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  1. Genetic Analysis of HIV-1 Subtypes in Nairobi, Kenya

    PubMed Central

    Khoja, Suhail; Ojwang, Peter; Khan, Saeed; Okinda, Nancy; Harania, Reena; Ali, Syed

    2008-01-01

    Background Genetic analysis of a viral infection helps in following its spread in a given population, in tracking the routes of infection and, where applicable, in vaccine design. Additionally, sequence analysis of the viral genome provides information about patterns of genetic divergence that may have occurred during viral evolution. Objective In this study we have analyzed the subtypes of Human Immunodeficiency Virus -1 (HIV-1) circulating in a diverse sample population of Nairobi, Kenya. Methodology 69 blood samples were collected from a diverse subject population attending the Aga Khan University Hospital in Nairobi, Kenya. Total DNA was extracted from peripheral blood mononuclear cells (PBMCs), and used in a Polymerase Chain Reaction (PCR) to amplify the HIV gag gene. The PCR amplimers were partially sequenced, and alignment and phylogenetic analysis of these sequences was performed using the Los Alamos HIV Database. Results Blood samples from 69 HIV-1 infected subjects from varying ethnic backgrounds were analyzed. Sequence alignment and phylogenetic analysis showed 39 isolates to be subtype A, 13 subtype D, 7 subtype C, 3 subtype AD and CRF01_AE, 2 subtype G and 1 subtype AC and 1 AG. Deeper phylogenetic analysis revealed HIV subtype A sequences to be highly divergent as compared to subtypes D and C. Conclusion Our analysis indicates that HIV-1 subtypes in the Nairobi province of Kenya are dominated by a genetically diverse clade A. Additionally, the prevalence of highly divergent, complex subtypes, intersubtypes, and the recombinant forms indicates viral mixing in Kenyan population, possibly as a result of dual infections. PMID:18784834

  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. 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

  4. 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.

  5. 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

  6. 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.

  7. 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

  8. 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

  9. Incidence of cancer in Nairobi, Kenya (2004-2008).

    PubMed

    Korir, Anne; Okerosi, Nathan; Ronoh, Victor; Mutuma, Geoffrey; Parkin, Max

    2015-11-01

    Cancer incidence rates are presented for the Nairobi Cancer Registry, a population-based cancer registry (PBCR) covering the population of the capital city of Kenya (3.2 million inhabitants in 2009). Case finding was by active methods, with standard and checks for accuracy and validity. During the period 2004-2008 a total of 8,982 cases were registered comprising 3,889 men (an age standardized incidence rate (ASR) of 161 per 100,000) and 5,093 women (ASR 231 per 1,00,000). Prostate cancer was the most common cancer in men (ASR 40.6 per 100,000) while breast cancer was the most common among women (ASR 51.7 per 100,000). Cervical cancer ranked the second most common cancer among women in Nairobi with an ASR of 46.1 per 100,000, somewhat lower than those of other registries in East Africa region. Breast and cervical cancers accounted for 44% of all cancers in women. Cancer of the oesophagus was common in both sexes, with a slight excess of cases in men (sex ratio 1.3). Unlike other regions in East Africa, the rate of Kaposi sarcoma was relatively low during the period (men 3.6/100,000; women 2.0/100,000). Although incidence rates cannot be calculated for the early years of the registry, the increase in relative frequency of prostate cancer and declines in frequency of Kaposi sarcoma may indicate underlying trends in the risk of these cancers. PMID:26139540

  10. 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

  11. Non-Formal Education in Urban Kenya: Findings of a Study in Kisumu, Mombasa and Nairobi.

    ERIC Educational Resources Information Center

    Thompson, Ekundayo J. D.

    Nonformal education (NFE) in urban Kenya was examined in a study that focused on Kisumu, Mombasa, and Nairobi. Data were collected from the following sources: a literature review; investigations of 88 nonformal, informal, and community schools and centers in the three cities; and interviews with 14 key persons involved in delivery of NFE. The…

  12. 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…

  13. Overweight, Obesity, and Perception of Body Image Among Slum Residents in Nairobi, Kenya, 2008–2009

    PubMed Central

    Van de Vijver, Steven; Oti, Sam; Kyobutungi, Catherine

    2013-01-01

    Introduction The increase in cardiovascular diseases in sub-Saharan Africa has been attributed in part to the changes in lifestyle, and the prevalence of risk factors for cardiovascular disease is higher among urban populations than among nonurban populations. The objective of this study was to determine the prevalence of overweight and obesity and examine perceptions of body size differentiated by sex and other determinants among slum dwellers in Nairobi, Kenya. Methods Analysis included 4,934 adults randomly selected from the Korogocho and Viwandani slums of Nairobi. Height and weight were measured during interviews; body mass index (BMI) was calculated. Perceptions of current and ideal body image were determined by using 18 silhouette drawings of body sizes ranging from very thin to very obese. We used multivariate logistic regression analysis to determine predictors of underestimation of body weight among overweight and obese respondents. Results Overall, 43.4% of women and 17.3% of men in the study population were overweight or obese. More than half (53%) of those who were overweight or obese underestimated their weight; 34.6% of women and 16.9% of men did so. In all BMI categories, more than one-third of women and men preferred body sizes classified as overweight or obese. Conclusion This study highlights the prevalence of overweight and obesity and the strong preference for larger body size among adults in the slums of Nairobi. Interventions to educate residents on the health risks associated with excess body weight are necessary as a part of strategies to reduce the prevalence of risk factors for cardiovascular disease in these settlements. PMID:24355105

  14. Correlates of condom use among sexually experienced secondary-school male students in Nairobi, Kenya.

    PubMed

    Yotebieng, M; Halpern, C T; Mitchell, E M H; Adimora, A A

    2009-03-01

    This study aimed to examine perceptual factors associated with condom use, and the relationship between condom use and the timing of sexual debut among male secondary school students in Nairobi, Kenya. Data are from the TeenWeb study, a school-based project that used the World Wide Web to assess the health needs of secondary school students, and tested the web's utility as a teaching and research modality. Analyses are based on 214 sexually experienced males aged 14 - 20 years who completed web-based questionnaires about their sexual attitudes and behaviour. Results indicate that students did not see themselves as susceptible to HIV/AIDS and believed condom effectiveness in preventing HIV to be low. Consequently, only a marginal association was found between agreeing that buying condoms is embarrassing and condom use at first sexual intercourse. However, contrary to expectation, agreeing that condoms often break (almost half of participants) was associated with a higher likelihood of condom use at first sex. Each year of delay in sexual debut increased the likelihood of using a condom at first sex by 1.44 times. In turn, having used a condom at first sex increased the likelihood of using one at the most recent sex by 4.81 times, and elevated general condom use ('most or all the time') by 8.76 times. Interventions to increase awareness about the role of condoms in preventing HIV, delay sexual initiation, and teach proper condom use among secondary-school students in Nairobi are needed.

  15. Preventable but neglected: rickets in an informal settlement, Nairobi, Kenya.

    PubMed

    Edwards, J K; Thiongó, A; Van den Bergh, R; Kizito, W; Kosgei, R J; Sobry, A; Vandenbulcke, A; Zuniga, I; Reid, A J

    2014-06-21

    Contexte : Le dispensaire de soins de santé primaire de Médecins sans Frontières au cœur du bidonville de Kibera, Nairobi, Kenya.Objectif : Décrire les caractéristiques démographiques et cliniques d'enfants ayant eu un diagnostic clinique de rachitisme de septembre 2012 à octobre 2013.Schéma : Revue descriptive et rétrospective du diagnostic et du traitement par vitamine D et calcium à travers les données des programmes de routine.Résultats : Sur 82 enfants répondant au diagnostic clinique de rachitisme, 57% étaient des garçons d'un âge médian de 12 mois tandis que l'âge médian des filles était de 14 mois. L'exposition au soleil déclarée par la famille était de ⩽3 heures par semaine pour 71% des enfants et 39% présentaient une malnutrition. Les constatations cliniques à l'arrivée ont mis en évidence un retard de développement moteur marqué chez 44% des enfants. Le taux de perdus de vue pendant le traitement a été de 40%.Conclusion : Cette étude a constaté que le rachitisme était une affection fréquente parmi les enfants vivant dans le bidonville de Kibera et que de nombreux facteurs de l'environnement de Kibera y contribuaient vraisemblablement. Comme le rachitisme est une maladie non transmissible qui peut bénéficier d'une prévention simple et peu coûteuse, nous suggérons qu'une supplémentation en vitamine D soit formellement recommandée par l'Organisation Mondiale de la Santé dans les soins de santé aux enfants en Afrique, surtout dans le contexte de bidonvilles.

  16. Impacts of roadway emissions on urban particulate matter concentrations in sub-Saharan Africa: new evidence from Nairobi, Kenya

    NASA Astrophysics Data System (ADS)

    van Vliet, E. D. S.; Kinney, P. L.

    2007-10-01

    Air quality is a serious and worsening problem in the rapidly growing cities of sub-Saharan Africa (SSA). However, the lack of ambient monitoring data, and particularly urban roadside concentrations for particulate matter in SSA cities severely hinders our ability to describe temporal and spatial patterns of concentrations, characterize exposure response relationships for key health outcomes, estimate disease burdens, and promote policy initiatives to address air quality. As part of a collaborative transportation planning exercise between Columbia University and the University of Nairobi, air monitoring was carried out in February 2006 in Nairobi, Kenya. The objective of the monitoring was to collect pilot data on air concentrations (PM2.5 and black carbon) encountered while driving in the Nairobi metropolitan area, and to compare those data to simultaneous 'urban background' concentrations measured in Nairobi but away from roadways. For both the background and roadway monitoring, we used portable air sampling systems that collect integrated filter samples. Results from this pilot study found that roadway concentrations of PM2.5 were approximately 20-fold higher than those from the urban background site, whereas black carbon concentrations differed by 10-fold. If confirmed by more extensive sampling, these data would underscore the need for air quality and transportation planning and management directed at mitigating roadway pollution.

  17. 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

  18. The supermarket for women's reproductive health: the burden of genital infections in a family planning clinic in Nairobi, Kenya

    PubMed Central

    Temmerman, M.; Kidula, N.; Tyndall, M.; Rukaria-Kaumbutho, R.; Muchiri, L.; Ndinya-Achola, J. O.

    1998-01-01

    OBJECTIVES: To study the burden of disease of reproductive tract infections (RTIs) and cervical dysplasia in women attending a family planning clinic in Nairobi, Kenya, and to assess the acceptability of integrating reproductive healthcare services into existing family planning facilities. METHODS: In a family planning clinic in Nairobi, Kenya, 520 women were enrolled in a study on RTI and cervical dysplasia. RESULTS: RTI pathogens were detected in over 20% of women, the majority being asymptomatic. HIV-1 testing was positive in 10.2%. The diagnosis of cervical dysplasia was made on 12% of the cytology smears (mild in 5.8%, moderate in 3.5%, severe in 1.2%), and 1.5% had invasive cervical cancer. The intervention of case detection of RTI and Papanicolaou smear taking was well received by clients and considered feasible by the staff. CONCLUSIONS: Early detection and treatment of potentially curable cervical lesions and RTI provide a unique opportunity to improve women's health. In Kenya, where the current contraceptive prevalence rate is 33%, family planning clinics are excellent sites to introduce health interventions. 


 PMID:9849556

  19. 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

  20. Microbial aetiology and diagnostic criteria of postpartum endometritis in Nairobi, Kenya.

    PubMed Central

    Temmerman, M; Laga, M; Ndinya-Achola, J O; Paraskevas, M; Brunham, R C; Plummer, F A; Piot, P

    1988-01-01

    Using a protected triple lumen device, Neisseria gonorrhoeae or Chlamydia trachomatis, or both, were isolated from the endometriums of five out of 35 women with clinical postpartum endometritis compared with none of a control group of 30 puerperal women without endometritis (p less than 0.05) in Nairobi, Kenya. These sexually transmitted agents were also found in 12 cervical specimens from women with and three without postpartum endometritis (p = 0.04). Mycoplasma hominis and Ureaplasma urealyticum were equally isolated from the endometrium in both groups. Histology showed plasma cell infiltration in 6/25 patients compared with 1/22 controls (p = 0.06). A history of foul lochia (p less than 0.01) and abdominal pain (p = 0.02) were associated with postpartum endometritis. Sexually transmitted agents appear to be major causes of puerperal upper genital tract infections in Nairobi. PMID:3137152

  1. 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

  2. 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.

  3. 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.

  4. 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.

  5. 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.

  6. Characteristics, medical management and outcomes of survivors of sexual gender-based violence, Nairobi, Kenya

    PubMed Central

    Van den Bergh, R.; Tayler-Smith, K.; Godia, P.; Sobry, A.; Kosgei, R. J.; Szumilin, E.; Harries, A. D.; Pujades-Rodriguez, M.

    2013-01-01

    Setting: Médecins Sans Frontières Clinic for sexual gender-based violence (SGBV), Nairobi, Kenya. Objectives: Among survivors of SGBV in 2011, to describe demographic characteristics and episodes of sexual violence, medical management, pregnancy and human immunodeficiency virus (HIV) related outcomes. Design: Retrospective review of clinical records and SGBV register. Results: Survivors attending the clinic increased from seven in 2007 to 866 in 2011. Of the 866 survivors included, 92% were female, 34% were children and 54% knew the aggressor; 73% of the assaults occurred inside a home and most commonly in the evening or at night. Post-exposure prophylaxis for HIV was given to 536 (94%), prophylaxis for sexually transmitted infections to 731 (96%) and emergency contraception to 358 (83%) eligible patients. Hepatitis B and tetanus toxoid vaccinations were given to 774 survivors, but respectively only 46% and 14% received a second injection. Eight (4.5%) of 174 women who underwent urine pregnancy testing were positive at 1 month. Of 851 survivors HIV-tested at baseline, 96 (11%) were HIV-positive. None of the 220 (29%) HIV-negative individuals who returned for repeat HIV testing after 3 months was positive. Conclusion: Acceptable, good quality SGBV medical care can be provided in large cities of sub-Saharan Africa, although further work is needed to improve follow-up interventions. PMID:26393011

  7. 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

  8. 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

  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. Elemental composition of tropospheric aerosols in Hanoi, Vietnam and Nairobi, Kenya.

    PubMed

    Gatari, Michael; Wagner, Annemarie; Boman, Johan

    2005-04-01

    Air pollution problems in major cities within the developing countries need to be studied. There are scanty measurements from the developing countries on airborne particles despite their adverse implications to human health, visibility and climate. One of the major sources of anthropogenic air pollution is energy production. Energy demand is bound to increase as population increases, especially in major cities of the world. Fine particles, particles with aerodynamic diameter < or = 2.5 microm, are mainly anthropogenic and these particles were collected in the capital cities of Vietnam and Kenya. A cyclone airborne particle collector was used to sample in Hanoi during the months of May to October 2000 and a dichotomous virtual impactor in Nairobi in February 2000. The samples were analysed for elemental content by an energy dispersive X-ray fluorescence (EDXRF) spectrometer. S, Cl, K and Fe exceeded atmospheric concentrations of 100 ng m(-3) at both cities. Atmospheric elemental concentrations in both Hanoi and Nairobi were orders of magnitude higher than their respective rural towns. Traffic, biomass and waste burning emissions were implicated as the main sources of air pollution in Nairobi, while coal combustion and road transport were the major sources in Hanoi. Regional air pollution had a major impact over Hanoi, whereas an influence of that kind was not identified in Nairobi. Pb and other toxic elements had concentration levels below WHO guideline, however, the two cities are threatened by future high levels of air pollution due to the high rate of population growth. Long-term measurements are required in both areas to evaluate if the alarming situation is deteriorating.

  12. 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.

  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. Timing and sequencing of events marking the transition to adulthood in two informal settlements in Nairobi, Kenya.

    PubMed

    Beguy, Donatien; Kabiru, Caroline W; Zulu, Eliya M; Ezeh, Alex C

    2011-06-01

    Young people living in poor urban informal settlements face unique challenges as they transition to adulthood. This exploratory paper uses retrospective information from the baseline survey of a 3-year prospective study to examine the timing and sequencing of four key markers (first sex, marriage, birth, and independent housing) of the transition to adulthood among 3,944 adolescents in two informal settlements in Nairobi city, Kenya. Event history analysis techniques are employed to examine the timing of the events. Results indicate that there is no significant gender difference with regard to first sexual debut among adolescents. For many boys and girls, the first sexual experience occurs outside of marriage or other union. For males, the sequencing of entry begins with entry into first sex, followed by independent housing. Conversely, for females, the sequencing begins with first sex and then parenthood. Apart from sexual debut, the patterns of entry into union and parenthood do not differ much from what was observed for Nairobi as a whole. The space constraints that typify the two slums may have influenced the pattern of leaving home observed. We discuss these and other findings in light of their implications for young people's health and well-being in resource-poor settings in urban areas.

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

    PubMed

    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.

  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. Entry into motherhood among adolescent girls in two informal settlements in Nairobi, Kenya.

    PubMed

    Beguy, Donatien; Ndugwa, Robert; Kabiru, Caroline W

    2013-11-01

    The contribution of adolescents' childbearing to total fertility rates in many sub-Saharan African countries is higher than in other parts of the world. In this paper, data collected from 897 female adolescents aged 15-19 years are analysed to investigate patterns and determinants of entry into motherhood in two informal settlements in Nairobi, Kenya, using Kaplan-Meier estimates and Cox regression models. About 15% of these adolescents have had a child. The findings show that marriage, being out of school and having negative models in peer, family and school contexts are associated with early childbearing among females aged 15-17 years. For adolescents aged 18-19 years, school attendance considerably delays entry into motherhood while marriage hastens its timing. Furthermore, older adolescents with high levels of social controls (parental monitoring or perceived peer orientation to or approval of prosocial behaviours) and individual controls (high religiosity and positive orientation to schooling) are likely to delay childbearing. Programmes aiming to reduce risky sexual behaviours that could lead to childbearing among adolescents should be introduced very early, and before the onset of sexual activity. Also, the findings underscore the need to identify and address the risky factors and reinforce the protective ones in order to improve sexual and reproductive health outcomes of adolescent girls in Nairobi slum settlements.

  18. Entry into motherhood among adolescent girls in two informal settlements in Nairobi, Kenya.

    PubMed

    Beguy, Donatien; Ndugwa, Robert; Kabiru, Caroline W

    2013-11-01

    The contribution of adolescents' childbearing to total fertility rates in many sub-Saharan African countries is higher than in other parts of the world. In this paper, data collected from 897 female adolescents aged 15-19 years are analysed to investigate patterns and determinants of entry into motherhood in two informal settlements in Nairobi, Kenya, using Kaplan-Meier estimates and Cox regression models. About 15% of these adolescents have had a child. The findings show that marriage, being out of school and having negative models in peer, family and school contexts are associated with early childbearing among females aged 15-17 years. For adolescents aged 18-19 years, school attendance considerably delays entry into motherhood while marriage hastens its timing. Furthermore, older adolescents with high levels of social controls (parental monitoring or perceived peer orientation to or approval of prosocial behaviours) and individual controls (high religiosity and positive orientation to schooling) are likely to delay childbearing. Programmes aiming to reduce risky sexual behaviours that could lead to childbearing among adolescents should be introduced very early, and before the onset of sexual activity. Also, the findings underscore the need to identify and address the risky factors and reinforce the protective ones in order to improve sexual and reproductive health outcomes of adolescent girls in Nairobi slum settlements. PMID:23688912

  19. Religion, religiosity and premarital sexual attitudes of young people in the informal settlements of Nairobi, Kenya.

    PubMed

    Gyimah, Stephen Obeng; Kodzi, Ivy; Emina, Jacques; Cofie, Nicholas; Ezeh, Alex

    2013-01-01

    Although attitudes to premarital sex may be influenced by several factors, the importance of religion to that discourse cannot be underestimated. By providing standards to judge and guide behaviour, religion provides a social control function such that religious persons are expected to act in ways that conform to certain norms. This study investigated the interconnectedness of several dimensions of religion and premarital sexual attitudes among young people in the informal settlements of Nairobi, Kenya. Using reference group as the theoretical base, it was found that those affiliated with Pentecostal/Evangelical faiths had more conservative attitudes towards premarital sex than those of other Christian faiths. Additionally, while a high level of religiosity was found to associate with more conservative views on premarital sex, the effect was more pronounced among Pentecostal groups. The findings are discussed in relation to programmes on adolescent sexuality. PMID:22716919

  20. 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

  1. 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.…

  2. 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.

  3. 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.

  4. 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

  5. A rapid assessment of drinking water quality in informal settlements after a cholera outbreak in Nairobi, Kenya.

    PubMed

    Blanton, Elizabeth; Wilhelm, Natalie; O'Reilly, Ciara; Muhonja, Everline; Karoki, Solomon; Ope, Maurice; Langat, Daniel; Omolo, Jared; Wamola, Newton; Oundo, Joseph; Hoekstra, Robert; Ayers, Tracy; De Cock, Kevin; Breiman, Robert; Mintz, Eric; Lantagne, Daniele

    2015-09-01

    Populations living in informal settlements with inadequate water and sanitation infrastructure are at risk of epidemic disease. In 2010, we conducted 398 household surveys in two informal settlements in Nairobi, Kenya with isolated cholera cases. We tested source and household water for free chlorine residual (FCR) and Escherichia coli in approximately 200 households. International guidelines are ≥0.5 mg/L FCR at source, ≥0.2 mg/L at household, and <1 E. coli/100 mL. In these two settlements, 82% and 38% of water sources met FCR guidelines; and 7% and 8% were contaminated with E. coli, respectively. In household stored water, 82% and 35% met FCR guidelines and 11% and 32% were contaminated with E. coli, respectively. Source water FCR≥0.5 mg/L (p=0.003) and reported purchase of a household water treatment product (p=0.002) were associated with increases in likelihood that household stored water had ≥0.2 mg/L FCR, which was associated with a lower likelihood of E. coli contamination (p<0.001). These results challenge the assumption that water quality in informal settlements is universally poor and the route of disease transmission, and highlight that providing centralized water with ≥0.5 mg/L FCR or (if not feasible) household water treatment technologies reduces the risk of waterborne cholera transmission in informal settlements.

  6. 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…

  7. The Impact of Sex Work Interruption on Blood-Derived T Cells in Sex Workers from Nairobi, Kenya

    PubMed Central

    Omollo, Kenneth; Boily-Larouche, Geneviève; Lajoie, Julie; Kimani, Makobu; Cheruiyot, Julianna; Kimani, Joshua; Oyugi, Julius

    2016-01-01

    Abstract Background: Unprotected sexual intercourse exposes the female genital tract (FGT) to semen-derived antigens, which leads to a proinflammatory response. Studies have shown that this postcoital inflammatory response can lead to recruitment of activated T cells to the FGT, thereby increasing risk of HIV infection. Objective: The purpose of this study was to evaluate the impact of sex work on activation and memory phenotypes of peripheral T cells among female sex workers (FSW) from Nairobi, Kenya. Subjects: Thirty FSW were recruited from the Pumwani Sex Workers Cohort, 10 in each of the following groups: HIV-exposed seronegative (at least 7 years in active sex work), HIV positive, and New Negative (HIV negative, less than 3 years in active sex work). Blood was obtained at three different phases (active sex work, abstinence from sex work–sex break, and following resumption of sex work). Peripheral blood mononuclear cells were isolated and stained for phenotypic markers (CD3, CD4, CD8, and CD161), memory phenotype markers (CD45RA and CCR7), activation markers (CD69, HLA-DR, and CD95), and the HIV coreceptor (CCR5). T-cell populations were compared between groups. Results: In HIV-positive women, CD8+CCR5+ T cells declined at the sex break period, while CD4+CD161+ T cells increased when returning to sex work. All groups showed no significant changes in systemic T-cell activation markers following the interruption of sex work, however, significant reductions in naive CD8+ T cells were noted. For each of the study points, HIV positives had higher effector memory and CD8+CD95+ T cells and lower naive CD8+ T cells than the HIV-uninfected groups. Conclusions: Interruption of sex work had subtle effects on systemic T-cell memory phenotypes. PMID:26879184

  8. Partner Disclosure and Early CD4 Response among HIV-Infected Adults Initiating Antiretroviral Treatment in Nairobi Kenya

    PubMed Central

    Trinh, T. Tony; Yatich, Nelly; Ngomoa, Richard; McGrath, Christine J.; Richardson, Barbra A.; Sakr, Samah R.; Langat, Agnes; John-Stewart, Grace C.; Chung, Michael H.

    2016-01-01

    Background Disclosure of HIV serostatus can have significant benefits for people living with HIV/AIDS. However, there is limited data on whether partner disclosure influences ART treatment response. Methods We conducted a retrospective cohort study of newly diagnosed, ART-naïve HIV-infected adults (>18 years) who enrolled at the Coptic Hope Center in Nairobi, Kenya between January 1st 2009 and July 1st 2011 and initiated ART within 3 months. Analysis was restricted to adults who reported to have either disclosed or not disclosed their HIV status to their partner. Analysis of CD4 response at 6 and 12 months post-ART was stratified by age group. Results Among 615 adults newly initiating ART with partner disclosure data and 12 month follow-up, mean age was 38 years and 52% were male; 76% reported that they had disclosed their HIV-status to their partner. Those who disclosed were significantly younger and more likely to be married/cohabitating than non-disclosers. At baseline, median CD4 counts were similar between disclosure groups. Among younger adults (< 38 years) those who disclosed had higher CD4 recovery than those who did not at 6 months post- ART (mean difference = 31, 95% CI 3 to 58 p = 0.03) but not at 12 months (mean difference = 17, 95% CI -19 to 52, p = 0.4). Among older adults (≥ 38years) there was no observed difference in CD4 recovery at 6 or 12 months between disclosure groups. Conclusion Among younger adults, disclosure of HIV status to partners may be associated with CD4 recovery following ART. PMID:27711164

  9. 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

  10. 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.

  11. 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

  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. 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…

  14. 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…

  15. 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…

  16. 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

  17. Outcome mapping for fostering and measuring change in risk management behaviour among urban dairy farmers in Nairobi, Kenya.

    PubMed

    Nyangaga, Julius N; Grace, Delia; Kimani, Violet; Kiragu, Monica W; Langat, Alfred K; Mbugua, Gabriel; Mitoko, Grace; Kang'ethe, Erastus K

    2012-09-01

    A study was undertaken to investigate and mitigate the risk from zoonotic Cryptosporidium associated with dairy farming in Dagoretti division, Nairobi, Kenya. Outcome mapping (OM), a relatively new tool for planning and evaluation, was used to foster and then monitor changes in farmer management of health risks. Elements of the OM framework, including the vision, mission and expected progress markers, were developed in participatory sessions and a set of progress markers was used for monitoring behaviour change in farmers participating in the project (the boundary partners). Behaviour change (the outcome challenge) was supported by a range of awareness and educational campaigns, working with strategic partners (extension agents and administrative leaders). The farmers the project worked with made considerable progress according to the markers; they demonstrated an understanding of cryptosporidiosis, established or maintained clean and well drained cattle sheds, and took conscious effort to reduce possible infection. Farmers who did not participate in the project (non-contact farmers) were found to be less advanced on the progress marker indicators. Non-contact farmers who carried out risk-reducing practices had done so independently of the project team. The administration leaders, as strategic partners, had a positive attitude towards the project and confidence in their ability to support project objectives. The study demonstrates the utility of OM in helping to identify and support behavioural change.

  18. Adherence to the Tobacco Control Act, 2007: presence of a workplace policy on tobacco use in bars and restaurants in Nairobi, Kenya

    PubMed Central

    Karimi, K J; Ayah, R; Olewe, T

    2016-01-01

    Introduction Despite extensive knowledge about effective tobacco control interventions, the prevalence of tobacco use in many middle- and low-income countries continues to rise. In these countries, public appreciation of levels of protection provided by laws and regulations on tobacco use and exposure to tobacco smoke is limited. After ratification of the Framework Convention on Tobacco Control, Kenya enacted the Tobacco Control Act, 2007, banning smoking in public places except in designated smoking areas. Objective To assess adherence to the Tobacco Control Act, 2007 by determining the presence of a workplace policy on tobacco use in bars and restaurants. Methods A survey of 176 liquor licensed bars and restaurants in Nairobi County was carried out. Their managers were asked about the presence of a workplace policy governing smoking of tobacco, and observations made on provisions that determine adherence to the Tobacco Control Act, 2007. Results Smoking took place in almost all bars and restaurants (150 (85%)). Half the establishments (86 (49%)) had a workplace policy governing tobacco use among employees, although a difference between bars (11 (23%)) and restaurants (75 (58%)) was recorded (p<0.001). Establishments at which managers had lower levels of education were less likely to have a workplace policy (p<0.001) and less likely to have ‘no smoking’ signs and designated smoking areas (p<0.005). Conclusions and recommendations Kenya's implementation of the Tobacco Control Act, 2007 does not provide sufficient protection of patrons and workers in bars and restaurants. It is important to sensitise hospitality workers to the dangers of tobacco smoke. Bar and restaurants managers should have a minimum post-secondary education level. The Tobacco Control Act, 2007 requires strengthening to ensure that bars and restaurants have a smoke-free environment. PMID:27683518

  19. Social and gender determinants of risk of cryptosporidiosis, an emerging zoonosis, in Dagoretti, Nairobi, Kenya.

    PubMed

    Kimani, Violet N; Mitoko, Grace; McDermott, Brigid; Grace, Delia; Ambia, Julie; Kiragu, Monica W; Njehu, Alice N; Sinja, Judith; Monda, Joseph G; Kang'ethe, Erastus K

    2012-09-01

    The aim of the study was to investigate the social and gender determinants of the risk of exposure to Cryptosporidium from urban dairying in Dagoretti, Nairobi. Focus group discussions were held in six locations to obtain qualitative information on risk of exposure. A repeated cross-sectional descriptive study included participatory assessment and household questionnaires (300 randomly selected urban dairy farming households and 100 non-dairying neighbours). One-hundred dairy households randomly selected from the 300 dairy households participated in an additional economic survey along with 40 neighbouring non-dairy households. We found that exposure to Cryptosporidium was influenced by gender, age and role in the household. Farm workers and people aged 50 to 65 years had most contact with cattle, and women had greater contact with raw milk. However, children had relatively higher consumption of raw milk than other age groups. Adult women had more daily contact with cattle faeces than adult men, and older women had more contact than older men. Employees had greater contact with cattle than other groups and cattle faeces, and most (77 %) were male. Women took more care of sick people and were more at risk from exposure by this route. Poverty did not affect the level of exposure to cattle but did decrease consumption of milk. There was no significant difference between men and women as regards levels of knowledge on symptoms of cryptosporidiosis infections or other zoonotic diseases associated with dairy farming. Awareness of cryptosporidiosis and its transmission increased significantly with rising levels of education. Members of non-dairy households and children under the age of 12 years had significantly higher odds of reporting diarrhoea: gender, season and contact with cattle or cattle dung were not significantly linked with diarrhoea. In conclusion, social and gender factors are important determinants of exposure to zoonotic disease in Nairobi.

  20. A Reasoned Action Model of Male Client Involvement in Commercial Sex Work in Kibera, A Large Informal Settlement in Nairobi, Kenya

    PubMed Central

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

    2015-01-01

    Male clients of female sex workers (FSWs) are epidemiologically important because they can form bridge groups linking high- and low-risk subpopulations. However, because male clients are hard to locate, they are not frequently studied. Recent research emphasizes searching for high-risk behavior groups in locales where new sexual partnerships form and the threat of HIV transmission is high. Sub-Saharan Africa public drinking venues satisfy these criteria. Accordingly, this study developed and implemented a rapid assessment methodology to survey men in bars throughout the large informal settlement of Kibera, Nairobi, Kenya, with the goal of delineating cultural and economic rationales associated with male participation in commercial sex. The study sample consisted of 220 male patrons of 110 bars located throughout Kibera’s 11 communities. Logistic regression analysis incorporating a modified Reasoned Action Model indicated that a social norm condoning commercial sex among male peers and the cultural belief that men should practice sex before marriage support commercial sex involvement. Conversely, lacking money to drink and/or pay for sexual services were barriers to male commercial sex involvement. Results are interpreted in light of possible harm reduction programs focusing on FSWs’ male clients. PMID:26778847

  1. 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

  2. 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

  3. 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.

  4. 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.

  5. Perception of vulnerability to HIV infection among older people in Nairobi, Kenya: a need for intervention.

    PubMed

    Chepngeno-Langat, Gloria

    2013-03-01

    It is evident that sexual activity tends to decrease with age. Nonetheless, it is still prevalent enough to be considered a risk factor for the spread of HIV among older people. This paper uses quantitative data for 2053 individuals to examine HIV risk perception and correlates of perceived risk among older people aged 50 years and older living in Nairobi slums. It emerged that a majority of older people did not consider themselves at risk of infection. Of those who felt at risk, a greater proportion sensed only a small chance of contracting HIV. Women cited 'no sexual activity' while men mentioned 'having only one and/or a faithful sexual partner' as the primary reasons for perceiving minimal risk of HIV infection. There were no differences by sex in the basis for perceiving moderate-to-great risk of infection. Religion is a key factor in risk perception with Muslims perceiving higher levels of risk and, conversely, devotees irrespective of faith perceiving lower levels of risk. Older people willing to be tested for HIV had a decreased likelihood of perceived risk compared with those unwilling to be tested. This paper recommends evaluation of older people's perception of risk in order to better inform interventions aimed at minimizing their vulnerability to HIV infection. PMID:22795035

  6. 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.

  7. 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

  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. 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

  10. 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

  11. The state of emergency obstetric care services in Nairobi informal settlements and environs: Results from a maternity health facility survey

    PubMed Central

    Ziraba, Abdhalah K; Mills, Samuel; Madise, Nyovani; Saliku, Teresa; Fotso, Jean-Christophe

    2009-01-01

    Background Maternal mortality in Sub-Saharan Africa remains a challenge with estimates exceeding 1,000 maternal deaths per 100,000 live births in some countries. Successful prevention of maternal deaths hinges on adequate and quality emergency obstetric care. In addition to skilled personnel, there is need for a supportive environment in terms of essential drugs and supplies, equipment, and a referral system. Many household surveys report a reasonably high proportion of women delivering in health facilities. However, the quality and adequacy of facilities and personnel are often not assessed. The three delay model; 1) delay in making the decision to seek care; 2) delay in reaching an appropriate obstetric facility; and 3) delay in receiving appropriate care once at the facility guided this project. This paper examines aspects of the third delay by assessing quality of emergency obstetric care in terms of staffing, skills equipment and supplies. Methods We used data from a survey of 25 maternity health facilities within or near two slums in Nairobi that were mentioned by women in a household survey as places that they delivered. Ethical clearance was obtained from the Kenya Medical Research Institute. Permission was also sought from the Ministry of Health and the Medical Officer of Health. Data collection included interviews with the staff in-charge of maternity wards using structured questionnaires. We collected information on staffing levels, obstetric procedures performed, availability of equipment and supplies, referral system and health management information system. Results Out of the 25 health facilities, only two met the criteria for comprehensive emergency obstetric care (both located outside the two slums) while the others provided less than basic emergency obstetric care. Lack of obstetric skills, equipment, and supplies hamper many facilities from providing lifesaving emergency obstetric procedures. Accurate estimation of burden of morbidity and

  12. 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

  13. Factors Influencing Bachelor of Education Arts Students' Selection of History as Career Subject: Case of University of Nairobi, Kenya

    ERIC Educational Resources Information Center

    Owino, Joseph Ogutu; Odundo, Paul Amolloh

    2016-01-01

    History is one of the teaching subjects studied by Bachelor of Education Arts students at the University of Nairobi. In the last five years, there has been a tremendous increase in the number of students specializing in History as a teaching subject. This paper therefore has examined factors influencing students' selection of History as career…

  14. 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…

  15. Attitudes of nursing staff towards computerisation: a case of two hospitals in Nairobi, Kenya

    PubMed Central

    2014-01-01

    Background The health sector is faced with constant changes as new approaches to tackle illnesses are unveiled through research. Information, communication and technology have greatly transformed healthcare practice the world over. Nursing is continually exposed to a variety of changes. Variables including age, educational level, years worked in nursing, computer knowledge and experience have been found to influence the attitudes of nurses towards computerisation. The purpose of the study was to determine the attitudes of nurses towards the use of computers and the factors that influence these attitudes. Methods This cross sectional descriptive study was conducted among staff nurses working at one public hospital (Kenyatta National Hospital, (KNH) and one private hospital (Aga Khan University Hospital (AKUH). A convenience sample of 200 nurses filled the questionnaires. Data was collected using the modified Nurses’ Attitudes Towards Computerisation (NATC) questionnaire. Results Nurses had a favorable attitude towards computerisation. Non-users had a significantly higher attitude score compared to the users (p = 0.0274). Statistically significant associations were observed with age (p = 0.039), level of education (p = 0.025), duration of exposure to computers (p = 0.025) and attitudes towards computerisation. Conclusion Generally, nurses have positive attitudes towards computerisation. This information is important for the planning and implementation of computerisation in the hospital as suggested in other studies. PMID:24774008

  16. 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

  17. T cell anergy and activation are associated with suboptimal humoral responses to measles revaccination in HIV-infected children on anti-retroviral therapy in Nairobi, Kenya.

    PubMed

    Buechler, M B; Newman, L P; Chohan, B H; Njoroge, A; Wamalwa, D; Farquhar, C

    2015-09-01

    HIV-infected children are less capable of mounting and maintaining protective humoral responses to vaccination against measles compared to HIV-uninfected children. This poses a public health challenge in countries with high HIV burdens. Administration of anti-retroviral therapy (ART) and revaccinating children against measles is one approach to increase measles immunity in HIV-infected children, yet it is not effective in all cases. Immune anergy and activation during HIV infection are factors that could influence responses to measles revaccination. We utilized a flow cytometry-based approach to examine whether T cell anergy and activation were associated with the maintenance of measles-specific immunoglobulin (Ig)G antibodies generated in response to measles revaccination in a cohort of HIV-infected children on ART in Nairobi, Kenya. Children who sustained measles-specific IgG for at least 1 year after revaccination displayed significantly lower programmed cell death 1 (PD-1) surface expression on CD8(+) T cells on a per-cell basis and exhibited less activated CD4(+) T cells compared to those unable to maintain detectable measles-specific antibodies. Children in both groups were similar in age and sex, CD4(+) T cell frequency, duration of ART treatment and HIV viral load at enrolment. These data suggest that aberrant T cell anergy and activation are associated with the impaired ability to sustain an antibody response to measles revaccination in HIV-infected children on ART. PMID:25739813

  18. Implications of high-/low-context communication for target audience member interpretation of messages in the Nimechill abstinence campaign in Nairobi, Kenya.

    PubMed

    Muraya, Julie Gathoni; Neville Miller, Ann; Mjomba, Leonard

    2011-09-01

    Although it ran on multiple mass media for the better part of a year, end line evaluation of the Nimechill youth abstinence campaign in Kenya indicated that exposure to the campaign had no relationship to youth decisions to defer sexual debut. One possible explanation of this lack of association could be that target audience members derived inconsistent and confusing meanings from visuals as opposed to text in the campaign. Employing Hall's concept of high- and low-context communication, we assessed target population interpretation of four campaign posters via 12 focus-group discussions and four individual in-depth interviews with Nairobi youth. We found that although participants endorsed and recognized campaign objectives, contextual cues in some campaign visuals were interpreted by participants as being contradictory to the abstinence message in the poster texts. In addition noticeable differences arose between the low-income and middle-/high-income groups in interpretation of one of the posters. We conclude with recommendations regarding use of visuals in high-context cultures and involvement of youth from various socioeconomic strata in campaign planning. PMID:21480020

  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. Participatory probabilistic assessment of the risk to human health associated with cryptosporidiosis from urban dairying in Dagoretti, Nairobi, Kenya.

    PubMed

    Grace, Delia; Monda, Joseph; Karanja, Nancy; Randolph, Thomas F; Kang'ethe, Erastus K

    2012-09-01

    We carried out a participatory risk assessment to estimate the risk (negative consequences and their likelihood) from zoonotic Cryptosporidium originating in dairy farms in urban Dagoretti, Nairobi to dairy farm households and their neighbours. We selected 20 households at high risk for Cryptosporidium from a larger sample of 300 dairy households in Dagoretti based on risk factors present. We then conducted a participatory mapping of the flow of the hazard from its origin (cattle) to human potential victims. This showed three main exposure pathways (food and water borne, occupational and recreational). This was used to develop a fault tree model which we parameterised using information from the study and literature. A stochastic simulation was used to estimate the probability of exposure to zoonotic cryptosporidiosis originating from urban dairying. Around 6 % of environmental samples were positive for Cryptosporidium. Probability of exposure to Cryptosporidium from dairy cattle ranged from 0.0055 for people with clinical acquired immunodeficiency syndrome in non-dairy households to 0.0102 for children under 5 years from dairy households. Most of the estimated health burden was born by children. Although dairy cattle are the source of Cryptosporidium, the model suggests consumption of vegetables is a greater source of risk than consumption of milk. In conclusion, by combining participatory methods with quantitative microbial risk assessment, we were able to rapidly, and with appropriate 'imprecision', investigate health risk to communities from Cryptosporidium and identify the most vulnerable groups and the most risky practices.

  1. Prevalence of intestinal parasitic infections in certified food-handlers working in food establishments in the City of Nairobi, Kenya

    PubMed Central

    Kamau, Paul; Aloo-Obudho, Penina; Kabiru, Ephantus; Ombacho, Kepha; Langat, Bernard; Mucheru, Obadiah; Ireri, Laban

    2012-01-01

    Most intestinal parasites are cosmopolitan with the highest prevalence in the tropics and subtopics. Rural-to-urban migration rapidly increases the number of food eating places in towns and their environs. Some of these eating estabishments have poor sanitation and are overcrowded, facilitating disease transmission, especially through food-handling. Our investigations in Nairobi, therefore, were set to determine the presence of intestinal parasites in food-handlers with valid medical certificates. Direct and concentrated stool processing techniques were used. Chisquare test and ANOVA were used for data analysis. The parasites Ascaris lumbricoides, Entamoeba histolytica and Giardia lamblia were observed in certified food-handlers. Significant difference was found in parasite frequency by eating classes and gender (χ2 = 9.49, P = 0.73), (F = 1.495, P = 0.297), but not in parasite occurrence between age brackets (χ2 = 6.99, P = 0.039). The six-month medical certificate validity period may contribute significantly to the presence of intestinal parasites in certified food-handlers. PMID:23554735

  2. Entry and re-entry into informal care-giving over a 3-year prospective study among older people in Nairobi slums, Kenya.

    PubMed

    Chepngeno-Langat, Gloria

    2014-09-01

    This paper analyses data from a 3-year prospective study to understand the factors associated with becoming a caregiver to a person with a chronic illness and examines the dynamics among caregivers over time. A total of 1485 participants were drawn from a study conducted in the slums of Nairobi, Kenya. Two waves of data collected in 2006 for the baseline and a follow-up in 2009 were used. Information on the demographic, self-reported health and socioeconomic characteristics such as education, sources of livelihood and employment status was used. Age was a significant factor in becoming a caregiver, but there were no significant differences by gender or marital status. New caregivers and those with more than one care-giving episode had a higher socioeconomic position than non-caregivers. Caregivers also had poorer health compared with non-caregivers, highlighting the association between being a caregiver and negative health outcomes. Additionally, having cared for someone with a HIV-related illness compared with other chronic conditions increased the likelihood of subsequently caring for another person in need of long-term care. This may be due to the heterosexual mode of HIV transmission in sub-Saharan Africa, hence clustering of infection within family or married couples. This finding draws attention to the need to provide timely interventions to caregivers for people with HIV-related illness who are likely to end up providing care to multiple care recipients. Furthermore, there is a need to enhance the indispensable contribution of informal caregivers through incorporating their role within the continuum of care for effective HIV and AIDS management. Overall, informal caregivers to persons with chronic illnesses perform the tasks of care-giving without any formal support from health or social services. Therefore, it is crucial to initiate policies and programmes to ease the burden of care that is borne by informal caregivers.

  3. 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

  4. 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.

  5. 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)

  6. 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

  7. The performance of constructed wetlands for, wastewater treatment: a case study of Splash wetland in Nairobi Kenya

    NASA Astrophysics Data System (ADS)

    Nzengy'a, Daniel Muasya; Wishitemi, B. E. L.

    2001-12-01

    The performance of a constructed wetland for wastewater treatment was examined for four months (December 1995 to March 1996). The study area, hereby referred to as the Splash wetland, is approximately 0·5 ha, and is located in the southern part of Nairobi city. Splash wetland continuously receives domestic sewage from two busy restaurants. Treated wastewater is recycled for re-use for various purposes in the restaurants. Both wet and dry season data were analysed with a view of determining the impact of seasonal variation on the system performance. The physical and chemical properties of water were measured at a common intake and at series of seven other points established along the wetland gradient and at the outlet where the water is collected and pumped for re-use at the restaurants. The physico-chemical characteristics of the wastewater changed significantly as the wastewater flowed through the respective wetland cells. A comparison of wastewater influent versus the effluent from the wetland revealed the system's apparent success in water treatment, especially in pH modification, removal of suspended solids, organic load and nutrients mean influent pH = 5·7 +/- 0·5, mean effluent pH 7·7 +/- 0·3; mean influent BOD5 = 1603·0 +/- 397·6 mg/l, mean effluent BOD5 = 15·1 +/- 2·5 mg/l; mean influent COD = 3749·8 +/- 206·8 mg/l, mean effluent COD = 95·6 +/- 7·2 mg/l; mean influent TSS = 195·4 +/- 58·7 mg/l, mean effluent TSS = 4·7 +/- 1·9 mg/l. As the wastewater flowed through the wetland system dissolved free and saline ammonia, NH4+, decreased from 14·6 +/- 4·1 mg/l to undetectable levels at the outlet. Dissolved oxygen increased progressively through the wetland system. Analysis of the data available did not reveal temporal variation in the system's performance. However, significant spatial variation was evident as the wetland removed most of the common pollutants and considerably improved the quality of the water, making it safe for re-use at the

  8. 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

  9. Maternal health care utilization in Nairobi and Ouagadougou: evidence from HDSS

    PubMed Central

    Rossier, Clémentine; Muindi, Kanyiva; Soura, Abdramane; Mberu, Blessing; Lankoande, Bruno; Kabiru, Caroline; Millogo, Roch

    2014-01-01

    Background Maternal mortality is higher and skilled attendance at delivery is lower in the slums of Nairobi (Kenya) compared to Ouagadougou (Burkina Faso). Lower numbers of public health facilities, greater distance to facilities, and higher costs of maternal health services in Nairobi could explain these differences. Objective By comparing the use of maternal health care services among women with similar characteristics in the two cities, we will produce a more nuanced picture of the contextual factors at play. Design We use birth statistics collected between 2009 and 2011 in all households living in several poor neighborhoods followed by the Nairobi and the Ouagadougou Health and Demographic Surveillances Systems (n=3,346 and 4,239 births). We compare the socioeconomic characteristics associated with antenatal care (ANC) use and deliveries at health facilities, controlling for demographic variables. Results ANC use is greater in Nairobi than in Ouagadougou for every category of women. In Ouagadougou, there are few differentials in having at least one ANC visit and in delivering at a health facility; however, differences are observed for completing all four ANC visits. In Nairobi, less-educated, poorer, non-Kikuyu women, and women living in the neighborhood farther from public health services have poorer ANC and deliver more often outside of a health facility. Conclusions These results suggest that women are more aware of the importance of ANC utilization in Nairobi compared to Ouagadougou. The presence of numerous for-profit health facilities within slums in Nairobi may also help women have all four ANC visits, although the services received may be of substandard quality. In Ouagadougou, the lack of socioeconomic differentials in having at least one ANC visit and in delivering at a health facility suggests that these practices stem from the application of well-enforced maternal health regulations; however, these regulations do not cover the entire set of four ANC

  10. Prevalence of cryptosporidiosis in dairy cattle, cattle-keeping families, their non-cattle-keeping neighbours and HIV-positive individuals in Dagoretti Division, Nairobi, Kenya.

    PubMed

    Kange'the, Erastus; McDermott, Brigid; Grace, Delia; Mbae, Cecilia; Mulinge, Erastus; Monda, Joseph; Nyongesa, Concepta; Ambia, Julie; Njehu, Alice

    2012-09-01

    This paper reports a study estimating the prevalence of cryptosporidiosis, an emerging zoonosis, in people and cattle in Dagoretti, Nairobi. A repeated cross-sectional survey was carried out among randomly selected cattle keepers in Dagoretti, their dairy cattle and their non-cattle-keeping neighbours in the dry and wet seasons of 2006. A survey was also carried out among a group of people living with human immunodeficiency virus (HIV). Faecal samples were examined for Cryptosporidium oocysts using the modified Ziehl-Neelsen method; 16 % of the samples were also examined using immunofluorescence antibody (IFA) technique. Quality control consisted of blind reviews of slides, examining split samples and confirming slide results with IFA. We found that members of dairy households had a dry season cryptosporidiosis prevalence of 4 % and wet season prevalence of 0.3 %, and non-dairy households, a prevalence of 5 and 0 %, respectively. The cattle dry season prevalence was 15 %, and the wet season prevalence, 11 %. The prevalence in people living with HIV was 5 %. The laboratory quality control system showed some inconsistency within and between different tests, indicating challenges in obtaining consistent results under difficult field and working conditions. In conclusion, this is the first reported study to simultaneously survey livestock, livestock keepers and their neighbours for cryptosporidiosis. We failed to find evidence that zoonotic cryptosporidiosis is important overall in this community. This study also draws attention to the importance of quality control and its reporting in surveys in developing countries.

  11. 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.

  12. 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

  13. 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

  14. 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

  15. Building global partnerships in infection prevention: a report from APIC Badger and the Nairobi Infection Control Nurses Chapter.

    PubMed

    McKinley, Linda; Auel, Candace; Bahr, Melody; Hutchings, Anna; Leary, Maria; Moskal, Nancy; Ngugi, Rose; Reppen, Melanie; Rosemeyer, Sally

    2013-03-01

    An international partnership between Wisconsin and Kenya was established after a serendipitous meeting with a newly formed infection control organization in Nairobi, Kenya, the Nairobi Infection Control Nurses Chapter (NICNC). Establishment of a sister chapter partnership between a Wisconsin Association for Professionals in Infection Control and Epidemiology chapter (APIC Badger) and the NICNC provided an opportunity to share resources. Although there are many barriers to developing infection prevention and control programs in Kenya, some needs can be met through such partnerships.

  16. 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

  17. 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

  18. Knowledge of sexually transmitted diseases, HIV infection and AIDS among sexually active adolescents in Nairobi, Kenya and its relationship to their sexual behaviour and contraception.

    PubMed

    Lema, V M; Hassan, M A

    1994-02-01

    A total of 675 male and female adolescents, aged 10 to 19 years, who were attending the adolescent antenatal clinic at the Kenyatta National Hospital and the Special STD and Skin Disease Clinic in Nairobi, between April 1, 1991 and July 31, 1991, were interviewed by means of partially structured questionnaire, to determine their level of awareness on sexually transmitted diseases, HIV infection, AIDS and contraception with its relationship to their sexual behaviour and contraceptive practice. Adolescents formed 27.6% of people attending the STD and Skin diseases clinic, of whom 52.9% were females and 41.2% were males. Majority of them were not in any formal employment. A few were students in schools in the city. 70.4% of the total group mentioned gonorrhoea as a sexually transmitted disease, as compared to only 54.3% who mentioned AIDS as a sexually transmitted disease. They only mentioned three diseases, namely gonorrhoea, syphilis, and AIDS (HIV infection). Majority of them had started coitus very early. They were involved with many and different partners, some of whom belonged to the high risk groups for HIV infection as well as STD's. As a reflection of their low awareness on AIDS, most of these sexually active adolescents had not changed their sexual behaviour, nor were they using any protective measure against STD's or HIV infection. The implications of these findings are discussed and possible remedial measures suggested.

  19. The KRISP 94 lithospheric investigation of southern Kenya — the experiments and their main results

    NASA Astrophysics Data System (ADS)

    Prodehl, C.; Ritter, J. R. R.; Mechie, J.; Keller, G. R.; Khan, M. A.; Jacob, B.; Fuchs, K.; Nyambok, I. O.; Obel, J. D.; Riaroh, D.

    1997-09-01

    an area about 150 km (N-S) × 100 km (E-W) and spanned the central portion of the Chyulu Hills and its surroundings, with an average station spacing of 10-30 km. The seismic refraction-wide-angle reflection survey was carried out in a 2-week period in February 1994. It consisted of two profiles: one extending from Lake Victoria across the western flank and the southernmost Kenya rift at Lake Magadi, the other extending from Athi River near Nairobi across the eastern flank of the rift, traversing the Chyulu Hills and terminating at the Indian Ocean near Mombasa. A total of 204 mobile seismographs, with an average station interval of about 2 km, recorded the energy of underwater and borehole explosions to distances of up to 730 km. Key results are as follows: (1) The crust reaches a maximum thickness of up to 44 km under the Chyulu Hills. (2) Only a minor upwarping of the crust-mantle boundary is seen under the rift proper in the Lake Magadi area. (3) To the west the crust shallows to about 34 km near Lake Victoria, in contrast to the thickening of the crust further north from the central part of the rift near Lake Baringo towards the west. (4) There is a steep rise of the Moho east of the Chyulu Hills towards the Indian Ocean. (5) P-wave velocities in the uppermost mantle are above 8 km/s except under the rift proper and under the Neogene volcanic centre of the Chyulu Hills, where the velocity is 7.9-8.0 km/s. (6) Under the Chyulu Hills, the Moho is replaced by a gradual crust-mantle transition, and the low velocities near the crust-mantle boundary extend to greater depths as evidenced by teleseismic tomography which indicates a velocity decrease of 3-5%, i.e. from 8.1-8.2 km/s to at least 7.9 km/s. Both effects are probably caused by the local recent volcanic activity, but cannot be interpreted as due to plume activity which is assumed to be present under the Nyanza craton further west. (7) Gravity modelling and first preliminary results of the magnetotelluric

  20. Gender differentials on the health consequences of care-giving to people with AIDS-related illness among older informal carers in two slums in Nairobi, Kenya.

    PubMed

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

    2011-12-01

    Informal caregivers, most often older people, provide valuable care and support for people ill due to AIDS, especially in poor-resource settings with inadequate health care systems and limited access to antiretroviral therapy. The negative health consequences associated with care-giving may vary depending on various factors that act to mediate the extent of the effects on the caregiver. This paper investigates the association between care-giving and poor health among older carers to people living with AIDS, and examines potential within-gender differences in reporting poor health. Data from 1429 men and women aged 50 years or older living in two slum areas of Nairobi are used to compare AIDS-caregivers with other caregivers and non-caregivers based on self-reported health using the World Health Organization disability assessment (WHODAS) score and the presence of a severe health problem. Women AIDS-caregivers reported higher disability scores for mobility and the lowest scores in self-care and life activities domains while men AIDS-caregivers reported higher scores in all domains (except interpersonal interaction) compared with other caregivers and non-caregivers. Multiple regression analysis is used to examine the association of providing care with health outcomes while controlling for other confounders. Consistently across all the health measures, no significant differences were observed between female AIDS-caregivers and female non-caregivers. Male AIDS-caregivers were however significantly more likely to report disability and having a severe health problem compared with male non-caregivers. This finding highlights a gendered variation in outcome and is possibly an indication of the differences in care-giving gender-role expectations and coping strategies. This study highlights the relatively neglected role of older men as caregivers and recommends comprehensive interventions to mitigate the impact of HIV and AIDS on caregivers that embrace men as well as women.

  1. 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

  2. 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

  3. PreliminaryEquatorial Paleomagnetic results from Mt Kenya lavas. Neil D Opdyke, 1, Dennis V Kent, 2, Kainian Huang ,1, J.P. Patel , 3

    NASA Astrophysics Data System (ADS)

    Opdyke, N. D.; Kent, D. V.; Huang, K.; Patel, J. P.

    2007-12-01

    Field work on this study was carried out in August of 2006 by field parties from the University of Florida and Rutgers University. Mt Kenya is believed to be Plio-Pleistocene in age and an Argon dating survey is underway Ten samples were taken at each site consisting of one exposure in individual lava Flows. These exposures are usually in road cuts, streambeds and in some cases roadbeds. We sampled 100 sites distributed around the Mt Kenya Massif and to the northeast along the Nyambini range. The equator bisex's Mt Kenya and all sites were sampled within 40" north or south of the equator . The samples were returned to the US and processed at the University of Florida paleomagnetic laboratory. Many sites were severely affected by lightning however after demagnetization 68 sites yielded directions with alpha 95's equal to or less than 10°. Normal magnetized sites dominate, with N=58 (Dec=1°,Inc -0.1°,α95=2.6°) whereas only 10 reverse sites(Dec. =181.9,Inc. .6°α 95=8°) were identified. The combined site mean direction is Dec=1.1°, Inc..= -0.2° and α 95=3.2°. This result is not significantly different from what is expected from the geocentric axial dipole. VGP's were calculated from each site and the dispersion is low with the ASD = 11° which is in agreement with model "G" of MacFadden and McElhinny .No transitional directions were identified . Quadrupole components are not resolved. 1 Department of geological Sciences, the University of Florida , 2 Dept of Geology, Rutgers University,3,dept of Physics ,The University of Nairobi

  4. Perceptions of School Leaders in Nairobi about Their Leadership Preparation and Development

    ERIC Educational Resources Information Center

    Okoko, Janet M.; Scott, Shelleyann; Scott, Donald E.

    2015-01-01

    The paper reports on a study undertaken in Nairobi, Kenya with school leaders. We examined their perceptions of the adequacy of their preparation experiences and what aspects remained problematic. This paper only reports on the survey findings which included rating-type and open-ended responses. Principals conceptualized their…

  5. 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…

  6. 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…

  7. Kenya 1989: results from the Demographic and Health Survey.

    PubMed

    1991-01-01

    The summary results from the 1989 Kenya Demographic and Health Survey are tabled and graphically presented. The nationally representative sample includes 8173 households with 7150 interviews from women 15-49 years. Data was collected between December and May 1989 from all provinces except the North Eastern Province and 4 northern provinces, which comprise about 5% of the population. Results include general characteristics of the population; the educational level of women; fertility trends (6.7 total fertility rate for 1986-88) compared to UN estimates (7.9 for 1980-5; fertility differentials by residence, and by educational level; age specific fertility (4 years for 15-19 year olds is 152 births/1000 women, 20-24 years is 314 births/100 women, and 303 birth/1000 women and declining thereafter with increasing age); fertility preferences (desired children, desire to stop childbearing, and planning status of births in 12 months prior to survey by birth order); current contraceptive use (contraceptive preference differentials, contraceptive prevalence by age and parity, and source of supply for current users of modern methods by method);contraception (knowledge and use of methods among currently married women, intention to use contraception in the future by currently married nonusers, and reason for nonuse by those 30 years and 30 years); marital and contraceptive status (current marital status, differentials in age at 1st marriage, and marital and contraceptive status); postpartum variables (duration of postpartum interval by current status, differentials in breastfeeding and amenorrhea, and postpartum status by duration since birth); infant mortality (infant mortality trends, infant mortality differentials for 1979-89 by residence and education level, and children ever born and surviving); and disease prevention and treatment (%12-23 months with health card and % immunized, %5 years with diarrhea 2 weeks prior to survey and % receiving different treatments, and type

  8. 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

  9. 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…

  10. Kenya 1993: results from the Demographic and Health Survey.

    PubMed

    1994-01-01

    The Kenya Demographic and Health Survey collected data from 7950 households and complete interviews with 7540 women aged 15-49 and 2336 men. The interviews took place between February 17 and August 15, 1993. The survey found that over the period 1965-1985, the population grew from 9.8 million to 19.9 million. The crude birth rate per 1000 declined from 52.5 to 47.2, while crude death rate also declined from 20.4 to 12.3. The annual rate of population growth increased from 3.22% to 3.49%, and life expectancy increased from 47.2 years to 56.9. The population is more concentrated in urban centers with 19.7% living therein compared to 8.6% in 1965. UN estimates put the rate of total fertility for 1985-90 at 6.8; the survey estimate for 1990-92 is 5.4, lower than the estimated rate of 8.1 for 1960-65. Contraceptive prevalence is low. Survey data are presented in tabular form under the following headings: distribution of survey sample population by socioeconomic characteristics; fertility trends; fertility differentials, 1990-92; age-specific fertility; mean ideal number of children by age and number of living children for all women; desire to stop childbearing among currently married women; planning status of births at the time of the survey by number of living children; contraceptive prevalence differentials; contraceptive prevalence by age and parity; percentage distribution of current users of modern methods by most recent source of supply, according to method; knowledge and use of methods among currently married women; intention to use contraception in the future among nonusers in union, by number of living children; reason for future nonuse among currently married women by age group; current marital status; differentials in age at first birth; union and contraceptive status; median duration of postpartum interval; differentials in breastfeeding and amenorrhea; infant mortality trends; infant mortality differentials, 1982-92; children ever-born and surviving

  11. Nairobi Forward-looking Strategies for the Advancement of Women: Issues and the Canadian Situation. Fact Sheets--1992 Update.

    ERIC Educational Resources Information Center

    Status of Women Canada, Ottawa (Ontario).

    The 1992 edition of the fact sheets provides information on new and revised Canadian government programs and policies about the implementation of the Nairobi Forward-looking Strategies for the Advancement of Women program that were adopted at the United Nations World Conference on Women in Kenya in 1985. This edition continues to address the…

  12. 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…

  13. 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…

  14. 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

  15. 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.

  16. A multipurpose serological survey in Kenya. 2. Results of arbovirus serological tests.

    PubMed

    Geser, A; Henderson, B E; Christensen, S

    1970-01-01

    Arbovirus infections are of public health interest in East Africa, where a very widespread epidemic of o'nyong-nyong fever was reported in 1959-60 and where the threat of yellow fever, present in neighbouring areas such as Ethiopia, remains. Sera collected in a serological survey in Kenya were therefore tested for antibodies against 3 group-A arboviruses (chikungunya, o'nyong-nyong and Sindbis), 6 group-B arboviruses (Zika, yellow fever, West Nile, Banzi, Wesselsbron and dengue 1), and Bunyamwera virus. The sera were examined mainly by the haemagglutination-inhibition test but a small proportion were also subjected to virus neutralization tests.The results showed that the prevalence of arbovirus tnfection varies markedly from area to area in Kenya. All types of arbovirus infections were more frequent on the coast than on the dry plateau around Kitui and the Lake Victoria area, The only exceptions were o'nyong-nyong and chikungunya, which were found to be just as prevalent on the coast as in Nyanza, where an epidemic was reported in 1959-60. Yellow fever antibodies were found to be present in about half of the people living on the coast but practically absent from the other two areas. It was concluded that the yellow fever antibodies in the coastal area must be due either to vaccination or to cross-reactions with other group-B arboviruses.

  17. Ceftriaxone no longer predictably cures chancroid in Kenya.

    PubMed

    Tyndall, M; Malisa, M; Plummer, F A; Ombetti, J; Ndinya-Achola, J O; Ronald, A R

    1993-02-01

    Ceftriaxone in a dose of 250 mg given intramuscularly is currently recommended for the treatment of chancroid. Among 133 men in Nairobi, Kenya, with culture-proven chancroid, who were treated with ceftriaxone, treatment failed in 35%. Poor outcome was associated with human immunodeficiency virus type 1 seropositivity. Thus, treatment recommendations for chancroid should be reevaluated.

  18. 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

  19. Girl domestic workers in Kenya.

    PubMed

    Mzungu, M

    1999-03-01

    This article exposes the conditions among children who are forced by their poor families to assume domestic work in households in Kenya. It is an accepted practice for parents to place daughters in households to help with housework and baby-sitting. The Sinaga Women and Child Labor Resource Center in Nairobi finds this exploitative and part of a wider practice that institutionalizes violence against women. The Center was established in 1995 to challenge the practice of child domestic labor. The Center's research reveals that child domestic workers tend to come from large, poor, and rural families or from urban slums. Wages are low or exchanged for shoes, clothes, and food. The hours of work are long. Mistreatment may include sexual molestation by male household members, beatings, verbal abuse, and mistrust. There is little recourse. Complaints from child workers or others outside the household can result in further mistreatment. Action against mistreatment is complicated by the prevailing image of activists as frustrated women with vendettas against men. The Center focuses on rehabilitation, literacy training, marketable skill development, and awareness creation. Counseling includes parents, children, and employers. Public awareness campaigns have resulted in employer referrals of youth workers for training. Other groups are joining the effort to improve conditions for child domestic workers.

  20. Double Fire Tragedy of Kenya

    PubMed Central

    Young, Lester; Orosco, Rowena; Milner, Stephen

    2010-01-01

    Objective: Within days of each other, 2 catastrophic fires occurred in Kenya. On January 28, 2009, a busy supermarket was destroyed in downtown Nairobi. Shortly thereafter on February 2, an overturned petrol tanker exploded near the village of Molo, 200 km from the capital. These 2 disasters, in an urban and a rural setting, respectively, illustrate the lack of disaster readiness on a local and national level. Methods: A call for assistance was responded to by the James Jordan Foundation, which sponsored a team from the United States to provide consultation and patient care. Subsequent to this team's experiences, a review of medical records at the Kenyatta National Hospital, interactions with government health officials, and investigation of public media resources, the following observations are reported. Results: Twenty-six victims died in the supermarket fire, and 20 who were admitted to local hospitals later succumbed. At Molo, 91 lives were claimed at the scene; 178 patients were admitted to various hospitals, 40 of whom died. Conclusion: The fires brought to light factors contributing to these events and their outcomes. In addition, it produced improvised solutions for resuscitation of mass casualties and the performance of emergency surgery with inadequate equipment and facilities. PMID:20076785

  1. 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

  2. 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

  3. The effect of work status on exclusive breastfeeding in Nairobi.

    PubMed

    Lakati, Alice; Binns, Colin; Stevenson, Mark

    2002-01-01

    For many women today work is essential for the economic survival of their families while they also fulfil their role of providing optimum nutrition to their babies through breastfeeding. The objective of the study is to document the effect of returning to work on exclusive breastfeeding by mothers in Kenya. A cross-sectional study of 444 working mothers was undertaken in Nairobi, Kenya. About one half of the mothers were in formal paid employment and the rest were self-employed. The mean number of hours the mothers were away from home due to work was 46.2 hours per week. The prevalence of exclusive breastfeeding was 13.3% at three months. Early introduction of complementary foods was high, with 46.4% of the mothers introducing other foods before one month. Breast milk insufficiency and return to work were the main reasons cited for the cessation of exclusive breastfeeding. In a logistic regression analysis the mode of work (fixed working hours versus shift working hours) was associated with exclusive breastfeeding at one month (OR=0.45) and two months (OR=0.39). Working mothers were able to continue breastfeeding, although the exclusive breastfeeding rates were low. The early introduction of other foods is of public health importance as it exposes infants to increased risk of infection and poor nutrition, particularly diarrhoeal diseases and may lead to flattening of the growth curve. Shift work makes it impossible for some mothers to exclusively breastfeed their infants.

  4. 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

  5. Small Farmers on the Move: Results of a Panel Study in Rural Kenya.

    ERIC Educational Resources Information Center

    Chege, Fred Wa; And Others

    To determine the degree of inequity operative between more progressive and less progressive farmers in Tetu, Kenya, baseline data from a 1970 survey of randomly selected farmers (N=354) were compared with data derived from a 1973 survey of 341 of the same respondents. Using the 1970 criteria for progressiveness (most progressive, upper middle,…

  6. 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…

  7. 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…

  8. 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

  9. 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

  10. 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

  11. 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 ...

  12. 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

  13. 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

  14. 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

  15. 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

  16. 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.

  17. 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

  18. 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

  19. 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

  20. Opinions about breastfeeding amongst middle-income African and Indian women in Nairobi.

    PubMed

    Lakhani, S; Jansen, A A

    1984-04-01

    Attitudes troward breastfeeding were assessed among 100 African and Asian women who attended the prenatal clinic of a private hospital in Nairobi, Kenya. The women were subjects in an ongoing nutrition study, but the present study was based only on their responses to 11 questions on breastfeeding. The investigators sought to identify factors which either encouraged or discouraged breastfeeding. The results were expected to be of use in developing strategies to reverse the current trend toward bottle feeding. The women delivered at the hospital and were interviewed shortly after discharge, either in their home or during a postpartum clinic visit. The subjects ranged in age from 16-35 years, and the majority were primaparous. Both the Asian and African women had similar educational backgrounds. Most of the Asian women were housewives, and most of the Africa women were employed as clerks or secretaries. At the time of discharge from the hospital, only 44% of the infants of the African women and only 13% of the infants born to the Asian women were being exclusively breastfed. 9% of the African mothers and 18% of rthe Asian women did not breastfeed at all. The remaining infants either received bottle feeds after each breastfeed or were given bottle feeds in place of breastfeeds at least once a day. Hospital routines unintentionally promoted bottle feeding, made it difficult for the women to establish breastfeeding, and may have given the women the impression that breastfeeding should be supplemented with bottle feeding. The women were separated from their infants, breastfeeding times were rigidly scheduled, the infants were bottle fed prior to the 1st breastfeeding, supplemental feeds were provided, and bottles were presented to the women each time their infants were brought to them. The women were poorly informed about the value of breastfeeding. Only 52% of the African women and 33% of the Asian women were aware that breast milk by itself provided infants with

  1. 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

  2. Implementation of the INTERGROWTH-21st Project in Kenya.

    PubMed

    Carvalho, M; Vinayak, S; Ochieng, R; Choksey, V; Musee, N; Stones, W; Knight, He; Cheikh Ismail, L

    2013-09-01

    The African site in the INTERGROWTH-21(st) Project was Parklands, a wealthy suburb of Nairobi, Kenya, with a largely middle-to-high socio-economic status population. There are three hospitals with obstetric units in Parklands, with approximately 4300 births per year. The Newborn Cross-Sectional Study (NCSS) sample was drawn from all three hospitals, covering 100% of births in this target population. The Fetal Growth Longitudinal Study (FGLS) sample was recruited from antenatal clinics serving these hospitals, using the eligibility criteria in the INTERGROWTH-21(st) protocol. Special activities to raise awareness of the study included securing media coverage and distributing leaflets in antenatal clinic waiting rooms. FGLS required women to be recruited in the first trimester; therefore, a major challenge at this study site was the high background frequency of first antenatal consultations in the second trimester. The problem was overcome by the study awareness campaign, as a result of which more women started attending antenatal care earlier in pregnancy.

  3. Disclosure of HSV-2 Serological Test Results in the Context of an Adolescent HIV Prevention Trial in Kenya

    PubMed Central

    Hallfors, Denise Dion; Cho, Hyunsan; Mbai, Isabella; Millimo, Benson; Atieno, Carolyne; Okumu, David; Luseno, Winnie; Hartman, Shane; Halpern, Carolyn T.; Hobbs, Marcia M.

    2015-01-01

    Objectives HSV-2 biomarkers are often used in adolescent sub-Saharan HIV prevention studies, but evaluations of test performance and disclosure outcomes are rare in the published literature. Therefore, we investigated the proportion of ELISA-positive and indeterminant samples confirmed by Western blot (WB); the psychosocial response to disclosure; and whether reports of sexual behavior and HSV-2 symptoms are consistent with WB confirmatory results among adolescent orphans in Kenya. Methods In 2011, 837 Kenyan orphan youth in grades 7 and 8 enrolled in an HIV prevention clinical trial with HSV-2 biomarker outcomes. We used a modified algorithm for the Kalon HSV-2 ELISA to improve specificity; positive and indeterminate results were WB-tested. We developed culturally sensitive protocols for disclosing positive results and documented psychosocial responses, reports of sexual contact, and HSV-2 symptoms. Results 28 adolescents (3.3%) were identified as HSV-2 seropositive; 6 as indeterminate. Of these, 22 positive and all indeterminants were WB-tested; 20 and 5, respectively, were confirmed positive. Most youth reported moderate brief stress after disclosure; 22% reported longer and more severe distress. Boys were more likely to be in the latter category. Self-reported virginity was highly inconsistent with WB confirmed positives. Conclusions The higher than manufacturer cut-off for Kalon ELISA modestly reduced the rate of false positive test results but also increased false negatives. Investigators should consider the risk-benefit ratio in deciding whether or not to disclose HSV-2 results to adolescent participants under specific field conditions. PMID:26139208

  4. 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

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

    PubMed Central

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

    2015-01-01

    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

  6. 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.

  7. Nephrotic Syndrome in Adult Africans in Nairobi

    PubMed Central

    Barr, R. D.; Rees, P. H.; Cordy, P. E.; Kungu, A.; Woodger, B. A.; Cameron, H. M.

    1972-01-01

    The adult nephrotic syndrome as met with in Nairobi is predominantly encountered in young sophisticated African women, most of whom began to use skin-lightening creams containing mercury before the symptomatic onset of their illness. The particular form of mercury involved is well known to cause the nephrotic syndrome in other circumstances—for example, when applied to the skin in the treatment of psoriasis. In these circumstances the pathogenetic mechanism is thought to be of an idiosyncratic type. The use of mercury-containing skin-lightening creams in the patients studied seemed to be particularly associated with a “minimal-change” (“light-negative”) renal glomerular lesion, this lesion being present in half of the patients. The prognosis in this group of patients seems remarkably good, with 50% entering remission, 77% of these doing so spontaneously on discontinuing the use of the creams. PMID:4111681

  8. An Evaluation of Intravaginal Rings as a Potential HIV Prevention Device in Urban Kenya: Behaviors and Attitudes That Might Influence Uptake within a High-Risk Population

    PubMed Central

    Wakasiaka, Sabina; Hoang, Tina Dan My; Bwayo, Job Joab; del Rio, Carlos; Priddy, Frances H.

    2008-01-01

    Abstract Purpose We sought to assess the potential acceptability of intravaginal rings (IVRs) as an HIV prevention method among at-risk women and men. Methods We conducted a qualitative assessment of initial attitudes toward IVRs, current HIV prevention methods, and common behavioral practices among female sex workers (FSWs) and men who frequent FSWs in Mukuru, an urban slum community in Nairobi, Kenya. Nineteen women and 21 men took part in six focus group discussions. Results Most participants, both male and female, responded positively to the concept of an IVR as a device for delivering microbicides. Women particularly liked the convenience offered by its slow-release capacity. Some female respondents raised concerns about whether male customers would discover the ring and respond negatively, whereas others thought it unlikely that their clients would feel the ring. Focus groups conducted with male clients of FSWs suggested that many would be enthusiastic about women, and particularly sex workers, using a microbicide ring, but that women's fears about negative responses to covert use were well founded. Overall, this high-risk population of FSWs and male clients in Nairobi was very open to the IVR as a potential HIV prevention device. Conclusion Themes that emerged from the focus groups highlight the importance of understanding attitudes toward IVRs as well as cultural practices that may impact IVR use in high-risk populations when pursuing clinical development of this potential HIV prevention device. PMID:18681822

  9. Lessons in posttraumatic stress disorder from the past: Venezuela floods and Nairobi bombing.

    PubMed

    Carlos Otero, Juan; Njenga, Frank G

    2006-01-01

    Identification and treatment of posttraumatic stress disorder (PTSD) are important following a disaster. Insights into how these aims can be achieved may be obtained from previous disasters. This article describes mental health initiatives following the 1999 flooding in Vargas State, Venezuela, and the 1998 U.S. Embassy bombing in Nairobi, Kenya. Following the Vargas State floods, a specialist mental health center devoted to the diagnosis, treatment, and follow-up of PTSD was established. Awareness and acceptance of the clinic was promoted by media campaigns and community-based activities. After 18 months, approximately 5000 people had been screened, of whom 62% were diagnosed with PTSD and treated. Moreover, the clinic's activities had expanded to include treatment of other medical conditions and assistance with nonmedical needs. Following the Nairobi bombing, a mass media campaign was initiated to create awareness of PTSD symptoms and help victims come to terms with their experience. This campaign was found to be well received and helpful. In addition, counselors were trained to support people living or working close to the blast. These examples show that mental health initiatives are feasible after a disaster and highlight a number of issues: (1) The intervention should be tailored to the needs of the target population; (2) Communication should be simple and appropriate; (3) Community-based activities are valuable in promoting awareness and acceptance of mental health initiatives; (4) Reducing the stigma often associated with mental health problems is important; and (5) The mass media can be helpful in promoting awareness of mental health issues following major trauma.

  10. Results of injection and tracer tests in Olkaria north east field in Kenya

    SciTech Connect

    Karingithi, C.W.

    1995-12-31

    Tracer and injection tests were performed in the Olkaria North East Field with the objective to reduce uncertainty in the engineering design and to determine the suitability of well OW-704 as a re-injection well for the waste brine from the steam field during production. An organic dye (sodium fluorescein) was injected into well OW-704 as a slug. The tracer returns were observed in well OW-M2 which is 580 m deep, 620 m from well OW-704 and well OW-716 which is 900 m from well OW-704. The other wells on discharge, OW-714, and OW-725 did not show any tracer returns. However, other chemical constituents suggested., that well OW-716 experienced a chemical breakthrough earlier than OW-M2. Tracer return velocities of 0.31 m/hr and 1.3 m/hr were observed. Results of the tracer and injection tests indicate that OW-704 may be used as a re-injection well provided a close monitoring program is put in place.

  11. 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.

  12. 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

  13. Serological evidence of arboviral infections among humans of coastal Kenya.

    PubMed

    Morrill, J C; Johnson, B K; Hyams, C; Okoth, F; Tukei, P M; Mugambi, M; Woody, J

    1991-06-01

    A serosurvey was conducted during September 1987 for evidence of human arboviral infections in the Coast Province of Kenya. Sera were collected from 1624 outpatients at three hospitals and tested for antibody to eight arboviruses by the indirect immunofluorescent antibody technique. Antibody prevalence rates were: Rift Valley fever, 2.8%; Sindbis, 2.6%; dugbe, 2.1%; dengue-2, 1.0%; West Nile, 0.9%; chikungunya, 0.7% and Nairobi sheep disease, 0.3%. Evidence of Crimean-Congo haemorrhagic fever viral antibody was not detected. The data suggested low arbovirus activity since 1982, when an epidemic of dengue occurred in this region, and revealed the first evidence of dugbe viral infection among humans in Kenya.

  14. 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.

  15. 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

  16. 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

  17. 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

  18. Teaching environmental lessons in Kenya through a children's magazine.

    PubMed

    Brace, J

    1983-12-01

    This article reports on a project in Kenya in which environmental lessons are taught through a children's magazine. The Mazingira Institute, a research institute in Nairobi, collaborates with the editor of Rainbow, an English-language weekly newspaper for children, in producing 1 issue each year devoted to a topic of developmental and environmental concern. Rainbow has a regular circulation of 17,000/week (75% in the smaller towns and rural areas) and an estimated readership of 150,000. The press run of the special environmental issue is increased to provide 3-5 free copies to each of the 10,000 primary schools in Kenya. Special topics have included water, renewable energy, trees for food, and nursery development of tree seeds. The topic is explored through an editorial, theme article, comic strip, and letters. In addition, each special issue contains a contest centered around 12 questions which provide valuable information about children's perceptions and understanding of the theme. Contest winners and their headmasters are brought to Nairobi, where headmasters meet with Institute staff to provide feedback on the use they make of the newspaper as a teaching tool. The budget for the project is under US$30,000. The last 2 issues were funded by the Canadian High Commissioner. The Mazingira Institute has proposed enlarging this project to include 8 English-speaking countries in Eastern and Southern Africa.

  19. 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

  20. Civil society organizations: capacity to address the needs of the urban poor in Nairobi.

    PubMed

    Ekirapa, Akaco; Mgomella, George S; Kyobutungi, Catherine

    2012-11-01

    We conducted a needs assessment that describes the landscape of civil society organizations (CSOs) in three informal settlements around Nairobi, Kenya. The numbers of CSOs have rapidly increased in areas underserved by governments including poor urban neighbourhoods but little is known about CSOs capacity to meet the priority health needs of the urban poor. It is also unclear why, despite a proliferation of CSOs, residents still experience unimproved health outcomes. We collected data on core activities, financial management, and governance structures. Of the 952 CSOs assessed, 47 per cent reported HIV/AIDS counselling, prevention, and treatment as their core activity. Most CSOs reported good financial management systems and governance structures but responses were not validated. Representation in district health stakeholder fora was low; most CSOs did not have the capacity to effectively deliver services that would have impact. For CSOs to realize the desired goal to improve the well-being of low-income populations, programmes to build their management capacity are essential.

  1. Isolation of human immunodeficiency virus from genital ulcers in Nairobi prostitutes.

    PubMed

    Kreiss, J K; Coombs, R; Plummer, F; Holmes, K K; Nikora, B; Cameron, W; Ngugi, E; Ndinya Achola, J O; Corey, L

    1989-09-01

    Recent epidemiologic studies have implicated genital/anorectal ulcer disease as an important cofactor for acquisition and transmission of human immunodeficiency virus (HIV) during sexual intercourse. To better understand the mechanism for the association between genital ulcers and HIV, exudates from 62 genital ulcers of 56 HIV-seropositive prostitutes in Nairobi (Kenya) were cultured for HIV. Twenty-six ulcer cultures could not be evaluated for the presence of HIV because of bacterial or fungal contamination. HIV was isolated from 4 (11%) of the 36 remaining uncontaminated ulcer cultures (2 introital, 1 vaginal, and 1 cervical) from 4 separate women. HIV was isolated from the cervical os from only 2 of the 4 women. HIV p24 antigen was detected in exudate from 1 of the 4 culture-positive ulcers and 0 of 32 culture-negative ulcers. Genital ulcers in seropositive patients should be regarded as potential sources of HIV, which could be important in transmission of HIV during intercourse. Public health measures aimed at controlling sexually transmitted genital ulcer diseases should be an integral part of acquired immunodeficiency syndrome (AIDS) prevention programs.

  2. Exploring perceptions of community health policy in Kenya and identifying implications for policy change

    PubMed Central

    McCollum, Rosalind; Otiso, Lilian; Mireku, Maryline; Theobald, Sally; de Koning, Korrie; Hussein, Salim; Taegtmeyer, Miriam

    2016-01-01

    Background: Global interest and investment in close-to-community health services is increasing. Kenya is currently revising its community health strategy (CHS) alongside political devolution, which will result in revisioning of responsibility for local services. This article aims to explore drivers of policy change from key informant perspectives and to study perceptions of current community health services from community and sub-county levels, including perceptions of what is and what is not working well. It highlights implications for managing policy change. Methods: We conducted 40 in-depth interviews and 10 focus group discussions with a range of participants to capture plural perspectives, including those who will influence or be influenced by CHS policy change in Kenya (policymakers, sub-county health management teams, facility managers, community health extension worker (CHEW), community health workers (CHWs), clients and community members) in two purposively selected counties: Nairobi and Kitui. Qualitative data were digitally recorded, transcribed, translated and coded before framework analysis. Results: There is widespread community appreciation for the existing strategy. High attrition, lack of accountability for voluntary CHWs and lack of funds to pay CHW salaries, combined with high CHEW workload were seen as main drivers for strategy change. Areas for change identified include: lack of clear supervisory structure including provision of adequate travel resources, current uneven coverage and equity of community health services, limited community knowledge about the strategy revision and demand for home-based HIV testing and counselling. Conclusion: This in-depth analysis which captures multiple perspectives results in robust recommendations for strategy revision informed by the Five Wonders of Change Framework. These recommendations point towards a more people-centred health system for improved equity and effectiveness and indicate priority

  3. Predicting Neisseria gonorrhoeae and Chlamydia trachomatis infection using risk scores, physical examination, microscopy, and leukocyte esterase urine dipsticks among asymptomatic women attending a family planning clinic in Kenya.

    PubMed

    Tyndall, M W; Kidula, N; Sande, J; Ombette, J; Temmerman, M

    1999-09-01

    This cross sectional study presents a risk scoring system that would identify women at highest risk for sexually transmitted infections (STIs). 1058 randomly selected women participated in the study in Nairobi, Kenya; of these, 1048 participants were included in the analysis. The study was conducted from May 1994 to July 1995 at a clinic sponsored by the Family Planning Association of Kenya. Information pertaining to the demographic, behavioral and social characteristics of the participants was gathered. In addition, a clinical algorithm, which includes physical examination, microscopy, and leukocyte esterase (LE) urine dipsticks, was employed to detect gonorrhea and chlamydia infections among asymptomatic women. The results revealed that the prevalence of STIs, including HIV-1, was high among women attending this urban family planning clinic. Standard demographic, behavioral, and clinical characteristics were only weakly associated with infection, resulting in poor sensitivity and specificity calculations in the risk scores. Detection of cervical infections gave a sensitivity of 85% and a specificity of 30%. A positive LE urine dipstick had a sensitivity of 63% and a specificity of 47%. Although the addition of physical examination and LE dipstick to the work-up improved the sensitivity of case detection, it did not improve the overall validity of the scoring system.

  4. 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

  5. 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.

  6. 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

  7. 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.

  8. Survey report: Kenya.

    PubMed

    Van Der Tak, J

    1986-06-01

    In Kenya, women still average about 8 children each, but the average family size desired by ever-married women dropped by 1 child, from 7.2 to 6.2, between 1978-84. The percentage of currently married women using contraception more than doubled, from 7 to 17%. These are highlights of trends revealed by comparison of the recently released results of the Kenya Contraceptive Prevalence Survey of 1984 with the Kenya Fertility Survey of 1977-78. The latest trends in Kenya's fertility and family planning can be expected to be of worldwide interest in view of the country's record high population growth rate of 4.2% a year. Estimated at 21 million in 1986, the population of Kenya is projected by the UN to quadruple to 83 million by 2025 and could reach as high as 116 million by 2100, according to the World Bank. Among the reasons cited for the failure of Kenya's government family planning program, established in 1968, are bureaucratic snarls, shortages of supplies and trained personnel, and short business hours and long waits in clinics that are not always easily accessible in rural areas. These problems are now being dealt with, but there remains the obstacle of a persistent desire for large families among the population. Over 80% of the 6581 women aged 15-49 interviewed in the 1984 survey knew of at least 1 contraceptive method. The survey report terms the more than doubling of current contraceptive use between 1978-84 as a major success for the family planning program. Yet, the 1984 level is low. Also, the contraceptive mix shifted toward less effective methods. Among currently married women using contraception, the proportion using modern methods was down from 61% in 1978 to 52% in 1984, with oral contraceptive (OC) use dropping from 29 to 19% of the total and rhythm increasing from 16 to 25%. Fertility change was negligible. There was a slight increase in children ever born among women 45-49 from 7.9-8.2 per woman, along with a small decrease in the current total

  9. 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

  10. 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

  11. 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

  12. 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

  13. 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

    2016-01-29

    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.

  14. 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

  15. 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.

  16. Sildenafil (Viagra) in the treatment of male erectile dysfunction in Nairobi.

    PubMed

    Magoha, G A

    2000-02-01

    This prospective open-label extension study was carried out to evaluate the effectiveness of sildenafil (Viagra) in the treatment of male erectile dysfunction in Nairobi, Kenya. A total of 219 adult male patients with erectile dysfunction were instructed to take 50 mg, 25 mg, or 100 mg of sildenafil orally 1 hour prior to planned sexual activity, but not more than once every 24 hours. Patients were reviewed at 4-week intervals for 16 weeks to assess the efficacy and adverse effects of the drug. The age range was 33-80 years with a mean of 62.5 years and a peak incidence in the 60-69 year age group. The causes of erectile dysfunction were organic (n = 119, 54.34%), psychogenic (n = 85, 38.81%), and mixed (n = 15). 200 patients (91.32%) had improved sexual function after treatment with Viagra. This improvement included improved erectile and orgasmic functions and overall sexual satisfaction. 157 patients responded to the 50-mg treatment regimen; 40, to the 25-mg regimen; and 3, to the 100-mg regimen. No improvement in sexual function was reported in 19 patients (8.68%) after Viagra administration. In addition, 7 patients reported mild and transient adverse effects of the drug, including mild headache, dyspepsia, facial flushing, nausea, and vomiting. In conclusion, oral sildenafil (Viagra) is an effective well-tolerated and simple treatment for male erectile dysfunction in the majority of cases. However, the cost of treatment may prohibit and limit its wide use by many deserving patients in this area.

  17. The Nairobi Day School: An African American Independent School, 1966-1984.

    ERIC Educational Resources Information Center

    Hoover, Mary Eleanor Rhodes

    1992-01-01

    Describes the Nairobi Day School in East Palo Alto (California), an independent African-American institution. Its history is traced from its founding in 1966 to its closing in 1984. The Nairobi method and model are proposed as solutions to several contemporary educational problems that African Americans face in public schools. (SLD)

  18. 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…

  19. 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).…

  20. 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…

  1. 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…

  2. "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…

  3. 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…

  4. “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

  5. 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

  6. 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

  7. From Project to Program: Tupange's Experience with Scaling Up Family Planning Interventions in Urban Kenya.

    PubMed

    Keyonzo, Nelson; Nyachae, Paul; Kagwe, Peter; Kilonzo, Margaret; Mumba, Feddis; Owino, Kenneth; Kichamu, George; Kigen, Bartilol; Fajans, Peter; Ghiron, Laura; Simmons, Ruth

    2015-05-01

    This paper describes how the Urban Reproductive Health Initiative in Kenya, the Tupange Project (2010-2015), successfully applied the ExpandNet approach to sustainably scale up family planning interventions, first in Machakos and Kakamega, and subsequently also in its three core cities, Nairobi, Kisumu and Mombasa. This new focus meant shifting from a "project" to a "program" approach, which required paying attention to government leadership and ownership, limiting external inputs, institutionalizing interventions in existing structures and emphasizing sustainability. The paper also highlights the project's efforts to prepare for the future scale up of Tupange's interventions in other counties to support continuing and improved access to family planning services in the new context of devolution (decentralization) in Kenya.

  8. Towards Elimination of Mother-to-Child Transmission of HIV: The Impact of a Rapid Results Initiative in Nyanza Province, Kenya

    PubMed Central

    Dillabaugh, Lisa L.; Lewis Kulzer, Jayne; Owuor, Kevin; Ndege, Valerie; Oyanga, Arbogast; Ngugi, Evelyne; Shade, Starley B.; Bukusi, Elizabeth; Cohen, Craig R.

    2012-01-01

    Many HIV-positive pregnant women and infants are still not receiving optimal services, preventing the goal of eliminating mother-to-child transmission (MTCT) and improving maternal child health overall. A Rapid Results Initiative (RRI) approach was utilized to address key challenges in delivery of prevention of MTCT (PMTCT) services including highly active antiretroviral therapy (HAART) uptake for women and infants. The RRI was conducted between April and June 2011 at 119 health facilities in five districts in Nyanza Province, Kenya. Aggregated site-level data were compared at baseline before the RRI (Oct 2010–Jan 2011), during the RRI, and post-RRI (Jul–Sep 2011) using pre-post cohort analysis. HAART uptake amongst all HIV-positive pregnant women increased by 40% (RR 1.4, 95% CI 1.2–1.7) and continued to improve post-RRI (RR 1.6, 95% CI 1.4–1.8). HAART uptake in HIV-positive infants remained stable (RR 1.1, 95% CI 0.9–1.4) during the RRI and improved by 30% (RR 1.3, 95% CI 1.0–1.6) post-RRI. Significant improvement in PMTCT services can be achieved through introduction of an RRI, which appears to lead to sustained benefits for pregnant HIV-infected women and their infants. PMID:22548155

  9. 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.

  10. Prevalence of malnutrition in Kenya.

    PubMed

    Ngare, D K; Muttunga, J N

    1999-07-01

    This cross-sectional study examined the prevalence, severity, regional differences and age-sex distribution of malnutrition in Kenya. About 6419 children (3294 males and 3125 females) from 14 districts in Kenya were examined using two anthropometric measurements: weight and height. The three nutritional status indicators used were stunting, wasting, and underweight, with an overall prevalence of 36%, 6%, and 27%, respectively. Findings indicated that stunting was lowest among the 6-12 month age group and highest among the 12-23 month age group, with a prevalence 15 times higher among boys. On the other hand, both growth stunting and wasting were most serious between 12 and 23 months of age, similar to previous reports. The most pressing form of malnutrition in Kenya is protein-energy malnutrition, which largely affects infants, preschool, and school children. Regional disparities in malnutrition were also observed, with a low malnutrition rate in Kiambu (22.6%) and a high malnutrition rate in Kwale (56.5%) districts. This study, as well as the results of previous findings, confirms the seriousness of malnutrition in Kenya. This paper suggests the implementation and development of monitoring and evaluation mechanisms to assess the impact of implemented program activities, particularly in districts with high malnutrition rates.

  11. 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

  12. Multiple human papillomavirus infections and HIV seropositivity as risk factors for abnormal cervical cytology among female sex workers in Nairobi.

    PubMed

    Patel, S J; Mugo, N R; Cohen, C R; Ting, J; Nguti, R; Kwatampora, J; Waweru, W; Patnaik, P; Donders, G G; Kimani, J; Kenney, D L; Kiviat, N B; Smith, J S

    2013-03-01

    We estimated type-specific prevalence of human papillomavirus (HPV) and examined risk factors for abnormal cervical cytology among 296 female sex workers from Nairobi, Kenya. Over half (54%) were infected with a high-risk (HR) HPV type, of which HPV16 and 52 were the most common types. HIV-1 prevalence was 23% and HIV-1 sero-positivity was associated with high-grade cervical lesions, particularly among women with CD4 count less than 500 cells/mm(3) (odds ratio [OR] = 6.9; 95% confidence interval [CI]: 1.7-24.9). Among women who had normal cytology at the time of entry into the study, the risk of having an abnormal Pap smear within one year was significantly elevated for women with multiple HPV types at study entry (adjusted odds ratio [aOR] = 6.0; 95% CI: 2.3-15.7) and with a subset of HR HPV types (aOR = 4.2; 95% CI: 1.6-11.2). Detection of multiple concurrent HPV infections may be a useful marker to identify women at risk of developing precancerous lesions in populations of high HPV prevalence.

  13. 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

  14. 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

  15. Emergency health and risk management in sub-saharan Africa: a lesson from the embassy bombings in Tanzania and Kenya.

    PubMed

    Clack, Zoanne A; Keim, Mark E; Macintyre, Anthony G; Yeskey, Kevin

    2002-01-01

    In 1998, terrorists simultaneously bombed United States Embassies in Dar es Salaam, Tanzania and Nairobi, Kenya. The local response to these bombings was unorganized and ad hoc, indicating the need for basic disaster preparedness and improvement of emergency management capabilities in both countries. In this context, risk and risk management are defined and are related to the health hazards affecting Tanzanians and Kenyans. In addition, the growing number of injuries in Tanzania is addressed and the relationship between risk management and injury is explored. Also, an emergency medicine-based strategy for injury control and prevention is proposed. Implications of implementing such a protocol in developing nations also are discussed.

  16. 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

  17. 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

  18. 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.

  19. Burden of invasive non-typhoidal Salmonella disease in a rural and urban site in Kenya, 2009–2014

    PubMed Central

    Verani, Jennifer R.; Toroitich, Samuel; Auko, Joshua; Kiplang’at, Samuel; Cosmas, Leonard; Audi, Allan; Mogeni, Ondari D.; Aol, George; Oketch, Dismas; Odiembo, Herine; Katieno, Jim; Wamola, Newton; Onyango, Clayton O.; Juma, Bonventure W.; Fields, Barry S.; Bigogo, Godfrey; Montgomery, Joel M.

    2016-01-01

    Background Invasive infections with non-typhoidal Salmonella (NTS) lead to bacteremia in children and adults and are an important cause of illness in Africa; however, few data on the burden of NTS bacteremia are available. We sought to determine the burden of invasive NTS disease in a rural and urban setting in Kenya. Methods We conducted the study in a population-based surveillance platform in a rural setting in western Kenya (Lwak), and an informal urban settlement in Nairobi (Kibera) from 2009 to 2014. We obtained blood culture specimens from participants presenting with acute lower respiratory tract illness, or acute febrile illness to a designated outpatient facility in each site, or any hospital admission for a potentially infectious cause (rural site only). Incidence was calculated using a defined catchment population and adjusting for specimen collection and healthcare seeking practices. Results A total of 12,683 and 9,524 blood cultures were analyzed from Lwak and Kibera, respectively. Of these, 428 (3.4%) and 533 (5.6%) grew a pathogen; among those 208 (48.6%) and 70 (13.1%) were positive for NTS in Lwak and Kibera, respectively. Overall, the adjusted incidence of invasive NTS disease was higher in Lwak (839.4 per 100,000 person-years observation [pyo]) compared with Kibera (202.5 per 100,000 pyo). The highest adjusted incidences were observed in children <5 years of age (Lwak 3,914.3 per 100,000 pyo and Kibera 997.9 per 100,000 pyo). In Lwak the highest adjusted annual incidence was 1,927.3 per 100,000 pyo (in 2010) and in Kibera 220.5 per 100,000 pyo (in 2011); the lowest incidences were 303.3 and 62.5 per 100,000 pyo respectively (in 2012). In both sites, invasive NTS disease incidence generally declined over the study period. Conclusion We observed an extremely high burden of invasive NTS disease in a rural area of Kenya and a lesser, but still substantial, burden in an urban slum. Although the incidences in both sites declined during the study period

  20. 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

  1. 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

  2. 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

  3. Couple Characteristics and Contraceptive Use among Women and their Partners in Urban Kenya

    PubMed Central

    Irani, Laili; Speizer, Ilene S.; Fotso, Jean-Christophe

    2014-01-01

    Background Few studies have used couple data to identify individual- and relationship-level characteristics that affect contraceptive use in urban areas. Using matched couple data from urban Kenya collected in 2010, this study determines the association between relationship-level characteristics (desire for another child, communication about desired number of children and FP use) and contraceptive use and intention to use among non-users. Methods Data were collected from three Kenyan cities: Nairobi, Mombasa and Kisumu. Baseline population-based survey data from the Measurement, Learning & Evaluation Project were used to identify 883couples (weighted value=840). Multivariate regressions used the couple as the unit of analysis. Results Almost two-thirds of couples currently used contraception. Adjusting for individual- and environmental-level characteristics, couples who desired another child were less likely to use contraception than couples wanting more children. In addition, couples where both partners reported communicating with each other regarding desired number of children and FP use were more likely to use contraception compared to couples that did not communicate. Analyses testing the association of relationship-level characteristics and intention to use contraception, among non-users, resembled those of current contraceptive users. Conclusion Couple-level characteristics are associated with current contraceptive use and future intent to use. Couples that discussed their desired number of children and FP use were more likely to use contraception than couples that did not communicate with each other. FP programs should identify strategies to improve communication in FP among couples and to ensure better cooperation between partners. PMID:24733057

  4. 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

  5. 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

  6. Television by Children in Kenya.

    ERIC Educational Resources Information Center

    Heath, Carla W.

    There are two categories of children's television in Kenya: television "for" children, most of which is imported, and television "by" children, all of which is produced in Kenya. Most of the television by children is produced and broadcast by Voice of Kenya television, much of it made up of programs growing out of extra-curricular activities at…

  7. 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

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

    PubMed Central

    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

  9. Factors Influencing Performance among Primary and Secondary School Pupils in Western Province of Kenya: A Policy Study.

    ERIC Educational Resources Information Center

    Eshiwani, George S.

    Analyses of the examination results for the Certificate of Primary Education, the Kenya Certificate of Education, and the Kenya Advanced Certificate of Education showed that academic achievement at the primary and secondary levels in the Western Province of Kenya is very poor, compared to the other provinces. To determine the school factors that…

  10. 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

  11. 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

  12. Menstrual pattern, sexual behaviors, and contraceptive use among postpartum women in Nairobi urban slums.

    PubMed

    Ndugwa, Robert P; Cleland, John; Madise, Nyovani J; Fotso, Jean-Christophe; Zulu, Eliya M

    2011-06-01

    Postpartum months provide a challenging period for poor women. This study examined patterns of menstrual resumption, sexual behaviors and contraceptive use among urban poor postpartum women. Women were eligible for this study if they had a birth after the period September 2006 and were residents of two Nairobi slums of Korogocho and Viwandani. The two communities are under continuous demographic surveillance. A monthly calendar type questionnaire was administered retrospectively to cover the period since birth to the interview date and data on sexual behavior, menstrual resumption, breastfeeding patterns, and contraception were collected. The results show that sexual resumption occurs earlier than menses and postpartum contraceptive use. Out of all postpartum months where women were exposed to the risk of another pregnancy, about 28% were months where no contraceptive method was used. Menstrual resumption acts as a trigger for initiating contraceptive use with a peak of contraceptive initiation occurring shortly after the first month when menses are reported. There was no variation in contraceptive method choice between women who initiate use before and after menstrual resumption. Overall, poor postpartum women in marginalized areas such as slums experience an appreciable risk of unintended pregnancy. Postnatal visits and other subsequent health system contacts provide opportunities for reaching postpartum women with a need for family planning services.

  13. A Qualitative Study of Barriers to Consistent Condom Use among HIV-1 Serodiscordant Couples in Kenya

    PubMed Central

    Ngure, Kenneth; Mugo, Nelly; Celum, Connie; Baeten, Jared M.; Morris, Martina; Olungah, Owuor; Olenja, Joyce; Tamooh, Harrison; Shell-Duncan, Bettina

    2014-01-01

    This study explored barriers to consistent condom use among heterosexual HIV-1 serodiscordant couples who were aware of the HIV-1 serodiscordant status and had been informed about condom use as a risk reduction strategy. We conducted 28 in-depth interviews and 9 focus group discussions among purposively-selected heterosexual HIV-1 serodiscordant couples from Thika and Nairobi districts in Kenya. We analyzed the transcribed data with a grounded theory approach. The most common barriers to consistent condom use included male partners’ reluctance to use condoms regardless of HIV-1 status coupled with female partners’ inability to negotiate condom use, misconceptions about HIV-1 serodiscordance, and desire for children. Specific areas of focus should include development of skills for women to effectively negotiate condom use, ongoing information on HIV-1 serodiscordance and education on safer conception practices that minimize risk of HIV-1 transmission. PMID:22085306

  14. 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

  15. 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

  16. 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…

  17. 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…

  18. Effectiveness of personalised, home-based nutritional counselling on infant feeding practices, morbidity and nutritional outcomes among infants in Nairobi slums: study protocol for a cluster randomised controlled trial

    PubMed Central

    2013-01-01

    Background Nutrition in the first 1,000 days of life (during pregnancy and the first two years) is critical for child growth and survival. Poor maternal, infant and young child nutrition (MIYCN) practices are widely documented in Kenya, with potential detrimental effects on child growth and survival. This is particularly a problem in slums, where most urban residents live. For example, exclusive breastfeeding for the first six months is only about two per cent. Innovative strategies to reach slum residents are therefore needed. Strategies like the Baby Friendly Hospital Initiative have proven effective in some settings but their effectiveness in resource-limited settings, including slums where many women do not deliver in hospital, is questionable. We propose to test the effectiveness of a home-based intervention on infant feeding practices, nutrition and health outcomes of infants born in two slums in Nairobi, Kenya. Methods/Design The study, employing a cluster-randomised study design, will be conducted in two slums in Nairobi: Korogocho and Viwandani where 14 community units (defined by the Government’s health care system) will form the unit of randomization. A total of 780 pregnant women and their respective child will be recruited into the study. The mother-child pair will be followed up until the child is one year old. Recruitment will last approximately one year and three months from September 2012 to December 2013. The mothers will receive regular, personalised, home-based counselling by trained Community Health Workers on MIYCN. Regular assessment of knowledge, attitudes and practices on MIYCN will be done, coupled with assessments of nutritional status of the mother-child pairs and diarrhea morbidity for the children. Statistical methods will include analysis of covariance and multinomial logistic regression. Additionally, cost-effectiveness analysis will be done. The study is funded by the Wellcome Trust and will run from March 2012 to February 2015

  19. 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

  20. Estimating the Size of the Female Sex Worker Population in Kenya to Inform HIV Prevention Programming

    PubMed Central

    Odek, Willis Omondi; Githuka, George N.; Avery, Lisa; Njoroge, Peter K.; Kasonde, Lombe; Gorgens, Marelize; Kimani, Joshua; Gelmon, Lawrence; Gakii, Gloria; Isac, Shajy; Faran, Emmanuel; Musyoki, Helgar; Maina, William; Blanchard, James F.; Moses, Stephen

    2014-01-01

    Background The high burden of HIV infections among female sex workers (FSW) in sub-Saharan Africa has been long recognised, but effective preventive interventions have largely not been taken to scale. We undertook a national geographical mapping exercise in 2011/2012 to assess the locations and population size of FSW in Kenya, to facilitate targeted HIV prevention services for this population. Methods and Findings We used a geographical mapping approach, consisting of interviews with secondary key informants to identify “hot” spots frequented by FSW, their operational dynamics and the estimated numbers of FSW in those spots. This was followed by validation of the estimates through interviews with FSW at each spot identified. The mapping covered Nairobi, the capital city of Kenya, and 50 other major urban centres. In total, 11,609 secondary key informant interviews were conducted to identify FSW spots. Further, a total of 6,360 FSW were interviewed for spot validation purposes. A total of 10,670 spots where FSW congregate were identified. The estimated FSW population in all the towns mapped was 103,298 (range 77,878 to 128, 717). Size estimates in the towns mapped were extended to smaller towns that were not mapped, using a statistical model. The national urban FSW population estimate was 138,420 (range 107, 552 to 169, 288), covering all towns of over 5,000 population. We estimated that approximately 5% of the urban female population of reproductive age in Kenya could be sex workers, which is consistent with previous estimates from other sub-Saharan African countries. Conclusions This study provides the first national level data on the size of the FSW population in Kenya. These data can be used to enhance HIV prevention programme planning and implementation for FSW, to form the basis for impact evaluations, and to improve programme coverage by directing efforts to locations with the greatest need. PMID:24595029

  1. 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,…

  2. The Training of Trainers in Educational Planning. Report of an IIEP Workshop (Nairobi, Kenya, June 29-July 10, 1987).

    ERIC Educational Resources Information Center

    United Nations Educational, Scientific, and Cultural Organization, Paris (France). International Inst. for Educational Planning.

    The main aim of the International Institute for Educational Planning's program "Training the Trainers" is to improve the technical skills of planning specialists and to develop their organizational capabilities so that they can run national training programs. The objectives of the workshop described in this reort were to design the content of…

  3. 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

  4. 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…

  5. A Multi-Model Real Time Forecasting Prototype System in the Mara Basin (Kenya/Tanzania)

    NASA Astrophysics Data System (ADS)

    Serrat-Capdevila, A.; Valdes, J. B.; Valdes, R.; Demaria, E. M.; Durcik, M.; Maitaria, K.; Roy, T.

    2013-12-01

    Remote sensing data and hydrologic models can respond to monitoring and forecasting needs in Africa and other poorly gauged regions. We present here the progress to date in developing a multi-model platform to provide hydrologic monitoring and forecasting using real time remote sensing observations. Satellite precipitation products such as CMORPH, TMPA (at 0.25° resolution) and PERSIANN-CCS (at 4km resolution) are used to force two models of different structure. One model is physically based and distributed, and the other is conceptual and lumped at the sub-basin level. The performance of both models is evaluated using different metrics, and the uncertainty in their predictions based on the errors incurred during the historical simulations period is computed. The models were compared and the potential increase in performance from using both models versus a single one will be assessed. This work provides insights into the advantages of a multi-model platform over a single model, with respect to different management and decision-making purposes. The methods were applied to the Mara Basin (Kenya/Tanzania), where growing human demands on water and land use are likely to alter significantly the hydrologic balance of the basin and the ecosystems that depend on it. These efforts are part of the Applied Sciences Team of the NASA SERVIR Program in collaboration with its East Africa Hub at the Regional Center for Mapping of Resources for Development (Nairobi,Kenya).

  6. 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.

  7. Factors associated with unintended pregnancy, poor birth outcomes and post-partum contraceptive use among HIV-positive female adolescents in Kenya

    PubMed Central

    2012-01-01

    Background Although the experiences of unintended pregnancies and poor birth outcomes among adolescents aged 15–19 years in the general population are well documented, there is limited understanding of the same among those who are living with HIV. This paper examines the factors associated with experiencing unintended pregnancies, poor birth outcomes, and post-partum contraceptive use among HIV-positive female adolescents in Kenya. Methods Data are from a cross-sectional study that captured information on pregnancy histories of HIV-positive female adolescents in four regions of Kenya: Coast, Nairobi, Nyanza and Rift Valley provinces. Study participants were identified through HIV and AIDS programs in the four regions. Out of a total of 797 female participants, 394 had ever been pregnant with 24% of them experiencing multiple pregnancies. Analysis entails the estimation of random-effects logit models. Results Higher order pregnancies were just as likely to be unintended as lower order ones (odds ratios [OR]: 1.2; 95% confidence interval [CI]: 0.8–2.0) while pregnancies occurring within marital unions were significantly less likely to be unintended compared to those occurring outside such unions (OR: 0.1; 95% CI: 0.1–0.2). Higher order pregnancies were significantly more likely to result in poor outcomes compared to lower order ones (OR: 2.5; 95% CI: 1.6–4.0). In addition, pregnancies occurring within marital unions were significantly less likely to result in poor outcomes compared to those occurring outside such unions (OR: 0.3; 95% CI: 0.1–0.9). However, experiencing unintended pregnancy was not significantly associated with adverse birth outcomes (OR: 1.3; 95% CI: 0.5–3.3). There was also no significant difference in the likelihood of post-partum contraceptive use by whether the pregnancy was unintended (OR: 0.9; 95% CI: 0.5–1.5). Conclusions The experience of repeat unintended pregnancies among HIV-positive female adolescents in the sample is partly

  8. Water disinfection and hygiene behaviour in an urban slum in Kenya: impact on childhood diarrhoea and influence of beliefs.

    PubMed

    Graf, Jürg; Meierhofer, Regula; Wegelin, Martin; Mosler, Hans-Joachim

    2008-10-01

    In this research project, we studied factors that presumably affect the incidence of diarrhoea among young children in urban slums in developing countries: consumption of safe drinks, hygiene behaviour, cleanliness of household surroundings and the quality of raw water. Beliefs concerning the causes of diarrhoea were also related to health-improving behaviour, namely the application of the water-treatment method SODIS (solar water disinfection) and hygiene behaviour. We conducted a survey in a shanty town in Nairobi, Kenya. Field workers interviewed 500 households. Analysis with regression models revealed that two out of the four postulated factors were significant: children have a lower risk of contracting diarrhoea when they consume high percentages of safe drinks and live in households with good hygiene. As regards beliefs, we found that biomedical knowledge of children's diarrhoea as well as the perceived social norm for treating water was associated with the use of SODIS and good hygiene. PMID:18821373

  9. Water disinfection and hygiene behaviour in an urban slum in Kenya: impact on childhood diarrhoea and influence of beliefs.

    PubMed

    Graf, Jürg; Meierhofer, Regula; Wegelin, Martin; Mosler, Hans-Joachim

    2008-10-01

    In this research project, we studied factors that presumably affect the incidence of diarrhoea among young children in urban slums in developing countries: consumption of safe drinks, hygiene behaviour, cleanliness of household surroundings and the quality of raw water. Beliefs concerning the causes of diarrhoea were also related to health-improving behaviour, namely the application of the water-treatment method SODIS (solar water disinfection) and hygiene behaviour. We conducted a survey in a shanty town in Nairobi, Kenya. Field workers interviewed 500 households. Analysis with regression models revealed that two out of the four postulated factors were significant: children have a lower risk of contracting diarrhoea when they consume high percentages of safe drinks and live in households with good hygiene. As regards beliefs, we found that biomedical knowledge of children's diarrhoea as well as the perceived social norm for treating water was associated with the use of SODIS and good hygiene.

  10. Indeterminate rapid HIV-1 test results among antenatal and postnatal mothers

    PubMed Central

    Matemo, D; Kinuthia, J; John, F; Chung, M; Farquhar, C; John-Stewart, G; Kiarie, J

    2011-01-01

    Summary The sensitivity and specificity of rapid HIV-1 tests may be altered during pregnancy and postpartum. We conducted a study to determine the prevalence and correlates of false-positive Abbott Determine™ and false-negative Uni-Gold™ rapid HIV-1 test results among antenatal and postnatal mothers attending a primary care clinic in Nairobi, Kenya. Mothers were tested for HIV-1 using Abbott Determine™ and non-reactive results were considered HIV-1 antibody negative. Reactive samples by Determine were re-tested by Uni-Gold™. Vironostika HIV-1 and Uni-FORM II Enzyme-linked immunosorbent assays were used to confirm samples that had positive Abbott Determine™ and negative Uni-Gold™. Among 2311 women who accepted HIV-1 testing, 1238 (54%) were tested antenatally and 1073 (46%) were tested postnatally. Of tested women, 274 (12%) women were reactive by Abbott Determine™ and on retesting with Uni-Gold™ 30 (11%) had indeterminate results. The prevalence of indeterminate results was significantly higher in antenatal women than in postnatal women (2% versus 1%, P = 0.03). In conclusion, indeterminate rapid HIV-1 test results are more common in the antenatal period and appropriate safeguards to confirm HIV-1 infection status should be implemented in antenatal programmes. PMID:19875832

  11. 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

  12. 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

  13. 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

  14. 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.

  15. 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)

  16. The consequences of post-election violence on antiretroviral HIV therapy in Kenya

    PubMed Central

    Pyne-Mercier, Lee D.; John-Stewart, Grace C.; Richardson, Barbra A.; Kagondu, Njeri L.; Thiga, Joan; Noshy, Haidy; Kist, Nadia; Chung, Michael H.

    2012-01-01

    Over 1000 individuals were killed and 600,000 were displaced during post-election violence (PEV) in Kenya in 2008. Antiretroviral therapy (ART) depends on continuous access to medications which may have been interrupted due to PEV. In a mixed-methods retrospective review, treatment interruption of ART during PEV was measured among 2534 HIV-positive adults attending the Coptic Hope Center for Infectious Diseases in Nairobi, Kenya. Clients experiencing treatment interruption were compared between the PEV period (30 December 2007 to 28 February 2008) and the same time period one year earlier. Treatment interruption was defined as visiting the pharmacy ≥48 hours after antiretrovirals were calculated to have been completed. Despite clinical services remaining open throughout the PEV period, more clients (16.1%) experienced treatment interruption than during the comparison period (10.2%). Mean daily pharmacy visits were significantly lower (87 vs. 104; p < 0.006) and more variable (p = 0.03) during PEV. Among clients present at both periods (n = 1605), the odds of treatment interruption were 71% higher during PEV (95% confidence interval [CI], 34–118%). In multivariate analysis, men (odds ratio [OR], 1.37; 95% CI, 1.07–1.76) and clients traveling ≥3 hours to clinic (OR, 1.86; 95% CI, 1.28–2.71) were significantly more likely to experience treatment interruption. Clients affected by PEV were interviewed about factors associated with treatment interruption using semi-structured methods. Clients described fear, lack of transportation, and violence as contributing to treatment interruption. Widespread violence associated with the 2007 election in Kenya revealed the dependence of HIV patients on a stable civil society and infrastructure to access medications. Without the ability to maintain consistent HIV therapy, some patients face rapid treatment failure. HIV programs should have appropriate contingency plans wherever political instability may occur. Peace may be

  17. It's Our Move Now: A Community Action Guide to the UN Nairobi Forward-Looking Strategies for the Advancement of Women.

    ERIC Educational Resources Information Center

    Sandler, Joanne

    This community action guide was developed to implement the strategies for the advancement of women developed at the United Nations world conference in Nairobi that ended the Decade for Women in 1985. The guide is intended to: (1) increase understanding and awareness of the existence of the Nairobi Forward-Looking Strategies for the Advancement of…

  18. 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.

  19. Fertility transition and socio-economic change in western Kenya.

    PubMed

    Uitto, J I

    1992-12-01

    Kenya's national survey data have shown patterns of fertility decline in the more socioeconomically advantaged regions. In the central areas, where urbanization and economic development is the highest, fertility has begun to decline rapidly. The lowest fertility was in Nairobi capital region; the Coast Province also experienced recent fertility decline. Fertility has remained high in the Western Province and in Nyanza, Rift Valley, and Eastern Provinces. The case study of Kisii district in Nyanza Province was used to illustrate the preconditions of high fertility. The district is an agriculturally rich region that includes rounded, steep-sided hills and narrow valleys. The district is a primary producer of cash crops such as coffee, tea, and pyrethrum, and other food crops including high-yielding varieties of maize. Farm size varies between 0.11 and 2.2 hectares and farms are owner occupied. All cultivable land is in use with traditional farming methods. Tractors are used in flat areas by 11.6% of farmers. 69.3% of farmers use fertilizers, but only 32% use insecticides and pesticides. Population density is 395 persons per square kilometer. The total fertility rate is 8.2 compared to 7.7 for the nation. 6% currently used contraception, and 23% have ever used. Fertility preferences of women under 25 years old is 6.9 children. Most farm labor, even among the wealthy farmers, is family labor organized by age and gender. Women are responsible for planting, weeding, harvesting and household chores. Male off-farm employment increases the agricultural production responsibilities of women. Only mothers of sons can control property and gain prestige. Modernization and land shortages have pressured families to increase nonfarm employment. PMID:12319223

  20. Dike injection and magma mixing in Kenya rift volcanoes

    NASA Astrophysics Data System (ADS)

    Anthony, E. Y.; Espejel, V.; Biggs, J.

    2009-12-01

    A nexus of volcanoes in the rift graben at approximately the latitude of Nairobi consist of central vent trachyte, phonolite, and peralkaline rhyolite and cinder cone and fissure-fed flows of basalt to benmoreite. The volcanoes are referred to as the Central Kenya Peralkaline Province (CKPP, Macdonald and Scaillet, 2006, Lithos 91, 59-73) and formed by a combination of processes including fractional crystallization, magma mixing, and volatile transport (Ren et al., 2006, Lithos 91, 109-124; Macdonald et al., 2008, JPet 49, 1515-1547). This presentation focuses on magma mixing for trachytes and phonolites for Suswa rocks, which are the southernmost part of the CKPP. We also explore the contribution of magma process studies to the interpretation of recent geodetic data, which indicate inflation/deflation of up to 21 cm for Kenyan volcanoes from 1997 to present (Biggs et al., 2009, Geology, in press). Incontrovertible evidence for magma mixing is found in field evidence, where a basaltic trachyandesite ash horizon is found interbedded with syncaldera trachyte (Skilling, 1993, J. Geol. Society London 150, 885-896), hand-specimen and thin-section petrography, and disequilibrium mineral chemistry. Precaldera lavas contain a homogeneous group of anorthoclase crystals with An content 6% or less. Syncaldera samples contain this same group and two other populations: polysynthetic twinned labradorite and andesine and anorthoclase with An content of 17%. Textures for all three groups indicate disequilibrium. Postcaldera flows contain the high and low An anorthoclase populations but lack the polysynthetic twinned labradorite and andesine. These observations suggest a model of injection of mafic magmas via diking into shallow trachtytic magma systems. Recent geodetic studies of dike injection and subsequent seismic/volcanic activity in both Ethiopia and Lengai point to the ongoing importance of these processes to rift evolution in East Africa.

  1. Demographic and Health Survey of Kenya in 1993.

    PubMed

    1994-01-01

    This report describes the 1993 Kenya Demographic and Health Survey (KDHS) questionnaires, sample frame, setting, research methods and data processing, and main outcome measures of fertility and mortality. The KDHS includes a household questionnaire, a woman's questionnaire, a man's questionnaire, and a services availability questionnaire. The questions were based on the DHS Model B questionnaire for low contraceptive usage countries and written in English for translation into Kiswahili and eight of the most widely spoken local languages. The household questionnaire asked about household members, dwelling characteristics, and sanitation questions. The women's questionnaire asked about background characteristics, reproductive history, knowledge and use of family planning, prenatal and delivery care, breast feeding and weaning, vaccinations, marriage, fertility preferences, husband's background and work, and awareness of AIDS. Interviewers measured the height and weight of women and children. The sample was nationally representative and involved a two-stage design that was stratified by urban and rural residence and district. Questionnaires were pretested. 102 persons were trained over a 4-week period in conducting the fieldwork. There were 12 interviewing teams that began fieldwork on February 18 and completed field work on August 15, 1993. Findings indicate that fertility declined in 10 years from 6.7 to 5.4 children/woman. Fertility was highest in Western Province (6.6 children) and lowest in Nairobi (3.4 children). Ideal family size was 3.7 children. 33% of married women currently used a contraceptive. Child mortality was 96 deaths per 1000 live births. Infant mortality was 62 deaths per 1000 live births. 79% of children aged 12-23 months were fully vaccinated. 33% of children were stunted; 12% were severely stunted; and 6% were wasted. 90% of respondents were aware of HIV transmission from mother to child. 66% perceived themselves at risk.

  2. 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

  3. 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

  4. 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

  5. Land use and climate change impacts on the hydrology of the upper Mara River Basin, Kenya: results of a modeling study to support better resource management

    NASA Astrophysics Data System (ADS)

    Mango, L. M.; Melesse, A. M.; McClain, M. E.; Gann, D.; Setegn, S. G.

    2011-07-01

    Some of the most valued natural and cultural landscapes on Earth lie in river basins that are poorly gauged and have incomplete historical climate and runoff records. The Mara River Basin of East Africa is such a basin. It hosts the internationally renowned Mara-Serengeti landscape as well as a rich mixture of indigenous cultures. The Mara River is the sole source of surface water to the landscape during the dry season and periods of drought. During recent years, the flow of the Mara River has become increasingly erratic, especially in the upper reaches, and resource managers are hampered by a lack of understanding of the relative influence of different sources of flow alteration. Uncertainties about the impacts of future climate change compound the challenges. We applied the Soil Water Assessment Tool (SWAT) to investigate the response of the headwater hydrology of the Mara River to scenarios of continued land use change and projected climate change. Under the data-scarce conditions of the basin, model performance was improved using satellite-based estimated rainfall data, which may also improve the usefulness of runoff models in other parts of East Africa. The results of the analysis indicate that any further conversion of forests to agriculture and grassland in the basin headwaters is likely to reduce dry season flows and increase peak flows, leading to greater water scarcity at critical times of the year and exacerbating erosion on hillslopes. Most climate change projections for the region call for modest and seasonally variable increases in precipitation (5-10 %) accompanied by increases in temperature (2.5-3.5 °C). Simulated runoff responses to climate change scenarios were non-linear and suggest the basin is highly vulnerable under low (-3 %) and high (+25 %) extremes of projected precipitation changes, but under median projections (+7 %) there is little impact on annual water yields or mean discharge. Modest increases in precipitation are partitioned

  6. 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…

  7. 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…

  8. 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

  9. The Mentorship of Kenya Ayers

    ERIC Educational Resources Information Center

    Boerner, Heather

    2016-01-01

    Being a college president has been Kenya Ayers' goal since she started in higher education in the late 1990s. "I'm really clear," she says. "I want to do this." Ayers is well on her way. She's been a provost, an academic dean and an administrative one, and an associate vice president of academic affairs at colleges in…

  10. 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.

  11. 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

  12. 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

  13. 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

  14. 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.

  15. A multipurpose serological survey in Kenya

    PubMed Central

    Geser, Anton; Henderson, Brian E.; Christensen, Svend

    1970-01-01

    Arbovirus infections are of public health interest in East Africa, where a very widespread epidemic of o'nyong-nyong fever was reported in 1959-60 and where the threat of yellow fever, present in neighbouring areas such as Ethiopia, remains. Sera collected in a serological survey in Kenya were therefore tested for antibodies against 3 group-A arboviruses (chikungunya, o'nyong-nyong and Sindbis), 6 group-B arboviruses (Zika, yellow fever, West Nile, Banzi, Wesselsbron and dengue 1), and Bunyamwera virus. The sera were examined mainly by the haemagglutination-inhibition test but a small proportion were also subjected to virus neutralization tests. The results showed that the prevalence of arbovirus tnfection varies markedly from area to area in Kenya. All types of arbovirus infections were more frequent on the coast than on the dry plateau around Kitui and the Lake Victoria area, The only exceptions were o'nyong-nyong and chikungunya, which were found to be just as prevalent on the coast as in Nyanza, where an epidemic was reported in 1959-60. Yellow fever antibodies were found to be present in about half of the people living on the coast but practically absent from the other two areas. It was concluded that the yellow fever antibodies in the coastal area must be due either to vaccination or to cross-reactions with other group-B arboviruses. PMID:5313066

  16. 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

  17. Behavioural effects of infant and child mortality on fertility in Kenya.

    PubMed

    Kimani, M

    2001-12-01

    This paper analyses the behavioural effects of infant and child mortality on birth intervals in Kenya. Analysing the behavioural effects of infant and child mortality on fertility independent of its biological effects has been considered a difficult task. In this paper, a procedure for analysing these effects separately is developed and applied to the 1989 Kenya Demographic and Health Survey (KDHS) data. The results of the analysis suggests that women in Kenya adopt various strategies such as curtailing the duration of breastfeeding, increasing frequency of coitus, and to a lesser extent use of contraception in order to replace infant or children who have died or to insure against those who are likely to die. These findings suggest the existence of behavioural effects of infant and child mortality on fertility in Kenya.

  18. 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

  19. 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

  20. Quality of Primary Education Inputs in Urban Schools: Evidence from Nairobi

    ERIC Educational Resources Information Center

    Ngware, Moses W.; Oketch, Moses; Ezeh, Alex C.

    2011-01-01

    This article examines the quality of primary school inputs in urban settlements with a view to understand how it sheds light on benchmarks of education quality indicators in Kenya. Data from a school survey that involved 83 primary schools collected in 2005 were used. The data set contains information on school quality characteristics of various…

  1. The fertility decline in Kenya.

    PubMed

    Robinson, W C; Harbison, S F

    1995-01-01

    In Sub-Saharan Africa Kenya is a prime example of a country experiencing a rapid decline in fertility and greater contraceptive prevalence. These changes have occurred since 1980 when fertility was high at 8.0 children per woman. In 1993 the total fertility rate (TFR) was 5.4, and the growth rate declined to about 2.0%. This transition is swifter than any country in contemporary Asia or historical Europe. The likely projection for Kenya is attainment of replacement level fertility during the 2020s and a leveling of population at about 100 million persons. Fertility has declined the most in urban areas and central and eastern regions. Bongaarts' proximate determinants (TFR, total marital fertility rate, total natural marital fertility rate, and total fecundity) are reduced to the proportion of currently married women using contraception, the proportion in lactational nonfecund status, and the proportion currently married. Actual fertility change is accounted for by total fertility change of 3.0 children. Lactational infecundability accounts for 0.5 potential births, and changes in marital fertility account for 1.0 reduced births per woman. About 70% of fertility reduction is accounted for by contraception and abortion. During 1977-78 80% of fertility control was due to lactational nonfecundity, 10% to nonmarriage, and 10% to contraception. In 1993 lactational nonfecundity accounted for 50% of the reduction, nonmarriage for 20%, and abortion about 30%. Future fertility is expected to be dependent on contraceptive prevalence. Kenya has experienced the Coale paradigm of preconditions necessary for demographic transition (willing, ready, and able). High fertility in Africa is not intractable. Creating the change in attitudes that leads to readiness is linked to education, health, and exposure to modernizing media and urban lifestyles. The public sector family planning program in Kenya has created the opportunity for access and availability of contraception. The key

  2. 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.

  3. Kenya's Maligned African Press: A Reassessment.

    ERIC Educational Resources Information Center

    Scotton, James F.

    Kenya's dozen or more newspapers and 50 news sheets edited and published by Africans in the turbulent 1945-52 preindependence period were condemned as irresponsible, inflammatory, antiwhite, and seditious by the Kenya colonial government, and this characterization has been accepted by many scholars and journalists, including Africans. There is…

  4. 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…

  5. 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…

  6. 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…

  7. 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

  8. Residual Disease and HPV Persistence after Cryotherapy for Cervical Intraepithelial Neoplasia Grade 2/3 in HIV-Positive Women in Kenya

    PubMed Central

    De Vuyst, Hugo; Mugo, Nelly R.; Franceschi, Silvia; McKenzie, Kevin; Tenet, Vanessa; Njoroge, Julia; Rana, Farzana S.; Sakr, Samah R.; Snijders, Peter J. F.; Chung, Michael H.

    2014-01-01

    Objective To assess residual cervical intraepithelial neoplasia (CIN) 2/3 disease and clearance of high-risk (hr) human papillomavirus (HPV) infections at 6 months after cryotherapy among HIV-positive women. Design Follow-up study. Methods 79 HIV-positive women received cryotherapy for CIN2/3 in Nairobi, Kenya, and underwent conventional cytology 6 months later. Biopsies were performed on high grade cytological lesions and hrHPV was assessed before (cervical cells and biopsy) and after cryotherapy (cells). Results At 6 months after cryotherapy CIN2/3 had been eliminated in 61 women (77.2%; 95% Confidence Interval, (CI): 66.4–85.9). 18 women (22.8%) had residual CIN2/3, and all these women had hrHPV at baseline. CD4 count and duration of combination antiretroviral therapy (cART) were not associated with residual CIN2/3. CIN3 instead of CIN2 was the only significant risk factor for residual disease (odds ratio, OR vs CIN2 = 4.3; 95% CI: 1.2–15.0) among hrHPV-positive women after adjustment for age and HPV16 infection. Persistence of hrHPV types previously detected in biopsies was found in 77.5% of women and was associated with residual CIN2/3 (OR = 8.1, 95% CI: 0.9–70). The sensitivity, specificity, and negative predictive value of hrHPV test in detecting residual CIN2/3 were 0.94, 0.36, and 0.96 respectively. Conclusions Nearly one quarter of HIV-positive women had residual CIN2/3 disease at 6 months after cryotherapy, and the majority had persistent hrHPV. CD4 count and cART use were not associated with residual disease or hrHPV persistence. The value of hrHPV testing in the detection of residual CIN2/3 was hampered by a low specificity. PMID:25343563

  9. TDRS satellite over African Rift Valley, Kenya, Africa

    NASA Technical Reports Server (NTRS)

    1983-01-01

    This post deploy view of a TDRS satellite shows a segment of the African Rift Valley near Lake Baringo, Kenya, Africa (3.0S, 36.0E). The African Rift Valley system is a geologic fault having its origins in southern Turkey, through the near east forming the bed of the Jordan River, Gulf of Aqaba, the Red Sea and down through east Africa. The line of lakes and valleys of east Africa are the result of the faulting activity.

  10. 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.

  11. Women in development: Kenya's experience.

    PubMed

    Herz, B

    1989-06-01

    In Kenya, the government has promoted economic policies, development programs, and a legal system geared to increase incentives and productive capacity for women. Economic strength, family health and population growth can be greatly effected by programs in women's education, health care, family planning and agriculture extension. There are 10 million women in Kenya and 60% are below 20 years of age. Women's groups have been successful in improving health and family planning practice. Women manage most small farms: 75% of the labor on the farms is provided by women. Kenya has introduced an extension system nationally focusing on women farmers as well as men. Women's demand for credit is strong and the government is considering helping expand credit through women's groups. Water is obtained by women and 9 of 10 spend more than an hour getting water each day for the family. By providing better access to water, more time can be spent on farming, family and other more important pursuits. There are many projects to improve community water supplies sponsored by both governmental and non- governmental organizations. About 1/3 girls and 2/5 boys complete primary school. Women that have more than 5 years of education have less than 3 children. There have been difficulties getting girls into later primary and secondary education, because fewer spots are allocated for girls in government-aided schools. The government it trying to improve this, but many girls drop out because of pregnancy. A third of the deaths of women between 15-35 is caused by maternal mortality. This high rate can be reduced with better prenatal care, better family planning, and more effective care at child birth. There are now about 100,000 new family planning acceptors each year. The World Bank and many international organizations have given support to the women's needs in the development process.

  12. 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

  13. Two-stage rifting in the Kenya rift: implications for half-graben models

    NASA Astrophysics Data System (ADS)

    Mugisha, F.; Ebinger, C. J.; Strecker, M.; Pope, D.

    1997-09-01

    The Kerio sub-basin in the northern Kenya rift is a transitional area between the southern Kenya rift, where crustal thickness is 30 km, and the northern Kenya rift, where crustal thickness is 20 km. The lack of data on the shallow crustal structure, geometry of rift-bounding faults, and rift evolution makes it difficult to determine if the crustal thickness variations are due to pre-rift structure, or along-axis variations in crustal stretching. We reprocessed reflection seismic data acquired for the National Oil Corporation of Kenya, and integrated results with field and gravity observations to (1) delineate the sub-surface geometry of the Kerio sub-basin, (2) correlate seismic stratigraphic sequences with dated strata exposed along the basin margins, and (3) use new and existing results to propose a two-stage rifting model for the central Kenya rift. Although a classic half-graben form previously had been inferred from the attitude of uppermost strata, new seismic data show a more complex form in the deeper basin: a narrow full-graben bounded by steep faults. We suggest that the complex basin form and the northwards increase in crustal thinning are caused by the superposition of two or more rifting events. The first rifting stage may have occurred during Palaeogene time contemporaneous with sedimentation and rifting in northwestern Kenya and southern Sudan. The distribution of seismic sequences suggests that a phase of regional thermal subsidence occurred prior to renewed faulting and subsidence at about 12 Ma after the eruption of flood phonolites throughout the central Kenya rift. A new border fault developed during the second rifting stage, effectively widening the basin. Gravity and seismic data indicate sedimentary and volcanic strata filling the basin are 6 km thick, with up to 4 km deposited during the first rifting stage.

  14. Community Perceptions of Air Pollution and Related Health Risks in Nairobi Slums

    PubMed Central

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

    2013-01-01

    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 lowamong the residents indicating the need for promoting awareness on air pollution sources and related health risks. PMID:24157509

  15. 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.

  16. 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.

  17. 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

  18. Constructing an action agenda for community empowerment at the 7th Global Conference on Health Promotion in Nairobi.

    PubMed

    Fawcett, Stephen; Abeykoon, Palitha; Arora, Monika; Dobe, Madhumita; Galloway-Gilliam, Lark; Liburd, Leandris; Munodawafa, Davison

    2010-12-01

    This report describes an action agenda for community empowerment developed by participants at the 7th Global Conference on Health Promotion in Nairobi. It outlines gaps and barriers in enabling community empowerment; including those related to institutional capacity, institutional relationships to the community, and institutional responses to the social structure of the community. The report features nine recommended actions to enhance community control of health promotion initiatives, develop sustainable resources for community health efforts, and support implementation and build evidence for health promotion effectiveness. Implementing these recommended actions can enhance community empowerment and help close the implementation gap in health promotion.

  19. “We are used to this”: a qualitative assessment of the perceptions of and attitudes towards air pollution amongst slum residents in Nairobi

    PubMed Central

    2014-01-01

    Background People’s perceptions of and attitudes towards pollution are critical for reducing exposure among people and can also influence the response to interventions that are aimed at encouraging behaviour change. This study assessed the perceptions and attitudes of residents in two slums in Nairobi regarding air pollution. Methods We conducted focus group discussions with residents aged 18 years and above using an emergent design in the formulation of the study guide. A thematic approach was used in data analysis. Results The discussions revealed that the two communities experience air pollution arising mainly from industries and dump sites. There was an apparent disconnect between knowledge and practice, with individuals engaging in practices that placed them at high risk of exposure to air pollution. Residents appear to have rationalized the situation in which they live in and were resigned to these conditions. Consequently, they expressed lack of agency in addressing prevalent air pollution within their communities. Conclusions Community-wide education on air pollution and related health effects together with the measures needed to reduce exposure to air pollution are necessary towards reducing air pollution impacts. A similar city-wide study is recommended to enable comparison of perceptions along socio-economic groups and neighbourhoods. PMID:24597487

  20. 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.

  1. 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…

  2. 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…

  3. 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.

  4. Some coprophilous fungi from Kenya.

    PubMed

    Caretta, G; Piontelli, E; Savino, E; Bulgheroni, A

    1998-01-01

    The occurrence of coprophilous fungi on samples of antelope, buffalo, zebra and hippopotamus dung collected from the Marula Estates in Kenya was recorded. A hundred and seventy three fungal isolates representative of 40 genera and 59 species were identified. Among these species, 23 were Ascomycetes (39%), 30 Deuteromycetes (50.8%), 5 Zygomycetes (8.5%) and 1 Basidiomycete (1.7%). Ascobolus immersus, Coprotus niveus, Iodophanus carneus, Lasiobolus lasioboloides, Podospora anserina, P. australis and Sporormiella minima were the dominant species occurring in the dung of these animals. Notes on infrequent or interesting Ascomycetes include Kernia nitida, Saccobolus versicolor, Sordaria fimicola and others. The interdependence of the vegetation of this area with the fungi occurring on the dung of these animals is discussed. PMID:16284849

  5. 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.

  6. 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

  7. 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

  8. [Female migration and social change in Africa. The case of Kenya].

    PubMed

    Vorlaufer, K

    1985-06-01

    Causes of the recent increase in female rural-urban migration in Kenya are investigated. "Reasons for this additional migration-wave are to be found in a general weakening of traditional values and authorities, the increasing land shortage and the resulting population pressure in the rural areas, which are factors that do in fact force women to migrate to towns." Comparisons are made with male migration flows. Regional differences in migration patterns are also noted. The author concludes that the increase in female migration is not a result of greater emancipation of women but rather a symptom of increasing poverty among Kenya's female population. (SUMMARY IN ENG)

  9. 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.

  10. 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

  11. 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

  12. Life cycle cost analysis of a stand-alone PV system in rural Kenya

    NASA Astrophysics Data System (ADS)

    Daly, Emma

    The purpose of this quantitative research study was to determine the economic feasibility of a stand-alone PV system to electrify a rural area in Kenya. The research conducted involved a comprehensive review of all the relevant literature associated with the study. Methodologies were extrapolated from this extensive literature to develop a model for the complete design and economic analysis of a stand-alone PV system. A women's center in rural Kenya was used as a worked example to demonstrate the workings of the model. The results suggest that electrifying the center using a stand-alone PV system is an economically viable option which is encouraging for the surrounding area. This model can be used as a business model to determine the economic feasibility of a stand-alone PV system in alternative sites in Kenya.

  13. Forensic case of lead poisoning from a battery manufacturing company in Nakuru, Kenya.

    PubMed

    Mbaria, James M; Ochodo, C; Nguta, Joseph Mwanzia

    2013-02-01

    Acute sickness involving dairy cattle (n = 5) with a morbidity of 100% occurred in a farm in Nakuru, Kenya. A case study was undertaken with the objective of establishing the cause of the sickness. Samples of blood, soil and industrial waste contained high levels of lead. The symptoms, results of postmortem and history of the case were used to establish the diagnosis of acute lead poisoning. This is a forensic case in court between the owner of the animals and a lead recycling company that dumped the industrial waste that was associated with the poisoning. There could be many unreported cases of lead poisoning in Kenya areas with heavy industrial activities since data on of lead poisoning in Kenya is scanty.

  14. 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

  15. 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

  16. 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

  17. 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…

  18. Quality of life for families with spina bifida in Kenya.

    PubMed

    van't Veer, Toos; Meester, Hanneke; Poenaru, Dan; Kogei, Agnes; Augenstein, Kimberly; Bransford, Richard

    2008-07-01

    Spina bifida (SB) affects children worldwide. Studies from developed nations have explored the impact of SB on the quality of life of children and their parents. However, there are no such studies available from developing countries. We have therefore undertaken to document the impact of the disability on the families of affected children in Kenya. A questionnaire was administered to 40 mothers and their children, who were receiving treatment for SB at our institution. The results of this study should indicate where community and governmental resources and educational efforts for the disabled should be directed.

  19. 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…

  20. 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,…

  1. 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…

  2. 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…

  3. 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…

  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. Using Smartphone Technology in Environmental Sustainability Education: The Case of the Maasai Mara Region in Kenya

    ERIC Educational Resources Information Center

    Dogbey, James; Quigley, Cassie; Che, Megan; Hallo, Jeffrey

    2014-01-01

    This study engaged key stakeholders in an economically and environmentally fragile region in Kenya in a unique, interdisciplinary, and integrative approach to explore the extent to which the use of smartphone technology helps access the environmental values and sustainability perspectives of the people of the Maasai land. The results of the study…

  6. 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…

  7. 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…

  8. Social capital and health in Kenya: A multilevel analysis.

    PubMed

    Musalia, John

    2016-10-01

    Despite the acknowledgment that social capital is an important predictor of good health and overall well being in wealthy countries, little empirical research has been conducted in developing countries, particularly in Africa, to examine this relationship. This study examines the association between cognitive (trust) and structural (membership in organization) social capital on health at both the individual and contextual levels. Health was measured using answers to a subjective question on physical health and anxiety/worry suffered by individuals within the last 30 days. This study utilized Afrobarometer data collected in Kenya in 2005 to examine this relationship using multilevel logistic statistical modeling. Upon controlling for socioeconomic and demographic factors, social capital was found to be significantly associated with anxiety/worry and physical health in Kenya. Membership in organizations was associated with increased odds (OR = 1.34, 95%CI: 1.02-1.76) of physical health problems, while individual trust was associated with a 6% (OR = 0.94, 95%CI: 0.90-0.99) reduction in the likelihood of physical health problems. Conversely, generalized trust was associated with a 37% reduction in the odds (OR = 0.63, 95%CI: 0.40-0.99) of anxiety/worry, while individual trust was associated with a 5% reduction (OR = 0.95, 95%CI: 0.90-1.00) of anxiety/worry. With the exception of membership in an organization that exacerbates physical health, both individual level trust and generalized trust were associated with better health outcomes in Kenya. The availability of social organizations at the contextual level was associated with worsening anxiety/worry although the effect size was small. These results show that social capital, particularly trust, is a concept that can apply to different social and cultural contexts and can potentially be harnessed to improve health in settings that suffer from resource poverty.

  9. Social capital and health in Kenya: A multilevel analysis.

    PubMed

    Musalia, John

    2016-10-01

    Despite the acknowledgment that social capital is an important predictor of good health and overall well being in wealthy countries, little empirical research has been conducted in developing countries, particularly in Africa, to examine this relationship. This study examines the association between cognitive (trust) and structural (membership in organization) social capital on health at both the individual and contextual levels. Health was measured using answers to a subjective question on physical health and anxiety/worry suffered by individuals within the last 30 days. This study utilized Afrobarometer data collected in Kenya in 2005 to examine this relationship using multilevel logistic statistical modeling. Upon controlling for socioeconomic and demographic factors, social capital was found to be significantly associated with anxiety/worry and physical health in Kenya. Membership in organizations was associated with increased odds (OR = 1.34, 95%CI: 1.02-1.76) of physical health problems, while individual trust was associated with a 6% (OR = 0.94, 95%CI: 0.90-0.99) reduction in the likelihood of physical health problems. Conversely, generalized trust was associated with a 37% reduction in the odds (OR = 0.63, 95%CI: 0.40-0.99) of anxiety/worry, while individual trust was associated with a 5% reduction (OR = 0.95, 95%CI: 0.90-1.00) of anxiety/worry. With the exception of membership in an organization that exacerbates physical health, both individual level trust and generalized trust were associated with better health outcomes in Kenya. The availability of social organizations at the contextual level was associated with worsening anxiety/worry although the effect size was small. These results show that social capital, particularly trust, is a concept that can apply to different social and cultural contexts and can potentially be harnessed to improve health in settings that suffer from resource poverty. PMID:27597538

  10. 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:

  11. 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

  12. 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…

  13. Education in the Republic of Kenya.

    ERIC Educational Resources Information Center

    Sheffield, James R.

    As in most developing countries, education in Kenya is reported to have developed through three broad, overlapping phases: traditional, missionary, and governmental as influenced by the country's geography, climate, population growth, economy, and striving for independence. In the process, long-range educational goals have evolved: 1) to provide…

  14. 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…

  15. Forests and competing land uses in Kenya

    NASA Astrophysics Data System (ADS)

    Allaway, James; Cox, Pamela M. J.

    1989-03-01

    Indigenous forests in Kenya, as in other developing countries, are under heavy pressure from competing agricultural land uses and from unsustainable cutting. The problem in Kenya is compounded by high population growth rates and an agriculturally based economy, which, even with efforts to control birth rates and industrialize, will persist into the next century. Both ecological and economic consequences of these pressures need to be considered in land-use decision making for land and forest management to be effective. This paper presents one way to combine ecological and economic considerations. The status of principal forest areas in Kenya is summarized and competing land uses compared on the basis of ecological functions and economic analysis. Replacement uses do not match the ecological functions of forest, although established stands of tree crops (forest plantations, fuel wood, tea) can have roughly comparable effects on soil and water resources. Indigenous forests have high, although difficult to estimate, economic benefits from tourism and protection of downstream agricultural productivity. Economic returns from competing land uses range widely, with tea having the highest and fuel wood plantations having returns comparable to some annual crops and dairying. Consideration of ecological and economic factors together suggests some trade-offs for improving land allocation decisions and several management opportunities for increasing benefits or reducing costs from particular land uses. The evaluation also suggests a general strategy for forest land management in Kenya.

  16. Energy conservation in Kenya: progress, potentials, problems

    SciTech Connect

    Schipper, L.; Hollander, J.M.; Milukas, M.; Alcamo, J.; Meyers, S.; Noll, S.

    1981-09-01

    A study was carried out of the flows of commercial energy in the economy of Kenya. Indications were sought of the extent to which energy conservation, (i.e., increase in efficiency of energy use) has reduced the ratio of energy inputs to economic outputs, in the post-1973 years. An assessment was made of the potential for energy conservation to reduce the growth of Kenyan energy use in the future and of significant barriers to increasing energy efficiency. Consideration was given to the role of government policy and of international assistance in fostering energy conservation in Kenya and other developing countries. The study was performed by analyzing available energy data and statistics from the largest oil companies, the Kenyan electric utility, and the government. These sources were supplemented by conducting personal interviews with personnel of nearly 50 commercial firms in Kenya. Direct consumption of fuel accounts for 94% of the commercial energy use in Kenya, while electricity accounts for 6%. The sectoral division of fuel use is: transportation 53%, industry 21%, energy production 11%, agriculture 9%, buildings and residences 5%, and construction 1%. For electricity the division is: buildings and residences 48%, industry 45%, energy production 4%, agriculture 2%, and construction 1%. Recent progress in conservation is reported.

  17. Early Primary Literacy Instruction in Kenya

    ERIC Educational Resources Information Center

    Dubeck, Margaret M.; Jukes, Matthew C. H.; Okello, George

    2012-01-01

    We report on a study that used observations, conversations, and formal interviews to explore literacy instruction in 24 lower-primary classrooms in coastal Kenya. Specifically, we report the ways literacy instruction is delivered and how that delivery aligns with practices understood to promote reading acquisition. We find (1) prioritization of…

  18. The HIV and AIDS Tribunal of Kenya

    PubMed Central

    2016-01-01

    Abstract Established under Section 25 of the HIV Prevention and Control Act of 2006, the HIV and AIDS Tribunal of Kenya is the only HIV-specific statutory body in the world with the mandate to adjudicate cases relating to violations of HIV-related human rights. Yet, very limited research has been done on this tribunal. Based on findings from a desk research and semi-structured interviews of key informants conducted in Kenya, this article analyzes the composition, mandate, procedures, practice, and cases of the tribunal with the aim to appreciate its contribution to the advancement of human rights in the context of HIV. It concludes that, after a sluggish start, the HIV and AIDS Tribunal of Kenya is now keeping its promise to advance the human rights of people living with and affected by HIV in Kenya, notably through addressing barriers to access to justice, swift ruling, and purposeful application of the law. The article, however, highlights various challenges still affecting the tribunal and its effectiveness, and cautions about the replication of this model in other jurisdictions without a full appraisal. PMID:27781008

  19. 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…

  20. 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…

  1. 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…

  2. 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…

  3. An integrated geophysical analysis of the upper crust of the southern Kenya rift

    NASA Astrophysics Data System (ADS)

    Simiyu, Silas M.; Keller, G. Randy

    2001-12-01

    Previous interpretations of seismic data collected by the Kenya Rift International Seismic Project (KRISP) experiments indicate the presence of crustal thickening within the rift valley area beneath the Kenya dome, an uplift centred on the southern part of the Kenya rift. North of the dome, these interpretations show thinning of the crust and an increase in crustal extension. To the south near the Kenya/Tanzania border, crustal thinning associated with the rift is modest. Our study was aimed at further investigating crustal structure from this dome southwards via a detailed analysis focused on upper crustal structure. We used results from surface geological mapping, drill hole data from water wells and geothermal exploration wells, KRISP 85 seismic data for a profile across the rift, KRISP 85 and 90 seismic data for a profile along the rift axis and KRISP 94 seismic data for a profile crossing southernmost Kenya to constrain gravity modelling and construction of integrated models of crustal structure. Our integrated analysis produced the following results concerning the structure and evolution of the southern Kenya rift: (1) the graben master faults are consistently located along the western margin of the rift valley, and there is no evidence for half-graben polarity reversals for a distance of about 300km (2) there is no axial (north-south) crustal symmetry with respect to the apex of the Kenya dome, and the crustal thickness may be as much related to pre-rift crustal type and thickness as it is to crustal thickening and modification by magmatic processes; (3) the pre-existing lithospheric contrast between the Archaean and Proterozoic basement terranes played a significant role in the location and structural geometry of the rift; (4) south of latitude 1°S, low velocities and densities observed under the western flank of the rift probably represent reworked Archaean Tanzanian craton; (5) magmatic modification of the upper crust is modest except near the major

  4. Energy demand and conservation in Kenya: initial appraisal

    SciTech Connect

    Schipper, L.

    1980-03-01

    Ongoing research into the use and conservation of energy in Kenya is reported briefly. A partial accounting of energy use in Kenya is presented, and evidence that some energy conservation has been taking place is discussed. A fuller accounting for all commercial energy flows is both possible and desirable. The work presented should serve as a basis for further data collection and analysis in Kenya, and can be used as a model for similar efforts in other countries. The author intends to continue much of this energy accounting in Kenya in the latter half of 1980.

  5. 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

  6. 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

  7. 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

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

    PubMed

    Isdory, Augustino; Mureithi, Eunice W; Sumpter, David J T

    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

  10. 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.

  11. 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

  12. Diversity and utilization of antimalarial ethnophytotherapeutic remedies among the Kikuyus (Central Kenya)

    PubMed Central

    Njoroge, Grace N; Bussmann, Rainer W

    2006-01-01

    Plants in Kenya are becoming increasingly important as sources of traditional medicines. The World Health Organization (WHO) has estimated that malaria kills about 2.7 million people every year, 90% of who are from Africa. Malaria continues to be a national concern in Kenya as it plays a major role in the high mortality rates being experienced currently. The use and miss-use of chloroquine to prevent and treat falciparium malaria has led to widespread appearance of chloroquine resistant parasites in Kenya and other tropical countries. These factors and the rising costs of non-chloroquine drugs have made the local people to turn to traditional remedies for management of this menace. This paper examines the current utilization of traditional plant medicines in managing malaria menace in Central Kenya. The results show both indigenous and introduced species are in use indicating traditional medicinal practices in this region are dynamic. In total 58 species in 54 genera and 33 families were identified. The family Rubiaceae was found to have the highest number of reported species. Use of the various taxa is compared between five districts within Central Province of Kenya. The commonest species in this pharmacopoeia are: Caesalpinia volkensii Harms, Strychnos henningsii Gilg, Ajuga remota Benth., Warbugia ugandensis Sprague and Olea europaea L. The first three species are used in all the five districts while the others are restricted in some of the districts. In 74% of the anti-malarial plant species reported in this study, the remedies are obtained in destructive manner and may need conservation measures to ensure sustainable utilization. The results of this study become a basis for selecting plants for further pharmacological and phytochemical studies in developing new and locally relevant anti-malarial agents. PMID:16451716

  13. 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.

  14. 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

  15. 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

  16. 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)

  17. Human aflatoxin exposure in Kenya, 2007: a cross-sectional study.

    PubMed

    Yard, Ellen E; Daniel, Johnni H; Lewis, Lauren S; Rybak, Michael E; Paliakov, Ekaterina M; Kim, Andrea A; Montgomery, Joel M; Bunnell, Rebecca; Abudo, Mamo Umuro; Akhwale, Willis; Breiman, Robert F; Sharif, Shahnaaz K

    2013-01-01

    Aflatoxins contaminate approximately 25% of agricultural products worldwide. They can cause liver failure and liver cancer. Kenya has experienced multiple aflatoxicosis outbreaks in recent years, often resulting in fatalities. However, the full extent of aflatoxin exposure in Kenya has been unknown. Our objective was to quantify aflatoxin exposure across Kenya. We analysed aflatoxin levels in serum specimens from the 2007 Kenya AIDS Indicator Survey - a nationally representative, cross-sectional serosurvey. KAIS collected 15,853 blood specimens. Of the 3180 human immunodeficiency virus-negative specimens with ≥1 mL sera, we randomly selected 600 specimens stratified by province and sex. We analysed serum specimens for aflatoxin albumin adducts by using isotope dilution MS/MS to quantify aflatoxin B1-lysine, and normalised with serum albumin. Aflatoxin concentrations were then compared by demographic, socioeconomic and geographic characteristics. We detected serum aflatoxin B1-lysine in 78% of serum specimens (range = Kenya, and it could be substantially impacting human health. Wide-scale, evidence-based interventions are urgently needed to decrease exposure and subsequent health effects.

  18. Worker exposure and health risks from volatile organic compounds utilized in the paint manufacturing industry of Kenya.

    PubMed

    Purvis, K L; Jumba, I O; Wandiga, S; Zhang, J; Kammen, D M

    2001-11-01

    This study provides a means for the evaluation of cleaner manufacturing and the provision of cost-effective worker health improvements in developing nations. Individual worker exposure to volatile organic compounds was measured in the paint manufacturing plants of Nairobi, Kenya. A variety of different paint production jobs were monitored, including laboratory researchers, mixers, tinters, fillers, cleaners, raw materials deliverers, and resins producers. Exposure levels were calculated based on a time-weighted average over an entire 8-10 hour workday. The paint solvents used can cause both acute and chronic health problems for the workers exposed. For example, over half of the organics monitored, i.e. benzene, styrene, and xylene, exhibit carcinogenic properties. The lifetime cancer risk from exposure to these paint solvents was estimated utilizing published cancer potencies, and the risks range from 1.90 x 10(-4) for raw materials deliverers to 2.60 x 10-2 for cleaners. The highest exposure tasks included cleaning the mixing vats and mixing the paint product, ranging from risks of 8.5 x 10(-4) to 2.6 x 10(-2), providing evidence that solvent exposure occurs due to point sources. Because of this, simple and inexpensive technologies should significantly reduce the excess exposure of workers in these manufacturing facilities. The cost of minor-innovations in the plants themselves, such as fans, drum and mixing vat covers, and respirators, could amount to as much as five times less than the estimated cost of treating workers who develop cancer due to paint solvent exposure. PMID:11757899

  19. 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

  20. Effect of a school feeding programme on nutritional status and anaemia in an urban slum: a preliminary evaluation in Kenya.

    PubMed

    Neervoort, Femke; von Rosenstiel, Ines; Bongers, Karlien; Demetriades, Matthew; Shacola, Marina; Wolffers, Ivan

    2013-06-01

    To reduce malnutrition and improve child survival, school feeding programmes have been established in many parts of Africa, although prevalence of child malnutrition and anaemia remains high, especially in urban slums. The objective of this study is to evaluate the effect of a school feeding programme in the slums of Nairobi (Kenya) on anaemia and nutritional status, together with an investigation for socioeconomic determinants that may overrule this effect. Sixty-seven children at the St. George primary school in Kibera participated in the school feeding programme for 1 year and data concerning anaemia rate, nutritional status and socioeconomic status were collected during a medical health check. Data were compared with a control group of children attending the same school, of the same age and with the same gender distribution without participation in a feeding programme. Data were analyzed with statistical software (SPSS 17.0). Children participating in the school feeding programme were less stunted (p = 0.02) and wasted (p = 0.02) than children in the control group, and levels of anaemia were lower (p = 0.01). Having no father (p = 0.01) and living in small families (p = 0.003) overruled the effect of the feeding programme. Also, the higher the mother's education, the more wasting was seen (p = 0.04) despite participation in the programme. The programme reduced anaemia and malnutrition and has improved child growth in our study group greatly, but we found that education level of the mother, family size and absence of a father overruled the effect of the school feeding programme. Because sample size of our study is small, we encourage further large-scaled research on reviewing programmatic interventions to develop optimal feeding strategies and improve nutritional status of children.

  1. Rabies and African wild dogs in Kenya.

    PubMed

    Kat, P W; Alexander, K A; Smith, J S; Munson, L

    1995-11-22

    Three packs of African wild dogs (Lycaon pictus) ranging to the north of the Masai Mara National Reserve in southwestern Kenya were monitored from 1988 to 1990. During a six week period (August 2-September 14, 1989), 21 of 23 members of one of these packs died. Histological examination of two brain samples revealed eosinophilic intracytoplasmic inclusions (Negri bodies), supporting a diagnosis of rabies viral encephalitis. An additional brain sample tested positive for rabies with a fluorescent antibody test. Nucleotide sequence of the rabies viral N and G genes from isolates of four African wild dogs (including an individual from Tanzania) indicated that infection was with a viral variant common among domestic dogs in Kenya and Tanzania. A hypothesis linking African wild dog rabies deaths to researcher handling is evaluated and considered implausible.

  2. Determinants of fertility in urban and rural Kenya: estimates and a simulation of the impact of education policy.

    PubMed

    Hyatt, D E; Milne, W J

    1993-03-01

    Fertility behavior and population growth and its impact on economics in Kenya are a concern because of recent trends. The aim of this research study was to examine the impact of multiple factors on fertility in urban and rural areas based on the 1984 Kenya contraceptive Prevalence Survey. Simulation models were used to project the number of births expected with the current educational program. The expectation was that increasing female education in rural areas would have an impact on birth probabilities. Policy implications are discussed in terms of increasing educational expenditures, particularly for rural women. The empirical model selected was based on theories on proximate determinants, demographic effects, and neoclassical models. A probit model was used to estimate whether or not a woman had a child in the year preceding the survey. Explanatory variables were economic (female employment and years of schooling), biological (mother's age and child mortality), and cultural (marital state, number of live births, and religion). The sample included 6405 women aged 15-49 years. Married urban women were 37% more likely than unmarried urban women to have given birth. Married rural women in monogamous marriages were 23% more likely to have given birth than their unmarried counterparts. The number in a marital union of wives did not affect the probability of birth in urban areas; the effect was quite small in rural areas. Probability of birth increased until age 25 in urban areas and to age 28 in rural areas. Previous live births had a small impact, and the inhibiting effect of an additional child is 2.7 times larger in urban than in rural areas. Only in urban areas did employment reduce the probability of a birth (by 7.4%). In rural areas, increases in education after the primary level were related to a decline in the probability of a birth (for a 26-year old woman there is a reduction in the probability of .18). The fertility rate of a woman completing secondary

  3. 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…

  4. 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,…

  5. 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,…

  6. 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

  7. 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…

  8. 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

  9. Promoting women's participation in Kenya's governance.

    PubMed

    Crawley, M

    1999-09-17

    This paper focuses on a research project that aims to help rural Kenyan women increase their participation in the democratic process. Nairobi-based Family Support Institute Executive Director Shanyisa Khasiani is implementing the research project with funding from the International Development Research Centre to help rural Kenyan women. The project, which involves the Makueni and Kakamega districts, will eventually see up to 30,000 women learn how to access information via computers, with the key goal of promoting civic education. Rural women's groups provided the project's entry points into the subject communities and presented the civic education needs of these communities to the project team. Aside from the main issue of political representation, other concerns emerged such as domestic violence, transportation needs, and employment of women to promote development. In view of these issues, the slogan "Be educated in politics!" was formed. The next phase of the project is to "train the trainers"--the women's group leaders--in computer skills. Each community will be provided with a resource center that is equipped with two computers and civic education reference materials. Teaching these women computer skills will enable them to communicate with one another, exchange ideas and learn what other nongovernmental organizations are doing about women's empowerment. The project will also enable rural Kenyan women use technology to help improve their economic status. PMID:12349368

  10. Promoting women's participation in Kenya's governance.

    PubMed

    Crawley, M

    1999-09-17

    This paper focuses on a research project that aims to help rural Kenyan women increase their participation in the democratic process. Nairobi-based Family Support Institute Executive Director Shanyisa Khasiani is implementing the research project with funding from the International Development Research Centre to help rural Kenyan women. The project, which involves the Makueni and Kakamega districts, will eventually see up to 30,000 women learn how to access information via computers, with the key goal of promoting civic education. Rural women's groups provided the project's entry points into the subject communities and presented the civic education needs of these communities to the project team. Aside from the main issue of political representation, other concerns emerged such as domestic violence, transportation needs, and employment of women to promote development. In view of these issues, the slogan "Be educated in politics!" was formed. The next phase of the project is to "train the trainers"--the women's group leaders--in computer skills. Each community will be provided with a resource center that is equipped with two computers and civic education reference materials. Teaching these women computer skills will enable them to communicate with one another, exchange ideas and learn what other nongovernmental organizations are doing about women's empowerment. The project will also enable rural Kenyan women use technology to help improve their economic status.

  11. 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

  12. 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.

  13. 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

  14. 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

  15. The Gender Context of HIV Risk and Pregnancy Goals in Western Kenya

    PubMed Central

    Kurth, Ann E.; Inwani, Irene; Wangombe, Anne; Nduati, Ruth; Owuor, Mercy; Njiri, Francis; Akinyi, Pamela; Cherutich, Peter; Osoti, Alfred; Kinuthia, John; Chhun, Nok; Kiarie, James

    2015-01-01

    Background Intentional childbearing may place heterosexual couples at risk of HIV infection in resource-limited settings with high HIV prevalence areas where society places great value on having children. Objective To explore cognitive, cultural, and spatial mapping of sexual and reproductive health domains and services in western Kenya among men and women. Design Community-based formative qualitative study design. Setting Five administrative/geographical divisions of Nyando District, western Kenya. Subjects Adult men 18 years and older and women who were of reproductive-potential ages (15 to 49 years for females) (n=90). Results Men and women have disparate goals for number of children and engage in gendered patterns of protective method use (contraceptives used by women often in secret, condoms by men but rarely). Conclusion HIV infection was still seen as stigmatizing. These study results are relevant to design of effective integrated delivery for reproductive and HIV services in high-burden sub-Saharan African countries. PMID:26766875

  16. 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

  17. 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

  18. Numerical modeling of geothermal systems with applications to Krafla, Iceland and Olkaria, Kenya

    SciTech Connect

    Bodvarsson, G.S.

    1987-08-01

    The use of numerical models for the evaluation of the generating potential of high temperature geothermal fields has increased rapidly in recent years. In the present paper a unified numerical approach to the modeling of geothermal systems is discussed and the results of recent modeling of the Krafla geothermal field in Iceland and the Olkaria, Kenya, are described. Emphasis is placed on describing the methodology using examples from the two geothermal fields.

  19. 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

  20. 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

  1. Kenya's forests: going up in smoke

    SciTech Connect

    Burnett, G.W.

    1985-01-01

    Closed forest and commercially valuable woodland account for at most 11,406 square miles in Kenya (about 5.2% of the country's area). Plantation forests, mainly of exotic conifers, cover more than 550 square miles, and it is hoped that exotic plantation species will entirely replace dependence on the indigenous forests for pulp, sawn timber and other roundwood. However, reliance on charcoal as a fuel has led to widespread deforestation, particularly along highways and within 20 miles of towns and major villages. Deforestation is likely to increase with increasing population pressure.

  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. 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…

  4. 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…

  5. 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…

  6. 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…

  7. 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…

  8. 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…

  9. Factors influencing place of delivery for women in Kenya: an analysis of the Kenya demographic and health survey, 2008/2009

    PubMed Central

    2013-01-01

    Background Maternal mortality in Kenya increased from 380/100000 live births to 530/100000 live births between 1990 and 2008. Skilled assistance during childbirth is central to reducing maternal mortality yet the proportion of deliveries taking place in health facilities where such assistance can reliably be provided has remained below 50% since the early 1990s. We use the 2008/2009 Kenya Demographic and Health Survey data to describe the factors that determine where women deliver in Kenya and to explore reasons given for home delivery. Methods Data on place of delivery, reasons for home delivery, and a range of potential explanatory factors were collected by interviewer-led questionnaire on 3977 women and augmented with distance from the nearest health facility estimated using health facility Global Positioning System (GPS) co-ordinates. Predictors of whether the woman’s most recent delivery was in a health facility were explored in an exploratory risk factor analysis using multiple logistic regression. The main reasons given by the woman for home delivery were also examined. Results Living in urban areas, being wealthy, more educated, using antenatal care services optimally and lower parity strongly predicted where women delivered, and so did region, ethnicity, and type of facilities used. Wealth and rural/urban residence were independently related. The effect of distance from a health facility was not significant after controlling for other variables. Women most commonly cited distance and/or lack of transport as reasons for not delivering in a health facility but over 60% gave other reasons including 20.5% who considered health facility delivery unnecessary, 18% who cited abrupt delivery as the main reason and 11% who cited high cost. Conclusion Physical access to health facilities through distance and/or lack of transport, and economic considerations are important barriers for women to delivering in a health facility in Kenya. Some women do not perceive a

  10. 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.

  11. 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

  12. 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

  13. Quality of care and contraceptive use in urban Kenya

    PubMed Central

    Pence, Brian W.; Curtis, Siân L.; Marshall, Stephen W.; Speizer, Ilene S.

    2015-01-01

    CONTEXT Family planning is highly beneficial to women’s overall health, morbidity, and mortality, particularly in developing countries. Yet, in much of sub-Saharan Africa, contraceptive prevalence remains low while unmet need for family planning remains high. It has been frequently hypothesized that the poor quality of family planning service provision in many low-income settings acts as a barrier to optimal rates of contraceptive use but this association has not been rigorously tested. METHODS Using data collected from 3,990 women in 2010, this study investigates the association between family planning service quality and current modern contraceptive use in five cities in Kenya. In addition to individual-level data, audits of select facilities and service provider interviews were conducted in 260 facilities. Within 126 higher-volume clinics, exit interviews were conducted with family planning clients. Individual and facility-level data are linked based on the source of the woman’s current method or other health service. Adjusted prevalence ratios are estimated using binomial regression and we account for clustering of observations within facilities using robust standard errors. RESULTS Solicitation of client preferences, assistance with method selection, provision of information by providers on side effects, and provider treatment of clients were all associated with a significantly increased likelihood of current modern contraceptive use and effects were often stronger among younger and less educated women. CONCLUSION Efforts to strengthen contraceptive security and improve the content of contraceptive counseling and treatment of clients by providers have the potential to significantly increase contraceptive use in urban Kenya. PMID:26308259

  14. 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

  15. Mycobacterium avium-related epizootic in free-ranging lesser flamingos in Kenya.

    PubMed

    Kock, N D; Kock, R A; Wambua, J; Kamau, G J; Mohan, K

    1999-04-01

    An epizootic in free-ranging lesser flamingos (Phoeniconaias minor) in Kenya resulted in more than 18,500 deaths from August through mid-November 1993. Disease was concentrated along the shores of Rift Valley Lakes Bogoria and Nakuru (Kenya) and did not involve any of the other avian or mammalian species frequenting the lakes. Coincidental to the outbreak was a bloom of algae on Lake Bogoria, toxins from which were first suspected to be causative. Discrete necrotic and granulomatous lesions were often noted in spleen and liver, and Mycobacterium avium serovar I was isolated from both organs. Escherichia coli and Pseudomonas aeruginosa also were often recovered in pure culture from liver. Gross and histopathological evaluation of the cases disclosed signs of acute sepsis and also chronic, potentially life-threatening lesions of mycobacteriosis, primarily involving the spleen and liver. Lesions typical for algae toxicosis were not seen in any birds. Deaths were attributed to septicemia complicated in those affected, by mycobacteriosis.

  16. 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.

  17. 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.

  18. Initiatives: Kenya. Puppets say it better.

    PubMed

    Mworogo, P

    1996-04-01

    It is taboo in Africa to discuss sexual issues with strangers and even trained family planning providers often feel uncomfortable discussing reproductive health issues with groups of people, especially men. In the wake of the successful use of puppets to teach audiences in South Africa about AIDS, the Family Planning Association of Kenya used puppets to teach men about family planning, sexually transmitted diseases, and HIV/AIDS. Trained puppetry troops now perform regularly in Kenya at male-dominated institutions in Nakuru and Kakamega. The approach has proved highly effective in drawing crowds of men to listen to reproductive health information. Puppetry represents real life, but remains one step removed from the real world. As such, puppets can be used to break down racial, social, and political barriers and stereotypes; they can say more on controversial issues than can a live actor without offending the audience; and they are highly portable and adaptable. Puppets offer the viewer and listener a nonthreatening opportunity to look and laugh at themselves.

  19. 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

  20. 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

  1. Older adults' perspectives on HIV/AIDS prevention strategies for rural Kenya.

    PubMed

    Muturi, Nancy; Mwangi, Samuel

    2011-12-01

    HIV/AIDS is devastating sub-Saharan Africa with great impact in the rural communities. Though prevention is the mainstay of various responses to the epidemic, communication strategies used to influence risk perception and motivate behavior change are culturally inappropriate, hence the lack of success. The bulk of prevention efforts target the 15-49 age group, resulting in limited knowledge and understanding of HIV/AIDS in adults over age 50 who are considered at a lower or no risk of infection. This paper addresses older adults as a key segment of the population in HIV/AIDS prevention given the increasing number that is living with the disease or newly infected. Many older adults are also caregivers of those infected and affected by the disease. As cultural, social, political, and opinion leaders in rural Kenya, older adults are in a position to influence attitudes and behaviors of their community members, but they have not been involved in the current intervention strategies. Through application of a participatory and culture-centered approach, the study sought views of older adults on the factors contributing to the epidemic in rural Kenya and their opinions on effective prevention strategies that are culturally appropriate. Several recommendations are made for a culture-specific HIV/AIDS prevention intervention for rural Kenya.

  2. Occurrences and toxicological risk assessment of eight heavy metals in agricultural soils from Kenya, Eastern Africa.

    PubMed

    Mungai, Teresiah Muciku; Owino, Anita Awino; Makokha, Victorine Anyango; Gao, Yan; Yan, Xue; Wang, Jun

    2016-09-01

    The concentration distribution and toxicological assessment of eight heavy metals including lead (Pb), cadmium (Cd), copper (Cu), chromium (Cr), nickel (Ni), mercury (Hg), arsenic (As), and zinc (Zn) in agricultural soils from Kenya, Eastern Africa, were investigated in this study. The results showed mean concentrations of eight heavy metals of Zn, Pb, Cr, Cu, As, Ni, Hg, and Cd in agricultural soils as 247.39, 26.87, 59.69, 88.59, 8.93, 12.56, 8.06, and 0.42 mg kg(-1), respectively. These mean values of eight heavy metals were close to the toxicity threshold limit of USEPA standard values of agricultural soils, indicating potential toxicological risk to the food chain. Pollution index values revealed that eight heavy metals severely decreased in the order Hg > Cd > As > Cu > Pb > Zn > Ni > Cr and the mean value of the overall pollution index of Hg and Cd was 20.31, indicating severe agriculture ecological risk. Potential pollution sources of eight heavy metals in agricultural soils were mainly from anthropogenic activities and natural dissolution. The intensification of human agricultural activities, the growing industrialization, and the rapid urbanization largely influenced the concentration levels of heavy metals in Kenya, Eastern Africa. Moreover, the lack of agricultural normalization management and poor enforcement of environmental laws and regulations further intensified the widespread pollution of agricultural soils in Kenya. PMID:27291978

  3. 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

  4. 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.

  5. 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

  6. 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.

  7. Breeding goals for the Kenya dual purpose goat. I. Model development and application to smallholder production systems.

    PubMed

    Bett, R C; Kosgey, I S; Bebe, B O; Kahi, A K

    2007-10-01

    A deterministic model was developed and applied to evaluate biological and economic variables that characterize smallholder production systems utilizing the Kenya Dual Purpose goat (KDPG) in Kenya. The systems were defined as: smallholder low-potential (SLP), smallholder medium-potential (SMP) and smallholder high-potential (SHP). The model was able to predict revenues and costs to the system. Revenues were from sale of milk, surplus yearlings and cull-forage animals, while costs included those incurred for feeds, husbandry, marketing and fixed asset (fixed costs). Of the total outputs, revenue from meat and milk accounted for about 55% and 45%, respectively, in SMP and 39% and 61% in SHP. Total costs comprised mainly variable costs (98%), with husbandry costs being the highest in both SMP and SLP. The total profit per doe per year was KSh 315.48 in SMP, KSh -1352.75 in SLP and KSh -80.22 in SHP. Results suggest that the utilization of the KDPG goat in Kenya is more profitable in the smallholder medium-potential production system. The implication for the application of the model to smallholder production systems in Kenya is discussed. PMID:17969711

  8. Breeding goals for the Kenya dual purpose goat. I. Model development and application to smallholder production systems.

    PubMed

    Bett, R C; Kosgey, I S; Bebe, B O; Kahi, A K

    2007-10-01

    A deterministic model was developed and applied to evaluate biological and economic variables that characterize smallholder production systems utilizing the Kenya Dual Purpose goat (KDPG) in Kenya. The systems were defined as: smallholder low-potential (SLP), smallholder medium-potential (SMP) and smallholder high-potential (SHP). The model was able to predict revenues and costs to the system. Revenues were from sale of milk, surplus yearlings and cull-forage animals, while costs included those incurred for feeds, husbandry, marketing and fixed asset (fixed costs). Of the total outputs, revenue from meat and milk accounted for about 55% and 45%, respectively, in SMP and 39% and 61% in SHP. Total costs comprised mainly variable costs (98%), with husbandry costs being the highest in both SMP and SLP. The total profit per doe per year was KSh 315.48 in SMP, KSh -1352.75 in SLP and KSh -80.22 in SHP. Results suggest that the utilization of the KDPG goat in Kenya is more profitable in the smallholder medium-potential production system. The implication for the application of the model to smallholder production systems in Kenya is discussed.

  9. Changes in Optimal Childcare Practices in Kenya: Insights from the 2003, 2008-9 and 2014 Demographic and Health Surveys

    PubMed Central

    Matanda, Dennis Juma; Urke, Helga Bjørnøy; Mittelmark, Maurice B.

    2016-01-01

    Objective(s) Using nationally representative surveys conducted in Kenya, this study examined optimal health promoting childcare practices in 2003, 2008–9 and 2014. This was undertaken in the context of continuous child health promotion activities conducted by government and non-government organizations throughout Kenya. It was the aim of such activities to increase the prevalence of health promoting childcare practices; to what extent have there been changes in optimal childcare practices in Kenya during the 11-year period under study? Methods Cross-sectional data were obtained from the Kenya Demographic and Health Surveys conducted in 2003, 2008–9 and 2014. Women 15–49 years old with children 0–59 months were interviewed about a range of childcare practices. Logistic regression analysis was used to examine changes in, and correlates of, optimal childcare practices using the 2003, 2008–9 and 2014 data. Samples of 5949, 6079 and 20964 women interviewed in 2003, 2008–9 and 2014 respectively were used in the analysis. Results Between 2003 and 2014, there were increases in all health facility-based childcare practices with major increases observed in seeking medical treatment for diarrhoea and complete child vaccination. Mixed results were observed in home-based care where increases were noted in the use of insecticide treated bed nets, sanitary stool disposal and use of oral rehydration solutions, while decreases were observed in the prevalence of urging more fluid/food during diarrhoea and consumption of a minimum acceptable diet. Logit models showed that area of residence (region), household wealth, maternal education, parity, mother's age, child’s age and pregnancy history were significant determinants of optimal childcare practices across the three surveys. Conclusions The study observed variation in the uptake of the recommended optimal childcare practices in Kenya. National, regional and local child health promotion activities, coupled with changes

  10. Population Genetics of Two Key Mosquito Vectors of Rift Valley Fever Virus Reveals New Insights into the Changing Disease Outbreak Patterns in Kenya

    PubMed Central

    Tchouassi, David P.; Bastos, Armanda D. S.; Sole, Catherine L.; Diallo, Mawlouth; Lutomiah, Joel; Mutisya, James; Mulwa, Francis; Borgemeister, Christian; Sang, Rosemary; Torto, Baldwyn

    2014-01-01

    Rift Valley fever (RVF) outbreaks in Kenya have increased in frequency and range to include northeastern Kenya where viruses are increasingly being isolated from known (Aedes mcintoshi) and newly-associated (Ae. ochraceus) vectors. The factors contributing to these changing outbreak patterns are unclear and the population genetic structure of key vectors and/or specific virus-vector associations, in particular, are under-studied. By conducting mitochondrial and nuclear DNA analyses on >220 Kenyan specimens of Ae. mcintoshi and Ae. ochraceus, we uncovered high levels of vector complexity which may partly explain the disease outbreak pattern. Results indicate that Ae. mcintoshi consists of a species complex with one of the member species being unique to the newly-established RVF outbreak-prone northeastern region of Kenya, whereas Ae. ochraceus is a homogeneous population that appears to be undergoing expansion. Characterization of specimens from a RVF-prone site in Senegal, where Ae. ochraceus is a primary vector, revealed direct genetic links between the two Ae. ochraceus populations from both countries. Our data strongly suggest that unlike Ae. mcintoshi, Ae. ochraceus appears to be a relatively recent, single 'introduction' into Kenya. These results, together with increasing isolations from this vector, indicate that Ae. ochraceus will likely be of greater epidemiological importance in future RVF outbreaks in Kenya. Furthermore, the overall vector complexity calls into question the feasibility of mosquito population control approaches reliant on genetic modification. PMID:25474018

  11. 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

  12. Effect of Providing Conditional Economic Compensation on Uptake of Voluntary Medical Male Circumcision in Kenya

    PubMed Central

    Thirumurthy, Harsha; Masters, Samuel H.; Rao, Samwel; Bronson, Megan A.; Lanham, Michele; Omanga, Eunice; Evens, Emily; Agot, Kawango

    2014-01-01

    IMPORTANCE Novel strategies are needed to increase the uptake of voluntary medical male circumcision (VMMC) in sub-Saharan Africa and enhance the effectiveness of male circumcision as an HIV prevention strategy. OBJECTIVE To determine whether small economic incentives could increase circumcision prevalence by addressing reported economic barriers to VMMC and behavioral factors such as present-biased decision making. DESIGN, SETTING, AND PARTICIPANTS Randomized clinical trial conducted between June 22, 2013, and February 4, 2014, among 1504 uncircumcised men aged 25 to 49 years in Nyanza region, Kenya. VMMC services were provided free of charge and participants were randomized to 1 of 3 intervention groups or a control group. INTERVENTIONS Participants in the 3 intervention groups received varying amounts of compensation conditional on undergoing circumcision at 1 of 9 study clinics within 2 months of enrollment. Compensation took the form of food vouchers worth 200 Kenya shillings (≈US $2.50), 700 Kenya shillings (≈US $8.75), or 1200 Kenya shillings (≈US $15.00), which reflected a portion of transportation costs and lost wages associated with getting circumcised. The control group received no compensation. MAIN OUTCOMES AND MEASURES VMMC uptake within 2 months. RESULTS Analysis of data for 1502 participants with complete data showed that VMMC uptake within 2 months was higher in the US $8.75 group (6.6%; 95% CI, 4.3%–9.5% [25 of 381]) and the US $15.00 group (9.0%; 95% CI, 6.3%–12.4% [34 of 377]) than in the US $2.50 group (1.9%; 95% CI, 0.8%–3.8% [7 of 374]) and the control group (1.6%; 95% CI, 0.6%–3.5% [6 of 370]). In logistic regression analysis, the US $8.75 group had significantly higher VMMC uptake than the control group (adjusted odds ratio [AOR] 4.3; 95% CI, 1.7–10.7), as did the US $15.00 group (AOR 6.2; 95% CI, 2.6–15.0). Effect sizes for the US $8.75 and US $15.00 groups did not differ significantly (P = .20). CONCLUSIONS AND RELEVANCE

  13. Dry spell trend analysis in Kenya and the Murray Darling Basin using daily rainfall

    NASA Astrophysics Data System (ADS)

    Muita, R. R.; van Ogtrop, F. F.; Vervoort, R. W.

    2012-04-01

    Important agricultural areas in Kenya and the Murray Darling Basin (MDB) in Australia are largely semi-arid to arid. Persistent dry periods and timing of dry spells directly impact the availability of soil moisture and hence crop production in these regions. Most studies focus on the analysis of dry spell lengths at an annual scale. However, timing and length of dry spells at finer temporal scales is more beneficial for cropping when considering a trade-off between the time scale and the ability to analyse dry spell length. The aim of this study was to analyse the interannual and intra annual variations in dry spell lengths in the regions to inform crop management. This study analysed monthly dry spells based on daily rainfall for 1961-2010 on a limited dataset of 13 locations in Kenya and 17 locations in the MDB. This dataset was the most consistent across both regions and future analysis will incorporate more stations and longer time periods where available. Dry spell lengths were analysed by month and year and trends in monthly and annual dry spell lengths were analysed using Generalised Linear Models (GLM) and the Mann Kendall test (MK). Overall, monthly dryspell lengths are right skewed with higher frequency of shorter dryspells (3-25 days). In Kenya, significant increases in mean dry spell lengths (p≤0.02) are observed in inland arid-to semi humid locations but this temporal trend appears to decrease in highland and the coastal regions. Analysis of the MDB stations suggests changes in seasonality. For example, spatial trends suggest a North-South increase in dry spell length in summer (December - February), but a shortening after February. Generally, the GLM and MK results are similar in the two regions but the MK test tends to give higher values of positive slope coefficients and lower values for negative coefficients compared to GLM. This may limit the ability of finding the best estimates for model coefficients. Previous studies in Australia and Kenya

  14. The circular migration of smallholders in Kenya.

    PubMed

    Bigsten, A

    1996-01-01

    Circular migration is a central phenomenon in the lives of smallholders in East Africa. Many migration decisions are not individual decisions, but rather household decisions in which the household allocates its labor force among activities to maximize household utility. A probit model which incorporates circular migration and takes into account contacts, information, and indivisibilities is used to analyze migration among 763 farm households in the Central and Nyanza provinces of Kenya. Study data are from a 1982 survey. The pull of high urban wages appears to be a far more important determinant of migration decision outcomes than the push of land scarcity, while a strong local nonagricultural economy does not seem to restrict migration. Networks of personal contacts were found to be highly significant determinants of migration. These findings suggest that rural development will probably not reduce the flow of migration.

  15. 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.

  16. The eradication of Simulium neavei from Kenya

    PubMed Central

    McMahon, J. P.; Highton, R. B.; Goiny, H.

    1958-01-01

    S. neavei, the vector of onchocerciasis, has been virtually eradicated from Kenya by larviciding measures in which DDT was used. Only a very small area remains infested and this is in the course of being treated by the Uganda medical authorities as it is part of a much larger focus occurring in that country. An account is given of the various surveys which have been carried out during the last ten years in Nyanza Province, involving 15 000 square miles (about 40 000 km2), and survey techniques are described. An account is given of the eradication measures carried out in North and South Nyanza, and techniques in connexion with dosing and checking operations are described. Costs for both surveys and eradication schemes are given, and minimum requirements for transport are indicated. PMID:13585062

  17. Establishing a One Health office in Kenya

    PubMed Central

    Mbabu, Murithi; Njeru, Ian; File, Sarah; Osoro, Eric; Kiambi, Stella; Bitek, Austine; Ithondeka, Peter; Kairu-Wanyoike, Salome; Sharif, Shanaaz; Gogstad, Eric; Gakuya, Francis; Sandhaus, Kaitlin; Munyua, Peninah; Montgomery, Joel; Breiman, Robert; Rubin, Carol; Njenga, Kariuki

    2014-01-01

    A One Health (OH) approach that integrates human,animal and environmental approaches to management of zoonotic diseases has gained momentum in the last decadeas part of a strategy to prevent and control emerging infectious diseases. However, there are few examples of howan OH approach can be established in a country. Kenya establishment of an OH office, referred to asthe Zoonotic Disease Unit (ZDU) in 2011. The ZDU bridges theanimal and human health sectors with a senior epidemiologist deployed from each ministry; and agoal of maintaining collaboration at the animal and human health interface towards better prevention and control of zoonoses. The country is adding an ecologist to the ZDU to ensure that environmental risks are adequately addressed in emerging disease control. PMID:25722779

  18. 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

  19. 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

  20. 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.

  1. 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.

  2. 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

  3. 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…

  4. 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…

  5. 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

  6. 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

  7. 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.

  8. Community context and the prevalence of premarital sex among young women in Kenya and the Philippines: trends and differences from 1993 to 2003.

    PubMed

    Chiao, Chi

    2010-05-01

    This study examines trends and differences in premarital sex prevalence from 1993 to 2003 among young women aged 15-24 in Kenya and the Philippines in relation to household and community membership. Using population-based Demographic and Health Surveys from these two countries, multilevel logistic models were used to estimate the relationships between premarital sex, community-level factors, and individual/household backgrounds. The results show a significant decline in premarital sex prevalence in Kenya but a significant increase in this in the Philippines, although, overall, premarital sex is more prevalent in Kenya than in the Philippines. Multilevel analyses further found dramatic differences in premarital sex risks across household and community membership and countries. The large difference in premarital sex risks across these countries suggests that policies aimed at promoting reproductive and sexual health among young women should be context specific. PMID:20089439

  9. 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

  10. Aflatoxins and kwashiorkor in Kenya: a hospital based study in a rural area of Kenya.

    PubMed

    de Vries, H R; Lamplugh, S M; Hendrickse, R G

    1987-12-01

    Aflatoxin analyses were undertaken on sera and urines of 41 children admitted to a rural hospital in Kenya with kwashiorkor, marasmus, marasmic kwashiorkor or normal nutrition (Wellcome Classification). Aflatoxins were detected most frequently and at highest concentrations in the sera of kwashiorkors who, conversely, showed aflatoxins least frequently in their urine and in concentrations that were disproportionately low compared with serum/urine aflatoxin levels in other groups. These findings indicate altered aflatoxin metabolism in kwashiorkor and support the hypothesis that there are special relationships between aflatoxins and kwashiorkor.

  11. 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

  12. The Nairobi Report: Frameworks for Africa-UK Research Collaboration in the Social Sciences and Humanities

    ERIC Educational Resources Information Center

    Harle, Jonathan

    2009-01-01

    Across Sub-Saharan Africa it is evident that humanities and social sciences research is in urgent need of support. Universities and researchers face many challenges, the results of declining funding in the face of huge increases in enrollments. Infrastructure and facilities are insufficient and incomes have fallen. Many academics have been forced…

  13. 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.

  14. 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

  15. Investigating the association between HIV/AIDS and recent fertility patterns in Kenya.

    PubMed

    Magadi, Monica Akinyi; Agwanda, Alfred O

    2010-07-01

    Findings from previous studies linking the HIV/AIDS epidemic and fertility of populations have remained inconclusive. In sub-Saharan Africa, demographic patterns point to the epidemic resulting in fertility reduction. However, evidence from the 2003 Kenya Demographic and Health Survey (KDHS) has revealed interesting patterns, with regions most adversely affected with HIV/AIDS showing the clearest reversal trend in fertility decline. While there is suggestive evidence that fertility behaviour in some parts of sub-Saharan Africa has changed in relation to the HIV/AIDS epidemic, more rigorous empirical analysis is necessary to better understand this relationship. In this paper, we examine individual and contextual community HIV/AIDS factors associated with fertility patterns in Kenya, paying particular attention to possible mechanisms of the association. Multilevel models are applied to the 2003 KDHS, introducing various proximate fertility determinants in successive stages, to explore possible mechanisms through which HIV/AIDS may be associated with fertility. The results corroborate findings from earlier studies of the fertility inhibiting effect of HIV among infected women. HIV-infected women have 40 percent lower odds of having had a recent birth than their uninfected counterparts of similar background characteristics. Further analysis suggests an association between HIV/AIDS and fertility that exists through proximate fertility determinants relating to sexual exposure, breastfeeding duration, and foetal loss. While HIV/AIDS may have contributed to reduced fertility, mainly through reduced sexual exposure, there is evidence that it has contributed to increased fertility, through reduced breastfeeding and increased desire for more children resulting from increased infant/child mortality (i.e. a replacement phenomenon). In communities at advanced stages of the HIV/AIDS epidemic, it is possible that infant/child mortality has reached appreciably high levels where the

  16. 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

  17. 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.

  18. 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

  19. Snake bites in Kenya: a preliminary survey of four areas.

    PubMed

    Coombs, M D; Dunachie, S J; Brooker, S; Haynes, J; Church, J; Warrell, D A

    1997-01-01

    Primary data were collected on the incidence, severity and species responsible for snake bites in 4 areas of Kenya: (i) Kakamega and western Kenya, (ii) Lake Baringo and Laikipia, (iii) Kilifi and Malindi, and (iv) northern Kenya. The overall average frequency of snake bite was 13.8 per 100,000 population per year (range 1.9-67.9). The minimum rate of snake bite mortality was 0.45/100,000/year. Thirty-four of the 50 units visited reported no knowledge of death from snake bite in the last 5 years. Possible reasons for the low estimates are discussed. Traditional treatments were common, especially the use of herbal remedies and incisions at the wound site.

  20. Serologic evidence of arboviral infections among humans in Kenya.

    PubMed

    Sutherland, Laura J; Cash, Ayla A; Huang, Yan-Jang Scott; Sang, Rosemary C; Malhotra, Indu; Moormann, Ann M; King, Christopher L; Weaver, Scott C; King, Charles H; LaBeaud, A Desiree

    2011-07-01

    Outbreaks of arthropod-borne viral infections occur periodically across Kenya. However, limited surveillance takes place during interepidemic periods. Using serum samples obtained from asymptomatic persons across Kenya in 2000-2004, we assessed (by indirect immunofluorescent assay) prevalence of IgG against yellow fever virus (YFV), West Nile virus (WNV), tick-borne encephalitis virus (TBEV), dengue virus serotypes 1-4 (DENV1-4), and chikungunya virus (CHIKV). Older persons on the Indian Ocean coast were more likely to be seropositive than children inland: YFV = 42% versus 6%, WNV = 29% versus 6%, TBEV = 16% versus 6%, DENV-1 = 63% versus 9%, DENV-2 = 67% versus 7%, DENV-3 = 55% versus 6%, DENV-4 = 44% versus 8%, and CHIKV = 37% versus 20%. Among inland samples, children in lowlands were more likely to be seropositive for CHIKV (42% versus 0%) than children in highlands. In Kenya, transmission of arboviral infection continues between known epidemics and remains common across the country.

  1. 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.

  2. 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.

  3. 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

  4. The petrology of the Chyulu Hills Volcanic Province, southern Kenya

    NASA Astrophysics Data System (ADS)

    Späth, A.; Le Roex, A. P.; Opiyo-Akech, N.

    2000-08-01

    The Quaternary Chyulu Hills Volcanic Province is located more than 100 km east of the Kenya Rift Valley. It consists of a large number of free-standing and coalesced volcanoes and cinder cones and numerous lava flows ranging in composition from nepheline-normative nephelinites, basanites, alkali basalts and hawaiites to orthopyroxene-normative subalkali basalts. In this paper, the authors briefly outline the geological setting of the Chyulu Hills Volcanic Province, present a classification scheme for its lavas and describe their petrography. Mineral chemistry data for selected olivine and clinopyroxene phenocrysts are presented together with the bulk rock major element compositions of selected samples. The petrography, phenocryst chemistry and bulk rock composition of the typically primitive Chyulu Hills lavas are consistent with a differentiation history dominated by olivine control. A process of delayed olivine fractionation, combined with limited mantle olivine accumulation, is proposed to explain the considerable compositional variability observed among olivine phenocryst cores. A trend of decreasing degree of silica-undersaturation from the oldest lavas, erupted in the northern Chyulu Hills, to progressively younger lavas in the southern part of the province is explained as a result of an age progressive decrease in the depth of melt generation and a coincident increase in the degree of melting.

  5. Premature mortality in active convulsive epilepsy in rural Kenya

    PubMed Central

    Bottomley, Christian; Fegan, Gregory; Chengo, Eddie; Odhiambo, Rachael; Bauni, Evasius; Neville, Brian; Kleinschmidt, Immo; Sander, Josemir W.; Newton, Charles R.

    2014-01-01

    Objective: We estimated premature mortality and identified causes of death and associated factors in people with active convulsive epilepsy (ACE) in rural Kenya. Methods: In this prospective population-based study, people with ACE were identified in a cross-sectional survey and followed up regularly for 3 years, during which information on deaths and associated factors was collected. We used a validated verbal autopsy tool to establish putative causes of death. Age-specific rate ratios and standardized mortality ratios were estimated. Poisson regression was used to identify mortality risk factors. Results: There were 61 deaths among 754 people with ACE, yielding a rate of 33.3/1,000 persons/year. Overall standardized mortality ratio was 6.5. Mortality was higher across all ACE age groups. Nonadherence to antiepileptic drugs (adjusted rate ratio [aRR] 3.37), cognitive impairment (aRR 4.55), and age (50+ years) (rate ratio 4.56) were risk factors for premature mortality. Most deaths (56%) were directly related to epilepsy, with prolonged seizures/possible status epilepticus (38%) most frequently associated with death; some of these may have been due to sudden unexpected death in epilepsy (SUDEP). Possible SUDEP was the likely cause in another 7%. Conclusion: Mortality in people with ACE was more than 6-fold greater than expected. This may be reduced by improving treatment adherence and prompt management of prolonged seizures and supporting those with cognitive impairment. PMID:24443454

  6. 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.

  7. 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

  8. 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

  9. 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…

  10. 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.

  11. 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

  12. 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

  13. Caldera-structure relationships in Kenya - Observations from satellite data

    NASA Technical Reports Server (NTRS)

    Blodget, Herbert W.

    1991-01-01

    Maps were constructed showing lineaments displayed on four Landsat MSS images, to study volcanic-tectonic relationships in the Kenya segment of the Gregory or eastern sector of the East African rift system. Many of the mapped lineaments correlated well with fractures shown on geological maps. Selected lineaments, transverse to the rift trend, could be extrapolated to intersect rift faults at locations correlative with the locations of Kenya's seven volcanic calderas. The volcano-genetic difference between these intersections vs. similar intersections having no obvious relationship to any type of volcanic vent is not yet understood.

  14. 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

  15. Opaline cherts associated with sublacustrine hydrothermal springs at Lake Bogoria, Kenya Rift valley

    SciTech Connect

    Renaut, R.W.; Owen, R.B.

    1988-08-01

    An unusual group of cherts found at saline, alkaline Lake Bogoria in the Kenya Rift differs from the Magadi-type cherts commonly associated with saline, alkaline lakes. The cherts are opaline, rich in diatoms, and formed from a siliceous, probably gelatinous, precursor that precipitated around submerged alkaline hot springs during a Holocene phase of high lake level. Silica precipitation resulted from rapid drop in the temperature of the spring waters and, possibly, pH. Lithification began before subaerial exposure. Ancient analogous cherts are likely to be localized deposits along fault lines.

  16. 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

  17. 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…

  18. 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…

  19. 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

  20. Evidence of injection drug use in Kisumu, Kenya: Implications for HIV prevention

    PubMed Central

    Agot, Kawango; Ohaga, Spala; Strathdee, Steffanie A.; Camlin, Carol S.; Omanga, Eunice; Odonde, Petronilla; Rota, Grace; Akoth, Kelvin; Peng, Juan; Wagner, Karla D.

    2015-01-01

    Background Injection drug use is increasingly contributing to the HIV epidemic across sub-Saharan Africa. This paper provides the first descriptive analysis of injection drug use in western Kenya, where HIV prevalence is already highest in the nation at 15.1%. Methods We draw on quantitative data from a study of injection drug use in Kisumu, Kenya. We generated descriptive statistics on socio-demographics, sexual characteristics, and drug-related behaviors. Logistic regression models were adjusted for sex to identify correlates of self-reported HIV positive status. Results Of 151 participants, mean age was 28.8 years, 84% (n=127) were male, and overall self-reported HIV prevalence reached 19.4%. Women had greater than four times the odds of being HIV positive relative to men (Odds Ratio [OR] 4.5, CI: 1.7, 11.8, p=.003). Controlling for sex, ever experiencing STI symptoms (Adjusted Odds ratio [AOR] 4.6, 95% CI 1.7, 12.0, p=.002) and sharing needles or syringes due to lack of access (AOR 3.6, 95% CI 1.2, 10.5, p=.02) were significantly associated with HIV positive status. Lower education (AOR 2.3, 95% CI 0.9, 5.6, p=.08), trading sex for drugs (AOR 2.8, 95% CI 0.9, 8.8, p=.08), being injected by a peddler (AOR 2.9, 95% CI 1.0, 8.5, p=.05), and injecting heroin (AOR 2.3, 95% CI 1.0, 5.7, p=.06), were marginally associated with HIV. Conclusions This exploratory study identified patterns of unsafe drug injection and concurrent sexual risk in western Kenya, yet few resources are currently available to address addiction or injection-related harm. Expanded research, surveillance, and gender sensitive programming are needed. PMID:25861945

  1. 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

  2. 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

  3. 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

  4. 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.

  5. 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…

  6. 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…

  7. 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,…

  8. 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…

  9. 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…

  10. 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…

  11. 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.…

  12. 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…

  13. 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…

  14. Wood, energy and households: Perspectives on rural Kenya

    SciTech Connect

    Barnes, C.; Ensminger, J.; O'Keefe, P.

    1984-01-01

    This book presents papers on the use of wood fuels in Kenya. Topics considered include domestic energy consumption, historical aspects, the Kenyan economy, ecology, supply and demand, forests, aspects of energy consumption in a pastoral ecosystem, estimation of present and future demand for wood fuels, and energy source development.

  15. 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).…

  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. 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)…

  18. 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…

  19. 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…

  20. School Leadership Challenges along Kenya's Borabu-Sotik Border

    ERIC Educational Resources Information Center

    Abaya, Joel

    2016-01-01

    This article is based on a qualitative multi-case study carried out in southwestern Kenya along the border areas of Nyanza and Rift Valley province. The purpose of the research was to examine the challenges public secondary school principals faced in their leadership roles and suggest efforts they might adopt to minimize the effects of these…

  1. 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…

  2. 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…

  3. Mycobacteriosis in the lesser flamingos of Lake Nakuru, Kenya.

    PubMed

    Sileo, L; Grootenhuis, J G; Tuite, C H; Hopcraft, J B

    1979-07-01

    In 1974, 51 debilitated lesser flamingos (Phoeniconaias minor) were easily captured at Lake Nakuru, Kenya. Nineteen (37%) of these had extensive mycobacterial lesions. Two years later it was difficult to locate any debilitated flamingos and no evidence of mycobacterial infection was found. Possible reasons for the high prevalence of mycobacteriosis in the 1974 collection are discussed.

  4. 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…

  5. 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.…

  6. 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…

  7. 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.

  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. 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.…

  10. "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…

  11. 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

  12. 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…

  13. 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…

  14. 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.…

  15. 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

  16. 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

  17. Devising Strategies for the Effective Education of Adults in the Developing Countries. Proceedings of the World Confederation of Organizations of the Teaching Profession Seminar on Adult Education (8th, Nairobi, Kenya, August 6, 1973).

    ERIC Educational Resources Information Center

    1973

    Proceedings presented are from a specialized seminar on adult education held in conjunction with the 22nd Assembly of the World Confederation of Organizations of the Teaching Profession (WCOTP). Statements from three countries are presented relating the seminar theme, "Devising Strategies for the Effective Education of Adults in the Developing…

  18. 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,…

  19. Speaking out for youth: Kenya's experience. Advocacy for reproductive health: Kenya.

    PubMed

    Karueru, J

    1996-01-01

    The Family Planning Association of Kenya (FPAK) and the Catholic Church agree on the problems of reproductive health among young people but disagree on the means of solving them. These problems lead to an increasing school dropout rate, unwanted pregnancies, increased incidence of sexually transmitted diseases, drug abuse, and the breakdown of the family. In 1992 a nationwide information, education, and communication (IEC) survey undertaken by FPAK found a hostile environment against youth reproductive health programs. In response to this finding the government launched a countrywide intervention called the Kenya Youth Initiatives Project. After convincing the staff and volunteers about the necessity of this drive FPAK adopted a youth policy: to provide reproductive health information and counseling to young people aged 10-24 whether sexually active or not and to support the introduction of family life education courses in schools. A review of legislative policy analysis also showed that the country lacked a national youth policy; discrepancies existed in laws governing social and medical issues affecting youth; and the law was fuzzy on the definition of the child and youth. Most opinions leaders supported the provision of information and services to youth, therefore a leader's advocacy strategic pack was developed containing IEC materials on teenage pregnancy, AIDS, STDs, and abortion. Involving young people in this effort entailed the recruitment, training, and deployment of 39 district youth advocates whose advocacy training lasted 6 weeks. They were deployed to give presentations on sexuality and reproductive health and to distribute booklets. In 1995 the National Council for Population and Development conducted five regional population conferences where youth reproductive health was the main topic. The same year a workshop on family life education and reproductive health invited government and church leaders. The targeting of religious leaders and of the mass

  20. 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

  1. Comparing bleaching and mortality responses of hard corals between southern Kenya and the Great Barrier Reef, Australia.

    PubMed

    McClanahan, T R; Baird, A H; Marshall, P A; Toscano, M A

    2004-02-01

    We compared the bleaching and mortality response (BMI) of 19 common scleractinian corals to an anomalous warm-water event in 1998 to determine the degree of variation between depths, sites, and regions. Mombasa corals experienced a greater temperature anomaly than those on the Great Barrier Reef (GBR) sites and this was reflected in the greater BMI response of most taxa. Comparing coral taxa in different sites at the same depth produced high correlation coefficients in the bleaching response in Kenya at 2 m (r=0.86) and GBR at 6 m depth sites (r=0.80) but less in the GBR for shallow 2 m sites (r=0.49). The pattern of taxa susceptibility was remarkably consistent between the regions. Coral taxa explained 52% of the variation in the response of colonies to bleaching between these two regions (Kenya BMI=0.90 GBR BMI+26; F(1,19) - 18.3; p < 0.001; r2 = 0.52). Stylophora and Pocillopora were consistently susceptible while Cyphastrea, Goniopora Galaxea and Pavona were resistant in both regions. Three taxa behaved differently between the two regions; Acropora, and branching Porites were both moderately affected on the GBR but were highly affected in Kenya while the opposite was true for Pavona. These results suggest that a colonies response to bleaching is phylogenetically constrained, emphasizing the importance of features of the host's physiology or morphology in determining the response to thermal stress.

  2. Detection of avian influenza viruses in wild waterbirds in the Rift Valley of Kenya using fecal sampling.

    PubMed

    Ofula, Victor O; Franklin, Alan B; Root, J Jeffrey; Sullivan, Heather J; Gichuki, Patrick; Makio, Albina; Bulimo, Wallace; Abong'o, Bernard O; Muchai, Muchane; Schnabel, David

    2013-06-01

    Highly pathogenic avian influenza virus A/H5N1 has been reported in 11 African countries. Migratory waterbirds have the potential of introducing A/H5N1 into east Africa through the Rift Valley of Kenya. We present the results of a wild bird surveillance system for A/H5N1 and other avian influenza viruses based on avian fecal sampling in Kenya. We collected 2630 fecal samples in 2008. Viral RNA was extracted from pools of 3-5 fecal samples and analyzed for presence of avian influenza virus RNA by real-time RT-PCR. Twelve (2.3%) of the 516 sample pools were positive for avian influenza virus RNA, 2 of which were subtyped as H4N6 viruses. This is the first report of avian influenza virus in wild birds in Kenya. This study demonstrates the success of this approach in detecting avian influenza virus in wild birds and represents an efficient surveillance system for avian influenza virus in regions with limited resources.

  3. 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

  4. Environmental security: a geographic information system analysis approach--the case of Kenya.

    PubMed

    Bocchi, Stefano; Disperati, Stefano Peppino; Rossi, Simone

    2006-02-01

    Studies into the relationships between environmental factors and violence or conflicts constitute a very debated research field called environmental security. Several authors think that environmental scarcity, which is scarcity of renewable resources, can contribute to generate violence or social unrest, particularly within states scarcely endowed with technical know-how and social structures, such as developing countries. In this work, we referred to the theoretical model developed by the Environmental Change and Acute Conflict Project. Our goal was to use easily available spatial databases to map the various sources of environmental scarcity through geographic information systems, in order to locate the areas apparently most at risk of suffering negative social effects and their consequences in terms of internal security. The analysis was carried out at a subnational level and applied to the case of Kenya. A first phase of the work included a careful selection of databases relative to renewable resources. Spatial operations among these data allowed us to obtain new information on the availability of renewable resources (cropland, forests, water), on the present and foreseen demographic pressure, as well as on the social and technical ingenuity. The results made it possible to identify areas suffering from scarcity of one or more renewable resources, indicating different levels of gravity. Accounts from Kenya seem to confirm our results, reporting clashes between tribal groups over the access to scarce resources in areas that our work showed to be at high risk. PMID:16391969

  5. Utilization rates and perceptions of (VCT) services in Kisii Central District, Kenya.

    PubMed

    Epule, Epule Terence; Mirielle, Moto Wase; Peng, Changhui; Nguh, Balgah Sounders; Nyagero, Josephat M; Lakati, Alice; Mafany, Ndiva Mongoh

    2012-11-01

    Voluntary counseling and testing (VCT) services have been set up in most Districts in Kenya due to the rising surge of HIV/AIDS. However, the use of these services among married persons has not been fully explored. In Kissi, the issue of VCT is pressing as the rate of HIV prevalence is close to 3%. In 2006, about 20 000 clients came for VCT services in Kenya yet only 165 of these were married persons. In the Keumbu sub-district hospital, of the more than 1000 clients that came for VCT services, approximately 29% were married persons. This paper therefore aims at determining the utilization of VCT services by married persons in the study area. The qualitative data was obtained principally through two focus group discussions (FGDs) in which the respondents were asked to comment on their use of VCT services while the quantitative data was obtained from interviews with 245 respondents. The qualitative data was analyzed through verbatim transcription while for the quantitative data; the responses were coded and populated into SPSS from which the frequencies and percentages were calculated. The results show that actual use of the VCT services is low (28.1%) but slightly higher among female respondents than males. The low usage may be attributed to (a) fear of results, (b) death anxiety, (c) lack of confidentiality and lastly, (d) fear of stigmatization. Female respondents were found to have a greater awareness of VCT and thus its potential use.

  6. Economic evaluation in primary health care: the case of Western Kenya community based health care project.

    PubMed

    Wang'ombe, J K

    1984-01-01

    This paper describes the methodology and presents preliminary results of an economic appraisal of a community based health care project in Kenya. Community health workers, trained for 12 weeks and deployed in two locations in Kenya's Western Province, act as first contact providers of basic health care and promoters of selected health, sanitation and nutrition practices. A Cost Benefit Analysis has been undertaken using the Willingness to Pay approach to compare the costs of the project and its benefits. The benefits are in the form of more easily accessible basic health care and are measured as consumer surplus accruing to the community. Gain in consumer surplus is consequent on the fall of average user costs and rise in utilisation of the project established points of first contact with primary health care. The argument for the economic viability of the project is validated by the large Net Present Value and Benefit Cost Ratio obtained for the whole of the project area and for the two locations separately. Although the evaluation technique used faces the problem of valuation of community time, aggregation of health care services at all points of first contact and the partial nature of cost benefit analysis evaluations, the results are strongly in favour of decentralisation of primary health care on similar lines in the rest of the country. PMID:6427933

  7. A qualitative exploration of the human resource policy implications of voluntary counselling and testing scale-up in Kenya: applying a model for policy analysis

    PubMed Central

    2011-01-01

    Background Kenya experienced rapid scale up of HIV testing and counselling services in government health services from 2001. We set out to examine the human resource policy implications of scaling up HIV testing and counselling in Kenya and to analyse the resultant policy against a recognised theoretical framework of health policy reform (policy analysis triangle). Methods Qualitative methods were used to gain in-depth insights from policy makers who shaped scale up. This included 22 in-depth interviews with Voluntary Counselling and Testing (VCT) task force members, critical analysis of 53 sets of minutes and diary notes. We explore points of consensus and conflict amongst policymakers in Kenya and analyse this content to assess who favoured and resisted new policies, how scale up was achieved and the importance of the local context in which scale up occurred. Results The scale up of VCT in Kenya had a number of human resource policy implications resulting from the introduction of lay counsellors and their authorisation to conduct rapid HIV testing using newly introduced rapid testing technologies. Our findings indicate that three key groups of actors were critical: laboratory professionals, counselling associations and the Ministry of Health. Strategic alliances between donors, NGOs and these three key groups underpinned the process. The process of reaching consensus required compromise and time commitment but was critical to a unified nationwide approach. Policies around quality assurance were integral in ensuring standardisation of content and approach. Conclusion The introduction and scale up of new health service initiatives such as HIV voluntary counselling and testing necessitates changes to existing health systems and modification of entrenched interests around professional counselling and laboratory testing. Our methodological approach enabled exploration of complexities of scale up of HIV testing and counselling in Kenya. We argue that a better

  8. 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.

  9. Prevalence of intestinal parasites among HIV patients in Baringo, Kenya

    PubMed Central

    Kipyegen, Cornelius Kibet; Shivairo, Robert Shavulimo; Odhiambo, Rose Ogwang

    2012-01-01

    Introduction HIV patients have reduced immune response which makes them more susceptible to different infections. This cross-sectional study was carried out to document the prevalence of intestinal parasites among HIV patients in Baringo County, Kenya. Methods Structured questionnaires were used to collect clinical information after obtaining consent from the participants. Stool samples were collected from 285 respondents for intestinal parasitic examination using direct and formol-ether concentration to detect ova and cysts. Chi-square (X2) statistical analysis was used to test level of significance at P = 0.05 using SPSS. Results A prevalence of 50.9% of intestinal parasites was recorded. Majority of the parasitic infections were waterborne protozoa with few helminthes. There was an association (P < 0.05) between intestinal parasitic infection and place of residence, agro-ecological location, family size, water source, treatment and reliability and diarrheal status. There was no association (P > 0.05) between age groups and gender with parasitic infection. Parasites identified were Entamoeba histolytica/dispar (58.3%), Giardia lamblia (16.6%), Ascaris lumbricoides (8.6%), Entamoeba coli (5.9%), Taenia saginata (5.3%), Trichuris trichuria (1.9%), Enterobius vermicularis (1.9%) and hookworm (1.3%). Conclusion There was high prevalence of intestinal parasites, therefore, health education to HIV patients and community health workers on the importance of good environmental sanitation and personal hygiene could curb water, food and individual contamination promoting good management and care of HIV patients, hence improving their health status. PMID:23330028

  10. 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

  11. Seismic monitoring of the Olkaria Geothermal area, Kenya Rift valley

    NASA Astrophysics Data System (ADS)

    Simiyu, Silas M.; Keller, G. Randy

    2000-01-01

    Seismic monitoring of the Olkaria Geothermal area in the southern Rift Valley region of Kenya has been carried out since 1985. The initial purpose of this effort was to determine the background level of seismicity before full exploitation of the geothermal resource was started. This monitoring began with one seismic station. However, since May 1996, a seismic network comprising six stations was operated and focused mainly on the East Production Field. During the 5 months of network recording up to mid-September 1996, more than 460 local events originating within the Olkaria Geothermal area ( Ts- Tp<5 s) were recorded, out of which 123 were well-located. Also, 62 events were recorded at regional distances (5 s< Ts- Tp<40 s), and 44 events at teleseismic distance ( Ts- Tp>40 s). During this period, the local microseismicity was found to be continuous with swarms occurring every 4-5 days. Duration magnitudes based on the coda length did not exceed 3.0. Preliminary spectral analysis shows three kinds of seismic signals, with only the first type displaying well-defined P- and S-phases. The seismicity is mainly concentrated in the central area of the recording network, and the linear alignments in the epicenters are striking. A prominent alignment occurs along the Ololbutot fault zone extending from the northern end of the greater Olkaria volcanic complex to the south near the southern terminus of Hell's gorge. Two other prominent alignments occur along NW-SE trends that coincide with fault zones which have been detected by geological and gravity studies. Consequently, they are interpreted to be associated with fluid movement in the geothermal field. These preliminary results suggest that seismic monitoring will be useful to both monitor the field during production and to help site additional wells.

  12. The Spectrum of Paediatric Intestinal Obstruction in Kenya

    PubMed Central

    Ooko, Philip Blasto; Wambua, Patricia; Oloo, Mark; Odera, Agneta; Topazian, Hillary Mariko; White, Russell

    2016-01-01

    Introduction Intestinal obstruction (IO) occurs when there is impedance to the flow of intestinal contents due to a congenital or acquired pathology, and is a common paediatric surgical emergency. This study aimed to assess the pattern and outcome of paediatric IO in western Kenya. Methods A retrospective review of all recorded cases of mechanical IO in patients aged 15 years or below admitted at Tenwek Hospital between January 2009 and December 2013. Results The cohort included a total of 217 children (130 boys and 87 girls). The mean age was 6.7 years (range: newborn-15 years), with most (65, 30%) cases aged 1-3 years. Vomiting (161, 74.2%), abdominal pain (152, 70%), abdominal tenderness (113, 52.1%), constipation (111, 51.2%), and abdominal distension (104, 47.9%) were the predominant signs and symptoms. The most common causes of IO were ascariasis (96, 44.2%), adhesions (34, 15.7%), and intussusception (30, 13.8%). Intussusception was the leading cause of IO in children aged ≤ 1 year, ascariasis in children aged 1-5 and 6-10 years, and adhesions in children aged 11-15 years. Operative management was undertaken in 120 (55.3%) cases with 39 (32.5%) of these having gangrenous bowel. The overall mortality rate was 5%. Conclusion The most common causes of mechanical bowel obstruction in this series were ascariasis, adhesions, and intussusception. Ascariasis remains a significant cause of paediatric IO in this region, thus public education, improved sanitation and deworming campaigns may be helpful in reducing the worm burden. PMID:27642384

  13. 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

  14. Grappling with the issue of homosexuality: perceptions, attitudes, and beliefs among high school students in Kenya.

    PubMed

    Mucherah, Winnie; Owino, Elizabeth; McCoy, Kaleigh

    2016-01-01

    While the past decade has seen an improvement in attitudes toward homosexuality, negative attitudes are still prevalent in many parts of the world. In general, increased levels of education tend to be predictive of relatively positive attitudes toward homosexuality. However, in most sub-Saharan countries, it is still believed that people are born heterosexual and that nonheterosexuals are social deviants who should be prosecuted. One such country is Kenya, where homosexuality is illegal and attracts a fine or jail term. The purpose of this study was to examine high school students' perceptions of homosexuality in Kenya. The participants included 1,250 high school students who completed a questionnaire on perceptions of homosexuality. The results showed that 41% claimed homosexuality is practiced in schools and 61% believed homosexuality is practiced mostly in single-sex boarding schools. Consistently, 52% believed sexual starvation to be the main cause of homosexuality. Also, 95% believed homosexuality is abnormal, 60% believed students who engage in homosexuality will not change to heterosexuality after school, 64% believed prayers can stop homosexuality, and 86% believed counseling can change students' sexual orientation. The consequences for homosexuality included punishment (66%), suspension from school (61%), and expulsion from school (49%). Significant gender and grade differences were found. The implications of the study findings are discussed.

  15. 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

  16. 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.

  17. Grappling with the issue of homosexuality: perceptions, attitudes, and beliefs among high school students in Kenya.

    PubMed

    Mucherah, Winnie; Owino, Elizabeth; McCoy, Kaleigh

    2016-01-01

    While the past decade has seen an improvement in attitudes toward homosexuality, negative attitudes are still prevalent in many parts of the world. In general, increased levels of education tend to be predictive of relatively positive attitudes toward homosexuality. However, in most sub-Saharan countries, it is still believed that people are born heterosexual and that nonheterosexuals are social deviants who should be prosecuted. One such country is Kenya, where homosexuality is illegal and attracts a fine or jail term. The purpose of this study was to examine high school students' perceptions of homosexuality in Kenya. The participants included 1,250 high school students who completed a questionnaire on perceptions of homosexuality. The results showed that 41% claimed homosexuality is practiced in schools and 61% believed homosexuality is practiced mostly in single-sex boarding schools. Consistently, 52% believed sexual starvation to be the main cause of homosexuality. Also, 95% believed homosexuality is abnormal, 60% believed students who engage in homosexuality will not change to heterosexuality after school, 64% believed prayers can stop homosexuality, and 86% believed counseling can change students' sexual orientation. The consequences for homosexuality included punishment (66%), suspension from school (61%), and expulsion from school (49%). Significant gender and grade differences were found. The implications of the study findings are discussed. PMID:27672345

  18. 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

  19. 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

  20. Attitudes of serodiscordant couples towards antiretroviral-based HIV prevention strategies in Kenya: a qualitative study.

    PubMed

    Fowler, Nikola; Arkell, Paul; Abouyannis, Michael; James, Catherine; Roberts, Lesley

    2015-01-01

    This qualitative study aims to gain in-depth information about the attitudes of HIV-serodiscordant couples towards two new methods of HIV prevention; Pre-Exposure Prophylaxis and Treatment as Prevention, both of which have been recently recommended by the World Health Organisation. Semi-structured interviews were conducted with 38 individuals in a serodiscordant relationship in Western Kenya. Topic guides were used to elicit information on perceived benefits, concerns, and preferences towards Treatment as Prevention and Pre-Exposure Prophylaxis. Data evaluation and thematic generation were developed using framework analysis. Results suggest that the majority of participants, irrespective of gender and HIV status, found Treatment as Prevention the more acceptable strategy. Key factors influencing this decision were HIV-negative participants' limited motivation to take prophylactic antiretrovirals and the likely health improvements Treatment as Prevention offers HIV-positive partners. However, issues were raised concerning the likelihood of low concurrent condom use and poor medication adherence when using these preventative approaches. It was concluded that the adoption of Treatment as Prevention as a method of HIV control in Kenya is likely to be more readily accepted by serodiscordant couples than Pre-exposure Prophylaxis. However, future implementation of either strategy would require measures to address the possibility of risk compensation and poor adherence.