Abstract Background Animal bites in humans provide an important source of epidemiological information which is crucial in enhancing rabies surveillance in humans and animals. Rabies post exposure prophylaxis consumes substantial resources and exerts a lot of financial burden on animal bite injury victims and consumes resources and time. The overall objective of this study was to conduct a rapid epidemiological appraisal of animal bite injury and rabies post exposure prophylaxis in Kisumu County, Kenya. Methods A retrospective cross-sectional study was conducted in 32 administrative units (Sub-locations or wards) in Kisumu County, Kenya. Data was collected from outpatient department (OPD) registers in four peri-urban health centres in Kisumu East Sub County, Kenya. An integration of epidemiological tools for disease mapping was applied in the study. Quantum Geographic Information System was used to create a thematic map and spatial distribution of the animal bite injuries in Kisumu County. Results There were 133 (63%) males and 78(37%) female cases. The range in age was 11 – 40 years. The cases were highest among 11-17 years age group. Among the cases were 14( 6.6% ) children less than 10 years , 63(29.9% ) were of age group between 11-17 years, 49(23.2%) were in the age group between 18-24 years, 41(19.4%) were in the age bracket between 25-31 years, 24 (11.4%) were between 32 and 38 years, while 20(9.5%) were 38 years and above. Majority, (87.2 %) of the animal bite injuries were inflicted by domestic dogs. Wild dogs/stray dogs contributed 8.1% of the total number of animal bite injury cases. Cats and unknown animals contributed 1.4% and 3.3 respectively. The epidemiological curve shows that more than one case of animal bite injury occurred daily in Kisumu County between June and December, 2019 with the highest daily figure being 7. The study revealed the need to strengthen animal bite injury and rabies prevention and control strategies in Kisumu County. Conclusion
The study assessed the implementation of Kenya comprehensive school health pilot intervention program. This pilot program has informed the Kenya Comprehensive School Health Policy which is a critical document in the achievement of Millennium Development Goals relating to child health, gender equality, universal education and environmental sustainability. The study was based on focus group discussions, field observations and in-depth interviews with government officers who implemented the pilot program. The findings were categorized into implementation process, what is working well, what is not working well and lessons learned. During the course of the study, it was noted that involvement of all stakeholders enhances program ownership and sustainability but if they are not well coordinated or where supportive supervision and monitoring is not carried out, then some components of the comprehensive school health program may not be sustainable. We learnt that comprehensive school health program increases students' enrolment, attendance and retention, factors that are very important in a country's human resources development. The study has shown that although the formulation of a policy may be participatory and bottom-top, the implementation requires allocation of enough resources and coordination to bridge the gap between policy formulation and implementation.
We sought to determine the knowledge and attitude of public health workers (PHWs) with respect to emerging and re-emerging zoonotic diseases and the practice of one health approach in the surveillance of zoonoses in the community. A cross-sectional study was conducted in 12 randomly selected districts of Nyanza province, Kenya. One hundred and ten randomly-selected PHWs were assessed using a structured questionnaire. Data were collected on their knowledge, attitudes and practices about common zoonotic diseases. Eighty-nine (81%) questionnaires were received back. Eighty-seven (98%) said they discuss zoonotic diseases with the local villagers during their community health work. The most commonly discussed disease was rabies (n=39). Seventy-six (85%) respondents reported ever discussing zoonoses with their veterinary colleagues. Over 85% of the PHWs asked for refresher training on H1N1, and 51% require training on highly pathogenic avian influenza (H5N1). Despite fair knowledge of rabies among the PHWs in Nyanza province, there is need for improving their attitude of the emerging and reemerging zoonoses. There is also need to improve their practice in terms of collaboration with the veterinarians in zoonoses surveillance in the community.
Introduction:In order to prevent and control the spread of COVID-19 in Kenya the Ministry of Health (MoH) issued unprecedented guidelines to be followed by all citizens.Adherence to the MoH COVID-19 prevention and control guidelines in rural areas is generally a function of the residents' knowledge, attitude, and practices (KAP).Evidence shows that public knowledge is important in tackling pandemics. Objective:The overall objective of this study was to assess the determinants of adherence to the COVID-19 prevention and control guidelines by the rural small scale shop operators (SSSOs) in Siaya County, Kenya.Method: This is a cross sectional survey conducted in sixteen randomly selected market centres across Siaya County in May, 2020.The SSSOs were identified using a systematic random sampling technique.One hundred and seventy two rural SSSOs were requested to answer simple semistructured questions posed by the enumerators.The questionnaire assessed demographic characteristics, knowledge, attitude, and practice of the rural SSSOs toward COVID-19 prevention and control.Data were analysed using the Statistical Package for the Social Sciences (SPSS), version 26.Descriptive analysis focused on frequencies and percentages while chi-square test was applied to determine the differences between groups for selected study variables. Result:The response rate was 100% (172) with male being 71.5% (123) and female 28.5% (49).Majority, that is 32.6% (56) of the SSSOs were in the age group, between 2s1-25.About 32.6% (56) had poor knowledge of COVID-19; (χ 2 (4 N=172)=25.965,p=.000), while only 12.2 % (21) had good knowledge.About 40.7% (70) of the respondents had poor attitude (χ 2 (4, N=172)=103.756, p=.000) towards equally, 33.1% (57) had poor practice (χ 2 (3, N=172)=13.814,p=.000). Conclusion:The rural SSSOs in Siaya County have basic awareness about COVID-19 which is not translated into the knowledge about the cause prevention and control of the disease.Interventions aimed at improving the KAP of the rural SSSOs should be undertaken in order to enhance adherence to the COVID-19 prevention and control guidelines.This will also assist in cascading the right COVID-19 information in the rural villages across the County.
The global problem of access to improved sanitation and water management practices has been compounded by the gap existing between knowledge and practice as well as attitude. The aim of this study was to assess households' knowledge and attitude on water, sanitation, and hygiene practices through a school health programme. Semistructured questionnaires, focus group discussions, key informant interviews, and observation checklist were used to obtain information from 95 households which were systematically sampled. It was found that a school programme may not improve the gap between knowledge, attitude, and practice but may be good for future generations. This was found to be due to sociocultural issues which impede hygiene transformation. The implication is that health programmes must find innovative ways of bridging this gap in order to bring change in households through culture sensitive interventions.
Community-led total sanitation (CLTS) is a widely used approach for enhancing sanitation practices. However, the impact of boosted CLTS on household latrine ownership has not been adequately evaluated. This study aims to investigate the factors associated with latrine possession among households, with a specific focus on single and CLTS-boosting implementation. A community-based repeated cross-sectional study was conducted in Siaya County, Kenya, involving 512 households at the baseline and 423 households at the follow-up. Data were analyzed using the mixed-effects logistic regression model. At the baseline, latrine possession was significantly associated with CLTS implementation (adjusted OR [aOR]: 3.01; 95% confidence interval [CI]: 1.41–6.44), literacy among households (aOR: 1.83; 95% CI: 1.12–2.98) and higher socioeconomic status (SES) (second level: aOR: 2.48; 95% CI:1.41–4.36, third level: aOR: 3.11; 95% CI: 1.76–5.50, fourth level: aOR: 10.20; 95% CI: 5.07–20.54). At follow-up, CLTS boosting (aOR: 7.92; 95% CI: 1.77–35.45) and a higher SES were associated with increased latrine ownership (second level: aOR: 2.04; 95% CI: 0.97–4.26, third level: aOR: 7.73; 95% CI: 2.98–20.03, fourth level: aOR: 9.93; 95% CI: 3.14–28.35). These findings highlight the significant role played by both single and CLST boosting in promoting universal latrine ownership and empowering vulnerable households to understand the importance of sanitation and open defecation-free practices.
Background: The burden of malaria, schistosomiasis and soil transmitted helminthes (STH) in the islands of Lake Victoria, Kenya, poses a considerable public health challenge. Although many studies have been conducted on the co-infection arising from these parasites, few have evaluated communities’ knowledge of the same. Increasing the level of knowledge about a disease or preventive chemotherapy is important, but efforts need to be focused on community perception and understanding of the problem so as to encourage engagement with the proposed control measures. This study aimed at understanding a community’s knowledge of malaria, schistosomiasis and STH in Lake Victoria island where an integrated preventive chemotherapy intervention was implemented.Methods: This study was conducted in Ngodhe Island in Lake Victoria in Homa Bay County, western Kenya region between April and May 2016. The study adopted a mixed method approach where both qualitative and quantitative data collection was performed concurrently. Results: A total of 239 people participated in this study. All the respondents reported that they had heard about malaria, 89.1% had heard about schistosomiasis while 87.4% had heard about STH. The majority of the respondents (93.3%) drew their drinking water directly from the lake and 80.3% reported bathing in the lake. Out of all the respondents, 96.2% knew about the ongoing preventive chemotherapy. Most respondents (94.1%) said they would participate in a preventive chemotherapy again, while 0.4% was not sure. The majority of the respondents (86.6%) reported that integrated strategy is the most effective approach to control the three infections in the Island.Conclusion: The findings show a very high knowledge about these diseases. Although this study found majority of the respondents are aware of the co-infection of malaria, schistosomiasis and STH, their behaviors such as bathing in the lake exacerbates the problem.
Provision of safe water, adequate sanitation, and hygiene has been lauded as one way of preventing diarrheal infections and improving health especially in developing countries. However, lack of safe water, inadequate sanitation, and poor hygiene practices in most parts of rural Kenya have posed a challenge that exposes the populace to diarrhea cases and possible deaths. In this regard, many nongovernmental organizations and governmental agencies have tried to provide water, sanitation, and hygiene services with poor results. This study was conducted using qualitative research methods in Central Nyakach in Kisumu County, Kenya. The methods were focus group discussions (FGD), key informant interviews (KII), and observation of homesteads. The data were then analyzed thematically. Findings revealed that water issues are gendered and its use is socially and culturally categorized. Water storage is affected by traditions such as use of a clay pot, while sanitation and hygiene issues are ritualized and bound by taboos. Latrines are majorly constructed by men and sharing the same with in-laws and older children is prohibited. Children faeces are thrown out in the open fields as a means of disposal and hand washing with soap is nonexistent, since it is believed that doing so would make a person lose the ability to rear livestock. The implications of these findings are that some of these sociocultural practices have a profound effect on health of the population. This affects health care delivery through high incidence rates of disease, encourages “unhealthy” environments through open defecation and pollution, and negates the government’s commitment to national and international policies on universal health care provision.
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