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PubMed1992

Visceral leishmaniasis and malaria prevalence in West Pokot District, Kenya.

The prevalence of visceral leishmaniasis and malaria in the human population of West Pokot district of Kenya was studied in 1986. A total of 2139 people was proportionately screened for the two diseases according to four age categories (0-4, 5-14, 15-44 and greater than 45 years). Diagnostic methods included the enzyme linked immunosorbent assay (ELISA) and Leishmanin skin test for visceral leishmaniasis, and parasitological examination for malaria. The epidemiological value of the spleen rate was evaluated in relation to visceral leishmaniasis and malaria endemicity. A general decline of infection rates with altitude was observed for both diseases. Visceral leishmaniasis was less prevalent than malaria, with less than 2% active cases in any age group and had the same distribution in both sexes. Malaria infection rate was highest in the younger age groups, declining from 21.5% in the 0-4 year old age group to 5.5% in people more than 45 years old. Malaria affected significantly more males than females. The spleen rate was inappropriate for epidemiological survey of either malaria or visceral leishmaniasis due to an overlap in the distribution of the two diseases.

Adolescent↗
PubMed2004

Sustainability of reductions in malaria transmission and infant mortality in western Kenya with use of insecticide-treated bednets: 4 to 6 years of follow-up.

CONTEXT: Insecticide-treated bednets reduce malaria transmission and child morbidity and mortality in short-term trials, but this impact may not be sustainable. Previous investigators have suggested that bednet use might paradoxically increase mortality in older children through delayed acquisition of immunity to malaria. OBJECTIVES: To determine whether adherence to and public health benefits of insecticide-treated bednets can be sustained over time and whether bednet use during infancy increases all-cause mortality rates in older children in an area of intense perennial malaria transmission. DESIGN AND SETTING: A community randomized controlled trial in western Kenya (phase 1: January 1997 to February 2000) followed by continued surveillance of adherence, entomologic parameters, morbidity indicators, and all-cause mortality (phase 2: April 1999 to February 2002), and extended demographic monitoring (January to December 2002). PARTICIPANTS: A total of 130,000 residents of 221 villages in Asembo and Gem were randomized to receive insecticide-treated bednets at the start of phase 1 (111 villages) or phase 2 (110 villages). MAIN OUTCOME MEASURES: Proportion of children younger than 5 years using insecticide-treated bednets, mean number of Anopheles mosquitoes per house, and all-cause mortality rates. RESULTS: Adherence to bednet use in children younger than 5 years increased from 65.9% in phase 1 to 82.5% in phase 2 (P<.001). After 3 to 4 years of bednet use, the mean number of Anopheles mosquitoes per house in the study area was 77% lower than in a neighboring area without bednets (risk ratio, 0.23; 95% confidence interval [CI], 0.15-0.35). All-cause mortality rates in infants aged 1 to 11 months were significantly reduced in intervention villages during phase 1 (hazard ratio [HR], 0.78; 95% CI, 0.67-0.90); low rates were maintained during phase 2. Mortality rates did not differ during 2002 (after up to 6 years of bednet use) between children from former intervention and former control households born during phase 1 (HR, 1.01; 95% CI, 0.86-1.19). CONCLUSIONS: The public health benefits of insecticide-treated bednets were sustained for up to 6 years. There is no evidence that bednet use from birth increases all-cause mortality in older children in an area of intense perennial transmission of malaria.

Animals↗
PubMed1997

Growth, development, and sexual dimorphism in vervet monkeys (Cercopithecus aethiops) at four sites in Kenya.

Body weight and ten body segment measurements were collected from 367 wild-trapped vervet monkeys (Cercopithecus aethiops) in central and southern Kenya. The animals represent between 70 and 95% of the animals in each of 30 troops at four geographical locations separated by 80 to 380 km. The capture sites differed in altitude, mean annual rainfall and temperature. Two questions are addressed: (1) what are the differences in male and female growth patterns, and (2) what is the relationship between size, climate, and availability of food? Each animal was assigned to an age class based on dental examination. Means for all variables do not diverge for males and females from birth to age class 4 (15-18 months). After this, male and female growth rates diverge. This sexual dimorphism in growth pattern may reflect timing of entry into the reproductive community. A nested analysis of variance (ANOVA) was employed to compare sites, groups within sites and individuals within groups. Statistically significant differences between sites in body weight and body segment measurements are found for adult females. Except for tail length, these differences do not follow Bergmann's or Allen's Rules correlating size differences and temperature, but rather may reflect proximity to cultivated areas or tourist lodges with greater access to human food.

Age Determination by Teeth↗
PubMedDate not supplied

Household characteristics affecting where mothers deliver in rural Kenya.

Data from a household survey were used to analyse the distribution of newborn deliveries in a rural area of Kenya. It was found that 52% of deliveries occurred at home or with traditional birth attendants. Using regression techniques, the most significant predictors of choosing an informal delivery setting are the household's distance from the nearest maternity bed and whether a household member has insurance. The results suggest that travel time is an important barrier to access. Therefore, quality improvements at existing facilities may not result in greater use of modern sector delivery, particularly if improvements are partially offset by user fees.

Developing Countries↗
PubMedDate not supplied

Socio-cultural information in support of local health planning: conclusions from a survey in rural Kenya.

Existing health information systems in developing countries are managed and used mainly by biomedically trained personnel and by general healthcare administrators. They focus on epidemiology, service utilization and finance; they generate little of the socio-cultural data needed for developing and adjusting health services and disease control programmes to local health-related perceptions, values and resources. This paper reviews some of the published literature on socio-cultural factors related to health and summarizes the findings of a health household interview study in rural Kenya. It concludes that local views on specific disease categories and their causes are crucial for the planning of local disease control and that health information systems need to be expanded to incorporate such data. It discusses methods of generating community-based socio-cultural health information likely to be useful, particularly at district level. Options include observation, household interviews, focus group discussions and key informant interviews. Four improvements are suggested: (1) health information systems should be reoriented to focus less on individual patients and clients and more on population-based information including socio-cultural data; (2) post-basic health manpower training is needed in applied health-related social sciences; (3) staff positions for social scientists at central, provincial and district levels of the health sector; and (4) expansion of research on national and local socio-cultural issues of relevance to health and care-seeking behaviour.

Community Health Planning↗
PubMed2000

Pregnancy outcome for nomadic Turkana pastoralists of Kenya.

The outcome of an individual pregnancy is a key component of overall reproductive success and is strongly influenced by environmental, behavioral, and biological variation within populations. This prospective study examined the outcomes of 68 pregnancies among nomadic Turkana of Kenya from July 1993 to July 1994. A total of 12 women experienced pregnancy losses, and 3 women experienced live births with a subsequent perinatal death. The following characteristics are associated with increased risk for experiencing a fetal or perinatal death: severe morbidity episodes, shorter nonpregnant intervals, lower third-trimester weight, higher third-trimester summed skinfolds but limited third-trimester reduction in summed skinfolds, and higher activity levels late in gestation. Turkana newborns measured within 48 hr of birth (n = 19) weighed an average of 2,860 +/- 640 g and had a mean ponderal index of 2.72 +/- 0.46. Variation in birth weight was predicted by preterm delivery, delivery during the wet season, and maternal morbidity levels. Birth length averaged 50.8 +/- 6.8 cm and was positively influenced by full term delivery, better maternal health, and birth during the dry season. These results suggest complicated pathways linking the physical environment, subsistence requirements, heterogeneity in maternal fitness, behavior, and pregnancy outcome. The results augment the larger picture of reproductive success for Turkana nomads who live in a highly variable savanna environment.

Birth Weight↗
PubMed1992

Hodgkin's disease in Kenya.

A total of 136 patients with Hodgkin's disease (HD) seen at a national referral hospital in Kenya over a 15-year period were studied. The overall male-to-female ratio was 2.6:1, with 65% of patients younger than 20 years of age. The bimodal incidence of HD frequently seen in the developed nations was absent, and the histologic pattern of the disease was similar to that seen in other African countries. Fifty percent of patients had advanced-stage disease when first seen. Over two thirds of patients treated had a clinical remission, and the relapse rate in all stages was approximately 30%. Therapy-related complications were common, with frequent myelosuppression and younger patients more susceptible.

Adolescent↗
PubMedDate not supplied

Age-related changes in body composition among Turkana males of Kenya.

To determine if age-related changes in body composition among males from an energetically limited population are similar to those of Western populations, we collected anthropometric data from Turkana pastoral nomads of northern Kenya. Measures included height, weight, and triceps, suprailiac, and subscapular skinfolds. Subjects were 132 nomadic and 90 settled Turkana males, with estimated ages 20+. Skinfold measures were used to calculate both fat-free mass (FFM) and percent body fat. Results were analyzed by 10-year age groups, using general linear models. Subpopulations did not differ in FFM, but percent body fat was significantly higher among settled males. Age-related changes in FFM were curvilinear, peaking in the 30 s for nomads and 40s for settled males, with a significant decline in men over 60 years of age. Nomadic males show declines in percent body fat from the 20 s onward, while percent body fat among settled males increased across age groups. These results indicate that age-related patterns of FFM in Turkana men are similar to those found in Western populations, but that age-related patterns of adiposity can differ. As such, they suggest that age-related patterns of fat-free mass in men may vary little across populations, while age-related patterns of adiposity are more closely related to environmental conditions.

Adiposity↗
PubMedDate not supplied

Incorporating psychosocial health into biocultural models: preliminary findings from Turkana women of Kenya.

This paper investigates the potential benefits and limitations of including psychosocial stress data in a biocultural framework of human adaptability. Building on arguments within human biology on the importance of political economic perspectives for examining patterns of biological variation, this paper suggests that psychosocial perspectives may further refine our understanding of the mechanisms through which social distress yields differences in health and well-being. To assess a model that integrates psychosocial experiences, we conducted a preliminary study among nomadic pastoralist women from northern Kenya. We interviewed 45 women about current and past stressful experiences, and collected anthropometric data and salivary cortisol measures. Focus group and key informant interviews were conducted to refine our understanding of how the Turkana discuss and experience distress. The results suggest that the most sensitive indicators of Turkana women's psychosocial experiences were the culturally defined idioms of distress, which showed high concordance with measures of first-day salivary cortisol. Other differences in stress reactivity were associated with the frequent movement of encampments, major herd losses, and direct experiences of livestock raiding. Despite the preliminary nature of these data, we believe that the results offer important lessons and insights into the longer-term process of incorporating psychosocial models into human adaptability studies.

Adaptation, Physiological↗
PubMed2004

Sedentism, seasonality, and economic status: A multivariate analysis of maternal dietary and health statuses between pastoral and agricultural Ariaal and Rendille communities in northern Kenya.

This paper examines longitudinal data to assess the effects of the recent transition from pastoralism to sedentary agriculture for Ariaal and Rendille mothers in northern Kenya. Dietary, morbidity, and anthropometric data resulting from bimonthly repeated surveys of the pastoral community of Lewogoso and the sedentary agricultural community of Songa, covering the period from September 1994-July 1995, were used to test two hypotheses: 1) that sedentism is associated with changes in diet, seasonality, morbidity, and socioeconomic differentiation, and 2) that these changes affect maternal body composition. The first hypothesis is partly supported, with starch replacing milk in the sedentary diet. Repeated-measures multivariate analysis of variance revealed no seasonal effects for diet in the agricultural sample, while starch consumption was significantly affected by seasonality for the pastoral sample. The agricultural community also featured economic dietary disparities favoring wealthier mothers, while no such effect was found in the pastoral community. However, no seasonal or economic effects were found for morbidity patterns in either sample. The second hypothesis is also partially supported, as a generalized estimating equations analysis revealed differences in the way diet and economic strata influence maternal anthropometric values. Economic status was significantly associated with maternal arm-fat area in Lewogoso. Milk was a significant factor associated with maternal weight and arm-muscle area in Songa. These findings are discussed in light of development policy implications.

Adipose Tissue↗
PubMed2004

Influence of Plio-Pleistocene aridification on human evolution: evidence from paleosols of the Turkana Basin, Kenya.

New stable carbon isotope measurements, coupled with paleoprecipitation estimates, both from Plio-Pleistocene paleosols of the Turkana Basin, Kenya, provide a high-resolution record of aridification and increasing C4 biomass during the past 4.3 Ma. This aridification trend is marked by several punctuations at 3.58-3.35, 2.52-2, and 1.81-1.58 Ma, during which the running mean and variance of delta13C and paleoaridity estimates increase, suggesting that the proportion of C4 biomass increases in savanna mosaics during periods of heightened aridity. Increase in C4 biomass during these aridification events not only increases the proportion of open habitats, but increases the spatial neg-entropy, or heterogeneity of the ecosystem. The aridification events identified correspond to intervals of increased turnover, but more importantly, increased diversity of bovids. Although the record of hominins from the Turkana Basin lacks the temporal resolution and diversity of the bovid record, the aridification intervals identified are marked by similar increases in the diversity and turnover of hominins. These results support the hypothesis that hominins evolved in savanna mosaics that changed through time, and suggest that the evolution of bovids and hominins was driven by shifts in climatic instability and habitat variability, both diachronic and synchronic.

Animals↗
PubMed1975

New studies of post-Pleistocene human skeletal remains from the Rift Valley, Kenya.

Prehistoric human crania from Bromhead's Site, Willey's Kopje, Makalia Burial Site, Nakuru, and other localities in the Eastern Rift Valley of Kenya are reassessed using measurements and a multivariate statistical approach. Materials available for comparison include series of Bushman and Hottentot crania. South and East African Negroes, and Egyptians. Up to 34 cranial measurements taken on these series are utilized to construct three multiple discriminant frameworks, each of which can assign modern individuals to a correct group with considerable accuracy. When the prehistoric crania are classified with the help of these discriminants, results indicate that several of the skulls are best grouped with modern Negroes. This is especially clear in the case of individuals from Bromhead's Site, Willey's Kopje, and Nakuru, and the evidence hardly suggests post-Pleistocene domination of the Rift and surrounding territory by "Mediterranean" Caucasoids, as has been claimed. Recent linguistic and archaeological findings are also reviewed, and these seem to support application of the term Nilotic Negro to the early Rift populations.

Black or African American↗
PubMed1975

New hominids from East Rudolf, Kenya, I.

Important new hominid fossils from the Plio-Pleistocene sediments of Lake Rudolf, Kenya, are described. They include: a partial, adult cranium with most of the calvaria and some of the facial skeleton preserved; a complete right femur; and bones of a single left lower limb--femur and upper and lower parts of the tibia and a small portion of fibula. Detailed comparative descriptions will be published later.

Animals↗
PubMed1976

The incidence of red-green colourblindness in the populations of Tripolitania, Cyrenaica and Fezzan in Libya, and of the Kikuyu, Kamba, Taita, Taveta and Luo tribes of Kenya.

The results of surveys of colourblindness carried out using the Ishihara test cards in Libya and Kenya, involving 384 and 504 individuals respectively, are reported. The Libyan samples, drawn from three geographically distinct regions of the country, are relatively homogeneous. The Kenyan samples, on the other hand, are heterogeneous, but in toto they display a markedly lower colourblindness percentage than do the Libyans. The Kenyan data are in broad accord with the other data available for sub-Saharan African populations. There are very few sets of comparative data available for North African populations, but the Libyan material displays a lower incidence of colourblindness than the values reported in European populations.

Color Vision Defects↗
PubMed1984

A hominine hip bone, KNM-ER 3228, from East Lake Turkana, Kenya.

A male hominine partial hip bone, KNM -ER 3228, from East Lake Turkana , Kenya is described. In most of its features this specimen resembles modern human male hip bones. This is especially true for functional features related to weight transfer from the trunk to the pelvis and within the pelvis, and to the effective action of musculature arising from the pelvis during the performance of the modern human type of bipedalism . KNM -ER 3228 is very similar to the Olduvai Hominid 28 and the Arago XLIV hip bones, both attributed to Homo erectus .

Acetabulum↗
PubMed1986

Preliminary observations on the BK 8518 mandible from Baringo, Kenya.

A newly discovered adult hominid mandible (BK 8518) from Baringo, Kenya, is described and assessed. The corpus, many of the tooth crowns, and most of the left ascending ramus are preserved. The teeth are heavily and asymmetrically worn. Compared with BK 67 (the 1966 mandible) the body of BK 8518 is more robust; the internal symphyseal buttressing is more pronounced; the M3s have seven cusps and exceed the M2s in size. There are no compelling reasons, however, to attribute the two mandibles to different taxa and, in view of the lack of any comprehensive taxonomic diagnosis for Homo erectus, "erectus-like," and habiline mandibular remains, the new specimen is also best regarded as Homo sp. indet. (aff. erectus).

Fossils↗
PubMed1987

Pliocene hominid partial mandible from Tabarin, Baringo, Kenya.

Sediments in the Tugen Hills, west of Lake Baringo, Kenya, form one of the best fossiliferous successions known in Africa spanning the period from 14 my to less than 4 my. Hominoid fossils have previously been recovered from a number of localities in the region. We describe here a new hominid mandible (KNM-TH 13150) from the site of Tabarin, in the Chemeron Formation. Isotopic determinations on a tuff below the fossiliferous horizon gives dates of 4.96 my and 5.25 my. The associated fauna is consistent with these results and independently suggests a minimum age for the specimen of 4.15 my. Although fragmentary, the preserved morphology of the Tabarin mandible is consistent with the diagnosis of the Pliocene hominid Australopithecus afarensis. It can be distinguished from all other currently recognized hominoid taxa.

Animals↗