Efficacy of artemisinin-lumefantrine for treatment of uncomplicated malaria after more than a decade of its use in Kenya.

BACKGROUND: The resistance of Plasmodium falciparum to antimalarial drugs remains a major impairment in the treatment and eradication of malaria globally. Following the introduction of artemisinin-based combination therapy (ACT), there have been reports of delayed parasite clearance. In Kenya, artemether-lumefantrine (AL) is the recommended first-line treatment of uncomplicated malaria. This study sought to assess the efficacy of AL after a decade of use as the preferred method of managing malarial infections in Kenya. We assessed clinical and parasitological responses of children under 5 years between May and November 2015 in Chulaimbo sub-County, Kisumu, Kenya. Patients aged between 6 and 60 months with uncomplicated P. falciparum mono-infection, confirmed through microscopy, were enrolled in the study. The patients were admitted at the facility for 3 days, treated with a standard dose of AL, and then put under observation for the next 28 days for the assessment of clinical and parasitological responses. Of the 90 patients enrolled, 14 were lost to follow-up while 76 were followed through to the end of the study period. Seventy-five patients (98.7%) cleared the parasitaemia within a period of 48 h while one patient (1.3%) cleared on day 3. There was 100% adequate clinical and parasitological response. All the patients cleared the parasites on day 3 and there were no re-infections observed during the stated follow-up period. This study, therefore, concludes that AL is highly efficacious in clearing P. falciparum parasites in children aged ≥6 and ≤60 months. The study, however, underscores the need for continued monitoring of the drug to forestall both gradual ineffectiveness and possible resistance to the drug in all target users.

Attitude, perceived risk and intention to screen for prostate cancer by adult men in Kasikeu Sub Location, Makueni County, Kenya

Background: Prostate cancer is increasingly becoming one of the most significant health problems facing Kenyan men and the commonest cause of cancer related death in men globally.Though increased survival rates occur when the diagnosis is done early, the disease is typically detected at a more advanced stage while participation in prostate cancer screening is extremely low. In addition, due to the aging population and population growth, the expected numbers will increase in forthcoming years. Thus, prevention and early detection has immense public health importance. Objective: This study assessed the attitude, perceived risk and intention to screen for prostate cancer by adult men in Kenya.Method: This study was conducted to identify factors associated with intention to be tested for prostate cancer risk among adult men in Kasikeu Sub location, Makueni County, Kenya. An analytical cross-sectional study design using quantitative methods was used.This was achieved through the use of Thomas Jefferson University Prostate Cancer Screening Survey questionnaire using face to face interviews. A sample of 155 men participated in the study and was selected using random selection. Screening for prostate specific antigen (PSA) within the next six months was done and explanatory variables namely attitude, social influence and perceived risk determine. Results: The sample population was aged between 25 to 94 years of age (mean 49.8, SD 16.7). The results indicated that all the men had heard of prostate cancer, but only 3.1% of the men had knowledge (causes and treatment); 2.4% had tested for prostate cancer, and 43.6 percent of the men intended to be tested in the next six months. There was no significant association between demographic factors such as marital status, religion, education level and screening intent (p>0.05). Variables that were significantly associated with intent to screen for cancer were attitude, social influence and perceived risk (p<0.05). Conclusion: There is need for increase health strategies to increase prostate cancer awareness, screening rates which are culturally sensitive and geared toward those living in rural areas with low education levels.In addition, health education should be geared toward modifying men's attitudes about PSA screening and target socially influential people in their lives especially the family. Recommendations: Qualitative studies could provide a more in depth understanding of perceived barriers to prostate cancer screening. This may provide health care professionals with the information they need to implement strategies to address these barriers, in order to increase prostate cancer screening in Kenyan men and ultimately decrease the rate of mortality from prostate cancer