Medicine and Health Sciences Commons^™

A Study On The Geophylogeny Of Clinical And Environmental Vibrio Cholerae In Kenya, J. Kiiru, A. Mutreja, A. A. Mohamed, R. W. Kimani, J. Mwituria, R. O. Sanaya, J. Muyodi, Gunturu Revathi, J. Parkhill, N. Thomson, G. Dougan, S. Kariuki

Pathology, East Africa

Cholera remains a significant public health challenge in many sub-Saharan countries including Kenya. We have performed a combination of phylogenetic and phenotypic analysis based on whole genome DNA sequences derived from 40 environmental and 57 clinical V. cholerae from different regions of Kenya isolated between 2005 and 2010. Some environmental and all clinical isolates mapped back onto wave three of the monophyletic seventh pandemic V. cholerae El Tor phylogeny but other environmental isolates were phylogenetically very distinct. Thus, the genomes of the Kenyan V. cholerae O1 El Tor isolates are clonally related to other El Tor V. cholerae isolated elsewhere …

The Contribution Of Emotional Partners To Sexual Risk Taking And Violence Among Female Sex Workers In Mombasa, Kenya: A Cohort Study, Stanley Luchters, Marlise L. Richter, Wilkister Bosire, Gill Nelson, Nzioki Kingola, Xu-Dong Zhang, Marleen Temmerman, Matthew F. Chersich

Population Health, East Africa

Objectives: To assess sexual risk-taking of female sex workers (FSWs) with emotional partners (boyfriends and husbands), compared to regular and casual clients. Experiences of violence and the degree of relationship control that FSWs have with emotional partners are also described.

Design: Cohort study with quarterly follow-up visit over 12-months.

Methods: Four hundred HIV-uninfected FSWs older than 16 years were recruited from their homes and guesthouses in Mombasa, Kenya. A structured questionnaire assessed participant characteristics and study outcomes at each visit, and women received risk-reduction counselling, male and female condoms, and HIV testing.

Results: Four or more …

Awareness, Treatment And Control Of Hypertension In Kenya, Jacob Kariuki, Eileen M. Stuart-Shor, Samuel Kimani, James Muchira, Jessica Demita, Heather Milton, Mercy Kamau, Vincent Mutuma, Darren Golden, Peris Kariuki

Office of Community Partnerships Posters

The emerging epidemic of hypertension (HTN) in sub-Saharan Africa is predicted to worsen. Uncontrolled HTN is associated with CVD, high morbidity and premature mortality; hence early detection, treatment and control of HTN is critical to reduction of the associated sequelae. The study was guided by the Social Ecological Model and principles of Community Based Participatory Research.

Supplementary Trainings On Non-Medical Topics For Community Health Workers In Mutsengo, Kenya, Steven Fox

CwiC-PH

• Assessed needs and looked for solutions that are
• Executed and maintained locally Income-generating
• Provided skills trainings to CHWs on these topics
• Help initiate projects using these skills
• These projects show some modest continuing success

Cost Estimation For Scale-Up Of Voucher Services In Kenya, Shubhra Kumar, Smita Sanghrajka, Benjamin Bellows

Reproductive Health

This document reports on the Government of Kenya’s Output-Based Aid (OBA) vouchers program—an affordable strategy to meet the international and national objectives for improved maternal and reproductive health. To help achieve the global Millennium Development Goals related to maternal and child health, the Kenyan government has launched several initiatives including this Vision 2030 flagship program which harmonizes global and national objectives by improving access and enhancing equity in health service delivery. The report finds that the three maternal health MDG indicators—maternal mortality rate, rate of institutional deliveries, and contraceptive prevalence—can all be improved substantially by scaling up the OBA program. …

Feasibility Of Routine Screening For Intimate Partner Violence In Public Health Care Settings In Kenya, Chi-Chi Undie, Catherine Maternowska, Margaret Mak'anyengo, Ian Askew

Reproductive Health

This Population Council study tested the feasibility of implementing intimate-partner violence (IPV) screening protocols in healthcare settings in Kenya where sexual and gender-based violence service referrals could be executed. Providers drawn from these sites were trained to routinely screen for IPV and to refer IPV-positive clients identified through this process for further care. This study demonstrates that providers, given the training, are willing and able to incorporate IPV screening into their practice—one that they perform in a severely resource-constrained context. Likewise, the findings indicate that incorporating IPV screening questions into client intake forms in a variety of public healthcare settings …

Status Report On The Sexual And Reproductive Health Of Adolescents Living In Urban Slums In Kenya, Donatien Beguy, Joyce Mumah, Salome Wawire, Kanyiva Muindi, Lindsey Gottschalk, Caroline W. Kabiru

Reproductive Health

This report highlights the sexual and reproductive health (SRH) challenges faced by adolescents living in slums in Nairobi, Kenya, as well as the perceptions and strategies that adolescents adopt to deal with each of these challenges. The results point to the fact that there is a range of experiences among adolescents with regard to knowledge, attitudes, and behaviors. Age, education, and marital status were often strongly associated with certain adolescent sexual and reproductive health experiences, highlighting the fact that targeted programs are needed to reach adolescents with SRH services at different stages of need. Consistent and persistent poverty reduction strategies …

Male Sex Workers Who Sell Sex To Men Also Engage In Anal Intercourse With Women: Evidence From Mombasa, Kenya, Priya Mannava, Scott Geibel, Nzioki King’Ola, Marleen Temmerman, Stanley Luchters

Obstetrics and Gynaecology, East Africa

Objective: To investigate self-report of heterosexual anal intercourse among male sex workers who sell sex to men, and to identify the socio-demographic characteristics associated with practice of the behavior.

Design: Two cross-sectional surveys of male sex workers who sell sex to men in Mombasa, Kenya.

Methods: Male sex workers selling sex to men were invited to participate in surveys undertaken in 2006 and 2008. A structured questionnaire administered by trained interviewers was used to collect information on socio-demographic characteristics, sexual behaviors, HIV and STI knowledge, and health service usage. Data were analyzed through descriptive and inferential statistics. …

Experiences Of Kenyan Healthcare Workers Providing Services To Men Who Have Sex With Men: Qualitative Findings From A Sensitivity Training Programme, Elise M. Van Der Elst, Evans Gichuru, Anisa Omar, Jennifer Kanungi, Zoe Duby, Miriam Midoun, Sylvia Shangani, Susan M. Graham, Adrian D. Smith, Eduard J. Sanders, Don Operario

Community & Environmental Health Faculty Publications

Introduction

Men who have sex with men (MSM) in Kenya are at high risk for HIV and may experience prejudiced treatment in health settings due to stigma. An on-line computer-facilitated MSM sensitivity programme was conducted to educate healthcare workers (HCWs) about the health issues and needs of MSM patients.

Methods

Seventy-four HCWs from 49 ART-providing health facilities in the Kenyan Coast were recruited through purposive sampling to undergo a two-day MSM sensitivity training. We conducted eight focus group discussions (FGDs) with programme participants prior to and three months after completing the training programme. Discussions aimed to characterize HCWs’ challenges in …

International Seminar On "Is Access Enough? Understanding And Addressing Unmet Need For Family Planning", Iussp Scientific Panel On Reproductive Health

Reproductive Health

The IUSSP Scientific Panel on Reproductive Health, in collaboration with STEP UP and AFIDEP, held a seminar in Nanyuki, Kenya, in May 2013. The seminar brought together 44 scientists, policymakers, and program managers to present and discuss a range of issues relating to the definition, determinants, and consequences of unmet need for family planning and program interventions designed specifically to reduce unmet need in groups at high risk. Based on discussions and presentations, unmet need (and family planning in general) should be looked at both from a development perspective and from a service-delivery and health-sector perspective. Overall, the seminar papers, …

Chronic Lymphocytic Leukemia In Kenya: An Immunophenotypic And Clinicopathologic Study, E. Mulwa-Babu, D. Paresh, M. Riyat

Pathology, East Africa

Objective: To define cases of chronic lymphocytic leukemia (CLL) by immunophenotypic criteria and describe the associated clinical features in patients diagnosed at Aga Khan University Hospital, Nairobi.

Background: Rising to the growing cancer challenge will require improved diagnostic services. CLL is common in elderly patients. The current international standard in diagnosis incorporates findings of immunophenotyping. Facilities for immunophenotyping have generally been unavailable in Kenya.

Method: A cross-sectional survey was conducted between August 2011 and April 2012. Potential cases were identified based on morphologic criteria. Consecutive samples were obtained and subjected to 3 colour immunophenotyping on a Cytomics FC 500 cytometer. …

Safe And Smart Savings Products For Vulnerable Adolescent Girls In Kenya And Uganda: Evaluation Report, Karen Austrian, Eunice N. Muthengi

Poverty, Gender, and Youth

The decision to engage in the development of girl-friendly savings accounts was made as part of the Population Council’s work with adolescent girls in Kenya. In June 2008 the Council and MicroSave Consulting started the Safe and Smart Savings Products for Vulnerable Adolescent Girls. Based on the market research and prior experience with developing programs for adolescent girls, a product concept for a group-based savings account was developed, in which the group model was used to address the legal constraints of minors not being able to hold individual accounts. In Kenya and Uganda, two financial institutions were identified, and the …

Insights Into Unmet Need In Kenya, Kazuyo Machiyama, John C. Cleland

Reproductive Health

Results from this study demonstrate that most women having unmet need for family planning in Kenya were aware of the two main contraceptive methods and a supply source, but many of the poorest, least educated women and those living in North Eastern Province were disadvantaged in this regard. Targeted expansion of access/information is a priority to meet the need of the disadvantaged populations. Kenya has one of the longest records of successful family planning programs in Africa, but this report has revealed some major defects, in particular excess reliance on two hormonal methods. Major future progress may well depend on …