Changing mother's hygiene and sanitation practices in resource constrained communities: case study of Turkana District, Kenya.

Lack of adequate sanitation, hygiene and safe portable water are serious global health problems that contribute to deaths of many children under the age of 5 years annually, mainly due to diarrhoeal diseases. This study was set out to determine the extent to which sanitation and hygiene promotion influenced mothers' and children's health in Turkana District; one of the arid Northern frontier Districts of Kenya. A repeat cross-sectional study design with multi-stage sampling method was used. A total of 300 mothers were randomly sampled for interviews in a baseline survey carried out in 2007 and in a post-intervention survey carried out in 2008. Data were collected using questionnaires and analyzed using SPSS for frequencies, cross tabulations and regression amongst other tests. Significant improvements were observed in hand washing practice, presence of hand washing soap at household and refuse pit ownership. In Kakuma Division the proportion of those who washed hands regularly increased from 48.8 to 91.3 % (χ(2) = 7.28, P = 0.122), in Lodwar Central, those who wash hands regularly increased from 85.5 to 89.9 % (χ² = 10.85, P = 0.028) while in Lokichogio, the proportions increased from 77.5 to 93.8 % (χ² = 15.56, P = 0.004). For hand washing soap at household, there was an increase in proportion of those who wash hands with soap from 65 to 78 % (χ² = 3.87, P = 0.049) within the group with no formal education. There was significant reduction of diarrhoea prevalence in children aged less than 5 years. Sanitation and hygiene promotion based on community participatory approaches can lead to significant reduction of diarrhoea in children.

Effects of hygiene and sanitation interventions on reducing diarrhoea prevalence among children in resource constrained communities: case study of Turkana District, Kenya.

Worldwide, lack of access to safe drinking water together with inadequate sanitation and hygiene is an overwhelming contributor to approximately 4 billion cases of illness annually. This study was set out to understand the effects of hygiene and sanitation interventions on targeted health outcomes including diarrhoeal prevalence in children's of Turkana District, Kenya. The interventions undertaken included capacity building and empowerment approach to trigger communities to demand hygiene and sanitation facilities. Three hundred mothers were randomly sampled in a baseline survey carried out in 2007 and in a post-intervention survey carried out in 2008 (a repeat cross-sectional study design). Specimens were collected for microbiological tests of key diarrhoea related pathogens. Overall, Faecal coliform counts per 100 ml sample had significant variations between 2007 and 2008; in Kakuma, reduced from 88 to 30.2 colony units (P = 0.005), Lodwar Central where the number reduced from 91 to 17.3 units (P = 0.003), and in Lokichogio Division, the number reduced from 63.8 to 23.6 units (P = 0.006). From the 230 stool samples examined, the proportion of children from whom infectious pathogens of Proteus spp. was isolated reduced from 16 to 7 % while Escherichia coli reduced from 54 to 41 %. Overall, prevalence of diarrhoea related microbes in children aged <5 years reduced from 91.3 % in 2007 to 78.3 % after intervention (2008). It is notable that sanitation and hygiene promotion leads to significant reduction of diarrhoea prevalence in children aged <5 years. Its application should therefore be up-scaled in resource constrained areas.

Prevalence of parasites of the local scavenging chickens in a selected semi-arid zone of Eastern Kenya.

A study to identify and estimate the prevalence of parasites of local chickens in a semi arid area of Kenya was conducted between March 2005 and August 2006. Three hundred and sixty (360) local chickens purchased from Yathui division of Machakos were examined. Of those, 93.3% had helminths. Nematodes were recovered in 268 (74.4%) chickens whereas 245 (68.1%) had cestodes. Tetrameres americana (37.7%), Ascaridia galli (33.3%) and Heterakis gallinarum (22.8%) were the most important nematode species identified. Raillietina echinobothrida (33.3%) and Davainea proglottina (19.4%) were the two most important cestode species identified. Two coccidia species, namely Eimeria necatrix (6.7%) and E. tenella (16.7%) were isolated and identified as per location in the digestive system. Important ectoparasites identified included Echidnophaga gallinacea (76.7%), Menacanthus stramineus (79.4%) and Dermanyssus gallinae (60.0%). Endo-parasites (helminths and coccidia) occurred in significantly (p<0.05) higher frequencies during the wet season than during the dry season. On the contrary, ecto-parasites were significantly (p<0.05) more fequent during the dry season. Male chickens generally exhibited increased odds for the occurrence of parasites than female birds. Further investigations are required to establish a plausible explanation for this. Overall, parasitism was a big constraint to chicken productivity in the study area. Urgent integrated parasite control approaches should be initiated to address parasitism in chickens in the Yathui cluster.