Detection of Anopheles stephensi Mosquitoes by Molecular Surveillance, Kenya.

The Anopheles stephensi mosquito is an invasive malaria vector recently reported in Djibouti, Ethiopia, Sudan, Somalia, Nigeria, and Ghana. The World Health Organization has called on countries in Africa to increase surveillance efforts to detect and report this vector and institute appropriate and effective control mechanisms. In Kenya, the Division of National Malaria Program conducted entomological surveillance in counties at risk for An. stephensi mosquito invasion. In addition, the Kenya Medical Research Institute conducted molecular surveillance of all sampled Anopheles mosquitoes from other studies to identify An. stephensi mosquitoes. We report the detection and confirmation of An. stephensi mosquitoes in Marsabit and Turkana Counties by using endpoint PCR and morphological and sequence identification. We demonstrate the urgent need for intensified entomological surveillance in all areas at risk for An. stephensi mosquito invasion, to clarify its occurrence and distribution and develop tailored approaches to prevent further spread.

The Worldview Genogram: A process model for enhancing diversity responsiveness and competence in education, training, and clinical supervision.

Diversity responsiveness and competence is an imperative in current graduate psychology training and few, if any, will debate this. However, what has been and still remains frustrating to most practicum and internship clinical supervisors and graduate school instructors is a dearth of safe and practical tools to enhance this process, particularly in terms of the awareness domain. The authors of this article present a process model, the Worldview Genogram (WVG), that has been developed and implemented in clinical field placements and classroom settings over the last 22 years with significant success. The WVG, anchored by a three-generational family-of-origin genogram, is a depiction of individual and cultural diversity constructs that impact a person's identity formation. A rationale for the model and specific, practical steps in implementing it in academic and clinical settings are described. The model's uniqueness lies in the fact that it is nonpathologizing, strengths-based, trainee driven, and predicated on instructor or supervisor modeling. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Impact of an Intervention to Minimize Overdiagnosis of Malaria Cases in a Low Risk Kenyan sub-County.

INTRODUCTION: Overdiagnosis of malaria cases hampers malaria control in developing countries. Due to lack of diagnostics, febrile cases are treated using signs and symptoms. We evaluated an intervention to minimize overdiagnosis in Ijara sub-County, Kenya. METHODS: Health workers were trained on case management and rapid diagnostic tests provided in late 2011. Malaria outpatient morbidity was assessed a year before and after the intervention coupled with data on rapid diagnostic tests consumption. RESULTS: The number of diagnosed malaria cases decreased from 15,615 in 2011 to 1,892 in 2012. This represents an 87.8% decrease. There was a significant difference in number of diagnosed monthly malaria cases during the pre-intervention (Mean = 1,299, SD = 550.4) and post-intervention periods (Mean = 158, SD = 160.9, t (12.9) = 6.9, p =.000, two tailed). Mean monthly consumption of rapid diagnostic tests was 730, with 5.2% testing positive. CONCLUSION: This intervention reduced overdiagnosis and overtreatment of malaria cases.

An assessment of malaria curative services in Ijara district, a remote community in the North-Eastern province of Kenya.

INTRODUCTION: Malaria is a major public health problem in Kenya and there is need to strengthen malaria control activities at the district level. METHODS: As part of this, an assessment of malaria curative services offered in health facilities in terms of health care material availability and the case management skills of the health workers was conducted in Ijara district. A questionnaire was administered to the health workers. Observation and physical inspection of malaria health care material and perusal of relevant documents were also carried out in all health facilities in 2011. RESULTS: All health facilities had the recommended drugs, though only 90% of facilities had quinine injection. All facilities lacked Rapid Diagnostic Tests, Adverse Drug Reaction reporting forms, and poor quality medicine forms. CONCLUSIONS: There is need to equip the health workers with up-to-date case management skills and to provide rapid diagnostic tests.