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During the last decade, importation and use of pesticides and fertilizers in Kenya has more than tripled. Improper handling of these chemicals by the small scale farmers continues to pose untold health risks. In an effort to assess the magnitude of the problems emanating from improper handling of these agrochemicals, a study was conducted in a rural agricultural community in Kenya between 1987 and 1990. The study investigated the extent of use of agrochemicals by farmers, the level of awareness of the dangers posed by these chemicals, and attitudes toward agricultural chemicals. The study population consisted of all 1,797 households in 10 villages randomly selected by cluster sampling in the Githunguri location of Kiambu District. Despite their limited knowledge of safety in handling and storage of agrochemicals or of the antidote for accidental poisoning, 100 percent of the farmers used pesticides extensively. Various health complaints related to agrochemicals were reported. By and large the community's or the individuals' lack of awareness of the risks associated with use of agrochemicals is believed to have contributed to some of the agrochemical poisonings. An intervention program has been initiated with the community as a key participant. The main emphasis is on safe procedures for handling agrochemicals., As in any other agricultural country, pesticides and fertilizers are the primary agrochemicals used by farmers in Kenya. The farmer uses these agrochemicals to control organisms that destroy crops and [...]

ObjectiveTo establish the operational feasibility and effectiveness of using locally available foods to prevent malnutrition and improve child growth in Kenyan children.DesignQuasi-experimental design with an intervention group of children in all villages in one region and a non-intervention group of children in all villages in an adjacent region. The intervention was the distribution of a monthly food ration for the index child, a separate family ration, and group education on appropriate complementary feeding and hygiene.SettingRural villages in the arid lands of eastern Kenya with a high prevalence of child malnutrition.SubjectsAll children in the target villages aged 6–20 months with weight-for-length Z-score (WHZ) greater than −2 at baseline.ResultsChildren in the intervention and non-intervention groups had similar baseline anthropometric measures. The caregivers in the intervention group confirmed that the intended amounts of food supplements were received and child nutrient intake improved. During the 7-month intervention period there were significant group differences in pre–post Z-score changes between the intervention and non-intervention groups for weight-for-age (0·82, P < 0·001) and weight-for-height (1·19, P < 0·001), but not for height-for-age (−0·20, P = 0·09), after adjusting for multiple covariates. Compared with the non-intervention group, the intervention group had a lower prevalence of wasting (0 % v. 8·9 %, P = 0·0002) and underweight (6·3 % v. 23·0 %, P < 0·0001). Infectious morbidity was similar in both groups.ConclusionsThe findings suggest that the distribution of locally available foods is operationally feasible and improves child weight gain and decreases acute malnutrition in Kenyan children. [ABSTRACT FROM AUTHOR]

Objective: Lead exposure has been associated with intellectual impairment in children in a number of international studies. Prevalence of elevated blood lead levels (eBLL ≥ 10μg/dL) of between 5 - 15% has been reported among in Nairobi (UNEP, 2006). However, little is known about potential environmental exposure for eBLLs among children in Kibera, Nairobi. Methods: A descriptive, cross-sectional study of children drawn from Kibera slums who presented at Yes to kids (Y2K) programme of VIPS Health Services at Woodley, Nairobi between June and August 2007 was carried out. The study assessed potential correlates of eBLLs in 387 children aged 6 to 59 months and had lived in Kibera slums since birth. Sampling was purposive. The factors examined were age, sex, breastfeeding history, respondent's education and occupation, type of house walls, sources of drinking water and kales, and awareness of lead poisoning among respondents. Potential risk factors such exposure to paint, contaminated playgrounds, glazed pottery, cosmetics and para-occupational as well as living near lead industry and pica behavior were also examined. Potential environmental sources of lead such as drinking water, soil and kales were analyzed for lead levels. Results: Seven percent (n = 27, N = 387) had BLLs above 10μg/dl. BLL = 10μg/dl was associated with non-permanent housing (p = 0.812), playing on potentially lead contaminated grounds (p = 0.627) and pica behavior (p = 0.439). Low risk parental occupation (p = 0.001) and Kales sourced from the market/kiosks (p = 0.001) were significantly associated with BLL = 10μg/dl. Soil lead levels (Soil Pb) ranged from 3,000 to 90,000μg/kg, which was very high compared to WHO acceptable range of 100 - 200μg/kg. There was weak linear association (r2 = 0.0160) between Soil Pb and mean BLLs for a given village. There were no detectable levels of lead in kales and tap water. Conclusions: The study found about 7% (N = 387) of the children tested had eBLL = 10μg/dl in an area with very high soil lead levels (range in Kibera slums: 3,365 - 89,570 μg/kg; WHO allowable range: 100 - 120μg/kg), raising a health flag that must be addressed using the multi-sectoral approach and further studies. It's important to note that the study design and its inherent limitations could have masked true picture of childhood lead poisoning in Kibera slums, Nairobi. [ABSTRACT FROM AUTHOR]

Background: Nearly three million neonates die each year, largely from preventable illnesses in developing countries. Sub-Saharan Africa has disproportionately high neonatal mortality. Community health worker (CHW) programs are a promising intervention to reduce mortality rates. This research evaluates a CHW newborn home visitation program in rural Kenya by assessing the frequency of health service utilization and overnight hospitalization., Methods: This quasi-experimental study encompassed two consecutive years and compared the rate of medical service utilization for neonatal illness in an intervention group with that of a control group using a household survey. Severity of neonatal illness was assessed by need for overnight hospitalization. Household, maternal, and child characteristics were collected., Results: A total of 489 surveys were completed and showed that 35% of not-visited families reported taking their infant to a healthcare facility, compared with 21% of CHW-visited families (P < 0.01). Rates of overnight hospitalization were 6% for not-visited infants and 1% for visited infants (P < 0.01). Few significant differences were found in household, maternal, and child characteristics., Discussion: This study found that a CHW newborn home visitation program in rural Kenya significantly decreased rates of health service utilization and overnight hospitalization, but did not have the power to detect an effect on neonatal mortality.

Objective: Lead exposure has been associated with intellectual impairment in children in a number of international studies. Prevalence of elevated blood lead levels (eBLL > or = 10ug/dL) of between 5 - 15% has been reported among in Nairobi (UNEP, 2006). However, little is known about potential environmental exposure for eBLLs among children in Kibera, Nairobi., Methods: A descriptive, cross-sectional study of children drawn from Kibera slums who presented at Yes to kids (Y2K) programme of VIPS Health Services at Woodley, Nairobi between June and August 2007 was carried out. The study assessed potential correlates of eBLLs in 387 children aged 6 to 59 months and had lived in Kibera slums since birth. Sampling was purposive. The factors examined were age, sex, breastfeeding history, respondent's education and occupation, type of house walls, sources of drinking water and kales, and awareness of lead poisoning among respondents. Potential risk factors such exposure to paint, contaminated playgrounds, glazed pottery, cosmetics and para-occupational as well as living near lead industry and pica behavior were also examined. Potential environmental sources of lead such as drinking water, soil and kales were analyzed for lead levels., Results: Seven percent (n = 27, N = 387) had BLLs above 10ug/dl. BLL > or = 10ug/dl was associated with non-permanent housing (p = 0.812), playing on potentially lead contaminated grounds (p = 0.627) and pica behavior (p = 0.439). Low risk parental occupation (p = 0.001) and Kales sourced from the market/kiosks (p = 0.001) were significantly associated with BLL > or = 10ug/dl. Soil lead levels (Soil Pb) ranged from 3,000 to 90,000ug/kg, which was very high compared to WHO acceptable range of 100 - 200ug/kg. There was weak linear association (r2 = 0.0160) between Soil Pb and mean BLLs for a given village. There were no detectable levels of lead in kales and tap water., Conclusions: The study found about 7% (N = 387) of the children tested had eBLL > or = 10ug/dl in an area with very high soil lead levels (range in Kibera slums: 3,365 - 89,570ug/kg; WHO allowable range: 100 - 120ug/kg), raising a health flag that must be addressed using the multi-sectoral approach and further studies. It's important to note that the study design and its inherent limitations could have masked true picture of childhood lead poisoning in Kibera slums, Nairobi.

Objective: The main objective of the study was to determine the prevalence of total, single and multiple intestinal worm infections among the primary school children in Nairobi City., Methods: A cross-sectional descriptive study was used to determine the status of intestinal worm infections whose subjects were drawn from eight city administrative divisions. Proportional random sampling method to select forty five (45) schools out of 320 public, private and non-formal schools was used. Using the school enrolment register for standard 3 and 4, fifty (50) pupils per school were selected to participate in the study. Quantitative data from the study subjects were collected by use of a structured questionnaire. In addition, stool specimens were collected from each study subject and examined by Kato-Katz laboratory method., Results: The four intestinal worms investigated constituted a total prevalence of 12.9%. This prevalence was found to be lower than that in two other previous studies. A. lumbricoides had the highest prevalence and S. mansoni had the lowest. Prevalence of single worm infections constituted 8.6% of the total prevalence. Differences in prevalence between males and females were observed only with respect to T. trichiura and hookworm species. Fourteen to sixteen (14-16) and 11-13 years of age groups had the highest total prevalence of 47% and 30.6% respectively. Differences in prevalence were not found among the school categories with exception of T. trichiura infections., Conclusion: Prevalence of total, single ahd multiple infections showed a downward trend when compared to the previous studies with Ascaris lumbricoides persisting with the highest prevalence.

Objective: This study assessed the role of governmental and non-governmental organizations in mitigation of stigma and discrimination among people infected and affected by HIV/AIDS in informal settlements of Kibera., Methods: This was a descriptive cross-sectional study and used a multi stage stratified sampling method. The study was conducted in Kibera, an informal settlement with a population of over one million people which makes it the largest slum not only in Kenya but in sub-Saharan Africa. The study targeted infected individuals, non-infected community members, managers of the organizations implementing HIV/AIDS programmes and service providers. In the process 1331 households were interviewed using qualitative and quantitative data collection instruments. Statistical Package for Social Sciences (SPSS) and Nudist 4 packages were used to analyze the quantitative and qualitative data respectively., Results: More than 61% of the respondents had patients in their households. Fifty five percent (55%) of the households received assistance from governmental and non-governmental organizations in taking care of the sick. Services provided included awareness, outreach, counseling, testing, treatment, advocacy, home based care, assistance to the orphans and legal issues. About 90% of the respondents perceived health education, counseling services and formation of post counseling support groups to combat stigma and discrimination to be helpful., Conclusion: Stigma and discrimination affects the rights of People Living with HIV/AIDS (PLWHAs). Such stigmatization and discrimination goes beyond and affects those who care for the PLWHAs, and remains the biggest impediment in the fight against HIV/AIDS in Kibera. Governmental and non-governmental organizations continue to provide key services in the mitigation of stigma and discrimination in Kibera. However, personal testimonies by PLWHAs showed that HIV positive persons still suffer from stigma and discrimination. Approximately 43% of the study population experienced stigma and discrimination.