deeply impacted, at times pitting students, faculty, and staff against one another, and disrupting the ability of Kenyan higher education to contribute to the…

  12. A resolution condemning the September 2013 terrorist attack at the Westgate Mall in Nairobi, Kenya, and reaffirming United States support for the people and Government of Kenya, and for other purposes.

    THOMAS, 113th Congress

    Sen. Coons, Christopher A. [D-DE

    2013-10-11

    11/06/2013 Resolution agreed to in Senate without amendment and with a preamble by Unanimous Consent. (consideration: CR S7888-7889) (All Actions) Tracker: This bill has the status Passed SenateHere are the steps for Status of Legislation:

  13. Delayed initiation of antiretroviral therapy among HIV-discordant couples in Kenya.

    PubMed

    Kahn, Talia R; Desmond, Michelle; Rao, Deepa; Marx, Grace E; Guthrie, Brandon L; Bosire, Rose; Choi, Robert Y; Kiarie, James N; Farquhar, Carey

    2013-01-01

    Timely initiation of antiretroviral therapy (ART) is particularly important for HIV-discordant couples because viral suppression greatly reduces the risk of transmission to the uninfected partner. To identify issues and concerns related to ART initiation among HIV-discordant couples, we recruited a subset of discordant couples participating in a longitudinal study in Nairobi to participate in in-depth interviews and focus group discussions about ART. Our results suggest that partners in HIV-discordant relationships discuss starting ART, yet most are not aware that ART can decrease the risk of HIV transmission. In addition, their concerns about ART initiation include side effects, sustaining an appropriate level of drug treatment, HIV/AIDS-related stigma, medical/biological issues, psychological barriers, misconceptions about the medications, the inconvenience of being on therapy, and lack of social support. Understanding and addressing these barriers to ART initiation among discordant couples is critical to advancing the HIV "treatment as prevention" agenda. PMID:22866934

  14. Impacts of Roadway Emissions on Urban Fine Particle Exposures: the Nairobi Area Traffic Contribution to Air Pollution (NATCAP) Study

    NASA Astrophysics Data System (ADS)

    Gatari, Michael; Ngo, Nicole; Ndiba, Peter; Kinney, Patrick

    2010-05-01

    Air quality is a serious and worsening problem in the rapidly growing cities of sub-Saharan Africa (SSA), due to rapid urbanization, growing vehicle fleets, changing life styles, limited road infrastructure and land use planning, and high per-vehicle emissions. However, the absence of ambient monitoring data, and particularly urban roadside concentrations of particulate matter in SSA cities, severely limits our ability to assess the real extent of air quality problems. Emitted fine particles by on-road vehicles may be particularly important in SSA cities because large concentrations of poorly maintained vehicles operate in close proximity to commercial and other activities of low-income urban residents. This scenario provokes major air quality concerns and its investigation should be of priority interest to policy makers, city planners and managers, and the affected population. As part of collaboration between Columbia University and the University of Nairobi, a PM2.5 air monitoring study was carried out over two weeks in July 2009. The objectives of the study were 1) to assess average daytime PM2.5 concentrations on a range of Nairobi streets that represent important hot-spots in terms of the joint distribution of traffic, commercial, and resident pedestrian activities, 2) to relate those concentrations to motor vehicle counts, 3) to compare urban street concentrations to urban and rural background levels, and 4) to assess vertical and horizontal dispersion of PM2.5 near roadways. Portable, battery-operated PM2.5 samplers were carried by field teams at each of the five sites (three urban, one commuter highway, and one rural site), each of which operated from 7 AM to 7 PM during 10 weekdays in July 2009. Urban background monitoring took place on a rooftop at the University of Nairobi. Preliminary findings suggest highly elevated PM2.5 concentrations at the urban sites where the greatest pedestrian traffic was observed. These findings underscore the need for air

  15. Malaria paediatric hospitalization between 1999 and 2008 across Kenya

    PubMed Central

    2009-01-01

    Background Intervention coverage and funding for the control of malaria in Africa has increased in recent years, however, there are few descriptions of changing disease burden and the few reports available are from isolated, single site observations or are of reports at country-level. Here we present a nationwide assessment of changes over 10 years in paediatric malaria hospitalization across Kenya. Methods Paediatric admission data on malaria and non-malaria diagnoses were assembled for the period 1999 to 2008 from in-patient registers at 17 district hospitals in Kenya and represented the diverse malaria ecology of the country. These data were then analysed using autoregressive moving average time series models with malaria and all-cause admissions as the main outcomes adjusted for rainfall, changes in service use and populations-at-risk within each hospital's catchment to establish whether there has been a statistically significant decline in paediatric malaria hospitalization during the observation period. Results Among the 17 hospital sites, adjusted paediatric malaria admissions had significantly declined at 10 hospitals over 10 years since 1999; had significantly increased at four hospitals, and remained unchanged in three hospitals. The overall estimated average reduction in malaria admission rates was 0.0063 cases per 1,000 children aged 0 to 14 years per month representing an average percentage reduction of 49% across the 10 hospitals registering a significant decline by the end of 2008. Paediatric admissions for all-causes had declined significantly with a reduction in admission rates of greater than 0.0050 cases per 1,000 children aged 0 to 14 years per month at 6 of 17 hospitals. Where malaria admissions had increased three of the four sites were located in Western Kenya close to Lake Victoria. Conversely there was an indication that areas with the largest declines in malaria admission rates were areas located along the Kenyan coast and some sites in

  16. Sharing Special Education Strategies in Rural Kenya

    ERIC Educational Resources Information Center

    Shamberger, Cynthia T.

    2014-01-01

    As a former special education teacher at the elementary, middle and high school levels, many unique and complex learning situations were encountered. The author, who was a junior faculty member on her initial trip to Kenya, experienced a very challenging, yet rewarding, learning opportunity with teachers gathered in a community located in rural…

  17. Child Labor and School Attendance in Kenya

    ERIC Educational Resources Information Center

    Moyi, Peter

    2011-01-01

    Sub-Saharan Africa has the highest incidence of child labor in the world and estimates show that it continues to grow. This paper examines the causes and magnitude of child labor in Kenya. Unlike previous studies that examined child labor as only an economic activity, this paper includes household chores. Including household chores is important…

  18. Relationship Transitions among Youth in Urban Kenya

    ERIC Educational Resources Information Center

    Clark, Shelley; Kabiru, Caroline; Mathur, Rohini

    2010-01-01

    The process of courtship and marriage in sub-Saharan Africa has changed remarkably. These changes, however, have received scant attention because recent research has focused on adolescent relationships' links to HIV/AIDS rather than to marriage. Drawing on detailed reports of 1,365 romantic and sexual partnerships from youths in Kisumu, Kenya, we…

  19. Curriculum Unit: Kenya and Tanzania, Tourist Economies.

    ERIC Educational Resources Information Center

    Lynn, Karen

    This curriculum guide is designed to enable teachers and ninth grade students to develop a clearer understanding of the countries of Kenya and Tanzania and the economic needs of their citizens. A pretest-posttest examination with 20 true or false questions, 2 essay questions, and a list of 50 vocabulary words is provided. Brief descriptions of the…

  20. Multilingual Education in Kenya: Debunking the Myths

    ERIC Educational Resources Information Center

    Orwenjo, Daniel Ochieng

    2012-01-01

    Arguments that have been advanced against multilingual education in Kenya and Africa in general are not new. Most post-colonial African governments have stuck to the pre-colonial education policies which have no relevance to the present day Africa and were, at best, guided by the interests of the colonial power. Unfortunately, most of the claims…

  1. Relative Contribution of Different Levels of Parental Involvement to Primary School Readiness in Preschool Pupils in Nairobi County

    ERIC Educational Resources Information Center

    Mungai, David N.

    2015-01-01

    Recent developments have led to a lot of emphasis being placed on early childhood education. Massive growth has also occurred in this segment of the education sector. Emphasis continues to be placed not just on growth but also on quality of the educational experiences that children are exposed to. In Kenya reports continue to emerge of pupils in…

  2. Lagos bat virus in Kenya.

    PubMed

    Kuzmin, Ivan V; Niezgoda, Michael; Franka, Richard; Agwanda, Bernard; Markotter, Wanda; Beagley, Janet C; Urazova, Olga Y; Breiman, Robert F; Rupprecht, Charles E

    2008-04-01

    During lyssavirus surveillance, 1,221 bats of at least 30 species were collected from 25 locations in Kenya. One isolate of Lagos bat virus (LBV) was obtained from a dead Eidolon helvum fruit bat. The virus was most similar phylogenetically to LBV isolates from Senegal (1985) and from France (imported from Togo or Egypt; 1999), sharing with these viruses 100% nucleoprotein identity and 99.8 to 100% glycoprotein identity. This genome conservancy across space and time suggests that LBV is well adapted to its natural host species and that populations of reservoir hosts in eastern and western Africa have sufficient interactions to share pathogens. High virus concentrations, in addition to being detected in the brain, were detected in the salivary glands and tongue and in an oral swab, suggesting that LBV is transmitted in the saliva. In other extraneural organs, the virus was generally associated with innervations and ganglia. The presence of infectious virus in the reproductive tract and in a vaginal swab implies an alternative opportunity for transmission. The isolate was pathogenic for laboratory mice by the intracerebral and intramuscular routes. Serologic screening demonstrated the presence of LBV-neutralizing antibodies in E. helvum and Rousettus aegyptiacus fruit bats. In different colonies the seroprevalence ranged from 40 to 67% and 29 to 46% for E. helvum and R. aegyptiacus, respectively. Nested reverse transcription-PCR did not reveal the presence of viral RNA in oral swabs of bats in the absence of brain infection. Several large bat roosts were identified in areas of dense human populations, raising public health concerns for the potential of lyssavirus infection. PMID:18305130

  3. Characteristics and patterns of use of emergency contraception among urban women in Nigeria and Kenya

    PubMed Central

    Morgan, Gwendolyn; Keesbury, Jill; Speizer, Ilene

    2014-01-01

    Rates of emergency contraception (EC) use in sub-Saharan Africa are highest in Kenya and Nigeria, although little is understood about user characteristics and use dynamics in these countries. In order to better meet the emergency contraceptive needs of women, and contribute to the limited knowledge base on EC in Africa, this study examines a large, representative sample of EC users. It draws on data collected from household surveys that included 7,785 sexually experienced women in urban Kenya and 12,653 sexually experienced women in urban Nigeria. Bivariate and multivariate analyses found that among these urban women, knowledge of EC was higher than reported in other nationally representative surveys (58% in Kenya and 31% in Nigeria). About 12% of sexually-experienced women in Kenya and 6% in Nigeria ever used EC, although fewer women (less than 5%) reported using EC in the past one year. Recent users of EC were more likely to be in their twenties, unmarried, and more highly educated than never users or ever users of EC in both countries. Results contradict public perceptions of EC users as younger adolescents, and indicate the importance of strengthening EC provision in Africa, including targeting information and services to unmarried women and supporting private pharmacies in delivering quality EC services. PMID:24615575

  4. Traumatic myiasis in free-ranging eland, reported from Kenya

    PubMed Central

    2013-01-01

    Background For centuries, immature stages of Dipterans have infested humans and animals, resulting in a pathological condition referred to as myiasis. Myiases are globally distributed but they remain neglected diseases in spite of the great medical and veterinary importance. Moreover, there is a paucity of information on the clinical-pathology and/or epidemiology of the infestation, especially in African free ranging wildlife. Findings In the present study we report for the first time an outbreak of traumatic cutaneous myiasis (caused by Old World screwworm, Chrysomyia bezziana and blowfly, Lucilia sp.) in free-ranging common elands (Taurotragus oryx). The infestation affected both animal sexes and different age classes, and had a negative impact on individual fitness as well as the overall health. Severely affected individuals were euthanized, while others were clinically treated, and apparently recovered. Conclusions This study indicates that myiasis-causing flies still exist in Kenya and are able to cause severe outbreaks of clinical cutaneous myiasis in wild animals. The status of these parasites in Kenya, which are of zoonotic potential, are either unknown or neglected. PMID:23566876

  5. Mineral content of traditional leafy vegetables from western Kenya.

    PubMed

    Orech, F O; Christensen, D L; Larsen, T; Friis, H; Aagaard-Hansen, J; Estambale, B A

    2007-12-01

    Socio-economic changes that have taken place in Africa have influenced people's eating habits in both rural and urban set-ups. Most people prefer introduced foods to traditional foods, including plant foods whose consumption is widely regarded as a primitive culture manifesting poor lifestyles. However, recent studies on traditional plant foods have shown that some are highly nutritious; containing high levels of both vitamins and minerals. They also have potential as a remedy to counter food insecurity since most are well adapted to the local environment, enabling them to resist pests, drought and diseases. This paper describes the mineral (calcium, iron and zinc) contents in some 54 traditional vegetable species collected from Nyang'oma area of Bondo district, western Kenya. Atomic absorption spectroscopy was used to determine the mineral content. We found that most traditional leafy vegetables, domesticated and wild, generally contain higher levels of calcium, iron and zinc compared with the introduced varieties such as spinach (Spanacia oleracea), kale (Brassica oleracea var. acephala) and cabbage (Brassica oleracea var. capitata). The results of this study could contribute towards identification, propagation and subsequent domestication and cultivation promotion of nutrient-rich and safe species within the farming systems of the local communities in Kenya, sub-Saharan Africa or elsewhere. PMID:17852510

  6. Social determinants of health and health inequities in Nakuru (Kenya)

    PubMed Central

    Muchukuri, Esther; Grenier, Francis R

    2009-01-01

    Background Dramatic inequalities dominate global health today. The rapid urban growth sustained by Kenya in the last decades has created many difficulties that also led to worsening inequalities in health care. The continuous decline in its Human Development Index since the 1990s highlights the hardship that continues to worsen in the country, against the general trend of Sub-Saharan Africa. This paper examines the health status of residents in a major urban centre in Kenya and reviews the effects of selected social determinants on local health. Methods Through field surveys, focus group discussions and a literature review, this study canvasses past and current initiatives and recommends priority actions. Results Areas identified which unevenly affect the health of the most vulnerable segments of the population were: water supply, sanitation, solid waste management, food environments, housing, the organization of health care services and transportation. Conclusion The use of a participatory method proved to be a useful approach that could benefit other urban centres in their analysis of social determinants of health. PMID:19439105

  7. The Impact of Human Mobility on HIV Transmission in Kenya

    PubMed Central

    Isdory, Augustino

    2015-01-01

    Disease spreads as a result of people moving and coming in contact with each other. Thus the mobility patterns of individuals are crucial in understanding disease dynamics. Here we study the impact of human mobility on HIV transmission in different parts of Kenya. We build an SIR metapopulation model that incorporates the different regions within the country. We parameterise the model using census data, HIV data and mobile phone data adopted to track human mobility. We found that movement between different regions appears to have a relatively small overall effect on the total increase in HIV cases in Kenya. However, the most important consequence of movement patterns was transmission of the disease from high infection to low prevalence areas. Mobility slightly increases HIV incidence rates in regions with initially low HIV prevalences and slightly decreases incidences in regions with initially high HIV prevalence. We discuss how regional HIV models could be used in public-health planning. This paper is a first attempt to model spread of HIV using mobile phone data, and we also discuss limitations to the approach. PMID:26599277

  8. Climate-disease connections: Rift Valley Fever in Kenya

    NASA Technical Reports Server (NTRS)

    Anyamba, A.; Linthicum, K. J.; Tucker, C. J.

    2001-01-01

    All known Rift Valley fever(RVF) outbreaks in Kenya from 1950 to 1998 followed periods of abnormally high rainfall. On an interannual scale, periods of above normal rainfall in East Africa are associated with the warm phase of the El Nino/Southern Oscillation (ENSO) phenomenon. Anomalous rainfall floods mosquito-breeding habitats called dambos, which contain transovarially infected mosquito eggs. The eggs hatch Aedes mosquitoes that transmit the RVF virus preferentially to livestock and to humans as well. Analysis of historical data on RVF outbreaks and indicators of ENSO (including Pacific and Indian Ocean sea surface temperatures and the Southern Oscillation Index) indicates that more than three quarters of the RVF outbreaks have occurred during warm ENSO event periods. Mapping of ecological conditions using satellite normalized difference vegetation index (NDVI) data show that areas where outbreaks have occurred during the satellite recording period (1981-1998) show anomalous positive departures in vegetation greenness, an indicator of above-normal precipitation. This is particularly observed in arid areas of East Africa, which are predominantly impacted by this disease. These results indicate a close association between interannual climate variability and RVF outbreaks in Kenya.

  9. Ecological factors influencing HIV sexual risk and resilience among young people in rural Kenya: implications for prevention.

    PubMed

    Harper, Gary W; Riplinger, Andrew J; Neubauer, Leah C; Murphy, Alexandra G; Velcoff, Jessica; Bangi, Audrey K

    2014-02-01

    Most new HIV infections in Kenya occur among young people. The purpose of this study was to understand ecological factors that influence HIV-related sexual risk and resilience among young people in rural Kenya and to elicit their ideas for HIV prevention interventions. Nine focus groups (N = 199) were conducted with both female (55%) and male (45%) participants (ages 14-24 years) living in rural communities in Kenya. Findings were organized into thematic areas related to the following systems of influence: (i) intrapersonal (substance use, HIV knowledge), (ii) interpersonal (peer pressure, lack of parent-child communication, interpersonal sexual violence), (iii) institutional/community (pornography, transactional sex, 'idleness', lack of role models) and (iv) socio-cultural/policy (Kikuyu culture, Western influence, religious beliefs, HIV-related stigma and gendered sexual scripts). Results regarding the types of HIV prevention programs that participants believed should be developed for young people in rural Kenya revealed seven primary themes, including (i) HIV prevention community/group workshops, (ii) condom distribution, (iii) job skills trainings, (iv) athletic and social clubs, (v) HIV-related stigma reduction campaigns, (vi) community-wide demonstrations and (vii) other HIV/AIDS activities led by young people. Implications for the development of culturally and developmentally appropriate HIV prevention interventions for young people in rural Kenya are discussed. PMID:23969629

  10. Khat Use, PTSD and Psychotic Symptoms among Somali Refugees in Nairobi – A Pilot Study

    PubMed Central

    Widmann, Marina; Warsame, Abdulkadir Hussein; Mikulica, Jan; von Beust, Johannes; Isse, Maimuna Mohamud; Ndetei, David; al’Absi, Mustafa; Odenwald, Michael G.

    2014-01-01

    In East-African and Arab countries, khat leaves are traditionally chewed in social settings. They contain the amphetamine-like alkaloid cathinone. Especially among Somali refugees, khat use has been associated with psychiatric symptoms. We assessed khat-use patterns and psychiatric symptoms among male Somali refugees living in a disadvantaged urban settlement area in Kenya, a large group that has not yet received scientific attention. We wanted to explore consume patterns and study the associations between khat use, traumatic experiences, and psychotic symptoms. Using privileged access sampling, we recruited 33 healthy male khat chewers and 15 comparable non-chewers. Based on extensive preparatory work, we assessed khat use, khat dependence according to DSM-IV, traumatic experiences, posttraumatic stress disorder (PTSD), and psychotic symptoms using standardized diagnostic instruments that had been adapted to the Somali language and culture. Hazardous use patterns like chewing for more than 24 h without interruption were frequently reported. All khat users fulfilled the DSM-IV-criteria for dependence and 85% reported functional khat use, i.e., that khat helps them to forget painful experiences. We found that the studied group was heavily burdened by traumatic events and posttraumatic symptoms. Khat users had experienced more traumatic events and had more often PTSD than non-users. Most khat users experience khat-related psychotic symptoms and in a quarter of them we found true psychotic symptoms. In contrast, among control group members no psychotic symptoms could be detected. We found first evidence for the existence and high prevalence of severely hazardous use patterns, comorbid psychiatric symptoms, and khat use as a self-medication of trauma-consequences among male Somali refugees in urban Kenyan refugee settlements. There is a high burden by psychopathology and adequate community-based interventions urgently need to be developed. PMID:25072043

  11. Outcomes and costs of implementing a community-based intervention for hypertension in an urban slum in Kenya

    PubMed Central

    van de Vijver, Steven; Gomez, Gabriela B; Agyemang, Charles; Egondi, Thaddaeus; Kyobutungi, Catherine; Stronks, Karien

    2016-01-01

    Abstract Objective To describe the processes, outcomes and costs of implementing a multi-component, community-based intervention for hypertension among adults aged > 35 years in a large slum in Nairobi, Kenya. Methods The intervention in 2012–2013 was based on four components: awareness-raising; improved access to screening; standardized clinical management of hypertension; and long-term retention in care. Using multiple sources of data, including administrative records and surveys, we described the inputs and outputs of each intervention activity and estimated the outcomes of each component and the impact of the intervention. We also estimated the costs associated with implementation, using a top-down costing approach. Findings The intervention reached 60% of the target population (4049/6780 people), at a cost of 17 United States dollars (US$) per person screened and provided access to treatment for 68% (660/976) of people referred, at a cost of US$ 123 per person with hypertension who attended the clinic. Of the 660 people who attended the clinic, 27% (178) were retained in care, at a cost of US$ 194 per person retained; and of those patients, 33% (58/178) achieved blood pressure control. The total intervention cost per patient with blood pressure controlled was US$ 3205. Conclusion With moderate implementation costs, it was possible to achieve hypertension awareness and treatment levels comparable to those in high-income settings. However, retention in care and blood pressure control were challenges in this slum setting. For patients, the costs and lack of time or forgetfulness were barriers to retention in care. PMID:27429489

  12. Effects of highly active antiretroviral therapy on the survival of HIV-infected adult patients in urban slums of Kenya.

    PubMed

    Muhula, Samuel Opondo; Peter, Memiah; Sibhatu, Biadgilign; Meshack, Ndirangu; Lennie, Kyomuhangi

    2015-01-01

    Recent improvements in access to Anti-Retroviral Therapy (ART) have radically reduced hospitalizations and deaths associated with HIV infection in both developed countries and sub-Saharan Africa. Not much is known about survival of patients on ART in slums. The objective of this study was to identify factors associated with mortality among adult patients on ART in resource poor, urban, sub-Saharan African setting. A prospective open cohort study was conducted with adult patients on ART at a clinic in Kibera slums, Nairobi, Kenya. The patients' enrollment to care was between March 2005 and November 2011. Descriptive statistics were computed and Kaplan-Meier (KM) methods used to estimate survival time while Cox's proportional hazards (CPH) model fitted to determine mortality predictors. A total of 2,011 adult patients were studied, 69% being female. Female gender (p=0.0016), zidovudine-based regimen patients (p<0.0001), CD4 count>351 patients (p<0.0001), WHO stage I patients (p<0.0001) and "Working" functional status patients recorded better survival probability on ART. In CPH analysis, the hazard of dying was higher in patients on Stavudine-based regimen(hazard ratio (HR)=.8; 95% CI, 1.5-2.2; p<0.0001),CD4 count<50 cells/µl (HR=1.6; 95% CI, 1.5-1.7;p<0.0001), WHO Stage IV at ART initiation (HR=1.3; 95% CI, 1.1-1.6; p=0.016) and bedridden patients (HR=2.7; 95% CI, 1.7-4.4;p<0.0001). There was increased mortality among the males, those with advanced Immunosuppression, late WHO stage and bedridden patients. The findings further justify the need to switch patients on Stavudine-based regimen as per the WHO recommendations. PMID:26090021

  13. Instructional Supervision in Public Secondary Schools in Kenya

    ERIC Educational Resources Information Center

    Wanzare, Zachariah

    2012-01-01

    This article reports some findings of study regarding practices and procedures of internal instructional supervision in public secondary schools in Kenya. The findings are part of a large-scale project undertaken in Kenya to determine the perceptions of headteachers, teachers and senior government education officers regarding the practices of…

  14. Early Childhood Education Programs in Kenya: Challenges and Solutions

    ERIC Educational Resources Information Center

    Nganga, Lydiah W.

    2009-01-01

    Early childhood education in Kenya serves the critical purpose of preparing young children for primary education. Notwithstanding the associated benefits for society as a whole, the government of Kenya is involved minimally. Indeed, parents are responsible for planning, developing and managing different early childhood programs. Consequently,…

  15. Growing Up in Kenya: Rural Schooling and Girls. Rethinking Childhood.

    ERIC Educational Resources Information Center

    Mungai, Anne M.

    This book examines the education of rural girls in Kenya and reports on a study of factors influencing girls' educational success or failure. Three chapters provide background on traditional values and practices affecting girls' education; describe Kenya's education system, including preprimary, primary (grades 1-8), secondary, university,…

  16. Human Rhinovirus B and C Genomes from Rural Coastal Kenya.

    PubMed

    Agoti, Charles N; Kiyuka, Patience K; Kamau, Everlyn; Munywoki, Patrick K; Bett, Anne; van der Hoek, Lia; Kellam, Paul; Nokes, D James; Cotten, Matthew

    2016-01-01

    Primer-independent agnostic deep sequencing was used to generate three human rhinovirus (HRV) B genomes and one HRV C genome from samples collected in a household respiratory survey in rural coastal Kenya. The study provides the first rhinovirus genomes from Kenya and will help improve the sensitivity of local molecular diagnostics. PMID:27469941

  17. Towards a Practical Proposal for Multilingualism in Education in Kenya

    ERIC Educational Resources Information Center

    Oduor, Jane A. N.

    2015-01-01

    This article proposes multilingualism in education, where indigenous languages are used alongside English as the media of instruction in schools to eventually promote their use in Kenya. It begins by stating Kenya's language policy in education. It then states the responses given by some primary and secondary school teachers who were interviewed…

  18. Human Rhinovirus B and C Genomes from Rural Coastal Kenya

    PubMed Central

    Agoti, Charles N.; Kiyuka, Patience K.; Kamau, Everlyn; Munywoki, Patrick K.; Bett, Anne; van der Hoek, Lia; Kellam, Paul; Nokes, D. James

    2016-01-01

    Primer-independent agnostic deep sequencing was used to generate three human rhinovirus (HRV) B genomes and one HRV C genome from samples collected in a household respiratory survey in rural coastal Kenya. The study provides the first rhinovirus genomes from Kenya and will help improve the sensitivity of local molecular diagnostics. PMID:27469941

  19. Dynamic seasonal nitrogen cycling in response to anthropogenic N-loading in a tropical catchment, Athi-Galana-Sabaki River, Kenya

    NASA Astrophysics Data System (ADS)

    Marwick, T. R.; Tamooh, F.; Ogwoka, B.; Teodoru, C.; Borges, A. V.; Darchambeau, F.; Bouillon, S.

    2013-05-01

    As part of a broader study on the riverine biogeochemistry in the Athi-Galana-Sabaki (A-G-S) River catchment (Kenya), we present data constraining the sources, transit and transformation of multiple nitrogen (N) species as they flow through the A-G-S catchment (~47 000 km2). The data-set was obtained in August-September 2011, November 2011, and April-May 2012, covering the dry season, short-rain season and long-rain season respectively. Release of, largely untreated, waste water from the city of Nairobi had a profound impact on the biogeochemistry of the upper Athi river, leading to low dissolved oxygen (DO) saturation levels (67-36%), high ammonium (NH4+) concentrations (1193-123 μmol L-1), and high dissolved methane (CH4) concentrations (6729-3765 nmol L-1). Total dissolved inorganic nitrogen (DIN) concentrations entering the study area were highest during the dry season (1195 μmol L-1), while total DIN concentration was an order of magnitude lower during the short and long rain seasons (212 and 193 μmol L-1, respectively). During the rain seasons, low water residence time led to relatively minimal instream N-cycling prior to discharge to the ocean. Conversely, increased residence time during the dry season creates two differences comparative to wet season conditions, where (1) intense cycling and removal of DIN in the upper- to mid-catchment leads to significantly less DIN export during the dry season, and (2) as a result of the intense DIN cycling, dry season particulate N export is significantly enriched in the N stable isotope ratio (δ15NPN), strongly reflecting the dominance of organic matter as the prevailing source of riverine nitrogen. The rapid removal of NH4+ in the upper study area during the dry season was accompanied by a quantitatively similar production of NO3- and nitrous oxide (N2O) downstream, pointing towards strong nitrification over this reach during the dry season. Nitrous oxide produced was rapidly degassed downstream, while the

  20. Results.

    ERIC Educational Resources Information Center

    Zemsky, Robert; Shaman, Susan; Shapiro, Daniel B.

    2001-01-01

    Describes the Collegiate Results Instrument (CRI), which measures a range of collegiate outcomes for alumni 6 years after graduation. The CRI was designed to target alumni from institutions across market segments and assess their values, abilities, work skills, occupations, and pursuit of lifelong learning. (EV)

  1. A campaign against violence: USAID / Kenya funds "Breaking the Silence".

    PubMed

    1997-01-01

    From November 25 to December 10, 1996, USAID/Kenya supported 16 days of activism against gender violence. Called "Breaking the Silence," this annual national campaign was aimed at raising awareness of the rising level of violence against women in Kenya. At meeting places around the country, the campaign, organized by the Coalition on Violence Against Women/Kenya and partially funded by USAID/Kenya, brought together hundreds of participants for a dialogue about gender-based violence. Speakers sought to debunk the myths surrounding violence, including the tendency to blame the victims of gender violence. Victims of violence described their treatment at the hands of abusers. Information brochures discussing domestic battery, wife killing, incest, and other forms of violence against women were distributed. USAID/Kenya has provided funding for this coalition since 1995. PMID:12321054

  2. Repeat Use of Post-exposure Prophylaxis for HIV Among Nairobi-Based Female Sex Workers Following Sexual Exposure.

    PubMed

    Izulla, Preston; McKinnon, Lyle R; Munyao, Julius; Ireri, Naomi; Nagelkerke, Nico; Gakii, Gloria; Gelmon, Lawrence; Nangami, Mabel; Kaul, Rupert; Kimani, Joshua

    2016-07-01

    As ART-based prevention becomes available, effectively targeting these interventions to key populations such as female sex workers (FSW) will be critical. In this study we analyze patterns of repeated post-exposure prophylaxis (PEP) access in the context of a large FSW program in Nairobi. During close to 6000 person-years of follow-up, 20 % of participants (n = 1119) requested PEP at least once and 3.7 % requested PEP more than once. Repeat PEP users were younger, had a higher casual partner volume, and were more likely to use condoms with casual and regular partners, have a regular partner, and test for HIV prior to enrolment. Barriers to PEP included stigma, side effects, and lack of knowledge, suggesting repeated promotion may be required for higher rates of uptake. A small subset of FSW, potentially those with heightened risk perception, showed a higher frequency of PEP use; these individuals may be most amenable to rollout of pre-exposure prophylaxis. PMID:25969181

  3. An integrated geophysical study of the northern Kenya rift

    NASA Astrophysics Data System (ADS)

    Mariita, Nicolas O.; Keller, G. Randy

    2007-06-01

    The Kenyan part of the East African rift is among the most studied rift zones in the world. It is characterized by: (1) a classic rift valley, (2) sheer escarpments along the faulted borders of the rift valley, (3) voluminous volcanics that flowed from faults and fissures along the rift, and (4) axial and flank volcanoes where magma flow was most intense. In northern Kenya, the rift faults formed in an area where the lithosphere was weakened and stretched by Cretaceous-Paleogene extension, and in central and southern Kenya, it formed along old zones of weakness at the contact between the Archean Tanzania craton and the Proterozoic Mozambique orogenic belt. Recent geophysical investigations focused on the tectonic evolution of the East African rift and on exploration for geothermal energy in the southern portion of the Kenyan rift provide considerable information and insight on the structure and evolution of the lithosphere. In the north, a variety of other data exist. However, the lack of an integrated regional analysis of these data was the motivation for this study. Our study began with the collection and compilation of gravity data, and then we used the seismic refraction results from the Kenya Rift International Seismic Project (KRISP), published seismic reflection data, aeromagnetic data, and geologic and drilling data as constraints in the construction of integrated gravity models. These models and gravity anomaly maps provide insight on spatial variations in crustal thickness and upper mantle structure. In addition, they show the distribution of basins and help characterize the distribution of magmatism along the axis of the northern sector of the rift. Our main observations are the following: (1) the region of thinning and anomalous mantle widens northward in agreement with previous studies showing that the crust thins from about 35 km in the south to 20 km in the north; (2) as observed in the south, gravity highs observed along the axis are due to mafic

  4. Solar electricity for Africa: The case of Kenya

    SciTech Connect

    Plas, R.J. van der

    1997-12-01

    This paper presents results of two recent World Bank efforts made in Kenya, Niger, and Cameroon to study the impact of two different renewable projects, one a Micro-Lights program involving about 500 lanterns and the second a survey of 410 households using solar electricity systems. The Micro-Lights program showed that users have distinct preferences in the style of the lamps, that they are willing to spend cash, and that they demand good quality. They may be initially satisfied, but rapidly want more from their purchases. The photoelectric system survey touched less than 1% of such households, and looked at user education, system size, satisfaction, expectations, age of system, appliances, and expectations.

  5. Attributions and Attitudes of Mothers and Fathers in Kenya

    PubMed Central

    Oburu, Paul Odhiambo

    2011-01-01

    SYNOPSIS Objective The present study examined differences and similarities between Kenyan mothers and fathers in attributions regarding successes and failures in caregiving situations and progressive versus authoritarian attitudes. Design Interviews were conducted with both mothers and fathers in 100 two-parent families in Kenya. Results Mothers were more likely to make attributions regarding adult-controlled failure in caregiving situations than were fathers, but mothers and fathers did not differ on attributions regarding uncontrollable success, child-controlled failure, or authoritarian or progressive attitudes. Moderate to large correlations were found between mothers and fathers in terms of attributions regarding uncontrollable success, authoritarian attitudes, and modernity of attitudes. Conclusions Kenyan mothers and fathers hold very similar attributions for success and failures in caregiving situations as well as parenting attitudes. PMID:21927588

  6. Concepts of Illness Among the Swahili of Lamu, Kenya.

    PubMed

    Gearhart, Rebecca; Abdulrehman, Munib Said

    2014-07-01

    The Swahili of Lamu, Kenya, understand illness as the result of a spiritual imbalance caused by personal transgression or an attack by harmful forces directed by an envious person. Another underlying component of the Swahili concept of illness is that each person's physical body operates in conjunction with personal attributes that are fixed at birth and determine moral character, behavior, and predisposition to ailments. When physical symptoms occur, the Swahili focus on identifying the human or supernatural entity that caused the illness in consultation with a range of healers who specialize in a variety of curing strategies. Two case studies illustrate how culturally congruent nursing care can be achieved when health care providers understand the Swahili framework of diagnosing and treating illness. PMID:24381118

  7. Transitioning Enhanced Land Surface Initialization and Model Verification Capabilities to the Kenya Meteorological Department (KMD)

    NASA Technical Reports Server (NTRS)

    Case, Jonathan L.; Mungai, John; Sakwa, Vincent; Zavodsky, Bradley T.; Srikishen, Jayanthi; Limaye, Ashutosh; Blankenship, Clay B.

    2016-01-01

    Flooding, severe weather, and drought are key forecasting challenges for the Kenya Meteorological Department (KMD), based in Nairobi, Kenya. Atmospheric processes leading to convection, excessive precipitation and/or prolonged drought can be strongly influenced by land cover, vegetation, and soil moisture content, especially during anomalous conditions and dry/wet seasonal transitions. It is thus important to represent accurately land surface state variables (green vegetation fraction, soil moisture, and soil temperature) in Numerical Weather Prediction (NWP) models. The NASA SERVIR and the Short-term Prediction Research and Transition (SPoRT) programs in Huntsville, AL have established a working partnership with KMD to enhance its regional modeling capabilities. SPoRT and SERVIR are providing experimental land surface initialization datasets and model verification capabilities for capacity building at KMD. To support its forecasting operations, KMD is running experimental configurations of the Weather Research and Forecasting (WRF; Skamarock et al. 2008) model on a 12-km/4-km nested regional domain over eastern Africa, incorporating the land surface datasets provided by NASA SPoRT and SERVIR. SPoRT, SERVIR, and KMD participated in two training sessions in March 2014 and June 2015 to foster the collaboration and use of unique land surface datasets and model verification capabilities. Enhanced regional modeling capabilities have the potential to improve guidance in support of daily operations and high-impact weather and climate outlooks over Eastern Africa. For enhanced land-surface initialization, the NASA Land Information System (LIS) is run over Eastern Africa at 3-km resolution, providing real-time land surface initialization data in place of interpolated global model soil moisture and temperature data available at coarser resolutions. Additionally, real-time green vegetation fraction (GVF) composites from the Suomi-NPP VIIRS instrument is being incorporated

  8. East African and Kuunga Orogenies in Tanzania - South Kenya

    NASA Astrophysics Data System (ADS)

    Fritz, H.; Hauzenberger, C. A.; Tenczer, V.

    2012-04-01

    Tanzania and southern Kenya hold a key position for reconstructing Gondwana consolidation because here different orogen belts with different tectonic styles interfere. The older, ca. 650-620 Ma East African Orogeny resulted from the amalgamation of arc terranes in the northern Arabian-Nubian Shield (ANS) and continental collision between East African pieces and parts of the Azania terrane in the south (Collins and Pisarevsky, 2005). The change form arc suturing to continental collision settings is found in southern Kenya where southernmost arcs of the ANS conjoin with thickened continental margin suites of the Eastern Granulite Belt. The younger ca. 570-530 Ma Kuunga orogeny heads from the Damara - Zambesi - Irumide Belts (De Waele et al., 2006) over Tanzania - Mozambique to southern India and clashes with the East African orogen in southern-central Tanzania. Two transitional orogen settings may be defined, (1) that between island arcs and inverted passive continental margin within the East African Orogen and, (2) that between N-S trending East African and W-E trending Kuungan orogenies. The Neoproterozoic island arc suites of SE-Kenya are exposed as a narrow stripe between western Azania and the Eastern Granulite belt. This suture is a steep, NNW stretched belt that aligns roughly with the prominent southern ANS shear zones that converge at the southern tip of the ANS (Athi and Aswa shear zones). Oblique convergence resulted in low-vorticity sinstral shear during early phases of deformation. Syn-magmatic and syn-tectonic textures are compatible with deformation at granulite metamorphic conditions and rocks exhumed quickly during ongoing transcurrent motion. The belt is typified as wrench tectonic belt with horizontal northwards flow of rocks within deeper portions of an island arc. The adjacent Eastern Granulite Nappe experienced westward directed, subhorizontal, low-vorticity, high temperature flow at partly extreme metamorphic conditions (900°C, 1.2 to 1.4 GPa

  9. A Study of Women's Access to Higher Education in Kenya with a Special Reference to Mathematics and Science Education.

    ERIC Educational Resources Information Center

    Eshiwani, George S.

    Results of a study of women's access to higher education in Kenya, especially in the areas of science and mathematics, are presented. Forty secondary school teachers completed a questionnaire, and women students studying science and science-based subjects were interviewed. Enrollment at the elementary, secondary, and college levels and the…

  10. Small-Scale Farming in Semi-Arid Areas: Livelihood Dynamics between 1997 and 2010 in Laikipia, Kenya

    ERIC Educational Resources Information Center

    Ulrich, Anne; Speranza, Chinwe Ifejika; Roden, Paul; Kiteme, Boniface; Wiesmann, Urs; Nusser, Marcus

    2012-01-01

    The rural population of semi-arid lands in Kenya face multiple challenges that result from population growth, poor markets, land use and climatic changes. In particular, subsistence oriented farmers face various risks and opportunities in their attempt to secure their livelihoods. This paper presents an analysis on how livelihood assets and…

  11. Teachers' Perceptions of Staff Development Programmes as It Relates to Teachers' Effectiveness: A Study of Rural Primary Schools in Kenya

    ERIC Educational Resources Information Center

    Ngala, Frederick B. J. A.; Odebero, Stephen O.

    2010-01-01

    Results-based management has gained currency in Kenya. After pre-service training, teachers take various staff development programmes to enhance their role effectiveness. Many studies which have associated staff development with employee productivity have not delved into the actual mechanisms in which staff development impact on teachers'…

  12. Family Structure, Parental Perceptions, and Child Labor in Kenya: What Factors Determine Who Is Enrolled in School?

    ERIC Educational Resources Information Center

    Buchmann, Claudia

    2000-01-01

    Analysis of household survey data in Kenya revealed that children's enrollment in school was affected by parents' expectations for future financial help from children and (for girls) by parents' perceptions of labor market discrimination against women, but not by patriarchal norms or child labor. The results challenge traditional explanations of…

  13. High Seroprevalence of Antibodies against Spotted Fever and Scrub Typhus Bacteria in Patients with Febrile Illness, Kenya

    PubMed Central

    Thiga, Jacqueline W.; Mutai, Beth K.; Eyako, Wurapa K.; Ng’ang’a, Zipporah; Jiang, Ju; Richards, Allen L.

    2015-01-01

    Serum samples from patients in Kenya with febrile illnesses were screened for antibodies against bacteria that cause spotted fever, typhus, and scrub typhus. Seroprevalence was 10% for spotted fever group, <1% for typhus group, and 5% for scrub typhus group. Results should help clinicians expand their list of differential diagnoses for undifferentiated fevers. PMID:25811219

  14. Strategies for Supporting Orphans and Vulnerable Children: An Exploratory Study of an Exemplary Model of Care in Kenya

    ERIC Educational Resources Information Center

    Mears, Melynda; Singletary, Jon; Rogers, Rob

    2011-01-01

    This qualitative study explored the extent to which programs in a religiously affiliated agency in Kenya incorporate 12 internationally sanctioned strategies for supporting orphans and vulnerable children in Sub-Saharan Africa (Olson, Knight, & Foster, 2006). The results indicated that all 12 strategies were being employed, though to varying…

  15. A Preliminary Note on Kenya Primary School Enrolment Trends over Four Decades. Create Pathways to Access. Research Monograph No. 9

    ERIC Educational Resources Information Center

    Somerset, Anthony

    2007-01-01

    Kenya has introduced policies to promote universal primary schooling at least three times since independence. Analysis of enrolments over four decades shows how these initiatives have resulted in gains in participation which have not always been sustained. This study illuminates the dynamics of efforts to increase access to education and acts as a…

  16. Why Did Abolishing Fees Not Increase Public School Enrollment in Kenya? Africa Growth Initiative. Working Paper 4

    ERIC Educational Resources Information Center

    Bold, Tessa; Kimenyi, Mwangi S.; Mwabu, Germano; Sandefur, Justin

    2013-01-01

    A large empirical literature has shown that user fees significantly deter public service utilization in developing countries. While most of these results reflect partial equilibrium analysis, we find that the nationwide abolition of public school fees in Kenya in 2003 led to no increase in net public enrollment rates, but rather a dramatic shift…

  17. The Tension of Elite "vs". Massified Higher Education Systems: How Prospective Students Perceive Public and Private Universities in Kenya

    ERIC Educational Resources Information Center

    Oketch, Moses O.

    2009-01-01

    This article examines how recent changes, leading to a diversified supply in Kenya's university education system, is reflected in prospective students' aspirations, perceptions and preferences to undertake university education. The results, based on a combination of a convenience and snowball sampling of settings, within which random samples of…

  18. Nutrition Transition in Rural Tanzania and Kenya.

    PubMed

    Keding, Gudrun

    2016-01-01

    All three types of malnutrition - underweight, overweight and micronutrient deficiency - are experienced in countries undergoing a nutrition transition, and they can occur in parallel in one community or even one household. To combat this triple burden of malnutrition, a combination of different strategies will be necessary, including a focus on food-based strategies that promote the consumption of a wide range of foods across nutritionally distinct food groups. In addition to a literature review, data from our own nutrition studies in both Tanzania and Kenya are presented in this paper. The literature review revealed an average of 10% of children in urban areas of Kenya and Tanzania with overweight and obesity, which is an alarming trend, and it is suggested that interventions need to start not only at school but also with adolescent girls and pregnant women to target the '1,000-day window'. From own study data, dietary patterns were generated that included a 'purchase' pattern dominated by bought and processed foods, indicating a possible nutrition transition even in the rural areas of both countries. Vegetable and especially fruit consumption was low in both countries. In addition, in Kenya, study participants exceeded the suggested maximum level of sugar consumption per day, which will most likely contribute to increasing levels in overweight and obesity prevalence and other noncommunicable diseases in general. As sugar was mainly consumed in combination with black tea, next to eating habits, changing drinking habits is also an important part of the nutrition transition and needs to receive more attention. A 'healthy eating at school and at home strategy' is suggested, which needs the support of both schools and parents/caregivers. In general, to take countermeasures against the negative trends of nutrition transition, joint efforts from all players in the field - not only those in nutrition, health and medicine, but also those in education and agriculture

  19. [Nursing under a different sky: West Kenya].

    PubMed

    Holmedahl, G M

    1993-06-01

    The author worked for almost two years in a remote little clinic in Chesta, West Kenya. It was common for a child to be brought to the clinic with high temperature and other symptoms and be treated for cerebral malaria, lung inflammation, or meningitis. These episodes occurred day and night, sometimes the children were saved and sometimes they died. The author arrived in Kenya on her fourth missionary assignment looking for work and acceptance as a registered nurse. Six weeks had to be spent at a polyclinic and 12 weeks at various children's wards with Kenyan hospitals. There was a lack of medicines and supplies and an enormous turnover of patients. The organization that she was associated with had problems in finding replacements in health work in West Kenya, where, in connection with the usual evangelical work, clinics had been in operation for 12 years. She was requested by NORAD to participate in the health care component of an integrated development program at the Chesta mission station in West Pokot. The work involved being on duty in the clinic as well as out in the field, driving around and even flying on the mission's helicopter to reach villages in the Cherangani Hills. There were mobile clinics at 6 sites in the mountains with 1 visit per month. At 2 of these sites there was an integrated development program comprising health, agriculture, school development, and evangelization. The World Health Organization's vaccination program was conducted at every site. The available services included a maternal-child health care clinic, family planning, teaching of local midwives, and treatment of the sick. The Christian principle of placing equal value on all people was the foundation of the work. This was especially important for women: to be considered not just as chattel of men but as work partners with their own identities and worth. PMID:8274335

  20. Perceptions of malaria and vaccines in Kenya.

    PubMed

    Ojakaa, David; Yamo, Emmanuel; Collymore, Yvette; Ba-Nguz, Antoinette; Bingham, Allison

    2011-10-01

    Malaria is a leading cause of morbidity and mortality in Kenya. To confront malaria, the Government of Kenya has been implementing and coordinating three approaches - vector control by distributing insecticide-treated bed nets and indoor residual spraying, case management, and the management of malaria during pregnancy. Immunization is recognized as one of the most cost-effective public health interventions. Efforts are underway to develop a malaria vaccine. The most advanced (RTS,S), is currently going through phase 3 trials. Although recent studies show the overwhelming support in the community for the introduction of a malaria vaccine, two issues - culture and the delivery of child immunization services - need to be considered. Alongside the modern methods of malaria control described above, traditional methods coexist and act as barriers to attainment of universal immunization. The gender dimension of the immunization programme (where women are the main child caretakers) will also need to be addressed. There is an age dimension to child immunization programmes. Two age cohorts of parents, caregivers, or family members deserve particular attention. These are the youth who are about to initiate childbearing, and the elderly (particularly mother-in-laws who often play a role in child-rearing). Mothers who are less privileged and socially disadvantaged need particular attention when it comes to child immunization. Access to immunization services is often characterized in some Kenyan rural communities in terms of living near the main road, or in the remote inaccessible areas. Should a malaria vaccine become available in the future, a strategy to integrate it into the immunization programme in Kenya should take into account at least two issues. First, it must address the fact that alongside the formal approach in malaria control, there exist the informal traditional practices among communities. Secondly, it must address particular issues in the delivery of

  1. Ocular rhinosporidiosis mimicking conjunctival squamous papilloma in Kenya – a case report

    PubMed Central

    2014-01-01

    Background Ocular rhinosporidiosis is a chronic granulomatous infection caused by a newly classified organism that is neither a fungus nor bacterium. It often presents as a benign conjunctival tumour but may mimic other ocular conditions. It is most often described in India. In Africa cases have been reported from South Africa, Kenya, Tanzania, Malawi, Uganda, Congo and Ivory Coast. Case presentation A 54 year old man was seen in Kenya with a lesion that resembled a conjunctival papilloma. We report resemblance to conjunctival papilloma and the result of vital staining with 0.05% Toluidine Blue. Conclusion Ocular rhinosporidiosis occurs in East Africa. It may resemble conjunctival squamous papilloma. Vital staining with 0.05% Toluidine blue dye did not distinguish the two lesions well. PMID:24708655

  2. Structural style of the Turkana Rift, Kenya

    SciTech Connect

    Dunkelman, T.J.; Karson, J.A.; Rosendahl, B.R.

    1988-03-01

    Multifold seismic reflection and geologic mapping in part of the eastern branch of the East African Rift system of northern Kenya reveal a major rift structure containing at least 3 km of Neogene sediment fill beneath Lake Turkana. This includes a series of half-graben basins, with centrally located quaternary volcanic centers, which are linked end-to-end by structural accommodation zones. Whereas the geometry of rifting is similar to that of the nonvolcanic western branch of the East African Rift system, the Turkana half-grabens are much smaller and may reflect extension of a thinner lithosphere or development of more closely spaced fracture patterns during rift evolution, or both.

  3. The Methanol Poisoning Outbreaks in Libya 2013 and Kenya 2014

    PubMed Central

    Rostrup, Morten; Edwards, Jeffrey K.; Abukalish, Mohamed; Ezzabi, Masoud; Some, David; Ritter, Helga; Menge, Tom; Abdelrahman, Ahmed; Rootwelt, Rebecca; Janssens, Bart; Lind, Kyrre; Paasma, Raido; Hovda, Knut Erik

    2016-01-01

    Background Outbreaks of methanol poisoning occur frequently on a global basis, affecting poor and vulnerable populations. Knowledge regarding methanol is limited, likely many cases and even outbreaks go unnoticed, with patients dying unnecessarily. We describe findings from the first three large outbreaks of methanol poisoning where Médecins Sans Frontières (MSF) responded, and evaluate the benefits of a possible future collaboration between local health authorities, a Non-Governmental Organisation and international expertise. Methods Retrospective study of three major methanol outbreaks in Libya (2013) and Kenya (May and July 2014). Data were collected from MSF field personnel, local health personnel, hospital files, and media reports. Findings In Tripoli, Libya, over 1,000 patients were poisoned with a reported case fatality rate of 10% (101/1,066). In Kenya, two outbreaks resulted in approximately 341 and 126 patients, with case fatality rates of 29% (100/341) and 21% (26/126), respectively. MSF launched an emergency team with international experts, medications and equipment, however, the outbreaks were resolving by the time of arrival. Interpretation Recognition of an outbreak of methanol poisoning and diagnosis seem to be the most challenging tasks, with significant delay from time of first presentations to public health warnings being issued. In spite of the rapid response from an emergency team, the outbreaks were nearly concluded by the time of arrival. A major impact on the outcome was not seen, but large educational trainings were conducted to increase awareness and knowledge about methanol poisoning. Based on this training, MSF was able to send a local emergency team during the second outbreak, supporting that such an approach could improve outcomes. Basic training, simplified treatment protocols, point-of-care diagnostic tools, and early support when needed, are likely the most important components to impact the consequences of methanol poisoning

  4. Ethnobotany of the Samburu of Mt. Nyiru, South Turkana, Kenya.

    PubMed

    Bussmann, Rainer W

    2006-01-01

    Traditional plant use is of extremely high importance in many societies, and prevalent in African communities. This knowledge is however dwindling rapidly due to changes towards a more Western lifestyle. The influence of modern tourism cannot be neglected in this context. This paper examines the plant use of the Samburu of the Mt. Nyiru area in Northern Kenya. The Samburu pastoralists of Kenya are still amongst the most traditional communities of the country and have retained most of their knowledge about the use of a large part of the plants in their environment for a wide variety of purposes. The results indicate that the local population has a very high knowledge of the plants in their surroundings, and attributes a purpose to a large percentage of the plants found. 448 plant species were collected, identified and their Samburu names and traditional uses recorded. 199 species were reported as of "no use". The high proportion of 249 plant species however had some traditional use: The highest number (180 species) was used as fodder, followed by 80 species that had medicinal use. Firewood (59 species), construction (42 species), tools (31 species), food (29 species) and ceremonial use (19 species) ranked far behind. Traditionally the Samburu attribute most illnesses to the effect of pollutants that block or inhibit digestion. This can include "polluted" food, contagion through sick people as well as witchcraft. In most cases the treatment of illness involves herbal purgatives to cleanse the patient. There are however frequent indications of plant use for common problems like wounds, parasites, body aches and burns. The change from a nomadic to a more sedentary lifestyle, often observed in other areas of the country, has affected the Samburu of remote Mt. Nyiru to a much lesser extent and did so far not lead to a major loss of traditional plant knowledge. However, overgrazing and over-exploitation of plant resources have already led to a decline of the plant

  5. Ethnobotany of the Samburu of Mt. Nyiru, South Turkana, Kenya

    PubMed Central

    Bussmann, Rainer W

    2006-01-01

    Traditional plant use is of extremely high importance in many societies, and prevalent in African communities. This knowledge is however dwindling rapidly due to changes towards a more Western lifestyle. The influence of modern tourism cannot be neglected in this context. This paper examines the plant use of the Samburu of the Mt. Nyiru area in Northern Kenya. The Samburu pastoralists of Kenya are still amongst the most traditional communities of the country and have retained most of their knowledge about the use of a large part of the plants in their environment for a wide variety of purposes. The results indicate that the local population has a very high knowledge of the plants in their surroundings, and attributes a purpose to a large percentage of the plants found. 448 plant species were collected, identified and their Samburu names and traditional uses recorded. 199 species were reported as of "no use". The high proportion of 249 plant species however had some traditional use: The highest number (180 species) was used as fodder, followed by 80 species that had medicinal use. Firewood (59 species), construction (42 species), tools (31 species), food (29 species) and ceremonial use (19 species) ranked far behind. Traditionally the Samburu attribute most illnesses to the effect of pollutants that block or inhibit digestion. This can include "polluted" food, contagion through sick people as well as witchcraft. In most cases the treatment of illness involves herbal purgatives to cleanse the patient. There are however frequent indications of plant use for common problems like wounds, parasites, body aches and burns. The change from a nomadic to a more sedentary lifestyle, often observed in other areas of the country, has affected the Samburu of remote Mt. Nyiru to a much lesser extent and did so far not lead to a major loss of traditional plant knowledge. However, overgrazing and over-exploitation of plant resources have already led to a decline of the plant

  6. Assessment of neonatal care in clinical training facilities in Kenya

    PubMed Central

    Aluvaala, Jalemba; Nyamai, Rachael; Were, Fred; Wasunna, Aggrey; Kosgei, Rose; Karumbi, Jamlick; Gathara, David; English, Mike

    2015-01-01

    Objective An audit of neonatal care services provided by clinical training centres was undertaken to identify areas requiring improvement as part of wider efforts to improve newborn survival in Kenya. Design Cross-sectional study using indicators based on prior work in Kenya. Statistical analyses were descriptive with adjustment for clustering of data. Setting Neonatal units of 22 public hospitals. Patients Neonates aged <7 days. Main outcome measures Quality of care was assessed in terms of availability of basic resources (principally equipment and drugs) and audit of case records for documentation of patient assessment and treatment at admission. Results All hospitals had oxygen, 19/22 had resuscitation and phototherapy equipment, but some key resources were missing—for example kangaroo care was available in 14/22. Out of 1249 records, 56.9% (95% CI 36.2% to 77.6%) had a standard neonatal admission form. A median score of 0 out of 3 for symptoms of severe illness (IQR 0–3) and a median score of 6 out of 8 for signs of severe illness (IQR 4–7) were documented. Maternal HIV status was documented in 674/1249 (54%, 95% CI 41.9% to 66.1%) cases. Drug doses exceeded recommendations by >20% in prescriptions for penicillin (11.6%, 95% CI 3.4% to 32.8%) and gentamicin (18.5%, 95% CI 13.4% to 25%), respectively. Conclusions Basic resources are generally available, but there are deficiencies in key areas. Poor documentation limits the use of routine data for quality improvement. Significant opportunities exist for improvement in service delivery and adherence to guidelines in hospitals providing professional training. PMID:25138104

  7. Crustal structure beneath the Kenya Rift from axial profile data

    USGS Publications Warehouse

    Mechie, J.; Keller, Gordon R.; Prodehl, C.; Gaciri, S.; Braile, L.W.; Mooney, W.D.; Gajewski, D.; Sandmeier, K.-J.

    1994-01-01

    Modelling of the KRISP 90 axial line data shows that major crustal thinning occurs along the axis of the Kenya Rift from Moho depths of 35 km in the south beneath the Kenya Dome in the vicinity of Lake Naivasha to 20 km in the north beneath Lake Turkana. Low Pn velocities of 7.5-7.7 km/s are found beneath the whole of the axial line. The results indicate that crustal extension increases to the north and that the low Pn velocities are probably caused by magma (partial melt) rising from below and being trapped in the uppermost kilometres of the mantle. Along the axial line, the rift infill consisting of volcanics and a minor amount of sediments varies in thickness from zero where Precambrian crystalline basement highs occur to 5-6 km beneath the lakes Turkana and Naivasha. Analysis of the Pg phase shows that the upper crystalline crust has velocities of 6.1-6.3 km/s. Bearing in mind the Cainozoic volcanism associated with the rift, these velocities most probably represent Precambrian basement intruded by small amounts of igneous material. The boundary between the upper and lower crusts occurs at about 10 km depth beneath the northern part of the rift and 15 km depth beneath the southern part of the rift. The upper part of the lower crust has velocities of 6.4-6.5 km/s. The basal crustal layer which varies in thickness from a maximum of 2 km in the north to around 9 km in the south has a velocity of about 6.8 km/s. ?? 1994.

  8. High altitude cerebral oedema during adventure training on Mount Kenya.

    PubMed

    Raitt, S

    2012-09-01

    The trekking ascent to Point Lenana (4,985m) on Mount Kenya is a popular objective for soldiers on adventurous training in Kenya. The standard route previously taken has been the Naro Moru route which involves an ascent rate far in excess of that recommended to avoid altitude illness. This article describes the case of a British soldier who developed high altitude cerebral oedema during an ascent of Point Lenana via the Naro Moro route. Recommendations to reduce the risk of altitude illness on Mount Kenya include alternative and more gradual routes of ascent. Early symptom recognition and descent are vital to prevent clinical deterioration. PMID:23472574

  9. Girls' Attitudes Towards Science in Kenya

    NASA Astrophysics Data System (ADS)

    Chetcuti, Deborah A.; Kioko, Beriter

    2012-07-01

    This study investigated girls' attitudes towards science in Kenya. It was carried out with 120 girls from four secondary schools in the Eastern province of Kenya. These were an urban single-sex (SS) and co-educational (Co-Ed) school and a rural SS and Co-Ed school. Different schools were chosen in order to explore whether there are any differences in attitudes in SS and Co-Ed schools and in schools in rural and urban areas. The methodology included the use of both questionnaires and focus group interviews. The main aim was to gain insight into the extent and depth of students' attitudes towards science. The findings of the study showed that the majority of Kenyan girls who participated in the study have a favourable attitude towards science. Girls in SS schools were found to have a more favourable attitude than those in Co-Ed schools, while girls in rural area schools were found to find science more relevant than those in urban schools. It emerged from this study that the attitudes of Kenyan girls are influenced by their perceptions of the relevance of science, enjoyment of studying science, perceptions of the suitability of science for a career, and their perceptions of subject difficulty.

  10. A multipurpose serological survey in Kenya

    PubMed Central

    Geser, Anton; Christensen, Svend; Thorup, Ib

    1970-01-01

    The need to develop methods for serological sample surveys has increased during recent years. The article describes the methods of sampling and blood collecting employed in a serological survey which was conducted in three different areas of Kenya. The purpose of the survey was primarily to gather information about the age-specific prevalence of various infections which were thought to pose public health problems in the country. An attempt was also made to identify environmental factors which might be associated with variation in the prevalence of the different infections. This was done by collecting data about such factors at the same time as the serological specimens were obtained in the selected survey groups. The experience gained during the field work showed that it is possible to achieve a high coverage of bleeding (80%) in randomly selected population groups living in rural Kenya when proper incentives are given to the examines. Venous blood could be obtained from subjects under field conditions down to the age of 2 years; from the babies only capillary blood could be obtained. PMID:5313065

  11. Geothermal energy research in Kenya: a review

    NASA Astrophysics Data System (ADS)

    Tole, Mwakio P.

    1996-11-01

    Geothermal energy for electricity generation is likely to become increasingly important in Kenya in the future. There are numerous centres of thermal activity in Kenya, particularly within the Rift Valley, although aridity and, consequently, availability of water may be a constraint to the development of large scale natural hydrothermal systems. Geothermal resources in the islands of Lake Turkana and those close to other rift lakes deserve further investigation as they do not suffer from the constraints of a shortage of water. The experience gained so far at Oikaria shows that environmental problems can be adequately addressed, though constant monitoring is necessary. H 2S emissions preclude the setting up of permanent residences within about 5 km of the geothermal power stations. Trace elements and radiation from geothermal fluids need to be monitored with respect to their impacts on plants and animals. The impact on the local hydrogeology also requires close observation. Multistage uses of geothermal fluids will greatly increase the benefits derived from this resource.

  12. Trends and Determinants of Antiretroviral Therapy Patient Monitoring Practices in Kenya and Uganda

    PubMed Central

    Dansereau, Emily; Gakidou, Emmanuela; Ng, Marie; Achan, Jane; Burstein, Roy; DeCenso, Brendan; Gasasira, Anne; Ikilezi, Gloria; Kisia, Caroline; Masters, Samuel H.; Njuguna, Pamela; Odeny, Thomas A.; Okiro, Emelda A.; Roberts, D. Allen; Duber, Herbert C.

    2015-01-01

    Introduction Patients receiving antiretroviral therapy (ART) require routine monitoring to track response to treatment and assess for treatment failure. This study aims to identify gaps in monitoring practices in Kenya and Uganda. Methods We conducted a systematic retrospective chart review of adults who initiated ART between 2007 and 2012. We assessed the availability of baseline measurements (CD4 count, weight, and WHO stage) and ongoing CD4 and weight monitoring according to national guidelines in place at the time. Mixed-effects logistic regression models were used to analyze facility and patient factors associated with meeting monitoring guidelines. Results From 2007 to 2012, at least 88% of patients per year in Uganda had a recorded weight at initiation, while in Kenya there was a notable increase from 69% to 90%. Patients with a documented baseline CD4 count increased from 69% to about 80% in both countries. In 2012, 83% and 86% of established patients received the recommended quarterly weight monitoring in Kenya and Uganda, respectively, while semiannual CD4 monitoring was less common (49% in Kenya and 38% in Uganda). Initiating at a more advanced WHO stage was associated with a lower odds of baseline CD4 testing. On-site CD4 analysis capacity was associated with increased odds of CD4 testing at baseline and in the future. Discussion Substantial gaps were noted in ongoing CD4 monitoring of patients on ART. Although guidelines have since changed, limited laboratory capacity is likely to remain a significant issue in monitoring patients on ART, with important implications for ensuring quality care. PMID:26275151

  13. Frequency of Epstein - Barr Virus in Patients Presenting with Acute Febrile Illness in Kenya

    PubMed Central

    Masakhwe, Clement; Ochanda, Horace; Nyakoe, Nancy; Ochiel, Daniel; Waitumbi, John

    2016-01-01

    Background Most acute febrile illnesses (AFI) are usually not associated with a specific diagnosis because of limitations of available diagnostics. This study reports on the frequency of EBV viremia and viral load in children and adults presenting with febrile illness in hospitals in Kenya. Methodology/Principal Findings A pathogen surveillance study was conducted on patients presenting with AFI (N = 796) at outpatient departments in 8 hospitals located in diverse regions of Kenya. Enrollment criterion to the study was fever without a readily diagnosable infection. All the patients had AFI not attributable to the common causes of fever in Kenyan hospitals, such as malaria or rickettsiae, leptospira, brucella and salmonella and they were hence categorized as having AFI of unknown etiology. EBV was detected in blood using quantitative TaqMan-based qPCR targeting a highly conserved BALF5 gene. The overall frequency of EBV viremia in this population was 29.2%, with significantly higher proportion in younger children of <5years (33.8%, p = 0.039) compared to patients aged ≥5 years (26.3% for 5–15 years or 18.8% for >15 years). With respect to geographical localities, the frequency of EBV viremia was higher in the Lake Victoria region (36.4%), compared to Kisii highland (24.6%), Coastal region (22.2%) and Semi-Arid region (25%). Furthermore, patients from the malaria endemic coastal region and the Lake Victoria region presented with significantly higher viremia than individuals from other regions of Kenya. Conclusions/Significance This study provides profiles of EBV in patients with AFI from diverse eco-regions of Kenya. Of significant interest is the high frequency of EBV viremia in younger children. The observed high frequencies of EBV viremia and elevated viral loads in residents of high malaria transmission areas are probably related to malaria induced immune activation and resultant expansion of EBV infected B-cells. PMID:27163791

  14. The development of the East African Rift system in north-central Kenya

    NASA Astrophysics Data System (ADS)

    Hackman, B. D.; Charsley, T. J.; Key, R. M.; Wilkinson, A. F.

    1990-11-01

    system in southern Ethiopia. The NE- and ENE-trending fissures of the eastern fringes of the Kenya dome, notably in the Meru-Nyambeni areaand in the Huri and Marsabit shields, parallel late orogenic structures dated at around 580-480 Ma. Alkaline trends characterize the petrochemistry of the Cenozoic volcanics: In the Gregory Rift, voluminous Miocene alkali basalts, associated with hawaiite/mugearite lavas, define a trend culminating in the Miocene flood phonolites of the eastern shoulderand in the trachyphonolites, trachytes and peralkaline rhyolites, with associated pyroclastics, in central volcanoes such as Korosi, Paka and Silali. Such trends may manifest in the products of a single volcanic centre, also regionally on a broadly cyclic basis. On the eastern flanks of the Kenya dome the flood phonolites are less evident, but the same alkaline trends dominate the lava sequences, supplemented by nephelinitic extrusives in parts of the Nyambeni Range and in the Laisamis area. Results from recent seismicity surveys in the Laisamis area indicate that crustal extension may be currently active on the eastern fringes of the Kenya dome, but manifest at greater depths than in the axial Gregory Rift-Lake Turkana zone: a correlation is suggested with the ultra-alkaline petrochemistry of some of the eastern multicentre shields.

  15. Mapping small wetlands of Kenya and Tanzania using remote sensing techniques

    NASA Astrophysics Data System (ADS)

    Mwita, E.; Menz, G.; Misana, S.; Becker, M.; Kisanga, D.; Boehme, B.

    2013-04-01

    Although wetlands in Tanzania and Kenya have great potentials for agricultural production and a multitude of uses, many of them are not even documented on official maps. Lack of official recognition has done little in preventing there over utilization. As the wetlands continue to play remarkable roles in the movement of people and terrestrial species in the region, it is important that they are monitored and properly managed. This study was undertaken in Usambara highlands and the Pangani floodplain in Tanzania, the Mount Kenya highlands and Laikipia floodplain in Kenya to map the different types of wetlands in terms of their size, density, spatial distribution and use patterns. Remote sensing techniques and field surveys were adopted, and 51 wetlands were identified in flood plains within the semi-arid and sub-humid lowlands, and inland valleys in the region. The detailed maps generated showed the intensity of wetland use, inland valleys being the most intensively used, and are useful in monitoring changes in wetlands for their effective management. The use of multispatial resolution imagery, combined with field survey and GIS produced satisfactory results for the delineation and mapping of small wetlands and their uses.

  16. Working Atmosphere and Job Satisfaction of Health Care Staff in Kenya: An Exploratory Study

    PubMed Central

    Goetz, Katja; Marx, Michael; Marx, Irmgard; Brodowski, Marc; Nafula, Maureen; Prytherch, Helen; Omogi Awour, Irene K. E.; Szecsenyi, Joachim

    2015-01-01

    Background. Job satisfaction and working atmosphere are important for optimal health care delivery. The study aimed to document working atmosphere and job satisfaction of health care professionals in Kenya and to explore associations between job satisfaction, staff characteristics, and working atmosphere. Methods. Data from the integrated quality management system (IQMS) for the health sector in Kenya were used. Job satisfaction was measured with 10 items and with additional 5 items adapted to job situation in Kenya. Working atmosphere was measured with 13 item questionnaire. A stepwise linear regression analysis was performed with overall job satisfaction and working atmosphere, aspects of job satisfaction, and individual characteristics. Results. Out of 832 questionnaires handed out, 435 questionnaires were completed (response rate: 52.3%). Health care staff indicated high commitment to provide quality services and low levels regarding the adequacy and functionality of equipment at their work station. The aspect “support of the ministry of health” (β = 0.577) showed the highest score of explained variance (32.9%) regarding overall job satisfaction. Conclusions. IQMS which also evaluates job satisfaction and working atmosphere of health care staff provides a good opportunity for strengthening the recruitment and retention of health care staff as well as improving the provision of good quality of care. PMID:26504793

  17. The occurrence and geochemistry of fluoride in some natural waters of Kenya

    NASA Astrophysics Data System (ADS)

    Gaciri, S. J.; Davies, T. C.

    1993-03-01

    In recent years the acquisition of considerable additional data on the hydrogeochemical behaviour of fluoride in natural waters of Kenya has been made possible by extensive surface-water and groundwater sampling campaigns as well as by improvements in analytical techniques. Ultimately, the principal source of fluoride relates to emissions from volcanic activity associated with the East African Rift System. Through various intermediate steps, but also directly, fluoride passes into the natural water system and components of the food chain. Ingestion by man is mainly through drinking water and other beverages. River waters in Kenya generally have a fluoride concentration lower than the recommended level (1.3 ppm) for potable water, thus promoting susceptibility to dental caries. Groundwaters and lake waters show considerably higher fluoride contents, resulting in the widespread incidence of fluorosis in areas where groundwater is the major source of drinking water, and lake fish is a regular component of the diet. This paper presents a synthesis of the data so far obtained on the sources and distribution of fluoride in the hydrological system of Kenya, examines the extent of fluorine toxicity and puts forward recommendations to combat or minimise the problem.

  18. Comparative efficacy of existing surveillance tools for Aedes aegypti in Western Kenya.

    PubMed

    Yalwala, Sancto; Clark, Jeffrey; Oullo, David; Ngonga, Daniel; Abuom, David; Wanja, Elizabeth; Bast, Joshua

    2015-12-01

    All traditional surveillance techniques for Aedes aegypti have been developed for the cosmopolitan domestic subspecies Ae. aegypti aegypti, and not the sylvatic subspecies, Ae. aegypti formosus. The predominant form in Western Kenya is Ae. aegypti formosus that is rarely associated with human habitations but is linked to transmission of sylvatic dengue virus strains. We compared five surveillance methods for their effectiveness in sampling Ae. aegypti formosus with the goal of determining a sustainable surveillance strategy in Kenya. The methods included larval and pupal surveys, oviposition trapping, BG-Sentinel trapping, resting boxes, and backpack aspirations. Larval and pupal surveys collected the highest number of Ae. aegypti formosus (51.3%), followed by oviposition traps (45.7%), BG-Sentinel traps (3.0%), and zero collected with either backpack aspiration or resting box collections. No Ae. aegypti formosus larvae or pupae were found indoors. The results indicate that oviposition traps and outdoor larval and pupal surveys were better surveillance methods for Ae. aegypti formosus in Western Kenya. PMID:26611965

  19. Genital infections and syndromic diagnosis among HIV-infected women in HIV care programs in Kenya

    PubMed Central

    Djomand, Gaston; Gao, Hongjiang; Singa, Benson; Hornston, Sureyya; Bennett, Eddas; Odek, James; McClelland, R. Scott; John-Stewart, Grace; Bock, Naomi

    2015-01-01

    Background Control of genital infections remains challenging in most regions. Despite advocacy by the World Health Organization (WHO) for syndromic case management, there are limited data on the syndromic approach, especially in HIV care settings. This study compared the syndromic approach against laboratory diagnosis among women in HIV care in Kenya. Methods A mobile team visited 39 large HIV care programs in Kenya and enrolled participants using population-proportionate sampling. Participants provided behavioral and clinical data with genital and blood specimens for lab testing. Results Among 1,063 women, 68.4% had been on antiretroviral therapy >1 year; 58.9% were using cotrimoxazole prophylaxis; 51 % had CD4+T-lymphocytes < 350 cells/mL. Most women (63.1%) reported at least one genital symptom. Clinical signs were found in 63% of women; and 30.8% had an etiological diagnosis. Bacterial vaginosis (17.4%), vaginal candidiasis (10.6%) and trichomoniasis (10.5%) were the most common diagnoses. Using laboratory diagnoses as gold standard, sensitivity and positive predictive value of the syndromic diagnosis for vaginal discharge were 47.6% and 52.7%, respectively, indicating a substantial amount of overtreatment. A systematic physical examination increased by 9.3% the positive predictive value for genital ulcer disease. Conclusions Women attending HIV care programs in Kenya have high rates of vaginal infections. Syndromic diagnosis was a poor predictor of those infections. PMID:25614522

  20. Implementing intensified tuberculosis case-finding among street-connected youth and young adults in Kenya

    PubMed Central

    Mercer, T.; Kimani, S.; Braitstein, P.; Buziba, N.; Carter, E. J.

    2016-01-01

    Background: Street-connected youth and young adults (SCY) suffer a myriad of health problems. In Kenya, SCY are at high risk for tuberculosis (TB) due to their congregate living situations. TB screening is not routinely implemented in SCY and there has been no published literature on the burden of TB in SCY in western Kenya. Program description: In 2011, the AMPATH TB Program, an experienced TB screening program, partnered with the Tumaini Center, a trusted street youth organization, to conduct intensified case finding (ICF) for pulmonary TB among SCY. Our program aimed to investigate the numbers of SCY who reported symptoms and those diagnosed with smear-positive pulmonary TB, and link SCY with TB to treatment. Results: Of 116 SCY who were screened, 114 (98%) had a positive questionnaire; 104 (90%) provided a spot sputum sample, 39 (34%) provided a morning sputum sample, and 111 (97%) reported cough of >2 weeks. One street youth tested smear-positive for TB and was treated through to cure. Conclusions: Implementing TB ICF is feasible in low-resource settings through unique collaborations between health care programs and community-based organizations. In addition to identifying smear-positive TB, our program uncovered a high burden of respiratory symptoms among SCY in Eldoret, Kenya. PMID:27358809

  1. Short term estimates of adult HIV incidence by mode of transmission: Kenya and Thailand as examples

    PubMed Central

    Gouws, E; White, P J; Stover, J; Brown, T

    2006-01-01

    Objective Patterns of transmission of HIV are different among different regions of the world and change over time within regions. In order to adapt prevention strategies to changing patterns of risk, we need to understand the behaviours that put people at risk of infection and how new infections are distributed among risk groups. Methods A model is described to calculate the expected incidence of HIV infections in the adult population by mode of exposure using the current distribution of prevalent infections and the patterns of risk within different populations. For illustration the model is applied to Thailand and Kenya. Results New infections in Kenya were mainly transmitted through heterosexual contact (90%), while a small but significant number were related to injecting drug use (4.8%) and men who have sex with men (4.5%). In Thailand, the epidemic has spread over time to the sexual partners of vulnerable groups and in 2005 the majority of new infections occurred among the low risk heterosexual population (43%). Men having sex with men accounted for 21% and sex work (including sex workers, clients, and partners of clients) for 18% of new infections. Medical interventions did not contribute significantly to new infections in either Kenya or Thailand. Conclusions The model provides a simple tool to inform the planning of effective, appropriately targeted, country specific intervention programmes. However, better surveillance systems are needed in countries to obtain more reliable biological and behavioural data in order to improve the estimates of incidence by risk group. PMID:16735294

  2. High Acceptability of HIV Pre-exposure Prophylaxis but Challenges in Adherence and Use: Qualitative Insights from a Phase I Trial of Intermittent and Daily PrEP in At-Risk Populations in Kenya

    PubMed Central

    Van der Elst, Elisabeth Maria; Mbogua, Judie; Operario, Don; Mutua, Gaudensia; Kuo, Caroline; Mugo, Peter; Kanungi, Jennifer; Singh, Sagri; Haberer, Jessica; Priddy, Frances; Sanders, Eduard Joachim

    2013-01-01

    This paper used qualitative methods to explore experiences of men who have sex with men and female sex workers in Nairobi and Mtwapa, Kenya, who used oral preexposure prophylaxis (PrEP) for HIV prevention as part of a four-month trial of safety, acceptability and adherence. Fifty-one of 72 volunteers who took part in a randomized, placebo-controlled, blinded trial that compared daily and intermittent dosage of PrEP underwent qualitative assessments after completing the trial. Analyses identified three themes: (i) acceptability of PrEP was high, i.e. side effects were experienced early in the study but diminished over time, however characteristics of pills could improve comfort and use; (ii) social impacts such as stigma, rumors, and relationship difficulties due to being perceived as HIV positive were prevalent; (iii) adherence was challenged by complexities of daily life, in particular post-coital dosing adherence suffered from alcohol use around time of sex, mobile populations, and transactional sex work. These themes resonated across dosing regimens and gender, and while most participants favored the intermittent dosing schedule, those in the intermittent group noted particular challenges in adhering to the post-coital dose. Culturally appropriate and consistent counseling addressing these issues may be critical for PrEP effectiveness. PMID:23080358

  3. The economic costs of malaria in children in three sub-Saharan countries: Ghana, Tanzania and Kenya

    PubMed Central

    2013-01-01

    Background Malaria causes significant mortality and morbidity in sub-Saharan Africa (SSA), especially among children less than five years of age (U5 children). Although the economic burden of malaria in this region has been assessed previously, the extent and variation of this burden remains unclear. This study aimed to estimate the economic costs of malaria in U5 children in three countries (Ghana, Tanzania and Kenya). Methods Health system and household costs previously estimated were integrated with costs associated with co-morbidities, complications and productivity losses due to death. Several models were developed to estimate the expected treatment cost per episode per child, across different age groups, by level of severity and with or without controlling for treatment-seeking behaviour. Total annual costs (2009) were calculated by multiplying the treatment cost per episode according to severity by the number of episodes. Annual health system prevention costs were added to this estimate. Results Household and health system costs per malaria episode ranged from approximately US$ 5 for non-complicated malaria in Tanzania to US$ 288 for cerebral malaria with neurological sequelae in Kenya. On average, up to 55% of these costs in Ghana and Tanzania and 70% in Kenya were assumed by the household, and of these costs 46% in Ghana and 85% in Tanzania and Kenya were indirect costs. Expected values of potential future earnings (in thousands) lost due to premature death of children aged 0–1 and 1–4 years were US$ 11.8 and US$ 13.8 in Ghana, US$ 6.9 and US$ 8.1 in Tanzania, and US$ 7.6 and US$ 8.9 in Kenya, respectively. The expected treatment costs per episode per child ranged from a minimum of US$ 1.29 for children aged 2–11 months in Tanzania to a maximum of US$ 22.9 for children aged 0–24 months in Kenya. The total annual costs (in millions) were estimated at US$ 37.8, US$ 131.9 and US$ 109.0 nationwide in Ghana, Tanzania and Kenya and included average

  4. Search for an astronomical site in Kenya (SASKYA) using climate reanalyses and high-resolution meteorological model data

    NASA Astrophysics Data System (ADS)

    Graham, Edward; Vaughan, Richard; Buckley, David A. H.; Tirima, Koi

    2016-04-01

    The goal of the Search for an Astronomical Site in Kenya (SASKYA) project is to identify the best possible site(s) in Kenya for astronomical optical observation, using ERA-interim climate reanalyses and high-resolution UK Met Office Africa Limited Area meteorological model (Africa-LAM) data. This initial search focusses on a selection of 13 candidate mountain peaks across Kenya. A mixture of 30 years (1981-2010) of relatively coarse-grained ERA-interim reanalyses data and 12 months' (2011-2012) of much higher resolution UK Met Office Africa-LAM data were used to determine the best possible sites. Cloud cover, precipitable water vapour (specific humidity), vertical velocity, aerosol loadings and wind data were analysed. The results confirm that many sites in Kenya are reasonably cloud free, with estimated photometric night fractions of possibly 50 % at the best sites. Significant seasonal inter-annual and inter-decadal variations in cloud cover can be expected, however. Average precipitable water vapour (PWV) values are uncomfortably high, but periods of much lower PWV can be expected during favourable conditions in the dry seasons. Long-term vertical velocities (as a proxy to determine areas of improved "seeing" conditions) indicate that good astronomical viewing conditions are likely to be dependent on the season and wind direction across Kenya. Finally, after full consideration of the climatological data, a trade-off is expected between the best possible site in climatological terms, and the practicalities of installing remote equipment in isolated, inaccessible areas with little or no infrastructure.

  5. Analysis of wood-energy production and consumption strategies among small-scale farmers in central Kenya

    SciTech Connect

    Mwangi, A.M.

    1992-01-01

    This study focuses on wood-energy production and consumption strategies among small-scale farm households in central Kenya. The specific objective were: (1) to determine how households had responded to specific wood-energy policies; (2) to identify factors associated with household adoption or non-adoption of the strategies. Different programs aimed at addressing wood-energy shortages in Kenya were initiated or strengthened during the 1980s: fuelwood or multipurpose tree planting; development and dissemination of improved stoves and fireplaces; promotion of increased accessibility to wood-energy substitutes. Household adoption levels for policy-supported strategies have remained low despite promotion. Survey data from two villages in Nyeri district were collected to determine the factors associated with adoption of the Kenya Ceramic Jiko, the [open quotes]Kuni Mbili[close quotes] stove/fireplace, kerosene stoves, electric cookers, and fuelwood or multipurpose tree planting. Adoption rates varied from as low as 1 percent for electricity to 43 percent for the Kenya Ceramic Jiko. Important policy variables included extension visits per year, income levels, years of formal education received by head of household, access to different fuels, area of farm-land owned, household size, and locational characteristics of the villages. Policy recommendations included: use of research results to direct policy; improvement of information flows between policy makers, extension agents, and technology-users; increased support of agroforestry; and better program coordination. Recommendations for further research included: examining more areas where efficiency gains in energy production and consumption can be made, extending the study to cover the drier parts of central Kenya, and conducting regular case studies in order to better understand the adoption process over time.

  6. RELATIONSHIP TRANSITIONS AMONG YOUTH IN URBAN KENYA.

    PubMed

    Clark, Shelley; Kabiru, Caroline; Mathur, Rohini

    2010-02-01

    The process of courtship and marriage in sub-Saharan Africa has changed remarkably. These changes, however, have received scant attention, as recent research has focused on adolescent relationships' links to HIV/AIDS rather than to marriage. Drawing on detailed reports of 1,365 romantic and sexual partnerships from youths in Kisumu, Kenya, we find that marital aspirations, school enrollment, emotional attraction, pregnancy, and independence from kin are all predictors of getting engaged or married. Furthermore, though men and women are much more likely to marry partners they believe are sexually exclusive, men who have multiple partners are actually more likely to get married. By focusing on the contemporary process of marriage, this paper offers an alternative portrayal of premarital relationships in sub-Saharan Africa. PMID:20885992

  7. RELATIONSHIP TRANSITIONS AMONG YOUTH IN URBAN KENYA

    PubMed Central

    Clark, Shelley; Kabiru, Caroline; Mathur, Rohini

    2010-01-01

    The process of courtship and marriage in sub-Saharan Africa has changed remarkably. These changes, however, have received scant attention, as recent research has focused on adolescent relationships’ links to HIV/AIDS rather than to marriage. Drawing on detailed reports of 1,365 romantic and sexual partnerships from youths in Kisumu, Kenya, we find that marital aspirations, school enrollment, emotional attraction, pregnancy, and independence from kin are all predictors of getting engaged or married. Furthermore, though men and women are much more likely to marry partners they believe are sexually exclusive, men who have multiple partners are actually more likely to get married. By focusing on the contemporary process of marriage, this paper offers an alternative portrayal of premarital relationships in sub-Saharan Africa. PMID:20885992

  8. The Murang'a landslide, Kenya

    NASA Astrophysics Data System (ADS)

    Davies, T. C.; Nyambok, I. O.

    1993-04-01

    On 15 May 1991, a landslide occurred at Gacharage Village in the Murang'a District of Kenya; it buried a house near the toe of a cliff, killing all eight residents in their sleep. The principal determining factors of the slide were a high, mechanically unstable slope of deeply weathered volcanic soil and a high sorption capacity of the surface soil layer. The slide was triggered by rapid saturation of the soil following a heavy downpour. Based on field investigations and laboratory studies, this paper discusses the physical properties and environmental factors that affected slope stability at Murang'a. It also points out the economic and social impact of landslides in the region and suggests remedial measures.

  9. The experiences of women refugees in Kenya.

    PubMed

    Cheruiyot, J

    1999-01-01

    This report brings together testimonies of two women refugees from Rwanda and Ethiopia who suffered violations during their countries¿ civil war and during their flight to Kenya. Emphasized in this report is rape, which is a grave violation of women's human rights. Overall, it is noted that the human rights of these women were violated within their countries of origin and in the countries where they sought refuge. These women were separated from their families, and also have witnessed the killings of their parents and other loved ones. From the testimonies, it is clear that rigorous measures must be taken by all States concerned to fulfill their obligation to protect citizens that are enshrined in various human rights instruments, as well as International Humanitarian Law. Moreover, it shows that the UN High Commission for Refugees and the Kenyan government, which is the host country, must do more to promote and protect the rights of refugees. PMID:12179102

  10. A retrospective study on findings of canine hip dysplasia screening in Kenya

    PubMed Central

    Kimeli, Peter; Mbugua, Susan W.; Cap, Roger M.; Kirui, Gilbert; Abuom, Tequiero O.; Mwangi, Willy E.; Kipyegon, Ambrose N.; Mande, John D.

    2015-01-01

    Aim: The current study was undertaken to evaluate the findings of canine hip dysplasia screening in Kenya. Materials and Methods: Records for 591 dogs were included in this study. The data was obtained from the national screening office, Kenya Veterinary Board, for the period between the years 1998 and 2014. Monthly screening records were assessed and information relating to year of evaluation, breed, sex, age, and hip score captured. Descriptive statistics of hip scores was computed based on year, sex, age, and breed. Results: A total of 591 records from the year 1998 to 2014 were retrieved at the National Screening Centre, the Kenya Veterinary Board. Each record was examined and data pertaining to year of screening, the breed, sex, age of the dogs, and the total hip score were recorded. The highest number of dogs screened for hip dysplasia (HD) was in the year 2009 and the lowest in the year 1998. More females than males were screened for HD and the mean age of all the dogs was 22.9±12.7 months. The most common breeds of dogs screened during the study period were German Shepherd (67.0%), Rottweiler (15.6%), and Labrador Retriever (12.2%). The mean hip score for the 591 dogs was 15.1±10.9 and the median 12.0. The mean hip scores per breed were; German Shepherd (16.3±12.1); Golden Retriever (16.0); Hungarian Vizla (15.0); Labrador Retriever (3.0±6.7); Great Dane (13.3±3.2); Rottweiler (12.2±8.2); Doberman (10.3±4.2); Rhodesian Ridgeback (9.6±3.8); and Boxer (9.3±0.6). Based on the hip score, moderate to severe HD was diagnosed in 16.6% of the dogs, mild HD in 32.7%, Borderline HD in 37.7%, fair HD in 6.9%, and good HD in 6.1%. Conclusion: Canine HD is a common occurrence in Kenya with most dogs suffering mild to border line HD. In addition, German Shepherd and Golden Retriever appear to be the most affected breeds. It is therefore recommended that stringent measures be imposed to dog breeding programs to avoid transmission of this undesirable trait and

  11. Valuing investments in sustainable land management using an integrated modelling framework to support a watershed conservation scheme in the Upper Tana River, Kenya

    NASA Astrophysics Data System (ADS)

    Hunink, Johannes E.; Bryant, Benjamin P.; Vogl, Adrian; Droogers, Peter

    2015-04-01

    We analyse the multiple impacts of investments in sustainable land use practices on ecosystem services in the Upper Tana basin (Kenya) to support a watershed conservation scheme (a "water fund"). We apply an integrated modelling framework, building on previous field-based and modelling studies in the basin, and link biophysical outputs to economic benefits for the main actors in the basin. The first step in the modelling workflow is the use of a high-resolution spatial prioritization tool (Resource Investment Optimization System -- RIOS) to allocate the type and location of conservation investments in the different subbasins, subject to budget constraints and stakeholder concerns. We then run the Soil and Water Assessment Tool (SWAT) using the RIOS-identified investment scenarios to produce spatially explicit scenarios that simulate changes in water yield and suspended sediment. Finally, in close collaboration with downstream water users (urban water supply and hydropower) we link those biophysical outputs to monetary metrics, including: reduced water treatment costs, increased hydropower production, and crop yield benefits for upstream farmers in the conservation area. We explore how different budgets and different spatial targeting scenarios influence the return of the investments and the effectiveness of the water fund scheme. This study is novel in that it presents an integrated analysis targeting interventions in a decision context that takes into account local environmental and socio-economic conditions, and then relies on detailed, process-based, biophysical models to demonstrate the economic return on those investments. We conclude that the approach allows for an analysis on different spatial and temporal scales, providing conclusive evidence to stakeholders and decision makers on the contribution and benefits of the land-based investments in this basin. This is serving as foundational work to support the implementation of the Upper Tana-Nairobi Water Fund

  12. 7 CFR 319.56-54 - French beans and runner beans from Kenya.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 5 2013-01-01 2013-01-01 false French beans and runner beans from Kenya. 319.56-54... § 319.56-54 French beans and runner beans from Kenya. French beans (Phaseolus vulgaris L.) and runner beans (Phaseolus coccineus L.) may be imported into the United States from Kenya only under...

  13. 7 CFR 319.56-54 - French beans and runner beans from Kenya.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 5 2014-01-01 2014-01-01 false French beans and runner beans from Kenya. 319.56-54... § 319.56-54 French beans and runner beans from Kenya. French beans (Phaseolus vulgaris L.) and runner beans (Phaseolus coccineus L.) may be imported into the United States from Kenya only under...

  14. 7 CFR 319.56-54 - French beans and runner beans from Kenya.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 5 2012-01-01 2012-01-01 false French beans and runner beans from Kenya. 319.56-54... § 319.56-54 French beans and runner beans from Kenya. French beans (Phaseolus vulgaris L.) and runner beans (Phaseolus coccineus L.) may be imported into the United States from Kenya only under...

  15. Determinants of Secondary School Learners Performance in Christian Religious Education in Lelan Sub County, Kenya

    ERIC Educational Resources Information Center

    Akaranga, Stephen; Simiyu, Patrick Cheben

    2016-01-01

    In Kenya, Christian Religious Education is taught and examined by the Kenya National Examinations Council in the Kenya Certificate of Secondary Education at the end of the four years of Secondary Education cycle. The teaching of this subject in Secondary Schools ensures that learners are offered an opportunity to develop morally and spiritually…

  16. Higher Education Marketisation and Its Discontents: The Case of Quality in Kenya

    ERIC Educational Resources Information Center

    Wangenge-Ouma, Gerald

    2008-01-01

    This study addresses the implications of higher education marketisation for quality in Kenya. It focuses on full fee-paying programmes, the de facto market source of revenue for Kenya's public universities. The study argues that Kenya's public universities were precipitately subjected to diminished public capitation, and so was their plunging into…

  17. Communal sanitation alternatives for slums: A case study of Kibera, Kenya

    NASA Astrophysics Data System (ADS)

    Schouten, M. A. C.; Mathenge, R. W.

    Despite the prominence of communal practices as a last resort for any decent way of sanitation in slum areas, its application and use is flagrantly ignored. This paper provides insight in the appropriateness of communal sanitation facilities for slum conditions. Recent scholarly investigations in developing countries provide theoretical and empirical evidence of a divergence between the expectations from the users of sanitation facilities, and the expectations from other stakeholders. This paper presents the results from a case study in the Kibera slum attached to Nairobi, which is one of the largest African slums. A series of interviews with government agencies, Non-Governmental Organisations and Community Building Organisations was carried out. In addition, a survey was conducted of 76 users of different sanitation facilities. The research culminates in a series of concerns on financial, technological, situational and participatory dimensions. The main conclusion is a firm confirmation that communal sanitation are indeed the only viable alternative for slums, and therefore, the results of the research advocate a serious recognition of the use and appropriateness of communal sanitation for slum dwellers.

  18. Hospitalized Children Reveal Health Systems Gaps in the Mother-Child HIV Care Cascade in Kenya.

    PubMed

    Njuguna, Irene N; Wagner, Anjuli D; Cranmer, Lisa M; Otieno, Vincent O; Onyango, Judith A; Chebet, Daisy J; Okinyi, Helen M; Benki-Nugent, Sarah; Maleche-Obimbo, Elizabeth; Slyker, Jennifer A; John-Stewart, Grace C; Wamalwa, Dalton C

    2016-03-01

    To identify missed opportunities in HIV prevention, diagnosis, and linkage to care, we enrolled 183 hospitalized, HIV-infected, ART-naïve Kenyan children 0-12 years from four hospitals in Nairobi and Kisumu, and reviewed prevention of mother-to-child transmission of HIV (PMTCT), hospitalization, and HIV testing history. Median age was 1.8 years (IQR = 0.8, 4.5). Most mothers received HIV testing during pregnancy (77%). Among mothers tested, 60% and 40% reported HIV-negative and positive results, respectively; 33% of HIV-diagnosed mothers did not receive PMTCT antiretrovirals. First missed opportunities for pediatric diagnosis and linkage were due to failure to test mothers (23.1%), maternal HIV acquisition following initial negative test (45.7%), no early infant diagnosis (EID) or provider-initiated testing (PITC) (12.7%), late breastfeeding transmission (8.7%), failure to collect child HIV test results (1.2%), and no linkage to care following HIV diagnosis (8.7%). Among previously hospitalized children, 38% never received an HIV test. Strengthening initial and repeat maternal HIV testing and PITC are key interventions to prevent, detect, and treat pediatric HIV infections. PMID:27308805

  19. Comparative tick counts on game, cattle and sheep on a working game ranch in Kenya.

    PubMed

    Wesonga, F D; Orinda, G O; Ngae, G N; Grootenhuis, J

    2006-01-01

    The main objective of the study was to determine the possible influence of host species on the maintenance of ticks in the field by determining the relative contribution of game animals compared to domestic animals. The study was carried out on a game ranch 32 km south-east of Nairobi. Tick counts were carried out on 30 Zebu cattle (Bos indicus) aged 1 to 3 years and 20 red Maasai sheep (Ovis aries) aged 6 months to 1 year grazing with game animals in a common area for a period of 2 years and these counts were compared with those on eland and Thomson's gazelle. Half-body counts were carried out on the cattle and sheep once every week. To avoid excessive stress, the animals were dipped in amitraz whenever the half body counts exceeded 50 fully engorged female ticks of any species. Tick counts on two wild animal species (eland (Taurotragus oryx) and Thomson's gazelle (Gazella thomsonii)) were carried out during the weekly culling of the herbivores. The results revealed that there was no significant difference in the number ticks per square metre between the wild ungulates and the domestic animals. PMID:17405627

  20. Lay perceptions of breast cancer in Western Kenya

    PubMed Central

    Naanyu, Violet; Asirwa, Chite Fredrick; Wachira, Juddy; Busakhala, Naftali; Kisuya, Job; Otieno, Grieven; Keter, Alfred; Mwangi, Anne; Omenge, Orango Elkanah; Inui, Thomas

    2015-01-01

    AIM: To explore lay perceptions of causes, severity, presenting symptoms and treatment of breast cancer. METHODS: In October-November 2012, we recruited men and women (18 years and older) from households and health facilities in three different parts of Western Kenya, chosen for variations in their documented burdens of breast cancer. A standardized and validated tool, the breast cancer awareness measure (BCAM), was administered in face-to-face interviews. Survey domains covered included socio-demographics, opinions about causes, symptoms, severity, and treatment of breast cancer. Descriptive analyses were done on quantitative data while open-ended answers were coded, and emerging themes were integrated into larger categories in a qualitative analysis. The open-ended questions had been added to the standard BCAM for the purposes of learning as much as the investigators could about underlying lay beliefs and perceptions. RESULTS: Most respondents were female, middle-aged (mean age 36.9 years), married, and poorly educated. Misconceptions and lack of knowledge about causes of breast cancer were reported. The following (in order of higher to lower prevalence) were cited as potential causes of the condition: Genetic factors or heredity (n = 193, 12.3%); types of food consumed (n = 187, 11.9%); witchcraft and curses (n = 108, 6.9%); some family planning methods (n = 56, 3.6%); and use of alcohol and tobacco (n = 46, 2.9%). When asked what they thought of breast cancer’s severity, the most popular response was “it is a killer disease” (n = 266, 19.7%) a lethal condition about which little or nothing can be done. While opinions about presenting symptoms and signs of breast cancer were able to be elicited, such as an increase in breast size and painful breasts, early-stage symptoms and signs were not widely recognized. Some respondents (14%) were ignorant of available treatment altogether while others felt breast cancer treatment is both dangerous and expensive. A

  1. Frequency and collective dose of medical procedures in Kenya.

    PubMed

    Korir, Geoffrey K; Wambani, Jeska S; Korir, Ian K; Tries, Mark; Kidali, Mike M

    2013-12-01

    The first comprehensive national survey on frequency and radiation dose imparted to the population from radiological procedures was carried out in Kenya and reported here. This survey involved assessment of frequency, typical patient radiation exposure, and collective effective dose from general radiography, fluoroscopy, interventional procedures (IPs), mammography, and computed tomography. About 300 x-ray facilities across the country were invited to participate in the survey, and a 31% response was recorded. The individual and collective radiation burdens of more than 62 types of pediatric and adult radiological examinations were quantified using effective and collective dose. The average effective dose for each radiological examination was assessed from the x-ray efficiency performance tests and patient data from over 30 representative radiological facilities. The results found indicated that over 3 million x-ray procedures were performed in 2011, resulting in an annual collective effective dose of 2,157 person-Sv and an annual effective dose per capita of 0.05 mSv. The most frequent examinations were general radiography (94%), computed tomography (3.3%), and fluoroscopy (2.5%). Although the contribution of computed tomography was small in terms of frequency, this procedure accounted for 36% of the effective dose per capita. General radiography was the most frequent type of examination with a contribution of 55% of the effective dose per capita. PMID:24162056

  2. Efficacy of two lion conservation programs in Maasailand, Kenya.

    PubMed

    Hazzah, Leela; Dolrenry, Stephanie; Naughton-Treves, Lisa; Naughton, Lisa; Edwards, Charles T T; Mwebi, Ogeto; Kearney, Fiachra; Frank, Laurence

    2014-06-01

    Lion (Panthera leo) populations are in decline throughout most of Africa. The problem is particularly acute in southern Kenya, where Maasai pastoralists have been spearing and poisoning lions at a rate that will ensure near term local extinction. We investigated 2 approaches for improving local tolerance of lions: compensation payments for livestock lost to predators and Lion Guardians, which draws on local cultural values and knowledge to mitigate livestock-carnivore conflict and monitor carnivores. To gauge the overall influence of conservation intervention, we combined both programs into a single conservation treatment variable. Using 8 years of lion killing data, we applied Manski's partial identification approach with bounded assumptions to investigate the effect of conservation treatment on lion killing in 4 contiguous areas. In 3 of the areas, conservation treatment was positively associated with a reduction in lion killing. We then applied a generalized linear model to assess the relative efficacy of the 2 interventions. The model estimated that compensation resulted in an 87-91% drop in the number of lions killed, whereas Lion Guardians (operating in combination with compensation and alone) resulted in a 99% drop in lion killing. PMID:24527992

  3. Development of a decision support system for crop disease monitoring, surveillance and prediction in Bomet county, Kenya

    NASA Astrophysics Data System (ADS)

    Otieno, O. M.

    2015-12-01

    The study proposes to use Geographic Information Systems and Remote Sensing techniques to spatially model Maize Lethal Necrosis (MLN) disease in maize growing areas in Kenya. Results from this work will be used for prediction, monitoring and to guide intervention on MLN. This will minimize maize yield losses resulting from MLN infestation and thus safeguard the livelihoods of maize farmers in Kenya. MLN was first reported in Kenya in September 2011 in Bomet county. It then subsequently spread to other parts in Kenya. Maize crops are susceptible to MLN at all growth stages. Once infected the only option left for the farmers is to burn their maize plantations. Infection rate and damage is very high affecting yields and sometimes causing complete loss of maize yield.The modelling exercise will cover the period prior to and after the incidence of MLN. Specifically, the analysis will integrate spatio-temporal information on maize phenology and field surveys with the intention of delineating the extent of MLN infestation and the degree of damage as a result of MLN. Additionally, the task will identify potential predisposing factors leading to MLN resurgence and spread and to predict potential areas where MLN is likely to spread and to estimate the potential impact of MLN on the farm holders. The area of study for this task will be Bomet County. Historical and current environmental and spatial indicators including temperature, rainfall, soil moisture, vegetation health and crop cover will be fed into a model in order to determine the main factors that aide the occurrence and the spread of MLN. Multi-spectral image processing will be used to produce indices to study maize crop health whilst image classification techniques will be used to identify crop cover clusters by differentiating the variations in spectral signatures in the area of study and hence distinguish infected, unaffected maize crops and other crop cover classes. Variables from these indicators will then be

  4. Beyond engagement in working with children in eight Nairobi slums to address safety, security, and housing: Digital tools for policy and community dialogue.

    PubMed

    Mitchell, Claudia; Chege, Fatuma; Maina, Lucy; Rothman, Margot

    2016-01-01

    This article studies the ways in which researchers working in the area of health and social research and using participatory visual methods might extend the reach of participant-generated creations such as photos and drawings to engage community leaders and policy-makers. Framed as going 'beyond engagement', the article explores the idea of the production of researcher-led digital dialogue tools, focusing on one example, based on a series of visual arts-based workshops with children from eight slums in Nairobi addressing issues of safety, security, and well-being in relation to housing. The authors conclude that there is a need for researchers to embark upon the use of visual tools to expand the life and use of visual productions, and in particular to ensure meaningful participation of communities in social change. PMID:27132645

  5. HIV-1 progression links with viral genetic variability and subtype, and patient's HLA type: analysis of a Nairobi-Kenyan cohort.

    PubMed

    Abidi, Syed Hani; Shahid, Aniqa; Lakhani, Laila S; Shah, Reena; Okinda, Nancy; Ojwang, Peter; Abbas, Farhat; Rowland-Jones, Sarah; Ali, Syed

    2014-02-01

    In a Nairobi-Kenyan cohort of 50 HIV-1 positive patients, we analysed the prevalence of HIV-1 subtypes and human leucocyte antigen (HLA) alleles. From this cohort, 33 patients were selected for the analysis of HIV-1 infection progression markers (i.e. CD4 cell counts and viral loads) and their association with HIV-1 genetic variability and subtype, and patient's HLA type. HIV-1 gag genetic variability, analysed using bioinformatics tools, showed an inverse relationship with CD4 cell count whereas with viral load that relationship was direct. Certain HLA types and viral subtypes were also found to associate with patients' viral load. Associations between disease parameters and the genetic makeup of the host and virus may be crucial in determining the outcome of HIV-1 infection. PMID:24142198

  6. Modeling the Cost Effectiveness of Malaria Control Interventions in the Highlands of Western Kenya

    PubMed Central

    Stuckey, Erin M.; Stevenson, Jennifer; Galactionova, Katya; Baidjoe, Amrish Y.; Bousema, Teun; Odongo, Wycliffe; Kariuki, Simon; Drakeley, Chris; Smith, Thomas A.; Cox, Jonathan; Chitnis, Nakul

    2014-01-01

    Introduction Tools that allow for in silico optimization of available malaria control strategies can assist the decision-making process for prioritizing interventions. The OpenMalaria stochastic simulation modeling platform can be applied to simulate the impact of interventions singly and in combination as implemented in Rachuonyo South District, western Kenya, to support this goal. Methods Combinations of malaria interventions were simulated using a previously-published, validated model of malaria epidemiology and control in the study area. An economic model of the costs of case management and malaria control interventions in Kenya was applied to simulation results and cost-effectiveness of each intervention combination compared to the corresponding simulated outputs of a scenario without interventions. Uncertainty was evaluated by varying health system and intervention delivery parameters. Results The intervention strategy with the greatest simulated health impact employed long lasting insecticide treated net (LLIN) use by 80% of the population, 90% of households covered by indoor residual spraying (IRS) with deployment starting in April, and intermittent screen and treat (IST) of school children using Artemether lumefantrine (AL) with 80% coverage twice per term. However, the current malaria control strategy in the study area including LLIN use of 56% and IRS coverage of 70% was the most cost effective at reducing disability-adjusted life years (DALYs) over a five year period. Conclusions All the simulated intervention combinations can be considered cost effective in the context of available resources for health in Kenya. Increasing coverage of vector control interventions has a larger simulated impact compared to adding IST to the current implementation strategy, suggesting that transmission in the study area is not at a level to warrant replacing vector control to a school-based screen and treat program. These results have the potential to assist malaria

  7. Mobile money, smallholder farmers, and household welfare in Kenya.

    PubMed

    Kikulwe, Enoch M; Fischer, Elisabeth; Qaim, Matin

    2014-01-01

    The use of mobile phones has increased rapidly in many developing countries, including in rural areas. Besides reducing the costs of communication and improving access to information, mobile phones are an enabling technology for other innovations. One important example are mobile phone based money transfers, which could be very relevant for the rural poor, who are often underserved by the formal banking system. We analyze impacts of mobile money technology on the welfare of smallholder farm households in Kenya. Using panel survey data and regression models we show that mobile money use has a positive impact on household income. One important pathway is through remittances received from relatives and friends. Such remittances contribute to income directly, but they also help to reduce risk and liquidity constraints, thus promoting agricultural commercialization. Mobile money users apply more purchased farm inputs, market a larger proportion of their output, and have higher profits than non-users of this technology. These results suggest that mobile money can help to overcome some of the important smallholder market access constraints that obstruct rural development and poverty reduction. PMID:25286032

  8. Mobile Money, Smallholder Farmers, and Household Welfare in Kenya

    PubMed Central

    Kikulwe, Enoch M.; Fischer, Elisabeth; Qaim, Matin

    2014-01-01

    The use of mobile phones has increased rapidly in many developing countries, including in rural areas. Besides reducing the costs of communication and improving access to information, mobile phones are an enabling technology for other innovations. One important example are mobile phone based money transfers, which could be very relevant for the rural poor, who are often underserved by the formal banking system. We analyze impacts of mobile money technology on the welfare of smallholder farm households in Kenya. Using panel survey data and regression models we show that mobile money use has a positive impact on household income. One important pathway is through remittances received from relatives and friends. Such remittances contribute to income directly, but they also help to reduce risk and liquidity constraints, thus promoting agricultural commercialization. Mobile money users apply more purchased farm inputs, market a larger proportion of their output, and have higher profits than non-users of this technology. These results suggest that mobile money can help to overcome some of the important smallholder market access constraints that obstruct rural development and poverty reduction. PMID:25286032

  9. Biodegradation of carbofuran in soils within Nzoia River Basin, Kenya.

    PubMed

    Onunga, Daniel O; Kowino, Isaac O; Ngigi, Anastasiah N; Osogo, Aggrey; Orata, Francis; Getenga, Zachary M; Were, Hassan

    2015-01-01

    Carbofuran (2,3-dihydro-2,2-dimethylbenzofuran-7-yl methylcarbamate) has been used within the Nzoia River Basin (NRB), especially in Bunyala Rice Irrigation Schemes, in Kenya for the control of pests. In this study, the capacity of native bacteria to degrade carbofuran in soils from NRB was investigated. A gram positive, rod-shaped bacteria capable of degrading carbofuran was isolated through liquid cultures with carbofuran as the only carbon and nitrogen source. The isolate degraded 98% of 100-μg mL(-1) carbofuran within 10 days with the formation of carbofuran phenol as the only detectable metabolite. The degradation of carbofuran was followed by measuring its residues in liquid cultures using high performance liquid chromatography (HPLC). Physical and morphological characteristics as well as molecular characterization confirmed the bacterial isolate to be a member of Bacillus species. The results indicate that this strain of Bacillus sp. could be considered as Bacillus cereus or Bacillus thuringiensis with a bootstrap value of 100% similar to the 16S rRNA gene sequences. The biodegradation capability of the native strains in this study indicates that they have great potential for application in bioremediation of carbofuran-contaminated soil sites. PMID:25844859

  10. Characterization of Moringa oleifera variety Mbololo seed oil of Kenya.

    PubMed

    Tsaknis, J; Lalas, S; Gergis, V; Dourtoglou, V; Spiliotis, V

    1999-11-01

    The oil from Moringa oleifera variety Mbololo seeds from Kenya was extracted using three different procedures including cold press (CP), extraction with n-hexane (H), and extraction with a mixture of chloroform/methanol (50:50) (CM). The oil concentration ranged from 25.8% (CP) to 31.2% (CM). The density, refractive index, color, smoke point, viscosity, acidity, saponification value, iodine value, fatty acid methyl esters, sterols, tocopherols (by HPLC), peroxide value, and at 232 and 270 nm and the susceptibility to oxidation measured with the Rancimat method were determined. The oil was found to contain high levels of unsaturated fatty acids, especially oleic (up to 75.39%). The dominant saturated acids were behenic (up to 6. 73%) and palmitic (up to 6.04%). The oil was also found to contain high levels of beta-sitosterol (up to 50.07%), stigmasterol (up to 17.27%), and campesterol (up to 15.13%). alpha-, gamma-, and delta-tocopherols were detected up to levels of 105.0, 39.54, and 77. 60 mg/kg of oil, respectively. The induction period (at 120 degrees C) of M. oleifera seed oil was reduced from 44.6 to 64.3% after degumming. The M. oleifera seed oil showed high stability to oxidative rancidity. The results of all the above determinations were compared with those of a commercial virgin olive oil. PMID:10552840

  11. A climate trend analysis of Kenya-August 2010

    USGS Publications Warehouse

    Funk, Christopher C.

    2010-01-01

    Introduction This brief report draws from a multi-year effort by the United States Agency for International Development's Famine Early Warning System Network (FEWS NET) to monitor and map rainfall and temperature trends over the last 50 years (1960-2009) in Kenya. Observations from seventy rainfall gauges and seventeen air temperature stations were analyzed for the long rains period, corresponding to March through June (MAMJ). The data were quality controlled, converted into 1960-2009 trend estimates, and interpolated using a rigorous geo-statistical technique (kriging). Kriging produces standard error estimates, and these can be used to assess the relative spatial accuracy of the identified trends. Dividing the trends by the associated errors allows us to identify the relative certainty of our estimates (Funk and others, 2005; Verdin and others, 2005; Brown and Funk, 2008; Funk and Verdin, 2009). Assuming that the same observed trends persist, regardless of whether or not these changes are due to anthropogenic or natural cyclical causes, these results can be extended to 2025, providing critical, and heretofore missing information about the types and locations of adaptation efforts that may be required to improve food security.

  12. Do Poverty Dynamics Explain the Shift to an Informal Private Schooling System in the Wake of Free Public Primary Education in Nairobi Slums?

    ERIC Educational Resources Information Center

    Oketch, Moses; Mutisya, Maurice; Sagwe, Jackline

    2012-01-01

    With the introduction of free primary education (FPE) in Kenya in 2003, it was expected that the burden on poor households in financing primary education would be reduced substantially. This in turn would increase enrolment in public schools and lead to universal primary education. However, studies have shown that a considerable proportion of…

  13. The prospects of enhanced space science training in kenya

    NASA Astrophysics Data System (ADS)

    Aseno, J. O.; Obel, J. D.

    To a limited extent, space exploration has been conducted in Kenya for almost the last two decades through a joint project (San Marco Project) between the Government of Kenya and the Government of Italy. Other space science activities in the country include remote sensing, space communications, meteorology and the use o f navigation and positioning satellite systems. To sustain space science activities in Kenya will require specialized training in the various disciplines of space sciences. Currently, there are no well coordinated training programmes in the country. Consequently, there is an urgent need for a well planned and a well coordinated space science training programme. This could be achieved through international co-operation and joint ventures between Kenya and space science institutions/organizations worldwide. The paper justifies the need for training in space science in Kenya and discusses socio-economic as well as environmental gains which would be realized due to increased space science activities arising from such training. Some of these gains would include participation in the launching and tracking, and control of satellite, managing and running a space centre or satellite launching and tracking station, decoding and synthesizing data from satellites and disseminating such data for public and scientific uses. The paper further offers suggestions on how the training requirements cited above could be achieved. It also highlights the level of expertise in space science disciplines and provides specific recommendations on the types of personnel that need to be trained. In addition, various forms and levels of training required to strengthen the role of space science in socio-economic development in Kenya, are discussed.

  14. Kenya: the development of private services and the role of the Kenya Veterinary Association.

    PubMed

    Chema, S; Gathuma, J M

    2004-04-01

    Private veterinary practice has existed in Kenya for more than half a century. Between the early 1930s and the mid-1960s, provision of clinical and advisory services almost entirely involved servicing commercial ranches and dairy farms. The Department of Veterinary Services (VSD) was mainly responsible for providing regulatory services in these areas. Until the mid-1960s, public sector veterinary responsibilities were predominantly associated with the prevention of notifiable diseases outside the commercial farming areas. In a major agrarian reform programme initiated in 1954, Kenya initiated an aggressive campaign promoting the dairy industry in the wetter areas of the country among small-scale farmers. In an effort to encourage dairy development, the VSD decided to provide some services, mainly tick control and subsidised artificial insemination. This support had a great positive impact on the 'smallholder' dairy industry. After the end of the colonial administration in 1963, most private practitioners left the country. A decision was therefore taken to transfer the responsibility of providing services of a 'private goods' nature, such as clinical services, temporarily to the public sector through the VSD. This was accompanied by significant expansion of training and the deployment of both professional veterinarians and para-professionals. By 1988, personnel costs had escalated to over 80% of the recurrent budget, leaving little for operational costs. This necessitated a policy change, which led to decreased government involvement in the delivery of animal health services. The private sector, as expected, responded appropriately to the change in policy. The Kenya Veterinary Association (KVA) launched a privatisation scheme (the Kenya Veterinary Association Privatisation Scheme) in 1994 to provide members with credit to set up private practices. The first phase of the scheme (1994-1996) was rated a success, with 100% loan repayments. The second phase of the

  15. Effect of Potato (Solanum tuberosum L.) Cropping Systems on Soil and Nutrient Losses Through Runoff in a Humic Nitisol, Kenya

    NASA Astrophysics Data System (ADS)

    Nyawade, Shadrack; Charles, Gachene; Karanja, Nancy; Elmar, Schulte-Geldermann

    2016-04-01

    Soil erosion has been identified as one of the major causes of soil productivity decline in the potato growing areas of East African Highlands. Potato establishes a protective soil cover only at about 45-60 days after planting and does not yield sufficient surface mulch upon harvest which leaves the soil bare at the critical times when rainfall intensities are usually high thus exposes soil to erosion. A field study was carried out using runoff plots during the short and long rainy seasons of 2014/15 respectively at the University of Nairobi Upper Kabete Farm, Kenya. The objectives were to assess the effect of soil surface roughness and potato cropping systems on soil loss and runoff, to determine the effect of erosion on nutrient enrichment ratio and to evaluate the soil organic matter fraction most susceptible to soil erosion. The treatments comprised of Bare Soil (T1); Potato + Garden Pea (Pisum sativa) (T2); Potato + Climbing Bean (Phaseolus vulgaris) (T3); Potato + Dolichos (Lablab purpureus) (T4) and Sole Potato (Solanum tuberosum L.) (T5). The amount of soil loss and runoff recorded in each event differed significantly between treatments (p<0.05) and were consistently highest in T1 and lowest in T4. Mean cumulative soil loss reduced by 6.4, 13.3 and 24.4 t ha-1from T2, T3 and T4 respectively compared to sole potato plots (T5), while mean cumulative runoff reduced by 8.5, 17.1 and 28.3 mm from T2, T3 and T4 respectively when compared with the sole potato plots (T5) indicating that T4 plots provided the most effective cover in reducing soil loss and runoff. Regression analyses revealed that both runoff and soil loss related significantly with surface roughness and percent cover (R2=0.83 and 0.73 respectively, p<0.05). Statistically significant linear dependence of runoff and soil loss on surface roughness and crop cover was found in T4 (p<0.05) indicating that this system was highly effective in minimizing soil loss and runoff. Enrichment ratio was on average

  16. Behavioral Responses of Patients in AIDS Treatment Programs: Sexual Behavior in Kenya*

    PubMed Central

    Thirumurthy, Harsha; Goldstein, Markus; Zivin, Joshua Graff; Habyarimana, James; Pop-Eleches, Cristian

    2012-01-01

    We estimate changes in sexual behavior for HIV-positive individuals enrolled in an AIDS treatment program using longitudinal household survey data collected in western Kenya. We find that sexual activity is lowest at the time that treatment is initiated and increases significantly in the subsequent six months, consistent with the health improvements that result from ART treatment. More importantly, we find large and significant increases of 10 to 30 percentage points in the reported use of condoms during last sexual intercourse. The increases in condom use appear to be driven primarily by a program effect, applying to all HIV clinic patients regardless of treatment status. PMID:22523483

  17. Behavioral Responses of Patients in AIDS Treatment Programs: Sexual Behavior in Kenya.

    PubMed

    Thirumurthy, Harsha; Goldstein, Markus; Zivin, Joshua Graff; Habyarimana, James; Pop-Eleches, Cristian

    2012-04-19

    We estimate changes in sexual behavior for HIV-positive individuals enrolled in an AIDS treatment program using longitudinal household survey data collected in western Kenya. We find that sexual activity is lowest at the time that treatment is initiated and increases significantly in the subsequent six months, consistent with the health improvements that result from ART treatment. More importantly, we find large and significant increases of 10 to 30 percentage points in the reported use of condoms during last sexual intercourse. The increases in condom use appear to be driven primarily by a program effect, applying to all HIV clinic patients regardless of treatment status. PMID:22523483

  18. Cost–effectiveness of community-based practitioner programmes in Ethiopia, Indonesia and Kenya

    PubMed Central

    McPake, Barbara; Witter, Sophie; Kielmann, Karina; Taegtmeyer, Miriam; Dieleman, Marjolein; Vaughan, Kelsey; Gama, Elvis; Kok, Maryse; Datiko, Daniel; Otiso, Lillian; Ahmed, Rukhsana; Squires, Neil; Suraratdecha, Chutima; Cometto, Giorgio

    2015-01-01

    Abstract Objective To assess the cost–effectiveness of community-based practitioner programmes in Ethiopia, Indonesia and Kenya. Methods Incremental cost–effectiveness ratios for the three programmes were estimated from a government perspective. Cost data were collected for 2012. Life years gained were estimated based on coverage of reproductive, maternal, neonatal and child health services. For Ethiopia and Kenya, estimates of coverage before and after the implementation of the programme were obtained from empirical studies. For Indonesia, coverage of health service interventions was estimated from routine data. We used the Lives Saved Tool to estimate the number of lives saved from changes in reproductive, maternal, neonatal and child health-service coverage. Gross domestic product per capita was used as the reference willingness-to-pay threshold value. Findings The estimated incremental cost per life year gained was 82 international dollars ($)in Kenya, $999 in Ethiopia and $3396 in Indonesia. The results were most sensitive to uncertainty in the estimates of life-years gained. Based on the results of probabilistic sensitivity analysis, there was greater than 80% certainty that each programme was cost-effective. Conclusion Community-based approaches are likely to be cost-effective for delivery of some essential health interventions where community-based practitioners operate within an integrated team supported by the health system. Community-based practitioners may be most appropriate in rural poor communities that have limited access to more qualified health professionals. Further research is required to understand which programmatic design features are critical to effectiveness. PMID:26478627

  19. An analysis of communication policies in Kenya.

    PubMed

    Mutere, A

    1988-01-01

    Although Kenya's current 5-Year National Development Plan cites communications as a public policy issue in terms of the establishment of basic infrastructural facilities, little attention has been given to this area. At the national level, a more specific approach to communication policy demands the formulation of coherent policies and their implementation through adequate institutional bodies. However, most policymakers are poorly equipped to deal with communication questions since they are interdisciplinary, technically complex, and politically sensitive. Policymaking must be based on a database that allows a minimal level of resource assessment, an inventory of locally available resources, a projection of needs for imported resources, and a scenario for resource development. The institutional location and accountability of communication need to be defined. Moreover, in promoting the strategies of self-reliance and decentralization, communication policy must consider the 4 aspects of a national information system: function, resource inventory, structure content, an control. The 1st task is to carry out a needs assessment exercise that determines what is required from a communications policy. A related task is audience analysis. Also essential is the analysis of policies that guide and constrain system development and the distribution and nature of political and economic power. Finally, feedback mechanisms must be devised for the determination of policy impact. Methods helpful in analyzing policy impact include systems analysis, resource assessment, trend extrapolation, the Delphi technique, and brainstorming. PMID:12281810

  20. Khat consumption in Masalani town, northeastern Kenya.

    PubMed

    Njuguna, John; Olieva, Salim; Muruka, Charles; Owek, Collins

    2013-01-01

    Khat is widely consumed in Kenya. It contains cathinone, a psychoactive alkaloid, whose health effects are similar to those of amphetamine. A descriptive study was done among men in a remote Kenyan town on consumption of khat. We administered semi-structured questionnaires. Of those interviewed, 68% chewed khat, and of those who chewed, half did so on a daily basis. Most prefer to chew it in the company of their friends and age mates, accompanied by soda, sweet tea, and cigarettes. Those employed were three times more likely to chew khat compared to those unemployed (OR = 2.8, 95% CI 1.03-7.6). A plausible reason is that they have regular sources of income to buy khat. Most respondents were knowledgeable about the health effects of khat, with a third reporting mental health problems. The major social consequences of khat chewing reported were negligence of responsibility by men, family break-up, promiscuity, and impotence. The consumption of khat may increase in the near future, given that a high proportion of the males in this district are below 19 years. This cohort will gradually finish school and gain employment. There may be need to put in place health education programs and provide recreational facilities targeting this group and those already chewing khat in this resource-limited setting. PMID:24377175

  1. Basing care reforms on evidence: The Kenya health sector costing model

    PubMed Central

    2011-01-01

    Background The Government of the Republic of Kenya is in the process of implementing health care reforms. However, poor knowledge about costs of health care services is perceived as a major obstacle towards evidence-based, effective and efficient health care reforms. Against this background, the Ministry of Health of Kenya in cooperation with its development partners conducted a comprehensive costing exercise and subsequently developed the Kenya Health Sector Costing Model in order to fill this data gap. Methods Based on standard methodology of costing of health care services in developing countries, standard questionnaires and analyses were employed in 207 health care facilities representing different trustees (e.g. Government, Faith Based/Nongovernmental, private-for-profit organisations), levels of care and regions (urban, rural). In addition, a total of 1369 patients were randomly selected and asked about their demand-sided costs. A standard step-down costing methodology was applied to calculate the costs per service unit and per diagnosis of the financial year 2006/2007. Results The total costs of essential health care services in Kenya were calculated as 690 million Euros or 18.65 Euro per capita. 54% were incurred by public sector facilities, 17% by Faith Based and other Nongovernmental facilities and 23% in the private sector. Some 6% of the total cost is due to the overall administration provided directly by the Ministry and its decentralised organs. Around 37% of this cost is absorbed by salaries and 22% by drugs and medical supplies. Generally, costs of lower levels of care are lower than of higher levels, but health centres are an exemption. They have higher costs per service unit than district hospitals. Conclusions The results of this study signify that the costs of health care services are quite high compared with the Kenyan domestic product, but a major share are fixed costs so that an increasing coverage does not necessarily increase the health

  2. Factors Contributing to the Current Academic Performance of Both Private Primary Schools and Public Primary Schools: A Case of Kitale Municipality, Kenya

    ERIC Educational Resources Information Center

    Catherine, Ochenje

    2015-01-01

    There have been current controversial discussions concerning the performance of private primary schools versus public primary schools in the Kenya Certificate of Primary Examination (K.C.P.E.). Lately, the private primary schools appear to be performing better than public primary schools. For example; in the 2003 K.C.P.E. results, more than 31% of…

  3. Teachers' and Learners' Attitudes towards the Impact of Availability and Use of Daily Newspapers on Students' Speaking Competence in English Language in Secondary Schools in Bungoma County, Kenya

    ERIC Educational Resources Information Center

    Napwora, Jesse Wekesa; Gudu, Benter Oseno; Mukwa, Chris Wekesa

    2016-01-01

    This paper highlights the results of a research conducted in Bungoma County of Kenya between 2008-2009. The objective of the study was to investigate the attitudes of teachers and students towards the impact of availability and use of daily newspapers on students' speaking competence in English language. The study was based on the Communicative…

  4. Predictive Factors and Risk Mapping for Rift Valley Fever Epidemics in Kenya

    PubMed Central

    Munyua, Peninah M.; Murithi, R. Mbabu; Ithondeka, Peter; Hightower, Allen; Thumbi, Samuel M.; Anyangu, Samuel A.; Kiplimo, Jusper; Bett, Bernard; Vrieling, Anton; Breiman, Robert F.; Njenga, M. Kariuki

    2016-01-01

    Background To-date, Rift Valley fever (RVF) outbreaks have occurred in 38 of the 69 administrative districts in Kenya. Using surveillance records collected between 1951 and 2007, we determined the risk of exposure and outcome of an RVF outbreak, examined the ecological and climatic factors associated with the outbreaks, and used these data to develop an RVF risk map for Kenya. Methods Exposure to RVF was evaluated as the proportion of the total outbreak years that each district was involved in prior epizootics, whereas risk of outcome was assessed as severity of observed disease in humans and animals for each district. A probability-impact weighted score (1 to 9) of the combined exposure and outcome risks was used to classify a district as high (score ≥ 5) or medium (score ≥2 - <5) risk, a classification that was subsequently subjected to expert group analysis for final risk level determination at the division levels (total = 391 divisions). Divisions that never reported RVF disease (score < 2) were classified as low risk. Using data from the 2006/07 RVF outbreak, the predictive risk factors for an RVF outbreak were identified. The predictive probabilities from the model were further used to develop an RVF risk map for Kenya. Results The final output was a RVF risk map that classified 101 of 391 divisions (26%) located in 21 districts as high risk, and 100 of 391 divisions (26%) located in 35 districts as medium risk and 190 divisions (48%) as low risk, including all 97 divisions in Nyanza and Western provinces. The risk of RVF was positively associated with Normalized Difference Vegetation Index (NDVI), low altitude below 1000m and high precipitation in areas with solonertz, luvisols and vertisols soil types (p <0.05). Conclusion RVF risk map serves as an important tool for developing and deploying prevention and control measures against the disease. PMID:26808021

  5. Traditional management of ear, nose and throat (ENT) diseases in Central Kenya

    PubMed Central

    Njoroge, Grace N; Bussmann, Rainer W

    2006-01-01

    Diseases of ear, nose and throat (ENT) often have serious consequences including hearing impairment, and emotional strain that lower the quality of life of patients. In Kenya, upper respiratory infections are among the most common infections encountered in outpatient facilities. Some of these infections are becoming difficult to control because some of the causing microorganisms have acquired antibiotic resistance and hence the need to develop new drugs with higher efficacy. Ethnobotanical studies have now been found to be instrumental in improving chances of discovering plants with antimicrobial activity in new drug development. In Kenya the majority of local people are turning to herbal remedies for primary health care needs. In most cases the sources of these remedies are undocumented and the knowledge about them passed orally form generation to generation, hence under threat of disappearing with current rates of modernisation. This study explored the traditional remedies used in managing various ENT diseases in seven districts of the Central Province of Kenya. The most common ENT conditions managed using traditional therapies include: common cold, cough, tonsillitis, otitis-media, chest pains and asthma. The results indicate that 67 species belonging to 36 plant families were utilized in this region. These plants were of varying habits; herbs (37.3%), shrubs (34.4%), trees (25.4%) as well as some grasses and sedges (3%). The traditional preparations were found to be made mainly from leaves (49%), roots (20.5%) and barks (12.5%). For each of the ENT conditions multiple species are utilized mainly as individual preparations but occasionally as polyherbal concoctions. In the case of common cold for example, 30 different species are used. Plants reported in this survey are important candidates for antimicrobial tests against ENT disease causing micro-organisms, especially those with antibiotic resistance. PMID:17192184

  6. An Assessment of Participatory Integrated Vector Management for Malaria Control in Kenya

    PubMed Central

    Mbogo, Charles; Mwangangi, Joseph; Imbahale, Susan; Kibe, Lydia; Orindi, Benedict; Girma, Melaku; Njui, Annah; Lwande, Wilber; Affognon, Hippolyte; Gichuki, Charity; Mukabana, Wolfgang Richard

    2015-01-01

    Background The World Health Organization (WHO) recommends integrated vector management (IVM) as a strategy to improve and sustain malaria vector control. However, this approach has not been widely adopted. Objectives We comprehensively assessed experiences and findings on IVM in Kenya with a view to sharing lessons that might promote its wider application. Methods The assessment used information from a qualitative external evaluation of two malaria IVM projects implemented between 2006 and 2011 and an analysis of their accumulated entomological and malaria case data. The project sites were Malindi and Nyabondo, located in coastal and western Kenya, respectively. The assessment focused on implementation of five key elements of IVM: integration of vector control methods, evidence-based decision making, intersectoral collaboration, advocacy and social mobilization, and capacity building. Results IVM was more successfully implemented in Malindi than in Nyabondo owing to greater community participation and multistakeholder engagement. There was a significant decline in the proportion of malaria cases among children admitted to Malindi Hospital, from 23.7% in 2006 to 10.47% in 2011 (p < 0.001). However, the projects’ operational research methodology did not allow statistical attribution of the decline in malaria and malaria vectors to specific IVM interventions or other factors. Conclusions Sustaining IVM is likely to require strong participation and support from multiple actors, including community-based groups, non-governmental organizations, international and national research institutes, and various government ministries. A cluster-randomized controlled trial would be essential to quantify the effectiveness and impact of specific IVM interventions, alone or in combination. Citation Mutero CM, Mbogo C, Mwangangi J, Imbahale S, Kibe L, Orindi B, Girma M, Njui A, Lwande W, Affognon H, Gichuki C, Mukabana WR. 2015. An assessment of participatory integrated vector

  7. Child undernutrition in Kenya: trend analyses from 1993 to 2008–09

    PubMed Central

    2014-01-01

    Background Research on trends in child undernutrition in Kenya has been hindered by the challenges of changing criteria for classifying undernutrition, and an emphasis in the literature on international comparisons of countries’ situations. There has been little attention to within-country trend analyses. This paper presents child undernutrition trend analyses from 1993 to 2008–09, using the 2006 WHO criteria for undernutrition. The analyses are decomposed by child’s sex and age, and by maternal education level, household Wealth Index, and province, to reveal any departures from the overall national trends. Methods The study uses the Kenya Demographic and Health Survey data collected from women aged 15–49 years and children aged 0–35 months in 1993, 1998, 2003 and 2008–09. Logistic regression was used to test trends. Results The prevalence of wasting for boys and girls combined remained stable at the national level but declined significantly among girls aged 0–35 months (p < 0.05). While stunting prevalence remained stagnant generally, the trend for boys aged 0–35 months significantly decreased and that for girls aged 12–23 months significantly increased (p < 0.05). The pattern for underweight in most socio-demographic groups showed a decline. Conclusion The national trends in childhood undernutrition in Kenya showed significant declines in underweight while trends in wasting and stunting were stagnant. Analyses disaggregated by demographic and socio-economic segments revealed some significant departures from these overall trends, some improving and some worsening. These findings support the importance of conducting trend analyses at detailed levels within countries, to inform the development of better-targeted childcare and feeding interventions. PMID:24410931

  8. Late Cenozoic fluvial dynamics of the River Tana, Kenya, an uplift dominated record

    NASA Astrophysics Data System (ADS)

    Veldkamp, A.; Buis, E.; Wijbrans, J. R.; Olago, D. O.; Boshoven, E. H.; Marée, M.; van den Berg van Saparoea, R. M.

    2007-11-01

    The Late Cenozoic development of the River Tana in Kenya has been reconstructed for its central reach near its confluence with the River Mutonga, which drains the Mount Kenya region. Age control for this system has been provided by K-Ar and Ar-Ar dating. Between 3.21 and 2.65 Ma a major updoming occurred, in relation to the formation of the Kenyan rift valley. The tilting related to this doming has been reconstructed from lava flows that preserve former river gradients. Linear projection of these trends to the current rift valley rim suggests a net updoming of the eastern Gregory Rift valley by at least ∼1 km during 3.21-2.65 Ma. In contrast, since 2.65 Ma the Tana system has been mainly subject to relatively minor epeirogenic uplift. Changing climatic conditions combined with continuing uplift yielded a typical staircase of strath terraces with at least 10 distinct levels. A more detailed reconstruction of the incision rates since 215 ka has been made, by correlating mineralogically fingerprinted volcaniclastic Tana deposits with dated tephras in a lake record. These volcaniclastic sediments were deposited during glacial periods, contemporaneous with lahars. The reconstructed incision rates for the three youngest terraces are ∼0.1-0.2 mm a-1, thus considerably faster than the overall average rate of valley incision since the Mid-Pliocene, of 0.06 mm a-1. A plausible uplift history has been reconstructed using the estimated ages of the Tana terraces and marine terraces on the Indian Ocean coastline. The result suggests an increase in the rate of incision by the River Tana at ∼0.9 Ma, an observation typical in most European river terrace staircases. The reconstructed Late Quaternary development of Tana valley indicates that a similar Quaternary uplift mechanism has operated in both Europe and East Kenya, suggesting a globally applicable process.

  9. Predicting malaria seasons in Kenya using multitemporal meteorological satellite sensor data.

    PubMed

    Hay, S I; Snow, R W; Rogers, D J

    1998-01-01

    This article describes research that predicts the seasonality of malaria in Kenya using remotely sensed images from satellite sensors. The predictions were made using relationships established between long-term data on paediatric severe malaria admissions and simultaneously collected data from the Advanced Very High Resolution Radiometer (AVHRR) on the National Oceanic and Atmospheric Administrations (NOAA) polar-orbiting meteorological satellites and the High Resolution Radiometer (HRR) on the European Organization for the Exploitation of Meteorological Satellites' (EUMETSAT) geostationary Meteosat satellites. The remotely sensed data were processed to provide surrogate information on land surface temperature, reflectance in the middle infra-red, rainfall, and the normalized difference vegetation index (NDVI). These variables were then subjected to temporal Fourier processing and the fitted Fourier data were compared with the mean percentage of total annual malaria admissions recorded in each month. The NDVI in the preceding month correlated most significantly and consistently with malaria presentations across the 3 sites (mean adjusted r2 = 0.71, range 0.61-0.79). Regression analyses showed that an NDVI threshold of 0.35-0.40 was required for more than 5% of the annual malaria cases to be presented in a given month. These thresholds were then extrapolated spatially with the temporal Fourier-processed NDVI data to define the number of months, in which malaria admissions could be expected across Kenya in an average year, at an 8 x 8 km resolution. The resulting maps were compared with the only existing map (Butler's) of malaria transmission periods for Kenya, compiled from expert opinion. Conclusions are drawn on the appropriateness of remote sensing techniques for compiling national strategies for malaria intervention. PMID:9692138

  10. Road traffic injuries in Kenya: a survey of commercial motorcycle drivers

    PubMed Central

    Matheka, Duncan Mwangangi; Omar, Faraj Alkizim; Kipsaina, Chebiwot; Witte, Jeffrey

    2015-01-01

    Introduction Motorcycle injuries contribute a substantial number of deaths and hospital admissions in Kenya. There is paucity of data to inform prevention strategies to address the issue. Therefore, the current study sought to explore the characteristics of 2 and 3-wheeler related road traffic injuries (RTIs) in Kenya. Methods A cross-sectional survey of motorcycle drivers involved in a RTI in the preceding 3 months was conducted in 11 urban and rural sites in Kenya's Thika town through face- to -face structured interviews. Drivers’ demographic information, comprehensive crash characteristics and socioeconomic impact of injury data were collected. Results Of 200 drivers injured, 98% were male, with average age of 28.4 years (SD±6.6). Of these drivers, 33% were not wearing any protective equipment. Negligence was the most reported cause of crash (33%), followed by slippery roads (21.0%) and speeding (17.5%). The risk of sustaining a bodily injury was 1.3 times higher in drivers who had not received prevention education compared to those who had received such education. People injured at night were 5 times more likely to sustain a bodily injury compared to those injured during the day. Only 8.5% of the drivers reported the injury incident to the police. Conclusion Majority of motorcycle related injuries in Thika town occur among young, productive, working-age male drivers. A high proportion of injuries are due to negligence on riding while not wearing any protective equipment compounded by lack of injury prevention education. Initiatives to foster helmet wearing, provision of high-quality affordable helmets, responsible driving and advocacy for stronger legislation, are recommended. PMID:26401211

  11. Antibodies to Neospora caninum in wild animals from Kenya, East Africa.

    PubMed

    Ferroglio, E; Wambwa, E; Castiello, M; Trisciuoglio, A; Prouteau, A; Pradere, E; Ndungu, S; De Meneghi, D

    2003-12-01

    The prevalence of antibodies to Neospora caninum was examined in six wild Artiodactyla species, and in five wild Carnivora species from Kenya. Blood sera (104 wild ungulates from Marula Estates (MEs), and 31 wild carnivores from Masai-Mara reserve and from other wildlife areas in northern and Southern Kenya), were screened using a Neospora agglutination test (NAT), with a twofold dilution (1:40-1:320 titres). Presence of NAT antibodies to N. caninun is reported here for the first time in zebra (Equus burchelli), eland (Taurotragus oryx), African buffalo (Syncerus caffer), Thompson gazelle (Gazella thompsoni), impala (Aepyceros melampus), warthog (Phacochoerus aethiopicus), spotted hyena (Crocuta crocuta) and in free-ranging cheetah (Acinonyx jubatus). At 1:80 dilution, prevalence was 61.5% in eland, 58.5% in zebra, 19.2% in Thompson gazelle, 33.3% in warthog, 50% in African buffalo, 30% in lion (Panthera leo), 20% in cheetah, and 33.3% in spotted hyena. Antibodies up to 1:320 titre were detected in eland (38.4%), zebra (19.5%), Thompson gazelle (3.8%) and lion (5%). Amongst herbivores, sero-prevalence was significantly (P<0.05) higher, at all dilutions, in "grazer/digger" species (e.g. eland and zebra) than in non-"grazer/digger" species (e.g. impala and Thompson gazelle). No antibodies to N. caninum were found in two leopards (Panthera pardus) and one serval (Felis serval). Our results indicates a steady presence of N. caninum in wild mammals from Kenya. The hypothesis of a sylvatic cycle of N. caninum could be suggested, but more data are needed to verify the hypothesis, as to evaluate the role of N. caninum infection on the dynamics of wild animals population in the study area. PMID:14651874

  12. The challenges of changing national malaria drug policy to artemisinin-based combinations in Kenya

    PubMed Central

    Amin, Abdinasir A; Zurovac, Dejan; Kangwana, Beth B; Greenfield, Joanne; Otieno, Dorothy N; Akhwale, Willis S; Snow, Robert W

    2007-01-01

    Backgound Sulphadoxine/sulphalene-pyrimethamine (SP) was adopted in Kenya as first line therapeutic for uncomplicated malaria in 1998. By the second half of 2003, there was convincing evidence that SP was failing and had to be replaced. Despite several descriptive investigations of policy change and implementation when countries moved from chloroquine to SP, the different constraints of moving to artemisinin-based combination therapy (ACT) in Africa are less well documented. Methods A narrative description of the process of anti-malarial drug policy change, financing and implementation in Kenya is assembled from discussions with stakeholders, reports, newspaper articles, minutes of meetings and email correspondence between actors in the policy change process. The narrative has been structured to capture the timing of events, the difficulties and hurdles faced and the resolutions reached to the final implementation of a new treatment policy. Results Following a recognition that SP was failing there was a rapid technical appraisal of available data and replacement options resulting in a decision to adopt artemether-lumefantrine (AL) as the recommended first-line therapy in Kenya, announced in April 2004. Funding requirements were approved by the Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM) and over 60 million US$ were agreed in principle in July 2004 to procure AL and implement the policy change. AL arrived in Kenya in May 2006, distribution to health facilities began in July 2006 coincidental with cascade in-service training in the revised national guidelines. Both training and drug distribution were almost complete by the end of 2006. The article examines why it took over 32 months from announcing a drug policy change to completing early implementation. Reasons included: lack of clarity on sustainable financing of an expensive therapeutic for a common disease, a delay in release of funding, a lack of comparative efficacy data between AL and

  13. Evaluation of Petrifilms(TM) as a diagnostic test to detect bovine mastitis organisms in Kenya.

    PubMed

    Gitau, George K; Bundi, Royford M; Vanleeuwen, John; Mulei, Charles M

    2013-03-01

    The study purpose was to validate Petrifilms(TM) (3M Microbiology, 2005) against standard culture methods in the diagnosis of bovine mastitis organisms in Kenya. On 128 smallholder dairy cattle farms in Kenya, between June 21, 2010 and August 31, 2010, milk samples from 269 cows that were positive on California Mastitis Test (CMT) were cultured using standard laboratory culture methods and Petrifilms(TM) (Aerobic Count and Coliform Count -3M Microbiology, 2005), and results were compared. Staphylococcus aureus was the most common bacterium isolated (73 % of samples). Clinical mastitis was found in only three cows, and there were only two Gram-negative isolates, making it impossible to examine the agreement between the two tests for Gram-negative- or clinical mastitis samples. The observed agreement between the standard culture and Petrifilm(TM) (3M Microbiology, 2005) results for Gram-positive isolates was 85 %, and there was fair agreement beyond that expected due to chance alone, with a kappa (κ) of 0.38. Using culture results as a gold standard, the Petrifilms(TM) had a sensitivity of 90 % for Gram-positive samples and specificity of 51 %. With 87 % of CMT-positive samples resulting in Gram-positive pathogens cultured, there was a positive predictive value of 93 % and a negative predictive value of 43 %. Petrifilms(TM) should be considered for culture of mastitis organisms in developing countries, especially when Gram-positive bacteria are expected. PMID:23108587

  14. Population-Based Incidence Rates of Diarrheal Disease Associated with Norovirus, Sapovirus, and Astrovirus in Kenya

    PubMed Central

    Shioda, Kayoko; Cosmas, Leonard; Audi, Allan; Gregoricus, Nicole; Vinjé, Jan; Parashar, Umesh D.; Montgomery, Joel M.; Feikin, Daniel R.; Breiman, Robert F.; Hall, Aron J.

    2016-01-01

    Background Diarrheal diseases remain a major cause of mortality in Africa and worldwide. While the burden of rotavirus is well described, population-based rates of disease caused by norovirus, sapovirus, and astrovirus are lacking, particularly in developing countries. Methods Data on diarrhea cases were collected through a population-based surveillance platform including healthcare encounters and household visits in Kenya. We analyzed data from June 2007 to October 2008 in Lwak, a rural site in western Kenya, and from October 2006 to February 2009 in Kibera, an urban slum. Stool specimens from diarrhea cases of all ages who visited study clinics were tested for norovirus, sapovirus, and astrovirus by RT-PCR. Results Of 334 stool specimens from Lwak and 524 from Kibera, 85 (25%) and 159 (30%) were positive for norovirus, 13 (4%) and 31 (6%) for sapovirus, and 28 (8%) and 18 (3%) for astrovirus, respectively. Among norovirus-positive specimens, genogroup II predominated in both sites, detected in 74 (87%) in Lwak and 140 (88%) in Kibera. The adjusted community incidence per 100,000 person-years was the highest for norovirus (Lwak: 9,635; Kibera: 4,116), followed by astrovirus (Lwak: 3,051; Kibera: 440) and sapovirus (Lwak: 1,445; Kibera: 879). For all viruses, the adjusted incidence was higher among children aged <5 years (norovirus: 22,225 in Lwak and 17,511 in Kibera; sapovirus: 5,556 in Lwak and 4,378 in Kibera; astrovirus: 11,113 in Lwak and 2,814 in Kibera) compared to cases aged ≥5 years. Conclusion Although limited by a lack of controls, this is the first study to estimate the outpatient and community incidence rates of norovirus, sapovirus, and astrovirus across the age spectrum in Kenya, suggesting a substantial disease burden imposed by these viruses. By applying adjusted rates, we estimate approximately 2.8–3.3 million, 0.45–0.54 million, and 0.77–0.95 million people become ill with norovirus, sapovirus, and astrovirus, respectively, every year in

  15. Seismic structure of the upper mantle beneath the southern Kenya Rift from wide-angle data

    NASA Astrophysics Data System (ADS)

    Byrne, G. F.; Jacob, A. W. B.; Mechie, J.; Dindi, E.

    1997-09-01

    In February 1994, the Kenya Rift International Seismic Project carried out two wide-angle reflection and refraction seismic profiles between Lake Victoria and Mombasa across southern Kenya. Our investigation of the data has revealed evidence for the presence of two upper mantle reflectors beneath southwestern Kenya, sometimes at short range, from seven shotpoints. Two-dimensional forward modelling of these reflectors using a pre-existing two-dimensional velocity-depth model for the crust [Birt, C.S., Maguire, P.H.K., Khan, M.A., Thybo, H., Keller, G.R., Patel, J., 1997. The influence of pre-existing structures on the evolution of the Southern Kenya Rift Valley — evidence from seismic and gravity studies. Tectonophysics 278, 211-242], has shown them to lie at depths of approximately 51 and 63 km. The upper reflector, denoted d 1, shallows by about 5-10 km in the area beneath Lake Magadi, situated in the rift itself. Correlations for the deeper reflector, denoted d 2, are sparse and more difficult to determine, so it was not possible to define any shallowing corresponding to the surface expression of the rift. Only limited control exists over the upper mantle velocities used in the modelling. Immediately beneath the Moho we use a value of P n calculated from the crustal model, and constraints from previous refraction, teleseismic and gravity studies, to determine the velocity at depth. At the d 1 reflector a reasonable velocity contrast was introduced to produce a reflector for modelling purposes. Beneath the d 1 reflector the velocity decreases to the average value over 3 km. Beneath the rift the velocity also rises across d 1 and again, decreases to the average value over the next 3 km. At the d 2 reflector a similar model is used. This model accounts for the presence of the mantle reflectors seen in the data by using layers of thin higher velocity in a lower background velocity. Due to the uncertainty in the velocities the absolute position of both d 1 and d 2

  16. Delivery of Open, Distance, and E-Learning in Kenya

    ERIC Educational Resources Information Center

    Nyerere, Jackline Anyona; Gravenir, Frederick Q.; Mse, Godfrey S.

    2012-01-01

    The increased demand and need for continuous learning have led to the introduction of open, distance, and e-learning (ODeL) in Kenya. Provision of this mode of education has, however, been faced with various challenges, among them infrastructural ones. This study was a survey conducted in two public universities offering major components of ODeL,…

  17. Kenya's Harambee Secondary School Movement: The Contradictions of Public Policy.

    ERIC Educational Resources Information Center

    Mwiria, Kilemi

    1990-01-01

    Explores history and characteristics of Kenya's Harambee secondary schools, community schools that serve over half the secondary school population. Examines the government's failure to assist Harambee schools in improving educational quality. Discusses polarization of the secondary school system, educational inequalities, and social and economic…

  18. Maternal Education and Immunization Status Among Children in Kenya.

    PubMed

    Onsomu, Elijah O; Abuya, Benta A; Okech, Irene N; Moore, DaKysha; Collins-McNeil, Janice

    2015-08-01

    Child morbidity and mortality due to infectious diseases continues to be a major threat and public health concern worldwide. Although global vaccination coverage reached 90 % for diphtheria, tetanus and pertussis (DTP3) across 129 countries, Kenya and other sub-Saharan countries continue to experience under-vaccination. The purpose of this study was to examine the association between maternal education and child immunization (12-23 months) in Kenya. This study used retrospective cross-sectional data from the 2008-2009 Kenya Demographic and Health Survey for women aged 15-49, who had children aged 12-23 months, and who answered questions about vaccination in the survey (n = 1,707). The majority of the children had received vaccinations, with 77 % for poliomyelitis, 74 % for measles, 94 % for tuberculosis, and 91 % for diphtheria, whooping cough (pertussis), and tetanus. After adjusting for other covariates, women with primary, secondary, and college/university education were between 2.21 (p < 0.01) and 9.10 (p < 0.001) times more likely to immunize their children than those who had less than a primary education. Maternal education is clearly crucial in ensuring good health outcomes among children, and integrating immunization knowledge with maternal and child health services is imperative. More research is needed to identify factors influencing immunization decisions among less-educated women in Kenya. PMID:25636652

  19. Comprehending Instructions for Using Pharmaceutical Products in Rural Kenya.

    ERIC Educational Resources Information Center

    Patel, V. L.; And Others

    1990-01-01

    Describes two studies on the comprehension of pharmaceutical text containing pictorial and written instructions by mothers in rural Kenya. Comprehension of printed instructions was compared with interpretation of illustrations, propositional analysis used in the study is explained, recall protocols are examined, and implications of writing…

  20. Teacher Training for Early Childhood Development and Education in Kenya

    ERIC Educational Resources Information Center

    Mbugua, Tata

    2009-01-01

    The training of early childhood development and education (ECDE) teachers in Kenya remains a priority in recognition of the vital role well-trained professionals play in the quality of early childhood experiences for children ages 0+ to 5+. This article provides a detailed overview of the current structure and training of ECDE professionals,…

  1. Cultural Interface Theory in the Kenya Context and Beyond

    ERIC Educational Resources Information Center

    Maakrun, Julie; Maher, Marguerite

    2016-01-01

    Yunkaporta's (2009) pedagogical "eight ways" conceptual framework, inspired by Nakata's (2007) cultural interface theory, provided the platform for interpretation of the data in the current study. Here we considered the transferability of the framework to a current initiative in Kenya and its usefulness in preparation for an expansion of…

  2. Description of Nemophora acaciae sp. nov. (Lepidoptera: Adelidae) from Kenya.

    PubMed

    Agassiz, David J L; Kozlov, Mikhail V

    2015-01-01

    Nemophora acaciae sp. nov. is described from Kenya on the basis of a large series bred from flowers of Acacia seyal and A. lahai. The new species differs from all Afrotropical Nemophora species by its dark brown forewing fascia with white medial stripe near the costal margin of forewing. The key to the Afrotropical Nemophora species is provided. PMID:26701526

  3. Perceptions and Reflections of Music Teacher Education in Kenya

    ERIC Educational Resources Information Center

    Akuno, Emily Achieng'

    2012-01-01

    This article builds on enquiry aimed to discover Kenyan music teachers' perceptions and expectations of their role; their view of the training they received; head teachers' perceptions and expectations of the role of the music teacher; and the expectations of both music teachers and head teachers of a music teacher education programme in Kenya.…

  4. Women Aspiring to Administrative Positions in Kenya Municipal Primary Schools

    ERIC Educational Resources Information Center

    Combat, Victor F. O.

    2014-01-01

    Even though female teachers in Kenya municipal primary schools are majority and highly qualified, they fill fewer administrative positions than men. This study assesses the extent of women's participation in leadership positions, society's perception of female leaders, selection criteria of educational administrators, and barriers that affect or…

  5. Right to Inclusive Education for Students with Disabilities in Kenya

    ERIC Educational Resources Information Center

    Elder, Brent C.

    2015-01-01

    This article explores the current inclusive education system in Kenya, and how those practices relate to Article 24 of the United Nations' Convention on the Rights of Persons with Disabilities (CRPD). Local laws and international instruments are presented to shed light on the extent to which students with disabilities have a right to inclusive…

  6. Democratic School Leadership Reforms in Kenya: Cultural and Historical Challenges

    ERIC Educational Resources Information Center

    Jwan, Julius; Anderson, Lesley; Bennett, Nigel

    2010-01-01

    In this article we discuss students', teachers' and school principals' perceptions of democratic school leadership reforms in Kenya. The article is based on a study that was conducted in two phases. In phase one (conducted between September and December 2007), interviews were undertaken with 12 school principals in which understandings of…

  7. Case Studies in Special Education: Cuba, Japan, Kenya, Sweden.

    ERIC Educational Resources Information Center

    Japanese National Commission for UNESCO, Tokyo.

    Collected is information provided by Cuba, Japan, Kenya, and Sweden on the historical background, the present situation, and the future outlook of their systems of special education. Introductory comments compare the national systems in terms of historical developments, arrangements for identifying the handicapped, special educational provisions,…

  8. Multilingualism, Language Policy and Creative Writing in Kenya

    ERIC Educational Resources Information Center

    Mbithi, Esther K

    2014-01-01

    Language use and creative writing go hand in hand. In the process of exploring language, we also engage in the study of literature. An engagement with literature is, indeed, a continuing process of improving our capacity to use language and refining our sensibility to good language use. In Kenya, there are clearly discernible patterns of creative…

  9. "Chwuech": Sustained Art Education among Luo Women of Western Kenya

    ERIC Educational Resources Information Center

    Wadende, Akinyi

    2011-01-01

    This article presents the findings of a qualitative study on the "Bang' jomariek," a women's group in West Reru in Western Kenya who engage in the production of indigenous arts and crafts (pots, baskets, and architecture) to generate income and explore politics, medicine, and other matters that affect them and their community. The women shared…

  10. Successful Community Nutrition Programming: Lessons from Kenya, Tanzania, and Uganda.

    ERIC Educational Resources Information Center

    Iannotti, Lora; Gillespie, Stuart

    This report on the key findings from a series of assessments of successful community nutrition programming conducted in Kenya, Tanzania, and Uganda between 1999 and 2000. The aim of the assessments was to identify key lessons learned from the successful processes and outcomes in these programs. The report is divided into eight chapters: (1)…

  11. Capacity Building of a District Education System: Insights from Kenya

    ERIC Educational Resources Information Center

    Datta, Dipankar; Phillip, Serene; Verma, Prashant Kumar

    2009-01-01

    Both (a) in-school factors such as over-focus on academic performance, absence of uniform, and corporal punishment, and (b) out-of school factors such as caring for ailing parents, child labor, etc., hinder participation of orphan and vulnerable children (PVC) in Free Primary Education (FOE) system in Nyasa Province, Kenya. In this context Concern…

  12. African Journal: Schooling and Politics in Rural Kenya

    ERIC Educational Resources Information Center

    Axelrod, Paul

    2008-01-01

    In 2003, York University awarded an honorary doctorate to Phoebe Asiyo, a former Kenyan member of Parliament, in recognition of her impressive human rights work. The author learned at the time that Ms. Asiyo's family provided major support to Wikondiek School (located near their home in western Kenya), many of whose students were AIDS orphans.…

  13. Academic Achievement of Girls in Rural Schools in Kenya

    ERIC Educational Resources Information Center

    Mungai, A. M.

    2012-01-01

    This study examined the effect of two family factors (financial, social capital) and school factors on students' achievement. One hundred eighty two, seventh-grade female students from nine schools in Muranga district, Kenya, were studied. The statistical procedures included logit regression, cross-tabulations, frequency counting and chi-square…

  14. Women and Higher Education Leadership in Kenya: A Critical Analysis

    ERIC Educational Resources Information Center

    Odhiambo, George

    2011-01-01

    This paper undertakes a critique of the gendered nature of leadership in modern universities in Kenya. The paper argues that the inclusive nature of African feminism makes it easier for both men and women to join in this discussion since African feminism demands a more holistic perspective that does not pit men against women but encourages them to…

  15. Enrolment Trends in Youth Polytechnics in West Pokot County, Kenya

    ERIC Educational Resources Information Center

    Patrick, Luyali E.; Maureen, Olel A.; Lucas, Othuon

    2015-01-01

    The concept of Youth Polytechnics (YPs) was started as village polytechnics in 1968 by the National Christian Council of Kenya (N.C.C.K.).They are managed by local communities, Non-Governmental Organizations, the government and religious bodies. The YPs offer a route for acquisition of technical and entrepreneurship skills in line with TIVET. In…

  16. E-Learning Readiness in Public Secondary Schools in Kenya

    ERIC Educational Resources Information Center

    Ouma, Gordon O.; Awuor, Fredrick M.; Kyambo, Benjamin

    2013-01-01

    As e-learning becomes useful to learning institutions worldwide, an assessment of e-learning readiness is essential for the successful implementation of e-learning as a platform for learning. Success in e-learning can be achieved by understanding the level of readiness of e-learning environments. To facilitate schools in Kenya to implement…

  17. Status of E-Learning in Public Universities in Kenya

    ERIC Educational Resources Information Center

    Makokha, George L.; Mutisya, Dorothy N.

    2016-01-01

    The purpose of this study was to assess the status of e-learning in public universities in Kenya. Data were collected using questionnaires administered to both students and lecturers randomly sampled from seven public universities. Questionnaire responses were triangulated with interviews from key informants and focus group discussions (FGDs).…

  18. Teacher-Trainees Attitudes towards Physical Education in Kenya

    ERIC Educational Resources Information Center

    Gitonga, E. R.; Andanje, M.; Wanderi, P. M.; Bailasha, N.

    2012-01-01

    This study investigates the attitudes of teacher trainees towards physical education (PE). It was hypothesised that teacher-trainees have negative attitudes towards PE. A total of 132 teacher trainees were randomly selected from a teacher Training College in Kenya completed a questionnaire adapted from Wear's attitude scale with equivalent forms.…

  19. The "Invisible" Drama/Theatre in Education Curriculum in Kenya

    ERIC Educational Resources Information Center

    Joseph, Christopher Odhiambo

    2016-01-01

    This vignette presents the state of theatre in Education Kenya. The paper argues that though there are several theatre in education like practices, these have not been entrenched in the school curriculum. Theatre in Education finds expression and manifestations outside the mainstream school curriculum for instance in schools and colleges drama…

  20. Assessing the Counselling Needs of High School Students in Kenya

    ERIC Educational Resources Information Center

    Nyutu, Pius N.; Gysbers, Norman C.

    2008-01-01

    The Student Counselling Needs Scale (SCNS) was administered to 867 participants recruited from high schools in Kenya. The data were analyzed using exploratory factor analysis yielding five factors: human relationships, career development, self development, social values, and learning skills were assessed. The findings highlighted the importance of…

  1. Private Agricultural Extension System in Kenya: Practice and Policy Lessons

    ERIC Educational Resources Information Center

    Muyanga, Milu; Jayne, T. S.

    2008-01-01

    Private extension system has been at the centre of a debate triggered by inefficient public agricultural extension. The debate is anchored on the premise that the private sector is more efficient in extension service delivery. This study evaluates the private extension system in Kenya. It employs qualitative and quantitative methods. The results…

  2. The Free Education Policy in Kenya: A Critique

    ERIC Educational Resources Information Center

    Limukii, Kaberia E.; Mualuko, Ndiku J.

    2012-01-01

    Educational reforms are crucial in a country if the reforms benefit the intended target group. One of the educational reforms in Kenya was the introduction of Free Primary Education. This was informed by the need to improve access and equity in provision of education. Informed by the need to eradicate ignorance, poverty and disease, the…

  3. University Education in Kenya: Current Developments and Future Outlook.

    ERIC Educational Resources Information Center

    Mutula, Stephen M.

    2002-01-01

    Discusses university education in Kenya, with an emphasis on patterns of financing and how this has affected overall operations of the universities. Assesses reforms to reduce government grants and make public universities self-sustaining, compares private and public universities, and discusses problems facing public universities and how they are…

  4. Professional Counseling in Kenya: History, Current Status, and Future Trends

    ERIC Educational Resources Information Center

    Okech, Jane E. Atieno; Kimemia, Muthoni

    2012-01-01

    The authors examine the history and development of the counseling profession in Kenya. This profession is deeply rooted in responses to the HIV/AIDS epidemic, the emergence of mental health needs created by the impact of political and community-based violence, increasing student unrest in public institutions, and government efforts to provide…

  5. Didactic Competencies among Teaching Staff of Universities in Kenya

    ERIC Educational Resources Information Center

    Karimi, Florah Katanu

    2014-01-01

    The aim of this study was to establish the levels and types of didactic competencies that exist among teaching staff in universities in Kenya, giving recognition to curriculum development, pedagogical attributes and quality assurance competencies. The study was carried out in two phases among two samples of the teaching staff population. The first…

  6. A National Study of Kenya's Public Institutions' Deans of Students.

    ERIC Educational Resources Information Center

    Maronga, Geoffrey Bosire; And Others

    1995-01-01

    Explores the leadership behavior of the deans of students in Kenya's public universities. Found significant differences among the perceptions of the deans of students, student affairs staff members, and student leaders regarding the real and ideal leadership behavior of the deans of students with regard to initiating structure and consideration.…

  7. Pregnancy history and current use of contraception among women of reproductive age in Burundi, Kenya, Rwanda, Tanzania and Uganda: analysis of demographic and health survey data

    PubMed Central

    Bakibinga, Pauline; Matanda, Dennis J; Ayiko, Rogers; Rujumba, Joseph; Muiruri, Charles; Amendah, Djesika; Atela, Martin

    2016-01-01

    Objective To examine the relationship between pregnancy history and the use of contraception among women of reproductive age (15–49 years) in East Africa. Methods Demographic and Health Surveys data from Burundi (2010), Kenya (2008–2009), Rwanda (2010), Tanzania (2010) and Uganda (2011) were used in the analysis. Logistic regression was used to determine the effects of women's pregnancy history on their use of contraception. Setting Burundi, Kenya, Rwanda, Tanzania and Uganda. Participants 3226, 2377, 4396, 3250 and 2596 women of reproductive age (15–49 years) from Burundi, Kenya, Rwanda, Tanzania and Uganda, respectively, were included in the analysis. Results Women who had experienced a mistimed pregnancy were more likely to use a modern contraceptive method during their most recent sexual encounter in Kenya, Rwanda, Burundi and Uganda. Other significant correlates of women's contraceptive use were: desire for more children, parity, household wealth, maternal education and access information through radio. In-country regional differences on use of modern contraceptive methods were noted across five East African countries. Conclusions Women's birth histories were significantly associated with their decision to adopt a modern contraceptive method. This highlights the importance of considering women's birth histories, especially women with mistimed births, in the promotion of contraceptive use in East Africa. Variations as a result of place of residency, educational attainment, access to family planning information and products, and wealth ought to be addressed in efforts to increase use of modern contraceptive methods in the East African region. PMID:26966059

  8. Gender differences in tobacco use in Kenya.

    PubMed

    Kaplan, M; Carriker, L; Waldron, I

    1990-01-01

    This study has assessed gender differences in smoking and the use of smokeless tobacco for younger adults and their parents in samples from five ethnic groups in Kenya. These samples were from two groups of pastoralists (the Maasai and the Samburu), a group engaged in fishing and farming (the Luo), and two groups of relatively Westernized Kenyans primarily involved in commercial occupations (from the Kisii and the Gikuyu ethnic groups). In four of the five study groups, there was little or no difference in the prevalence of smokeless tobacco use in either the younger or older generation. Similarly, in four of the study groups there was little or no gender difference in the prevalence of smoking for the older generation. In contrast, for the younger generation in every study group except the Luo, men were much more likely than women to smoke cigarettes. The attitudes toward tobacco use reported by the younger generation showed similar patterns. In every study group except the Luo, the younger adults reported that smokeless tobacco use was socially acceptable for both men and women, but smoking was acceptable only for men. Many of the younger women reported that they did not smoke because it would not be socially acceptable. The interview data suggest that the social prohibition against women's smoking was one component of more general restrictions on women's behavior, and the absence of restrictions on men's smoking was related to men's greater social power. The Luo were the only study group in which respondents reported that women should have as much influence as men in decision making. Correspondingly, the Luo were the only study group in which most respondents considered it acceptable for women to smoke and women were as likely as men to smoke cigarettes. PMID:2309128

  9. Barriers and Facilitators to Health Behaviour Change and Economic Activity among Slum-Dwelling Adolescent Girls and Young Women in Nairobi, Kenya: The Role of Social, Health and Economic Assets

    ERIC Educational Resources Information Center

    Austrian, Karen; Anderson, Althea D.

    2015-01-01

    Adolescent girls and young women in urban slum areas in developing countries face a myriad of challenges regarding education, sexual health, livelihoods and gender-based violence. One way of understanding how these challenges interact with each other is through the Asset Building Framework, which posits that girls need a combination of social,…

  10. Mosquito-borne arbovirus surveillance at selected sites in diverse ecological zones of Kenya; 2007 – 2012

    PubMed Central

    2013-01-01

    Background Increased frequency of arbovirus outbreaks in East Africa necessitated the determination of distribution of risk by entomologic arbovirus surveillance. A systematic vector surveillance programme spanning 5 years and covering 11 sites representing seven of the eight provinces in Kenya and located in diverse ecological zones was carried out. Methods Mosquitoes were sampled bi-annually during the wet seasons and screened for arboviruses. Mosquitoes were identified to species, pooled by species, collection date and site and screened for arboviruses by isolation in cell culture and/or RT-PCR screening and sequencing. Results Over 450,000 mosquitoes in 15,890 pools were screened with 83 viruses being detected/isolated that include members of the alphavirus, flavivirus and orthobunyavirus genera many of which are known to be of significant public health importance in the East African region. These include West Nile, Ndumu, Sindbis, Bunyamwera, Pongola and Usutu viruses detected from diverse sites. Ngari virus, which was associated with hemorrhagic fever in northern Kenya in 1997/98 was isolated from a pool of Anopheles funestus sampled from Tana-delta and from Aedes mcintoshi from Garissa. Insect only flaviviruses previously undescribed in Kenya were also isolated in the coastal site of Rabai. A flavivirus most closely related to the Chaoyang virus, a new virus recently identified in China and two isolates closely related to Quang Binh virus previously unreported in Kenya were also detected. Conclusion Active transmission of arboviruses of public health significance continues in various parts of the country with possible undetermined human impact. Arbovirus activity was highest in the pastoralist dominated semi-arid to arid zones sites of the country where 49% of the viruses were isolated suggesting a role of animals as amplifiers and indicating the need for improved arbovirus disease diagnosis among pastoral communities. PMID:23663381

  11. Evaluation of rhizosphere, rhizoplane and phyllosphere bacteria and fungi isolated from rice in Kenya for plant growth promoters.

    PubMed

    Mwajita, Mwashasha Rashid; Murage, Hunja; Tani, Akio; Kahangi, Esther M

    2013-01-01

    Rice (Oryza sativa L.) is the most important staple food crop in many developing countries, and is ranked third in Kenya after maize and wheat. Continuous cropping without replenishing soil nutrients is a major problem in Kenya resulting to declining soil fertility. The use of chemical fertilizers to avert the problem of low soil fertility is currently limited due to rising costs and environmental concerns. Many soil micro-organisms are able to solubilize the unavailable phosphorus, increase uptake of nitrogen and also synthesize growth promoting hormones including auxin. The aim of this study was to isolate and characterize phyllosphere, rhizoplane and rhizosphere micro-organisms from Kenyan rice with growth promoting habits. In this study whole plant rice samples were collected from different rice growing regions of Kenya. 76.2%, over 80% and 38.5% of the bacterial isolates were positive for phosphate solubilization, nitrogenase activity and IAA production whereas 17.5% and 5% of the fungal isolates were positive for phosphate solubilization and IAA production respectively. Hence these micro-organisms have potential for utilization as bio-fertilizers in rice production. PMID:24349944

  12. Right to health encompasses right to access essential generic medicines: challenging the 2008 Anti-Counterfeit Act in Kenya.

    PubMed

    Maleche, Allan; Day, Emma

    2014-01-01

    To what extent has the right to access generic HIV medication been implemented in Kenya for the 1.6 million people living with HIV? How does this relate to the right to health under international and national law? This paper examines a constitutional challenge brought to the High Court of Kenya in 2009 (the "Anti-Counterfeit Case") against the Anti-Counterfeit Act of 2008, which the petitioners, all of whom were living with HIV, argued would affect their ability to access affordable and generic antiretroviral medication. They argued that this would amount to a violation of their right to life, dignity, and health. This case is particularly interesting because the new Kenyan Constitution came into force in 2010, after the case had been filed, and specifically provided for the right to health for all of Kenya's citizens, as well as giving direct effect to all international laws ratified by the Kenyan government. This paper follows the Anti-Counterfeit Case, which includes amendments filed by the petitioners following the new constitutional changes, the arguments by the different parties in the case, and the inappropriateness of counterfeit laws as measures to control substandard and falsified medicine. The case has resulted in the suspension of significant parts of the Anti-Counterfeit Act that would pose a challenge to parallel importation, and to the court issuing a directive that the sections be amended. The judgment is examined in detail, as are the broader implications of this case for other countries in Eastern Africa. PMID:25569728

  13. Responding to population pressure in the rural Kenya.

    PubMed

    Ogutu, Z A

    1993-08-01

    Population pressure in Kenya evolved out of colonial policies and was present in early periods because of soil erosion and degradation, declining crop yields, changes in farming systems, use of marginal lands, shortages of fuelwood and food, and landlessness. Between 1900 and 1910, colonists made room for European settlers by seizing control of "empty lands." These schemes failed to account for pastoral or shifting land use patterns, failed to balance African land use with resources, and failed to recognize individual title to land based on continuous use. The result was loss of pastoral lands and confinement to other unused lands, a change in the spatial economy of Africans, and disruption of equitable access to natural resources. Population concentration in areas with high potential resulted in small plots and the necessity to migrate to marginal lands. The African Land Commission was formed during the 1920s and 1930s. Rehabilitation programs and protected areas were established during the early 1940s. Agricultural development focused on high potential areas and ecological potential rather than on sociocultural factors or population pressure on drier lands. The presence of privileged classes exacerbated inequalities in land distribution. Only 17-18% of Kenyan lands were high potential areas, and, by 1963, it was recognized that there was an imbalance between resources and population numbers. Reliance on land for survival further contributed to land congestion. The land entitlement strategies of the 1940s and 1950s contributed to buy-outs and increasing landlessness. Technological innovation contributed to greater use of marginal or semiarid lands. Policies and strategies were introduced in the colonial period to reduce environmental degradation. These included intensive farming, zero grazing, intercropping, agroforestry, development of roadside reserves, and industrialization. Recommendations were made to address poverty and to invest in longterm agricultural

  14. Risk factors associated with infectious bursal disease vaccination failures in broiler farms in Kenya.

    PubMed

    Mutinda, Wanzila Usyu; Nyaga, Philip Njeru; Mbuthia, Paul Gichohi; Bebora, Lilly Caroline; Muchemi, Gerald

    2014-04-01

    Immunization together with application of biosecurity measures are the principal methods of preventing infectious bursal disease outbreaks in high-risk areas. However, outbreaks in vaccinated chicken flocks have been reported in many parts of the world as a result of factors of vaccine virus, animal, or vaccine handler. In Kenya, such outbreaks have been reported, but the causes have not been studied. This study aimed at determining the risk factors associated with vaccine handling leading to vaccine failure in broiler flocks in Kwale County, Kenya. Structured questionnaires and visual observations were used to collect data from 83 broiler farms, 6 breeding farms, and 17 vaccine outlets. Relative risk (RR) analysis was used to determine the association between identified potential risk factors and vaccination failure. Results show that vaccines were properly handled in all vaccine outlet shops. Breeding farms maintained high levels of biosecurity and employed standard vaccine handling practices. Basic biosecurity practices were poor in broiler farms. Broiler farms failed to meet all the recommended standard procedures for vaccine storage, reconstitution, and administration. Risk factors included poor vaccine storage (RR = 8.7) and use of few drinkers to administer vaccine (RR = 5.8); traces of disinfectants in drinkers used to administer live vaccine (RR = 2.8); use of wrong vaccine-infectious bronchitis instead of infectious bursal disease vaccine (RR = 2.1); and use of improper diluents (RR = 1.6). Broiler farmers need training on basic farm biosecurity measures and standard vaccine handling practices. PMID:24414247

  15. The Impact of Out-Migration on the Nursing Workforce in Kenya

    PubMed Central

    Gross, Jessica M; Rogers, Martha F; Teplinskiy, Ilya; Oywer, Elizabeth; Wambua, David; Kamenju, Andrew; Arudo, John; Riley, Patricia L; Higgins, Melinda; Rakuom, Chris; Kiriinya, Rose; Waudo, Agnes

    2011-01-01

    Objective To examine the impact of out-migration on Kenya's nursing workforce. Study Setting This study analyzed deidentified nursing data from the Kenya Health Workforce Informatics System, collected by the Nursing Council of Kenya and the Department of Nursing in the Ministry of Medical Services. Study Design We analyzed trends in Kenya's nursing workforce from 1999 to 2007, including supply, deployment, and intent to out-migrate, measured by requests for verification of credentials from destination countries. Principle Findings From 1999 to 2007, 6 percent of Kenya's nursing workforce of 41,367 nurses applied to out-migrate. Eighty-five percent of applicants were registered or B.Sc.N. prepared nurses, 49 percent applied within 10 years of their initial registration as a nurse, and 82 percent of first-time applications were for the United States or United Kingdom. For every 4.5 nurses that Kenya adds to its nursing workforce through training, 1 nurse from the workforce applies to out-migrate, potentially reducing by 22 percent Kenya's ability to increase its nursing workforce through training. Conclusions Nurse out-migration depletes Kenya's nursing workforce of its most highly educated nurses, reduces the percentage of younger nurses in an aging nursing stock, decreases Kenya's ability to increase its nursing workforce through training, and represents a substantial economic loss to the country. PMID:21413982

  16. The millipede genus Eviulisoma Silvestri, 1910 in Kenya, with descriptions of new species (Diplopoda, Polydesmida, Paradoxosomatidae)

    PubMed Central

    VandenSpiegel, Didier; Golovatch, Sergei I.

    2014-01-01

    Abstract The genus Eviulisoma, the largest among Afrotropical Paradoxosomatidae, currently encompasses 36 species or subspecies, including six new from Kenya: Eviulisoma ngaia sp. n., Eviulisoma ngaiaorum sp. n., Eviulisoma taitaorum sp. n., Eviulisoma taita sp. n., Eviulisoma kirimeri sp. n. and Eviulisoma kakamega sp. n. In addition, Eviulisoma alluaudi Brolemann, 1920 and Eviulisoma silvestre (Carl, 1909) are recorded for the first time beyond their type localities in Kenya and Tanzania, respectively, based on new material from Kenya. A key is given to all ten species of the genus presently reported from Kenya. PMID:25561851

  17. One Health stakeholder and institutional analysis in Kenya

    PubMed Central

    Kimani, Tabitha; Ngigi, Margaret; Schelling, Esther; Randolph, Tom

    2016-01-01

    Introduction One Health (OH) can be considered a complex emerging policy to resolve health issues at the animal–human and environmental interface. It is expected to drive system changes in terms of new formal and informal institutional and organisational arrangements. This study, using Rift Valley fever (RVF) as a zoonotic problem requiring an OH approach, sought to understand the institutionalisation process at national and subnational levels in an early adopting country, Kenya. Materials and methods Social network analysis methodologies were used. Stakeholder roles and relational data were collected at national and subnational levels in 2012. Key informants from stakeholder organisations were interviewed, guided by a checklist. Public sector animal and public health organisations were interviewed first to identify other stakeholders with whom they had financial, information sharing and joint cooperation relationships. Visualisation of the OH social network and relationships were shown in sociograms and mathematical (degree and centrality) characteristics of the network summarised. Results and discussion Thirty-two and 20 stakeholders relevant to OH were identified at national and subnational levels, respectively. Their roles spanned wildlife, livestock, and public health sectors as well as weather prediction. About 50% of national-level stakeholders had made significant progress on OH institutionalisation to an extent that formal coordination structures (zoonoses disease unit and a technical working group) had been created. However, the process had not trickled down to subnational levels although cross-sectoral and sectoral collaborations were identified. The overall binary social network density for the stakeholders showed that 35 and 21% of the possible ties between the RVF and OH stakeholders existed at national and subnational levels, respectively, while public health actors’ collaborations were identified at community/grassroots level. We recommend

  18. Volcanic unrest in Kenya: geological history from a satellite perspective

    NASA Astrophysics Data System (ADS)

    Robertson, E.; Biggs, J.; Edmonds, M.; Vye-Brown, C.

    2013-12-01

    The East African Rift (EAR) system is a 5,000 km long series of fault bounded depressions that run from Djibouti to Mozambique. In the Kenyan Rift, fourteen Quaternary volcanoes lie along the central rift axis. These volcanoes are principally composed of trachyte pyroclastics and trachyte and basaltic lavas forming low-angle multi-vent edifices. Between 1997 and 2008, geodetic activity has been observed at five Kenyan volcanoes, all of which have undergone periods of caldera collapse and explosive activity. We present a remote-sensing study to investigate the temporal and spatial development of volcanic activity at Longonot volcano. High-resolution mapping using ArcGIS and an immersive 3D visualisation suite (GeovisionaryTM) has been used with imagery derived from ASTER, SPOT5 and GDEM data to identify boundaries of eruptive units and establish relative age in order to add further detail to Longonot's recent eruptive history. Mapping of the deposits at Longonot is key to understand the recent geological history and forms the basis for future volcanic hazard research to inform risk assessments and mitigation programs in Kenya. Calderas at Kenyan volcanoes are elliptical in plan view and we use high-resolution imagery to investigate the regional stresses and structural control leading to the formation of these elliptical calderas. We find that volcanoes in the central and northern segments of the Kenyan rift are elongated nearly parallel to the direction of least horizontal compressive stress, likely as a reflection of the direction of the plate motion vector at the time of caldera collapse. The southern volcanoes however are elongated at an acute angle to the plate motion vector, most likely as a result of oblique opening of the Kenyan rift in this region.

  19. Impact of the Kenya post-election crisis on clinic attendance and medication adherence for HIV-infected children in western Kenya

    PubMed Central

    Vreeman, Rachel C; Nyandiko, Winstone M; Sang, Edwin; Musick, Beverly S; Braitstein, Paula; Wiehe, Sarah E

    2009-01-01

    Background Kenya experienced a political and humanitarian crisis following presidential elections on 27 December 2007. Over 1,200 people were killed and 300,000 displaced, with disproportionate violence in western Kenya. We sought to describe the immediate impact of this conflict on return to clinic and medication adherence for HIV-infected children cared for within the USAID-Academic Model Providing Access to Healthcare (AMPATH) in western Kenya. Methods We conducted a mixed methods analysis that included a retrospective cohort analysis, as well as key informant interviews with pediatric healthcare providers. Eligible patients were HIV-infected children, less than 14 years of age, seen in the AMPATH HIV clinic system between 26 October 2007 and 25 December 2007. We extracted demographic and clinical data, generating descriptive statistics for pre- and post-conflict antiretroviral therapy (ART) adherence and post-election return to clinic for this cohort. ART adherence was derived from caregiver-report of taking all ART doses in past 7 days. We used multivariable logistic regression to assess factors associated with not returning to clinic. Interview dialogue from was analyzed using constant comparison, progressive coding and triangulation. Results Between 26 October 2007 and 25 December 2007, 2,585 HIV-infected children (including 1,642 on ART) were seen. During 26 December 2007 to 15 April 2008, 93% (N = 2,398) returned to care. At their first visit after the election, 95% of children on ART (N = 1,408) reported perfect ART adherence, a significant drop from 98% pre-election (p < 0.001). Children on ART were significantly more likely to return to clinic than those not on ART. Members of tribes targeted by violence and members of minority tribes were less likely to return. In qualitative analysis of 9 key informant interviews, prominent barriers to return to clinic and adherence included concerns for personal safety, shortages of resources, hanging priorities, and

  20. Some cultural constraints which affect child survival and development in Kenya with reference to Kwale district.

    PubMed

    Mutunga, S N

    1986-09-01

    Close to 20% of children in some districts of Kenya die before their 2nd birthday. Diarrhea, acute respiratory diseases, measles, and malaria are responsible for 70% of these deaths and can be prevented through a basic educational strategy encompassing informal, formal, and nonformal components. Since the changing of attitudes is essential to such a strategy, educators must pay attention to the elements of culture and incorporate useful aspects into the curriculum. At the same time, cultural beliefs that hinder good health habits and counterproductive superstitions must be eradicated. Some have argued that education is too expensive to provide on a mass scale; however, countries that fail to provide the basic educational services will face even greater costs in the long-term as a result of unemployment and poverty. In Kenya's Kwale District, female illiteracy stands at 50% and only 42% of female children attend school compared to 58% of boys. Cultural factors that have hindered educational efforts in this district include: strong ties with the past, a noncompetitive spirit, a high divorce rate, female circumcision coinciding with the age of school entry, a subsistence existence, a need to use children for domestic chores, and a lack of sex education. The success of an educational program in such areas depends on the commitment, competence, and resourcefulness of its teachers. PMID:12341568

  1. Prevalence and Correlates of Pain and Pain Treatment in a Western Kenya Referral Hospital

    PubMed Central

    Owino, Claudio; Gramelspacher, Gregory P.; Monahan, Patrick O.; Tabbey, Rebeka; Hagembe, Mildred; Strother, Robert M.; Njuguna, Festus; Vreeman, Rachel C.

    2013-01-01

    Abstract Background Pain is often inadequately evaluated and treated in sub-Saharan Africa (SSA). Objective We sought to assess pain levels and pain treatment in 400 hospitalized patients at a national referral hospital in western Kenya, and to identify factors associated with pain and pain treatment. Design Using face-validated Kiswahili versions of two single-item pain assessment tools, the Numerical Rating Scale (NRS) and the Faces Pain Scale–Revised (FPS-R), we determined patients' pain levels. Additional data collected included patient demographics, prescribed analgesics, and administered analgesics. We calculated mean pain ratings and pain management index (PMI) scores. Results Averaged between the NRS and FPS-R, 80.5% of patients endorsed a nonzero level of pain and 30% of patients reported moderate to severe pain. Older patients, patients with HIV, and cancer patients had higher pain ratings. Sixty-six percent of patients had been prescribed analgesics at some point during their hospitalization, the majority of which were nonopioids. A majority of patients (66%) had undertreated pain (negative scores on the PMI). Conclusion This study shows that hospitalized patients in Kenya are experiencing pain and that this pain is often undertreated. PMID:24032753

  2. HIV type 1 gag genetic diversity among antenatal clinic attendees in North Rift Valley, Kenya.

    PubMed

    Nyagaka, Benuel; Kiptoo, Michael K; Lihana, Raphael W; Khamadi, Samoel A; Makokha, Ernest P; Kinyua, Joyceline G; Mwangi, Joseph; Osman, Saida; Lagat, Nancy J; Muriuki, Joseph; Okoth, Vincent; Gicheru, Michael; Ng'ang'a, Zipporah; Songok, Elijah M

    2012-05-01

    HIV genetic recombination and high mutation rate increase diversity allowing it to escape from host immune response or antiretroviral drugs. This diversity has enabled specific viral subtypes to be predominant in specific regions. To determine HIV-1 subtypes among seropositive antenatal clinic attendees in Kenya's North Rift Valley, a cross-sectional study was carried out on 116 HIV-1-positive blood samples. Proviral DNA was extracted from peripheral blood mononuclear cells by DNAzol lysis and ethanol precipitation. Polymerase chain reactions using specific primers for HIV-1 gag and population sequencing on resulting amplicons were carried out. Phylogenetic analysis revealed that 81 (70%) were subtype A1, 13 (11%) subtype D, 8 (7%) subtype C, 3 (3%) subtype A2, 1 (1%) subtype G, and 10 showed possible recombinants: 5 (4%) subtype A1D, 4 (3%) subtype A1C, and 1 (1%) subtype A2C. These data support the need to establish circulating subtypes for better evaluation of effective HIV diagnostic and treatment options in Kenya. PMID:21827277

  3. Infectious diarrhoea in antiretroviral therapy-naïve HIV/AIDS patients in Kenya

    PubMed Central

    Wanyiri, Jane W.; Kanyi, Henry; Maina, Samuel; Wang, David E.; Ngugi, Paul; O'Connor, Roberta; Kamau, Timothy; Waithera, Tabitha; Kimani, Gachuhi; Wamae, Claire N.; Mwamburi, Mkaya; Ward, Honorine D.

    2013-01-01

    Background Diarrhoea is a significant cause of morbidity and mortality in immunocompromised patients. The objectives of this study were to investigate the aetiological agents, risk factors and clinical features associated with diarrhoea in HIV/AIDS patients in Kenya. Methods Sociodemographic, epidemiological and clinical data were obtained for 164 HIV/AIDS patients (70 with and 94 without diarrhoea) recruited from Kenyatta National Hospital, Kenya. Stool samples were examined for enteric pathogens by microscopy and bacteriology. Results Intestinal protozoa and fungi were identified in 70% of patients, more frequently in those with diarrhoea (p<0.001). Helminths were detected in 25.6% of patients overall, and bacterial pathogens were identified in 51% of patients with diarrhoea. Polyparasitism was more common in patients with diarrhoea than those without (p<0.0001). Higher CD4+ T-cell count (OR = 0.995, 95% CI 0.992–0.998) and water treatment (OR = 0.231, 95% CI 0.126–0.830) were associated with a lower risk of diarrhoea, while close contact with cows (OR = 3.200, 95% CI 1.26–8.13) or pigs (OR = 11.176, 95% CI 3.76–43.56) were associated with a higher risk of diarrhoea. Conclusions Multiple enteric pathogens that are causative agents of diarrhoea were isolated from stools of antiretroviral therapy-naïve HIV/AIDS patients, indicating a need for surveillance, treatment and promotion of hygienic practices. PMID:24026463

  4. Chemistry and chronology of magmatic processes, Central Kenya Peralkaline province, East African Rift

    NASA Astrophysics Data System (ADS)

    Anthony, E.; Deino, A. L.; White, J. C.; Omenda, P. A.

    2014-12-01

    We report here a synthesis of the geochemistry of magma evolution correlated with 40Ar/39Ar, 14 C, and U-series chronology for volcanoes in the Central Kenya Peralkaline Province (CKPP). The volcanic centers - Menengai, Eburru, Olkaria, Longonot, and Suswa - are at the apex of the Kenya Dome, and consist of trachyte, phonolite, comendite, and pantellerite. These volcanic centers are within the graben of the EARS and are characterized by a shield-building phase followed by caldera collapse and subsequent post-caldera eruptions. Geochemical modeling demonstrates that the magmas are the result of fractional crystallization of alkali basaltic magmas and magma mixing. Longonot and Suswa have the most chronologic data -14 C, Ar/Ar and U-series - and they show that the youngest eruptions have 230 Th/232Th of 0.8, which was inherited from the magma system prior to eruption. Subsequent changes in 230 Th/232 Th are due to post-eruptive decay of 230 Th and correlate well with 14 C and Ar/Ar.

  5. A study of mycobacteria isolated from cervical lymph glands of African patients in Kenya

    PubMed Central

    Šula, Ladislav; Stott, H.; Kubín, M.; Kiaer, J.

    1960-01-01

    Tuberculosis of the cervical lymph glands is common among Africans, but little is known at present about the causal type of mycobacterium. A study was therefore made in 1958, jointly by WHO and the Kenya Medical Department, to isolate and type mycobacteria from specimens of cervical lymph glands from African patients. From 57 such specimens, collected throughout Kenya and sent to the Tuberculosis Research Institute in Prague for bacteriological and histological examination, 41 strains—all typed as Myco. tuberculosis var. hominis—were isolated, studied in subculture, and tested for drug sensitivity and animal pathogenicity. The cultural, pathogenic, biochemical, and other characteristics of these strains show that mycobacteria isolated from tuberculous cervical lymph glands of Africans essentially resemble those similarly isolated from Europeans, but that all of them were of the human type. No bovine or atypical strains were isolated. The importance of investigating the chest condition of Africans suspected of having tuberculous cervical lymph glands is demonstrated by the high incidence of chest lesions revealed on radiological examination of such persons. This report describes in detail the various methods employed in the study for making cultures, drug sensitivity tests, and histological examinations; the characteristics of the mycobacterial strains isolated; and the results of the bacteriological, clinical, histological, and radiological examinations performed. ImagesFIG. 1FIG. 2FIG. 3FIG. 4FIG. 5FIG. 6FIG. 7FIG. 8FIG. 9FIG. 10FIG. 11FIG. 12 PMID:20604079

  6. Assessing the accuracy of satellite derived global and national urban maps in Kenya.

    PubMed

    Tatem, A J; Noor, A M; Hay, S I

    2005-05-15

    Ninety percent of projected global urbanization will be concentrated in low income countries (United-Nations, 2004). This will have considerable environmental, economic and public health implications for those populations. Objective and efficient methods of delineating urban extent are a cross-sectoral need complicated by a diversity of urban definition rubrics world-wide. Large-area maps of urban extents are becoming increasingly available in the public domain, as are a wide-range of medium spatial resolution satellite imagery. Here we describe the extension of a methodology based on Landsat ETM and Radarsat imagery to the production of a human settlement map of Kenya. This map was then compared with five satellite imagery-derived, global maps of urban extent at Kenya national-level, against an expert opinion coverage for accuracy assessment. The results showed the map produced using medium spatial resolution satellite imagery was of comparable accuracy to the expert opinion coverage. The five global urban maps exhibited a range of inaccuracies, emphasising that care should be taken with use of these maps at national and sub-national scale. PMID:22581985

  7. Heroin shortage in Coastal Kenya: A rapid assessment and qualitative analysis of heroin users’ experiences

    PubMed Central

    Mital, Sasha; Miles, Gillian; McLellan-Lemal, Eleanor; Muthui, Mercy; Needle, Richard

    2016-01-01

    Introduction While relatively rare events, abrupt disruptions in heroin availability have a significant impact on morbidity and mortality risk among those who are heroin dependent. A heroin shortage occurred in Coast Province, Kenya from December 2010 to March 2011. This qualitative analysis describes the shortage events and consequences from the perspective of heroin users, along with implications for health and other public sectors. Methods As part of a rapid assessment, 66 key informant interviews and 15 focus groups among heroin users in Coast Province, Kenya were conducted. A qualitative thematic analysis was undertaken in Atlas.ti. to identify salient themes related to the shortage. Results Overall, participant accounts were rooted in a theme of desperation and uncertainty, with emphasis on six sub-themes: (1) withdrawal and strategies for alleviating withdrawal, including use of medical intervention and other detoxification attempts; (2) challenges of dealing with unpredictable drug availability, cost, and purity; (3) changes in drug use patterns, and actions taken to procure heroin and other drugs; (4) modifications in drug user relationship dynamics and networks, including introduction of risky group-level injection practices; (5) family and community response; and (6) new challenges with the heroin market resurgence. Conclusions The heroin shortage led to a series of consequences for drug users, including increased risk of morbidity, mortality and disenfranchisement at social and structural levels. Availability of evidence-based services for drug users and emergency preparedness plans could have mitigated this impact. PMID:26470646

  8. Malaria treatment-seeking behaviour and recovery from malaria in a highland area of Kenya

    PubMed Central

    Sumba, Peter O; Wong, S Lindsey; Kanzaria, Hemal K; Johnson, Kelsey A; John, Chandy C

    2008-01-01

    Background Malaria epidemics in highland areas of Kenya cause significant morbidity and mortality. Methods To assess treatment-seeking behaviour for malaria in these areas, a questionnaire was administered to 117 randomly selected households in the highland area of Kipsamoite, Kenya. Self-reported episodes of malaria occurred in 100 adults and 66 children. Results The most frequent initial sources of treatment for malaria in adults and children were medical facilities (66.0% and 66.7%) and local shops (19.0% and 30.3%). Adults and children who initially visited a medical facility for treatment were significantly more likely to recover and require no further treatment than those who initially went to a local shop (adults, 84.9% v. 36.8%, P < 0.0001, and children, 79.6% v. 40.0%, P = 0.002, respectively). Individuals who attended medical facilities recalled receiving anti-malarial medication significantly more frequently than those who visited shops (adults, 100% vs. 29.4%, and children, 100% v. 5.0%, respectively, both P < 0.0001). Conclusion A significant proportion of this highland population chooses local shops for initial malaria treatment and receives inappropriate medication at these localshops, reslting in delay of effective treatment. Shopkeeper education has the potential to be a component of prevention or containment strategies for malaria epidemics in highland areas. PMID:19036154

  9. Median age at menopause in a rural population of western Kenya.

    PubMed

    Noreh, J; Sekadde-Kigondu, C; Karanja, J G; Thagana, N G

    1997-10-01

    This was a cross sectional descriptive study to discuss the median age of menopause in a rural area of Western Kenya. The broad objective of the study was to describe the demographic and biophysical characteristics of the study population and determine the age of menopause. A review of the current and medieval records shows average age of menopause has remained relatively constant at 50 years in contrast to the receeding age of menarche. A total of 1078 women aged between 40-60 years were interviewed. The majority (98.8%) were from one ethnic group, the Luhya. Of the 1078 women, 880 (81.4%) were married and 198 (18.6%) were single. The average number of children per woman was 7.74. Most of the women (75.1%) had attained primary school education. Their husbands were unskilled workers in 30.1% of the cases. The mean weight and height of the women was 60.74 kg and 161.1 cm respectively. Using methods of probit analysis, the median and modal age of menopause was found to be 48.28 years in this group of western Kenya women. If generalised for the whole country, these results suggest that an average Kenyan woman lives for over ten years beyond menopause. It is recommended that more attention should be given to the special health problems of postmenopausal population. PMID:9529744

  10. Use of Lot Quality Assurance Sampling to Ascertain Levels of Drug Resistant Tuberculosis in Western Kenya

    PubMed Central

    Cohen, Ted; Zignol, Matteo; Nyakan, Edwin; Hedt-Gauthier, Bethany L.; Gardner, Adrian; Kamle, Lydia; Injera, Wilfred; Carter, E. Jane

    2016-01-01

    Objective To classify the prevalence of multi-drug resistant tuberculosis (MDR-TB) in two different geographic settings in western Kenya using the Lot Quality Assurance Sampling (LQAS) methodology. Design The prevalence of drug resistance was classified among treatment-naïve smear positive TB patients in two settings, one rural and one urban. These regions were classified as having high or low prevalence of MDR-TB according to a static, two-way LQAS sampling plan selected to classify high resistance regions at greater than 5% resistance and low resistance regions at less than 1% resistance. Results This study classified both the urban and rural settings as having low levels of TB drug resistance. Out of the 105 patients screened in each setting, two patients were diagnosed with MDR-TB in the urban setting and one patient was diagnosed with MDR-TB in the rural setting. An additional 27 patients were diagnosed with a variety of mono- and poly- resistant strains. Conclusion Further drug resistance surveillance using LQAS may help identify the levels and geographical distribution of drug resistance in Kenya and may have applications in other countries in the African Region facing similar resource constraints. PMID:27167381

  11. Weekly miscarriage rates in a community-based prospective cohort study in rural western Kenya

    PubMed Central

    Dellicour, Stephanie; Aol, George; Ouma, Peter; Yan, Nicole; Bigogo, Godfrey; Hamel, Mary J; Burton, Deron C; Oneko, Martina; Breiman, Robert F; Slutsker, Laurence; Feikin, Daniel; Kariuki, Simon; Odhiambo, Frank; Stergachis, Andreas; Laserson, Kayla F; ter Kuile, Feiko O; Desai, Meghna

    2016-01-01

    Objective Information on adverse pregnancy outcomes is important to monitor the impact of public health interventions. Miscarriage is a challenging end point to ascertain and there is scarce information on its rate in low-income countries. The objective was to estimate the background rate and cumulative probability of miscarriage in rural western Kenya. Design This was a population-based prospective cohort. Participants and setting Women of childbearing age were followed prospectively to identify pregnancies and ascertain their outcomes in Siaya County, western Kenya. The cohort study was carried out in 33 adjacent villages under health and demographic surveillance. Outcome measure Miscarriage. Results Between 2011 and 2013, among 5536 women of childbearing age, 1453 pregnancies were detected and 1134 were included in the analysis. The cumulative probability was 18.9%. The weekly miscarriage rate declined steadily with increasing gestation until approximately 20 weeks. Known risk factors for miscarriage such as maternal age, gravidity, occupation, household wealth and HIV infection were confirmed. Conclusions This is the first report of weekly miscarriage rates in a rural African setting in the context of high HIV and malaria prevalence. Future studies should consider the involvement of community health workers to identify the pregnancy cohort of early gestation for better data on the actual number of pregnancies and the assessment of miscarriage. PMID:27084287

  12. Factors Influencing Local Communities' Satisfaction Levels with Different Forest Management Approaches of Kakamega Forest, Kenya

    NASA Astrophysics Data System (ADS)

    Guthiga, Paul M.; Mburu, John; Holm-Mueller, Karin

    2008-05-01

    Satisfaction of communities living close to forests with forest management authorities is essential for ensuring continued support for conservation efforts. However, more often than not, community satisfaction is not systematically elicited, analyzed, and incorporated in conservation decisions. This study attempts to elicit levels of community satisfaction with three management approaches of Kakamega forest in Kenya and analyze factors influencing them. Three distinct management approaches are applied by three different authorities: an incentive-based approach of the Forest Department (FD), a protectionist approach of the Kenya Wildlife Service (KWS), and a quasi-private incentive-based approach of Quakers Church Mission (QCM). Data was obtained from a random sample of about 360 households living within a 10-km radius around the forest margin. The protectionist approach was ranked highest overall for its performance in forest management. Results indicate that households are influenced by different factors in their ranking of management approaches. Educated households and those located far from market centers are likely to be dissatisfied with all the three management approaches. The location of the households from the forest margin influences negatively the satisfaction with the protectionist approach, whereas land size, a proxy for durable assets, has a similar effect on the private incentive based approach of the QCM. In conclusion, this article indicates a number of policy implications that can enable the different authorities and their management approaches to gain approval of the local communities.

  13. A Policy Analysis of the implementation of a Reproductive Health Vouchers Program in Kenya

    PubMed Central

    2012-01-01

    Background Innovative financing strategies such as those that integrate supply and demand elements like the output-based approach (OBA) have been implemented to reduce financial barriers to maternal health services. The Kenyan government with support from the German Development Bank (KfW) implemented an OBA voucher program to subsidize priority reproductive health services. Little evidence exists on the experience of implementing such programs in different settings. We describe the implementation process of the Kenyan OBA program and draw implications for scale up. Methods Policy analysis using document review and qualitative data from 10 in-depth interviews with facility in-charges and 18 with service providers from the contracted facilities, local administration, health and field managers in Kitui, Kiambu and Kisumu districts as well as Korogocho and Viwandani slums in Nairobi. Results The OBA implementation process was designed in phases providing an opportunity for learning and adapting the lessons to local settings; the design consisted of five components: a defined benefit package, contracting and quality assurance; marketing and distribution of vouchers and claims processing and reimbursement. Key implementation challenges included limited feedback to providers on the outcomes of quality assurance and accreditation and budgetary constraints that limited effective marketing leading to inadequate information to clients on the benefit package. Claims processing and reimbursement was sophisticated but required adherence to time consuming procedures and in some cases private providers complained of low reimbursement rates for services provided. Conclusions OBA voucher schemes can be implemented successfully in similar settings. For effective scale up, strong partnership will be required between the public and private entities. The government’s role is key and should include provision of adequate funding, stewardship and looking for opportunities to utilize

  14. Maasai perception of the impact and incidence of malignant catarrhal fever (MCF) in southern Kenya.

    PubMed

    Bedelian, Claire; Nkedianye, David; Herrero, Mario

    2007-03-17

    We investigated the perceived impact of malignant catarrhal fever (MCF) to pastoralists in Isinya Division, a wildlife dispersal area of Nairobi National Park, and used a range of participatory epidemiology methodologies. We compared the relative importance, incidence and impact of MCF compared to other locally defined important diseases with a total of 158 respondents in 11 group meetings and 21 household meetings in July 2004. Direct losses due to disease were investigated through lowered prices as a result of the emergency sale of disease-infected animals. Overall, Maasai in Isinya Division perceived east coast fever (ECF) to be the most important cattle disease and to have the highest incidence. Anthrax was considered to have the largest impact. In areas within or adjacent to the wildebeest calving zone, MCF was perceived to be the most important cattle disease and also to have the largest impact. Outside the calving zone, MCF was considered the fourth-most important disease with the fourth largest impact, and these were areas where wildebeest were less common. MCF was also the fourth-most common disease, and across the Division incidence was estimated at 5% in calves and 10% in adults. However, MCF incidence varied greatly throughout the study area, from 3% to 12%, and the highest incidence risks were found in areas where wildebeest came to calve. The percent drop in sale price per animal infected with MCF was estimated at 50% for MCF for the year 2003-2004. Forced avoidance movements away from wildebeest calves were reported to decrease livestock production due to loss of access to prime grazing sites. As suggested by pastoralists in this study, the development of compensation schemes or incentives from wildlife would reduce the conflict between livestock keeping and wildlife conservation. PMID:17123651

  15. Organizational Cultural Factors Hindering Women Ascending to Top Management Positions in Public Universities in Kenya: A Case of Moi University

    ERIC Educational Resources Information Center

    Makori, Rebecca S.; Onyango, Maria; Attyang, Judith Miguda; Bantu, Edward; Onderi, Peter Omae

    2016-01-01

    It is observed that the major setback to economic development in Kenya is stagnation in industrial development. To overcome these, Kenya plans to be a middle level income nation by the year 2030. These plans are to be realized through "Vision 2030." To achieve these goals, Kenya requires gender mainstreamed team of highly skilled workers…

  16. Soil Quality and Human Migration in Kenya and Uganda

    PubMed Central

    Gray, Clark L.

    2011-01-01

    Soil degradation is widely considered to be a key factor undermining agricultural livelihoods in the developing world and contributing to rural out-migration. To date, however, few quantitative studies have examined the effects of soil characteristics on human migration or other social outcomes for potentially vulnerable households. This study takes advantage of a unique longitudinal survey dataset from Kenya and Uganda containing information on household-level soil properties to investigate the effects of soil quality on population mobility. Random effects multinomial logit models are used to test for effects of soil quality on both temporary and permanent migration while accounting for a variety of potential confounders. The analysis reveals that soil quality significantly reduces migration in Kenya, particularly for temporary labor migration, but marginally increases migration in Uganda. These findings are consistent with several previous studies in showing that adverse environmental conditions tend to increase migration but not universally, contrary to common assumptions about environmentally-induced migration. PMID:22016577

  17. Place of Residence Moderates the Risk of Infant Death in Kenya: Evidence from the Most Recent Census 2009

    PubMed Central

    Kipruto, Samuel; Epprecht, Michael; Galea, Sandro

    2015-01-01

    Background Substantial progress has been made in reducing childhood mortality worldwide from 1990–2015 (Millennium Development Goal, target 4). Achieving target goals on this however remains a challenge in Sub-Saharan Africa. Kenya’s infant mortality rates are higher than the global average and are more pronounced in urban areas as compared to rural areas. Only limited knowledge exists about the differences in individual level risk factors for infant death among rural, non-slum urban, and slum areas in Kenya. Therefore, this paper aims at 1) assess individual and socio-ecological risk factors for infant death in Kenya, and at 2) identify whether living in rural, non-slum urban, or slum areas moderated individual or socio-ecological risk factors for infant death in Kenya. Methodology We used a cross-sectional study design based on the most recent Kenya Population and Housing Census of 2009 and extracted the records of all females who had their last child born in 12 months preceding the survey (N = 1,120,960). Multivariable regression analyses were used to identify risk factors that accounted for the risk of dying before the age of one at the individual level in Kenya. Place of residence (rural, non-slum urban, slum) was used as an interaction term to account for moderating effects in individual and socio-ecological risk factors. Results Individual characteristics of mothers and children (older age, less previously born children that died, better education, girl infants) and household contexts (better structural quality of housing, improved water and sanitation, married household head) were associated with lower risk for infant death in Kenya. Living in non-slum urban areas was associated with significantly lower infant death as compared to living in rural or slum areas, when all predictors were held at their reference levels. Moreover, place of residence was significantly moderating individual level predictors: As compared to rural areas, living in urban areas

  18. Hydrochemistry of the Lake Magadi basin, Kenya

    USGS Publications Warehouse

    Jones, B.F.; Eugster, H.P.; Rettig, S.L.

    1977-01-01

    New and more complete compositional data are presented for a large number of water samples from the Lake Magadi area, Kenya. These water samples range from dilute inflow (300 g/kg dissolved solids). Five distinct hydrologic stages can be recognized in the evolution of the water compositions: dilute streamflow, dilute ground water, saline ground water (or hot spring reservoir), saturated brines, and residual brines. Based on the assumption that chloride is conserved in the waters during evaporative concentration, these stages are related to each other by the concentration factors of about 1:28:870:7600:16,800. Dilute streamflow is represented by perennial streams entering the Rift Valley from the west. All but one (Ewaso Ngiro) of these streams disappear in the alluvium and do not reach the valley floor. Dilute ground water was collected from shallow pits and wells dug into lake sediments and alluvial channels. Saline ground water is roughly equivalent to the hot springs reservoir postulated by Eugster (1970) and is represented by the hottest of the major springs. Saturated brines represent surficial lake brines just at the point of saturation with respect to trona (Na2CO3.NaHCO3.2H2O), while residual brines are essentially interstitial to the evaporite deposit and have been subjected to a complex history of precipitation and re-solution. The new data confirm the basic hydrologic model presented by Eugster (1970) which has now been refined, particularly with respect to the early stages of evaporative concentration. Budget calculations show that only bromide is conserved as completely as chloride. Sodium follows chloride closely until trona precipitation, whereas silica and sulfate are largely lost during the very first concentration' step (dilute streamflow-dilute ground water). A large fraction of potassium and all calcium plus magnesium are removed during the first two concentration steps (dilute streamflow-dilute ground water-saline ground water). Carbonate and

  19. The uppermost mantle beneath the Kenya dome and relation to melting, rifting and uplift in East Africa

    NASA Astrophysics Data System (ADS)

    Davis, Paul M.; Slack, Philip D.

    2002-04-01

    We compare new results on S-wave delays and P wave tomography to characterize the rising limb and melt zone of an inferred mantle convection cell beneath the Kenya dome. These results are extended to the Nyiragongo and Ethiopia domes using long wavelength gravity and topography. We suggest that the east African rift results from separation of deeper mantle upwelling into three currents that impinge on and erode the base of the lithosphere. Their thermal buoyancy drives the domal uplift, whereas brittle failure of the upper lithosphere forms the rift grabens.

  20. Prevalence of Hepatitis B Virus Infection in Kenya, 2007.

    PubMed

    Ly, Kathleen N; Kim, Andrea A; Umuro, Mamo; Drobenuic, Jan; Williamson, John M; Montgomery, Joel M; Fields, Barry S; Teshale, Eyasu H

    2016-08-01

    Current estimates put the prevalence of hepatitis B virus (HBV) infection in Kenya at 5-8%. We determined the HBV infection prevalence in the human immunodeficiency virus (HIV)-negative Kenyan adult and adolescent population based on samples collected from a national survey. We analyzed data from HIV-negative participants in the 2007 Kenya AIDS Indicator Survey to estimate the HBV infection prevalence. We defined past or present HBV infection as presence of total hepatitis B core antibody (HBcAb), and chronic HBV infection (CHBI) as presence of both total HBcAb and hepatitis B surface antigen (HBsAg). We calculated crude and adjusted odds of HBV infection by demographic characteristics and risk factors using logistic regression analyses. Of 1,091 participants aged 15-64 years, approximately 31.5% (95% confidence interval [CI] = 28.0-35.3%) had exposure to HBV, corresponding to approximately 6.1 million (CI = 5.4-6.8 million) with past or present HBV infection. The estimated prevalence of CHBI was 2.1% (95% CI = 1.4-3.1%), corresponding to approximately 398,000 (CI = 261,000-602,000) with CHBI. CHBI is a major public health problem in Kenya, affecting approximately 400,000 persons. Knowing the HBV infection prevalence at baseline is important for planning and public health policy decision making and for monitoring the impact of viral hepatitis prevention programs. PMID:27273644

  1. Assessing reading fluency in Kenya: Oral or silent assessment?

    NASA Astrophysics Data System (ADS)

    Piper, Benjamin; Zuilkowski, Stephanie Simmons

    2015-04-01

    In recent years, the Education for All movement has focused more intensely on the quality of education, rather than simply provision. Many recent and current education quality interventions focus on literacy, which is the core skill required for further academic success. Despite this focus on the quality of literacy instruction in developing countries, little rigorous research has been conducted on critical issues of assessment. This analysis, which uses data from the Primary Math and Reading Initiative (PRIMR) in Kenya, aims to begin filling this gap by addressing a key assessment issue - should literacy assessments in Kenya be administered orally or silently? The authors compared second-grade students' scores on oral and silent reading tasks of the Early Grade Reading Assessment (EGRA) in Kiswahili and English, and found no statistically significant differences in either language. They did, however, find oral reading rates to be more strongly related to reading comprehension scores. Oral assessment has another benefit for programme evaluators - it allows for the collection of data on student errors, and therefore the calculation of words read correctly per minute, as opposed to simply words read per minute. The authors therefore recommend that, in Kenya and in similar contexts, student reading fluency be assessed via oral rather than silent assessment.

  2. A Biosecurity Survey in Kenya, November 2014 to February 2015.

    PubMed

    Ndhine, Edwardina Otieno; Slotved, Hans-Christian; Osoro, Eric Mogaka; Olsen, Katja N; Rugutt, Moses; Wanjohi, Cathryn W; Mwanda, Walter; Kinyagia, Benson Mburu; Steenhard, Nina R; Hansen, John-Erik Stig

    2016-01-01

    A biosecurity survey was performed to gather information on the biosecurity level and laboratory capacity in Kenya for the purpose of providing information outlining relevant components for biosecurity legislation, biosecurity implementation, and enforcement of biosecurity measures in Kenya. This survey is, to the authors' knowledge, the first to be published from an African country. A total of 86 facilities with laboratories covering relevant categories, such as training laboratories, human diagnostic laboratories, veterinary diagnostic laboratories, and research laboratories, were selected to participate in the survey. Each facility was visited by a survey team and staff were asked to answer 29 groups of questions from a questionnaire. The survey showed that Kenyan laboratory facilities contain biological agents of biosecurity concern. The restrictions for these agents were found to be limited for several of the facilities, in that many laboratory facilities and storage units were open for access by either students or staff who had no need of access to the laboratory. The survey showed a great deal of confusion in the terms biosecurity and biosafety and a generally limited biosecurity awareness among laboratory personnel. The survey showed that the security of biological agents of biosecurity concern in many facilities does not meet the international requirements. The authors recommend developing a legal framework in Kenya for effective controls, including national biosecurity regulations, guidelines, and procedures, thereby reducing the risk that a Kenyan laboratory would be the source of a future biological attack. PMID:27482879

  3. Composition of the crust beneath the Kenya rift

    USGS Publications Warehouse

    Mooney, W.D.; Christensen, N.I.

    1994-01-01

    We infer the composition of the crust beneath and on the flanks of the Kenya rift based on a comparison of the KRISP-90 crustal velocity structure with laboratory measurements of compressional-wave velocities of rock samples from Kenya. The rock samples studied, which are representative of the major lithologies exposed in Kenya, include volcanic tuffs and flows (primarily basalts and phonolites), and felsic to intermediate composition gneisses. This comparison indicates that the upper crust (5-12 km depth) consists primarily of quartzo-feldspathic gneisses and schists similar to rocks exposed on the flanks of the rift, whereas the middle crust (12-22 km depth) consists of more mafic, hornblende-rich metamorphic rocks, probably intruded by mafic rocks beneath the rift axis. The lower crust on the flanks of the rift may consist of mafic granulite facies rocks. Along the rift axis, the lower crust varies in thickness from 9 km in the southern rift to only 2-3 km in the north, and has a seismic velocity substantially higher than the samples investigated in this study. The lower crust of the rift probably consists of a crust/mantle mix of high-grade metamorphic rocks, mafic intrusives, and an igneous mafic residuum accreted to the base of the crust during differentiation of a melt derived from the upper mantle. ?? 1994.

  4. Integration of mental health into primary care in Kenya.

    PubMed

    Jenkins, Rachel; Kiima, David; Njenga, Frank; Okonji, Marx; Kingora, James; Kathuku, Dammas; Lock, Sarah

    2010-06-01

    Integration of mental health into primary care is essential in Kenya, where there are only 75 psychiatrists for 38 million population, of whom 21 are in the universities and 28 in private practice. A partnership between the Ministry of Health, the Kenya Psychiatric Association and the World Health Organization (WHO) Collaborating Centre, Institute of Psychiatry, Kings College London was funded by Nuffield Foundation to train 3,000 of the 5,000 primary health care staff in the public health system across Kenya, using a sustainable general health system approach. The content of training was closely aligned to the generic tasks of the health workers. The training delivery was integrated into the normal national training delivery system, and accompanied by capacity building courses for district and provincial level staff to encourage the inclusion of mental health in the district and provincial annual operational plans, and to promote the coordination and supervision of mental health services in primary care by district psychiatric nurses and district public health nurses. The project trained 41 trainers, who have so far trained 1671 primary care staff, achieving a mean change in knowledge score of 42% to 77%. Qualitative observations of subsequent clinical practice have demonstrated improvements in assessment, diagnosis, management, record keeping, medicine supply, intersectoral liaison and public education. Around 200 supervisors (psychiatrists, psychiatric nurses and district public health nurses) have also been trained. The project experience may be useful for other countries also wishing to conduct similar sustainable training and supervision programmes. PMID:20671901

  5. Effectiveness of Communication on Students Discipline in Secondary Schools in Kenya

    ERIC Educational Resources Information Center

    Kindiki, Jonah Nyaga

    2009-01-01

    The influence of communication on student discipline in secondary schools is an issue of continued debate in Kenya. This study was necessitated by the growing concern by education stakeholders in Kenya over the rising reports of student indiscipline in secondary schools. The study utilized qualitative approach with questionnaires, interviews and…

  6. China's Cooperation in Education and Training with Kenya: A Different Model?

    ERIC Educational Resources Information Center

    King, Kenneth

    2010-01-01

    This is the first detailed study of the character and particularity of China's rapidly growing education and training cooperation with Kenya. Set against the 50-year history of Kenya's engagement with China, it pays special attention to the human resources targets of the Forum for China-Africa Cooperation (FOCAC) from 2000. It argues that the…

  7. 7 CFR 319.56-45 - Shelled garden peas from Kenya.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... CFR 319.56-45 and have been inspected and found free of pests.” (Approved by the Office of Management... 7 Agriculture 5 2013-01-01 2013-01-01 false Shelled garden peas from Kenya. 319.56-45 Section 319... Shelled garden peas from Kenya. Garden peas (Pisum sativum) may be imported into the continental...

  8. 7 CFR 319.56-45 - Shelled garden peas from Kenya.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... CFR 319.56-45 and have been inspected and found free of pests.” (Approved by the Office of Management... 7 Agriculture 5 2010-01-01 2010-01-01 false Shelled garden peas from Kenya. 319.56-45 Section 319... Shelled garden peas from Kenya. Garden peas (Pisum sativum) may be imported into the continental...

  9. 7 CFR 319.56-45 - Shelled garden peas from Kenya.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... CFR 319.56-45 and have been inspected and found free of pests.” (Approved by the Office of Management... 7 Agriculture 5 2012-01-01 2012-01-01 false Shelled garden peas from Kenya. 319.56-45 Section 319... Shelled garden peas from Kenya. Garden peas (Pisum sativum) may be imported into the continental...

  10. 7 CFR 319.56-45 - Shelled garden peas from Kenya.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... CFR 319.56-45 and have been inspected and found free of pests.” (Approved by the Office of Management... 7 Agriculture 5 2014-01-01 2014-01-01 false Shelled garden peas from Kenya. 319.56-45 Section 319... Shelled garden peas from Kenya. Garden peas (Pisum sativum) may be imported into the continental...

  11. 7 CFR 319.56-45 - Shelled garden peas from Kenya.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... CFR 319.56-45 and have been inspected and found free of pests.” (Approved by the Office of Management... 7 Agriculture 5 2011-01-01 2011-01-01 false Shelled garden peas from Kenya. 319.56-45 Section 319... Shelled garden peas from Kenya. Garden peas (Pisum sativum) may be imported into the continental...

  12. Conformity and Change: Community Effects on Female Genital Cutting in Kenya

    ERIC Educational Resources Information Center

    Hayford, Sarah R.

    2005-01-01

    In this article, I analyze women's decisions to have their daughters circumcised based on data from 7,873 women in Kenya collected in the 1998 Kenya Demographic and Health Survey. I use multilevel models to assess the degree to which women's decisions are correlated with the decisions of other women in their community, in addition to studying the…

  13. Gender Factor in Decision Making: Challenges Facing Women Leadership Development in Primary Schools' Management in Kenya

    ERIC Educational Resources Information Center

    Choge, Jepkemboi Ruth

    2015-01-01

    The degree of attention given to women leadership in Education in Kenya has increased considerably in the recent years especially after the government introduced the affirmative action for both girls and women in education and employment in support of Millennium Development Goals, World Conventions, the Kenya Vision 2030 blue print for economic…

  14. Rate of Financial Return to University Schooling among Lecturers in Two Public Universities in Kenya

    ERIC Educational Resources Information Center

    Rugar, T. O.; Ayodo, T. M. O.; Agak, J. O.

    2010-01-01

    Influence of education on earnings among workers is well documented. However, the level of relationship that exists between earnings and schooling among lecturers in public universities in Kenya remain undetermined. The purpose of this study was to establish the financial profitability of university schooling in Kenya. The study was based on the…

  15. Rationale for Critical Pedagogy of Decolonization: Kenya as a Unit of Analysis

    ERIC Educational Resources Information Center

    Gatimu, M. Wangeci

    2009-01-01

    In December 2007, political violence erupted in Kenya after a general election. Both Kenya and the international community were confronted with the question as to why citizens of a hitherto peaceful nation would engage in acts of hooliganism and violence after exercising a democratic right in a national election. This paper examines how new…

  16. Public by Day, Private by Night: Examining the Private Lives of Kenya's Public Universities

    ERIC Educational Resources Information Center

    Wangenge-Ouma, Gerald

    2012-01-01

    This article examines the emergence of the public university in Kenya as a key provider of private higher education, characterised mainly by the phenomenon of the "private public university student." It probes the broader socio-economic reforms circumscribing the privatisation of Kenya's public universities and the local and global forces…

  17. Occurrence, diversity and pattern of damage of Oplostomus species (Coleoptera: Scarabaeidae), honey bee pests in Kenya

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Several arthropod pests including the hive beetles Aethina tumida and Oplostomus haroldi and the ectoparasite Varroa destructor have recently been identified as associated with honey bee colonies in Kenya. Here, we report the first documentation of O. fuligineus in Kenya, a related scarab of O. haro...

  18. The Abolition of Secondary School Fees in Kenya: Responses by the Poor

    ERIC Educational Resources Information Center

    Ohba, Asayo

    2011-01-01

    Following the 2007 presidential election, the Government of Kenya abolished secondary school fees in 2008. In the context of this significant change in policy, this study examines the effect of fees on transition to secondary schooling by following 109 primary school leavers in rural Kenya after the fee abolition, starting in 2007. The study draws…

  19. Women Education and Economic Development in Kenya: Implications for Curriculum Development and Implementation Processes

    ERIC Educational Resources Information Center

    Syomwene, Anne; Kindiki, Jonah Nyaga

    2015-01-01

    This paper is a discussion of the relationship between women education and sustainable economic development in Kenya and its implications for curriculum development and implementation processes. The argument advanced in this paper is that the solution to the development problems in Kenya and other developing nations lies on women education.…

  20. Our University: Ethnicity, Higher Education and the Quest for State Legitimacy in Kenya

    ERIC Educational Resources Information Center

    Munene, Ishmael I.

    2012-01-01

    In East Africa, no other country has witnessed as great a surge in university institutions as Kenya. The intent of this paper is to explore the persistence of the ethnic configurations in the surge of higher education in Kenya, within the context of the country's history. Outlining the major flashpoints in the country's history will be…