19 results on '"Amwayi, S."'
Search Results
2. Risk factors for severe Rift Valley fever infection in Kenya, 2007
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David Schnabel, Janusz T. Paweska, Patrick Nguku, M. Kariuki Njenga, L. Hannah Gould, Amwayi S. Anyangu, Daniel R. Feikin, Allen W. Hightower, Edith R. Lederman, Carol Y. Rao, Robert F. Breiman, Jared Omolo, Mark A. Katz, Shahnaaz K. Sharif, and David Mutonga
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Adult ,Male ,Veterinary medicine ,medicine.medical_specialty ,Adolescent ,Rift Valley Fever ,Antibodies, Viral ,Severity of Illness Index ,Serology ,Disease Outbreaks ,Young Adult ,Risk Factors ,Virology ,Internal medicine ,Severity of illness ,Epidemiology ,Medicine ,Animals ,Humans ,Risk factor ,Rift Valley fever ,business.industry ,Outbreak ,Odds ratio ,Articles ,medicine.disease ,Rift Valley fever virus ,Kenya ,Infectious Diseases ,Animals, Domestic ,Attributable risk ,Parasitology ,Female ,business - Abstract
A large Rift Valley fever (RVF) outbreak occurred in Kenya from December 2006 to March 2007. We conducted a study to define risk factors associated with infection and severe disease. A total of 861 individuals from 424 households were enrolled. Two hundred and two participants (23%) had serologic evidence of acute RVF infection. Of these, 52 (26%) had severe RVF disease characterized by hemorrhagic manifestations or death. Independent risk factors for acute RVF infection were consuming or handling products from sick animals (odds ratio [OR] = 2.53, 95% confidence interval [CI] = 1.78-3.61, population attributable risk percentage [PAR%] = 19%) and being a herds person (OR 1.77, 95% CI = 1.20-2.63, PAR% = 11%). Touching an aborted animal fetus was associated with severe RVF disease (OR = 3.83, 95% CI = 1.68-9.07, PAR% = 14%). Consuming or handling products from sick animals was associated with death (OR = 3.67, 95% CI = 1.07-12.64, PAR% = 47%). Exposures related to animal contact were associated with acute RVF infection, whereas exposures to mosquitoes were not independent risk factors.
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- 2010
3. Rift Valley fever outbreak--Kenya, November 2006-January 2007
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Nguku, P., Sharif, S., Omar, A., Nzioka, C., Muthoka, P., Njau, J., Dahiye, A., Galgalo, T., Mwihia, J., Njoroge, J., Limo, H., Mutiso, J., Kalani, R., Sheikh, A., Nyikal, J., Mutonga, D., Omollo, J., Guracha, A., Muindi, J., Amwayi, S., Langat, D., Owiti, D., Mohammed, A., Musaa, J., Sang, R., Breiman, R., Njenga, K., Feikin, D., Katz, M., Burke, H., Nyaga, P., Ackers, M., Gikundi, S., Omballa, V., Nderitu, L., Wamola, N., Wanjala, R., Omulo, S., Richardson, J., Schnabel, D., Martin, S., Hoel, D., Hanafi, H., Weiner, M., Onsongo, J., Kojo, T., Duale, M., Hassan, A., Dabaar, M., Njuguna, C., Yao, M., Grein, T., Formenty, P., Telfer, B., Lepec, R., Feldmann, H., Grolla, A., Wainwright, S., Lederman, E., Farnon, E., Rao, C., Kapella, B.K., and Gould, H.
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Market trend/market analysis ,Epidemics -- Kenya ,Epidemics -- Forecasts and trends ,Rift Valley fever -- Causes of ,Rift Valley fever -- Care and treatment - Abstract
In mid-December 2006, several unexplained fatalities associated with fever and generalized bleeding were reported to the Kenya Ministry of Health (KMOH) from Garissa District in North Eastern Province (NEP). By [...]
- Published
- 2007
4. A National Cholera Epidemic With High Case Fatality Rates--Kenya 2009
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Loharikar, A., primary, Briere, E., additional, Ope, M., additional, Langat, D., additional, Njeru, I., additional, Gathigi, L., additional, Makayotto, L., additional, Ismail, A. M., additional, Thuranira, M., additional, Abade, A., additional, Amwayi, S., additional, Omolo, J., additional, Oundo, J., additional, De Cock, K. M., additional, Breiman, R. F., additional, Ayers, T., additional, Mintz, E., additional, and O'Reilly, C. E., additional
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- 2013
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5. Syphilis among pregnant women in Juba, Souther Sudan
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Emmanuel, SK, primary, Lado, M, additional, Amwayi, S, additional, Abade, AM, additional, Oundo, JO, additional, and Ongus, Jr, additional
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- 2011
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6. Risk Factors for Severe Rift Valley Fever Infection in Kenya, 2007
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Anyangu, Amwayi S., primary, Njenga, M. Kariuki, additional, Paweska, Janusz T., additional, Lederman, Edith R., additional, Mutonga, David, additional, Sharif, Shahnaaz K., additional, Katz, Mark, additional, Schnabel, David, additional, Nguku, Patrick M., additional, Gould, L. Hannah, additional, Feikin, Daniel R., additional, Hightower, Allen, additional, Rao, Carol Y., additional, Omolo, Jared O., additional, and Breiman, Robert F., additional
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- 2010
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7. Environmental Assessment and Blood Lead Levels of Children in Owino Uhuru and Bangladesh Settlements in Kenya.
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Etiang' NA, Arvelo W, Galgalo T, Amwayi S, Gura Z, Kioko J, Omondi G, Patta S, Lowther SA, and Brown MJ
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Background: Lead exposure is linked to intellectual disability and anemia in children. The United States Centers for Disease Control and Prevention (CDC) recommends biomonitoring of blood lead levels (BLLs) in children with BLL ≥5 μg/dL and chelation therapy for those with BLL ≥45 μg/dL., Objectives: This study aimed to determine blood and environmental lead levels and risk factors associated with elevated BLL among children from Owino Uhuru and Bangladesh settlements in Mombasa County, Kenya., Methods: The present study is a population-based, cross-sectional study of children aged 12-59 months randomly selected from households in two neighboring settlements, Owino Uhuru, which has a lead smelter, and Bangladesh settlement (no smelter). Structured questionnaires were administered to parents and 1-3 ml venous blood drawn from each child was tested for lead using a LeadCare
® II portable analyzer. Environmental samples collected from half of the sampled households were tested for lead using graphite furnace atomic absorption spectroscopy., Results: We enrolled 130 children, 65 from each settlement. Fifty-nine (45%) were males and the median age was 39 months (interquartile range (IQR): 30-52 months). BLLs ranged from 1 μg/dL to 31 μg/dL, with 45 (69%) children from Owino Uhuru and 18 (28%) children from Bangladesh settlement with BLLs >5 μg/dL. For Owino Uhuru, the geometric mean BLL in children was 7.4 μg/dL (geometric standard deviation (GSD); 1.9) compared to 3.7 μg/dL (GSD: 1.9) in Bangladesh settlement (p<0.05). The geometric mean lead concentration of soil samples from Owino Uhuru was 146.5 mg/Kg (GSD: 5.2) and 11.5 mg/Kg (GSD: 3.9) (p<0.001) in Bangladesh settlement. Children who resided <200 m from the lead smelter were more likely to have a BLL ≥5 μg/dL than children residing ≥200 m from the lead smelter (adjusted odds ratio (aOR): 33.6 (95% confidence interval (CI): 7.4-153.3). Males were also more likely than females to have a BLL ≥5 μg/dL (39, 62%) compared to a BLL<5 μg/dL [aOR: 2.4 (95% CI: 1.0-5.5)]., Conclusions: Children in Owino Uhuru had significantly higher BLLs compared with children in Bangladesh settlement. Interventions to diminish continued exposure to lead in the settlement should be undertaken. Continued monitoring of levels in children with detectable levels can evaluate whether interventions to reduce exposure are effective., Participant Consent: Obtained., Ethics Approval: Scientific approval for the study was obtained from the Ministry of Health, lead poisoning technical working group. Since this investigation was considered a public health response of immediate concern, expedited ethical approval was obtained from the Kenya Medical Research Institute and further approval from the Mombasa County Department of Health Services. The investigation was considered a non-research public health response activity by the CDC., Competing Interests: The authors declare no competing financial interests.- Published
- 2018
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8. Strengthening health systems in Africa: a case study of the Kenya field epidemiology training program for local frontline health workers.
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Roka ZG, Githuku J, Obonyo M, Boru W, Galgalo T, Amwayi S, Kioko J, Njoroge D, and Ransom JA
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The logistical and operational challenges to improve public health practice capacity across Africa are well documented. This report describes Kenya's Field Epidemiology and Laboratory Training Program's (KFELTP) experience in implementing frontline public health worker training to transfer knowledge and practical skills that help strengthen their abilities to detect, document, respond to, and report unusual health events. Between May 2014 and May 2015, KFELTP hosted five training courses across the country to address practice gaps among local public health workers. Participants completed a 10-week process: two 1-week didactic courses, a 7-week field project, and a final 1-week course to present and defend the findings of their field project. The first year was a pilot period to determine whether the program could fit into the existing 2-year KFELTP model and whether this frontline-level training would have an impact on local practice. At the end of the first year, KFELTP certified 167 frontline health workers in field epidemiology and data management. This paper concludes that local, national, and international partnerships are critical for improving local public health response capacity and workforce development training in an African setting., Competing Interests: Not applicable.Not applicable.The authors declare that have no competing interests.Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
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- 2017
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9. Evaluation of the efficacy, acceptability and palatability of calcium montmorillonite clay used to reduce aflatoxin B1 dietary exposure in a crossover study in Kenya.
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Awuor AO, Yard E, Daniel JH, Martin C, Bii C, Romoser A, Oyugi E, Elmore S, Amwayi S, Vulule J, Zitomer NC, Rybak ME, Phillips TD, Montgomery JM, and Lewis LS
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- Bentonite adverse effects, Cross-Over Studies, Female, Humans, Kenya, Male, Aflatoxin B1 toxicity, Bentonite chemistry, Diet, Environmental Exposure
- Abstract
Acute aflatoxin exposure can cause death and disease (aflatoxicosis) in humans. Aflatoxicosis fatality rates have been documented to be as high as 40% in Kenya. The inclusion in the diet of calcium silicate 100 (ACCS100), a calcium montmorillonite clay, may reduce aflatoxin bioavailability, thus potentially decreasing the risk of aflatoxicosis. We investigated the efficacy, acceptability and palatability of ACCS100 in a population in Kenya with recurring aflatoxicosis outbreaks. Healthy adult participants were enrolled in this double-blinded, crossover clinical trial in 2014. Following informed consent, participants (n = 50) were randomised to receive either ACCS100 (3 g day
-1 ) or placebo (3 g day-1 ) for 7 days. Treatments were switched following a 5-day washout period. Urine samples were collected daily and assessed for urinary aflatoxin M1 (AFM1 ). Blood samples were collected at the beginning and end of the trial and assessed for aflatoxin B1-lysine adducts from serum albumin (AFB1 -lys). AFM1 concentrations in urine were significantly reduced while taking ACCS100 compared with calcium carbonate placebo (β = 0.49, 95% confidence limit = 0.32-0.75). The 20-day interval included both the placebo and ACCS100 treatments as well as a washout period. There were no statistically significant differences in reported taste, aftertaste, appearance, colour or texture by treatment. There were no statistically significant differences in self-reported adverse events by treatment. Most participants would be willing to take ACCS100 (98%) and give it to their children (98%). ACCS100 was effective, acceptable and palatable. More work is needed to test ACCS100 among vulnerable populations and to determine if it remains effective at the levels of aflatoxin exposure that induce aflatoxicosis.- Published
- 2017
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10. Prevalence of undiagnosed diabetes and pre-diabetes among hypertensive patients attending Kiambu district Hospital, Kenya: a cross-sectional study.
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Meme N, Amwayi S, Nganga Z, and Buregyeya E
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- Adult, Aged, Aged, 80 and over, Cross-Sectional Studies, Diabetes Mellitus diagnosis, Female, Glycated Hemoglobin metabolism, Hospitals, District, Humans, Kenya epidemiology, Male, Middle Aged, Outpatients, Prediabetic State diagnosis, Prevalence, Blood Glucose metabolism, Diabetes Mellitus epidemiology, Hypertension epidemiology, Prediabetic State epidemiology
- Abstract
Introduction: Hypertension (HTN) and diabetes mellitus (DM) are two common non-communicable diseases (NCDs) that are closely linked: one cannot be properly managed without attention to the other. The aim of this study was to determine the prevalence of undiagnosed diabetic and pre-diabetic states that is abnormal glucose regulation (AGR) and factors associated with it among hypertensive patients in Kiambu Hospital, Kenya., Methods: We conducted a cross-sectional study from February 2014 to April 2014. Hypertensive patients aged ≥ 18 attending the out-patient medical clinic were included in the study. Pregnant and known diabetic patients were excluded. Data was collected on socio-demographics, behavior, and anthropometrics. Diabetes status was based on a Glycated Haemoglobin (HbA1C) classification of ≥ 6.5% for diabetes, 6.0-6.4% for pre-diabetes and ≤ 6.0% for normal. AGR was the dependable variable and included two diabetic categories; diabetes and pre-diabetes., Results: We enrolled 334 patients into the study: the mean age was 59 years (Standard deviation = 14.3). Of these patients 254 (76%) were women. Thirty two percent (107/334; 32%) were found to have AGR, with 14% (46) having un-diagnosed DM and 18%(61) with pre-diabetes. Factors associated with AGR were age ≥ 45 (OR = 3.23; 95% CI 1.37 ≥ 7.62), basal metabolic index (BMI) ≥ 25 Kg/m(2) (OR = 3.13; 95% CI 1.53 - 6.41), low formal education (primary/none)(OR= 2; 95%CI 1.08 - 3.56) and family history of DM (OR = 2.19; 95%CI 1.16 - 4.15)., Conclusion: There was a high prevalence of undiagnosed AGR among hypertensive patients. This highlights the need to regularly screen for AGR among hypertensive patients as recommended by WHO.
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- 2015
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11. Establishing a field epidemiology elective for medical students in Kenya: a strategy for increasing public health awareness and workforce capacity.
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Arvelo W, Gura Z, Amwayi S, Wiersma P, Omolo J, Becknell S, Jones D, Ongore D, and Dicker R
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- Adult, Curriculum, Female, Humans, Kenya, Male, Public Health education, Schools, Medical, Workforce, Young Adult, Education, Medical, Undergraduate methods, Epidemiology education, Students, Medical
- Abstract
Medical students have limited exposure to field epidemiology, even though will assume public health roles after graduation. We established a 10-week elective in field epidemiology during medical school. Students attended one-week didactic sessions on epidemiology, and nine weeks in field placement sites. We administered pre- and post-tests to evaluate the training. We enrolled 34 students in 2011 and 2012. In 2011, we enrolled five of 24 applicants from a class of 280 medical students. In 2012, we enrolled 18 of 81 applicants from a class of 360 students; plus 11 who participated in the didactic sessions only. Among the 34 students who completed the didactic sessions, 74% were male, and their median age was 24 years (range: 22-26). The median pre-test score was 64% (range: 47-88%) and the median post-test score was 82% (range: 72-100%). Successful completion of the field projects was 100%. Six (30%) students were not aware of public health as a career option before this elective, 56% rated the field experience as outstanding, and 100% reported it increased their understanding of epidemiology. Implementing an elective in field epidemiology within the medical training is a highly acceptable strategy to increase awareness for public health among medical students., (Published by Elsevier Ltd.)
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- 2015
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12. Antimicrobial resistance: capacity and practices among clinical laboratories in Kenya, 2013.
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Odhiambo F, Galgalo T, Wences A, Muchemi OM, Kanyina EW, Tonui JC, Amwayi S, and Boru W
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- Adult, Attitude of Health Personnel, Child, Communication Barriers, Escherichia coli isolation & purification, Health Facility Size, Humans, Kenya epidemiology, Microbial Sensitivity Tests, Practice Patterns, Physicians' statistics & numerical data, Retrospective Studies, Salmonella isolation & purification, Shigella isolation & purification, Workforce, Clinical Laboratory Services organization & administration, Clinical Laboratory Services statistics & numerical data, Drug Resistance, Multiple, Bacterial, Professional Practice organization & administration, Professional Practice statistics & numerical data
- Abstract
Introduction: Antimicrobial resistance is neglected in developing countries; associated with limited surveillance and unregulated use of antimicrobials. Consequently, delayed patient recoveries, deaths and further antimicrobial resistance occur. Recent gastroenteritis outbreak at a children's home associated with multidrug resistant non-typhoidal Salmonella spp, raised concerns about the magnitude of the problem in Kenya, prompting antimicrobial resistance assessment preceding surveillance system establishment., Methods: Eight public medical laboratories were conveniently selected. Questionnaires were administered to key informants to evaluate capacity, practice and utilization of antimicrobial susceptibility tests. Retrospective review of laboratory records determined antimicrobial resistance to isolates. Antimicrobial resistance was defined as resistance of a microorganism to an antimicrobial agent to which it was previously sensitive and multidrug resistance as non-susceptibility to at least one agent in three or more antimicrobial categories., Results: The laboratories comprised; 2(25%) national, 4(50%) sub-national and 2(25%) district. Overall, antimicrobial susceptibility testing capacity was inadequate in all. Seven (88%) had basic capacity for stool cultures, 3(38%) had capacity for blood culture. Resistance to enteric organisms was observed with the following and other commonly prescribed antimicrobials, ampicillin: 40(91%) Salmonella spp isolates; Tetracycline: 16(84%) Shigella flexineri isolates; cotrimoxazole: 20(100%) Shigella spp isolates, 24(91%) Salmonella spp isolates. Comparable patterns of multidrug resistance were evident with Shigella flexineri and Salmonella typhimurium. Ten (100%) clinicians reported not using laboratory results for patient management, for various reasons.
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- 2014
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13. Assessing the prevalence of spina bifida and encephalocele in a Kenyan hospital from 2005-2010: implications for a neural tube defects surveillance system.
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Githuku JN, Azofeifa A, Valencia D, Ao T, Hamner H, Amwayi S, Gura Z, Omolo J, Albright L, Guo J, and Arvelo W
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- Female, Humans, Infant, Newborn, Kenya epidemiology, Male, Population Surveillance, Prevalence, Retrospective Studies, Encephalocele epidemiology, Neural Tube Defects epidemiology, Spinal Dysraphism epidemiology
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Introduction: Neural tube defects such as anencephaly, spina bifida, and encephalocele are congenital anomalies of the central nervous system. Data on the prevalence of neural tube defects in Kenya are limited. This study characterizes and estimates the prevalence of spina bifida and encephalocele reported in a referral hospital in Kenya from 2005-2010., Methods: Cases were defined as a diagnosis of spina bifida or encephalocele. Prevalence was calculated as the number of cases by year and province of residence divided by the total number of live-births per province., Results: From a total of 6,041 surgical records; 1,184 (93%) had reported diagnosis of spina bifida and 88 (7%) of encephalocele. Estimated prevalence of spina bifida and encephalocele from 2005-2010 was 3.3 [95% Confidence Interval (CI): 3.1-3.5] cases per 10,000 live-births. The highest prevalence of cases were reported in 2007 with 4.4 (95% CI: 3.9-5.0) cases per 10,000 live-births. Rift Valley province had the highest prevalence of spina bifida and encephalocele at 6.9 (95% CI: 6.3-7.5) cases per 10,000 live-births from 2005-2010., Conclusion: Prevalence of spina bifida and encephalocele is likely underestimated, as only patients seeking care at the hospital were included. Variations in regional prevalence could be due to referral patterns and healthcare access. Implementation of a neural tube defects surveillance system would provide a more thorough assessment of the burden of neural tube defects in Kenya.
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- 2014
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14. Aetiology and factors associated with bacterial diarrhoeal diseases amongst urban refugee children in Eastleigh, Kenya: A case control study.
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Boru WG, Kikuvi G, Omollo J, Abade A, Amwayi S, Ampofo W, Luman ET, and Oundo J
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Introduction: Kenya is home to over 400 000 refugees from neighbouring countries. There is scanty information about diarrhoea amongst urban refugees in Kenya., Objectives: We investigated the enteric bacteria causing diarrhoea amongst urban refugee children and described the associated factors., Method: During the period of August-December 2010, urban refugee children between the ages of two and five who attended Eastleigh County Council Health Centre were enrolled into the study. Diarrhoeal cases were compared with age-matched children with no diarrhoea (controls). Stool specimens were collected and enteric bacteria isolated. A questionnaire was administered to identify risk factors., Results: A total of 41 cases and 41 controls were enrolled in the study. The age and country of origin were similar for cases and controls. The bacterial isolation rates amongst the cases were: non-pathogenic Escherichia coli 71%, Shigella dysenteriae 2.4%, Shigella flexneri 2.4%, Salmonella paratyphi 5%. For the controls, non-pathogenic E. coli 90% and enterotoxigenic E. coli (ETEC) 2.4% were amongst the organisms isolated. All isolates were resistant to amoxicillin; resistance to other antibiotics varied by isolate type. Factors associated independently with diarrhoea included children not washing their hands with soap (aOR 5.9, p < 0.05), neighbour(s) having diarrhoea (aOR 39.8, p < 0.05), children not exclusively breastfed for their first 6 months (aOR 7.6, p < 0.05) and children eating food cooked the previous day (aOR 23.8, p = 0.002)., Conclusions: Shigella species, Salmonella species and ETEC were found to be responsible for diarrhoea amongst the urban refugee children. Measures to control and guide the use of antibiotics are critical for the prevention of antibiotic resistance. Efforts to improve personal and domestic hygiene, including educational campaigns to promote appropriate handwashing, should be encouraged., Competing Interests: The authors declare that they have no financial or personal relationship(s) that may have inappropriately influenced them in writing this article.
- Published
- 2013
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15. High case fatality cholera outbreak in Western Kenya, August 2010.
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Onyango D, Karambu S, Abade A, Amwayi S, and Omolo J
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- Adolescent, Adult, Aged, Aged, 80 and over, Child, Child, Preschool, Female, Humans, Kenya epidemiology, Male, Middle Aged, Young Adult, Cholera mortality, Disease Outbreaks statistics & numerical data
- Abstract
Introduction: Cholera is a disease caused by the bacterium Vibrio cholera and has been an important public health problem since its first pandemic in 1817. Kenya has had numerous outbreaks of cholera ever since it was first detected there during 1971. In August 2010 an outbreak of cholera occurred in Kuria West District spreading to the neighboring Migori District. We conducted an investigation in order to determine the magnitude of the problem and institute control measures., Methods: In order to update the line lists we reviewed records in Migori and Kuria district hospitals and conducted active case search in the community between 30th August and 6th September 2010. Data was analyzed using Epi-Info 3.5.2., Results: A total of 114 cases and with 10 deaths (Case Fatality Rate = 9%) were documented. The index case was an 80 years old woman from Mabera Division who had hosted a cultural marriage ceremony a day before the outbreak. The mean age of case patients was 34.5 years (Standard Deviation=23.4) with a range 5 to 80 years. Females accounted for 61.4% of cases; people aged 10-39 years accounted 46.9%, those 40-69 years accounted for 29.2% and those above 70 years accounted for 9.7% of the cases. Sixty percent of deaths occurred among patients aged 50 years and over, case fatality rate was highest in this age group (16.7%) followed by those aged 40-49 years (12.5%), 20-29 years (10%) and 10-19 years (4.8%). The outbreak was confirmed within 2 weeks of onset after one (16.7%) of the six samples taken tested positive for V. cholera (serotype Inaba)., Conclusion: High case fatality rate and late laboratory confirmation was noted in this outbreak. There was urgent need to capacity build the districts on cholera case management, outbreak management, and equip the Migori District Hospital laboratory to allow prompt confirmation.
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- 2013
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16. BRUCELLOSIS IN TEREKEKA COUNTY, CENTRAL EQUATORIA STATE, SOUTHERN SUDAN.
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Lado D, Maina N, Lado M, Abade A, Amwayi S, Omolo J, and Oundo J
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- Adult, Animals, Antibodies, Bacterial blood, Brucellosis blood, Brucellosis transmission, Case-Control Studies, Cattle, Dairy Products adverse effects, Dairy Products microbiology, Female, Humans, Immunologic Factors blood, Male, Prevalence, Risk Factors, South Sudan epidemiology, Brucella immunology, Brucella isolation & purification, Brucellosis diagnosis, Brucellosis epidemiology, Health Knowledge, Attitudes, Practice, Poverty statistics & numerical data
- Abstract
Objectives: To identify factors associated with Brucellosis in patients attending Terekeka Health Facility, Terekeka County, Central Equatoria State, Southern Sudan and to evaluate the utility of the rapid test kit Euracil®., Design: A facility based case-control study., Setting: Terekeka Health Facility, Terekeka County, Central Equatoria State, Southern Sudan., Subjects: Cases were patients presenting at the Terekeka Health Facility with clinical symptoms suggestive of Brucellosis and tested positive for Brucellosis by rapid antigen test while controls were selected from individuals attending Terekeka Health facility with health problems unrelated to brucellosis or febrile illness., Results: A total of fifty eight cases with clinical symptoms suggestive of and tested positive for Brucellosis by rapid antigen test presented. A total of 116 consented controls were recruited into the study. Males accounted for 52% of the cases and 53% of the controls. The mean age was 31 years for both groups. Cases without formal education were 84% while 40% had no source of income, 20% of the cases and 14% of the controls were cattle keepers while 5% of the cases and 13% of the controls were students. In multivariate analysis there were many factors associated with Brucellosis like consumption of raw meat, living with animals at the same place, raising of goats, farm cleaning contact, eating of aborted and wild animals. Logistic regression revealed two factors associated with the disease; consumption of raw milk (OR=3.9, P-value 0.001, 95% CI 1.6666-9.0700) was a risk factor while drinking boiled milk was protective (OR = 0.09, p-value 0.000, 95% CI, 0.1-0.2)., Conclusions: The main age-groups affected were 20-30 years with males being affected more than females. Drinking of raw milk was significantly associated with Brucellosis while drinking boiled milk was protective. There should be active public health education on the benefits of boiling milk before consumption. Further studies to elucidate the extent and epidemiology of brucellosis in humans and animals in Southern Sudan are recommended.
- Published
- 2012
17. An investigation of a major outbreak of Rift Valley fever in Kenya: 2006-2007.
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Nguku PM, Sharif SK, Mutonga D, Amwayi S, Omolo J, Mohammed O, Farnon EC, Gould LH, Lederman E, Rao C, Sang R, Schnabel D, Feikin DR, Hightower A, Njenga MK, and Breiman RF
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- Adolescent, Adult, Aged, Aged, 80 and over, Antibodies, Viral blood, Child, Child, Preschool, Climate, Female, Forecasting, Humans, Kenya epidemiology, Male, Middle Aged, Population Surveillance methods, Soil analysis, Young Adult, Disease Outbreaks, Rift Valley Fever epidemiology, Rift Valley Fever mortality, Rift Valley Fever prevention & control, Rift Valley Fever virology, Rift Valley fever virus genetics, Rift Valley fever virus immunology, Rift Valley fever virus isolation & purification
- Abstract
An outbreak of Rift Valley fever (RVF) occurred in Kenya during November 2006 through March 2007. We characterized the magnitude of the outbreak through disease surveillance and serosurveys, and investigated contributing factors to enhance strategies for forecasting to prevent or minimize the impact of future outbreaks. Of 700 suspected cases, 392 met probable or confirmed case definitions; demographic data were available for 340 (87%), including 90 (26.4%) deaths. Male cases were more likely to die than females, Case Fatality Rate Ratio 1.8 (95% Confidence Interval [CI] 1.3-3.8). Serosurveys suggested an attack rate up to 13% of residents in heavily affected areas. Genetic sequencing showed high homology among viruses from this and earlier RVF outbreaks. Case areas were more likely than non-case areas to have soil types that retain surface moisture. The outbreak had a devastatingly high case-fatality rate for hospitalized patients. However, there were up to 180,000 infected mildly ill or asymptomatic people within highly affected areas. Soil type data may add specificity to climate-based forecasting models for RVF.
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- 2010
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18. Syphilis among pregnant women in Juba, Southern Sudan.
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Emmanuel SK, Lado M, Amwayi S, Abade AM, Oundo JO, and Ongus JR
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- Adolescent, Adult, Cross-Sectional Studies, Female, Health Knowledge, Attitudes, Practice, Humans, Pregnancy, Pregnancy Complications, Infectious microbiology, Pregnancy Complications, Infectious prevention & control, Prenatal Care, Prevalence, Risk Factors, Socioeconomic Factors, Sudan, Syphilis diagnosis, Syphilis prevention & control, Young Adult, Pregnancy Complications, Infectious epidemiology, Syphilis epidemiology
- Abstract
Objective: Determine factors associated with syphilis among pregnant women., Design: Cross-sectional study., Setting: Antenatal clinics of Juba Teaching Hospital, Malakia National Health Insurance Centre and Munuki Primary Health Care Centre in Juba, Southern Sudan., Subjects: Consenting pregnant women not on syphilis treatment., Main Outcome Measures: Socio-demographic and clinical data, knowledge and behavioural characteristics., Results: Of the 231 pregnant women participants, 51 (22.1%) were positive for syphilis with the rapid plasma reagin test and 79 (34.2%) were positive with the treponema pallidum Haemagglutination assay. Risk factors for syphilis were: housewife (OR 2.808; P= 0.0116), abortion (OR 2.654; P= 0.0116) and partner travel (OR 2.149; P= 0.028). Attending antenatal clinic for previous pregnancy was protective (OR 0.281; P= 0.0004) for syphilis., Conclusions: This is the first study to determine the prevalence and associated factors in the three clinics in Juba, South Sudan. There is a high prevalence of syphilis in pregnant women attending the selected health facilities. Treponema Pallindum Haemagglulination Assay can be used as a field test for syphilis due to its high sensitivity and specificity. Health education, screening and treating positive expectant mothers can reduce the prevalence of syphilis.
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- 2010
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19. High mortality in a cholera outbreak in western Kenya after post-election violence in 2008.
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Shikanga OT, Mutonga D, Abade M, Amwayi S, Ope M, Limo H, Mintz ED, Quick RE, Breiman RF, and Feikin DR
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Case-Control Studies, Child, Child, Preschool, Female, Humans, Kenya epidemiology, Male, Middle Aged, Odds Ratio, Time Factors, Young Adult, Cholera epidemiology, Cholera mortality, Disease Outbreaks, Politics, Violence
- Abstract
In 2008, a cholera outbreak with unusually high mortality occurred in western Kenya during civil unrest after disputed presidential elections. Through active case finding, we found a 200% increase in fatal cases and a 37% increase in surviving cases over passively reported cases; the case-fatality ratio increased from 5.5% to 11.4%. In conditional logistic regression of a matched case-control study of fatal versus non-fatal cholera infection, home antibiotic treatment (odds ratio [OR] 0.049; 95% CI: < 0.001-0.43), hospitalization (OR, 0.066; 95% CI, 0.001-0.54), treatment in government-operated health facilities (OR, 0.15; 95% CI, 0.015-0.73), and receiving education about cholera by health workers (OR, 0.19; 95% CI, 0.018-0.96) were protective against death. Among 13 hospitalized fatal cases, chart review showed inadequate intravenous and oral hydration and substantial staff and supply shortages at the time of admission. Cholera mortality was under-reported and very high, in part because of factors exacerbated by widespread post-election violence.
- Published
- 2009
- Full Text
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