The Prevalence and Knowledge of Emergency Contraceptive Pills (ECP’s) among women in Kibera, Nairobi

Background: Emergency contraception (EC) refers to the use of certain contraceptive methods by women and girls to prevent pregnancy after unprotected sexual intercourse. Many women who have a need for emergency contraception do not use it. Usually, women simply do not know that it exists or, if they know, they do not know where to get it or how or when to use it.Young and unmarried women constitute a high risk group for unsafe abortions. It has been estimated that widespread use of emergency contraception may significantly reduce the number of abortion-related morbidity and mortality. The Consortium for Emergency has set a goal of making emergency contraceptive pills a standard part of reproductive health care worldwide. Objectives: The main objective of this study was to evaluate the prevalence, knowledge, attitudes and practises towards the uptake of emergency contraceptive pills by women in Kibera slum,Nairobi, Kenya Design: A Cross-sectional survey was conducted in Kibera, Nairobi Method: Multi stage sampling was used to determine the study population and 384 women were interviewed using a structured questionnaire. SPSS version 16 and STATA version 11 were used for statistical analyses. Results: The results were that the mean age of the women was 26 years with a standard deviation of 7.4. Majority of the women were married (52%). More than half (58%) reported to use a method of contraception. The prevalence of emergency contraceptive pill was found to be (23%).The findings of this study show that knowledge of emergency contraceptive pills was high (74%) meaning many women have heard about it. The main source of information of Emergency Contraceptive Pills (ECPs) was from friends and family (34%). However when it came to its usage, (37%) of the women thought that it would cause health problems if they used it, while (25%) were not familiar with the emergency contraceptive pill itself, hence were afraid of using it. The main reason for the women not using emergency contraceptives was because of misinformation (62%) followed by a lack of awareness (38%). Conclusion: This study found the prevalence of ECP to be 23% and that knowledge on ECP was adequate with more than half the women reporting to have heard of ECP. However awareness does not lead to use of ECP’s and the method is underused. The major constraint to ECP use was misinformation, with many women fearing that ECP might cause health problems or interfere with their fertility. Religion was also a constraint to ECP with only Protestants reporting its use.&nbsp

Lay perceptions of risk factors for Rift Valley fever in a pastoral community in northeastern Kenya

Background: Human behavioral factors have been found to be central in the transmission of Rift Valley fever. Consumption of contaminated meat and milk in particular have been identified as one of the key risk factors for the transmission of Rift Valley fever in humans. In pastoral communities, livestock is the main source of livelihood from which many benefits such as food as well as economic and cultural services are derived. Zoonotic diseases therefore have a great impact on pastoral communities livelihoods. However, lay perceptions regarding the transmission of these diseases including Rift Valley fever hampers their effective control. This study investigated the lay perceptions of risks for Rift Valley fever transmission in a pastoral community in northeastern Kenya. Methods: A qualitative study was carried out in Ijara district, Kenya which was one of the hotspots of Rift Valley during the 2006/2007 outbreak. Data were collected using focus group discussions and narratives guided by checklists. Eight focus group discussions consisting of 83 participants and six narratives were conducted. Data was transcribed, coded and analysed according to Emergent themes. Results: The participants reported that they had experienced Rift Valley fever in their livestock especially sheep and in humans both in 1997/1998 and 2006/2007. However, they believed that infections in humans occurred as a result of mosquito bites and had little to do with their consumption of meat, milk and blood from infected livestock. The participants in this study indicated that they had heard of the risks of acquiring the disease through consumption of livestock products but their experiences did not tally with the information they had received hence to them, Rift Valley fever was not transmissible through their dietary practices. Conclusions: Though the communities in this region were aware of Rift Valley fever, they did not have elaborate information regarding the disease transmission dynamics to humans. To avoid misconception about transmission of the disease, intervention strategies, require to be accompanied by comprehensive explanations of the dynamics of its transmission. It is necessary to develop appropriate interventions that take into consideration, lay perceptions of risk factors for the disease and communities’ livelihood strategies

Knowledge, Attitude and Practice factors associated with condom use among undergraduate Students of a Public University in Kenya (A case of Jomo Kenyatta University of Agriculture and Technology)

Condoms offer protection against unwanted pregnancy and some sexually transmitted infections including HIV. Interventions to promote condom use are essential in efforts to slow the spread of HIV. This study sought to find out factors associated with condom use among undergraduate university students at JKUAT, given that majority of the students fall within the vulnerable I5-24 year’s age bracket. The study focused on condom use and students (knowledge, attitudes and practices (KAP) on specific issues of HIV). A cross sectional study design was adopted. Simple random sampling was used to obtain the required sample size for both quantitative data (461 respondents) and snowball sampling for qualitative data (64 respondents). Data analysis was conducted using MS Access, SPSS and MS Excel applications. The findings of this study revealed among 461, 66.2% (305) had experienced sexual intercourse. The overall level of condom use was high 72.8% (222). There was a significant relationship between condom use and general attitude (P<0.001). However, there was no significantrelationship between condom use and (knowledge on specific issues of HIV and practices). Continuous health education campaigns on sexuality, proper usage and advantages of condoms should be enhanced

Fungal Infections among Diabetic Foot Ulcer- Patients Attending Diabetic Clinic in Kenyatta National Hospital, Kenya

Objective: To isolate and identify fungal pathogens associated with dermatophytoses in diabetic patients and identify the spectrum of yeasts colonising diabetic foot ulcers at Kenyatta National Hospital.Design: A cross sectional Laboratory based study.Setting: The Kenyatta National Hospital diabetic clinic.Subjects: Sixty one patients with diabetic foot ulcers from August to November 2009.Results: The five most occurring pathogens were Biopolaris hawaiiensis (5.5%), Trichophyton schoenleinii (3.7%), Aspergillus niger (3.0%), Trichophyton rubrum (3.0%), Fusarium oxysporum (3.0%). Other moulds accounted for less than 3.0%. One suspected case (0.6%) of Penicilium marneffei was isolated although it could not be ascertained due to its high containment requirement. Among the dermatophytes, the most occurring mould was Trichophyton schoenleinii (3.7%) while in non-dermatophyte was Biopolaris hawaiiensis (5.5%). Eight pathogenic yeasts were identified with C. parapsilosis (6.1 %) being the most common followed by C. famata (3.0%). Fungal infestation was highest in callus formation (78.6%).Conclusion: Fungal aetiological agents are significant cause of diabetic wound infection and may require antifungal intervention for successful management of diabetic foot ulcers

A School-Based Cross-Sectional Survey of Adverse Events following Co-Administration of Albendazole and Praziquantel for Preventive Chemotherapy against Urogenital Schistosomiasis and Soil-Transmitted Helminthiasis in Kwale County, Kenya

Background Soil-transmitted helminths and schistosomiasis are mostly prevalent in developing countries due to poor sanitation and lack of adequate clean water. School-age children tend to be the target of chemotherapy-based control programmes because they carry the heaviest worm and egg burdens. The present study examines adverse events (AEs) experienced following co-administration of albendazole and praziquantel to school-age children in a rural area in Kwale County, Kenya. Methods Children were treated with single doses of albendazole and praziquantel tablets and then interviewed using a questionnaire for post treatment AEs. Results Overall, 752 children, 47.6% boys, participated in the study. Their median (interquartile range) age was 12.0 (10.0–14.0) years. A total of 190 (25.3%) children reportedly experienced at least one AE. In total, 239 cases of AEs were reported with the most frequent being abdominal pains (46.3%), dizziness (33.2%) and nausea (21.1%). Majority of the reported AEs (80.8%) resolved themselves while 12.1% and 6.3% were countered by, respectively, self-medication and visiting a nearby health facility. More girls (60.5%) than boys (39.5%) reported AEs (P = 0.027). Conclusions The AEs were mild and transient, and were no worse than those expected following monotherapy. The current study adds to the evidence base that dual administration of albendazole and praziquantel in school-based mass drug administration is safe with only mild adverse events noted

Low permeability triple-layer plastic bags prevent losses of maize caused by insects in rural on-farm stores

Participatory on-farm trials were conducted to assess effectiveness of Purdue Improved Crop Storage (PICS™) bags for storage of maize in small-scale farmers’ stores in rural villages in eastern Kenya. A PICS bag is a three-layered hermetic bag-system that forms a barrier against the influx of oxygen and the escape of carbon dioxide. Jute, woven polypropylene or PICS bags were filled with shelled maize grain, purchased from the participating farmers, and the three sets of bags kept in the farmers’ own stores for 35 weeks. Oxygen and carbon dioxide levels in the PICS bags were monitored, as well as the temperature and relative humidity in all the bags. Grain moisture, live insect population, grain damage and weight loss were examined at intervals of seven weeks. Oxygen and carbon dioxide composition demonstrated that PICS bags are capable of sustaining good air-barrier properties under farmer storage conditions. Moreover, moisture content of maize stored in PICS bags did not change throughout the storage period whereas the moisture content of maize stored in polypropylene and jute bags decreased significantly in the final 14 weeks. Maize stored in PICS bags remained free from insect infestation and the weight loss due to insect damage was below 1 %. On the contrary, polypropylene and jute bags permitted profuse build-up of insect populations. At 35 weeks, grain damage reached 77.6 % and 82.3 % corresponding to 41.2 % and 48.5 % weight loss in the polypropylene and jute bags respectively. These findings demonstrate that PICS bags are effective in controlling losses caused by storage pests under farmer storage conditions

Spatial distribution and co-infection with urogenital and intestinal schistosomiasis among primary school children in Migori County, Kenya

Background: Schistosomiasis is the most prevalent helminthic infection in sub-Saharan Africa. School age children have the highest burden. Chronic schistosome infections in children can have irreversible effects lasting throughout adulthood.Objective: To determine the prevalence, intensity and distribution of urogenital and intestinal schistosomiasis among primary school children in Migori County, Kenya.Design: Descriptive cross-sectional study.Setting: Primary schools in Migori County, Kenya.Subjects: Children aged seven to fourteen years.Results: We enrolled 1,784 children with the ratio of female to males being 1:1. Their mean age was 11.4 years (standard deviation ± 1.6). The overall prevalence of infection was 26%, with urogenital and intestinal schistosomiasis being found in 9% and 20% of children, respectively. A trend of increasing prevalence with increasing age of children was observed. Boys had a 50% higher risk of being infected with schistosomiasis when compared to girls (adjusted odds ratio 1.5, 95% confidence interval 1.2-1.9). Intensities of schistosome infections did not vary significantly across gender and age. Nyatike Constituency had the highest prevalence of schistosomiasis (54%).Prevalence in schools ranged from 1.7 to 89%. Seven schools (23%) had a schistosomiasis prevalence of at least 50% while 12 (39%) schools had schistosomiasis prevalence of between 10 and 50%.Conclusion: Our study showed that schistosomiasis is endemic in the study area and represents a significant public health problem among school children. The area should be prioritised for interventions including mass deworming, public health education and sanitation improvement

Socio-Economic and Institutional Constraints to Accessing Credit among Smallholder Farmers in Nyandarua District, Kenya

Amongst the challenges faced by smallholder farmers in production is inaccessibility to credit. This study sought to identify household socio-economic and institutional constraints influencing access to credit among smallholder farmers in Nyandarua District. The study used a Logit model. Both quantitative and qualitative data were acquired from primary and secondary sources. Primary data was collected using questionnaires through a survey design. A sample of 164 smallholder farmers was selected using stratified, multi-stage random sampling techniques. Data was analyzed using descriptive statistics and maximum likelihood method using Statistical Package for Social Sciences (SPSS). The study established that socio-economic constraints such as age, gender, household size, farm income, collateral and awareness are critical determinants of access to credit. The study also established that institutional requirements such as costs involved in operating / maintaining bank accounts, loan requirements and transaction costs involved in the credit process influenced access to credit. The study concludes that household socio-economic characteristics and institutional requirements influence access to credit. Key recommendations made include the need by government to deal with bureaucracies involved in land registration to benefit majority of smallholder farmers who remain insecure in the land they use without proof of ownership and also to make easier the registration of lease certificates for those who do not own land and use land on leasehold tenure system. Financial institutions should also put in place less stringent credit requirements and reduce credit costs especially interest rates to make credit more affordable. Keywords: socio-economic and institutional constraints, credit access, smallholder farmers, logit model