Soil Transmitted Helminthes Prevalence among Pre-School Age Children in Elburgon Municipality, Kenya

The prevalence of soil transmitted helminthes infection in pre-school age children was assessed in Elburgon Municipality, Kenya using Kato Katz as the standard parasitological survey diagnostic technique. Children between 6 months and 5 years were examined for STH infections. Out of 179 children examined, 154 (86%) were positive for the STH studied with Trichuris trichura accounting for the highest infection with 91 (50.84%), Ascaris, lumbricoides 45 (25.14%), and hookworm 18 (10.06%). Multiparasitism was evident with an overall 48 (28%) infection with a combination of two or three of the STH species studied. The high STH prevalence reported in this study was a result of unhygiene living environment with conditions that facilitate STH infections and transmission. T. Trichura had the highest prevalence because this is an urban STH species as compared to A. lumbricoides and hookworm. STH in pre-school age children is a virgin field in helminthes control. Mass deworming programs and parental education are required for effective STH control in this age group population that other is most vulnerable to helminthes infection. Keywords: soil transmitted helminthes, pre-school age children, prevalence, kato kat

Impact of Socio-Economic Factors on Sth Infection amongst Psac in Elburgon Municipality, Kenya

Socio-economic factors have been associated with high prevalence of soil transmitted helminthes infection in endemic areas. STH studies have been extensively conducted among school age children but non-school going children mostly those below five years and who actively play with soil are not common. In this study, 120 households in Elburgon Municipality were accessed using a structured question to determine the impact of these socio-economic factors on STH infection among pre-school age children. Kato Katz technique was used to determine the evidence of helminthes infection in 179 children who provided stool sample. The result from this study revealed that there was a general high prevalence 154 (86%) of STH infection with any of Trichuris trichura, Ascaris lumbricoides and hookworm or a combination of any two. The overall mother’s and father’s educational level and father’s occupation showed significant difference (p<0.05) in PSAC STH infection. Mother’s occupation and head of family revealed no significant difference (p>0.05) in this children age group infection. In Elburgon Municipality, households are crowded in living conditions that can be termed as semi urban slums and children often play together in common play grounds. Regardless of both parent’s educational level and occupation STH infection in young children remained high because of common hygienically compromised environments. This study suggest that it might be difficult to improve the socio-economic status of populations living in semi-urban slum like households but frequent health education programs for both parents about these intestinal worms can be effective tool that will help in control STH infections in PSAC. Keyword: Socio-economic, Soil Transmitted Helminthes, Pre-School Age, Kato Kat

Effect of Aflatoxin B-1 on Transmissibility of Trypanosoma Congolense in Mice

Mycotoxins as secondary metabolites are known to be common contaminants of both human food and animal feed. If ingested in minute but regular doses, they are known to cause suppression of the immune system and therefore, alter pathogenesis of many infectious diseases. Trypanosoma congolense an intravascular parasite is the most important cause of African animal trypanosomosis. The aim of this work was to investigate the effect of aflatoxin B-1, a common mycotoxin on transmissibility of T. congolense. Female Swiss white mice were intra-peritoneally injected with 0.05mg/kg body weight aflatoxin B-1 every after 3 days upto 10 times and on the 21st day were infected with T. congolense. Parasitological parameters including weight, packed cell volume and parasitemia levels of aflatoxin B-1-injected-T. congolense-infected mice were compared with those of T. congolense-infected mice. In a separate study, aflatoxin B-1-injected-T. congolense-infected and T. congolense-infected mice (12 each) were fed on by 400 tsetse flies. Some of these flies were used to cyclically infect 100 uninfected mice. ANOVA and mean separation were used to determine differences between the test and control mice. It was observed that there was significant difference (p?0.05) in body weight but no significant difference in packed cell volume, establishment of infection within the tsetse flies and subsequent transmission to uninfected mice. It was concluded that aflatoxin B-1 has an effect on pathogenesis and hence transmissibility of T. congolense. Keywords: Aflatoxin B-1, Trypanosoma congolense, pathogenesis, transmissibilit

Implementation of Universal Health Coverage Program in Kisumu County, Kenya: Importance of Social Marketing Strategies

Universal Health Coverage is where communities have access to all needed health services without financial hardship. In Kenya, Universal Health Coverage (UHC) program was launched in December 2018, through a presidential decree. This study aimed to understand population needs, acceptability, and perceptions about UHC implementation. The study was undertaken in four pilot counties of Kisumu, Machakos, Nyeri and Isiolo between February and March 2019, using exploratory qualitative data collection techniques. However, this paper focuses on the County of Kisumu which was selected due to its high prevalence of infectious diseases. Respondents included women of reproductive age, men, youth, and elderly persons. In-depth interviews were conducted among health care providers and managers. Scientific and ethical approval was obtained from the Kenya Medical Research Institute’s Scientific and Ethical Review Unit (SERU). Consenting to participate was individualized. Analysis was done thematically. Findings suggest that UHC was understood variously by different groupings. Sensitization about the UHC programme was done through electronic media, by CHVs, education sessions, political class and outreaches. Planning for the programme was done by holding meetings, trainings for community registration and developing budgets. However there was a lot os misunderstanding, confussion and misconcepts about the UHC concept as it was seen as a means to seek for votes by politicians. Barriers for successful implementation included critically understaffed facilities.

Challenges in management and treatment outcomes of HIV among adolescents and young adults in a county hospital in Kenya

Objective: To evaluate the challenges in management of HIV among adolescents and young adults (AYA) aged 10-24 years and their treatment outcomes in terms of viral load suppression. Design: Cross sectional study with primary and secondary data. Setting: Secondary level health facility in sub-Saharan Africa. Subjects: Data on treatment outcomes was obtained from 106 subjects through abstraction from files. Primary data on challenges in management was obtained from in-depth interviews on 18 subjects, one focused group discussion with seven participants and 10 key informant interviews. Main Outcome Measures: Viral load suppression after at least six months of treatment. Results: Out of 106 eligible adolescents, records on viral suppression were only available for 60 (56.7%). For those who had available records, 85 (80%) had achieved viral suppression, with viral load <1000 copies per ml. Of those who had achieved viral suppression, 80 (75%) had undetectable levels. The viral suppression was associated with the type of treatment, adherence to medication and follow-up status [p= <0.0001, p= <0.0001, p= <0.002,] respectively. The main themes on challenges in management identified from the interviews and focused group discussion were psychosocial and difficulty in taking medication as follows: Conclusions: The main challenges in the management of HIV within this population are psychosocial and medication-use related. Viral suppression was associated with first line of treatment, adherence to medication and active follow up status