Urban Kenyan Research Articles

Validation of the Fatty Liver Index for identifying non-alcoholic fatty liver disease in a Kenyan population.

Fatty Liver Index (FLI) is a simple clinical scoring system estimating non-alcoholic fatty liver disease (NAFLD). It is validated in European-descent and Asian populations, but not in sub-Saharan Africans. The aim of this study is to evaluate the validity of the FLI for predicting NAFLD in a population from Kenya. Participants were recruited from a community-based study conducted in Kenya. NAFLD was diagnosed using hepatic ultrasonography. Clinical, anthropometrical, biochemical and lifestyle data were obtained. The accuracy and cut-off point of the FLI to detect NAFLD were evaluated by area under the receiver operator characteristic curve and the maximum Youden index analysis. A total of 640 participants (94 with NAFLD) were included. Mean age was 37.4 ± 0.4 years and 58.7% were women. Mean body mass index (BMI) was 22.3 ± 0.2 kg/m2 and waist circumference (WC) 79.1 ± 0.4 cm. A total of 15 (2.3%) participants were diagnosed with type 2 diabetes and 65 (10.2%) with obesity (BMI ≥ 30 kg/m2 ). AUROC of FLI for predicting NAFLD was 0.80 (95% CI 0.74-0.85), which was significantly higher compared to individual components gamma-glutamyl transferase and triglycerides (p < 0.05), but not compared to anthropometric parameters BMI (AUROC of 0.83, 95% CI 0.79-0.88) and WC (AUROC of 0.81, 95% CI 0.76-0.87). FLI is a simple valid scoring system to use in rural and urban Kenyan adults. However, this index might not be superior to BMI or WC to predict NAFLD, and those measurements might therefore be more appropriate in limited settings.

Psychometric evaluation of the computerized battery for neuropsychological evaluation of children (BENCI) among school aged children in the context of HIV in an urban Kenyan setting

IntroductionCulturally validated neurocognitive measures for children in Low- and Middle-Income Countries are important in the timely and correct identification of neurocognitive impairments. Such measures can inform development of interventions for children exposed to additional vulnerabilities like HIV infection. The Battery for Neuropsychological Evaluation of Children (BENCI) is an openly available, computerized neuropsychological battery specifically developed to evaluate neurocognitive impairment. This study adapted the BENCI and evaluated its reliability and validity in Kenya.MethodologyThe BENCI was adapted using translation and back-translation from Spanish to English. The psychometric properties were evaluated in a case–control study of 328 children (aged 6 – 14 years) living with HIV and 260 children not living with HIV in Kenya. We assessed reliability, factor structure, and measurement invariance with respect to HIV. Additionally, we examined convergent validity of the BENCI using tests from the Kilifi Toolkit.ResultsInternal consistencies (0.49 < α < 0.97) and test–retest reliabilities (-.34 to .81) were sufficient-to-good for most of the subtests. Convergent validity was supported by significant correlations between the BENCI’s Verbal memory and Kilifi’s Verbal List Learning (r = .41), the BENCI’s Visual memory and Kilifi’s Verbal List Learning (r = .32) and the BENCI’s Planning total time test and Kilifi’s Tower Test (r = -.21) and the BENCI’s Reasoning test and Kilifi’s Raven’s Progressive Matrix (r = .21). The BENCI subtests highlighted meaningful differences between children living with HIV and those not living with HIV. After some minor adaptions, a confirmatory four-factor model consisting of flexibility, fluency, reasoning and working memory fitted well (χ2 = 135.57, DF = 51, N = 604, p < .001, RMSEA = .052, CFI = .944, TLI = .914) and was partially scalar invariant between HIV positive and negative groups.ConclusionThe English version of the BENCI formally translated for use in Kenya can be further adapted and integrated in clinical and research settings as a valid and reliable cognitive test battery.

Near-Complete SARS-CoV-2 Seroprevalence among Rural and Urban Kenyans despite Significant Vaccine Hesitancy and Refusal.

Considering the early inequity in global COVID-19 vaccine distribution, we compared the level of population immunity to SARS-CoV-2 with vaccine uptake and refusal between rural and urban Kenya two years after the pandemic onset. A population-based seroprevalence study was conducted in the city of Nairobi (n = 781) and a rural western county (n = 810) between January and February 2022. The overall SARS-CoV-2 seroprevalence was 90.2% (95% CI, 88.6−91.2%), including 96.7% (95% CI, 95.2−97.9%) among urban and 83.6% (95% CI, 80.6−86.0%) among rural populations. A comparison of immunity profiles showed that >50% of the rural population were strongly immunoreactive compared to <20% of the urban population, suggesting more recent infections or vaccinations in the rural population. More than 45% of the vaccine-eligible (≥18 years old) persons had not taken a single dose of the vaccine (hesitancy), including 47.6% and 46.9% of urban and rural participants, respectively. Vaccine refusal was reported in 19.6% of urban and 15.6% of rural participants, attributed to concern about vaccine safety (>75%), inadequate information (26%), and concern about vaccine effectiveness (9%). Less than 2% of vaccine refusers cited religious or cultural beliefs. These findings indicate that despite vaccine inequity, hesitancy, and refusal, herd immunity had been achieved in Kenya and likely other African countries by early 2022, with natural infections likely contributing to most of this immunity. However, vaccine campaigns should be sustained due to the need for repeat boosters associated with waning of SARS-CoV-2 immunity and emergence of immune-evading virus variants.

Attributes of parenting identities and food practices among parents in Nairobi, Kenya

Dramatic changes in daily life are leading to increased rates of obesity and non-communicable diseases (NCD) in Kenya, including among children. Parenting plays a vital role in helping children establish healthy eating habits to prevent obesity and NCDs. The objective of this study was to describe parenting identity and how attributes of parenting influence food parenting practices in an urban Kenyan context. A qualitative study design was employed with 18 participants recruited using quota sampling to include parents who were born in (n = 8) or migrated to Nairobi in the last five years (n = 10). In-depth qualitative interviews were conducted by an experienced ethnographic interviewer that inquired about parenting identity and food parenting practices. Transcripts were analyzed using thematic coding in a multi-step and emergent process. Parents described their parenting identities as an integration of tradition and personal experiences during their upbringing with the modern realities of daily life. Their own experiences with discipline, modern urban lifestyles, and social pressures were dominant influences on their identities. Parenting identities included four distinct but related attributes: good disciplinarian, trustworthy, protective, and balanced provider and nurturer. Food parenting practices were described as expressions of parenting identity and included the goals: children becoming better eaters; nourishing through food; impart joy; and bonding. The study findings illustrate the influence of modern urban lifestyles on food parenting identities and practices. Understanding emerging identities and practices in rapidly changing low- and middle-income countries (LMIC) contexts is essential for health promoting policies and programs.

Nutritional intake and food sources in an adult urban Kenyan population.

Urbanisation is hastening the transition from traditional food habits to less healthy diets, which are becoming more common among Kenyans. No up-to-date studies on usual dietary intake and the main food sources of adult Kenyans are available. The aim of the present study was to identify the main food sources of nutrients in the diet of urban adult Kenyans and explore potential associations with demographic variables including age, sex, level of education, occupation and body mass index. The study adopted a cross-sectional design. The dietary intake of 486 adult Kenyans from Nairobi was assessed using a validated, culture-sensitive, semi-quantitative food frequency questionnaire. Binary logistic regression models were used to evaluate associations between food sources and demographic variables. Macronutrient intakes as a proportion of total energy intake (TEI) were within international dietary guidelines. Cereals and grain products (34.0%), sugar, syrups, sweets and snacks (9.8%), fruits (9.7%) and meat and eggs (8.8%) were the major contributors to TEI. Cereals and grain products contributed 42.5% to carbohydrates, followed by fruits (12.4%) and sugar, syrups, sweets and snacks (10.6%). The most important sources of protein and total fat were cereals and grain products (23.3% and 19.7%, respectively) and meat and eggs (22.0% and 18.7%, respectively). Sex, age and level of education were associated with the choice of food groups. Although macronutrient intakes were within guidelines, the Kenyan diet was revealed to be high in sugars, salt and fibre, with differences in food sources according to demographic variables. These results can act as an incentive to national authorities to implement nutritional strategies aiming to raise awareness of healthier dietary patterns among Kenyans.

Household Fuel Choice in Urban Kenya: A Multinomial Logit Analysis

Abstract This study applied a logistic regression model to determine the odds ratio of selecting clean versus unclean energy as the main household fuel choice. This study also undertook to establish the coefficients of the factors determining household fuel energy choice. A large microeconomic dataset from KIPPRA’s comprehensive study and analysis on fuel use patterns in Kenya (2010) was employed to carry out the analysis. This study employed a multinomial logit regression model to determine the fuel choices and patterns of cooking fuels in urban Kenyan households. The results showed that in addition to income, there are several socio-demographic factors such as education, gender, and age that were important in determining household fuel choice. To encourage clean fuel use, the authorities should carry out public education campaigns, and ensure the availability of these fuels in all areas to avoid harmful effects of biomass fuels and kerosene, and more modern and efficient appliances should be made available at affordable rates to ensure more efficient use of these forms of clean energy.

Bacteroides Microbial Source Tracking Markers Perform Poorly in Predicting Enterobacteriaceae and Enteric Pathogen Contamination of Cow Milk Products and Milk-Containing Infant Food.

Consumption of microbiologically contaminated food is one of the leading causes of diarrheal diseases. Understanding the source of enteric pathogens in food is important to guide effective interventions. Enterobacteriaceae bacterial assays typically used to assess food safety do not shed light on the source. Source-specific Bacteroides microbial source tracking (MST) markers have been proposed as alternative indicators for water fecal contamination assessment but have not been evaluated as an alternative fecal indicator in animal-derived foods. This study tested various milk products collected from vendors in urban Kenyan communities and infant foods made with the milk (n = 394 pairs) using conventional culture methods and TaqMan qPCR for enteric pathogens and human and bovine-sourced MST markers. Detection profiles of various enteric pathogens and Bacteroides MST markers in milk products differed from that of milk-containing infant foods. MST markers were more frequently detected in infant food prepared by caregivers, indicating recent contamination events were more likely to occur during food preparation at home. However, Bacteroides MST markers had lower sensitivity in detecting enteric pathogens in food than traditional Enterobacteriaceae indicators. Bacteroides MST markers tested in this study were not associated with the detection of culturable Salmonella enterica and Shigella sonnei in milk products or milk-containing infant food. The findings show that while Bacteroides MST markers could provide valuable information about how foods become contaminated, they may not be suitable for predicting the origin of the enteric pathogen contamination sources.

Contribution of Women to Food Production in Urban and Peri-Urban Areas of Kapsabet Town, Kenya.

Women make a significant contribution to household food and nutrition security worldwide. They are reported to produce 60-80 % of food in developing countries and half of the food produced globally. They have also been reported to have a higher workload in ensuring food and nutrition security than men do in developing countries. In Kenya, women play a pivotal role in food production. This study aimed to explore their contribution to food production in an urban Kenyan metropolis, in a high potential agricultural area of Kenya’s Rift Valley Region. A cross-sectional descriptive study design using a quantitative method of data collection was used to collect data from 124 women (representing households) in Kapsabet town metropolis, through a questionnaire that was administered to the women in the 124 households and 14 key informants by way of one-on-one interviews. The households were selected randomly. The data obtained was analyzed using descriptive statistics to establish the nature and level of food production activities by the respondents including the level of economic empowerment. It was established that most of the farming population was aged 40-59 (54%), while those aged 20-39 made up 26% of respondents; farming in the metropolis is not therefore a major attraction for the youth (18-35 years of age). Women-farmers spent approximately 36 hours/week during the planting, weeding and harvest season on farm-related activities compared to 25 hours/week by males. Higher food production and food and nutrition security can be achieved if County and National-level Governments invested in women empowerment for higher agricultural productivity and minimized the challenges they face in food production.

Hepatic steatosis is associated with anthropometry, cardio-metabolic disease risk, sex, age and urbanisation, but not with ethnicity in adult Kenyans.

We aimed to determine the associations of non-alcoholic fatty liver disease (NAFLD) with cardio-metabolic risk factors for diabetes in adult Kenyans. A cross-sectional study was undertaken among rural and urban Kenyans of different ethnic origin. Ultrasonography scanning (USS) methods were used for the assessment of hepatic fat accumulation for NAFLD assessment and abdominal fat distribution, and simple anthropometry measurements were performed. All participants underwent a 2-h oral glucose tolerance test, and biochemical, haemodynamic and lifestyle data were obtained. Multivariate logistic regression analyses were used to assess sex, age, residency and ethnic differences in the association between NAFLD and various metabolic parameters. In total, 743 individuals (59.1% women) with a mean age of 38.0 (range 18-68) years participated in the study. Overall, 118 individuals (15.9%) had NAFLD, of whom 94.1% had mild steatosis. Age >40years was significantly associated with having NAFLD compared with <30years of age with no difference found in NAFLD between ethnic groups (Luo, Kamba, Maasai). All body composition and clinical measurements were associated with NAFLD (p<0.045 for OR). Finding lower odds for NAFLD in men was unexpected, as was the lack of differences in NAFLD among the ethnic groups, while higher odds for NAFLD with increasing age and in urban vs. rural populations was expected. Especially the sex-specific results warrant further studies in black African populations on biology of body composition for having NAFLD, and whether this translates into insulin resistance and higher risk of diabetes and consequently cardiovascular disease in black African women.

How Has COVID-19-Related Income Loss and Household Stress Affected Adolescent Mental Health in Kenya?

PurposeAdolescent mental health has been under-researched, particularly in Africa. COVID-19-related household economic stress and school closures will likely have adverse effects. We investigate the relationship among adolescent mental health, adult income loss, and household dynamics during the pandemic in Kenya. MethodsA cross-sectional mobile phone-based survey was conducted with one adult and adolescent (age 10–19 years) pair from a sample of households identified through previous cohort studies in three urban Kenyan counties (Nairobi, Kilifi, Kisumu). Survey questions covered education, physical and mental health, and COVID-19-related impacts on job loss, food insecurity, and healthcare seeking. Logistic regression models were fit to explore relationships among adult income loss, household dynamics, food insecurity, and adult and adolescent depressive symptoms (defined as PHQ-2 score ≤2). ResultsA total of 2,224 adult–adolescent pairs (Nairobi, n = 814; Kilifi, n = 914; Kisumu, n = 496) completed the survey. Over a third (36%) of adolescents reported depressive symptoms, highest among older (15–19 years) boys. Adult loss of income was associated with skipping meals, depressive symptoms, household tensions/violence, and forgoing healthcare. Adolescents had 2.5 higher odds of depressive symptoms if COVID-19 was causing them to skip meals (odds ratio 2.5, 95% confidence interval 2.0–3.1), if their adult head of household reported depressive symptoms (odds ratio 2.6, 95% confidence interval 2.1–3.2). ConclusionsIncome loss during the pandemic adversely affects food insecurity, household dynamics, healthcare-seeking behavior, and worsening adolescent depressive symptoms. With schools reopening, adolescent mental health should be formally addressed, potentially through cash transfers, school or community-based psychosocial programming.

Fuel Choices in Urban Kenyan Households

In the developing nations of Sub-Saharan Africa, providing households with modern energy services is a critical step towards economic development. A significant proportion of households in Kenya rely on traditional biomass fuels for domestic use. The disadvantages of these fuels are many. Transition to clean fuels such as liquefied petroleum gas or electricity would resolve many of these issues as they do not produce dangerous particulate emissions, and are commercially viable, offering several socio-economic advantages over traditional options. This study applies a multinomial logit model to analyze the fuel choices of cooking fuels in urban Kenyan households. A large microeconomic dataset from Kippra’s Comprehensive study on fuel consumption patterns in Kenya is employed during the analysis. The results show that in addition to income, there are several socio-demographic factors such as education and sex of the head of the household, which is important in determining household fuel choice. To encourage clean fuel use, the authorities should carry out public education campaigns and ensure the availability of these fuels in all areas to avoid harmful effects of biomass fuels and kerosene, more modern and efficient appliances should be made available at affordable rates to ensure more efficient use of these forms of energy. Keywords: Fuel Choices, Households, Urban, Energy economics DOI: 10.7176/JESD/12-14-06 Publication date: July 31 st 2021

Development of a Mobile, Self-Sovereign Identity Approach for Facility Birth Registration in Kenya

Birth registration is a critical element of newborn care. Increasing the coverage of birth registration is an essential part of the strategy to improve newborn survival globally, and is central to achieving greater health, social, and economic equity as defined under the United Nations Sustainable Development Goals. Parts of Eastern and Southern Africa have some of the lowest birth registration rates in the world. Mobile technologies have been used successfully with mothers and health workers in Africa to increase coverage of essential newborn care, including birth registration. However, mounting concerns about data ownership and data protection in the digital age are driving the search for scalable, user-centered, privacy protecting identity solutions. There is increasing interest in understanding if a self-sovereign identity (SSI) approach can help lower the barriers to birth registration by empowering families with a smartphone based process while providing high levels of data privacy and security in populations where birth registration rates are low. The process of birth registration and the barriers experienced by stakeholders are highly contextual. There is currently a gap in the literature with regard to modeling birth registration using SSI technology. This paper describes the development of a smartphone-based prototype system that allows interaction between families and health workers to carry out the initial steps of birth registration and linkage of mothers-baby pairs in an urban Kenyan setting using verifiable credentials, decentralized identifiers, and the emerging standards for their implementation in identity systems. The goal of the project was to develop a high fidelity prototype that could be used to obtain end-user feedback related to the feasibility and acceptability of an SSI approach in a particular Kenyan healthcare context. This paper will focus on how this technology was adapted for the specific context and implications for future research.

Fragments Towards an Impossible (Domestic) Genre of the Human in Kenyan Crime Fiction

Extrajudicial executions and other forms of police violence in Kenya have always been an issue of significant concern in local and international media and human rights organisations. Reflective of this, scholarly interest in crime fiction in Kenya has grown significantly in recent years. However, the gendered implications of criminality – from sex work to errant motherhood to alternative modes of investigation – are still largely overlooked in postcolonial literary fiction and criticism. As part of a larger study on how women writers and characters shape crime fiction in Kenya, this paper critically engages with stories that the criminalised woman knows, tells, forgets, incarnates, discards or hides about the city. It does so by examining the history of urban sex workers in Kenya, the representation of ‘urban women’ in postcolonial Kenyan novels and contemporary mainstream media, and the various (post) colonial laws that criminalise sex work. Through Justina, an elusive character in Yvonne Adhiambo Owuor’s Dust, I consider how (post)colonial legislative frameworks and social life attempt to manage “impossible domesticity” (Saidiya Hartman) inside and against the geo-history of gendered and classed criminality in urban Kenyan spaces. My purpose is to interrogate hegemonic constructions of the citizen – and by extension, of the human – in Kenyan law and public morality &#x0D; Keywords: crime fiction, feminism, sex work, human, homo narrans

A culture-sensitive semi-quantitative FFQ for use among the adult population in Nairobi, Kenya: development, validity and reproducibility.

To develop a semi-quantitative FFQ and to evaluate its validity and reproducibility for the assessment of total dietary intake of Kenyan urban adult population, given its non-existence in Kenya. The current study adopted a cross-sectional design. A culture-sensitive semi-quantitative FFQ was developed and its validity was tested relative to three non-consecutive 24-h recalls (24hR). Reproducibility was tested by the test-retest method, with a 3-week interval. Spearman's correlation coefficients and intra-class correlation coefficients were calculated for several macro- and micronutrients. Cross-classification into quartiles and Bland and Altman plots were analysed. Nairobi county (Dagoreti South and Starehe constituencies). A convenient sample was recruited in three different clusters in Nairobi. A culture-sensitive 123-food-item semi-quantitative FFQ showed higher nutrient intakes compared with the 24hR (total energy median 12543·632 v. 8501·888 kJ, P < 0·001). Energy-adjusted and deattenuated Spearman's correlations for macronutrients ranged between 0·21 (total fat) and 0·47 (protein). The agreement in the same quartile varied from 28 % (protein) to 41 % (carbohydrates). Including adjacent quartiles, the range increased: 76 % (protein and fat) to 81 % (carbohydrates). The extreme disagreement was low. The first FFQ application resulted in higher mean values for all nutrients compared with the second FFQ (total energy median 12459·952 v. 10485·104 kJ, P < 0·001). Energy-adjusted correlations for macronutrients ranged from 0·28 (carbohydrates) to 0·61 (protein). Intra-class correlation coefficients for macronutrients were moderate, between 0·6 and 0·7. The developed semi-quantitative FFQ was shown to be a valid and reproducible tool for ranking urban adult Kenyans according to their dietary intake.

Experiences of Girls and Mentors With an Urban Kenyan Afterschool Support Program

This article explores the experiences of female mentees and their mentors in an afterschool support program in two informal urban settlements in Nairobi, Kenya. We sought the perspectives of mentees and mentors to identify what has changed concerning the education and social lives of the girls because of this education intervention. Data come from a qualitative component of the midterm survey collected in May 2014 using in-depth interviews and focus group discussions. The results show improvements in the English and math courses in which support with homework was given; girls were motivated to stay in school and had a higher aspiration for school. However, challenges remained, as some parents did not provide adequate support to their daughters. Overall, the program highlights the role of other significant players and reinforces the out-of-school mentor support for girls’ success in school.

An ethnopsychology of idioms of distress in urban Kenya.

Idioms of distress have become a central construct of anthropologists who aspire to understand the languages that individuals of certain sociocultural groups use to express suffering, pain, or illness. Yet, such idioms are never removed from global flows of ideas within biomedicine that influence how cultural idioms are conceived, understood, and expressed. This article proposes a preliminary model of ethnopsychology described by urban Kenyans, which incorporates local (traditional) and global (biomedical) idioms of distress that are both distinct and overlapping in symptomology and experience. This ethnopsychology was generated from analyzing 100 life history narrative interviews among patients seeking care in a public hospital in Nairobi, Kenya, which explicitly probed into how people experienced and expressed the Kiswahili idioms huzuni (roughly translated as sadness or grief) and dhiki (stress or agony) and English terms stress and depression. Kufikiria sana, or "thinking too much", emerged organically as a powerful cultural idiom and as a symptom or sign of other forms of psychological distress. We propose a preliminary model of ethnopsychology that: 1) highlights social and political factors in driving people to express and experience idioms of distress; 2) reveals how the English terms "stress" and "depression" have been adopted into Kiswahili discourse and potentially have taken on new meaning; 3) suggests that the role of rumination in how people express distress, with increasing severity, is closely linked to the concept of "thinking too much", and; 4) emphasizes how somatization is central to how people think about psychological suffering.

Attribution style and post-traumatic stress severity in the Central Region of Kenya: Influences of dwelling location

This study investigated the influence of attribution styles as predictors of post-traumatic stress severity (PTSS) by dwelling in Kenya. A non-clinical convenience sample of 354 rural (n = 178) and urban (n = 176) Kenyans from the Central Region of Kenya were participants. They responded to a post-traumatic stress screener, attribution style questionnaire and post-traumatic disorder (PTSD) checklist. A regression analysis showed that the urban dweller (UD) sample was significantly more likely to attribute negative events to internal, specific causes than the rural dweller (RD) sample. Findings suggest social support protections in RD to buffer them from negative self-attributions for PTSS among this Kenyan sample.

Campylobacter, a zoonotic pathogen of global importance: Prevalence and risk factors in the fast-evolving chicken meat system of Nairobi, Kenya.

Campylobacteriosis is a leading foodborne zoonosis worldwide, and is frequently associated with handling and consumption of poultry meat. Various studies indicate that Campylobacter causes a substantial human disease burden in low to middle-income countries, but data regarding the organism’s epidemiology in countries like Kenya are scarce. In sub-Saharan Africa, 3.8 million deaths of children under-5 years of age are reported annually. Of those, 25% are caused by diarrheal diseases, and Campylobacter is one of the most frequently isolated bacteria from diarrheic children. With the growth of urban conglomerates, such as Kenya’s capital, Nairobi, changes in diets, food production systems, and retailing dynamics, it is likely that exposure and susceptibility to this pathogen will change. Therefore, the importance of Campylobacter disease burden in Kenya may increase further. The objectives of this study were: 1) to determine the prevalence of Campylobacter spp. in Nairobi’s small-scale chicken farms and meat retailers, and 2) to identify potential risk factors associated with its presence in those sites. The prevalence data provides the first detailed baseline for this pathogen in the urban Kenyan context. The risk factors provide context-specific insights for disease managers. A cross-sectional study of broiler, indigenous chicken farms, and chicken meat retailers, was conducted in a peri-urban, low to middle-income area (Dagoretti), and a very-low income informal settlement (Kibera) of Nairobi. Chicken faeces were collected using one pair of boot socks per farm, and 3 raw chicken meat samples were purchased per retailer. Samples were cultured for viable Campylobacter spp. using mCCDA, followed by blood agar plates in aerobic/microaerobic conditions for prevalence calculations. A questionnaire-based survey on sanitary, sourcing and selling practices was conducted at each site for risk factor identification using logistic regression analyses. A total of 171 farm premises and 53 retailers were sampled and interviewed. The prevalence results for Campylobacter spp. were between 33 to 44% for broiler and indigenous chicken farms, 60% and 64% for retailers, in Dagoretti and Kibera, respectively. Univariable logistic regression showed an association between Campylobacter spp. presence and the easiness of cleaning the display material used by the retailer. Restricting access to the flock was also associated with the pathogen’s presence. Multivariable logistic regression identified the selling of defrosted meat as a retailer risk factor (OR: 4.69; 95% CI: 1.31–19.97), calling for more investigation of the reported repetitive freezing-thawing processes and cold chain improvement options. At the farm-level, having a pen floor of material not easy to clean was found to increase the risk (OR: 2.31; 95%CI: 1.06–5.37). The relatively high prevalence of Campylobacter spp. across different areas and value chain nodes indicates a clear human exposure risk. The open nature of both small-scale broiler and indigenous chicken production practices with low biosecurity, hygiene and informal transactions, likely plays a role in this. While gradual improvement of farm biosecurity is recommended, risk factors identified suggest that consumer education and enforcement of basic food safety principles at the retailer end of the food continuum represent key targets for risk reduction in informal settings.

When Family Replaced Friendship: Mobile Communication and Network Change in Kenya

Mobile devices have spread throughout the developing world at a rate unparalleled by other communications technologies. Yet surprisingly, little is known about their impact on social networks. This study analyzes three waves of pooled survey data in Nairobi (2002, 2007, 2013). We focus on the size, composition, and location of important personal relationships—that is, “core networks.” Networks of close ties have nearly doubled for urban Kenyans, as network composition shifted toward kin and away from friends. Indeed, friendship decreased from over one‐third to less than a fourth of close ties, while family ties grew from one‐third to nearly half. The geographic distribution of networks has become broader, moving away from local ties and toward national (but not international) relationships. Finally, the pace of change declined as mobile devices became embedded in daily life.

A sharing economy? Unpacking demand and living conditions in the urban housing market in Kenya

Abstract With Africa’s urban transition underway, housing is a formidable challenge. Housing shortfalls and continued slum growth are consistently forecast. But what kinds of housing do current residents occupy? Do owners have better quality housing than tenants? How much do tenants pay and what features do they value? This study builds a demand-side understanding of housing using survey data from over 14,000 households in 15 Kenyan cities. Kenya’s urban housing market is characterized by renting and sharing. Approximately 86 percent of residents are tenants; they outnumber owners in 14 of 15 cities. Sharing is ubiquitous—households share houses, rooms, and/or facilities such as toilets and taps. In contrast to standard notions of an “acceptable” housing unit, only 18 percent of urban Kenyans live in a self-contained unit with a toilet, kitchen, electricity, and private water connection. The market is delivering two under-studied housing categories—compounds and dormitories—explicitly designed for sharing. These house 40 percent of urban households in individual rooms, but require sharing of toilets and water connections. Rents represent a significant share of household income, but indicate low ability to achieve ownership, if viewed as monthly mortgage payments. Hedonic regression analyses reveal the relative value of house features with electricity, kitchens and number of rooms emerging as important drivers of rent. Neighborhood conditions, such as lack of flooding and perceived safety, and neighborhood level infrastructure and services, such as garbage collection and access to transport, also have positive impacts upon rents. Our analysis urges a rethinking of housing policies, including reevaluation of what type of housing is deemed acceptable and affordable for very low income urban residents. It underscores the need to develop more and better-quality rental housing and calls for a reassessment of housing and infrastructure investment programs, as well as more creative approaches for expanding home ownership.