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This cross-sectional study sought to establish the level of knowledge of diabetes among community members in rural and urban areas of Kenya and determine how this impacts on attitudes and practices towards diabetes. A face-to-face interview was performed for selected respondents using a structured questionnaire for data collection. Of 1982 respondents, 1151 (58%) were female and 831 (42%) male and age ranged from 13 to 65 years. There were 539 (27%) with a good knowledge of diabetes; of these 52% had tertiary education; 25% had secondary education, and 14% and 9% had primary and no education, respectively. Only 971(49%) of the respondents had a positive attitude towards diabetes, while 813 (41%) demonstrated good practices towards diabetes. This study indicated that the level of knowledge of diabetes was poor. It also indicated poor attitudes and practices of the community towards diabetes. A comprehensive nationwide diabetes education programme is necessary to improve this situation. [ABSTRACT FROM AUTHOR]

Export earnings from livestock products are important to Kenya's economic development but recent fluctuations in exports warrant investigation of the responsible factors. Cointegration and error-correction representation following the Engle-Granger and Johansen procedures are used to test for long-run equilibrium relationships among exports of meat, milk and butter. Two cointegrating vectors involving milk and butter exports as endogenous variables are identified from the three-commodity system. Tests for exogeneity support the independence of meat exports of the other commodities. Estimates of restricted error-correction models corroborate these findings, leading to acceptance of the hypothesis that milk and butter exports are indeed determined endogenously. Conclusions are that meat exports are not related to milk and butter exports and that exports of milk and butter influence each other just as much as does the foreign exchange rate, the level of the national income and the price differential between export and domestic prices. [ABSTRACT FROM PUBLISHER]

Background: Persons seeking emergency injury care are often from higher-risk and underserved key populations (KPs) and priority populations (PPs) for HIV programming. While facility-based HIV Testing Services (HTS) in Kenya are effective, emergency department (ED) delivery is limited, despite the potential to reach underserved persons., Methods: This quasi-experimental prospective study evaluated implementation of the HIV Enhanced Access Testing in Emergency Departments (HEATED) at Kenyatta National Hospital ED in Nairobi, Kenya. The HEATED program was designed as a multi-component intervention employing setting appropriate strategies for HIV care sensitization and integration, task shifting, resource reorganization, linkage advocacy, skills development and education to promote ED-HTS with a focus on higher-risk persons. KPs included sex workers, gay men, men who have sex with men, transgender persons and persons who inject drugs. PPs included young persons (18-24 years), victims of interpersonal violence, persons with hazardous alcohol use and persons never HIV tested. Data were obtained from systems-level records, enrolled injured patient participants and healthcare providers. Systems and patient-level data were collected during a pre-implementation period (6 March - 16 April 2023) and post-implementation (period 1, 1 May - 26 June 2023). Additional, systems-level data were collected during a second post-implementation (period 2, 27 June - 20 August 2023). HTS data were evaluated as facility-based HIV testing (completed in the ED) and distribution of HIV self-tests independently, and aggregated as ED-HTS. Evaluation analyses were completed across reach, effectiveness, adoption, implementation and maintenance framework domains., Results: All 151 clinical staff were reached through trainings and sensitizations on the HEATED program. Systems-level ED-HTS among all presenting patients increased from 16.7% pre-implementation to 23.0% post-implementation periods 1 and 2 (RR = 1.31, 95% CI: 1.21-1.43; p  < 0.001). Among 605 enrolled patient participants, facilities-based HTS increased from 5.7% pre-implementation to 62.3% post-implementation period 1 (RR = 11.2, 95%CI: 6.9-18.1; p  < 0.001). There were 440 (72.7%) patient participants identified as KPs (5.6%) and/or PPs (65.3%). For enrolled KPs/PPs, facilities-based HTS increased from 4.6% pre-implementation to 72.3% post-implementation period 1 (RR = 13.8, 95%CI: 5.5-28.7, p  < 0.001). Systems and participant level data demonstrated successful adoption and implementation of the HEATED program. Through 16 wk post-implementation a significant increase in ED-HTS delivery was maintained as compared to pre-implementation., Conclusions: The HEATED program increased overall ED-HTS and augmented delivery to KPs/PPs, suggesting that broader implementation could improve HIV services for underserved persons already in contact with health systems.

Background: Interpersonal violence is a significant contributor to global morbidity, and affects young adults, particularly males. In Kenya, injuries, including those from interpersonal violence, are a leading cause of emergency department (ED) visits., Objective: This study aims to evaluate the frequency, demographics, and types of injuries caused by interpersonal and intimate partner violence among patients presenting to the Kenyatta National Hospital (KNH) ED in Nairobi, Kenya., Methods: This was a prospective cross-sectional study among injured adult patients presenting to the KNH ED., Results: Of 665 enrolled patients, 82% identified as male and the median age was 30 years. Among enrollees, 257 (39%) reported ever having experienced physical, sexual, and/or emotional violence. Seventy-one patients reported a history of intimate partner violence; more than half had experienced intimate partner violence within the past 12 months., Conclusions: Research on interpersonal injuries in ED settings is lacking, but data from a single Kenyan ED reveals a significant portion of injured patients with a history of interpersonal and intimate partner violence.

Background: Epidemiological data show substantial variation in the risk of HIV infection between communities within African countries. We hypothesised that focusing appropriate interventions on geographies and key populations at high risk of HIV infection could improve the effect of investments in the HIV response., Methods: With use of Kenya as a case study, we developed a mathematical model that described the spatiotemporal evolution of the HIV epidemic and that incorporated the demographic, behavioural, and programmatic differences across subnational units. Modelled interventions (male circumcision, behaviour change communication, early antiretoviral therapy, and pre-exposure prophylaxis) could be provided to different population groups according to their risk behaviours or their location. For a given national budget, we compared the effect of a uniform intervention strategy, in which the same complement of interventions is provided across the country, with a focused strategy that tailors the set of interventions and amount of resources allocated to the local epidemiological conditions., Findings: A uniformly distributed combination of HIV prevention interventions could reduce the total number of new HIV infections by 40% during a 15-year period. With no additional spending, this effect could be increased by 14% during the 15 years-almost 100,000 extra infections, and result in 33% fewer new HIV infections occurring every year by the end of the period if the focused approach is used to tailor resource allocation to reflect patterns in local epidemiology. The cumulative difference in new infections during the 15-year projection period depends on total budget and costs of interventions, and could be as great as 150,000 (a cumulative difference as great as 22%) under different assumptions about the unit costs of intervention., Interpretation: The focused approach achieves greater effect than the uniform approach despite exactly the same investment. Through prioritisation of the people and locations at greatest risk of infection, and adaption of the interventions to reflect the local epidemiological context, the focused approach could substantially increase the efficiency and effectiveness of investments in HIV prevention., Funding: The Bill & Melinda Gates Foundation and UNAIDS., (Copyright © 2014 Elsevier Ltd. All rights reserved.)