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PubMed1976

Acute haemorrhagic conjunctivitis and enterovirus 70 in Kenya.

The pandemic of acute haemorrhagic conjunctivitis that started in Ghana in 1969 and spread to many countries in Africa, Asia and Europe reached Kenya in April 1971. From one patient virus was isolated. This was possibly the first strain ever isolated of Enterovirus 70. Identification took time and was finished long after the publication of isolation of the new virus in Japan. Cross neutralization tests with the virus from Japan showed close relationship between the two. During a second epidemic in Kenya in 1974 many more strains of the virus were isolated. The history of isolation and identification and the clinical picture of the disease as seen in Kenya are described.

Acute Disease↗

PubMed1991

Adolescent sexuality in Kenya.

Adolescent sexuality has become a major problem all over the world. This review paper describes the main problems encountered in Kenya with regards to adolescent sexuality. The role of the Government and some non-governmental organisations is outlined. Factors which contribute to the problem of adolescent sexuality in Kenya are described. The paper stresses the role of research in solving these problems and finally suggests some strategies which may be adopted in order to minimise the undesirable effects of adolescent sexuality in Kenya.

Adolescent↗

PubMed1989

Immunisation of cattle against theileriosis in Coast Province, Kenya: laboratory evaluation of a Theileria parva parva stabilate for use in 'infection and treatment' immunisation in the field.

Theileria parva parva Marikebuni stock, previously shown to give good protection to immunised cattle in Kilifi District, Coast Province of Kenya, was chosen for large scale immunisation in the district. A large sporozoite stabilate was prepared and evaluated for efficacy and safety in the 'infection and treatment' method, using a long or short acting formulation of oxytetracycline. Susceptible cattle were infected with selected doses of stabilate (10(0), 10(-1), 10(-1.7) and left either as untreated controls, or treated with one of the two oxytetracycline formulations. It was concluded that stabilate dilution at 10(-0.7) or 10(-1) in combination with either formulation of oxytetracycline would effect satisfactory immunisation. The short acting oxytetracycline treatment was judged to be the most efficacious in protecting cattle against homologous challenge. On heterologous challenge it was found that T p parva Marikebuni immune cattle were protected against seven T p parva stocks from Kilifi District and also against four stocks of T p parva from other areas of Kenya. In addition, the Marikebuni stock provided partial protection against challenge by T p lawrencei stocks. Furthermore, cattle immune to T p parva and T p lawrencei were protected against lethal challenge of T p parva Marikebuni stock. Thus, it appears that large scale immunisation of cattle against theileriosis in Kilifi District could be undertaken using the Marikebuni stock. With continued assessment, this stock could provide a master theilerial stock for immunisation against cattle theileriosis in areas free of buffaloes elsewhere in Kenya.

Animals↗

PubMed1989

Comparison of four nitroimidazole compounds for treatment of symptomatic amoebiasis in Kenya.

Four antiamoebic drugs currently used in many Kenyan hospitals and health centres were compared for their efficacy on symptomatic luminal amoebiasis in Kiambu, Kilifi, and Machakos hospitals during this study. The drugs were; the brand metronidazole (Flagyl, May & Baker, Kenya Ltd.), the generic metronidazole (Metrozol, Cosmos Ltd., Nairobi, Kenya), the brand tinidazole (Fasigyn, Pfizer Laboratories Ltd.) and the generic tinidazole (Tynazole Laboratory and Allied Equipments, Kenya Ltd). Clinical cure was achieved in all individuals receiving any of the four drugs. Parasitological cure was better for those receiving either Flagyl or Fasigyn, than those receiving the generic counterparts. Both parasitological and clinical cures were achieved in about 50% of all those who received either Flagyl or Fasigyn. It appears that Flagyl and Fasigyn are not as efficacious as previously reported but are still much better than their generic counterparts for the treatment of symptomatic Entamoeba histolytica infections.

Adolescent↗

PubMed1978

Poliomyelitis: Epidemiology and prophylaxis. 6. Geographic synchronism in poliomyelitis epidemics in Kenya.

In the 1950s, van Loghem drew attention to what he called "synchronism" in the epidemics of poliomyelitis in western Europe. The 1952 epidemic in the Netherlands affected Belgium and neighbouring parts of the Federal Republic of Germany at the same time. A comparable phenomenon is described from Kenya. Notwithstanding the fact that in the three population concentrations of the country the three poliovirus types may well be endemic, epidemics of poliomyelitis repeatedly occurred synchronously in these areas. However, there seems to be no synchronism between poliomyelitis epidemics in Kenya and those in neighbouring East African countries. Tentative explanations are put forward for the similarities and differences between Europe and East Africa. The importance of the phenomenon as observed in Kenya for control by mass immunization campaigns is stressed.

Humans↗

PubMed1987

Infant feeding practices in Kenya, Mexico and Malaysia. The rarity of the exclusively breast-fed infant.

Infant feeding practices of 6149 mothers in Kenya, Mexico and Malaysia are reported. A high proportion of mothers initiated breast-feeding in each country regardless of social class. Most Kenyan mothers continued to breast-feed for at least 12 months. In Mexico and Malaysia, however, breast-feeding was discontinued relatively early, especially among urban mothers. Early supplementation of breast-fed infants with milk and/or other food was a common practice in each of the three countries. Among breast-fed infants below 4 months of age, the percentages who were exclusively breast-fed in the urban elite, urban poor and rural groups respectively were 6, 14 and 21 per cent in Kenya, 8, 19 and 31 per cent in Mexico, and 11, 9 and 11 per cent in Malaysia. Supplementation of breast-fed infants in the first two months of life was more likely to be with infant formula than with any other milk or food. At three months of age, however, nonmilk foods were the most common supplements in all population groups with the exception of those in urban Kenya. The policy implications are discussed.

Animals↗

PubMed1968

Yellow fever immunity surveys in northern Uganda and Kenya and eastern Somalia, 1966-67.

Recent epidemics of yellow fever in eastern Africa have stimulated serological surveys in the Karamoja district of Uganda, the northern frontier district of Kenya and the Giohar district of Somalia. All sera collected in the surveys were screened for group B arbovirus antibody using the HI test. Yellow fever immunity was confirmed by the mouse-protection test.No yellow fever immunity was found in sera collected from a residential tribal group at Karamoja but a small number of samples from persons who had previously lived outside the district showed immunity. Immunity was detected in sera from areas of the Northern Frontier district of Kenya. It is thought that this immunity may, in some areas, have resulted from extensions of the Ethiopian epidemic of 1960-62 into the region, but in another area of the district the immunity seems to have arisen from continuing focal transmission within Kenya. Yellow fever immunity was also detected in Somalia.

Adolescent↗

PubMed1981

Distribution in Kenya of intermediate hosts of Schistosoma.

A major factor in the geographical distribution of endemic schistosomiasis in Kenya is the discontinuous distribution of intermediate hosts. Biomphalaria pfeifferi is the main transmitter of S. mansoni and is found in the altitude zone 300-2,300 m; its absence from the costal region results in the absence of endemic schistosomiasis mansoni amongst the large human population in the coastal region. Snails belonging to the Bulinus africanus group appear to be responsible for all transmission of S. haematobium; they occur from near sea-level to an altitude of about 1,800 but are discontinuously distributed. There appears to be considerable potential for increase in the areas in which each form of schistosomiasis is endemic, taking into account existing patterns of snail distribution and likely developments in irrigation and water conservation. New localities reported here considerably extend the known distribution in western Kenya of B. truncatus, which could serve as an effective intermediate host for S. haematobium if a suitable strain were to become established in Kenya.

Animals↗

PubMed1993

Is periodontal disease on the increase in Kenya? A review.

During a recent scientific meeting held in Botswana (16th-19th October 1991), it was reported that the oral health situation in developing countries was typified by an increase in the prevalence of dental diseases. Kenya was cited as one of the typical examples of this worrying trend. For there to be an increase in dental diseases, there must be a concomitant increase or an upward shift in the main aetiological factor(s) or factors associated with dental diseases. This paper looks at these factors in relation to periodontal disease and reviews some of the major prevalence studies of periodontal disease that have been carried out in Kenya. It also presents some arguments to show that there is no unequivocal evidence that periodontal disease is on the increase in Kenya.

Adolescent↗

PubMed1993

Survey of sickle disease in Kenya.

In Kenya and most of Eastern Africa, sickle haemoglobin (HbS) is the pre-dominant beta-globin chain abnormality; homozygous sickle cell disease, (SCA), is the predominant form of sickle cell disease. Although the prevalence of sickle cell trait (SCT) in Kenya was known, the magnitude of SCA was yet to be established. We performed a national survey in all hospitals from November 1987 to May 1990 and found 3605 cases with SCA. Age was recorded for 2821 patients. Seventy-seven per cent of these patients were below the age of fifteen. The oldest patient was a 50-year-old female. The paediatric to adult ratio was 3:1. More than 80% of the patients were of Luo or Luhya ethnic origin (Luo 58.4%, Luhya 23.9%). There was a discrepancy between SCT rate (SCTr) and the percentage distribution of SCA patients per province. The Kambes of the Mijikenda group in the Coast Province with the highest SCTr (35%) constituted only 8.5%, but the Luos with a SCTr of 28%, 58% of the total SCA patient population in Kenya. We found reports of SCA in the Somali and Turkana, in whom no SCT had been found previously.

Adolescent↗

PubMed1995

The presence of sickle cells in the peripheral blood film. Specificity and sensitivity of diagnosis of homozygous sickle cell disease in Kenya.

The final diagnosis of sickle cell disease (SCD) is established by haemoglobin (Hb) electrophoresis. The test, however, is expensive and absent in most hospitals in Kenya. We studied sensitivity, specificity and cost-effectiveness of the peripheral blood film (PBF) in diagnosing sickle cell anaemia (SCA), the most common type of sickle cell disease (SCD) in Kenya. The PBF can be done even in dispensaries. The study was performed in SCA endemic western Kenya in 767 subjects during 12 months. Hb level, WBC count, PBF, sickle cell test (SCT) and cellulose acetate paper electrophoresis (CAPE) were performed. In the PBF, presence of sickle cells was pathognomonic for SCA. SCA was found in 21, sickle cell trait in 120, and normal genotype in 616 subjects. Sensitivity of the PBF versus SCT and CAPE to detect SCA was 76% with a specificity of 99.7%. The PBF was cheaper than both methods by 31.1%.

Adolescent↗

PubMed1997

Adolescent sexual behavior along the Trans-Africa Highway in Kenya.

OBJECTIVE: To describe the demographic characteristics and HIV-related risk behaviors of adolescents frequenting truck stops along the Trans-Africa Highway in Kenya. METHODS: A cross-sectional study of 200 adolescents (52% female) aged 15-19 years was conducted at the Malaba, Sachangwan and Mashinari truck stops in Kenya. A standardized questionnaire assessing the adolescents' demographic characteristics and sexual behavior was administered. RESULTS: Most (89%) of the adolescents interviewed were out of school. Their median monthly family income was Ksh1000 (US$25). Most felt that their families provided inadequate access to food (72%), clothing (70%) and pocket money (87%). Ninety-three per cent of girls and 87% of boys had ever had sexual intercourse and of these 54% of girls and 38% of boys had ever used a condom. Fifty-two per cent of the girls and 30% of the boys reported ever having had a sexually transmitted disease. Forty-six percent of girls reported usually having sex with truck drivers, 78% of girls reported usually exchanging sex for gifts or money and 59% of boys reported usually giving gifts or money for sex. Subjects engaging in these three risk behaviors were generally less likely to be in school, less likely to live with relatives and less likely to report getting along well with their parents. CONCLUSION: Adolescents at truck stops along the Trans-African Highway in Kenya appear to be at significant risk for HIV infection. In the absence of an immediate and wide-ranging intervention, these conditions are likely to facilitate the spread of HIV from truck drivers and sex workers to adolescents.

Acquired Immunodeficiency Syndrome↗

PubMed1998

National tuberculin survey of Kenya, 1986-1990.

SETTING: The first tuberculin survey conducted in Kenya by the World Health Organisation in 1958-1959 found an annual risk of tuberculosis infection (ARTI) of 2.5%. OBJECTIVE: To estimate the ARTI and its trend in recent years and to compare the estimated incidence rates with the notification rates. DESIGN: A tuberculin survey was held in 12 randomly selected districts in the period 1986-1990. Tuberculin testing with 2TU PPD RT 23 + Tween 80 was performed in 40,365 primary schoolchildren aged 6-13. RESULTS: Of 14,984 non BCG-vaccinated children, 1,380 (9.2%) had indurations of > or = 10 mm. Double testing with PPD RT 23 and PPD-scrofulaceum in 980 non BCG-vaccinated children revealed a high level of infections due to mycobacteria other than tuberculosis (MOTT). Therefore, the prevalence of tuberculous infection was based on the sum of 50% of the indurations of 17 mm and all indurations of 18 mm or more multiplied by two. The prevalence of tuberculous infection in schoolchildren aged on average 8.4 years, 'weighted' for the population size according to the provisional results of the 1989 census, was calculated at 5.5%. The corresponding ARTI is 0.6%. CONCLUSION: The ARTI has declined by an average 4.6% per year. The tuberculosis problem differs from one area to the next, with the highest prevalences of infection on the coast and in Eastern Kenya, and the lowest in Western Kenya. Although the average ratio of observed and estimated incidences indicate that 70% of incident cases are notified, considerable inter-district variations are observed.

Adolescent↗

PubMed1998

Antituberculosis drug resistance surveillance in Kenya, 1995.

SETTING: Twenty-two of the 42 administrative districts in Kenya. OBJECTIVE: To determine the prevalence of drug resistance in newly diagnosed patients with pulmonary tuberculosis, to determine possible risk factors associated with resistance, and to establish standard routine surveillance of drug resistance. DESIGN: Cross-sectional study. METHODS: Sputum samples from newly diagnosed patients with smear-positive pulmonary tuberculosis were analysed using standard procedures. RESULTS: Of 638 patients, 85% were culture positive for Mycobacterium tuberculosis. Of 491 patients tested for susceptibility to isoniazid, streptomycin, rifampicin and ethambutol, 90.8% had fully sensitive strains and 9.2% had a strain resistant to one or more drugs. Of 445 patients with no history of previous chemotherapy, 6.3% had a resistant strain. Of 46 patients with a history of previous chemotherapy, 37% had a resistant strain. No resistance to either rifampicin or ethambutol was detected. There was a strong association between previous chemotherapy and resistance. Resistance was not associated with age or sex. High concordance between Kenya's results and those of the Mycobacterium Reference Unit in the UK on both drug-sensitive and drug-resistant strains indicates that clinically significant and comparable data can be obtained from laboratories employing unsophisticated and inexpensive standard procedures. CONCLUSION: Rates of initial drug resistance are still low in Kenya. The increase in acquired resistance to isoniazid requires monitoring.

Adult↗

PubMed1988

Factors related to ovulation method efficacy in three programs: Bangladesh, Kenya, and Korea.

Sociodemographic and reproductive health data were gathered on approximately 200 acceptors in each of three programs offering the Ovulation Method of Natural Family Planning. The programs were located in Bangladesh, Kenya, and Korea. In addition, a one year follow-up was attempted to assess continuation and efficacy. Descriptive data show a variety of religious, educational, income, family, and family planning backgrounds among acceptors. Life table analyses of reported unplanned pregnancy occurrence among spacers and limiters combined was 15% at 12 months in Bangladesh, 11% in Kenya and 13% in Korea. The pregnancy rate at 12 months for all pregnancies, planned and unplanned, was 27.0, 26.0, and 23.7, respectively. In Bangladesh 37 of the 48 unplanned pregnancies were user-related as were all of the 14 unplanned pregnancies in Kenya and 17 of the 20 in Korea. Method failure was the reported cause of pregnancy in only 2 of the 83 unplanned pregnancies. A major aspect of this study was the assessment of higher risk population subgroups; increasing age, education, previous pill use and previous family planning are significantly associated with fewer unplanned pregnancies while religion, attendance as a couple, family planning intention, size and source of referral do not have a demonstrated impact on pregnancy occurrence. The time of entry into the data set in relation to time of initial NFP acceptance may be an important variable in assessing OM effectiveness.

Adolescent↗

PubMed2001

Ovine lentivirus is aetiologically associated with chronic respiratory disease of sheep on the Laikipia Plateau in Kenya.

A study was undertaken to investigate the occurrence of ovine lentivirus (OvLV) infection in sheep with chronic respiratory disease on the Laikipia Plateau, Kenya. All seven Merino crossbred sheep with chronic dyspnoea and emaciation examined for gross and microscopic lesions had lymphoid interstitial pneumonia (LIP), and one also had pulmonary abscesses. Two of the sheep with LIP also had lesions of ovine pulmonary carcinoma (OPC, jaagsiekte). Using in situ hybridization, OvLV DNA localized to a high proportion of pulmonary macrophages in lungs with lesions of LIP. Lung tissue samples from six of these sheep were positive for a syncytium-inducing virus in cultures of lamb testis cells. Thin-section electron microscopy of infected cells showed virions with morphogenesis typical of lentiviruses. In a western blotting assay, monoclonal antibodies to the OvLV capsid (CA, p27) and matrix (MA, p15) proteins of a North American OvLV isolate reacted with similar-sized bands of the virus, and serum from six of the sheep were reactive with CA from the Kenyan viral isolate. Using an OvLV agar gel immunodiffusion (AGID) test, all seven sheep were positive for serum antiviral antibody, as were 29% of 63 clinically normal sheep from Laikipia District. However, when sera from the healthy sheep were tested in a western blot assay, only 52% had IgG reactive to the OvLV CA, indicating a high rate of false negative reactions with the AGID test. Serum samples from 87 Red Maasai or Dorper crossbred sheep from two farms in other parts of Kenya were OvLV seronegative by both the AGID test and the western blot assay. These results document the first identification of OvLV as a cause of chronic respiratory disease in sheep in Kenya and show a high rate of infection in sheep flocks, with a high prevalence of chronic respiratory disease.

Animals↗

PubMed1995

STDs, HIV, AIDS and urbanisation process in Kenya.

The AIDS epidemic in Kenya constitutes the greatest public health challenge of our time. It has been recognized that social factors associated with urbanization process are important in the rapid spread of Acquired Immune Deficiency Syndrome (AIDS) in Kenya. It is, therefore imperative to provide knowledge, attitude and practice (KAP) baseline data that would provide a basis for designing intervention measures for changing sexual practices in order to avoid AIDS. The study focused on eight districts of Kenya, namely; Mombasa, Machakos, Kajiado, Nairobi, Nyeri, Kisumu, South Nyanza (now Kuria, Migori and Homa Bay) and Busia (figure 1). There is a high and widespread awareness of AIDS. However, the actual knowledge of AIDS appeared to be lacking since most respondents associated the disease with other forms of "curses". The younger generation appeared to be more aware of STDs, HIVs and AIDS but the awareness decreases with age and increases with the level of education. It is, therefore, important that the programmes on STDs, HIVs and AIDS should be intensified. Mass media and other interpersonal communication channels should also be intensified since they play an important role in imparting knowledge and awareness about the dreaded disease.

Journal Article↗

PubMed1995

Maize flour contaminated with toxigenic fungi and mycotoxins in Kenya.

The majority of the Kenyan human population may be exposed to regular doses of a wide spectrum of highly toxic, carcinogenic, immunosuppressive, mutagenic, and hepatotoxic mycotoxins through the consumption of maizemeal. Maizemeal is consumed in Kenya at the rate of about 0.4kg/person/day, therefore, even the lowest amount of toxins consumed can cause significant effects as some are cumulative. Maize is also a major component in livestock and poultry feed, and the therefore regular indirect human exposure through the consumption of animal products that contain mycotoxin residues could be common. Due to these suspected risks, it is imperative to establish whether consumers in Kenya are actually exposed to dangerous mycotoxins in maize products hence this survey. Forty samples of flour packed in 90kg bags, 58 samples of "Ugali" brand (milled and packed by the Milling Corporation of Kenya Ltd), and 74 samples of "Jogoo" brand ( Unga Maize Millers) were collected from the Nairobi area. The samples were analysed for resident mycoflora, and some mycotoxins associated with key fungal species. Important fungal species isolated from the flour included Aspergillus flavus, A. sulphureus, Fusarium moniliforme, Penicillium stoloniferum, and P. cyclopium. All the three brands of flour were contaminated with Aflatoxins B1 and B2 (0.4-20 ug/kg), Ochratoxin A(50-1,500 ug/kg), and Zearalenone (2,500 - 5,000 ug/kg). Ochratoxin A was the most prevalent mycotoxin. These data provide a warning that the mycotoxin contamination problem in maizemeal is critical and consumers' health is at risk. Therefore, rigorous countrywide monitoring of mycotoxins in this staple food should be pursued. If possible, maize products should be subjected to stiff microbial quality control from the farm gate to the market shelf.

Journal Article↗