An appraisal of rabies occurrence and control in Kisumu Municipality, Kenya

Background: Rabies is a serious neglected disease which occurs worldwide. In urban areas, the control of the disease is expected to be hampered by several unique constraints.Objective: To appraise the occurrence and control of rabies.Study Design: The tools used in the study included key informant interviews with senior veterinary and medical officers and a questionnaire survey on 15 veterinary officers and 9 human physicians. The occurrence of animal bites and costs involved in treatment was also investigated using retrospective hospital data for the year 2007. Setting: Kisumu Municipality, Kenya.Results: The control of rabies was under the Veterinary Department through dog vaccinations and baiting, and also under the Department of Public Health (DPH) through people vaccinations and post exposure treatments. The constraints observed were poor coordination in rabies control efforts, understaffing and limited resources. Animal bites were common with 1270 cases reported during 2007. The post-bite rabies vaccines were mainly purchased from local chemists at KES 7,500 per full dose. This amounted to an annual total cost of KES 9,525,000 (136,071 USD). The bites were mainly from domestic dogs (89%) and occurred commonly in highly populated areas. The mean age of people with bites was 21 (2.5 - 78) years, showing that young people had a higher risk. Males (59%) were at higher risk of bites than females (41%). Conclusions: It would be important for the relevant departments to harmonise theirrabies control strategies and also address the prevalent constraints by using local networks. The incidence of rabies and the associated epidemiology needs proper updated documentation with a view of carrying out mass vaccination of dogs at times free of cost to the economically disadvantaged owners

The Prevalence of Ecto and Endoparasites in Pigs in Urban and Peri-Urban Areas of Mwanza City, Tanzania

Parasitism is the most serious constraint causing continuous ill-healthand lowered productivity in livestock in Tanzania and sub-Saharan Africa as a whole. This study was carried out in urban and peri-urban areas of Mwanza city and aimed to determine the prevalence of parasitic infections in pigs kept by small holder livestock keepers. A random sample of 14 urban farmers with a total of 213 pigs and 14 peri-urban farmers with a total of 155 pigs were selected. Faecal samples were collected from each pig. Ectoparasites were examined and their morphological characteristics recorded. Direct smear floatation and sedimentation methods were employed to detect endoparasites in the faeces. The prevalence of different types of endoparasites in urban Mwanza city pigs were: Strongylidnematodes (11.7%) Entomoeba ssp (27.2%), Ascaris suum (1.8%)  Balntidium coli (3.8%) and Coccidia spp (3.3%) and the only ectoparasites found was sarcoptic mange (1.4%). In the peri -urban area the  endoparasites found were Entomoeba spp (51.6%), Strongylid nematodes (9.7%), Coccidia spp (5.8%). Ascaris suum (12.9%) Balantidium coli 20.6%) and Trichurus suis (3.8%) and the ectoparasites was sarcoptic mange (21.9%). Every piggery where samples were taken, the management system was assessed. The difference in the livestock management systems in the two areas clearly explains the observed high prevalence of parasite infection in the peri-uban compared to the urban areas of Mwanza city. The negative impact of these parasites on livestock production and their public health importance -since some of them are zoonotic in nature- cannot be underestimated. The present study validates the need to bring awareness to the farmers and the public at large so that they may embark on cost effective development of parasite control strategies.Key words: Mwanza urban, peri-urban, endoparasites, ectoparasites, protozoa, zoonosis, Tanzania, pig

Socio-cultural factors influencing utilization of prevention-of-mother-to child-transmission of HIV strategies among women attending antenatal care clinics in Rachuonyo North Sub-County-Homa-Bay County, Kenya

Objective: To assess the sociocultural characteristics influencing HIV positive women attending antenatal care clinics in North Rachuonyo Sub- CountyDesign: Health facility cross sectional studySetting: 20 antenatal care clinics in North Rachuonyo Sub-CountySubjects: Three hundred and eighty-five HIV infected pregnant women as participants.Results: The mean age of the women interviewed was 25.7 years (range =31) and 67% were married. Majority 60% (95% CI:55.0 -64.8) did not seek permission to know or undertake HIV testing, this contributed to nondisclosures of the HIV status where 13.6% (95% CI:9.0 -20.1) were in single parenthood and non- committal relationships and perceived fear of stigma and discrimination by partner 25% (95%CI:29.7 – 45.0). Barriers impeding women participation on MTCT awareness programs included cultural practices such as wife inheritance (26.8%), lack of support from partners in attending PMTCT services (25%), fear of losing property inheritance once HIV status is known by the family (22.3%) and cultural sexual ritual and beliefs by unknown partners 17.1%. Public discrimination and stigmatization 52%, protracted high cost of drugs 18% and 7% of health care attitude contributes to underutilization of PMTCT services. There are significant association between age, marital status and occupation with utilization of PMTCT services unlike to women with formal education.Conclusion: The study showed sociocultural impediments with little potential impact to influence, improve and promote PMTCT services. Therefore, there is need to further intervention and educating women by demystifying sociocultural factors associated with HIV/AIDS spread by engaging various players, stakeholders and other community resource persons to increase utilization with a goal towards free HIV generation

Knowledge and attitude as determinant factors in HIV care among pregnant women in Rachuonyo North, Homa-Bay County, Kenya

Background: Mothers knowledge and attitude on PMTCT is a highly effective intervention with enormous potential to enhance access and utilization of PMTCT services Objective: To assess knowledge, attitude and practices of HIV infected women on Prevention of mother to child transmission attending antenatal care clinics in Rachuonyo North, Homa- Bay County, Kenya. Design: A cross sectional study Setting: Twenty antenatal care clinics in Rachuonyo North, Homa-Bay County, Kenya Subjects: HIV infected pregnant women.Results: PMTCT coverage and utilization was 77%. Majority (71.2%, 95% CI: 66.7 – 75.7) of the respondents had positive health seeking behaviours. Approximately 65.5%, of respondents understood four prong approach of PMTCT whereas, 64.9% of the respondents attended ANC clinics > 4 visits which is standard with WHO. The reasons cited by respondents for PMTCT interventions included ARV prophylaxis with EBF (42.1%, 95% CI: 37.2 – 47.1) ARV prophylaxis with BM substitute (22.9%, 95% CI:18.9 - 27.3) among others. There was significant association between attitude on PMTCT and health seeking behaviour, (AOR = 1.57, 95%CI: 1.09 – 4.15) and p=0.004<0.05. Willingness to test for HIV had a significant association with attitude on PMTCT (AOR =1.90, 95% CI: 1.08 – 8.21) with p - value<0.001. Conclusion: There was significant association between attitude on PMTCT and health seeking behaviour. Knowledge on when MTCT occurs in pregnancy and delivery is critical and key determinant to influence access and utilization of PMTCT services. Accurate information on the PMTCT service access and utilization significantly addresses psychosocial support services

Herbal Medicines in Kenya: A Review of the Toxicity and Quality Control Issues

In sub-Saharan Africa, it is estimated that 80% of the population depends on indigenous medicines for primary health-care. These herbs often contain highly active pharmacological compounds whose pharmacotherapeutic and toxicity profiles have not been well characterized. Toxicity may be related to several intrinsic and extrinsic factors. Most of the available reports related to the toxic effects of herbal medicines cite hepatoxicity as the most frequently experienced toxicity. However, noxious effects involving kidneys, the nervous system, skin, blood, the cardiovascular system, mutagenicity and carcinogenicity have also been published. This article presents a systematic review on safety and toxicity of herbal medicines used in Kenya. Keywords: Herbal medicine, herbal preparations, toxicity, Kenya, regulations, complementary and alternative medicin

The role of parasitic diseases as causes of mortality in cattle in a high potential area of central Kenya: a quantitative analysis

Postmortem records of cattle brought to the Veterinary School in Kabete near Nairobi were examined for a period of 15 years (1984-1998, inclusive) in order to establish the role that parasitic diseases played as causes of death. The cattle were mainly of exotic breeds but a few were crosses or of indigenous breeds. There was a total of 1 413 cases of deaths from various diseases of which 177 (13 %) were due to parasites. The tick-borne diseases were in high proportions and accounted for 84,7% among the parasitic causes, which represented 10,6% of all the deaths recorded. The main tick-borne disease was East Coast fever (ECF) (65 %) followed by heartwater (10,2 %), babesiosis (5 ,1 %) and anaplasmosis (4,5 %). Hydatidosis was responsible for 7,3 % of deaths from parasitic causes. Deaths from ECF were recorded in all the 15 years and in high proportions compared to those due to heartwater (8/15), babesiosis (7/15) and anaplasmosis (5/15). Over the period under consideration, no decline was noted among various disease conditions despite advances made in controlling tick vectors and in the treatment of various parasitic conditions. The area covered by this study has the advantage of having several veterinary-related institutions close by. Hence knowledge and awareness about livestock diseases is relatively high compared to other parts of the country. It is therefore challenging to the Veterinary Department to examine the service delivery systems and other factors that may contribute to the persistent presence of these fatal parasitic conditions of cattle.The articles have been scanned in colour with a HP Scanjet 5590; 600dpi. Adobe Acrobat v.9 was used to OCR the text and also for the merging and conversion to the final presentation PDF-format.mn201

Characterisation of productivity and diseases affecting dairy goats in smallholder systems of Greater Thika Region, Kenya

The current cross-sectional study aimed at characterising the productivity and diseases affecting dairy goats kept by smallholder farmers in three sub-counties in Thika Region, Kenya. Standard questionnaires were administered to 240 farmers through face-to-face interviews and the outputs were analysed using descriptive and inferential statistics. The farmers mainly kept crosses of Toggenburg (45.9 %), Kenyan Alpine (29.5 %) and Saanen (17.4 %) dairy goats. The average dairy goat flock size was 4.5 (range 1–23) and 77.5 % of the goats were kept for production of milk for domestic consumption. The average milk production per goat per day was 1.26 litres (range 0.5 to 3.5 litres) and was significantly (p 0.05) associated with sub-county of origin, main occupation of the owner, breed, and lactation stages. Goats were mainly fed on napier grass, maize stovers, natural grass and hay; and these feeds did not influence (p 0.05) the milk production levels. The farmers identified helminthosis (84.6 %), pneumonia (32.9 %), coccidiosis (25.8 %) and mastitis (25 %), as the most prevalent goat diseases. In conclusion, the study showed that dairy goat farming in greater Thika Region was characterised by low-input with an objective of provision of milk for home consumption. The observed challenges of low milk productivity and diseases should be addressed by the local extension workers through training on improved husbandry, nutrition and health management of the dairy goats

Haematology of experimental Trypanosoma brucei rhodesiense infection in vervet monkeys

Haematological aberrations associated with human infective trypanosomes were investigated in the vervet monkey model of the Rhodesian sleeping sickness. Four monkeys were infected intravenously with 104 Trypanosoma brucei rhodesiense and monitored for changes in the blood profile using a haematological analyser. A chronic infection lasting between 48 and 112 days was observed. Microcytic hypochromic anaemia, which was characterized by a decline in packed cell volume (PCV), red blood cell (RBC) numbers, mean corpuscular volume (MCV) and mean corpuscular haemoglobin concentration (MCH) developed at an early stage, and persisted throughout the infection. The mean platelet counts declined significantly from 3 x 105/μl (day 0 post infection) to 6.8 x 104/μl (day 7 post infection) and remained low in all the animals. However, the mean platelets volume rose during the course of the infection. An initial decline in total white blood cell (WBC) counts occurred between day 0 and 7 (3.1 x 106/μl) and remained low up to day 35 post infection (3.5 x 106/μl). This was followed by an increase in WBC counts, principally associated with increased lymphocyte numbers. It is concluded that microcytic hypochromic anaemia, thrombocytopaenia and an initial leucocytopaenia are the most important haematological changes associated with a chronic infection of T.b. rhodesiense infection in vervet monkeys. African Journal of Health Sciences Vol. 13 (3-4) 2006: pp. 59-6

Influence of Cyclophosphamide on the Haematological Profile of Laboratory Bred African Soft-furred Rats (Mastomys natalensis)

The African soft-furred rat (Mastomys natalensis) has been shown to be a possible model for propagation  of Trypanosoma brucei gambiense. This study aimed at determining the baseline biological reference values  and reproductive data of a laboratory bred Mastomys colony, which was established at TRC. In addition,  the effect of cyclophosphamide (an immunosuppressant) treatment (s) on the haematological profile  was investigated. The mean gestation period was 23 days and the mean litter size was eight. At birth, the  pups weighed 2.4±0.23 g and the weights increased to 78.0±10.6 g in males and 53.9±4.5 g in females by  90 days. The mean haematological values were significantly (p<0.05) higher in adults than juveniles.  However, there was no statistical difference of haematological values between the sexes.  Cyclophosphamide treatment caused a macrocytic hypochromic anaemia, which was noted 24 hours after  treatment and was more severe in animals treated more than once. Thus, in studies involving a disease that  causes anaemia, repeated cyclophosphamide treatment should be limited. Our study is a contribution to  the clinical and biological characterization of the disease pattern in this preferred rodent model of T. b.  gambiense.

The point prevalence of gastro-intestinal parasites in calves, sheep and goats in Magadi division, south-western Keny

Helminths cause great economic loss in livestock in Africa, and can be categorized as either direct or indirect losses. Arid and semi-arid lands (ASAL) in Kenya comprise 71 % of total land area and harbour the largest population of cattle, sheep and goats. However, little information on the distribution and impact of gastro-intestinal (GIT) parasitism in these animals is available. This survey was conducted to establish the prevalence of GIT parasites infecting calves, sheep and goats and their relative importance in Magadi division, which is semi-arid. Faecal samples were obtained directly from the rectum of 109 calves, 133 goats and 20 sheep and submitted to the laboratory for faecal worm egg counts, and coccidial oocysts examination using a modified McMaster method. The significance of differences in mean egg count per gram (epg) between animal species and herds (farms) were assessed using analysis of variance. The overall prevalence of nematodes in the calves, sheep and goats was 69.2 %, 80 % and 82 %, respectively. About 10 % of sheep and goats had epgs higher than 1 000, the remainder having light to moderate infections. The overall prevalence of coccidial oocysts in calves, sheep and goats was 30 %, 44 % and 45 %, respectively. Poor productivity in ASAL areas, where nutrition is often poor, is likely to be pronounced in the presence of parasite infections. These findings indicate that viable internal parasite control should be implemented in the study area in order to increase the productivity of the livestock there