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Introduction: Visceral Leishmaniasis (VL) is endemic in 14 of the 47 counties in Kenya. An upsurge of VL cases started in March 2017, the number of cases continued rising and by June 2017, 104 cases and 3 deaths had been reported. We conducted an investigation to describe the magnitude and pattern of the outbreak and to assess factors associated with VL infection among the cases. Methods: We conducted a secondary data analysis of VL data from 1st January 2014 to 11th July 2017 obtained from Marsabit county referral hospital and Laisamis Mission Hospitals, with a VL case being defined as any entry with a clinical or laboratory diagnosis of VL. We also conducted a frequency matched case-control study among 76 case-patients and 152 controls. A confirmed case was a person with positive rK39 serology for VL from 1st April 2017 through 11th July 2017; whereas a control was a person within a defined age-category as a case, without signs/symptoms of VL since 1st January 2017, and negative on serology. We calculated attack rates (AR) and case fatality rates (CFR) over the study period. In the case control study, we conducted unconditional logistic regression with adjusted odds ratio (AOR) and 95% confidence interval (CI). Results: A total of 383 records were reviewed, out of which 308(80%) were rK39 positive. Of the 308 confirmed cases. 256 (83%) were males. The overall AR was 169/1000 while AR among children

Background: Long-lasting insecticidal nets (LLINs) and indoor residual spraying (IRS) are the main malaria vector control measures. Kenya has employed multiple approaches, including free mass net distribution campaigns, for distributing LLINs to the community that resulted in increased household ownership of one or more nets from 44% in 2010 to 63 % in 2015. Migori and Homa Bay Counties are among the malaria endemic counties in Western Kenya that benefitted from three free mass net distribution campaigns between 2012 and 2018.. Widespread pyrethroid resistance among the primary vectors in Western Kenya has necessitated the re-introduction of IRS using an organophosphate insecticide, pirimiphos-methyl (Actellic® 300CS), as part of a strategy to manage insecticide-resistance. Evaluation of the effectiveness of the combined use of non-pyrethroid IRS and LLINs have yielded varied results. We aimed to evaluate malaria indicators before and after the introduction of IRS in a high malaria transmission area compared with an adjacent area where IRS was not introduced until one year later to estimate the effect of the intervention in an area with pyrethroid resistance.Methods: We reviewed records (MoH 405 A, 405 B, and 706) and tallied monthly aggregate of outpatient department (OPD) attendance, suspected malaria cases, those tested for malaria and those testing positive for malaria at two health facilities, one from Nyatike, an intervention sub-county, and one from Suba, a comparison sub-county, both located in Western Kenya, from February 1, 2016, through March 31, 2018. The first round of IRS was conducted in February – March 2017 in Nyatike sub-county and the second round one year later in both Nyatike and Suba sub-counties while the mass distribution of LLINs has been conducted in both locations. We performed a descriptive analysis and estimated the effect of the interventions and temporal changes of malaria indicators using Poisson regression for a period before and after implementation of the first round of IRS.Results: A higher reduction in the intervention area in total OPD, the proportion of OPD visits due to suspected malaria, testing positivity rate and annual malaria incidences except for the total OPD visits among the under 5 children where 59% decrease was observed in the comparison area while 33% decrease was observed in the intervention area (net change -27%, P Conclusions: Our findings demonstrated a reduced malaria burden among population protected by both non-pyrethroid IRS and LLINs implying a possible additional benefit afforded by the combined intervention in malaria endemic zone.

BACKGROUND:Cholera remains a public health problem in Kenya despite increased efforts to create awareness. Assessment of knowledge, attitude and practice (KAP) in the community is essential for the planning and implementation of preventive measures. We assessed cholera KAP in a community in Isiolo County, Kenya. METHODS:This cross-sectional study involved a mixed-methods approach utilizing a questionnaire survey and focus group discussions (FGDs). Using multistage sampling with household as the secondary sampling unit, interviewers administered structured questionnaires to one respondent aged ≥18 years old per household. We created knowledge score by allotting one point for each correct response, considered any total score ≥ median score as high knowledge score, calculated descriptive statistics and used multivariate logistic regression to examine factors associated with high knowledge score. In FGDs, we randomly selected the participants aged ≥18 years and had lived in Isiolo for >1 year, conducted the FGDs using an interview guide and used content analysis to identify salient emerging themes. RESULTS:We interviewed 428 participants (median age = 30 years; Q1 = 25, Q3 = 38) comprising 372 (86.9%) females. Of the 425/428 (99.3%) who had heard about cholera, 311/425 (73.2%) knew that it is communicable. Although 273/428 (63.8%) respondents knew the importance of treating drinking water, only 216/421 (51.3%) treated drinking water. Those with good defecation practice were 209/428 (48.8%). Respondents with high knowledge score were 227/428 (53.0%). Positive attitude (aOR = 2.88, 95% C.I = 1.34-6.20), treating drinking water (aOR = 2.21, 95% C.I = 1.47-3.33), age