Prevalence and spatial distribution of Trematode cercariae in Vector Snails within different Agro-Ecological Zones in Western Kenya, 2016.

INTRODUCTION: Freshwater vector snails' distribution, infection with cercariae, preferred habitat and possible trematodiases transmission foci is not well known in Western Kenya. We sought to determine the distribution and prevalence of infection of snails per agro-ecological zone and environmental factors in vector snail habitats. METHODS: We conducted a cross-sectional survey from March, 2016 - May, 2016, harvested and identified snails using shell morphology, determined their infection with trematode cercariae using microscopy, used descriptive statistics to estimate the prevalence of infection and relationship between snail abundance and environmental factors. RESULTS: We sampled a total of 1,678 vector snails from 47 sampling sites of which 42% were Lymnaeid, 23% Biomphalaria, 10% Bulinus, 22% Oncomelaniae and 2% Melanoides. Lower Midland I Ago-Ecological Zones had 44% of the snails and streams from springs had 41% of the snails. Overall, 26.5% (445/1678) (95% CI: 24.4 - 28.6) of the snails shed cercariae. Cercariae were found in 11 (23%) of the sites and in all zones. F. gigantica cercariae were shed by L. natalensis, B. pfeifferi, B. sudanica. Lakeshore had both F. gigantica and S. mansoni cercariae shed by B. sudanica. About 72% (1,202/1,678) of snails were found in water with a pH 6.5 - 7.5. Grass habitat had 54% (912/1,678) of the snails. CONCLUSION: Lymnaeid snails were present in all the zones, while streams from springs and near neutral habitats had most of the snails. Infection with trematode cercariae was noted in all the zones. Trematodiases control should be focused on all zones especially in freshwater streams and lakeshores.

Investigation of anthrax in an endemic region in Kenya: a mixed methods approach.

In Kenya, human anthrax cases most often occur linked to animal anthrax. In most cases, human behaviors, especially slaughter and consumption of meat from animal anthrax cases, has been implicated. This case study is based on an anthrax outbreak investigation conducted in an endemic region in Kenya in May 2016.The case study simulates how a mixed methods approach can be used in epidemiologic research.To fully benefit from this case study, participants should have had prior lectures or other instruction in quantitative and qualitative study designs and sampling approachesused in epidemiologic research. The case study is ideally suited for trainees at intermediate or advance level training in field epidemiology who should be able to complete the case study in approximately 3 hours.

Prevalence and factors associated with metabolic syndrome in an urban population of adults living with HIV in Nairobi, Kenya.

INTRODUCTION: Metabolic syndrome affects 20-25% of the adult population globally. It predisposes to cardiovascular disease and Type 2 diabetes. Studies in other countries suggest a high prevalence of metabolic syndrome among HIV-infected patients but no studies have been reported in Kenya. The objective of this study was to assess the prevalence and factors associated with metabolic syndrome in adult HIV-infected patients in an urban population in Nairobi, Kenya. METHODS: In a cross-sectional study design, conducted at Riruta Health Centre in 2016, 360 adults infected with HIV were recruited. A structured questionnaire was used to collect data on socio-demography. Blood was collected by finger prick for fasting glucose and venous sampling for lipid profile. RESULTS: Using the harmonized Joint Scientific Statement criteria, metabolic syndrome was present in 19.2%. The prevalence was higher among females than males (20.7% vs. 16.0%). Obesity (AOR = 5.37, P < 0.001), lack of formal education (AOR = 5.20, P = 0.002) and family history of hypertension (AOR = 2.06, P = 0.029) were associated with increased odds of metabolic syndrome while physical activity (AOR = 0.28, P = 0.001) was associated with decreased odds. CONCLUSION: Metabolic syndrome is prevalent in this study population. Obesity, lack of formal education, family history of hypertension, and physical inactivity are associated with metabolic syndrome. Screening for risk factors, promotion of healthy lifestyle, and nutrition counselling should be offered routinely in HIV care and treatment clinics.