Predictors of linkage to care following community-based HIV counseling and testing in rural Kenya

Despite innovations in HIV counseling and testing (HCT), important gaps remain in understanding linkage to care. We followed a cohort diagnosed with HIV through a community-based HCT campaign that trained persons living with HIV/AIDS (PLHA) as navigators. Individual, interpersonal, and institutional predictors of linkage were assessed using survival analysis of self-reported time to enrollment. Of 483 persons consenting to follow-up, 305 (63.2%) enrolled in HIV care within 3 months. Proportions linking to care were similar across sexes, barring a sub-sample of men aged 18–25 years who were highly unlikely to enroll. Men were more likely to enroll if they had disclosed to their spouse, and women if they had disclosed to family. Women who anticipated violence or relationship breakup were less likely to link to care. Enrolment rates were significantly higher among participants receiving a PLHA visit, suggesting that a navigator approach may improve linkage from community-based HCT campaigns.Vestergaard Frandse

Novel sources of drought tolerance from landraces and wild sorghum relatives

Sorghum (Sorghum bicolor [L.] Moench) is the fifth most important cereal crop worldwide and second aftermaize (Zeamays L.) in Kenya. It is an important food security crop in arid and semi-arid lands, where its production potential is hampered by drought. Drought tolerance can be measured by a plant’s ability to resist premature senescence, often described as stay-green. This study was carried out with the objective of identifying novel stay-green trait among wild and landrace genotypes of sorghum. Forty-four sorghum genotypes that included 16 improved, nine landraces, and 17 wild relatives of sorghum alongside known stay-green sources, B35 and E36-1, were evaluated under well-watered and water-stressed conditions in an alpha-lattice design of three replications. Data was collected on plant height (PHT), flag leaf area (FLA), panicle weight (PWT), 100-seed weight (HSW), relative chlorophyll content (RCC), number of green leaves at maturity (GLAM), days to 50% flowering (DFL), and grain yield (YLD). Genetic diversity was determined using diversity arrays technology (DArT) sequencing and quality control (QC) markers were generated using a java script. Lodoka, a landrace, was the most drought-tolerant genotype, recorded the highest numbers of RCC and GLAM, and outperformed B35 and E36-1 in yield under water-stress and well-watered conditions. The RCC was highly correlated with GLAM (r = .71) and with yield-related traits, HSW (r = .85), PWT (r = .82), and YLD (r = .78). All traits revealed high heritability (broad-sense) ranging from 60.14 to 98.4% for RCC and DFL, respectively. These results confirm earlier reports that wild relatives and landraces are a good source of drought tolerance alleles

Rural-Urban Differences in Maternal Responses to Childhood Fever in South East Nigeria

Childhood fevers due to malaria remain a major cause of morbidity and mortality among under-five children in Nigeria. The degree of vulnerability perceived by mothers will affect their perception of the severity and threat of their child's fever and the patterns of health care use. This study was undertaken to compare maternal responses to childhood fever in urban and rural areas of Enugu, south east Nigeria.Data was collected with pre-tested interviewer-administered questionnaires from 276 and 124 urban and rural households respectively. In each household, only one woman aged 15-49 years who had lived in each of the urban and rural communities for at least one year and had at least one child less than 5 years old was interviewed. Malaria was mentioned as the commonest cause of childhood fevers. Rural mothers were more likely to recognize danger signs and symptoms than urban mothers. Rural mothers use more of informal than formal health services, and there is more home management of the fever with urban than rural mothers. Chloroquine, ACT, SP and Paracetamol are the main drugs given at home for childhood fevers, but the rural mothers were more likely to use leftover drugs from previous treatment to treat the fevers than urban mothers. The urban respondents were also more likely to use a preventive measure. Urban mothers sought actions faster than rural mothers and the total cost of treatment was also higher in urban areas.Both urban and rural mothers are aware that malaria is the major cause of childhood fevers. Although rural mothers recognize childhood fever and danger signs better than urban mothers, the urban mothers' responses to fever seem to be better than that for rural mothers. These responses and differences may be important for geographical targeting by policy makers for malaria interventions

Adapting agriculture to climate change: a synopsis of Coordinated National Crop Wild Relative Seed Collecting Programs across five continents.

Na publicação: Marcelo B. Medeiros

Health care switching behaviour of malaria patients in a Kenyan rural community

Patients ordinarily use multiple sources of health care. This study reveals the transitions patients in a rural region of Gusii, Kenya are likely to make beyond the homestead in their search for alternatives to combat malaria. Malaria is a very common health problem in the region resulting in enormous human and economic losses. Data on health care seeking behaviour were collected over a 10-month period. The primary data for this paper is from malaria-focused ethnographic interviews with 35 adults (18 women and 17 men). Results show that patients are more likely to start with self-treatment at home as they wait for a time during which they observe their progress. This allows them to minimise expenditure incurred as a result of the sickness. They are more likely to choose treatments available outside the home during subsequent decisions. The decisions include visiting a private health care practitioner, a government health centre or going to a hospital when the situation gets desperate. Knowledge and duration of sickness, the anticipated cost of treatment, and a patient's judgement of the intensity of sickness determine their choice of treatment.Health care Behaviour Malaria Focused ethnographic study Gusii Kenya

Is there a link between socio-cultural practices and vulnerability to Rift Valley fever in Baringo County, Kenya?

Rift Valley Fever (RVF) is a zoonotic disease that affects domestic ruminants, particularly sheep, cattle and goats. In livestock and humans, RVF is spread through bites from infected aedes and culex mosquitoes. Additional avenues of human infections include contact with infected animal secretions, tissues and aerosols. In Kenya, RVF outbreaks have occurred ten times with the first recorded in 1931 and the last in 2006. During the 2006-2007 outbreak, RVF occurred in Baringo County for the first time. The outbreak was associated with El Nino/Southern Oscillations related climatic anomalies. Through an on-going study on community adaptation to Malaria and RVF, which specifically focuses on how culture influences disease, data on socio-cultural practices in livestock production has been collected through focus group discussions and key informant interviews among the Tugen and Ilchamus communities of Baringo County. Preliminary findings show that both communities largely depend on livestock for their livelihoods. In terms of risk of exposure to RVF, both communities exhibit vulnerability based on their low level of awareness of the disease; consumption of meat from animals that die of diseases and unknown causes; disposal of dead animals; close contact with both healthy and sickly livestock; and management of human febrile illnesses. The study concludes that both communities are vulnerable to RVF and recommends that they should receive targeted awareness creation messages on the occurrence, transmission and prevention of RVF in order to decrease vulnerability to human and livestock infections

Youth participation in smallholder livestock production and marketing

Agriculture is a leading source of employment for rural populations in Kenya. Through a mixed methods approach, this study sought to investigate youth participation in smallholder livestock production and marketing in Baringo County. The specific focus is on how social norms and micropolitics enable or constrain participation of particular groups of young people. The study established that personal choice, preference for paid over unpaid labour and gender norms in asset access, ownership and control influence smallholder participation in livestock production and trade. This shows a disconnect between Kenya’s youth policy which advocates for equitable distribution of employment opportunities and the reality at community level. Interventions that seek to improve livestock production and marketing, particularly involving young people, should therefore adopt strategies that recognise these norms as a first step to addressing social exclusion