Development and delivery of evidence-based messages to reduce the risk of zoonoses in Nairobi, Kenya

This paper is part of a special supplement on assessing and managing urban zoonoses and food-borne disease in two African cities (Nairobi, Kenya and Ibadan, Nigeria).This paper describes a trans-disciplinary process of co-generating and disseminating evidence-based messages for reducing the risk from cryptosporidiosis and other zoonoses in an urban community in Nairobi. Research findings about disease prevalence, risk factors and observed risky and risk-mitigating practices were analysed by a team comprising researchers, community members and local policy- and decision-makers. Using participatory planning, multiple strategies were developed for disseminating key information. We identified five vulnerable groups at higher risk of exposure to cryptosporidiosis and other cattle zoonoses with similar transmission pathways (women, children, elderly people, immunosuppressed people and male farm workers). For each group, targeted messages were developed. Good practices already in use, as were also practices as practices to improve environmental conditions. These messages were disseminated through printed material, in a workshop, through community campaigners and also an edutainment soap opera episode broadcast on Kenyan television. In conclusion, a participatory and trans-disciplinary process can help transform the findings of research into messages that are targeted, attractive and understandable

Social and gender determinants of risk of cryptosporidiosis, an emerging zoonosis, in Dagoretti, Nairobi, Kenya

This paper is part of a special supplement on assessing and managing urban zoonoses and food-borne disease in two African cities (Nairobi, Kenya and Ibadan, Nigeria).The aim of the study was to investigate the social and gender determinants of the risk of exposure to Cryptosporidium fromurban dairying in Dagoretti, Nairobi. Focus group discussions were held in six locations to obtain qualitative information on risk of exposure. A repeated cross-sectional descriptive study included participatory assessment and household questionnaires (300 randomly selected urban dairy farming households and 100 non-dairying neighbours). Onehundred dairy households randomly selected from the 300 dairy households participated in an additional economic survey along with 40 neighbouring non-dairy households. We found that exposure to Cryptosporidium was influenced by gender, age and role in the household. Farm workers and people aged 50 to 65 years had most contact with cattle, and women had greater contact with raw milk. However, children had relatively higher consumption of raw milk than other age groups. Adult women had more daily contact with cattle faeces than adult men, and older women had more contact than older men. Employees had greater contact with cattle than other groups and cattle faeces, and most (77 %) were male. Women took more care of sick people and were more at risk from exposure by this route. Poverty did not affect the level of exposure to cattle but did decrease consumption of milk. There was no significant difference between men and women as regards levels of knowledge on symptoms of cryptosporidiosis infections or other zoonotic diseases associated with dairy farming. Awareness of cryptosporidiosis and its transmission increased significantly with rising levels of education. Members of nondairy households and children under the age of 12 years had significantly higher odds of reporting diarrhoea: gender, season and contact with cattle or cattle dung were not significantly linked with diarrhoea. In conclusion, social and gender factors are important determinants of exposure to zoonotic disease in Nairobi

Outcome mapping for fostering and measuring change in risk management behaviour among urban dairy farmers in Nairobi, Kenya

A study was undertaken to investigate and mitigate the risk from zoonotic Cryptosporidium associated with dairy farming in Dagoretti division, Nairobi, Kenya. Outcome mapping (OM), a relatively new tool for planning and evaluation, was used to foster and then monitor changes in farmer management of health risks. Elements of the OM framework, including the vision, mission and expected progress markers, were developed in participatory sessions and a set of progress markers was used for monitoring behaviour change in farmers participating in the project (the boundary partners). Behaviour change (the outcome challenge) was supported by a range of awareness and educational campaigns, working with strategic partners (extension agents and administrative leaders). The farmers the project worked with made considerable progress according to the markers; they demonstrated an understanding of cryptosporidiosis, established or maintained clean and well drained cattle sheds, and took conscious effort to reduce possible infection. Farmers who did not participate in the project (non-contact farmers) were found to be less advanced on the progress marker indicators. Non-contact farmers who carried out risk-reducing practices had done so independently of the project team. The administration leaders, as strategic partners, had a positive attitude towards the project and confidence in their ability to support project objectives. The study demonstrates the utility of OM in helping to identify and support behavioural change

Social and gender determinants of risk of cryptosporidiosis, an emerging zoonosis, in Dagoretti, Nairobi, Kenya

The aim of the study was to investigate the social and gender determinants of the risk of exposure to Cryptosporidium from urban dairying in Dagoretti, Nairobi. Focus group discussions were held in six locations to obtain qualitative information on risk of exposure. A repeated cross-sectional descriptive study included participatory assessment and household questionnaires (300 randomly selected urban dairy farming households and 100 non-dairying neighbours). One-hundred dairy households randomly selected from the 300 dairy households participated in an additional economic survey along with 40 neighbouring non-dairy households. We found that exposure to Cryptosporidium was influenced by gender, age and role in the household. Farm workers and people aged 50 to 65 years had most contact with cattle, and women had greater contact with raw milk. However, children had relatively higher consumption of raw milk than other age groups. Adult women had more daily contact with cattle faeces than adult men, and older women had more contact than older men. Employees had greater contact with cattle than other groups and cattle faeces, and most (77 %) were male. Women took more care of sick people and were more at risk from exposure by this route. Poverty did not affect the level of exposure to cattle but did decrease consumption of milk. There was no significant difference between men and women as regards levels of knowledge on symptoms of cryptosporidiosis infections or other zoonotic diseases associated with dairy farming. Awareness of cryptosporidiosis and its transmission increased significantly with rising levels of education. Members of non-dairy households and children under the age of 12 years had significantly higher odds of reporting diarrhoea: gender, season and contact with cattle or cattle dung were not significantly linked with diarrhoea. In conclusion, social and gender factors are important determinants of exposure to zoonotic disease in Nairobi

Development and delivery of evidence-based messages to reduce the risk of zoonoses in Nairobi, Kenya

This paper describes a trans-disciplinary process of co-generating and disseminating evidence-based messages for reducing the risk from cryptosporidiosis and other zoonoses in an urban community in Nairobi. Research findings about disease prevalence, risk factors and observed risky and risk-mitigating practices were analysed by a team comprising researchers, community members and local policy- and decision-makers. Using participatory planning, multiple strategies were developed for disseminating key information. We identified five vulnerable groups at higher risk of exposure to cryptosporidiosis and other cattle zoonoses with similar transmission pathways (women, children, elderly people, immunosuppressed people and male farm workers). For each group, targeted messages were developed. Good practices already in use, as were also practices as practices to improve environmental conditions. These messages were disseminated through printed material, in a workshop, through community campaigners and also an edutainment soap opera episode broadcast on Kenyan television. In conclusion, a participatory and trans-disciplinary process can help transform the findings of research into messages that are targeted, attractive and understandable