School of Health Sciences

Extent of Disaster Risk Preparedness in Informal Settlements of Nyeri Town, Nyeri County, Kenya

2025-01-01T00:00:00Z

Extent of Disaster Risk Preparedness in Informal Settlements of Nyeri Town, Nyeri County, Kenya Muriuki, Zachary K. Informal settlements are growing in the world everyday due to poverty and inadequate land to settle. Most informal settlements are faced with a myriad of problems ranging from inadequate infrastructure, poor sanitation, water and noise pollution among others. This study sort to determine the extent of disaster risk preparedness in the informal settlements of Nyeri town, Nyeri County. The specific objectives of the study were to assess the level of awareness on the types of disasters and existing policies to address them, to establish disaster mitigation measures in place, to identify the role of stakeholders in disaster management, to identify the challenges encountered during disaster risk reduction initiatives. The study targeted residents of informal settlements in Majengo Witemere Ngangarithi kwa Mwaura, Mathari “transformer”, and Ruring’u Muslim village. This research applied descriptive cross-sectional study design. A sample of 384 residents was selected among the residents. Data was collected by use of questionnaires and key informant interview guide. Data analysis was done using SPSS version 21. Univariate analysis for each variable was done so as to yield descriptive statistics that was used to analyze the variables. Presentation of the findings was done through prose, tables and figures. The results indicated that there was a significant association between the area of residence and the level of compliance of policy rules concerned with disaster risk reduction [X2 (3) = 11.446, p-value =0.010<0.05]. However, there was no significant association between the area of residence and level of awareness of the disasters that could affect them [X2 (3) = 2.99, p-value =0.393>0.05], and neither was there significant association between the area of residence and level of awareness of any policy rule concerned with disaster risk reduction [X2 (3) =7.026, p-value =0.071>0.05]. Key informants interview was administered to 10 key informants within Nyeri County, these included each Managers and supervisors of Ministry of Health Nyeri County, County Government of Nyeri department disaster Management, Nationals interior and coordination office Nyeri, Kenya Red Cross Society Nyeri office and County National Disaster Management Authority Nyeri office. It was concluded that Risk assessment as a step for successful disaster reduction measures will ensure that the community members are aware of the possible hazards. National and County government should incorporate the national and international guidelines in their policy. Lessons learnt from previous disasters that have affected other informal settlements and other parts of the country should inform the formulation of mitigation measures for disaster management. The researcher further recommends to the scholars to consider research on disaster risk preparedness as the strategy of counties development agenda and Social and economic potentials that the County Governments can tap in informal settlements.

Factors Influencing Effectiveness of Community Based Tuberculosis Care Among Patients in Meru County, Kenya

2022-01-01T00:00:00Z

Factors Influencing Effectiveness of Community Based Tuberculosis Care Among Patients in Meru County, Kenya Mberia, Jane Kawira Factors that influence the effectiveness of Community Based Tuberculosis Care (CBTC) may differ depending on population setting, characteristics, cultural practices, life style and economic status. It is unclear factors that influence the effectiveness of CBTC with reported low case notification rate (280 per cases 100, 000 populations), low treatment success rate (<90%) below the WHO target of 90% and above followed by low community referrals (<9%) (MOH, 2014). This was a descriptive cross- sectional study design that collected quantitative and qualitative data to determine the effectiveness of Community based tuberculosis care (CTBC) among patients in Meru County. The main objective of the study was to determine factors that influence the effectiveness of CBTC among TB patients aged 18 years and above in Meru County. Specific objective included determinations of demographic factors, socio-economic factors, treatment factors, to assess the role of community health volunteers and to assess the patient's perceptions in Meru County. The study was conducted in Meru County health facilities implementing CBTC. Semi-structured questionnaires and key informants guide were used to collect data from the respondents. A sample size of 345 respondents were enrolled from high and low volume tuberculosis control zones and at the facility level (2:1). Simple random sampling, was used to select the health facilities, proportionate sampling was used to identify the number of participants to be enrolled in each facility, At the facility level simple random sampling method was used to identify participants during drug refill days. Quantitative data were analyzed using SPSS version 24 for statistics and STATA version 13 was used for inferential statistics. Qualitative data was transcribed manually. Overall 345 patients were recruited to participate in the study. The mean age of the respondents was 37.17 (+2) years and a standard deviation of 12.528 years. Majority of the respondents were males 267(77.4%), females only 78(22.6%). The respondents who had attained primary level of education 247(71.55%). Majority of the respondents were aged 18-36 years 195(56.5%). The main source of income the study respondents was mainly employment 217(62%). Majority of the respondents 210 (60.9%) took less than three months before seeking treatment despite having experienced signs and symptoms of tuberculosis. Effectiveness of CBTC improved with the age and level of education of the respondents at OR 1.39, 1.79 and OR 1.01, 1.02 respectively, although there was no significant association (p-0.076, p-0.788 respectively). The effectiveness of community based tuberculosis increased with the frequency of tuberculosis related outreach services; having outreach services on monthly basis was more effective at OR-1.00 compared to quarterly and annually at OR -0.29, OR-0.21 respectively at a confidence interval of 95% (CI 0.04-1.90). The study concluded that: Majority of the study respondents were males of primary level of education residing in rural areas. Majority of the respondents had temporary employment which had low income of below Kshs.10, 000 per month. Majority of treatment supporters were trained by healthcare workers before initiation of tuberculosis treatment. Minimal numbers of households were visited by community health volunteers within the first month of treatment. The study recommended that: Enhanced programs on tuberculosis should be designed and focused to male gender in the periphery. Enhance community based social protection measures such as cash transfer or incentives. Upscaling dissemination of knowledge on tuberculosis by health professionals. Training of more community health volunteers on basis modules of tuberculosis to improve household visits within one month of initiation of treatment.

Epidemiology and Characterization of Echinococcus in Samburu and Maasai Mara Game Park and Surrounding Environments in Kenya

2022-01-01T00:00:00Z

Epidemiology and Characterization of Echinococcus in Samburu and Maasai Mara Game Park and Surrounding Environments in Kenya Kithinji, Dorothy Kagendo Echinococcus granulosus parasite exists in two distinct life cycle patterns; domestic cycle involving domestic dogs and livestock; and sylvatic cycle that involves wild canids and wild herbivores. Humans become infected via ingestion of taeniid eggs shed by infected canids. Characterization of echinococcus species, the major cause of Echinococcus is necessary for prevention and control. This study was carried out to characterize genotypes and haplotypes of Echinococcus species and the disease epidemiology in wildlife and domestic cycles in Samburu and Maasai Mara game parks and surrounding environments. Humans in two pastoral communities, were examined for presence of hydatid cysts. Additionally, animal organs were collected for inspection of hydatid cysts. Faecal samples were also collected for taeniid eggs examination, and those specimens used for genotypic and haplotype analysis. A total of 4078 (1501 Samburu and 2577 Maasai Mara) individuals were examined by ultra sound for presence of hydatid cysts. The prevalence for the presence of cystic echinococcosis (CE) was 1.2% within Maasai Mara and 1.1% in Samburu. Prevalence was high in women compared to men with majority of cysts sequestered in the liver followed by the lungs. Nine hundred and six faecal samples (906) of domestic dogs were screened and 6.1% were positive for taeniid eggs. In wildlife, 729 faecal samples of wild carnivores had a 7.3% taeniid eggs positivity. Molecular analysis of cyst samples from Samburu and Maasai Mara livestock yielded 33.2% and 38.8% distinct sequences respectively. Specific genotypes in Samburu Echinococcosis granulosus (G1-3), Echinococcus canadensis (G6/7) and Echinococcus ortleppi (G5). Defined sequences in Maasai Mara livestock were 38.2% and all were Echinococcus granulosus (G1-3). In samburu, genotypes in domestic dogs were 9E. granulosus (G1-3) and 47E. felidis while other Taenia in the area included 7T. multiceps, 10T. madoquae and Taenia species, a species not yet described globally. In Maasai Mara domestic dog samples, genotypes included 86 E. granulosus (G1-3), 3 E. felidis, 2 E. ortleppi, 1 E. canadensis, 2 T. hydatigena and 2 T. multiceps. In wild carnivores, specific genotypes including 31 E. granulosus (G1-3) the sheep strain, 53E. felidis the lion strain, 2 E. canandensis G6/7,9 T. hydatigena, 1 T. Multiceps, amd T. Saginata, and Maasai Mara 1 E. granulosus (G1-3) (the sheep strain, 57 E. felidis, 6 T. multiceps, and 22 T. hydatigena were identified in Samburu and Maasai Mara respectively Phylogenetic analysis showed markable differences within the two cyles, which seem to overlap. The study concluded that Domestic dogs pose significant danger and residents and transmission of cystic Echinococcosis. There necessity to unveil intermediate host for the rare echinococcus ortleppi, to reveal existence of Echinococcus canandensis in wildlife, and to explore more on intermediate host for Echinococcus felidis, Finally, more studies on genomic differences between Echinococcus granulosus s.s genotype and Echinococcus felidis are required.

Analysis of Intestinal Schistosomiasis and Soil Transmitted Helminthiasis in Relation to Household Access to Water, Sanitation and Hygiene in Mwea, Kirinyaga County, Kenya

2022-01-01T00:00:00Z

Analysis of Intestinal Schistosomiasis and Soil Transmitted Helminthiasis in Relation to Household Access to Water, Sanitation and Hygiene in Mwea, Kirinyaga County, Kenya Gichuki, Paul Muriithi Intestinal schistosomiasis and soil-transmitted helminthiasis are major global public health problems. Preventive chemotherapy is the main control strategy, however in settings with poor access to water, sanitation and hygiene, the reduction in burden and morbidity is followed by rapid reinfection. A longitudinal study was carried out to assess the association between the two infections and access to improved water, sanitation and hygiene between July 2017and December 2018. 905 household heads were interviewed, and 3292 stool samples collected. The stool samples were screened for infection. Infected participants were treated with praziquantel 40mg/kg for intestinal schistosomiasis and albendazole 400mg for soil transmitted helminthiasis and followed up at 3 and 12 months. Associations were tested for significance using chi-square test (x2) or the Fisher exact test for categorical variables. Variables associated with intestinal schistosomiasis infection were analyzed using univariable analysis and the strength of the association measured as odd ratio (OR) using mixed effects logistics regression at 95% confidence interval, with values considered significant at p<0.05. Prevalence of any infection was 20.4%,0.4%, soil-transmitted helminthiasis and 20.1% intestinal schistosomiasis. 15.9% households had access to an improved water source, and 74.9% improved sanitation. The study recommends inclusion of adult community in mass drug administration, provision of improved water sources, sustained surveillances and hygiene education.