Sero-prevalence and risk factors for human brucellosis in Marsabit county, Kenya (2014)

Introduction: brucellosis is among the world's most widespread zoonotic diseases which is recognized as a public health concern in both developed and developing countries. It is endemic in Kenya's pastoral communities where it is associated with significant economic losses due to decreased animal productivity and high burden in humans. The objectives of this study were: i) To estimate the sero-prevalence and determine the risk factors of brucellosis in humans ii) To assess the knowledge attitude and practices (KAP) of a pastoral community in relation to brucellosis transmission and control. Methods: cross-sectional survey was conducted within the pastoral ecosystem of Marsabit County. A total of 227 households were randomly selected. Blood samples were aseptically drawn from the selected humans and tested for Brucella immunoglobulin G (IgG) antibodies. Questionnaires were administered via personal interviews to the head of each study household to assess risk factors of transmission. Univariate and subsequently multivariate logistic regression analysis were performed examine the factors independently associated with Brucella seropositivity after adjustment for the effects of other explanatory variables. Results: the individual Brucella sero-prevalence was estimated at 44% (332/755) and that of the household at (73.13%). Although the majority (85.5%) of the respondents had heard of brucellosis, only a few could identify the disease by clinical signs in both humans and animals. The majority (88.5%) engaged in practices that were likely to enhance Brucella transmission and thus spread. Being a male herder increased the risk of infection by almost twice (OR=1.8136) compared to females. People who were either students, farmers, skilled or non-skilled off farm workers were less likely (OR=0.3053, 0.9038, 0.7749 and 0.2010 respectively) to be infected with brucellosis than housewives. Households where milk was boiled before consumption were less likely (OR=0.404) to have a higher rate of brucellosis infection than those who consumed raw milk. Households that used milk from their own animals were much less likely (OR= 0.1754) to have infection than those that use milk from other sources. Households that kept sheep and those that had members who assisted animals during delivery were more likely to have higher rates of brucellosis than those who never kept sheep and those who never assisted in delivery respectively. Conclusion: brucellosis is endemic in Marsabit County despite the low levels of knowledge and good control practices by the community. Consumption of raw milk and close contact with animal, particularly sheep are the highest risk factors There is a need for implementation of effective prevention strategies and advocacy practices like targeted livestock vaccinations and public education

Epidemiology of snake bites in selected areas of Kenya

Introduction: Snake bites are a silent public health problem in Kenya. Previous studies on snake bites in the country have mainly focused on identifying offending snake species, assessing the severity of envenomation and testing the efficacy of antivenom. Factors associated with snake bites in the country are yet to be fully understood. The aim of this work was to determine pharmaco-epidemiological factors associated with snake bites in areas of Kenya where incidence, severity and species responsible for snake bites have been reported. Methods: Kakamega provincial hospital, Kabarnet, Kapenguria and, Makueni district hospitals were selected as study sites based on previous findings on incidence, severity and species responsible for snake bites in catchment areas of these hospitals. Persistent newspaper reports of snake bites in these areas and distribution of snakes in Kenya were also considered. Cases of snake bites reported between 2007-2009 were retrospectively reviewed and data on incidence, age, site of the bites, time of bite and antivenom use was collected. Results: 176 bites were captured, 91 of which occurred in 2009. Individual incidence was between 2.7/100,000/year and 6.7/100,000/year. Bites peaked in the 1-15 year age group while 132/176 bites were in the lower limb area and 49/176 victims received antivenom. Most bites occurred during the dry season, in the bush and in the evening. Overall mortality was 2.27%. Conclusion: There is a need to sensitize the Kenyan public and healthcare personnel on preventive measures, first aid and treatment of snake bites