Abstract
A healthcare-use survey was conducted in the Kibera informal settlement in Nairobi, Kenya, in July 2005 to inform subsequent surveillance in the site for infectious diseases. Sets of standardized questionnaires were administered to 1,542 caretakers and heads of households with one or more child(ren) aged less than five years. The average household-size was 5.1 (range 1-15) persons. Most (90%) resided in a single room with monthly rents of US$ 4.50-7.00. Within the previous two weeks, 49% of children (n=1,378) aged less than five years (under-five children) and 18% of persons (n = 1,139) aged > or = 5 years experienced febrile, diarrhoeal or respiratory illnesses. The large majority (> 75%) of illnesses were associated with healthcare-seeking. While licensed clinics were the most-frequently visited settings, kiosks, unlicensed care providers, and traditional healers were also frequently visited. Expense was cited most often (50%) as the reason for not seeking healthcare. Of those who sought healthcare, 34-44% of the first and/or the only visits were made with non-licensed care providers, potentially delaying opportunities for early optimal intervention. The proportions of patients accessing healthcare facilities were higher with diarrhoeal disease and fever (but not for respiratory diseases in under-five children) than those reported from a contemporaneous study conducted in a rural area in Kenya. The findings support community-based rather than facility-based surveillance in this setting to achieve objectives for comprehensive assessment of the burden of disease.
Highlights
During 1950-2008, the proportion of the world’s population living within cities grew from 33% to 50% (1)
Massive urbanization has led to crowded residential communities with poor sanitation, water and air quality
This has resulted in various stresses on health systems with potential implications on disease-incidence rates and rapid spread of recognized and emerging infectious diseases
Summary
During 1950-2008, the proportion of the world’s population living within cities grew from 33% to 50% (1). To identify the emerging pathogens, characterize their epidemiology and the burden of disease, and assist in identifying priorities for the prevention of diseases, the International Emerging Infections Program (IEIP) of the Centers for Disease Control and Prevention (CDC), in collaboration with the Kenya Medical Research Centre (KEMRI), established a surveillance for key infectious disease syndromes and their aetiologies.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
