Neurocognitive and mental health outcomes in children with tungiasis: a cross-sectional study in rural Kenya and Uganda

Background: Tungiasis, a neglected tropical parasitosis, disproportionately affects children. Few empirical studies have reported neurocognitive and mental health outcomes of children with ectoparasitic skin diseases like tungiasis. Pathophysiology of tungiasis suggests it could detrimentally affect cognition and behaviour. This study pioneered the investigation of neurocognitive and mental health outcomes in children with tungiasis. Methods: This was a multi-site cross-sectional study including 454 quasi-randomly sampled school-children aged 8–14 from 48 randomly selected schools in two counties in Kenya and a district in Uganda. The participants were stratified into infected and uninfected based on the presence of tungiasis. The infected were further classified into mild and severe infection groups based on the intensity of the infection. Adapted, validated, and standardized measures of cognition and mental health such as Raven Matrices and Child Behaviour Checklist were used to collect data. Statistical tests including a multilevel, generalized mixed-effects linear models with family link set to identity were used to compare the scores of uninfected and infected children and to identify other potential risk factors for neurocognitive and behavioural outcomes. Results: When adjusted for covariates, mild infection was associated with lower scores in literacy [adjusted β(aβ) = − 8.9; 95% confidence interval (CI) − 17.2, − 0.6], language (aβ = − 1.7; 95% CI − 3.2, − 0.3), cognitive flexibility (aβ = − 6.1; 95% CI − 10.4, − 1.7) and working memory (aβ = − 0.3; 95% CI − 0.6, − 0.1). Severe infection was associated with lower scores in literacy (aβ = − 11.0; 95% CI − 19.3, − 2.8), response inhibition, (aβ = − 2.2; 95% CI − 4.2, − 0.2), fine motor control (aβ = − 0.7; 95% CI − 1.1, − 0.4) and numeracy (aβ = − 3; 95% CI − 5.5, − 0.4). Conclusions:This study provides first evidence that tungiasis is associated with poor neurocognitive functioning in children. Since tungiasis is a chronic disease with frequent reinfections, such negative effects may potentially impair their development and life achievements

Determinants of Participation in the Nonfarm Sector in a Conflict-Based Resettlement Scheme

The rural labour force in developing countries has been growing rapidly, but employment opportunities are not keeping pace. Hence, nonfarm employment must expand if deepening rural poverty is to be avoided. This is even more important for resettled households who are faced by numerous challenges in adapting to new environments which causes major changes in their livelihood activities. The probability of a households decision to participate in the nonfarm sector in a conflict based resettlement scheme is influenced by age, possession of a technical skill, number of dependents, size of cultivated land, wealth and time taken to walk to a water source. This paper recommends incorporating vocational training centers in resettlement schemes, promotion of primary production as a foundation for wealth creation and incorporating good water supply so as to reduce the time taken to walk to a water source

DETERMINANTS OF CHOICE OF ALTERNATIVE LIVELIHOOD DIVERSIFICATION STRATEGIES IN SOLIO RESETTLEMENT SCHEME, KENYA

Livelihood diversification by agricultural households in sub-Saharan Africa contributes significantly to household income. Over the last three decades there has been increased interest in literature on the subject. However, little has been done on the determinants of choice of alternative sets of strategies by households as well as the livelihood strategies chosen by resettled households. This study fills this gap in knowledge. This is important because it will guide policy makers in coming up with policies, programs and projects, that enable resettled households to easily reconstruct their livelihoods. The study addressed two objectives; first, it described the livelihood activities carried out by households in Solio, a resettlement scheme in central Kenya. Secondly, it evaluated the factors that influence the choice of alternative sets of livelihood strategies in the study area. To achieve the first objective, descriptive statistics were used to characterize the resettlement scheme using data collected through a semi-structured questionnaire and focus group discussions. The second objective was achieved by running a negative binomial regression model using data collected through a semi-structured questionnaire involving 196 respondents. The study found that households had diversified livelihoods from agriculture, where off-farm activities contribute over 67.4% of total household income. Age of the household head and possession of a technical skill were found to positively influence the number of livelihood strategies a household was involved in. Time taken to a water source was found to negatively influence the number of livelihood strategies a household was involved in. The study recommended, first, the improvement of access to water for domestic purposes as well as irrigation for crop production to supplement the low rainfall in the study area. Secondly, vi improvement of access to technical skills and training, and increased funding to village vocational training centers, for them to be better equipped to offer technical skills training which positively influence livelihood diversification. Such programs will positively influence livelihood diversification in rural areas and therefore curb the problems of food insecurity and youth unemployment