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Macharia Z, Ogoti B, Otieno M, Gitonga P, Bosco-Lauth A, Maritim M, Lemarkoko E, Keya A, Sankok J, Gitao G, Onono J, Oyugi J, Bowen RA. Transmission of SARS-CoV-2 among underserved pastoralist communities in Kajiado County, Kenya: 2020-2022. PLoS One 2024; 19:e0308318. [PMID: 39116080 PMCID: PMC11309416 DOI: 10.1371/journal.pone.0308318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 07/22/2024] [Indexed: 08/10/2024] Open
Abstract
Initial transmission of severe acute respiratory syndrome virus-2 (SARS-CoV-2) was highest in densely populated regions of Kenya. Transmission gradually trickled down to the less densely populated, remote and underserved regions such as the pastoral regions of Kajiado County which are characterized by poor healthcare systems. Molecular assays that were pivotal for COVID-19 diagnosis were not available in these regions. Serology is an alternative method for retrospectively tracking the transmission of SARS-CoV-2 in such populations. Dry blood spots (DBS) were prepared from consenting patients attending six health facilities in Kajiado County from March 2020 to March 2022. Upon elution, we conducted an enzyme-linked immunosorbent assay (ELISA) for the detection of SARS-Cov-2 IgG antibodies. Of the 908 DBSs we analyzed, 706 (78%) were from female participants. The overall seropositivity to SARS-Cov-2 antibodies was 7.3% (95% CI 5.7-9.1). The elderly (over 60 years) and male participants had a high likelihood of testing positive for SAR-CoV-2 infections. Mashuru (15.6%, 14/90) and Meto (15%, 19/127) health facilities registered the highest proportion of seropositive participants. Evidence of SARS-CoV-2 transmission among pastoralists in the remote and underserved regions of Kajiado County was established by DBS sampling and serologic testing.
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Affiliation(s)
- Zipporah Macharia
- Institute of Tropical and Infectious Diseases (UNITID), University of Nairobi, Nairobi, Kenya
- Department of Medical Microbiology and Immunology, University of Nairobi, Nairobi, Kenya
| | - Brian Ogoti
- Department of Medical Microbiology and Immunology, University of Nairobi, Nairobi, Kenya
- Center of Epidemiological Modelling and Analysis, University of Nairobi, Nairobi, Kenya
| | - Magdaline Otieno
- Institute of Tropical and Infectious Diseases (UNITID), University of Nairobi, Nairobi, Kenya
| | - Pauline Gitonga
- Department of Biomedical Sciences, Colorado State University, Fort Collins, Colorado, United States of America
| | - Angela Bosco-Lauth
- Department of Biomedical Sciences, Colorado State University, Fort Collins, Colorado, United States of America
| | - Marybeth Maritim
- Department of Clinical Medicine and Therapeutics, University of Nairobi, Nairobi, Kenya
| | | | - Aggrey Keya
- Kajiado County Referral Hospital, Kajiado Town, Kajiado, Kenya
| | - Joseph Sankok
- Kajiado County Referral Hospital, Kajiado Town, Kajiado, Kenya
| | - George Gitao
- Department of Pathology, Microbiology and Parasitology, University of Nairobi, Nairobi, Kenya
| | - Joshua Onono
- Department of Public Health Pharmacology and Toxicology, University of Nairobi, Nairobi, Kenya
| | - Julius Oyugi
- Institute of Tropical and Infectious Diseases (UNITID), University of Nairobi, Nairobi, Kenya
- Department of Medical Microbiology and Immunology, University of Nairobi, Nairobi, Kenya
| | - Richard A. Bowen
- Department of Biomedical Sciences, Colorado State University, Fort Collins, Colorado, United States of America
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Bukuluki P, Kisaakye P, Mulekya F, Mushomi J, Mayora C, Palattiyil G, Sidhva D, Nair H. Disruption in accessing sexual and reproductive health services among border populations during COVID-19 lockdown in Uganda. J Glob Health 2022; 12:04065. [PMID: 35972848 PMCID: PMC9380899 DOI: 10.7189/jogh.12.04065] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background The spread of COVID-19 exposed the inadequacies inherent in the health care systems of many countries. COVID-19 and the attendant demands for emergency treatment and management put a significant strain on countries' health care systems, including hitherto strong health systems. In Uganda, as the government strived to contain COVID-19, other essential health care services were either disrupted or completely crowded out. Balancing the provision of COVID-19 treatment and management services and at the same time offering sexual and reproductive health and rights services (SRHR) proved to be a considerable challenge in these circumstances. COVID-19 prevention-related travel restrictions and border closures had far-reaching negative consequences on the mobility of individuals to access essential health services in Uganda. The situation may have been worse for cross-border communities that sometimes access services across the borders. Methods Using quantitative data from 1521 respondents and qualitative data (20 key informant interviews and 12 focus group discussions), we investigate the disruption in accessing SRHR services for border communities in Uganda during COVID-19. Results Results indicate that females (adjusted odds ratio (aOR) = 1.3; 95% confidence interval CI = 1.08-1.79), those with primary education (aOR = 1.47; 95% CI = 1.61-2.57), currently employed (aOR = 2.03; 95% CI = 1.61-2.57) and those with the intention to leave current residence (aOR = 2.09; 95% CI = 1.23-3.55) were more likely to have experienced a disruption in accessing SRHR services. However, respondents aged 35 years, or more were less likely to have experienced a disruption compared to their younger counterparts. Conclusions Results shed light on the disruption of access toSRHR services during pandemics such as COVID-19 among a highly mobile population. There is a need to invest in building strong and resilient health care systems that can guarantee continuous access to essential health services including SRHR provisions among mobile populations during pandemics.
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Affiliation(s)
- Paul Bukuluki
- Department of Social Work and Social Administration, School of Social Sciences, Makerere University, Kampala, Uganda
| | - Peter Kisaakye
- Department of Population Studies, School of Statistics and Planning, Makerere University, Kampala, Uganda
| | - Francis Mulekya
- Department of Social Work and Social Administration, School of Social Sciences, Makerere University, Kampala, Uganda
| | - John Mushomi
- Department of Population Studies, School of Statistics and Planning, Makerere University, Kampala, Uganda
| | - Chrispus Mayora
- Department of Health Policy, Planning and Management, School of Public Health, Makerere University, Kampala, Uganda
| | - George Palattiyil
- Department of Social Work, School of Social and Political Science, The University of Edinburgh, Edinburgh, UK
| | - Dina Sidhva
- Department of Social Work, School of Education and Social Sciences, University of the West of Scotland, Paisley, UK
| | - Harish Nair
- Centre for Global Health, Usher Institute, The University of Edinburgh, Edinburgh, UK
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