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Hightower A.,Centers for Disease Control and Prevention | Kinkade C.,Centers for Disease Control and Prevention | Nguku P.M.,Ministry of Public Health and Sanitation | Anyangu A.,Field Epidemiology and Laboratory Training Program FELTP | And 6 more authors.
American Journal of Tropical Medicine and Hygiene | Year: 2012

We estimated Rift Valley fever (RVF) incidence as a function of geological, geographical, and climatological factors during the 2006-2007 RVF epidemic in Kenya. Location information was obtained for 214 of 340 (63%) confirmed and probable RVF cases that occurred during an outbreak from November 1, 2006 to February 28, 2007. Locations with subtypes of solonetz, calcisols, solonchaks, and planosols soil types were highly associated with RVF occurrence during the outbreak period. Increased rainfall and higher greenness measures before the outbreak were associated with increased risk. RVF was more likely to occur on plains, in densely bushed areas, at lower elevations, and in the Somalia acacia ecological zone. Cases occurred in three spatial temporal clusters that differed by the date of associated rainfall, soil type, and land usage. Copyright © 2012 by The American Society of Tropical Medicine and Hygiene.


PubMed | Kenya Ministry of Public Health and Sanitation, Centers for Disease Control and Prevention, Field Epidemiology and Laboratory Training Program FELTP and African Inland Church Kijabe Hospital
Type: | Journal: The Pan African medical journal | Year: 2015

Neural tube defects such as anencephaly, spina bifida, and encephalocele are congenital anomalies of the central nervous system. Data on the prevalence of neural tube defects in Kenya are limited. This study characterizes and estimates the prevalence of spina bifida and encephalocele reported in a referral hospital in Kenya from 2005-2010.Cases were defined as a diagnosis of spina bifida or encephalocele. Prevalence was calculated as the number of cases by year and province of residence divided by the total number of live-births per province.From a total of 6,041 surgical records; 1,184 (93%) had reported diagnosis of spina bifida and 88 (7%) of encephalocele. Estimated prevalence of spina bifida and encephalocele from 2005-2010 was 3.3 [95% Confidence Interval (CI): 3.1-3.5] cases per 10,000 live-births. The highest prevalence of cases were reported in 2007 with 4.4 (95% CI: 3.9-5.0) cases per 10,000 live-births. Rift Valley province had the highest prevalence of spina bifida and encephalocele at 6.9 (95% CI: 6.3-7.5) cases per 10,000 live-births from 2005-2010.Prevalence of spina bifida and encephalocele is likely underestimated, as only patients seeking care at the hospital were included. Variations in regional prevalence could be due to referral patterns and healthcare access. Implementation of a neural tube defects surveillance system would provide a more thorough assessment of the burden of neural tube defects in Kenya.


Maina-Gathigi L.,Field Epidemiology and Laboratory Training Program FELTP | Omolo J.,Field Epidemiology and Laboratory Training Program FELTP | Wanzala P.,Kenya Medical Research Institute | Lindan C.,University of California at San Francisco | Makokha A.,Jomo Kenyatta University of Agriculture and Technology
Maternal and Child Health Journal | Year: 2013

To determine utilization of iron and folic acid supplementation services among pregnant women in Kenya. A cross sectional study was conducted at Nyeri Hospital, a regional referral hospital in central Kenya. Women attending the antenatal clinic were selected through systematic sampling. A semi-structured questionnaire was administered to collect information on utilization of folic acid and iron supplementation services. Women who ingested folic acid or iron supplements for >4 days in a week were considered "highly compliant". The health worker in-charge of the antenatal clinic was interviewed about the frequency of supplement stock-outs during the past year. Haemoglobin concentration was measured directly from one drop of capillary blood and measured using portable HEMOCUE B-Hb photometer. Of the 381 women interviewed, only 23.6 % obtained antenatal care in the first trimester; 69.3 and 51.2 % received folic acid and iron supplements, respectively. However, only half (45-58 %) received any information about supplementation. Most women were initiated on folic acid (80.7 %) or iron (67.7 %) after 12 and 16 weeks of gestation, respectively, well after the recommended time period. However, more than 80 % of those who received folic acid and iron were highly compliant. Stock-outs were common at the facility. Of 361 women tested for Hb level, the prevalence of anaemia (Hb levels < 11 g/dl) was 7.8 %. Health workers need to better explain the importance of supplements to pregnant women. Women who come late to antenatal clinic miss opportunities to start supplementation early in pregnancy. Problems with supply chain management exacerbate the problem. © 2012 Springer Science+Business Media, LLC.


PubMed | Field Epidemiology and Laboratory Training Program FELTP
Type: Journal Article | Journal: Maternal and child health journal | Year: 2013

To determine utilization of iron and folic acid supplementation services among pregnant women in Kenya. A cross sectional study was conducted at Nyeri Hospital, a regional referral hospital in central Kenya. Women attending the antenatal clinic were selected through systematic sampling. A semi-structured questionnaire was administered to collect information on utilization of folic acid and iron supplementation services. Women who ingested folic acid or iron supplements for >4days in a week were considered highly compliant. The health worker in-charge of the antenatal clinic was interviewed about the frequency of supplement stock-outs during the past year. Haemoglobin concentration was measured directly from one drop of capillary blood and measured using portable HEMOCUE B-Hb photometer. Of the 381 women interviewed, only 23.6% obtained antenatal care in the first trimester; 69.3 and 51.2% received folic acid and iron supplements, respectively. However, only half (45-58%) received any information about supplementation. Most women were initiated on folic acid (80.7%) or iron (67.7%) after 12 and 16weeks of gestation, respectively, well after the recommended time period. However, more than 80% of those who received folic acid and iron were highly compliant. Stock-outs were common at the facility. Of 361 women tested for Hb level, the prevalence of anaemia (Hb levels<11g/dl) was 7.8%. Health workers need to better explain the importance of supplements to pregnant women. Women who come late to antenatal clinic miss opportunities to start supplementation early in pregnancy. Problems with supply chain management exacerbate the problem.


PubMed | Zoonotic Disease Unit, Directorate of Veterinary Services, University of Nairobi, Kenyatta University and 2 more.
Type: | Journal: Zoonoses and public health | Year: 2017

To improve estimates of C.burnetii epidemiology in Kenya, a survey was undertaken in small ruminants in Baringo County, where acute cases of Q fever in humans had been reported in 2014. From 140 household herds selected, 508 (60.5%) goats and 332 (39.5%) sheep were included and an indirect ELISA assay for C.burnetii IgG antibodies performed. In addition, epidemiological information at both herd and animal level was collected. Generalized mixed-effects multivariable logistic model using herd as the random effect was used to determine variables correlated to the outcome. Overall seroprevalence was 20.5% (95% CI: 17.8%, 23.3%). Goats had 26.0% (95% CI: 22.2%, 30.0%) compared to sheep 12.2% (95% CI: 8.7%, 16.0%). Nomadic pastoralism, goats and older animals (>1year) were associated with greater risk of C.burnetii seropositivity (P=0.05). Heterogeneity in C.burnetii seropositivity was observed across the sublocations (P=0.028). Evidence of C.burnetii exposure in small ruminants revealed poses a potential risk of exposure to the people living in close proximity to the animals. We recommended integrated animal-human surveillance and socio-economic studies for C.burnetii, to aid our understanding of the risk of transmission between the animals and humans, and in the design of prevention and control strategies for the disease in the region.


PubMed | Kenya Ministry of Health, Jomo Kenyatta University of Agriculture and Technology and Field Epidemiology and Laboratory Training Program FELTP
Type: | Journal: The Pan African medical journal | Year: 2015

An estimated 55,000 people die from rabies annually. Factors promoting dog vaccination, estimates of vaccination coverage and knowledge on rabies are important for effective rabies control. We sought to establish these estimates at household (HH) level and whether rabies knowledge is associated with proper control practices.Cross-sectional cluster survey with two-stage sampling was employed in Kakamega County to enroll HH members above 18 years. A set of questions related to rabies knowledge and practice were used to score participant response. Score above the sample mean was equated to adequate knowledge and proper practices respectively. Independent t-test was used to evaluate the differences of sample mean scores based on dog vaccination status. Bivariate analysis was used to associate knowledge to practices.Three hundred and ninety HHs enrolled and had a population of 754 dogs with 35% (n = 119) HH having vaccinated dogs within past 12 months. Overall mean score for knowledge was 7.0 (2.8) with range (0-11) and 6.3 (1.2) for practice with range (0-8). There was a statistically significant difference in mean knowledge (DF = 288, p < 0.01) and practice (DF = 283, p = 0.001) of HH with vaccinated dogs compared to ones with unvaccinated dogs. Participants with adequate rabies knowledge were more likely to have proper health seeking practices 139 (80%) (OR = 3.0, 95% CI = 1.4-6.8) and proper handling practices of suspected rabid dog 327 (88%) (OR = 5.4, 95% CI = 2.7-10.6).Rabies vaccination below the 80% recommended for herd immunity. Mass vaccination campaign needed. More innovative ways of translating knowledge into proper rabies control practice are warranted.

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