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PubMed2001

Characteristics of larval anopheline (Diptera: Culicidae) habitats in Western Kenya.

A longitudinal survey of mosquito larval habitats was carried out in Asembo Bay, western Kenya, during the rainy season of 1998. All pools of standing water along a 700-m transect were sampled twice per week. For each habitat, eight environmental variables were recorded and a sample of anopheline larvae was collected for identification. In total, 1,751 Anopheles gambiae s.l. and 2,784 Anopheles funestus Giles were identified. Identification of An. gambiae s.l. by polymerase chain reaction (PCR) indicated that 240 (14.7%) were An. gambiae Giles and 858 (52.4%) were An. arabiensis Patton; PCR failed to identify 539 (32.9%) specimens. Repeated measures logistic regression analysis indicated that An. gambiae and An. arabiensis larvae were associated with small, temporary habitats with algae and little or no aquatic vegetation. Anopheles funestus larvae were associated with larger, semipermanent bodies of water containing aquatic vegetation and algae. Direct comparison of habitat characteristics associated with either An. gambiae or An. arabiensis revealed that algae were associated more commonly with habitats containing An. gambiae; no other differences were detected. Chi-square analysis indicated that these species were collected from the same habitat more frequently than would be expected by chance alone. Together, these results indicate that An. gambiae and An. arabiensis have similar requirements for the larval environment and that, at least in western Kenya, they do not segregate into separate habitats.

Animals↗
PubMed2001

Anopheline mosquito survival strategies during the dry period in western Kenya.

The dry season survival mechanism of Anopheles gambiae Giles is one of the most vexing deficiencies in our understanding of the biology of the major malaria vectors. In this study, we examined the dynamics of anopheline adult mosquitoes, their larval habitats, and egg survival potential during the dry season in the basin region of Lake Victoria, western Kenya. Through field surveys, we demonstrated two survival strategies of An. gambiae sensu stricto during the dry season: continuous reproduction throughout the year and embryo dormancy in moist soil for at least several days. We further demonstrated that An. gambiae shows a strong preference for moist soil as an oviposition substrate rather than dry soil substrate under the insectary conditions. The observation that anopheline eggs remain a dormant stage to resist desiccation clearly contrasts the conventional wisdom that anopheline eggs hatch shortly after they are laid. Our results from western Kenya are consistent with the suggestion that anopheline mosquitoes do not necessarily suffer a severe population bottleneck during the dry season and thus maintain a large effective population size.

Animals↗
PubMed2001

Effect of permethrin-impregnated nets on exiting behavior, blood feeding success, and time of feeding of malaria mosquitoes (Diptera: Culicidae) in western Kenya.

The impact of permethrin-treated bednets on the feeding and house entering/exiting behavior of malaria vectors was assessed in two studies in western Kenya. In one study, matched pairs of houses were allocated randomly to receive bednets or no bednets. Exiting mosquitoes were collected in Colombian curtains hung around half of each house; indoor resting mosquitoes were collected by pyrethrum spray catches. The number of Anopheles gambiae Giles and An. arabiensis Patton estimated to have entered the houses was unaffected by the presence of bednets; Anopheles funestus Giles was less likely to enter a house if bednets were present. Anopheles gambiae and An. funestus were less likely to obtain a blood meal and significantly more likely to exit houses when bednets were present. No difference was detected in An. arabiensis rates of blood feeding and exiting. In a second experiment, hourly night biting collections were done on 13 nights during the rainy season to assess whether village-wide use of permethrin-treated bednets caused a shift in the time of biting of malaria vectors. A statistically significant shift was detected in the biting times of An. gambiae s.l., although the observed differences were small. No change was observed in the hourly distribution of An. funestus biting. Our study demonstrated that, at least in the short-term, bednets reduced human-vector contact and blood feeding success but did not lead to changes in the biting times of the malaria vectors in western Kenya.

Animals↗
PubMed2005

First biologic and genetic characterization of Toxoplasma gondii isolates from chickens from Africa (Democratic Republic of Congo, Mali, Burkina Faso, and Kenya).

The prevalence of Toxoplasma gondii in free-ranging chickens (Gallus domesticus) is a good indicator of the prevalence of T. gondii oocysts in the soil because chickens feed from the ground. In the present study, prevalence of T. gondii in chickens from Democratic Republic of Congo, Mali, Burkina Faso, and Kenya is reported. The prevalence of T. gondii antibodies in sera of 50 free-range chickens from Congo was 50% based on the modified agglutination test (MAT); antibody titers were 1:5 in 7, 1:10 in 7, 1:20 in 6, 1:40 in 1, and 1:160 or more in 4 chickens. Hearts, pectoral muscles, and brains of 11 chickens with titers of 1:20 or more were bioassayed individually in mice; T. gondii was isolated from 9, from the hearts of 9, brains of 3, and muscles of 3 chickens. Tissues of each of the 14 chickens with titers of 1:5 or 1:10 were pooled and bioassayed in mice; T. gondii was isolated from 1 chicken with a titer of 1:10. Tissues from the remaining 25 seronegative chickens were pooled and fed to 1 T. gondii-free cat. Feces of the cat were examined for oocysts, but none was seen. The results indicate that T. gondii localizes in the hearts more often than in other tissues of naturally infected chickens. Genotyping of these 10 isolates using the SAG2 locus indicated that 8 were isolates were type III, 1 was type II, and 1 was type I. Two isolates (1 type I and 1 type III) were virulent for mice. Toxoplasma gondii was isolated by mouse bioassay from a pool of brains and hearts of 5 of 48 chickens from Mali and 1 of 40 chickens from Burkina Faso; all 6 isolates were avirulent for mice. Genetically, 4 isolates were type III and 2 were type II. Sera were not available from chickens from Mali and Burkina Faso. Toxoplasma gondii antibodies (MAT 100 or more) were found in 4 of 30 chickens from Kenya, and T. gondii was isolated from the brain of 1 of 4 seropositive chickens; this strain was avirulent for mice and was type II. This is the first report on isolation and genotyping of T. gondii from any source from these 4 countries in Africa.

Agglutination Tests↗
PubMed1992

Dermatophilosis in camels (Camelus dromedarius Linnaeus, 1758) in Kenya.

Natural dermatophilosis (caused by Dermatophilus congolensis Van Saceghem, 1915) has only recently been described in camels (Camelus dromedarius). Further work has shown that the disease is actually widespread. At the Ol Maisor farm where it was first diagnosed (in the Laikipia district of northern Kenya), detailed investigations have revealed that thirty camels (ten calves and twenty adult animals) were infected. The signs varied from mild to more than 50% skin involvement. Patches of wool on the rump were easily detachable with many hard, white crusts. Similarly, another twenty camels from a totally different area of northern Kenya (Samburu district) were found to be infected with D. congolensis. Bacterial isolation was used to confirm the diagnosis. At Ol Maisor farm, twenty sheep were also found to have severe dermatophilosis. There were scabs and many areas of wool shedding. The shed wool had crusts similar to those observed on camels. Experimental infection with D. congolensis isolated from camels was conducted, by means of scarification, on the skin of two goats. The same experimental infection was possible in two calves, taking two weeks to become established. After thirty days there were disseminated foci of infection on the heads of the calves, especially around the eyes. Although these findings cannot show the actual source of D. congolensis, it is possible that the same organism causes dermatophilosis in the different animals.

Actinomycetales↗
PubMed1994

Health care-seeking behavior related to the transmission of sexually transmitted diseases in Kenya.

OBJECTIVES: The purpose of this study was to identify health-care seeking and related behaviors relevant to controlling sexually transmitted diseases in Kenya. METHODS: A total of 380 patients with sexually transmitted diseases (n = 189 men and 191 women) at eight public clinics were questioned about their health-care seeking and sexual behaviors. RESULTS: Women waited longer than men to attend study clinics and were more likely to continue to have sex while symptomatic. A large proportion of patients had sought treatment previously in both the public and private sectors without relief of symptoms, resulting in delays in presenting to study clinics. For women, being married and giving a recent history of selling sex were both independently associated with continuing to have sex while symptomatic. CONCLUSIONS: Reducing the transmission of sexually transmitted diseases in Kenya will require improved access, particularly for women, to effective health services, preferably at the point of first contact with the health system. It is also critical to encourage people to reduce sexual activity while symptomatic, seek treatment promptly, and increase condom use.

Female↗
PubMed2001

Challenges in implementing a point-of-use water quality intervention in rural Kenya.

To prevent diarrheal diseases in western Kenya, CARE Kenya initiated the Water, Sanitation, and Education for Health (WASEH) Project in 1998. The project targets 72 farming and fishing communities with a total population of 43 000. Although the WASEH Project facilitated construction of shallow wells and pit latrines, the water quality still needed improvement. Consequently, in 2001, CARE implemented the Safe Water System (which consists of point-of-use water treatment with sodium hypochlorite, safe storage, and behavior change techniques) within the already established WASEH infrastructure, using existing community organizations in combination with a social marketing approach that introduced affordable products. The project has resulted in adoption rates of 33.5% for chemical water treatment and 18.5% for clay pots modified for safe water storage.

Behavior Therapy↗
PubMedDate not supplied

Travel as a risk factor for malaria requiring hospitalization on a highland tea plantation in western Kenya.

BACKGROUND: Over the past two decades, endemic malaria returned to the western highlands of Kenya, a region that had been free of endemic malaria during the preceding 30 years. A study of malaria patients admitted to a tea estate hospital was conducted to estimate the risk of severe malaria when acquired during travel away from the tea estates compared with infections that had probably been locally acquired. METHODS: From May 1998 to March 2000, 1,296 patients were evaluated with a case-control design and standardized questionnaire during their hospitalization. Death certificates from the tea estates were examined from 1964 to 1972 and 1986 to 1999. RESULTS: Travel away from the tea estates during the 2 months prior to hospitalization (n = 432) was strongly associated with a diagnosis of malaria (odds ratio 2.7, 95% CI 2.1-3.5). The estimate of risk associated with travel was consistent with known malaria endemicity, the Rift Valley Province having a much lower malaria transmission than the area around Lake Victoria. The seasonality of malaria-related deaths indicates that many lowland-origin children probably contracted their fatal infection away from the tea plantation. CONCLUSIONS: Travel within Kenya is a significant risk factor for hospitalization owing to malaria on the tea estates; expatriate travelers need to be aware that the East African highlands cannot be regarded as malaria free.

Adolescent↗
PubMed1996

The prevalence of malocclusion in 13- to 15-year-old children in Nairobi, Kenya.

Data on occlusal features and the need for orthodontic treatment in Kenya is scanty. This study was carried out to determine the prevalence of malocclusion in children in Nairobi, Kenya. Nine hundred and nineteen children aged 13-15 years (468 male, 451 female) were examined. The registration method used was that described by Björk et al. The prevalence of malocclusion was 72%. The predominant anteroposterior relationship of the dental arches was neutral occlusion (93%). Specific malocclusion traits were highest for crowding (19%), rotations (19%), posterior crossbite (10%), maxillary overjet (10%), and frontal open bite (8%). There was no statistically significant difference in the overall prevalence of malocclusion between males and females, but some occlusal traits were significantly higher in males. Although the findings indicate that the present population is not characterized by a substantial difference in the overall prevalence of malocclusion compared with other communities, some traits differed in prevalence from those reported elsewhere.

Adolescent↗
PubMed1997

The need and demand for orthodontic treatment in 13- to 15-year-olds in Nairobi, Kenya.

The need for orthodontic treatment in Kenya was previously not been investigated. This study was undertaken to assess the need for orthodontic treatment in 13- to 15-year-old children in Nairobi. The objective need was assessed in 919 children by using the Norwegian treatment need index, and the subjective need was assessed in 739 children by using a structured questionnaire. Objective treatment need was recorded in 29% and subjective need in 33% of the children. Less than 1% were allocated the 'very great need' category. Relatively more girls than boys were dissatisfied with the appearance of their teeth, and a significantly higher number of girls (P < 0.001) said they would like to have their teeth straightened. The children's perceived need for treatment correlated significantly with the treatment need index. Fixed appliances were found necessary for correcting malocclusion in 23% of the children and removable appliances in 6%. Future studies in Kenya should be directed at determining the societal perception of malocclusion, upon which treatment standards may be based.

Adolescent↗
PubMed2002

Defining and detecting malaria epidemics in the highlands of western Kenya.

Epidemic detection algorithms are being increasingly recommended for malaria surveillance in sub-Saharan Africa. We present the results of applying three simple epidemic detection techniques to routinely collected longitudinal pediatric malaria admissions data from three health facilities in the highlands of western Kenya in the late 1980s and 1990s. The algorithms tested were chosen because they could be feasibly implemented at the health facility level in sub-Saharan Africa. Assumptions of these techniques about the normal distribution of admissions data and the confidence intervals used to define normal years were also investigated. All techniques identified two "epidemic" years in one of the sites. The untransformed Cullen method with standard confidence intervals detected the two "epidemic" years in the remaining two sites but also triggered many false alarms. The performance of these methods is discussed and comments made about their appropriateness for the highlands of western Kenya.

Adolescent↗
PubMed2002

Meteorologic influences on Plasmodium falciparum malaria in the Highland Tea Estates of Kericho, Western Kenya.

Recent epidemics of Plasmodium falciparum malaria have been observed in high-altitude areas of East Africa. Increased malaria incidence in these areas of unstable malaria transmission has been attributed to a variety of changes including global warming. To determine whether the reemergence of malaria in western Kenya could be attributed to changes in meteorologic conditions, we tested for trends in a continuous 30-year monthly malaria incidence dataset (1966-1995) obtained from complete hospital registers at a Kenyan tea plantation. Contemporary monthly meteorologic data (1966-1995) that originated from the tea estate meteorologic station and from global climatology records were also tested for trends. We found that total hospital admissions (malaria and nonmalaria) remained unchanged while malaria admissions increased significantly during the period. We also found that all meteorologic variables showed no trends for significance, even when combined into a monthly suitability index for malaria transmission. We conclude that climate changes have not caused the highland malaria resurgence in western Kenya.

Altitude↗
PubMed2003

Dyspepsia symptoms and Helicobacter pylori infection, Nakuru, Kenya.

The prevalence of Helicobacter pylori infection was studied in 138 patients with dyspepsia in a hospital in Nakuru, Kenya, and in 138 asymptomatic sex- and age-matched controls from the same population. Anti-H. pylori immunoglobulin (Ig) G was more prevalent in dyspeptic than asymptomatic persons (71% vs. 51%), particularly those <30 years old (71% vs. 38%). H. pylori seropositivity was associated with dyspepsia after adjusting for age, sex, and residence (urban or rural). Among adults, the association between H. pylori infection and dyspepsia remained after adjusting for the above factors and for educational attainment, family size, and manual occupation. H. pylori infection in asymptomatic residents of Nakuru, Kenya, was more prevalent in older persons, with a rate of 68%, than in those 31-40 years of age. However, young persons with dyspepsia had an unexpectedly high prevalence of H. pylori infection. H. pylori test-and-treat strategy should be considered in Kenyan patients with dyspepsia, particularly in persons <30 years of age.

Adolescent↗
PubMed2005

Plasmodium falciparum spatial analysis, western Kenya highlands.

We carried out a population-based study to determine the unbiased, age-specific Plasmodium falciparum prevalence, asexual and sexual parasite density, and spatial distribution to establish rates of infection at a site in western Kenya. Three cross-sectional surveys were carried out in western Kenya highlands. Blood samples were taken from 1,388 persons from 6 months to 75 years of age. Parasite prevalence and densities in the population decreased with age and distance from valley bottoms. Children from 1 to 4 years of age had the highest parasite prevalence (38.8%-62.8%); in adults, prevalence declined to 2.9%-24.1%. Malaria prevalence declined by an average of 19% from July to December 2002 across age groups. These observations suggest that parasite transmission is intense at this altitude. Asexual parasite density indicated clustering near major vector breeding habitats. Variability in seasonal prevalence indicates transmission instability and susceptibility to epidemics.

Adolescent↗
PubMed2006

Tickborne arbovirus surveillance in market livestock, Nairobi, Kenya.

To identify tickborne viruses circulating in Kenya and the surrounding region, we conducted surveillance at abattoirs in Nairobi, Kenya. Species of ticks collected included Rhipicephalus pulchellus (56%), Amblyomma gemma (14%), R. appendiculatus (8%), A. variegatum (6%), and others. A total of 56 virus isolates were obtained, 26 from A. gemma, 17 from R. pulchellus, 6 from A. variegatum, and 7 from other species. Virus isolates included Dugbe virus (DUGV), an unknown virus related to DUGV, Thogoto, Bhanja, Kadam, Dhori, Barur, and foot-and-mouth disease (FMDV) viruses. This is the first report of Dhori virus isolation in East Africa and the first known isolation of FMDV associated with tick collection. Our results demonstrate the potential for tickborne dissemination of endemic and emergent viruses and the relevance of A. gemma in the maintenance of tickborne viruses in this region.

Abattoirs↗
PubMed1999

Prevalence of besnoitiosis in domestic ruminants in Kenya: a preliminary survey.

A preliminary survey on the prevalence of besnoitiosis in domestic ruminants in Kenya based on field and farm visits, clinical and post mortem examinations and histopathological examination of tissues and biopsies, showed that goats are the most affected, followed by cattle, while sheep were unaffected. Caprine besnoitiosis occurred in a continuous belt in 5 of the 8 provinces in Kenya stretching from the Coast, Eastern, North Eastern, Nairobi and the Rift Valley Provinces. Mandera, in the North Eastern Province, had the highest prevalence rate of 36%, followed by Kwale (35%), Isiolo (35%), Marsabit (33%), Wajir (28%), Nairobi (26%), Meru (24%), Garissa (21%), Taita Taveta (18%), Embu (17%), Kitui (9%), Machakos (7%), Laikipia (3%), Kajiado (2%) and Turkana and Elgeyo-Marakwet (1% each). In all flocks where the prevalence rates were over 6%, kids were observed to be affected. There were no significant differences (P < 0.05) between the prevalence rates in bucks and does (18% and 18.4, respectively), but kids were less (4%) affected. Bovine besnoitiosis was found only in the Tana River District, with an infection rate of 11%.

Animals↗
PubMed2002

An epidemiological survey demonstrating decline in reproductive efficiency with age and non-seasonality of reproductive parameters in German shepherd bitches in Kenya.

An epidemiological survey undertaken in Kenya indicated that 2 previously well-established factors, namely decline in reproductive efficiency with age, and non-seasonality of canine reproductive parameters, hold true for German shepherd (GSD) bitches in Kenya. Data collection forms were distributed to randomly selected GSD breeders and information so obtained was verified using East African Kennel Club records. Whelping was recorded throughout the year. The litter size varied from 1 to 14 pups per litter with a mean of 6.3 +/- 0.4 SD puppies. Records of 567 whelpings and 3592 puppies were studied. The mean monthly whelping rate was 47.3 +/- 7.2. There was no significant difference in the mean litter size by month (P < 0.05).

Age Factors↗
PubMed1988

Indigenous human cutaneous leishmaniasis caused by Leishmania tropica in Kenya.

Six Leishmania isolates from 3 indigenous Kenyans (2 isolates from one patient) and 2 Canadian visitors in Kenya were characterized by cellulose acetate electrophoresis. The isolates were compared among themselves and with reference strains of Leishmania donovani, L. aethiopica, L. major, L. tropica, and L. arabica using 9 enzymes: malate dehydrogenase (MDH), malic enzyme (ME), phosphogluconate dehydrogenase (6PGD), glucose-6-phosphate dehydrogenase (G6PD), aspartate aminotransferase (ASAT), adenylate kinase (AK), mannose phosphate isomerase (MPI), glucose phosphate isomerase (GPI), and phosphoglucomutase (PGM). Enzyme migration patterns of isolates from the 3 indigenous Kenyans were indistinguishable from those of 2 L. tropica reference strains. The isolates from the 2 Canadians yielded migration patterns of 7 enzymes that were indistinguishable from those of 2 L. tropica reference strains. However, migration patterns of 2 enzymes, PGM and ME, differed from all migration patterns of the 10 reference strains. Balb/c mice were inoculated with stationary phase promastigotes cultured from 3 stabilates from the lesions of 2 of the Kenyan patients. The mice developed no gross pathological lesions in 6 months time. All of the study patients developed cutaneous leishmaniasis while living in or visiting districts in Central and Rift Valley Provinces, Kenya. This is the first report of human cutaneous leishmaniasis caused by L. tropica indigenous to Africa south of the Sahara.

Adolescent↗