Determinants of Demand for Health Care Among Sexually Transmitted Infections Patients in Kenya

Globally, sexually transmitted infections (STIs) have become an enormous burden leading to high mortality and morbidity. In Kenya, various policies have been formulated to address various conditions including STIs. Individuals suffering from STIs are highly encouraged to seek medical care and avoid transmitting to uninfected individuals. In Kenya, about 14% of men and 25% of women never sought treatment for STIs or advice from any healthcare service provider. Furthermore, 42% and 23% of people with sexually transmitted infections had been symptomatic for a period of one and two weeks respectively. Although numerous studies have been conducted in many countries to establish the determinants of healthcare use among people with sexually transmitted infections, there is still very little information on the determinants of healthcare use among STI patients in Kenya. The aim of this study was to determine factors influencing health care demand for STIs in Kenya. The study analyzed data from the 2014 Kenya Demographic Household Survey (KDHS). Descriptive statistics and binary probit regression analyses were done to explore factors influencing the use of health services among STI patients in Kenya. The findings revealed that the age of the patient, sex, marital status, education levels, wealth quintiles, employment status, residence, and sex partners were statistically significant determinants of the utilization of healthcare services among STI patients in Kenya

Effects of an E-Learning Module on Students’ Attitudes in an Electronics Class

Research has shown that students exhibit negative attitudes towards Electronics especially when they are taught using the conventional method. This is in addition to poor instructional methods that do not promote individualization of instruction or make learning interesting. The purpose of this study was to design an e-learning module in “Transistors” – a topic in the Electronics course - and determine its effects on students’ attitudes in Kenyan Polytechnics. The Solomon-three quasi-experimental, non-equivalent control group research design was used for the study. A sample consisting of 103 first year Electronic Engineering students from three Polytechnics were randomly assigned to three groups; one experimental, E and two controls; C1 and C2. A self-administered Students’ Attitude Questionnaire (SAQ) with a calculated Cronbach-alpha reliability coefficient of 0.88 was used for data collection. The data was analysed using t-tests and the analysis of covariance (ANCOVA) statistical test at an alpha level of significance of 0.05. The results of the t-test revealed that the differences in gain from pre-test to post-test between groups E and C1 were significant in favour of group E. Further results using ANCOVA revealed that there were statistically significant differences in post-test scores for students’ attitudes between groups E and C2 in favour of group E. This showed that the presence of a pre-test had a significant effect on students’ attitude towards the topic being taught irrespective of whether they were taught using the e-learning module or the conventional method. The findings of the study shall be useful to Electronics students and lecturers, curriculum developers, e-learning practitioners and educational policy makers in Kenya. Keywords: e-learning, conventional method, attitudes, electronics, transistors, studen

Activity-specific mobility of adults in a rural region of western Kenya

Improving rural household access to resources such as markets, schools and healthcare can help alleviate poverty in low-income settings. Current models of geographic accessibility to various resources rarely take individual variation into account due to a lack of appropriate data, yet understanding mobility at an individual level is key to knowing how people access their local resources. Our study used both an activity-specific survey and GPS trackers to evaluate how adults in a rural area of western Kenya accessed local resources. We calculated the travel time and time spent at six different types of resource and compared the GPS and survey data to see how well they matched. We found links between several demographic characteristics and the time spent at different resources, and that the GPS data reflected the survey data well for time spent at some types of resource, but poorly for others. We conclude that demography and activity are important drivers of mobility, and a better understanding of individual variation in mobility could be obtained through the use of GPS trackers on a wider scale

High prevalence of <i>Rickettsia africae</i> variants in <i>Amblyomma variegatum</i> ticks from domestic mammals in rural western Kenya: implications for human health

Tick-borne spotted fever group (SFG) rickettsioses are emerging human diseases caused by obligate intracellular Gram-negative bacteria of the genus Rickettsia. Despite being important causes of systemic febrile illnesses in travelers returning from sub-Saharan Africa, little is known about the reservoir hosts of these pathogens. We conducted surveys for rickettsiae in domestic animals and ticks in a rural setting in western Kenya. Of the 100 serum specimens tested from each species of domestic ruminant 43% of goats, 23% of sheep, and 1% of cattle had immunoglobulin G (IgG) antibodies to the SFG rickettsiae. None of these sera were positive for IgG against typhus group rickettsiae. We detected Rickettsia africae–genotype DNA in 92.6% of adult Amblyomma variegatum ticks collected from domestic ruminants, but found no evidence of the pathogen in blood specimens from cattle, goats, or sheep. Sequencing of a subset of 21 rickettsia-positive ticks revealed R. africae variants in 95.2% (20/21) of ticks tested. Our findings show a high prevalence of R. africae variants in A. variegatum ticks in western Kenya, which may represent a low disease risk for humans. This may provide a possible explanation for the lack of African tick-bite fever cases among febrile patients in Kenya

First report of root rot caused by Pythiumspp. on chickpea in South Africa

Chickpea is a relatively new crop in the NE South Africa. High incidences of plant death were observed in an experiment that was established in 2012 in Mziniti, South Africa to assess the agronomic performance of 66 elite chickpea lines from International Crop Research Institute for Semi-Arid Tropics. Infected plants showed signs of root rot. Therefore this study aimed at investigating the cause of the root rot. Roots of infected plants were sampled and incubated at 25°C until colonies of the pathogen were observed. Colonies were sub-cultured with sterile soil extract and sterile leaf blades. Isolates were stored in sterile distilled water with leaf blades in screw capped 15 ml McCarthy bottles at 18°C. The pathogen was identified as Pythium irregulare based on morphological structures and species description. The isolates were inoculated on healthy potted chickpea plants and these showed root rot symptoms similar to field observation. The pathogen was re-isolated from the inoculated plants and cultured; they showed similar characteristics to the ones observed during the first isolation. This is the first report of P. irregulare incidence on chickpea in South Africa

Seroevidence of Zoonotic Viruses in Rodents and Humans in Kibera Informal Settlement, Nairobi, Kenya

Rodents are known reservoir hosts for a number of pathogens that can spillover into humans and cause disease. These threats are likely to be elevated in informal urban settlements (i.e., slums), where rodent and human densities are often high, rodents live in close proximity to humans, and human knowledge of disease risks and access to health care is often limited. While recent research attention has focused on zoonotic risks posed by urban rodents in major cities around the world, informal urban settlements have received far less attention. Here we report on a study in which samples were collected from 195 commensal rodents and 124 febrile human patients in the Kibera informal settlement in Nairobi, Kenya (one of the largest informal urban settlements in the world). Using immunofluorescence assays, samples were screened for antibodies against common rodent-borne zoonotic virus groups, namely orthopoxviruses, arenaviruses, and hantaviruses. We detected antibodies against orthopoxviruses in rodents (4.1% positive) and antibodies in humans against orthopoxviruses, arenaviruses, and hantaviruses (4.8%, 3.2%, and 8.1% positive, respectively). No rodents had antibodies against arenaviruses or hantaviruses. These results provide strong evidence for the circulation of zoonotic viruses in rodents and humans in Kibera urban settlement, but discordance between viruses detected in host groups indicates that other species or taxa may also serve as reservoirs for these zoonotic viruses or that humans testing positive could have been exposed outside of the Kibera settlement. More broadly, this study highlights the threat posed by zoonotic viruses in informal urban settlements and the need to mitigate human exposure risks.Peer reviewe

Seroevidence of Zoonotic Viruses in Rodents and Humans in Kibera Informal Settlement, Nairobi, Kenya

Rodents are known reservoir hosts for a number of pathogens that can spillover into humans and cause disease. These threats are likely to be elevated in informal urban settlements (i.e., slums), where rodent and human densities are often high, rodents live in close proximity to humans, and human knowledge of disease risks and access to health care is often limited. While recent research attention has focused on zoonotic risks posed by urban rodents in major cities around the world, informal urban settlements have received far less attention. Here we report on a study in which samples were collected from 195 commensal rodents and 124 febrile human patients in the Kibera informal settlement in Nairobi, Kenya (one of the largest informal urban settlements in the world). Using immunofluorescence assays, samples were screened for antibodies against common rodent-borne zoonotic virus groups, namely orthopoxviruses, arenaviruses, and hantaviruses. We detected antibodies against orthopoxviruses in rodents (4.1% positive) and antibodies in humans against orthopoxviruses, arenaviruses, and hantaviruses (4.8%, 3.2%, and 8.1% positive, respectively). No rodents had antibodies against arenaviruses or hantaviruses. These results provide strong evidence for the circulation of zoonotic viruses in rodents and humans in Kibera urban settlement, but discordance between viruses detected in host groups indicates that other species or taxa may also serve as reservoirs for these zoonotic viruses or that humans testing positive could have been exposed outside of the Kibera settlement. More broadly, this study highlights the threat posed by zoonotic viruses in informal urban settlements and the need to mitigate human exposure risks.Peer reviewe

Serological Evidence of Exposure to Onyong-Nyong and Chikungunya Viruses in Febrile Patients of Rural Taita-Taveta County and Urban Kibera Informal Settlement in Nairobi, Kenya

Several alphaviruses, such as chikungunya (CHIKV) and Onyong-nyong (ONNV), are endemic in Kenya and often cause outbreaks in different parts of the country. We assessed the seroprevalence of alphaviruses in patients with acute febrile illness in two geographically distant areas in Kenya with no previous record of alphavirus outbreaks. Blood samples were collected from febrile patients in health facilities located in the rural Taita-Taveta County in 2016 and urban Kibera informal settlement in Nairobi in 2017 and tested for CHIKV IgG and IgM antibodies using an in-house immunofluorescence assay (IFA) and a commercial ELISA test, respectively. A subset of CHIKV IgG or IgM antibody-positive samples were further analyzed using plaque reduction neutralization tests (PRNT) for CHIKV, ONNV, and Sindbis virus. Out of 537 patients, 4 (0.7%) and 28 (5.2%) had alphavirus IgM and IgG antibodies, respectively, confirmed on PRNT. We show evidence of previous and current exposure to alphaviruses based on serological testing in areas with no recorded history of outbreaks.Peer reviewe

Serological Evidence of Exposure to Onyong-Nyong and Chikungunya Viruses in Febrile Patients of Rural Taita-Taveta County and Urban Kibera Informal Settlement in Nairobi, Kenya

Several alphaviruses, such as chikungunya (CHIKV) and Onyong-nyong (ONNV), are endemic in Kenya and often cause outbreaks in different parts of the country. We assessed the seroprevalence of alphaviruses in patients with acute febrile illness in two geographically distant areas in Kenya with no previous record of alphavirus outbreaks. Blood samples were collected from febrile patients in health facilities located in the rural Taita-Taveta County in 2016 and urban Kibera informal settlement in Nairobi in 2017 and tested for CHIKV IgG and IgM antibodies using an in-house immunofluorescence assay (IFA) and a commercial ELISA test, respectively. A subset of CHIKV IgG or IgM antibody-positive samples were further analyzed using plaque reduction neutralization tests (PRNT) for CHIKV, ONNV, and Sindbis virus. Out of 537 patients, 4 (0.7%) and 28 (5.2%) had alphavirus IgM and IgG antibodies, respectively, confirmed on PRNT. We show evidence of previous and current exposure to alphaviruses based on serological testing in areas with no recorded history of outbreaks.Peer reviewe

Electronic data collection to enhance disease surveillance at the slaughterhouse in a smallholder production system

Globally, meat inspection provides data for animal health surveillance. However, paper-based recording of data is often not reported through to higher authorities in sufficient detail. We trialled the use of an electronic meat inspection form in Kenyan slaughterhouses, in lieu of the currently used paper-based format. Meat inspectors in two ruminant slaughterhouses completed and submitted an electronic report for each animal slaughtered at their facility. The reports, which captured information on the animal demographics and any eventual condemnations, were stored in a central database and available in real-time. A stakeholder meeting was held towards the end of the study. Over the 2.75 year study period, 16,386 reports were submitted; a downward linear trend in the monthly submissions was noted. There was a week effect, whereby more reports were submitted on the market day. Of the slaughtered animals, 23% had at least a partial condemnation. The most frequently condemned organs were the liver, lungs and intestines; the primary reasons for condemnations were parasitic conditions. Lack of feedback and difficulty capturing animal origin information were the primary challenges highlighted. The study demonstrated that electronic data capture is feasible in such challenging environments, thereby improving the timeliness and resolution of the data collected