HIGH ACCEPTABILITY OF COTRIMOXAZOLE AND ANTIRETROVIRAL TREATMENT AMONG HIV INFECTED TUBERCULOSIS PATIENTS OFFERED INTEGRATE

Cape Town TB Conferenc

Mean water balance dynamics and smallholder management options for improved agro-ecosystem productivity

United States Agency for International Developmen

Responding to Major Burn Disasters in Resource-Limited Settings: Lessons Learned From an Oil Tanker Explosion in Nakuru, Kenya.

BACKGROUN

Trends in outpatient malaria cases, following Mass Long Lasting Insecticidal Nets (LLIN) distribution in epidemic prone and endemic areas of Kenya

Background: There were over 6 million case of malaria reported in Kenya in 2015 and it remains a major public health priority despite significant investments in interventions to control and prevent infections in high risk areas.Objectives: To analyse trends from 2011-2015, and report i) outpatient department (OPD) malaria case prevalence, ii) the proportion of confirmed malaria cases of all OPD cases stratified by age category, and iii) the proportion of the population potentially protected by long-lasting insecticidal nets (LLINs), following mass distribution of LLINs in malaria epidemic prone and endemic areas.Design: A retrospective study.Setting: Kenya’s Coast endemic, Lake endemic and Highland epidemic zones.Subjects: All outpatient malaria cases reported in the District Health Information System.Results: The proportion of people who received mass LLINs ranged from 80-95% in epidemic prone and endemic areas of Kenya. The coastal endemic zone had the lowest number of reported malaria cases at almost 840,000 in 2011, compared with the lake endemic zone which reported 4.3 million total cases. Confirmed malaria cases of all the OPD morbidity increased by 1%, 20% and 4% in the Highland epidemic prone, the Lake and Coast endemic region in 2011 to 2015, respectively. There was a trend towards fewer cases across all three high risk regions from 2012-2013, but this reversed with increasing cases being reported in 2014-2015.Conclusion: Despite a high LLIN coverage malaria cases increased over time. There is need for patient-level studies to assess if LLINs are being used appropriately and to look towards other complimentary malaria prevention strategies

Public Health Risks from Mismanagement of Healthcare Wastes in Shinyanga Municipality Health Facilities, Tanzania

The increase of healthcare facilities in Shinyanga municipality has resulted in an increase of healthcare wastes, which poses serious threats to the environment, health workers, and the general public. This research was conducted to investigate management practices of healthcare wastes in Shinyanga municipality with a view of assessing health risks to health workers and the general public. The study, which was carried out in three hospitals, involved the use of questionnaires, in-depth interview, and observation checklist. The results revealed that healthcare wastes are not quantified or segregated in all the three hospitals. Healthcare wastes at the Shinyanga Regional Referral Hospital are disposed of by on-site incineration and burning and some wastes are disposed off-site. At Kolandoto DDH only on-site burning and land disposal are practiced, while at Kambarage UHC healthcare solid wastes are incinerated, disposed of on land disposal, and burned. Waste management workers do not have formal training in waste management techniques and the hospital administrations pay very little attention to appropriate management of healthcare wastes. In light of this, it is evident that management of healthcare solid wastes is not practiced in accordance with the national and WHO’s recommended standards

Assessment of community led total sanitation uptake in rural Kenya

Background: Community Led Total Sanitation (CLTS) is an innovative community led drive to set up pit latrines in rural Kenya with an aim of promoting sustainable sanitation through behaviour change. It’s a behaviour change approach based on social capital that triggers households to build pit latrines without subsidy. The Ministry of Health introduced the CLTS campaign in 2007 and the first road map to ODF ended in 2013. Since the commencement of the CLTS Programme in, there is little documentation on assessment of its uptake from triggering to the certification of open defecation free villages.Objective: To assess the magnitude of Community Led Total Sanitation (CLTS) triggering to certification of Open Defecation free (ODF) villages in rural Kenya.Design: A retrospective descriptive study.Setting: The 47 counties in Kenya. Kenya is projected to have a population of 46 million people with the majority as rural populace. The study unit were Villages across the 47 counties from the data generated in the CLTS monitoring and evaluation dataset.Results: The number of triggered villages (11641) compared to those that reached certification stage (3131) reduced significantly. Busia County achieved the 100% target for triggering. There was a significant decline of the proportions per county in the process of claiming, verifying and certifying ODF villages however Busia, Siaya and Vihiga were leading across the counties. The proportion of CLTS facilitators and CLTS certified villages per county were incongruent.Conclusion: There was low uptake of CLTS from the triggering phase to the certification phase due to plausible factors such as inadequate monitoring of the CLTS process, inadequate funding of CLTS programmeming and conflicting work demands on the CLTS facilitators leading to reduced momentum as observed in Uganda

Trends of reported outpatient malaria cases to assess the Test, Treat and Track (T3) policy in Kenya

Background: Kenya reports over six million malaria cases annually. In 2012 the country adopted the Test, Treat and Track (T3) policy to ensure that all suspected malaria cases are tested, confirmed cases are treated with quality-assured drugs and timely accurate malaria surveillance are in place to guide policy and practice.Objective: To describe the trends of confirmed outpatient malaria cases and the consumption of artemisinin-based combination therapy (ACT) in the government health facilities in Kenya following the roll out of the T3 initiative.Design: A retrospective review study.Setting: All government health facilities in the 47 counties.Subjects: Secondary data on all outpatient malaria cases and ACT consumed as reported in the District Helth Information Software (DHIS).Results: Total malaria cases decreased from 8.5 to 6.8million cases in 2012 and 2015, respectively. Confirmed malaria cases increased from 1.97 (23%) to 4.9 (72%) million cases. The greatest decrease in total malaria cases and the greatest rise in confirmation of suspected cases occurred in the lower level health facilities. More confirmation of suspected cases occurred in the malaria endemic regions compared to other epidemiological zones. Excess ACT consumption reduced by 46% to reach 27% in 2015.Conclusion: Though there was increased confirmation of suspected malaria, still onethird of the outpatients were treated clinically in 2015. About one-third of ACTs were also used in excess in 2015. There is need for enhanced efforts to adhere to the T3 policy and malaria elimination guidelines

An assessment of water, sanitation and hygiene (wash) practices and quality of routinely collected data in Machakos County Kenya

Background: Poor water, sanitation, and hygiene (WASH) practices, predispose to childhood morbidity and mortality globally, and especially from diarrhoeal diseases. Machakos County in its community strategy utilises Community Health Workers (CHWs) to promote WASH practices and to collect household based data using a structured reporting tool. There is no published data on WASH in Machakos County.Objectives: To assess (i) WASH practices, and (ii) completeness and accuracy of routinely collected data on household water, sanitation and hygiene with reported childhood diarrhoea cases of all community units in Machakos County, Kenya.Design: Descriptive ecological studySetting: Machakos County, KenyaSubjects: Household unitsResults: A total of 137,540 households were served by the CHWs between January and December 2014. The number of households was not updated as per ministry of health recommendation, after six months hence the denominator remained constant. There was a high uptake of households with treated drinking water (92%), availability of hand washing facilities in (89%) and availability of functional pit latrines (98%). A total of 4,012 diarrhoea cases were reported in the County, with an average of 90 cases every month, except in the month of August where 3,020 cases of diarrhoea were reported. There was no apparent relationship observed between WASH practices and occurrence of under five diarrhoea cases.Conclusion: Water, sanitation and hygiene practices at community level in Machakos County are in keeping with post 2015 WASH targets and indicators, with few cases of under-five diarrhoea reported. Data quality and completeness need to be addressed for effective programme evaluation