Nutritional Status of Orphaned and Separated Children and Adolescents Living in Community and Institutional Environments in Uasin Gishu County, Kenya

Objective: To describe the nutritional status of orphaned and separated children and adolescents (OSCA) living in households in the community (HH), on the street, and those in institutional environments in western Kenya. Methods: The study enrolled OSCA from 300 randomly selected households (HH), 19 Charitable Children’s Institutions(CCIs), and 100 street-involved children. Measures of malnutrition were standardized with Z-scores using World Health Organization criteria; Z-scores #-2 standard deviations (sd) were moderate-severe malnutrition. Data were analyzed using multivariable logistic regression adjusting for child age, sex, HIV status, whether the child had been hospitalized in theprevious year, time living with current guardian, and intra- household clustering for adequacy of diet and moderate-severe malnutrition. Results: Included are data from 2862 participants (1337 in CCI’s, 1425 in HH’s, and 100 street youth). The population was 46% female with median age at enrolment of 11.1 years. Only 4.4% of households and institutions reported household food security; 93% of children in HH reported an adequate diet vs. 95% in CCI’s and 99% among street youth. After adjustment, OSCA in HH were less likely to have an adequate diet compared to those in CCI’s (AOR 0.4, 95% CI 0.2–1.0). After adjustment, there were no differences between the categories of children on weight-for-age, weight-for-height, or BMI-for-age. Children living in HH (AOR 2.6, 95% CI: 2.0–3.4) and street youth (AOR: 5.9, 95% CI: 3.6–9.5) were more likely than children in CCI’s to be low height-for-age. Conclusion: OSCA in HH are less likely to have an adequate diet compared to children in CCI’s. They and street children are more likely to be moderately-severely low height-for-age compared to children in CCI’s, suggesting chronic malnutrition among them

Felt stigma among people living with HIV/AIDS in rural and urban Kenya

Background: Individuals suffer from felt stigma when they internalize negative perceptions regarding themselves. People living with HIV (PLWH) employ diverse coping mechanisms when their self worth and networks are disrupted by stigma. The social network perspective suggests response to stigma is shaped by social context. Objective: This paper examines whether internalized HIV stigma among PLWH changes over time, and whether it differs with demographics and rural or urban location. Methods: Semi-structured interviews were conducted with support group members in two waves that were 12 months apart. Current analyses focus on examining whether HIV felt stigma differs with demographic characteristics and rural or urban location. Further, we explore whether there is variation in magnitude of change at the two sites over time. T-tests are used to compare each stigma item by waves and sites. Factor analysis is utilized to correlate and reveal the relationship between stigma items, while bivariate and logit models investigate the relationship between stigma items and site, gender, marital status and education. Results: Study findings highlight a gender and rural-urban dichotomy that seems to influence the experience of HIV felt stigma. Being urbanite and being female significantly decreases agreement with selected stigma items. While the urban sample reveals significant difference between the two waves, the rural experience indicates insignificant change over time. The difference between the two sites reflects a distinction between modern and pre-modern social structures. Conclusions: This study suggests internalized feelings of HIV stigma may vary with social context and gender. Thus, interventions to support PLWH in Kenya must take into account gender and unique social configurations

Temperament characteristics of street and non-street children in Eldoret, Kenya

Objective: To examine the interaction of temperament and environment and how these impact on the psychological function of street children and non-street children in Eldoret Kenya. Method: This was a cross-sectional study conducted in Eldoret town. A Revised Dimensions of Temperament Survey (DOTSR) a 54 item, factor-analytically-developed self-report instrument that measures nine temperament dimensions was used. Results: The statistical analysis showed that the largest significant level was on the approach/withdrawal dimension (F = 12.38,

Body mass index (BMI)-for-age among orphaned and separated children aged 10–18 years living in Charitable Children’s Institutions (CCI’s), in households in the community (HH), and on the street (SCY) participating in OSCAR’s Health and Well-Being Study.

<p>Body mass index (BMI)-for-age among orphaned and separated children aged 10–18 years living in Charitable Children’s Institutions (CCI’s), in households in the community (HH), and on the street (SCY) participating in OSCAR’s Health and Well-Being Study.</p

Unadjusted and adjusted^*odds ratios (OR) and 95% confidence intervals (CI) describing moderate to severely low malnutrition (Z scores ≤-2 standard deviations) among orphaned and separated children aged 0–18 years living in Charitable Children’s Institutions (CCI’s), community-based households (HH), and those living on the street participating in OSCAR’s Health and Well-Being Study.

*<p>Odds ratios are adjusted for intra-household/institution clustering, as well as child age, sex, HIV status, having been hospitalized in the previous year, and length of time with present guardian.</p>1<p>Among children 5 years and under.</p>2<p>Among children 10 years and under.</p>3<p>Among children 0–18 years of age.</p>4<p>Among children 10–18 years of age.</p

Baseline sociodemographic and clinical characteristics of children in Charitable Children’s Institutions (CCI’s), community-based households (HH), and street youth participating in the Orphaned and Separated Children’s Assessments Related to their (OSCAR’s) Health and Well-Being Study.

*<p>IQR: Interquartile range.</p

Height-for-age among orphaned and separated children aged 0–18 years living in Charitable Children’s Institutions (CCI’s), in households in the community (HH), and on the street (SCY) participating in OSCAR’s Health and Well-Being Study.

<p>Height-for-age among orphaned and separated children aged 0–18 years living in Charitable Children’s Institutions (CCI’s), in households in the community (HH), and on the street (SCY) participating in OSCAR’s Health and Well-Being Study.</p

Weight-for-height among orphaned and separated children aged 0–5 years living in Charitable Children’s Institutions (CCI’s), in households in the community (HH) participating in OSCAR’s Health and Well-Being Study.

<p>Weight-for-height among orphaned and separated children aged 0–5 years living in Charitable Children’s Institutions (CCI’s), in households in the community (HH) participating in OSCAR’s Health and Well-Being Study.</p

Detailed responses to and culminating scores of household food security^*among Charitable Children’s Institutions (CCI’s) and community-based households (HH) participating in OSCAR’s Health and Well-Being Study.

*<p>Household food security as measured by the Household Food Insecurity Access Scale (HFIAS) specifically adapted by the USAID Food and Nutrition Technical Assistance (FANTA) project for use in Developing Countries <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0070054#pone.0070054-Coates1" target="_blank">[28]</a>.</p>1<p>Chi-square test.</p>2<p>Fisher exact test.</p

Categorization of household food security^*into food secure, mildly, moderately, or severely food insecure among Charitable Children’s Institutions (CCI’s) and community-based households (HH’s) participating in OSCAR’s Health and Well-Being Study.

*<p>Household food security as measured by the Household Food Insecurity Access Scale (HFIAS) specifically adapted by the USAID Food and Nutrition Technical Assistance (FANTA) project for use in Developing Countries <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0070054#pone.0070054-Coates1" target="_blank">[28]</a>.</p>1<p>Fisher’s exact test.</p