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Background In Kenya, about 3000 fistula cases are estimated to occur every year with an incidence of 1/1000 women. This study sought to identify risk factors associated with developing obstetrics fistula in order to guide implementation of appropriate interventions. Methods An unmatched case control study was conducted in three major hospitals in Kenya between October and December 2010. Cases were patients who had fistula following delivery within the previous five years. Controls were systematically selected from women who attended obstetrics and gynecology clinics at these hospitals, and did not have present or past history of fistula. Odds ratio was used as measure of association with their corresponding 95% confidence interval. Factors with p value of 24 hours (OR = 4.7, 95% CI = 2.4 -9.2), seeking delivery services after 6 hours of labour onset (OR = 6.9, 95% CI = 2.2-21.3), taking more than 2 hours to reach a health facility (OR = 5.7, 95% CI = 2.9 -11.5), having none or primary education (OR = 9.6, 95% CI = 3.3 –27.9) and being referred to another facility for emergency obstetrics services (OR = 8.6, 95% CI = 2.7 –27). Conclusions Risk factors for developing obstetrics fistula were delays in care seeking including delay in making decision to seek delivery servers after six hours of labour onset, taking more than two hours to reach a health facility, labour duration of more than 24 hours and having no formal or primary education. Efforts geared at strengthening all levels of the health system to reduce delays in access to emergency obstetric care are needed.

Results Prevalence of tungiasis was 57% (218/385; 95% CI=51.7%-61.6%). Itching (89.1%) was the most common associated symptom, followed by pain upon pressure (67.3%), sleep disturbance (58.2%) and walking difficulties (53%). In multivariate logistic regression analysis the following independent factors were identified to be associated with tungiasis: living in houses with an earthen floors (adjusted OR=3.84; 95%IC: 2.09-7.06), walking barefooted (OR=3.28; 1.78-6.04), having a common resting place outside the house (OR=2.36; 1.01-5.51) and presence of rats on the compound (OR=1.69; 1.03-2.75).