A community health worker program for the prevention of malaria in eastern Kenya.

OBJECTIVE: To assess whether the development and implementation of a community health worker (CHW) project in rural Kenya was associated with an increase in knowledge about malaria and the use of insecticide-treated nets (ITNs) in children under five years of age. METHODS: A baseline knowledge and behavior questionnaire, adopted from the Kenyan Demographic Health Survey, was conducted in August 2007 by Kenyan health officials in 75 villages. Two CHWs were chosen from each village and trained in appropriate use of ITNs. The CHWs provided educational sessions and ITNs to mothers in their respective villages. A follow-up survey was conducted in March 2008 of all families with children less than five years of age within randomly selected villages. The main questions addressed during the follow-up survey included knowledge about malaria and the practice of correctly using ITNs. FINDINGS: There were 267 surveys compiled for knowledge assessment before the intervention and 340 in the post-intervention analysis with an approximate 99% family participation rate. Of the families surveyed, 81% correctly knew the cause for malaria before the study and 93% after the CHW intervention (p < 0.01). Of those surveyed before the intervention, 70% owned and correctly used mosquito nets compared with 88% after the CHW intervention (p < 0.01). CONCLUSIONS: There was a significant increase in knowledge about malaria and use of ITNs after the implementation of the CHW program.

Prevalence of Intestinal Worm Infections among Primary School Children in Nairobi City; Kenya

Objective: The main objective of the study was to determine the prevalence of total; single and multiple intestinal worm infections among the primary school children in Nairobi City. Methods: A cross-sectional descriptive study was used to determine the status of intestinal worm infections whose subjects were drawn from eight city administrative divisions. Proportional random sampling method to select forty five (45) schools out of 320 public; private and non-formal schools was used. Using the school enrolment register for standard 3 and 4; fifty (50) pupils per school were selected to participate in the study. Quantitative data from the study subjects were collected by use of a structured questionnaire. In addition; stool specimens were collected from each study subject and examined by Kato-Katz laboratory method. Results: The four intestinal worms investigated constituted a total prevalence of 12.9. This prevalence was found to be lower than that in two other previous studies. A. lumbricoides had the highest prevalence and S. mansoni had the lowest. Prevalence of single worm infections constituted 8.6of the total prevalence. Differences in prevalence between males and females were observed only with respect to T. trichiura and hookworm species. Fourteen to sixteen (14-16) and 11-13 years of age groups had the highest total prevalence of 47and 30.6respectively. Differences in prevalence were not found among the school categories with exception of T. trichiura infections. Conclusion: Prevalence of total; single and multi- ple infections showed a downward trend when compared to the previous studies with Ascaris lumbricoides persisting with the highest prevalence

Determinants of immunisation coverage in Butere-Mumias district, Kenya.

BACKGROUND: Butere-Mumias district is one of the districts which performs poorly on immunisation coverage, as observed from the Kenya Expanded Programme of Immunisation reports. OBJECTIVE: To identify factors that contribute to the low level of immunisation coverage in the district among children under the age of five years. DESIGN: Cross-sectional descriptive study. SETTING: Butere-Mumias district. RESULTS: Out of the 293 mothers who were sampled, 238 (80%) had attained primary level of education while, 55 (20%) attained secondary level and above. Immunisation coverage was found to be 35% in this district. Long distances to health facilities, poor states of the roads, age, attitude and knowledge regarding immunisation among mothers were significant factors that determined immunisation coverage. CONCLUSION: Low levels of education, long distances to the nearest health facilities, lack of knowledge on immunisations and lack of staff were responsible for the low coverage. There is therefore, need to act on these factors which hamper the immunisation coverage in order to reduce child mortality rate which are attributable to non-immunisation.

Agrochemicals exposure and health implications in Githunguri location, Kenya.

A study conducted in a rural agricultural community (Githunguri location) in Kenya between 1987 and 1990 investigated the extent of use of agrochemicals, especially pesticides, by the farmers; their level of awareness of the dangers posed by these chemicals and their attitudes towards agricultural chemicals in general. The findings showed that more than 95% of the farmers used pesticides extensively. More women than men were found to be at risk of agrochemicals exposure, while babies and children were at more risk of agrochemicals exposure than the women. In this community, knowledge and awareness regarding safety in handling and storage of agrochemicals was to some extent limited. For instance, many had no knowledge of an antidote in case of accidental poisoning. Additionally, suicidal attempts by ingestion of agrochemicals was prevalent. Improper handling of the agrochemicals by the community members was implicated to have adverse health effects. These health effects were reported in form of complaints. They ranged from acute to chronic conditions. Consequently, an intervention programme was launched with the women as the key players. It is envisaged that community participation in the on going intervention programme is saving babies, children, women and the community at large from agrochemicals hazards.