Widening geographic range of Rift Valley fever disease clusters associated with climate change in East Africa.

BACKGROUND: Recent epidemiology of Rift Valley fever (RVF) disease in Africa suggests growing frequency and expanding geographic range of small disease clusters in regions that previously had not reported the disease. We investigated factors associated with the phenomenon by characterising recent RVF disease events in East Africa. METHODS: Data on 100 disease events (2008-2022) from Kenya, Uganda and Tanzania were obtained from public databases and institutions, and modelled against possible geoecological risk factors of occurrence including altitude, soil type, rainfall/precipitation, temperature, normalised difference vegetation index (NDVI), livestock production system, land-use change and long-term climatic variations. Decadal climatic variations between 1980 and 2022 were evaluated for association with the changing disease pattern. RESULTS: Of 100 events, 91% were small RVF clusters with a median of one human (IQR, 1-3) and three livestock cases (IQR, 2-7). These clusters exhibited minimal human mortality (IQR, 0-1), and occurred primarily in highlands (67%), with 35% reported in areas that had never reported RVF disease. Multivariate regression analysis of geoecological variables showed a positive correlation between occurrence and increasing temperature and rainfall. A 1°C increase in temperature and a 1-unit increase in NDVI, one months prior were associated with increased RVF incidence rate ratios of 1.20 (95% CI 1.1, 1.2) and 1.93 (95% CI 1.01, 3.71), respectively. Long-term climatic trends showed a significant decadal increase in annual mean temperature (0.12-0.3°C/decade, p<0.05), associated with decreasing rainfall in arid and semi-arid lowlands but increasing rainfall trends in highlands (p<0.05). These hotter and wetter highlands showed increasing frequency of RVF clusters, accounting for 76% and 43% in Uganda and Kenya, respectively. CONCLUSION: These findings demonstrate the changing epidemiology of RVF disease. The widening geographic range of disease is associated with climatic variations, with the likely impact of wider dispersal of virus to new areas of endemicity and future epidemics.

Prevalence of major external structural birth defects in Kiambu County, Kenya, 2014-2018.

INTRODUCTION: major external structural birth defects are typical and have been associated with childhood morbidity, mortality and lifelong resource-intensive disabilities. These defects continue to occur; however, they are yet to be recognized as public health problems in Kenya. The objective of this study was to estimate the prevalence of major external structural birth defects in Kiambu County in Kenya, 2014-2018. METHODS: a cross-sectional study design was adopted; a retrospective review of medical records was conducted between 2014 and 2018 abstracting 873 birth defects. Following a predetermined inclusion criterion, a five-year prevalence numerator of 362 cases was determined, whereas, a five-year prevalence denominator of 299,854 cases of registered live-births was obtained from the birth registrar. Annual prevalence estimates of 29 sub-groups and 6 groups of these defects were calculated as the number of cases (numerator) divided by the number of live-births (denominator). Associated 95% binomial exact confidence intervals were also computed and expressed per 100,000 live-births. RESULTS: defects of the musculoskeletal system, the central nervous system, orofacial, genital organs, eye and anus were observed. Defects of the musculoskeletal system were the most prevalent, ranging from 22.98 (95% CI: 11.87-40.13) to 116.9 (95% CI: 92.98-145.08) per 100,000 live-births. Defects of the central nervous system followed ranging between 13.40 (95% CI: 5.39-27.61) and 32.79 (95% CI: 20.79-49.19) per 100,000 live-births. CONCLUSION: despite musculoskeletal system defects being the most common group, hypospadias; a defect of the male genital organ was the most prevalent among the sub-group of these defects.

Prevalence and risk factors for low back pain among university teaching staff in Nairobi, Kenya: a cross-sectional study.

Background: To date, there are few studies carried out on low back pain (LBP) among university teaching staff in developing countries despite academics being a high-risk group for LBP. In Kenya, to the best of our knowledge, there are no published studies that have investigated risk factors for LBP among teaching staff. The objectives of this study were to estimate the prevalence of LBP among teaching staff of the University of Nairobi (UoN), during the period June 2016 - May 2017, and to identify its socio-demographic and work-related risk factors. Methods: An analytical cross-sectional study design was used to estimate the prevalence and investigate the risk factors for LBP among 136 teaching staff of UoN. A semi-structured questionnaire was used to collect data on LBP history, work-related and socio-demographic characteristics of the study participants. The 12-month prevalence of LBP and its associated 95% exact binomial confidence interval were estimated. A mixed-effects logistic regression model was used to evaluate the relationship between the predictors and LBP. Results: The estimated 12-month prevalence of LBP was 64% (95% CI: 55.3%-72.0%). From the multivariable analysis, physical inactivity (aOR: 6.0; 95% CI: 1.2-29.6), office chairs without lumbar supports (aOR: 3.3; 95% CI: 0.1-0.9) and high workplace stress (aOR: 4.4; 95% CI: 1.1-17.5) were identified as significant risk factors for LBP among the respondents. Conclusions: This study has revealed a high burden of LBP among teaching staff of the UoN and undoubtedly mimics the situation in other higher learning institutions in Kenya. Physical inactivity, sitting on chairs without lumbar supports and workplace stress have been identified as modifiable risk factors for LBP among teaching staff. This suggests a need to strengthen advocacy for regular physical activity, team-building activities and investment in office infrastructure to mitigate the effects of LBP within learning institutions.