Women's empowerment and intra-household gender dynamics and practices around sheep and goat production in South East Kenya.

Small ruminant production facets like decision-making, ownership, labour allocation, access to- and control over assets are gendered. This study investigates intra-household gender dynamics and practices around sheep and goat production among smallholder farmers in South East region of Kenya. A quantitative study was conducted on 358 dual-headed (married) households to generate gender-disaggregated data on ownership, decision-making and labour allocation around small ruminant production. Qualitative data was collected through focused group discussions to bring out the community perspectives. From the findings, the average number of small ruminants owned by the households as reported by men was slightly higher than women. The average number of small ruminants solely owned by men was significantly higher than by women. Men reported a relatively higher number of jointly owned small ruminants compared to women. More women than men reported that they could give as a gift, sell-off and slaughter jointly owned small ruminants without consulting their spouses. Small ruminants were considered the most important livestock asset in supporting a household's livelihood by relatively more women than men. Men had more decision-making autonomy over jointly owned small ruminants compared to women. Production tasks around small ruminants such as feeding, watering, selling milk and cleaning housing structures were mostly performed by the women. Qualitative data identified men as the de facto owners of small ruminants with a higher power position in making the important production decisions. The study offers three implications on the design of livestock interventions to empower women, the interventions should ensure that; 1) women are not just owners of livestock assets but also share power and decision-making rights in all aspects of production, 2) production labour is shared equitably between men and women and, 3) women access benefits from livestock production even when animals are owned by men.

Factors predisposing women and children to indoor air pollution in rural villages, Western Kenya.

BACKGROUND: Indoor air pollution (IAP) remains a major global public health hazard more so in developing countries where use of fossil fuels is still very common. However, despite the popularity of kerosene and fuelwood as energy sources among many households in the Sub-Saharan Africa, little is known about their health effects and the predisposing factors particularly on those with direct exposure. This study sought to relate indoor air pollution exposure to self-reported prevalence of respiratory outcomes including (sputum production, congestion, breathing difficulties, eye problems, fatigue, and headaches and wheezing) among women and children of Trans Nzoia County, in the rural villages of western Kenya. METHODS: In this cross-sectional survey, simple random technique was used to select 251 households from 14 villages. Households were the sampling units, while the woman of the household with/or in custody of a child aged less than 5 years old were the unit of analysis. A total of 251 women with/or in custody of a child aged less than 5 years old took part in the study. A structured questionnaire was used to collect information on cause and effects of IAP among women and children. Data was analyzed descriptively and inferentially. We used Poisson generalized linear models with IAP symptoms and indoor cooking as dependent variables and household profiles and other socio-demographics as independent variables to identify the factors that affect health outcome. RESULTS: Mean age of respondents was 36.49 years, (95% CI [35.5, 37.5]). Most (64.5%) houses were semi-permanent, with 58.6% having an average kitchen size (5.6 m2). Wood and kerosene were the most preferred fuel types for cooking (96.8%) and lighting (97.4%), respectively. Smoke from the wood was identified as the dominant (96.8%) source of IAP. Most women (92.0%) and children (95.4%) had coughs of varying intensities during the year, while 31.5% of the women reported wheezing. About 98% of them experienced fatigued and headaches. Use of wood fuel was associated with increased coughing (p = 0.03), phlegm (p = 0.02), wheezing (p = 0.04), eye problems (p = 0.03) and headaches (p = 0.01) among women and children in the previous 24 h. Education level, ventilation, main fuel source used in 24 h, indoor cooking and house type were significantly associated with IAP health effects (p ≤ 0.05). CONCLUSIONS: Supporting the impoverished households and increasing their level of awareness on health-effects of IAP occasioned by use of biomass fuel while cooking indoors may be the first step in implementing a programme aimed at reducing exposure among rural households in Trans Nzoia County, in rural parts of Western Kenya.

Epidemiology of taeniosis, cysticercosis and trichinellosis in Iran: A systematic review.

BACKGROUND: The aim of this review was to establish the current epidemiology of taeniosis, cysticercosis and trichinellosis among humans and animals in Iran by carrying out a comprehensive assessment of published articles reporting on these foodborne zoonotic diseases across the country. METHODS: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was used in the search for relevant published articles reporting on cysticercosis, taeniosis and trichinellosis in Iran using a number of appropriate key words. The search was conducted through PubMed, Web of Science, Google Scholar, SpringerLink, SCOPUS, WHOLIS, FAO and CDC. Published scientific articles including journals, books and book chapters reporting on cysticercosis, taeniosis and trichinellosis in Iran for the period between 1967 and 2018 were selected. RESULTS: A total of 37 articles met the search criteria and were incorporated in this review. Of these, 10 (27%) reported on human taeniosis, 15 (40.5%) on cysticercosis (10 on Taenia saginata and five on Taenia spp. cysticercosis) and 12 (32.5%) on trichinellosis. T. saginata was implicated in all human taeniosis cases. All Taenia spp. cysticercosis cases were reported among domesticated pigs and wild animals. A case of neurocysticercosis was reported in a male patient at Shohada Hospital in Tehran. Eleven (91.7%) of the 12 studies reported on trichinellosis among wild animals, while one (8.3%) study detected anti-Trichinella IgG in 8 (2.2%) of the 364 at-risk human beings tested. Nevertheless, most of these studies were carried out in northern Iran. CONCLUSION: This review found T. saginata to be the most prevalent and of greater economic and public health significance in Iran. However, T. solium and Trichinella spp. were of little significance to human health. More studies should focus on other regions besides northern Iran.

Tick-borne zoonoses in the Order Rickettsiales and Legionellales in Iran: A systematic review.

BACKGROUND: Tick-borne zoonoses in the Order Rickettsiales and Legionellales cause infections that often manifest as undifferentiated fevers that are not easy to distinguish from other causes of acute febrile illnesses clinically. This is partly attributed to difficulty in laboratory confirmation since convalescent sera, specific diagnostic reagents, and the required expertise may not be readily available. As a result, a number of tick-borne zoonoses are underappreciated resulting in unnecessary morbidity, mortality and huge economic loses. In Iran, a significant proportion of human infectious diseases are tick-borne, with anecdotal evidence suggesting that tick-borne zoonoses are widespread but underreported in the country. Epidemiological review is therefore necessary to aid in the effective control and prevention of tick-borne zonooses in Iran. The aim of this review is to provide an in-depth and comprehensive overview of anaplasmosis, ehrlichiosis, spotted fever group rickettsioses and coxiellosis in Iran. METHODS: Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, all relevant publications on tick-borne zoonoses in the Order Rickettsiales and Legionellales in Iran were searched using a number of search terms. The search was confined to authentic resources from repositories of popular data bases among them PubMed, Web of Science, Google Scholar, Science Direct, SpringerLink and SCOPUS. The search items included peer reviewed journals, books and book chapters published between 1996 and 2017. RESULTS: A total of 1 205 scientific publications and reports were sourced, of which 63 met the search criteria and were reviewed. Of the 63 articles reviewed, 36 (57.1%) reported on coxiellosis, 15 (23.8%) on anaplasmosis, 11 (17.5%) on ehrlichiosis and 1(1.6%) on spotted fever group rickettsiae in a large scale study involving four countries, among them Iran. The existence of tick-borne pathogens in the Order Rickettsiales and Legionellales was confirmed by molecular, serological and microscopic techniques conducted on samples obtained from sheep, cattle, goats, camels, poultry, animal products (milk and eggs), dogs, ticks and even human subjects in different parts of the country; pointing to a countrywide distribution. DISCUSSION: Based on the review, coxiellosis, anaplasmosis, ehrlichiosis, and SFG rickettsiae can be categorized as emerging tick-borne zoonotic diseases in Iran given the presence of their causiative agents (C. burnetii, A. phagocytophilum, A. marginale, A. bovis, A. ovis, A. central, E. canis, E. ewingii, E. chaffeensis and R. conorii) collectively reported in a variety of domestic animals, animal products, arthropods and human beings drawn from 22 provinces in Iran. CONCLUSION: Given the asymptomatic nature of some of these zoonoses, there is a high likelihood of silent transmission to humans in many parts of the country, which should be considered a public health concern. Presently, information on the transmission intensity of tick-borne zoonoses caused by pathogens in the Order Rickettsiales and Legionellales to humans and its public health impact in Iran is scanty.

Spatial distribution and habitat characterization of mosquito species during the dry season along the Mara River and its tributaries, in Kenya and Tanzania.

BACKGROUND: Vector-borne diseases are increasingly becoming a major health problem among communities living along the major rivers of Africa. Although larger water bodies such as lakes and dams have been extensively researched, rivers and their tributaries have largely been ignored. This study sought to establish the spatial distribution of mosquito species during the dry season and further characterize their habitats along the Mara River and its tributaries. METHODS: In this cross-sectional survey, mosquito larvae were sampled along the Mara River, its two perennial tributaries (Amala and Nyangores), drying streams, and adjacent aquatic habitats (e.g. swamps, puddles that receive direct sunlight [open sunlit puddles], rock pools, hippo and livestock hoof prints, and vegetated pools). Each habitat was dipped 20 times using a standard dipper. Distance between breeding sites and human habitation was determined using global positioning system coordinates. The collected mosquito larvae were identified using standard taxonomic keys. Water physico-chemical parameters were measured in situ using a multiparameter meter. Mean mosquito larvae per habitat type were compared using analysis of variance and chi-square tests, while the relationship between mosquito larvae and physico-chemical parameters was evaluated using a generalized linear mixed model. The Cox-Stuart test was used to detect trends of mosquito larvae distribution. The test allowed for verification of monotonic tendency (rejection of null hypothesis of trend absence) and its variability. RESULTS: A total of 4001 mosquito larvae were collected, of which 2712 (67.8%) were collected from river/stream edge habitats and 1289 (32.2%) were sampled from aquatic habitats located in the terrestrial ecosystem about 50 m away from the main river/streams. Anopheles gambiae s.s, An. arabiensis, and An. funestus group, the three most potent vectors of malaria in Sub-Saharan Africa, together with other anopheline mosquitoes, were the most dominant mosquito species (70.3%), followed by Culex quinquefasciatus and Cx. pipiens complex combined (29.5%). Drying streams accounted for the highest number of larvae captured compared to the other habitat types. A stronger relationship between mosquito larvae abundance and dissolved oxygen (Z = 7.37, P ≤ 0.001), temperature (Z = 7.65, P ≤ 0.001), turbidity (Z = -5.25, P ≤ 0.001), and distance to the nearest human habitation (Z = 4.57, P ≤ 0.001), was observed. CONCLUSIONS: Presence of malaria and non-malaria mosquito larvae within the Mara River basin calls for immediate action to curtail the insurgence of vector-borne diseases within the basin. A vector control program should be conducted during the dry period, targeting drying streams shown to produce the highest number of larval mosquitoes.

Effect of climatic variability on malaria trends in Baringo County, Kenya.

BACKGROUND: Malaria transmission in arid and semi-arid regions of Kenya such as Baringo County, is seasonal and often influenced by climatic factors. Unravelling the relationship between climate variables and malaria transmission dynamics is therefore instrumental in developing effective malaria control strategies. The main aim of this study was to describe the effects of variability of rainfall, maximum temperature and vegetation indices on seasonal trends of malaria in selected health facilities within Baringo County, Kenya. METHODS: Climate variables sourced from the International Research Institute (IRI)/Lamont-Doherty Earth Observatory (LDEO) climate database and malaria cases reported in 10 health facilities spread across four ecological zones (riverine, lowland, mid-altitude and highland) between 2004 and 2014 were subjected to a time series analysis. A negative binomial regression model with lagged climate variables was used to model long-term monthly malaria cases. The seasonal Mann-Kendall trend test was then used to detect overall monotonic trends in malaria cases. RESULTS: Malaria cases increased significantly in the highland and midland zones over the study period. Changes in malaria prevalence corresponded to variations in rainfall and maximum temperature. Rainfall at a time lag of 2 months resulted in an increase in malaria transmission across the four zones while an increase in temperature at time lags of 0 and 1 month resulted in an increase in malaria cases in the riverine and highland zones, respectively. CONCLUSION: Given the existence of a time lag between climatic variables more so rainfall and peak malaria transmission, appropriate control measures can be initiated at the onset of short and after long rains seasons.

Determinants of climate change awareness level in upper Nyakach Division, Kisumu County, Kenya.

Improving the understanding of climate change awareness is one of the top priorities in climate change research. While the African continent is among the regions with the highest vulnerability to climate change, research on climate knowledge and awareness is lacking. Kenya is already grappling with the impacts of climate change, which are projected to increase in a non-linear and non-predictable manner. This study sought to determine climate change awareness levels among households residing in Upper Nyakach Division, Kisumu County, Kenya using common climate change markers viz heavy rainfall, floods, droughts and temperature. A cross-sectional survey design was adopted in which 384 household heads were selected as respondents from 11 sub-locations; all located within Upper Nyakach Division. A questionnaire was used to collect data. Most (90.9 %) respondents had observed changes in the overall climate. Awareness level of climate change varied significantly across the 11 sub-locations. To further gain insight unto which variables were the most significant determinant of climate change awareness in upper Nyakach division, Kisumu county, a Generalized Linear Model (GLM) with Poisson error distribution was built. The model indicated that sex of the household head, education level and age significantly influenced respondents' awareness to climate change markers. Most (87 %) households reported rising temperatures over the past 20 years. Over half (55.2 %) the respondents had observed declining rains, with significant differences being observed across age groups. Up to 75 % of the respondents reported increased droughts frequency over the last 20 years, with significant differences observed across gender. Most (86.7 %) respondents reported having observed changes in water sources with significant differences reported across age groups. The respondents reported an increased prevalence of malaria with significant differences being observed among the education levels and households' main livelihoods. The general population of the Upper Nyakach Divison is aware of changing global climate. However, more effort is required in mitigating climate change as per the local settings. Awareness campaign aimed at increasing knowledge of climate change markers among community members is recommended.

Presence and distribution of mosquito larvae predators and factors influencing their abundance along the Mara River, Kenya and Tanzania.

Among all the malaria controlling measures, biological control of mosquito larvae may be the cheapest and easiest to implement. This study investigated baseline predation of immature mosquitoes by macroinvertebrate predators along the Mara River, determined the diversity of predators and mosquito larvae habitats and the range of their adaptive capacity to water physico-chemical parameters. Between July and August 2011, sampling sites (n=39) along the Mara River were selected and investigated for the presence of macroinvertebrate predators and mosquito larvae. The selected sampling sites were geocoded and each dipped 20 times using standard mosquito larvae dipper to sample mosquito larvae, while a D-frame dip net was used to capture the macroinvertebrate predators. Water physico-chemical parameters (dissolved oxygen, temperature, pH, conductivity, salinity and turbidity) were taken in situ at access points, while hardness and alkalinity were measured titrimetically. The influence of macroinvertebrate predator occurrence was correlated with mosquito larvae and water quality parameters using Generalized Linear Model (GLM). Predators (n=297) belonging to 3 orders of Hemiptera (54.2%), Odonata (22.9%) and Coleoptera (22.9%), and mosquito larvae (n=4001) belonging to 10 species, which included An.gambiae s.l (44.9%), Culex spp. (34.8%) and An. coustani complex (13.8%), An. maculipalpis (3.6%), An. phaorensis (1.2%), An. funestus group (0.5%), An. azaniae (0.4%), An. hamoni (0.3%), An. christyi (0.3%), An. ardensis (0.08%), An. faini (0.07%), An. sergentii (0.05%) and 0.05% of Aedes mosquito larvae which were not identified to species level, due to lack of an appropriate key, were captured from different habitats along the Mara river. It was established that invasion of habitats by the macroinvertebrate predators were partially driven by the presence of mosquito larvae (p < 0.001), and the prevailing water physico-chemical parameters (DO, temperature, and turbidity, p <0.001). Understanding abiotic and biotic factors which favour mosquitoes and macroinveterbrate co-occurrence may contribute to the control of malaria.

Distribution and abundance of schistosomiasis and fascioliasis host snails along the Mara River in Kenya and Tanzania.

We purposively selected 39 sampling sites along the Mara River and its two perennial tributaries of Amala and Nyangores and sampled snails. In addition, water physicochemical parameters (temperature, turbidity, dissolved oxygen, conductivity, alkalinity, salinity and pH) were taken to establish their influence on the snail abundance and habitat preference. Out of the 39 sites sampled, 10 (25.6%) had snails. The snail species encountered included Biomphalaria pfeifferi Krauss - the intermediate host of Schistosoma mansoni Sambon, Bulinus africanus - the intermediate host of Schistosoma haematobium, and Lymnaea natalensis Krauss - the intermediate host of both Fasciola gigantica and F. hepatica Cobbold. Ceratophallus spp., a non-vector snail was also encountered. Most (61.0%) of the snails were encountered in streamside pools. Schistosomiasis-transmitting host snails, B. pfeifferi and B. africanus, were fewer than fascioliasis-transmitting Lymnaea species. All the four different snail species were found to be attached to different aquatic weeds, with B. pfeifferi accounting for over half (61.1%) of the snails attached to the sedge, followed by B. africanus and Lymnaea spp., accounting for 22.2 and 16.7%, respectively. Ceratophallus spp. were non-existent in sedge. The results from this preliminary study show that snails intermediate hosts of schistosomiasis and fascioliasis exists in different habitats, in few areas along the Mara River, though their densities are still low to have any noticeable impacts on disease transmission in case they are infected. The mere presence of the vector snails in these focal regions calls for their immediate control and institution of proper regulations, management, and education among the locals that can help curtail the spread of the snails and also schistosomiasis and fascioliasis within the Mara River basin.