Asthma control and factors associated with control among children attending clinics at a national referral hospital in western Kenya

Background: Asthma control is the extent to which the various manifestations of asthma have been reduced or removed by treatment. In developing countries including Kenya, many children continue to visit hospitals with acute symptoms of asthma, which is a pointer to poor control.Objectives: To determine the level of asthma control and factors associated with the observed control among children at a national referral hospital.Design: Cross-sectional studySetting: Moi Teaching and Referral Hospital, Eldoret, Kenya paediatric clinics.Subjects: A total of 166 asthmatic children aged 6-11 years and their parents/caretakers were enrolled between August 2016 and October 2017.Main Outcome: Level of control using childhood asthma control test (c-ACT)Results: The median age of enrolled children was 8.17 years with males being the majority, 94 (56.6%). Using c-ACT, 92 (55.4%, 95%CI: 47.52, 63.10) had well controlled asthma at baseline. At univariate analysis, having a medical insurance cover (p=0.034), dry season (p=0.036), and parental perception of asthma control (p=0.002) were significantly associated with good control of asthma. Acceptance that a child had asthma was associated with poor control of asthma, p=0.046. On multivariate logistic regression, a perception of a well-controlled child by the parent/caretaker correlated well with good control of asthma.Conclusion: About half of the children in this set up have good control of asthma with the observed status of control being affected by parental/caretaker perception on asthma

Revealing the extent of the first wave of the COVID-19 pandemic in Kenya based on serological and PCR-test data

Policymakers in Africa need robust estimates of the current and future spread of SARS-CoV-2. We used national surveillance PCR test, serological survey and mobility data to develop and fit a county-specific transmission model for Kenya up to the end of September 2020, which encompasses the first wave of SARS-CoV-2 transmission in the country. We estimate that the first wave of the SARS-CoV-2 pandemic peaked before the end of July 2020 in the major urban counties, with 30-50% of residents infected. Our analysis suggests, first, that the reported low COVID-19 disease burden in Kenya cannot be explained solely by limited spread of the virus, and second, that a 30-50% attack rate was not sufficient to avoid a further wave of transmission.</ns4:p

Revealing the extent of the first wave of the COVID-19 pandemic in Kenya based on serological and PCR-test data.

Policymakers in Africa need robust estimates of the current and future spread of SARS-CoV-2. We used national surveillance PCR test, serological survey and mobility data to develop and fit a county-specific transmission model for Kenya up to the end of September 2020, which encompasses the first wave of SARS-CoV-2 transmission in the country. We estimate that the first wave of the SARS-CoV-2 pandemic peaked before the end of July 2020 in the major urban counties, with 30-50% of residents infected. Our analysis suggests, first, that the reported low COVID-19 disease burden in Kenya cannot be explained solely by limited spread of the virus, and second, that a 30-50% attack rate was not sufficient to avoid a further wave of transmission

Children's and adolescents' rising animal-source food intakes in 1990-2018 were impacted by age, region, parental education and urbanicity

Animal-source foods (ASF) provide nutrition for children and adolescents physical and cognitive development. Here, we use data from the Global Dietary Database and Bayesian hierarchical models to quantify global, regional and national ASF intakes between 1990 and 2018 by age group across 185 countries, representing 93% of the worlds child population. Mean ASF intake was 1.9 servings per day, representing 16% of children consuming at least three daily servings. Intake was similar between boys and girls, but higher among urban children with educated parents. Consumption varied by age from 0.6 at <1 year to 2.5 servings per day at 1519 years. Between 1990 and 2018, mean ASF intake increased by 0.5 servings per week, with increases in all regions except sub-Saharan Africa. In 2018, total ASF consumption was highest in Russia, Brazil, Mexico and Turkey, and lowest in Uganda, India, Kenya and Bangladesh. These findings can inform policy to address malnutrition through targeted ASF consumption programmes. (c) 2023, The Author(s)

Incident type 2 diabetes attributable to suboptimal diet in 184 countries

The global burden of diet-attributable type 2 diabetes (T2D) is not well established. This risk assessment model estimated T2D incidence among adults attributable to direct and body weight-mediated effects of 11 dietary factors in 184 countries in 1990 and 2018. In 2018, suboptimal intake of these dietary factors was estimated to be attributable to 14.1 million (95% uncertainty interval (UI), 13.814.4 million) incident T2D cases, representing 70.3% (68.871.8%) of new cases globally. Largest T2D burdens were attributable to insufficient whole-grain intake (26.1% (25.027.1%)), excess refined rice and wheat intake (24.6% (22.327.2%)) and excess processed meat intake (20.3% (18.323.5%)). Across regions, highest proportional burdens were in central and eastern Europe and central Asia (85.6% (83.487.7%)) and Latin America and the Caribbean (81.8% (80.183.4%)); and lowest proportional burdens were in South Asia (55.4% (52.160.7%)). Proportions of diet-attributable T2D were generally larger in men than in women and were inversely correlated with age. Diet-attributable T2D was generally larger among urban versus rural residents and higher versus lower educated individuals, except in high-income countries, central and eastern Europe and central Asia, where burdens were larger in rural residents and in lower educated individuals. Compared with 1990, global diet-attributable T2D increased by 2.6 absolute percentage points (8.6 million more cases) in 2018, with variation in these trends by world region and dietary factor. These findings inform nutritional priorities and clinical and public health planning to improve dietary quality and reduce T2D globally. (c) 2023, The Author(s)

COVID-19 transmission dynamics underlying epidemic waves in Kenya

Policy decisions on COVID-19 interventions should be informed by a local, regional and national understanding of SARS-CoV-2 transmission. Epidemic waves may result when restrictions are lifted or poorly adhered to, variants with new phenotypic properties successfully invade, or when infection spreads to susceptible sub-populations. Three COVID-19 epidemic waves have been observed in Kenya. Using a mechanistic mathematical model, we explain the first two distinct waves by differences in contact rates in high and low social-economic groups, and the third wave by the introduction of higher-transmissibility variants. Reopening schools led to a minor increase in transmission between the second and third waves. Socio-economic and urban/rural population structure are critical determinants of viral transmission in Kenya

Rural wood fuel consumption and deforestation in Tanzania: A case of two selected villages in Mvomero district

This paper presents the results of the study which focused on rural wood fuel consumption and deforestation in two selected villages in Mvomero District. The objectives of study were to examine types and amount of wood fuel consumed by households, and to determine the extent to which wood fuel consumption cause deforestation. Stratified random sampling method was applied to select 90 households for interviews in the study area. The study established that in the year of study, the two study villages' annual fuel wood consumption was 50,838.2 m3 and 1,202.04 tons of charcoal. As a result of this rate of consumption, about 1,056.88 hectares of forest were cleared to meet the wood fuel demand in the study area. The study concludes that wood fuel consumption in the study area is very high and environmentally unsustainable in such a way that if continues unchecked, will result in devastating situation of deforestation. It recommends that immediate and long term measures should be undertaken to rescue the situation. Immediate measures include promotion of the use of wood saving stoves and use of alternative sources such as solar energy, biogas and briquettes made from biomass. The long-term measures include implementation of reforestation and rural electrification programmes.Institute of Rural Development Planning (IRDP

Using contact data to model the impact of contact tracing and physical distancing to control the SARS-CoV-2 outbreak in Kenya

Background: Across the African continent, other than South Africa, COVID-19 cases have remained relatively low. Nevertheless, in Kenya, despite early implementation of containment measures and restrictions, cases have consistently been increasing. Contact tracing forms one of the key strategies in Kenya, but may become infeasible as the caseload grows. Here we explore different contact tracing strategies by distinguishing between household and non-household contacts and how these may be combined with other non-pharmaceutical interventions. Methods: We extend a previously developed branching process model for contact tracing to include realistic contact data from Kenya. Using the contact data, we generate a synthetic population of individuals and their contacts categorised by age and household membership. We simulate the initial spread of SARS-CoV-2 through this population and look at the effectiveness of a number of non-pharmaceutical interventions with a particular focus on different contact tracing strategies and the potential effort involved in these. Results: General physical distancing and avoiding large group gatherings combined with contact tracing, where all contacts are isolated immediately, can be effective in slowing down the outbreak, but were, under our base assumptions, not enough to control it without implementing extreme stay at home policies. Under optimistic assumptions with a highly overdispersed R0 and a short delay from symptom onset to isolation, control was possible with less stringent physical distancing and by isolating household contacts only. Conclusions: Without strong physical distancing measures, controlling the spread of SARS-CoV-2 is difficult. With limited resources, physical distancing combined with the isolation of households of detected cases can form a moderately effective strategy, and control is possible under optimistic assumptions. More data are needed to understand transmission in Kenya, in particular by studying the settings that lead to larger transmission events, which may allow for more targeted responses, and collection of representative age-related contact data