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The teachers' perceptions on environmental education play a key role on how students learn, retain and apply the knowledge, attitudes and skills in changing their perceptions of their environment. This also enhances their achievement in environmental education. This study was designed to investigate the effects of teachers' perceptions on students' perceptions and achievement in environmental education in Gilgil Sub-county of Nakuru County, Kenya. A causal comparative survey research design was used for this study. Purposive sampling was used to identify the secondary school category and the class level that formed the study sample. The sample size was composed of 150 form three biology students who had been taught the topic ecology in biology and 20 biology teachers. Three instruments namely, Students' Questionnaire (SPEEQ), the Teachers' Questionnaire (TPEEQ) and an achievement test (EAT) were used to collect data. Five experts in biology education validated the instruments developed. Reliability of the instruments was computed using the Cronbach's alpha coefficient and values of 0.93 for SPEEQ, 0.80 for TPEEQ and 0.87 for EAT were obtained. Both inferential and descriptive statistics were used in the analysis of data. The t-test and Pearson's product moment correlation coefficient were used to analyse the data. The data collected were analysed with the help of the statistical package for social science (SPSS). The alpha level for the rejection or acceptance of the hypotheses was at 0.05. The results showed that both teachers and students had a good perception in environmental education (EE). It was found that, there is no statistically significant relationship between biology students' perception of their environment and EE and their achievement in EE. There is no statistically significant gender difference in students' perceptions and achievement in EE. There is no statistically significant relationship between biology teachers' perceptions in EE and the students' achievement in EE. The findings further indicated that teachers have no regular in-service training in EE. It was hoped that the findings of this study would help EE teacher trainers to evaluate the teacher-training curriculum and therefore form a basis for evaluating the present EE teacher-training curriculum.

Introduction: To effectively regulate and reduce antibiotic use, in the livestock sector, a thorough understanding of the flow of veterinary antibiotics will help to identify key nodes in the chain for targeted interventions. The aim of this study was to understand the flow of antibiotics from import to end-user, and identify relevant governance mechanisms. Methods: A mixed methods approach was used to collect data in three Kenyan counties (Nairobi, Kiambu, and Kajiado). Focus group discussions (n = 23), individual interviews (n = 148), and key informant interviews (n = 10) were conducted. Results: The key actors identified include primary wholesalers, secondary wholesalers, retailers, animal health service providers (AHSPs), and farmers. Kenya imports 100% of its veterinary antibiotics: primary wholesalers legally import antibiotics as finished pharmaceutical products (90%) or active pharmaceutical ingredients (10%) after approval by the Veterinary Medicines Directorate. Secondary wholesalers play a major role in the distribution of antibiotics (60% of antibiotics) from importers to farmers, AHSPs, and retailers. Some of the illegal sources of antibiotics include unlicenced/unauthorized middlemen and online platforms that sell directly to retailers, AHSPs, and farmers. Discussion: Despite the presence of various laws and regulations governing the antibiotic value chain, implementation has been a challenge due to financial and human resource constraints. This contributes to over-the-counter sale of antibiotics without prescription, unlicensed businesses selling antibiotics, illegal importation, and presence of poor-quality drugs. There is a need to review the applicability of existing policies and address policy gaps (e.g., product containing antibiotic combinations, and use of human critically important antibiotics) to ensure the prudent sale and use of antibiotics, pharmacovigilance, antimicrobial use surveillance, and developing a business model that aligns with antibiotic stewardship. Additional interventions include awareness raising and capacity building of the different stakeholders along the antibiotic distribution chain to reduce antibiotic mis- and overuse. [ABSTRACT FROM AUTHOR]

Irrigation not only helps to improve food security but also creates numerous water bodies for mosquito production. This study assessed the effect of irrigation on malaria vector bionomics and transmission in a semi-arid site with ongoing malaria vector control program. The effectiveness of CDC light traps in the surveillance of malaria vectors was also evaluated relative to the human landing catches (HLCs) method. Adult mosquitoes were sampled in two study sites representing irrigated and non-irrigated agroecosystems in western Kenya using a variety of trapping methods. The mosquito samples were identified to species and assayed for host blood meal source and Plasmodium spp. sporozoite infection using polymerase chain reaction. Anopheles arabiensis was the dominant malaria vector in the two study sites and occurred in significantly higher densities in irrigated study site compared to the non-irrigated study site. The difference in indoor resting density of An. arabiensis during the dry and wet seasons was not significant. Other species, including An. funestus, An. coustani, and An. pharoensis, were collected. The An. funestus indoor resting density was 0.23 in irrigated study site while almost none of this species was collected in the non-irrigated study site. The human blood index (HBI) for An. arabiensis in the irrigated study site was 3.44% and significantly higher than 0.00% for the non-irrigated study site. In the irrigated study site, the HBI of An. arabiensis was 3.90% and 5.20% indoor and outdoor, respectively. The HBI of An. funestus was 49.43% and significantly higher compared to 3.44% for An. arabiensis in the irrigated study site. The annual entomologic inoculation rate for An. arabiensis in the irrigated study site was 0.41 and 0.30 infective bites/person/year indoor and outdoor, respectively, whereas no transmission was observed in the non-irrigated study site. The CDC light trap performed consistently with HLC in terms of vector density. These findings demonstrate that irrigated agriculture may increase the risk of malaria transmission in irrigated areas compared to the non-irrigated areas and highlight the need to complement the existing malaria vector interventions with novel tools targeting the larvae and both indoor and outdoor biting vector populations. [ABSTRACT FROM AUTHOR]

Background: Malaria in western Kenya is currently characterized by sustained high Plasmodial transmission and infection resurgence, despite positive responses in some areas following intensified malaria control interventions since 2006. This study aimed to evaluate long-term changes in malaria transmission profiles and to assess patterns of asymptomatic malaria infections in school children aged 5–15 years at three sites in western Kenya with heterogeneous malaria transmission and simultaneous malaria control interventions. Methods: The study was conducted from 2018 to 2019 and is based on data taken every third year from 2005 to 2014 during a longitudinal parasitological and mosquito adult surveillance and malaria control programme that was initiated in 2002 in the villages of Kombewa, Iguhu, and Marani. Plasmodium spp. infections were determined using microscopy. Mosquito samples were identified to species and host blood meal source and sporozoite infections were assayed using polymerase chain reaction. Results: Plasmodium falciparum was the only malaria parasite evaluated during this study (2018–2019). Asymptomatic malaria parasite prevalence in school children decreased in all sites from 2005 to 2008. However, since 2011, parasite prevalence has resurged by > 40% in Kombewa and Marani. Malaria vector densities showed similar reductions from 2005 to 2008 in all sites, rose steadily until 2014, and decreased again. Overall, Kombewa had a higher risk of infection compared to Iguhu (χ2 = 552.52, df = 1, P < 0.0001) and Marani (χ2 = 1127.99, df = 1, P < 0.0001). There was a significant difference in probability of non-infection during malaria episodes (log-rank test, χ2 = 617.59, df = 2, P < 0.0001) in the study sites, with Kombewa having the least median time of non-infection during malaria episodes. Gender bias toward males in infection was observed (χ2 = 27.17, df = 1, P < 0.0001). The annual entomological inoculation rates were 5.12, 3.65, and 0.50 infective bites/person/year at Kombewa, Iguhu, and Marani, respectively, during 2018 to 2019. Conclusions: Malaria prevalence in western Kenya remains high and has resurged in some sites despite continuous intervention efforts. Targeting malaria interventions to those with asymptomatic infections who serve as human reservoirs might decrease malaria transmission and prevent resurgences. Longitudinal monitoring enables detection of changes in parasitological and entomological profiles and provides core baseline data for the evaluation of vector interventions and guidance for future planning of malaria control. [ABSTRACT FROM AUTHOR]

Background: Despite the growth in mobile technologies (mHealth) to support Community Health Worker (CHW) supervision, the nature of mHealth-facilitated supervision remains underexplored. One strategy to support supervision at scale could be artificial intelligence (AI) modalities, including machine learning. We developed an open access, machine learning web application (CHWsupervisor) to predictively code instant messages exchanged between CHWs based on supervisory interaction codes. We document the development and validation of the web app and report its predictive accuracy. Methods: CHWsupervisor was developed using 2187 instant messages exchanged between CHWs and their supervisors in Uganda. The app was then validated on 1242 instant messages from a separate digital CHW supervisory network in Kenya. All messages from the training and validation data sets were manually coded by two independent human coders. The predictive performance of CHWsupervisor was determined by comparing the primary supervisory codes assigned by the web app, against those assigned by the human coders and calculating observed percentage agreement and Cohen's kappa coefficients. Results: Human inter-coder reliability for the primary supervisory category of messages across the training and validation datasets was 'substantial' to 'almost perfect', as suggested by observed percentage agreements of 88–95% and Cohen's kappa values of 0.7–0.91. In comparison to the human coders, the predictive accuracy of the CHWsupervisor web app was 'moderate', suggested by observed percentage agreements of 73–78% and Cohen's kappa values of 0.51–0.56. Conclusions: Augmenting human coding is challenging because of the complexity of supervisory exchanges, which often require nuanced interpretation. A realistic understanding of the potential of machine learning approaches should be kept in mind by practitioners, as although they hold promise, supportive supervision still requires a level of human expertise. Scaling-up digital CHW supervision may therefore prove challenging. Trial registration: This was not a clinical trial and was therefore not registered as such. [ABSTRACT FROM AUTHOR]

There has been high interest in religious and spirituality practices among college students due to positive benefits to university life. However, no studies have been conducted examining nursing students' religiosity and use of spiritual coping and its impact on their QOL. This cross-sectional, descriptive study measured the QOL and examined the predictive roles of religiosity and spiritual coping among nursing students from four countries. Nursing students reported high overall QOL and health. Significant differences were revealed on the religiosity and spiritual coping of students in terms of demographic characteristics. Findings show frequent attendance to organized and non-organized religious activities lead to better physical and environmental domains, and using non-organized religious activities frequently lead to improved psychological health. More frequent use of non-religious coping strategies was associated with better physical, psychological, and environmental health, and improved social relationships. [ABSTRACT FROM AUTHOR]

Background: Insecticide resistance has emerged as one of the major challenges facing National Malaria Control Programmes in Africa. A well-coordinated national database on insecticide resistance (IRBase) can facilitate the development of effective strategies for managing insecticide resistance and sustaining the effectiveness of chemical-based vector control measures. The aim of this study was to assemble a database on the current status of insecticide resistance among malaria vectors in Kenya. Methods: Data was obtained from published literature through PubMed, HINARI and Google Scholar searches and unpublished literature from government reports, research institutions reports and malaria control programme reports. Each data source was assigned a unique identification code and entered into Microsoft Excel 2010 datasheets. Base maps on the distribution of insecticide resistance and resistance mechanisms among malaria vectors in Kenya were generated using ArcGIS Desktop 10.1 (ESRI, Redlands, CA, USA). Results: Insecticide resistance status among the major malaria vectors in Kenya was reported in all the four classes of insecticides including pyrethroids, carbamates, organochlorines and organophosphates. Resistance to pyrethroids has been detected in Anopheles gambiae (s.s.), An. arabiensis and An. funestus (s.s.) while resistance to carbamates was limited to An. gambiae (s.s.) and An. arabiensis. Resistance to the organochlorine was reported in An. gambiae (s.s.) and An. funestus (s.s.) while resistance to organophosphates was reported in An. gambiae (s.l.) only. The mechanisms of insecticide resistance among malaria vectors reported include the kdr mutations (L 1014S and L 1014F) and elevated activity in carboxylesterase, glutathione S-transferases (GST) and monooxygenases. The kdr mutations L 1014S and L 1014F were detected in An. gambiae (s.s.) and An. arabiensis populations. Elevated activity of monooxygenases has been detected in both An. arabiensis and An. gambiae (s.s.) populations while the elevated activity of carboxylesterase and GST has been detected only in An. arabiensis populations. Conclusions: The geographical maps show the distribution of insecticide resistance and resistance mechanisms among malaria vectors in Kenya. The database generated will provide a guide to intervention policies and programmes in the fight against malaria. [ABSTRACT FROM AUTHOR]

Background: Rural settings in Sub-Saharan Africa (SSA) consistently report low participation in non-communicable disease (NCD) treatment programs and poor outcomes.Objective: The objective of this study is to assess the impact of the implementation of a patient-centered rural NCD care delivery model called Bridging Income Generation through grouP Integrated Care (BIGPIC).Design: The study prospectively tracked participation and health outcomes for participants in a screening event and compared linkage frequencies to a historical comparison group.Participants: Rural Kenyan participants attending a voluntary NCD screening event were included within the BIGPIC model of care.Interventions: The BIGPIC model utilizes a contextualized care delivery model designed to address the unique barriers faced in rural settings. This model emphasizes the following steps: (1) find patients in the community, (2) link to peer/microfinance groups, (3) integrate education, (4) treat in the community, (5) enhance economic sustainability and (6) generate demand for care through incentives.Main Measures: The primary outcome is the linkage frequency, which measures the percentage of patients who return for care after screening positive for either hypertension and/or diabetes. Secondary measures include retention frequencies defined as the percentage of patients remaining engaged in care throughout the 9-month follow-up period and changes in systolic (SBP) and diastolic blood pressure (DBP) and blood sugar over 12 months.Key Results: Of the 879 individuals who were screened, 14.2 % were confirmed to have hypertension, while only 1.4 % were confirmed to have diabetes. The implementation of a comprehensive microfinance-linked, community-based, group care model resulted in 72.4 % of screen-positive participants returning for subsequent care, of which 70.3 % remained in care through the 12 months of the evaluation period. Patients remaining in care demonstrated a statistically significant mean decline of 21 mmHg in SBP [95 % CI (13.9 to 28.4), P < 0.01] and 5 mmHg drop in DBP [95 % CI (1.4 to 7.6), P < 0.01].Conclusions: The implementation of a contextualized care delivery model built around the unique needs of rural SSA participants led to statistically significant improvements in linkage to care and blood pressure reduction. [ABSTRACT FROM AUTHOR]

Cultural rites can be a panacea when the immense social capital embedded in them is taken stock of as well as they can be a perfidy when all the retrogressive aspects they constitute are taken into consideration. The aim and objective of this article is to generate debate and discourse on panacea and perfidy of cultural rites with particular focus on circumcision. The article used eclectic data sources. Cultural rite of circumcision is a panacea due to an array of factors: it marks entry into adulthood from childhood; it is a mark of cultural social identity in many societies of the world; it constitutes immense social capital and, currently, it serves as a platform for mitigating the effects of HIV/AIDS. Cultural rite of circumcision is also a perfidy due to: its violation of human rights to health; because it undermines boys' and girls' access to school; and because it is usually a leeway to early sexual overtures. The paper recommends to governments to: hold on their responsibilities to safeguard their citizens' rights to health; ensure that male circumcision is surgically safe and done in a hygienic environment; and, alongside NGOs and civil society, educate communities to balance between the human rights pertaining to circumcision and cultural rights. [ABSTRACT FROM AUTHOR]

The influence of processing methods of toasting and solar drying on the in vitro protein digestibility and vitamins content of edible winged termites, green grasshoppers, and brown grasshoppers consumed in Siaya, district of Kenya, was determined using standard methods. Analysis was done on fresh, toasted, toasted dried, and fresh dried insect samples. There was no significant change ( p > 0.05) in protein digestibility in the termite samples, while a significant decrease ( p ≤ 0.05) in the grasshopper samples was observed on toasting and drying. There was a significant reduction ( p ≤ 0.05) in riboflavin content with 4.18 mg/100 g in fresh termites, 2.76 mg/100 g in toasted termites, 2.26 mg/100 g in fresh dried termites, and 1.50 mg/100 g in toasted dried termites on processing. There was also a significant reduction ( p ≤ 0.05) in niacin content in the grasshoppers with 3.61 mg/100 g in fresh green grasshopper, 3.28 mg/100 g in toasted green grasshopper, 3.22 mg/100 g in fresh dried green grasshoppers, and 3.06 mg/100 g in toasted dried green grasshoppers. A significant reduction ( p ≤ 0.05) in retinol content with 2.24 μg/g in fresh termites, 1.56 μg/g in toasted termites, 1.02 μg/g in toasted dried termites, and 0.98 μg/g in fresh dried termites was also reported. The processing methods of the insects affected their nutrient potential as evidenced by the changes in protein digestibility and vitamins content. Therefore, optimal processing methods need to be investigated even as we promote commercialization of these insects. [ABSTRACT FROM AUTHOR]

Background: Studies were conducted between April 2004 and February 2006 to determine the blood-feeding pattern of Anopheles mosquitoes in Mwea Kenya. Methods: Samples were collected indoors by pyrethrum spay catch and outdoors by Centers for Disease Control light traps and processed for blood meal analysis by an Enzyme-linked Immunosorbent Assay. Results: A total of 3,333 blood-fed Anopheles mosquitoes representing four Anopheles species were collected and 2,796 of the samples were assayed, with Anopheles arabiensis comprising 76.2% (n = 2,542) followed in decreasing order by Anopheles coustani 8.9% (n = 297), Anopheles pharoensis 8.2% (n = 272) and Anopheles funestus 6.7% (n = 222). All mosquito species had a high preference for bovine (range 56.3- 71.4%) over human (range 1.1-23.9%) or goat (0.1-2.2%) blood meals. Some individuals from all the four species were found to contain mixed blood meals. The bovine blood index (BBI) for An. arabiensis was significantly higher for populations collected indoors (71.8%), than populations collected outdoors (41.3%), but the human blood index (HBI) did not differ significantly between the two populations. In contrast, BBI for indoor collected An. funestus (51.4%) was significantly lower than for outdoor collected populations (78.0%) and the HBI was significantly higher indoors (28.7%) than outdoors (2.4%). Anthropophily of An. funestus was lowest within the rice scheme, moderate in unplanned rice agro-ecosystem, and highest within the non-irrigated agro-ecosystem. Anthropophily of An. arabiensis was significantly higher in the nonirrigated agro-ecosystem than in the other agro-ecosystems. Conclusion: These findings suggest that rice cultivation has an effect on host choice by Anopheles mosquitoes. The study further indicate that zooprophylaxis may be a potential strategy for malaria control, but there is need to assess how domestic animals may influence arboviruses epidemiology before adapting the strategy. [ABSTRACT FROM AUTHOR]

Background: The survivorship and distribution of Anopheles arabiensis larvae and pupae was examined in a rice agroecosystem in Mwea Irrigation Scheme, central Kenya, from August 2005 to April 2006, prior to implementation of larval control programme. Methods: Horizontal life tables were constructed for immatures in semi-field condition. The time pent in the various immature stages was determined and survival established. Vertical life tables were obtained from five paddies sampled by standard dipping technique. Results: Pre-adult developmental time for An. arabiensis in the trays in the experimental set up in he screen house was 11.85 days from eclosion to emergence. The mean duration of each nstar stage was estimated to be 1.40 days for first instars, 2.90 days for second instars, 1.85 days for third instars, 3.80 days for fourth instars and 1.90 days for pupae. A total of 590 individuals emerged into adults, giving an overall survivorship from L1 to adult mergence of 69.4%. A total of 4,956 An. arabiensis immatures were collected in 1,400 dips throughout the sampling period. Of these, 55.9% were collected during the tillering stage, 42.5% during the transplanting period and 1.6% during the land preparation stage. There was a significant difference in the An. arabiensis larval densities among the five stages. Also there was significant variation in immature stage composition for each day's collection in each paddy. These results indicate that the survival of the immatures was higher in some paddies than others. The mortality rate during the transplanting was 99.9% nd at tillering was 96.6%, while the overall mortality was 98.3%. Conclusion: The survival of An. arabiensis immatures was better during the tillering stage of rice growth. Further the survival of immatures in rice fields is influenced by the rice agronomic activities including addition of nitrogenous fertilizers and pesticides. For effective integrated vector management, the application of larvicides should target An. arabiensis larvae at the tillering stage (early vegetative stage of rice) when their survival in the aquatic habitats is igh to significantly reduce them and the larvicides should be long-lasting to have a significant impact on the malaria vector productivity on the habitats. [ABSTRACT FROM AUTHOR]

Background: Continuous land cover modification is an important part of spatial epidemiology because it can help identify environmental factors and Culex mosquitoes associated with arbovirus transmission and thus guide control intervention. The aim of this study was to determine whether remotely sensed data could be used to identify rice-related Culex quinquefasciatus breeding habitats in three rice-villages within the Mwea Rice Scheme, Kenya. We examined whether a land use land cover (LULC) classification based on two scenes, IKONOS at 4 m and Landsat Thematic Mapper at 30 m could be used to map different land uses and rice planted at different times (cohorts), and to infer which LULC change were correlated to high density Cx. quinquefasciatus aquatic habitats. We performed a maximum likelihood unsupervised classification in Erdas Imagine V8.7® and generated three land cover classifications, rice field, fallow and built environment. Differentially corrected global positioning systems (DGPS) ground coordinates of Cx. quinquefasciatus aquatic habitats were overlaid onto the LULC maps generated in ArcInfo 9.1®. Grid cells were stratified by levels of irrigation (well-irrigated and poorly-irrigated) and varied according to size of the paddy. Results: Total LULC change between 1988-2005 was 42.1 % in Kangichiri, 52.8 % in Kiuria and and 50.6 % Rurumi. The most frequent LULC changes was rice field to fallow and fallow to rice field. The proportion of aquatic habitats positive for Culex larvae in LULC change sites was 77.5% in Kangichiri, 72.9% in Kiuria and 73.7% in Rurumi. Poorly - irrigated grid cells displayed 63.3% of aquatic habitats among all LULC change sites. Conclusion: We demonstrate that optical remote sensing can identify rice cultivation LULC sites associated with high Culex oviposition. We argue that the regions of higher Culex abundance based on oviposition surveillance sites reflect underlying differences in abundance of larval habitats which is where limited control resources could be concentrated to reduce vector larval abundance. [ABSTRACT FROM AUTHOR]

Community health workers (CHWs) are used increasingly in the world to address shortages of health workers and the lack of a pervasive national health system. However, while their role is often described at a policy level, it is not clear how these ideals are instantiated in practice, how best to support this work, or how the work is interpreted by local actors. CHWs are often spoken about or spoken for, but there is little evidence of CHWs' own characterisation of their practice, which raises questions for global health advocates regarding power and participation in CHW programmes. This paper addresses this issue. A case study approach was undertaken in a series of four steps. Firstly, groups of CHWs from two communities met and reported what their daily work consisted of. Secondly, individual CHWs were interviewed so that they could provide fuller, more detailed accounts of their work and experiences; in addition, community health extension workers and community health committee members were interviewed, to provide alternative perspectives. Thirdly, notes and observations were taken in community meetings and monthly meetings. The data were then analysed thematically, creating an account of how CHWs describe their own work, and the tensions and challenges that they face. The thematic analysis of the interview data explored the structure of CHW's work, in terms of the frequency and range of visits, activities undertaken during visits (monitoring, referral, etc.) and the wider context of their work (links to the community and health service, limited training, coordination and mutual support through action and discussion days, etc.), and provided an opportunity for CHWs to explain their motivations, concerns and how they understood their role. The importance of these findings as a contribution to the field is evidenced by the depth and detail of their descriptive power. One important aspect of this is that CHWs' accounts of both successes and challenges involved material elements: leaky tins and dishracks evidenced successful health interventions, whilst bicycles, empty first aid kits and recruiting stretcher bearers evidenced the difficulties of resourcing and geography they are required to overcome. The way that these CHWs described their work was as healthcare generalists, working to serve their community and to integrate it with the official health system. Their work involves referrals, monitoring, reporting and educational interactions. Whilst they face problems with resources and training, their accounts show that they respond to this in creative ways, working within established systems of community power and formal authority to achieve their goals, rather than falling into a 'deficit' position that requires remedial external intervention. Their work is widely appreciated, although some households do resist their interventions, and figures of authority sometimes question their manner and expertise. The material challenges that they face have both practical and community aspects, since coping with scarcity brings community members together. The implication of this is that programmes co-designed with CHWs will be easier to implement because of their relevance to their practices and experiences, whereas those that assume a deficit model or seek to use CHWs as an instrument to implement external priorities are likely to disrupt their work. [ABSTRACT FROM AUTHOR]

Background: Work-related musculoskeletal disorders (WMSDs) are a global public concern for health and social-care systems, as well as individuals. They are the second-most prevalent cause of disability globally. Objectives: The primary objective was to determine the prevalence of WMSDs amongst flower farm workers. The secondary objective was to determine the association between the socio-demographic characteristics and the presence of WMSDs in the previous 12-month period. Method: A cross-sectional descriptive study was conducted. A sample of 270 participants was drawn from 897 farm workers. Quantitative data related to musculoskeletal disorders were collected using the Nordic Musculoskeletal Questionnaire (NMQ). Descriptive statistics were undertaken using frequencies and percentages. Inferential statistics were analysed using a chi-squared test (X2) based on an alpha level of p < 0.05. Results: A total of 184 (68.1%) respondents reported musculoskeletal discomfort. Amongst the 184 respondents, 178 were performing general farm work. Most 103 (38.1%) of the WMSDs were reported in the lower back. There was a strong association between job designation as a general worker (p = 0.016), an older age (p = 0.027) and having worked for a long time as a farm worker (p = 0.041) and WMSDs. Conclusion: Flower farm workers in Kenya were found to be heavily burdened by WMSDs. Furthermore, the job designation, older age, as well as having worked for a long time, predisposes workers to the risk of developing WMSDs. Clinical implications: The high prevalence of WMSDs necessitates policy reform in the flower farm industry. [ABSTRACT FROM AUTHOR]

The increasing demand for cultivated lands driven by human population growth, escalating consumption and activities, combined with the vast area of uncultivated land, highlight the pressing need to better understand the biodiversity conservation implications of land use change in Sub-Saharan Africa. Land use change alters natural wildlife habitats with fundamental consequences for biodiversity. Consequently, species richness and diversity typically decline as land use changes from natural to disturbed. We assess how richness and diversity of avian species, grouped into feeding guilds, responded to land use changes, primarily expansion of settlements and cultivation at three sites in the Lake Victoria Basin in western Kenya, following tsetse control interventions. Each site consisted of a matched pair of spatially adjacent natural/semi-natural and settled/cultivated landscapes. Significant changes occurred in bird species richness and diversity in the disturbed relative to the natural landscape. Disturbed areas had fewer guilds and all guilds in disturbed areas also occurred in natural areas. Guilds had significantly more species in natural than in disturbed areas. The insectivore/granivore and insectivore/wax feeder guilds occurred only in natural areas. Whilst species diversity was far lower, a few species of estrildid finches were more common in the disturbed landscapes and were often observed on the scrubby edges of modified habitats. In contrast, the natural and less disturbed wooded areas had relatively fewer estrildid species and were completely devoid of several other species. In aggregate, land use changes significantly reduced bird species richness and diversity on the disturbed landscapes regardless of their breeding range size or foraging style (migratory or non-migratory) and posed greater risks to non-migratory species. Accordingly, land use planning should integrate conservation principles that preserve salient habitat qualities required by different bird species, such as adequate patch size and habitat connectivity, conserve viable bird populations and restore degraded habitats to alleviate adverse impacts of land use change on avian species richness and diversity., (© 2024. The Author(s).)

Background: Peste des petits ruminants (PPR) is a contagious viral disease of small ruminants. Serum samples from sheep (n = 431) and goats (n = 538) of all ages were collected in a cross-sectional study in Turkana County, Kenya. The objective was to estimate the sero-prevalence of PPR virus (PPRV) infection and associated risk factors in both species. PPRV competitive enzyme-linked immuno-sorbent assay (c-ELISA) analysed the presence of antibodies in the samples. All analyses were conducted for each species separately. Multivariable logistic regression models were fitted to the data to assess the relationship between the risk factors and PPRV sero-positivity. Mixed-effect models using an administrative sub-location as a random effect were also fitted to adjust for possible clustering of PPRV sero-positivity. Intra-cluster correlation coefficients (ρ) that described the degree of similarity among sero-positive responses for each species in each of the six administrative divisions were estimated., Results: Goats had a significantly higher sero-prevalence of 40% [95% confidence interval (CI): 36%, 44%] compared to sheep with 32% [95% CI: 27%, 36%] (P = 0.008). Combined sero-prevalence estimates were heterogeneous across administrative divisions (n = 6) (range 22% to 65%) and even more across sub-locations (n = 46) (range 0% to 78%). Assuming that PPRV antibodies are protective of infection, a large pool of PPRV susceptible middle age group (>6 months and < 24 months) in both species was estimated. This was based on the low sero-prevalence in this group in goats (14% [95% CI: 10%, 20%]) and in sheep (18% [95% CI: 13%, 25%]). Regression analysis returned significant risk factors across species: in sheep - vaccination status, age and administrative division; in goats - sex, age, administrative division and sex*age interaction. The intra-sub-location correlation coefficients varied widely across divisions (range <0.001 to 0.42) and across species within divisions., Conclusions: Biological, spatial and socio-ecological factors are hypothesized as possible explanations for variation in PPRV sero-positivity in the Turkana pastoral ecosystem.

Background: The scaling up of malaria vector control efforts in Africa has resulted in changing the malaria vectorial systems across different ecological settings. In view of the ongoing trends in vector population dynamics, abundance, species composition and parasite infectiousness, there is a need to understand vector distribution and their contribution to malaria transmission to facilitate future planning of control strategies. We studied indoor and outdoor malaria transmission dynamics and vector population variability of Anopheles mosquitoes in Taveta district along the Kenyan Coast., Methods: Anopheles mosquitoes were collected indoors and outdoors in 4 ecologically different villages using CDC light traps (both indoor and outdoor) and aspiration method (day resting indoors; DRI) methods. Mosquitoes were examined for infection with P. falciparum sporozoites and blood feeding preferences using enzyme linked immunosorbent assay (ELISA). The An. gambiae and An. funestus complexes were identified by PCR technique to determine the sibling species composition., Results: A total of 4,004 Anopheles mosquitoes were collected consisting of 34.9%% (n = 1,397) An. gambiae s.1., 28.1% (n = 1,124) An. funestus s.l., 33.5% (n = 1,340) An. coustani and 3.6% (n = 143) An. pharoensis. A total of 14,654 culicine mosquitoes were collected, mainly Cx. quinquefasciatus. Of the total Anopheles collected, 3,729 were tested for P. falciparum sporozoite infection. The sporozoite transmission was found to be occurring both indoors and outdoors. The overall sporozoite infectivity was 0.68% (n = 2,486) indoors and 1.29% (n = 1,243) outdoors. Indoor and outdoor sporozoite infectivity and the vectorial systems varied across the 4 ecological villages. Entomological inoculation rates for the 4 villages indicate that there was site-to-site variation. In the 4 villages, Mwarusa had the highest EIRs with An. arabiensis, An. funestus and An. coustani contributing to 23.91, 11.96 and 23.91 infectious bites per person per year ib/p/year respectively. In Kiwalwa and Njoro outdoor EIR was significantly higher than indoors., Conclusions: This study shows that malaria transmission is occurring both indoors and outdoors. The main vectors are An. arabiensis, An. funestus and An. coustani indoors while An. coustani is playing a major role in outdoor transmission. Effective malaria control programmes, should therefore include tools that target both indoor and outdoor transmission.

Studies were conducted to determine the contribution of diverse larval habitats to adult Anopheles arabiensis Patton and Culex quinquefasciatus Say production in a rice land agro-ecosystem in Mwea, Kenya. Two sizes of cages were placed in different habitat types to investigate the influence of non-mosquito invertebrates on larval mortalities and the contribution of each habitat type to mosquito productivities, respectively. These emergence traps had fine netting material covers to prevent adult mosquitoes from ovipositing in the area covered by the trap and immature mosquitoes from entering the cages. The emergence of Anopheles arabiensis in seeps, tire tracks, temporary pools, and paddies was 10.53%, 17.31%, 12.50%, and 2.14%, respectively, while the corresponding values for Cx. quinquefasciatus were 16.85% in tire tracks, 8.39% in temporary pools, and 5.65% in the paddies from 0.125 m3 cages during the study. Cages measuring 1 m3 were placed in different habitat types which included paddy, swamp, marsh, ditch, pool, and seep to determine larval habitat productivity. An. arabiensis was the predominant anopheline species (98.0%, n = 232), although a few Anopheles coustani Laveran (2.0%, n = 5) emerged from the habitats. The productivity for An. arabiensis larvae was 6.0 mosquitoes per m2 for the temporary pools, 5.5 for paddy, 5.4 for marsh, 2.7 for ditch, and 0.6 for seep. The Cx. quinquefasciatus larval habitat productivity was 47.8 mosquitoes per m2 for paddies, 35.7 for ditches, 11.1 for marshes, 4.2 for seeps, 2.4 for swamps, and 1.0 for temporary pools. Pools, paddy, and marsh habitat types were the most productive larval habitats for An. arabiensis while paddy, ditch, and marsh were the most productive larval habitats for Cx. quinquefasciatus. The most common non-mosquito invertebrate composition in the cages included Dytiscidae, Notonectidae, Belostomatidae, and Ephemerellidae, and their presence negatively affected the number of emergent mosquitoes from the cages. In conclusion, freshly formed habitats are the most productive aquatic habitats, while old and more permanent habitats are the least productive due to natural regulation of mosquito immatures.

Cryptosporidium parasites are leading causes of enteric disease, especially in children. A prospective survey on the prevalence of cryptosporidiosis in children less than five years of age was undertaken at six microbiology laboratories in Kenya on fecal samples submitted for routine parasite and ova investigations. Analysis of 4,899 samples over a two-year study period showed an overall prevalence of cryptosporidiosis of 4% that was highest between November to February. Investigations on the nature of enteric diseases prompting ova and cyst examination requests showed 66.4% had acute diarrhea, 9% had persistent diarrhea, and 21% had recurrent diarrhea. The main symptoms were abdominal pain (51.1%), vomiting (51.6%), and abdominal swelling (11%). The prevalence of cryptosporidiosis was highest among children 13-24 months of age (5.2%) and least among those 48-60 months of age (2%). No significant differences were observed by sex but vomiting was slightly higher in males than in females (65% males and 52% females; P = 0.07). Cryptosporidiosis was significantly associated with persistent diarrhea (P = 0.0001, odds ratio [OR] = 2.193, 95% confidence interval [CI] = 1.463-3.29), vomiting (P = 0.0273, OR = 1.401, 95% CI = 1.04-1.893), and abdominal swelling (P = 0.0311, OR = 1.56, 95% CI = 1.04-2.34). Genotype analysis based on polymerase chain reaction-restriction fragment length polymorphism of the 18S rRNA gene fragment showed that 87% (153 of 175) of the Cryptosporidium isolates were C. hominis, 9% (15 of 175) were C. parvum, and remaining 4% were C. canis, C. felis, C. meleagridis, and C. muris. The most common protozoa in coinfected patients were Entamoeba histolytica/E. dispar, E. coli, and Giardia intestinalis (6%, 5%, and 2%, respectively). Our results show that Cryptosporidium is among the most common protozoan parasites in children with enteric diseases and that anthroponotic species are the leading cause of human cryptosporidiosis in Kenya, which suggests that human-to-human transmission is the main mode of spread.

Sorghum and finger millet grains are traditional staple foods in Kenya. However, they have naturally occurring anti-nutritional factors, such as phytic acid, that decrease their dietary availability. This work determined the effect of fermentation and malting on the phytic acid content of, and mineral availability in five varieties of sorghum and four varieties of finger millet grain grown in Kenya. Phytic acid ranged from 875.1 to 2,211.9 mg/100 g in sorghum. The levels in finger millet ranged from 851.6 to 1,419.4 mg/100 g grain. Fermentation resulted in a mean decrease of phytic acid in of 64.8% after 96 hours and 39.0% after 72 hours in sorghum grain. In finger millet, there was a mean decrease of 72.3% and 54.3% after 96 and 72 hours, respectively. Malting also resulted in a mean decrease of 23.9 and 45.3% after 72 and 96 hours, respectively. The extent of decrease of phytic acid differed among the grain varieties. Fermentation increased the rate of available iron, manganese, and calcium in both sorghum and finger millet. The available minerals were generally higher in finger millet than in sorghum after fermentation. Fermentation was also more effective than malting in reducing phytic acid in sorghum and finger millet. Simple traditional food processing methods can therefore be used to increase mineral availability.