Submit to survive: an exploration of sexual cleansing as an act of violence against widows in the Luo community of Kenya.

In this paper, the sexual 'cleansing' of widows and subsequent inheritance is assessed for its socio-cultural significance. Although the practice has been well studied in the context of HIV in Sub-Saharan Africa, it has not been widely examined as an act of sexual violence against women. To address this gap, in-depth interviews were conducted with 27 widows aged 29 to 90 years in Siaya County in Southwest Kenya. A majority of participants stated the cleansing ritual was forcefully initiated, violently fulfilled, and frequently seen as rape. Findings from this study necessitate the identification of the cultural practice of widow cleansing as an act of violence against women. Doing so will facilitate the creation of a legal framework with which to act to eliminate the practice.

"I was forced into it": The continued violation of widows from the Luo community of Kenya through sexual cleansing rituals.

Sexual cleansing is part of the social transition process for widows to become eligible to remarry after the death of her husband. This ritual is conducted to cleanse the widow of evil spirits resulting from the death of her husband. This qualitative study explored the sexual cleansing ritual in the Luo community in southwest Kenya. This paper aims to examine the widows' perceptions of the social constructs surrounding the practice of the sexual cleansing ritual that maintains its continued existence in this community. Twenty-seven face-to-face in-depth interviews were conducted with widows who had undergone sexually cleansing. Data was analyzed using conventional content analysis. Three main themes emerged in the exploration of the social construction of the sexual cleansing ritual of widows. The findings therein highlight the precarious situation of widows and the need for social support services for women who have been sexually cleansed.

Inadequacies in service delivery for the diagnosis and treatment of vaginitis and vaginosis in Nairobi, Kenya.

Vulvovaginal candidiasis (VVC), a common cause of vaginitis, affects 75% of women in their lifetime. In Kenya, vaginitis/VVC is managed using the vaginal discharge syndrome guidelines. We assessed how frequently healthcare workers consider the diagnosis of vaginitis/VVC in symptomatic women, and adherence to the syndromic guidelines, outpatient records at Nairobi City County health facilities, of non-pregnant symptomatic females aged ≥15 years were abstracted. Descriptive statistics were applied, and analysis of determinants of practice determined using multivariable logistic regression models. Of 6,516 patients, 4,236 (65%) (inter-facility range 11-92%) had vaginitis of which 1,554 (37%) were considered VVC (inter-facility range 0-99%). Vaginitis was associated with facility, adjusted odds ratio (aOR) 2.80 (95% confidence interval (CI) 1.64-4.76) and aOR 0.03 (95% CI 0.02-0.04); and month, aOR 0.33 (95% CI 0.25-0.43). Vaginal examination was in 53% (inter-facility range 0-98%). Adherence to syndromic treatment was 56% (inter-facility range 0-83%), better with older patients (aOR 7.73, 95% CI 3.31-18.07). Vaginitis and VVC are commonly diagnosed in symptomatic patients in Nairobi; adherence to the syndromic guidelines is low and differs across the health facilities. Interventions to improve adherence are needed.

Quaternized chitosan as a biopolymer sanitizer for leafy vegetables: synthesis, characteristics, and traditional vs. dry nano-aerosol applications.

A series of quaternary dimethyl-(alkyl)-ammonium chitosan derivatives (QACs) was synthesized and studied for physicochemical properties and bioactivity. The QACs tended to spontaneously self-assembly into nanoaggregates. Antimicrobial activity was examined in vitro on Gram-negative Escherichia coli (E. coli) and Gram-positive Listeria innocua (L. innocua) bacteria as well as phytopathogenic fungus Botrytis cinerea. The hexyl chain-substituted QAC-6 demonstrated the highest potency causing 3.0- and 4.5-log CFU mL-1 reduction of E. coli and L. innocua, respectively. QAC-6 was tested for antimicrobial activity on stainless steel coupons and fresh spinach leaves. A traditional 'wet' application (spray) and dry Engineered Water Nanostructure (EWNS) approach were used for spinach decontamination. With both approaches, significant reduction of microbial load on the treated produce was achieved. The wet application showed a greater reduction of microbial load, while the advantages of EWNS were reaching the antimicrobial effect with miniscule dose of active agent leaving treated surface visibly dry.

Geographical and temporal distribution of hawkmoth (Lepidoptera: Sphingidae) species in Africa.

BACKGROUND: Hawkmoths consist of species where most adults are nocturnal, but there are some day-flying genera. Hawkmoth species have a wide variety of life-history traits, comprising species with adults (mostly nectarivorous though with some exceptions, honey-feeding), but there are also species that do not feed at all. The nectarivorous species are an important component of tropical ecosystems, with significant roles as major pollinators of both crops and wild flora with the pollination done by the adult stage. Pollinators are in decline world-wide and there is need for baseline data to provide information about their conservation strategies. Species occurrence data from Museum collections have been shown to be of great value as a tool for prioritising conservation actions in Africa. The National Museums of Kenya (NMK) have a large and active entomology collection that is in continuous growth. The NMK's collection of hawkmoths had not been digitised prior to 2017. This moth family Sphingidae includes about 1,602 species and 205 genera worldwide (Kitching et al. 2018) with the majority of these species occurring in Africa. These moth species can also be used as indicators in biodiversity assessments as they can be easily sampled and identified. However, hawkmoths have rarely been surveyed over the long term for this purpose. Long-term datasets are of unquestionable significance for understanding and monitoring temporal changes in biodiversity. These hawkmoth data have addressed one of the most significant challenges to insect conservation, the lack of baseline information concerning species diversity and distribution and have provided key historic hawkmoth species diversity and distribution data that can be used to monitor their populations in the face of climate change and other environmental degradation issues that are facing the world today. The publication of the hawkmoth species occurrence data records in GBIF has enhanced data visibility to a wider audience promoting availability for use. NEW INFORMATION: The hawkmoth (Lepidoptera: Sphingidae) collection at the National Museums of Kenya was digitised from 2017 - 2020 and this paper presents details of species occurrence records as in the insect collection at the NMK, Nairobi, Kenya.The collection holds 5,095 voucher specimens consisting of 88 genera and 208 species. The collection covers the period between 1904 and 2020.The geographical distribution of the hawkmoths housed at the NMK covers East Africa at 81.41%, West Africa at 7.20%, Southern Africa at 6.89%, Central Africa at 4.02% and North Africa at 0.2%.

Environmental health literacy and household air pollution-associated symptoms in Kenya: a cross-sectional study.

BACKGROUND: Household air pollution (HAP) is a significant source of the global burden of disease. Our objective was to evaluate the association between environmental health literacy (EHL), a domain of health literacy (HL) that describes the ability to use environmental health information to reduce health risks, and symptoms associated with HAP. METHODS: We performed a cross-sectional population-based study of 353 households in Kasarani, Kenya. One individual from each household was surveyed using our novel EHL survey tool. Baseline characteristics were compared between individuals who were symptomatic (i.e., experiencing cough, shortness of breath, phlegm production, wheeze, chest tightness, headache, eye irritation, or burns from cooking at least 5 times per month) versus individuals who were asymptomatic (i.e., experiencing none or symptoms no more than once per month). Multivariate logistic regression was used to determine the odds ratios (OR) of self-reported symptoms associated with HL, stratified by median EHL, adjusting for education, self-perceived health and solid fuel use. RESULTS: A total of 100 individuals (28%) reported experiencing one or more symptoms at least 5 times per month, including 31.2% of solid fuel users and 30.3% of non-solid fuel users. Among individuals with high EHL, higher HL was associated with lower risk of experiencing symptoms (OR = 0.26; 95% CI 0.10-0.67), however, there was no association among individuals with low EHL (OR = 0.85; 95% CI 0.34-2.13). Among solid fuel users, the association between HL and risk of experiencing symptoms was driven by individuals with high EHL (OR = 0.30; 95% CI 0.05-1.84), rather than those with low EHL (OR = 1.22; 95% CI 0.36-4.16). CONCLUSIONS: To the best of our knowledge, this was the first study to assess the association between EHL, HL, and HAP-associated symptoms. Our findings highlight the potential importance of EHL in promoting sustainable interventions to reduce symptoms associated with HAP from solid fuel use among communities in Kenya.

Swallowtail butterflies (Lepidoptera: Papilionidae) species diversity and distribution in Africa: The Papilionidae collection at the National Museums of Kenya, Nairobi, Kenya.

BACKGROUND: Species data from the Museum collections have been shown to be of great value as a tool for prioritising conservation actions in Africa (Fjeldsa and Tushabe 2005). The National Museums of Kenya (NMK) have an entomology collection, housed in 4,000 drawers in cabinets that contain over 1.5 million specimens, including the largest butterfly collection in Africa (Arnett et al. 1997). Lampe and Striebing (2005) demonstrated how to digitise large insect collections in order to make their associated label data into databases that can be used for functions, such as creating distribution maps. The NMK's swallowtail butterflies' collection had not been digitised and thus there was a need to capture the label data to create a database that can be used for mapping the distribution of the species in Kenya and elsewhere. These data have addressed one of the most significant challenges to insect conservation i.e. the lack of baseline information concerning species diversity and distribution (Summerville and Crist 2003). These data have provided key historic papilionid species diversity and distribution data that can be used to monitor their populations, as butterflies are declining due to changes in land use, intensive agriculture and pestcide use, diseases and pest and climate change (Potts et al. 2016; Bongaarts 2019). The publication of the occurrence data records in GBIF has been undertaken, thus making the data available to a wider audience and promoting availability for use. NEW INFORMATION: The swallowtail butterflies collection at the National Museums of Kenya was digitised from 2017-2019 and this paper presents details of the Papilionid collection at the Zoology Department, NMK, Nairobi, Kenya.The collection holds 7,345 voucher specimens, consisting of three genera and 133 species. The collection covers the period between 1850 to 2019.The distribution of the swallowtail butterflies, housed at the NMK, covers East Africa with 88%, Central Africa (6%), Western Africa (4%) and Southern Africa (2%).

Barriers to malaria prevention among immigrant travelers in the United States who visit friends and relatives in sub-Saharan Africa: A cross-sectional, multi-setting survey of knowledge, attitudes, and practices.

BACKGROUND: Despite achievements in the reduction of malaria globally, imported malaria cases to the United States by returning international travelers continue to increase. Immigrants to the United States from sub-Saharan Africa (SSA) who then travel back to their homelands to visit friends and relatives (VFRs) experience a disproportionate burden of malaria illness. Various studies have explored barriers to malaria prevention among VFRs and non-VFRs-travelers to the same destinations with other purpose for travel-but few employed robust epidemiologic study designs or performed comparative analyses of these two groups. To better quantify the key barriers that VFRs face to implement effective malaria prevention measures, we conducted a comprehensive community-based, cross-sectional, survey to identify differences in malaria prevention knowledge, attitudes, and practices (KAP) among VFRs and others traveling to Africa and describe the differences between VFRs and other types of international travelers. METHODS AND FINDINGS: Three distinct populations of travelers with past or planned travel to malaria-endemic countries of SSA were surveyed: VFRs diagnosed with malaria as reported through a state health department; members of the general VFR population (community); and VFR and non-VFR travelers presenting to a travel health clinic, both before their pretravel consultation and again, after return from travel. A Community Advisory Board of African immigrants and prior qualitative research informed survey development and dissemination. Across the three groups, 489 travelers completed surveys: 351 VFRs and 138 non-VFRs. VFRs who reported taking antimalarials on their last trip rated their concern about malaria higher than those who did not. Having taken five or more trips to SSA was reported more commonly among VFRs diagnosed with malaria than community VFRs (44.0% versus 20.4%; p = 0.008). Among travel health clinic patients surveyed before and after travel, VFR travelers were less successful than non-VFRs in adhering to their planned use of antimalarials (82.2% versus 98.7%; p = 0.001) and employing mosquito bite avoidance techniques (e.g., using bed nets: 56.8% versus 81.8%; p = 0.009). VFRs who visited the travel health clinic were more likely than VFR respondents from the community to report taking an antimalarial (83.0% versus 61.9%; p = 0.009), or to report bite avoidance behaviors (e.g., staying indoors when mosquitoes were out: 80.9% versus 59.5%; p = 0.009). CONCLUSIONS: We observed heterogeneity in malaria prevention behaviors among VFRs and between VFR and non-VFR traveler populations. Although VFRs attending the travel health clinic appear to demonstrate better adherence to malaria prevention measures than VFR counterparts surveyed in the community, specialized pretravel care is not sufficient to ensure chemoprophylaxis use and bite avoidance behaviors among VFRs. Even when seeking specialized pretravel care, VFRs experience greater barriers to the use of malaria prevention than non-VFRs. Addressing access to health care and upstream barrier reduction strategies that make intended prevention more achievable, affordable, easier, and resonant among VFRs may improve malaria prevention intervention effectiveness.