Population In Kenya Research Articles

Mapping the spatial patterns of ethnic segregation and its implications to urban policy in Nairobi city

In modern times, cities around the world have grappled with the challenges of racial and ethnic segregation. In Nairobi city, with its diverse ethnic makeup, there is widening inequalities and emerging patterns of ethnic segregation, where the five main ethnic groups - Kamba, Luo, Kikuyu, Luhyia, and Kisii - experience varying levels of spatial concentration. This study analysed the spatial patterns of ethnic segregation in Nairobi, using geocoded questionnaire data from the 2019 Kenya population and housing census data. We used the Index of Dissimilarity in STATA software and Geo-segregation Analyzer and Anselin’s Local Moran I method in GIS to map ethnic segregation patterns. Our findings uncovered a striking socio-spatial divide based on ethnicity. Anselin Local Moran’s I indicators further pinpointed areas with the highest levels of segregation and spatial clustering of specific ethnic groups. These findings offer crucial insights for urban planners and policymakers. By pinpointing areas experiencing the most severe spatial segregation, our research could inform spatially targeted interventions and resource allocation. This could inform policies that foster inclusivity, reduce spatial inequalities, and build a more equitable and socially cohesive city.

Modeling the Effects of Social Factors on Population Dynamics Using Age-Structured System

The study of demographics is important not only for policy formulation but also for better understanding of human socio-economic characteristics, and assessment of effects of human activities on environmental impact. It is interesting to note that apart from the common population control strategies, industrialization, economic development and improvement of living standards affects population growth parameters. In this paper, an age-structured model was formulated to model population dynamics, and make predictions through simulation using 2019 Kenya population data. The age-structured mathematical model was developed, using partial differential equations on population densities as functions of age and time. The population was structured into 20 clusters each of 5 year interval, and assigned different birth, death rate and transition parameters. Crank-Nicolson numerical scheme was used to simulate the model using the 2019 parameters and population as initial conditions. It was found that; provision of social factors to an efficacy level of δ≥0.75 to a minimum of 70% population leads to a decrease of mortality rate form μ<sub>old</sub>=0.0313 to μ<sub>new</sub>=0.00184 and an increase in birth rate from β<sub>old</sub>=0.02639 to β<sub>new</sub>=0.05104. This collectively leads to an increase in population by 50% from 38,589,011 to 57,956,100 after 35 years. The initial economic dependency ratio of 1:2, was also improved due to changes in technology and improvement of living standards, to a new ratio of 1:1.14. The graphical presentation in form of a pyramid showed a trend of transition from expansive to constrictive population pyramid. This population structure is stable and remains relatively constant as long as the social factors are maintained.

HIV Social-network intervention more effective in older populations in Kenya

US President’s Emergency Plan for HIV/AIDS has been credited with saving 25 million lives in sub-Sahara Africa and, as such, constitutes a preeminent US foreign policy achievement of the twenty-first century. However, the implementation of effective HIV/AIDS pharmacological interventions remains a challenge in rural Kenyan communities. Of particular importance are patient retention and care engagement and their interaction with age disparities that are sensitive to different socioeconomic contexts, as well as time-in-treatment. For the first time, we perform an intermediation and triple interaction intent-to-treat secondary analysis on a social network-based randomized controlled trial. We hypothesize that the temporal interactions of critical demographic features with a treatment/control indicator variable may significantly explain patient retention and that these results are intermediated by social network phenomena. We find that not only does extended time-in-treatment significantly improve primary outcomes, but the threefold interaction along with age and treatment itself is sufficiently flexible to fit the data remarkably well without unnecessary elaboration, an effect that is mediated via internalized stigma. This strongly suggests that patient retention varies by age group. Rather than deploying one-size-fits-all solutions, foreign and public policymakers should invest in research that considers how interventions might be optimized for different ages.Trial registration Clinical Trial Number. NCT02474992 (note: the main trial report was published here https://doi.org/10.1371/journal.pone.0255945.) Date of submission: June 6, 2015.

11.O. Scientific session: Mental Health Among Sexual and Gender Minority Populations in Diverse Structural Stigma Environments

Abstract Research conducted across numerous countries finds that sexual minority (e.g., lesbian, gay, and bisexual [LGB]) and gender minority (e.g., transgender [T]) individuals represent high-risk populations for poor mental health and suicidality. These disparities are believed to be a consequence of a stigmatizing environment and sexual and gender minority individuals’ disproportionate exposure to stigma-based stress compared to cisgender (i.e., non-transgender) heterosexuals. Stigma occurs at multiple levels to compromise LGBT individuals’ health. At the structural level, stigma manifests as unjust laws, policies, and cultural norms that deny, or fail to protect, the equal rights of LGBT individuals. At the interpersonal level, stigma manifests as discrimination in social interactions, social exclusion, and outright victimization. At the individual level, stigma can tax LGBT individuals’ coping resources by requiring costly behavioral strategies such as concealment of one’s LGBT identity. In this workshop, four studies from different regional environment with varying degree of structural stigma will be presented, i.e., the USA, Switzerland, Rwanda, and Kenya. They resent novel findings on the processes and mechanism underlying LGBT populations increased risk of mental health and links between stigma experiences at different levels. Dr. Clark will present a study of how negative news media coverage influence suicidality among LGBT young adults in the USA using intensive longitudinal assessments. Dr. Pfister will present findings from in-depth interviews concerning suicidality with individuals representing a wide variety of sexual and gender minority identities in Switzerland. Dr. van der Star will present a study exploring how structural stigma environments are linked to interpersonal and individuals level stigma experiences in sexual minorities representing different generations of LGBT populations. Dr. Stojanovski will present data from surveys and interviews of LGBT populations in Kenya and Rwanda focusing on experiences of discrimination and mental health. Key messages • Negative media reporting, discrimination, and barriers to health care can influence mental health and suicidality among LGBT individuals. • Identity concealment may represent a mechanism through which sexual minorities navigate structurally stigmatizing climates.

Characterization of Pasture Production Systems in Makueni County of Kenya

Livestock feed is a key factor influencing animal production and productivity as evidenced by the increased demand for animal source foods (ASFs) to feed a growing human population in Kenya. However, there exists untapped potential of pasture commercialization and hence the need to harness the social, economic and environmental benefits in the ASALs for overall rural development. A study was conducted to characterize the existing pasture production systems in Makueni County. A purposive random sampling of 300 respondents drawn from 3 Sub-counties and 12 wards was conducted in Makueni County in January, 2021. The study aimed to characterize existing pasture production systems using a structured questionnaire. Data were analyzed using descriptive and inferential statistics. Multivariate statistical techniques; principal Component Analysis (PCA) and Cluster Analysis (CA) were used to determine whether or not there were significant differences in the pasture production systems in Makueni County. Results of the study showed that majority (97%) of the farmers were small scale farmers (SSFs) who dedicated less than 5 acres of their land to pasture production. The mean age of small- scale farmers was 52 years compared to 55 years for the large-scale farmers (LSFs). Most of the households were male headed (83%). Most of the SSFs household heads had primary level of education level or lower while most of the large-scale household heads had secondary education and above. Majority (35%) of SSFs owned the land under pasture without a title while most of the LSFs had a title. The land under pasture for SSFs was about 2 acres with an average of 102 bales per season while LSFs had about 23 acres under pasture and produced about 1,762 bales per season. Majority (92%) grew local grass varieties and sold their pasture in form of a bale. 58% of SSFs sited NGOs as their main source of grass seeds while LSFs mainly sourced from agrovets Results of PCA revealed that 6 of the 17 components had eigen values greater than 1 and accounted for 58% of the total variance. Based on Euclidian distance, six clusters were determined using the agglomeration schedule. ANOVA analysis of the six profiles were estimated to have p-values of 0.000, suggesting the existence of significance difference between cluster 1 to 6 in relation to the 6 profiles and hence concluding the existence of variations in pasture production systems in Makueni County. Development strategies should focus on knowledge of and improved access to grass seeds to farmers as well as development of standards of the mode of sale of pasture.

Association between coagulation indicators and menorrhagia among women in Kenya.

Despite the significant burden of menorrhagia (bleeding > 80 mL every menstrual cycle) among women in Western Kenya, it remains unknown whether coagulation disorders are an important underlying cause of this condition in the region. This study assessed differences in coagulation profiles, associations between menorrhagia and coagulation profiles and compared morphological features of platelets among women attending Bungoma County Referral Hospital in Kenya. A comparative cross-sectional study of women with and without menorrhagia, aged 18-45 years, was performed between December 2022 and September 2023. Sociodemographic factors, prothrombin time (PT), activated partial thromboplastin time, thrombin time, fibrinogen, international normalised ratio (INR), and platelet count were compared between groups, and associations with menorrhagia were assessed. Prothrombin time and INR levels above normal references were deemed increased. A total of 428 (214 per group) women were included. Family history of bleeding disorders (p < 0.0001) was more frequent in menorrhagic than in non-menorrhagic women. Additionally, menorrhagic women had high PT (p < 0.0001) and high INR (p < 0.0001) levels. Menorrhagia was significantly associated with an increased PT (odds ratio = 2.129, 95% confidence interval = 1.658-2.734; p < 0.0001) and increased INR (odds ratio = 7.479, 95% confidence interval = 3.094-18.080; p < 0.0001). In this population in Western Kenya, menorrhagia was associated with a family history of bleeding disorders, increased PT, and increased INR. Routine assessment of the coagulation profile and family history of bleeding disorders is crucial for diagnosing and managing menorrhagia. Our findings suggest that menorrhagic and non-menorrhagic women differ in terms of PT and INR, which may be predictive of menorrhagia.

Mapping Population Densities and Waste Management Systems in Mombasa County: A Literature Review of GIS and Remote Sensing Techniques

Mombasa County is one of the five counties along the coastline of Kenya. Currently, Mombasa County has a human population of 1.2 million people, and the population is rapidly increasing through rural-urban immigration and natural births. However, the inadequacy of well-established waste management systems on the mainland and coastlines of the County is a threat to the well-being of the local residents. Poorly disposed of wastes both on land and at sea can lead to health problems not only for humans and terrestrial animals but also for aquatic animals such as fish, with the latter being one of the main sources of affordable proteins for poor coastal communities. This paper aimed to conduct a review of the spatial human population density of Mombasa County and the geospatial location of waste dumping sites and their proximity to settled areas. This literature review synthesized existing research on the application of Geographic Information Systems (GIS) and Remote Sensing techniques in mapping population densities and assessing waste management systems. The review began by examining studies that investigate population distribution patterns in urban and rural areas, utilizing GIS to analyze demographic data and satellite imagery. It explored methodologies used to estimate population densities, including dasymetric mapping, spatial interpolation, and land use classification techniques. Key findings were that limited studies have utilized GIS technologies to assess the population in Kenya. GRASP and Random Forest (RF) were the main techniques previously used to assess population densities in the rural Taita Hills area and along the coastal region. The population has exponentially increased in Mombasa County since the 1950s and is projected to increase further. Additionally, waste management in Mombasa County is majorly controlled by the county government. Ten geo-tagged waste collection spots were identified during the review, spread across the residential areas. In conclusion, the county should endeavor to employ GIS techniques to assess the rapid population change within the county and have targeted interventions to address the disparities in waste collection systems against population increase.

Retrospective Seroprevalence of Orthopoxvirus Antibodies among Key Populations, Kenya.

We identified a cluster of mpox exposures among key populations in Kenya through retrospective serologic screening. We identified strong seropositivity among sex workers and gay, bisexual, and other men who have sex with men. These findings demonstrate the need for increased mpox surveillance among mpox-endemic and mpox-endemic-adjacent regions in Africa.

Programmatic mapping and estimating the population size of female sex workers, men who have sex with men, people who inject drugs and transgender populations in Kenya

Introduction Effective coverage of Human Immunodeficiency Virus prevention services for Key Populations (KPs) including female sex workers (FSWs), men who have sex with men (MSM), people who inject drugs (PWID) and transgender (TG) people necessitates periodic validation of physical venues and size estimates. Kenya conducted a robust size estimation of KPs in 2012 and a repeat mapping and size estimation exercise was conducted in 2018 to update KP Size Estimates and sub-typologies within each County for calculation of realistic program indicators. Methods A prospective mixed methods programmatic mapping approach adopted comprised two steps. The first step involved consolidating and documenting all known venues where KPs congregate while the second step included visiting and validating these venues confirming their active status. Data were collected in 34 out of 47 Counties in Kenya between January and March 2018. Data collected included estimated number of KPs (range), venue typology and timing of operation of each venue. Results We estimated a total number of 167,940 (129,271 to 206,609) FSWs; 32,580 (24,704 to 40,455) MSM; 16,063 (12,426 to 19,691) PWIDs and 4,305 (2,826 to 5,783) transgender people congregating at 10,250, 1,729, 401 and 1,218 venues respectively. Majority of the venues for FSW (81%), MSM (64%) and transgender people (67%) were bars with and without lodging, PWIDs were mostly found on streets and injecting dens (70%). Around 9% of FSW and MSM and11% of PWIDs were below the age of 18 years. Conclusion This study provided information on young KPs, female PWIDs, MSWs and for the first time, TG people in Kenya. The exercise updated size estimates of KPs by typology and provided new evidence for resource allocation, planning of interventions and targets. Programmatic mapping continues to be a useful approach supporting programs to achieve high levels of coverage and prioritize resources.

Clinical characteristics, anti-SARS-CoV-2 IgG titers, and inflammatory markers in individuals with post-COVID-19 condition in Kenya: a cross-sectional study.

Post-coronavirus disease 2019 (post-COVID-19) is associated with considerable morbidity and reduced quality of life. However, studies characterizing the post-COVID-19 condition in Kenya are limited. This study aimed to determine the prevalence of post-COVID-19 condition and determine the clinical characteristics, anti-SARS-CoV-2 IgG titers, and concentrations of inflammatory markers of individuals with post-COVID-19 condition in Kenya. This descriptive cross-sectional study was conducted at the Kenyatta University Health Unit, Kenya. Demographic and clinical data were collected using a questionnaire. The serum levels of anti-SARS-CoV-2 antibodies, interleukin 6 (IL-6), and C-reactive protein (CRP) were quantified by enzyme-linked immunosorbent assays. Independent samples t-test was used to compare the anti-SARS-CoV-2 IgG, IL-6, and CRP levels between the participants with and without post-COVID-19 symptoms. The case definition for post-COVID-19 condition was persistence of acute COVID-19 symptoms or emergence of new symptoms 3 months after COVID-19 diagnosis, symptoms lasting for ≥2 months, and absence of any other etiological basis to explain the symptoms. A total of 189 volunteers were recruited in this study (median age: 21 years, range: 18-71 years; male, 49.2%). Forty participants reported having had at least one COVID-19 positive diagnosis in the past, of which 12 (30%) complained of post-COVID-19 symptoms. Significant differences in the number and duration of symptoms were observed between the individuals with and without post-COVID-19 symptoms (t-statistic = 2.87, p = 0.01; t-statistic = 2.39, p = 0.02, respectively). However, no significant differences in serum levels of anti-SARS-CoV-2 IgG, IL-6, and CRP were observed between the two groups (P = 0.08, 0.9, and 0.28, respectively). These findings suggest that post-COVID-19 condition is a health concern even for a relatively young population in Kenya and globally. This condition requires more attention and well-designed studies to better define it and identify clinical chemistry markers that can be used for its diagnosis.

A Wireless Network for Monitoring Pesticides in Groundwater: An Inclusive Approach for a Vulnerable Kenyan Population.

Safe drinking water is essential to a healthy lifestyle and has been recognised as a human right by numerous countries. However, the realisation of this right remains largely aspirational, particularly in impoverished nations that lack adequate resources for water quality testing. Kenya, a Sub-Saharan country, bears the brunt of this challenge. Pesticide imports in Kenya increased by 144% from 2015 to 2018, with sales data indicating that 76% of these pesticides are classified as highly hazardous. This trend continues to rise. Over 70% of Kenya's population resides in rural areas, with 75% of the rural population engaged in agriculture and using pesticides. Agriculture is the country's main economic activity, contributing over 30% of its gross domestic product (GDP). The situation is further exacerbated by the lack of monitoring for pesticide residues in surface water and groundwater, coupled with the absence of piped water infrastructure in rural areas. Consequently, contamination levels are high, as agricultural runoff is a major contaminant of surface water and groundwater. The increased use of pesticides to enhance agricultural productivity exacerbates environmental degradation and harms water ecosystems, adversely affecting public health. This study proposes the development of a wireless sensor system that utilizes radio-frequency identification (RFID), Long-range (LoRa) protocol and a global system for mobile communications (GSM) for monitoring pesticide prevalence in groundwater sources. From the system design, individuals with limited literacy skills, advanced age, or non-expert users can utilize it with ease. The reliability of the LoRa protocol in transmitting data packets is thoroughly investigated to ensure effective communication. The system features a user-friendly interface for straightforward data input and facilitates broader access to information by employing various remote wireless sensing methods.

Cost-effectiveness of group medical visits and microfinance interventions versus usual care to manage hypertension in Kenya: a secondary modelling analysis of data from the Bridging Income Generation with Group Integrated Care (BIGPIC) trial

The Bridging Income Generation with Group Integrated Care (BIGPIC) trial in rural Kenya showed that integrating usual care with group medical visits or microfinance interventions reduced systolic blood pressure and cardiovascular risk in participants. We aimed to estimate the incremental cost-effectiveness of three BIGPIC interventions for a modelled cohort and by sex, as well as the cost of implementing these interventions. For this analysis, we used data collected during the BIGPIC trial, a four-group, cluster-randomised trial conducted in the western Kenyan catchment area of the Academic Model Providing Access to Healthcare. BIGPIC enrolled participants from 24 rural health facilities in rural western Kenya aged 35 years or older with either increased blood pressure or diabetes. Participants were assigned to receive either usual care, group medical visits, microfinance, or a combination of group medical visits and microfinance (GMV-MF). Our model estimated the incremental cost-effectiveness of the three BIGPIC interventions via seven health states (ie, a hypertensive state, five chronic cardiovascular-disease states, and a death state) by simulating transitions between health states for a hypothetical cohort of individuals with hypertension on the basis of QRISK3 scores. In every cycle, participants accrued costs and disability-adjusted life-years (DALYs) associated with their health state. Incremental cost-effectiveness ratios (ICERs) were calculated for the entire modelled cohort and by sex by dividing the incremental cost by the incremental effectiveness of the next most expensive intervention. The main outcome of this analysis was ICERs for each intervention evaluated. This analysis is registered at ClinicalTrials.gov (NCT02501746). Between Feb 6, 2017, and Dec 29, 2019, 2890 people were recruited to the BIGPIC trial. 2020 (69·9%) of 2890 participants were female and 870 (30·1%) were male. At baseline, mean QRISK3 score was 11·5 (95% CI 11·1-11·9) for the trial population, 11·9 (11·5-12·2) for male participants, and 11·3 (11·0-11·6) for female participants. For the population of Kenya, group medical visits were estimated to cost US$7 more per individual than usual care and result in 0·005 more DALYs averted (ICER $1455 per DALY averted). Microfinance was estimated to cost $19 more than group medical visits but was only estimated to avert 0·001 more DALYs. Relative to group medical visits, GMV-MF was estimated to cost $29 more and avert 0·009 more DALYs ($3235 per DALY averted). Relative to usual care, GMV-MF was estimated to cost $37 more and avert 0·014 more DALYs ($2601 per DALY averted). In the first year of the intervention, usual care was estimated to be the least expensive intervention to implement ($87 per participant; $10 238 per health-facility catchment area [HFCA]), then group medical visits ($99 per participant; $12 268 per HFCA), then microfinance ($120 per participant; $14 172 per HFCA), with GMV-MF estimated to be the most expensive intervention to implement ($139 per participant; $16 913 per HFCA). Group medical visits and GMV-MF were estimated to be cost-effective strategies to improve blood-pressure control in rural Kenya. However, which intervention to pursue depends on resource availability. Policy makers should consider these factors, in addition to sex differences in programme effectiveness, when selecting optimal implementation strategies. US National Institutes of Health.

Assessment of Heat Exposure and Health Outcomes in Rural Populations of Western Kenya by Using Wearable Devices: Observational Case Study.

Climate change increasingly impacts health, particularly of rural populations in sub-Saharan Africa due to their limited resources for adaptation. Understanding these impacts remains a challenge, as continuous monitoring of vital signs in such populations is limited. Wearable devices (wearables) present a viable approach to studying these impacts on human health in real time. The aim of this study was to assess the feasibility and effectiveness of consumer-grade wearables in measuring the health impacts of weather exposure on physiological responses (including activity, heart rate, body shell temperature, and sleep) of rural populations in western Kenya and to identify the health impacts associated with the weather exposures. We conducted an observational case study in western Kenya by utilizing wearables over a 3-week period to continuously monitor various health metrics such as step count, sleep patterns, heart rate, and body shell temperature. Additionally, a local weather station provided detailed data on environmental conditions such as rainfall and heat, with measurements taken every 15 minutes. Our cohort comprised 83 participants (42 women and 41 men), with an average age of 33 years. We observed a positive correlation between step count and maximum wet bulb globe temperature (estimate 0.06, SE 0.02; P=.008). Although there was a negative correlation between minimum nighttime temperatures and heat index with sleep duration, these were not statistically significant. No significant correlations were found in other applied models. A cautionary heat index level was recorded on 194 (95.1%) of 204 days. Heavy rainfall (>20 mm/day) occurred on 16 (7.8%) out of 204 days. Despite 10 (21%) out of 47 devices failing, data completeness was high for sleep and step count (mean 82.6%, SD 21.3% and mean 86.1%, SD 18.9%, respectively), but low for heart rate (mean 7%, SD 14%), with adult women showing significantly higher data completeness for heart rate than men (2-sided t test: P=.003; Mann-Whitney U test: P=.001). Body shell temperature data achieved 36.2% (SD 24.5%) completeness. Our study provides a nuanced understanding of the health impacts of weather exposures in rural Kenya. Our study's application of wearables reveals a significant correlation between physical activity levels and high temperature stress, contrasting with other studies suggesting decreased activity in hotter conditions. This discrepancy invites further investigation into the unique socioenvironmental dynamics at play, particularly in sub-Saharan African contexts. Moreover, the nonsignificant trends observed in sleep disruption due to heat expose the need for localized climate change mitigation strategies, considering the vital role of sleep in health. These findings emphasize the need for context-specific research to inform policy and practice in regions susceptible to the adverse health effects of climate change.

Comparative performance of the InBios SCoV-2 DetectTM IgG ELISA and the in-house KWTRP ELISA in detecting SARS-CoV-2 spike IgG antibodies in Kenyan populations

Background The InBios SCoV-2 DetectTM IgG ELISA (InBios) and the in-house KWTRP ELISA (KWTRP) have both been used in the estimation of SARS-CoV-2 seroprevalence in Kenya. Whereas the latter has been validated extensively using local samples, the former has not. Such validation is important for informing the comparability of data across the sites and populations where seroprevalence has been reported. Methods We compared the assays directly using pre-pandemic serum/plasma collected in 2018 from 454 blood donors and 173 malaria cross-sectional survey participants, designated gold standard negatives. As gold standard SARS-CoV-2 positive samples: we assayed serum/plasma from 159 SARS-CoV-2 PCR-positive patients and 166 vaccination-confirmed participants. Results The overall agreement on correctly classified samples was &gt;0.87 for both assays. The overall specificity was 0.89 (95% CI, 0.87–0.91) for InBios and 0.99 (95% CI, 0.97–0.99) for KWTRP among the gold standard negative samples while the overall sensitivity was 0.97 (95% CI, 0.94–0.98) and 0.93 (95% CI, 0.90– 0.95) for InBios and KWTRP ELISAs respectively, among the gold standard positive samples. Conclusions Overall, both assays showed sufficient sensitivity and specificity to estimate SARS-CoV-2 antibodies in different populations in Kenya.

The influence of geology on the quality of groundwater for domestic use: a Kenyan review.

Kenya's population, akin to other Sub-Saharan countries, is rapidly growing. With the increasing unreliability of surface water, groundwater resources are becoming highly relied on for domestic and industrial use. Despite several known contaminants reported in different parts of the country, no study has attempted to correlate groundwater quality in the different geological provinces. This review critically synthesizes the influence of Kenya's diverse geology on groundwater quality for human consumption. This was achieved through a review of published journal articles and other research material through research and government databases. Groundwater was categorised based on the major geological provinces including the Archaean volcanic Nyanzian Craton, the Proterozoic metamorphic Mozambique Mobile Belt (MMB) and volcanic Kisii Group, the Palaeozoic and Mesozoic sediments, and Tertiary volcanic Rift Valley. Groundwater quality in these regions showed a characteristic high concentration of fluoride (F-) in volcanic aquifers of the Rift Valley and Nyazian Craton and metamorphic aquifers of the MMB, where mineral dissolution was the main process of F- release. High salinity was common in metamorphic aquifers in the MMB and the Palaeozoic and Mesozoic sedimentary aquifers where mineral dissolution and seawater intrusion were the common contributors to salinity. Other contaminants such as lead and iron were reported in localised areas in the sedimentary and metamorphic aquifers, respectively. Anthropogenic contaminants such as Escherichia coli (E.coli), NO3 -, and NO2 - were common in shallow groundwater resources in most informal settlements in urban areas. Due to the presence of health implications, of the highlighted contaminants, such as fluorosis, high blood pressure and diarrhoea (due to high F- and salinity) in affected regions, this review highlights the need for an active water resource management program in any country relying on groundwater resources to determine the presence of all region-specific potentially harmful chemical elements and mitigation measures in all its water resources.

Determining the optimal diagnostic and risk stratification approaches for people with hypertension in two rural populations in Kenya and The Gambia: a study protocol for IHCoR-Africa Work Package 2.

Sub-Saharan Africa (SSA) has one of the highest prevalences of hypertension worldwide. The impact of hypertension is of particular concern in rural SSA, where access to clinics and hospitals is limited. Improvements in the management of people with hypertension in rural SSA could be achieved by sharing diagnosis and care tasks between the clinic and the community. To develop such a community-centred programme we need optimal approaches to identify and risk stratify patients with elevated blood pressure. The aim of the study is to improve the evidence base for diagnosis and risk estimation for a community-centred hypertension programme in two rural settings in SSA. We will conduct a cross-sectional study of 1250 adult participants in Kilifi, Kenya and Kiang West, The Gambia. The study has five objectives which will determine the: (1) accuracy of three blood pressure (BP) measurement methods performed by community health workers in identifying people with hypertension in rural SSA, compared to the reference standard method; (2) relationship between systolic BP and cardiovascular risk factors; (3) prevalence of hypertension-mediated organ damage (HMOD); (4) accuracy of innovative point-of-care (POC) technologies to identify patients with HMOD; and (5) cost-effectiveness of different combinations of BP and HMOD measurements for directing hypertension treatment initiation. This study will determine the accuracy of three methods for community BP measurement and POC technologies for HMOD assessment. Using the optimal methods in this setting it will estimate the prevalence of hypertension and provide the best estimate to date of HMOD prevalence in SSA populations. The cost-effectiveness of decision-making approaches for initiating treatment of hypertension will be modelled. These results will inform the development of a community-centred programme to improve care for hypertensive patients living in rural SSA. Existing community engagement networks will be used to disseminated within the research setting.

Translation, cultural adaptation and validation of the Swahili Pain Catastrophizing Scale among refugees who survived torture and/or war trauma in Kenya: An observational study.

Accurate assessment of any patient relies on the use of appropriate measurements which are culturally- and linguistically-applicable and valid. The following study aimed to translate, cross-culturally adapt and test the nomological validity, structural validity, internal consistency, test-retest reliability, sensitivity-to-change and feasibility of the Swahili version of the Pain Catastrophizing Scale (Swa-PCS) among refugees who survived torture/war trauma living with chronic pain in Kenya. An observational study was conducted. Translation and cultural adaptation of the original PCS for the Swahili-speaking refugee population in Kenya, who survived torture or war trauma was undertaken. Following this process, a validation study was conducted on the newly-adapted instrument, to ascertain the psychometric properties (nomological validity, structural validity, internal consistency, test-retest reliability, sensitivity-to change, and ceiling and floor effects). Fifty participants were included in this study. Correlations between pain catastrophization and fear-avoidance behavior measures were significant (r = 0.538, p < 0.01). Ceiling effects were 42-48% with no floor effects. Standard errors of measurement values were between 0.938 and 3.38. Minimal-detectable-change values were between 2.17 and 7.82. Internal consistency was satisfactory to good, for the whole and subsections respectively (range α = 0.693-0.845). Magnification had the lowest α. Test-retest reliability was also satisfactory to good (range ICC = 0.672-0.878). Confirmatory factor analysis confirmed that the Swa-PCS had three factors which explained the majority of the variance. Root mean square error of approximation and comparative fit index were calculated for goodness-of-fit assessment, and were 0.18 and 0.83, respectively. This study showed that the adapted Swa-PCS displayed overall satisfactory to good internal consistency, test-retest reliability and sensitivity-to-change. Furthermore, the Swa-PCS scores were related to fear-avoidance behavior scores as expected (nomological validity). Structural validation of the Swa-PCS requires further investigation. Further testing of the psychometric properties of the Swa-PCS is however warranted.

Strategic Management Practices on Poverty Alleviation Among Farmers in Kakamega County, Kenya

Improving the standard of living in underdeveloped regions is a pressing issue in the modern era of globalization. More than 80% of Kenyans get their living from farming or other non- urban sources in rural areas. More than half of Kenya's population is impoverished, meaning they cannot afford to meet their most basic demands. There have been various strategic management practices that have been employed to alleviate poverty in Mumias East Sub County, Kakamega County. As a result, this study examined the effects of strategic management methods on the reduction of poverty among small-scale farmers in Mumias East Sub County, Kenya. The study's findings on how to reduce poverty was useful to policymakers at both the county and federal levels. The study was based on, resource mobilization theory, knowledge-based theory, technology acceptance model 3, and random utility theory. This study, which aimed to adopt a descriptive study design, recruited 105 participants from among the 221 upper and middle managers in Mumias East Sub County, Kakamega County Government. In order to combine primary and secondary sources, surveys were deployed. The validity and reliability of the research tools are established by pilot testing. The questionnaire's construct and content validity were ensured through careful design and testing to ensure that it accurately captures the intended data. Using a Cronbach alpha cutoff of 0.7 was ensured reliability. Tables and graphs were used to display the data. In order to comprehend the structures and dynamics of the data, descriptive and inferential statistics were calculated using the Statistical Package for the Social Sciences. Labeling different groups and themes were used in a thematic analysis of qualitative data. The inferential statistics included Pearson's correlation, ANOVA, and multiple regression analysis. The goal of the research was to identify the connections between poverty relief efforts and resource mobilization, technological innovation, and strategic education. The activity was conducted in an ethical manner. The modern technology variable was found to have a positive significant influence on poverty alleviation effort amongst small-scale farmers in Mumias East Sub County, Kakamega County. The study concludes that mobilizing resources for poverty alleviation can lead to increased access to basic necessities such as food, clean water, and healthcare. This can improve the overall well-being and quality of life for individuals living in poverty. The study recommends that the County should invest in education and skills development, individuals can gain the necessary knowledge and tools to secure better job opportunities and increase their earning potential.

Potential health and economic impact of achieving Kenya’s overweight and obesity reduction target: a modelling study

IntroductionKenya has adopted the WHO target of halting the rise of overweight, including obesity, by 2025. This paper assesses the potential impact of achieving the set target on health, healthcare...

Management practices in facilities providing HIV services to key populations in Kenya and Malawi: A descriptive analysis of management in community-based organizations.

HIV services for key populations (KP) at higher risk of HIV infection are often delivered by community-based organizations. To achieve HIV epidemic control, countries need to scale up HIV services for KP. Little is known about the management practices of community-based organizations delivering health services. We explored the management practices and facility characteristics of community-based health facilities providing HIV services to key populations as part of the LINKAGES program in Kenya and Malawi. We collected information on management practices from 45 facilities called drop-in centers (DICs) during US Government FY 2019, adapting the World Management Survey to the HIV community-based health service delivery context. We constructed management domain scores for each facility. We then analyzed the statistical correlations between management domains (performance monitoring, people management, financial management, and community engagement) and facility characteristics (e.g., number of staff, organization maturity, service scale) using ordinary least square models. The lowest mean management domain scores were found for people management in Kenya (38.3) and financial management in Malawi (25.7). The highest mean scores in both countries were for performance monitoring (80.9 in Kenya and 82.2 in Malawi). Within each management domain, there was significant variation across DICs, with the widest ranges in scores (0 to 100) observed for financial management and community involvement. The DIC characteristics we considered explained only a small proportion of the variation in management domain scores across DICs. Community-based health facilities providing HIV services to KP can achieve high levels of management in a context where they receive adequate levels of above-facility support and oversight-even if they deliver complex services, rely heavily on temporary workers and community volunteers, and face significant financial constraints. The variation in scores suggests that some facilities may require more above-facility support and oversight than others.