Western Kenya Highlands Research Articles

Spatio-temporal characterization of malaria prevalence in a peri-urban resource limited setting of Western Kenya Highlands

Background: Malaria is the main killer disease in sub-Sahara Africa. Objective: The study identified malaria prevalence patterns in relation to space and time trends in a peri-urban resource limited setting of Western Kenya highlands aimed at strengthening implementation of malaria control strategies. Method: A longitudinal study was carried out in Mbale town and its environs, Vihiga County, from December 2019 to November 2020. Among patients who presented themselves at Mbale Provincial Rural Training health center for different medical issues, 768 malaria confirmed patients were recruited and signed consent before the study commenced. Data was collected using questionnaire and microscopy which was presented through graphs, frequency, means and analyzed using linear regression. P-value ≤ 0.05 was considered statistically significant. Results: Plasmodium falciparum malaria constituted 98.7%,while P. malariae, P. vivax, and P. ovale constituted 1.3%. Linear regression analysis showed effect of age, gender and location on malaria prevalence as (R2 = 0.7, [F (3,764) = 1.854], p < 0136). Malaria prevalence varied in different months due to changes in amount of rainfall and temperatures received. Conclusion: Spatio-temporal characterization and many mosquito breeding grounds influenced malaria prevalence in the study area. Malaria control strategies should be strengthened in relation to space and time-trend. Keywords: Plasmodium species; space; time trend; malaria prevalence; socio-economic factors; demographic factors.

Effect of socio-economic factors on malaria prevalence in a Peri-urban setting in Vihiga County, Western Kenya Highlands

Effect of socio-economic factors on malaria prevalence in a Peri-urban setting in Vihiga County, Western Kenya Highlands

Vectorial drivers of malaria transmission in Jabi Tehnan district, Amhara Regional State, Ethiopia

Among the factors affecting the effectiveness of malaria control is poor knowledge of the entomologic drivers of the disease. We investigated anopheline populations as part of a baseline study to implement house screening of windows and doors as a supplementary malaria control tool towards elimination in Jabi Tehnan district, Amhara Regional State of Ethiopia. The samples were surveyed monthly using CDC light traps between June 2020 and May 2021. Mosquito trap density (< 3 mosquitoes/trap) was low, however, with a high overall Plasmodium sporozoite rate (9%; indoor = 4.3%, outdoor = 13.1%) comprising P. falciparum (88.9%) and P. vivax (11.1%). Anopheles gambiae s.l., mostly An. arabiensis, comprised > 80% of total anopheline captures and contributed ~ 42% of Plasmodium-infected mosquitoes. On the other hand, morphologically scored Anopheles funestus s.l., constituting about 6% of anopheline collections, accounted for 50% of sporozoite-infected mosquitoes. Most of the infected An. funestus s.l. specimens (86.7%) were grouped with previously unknown or undescribed Anopheles species previously implicated as a cryptic malaria vector in the western Kenyan highlands, confirming its wider geographic distribution in eastern Africa. Other species with Plasmodium infection included An. longipalpis C, An. theileri, An. demillioni, and An. nili. Cumulatively, 77.8% of the infected mosquitoes occurred outdoors. These results suggest efficient malaria parasite transmission despite the low vector densities, which has implications for effective endpoint indicators to monitor malaria control progress. Additionally, the largely outdoor infection and discovery of previously unknown and cryptic vectors suggest an increased risk of residual malaria transmission and, thus, a constraint on effective malaria prevention and control.

A multi-component forager-to-herder sequence at Kapsoo Rockshelter (Chebinyiny) on the Uasin Gishu Plateau, Kenya

ABSTRACT Early archaeological investigations of the Uasin Gishu Plateau of west-central Kenya highlighted its potential importance as a geographic link between the Central Rift, the Lake Victoria Basin and the western Kenyan highlands from the Middle Stone Age to the Pastoral Neolithic and Iron Age periods. Despite this, the region has seen little focused research in recent decades. Here, we report on archaeological research at the site of Kapsoo Rockshelter, Chebinyiny Hill (GmJf1), near Moiben on the northern end of the Uasin Gishu Plateau. We combine data from original fieldwork in 1982 with renewed test excavations at Kapsoo carried out in 2022. Results of lithic, faunal and material analyses combined with radiocarbon dating reflect occupation of the northern plateau from the late Pleistocene to the late Holocene and provide the first radiometric dates for the presence of mobile herders in this region. Quantitative assessment of the rich lithic record at the site identifies significant technological change over time, providing a description of the regional Later Stone Age sequence. Finally, we present hypotheses for the relationship between Kapsoo and the nearby undated sequence at Muringa, as well as how these records fit into broader patterns of economic change across southwestern Kenya.

Self-Reported Symptoms at Last Febrile Illness as a Predictor of Treatment-Seeking in Western Kenya: A Cross-Sectional Study.

Timely treatment-seeking behavior can reduce morbidity and mortality due to infectious diseases. Patterns of treatment-seeking behavior can differ by access to health care, and perceptions of disease severity and symptoms. We evaluated the association between self-reported symptoms at last illness and the level of treatment-seeking behaviors. We analyzed cross-sectional data from 1,037 participants from the lowlands and highlands of Western Kenya from 2015 using logistic regression models. There was considerable heterogeneity in the symptoms and treatment-seeking behaviors reported among individuals who were febrile at their last illness. A greater number of self-reported categories of symptoms tended to be associated with a higher likelihood of treatment-seeking in both sites. Participants were significantly more likely to seek treatment if they reported fever, aches, and digestive symptoms at last illness than just fever and aches or fever alone, but the frequency of treatment-seeking for fever in combination with aches and respiratory symptoms did not follow a consistent pattern. Among those who sought treatment, most used a formal source, but the patterns were inconsistent across sites and by the number of symptoms categories. Understanding the drivers of treatment-seeking behavior after febrile illness is important to control and treat infectious diseases in Kenya.

Development of a Conceptual Framework for Integrated Vector Management in the Heterogeneous Malaria Ecosystem of Western Kenya Highlands

Malaria heterogeneity in the highlands is due to range of factors including seasonal weather changes, climate variability, land-use changes, topography, drug resistance, and malaria control programs. High coverage of long lasting insecticide treated nets is the basis of vector control in epidemic prone western Kenya highlands. Long lasting insecticide treated nets have effectively controlled malaria in the hypo-endemic zones, but not in meso-endemic and hyper-endemic zones where significant residue of transmission remains despite control efforts. Inadequate policy on integrated vector management application for ecologically heterogeneous ecosystems hinders effective malaria control. Advances in ecological and epidemiological studies have improved our understanding on vector distribution determinants and malaria transmission enabling us to effectively integrate indoor residual spraying into the existing long lasting insecticide treated nets programme. Data on malaria vector abundance and parasite prevalence for different malaria ecosystems within western Kenya highlands before and after mass insecticide treated bed-net distribution campaigns was gathered to assess the efficacy of the long lasting insecticide treated nets based control efforts. Field tests were carried out to determine the impact of combined indoor residual spray and long lasting insecticide treated nets on vector indoor resting densities in zones where insecticide treated nets alone had limited efficacy or zero efficacy was observed. Female An. gambiae s.l resting densities of 0.1 mosquitoes/ house/night were associated with a plasmodium falciparum (pf) prevalence rate of 10% or below. This observation enabled the development of a framework for the inclusion of indoor residual spray in integrated vector management with the suggestion that IRS should be applied in malaria eco-epidemiological zones where An. gambiae s.l resting densities exceeds 0.1 females/ house/ night. Similarly, only those houses with a resting density of 0.1 females An. gambiae s.l and above should be targeted during spraying. Such an approach would significantly reduce the cost associated with indoor residual spray and provides a rationale for judicious integration of indoor residual spray within existing long lasting insecticide treated nets control programmes.

Altitude, not potential larval habitat availability, explains pronounced variation in Plasmodium falciparum infection prevalence in the western Kenya highlands

Progress in malaria control has stalled over the recent years. Knowledge on main drivers of transmission explaining small-scale variation in prevalence can inform targeted control measures. We collected finger-prick blood samples from 3061 individuals irrespective of clinical symptoms in 20 clusters in Busia in western Kenya and screened for Plasmodium falciparum parasites using qPCR and microscopy. Clusters spanned an altitude range of 207 meters (1077-1284 m). We mapped potential mosquito larval habitats and determined their number within 250 m of a household and distances to households using ArcMap. Across all clusters, P. falciparum parasites were detected in 49.8% (1524/3061) of individuals by qPCR and 19.5% (596/3061) by microscopy. Across the clusters, prevalence ranged from 26% to 70% by qPCR. Three to 34 larval habitats per cluster and 0-17 habitats within a 250m radius around households were observed. Using a generalized linear mixed effect model (GLMM), a 5% decrease in the odds of getting infected per each 10m increase in altitude was observed, while the number of larval habitats and their proximity to households were not statistically significant predictors for prevalence. Kitchen located indoors, open eaves, a lower level of education of the household head, older age, and being male were significantly associated with higher prevalence. Pronounced variation in prevalence at small scales was observed and needs to be taken into account for malaria surveillance and control. Potential larval habitat frequency had no direct impact on prevalence.

Assessment of knowledge of malaria and its control practices in mining and sugarcane growing regions of Western Kenya highlands.

Despite upscaled control efforts, deaths and hospitalization due to malaria remained high in counties of western Kenya highlands. This study assessed the knowledge of malaria in two rural communities, the control strategies they use, and their capacity to integrate the available control programs. A cross-sectional survey was carried out in two rural villages in November - December 2018. Focus group discussions and a questionnaire survey were carried out in 736 households. Frequencies and proportions were used for descriptive analysis while the Chi-square test was used to determine factors that were associated with knowledge of malaria at p ≤ 0.05. Ninety-seven percent of the respondents had knowledge of malaria and this was associated with the level of education attained (χ2 = 30.108; p > 0.0001). Bed net ownership was at 86% and 92% correctly identified its use. Draining stagnant water (53.9%) was the most cited environmental management practice. There was awareness of the risk factors of malaria transmission in the study sites. The local communities must be mobilized and empowered through EIC for the control practises to bear fruit against malaria transmission. However, more sensitization needs to be done to optimize the use of malaria control practices.

A new approach to detecting patterns of ENSO teleconnections with temperature and rainfall patterns in the Western Kenya Highlands separates seasonal, auto-correlated, and random effects

A new approach to detecting patterns of ENSO teleconnections with temperature and rainfall patterns in the Western Kenya Highlands separates seasonal, auto-correlated, and random effects

Assessment of global reanalysis precipitation for hydrological modelling in data-scarce regions: A case study of Kenya

Study region19 flood prone catchments in Kenya, Eastern Africa Study focusFlooding is a major natural hazard especially in developing countries, and the need for timely, reliable, and actionable hydrological forecasts is paramount. Hydrological modelling is essential to produce forecasts but is a challenging task, especially in poorly gauged catchments, because of the inadequate temporal and spatial coverage of hydro-meteorological observations. Open access global meteorological reanalysis datasets can fill in this gap, however they have significant errors. This study assesses the performance of four reanalysis datasets (ERA5, ERA-Interim, CFSR and JRA55) over Kenya for the period 1981–2016 on daily, monthly, seasonal, and annual timescales. We firstly evaluate the reanalysis datasets by comparing them against observations from the Climate Hazards group Infrared Precipitation with Station. Secondly, we evaluate the ability of these reanalysis datasets to simulate streamflow using GR4J model considering both model performance and parameters sensitivity and identifiability. New hydrological insights for the regionWhile ERA5 is the best performing dataset overall, performance varies by season, and catchment and therefore there are marked differences in the suitability of reanalysis products for forcing hydrological models. Overall, wetland catchments in the western regions and highlands of Kenya obtained relatively better scores compared to those in the semi-arid regions, this can inform future applications of reanalysis products for setting up hydrological models that can be used for flood forecasting, early warning, and early action in data scarce regions, such as Kenya.

Bed net use and malaria treatment-seeking behavior in artisanal gold mining and sugarcane growing areas of Western Kenya highlands

Provision of the bed net in Sub-Saharan Africa has substantially resulted in the decrease in malaria incidences in the region. However, malaria still ravages these regions causing significant deaths. This situation has been attributed to socio-economic inequalities that reduce access to the net, failure to seek treatment, and poor antimalarial drug use. Information about these factors in malaria control in Western Kenya highlands is not clearly documented. This study sought to find out bed net availability and use, treatment-seeking, and antimalarial drug use behavior in two rural communities. The study was a qualitative-quantitative baseline cross-sectional survey carried out in two rural villages in Western Kenya highlands in November – December 2018. Focus group discussion, a semi-structured questionnaire, and in-depth interviews were conducted in 736 households to determine: socio-demographic characteristics; bed net availability and use; action taken when sick with malaria, and antimalarial drug usage. Socio-demographic characteristics and the responses of the participants were expressed as percentages. Dependent and independent variables were cross-tabulated for calculation of OR and association was tested using Pearson Chi-square at 95% CI and a p ≤ 0.05 was considered significant. Ninety-three percent of the respondents had used the net the previous night, females (56.50%) constituted the majority of respondents, going to health facility (84.26%) was the preferred action taken when a person had malaria, Artemether Lumefantrine (90.19%), and a pain killer was the most cited drug, 22.96% of the responders reported to have failed to complete antimalarial dose saying that they had recovered from the malaria bout and 9.80% reported to re-use the remaining part of the dosage. This was the first study in mining and sugarcane growing communities in Western Kenya Highlands that has shown that there was no association between socio-demographic parameters and bed net use, action taken when having malaria, and adherence to drug use. The two rural communities have the bed net and know its use. They have good knowledge of malaria and seek treatment whenever they saw malaria signs. The study also reported that the action the sick person took when they had a malaria bout, the drug they got from the health facility, or failure to complete an AL dosage regimen was not associated with socio-demographic characteristics of the responder. These findings raise the need for further qualitative studies in other settings to accept or deny that there was no association between socio-demographics and action taken when hit with malaria bout, the drug used, and failure to complete drug dosage.

Resistance of Anopheles gambiae sensu lato to Pirimiphos-methyl Insecticide in Kakamega County, Highlands of Western Kenya

Background: Insecticide treated bed nets and Indoor residual spraying remains the principal interventional malaria control strategies. To achieve malaria disease eradication, vector control programmes that monitor insecticide resistance profiles are necessary.&#x0D; Objective: The study evaluated pirimiphos-methyl susceptibility of Anopheles gambiae sensu lato in Kakamega County, western Kenya.&#x0D; Methods: Adult Anopheles gambiae sensu lato mosquitoes were assayed using World Health Organization tube bioassay against 0.25% pirimiphos-methyl. Susceptible and non-susceptible populations were characterized to species-level using Polymerase Chain Reaction. Susceptible and resistant mosquitoes were further subjected to G119S Acetylcholisterase (ace 1R) mutation detection.&#x0D; Results: Anopheles arabiensis was the predominant species in all study population Mumias east (62%), Malava (68%), Ikolomani (77%) and Lurambi (82%). Results showed phenotypic susceptibility to pirimiphos-methyl. Mortality was low in Mumias east (80.6%) and high in Lurambi (89.0%). G119S mutations ranged from 3.0% to 8.9% in Anopheles arabiensis whereas G119S mutations were relatively low ranging from 0.0% to 3.1% in Anopheles gambiae s.s populations. Study populations tested were consistent with Hardy-Weinberg equilibrium (P&gt;0.05).&#x0D; Conclusion: We observed pirimiphos-methyl resistance in Anopheles arabiensis and Anopheles gambiae s.s. study populations. Results showed G119S mutation in resistance population. Resistance monitoring and management are urgently required.&#x0D; Keywords: Anopheles gambiae s.l; G119S mutation; Pirimiphos-methyl; Resistance.

Factors related to long-lasting insecticidal net (LLIN) use during travel in western Kenya: A descriptive analysis

BackgroundOvernight travel predicts increased likelihood of Plasmodium infection and may introduce parasite strains to new areas, but deviations from routine at-home use of long-lasting insecticidal nets (LLINs) during travel are not well studied. MethodsCross-sectional data were taken in 2015 from the western Kenyan highlands and lowlands. Household surveys assessed individual travel activity during the previous month, LLIN use (at home and away), and current Plasmodium infection status. Crude and adjusted logistic regression was used to estimate the odds ratios (OR) of current malaria infection relative to travel within the last month. ResultsHighland residents who had traveled were more likely to have Plasmodium infection at the time of interview than highland residents who had not traveled (adjusted OR = 4.09 [1.60, 10.52]). Alternately, in the lowlands those who traveled overnight were significantly less likely to be infected vs non-travelers (adjusted OR = 0.56 [0.39,0.96]). Rates of LLIN use during travel were lower than reported rates while at home. Despite this, among travelers, LLIN use during travel was not associated with likelihood of Plasmodium infection for either region. ConclusionsTravel had heterogeneous associations with infection status for the lowlands and highlands of western Kenya. Given the higher prevalence of malaria in the lowlands, travel is unlikely to increase likelihood of exposure. Conversely, travel from the lower-prevalence highlands may have taken respondents to higher prevalence areas. LLIN use while traveling differed from at-home habits and may depend on availability of LLINs where the traveler sleeps.

Detection of Plasmodium Sporozoites and Blood-Meal Source in a Population of Anopheles Coustani Senso Lato in Kakamega County, Western Kenya

Background Re-emerging of malaria vectors in the highlands of Western Kenya pose a challenge to malaria eradication efforts . Anopheles coustanis.l is a sub-Saharan mosquito species implicated in transmission of malaria in many parts of Africa as a secondary vector. It is zoo-anthropophilic species that has been assumed to be of negligible importance which may not be the case. This study therefore aimed at getting the malaria vectorial system of the study area, has tried to determine the relative abundance of the vectors and a new outdoor malaria vector. Methods A cross sectional study was carried out in April to June, 2020 in Eluche location, Mumias East sub-County, Kakamega County, Kenya. Pyrethrum spray collections (PSC) and Centers for Disease Control (CDC) and prevention light traps were used for sampling mosquitoes. Mosquitoes were collected both indoors; between 0700h and 1100h using PSC and outdoors between 1800h and 0700h using CDC light traps. All mosquitoes were identified morphologically and female Anopheles’ heads and thorax were analyzed using Polymerase Chain Reaction (PCR) for Plasmodium sporozoite detection and blood-meal source identification. Results A total of 376 female Anopheles mosquitoes were collected composed of: An. coustanis.l, 42.55%; An. funestus, 27.66%; An. maculipulpis, 25.00%; An. arabiensis, 4.26% and An. gambiaes.s, 0.53%. Malaria sporozoites were detected in only An. coustani (1.06%). Conclusion There is a possibility of Anopheles coustani mosquito involvement in malaria transmission in Mumias east, Kakamega County.

A threshold-free approach with age-dependency for estimating malaria seroprevalence

BackgroundIn malaria serology analysis, the standard approach to obtain seroprevalence, i.e the proportion of seropositive individuals in a population, is based on a threshold which is used to classify individuals as seropositive or seronegative. The choice of this threshold is often arbitrary and is based on methods that ignore the age-dependency of the antibody distribution.MethodsUsing cross-sectional antibody data from the Western Kenyan Highlands, this paper introduces a novel approach that has three main advantages over the current threshold-based approach: it avoids the use of thresholds; it accounts for the age dependency of malaria antibodies; and it allows us to propagate the uncertainty from the classification of individuals into seropositive and seronegative when estimating seroprevalence. The reversible catalytic model is used as an example for illustrating how to propagate this uncertainty into the parameter estimates of the model.ResultsThis paper finds that accounting for age-dependency leads to a better fit to the data than the standard approach which uses a single threshold across all ages. Additionally, the paper also finds that the proposed threshold-free approach is more robust against the selection of different age-groups when estimating seroprevalence.ConclusionThe novel threshold-free approach presented in this paper provides a statistically principled and more objective approach to estimating malaria seroprevalence. The introduced statistical framework also provides a means to compare results across studies which may use different age ranges for the estimation of seroprevalence.

Larval flushing alters malaria endemicity patterns in regions with similar habitat abundance

A model of Anopheles gambiae populations dynamics coupled with Plasmodium falciparum transmission dynamics is extended to include mechanisms of larval flushing which are known to occur. Flushing dynamics are modeled using a simulation that incorporates seasonal, autocorrelated, and random components based on 30 years of rainfall data for the Kakamega District of the western Kenya highlands. The model demonstrates that flushing phenomena can account for differences between regions with the same annual larval habitat pattern, changing the World Health Organization endemicity classification from either hyperendemic or holoendemic to hypoendemic disease patterns. Mesoendemic patterns of infection occur at the boundary of the holoendemic to hypoendemic transition. For some levels of flushing the entomological inoculation rate drops to an insignificant amount and disease disappears, while the annual indoor resting density remains well above zero. In these scenarios, the disease is hypoendemic, yet the model shows that outbreaks can occur when disease is introduced at particular time points.

Abundance and Distribution of Malaria Vectors in Various Aquatic Habitats and Land Use Types in Kakamega County, Highlands of Western Kenya.

Management of malaria transmission relies heavily on vector control. Implementation and sustenance of effective control measures require regular monitoring of malaria vector occurrences, species abundance and distribution. The study assessed mosquito larval species composition, distribution and productivity in Kakamega County, western Kenya. A cross-sectional survey of Anopheline larvae was conducted in various aquatic habitats and land use types in Kakamega County, highlands of western Kenya between the month of March and June 2019. One thousand, five hundred and seventy six aquatic habitats were sampled in various land use types. The mean densities of An. gambiae s.l (46.2), An. funestus (5.3), An. coustani (1.7), An. implexus (0.13) and An. squamosus (2.0) were observed in fish ponds, burrow pits, drainage ditches, and tire tracks, respectively. High mean densities of An. gambiae s.l was reported in farmland (20.4) while high mean abundance of An. funestus s.l (8.2) and An. coustani s.l (4.0) were observed in artificial forests. The study revealed that the productivity of anopheles larvae varied across various habitat types and land use types. Therefore, treatment of potential breeding sites should be considered as an additional strategy for malaria vector control in Kakamega County, western Kenya.

Low exposure to Plasmodium falciparum and Acquisition of Antibodies to Circumsporozoite Protein Antigens in Individuals Living in Western Highlands of Kenya with Unstable Malaria Transmission

Background: Malaria continues to be a major public health concern despite the concerted efforts to eliminate it. Antibodies to Plasmodium falciparum (P. falciparum) antigens are involved in prevention of infection and disease with some of the antigens being targeted as lead candidates in vaccine development. However, most of the studies have been done in malaria endemic areas with little information available on exposure and acquisition of protective antibodies in areas of low and unstable malaria transmission. This study sought to determine whether the extent of exposure to P. falciparum affect acquisition of protective antibodies by measuring antibody levels and determine the prevalence of circumsporozoite protein (CSP) and crude schizont extract (SE) in individuals living in an area with low unstable malaria transmission in Western Highlands of Kenya.Methods: Sixty plasma samples from individuals living in an area of low unstable malaria transmission in Western Highlands of Kenya were randomly selected and categorized into three age groups: 18years (n=14). Antibodies levels in plasma were measured by Enzyme Linked Immunosorbent Assay (ELISA) and compared to known positive and negative control plasma samples. Prevalence and levels of antibodies produced against circumsporozoite protein and schizont extract antigens were compared between age groups.Results. The prevalence of antibodies ranged from 0% to 14.29% at arbitrary units (AU)>2 for the two antigens. The antibody prevalence did not significantly increase with age (P>0.05) but correlated with CSP and SE antigens (r=0.5977; P<0.05).Conclusion This study highlights antibody responses to CSP and SE antigens in individuals living in low and unstable malaria transmission. The levels of antibodies were generally low across all age groups and there were no significant differences among age groups. Longitudinal study on more antigens is needed to inform exploration of multi-antigen vaccines and also adopt several control measures including Epidemic Preparedness and Response (EPR).

A geostatistical framework for combining spatially referenced disease prevalence data from multiple diagnostics.

Multiple diagnostic tests are often used due to limited resources or because they provide complementary information on the epidemiology of a disease under investigation. Existing statistical methods to combine prevalence data from multiple diagnostics ignore the potential overdispersion induced by the spatial correlations in the data. To address this issue, we develop a geostatistical framework that allows for joint modelling of data from multiple diagnostics by considering two main classes of inferential problems: (a) to predict prevalence for a gold-standard diagnostic using low-cost and potentially biased alternative tests; (b) to carry out joint prediction of prevalence from multiple tests. We apply the proposed framework to two case studies: mapping Loa loa prevalence in Central and West Africa, using miscroscopy, and a questionnaire-based test called RAPLOA; mapping Plasmodium falciparum malaria prevalence in the highlands of Western Kenya using polymerase chain reaction and a rapid diagnostic test. We also develop a Monte Carlo procedure based on the variogram in order to identify parsimonious geostatistical models that are compatible with the data. Our study highlights (a) the importance of accounting for diagnostic-specific residual spatial variation and (b) the benefits accrued from joint geostatistical modelling so as to deliver more reliable and precise inferences on disease prevalence.

Association Between Seropositivity of Helicobacter pylori Infection and Anaemia Amongst Children Aged 5-15 Years in Western Highlands of Kenya

Anaemia is a global health problem, whose development is influenced by several factors. Helicobacter pylori infection is among the factors associated with anaemia. Long term interruption of malaria transmission in the highland area of Kipsamoite led to an increase of haemoglobin levels in some few individuals. However, there are still reported cases of low Hb levels associated with anaemia. In studies that have been done on the role of H. pylori infections on anaemia, researchers hold varied views on whether or not H. pylori infections play a role in iron deficiency anaemia. This study investigated the association between H. pylori infections and anaemia in children aged 5-15 years in Western highland region of Kenya. The study adopted a case-control design and purposive sampling technique was used in selection of subjects. Haemoglobin levels and H. pylori occurrence were measured and entered into Microsoft excel. These data was summarized into descriptive statistics. Chi-square was used in hypotheses testing. A total of 105 participants were enrolled, 35 were cases and 70 were the controls. The mean haemoglobin level was found to be statistically significantly (p<0.00), haemoglobin of cases was lower (11.05 1.726) than that of controls (13.011.897). The proportion of anaemic children among the cases was 77.1% (27) while the non-anaemic were 22.9% (8). The Chi-square showed positive statistical significant difference (p<0.05) between cases and controls. The study concluded that there was a great association between H. pylori infection and occurrence of anaemia in Western region of Kenya.